ER (1994–2009): Season 13, Episode 16 - Crisis of Conscience - full transcript

Previously on E.R.:

Our goal is to enroll
200 donor-recipient pairs.

By mixing and matching,

we'd find kidneys
for almost 50% of them.

Ask me again.

Ask me to marry you.

(rock music playing)

If it is what I think,

it scares
the hell out of me.

She's yours, Tony.

Is it possible?



Oh, crap!

What time is it?

6:15. You let me
fall asleep!

(groans)

I don't want
to stay over.

It's okay.
No, it's not okay.

We agreed that
it was too soon

for Sarah to deal
with this.

Sleep in for
another hour.

She won't even know
you're here.

Well, when are you
going to tell her?

Tell her what?

Come on.

I don't even know
if it's true.



Well, you will be
if you do the test.

What am I
supposed to do?

"Hey, can I have some
of your DNA?

I want to find out
if I'm your father"?

What if I'm not?
I don't want to mess
with the kid's head.

Why, are you afraid
to find out?
No. Maybe.

I don't know.

Maybe the actual biology
doesn't matter anyway, huh?

Of course
it does.

You want something
to eat before you go?

No, I'm fine.

Some juice?

SARAH:
We don't have any.

I'm sorry.
Did we wake you?

No, I couldn't sleep.

I'm just leaving.

You don't have to sneak out.

She's not sneaking out.
She's going to work.

And I'm... late.

I'll page you later?

Okay.

I made coffee.

Since when do you
drink coffee?

Since we ran out of juice.

Oh. Give me some.

Sorry, I meant to go
to the store.

I just...

You know, if you
want me to,

I can do all
the cooking

and the shopping
and cleaning.

If you did that,

when would you
do your homework

and talk to boys
on the phone and text?

It's called multitasking.

Since it is plainly ludicrous

to page a surgeon at 6:15
in the morning

for something as silly
as Tylenol,

the only conceivable explanation
I have for your call

is that you have a crush on me.

I'm flattered. Thank you.
Good-bye.

Who was that?

This new ICU nurse.
She's useless.

Someone needs to
show her the ropes.

Did you say "ropes"?

Jane, come on.

I have to round soon.

FYI? This is my last night
in the call room.

The prosthetics lab
could be fun.

No, we're through
with hospital kink.

We're staying
at your place next time.

Whoa, whoa, whoa.

No, we can't. I...

I know, I know,
you have no bed,

you sleep on the couch,
your sink is clogged,

this pathetic "I
work all the time,

so my place is
a rat hole" thing

is not going
to fly anymore.

What?

Yeah, you're going to
clean up your apartment

and buy a proper
bed today.

Jane, just because you want
to stay at my place...

Hey, it's been
three months, okay?

Upgrade the sleeping
arrangements

or you will be punished.
Ooh.

Do you understand?

Yeah.

It's tradition,
a symbol.

Yeah, a symbol of the
wedding industrial complex.

No, I'll wear a ring.

I want to wear a ring,

you just have to abide
by my ring policy.

Your ring policy?

Yeah, if one of us
loses our wedding ring,

we replace the
ring immediately

and give the new
ring full status.

You're going to lose it?

Well, I don't know, if something
happens to the ring,

and everybody freaks out
like the marriage is doomed.

But a simple gold band
would be very nice.

Now we're getting somewhere.

So do you think we should
make an announcement

or just tell people
individually

and let it
trickle out?

Uh, is it all right
if we wait a while?

Really? Why?

When-when you tell people
you're getting married,

they start asking a million
questions about a wedding,

and marriage
is not about wedding.

Like it's not about ring.

Let's just enjoy this
for a while,

the two of us, okay?

That's fine.

A secret engagement
will be fun.

All right, Jane,
you take the boob rash

and, Ray, you get the
bounty hunter with the gout.

Dr. Kovac returns.

Nice seeing you
again, man.

You, too.
Welcome back.

It was weird
here without you.

What's that?

A rat died in the air vent.

There's a cleaning crew
up there.

MAN:
All right,
I think this is the one.

Hey, did you really squash
your own hand in a vise?

I mean, 'cause,
wow, that's...

OLBES:
Need a doc here.

LOCKHART:
Jane, why don't we take this?

35-year-old with
uncontrollable seizures.

You, take the bus.

Something bad's going to
happen on the El today.

I upped my meds, but-but-but
the seizures won't stop.

Well, you're not
seizing now.

No, yes, yes, I am.

I-I... two milligrams of Ativan
should take care of it.

Sir, you're sitting up
and you're talking to me.

You're not having
a seizure.

Can we not stop here?

We're about
to transfer you.
Yeah, but can you

just move me back
at all here?

Just be patient.

Move me now, please?!
All right, all right.

(shrieks)

Lily's sick,
Marquez is out on vacation,

and the rest of us
are doing doubles

trying to cover
all their shifts.

This is why nurses
quit and burn out.

Shortage just keeps
getting worse.

What about you boy Ben?

Uh, he was lured
to a hospital in Minneapolis.

New cars for nurses
willing to stay six months.

Cool with that?

What, I got left
for a Camry?

Nah, it's a good gig.

I can't blame him.

Anna Hayes, 39,

vomiting and altered
mental status.

Tachy to 120,
sats 92 on room air.

This your mom?

Yeah. I could barely
wake her up this morning.

Ms. Hayes,
I'm Dr. Gates.

Can you open your eyes
for me, please?

Please, just take me home.

No, you need oxygen and fluids.

Wait, is she going
to be all right?

Honey, I'm fine.

Ma'am, you're not fine,
you're severely dehydrated,

but we're going to
help you with that.

Access?

20-gauge in the right antecube,
but it blew.

MAN:
Sam?

Trauma One's open.

I'll be right in.

Hey, Jeff, what's up?

I think we have something
that belongs to you.

Alex, what happened?

Okay, Mr. Brewer,
let's get you hooked up.

Yeah, okay.
You're not going to need that.

You're not going
to need that?

No?

No, these are temporal lobe
seizures, okay?

I never have any cardiac
or respiratory symptoms.

Okay, well, we'll just hook you
up to be safe.

If you haven't noticed,

my-my, uh, seizures
are unusual.

I get hunches, premonitions,
that sort of thing.

Nothing ever shows up
on the heart monitor.

I see.
Yeah.

Oh, here comes another one.

I'm sensing...

bacon and eggs.

There you go, okay?

So can you just
give me the Ativan

and I'll be out of your hair?

I'm sorry, but
I just think

anybody could have made that
prediction, Mr. Brewer.

Look, I know that, uh, it looks
like I'm making this stuff up

just so I can get drugs...

...but that's not what's
going on, okay?

Can you call my neurologist?

He'll back me up.

Did you get what
you want, Alex?

Huh? A couple bags
of quarters?

You know what?
You can be in jail right now.

It's not anything like
they're saying, okay?

Officer Greenberg is going
to take you home.

I'm going to call you
every half hour.

You don't answer that phone,
we got a problem.

Mom, it's not my fault.

Of course, it's not,
it never is.

Mom, please,
just listen to me.

I have to go back
to work.

I'll talk
to you tonight.

Thank you very much, Jeff.
Yeah.

Hey. What's up with Alex?

He knocked off
a Laundromat near his school.

Ah...

I'll get better faster
at home, really.

Mom, you're sick, okay?

We're not leaving.

She hates hospitals.

Oh, but this is County.

This is nice here.

You get organic food
and room massage.

We have ice sculptures.

You're going to
love it here.

All right, she needs coags.

She's oozing
around the needle.

Pulse up to 125.

You know, when you were four
years old,

our neighbor fell off
that ladder

and they brought him here.

Mr. Madsen?

Oh, he was such
a grouch.

He was always yelling at you
and your brother

for playing too loud.

But when you found
out he was sick,

you wanted to visit him.

Systolic's only 84.

She needs access, Gates.

I'm trying, Sam.
She's clamping down.

One more try
and I'll go central.

You stood up on your chair

and you stuck your favorite
toy turtle

in bed with him,
and you said anybody

who was sick,
needed a toy turtle.

She's making this up.

No, no, I made a lot
of mistakes, son,

but you were the one thing
I got right.

All right, I'm in, Sam.

Let's get the fluids up.

You okay?

Yeah.

Morning, Neela.
Ready to round?

Uh, sorry. Shoot,
I need five more minutes.

I overslept.
I never oversleep.

Is that a yoga mat?

Yeah, there's an Ashtanga
class in the anesthesia
conference room.

You should check it out.

Nurses station,
five minutes.

I'll see you there.

Uh, hello, good morning.

I'm Dr....

Manish?

Hi. Uh, this is the doctor
I was telling you about.

I'm Emily.

I've heard a lot
about you.

What are you doing here?

Uh, well, I was...
Saving my life.

I was giving a talk about
the paired exchange program

at a dialysis center
in Evanston...

EMILY:
He was really impressive.

He gave us all hope.

And there were all
these people there,

and they were just waiting
and suffering

and it inspired me.

To donate your kidney?

You ran screaming
from a blood drive.

Well, I was moved
by their stories.

We've worked together
every day for the past month.

How come you never said
anything?

'Cause I thought
that I'd chicken out.

I've been on dialysis
for six years,

on the UNOS list
for five.

I'd just about given up
when, boom,

Manish walks
into my life.

Got tested, turns out
I'm a good match.

Wow.

EMILY:
Amazing, right?

It's like right out
of a movie or something.

What's your differential?

Infectious hepatitis is
at the top of my list.

Sent viral titers.

Good. What else?

Hepato-renal syndrome,
vascular disorder,

autoimmune,
alcoholic hepatitis.

But my mom doesn't drink.

Oh, we're just running
through the possibilities.

Here, Luka, Jane's
tibia fractures

got compartment
syndrome-- ortho's MIA.

What about toxic ingestions?

Acetaminophen,

poison
mushrooms?

Tox screen's negative,
acetaminophen's zero.

KOVAC:
Okay, get a CT and notify
nephrology and GI.

Sam, come with me.

Is there, uh, is there anyone
else you want to be here?

My other son's at work.

Don't bother him.

Oh, I think he should be here.
Is it close?

He's a repair guy over
at Begley's Appliances.

My mom works there, too.

It's just the stomach flu.
Don't bother Nick.

It's a little
more serious.

You know what?
Why don't you go out
to the front desk.

The clerk will help you
call your brother.

It's all right, honey. Go.

It's out there
to the left.
Thanks.

You're scaring him.

You're in acute
liver failure, ma'am.

This-this is
a little scary.

Did you hear what I said?

This is serious.

You could die.

I heard you.

Do you have any questions?

No.

Manish nearly fainted
the other day

when I was drawing blood.

Now he's giving his kidney
to someone he barely just met.

Isn't that a
little strange?

No, everyone goes through
some kind of a mini-life
crisis in their 20s.

He's far from family,
he's unattached,

he's unsure about career,

he's drifting,
he's looking for purpose.

Some people
donate kidneys,

others end up
working at the Jumbo Mart.

Who are we to judge?

CRENSHAW:
Neela, what are
you doing?

I came down to see
the volvulus case.

But you're supposed to be
covering the post-op floor.

You done with all
those dressing changes?

Well, not all of them, no.

Okay, I'm going to leave
you kids to work this out.

I'll be in
Curtain Three.

You, upstairs, shoo.
Well...

What is this?

A consult note.

I said black ink
today. Only black.
Oh...

What color is this?
Eh, blue.

Oops.

Hey, Mayday.

How's it going?

Well, my attending
thinks I'm a complete idiot,

and Crenshaw's back
to being a little bitch.

Hey, most hepatic toxins
take a few days

to destroy the
liver, right?

Yeah.

So, theoretically,
you could trash your liver,

but by the time you become
symptomatic,

the toxin couldn't be detected
in the blood.

I suppose.

Hmm. I'll page you later, okay?

Ms. Hayes?

Anna.

Anna...

What's a young, healthy woman
with no medical history

doing with fulminant
liver failure?

Aren't you the doctor?

You got a family,
40 good years ahead of you.

Yet when I told you, you might
die, you hardly reacted.

Yeah. I guess we all have
our own way

of dealing with bad news.

Huh. You know, I used to be
a paramedic for ten years

before I became a doctor.

Young healthy patients,

no matter how religious, mellow,
Zen they were...

they don't want to die.

Something kicks in--
instinct.

Maybe I've just been
too tired to cry.

You seem depressed.

(chuckles)

Let's say someone wanted
to kill themselves

without anyone knowing
it was suicide.

You know, there's a whole
class of chemicals

that can damage the liver just
days after they're ingested.

Please.

I just want to go to sleep now.

Fuels and solvents found
in refrigerators, dryers,

cleaning products.

Stuff you'd have access
to every day at your job.

Come on, Anna,
tell me what you took

so I can help you.

Your sons deserve to have
you around.

They're all grown up now.

I know I'm right about this.

Propane? Kerosene?
Carbon tetrachloride?

What? Tell me.

I hear if you mix it with juice,
it's got quite a kick.

Everything okay?

(groans)
Anna? Anna?! Anna!

Everything's back to normal
with you and Luka?

Uh, I don't know
if I'd say normal,

but they're good.

How's things with
you and Katey?

Uh, she's great.
Really great.

But?

But nothing.
She's awesome.

Our friend's hurt. Help!

Don't move so fast.
Come on, you're tough.

Please don't make me walk.
You can do it.

Come on, guys,
give her a break.

I got her.
Get a gurney
over here please.

COACH:
Are you a doctor?

We both are.
BARNETT:
Okay, what happened?

They were doing a formation
called layer cake.

Most schools do three
layers and we do five.

Tasha fell all the way
from the top.

LOCKHART:
Wow, four layer fall, huh?

COACH:
I need this kiddo
back in action

for the Great Lakes Regionals.

Okay, Tasha, let's go.

GATES:
Clear.

Still V tach. No pulse.

Gates, I got poison control
on the line.

All right, put them
on speakerphone.

Wh... What's this about?
TAGGART:
Okay, she's on.

Possible carbon
tetrachloride overdose.

Fulminant liver
and kidney failure.

Why the hell didn't you
say anything about this before?

It was just a hunch.

(over speakerphone):
When did the exposure occur?

Unclear.

Transaminases
in 2,000 range.

It's too late.

Nothing to offer other
than supportive measures.

Nothing to offer?

No. If it's carbon tet,
the damage to the liver
has already been done.

(over speakerphone):
I'm afraid that's right.

Cell death is irreversible
at this point.

All right, thanks.

Epi's in, fourth dose.

KOVAC:
Another hundred of lido
and recheck the K.

Wh... why were you
withholding patient history?

I wasn't sure. She
didn't fully admit it.

Charging to 360.

Where'd her son go?

He's out at the front desk

trying to bet ahold
of his brother.

Well, he better find him fast.

All right, clear.

I don't think I could
do something like this
for a stranger.

So, maybe it bothers
me that you can.

Look, Emily's parents
are too old to be donors.

She's getting sicker
every day.

You would have done
the same thing.

I don't think so.

You're a better person.

I'm not a better
person, Neela.

I'd be too worried about
time lost from work,
complications.

I don't mean
to be negative,

but you have to at least
consider the possibility
of bleeding, infection...

I've considered it.
We've all considered it.

It's covered.
Covered?

Manish...

Look, it wasn't my intent,
it wasn't why I agreed,

but they offered,
they insisted actually.

Manish, no.

Just listen, okay?

First I refused.

But then I started thinking
what $50,000

could do for
my family.

Stop. I don't want
to hear any more.

Look, when I was 14, my
parents sent me here to live

with a distant cousin.

I went to school,

I learned English,
I played baseball,

while my sisters sewed shirts
for two dollars a day in Mumbai.

I understand you
feel guilty.

Yeah, well,
with $50,000,

I could hire an
immigration lawyer.

I can get my whole
family over here.

My parents could get
proper health care.

My sisters could get
a proper education.

Emily's family is wealthy.

It's no hardship
for them.

So why not?

Because people don't sell
their body parts

in this country, period.

Not to mention the fact
that you could put

our whole transplant
program in jeopardy.

Nobody needs to know.
But I know, Manish.

I don't understand
why you told me,

but if you were looking
to clear your conscience,

I can't help you there.

Of all people, I would think
that you would understand.

Well, I don't understand.

I don't. And I kind of resent
the assumption that I should.

You can't do this,
Manish, I'm sorry.

No deformities,
no step-offs.

We have this one cheer,
it's so cool.

It's called paper dolls.

Yeah, it's our signature
formation.

It's like a college level
routine.

DAWN:
Pulse is in the 120s,

and the hemacue
is dropping.

That would be because
she's bleeding into her belly.

I have fluid here.

We've got the All-Cheer
Regionals coming up next week.

I've been driving them too hard.

The outer flyers have their
outside hand in the half "Y,"

and the other hand grabs
hold of the middle flyer.

That's me.

And the ending is really cute.

Sounds great.

Liter of warm saline
wide open,

and call for O-neg.
Make sure surgery knows

to get down here.

Oh, my God, surgery?

If we don't have a middle flyer
for the competition,

we are so screwed.
Watch it, girls.

Why don't we worry less about
the competition

and more about your
friend, okay?

I'll get the infuser.

Do you guys have
any warm saline?

There's LR in the oven.

K is 7.2. Amp of D-50
and ten units of insulin.

Her nose is bleeding.

Her coags are
through the roof.

Oh, my God, she wasn't
like this when I left.

Her condition
changed quickly.

Without a functioning liver,

toxins start to accumulate
in the blood.

She's in an abnormal
heart rhythm.

She isn't getting enough
blood to her brain

and body.

We're doing CPR,

and giving her medications,

but she's just not responding.

But can't you just do something
to fix her liver?

Once the cells have died,
there's little we can do, Evan.

So is this it,
or what?

KOVAC:
We're breathing and compressing
her heart for her,

but your mother's body is...
shutting down.

Anything you guys want to say?

No, Mom, okay?

This isn't
happening.

This can't be happening.

Please don't go.

Don't let her die.
One more round for the kids?

Sam.

All right, clear.

Whoa, wait a minute.
She's got a pulse.

Sinus rhythm.

I don't understand,
is she dying or not?

Her heart is beating,

but her brain was deprived
of oxygen for a long time.

It's very likely that she
suffered serious brain injury.

Wow. She can't
even die right.

Pressure's stabilized
after two liters,

but her crit's
still dropping,

and did I mention I
hate cheerleaders?

I hate clowns.

I heard Gates was afraid
of folksingers.
Really?

Two plus guarding
with rebound on the left.

Could be a splenic rupture.

Neela, you writing
this down?

Yes, Dr. Crenshaw,
I am.

How do you stand this?
I don't know.

I'm like a battered child.

I just keep coming
back for more.

All right, let's bring her up
to whatever OR is open.

Dr. Dubenko
will meet you there.

Okay, girls, Tasha's going
to surgery now.

Everyone say good-bye
and wish her luck.

I'm really sorry
you need surgery

and everything, Tash.
But you should know

that we'll have to replace
you for All-Cheer.

Where's my mom?

(cheerleaders giggling)

Hey, she sacrificed her spleen
for you guys.

Show some respect.

RASGOTRA:
It's going to be okay.

I'll explain everything
as we go.

Am I going to have
a big scar?

Not if we
can help it.

Let me tell you
something about Mom...
Don't talk like that, okay?

I'm in the middle
of something.

She's not going to die.

This is the best idea
she's had in a long time.

You don't mean that. This is
your mother we're talking about.

You don't know the first
thing about my mother.

I know that she's
barely alive,

and I know you guys
should be in there

instead of out here
fighting in the hall.

Sorry, I just don't care.

Why do you
hate her so much?

Ever since Dad died, all she
does is try to make us happy.

Happy, right.

By gambling on the Internet
all day?

It helps her relax.

Shut up!

She started out with
a few dollars on poker.

And by the end of the year,
she'd lost everything.

The crummy cars, the
savings from our dad.

She has a problem.

When they stopped
giving her credit,

she took out more cards
in our name

and racked up more debt.
$80,000, Evan.

We got to live
with that now.
She was trying to get help.

Stop making excuses for her!

The house is in foreclosure,
Evan.

Next week, you're going
to be homeless.

All right, she may
be screwed up,

but she's your mother.

That's not good enough.

It's not.

Can I get your
advice on something?

Yeah, of course.

Well, let's say I knew
a really nice person

about to do
a pretty bad thing.

But this bad thing

had really good consequences
for a bunch of people.

You don't need my advice.

Yes, I do.

No, no, 'cause you have
like this ethical alarm system

hardwired into your brain.

Makes you a self-righteous
pain in the ass,

but it's one of the best
things about you.

But... if I tell what I know,

it's going to mess things up
for a whole bunch of people.

They'll get over it.

It will be a major betrayal.

Uh, do the right thing, Neela.

That's all I'm saying.

Is this where
I'm having my operation?

Yep. The ORs
are straight ahead.

I'm scared.

I know. But we're going
to take good care of you.

My stomach...

Hey, we'll get you
more pain medication

when we get to pre-op.

No. That's not it.

Is it your mom?

We won't start
until she gets here.

I didn't fall
from the top of the formation.

You didn't?

The other girls...
they did this.

They did this to me.

New cheerleaders are forced
to submit to ten minutes

in an equipment closet
in their gym.

The newbie just takes it

while her teammates
do whatever they want.

Tasha got kicked
in the stomach

till she started
coughing up blood.

I trust the authorities
have been notified.

Ray's on it.
Good.

Lucien, there's something else
I need to talk to you about.

Sure. Go ahead.

(knocking)

Can it wait?
Not really.

Well, it's going to have to.

Our cases are
completely backed up.

Let's go.

Oh, Dr. Kovac,
you really must see this.

This is, uh...

Fred and Brenda.

Neurovascular symptoms
after a Handfasting Ceremony.

A what?
It's a Wiccan wedding.

The guests bound
our wrists with cords.

It's where the expression
"tie the knot" comes from.

LOCKHART:
These are really strong.

Braided to be tough,
like our marriage bond.

BRENDA:
Regular scissors
didn't work,

and the knots were
too tight to undo.

I can't feel my fingers.
And I can't move my thumb.

Is a Wiccan ceremony
recognized by the state?

No. We have to
get married

at the courthouse
so I can put Fred

on my insurance.
They don't recognize us
because we don't believe

in mating for life.

Oh, you don't?

BRENDA:
We are betrothed for
one year and one day.

FRED:
To be reevaluated at
the end of that period.

Yeah, well, it does seem like
"till death" is kind of extreme.

Yeah. Just Judeo-Christian
bullcrap.

I don't think so.

We're getting married,

and all those
things are on

our minds.

Sorry. Just slipped out.

Uh... okay. That's all right.
(stammers)

Um, all right, um...
I'll be right back, okay?

What, the first people we
tell are strangers? Wiccans?

I just felt
like saying it.

Hey, Abby, have you seen
the cheerleading coach?

She's outside practicing
with the girls.

Oops.

When tissues are deprived
of oxygen for a long time,

they produce acids, so we're
giving her medicine for that.

How long can she
live like this?

Weeks. Months.

It's hard to tell.

But it's just a matter
of time, right?

I mean, if you want to help
us, don't prolong this.

She's not suffering.

Evan and I are going to have
to be responsible for her.

We're the only
close family she has.

We're alone.
It's too much.

I understand.
Social worker will call you.

We have programs.

There's a support group.

Please. We've
been through enough.

She's been having
runs of V tach.

Forget the lido drip.

What, you want amiodarone?

No. Why prolong
the inevitable?

That's not
your call to make.

Oh, come on, Sam, we
both know how this ends.

Why put her
boys through it?

She's a full code. We don't know
the extent of her injuries.

We gave her CPR
for 40 minutes.

Her brain is fried.

Another run of ten.

Sam, your
little raver is

having a dystonic
reaction to Haldol.

It's cool. Go.

The lido is hanging
and the infuser is set.

If she has another run,

start the drip, okay?

Page Dr. Kovac and tell him

his patient in Trauma One
is coding.

Thanks.

You heard
what happened last year.
(girls cheering)

My girls are not staying
in the same motel

as the football team.

I need to talk
to you about Tasha.

How's she doing?
Get off the phone.

I'll call you back.

Tasha's injuries were
not caused by a fall.

What do you mean?
I saw her hit the ground.

She was forced into a closet,

and then she was beaten
by the other girls.

What? My girls
would never...

Come on!
Don't do this!

She knows you know.

It's not what you think.

Tasha's sensitive.

Never really fit in
with the others.

What she's referring to

is just a little
team-building exercise we do.

They ripped open her spleen.

That's not little.
And I definitely wouldn't

consider that
team-building.

My girls are
regional champions.

They're under a
lot of pressure.

Why don't you
save the excuses

for these guys,
all right?

Mom, I don't care
what happened.

I don't care
about the money.

Just please don't go.

Another mig of epi.

Charged to 360. Clear.

KOVAC:
Resume compressions.

What were you thinking?
Why didn't you talk to me?

Lido isn't going
to change the outcome.

I thought you'd agree.

Yeah, well,
we work together here, Gates.

Clear!

I'll be right back.

Gates, you can't leave
in the middle of a code.

The kid should
be in here.

Gates!

Hey!

What do you want?

Look, I know you're angry,
and I know you got screwed.

You don't know anything.

I know your dad died,
and your mom messed up.

It ain't fair.

No, it isn't.

But your mom is dying.

And I know you care.

Because, if you didn't,
you wouldn't be out here
sulking in the hall.

You go in there and you
forgive your mother right now.

I can't.

Nick, you have one shot
at being with your mother

while she's dying.

Hold compressions.

(flatline alarm buzzing)

That's enough.

Save a cheerleader,
save the world.

Lucien, I still need to talk
to you about that thing.

Well, make it quick.
Manish is on the table,
everyone's waiting.

Well, that's
what it's about.

Emily paid Manish
for his kidney.

That's ridiculous.
He knows better.

Well, it's true.
He told me.

He was screened by psych.

They would have
picked this up.

Well, they didn't.
Come on.

It's wrong, and could jeopardize
the whole transplant program.

All right.
All right, Neela.

All right, well, look.

Just as an exercise,
consider this.

There are over 65,000 people

on the UNOS list
waiting for kidneys.

Can we really rely on voluntary
altruism to solve this problem?

What are you saying?
What am I saying?

Well, when somebody
donates a kidney,

the recipient obviously
benefits, right?

Hospitals make money.

The surgeons get paid.

The donor who
gives up a kidney

gets flowers
and a handshake.

Am I right?
Are you kidding?

So many sick people,
so few organs.

Why not let market forces
sort out the imbalance?

Because people
aren't commodities.

We don't live in a world

where it's all right for rich
people to buy body parts

from those less fortunate.

Hey, it's legal to
rent out your uterus,

or to harvest your eggs
for money.

You can get paid
to donate sperm.

How is this different?
All I know is that

a dying girl is going
to get a new kidney today.

Then what happens
to the 65,000 others

who can't afford to buy one?

SHIRLEY:
Ancef will be ready to run soon.

Quick question.
Why are you doing this?

Excuse me?

Why are you giving
this girl your kidney?

I guess I've been inspired
by the work that we do here.

Mm-hmm. And you would never
dream of jeopardizing everything

by doing something stupid
and illegal, would you?

What are you talking about?
You know exactly what

he's talking about.

Okay, Emily wanted
to give me money,

but I turned her down
after talking to Neela.

Money was never
part of the reason

why I wanted to do
any of this.

Lucien, he's just saying
what he knows you need to hear.

She's obviously made
up her mind about me.

I don't know what else to say.

All right.
That's enough.

Neela, let's go scrub.

No. I won't be a part of this.

Fine. Shirley,
have Crenshaw get me a surgeon

who actually wants to operate.

You can get out
of here, Neela. Now.

The tornado was hard to see
against the background,

so I painted it black.

I was going to put some
lights in the bottom,

but I ran out of time.

Wow, that should look
really, really cool. Sam.

Yeah, and I fell down the stairs
at school and it broke.

(laughs):
That's not the only
thing you broke.

I know-- I broke
my tibia and my fibula.

Can you fix it fast?

I can fix you up
in about an hour.

An hour?!

I'll never have time
to finish my tornado

before the end
of the science fair.
Hey, did you know

that casts give off heat
when they're hardening?

No.
Mm-hmm.

It's called an
exothermic reaction.

It could make
a pretty cool science project.

Can you help me make it?!

Uh, sure. I'll
get the stuff.

Sam, can you dispose

of the rest
of that Ativan, please?
Sure.

Hi.
Hi.

So, I talked to
your neurologist,
Uh-huh.

and I got quite an earful
about temporal lobe epilepsy.

Yeah.
Interesting stuff.

Well, I told you
I was the real deal.
Mm-hmm.

Well, do you have any
last words of psychic wisdom

before I medicate you and sever
your ties to the paranormal?

Oh, sure.

Um, well, I see great things
for you in the year to come,

although you will
struggle to...

balance home and career.

That's it?

Yeah.

(laughs)

That's the most generic fortune
I've ever heard.

And you should really invite
your dad to the wedding.

I'm just saying.

KOVAC:
Gates.
Hm?

Can you explain
this, please?
Explain what?

Why did you write
"idiopathic liver failure"

on her death certificate
worksheet?

It should be "carbon
tetrachloride ingestion."

Well, she never admitted it
straight-out.

We don't know
what really happened.

You can't withhold information
whenever it suits you.

What she told you needs to be
part of the medical record.

If we document suicidality,
then life insurance won't pay.

We say it was a natural
death-- what's the harm?

The harm is that it's unethical,
and it's insurance fraud.

Oh, come on, insurance
companies screw people
over any chance they get.

And why should those
kids be punished for
the rest of their life

because of something
their mother did?

Gates, I'm worried about you.

Don't worry about me.
I'm all right.

No, I'm worried about
your ability to do this job.

And it's too bad
because you're good,

but you-you... you lie
and you think nothing of it.

It's not lying
if we don't know for sure.

Now, come on, let their mother
do this one last thing for them.

I'm not going to let you

lie for them, Gates.

Hey, Gates, can you
sign this discharge?
Later.

Jane, you seen Neela?

Uh, Dubenko sent
her home early.

Oh.

I just had to wheel
an appy up from the ER,

in case you're
wondering.

Wondering what?

Why I'm here.

Good night, Jane.

King-sized,
wrought iron frame.

The rest is up to you.

Hey, you guys,
have you seen Tony around?

Not in a while.
Okay, have a good night.

Do you think I chased away
my father too fast?
No.

EVAN:
Where are you taking her?

Maybe I should've at least
listened to what he had to say.

Why? You can call him.
I tried.

He checked out of his hotel--
the number he gave me

in Texas is
disconnected.
Um, Abby, uh...

Sorry, I just need a minute
to check something, okay?

Hey, Malik, do we still

have the chart on Anna Hayes?

You think I memorize the
name of every patient
who comes through here?

The woman that died
of liver failure.

I forgot to do some paperwork
for the death certificate.

Here you go.
Thanks.

Hey, first day back.
How'd it go?

Just like riding a bike.

LOCKHART:
Luka, I told Miranda
we'd be home by 8:00.

Coming.

Good night.
See ya.

Hey.
Hey.

How'd it go with
your little secret?

Oh, terrible, actually.
Worse than expected.

But our cheerleader
did well, though.

The police are interviewing
the whole squad

as well as the coach, so...
Oh, good.

Getting off soon?

Uh, yeah, thank God.

Yeah, me, too.

Want to grab a beer?

Sounds good, but, um...

I've got some dictations to do.

Okay. Another time.

Dr. Gates.

You're still here.

Yeah. Our uncle drove
in from Ann Arbor.

He wanted to see her.

I'm sorry for your loss.

You know, I never
got to thank you

for everything you did.

It's my job.

You really helped us.

Yeah. Good night, Nick.

You know, she knew it
was the only way out.

Had to look natural so we
could get the insurance money.

I found some old solvent
at the store.

You helped her?

I left out a bottle.

At least she finally
got something right.

Good night, Doc.

Leave me alone.
No, you can't break

and steal things, Alex--
you know that.

You do that, you're going to
end up on the wrong track...

Mom, you're not
in my head, okay?

You-you don't know
what happened!

Alex, come on.

TAGGART:
Alex! Open this door!

You hear me?

Right now!

Open the door!

Go away!

(crying):
I can't go away-- I'm your mom!

Come on, Alex,
don't do this to me.

Hey...

Hey, do you remember
that time that, uh,

we made that science project
for your school, that volcano?

And I couldn't get
the mix of, uh,

of baking soda
and vinegar right?

And it erupted

all over the living room.

(sighs)

What were you, what,
five or six?

I know I didn't give you
the most stable childhood, okay?

I know you've seen
a lot of crazy stuff,

that is mostly my fault.

But the only thing I ever wanted
was for you to be happy, Alex.

Okay?

And I don't know
how to give that to you.

So, please...

tell me what to do.

I know you're listening
in there, Alex, okay?

I love you.

You know that, right?

(sighs)

(sighs, sniffles)

Hi.

Hi.
You look tired.

Want a beer?

(chuckles):
Yeah, thanks.

I made chili, salad

and corn bread
from scratch.

I know what your
next question is.

My homework's already done.

All right.

No more fast food
around here.

Wow, Sarah,
this looks great.

Yeah.

Leaving so soon?

Guess not.