Chicago Med (2015–…): Season 4, Episode 22 - With A Brave Heart - full transcript
- Hey.
- Thanks for coming.
Hospital food, I know.
But the French toast
is surprisingly good.
Not at all. Let's do it.
Okay. But first...
I have a little
something for you.
What are these?
Airline tickets to Honolulu.
For our wedding.
Where you wanted to go
first time around, remember?
But we couldn't afford it.
Danny, that is so sweet.
Thank you.
I don't know what to say.
How about, um, aloha?
Honolulu! Take that.
- Whoa.
- What?
What's this?
Um, Robin gave it to me.
I don't really need it
but you know...
it makes her happy
so I'm going to do it.
Come on, French toast.
Come on, Waikiki!
Finally you're going
to learn how to surf, right?
Remember you've just
had abdominal surgery
so be patient.
It takes a while to recover.
You need to be ambulatory.
Walk every day.
But don't push it.
Got it.
Great to see
you two back together.
I like to think it was
because of Bernie and me.
Whatever.
You know, when you go through
something like this,
makes you appreciate
everything you have.
Good friends, a wonderful
woman, a brand new baby.
Not to mention a wife
and teenage daughter.
- Ethan.
- I know, I know.
But we're working something out.
I promise I'm going to
take good care of your sister.
I look forward
to hearing your plans.
Connor...
I hope you know I did everything
I could for your father.
I do.
I'm here for you.
If there's...
If there's anything I can do.
Thank you.
Hey, Nina.
Are you doing
the autopsy on my dad?
Yes, um...
before I start, maybe you...
want some time with him?
Yeah, please. Thank you.
I hated you.
I blamed you for Mom's death.
I blamed you for...
so many things.
Maybe I was seeing it all wrong.
You weren't the best dad.
But maybe if I'd
been a better son...
you'd have been a better father.
Man, I...
I'm sorry.
Remember our cochlear implant
patient Peter Rush?
Yeah. Usher Syndrome.
Why, is he back?
Is his eyesight worse?
Yes, but that's
not why he's here.
It's his wife, Bonnie.
- This way.
- Okay.
Hello, Bonnie.
- Who's that?
- Dr. Manning.
- Sorry. I don't see too well.
- No need to apologize.
Congratulations
on your marriage.
So what seems to be the trouble?
She says she doesn't
need to be here.
There's nothing wrong with her.
I made her come.
Her heart doesn't sound right.
Doesn't sound right?
I had my head on her chest.
I heard it.
May I?
You heard right.
Sounds like a systolic murmur.
Do you ever feel dizzy
or out of breath?
Yes, you do.
Let's get her on the monitors.
Need a CBC, BMP, cardiac labs,
a D-Dimer, chest x-ray...
And a 12-lead EKG
and a cardiac echo.
Right.
She's saying sorry,
he was right.
We'll be back
when we get the results.
Dan.
I got a patient of yours,
Delmar Brendl.
Yeah, he won't let me
treat him unless
you're in the room.
- Hey, Del.
- Dr. Charles, I'm fine.
I really don't need to be here.
He was found at the bottom
of his stairs
at his apartment building.
- I didn't get hurt.
- But he couldn't get up.
The manager called
the paramedics.
Well, Del's been a patient
of mine for a couple years now.
I'm treating him for
generalized anxiety disorder,
panic attacks,
and making some real progress.
Mr. Brendl, why weren't you
able to get up?
I don't know.
My right leg is a little weak.
And my left. And my left arm.
- Anything else bothering you?
- You mean like the headaches?
Everybody gets headaches, right?
Do me a favor. Put your feet up.
Flex your foot like you're
stepping on the gas.
The other side.
Your left side's weaker.
Yeah, I know.
I told you that.
It's no big deal.
Monique, let's get a 12-lead
EKG, CT head, CTLS spine and...
No needles. I hate needles.
And cardiac labs.
You can totally do this, Del.
Gonna be over in a flash,
I promise you.
That really hurts!
I haven't done anything.
Here. Del, Del. Look at me.
Right here, all right.
Doing great.
In through the nose.
Out through the mouth.
Gonna be fine.
When we woke up,
I looked over and Henry
had this rash all over.
- Okay if I look in your mouth?
- Sure.
It's clear.
- Any trouble breathing?
- No.
Mr. Kupfer
puts out a star for Christmas.
Yes he does, Joanie.
Honey, give us a second.
We're talking to the doctor.
It's Alzheimer's.
Well, your rash... it's hives.
Pretty sure you're having
an allergic reaction.
To what?
He doesn't have any allergies.
People can develop them
at any age.
April, let's give Mr. Wilks
50 milligrams of Benadryl IV,
150 milligrams of Zantac IV.
Also, let's get a CBC and BMP
and send a UA for tox and EO's.
Standard blood
and urine tests. Fist.
Let's see if the antihistamines
get rid of your rash,
make you feel better.
I'm afraid your husband's going
to be here a few hours.
I'm not his wife.
Joanie's my wife.
- Am I sick?
- No, honey, you're fine.
It's Henry.
I'll check back in a little bit.
Excuse me.
- Dad.
- Hi, honey.
Hey, I need to talk to you.
Shoot.
Wedding in Hawaii?
Right.
Dad, do you really think
this is a good idea?
Honey, it's what your mom
always wanted.
- Yeah, I know but...
- Trust me.
She was delighted. Delighted.
Yeah, of course she was.
I mean, she wouldn't want
to disappoint you.
- What do you mean?
- Mom is thrilled
about the wedding, but...
she's not well.
She can't handle
a trip to Hawaii.
She's gonna have
a couple mai tais
and sleep the whole flight.
Then once we get there
she's not lifting a finger
'cause it's first class
all the way.
You have my word on that.
Charles.
Mr. Brendl's cardiac labs
came back negative.
But his head CT showed
a frontal mass with focal edema
and midline shift.
- A tumor?
- Very possibly.
Neurosurgery and Neurology
want a stat MRI.
I mean,
he's really claustrophobic.
The CT was bad enough,
now with all the banging?
He'll jump out of his skin.
Ingrid, got your text.
What is it?
I just got some news, Will.
Tim Burke... he's out of prison.
Already?
He only got a two-year sentence.
Model prisoner, no priors.
He's out on parole.
- Should I be worried?
- Will...
You are responsible
for his father
and his brother being
incarcerated.
This is hard for me to say,
but...
I think the safest thing
would be for you to relocate.
Out of state.
The purpose
of the Glenn procedure
is to improve
Sophie's oxygenation
and reduce pulmonary
artery pressure.
- Any questions?
- No.
The operation
is not without risk,
particularly in light
of Sophie's previous surgery.
Each time you open the chest,
it becomes more difficult.
We expect Sophie's adhesions
to be extensive.
But we're optimistic.
She's a strong little girl.
Okay, thank you.
Hey, you're doing great.
They're great surgeons, Phillip.
Sophie's in the very best hands.
You know, it might just be
because you're here, but um...
I just think that everything's
going to work out.
Yeah.
It's terrible!
God, that was terrible.
That was terrible.
The banging. God.
J-just get me out of here, man.
You did great.
Absolutely great.
Del, this is Dr. Abrams.
He is a neurosurgeon.
Best one in Chicago.
If not the entire United States.
- My mistake.
- S-surgeon?
Yeah, you have a tumor.
A frontoparietal
convexity meningioma.
- I have a tumor in my brain?
- That's where the weakness
is coming from. But Dr. Abrams
is pretty sure that it's benign.
- And operable.
- Okay.
Okay, just knock me out
and let's get it over with.
Here's the thing.
Because of the location
of the tumor,
it's going to have to be what
we call an awake procedure.
Awake?
Yeah, not the entire procedure.
You'll be anesthetized
but then at a certain point
we'll have to lower the sedation
so I can monitor
your motor functions.
So I'll just...
be lying there awake
with the top of my skull off?
- Yeah, more or less.
- I know it sounds extreme,
but it's actually
remarkably common.
No, forget it.
I-I'm not doing that.
Okay.
Um... wait here,
I'll be right back.
Sam!
Dan, he said no.
I'm not going to twist his arm.
I'll talk to him.
What? The guy's a terrible risk.
What if he flips out in surgery?
He could herniate.
If he does that,
I'll calm him down.
Really? I'd say you've done
a piss poor job of that so far.
Sam, come on.
If you don't operate,
that tumor's going to kill him.
All right, if you get him
to agree, page me.
- Looking for a job?
- No.
Just curious.
There's a lot of jobs
for E.D. docs out there,
you know?
Well, hey, nice to know
you're wanted, right?
Let's go.
Bonnie, Peter.
This is Dr. Latham, our chief
of cardiothoracic surgery.
He's made a diagnosis.
Your cardiac echo shows
a condition which is...
Why don't you let me sign?
With your permission, of course.
You know ASL?
I try to learn
a new language every year.
This year it's Hindi,
last year ASL.
It's an elegant language.
Correct me if I make a mistake.
Okay.
Your cardiac echo shows
a condition associated
with hearing loss.
Mitral valve prolapse.
Is it serious?
The leaflets
of your mitral valve
bulge when your heart
contracts, allowing
blood to leak back
into your atrium.
I can repair with minimally
invasive surgery.
She's asking if
she really needs it.
She doesn't feel that bad.
It's better to do it before
you feel really sick.
- There's less risk.
- Yeah.
And you're in danger
of getting endocarditis.
It's a heart infection.
He's asking if he can go ahead
and schedule the procedure.
- Mr. Wilks' test results.
- Wife's got Alzheimer's
but, hey, why should
that slow you down?
Go out, get another woman...
have her come live with you.
It's really nice, Ethan,
when we actually agree
on something.
Yeah.
Hey, Mr. Wilks.
How are you feeling?
- Better, thanks.
- I see your hives are fading.
And as I thought
your blood work is normal.
I do recommend
you see an allergist
to figure out what
you were sensitive to.
- I will.
- I will start your discharge.
While you're waiting,
I'll get Joanie a bite.
- Pick me up something too.
- Okay.
Come on, Joanie.
How about some scrambled eggs?
- Scrambled eggs!
- Yes!
Dr. Rhodes...
Sophie just went up
for a pre-op.
Good.
Yeah... can I ask you something?
You've known Natalie
for a while.
I mean, yeah, we've worked
together for a few years.
So...
what do you think?
Will she like it?
Um...
it's a very nice ring.
Yeah, right, well...
I'd only propose if
everything goes well.
- Right.
- Right. Um...
Thanks, man.
Will, I need you.
They're bringing in
Sydney Hawkins.
- Your kidney recipient?
- Yeah.
You're going to Baghdad.
Sydney Hawkins, mid-30s,
kidney transplant. GCS 15.
Sats at 95.
Complaining of flu-like
symptoms, edema,
and left lower quadrant
abdominal pain.
Maggie...
I'm sorry.
Sorry for what, Sydney?
I... I'm nothing but trouble.
No, you're not. Don't say that.
On my count. One, two, three!
Four liters nasal O2,
stat chest x-ray, CBC, BMP,
cyclospirine
and renal ultrasound.
Right.
Get a non-contrast
CT abdomen and pelvis.
Take a look
at her kidney as well.
She seems pretty uremic.
Sidney Hawkins.
Looks like she might
be rejecting my kidney.
Maggie, I'm so sorry.
Help, help! Henry can't breathe!
Somebody!
He was just eating
a sandwich and suddenly...
He's having
an allergic reaction.
I've got to look in your mouth.
All right, tongue's swollen.
He's got hives in his mouth.
- Epi?
- Yeah, .3 milligrams IM
and 125 of Solu-Medrol IV stat.
Let's get him on oxygen.
Another round of epi.
Sat's at 86. He's tripoding.
All right, he's in anaphylaxis.
I've got to intubate
before his airway closes.
20 of etomidate, 100 of sux.
I'm in.
Bag him.
89... they're coming up.
BP and heart rate are okay.
- He's stable.
- Thank God!
My God, whatwhatwhat
could've caused this?
- What did he eat?
- It was a roast beef sandwich.
Wait, where's Joanie?
Where is she?
Hey, did you see
a woman leave this room
just a minute ago?
Yes, she's headed outside.
Joanie!
My God!
Joanie!
Whoa, whoa, whoa, whoa, whoa!
Whoa, whoa, whoa!
Lots of cars.
Let's get you where it's safe.
Honey! Honey!
Honey.
- Are you okay?
- I'm okay.
Okay.
Connor.
Hey, Nina, what's up?
Your father didn't have
a history of diabetes, did he?
No, why?
He died from
an overdose of insulin.
Insulin.
That doesn't make any sense.
It was synthetic.
Someone in the hospital
gave it to him.
I have to label
his death suspicious.
So were they able to determine
your father's cause of death?
No, not yet.
Such a sudden arrhythmia.
I'd have to guess
it was a pulmonary embolism.
- Dr. Rhodes...
- She's bleeding. Suction.
Suction.
It's coming from
her right atrium.
The adhesions from the
sternum must've torn it open.
Dammit.
Let's do a sucker bypass.
Sats are down to 52.
11 blade and an aortic cannula.
And...
- I'm in.
- Sats are up to 76.
80...
Prolene stitch
for the SVC cannula.
Time to wake him up. You ready?
- Yes, sir.
- Lighten his sedation.
Maggie?
Sydney's scans came back.
There's a tumor on her kidney.
That's what's been causing
her kidney failure.
A tumor? Cancer?
It looks that way.
We'll know more
after the biopsy.
God, I gave her a bad kidney.
No, no, they examined
your kidney thoroughly.
There was no sign of a tumor.
Sydney clearly developed
it after her transplant.
As if her life
wasn't hard enough.
Well, let's hope they
get it all and she recovers.
Sydney?
Do you understand
what's happening?
They're trying to make me well.
That's right.
We're all just
trying to make you well.
Thank you.
Go ahead.
I've excised the misshapen
section of the valve.
I'm starting now to reconstruct.
Surgery's going well.
No surprises.
What were we thinking?
What's going on?
Bonnie and I,
we talked about having a baby.
So stupid.
Me going blind...
Bonnie with her heart...
- Her heart's going to be fine.
- But what next?
You know, Peter, none of us
get any guarantees in life.
We all just... face what comes.
I look at you and Bonnie
and I think you two do great.
I think you two can handle
almost anything.
Mr. Brendl, can you hear me?
- Who's that?
- That's Dr. Abrams.
You're in surgery, Del,
and it's going great.
I need to map different
pathways in your brain
so I'll be touching
certain areas
and asking you to respond
to my questions.
Count to five for me.
One.
Two.
So the top of my skull is off?
A portion of it, yes.
We talked about that, too.
Continue counting.
- My brain is just exposed?
- Del, you've got this.
Deep breaths, okay?
In through the nose...
Out through the mouth.
Three.
Four.
No, I want to stop.
Make him stop.
Del, it's okay.
You're doing great.
You got me into this.
Get me out?
- Stop squirming.
- No, no, no, no, no, no, no!
Del, look at me.
Right here, right here.
His breathing is too shallow.
He's retaining CO2.
- His brain's going to swell.
- Get me out, get me out!
Either you do something
or I'm going to re-sedate
and end this.
Please, please,
I can't stand it!
Okay, Del. I need you to tell
me, how are your feet?
Can you feel your feet?
I can't, I can't!
Dan!
Del, I'm touching
your right foot.
Can you feel me touching
your right foot?
Yeah, I can feel it.
Can we please stop?
Okay, great.
Now how about your knee?
I'm squeezing your right
kneecap, can you feel that?
- Yeah, I can feel it.
- So, so your feet,
your stomach, your legs,
your hands are all okay, right?
- I'm okay.
- Yeah.
You're doing really,
really well.
I mean, you're answering
my questions.
I think that that means that
maybe you can answer some of
Dr. Abrams' questions, too.
- What comes after three?
- After three...
After three...
You know this one.
- Four.
- You're so much stronger
than you think you are,
you know that?
What did FDR say?
Come on, we talk
about this all the time.
- Roosevelt.
- You have nothing to fear...
- But fear itself.
- That's right.
Raise your right index finger.
That's a lot of narrowing
in the right branch.
And the left as well.
We need a new plan.
There's no way to anastomose
to the trunk of the artery.
We need to attach
further up the right side.
But if we don't attach
to both sides,
she'll only oxygenate
half her blood.
It's a lot better than none.
She'll never sat above 75
for the rest of her life.
She'll be in heart failure
by the age of 30!
Which can be controlled
by medications.
- Connor...
- I won't let this girl die
because we tried to bite off
more than we can chew.
I know this is
a difficult time for you.
You've suffered a loss.
But I've seen you
do things in the OR
that I did not think possible.
This is not the time
to back away from a challenge.
All right.
Two anastomosis sets.
Let's move it.
- So what are you saying?
- We think it was
the roast beef sandwich
that you're allergic to.
That's what kicked off
the attack.
Roast beef?
I've eaten roast beef
my whole life.
I like roast beef.
Have you been
in the woods recently?
Woods? Yeah, I...
A month ago I went fishing
in Kentucky.
Any tick bites?
Yes, he called me and said
there were ticks everywhere.
A bite from the lone star
tick which is common in
the Southeast like Kentucky can
cause a sensitivity to meat.
You'll need to confirm
with an allergist,
but in the meantime it's best
that you stay away from meat.
God.
Mr. Wilks, we were very lucky
with your wife today.
Has this happened before?
She can wander off.
We have to keep an eye on her.
Yes, you do.
If you find you can't manage...
you know, there are facilities.
Joanie was in one. Nice place.
But she was depressed.
Missed her house,
Roxanne and me.
She's a lot happier now.
We missed her, too.
I know that look.
You don't approve
of how we live.
I doubt you have
any idea what it's like
to little by little lose
someone you care deeply about.
If it hadn't been for
Roxanne's love and support...
I could never
take care of Joanie.
It's not a perfect situation,
but it's the best we can do.
Excuse us.
You're gonna be okay.
Unusual arrangement
but seems to work.
I guess.
People can live
any way they want.
I'm glad to hear you say that.
- Emily called.
- Yeah?
She and Bernie have a plan.
They'd like to discuss it
with us over dinner.
What is this plan?
I'm going to let Emily tell you.
I informed Ms. Rush
that her surgery went well
and that I anticipate
that she'll only need
to spend another three days
in the hospital.
Dr. Halstead.
Mr. Rush asked me to tell you
that they've decided
they will try to have a baby.
A sheyne por.
A lovely couple.
Thank you for
asking me to consult.
- Thank you.
- Thank you.
A baby?
They didn't think
they could handle one.
Looks like they
changed their mind.
I guess when you've already
been through so much together...
Nothing much scares you.
Yeah.
Snip.
Time on pump?
Three hours 14.
Should we take her off bypass?
That should do it.
Pressure's good.
Normal rate and rhythm.
Sats are at 88.
She's going to make it.
Close, if you don't mind.
Not at all.
Hey.
What is it?
I've decided
I'm not going to relocate.
- Why?
- I'm tired of being afraid.
I don't want to run away.
I'd like to think that
you were staying because of me,
but that's not the reason,
is it?
Natalie?
My loss.
Be safe, okay?
I was able to completely
resect the tumor
and as I expected it's benign.
Dr. Charles, I couldn't
have done it without you.
Thank you.
I'm the one you should
be thanking, but so be it.
You should be proud of yourself.
The inspirational speech
you gave that nutcase?
The FDR quote?
That was a dreadful cliché,
but effective.
Yeah.
All right, Daniel, I'll bite.
What's the problem?
Well... um... fear.
I think I'm having
a really hard time
facing the fact that I'm going
to lose somebody that I love.
- And?
- And what?
Who doesn't have
a hard time with that?
Shrinks.
Have to make a meal
out of everything.
Hey, honey. It's Dad.
Um, I think I'm going to need
your help with something.
Emily, there's more blankets
for the guest room in
the hall closet and pillows.
A- Thanks.
Ethan. Do you want more chicken?
No, thanks.
Jamie, did you put out fresh
towels for Emily and your dad?
Mom...
Sorry, the bed's only a queen.
The king wouldn't fit.
It's okay.
I'm used to the couch.
You and Emily
should sleep together so
she can keep an eye on you.
Did you remember
to take your stool softener?
No, I didn't.
- I'll clear.
- Jamie can do that.
Honey, I'll take the baby.
No, sit. I'm fine.
Okay. I'll help him.
So... you're not judging, right?
No, no.
Hey, didn't I tell Emily
how happy I was for her?
Living together with Bernie's
wife and daughter?
I just couldn't tell
how sincere you were.
Okay.
This might actually
be the best solution.
Emily's always had trouble
with stability.
Bernie's family seems...
pretty stable.
Look, what can I say?
Everybody's happy.
So... why shouldn't I be?
- I have something to tell you.
- What?
I'm late.
- Late?
- My period.
Maggie.
They got the path results
back on Sydney.
The tumor is malignant. My God.
There is another issue.
Pathology says it's not
primary kidney cancer.
What do you mean?
The tumor is actually
breast cancer.
Metastatic breast cancer.
Sydney has breast cancer?
And it spread?
Actually...
shshe doesn't.
You're saying that I have
metastatic breast cancer?
When was the last time
you had a mammogram, Maggie?
Um, I don't know. I...
A while.
You're going
to have a mammogram.
Today. Now.
- Come on.
- No.
One second.
Maggie...
You don't have to worry, Sydney.
You're going to be okay.
Thank you.
Sharon, I can handle this.
Come on.
We did it.
We saved that little girl.
Yeah.
We're a great team.
Connor.
I'm so sorry about your father.
But...
now there's nothing
keeping us apart.
- What?
- He's gone, you're free.
- No, Ava...
- No, no, no, listen to me.
We can be together now.
I think that you and I
are way past that.
We're not.
We'll start over. We'll just...
Ava, stop!
Okay? We're finished.
That's it.
You ungrateful prick.
Rot in hell.
My goodness.
This is so beautiful. Thank you!
My goodness gracious.
Not quite Hawaii
but it's close, right?
Yeah.
My goodness, look who's here!
What are you guys doing here?
- Hi, Mom.
- My God!
- Congratulations, CeCe.
- Congratulations for what?
Mrs. C!
I am so happy to finally
be at your wedding.
Wedding? Now?
If you'd still have me.
Come on, then.
I'm like, my God.
My God.
- Carolyn, this is Keoni.
- Hi, Keoni.
- Welcome.
- Thank you.
In the Hawaiian language...
the Hawaiian for love is aloha.
You will share these leis.
Exchange them in
the spirit of your aloha.
Sophie should be able
to leave the hospital
in about a week or ten days.
And after that
she'll begin to thrive.
Hit her milestones...
Crawling, walking, growing.
Natalie...
You've helped me so much
through a very difficult time.
I'm glad I could.
There's something
I wanted to ask you.
Dr. Manning, can I?
- Will you give me a second?
- Yeah.
- What is it?
- Tim Burke's out of prison.
And I advised Will
to relocate, but he won't...
Because of you.
He loves you.
He is brave... and devoted...
and you will never
find another guy like him.
You would be a fool
not to take him back.
Natalie. What are you...
Agent Lee told me
what was going on.
Will. I am so sorry.
Whoa.
Natalie!
I got you.
Natalie.
No!
Natalie...
Natalie, come on. Wake up.
- Thanks for coming.
Hospital food, I know.
But the French toast
is surprisingly good.
Not at all. Let's do it.
Okay. But first...
I have a little
something for you.
What are these?
Airline tickets to Honolulu.
For our wedding.
Where you wanted to go
first time around, remember?
But we couldn't afford it.
Danny, that is so sweet.
Thank you.
I don't know what to say.
How about, um, aloha?
Honolulu! Take that.
- Whoa.
- What?
What's this?
Um, Robin gave it to me.
I don't really need it
but you know...
it makes her happy
so I'm going to do it.
Come on, French toast.
Come on, Waikiki!
Finally you're going
to learn how to surf, right?
Remember you've just
had abdominal surgery
so be patient.
It takes a while to recover.
You need to be ambulatory.
Walk every day.
But don't push it.
Got it.
Great to see
you two back together.
I like to think it was
because of Bernie and me.
Whatever.
You know, when you go through
something like this,
makes you appreciate
everything you have.
Good friends, a wonderful
woman, a brand new baby.
Not to mention a wife
and teenage daughter.
- Ethan.
- I know, I know.
But we're working something out.
I promise I'm going to
take good care of your sister.
I look forward
to hearing your plans.
Connor...
I hope you know I did everything
I could for your father.
I do.
I'm here for you.
If there's...
If there's anything I can do.
Thank you.
Hey, Nina.
Are you doing
the autopsy on my dad?
Yes, um...
before I start, maybe you...
want some time with him?
Yeah, please. Thank you.
I hated you.
I blamed you for Mom's death.
I blamed you for...
so many things.
Maybe I was seeing it all wrong.
You weren't the best dad.
But maybe if I'd
been a better son...
you'd have been a better father.
Man, I...
I'm sorry.
Remember our cochlear implant
patient Peter Rush?
Yeah. Usher Syndrome.
Why, is he back?
Is his eyesight worse?
Yes, but that's
not why he's here.
It's his wife, Bonnie.
- This way.
- Okay.
Hello, Bonnie.
- Who's that?
- Dr. Manning.
- Sorry. I don't see too well.
- No need to apologize.
Congratulations
on your marriage.
So what seems to be the trouble?
She says she doesn't
need to be here.
There's nothing wrong with her.
I made her come.
Her heart doesn't sound right.
Doesn't sound right?
I had my head on her chest.
I heard it.
May I?
You heard right.
Sounds like a systolic murmur.
Do you ever feel dizzy
or out of breath?
Yes, you do.
Let's get her on the monitors.
Need a CBC, BMP, cardiac labs,
a D-Dimer, chest x-ray...
And a 12-lead EKG
and a cardiac echo.
Right.
She's saying sorry,
he was right.
We'll be back
when we get the results.
Dan.
I got a patient of yours,
Delmar Brendl.
Yeah, he won't let me
treat him unless
you're in the room.
- Hey, Del.
- Dr. Charles, I'm fine.
I really don't need to be here.
He was found at the bottom
of his stairs
at his apartment building.
- I didn't get hurt.
- But he couldn't get up.
The manager called
the paramedics.
Well, Del's been a patient
of mine for a couple years now.
I'm treating him for
generalized anxiety disorder,
panic attacks,
and making some real progress.
Mr. Brendl, why weren't you
able to get up?
I don't know.
My right leg is a little weak.
And my left. And my left arm.
- Anything else bothering you?
- You mean like the headaches?
Everybody gets headaches, right?
Do me a favor. Put your feet up.
Flex your foot like you're
stepping on the gas.
The other side.
Your left side's weaker.
Yeah, I know.
I told you that.
It's no big deal.
Monique, let's get a 12-lead
EKG, CT head, CTLS spine and...
No needles. I hate needles.
And cardiac labs.
You can totally do this, Del.
Gonna be over in a flash,
I promise you.
That really hurts!
I haven't done anything.
Here. Del, Del. Look at me.
Right here, all right.
Doing great.
In through the nose.
Out through the mouth.
Gonna be fine.
When we woke up,
I looked over and Henry
had this rash all over.
- Okay if I look in your mouth?
- Sure.
It's clear.
- Any trouble breathing?
- No.
Mr. Kupfer
puts out a star for Christmas.
Yes he does, Joanie.
Honey, give us a second.
We're talking to the doctor.
It's Alzheimer's.
Well, your rash... it's hives.
Pretty sure you're having
an allergic reaction.
To what?
He doesn't have any allergies.
People can develop them
at any age.
April, let's give Mr. Wilks
50 milligrams of Benadryl IV,
150 milligrams of Zantac IV.
Also, let's get a CBC and BMP
and send a UA for tox and EO's.
Standard blood
and urine tests. Fist.
Let's see if the antihistamines
get rid of your rash,
make you feel better.
I'm afraid your husband's going
to be here a few hours.
I'm not his wife.
Joanie's my wife.
- Am I sick?
- No, honey, you're fine.
It's Henry.
I'll check back in a little bit.
Excuse me.
- Dad.
- Hi, honey.
Hey, I need to talk to you.
Shoot.
Wedding in Hawaii?
Right.
Dad, do you really think
this is a good idea?
Honey, it's what your mom
always wanted.
- Yeah, I know but...
- Trust me.
She was delighted. Delighted.
Yeah, of course she was.
I mean, she wouldn't want
to disappoint you.
- What do you mean?
- Mom is thrilled
about the wedding, but...
she's not well.
She can't handle
a trip to Hawaii.
She's gonna have
a couple mai tais
and sleep the whole flight.
Then once we get there
she's not lifting a finger
'cause it's first class
all the way.
You have my word on that.
Charles.
Mr. Brendl's cardiac labs
came back negative.
But his head CT showed
a frontal mass with focal edema
and midline shift.
- A tumor?
- Very possibly.
Neurosurgery and Neurology
want a stat MRI.
I mean,
he's really claustrophobic.
The CT was bad enough,
now with all the banging?
He'll jump out of his skin.
Ingrid, got your text.
What is it?
I just got some news, Will.
Tim Burke... he's out of prison.
Already?
He only got a two-year sentence.
Model prisoner, no priors.
He's out on parole.
- Should I be worried?
- Will...
You are responsible
for his father
and his brother being
incarcerated.
This is hard for me to say,
but...
I think the safest thing
would be for you to relocate.
Out of state.
The purpose
of the Glenn procedure
is to improve
Sophie's oxygenation
and reduce pulmonary
artery pressure.
- Any questions?
- No.
The operation
is not without risk,
particularly in light
of Sophie's previous surgery.
Each time you open the chest,
it becomes more difficult.
We expect Sophie's adhesions
to be extensive.
But we're optimistic.
She's a strong little girl.
Okay, thank you.
Hey, you're doing great.
They're great surgeons, Phillip.
Sophie's in the very best hands.
You know, it might just be
because you're here, but um...
I just think that everything's
going to work out.
Yeah.
It's terrible!
God, that was terrible.
That was terrible.
The banging. God.
J-just get me out of here, man.
You did great.
Absolutely great.
Del, this is Dr. Abrams.
He is a neurosurgeon.
Best one in Chicago.
If not the entire United States.
- My mistake.
- S-surgeon?
Yeah, you have a tumor.
A frontoparietal
convexity meningioma.
- I have a tumor in my brain?
- That's where the weakness
is coming from. But Dr. Abrams
is pretty sure that it's benign.
- And operable.
- Okay.
Okay, just knock me out
and let's get it over with.
Here's the thing.
Because of the location
of the tumor,
it's going to have to be what
we call an awake procedure.
Awake?
Yeah, not the entire procedure.
You'll be anesthetized
but then at a certain point
we'll have to lower the sedation
so I can monitor
your motor functions.
So I'll just...
be lying there awake
with the top of my skull off?
- Yeah, more or less.
- I know it sounds extreme,
but it's actually
remarkably common.
No, forget it.
I-I'm not doing that.
Okay.
Um... wait here,
I'll be right back.
Sam!
Dan, he said no.
I'm not going to twist his arm.
I'll talk to him.
What? The guy's a terrible risk.
What if he flips out in surgery?
He could herniate.
If he does that,
I'll calm him down.
Really? I'd say you've done
a piss poor job of that so far.
Sam, come on.
If you don't operate,
that tumor's going to kill him.
All right, if you get him
to agree, page me.
- Looking for a job?
- No.
Just curious.
There's a lot of jobs
for E.D. docs out there,
you know?
Well, hey, nice to know
you're wanted, right?
Let's go.
Bonnie, Peter.
This is Dr. Latham, our chief
of cardiothoracic surgery.
He's made a diagnosis.
Your cardiac echo shows
a condition which is...
Why don't you let me sign?
With your permission, of course.
You know ASL?
I try to learn
a new language every year.
This year it's Hindi,
last year ASL.
It's an elegant language.
Correct me if I make a mistake.
Okay.
Your cardiac echo shows
a condition associated
with hearing loss.
Mitral valve prolapse.
Is it serious?
The leaflets
of your mitral valve
bulge when your heart
contracts, allowing
blood to leak back
into your atrium.
I can repair with minimally
invasive surgery.
She's asking if
she really needs it.
She doesn't feel that bad.
It's better to do it before
you feel really sick.
- There's less risk.
- Yeah.
And you're in danger
of getting endocarditis.
It's a heart infection.
He's asking if he can go ahead
and schedule the procedure.
- Mr. Wilks' test results.
- Wife's got Alzheimer's
but, hey, why should
that slow you down?
Go out, get another woman...
have her come live with you.
It's really nice, Ethan,
when we actually agree
on something.
Yeah.
Hey, Mr. Wilks.
How are you feeling?
- Better, thanks.
- I see your hives are fading.
And as I thought
your blood work is normal.
I do recommend
you see an allergist
to figure out what
you were sensitive to.
- I will.
- I will start your discharge.
While you're waiting,
I'll get Joanie a bite.
- Pick me up something too.
- Okay.
Come on, Joanie.
How about some scrambled eggs?
- Scrambled eggs!
- Yes!
Dr. Rhodes...
Sophie just went up
for a pre-op.
Good.
Yeah... can I ask you something?
You've known Natalie
for a while.
I mean, yeah, we've worked
together for a few years.
So...
what do you think?
Will she like it?
Um...
it's a very nice ring.
Yeah, right, well...
I'd only propose if
everything goes well.
- Right.
- Right. Um...
Thanks, man.
Will, I need you.
They're bringing in
Sydney Hawkins.
- Your kidney recipient?
- Yeah.
You're going to Baghdad.
Sydney Hawkins, mid-30s,
kidney transplant. GCS 15.
Sats at 95.
Complaining of flu-like
symptoms, edema,
and left lower quadrant
abdominal pain.
Maggie...
I'm sorry.
Sorry for what, Sydney?
I... I'm nothing but trouble.
No, you're not. Don't say that.
On my count. One, two, three!
Four liters nasal O2,
stat chest x-ray, CBC, BMP,
cyclospirine
and renal ultrasound.
Right.
Get a non-contrast
CT abdomen and pelvis.
Take a look
at her kidney as well.
She seems pretty uremic.
Sidney Hawkins.
Looks like she might
be rejecting my kidney.
Maggie, I'm so sorry.
Help, help! Henry can't breathe!
Somebody!
He was just eating
a sandwich and suddenly...
He's having
an allergic reaction.
I've got to look in your mouth.
All right, tongue's swollen.
He's got hives in his mouth.
- Epi?
- Yeah, .3 milligrams IM
and 125 of Solu-Medrol IV stat.
Let's get him on oxygen.
Another round of epi.
Sat's at 86. He's tripoding.
All right, he's in anaphylaxis.
I've got to intubate
before his airway closes.
20 of etomidate, 100 of sux.
I'm in.
Bag him.
89... they're coming up.
BP and heart rate are okay.
- He's stable.
- Thank God!
My God, whatwhatwhat
could've caused this?
- What did he eat?
- It was a roast beef sandwich.
Wait, where's Joanie?
Where is she?
Hey, did you see
a woman leave this room
just a minute ago?
Yes, she's headed outside.
Joanie!
My God!
Joanie!
Whoa, whoa, whoa, whoa, whoa!
Whoa, whoa, whoa!
Lots of cars.
Let's get you where it's safe.
Honey! Honey!
Honey.
- Are you okay?
- I'm okay.
Okay.
Connor.
Hey, Nina, what's up?
Your father didn't have
a history of diabetes, did he?
No, why?
He died from
an overdose of insulin.
Insulin.
That doesn't make any sense.
It was synthetic.
Someone in the hospital
gave it to him.
I have to label
his death suspicious.
So were they able to determine
your father's cause of death?
No, not yet.
Such a sudden arrhythmia.
I'd have to guess
it was a pulmonary embolism.
- Dr. Rhodes...
- She's bleeding. Suction.
Suction.
It's coming from
her right atrium.
The adhesions from the
sternum must've torn it open.
Dammit.
Let's do a sucker bypass.
Sats are down to 52.
11 blade and an aortic cannula.
And...
- I'm in.
- Sats are up to 76.
80...
Prolene stitch
for the SVC cannula.
Time to wake him up. You ready?
- Yes, sir.
- Lighten his sedation.
Maggie?
Sydney's scans came back.
There's a tumor on her kidney.
That's what's been causing
her kidney failure.
A tumor? Cancer?
It looks that way.
We'll know more
after the biopsy.
God, I gave her a bad kidney.
No, no, they examined
your kidney thoroughly.
There was no sign of a tumor.
Sydney clearly developed
it after her transplant.
As if her life
wasn't hard enough.
Well, let's hope they
get it all and she recovers.
Sydney?
Do you understand
what's happening?
They're trying to make me well.
That's right.
We're all just
trying to make you well.
Thank you.
Go ahead.
I've excised the misshapen
section of the valve.
I'm starting now to reconstruct.
Surgery's going well.
No surprises.
What were we thinking?
What's going on?
Bonnie and I,
we talked about having a baby.
So stupid.
Me going blind...
Bonnie with her heart...
- Her heart's going to be fine.
- But what next?
You know, Peter, none of us
get any guarantees in life.
We all just... face what comes.
I look at you and Bonnie
and I think you two do great.
I think you two can handle
almost anything.
Mr. Brendl, can you hear me?
- Who's that?
- That's Dr. Abrams.
You're in surgery, Del,
and it's going great.
I need to map different
pathways in your brain
so I'll be touching
certain areas
and asking you to respond
to my questions.
Count to five for me.
One.
Two.
So the top of my skull is off?
A portion of it, yes.
We talked about that, too.
Continue counting.
- My brain is just exposed?
- Del, you've got this.
Deep breaths, okay?
In through the nose...
Out through the mouth.
Three.
Four.
No, I want to stop.
Make him stop.
Del, it's okay.
You're doing great.
You got me into this.
Get me out?
- Stop squirming.
- No, no, no, no, no, no, no!
Del, look at me.
Right here, right here.
His breathing is too shallow.
He's retaining CO2.
- His brain's going to swell.
- Get me out, get me out!
Either you do something
or I'm going to re-sedate
and end this.
Please, please,
I can't stand it!
Okay, Del. I need you to tell
me, how are your feet?
Can you feel your feet?
I can't, I can't!
Dan!
Del, I'm touching
your right foot.
Can you feel me touching
your right foot?
Yeah, I can feel it.
Can we please stop?
Okay, great.
Now how about your knee?
I'm squeezing your right
kneecap, can you feel that?
- Yeah, I can feel it.
- So, so your feet,
your stomach, your legs,
your hands are all okay, right?
- I'm okay.
- Yeah.
You're doing really,
really well.
I mean, you're answering
my questions.
I think that that means that
maybe you can answer some of
Dr. Abrams' questions, too.
- What comes after three?
- After three...
After three...
You know this one.
- Four.
- You're so much stronger
than you think you are,
you know that?
What did FDR say?
Come on, we talk
about this all the time.
- Roosevelt.
- You have nothing to fear...
- But fear itself.
- That's right.
Raise your right index finger.
That's a lot of narrowing
in the right branch.
And the left as well.
We need a new plan.
There's no way to anastomose
to the trunk of the artery.
We need to attach
further up the right side.
But if we don't attach
to both sides,
she'll only oxygenate
half her blood.
It's a lot better than none.
She'll never sat above 75
for the rest of her life.
She'll be in heart failure
by the age of 30!
Which can be controlled
by medications.
- Connor...
- I won't let this girl die
because we tried to bite off
more than we can chew.
I know this is
a difficult time for you.
You've suffered a loss.
But I've seen you
do things in the OR
that I did not think possible.
This is not the time
to back away from a challenge.
All right.
Two anastomosis sets.
Let's move it.
- So what are you saying?
- We think it was
the roast beef sandwich
that you're allergic to.
That's what kicked off
the attack.
Roast beef?
I've eaten roast beef
my whole life.
I like roast beef.
Have you been
in the woods recently?
Woods? Yeah, I...
A month ago I went fishing
in Kentucky.
Any tick bites?
Yes, he called me and said
there were ticks everywhere.
A bite from the lone star
tick which is common in
the Southeast like Kentucky can
cause a sensitivity to meat.
You'll need to confirm
with an allergist,
but in the meantime it's best
that you stay away from meat.
God.
Mr. Wilks, we were very lucky
with your wife today.
Has this happened before?
She can wander off.
We have to keep an eye on her.
Yes, you do.
If you find you can't manage...
you know, there are facilities.
Joanie was in one. Nice place.
But she was depressed.
Missed her house,
Roxanne and me.
She's a lot happier now.
We missed her, too.
I know that look.
You don't approve
of how we live.
I doubt you have
any idea what it's like
to little by little lose
someone you care deeply about.
If it hadn't been for
Roxanne's love and support...
I could never
take care of Joanie.
It's not a perfect situation,
but it's the best we can do.
Excuse us.
You're gonna be okay.
Unusual arrangement
but seems to work.
I guess.
People can live
any way they want.
I'm glad to hear you say that.
- Emily called.
- Yeah?
She and Bernie have a plan.
They'd like to discuss it
with us over dinner.
What is this plan?
I'm going to let Emily tell you.
I informed Ms. Rush
that her surgery went well
and that I anticipate
that she'll only need
to spend another three days
in the hospital.
Dr. Halstead.
Mr. Rush asked me to tell you
that they've decided
they will try to have a baby.
A sheyne por.
A lovely couple.
Thank you for
asking me to consult.
- Thank you.
- Thank you.
A baby?
They didn't think
they could handle one.
Looks like they
changed their mind.
I guess when you've already
been through so much together...
Nothing much scares you.
Yeah.
Snip.
Time on pump?
Three hours 14.
Should we take her off bypass?
That should do it.
Pressure's good.
Normal rate and rhythm.
Sats are at 88.
She's going to make it.
Close, if you don't mind.
Not at all.
Hey.
What is it?
I've decided
I'm not going to relocate.
- Why?
- I'm tired of being afraid.
I don't want to run away.
I'd like to think that
you were staying because of me,
but that's not the reason,
is it?
Natalie?
My loss.
Be safe, okay?
I was able to completely
resect the tumor
and as I expected it's benign.
Dr. Charles, I couldn't
have done it without you.
Thank you.
I'm the one you should
be thanking, but so be it.
You should be proud of yourself.
The inspirational speech
you gave that nutcase?
The FDR quote?
That was a dreadful cliché,
but effective.
Yeah.
All right, Daniel, I'll bite.
What's the problem?
Well... um... fear.
I think I'm having
a really hard time
facing the fact that I'm going
to lose somebody that I love.
- And?
- And what?
Who doesn't have
a hard time with that?
Shrinks.
Have to make a meal
out of everything.
Hey, honey. It's Dad.
Um, I think I'm going to need
your help with something.
Emily, there's more blankets
for the guest room in
the hall closet and pillows.
A- Thanks.
Ethan. Do you want more chicken?
No, thanks.
Jamie, did you put out fresh
towels for Emily and your dad?
Mom...
Sorry, the bed's only a queen.
The king wouldn't fit.
It's okay.
I'm used to the couch.
You and Emily
should sleep together so
she can keep an eye on you.
Did you remember
to take your stool softener?
No, I didn't.
- I'll clear.
- Jamie can do that.
Honey, I'll take the baby.
No, sit. I'm fine.
Okay. I'll help him.
So... you're not judging, right?
No, no.
Hey, didn't I tell Emily
how happy I was for her?
Living together with Bernie's
wife and daughter?
I just couldn't tell
how sincere you were.
Okay.
This might actually
be the best solution.
Emily's always had trouble
with stability.
Bernie's family seems...
pretty stable.
Look, what can I say?
Everybody's happy.
So... why shouldn't I be?
- I have something to tell you.
- What?
I'm late.
- Late?
- My period.
Maggie.
They got the path results
back on Sydney.
The tumor is malignant. My God.
There is another issue.
Pathology says it's not
primary kidney cancer.
What do you mean?
The tumor is actually
breast cancer.
Metastatic breast cancer.
Sydney has breast cancer?
And it spread?
Actually...
shshe doesn't.
You're saying that I have
metastatic breast cancer?
When was the last time
you had a mammogram, Maggie?
Um, I don't know. I...
A while.
You're going
to have a mammogram.
Today. Now.
- Come on.
- No.
One second.
Maggie...
You don't have to worry, Sydney.
You're going to be okay.
Thank you.
Sharon, I can handle this.
Come on.
We did it.
We saved that little girl.
Yeah.
We're a great team.
Connor.
I'm so sorry about your father.
But...
now there's nothing
keeping us apart.
- What?
- He's gone, you're free.
- No, Ava...
- No, no, no, listen to me.
We can be together now.
I think that you and I
are way past that.
We're not.
We'll start over. We'll just...
Ava, stop!
Okay? We're finished.
That's it.
You ungrateful prick.
Rot in hell.
My goodness.
This is so beautiful. Thank you!
My goodness gracious.
Not quite Hawaii
but it's close, right?
Yeah.
My goodness, look who's here!
What are you guys doing here?
- Hi, Mom.
- My God!
- Congratulations, CeCe.
- Congratulations for what?
Mrs. C!
I am so happy to finally
be at your wedding.
Wedding? Now?
If you'd still have me.
Come on, then.
I'm like, my God.
My God.
- Carolyn, this is Keoni.
- Hi, Keoni.
- Welcome.
- Thank you.
In the Hawaiian language...
the Hawaiian for love is aloha.
You will share these leis.
Exchange them in
the spirit of your aloha.
Sophie should be able
to leave the hospital
in about a week or ten days.
And after that
she'll begin to thrive.
Hit her milestones...
Crawling, walking, growing.
Natalie...
You've helped me so much
through a very difficult time.
I'm glad I could.
There's something
I wanted to ask you.
Dr. Manning, can I?
- Will you give me a second?
- Yeah.
- What is it?
- Tim Burke's out of prison.
And I advised Will
to relocate, but he won't...
Because of you.
He loves you.
He is brave... and devoted...
and you will never
find another guy like him.
You would be a fool
not to take him back.
Natalie. What are you...
Agent Lee told me
what was going on.
Will. I am so sorry.
Whoa.
Natalie!
I got you.
Natalie.
No!
Natalie...
Natalie, come on. Wake up.