Chicago Med (2015–…): Season 8, Episode 3 - Winning the Battle, but Still Losing the War - full transcript

Move the CR!

Stay with me.

So this is how
it's gonna be?

All day long, you've been
talking down to me.

I should have
given you credit.

I was very impressed
with the way

you nearly killed our patient.

[suspenseful music]

We are running low
on a number of key supplies.

No, no, no, no, no!
Stop! Stop! I need that dye.

We can't have one patient
depleting our supplies.



So call into the hospital.

We're all in the same boat.

Dr. Cuevas and I
have a strong hunch

that David is developing
schizoaffective disorder.

No! My boy isn't crazy.

Stay away from us.

How is that boy
supposed to get any help?

It is a real pleasure

to finally meet you,
Dr. Hawthorne.

My colleague at Med,
David Kwan,

he sings your praises highly.

Oh, I'm not the doctor.

I'm her assistant, Katherine.

Okay.



Sign and date
these forms, please.

Just wherever you see
a highlight.

While you're
finishing up with that,

I'll go over our
policies and procedures.

Everything you discuss
with Dr. Hawthorne

is confidential,
except in the event she feels

- you're a danger to yourself.
- You know what, Katherine?

I'm... I'm actually a
practicing psychiatrist myself,

so, I mean, if you'd like,
you can skip that part.

I totally get it,

but Dr. Hawthorne,
who you'll meet next week,

requires we go through
the policies together.

If the doctor feels that you're
a danger to yourself or others,

- she's required to report...
- You know what, Katherine?

I appreciate you're just
trying to do your job.

But, um, maybe you could tell
Dr. Hawthorne

to give me a call when she has
a chance

to meet me herself
in person, okay?

Um, you know what?

On second thought,
maybe tell her not to bother.

Yeah.

It's been a long time since

you had to hunt
for a therapist.

Want me to shoot you
some names?

I got a small stockpile
of referrals.

I gotta be honest, Sharon,

after these last
two experiences,

my interest in the process
might be waning.

I mean, this morning
in particular

actually had me questioning
the state of psychiatry.

Well, that
assembly-line mentality

is plaguing much
of medicine these days,

not just psychiatry.

But don't worry,
you'll find your person.

- See you later.
- No coffee?

Ugh, no.
I don't have any time.

We're implementing a new
drug shortage protocol,

so I'll be in the ED all
morning walking the staff

through the new guidelines.

You couldn't get
the enforcer,

otherwise known
as Maggie Lockwood on that?

[chuckles]
She's in Paris.

She and Ben never
took their honeymoon,

and she was gonna
lose her vacation days.

- Wow.
- Yeah.

Well, still, not a great time

to be short-staffed,
though, right?

There's never a good time.

- Yep, you got that right.
- See you later.

[alarm beeps]

Get these off me!

David Sullivan,
17-year-old male.

Oh, we've met.
David, it's me, Dr. Archer.

- Do you remember me?
- I can't stay here.

They're gonna find me.
I have to keep moving.

- I can't stay in one place!
- It's okay, honey.

- You're safe. You're safe.
- He ran naked into the street.

Dad managed to grab him
before he got hit by a car.

No visible injuries
that I can see.

Gave him 0.5
of lorazepam en route.

Hello, again, Mrs. Sullivan.
Is your husband all right?

[stammering] He's fine, yeah.
He's just a bit shaken up.

He drove behind us,
should be here any minute.

- Doris, would you...
- Page psych. I'm on it.

Okay, finish my sentences
for me, why don't you?

Okay, David, we're gonna
loosen your restraints now

and move you to the bed.

I need you to stay still.

Keep your hands
by your side, all right?

Okay, ready, everybody?

On my count, one, two, three.

Good. Okay.

Very good, okay.

- Oh, no, no, no, no, no!
- It's all right.

- It's all right.
- David, please.

Just let the doctor
look at you, okay, honey?

They came inside the light.

They're trying to steal
my DNA so they can clone me.

Okay, so what do you think
could have triggered this?

We were at a stoplight,

and David became fixated
on this billboard.

It was just some random man
selling car insurance.

He's not random.
He works for them.

- There's a whole network.
- I don't know.

He started taking
his clothes off and telling us

that they were... they were
bugged with recording devices.

And then right when the light
turned green, he bolted.

He ran across four lanes
of oncoming traffic.

There was...

[suspenseful music]

There was a pickup truck
that was coming right at him.

- And he... [breathing heavily]
- Eric.

- Sir, are you all right?
- Oh, my God, Eric!

All right,
let's get him to the ground.

- Eric! Eric!
- Come on.

- What's going on with him?
- It was meant for me.

- They're gonna kill us all!
- It's okay, honey.

Mom, we gotta
get out of here now.

- Let's get a gurney over here!
- It's okay.

- Come on!
- Oh, my God.

No, no, no! No, no!

[breathing heavily]

[♪]

Your husband's CT angiogram
showed an aortic dissection.

That's essentially a tear
in the wall of his aorta.

So Eric didn't
have a heart attack?

Well, a dissection
can often mimic

heart attacks in presentation.

This particular tear
is very close to his heart,

which is why we need to get him
to surgery as soon as possible

in order to repair it.

- Open heart surgery?
- Mm-hmm, yes.

Dr. Morris, one of our
cardiothoracic surgeons,

will be performing
the operation.

He's on his way here now.

Oh.

Okay, can I see Eric
before he goes under?

Yes, of course.

Once we get him to pre-op,
I'll have a nurse come get you.

How about we go somewhere
and chat for a bit?

[whispering] Thank you.

Okay.

I don't understand.

Why would David think that
this man on a billboard

was after him?

It's what we call
a delusion of persecution.

Yeah, one becomes convinced
that some individual,

you know, or group is
conspiring to harm them

or the people that they love.

And these delusions,
that's something that

you see with schizophrenia?

It is, yeah.

I know Eric and I
weren't exactly receptive

the last time we all spoke.

We completely understand.

It's... it's a lot to take in.

I Just thought
that David was going

through some kind of phase,
growing pains, you know?

But in these last couple
of days, it's like he's...

He's lost all touch
with reality.

It's just like,
I feel him slipping away.

Mrs. Sullivan, I promise you,
David is still there.

Yeah, and with treatment,
these episodes will become

less severe and less frequent.

And with proper management,
they can even go away.

What do you mean, medication?

That's a crucial component,
yeah.

David thinks people
are trying to poison him.

How am I going to convince him
to take pills?

There are actually
inject able versions

of many antipsychotics.

Though we don't generally
start there.

Those are usually held
in reserve

for non-compliant patients.

Of course.

I'm just saying, if he refuses
or becomes non-cooperative,

- they're an option.
- Right.

But we'll cross that bridge
if and when we get there.

In the long run,
it's just much better

if we can get David on board
with taking medication.

Okay.

- Ms. Martin, I'm Doctor...
- [gags]

[spits] Liza.

Sorry, you were saying?

Uh, I'm Dr. Choi.

I understand you haven't
been feeling well.

Yeah I can't
keep anything down.

And you're 12 weeks along.

Uh, that's just an estimate.

I only just recently
found out I was pregnant.

I haven't gotten around
to see a doctor just yet.

Well, in that case, we'll go
ahead and run an ultrasound.

Doris, will you mind
grabbing Dr. Asher?

- Sure thing.
- Thanks.

So when did the vomiting
and diarrhea start?

Just last night.

And you haven't
taken any medication?

No, nothing.

I don't want to take anything
while I'm pregnant.

Well, you know there are
some nausea medications

that are safe for pregnancy.

Still, I just...

I would rather not.

I'll be fine.

I just really came in here
to make sure the baby's okay.

Understood.
Mind if I press on your belly?

I just want to see
if anything feels tender.

Mm-hmm.

[suspenseful music]

No, no, no. No, no, no.

I don't want her.

You'll have to get me
another doctor.

Dr. Asher?

Hannah Asher, right?

Yeah.
She's an excellent physician.

She's an addict.

You get me another doctor,
or I'm leaving.

Whoa, whoa, whoa.
Okay, okay, okay.

Just hold on a moment.

[♪]

Hey, Hannah, sorry,
I jumped the gun, actually.

We're all good.

Oh, okay.

Well, in that case,
I'm grabbing breakfast

if anybody's looking for me.

Dr. Tanaka-Reed,
hold up a minute.

Can you have them
update that for me?

Thank you.

Look, I... [clears throat]
I wanted to clear the air.

The other day, I may have come
off a little condescending.

I appreciate the
acknowledgment, Dr. Marcel.

Of course, and if there's
anything you'd like to say...

No, don't think so.

We're all good.

What, you didn't
have time to grab him

flowers from the gift shop?

Huh?

I mean, I expect the other docs

to go soft on the residents.

I thought you had grit.

Well,
no man's an island, right?

Aha.

You know, island life's
really not so bad.

Maybe you just don't
have the stomach for it.

Dr. Marcel, you've got
a trauma incoming.

Well, thanks for
that pep talk, coach.

Any time.

[groaning]

What do we got?

Marcus Walker, 50-year-old
male, fall from standing.

Gave him a 500 liter
bolus en route.

Pressure's hanging
around 100, systolic.

Heart rate's 120.

Yeah, I've never seen him
in this much pain.

It hasn't let up since
he hit the pavement.

This is his sister, Janet.

Did you witness
the fall, Janet?

He lost his balance
stepping off the sidewalk.

It didn't look that bad,
but then he couldn't get up.

Okay, we'll give him
something for the pain.

We just got to find
the source of it first.

Any medications
we should know about?

Dialysis.

Oh, and he takes ramipril
for his blood pressure.

Okay, here we go, guys.

Nice and easy on my count,
okay?

One, two, three.

- [groans]
- I'm sorry, Marcus.

I'm right here, Marcus.
I'm right here.

Janet, let's give the doctor
some room to work, okay?

We're gonna take care of him,
Janet, we got this.

Let's hang a unit
of whole blood.

Pressure it in, Ron.

Hey, Marcus, put your arms
by your side for me.

There you go, bud.
Deep breaths.

Okay, lungs are clear.

- He's still shocking.
- Yeah.

He's bleeding from somewhere.

Let's fast him, Dr. Taylor.

[tense music]

[♪]

Belly's negative.

Really?

Yeah.

All right,
let's get him on his side.

Herbert, come over, please.

All right, here we go.
Nice and easy, all right?

One, two, three.

[groans]

There you go.
You're doing great.

You're doing great, Marcus.

[♪]

What is it?

Oh.

An abscess.

Looks like it.

Pus under pressure.

It's gotta be
the source of the pain.

All right, let's drain it.

Scalpel.

[groans]

Hematoma.

Yep.

Hold pressure and pack it in.

- You got it?
- Yeah.

- Okay.
- Got it.

All right, give me
another unit of whole blood.

Start DDAVP and a unit
of platelets, stat.

Come on, let's move, folks.

Ms. Arya, hello again.

Indrani, please.

Indrani, I got the results
back on your culture.

Unfortunately,
you tested positive

for an infection called MRSA.

From an ingrown toenail?

MRSA is really hard
to treat, isn't it?

While it is resistant
to many antibiotics,

luckily, there are a couple
that still work for it.

How long do I have
to be on antibiotics?

- About seven to ten days.
- Oh.

See, I told you you wouldn't
have to cancel your trip.

Oh, yeah?
Where are you headed?

Well, I'm going to Scotland
in a few weeks

to hike the West Highland Way.

It's a 96-mile trail
through the Scottish Highlands.

96 miles?

I've been training
for the last year.

I may be pushing 60,
but I don't feel it.

Let's start with vancomycin.

No, I can't take vancomycin.
I'm allergic.

Aha, I see that.

I had a terrible reaction
when I was a kid.

My throat closed up.

Then we will steer clear.
Nancy?

- Linezolid? On it.
- Mm-hmm.

We'll get you in tip top
shape for Scotland, Indrani.

I've been wanting
to do this a long time.

Um, Dr. Halstead,
the pharmacy

won't release the medication.

What?

Is there a problem?

[suspenseful music]

No, just probably
a system glitch.

Sit tight,
and I'll be right back.

Look, per the new protocol,

you're gonna have to go through
Infectious Disease first.

And they're going to want
to try incising

and draining
the infected tissue

before they approve
giving linezolid.

Incising and draining?

So source control.

That is not gonna
cut it, Ms. Goodwin.

She needs linezolid.

I mean, can't we just
say that, um,

you know, Infectious Disease
already signed off?

No, we cannot, Dr. Halstead.

Linezolid is on
the restricted list

due to extremely low inventory.

There's a region-wide shortage.

And we are dealing
with a systemic MRSA infection.

You're looking at the patient
in front of you.

But the Oversight Committee
designed the guidelines

to ration these drugs
to the most severe cases.

I have seen early
source control work wonders.

Give it a shot.

- [sighs]
- Dr. Marcel.

- Yeah?
- I got Marcus' CAT scans.

Uh-huh.

Two very severe
lumbar burst fractures.

All from a spill
on the sidewalk?

Take a look.

Oof.

Renal disease definitely
sped up his bone loss.

He's gonna need spinal
stabilization surgery.

Yeah, agreed, only option
to get him walking again.

Given his co-morbidities,
without it,

he's just
gonna circle the drain.

All right, let's...
Let's go talk to neurosurgery.

And David, this voice
that you're hearing,

is it male or female?

I don't know.

It's more like
it has its own language,

its own way of communicating.

And then my brain
translates messages

- so I can understand them.
- Mm.

Are you getting
any messages right now?

That you're
writing down everything

I say because
you work for them.

[♪]

You're one of their spies,
aren't you?

No, I'm not a spy.

Then give me your notebook.

I'm not gonna give you
my notebook, David.

Give it to me.

David, I need you
to listen to me.

I'm a doctor.

I'm writing things down
so I can

better understand
what's going...

Get out of here!

Out, now!

David, David,
how about Dr. Cuevas

puts her notebook away for now.

Would that make you
feel better?

And I notice you've been
checking out this vent.

There's a camera in there.

Huh.

They're always watching me.

There isn't a camera
in there, David.

Yeah, I'm pretty sure
that there isn't.

But, you know, we're...

We're happy to cover it up
if it'll

make you more comfortable.

Okay, good.

So why don't I go see
what I can scrounge up.

And I have another
couple of patients

I need to check in on,
but in the meantime,

is there anything else
I can get you?

Can I have a Coke?

Absolutely.

Okay, so back in a bit.

And Dr. Cuevas, can I just
get a quick word, please?

[♪]

So with patients
experiencing paranoia,

I've found that it's probably
not the best idea to push back

too hard on their
version of events,

you know,
especially at the outset.

There's actually
evidence-based research

suggesting the opposite,

that you shouldn't reinforce
a patient's delusion.

Instead, you should
try to explain to them

why they're experiencing
things differently.

I hear you,
except that that's

pretty much impossible
if you haven't

first established trust.

But very glad
to hear that you are

keeping up on the literature.

Way to go.

[♪]

Ooh, got Choi
as your advisor.

Luck really isn't on your side.

Why?

He's been really cool with me.

Yeah, well, I wouldn't
get too comfortable.

Word is, he's a real hard-ass.

Got his last resident fired.

Olga, what are you
doing down here?

I was gonna ask you
the same thing.

- I assumed you were out today.
- Why's that?

Oh, well, Dr. Choi
asked me to ultrasound

his pregnant patient.

I don't understand.
Why would he ask you?

I cover the ED.

[tense music]

So do you have a question
about my qualifications

- or something?
- Of course not, Hannah.

Then why would you
ask another obstetrician

to do an ultrasound
in the ED when I'm here?

Obviously, you don't trust me.

It's not that.

I...
[sighs]

The patient
requested another doctor.

She... she knew about your past.

What? How?

Does she know me personally?

She didn't volunteer
that information,

- so I didn't press it.
- Fine.

- Forget it.
- Hannah.

I'm just so sick of this
following me everywhere I go.

No matter how much
progress I make,

everyone's still judging me
for who I used to be.

[♪]

Nope.

Medically, it's just too risky.

Chronic hypertension,
end-stage renal disease...

The list goes on and on
with this patient.

The real kicker
is that platelet count.

I'm not touching anyone whose
platelet count's below 100k.

Listen, we know that he's
not an ideal candidate.

Oh, wait, I almost forgot.

You guys also hacked
his back open in the ED,

making a posterior
approach impossible.

Should I go on?

Look, I can give you
great anterior exposure.

All you have to do
is stabilize his spine.

I'll take care
of everything else.

Oh, you'd be
assisting me on this one?

Wow, way to save your
strongest argument for last.

Maybe you're just worried
about your stats, Sam.

[scoffs]

Send him up
to interventional radiology.

Have them inject cement
into his fractures.

That'll at least
get him sitting up.

But that won't
get him walking.

And lack of movement
is dangerous

in Marcus's condition.

He can develop pressure sores,
blood clots, pneumonia.

All preferable to him
bleeding out on my table.

[sighs]

We just need
to get his platelet count up.

Yeah, it's the only way
to get Marcus

healthy enough for surgery
and Abrams on board.

All right, I'll...

I'll order a couple of units
of platelets, all right?

[knock at door]

Patty, any updates
on your husband?

Oh, he just
went into surgery.

Dr. Archer said
it will be a while

before there's any updates.

Okay, well,
he's in very good hands.

You can trust me on that.

David, got that Coke
you asked for

and some stuff for the vent.

Do you think you might
be up for chatting a bit?

You all right, pal?

[suspenseful music]

Trini gave him something
just to calm him down.

Huh.

Okay, back in a second.

What did you give him?

6 of risperidone.

What?

Who the hell ordered that?

I did.

[♪]

He became extremely agitated
and was resisting restraints.

Lorazepam worked
this morning.

You didn't see
how upset he was.

Haldol then.

He was going to
tear out his IV.

His mom was freaking out,
begging me to do...

Well, you cannot
let a family member

pressure you into making
a rushed treatment call.

It wasn't rushed.
It was necessary.

And besides, the meds
will clear his system

by tomorrow morning
at the latest.

At which point,
we'll be back at square one

with David,
if we're lucky, all right?

Any trust established,
down the drain.

How about this, in the future,
maybe at least page me

before administering a very
high dose of antipsychotics

to a patient
we're still evaluating?

With all due respect,
Dr. Charles,

I am not a trainee.

And 6 milligrams is well within
the standard of care, I...

Standard of care,
whatever that is,

is not some blanket template
you follow

without any regard
for the person in front of you

you're supposed to be helping!

[tense music]

[♪]

Hey, Janet.

I just want to let you know,
the nurse will be by soon

to start Marcus'
platelet transfusion, okay?

[apprehensive music]

[♪]

I know it's been a rough day.

More like a rough year.

Lost my husband in January.

I'm so sorry.

Marcus came out from
California for the funeral

and just never went home,

moved in with me.

You must really get on.

[sniffles] Never had
a choice in the matter.

We're twins, actually.

Marcus was born
45 seconds before me,

but you'd think he was
years older, the way he acts.

Seeing him here like this,
so fragile...

It's really hard.

[♪]

I want you to know that, uh,

we're gonna do everything
we can for Marcus, I promise.

Okay.

What is it?

I was just looking back
in Marcus's history.

His platelets
have always been low.

Huh.

Do you think this is chronic?

Some kind of undiagnosed
blood disorder, or...?

- ITP would be my guess.
- Oh, man.

And if that's the case,

a transfusion is not
gonna do much.

I mean, his body would just
keep chewing up

any new platelets we give him.

Well, unless...

Unless what?

Um, forget it, actually.

I thought I had something.

But let's just hope
the transfusion

moves the needle a little,
okay?

[suspenseful music]

[♪]

Podiatry incised
and drained the toe.

They had to cut the nail out.

I'm not a doctor,
but it looks like

it's getting worse to me.

Don't worry. I'm on it.

We're gonna get you
the medicine you need.

Dr. Halstead, can I
speak with you outside?

What's wrong?

Just give us a moment.

We're now completely
out of linezolid.

You've gotta be kidding me.

I knew it.

I knew source control
wasn't gonna cut it.

How soon are we expecting
to get it back in stock?

Tomorrow morning,
at the earliest.

Order vancomycin.

She's allergic.

I know, all right,
but I've got an idea.

- [knock at door]
- Hey, Liza.

So got your labs back,
and they look good.

Your white blood count
is slightly elevated,

but that's pretty common
in pregnancy.

I think we're just looking
at a stomach bug.

Makes sense.

I can go home then?

Yeah, Dr. Patchefsky
sent down a list

of OB-GYN referrals,

as well as some
genetic testing counselors.

We'll just add those
to your discharge.

Genetic testing?

I thought she said the...

The baby looked healthy
on the ultrasound.

Genetic testing
for hereditary conditions

is completely optional.

But the baby's healthy,
right?

Yeah.

Hey, listen, if...

Liza, my dear.

I have your
discharge paperwork.

I'm not sure
I'm following you.

You want to give me a drug
I told you almost killed me?

And we'll do everything
we can to mitigate the chances

- of another adverse reaction.
- How, exactly?

Through a process
called desensitizing.

We'll pre-medicate you with
steroids and antihistamines

and then administer the
vancomycin via a slow IV drip.

And can you promise me
that my throat

won't close up again?

I can't promise that, no.

But if you do
go into anaphylaxis,

we'll have epinephrine
at the ready.

Worst case scenario,
we might need to intubate,

but that would
only be temporary.

Intubate me? No, no.

I'll go to another hospital.

Well,
we've called everywhere.

The earliest anyone has
linezolid is tomorrow.

So I'll wait.

As you're seeing,
MRSA moves fast.

I am afraid
if we wait until tomorrow,

it will have already
spread to the bone.

You could lose
your leg, Indrani.

[♪]

Give me the vancomycin.

Okay.

Marcus' platelet count rose
from 50,000 to 105,000.

Can you believe it?

That's great.

It's fantastic.

He must not have ITP after all.

Do me a favor.

Show Abrams these updated labs.

I think he'll be more receptive
if you deliver them solo.

How could he possibly
refuse to operate now?

It's Abrams.

I'll get him on board.

Dr. Choi?
We've got a problem.

Liza?

I thought she had left.

I came in
to turn over the room,

and I found her passed out.

Let's get her
back in the bed

and up on the monitors.
Ready?

One, two, three.

All right. All right.

Liza?
Liza, can you hear me?

All right, let's re-start
her IV and get a Foley in her.

- Grab OB.
- Patchefsky, right?

No, no, no. No time.

- Grab Asher.
- Okay.

She's hypotensive.
BP 85/43.

Maybe she vasovagaled?

Her white count was more
significant than I thought.

[alarm beeping]

Liza.

- You know her?
- Yeah, Doris filled me in.

How long had she
been experiencing symptoms

when she came in?

Less than 24 hours.

And that's self-reported
from the patient?

Yeah, why?

[♪]

Bolus a liter
of normal saline.

Hannah, we've been
giving her fluids.

Could this be sepsis?

We could start a broad
spectrum antibiotic.

Let's just see
what this does first.

I don't think
we're looking at sepsis.

I think she's hypovolemic
from massive volume depletion.

I suspect she's been sick
a lot longer than she reported.

BP's starting to come up.

[machine beeping]

[♪]

Appreciate you stepping up
to the plate on this one, Sam.

His platelets sure turned
around fast, didn't they?

Marcus is a fighter.

All right, this is my show.

Once we get to the spine,
you follow my lead, understood?

Fair enough.

Mia, start my play list.

[jazz music playing]

All right, after you.

Scalpel.

[♪]

Where are we at?

I gave 125 of the
methylprednisolone

and 50 of diphenhydramine.

All right, we're ready
to start the vancomycin.

Now, we're gonna
take it slowly,

gradually increase the dose
over time.

Are you ready?

As I'll ever be.

[tense music]

[♪]

Something doesn't feel right.
[machine beeping]

- Okay.
- Oh, my God.

Oh, my God.
My throat... I can't swallow.

Okay, we got you.
Nancy, 0.3 of Epi.

[breathing heavily]
I can't...

It takes time to work.

Just stay calm.
Keep your eyes on me.

Another 0.3 of Epi and another
50 of diphenhydramine.

Mask.

There you go.

Get ready to intubate.

Just a precaution.

[♪]

I think it's working.

Slow, deep breaths.

In through the nose,
out through the mouth.

[exhales slowly]

That's it.

So how long have you
actually been sick?

This is day six.

Ever since I stopped using.

Did you know
that these symptoms

are a result of withdrawal?

I figured.

Dr. Asher, if I outed you
to your colleagues...

No.

No, you didn't.

Everyone here knows
that I'm in recovery.

And you don't have
to call me Dr. Asher.

It does feel kind of weird
calling you by your last name.

I won't tell anyone in group.

Thank you.

I don't even
know if the drugs

have cleared my system yet.

I couldn't risk you
running a drug test on me,

given everything you know
about me.

I just... I don't want
anyone taking my baby away.

Well, I commend you
for quitting, Liza.

Going cold turkey
is really hard.

[solemn music]

There are some medications
like Suboxone and methadone

that can help curb
the cravings.

Those are opiates, right?

Yes.

But when you're
medically supervised,

you are allowed to be
on them while you're pregnant.

The risk to the fetus
is minimal...

No.

If there are any risks,
then no.

I probably shot up,

like, a half dozen times
during my first trimester.

And still, by some miracle,
the baby seems to be okay.

I can't do anything
to jeopardize that.

I won't.

[knock at door]

Come in.

I was going to check
with Mrs. Sullivan

to see if she would agree
to David spending

a couple of nights
in the psych ward.

I figure we can
talk to him more,

begin to find the correct
medication and dosage.

Well, that sounds good,
Dr. Cuevas.

Thank you.

Oh, and his father
is out of surgery.

No complications.

Well, good stuff.
I'm glad to... glad to hear too.

I should have spoken to you
first before medicating David.

Look, you know it was
a chaotic situation,

and I understand that you felt
the need to act swiftly.

I do.

I probably did jump
to medication too quickly,

if I'm being honest.

[pensive music]

I know I rely heavily
on the literature

and the standard of care,

but I just don't always feel

like I can trust
my own instincts.

I mean, it took me
years, years.

And still, I have...

I have my days when... you know?

But this, I can promise you,
you will get there.

You will.

There's not a shred
of doubt in my mind.

Trust me on that.

[♪]

Hey, Janet.

Marcus did great.

I can't thank you
both enough.

No need.

He's got a long road ahead,

but with physical therapy,
I'm confident

he'll be back on his feet.

[stammers]
Can... can I see him?

Of course.
I'll take you to recovery.

Now, he's just waking up, so he
might be a bit groggy, okay?

This way.

Dr. Abrams,
I heard the good news.

I really appreciate...

Yeah, you two ever pull
a stunt like that again,

I won't keep it to myself.

I'll go straight to Goodwin.

Excuse me?

I don't appreciate
being conned into surgery

- under false pretenses.
- Wait.

I'm sorry, Dr. Abrams.
What are you talking about?

[tense music]

My antenna went up
when Marcus's platelets

corrected so quickly.

So I had the lab run
an anti-platelet antibody test

while we were in surgery.

You might be interested
in the results.

- Marcus has ITP.
- Mm-hmm.

But this doesn't
make any sense.

If Marcus has ITP,
the transfusion

- shouldn't have worked.
- Correct.

Unless someone gave him
a little assistance.

[♪]

You gave Marcus steroids,
didn't you?

And that's why
his platelet count went up.

I know steroids
can be controversial

- in the surgical settings...
- To put it lightly.

You put him at greater risk
of post-op infection.

Vanessa, believe me
when I tell you,

this was our only play.

Our only play?

I was left in the dark.

Look, I didn't want you
catching any heat

if things went south, okay?

I have more cover
as an attending.

I was trying to protect you.

[tense music]

I do not need
your protection.

I need your respect.

Vanessa,
of course I respect you.

It does not feel
that way right now.

[♪]

Looking much better, Indrani.

Some techs will be back soon
to move you upstairs.

We're gonna keep you on IV
vancomycin for a few days

and then switch you over
to the oral version.

Dr. Halstead,
I can't thank you enough.

I'm just sorry we had to
put you through all that.

Oh, it was worth it,
believe me.

That's where I'm going to be
next month.

I'm adding it
to my bucket list.

Would you excuse me
for a moment?

Of course.

Ms. Goodwin.

Stop by my office
before you leave tonight.

I'd like a word.

Will do.

Dr. Choi,

uh, this is for you.

I saw you were staying on
for the night shift,

so I figured you might
need a caffeine boost.

Oh, and these are also for you.

It's my CV,
in-progress research papers,

and all my case logs to date.

For our first advisor meeting
tomorrow.

Ah, well, you are
really prepared, Zach.

Will you excuse me?

Yeah, of course.

See you tomorrow.

See you tomorrow.

- Hey.
- Hey.

Liza agreed to be admitted
overnight for observation.

Good.

She's in withdrawal, I take it.

Don't worry,
I won't say anything.

I appreciate that, Ethan.

And while I suspect
that the drugs

have already
cleared her system,

she's terrified someone
might report her.

The last thing
she needs is to be

penalized for seeking care.

Look, you were
absolutely right, by the way,

to bring in Dr. Patchefsky.

I never should have
given you flack for that.

Look, I know
how frustrating it is

to always feel like
you're being held

to some former version
of yourself.

But on the flip side,
because of who you were

and what you went through,

you were able
to connect to Liza

in a way no one else could.

[pensive music]

Yeah.

I guess that's true.

Maybe it's not always
such a bad thing,

having your reputation
precede you.

[♪]

Great work today, Sam.

[tense music]

[♪]

Goodnight, Dr. Taylor.

Ooh, ouch.

Why, I see you've got yourself
quite the fan club.

You know,
maybe I was wrong about you.

You might be cut out
for island life after all.

[♪]

So let me get this straight.

You gave the patient
an antibiotic

you knew she was allergic to...

Only after I advised her
of the potential risks

and with her full consent.

Which, trust me,
wouldn't hold up in court

if this thing
had gone sideways.

Well, Ms. Goodwin,
it wasn't my first choice.

I understand
the new protocols got off

to a bit of a rocky start
today, but...

They're not working.

I have no doubt
they were designed

with the best of intentions,

but as your boots
on the ground,

I have to give it
to you straight.

Let me give it
to you straight.

These supply chain issues are
not gonna resolve anytime soon,

and not for lack of trying
on my part.

So as imperfect as these
new protocols may be,

we need some sort of semblance
of order in the ED.

I can't have it turning
into the Wild West!

Honestly, Ms. Goodwin,
I think we're already there.

[♪]

[dramatic music]

[♪]

[wolf howls]