ER (1994–2009): Season 11, Episode 8 - Shot in the Dark - full transcript

Previously on ER:

Look, Luka...

I'm glad we're friends.

But I've got a dad.

Fingernails,
tattoo, the hair?

It's the whole package.
Well, I'll talk
to my band mates

and see if I can't
pull it back a little.

You off?
Yeah.

If you wait for a second,
I'll walk out with you.

Okay.

Damn it!



( speaking Chinese )

Son of a bitch!

He should be in a nursing home.

I'd never do that to him.

You can stay here for tonight.
Plenty of room.

Actually, you can stay
as long as you'd like.

( shower running )

KOVAC:
Hey.

SAM:
Hey. How was your night?

The usual.

Anything good?

Uh, guy got his arm caught
in a sausage-making machine.

( chuckling )

Nice.



I'm not on until 9:00.

I can drop Alex
off at school,

but can you pick
him up at 3:00?

Sure. After I get
some sleep.

Morning.

( yawns )

Mom, I need ten bucks
for the class field trip
to Millennium Park.

Okay.

They've got
a giant silver sculpture

shaped like a bean.

If I don't get the
money in today,

I have to stay behind
and do homework with
the fifth graders.

Okay, okay.

What, you've never
seen a kid pee before?

This is gonna bounce.

Whoa. That's a lot of zeros.

Tuition was expensive.

No wonder you're
still sleeping
on Abby's sofa.

You know, you can defer
paying off your loans

until after you
finish residency.

Not this one.
This is for my father.

What? Your dad's
leaning on you?

It's for my brother's
university tuition.

My parents put me
through school,

so now it's my turn to help.

They can't wait until
after residency,

when you're making
the real money?

Is there something
you need, Ray?

How would you like
to work Christmas for me?

I'm already
working New Year's.

Look, you do Christmas,

and I'll take
your New Year's Eve.

You'd work
New Year's Eve?
It's important for my mom

to have us all together
on Christmas.

Come on, I'll take
Ramadan for you.

I'm not Muslim, I'm Sikh.

Oh, great.
Well, I'll cover

whenever you want
to take a Sikh day.

Oh, this is unbelievable.

What? Weaver's got
a boyfriend?

Only 39%
of the staff

has had a flu shot
this year.

I don't want massive
absenteeism in January.

I had mine.
I'll get one today.

How 'bout you, Ray?
Uh, tomorrow.

My band's gotta play
at Delilah's tonight.

Can't have a sore arm.
Sore arm?

How about 100% compliance
by next week?

You have had some lame excuses
for the past two months.

What are you
talking about?
First you had a cold.

Oh, yeah, then you
were sleep-deprived.

Police officer got shot.
ETA: two minutes.

Where's the wound?
I couldn't understand them.

The sirens were too loud.
All right, let's
clear Trauma One.

Neela, Ray, Chuny,
you're with me.

Call upstairs to
the OR and RT.

Mary, get some extra
security down here

to handle the press.

Do me a favor.
Give me a flu shot today.

What?

Yeah, get me when
I'm not expecting it.

Just stick me quick.

I got a thing about needles.

NEELA:
Paramedics probably
have two IVs.

You can go femoral,
if we need it.

( tires screeching )

( brakes squeal )

Eddie Escobar,
caught one in the neck.

Lost a lot of blood.
This is a "throw and go"?

We were ten blocks away.
!
I'm Dr. Lewis.

You're at County General.

You should have called
the paramedics.

We'd still be waiting
on the street.

C-collar.
Board's ready.

One, two, three.

We're going to give you
oxygen through your nose,

okay, Eddie?
Thank you.

Pulse is thready.

Take my keys, Gary.

It's okay, Eddie.
Try not to move.

Someone needs to feed my dogs.

Have an intubation tray ready.

And there's a filing cabinet

in the bedroom
with all my papers.

Yeah, forget
about that.

You're gonna be okay.
Tell him, Doc.

Trauma panel, type and cross
for six units,

call X ray, get
a portable neck and chest.

I threw up all
over Amy's collage.

It was so embarrassing.

Oh, that's okay.

We see like
100 puking kids a day.

Really?

Mm-hmm.

Mom's here.
This is Dr. Lockhart.

Hi.
School nurse
called my office.

Uh, yeah, they sent her in
for vomiting and fever.

Is she okay?

Well, seems like
it's just the flu.

Are you okay, honey?

I should take her
to see our doctor.

Well, she's here now.
Why don't you...?

I see how busy you are.

Well, it's not that...

You want to go
see Dr. Ben?

( stammers )

Look, it's probably just

the stomach flu.
Let us run a few tests,

we'll give her some IV fluid,
she'll be good as new.

How long's that
going to take?
About an hour.

Can we move her
to a real room?

I'll work on it.

Oh, hey, Sam,
this little girl
needs a line

and Tigan.

You'll have to ask Malik.

Excuse me! Excuse me.

Excuse me!
Sub-Q air, but otherwise okay.

Come on. Excuse me!
Two units oh neg.

Looks like the bullet
missed your spinal cord.

That's good, buddy.
Excuse me.

That's good news.
Sats aren't so hot.

LEWIS:
He needs plastic.

RAY:
Yeah, I'm all over it.

LEWIS:
Eddie, we're gonna stick
a tube down your throat

to give you more oxygen.

Whatever you say, Doc.

You're gonna go
to sleep first.

20 of Etomidate, 800 of SUX.

Everyone else okay?

We're all good, Eddie.

You get the perp?

Couple of double taps
to the chest. He went down.

Go for it, Ray.

SAM:
What happened?

McWAYNE:
Convenience store holdup.

Chased the guy into
an apartment building.

Called for backup,

the scumbag starts shooting

out the window.

All right, there's
too much blood.

SAM:
Pulse ox only 72.

LEWIS:
Okay, pull out
and bag him up.

You want me to do it?

RAY:
No, no, no, I got it.
Give me a straight blade.

You cut yourself.

No, that's...

It's nothing.
We should take care of it.

No, really, it's okay.

One more shot, Ray.

Ray?

Just... give me
some cricoid pressure.

I can get this.

I still can't see the cords.

Okay, that's it.
You want me to try?

How 'bout you try?

RAY:
Crike tray.

Yeah?

Yes. Betadine.

11 blade.
No, Sam, third drawer
of the crash cart.

Get the trake light.

The what?

You going fiber optic?

Not exactly.

Got it.
Where's the scope?

It's a blind procedure.

Great. Who's in charge
of this ER?
That would be me.

You can stay here, sir,
but you have to be quiet.

Okay...

Bend the tip to 90 degrees.

Turn the lights off.

Pass in the midline,
with the jaw forward.

Sats are dropping. Shouldn't
we be prepping the neck?

When you're through
the cords, you'll see
a pre-tracheal glow.

He needs a crike.

That's the glow.
You won't see it

if you're in the esophagus.

Okay, that's it.

Bag him. Turn the lights on.

Very slick.

How about a subclavian?

Okay. Good breath sounds.

Number six gloves,
Dr. Barnett?

Seven and a half.

Sterile drape and
finder needle, please.

OFFICER:
I've got Mallory.

This is Eddie's fiancee.

LEWIS:
Okay.

( sobbing ):
Oh, my God, Eddie...

I'm Dr. Lewis.
He's doing okay.

He was shot?

Once.

In the neck.

He's sedated
with medication,

but you can sit with him,
hold his hand if you want.

I was playing around
with my nephew.

We were wrestling.

Looks like he kicked your butt.
Is the rib sore?

Right there, yeah.

Okay, Mr. Sakabu, I think
it's nothing but a bruise.

What about my shoulder?

( sighs )

Any pain when I press?

It's more on the inside.

It's probably
just a strain.

I'll have the nurse bring
your discharge instructions.

Hey, hey, hey, I didn't know
you were in today.

Oh, my stupid alarm
didn't go off.

Rough night, huh?

Yeah.

You okay?

Uh-huh.

Okay, got a quick one for you,
ready for discharge.

Uh... give me a couple
of minutes, okay?

Good news. Labs are fine.
White count's not elevated...

So, we can go.

Mom...

( sobbing ):
Mom.

Are you all right, honey?

What's wrong?

It hurts now.

Where does it hurt?

Right here!

Here?

Ow!

So, tell me, does it hurt more
when I take my hand away?

Ow.
Listen, I'm going
to get you

some medicine for
that pain, okay?

I need to run
some more tests.

Start with four of MS.

Thanks.

I thought she'd
be better by now.

Well, sometimes
what starts out

looking like stomach flu

ends up to be
something else.

Like what?
Appendicitis.

You said it
wasn't serious.
Well, it may not be.

I'd just like to have a surgeon
take a look at it...

You think she needs
an operation?
It's a possibility.

Oh, God. No.

No, she's not having
surgery, not here.

If she does need it,
it's a very simple operation.

I need to talk
to my husband.
Okay, there's time.

I need to do
another blood test,
possibly do an X ray...

You can't do surgery without
my permission, right?

Right.

One step at a time, okay?

You call your husband;
I'll get things started.

Excuse me.

Hey, Ray.
Is Carter in there?

No, just Lewis.

How's the cop?

Stable for now.
What's in your hand?

A chart.
Okay, the other hand.

A pen. I didn't say
I'd do it.

Hey, anybody seen Dr. Chen?

Sorry.

Do you have any plans
for New Year's Eve?

You're not really my type.

Funny.

My band's got
a party gig.

Can you take
the p.m. for me?

On New Year's Eve?

Well, look at it this way:

You won't have to go to
a square dance by yourself.

Or with a date,
or whatever.

You give my med student
lecture for me in January.

Deal.

Suspect's been
wounded and
apprehended.

Do we have an ETA?

No, I'm sorry.
They haven't
called it in yet.

We'll be with the family.

Okay.

Ten-year-old girl,
fever, vomiting,

right lower quadrant
tenderness.

Rule out appy.

Yeah, CT
or ultrasound?

It depends.

What the hell was that?

What?

PRATT:
Jing Mei...

Hmm.

Oh, sorry.

Coffee was brewing.

You okay to work?

Uh... uh-huh, yeah, sure.

What have you got?

35-year-old,
strain and sprain.

Chest and shoulder
contusion.

Okay...

You don't want to
see the patient?

No, I trust you.

How's your dad doing?

( sighs )

Okay.

I mean, I've got a nurse
for him 16 hours a day,

and then from 11:00 to
7:00, it's just me.

So, you're not
getting much sleep?

No, a couple hours.

Hey, Dr. Chen,
Carter's got a baby in status.

Need you for that suspect
in that cop shooting.

How soon?
Right now.

( sighs )

Multiple gunshots to
the chest and abdomen.

Any vitals?
No pulse
in the field.

That's the son
of a bitch.
How long was he down?

Cops had to secure the building.

How long did
that take?
They made us wait 45 minutes.

It only takes 20
minutes to bleed out.
If there'd have been

a second shooter in
there, she'd be full
of holes, too, okay?

Prep two of O-neg
on the infuser.

NEELA:
On my count. One, two...

Hold on. Hold on.
He's cuffed.

Who's got the key?
!
Not me. You got
the keys, Tommy?

I'll check with Hogan.
Quickly, please.

Start on the paramedic gurney.

Betadine, 32 french.

Thoracotomy's
all yours, Neela.

You're going to assist?
!
You'll be fine.

Sterile gloves and a 10 blade.

MALIK:
First unit's up.

I need to lift up his arm

to make the incision.
!
Excuse me.

Where's the damn key?
We're working on it.

Malik, get the
bolt cutters.
Take it easy.

I've got it.
Can the officers
wait outside?

The suspect's in police
custody and uncuffed.
We're waiting right here.

I don't think he's
going to jump off
the bed anytime soon.

Hook up the thoraseal.
Give her room to work.

You think he's
got a chance?

Why do you think they're
letting me crack his chest?

That thing's got
to wait outside.

That "thing"
is a service animal.

A service animal
with fleas.

Actually, fleas have
a natural aversion to minis.

Hey, Abby, Dilantin
level's back on...

Carter, this is Mrs. Gelden
and her guide horse, Ruby.

Who should be outside.

We let seeing-eye
dogs in here.

Our floors
are gonna be

covered with
horse crap.

She's housebroken.

What if she spooks?

Oh, we've been
on the El,

airplanes, elevators.

She can stay.

Thank you.

See you later, Ruby.

Dr. Carter, Officer
Escobar's son is here.

Okay, we're-we're still working
on his dad.

The kid's anxious to see him.

Let me... let me
go check for you.

Thanks.

No, we're too close
to the skull.

Can you stop
the bleeding?

Direct pressure for now.

Got it.
Call Angio.

Maybe we can balloon
the proximal carotid.

They just picked up
his son at school.

Arlo's here?

How old is your son?

15. I'm not his mother.

Arlo's from Eddie's
first marriage.

Fine. Throw down
a fresh drape.

I'll be next door.

RAY:
CVC's in.
Need a repeat chest.

Hey, Arlo.

It's not as bad
as it looks.

It's okay.
You can come on up here.

What is she
doing here?

I want her out
right now.
Mom...

Uh, excuse me, ma'am.

Let's not get
into this.

ARLO:
Mom, come on.

You shouldn't
be here.

Mom! Mom!
Get out!

Can you just
shut up!

Okay, everybody shut up.

Officer, you and Mallory
need to step outside.

I don't want
to leave him.

Everyone gets to see him,

just one at a time.

Come on.

LEWIS:
We're going to start
X rays on your father.

You can say
hello quickly.

Dad.

It's Arlo.

I'm here.

He can't talk
with the tube in his mouth.

You're going to
be all right.

LEWIS:
Ray, take them
to the family room.

RAY:
Me?

You're tough, Dad.

All right, honey.
That's enough.

Dr. Barnett will answer
any questions you have.

Okay, right
this way, guys.

LEWIS:
Sam, check
a second hemocue.

I think it's next door.
!
Yes.

You got a rhythm?

Units five and six are up.

Hold compressions.

Asystole.

How's his volume?

Heart's filling well.

Too many holes.

We could try high-dose epi.

CARTER:
Penetrating trauma

with no pulse
in the field.

Okay.

11:07.

He's dead?

Yeah.

You just saved the taxpayers
a million bucks

in trial fees and prison costs.

What happened
to your wrist?

Oh. I don't know.

Neela, do you want to help
Officer McWayne out here?

I was gonna
find some family...

Why don't you get
Officer McWayne started

in the suture room?

Sorry about
the misunderstanding.

Some people are freaked out
by little animals.

I'm going to clean
your cut out.

I have a cousin
who gets nervous

around Chihuahuas.

Is she wearing sneakers?

Yes. It keeps her
from slipping on the floor.

My husband wants her
transferred to Mercy.

Surgery's on their way
down to check her out.

We want to move her.

You're gonna have
to find a surgeon at Mercy

to accept her before
I can okay a transfer.

Whoa, whoa!

Hey! Hey!
Back off, Ruby.

Doctor, can you
come to the phone?

Yes. Just one minute, okay?

I'll be right back.

Re-prep the wound
and tie up the horse.

It's my husband. He's driving
back from Detroit.

Okay. Hi.
This is Dr. Lockhart...

Yes, I am.

( loud screaming )

Mr. Trager...

M-Mr. Trager.

I-I understand.

We will.

Yes, your wife is working
on that right now.

We-We would never do that, sir.

I got paged about
a patient transfer?

Wendall Meade,
Social Services.

Okay, well, why...
Thank God
you're here.

Sir, why don't you just
get here as soon as you can

and we won't make
any decisions...

( dial tone )

Nice talking to you, too.

Little pinprick...
and some burning.

( groans )

Sorry.

Ow...

Must be a pain
in the ass

having to waste
all that time

trying to save
a scumbag's life.

He jacked
a mini-mart, doc.

Looks like a 14-year-old.

Feels like a foreign body.

Something hard.

Is it possible
you were shot?

I don't think so.

I remember I scraped
my wrist when I fell.

How about there?

Mm-mm. That's
a loop of bowel.

I left messages for
three surgeons at Mercy.

They'll call back.

How long can we wait?

ABBY:
Eight to ten hours.

Hmm. I can't find
the appendix.

What does that mean?

Uh, usually if it's enlarged,
it's easy to find.

So she may not
have appendicitis?

Well, it's not
a perfect test.

She could still
have the disease

even if the ultrasound
is normal.

Can't you people give
me a straight answer?

I would say,
based on her fever
and tenderness

that it is
appendicitis.

Well, she said it
was the stomach flu,

and then she
changed her mind.

Now you can't
find her appendix?

Transfer Center
from Mercy

wants to talk
to the attending.

Finally.

Hang a gram
of cefotetan.

Do you think
I need an operation?

Do I need it soon?

Yup.

Can I have it here?

Well, you could,

but your parents
want you to have it

at a different hospital.

Won't that take a while?

Not too long.
It'll be okay.

Why can't I decide?

Because when you're a kid,

your parents get to decide
what's best.

The only way to stop
the bleeding right now

is by blowing up
a balloon in
his artery.

This X ray is
gonna guide us
to the right spot.

How does he get blood
to his brain?

Dr. Lewis?

That's a good
question, Arlo.

Two carotid arteries
supply the brain,

right and left. Okay?

If one gets blocked,
Mother Nature has a backup plan.

It is called the
circle of Willis.

It's a detour,

but it allows the
blood from the right

to get over to
the lefthand side.

I understand.

So, he can recover?

Well, priority number one
is to stop the bleeding.

If you're not wearing lead,
we need to ask you to leave.

Okay I'll come get you
when we're done, all right?

Thanks, Dr. Barnett.

Ray is fine.

Okay, Ray.

FRANK:
Sam,

Dr. Kovac called.

Did you take
a message?

Sounds like your kid got
suspended from school again.

I may need
to leave.

In a minute.

Dr. Lewis...

Have them
step outside.

I removed a foreign body
from Officer McWayne's arm.

What's that?

Feels like a plastic BB.

Could be what shot
your patient, as well.

I don't think that's
enough to sever a
carotid artery.

You sure?

Officer Escobar
was shot with
this metal slug

from the sub-Q, right
upper trapezius.

Looks like
a nine-millimeter.

Is that what the
suspect used?

I don't think so.

Nine-millimeter
semi-automatic,

standard issue.
That's what we carry.

KOVAC:
I can pick him up. It's not a
problem. Stay at work.

SAM:
Well, what is it about?

I don't know. The school
didn't tell me anything.

What do you mean
they didn't tell you?

What did he do?

They just said, uh,
to come in for a meeting.

Well, is he okay?

Yeah, yeah, he's fine.
He's fine.

All right. Well, just call me
as soon as you get back.

I will.

Okay. Thanks.
I have a tetanus shot
for Officer McWayne.

Oh, uh, they're
being interviewed

about the friendly
fire thing.

Is it for sure now?

Well, they found
a pellet gun

next to the suspect
at the scene.

So he didn't shoot the cop then?

Guess not.

Arlo, you should be
in the Family Room.

Is that the guy
who shot my dad?

He was the suspect
they were pursuing.

Can I go in there?

Probably not a good idea.

I want to see him.

Arlo...

He's a kid.

You don't have
to do this.

Was he on drugs?

I can't say.

Did he have a police record?

I don't know.

Why would he do that?

Why would he shoot my dad?

Arlo, we're not exactly
sure who shot your dad.

He may have been accidentally
shot by a police officer.

What?

But-But I thought he...

This guy was only
carrying a BB gun.

They won't
know for sure

until the ballistics
tests are completed.

Oh, man.

One of his own guys?

McWAYNE:
Arlo?

Can we talk to you?

Which one of you guys did it?

We don't know
anything yet.

Why don't we go and
sit down somewhere?

We're sorry.
It's not
your fault.

It comes with the job.

There, our balloon is up,
and the vessel is occluded.

Can we ask family in?

Not just yet.

Entrance wound is dry
as a bone.

Nice.

He's not
waking up.

He's still comatose
with a flaccid paralysis

and an upgoing toe.

LEWIS:
So much for collateral flow.

But you can repair
the carotid.

DUBENKO:
Oh, it'd likely
do more harm

than good. It's not a procedure
that I'm comfortable with.

But if the wife consents...

Uh, it's his fiancée.

It's not her call then.

We have an ex-wife.

Is there a blood relative?

Yeah, a son, but he's 15.

Could he be a mature minor?

A what?

It's when a kid's mature enough
to make medical decisions.

LEWIS:
Could be.

Okay. I'll talk to him.

LEWIS:
Get Wendall in

on this, and, uh, find me
if you need me, okay?

Okay.

Dr. Dubenko, need
you right now.

Uh, keep his crit above 30,
P02 90.

Ten-year-old appy,
systolic's 60.

She's septic?

Antibiotics
are on board.

We're running
in a liter.

Who saw her from surgery?

No one. Family wants her
transferred.

That isn't
happening.

Dr. Hong
at Mercy accepted her.

Pressure's up
to 70 with 500.

They're sending
an ambulance.

I'm sorry, ma'am.
Your daughter is very sick.

She needs surgery right now.
Do we have consent?

No. She said
we could wait.

In most cases
we could.

This is unusual.

The infection spread
to her bloodstream

very quickly.
I'm sorry, Mrs. Trager.

We need your consent
for surgery.

My husband will be here
any minute.

We don't
have time.
I need to wait for him.

It's life-threatening.

Okay. We'll "double doctor" it.

Wha... What?

Two physician signatures
can override your consent.

Well...

Sign it.
Sign it. Let's go.

This is not
what we agreed on.

I'm sorry.

I've never done
this before.

No one gets in trouble

for acting in the best interest
of the patient.

Tell that to
Dr. Corday.

...treating your...

Sorry, I was tied up.

Everyone,
this is Wendall Meade.

Hi, Arlo.
C-Can he stay?

If it's okay with Arlo.

Yeah?

Okay. So, the two treatment
options.

We can use a catheter

to plug up the artery
with coils.

Like with the balloon?

Yeah, and that
would give him a 15% chance

of getting better.

85% chance of still staying
in a coma.

Or we can do surgery
to reconnect the artery.

If we do that, that would give
him 30% chance of improving.

That's a
little better.

Yeah, well, it's risky.

Usually with surgery, half the
time the patient deteriorates

or dies.

The surgery sounds too risky.

WENDALL:
Do you understand
the choices, Arlo?

They both kind of suck.

Can you explain them
back to me?

What?

I need to make sure that he
understands the options.

I'll make sure he does.

Arlo?

Well, if we play it safe,

there's a small chance
he gets better.

If we do the surgery,

there's a bigger chance
that he'll improve,

but an even bigger risk
that he'll get sicker.

That's right.

It's your call.

What are you
talking about?

We've decided
that Arlo's a mature minor.

He can make the decision.

BENITA:
By himself?
He can't

handle this.
Yes, I can.

No, you can't.

You're 15 years old.
He's my dad.

In cases like this,
the decision has to be made

by a blood relative.
It's the law.

How can this be right?

Between you and me,
it's not the end of the world,

but the school board
has a zero tolerance approach

to what they consider
pornographic.

What?!

He brought this to school.

He was showing it
to the other kids.

That might not
be appropriate.

They have lots of cool
electronic gadgets in here.

I don't think they were looking
at the gadgets.

That your name
on the mailing label?

Yeah.

And you're
Alex's stepfather?

Not exactly.

I see.

But you take an active role
in the child-rearing.

Yeah, I pick him up from school,
and we, uh, do sports.

I took him fishing...

That's great.

Alex and his mom, we'll
been all living together.

It's going well.

And how long has that
been the arrangement?

About a week.

Ray, do-do-do-do you
have a minute?

Hey. Hot chocolate?
It's my treat.

I'm really sorry
about my mom.

Look, she's just
looking out for you, okay?

By freaking out?!

My dad's lucky that she won't
even talk to him anymore.

You okay with
what we talked about?

About your dad.

Last year, for the
ninth grade prom,

there was this girl Sarah.

Yeah?

I was too afraid
to ask her.

But my dad told me that
you gotta take chances,
or you miss out.

She was already going
with this guy from
the baseball team.

Two weeks later, she
asked me to go to a
concert on the pier.

Sounds like your dad's
a pretty cool guy.

He'd want the surgery.

Okay, then
that's what we'll do.

But my mom's gonna
freak out...

It's your decision.

And I'll back you up.

You will?

Sure thing.

Abdominal pain
and near-syncope
from hypotension.

He was here this morning.
Dr. Pratt's patient.

Marina, find Pratt and
grab the ultrasound.

He thought it was a bruise.

When did you get dizzy?

A few hours ago.

Why didn't you come back?

Doctor said
it wasn't serious.

Pressure's only 80 palp.

Trendelenberg,
a liter of saline.

CBC, type and
cross for 4.

Sir, where
does it hurt?

Sonosite.
What's up?

You sent home
an unstable patient.

Damn. He lacerated
his spleen.

Call surgery.

Dr. Pratt...

I signed off
on this guy.

Hey, he was just rolling
around with his nephew.

You didn't
mention belly pain.

He didn't have any.

Did you even
check a crit?

It would've been normal.

His shoulder was hurting?

Yeah, but there was
no point tenderness...

Free blood irritates
the diaphragm

and gives you referred
shoulder pain.

You missed it because
you forgot about Kerr's sign.

No, we missed it

because you were too tired
to see the patient.

So what did the principal say?

Why can't you tell me now?

All right, okay,
when I get home.

Arlo's consenting for surgery.
It's all taken care of.

And you called it in?

Vascular's ready for him.

Okay.

I'll sort the pre-op list.

All right. I have to go pump
before I explode.

Carolyn made it to the OR.

Who?

Appendix girl.

Great.

You're busy today.

Declared a 15-year-old
a mature minor,

overrode parental consent
on an appy...

And took a kid away
from abusive parents.

It's the triple crown
of social work.

When are you off?

Another hour.

Want to get some dinner?

Thanks. I have
plans already.

Not-Not with anyone,
if that's what
you're wondering.

Not a problem.

You could come along,
but I have to warn you,
it's pretty physical.

Oh, yeah?

Dr. Carter, Neuro's
admitting my CVA in Four.

Thanks.

Abby, that's two
to sign out.

It's 7:05.
I know.

I've been here
five minutes too long.

Stroke patient, tele admit,

and a cop Dubenko's
sending to surgery.

You've still got
three on the board.

I know.
They're all discharged.

Anyway, you
forgot something.

Abby, what?

Ow!

Your flu shot.

You're welcome!

Pressure's good.
122/76.

You feeling better,
Mr. Sakabu?

Yes, thank you
very much.

Okay if the nephew
comes back?

Yeah, sure. We might be able
to get more history.

Are you on, uh,
any medication?

SAKABU:
No.

Any allergies?

Uh-uh.
How could this happen?

It's a very unusual
presentation.

You need enough force to break
a rib that cuts into the spleen.

My nephew's
a pretty tough kid.

He'd have to be to cause
something like this.

My uncle going
to be okay?

Hey, have you seen Susan?

She signed out.
Oh, great.

Uh, no, just page her
again for me, please.

What do you need?

I cannot believe Ray
dumped this on me.

I'm supposed to be taking
care of this cop's kid.

I have no idea
what's going on.

He signed out to you?
Why would he do that?

I was in his exit
path to the door.

Dr. Lockhart,
this is Keith Trager.

Daughter has appendicitis.

Right. Hi. Uh, we
spoke on the phone...

Where is she?
Her condition worsened

and we had to take
her up to surgery.

Okay, you were supposed
to transfer her.

I know.
There wasn't time for that, sir.

Take me to her, now.

Okay, just
one second.

There's a problem
with Arlo?

Ray said it was
all settled, but
he's very upset.

I know the case.
You want me to take it?

Can you? Thank you.

TRAGER:
Excuse me...!

LOCKHART:
Yeah, I'm coming.

Arlo...

Where's Ray?

He had to leave.

When's he coming back?

Actually, he left
for the night.

He left?!

I'm sure I can help.

He promised me he would
help me talk to my mom.

I can do that.

Oh, my God.

They're doing the operation
through the scope,

which means a smaller scar
and shorter recovery.

So... sh-she's okay?

It's not a complicated
procedure.

Everything's fine,
Keith.

Who's that operating?

That's the Chief of Surgery.
He's the best.

DUBENKO ( over speaker ):
Up on the Bovie.

Dr. Dubenko,
the parents are here.

Oh, she's doing great.

We caught it before it burst.

( alarm beeping )

What's that?

Pulse ox probe slipped off.

Everything's fine.

You know, I brought my dad
here for back surgery.

He never left.

Well, that's not going
to happen.

He died on the table.

Some junior doc
botched the job.

I'm sorry to hear that.

I hate this hospital.

Where's the other doc?

Dr. Barnett
isn't available.

He took off.

So, Arlo, have you decided
on which treatment

you would like us
to pursue?

I want him to have
the operation.

BENITA:
It's too risky, honey.

It's what he'd want.

Isn't it better to have him
around, even if he's sick,

than to lose him forever?

You should listen
to you mother...

Why does he have
to be in here?

He's your father's
best friend.

I feel bad, too!

I don't even know why we're
still talking about this!

Ray said
it was my decision!

What, you don't
want my opinion?!

No!

Tell her.

Legally,
Arlo has the right...

He's too young.
No, I'm not!

Don't talk to your
mother like that!

Maybe if I reviewed
the cases one more...

No! I understood it
the first time!

Dad would want to go for it.

BENITA:
I know that's how
he always talked.

He liked to take
chances.

That's what probably
got him shot!

Look, we're not going
to make any progress...

I want him to have
the operation.

If you approve
this surgery...

how are you going
to feel if he dies?

He's not gonna die.

He could die.

Are you ready to
live with that?

I'm trying
to protect you.

I know you think
you're all grown up.

Are you ready to
accept responsibility

for your father's death?

( sighs )

Yeah, hey, Marie, it's Dr. Chen.

How's he doing?

Uh, okay, well, go ahead and
push another two of Ativan.

Yeah. Listen, um, any chance
you can work late tonight?

Yeah, we're getting slammed
and, uh, I don't think

I'm gonna be able
to get home till 2:00 a.m.

That would be great.

Thank you... yeah,
thank you so much.

Okay, bye.

Hey.
Hey.

Sorry about
Uncle Sumo's spleen.

Yeah, well,
we caught it in time.

Who knew his nephew
was the size of a Hummer?

( chuckles )

Didn't mean to snap
at you earlier.

No, no, I was the Attending.

I should've seen him.

So who's the potassium for?

My dad.

You know, you gotta go easy
on that stuff.

Of course.
40 a day, for his diarrhea.

This should last me a few weeks.

Hey.

Hey.

That's a big wall.

Yeah, I'm in training.

For what, taking down PCPers?

Triathlon.

Hey, Wendy.

Hey, Brett.
This is John.

Hi.

First time?

Nah, I did this once

when I was a kid.

All right, thanks.

Take good care of him.
See you at the top.

Let's go over
to the beginner wall.

Is this how this this thing
is supposed to go?

Sure, if you want to hang
upside down by your balls.

What's going on?

The family decided not
to have the surgery.

The family?

We've been together
for three years.

Don't I get any say in this?

Hello, this is
Dr. Rasgotra in the ER.

We're canceling the carotid
surgery on patient Escobar.

Yes,
I can hold.

Hey, John.

Hi.

So you two
are dating, huh?

Nah, we're
just friends.

Well, that's how it starts.

We went out for a year or two.

Oh, yeah? Great.

I thought we might
even get married.

Then one day she tells me

she wants to start
seeing other people.

Why do they
say that?

If you want to break up,
you should just do it.

Is the rope supposed
to be this loose?

Better?

Yeah, thanks.

( grunting )

Hey.
Hey.

Did you get
back to sleep?

No, not really.

Sorry.

Okay, where's Alex?

Up in his room.

Want a beer?

Do I need one?

He brought this to school.

That's it?

That's such crap.

Where'd he get it?

You subscribe?

I like the articles.

Oh, please.

So listen, anyway, uh...

a friend of his had the magazine
in the bathroom.

In the stall.

At school...

You know,
the kid was...

Are you kidding me?

Oh, my God.

Do you think
that Alex is?

I thought it would be
at least a year or two

until I had to deal with this.

Well, I guess I need
to talk to him.

Yup.

So I'm here
twice a week.

Any time you want
to join me?

Yeah, that'd be great.

Brett could give you
another lesson.

Oh, he's quite a teacher.

Hey, see you
next time.

Bye.

I've got an outfit just
like that at home,

but I didn't want
to show off.

So, are you hungry?

Um, no. No, not really.

You got to eat dinner.

I think I'm just going
to grab something at home.

Come on, you've been
a good sport, my treat.

Okay.

So what are you
in the mood for?

I don't know.

Indian? No.

Chinese?

Uh... sushi?

Had it for lunch.

What about
deep dish pizza?

I could go for pizza.

I know a really good
pizza place over on...

Yeah, too
many carbs.

Right.

Hey, I have an idea.

Okay, close your eyes.

Pick a page and point.

That's where we go.

What if it's
a donut shop?

Are you in this or not?

There?

Not there.

All right,
right there.

And the winner is...

Uncle Vito's
Mongolian Barbecue.

What's that?

Um, it's Italian.

It's Asian.
It's maybe Southern.

All right, close your eyes
and do it again.

No, no, you
made the rules.

Mongolian barbecue?

Yeah, but it's
in Downer's Grove.

We don't go that far.

Well, are you
in this or not?

All right.

I hope they have tofu.

Officer McWayne.

They're moving him
up to the ICU.

Okay, um... thank you.

Arlo!

Arlo!
It's okay.

Where's he going?

Probably just getting
a snack across the street.

He seems really upset.

It'll pass.

Well, maybe I should
go and talk to him.

No, he's too emotional.

You can't talk to him
when he gets this way.

I hope he doesn't feel like
he was forced into this.

Are you sure you don't want
to think about it some more?

Maybe discuss it with him
after he calms down.

It won't help.

He's not being realistic.

That's why we had to make
the decision for him.

He's too
confused.

I heard him express
a strong opinion more than once.

You and I both know
it was the wrong choice.

He was hoping for something
that's never going to happen.

He loves his father,
but I'm the one

who has
to set limits.

Anyway, thanks
for everything you did.

I'm not sure I helped.

When you let us
work it out together,

you did the right thing.

( knocking )

Yeah?

Hey, can I come in?

I didn't know
you liked The Goon.

They didn't
have Hellboy.

So look, uh,
about today at school...

Mr. Elmore is such a loser.

Yeah, uh...

What happened with that
kid in the bathroom...

I just wanted
to make sure

you didn't have
any questions.

About what?

You know, about
what he was doing.

Spanking the monkey?

Yeah.

What about it?

Well, it's normal, but...

it's not the kind of thing
you should do at school.

You think I'm stupid?

At your age, it can be
a confusing time.

If you ever
want to,

you can always talk
to me about these things.

Okay.

Okay. Good night.

RAY:
So I heard
there was

an after-hours club
at the Crowbar.

Cool.

Have you
seen Kristy?

Yeah, she's pulling
around the side.

Hey, you're late.

We went on
at 9:00.

How could you just
leave like that?

I'll meet you
in the car.

I'm sorry. What?

You abandoned that kid.

I signed out my patients
when my shift was over.

To Abby-- you should
have signed out to me.

I knew the case.
You were busy.

You thought it
was quick and easy.

Well, it got complicated, Ray.

How did it
get complicated?

The kid wanted his dad
to have surgery.

Well, how long did you discuss
it with him, two minutes?

He understood
everything.

His dad's not having
the surgery.

Why not?

Because you weren't there.

His mom gave him a hard time
about it and he gave in.

Did you at least
talk to them?

Yes.

Well, all he needed was a little
hand-holding, Neela.

I mean, God, is that
so hard for you?

Don't turn this around
to make it about me.

You promised to help him.

No, I told
him...

It's not my job, or anyone
else's, to keep your promises.

My shift was over.

He was counting on you.

I had a gig.

Screw your gig.
Medicine isn't a day job.

This coming from a girl

who was selling hot dogs
three months ago?

I was off at 7:00.
Abby was off at 7:00.

But we were still there
taking care of our patients.

You know what, we would never
leave the hospital

if we had to stick around
to tuck in every patient.

I'm not talking
about every patient.

I'm talking about one kid.

It was the most important
decision of his life.

He trusted you, and you left.