Chicago Med (2015–…): Season 4, Episode 4 - Backed Against the Wall - full transcript
The CPD pays Dr. Halstead an unexpected visit; Ethan is skeptical of a woman experiencing chronic pain; Natalie takes care of a cancer patient whose brother refuses to help.
.
[upbeat music]
♪
- Good workout?
- Bring on the day.
- Me too.
- Come on, what are you eating?
- Peanut butter-banana-bacon
sandwich.
Delicious.
Elvis was on to something.
- I get it, you crave calories.
But I told you, healthy ones
are best for the baby.
- I know--that's why I
doubled up on the bananas.
Anyway, just came in to say,
I give up.
You've been nagging
me to meet Bernie.
He's been all over
me to meet you,
so let's just get it over with.
- I can meet
tonight after work.
Molly's?
- Or before work?
Maybe in, like, an hour?
Hospital café?
Bernie's got a tight schedule.
- You know what?
I want to meet Bernie
more than
I want to argue with you.
So fine.
I'll be there.
- Thank you.
He's a really good guy,
Ethan.
I love him.
You will, too.
- [sighs]
- Linda Harper,
28-year-old female, GCS 12,
diaphoretic, and very confused.
BP 100 over 76.
Heart rate 120.
Normal sinus rhythm EKG.
Dad said Mom's been fighting
a cold the last few weeks.
Today she was holding
the baby and passed out.
Landed on him.
- Okay.
- It's okay, little man.
Dad's right here.
Everything's gonna be
all right.
- Evan Harper,
18-month-old male,
gross deformity of the right
arm, splinted in the field,
no other apparent injuries,
.10 morphine en route.
- Okay, his arm needs to
be reduced and casted.
Let's do it in
special procedures.
- Wait, you're taking him away?
- We need to set his fracture.
He's only a toddler.
It's safer to do it upstairs.
- But my wife's staying here.
- Go be with your son.
We'll take really good
care of your wife.
- James, where are you?
- Linda, I'm right here.
I'm right here.
I've gotta go be with Evan.
I'll be back as soon as I can.
Will you call her brother
Manny?
I don't want her to be alone.
- Yeah.
- I'll get the number,
get him down here.
- Thank you.
All right, let's get a CBC,
CMP, COAGS,
cardiac labs,
and let's start a 12 Lead EKG.
- Whoa, Dr. Manning.
- Oh, my God.
[dramatic music]
♪
.
Your patient's brother is here,
Manny Calderon.
- Ah, thank you, Leah.
Mr. Calderon?
- [speaking Spanish]
- Hi, I'm Dr. Manning.
I've been treating your sister,
Linda.
- Is she okay?
The nurse said she fell.
- She passed out.
We're trying to figure out why.
- What about the baby, Evan?
- He has a broken arm,
but he's going to be okay.
James is with him, and until
he comes back, Linda said
I can share with you
what I've learned so far.
Come on,
I'll take you back to her.
So, Linda's upper body
is covered in bruises.
There's also petechiae--the
small capillaries of her skin
are inflamed and bleeding.
I think it's all
a result of something
happening inside her body.
- She has more
than a cold then.
- Until I know more,
I don't want to speculate.
Here, she's in here.
- [exhales]
Manny.
[speaking Spanish]
- [speaking Spanish]
Okay?
- Great. Emily asked
you to be the buffer
for the Bernie introduction,
didn't she?
- She's nervous.
She wants you to like him.
Or at least not scare him.
- Right, because I'm
the problem in this.
- Just try to
have an open mind.
Hey, Emily.
- Ethan, this is my
boyfriend Bernard Kim.
- Call me Bernie.
- Nice to meet you.
- Honey, this is April.
- Oh, April, it's
lovely to meet you.
- Oh, okay, we're hugging.
- Emily and I are just--
we're just so touched
by how supportive
you've been and--thank you.
- It's my pleasure.
- So, why don't
we grab a table?
Keep things moving?
Babe?
- Yeah.
- Oh, you're not coming?
- Greetings are done.
Nobody ran.
You don't need me anymore.
[edgy music]
♪
- Look, I am not bragging when
I say that this hybrid O.R.
could revolutionize
trauma surgery's interaction
with emergency medicine.
It's set up for interventional
and open procedures.
We've got surgical lights,
we've got a C-arm, case carts.
There is a scrub
room right outside.
Okay, maybe I'm bragging
just a little bit.
[light laughter]
- Doctor, can I get
a shot of you in front of
the operating table?
- Yeah, sure.
- All right,
thank you, everybody.
The hospital's PR department
will forward you
complete press kits.
- Thank you.
- So, I'm going to bring
the "Trib" through in five
and then the local
NBC affiliate after that.
- I'll be ready.
- I really appreciate
your putting on the charm.
- Mrs. Goodwin,
you built me Xanadu.
I would sing and dance
for you if you wanted.
- Oh, I'm gonna
hold you to that.
[both laugh]
- Oh, my God,
it's Doctor Connor Rhodes.
Can I have your autograph?
- You're gonna
have to get in line.
I'm kind of a big
deal around here.
- [scoffs]
I've gotta admit,
this is an impressive space.
- Yeah.
Feels right.
Look, um...now that I am
officially open for business,
it's pretty easy to see
how jumping the gun
last week was a mistake.
I'm sorry.
Are we good?
- We're good.
[phone buzzes]
It's Latham.
I've gotta go.
Congratulations, Connor.
- Thank you.
- Hey, you could
have told me
Bernie's old enough
to be my dad.
- First, that's
an exaggeration.
Second, I didn't know.
It's just a number, right?
Does it really matter?
- No, not if Emily
acted like an adult
instead of a 12-year-old.
- You mean like how
you're acting right now?
- April, every boyfriend
my sister's had
has been a train wreck.
You really think Bernie,
who she met in AA,
who's 20 years older,
is gonna be different?
- Well, I mean, she does, so
you have to give him a chance.
- I wanted to, but then I
walked into the cafeteria
and I saw the same red flags.
April, I know how this ends.
He splits, she folds, and I'm
left to pick up the pieces.
- Let's just hope this time
you're wrong, okay?
Look, I've gotta get on
transport right now.
Let's pick this up later.
- The OTCs did nothing.
Urgent care prescribed
Zofran and Immodium.
Been taking them for
over a week, but--
Oh, it's so embarrassing.
- It's okay, I get it.
Both ends?
- I haven't eaten in days.
Where is it all coming from?
- Likely viral gastroenteritis.
- Urgent care said the same
thing, but I've been like this
almost a month,
and it's not even flu season.
- Unfortunately, there's often
an exception to the rule,
and this time it's you.
Tests?
- CBC, CMP, quantitative HCG.
- Oh, that hurts.
- CT abdomen and pelvis,
got it.
- Techs will be by soon
to take you for your scan.
- The sooner the better.
I really feel like crap.
- No pun intended, right?
- Ms. Blake, I'm Dr. Choi.
- Oh, thank God.
Finally, a real doctor.
- 44-year-old female,
complaints of lumbago.
Pain 10 out of 10.
HPI symptoms--
- The important info--
I was getting
dressed for work,
bent down to put on my shoes,
and my back locked up.
- Well, why don't
we take a look?
Is it okay if student doctor
McNeal examines you?
- Have you done this before?
Oh, wonderful.
- I'll be gentle.
- Guess you can't make
the pain any worse.
Ow.
Ah.
Laid on the floor for an hour
hoping the pain would ease up.
Nothing.
Oh...mm...
- I see a surgical scar.
- Discectomy?
- L4. Two years ago.
Felt pretty good right after,
but these days
it feels like a bad sneeze
could paralyze me.
- Unfortunately,
as common as back pain is,
there's not a perfect fix.
- Slow, slow.
- Press against my
hand like a gas pedal.
- It hurts.
Stabbing pain.
We have to do the other leg?
It's gonna hurt, too.
So will flexion, extension,
the femoral stretch,
FABER test.
- Been down
this road a few times?
- Today's the worst
it's ever been, though.
- What would you suggest?
- CT?
Five of Valium for the spasm?
- Oh, bless you.
[sighs]
Ohh...
- She got on you a bit.
Patients are going to do that.
Don't take it personally.
- It's all good.
When I was playing ball,
I had an OC could rip me
a new one like no other.
Compared to him,
Nora's a peach.
- Hey, Doc.
- Hey.
- Got a sec?
- Yeah, what's up?
- Not here.
[tense music]
♪
Here's the deal.
Your voice on Ray Burke's
wire is a problem.
- Yeah, Jay told me.
I'm sorry.
I didn't know PD had
something going on with him.
- Well, it's not just PD.
Feds are in on this too.
It's a joint task force.
Listen.
I just came to
give you the heads-up.
They're looking your way now.
- Me?
- Mm-hmm.
- What for?
- Taking kickbacks.
- What the hell are
you talking about?
- You ran Ray's blood
for free and off the books,
then accepted a sweetheart deal
on his wedding venue.
It's a bad move.
- I was treating a patient
from the neighborhood.
E.D. docs, they make house
calls all the time.
They've never been
an issue with the hospital.
- Well, they are with the Feds.
- Unbelievable.
- Yeah, I--look.
You can still get
ahead of this, okay?
You can make it go away.
'Cause from now on,
whatever happens between you
and Ray, pass it on.
Become a CI for the taskforce.
- An informant.
That's crazy.
No way.
- Doc, this is a big case.
High priority, understand?
You don't have
a lot of options.
- Maybe, but I'm...
I'm still not doing it.
- Will, listen to me.
You get jammed up
with the Feds,
it could cost you
your medical license.
- I said no.
- It's the wrong answer.
I'll be in touch.
- [crying]
- Doctor.
- [moaning, crying]
- BP's dropping,
down to 90 over 70.
Heart rate's jumped, 130.
- Spleen's abnormal.
Ultrasound.
- [wailing]
Spleen is grossly enlarged.
Also, free fluid
in the abdomen.
Wasn't there on intake.
Grab two units
and then let's move.
I need some help!
- What's going on?
- She's bleeding internally.
We need to get her
up to surgery now
to control it.
- She'll be okay though,
right?
- [screaming]
.
- Doctor Manning.
- Hi.
Linda, your labs came back.
The cold you can't shake,
the bruising and petechiae,
and now your spleen--
they're from
Primary Myelofibrosis.
It's a type of leukemia.
- Oh, my God.
- Leukemia.
That's cancer.
- It is.
There are some medications
that treat the disease,
but the side effects
can be extreme
and the results
are unproven.
There is one treatment
that can offer a cure.
It's a stem cell transplant.
- Transplant?
There's a list, right?
I'll be at the bottom.
- No, no.
There are lists for organs
like hearts and lungs.
Because they come
from deceased donors,
there's a limited supply.
But stem cells come
from living donors.
So anyone able to give blood
can likely also
give stem cells.
There are a lot of options.
- See, baby,
we're gonna beat this.
Thank you, Doctor Manning.
- Of course.
I'll call hematology
to get things started, okay?
- Gracias.
- BP's still low,
temp's ticked up, 102.
- And three trips
to the bathroom.
I couldn't even
keep down ice chips.
- I'm sorry.
I wish I had an answer.
All your blood work
was within normal limits.
And the CT did show
a cyst in your ovaries,
but that's not uncommon.
- Yeah, my sister
has the same thing.
- Your neck hurt?
- Stiff.
- Headache?
- Off and on.
- Set up for
a lumbar puncture?
- Isn't that a spinal tap?
For the flu?
- It's possible
that it's evolved
into encephalitis
or meningitis.
- I will never skip
another flu shot, I swear.
- Is there someone
we can call for you?
- No, my girlfriends,
they'll bring drama
I don't need right now.
- Mm-hmm.
[phone vibrating]
What about your sister?
- She and my parents
live out of state.
It's okay,
I've got my podcasts,
and they can actually go
with me into the bathroom.
- They might make
better company, then.
- I see the Valium's helping.
- I'm trying to move around
a little, loosen things up.
Those my CT results?
- Yes, scans show spinal
degeneration and scar tissue
at L3 through L5.
We suspect it's chronic and
not the cause of today's pain.
That's likely structural, so--
- You want an MRI.
Compare it to the scan taken
when I had surgery
two years ago to see
if anything's different.
- Forgot.
You know the drill.
- Yeah, so I know an MRI won't
show anything more than the CT.
You'll give me some
low grade muscle relaxer,
recommend physical therapy,
but those meds
won't do anything
more than a baby aspirin.
And I'm a lawyer, a partner at
Astor, Caldwell and Davis.
I don't have time to lie on
the floor doing pelvic bridges
with some glorified trainer.
So how about you just write me
a script for what will work?
Norco 10-325s,
then we can all get
on with our lives.
- I'll talk to the pharmacy.
[somber music]
- I take it back.
I think Nora's got the edge
over my old coach.
What are you doing?
- Running Nora's name through
the Illinois
prescription database.
See if she's flagged
as a frequent flyer.
- You think she's just trying
to score pills?
Faking her pain?
- Maybe.
Dodging an MRI
and then immediately
pressing for meds
reeks of a con job.
She's not on file.
Still doesn't mean
we're getting the whole story.
- So what do we do?
- Nora had her back surgery
at East Mercy.
Call over there.
See if she's only
coming to us
because they cut her off.
[alarm blares]
- Cesar.
- Ricky Glendon, 19.
Hit by a bus.
GCS 5, intubated on scene.
Hypotensive, but no obvious
long bone deformities.
- Belly's hard as a rock.
Maggie?
- I got you.
Baghdad's ready.
- All right, let's get him in.
All right.
On my count.
One, two, three.
Give me the ultrasound.
Fast scan's positive.
There's free fluid
in the belly.
I need to get in there.
We'll do it in the hybrid O.R.
Maggie, decision time.
You on my team or no?
- I'm in.
- Good.
Page anesthesia,
assemble the others,
and prep the hybrid O.R.
for surgery.
- Copy that.
April.
Take over the AD?
- As long as you need.
- All right.
- Jay, where are you?
Call me back.
Better yet,
stop by the hospital.
- Everything okay?
- Uh, yeah, just...
you know Jay and I,
still arguing
over Dad's stuff.
- Really? I thought Pat
didn't hold on to anything.
- Yeah, he didn't.
These are old baseball cards.
- Oh.
So what was all that
with Voight this morning?
So secretive.
- Nothing, uh...
he wanted a curbside diagnosis
because he doesn't trust
his own doctor.
He's a pain in the ass.
- He should get
a second opinion for that.
Get it?
Pain...in the ass.
- Oh, yeah.
That's funny.
- Ha. No, it wasn't.
[phone vibrates]
But that's why I love you.
Oh, it's Goodwin.
I gotta go.
I'll see you.
- [sighs]
[knock on door]
- We get a stem
cell donor for Linda?
- Come in and close the door.
There's a problem.
Linda Harper
isn't a U.S. citizen.
That complicates her ability
to access a transplant network.
- Why? Patients can't be denied
based on immigration status.
- No, but they can if they're
unable to prove they have
stable insurance
to cover the procedure
and the follow-up cost.
- But she has insurance.
James, her husband,
is a citizen
and covered by Medicaid.
Doesn't that include Linda?
- The marriage allows Linda
to apply for a green card,
but until she has
official legal status,
James' Medicaid
does not extend to her.
- This is ridiculous.
So despite the abundance
of stem cell donors out there,
Linda can't get to any of them
because of red tape?
Ms. Goodwin, a transplant
is the only treatment
that can save her life.
- I know.
That's why I think the family
should bypass the network
altogether
with a direct donation
from her brother, Manny.
- And pay out of pocket?
- It's expensive, I know.
But there's not
a better option.
- I'll speak with James.
- All right.
- Thank you.
- Mm-hmm.
- When this is tied,
the mesentery
will be hemostatic.
[machine beeping]
[alarm chirping]
- Marty, talk to me.
- Massive ST elevations.
- Kid's 19
and he's having a heart attack?
- Apparently.
- We need an angiogram.
Let's get the C-arm in place.
Maggie?
- Introducer kit,
wire and lead.
- Read my mind.
Let's go.
- So, your LP revealed
a high presence of white cells
in your cerebral spinal fluid.
- So it is encephalitis
or meningitis.
- Yes and no.
The search for
the infecting bacteria
or virus was inconclusive.
You have the symptoms,
but not the cause.
- [slurring]
That's strange, isn't it?
- Tara, you're slurring.
- My face feels weird.
Tingly.
- Ptosis of the left eyelid.
It's really droopy.
Left corner of
the mouth is lagging.
Seventh cranial nerve issue?
- Mm-hmm.
Does your mouth feel dry?
- Tastes like metal.
- These new signs--
whatever is going on,
it is definitely
affecting her brain.
- Let's get an MRI and push her
to the front of the list.
Squeeze my fingers.
- What's wrong with me?
- We're gonna find out.
Order a transvaginal
ultrasound as well.
- For the ovarian cysts?
Why?
We already saw them on the CT.
- Yeah, well,
I want a better look.
- Okay.
- I understand it's
an enormous amount of money.
- I don't care.
We'll take out loans,
sell the car.
It's Linda's life.
- And in all honesty,
this is the hardest part.
The medicine itself
is straightforward.
Manny, as Linda's brother,
you are the ideal candidate
to donate your stem cells.
It's a series of infusions
to boost your bone
marrow production.
- When can he start?
- Today.
By the end of next week,
it's likely you'll be
able to donate to Linda.
Manny, you all right?
- I don't know.
- Mr. Calderon,
it's a simple procedure.
- I don't think I can.
- Can what?
- Donate.
- Manny, what the hell
are you talking about?
- I'm sorry, James.
I just...
I can't.
- Manny, you have to.
- Mr. Calderon, I don't
know if you understand.
If we don't do this transplant,
your sister--
- I know.
But I can't.
- What the hell's
wrong with you?
You're her brother.
Then leave.
- Mr. Harper--
- If you're not gonna help,
just get the hell out of here.
I said out!
[objects clattering]
[tense music]
♪
- Manny, are you okay?
- [speaking Spanish]
- Why?
- I'm sorry, James.
- Without you, she'll die.
♪
.
- Your sister needs you,
Mr. Calderon.
Please, help us
understand your decision.
- Donating stem cells means
my name goes into your system.
They monitor them.
That's how they get you.
- Ah.
You're undocumented as well,
aren't you?
- Yes.
And so is my wife.
She's pregnant.
I love my sister.
I risked our lives to get us
here from El Salvador, but...
if I get deported...
- The hospital is prohibited
from sharing personal data
to law enforcement.
That includes
immigration officials.
No one will know you're here.
- Government will find out.
They'll come for me
and then for my wife.
- Mr. Calderon,
I realize that these are
uncertain times for immigrants
but you'd be donating
stem cells to your sister.
You'd be saving her life.
- They won't care.
You don't understand.
How could you?
But it's real.
They take people from work,
from home.
They separate families.
I might never
see my wife again.
Meet our child.
I'm sorry.
No.
[somber music]
- Damn it, the tear
is too close
to the takeoff of the LAD.
I can't deploy the stent
without occluding
the left main.
We're gonna have to crack
him open and revascularize.
- I'll call upstairs
and get us a bypass machine
and perfusionist.
- And Dr. Bardovi, too.
I'm going to need an extra set
of hands to assist.
Okay, let's prep and drape.
- On it.
- [sighs]
- Tara's MRI results.
- Clean--no tumors,
lesions, or clots.
- And the
transvaginal ultrasound.
Scan only shows
simple ovarian cysts.
Nothing abnormal. Are you
going to fill me in on why
you doubled back to look
at the cysts?
- I thought one
might have been a teratoma.
- A clump of cells
that shouldn't be there.
- Well, it would explain
the sharpness she feels
in her abdomen,
and if the teratoma
contains primitive
brain cells...
could have tricked
her immune system
into attacking
her actual brain cells.
- Causing the
neurologic symptoms.
Okay, yeah,
I see the connections,
but the kind of teratoma
that you're describing
is super rare.
- Yes.
But a teratoma
is the only thing
that connects all her
symptoms.
- Then why didn't it
show up on the ultrasound?
- I don't know.
But just because
a radiologist couldn't see it
does not mean
it's not there.
Dr. Halstead, there
are cysts in each ovary.
Even if there is
a teratoma hiding,
you don't know
which one it's in.
- Yeah.
Our only move would
be to push for surgery.
Take them both out.
- An oophorectomy.
You want me to call gyne?
- She's only 30.
I do this, she won't
be able to have kids.
- So, do I call gyne?
- No. Start over.
Take a new history.
Draw all new labs
and test for zebras.
Start with an ANA, SSA, SSB,
and antithyroglobulin
antibodies.
- Okay.
[solemn music]
♪
- Connor.
- Oh, wow.
I asked for the CT fellow
and I get the Attending.
My new title really
carries some weight.
- Easy there, tiger.
You only got me because
the elective CABG
I was starting
is now on hold
because your trauma needs
a bypass machine.
- Also maybe because
you miss operating with me.
Scrub in.
Bypass machine should
be down here any minute.
- Actually, I put
a hold on that order.
Machine's already prepped and
ready for use up in the O.R.
Simpler to bring your patient
up than the equipment down.
- You're right.
Let's do it.
- Guess I do miss
operating with you.
Love hearing you say I'm right.
- Dr. Choi?
Just heard back
from East Mercy.
Nora's not on file
as a frequent flier.
Never been a patient there.
- Well, she definitely
had a surgery.
Scar on her back
is clear proof.
- Well, I'll start calling
other hospitals,
see if she's on
file somewhere else.
If Nora is playing us,
it stands to reason
she'd also lie about where
she had her operation.
- Maybe it's simpler than that.
If I were trying
to game the system,
I certainly wouldn't
use my real name.
- So, if she's not Nora Blake,
who is she?
- Good question.
Dr. Charles,
can I ask you something?
I've got a strong feeling
my patient gave a fake name
to get a prescription.
- Huh.
You think we're
dealing with addiction?
- Likely,
but I can't help her with it
if I can't separate
fact from fiction.
- You know,
often when people lie,
they tend to describe
things in generalities.
But when they use specifics,
it's more likely
they're telling the truth.
Your patient give
you any details?
- The type of meds she wanted.
Oh, and her job.
That she's a partner
at a law firm.
Astor, Caldwell, and Davis.
- Hmm. Start there.
- Thanks.
- There.
Nora Blake is actually
Brenna McDouglas.
- Gotcha.
- Am I a match?
- No, I'm sorry.
You don't have enough HLA
markers in common with Linda.
- What about Evan?
He's the only
other blood relation.
- It's possible,
but the injections needed
to boost stem cells increase
the chance that the donors
themselves develop
leukemia in the future.
Evan's family history
and his young age...
His risk would be
significantly higher.
- Is there any other way?
- Stem cells can also be
extracted directly
from Evan's bone marrow,
but it's an invasive process,
and given Evan's weight, it
would take multiple procedures
to harvest the amount
of cells needed.
It would be painful for him,
and I can't guarantee it
would be successful for you.
[somber music]
♪
- So the only way to save
my wife is to give my son
the disease that's killing her
or put him through hell
and hope for the best?
- I'll donate my stem cells.
[both speaking Spanish]
I came to the United States
for a better life.
Linda has one
with James and Evan.
I can't take that from her.
- [crying]
.
- Fine, you got me.
My name's Brenna McDouglas,
not Nora Blake.
Can I have my
prescription now?
- It may feel like
you need them,
but more pills
aren't the answer.
- I'm in pain.
Don't you even care?
- Yes, we care.
And we want to help.
Let us set you up
with an addiction therapist
who can devise
a pain management strategy
that doesn't involve opioids.
Here's some referrals
that I think
you should
take a look at.
- No! I don't need
a therapist or a new plan.
I need my refill.
What is the big deal?
My God.
I'm a lawyer
with great insurance,
not some junkie
off the street.
Or worse,
some hombre that probably
can't even speak the language.
That guy in the next room--
Mexican or whatever--
he attacked a man.
He fought him right
in the emergency room.
But nobody gave him a hard
time or prevented his care.
No. The doctor,
the administrator--
they're bending
over backwards for him.
There is no way
he comes before me.
So give me my prescription
or, so help me,
I will sue you
and this entire emergency room.
- No.
- Then get out,
and send me your boss.
[dramatic music]
♪
- Dr. Lanik,
my patient would like a word.
♪
- You ready?
- Routine LIMA procedure
should do it.
Mammary artery's
a perfect size match.
But, if for any reason
it feels off,
we'll use
the saphenous vein instead.
What, you disagree?
- No, approach is spot on,
just wondering why
you're in
the lead surgeon position.
- Because this is my patient.
- He was
when he was downstairs,
but now he's upstairs.
- I've been with Ricky
since he entered the E.D.
I'm gonna see him
through to the end.
- And I have
no problem with that,
as long as it's as
my number two.
[tense music]
- Scalpel please, Beth.
- Stop.
- Beth, scalpel.
- Hand him that instrument,
and you're off my team.
This is my O.R., Dr. Rhodes...
You can assist
or you can leave.
What will it be?
♪
I already told you,
the CT cases on the CT floor
belong to the CT Attending.
This shouldn't have
even been an issue.
- No, because I wouldn't
even be up here if I had
a bypass machine downstairs.
- Well, you don't.
Scalpel.
♪
- It's about time.
I've been trying
to reach you for hours.
Voight says the Feds
want to come after me.
- Yeah, I know.
- Well, what the hell?
You couldn't let me know I was
about to get sucker punched?
- The Feds kept it from me.
They know you're my brother.
That I'd run interference.
- And did you?
- Deaf ears.
PD, the Feds,
they've been looking for a way
into Ray Burke's circle
for years.
Now they got one,
they're not letting go.
- I'm calling Ray, I'm giving
the venue back.
This is not worth it
to save a few bucks.
- Will, you can't do that.
Judges are expediting warrants
and your clearance
in the CI program.
This is happening.
- Whose side are you on?
- Look, I'm not happy
about making you a CI.
But Ray Burke is a bad guy.
Have I told you about
all the felonies?
Will, they want him for murder.
He's gotta go away.
So if I was running
the task force, yeah,
I'd wanna use you too.
- Ray's that dangerous
a criminal
and your best plan
to nab him is me.
- He hardly ever lets anyone
but family past the front door.
You're perfect.
You're a squeaky clean kid
from the neighborhood
who's now an attending
at a big-time hospital.
For Christ's sakes,
he invited you in.
- This is insane.
- Sometimes you've gotta do
things you don't want to do.
That's life.
- No.
Screw the task force,
screw Voight,
and screw you.
[machine beeping rapidly]
- She's seizing.
- 5 of Ativan.
- SATs have plummeted.
70.
- Face and lips are turning
blue; she's cyanotic.
Can't protect
her airway either.
I'm intubating.
- Sux and etomidate?
- Don't need meds.
She's out.
♪
I'm in.
Bag her.
Cancel the new labs, transfer
to gyne for the oophorectomy.
Both ovaries have to come out.
- But, Dr. Halstead--
- I don't have
a choice anymore.
If I don't act now,
she'll be dead.
Prep her to move.
- It'll take five infusions
to boost your stem cells
to donation level.
So come back tomorrow
and I'll meet you
at the outpatient clinic
for number two.
- I know helping Linda is
the right thing to do, but...
I'm scared.
- Manny...
What's going on right now
in this country--I'm sorry.
I hope it's not
always like this.
See you tomorrow.
[sirens wailing]
[tense music]
- Stop!
- Hey!
- Stop right there.
Immigration
and Customs Enforcement.
You're under arrest.
- Hey, what are you doing?
No, no, no, you need to stop.
This man is
donating stem cells.
- Ma'am, please step back.
- I need you to stop.
He is saving a life.
Get your hands off of me!
- Ma'am.
♪
.
- Due diligence?
That's your position?
- A patient made a complaint
against Mr. Calderon
regarding an altercation
with Mr. Harper.
I looked into it and discovered
the immigration issue.
Unsure what
hospital policy was,
I brought the matter
to Ms. Garrett.
- I reached out to legal
for clarification.
They reached out to
immigration officials
for further explanation
of federal protocols.
- You're passing around
Manny's information
like it's a game
of Telephone.
Agents took him down
at the hospital!
- The hospital is protected
as a sensitive location.
ICE had no right
to make an arrest here.
- I was informed that there
was an active Immigration
and Customs Enforcement warrant
on file for Mr. Calderon.
So when authorities
asked for permission
to come on the property,
I gave it.
- Did you even read this?
They took Manny for
a misdemeanor theft charge
from 2010.
Stolen items valued at $8.62.
You gave permission for this.
- Manny's wife
is also undocumented
and she's pregnant.
We just put a target
on her back.
- I am not happy with
the way this turned out.
But my duty is to protect
this hospital,
not to pick fights
with the Feds.
I am sorry.
[solemn music]
♪
- Tough day, huh?
You all right?
- She used an alias,
lied to score drugs.
She should be the one
in cuffs,
not that poor guy
just trying to help his sister.
- I'm with you.
But, look, I mean,
she's an addict, right?
And putting her behind bars
wouldn't work anyway.
- I'm gonna have a lot
of cases that break
the wrong way,
aren't I?
- Mm-hmm.
But you know what?
You're also gonna have
a whole lot that won't.
- Pathology report.
One of the ovarian cysts
was a teratoma.
- Oh, thank God.
What if I'd been wrong?
- Are you supposed
to say stuff like that
to a third year
medical student?
- Probably not, but that was
the toughest call
I've ever had to make.
- Yeah, but you said
you didn't have a choice,
so how tough
could it have been?
- I'm sorry.
I am so sorry.
- Did the hospital
change their position?
Are they gonna help?
What is this?
- I compiled a list of
immigration attorneys.
Perhaps they can get
Manny released quickly
or expedite
Linda's citizenship
so she has easier access
to the transplant network.
- That family came to us
for medical help,
and the best we could do is
give them a list of lawyers?
There are millions of
people out there like Manny.
What happens if they get sick?
This is telling them, "Be
afraid to go to the doctor."
♪
- Hey.
- Hey.
- About earlier--
sorry I had to get rough.
- Don't be.
You were just
protecting your territory.
So am I.
- What are you looking for?
- About 3 1/2 square feet.
- Ah.
Space for a bypass machine.
Of course.
Big ticket item.
Good luck.
- Good night.
- Ethan.
Hey, you got a minute?
- Bernie,
it's been a long day.
I just want to go home
and not think about anything.
- Please.
Hey, uh...
I'm really sorry I put you
in this position.
Look, I'm a--
I'm a middle-aged guy,
and I meet your sister in AA.
We start dating,
we shouldn't,
and I get her pregnant.
And I'd be furious, too,
if I were you.
But I'm committed
to my sobriety.
And...
Look, all I can say is
I love Emily.
And I'm gonna take care
of her.
And our baby.
- Okay, Bernie.
Okay.
- [sighs]
- Look, man, it's been
a pretty long day
so I don't want to
get into it with you, okay?
- I'm really your only option?
- Yeah.
- Okay then.
[dramatic music]
♪
.
[dramatic music]
♪
[wolf howling]
[upbeat music]
♪
- Good workout?
- Bring on the day.
- Me too.
- Come on, what are you eating?
- Peanut butter-banana-bacon
sandwich.
Delicious.
Elvis was on to something.
- I get it, you crave calories.
But I told you, healthy ones
are best for the baby.
- I know--that's why I
doubled up on the bananas.
Anyway, just came in to say,
I give up.
You've been nagging
me to meet Bernie.
He's been all over
me to meet you,
so let's just get it over with.
- I can meet
tonight after work.
Molly's?
- Or before work?
Maybe in, like, an hour?
Hospital café?
Bernie's got a tight schedule.
- You know what?
I want to meet Bernie
more than
I want to argue with you.
So fine.
I'll be there.
- Thank you.
He's a really good guy,
Ethan.
I love him.
You will, too.
- [sighs]
- Linda Harper,
28-year-old female, GCS 12,
diaphoretic, and very confused.
BP 100 over 76.
Heart rate 120.
Normal sinus rhythm EKG.
Dad said Mom's been fighting
a cold the last few weeks.
Today she was holding
the baby and passed out.
Landed on him.
- Okay.
- It's okay, little man.
Dad's right here.
Everything's gonna be
all right.
- Evan Harper,
18-month-old male,
gross deformity of the right
arm, splinted in the field,
no other apparent injuries,
.10 morphine en route.
- Okay, his arm needs to
be reduced and casted.
Let's do it in
special procedures.
- Wait, you're taking him away?
- We need to set his fracture.
He's only a toddler.
It's safer to do it upstairs.
- But my wife's staying here.
- Go be with your son.
We'll take really good
care of your wife.
- James, where are you?
- Linda, I'm right here.
I'm right here.
I've gotta go be with Evan.
I'll be back as soon as I can.
Will you call her brother
Manny?
I don't want her to be alone.
- Yeah.
- I'll get the number,
get him down here.
- Thank you.
All right, let's get a CBC,
CMP, COAGS,
cardiac labs,
and let's start a 12 Lead EKG.
- Whoa, Dr. Manning.
- Oh, my God.
[dramatic music]
♪
.
Your patient's brother is here,
Manny Calderon.
- Ah, thank you, Leah.
Mr. Calderon?
- [speaking Spanish]
- Hi, I'm Dr. Manning.
I've been treating your sister,
Linda.
- Is she okay?
The nurse said she fell.
- She passed out.
We're trying to figure out why.
- What about the baby, Evan?
- He has a broken arm,
but he's going to be okay.
James is with him, and until
he comes back, Linda said
I can share with you
what I've learned so far.
Come on,
I'll take you back to her.
So, Linda's upper body
is covered in bruises.
There's also petechiae--the
small capillaries of her skin
are inflamed and bleeding.
I think it's all
a result of something
happening inside her body.
- She has more
than a cold then.
- Until I know more,
I don't want to speculate.
Here, she's in here.
- [exhales]
Manny.
[speaking Spanish]
- [speaking Spanish]
Okay?
- Great. Emily asked
you to be the buffer
for the Bernie introduction,
didn't she?
- She's nervous.
She wants you to like him.
Or at least not scare him.
- Right, because I'm
the problem in this.
- Just try to
have an open mind.
Hey, Emily.
- Ethan, this is my
boyfriend Bernard Kim.
- Call me Bernie.
- Nice to meet you.
- Honey, this is April.
- Oh, April, it's
lovely to meet you.
- Oh, okay, we're hugging.
- Emily and I are just--
we're just so touched
by how supportive
you've been and--thank you.
- It's my pleasure.
- So, why don't
we grab a table?
Keep things moving?
Babe?
- Yeah.
- Oh, you're not coming?
- Greetings are done.
Nobody ran.
You don't need me anymore.
[edgy music]
♪
- Look, I am not bragging when
I say that this hybrid O.R.
could revolutionize
trauma surgery's interaction
with emergency medicine.
It's set up for interventional
and open procedures.
We've got surgical lights,
we've got a C-arm, case carts.
There is a scrub
room right outside.
Okay, maybe I'm bragging
just a little bit.
[light laughter]
- Doctor, can I get
a shot of you in front of
the operating table?
- Yeah, sure.
- All right,
thank you, everybody.
The hospital's PR department
will forward you
complete press kits.
- Thank you.
- So, I'm going to bring
the "Trib" through in five
and then the local
NBC affiliate after that.
- I'll be ready.
- I really appreciate
your putting on the charm.
- Mrs. Goodwin,
you built me Xanadu.
I would sing and dance
for you if you wanted.
- Oh, I'm gonna
hold you to that.
[both laugh]
- Oh, my God,
it's Doctor Connor Rhodes.
Can I have your autograph?
- You're gonna
have to get in line.
I'm kind of a big
deal around here.
- [scoffs]
I've gotta admit,
this is an impressive space.
- Yeah.
Feels right.
Look, um...now that I am
officially open for business,
it's pretty easy to see
how jumping the gun
last week was a mistake.
I'm sorry.
Are we good?
- We're good.
[phone buzzes]
It's Latham.
I've gotta go.
Congratulations, Connor.
- Thank you.
- Hey, you could
have told me
Bernie's old enough
to be my dad.
- First, that's
an exaggeration.
Second, I didn't know.
It's just a number, right?
Does it really matter?
- No, not if Emily
acted like an adult
instead of a 12-year-old.
- You mean like how
you're acting right now?
- April, every boyfriend
my sister's had
has been a train wreck.
You really think Bernie,
who she met in AA,
who's 20 years older,
is gonna be different?
- Well, I mean, she does, so
you have to give him a chance.
- I wanted to, but then I
walked into the cafeteria
and I saw the same red flags.
April, I know how this ends.
He splits, she folds, and I'm
left to pick up the pieces.
- Let's just hope this time
you're wrong, okay?
Look, I've gotta get on
transport right now.
Let's pick this up later.
- The OTCs did nothing.
Urgent care prescribed
Zofran and Immodium.
Been taking them for
over a week, but--
Oh, it's so embarrassing.
- It's okay, I get it.
Both ends?
- I haven't eaten in days.
Where is it all coming from?
- Likely viral gastroenteritis.
- Urgent care said the same
thing, but I've been like this
almost a month,
and it's not even flu season.
- Unfortunately, there's often
an exception to the rule,
and this time it's you.
Tests?
- CBC, CMP, quantitative HCG.
- Oh, that hurts.
- CT abdomen and pelvis,
got it.
- Techs will be by soon
to take you for your scan.
- The sooner the better.
I really feel like crap.
- No pun intended, right?
- Ms. Blake, I'm Dr. Choi.
- Oh, thank God.
Finally, a real doctor.
- 44-year-old female,
complaints of lumbago.
Pain 10 out of 10.
HPI symptoms--
- The important info--
I was getting
dressed for work,
bent down to put on my shoes,
and my back locked up.
- Well, why don't
we take a look?
Is it okay if student doctor
McNeal examines you?
- Have you done this before?
Oh, wonderful.
- I'll be gentle.
- Guess you can't make
the pain any worse.
Ow.
Ah.
Laid on the floor for an hour
hoping the pain would ease up.
Nothing.
Oh...mm...
- I see a surgical scar.
- Discectomy?
- L4. Two years ago.
Felt pretty good right after,
but these days
it feels like a bad sneeze
could paralyze me.
- Unfortunately,
as common as back pain is,
there's not a perfect fix.
- Slow, slow.
- Press against my
hand like a gas pedal.
- It hurts.
Stabbing pain.
We have to do the other leg?
It's gonna hurt, too.
So will flexion, extension,
the femoral stretch,
FABER test.
- Been down
this road a few times?
- Today's the worst
it's ever been, though.
- What would you suggest?
- CT?
Five of Valium for the spasm?
- Oh, bless you.
[sighs]
Ohh...
- She got on you a bit.
Patients are going to do that.
Don't take it personally.
- It's all good.
When I was playing ball,
I had an OC could rip me
a new one like no other.
Compared to him,
Nora's a peach.
- Hey, Doc.
- Hey.
- Got a sec?
- Yeah, what's up?
- Not here.
[tense music]
♪
Here's the deal.
Your voice on Ray Burke's
wire is a problem.
- Yeah, Jay told me.
I'm sorry.
I didn't know PD had
something going on with him.
- Well, it's not just PD.
Feds are in on this too.
It's a joint task force.
Listen.
I just came to
give you the heads-up.
They're looking your way now.
- Me?
- Mm-hmm.
- What for?
- Taking kickbacks.
- What the hell are
you talking about?
- You ran Ray's blood
for free and off the books,
then accepted a sweetheart deal
on his wedding venue.
It's a bad move.
- I was treating a patient
from the neighborhood.
E.D. docs, they make house
calls all the time.
They've never been
an issue with the hospital.
- Well, they are with the Feds.
- Unbelievable.
- Yeah, I--look.
You can still get
ahead of this, okay?
You can make it go away.
'Cause from now on,
whatever happens between you
and Ray, pass it on.
Become a CI for the taskforce.
- An informant.
That's crazy.
No way.
- Doc, this is a big case.
High priority, understand?
You don't have
a lot of options.
- Maybe, but I'm...
I'm still not doing it.
- Will, listen to me.
You get jammed up
with the Feds,
it could cost you
your medical license.
- I said no.
- It's the wrong answer.
I'll be in touch.
- [crying]
- Doctor.
- [moaning, crying]
- BP's dropping,
down to 90 over 70.
Heart rate's jumped, 130.
- Spleen's abnormal.
Ultrasound.
- [wailing]
Spleen is grossly enlarged.
Also, free fluid
in the abdomen.
Wasn't there on intake.
Grab two units
and then let's move.
I need some help!
- What's going on?
- She's bleeding internally.
We need to get her
up to surgery now
to control it.
- She'll be okay though,
right?
- [screaming]
.
- Doctor Manning.
- Hi.
Linda, your labs came back.
The cold you can't shake,
the bruising and petechiae,
and now your spleen--
they're from
Primary Myelofibrosis.
It's a type of leukemia.
- Oh, my God.
- Leukemia.
That's cancer.
- It is.
There are some medications
that treat the disease,
but the side effects
can be extreme
and the results
are unproven.
There is one treatment
that can offer a cure.
It's a stem cell transplant.
- Transplant?
There's a list, right?
I'll be at the bottom.
- No, no.
There are lists for organs
like hearts and lungs.
Because they come
from deceased donors,
there's a limited supply.
But stem cells come
from living donors.
So anyone able to give blood
can likely also
give stem cells.
There are a lot of options.
- See, baby,
we're gonna beat this.
Thank you, Doctor Manning.
- Of course.
I'll call hematology
to get things started, okay?
- Gracias.
- BP's still low,
temp's ticked up, 102.
- And three trips
to the bathroom.
I couldn't even
keep down ice chips.
- I'm sorry.
I wish I had an answer.
All your blood work
was within normal limits.
And the CT did show
a cyst in your ovaries,
but that's not uncommon.
- Yeah, my sister
has the same thing.
- Your neck hurt?
- Stiff.
- Headache?
- Off and on.
- Set up for
a lumbar puncture?
- Isn't that a spinal tap?
For the flu?
- It's possible
that it's evolved
into encephalitis
or meningitis.
- I will never skip
another flu shot, I swear.
- Is there someone
we can call for you?
- No, my girlfriends,
they'll bring drama
I don't need right now.
- Mm-hmm.
[phone vibrating]
What about your sister?
- She and my parents
live out of state.
It's okay,
I've got my podcasts,
and they can actually go
with me into the bathroom.
- They might make
better company, then.
- I see the Valium's helping.
- I'm trying to move around
a little, loosen things up.
Those my CT results?
- Yes, scans show spinal
degeneration and scar tissue
at L3 through L5.
We suspect it's chronic and
not the cause of today's pain.
That's likely structural, so--
- You want an MRI.
Compare it to the scan taken
when I had surgery
two years ago to see
if anything's different.
- Forgot.
You know the drill.
- Yeah, so I know an MRI won't
show anything more than the CT.
You'll give me some
low grade muscle relaxer,
recommend physical therapy,
but those meds
won't do anything
more than a baby aspirin.
And I'm a lawyer, a partner at
Astor, Caldwell and Davis.
I don't have time to lie on
the floor doing pelvic bridges
with some glorified trainer.
So how about you just write me
a script for what will work?
Norco 10-325s,
then we can all get
on with our lives.
- I'll talk to the pharmacy.
[somber music]
- I take it back.
I think Nora's got the edge
over my old coach.
What are you doing?
- Running Nora's name through
the Illinois
prescription database.
See if she's flagged
as a frequent flyer.
- You think she's just trying
to score pills?
Faking her pain?
- Maybe.
Dodging an MRI
and then immediately
pressing for meds
reeks of a con job.
She's not on file.
Still doesn't mean
we're getting the whole story.
- So what do we do?
- Nora had her back surgery
at East Mercy.
Call over there.
See if she's only
coming to us
because they cut her off.
[alarm blares]
- Cesar.
- Ricky Glendon, 19.
Hit by a bus.
GCS 5, intubated on scene.
Hypotensive, but no obvious
long bone deformities.
- Belly's hard as a rock.
Maggie?
- I got you.
Baghdad's ready.
- All right, let's get him in.
All right.
On my count.
One, two, three.
Give me the ultrasound.
Fast scan's positive.
There's free fluid
in the belly.
I need to get in there.
We'll do it in the hybrid O.R.
Maggie, decision time.
You on my team or no?
- I'm in.
- Good.
Page anesthesia,
assemble the others,
and prep the hybrid O.R.
for surgery.
- Copy that.
April.
Take over the AD?
- As long as you need.
- All right.
- Jay, where are you?
Call me back.
Better yet,
stop by the hospital.
- Everything okay?
- Uh, yeah, just...
you know Jay and I,
still arguing
over Dad's stuff.
- Really? I thought Pat
didn't hold on to anything.
- Yeah, he didn't.
These are old baseball cards.
- Oh.
So what was all that
with Voight this morning?
So secretive.
- Nothing, uh...
he wanted a curbside diagnosis
because he doesn't trust
his own doctor.
He's a pain in the ass.
- He should get
a second opinion for that.
Get it?
Pain...in the ass.
- Oh, yeah.
That's funny.
- Ha. No, it wasn't.
[phone vibrates]
But that's why I love you.
Oh, it's Goodwin.
I gotta go.
I'll see you.
- [sighs]
[knock on door]
- We get a stem
cell donor for Linda?
- Come in and close the door.
There's a problem.
Linda Harper
isn't a U.S. citizen.
That complicates her ability
to access a transplant network.
- Why? Patients can't be denied
based on immigration status.
- No, but they can if they're
unable to prove they have
stable insurance
to cover the procedure
and the follow-up cost.
- But she has insurance.
James, her husband,
is a citizen
and covered by Medicaid.
Doesn't that include Linda?
- The marriage allows Linda
to apply for a green card,
but until she has
official legal status,
James' Medicaid
does not extend to her.
- This is ridiculous.
So despite the abundance
of stem cell donors out there,
Linda can't get to any of them
because of red tape?
Ms. Goodwin, a transplant
is the only treatment
that can save her life.
- I know.
That's why I think the family
should bypass the network
altogether
with a direct donation
from her brother, Manny.
- And pay out of pocket?
- It's expensive, I know.
But there's not
a better option.
- I'll speak with James.
- All right.
- Thank you.
- Mm-hmm.
- When this is tied,
the mesentery
will be hemostatic.
[machine beeping]
[alarm chirping]
- Marty, talk to me.
- Massive ST elevations.
- Kid's 19
and he's having a heart attack?
- Apparently.
- We need an angiogram.
Let's get the C-arm in place.
Maggie?
- Introducer kit,
wire and lead.
- Read my mind.
Let's go.
- So, your LP revealed
a high presence of white cells
in your cerebral spinal fluid.
- So it is encephalitis
or meningitis.
- Yes and no.
The search for
the infecting bacteria
or virus was inconclusive.
You have the symptoms,
but not the cause.
- [slurring]
That's strange, isn't it?
- Tara, you're slurring.
- My face feels weird.
Tingly.
- Ptosis of the left eyelid.
It's really droopy.
Left corner of
the mouth is lagging.
Seventh cranial nerve issue?
- Mm-hmm.
Does your mouth feel dry?
- Tastes like metal.
- These new signs--
whatever is going on,
it is definitely
affecting her brain.
- Let's get an MRI and push her
to the front of the list.
Squeeze my fingers.
- What's wrong with me?
- We're gonna find out.
Order a transvaginal
ultrasound as well.
- For the ovarian cysts?
Why?
We already saw them on the CT.
- Yeah, well,
I want a better look.
- Okay.
- I understand it's
an enormous amount of money.
- I don't care.
We'll take out loans,
sell the car.
It's Linda's life.
- And in all honesty,
this is the hardest part.
The medicine itself
is straightforward.
Manny, as Linda's brother,
you are the ideal candidate
to donate your stem cells.
It's a series of infusions
to boost your bone
marrow production.
- When can he start?
- Today.
By the end of next week,
it's likely you'll be
able to donate to Linda.
Manny, you all right?
- I don't know.
- Mr. Calderon,
it's a simple procedure.
- I don't think I can.
- Can what?
- Donate.
- Manny, what the hell
are you talking about?
- I'm sorry, James.
I just...
I can't.
- Manny, you have to.
- Mr. Calderon, I don't
know if you understand.
If we don't do this transplant,
your sister--
- I know.
But I can't.
- What the hell's
wrong with you?
You're her brother.
Then leave.
- Mr. Harper--
- If you're not gonna help,
just get the hell out of here.
I said out!
[objects clattering]
[tense music]
♪
- Manny, are you okay?
- [speaking Spanish]
- Why?
- I'm sorry, James.
- Without you, she'll die.
♪
.
- Your sister needs you,
Mr. Calderon.
Please, help us
understand your decision.
- Donating stem cells means
my name goes into your system.
They monitor them.
That's how they get you.
- Ah.
You're undocumented as well,
aren't you?
- Yes.
And so is my wife.
She's pregnant.
I love my sister.
I risked our lives to get us
here from El Salvador, but...
if I get deported...
- The hospital is prohibited
from sharing personal data
to law enforcement.
That includes
immigration officials.
No one will know you're here.
- Government will find out.
They'll come for me
and then for my wife.
- Mr. Calderon,
I realize that these are
uncertain times for immigrants
but you'd be donating
stem cells to your sister.
You'd be saving her life.
- They won't care.
You don't understand.
How could you?
But it's real.
They take people from work,
from home.
They separate families.
I might never
see my wife again.
Meet our child.
I'm sorry.
No.
[somber music]
- Damn it, the tear
is too close
to the takeoff of the LAD.
I can't deploy the stent
without occluding
the left main.
We're gonna have to crack
him open and revascularize.
- I'll call upstairs
and get us a bypass machine
and perfusionist.
- And Dr. Bardovi, too.
I'm going to need an extra set
of hands to assist.
Okay, let's prep and drape.
- On it.
- [sighs]
- Tara's MRI results.
- Clean--no tumors,
lesions, or clots.
- And the
transvaginal ultrasound.
Scan only shows
simple ovarian cysts.
Nothing abnormal. Are you
going to fill me in on why
you doubled back to look
at the cysts?
- I thought one
might have been a teratoma.
- A clump of cells
that shouldn't be there.
- Well, it would explain
the sharpness she feels
in her abdomen,
and if the teratoma
contains primitive
brain cells...
could have tricked
her immune system
into attacking
her actual brain cells.
- Causing the
neurologic symptoms.
Okay, yeah,
I see the connections,
but the kind of teratoma
that you're describing
is super rare.
- Yes.
But a teratoma
is the only thing
that connects all her
symptoms.
- Then why didn't it
show up on the ultrasound?
- I don't know.
But just because
a radiologist couldn't see it
does not mean
it's not there.
Dr. Halstead, there
are cysts in each ovary.
Even if there is
a teratoma hiding,
you don't know
which one it's in.
- Yeah.
Our only move would
be to push for surgery.
Take them both out.
- An oophorectomy.
You want me to call gyne?
- She's only 30.
I do this, she won't
be able to have kids.
- So, do I call gyne?
- No. Start over.
Take a new history.
Draw all new labs
and test for zebras.
Start with an ANA, SSA, SSB,
and antithyroglobulin
antibodies.
- Okay.
[solemn music]
♪
- Connor.
- Oh, wow.
I asked for the CT fellow
and I get the Attending.
My new title really
carries some weight.
- Easy there, tiger.
You only got me because
the elective CABG
I was starting
is now on hold
because your trauma needs
a bypass machine.
- Also maybe because
you miss operating with me.
Scrub in.
Bypass machine should
be down here any minute.
- Actually, I put
a hold on that order.
Machine's already prepped and
ready for use up in the O.R.
Simpler to bring your patient
up than the equipment down.
- You're right.
Let's do it.
- Guess I do miss
operating with you.
Love hearing you say I'm right.
- Dr. Choi?
Just heard back
from East Mercy.
Nora's not on file
as a frequent flier.
Never been a patient there.
- Well, she definitely
had a surgery.
Scar on her back
is clear proof.
- Well, I'll start calling
other hospitals,
see if she's on
file somewhere else.
If Nora is playing us,
it stands to reason
she'd also lie about where
she had her operation.
- Maybe it's simpler than that.
If I were trying
to game the system,
I certainly wouldn't
use my real name.
- So, if she's not Nora Blake,
who is she?
- Good question.
Dr. Charles,
can I ask you something?
I've got a strong feeling
my patient gave a fake name
to get a prescription.
- Huh.
You think we're
dealing with addiction?
- Likely,
but I can't help her with it
if I can't separate
fact from fiction.
- You know,
often when people lie,
they tend to describe
things in generalities.
But when they use specifics,
it's more likely
they're telling the truth.
Your patient give
you any details?
- The type of meds she wanted.
Oh, and her job.
That she's a partner
at a law firm.
Astor, Caldwell, and Davis.
- Hmm. Start there.
- Thanks.
- There.
Nora Blake is actually
Brenna McDouglas.
- Gotcha.
- Am I a match?
- No, I'm sorry.
You don't have enough HLA
markers in common with Linda.
- What about Evan?
He's the only
other blood relation.
- It's possible,
but the injections needed
to boost stem cells increase
the chance that the donors
themselves develop
leukemia in the future.
Evan's family history
and his young age...
His risk would be
significantly higher.
- Is there any other way?
- Stem cells can also be
extracted directly
from Evan's bone marrow,
but it's an invasive process,
and given Evan's weight, it
would take multiple procedures
to harvest the amount
of cells needed.
It would be painful for him,
and I can't guarantee it
would be successful for you.
[somber music]
♪
- So the only way to save
my wife is to give my son
the disease that's killing her
or put him through hell
and hope for the best?
- I'll donate my stem cells.
[both speaking Spanish]
I came to the United States
for a better life.
Linda has one
with James and Evan.
I can't take that from her.
- [crying]
.
- Fine, you got me.
My name's Brenna McDouglas,
not Nora Blake.
Can I have my
prescription now?
- It may feel like
you need them,
but more pills
aren't the answer.
- I'm in pain.
Don't you even care?
- Yes, we care.
And we want to help.
Let us set you up
with an addiction therapist
who can devise
a pain management strategy
that doesn't involve opioids.
Here's some referrals
that I think
you should
take a look at.
- No! I don't need
a therapist or a new plan.
I need my refill.
What is the big deal?
My God.
I'm a lawyer
with great insurance,
not some junkie
off the street.
Or worse,
some hombre that probably
can't even speak the language.
That guy in the next room--
Mexican or whatever--
he attacked a man.
He fought him right
in the emergency room.
But nobody gave him a hard
time or prevented his care.
No. The doctor,
the administrator--
they're bending
over backwards for him.
There is no way
he comes before me.
So give me my prescription
or, so help me,
I will sue you
and this entire emergency room.
- No.
- Then get out,
and send me your boss.
[dramatic music]
♪
- Dr. Lanik,
my patient would like a word.
♪
- You ready?
- Routine LIMA procedure
should do it.
Mammary artery's
a perfect size match.
But, if for any reason
it feels off,
we'll use
the saphenous vein instead.
What, you disagree?
- No, approach is spot on,
just wondering why
you're in
the lead surgeon position.
- Because this is my patient.
- He was
when he was downstairs,
but now he's upstairs.
- I've been with Ricky
since he entered the E.D.
I'm gonna see him
through to the end.
- And I have
no problem with that,
as long as it's as
my number two.
[tense music]
- Scalpel please, Beth.
- Stop.
- Beth, scalpel.
- Hand him that instrument,
and you're off my team.
This is my O.R., Dr. Rhodes...
You can assist
or you can leave.
What will it be?
♪
I already told you,
the CT cases on the CT floor
belong to the CT Attending.
This shouldn't have
even been an issue.
- No, because I wouldn't
even be up here if I had
a bypass machine downstairs.
- Well, you don't.
Scalpel.
♪
- It's about time.
I've been trying
to reach you for hours.
Voight says the Feds
want to come after me.
- Yeah, I know.
- Well, what the hell?
You couldn't let me know I was
about to get sucker punched?
- The Feds kept it from me.
They know you're my brother.
That I'd run interference.
- And did you?
- Deaf ears.
PD, the Feds,
they've been looking for a way
into Ray Burke's circle
for years.
Now they got one,
they're not letting go.
- I'm calling Ray, I'm giving
the venue back.
This is not worth it
to save a few bucks.
- Will, you can't do that.
Judges are expediting warrants
and your clearance
in the CI program.
This is happening.
- Whose side are you on?
- Look, I'm not happy
about making you a CI.
But Ray Burke is a bad guy.
Have I told you about
all the felonies?
Will, they want him for murder.
He's gotta go away.
So if I was running
the task force, yeah,
I'd wanna use you too.
- Ray's that dangerous
a criminal
and your best plan
to nab him is me.
- He hardly ever lets anyone
but family past the front door.
You're perfect.
You're a squeaky clean kid
from the neighborhood
who's now an attending
at a big-time hospital.
For Christ's sakes,
he invited you in.
- This is insane.
- Sometimes you've gotta do
things you don't want to do.
That's life.
- No.
Screw the task force,
screw Voight,
and screw you.
[machine beeping rapidly]
- She's seizing.
- 5 of Ativan.
- SATs have plummeted.
70.
- Face and lips are turning
blue; she's cyanotic.
Can't protect
her airway either.
I'm intubating.
- Sux and etomidate?
- Don't need meds.
She's out.
♪
I'm in.
Bag her.
Cancel the new labs, transfer
to gyne for the oophorectomy.
Both ovaries have to come out.
- But, Dr. Halstead--
- I don't have
a choice anymore.
If I don't act now,
she'll be dead.
Prep her to move.
- It'll take five infusions
to boost your stem cells
to donation level.
So come back tomorrow
and I'll meet you
at the outpatient clinic
for number two.
- I know helping Linda is
the right thing to do, but...
I'm scared.
- Manny...
What's going on right now
in this country--I'm sorry.
I hope it's not
always like this.
See you tomorrow.
[sirens wailing]
[tense music]
- Stop!
- Hey!
- Stop right there.
Immigration
and Customs Enforcement.
You're under arrest.
- Hey, what are you doing?
No, no, no, you need to stop.
This man is
donating stem cells.
- Ma'am, please step back.
- I need you to stop.
He is saving a life.
Get your hands off of me!
- Ma'am.
♪
.
- Due diligence?
That's your position?
- A patient made a complaint
against Mr. Calderon
regarding an altercation
with Mr. Harper.
I looked into it and discovered
the immigration issue.
Unsure what
hospital policy was,
I brought the matter
to Ms. Garrett.
- I reached out to legal
for clarification.
They reached out to
immigration officials
for further explanation
of federal protocols.
- You're passing around
Manny's information
like it's a game
of Telephone.
Agents took him down
at the hospital!
- The hospital is protected
as a sensitive location.
ICE had no right
to make an arrest here.
- I was informed that there
was an active Immigration
and Customs Enforcement warrant
on file for Mr. Calderon.
So when authorities
asked for permission
to come on the property,
I gave it.
- Did you even read this?
They took Manny for
a misdemeanor theft charge
from 2010.
Stolen items valued at $8.62.
You gave permission for this.
- Manny's wife
is also undocumented
and she's pregnant.
We just put a target
on her back.
- I am not happy with
the way this turned out.
But my duty is to protect
this hospital,
not to pick fights
with the Feds.
I am sorry.
[solemn music]
♪
- Tough day, huh?
You all right?
- She used an alias,
lied to score drugs.
She should be the one
in cuffs,
not that poor guy
just trying to help his sister.
- I'm with you.
But, look, I mean,
she's an addict, right?
And putting her behind bars
wouldn't work anyway.
- I'm gonna have a lot
of cases that break
the wrong way,
aren't I?
- Mm-hmm.
But you know what?
You're also gonna have
a whole lot that won't.
- Pathology report.
One of the ovarian cysts
was a teratoma.
- Oh, thank God.
What if I'd been wrong?
- Are you supposed
to say stuff like that
to a third year
medical student?
- Probably not, but that was
the toughest call
I've ever had to make.
- Yeah, but you said
you didn't have a choice,
so how tough
could it have been?
- I'm sorry.
I am so sorry.
- Did the hospital
change their position?
Are they gonna help?
What is this?
- I compiled a list of
immigration attorneys.
Perhaps they can get
Manny released quickly
or expedite
Linda's citizenship
so she has easier access
to the transplant network.
- That family came to us
for medical help,
and the best we could do is
give them a list of lawyers?
There are millions of
people out there like Manny.
What happens if they get sick?
This is telling them, "Be
afraid to go to the doctor."
♪
- Hey.
- Hey.
- About earlier--
sorry I had to get rough.
- Don't be.
You were just
protecting your territory.
So am I.
- What are you looking for?
- About 3 1/2 square feet.
- Ah.
Space for a bypass machine.
Of course.
Big ticket item.
Good luck.
- Good night.
- Ethan.
Hey, you got a minute?
- Bernie,
it's been a long day.
I just want to go home
and not think about anything.
- Please.
Hey, uh...
I'm really sorry I put you
in this position.
Look, I'm a--
I'm a middle-aged guy,
and I meet your sister in AA.
We start dating,
we shouldn't,
and I get her pregnant.
And I'd be furious, too,
if I were you.
But I'm committed
to my sobriety.
And...
Look, all I can say is
I love Emily.
And I'm gonna take care
of her.
And our baby.
- Okay, Bernie.
Okay.
- [sighs]
- Look, man, it's been
a pretty long day
so I don't want to
get into it with you, okay?
- I'm really your only option?
- Yeah.
- Okay then.
[dramatic music]
♪
.
[dramatic music]
♪
[wolf howling]