Chicago Med (2015–…): Season 1, Episode 18 - Timing - full transcript

Dr. Rhodes treats Dr. Downey while Dr. Halstead receives clarity from Goodwin.

Is your mom flying in for tonight?

No, she's got an early day tomorrow.

Doesn't want to red-eye
back. She sent me a check.

Well, then after the ceremony,

let's you and I go out and celebrate.

Depends on how late it is.

Reese, it's your graduation.

You've earned it.

Okay.

Okay, well, I'll be the
guy clapping the loudest.

Please don't.



I'll see you later.

- Morning.
- Hey.

Oh, no, don't tell me you lost it again.

- What?
- Your wedding ring.

Oh, uh... no.

I decided it was time to take it off.

Can't get used to it
not being there, though.

- Dr. Manning?
- [baby crying]

Six-month-old boy, Michael Thomas.

Suffering from diarrhea, vomiting.

You're going to Treatment Six.

Hi, I'm Dr. Manning.

Something's really wrong with him.

Hey, don't worry. We're
gonna take good care



- of your baby.
- Okay.

Page Dr. Rhodes. Dr.
Halstead, you're with me.

It's Dr. Downey.

[dramatic music]

♪ ♪

- Talk to me.
- BP's 90 over 60.

Rate of 110. Respiration's at 38.

Okay, we're going to
Trauma Three, Baghdad.

He was found at home.

He dialed 911 himself, but he was down

by the time we got there.

Dr. Downey, can you hear me?

- [groans]
- Are you in pain?

Get ready to rotate.

No breath sounds on the
right. Need an X-ray.

♪ ♪

Sharon, we need you in Baghdad.

On my count.

One... two... three.

- Transfer.
- [all grunt]

Get it out.

[medical chatter]

X-ray clear.

[machine whirring]

There's fluid in his chest.

He just had an RFA yesterday.

His liver must be bleeding into it.

- Yeah.
- Yeah?

All right, hemopneumothorax
on the right.

All right, we're gonna put in a
chest tube to drain the blood.

2 of Versed. 5 of morphine.

Right away.

Sorry about the shirt.

Pulse is thready.

All right, get a groin
line in, will you?

Yep.

Dr. Halstead.

♪ ♪

- Okay, I'm in.
- How's he doing?

His liver is bleeding into his chest.

I need to open him up to stop it.

How close are we?

All right, I'm in.

Activate the MTP. Tell 'em to send

all the blood they have
and meet me in the O.R.

Copy.

♪ ♪

You gotta stop the bleeding.
I'm barely keeping up.

- Dr. Rhodes?
- Can't get to the diaphragm.

The right lung is in the
way. Can you collapse it?

- Give me some room?
- Yeah.

[tense music]

Set up the Argon Plasma Coagulator.

Putting in a bronchial
blocker right now.

♪ ♪

- [sighs]
- Allen.

It's coming. In a sec.

Lung deflating.

Good.

♪ ♪

Okay, I see the bleed.

All set with DRB?

♪ ♪

Bleeding's slowing.
It's still pretty oozy.

How much product has he gotten?

Six platelets, one cryo.

We're gonna have to
warm him up in the ICU

and continue transfusions.
Make sure he can form clots.

Want me to close?

No. My teacher.

I'll close.

♪ ♪

So, insomnia, obsessive pacing,

aggression?

Some of that.

And this is a parrot?

Right.

What else you know about the bird?

He was kept by a hoarder.
Basically lived in a trash heap.

Abused?

Certainly neglected.

Yelled at a lot.

Look, I don't know what to
do. I tried to give him away,

but nobody'll take him.

How's he feel about you?

How should I know? He's a bird.

Will you do me a favor,
and before you try

and give him away again,
can I come by and meet him?

You wanna meet the parrot?

Very much so.

How about lunch today?
I'll bring sandwiches.

Okay.

What's wrong with our baby?

He's probably just weak, right?

From the diarrhea?

We've given him fluids,
so he's not dehydrated.

Was he born prematurely?

No.

His liver's enlarged.

Oh, my God.

Was he exposed to any
toxins in the house?

No, we're careful about that.

Anything else you can think of?

Only... he... he just
started sitting up,

but he hasn't been able to
do that the last couple days.

Okay.

Let's order a CBC, CMP,
UA, and blood cultures,

and let's start a 10cc bolus
of albumin and page Dr. Grant.

What is all that?

We just need to run some further tests,

and I'm bringing in a
specialist to consult.

Okay?

We're gonna find out
what's going on with you.

[solemn music]

Be back shortly.

♪ ♪

You could have just dropped me off.

My mama told me, "Escort
a lady to the door."

[laughs]

- Well, here I am.
- Mm-hmm.

- Safe and sound.
- Yes.

Both: Muah.

See you tonight.

[mouthing words]

- Hey, Maggie?
- Yeah?

Any word on Dr. Downey?

He's out of surgery and stable.

Oh, good. Good.

How's the renovation
going? Bert's "man cave."

You know, I thought
it would cheer him up,

but he's not showing
any interest at all.

I feel like I'm being punished
for not retiring with him.

Rough at home, huh?

That's an understatement.

- Morning, Ms. Goodman.
- Dr. Halstead.

That woman...

does not like me.

You haven't exactly made her life easy.

How's the job search going?

Hey, got an offer yesterday
from Mount Sinai, Miami.

Oh.

Plus Memorial West in California.

So, either way, looks
like sunshine for me.

What about Med?

Lost cause.

Should have heard by now.

Oh, well.

Hey, you know, Dr. Manning...

What?

She's not wearing her
wedding ring anymore.

Why would you tell me that?

Timing, Dr. Halstead.

That's what it's all about.

His fault. Shouldn't have been

- wearing that shirt.
- Oh, lovely.

Oh, that seems like a pleasant one.

Take them to Treatment Three, please.

Oh, thank you.

April, you busy?

- I'm with you.
- [exhales]

All right, fellas, I'm Dr. Halstead.

- Follow me.
- Don't need this.

- Just let 'em take a look.
- I'm fine.

All right, come on. Let's
get you on this bed.

No, no, just... Just wanna go home.

- Ah.
- Okay, what happened?

Went out to party after the game,

he sees these Cards fans...

Douchebag's wearing a "Cubs suck" shirt.

Yet, we won. How could
we suck, douchebag?

- Sir, please stay on the bed.
- Down... sit down.

Dan got the worst of it.
Got kicked in the ribs.

- Stay on the bed.
- Let me go!

- [grunts and gasps]
- Security!

- You, hold him!
- Dan, what're you doing?

- [gasping and coughing]
- You all right, April?

You okay? Yeah, I'm okay.

Get this guy in restraints. 5 of Haldol.

- I'm okay.
- No! No!

- I'm okay.
- You good... okay.

- Oh, God.
- You okay?

- I'm fine.
- All right, let's go over here.

Cardiomegaly.

What?

Michael's heart is enlarged.

What would cause that?

Given everything else,

I'd say we're looking
at a genetic disease.

How can that be? We're both fine.

You could each be carrying one
faulty recessive gene which,

when paired together,
can express in Michael.

Dr. Manning, BP and sats are dropping.

[machine beeping]

He's not breathing.

- Oh, my God.
- Tube him now.

10 mics dopamine per
kilo and 15 of fentanyl.

Right away.

[dramatic music]

♪ ♪

I'm in.

♪ ♪

Sats are coming up.

All right, let's get him up to the PICU.

Okay, I'll go with him.

Where is he going? What's happening?

He's stable. We're taking him up

to pediatric intensive care.

- You can come with.
- And then what?

There are many genetic diseases

that could be causing this. We
need to determine which one.

Chicago Med can do fast
genetic sequencing.

We'll need blood samples from
the three of you to analyze.

Hopefully we'll have a
diagnosis in 26 hours.

But what if he keeps getting worse?

We're gonna do everything that we can.

Okay? Go ahead.

♪ ♪

Didn't mean to hit her. I'm sorry.

I'm sorry.

Really, I'm fine.

Your lungs are clear.

So can I go back to work?

Just hold on.

- Does this hurt?
- No.

You finished?

- Here?
- Ow.

Okay.

On a scale of one to
ten, how bad's the pain?

Three.

That means it's a seven or eight.

Hey, you're probably
okay, but I'd like to get

- a chest X-ray just to be safe.
- No way.

April, you have some
pain and tenderness.

A broken rib could have punctured

your liver or your lung.

I want to make sure you
don't have pneumothorax.

- I'm not short of breath.
- We don't want to see you

wheeled back in here on a gurney.

Ms. Goodwin, I appreciate that,

but you are all overreacting.

I'm telling you, I'm fine.

He's been off the
lorazepam for two hours,

and he still hasn't woken up,

and he's still completely
reliant on the vent.

[sighs] So you needed me to tell you

he should have come to by now?

No, I needed you to
tell me why he hasn't.

Could it just be that his
poor liver function is

preventing him from
metabolizing the lorazepam?

Dr. Rhodes, you called a
neurosurgeon in to consult.

Obviously, you suspect something else.

I'm afraid he might have
stroked on the table.

And you were hoping
I'd tell you otherwise.

I can't. His pupils are sluggish.

We need a head CT.

You should have already ordered one.

[solemn music]

Call me when he's done in radiology.

♪ ♪

[machines beeping]

100 mics of epi.

Got it.

[dramatic music]

♪ ♪

What happened?

Heart slowed to 40.

IV's blown.

We need to give the
epi through the tube.

♪ ♪

Holding compressions.

♪ ♪

[baby coos]

Heartbeat's normal.

[exhales]

[solemn music]

♪ ♪

I know.

Let's just hope this little guy makes it

until we get those results back.

♪ ♪

He won't fly. Just does this all day.

Paces.

What else he do?

I know this sounds crazy, but
I think he gets nightmares.

He'll suddenly cry out in his sleep.

It's not crazy.

It's actually consistent.

- To what?
- Don't touch that.

PTSD.

Post Traumatic Stress?

Come on. A parrot?

Parrots are highly intelligent,

and very socially attuned.

There is, in fact,

a program at the VA in San Francisco

that matches vets with PTSD
with similarly afflicted birds.

So he can help me?

Possible.

Don't touch that.

What do I do?

Eh, take care of him.

Talk to him. Hang out with him.

For starters, teach him
something else to say.

[laughs]

Don't touch that.

We've extracted DNA from
the baby and both parents,

and the DNA samples have been prepared,

so that we can load
it into the sequencer,

which will give us the
genetic code of each.

Once we have that,

we can target specific
parts of the baby's genome,

based on the baby's symptoms,
and give a gene-based diagnosis.

Mm-hmm.

[exhales]

Reese.

- Hmm?
- I mean, that's pretty amazing,

don't you think?

Yeah.

Oh, you're thinking
about your graduation?

No, uh...

I'm thinking about the baby.

He's so...

little and helpless and in so much pain.

I know that you've had second thoughts,

but it's actually a good thing

you stuck with pathology.

- It is?
- Yes.

You don't want to get so
involved with patients.

What if...

that poor little baby doesn't make it?

You're gonna feel terrible.

[solemn music]

Yeah, I am.

I would too.

That's why I like it down here.

I'm... I'm not good with suffering.

It's just...

too much up there.

♪ ♪

- Dr. Halstead.
- Mm-hmm?

For you.

[chuckles]

From the hiring committee.

Didn't even have the balls
to tell me in person.

"Dr. Halstead, we are
pleased to offer you

"a full-time position
as attending physician

in emergency medicine
at Gaffney Chicago Med."

Hey...

congrats.

Well, well, well. "Lost cause," huh?

I can't believe it.

I must have some, uh, mystery friend

on the committee. Overruled Goodwin.

You dope.

Nobody overrules Goodwin.

You wouldn't have gotten
that without her say-so.

Congrats.

[chuckles] [sighs]

[dark music]

♪ ♪

What do you see?

You want the good news or the bad?

Let me have it all, Sam.

David didn't have a stroke.

He's gonna wake up,
but the problem is here

in his temporal lobe.

It's a mass.

The cancer spread to his brain.

Metastic hepastatic carcinoma.

It's very bad news.

♪ ♪

Is it operable?

- No.
- Hold on just a second.

The core of the mass is
centered over area 5,

the superior parietal gyrus.

- Meaning?
- If I resect,

he'll have asteriognosis.

You won't recognize objects by touch.

You won't know the meaning of sensations

or be able to coordinate

between your visual and tactile systems,

and that would be a good outcome.

You can't be sure that's
gonna be the case.

Without the surgery,

what can I look forward to?

Well, headache...

Already got that.

Loss of motor skills, bodily functions,

uh, neuropathic pain,

seizures, delusions...

A smorgasbord.

Look, I'll give surgery a shot.

It's your call, David.
You know my reservations.

All due respect, Dr. Abrams is not

the only neurosurgeon in this hospital.

No,

but he's the best.

[tense music]

No surgery.

Dr. Downey, we should at
least get a second opinion.

I'm satisfied with
Dr. Abrams' prognosis.

♪ ♪

Thank you, Sam.

David.

By the way, Sam...

♪ ♪

I've always appreciated
your bedside manner.

♪ ♪

Come back later.

♪ ♪

I may feel like some company.

♪ ♪

Ms. Goodwin.

I want to thank you.

I'm going to accept Med's offer.

My fear is, is you're gonna find a way

to get yourself kicked off the staff.

I'm curious to see how long it'll take.

- I'm headed home, Mag.
- Any plans?

I'm just gonna make a big meal.

Bert always loves my cooking.

That should put him in a better mood.

Let's hope.

- Hey.
- Hey.

I checked on the baby. He's stable.

Oh, I'm gonna go up and see him.

You're graduating tonight, right?

- Mm-hmm.
- Well, why don't you just

take off? We won't know anything

until the morning.

I won't stay long.

Bye.

- Night.
- Night.

- Hey.
- Hey.

Remember when you were a
kid and you lost a tooth

and you kept running
your tongue over the gap?

Without my wedding ring,
it's like the same thing.

Something's missing.

Well, I don't know if
it's any consolation,

but what do they say?

"One door closes and another one opens."

I don't know about that,

but thanks.

- Night.
- Night.

- Natalie.
- Yeah.

Hey, did you hear?

I got an offer from Med.

That's great.

You're gonna take it, right?

- Of course, yeah.
- Good.

And I promise, from now on,
I'll never argue with you.

You will be an attending,

so you won't have to argue with me.

You can just boss me around.

- That's a good point.
- Yeah.

No, uh, I'll never do that either.

Well, congratulations.

Thank you.

- Good night.
- Night.

[gentle music playing]

Between the incision and my head,

I'm not sure which hurts worse.

Well, those fentanyl boluses
aren't doing much for you.

I'll order a morphine PCA.

[quietly] No...

I hate morphine.

Makes me loopy.

Turn that up a little, will you?

♪ ♪

- How's that?
- Yeah.

♪ ♪

[exhales]

[chuckles softly]

I'd hoped to make it to
the islands one more time.

[stammers]

Flying's such a hassle

these days.

As soon as we can, we'll
get you out of the ICU

and into a room...

one with a view.

[chuckles softly]

♪ ♪

Hey, easy there.

[breathing deeply]

♪ ♪

Dr. Rhodes...

♪ ♪

You know what I'm facing.

I do.

♪ ♪

I'd just as soon skip it.

If you know what I mean.

♪ ♪

Check out a little early.

I'd need some help though.

♪ ♪

You know I can't do that.

♪ ♪

Yeah, yeah.

♪ ♪

Well... [exhales]

♪ ♪

I guess we're all

given our measure of suffering.

♪ ♪

God's medicine.

[solemn music]

♪ ♪

Parrot's are supposed to fly.

Don't you know that?

Here.

Maybe this'll help.

Come on.

Like this. Flap your wings, come on.

Flap your wings.

Come on, fly.

Come on, like this.

Watch me.

Can you fly?

Like this.

Come on.

Flap your wings. Fly.

Come on, you can fly.

Fly. Fly.

Fly!

[sighs]

We're not making much progress here.

- Mm.
- [both laughing softly]

Okay, good night, son.

Ah. [chuckles]

Sweet dreams.

[clears throat]

And what you need to do

is tell me who this
guy is that popped you

so I can have a little,
uh, talk with him.

[chuckles] No, I do not want to see him

back in the E.D. Thank you.

- Mm-hmm.
- [both chuckle]

Mm.

- Thank you.
- You're welcome.

Anyway...

it's not that bad.

I've taken worse shots.

So you been hit like this before?

Lots of times.

Nursing is a dangerous profession.

Maybe you should leave it.

What, quit my job?

- Yeah.
- And do what?

Marry me.

[laughs] What?

I want you to marry me, April.

[stirring music]

♪ ♪

Reese?

What?

You missed your graduation.

I fell asleep.

I was afraid to leave the baby.

I texted you. I-I called.

What?

Dead.

Did we get the results?

[tense music]

I need to call Dr. Manning.

♪ ♪

"Have a nice day."

Can't you say that?

"Have a nice day."

Okay. I'll be back tonight.

Be back tonight.

Be back tonight.

Say that again?

Be back tonight.

Be back.

Yeah, I will.

Be back.

[chuckles]

♪ ♪

Really sorry to hear about David.

♪ ♪

Can imagine that's gotta
be very difficult for you.

He's given me so much.

How do I ever pay that back?

How do you know you haven't already?

♪ ♪

Yeah.

♪ ♪

Get out. What did you say?

I said I had to think about it.

You better.

He give you a ring?

No, it was a spur of the moment thing.

Hmm.

You even love him?

Yeah, I love him.

It seems you have a
big decision to make.

- Hey, Maggie?
- Hey.

- You seen Goodwin?
- No.

She missed the budget meeting.

It's not like her.

No, it isn't.

Michael has a condition called

Long-Chain Acyl CoA
Dehydrogenase Deficiency,

or LCADD.

I know it's a lot of words,

but what it basically boils
down to is he can't process fat.

So...

When, uh, the body can't
use fat for energy,

it relies on glucose,

but there's only a
limited amount available.

Michael suffered a severe
drop in blood sugar.

Blood sugar?

That's what caused him to stop breathing

and-and his heart?

It doesn't have to happen again.

It can be managed.

How?

We're giving him intravenous dextros...

Getting his blood sugar up.
That will keep him stable.

So he's gonna be okay?

Michael will always have the condition,

but by altering his
diet, we can control it.

He'll be able to live a
long and healthy life.

[both sigh]

Oh, thank you. Thank you.

[chuckles]

[solemn music]

♪ ♪

[exhales]

You're in pain.

- It's no big deal.
- Enough.

April, you're getting that X-ray.

Really, I do not...

No, go to radiology now.

I'm putting in the order.

Okay.

Bert, is that you?

No, it's me, Maggie.

- Maggie.
- Sharon, I've been calling you.

What happened?

Bert...

Is he all right?

What is it?

He left.

Oh...

He said, uh, "I don't know
how much time I have left",

but I want to spend it happy."

No, he didn't.

♪ ♪

[exhales]

I don't make him happy.

He's just being a fool, Sharon.

He's gonna be coming
right back. You'll see.

No, Maggie.

[sniffles] He's gone.

He's gone.

Oh, Sharon.

I can't do this. I gotta
get myself together.

- I gotta go to work.
- No, wait a minute, now...

I missed that budget
meeting this morning.

It doesn't matter.

Come on, let's go. Let's go.

You sure you don't want to stay home?

Come on.

Let's go.

Thank you.

Let's go.

♪ ♪

Reese.

You were supposed to
get this last night.

What is it?

Open it and find out.

[phone chimes]

Oh, I gotta get back to the lab.

Um...

enjoy that.

[stirring music]

♪ ♪

Hey, Reese.

Pardon me,

Dr. Reese.

[chuckles]

Well done.

♪ ♪

[gentle music playing]

♪ ♪

Dr. Downey.

♪ ♪

[hoarsely] Dr. Rhodes.

So you had mentioned

wanting to get back to the islands.

♪ ♪

So I thought...

♪ ♪

There you go.

♪ ♪

Hm.

[sighs]

Pikake.

Sorry?

Hawaiian name...

for this jasmine.

♪ ♪

I thought you should know,

I am starting my
cardiothoracic fellowship.

♪ ♪

So I haven't been wasting my time.

Not entirely, no.

[both chuckle softly]

[sniffles]

♪ ♪

I never asked. Do you have any family?

♪ ♪

I had a sister.

Passed away.

If you're wondering...

I've left instructions.

Cremation.

♪ ♪

Okay.

♪ ♪

Thank you...

for everything.

It's been a good ride.

♪ ♪

Yes, it has.

Yes, it has.

♪ ♪

♪ ♪

[machines beeping]

♪ ♪

Dr. Downey's coding.

He has a DNR. Let him go.

♪ ♪

Dr. Shore.

Dr. Reese.

We are thrilled to have you.

Hey, you wanna see one

- badass gastric carcinoma?
- [chuckles]

[laughs]

Yeah.

Dr. Shore, you've been really nice,

and I appreciate your encouragement...

but I have decided not
to go into pathology.

Wh... what are you talking about?

I think I would do
better treating patients.

But we're... We're counting on you.

I'm really sorry.

You realize, don't you, that
pathology is your match?

If... if you don't take
this, you won't have a job.

I know.

[exhales]

What're you going to do?

[solemn music]

I don't know.

♪ ♪

This is the E.D. you'll
be rotating through.

On this side are the trauma bays,

over there are the treatment rooms.

That is called Baghdad.
You will learn why later.

I have schedules.

Uh, Jeff... Jeff Clarke. Welcome.

Our new fourth-year students.

It's time for my "Welcome
to Chicago Med" speech.

How do I look?

[scoffs] Visine?

My eyes that bad?

You can get through this.

Okay.

Jeff?

Hey, Natalie.

- What?
- Oh, my gosh.

You're in med school?

Yeah, um, I hurt my back on the job,

so no more lugging fire hose.

I always liked the
medical side of things.

Didn't realize bio-chem would
be such a bitch, but...

[laughs] Hey, Maggie.

- You see who's here?
- Hey, I heard the rumors.

- How you doing, Maggie?
- It's good to see you, Jeff.

Good to see you.

So, clearly, I am the
oldest one in my class.

[both laugh]

- Um, they call me "Pops."
- Wow.

- [laughs]
- Yeah, it's cute.

Hey, Will, you ever meet Jeff Clarke?

- You were a firefighter, right?
- That's right.

- Hi.
- Jeff and my Jeff

were really good friends.

We used to call them the two Jeffs.

- [laughs]
- That's great.

We had such a great time together.

How's Lisa?

We're divorced.

Oh, I'm sorry.

- No...
- Dr. Halstead?

Thank you.

Well, it's really
great to have you here.

Good to be here.

- See ya.
- Bye.

Uh, excuse me.

It's good to see you, Jeff.

- April.
- Hey.

- Your X-ray.
- Yeah.

Uh, the blow didn't cause
any significant damage.

Told you.

It did show us something else.

Uh, there's a coin legion in
the upper lobe of your lung.

Given your history, I
think we can rule out

lung cancer or lymphoma.

Then what is it?

Well, we'll need a bronchoscopy

and an IGRA to confirm,

but I'm pretty sure

you have tuberculosis.

What?

I've got TB?

[solemn music]

Yeah, I'm afraid so.

♪ ♪

Dr. Rhodes,

we're so very sorry for your loss.

Thank you.

Um, Ms. Goodwin, I'm gonna
need a few personal days,

- if that's all right.
- Of course.

- Thanks.
- Yeah.

Thinking about you, pal.

Appreciate that.

♪ ♪

So, uh, how you doing?

- What do you mean?
- I don't know.

Haven't quite seemed yourself lately.

Eh, hasn't been a good day.

Oh.

Sorry to hear it.

♪ ♪

Oh, Dr. Reese.

I understand that
congratulations are in order.

I just quit pathology.

Nice fricking move. Right on, sister.

I knew you were smart.

I don't have a job.

So what?

You're gonna be fine.

♪ ♪

His vocabulary's improving.

He said "be back" to me this morning.

- Nice.
- Pretty smart.

He knew I was leaving.

Come on, show Dr. Charles.

Say, "Be back."

"Be back tonight."

[whispers] Performance anxiety, man.

He did say it.

I heard him. He said
it to me this morning.

I believe you.

Whoa.

Look at that.

[stirring music]

Dang.

Good job.

More success than I have
with most of my patients.

♪ ♪

Congratulations.

To the both of you.

♪ ♪

♪ ♪

♪ ♪

Oh! [chuckles]

♪ ♪

♪ ♪

♪ ♪

♪ ♪