ER (1994–2009): Season 10, Episode 18 - Where There's Smoke - full transcript

Previously on E.R.

You did it.

We have a baby.

Will you be home late...
again tonight?

RASGOTRA:
I've got the med list.

CARTER:
Why didn't you have it before?

Phenelzine?

She'll be a star in Internal

Medicine or research.

You have to be more decisive.

Should we try the
high-dose epi?



I assessed it, I ordered it,

I pushed it.

I gave her the order.

You falsified
the chart.

CARTER:
That's a felony.

Nothing I did
on this shift

can convince me
or anyone else

that I belong here.

She's not ER doc.

We need more wipes.

Where's your mom?

She's late.

Hey, nine ounces.

Nice.



( laughs )

Can't say I
don't produce.

( laughter )

( doorbell rings )

Better put on your shirt.

She already thinks we're pervs.

( laughs )
Come on, baby.

You gonna be good
for your Grandma?

Yeah, you're always a good boy,
aren't you?

That's my baby.

That's my baby.

I'm sorry.

My battery
was dead.

I had to
get a jump.
That's all right.

Hi, baby...

Hands. Wait. Hands, hands.

( muttering )

Hi, Ma.

Hi. Carlos is going
to buy me a new battery.

Hmm. Really?
Mm-hmm.

What you need
is a new car, Ma.

Yeah?
Preferably with
some air bags.

Yes, well, you going
to buy it for me?

Oh, yeah, right.

My brother's a saint,

'cause he's getting her
a new battery,

but I got to pick up the tab
for a whole new car?

Uh-huh.

All right. He didn't sleep
very well last night, so

Oh.
you might want
to put him down early

for his morning nap.

Ay, que lindo.

Just like your mother,
only don't be so stubborn, okay?

You ready to go, babe?

Yeah.

Say good-bye to Mama.

Good-bye, boo.

And Mommy, too.

Say good-bye.

( sighs )

Bye, baby. Bye-bye.

Come on, sweetie.
Okay.

( baby crying )

It's all right, papa.
Don't worry.

We'll be back.

Boy, your son's got a set

of pipes on him, huh?

Yeah? He gets that
from your side of the family.

Oh, yeah?

What are you
trying to say, hmm?

( laughs )

I got a big mouth?
( laughter )

You want, uh, turkey
or peanut butter sandwich?

Both.

You want a turkey
with peanut butter sandwich?

You used to make it
for me, remember?

No, I didn't.

Well, somebody did.

Hey, what are sodomy laws?

( knock at door )

I'll get it.

What are you
doing here?

Just got off work.

Thought I'd stop
by, say hello.

Hey.

Guess he misses
us or something.

I have to be at work
in, like, 40 minutes,

and he has to be
at school, like, now.

ALEX:
You know, if he wants,
I could stay home.

TAGGART:
Yeah, nice try.

Come on. Gina got a ticket

for double parking
last time. Go.

Hey, when are
you going to stop
working night shifts?

Soon.

And-And what are
sodomy laws?

Out.

You know,

I have a couple of minutes
before I have to leave.

Really?

Uh-huh.

A lot can happen
in a few minutes.

I'm sorry...

It doesn't have
to be anything fancy.

I'm really tired.

How tired?

Not that tired.

LOCKHART:
How did you score?

Hmm?

On your boards.

Don't know.

I can't bring
myself to look.

With any luck,
I failed.

Well, that's
a positive attitude.

I'm serious. Part
of me is afraid

I'll actually be
given a license

to practice
medicine one day.

Isn't that kind of the point?

When I was good
at it, yeah.

Between annoying
attendings,

butting heads with the nurses,
and of course,

being responsible for the death
of a patient because I try

to be aggressive...

Oh. The writing's on the wall
for me, wouldn't you say?

Well, you're not
a good doctor

until you've
killed someone.

Spoken like someone
who hasn't.

So, how are you doing?

Fine.

Then I don't have much
of a poker face, do I?

Abby, pilonidal cyst in Four,
Gallant shingles in Two,

Neela vaginal bleeding in One.

Get to work.

Sorry I'm
late, Deb.

I had to meet with
risk management.

Oh my God.
Are you okay?

Uh, well, my feet are swollen,
my back is killing me,

and apparently,
my waddle's too slow

for some people.

We got a long
day ahead of us.

The sooner we start, the better.

All right, we're
doing interviews

on the phenelzine death.

So, I'll need some time
off the floor.

Are we being sued?

MAN:
Not yet. Just need

to clarify
the hospital's defense.

All right, Gallant,
you're up last at 11:30.

Actually, the attending's
up last since he's the one

who'll be named in the suit.

God knows Carter's got assets.

That why he leave the country?

All right, we'll start
at the bottom

and work our way up.

Neela, that's you.
What? The guy's

medical records fell
through the cracks.

It's not like

anyone did anything wrong.

What's the matter
with you, man?

I'm telling you,
this chick is hot.

A little overweight,
but in a good way.

Look, I'm not interested, man.

Mike, she's
your type.
I'm busy.

You got Lieutenant James
on line one.

Tell him I'll call back.

Busy doing what,
playing soldier?

Man, you need
to get a life.

Dr. Gallant,
did you treat

the immersion burn
in Exam Four?

Yeah. There a problem?
Did I tell you she's
a college grad?

No. Not at all. I thought

you did an excellent job
with the debridement.

Magna cum laude.
Ever consider switching
to surgery?

It's never too late, you know.

I think I'm pretty
well committed.

Oh, well,
if you change your mind.

The chick has legs
up to here.

Dr. Pratt.
You're playing
games.

Susan's with risk management
so you'll need to present to me.

Yeah, okay.
You all right?
Yeah. Why?

Well, how's your dad doing?

Oh, he's much
better, thanks.

Okay.

We have a, uh,

homeless John Doe,
approximately 70 years old,

found in a makeshift tent
in Lincoln Park,

cold and altered.

His, uh, sugar's at 435,

so I gave him eight units
of insulin subq.

Yeah. How long has
he been outside?

Rectal temp's 92.3.

Overnight?

( grunts )

Diabetic ulcerations
on the feet.

PRATT:
He also has high
blood pressure-- 180/95

and evidence
of a prior MI on the EKG.

Pretty bad cataracts, too.

Sure he's homeless?

Well, it fits the bill, right?

Nails are groomed.

Check missing persons.

Maybe he's a wanderer.

Sir. Sir...

Oh.

Great.

( laughs )

Here.

Seems like
he's incontinent, too.

CORDAY:
Kerry,

my department's
in utter chaos.

Since Robert,
there's been no leadership,

scheduling's
a bloody nightmare

and there's nobody
representing us

at the bargaining table.

Our salaries
have been cut back.

I know.

Well, what are you going
to do about it?

Have the new Surgery
Department head

assess the situation and
get back to me about it.

You selected a chairman?

Dr. Weaver,
Sandy on line two.

Chairwoman. Can you
find out if it's urgent?

Unless you prefer to
be gender-nonspecific

and simply referred
to as Chair.

It's only about dinner.

You can call her back.

Good. I'm late
for a medical

executive committee meeting.

I don't understand.

When was this decided?

Two months ago,
something like that.

Still need
final approval,

but that shouldn't
be an issue.

Uh, well, that's fine,

but it would've been nice
to have been asked.

Three months maybe?
I-I don't know.

Something like that.
You don't want it?

Maybe. I don't know.

Still, it-it would
have been nice

to be given a choice
in the matter.

How long has your back been
hurting, Mr. Halpern?

Uh, couple
of days now.

Did you fall
or strain yourself?

I slipped on the stairs
about a week ago.

Might have triggered
something.

I... I had a slipped disk
a few years back.

Did you have
surgery for it?

No, no.

I couldn't afford it.

It-It just flares up once
in awhile.

I usually just take Vicodin.

Let me guess.

You're allergic to Tylenol
and ibuprofen,

and Vicodin is the only thing
that works.

Yeah. I don't really
like the stuff, but

you know, what am I going
to do, you know?

Abby?

T and L spine
and get some urine?

Yup. We'll be
right back.

Then run a tox screen,
check his records,

make sure he's
not drug-seeking.

You read my mind.

So, you think you'll
match at County?

( laughs )

I don't know.

So, you basically
let a desk clerk
get in the way

of your getting
a medical history.

I suppose I did.

And did you inform
Dr. Gallant

that you didn't have
Mr. Sanchez's current med list?

Yes.

And yet he gave the order
for Demerol?

Yes.

Do you have anything else?

No, I'm good.

LEWIS:
Okay. Thanks, Neela.

Oh, by the way,
I have a friend

who's doing a study

on neuroprotective
agents in stroke.

And they're looking
for students

to work part-time in the lab.

Research?

Just check it out.

CHEN:
This is crazy.

If Susan knew she was going

to be in some inquisition
all day,

she should have scheduled
another attending.

Abby, chest pain, scalp
lac, itchy groin rash.

I've already got eight
on the board.

And I've got twelve.
What's your point?

Dr. Chen, old frozen guy's
waking up.

He asked for some water.

Oh, hey, uh, Kovac called.

He said next time he's going
to have a triple latte first.

Does that make sense?

Yeah.

Aren't you two
living together now?

No.

Well, for what's
it's worth,

I think Luka's
a good guy.

Uh, wait, you didn't...
Sleep with him? Nah.

I went in a completely
different direction.

Hi, I'm Dr. Chen.

Can you tell me
your name, sir?

Jones.

First name is Bob.

Is there any family
we can contact, Bob?

No. No.

I'm homeless.

Mr. Jones,
your hemoglobin A1C suggests

that your diabetes was
under control until recently.

What happened?

No missing persons report
that fits.

( sighs )

Well, we'll just have
to call social services,

get him placed somewhere.

Yes.

I need somewhere to live.

All right, recheck d-stick
and urine ketone...

You know what?
Why am I doing this?

He's Pratt's patient.

So, the clonopin's working?

Okay, no.
That's good.

Just, uh, give me a call
if he gets agitated again.

All right.

What are you doing?

I was talking
to your father's nurse.

She tried to call,
but you were busy.

Seems like he tried
to fry a steak

while she was stripping his bed.

What?

Yeah. He set off all
the smoke alarms,

scared himself up pretty good,
but he's okay now.

Oh, my God.

I gave her verbal orders
for P.R.N. clonopin.

It has a long
half-life.

But you might want

to consider
restraints, though.

Dr. Chen, Rescue 3-8
has, uh, two critical

and six serious
from a structure
fire collapse.

Okay, give it to me.
I'll call resp,

make sure they have a couple
of vents ready.

Page trauma and
burn fellows,

set up the
rapid infusers

and get Lewis out
of that damn meeting.

She discovered that he once
had a bad reaction to morphine,

and sought out an alternative.

It was smart on her part.

But she didn't tell you
what that alternative was?

No. Not specifically.

Did you hear
Dr. Gallant
give the order

to push Demerol?

No,

but to be fair, I had stepped
out of the room briefly.

What are you guys

looking for exactly?

The truth.

Meaning you think
there's some sort of cover-up?

( knock at door )

Excuse me, Dr. Lewis.

F.D.'s rolling up
with criticals.

What have we got?

Tommy Mason, 33,
full thickness burns

to the face,
neck and chest.

Unconscious
at the scene.

BP's 90 palp,
tubed for agonal resps.

Residential
fire?

Abandoned warehouse.
Should've let it burn.

Nobody inside to save.

Sam, Gallant, you take

the next one,
Pratt, you come with me.

What happened?

Industrial fire.

17 got hit
pretty bad.

How'd your meeting go?
Fine.

Ah, watch it!

Andy Fash, 22,
smoke inhalation.

Passed out and
took a fall.

Dislocated knee.

BP's 132/80.

Complains of
belly pain.

Good pulse on the foot.
Pelvis is stable.

It's okay, I'm cool.
How's Mason?

We don't know yet.
I'll get the next one.

This the second critical?

Next rig.

It took awhile
to fish her out.

Abby, you
take this one.

By myself?

Yeah. Chen and Pratt
in the next door.

Gallant, Neela,
you're with me.

OLBES:
29-year-old female,
chest and pelvis crush.

Injury on scene
with prolonged extrication.

Hi, I'm Dr. Lewis.

RASGOTRA:
Oh my God.

It's Sandy.

Hey, Doc.

Got a flash. Wire.

Sandy, you need
to stay still, okay.

BP's 80 palp.

Tell Gemmill to stop trying
to get a look at my boobs.

Chest is up.
Multiple rib fractures.

Pneumothorax. She
needs a chest tube.

I was about to say that.

( alarm beeping )
Pulse ox is down to 78.

How about one of you doing it,
instead of talking about it?

Ten blade.

Tegaderm for the line.

Sandy, how
are you doing?

I've been better.

I remember you.

How's the baby?

You have carbonaceous
material in both nares.

We need to think about
securing your airway.

You wanna shut me up by sticking
a tube down my throat, huh?

We want to help you breathe
better.

I want to...
I want to talk to Kerry first.

You cut in the fifth intercostal
space, mid-axillary line.

Yeah, I'm aware of that.

Free fluid in both
pericolic gutters.

Sandy, you need the OR.

We're going to have to intubate.

( gasping ):
What's taking her so long?

I paged her.

Okay, I'm in.

Please...

Okay, okay.

Put her on 100% non rebreather,

but the minute she gets down
here, I'm going to intubate you.

We need another
doc in here.
Go, Gallant.

I have to sew in
the chest tube.

No, they don't want a student,
they want a doc.

Neela, have you ever done
a horizontal mattress?

Yes.

Dazzle me.

What do you need?

CHEN:
Glove up-- 60% surface area
burns with hypoxia.

Guy needs an escharotomy.

Wide prep. 10 blades for the
both of us.

We'll open a square over the
entire chest down to the subq.

BP's down to 70 palp.

Gallant, check the ET for a
leak, may have to reintubate.

Yes, ma'am.
Ready?

Every time.

Anterior axillary line,

all the way down
to the tenth rib.

Join the top and bottom

transversely.
All right, Mike,

you should be able
to bag him now.

Nope. Sats are dropping.

Hold up, 18 angiocath.

What?

Tracheal shift.

Found a puncture wound,

tension pneumo on the left.

Gotta needle him.

Hemostat and four-oh vicryl.

Pulse is stronger,
sats coming up.

Nice catch, Gallant.

Hey, Abby needs some help in
here with a knee reduction.

Pratt.

I'm in the middle of
tying off a bleeder.

Gallant can take over.

GALLANT:
Sterile gloves.

What's up?

Lateral dislocation with
equivocal pedal pulses.

Mild wheezing. Maybe has
some smoke inhalation.

Is he hanging in there?

His chest was burned so bad
he couldn't breathe.

He's intubated and doing
a little bit better.

MALIK:
Systolic's 120
with 50 on board.

What about Lopez?

We don't know yet.

He's had 250 mikes
of Fentanyl.

I told the old-timers
I'd race 'em to the top.

All right, man,
this is gonna hurt.

We have to pull
on your lower leg

and move it back up
onto the knee.

17 years on the job between 'em.

I got eight months...

Come on, stabilize
the distal femur.

Let's get ready to pull.

Tommy got up there first,
then Sandy...

You got enough countertraction?

I remember thinking
the old guy won...

Yeah. You ready?

Then I saw 'em both drop...

One, two, three...

( Fesh screaming )

Where's Sandy?

Trauma One.

How bad is it?

She's conscious.

WEAVER:
Excuse me. Excuse me.

Crit's 24
after two units.

Sandy?

Oh, God.

Hey, baby...

What'd you go
and do?

Roof collapsed.

Bilateral rib fractures,
pneumothorax,

intra-abdominal bleed,
pubic rami fractures.

We need to get her
to the OR.

It's a good thing I pumped, huh?

Chest tube output's
slowing down.

Pulse ox 87...

She's on a hundred percent?

Yeah.
Why isn't she intubated?

She refused it
till you got here.

I only wanted to say hey.

Type specific's here.

It's gonna be okay.

Sandy...
( alarm beeping )

( snapping fingers )
Sandy.

Sandy, you need to stay awake,
sweetie.

You need to stay
awake, Sandy!

20 of etomidate
and 120 of sux.

Pressure's drifting down.

Sandy, you need
to stay awake.
8-oh tube?

And a number two mac.

Sandy... Sandy!
I need to do this.

Sats in the 70s--
we should be bagging.

Uh, Kerry.

Push the drugs.

I need an end-tidal
CO2 detector.

Etomidate first?

Kerry, you need
to let us do this.

No. Please... she's my wife.

How long am I going
to be in this?

When you dislocate, you tear up
a bunch of knee ligaments.

Those heal, right?

Even with surgery, still
could be some instability.

I've wanted to do this
since I was a kid, you know?

There are some new
artificial ligaments,

but if it's really bad,
you may need knee replacement.

Mason says it's a calling.

So what happens
when you can't answer it?

Good pulses, he's stable.

Keep an eye on his airway.

I'll see if they
need me next door.

What happened?

Must be a
cardiac injury.

I lost the pulse.

Start compressions.

Thoracotomy tray
to Dr. Gallant.

You're serious?

Why not?

He's earned it.

10 blade then
Mayo scissors.

Put up a screen.
They don't need to see this.

Okay, rib spreader.

Open the pericardium
with the metz.

Stay anterior or you'll
cut the phrenic nerve.

You do remember the anatomy
of the phrenic nerve?

Edema and secretions...

Tube's not advancing.

You asked for an eight-oh.

BP 108 over 68.

Come on, come on, honey.

Switch to a seven
and a half?

Come on,
you can do this.

Sats 83, 82...

I'm switching to
fiberoptic scope.

Suction
and crichoid.

81, 80...

Kerry?

I see cords.

Get her a tube.

79, 78...

I'm in.

Bag her.

Good yellow on
the CO2 monitor.

Pressure's 120 palp.

Another four of Ativan
and six of Pavulon.

You okay, Dr. Weaver?

Portable vent?

Just keep
bagging her.

Okay, Mr. Fesh,
we're going to
move you to...

( gasping )
You all right?

I can't breathe.

I think I hear
stridor.

Okay. Try continuous
albuterol at 20
per hour. Pratt?

Pratt, I need you
in here.

I think this in here needs
me a little bit more.

I'll start
an atrial line.

He needs four units now.

Okay, we can
try a foley.

He's diaphoretic.

This guy's in respiratory
distress.

He must have an upper
airway burn.

Crank up the O2.

Ventricle's starting to fill.

Come on, crank it up.

Abby, does he need intubation?

PRATT:
Just bag him, I'll be
there in a few minutes.

All right, ambu mask at 100%.

What's happening?

Okay, you need to try
to relax, all right?

Just relax.

No reading on the pulse ox.

He's out.

All right, try a jaw thrust.

There's no chest excursion.

I can't bag him.

20cc's for the balloon.

Extend his neck.

We did.

Good hemostasis with the foley.

Another two units
and we just might save this guy.

Okay, fine-- etomidate and sux.

You got it.

Push the drugs, Abby.
One of us

will be
right there.

Run of six.

Heart's still empty.

Where's he losing it?

Abby, try a six-oh. Take a look.

Okay, sponge stick
and more suction.

Clamp the hilar vessels.
Abby, what do you see?

Nothing!

( quietly ):
Larynx is swollen shut.

Sats are down to 72.

This is ridiculous.

I can't ventilate him.

Just keep bagging.

I'll be right there
in a second.

All right, 11 blade
and a five shiley.

What?
You heard me.

All right.

Okay, hilum's clamped.

So's the aorta.

V-tach.

Internal paddles.
Charge to 30.

Clear.

Abby, how you
doing in there?
You okay?

Yup.

Tube and curved kelly.

Ectopy on the monitor.

You do this before?

Nope.

Charged.

Clear.

No change.

Amp of epi.

Sixty.

Charged.
Never mind.

What?
Clear.

I criked him.

By yourself?

Sats are up,
he's fine.

Now, that's
a med student.

Going again.
100 of lidocaine.

Charged.

Clear.

Still V-fib.

Asystole.

Okay, come on, five of epi.

High dose could get us
a shockable rhythm.

Stop compressions.

Don't bother, man.

12:27.

Should we let
those guys in?

After we close the chest.

Oh silk on a needle driver.

BP's only 82 over 60.
You want more blood?

Another two units
and squeeze in the FFP.

Fractured liver,
pelvis, ribs, humerus...

God, what's not broken?

Kerry, do you have
the C-spine film?

It's Sandy.
What?

Oh, God.

Who's operating?

Anspaugh hopefully,
and Dean.

Ignacio's anesthesia,
Shirley's circulating.

Good, that's good.

Platelets are here.

Do you want to stay with her?

What?

Would you like to observe?

Yes. Yes, I would

Right. Um...

Chest tube on water seal.

You got it.

Really cool of you,
by the way.

The O.R.'s ready.

All right, let's go then.

I'll say a prayer for you,
Dr. Weaver.

Kerry, she'll pull through.
She's a fighter.

I'm right here, Sandy.
I'm not going anywhere.

Have the blood bank
send four units upstairs.

SAM:
They're already
ahead six.

HUTCH:
How is she?

Her lung collapsed.
We were able to reinflate it.

She's lacerated her liver,
which we need to repair
right away.

Mija... oh, my God...

What happened?
Where are you taking her?

Try not to be scared.
She needs an operation.

Sandy.

Mija...

¿me puedes oir?

Mija?

She's not
conscious, ma'am.

Where's Henry?

With my wife.

Is Sandy going
to be all right?

Yes. Uh, I will be with her
in the O.R.,

but there's a waiting room
upstairs...

and I'll call you the minute
that she gets out of surgery.

Take care of her.

We will.

I'll take 'em up.

WOMAN:
No...

No... no...

( sobbing ):
No!

I can tell you
exactly what happened.

We-we had a very recent
discharge summary

documenting an adverse reaction
to morphine.

The patient was in pain.

I gave the order
to administer Demerol.

I shouldn't have. End of story.

Not exactly.

LEVINE:
Luis Sanchez's chart
is incomplete.

No attending note.
Any idea why that is?

Well, maybe Dr. Carter
didn't have a chance to do it

before it was sequestered
by legal.

He was leaving for
Africa that night, so...

So he was a little distracted
is what you're saying.

No, I'm not saying that at all.

Do you think he needed time
to get his facts straight?

What? No. It w...
it was a busy night.

We had a lot of patients.

Is Dr. Carter typically
available to you?

Of course he is.

What are you doing?
I thought you were supposed
to help us here.

I am... by preparing you
for the difficult questioning

you may face
in a deposition.

Do you feel supported
by Dr. Carter as an attending?

( sighs ):
Yes. He's a great teacher.

He's one of the finest
physicians I've worked with,

and I respect his opinion
tremendously.

So why didn't you present
to him?

LEWIS:
It just doesn't
make sense,

because he was
probably 30 feet
away the whole time.

Was Dr. Carter informed
of the decisions

you were making
in your treatment plan?

No.

I wanted to handle it myself.

I thought I was better
at this job than I guess I am.

I'm completely
responsible.

Nobody else is.

Will you state if deposed?

Yes.

When is that
supposed to take place?

A deposition?
We're not sure.

We haven't heard
from the family yet.

I might not be able to do it
for awhile.

Why is that?

The Army called me up.

I'm going to be deployed
to Iraq.

Excuse me.

Whatever, you know?
I got Chris Halpern's
medical records.

Even just a half an hour--
be nice to see you.

That's all
I was thinking.
Gallant?

Oh, uh, Halpern, right.

Refresh my memory.
Call me back.

Desperately
seeking Vicodin.
Love you.

Yeah...
Hey, did you
hear anything

about Sandy Lopez?

No. You?

Puts it in perspective, huh?

So, Mr. Halpern managed
to hit up

every local hospital
for Vicodin this year.

You want to know what
his tox screen showed?

What, narcotics and benzos?

Nope. Nothing.
He's clean.

Aspirin and caffeine.

Uh, excuse me.

I'm wondering if you could
find out about my sister.

The guys told me she was
in surgery and you might know.

You're Sandy's brother.

I'm one of 'em. She okay?

Uh, let me make a call.
Thanks.

Falciform ligament clamped.

DEAN:
Systolic's in the 90's.

SHIRLEY:
Two more units
going in.

How long have you two
been together?

Ready the cell saver.

Three years.

One of which included
a pregnancy.

That gets you bonus time
in the equation.

Okay, there's lots
of blood. Suction.

Uh, looks venous.

SHIRLEY:
Hemocue's 8.3.

We met here.

At the hospital?

That's the last place
I expected to find anyone.

Right, uh, the spleen

looks good... but...

there's a grade four
hepatic lac.

Bovie.

I miss Mark, too.

Let's pack off the liver.

Shirley, Shirley,
can you wipe my brow?

Lap pads.

I need lots of them.

Neela, what's the
therapeutic range
of procainamide?

Four to ten mikes per mil,
but you also have to measure
its active metabolite.

Procain plus NAPA
should be under 40.

Did you open that
envelope yet?

Yes.
And let me guess:
you passed.

Yes.

And you're not
in the least bit
excited about that?

I'm a little excited
about it, I suppose.

Don't have to tell my parents
I flunked the boards.

I don't know.

I'm not sure
it means anything...

but I suppose we should at least
go celebrate passing tonight.

Well, I'm not much
in the mood myself.

Yeah.

Susan... what
are you doing?

Please let these be
Braxton-Hicks.

( beeping )
What's wrong?

You need to isolate
the segmental veins.

Trying...

Kerry.

How is she doing?

SHIRLEY:
Systolic's down to 78.
She must have

a retrohepatic
caval injury.

Oh, God...

Okay, clamp
the suprarenal I.V.C.

ANSPAUGH:
All right,
I'll take over.

Large angled Satinsky.

Come on, baby... please don't
scare me like this.

I.V.C. clamped.
Mark time.

( alarm ringing )
C.V.P. dropped to zero.

Uh, start an epi infusion.
Keep her temp up.

All right, suprahepatic
cava clamped.

You sure you should be
in here?

She's fine.

SHIRLEY:
Bradycardia.

Oh... she's lost her
filling pressure.

Can you unclamp?

If we do, she'll
bleed out.
And if we don't,

her heart stays
empty and she arrests.

Oh, God.

Systolic's only 60.

Mig of atropine. Let's prep
the chest for a Schrock.

Ten blade.

Heart rate's down to 58.

Sternal saw.

Kerry, we have to put
in an atrio-caval shunt

In order to do
that, we have to
open up the chest.

It'll improve her
preload and get blood
back to the heart.

Kerry.

Do it.

( sternal saw buzzing )

Nicotine, coffee
and aspirin.

Setting yourself up
for an ulcer.

I don't drink coffee.

Okay, soda then.

Lot of caffeine
in your system.

Over-the-counter
migraine tablets.

They don't do
squat, though.

Nothing works
but Imitrex.

That's a pretty expensive
medication...

especially for someone
who doesn't work much,

not insured anywhere.

Yeah, well, thanks
a lot, Uncle Sam.

How long have you
had the headaches?

Ever since I pulled sand duty
in the Gulf.

What branch?

Army.

Yeah, me, too.

Don't count on the benefits.

I spend a year in the desert,
came home with migraines.

The V.A. says
it's not service-related.

Won't give me a dime.

That why you
sell the Vicodin?

Pay for the Imitrex?

What unit?

43rd Battalion,
Medical Corp.

You going to turn me in?

No.

But I'm not going to give you
the Vicodin, either.

That's fair enough.

You stay low...
watch your back.

You didn't say how
your meeting went.

( sighs ):
It's going to be fine.

Look, I'm... sorry

I've been...
I don't know...

bitchy about
this whole thing.

It's just not
comfortable for me...

lying and having
someone else cover
my mistakes,

and... it just sort of
keeps on compounding,

one on top of the other.

( sighs )

I'm being deployed to Iraq.

I'm heading for Texas
tomorrow morning.

You haven't finished
your residency.

Yeah, I know.

I'm going to finish up the last
few electives down there.

They called you up,
just like that?

Yeah.

You're a coward.

What? What?

A coward and a liar.

I never asked you to do this
for me, but you did,

and now you're leaving,
and I'm supposed to live

with the fact
that I killed a man

and that you helped to lie
for me to cover it up?

Listen, Neela...
Go, Michael.

Go to bloody Iraq...

and tell yourself
you've done something noble.

I had to protect you
and Dr. Carter.

No... you didn't.

Well, at least
the contractions stopped.

So the subq terb worked?

Uh, she's still one centimeter
dilated and 50 percent effaced.

You can sit up now.

So, I should just,
uh... take it easy,

cut back on
a few shifts?

You were having
regular contractions.

Your cervix has softened,
shortened and dilated.

Bed rest, huh,
plain and simple.

For how long?

35-weekers do well,
full terms do better.

Mm-hmm.

No way. I can't stay in bed
for five weeks.

You can and you will.

Schedule an appointment
for an N.S.T.

with my office in a week.

( sighs ):
This blows.

The whole day blows.

Yeah...

What else happened?

Nothing.

Oh, I failed my boards.

What?

Need a 182 to pass,
I got a 167.

Oh, Abby.

Oh...
I'm sorry.

It's okay.

Well, how were you
supposed to study?

You were pulling
double shifts.

It's fine.

It's not like
a burning building

collapsed
on me or anything.

I'll just take
them again.

ANSPAUGH:
Ah, atrium's oozing.

Another 2-O, I can oversew
the purse-string.

V-fib.

ANSPAUGH:
Charge to 30.

I love you so much.

Come on.

Clear.

Clear.

No change.

CORDAY:
Okay, teflon
pledgets.

ANSPAUGH:
Oh, God.

There's blood pouring
out of her ET tube.

D.I.C.

CORDAY:
More platelets
and FFP.

Clear.

Asystole.

Resume cardiac
massage.

ANSPAUGH:
Elizabeth...

CORDAY:
Mig of atropine.

You can stop.

She's gone.

Kerry...

Can you take it out?

By law, we're not
supposed to...

Please.

Of course.

I'm so sorry.

We wanted more.

I had to twist her arm
to have a baby, but...

once Henry was here,
she said, "I can do this.

Eight more
and we got a team."

Sandy had a big family.

I only had her.

And Henry.

What am I supposed to do now?

Would you like me
to talk to the family?

No...

No, I'll go do it.

Hey, you hiding out
or taking inventory?

Oh, just looking
for Reglan.

You leaving?

I've been ordered

to sit on my sofa
for five weeks.

Sounds good to me.

Yeah, I bet.

Do people know?

No, not really.

You prefer it
that way?

You know...

Look, what you did
was stupid,

but there were a lot
of circumstances

that conspired to kill
Luis Sanchez.

The nursing home should've
put a medic alert bracelet

on him but they didn't.

You should've gotten
a full med list,

but you didn't.

If it goes to court,

the Army'll send me
back to testify.

Nah, I doubt
it'll happen.

The bottom line is,

people don't sue
doctors they like,

and for whatever reason,
Mrs. Sanchez liked you.

Take care of yourself
over there, okay?

Yeah.

You have a healthy,
happy baby, Dr. Lewis.

KOVAC:
Hey.

You get called in early?

No, my shift doesn't
start for an hour.

I wanted to see you.

Maybe we can get
a coffee or something.

Sandy Lopez died today.

Who?

Weaver's Sandy.

GALLANT:
Take care, of yourself,
Dr. Kovac. Sam.

So how long
have you got?

Here?

About an hour.

On your tour of duty.

Year at least.

Maybe longer.

So you were just
going to sneak out

under cover
of darkness?

No hi, bye,
kiss my ass, nothing?

You know, I'm not
much for send-offs.

I don't care
what you call it.

There's a war
going on.

Going to miss having
you around, man.

Yeah, right.

No, I'm serious.

You're an honorable guy.

I'm not sure
I've ever met one.

Don't go getting
yourself killed.

( loud music plays )

Alex? Alex?

( sighs )

Alex, get out here.

Mom, guess what?

Alex, turn it down, okay?

I had a crappy day
and I got a major headache.

You look good, though.

Dad's here.

Is there anything
I can do?

You need me
to watch Henry,

or do you need
a ride home?

He's with Sandy's family.

Dr. Weaver...

It's okay.

( sobbing )

Dr. Weaver,
it's okay.

It's okay.

( sobbing continues )

Shh, it's okay.

Got anything else?

No, that's
about it.

NEELA:
You'll need this.

Rabbit's foot.

It's American
for good luck, isn't it?

Thanks.

You're welcome.

You'd better
come back,

you know that,
don't you?

Yeah, I will.

You just better be
a damn good doctor

when I do.

You ready?

Bye, Michael.

( doorbell chimes )

Hi, Eduardo.

I'm here to get Henry.
Is he awake?

Listen, he's not here.

I think he's with
my aunt or something.

No, no, you...

You told me that
Theresa...

Look, it's nothing
personal, okay?

I mean, I always
really liked you.

Wait a minute.

You said that Theresa
was taking care of him.

We're his blood relatives.

What are you
talking about?

What's...
going on here?

Where's Henry?

I don't know.

Where is my son?

Sandy's son.

I don't understand what
you're talking about.

What... I don't understand
what you're talking about.

Where is he?

I hear him.
Let me in.

No, no,
that's mine.

( talking at once )

No, Kerry,
he's not here.

I know my own
son's voice!

Let me inside.

I'm really sorry.

Please!
Please!

No.

Why are you doing this?

Give me my boy.

Why are you doing this?
Let me in.

Damn it, let me in!

Give me my son.

Give me back my son.