Chicago Med (2015–…): Season 8, Episode 4 - The Apple Doesn't Fall Far from the Teacher - full transcript

Dr. Halstead, pharmacy
won't release the medication.

I've got an idea.

There's a
region-wide shortage.

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

I think we're already there.

I'm a recovering addict.

I need to earn my reputation
back with everyone.

But with you, it doesn't feel
like that's ever gonna happen.

You suffered a stroke.

If I can't operate
again, what does it matter?

If it had been
me on the table,



I'm pretty sure he would
have done the same thing.

Hey. Sorry I'm late, Dean.

I don't know what was going
on with traffic today.

I got caught up
in it too. You know,

you can blame the HyperTrain
unveiling for that one.

It shut down the Red Line. A
lot more people on the road.

- HyperTrain?
- Yeah.

You know, Jack Dayton's new toy.

Oh, yeah.

Jack Dayton. Right,
Mr. Megabucks.

Yeah. Yeah, sure, genius.

That HyperTrain is supposed

to revolutionize
public transportation

by moving twice
the speed of the I.



Meanwhile, it takes
us schmucks in cars

twice as long to get to work.

How come Blake's
locker is empty?

You hadn't heard? Blake
tendered her resignation.

She's taking a job at
Brigham and Women's.

- Boston?
- Uh-huh.

Guess she's good enough
to perform surgery again.

- When did all this happen?
- Oh, I don't know.

I got an email
about it last night.

When is she leaving?
She can't leave.

I need to talk to her.

You probably
blame yourself, huh?

No answer?

Voicemail.

All right. I got
to go talk to her.

- I'll be back in an hour, OK?
- All right.

Just don't make it
any more than that.

Hey, Candace. I'm Dr. Asher.

- Hi.
- All right.

Well, it says in here
that you are at 28 weeks.

- Mm-hmm.
- So how's your pregnancy been?

You know, it was going great,

but my lower back
started hurting

about a week ago,
this sharp pain.

- And it's only gotten worse.
- Mm-hmm.

And I called my
OB this morning.

And she told me to
come here right away.

OK. Have you had any
abdominal pains, any cramping?

No. No, just my back.

OK, CBC, CMP, and
urine cultures, please.

Ooh.

- You OK?
- No, no, no.

It's good. She's, um...

She's kicking. I'm sorry.

I've had three miscarriages
over the last six years.

And I'm alone right now with
my husband away on business,

so I'm kind of on edge.

Well, that's totally
understandable.

Let's get your feet up
here, get you comfy.

We'll put you on a
fetal heart rate monitor

just to make sure that that
baby is happy and healthy.

All right? I'll be right back.

Thank you.

- Maggie, you're back.
- Hey.

- Yeah.
- How was your honeymoon?

- It was Paris, right?
- Mm-hmm.

Mm, nice.

Oh, wait.

Paris sounds so great.

I've never been anywhere.

I have a passport. I've
just never used it.

It'll happen.

Thank you.

Dr. Asher.

Just a reminder, you still need
to submit your urine sample

for your weekly drug test.

Right. Of course.

I've been doing it the
last six months now.

How could I forget?

OK, then.

Nope. No pedestrian
access here.

Oh, come on, man.

My friend's building
is up on Ontario.

Sorry, the barricade
is here for a reason.

Jack Dayton, he's showing off
his new HyperTrain down there.

Whoa!

What happened?

The train jumped the tracks!

Hey, come on! Come on!

Are there more
people down there?

Come on, come on.
Let's go, let's go.

Go. Come on.

Hello?

Is anybody in there?

Help!

Hello?

Over here!

Hello?

Help us, please! Help us!

Hold on! I'm coming!

Oh, over here!

Hey!

Oh, thank God.

I tried 911, but there's no
service down here, of course.

- I'm Jack Dayton.
- Yeah, I know.

- Are you hurt?
- I can't tell.

My leg's stuck.

Easy, easy, easy.

All right. Here we go.

One, two, three.

Ow!

Come here.

Your left knee.
Here, sit down.

Let me take a look at that knee.

- It can wait.
- I'm a doctor.

Over there in the
conductor's compartment.

His name is Nathaniel.
He works for me.

He was driving the train.
Come on.

Nathaniel, can
you hear me, bud?

Keep your weight
off that left knee.

Hey, buddy. Can you hear me?

- Ah!
- There you go.

Ah, ah!

All right. I think
we can pull him out.

I can't...
I can't breathe.

Looks like the lithium
ion battery got dislodged,

hit him in the chest.

OK.

All right. Here we go.

All right, I want you to...

I want you to grab
him by his ankles.

Nathaniel, I'm gonna bring
you up a little bit, OK?

OK.

Keep going. Right here.

- Yeah.
- Right here.

OK, OK.

It's gonna be all right.
It's gonna be all right.

I got you, buddy. I got you.

There you go.

OK, look at me.

Nathaniel, you have
a flailed chest

and likely a
hemopneumothorax, OK?

What does that mean?

He broke several
ribs on both sides,

which is now causing a
free-floating segment.

His lung is likely collapsed,

and his chest is filled
with blood and air.

- Let's get him out of here.
- No, no, no, no.

Sounds like the tunnel is
still coming down around us.

Yeah, then we
better move quick.

- Come on.
- No, no, no.

If we try to move him,
we could make it worse.

All right, then.
I'll go get some help.

No, it's too dangerous
the way I came in.

- All right?
- So what do we do?

We wait until CFD
comes to get us out.

It's the safest
option, all right?

I need to get control
of this bleed.

I need to create a pressure
dressing for this wound.

Give me your tie.

Hang in there for me, Nathaniel.

And you're gonna feel
some pressure, OK?

OK.

Morning, Dr. Taylor.

Hey.

Rose, Emmanuel, this
is Dr. Halstead.

Hi. Sorry to hear you're
feeling poorly, Rose.

Dr. Taylor thought I
might be able to help.

The more, the merrier. I'm
well-accustomed to doctors.

My wife has type 1
diabetes and hypertension.

But Rose is here today
because of a chronic UTI.

Her internist prescribed her
several rounds of antibiotics,

but none of them
have done anything.

So I sent a urine
test with cultures.

Mm-hmm.

Multi-resistant
fungal infection.

"Fungal" is such an
unpleasant word, isn't it?

A lot of medical words are...

Phlegm, discharge.

Rose taught 11th grade
English composition

for 32 years.

Words are her thing.

Some are just
naturally embarrassing,

like having a fungus.

Well, no need to be
embarrassed here, Rose.

It says it's sensitive
to voriconazole

and amphotericin only.

So voriconazole.
200 milligrams. IV.

Um, I had the same thought,
but there's a problem.

- It's on the shortage list.
- For three weeks now.

What about this
other medication?

Let us talk it over.
We'll be right back.

Amphotericin B is old-school.

- They call it amphoterrible.
- I know.

And Rose's kidneys are
already compromised

because of her diabetes.

Her creatinine is 2.8 to start.

Ampho will knock them out
and put her in dialysis,

or worse, kill her.

It has to be voriconazole.

Let's start calling around
hospitals, pharmacies,

- see if they have any.
- No, I already did.

Everyone I talked to
in Chicago was out.

I'm not sure what
the next move is,

which is why I
dragged you into this.

I mean, what do you do if
you can't get the only drug

that'll treat an infection?

The pain is
localized to her back.

It says here her UA is dirty.

Yeah, that's not
normal for a urine dip,

but it also doesn't
scream infection either.

- Mm-hmm.
- I checked the shortage list,

and I know that the
contrast dye supply is low.

- It's currently restricted.
- Yes.

But protocol also states that
if a patient needs a CT...

OK, did you ultrasound
her for a kidney stone?

- No.
- Why don't you?

Kidney stones usually
present in pregnant women

- with peritonitis or flank pain.
- Right.

Candace only
has low back pain.

Sure. You can still
ultrasound her to check.

I could, but as we both know,

ultrasound is not very
sensitive for a stone.

A CT would give me a
much better picture

- of what's actually going on.
- OK.

So if the ultrasound doesn't
show anything conclusive,

you'll order the CT, yeah?

- I'll do an ultrasound then.
- Right.

And you might want to start
her on empiric antibiotics too.

In case it's pyelonephritis,
you should get ahead of that.

I mean, like, it's
perfectly natural

for a teenager to
want distance from...

From their parents,
right? But I don't know.

Recently, it just seems like
she doesn't want anything

to do with me at all anymore.

That may only be temporary.

And it's healthy
for your daughter

to seek out this
kind of independence.

You think that I, of all
people, wouldn't know that?

But I don't know, man.

It's been a...

surprisingly difficult
pill to swallow, you know?

And that kind of dovetails
with this other issue

that I'm having at work, right,

involving being there for
patients in difficult times.

I mean, I'm used to living

in those uncomfortable
moments, right?

I mean, it's what we do.

You know what I'm talking about.

You've been doing
this a long time.

- Mm-hmm.
- But recently,

when, say, I have
to give a patient,

like, a really tough
diagnosis, right,

like, tell them or the
people that they love

that they have a lifelong
mental illness...

Their lives are over.

Yeah.

And I've been haunted
by these moments, right?

They stick with me.

It's like sometimes
they stare back at me.

Sometimes they cry.

Sometimes they don't know
what to do, nor should they.

But you know what?
Maybe I should.

Dr. Green well?

Please, go on.

Are you all right?

My chest.

I think... I think I might
be having a heart attack.

Dr. Green well! Otis!

Dr. Green well?

Dr. Green well?

- What do we got?
- Otis Green well, 52 years old.

Collapsed into a
glass coffee table.

EKG was normal.

Multiple lacerations
to the forearm.

We applied pressure
dressings en route

and gave him an aspirin.

He was having chest pains.

Make sure he gets a
complete cardiac workup.

Will do, Dr. Charles.

I'll be right out
here, Dr. Green well, OK?

He's a doctor?

Yeah. My therapist, in fact.

So take good care of him, OK?

Pulse is weak.

He's likely in hemorrhagic
shock from all the blood loss.

Please, am I going to die?

I'm gonna do
everything in my power

to make sure that
doesn't happen, OK?

All right.

Anyone there?
Anyone in there?

Yeah, yeah! Hey, help us!

Hey, Severide?

Severide, is that you?

It's Crockett!

Crockett? Hey, what's
going on in there?

What's the situation?

There's three of us in here!

Two of us are OK, but
the train's conductor,

he's badly hurt.

He's pretty shocky.

This passageway is too narrow.

We'll try and widen it and
get a backboard through.

- It might take a while.
- No.

No, listen to me.
We can't wait.

I need you to get me some
supplies off the ambo,

and I need you to call Med.

I need them to send some
things you don't have.

Copy that!

Just hold tight, Crockett!

Nathaniel doesn't
have that long.

If we're gonna save him, we got
to do it right here, right now.

People, I don't
have many details,

but Crockett is
down in the tunnel

trying to help those
who are injured.

I do know that he
is in touch with CFD

and appears to be
safe at this time.

And I'll update you as soon
as I hear anything more.

Thank you.

Jeez.

I hope he's OK.

Yeah.

Come on.

Ms. Goodwin, we were
just coming to find you.

- Do you have a second?
- Sure.

My patient, Rose Fremont,

has a serious fungal
infection that needs treating.

And the only drug
that can help her,

voriconazole, is unavailable
all throughout Chicago.

Well, could be just
another region-wide shortage.

I'll reach out to our
suppliers out of state.

The army, navy,
and national guard

might be resources as well.

Just do what you can
for her in the meantime.

OK. She's gonna need pressors
to keep her blood pressure up.

Speaking of the army, I
heard about your brother.

Yeah, Jay needed a change.

I think it'll be good for him.

Ah. Well, I know
you two are close.

I'll make those calls.

Adia, talk to me.

Trey Bruso, 22. BP 138/80.

Heart rate, 104.

Fell off a ladder
while painting a house.

I hate hospitals.

OK, we won't take
that personally,

but we'll still try
to get you back up

on that ladder soon, all right?

OK, everyone. Let's get
ready for a transfer.

OK, ready?

One, two, three.

No breath sounds
on the right side.

We need an X-ray!

I want out of here!

The faster we
can get this done,

the faster you can
leave, Trey, all right?

Just relax. Relax.

Stand back.

40% pneumothorax
to the right chest.

Let's get a chest
tube. 28 french.

Sorry, Ethan.

There's a problem.

I sent the last Pleur-evac
out to the tunnel collapse.

Crockett requested it.

- This is ridiculous.
- Relax, Kai.

Dr. Marcel shouldn't
be putting a chest tube

in someone under those
conditions anyway.

- It's not a sterile environment.
- Oh, really?

You think I should have sent
him a note explaining that?

So now our patient
needs a chest tube,

and we can't connect it
to a drainage system.

How is that supposed to work?

The Helmand
Province. Remember?

Oh, yeah. I'll hit
up central supply.

- Yeah, you want help?
- No, I'm good.

It's like riding a bike.

One of you guys want to tell
me what you're talking about?

Pay attention, Kai. You
might learn something.

Mind if I join you?

Candace, this is
Dr. Archer, Chief of the ED.

He's been consulting
on your case.

- How you doing, Candace?
- My back really hurts.

Well, hopefully, that won't
be the case much longer,

so bear with us.

Was I right about
the kidney stones?

I'm not seeing any stone,

but I am seeing
some hydronephrosis

on her left kidney.

- Ah.
- What does that mean?

Your kidney is not
draining effectively,

so it's a little swollen.

I'm concerned that
it might be infected,

so it's a good thing
that Dr. Asher here

has already started
you on antibiotics.

Will it hurt the baby?

The sooner we get
ahead of it, the better.

Give her four of morphine for
the pain and call urology.

Excuse us, Candace.

We don't know for certain
that it's a kidney infection.

If it walks like
a kidney infection

and talks like a
kidney infection...

Hydronephrosis is not
uncommon in pregnant women.

When a uterus gets enlarged,
it can cause urine to back up

and dilate the kidneys.

It doesn't confirm an infection.

I appreciate
your determination

to get a definitive diagnosis,

but you are
over thinking this one.

You know, I just
have this feeling

that I'm never gonna
pass some test of yours.

Oh, God. All right.

Look, I'm getting squeezed
by a lot of shortages,

including contrast dye.

And if the
antibiotics don't work

and if her back pain gets worse,

then you can send her for a CT.

I removed the shards,
redressed his wounds.

Did you get his labs back yet?

Yeah, he's not having an MI.

Though his heart rate was
elevated when he came in,

there's no sign of a
cardiac event at all.

I mean, he's in good health,
but he said he's not sleeping.

Huh. Shoot me his chart.

Yeah.

Well,
this is awkward.

Oh, come on.

We're both doctors, Otis.
Stuff happens, right?

But let's face it, Dan.

I'm supposed to be
taking care of you.

Well, you're gonna have
plenty of opportunity

to do that, all right?

- What do you think happened?
- I don't know.

I just... I must
have passed out.

- Happen before?
- No.

Dr. Hudgins said

that you were having
a hard time sleeping.

Yeah. I haven't been
sleeping much recently, no.

What would you say to the idea

that maybe what you had
was a little panic attack?

Well, let's say that
it was a panic attack.

I guess maybe it could
have been the result

of a buildup of stressors.

All right. All right.

I'm wondering what
those might be.

I mean, when it
happened, I was talking

about the difficulty
that I've been having

giving bad news to patients.

Does that sound right?

I actually don't remember.

Look, I really just
want to go home, OK?

OK.

Except your heart
rate is going back up.

I'm... I'm sure it'll be fine.

Yeah, yeah.
You're all right.

It's not a heart attack,
OK? Just breathe.

OK.

Oh! Oh, the pain, it's back!

Five of Valium, please.

Look at me. Look at me.

In through the nose,
out through the mouth.

In through the nose.

OK, secure!

OK, first bag coming to ya!

All right!

OK, got it!

OK, looks good.

Put that over
there by Nathaniel.

OK, will do.

OK, send the next one!

All right!

Pull!

It's stuck.

It's caught on something.

Pull harder!

- Jack, I need you.
- Yeah, coming.

Give me a hand
with this Pleur-evac.

Yeah, got it.

Crockett!

You OK?

I'm stuck.

Oh, no.

OK, yes. Thank you
for letting me know.

That was CFD.

There's been a secondary
collapse in the subway tunnel.

They lost contact
with Dr. Marcel.

Do they know if he's OK?

It's unclear.

They said they're doing
everything they can

to tunnel him out now.

OK.

Dr. Asher, we need you.

What happened?

She wasn't
complaining of nausea,

and then she just
started vomiting.

OK, let me see.

101.2.

Is this all from
a kidney infection?

Well, let's get her up
to radiology for a CT.

Thank you.

I can move my arm
freely on the other side.

If I could just get the
right angle to pull it out...

Hey, Nathaniel?

Nathaniel, can you hear me?

I think he's losing
consciousness.

He's gonna stop
protecting his airway.

Come on. What can I do?

Throw your weight against me.

Square in the back.

Give it everything you got.

What are you talking about?

You hit me just right.

Pop my shoulder
out of its socket.

I think I can reposition myself

to get the leverage I
need to pull my arm free.

Come on, Nathaniel
doesn't have much longer.

- I could break your arm.
- Just do it.

OK.

- Ready?
- Now.

Aah!

That did it.

Pull my arm free.

Grab my wrist.

I want you to pull my arm
straight out in front of me.

I need to pop my shoulder
back in the socket.

Go, go, go, go! Go, go, go!

Aah!

Oh, I'm good.

I'm good. I'm good.

Crockett, listen, if we
don't get out of here fast,

this whole wall and
everything above us

could come crashing
down any second.

Nathaniel is the priority.

Come on. I need your help.

- You got your phone on you?
- Yeah.

All right. I
need some light.

All right, Nathaniel.

We're gonna get you
fixed up. OK, buddy?

I want you to take the
blood out of that red bag.

And there should be
some tape in there.

I want you to tear
me a little piece.

And there's a
needle in that bag.

I want you to pull that out
and get that ready for me.

Got it.

All right, this might
feel a little uncomfortable.

OK, buddy?

There you go.

I know, I know.
Easy, easy, easy.

He's lost a lot of blood.

We need to get his
blood pressure back up

before we do anything else.

You got that needle prepped?

Yeah.

We got to sedate
him, intubate him.

And then we're gonna hook him up

to that portable
ventilator there, OK?

OK.

I'm gonna get you
out of here, OK?

We've got to get that
halfway into the chamber.

There we go.

Anything else I can do?

Yeah, why don't you get
us a little bit more light,

if you can?

You get a collapsed
lung to re-expand

by evacuating the excess air
in the chest with a chest tube.

And you hook it to a
water seal drainage system

to keep the air from coming
back through the tube.

That's right, but
what if you don't have

a commercial drainage system?

You have to make
one. Three bottles.

Bottle number one is
the collection bottle.

All the fluid and air
that exits the chest tube

comes here first.

Now the fluid stays, but the
air is still on the move,

so we have to reroute that
air through this tube here,

into bottle number
two, the water seal.

And that water keeps
the air from heading back

- the other way.
- Exactly.

Bottle number three
is for suction.

We connect this bottle to
the regulator in the wall,

and it creates a
negative pressure vacuum

that sucks all the air
through all three bottles

but only to the level of
water in the suction bottle.

Makes sense, but
kind of primitive.

But it works.

Two of Versed, 100 fentanyl?

Yeah.

Fentanyl is in.

Go ahead. Put
it in the tube.

Lidocaine.

Scalpel.

And that's how you
DIY a drainage system.

OK.

- Let's secure the tube.
- OK.

So there isn't any
voriconazole anywhere

because the FDA cited
the manufacturer

for workplace issues.

And until that gets resolved,

there will continue to
be a production delay.

So that's it?

Rose might die because the
manufacturer screwed up?

Look, it infuriates me too.

What can be done
for Rose right now?

We can try to
mitigate her symptoms.

But unless we treat
the infection,

she's going to get worse.

All right. I'll keep
searching on my end.

And if anything comes
up, I'll let you know.

Look, I wouldn't mention
this if we weren't desperate,

but I had a friend
in medical school

who was able to get
pharmaceutical-grade drugs.

What do you mean?

For students who wanted
to pull all-nighters.

Usually, it was like
Ritalin or Adderall,

but it seemed like he
had access to everything.

You're talking like
some kind of drug dealer.

It's illegal, yes, but
we're out of options.

How would we even know
the drugs are legit?

He has relationships
with pharmacists.

The quality of the
medicine is not an issue.

Vanessa, we could
lose our licenses,

maybe even go to jail.

I want to help Rose, I do,

but not that way.

No, we can't.

- The light helps. Thanks.
- Yeah.

OK, Nathaniel is sedated.

Hand me this tube
when I ask for it, OK?

- Yeah.
- All right.

OK, intubating.

OK, tube.

OK, tube is in.

OK, we're in business.

OK.

I'm still not hearing
enough breath sounds

in the left chest.

We have to drain the blood.
He needs a chest tube.

Can you fetch me that jump bag,

the one with the
Pleur-evac, please?

Yeah.

Candace's CT results.

Retrocecal appendicitis.

Really?

Well, that's not something
you see every day.

No, it's not.

And the fact that her
appendix is angled medially

explains why she
only had back pain.

Uh-huh.

Change her antibiotics to
ceftriaxone and Flagyl.

Call the OR and have
them open for a lap appy.

I'll join you,

in case anything goes
wrong with the pregnancy.

Mm-hmm.

My heat.

She's not making any sense.

Pressure is down. MAP's 45.

Her septic shock
is getting worse.

Add vasopressin and increase
the Levophed to 20 mics.

My feet...

are cold.

Is there nothing else
you can do for her?

Yeah, place a foley and
update me on her urine output.

That's it?

I'm begging you, please!

I'll be right back.

How are you feeling?

A little sheepish.

I think you might
be on to something

with this panic attack idea.

I mean, what do
you think's going on?

Because at this point,

it's kind of difficult
to ignore the fact

that in both instances,

I was talking about
the difficulty

that I've been having
giving patients bad news

when you were triggered.

Yeah.

I read journals all the
time to keep up, stay fresh.

Uh-huh, OK.

I recently read about
sporadic fatal insomnia, SFI.

You heard of it?

You know, I'm familiar
with familial fatal insomnia.

It's a genetic brain
disorder, right?

Yes. SFI is a variant.

It's non genetic
and even more rare.

It starts with a mild
inability to sleep

that progressively worsens

until it robs you of your
faculties and kills you.

Right, and so,

you're concerned that
you might have this

or that you're developing it?

I know it's irrational,
but I... I can't help it.

I'm really scared.

Well, I mean, have you
thought about getting tested?

No, I can't do that.

Hey, a simple PET scan

will tell you everything
you need to know.

But that's the problem.

If I test positive,
my life is over.

Every last second I have
will be consumed by that.

I won't
be able to function.

But, I mean, aren't you kind
of consumed by it already?

I'm so tired.

Well, I mean,
of course you are.

Look, have you thought
about, I don't know,

what clarity might
bring to this scenario?

Look, if you test negative,

you get a good night's
sleep, right? That's easy.

But even if you test
positive, which is unlikely,

look, I mean, it'd be difficult,

but wouldn't it also kind
of, I don't know, inform

how you want to spend the
rest of the time you had left?

People you might want
to hang out with?

The places you might want to go?

I don't know, it
just seems to me

that there's an upside
to clarity both ways.

I'll get the scan.

Voriconazole, the antifungal?

Yeah, thought I'd check
anyway. Thank you.

Will.

Voriconazole.
200-milligrams. Tablets.

I know it's an IV, but the
bio availability is the same.

Where'd you get them?

It turns out
someone did have it.

No.

Will.

These are the real
deal from a pharmacy.

The prescription was
filled two months ago.

Check the label. I've already
called and verified it.

And your friend just
happened to have them?

He said that sometimes

people empty out their
medicine cabinets,

and they turn over
the contents to him.

- That's how he got these.
- That's called diversion.

It's a crime.

Rose will likely die
from this infection.

You know that.

Even if you were to
give her these pills,

how are you gonna
explain it in her chart?

I don't know.

I guess we wouldn't put them in?

She needs these pills, Will.

There's only one
way to do this.

No, no. You stay here.

Hey, Nancy. Could
you give us a moment?

Sure.

Thank you.

Emmanuel, I found
some voriconazole.

Oh, thank God.

But I can't give it to Rose.

- I don't understand.
- Yeah.

The pills weren't acquired
through the proper channels.

But I assure you, this is
the antifungal Rose needs.

It will knock out her infection.

It will save her life.

I just can't legally
give them to her,

but you can.

It's your decision.

Dr. Taylor and I
cannot know about this.

We'll check back
in a little while.

You put your blood,
sweat, and tears

into a project like this train.

You try to anticipate every
potential catastrophe,

only to be undone
by rusty old tracks

and cracked tunnel walls.

So it was the tunnel's fault?

It's not my train's.

Let me guess,
you're one of those

"never explain, never
complain" guys, yeah?

Yeah, well, this day
wasn't good for me either.

- What's that?
- Oh, the battery on the vent.

It's dying.

Why are you down
here, Crockett?

What do you mean?

A train crashes, and
a tunnel collapses,

and you run in.

Why?

I... I just did.

You want to know why
I created this train?

To change the world.

Chicago first, but soon,

every other city
would see a faster,

more efficient, cost-effective,

environmentally-friendly
mode of transportation.

Jack Dayton has done it again.

A brilliant innovator. A hero.

That's the portrait I try to
paint for the media anyway.

The truth is, I
developed this train

to make me another fortune.

Money and ego have
been the motivation

behind almost every
decision I've ever made.

Every good deed.

Every good deed has
really been self-serving,

unlike you.

No.

What?

Believe me, Jack, I...

I am far from selfless.

Crockett?

Ah, hey.

OK, so what do you guys say?

Want to get out of here?

My results.

Negative.

Oh.

Oh, good God.

Oh, thank God.

Hopefully, you can
get a little sleep now.

I can't thank you enough, Dan.

Hey, I'm just really happy
it turned out the way it did.

But I think

we should stop seeing
each other professionally,

I'm afraid.

I'm sorry, but this has been

a massive breach of
therapeutic boundaries.

You know what, I would
actually really like

to continue, if
it's OK with you.

You want me to stay on as
your therapist after this?

What, are you kidding me?

I mean, all this experience
has done for me today

is humanize you.

We might have hit the fast
forward button a little bit,

but, Otis, do you have any idea
how difficult it is out there

to find a practitioner
who will just, you know,

listen and talk and be present?

All I saw today was the kind of,

I don't know, humanity, right,

that made me really want
to keep working with you,

if you're good with it.

Sure.

Good.

Everyone, gather
around, please.

- Everyone?
- Good news.

We've just been informed
that Dr. Marcel is safe,

and he and his patients,
including Jack Dayton,

are en route.

All right, everybody.
Let's get back to work.

So how'd it go?

Uh, good.

You showed Dr. Choi how to
do that thing with the bottles?

Yeah, I did.

In Afghanistan, we
had a whole lot of GSWs

without a whole
lot of equipment,

but we did have bottles.

Cool.

Yeah, it's cool.

In any case, he
is a good teacher.

Hey, and FYI, Dr. Marcel is
a pretty good teacher too.

Hmm.

Excuse me.

Nice work today, Dr. Asher.

- Thank you.
- Yeah.

Your patient got lucky.
She had a good doctor.

And which one of us is that?

Well, we both know.

Listen, your weekly drug test,
we can dispense with that.

Great.

Pressure is stable and
has been for some time now,

even without the pressors.

We'll have to wait for
your cultures to come back,

but I'd wager the
infection is resolving.

I feel... what's the
word I'm looking for?

Relieved?

Sanguine.

Good word. People
don't use it enough.

It certainly seems like
she's getting back to normal.

Well, hopefully, if
this all continues,

you can go home tomorrow.

We can't thank you enough.

It worked.

Yeah, look.

We did what we had to do,

but no one can ever
know about this.

Ever.

They're here!

Nathaniel Perry, 34 years old.

Chest was crushed
in a train crash.

Dr. Marcel intubated
him in the field

and placed a chest tube.

All right, I got
him. All right.

You're going to two.

Mr. Dayton, sorry to meet
you under these circumstances.

Sharon Goodwin, executive
director of patient services.

And I'm Dr. Choi. Let's
get you checked out.

All right, and Crockett
said I'm gonna needed an MRI.

Will do.

- Where is Crockett?
- He's OK, right?

Yeah, he said he
had to see someone

and that it couldn't wait.

Pamela?

Pamela, please.

Pamela, please talk...

Crockett, are you OK?

Yeah. Where's your mom?

She left for
Boston this morning.

I'm sending these
things on to her.

I need to tell her something.

Yeah, she saw you called.

She didn't want to talk to you.

I get it.

Could you tell her
something for me?

Just tell her

I haven't been entirely
honest with her.

Honest with myself, really.

Oh?

Your mom never would
have risked her ability

to perform surgery.

I mean, you said so yourself
when she was on the table.

But I made the decision
I wanted anyway.

It was selfish.

I didn't want to lose her.

But I guess I lost her anyway.

I'm sorry.

You take care, Ava.

You, too, Crockett.