Chicago Med (2015–…): Season 3, Episode 19 - Crisis of Confidence - full transcript
Dr. Manning rushes to save a young boy with a life threatening case of the flu; April suspects Dr. Choi's sister stole opioid pain killers; Dr. Rhodes and Dr. Bekker disagree over the best ...
.
- All right, here we go.
Next bucket wins.
Check.
- All right, hold on.
I gotta tie my shoe.
So, how are you
and Natalie doing?
- I see what you're doing.
It's not gonna work.
- Seriously.
I just wanted to see
if you two are getting along.
- Seriously, things have
never been better.
I'm a lucky guy.
Now quit stalling.
- Well, I'm glad
you didn't screw things up.
'cause you can be
a real knucklehead.
- What's that supposed to mean?
- Yes!
[hip-hop music playing]
- Ethan, this way.
- What the hell happened?
- Uh, this guy,
I think he OD'd.
- You should've called 911.
- Look around.
Last thing I wanna do is
get anyone in trouble.
♪
- Em, it's 7:00 a.m.
What are you even doing here?
- I was out dancing
with my friends.
Got invited over here after.
- Don't you have work today?
- Ethan, don't worry,
I'll be there.
- [gagging]
- Over here.
His name's Jeremy.
- Jeremy?
Hey, Jeremy...
what did you take, huh?
Does anyone know what he took?
- [gagging]
- Heroin.
He's choking.
- Oh, God.
[tense music]
- I can't clear it.
Em, see if you can find a pen.
- What? Why?
- He's not breathing.
He needs a surgical airway.
♪
[indistinct murmuring]
♪
- Hey!
- Here, got one.
- Unscrew the top.
♪
- [groans]
- I'm in.
- [gasps]
- He's breathing.
♪
- Unfortunately,
I have to bring up
last week's
mass casualty incident,
because in the chaos,
it seems 40 pills of Percocet
disappeared from
the medication dispensary.
- That's a street value
of $2,500.
- Someone took advantage
of that situation.
So, we will be implementing
new protocols
to prevent that from happening
in the future.
- Keep your eye out for a memo
in the next few days.
Any questions?
Good.
Back to work.
[keys jangling]
[solemn music]
♪
[door beeps]
- Go to Four.
- [breathing heavily]
- Tracy Herman,
25-year-old female.
21 weeks pregnant.
GCS, 14, dyspneic.
This is her mother, Pam.
- Is my baby okay?
- We're gonna take a look.
All right, Tracy,
I'm Dr. Manning.
Can you tell me what happened?
- I don't know.
- We were having breakfast
and she just collapsed.
- All right, let's transfer her
and put her on the monitors.
On my count,
ready, one, two, three.
- [gasps]
- Any pain or discomfort?
- No.
♪
- Breath sounds are clear
and present bilaterally,
but I am hearing
a systolic murmur.
- What does that mean?
- It's probably the pregnancy
putting a strain on your heart.
Have you had any bleeding?
- Uh, just some spotting,
but my OB said it's normal.
- It can be.
Uh, Doris, let's get
a fetal ultrasound,
uh, chest X-ray, and call up to
Cardiology for an ECHO, okay?
All right, Tracy,
just try to relax.
All right, we're gonna do
everything we can
to figure this out, all right?
- Thank you.
- Yeah.
♪
- Oh, goodie.
Lime flavor today.
- I, uh, just checked
with the charge nurse.
Your last set of labs
look good.
If everything holds
for the next 24 hours,
they'll put you back
on solid foods.
- Whoo.
Wonderful news.
- I also told her
about your nausea.
She'll be over in a few minutes
with some ondansetron.
- Sarah?
I know I haven't
said it enough, but...
thank you.
I can't tell you
how grateful I am
for all you've done for me
since the transplant.
No, just, uh, one more thing.
It looks like I'll still
be in rehab for a while.
Uh, I haven't checked my mail
since all this happened.
I'm sure the bills
are piling up.
- You want me to run
to your apartment?
- Unfortunately,
I have no one else to ask.
- All right, but it'll
have to wait a few hours.
Dr. Charles and I have rounds
at Cohn County.
- The jail?
Ooh, sounds fascinating.
[groans]
All right.
Now, this certainly
can wait till after.
It's this key right here.
I made a short list
of things I need.
If you don't mind.
- "No clues to
mystery surrounding
"missing college co-eds
Search for Indiana girl
goes on."
- This poor young lady,
Olivia Coveny,
seems to have disappeared
from the Madison campus,
what, about ten years ago?
- "Wisconsin girl missing."
What am I looking at?
- Seems like somebody
is trying to make a case
that Robert Haywood
is a very bad guy.
- Sarah Reese's father?
- Yeah.
Well, I mean, apparently,
he was a visiting lecturer
at all of these colleges
at the same time that
these women disappeared.
- And you don't know
who sent you this?
- Nope. Somebody slipped it
under my door.
Apparently, somebody knows
that I'm working
with Robert Haywood.
- I think if you think
there's something there,
you should turn it over
to the police.
- Turn what over to the police?
It's all completely
circumstantial.
There's nothing in here
that connects him
to any one of these women.
And if you read the articles,
every single one of these cases
has been thoroughly
investigated by the police.
- You haven't shared this
with Dr. Reese yet, have you?
- Absolutely not.
[tense music]
[door beeps]
- We set up Baghdad
as soon as you called.
How's he doing?
- Got an ET tube in
on the right, but held off
on the naloxone.
They don't want him waking up
with a tube in his neck.
But he needs a better airway.
Get me a number eight
trach tube.
You ready to get him
on the monitors?
All right, we're gonna
transfer him on my count.
Everybody ready?
One, two, three.
♪
I'm in.
Bag him.
♪
- BP's dropping.
88 over 50.
- All right,
he's still intoxicated.
We need to reverse him.
Push 2 milligrams
of naloxone IV.
♪
- How's Jeremy?
- It's gonna take time for the
drugs to clear from his system,
but he should be okay.
- [exhales]
I'm gonna go home and change.
I'll be back for work
in a couple of hours.
♪
- Heroin?
What was she thinking,
going to that party?
- I'm not sure
she was thinking.
- [sighs]
- Hey.
How was the game?
- I'm filing a protest
with the league commissioner.
- So you lost?
- Dr. Manning?
- [laughs] Yes?
- Imaging results from
your pregnant patient
in Treatment Four.
- You better page CT surgery.
- Yeah.
Maggie?
- Yeah?
Okay.
- Now, the access to the atria
of both hearts.
- We're ready to clamp.
Left is clamped.
[solemn music]
And the right...
- Dr. Bekker will now perform
the separation.
- Scalpel.
- Josh, have peeds
surgery ready.
[alarm beeping]
What's happening?
- Heart rate's diving.
The twins are bradying down.
- Dr. Bekker?
- I don't know, my incision
was superficial.
- Step aside.
- Heart rate's down to 44.
- There's no bleeding.
We haven't cut near
any major vessels.
- We need to push atropine.
- No, it's too late.
[electricity drones]
Congratulations, Dr. Latham.
According to the computer
simulation,
your team just killed
both twins.
- Yes, we did.
- I don't know what happened.
- That's why we conduct
these exercises, Dr. Bekker,
so that we can predict
all outcomes
and make the necessary
adjustments on game day.
- Dr. Frisch, my team
will evaluate our approach
and determine what went wrong.
- We'll gather again
this afternoon
and resume the procedure.
- I'd like all
possible scenarios
on my desk before lunch.
- Yes, Dr. Latham.
- Keep your chin up.
You'll figure it out.
- You know, you don't
have to do that.
- What?
- Act like you don't enjoy
seeing me on the hot seat.
Go ahead and buy it.
If I were in your position,
I would.
- Dr. Rhodes, Dr. Bekker,
they need you in the ED.
- Okay.
- You're saying I have
damage to my heart?
- Uh, to be specific,
it's your mitrovalve.
Uh, when it's not
functioning properly,
the body doesn't get
enough oxygen.
- Which is why you've
been feeling so weak
and short of breath.
- But she's never had any
problems with her heart before.
- In all likelihood,
Tracy was born with a defect,
and it just didn't show
any symptoms until now.
Um, the baby has apparently
added strain to your heart,
which has caused it
to present itself.
- We'll need surgery
to replace the defective valve.
- Oh...
Okay.
- There are...
potential complications.
- Complications?
[disquieting music]
- Due to your pregnancy,
the medication needed
to conduct the surgery
could cause a life threatening
vaginal bleed,
and given that your fetus
hasn't reached viability...
- Wh--what are you saying?
- We think it's best for
your health if you terminate
before undergoing surgery.
- What?
No.
You don't understand.
- Her husband, Roy...
we lost him in a car accident
three months ago.
♪
- [sobbing]
We had just got the news
that I was pregnant.
♪
He was so excited.
He wanted this so bad.
- Tracy, trust me,
I understand
what you're going through,
but without this surgery,
neither you nor your baby
will survive.
♪
- Honey, please...
listen to the doctors.
- No. No!
This baby is all I have left.
♪
I won't let you
take it from me.
♪
.
- The patient understands
that, without surgery,
condition could be fatal?
- Yeah, we explained the risks.
- Well, so, your concerns
are certainly justified.
We need blood thinners to keep
the bypass pump for clotting.
Hm. Have you considered
a minimally invasive
valvuloplasty?
- Yes, but due to
the level of stenosis
and the presence
of regurgitation,
we don't feel that
she's a candidate.
We have to open her chest.
- What if there is
another option?
- What?
- If we lower the dose
of the blood thinners
and use a heparin-coated
bypass tube,
there is a chance that we could
save both mom and baby.
- According to Dr. Manning,
Tracy's Level Two ultrasound
showed placenta previa,
which puts her at
an even greater risk
of developing a serious bleed.
- Ava, you heard what she said.
This baby is all she has left
of her dead husband.
Don't we have an obligation
to honor the patient's wishes?
- So, we should let the
patient's emotional involvement
impact our medical decisions?
- I think we owe it to her
to give it a shot, yes.
- With close monitoring,
it is possible
to stay ahead of any bleeding.
Dr. Rhodes, if you believe
that this is the best
course of action,
please proceed.
- Thank you.
[solemn music]
♪
- Well...good luck.
♪
- Are you taking her
up to surgery?
- Yeah. I'm worried about her.
Connor's taking a big risk.
- Hey, you two, Treatment Six.
- Okay.
Hi.
- You must be Cody.
- [coughing]
- What's his temp?
- 102.
- He's been like this
for over a week.
Uh, I've had him on Tamiflu,
bed rest, fluids.
We've tried everything.
He--he just keeps
getting worse.
- It's been an--an extremely
harsh flu season.
Is anyone else
in your household sick?
- No, it's just the two of us.
I've been spared so far,
I-I assume 'cause
I was vaccinated.
- And what about Cody?
- Uh, unfortunately not.
No, I-I know
what you're thinking.
It's not like that.
Uh, Cody has a--
a long list of allergies.
Last year, he had a severe
reaction to the vaccine.
I-I didn't wanna put him
through that again, you know?
- I understand, all right.
It makes sense why you didn't
wanna get him vaccinated.
Let's get a CBC, CMP,
and a chest X-ray, okay?
I promise we're gonna do
everything we can
to take care of your son, okay?
We'll be back soon.
- All right...
couple of more seconds
and I'll have the valve free.
[mumbles]
- No evidence of bleeding.
- Good.
There. Got it.
All right,
let's get a sizing tool.
I'm gonna measure the opening,
determine what size valve
we need.
Let's start with a 21.
Yep. Let's open a 21-millimeter
porcine valve.
- Manufacturer had
some production delays
with that size valve.
It's on backorder.
But I have a mechanical.
- Can we get one
from another supplier?
- Sure, but it'll take
an hour or more
for a rep to get here.
- Marty?
- With any other patient,
maybe,
but every minute
this woman's on pump
reduces her chances of
maintaining this pregnancy.
- [sighs]
♪
Okay, then let's open
the mechanical valve.
- Mechanical valve means she'll
need heparin post-operatively.
She'll be more likely to bleed.
We need to wait for a porcine.
- You heard what Marty said.
This baby doesn't have an hour.
We don't have a choice.
♪
- Thank you again for stopping.
It saves me so much time.
- Right on the way back from
Cohn County. Pretty easy.
- I'll only be
a couple of minutes.
- You know, it's a pretty hefty
list your dad left for you.
Are you sure you don't want
some help?
- Do you mind? In case
I can't fit it all in one box?
[laughs]
- Not at all.
[door closes]
- I'll go pack some clothes.
- He said he wanted
a book or two?
- Yeah, I think his office
is down the hall.
[disquieting music]
♪
- Dr. Charles, you ready?
- Yeah.
- Do you have a book?
- Right over here.
♪
- You made it...
on time.
- [scoffs]
Don't act so surprised.
How's he doing?
- Stable for the moment.
- Uh...listen,
about this morning...
thanks for being there.
- Yeah.
- Guess I better get to work.
I'll check in later.
- You hear about
the missing Percocet?
- Yeah, I'm not surprised.
It was a chaotic day.
- You know, I hate to even
mention this, but...
you don't think
Emily could've had
something to do with it,
do you?
- What?
- She was working that day,
she had access,
and now her friend
OD's at a party?
And how'd she afford
those new Louboutins?
- Lou--Loubout--what?
- The shoes she had on.
Do you know how expensive
they are?
- April, you're the one
that keeps telling me
to give her a chance.
Did Emily show poor judgment
this morning? Absolutely.
But this kid OD'd on heroin,
not Percocet.
Is there something else
about Emily I'm missing?
- No, uh...I'm sorry.
Forget I mentioned it.
- Okay.
- So, get this,
it turns out that
Robert Haywood did know
one of those co-eds
that disappeared:
Olivia Coveny.
- Oh, yeah?
- The one from Madison,
yeah, was his student.
And I saw a picture of 'em
together this morning
at his apartment.
- Wait a minute,
you--you went to his apartment?
- Sarah and I were doing rounds
at the jail this morning,
and she needed to pick up
some of this stuff,
and so we just stopped
on the way back.
- But what happened to,
"We're gonna forget
all about it"?
- She asked for my help.
What am I supposed to do,
sit in the car?
And I couldn't help, seeing
the picture was right there.
And, by the way,
part of me says,
"So they knew each other.
So what?
Student, you know, teacher."
But the thing is
is that in the picture,
he had his arm around her.
- Well, have you
considered calling
the Madison Police Department?
- No, I did.
The detective I talked to,
I don't know, he just
didn't seem that interested.
You know, ten years ago,
it was a cold case.
- Mm.
- If I only had, like, two more
minutes in that apartment.
- Daniel...
- What?
- Be careful.
[machine beeping]
- Sats are dropping.
- What's happening?
- Respiratory failure.
- Bag him.
- 20 of etomidate, 100 of sux.
We need to intubate now.
- [wheezing]
- Sats are down to 87.
[tense music]
♪
- Nat...
- I'm almost there.
- Oh, God...
- 82.
- I'm in.
- [exhales]
- Now, let's get
10 parts per million
of inhaled nitric oxide.
Let's get a chest X-ray
for tube placement.
♪
.
- Dad?
- Oh, Sarah.
- She's even lovelier
than you said.
[soft music]
♪
- Thank you.
- I should probably get going,
but, um...
thank you, Robert.
This has meant so much to me.
- As to me.
♪
- What was that all about?
- That...was the widow
of my heart donor.
She had asked to meet me.
I admit I was reticent
about the whole thing,
but, surprisingly...
it felt good.
♪
- Sats are still in the tank.
- Nitric oxide didn't work.
- Neither did low volume
ventilation.
- Where's the mom?
- She went to grab
a cup of coffee.
- We should get him
up to the PICU.
- I called already.
They don't have
an isolation room available.
This flu epidemic
is wreaking havoc.
- It's time to consider ECMO.
- Yeah.
Hey, uh,
what do you think of this?
- A rash?
- Mm-hmm.
- It's not abnormal.
I'll call the ICU, see if
they have an extra iso room.
- Thanks.
- Dr. Choi, we need you.
[tense music]
He's having a seizure.
- Push 2 of Ativan.
All right, take it easy,
take it easy.
His eyes are icteric.
There's something wrong
with his liver.
- From the heroin?
- Not likely.
Did we get his labs back?
- I think they came in
a few minutes ago.
- Okay.
♪
Positive for acetaminophen.
That's in Percocet.
Uh, let's also start a NAC,
140 milligrams per kilogram.
- Okay.
[solemn music]
♪
- April, what you said
about the missing drugs...
- Oh, forget it,
I shouldn't have gone there.
- Actually, you should've.
I thought this kid
OD'd on heroin,
but his labs came back positive
for both opioids
and acetaminophen.
I can't tell it's exactly
what he took, but...
the most likely source is
Percocet, our missing drug.
You thought from the beginning
this could be a possibility.
Why?
- I don't know.
Maybe what you've told me
about her history.
- April, what aren't
you telling me?
♪
- Remember that first day
Emily came to stay with you?
- Yeah.
She cleaned up
and cooked dinner.
- She also had
some people over.
I found an ash tray
full of cigarette butts
in the bathroom.
- You didn't think
I should know?
- I just--I wanted you two
to get off on the right foot.
She begged me
not to say anything.
I'm sorry.
I should've told you.
- Yeah.
- I'm gonna go talk to her.
Maybe she'll come clean to me.
- No.
She's my sister.
I'll do it.
♪
- [murmurs]
-[laughs]
- Dr. Charles,
what a pleasant surprise.
- Dr. Haywood, just wanted to--
to stop by,
see how you're doing.
- Well, I won't be running
a marathon any time soon,
but I'm getting along
much better.
- You know, Sarah told me you
spent some time up in Madison.
I had no idea.
- Yeah.
I spent a few semesters.
- You know, they keep on
bugging me to come up there
and do a forensic
psychiatry seminar.
I don't know, worth my time?
Worth the trip?
- I found Madison to be
a bit, uh, claustrophobic.
- Good to know.
Good to know.
- Could you do me a favor?
- Course.
- Would you mind...
getting me a book
from that box?
Yeah.
[brooding music]
♪
Ha, Grisham.
Well, Sarah doesn't
know me very well.
- All right, Dr. Haywood,
time for your exercises.
- Sorry to cut this short,
Dr. Charles.
I hope you'll stop by
again soon.
- You can count on it.
♪
[intriguing music]
♪
- The surgery was a success.
We managed to replace
your valve
and stave off any bleeding.
- And the baby?
- The baby pulled through
just fine.
- Thank you, Dr. Rhodes.
- Thank you.
- I'll be back to check in
on you soon,
see how you're doing, okay?
- Dr. Rhodes, good work.
- Things broke our way
this time.
- Nonetheless, well done.
- Hey, I was wondering,
uh, has there been any progress
on the conjoined twins
simulation?
- Uh, Dr. Bekker and I suspect
it was the placement
of the clamps
that caused the problem,
but we've already confirmed
that the coronary vessels and
vagus nerve were not affected.
- What about
the sinoatrial node?
- We hadn't considered that,
given its location.
- Well, the anatomy of these
hearts is highly irregular,
so it's possible that
we clamped the SA node
and it cut off the heart's
electrical activity.
- So are you suggesting moving
the L.A. clamp laterally?
- Worth a shot.
- Ah...
Dr. Rhodes,
why don't we test your theory
before the next simulation?
Meet me in the lab in an hour.
- Okay.
- I take it that means good
news for Tracy and her baby?
- You know what they say,
right?
Fortune favors the bold.
- Catheter's in good position.
Let's double-check
circuit tubing,
and set goal flow at 35 to 40
ccs per kilogram per minute.
I was lucky there was
an ECMO available.
I was afraid
they'd all be taken.
- Um, you...
I don't think
we should put him on ECMO.
- Why not?
- The rash on Cody's IV site,
given his history of
intense allergic reactions?
I think he may have undiagnosed
systemic mastocytosis.
- You're jumping to that
from a rash?
- Kids with mastocytosis
generally produce
an overabundance of histamine.
If Cody has it,
passing his blood
through the machine could send
him into anaphylactic shock.
Given the state
his lungs are in,
he would not survive that.
- Mastocytosis is
extremely rare, Natalie,
and we don't have time for
a biopsy to confirm it.
- Dr. Halstead, we're ready.
- All right.
- What about PLV?
- Partial liquid ventilation?
I thought that was reserved
for preemies.
- There have been
some clinical trials
with encouraging results.
- PLV's a good idea, in theory.
I--I'm not sure we should be
risking a kid's life
by using a treatment
that's unproven.
- Will, I know we've had
our disagreements,
but I really think
this could work.
- Your patient, your call.
[soft music]
- Stop. We're not
putting him on ECMO.
♪
.
- Wait a minute, you--you're
saying you wanna drown my son?
- I assure you, Karen,
Cody will not drown.
- But you--you--you're gonna
fill his lungs with fluid.
- It's called Perflubron.
- It has unique properties,
including the ability to hold
large amounts of oxygen.
- Yeah, at this point,
Cody's lungs are too damaged
to absorb oxygen
through the air,
so our hope is
that this treatment
helps oxygen penetrate
Cody's lungs
and restore his breathing.
- Have you done this before?
- Um...
- This procedure is performed
quite often with neonates.
We feel strongly
it's the best chance we have
at saving your son's life.
- Okay.
- Go ahead.
- Maggie, I'm gonna be out
of pocket for a little bit.
- For how long?
- Uh, three or four hours.
If anybody needs me,
just redirect them to Dr. Kwon.
- You got it.
- Daniel...
Where are you going?
- Robert Haywood still has
a storage locker
in Madison, Wisconsin
that he rented before
Olivia Coveny disappeared.
- Okay?
- Okay, so I'm going up there
to check it out.
- Come on, Daniel,
let the proper authorities
handle it.
- The proper authorities,
they're just not
that interested right now.
I have a limited window.
- Stop.
Look, I know you're trying
to protect Dr. Reese,
but no matter what you find,
you are really putting your
relationship with her at risk.
- Sharon, if there's
even a remote chance
that any of
this stuff is true--
and, trust me,
I don't want it to be--
it's a risk
I'm willing to take.
[solemn music]
♪
- Hear you might have
found a solution.
- Fingers crossed.
- Looks like it's all coming up
roses for you today.
- You two, join me.
- Yes, sir.
I mean, I'm still hoping it's
me who gets to do the surgery.
- No surprise there.
- If we move the two clamps
to the center of the bridge,
between the two atria,
that could solve our problem.
I'll let Dr. Frisch know
that we're ready
to run another simulation.
- Okay.
- Dr. Rhodes, Dr. Bekker,
they need you back in the ICU.
[tense music]
[machine beeping]
- What's going on?
- Her BP just
started plummeting.
- Bag her.
- What's going on
with my daughter?
- Uh, ma'am...
- She's hemorrhaging.
- Uh...all right.
All right, hang 2 units
of o-neg on a pressure bag.
Give me the ultrasound.
We need to check her fetus
and take a look
at her placenta.
♪
- Placenta's marginally
separating,
causing her to bleed.
- Fetal heart tones are strong.
We'll reverse
the blood thinners.
Hopefully, the placenta
will tamponade itself.
- If we reverse the thinners,
her new valve could clot off.
We'll lose mom and baby.
We have to get her to the O.R.
- Look, we can still save
this pregnancy.
- It's too late for that.
If we have any hope of
getting control of this bleed,
she needs an emergency
hysterectomy.
- Stop the heparin drip.
Bolus a gram of TXA.
We're not gonna lose
either of them.
♪
- [sighs]
He still hasn't woken up.
- No.
How well do you know Jeremy?
- Not that well.
I mean, just from around.
I had no idea
he was using heroin.
- I don't think that's
what Jeremy OD'd on.
- No?
- No.
Pretty sure it was Percocet,
which, coincidentally,
is the same drug
that went missing from
the dispensary last week.
- So?
[chuckles]
What, are you suggesting
that I took them?
- Did you?
- You know how easy it is
to score pharmaceuticals
on the street?
Jeremy could've gotten them
from anyone.
- But he was at the party
with you.
- Ethan, I swear,
I didn't take those drugs.
- So where'd you get the money
for the Louboutins?
- [scoffs]
Louboutins?
What do you even know
about Louboutins?
♪
She put you up to this,
didn't she?
Your uptight narc
of a girlfriend.
You know, all the two of you
have done since I moved in
is hover around, waiting for me
to make a mistake.
- That's not true.
- Yeah, all my life
it's been like this.
You know, I've had it.
- Emily...
- No, I'm not working
some place
that thinks I'm a criminal.
- Em--
Emily...
- Happy?
You got him all
to yourself now.
[solemn music]
♪
- How's she doing?
- She's passing an old clot,
but there's no more
active bleeding.
Placenta looks like
it tamponaded itself.
- Fetal heart tones are steady.
- [relieved sigh]
- We've got a problem.
Pressure's down.
- Heart rate's spiking.
She's clotting off that valve.
- We need to get her to
the O.R. and replace the valve.
Let's go, come on!
[tense music]
- What's happening?
♪
- Stop!
No pulse.
She must be in v-fib.
- Let's get a crash cart!
Come on.
Come on, Tracy.
Come on.
Stay with us.
- Charge to 200.
[paddles whir]
Clear!
[device trilling]
No pulse.
- Milligram of epi.
- Please save her! Please!
- Hold compressions.
- Come on.
- Clear!
♪
Still no pulse.
- Charge again.
Charge!
[paddles whirring]
♪
Clear!
[device trilling]
♪
Another milligram of epi.
- Connor...
she's gone.
♪
- Oh, God, no!
[sobbing]
No, no, no!
[sobbing]
No...
[somber music]
♪
- Time of death, 17:23.
♪
.
[soft, solemn music]
♪
- If you want, I can help
the mother with the paperwork.
- No.
This is my responsibility.
♪
Ms. Barker, I am so sorry
for your loss.
- You talked my daughter
into this,
and now she's gone forever.
You did this.
This is all your fault!
It's all your fault!
[sobbing]
♪
- Dr. Manning...
Cody's temp's back up to 103.7.
- What are his sats?
- 83%.
- 83?
He's getting worse.
Okay.
♪
- Hey, how's he doing?
- PLV's not working.
I made a huge mistake, Will.
- Natalie--
- No, I should've just
put him on ECMO,
but I got carried away,
and I might've just put
his life in jeopardy.
Why didn't I just
listen to you?
- Good thing you didn't.
You were right.
- What?
- Cody tested positive
for mastocytosis.
- [surprised chuckle]
- If you had put Cody on ECMO,
he could've gone into
anaphylactic shock.
♪
You may have just saved
his life.
- No, I haven't...
not yet.
♪
- Guess things got out of hand
last night.
- Yeah, you're lucky
Emily called us.
- According to your blood work,
you had a high concentration
of opioids in your system,
along with toxic levels
of acetaminophen.
- Most likely due
to the Percocet.
- Yeah.
- So where'd you get
those pills?
Do you have a prescription?
- No--
I mean...my dad does.
He had back surgery
a few weeks ago.
I swept some from
his medicine cabinet.
I feel like an idiot.
- Get some rest.
We'll check on you soon.
[disquieting music]
You think he's telling
the truth?
- No reason to doubt him.
When it comes to my sister, I'm
so used to assuming the worst.
I never should've accused her
of stealing those drugs.
Have Noah work up
Jeremy's discharge.
I need to find Emily,
make things right.
♪
- Dr. Manning?
- Yes?
[soft heartfelt music]
♪
- Cody's sats are
back above 90.
Looks like he's out
of the woods.
- Thank you for saving my boy.
- Of course.
♪
- I just found out myself.
Neurology's in there now,
doing a quick exam.
- You know what,
we did good today.
- Yeah, we did, didn't we?
- I mean, together.
♪
- Dr. Rhodes, good.
We're just about
to get started.
- You coming?
- Dr. Latham,
with your permission,
I would like to remove myself
from the team.
[solemn music]
♪
- Why?
- I think it would be best
for the patients
and for everyone involved.
A surgery with
this level of difficulty
and in that environment...
♪
I don't know that
I can trust my judgment.
- Are you sure about this?
- Yes.
- Mm.
Very well.
♪
- So, your dad had
back surgery?
- Yeah.
- Awfully convenient.
- Well, I told you,
that's where I got them.
- Mm-hmm.
According to your tox screen,
the Percocet you took
were hospital grade.
That means they
didn't come from
your dad's medicine cabinet.
♪
Possessing
a Schedule Two narcotic
with that level of potency
is a felony offense.
Now, I'm not gonna report you,
but I need you to tell me.
♪
- Emily.
She sold them to me.
♪
- Emily?
♪
Em?
♪
[suspenseful music]
♪
[knocking on door]
- What's up?
You want a rematch?
- [laughs]
I was just wondering,
are you still holding onto
Mom's wedding ring?
- Yeah, of course.
Why wouldn't I?
[soft hopeful music]
Oh...
♪
- Just trying not to be
a knucklehead.
- Okay, uh, well, come on in,
and I'll go get it.
♪
.
[dramatic music]
♪
[wolf howls]
- All right, here we go.
Next bucket wins.
Check.
- All right, hold on.
I gotta tie my shoe.
So, how are you
and Natalie doing?
- I see what you're doing.
It's not gonna work.
- Seriously.
I just wanted to see
if you two are getting along.
- Seriously, things have
never been better.
I'm a lucky guy.
Now quit stalling.
- Well, I'm glad
you didn't screw things up.
'cause you can be
a real knucklehead.
- What's that supposed to mean?
- Yes!
[hip-hop music playing]
- Ethan, this way.
- What the hell happened?
- Uh, this guy,
I think he OD'd.
- You should've called 911.
- Look around.
Last thing I wanna do is
get anyone in trouble.
♪
- Em, it's 7:00 a.m.
What are you even doing here?
- I was out dancing
with my friends.
Got invited over here after.
- Don't you have work today?
- Ethan, don't worry,
I'll be there.
- [gagging]
- Over here.
His name's Jeremy.
- Jeremy?
Hey, Jeremy...
what did you take, huh?
Does anyone know what he took?
- [gagging]
- Heroin.
He's choking.
- Oh, God.
[tense music]
- I can't clear it.
Em, see if you can find a pen.
- What? Why?
- He's not breathing.
He needs a surgical airway.
♪
[indistinct murmuring]
♪
- Hey!
- Here, got one.
- Unscrew the top.
♪
- [groans]
- I'm in.
- [gasps]
- He's breathing.
♪
- Unfortunately,
I have to bring up
last week's
mass casualty incident,
because in the chaos,
it seems 40 pills of Percocet
disappeared from
the medication dispensary.
- That's a street value
of $2,500.
- Someone took advantage
of that situation.
So, we will be implementing
new protocols
to prevent that from happening
in the future.
- Keep your eye out for a memo
in the next few days.
Any questions?
Good.
Back to work.
[keys jangling]
[solemn music]
♪
[door beeps]
- Go to Four.
- [breathing heavily]
- Tracy Herman,
25-year-old female.
21 weeks pregnant.
GCS, 14, dyspneic.
This is her mother, Pam.
- Is my baby okay?
- We're gonna take a look.
All right, Tracy,
I'm Dr. Manning.
Can you tell me what happened?
- I don't know.
- We were having breakfast
and she just collapsed.
- All right, let's transfer her
and put her on the monitors.
On my count,
ready, one, two, three.
- [gasps]
- Any pain or discomfort?
- No.
♪
- Breath sounds are clear
and present bilaterally,
but I am hearing
a systolic murmur.
- What does that mean?
- It's probably the pregnancy
putting a strain on your heart.
Have you had any bleeding?
- Uh, just some spotting,
but my OB said it's normal.
- It can be.
Uh, Doris, let's get
a fetal ultrasound,
uh, chest X-ray, and call up to
Cardiology for an ECHO, okay?
All right, Tracy,
just try to relax.
All right, we're gonna do
everything we can
to figure this out, all right?
- Thank you.
- Yeah.
♪
- Oh, goodie.
Lime flavor today.
- I, uh, just checked
with the charge nurse.
Your last set of labs
look good.
If everything holds
for the next 24 hours,
they'll put you back
on solid foods.
- Whoo.
Wonderful news.
- I also told her
about your nausea.
She'll be over in a few minutes
with some ondansetron.
- Sarah?
I know I haven't
said it enough, but...
thank you.
I can't tell you
how grateful I am
for all you've done for me
since the transplant.
No, just, uh, one more thing.
It looks like I'll still
be in rehab for a while.
Uh, I haven't checked my mail
since all this happened.
I'm sure the bills
are piling up.
- You want me to run
to your apartment?
- Unfortunately,
I have no one else to ask.
- All right, but it'll
have to wait a few hours.
Dr. Charles and I have rounds
at Cohn County.
- The jail?
Ooh, sounds fascinating.
[groans]
All right.
Now, this certainly
can wait till after.
It's this key right here.
I made a short list
of things I need.
If you don't mind.
- "No clues to
mystery surrounding
"missing college co-eds
Search for Indiana girl
goes on."
- This poor young lady,
Olivia Coveny,
seems to have disappeared
from the Madison campus,
what, about ten years ago?
- "Wisconsin girl missing."
What am I looking at?
- Seems like somebody
is trying to make a case
that Robert Haywood
is a very bad guy.
- Sarah Reese's father?
- Yeah.
Well, I mean, apparently,
he was a visiting lecturer
at all of these colleges
at the same time that
these women disappeared.
- And you don't know
who sent you this?
- Nope. Somebody slipped it
under my door.
Apparently, somebody knows
that I'm working
with Robert Haywood.
- I think if you think
there's something there,
you should turn it over
to the police.
- Turn what over to the police?
It's all completely
circumstantial.
There's nothing in here
that connects him
to any one of these women.
And if you read the articles,
every single one of these cases
has been thoroughly
investigated by the police.
- You haven't shared this
with Dr. Reese yet, have you?
- Absolutely not.
[tense music]
[door beeps]
- We set up Baghdad
as soon as you called.
How's he doing?
- Got an ET tube in
on the right, but held off
on the naloxone.
They don't want him waking up
with a tube in his neck.
But he needs a better airway.
Get me a number eight
trach tube.
You ready to get him
on the monitors?
All right, we're gonna
transfer him on my count.
Everybody ready?
One, two, three.
♪
I'm in.
Bag him.
♪
- BP's dropping.
88 over 50.
- All right,
he's still intoxicated.
We need to reverse him.
Push 2 milligrams
of naloxone IV.
♪
- How's Jeremy?
- It's gonna take time for the
drugs to clear from his system,
but he should be okay.
- [exhales]
I'm gonna go home and change.
I'll be back for work
in a couple of hours.
♪
- Heroin?
What was she thinking,
going to that party?
- I'm not sure
she was thinking.
- [sighs]
- Hey.
How was the game?
- I'm filing a protest
with the league commissioner.
- So you lost?
- Dr. Manning?
- [laughs] Yes?
- Imaging results from
your pregnant patient
in Treatment Four.
- You better page CT surgery.
- Yeah.
Maggie?
- Yeah?
Okay.
- Now, the access to the atria
of both hearts.
- We're ready to clamp.
Left is clamped.
[solemn music]
And the right...
- Dr. Bekker will now perform
the separation.
- Scalpel.
- Josh, have peeds
surgery ready.
[alarm beeping]
What's happening?
- Heart rate's diving.
The twins are bradying down.
- Dr. Bekker?
- I don't know, my incision
was superficial.
- Step aside.
- Heart rate's down to 44.
- There's no bleeding.
We haven't cut near
any major vessels.
- We need to push atropine.
- No, it's too late.
[electricity drones]
Congratulations, Dr. Latham.
According to the computer
simulation,
your team just killed
both twins.
- Yes, we did.
- I don't know what happened.
- That's why we conduct
these exercises, Dr. Bekker,
so that we can predict
all outcomes
and make the necessary
adjustments on game day.
- Dr. Frisch, my team
will evaluate our approach
and determine what went wrong.
- We'll gather again
this afternoon
and resume the procedure.
- I'd like all
possible scenarios
on my desk before lunch.
- Yes, Dr. Latham.
- Keep your chin up.
You'll figure it out.
- You know, you don't
have to do that.
- What?
- Act like you don't enjoy
seeing me on the hot seat.
Go ahead and buy it.
If I were in your position,
I would.
- Dr. Rhodes, Dr. Bekker,
they need you in the ED.
- Okay.
- You're saying I have
damage to my heart?
- Uh, to be specific,
it's your mitrovalve.
Uh, when it's not
functioning properly,
the body doesn't get
enough oxygen.
- Which is why you've
been feeling so weak
and short of breath.
- But she's never had any
problems with her heart before.
- In all likelihood,
Tracy was born with a defect,
and it just didn't show
any symptoms until now.
Um, the baby has apparently
added strain to your heart,
which has caused it
to present itself.
- We'll need surgery
to replace the defective valve.
- Oh...
Okay.
- There are...
potential complications.
- Complications?
[disquieting music]
- Due to your pregnancy,
the medication needed
to conduct the surgery
could cause a life threatening
vaginal bleed,
and given that your fetus
hasn't reached viability...
- Wh--what are you saying?
- We think it's best for
your health if you terminate
before undergoing surgery.
- What?
No.
You don't understand.
- Her husband, Roy...
we lost him in a car accident
three months ago.
♪
- [sobbing]
We had just got the news
that I was pregnant.
♪
He was so excited.
He wanted this so bad.
- Tracy, trust me,
I understand
what you're going through,
but without this surgery,
neither you nor your baby
will survive.
♪
- Honey, please...
listen to the doctors.
- No. No!
This baby is all I have left.
♪
I won't let you
take it from me.
♪
.
- The patient understands
that, without surgery,
condition could be fatal?
- Yeah, we explained the risks.
- Well, so, your concerns
are certainly justified.
We need blood thinners to keep
the bypass pump for clotting.
Hm. Have you considered
a minimally invasive
valvuloplasty?
- Yes, but due to
the level of stenosis
and the presence
of regurgitation,
we don't feel that
she's a candidate.
We have to open her chest.
- What if there is
another option?
- What?
- If we lower the dose
of the blood thinners
and use a heparin-coated
bypass tube,
there is a chance that we could
save both mom and baby.
- According to Dr. Manning,
Tracy's Level Two ultrasound
showed placenta previa,
which puts her at
an even greater risk
of developing a serious bleed.
- Ava, you heard what she said.
This baby is all she has left
of her dead husband.
Don't we have an obligation
to honor the patient's wishes?
- So, we should let the
patient's emotional involvement
impact our medical decisions?
- I think we owe it to her
to give it a shot, yes.
- With close monitoring,
it is possible
to stay ahead of any bleeding.
Dr. Rhodes, if you believe
that this is the best
course of action,
please proceed.
- Thank you.
[solemn music]
♪
- Well...good luck.
♪
- Are you taking her
up to surgery?
- Yeah. I'm worried about her.
Connor's taking a big risk.
- Hey, you two, Treatment Six.
- Okay.
Hi.
- You must be Cody.
- [coughing]
- What's his temp?
- 102.
- He's been like this
for over a week.
Uh, I've had him on Tamiflu,
bed rest, fluids.
We've tried everything.
He--he just keeps
getting worse.
- It's been an--an extremely
harsh flu season.
Is anyone else
in your household sick?
- No, it's just the two of us.
I've been spared so far,
I-I assume 'cause
I was vaccinated.
- And what about Cody?
- Uh, unfortunately not.
No, I-I know
what you're thinking.
It's not like that.
Uh, Cody has a--
a long list of allergies.
Last year, he had a severe
reaction to the vaccine.
I-I didn't wanna put him
through that again, you know?
- I understand, all right.
It makes sense why you didn't
wanna get him vaccinated.
Let's get a CBC, CMP,
and a chest X-ray, okay?
I promise we're gonna do
everything we can
to take care of your son, okay?
We'll be back soon.
- All right...
couple of more seconds
and I'll have the valve free.
[mumbles]
- No evidence of bleeding.
- Good.
There. Got it.
All right,
let's get a sizing tool.
I'm gonna measure the opening,
determine what size valve
we need.
Let's start with a 21.
Yep. Let's open a 21-millimeter
porcine valve.
- Manufacturer had
some production delays
with that size valve.
It's on backorder.
But I have a mechanical.
- Can we get one
from another supplier?
- Sure, but it'll take
an hour or more
for a rep to get here.
- Marty?
- With any other patient,
maybe,
but every minute
this woman's on pump
reduces her chances of
maintaining this pregnancy.
- [sighs]
♪
Okay, then let's open
the mechanical valve.
- Mechanical valve means she'll
need heparin post-operatively.
She'll be more likely to bleed.
We need to wait for a porcine.
- You heard what Marty said.
This baby doesn't have an hour.
We don't have a choice.
♪
- Thank you again for stopping.
It saves me so much time.
- Right on the way back from
Cohn County. Pretty easy.
- I'll only be
a couple of minutes.
- You know, it's a pretty hefty
list your dad left for you.
Are you sure you don't want
some help?
- Do you mind? In case
I can't fit it all in one box?
[laughs]
- Not at all.
[door closes]
- I'll go pack some clothes.
- He said he wanted
a book or two?
- Yeah, I think his office
is down the hall.
[disquieting music]
♪
- Dr. Charles, you ready?
- Yeah.
- Do you have a book?
- Right over here.
♪
- You made it...
on time.
- [scoffs]
Don't act so surprised.
How's he doing?
- Stable for the moment.
- Uh...listen,
about this morning...
thanks for being there.
- Yeah.
- Guess I better get to work.
I'll check in later.
- You hear about
the missing Percocet?
- Yeah, I'm not surprised.
It was a chaotic day.
- You know, I hate to even
mention this, but...
you don't think
Emily could've had
something to do with it,
do you?
- What?
- She was working that day,
she had access,
and now her friend
OD's at a party?
And how'd she afford
those new Louboutins?
- Lou--Loubout--what?
- The shoes she had on.
Do you know how expensive
they are?
- April, you're the one
that keeps telling me
to give her a chance.
Did Emily show poor judgment
this morning? Absolutely.
But this kid OD'd on heroin,
not Percocet.
Is there something else
about Emily I'm missing?
- No, uh...I'm sorry.
Forget I mentioned it.
- Okay.
- So, get this,
it turns out that
Robert Haywood did know
one of those co-eds
that disappeared:
Olivia Coveny.
- Oh, yeah?
- The one from Madison,
yeah, was his student.
And I saw a picture of 'em
together this morning
at his apartment.
- Wait a minute,
you--you went to his apartment?
- Sarah and I were doing rounds
at the jail this morning,
and she needed to pick up
some of this stuff,
and so we just stopped
on the way back.
- But what happened to,
"We're gonna forget
all about it"?
- She asked for my help.
What am I supposed to do,
sit in the car?
And I couldn't help, seeing
the picture was right there.
And, by the way,
part of me says,
"So they knew each other.
So what?
Student, you know, teacher."
But the thing is
is that in the picture,
he had his arm around her.
- Well, have you
considered calling
the Madison Police Department?
- No, I did.
The detective I talked to,
I don't know, he just
didn't seem that interested.
You know, ten years ago,
it was a cold case.
- Mm.
- If I only had, like, two more
minutes in that apartment.
- Daniel...
- What?
- Be careful.
[machine beeping]
- Sats are dropping.
- What's happening?
- Respiratory failure.
- Bag him.
- 20 of etomidate, 100 of sux.
We need to intubate now.
- [wheezing]
- Sats are down to 87.
[tense music]
♪
- Nat...
- I'm almost there.
- Oh, God...
- 82.
- I'm in.
- [exhales]
- Now, let's get
10 parts per million
of inhaled nitric oxide.
Let's get a chest X-ray
for tube placement.
♪
.
- Dad?
- Oh, Sarah.
- She's even lovelier
than you said.
[soft music]
♪
- Thank you.
- I should probably get going,
but, um...
thank you, Robert.
This has meant so much to me.
- As to me.
♪
- What was that all about?
- That...was the widow
of my heart donor.
She had asked to meet me.
I admit I was reticent
about the whole thing,
but, surprisingly...
it felt good.
♪
- Sats are still in the tank.
- Nitric oxide didn't work.
- Neither did low volume
ventilation.
- Where's the mom?
- She went to grab
a cup of coffee.
- We should get him
up to the PICU.
- I called already.
They don't have
an isolation room available.
This flu epidemic
is wreaking havoc.
- It's time to consider ECMO.
- Yeah.
Hey, uh,
what do you think of this?
- A rash?
- Mm-hmm.
- It's not abnormal.
I'll call the ICU, see if
they have an extra iso room.
- Thanks.
- Dr. Choi, we need you.
[tense music]
He's having a seizure.
- Push 2 of Ativan.
All right, take it easy,
take it easy.
His eyes are icteric.
There's something wrong
with his liver.
- From the heroin?
- Not likely.
Did we get his labs back?
- I think they came in
a few minutes ago.
- Okay.
♪
Positive for acetaminophen.
That's in Percocet.
Uh, let's also start a NAC,
140 milligrams per kilogram.
- Okay.
[solemn music]
♪
- April, what you said
about the missing drugs...
- Oh, forget it,
I shouldn't have gone there.
- Actually, you should've.
I thought this kid
OD'd on heroin,
but his labs came back positive
for both opioids
and acetaminophen.
I can't tell it's exactly
what he took, but...
the most likely source is
Percocet, our missing drug.
You thought from the beginning
this could be a possibility.
Why?
- I don't know.
Maybe what you've told me
about her history.
- April, what aren't
you telling me?
♪
- Remember that first day
Emily came to stay with you?
- Yeah.
She cleaned up
and cooked dinner.
- She also had
some people over.
I found an ash tray
full of cigarette butts
in the bathroom.
- You didn't think
I should know?
- I just--I wanted you two
to get off on the right foot.
She begged me
not to say anything.
I'm sorry.
I should've told you.
- Yeah.
- I'm gonna go talk to her.
Maybe she'll come clean to me.
- No.
She's my sister.
I'll do it.
♪
- [murmurs]
-[laughs]
- Dr. Charles,
what a pleasant surprise.
- Dr. Haywood, just wanted to--
to stop by,
see how you're doing.
- Well, I won't be running
a marathon any time soon,
but I'm getting along
much better.
- You know, Sarah told me you
spent some time up in Madison.
I had no idea.
- Yeah.
I spent a few semesters.
- You know, they keep on
bugging me to come up there
and do a forensic
psychiatry seminar.
I don't know, worth my time?
Worth the trip?
- I found Madison to be
a bit, uh, claustrophobic.
- Good to know.
Good to know.
- Could you do me a favor?
- Course.
- Would you mind...
getting me a book
from that box?
Yeah.
[brooding music]
♪
Ha, Grisham.
Well, Sarah doesn't
know me very well.
- All right, Dr. Haywood,
time for your exercises.
- Sorry to cut this short,
Dr. Charles.
I hope you'll stop by
again soon.
- You can count on it.
♪
[intriguing music]
♪
- The surgery was a success.
We managed to replace
your valve
and stave off any bleeding.
- And the baby?
- The baby pulled through
just fine.
- Thank you, Dr. Rhodes.
- Thank you.
- I'll be back to check in
on you soon,
see how you're doing, okay?
- Dr. Rhodes, good work.
- Things broke our way
this time.
- Nonetheless, well done.
- Hey, I was wondering,
uh, has there been any progress
on the conjoined twins
simulation?
- Uh, Dr. Bekker and I suspect
it was the placement
of the clamps
that caused the problem,
but we've already confirmed
that the coronary vessels and
vagus nerve were not affected.
- What about
the sinoatrial node?
- We hadn't considered that,
given its location.
- Well, the anatomy of these
hearts is highly irregular,
so it's possible that
we clamped the SA node
and it cut off the heart's
electrical activity.
- So are you suggesting moving
the L.A. clamp laterally?
- Worth a shot.
- Ah...
Dr. Rhodes,
why don't we test your theory
before the next simulation?
Meet me in the lab in an hour.
- Okay.
- I take it that means good
news for Tracy and her baby?
- You know what they say,
right?
Fortune favors the bold.
- Catheter's in good position.
Let's double-check
circuit tubing,
and set goal flow at 35 to 40
ccs per kilogram per minute.
I was lucky there was
an ECMO available.
I was afraid
they'd all be taken.
- Um, you...
I don't think
we should put him on ECMO.
- Why not?
- The rash on Cody's IV site,
given his history of
intense allergic reactions?
I think he may have undiagnosed
systemic mastocytosis.
- You're jumping to that
from a rash?
- Kids with mastocytosis
generally produce
an overabundance of histamine.
If Cody has it,
passing his blood
through the machine could send
him into anaphylactic shock.
Given the state
his lungs are in,
he would not survive that.
- Mastocytosis is
extremely rare, Natalie,
and we don't have time for
a biopsy to confirm it.
- Dr. Halstead, we're ready.
- All right.
- What about PLV?
- Partial liquid ventilation?
I thought that was reserved
for preemies.
- There have been
some clinical trials
with encouraging results.
- PLV's a good idea, in theory.
I--I'm not sure we should be
risking a kid's life
by using a treatment
that's unproven.
- Will, I know we've had
our disagreements,
but I really think
this could work.
- Your patient, your call.
[soft music]
- Stop. We're not
putting him on ECMO.
♪
.
- Wait a minute, you--you're
saying you wanna drown my son?
- I assure you, Karen,
Cody will not drown.
- But you--you--you're gonna
fill his lungs with fluid.
- It's called Perflubron.
- It has unique properties,
including the ability to hold
large amounts of oxygen.
- Yeah, at this point,
Cody's lungs are too damaged
to absorb oxygen
through the air,
so our hope is
that this treatment
helps oxygen penetrate
Cody's lungs
and restore his breathing.
- Have you done this before?
- Um...
- This procedure is performed
quite often with neonates.
We feel strongly
it's the best chance we have
at saving your son's life.
- Okay.
- Go ahead.
- Maggie, I'm gonna be out
of pocket for a little bit.
- For how long?
- Uh, three or four hours.
If anybody needs me,
just redirect them to Dr. Kwon.
- You got it.
- Daniel...
Where are you going?
- Robert Haywood still has
a storage locker
in Madison, Wisconsin
that he rented before
Olivia Coveny disappeared.
- Okay?
- Okay, so I'm going up there
to check it out.
- Come on, Daniel,
let the proper authorities
handle it.
- The proper authorities,
they're just not
that interested right now.
I have a limited window.
- Stop.
Look, I know you're trying
to protect Dr. Reese,
but no matter what you find,
you are really putting your
relationship with her at risk.
- Sharon, if there's
even a remote chance
that any of
this stuff is true--
and, trust me,
I don't want it to be--
it's a risk
I'm willing to take.
[solemn music]
♪
- Hear you might have
found a solution.
- Fingers crossed.
- Looks like it's all coming up
roses for you today.
- You two, join me.
- Yes, sir.
I mean, I'm still hoping it's
me who gets to do the surgery.
- No surprise there.
- If we move the two clamps
to the center of the bridge,
between the two atria,
that could solve our problem.
I'll let Dr. Frisch know
that we're ready
to run another simulation.
- Okay.
- Dr. Rhodes, Dr. Bekker,
they need you back in the ICU.
[tense music]
[machine beeping]
- What's going on?
- Her BP just
started plummeting.
- Bag her.
- What's going on
with my daughter?
- Uh, ma'am...
- She's hemorrhaging.
- Uh...all right.
All right, hang 2 units
of o-neg on a pressure bag.
Give me the ultrasound.
We need to check her fetus
and take a look
at her placenta.
♪
- Placenta's marginally
separating,
causing her to bleed.
- Fetal heart tones are strong.
We'll reverse
the blood thinners.
Hopefully, the placenta
will tamponade itself.
- If we reverse the thinners,
her new valve could clot off.
We'll lose mom and baby.
We have to get her to the O.R.
- Look, we can still save
this pregnancy.
- It's too late for that.
If we have any hope of
getting control of this bleed,
she needs an emergency
hysterectomy.
- Stop the heparin drip.
Bolus a gram of TXA.
We're not gonna lose
either of them.
♪
- [sighs]
He still hasn't woken up.
- No.
How well do you know Jeremy?
- Not that well.
I mean, just from around.
I had no idea
he was using heroin.
- I don't think that's
what Jeremy OD'd on.
- No?
- No.
Pretty sure it was Percocet,
which, coincidentally,
is the same drug
that went missing from
the dispensary last week.
- So?
[chuckles]
What, are you suggesting
that I took them?
- Did you?
- You know how easy it is
to score pharmaceuticals
on the street?
Jeremy could've gotten them
from anyone.
- But he was at the party
with you.
- Ethan, I swear,
I didn't take those drugs.
- So where'd you get the money
for the Louboutins?
- [scoffs]
Louboutins?
What do you even know
about Louboutins?
♪
She put you up to this,
didn't she?
Your uptight narc
of a girlfriend.
You know, all the two of you
have done since I moved in
is hover around, waiting for me
to make a mistake.
- That's not true.
- Yeah, all my life
it's been like this.
You know, I've had it.
- Emily...
- No, I'm not working
some place
that thinks I'm a criminal.
- Em--
Emily...
- Happy?
You got him all
to yourself now.
[solemn music]
♪
- How's she doing?
- She's passing an old clot,
but there's no more
active bleeding.
Placenta looks like
it tamponaded itself.
- Fetal heart tones are steady.
- [relieved sigh]
- We've got a problem.
Pressure's down.
- Heart rate's spiking.
She's clotting off that valve.
- We need to get her to
the O.R. and replace the valve.
Let's go, come on!
[tense music]
- What's happening?
♪
- Stop!
No pulse.
She must be in v-fib.
- Let's get a crash cart!
Come on.
Come on, Tracy.
Come on.
Stay with us.
- Charge to 200.
[paddles whir]
Clear!
[device trilling]
No pulse.
- Milligram of epi.
- Please save her! Please!
- Hold compressions.
- Come on.
- Clear!
♪
Still no pulse.
- Charge again.
Charge!
[paddles whirring]
♪
Clear!
[device trilling]
♪
Another milligram of epi.
- Connor...
she's gone.
♪
- Oh, God, no!
[sobbing]
No, no, no!
[sobbing]
No...
[somber music]
♪
- Time of death, 17:23.
♪
.
[soft, solemn music]
♪
- If you want, I can help
the mother with the paperwork.
- No.
This is my responsibility.
♪
Ms. Barker, I am so sorry
for your loss.
- You talked my daughter
into this,
and now she's gone forever.
You did this.
This is all your fault!
It's all your fault!
[sobbing]
♪
- Dr. Manning...
Cody's temp's back up to 103.7.
- What are his sats?
- 83%.
- 83?
He's getting worse.
Okay.
♪
- Hey, how's he doing?
- PLV's not working.
I made a huge mistake, Will.
- Natalie--
- No, I should've just
put him on ECMO,
but I got carried away,
and I might've just put
his life in jeopardy.
Why didn't I just
listen to you?
- Good thing you didn't.
You were right.
- What?
- Cody tested positive
for mastocytosis.
- [surprised chuckle]
- If you had put Cody on ECMO,
he could've gone into
anaphylactic shock.
♪
You may have just saved
his life.
- No, I haven't...
not yet.
♪
- Guess things got out of hand
last night.
- Yeah, you're lucky
Emily called us.
- According to your blood work,
you had a high concentration
of opioids in your system,
along with toxic levels
of acetaminophen.
- Most likely due
to the Percocet.
- Yeah.
- So where'd you get
those pills?
Do you have a prescription?
- No--
I mean...my dad does.
He had back surgery
a few weeks ago.
I swept some from
his medicine cabinet.
I feel like an idiot.
- Get some rest.
We'll check on you soon.
[disquieting music]
You think he's telling
the truth?
- No reason to doubt him.
When it comes to my sister, I'm
so used to assuming the worst.
I never should've accused her
of stealing those drugs.
Have Noah work up
Jeremy's discharge.
I need to find Emily,
make things right.
♪
- Dr. Manning?
- Yes?
[soft heartfelt music]
♪
- Cody's sats are
back above 90.
Looks like he's out
of the woods.
- Thank you for saving my boy.
- Of course.
♪
- I just found out myself.
Neurology's in there now,
doing a quick exam.
- You know what,
we did good today.
- Yeah, we did, didn't we?
- I mean, together.
♪
- Dr. Rhodes, good.
We're just about
to get started.
- You coming?
- Dr. Latham,
with your permission,
I would like to remove myself
from the team.
[solemn music]
♪
- Why?
- I think it would be best
for the patients
and for everyone involved.
A surgery with
this level of difficulty
and in that environment...
♪
I don't know that
I can trust my judgment.
- Are you sure about this?
- Yes.
- Mm.
Very well.
♪
- So, your dad had
back surgery?
- Yeah.
- Awfully convenient.
- Well, I told you,
that's where I got them.
- Mm-hmm.
According to your tox screen,
the Percocet you took
were hospital grade.
That means they
didn't come from
your dad's medicine cabinet.
♪
Possessing
a Schedule Two narcotic
with that level of potency
is a felony offense.
Now, I'm not gonna report you,
but I need you to tell me.
♪
- Emily.
She sold them to me.
♪
- Emily?
♪
Em?
♪
[suspenseful music]
♪
[knocking on door]
- What's up?
You want a rematch?
- [laughs]
I was just wondering,
are you still holding onto
Mom's wedding ring?
- Yeah, of course.
Why wouldn't I?
[soft hopeful music]
Oh...
♪
- Just trying not to be
a knucklehead.
- Okay, uh, well, come on in,
and I'll go get it.
♪
.
[dramatic music]
♪
[wolf howls]