ER (1994–2009): Season 14, Episode 6 - The Test - full transcript

[instrumental music]

(male narrator)
Previously on "ER."

This disease
is invariably fatal.

‐ Derrek Lee.
‐ This is for you, buddy.

The whole team signed it.

Written boards are in a week.
Failure is not an option.

If we quiz each other
every day, we'll nail it.

(Abby)
Yeah. How soon can you fly home?

It's‐it's gonna be
at least another week.

‐ Another week?
‐ You're right. I'm 19.

‐ 'Nineteen?'
‐ No way.



I started college when I was 12.

If you've decided
you're not an alcoholic

I can't help you.

If you are, I'll
be your sponsor again.

Let me know
what you decide.

[instrumental music]

[clattering]

‐ Abby.
‐ Just a second.

Crap.

Med Staff office says
you can't work tonight.

Right. See ya.

I'm serious, you're banned

until you deal with
your incomplete charts.

Excuse me, Frank.



I told them I was gonna
sling you over my shoulder

and carry you down
to the office myself.

Sling me over your shoulder?

'You're backed up six months.'

Oh, good, you're here.

Paramedics are bringing in
a guy who's out of his head

and combative, we could use
the extra set of hands.

Want me to get some Ativan?

Well, they gave him
10 mgs already.

Hasn't touched him.

Abby, don't go out there.

I think Frank
has a crush on me.

Oh, would you go see
the Med Staff, please?

They're bugging me
about your charts.

‐ Nemo Lynch, 32.
‐ There's a snake!

Ran through
the water tower naked

jumped through a plate glass
window and kept running.

Sounds like PCP.

(Pratt)
'Alright, 20 of ziprasidone IM.'

‐ 'Got it.'
‐ Whoa, whoa, whoa!

Hey, you need some help here?
Moretti's got me triaging.

‐ 'What am I supposed to do?'
‐ 'Don't worry about that.'

Just worry about keeping

the patients out of the doorway.

Vitals are stable,
abdomen's non‐tender

stab wounds look superficial

so why is the ER
calling for a surgeon?

Uh, you're a great
mentor, Neela.

That was a question.

Why does this guy
need an ex‐lap?

Can't trust the exam
if the patient's too high.

You've been listening
to a word I'm saying?

Can I ask a question?
It's a little embarrassing.

Well, it's better to ask a dumb
question rather than fake it.

I appreciate your
attitude towards that.

I‐I really do.

I mean it's reassuring
to know that someday‐‐

Yeah, Harold,
sometime today.

Uh, my girlfriend, Lacey

her homecoming
dance is comin' up.

‐ Homecoming dance?
‐ Yeah, she's in the court.

Out of my league looks‐wise

but I guess there's
a certain cache

in dating a doctor when
you're still in high school.

Your girlfriend's
in high school?

Yeah, she's
a senior at Woodland.

Anyway, there
are certain skills..

...expectations..

...certain rites of passage

that a certain
homecoming princess

is gonna be
counting on, you know?

No, I'm not sure I do.

I've never been
to the dance.

I don't know how to do
the mambo or pin the corsage.

Do you have any idea
what I'm talking about?

You know, I didn't
grow up in this country

so I'm not sure I'm
the best person to answer‐‐

Neela, help me.

I'm‐I'm a virgin.

‐ You guys alright in here?
‐ Get away, you freak!

You wrote the map
on the skin.

‐ We're doing just fine.
‐ I know where you hid it.

I will not be the conduit.

[breathing heavily]

(Samantha)
'Sedation's kicking in.'

Interns, your first
quarter evaluations

are in your boxes.

Find me if you want to discuss.

Moretti, now's not a good time.

Nobody told us
we were being tested.

Every patient is a test
of your intellect

of your wit, of your
organizational skills.

‐ Come on.
‐ Get the snake!

‐ Whoa!
‐ Shut up!

And hold still!
We're gonna get the snake.

See that?
Every patient's a test.

And Sam just got
an A this time.

[screaming]

[man laughing]

I guess I spoke too soon.

[grunts]

[theme music]

I stole this
from the GYN Clinic.

‐ What?
‐ I didn't steal, steal it.

I'll‐I'll take it back
just as soon you‐‐

I'm not touching
that thing.

Just go over
the relevant anatomy.

‐ That's all I ask.
‐ Oh, come on, man.

Put that thing away.

(Abby)
'No free air
under the diaphragm.'

He's just so smug all the time.

I mean, have you ever
met anybody so smug?

Let me guess. Moretti?

Every time I
come down you guys

are talking about
the same thing.

Well, he's an ass

but I can't deny

'he's a smart guy.'

‐ C‐spine is fine.
‐ Should I take off his collar?

‐ No, we'll do it upstairs.
‐ 'This one's a lot of fun.'

(Abby)
Make sure you get him up
before the sedation wears off.

Here's everything
you need to know.

Oh, we're good. Go.

‐ He can't hear anything, right?
‐ No.

He's had enough sedation
to take down an elephant.

Okay, so, where
exactly is the G‐spot?

[whispering]
Put that thing away.

Hey! I hope you're on top
of your game tonight, Lockhart.

You know, I've got
the boards tomorrow.

You're gonna be taking
all the hard cases.

Why are you working
the night before your boards?

It was supposed to be Morris'
shift, but he's taking 'em too.

‐ He couldn't find anybody else?
‐ Nope.

And he swore
that he would fail

if I didn't bail him out.

But I'll do fine.
I test well.

‐ What'd you hear from Luka?
‐ Taking longer than expected.

He has to retrofit his dad's
house for a wheelchair, so..

‐ Oh.
‐ 'This is completely unfair.'

‐ Guy's clearly on a power trip.
‐ Abby, check this out.

Four pages of categories.

Procedures,
patient relations

intellectual curiosity

each rated on
a one to five scale.

He gave us ones
across the board.

‐ Is that good or bad?
‐ Bad!

No comments,
no written feedback.

‐ It's just ones.
‐ So uncool.

I'm never gonna get
a Toxicology fellowship

with this on my record.

Oh, that's not true.
That's not true.

Are we supposed
to learn from this?

You have to talk to him.

‐ Yeah, would you?
‐ Please?

Frank, what's up with the lab?

I've been waiting
three hours for a CBC.

Something about a flow
cytometer. It'll be a while.

Oh, your kid's
school called twice.

Alex is biting off
lizard heads again?

Shut up, Frank.
He's not a sociopath.

That's right.
Ignore the problem.

‐ It'll go away.
‐ Well, it's too late.

I have to call 'em
tomorrow morning.

Mm‐hmm.

(Moretti)
'Hey, uh, Sam.'

You're supposed to be
covering triage right now.

‐ What?
‐ Yeah.

Nurses rotate every
two hours. You're up.

Come on.

Excuse me.

‐ Yeah. Hi.
‐ Hi.

Listen, slamming
the interns

without giving any
concrete suggestions

isn't helping anybody.

These numeric evaluations are..

...useless.

Don't worry, Abby.
I gave you solid threes.

Yeah, listen,
they're freaking out

about the bad evaluation

instead of focusing
on how to improve.

‐ Illustrating my point.
‐ Which is what, exactly?

Are they concerned about giving
the patients sub‐optimal care?

No. What they're worried
about is how it's gonna look‐‐

They need mentors,
constructive feedback, guidance.

‐ No.
‐ You know, they're just kids.

Arrogance and inexperience

are a lethal combination.

There's gotta be
a more effective

way of teaching
them that than‐‐

Abby, look,
I‐I understand

it's your natural
instinct to listen

to wanna be supportive
and to, you know..

But in the end, with..

Forget it. Can't..

‐ Excuse me.
‐ Hang on a bit.

Okay, ma'am, why are you here?

‐ He got a cough.
‐ Oh, yeah? Let me see.

Hey. Let me see.

His breathing's okay.
You know what?

I'll try to get you back
as soon as I can, alright?

‐ But..
‐ Hello.

Uh, sir, let me see
your hand. Let me see.

‐ 'Come over here. Sit down.'
‐ 'Hey!'

‐ 'Hey!'
‐ Yes?

I've been here for three hours.
This guy just walked in.

Yeah, well, this guy's bleeding.

Okay, well, my
head is exploding.

You look comfortable to me.

Don't tell me
what I'm feeling.

[sighs]
Alright, do you
get headaches a lot?

Never like this.

Alright. Here,
grab that.

I'll get back
to you in a second.

Follow me.

‐ This place is gross.
‐ Well, you get used to it.

‐ What's your name?
‐ Heather.

Heather, I'm Dr. Gates.
This is Sam.

Sam, Heather here says she
has an exploding headache.

Hmm, let's get you checked out.

Moretti have you
working in Waiting?

‐ Yeah, all day.
‐ Don't take it personally.

He's doing that
to all the residents.

I better get back.

Take a seat over here.

On a scale of one to ten
how bad is your headache?

It's a ten.

You're pretty
calm for a ten.

Yeah, so you
think I'm lying?

I have a high
tolerance for pain.

‐ Where are your parents?
‐ I don't know.

Out.

Okay, well, give me their
numbers, we can examine you

but we need their
permission for any treatment.

(Morris)
Sam, you've seen Pratt?

He's in Exam 3
reducing a shoulder.

Are you on tonight?

You mean, on as in
lively and invigorated

or on as in working?

‐ What?
‐ Morris.

‐ What are you doing?
‐ I'm looking for you.

‐ Why aren't you home studying?
‐ No, no, no.

I‐I got too much
nervous energy.

There's no way I'm
gonna be able to sleep.

I came in so we
could study together.

Wait, wait, the only reason
I took over your shift

was so that you
could stay home.

Come on, come on,
we can help each other

get psyched,
get‐get focused.

Listen, if you're
here, I'm out.

Dude, you need to work
on your game face.

‐ What?
‐ Game face, Greg.

What's wrong with you?

Shrug your shoulders.

‐ Can I open my eyes now?
‐ Yeah.

Okay, the good news
is your neuro exam

is totally normal

but you have trigger
points in your neck.

‐ Which means?
‐ It's a tension headache.

You'll feel better
with some ibuprofen.

Aren't you gonna do
a CAT scan or something?

You don't need one.

Well, do one anyway.

We don't do tests just
'cause patients want them.

Why not?

It's a waste
of resources.

Okay, well, make my dad
pay 'cause he's rich.

That's not
really the issue.

You just said it was
about resources, so..

Is this your
home phone number?

Yeah.

So when I call it, why do
I get a video rental store?

Video rental?

I didn't even know
those still existed.

That isn't funny.

My mom is dead and my
dad is in New York

and he doesn't need
you guys bothering him.

So not that big a deal.

600 of ibuprofen once
you get the dad's consent.

And give us his real number.
No more games.

That was so cool, defending
us from Moretti like that.

Well, we were just discussing
different teaching philosophies.

Well, yours is better,
which is why there's no way

I'm gonna present to him.
You got a minute?

You can't boycott
an attending.

I can't? Come on.
Just for today.

(Tony)
'My point is, hanging out in the
waiting area is inefficient.'

Just get back
out there, Gates.

I should be here
clearing beds

Moretti, and you know it.

Last month a woman arrested

in an ER waiting room

because nobody was
paying attention.

Brian?

‐ Hey.
‐ 'What are you doing?'

13‐year‐old male in acute
respiratory distress.

Tony. It's really bad this time.

I know this kid, he's got

a progressive
neuromuscular disorder.

‐ I know him from ICU.
‐ Okay.

Hey, buddy, how you doing?

‐ Pretty good.
‐ Yeah?

Did you see D. Lee hit
for the cycle last night?

No, I missed it.

You're gonna have to give me
a play‐by‐play, huh?

Pulse ox is only 78.
Let's go.

(Serena)
'He needs oxygen.'

Sam, you're with me.
Where we going?

‐ 'Uh, Trauma 1.'
‐ Brian, wait right here.

‐ I'll be right back.
‐ 'Hey! Hey!'

Alright, let's set up
a non‐rebreather

and, uh, let's get an ABG going.

Find someone else
to cover triage.

I'm staying with this kid.

(Moretti)
'He left? What do
you mean he left?'

He was here,
and then he was gone.

Is that clear
enough for you?

Did he say
where he was going?

Frank, where's
the Crohn's fistula?

Ask me again in English.

Uh, never mind.
I found her.

Do women often need
additional lubrication?

Harold, get a consult form.

I mean, it seems like
if you're willing to put in

the time to sufficiently
stimulate the area..

You know, isn't there
anyone in your life

that'd be more
appropriate for this talk?

Like a brother?
Uncle? Anyone?

No, just grandpa

and he thinks I still
believe in the stork.

Dr. Moretti,
is there anything special

I should know about
the Crohn's lady?

She's narcissistic.
She's addicted to morphine.

And if she says that
she's allergic to NSAIDs

she's lying.

Thanks for the warning.

Excuse me, I'm looking for..

...you. Dr. Moretti.

I'm Skye Wexler,
your new attending.

‐ We spoke on the phone.
‐ Oh, yeah.

I didn't realize you
were starting already.

Yeah, tonight's the night.

Uh, alright.
Uh, follow me.

When you, um, uh..

...write your initials
in this column over here

when you pick up a patient

and chart any progress in
this column over here, okay?

Frank, sorry,
this is Dr. Wexler.

She's gonna be taking
some shifts with us

over the next month or so

and this is one
of our lifers, Haleh.

Hey.

‐ Hello.
‐ Hi.

You new to Chicago?

Doing locums to
make some extra cash.

‐ Locums?
‐ Yes.

Like moonlighting,
mostly nights.

Ah, that's
when I work too.

Oh, yeah, so much
better than being stuck

in a hospital all day
when it's beautiful outside.

I hear you.
I'm a big hiker myself.

You bump your head?

Hang in there, Josh.
I'm almost done.

ABG's back. 7.18.

‐ CO2, 66.
‐ Yeah.

‐ He's retaining.
‐ What does that mean?

It means he's tiring out.

You try breathing
50 times a minute.

You're gonna have
washboard abs after this.

Art line's in.

That's so we can check your
blood gasses without needles.

‐ You see the shadow?
‐ Is that fluid?

(Pratt)
'Yeah, most likely
aspiration pneumonia.'

His swallowing muscles are weak,
it's not protecting his‐‐

‐ Airway.
‐ Right.

I never should have let you go
to that Kelly Clarkson concert.

That's not why I have pneumonia.

Did she just say Kelly Clarkson?

‐ You have a problem with that?
‐ Good thing you're sick.

Because I'd be giving you
so much crap. Kelly Clarkson?

(Pratt)
Hey, Sam, gram of ceftriaxone
and a liter of NS.

Which one of you is Pratt?

‐ That'd be him.
‐ Hey, I'm Skye Wexler.

New attending. I'm doing
the overnights with you.

‐ Oh, nice to meet you.
‐ We should call Hopkins.

We're supposed to report any ER
visits to the study coordinator.

(Skye)
'I heard you have
the boards tomorrow.'

‐ Yeah.
‐ I'll hang here. You can study.

Really. Go.

Gates, you good with this?

‐ 'Yeah.'
‐ Alright, buddy.

We'll get you feeling
better soon, okay?

Looks like you're
stuck with me, Josh.

(Skye)
Let me take a look at the film.

(Samantha)
'Here.'

Your feet must be tired.

This hospital bites.

I've been here for hours,
and nobody's done anything.

We get busy.

What are you doing?

Trying to find someone
who gives a crap.

Yeah, well, those computers
are for staff only.

Go back to your bed.

Hey, did you hear me?

'I have chest pain'

and it's really, really bad.

I'll get someone
to check you out, okay?

‐ How's the boy doing?
‐ Struggling.

Headed for a tube.

So what are you
doing out here?

The new attending came in.
She said that she'd take over.

Wait, wait, wait.

You left a patient
in respiratory failure

with an untested attending
that you've never met?

Oh, well, I..

I'm kidding.
I sent her in there.

[chuckles]

‐ Ha ha ha.
‐ Okay, thanks.

Hey, doctor.
Check me out.

Hey...what happened?
There you are.

You show up out of nowhere
and then suddenly you disappear.

‐ How you doing?
‐ Good. You seemed busy..

‐ Yeah.
‐ Didn't wanna get in your way.

Is everything alright?

You look like hell.

[laughs]
Oh, I..

No, I drove all night
to get here, so..

‐ Oh.
‐ Yeah.

Dr. Pratt, I'm sorry.

This is, uh,
Brian, my son.

‐ Oh, really?
‐ Yeah, yeah.

Hey, aren't you in
a college on the East Coast?

Yes, he is.

And now this is the part
where you tell me

why you're not in school

and you're here
visiting me at work.

‐ What's that?
‐ Happy birthday, dad.

You drove all night
to give me a book?

No, it's not just a book.
It's not just a book.

It's not just a book.

It's like a new
way of thinking.

Really?

Alright, well..

You remember when you were in
college and you got so excited

about everything
that you learn?

Come on, let's get
out of here, um..

You look like you
haven't eaten in a week.

‐ Nice to meet you.
‐ Okay. Hey.

Skye has my sign‐out.

(Pratt)
'Alright.'

It's the natural course
of Fazio‐Londe disease.

Eventually, the respiratory
muscles aren't strong enough

to clear secretions.

So there are no
other options.

This is Dr. Bazzano
from Pediatric Neurology.

Hi, Joshua.

‐ 'You're his mom?'
‐ Yeah.

Acidosis is worse.

So...listen up, buddy.

Your, uh, your muscles
that help you breathe

are starting to get tired.

Tell me something I don't know.

So we're gonna have
to put a tube down

'and that will breathe for you.'

(Serena)
'Oh, God.'

The ventilator is temporary,
it'll give his muscles a rest

so the antibiotics
can do their thing.

(Serena)
'And after the pneumonia
is treated we can'

take the tube out?

Well, that's the hope.

Okay.

It's gonna be okay.

We talked about
this possibility.

(Bazzano)
I have to run upstairs.
I'll see you guys up in the ICU.

Thanks, doctor.

Do you understand everything
the doctors are saying?

Yeah.

‐ Mom?
‐ Yeah, honey?

The situation demands a slushy.

Josh, sorry,
but you've got to be NPO.

Ah, come on, let's‐let's
give the kid a slushy, huh?

'You can live with that, huh?'

Sweet.

Okay.

‐ Where do I..
‐ The Jumbo Mart.

My kid loves 'em too.
It's across the street.

Come on.
I'll take you.

Be right back.

Good catch.

You're not tubing me.

Headache's gone.
Now it's chest pain.

EKG was fine.
Exam was normal.

Did you do a beta HCG?
Could explain this whole thing.

Keep her on oxygen. Call if she
has any more sustained decels.

Abby, HCG?

Oh, yeah.
It was negative.

I have to check
on a sick asthmatic.

Oh, that's cool.
I got this.

Okay.

Hey. I'm Dr. Wexler.

I'm in charge tonight.

Lucky you.

‐ Deep breath.
‐ I can't.

You can try.

[exhales]

Again.

[exhales]

Well, your heart
and lungs sound good.

Oxygen level is perfect.

Better keep looking then.

You know, your pain
can't be that bad

if you're able to text your
friends all through my exam.

I'm not texting.

‐ I'm trying to get online.
‐ Hmm.

Reception in here sucks.

Is there a computer in here
that I can use or something?

(Neela)
'Dr. Wexler, do you
know where Pratt is?'

‐ I can't find him anywhere.
‐ You could try the break room.

‐ I know he's studying.
‐ Thanks.

Sorry about that.
You were saying?

Just forget it.
Never mind.

Of course, we have the grand
old dame of cramming, caffeine.

Grand old dame?

300 milligrams, baby

to keep our engines
nice and revved.

Oh, and this.

Okay, this..

...this is the silver bullet.

If you get stuck on the test..

[squeaks]

...squeeze this,
the answer will come.

[squeaking]

Hey, I don't need
any good luck charms.

You can't reject
a good luck charm.

That's like the opposite
of good luck, as in bad luck.

I don't believe in luck.

I believe in preparation

and...I'm prepared.

Whoa, what's all this?

Well, you know, we got
the boards tomorrow.

Yeah, and, uh..

...how exactly does this fit in?

Something to perk us up
when our stamina flags.

Well, do you guys mind if
Harold hangs here for a while?

He could benefit from
your, uh, tutelage.

No, no way, we have
too much ground to cover.

Come on, if you don't know it
by now this isn't gonna help.

That's not necessarily true.

'Studies have shown
that cramming can improve'

short‐term performance.

‐ See? Have a seat, Harold.
‐ Oh, excellent.

Uh, great guys.

Smart, experienced.

So what topics
do you wanna cover?

Uh, just some
basic fundamentals.

No appetite?

Dairy is pumped
full of hormones

and wheat is
genetically modified.

Right. Uh, okay, I'll try
to find you some organic Jell‐O.

Urine aminolevulinic
acid is elevated

suggests a problem with
porphyrin metabolism.

Mm‐mm. She does seem to
have a serious fear of food.

Acute porphyria can be brought
on by caloric restriction.

Well, see, it fits.

Hematology said to order
an erythrocyte enzyme assay.

Okay.

Cool case, Grady,
but make sure

to keep moving the other
patients through.

Okay.

Hey, Abby.

‐ Hey.
‐ How is everything?

It's better.

Much better.

‐ You been going to meetings?
‐ Yes.

Okay, 'cause I haven't seen you.

Well, the last
couple of times

I, um...I worked late

so I couldn't make
it to St. Mark's.

Oh, I see.

And I kind of wanted
to go somewhere..

...where...nobody knew me.

Hmm.

Why is that?

I don't know.

Well, look, the, um, church
on Franklin has got meetings

all hours, day and night.

Okay. Thanks.

That's good to know.

When your infection clears,
your vital capacity will improve

and they'll take
the tube out.

Be real. I'll never
get off the vent.

Oh, don't say that, Josh.

I've been thinking
about this moment

pretty much continuously
since I got my diagnosis.

No tube.

'So that's it?
You're just gonna give up now?'

And...I need to make it
look like it's your decision.

'What?'

It would kill my mom
if she knew this was my idea.

‐ I promised her I'd fight.
‐ So fight.

They're doing research
on neuromuscular diseases

all over the world.

It's not gonna help me now.

They could come up
with a breakthrough

tomorrow, Josh.

They're years away from a cure.

Whether we like it or not,
this is happening.

My mom can start
getting over it now..

'...or a year from now'

when she's given up everything
to be by my bedside

while I wither away
on a ventilator.

Josh..

Tony...you get me.

I know you understand.

He's a bright kid.
He knows what's in store.

Intellectual understanding isn't
the same as emotional maturity.

No. I know him.
He understands what he's doing.

You're absolutely
sure about this?

‐ Yeah.
‐ Okay.

Do me a favor
and run it by Ethics.

You can tell them your
attending's onboard.

Thank you.

Hey, Sam.

‐ It is Sam, right?
‐ Yeah.

Could you give our asthmatic
in 2 a 125 of Solu‐Medrol?

I already did.

Part of Moretti's
new asthma protocol.

You don't need
doctor's orders

if the patient meets
certain criteria.

Efficient. I like it.
Could I take a look?

Sure. Hey, Frank, do you
have the asthma flowchart?

Hey, kid!

This is a hospital,
not an Internet cafe!

(Samantha)
What's wrong with you?

What is wrong with you?

I called your dad and somebody's
on their way to come get you.

You shouldn't have done that.
He didn't want to be bothered.

‐ Of course, he does.
‐ How can you possibly say that?

You don't know him
and you don't know me.

Because I'm a parent
and I understand a parent‐‐

Oh, shut up,
you phony bitch.

It's like, um, it's
already after 3:00.

I think it's about
time we go to bed.

No. I think it's time we opened
another bottle of champagne.

Here.

‐ Really?
‐ 'Mm‐hmm.'

'Did I tell you I'm taking a
course on the history of wine?'

‐ No.
‐ I know, I know.

It sounds like, uh, major
slacker territory, huh?

But it's actually
this awesome survey

of Western civilization.

I mean, there's
the Last Supper

'the Spanish Inquisition,
the Yalta Conference.'

'You name it, somehow
wine was involved.'

‐ Yeah, well, wine is‐‐
‐ 'Oh!'

I switched my
major to Semiotics.

A degree in
the meaning of meaning.

I mean, could there be
anything cooler than that?

‐ No, I don't..
‐ Well..

But, Brian..

I know what you're
gonna say, I‐I know.

I don't want to be
pre‐med though, dad.

I don't. I thought you
were cool with that.

No, I am. That's not..

Why, why are you here?

It's your birthday.

Alright, but what's
the real reason?

It's..

I remember when I was

uh, in fourth grade

you showed up..

...and you said,
it was right before lunch

and you said we're gonna go
on this secret surprise mission.

‐ That's what you said.
‐ Uh‐huh.

And I remember,
I remember..

...looking out
the window of the car

just, I'm thinking,
I'm wondering

where are we gonna go?

And that, I just, I swear

that was just one of the..

...that was the most
exciting moment of my life.

You're talking about
the time we went ice fishing?

Yeah.

It was you and me
and the lake.

And...I, I just..

...I just, I‐I‐I
wanted to, I wanted to..

...to thank you.
Thanks...for that.

'Thanks.'

You're welcome.

[chuckles]

I'll call the school,
they can send

the new syllabus
to the ICU.

Thanks, mom.

‐ Sat is 81.
‐ You guys ready?

Actually, we're gonna hold off.

(Samantha)
'What do you mean, "hold off?"'

We're not intubating.

'He won't tolerate the pressure
generated by the ventilator.'

But I thought you
said before that he‐‐

(Tony)
'I have new information now.'

And the clinical
picture has changed.

What kind of new information?

Are you onboard
with this?

Dr. Gates and I have discussed
the options at length.

(Samantha)
'You really think this
is such a good idea

'on your first night attending?'

I've been attending
for ten years.

I don't understand.
This wasn't the plan.

Well, we have
a different plan now.

(Serena)
'But he's in
respiratory failure.'

We'll give him medicine
to keep him comfortable

'and take away the air hunger.'

‐ Tony, no‐‐
‐ Trust him, mom.

Okay.

How's your new,
uh, interns doing?

Uh, overzealous
and inexperienced

but they seem
like an okay bunch.

Well, I had to send
mine to man camp today.

(Morris)
So I wake up the next
morning and I look over

and that best‐in‐show hottie
from the night before?

Big, hairy mustache.

[all laughing]

And that, my young lads,
is why drinking is bad.

(Abby)
'Looks like you have your noses
to the grindstone in here.'

Yeah, well, we got
a little distracted.

It's only 4 o'clock.

The night is still young, huh?

Go! Go! Go!

[all chanting]
Go! Go! Go!

[groans]

Harold, I need
you upstairs, now.

But we were just getting
to toys and accessories.

It's not
an invitation.

Abby, paranoid chemical lady
in 2 dropped her pressure.

‐ Alright.
‐ Come on. Party's over.

Come on.

Whatever poisonous
advice they gave you

you must forget
it immediately.

Most of what they said
made a lot of sense.

What did they tell you?

Well, Morris said
the greatest sex happens

when you're in love.

‐ Oh. He did?
‐ Yeah.

And all Pratt talked
about was how to keep

the lines of
communication open.

You're joking.

I do still have some

unanswered questions, though.

Do two orgasms
40 minutes apart

still qualify
as multiple?

‐ 'Pulse ox is 84.'
‐ 'Alright. Crank up the O2.'

It's progressive.

There's no cure.
He has the right to stop.

Oh, what about his mother?
Doesn't she have any rights?

My obligation is to my
patient, not to his mother.

Josh doesn't want his
mom to know about this.

He's 13!

People make bad decisions
when they're 13.

Laying in bed being hooked up to
a ventilator? It's not a life.

He can, he can still think.
He can communicate.

Maybe he's around when
they discover a cure.

He doesn't want to lay
around in bed hooked up

to a bunch of machines
waiting for a miracle.

What part of that
do you not understand?

We're not intubating, Sam.

What are you doing?

Hi, can you tell me who's on
call for Ethics today, please?

It's Larabee. I've discussed
this with him already.

‐ I'm not gonna sit‐‐
‐ Alright, stop, Sam!

I'm the doctor!
This is my call!

Now, you can either go mix his
morphine drip or you can take

yourself off this case
because we're done here.

[door bangs open]

‐ 'Suction.'
‐ She had headaches.

Abdominal pain,
rash, mood swings.

Tube.

Porphyria seemed to explain

all her unrelated complaints.

Okay. I'm in.

‐ Pass me the bag.
‐ Nice job, Abby.

Yeah, Abby.
Real nice job.

You and your intern spent
eight hours working up a zebra

without ruling out common causes
for acute abdominal pain.

(Haleh)
X‐ray's back.

[sighs]
Free air under the diaphragm,
probably a perfed ulcer.

Which might
not be perfed

if you had diagnosed
this four hours ago.

(Neela)
'OR 3 is ready.'

Haleh will help you
get her upstairs.

Alright, that's it,
you two. Okay, I got this.

‐ Sat's coming up.
‐ What's her access?

‐ Did you guys send the coags?
‐ Yep. They're cooking.

[indistinct chattering]

I'm sorry. I went
down the wrong path.

You got excited
about your hypothesis.

It's fine.

It's good.

This is my fault.
I'm supposed to know better.

Excuse me, I'm here
to pick up Heather Baker.

Are you family?

I oversee the Chicago property.

I have a letter from her father

which allows you
to release her to me.

Well, I don't
know where she is

and I'm kind of busy,
so you're gonna have to wait.

Well, I've been
waiting almost an hour.

Sorry.

(Skye)
Sam, I have a kid in 4 who needs

'the wax cleaned
out of his ear.'

I'm a little tied up right now.

I'd appreciate it
if you could pull up

the troponins
for our rule‐out MI.

I don't have a password
for the lab computer yet.

Lily, Lily,
take this to Gates.

[intense music]

[music continues]

Heather!

'Don't!'

Heather, stop!

No, I don't want this!

Hold still, Heather.
You're making this harder.

Hypoxia makes people combative.

She was here all alone all
night with vague complaints.

‐ None of us wondered why.
‐ She kept changing her story.

‐ She's calming down.
‐ That's the Valium overdose.

‐ Next, she'll stop breathing.
‐ '18 gauge in the antecube.'

Alright, go ahead
and give the flumazenil.

I totally missed it again.

Yeah, I saw her too.
I blew her off.

(Abby)
'Big occipital lac back here.'

(Samantha)
I knocked her down pretty hard.

She cracked her head
on the platform.

Page Psych.
They need to come see her.

NG's in. Tape?

‐ 'Placement's good. Charcoal.'
‐ '50 grams.'

(Pratt)
'Right.'

'Here goes.'

I should have seen it.
I thought she was playing games.

‐ I should have seen it.
‐ You saved her life, Sam.

Don't be too hard on yourself.

‐ 'Hey.'
‐ Hey.

Thank you.

[Pratt sighs]

What can I say? I...
overreacted about the ulcer.

‐ No, you didn't.
‐ Happens to everyone.

And she did
great in the OR.

How do people do this?

Working with interns
is always tricky.

It's hard to supervise
without micromanaging.

It's not just
the interns.

It's everything.

Some guy shoved me on
the El today and I lost it.

I followed him off
the train screaming

even though it
wasn't my stop.

I also fired the nanny,
which is totally irrational

because Joe's fall had
nothing to do with her

but I couldn't look at her
without thinking about it.

Oh, that's understandable.

No, it's not.

It's‐it's like I'm actually
trying to screw things up.

You know, it sounds
like you need a day off.

I wish...it were that simple.

Is there anything I can do?

Do you mind if I sign
out a little early?

[sighs]

Sure.

Thanks.

I finished the brow lac
on the carpenter.

Well, that was fast.

Didn't need
a two‐layer closure?

Well, actually, Dr. Morris
just had me DermaBond it.

Oh, okay.

And how's our
gastroenteritis girl doing?

Is she keeping
Gatorade down?

Well, I‐I didn't really
end up pushing fluids

because Dr. Morris said to
just go ahead with the bolus.

And I saw Ortho was down
here reducing that shoulder.

How much ketamine
did you need?

I ended up using propofol
because Dr. Morris..

...well, he decided
that he wasn't..

‐ 'Morris?'
‐ What? What? Geez!

I asked for Benadryl,
patient gets Atarax.

I order a splint,
kid gets an Ace.

What kind of creepy loser

'hangs out in
the break room all night'

second‐guessing other attendings

when he's not even on schedule?

'I don't know
if I'm being Punk'd'

or if you haze all
new attendings this way

but I don't need you
double‐checking my work.

The only reason I am here

'is to make some extra
cash for a surf trip.'

'Come December, I am gone.'

So you can stop worrying

that I'm after your
job or your promotion

or whatever you
and your micro‐penis

'are so afraid of.'

Oh!

Hi, Archie Morris.

I have no idea who you are

or what you're talking about.

Got to bounce. You good?

[Morris sighs]

(Samantha)
'Hey. You're okay.'

'We got rid of all
the pills you took.'

'Heather, we didn't take very
good care of you last night.'

I'm sorry for that.

Your dad's on a plane.

He'll be here
in about an hour.

Is Elizabitch coming too?

Who?

[crying]
His wife.

He married her
after my mom died.

Eight months after my mom died.

[crying]
'She convinced him to move'

'to New York and leave me here.'

What do you mean
"leave you here?"

She didn't want a step kid.

So he visits..

...takes me out to lunch
and buys me things.

But mainly, he just
pays people to tend to me

like I am
a high‐maintenance garden.

Why did you do it?

Why did you save me?

‐ Heather..
‐ I wanted to die.

Things will get better, I swear.

Don't you have to
get out of here?

Yeah, well, it doesn't
start for another hour.

I can't believe you worked
the overnight before the boards.

After a few years
of getting no sleep

you get used to it.

Uh, not me.

I don't think I'll
ever get used to it.

I hate working nights.

‐ Always have.
‐ Here.

‐ Good luck today.
‐ Thanks.

[sighs]

[squeaking]

He's unconscious
and bradycardic

but he's still
breathing, so..

Could be a while
before he actually‐‐

Yeah, I‐I‐I get it.

His mom's in shock.

I don't think she
was expecting this.

But she knew that
he had a fatal‐‐

I mean, today.

She wasn't
expecting this today.

She thought they
had more time.

Of course, she did.

(Tony)
Serena, this is, uh, Julia.

She's a chaplain here.

Chaplain?

Yeah.

I'm so...sorry.

[labored breathing]

I can't do this.

It's not the natural
order of things.

Do you wanna say a prayer?

‐ No.
‐ 'Okay.'

Do you want me to say a prayer?

[crying]
No.

[Wilco singing
"How To Fight Loneliness"]

♪ How to fight loneliness ♪

♪ Smile all the time ♪

♪ Shine you teeth
till meaningless ♪

♪ Sharpen them with lies ♪

♪ And whatever's going down ♪

♪ Will follow you around ♪

♪ That's how you
fight loneliness ♪

♪ You laugh at every joke ♪

♪ Drag your blanket blindly ♪

♪ And fill your
heart with smoke ♪

♪ And the first
thing that you want ♪

♪ Will be the last
thing you ever need ♪

♪ That's how you fight it ♪

[instrumental music]

[music continues]

[instrumental music]