Chicago Med (2015–…): Season 4, Episode 7 - The Poison Inside Us - full transcript

I'm sorry, Nat,

I just gotta do something
quick for Jay.

I'm gonna be a few minutes late.

Thanks.

Hey, why didn't you call 911?

We called you.

Hi, Ray.

So what made you fall?

I took one look at that carburetor...

Can you tell me how old you are?

62.



- What month is it?
- Come on, Will.

Ray, what month is it?

It's... It's, uh...

I can't remember.

Your eye movement's a little sluggish.

I need to get you to the
hospital for an MRI.

Happy to do it, first thing tomorrow.

Ray.

So he's got a bridge game today

with some friends that...

Hasn't seen in a while.

Look at your father.

He could be having a stroke right now.

If he is and we don't get
him to the hospital,



he could die.

I'll get you in and out in an hour.

Really? An hour?

Promise.

Fine, get my stuff.

- All right, come on.
- Okay.

- All right, there we are.
- Okay.

An hour.

Em, you sure you should
be going to Vegas?

I mean, you did meet in AA.

Ethan, Bernie has a lead
on a really good job.

I mean, we're gonna buy a house.

Look, I know you're worried about me,

but everything's gonna be okay.

Em, he has pancreatitis.

You have to keep his drain clean.

Check his glucose every four hours.

It's a lot of work.

I know.

Well, if we're gonna get
to Omaha by dinner,

we gotta hit the road.

Drive safely, okay?

We will.

- And, Bernie...
- Don't worry, Doc.

I'll be checking my glucose.

Thanks for everything.

Call when you get there?

I will.

- Thanks for your help.
- Yeah, of course.

See you at work.

Yeah.

Hey, haven't seen your
big, red shadow today.

Yeah, he's running a little late.

- Oh, hey, um...
- Yeah?

Have you noticed Will acting
a little weird lately?

He is getting married in a month.

Makes most men act a little weird.

Yeah, I guess.

Heard Emily left.

Oh, yeah.

So?

So?

So now what?

Nothing.

- Really?
- Yeah.

Emily was the only thing
keeping you two apart.

She actually just made our
problems more obvious.

Really, there's nothing
left between me and Ethan.

If you say so.

Dr. Choi,

there's a patient in Treatment Four

that's insisting to see you.

You know him?

Don't think so, but I'll check him out.

All right, then.

Mr. Patrick,

hey, I'm Dr. Choi.

What brings you in today?

I was looking for Dr. Ethan Choi.

- Is that you?
- Yeah.

And why are you looking
for me specifically?

Do you recall seeing my
wife here a year ago?

Megan Patrick?

I'm sorry, not off the top of my head.

Why?

'Cause you're the
doctor that killed her.

- I don't care what
you remember.

Just give me the facts.

I understand...

but first, I just want you to know

that I realize you've been
through something truly awful...

Sit down.

Just tell me what happened.

Okay, Mr. Patrick,

but I have to look up her chart.

Go... go ahead.

Man, those vanilla lattes
never get old, do they?

Why do people think drinking
black coffee makes them cool?

We don't, we are cool, so
we drink black coffee.

Is that my dad?

- I do have one final question.
- Yes?

How you feeling?

Second trimester, and a lot better.

Thank you.

- You look fantastic.
- Hey, Dad.

- Thank you.
- Connor, hello.

Hello, Dr. Bekker.

You are a little far from
your office, aren't you?

Didn't you hear?

I have a seat on the board now.

I guess we'll be seeing
more of each other.

Great.

Hey, Ms. Garrett.

Yes?

Can you tell me why

my father has a seat
on the hospital board?

Well, it's the least we can do

after he donated all that money.

The money for...

Wait...

Is he the principal donor
for the Hybrid OR?

Nice having a rich dad.

Unbelievable.

He is always trying to undercut me,

trying to have some
kind of power over me.

Oh...

Wait a second, did you know?

You knew and you didn't tell me.

So instead, you lie to me,
to my face for weeks?

I didn't lie. I just didn't mention it.

No, Ava, that is a lie.

That's great.

Thank you very much.

Your wife was admitted
to the ED at 7:12 a.m.

Her blood pressure was
104/62, heart rate 87.

Dr. Manning, you're going
to Treatment Three.

Monique, go with her.

Claire Burton, ran her bike
into a car on Michigan Avenue.

Vitals stable.

Can't get any answers out of her,

but she definitely looks pregnant.

Claire, I'm Dr. Manning,
do you remember me?

- I used to eat a lot of carrots...
- Dr. Charles.

But, you know, they don't
really help your eyes

I don't really need them anyway...

- She manic?
- Yes, bipolar.

I treated her a few months
ago for morning sickness.

All right, let's move her on my count.

Ready, one, two, three.

Anybody we should call?

As far as I know, boyfriend's
out of the picture.

Oh, my gosh.

Sometimes, if I look at
something for too long,

I feel like all that energy
is gonna turn into a laser

and just burn a hole right though

whatever it is that I'm looking at.

I heal a lot faster than others...

Claire, does it hurt anywhere?

Two Haldol, please.

A lot of times I try not to
look at anything but myself.

Claire, Claire, can you
tell me if anything hurts?

Every single molecule on
my skin is something...

She'll calm down in a couple minutes.

- I'm right outside.
- Okay, thank you.

And I just heal.

Does anybody know what
happened to my bike?

This... it's just a
little bit of a cut.

Maybe... I could just
get my bike and go.

What are you doing? Ray's
gonna be here any minute.

Our tail has him seven minutes out.

You need to call off the MRI.

What are you talking about?

That bridge game is the summit

between Ray and his crew
that we've been waiting for.

This is where he's going
to incriminate himself.

So I'll do one test and send him home.

Listen, you work for us

and I am telling you to call it off.

I work for the hospital,

and he needs an MRI,
so he's gonna get one.

We can make your life very hard.

Make sure you get him
home for that meeting.

What's going on?

I just got a weird vibe from Dr.
Choi's patient.

- I'll check it out.
- Yeah.

O2 sats, 86%.

You need my help?

No.

We're fine in here, thanks.

All right.

Yeah, something's up.

Ethan wouldn't even let me in the room.

Okay, I'll call security

and have them keep an eye on them.

Derek Glenn, 35 MVC, BP 110/60,

heart rate's 120, left
upper quadrant pain.

Why the hell is he in my OR?
It's not a treatment room.

I was told to park him here

because all the other rooms are full.

All right. Let's get an ultrasound.

Hey there, Derek,

can you tell me where it hurts?

- Right here.
- All right.

Is there anyone you need us to call?

Already called my wife.

Good.

Well, it looks like you've got

some free fluid around your spleen.

That usually indicates a small tear,

which we do sometimes
see with blunt trauma.

Now, the good news is 90% of
these bleeds stop on their own.

So for now I'd just like
to get a scan to confirm,

and then we'll keep a close eye on you

to make sure that you're stable.

- That sound okay?
- Yeah, sure.

Good.

Let's get him a CBC, CMP, coag panel,

type and cross four units of blood,

and set him up for a CT.

We will get you all set up,

and then I'll be back to
check in on you soon, okay?

- Look, about this morning.
- I don't want to hear it.

So what if your father's
the main donor?

This hybrid room has been a godsend.

That's not the point.

You're saving lives with it.

Who cares where the money came from?

I do,

and you should know me
well enough to know

that I don't want to be
beholden to my father.

- Connor...
- You should have told me.

How many more damn
papers do I got to sign?

That's it.

We're gonna get this done right now.

About time.

Let's get this done fast, okay?

It's a head MRI. It takes
as long as it takes.

Let's lay you down.

Ray, I got to see some more patients,

but I'll be back before you're done.

Yeah.

What was her normal dose of Quetiapine?

It was 800 milligrams,

but I cut it in half to
be safe for the baby.

Huh, that might explain
the onset of the mania.

Well, the standard of care
is to cut the dose in half.

There's actually been
some new research,

a couple of new papers,
both suggesting...

Dr. Charles, I can't keep up
with every psychiatric journal.

Course you can't.

I didn't have a choice.
I did what I had to do.

Dr. Manning.

What's wrong?

Your placenta must have
abrupted from the accident.

Call OB, we need to get her
upstairs for a delivery.

Delivery... did something
happen to my baby?

Is he gonna be okay?
What's wrong with my baby?

Everything's gonna be fine.
Let's get you upstairs,

and then we'll figure out
what happens next, okay?

Are you sure I didn't hurt the baby?

Are you sure? What if I hurt it?

Your wife was given anti-histamine,

steroids, and epinephrine,

but progressed to cardiac arrest.

I performed CPR with
ACLS for 35 minutes,

but she never regained circulation...

and at 9:17, she was pronounced dead.

Mr. Patrick.

I assure you, we did
everything we could.

No.

I can only imagine the pain you felt.

She couldn't breathe.

Do you know what's that like?

I want you to know how it feels.

- This is your...
- Mr. Patrick!

There's a toxic spill.

Evacuate the ED now!

Code Orange! Everyone, out, right now.

Get your patients out right now!

Code Orange!

Get out! Everybody, out!

Go, move!

This is Maggie Lockwood.

Toxic exposure in the ED. I repeat,

toxic exposure in the ED.

Get the hospital on bypass right now.

Start the internal disaster protocol.

Everyone, out now!

Move, move!

Dr. Rhodes.

Eva, get me a gurney.

They're all in use.

- What's going on?
- Toxic spill.

We need to get you out of here.

No, that's too dangerous.

What are you doing?

This room has positive
pressure ventilation.

We're safe as long as we stay in here.

What happened?

Why did we stop? What's going on?

I don't know.

Move! Move! Move!

Everybody, out!

Moving out the truck!

Head trauma, GCS nine, we just got her

so she needs a full trauma
workup when you land.

35% TBSA second- and
third-degree burns.

Take 'em straight to the burn center.

- Maggie.
- Yeah?

- Have you seen Natalie?
- Don't worry.

I saw her take a patient
upstairs before the spill.

Dr. Choi.

- You need to sit down.
- I'm okay.

But we have more
patients in ambulances,

so we need to triage in the
red, yellow, and green

and get the sickest ones
off in the first wave.

Make sure everyone's
showered and deconned.

You got it.

How long till you can detox my ED?

Depends on the floor plan,
ventilation, size of spill.

I'm sending Squad in now.

Soon as they get us the samples,

we'll take them down to the
lab and try and ID the toxin.

And what about Mr. Patrick?

We're looking into him now.
Background, employment, family,

anything that'll give us a lead.

We already have 12 hospital
staff and patients

in respiratory distress.

We need to figure this out and fast.

Got it.

Easy, easy, easy.

- You okay?
- Yeah.

Why are we here? What is this place?

Orthopedics.

They're renovating the rehab floor.

I'm supposed to have my baby.

You... you said I was bleeding.

Emergency exits are locked.

I was thinking maybe a Code Orange.

Would explain why the
elevators when down.

Oh, there's a lot more blood.
A lot more blood.

Her bleeding's much worse.
Call Labor and Delivery.

Worse? What does that mean?
Is my baby dying?

No, we need to lay you down, okay?

- Come on.
- He's dying, isn't he?

- My baby's dying.
- No, he's not.

Come on, let's lay you down.

Just lay down right here.

You're all right. There you go.

Dr. Charles.

There's no signal. I
can't find a signal.

Oh, my God. I killed him.

Just stay right there, okay?

We have to figure out a way
to break open these doors.

We need to get her upstairs.

Natalie, we're not getting
through those door.

We're gonna have to do a c-section.

This is all my fault. I killed my baby.

His pressure's dropping.

Derek, are you feeling dizzy?

A little. What does that mean?

That means you're still bleeding.

The tear in your spleen isn't
clotting like I'd hoped.

He's got a lot more free fluid.

Hey, hey!

Cruz!

I need to get this patient upstairs.

Sorry, doc, I can't open these doors

until we get the place clear.

Just to get a couple units
from the blood bank.

Even if I wanted to,

all of the stairs are locked down

so the gas can't spread.

Emergency exits, everything.

We'll get you out as soon as possible.

All right.

We need to keep his pressure up
until they get us out of here.

I'll hang a bag of saline.

I got it.

April, we need more oxygen masks.

Fire brought out everything
they could find.

All right, see how many
nasal cannulas we have.

The worst patients can
always double up.

Ethan, you need to sit down.

I'm okay.

I'm fine. I'll be okay.

Okay, you let this nurse
know if you feel any

nausea, dizziness, or problems
with your vision, okay?

Hey, Will!

Where's our dad?

He's safe. He's still upstairs.

Then go and get him out of there.

I can't.

They've locked down
the entire hospital.

You're a doctor.

You go find whoever's got the key

and you get him the hell out.

Look, guys, I'm sorry,

but it just doesn't work like that.

Will, you said it'll only take an hour.

Yeah, and it should have, but
we're having an emergency.

Dr. Halstead!

- Guys, I got to go.
- Ethan! Ethan, breathe.

Ethan?

Talk to me, Ethan.

- Talk to me.
- Get him on O2!

- Mask!
- Here you go.

Ethan.

- Ethan.
- Hang in there, Ethan.

How's he doing?

Not good.

We'll get him through this.

He was trying to keep me safe.

Back there in the ED.

That's... that's why he
didn't let me in the room.

Yeah.

I've never done a c-section.

I haven't even seen one in years.

We're gonna figure it out.

But we don't have any instruments

or emergency supplies or pain meds.

There's got to still be some
supplies on this floor.

What if we just held pressure?

I mean, whatever's happening
in the hospital right now

can't last forever.

We have to do this now.
We don't have a choice.

Listen,

whatever doubts you may or may not have

about your previous treatment
of this patient...

I led her to believe

that she could go through
with this pregnancy.

She can't take care of a baby.

She can't even take care of herself.

Then you were in a very
difficult situation...

If I operate on her in
this hallway and she dies,

that's my fault.

Okay.

Okay, look.

I'm going to find a signal

and get an OBGY on the phone.

But no one can get down here.

No, no, so she can talk us
through it on the phone.

Together.

Okay?

Please tell me you found something.

Jacob Patrick is an engineer
at a textile factory.

He has access to numerous
industrial toxins.

We're hoping to have
it narrowed down soon.

- Please keep me posted.
- I will.

You can't be serious!

Until an ambulance shows up with more,

there's nothing we can do.

What's going on?

Ethan and Mr. Patrick and
both in bronchospasm

and in need of racemic epi.

The problem is there's
only one dose left.

Which, obviously, we
should give to Ethan.

Who's doing worse?

That's the thing. Mr. Patrick is.

You're not really thinking
of giving it to him.

I'm following protocol, April.

Whichever patient has the greatest need

gets treated first.

He came here on a suicide mission.

I'm sorry.

Give Mr. Patrick the epi.

This is wrong.

What's happening?

The bleed isn't stopping.

I'll hang some Ringer's.

- I'm gonna embolize it.
- What?

We're just putting a
wire into his groin.

It's a simple procedure.

Not without nurses or techs,
let alone anesthesia.

No, we can twilight him with Versed.

Look, we don't have a choice.

We need to close off the vessel,

and frankly, I'm not
interested in your opinion.

All right, hey, guys inside checked.

They can't find any more
doses of racemic epi.

We have to do something.

His airway's almost closed.

I mean, we could try
methylprednisolone.

It's not great, but it's
better than nothing.

Okay, where can I find it?

In the respiratory therapist carts.

All right, what does
that cart look like?

We're wasting time.

- April!
- Hey, you can't go in there!

Give it to him now.

That was incredibly stupid.

Let's hope this works.

All right, come on.

Let's get you decontaminated.

Do you have reception?

I've got one bar. It's ringing.

I'm not cutting until you get someone.

Cutting melon, cutting chicken,

cutting me, cut the baby.

No one's gonna hurt the baby, Claire.

Her Haldol's wearing off.

Is someone answering?

Yes, this is Dr. Charles.

I need an OB immediately

to talk me through an
emergency C-section.

They're getting Dr. Grant.

Come here and put her on speaker.

I-I-I can't. I'll lose the call.

I'll drop the call. Dr.
Grant, thank God.

I have a woman, 36 weeks,
abrupted placenta,

already lost a couple units of blood.

Some lidocaine which
we've administered.

A scalpel and a few clamps.

Okay, okay, here we go.

Dr. Grant says to start the incision

three centimeters below the umbilicus.

Okay,

here we go.

Come on.

Come on.

Damn it.

The pressure's still dropping.

I can't get the wire in there.

The anatomy's too challenging.

Hang 500 of albumin.

We'll hold pressure until
we can get him out of here.

He won't make it that long.

There's nothing else we can do.

We can remove his spleen.

We can't open him up. He'll
lose too much blood,

and we don't have any to give him.

I'm a universal donor.

That's insane. The surgery
will take too long.

Well, then do it faster.

Ava, what are you trying to prove?

I'm trying to save his life.

If you do this,

you both are gonna bleed
out before I'm done.

Unless you have a better idea,

I suggest you stop making
excuses and get started.

How's your breathing?

Good? All right.

Will.

Be right back.

Congratulations.

They called off Ray's meeting.
You screwed it up.

He was sick. What was I supposed to do?

What I told you to do.
Stay out of the way.

I didn't know there was gonna
be a toxic spill, Jay.

This is why we don't take chances,

and you needed to listen.

He could have had a stroke.

I wasn't gonna let him die.

I took an oath.

PD's narrowed down the possible toxins.

We hope to have an answer soon.

Look, I understand you're upset, April.

Ethan is dying, and you
didn't fight for him.

I did what I was obligated to do,

and Dr. Choi would have
done the same thing.

Can you seen the splenic artery?

Not yet.

I'm still getting through
the mesenteric fat.

Just keep going.

Ava, you've probably
given a pint by now.

I'm doing fine.

You're gonna run out of blood
before we even get there.

If I stop transfusing now, he'll die.

This is crazy.

Okay, tell Dr. Grant I'm
through the uterine wall...

and ready to deliver.

Through the wall. It's a baby.

Through the wall.

Yeah, she's through the uterine wall.

Hold on.

The placenta's in the way.

I can't see the head.

Ask Dr. Grant if I should
extend the incision

or reach through the placenta.

Well, can you reach around it?

- Is there any room?
- Ask Dr. Grant.

Yes, Dr. Grant, Dr.
Manning wants to know

if she should extend the incision

or go through the placenta.

Dr. Grant says that...

That she totally trusts
you to make that call.

No, she needs to tell
me which way to go.

Make the call, Manning.
Manning, make the call.

Dr. Grant says that without being there

to assess the position of the placenta,

there's no way that she can
make that determination.

You need to decide.

I'm going through the placenta.

Hold on, it's too high.

I need you to come over
here and push down on it.

- Here?
- Yeah, I think so.

Okay, I'm sorry, but
you're gonna feel this.

Get out of me! Help!

Get out of me.

Did you get the baby?

No.

Maybe I should do the incision.

Stop! Get off me! Stop!

Okay, okay, Hold on.

How about now?

Yeah, okay...

I think... yeah, there it is.

Okay, push again. Push again.

Get off me!

I got it.

The baby...

Push. Push. I got it.

- Keep pushing.
- How's the baby?

I got it.

How's the baby?

He's not breathing.

His trachea's blocked with secretions.

- What do you need?
- An aspirator.

Something to get the secretions out.

All I got is this IV tubing.

Give it to me.

He's okay.

You did it.

Yeah.

Baby greens, baby
carrots, baby teeth...

Baby single parents, baby teeth,

baby blankets, warm
blankets, fuzzy blankets.

The artery's almost
impossible to get to.

You okay?

Yeah.

Ava.

You need to sit down
before you pass out.

I'm okay.

Hey! Hey. Hey.

I'm not taking out the
tube till you're done.

All right, stay with me just
a little bit longer, okay?

Hold on for me. Stay with me.

And...

All right. And...

All right. We did it.

Ava? Ava!

Ava.

Hey, Ava-whoa.

Okay. Okay.

Hold on here.

Okay, there we go.

There we go.

Did we do it?

Yeah.

Yeah, we did it.

Coming through.

Any changes?

Nothing.

All right, keep him going.

Word is we should have
an ID on the toxin soon.

He's in v-fib.

April, start compressions.

I need these cuffs off.

Monique, charge to 200.

Bag.

Clear.

Continue compressions. Charge again.

Clear.

Still no pulse.

Charge again.

Clear.

- Continue compressions...
- No, he's gone.

Time of death, 12:12.

They identified the toxin.

It's cyanide.

Oh, God.

Ethan.

Okay, let's go everyone. Let's go.

We got the all clear. Let's
get everyone inside.hot.

All affected staff, go
to Trauma Two and Three

and we'll triage from there.

Let's go.

Give a dose to everyone who's affected.

- What is it?
- Hydroxocobalamin.

It helps counteract the cyanide.

I got the hydroxocobalamin.

Think it'll work?

As you know, there's no
antidote to cyanide.

But it's the best chance we got.

Dr. Grant, how's Claire doing?

She and the baby are both stable.

You did a nice job.

Well, I couldn't have
done it without you.

I don't follow.

The phone call with Dr. Charles.

Thank you for getting me
through the c-section.

I wasn't on any phone call.

Dr. Charles,

you lied to me.

Yes, I did.

You tricked me into doing a surgery

that endangered both
Claire and her baby.

What you did was reckless
and unprofessional.

You had no right to manipulate me.

Can I show you something?

She looks good.

Yeah.

Meds kicked in.

Listen, you were trying to
solve a very tricky problem,

and most doctors would have tried

to talk her out of this pregnancy...

But you... you saw the woman,

not the mental illness.

You have excellent instincts, Nat.

Just gotta trust 'em.

We've got a room for him in ICU.

We're moving him upstairs.

I'll make sure they call
if anything changes.

Thank you.

Ms. Goodwin, you were right.

He would have done the same thing.

His pressure's going up.

I think the medicine's working.

All right, get him upstairs.

Two units of PRBC are up.

What happened?

The surgery got a little complicated,

but you're gonna be fine.

In fact, your wife is
waiting for you in the ICU.

They're gonna get you up to her,

and I'll be there to meet
you in just a minute.

Here you go.

You know I hate peanuts.

Well, as long as you're
not allergic, right?

What you did back there...

you were incredible.

Derek's alive because of you...

So thank you.

Wait.

About your father.

No, forget it, Ava.

I-I had no right to get
upset with you like that.

- I'm sorry...
- No, Connor.

It was me.

I was the one who asked your father

to donate to the Hybrid Room.

What... you?

You were taking that job
at the Mayo Clinic.

I didn't want to lose you.

Will, are you all right?

That's blood.

Were you exposed to the cyanide?

Maybe.

Let's get you back inside. Come on.

Let's go.

April, the ICU just called.

Dr. Choi's improving.

Oh, thank God.

Go on, go up there. I'll
cover your patients.

Okay.

Hey, you know, what I said earlier

about there being nothing
left between us.

- I was wrong.
- I knew that.

Hey, you're up.

Yeah.

So it turns out it's not cyanide.

It's an ulcer.

Huh.

Did you know this was happening?

I had no idea.

What is going on, Will?

Are you stressed?

- No.
- Really?

Because I have to say you've
not been yourself lately.

Natalie, most ulcers are bacterial.

- They're not stress-related...
- I know that.

With the way you've been
acting, it is not...

There's nothing going on.

I'll go get your antibiotics.

- Thanks.
- Yeah.

Is there something
you're not telling me?

No.

Everything's fine.

Okay.

Vicki.

Hey.

I got a call from the hospital.

Apparently you haven't updated
your emergency contact.

Are you okay?

I will be.

Are you back in town?

Couple months now.

I'm back at the VA.

- I should have called...
- It's okay.

Glad to see you.

So how was Germany?

It was good.

I've had enough bratwurst
to last me a lifetime,

but my skiing has
vastly improved, so...

That's good.

I see you're still funny

even when you're laid
up in a hospital bed.