ER (1994–2009): Season 13, Episode 4 - Parenthood - full transcript

Abby and Kovac discover both the joys and difficulties of raising a newborn; Morris is wrongfully accused of being a child molester; Pratt has his trial-by-fire when he has to handle the ER alone, juggling multiple traumas, teaching duties and a troublesome intern. Neela continues to be the target of her difficult supervisor, and Sam discovers her sons latest extra-curricular activity.

Previously on ER:

Are you loving
motherhood?
Yeah.

PRATT:
Oh, this isn't awkward?

What? That you and I
are equals now?

Dr. Crenshaw is
our new chief resident.

Neela Rasgotra.

Two years in the ER,
then defected.

It took you that long
to figure out you were
wasting your time?

I'm your daddy.
What's up?

How's the new intern doing?
She's very, uh, devoted.

(quietly):
Thank you, Jesus.



Were you the best one there?

How many people did you save?

Did you rock?

Next time you don't do
what I tell you to do,

or any other attending
tells you to do,

you're gonna find yourself
getting bum-rushed

right out of this program.

You don't even
appreciate the fact

that I took
the time and money

to go out and buy you
some new clothes.

I didn't ask you
to do that.

No, because you'd rather
go to school dressed
like a bag lady.

Would you rather
I dressed like a slut?!

Because that's how most
of the other girls dress.



I'd rather you dressed
like someone that has

a mother that
cares about her.

Tony, would you please
say something?
Good morning.

What's wrong
with the way I dress?

She won't even try on the
clothes I bought for her.

Those are nice.

They're ugly, and I refuse
to conform to some anorexic,

media-fueled ideal

of beauty.

That's fine,

but you're not leaving
the house dressed like that.

Tony?

I hate

living here!

LOCKHART:
We never resolved
the nanny issue.

Do you really want someone else
raising our child?

Well, I'm just talking
about a few hours a week

so I can at least get
some stuff done around here.

Oh, I thought we had agreed
to stagger our shifts.

Well, and what,
never see each other?

I mean, even
if that was practical,

after your
first day alone,

you'd be begging
for help, trust me.

Mm. I think
I can handle it.

Well, if you can
handle it so well,

help me get Joe
in the car.

We're late for our first
Mommy and Baby class.

(baby cooing)

What?

Nothing.

What? I thought it
would be fun for... What?

I didn't say anything. What?

(speaking Croatian)

I'm late for work. Bye.

I'll call you later.

Don't forget his frog.

(toy croaking)

(Joe crying)
I know.

Come here. Oh.
Can you say

"Daddy is a butthead," hmm?

Why is your daddy a butthead?

SARAH:
I look like a dork.

GATES:
No, you don't.

This is not my style,
and this is not me.

If you didn't like what
your mother bought you,

ask her to go shopping.

Then you guys buy
something together.

What are you doing?

Damage control.

Sarah...
What?

This is not cool.

Do you mind?
I'm changing.

I hope your mother
doesn't find out about this.

She won't.

And besides, you don't know

what it's like
for girls my age these days.

Hmm.
There is a lot
of pressure at school.

Oh.

What you wear,
what you eat,
what you don't eat.

What's his name?

Who?

This is obviously about a guy.

No, it's not.

Yes, it is.

Maybe I should dress
like a hussy.

Maybe we should get
you a plaid jacket.

We'll just tell everyone
you're a lesbian.

(sighs)

Adam.
Huh?

Adam Horner, but he doesn't even
look at me.

Well, good. I don't want
some guy named Horndog

anywhere near you.

It's Horner.

Listen, most guys are jerks,
but if you want this guy...

Okay, wait a minute.

You're a guy.

Exactly, and if you want
this guy to notice you,

forget about your clothes
and ignore him.

That's your advice?
Yup.

Ignore him?

Yup, that's right.

Wow. You really suck
at this.

Trust me. Most guys want
what they can't have.

You ignore him, that guy'll come
running to you, all right?

Try not to kill anyone today.

Bye.

TAGGART:
He's out.

PRATT:
All right.

Hope, you're going
to take a deep breath,

and you're going
to hold it.

Now, if you don't get
the tube in by the time

you run out of air, we're gonna
stop, and we're gonna bag.

Okay? Are you ready?

With you and Jesus
guiding my hand, I am.

PRATT:
Right.

(inhales deeply)

Okay, sweep the tongue
to the side

and advance until
you're in the vallecula.

Elevate the scope
at a 45-degree angle.

See the cords?

All right, I'll give you
some cricoid pressure.

How's that?
Come on, Hope.

The cords should be
right there. He's a young guy.

All right, pull up more, but do
not rock back against the teeth.

Aim the end of the handle

to where the wall
meets the ceiling.

Can you see
the aryepiglottic folds?

Hello?!

Sats are
dropping. Pratt.

Whoa. All right,
pull out.

You bag, you breathe.

(loud panting)
I'm sorry...
I ran...

If you were doing
what I told you to do,

you should have been able
to pass the tube. Come on.

Maybe you should
sit down.
Yeah.

Okay.
I don't feel so good.

Uh, I'm in.

(thudding)

Yeah, this should keep it
from swelling.

Oh, bless you, Sam.

What happened
to her?

Nothing.
(pager buzzes)

Damn, it's only
the morning test.

What are you doing
with the transport beeper?

I gave that to Jane.

You know, I don't think she
really wanted it, so I offered.

You can't monopolize
the beeper, Ray.

The other residents need
the experience, too.

She gets airsick.

Hey, what's going on
with your rhabdomyolysis guy?

He's pretty stable.
He's making urine.

What about his creatinine?

I'd have to
check the chart.
Peak CPK?

Medicine team's
all over it.

Come on, man.
You got to be all over it.

You cannot let
the internal med docs

take over
your patient's care.

I can't?
Hey, I'm serious, man.

You've got
critical patients.

You got to stay
on top of the labs.

I know, but the guy was ready
to hand off, and I...

And what?
And that was
a great talk.

What the hell's going on
with the PACS system?

Down again.

They said they should
have it running in an hour,

but they've been saying
that since yesterday.

So, is it true?

Rumor is
you killed an intern.

Yeah, I wish.

You know, everything
in this place is crap.

The equipment sucks,
the students are incompetent,

the interns
can't finish a chart,

the residents-- they don't give
a damn about their patient...

Yeah, okay, okay, Kovac.

I see what
you're going to say.

That I was the same way,
right? But I wasn't.

I didn't say anything.

Yeah, I could chart,
I could clear beds,

and I never passed out
tubing a patient.

I know, you were
really, really special.

You need to go through
in-service exam results

with your residents.

Have you seen these?

See, this is exactly
what I'm talking about.

They don't know jack
about emergency medicine.

Solomon is an idiot,

Hope is annoying
and incompetent,

Gates should have stayed
a paramedic, and Jane is like...

What's wrong with
Jane? She is good.

No, Jane is creepy,
I'm serious.

She's always
sneaking up on me.

She's like those twins
in The Shining.

Look, in-service shows you
their strengths and weaknesses,

so focus on that.

They all have their
own learning process,

so you need to
adjust accordingly.

If the residents fail, it may be
because you're a bad teacher.

(sighs)

(sighs)

WOMAN:
Down on two,
up on three,

and mommies let go!

Good.

Everyone pick up their babies.

Hi.

I'm sorry I'm late.

I'm Abby, and,
uh, this is Joe.

Hi.

Hi.

Um, am-am I in the right place?

This is the, uh,
Mommy and Baby class?

Yes. Yes, it is.

Good. Well, uh... I'm a mommy...

(laughs)

...and, uh... and
this is a baby.

Uh, yeah, being suspended
by his crotch.

Excuse me?

You're carrying your child

in a device that can cause
hip luxation and spinal injury.

He really should be in a sling.

Oh, well, you know,
I'm a doctor, um, and...

Then you'd think
she'd know better.

She is sitting
right here.

WOMAN:
Well, um, then
you should know

that, um, a happy, healthy baby
is always carried in a sling.

Well, I do know

that if you dress your baby
like some sort of
designer accessory,

you're headed
for problems.

But don't worry.

I work in the ER,

so I'll be there
to take care of her

when she comes in 14, pregnant,
with a drug overdose.

Maybe this isn't
the best class for you.

WOMAN:
Thank you so much

for the lunch tray, Archie.

I particularly enjoyed
the bread pudding.

Oh, you're welcome, Emma.

That's one
of my favorites, too.

Ah, the return of Goat Boy.

I heard one of the doctors
made a charm bracelet

from all they took
from his belly.

Okay, here's what we got:
stable CHF, going to tele.

76-year-old lady with
pyelo, had levaquin.

Incomplete miscarriage.

Do a repeat pelvic
in an hour

to see if everything passed
and the os is closed.

Wait a minute, wait a minute.
What the hell are these?

Pass-ons. Oh, and her BP's a
little low, like 90 systolic.

She's type-and-crossed
for transfusion?

No, but that's a...
that's a good idea.
Do that, totally.

Two-year-old with
possible meningitis.

Ceftriaxone on board.

Currently at CT,
needs an LP when he gets back.

Morris, we do not
sign out spinal taps.

Since when?
Wait a minute,
wait a minute.

Hold on. These aren't pass-ons.
They're train wrecks.

I'm not taking them.
Dude, I can't.

Max has a soccer game.
It's the playoffs.

I promised him I'd be there.

Who?
My son.

It's a family thing.
Yeah, his family even
know about you yet?

No, no, no, no. We're keeping
that on the low-low for now.

You know what I'm saying?

(chuckles)
Exactly.

Thanks, dog.

Did you just
see that?

Yup. He's your dogboy.

Please. He's
not my dog,

and he's not my boy.

And we don't use
the two together.

I know.
So, you're gonna
take one of these?

Nope. I have a trauma coming in,

and you're not always going
to have the luxury

of having another attending
on shift with you.

You need to learn how to handle
these things on your own.

Mr. Jennings is
on his way up to ortho

and Lundquist
is out of here.

Nice job, Ray.

Here's four more.

Are you kidding me?

Is this about
the transport beeper?

The packing is webril,
and we wrap with bias.

We try to keep it tight
enough to immobilize,

but not to the point
of discomfort.

You don't want to
cut off circulation.

Solomon,

you know, you didn't
do so hot

on the Ortho section
of the in-service.

So what's the difference
between a Jones

and a Dancer fracture?

Dancer's a proximal
avulsion.

Does great with
conservative therapy.

Jones is transverse,
a little more distal

and you got to keep
an eye on this bad boy

because there's a good
chance of non-union.

Let me guess: you just had
a patient like that?

No.

Right. Come on.

Who's got somebody
in Curtain 2?

Uh, me, sir.

48-year-old PSVT resolved
with adenosine.

Excuse me, doctor.
Is your boss still here?

Excuse me.

I need to speak with Archie.

Dr. Morris is not my boss

and I'm afraid
he's gone for the day.

Is there something
I can help you with?

No.

Jane, you need to focus

on Cardiology.

What are the options
with a hemodynamically stable

wide complex tachyarrhythmia?

Lidocaine if you think V tach.

What else?

(coughing)
Amiodarone.

Okay, I'm guessing amiodarone.

Well, procainamide and amio
can do the trick,

but you want to stay away
from beta and calcium blockers

'cause you'll end up
with V fib

if you have a bypass tract.
Right?

So how'd you manage to fail
every subsection

of the in-service exam?

I guess I just don't test well.

Well, you better start.
Come on.

Have you got
something to present?

No. Actually I started
with Dr. Kovac...

Where are your charts?
Let me see them.

Well, I'm still
working on them.

I told you to keep
them current.

You got to do them
as you go.

What part of this concept
don't you understand?

KOVAC:
Five-year-old with
crush injury to abdomen.

He and grandpa were
chopping down a tree.

They're bringing grandfather
with chainsaw injuries.

All right, I got it.

All right, keep working
up your patients

and grab a couple more charts.

KOVAC:
He needs O-neg, a second line,
and page surgery.

Where do you think
you're going?

Chainsaw injuries
can be gnarly.

No, no, no, you need to finish
with the patients you've got

before you do
anything else.

Dr. Rasgotra?
Yes.

Hi, I'm Katey Evans--
medical student.

Dr. Crenshaw told me
to shadow you today.

He did?

I got the feeling I was
getting on his nerves.

He gives that impression
to everyone.

Hey, Katey.

Friend of yours?

Hardly.

We went out a
couple times.

It didn't work out.

Too bad. He's cute.

Cute, but he's way
too into himself

and to be honest,
he's orally challenged.

Oh, bad breath?

Not exactly-- he won't
go south of 14th Street.

You know... He refuses
to dine at the Y?

Oh, I'm sorry.

This is what
I'm talking about.

Making friends
and saving lives.

Does it get any better
than this, ladies?

No, it does not.

So, Mrs. Draper is back
for her 27th hospital admission.

Status: postpancreatic
pseudocyst.

27th?

Yes. Someone needs
to tell her

the hospital stopped giving out
frequent flier miles.

Oh, and she's a chronic
rectal discomfort.

And you two get
to work her up

and review her old charts.

All 27?

No. Why don't you forget
all about visits

six, 13 and, um...
what do you think, 21?

Yeah, that should
keep it interesting.

It'll be like playing
patient roulette.

Be prepared to present her
at afternoon rounds.

Smiles all around.

Maybe he should use
his extensive surgical skills

to remove that bug
from his ass.

Oh, saved by the bell.
We're paged to the ER.

I'm so glad I'm not
doing an ER rotation.

I have heard horror stories.

Oh, it's not so bad--

once you get used
to the smell.

The line is good to go.

Pressure's only 85
after the bolus.
How much O-neg?

40 per kilo.
800cc's.

Chest and pelvis films are back.
KOVAC:
Let me see.

Sam, your son's school called.

Said he never showed up
for homeroom.
First hemoglobin is 9.8.

What?
I dropped him off this morning.

Type and cross four units.
He's losing a ton of blood.

Crush injury?

Yeah. Unstable pelvis.

Open book fracture with complete

SI joint disruption

and lateral displacement.
SAM
I've got the T-POD.

How's the belly?

Spleen is okay.
Looks like a small liver lac.

So he goes to angio first?
For embolization.

Hypotension
and pelvic fracture has...
A 50% mortality.

Blood at the meatus.

Probably tore his urethra,
but that'll have to wait.
Along with his liver.

If they can stop the pelvic
bleeders in angio,

he might make it to the OR.

Okay, bring blood, FFP, and
get him on a portable monitor.

It wasn't a very big tree.

It was only about eight inches
in diameter.

I was just finishing the cut
when the chainsaw broke... Ow!

Sorry about that,
Mr. King.

We're going to get you
really numbed up right now.

Another five of lido to me.

How we doing in here?

He's pretty lucky.

Most of these wounds
look superficial.

I'm just going
to clean and close.

How's my grandson?

Uh, his injuries are serious:
he's bleeding internally,

but he's hanging in there.

Can I see him?
KOVAC:
Not right now.

We're taking him upstairs
and we're going to try

to stop the bleeding, okay?

You good down here
if I go up to angio with him?

Yeah.

I'm good. Go.

Okay.

I was being so careful.

I thought he was safe.

Don't worry, sir. We're doing
everything we can to help him.

Are you almost
finished in here?

No. Why?

I could really use your help
in Curtain 2.

You've got to be a little bit
more specific, Ray.

Okay,
Morris' little old UTI lady,

the one that's just "waiting for
a ride," has a systolic of 55.

(sighs)
Damn it, Morris.

All right, here,
keep irrigating

and set up
another suture kit.

I'll be right back.
Got it.

76-year-old,

fever and gram-negative rods
on the UA.

Morris said she was tucked,
nothing to do.

I guess he lied.
Yeah.

Tachy after two liters, he
should have seen this coming.

Access?
PIV, we're working
on another...

HALEH:
Pratt!
Here.

BARDELLI:
Rennie Stevens,
welding tank explosion.

Second- and third-degree burns
over chest, face, and arms.

Vitals?

Tachy, BP: 138/90,
sat 82.

Other one's
more stable.
Other one?

Luis Escobar, 23,

shrapnel to neck
and left chest.

Vitals stable,
good breath sounds.

All right.

I better page an attending.
I am an attending.
I got this.

Put him in Trauma Two.
Jane!

You're with Haleh.
Solomon, you're with me.

Come on,
Trauma One.

Let's go.

Ray, titrate dopamine
and mix up levophed

if she doesn't respond
to 10 mikes.

All right.
All right?

Alex, where are you?

No, you're not.
Don't lie to me.

The school called
the hospital.

Yeah, well, you got ten minutes
to get your butt back to...

Solomon,
help Sam make some room.

Please give me something
for the pain!

All right,
another five of morphine.

Hang tough, Mr. Stevens.
We're going to help you.

Start a second line with
two liters of LR, wide open.

Full thickness
over the entire chest.

I'll alert the burn unit.

Sats down to 83.

Okay, listen to me
very closely, Mr. Stevens.

We need to put a tube in
to help you breathe, okay?

Eight-oh and an
intubation tray.

I'll be right back.

Talk to me, ladies.

Blunt and penetrating trauma.

Thrown against a wall
by the blast.

Looks like shrapnel

to the upper torso and neck.

Hey, what's
your name, man?

Luis. Luis Escobar.
How's Rennie?

Uh, we're working on him,
but now it's your turn.

Tell me where it hurts.
My chest.

BP: 95/65.

Yup, he's decreased
on the left.

Sats 92%.

Any pain here?

(Escobar yells)

All right, CBC, chemistry,
coags, type-and-cross for two,

liter of ringers, C-spine,
chest, and pelvis. Page surgery.

I'll be right back.
You're doing good, Mr. Escobar.

(crowd applauds)

MORRIS:
That's it, Max.

That's it. Hustle!

MAN:
Go, Stuart, stay with him.

Come on, Max, come on.

You take this guy.

If you can't go around him,
you go through him!

Hey, come on, man.

What?
You're not setting
a good example.

Whoo!

That's it.
Nice, nice, buddy.

You're killing them
out there.

Who is that
with your son?

I don't know.

Excuse me, Coach?

Who's Max talking to?

COACH:
I'm not sure.
He said he was a friend.

Chest x-ray on Escobar.

All right,
pneumothorax on the left.

Set up for a chest tube.

I'll be right over.
We're having a hard time
finding a second line.

Dr. Pratt,
he's bradying down!

Hold on.
Try a saphenous.

If that doesn't work,
we'll go central.
Right.

Heart rate's in the 40s!

I need to put a tube
in your chest

to re-expand your
lung, Mr. Escobar.

Need any help in here?
Push 50 mikes of fentanyl.

What's going on
with Morris' patient?

Uh, I think
she's doing okay.

I handed her off
to Gates.

Gates?
You left her with Gates?

Yeah, he's all over it.

All right, you're going to
feel some pressure here, okay?

(grunts)

Gates is an intern, Ray.

Who's supervising him?

I guess,
officially, you are.

Jane, find out
what's going on with Gates.

I'm not having any luck
with the ABG.

Angle the needle
at 45 degrees.

I can't see.
My glasses keep fogging.

Well, maybe next time,

you should leave
the hazmat uniform at home.

Feel for the pulse.
You see that?
Yo, Doc.

Your sheet metal guy in Exam 3
lost his foot pulse.

Nurses can't get
his leg out.

All right, tell them to give him
five more of morphine

and, uh, grab me a Doppler.

I'll be there in a few minutes.

Someone grab me
a central line kit.

This young lady needs
a CVP monitor.

You're putting it
in a central line?
Yes.

Early Goal-Directed Therapy
for Sepsis--

all the kids are doing it.

Are we going to get in trouble?

No, this lady is in trouble.

We're trying to save her,
that's what we do.

God,

give us the strength
and the knowledge

to help save
this sweet woman.

Hallelujah to that, sister.

Good embolization
of the superior gluteals

and pudendal arteries.

That ought to buy you
a little time.

Pressure's back down to 60.

Another 400 of PRBCs.

Crenshaw's standing by
in the OR.

Looks like the liver
lac opened up.

His heart rate's
dropping.
Damn it.

Okay, let's transfer him.

One, two, three.

Mig of atropine and
squeeze in the blood.

Want me to continue bagging?

No, see what they need
in the ER.

I've got this.

Hi, it's me.

Mommy and Baby
was a freak show.

Um, so we're headed
to the park and I thought maybe

even if you only had
a couple minutes,

you might want to come by
and say hi.

I'm going to look
for some normal moms,

so we'll be here
for a while.

Bye.

Hi.
Hey.

Can I sit here?

Sure.
Yo no quiero
perder mi trabajo

pero si mi jefa se entera,
es la primer vez en mi trabajo

y yo estoy muy nerviosa,
yo no se que hacer.

Quisas estas tarde.

Is everything okay?

She thinks she's pregnant.

Oh, congratulations.

Oh, no.

No?

No, the father is the husband
of the woman she works for.

Oh.

Wow, that's...

What's she going to do?

I told her to
have an abortion.

That's what I did.

You got pregnant
with the husband

of the woman you work for, too?

It happens.

Los uniqos hombres
que no fantasayan

con estar con sus nanasson
los que ya estan haciendo.

Mm.

What'd she say?

Oh, "The only husbands
that don't fantasize

about banging
their nanny...

are the ones
who are already doing it."

It's sort of our nanny motto.

Oh, you're all nannies?

Yeah, aren't you?

Yes.

Yes, I am.

All right, tube's in position,
no pneumo.

Vent pressures
are almost 50.

Damn it. Chest wall's
restricting lung expansion.

He needs an escharotomy.
Ten blade.

Sats down to 84.

All right,

put the vent rate up to 25

and the tidal volume
down to 500.

Solomon, I need room, man.

Okay, Mr. King.

We're gonna find you
a new parking spot.

Mr. King?

Mr. King,
can you hear me?!

TAGGART:
Son of a bitch.

Pratt!

The little head lac's
not so little.

All right,
keep pressure on it.

He must've hit
something arterial.

Recheck a crit and
type and cross for two.

Okay, okay, sats are coming up.
Thank you.

That's one down.
We need an
attending in here.

Pratt, take
a look at this.

All right, what's that,
fluid in the spleen?

Looks like a hematoma.
Where's surgery?

Paged them three times.
Anything else
in the abdomen?

Nothing in Morrison's.
Vitals stable?

Tachy, but pressure's okay.

Second hematocrit 38.

Entrance and exit lateral
to the midline.

Doesn't penetrate platysma.

Burn unit on two.

IV blew. We can't get
a second line in here.

And grandpa's crit
is down to 29.

All right,
I'll be right there.

What's going on with Gates?

He's asking for
a rib spreader.

What the hell would he be
doing with a rib spreader?

I'm not really sure.

TAGGART:
Pratt, what do you
want me to do?

Just a sec.
What's going on out there?

Sorry, sorry, we were
stuck upstairs.

What do you need?
Burn unit is holding.

All right, page Kovac.
Don't bother.

We left him
with a pelvic trauma.

The boy crumped
in angio.

All right, uh...

Neela, get this guy up to CT.
Ray will fill you in on the way.

Haleh, transfer that
burn unit call next door.

Jam it into overdrive.
Go! Go! Go! Go! Go!

Come on, ref.

That's a foul.
Come on, this is soccer,

not water ballet.

Way to go, buddy, dig deep.
Work that ball.

Hey. Sorry I'm late.
I got hung up at work.

How are they doing?

Winning two to one.
Go, Stuart.

Go, Stuart!
Come on, Max!

Dude, you stay
with him, buddy.

Come on, Maxie.

Kick in the
afterburners, baby.

Do you know that guy?

No, who is he?

Apparently,
he's a friend of Max's.

Never seen him before.

Oh, okay, don't get fancy.

Don't get fancy, just...
just put it in the net!

Put it in the net!

Goal!

(cheering)

Yes!

Baby!

That was a rocket, huh?!

That's got to hurt, right?

Yes!
All right!

Did you see that?!
Yeah, that was beautiful.

You were giving them a taste
of Maximum destruction.

(growls)

Hey! What the hell do you think
you're doing?

Did you touch my kid?!

What?

You touched my kid.
Whoa, whoa, wait.

He's not your kid?

No, I don't know
who this creep is.

Is this how you
get your jollies,

touching little boys
at a park?!

Whoa, whoa, whoa,

you're making
a big mistake here.

I think you're
making the mistake

you freakin' pervert.
Back off, man.

What, am I too
big for you?

Sir, are you okay?

Wake up.
Wake up, sir.

Call 911.
Get an ambulance.

And the cops.

There's no need to panic.
It's all good.

I'm an ER doc.
I'm an ER doctor.

Everybody just back up.

Let me do what I have to do
and give me...

Oh!

They spent about
a million dollars

on fertility drugs
to have this kid.

Look at her, that's not
a million-dollar baby.

Right, like,
take the hint, lady.

Maybe there's a good reason
why Mother Nature

doesn't want you
having kids of your own.

(speaking Spanish)

The woman she works
for is a bitch.

(speaking Spanish)

She felt sorry
for her husband.

He seemed so lonely.

(speaking Spanish)

She was always going away
with her friends.

And all she did
was shop.

My boss has closets
full of clothes

she never wears.

Which is good for me.

So you wear her clothes?

What, you don't?
No.

You fool around
with her husband?
No.

He's ugly?

No.
Oh, no, he's...

he's hot.
He's a doctor.

I worked for
some doctors.

They wanted to kids safe
so they let me drive the Lexus.

And they went away a lot,

so I could always
use their apartment.

Which they didn't know about.

Course not.

Course not.

How you feeling, Mr. King?

I was a little woozy there
for a bit,

but I feel better after my nap.

Bacitracin and
a gauze dressing.

These need to come out
in seven days.

You know, I could probably
take those out myself.

No.

You need to come in
for a wound check.

Hey, make sure
that guy's X-ray

goes up with him
to the burn unit.

He's had three
liters of fluid

and needs seven more in
the first eight hours.

Is there any chance
I can be with my grandson?

I don't think so,

but we can get an update
on his condition.

CT's back on Escobar.
Grade three splenic lac.

Okay, good.
Consent for surgery
and he's all yours.

Sorry, but my chief
wants to observe him

down here for a while.
You just told me
he tore his spleen.

With no free blood,
and stable crits.

His belly's tender,
he's tachycardic,

and he'll have other fluid
losses through his burn.

The OR's full.

We can't take him
right now anyway.

Well, we can't keep
him down here.

We're getting slammed and
he's tying up a trauma room.

I don't know.
Put him in the ICU.

Crenshaw says we can't
use our last bed in ICU.

Hey, that's not
Crenshaw's call.

What do you want me to do?

I want you
to get rid of him.

If his crits are stable
for six hours,

he can go to telemetry.

Neela...

Louise Escobar's
girlfriend is here.

All right, I got
to go find Gates

before he kills somebody.

When I get back, that
guy better not be here.

Systolic pressure in the 70s

after aggressive fluid
resuscitation but responded well

to a dopamine infusion at
10 mikes per kilo per minute.

What have you been doing?
Excuse me.

Central venous
oxygen saturation

is in target range of 88%.

At this time, patient
remains guarded but stable

for critical
care service.
What is that?

I'm dictating my notes.

And you're kidding me, right?

There's no time
for you to send stuff

to a transcription service.

I need your notes
on the chart now.

Well, I find it so inefficient
to write everything down.

Yeah, well, that's
how we all do it,

so you better figure it out.

And what were you doing
with a rib spreader?

Well, one of your minor victims
from the explosion came in

with metal wrapped
around his leg.

It was occluding blood
flow to the foot,

so I used the rib spreader
to pull the metal off.

Seemed safer than a
blowtorch, right?

Yeah, right, right, right.

Okay, hold on, hold on,
one second, one second, man.

I get it, okay.

You're the cool guy, the
paramedic who became a doctor.

And I'm pretty sure that
all the residents are eating up

your war stories
and tales from the street--

I don't tell war stories.
But this is the ER.

And we have a way
of doing things,

a curriculum for shaping
young doctors, even you.

Oh, is that what this is about?

You feel the need to "shape" me?

Why don't you just teach me.
I like the shape I'm in.

I can't teach somebody
who thinks they know everything.

What are you talking about?

Talking about you running
around here unsupervised.

Putting in central lines.
What was I
supposed to do?

You were busy in
a double trauma.

I saved some woman's life
and some guy's foot.

And what would have happened
if you had messed up

on either one?
I don't know.

Who would have been responsible
for that? Not you.

Me. It would have been
my ass on the line.

So do we have to go through this
every damn shift?

I don't know. You going to ride
my ass every damn shift?

Because you seem to be
missing the point here.

I didn't mess up.
That's not the point,
and that's your problem.

Who's got
the urosepsis case?

Dr. Gates. At
your service.

Maya Tennyson,
Critical Care.

Yeah, excuse me,
Dr. Tennyson,

but we're in the middle
of some...
She's still on dopa at 10?

She's holding
her pressure

like a champ.

Hmm, nice work

with the early
goal-directed therapy.

By the way,
I love the dictation.

I can never read
anyone's writing down here.
The Bluetooth.

You just speak in this
little machine right here

and it prints up
instantly at the desk.
I like it.

This ER needed an attending
with some initiative.

Hey, I'm the attending.
He's an intern.

Well, actually, the Bluetooth
was Dr. Pratt's idea.

Huh.

I want to see the rest
of your charts now.
I bet you do.

Hey, Timmy, do they still
put people's names on hats

and stuff like that
in the gift shop?

You know what?
I think so.

But if you want to write
your name in your underwear

or something, man,
a Sharpie works

just as well.
No, no, no.

I just need to get
a gift for somebody.

What the hell happened to you?

I was attacked by ninjas.
What's it look like?

Who's this?
Obnoxious soccer dad,

blunt head trauma with LOC,

breathing on his own,
normal vitals. What's open?

Talk to me, Morris.
Nothing to talk about.

Guy came at me.
I defended myself.

I'm patching him up.

Why'd he come at you?

Have you ever been
to a kids' soccer game?

Those parents are crazy.

I would never do anything
to hurt my grandson, Irene.

It was an accident.

What were you thinking?

He's only
five years old.

He shouldn't
be anywhere

near a chainsaw.
He wasn't.

Then why is
he in surgery?
Hey, I'm Dr. Pratt.

Uh, Dennis King,
this is my wife, Irene.

I can't believe this.

We only leave
our son with family,

just to be safe, and this
is how we're rewarded?
We're doing

everything we can
for Thomas.

Why don't I have a
nurse take you up

so you can
be with him

when he gets
out of surgery?
Okay.

Dennis, Dennis,

I'm sorry.

You know I am.

I know,

Dad, I know.

I raised my two boys by myself.

Wasn't easy being
a single dad back then. I...

I don't think I was
very good at it.

I thought I could
make up for it

by being a terrific

grandfather, but...

Looks like I blew that too.

Pratt.

You got a sec?

Yeah. I'll be right back,
Mr. King.

Thanks.

What's going on?

The police are here
for Morris

in connection
with an assault.

And there are two moms
with the cops

saying that Morris
is a child molester.

What?

SAM:
I got a feeling the white mom's
got a boxer's fracture.

What is Morris' problem?

Brain damage is the first
thing that comes to mind.

Dr. Pratt.

Escobar's losing his airway.

RASGOTRA:
Why didn't you intubate

prophylactically?
PRATT:
His face was spared.

He didn't seem like
he had respiratory issues.

PRATT:
Damn, he's already got

too much swelling.
Page Crenshaw again.

And get someone
from ENT down here.

Sats down to 76.

All right, somebody
get me a smaller tube.

A 7-5, 7-0.
It's too late for that.

You might need
an open trach.

Heart rate is dropping.

Please help him.
He was just talking

to me.
Damn, that 7-0 won't pass.

He needs a trach.

ENT is in OR 2 on a
radical neck dissection.

They can't come
down right now.
ENT needs to be here.

Well, they're not,
and this guy needs

an airway.
And you're sure
you can do this?

I think so.
You better know so.
How many have you done?

I've assisted on several.

Oh, man.

All right, OR Girl, please
do not make me regret this.

Okay, Katey, Betadine
and sterile sixes.

Without electrocautery juice,

this will be messy.
All right, Haleh.

Can you take Tina
to the Family Room?

Sure.
No, no,

I want to stay with him.
Come on, honey.

No, I want to stay...
We'll come and get you

as soon as we make him
more comfortable.

Okay,15 blade to me.

Neela.

Oh, I was hoping there would
be a reasonable explanation

for your incessant paging,
but you know what?

This is not it.

I had to do
a tracheotomy tube.

Oh, really, and who
told you to do that?

Because I sure didn't.

Nobody did.

My chief didn't
answer his pages.

You did this
without any supervision?

Dr. Pratt was here.

Oh, great, that
is such a relief.

Unfortunately, your little
ER forest friends

don't count anymore.
You want to be a surgeon?

Huh, want to be
a big girl doctor?

This isn't Barbie's
Dream Doll Hospital

you're playing in.
I am the ER attending.

Dr. Rasgotra was only
following my orders.

Oh. I'm sorry. Hello.

Dr. Pratt,
is it?

I took your silence
for subservience.

You know, not a lot
of ER attendings

have the skills to do a trach.

Very impressive,
Dr. Pratt.

Well, you just, uh,
take care of my girl here

and we'll call it even.

You don't need
to worry about that.

Dr. Rasgotra gets
plenty of my attention.

Oh, I think

I can manage this from here.

Why don't you girls, uh,

finish up down here.

You've done more than
enough. Believe me.

Wow, you're so lucky.

He seems like a great guy.

Yeah, right.
I'm going to go
and find the girlfriend,

tell her
what's happening.

Hey.

You did good, man.

Thanks.

(chuckles)

Must be quiet if you
have time to stand around.

How's the kid?

Looks like he's going
to pull through.

How's the grandfather?

Eh, he's a little worried,
but he'll be okay.

You make out okay
down here?

I heard you had two
more traumas come in.

Nothing I
couldn't deal with.

Well, if it's that quiet,

maybe I'll leave a
little early tonight.

Abby could probably use
some help with the baby.

Go ahead. Go for it.

Sure?

Yeah. I got it all
dialed in down here.

This place practically
runs itself.

Can one of you look
at a suspected hand fracture?

Who ordered
the films?

I did.

Everybody was busy.

I'll take it.

Did you find Alex?

Oh, yes, he was ditching school
with a friend at the mall.

(clicks tongue)

I guess I have all that
to look forward to, huh?

Yep.

You saved that guy.

It was so cool.
You mean "terrifying."

Dude, you rocked.

Did you see the look
on Crenshaw's face?

The one that suggested
he was going to punish me

for the rest of my
natural life for
what I just did?

You spanked him.

Deep down, I think
he probably likes it.

(chuckles):
Seriously.

You know it's always
those type-A guys

that are so wound up
they go home and put on a diaper

or want to be led around
by a leash.

(laughing):
You're mad.

Hey, Neela.
Hey.

Um, uh... Ray Barnett.

I don't think
we've officially met.

Katey.
Hey.

Um, I'm still getting
some of your mail.

Oh. I'm sorry.

I've tried to change
everything over.

Well, I don't mind.

I just figured you might
need some of these.

Thank you.

Okay.

Okay. Uh, I'll see
you guys around.

It was nice meeting you.

You two lived together?

Oh, we were roommates.

Hope you had benefits.

It wasn't like that.
We were just friends.

Why? That guy
is smoking hot.

Does he have a girlfriend?

Not that I know of.

I just remembered something.

Um, I'll catch up
with you later, okay?

Sure.

(sighs)

Witnesses confirm
that the other guy started

and you just
pushed him away.

I told you that.

But that doesn't
explain touching the kid.

I wasn't "touching" him.

My relationship to the boy
is complicated.

It's, uh, sort of a secret.

No, no, not like that.

Well, your hand isn't broken,
it's just sprained.

It would have been worth
a fracture if I would have

knocked out that freaky little
leprechaun's teeth.

What's going to happen
to him?

He's going to jail.

What do you think
about that, Max?

Wait!

Wait! Wait!

Don't arrest my dad.

What did he say?

Max,
what's going on?

This is where
I leave.

Good luck
with that, Pops.

Mom, Mom, this is my dad...

Dr. Archie Morris.

What's up?

PRATT:
Hey, Timmy, did you get it?

Yeah, but I didn't get
a chance to wrap it.

Nah, it's all good.

(chuckling)

Gates! Wow, just the man
I was looking for.

Here, I got a
present for you.

What's this for?

It's so, uh, people
know who you are.

Hey. You didn't
have to do this.

Yeah, I did.

Let's see.

(chuckles)

What the hell is this?

(Timmy, Pratt laughing)

Students wear
short coats.

It helps remind
everyone, including you,

that you are
still learning.

You feel better now?

I feel great, man. Yeah.

(laughs)

(softly):
Gates.

(baby crying over monitor)

Hey.

Hi.

How long has he been crying?

About ten minutes.

I think he'll
settle down.

How was your shift?

Uh, the usual-- I had a five-
year-old kid crushed by a tree.

I don't want to hear any stories

about bad things
happening to children.

He survived, okay?

How about your day?

It was divine.

Hmm.

Look, I've been thinking.

Maybe you're right,
maybe we should get somebody

like a nanny...
No, thanks.

But I thought you...
I changed my mind.

(sighs)

No nannies... just us.

(baby continues crying)

Doesn't sound like
he's settling down, hmm?

(laughs)

I'll get him.

(sighs)

KOVAC (over monitor):
Hey, hey, hey.

What's all that crying?

* Should I stay
or should I go now? *

* If I stay
it will be trouble *

* If I go it will be double... *

That good, hmm?

I should have stayed
a paramedic.

No. Doctors are much more sexy.

(grunts)

(chuckles)

Rough day?

Yeah, one of my attendings
has it out for me.

Either that
or he's in love with me.

I can't tell which.

How was your temp gig?

Same thing,
different people.

(sighs)

Nobody knows you.
Nobody really talks to you.

It's like being
the office ghost.

Do you want a drink?

No, I have to study.

GIRL:
Knock-knock. You decent?

I'm in my thong.

Guess what?

I take it your
homework is done?

Yeah.

I've got some stuff
from school you need to sign.

I left them on the table.

All right.

There's lasagna in the fridge
if you get hungry later.

Thanks.

Well, you were right
about Adam Horner.

Oh, yeah?
Yeah.

I ignored him
all day,

even when he was looking at
me, and tonight he IM'd me.

The Horndog comes through.

It's Horner.
Watch it.

I bruise easy.

Did you save anyone today?

Yes. Actually, I separated
a pair of Siamese twins.

Must be gross
seeing all that blood, huh?

Nah, I saw more blood
when I was a paramedic.

Besides, I'm half vampire,
so I kind of dig it.

(laughs)

Do you want me
to help you study?

No. I want you to work
things out with your mother.

I'd rather shave my head.

Oh. All right, good,
I have a razor

in the bathroom,
we can shave it

into a nice
little Mohawk.

(laughing):
Okay, I'm just kidding.

I'll talk to her.

Sometime.

Tonight?

Yeah.

Hey.

Good night, baby girl.

Night, Doc.

(over boom box):
For the next hour,
we're going to be talking

about abdominal pain
in the elderly patient.

Now, I don't have to tell you

what an important disease
this is...

No pass-ons,
no major tragedy, no deaths.

Gates still here?

You just missed him.

What about his charts?

They're over there.

Hey, you know, from what
I've seen, cat's a good doctor.

Oh, he's all right.

Plenty of room
for improvement.

Dr. Morris, I heard
some guy attacked you.

Are you okay?

Oh, yes, yeah,
I turned the other cheek.

You know what Jesus said.

You know...
when the, those guys

who trespassed against him,

as those who trespassed

against us--
can I get an amen?

Amen.
Amen.

I have a patient
waiting, so...

Good night, Dr. Morris.

God bless you.

God bless all of us.

Hey.

You want to grab a bite
with me and Max and his moms?

You worked things out, huh?

Yeah. Yeah,
they're pretty cool.

And if everything
goes well at Ike's,

we may really work
things out tonight.

if you know
what I'm saying,

Morris...
and I think you do.

You do know
they're a couple, huh?

Yeah, a couple
of lesbians

in desperate need of
a Morris sandwich. Unh.

You know
you're sick, right?

What?

Good night, Archie.

HOPE:
Could you help me
with a two-layer closure?

Nope, nope, not now, I'm off.

Weaver should be here
any minute now.

(sighs)

All right, wait, wait, wait.

First off, you never want to
inject directly into the wound.

It distorts the anatomy
for your repair.

He needs regional
anesthesia.

Have you ever done
an infraorbital block?

Not really.

Okay, well, it's pretty easy
once you know the tricks.

Now, first, what
you want to do is

you want to use your
left index finger

to palpate the
infraorbital ridge.

Got it.
Good.

Now you're going to
inject one centimeter

lateral to the ala
and advance upward

until you're five millimeters
from the ridge.

Good, good, very good.