ER (1994–2009): Season 10, Episode 13 - Get Carter - full transcript

CORDAY:
Oh, look,
here they are.

Fantastic.

Hey.

Hi.
Good morning,
Ella.

Hi.

Happy birthday,
Sydney.

Are you ready
for your party?

She's been ready for a month.

We're going
to aquarium,

and then we're
having a puppy party.

It seemed like
a good idea



at the time.

I put her present
and a card

in Ella's backpack.
Thanks.

I'm must say,
you're awfully brave

taking this on alone.

Hey, you're welcome
to come with us.

Yeah, Mommy.

Come with us, please!

Oh, Ella, I have to work
in the hospital.

I'd come if I could,
but I have to do

a pancreaticojejunostomy
at 9:00.

No problem.

I'll come another time,
I promise.

You have fun at the party.



Okay.
Thanks, Dave.

I'll pick her up
around 6:00?
They should be well

into their sugar rush by then.

Marvelous.

All right, girls.

Love you. Bye.
GIRLS:
Bye.

KEM:
Do you think I could talk

to someone in the infectious
disease department?

It would be great
to compare adherence statistics

for HIV patients in Chicago.

Yeah, I can probably
arrange that.

And it would be really helpful

if I could spend
some time in your
clinical lab.

'Cause even though
the chances

of us getting
one are remote,

I would love
to take look

at the current
generation
flow cytometer.

Uh-huh, uh-huh.

And counting lymphocytes
under a microscope

is the best I
can do for now.

Yeah, I just got to check
all this with Dr. Weaver.

Frank, have you seen Dr. Weaver?
Try the lounge.

I'll be right back.

Breakfast pierogie?

His dedication to the staff

and patients will be hard
to replicate.

Kerry?
To duplicate.

Ooh, sorry. I didn't
mean to interrupt.

You didn't. Have
you seen Dr. Lewis?

No. I just got on.

Hey, would you mind

if Kem observed in
the hospital today?

Yeah.

Um, she has her
master's degree
in public health.

That's no reason
to punish her.

Give the poor woman
a credit card, Carter,

and let her have some fun.

I tried that.

She, uh, would like to speak
to the public health nurses

and see how
we track communicable diseases.

Sure, fine.
Maybe she can
motivate some

of the slackers
around here.

Frank, where's Lewis?
Got me.

Okay, I want everybody
in the lobby at 9:00

for the dedication.

Huh.

What dedication?

Well, they're renaming
the hospital Romano Memorial.

( chuckles )
I'm not kidding.

Where is Kem?

There.

Ah.

Do all the patients

with sexually
transmitted
infections

get routine
HIV testing?

Sometimes.

It depends
on the doctor.

Do you refer them
to your STI clinic?

I don't think
we have one.

Hi.

Did you talk
to Dr. Weaver?

Yeah. She said
everything's fine.

Kem's going to be hanging out
in the hospital today.

Why?

Morning, folks.

Ride-along?

Yup.

Interns have
to do, uh,

paramedic ride-alongs
twice a year.

Lets them see what real
medicine's all about.

Oh, yeah,
right.

You might want to pop
a couple steroids

before we try
lifting this one, Doc.

31-year-old male,
fell down a flight of stairs.

Complains of back
and diffuse abdominal pain.

Frank, did any labs come back
on the Gorham kid?

Frank, you all right?

I think I'm having
a heart attack.

Are you kidding?

Do I look like
I'm kidding?

Okay, here, here.
Sit down. Sit down.

I need some nitro over here!

( belches )

( sighs )

Oh.

That feels
a lot better.

You know, I bet it was just
those breakfast pierogies.

Thanks.

Hey, check you
out, Mr. GQ.

What, do you have
a deportation hearing?

Have another
pierogie, Frank.

CARTER:
Hey, Luka, could
use another set

of hands over here.

I'm not on.
It's just for the transfer.

Where's Dr. Lewis?

Uh, did you check
the on-call room?

I think she's sleeping.

Are you kidding me?

She wasn't feeling well.

Do you need something?

Yeah, I need someone to
run this damn department.

Can't help you there.

Hey, uh, Susan,

the Medical Executive
Committee has authorized

a nationwide
search to look

for Romano's
replacement.

Until we can find a
suitable candidate,

we'd like you
to step in.

Oh, Kerry, thank you
for the vote of confidence,

but, um, I, uh, I...
I'll pass.

I'm going home.

Wait. It's-it's an extra
three grand a month.

Do med students qualify?

I'm sorry. I'm
just not interested.

Why not?

Um, I'm pregnant.

( vomiting )

Cleanup on
aisle five.

I'll phone upstairs
as soon as I'm done down here.

Please let me sit up.

I can't catch my breath.

That's 'cause you've got
too much weight on your chest.

We need to get
an X ray of
your neck first.

No, you don't.

Uh, yeah,
we can use the nexus criteria.

If he's alert
and sober

without any focal
neuro deficits,

distracting injury,
or neck pain,

then he's low risk
for C-spine fracture.

Any pain in here, sir?

No.

What are you doing here today
if you're not working?

I'm giving a lecture
to the med students

on clinical decision-making
without the use

of ancillary tests.

Look towards me.

Now look at
Dr. Kovac.

Any pain there?

No.

That's very cool.

Our health care system
requires us to diagnose

and treat with a minimum
of tests and equipment.

Hey, maybe Kem could sit in
on your lecture?

She's doing a little recon
in the hospital today.

I-I never taught
in the classroom before.

Oh, you're a natural.
Okay, his neck's clear.

Let's get him
off the board

and sit him up.

Ready? One, two, three, go.

Hemocue is 12.8.

Trauma labs drawn.

This is exactly
what I'm talking about.

All he needs is a CBC and UA.

Diffuse
abdominal pain--

he meets trauma guidelines.

I'm sending a trauma panel.

There's no rebound
or guarding.

He doesn't need LFTs;
he doesn't need amylase;

and he doesn't need
to be typed and crossed.

Nurses have to follow protocols.

They're unnecessary.

You know what?

Why don't you save
the lectures

for your med students

'cause the nurses
don't want to hear it.

Weaver says to get your butts
in the lobby pronto.

WEAVER:
Dr. Robert Romano

was a fixture
in this hospital for years.

His dedication to the staff

and patients will be hard
to forget.

And his generosity continues
even now.

Hey, how you doing?

Very good, thank you.

A significant portion
of Dr. Romano's estate was left

to this hospital
to further our service

of this community.

And to that end,
I am pleased to announce

the creation of...

the Robert Romano Center

for Gay, Lesbian,

Bisexual and Transgendered
Health Care.

This new facility will provide
the latest

in health services
to those patients

and their families.

She didn't.

Oh, yes, she did.

All right, that's it.
Back to work.

Pratt, you missed
your appointment with Bob Harris

from Risk Management.

Yeah, I know. I've
been a little busy.

Yeah. I got you another
appointment in 30 minutes.

Don't be late.

Is it just me, or do the eyes
seem to follow you?

Was Romano's prosthetic arm
destroyed in the accident?

Why?

Because if it wasn't,

it's going to hunt Dr. Weaver
down and strangle her.

He wasn't a big supporter
of gay rights?

Uh, no, not really.

That's too creepy.

Did I miss the dedication?

More like postmortem payback.

Oh, my God.

All right,
looks clear to me.

What do you think?

I think we should discuss it
over dinner.

Really?

You like Moroccan?

I'll eat just
about anything.

Okay.

TAGGART:
Pratt!

Approximately 20-year-old male,

feet versus tree
at 30 miles per hour.

Was he thrown from a car?
This thing is frozen.

Yeah, his buddies wrapped him up
and tied him to a toboggan

and sent him down
a hill like some
sort of body luge.

Witnesses say
he bounced off the tree

and wound up in a creek.

I can palpate a
decent carotid,

but we can't get his
arm out for a BP.

We got his boots off.

It looks like
bilateral foot fracture.

He may have a spinal injury.

Maybe we should get Carter
on this.

What's wrong
with you?

Hey, come find me later.

All right, let's get

ten liters
of warm irrigation solution

so we can thaw out
this damn blanket,

and let's cut off this tape

so we can do
a proper assessment.

I hate this time of year.

We must get
30 slip-and-fall calls a week,

right, Bardelli?

At least.

Here's an idea--
if it's icy

and you're old,
don't go outside.

Save yourself a broken hip.

( yelling and thumping )

MAN:
Go away.

You called 911 for paramedics?

MAN:
Shut up, bitch.

WOMAN:
I'm not gonna shut up.

You shut up.

Hello? Is someone hurt in there?

WOMAN:
Leave me alone.

Great. I'll call
the police.

Hold on. What
are we doing?

We need to
get in there.

Not till the police get here.

Are you kidding me?

What if he's
hurting her?

We wait for the cops.

EMT got shot last year

going in without backup.

Open the door.

You have to enter two
pages of demographics

for every patient that
walks through the door?

Yes.

So, what do you do with
all the information?

That's really up
to the public health geeks.

Do you ever use it
to try and track down

patients who leave
without being seen?

You have to ask
one of the docs.

So, how many people leave
without seeing a doctor?

Look, lady, I
just work here.

What kind of training
do you need for this job?

Dr. Weaver?

Hmm?

Do you know how
many patients leave

without getting
medical attention?

How about calling off
this grand inquisition?

Somewhere around
five percent.

Some of us
are trying
to work here.

Hi. Uh, I just
got off the phone
with Dr. Farina,

and someone's going
to phone me back

about letting you
take a tour of the lab.

That's great.

So, do you want
to try and catch
Luka's lecture,

and I'll just have
you paged when
I hear something?

Luka didn't seem
too keen on the idea.

Oh, he's just shy.

I think
he'll appreciate your interest.

Kerry, are we truly to believe

that Robert left
a substantial donation

to establish a gay
and lesbian center?

Gay, lesbian, bisexual
and transgendered--

whatever the hell that means.

The actual
designation
was left

to the discretion
of the board.

This is the
one area

where we felt
that County was
truly lacking.

Revenge is a dish
best served cold.

( sirens blaring )

Yo, Morales, the
police are here, man.

Come on.
This is crazy.

Just relax, man.

Right here.

GALLANT:
Listen, there's a woman inside.

It sounds like
she's being killed.

( yelling and thumping inside )

This is the police department.

Open the door.

Back up.

Back up, back up.

Sit down, sir.
Sit down.

She tripped.

Ma'am, are you okay?

He pushed me.

She's drunk. She tripped.

Sit down now, sir.

You're the drunk.

You liar.

I think you better
take a look at her.

I'm gonna kill you, bitch.
Quiet down!

I swear to God,
I'm gonna kill you.

Enough of that.

Patients with peripheral vertigo

do not require CT scanning.

What clinical test
will diagnose BPPV?

Anyone?

Sheila?

Could you repeat that last part?

Ah, come on, guys.

Positional test for vertigo?

( sighs )

Rectal temp's
87.6 degrees.

I think he's
coming around.

Hey, what's your name, man?

Doug.

Doug, you want to tell me
what happened? Talk to me.

A hockey initiation.

I'm cold.

Well, we're working on that.

You want to start pleural lavage

with bilateral chest tubes?

No. Let's do
external rewarming.

He's groggy
and under 89 degrees.

That's the criteria
for active rewarming.

Yeah, but he's progressing
on his own.

Let's get a warming blanket,
heated IV fluids,

and heated O2 by mask.

What happened to this guy?

Well, looks like
Doug's friends here

took him sledding,
and he wound up swimming.

Temp: 87.6.

We're using
passive rewarming.

Rest of the vitals?

BP is good:
112/78.

Pulse: 106.

Sinus tach
on the monitor.

Films?

PRATT:
Bilateral calcaneal
fractures

and a compression fracture
of L-5.

Doug, can you wiggle your toes?

Can you wiggle your toes, Doug?

All right, let's
get an MRI

to rule out spinal cord injury.

No. Lumbar
compression
fractures

like this almost never
have cord involvement.

He can't moves
his toes.

That's probably
from the frostbite.

Try some warm water immersion.

CARTER:
Yeah.

DTRs are two plus
and equal.

How's the rectal tone?

Pretty normal.
Good.

Sacral nerves are intact.

S two, three, four,

and keeps the poop
off the floor.

There's sensory
loss in the toes.

Not in the distribution
of a dermatome.

Warm up the toes
and reassess.

No MRI.

( Doug breathing loudly )

I can't feel my toes.

We're warming them up, Doug.

I can't feel anything.

What's happening?

Well, you broke both your heels

and one of your vertebrae.

Oh, my back's broken?

It's a compression
fracture.

Your legs took
most the impact.

So, am I paralyzed?

We're still waiting.

No. Am I paralyzed?

Just tell me.

( Doug breathing loudly )

Get the MRI.

Look, can you call my dad?

Can somebody call my dad?

But Dr. Carter said...

Just do it.

Dr. Pratt, you're a hard man
to track down.

Bob Harris.

I'm with the hospital's
Risk Management Department.

Yeah. I can't
talk right now.

Yeah, I realize
you're busy, Doctor.

I need you
to write up your recollections

of a case regarding
an MVA patient

by the name of Martin Brodie.

He suffered from ankle...

Ankylosing
spondylitis.

Yeah. The disease
turned the guy's neck

into a breadstick.

Were the injuries he received

from the car accident
exacerbated by his condition?

He came in having
trouble breathing.

I tried to help him.

And there were
complications?

Look, I snapped the guy's neck.

Now he's a quadriplegic.

The insurance settlement

on this one is going
to be in the millions.

Do you have any idea

how much 24/7 nursing care
in a state facility costs?

I mean, Martin Brodie's
a 19-year-old boy

looking at, what,
40-50 more years

of total paralysis?

Have your notes on my desk
by 9:00 a.m.

GALLANT:
Pupils equal
and reactive.

I hope he
rots in jail.

Pulse: 105;
BP: 118/82

with descent sats
around 94%.

Smells like her blood alcohol's
about the same.

MORALES:
From what I can tell,

all these lacerations
are superficial

and both her lungs are up.

Is there any chest pain,
belly pain?

Hey, Amy, stay with us.

Where did he go?

He's being arrested.

Listen, she's going
to need a head CT.

Keep her on the monitor
and stand by with a tube

just in case she
starts to go south.

All right.

Hey, do you hear something?

Sounds like
a kid crying.

( gunshot )

Wait! Wait, wait, wait.

It's just a kid.
It's just a kid.

Drop the gun, son.

I thought you were my dad.

( panting )

With a normal neurologic exam

and a Glasgow Coma Score
of 15,

you do not need a head CT,

and you save $2,000
in health care costs.

We do about ten
unnecessary scans a day.

Dr. Kovac,

the costs to procure
and maintain a CT scanner

are relatively fixed,
am I right?

Yeah.

So, if you eliminated
half the scans,

wouldn't that then

double the costs
of the tests you did do?

There would be no real savings
in health care dollars,

and the patient would actually
be billed twice as much.

Wouldn't the real
solution be

to have several hospitals
share one scanner?

Did you send Mrs. Wintermuhe

to radiology?

No, I sent her home.

What about her abdominal pain?

Uh, it was more discomfort
than pain.

Her husband's been off work
with a worker's comp claim,

and her son just moved back home
with his daughter

while he's going
through a nasty divorce.

Did you get her
whole family history?

Half the people
that come in here

just want to talk
to somebody.

How's your son doing?

Uh, fine.

He hasn't given himself
a thoracotomy yet,

so that's good news.

He'll probably end up
a brain surgeon.

Yeah, or a grave robber.

You're a "glass-half-full"
kind of guy, huh?

Hey, how's
the teaching going?

Ask Kem.

She seems to be doing
most of the talking.

Yeah, she can be
a little inquisitive.

I'll talk to her.

Don't any of
these patients

have primary
care doctors?

There's a three-month wait
to be seen in the clinic.

( loud coughing and wheezing )

Hi, Mrs. LeMonier.

I'm Neela.

( coughing and wheezing
continue )

Can you tell me
what's wrong?

My children are sick.

You don't sound
very well yourself.

Parlez-vous Francais,
Madame?

Ah, oui.

D'ou etes-vous?

Haiti.

She's from Haiti.

Do you recognize that?

Pneumonitis?

It sounds like pertussis.

Whooping cough?
Really?

CARTER:
Hey, there you are.

John, I think this
woman has pertussis.

Is that possible?

Yeah, we get
the odd case.

In Chicago?
Mm-hmm.

How's the lecture going?

Interesting. Luka's
an excellent teacher.

( laughing )

I should probably
be getting back,

but I think Neela
needs a translator.

Oh, I think we can
probably manage that.

Dr. Farina called.

He's ready to
give you a tour

of the infectious
disease department.

What about
the lecture?

I think he'll understand.

Hey, Neela, can you take
Kem up to 5 West?

Certainly.

If you see Luka,
tell him I'm sorry

I missed the rest
of his lecture.

Yeah, come find me
when you're done.

And check out
that woman.

Is that the domestic?

Yeah. Superficial lacs,
maybe a broken arm.

We got a kid, too.

He almost shot
Gallant's head off.

So, how are you
liking Chicago?

It's very... nice.

How long have
you been here?

I've been in America
for seven years.

Chicago
for the last three.

Do you like it?

I still feel
like I'm getting settled in.

But it's quite pleasant
for a big city, really.

Although it's not quite London.

No. Or Paris.

No.

It's much more agreeable
in the summer.

Tad warmer, too.

That is good to know.

The people
are friendly enough.

Yeah. They're larger
than I expected-- the people.

Yeah. They're quite fond
of their giant portions here.

Big Gulp, Supersize,
Monster Fries-- all that.

I saw a woman drinking a bucket
of coffee this morning.

Actually, that's quite common.

Is this a med-surg admit?

Yeah. And let's run in
a gram of Ancef, too.

No. I just want to go home.

Okay. We'll see
what we can do.

How we doing over here?

It's okay, Rudy.

Dr. Carter's
one of the good guys.

He's going to help
you and your mom.

Physically, he's fine.

How are you?

My ears are still ringing,
but I'm cool.

Did you call DCFS?

Yeah.

Okay, Rudy,

I'll be back
in a little bit

to check in on you
and your mom, okay?

Vitals "q" 30 minutes
and CBC in an hour,

and set up a suture
set with 4-0 nylon.

Okay.

Doug. How are
you feeling?

Better. Warmer.

Good. Where's he coming from?

MRI.

I said he didn't need that.

Pratt thought otherwise.

It's not my job
to make sure

your residents listen to you.

I'm getting pretty tired

of the doctors thinking
that we work for them

or that they can
tell us what to do.

The patients think
it works that way, too.

I'm staying out of
this conversation.

And what is with Kovac

and his holier-than-thou
healing hands?

I'm getting pretty sick of that.

Oh, I don't know.

Those healing hands

have their good points,
right, Abby?

Did you go out with Kovac?

Briefly, yeah.

And Carter?
Yup.

Abby's the ER slut.

I went out
with two doctors

in the five years
that I've worked here.

Hey, Abby, are we
still on for tonight?

Yeah.
Great.

( chuckling ):
We're studying.

And you shouldn't talk, Chuni.

( chuckling )

Kovac gets around.

Our goal is to get

all of our triple combination
therapy patients

to an undetectable
viral load.

I'd be ecstatic

just to be able
to follow CD4 counts.

Would it be possible
for me to visit the AIDS ward?

It would if we had one.

15 years ago, we
had an entire floor
of AIDS patients.

Now, the few inpatients
we care for

are on the general
medical service.

We had a gentlemen earlier
in the week with Kaposi's,

but he was discharged
yesterday.

It's so different
from what I deal with.

I see thousands of deaths
from opportunistic infections.

You're welcome to observe
in the outpatient clinic.

These are your
AIDS patients?

Mm-hmm.

NEELA:
Breath sounds are diminished
on the left, I think.

He has a scar
over his fifth rib.

From a chest tube.

That's right.

Some quack stuck one in me
last year.

You're not going
to do that again, are you?

Not if we can help it.

Did you send the human
toboggan for an MRI?

Yeah, I was just...

Even though I told you
it was unnecessary.

The guy started freaking
out once you left.

He was worried
about paralysis.

Uh-huh, and you...?

I was trying
to be thorough.

Ah, well, so was I.

Next time you disagree
with my orders,

come and talk to me
about it, okay?

Okay.

You ready
to present this?

Neela.

Mr. Morgan is 64.

He has Wegener's
Granulamatosis,

which is an
inflammation

of the upper and lower
respiratory tract.

Vitals are in
the normal range.

So, he's satting at 92?

He's not taking
any deep breaths.

'Cause it hurts like hell.

I told you that already.

Sounds like
pleural effusion.

Yeah. You need to do
a thoracentesis.

I've already paged
Pulmonology.

Well, that's good,
as long as Mr. Morgan

doesn't mind gasping for air
until sometime tomorrow.

Tomorrow? I could
be dead by then.

He's had a number
of bronchoscopies.

They put his lung down last year
doing a thoracentesis,

and had to put in
a chest tube.

He'll be better off
if they do it upstairs.

He will...
Yeah.

...or you will?

You sent a guy for
an MRI this morning
that he doesn't need

'cause you were worried
about paralysis,

and now you don't want
to do a thoracentesis.

So?

So, sounds to me
like you're still
a little gun-shy

from... breaking
that kid's neck.

Man, there's tons
of scar tissue
around his lung.

Besides,
a thoracentesis down here

only opens him up
for a risk of infection.

Okay. I'll do it.

Neela, would you set me up
for a thoracentesis, please?

All right, Betadine the chest.

Load up a syringe
with one percent of Lido.

I got this.

I really don't mind doing this.

I said I got it.

Okay, Mr. Morgan,
we're going to sit you up

and drain some of the fluid
out of your lungs

so you can breathe
better.

It's about time.

Does this guy
know what he's doing?

You are in very good hands
with Dr. Pratt.

And I'll be back
in a little bit.

I've been looking
all over for you.

Hey. You're back already?

You really should come
and see this patient.

How did it go
with Dr. Farina?

He was very nice
and generous

with his time
and his data,

but I'm still ten years away
from the results he's getting.

Are you finished
with Mr. Yarrow?

Leg lac in Two.

Yeah. He's good.

Just wash out the wound,
give him a tetanus shot

and eight of morphine.

Anything else?

That should do it.

Have you ever heard
of Echo Free?

Let me guess.

Something Kovac does
instead of pain meds?

No. It's a club
on LaSalle.

My friend DJs there.

A bunch of us
are going tonight--

if you don't mind
hanging around with nurses.

I don't think I'd be
much good tonight.

I'm having a bad day.

All the more reason
to go out with us.

Nurses make people
feel better all the time.

Mmm.

Hey, Pratt, pick up line six.

Take a message.

It's Dr. Chen.

She's calling
from Shoe Goo, Kin Goo--

Okay.
somewhere in China.

I have to take this.

Hey, what's up?

What?! When?

Oh, I'm sorry.

What room is
Mr. Yardley in?

Listen, it's not
your fault, Jing-mei.

You know that.

Pulseless foot?
You paged a surgeon.

You just stay focused

on getting
your father better.

Dr. Lawson came and got him.

No, I was talking
to somebody else.

Who?

The radiologist.

They took him down
for an angiogram,

wound up doing angioplasty
and putting in a stent.

He's good.

Yeah, I know.
Well, that's wonderful.

But someone could have
at least called to tell me.

Dr. Pratt,
Mr. Morgan's

dropped his
pressure-- 86/66.

All right, look,
I've got to take this.

Talk to Dr. Chen.

Her mother just died.

Vouz-avez
d'incontinence?

Oui, un peu.

All right, uh, let's get
a bordetella PCR,

pertussis serologies
and a culture.

Avez-vous
des autres enfants?

( coughs ):
Oui...

j'ai un bebe de 18 mois.

Il est chez moi avec ma maman.

Est-ce qu'ils ont
malade?

Ma mere, elle
est très malade,

mais elle ne
viendra pas
a l'hôpital.

Elle n'aime pas les
docteurs americains.

D'accord.
Pas de probleme.

Merci.

Did you get all that?

She has another kid?

An 18-month-old

who's at home
with her sick mother.

Well, they both
need to come in.

They're both
probably infected.

Grandmother won't come
to the hospital.

She doesn't trust
American doctors.

That's a problem.

Can't treat them
unless they come in.

What if we go there?

This is America.

We don't make house calls.

Don't.

What?

( laughing ):
You know what.

I'm not leaving the hospital.

Do you see
how many patients I have?

Okay, I mean it. Stop it.

( sighs )

Gallant.

I need you guys
to make a run for me.

I'd like
to stick around

with my buddy Rudy here,
just until DCFS shows up.

After that, then.

Carter, Pratt needs you
in Exam Three.

Sats 78.

It's a tension pneumo.

16 gauge angiocath
and betadine.

He's not breathing.
Should I bag him?

No, it'll make the pneumo worse.

Open up a chest tube tray.

Size 8h gloves.

Heart rate's dropping.
Do you want a crash cart?

All right, slow down.
ABCs.

I know what the problem is.

Then treat it.

No pulse.

He's not breathing.

Okay, bag him.

I knew this was going to happen.

This is why I wanted pulmonary
to do this.

Takes a minute
for the lung to re-expand.

Chest tube is definitive.

Pressure's 94/62.
It's coming up.

Ten blade.

He's waking up.

Okay, let's run in
the fluids, wide open.

I've got a femoral pulse.

Curved Kelly.
Pressure's
coming up.

Sats 82 and rising.

28 French.

Here, you wanna sew this?

Sure.

Uh, where you going?

This guy's good,
and I've got other patients.

Uh, Dr. Pratt...

I'll be back.

Hey, have you seen Pratt?

Nope.
What about Kem?

Haven't seen her, either.

Maybe they're together.

You need to keep
better track of
your woman, Carter.

Hey, Chuni,
have you seen Pratt?

Sorry.
We have rules,
too, you know.

What are you
talking about?

What the hell's
going on?

The paramedics
needed a translator.

You took her with you?

She's persuasive.

She's febrile.
She's also diabetic.

Weak pulse, and was
already pretty out of it
when we found her.

( baby crying )

She was still talking
when we found her.

I just can't believe
that you would go out there.

Temp: 40.2.
Accucheck: 252.

All right, full set of labs,

uh, pertussis PCR and culture,
and blood cultures.

( coughing )
Well, that
sounds good.

How long has
she had that?

Several months.
Several months.

She said a lot of other people
in the building are sick.

And you exposed
yourself to them?

Has she been
coughing up anything?

MARQUEZ:
Ectopy.
Ma'am?

All right, run a liter
wide open.

Let's get a 12 lead on her.

BP's dropping 92/56.

Okay, she's septic
and hypotensive.

Let's mix up some
dopamine, titrate

to a systolic of
90, 3.375 of Zosyn

and 150 of Gent.

Pertussis is not a risk
to my pregnancy.

You don't know
what else she's
carrying. Maybe TB.

What do you think
I'm exposed to back home?

Why don't you go
ask Mrs. LeMonier

if her mother has any
advanced directives.

You sure you two
aren't married?

I need a portable x-ray.

Get him in here. Pratt!

I need another set
of hands.

I've got a pretty
nasty head lac in here.

Get a med student
to do it.

You need to sit down
and roll up your sleeve, Louie.

If you don't get your epa shot,
you're going to get sick again.

Do you want to be sick,
end up in the hosp...?

Hey, hey, hey!
Help! Security!

Hey, Louie, put her
down, or I'm going
to call your mother.

Now say you're sorry.

Sorry. Sorry.

She didn't give
me any gum.

All right, well,
that's no reason

to pick her up. Here.

Sit down and
behave yourself.

You okay?

I just... Yeah.

Louie's a lifter.

He likes to pick things
up, including nurses.

Just have to give him
a stick of gum before
you give him a shot.

Yeah, now you tell me.

Um... listen,
about earlier.

I don't want you to get
the wrong idea about Luka.

He's a good guy.

I'm not looking
for anything right now.

Okay. I just thought
you should know.

Thank you, but independence
works pretty good for me...

although I wouldn't mind
some regular sex.

No kidding. I'd settle
for irregular sex.

Can you help
my husband?!

LOCKHART:
What's the problem?

It's my leg.
Did you fall?

No, no. She shot me.

Mom's still sleeping off

her bender--
she got about 30 stitches.

Her head CT
was negative,

but surgery wants to
watch her overnight.

BP's 110/78
after three liters,

and her crit's 41.
That's pretty good.

Listen, if they're going
to discharge her in the morning,

why don't we just keep the kid
here with her overnight?

Oh, DCFS won't let us
do that.

They'll want to place him
under foster care.

It's only one night.

Then we need
to admit him.

What?

He's looking a
little dehydrated.

He was complaining of
abdominal pain earlier.

Let's observe him
overnight for a
rule-out appy.

Look, if he
was your kid...

I'll start a chart.

Hey, Rudy.

Got good news for you.

You and your mom-- you
get to spend the night
at my hospital tonight.

You hungry? Is there
anything I could get you?

They took my gun.

The police took your
father's gun because
it's dangerous, okay?

You could hurt yourself
or somebody else.

How am I going
to protect my mom?

Look, buddy, your dad...

he's going to jail
for what he did.

Okay? You don't
have to be worried
about him now.

He'll get out.
He always does.

Turns off the lights
so I can't see him

hitting my mom...
or find the phone...

but I can always hear him.

BARDELLI:
Yo, Mike.

Yeah, in a minute.

We got to roll, man.

( sighs )

Look, I'll be
back, okay?

I promise.

Everything'll
be okay.

No cardiac motion,
no effusion or tamponade.

Resume CPR.
Qu'est-ce qui se passe?

KEM:
Les docteurs font
tout qu'ils peuvent.

Zosyn is up,
another liter up.

Another round of
Epi and atropine.

Could be massive PE or MI.

Hypovolemia-possible.

Hypoxia-possible.

No pneumo, hypothermia,
or tamponade.

All right, hold CPR.

V-tach. I'll shock her.

Charge it to 360.

Clear.

V-fib. Clear.

She's flatlined.

MARQUEZ:
Want to pace her?

You ran it. You call it.

Time of death: 5:48.

I'm very sorry, ma'am.

Maybe if she had come in

two weeks earlier,
we could've...

You ran a good code.

Didn't help her any.
Nous sommes desole,

ma'am, mais il
n'y a rein qu'ils
pourraient faire.

Non! Ce n'est
pas possible.
Carter, Abby needs you in here.

Two liters in,
pressure's up to 120 systolic.

Gram of Ancef.
Update his tetanus.

What's up?
You tell me.

GSW with no exit wound.
I can't find the bullet.

Pelvic and chest films
are clear.

Maybe it migrated
to the foot.

I checked, but let's
get a foot and a tib-fib.

I didn't even want
a gun in the house.

And now I know why.

KELLY:
It was an accident.

I told you I didn't want
to learn how to use it.

SAM:
First hemocue's 12.4.

Frequent PVCs on the monitor.

Repeat the hemocue
in 30 minutes.

Sir, do you have
any heart problems?

No.

Do you use cocaine
or crystal meth?

KARL:
No, no, no.

Ooh...

Bullet's in
the right ventricle.

LOCKHART:
Are you kidding me?

What is it?
Di-Did you find it?
Mm-hmm.

The bullet traveled
up your femoral vein

into the inferior vena cava
into your heart.

( alarm buzzing )

What is that?
Run of six--

100 of lidocaine.

Can you get it out?

Yeah. He'll need an operation.

KELLY:
On his heart?

The bullet is irritating
his heart, right?
Yeah.

Let's page Corday
and cardiothoracic

just to be safe,

and re-bolus 50

of lido in five.

Help me roll him
on his right side.

Will that help
it to come out?

Uh, no, but that
should keep the bullet

from entering
into his lungs.

Is that bad?

We don't want
that to happen.

You put a bullet in my heart?

I shot you in the leg,

and it was an accident.

Um, you got this?

Yep.

Paramedics ran
over our ball.

Yeah, well, it happens.

So, seven is my record.

What?

We lost seven patients
in one shift

my second year
of residency.

Is that supposed
to cheer me up?

( sighs )

You know... when you
first got here,

you were... dangerous,
reckless and arrogant.

Is this your idea
of a pep talk?

Hey, we all get
our confidence rattled.

If you don't, then you should
start worrying,

'cause it means
that you've stopped caring,

and believe me,
you could do

a lot more harm
playing it safe.

So we're damned if we do,
damned if we don't.

What do you want me
to tell you...

everything's going to be okay?

That you're going
to get so good

that nothing bad is ever
going to happen again?

Forget it.
This is what we do.

If we're successful
in our jobs,

then patients live,
and if we're not...

sometimes they die.

Or wind up paralyzed.

Did you do
what you thought was best?

Was there a chance
that you might've been right?

Afterwards, did you tell the kid
what had happened?

Yeah.
All right, then.

Quit feeling sorry for yourself.

You're a good doctor.

Start acting like it.

CARTER:
Hey.

How's the daughter?

Better than I would be
if I'd just seen my mother die.

Are you angry with me?

No.

But I didn't expect you to be
doing paramedic ride-alongs.

Did you even
eat lunch today?

I'll grab something.

You need
to eat properly.

Carter, did you treat the woman
with pertussis?

Yeah, why?

I think you better
get out here.

I don't speak French,

so I don't know
what they're saying.

Who are "they"?

( people coughing harshly )

They're Mrs. LeMonier's
neighbors.

I told them that everyone
in the building should be

examined and
possibly inoculated.

You did?
( coughing continues )

Now you're angry.

I'm not angry.

Let's get everybody into Triage

and round up as much pertussis
vaccine as you can.

Can I help?

I love you!

( chuckles ):
Yeah, yeah.

John, where's the man
with the bullet in his heart?

He's gone.

What, he's dead?

No, no, no, they
took him upstairs.

Who?

Um, Dr. Lawson.
Who the hell

is this Dr. Lawson?

He's the new invasive
radiologist.

I was supposed to pick
my daughter up 40 minutes ago,

but I stayed late
because I was paged down here.

Well, he said he
wanted to do it

so that you
didn't have to. Jeez.

What are you doing?

You must be Dr. Corday.

That's right.

Uh, sorry, you
got involved in
this case how?

I was downstairs.

I saw his chest X ray.

Well, I was the
consulting surgeon.

Actually, this is the
second patient of mine

you've poached today.

Got it.

Advancing the guide sheath
and moving south.

If there are options
in treatment,

we should present them
together to the patient

so they can hear the risks and
benefits of both procedures.

I'm sorry.

I thought you'd appreciate

having two fewer procedures
to do today.

Bullets in the femoral vein.

You can have
your patient back now.

What?

You can take him to the OR
for a cut-down.

It's nice to finally meet you,
Dr. Corday.

I look forward to working
together again soon.

Good night.

DOUG:
Hey, Dr. Pratt.

Hey.
Hey, I just wanted
to thank you.

You saved my life.

Not really.

I came in here a few hours
ago with a broken back,

and now I'm going home.

Well, you still have
a compression fracture

of your vertebrae.

Yeah, I know, but
I'm not paralyzed.

Thank you.

You're the best.

Mom, can you hear me?

Mom, wake up.

Mom.

Hey, little man.

What's happening?

My mom won't wake up.

It's all my fault.

No, it's not.

The doctors just
gave her something

so she could sleep.

( sighs )

I couldn't protect her.

That's not your job.

Yes, it is.

She doesn't have anybody else
to do it.

Well, it says here
you do a great job

of taking care of your mom.

Then why is she in the hospital?

You know,
sometimes things happen

that we have no control of.

Bad things,
even when we do our best.

But

I think your mom's lucky
to have somebody like you

looking out for her.

( people coughing )

TAGGART:
Your arm may hurt.

You may feel a little achy.

( speaking French )

But it'll pass.

( speaking French )

If it doesn't,
you need to come back

to the hospital.

( Kem speaking French )

Hey, Luka, you busy?
No.

You mind helping me examine
these patients?

They all may have been exposed
to pertussis.

Why not?

You don't mind?

Nope. This at least
I'm good at.

Hey, Kem enjoyed
your lecture.

Yeah, she's the only one.

I don't think I got through
to any of the others.

Maybe it's the accent.

WEAVER:
What the hell is this?

KEM:
These people may be infected
with whooping cough.

Well, then they should be seeing
their primary care physician.

From what I've seen,

you are their primary care
physician.

Kem.
If you don't give
these people

the medical care they need,

they won't seek treatment
elsewhere,

and you'll have a full-blown
epidemic on your hands.

Mm, yeah,
I think what Kem's

trying to say...
All right, Carter,

she doesn't need you
interpreting for her.

She's making herself
perfectly clear.

Looks like you've got
your work cut out for you.

All right, do it,
but do it quickly.

And from now on, no one else
is going to Africa.

I'm tired of this
Dr. Schweitzer routine.

Did I say
something wrong?

Not at all.

18-year-old, Peter Spratt,
took a hockey puck to the face.

Looks like a possible
mandible fracture,

like he swallowed some teeth
and a lot of blood, too.

Okay, I got this.

Uh, he's not
moving enough air

and his jaw's too
busted up to intubate.

All right, let's get a 7-0
ET tube and Surgilube.

I'm going nasal.

Um... Pratt.

It's okay.

Dr. Kovac showed me
how to do it.

Tachy at 112,
sats are 92 and dropping.

Apparently somebody's
been listening to you.

( coughing continues )

I'm sorry I'm a little late.

No worries.

They're just watching a movie.

Hi, Ella.

Okay, it's time to go.

Put your shoes on.

It's almost over.

How were the puppies?

Uh, messy,
but the kids had fun.

You want a piece
of birthday cake?

No, I haven't
had dinner yet.

Well, in that case,
how about a slice of pizza?

I'll even throw in
a glass of wine.

All right then.

So, uh, how was
your pancake-juju thing?

My what?

Your surgery.

The operation you were doing
this morning.

Pancreaticojejunostomy.

You made that up,
didn't you?
No.

Oh, come on, admit it.

You have the perfect job
for getting out of things.

I mean, who's going to argue
with a surgeon?

"Yeah, I'm really sorry.

"I'd love to help you move
this weekend,

"but I have to separate a pair
of Guatemalan twins

who are joined at the testes."

( chuckles ):
Actually,
a pancreaticojejunostomy

is a replumbing
of the upper GI tract.

Sounds painful.

Can you get that
from working out,

'cause my shoulder's
been killing me.

I believe that's called old age.

Ouch.

After I go to all the trouble
of making you this nice dinner?

Cheers.

Cheers.

Happy birthday.

GALLANT:
Hey, Rudy.

How you doing, man?

You hungry?

I went and picked us up

some burgers and
some French fries

because I am starving.

I also got you this.

Go ahead. Take it.

So you don't ever
have to worry

about the lights going out.

Busy.

No kidding.

How was your day?

Sucked. Yours?

Same.

About this morning...

Oh, forget it.

No, I know sometimes
I can be overzealous--

is that...
is that the word?

I don't know. Is that
Croatian for "jerk"?

I'm sorry.

I didn't want to take
my frustrations out on you.

You know, sometimes
I just feel very passionate...

KEM:
John!

Want a bite?

No. What are you doing?

I thought we were going
to Ike Ryan's for dinner.

Oh, no, we are, but
I was just famished.

I needed something
to hold me over.

All this?!

( laughs ):
I couldn't decide.

There was too much
to choose from.

I got Twinkies
and Ho Hos.

This is all crap.
MoonPies.

This is all junk food.

I know, but it
tastes so good.

I must be getting cravings.

All I can think about
is chocolate and sex.

God, I am so happy.

Are you happy?

Yeah.

Thanks for letting me
come to the hospital today.

I love to watch you work.

You're such a stud!

Oh, stop it.

It's true.

It was all I could do
to keep my hands off you.

That's it--
no more sugar for you.

Can I come tomorrow?

Uh, no.

Why not?

'Cause Dr. Weaver said
she'd fire me if you did.

She didn't.

Actually, she did, yeah.

I should talk to her.

No, please, don't.
No, no, no.

What? Did I do
something wrong?

Did I get in the way?

Did I ask too
many questions?

I asked too
many questions.

Did I ask too many questions?

How many of
those chocolate
bars did you eat?

CARTER:
Après-vous.

KEM:
Merci.