Chicago Med (2015–…): Season 8, Episode 5 - Yep, This Is the World We Live In - full transcript
There's been a collapse
in the subway tunnel.
Over here! I'm Jack Dayton.
Over there. He works for me.
His lung is likely collapsed.
- Let's get him out here.
- No, no, no.
If we're gonna save him,
we got to do it right here.
I mean, what do you do
if you can't get
the only drug that
will treat an infection?
- I'll start calling around.
- Everyone I talk to is out.
I know someone
who has access to everything.
You're talking like
some kind of drug dealer.
Look, no one can ever know
about this.
In the future,
maybe at least page me
before administering
a very high dose...
Six milligrams is well within
the standard of care.
The standard of care is not
some blanket template
you follow without any regard
for the person you're supposed
to be helping.
I just don't always
trust my own instincts.
I can promise you,
you will get there.
I don't have a shred of doubt
in my mind.
Good morning.
Hi.
So night shift left us
three patients.
A bipolar woman, 38.
Checked herself in.
A gentleman with CTE, 64.
Got booted from
his board and care home.
Let me guess,
smoking violation?
Yeah.
And lastly,
a 31-year-old psychotic
in an extrapyramidal state.
You know, that gentleman
looks like we probably
just have to rebalance his
meds, but these other two,
I think we're gonna
have to admit.
Agreed, but once again,
there are no beds
in the psych unit
and all the other local EDs
are at capacity.
Well, we got to branch out.
Check the TRCs.
See if they have any room.
Every morning
it's the same thing.
Psych patients
just stashed around the ED.
You know, my parents,
where they come from,
no one talks about psychiatry.
In fact, they're not convinced
I'm even a real doctor
because my brother is
a pediatric spine surgeon.
So they see him
helping kids walk again,
but me...
pretty good argument...
I'm not even treating patients,
just shuffling them off
somewhere else.
- Will. Will. Hey.
- Good morning.
So I reached out
to Rose Fremont,
our UTI from the other day,
and I know what happened
didn't happen...
That's okay.
I've been
thinking about her too.
- How's she doing?
- She's amazing.
She said she finally
feels like herself again.
That's really great news.
Yeah, you know, still,
we never buy drugs
from that dealer again.
Or any dealer.
- Hey.
- Hey.
You and Will
are getting close.
Uh, yeah.
I guess, we are.
Hey, where are you headed?
Treatment four.
No, I need you
in treatment six.
Archer's already there.
Yeah... oh,
treatment seven then.
Dr. Halstead,
I need you in treatment four.
I'll send you the chart.
Will, Will, Will,
scratch that.
- I already got it.
- Wait. Hold...
Mags, Mags, I'll be in four.
Yeah.
- April.
- Ethan.
Uh, and you
got the chart, so...
I got to go.
*CHICAGO MED*
Season 08 Episode 05
Episode Title:
"Yep, This Is the World We Live in"
Hey, I'm Dr. Choi.
Aired on: October 19, 2022.
Brock Huntley.
Nice to meet you, sir.
- So...
- Sorry.
I should've introduced you.
Dr. Choi and I
used to work together.
He is an excellent physician.
Thank you.
So, Brock, what's going on?
Feeling pretty lousy, sir.
For how long? Days, weeks?
- More like months.
- Yeah, that's why we're here.
Brock has been seen by a number
of internists at my group.
Fever, headache,
abdominal pain,
diarrhea, high white count.
It sounds like
viral gastroenteritis.
That is what
we thought as well,
but bugs usually
come with vomiting.
That hasn't been a symptom.
- It's a little tender.
- Ah, sorry about that.
Sometimes small talk's
a good distraction.
So what do you do, Brock?
I'm a mechanic.
I'm in between jobs.
I work on Honeywell AGT1500s.
It's a gas turbine engine,
right?
- Yeah.
- High powered.
So, Dr. Choi,
what do you think?
Well, the diffused belly pain
could indicate
a surgical issue,
but the other symptoms
like headache, diarrhea...
- They don't support it.
- No.
All right, Brock, next steps.
Labs.
Stools, ultrasound,
CT, the works.
As long as
we figure this out.
I'll be right back.
Hey, Ethan.
Dr. Choi.
Yeah.
Hey, I'm really sorry
for the sneak attack.
I just was worried that
reuniting in a treatment room
would be awkward, which it was.
Yeah, a little,
but no harm, no foul.
I hope not.
I know using Maggie to skirt
the system and cherry-pick
a doc must be a headache
for the ED chief.
Yeah, but good thing
it's not me anymore.
My choice.
April Sexton in the flesh.
Dr. Marcel.
Man, it's been forever.
Maybe for you.
I mean, for me,
it feels like yesterday.
Oh, that's because it was.
I saw you.
The Trib, the "Sun-Times".
- The tunnel collapse.
- Mm-hmm.
I got to say, the heroics
were not a surprise,
but I didn't see
transplant surgeon coming.
Yeah, well, I guess like you,
I was looking
for something more.
Excuse me.
It's the ICU.
It's really nice to see you.
You too.
Hey.
I came in to say good morning
and suddenly
alarms start going off.
Nathaniel,
what's going on, bud?
I... I can't breathe.
Sats are into the 80s
and dropping.
Heart rate's climbing.
Yeah, he's in
respiratory distress.
Cannula, mask him.
High flow O2 please.
I was in with his sister
yesterday telling jokes,
laughing.
He was fine.
And call anesthesia.
We're intubating him.
CT PE to follow.
What's happening?
I'm gonna find out, okay?
Lift your chin up.
There you go.
He's looking better.
I gave him 2 of benztropine.
Gonna let him rest a bit
and then discharge him.
How's it going
with those transfers?
You know, the overnight intake?
I found them each a spot
in therapeutic
residential centers.
Oh, excellent.
They are successfully
shuffled off to someplace else.
Dr. Charles, I just sent you
treatment three.
Good Samaritan found him
wandering in the street.
No phone, no wallet,
no ID, and very confused.
- Thanks, Mags.
- Right.
Where am I?
You are in the hospital.
Um... I'm Dr. Charles,
and this is Dr. Cuevas.
What's your name?
I, um...
I don't know.
Will.
- Hey, you.
- Hey.
I was hoping I'd run into you.
Odds were in your favor.
I've been working
a bunch of double shifts.
- Money troubles again.
- Wait. What?
I heard you bought
a whole apartment building.
Uh, long story.
What's, uh, what's up
with your gig?
Oh, well, COVID burnout.
You know, hit the practice
really hard.
And you know what?
It's been a challenge,
but really rewarding.
- I'm proud of you.
- Thank you, Will.
So he doesn't know his name,
age, where he lives,
or how he ended up
wandering the streets.
I mean, you think
he's unhoused?
I'm not really
getting that vibe.
His clothes are clean,
they fit.
- Mm.
- Fingernails are trimmed.
Well, he's clearly anxious
and in some sort
of dissociative state.
Could be drug induced or
self-medicating mental illness.
Yeah, perhaps.
I mean, unless it's a stroke.
I didn't see any facial
paralysis or muscle weakness.
I was thinking more
atypical TIA.
Okay, well, since right now
it could be anything,
I'm gonna order head CT, labs,
tox screen, chest X-ray, EKG,
EEG to check for
subclinical seizures,
and CT to check for stroke.
Excellent.
Sounds like a plan.
Okay.
Excuse me.
Please, could you help me?
My name is Elinor Whipple.
I fell last night.
Actually, this watch
that my son gave me
called the paramedics.
He lives in Oregon.
Oh, boy.
Well, are you all right?
- You feeling better?
- Oh, yeah.
I just have a bruise on my hip.
You know, the doctor
discharged me hours ago
and the van was
supposed to drive me home,
but it's been a long time.
Nobody's come.
Let me see if I can
figure out what's going on.
- Okay?
- Thank you.
Mags, do you have an update
on Elinor Whipple's
transportation?
- Medicar still hasn't come?
- No.
I'm gonna make a call
and light a fire.
Thank you.
Maggie, the charge nurse,
is gonna call the company
and see what's happening.
I just want to go home.
My husband spent
his final weeks in hospice.
I don't like hospitals.
Why don't we see if we can
find you a place to...
To sit while you wait.
- Oh, thank you.
- Okay?
- I'm Dr. Charles, by the way.
- Thank you, Dr. Charles.
Male, late 20s.
Stoned out of his mind.
Picked him up
talking to a mailbox.
Wouldn't give a name.
- Oh, my God, Devon.
- You know him?
Yeah, sort of.
From med school.
- Wait, wait!
- Get off!
I'm out of here.
Come at me! Let's go!
Get back. Get back.
Hey.
- Get off, man.
- Taser, Taser!
No. Don't hit Ethan.
Pile on.
All right.
Ethan, are y'all all right?
I'm good.
Dean got the worst of it.
Hey.
Wait. That's Devon.
Seriously?
Guy who just went all
"Incredible Hulk"
is the dealer we're using
to treat Rose?
It gets worse.
His tox report just came back...
Cocaine laced with PCP.
PCP?
Hold on, you told me this guy
was into party pills
and medicine cabinet pharma.
I thought he was.
We had to use him, though.
I mean, Rose needed those meds.
She could've died.
We didn't have another play,
but that was then.
I mean, now,
we have to call the police.
Laced drugs? Come on.
Whoever gave them to Devon,
they have to be off the street.
If we call PD, they're gonna
ask Devon a lot of questions
and my name could come up.
Vanessa, as long as
there's a bad batch out there,
someone else could OD.
No, you're right.
We call CPD.
If I would've known Devon
was involved in hard drugs,
I would've never suggested
going to him.
Hey. I know.
I think they might
be a thing.
Keep walking, Doris.
Easy, easy.
You're lucky
I tired him out for you.
Yeah, the way you went at him
with your face and ribs,
that was impressive.
Even smiling hurts,
all right?
'Cause your jaw's swollen.
Let me see your ribs.
All right, I got it.
I got it. I got it.
All right.
Flesh wound?
Oh, yeah, yeah. Nice one.
Hey, Zach, do a work up.
No, no.
First year resident, no, no.
- I don't think so.
- Hey, come on.
We're still a teaching
hospital, Dean.
It's already
been a day, okay?
Just order me X-rays
for my ribs
and a CT for my jaw,
will you, please?
Yeah, you got it, man.
Hey.
Ooh, man.
I go upstairs to deliver
a baby and miss all the action.
How you doing?
- I'll live.
- Okay.
If you need anything,
I'm around.
All right.
This is Nathaniel's
chest X-ray
from when he was admitted.
The left chest had
a hemopneumothorax.
The right chest,
however, was okay.
Gene.
Now, his chest X-ray
from 30 minutes ago.
Night and day.
Wait,
this happened in 36 hours?
It caught me
by surprise too.
Yeah.
- Peter.
- I'm sorry to interrupt.
Peter, what's going on?
Nathaniel has given
permission for the hospital
to share his medical
information with Mr. Dayton.
Now, I know this is
unorthodox,
but I built that train.
Nathaniel, he's been with me
for years
and my team, they're more than
just employees.
They may as well be family.
Legal signed off on it.
Okay. Peter, thank you.
Bilateral multi-lobar
consolidation.
- Heavy scarring, inflammation.
- Which means?
His lungs are destroyed,
but this much damage this fast,
how?
- Only thing I can think of...
- Train's batteries.
Mm-hmm.
From when he was trapped
in the conductor's compartment.
The tunnel was
full of moisture.
Leaky lithium ion batteries
plus moisture?
Hydrofluoric acid.
Highly corrosive, toxic.
- Nathaniel inhaled it.
- So what's the fix?
At this point,
a lung transplant.
I'll put Nathaniel
on the list immediately.
In the meantime, I'd like
to get him off the vent
and onto ECMO.
Take some pressure
off his lungs.
I'm afraid ECMO's
not an option.
Tubing shortage.
The machine's down
until the shipment arrives.
When will that be?
Maybe two days, three?
People spend weeks
on ventilators.
Sometimes longer, right?
So maybe we're in good shape.
We're not.
Nathaniel's lungs
are so injured,
the vent's barely doing the job
and I've only got a little
wiggle room with the settings
without risking further damage.
Even with the vent,
we're sinking.
Fever notched up a bit.
I've just been laying here,
but I'm spent.
Your body's at war.
Unfortunately, I don't know yet
what it's fighting against.
The labs and scans
didn't show anything?
Nothing definitive.
A mild enlargement
of the liver and spleens,
swollen lymph nodes,
global intestinal inflammation.
So all viral symptoms,
but not pointing
in a specific direction.
Brock, you've got an
extensive vaccination history.
I see the requirements like
mumps, measles, rubella.
Some optionals
like flu and COVID,
but there are a few that are
only for international travel.
Have you left the country
recently?
No. Never.
I'm from Chicago.
I... I've been in Georgia since
graduating high school.
First the south of Atlanta
then near the coast.
I just recently
moved back home.
Should we bring in
infectious diseases?
I could call a fellow,
but if there's been no travel
then I don't think she'll have
anything new to add.
Where do we go
from here then?
More labs.
Blood and stool cultures,
a mono spot test,
but I'll definitely put you on
empiric broad-spectrum
antibiotics.
Hopefully, we can
get that fever down.
So our mystery patient...
EEG and CT, both negative.
He didn't have a seizure
or stroke.
Tox also negative,
so not drugs.
His electrolytes
were a little off,
but I'm not buying amnesia.
No, me neither.
I just hung
a second bag of fluids.
He seems more alert
than when he came in.
- Thank you, Nancy.
- Good.
How you doing?
It's Dr. Charles
and Dr. Cuevas again.
- Do you remember us from before?
- Kind of.
Do you know where you are?
Uh, looks like the hospital.
Emergency room.
Mm-hmm.
And do you know who you are?
Harris. I'm Harris Bevel.
- And how old are you, Harris?
- 28.
And where do you live?
Wrigleyville.
Near the ballpark.
Wow.
That's the north side of town.
Do you know how you ended up
here in the West Loop?
No. I'm not sure.
I don't know why
I would be outside.
I don't know why
I would take that risk.
What do you mean by that?
Taking the risk.
It's dangerous outside.
It's hard to hide.
You got to always have
a hiding spot.
Okay. Okay.
Yeah, well, I noticed
you haven't really
touched your sandwich.
What? No appetite?
Didn't have the energy.
I'm tired.
I don't sleep that much.
So is that having a hard time
falling asleep,
having a hard time
staying asleep...
Yeah, yeah, that one.
Every night, 3 a.m.,
I'm wide awake thinking,
you know, worrying.
About anything in particular?
No. Just... everything.
Yeah. I get it.
That happens to me
sometimes too.
- It does?
- Oh, yeah.
Sometimes the world just...
moves too fast.
You know?
What about family?
Harris, anyone live nearby?
No. Tucson.
Any friends?
I have... I haven't seen them
in a while.
Okay.
You know what?
That's been really helpful.
Dr. Cuevas and I are gonna
step out for bit.
Do you mind hanging out
for a little while?
- No.
- We'll be back soon, okay?
If I were a gambler,
I'd bet big on Harris having
undiagnosed depression.
I don't disagree.
I don't think
he's a suicide risk,
but I'm just not crazy
about discharging him, either.
Yeah, me too.
One problem, psych unit's full,
and I used up all the TRC
options this morning.
I'm gonna
call up there anyway.
I mean, you never know.
There could be somebody's
on a hold who's expiring today,
getting discharged early.
It's worth a shot.
Okay.
I'll call Harris' family.
See if I can get
more of a history.
Excellent.
Need some help, Dr. Charles.
Patients are piling up.
I need trauma two back.
Elinor's still here?
Yeah, I called Medicar
three times.
They're short on drivers.
Skip them all together
and call Uber or taxi?
No, no, no, let's stick
with medical transport.
I mean, at least we know them.
Copy that,
but I still need the room.
Mags, do you mind if we just
set up a chair for her
in the nursing station?
I know it's not ideal,
but she's just had
a really rough day.
- Yeah. I'll find a corner.
- Thank you very much.
Okay.
So news?
A pair of lungs
has become available.
Well, that's great.
The donor died
in a car crash.
These lungs are
beat up pretty good.
- Will they work?
- No, not right now,
but I believe with EVLP,
they can be resuscitated.
- EVLP?
- Yeah.
Ex vivo lung perfusion.
Instead of sitting on ice,
the donor lungs are attached
to a machine that
circulates blood through them.
Well, thank God
for tech, huh?
There is one issue.
The hospital doesn't have
an EVLP machine.
Supply chain disruptions have
led to a delay in delivery.
Why are we talking about EVLP
if we don't have the machine?
We think that you
and your engineering team
can build an EVLP machine
using parts from machines
that are already
in the hospital.
All the schematics are online.
Here's the thing, Jack.
If we pass on these lungs,
I don't think another pair
will become available in time.
So intricate machinery,
a ticking clock,
and a life at stake.
Yeah.
It is a monumental challenge.
No question.
Well then, I'm on board.
- Excellent.
- Great.
The police.
Multiple non-displaced
lateral rib fractures.
- Yeah, yeah, yeah.
- Heavy contusions.
Yeah, yeah. My jaw.
Dislocated
temporomandibular joint.
It needs to be reduced.
All right. Grab Ethan.
He's with a patient.
Dr. Halstead and Dr. Taylor
are busy also, but I'm free.
How many jaw reductions
have you done?
Get Asher.
Patients all over the place.
A battle royale
in the football.
I guess it's just another day
in the ED, huh?
You miss the action?
Yeah. A little.
But really, I miss y'all.
What are you doing
this evening?
X-ray tech Mike
moonlights as a DJ.
He's spinning tonight.
A bunch of us are going.
We could dance away the day
like we used to.
- I'm in.
- Yeah?
Yeah, of course.
- Soon.
- Okay.
And apparently we have
a lot to catch up on.
Yeah.
Full disclosure,
it's been a decade
since I've reduced a jaw,
but I just watched one
on YouTube,
so see one, do one, right?
That's not funny.
- It's a little funny.
- It's not funny.
Okay. Here we go.
Open up.
- Let's do this. Ready?
- Uh-huh.
- One, two...
- Uh-huh.
Damn.
Holy.
You're welcome.
Hey.
The empiric antibiotics
aren't doing anything.
His fever's still ticking up,
and now he's having trouble
breathing.
- And his belly pain?
- It's worse.
Is there anything
in the latest labs?
No. Mono test was negative.
The blood cultures
are unremarkable so far,
but his lymphocytes
were on the high side.
You're thinking lymphoma.
It's been in the back
of my mind all day.
I just didn't want to jump
straight to the worst option.
Well, I still don't.
His sed rate and CRP are high.
Rising inflammatory markers
could point to
an autoimmune issue.
Kawasaki disease?
Kawasaki primarily
affects children
and often presents
with a telltale rash.
That wasn't one
of Brock's symptoms.
Doesn't rule it out, though.
It could just be
an odd presentation.
You know what?
You're right.
I don't think it's Kawasaki,
but you've given me a thought.
I want to run one more test.
Okay, I like it.
Arterial and venous tubing
from a dialysis machine.
Pumps, oxygen at or, gas and heat
exchanger from an ECMO.
Bits and pieces
of an enclosure bed
and added plastic
for the housing.
It's not fancy,
but I think it's gonna work.
You're not sold.
I don't like the housing.
It's too flimsy.
It's got to be stronger.
It can't tear.
It can't collapse.
I mean, this is
what holds the donor lungs.
Yeah, the lungs,
they're precious.
They have to be treated
as such.
Cradled.
Like a newborn.
How about an incubator?
Yeah. Hey, Alex, baby floor.
Get me an incubator.
Donor lungs have arrived.
Great. Let's take a look.
Thank you.
Oh, geez.
It's worse shape
than I thought.
Yeah, but seven, eight hours
of perfusion and aeration...
I'm cautiously optimistic.
How long until
the machine is ready?
Five minutes.
Prep the donor lungs.
Sharon.
We have a situation in the ED.
I cannot believe
you put this hospital
in that kind of legal jeopardy.
And yourselves.
You are to fully cooperate
with these detectives.
Is that understood?
Okay.
What the hell is going on?
Will and Vanessa went rogue.
It's bad.
- Bought meds off a drug dealer.
- Wha...
That guy.
What's your pain level now,
one through ten?
Uh, 35.
IV fentanyl isn't doing it.
The line's working fine.
I've reduced dozens of jaws.
I've treated thousands
of broken ribs.
Pain meds help those patients,
they should be
helping me, yeah?
Here, let me
see my chart, please.
Are you kidding me?
Get Dr. Asher in here now.
Oh, hey.
So I was able to free up a bed
in the psych unit
for Harris, so that's good.
That's great,
because I think his depression
stems from childhood PTSD.
Really?
Do you remember
a couple weeks ago
that shooting on Clark Street?
Yeah, that guy
with all the body armor.
Like, 2,000 rounds of ammun...
That was at Wrigleyville
where Harris says he lives.
And it turns out
that all went down
in front of
Harris' apartment building.
Oh, my God.
So he, like...
He saw the whole thing?
He heard it.
I just talked
to his sister in Tucson,
and she said that he locked
himself in the apartment
and laid low in the closet.
So he was never in danger,
but apparently since that day,
he's just been off.
Yeah, this morning he said,
"It's dangerous outside.
You always need
to find a hiding spot."
Talking about mass shootings.
Mm-hmm.
I was in sixth grade
when I had my first
active shooter drill,
and speaking from experience,
they're terrifying.
So it's reasonable to think
that this incident
triggered some
deep-rooted fears
that led us
to where we are now.
I mean, in my day, it was,
you know, it was air raid drill
in case of nuclear
frickin' war.
- Duck and cover, you know?
- Your patient.
Harris Bevel, he's gone.
- What?
- I'm gonna call the other EDs
and see if he shows up
at one of them.
I'll reach out to CPD,
ask them to do a welfare check
at his apartment.
I'll call security in case
somebody saw him leave.
- All right.
- You underdosed...
You underdosed me.
Come here.
Come here.
All right, I'm 6 foot, 180.
The healthy, responsible dose
of fentanyl for me
would be 150mics.
You gave me 25.
I'm so sorry.
I got a dislocated jaw
and broken ribs,
not a paper cut.
I'll fix it. 150mics.
I'll put in the order.
Do it.
Now the doctors are
fighting with each other?
I just want to go home, please.
I'm sorry, Nathaniel.
I know you're uncomfortable.
"Never say die."
That's the spirit.
I'll be right back.
Vent's not cutting it.
Donor lungs have only been
perfusing for four hours.
- Is that long enough?
- It's gonna have to be.
Please have answers.
I do.
The last lab I ran was
a COVID antibody test.
- It was positive.
- I have COVID?
No. You had COVID.
Your symptoms now are the
lasting effects of the virus.
- You're thinking MIS.
- What's that?
Multisystem
inflammatory syndrome.
It's a condition associated
with COVID-19.
It can impact the heart,
lungs, kidneys, brain,
or gastrointestinal organs.
It's rare and it's been
affecting children.
And it's only been found
in a handful of adults.
That's why it wasn't
on our radar
until everything else
was ruled out.
Few months ago,
I had a couple weeks
of complete exhaustion.
I COVID tested multiple times,
rapid and PCR,
but the results
were always negative.
I probably had it, didn't I?
Yeah, very likely.
It threw my world into chaos,
especially at work.
Yeah, I couldn't
pull my weight at all.
Boss got on me.
Colleagues didn't trust me.
It all got to be too much,
so I bolted.
I left in the middle
of the night.
Went home.
I'm sorry, man.
I know how physical setbacks
can upend your life,
but they don't have to
hold you down forever.
MIS is manageable
with high dose steroids,
and you can
get back to your life.
Return to work in Savannah.
That's where you said you were
most recently living, right?
No, he just said
near the coast.
Oh, my mistake.
Anyway, I'm gonna have to
admit you for treatment
and a nurse will be by
to start the paperwork.
Okay?
April, speak with you a moment.
Is Brock AWOL?
The engine he works on,
the Honeywell AGT1500,
it powers the M1 Abrams.
That's an army tank.
The army's third infantry
uses that tank.
They're based at Fort Stewart,
Savannah, Georgia.
Near the coast.
Third ID also has
soldiers in Africa.
Looking at Brock's
vaccination history,
if he had to deploy there,
he could.
I know Brock is army,
but when he said, "left
in the middle of the night,"
did that mean he was
on active duty and went AWOL?
That's why you didn't want me
taking this case.
You thought if I found out,
I'd turn him in.
Can you blame me?
Ethan, when it comes
to the military,
you rarely look the other way.
No, guess I haven't.
I assume you're gonna
call the MPs.
No, I'm not.
I wasn't expecting that.
Guess the world's not
so black and white anymore.
Still, skipping out
on a commitment
is a serious offense,
so whether he goes back
to his unit or gets out
of the army altogether,
he's gonna need some help.
I am texting you a contact
to a military attorney.
Will you pass it on to Brock?
Absolutely.
Security didn't see Harris.
You check the local ED?
Hasn't turned up and CPD's
welfare check came up dry too.
Dr. Charles, just heard back
from Medicar dispatch.
Elinor's van is gonna be in the
main entrance in three minutes.
What? They told me
Ambo Bay in an hour.
Well, welcome to my world.
The left hand has no idea
what the right hand is doing.
- Grab me a wheelchair, please.
- Okay.
Elinor, guess what?
Your ride is finally arriving.
I haven't taken my blood
pressure or cholesterol pills
or my arthritis.
My joints really hurt.
Oh, I'm so sorry.
Well, you know what?
You're gonna be home
before you know it
and you can take
all your meds then.
- When will that be?
- Now. Right now.
- Come on.
- Well, it's about time.
I have been waiting here
since last night.
You can't do this to people.
You are absolutely right,
which is why we need to
get you out of here
as quickly as possible.
Did she eat or drink
anything today?
I don't know.
I reached out
to Upton at CPD.
She thinks even with Devon's
statement and your confession,
the state's department is
unlikely to pursue charges.
- That's a relief.
- Yeah.
Hopefully, we dodged
one bullet.
Just have to see
if the hospital hits us
with disciplinary action.
How's Devon doing?
Drugs are out of his system,
so he's gonna be okay.
For real, Will?
Buying drugs off the street,
and then you just
pull Vanessa into it?
It's a little more
complicated than that.
I mean, you want
to risk your own career,
I mean, that's fine.
- But don't...
- Maggie.
Don't risk Vanessa's.
Where's the van?
You said it was here.
I'm sure it's just
stuck in traffic.
I'm sure it'll be here
any minute.
I'll call them.
Hey, Elinor.
Can you breathe with me?
Slow and deep just like this.
Yeah, I'm at the main
entrance with Elinor Whipple.
There's no van.
Please do not put me on hold.
How do the donor lungs
look to you?
Better than
when they came in.
Riley, can you open it up,
please?
Okay.
Oh, finally.
Look, Elinor.
The van's here. There it is.
I don't even care anymore.
I'm so tired.
I just want this whole thing
to be over.
Uh... is that just venting or
is that a threat of self-harm?
I don't know.
Sorry it took us so long.
It's our eighth run of the day.
- Still got two more.
- Okay. Well, you're here now.
Guess what, Elinor?
It's finally time to go home.
Let's get you into the van...
You're hurting me.
Get away.
We're just trying
to help you get home.
Do you want to get
in the van, Elinor?
What's going on?
She's exhausted, in pain.
She missed
her daily medication.
Hasn't eaten all day,
and she's likely dehydrated.
I don't think
we can take her like this.
Yeah, well, I'm not gonna
let you anyway.
Okay, well, at least
we have a bed.
I'll call psych.
Tell them we're on our way up.
Gave her 0.5 of Xanax
to calm her down.
You know, fluids,
good night's sleep,
getting her back
on her regular med schedule's
gonna help a lot and then
we'll go from there.
We move mountains
to be in a position
to open up space for Harris,
a man seriously
in need of help,
but now he's in the wind
and Elinor,
who should've been home hours
ago, is in the psych unit.
Irony sucks.
Yeah.
Pushing the rock uphill
and we're not even
helping people.
We're just creating patients
along the way.
Maybe my parents were right.
Not much to do for busted
ribs except ice them down.
- Maybe this Velcro binder...
- Oh, thanks.
Will help keep
the packs in place.
Yeah.
Moving, breathing,
feels like I'm being stabbed.
Good times.
I'll just put this
in your bag.
Thank you.
Uh, listen, um.
I'm sorry for blowing up
on you earlier.
- It's the pain talking.
- Dean, no.
Everything that happened today,
that is totally on me
and my complicated history
with opiates.
Okay, I know their dark side,
so my instinct is to protect
people from getting sucked in.
- I know I was projecting, but...
- No, it's okay.
It's okay. I get it.
All right.
Can I give you a hand
with your bag?
Uh...
I'll help you up.
Ah, Dr. Taylor, Dr. Halstead,
a moment.
So the board is not happy
that two of our ED doctors
went to a street dealer.
- That was...
- I'm sorry...
Mm.
But they're not going to press
the matter any further.
You're good doctors.
You're fighting
for your patients
and you're being put
in an untenable situation.
And I'm sorry about that.
I understand with your backs
up against the wall
how you'd need to look
for creative solutions.
All I ask is that
in the future,
you give me a heads up.
He's back?
Walked in a few minutes ago.
Have you talked to him yet?
Briefly, but he specifically
asked to speak to you.
- Me?
- Yeah.
I mean, he feels rapport
because you connected
with him today,
and I saw it happen.
Nellie, of course the system
is deeply flawed,
and it often feels like wins
can be really hard to come by,
but you got one today.
So good work, Doctor.
- Really.
- Thanks.
Dr. Marcel.
Yeah. Hey.
You already started
weaning the vent?
The new lungs are working.
I hope to try an SBT tomorrow,
but we're off to a good start.
Well, internet's gonna
blow up.
I got 30 million
social media followers
waiting to hear
how this story ends.
Yeah, Med's gonna
go viral, huh?
Not just Med, Dr. Marcel.
You saved Nathaniel's life
twice now.
Both in spectacular fashion.
What are you on, by the way?
- Twitter, Insta, TikTok?
- None of the above.
Well, no worries.
I'll text my PR team.
Set up accounts for you.
In the meantime, get ready
for what comes next.
What's that?
Fame.
Put your hands up! Yeah!
♪ When I'm gone
♪ When I'm gone,
I'm never really gone ♪
♪ You think you're moving on
♪ But it won't be for long,
you'll see ♪
♪ When I'm gone,
I'm never really gone ♪
♪ You think you're moving on
♪ But no one's gonna
feel like, feel like me ♪
♪ I'm tired of you,
touch you like I do ♪
♪ Know you never forget
♪ When I'm gone,
I'm never really gone ♪
♪ You think you're moving on
♪ But no one's gonna
feel like, feel like me
in the subway tunnel.
Over here! I'm Jack Dayton.
Over there. He works for me.
His lung is likely collapsed.
- Let's get him out here.
- No, no, no.
If we're gonna save him,
we got to do it right here.
I mean, what do you do
if you can't get
the only drug that
will treat an infection?
- I'll start calling around.
- Everyone I talk to is out.
I know someone
who has access to everything.
You're talking like
some kind of drug dealer.
Look, no one can ever know
about this.
In the future,
maybe at least page me
before administering
a very high dose...
Six milligrams is well within
the standard of care.
The standard of care is not
some blanket template
you follow without any regard
for the person you're supposed
to be helping.
I just don't always
trust my own instincts.
I can promise you,
you will get there.
I don't have a shred of doubt
in my mind.
Good morning.
Hi.
So night shift left us
three patients.
A bipolar woman, 38.
Checked herself in.
A gentleman with CTE, 64.
Got booted from
his board and care home.
Let me guess,
smoking violation?
Yeah.
And lastly,
a 31-year-old psychotic
in an extrapyramidal state.
You know, that gentleman
looks like we probably
just have to rebalance his
meds, but these other two,
I think we're gonna
have to admit.
Agreed, but once again,
there are no beds
in the psych unit
and all the other local EDs
are at capacity.
Well, we got to branch out.
Check the TRCs.
See if they have any room.
Every morning
it's the same thing.
Psych patients
just stashed around the ED.
You know, my parents,
where they come from,
no one talks about psychiatry.
In fact, they're not convinced
I'm even a real doctor
because my brother is
a pediatric spine surgeon.
So they see him
helping kids walk again,
but me...
pretty good argument...
I'm not even treating patients,
just shuffling them off
somewhere else.
- Will. Will. Hey.
- Good morning.
So I reached out
to Rose Fremont,
our UTI from the other day,
and I know what happened
didn't happen...
That's okay.
I've been
thinking about her too.
- How's she doing?
- She's amazing.
She said she finally
feels like herself again.
That's really great news.
Yeah, you know, still,
we never buy drugs
from that dealer again.
Or any dealer.
- Hey.
- Hey.
You and Will
are getting close.
Uh, yeah.
I guess, we are.
Hey, where are you headed?
Treatment four.
No, I need you
in treatment six.
Archer's already there.
Yeah... oh,
treatment seven then.
Dr. Halstead,
I need you in treatment four.
I'll send you the chart.
Will, Will, Will,
scratch that.
- I already got it.
- Wait. Hold...
Mags, Mags, I'll be in four.
Yeah.
- April.
- Ethan.
Uh, and you
got the chart, so...
I got to go.
*CHICAGO MED*
Season 08 Episode 05
Episode Title:
"Yep, This Is the World We Live in"
Hey, I'm Dr. Choi.
Aired on: October 19, 2022.
Brock Huntley.
Nice to meet you, sir.
- So...
- Sorry.
I should've introduced you.
Dr. Choi and I
used to work together.
He is an excellent physician.
Thank you.
So, Brock, what's going on?
Feeling pretty lousy, sir.
For how long? Days, weeks?
- More like months.
- Yeah, that's why we're here.
Brock has been seen by a number
of internists at my group.
Fever, headache,
abdominal pain,
diarrhea, high white count.
It sounds like
viral gastroenteritis.
That is what
we thought as well,
but bugs usually
come with vomiting.
That hasn't been a symptom.
- It's a little tender.
- Ah, sorry about that.
Sometimes small talk's
a good distraction.
So what do you do, Brock?
I'm a mechanic.
I'm in between jobs.
I work on Honeywell AGT1500s.
It's a gas turbine engine,
right?
- Yeah.
- High powered.
So, Dr. Choi,
what do you think?
Well, the diffused belly pain
could indicate
a surgical issue,
but the other symptoms
like headache, diarrhea...
- They don't support it.
- No.
All right, Brock, next steps.
Labs.
Stools, ultrasound,
CT, the works.
As long as
we figure this out.
I'll be right back.
Hey, Ethan.
Dr. Choi.
Yeah.
Hey, I'm really sorry
for the sneak attack.
I just was worried that
reuniting in a treatment room
would be awkward, which it was.
Yeah, a little,
but no harm, no foul.
I hope not.
I know using Maggie to skirt
the system and cherry-pick
a doc must be a headache
for the ED chief.
Yeah, but good thing
it's not me anymore.
My choice.
April Sexton in the flesh.
Dr. Marcel.
Man, it's been forever.
Maybe for you.
I mean, for me,
it feels like yesterday.
Oh, that's because it was.
I saw you.
The Trib, the "Sun-Times".
- The tunnel collapse.
- Mm-hmm.
I got to say, the heroics
were not a surprise,
but I didn't see
transplant surgeon coming.
Yeah, well, I guess like you,
I was looking
for something more.
Excuse me.
It's the ICU.
It's really nice to see you.
You too.
Hey.
I came in to say good morning
and suddenly
alarms start going off.
Nathaniel,
what's going on, bud?
I... I can't breathe.
Sats are into the 80s
and dropping.
Heart rate's climbing.
Yeah, he's in
respiratory distress.
Cannula, mask him.
High flow O2 please.
I was in with his sister
yesterday telling jokes,
laughing.
He was fine.
And call anesthesia.
We're intubating him.
CT PE to follow.
What's happening?
I'm gonna find out, okay?
Lift your chin up.
There you go.
He's looking better.
I gave him 2 of benztropine.
Gonna let him rest a bit
and then discharge him.
How's it going
with those transfers?
You know, the overnight intake?
I found them each a spot
in therapeutic
residential centers.
Oh, excellent.
They are successfully
shuffled off to someplace else.
Dr. Charles, I just sent you
treatment three.
Good Samaritan found him
wandering in the street.
No phone, no wallet,
no ID, and very confused.
- Thanks, Mags.
- Right.
Where am I?
You are in the hospital.
Um... I'm Dr. Charles,
and this is Dr. Cuevas.
What's your name?
I, um...
I don't know.
Will.
- Hey, you.
- Hey.
I was hoping I'd run into you.
Odds were in your favor.
I've been working
a bunch of double shifts.
- Money troubles again.
- Wait. What?
I heard you bought
a whole apartment building.
Uh, long story.
What's, uh, what's up
with your gig?
Oh, well, COVID burnout.
You know, hit the practice
really hard.
And you know what?
It's been a challenge,
but really rewarding.
- I'm proud of you.
- Thank you, Will.
So he doesn't know his name,
age, where he lives,
or how he ended up
wandering the streets.
I mean, you think
he's unhoused?
I'm not really
getting that vibe.
His clothes are clean,
they fit.
- Mm.
- Fingernails are trimmed.
Well, he's clearly anxious
and in some sort
of dissociative state.
Could be drug induced or
self-medicating mental illness.
Yeah, perhaps.
I mean, unless it's a stroke.
I didn't see any facial
paralysis or muscle weakness.
I was thinking more
atypical TIA.
Okay, well, since right now
it could be anything,
I'm gonna order head CT, labs,
tox screen, chest X-ray, EKG,
EEG to check for
subclinical seizures,
and CT to check for stroke.
Excellent.
Sounds like a plan.
Okay.
Excuse me.
Please, could you help me?
My name is Elinor Whipple.
I fell last night.
Actually, this watch
that my son gave me
called the paramedics.
He lives in Oregon.
Oh, boy.
Well, are you all right?
- You feeling better?
- Oh, yeah.
I just have a bruise on my hip.
You know, the doctor
discharged me hours ago
and the van was
supposed to drive me home,
but it's been a long time.
Nobody's come.
Let me see if I can
figure out what's going on.
- Okay?
- Thank you.
Mags, do you have an update
on Elinor Whipple's
transportation?
- Medicar still hasn't come?
- No.
I'm gonna make a call
and light a fire.
Thank you.
Maggie, the charge nurse,
is gonna call the company
and see what's happening.
I just want to go home.
My husband spent
his final weeks in hospice.
I don't like hospitals.
Why don't we see if we can
find you a place to...
To sit while you wait.
- Oh, thank you.
- Okay?
- I'm Dr. Charles, by the way.
- Thank you, Dr. Charles.
Male, late 20s.
Stoned out of his mind.
Picked him up
talking to a mailbox.
Wouldn't give a name.
- Oh, my God, Devon.
- You know him?
Yeah, sort of.
From med school.
- Wait, wait!
- Get off!
I'm out of here.
Come at me! Let's go!
Get back. Get back.
Hey.
- Get off, man.
- Taser, Taser!
No. Don't hit Ethan.
Pile on.
All right.
Ethan, are y'all all right?
I'm good.
Dean got the worst of it.
Hey.
Wait. That's Devon.
Seriously?
Guy who just went all
"Incredible Hulk"
is the dealer we're using
to treat Rose?
It gets worse.
His tox report just came back...
Cocaine laced with PCP.
PCP?
Hold on, you told me this guy
was into party pills
and medicine cabinet pharma.
I thought he was.
We had to use him, though.
I mean, Rose needed those meds.
She could've died.
We didn't have another play,
but that was then.
I mean, now,
we have to call the police.
Laced drugs? Come on.
Whoever gave them to Devon,
they have to be off the street.
If we call PD, they're gonna
ask Devon a lot of questions
and my name could come up.
Vanessa, as long as
there's a bad batch out there,
someone else could OD.
No, you're right.
We call CPD.
If I would've known Devon
was involved in hard drugs,
I would've never suggested
going to him.
Hey. I know.
I think they might
be a thing.
Keep walking, Doris.
Easy, easy.
You're lucky
I tired him out for you.
Yeah, the way you went at him
with your face and ribs,
that was impressive.
Even smiling hurts,
all right?
'Cause your jaw's swollen.
Let me see your ribs.
All right, I got it.
I got it. I got it.
All right.
Flesh wound?
Oh, yeah, yeah. Nice one.
Hey, Zach, do a work up.
No, no.
First year resident, no, no.
- I don't think so.
- Hey, come on.
We're still a teaching
hospital, Dean.
It's already
been a day, okay?
Just order me X-rays
for my ribs
and a CT for my jaw,
will you, please?
Yeah, you got it, man.
Hey.
Ooh, man.
I go upstairs to deliver
a baby and miss all the action.
How you doing?
- I'll live.
- Okay.
If you need anything,
I'm around.
All right.
This is Nathaniel's
chest X-ray
from when he was admitted.
The left chest had
a hemopneumothorax.
The right chest,
however, was okay.
Gene.
Now, his chest X-ray
from 30 minutes ago.
Night and day.
Wait,
this happened in 36 hours?
It caught me
by surprise too.
Yeah.
- Peter.
- I'm sorry to interrupt.
Peter, what's going on?
Nathaniel has given
permission for the hospital
to share his medical
information with Mr. Dayton.
Now, I know this is
unorthodox,
but I built that train.
Nathaniel, he's been with me
for years
and my team, they're more than
just employees.
They may as well be family.
Legal signed off on it.
Okay. Peter, thank you.
Bilateral multi-lobar
consolidation.
- Heavy scarring, inflammation.
- Which means?
His lungs are destroyed,
but this much damage this fast,
how?
- Only thing I can think of...
- Train's batteries.
Mm-hmm.
From when he was trapped
in the conductor's compartment.
The tunnel was
full of moisture.
Leaky lithium ion batteries
plus moisture?
Hydrofluoric acid.
Highly corrosive, toxic.
- Nathaniel inhaled it.
- So what's the fix?
At this point,
a lung transplant.
I'll put Nathaniel
on the list immediately.
In the meantime, I'd like
to get him off the vent
and onto ECMO.
Take some pressure
off his lungs.
I'm afraid ECMO's
not an option.
Tubing shortage.
The machine's down
until the shipment arrives.
When will that be?
Maybe two days, three?
People spend weeks
on ventilators.
Sometimes longer, right?
So maybe we're in good shape.
We're not.
Nathaniel's lungs
are so injured,
the vent's barely doing the job
and I've only got a little
wiggle room with the settings
without risking further damage.
Even with the vent,
we're sinking.
Fever notched up a bit.
I've just been laying here,
but I'm spent.
Your body's at war.
Unfortunately, I don't know yet
what it's fighting against.
The labs and scans
didn't show anything?
Nothing definitive.
A mild enlargement
of the liver and spleens,
swollen lymph nodes,
global intestinal inflammation.
So all viral symptoms,
but not pointing
in a specific direction.
Brock, you've got an
extensive vaccination history.
I see the requirements like
mumps, measles, rubella.
Some optionals
like flu and COVID,
but there are a few that are
only for international travel.
Have you left the country
recently?
No. Never.
I'm from Chicago.
I... I've been in Georgia since
graduating high school.
First the south of Atlanta
then near the coast.
I just recently
moved back home.
Should we bring in
infectious diseases?
I could call a fellow,
but if there's been no travel
then I don't think she'll have
anything new to add.
Where do we go
from here then?
More labs.
Blood and stool cultures,
a mono spot test,
but I'll definitely put you on
empiric broad-spectrum
antibiotics.
Hopefully, we can
get that fever down.
So our mystery patient...
EEG and CT, both negative.
He didn't have a seizure
or stroke.
Tox also negative,
so not drugs.
His electrolytes
were a little off,
but I'm not buying amnesia.
No, me neither.
I just hung
a second bag of fluids.
He seems more alert
than when he came in.
- Thank you, Nancy.
- Good.
How you doing?
It's Dr. Charles
and Dr. Cuevas again.
- Do you remember us from before?
- Kind of.
Do you know where you are?
Uh, looks like the hospital.
Emergency room.
Mm-hmm.
And do you know who you are?
Harris. I'm Harris Bevel.
- And how old are you, Harris?
- 28.
And where do you live?
Wrigleyville.
Near the ballpark.
Wow.
That's the north side of town.
Do you know how you ended up
here in the West Loop?
No. I'm not sure.
I don't know why
I would be outside.
I don't know why
I would take that risk.
What do you mean by that?
Taking the risk.
It's dangerous outside.
It's hard to hide.
You got to always have
a hiding spot.
Okay. Okay.
Yeah, well, I noticed
you haven't really
touched your sandwich.
What? No appetite?
Didn't have the energy.
I'm tired.
I don't sleep that much.
So is that having a hard time
falling asleep,
having a hard time
staying asleep...
Yeah, yeah, that one.
Every night, 3 a.m.,
I'm wide awake thinking,
you know, worrying.
About anything in particular?
No. Just... everything.
Yeah. I get it.
That happens to me
sometimes too.
- It does?
- Oh, yeah.
Sometimes the world just...
moves too fast.
You know?
What about family?
Harris, anyone live nearby?
No. Tucson.
Any friends?
I have... I haven't seen them
in a while.
Okay.
You know what?
That's been really helpful.
Dr. Cuevas and I are gonna
step out for bit.
Do you mind hanging out
for a little while?
- No.
- We'll be back soon, okay?
If I were a gambler,
I'd bet big on Harris having
undiagnosed depression.
I don't disagree.
I don't think
he's a suicide risk,
but I'm just not crazy
about discharging him, either.
Yeah, me too.
One problem, psych unit's full,
and I used up all the TRC
options this morning.
I'm gonna
call up there anyway.
I mean, you never know.
There could be somebody's
on a hold who's expiring today,
getting discharged early.
It's worth a shot.
Okay.
I'll call Harris' family.
See if I can get
more of a history.
Excellent.
Need some help, Dr. Charles.
Patients are piling up.
I need trauma two back.
Elinor's still here?
Yeah, I called Medicar
three times.
They're short on drivers.
Skip them all together
and call Uber or taxi?
No, no, no, let's stick
with medical transport.
I mean, at least we know them.
Copy that,
but I still need the room.
Mags, do you mind if we just
set up a chair for her
in the nursing station?
I know it's not ideal,
but she's just had
a really rough day.
- Yeah. I'll find a corner.
- Thank you very much.
Okay.
So news?
A pair of lungs
has become available.
Well, that's great.
The donor died
in a car crash.
These lungs are
beat up pretty good.
- Will they work?
- No, not right now,
but I believe with EVLP,
they can be resuscitated.
- EVLP?
- Yeah.
Ex vivo lung perfusion.
Instead of sitting on ice,
the donor lungs are attached
to a machine that
circulates blood through them.
Well, thank God
for tech, huh?
There is one issue.
The hospital doesn't have
an EVLP machine.
Supply chain disruptions have
led to a delay in delivery.
Why are we talking about EVLP
if we don't have the machine?
We think that you
and your engineering team
can build an EVLP machine
using parts from machines
that are already
in the hospital.
All the schematics are online.
Here's the thing, Jack.
If we pass on these lungs,
I don't think another pair
will become available in time.
So intricate machinery,
a ticking clock,
and a life at stake.
Yeah.
It is a monumental challenge.
No question.
Well then, I'm on board.
- Excellent.
- Great.
The police.
Multiple non-displaced
lateral rib fractures.
- Yeah, yeah, yeah.
- Heavy contusions.
Yeah, yeah. My jaw.
Dislocated
temporomandibular joint.
It needs to be reduced.
All right. Grab Ethan.
He's with a patient.
Dr. Halstead and Dr. Taylor
are busy also, but I'm free.
How many jaw reductions
have you done?
Get Asher.
Patients all over the place.
A battle royale
in the football.
I guess it's just another day
in the ED, huh?
You miss the action?
Yeah. A little.
But really, I miss y'all.
What are you doing
this evening?
X-ray tech Mike
moonlights as a DJ.
He's spinning tonight.
A bunch of us are going.
We could dance away the day
like we used to.
- I'm in.
- Yeah?
Yeah, of course.
- Soon.
- Okay.
And apparently we have
a lot to catch up on.
Yeah.
Full disclosure,
it's been a decade
since I've reduced a jaw,
but I just watched one
on YouTube,
so see one, do one, right?
That's not funny.
- It's a little funny.
- It's not funny.
Okay. Here we go.
Open up.
- Let's do this. Ready?
- Uh-huh.
- One, two...
- Uh-huh.
Damn.
Holy.
You're welcome.
Hey.
The empiric antibiotics
aren't doing anything.
His fever's still ticking up,
and now he's having trouble
breathing.
- And his belly pain?
- It's worse.
Is there anything
in the latest labs?
No. Mono test was negative.
The blood cultures
are unremarkable so far,
but his lymphocytes
were on the high side.
You're thinking lymphoma.
It's been in the back
of my mind all day.
I just didn't want to jump
straight to the worst option.
Well, I still don't.
His sed rate and CRP are high.
Rising inflammatory markers
could point to
an autoimmune issue.
Kawasaki disease?
Kawasaki primarily
affects children
and often presents
with a telltale rash.
That wasn't one
of Brock's symptoms.
Doesn't rule it out, though.
It could just be
an odd presentation.
You know what?
You're right.
I don't think it's Kawasaki,
but you've given me a thought.
I want to run one more test.
Okay, I like it.
Arterial and venous tubing
from a dialysis machine.
Pumps, oxygen at or, gas and heat
exchanger from an ECMO.
Bits and pieces
of an enclosure bed
and added plastic
for the housing.
It's not fancy,
but I think it's gonna work.
You're not sold.
I don't like the housing.
It's too flimsy.
It's got to be stronger.
It can't tear.
It can't collapse.
I mean, this is
what holds the donor lungs.
Yeah, the lungs,
they're precious.
They have to be treated
as such.
Cradled.
Like a newborn.
How about an incubator?
Yeah. Hey, Alex, baby floor.
Get me an incubator.
Donor lungs have arrived.
Great. Let's take a look.
Thank you.
Oh, geez.
It's worse shape
than I thought.
Yeah, but seven, eight hours
of perfusion and aeration...
I'm cautiously optimistic.
How long until
the machine is ready?
Five minutes.
Prep the donor lungs.
Sharon.
We have a situation in the ED.
I cannot believe
you put this hospital
in that kind of legal jeopardy.
And yourselves.
You are to fully cooperate
with these detectives.
Is that understood?
Okay.
What the hell is going on?
Will and Vanessa went rogue.
It's bad.
- Bought meds off a drug dealer.
- Wha...
That guy.
What's your pain level now,
one through ten?
Uh, 35.
IV fentanyl isn't doing it.
The line's working fine.
I've reduced dozens of jaws.
I've treated thousands
of broken ribs.
Pain meds help those patients,
they should be
helping me, yeah?
Here, let me
see my chart, please.
Are you kidding me?
Get Dr. Asher in here now.
Oh, hey.
So I was able to free up a bed
in the psych unit
for Harris, so that's good.
That's great,
because I think his depression
stems from childhood PTSD.
Really?
Do you remember
a couple weeks ago
that shooting on Clark Street?
Yeah, that guy
with all the body armor.
Like, 2,000 rounds of ammun...
That was at Wrigleyville
where Harris says he lives.
And it turns out
that all went down
in front of
Harris' apartment building.
Oh, my God.
So he, like...
He saw the whole thing?
He heard it.
I just talked
to his sister in Tucson,
and she said that he locked
himself in the apartment
and laid low in the closet.
So he was never in danger,
but apparently since that day,
he's just been off.
Yeah, this morning he said,
"It's dangerous outside.
You always need
to find a hiding spot."
Talking about mass shootings.
Mm-hmm.
I was in sixth grade
when I had my first
active shooter drill,
and speaking from experience,
they're terrifying.
So it's reasonable to think
that this incident
triggered some
deep-rooted fears
that led us
to where we are now.
I mean, in my day, it was,
you know, it was air raid drill
in case of nuclear
frickin' war.
- Duck and cover, you know?
- Your patient.
Harris Bevel, he's gone.
- What?
- I'm gonna call the other EDs
and see if he shows up
at one of them.
I'll reach out to CPD,
ask them to do a welfare check
at his apartment.
I'll call security in case
somebody saw him leave.
- All right.
- You underdosed...
You underdosed me.
Come here.
Come here.
All right, I'm 6 foot, 180.
The healthy, responsible dose
of fentanyl for me
would be 150mics.
You gave me 25.
I'm so sorry.
I got a dislocated jaw
and broken ribs,
not a paper cut.
I'll fix it. 150mics.
I'll put in the order.
Do it.
Now the doctors are
fighting with each other?
I just want to go home, please.
I'm sorry, Nathaniel.
I know you're uncomfortable.
"Never say die."
That's the spirit.
I'll be right back.
Vent's not cutting it.
Donor lungs have only been
perfusing for four hours.
- Is that long enough?
- It's gonna have to be.
Please have answers.
I do.
The last lab I ran was
a COVID antibody test.
- It was positive.
- I have COVID?
No. You had COVID.
Your symptoms now are the
lasting effects of the virus.
- You're thinking MIS.
- What's that?
Multisystem
inflammatory syndrome.
It's a condition associated
with COVID-19.
It can impact the heart,
lungs, kidneys, brain,
or gastrointestinal organs.
It's rare and it's been
affecting children.
And it's only been found
in a handful of adults.
That's why it wasn't
on our radar
until everything else
was ruled out.
Few months ago,
I had a couple weeks
of complete exhaustion.
I COVID tested multiple times,
rapid and PCR,
but the results
were always negative.
I probably had it, didn't I?
Yeah, very likely.
It threw my world into chaos,
especially at work.
Yeah, I couldn't
pull my weight at all.
Boss got on me.
Colleagues didn't trust me.
It all got to be too much,
so I bolted.
I left in the middle
of the night.
Went home.
I'm sorry, man.
I know how physical setbacks
can upend your life,
but they don't have to
hold you down forever.
MIS is manageable
with high dose steroids,
and you can
get back to your life.
Return to work in Savannah.
That's where you said you were
most recently living, right?
No, he just said
near the coast.
Oh, my mistake.
Anyway, I'm gonna have to
admit you for treatment
and a nurse will be by
to start the paperwork.
Okay?
April, speak with you a moment.
Is Brock AWOL?
The engine he works on,
the Honeywell AGT1500,
it powers the M1 Abrams.
That's an army tank.
The army's third infantry
uses that tank.
They're based at Fort Stewart,
Savannah, Georgia.
Near the coast.
Third ID also has
soldiers in Africa.
Looking at Brock's
vaccination history,
if he had to deploy there,
he could.
I know Brock is army,
but when he said, "left
in the middle of the night,"
did that mean he was
on active duty and went AWOL?
That's why you didn't want me
taking this case.
You thought if I found out,
I'd turn him in.
Can you blame me?
Ethan, when it comes
to the military,
you rarely look the other way.
No, guess I haven't.
I assume you're gonna
call the MPs.
No, I'm not.
I wasn't expecting that.
Guess the world's not
so black and white anymore.
Still, skipping out
on a commitment
is a serious offense,
so whether he goes back
to his unit or gets out
of the army altogether,
he's gonna need some help.
I am texting you a contact
to a military attorney.
Will you pass it on to Brock?
Absolutely.
Security didn't see Harris.
You check the local ED?
Hasn't turned up and CPD's
welfare check came up dry too.
Dr. Charles, just heard back
from Medicar dispatch.
Elinor's van is gonna be in the
main entrance in three minutes.
What? They told me
Ambo Bay in an hour.
Well, welcome to my world.
The left hand has no idea
what the right hand is doing.
- Grab me a wheelchair, please.
- Okay.
Elinor, guess what?
Your ride is finally arriving.
I haven't taken my blood
pressure or cholesterol pills
or my arthritis.
My joints really hurt.
Oh, I'm so sorry.
Well, you know what?
You're gonna be home
before you know it
and you can take
all your meds then.
- When will that be?
- Now. Right now.
- Come on.
- Well, it's about time.
I have been waiting here
since last night.
You can't do this to people.
You are absolutely right,
which is why we need to
get you out of here
as quickly as possible.
Did she eat or drink
anything today?
I don't know.
I reached out
to Upton at CPD.
She thinks even with Devon's
statement and your confession,
the state's department is
unlikely to pursue charges.
- That's a relief.
- Yeah.
Hopefully, we dodged
one bullet.
Just have to see
if the hospital hits us
with disciplinary action.
How's Devon doing?
Drugs are out of his system,
so he's gonna be okay.
For real, Will?
Buying drugs off the street,
and then you just
pull Vanessa into it?
It's a little more
complicated than that.
I mean, you want
to risk your own career,
I mean, that's fine.
- But don't...
- Maggie.
Don't risk Vanessa's.
Where's the van?
You said it was here.
I'm sure it's just
stuck in traffic.
I'm sure it'll be here
any minute.
I'll call them.
Hey, Elinor.
Can you breathe with me?
Slow and deep just like this.
Yeah, I'm at the main
entrance with Elinor Whipple.
There's no van.
Please do not put me on hold.
How do the donor lungs
look to you?
Better than
when they came in.
Riley, can you open it up,
please?
Okay.
Oh, finally.
Look, Elinor.
The van's here. There it is.
I don't even care anymore.
I'm so tired.
I just want this whole thing
to be over.
Uh... is that just venting or
is that a threat of self-harm?
I don't know.
Sorry it took us so long.
It's our eighth run of the day.
- Still got two more.
- Okay. Well, you're here now.
Guess what, Elinor?
It's finally time to go home.
Let's get you into the van...
You're hurting me.
Get away.
We're just trying
to help you get home.
Do you want to get
in the van, Elinor?
What's going on?
She's exhausted, in pain.
She missed
her daily medication.
Hasn't eaten all day,
and she's likely dehydrated.
I don't think
we can take her like this.
Yeah, well, I'm not gonna
let you anyway.
Okay, well, at least
we have a bed.
I'll call psych.
Tell them we're on our way up.
Gave her 0.5 of Xanax
to calm her down.
You know, fluids,
good night's sleep,
getting her back
on her regular med schedule's
gonna help a lot and then
we'll go from there.
We move mountains
to be in a position
to open up space for Harris,
a man seriously
in need of help,
but now he's in the wind
and Elinor,
who should've been home hours
ago, is in the psych unit.
Irony sucks.
Yeah.
Pushing the rock uphill
and we're not even
helping people.
We're just creating patients
along the way.
Maybe my parents were right.
Not much to do for busted
ribs except ice them down.
- Maybe this Velcro binder...
- Oh, thanks.
Will help keep
the packs in place.
Yeah.
Moving, breathing,
feels like I'm being stabbed.
Good times.
I'll just put this
in your bag.
Thank you.
Uh, listen, um.
I'm sorry for blowing up
on you earlier.
- It's the pain talking.
- Dean, no.
Everything that happened today,
that is totally on me
and my complicated history
with opiates.
Okay, I know their dark side,
so my instinct is to protect
people from getting sucked in.
- I know I was projecting, but...
- No, it's okay.
It's okay. I get it.
All right.
Can I give you a hand
with your bag?
Uh...
I'll help you up.
Ah, Dr. Taylor, Dr. Halstead,
a moment.
So the board is not happy
that two of our ED doctors
went to a street dealer.
- That was...
- I'm sorry...
Mm.
But they're not going to press
the matter any further.
You're good doctors.
You're fighting
for your patients
and you're being put
in an untenable situation.
And I'm sorry about that.
I understand with your backs
up against the wall
how you'd need to look
for creative solutions.
All I ask is that
in the future,
you give me a heads up.
He's back?
Walked in a few minutes ago.
Have you talked to him yet?
Briefly, but he specifically
asked to speak to you.
- Me?
- Yeah.
I mean, he feels rapport
because you connected
with him today,
and I saw it happen.
Nellie, of course the system
is deeply flawed,
and it often feels like wins
can be really hard to come by,
but you got one today.
So good work, Doctor.
- Really.
- Thanks.
Dr. Marcel.
Yeah. Hey.
You already started
weaning the vent?
The new lungs are working.
I hope to try an SBT tomorrow,
but we're off to a good start.
Well, internet's gonna
blow up.
I got 30 million
social media followers
waiting to hear
how this story ends.
Yeah, Med's gonna
go viral, huh?
Not just Med, Dr. Marcel.
You saved Nathaniel's life
twice now.
Both in spectacular fashion.
What are you on, by the way?
- Twitter, Insta, TikTok?
- None of the above.
Well, no worries.
I'll text my PR team.
Set up accounts for you.
In the meantime, get ready
for what comes next.
What's that?
Fame.
Put your hands up! Yeah!
♪ When I'm gone
♪ When I'm gone,
I'm never really gone ♪
♪ You think you're moving on
♪ But it won't be for long,
you'll see ♪
♪ When I'm gone,
I'm never really gone ♪
♪ You think you're moving on
♪ But no one's gonna
feel like, feel like me ♪
♪ I'm tired of you,
touch you like I do ♪
♪ Know you never forget
♪ When I'm gone,
I'm never really gone ♪
♪ You think you're moving on
♪ But no one's gonna
feel like, feel like me