ER (1994–2009): Season 10, Episode 4 - Shifts Happen - full transcript
Confident second-year resident Pratt wants to prove his abilities when he works the graveyard shift (11 p.m. to 7 a.m.), but his heroics sometimes backfire. Pratt shows contempt for a man, Ed Gamble (PAUL CASSELL), who presents no symptoms of disease but temporarily loses his speech.
What do you want?
A foot rub.
I'll...
I'll settle for coffee.
( panting )
I'm Gillian.
I was working with Luka
and John in the Congo.
Ah.
John asked Luka
to give you this.
He wrote me a letter?
I think he wanted to try
and explain why he stayed.
I don't want to talk
about Carter anymore.
Why are you mad?
I'm not mad.
I'm sure you'll find yourself
a new bang-buddy.
Good night.
You're not her doctor;
you're her nurse.
When I ask you not to do
something, don't do it.
I hate my job.
Pardon me.
Excuse me.
Whoa, whoa, whoa, whoa.
I need a paper.
We're closed.
Come on, man.
Show me some love.
Come on.
Ah.
Old news by now.
So she's had her bath?
Good. Good.
Yeah, could you put her on for
me, so I could say good night?
( sighs )
Oh.
Um, okay then.
Well, give her a kiss good night
for me then
and, uh, I shall see you
in the morning.
No, I won't work too hard.
Yeah, okay. Bye.
Everything okay?
Yeah.
She's watching Clifford.
Hmm.
You know, everyone's
allowed a little downtime.
Even Ella's mother.
You disagree?
I don't know.
It's just sneaking
out of the house like this--
it all feels
a little...
unseemly.
You say unseemly. I say sexy.
That, too.
Not to mention fun.
Our shift starts in...
My car's fast.
You've just had a shower.
Water's cheap.
You're half-dressed.
You're not.
Mr. Drake in Two is waiting
on his second troponin.
Psych needs to evaluate
the woman in Four
who says she's been pregnant
for the past seven years.
Eloise is back?
Yup, with the mother
of all yeast infections.
I gave her a Fluconazole/Haldol
cocktail.
Frequent flyer?
Logs in more hours than me,
which is saying something.
Have we met?
No.
Damn, is everybody new
around here or what?
Fresh out of nursing school.
Or fresh off the boat.
I haven't seen
anything like this
since shore leave in Manila.
Think fast, truant.
You still here, wheezy?
Oh, hell, yeah.
Home sweet home
and right on time, buddy.
No, see, this is mi casa,
not su casa.
Remember, you're just visiting
from Whitebread, Iowa,
or wherever you're from.
That's Whitebread, Florida,
actually.
Hey, Pratt.
Is there a warfarin-
phenobarb interaction?
Up the warfarin because
you've got increased
hepatic metabolism.
Secondly, I'll more than make up
for being a few minutes late.
And third, I'm not your buddy.
Hey, Coop, Cubbies,
Friday night,
behind home plate,
you and me?
Hell, yeah.
Suds and dogs?
I'm there, Daddy.
Cool.
You two gonna kiss next?
Ortho on line one for you.
Well, unless there's a phone
in the can, take a message.
Uh, Pratt.
We have a rectal
mass guy in Two
personally asking for you.
Dr. Pratt, I have a man with
urticaria I need to present.
You're going to have
to give me a minute.
And can you supervise
my pelvic exam?
Yeah, all right, in a sec.
What's the dose of IV Reglan?
Damn, how many of you newbies
are there?
That mean med students?
There are lots of us.
Yeah. Well, am I
the only second-year here?
I'm sorry.
I didn't see Dr. Cooper.
I would've asked
Dr. Morris, but, uh...
COOP:
He's stuck
with a patient in Two.
The sprained ankle?
Damn it, Morris, I have
30 patients on the rack
and 40 in Triage.
A little multitasking
on your part would be helpful.
Hey, you're not doing
that clown any favors
by picking up his slack.
Okay, not a single chart's
been picked up
in the past 45 minutes.
It's called a work ethic,
people.
Since when is
Weaver on graveyard?
God forbid you should
take a patient
the last hour
of your shift.
You might have to stay
an extra 20 minutes.
Once a month.
She says it's the only way
to keep up her skills.
I worked all day, too.
You think I'm not tired?
Never thought I'd say this,
but I kinda miss Little Stumpy.
Pratt, you forgot to sign
your QA forms last night.
MAN:
Get me out of here!
You want to grab
this first?
I'm off the clock.
Come on, you
heard Weaver.
Open tibia fracture
after a motorcycle accident
three hours ago.
I never gave permission
for this!
You have his films?
Right here.
Name's Mathers and he's
not a happy camper.
How you doing,
Mr. Mathers?
I don't want to be
in this hellhole!
That's how I'm doing!
St. T's shipped him
because they...
They dumped me
'cause I don't have insurance.
You're here, sir,
because you require
a higher level of care
than they're capable of giving.
I work for a living,
damn it!
I'm not
some county welfare case.
Hey!
This look like TV to you?
What are you doing?
Had a gram of Ancef
and six of MS.
God, I deserve
better than this...
No, the best thing that
could've happened to you
was coming to County.
You're about to receive
the finest health
care in Chicago.
Isn't anyone going to help
deliver my precious baby?!
Eloise, you've been pregnant
for seven years,
you can wait ten more minutes.
All right, listen up, listen up.
We're the A team, people.
You know what that means?
That means we have exactly 12
hours to clear this place out
and show those quacks
at the day shift how it's done.
WOMAN:
Most people are quite pleased
with its lifelike appearance
and the attention
paid to detail...
Yeah, well, they should've
clipped my nails then.
With a minimum of motion,
your own muscle signals will
trigger the arm, so that...
Yeah, I read the brochure.
Let's go.
To bend the arm, simply
contract your biceps.
That's it.
Biceps up, triceps down,
biceps up, triceps down.
They actually pay you
to state the obvious?
Okay, pausing, as you just did,
causes the arm to lock.
How do you unlock it?
Well, it requires
a quick co-contraction,
but that's too advanced for now.
No, we're not ready
to move on
to the hand yet.
We don't have to.
Look, how do you put it on?
Donning and doffing are
much more complex tasks.
Harness first
or stump in the socket?
Dr. Romano, it's late...
I want my damn arm,
all right?!
I've waited long enough!
Let's go.
MATHERS:
Screwy thing is
if I was on welfare,
Medicaid would've
covered me there, right?
Right.
Now, remember.
Open fractures can lead
to gram-negative osteomyelitis,
which is why we
add gentamycin.
Veins are sclerosed.
Excuse me.
Ever use IV drugs, Mr. Mathers?
Years ago.
Doesn't mean I should
be butchered at County.
You're absolutely right.
And that's why we're going
to have our best
work your central line.
Neela?
Right.
Wait, what is she?
Ten?
No, almost 16.
Lester, I need you
to call Ortho.
Tell them that Dr. Pratt's
open fracture patient
needs to be
in the OR no later
than three hours
from now.
It was a pleasure
working with you, sir.
Doesn't she need
to be supervised?
( sighs )
Hey, Mike.
Can you spot this one
for me, man?
Hey.
What?
I've had to take a whiz
since I got here.
Freddy!
Freddy, if you don't get up,
you're going to lose your gurney
and spend the night
on the floor.
But I like a firm mattress.
PRATT:
What's his blood alcohol?
429 but it smells
a lot higher.
He ain't going anywhere
on his own.
Come on, up you go, Freddy.
FREDDY:
Anybody ever tell you
you're beautiful?
Yeah, all the time.
Come on.
Mag and thiamine, keep
him till he's sober
and tell housekeeping
there's vomit in the hall.
I think I'm going
to be sick.
She new?
She's wearing white
pants, isn't she?
Why? You want
to date her?
Hey, hold on now.
I thought things were
good between us.
You know, cards on the table,
no hard feelings...
We talked about this.
Oh, none whatsoever.
WEAVER:
Pratt.
Ready for you to present.
Okay, let me take
a leak first.
No.
Rick Mathers, open tib
on Ancef and gent
awaiting Ortho for a washout
and ORIF.
He has a history of IVDA,
needs a central line.
Better have more than that.
Exam 4, ureteral colic
waiting on a CT urogram,
pain-free with Toradol.
How's his
renal function?
BUN 15,
creatinine 1.1.
Curtain 2, febrile PID,
got foxy-doxy.
She's being admitted to GYN.
And in here, we've got
Betsy Wimbel, 28,
exacerbation
of Crohn's disease
with abdominal pain
and diarrhea.
Percocet's
not touching her.
It's cramping again.
Another 100 of Demerol
for Betsy, please.
Steroids?
Gram of Solumedrol.
And I called GI to get her
admitted for intractable pain.
Sounds good.
Yeah.
Should be going upstairs
any time now.
Thank you, Dr. Pratt.
I appreciate your going
to bat for me.
Oh, it's nothing.
Anything for you, Betsy.
I like your style, man.
Oh, yeah?
Well, get your own.
Numb it! Numb it!
Hold still,
Mr. Mathers.
We're almost done.
You aiming
for the sternal notch?
( wailing in pain )
Still no flash.
All right, you're
too inferior.
Aim more cephalad.
No, she has to avoid
the subclavian artery.
NEELA:
I know, I know...
Ow! God!
Here, let me try it.
No.
Are you following
the landmarks?
Yes!
Oh, God!
CHEN:
What's going
on in here?
They're stabbing me
to death here!
Four attempts at a central line.
Here, I'll take that.
What, a Chink now?
What is this,
the damn UN?
You aim above
and posterior
to the index finger
in the sternal notch.
Hello.
( screaming ):
Oh, God.
RASGOTRA:
I thought I was.
Advancing...
Got a flash.
Guidewire.
I guess I'm more comfortable
with the IJ approach.
Well, you need
to learn them both.
( Mathers moaning )
All right, I'm in.
Oh, thank God somebody here
knows what they're doing.
Gallant, can you
sew it in for me?
I was off an hour ago.
Me, too.
She hates me, doesn't she?
Who? Dr. Chen?
She thinks I'm interested
in her boyfriend,
but I'm not.
( chuckles )
Should I talk to her?
I would leave
it alone.
They broke up.
She and Dr. Pratt?
When?
Last week.
Let go of my sleeve, Freddy.
But I love you.
Dr. Chen?
Let's see if you feel that way
in the morning.
Another two of lorazepam.
Do you have a moment?
Uh, actually,
I'm on my way out.
Put Freddy in Curtain Two
and give him to Dr. Morris,
wherever he is. Thank you.
It's just that I think
we got off on the wrong foot
and I'd very much
like to remedy that.
What?
Dr. Pratt's
a bit of a flirt,
of which I'm sure
you're well aware,
but I want you to know,
I did nothing to bring it on.
In fact, I think
he rather can't help himself.
But if I did anything
to worsen the situation,
I apologize,
and I'd hope
you wouldn't penalize me
over something
which I had no control.
Penalize you?
Be hard on me.
Show me up
in front of the others.
Um... look...
Neela.
I'm hard on all
my med students,
especially the women,
because I have to be,
for their own good.
If I were you, I'd worry
more about my skills
and less about Dr. Pratt.
All right,
Mr. Coston's discharged;
Mrs. Provost,
admitted to Cards;
Lemony Jones is AMA
and don't bother me
unless you've got
some money for me, please.
FREDDY:
* You put
your right hand in *
Who's got big mouth Freddy?
* You put your right hand out
Chen assigned him
to Morris.
Yeah, well,
he's mine now.
* You put
your right hand in *
* And you shake it all about
* You do the hokey-pokey
Keep pushing Ativan
till he shuts up.
Yeah, right.
* Turn yourself around...
Geez!
One more patient.
No, not now. Later.
No, wait, please.
You won't even have
to go very far.
He's right over here.
His name is, uh...
Hey, stop.
Okay? Just stop.
Betsy, nobody's been in
to see you yet?
( strained ):
No. Is it going
to be much longer?
Well, let me get
on the horn to GI,
and tell them my girl's tired
of waiting on her consult, okay?
ANDY:
Um, can I talk now?
Yeah, go ahead.
Ed Gamble, 28,
developed
an expressive aphasia
while fighting
with his wife.
Stopped talking
mid-sentence.
It was all
very dramatic.
I can talk now though.
Have you done a
full neuro exam?
No, but my husband
passed the idiot test
with flying colors.
( knocks on window )
Excuse me.
What's up?
Weaver knows,
but just in case,
dislocated shoulder,
check post-
reduction film.
Mm-hmm.
Pancreatitis,
30 of morphine,
just make sure
he's breathing.
And I'm out of
here unless you
need me to stay.
Now, why would
I need that?
Because it's crazy-busy
and there's only one
attending on the floor?
Nah, got it this.
I was hoping
you'd say that.
For you.
And Morris is MIA.
He's got an LOL waiting on
a pelvic for over 14 hours now.
Okay.
You leaving?
Yeah, finally.
PARAMEDIC:
73-year-old female,
chronic emphysema on home 02.
Told her granddaughter
she couldn't breathe.
Kid called 9-1-1.
Ma'am, what's
your name?
Winnie Crawford,
that's her name.
COOP:
She's not moving air.
Okay, let's get Miss Crawford
into Trauma One.
Abby?
Uh, my shift's over.
You.
You want to be a doctor?
Move it!
Um, by the way,
uh, your loan's
not going to go through.
Not with a FICO of 428.
They gave you my credit rating?
I saw the application
on the fax.
Couldn't lease a moped
with a score that low.
WEAVER:
Get her on 100%
non-rebreather.
Is Grandma okay?
We're trying
to help her.
Hang a liter of saline.
We have an IV yet?
GIRL:
She doesn't like hospitals.
DUVATA:
Working on it.
Pressure's 86/52.
Don't do that!
I need a 7-0 tube
and a Mac 3.
Stop it!
Okay, someone get her
to the family room.
She wouldn't like it.
She's DNR!
What did you say?
WEAVER:
Sweetie,
do you know what DNR means?
She doesn't want to be naked.
( Coop sighs )
Hypoxic on 15 liters,
respiratory failure.
We have to tube her.
Not if she's DNR.
The child wouldn't know the term
unless it had been discussed.
It doesn't matter.
Without documentation,
we resuscitate.
Am I right?
Put her on a vent,
she'll never come off.
Morphine and oxygen
until we know different.
Erica, do you know
where your parents are?
My mom's out with her boyfriend.
Okay, take her
to the family room.
Get a number
for the mom.
Come with me, all right?
Okay, shut your eyes
and don't let me open them.
You think it's bad?
I asked for a divorce.
You didn't ask.
And he starts
with the mute act,
which is a childish variation
on his cold shoulder act.
( knocking )
Sorry to interrupt.
Excuse me.
Jeez.
Intubated benzo overdose,
waiting for an ICU bed.
Radiator fluid burn needs
Thermazine dressings.
Incised thrombosed
hemorrhoid needs to
go home for sitz bath.
So, what are you
telling me for?
Those are all Morris'.
Man, I've been
up and down
this hallway;
I cannot find him.
Plus, I'm late for
dinner with my folks.
All right,
give it to me.
Thank you.
Have a good night.
Yeah.
He's doing it again.
He's doing what?
Not talking.
Look, obviously,
this is Ed's way
of keeping me hooked.
That or he's really lost it.
Either way, he needs help.
Okay.
Thank you.
Hey, I need you
to do me a favor.
I need you to call Psych
for a consult
on Mr. Gamble.
Yes, Doctor.
Dr. Pratt?
What?
I have a patient
who was bit by a rat.
All right, come on.
Should I send off a CBC?
For what, rabies?
Nurse?
Come on.
That woman blew her nose
on my smock.
Well, maybe she's
not a Tweety fan.
Hey, I need you
to update his tetanus
and I need you to test
his flexor tendons.
No, don't test me, man.
Just test the rat.
( screams )
This is not what I went
to nursing school for.
I quit.
Irrigate. Put
him on Keflex
and chuck the rat
in the bio bin.
I've got to take another piss.
Dr. Pratt, I've got a lady
with dysmenorrhea.
Mm-mm, mm-mm.
Here, take that.
Prostate pain and a
baby with a impetigo?
MORRIS:
If it's obstruction,
what would the
diameter be?
Ten mill... so then
over ten millimeters
then I should
call surgery?
Son of a bitch.
Hang up!
What?
You're
a second-year resident,
not a med student.
You can't be calling
your mother, your father
or your cousin
who's a podiatrist
to help get through a shift.
Now get out on the floor
and do your damn job!
And for God's sake,
light a match or something.
( opens door latch )
Hi.
Hey.
Figured I owed
you a visit.
And... Gillian invited me
for dinner.
It's 10:00.
Well, I didn't think
you'd take me up on it.
Oh.
Uh, sorry,
I can't stay,
uh, but there's still
some Thai left in the fridge,
if you want.
Uh, see you in a couple months.
Thanks.
Okay.
Need any help with that?
No, no, I'm good.
Um, bye, Abby.
Where's she going?
Ah, back to Montreal.
Her boyfriend's been bugging her
to go back home.
I thought you two were...
Nah, it's
complicated.
Mm.
PRATT:
This guy Mathers
is approaching
the six-hour mark.
He needs a washout in the OR.
or he's going to get
some serious osteo...
Yeah, well, we're a little busy
down here, too.
Dumb...
Your acute abdomen
is acutely constipated.
Give him an enema
and some Colace.
Now, how did I know
you were going to say that?
Because you know you
shouldn't have bothered
to call me down in
the first place?
Hey, I got a board to clear.
Yeah, yeah.
Look, put a fresh
saline dressing
on my open fracture
guy, would you?
Yes, Doctor.
You do speak
English, right?
Yes, Doctor.
( sighs )
All right, looks like
we're making progress.
Only 30 on the board.
And 50 in Triage.
So we better fuel up.
Feel like making a
burger run, my treat?
Cafeteria's closed.
McDonald's isn't.
You got feet.
Excuse me, Doctor?
Oh, I see you're
talking again.
It sort of comes and goes.
Were you able
to determine anything?
No, not yet, but we
got a special doctor
coming to see you,
so you better get into
bed before you miss him.
So, you think
it's just stress?
I don't know.
You pulled me out of a movie
for Betsy Wimbel?
Is there a problem?
Yeah, she's in here
three times a month
with the same complaints
and still somehow manages
to squeeze Demerol out
of residents like you
who don't pull
her old charts.
Yeah, that's all fine and dandy,
but she's got real disease--
guaiac-positive stool
and intractable pain.
She's a manipulative
drug-seeker
and we are not here
to support her habit.
So examine her,
put a note in her chart
stating that you won't admit.
Bump her steroids,
give her a few Vicodin
and do not call me again.
I'm just asking you
to take care of your patient.
Actually, she's
your patient now.
Hey, Lester.
Medicate and discharge
my Crohn's patient.
Tell her you're sorry,
but she won't be admitted.
ABBY:
You seem to be getting
your strength back.
I couldn't run a
four-minute mile,
but I'm doing okay.
Still a little anemic.
Are you glad to be home?
Yes and no.
I miss it.
You're not in your own head
all the time.
You're a part of something
that's in constant
motion over there.
Any break from it
you get is a luxury,
not just something to
be taken for granted.
And that's different
from County how?
It's its own addiction,
I guess.
Yeah, it certainly
hooked Carter.
Yeah.
How are you doing
with that?
What, without him,
you mean?
I'm fine.
I'm better than fine.
So you're happy?
( chuckles )
Getting there.
I made a few decisions.
Like what?
I don't want
to jinx myself.
( pager beeps )
Work wants me back.
Tonight?
Pretend you didn't get a page.
I need the money.
See you soon then?
Yeah.
Good night.
DUVATA:
Corina Wybel
is waiting on amylase
and Mathers is
still in Sutures.
He didn't go up
to surgery yet?
Hey,
I thought you left.
What can I say?
The attrition rate
for nurses here sucks.
Ha, ha, Tweety girl?
Yeah, writing was on
the wall for that one.
It's kind of a drag you
got called back in, though.
Not really.
Double overtime.
How's it going?
Are you talking to me?
Yeah.
Fine.
Glad to hear it.
You're one of the best
nurses on the floor.
With all the changes that
Robert's been making,
I'd, uh, hate
to lose you.
Thanks.
NEELA:
Abby, do you know
where I can find
paper and crayons
for a little girl?
Is she a patient?
No, but...
Your evaluation as a med
student revolves around
how many patients
you can carry,
not how many children
you can baby-sit.
Take a cue from some of your
colleagues and get busy.
Okay, the wrist film's negative.
Ace wrap and he's out of here
with RICE.
Got it.
Scombroid patient
had two liters,
tolerating POs, discharge
with a clear liquid diet.
Yes, sir.
Threatened AB
is Rh-positive.
Send her home with pelvic rest,
no intercourse,
no tampons, no douching.
Thanks.
( sighs )
Morris.
Why do I have a board
full of nasty
and you're studying radiology?
Uh, Damian here came
in with wheezing.
Yeah, he's got a quarter
in his upper esophagus.
So, what's your point?
I'm thinking
it'll just pass.
In my poop?
So, that's it?
We just wait till it comes out?
No, actually,
being that he's symptomatic,
we call in a specialist who can
take it out with an endoscope.
Is that an operation?
With no cutting involved.
All right, who's the
GI consult on call?
Hampton,
a very special friend of mine.
You page her.
COOP:
Pratt!
DUMAR:
Pulse ox 98
on two liters.
Street racing MVA,
first of three.
Sicker one's coming in
right behind me.
Witness said car
rolled three times.
No, man, it was
at least four.
Excuse me.
Janie Timmons,
16, restrained
but loose after
several rolls.
Unknown LOC,
GCS 234.
Janie, can you hear me?
CSF out the ears.
And blood in the airway.
Page neurosurg
and trauma.
Bet you money she's got
a bleed in her brain.
Wait a minute.
Wait a minute.
Where we going?
What's open?
Nothing. Uh, end-stage emphysema
in One, a possible DNR.
Possible?
Yeah.
Let's go.
Look out.
Triple MVA--
we need this room.
Wait, she needs
a monitored bed.
Not if she's a DNR.
We're waiting
for confirmation on that.
She's got end-stage emphysema.
Consider it confirmed.
Come on. Let's go.
PRATT:
Let's go. Come on.
Come on. Come on.
Out. Out.
Out. Out.
His '64 Mustang
lost out to a Z28.
Good vitals, unknown LOC,
chest abrasion
with closed fracture
of the humerus.
The classic people
always challenge.
WEAVER:
We'll get a C-spine
in CT, but he needs a chest
and AP pelvis.
That's going to
take a while.
They're slammed.
Okay, if CT opens first,
we'll have to send him there.
You want to go
when he does?
No, I can't.
I'm the only attending
and Pratt's the senior
on the floor.
Abby, you go.
It's my fault.
They're young.
They're allowed to be stupid...
No one's allowed to be
that stupid, Mr. Vangoss.
I got bone sticking out
of my legs!
Six Flags only better.
Cranial nerves grossly intact.
I've been here
six hours!
MORRIS:
Somebody needs
to shut him up.
Oh, my God!
...cleared.
Harlin was always
like a total G force, you know?
Good breath sounds.
Hey, where's Janie?
Yeah, you're just now asking?
The belly's tender.
I don't want to
inconvenience anybody.
Take the rectal.
What?
Needs someone to find out
about his girlfriend,
doesn't he?
You're going up my butt?
Just one finger.
PRATT:
Multiple lac
scalp and occiput.
MORRIS:
Hey, Pratt, your
guy in Sutures
is having a meltdown.
Later. Looks like
a skull fracture
with a step off.
Sats are down to 90.
Threatening to sue
everybody and their brother,
but mostly you.
MALIK:
Whoa, she's
blowing some teeth.
Oh, wow. Hey,
where the hell
you're going?
Bathroom.
( alarm beeping )
Sats 88... 86...
Okay.
All right,
after I secure the airway,
chest tube
and subclavian on the right.
Dr. Pratt, Psych won't see
your aphasia patient
unless you clear
a head CT first.
The guy's freaking out
'cause his wife's leaving.
He doesn't need a damn head CT.
Okay, give me the tube.
Okay.
Pulse is down to 65.
You better kick it.
JERRY:
Pratt, Hampton
called from GI.
She's not going
to see the quarter kid
till morning, but she plans
on seeing Romano first.
I'm in. Is that all she said?
No, actually. She said
you're an asshole, too.
Good night.
Wow. If it's 1:00 in the
morning, I guess it's lunchtime.
You got to try this.
Mm, sure. What is it?
Dinuguan.
Oh, yeah?
What's that?
Cooked pork blood.
Did I ever mention
I was half Jewish?
( "I Love the Nightlife"
blaring from stereo )
Hey, Randi, I'm still waiting
on Ortho
for my open fracture guy.
As soon as they call, you
make sure you tell them...
They called. They said
that you should irrigate him
because they're kind of busy
right now.
Nice.
Neela, find Morris and
have him supervise you
on doing a poor man's
washout on Mr. Mathers.
Any idea where he is?
No, but that's an MSP--
med student problem.
I love being an R2.
So, what do you think?
I think it's little loud.
Well, if I have to
stay up these hours,
so does everybody else.
No. He hasn't gone
to radiology yet.
That's the problem.
High-speed MVA, blunt trauma.
He really needs a belly CT.
Can't you just sneak us in?
Thank you.
Okay, Mr. Vangoss,
we're going up to the CT room.
I was 17
when that song first came out.
You probably weren't
even born yet.
Oh, I was around.
Hi.
Hi.
DORSET:
Elizabeth, hold the door.
Oh, oh. We're
full, I'm afraid.
Oh.
Well, I'll catch the next one.
He's cute.
Did you guys ever
get together?
Who?
Dorset.
Didn't he ask you
out or something?
Uh, I suppose you could say
we're... dating.
Really?
What?
What?
What? You think
it's too soon?
I didn't say that.
I think it's too soon.
I... I... I just
said he was cute.
Yeah.
Too soon.
( groaning )
You're not too good
at this, are you?
It should start
to feel numb soon.
What the hell
is that stuff?
Sterile saline--
washes the germs out.
And you're just now
getting around to this?
We thought you'd be
in the OR by now,
but this will buy us
an extra hour or two.
Before what?
WEAVER:
What do you think
you're doing?
Temporary washout.
WEAVER:
Which is not
a procedure
a med student performs
without resident supervision.
Oh, great, she's
not even a doctor?
Stop what you're doing
and tell me who the resident is
on this case.
Dr. Pratt, but he asked
Dr. Morris
to supervise on his behalf.
So where's Dr. Morris?
I'm surrounded by incompetents.
MATHERS:
Hey! Hey, how do
you think I feel?
This one's
been trying
to kill me all night.
Oh, my God.
( Bob Marley's "Jammin'" plays )
No mass, no hemorrhage,
normal ventricles, no shift.
So he's clear?
Crystal.
Hey, Mr. Gamble.
Your head CT looks good.
Everything's fine.
So what do I do now?
Well, I've arranged
for you to speak
with one of our
mental health
specialists.
I'm not crazy.
No, you're not.
You're just
stressed and...
Then give me something for that,
but don't send me to a shrink.
God, the last thing
I need is
for Gloria to have proof
I'm nuts.
Pratt, dislocated
patella.
COPD exacerbation.
I and D
on a pilonidal cyst.
And don't pass these off
on that idiot Morris.
Look, I know you think
I'm a wuss...
Mr. Gamble, I
don't have time...
Just give me something
to get me through the night.
Hey, I want you to give Ed here
two milligrams of obecalp IV
and discharge him.
Obecalp?
You know what Obecalp is?
Yes, Doctor.
Thank you.
Thank you very much.
Yeah. Whatever
works, right?
Yeah.
Erica?
What does DNR mean?
It stands
for Do Not Resuscitate,
which means...
someone doesn't want
to be kept alive by machines
if they should get very sick.
Let's get you back
to the other room
where you can rest.
Can I stay here?
She says she sleeps better
with me.
Sure.
Good night.
Night.
I'm glad you have time
for a Kodak moment.
I know I sure
as hell don't.
We still got 20
on the board
and 35 in Triage.
Sorry. She's by herself here.
It's hard, isn't it?
Learning where your
time is best spent,
whether it's with the
patient or their family.
Well, you know,
that's really rough.
Now if you're done
playing house,
do an I and D
on Mr. Brier's pilonidal cyst.
Hey, hey.
He's tough, but he's got
the goods, you know?
Yeah.
Yeah. Hey, have you ever
heard of Obecalp?
Because I can't find it
in the PDR.
It's "placebo"
spelled backwards.
Oh.
Who's prescribing it?
Um...
Dr. Pratt.
WEAVER:
Obecalp?
Look, the guy's
playing games
with his wife.
He gets panicky
whenever I
mention Psych,
and he begs me to
give to him something
to calm his nerves.
So I give him saline.
And it looks like
he feels a lot better.
No harm, no fowl.
Do you ever hear
of truth-telling?
Deceptive practices?
Yeah, but he...
Not only have
you breached
every principle
of medical ethics,
you've also opened us
up to a lawsuit
if this patient finds
out what you did.
MALIK:
Dr. Weaver, your MVA guy
is crashing in CT.
Damn it.
Hey, Severa, I guess
you better pull the plug
on Mr. Gamble's Obecalp.
I never gave it to him.
MAN:
Doctor,
how long before my son
is taken care of?
Your son...
Damian-- the quarter?
Oh, right, right.
Um, well, it looks
like the, uh...
the GI doctor
who performs the procedure
won't be able to see him
till the morning.
Oh.
When in the
morning?
I'm not sure, but he's stable
and I don't see a problem.
We've been here for 14 hours.
No one's done a damn thing.
Damian's scared
to death.
She needs to get
to bed. We all do.
Look, I know it's hard...
This is an emergency
room, right?
There's a quarter
in my son's throat.
He can't breathe.
Now, that's an
emergency, isn't it?
( alarms blaring )
What happened?
He got altered,
and his sats drifted down.
Did you finish the scan?
No.
How long has
he been down?
Under five minutes.
Let's tube him.
Pulmonary edema?
More than likely.
Okay, stop
compressions.
Still no pulse.
Never, never send an even
slightly unstable patient
to CT without a doctor.
You told me to bring him...
I'm talking to me.
I'm in.
You coming?
Pratt's trying the
old Foley trick.
What?
Yeah, that's
what's so cool.
Okay, Foley and a two mac blade.
All right, sats
is 96, BP steady.
Mm-hmm.
All right, come on.
Okay, so now,
what we want to do is
put this tube
just past the quarter.
And once
we do that,
we're going to blow up
the little balloon
with saline,
and hopefully pull the quarter
back into his mouth.
Couldn't he aspirate the quarter
into his lungs?
Not if I grab it first.
Now, here's the
tricky part.
Okay.
And...
presto.
( laughs )
Dr. Pratt.
( laughs )
Here. One for
the piggy bank.
( laughs )
( speaking Tagalog )
DUVATA:
Oh, Abby,
you're back.
Can you cover
for Melinda in Triage?
Sure.
Love to. Triage
is my personal favorite.
Thanks for asking.
Hey, where's Weaver?
Bars are closing.
We're gonna get slammed.
She's still in CT, which
means the R2s are in charge,
and that scares me.
You and me, man.
All right, let's get
the party started.
( loud music playing )
You! Come on.
Come show me some love.
Come here.
Please tell me
it's not just 3:00.
Shut the hell up!
How's anybody supposed
to sleep around here?!
MALIK:
Yo, Abby.
Any time now.
Okay, where
are we at?
Now serving #47.
This is Jay-Jay.
He has a toothache.
Thank you.
Hey, Jay-Jay, how you feeling?
Tooth hurts.
Uh, when did you
first notice it?
About a year ago.
Excuse me.
Yep, have a seat.
I'll be right with you.
No, we've already
been seen.
My son was feeling
a little queasy
in the parking lot.
It might just be
the anesthesia,
but could you get
Dr. Pratt to maybe...
Oh, my God.
Pratt!
Pratt!
Damian...
Here, help me
lie him down...
What did he
come in for?
He swallowed a quarter.
Blood looks arterial.
Page surgery
and vascular.
Aorto-esophageal
fistula?
Pratt, I need you
at Curtain One.
Not now. Get a gurney.
What's going on?
Probable aorto-
esophageal fistula
after a foreign body
removal in the ER.
You did endoscopy?
I used a foley.
Are you out
of your mind?
It worked fine. The quarter
he swallowed must've been
in there too long.
Ten minutes after he was
discharged, this happens.
All right,
we'll take it from here.
Tran-esophogeal erosion needs
immediate aortic repair.
Apparently, not all
ER residents can
walk on water.
You know, you're
lucky this happened
while they were
still here.
Otherwise this boy
would be dead.
Add five of Peep
once he's on a vent.
Andy, what did the NG
aspirate show on Maloney?
Uh, let me find out.
Pratt!
Lungs clear.
Let's get some 02
and check a D-stick.
Watch it.
Syncopal episode?
Only groans with a sternal rub.
We were getting
ready to go
and then he sort
of slumped to the floor.
All right, let's
get him on the bed.
One, two, three, up.
All right, put him
on the monitor,
and get me some vitals.
I'm on it.
I thought
he was kidding...
Pupils asymmetric,
mild ptosis.
He was fine other
than being a nut case.
Young, healthy guy
with transient loss of speech.
SonoSite.
A negative CT.
Turn that damn music off.
Listen, man, I got this.
It's okay.
Any risk factors
for stroke?
No. Decreased tone
on the right.
Oh, my God,
he had a stroke?
Call CT.
Have them clear a room.
Uh, I think I have
something here.
This is my patient,
all right?
Might be
a carotid dissection.
Let me see that.
Tapering occlusion
of the left carotid.
What is that?
Your husband has a tear
in one of his main arteries
which caused a clot.
Dr. Pratt, your open-
fracture patient demands
to be euthanized.
Mr. Mathers
is still here?
Go. I got your
back on this.
Get consent for TPA.
.9 migs per kig.
Okay.
That enough of Triage.
Let it be someone else's turn
for a change.
( speaking Tagalog )
And I know
you're talking about me.
Hey, Abby,
is Exam Two open?
I'm on a break.
Hi, uh, I'd like to find out
if I qualify for a cash advance.
Uh, uh, sorry,
I have to go.
Neela.
Yes?
Grandma's dead.
The little girl's sleeping.
We need the bed.
Hey, how you doing?
Sleepy.
Morphine's kicked in.
That and it's 4:30
in the morning.
Am I gonna lose this thing
or what?
My leg.
No.
'Cause I'm...
not the kind of guy
who could get along without it.
I work for a living, you know.
Look, I know
I've said it before,
but we're gonna get you
in the OR real soon.
That's what I hear...
Get Coop to cover for me,
would you?
Where do you think
you're going?
To take care of something
that should've been done
eight hours ago.
Starts screaming bloody murder,
right in the middle
of the course.
Makes you wonder
what he would've done
if he were four over par.
Hey, how you guys doing?
Dr. Pratt from the ER.
Size eight-and-a-half gloves,
please.
What do you think
you're doing?
I'm here to hold
your retractors.
Reamer to me. Drill
for the cup screws.
Been calling you guys for hours
on that open tibia fracture.
Well, now that I'm here to help,
you can free somebody up
for the consult.
Just show me where to pull.
Shh, it's all right...
( baby crying )
( baby crying )
Hello?
Hi.
Is Richard here?
Honey,
your ex-wife is here.
How old now?
14 months.
( toys clatter )
( baby screaming )
What do you want?
I need a favor.
Abby, it's 8:00
in the morning.
Yeah, I know. I don't
have a lot of time.
I need you
to co-sign a loan.
Why don't you
just declare bankruptcy?
Look, I'm not in trouble,
okay?
I just need you...
Want me to support you?
No.
I never asked for alimony.
I didn't contest
anything in court.
I didn't even take
the damn furniture.
You could have if you wanted to.
Look, you must know
how much I hate doing this.
I wouldn't do it unless
it was absolutely necessary.
I don't want your money,
I just want your signature.
Oh, good morning.
Yeah, hi.
Yeah, I just got in
and already I've heard
from the Ortho, Psych,
and GI departments,
not to mention
our own Dr. Weaver
about your medical
hijinks last night.
The carotid clot
was a total zebra;
Ortho was taking
their time;
and Hampton refused
to get her lazy ass
down here for a...
You are a screwup,
Pratt.
And just to be clear,
I didn't like you
before I knew that.
Mmm, Kenyan roast.
Can't beat it
for flavor or punch.
Triple espresso,
yes, I can.
Hey, your septic pancreatitis
is still waiting on an ICU bed.
Thanks.
How'd it go?
Good.
Hey.
Hey.
How's the quarter kid?
Corday says
he's gonna be fine.
Hey, Coop, I heard
you caught
a carotid
dissection. Nice.
Thanks, man.
Did a rotation with
the stroke team in June.
Anybody could've missed it.
Yeah, well, started Mr. Gamble
on anticoagulants,
tear should heal on its own.
And he keeps talking.
You headed home?
Yeah, why? You're not?
I'm going to hit
the gym first.
Hey, Coop.
Thanks, man.
Yeah, sure.
Anything for a buddy.
A foot rub.
I'll...
I'll settle for coffee.
( panting )
I'm Gillian.
I was working with Luka
and John in the Congo.
Ah.
John asked Luka
to give you this.
He wrote me a letter?
I think he wanted to try
and explain why he stayed.
I don't want to talk
about Carter anymore.
Why are you mad?
I'm not mad.
I'm sure you'll find yourself
a new bang-buddy.
Good night.
You're not her doctor;
you're her nurse.
When I ask you not to do
something, don't do it.
I hate my job.
Pardon me.
Excuse me.
Whoa, whoa, whoa, whoa.
I need a paper.
We're closed.
Come on, man.
Show me some love.
Come on.
Ah.
Old news by now.
So she's had her bath?
Good. Good.
Yeah, could you put her on for
me, so I could say good night?
( sighs )
Oh.
Um, okay then.
Well, give her a kiss good night
for me then
and, uh, I shall see you
in the morning.
No, I won't work too hard.
Yeah, okay. Bye.
Everything okay?
Yeah.
She's watching Clifford.
Hmm.
You know, everyone's
allowed a little downtime.
Even Ella's mother.
You disagree?
I don't know.
It's just sneaking
out of the house like this--
it all feels
a little...
unseemly.
You say unseemly. I say sexy.
That, too.
Not to mention fun.
Our shift starts in...
My car's fast.
You've just had a shower.
Water's cheap.
You're half-dressed.
You're not.
Mr. Drake in Two is waiting
on his second troponin.
Psych needs to evaluate
the woman in Four
who says she's been pregnant
for the past seven years.
Eloise is back?
Yup, with the mother
of all yeast infections.
I gave her a Fluconazole/Haldol
cocktail.
Frequent flyer?
Logs in more hours than me,
which is saying something.
Have we met?
No.
Damn, is everybody new
around here or what?
Fresh out of nursing school.
Or fresh off the boat.
I haven't seen
anything like this
since shore leave in Manila.
Think fast, truant.
You still here, wheezy?
Oh, hell, yeah.
Home sweet home
and right on time, buddy.
No, see, this is mi casa,
not su casa.
Remember, you're just visiting
from Whitebread, Iowa,
or wherever you're from.
That's Whitebread, Florida,
actually.
Hey, Pratt.
Is there a warfarin-
phenobarb interaction?
Up the warfarin because
you've got increased
hepatic metabolism.
Secondly, I'll more than make up
for being a few minutes late.
And third, I'm not your buddy.
Hey, Coop, Cubbies,
Friday night,
behind home plate,
you and me?
Hell, yeah.
Suds and dogs?
I'm there, Daddy.
Cool.
You two gonna kiss next?
Ortho on line one for you.
Well, unless there's a phone
in the can, take a message.
Uh, Pratt.
We have a rectal
mass guy in Two
personally asking for you.
Dr. Pratt, I have a man with
urticaria I need to present.
You're going to have
to give me a minute.
And can you supervise
my pelvic exam?
Yeah, all right, in a sec.
What's the dose of IV Reglan?
Damn, how many of you newbies
are there?
That mean med students?
There are lots of us.
Yeah. Well, am I
the only second-year here?
I'm sorry.
I didn't see Dr. Cooper.
I would've asked
Dr. Morris, but, uh...
COOP:
He's stuck
with a patient in Two.
The sprained ankle?
Damn it, Morris, I have
30 patients on the rack
and 40 in Triage.
A little multitasking
on your part would be helpful.
Hey, you're not doing
that clown any favors
by picking up his slack.
Okay, not a single chart's
been picked up
in the past 45 minutes.
It's called a work ethic,
people.
Since when is
Weaver on graveyard?
God forbid you should
take a patient
the last hour
of your shift.
You might have to stay
an extra 20 minutes.
Once a month.
She says it's the only way
to keep up her skills.
I worked all day, too.
You think I'm not tired?
Never thought I'd say this,
but I kinda miss Little Stumpy.
Pratt, you forgot to sign
your QA forms last night.
MAN:
Get me out of here!
You want to grab
this first?
I'm off the clock.
Come on, you
heard Weaver.
Open tibia fracture
after a motorcycle accident
three hours ago.
I never gave permission
for this!
You have his films?
Right here.
Name's Mathers and he's
not a happy camper.
How you doing,
Mr. Mathers?
I don't want to be
in this hellhole!
That's how I'm doing!
St. T's shipped him
because they...
They dumped me
'cause I don't have insurance.
You're here, sir,
because you require
a higher level of care
than they're capable of giving.
I work for a living,
damn it!
I'm not
some county welfare case.
Hey!
This look like TV to you?
What are you doing?
Had a gram of Ancef
and six of MS.
God, I deserve
better than this...
No, the best thing that
could've happened to you
was coming to County.
You're about to receive
the finest health
care in Chicago.
Isn't anyone going to help
deliver my precious baby?!
Eloise, you've been pregnant
for seven years,
you can wait ten more minutes.
All right, listen up, listen up.
We're the A team, people.
You know what that means?
That means we have exactly 12
hours to clear this place out
and show those quacks
at the day shift how it's done.
WOMAN:
Most people are quite pleased
with its lifelike appearance
and the attention
paid to detail...
Yeah, well, they should've
clipped my nails then.
With a minimum of motion,
your own muscle signals will
trigger the arm, so that...
Yeah, I read the brochure.
Let's go.
To bend the arm, simply
contract your biceps.
That's it.
Biceps up, triceps down,
biceps up, triceps down.
They actually pay you
to state the obvious?
Okay, pausing, as you just did,
causes the arm to lock.
How do you unlock it?
Well, it requires
a quick co-contraction,
but that's too advanced for now.
No, we're not ready
to move on
to the hand yet.
We don't have to.
Look, how do you put it on?
Donning and doffing are
much more complex tasks.
Harness first
or stump in the socket?
Dr. Romano, it's late...
I want my damn arm,
all right?!
I've waited long enough!
Let's go.
MATHERS:
Screwy thing is
if I was on welfare,
Medicaid would've
covered me there, right?
Right.
Now, remember.
Open fractures can lead
to gram-negative osteomyelitis,
which is why we
add gentamycin.
Veins are sclerosed.
Excuse me.
Ever use IV drugs, Mr. Mathers?
Years ago.
Doesn't mean I should
be butchered at County.
You're absolutely right.
And that's why we're going
to have our best
work your central line.
Neela?
Right.
Wait, what is she?
Ten?
No, almost 16.
Lester, I need you
to call Ortho.
Tell them that Dr. Pratt's
open fracture patient
needs to be
in the OR no later
than three hours
from now.
It was a pleasure
working with you, sir.
Doesn't she need
to be supervised?
( sighs )
Hey, Mike.
Can you spot this one
for me, man?
Hey.
What?
I've had to take a whiz
since I got here.
Freddy!
Freddy, if you don't get up,
you're going to lose your gurney
and spend the night
on the floor.
But I like a firm mattress.
PRATT:
What's his blood alcohol?
429 but it smells
a lot higher.
He ain't going anywhere
on his own.
Come on, up you go, Freddy.
FREDDY:
Anybody ever tell you
you're beautiful?
Yeah, all the time.
Come on.
Mag and thiamine, keep
him till he's sober
and tell housekeeping
there's vomit in the hall.
I think I'm going
to be sick.
She new?
She's wearing white
pants, isn't she?
Why? You want
to date her?
Hey, hold on now.
I thought things were
good between us.
You know, cards on the table,
no hard feelings...
We talked about this.
Oh, none whatsoever.
WEAVER:
Pratt.
Ready for you to present.
Okay, let me take
a leak first.
No.
Rick Mathers, open tib
on Ancef and gent
awaiting Ortho for a washout
and ORIF.
He has a history of IVDA,
needs a central line.
Better have more than that.
Exam 4, ureteral colic
waiting on a CT urogram,
pain-free with Toradol.
How's his
renal function?
BUN 15,
creatinine 1.1.
Curtain 2, febrile PID,
got foxy-doxy.
She's being admitted to GYN.
And in here, we've got
Betsy Wimbel, 28,
exacerbation
of Crohn's disease
with abdominal pain
and diarrhea.
Percocet's
not touching her.
It's cramping again.
Another 100 of Demerol
for Betsy, please.
Steroids?
Gram of Solumedrol.
And I called GI to get her
admitted for intractable pain.
Sounds good.
Yeah.
Should be going upstairs
any time now.
Thank you, Dr. Pratt.
I appreciate your going
to bat for me.
Oh, it's nothing.
Anything for you, Betsy.
I like your style, man.
Oh, yeah?
Well, get your own.
Numb it! Numb it!
Hold still,
Mr. Mathers.
We're almost done.
You aiming
for the sternal notch?
( wailing in pain )
Still no flash.
All right, you're
too inferior.
Aim more cephalad.
No, she has to avoid
the subclavian artery.
NEELA:
I know, I know...
Ow! God!
Here, let me try it.
No.
Are you following
the landmarks?
Yes!
Oh, God!
CHEN:
What's going
on in here?
They're stabbing me
to death here!
Four attempts at a central line.
Here, I'll take that.
What, a Chink now?
What is this,
the damn UN?
You aim above
and posterior
to the index finger
in the sternal notch.
Hello.
( screaming ):
Oh, God.
RASGOTRA:
I thought I was.
Advancing...
Got a flash.
Guidewire.
I guess I'm more comfortable
with the IJ approach.
Well, you need
to learn them both.
( Mathers moaning )
All right, I'm in.
Oh, thank God somebody here
knows what they're doing.
Gallant, can you
sew it in for me?
I was off an hour ago.
Me, too.
She hates me, doesn't she?
Who? Dr. Chen?
She thinks I'm interested
in her boyfriend,
but I'm not.
( chuckles )
Should I talk to her?
I would leave
it alone.
They broke up.
She and Dr. Pratt?
When?
Last week.
Let go of my sleeve, Freddy.
But I love you.
Dr. Chen?
Let's see if you feel that way
in the morning.
Another two of lorazepam.
Do you have a moment?
Uh, actually,
I'm on my way out.
Put Freddy in Curtain Two
and give him to Dr. Morris,
wherever he is. Thank you.
It's just that I think
we got off on the wrong foot
and I'd very much
like to remedy that.
What?
Dr. Pratt's
a bit of a flirt,
of which I'm sure
you're well aware,
but I want you to know,
I did nothing to bring it on.
In fact, I think
he rather can't help himself.
But if I did anything
to worsen the situation,
I apologize,
and I'd hope
you wouldn't penalize me
over something
which I had no control.
Penalize you?
Be hard on me.
Show me up
in front of the others.
Um... look...
Neela.
I'm hard on all
my med students,
especially the women,
because I have to be,
for their own good.
If I were you, I'd worry
more about my skills
and less about Dr. Pratt.
All right,
Mr. Coston's discharged;
Mrs. Provost,
admitted to Cards;
Lemony Jones is AMA
and don't bother me
unless you've got
some money for me, please.
FREDDY:
* You put
your right hand in *
Who's got big mouth Freddy?
* You put your right hand out
Chen assigned him
to Morris.
Yeah, well,
he's mine now.
* You put
your right hand in *
* And you shake it all about
* You do the hokey-pokey
Keep pushing Ativan
till he shuts up.
Yeah, right.
* Turn yourself around...
Geez!
One more patient.
No, not now. Later.
No, wait, please.
You won't even have
to go very far.
He's right over here.
His name is, uh...
Hey, stop.
Okay? Just stop.
Betsy, nobody's been in
to see you yet?
( strained ):
No. Is it going
to be much longer?
Well, let me get
on the horn to GI,
and tell them my girl's tired
of waiting on her consult, okay?
ANDY:
Um, can I talk now?
Yeah, go ahead.
Ed Gamble, 28,
developed
an expressive aphasia
while fighting
with his wife.
Stopped talking
mid-sentence.
It was all
very dramatic.
I can talk now though.
Have you done a
full neuro exam?
No, but my husband
passed the idiot test
with flying colors.
( knocks on window )
Excuse me.
What's up?
Weaver knows,
but just in case,
dislocated shoulder,
check post-
reduction film.
Mm-hmm.
Pancreatitis,
30 of morphine,
just make sure
he's breathing.
And I'm out of
here unless you
need me to stay.
Now, why would
I need that?
Because it's crazy-busy
and there's only one
attending on the floor?
Nah, got it this.
I was hoping
you'd say that.
For you.
And Morris is MIA.
He's got an LOL waiting on
a pelvic for over 14 hours now.
Okay.
You leaving?
Yeah, finally.
PARAMEDIC:
73-year-old female,
chronic emphysema on home 02.
Told her granddaughter
she couldn't breathe.
Kid called 9-1-1.
Ma'am, what's
your name?
Winnie Crawford,
that's her name.
COOP:
She's not moving air.
Okay, let's get Miss Crawford
into Trauma One.
Abby?
Uh, my shift's over.
You.
You want to be a doctor?
Move it!
Um, by the way,
uh, your loan's
not going to go through.
Not with a FICO of 428.
They gave you my credit rating?
I saw the application
on the fax.
Couldn't lease a moped
with a score that low.
WEAVER:
Get her on 100%
non-rebreather.
Is Grandma okay?
We're trying
to help her.
Hang a liter of saline.
We have an IV yet?
GIRL:
She doesn't like hospitals.
DUVATA:
Working on it.
Pressure's 86/52.
Don't do that!
I need a 7-0 tube
and a Mac 3.
Stop it!
Okay, someone get her
to the family room.
She wouldn't like it.
She's DNR!
What did you say?
WEAVER:
Sweetie,
do you know what DNR means?
She doesn't want to be naked.
( Coop sighs )
Hypoxic on 15 liters,
respiratory failure.
We have to tube her.
Not if she's DNR.
The child wouldn't know the term
unless it had been discussed.
It doesn't matter.
Without documentation,
we resuscitate.
Am I right?
Put her on a vent,
she'll never come off.
Morphine and oxygen
until we know different.
Erica, do you know
where your parents are?
My mom's out with her boyfriend.
Okay, take her
to the family room.
Get a number
for the mom.
Come with me, all right?
Okay, shut your eyes
and don't let me open them.
You think it's bad?
I asked for a divorce.
You didn't ask.
And he starts
with the mute act,
which is a childish variation
on his cold shoulder act.
( knocking )
Sorry to interrupt.
Excuse me.
Jeez.
Intubated benzo overdose,
waiting for an ICU bed.
Radiator fluid burn needs
Thermazine dressings.
Incised thrombosed
hemorrhoid needs to
go home for sitz bath.
So, what are you
telling me for?
Those are all Morris'.
Man, I've been
up and down
this hallway;
I cannot find him.
Plus, I'm late for
dinner with my folks.
All right,
give it to me.
Thank you.
Have a good night.
Yeah.
He's doing it again.
He's doing what?
Not talking.
Look, obviously,
this is Ed's way
of keeping me hooked.
That or he's really lost it.
Either way, he needs help.
Okay.
Thank you.
Hey, I need you
to do me a favor.
I need you to call Psych
for a consult
on Mr. Gamble.
Yes, Doctor.
Dr. Pratt?
What?
I have a patient
who was bit by a rat.
All right, come on.
Should I send off a CBC?
For what, rabies?
Nurse?
Come on.
That woman blew her nose
on my smock.
Well, maybe she's
not a Tweety fan.
Hey, I need you
to update his tetanus
and I need you to test
his flexor tendons.
No, don't test me, man.
Just test the rat.
( screams )
This is not what I went
to nursing school for.
I quit.
Irrigate. Put
him on Keflex
and chuck the rat
in the bio bin.
I've got to take another piss.
Dr. Pratt, I've got a lady
with dysmenorrhea.
Mm-mm, mm-mm.
Here, take that.
Prostate pain and a
baby with a impetigo?
MORRIS:
If it's obstruction,
what would the
diameter be?
Ten mill... so then
over ten millimeters
then I should
call surgery?
Son of a bitch.
Hang up!
What?
You're
a second-year resident,
not a med student.
You can't be calling
your mother, your father
or your cousin
who's a podiatrist
to help get through a shift.
Now get out on the floor
and do your damn job!
And for God's sake,
light a match or something.
( opens door latch )
Hi.
Hey.
Figured I owed
you a visit.
And... Gillian invited me
for dinner.
It's 10:00.
Well, I didn't think
you'd take me up on it.
Oh.
Uh, sorry,
I can't stay,
uh, but there's still
some Thai left in the fridge,
if you want.
Uh, see you in a couple months.
Thanks.
Okay.
Need any help with that?
No, no, I'm good.
Um, bye, Abby.
Where's she going?
Ah, back to Montreal.
Her boyfriend's been bugging her
to go back home.
I thought you two were...
Nah, it's
complicated.
Mm.
PRATT:
This guy Mathers
is approaching
the six-hour mark.
He needs a washout in the OR.
or he's going to get
some serious osteo...
Yeah, well, we're a little busy
down here, too.
Dumb...
Your acute abdomen
is acutely constipated.
Give him an enema
and some Colace.
Now, how did I know
you were going to say that?
Because you know you
shouldn't have bothered
to call me down in
the first place?
Hey, I got a board to clear.
Yeah, yeah.
Look, put a fresh
saline dressing
on my open fracture
guy, would you?
Yes, Doctor.
You do speak
English, right?
Yes, Doctor.
( sighs )
All right, looks like
we're making progress.
Only 30 on the board.
And 50 in Triage.
So we better fuel up.
Feel like making a
burger run, my treat?
Cafeteria's closed.
McDonald's isn't.
You got feet.
Excuse me, Doctor?
Oh, I see you're
talking again.
It sort of comes and goes.
Were you able
to determine anything?
No, not yet, but we
got a special doctor
coming to see you,
so you better get into
bed before you miss him.
So, you think
it's just stress?
I don't know.
You pulled me out of a movie
for Betsy Wimbel?
Is there a problem?
Yeah, she's in here
three times a month
with the same complaints
and still somehow manages
to squeeze Demerol out
of residents like you
who don't pull
her old charts.
Yeah, that's all fine and dandy,
but she's got real disease--
guaiac-positive stool
and intractable pain.
She's a manipulative
drug-seeker
and we are not here
to support her habit.
So examine her,
put a note in her chart
stating that you won't admit.
Bump her steroids,
give her a few Vicodin
and do not call me again.
I'm just asking you
to take care of your patient.
Actually, she's
your patient now.
Hey, Lester.
Medicate and discharge
my Crohn's patient.
Tell her you're sorry,
but she won't be admitted.
ABBY:
You seem to be getting
your strength back.
I couldn't run a
four-minute mile,
but I'm doing okay.
Still a little anemic.
Are you glad to be home?
Yes and no.
I miss it.
You're not in your own head
all the time.
You're a part of something
that's in constant
motion over there.
Any break from it
you get is a luxury,
not just something to
be taken for granted.
And that's different
from County how?
It's its own addiction,
I guess.
Yeah, it certainly
hooked Carter.
Yeah.
How are you doing
with that?
What, without him,
you mean?
I'm fine.
I'm better than fine.
So you're happy?
( chuckles )
Getting there.
I made a few decisions.
Like what?
I don't want
to jinx myself.
( pager beeps )
Work wants me back.
Tonight?
Pretend you didn't get a page.
I need the money.
See you soon then?
Yeah.
Good night.
DUVATA:
Corina Wybel
is waiting on amylase
and Mathers is
still in Sutures.
He didn't go up
to surgery yet?
Hey,
I thought you left.
What can I say?
The attrition rate
for nurses here sucks.
Ha, ha, Tweety girl?
Yeah, writing was on
the wall for that one.
It's kind of a drag you
got called back in, though.
Not really.
Double overtime.
How's it going?
Are you talking to me?
Yeah.
Fine.
Glad to hear it.
You're one of the best
nurses on the floor.
With all the changes that
Robert's been making,
I'd, uh, hate
to lose you.
Thanks.
NEELA:
Abby, do you know
where I can find
paper and crayons
for a little girl?
Is she a patient?
No, but...
Your evaluation as a med
student revolves around
how many patients
you can carry,
not how many children
you can baby-sit.
Take a cue from some of your
colleagues and get busy.
Okay, the wrist film's negative.
Ace wrap and he's out of here
with RICE.
Got it.
Scombroid patient
had two liters,
tolerating POs, discharge
with a clear liquid diet.
Yes, sir.
Threatened AB
is Rh-positive.
Send her home with pelvic rest,
no intercourse,
no tampons, no douching.
Thanks.
( sighs )
Morris.
Why do I have a board
full of nasty
and you're studying radiology?
Uh, Damian here came
in with wheezing.
Yeah, he's got a quarter
in his upper esophagus.
So, what's your point?
I'm thinking
it'll just pass.
In my poop?
So, that's it?
We just wait till it comes out?
No, actually,
being that he's symptomatic,
we call in a specialist who can
take it out with an endoscope.
Is that an operation?
With no cutting involved.
All right, who's the
GI consult on call?
Hampton,
a very special friend of mine.
You page her.
COOP:
Pratt!
DUMAR:
Pulse ox 98
on two liters.
Street racing MVA,
first of three.
Sicker one's coming in
right behind me.
Witness said car
rolled three times.
No, man, it was
at least four.
Excuse me.
Janie Timmons,
16, restrained
but loose after
several rolls.
Unknown LOC,
GCS 234.
Janie, can you hear me?
CSF out the ears.
And blood in the airway.
Page neurosurg
and trauma.
Bet you money she's got
a bleed in her brain.
Wait a minute.
Wait a minute.
Where we going?
What's open?
Nothing. Uh, end-stage emphysema
in One, a possible DNR.
Possible?
Yeah.
Let's go.
Look out.
Triple MVA--
we need this room.
Wait, she needs
a monitored bed.
Not if she's a DNR.
We're waiting
for confirmation on that.
She's got end-stage emphysema.
Consider it confirmed.
Come on. Let's go.
PRATT:
Let's go. Come on.
Come on. Come on.
Out. Out.
Out. Out.
His '64 Mustang
lost out to a Z28.
Good vitals, unknown LOC,
chest abrasion
with closed fracture
of the humerus.
The classic people
always challenge.
WEAVER:
We'll get a C-spine
in CT, but he needs a chest
and AP pelvis.
That's going to
take a while.
They're slammed.
Okay, if CT opens first,
we'll have to send him there.
You want to go
when he does?
No, I can't.
I'm the only attending
and Pratt's the senior
on the floor.
Abby, you go.
It's my fault.
They're young.
They're allowed to be stupid...
No one's allowed to be
that stupid, Mr. Vangoss.
I got bone sticking out
of my legs!
Six Flags only better.
Cranial nerves grossly intact.
I've been here
six hours!
MORRIS:
Somebody needs
to shut him up.
Oh, my God!
...cleared.
Harlin was always
like a total G force, you know?
Good breath sounds.
Hey, where's Janie?
Yeah, you're just now asking?
The belly's tender.
I don't want to
inconvenience anybody.
Take the rectal.
What?
Needs someone to find out
about his girlfriend,
doesn't he?
You're going up my butt?
Just one finger.
PRATT:
Multiple lac
scalp and occiput.
MORRIS:
Hey, Pratt, your
guy in Sutures
is having a meltdown.
Later. Looks like
a skull fracture
with a step off.
Sats are down to 90.
Threatening to sue
everybody and their brother,
but mostly you.
MALIK:
Whoa, she's
blowing some teeth.
Oh, wow. Hey,
where the hell
you're going?
Bathroom.
( alarm beeping )
Sats 88... 86...
Okay.
All right,
after I secure the airway,
chest tube
and subclavian on the right.
Dr. Pratt, Psych won't see
your aphasia patient
unless you clear
a head CT first.
The guy's freaking out
'cause his wife's leaving.
He doesn't need a damn head CT.
Okay, give me the tube.
Okay.
Pulse is down to 65.
You better kick it.
JERRY:
Pratt, Hampton
called from GI.
She's not going
to see the quarter kid
till morning, but she plans
on seeing Romano first.
I'm in. Is that all she said?
No, actually. She said
you're an asshole, too.
Good night.
Wow. If it's 1:00 in the
morning, I guess it's lunchtime.
You got to try this.
Mm, sure. What is it?
Dinuguan.
Oh, yeah?
What's that?
Cooked pork blood.
Did I ever mention
I was half Jewish?
( "I Love the Nightlife"
blaring from stereo )
Hey, Randi, I'm still waiting
on Ortho
for my open fracture guy.
As soon as they call, you
make sure you tell them...
They called. They said
that you should irrigate him
because they're kind of busy
right now.
Nice.
Neela, find Morris and
have him supervise you
on doing a poor man's
washout on Mr. Mathers.
Any idea where he is?
No, but that's an MSP--
med student problem.
I love being an R2.
So, what do you think?
I think it's little loud.
Well, if I have to
stay up these hours,
so does everybody else.
No. He hasn't gone
to radiology yet.
That's the problem.
High-speed MVA, blunt trauma.
He really needs a belly CT.
Can't you just sneak us in?
Thank you.
Okay, Mr. Vangoss,
we're going up to the CT room.
I was 17
when that song first came out.
You probably weren't
even born yet.
Oh, I was around.
Hi.
Hi.
DORSET:
Elizabeth, hold the door.
Oh, oh. We're
full, I'm afraid.
Oh.
Well, I'll catch the next one.
He's cute.
Did you guys ever
get together?
Who?
Dorset.
Didn't he ask you
out or something?
Uh, I suppose you could say
we're... dating.
Really?
What?
What?
What? You think
it's too soon?
I didn't say that.
I think it's too soon.
I... I... I just
said he was cute.
Yeah.
Too soon.
( groaning )
You're not too good
at this, are you?
It should start
to feel numb soon.
What the hell
is that stuff?
Sterile saline--
washes the germs out.
And you're just now
getting around to this?
We thought you'd be
in the OR by now,
but this will buy us
an extra hour or two.
Before what?
WEAVER:
What do you think
you're doing?
Temporary washout.
WEAVER:
Which is not
a procedure
a med student performs
without resident supervision.
Oh, great, she's
not even a doctor?
Stop what you're doing
and tell me who the resident is
on this case.
Dr. Pratt, but he asked
Dr. Morris
to supervise on his behalf.
So where's Dr. Morris?
I'm surrounded by incompetents.
MATHERS:
Hey! Hey, how do
you think I feel?
This one's
been trying
to kill me all night.
Oh, my God.
( Bob Marley's "Jammin'" plays )
No mass, no hemorrhage,
normal ventricles, no shift.
So he's clear?
Crystal.
Hey, Mr. Gamble.
Your head CT looks good.
Everything's fine.
So what do I do now?
Well, I've arranged
for you to speak
with one of our
mental health
specialists.
I'm not crazy.
No, you're not.
You're just
stressed and...
Then give me something for that,
but don't send me to a shrink.
God, the last thing
I need is
for Gloria to have proof
I'm nuts.
Pratt, dislocated
patella.
COPD exacerbation.
I and D
on a pilonidal cyst.
And don't pass these off
on that idiot Morris.
Look, I know you think
I'm a wuss...
Mr. Gamble, I
don't have time...
Just give me something
to get me through the night.
Hey, I want you to give Ed here
two milligrams of obecalp IV
and discharge him.
Obecalp?
You know what Obecalp is?
Yes, Doctor.
Thank you.
Thank you very much.
Yeah. Whatever
works, right?
Yeah.
Erica?
What does DNR mean?
It stands
for Do Not Resuscitate,
which means...
someone doesn't want
to be kept alive by machines
if they should get very sick.
Let's get you back
to the other room
where you can rest.
Can I stay here?
She says she sleeps better
with me.
Sure.
Good night.
Night.
I'm glad you have time
for a Kodak moment.
I know I sure
as hell don't.
We still got 20
on the board
and 35 in Triage.
Sorry. She's by herself here.
It's hard, isn't it?
Learning where your
time is best spent,
whether it's with the
patient or their family.
Well, you know,
that's really rough.
Now if you're done
playing house,
do an I and D
on Mr. Brier's pilonidal cyst.
Hey, hey.
He's tough, but he's got
the goods, you know?
Yeah.
Yeah. Hey, have you ever
heard of Obecalp?
Because I can't find it
in the PDR.
It's "placebo"
spelled backwards.
Oh.
Who's prescribing it?
Um...
Dr. Pratt.
WEAVER:
Obecalp?
Look, the guy's
playing games
with his wife.
He gets panicky
whenever I
mention Psych,
and he begs me to
give to him something
to calm his nerves.
So I give him saline.
And it looks like
he feels a lot better.
No harm, no fowl.
Do you ever hear
of truth-telling?
Deceptive practices?
Yeah, but he...
Not only have
you breached
every principle
of medical ethics,
you've also opened us
up to a lawsuit
if this patient finds
out what you did.
MALIK:
Dr. Weaver, your MVA guy
is crashing in CT.
Damn it.
Hey, Severa, I guess
you better pull the plug
on Mr. Gamble's Obecalp.
I never gave it to him.
MAN:
Doctor,
how long before my son
is taken care of?
Your son...
Damian-- the quarter?
Oh, right, right.
Um, well, it looks
like the, uh...
the GI doctor
who performs the procedure
won't be able to see him
till the morning.
Oh.
When in the
morning?
I'm not sure, but he's stable
and I don't see a problem.
We've been here for 14 hours.
No one's done a damn thing.
Damian's scared
to death.
She needs to get
to bed. We all do.
Look, I know it's hard...
This is an emergency
room, right?
There's a quarter
in my son's throat.
He can't breathe.
Now, that's an
emergency, isn't it?
( alarms blaring )
What happened?
He got altered,
and his sats drifted down.
Did you finish the scan?
No.
How long has
he been down?
Under five minutes.
Let's tube him.
Pulmonary edema?
More than likely.
Okay, stop
compressions.
Still no pulse.
Never, never send an even
slightly unstable patient
to CT without a doctor.
You told me to bring him...
I'm talking to me.
I'm in.
You coming?
Pratt's trying the
old Foley trick.
What?
Yeah, that's
what's so cool.
Okay, Foley and a two mac blade.
All right, sats
is 96, BP steady.
Mm-hmm.
All right, come on.
Okay, so now,
what we want to do is
put this tube
just past the quarter.
And once
we do that,
we're going to blow up
the little balloon
with saline,
and hopefully pull the quarter
back into his mouth.
Couldn't he aspirate the quarter
into his lungs?
Not if I grab it first.
Now, here's the
tricky part.
Okay.
And...
presto.
( laughs )
Dr. Pratt.
( laughs )
Here. One for
the piggy bank.
( laughs )
( speaking Tagalog )
DUVATA:
Oh, Abby,
you're back.
Can you cover
for Melinda in Triage?
Sure.
Love to. Triage
is my personal favorite.
Thanks for asking.
Hey, where's Weaver?
Bars are closing.
We're gonna get slammed.
She's still in CT, which
means the R2s are in charge,
and that scares me.
You and me, man.
All right, let's get
the party started.
( loud music playing )
You! Come on.
Come show me some love.
Come here.
Please tell me
it's not just 3:00.
Shut the hell up!
How's anybody supposed
to sleep around here?!
MALIK:
Yo, Abby.
Any time now.
Okay, where
are we at?
Now serving #47.
This is Jay-Jay.
He has a toothache.
Thank you.
Hey, Jay-Jay, how you feeling?
Tooth hurts.
Uh, when did you
first notice it?
About a year ago.
Excuse me.
Yep, have a seat.
I'll be right with you.
No, we've already
been seen.
My son was feeling
a little queasy
in the parking lot.
It might just be
the anesthesia,
but could you get
Dr. Pratt to maybe...
Oh, my God.
Pratt!
Pratt!
Damian...
Here, help me
lie him down...
What did he
come in for?
He swallowed a quarter.
Blood looks arterial.
Page surgery
and vascular.
Aorto-esophageal
fistula?
Pratt, I need you
at Curtain One.
Not now. Get a gurney.
What's going on?
Probable aorto-
esophageal fistula
after a foreign body
removal in the ER.
You did endoscopy?
I used a foley.
Are you out
of your mind?
It worked fine. The quarter
he swallowed must've been
in there too long.
Ten minutes after he was
discharged, this happens.
All right,
we'll take it from here.
Tran-esophogeal erosion needs
immediate aortic repair.
Apparently, not all
ER residents can
walk on water.
You know, you're
lucky this happened
while they were
still here.
Otherwise this boy
would be dead.
Add five of Peep
once he's on a vent.
Andy, what did the NG
aspirate show on Maloney?
Uh, let me find out.
Pratt!
Lungs clear.
Let's get some 02
and check a D-stick.
Watch it.
Syncopal episode?
Only groans with a sternal rub.
We were getting
ready to go
and then he sort
of slumped to the floor.
All right, let's
get him on the bed.
One, two, three, up.
All right, put him
on the monitor,
and get me some vitals.
I'm on it.
I thought
he was kidding...
Pupils asymmetric,
mild ptosis.
He was fine other
than being a nut case.
Young, healthy guy
with transient loss of speech.
SonoSite.
A negative CT.
Turn that damn music off.
Listen, man, I got this.
It's okay.
Any risk factors
for stroke?
No. Decreased tone
on the right.
Oh, my God,
he had a stroke?
Call CT.
Have them clear a room.
Uh, I think I have
something here.
This is my patient,
all right?
Might be
a carotid dissection.
Let me see that.
Tapering occlusion
of the left carotid.
What is that?
Your husband has a tear
in one of his main arteries
which caused a clot.
Dr. Pratt, your open-
fracture patient demands
to be euthanized.
Mr. Mathers
is still here?
Go. I got your
back on this.
Get consent for TPA.
.9 migs per kig.
Okay.
That enough of Triage.
Let it be someone else's turn
for a change.
( speaking Tagalog )
And I know
you're talking about me.
Hey, Abby,
is Exam Two open?
I'm on a break.
Hi, uh, I'd like to find out
if I qualify for a cash advance.
Uh, uh, sorry,
I have to go.
Neela.
Yes?
Grandma's dead.
The little girl's sleeping.
We need the bed.
Hey, how you doing?
Sleepy.
Morphine's kicked in.
That and it's 4:30
in the morning.
Am I gonna lose this thing
or what?
My leg.
No.
'Cause I'm...
not the kind of guy
who could get along without it.
I work for a living, you know.
Look, I know
I've said it before,
but we're gonna get you
in the OR real soon.
That's what I hear...
Get Coop to cover for me,
would you?
Where do you think
you're going?
To take care of something
that should've been done
eight hours ago.
Starts screaming bloody murder,
right in the middle
of the course.
Makes you wonder
what he would've done
if he were four over par.
Hey, how you guys doing?
Dr. Pratt from the ER.
Size eight-and-a-half gloves,
please.
What do you think
you're doing?
I'm here to hold
your retractors.
Reamer to me. Drill
for the cup screws.
Been calling you guys for hours
on that open tibia fracture.
Well, now that I'm here to help,
you can free somebody up
for the consult.
Just show me where to pull.
Shh, it's all right...
( baby crying )
( baby crying )
Hello?
Hi.
Is Richard here?
Honey,
your ex-wife is here.
How old now?
14 months.
( toys clatter )
( baby screaming )
What do you want?
I need a favor.
Abby, it's 8:00
in the morning.
Yeah, I know. I don't
have a lot of time.
I need you
to co-sign a loan.
Why don't you
just declare bankruptcy?
Look, I'm not in trouble,
okay?
I just need you...
Want me to support you?
No.
I never asked for alimony.
I didn't contest
anything in court.
I didn't even take
the damn furniture.
You could have if you wanted to.
Look, you must know
how much I hate doing this.
I wouldn't do it unless
it was absolutely necessary.
I don't want your money,
I just want your signature.
Oh, good morning.
Yeah, hi.
Yeah, I just got in
and already I've heard
from the Ortho, Psych,
and GI departments,
not to mention
our own Dr. Weaver
about your medical
hijinks last night.
The carotid clot
was a total zebra;
Ortho was taking
their time;
and Hampton refused
to get her lazy ass
down here for a...
You are a screwup,
Pratt.
And just to be clear,
I didn't like you
before I knew that.
Mmm, Kenyan roast.
Can't beat it
for flavor or punch.
Triple espresso,
yes, I can.
Hey, your septic pancreatitis
is still waiting on an ICU bed.
Thanks.
How'd it go?
Good.
Hey.
Hey.
How's the quarter kid?
Corday says
he's gonna be fine.
Hey, Coop, I heard
you caught
a carotid
dissection. Nice.
Thanks, man.
Did a rotation with
the stroke team in June.
Anybody could've missed it.
Yeah, well, started Mr. Gamble
on anticoagulants,
tear should heal on its own.
And he keeps talking.
You headed home?
Yeah, why? You're not?
I'm going to hit
the gym first.
Hey, Coop.
Thanks, man.
Yeah, sure.
Anything for a buddy.