ER (1994–2009): Season 1, Episode 19 - Love's Labor Lost - full transcript

Hut‐hut‐hut.

Button‐hook
at the manhole cover.

‐ Boom.
‐ Ooh!

Montana to Rice.
Ho!

‐ They're on different teams.
‐ Since when?

When I watched
their last game at Carol's.

‐ But that was way back.
‐ I'll say.

‐ Go long.
‐ Me go long?

Ah, I'm‐I'm out of shape.
You go long.

‐ I'll go long.
‐ Alright.

‐ Doug.
‐ What?



Too far
for the Ivy League arm?

Car!

Hey, you butthead!
What, are you out of your mind?

Not another one.

Go get a gurney, Doug.

I'm not playing catch
with you anymore.

Nice of his buddies
to drop him off.

‐ What are friends for?
‐ Dr. Ross.

Three month old seizing
in One. Temp's 105.

‐ I got him, Doug. Go.
‐ Is Dr. Benton..

Oh..

'Give her
three more of morphine.'

Make it five.
Call X‐ray down here stat.

‐ Susan, I need you in here.
‐ Okay.



‐ Dr. Benton's gonna X‐rays‐‐
‐ Come on, Carter.

Move, move, move.

‐ Please, Petey. Oh, it hurts.
‐ Okay, ma, okay, ma.

Listen, alright.

Get an X‐ray of the right hip,
chest and pelvis, now.

‐ What about a C‐spine?
‐ Carter, come on.

Get the hell
outta here, alright!

'Carter, come with me.'

‐ Pulse thready and weak.
‐ What we've got?

‐ He's bleeding.
‐ Multiple trauma. Gown up.

O2, 15 liters.
Start a flow sheet.

‐ What's Benton doing?
‐ His mom broke her hip.

‐ Oh, God!
‐ That's bad at her age.

BP's low, 60/30.

CBC, type and cross eight units.
Run the saline wide open.

Carter, Deb,
guy's out of it.

Primary survey's done.
Now what do you get?

Uh, get a‐get a CT?

‐ Narcan 0.8.
‐ And then you got to get the‐‐

Glucose 85.

Get smart, nurses.
And nod sagely.

Get her another five
of morphine, CBC, CHEM 7

UA, EKG, hip, chest and pelvis.
Move. Come on.

No, no, no.
Don't take it off.

Somebody call the chief
of orthopedics and tell him

to get off his ass
and get down here now!

We need to undress
you, Mrs. Benton.

Please, not in front of Petey.

‐ Peter? Peter.
‐ What?

She doesn't want to be naked
in front of her son.

Okay. Alright, ma, um..

Alright, I'll, uh,
I'll be outside, okay?

'Here's the blood clav.'

I'll be right out here.

‐ He's going down the tubes.
‐ Can I intubate him?

Not this time.
It could be a neck fracture.

Always look everywhere.
We'll roll him.

‐ I got his head.
‐ Ready, and now.

Yes, there we go.
Single gunshot wound. And back.

‐ Heart's racing, 180.
‐ He barely has a pulse.

Put the blood
on a pressure bag.

Cap refill's bad.
No pulse. He's arrested.

Alright.
Carter, take over CPR.

‐ We got to crack his chest.
‐ I got it.

'Thoracotomy tray!'

We do a thoracotomy, when?

'A penetrating trauma
and full arrest?'

Exactamundo.

'I need the rib spreader.'

'We have towels, scalpel..'

Move your hands, Carter.

‐ 'Put the blood on the pump.'
‐ There we go.

Rib spreader.

'I'm in.'

'Pericardium's dry.'

Aorta..
Statinsky.

Is the OR team on alert?

They just finished
that perf appy.

‐ Suction.
‐ We got another customer.

‐ There it is.
‐ 'Nice save, Mark.'

We got a faint pulse.
Let's go.

I got to get home.
I'm on tonight.

Well, I'll have the place
emptied out for you.

‐ Deal.
‐ You taking the El home?

‐ Yeah.
‐ Oh, hang on a sec.

I'll go with you.
Lily, I'm back tonight.

Could....you finish
the nurse's notes?

‐ Sure.
‐ Bye.

Who the hell stat
paged me down here

for some old lady
with a broken hip?

‐ Hey, Peter.
‐ Dr. Wilson, I'm Dr. Benton.

Pulled me out of a damn
department head meeting.

This is my mother and
well, she broke her hips.

Now, that she did,
Dr. Benton.

Alright, Blair, put her
on your OR schedule.

No, no, no. Sir, I want
you to do the surgery.

ER admits go
to the teaching‐‐

No, I don't want a resident
operating on her.

‐ She's my mother.
‐ I'll scrub in.

So does that mean you're gonna
be the one holding the knife?

Alright, I wanna scrub in, too.

I'll be in there.

That's not good enough, sir.

Now look, I know
this is your mother

but you are way
over the line, son.

I'll page you
when we're done.

‐ Look, I don't‐‐
‐ Now back off.

'So...you tried
to sand it off?'

Isn't that what you do?

Yeah, but we don't
use a power sander.

Hmm.

Mr. Longet is a diabetic

as well as an amateur
dermatologist.

Vera didn't want me
just crossing it out.

Hmm. Well, uh,
one gram of Ancef

update his tetanus and get
Plastics to see him.

They may have
to do a graft.

Ah, maybe, you can move
that serpent head.

Onto the body
of a goddess?

I'll be right back.

Did you eat lunch?

Nah, the cafeteria
was already closed.

‐ Voila.
‐ Thank you.

Hey, word is out.
You're gonna be an ER attending.

‐ Congratulations.
‐ Well, it's not a lock.

‐ Can I borrow your pen?
‐ Yeah.

A lifetime of this, huh?
Phew.

Well, you know.
The ER, it's great.

‐ Free time's your own.
‐ What free time?

Well, after your residency.

You get skilled in
every aspect of medicine.

‐ You see a variety of cases.
‐ Mm‐hmm.

You have an immediate effect
upon your patients' lives.

But mainly, it's, uh, it's
like joining the circus.

'I'm telling you,
the opening goes in the back.'

‐ Okay‐‐
‐ Hold it, hold it, hold it.

Oh, my God,
I'm as big as a house.

'Hi.'

‐ Hi.
‐ Hi.

I'm Dr. Mark Greene.

‐ Sean O'Brien.
‐ Hi, Sean.

‐ I'm Jodi.
‐ Hi, Jodi.

Why don't you
hop up on that bed?

I don't think
I can hop anywhere.

‐ Easy.
‐ Alright.

What seems
to be the problem?

Our baby's due
in two weeks

and I have to pee
every 30 seconds.

‐ It burns and my stomach hurts.
‐ Stomach hurts.

Sounds like a bladder infection.
Does this hurt?

No. Just don't push too hard.
I got to go again.

Okay.

Thirty six minus four.

Baby's about
five or six pounds.

Do you have any
other medical problems?

‐ No. No.
‐ Thanks.

‐ Oh..
‐ Is that cold?

Yes.

I'll just take
a quick listen here.

‐ I love that sound.
‐ That's great.

That's great.

Any, uh, cramping?
Any vaginal bleeding?

‐ No.
‐ Okay.

You can feel
the baby move?

Uh‐huh.

Think you can give me
a urine sample?

‐ Are you kidding?
‐ No.

Yes, I think
I can do that.

'Okay, I want you to follow my
finger with just your eyes.'

Good. Okay, now squeeze
your eyes tight like this.

'Mm‐hmm.'

Great. Okay, press against
my hand with your face.

Great. Okay.

Show me your teeth.

'Ah. Ah.'

Is grandma ever going
to be able to walk again?

Yeah, yeah, yeah,
she's gonna be fine.

I know what
you're thinking, Jackie

so why don't you
just go ahead and say it?

Shut up, Peter.

No, no, go ahead
and say it.

I mean, it's my fault
that this happened, right?

I'm so pig‐headed
and self‐centered.

Peter...just shut up
and sit down.

BP's 90/60..

I found him in the green house,
passed out in the back.

Comes to visit me
at my place of work

and this is the shape
that he's in!

Hydrate with
a liter of saline.

You're gonna go
where I tell you to go.

I am not losing another son
to alcohol and drugs. I am not!

She's 38 weeks but I think
her dates are off.

Baby's small on exam.
Initial BP is 130/90.

But over a couple of hours,
BP's been fine. Around 120/80.

FHT is normal,
no cramps or spotting.

Got your test results.

UA shows white cells
too numerous to count

bacteria two plus protein
CBC's normal, no fever.

Simple cystitis.

Fluids, rest
and a course of Bactrim.

It's a bladder
infection.

‐ Who are they?
‐ Med students.

They're so young.

I know. It's disgusting,
isn't it?

Near‐term antibiotic of choice
is Macrodantin, okay?

Now, I want you to take these.

Lots of fluids.

Rest and follow up with your
doctor in the morning, okay?

The Sulfas compete
with bilirubin

for the binding
sites on albumen

increasing the risk
of neo‐natal jaundice.

He saves lives, he teaches,
he slices and dices..

Listen, Deb, can you work up
a weak and dizzy

and treat it for me?

‐ Uh, doctors?
‐ Mm‐hmm.

Would you sign a get‐well card?

Sure.

Who is this for?

Me.

‐ What is it?
‐ Hemorrhoids.

Yeah, that's
right there.

‐ Dr. Ross, kid's crashing.
‐ What? Here.

Ah!

His alcohol level's down to
zero. His pulse is down to 40.

Pupils are pinpoint.
Haleh, get a BP.

‐ He's frothing at the mouth.
‐ Is it drugs?

Something else is going on.
He's incontinent.

‐ Negative drug screen.
‐ BP is 70/50.

Where do you work?

‐ Wrigleyville Nursery.
‐ Nursery, as in school?

‐ No, like in plants.
‐ Outside, or in the office?

‐ Both.
‐ Yeah? Mig of Atropine.

IV push. Take off
his clothes. Wear gloves.

Let's start a drip.
Milligram an hour

2‐PAM, one gram
over 30 minutes.

‐ What's wrong with him?
‐ It's insecticide poisoning.

What kind of chemicals
do you carry?

I don't know.
We use everything.

We were spraying in
the greenhouse, this morning.

‐ Is he gonna be alright?
‐ I think so.

‐ I'm gonna call the nursery.
‐ Mm‐hmm.

‐ What do you have?
‐ Elderly man with hemorrhoids.

Oh, yuck. Everyone is so
old and sick around here.

Yeah. This is a hospital.

Yeah, I guess.

‐ Where's Benton?
‐ He's in surgery with his mom.

‐ Hey.
‐ Hi, guys.

‐ You working the graveyard?
‐ Yep.

Seven p. m., no Benton. Maybe,
I'll get home by 8:00 for once.

Somebody help me!

My wife's unconscious
in the car!

Dr. Greene!

Please,
somebody help me!

She's pregnant!
Hurry!

She just
passed out!

'Dr. Tuleesi calling 5‐8‐3‐9.'

'Dr. Breichman,
please check'

'with the doctor's
message center.'

'Dr. Patchett, report to ER
in Room Seven.'

Okay, it's fine.

Freeze right there!

It's my mother.
I want to scrub in.

Well, you take
one more step

and I will have your ass
hanging on my wall

right next
to your...residency.

I want to help.

Don't test me.

Out!

'Now divide the
iliotibial tract.'

'Hemostat.'

‐ Here?
‐ No, no, no, no.

'Where the hell did you
learn your surgical anatomy?'

'Right here.'

Watch her airway.

‐ Get a stat BP.
‐ She looks postictal.

‐ '15 liters by mask.'
‐ Oh, my God. What's going on?

Carter, help Mr. O'Brien.

Mr. O'Brien,
we need to work here.

'BP's high. 160/110.'

You okay, babe.

'We got a second IV.'

‐ Do you need blood?
‐ She's eclamptic.

‐ Mag sulfate, four grams IV.
‐ I'm right here, baby.

‐ Get your coffee yet?
‐ Do you need blood?

She needs a Chem 24,
a coag panel.

And put her
on a fetal monitor.

'Cap refill's fair.'

‐ Mr. O'Brien?
‐ Yeah.

Your wife has Eclampsia.

‐ Is she gonna die?
‐ No. No.

'We just need to get her
admitted and medicated.'

She's seizing!

Carter, grab
a bite block.

‐ Is that Mag in?
‐ Got it.

‐ Restrain her.
‐ Somebody do some..

Somebody help her!

'Help her.'

Push another
four of Mag sulfate.

‐ Baby, you'll be okay.
‐ Another four Mag.

'IV's out.'

The other one is blown.

I'll thrown in
an external jugular.

Two migs of Ativan.

Where's the prep pad?

Restrain her.

'Ativan's ready.'

'Alright, restrain her.'

‐ Get the suction ready.
‐ It's in.

‐ You got her?
‐ Sort of.

'O2 to 15 liters.'

'Okay. Seizure's stopping.'

Alright, let's hyperventilate
her. Get doptones‐‐

‐ Grab the AMBU.
‐ Let me do a quick pelvic.

'Let's get a blood gas.'

Lift up this leg.

Fetal heart tones,
strong at 140.

‐ That's good news.
‐ 'Running 30cc's of saline.'

Two centimeters dilated,
80% effaced. Membrane's intact.

Call upstairs, see
who's on call for OB.

Doctor, what the hell
is going on?

Your wife has a disorder
of late pregnancy

known as Eclampsia.

The blood vessels
go into spasm

causing a lack of
oxygen to the brain

which leads
to the seizures.

We're relaxing them
with this medicine.

‐ What about the baby?
‐ We'll need to deliver.

‐ When?
‐ Soon.

'Very soon.'

So who's in
Trauma One?

A 30‐year‐old
pregnant woman

with an eclamptic seizure.

She's postictal,
but she's coming around.

‐ BP's stabilized?
‐ Mm‐hmm.

‐ Mag sulfate going?
‐ Mm‐hmm.

Okay, well, I'll take over.
Go home.

Nah, that's alright. I'd like
to see her through to OB.

‐ I can handle it.
‐ No, no, no.

It's not about you.
It's me. See I..

I saw her earlier
and I diagnosed UTI.

I sent her out and she
seized in the parking lot.

‐ Oops.
‐ Yeah.

And I thought the protein in her
urine was due to cystitis.

And I blew off
one borderline BP.

I'd feel better
if I saw her through.

‐ Yeah.
‐ Okay.

Fundal placenta.
Looks okay.

BP 120/70.
That's very nice.

‐ Look at little hunter.
‐ Dermot.

‐ Jason.
‐ Patrick.

‐ Is that a boy, or what?
‐ Four plus turtle sign.

‐ What's that?
‐ What?

He looks like
a little head

'kind of peeking out.'

Okay, you give a score of zero
or two for each category.

Movement?

He seems very active.

Every night,
around the same time.

Okay. Score two.

Also breathing tone,
amount of fluid. He's an eight.

'Anything less than
a six, and you worry.'

‐ Okay.
‐ You do the AFI.

Yeah.

You divide the abdomen
into four.

Okay.

Find the deepest
pockets of fluid

without fetal parts
or umbilical cord.

You mark..

'...each corner of
the quadrant, okay?'

'Measure and then add up.'

Is‐is that what this
number is, I figure?

No. That's
the baby's heart rate.

That should be
between 120 and 160.

So 140's perfect.

Yeah.

The baby's in great shape.

Biophysical profile's eight.

AFI's 14.

Cervix is favorable.

I've got a non‐stress
test started.

Mm‐hmm. I feel
very comfortable.

I've delivered a couple
of hundred babies.

But it's 9 o'clock. So we'll
see you in about an hour?

What did Coburn say?

Well, she's at St. Luke's
and she says she'll be here

as soon as she's finished
with her repeat C‐section.

Oh, and she wants me
to start an induction.

That is, of course,
if I feel comfortable.

‐ She said that?
‐ Yeah.

‐ What a bitch.
‐ I know.

Hey, Drake.

‐ How do things look?
‐ It looks great.

BP's have been
perfectly normal.

Oh, boy. How can I..

Excuse me.

He can't be more
than 12 years old.

He's the OB resident on call.

I just spoke with Dr. Coburn,
our OB attending.

And she agrees that
we need to deliver you soon.

Does that mean you
have to do a C‐section?

I wanna deliver naturally.

Well, your Eclampsia's
under control.

The baby's in good shape.

And the cervix
is favorable.

I'd say we do
a trial of labor.

And if that
doesn't work?

I think
it will work.

I wanna give it a try.

Let's do it!

Excuse me.

‐ Yep?
‐ Mark.

Do you feel competent to handle
this down here without me?

We're getting
slammed upstairs.

Yeah. I think I can
muddle through.

Right. I'll check back
with you at say, 23:00?

Roger.

‐ Carol.
‐ Yeah.

Could you give Mrs. O'Brien
0.5 Pitocin IV?

‐ You're inducing down here?
‐ No, we're gonna start here.

And then we'll
get her up to OB.

Okay.

How frequent
are the contractions?

Every ten
minutes or so.

'Okay, let's have
Dr. Greene decide.'

You're kidding.

We can't call him Baby X
when we call our parents.

Alright, let's
take a quick look.

Okay.

Okay. It's five
centimeters dilated

90% effaced,
station minus two.

‐ Membrane's intact.
‐ You wanna look too?

‐ May I?
‐ Why not?

Everybody else's
been poking around in there.

Here.

Hmm..

"Ian, Patrick, Dermot."

sounds like the cast
of "Finian's Rainbow".

‐ Ow!
‐ Sorry.

"Hunter."

Hunter O'Brien?

You agree with
my assessment?

Uh...yeah.

Your labor's progressing along
nicely and quickly.

The baby's doing great.

Is it normal
for the baby's heart rate

'to be going down
like that?'

As long as it's only briefly
and it stays over 120.

Jared's on both lists.

‐ Oh, I don't know.
‐ It's not my favorite. No.

Compromise is
the soul of marriage.

Jared it is.

‐ Jared.
‐ Jared.

Jared's..

‐ Jared?
‐ Yes.

Okay, feel better.

‐ Thank you.
‐ You're welcome.

Hey, Mark, how come
the OB case is still here?

They're still busy upstairs.
I got to call again.

Dr. Greene!
Something's wrong.

The baby's heart..
The‐the monitor's down to 90.

Something's not right. It's not
supposed to go that low, right?

Hey, ma.
Hangin' in there?

‐ Hey, how you doing, ma?
‐ Why so long in the recovery?

She's 76.

‐ Estimated blood loss?
‐ 500 cc's.

Alright.
Post‐op orders?

She may be your mother,
but she's my patient.

We're taking
the OR elevator.

She's going to 604.

It was bound to happen
sooner or later, Peter.

Okay, sweetie, sweetie, let's
try deep, cleansing breaths.

‐ Let's exhale on the count of‐‐
‐ Shut up, Sean!

Call OB and get
the FAS in here.

How we doing,
Mrs. O'Brien?

I believe I'll have
an epidural.

Contractions are two
to three minutes apart.

No kidding.

Tracing's showing
decreased reactivity.

What's that?

The baby's heart rate
is reacting

and varying
less than it should.

But babies sleep
in 20 minute cycles

so what we want to do
is wake him up.

‐ Rise and shine.
‐ Whoa.

'There we go.
He was just sleeping.'

The heart rate's back up.

‐ Get an ETA on Coburn.
‐ Okay.

I'm Dr. Urami,
anesthesiology.

I'm here to do
your epidural.

Oh, yes, please,
let's do that. Oh.

How's that epidural?

‐ Wonderful.
‐ These are great.

I'm gonna show these pictures
of little Jared to my students.

‐ Eighth graders?
‐ Yeah.

‐ You know, like show and tell.
‐ In Math class?

Now we can get a pressure
reading inside the uterus.

This uh, scalp electrode..

'...monitors the pulse
rate more exactly.'

Enjoying the show?

Yeah.
I mean, no.

'She's eight centimeters
dilated.'

'Completely effaced.'

Won't be long.

There's another decel.

Variable with a late component.

Let's infuse
500 cc's normal saline

through the
uterine catheter.

Like a regular IV?

Yeah.

And we need to
get her up to OB.

I'll see if I can light
a fire under someone's butt.

‐ Is something wrong?
‐ No, we're okay.

‐ Page Coburn again.
‐ Okay.

'Why can't I just send her up?'

She's inches away and
the epidural's wearing off.

Well, then find Drake!
Hurry up!

Breathe, breathe. Breathe.

You wanna try
some of the breathing?

You know that fantasy
you have about me

quitting work, staying at home
and having a bunch of kids?

‐ 'Forget it. This is it!'
‐ Okay.

Repetitive lates.
We need to deliver.

‐ Okay. I need to take a look.
‐ Try some single breaths.

Fully dilated,
100% effaced.

It's time to start
to push.

‐ Already?
‐ Yep.

‐ Here?
‐ Here. Carter.

‐ Run and get Carol.
‐ Okay.

‐ Oh! Oh!
‐ Look at me.

Try some breathing.
Try some breathing.

I love you so much, babe.

So much.

‐ So much!
‐ Ow! Shut up!

Get a baby warmer
and a newborn

resuscitation tray
in Three, stats.

Nine, ten.

Take a breath.
Take a breath, sweetie.

‐ Welcome back.
‐ Did I go home?

Okay, push. One, two, three,
four, five, six..

...seven, eight, nine, ten.

‐ I'm not ready to be a mother.
‐ Come on, bear down.

I can't!
It's gonna rip me apart.

Push. One, two, three, four.

‐ Five, six.
‐ I can't!

‐ I can't! Get it out!
‐ Nine, ten.

Carter. Carter, go
to the OB and drag Drake down.

Tell him to bring some
forceps, okay? Go. Go.

She's not progressing.

The baby's heart rate's
dangerously low.

I'm gonna start
the pudendal block.

Okay, I'll gown up.

OB's got two C‐sections
and three..

Hey, Mark. Mark.

No one will blame you
if you wait for OB.

The baby monitor says,
now or never.

‐ Why put your ass on the line?
‐ 'Cause I've come this far.

I'm gonna see it through.

‐ Where's Coburn?
‐ In transit.

'What,
is she coming by camel?'

Get her BP.

'BP's still climbing.
150/100.'

Go, Mark,
baby's bradying down.

‐ Okay. Now don't push.
‐ Just relax, okay?

Before I break the blades,
cut a median episiotomy.

‐ The head.
‐ Can you breathe?

Right.
Here comes the head.

‐ Look at me.
‐ Let me get a blanket.

‐ Damn!
‐ Get him out.

‐ He's stuck. Shoulder dystocia.
‐ What's that?

His shoulder's hung up
on the pubic bone.

‐ That's okay, sweetie.
‐ Oh, my God.

Leads off.

Macrobert's maneuver.

Push the legs up
towards her head.

‐ Okay, lift her legs.
‐ I've got it.

'Straight up in the air.
Straight up in the air.'

Someone push down
on the abdomen.

What are you doing?

Trying to free
his shoulders. Push.

Carter, not fundal pressure.
Down here. Down here.

He's‐he's jammed.
Stat, page OB.

Oh, my God, do something!

Let's try a woods.

'I need to extend
the episiotomy.'

'If I can rotate the posterior
shoulder medially..'

I love you, baby.

Try to deliver
the posterior shoulder.

He's jammed in.
Come on.

Come on!
Come on.

Hey, why can't you
deliver this baby?

Mr. O'Brien, please.

It's not working.
Let her, let her go.

'Let her go.
It's not working.'

‐ Zavanelli.
‐ What are you doing?

Zavanelli. We've got
to push the baby back in.

‐ Then what?
‐ We're almost through.

'Well, we gotta roll her
on her left side.'

Susan, get your hand in here.
Grab a caesarean tray. Run!

'Climb on up.
Hold her head in.'

Throw...throw a sheet over her.

‐ Get her into Trauma One.
‐ I love you so much.

Find out
if Benton's still here.

‐ Splash and crash.
‐ Okay.

Where are you taking her?

We've got to do an emergency
C‐section.

‐ I need your consent.
‐ What the hell you're doing?

‐ Have you done this before?
‐ I've scrubbed in many times.

No. I want somebody
else in here.

Look, we can't wait.
If we wait five more minutes

your baby's brain is dead.

‐ Come we gotta go‐‐
‐ Go! Go! Go!

‐ 'Watch the IV.'
‐ Do it!

'Keep moving. Mr. O'Brien,
please get out of the way.'

‐ 'Let them work.'
‐ Sweetie, I'm right here.

I love you so much.

‐ We're almost home.
‐ 'Mr. O'Brien.'

We're almost out of here.

I love you, Jodi.
I'm right here. Right here.

‐ Call respiratory stat.
‐ I love you‐‐

'Mr. O'Brien, you have‐‐'

‐ Jodi, you know, I love you.
‐ Wait out here.

I'm right here!
I'm right here.

Splash it
with Betadine.

‐ BP's sky high, 170/120.
‐ What about anesthesia?

No. There's no time.
I'll throw in a local.

‐ Oh! She's seizing!
‐ Grab the bite block.

Let's paralyze
and intubate.

Versed four migs.

Norcuron ten.

Intubation tray.

‐ Get respiratory down here.
‐ 7.5.

‐ Suction standing by.
‐ Okay, O2 at 15.

'Carter, try to get in here.'

'We're just gonna
bag her for now.'

Get that typed blood
cross‐matched and down here.

Where's the coag panel?

‐ Get a vent ready.
‐ Her BP's 200/130.

'...to stroke out.'

Okay, everybody, just take
a deep breath, alright?

Okay, Hydralazine, ten migs.

Another bolus of Mag sulfate.

Somebody call NICU.

And get somebody
down here...for the baby.

Somebody physically
go up to the OB.

And drag somebody
down here, okay?

Go!

'Get the suction ready.'

Scalpel.

Let's see.

Is that the fascia?

Uh...yeah, yeah,
that looks right.

‐ Grab with those clippies.
‐ Hydralazine's in.

‐ Grab an army navy.
‐ Suction.

Metz.

The long scissors.

Retract there.

I'm in.

Isn't there something
about a bladder flap?

‐ 'Pickups.'
‐ 'Suction.'

‐ 'I'm dividing the peritoneum.'
‐ 'Hemostat.'

Okay, we're in.

Grab that side and pull.

Get a retractor in there.

'We need exposure.
Pull.'

Oh, man.

That's wide enough.

Alright now, scalpel.

You cut across the lower
segment of the uterus?

You're asking me?

I'm asking God.

'Suction. No here.'

I don't think
you're all the way through.

I don't want to cut the baby.

'Open a pack of lap pads.'

‐ 'Retract this way. More.'
‐ 'Okay.'

Here..

There. I think I'm in.

‐ Oh, my God!
‐ There's two liters in there.

She's got an abruption.

‐ She's bleeding out.
‐ Carter, Chen, gown up.

'Get the baby out.'

'Open those IV lines.'

'Hurry, Mark, get him out.'

‐ Get the baby.
‐ Pump in saline.

Forget that
cross‐match.

Eight units of O‐neg
down here, stat.

‐ Hurry up.
‐ I got him.

‐ He's big.
‐ Hurry up. Suction his airway.

‐ BP's okay, 120 over 80.
‐ He's blue. Hurry up.

'The cord's free.'

Suction.
Suction his nose.

Umbilical clamp.

He's not breathing.

Okay, clamp.

Alright.
Bag him.

Carter, get in here.

Carter?

Get in here.
Follow my hand down.

‐ Feel the aorta?
‐ I don't know.

‐ It's pulsing.
‐ Yeah. I do.

Okay. Push down on it
and don't let go.

‐ You got it?
‐ I think so.

‐ Don't think, do.
‐ I got it.

‐ Is he alive?
‐ BP's holding. 110/70.

'Move. Move.'

Start CPR.

I'm gonna intubate.

Alright.

‐ Heel stick of glucose.
‐ Tone is flaccid.

'We need a blood gas.'

I can't see. Suction.

‐ O‐neg's here.
‐ Alright. Pump it in.

I think I'm in.

Bag him.

Quick listen.

Chest expands
while we're bagging.

Yeah, okay. We got it.

Tape it and keep bagging.

Alright, blood sugar's 20.

Give him D‐10.

He's got no veins.

Hyperventilate him.

'I'm gonna try
an umbilical line.'

‐ 'What about some epi?'
‐ 'Point zero four.'

‐ Epi down the tube.
‐ Here's the epi.

Release that clamp
after I tie this off.

Release the clamp.

Oh, my God,
how can you see?

I don't know.

Grab a bag of O‐neg.

'Give him ten per kilo.'

40 cc's.

Oh, come on.

'Come on.'

That's the umbilical vein.

'Okay, hook it up
while I advance it.'

'Okay. It's going.'

Glucose at five mil per kilo.

'Follow me down.'

'20 mils.'

'Come on, little guy.
Come on.'

He moved. I swear
to God, he moved.

It's going, 100.

‐ Regown me.
‐ He's pinking up.

She's had three units,
two liters normal saline.

‐ Vitals?
‐ BP's 80/50, pulse 112.

I can live with that
and so can she.

Baby's five minute Apgar
is much better. Eight.

That's good.

‐ Go ahead and regown Susan.
‐ Look who's here.

What's going on in here?

I intubated.
The baby went bad.

I tried forceps and got
a shoulder dystocia.

She seized. I paralyzed
and did a crash section.

'Got in there and there were two
liters of blood in her uterus.'

‐ You knew she'd abrupted?
‐ No, once I got in there.

'Baby nearly died.'

Who is this and what's
he doing in there?

I'm John Carter, med student,
and I'm pressing on the aorta.

It's a damned mess.
What did you use, a chain saw?

Well, I couldn't
just stand around

waiting while
that baby died.

Get an NICU Transport Team
over here.

And the OB resident on call.

'You should have let me know
you were in over your head.'

Oh!

We've got hemostasis.

Someone call respiratory.

Okay, Carson, you can
let go of the aorta.

Wait, wait. Wait. Wait.
Just‐just stop. Just stop.

'Looks good.
Bleeding stopped.'

Go talk to the father.

'Suction.'

Is my baby alright?

He was apneic at first. But his
five minute Apgar was very‐‐

Stop hiding behind
that damn medical crap!

I think your baby's
gonna be fine. Let's go.

Don't‐don't take my son.

‐ And Jodi?
‐ There was bleeding.

She's had transfusions,
but she's stabilized now.

Dr. Coburn the OB specialist
is in with her now.

‐ She's closing the incision.
‐ How can this happen?

Well, what we need
to do right now is

get your son upstairs.
Now, go! Go.

‐ Everything's okay, right?
‐ Go, be with your baby.

There's nothing
you can do down here.

She's gonna be okay, right?

She's stabilized.
Go with your son.

I have never seen such a chain
of errors in judgment.

‐ You mean, I did what you said.
‐ You miss a preeclampsia!

You underestimate
the fetal weight.

I was expecting OB backup.

You miss a
placental abruption.

‐ What?
‐ Blood clot. Right there.

You do an ill‐advised
forceps delivery

on a baby that's too big
and then you..

Then you do a hack job
of a C‐section.

Hello!
It was me in the barrel

with the baby
going down the tubes.

The only thing that saved you
from disaster was dumb luck.

Yeah, well, if it wasn't
for me, the mother

would be dead
and the baby a vegetable.

‐ Who's on OB call?
‐ Drake.

Mark. Mark.

She's just covering herself.

She was right.
It was my screw up.

You were great in there, Mark.
I couldn't have done that.

It was my fault, you know, it
was my fault that she went sour.

‐ She's my patient.
‐ No one is going to blame you.

‐ Nah, they don't have to.
‐ Dr. Greene!

She's crashing!

‐ How many units has she had?
‐ BP's falling, 70/40.

Two O‐neg, two saline packs.

You run the resuscitation.
Her cap refill's bad.

I'll throw in
an arterial line.

Somebody put those blood bags
on a rapid infuser.

Hook up the transducer.

Give her a mig of Atropine.
Check a manual BP.

She's really bleeding
from the puncture site.

‐ Somebody put pressure on it.
‐ I got it.

‐ IV site's oozing too.
‐ I don't hear it. 65 palp.

Hang a Dopamine drip.

Pull her off that respirator
and bag her.

'The blood stopped clotting.
She's going into DIC.'

Oh, damn! Order up ten units
cryoprecipitate and platelets.

‐ Uh‐oh. Multi‐focal PVCS.
‐ Oh, what now?

Lidocaine 100 migs, IV push.
Start a drip.

Mark the time, 05:42.
Charging, 260.

'Clear.'

Again. 300.

Clear.

She's oozing from
every cut surface.

We're chasing our
tails in here.

Time down?

Thirty three minutes.
More PVC.

She's maxed out
on Lidocaine.

Add Pronestyl, 30 migs
a minute, up to 200.

‐ No pulse. We're losing her.
‐ Get a Dopamine drip.

‐ Charging.
‐ Out of the way.

Out of the way.

'Again, 360.'

'Off.'

‐ 'Give her 300, IV push.'
‐ 'Blood gas is bad, 302/50.'

It's been five minutes
since her last high dose epi.

Another seven.

Mark, she's gone.

It's 30 minutes
past too late.

I'm calling it.

Time of death, 06:46.

It's not flatline.
It's fine V‐fib.

Another seven migs epi.

Dr. Greene?

Dr. Greene?

I, uh..

...just wanted to say to,
or to tell you

that, um, I thought what
you did was a heroic thing.

It's just one stop the other
way, right by the train station.

‐ I got to get going.
‐ Come on.

Not only does Shorty's have
the greasiest eggs in town

and stuff falls
from the ceiling

every time
the El goes by.

Sounds attractive, Susan.

I just got a million
things I got to do.

Are you sure you're okay?

I'm fine. Scout's honor.

Is Jen home?