Chicago Med (2015–…): Season 1, Episode 16 - Disorder - full transcript

And easy on the CrossFit
for a while, okay?

- Okay.
- Thank you.

Just cleared Treatment 3.
Just got to turn it over.

- Sure.
- Man, we're up again already?

- Looks like it.
- What's going on?

- Who are they?
- Big brother.

- Hey.
- Oh.

- Up.
- JCAHO.

Yeah, they're doing a
surprise site survey.

- Who's JCAHO?
- The Joint Commission.

They rate the performance standards



of hospitals and certify them.

So far, JCAHO's reports
have been positive.

So let's keep it that way.

Stick to protocols and with big smiles.

Dr. Choi, we're gonna need

some of your Navy-inspired
discipline today.

Sorry, I'm with the paramedics today.

- Resident ride along.
- Mm.

And discipline, that a nice
way of saying I'm a tight ass?

Oh, yes. Tight.

I didn't say that.

And, uh, getting those docs in line,

isn't that? the chief
resident's job anyway?

Wonderful, the guy enforcing the rules



is the one who's always breaking them.

Yeah.

Good luck with that.

Code One team to the ED.

- What do we got?
- Nathan Clay.

58-year-old male. "Peeds" versus auto.

GCS 12. Vitals stable.

Gross deformity to the left upper arm.

- Right in here.
- Ow.

He's complaining of
chest and back pains.

Mr. Clay, can you hear me?

Mr. Clay? On my count.

One, two, three.

Central line and a CVC catheter.

- Right away.
- Airway's intact.

- Breath sounds clear bilaterally.
- Ow!

Tenderness in the left chest

and thoracic spine. What happened here?

He's walking with his
wife on Michigan Avenue.

Suddenly flips out,
starts wailing on her.

A couple of Samaritans
jumped in to help out.

He takes off right into traffic.

Score one for, uh, karma.

12-lead EKGs, chest X-rays,

CT of the chest, abdomen, and pelvis,

with recons of the TLS spine.

- On it.
- Leave me... no.

Leave me alone. I'm fine.

Laura Clay. 55-year-old female.

- GCS 15.
- I'm fine.

I need to get to my husband.

Whoa, whoa, whoa. Ma'am, ma'am, ma'am.

- Okay.
- Heart rate's tachycardic.

This is all my fault.

Look, I blocked my fall with
my hand, not my C spine.

I'm neurologically intact.

Technical. Are you a doctor?

- Yes, yes, I am.
- Laura! Please...

- Dr. Rhodes!
- Honey, I'm here.

- Ma'am, stay right there.
- I'm right here.

There are too many of them!

- I'm here, my love!
- Help me!

2... I need restraints. 2
of Versed and 5 of Haldol.

- There are too many of th...
- No, not Haldol!

Quetiapine. He's not abusive.

He has Lewy Body Dementia.

Wait, scratch the
Haldol. 25 of quetiapine.

- Laura!
- It's all right, my love.

What the hell's Lewy Body?

Debilitating form of dementia.

Alzheimer's meets Parkinson's.

He took a pretty good whack.

He's got a chest bruise,
left first rib fracture,

proximal humerus fracture.

- How are his labs?
- It's all good.

Calcium was elevated.

I suspect he'll develop a
kidney stone down the road,

but it's likely he's had a few before.

Prior heart surgery?

Says it was a quadruple bypass.

Had it done at Northwestern
five years ago.

- He remembers the details?
- Yeah, he's lucid.

Somewhat. All right, EKG is normal,

but because of the prior heart surgery,

I'm gonna repeat it every few hours.

He's all yours.

Mr. Clay?

Mr. Clay, I'm Dr. Charles.
How are you feeling?

My wife, Laura, where is she?

She's being treated right
now, but will be in shortly.

I hurt her again, didn't I?

This isn't the life she deserves.

Mr. Clay?

Mr. Clay?

Damn, you got the
online thing down, huh?

- There was a time.
- Yeah, what's her name?

Easy. She's taken.

Vicki. Doctor at the VA.

Oh, man.

There are so many female paramedics

who are gonna be sorry to
hear you're off the market.

Couple guys, too.

Well, you let 'em down easy for me.

All right.

You sure you gonna be okay back here?

'Cause we can just throw
Desmond in the back.

Eh, I'm fine.

Ambo's like the Humvee.
You sit where there's room.

- Comfort's not a factor.
- Well, good.

This day's gonna go by quick then.

Ambo 61, 40-year-old
male down in his home.

222 Bromley Avenue.

Some kind of lower extremity insult.

He's in severe pain, possibly trapped.

Copy Main. Ambo 61 responding.

All right, we're on!

It doesn't make any sense.

I've had Boomer since he was a puppy.

He's super loyal. I leave
the room for a second,

he's looking for me.

I had a dog like that.

He might nip a little, but
this was a full-on attack.

In my experience, dogs
can be unpredictable.

Even really friendly ones.

Sometimes if a dog's
in pain, though, he...

He wasn't.

We were playing tug of
war, like we always do.

Dog bites shouldn't be stitched.

They need to stay open

so the wound doesn't become infected.

Also, I'm gonna give you a tetanus shot

and an antibiotic.

Boomer's healthy. He's
had all his shots.

It's just a precaution.

Paul's in trouble down there.

- Did you call 911?
- Yes, I'm his neighbor.

Paul?

It's the paramedics.

- Ooh.
- Ooh, that's ripe.

Man, look at this. He's a hoarder.

What do you think?

You good going in there?

- I'm good.
- Okay.

Uh, get the truck company here.

Tell 'em they're gonna
have to help dig us out,

and grab me a second radio.

And, uh, I'm gonna try and
go in through the back door.

You got it.

Paul!

Everything okay?

Okay.

Third squad caught a high-rise fire.

Dispatch is pulling a truck
from up north to help us out.

It'll be a while before they get here.

In the beginning, I wanted
to think it would pass.

Any wife would, but
I'm also a neurologist,

and I couldn't ignore his symptoms.

Oh, so you diagnosed
the Lewy Body Dementia?

Yes, but I got second
and third opinions,

and they both agreed it was LBD,

and that was about four years ago.

Four years, really?

You know, Nathan expressed
deep regret to me

about the pain that he's caused you.

That kind of insight is rare

for somebody who's been
battling LBD for that long.

Well, my husband was an engineer,

and his brain is wired
to solve problems.

Last year, I retired early.

I wanted to devote more time
to his cognitive therapy.

Hmm, well, it's been working.

There's moments when he's lucid.

But more and more, it's this.

Mrs. Clay,

Nathan's latest EKG is still normal.

I want to do another one in a few hours,

but if it is good too,
I'll discharge him.

- Thank you, doctor.
- Mm-hmm.

I know that it would be better
and safer for the both of us

if Nathan went to a care facility,

but if I do that, then it's over.

And I'm not ready to give up our Sundays

listening to opera.

I know it's hard to imagine,
but my Nathan is still in there.

Last week he made me
dinner, Florentine lasagna.

He can still cook?

Well, meals take longer to
prepare than they used to,

but...

he does it for me.

He's fighting just as hard as I am.

Hi, honey.

Everything's gonna be okay.

Everything's okay.

How you doing, Ethan?

Fine, as long as I
breathe through my mouth.

Is it as tight in
there as I think it is?

It's worse.

Are you claustrophobic?

Didn't used to be.

I mean, and Tate totally snores,

but I don't mind.

Oh, he does this thing where
he shoots his dirty boxers

into the hamper like a buzzer beater.

Anyway, it's cute.

Oh, my God.

You're in love.

Whoa, whoa, whoa, whoa. What's that?

What's what?

Used gloves go in the
bio bin, not the trash.

Okay, those were actually clean though.

- They were on the floor.
- Probably just got stuck

to the pair that came out before them.

Unless you're certain, it's bio.

Come on, Maggie. You know the protocol.

I do.

I've also been through this circus

about a dozen times.

JCAHO days are about patient care,

not about a pair of latex gloves.

Look, I'm already in the
doghouse with Goodwin.

If there's any chance of
getting out, I want it.

So by the book... by the book.

By the book.

Okay honey, eight across.

It's five letters

and the clue is rental agreement,

and the first letter is L.

I'm thinking the second is E.

L-E...

Lease.

Good. Good, honey.

All right, next one.

We're gonna do 23 down.

Six letters.

The clue is collects...

With an S.

- What happened?
- I don't know.

His blood pressure tanked.

All right, bag and hang a liter bolus.

- Yes, doctor.
- SATS are dropping.

- Intubate?
- Yep.

Grab the bag and hook it up to the O2.

All right, 20 of etomidate. 100 of sux.

Let's bring in the FAST scan.

- April, give me some pressure.
- Here, doctor.

And I'm in.

- Got it.
- Okay.

- Scan.
- Here you go.

Heart rate 110.

All right, belly's clean.

Poor wall motion of the
LV and a small effusion.

He's bleeding internally?

Dr. Charles.

Mrs. Clay, please, right over here.

SATS are back up.

Oxygenation improving.

It's not gonna matter if he
goes into cardiac arrest.

CT of the heart and great vessels.

Let's get him ready to go.

Laura?

If we may?

The blunt trauma from the car accident

displaced one of Nathan's bypass grafts.

His aorta is leaking blood.

- A pseudo-aneurysm.
- Mm-hmm.

How bad?

Right now it's just a slow drip.

It hasn't ruptured yet.

So there's still an opportunity

to operate, repair the suture line,

and plug the hole?

Normally, yes.

Your husband's prior
heart bypass surgery

significantly increases the
difficulty of the operation.

His odds of surviving
the procedure plummet.

So if surgery isn't a
viable option, what is?

Given the circumstances,

we feel the safest choice

is to make Nathan comfortable.

How long?

We can't be certain.

A day, a week,

maybe a few months

until the aneurysm ruptures.

We're very sorry.

Help. I can't move.

I'm coming, Paul.

Don't touch that!

What was that?

Ah!

Ethan, what happened?

Got bit by the lid of a tin can.

Truck company is almost here.

They're going to clear a path
to get the stretcher through.

Please, hurry!

Hold on, Paul!

Oh, thank God.

I haven't been able to
pee in over 16 hours.

I thought I was gonna explode.

Brachytherapy for prostate cancer?

Two days ago.

My urologist said it was the way to go.

Who's your urologist?

I'll call and tell them
you've experienced a blockage.

Dr. Mason, over at Advocate South.

Uh, contact info's, uh, in my phone

in my pants pocket.

Oh, sorry.

Oh, whoa, whoa, whoa, whoa, whoa, whoa.

Everything okay?

Just a little spill. I got it.

Okay, hold on.

I'll call environmental services
and have them send a janitor.

It's just pee.

I've cleaned it a thousand times.

Yeah, but not with JCAHO
and Robocop Halstead

on the prowl.

By the book, remember?

Oh, man.

I think the seed came out.
It's radioactive, right?

Oh, it did.

Okay, I'll call Urology instead.

Cath lab for a cardio angiogram?

Should give a better view
of Nathan's pseudo-aneurysm

and hopefully help me estimate
a timeline for his wife.

You mind grabbing me an MRI of his head

while you're up there?

Brain scan?

His injuries don't necessitate it.

It's not for him. It's for me.

Uh, Dr. Charles.

Dr. Rhodes, his awareness
and gross motor skills

are just too strong

for somebody who's been
battling LBD as long as he has.

No amount of cognitive therapy
in the world is gonna outthink

this disease to the degree
that he appears to be.

Laura and two other neurologists

have all agreed on the
Lewy Body diagnosis.

- You think they're wrong?
- I don't know what to think.

That's why I need the scan.

I need the wife's consent.

Hasn't she been through enough?

I'm just trying to spare
her some false hope here.

- Um.
- Hello.

- Gentlemen.
- Doctors.

JCAHO day isn't exactly the time

to be sneaking in unauthorized tests.

I don't know what to tell you.

- Okay.
- Thanks, pal.

Mm.

What've we got?

Hey, guys, start clearing out!

Don't touch that.

Get away.

- Get away.
- There's a second person.

I'm hearing another victim.

Ethan, the neighbors seem
sure it's only Paul in there.

Don't touch that!

There's someone else here.

Dr. Perrington,

got a hemoptysis patient.

Chest X-ray says it's a COPD,
but I think he needs a bronch.

You want to take a quick look?

Really?

The esteemed Dr. Halstead
needs my help with a patient.

I'm honored.

Look, I, uh... I'm sorry about
what happened the other day.

You want a consult, page my resident.

Okay, no redness, no inflammation.

Looks good.

So I can go?

The nurses are working on your
discharge paperwork right now.

Your wound should heal in
about seven days or so.

Until then, irrigate them
and keep them covered.

You all right? Oh, just itchy

and a little sweaty.

Mind if I take a look?

No rash.

Could be an allergic
reaction to the antibiotics.

- You do feel warm though.
- I'll get a temp.

Oh, my sister checking in.

I left Boomer with her.

She's not a dog person either.

I get the impression
they're not for you.

I've treated a lot of dog wounds,

especially on kids.

It's 99.4. Was normal at intake.

- CBC and CMP?
- Yeah.

- I'm not out of here, am I?
- Sorry.

Itching and fever, even a low one,

could be more than an allergic reaction.

Someone will be with you shortly.

Paul, is there anyone else in the house?

No, no, it's just me.

You've got to hurry!

Ah! Ah!

Ethan, what happened?

Are you okay?

Ahh!

- What's all this?
- Well, it's pretty clear

an attending job at
Med isn't gonna happen.

You don't know that.

Just being realistic.

Perrington's on the hiring committee.

She hates me.

Not to mention Goodwin.

But really, Miami, Will?

I've seen you sunburn walking
from the ED to your car.

Hey, got to go where the jobs are.

No coffee. JCAHO day.

Right.

I don't understand.

There should be atrophy,
heavy degeneration,

tangled cells in the white matter.

When was this taken?

About an hour ago.

I'm sorry. I had a hunch.

I rushed it. I really should have...

That is a healthy brain.

There's no disease. This means that...

Nathan doesn't have Lewy Body Dementia.

He has the symptoms.

Keeps getting worse.
Practically a textbook case.

How?

Take a look at this cross
section we took during the MRI.

Notice the adenoma,

benign tumor, in the parathyroid gland.

So you think this is all
hormonal irregularity?

Elevated parathyroid hormone

is consistent with increased calcium

and cognitive impairment.
Nathan has both.

Yes, but he also has hallucinations,

physical aggression. You don't see that

in patients with hyperparathyroidism.

That's where his recent bypass
surgery makes him unique, okay?

The beta blocker he's
been taking ever since

causes increased levels
of violent behavior

in a select amount of patients.

Oh, my God.

A hormonal imbalance

with a medication side effect.

Why didn't I see that?

The clues were right in front of me.

Because they mimic the symptoms

of Lewy Body Dementia to a T,

and four years ago that adenoma
would have been so small

no scan could have caught it.

Look, I'm just telling you

that presented with the same evidence,

I would have done
exactly the same thing,

reached exactly the same diagnosis.

Anybody would have.

You didn't.

I did.

And if I had caught
the PTH four years ago,

Nathan doesn't run into traffic,

doesn't get hit by a car.

Today never happens.

He's dying

and it's entirely my fault.

Don't touch that!

Help. Please, please anybody!

I need help!

Ethan.

Ethan, talk to me.

Ethan, do you copy?

Let's go.

Living room's clear.

- Thank God.
- Paul?

- Help me, please.
- Paul, I'm Dr. Choi.

Okay, your heart's racing.
When's the last time

you had any fluids?

My leg, burned it. Yeah.

- I see that.
- Don't touch that.

- How did this happen?
- I was cooking.

I tripped and spilled
a frying pan, grease.

This didn't just happen.

This burn is thick, leathery.

- 24 hours old?
- I guess.

Why didn't you seek help sooner?

I didn't want anybody to see how I live.

Okay, I'm here now.

Gonna take care of you.

Brachytherapy seed.

Yep, doesn't happen often,

but it can get expelled in the urine.

So, um, how radioactive is it?

To us, harmless.

Still, don't touch it
with your bare hands.

Whoa.

So you're not gonna dispose of it?

Not on JCAHO day.

Sorry.

Call the radiation safety officer.

Oh, man.

Here we go.

I get it.

You didn't do Nathan's bypass surgery.

You don't know what you're walking into.

I can get you every angio he had.

You will know exactly where the
surgeon placed every suture.

The bigger issues are the adhesions

and scar tissue that have
formed over the last five years.

We can expose a healthy
heart in 10 or 15 minutes.

After a quadruple bypass surgery,

it could take hours.

An infinite number of
complications can arise.

When I decided to make
Nathan comfortable,

I believed he had a
neurological death sentence.

Now it's a whole new world.

The dementia can be reversed.

I understand, but the fact
that he doesn't have LBD

doesn't make the surgery any easier.

Nathan's odds of dying
in that operating room

are just as high as they ever were.

It's still my recommendation
to not operate.

I'm sorry.

I'll do the surgery.

Thank you.

Thank you for giving us a second chance.

Difficult is not impossible.

Hmm.

- Brett, how close are you?
- Ugh, Ethan, finally.

- You okay?
- I'm fine, but Paul's got

a serious third degree burn
that needs to be released

in the ED. ETA?

I think we're almost to the kitchen.

We need more room for the gear.

Don't touch that! Get away, get away.

Who was that?

The other person I heard, a parrot.

Look, you still have
the hallway to deal with

and Paul's foot's still swelling.

No pulse in the instep or ankle.

All right, uh, we're
coming as fast as we can.

But not fast enough?

Okay, Paul, here's the deal.

Your skin's so burned,
blood can't get in

or out of your foot. I'm
gonna cut into your leg

on both sides of the burn
to release the pressure.

Here?

I wait any longer, you're
gonna lose your foot.

But... is it gonna hurt?

Already pushed morphine in your IV.

That'll help.

But I'll feel it?

Focus on me, not my hands.

It'll be over before you know it.

Okay?

Deep breath.

Then exhale.

Keep breathing, Paul. Keep breathing.

Big breath.

Bigger exhale.

Done.

Good job, Paul.

Good job.

A high white cell count,
what does that mean?

You probably have an infection.

- From Boomer?
- It's possible.

Have you felt sick recently?

No, not really.

I mean, every now and then
my throat aches a little.

It doesn't really bother me though.

Hmm.

Hmm, the lymph nodes are swollen,

consistent with an upper
respiratory infection.

Let's get a rapid strep test.

What kind of dog is Boomer?

Boxer bulldog mix.

A rescue.

When I went to the shelter,
all the dogs swarmed me,

but Boomer hung back.

Not because he was shy.

It was a move so he'd stand out.

He was playing me.

Smart dog.

I'm gonna swab the back of your throat.

I'll get this to the lab.

I'm doing what I think is right.

Nathan's mental impairment
is due to a pea-sized tumor

that is easily removable.

A 45-minute operation will cure him.

But first, he has to survive

this monumentally difficult surgery.

I'm sorry, you can't bring
your dog into the hospital.

It's my sister's dog.

She's somewhere in the back
not answering her texts.

Only service dogs in the ED.

I'm sorry.

- Oh, is this Boomer?
- How'd you know?

I've been taking care of Tara.

She said he was a boxer bulldog mix.

I thought it was only
gonna be one or two hours.

It's been five. Is she okay?

She spiked a low fever.

- We're testing for strep.
- Strep?

That's nothing. Okay, good.

Look, I have to go to work.

There's no pets allowed in my building.

He barks one time and I can get evicted.

I'm sorry, there's
nowhere else to take him.

Um, no, no, no. I can't take this...

I know.

It all happened really fast.

What do I do?

Get him out of here. Now.

- But where do I take...
- Reese, I don't care where.

Just out.

Hey, look at this guy.

Yeah, Earl, this is Boomer.

Could you watch him for a minute?

But don't get too close because...

Oh, come on, fella.

Come on, guy. Let's go.

Come on, big boy.

Hey. Okay.

Okay.

When I'm out,

the city will condemn my home,

won't they?

Fresh start, I guess.

Get away. Don't touch that.

Don't touch that.

There they are. Ethan.

Hey, guys.

Hey, you okay?

For a second there, it sounded like...

Little hairy for a while, that's all.

Escharotomy in the field.

Damn, nice job.

One across. Six letters.

Bread, milk, eggs.

Thoughts?

Staple.

Nice.

Thank you.

Sure.

All right, guys.

- Got it, clear.
- Lift him up.

Don't touch that.

Dr. Manning,

uh, Tara's rapid strep
came back negative.

Okay, so we're back at square one.

You know what, let's run a, uh...

Easy! Easy.

I'm sorry. I am so sorry.

- Hey, Earl, what's going on?
- I don't know what happened.

Twenty people petted this dog,

and this patient is the
only one he barked at.

Come on, boy. Come on.

Come on, Boomer. Come
on, come on, Boomer.

Let's run an infused CT
chest and abdomen on Tara.

Oh, I've heard stories.

- Mm-hmm.
- Yeah.

Easy.

Snakes in the grass.

Bypass grafts are buried
in the scar tissue,

tough to see.

Soften your grip...

an... and go slow.

- I see it.
- Mm-hmm.

Proximal pseudo-aneurysm
of the LAD bypass graft.

Let's cannulate and get him on the pump

so we can do the repair.

No, I don't need the pump.

It just needs a single repair stitch.

I can do it on the beating heart.

- 8-0 suture.
- Suture.

EKG's ischemic. STs elevation.

Pseudo-aneurysm's ruptured.

He's bleeding. 8-0 suture to me.

- I've got the better angle.
- Dr. Rhodes.

I pushed for the surgery.
I can't lose him.

I'll get you better exposure.

There.

Going to put a second stitch in now.

Don't back-wall the graft.

Bleeding has stopped
and EKG's improving.

Pressure's good.

We're out of the woods.

Not yet.

I want to check his other bypass grafts.

Something goes wrong in the future,

no surgeon's gonna open
his chest a third time.

Lymphoma.

I have cancer?

The next step is a biopsy to
determine exactly which kind.

But I'm only 26.

I go to the gym every day.

I don't smoke.

I know.

It's not fair.

But I don't feel sick.

Well, that's because
it was caught early.

You have time to get way ahead of this.

Mm-hmm.

The lymph nodes are
around here, aren't they?

Boomer's been nipping at me for a month.

Always right there.

Do you think he knew?

Maybe.

It seems some dogs can smell cancers,

even in the very early stages.

Yeah, he wasn't attacking you.

He was trying to protect you.

Maggie, what's going
on with Treatment 4?

- We don't have the space for this...
- I know, I know. It's been all day.

Dr. Halstead, environmental
services hasn't shown up yet.

I can't even get an estimate
as to when they will.

I'll go see them in person.

I'll drag someone down
here if I have to.

Knock some heads.

I need that room back.

How's he doing?

Well.

Good.

How are you doing?

As a neurologist,

Lewy Body Dementia was
my worst nightmare.

I'd seen so many cases,

and I'm wondering

if it influenced my diagnosis.

Hmm.

Medicine, you know.

Imperfect science.

Practiced by human beings, no less.

Four years we could have been doing CTs,

but I had an answer,
so there was no reason

to continue radiating his brain.

I robbed Nathan

of his mind.

I imprisoned him.

I drained our savings.

Squandered our time together,

time that we can never get back.

How am I gonna tell him what I've done?

He's never gonna forgive me.

Your husband's gonna forgive you, Laura.

I want you to trust me on that.

Your struggle,

if I may,

is figuring out

how you're gonna forgive yourself.

Vitals are stable.

EKG looks good.

Cleveland Clinic has an axiom.

Emergency surgery on a healthy heart?

Yes.

Redo surgery for a repaired heart?

Yes.

Emergency surgery for a repaired heart?

No,

because overwhelmingly,

those patients die on the table.

I couldn't do nothing.

I suspect it was ego more than altruism.

Great surgeons

know the balance.

You're confident,

not arrogant.

I like that, Dr. Rhodes.

Nice job today.

You're good. You're good.

Good boy.

Good boy.

Don't come from above.

Come from the front so he can see you,

and hold out the back
of your hand first.

- Okay.
- Come on, buddy.

- Yeah?
- Yeah.

Hey, there.

Did you ever hear that
origin story about dogs?

In Eden, humans and animals got along,

even spoke the same language,

but when Adam and Eve sinned
and God drove them out,

a great chasm opened up
between people and animals.

And as the chasm grew wider,
at the very last moment,

a dog leaped across it to be with us.

That's a great story.

Yeah.

Come in.

Ms. Goodwin, can I talk
to you for a moment?

Quickly, I'm on the
homestretch with JCAHO,

and I don't want to let up now.

I know my voice isn't official,

but I'd like to put in a good word

for Will regarding the
open ED attending position.

Really?

It'd be a shame to lose him.

He's a great doctor.

He cares about this hospital.

Just a few weeks ago you asked
to be taken off his shifts.

We don't always see eye to eye,

but his heart is in the right place.

Well, Dr. Manning,

I'm glad your opinion of
Dr. Halstead has changed.

Okay.

Dr. Halstead, environmental services

are on their way?

Nope.

Turns out, every department
in the hospital's calling ES

to handle things they normally
take care of themselves.

Be tomorrow before a janitor shows up.

Ah, bureaucracy.

Whew.

Mm.

There. The room is yours again.

Against protocol?

I won't tell if you won't.

Huh, guess that means I
get to clean this up now

the way I wanted to eight hours ago.

- You know, toss me a pair.
- Oh?

You know, the kind
that, uh, stick to yours

when you pull 'em out.

- You want in?
- Heck yeah.

We've come this far.

And they call you Robocop.

Robocop?

Katrina.

Reese, come with me.

Uh-oh.

Yeah, I've seen that look.

Dr. Rhodes.

Everyone.

Look, we all know how important
JCAHO site visits are.

Yet, despite what I
said about the rules,

my team ordered tests on the sly,

brought a dog into the ED,

and handled radioactive material.

Sharon, you have every
right to be upset.

Really. But we can't really be ignoring

the, uh, the second law
of thermodynamics here.

Now, can we?

How's that?

Well, systems do tend to degenerate

into ever more disordered
versions of themselves, right?

I mean, look around you.

All we're doing here, all day long,

is battle the universe's
desire to fall apart.

Yeah, should've seen the
house I was in today.

I'm just saying, I love rules.

We all do, but in bringing
order to disorder,

every now and then a
couple gonna get bent.

Nice try, Daniel.

But the good news is JCAHO

didn't catch any of you,

so we keep our top rating.

I'll see you all tomorrow.

Second law of thermodynamics.

Please.