ER (1994–2009): Season 13, Episode 22 - Sea Change - full transcript

Previously on ER:

So you quit your job and get
married in the same week?

I'm a new guy now.

Maybe some of that love will rub
off on all of us here

and help us find someone
as special as you two have.

I got them the honeymoon
suite at the Ritz

for a few nights, but...

they say they can't use it on
account of Joe and everything.

Oh, it's go time.

You're a real prick,
you know that?

What?!
Gates!



Stop it!
Tony!
Gates!

I don't love you.

So that's it?

We're done?

Yeah.

Because Ray
couldn't get over you?

Have you seen my other sock?

I just bought these.

Nobody wears socks in Hawaii.

Ugh, I can't believe
it's almost 9:00.

I can't believe
Joe's still asleep.

Couldn't find anyone to
cover your shift for today?

No, that's the problem
with surprise weddings.

It's hard to plan.



I'll stop by later.

I have to tie up some
loose ends with Anspaugh.

You've got to be kidding me.

What?

Married five days and
I'm already getting mail

addressed to Mrs. Luka Kovac.

Nice.

You know, being married isn't
gonna change the fact

that I don't cook...

or sew...

or keep track of your socks.
Okay.

That's fine in Chicago,

but on our honeymoon...

you're going to be serving me
martinis wearing only this.

Got me a bikini.

I'm a liberated

modern husband.

I like to shop.

Abby and Luka are crazy.

Who turns down three free nights

in the honeymoon suite
at the Ritz?

Hope?

Wow.

Oh, my...

Oh...

(giggles):
You know,

when I was eight, I found this
book in my parents' bedroom,

Sex and the Christian Marriage.

And the very first
page, it said,

"Orgasms bring a couple
closer to God."

So that night at the dinner
table, I asked my parents

what an orgasm was.

What'd they say?

An orgasm is a very special
kind of prayer.

Which is fine and actually
kind of sweet,

but, like, later that week,

I had my first sleepover
at a friend's house.

So her mom asks me
what my bedtime routine is

and I said, "bath,
toothbrushing, orgasm, sleep."

(laughs):
You did not.

I did.

I was never invited back.

(cork pops)
Ah!

Champagne?

It's 8:00 in the morning.

I have no sense of time
in this place.

Arch, you got to be at
work in, like, an hour.

Shh!
Dirty word.

What is?
Work.

Oh.

Well, I don't have to be in
till 4:00, so...

you go ahead and then I'll
check us out of the room.

No. No, no, no.

We're staying another night.

Another three nights.

What?
That's crazy.

This room must be like
a thousand dollars a night.

They comped us.

Why would they do that?

I guess we're spending
so much on room service,

we made it worth their while.

Now...

mimosa?

Nimosa.

Oh...

(laughs)

Hey!

Damn it.

Hey, hey, Betina, hey.

Hold up.

All right, all right,
look, look.

I got it now.

I figured you out.

Figured me out?

You've had it with the guys
who are trying to be cool

and you're ready
for someone real.

Got someone you want
to set me up with?

Come on now, help me out, okay?

I've seen the light.

Or maybe you're just
saying what you think

I need to hear
to go out with you?

Oh, it's not like that.

Really. Really.

Greg...

I like you.

But I have been dating
guys like you for years.

You will do whatever
it takes to get the girl,

but in the end,
it's just about the chase.

Betina, I'm not
like that anymore.

I've changed.

This is it?

They closed the ER
for a paint job?

Well, it's only
been a few days.

You can't expect a drastic
change overnight.

Mine point exactly, Dr. Pratt.

See you later.
I've got radiology

rounds in the ICU.
Wait!

Pratt, I got a hypotensive
patient here, 87/45.

All right,
what's the baseline?

She runs low.
Always has.

Why is it that you
know that an I don't?

She's febrile,
too, 103.

Okay, any vomiting,
any coughing?

Just a little belly pain.

I could see my doctor
tomorrow when I get home.

Where's home?
Boston.

We're here for
her physics conference.

I'm gonna cut
his eyes out

and send him home in a box!

Need some help here!

Sam, liter of saline,
find her a monitored bed,

and I'll be in as soon as I can.

Let me out of this right
now! Let me out of here!
Can't you just give me

an antibiotic or something?

We've been waiting in
triage nearly three hours.

I know, I'm sorry, that's the
way it goes around here.

You know what, let me see
if there's an open bed.

I'll be right back.

Sam...

meet my parents,
Barb and Len.

They're visiting
from Long Island.

Oh, hi.
Nice to meet you.

Hey, Weston, come on, man,
you're up.

This guy needs a chest tube.

I'll find
you guys later.

Well, you must be
very proud of Larry.

Have a good tour.

You're even prettier
than he said you were.

Oh...

We're so happy he finally
found a girlfriend.

STAB VICTIM:
Let me out of here, you bastard!

Where the hell'd they move
the ortho stuff?

I'm sorry for springing my
parents on you like that.

I am not your girlfriend, Larry,
you know that, right?

Oh, come on.

Sam...

We made out... at a wedding.

That's what drunk single people
do at weddings.

Doesn't mean we're an item.

Well, I'm not the type to
take sex casually, Sam.

We did not have sex.

Depends on how
you define sex.

Larry, we did not have sex.

Outercourse doesn't count?

Oh, my God.
What?

Ace or splint?

Ace is cool.

So where are all the
so-called improvements

you guys did while
you were closed?

Oh, what, you didn't see
the new admit desk?

Or how about our
electrical outlets?

They are a new shade of red.

All right.

How did you hurt
your ankle?

Running all over the hospital
with Dr. Moretti.

Who?
Dr. Moretti.

He's head of the ICU.
(pager beeps)

I'm doing a month
up there with him.

Wiggle your toes.

I'm wearing a pager
for the Rapid Response team.

The what?
It's Moretti's
latest invention.

When nurses get a bad feeling
about the patients,

they call us and we run.

Like a code team.

More like a pre-code team.

Why don't you let me
have the docs

take a look at your ankle
just to be sure?

As long as it's not Ray.

Yeah, you got it.

Okay, Morris...

you finally close the deal
with Hope or not?

Hey, all I can say...

this is the first time I left
our hotel room in three days.

Mostly we're just praying.

Lot of special prayers, huh?

Hey, what about you and
our favorite radiologist?

Come on, you got to respect
a woman's privacy, right?

You sly dog.

Anybody seen Ray around?

No. He's a couple
hours late.

He's probably still
hung over from the wedding.

He was in pretty bad shape.

And, Sam, whoo, baby,
wild night, huh?

Please shut up.

Katey Alvaro's in curtain two.

She twisted her ankle.

Doesn't look broken, but...

take a look.
I'm on it.

Larry?

I'm gonna kill him.

Hey, anybody see our physicist
in curtain three?

Yeah, I got to slow down in SVT,
but she's next for sure.

Excuse me, we're still
waiting for a doctor.

I'm sorry,
we're really busy.

How are you feeling?

Run down.

I've been working my ass off
for the last six months

prepping for this conference.
Six months?

Try 20 years.

You've been working on quantum
processing your entire career.

Quantum processing?

Oh, theory in physics which says
that an atom can exist

in two places at the same time
and I showed

that it can work
in a larger matrix.

I have no idea what you just
said, but it sounds impressive.

It pretty much blew the lid
off the entire field.

Well, I think what you've
got is probably viral,

but I'm going to send
some blood tests to be safe.

Sam, we're gonna do dinner
at 8:00 at Osteria Angelo.

Great! Have a good time.

Yeah, I'm sorry.
I don't mean to sound

like uptight mainlander,
but I find it hard to believe

that you can't rent a car
with a car seat in it.

Okay.

Right, we'll bring our own.

Yes, mahalo for nothing.

GATES:
Sophia Van Brummellen, 35,

fell down a 15-foot
flight of stairs.

I'm Dr. Morris.
Can you tell me your name?

I'm gonna be sick.
Okay, roll her on her side.

WOMAN:
Please be okay.
Let her be okay.

Abby, need some help here.
Um, hello.

What happened?

She fell down stairs...
I want to hear it from her.

She slipped and she fell down--
her head was bouncing

down the stairs,
when she got to the bottom,

she wasn't moving
and she wasn't talking.

I'm Dr. Lockhart,
any medications

or allergies?
No, she's healthy.

My...
Okay, hang in there,

we're going to
take care of you.
What's her access?

GATES:
18 gauge in the right antecube.
She's seizing.

MORRIS:
Ativan, two migs,
let's get Trauma down here.

I need a second line
and 50 of manninol right away.

We've got a dilated stomach
with exaggerated incisura.

Call Ultrasound.

Why?
Caterpillar sign,

could be pyloric stenosis.

Pratt, I need
an antibiotics order
for our physicist in Three.

Micro called, she's got gram
positive cocci on the stain.

That's probably just
contaminated, she looks
too good to be septic.

She's still febrile
and tachy, and how would
you know how she looks?

You haven't seen her
since we brought her
back an hour ago.

Sam, I've got
an obstructed newborn,

a perfed ulcer
on his sixth unit of blood,

and my aphasic boxer just
dropped his pressure in CT.

Give her two grams of
ceftriaxone and I'll see
her as soon as I can, okay?

LARRY:
Guess what?

I'll be house-sitting
for Luby while they're away.

Luby?

Luka and Abby.

You know, like Brangelina,

Bennifer, Tomkat.

I hear it's a nice place,
and Abby says it's okay
if you sleep over.

What? Are you for real?

Well, I didn't think
it would be right

to have sex in their bed
without at least asking.

(door slams)

Load with a gram of dilantin.

What is that?
A medicine to keep her

from seizing again.
If you want to be here,

you're going to have
to step back.

GATES:
More suction.
It's cranked all the way up.

Nothing's coming out.
Come on, Gates.

I'm trying,
I can't see crap.
Sat's are down to 86.

Is that bad?

Abby, switch with Gates.
I haven't even tried yet.

Exactly.
I'm being blamed
for equipment failure?

Don't make this
about you, please.

What are you doing?

The tube will protect her airway
and allow us to breathe for her.

Is he still mad
about the propofol?

MORRIS: We've given her
medicine for pain and sedation
to keep her comfortale.

Yeah, that or the thing
that happened at the wedding.

What happened at the wedding?
Nothing. Yeah, it's
the propofol.

Wants me to kiss the ring.

Why don't you just apologize
and get it over with?

'Cause I have nothing
to apologize for.

MORRIS:
Secure the tube and call
respiratory for a vent.

Post-op morbidity
and mortality are up

seven percent
this year.

Really? Why?

I don't know, but
I'm going to find out.

I'm conducting an
internal audit into
the post-op unit.

I want every med,
every hiccup

meticulously
recorded.

Nurses are going
to hate you.

No, they're going
to hate you.

You're in charge
of the investigation.

ER Trauma call.

Not you, Dusty.

I want you hands-on
at the PACU unit.

You're not doing consults
till the audit's over.

CRENSHAW:
Oh, boo.

Hey.

Hey.

Hey.

(sighs)

Surgery's here.
What do you got?

A 35-year-old fell
down a flight of stairs.

Head trauma,
intubated,
FAST negative,

labs pending.

Came in altered,
five -centimeter scalp lac.

Access?

18-gauge
times two.

First crit 37,
second one cooking.
Okay.

Want me to bag for you?

No, I got it.
Bolus is done.

Hey, Run D
five half at
75 an hour.

You don't want
a fluid overload

till we know
what's going
on in her head.

It was a nice wedding.

Thanks.

Sorry I got so crazy.

I think because I
knew I was leaving.

I let it all hang out.

I mean, you hardly
even know me,

and then I had to go
and be like that.

Don't worry about it.

Dr. Morris, your TPA patient
is seizing.

I'm busy here.
Find Pratt.

Don't worry about it.
I got it. Go.

Mae Lee, call CT.

Tell 'em we're
coming up.

Is there a Megan
Strand here?

That's me.

Neighbors heard screaming
in your house this morning.

We were having
an argument.

Where the hell
is my ceftriaxone?

No, it's Pratt.

P-R-A-T-T.

Hell, no, I'm not new!
Are you?

Listen, just send
the stuff down, all right?

I ordered the antibiotics
over an hour ago.

Learned helplessness
is pervasive in the ER.

Can't have a home-schooled
pharmacy tech wag the dog.

You rang?

What's going on?
Who are you?

I'm Dr. Kevin Moretti.

I'm the clinical
director of the ICU.

They called
me down here

'cause your wife's
condition is deteriorating.

Talk to me.
Fever to 103.

Stain showed
gram positive cocci.

Yeah, we thought
it was a contaminant.

Which is stupid.

Katey, set up
for a subclavian,

prime the line
and get a CVP monitor.

Draw a lactate
now, you,

and, uh, give me six units
of packed blood cells

standing by
in the blood bank.

Who was the attending
on this case?

Me.
Really?

Well, you dropped
the ball, didn't you?

Excuse me?

She's septic.
It's obvious.

You should have
anticipated this.

PRATT:
She's young,
she's healthy.

She had no reason...

She doesn't need
a reason.

(laughs)
A reason.

Breathe, please.

Katey,

do you see any signs
of impending shock here?

Tachycardia out of
proportion with the fever,

widening pulse
pressure.

See that? Even
a medical student

could see it coming
from a mile away.

Must be some
new-attending thing.

We'll take care
of your wife, sir.

Don't worry about it.

I can manage my own patients,
thank you.

Really? Then why did one of
your nurses activate my team?

Excuse me.

I knew you were getting slammed.
She needed attention.

The Rapid Response team
doesn't even cover the ER!

Well, if you can't handle
slam dunk cases like this,

maybe we should.

Give me one percent
lido. Let's go.

Explain this again. I don't
understand. My wife is healthy.

All right,
calm down, sir.
Honey, it's okay.

Look, the bacteria could
have seeded the bloodstream

through the lungs, a cut in
the skin, her intestines.

Second
liter's in.

Mm-hmm.

Goal-directed resuscitation
for septic shock is so easy,

yet so difficult
for you ED types.

She's in shock?

Systolic's
only 82.

That would be a yes.

The key is to preserve effective
tissue perfusion

while avoiding excessive

myocardial oxygen
consumption.

Translation--
get oxygen

to the body
without stressing the heart.

We need CVP monitoring

and continuous central venous
sats to keep track of that.

See that? He's
learning already.

PRATT:
That requires ICU-level
monitoring.

We're too busy
down here.

We can't do that.

Really? You can't?

You can, and you will. Watch.

We don't have
the nursing capacity.

Patients come in,
we stabilize them,

then we send them up.

That's how it works.
Yeah?

You forget about
that eight hours

that they sit around in triage.

And wait another five
to get a bed.

Look, it's not great, okay,
but it's the reality.

Reality is nothing more
than a persistent illusion.

Einstein said that.

I'm a physicist.

Memorized everything
that guy ever wrote.

See that? Even more reason
not to sit around

and let your organs rot away
like rancid meat.

Nobody's organs are rotting.

Free air under
the diaphragm.

Probably a perfed
diverticulum.

What's that mean?

Um, what that means is,
an infection

in your intestines has
eroded through the wall.

We need to get in there,
clean up and repair the hole.

Lucien, don't you tired
of ER docs waiting around

for the surgeons to come
down and save the day?

Give 'em a break,
Kevin. You know what
it's like down here.

I'm going to call the OR,
tell them we're bringing her up.

It's true-- I know
that we're just monkeys

on a minor planet
on an average star,

but...

let's not pretend
that sepsis is beyond our reach.

If you're trying
to quote Hawking,

you mangled it.

I think I'm in love.

BLAKE:
Alison!
What are you
doing here, Blake?

Hey, look, she called
me, all right?

Hey, whoa, guys, hey!
JAMES:
You don't get to do this!

Whoa, whoa,
come on!
Hey, hey, come on.

She wants me here, okay?

Take it easy, all
right? Come on. Whoa!

Stay away from my wife!

Where are you
taking her?

CT scan.
Can I go, too?

No, no, no.
Why don't you stay here?

Dr. Gates will be
with her the whole time.

Is everything okay?

No, my girlfriend's
in a coma.

It's all my fault, so, no,
everything is not okay.

All your fault?

How is that?

I left my roller blades
at the top of the stairs.

It's polished concrete.

It's very slippery.

We were fighting,
and she tripped.

Well, did you explain
to the cops what happened?

I'm sure
they'll sort it out.

Yeah.

No, it's been a bad year.

How so?

Moved to Chicago
five months ago for my job.

Ever since,
we've been fighting constantly.

These huge,
dish-breaking fights.

And we never used to do that.

You know?

It's like
the city's changed her.

Well, transitions are hard.

Been together
ever since college.

Been through a lot.

You know, us coming out
to her family,

and her brother dying.

You think you can make it
through that kind of stuff,

you think you can make it
through anything.

Who knew, after 15 years,

and everything would turn
so much?

It's scary.

Yeah.

BLAKE:
Quantum information

processing,
teleportation.

You know, we've been
chasing the same questions

since grad school.

I'm sorry if he feels
threatened by it,

but there are
certain conversations

she can only
have with me.

Vice versa.

But it's only work, right?

Yeah, we're
both married.

Happily married.

Can't say that the idea has
never crossed my mind, but

Alison and I just
really click.

I don't know anybody
else, male or female,

who challenges me
like she does.

They have this thing.

They're together
in the lab all day,

and then she gets home,

and everything's,
"Blake said this,

Blake did that."

Something about it
has always felt weird.

He's her work husband.

Yeah, people spend more time
at work than they do at home.

Share experiences,
develop a verbal shorthand.

Of course,
some intimacy develops.

The two men in my life--
they don't get each other.

Really? Never would have
noticed that.

The OR's ready.
Okay.

Two planets revolving
around the same sun.

Collision is
inevitable, right?

They try to stay out
of each other's orbits

to keep the solar system
in order, but...

(laughs)
it's a useless exercise.

Disorder rules.
Oh, yeah.

The universe always
reverts to equilibrium.

I'll see you upstairs, okay?

JAMES:
Wait!

Honey, I'm sorry.

I went a little crazy.

James. James.

I want you
to do something for me.

BLAKE:
So, am I going
to have a scar?

No. The edges came together
nicely. It'll be small.

Hey. I have to head back up
to the ICU,

but I wanted to suggest
that you write this case up

for M and M next week.

What's M and M?

Uh, it's a conference
where we present our mistakes

and learn from them.

You made a mistake
with Alison?

No. No.
Well...

Will you please excuse us
for a minute?

What-what are you
trying to do?

Trying to
wake you up.

Why are you talking like that
in front of a patient?

How does that help anyone?

Where'd you go to
medical school?

Here.
And your residency?

Here.

Mm-hmm. Your
internship?

Why are you asking?
You know it was here.

Because I think that you have
been lulled into complacency

by too many years
in this place.

You know what? You got a problem
with the ER, you talk to Kovac.

Well, no, it's too late
for Kovac.

He's the old guard.

I think you could really
turn things around here.

You know what? Now, you're
really starting to bore me.

How about this?
How about you go up

and harass your own department,
and stay out of mine?

It's always nice to
talk to you, Dr. Pratt.

Will someone please make
this jerk disappear?

Who?
The guy is toxic.

What guy?

Oh, hey, excuse me.

Excuse me?
Can you hold up?

Did you finish
interviewing
Megan Strand?

Yeah. We're just waiting to see
if we can get a statement

from Sophia
when she wakes up.

Oh, that might
be a while.

She's intubated,
but, listen,

I was talking
to Megan,

and her affect
seems totally
appropriate.

The injury matches her
story, and I'm just...

I don't know.
I'm not getting
that abuse vibe.

Thanks, Doc.
Yeah.

Make sure you write that
in the record.

It'll be helpful
if this goes to court.

Right. Thanks.

Well, no-no
promotional rate?

What about
frequent flyer programs?

Triple A? Fine.

Uh, three more nights
at the honeymoon suite.

Charge the card.

Don't get snarky.
I'm too fragile.

Oh, I thought things were
going well with you and Hope.

Yeah, they are.
Really well.

Staircase girl
has a head bleed.

Frontal parenchymal bleed?

Yeah, less common
than a sub or epidural,

but consistent
with a fall.

Okay, I'll call
Neurosurge. Thanks.

Hey, Neela, hey.

Have you heard
anything from Ray yet?

Why, no. I thought
he'd be here.

Yeah, well, I mean,
that the ER closed,

maybe schedules
got confusing.

Yeah.

I'll try paging
him again.

Hey, Mayday, I hear

you're taking
the gastroschisis kid up.

Yeah, I'm just about
to write the admission orders.

Operating on adhesions
create new adhesions?

Possibly, but we don't
have a choice

if he's acutely
obstructed.

All right. I'll keep
him NPO. Thanks.

Hey, Morris,
you got a snake breeder

with a fang
in her leg.

Nice seeing you, Tony.

Thanks for the consult.

Hey, what?
What did I do?

This is easy for
you, isn't it?
What?

"Hey, Mayday, did you see
my gastroschisis kid?"

Like nothing happened.

Come on, Neela,
you're not being fair.

I mean, how can
you be so casual?

Hey, you're the one that
broke up with me, remember?

Meg. Sarah. Everything just
rolls right off of you.

All right, you
know what?

Why don't you tell me how
upset you want me to be?

On a scale of one to
ten, what, a seven?

And then, when
you're feeling needy,

we'll crank it
up to an eight,

put it down to a five when you
want to get your work done.

Now you're just being an ass.

You think this doesn't
upset me? It does.

This is painful for me,
but you want what you want.

You know, so I just...

We're trying to figure how
to work without the drama.

But now I realize
something-- you,
you like this.

You want
the drama.
That's not true.

It is true.
I don't want
the drama.

No matter how I act,
you're gonna be upset.

You're the one
at the wedding being...
You know why?

Because that's the only way
you can maintain this stupid,

narcissistic game.

Wow. I hope that
never happens to us.

RASGOTRA:
They managed to repair
her damaged intestine,

but her blood pressure
dropped very low.

It'll be a while
before we know anything.

Six hours ago she
was giving a talk

in front of hundreds
of people.

How did she end up
here?

Well, sometimes things
just... happen.

There's really no way
to make sense of it.

She's not in pain?

I'll make sure
she has a morphine order.

How's she doing?

Still needs dopa to keep
her systolic above 85.

And I think
she's third spacing.

She had a touch of DIC,
lost two liters in the OR.

Hey, um, why didn't
you scrub in?

Well, I wasn't sure
that you'd want me to.

Why wouldn't I?

(sighing):
Men are impossible.

Listen, Neela,
about the...

Do you think I'm
a narcissist?

Well, to a certain extent,
all surgeons are.

Yeah, it's good
for the job.

CRENSHAW:
Hey, guys, uh,

Mae Lee's off
to the airport.

I just wanted
to thank you guys

for an amazing
experience.

Good-bye, Mae Lee.

Yeah, strong work this month,
Mae Lee.

It's the ER.

One final consult
before you go?

Call me if you're ever
in San Francisco.

Little freak tried to
kiss me at the wedding.

What's she still
doing here?

Get her to the ICU.

Oh, runs of v-tach,
she's not ready to move.

Oh, come on.

It's a hundred
feet of corridor,

and it'd be better for
her to code in the ICU
instead of here.

Well, for her or for us?

I'm serious, Neela.

You know, we got
five full ORs,

we need to make room.

Let's go.

MORRIS:
She loves tulips.

uh... yellow.

No, no, no, no, no,
uh, white.

White. Two,
two dozen

white tulips...

hey, newlyweds,
to be delivered

to room 1258
at the Ritz.

How, how's it feel,
guys?

You know Morris is staying
in our honeymoon suite?

What?
Yup.

With Hope.

They won't leave.

Did you wake up the next day
feeling different?

Uh, not really.
Yeah.

Just a little.
Well...
not that much.

Well, your wedding was awesome.

I just hope that thing I did

didn't make you lose
your security deposit.

What thing?
What?

Hey, everyone,

in the ER,
for the first time,

Mr. and Mrs. Luka Kovac!

(applause)
Oh,

sorry, Abby,
Dr. and Mrs.

Luka Kovac.
Doctor and doctor.

Sorry.
Hey, Chief,

aren't you supposed to be
in Bora Bora by now?

Uh, Hawaii.

And I just attended my last
department head meeting

so I'm officially no
longer your chief.

You're kidding.
Wow.

It's like
your wedding happened

and now
everything's changed.

You're married, uh,
I'm with Hope,

uh, you're not the chief
anymore,

there's new ramps
in the bathroom--

It's a brave
new world.

Gates is still
a pain in the ass, though.

At least there's something
you can count on.

You done, Morris?
You had enough?

Tony, there's a lawyer
out there

who says he needs
to talk to you.

Thanks, Dawn.
Hide, Gates.

I'll tell him you
went home sick.

I'm going.

See you at home.
Okay.

Uh... being married does feel
a little different.

Yeah, it does.

DUBENKO:
Aww...

look at that.

Lucien.
Hey, Luka.

Abby, I saw
the Cheetos bezoar.

Send him home
on miralax,

have him follow up
with GI.
Okay, done.

Nice wedding,
by the way.

I offered to
replace the bidet.

What bidet?

MARQUEZ:
Abby!

Your head injury in Trauma
Two lost her pulse.

Clear!

MARQUEZ:
Still v-fib.
Going again.

And... clear!

I was on the phone,
they paged me.

What's going on?

Sophia's heart went
into a dangerous rhythm.

Oh, my God.
Epi's in.

All right, back
up, back up!

Clear!

Resuming CPR.

Oh, no, no, baby,
don't do this.

Lidocaine's ready.

DUBENKO:
Okay, is neurosurge
involved?

No, there's nothing
to evacuate,

the bleed's
parenchymal.
You can't
leave me now,

you hear me?

Go ahead,
give the lido.

Things that we said
and the way we were,

it's not us, right?

You're my rock,
always calm.

DUBENKO:
Another epi,
charge 360.

Megan, when you said
Chicago changed her,

what did you mean?

That she's so testy,
and, and paranoid.

(sobbing):
Please don't die.
Okay, clear.

Please clear.
Watch out.

Move.

We have a pulse.

She's back.

What do you think of this film?

Uh... Frontal lobe bleed,
no shift.

You think it could be a
preexisting AVM exacerbated

by the head trauma?

I mean, a frontal lobe mass
would explain the personality

and the behavioral
changes--

You're a romantic, Abby.

What?

You don't want
to believe

that after years
of partnership,

they started hating
each other.

Call Radiology.

If you're right,
she needs angio.

The girl's lived with you
for ten years.
Yeah, yeah.

You're the closest thing
she's had to a father.

So, that's gotta count
for something, right?
It does.

Given the situation,

I'd say you have equal standing
to seek custody.

Equal? The same as
her grandparents?

Even though I'm not
a blood relative?
Yep.

Especially if Sarah wants
to stay with you.

Wow.

Well, I just thought because
I wasn't related...

This is good. All right,
okay, good, good.

What, what else?
What's next?

Well, first thing is
to talk to Sarah.

Make sure
she wants to stay.

She does.
I know she does.

12-year-olds can
be fickle.

I've got two adolescents
at home.

Talk to her.
All right,
then what?

Then call the grandparents
and let them know.

So, that's it?

That's it.

Okay.

Injecting
the cyanoacrylate.

Amazing pickup, Abby.

What made you think
of AVM?

Well, her girlfriend
kept going on

about how she'd become

like a totally
different person lately.

Lots of couples
go through that,

they don't all have
arterio-venous malformations

in their brain.

Well, it was just a
hunch, I guess.

Congrats on the wedding.

You think it's going
to be strange

to be a husband
and wife working together?

No, it's definitely
strange

to have people refer
to us that way.

Get used to it.

Contrast.
Are you married?

Oh, no.

Only people I ever meet
are doctors.

And doctors make
crummy husbands.

No offense.

You know, I used to
think it'd be cool

to end up with a
composer or an artist,

someone that would bring
something totally different

to the dinner
table, but...

you know, it's really nice
to go home to somebody

who understands all this.

I can see that.

Look.

No more antegrade
opacification
of contrast.

So the embolization
worked.
Yep.

Great.
Very nice.

BETINA:
What are you doing here?

Oh, I just came to
check on the patient.

Uh... wait a
minute, I thought

that Morris was
the attending, so you...

Okay, uh,
thanks, Betina.

I'm going to give
Megan the good news.

I was on a little break,

so I thought
I'd bring you some coffee.

Oh, don't drink coffee.

Well, that's, uh...
good to know.

Now, listen, Betina...

I just want to hangout
with you for a while.

No plans, no games, just me.

And the patient here
on the table.

(chuckling)

You can stay
but don't touch anything.

KATEY:
Hospital day 12

for this 72-year-old
with a GI bleed.

Vitals stable
overnight,

pressures in the 90
to...
Who was the
first person

to measure blood
pressure, anybody?

It was a clergyman in the year
17... blah, blah, blah.

And he took a glass tube

and he stuck it

into the carotid artery
of a horse

and he was very surprised
to see the blood rise up

into the air
about nine feet.

Why he did this exactly,
I have no idea.

I mean it's very, you know,
impractical for human beings.

And I'm sure the horse
didn't appreciate it.

Sorry about that.
Go ahead, go ahead.

F-Finish,
Katey, go.
Okay.

Uh... next we have
a 64-year-old

presenting...
RASGOTRA:
Hi, we need
a room!

This is Alison MacKenzie,
our septic with the bowel perf.

Lost a lot of blood,
having some ectopy,

and didn't tolerate the trip
down the hall too well.

Tachy, on
two pressors.

CVP is only six.

Run of v-tach.

Can I ask you
a question?

Why didn't you stabilize
this patient

in post-op instead of
bringing us this shocky,

fragile mess?
Well,

she got four units
of blood

and...
Look, I'm not
an idiot,

I know about the
post-op audit

that Dubenko's doing.
He doesn't want this patient

in his PACU because
it'll mess up his data.

No, that's not
what's happening here.

He'd rather have
her code and die

in the ICU than
on his watch.

Die?
Yeah, well,

we'll try to avoid that.

You tell Lucien
this can't happen again.

You know, this
wasn't his idea.

Yeah, right.
You know,
I...

I thought she was
ready to move.
KATEY:
V-tach!

No pulse.

Starting compression.

Oh, no, this can't be happening.

Charge to 200.

Nice job, Neela.

Let's just stay focused
on the patient, shall we?

Clear.

KRISTIN:
Katey, someone
on the phone

says they've got to talk to you
right now,

it's an emergency.
I'm in the middle of a code.

No, go, just go,
just go.

And there's
a guy outside

begging to come in
to see this patient.

He's not family.

He can't be here.

You might want to rethink that.

What?

Look, your wife is doing
everything she can

not to die right now.

She could probably use

all the support
she could get.

Epi's in.

Okay, going again.

Clear.

Well, her heart is beating
at a normal rhythm, but...

her blood pressure is
still dangerously low.

Isn't there something
you can do about that?

We've maxed out
the medications.

They're not helping.

It's possible that the part
of her brain

that controls the
blood pressure isn't
functioning properly.

What?

Why not?

Because she received 45 minutes
of CPR.

Her brain was deprived of oxygen
during that time.

And when that happens,

we often see some degree
of neurologic injury.

She walked in
here today

with a stomach ache

and now you're telling me
her brain is damaged.

Look, I don't want
to take away all hope,

but I want to
be realistic here.

If she survives...

there most likely will
be neurologic deficits.

When will we know?

Well, there's no
way to predict.

It's a waiting game now,
I'm afraid.

Sorry.

I see.

You can go.

Please go.

Before she went
into surgery,

she asked me to
give this to you.

James.
I resented it
for so long

this thing you two have.

Even now I've got to
share her with you.

What did he give him?

I don't know.

Data.

Some kind of
treasured lab secret.

Well, how do you know?

Well, you work in the ICU long
enough, you start to recognize

these scenes are
frighteningly familiar.

They kiss their
spouse, their kids,

they say good-bye
to friends...

A certain percentage
have a deep, dark secret,

like an illegitimate child or
a secret debt or something,

but occasionally you
see something like this.

Practicalities.

Information
that must be passed on.

A computer password or a combo
to a safe or something.

Wow.

You're pretty jaded.

Many long,
tortuous cases.

You know, the human psyche was
not designed to deal with this.

Cave dwellers had to deal
with a lot more actual death,

but they were not subjected to
the slow, mechanized torture

that is the ICU.

Well, why do
you do it then?

To save the salvageable

and to give the rest
a dignified death.

Just a little low
on dignity these days.

Well, I'd have a hard
time working here.

Surgeons just like to get in,
do their job, and get out.

Yeah, well,
that's your job, but...

we are left to deal with
the dregs and it's not pretty.

I just want us all to do better.

I'm sick of seeing people die.

She had what's known as an
arterial venous malformation

in the part of her brain

that's responsible
for mood and personality.

That explains why she
seemed different to you.

And it's fixed now?

Yes, the radiologist was able
to clot off the veins

using a special kind
of glue.

And she'll go back
to the way she was?

Uh, that's the hope, yeah.

Did you hear that, baby?

It's all going
to be okay.

All right, she's waking
up, so we're going

to take out
her breathing tube now.

DAWN:
Nifs are good

and she's following commands
perfectly.

Okay, I'll need you to cough
on the count of three.

Okay? Ready?

One, two, three.

(coughing)

(weakly):
Megan...

I'm sorry.

I am so, so sorry.

I was upset.

I just... I didn't
mean to push you.

Okay?

Okay?

MORRIS:
Chocolate-covered strawberries,

room 1258.

No.

No, n-n-no,
I haven't checked out.

No, there must
be some mistake.

There's not
a mistake.

I checked out
of the hotel.

What? No. W-Why?

I-I paid for
three more nights.

I know you did,
which is crazy.

I got them
to refund your card.

I don't, I don't
want a refund.

Let's call them.

(laughing):
Archie, stop.

No, look,

the flowers,
the spa treatments--

it's all lovely,
but I don't need it.

Time to get back
to real life.

(sighing):
I don't want real life.

I-I-I like fake life where
we, where we wake up together

and take bubble baths and
eat bonbons for breakfast.

I don't want our crazy
wedding fling to end.

Uh...

Who said anything
about it ending?

I wasn't sure if...
(sighs)

Dr. Morris,

I have not done this
with anyone

in a long, long time,

and it's not because...

I haven't had
the opportunity.

I decided

to sleep with you
because it means something.

This isn't a fling.

At least not for me.

She snapped,
she had a momentary lapse.

It's not like she's
a chronic abuser.

We don't know that, and even
if we did, it doesn't matter.

RASGOTRA:
Hey, guys.

Did Ray ever show up?
GATES:
No.

No.
Well, did he call?

It's not like Megan was trying
to throw her down the stairs.

Oh, please,
give me a break.

She pushed her.
If this didn't happen,

Sophia's AVM
wouldn't have been diagnosed.

Excuse me,
is Dr. Pratt still in?

Nurses' station.

All I'm saying is one incident
doesn't make it abuse.

She responded to
anger with violence.

That's, like,
the definition.

MORETTI:
Dr. Pratt.

Oh, boy.

I thought I was done
with you already.

Millicent Lawford.

MI in the ER waiting room,

sat there seven hours
without being triaged.

Gertie Minton.

Renal failure,
12 hours to be seen,

and then arrested
from hyperkalemia.

Derek Shank,

in the ER three days

without DVT prophylaxis,

died-- died-- of a PE before
he made it to the floor.

We can do better
for these people.

Okay, look, look, I
get your point, okay?

But the problems
are systemic.

Too many people, not
enough resources.

Now, how do you suppose
that we address that?

Well, first, I think we start
by not believing

that this is
the best we can do.

Because it's not.

Right.

These are for you.

Ray?

Ray?

Ray?

SARAH:
So I could totally tell

that Melissa was copying
off my paper,

but if I tell on her,
then I'm a snitch,

and if I don't, then I'm
like an accomplice, right?

Right.

And I know, I know,
she's just cheating herself,

but it still seems
like she wouldn't do that.

Yeah, and, uh, we learned
in chemistry today

how to freebase cocaine.

Really?

Tony, you're totally
not listening to me.

(sighs)

Sarah, when your
grandparents wanted you

to move in with them,

I thought that, maybe,
it was the best thing.

I don't want to go
to a new school, Tony.

I don't want
to go and live with them.

I was scared and I...

I just didn't think I had
what it takes to do this,

but then when we
took the test,

I realized that...

I wish it had gone
the other way.

I wanted to be your dad.

I wanted that, too.

So...

I work a lot and I'm messy

and I may embarrass you at
father-daughter dances...

...but I really love you, Sarah.

You're my family.

And it turns out that...

if you want to stay with me,

you can, if you-- I mean,
if you still want to.

(Sarah laughing)

(Kovac speaking Croatian)

Hi.

Hey.

I missed you guys.

Missed you, too.

How was your shift?

Oh... who cares?

It's done.

No work for two weeks,
the honeymoon starts now.

Does that mean you're ready
to change into the bikini?

Maybe after Joe
goes to bed.

Joe, go to bed now.

I got him.

Sweetie...

You playing soccer?

(phone ringing)

Hello.

(speaking Croatian)

Hey, Donald, it's Kevin.
Yeah.

Look, I'm glad
I caught you.

(clears throat)

Do you remember the thing
that we discussed earlier

about the ER?

Yeah, well,
I can't believe I'm saying this,

but, um,
I think I've changed my mind.

I have changed my mind.

I'll do it.

Have a good one.

Oh, good night.

Oh, good night, good night.

MORRIS:
Stay out of the ICU.

That guy's a dick.

(Hope laughs)

(laughs quietly)