ER (1994–2009): Season 4, Episode 18 - Gut Reaction - full transcript

When a compatible bone marrow donor cannot be located, Scott Anspaugh agrees to undergo a new round of chemotherapy, even though there appears to be little point. Doug Ross suggests to Jeanie Boulet that Scott may have agreed to t...

[theme music]

(female narrator)
Previously on "ER."

Ah, ah, thank you.
Thank you.

‐ So it's true?
‐ I've been tryin' to tell ya.

I'm not renewing my fellowship

'cause I'm applying for
an attending position.

(grandfather)
You should have had some sense.
Called your family.

It was not your decision,
Charles.

I'm sorry.

And here are some condoms.

‐ Use them.
‐ I will.



The, uh, bone marrow registry

found eight people

who preliminarily match
your marrow type.

‐ David.
‐ I've got something in my eye.

Could you?

Who the hell was that?

(Hathaway)
'Yosh, I need a hand.'

(Takata)
What have you got?

Boxes, antibiotics,
clinic expendables.

Right here, Jerry.
Thank you.

Ow. You know, heavy lifting
is not in my job description.

Hey, where we gonna
put this stuff?

Um, you know, let's put it
in the lounge for now.

Hey, Carol. Delivery dude's
waitin' on a check out here.



I'll be right there.

Carol, wh‐what is all this?

Oh, um, Mrs. Carter came through

with another donation
for medical supplies.

If it's okay with you

I thought I would stash
them in the lounge

until I find a storage space.

Oh, far be it for me to impede
the good work of the clinic.

So, tonight's
the big night, huh?

Yep.

Any last minute things
I can help you with?

Everything's under control.

Alright, I just,
I'm really impressed that

you volunteered
to do this year's banquet.

Oh, Jerry's been helpin' me out.

Uh‐huh, so what's on the menu?

Well, we have
herb‐roasted chicken.

‐ We have scalloped potatoes‐‐
‐ Uh...Dr. Greene?

Actually, things didn't go
quite as planned.

‐ Wh‐what do you mean?
‐ I didn't wanna worry you.

You're worrying me, Jerry.

Well, the caterer couldn't do
the spread for the money we had

so, I had to make alternate
arrangements.

Oh, I hope it's not a buffet.

No, it's not.
It's a Smorgasbord.

Mark, do you have a minute?

Uh...sure.
Smorgasbord?

Yeah, it's gonna be great.
I got a great Swedish caterer.

She's a friend
of my Aunt Greta's.

What was that strange memo
from the dean all about?

Uh, apparently,
he wants to explore hiring

a, uh, pediatric
emergency attendent.

‐ And whose dumb idea was that?
‐ Doug's.

Doug? D‐Doug Ross
went to the dean?

Uh, yeah, and the dean thought
it was worth investigating.

And you're telling me
that Doug Ross

is actually interested
in such a position?

He might be.

No, as a, as emergentologists,
we're trained to handle

anyone who comes
through the door.

We do not need
a pediatric attending here.

Yeah, don't worry.
It's not gonna happen.

Okay, they're gonna make
a committee

they'll determine that
it's not cost‐effective

and it'll all be history.

(Ross)
'Miss Beavans, please.
Just let us run some tests.'

I don't have time.

She's got a high fever
and she's vomiting.

You've kept me waiting
for over three hours.

If I don't get to work
right now, I'm gonna be fired.

It'll just take a few minutes.
That's all it's gonna take.

That's what the nurse
said an hour ago.

She could, she could have
a‐a kidney infection, or worse.

Just let us get a urine sample.

I'll bring her back tonight.

I can't let you leave with her.

‐ You can't stop me!
‐ The police would say I can.

You'd call the cops on me?

Absolutely. For‐for
endangering a child? You bet.

Wait! I'll call the cops
for kidnappin'!

What's going on here?

She's got a 105 fever.

She's vomiting for two days,
no source of infection.

He threatened
to call the cops on me.

I'm sure we can work this out
without police involvement.

I am not letting you leave
without giving this child tests.

Like hell you won't!

Bring her back
or you're gonna be sorry!

He wants to be in attending?

[theme music]

Pedialyte, you make sure
she gets plenty of that.

Ibuprofen for fever. And then
we'll call you with the results.

Now, you sure you don't
want me to call your boss

and tell him
why you're late?

‐ Don't bother.
‐ Okay. Alright.

Son of a bitch.

Sure hope
it doesn't rain tonight.

The parking lot's such a schlep
and I'm wearing a new dress.

Not to worry.
It is not going to rain.

Channel Two News said
it's gonna storm.

Channel Two News doesn't know
what they're talking about.

No bursitis, no rain.

Hey, Carter, can I grab
a ride with you and Anna

to the banquet tonight?

‐ Doug's workin' late.
‐ I'm not goin' with Anna.

You two break up?

We're just friends.

Oh, I thought you were dating.

No. No. No. I mean we've gotten
really close, but no.

You thought we were dating, huh?

Yeah, I thought I picked up
on something.

Something that she said?

No, I thought I picked up

on some chemistry
between the two of you.

Hmm.

I mean, there's been
moments, but, um..

...you know you hate to
screw up a good friendship.

That's lame, Carter.
Ask her out.

I hope Romano doesn't page me.

He sure keeps you
on a short leash.

I'd cut it in a heartbeat

if I weren't afraid
of losing my visa.

Uh, Morgenstern
might sponsor you.

‐ Huh! Out of the frying pan.
‐ What do you mean?

Well, he's a strange fish,
Morgenstern, don't you think?

‐ No, not really.
‐ You respect him?

Yes, of course. Why?

I heard he was
cutting up cadavers

in the anatomy lab.

‐ So?
‐ Well, it's nothing.

I suppose I'm looking

for a convincing reason
not to go back home.

Whoa, is your fellowship up?

No. I've been offered
senior lecturer

at Gloucestershire
Royal Hospital.

Wow! Congratulations.

Yeah, I'm not sure
I want to go back

into that old boys
network again.

At least here, a woman
has a fighting chance.

(Weaver)
'Ready, one, two, three.'

‐ Ooh.
‐ Gently.

71‐year‐old male,
Lyle Swanson.

T‐boned when a drunk ran a red.

No LOC, BP 150 over 98.

Pulse 90, resps 25,
minor lacs‐‐

Allison...look at you.
How are you?

I'm doin' fine, Dr. Corday,
thanks to you.

She's been on the job
three days.

Wouldn't know
she's just a trainee.

How's your leg?

Oh, I got a ways to go

but I'm gettin'
the strength back.

I'm thrilled for you.

Could we finish
with the bullet, please?

Sorry. BP 150 over 98,
pulse 90, resps 25.

Minor lacs to the head
and lower extremities.

Patient noticed chest pains
after slamming

into the steering wheel.

Well done.

Any time. See you.

No evidence of pneumo.

Good peripheral pulse
without extremity tenderness.

Pupils equal.
Disc margins clear.

'What are you thinking?'

Worst case scenario,
cardiac contusion

or an aortic tear.

Start with a chest x‐ray.

Excuse me?

Get a chest film.

I've got
a paraesophageal hernia.

Probably torsed my stomach.

Are you a doctor?

Pathologist.

Better rule out a volvulus.

Lydia, call for
a portable chest.

Peter, what do you think?

I think Dr. Swanson
just beat us to the diagnosis.

Hey, are you going to this,
uh, banquet tonight?

Uh, sounds kind of hokey.

Actually, it was
great fun last year.

It was a nice dinner.
It's good wine.

Everybody ended up
doin' the limbo.

‐ I don't know.
‐ Oh, come on.

I guess,
if you're gonna go.

Would you like to go together?

Sure. Why not?

Alright, I'll pick you
up at uh, 8 o'clock?

Great.

Jerry, why didn't you tell me
there was a deposit?

'Cause I thought you were
taking care of the band.

Look, if I'd known there was
a deposit, I would've paid it.

No, you don't understand.

I've got 60 people
showin' up tonight.

‐ You cannot cancel on me.
‐ Mark, telephone.

Can you hold on a second?
Is it important?

It's the florist
for the banquet tonight.

I'll tell her
you're with a patient.

No, no, no.
What does she want?

Well, she tried to deliver
your centerpieces

to the Shangri lodge

but there was nobody there
to receive 'em.

Uh, have them delivered here.

‐ To the ER?
‐ Yeah.

Look, you've got to be able
to find a band for me tonight.

You know what, I have couple
buddies that are musicians.

Jerry, back to work.

What's that?
"The Machine?"

That sounds good.
Fine, book 'em.

I'll pay the late fee. Yeah.

Damn it.

Labs are back
on Quinesha Beavans.

She's got gram‐negative
rods in her urine.

Her CBC shows a left shift.

‐ Urosepsis.
‐ Probably.

Ah, it's good thing you had
Mrs. Beavans stick around

so you could run the tests.

Make sure you tell
Kerry Weaver about that.

Let's see, you want me
to call her

and make sure
she brings in Quinesha

for IV antibiotics?

I can be diplomatic, buddy.

I know you can.

Dr. Swanson made a correct
self‐diagnosis.

He's got a
nasty‐looking volvulus.

Looks like he's gonna
need a gastrectomy.

Have you ever removed
the entire stomach?

No. What about you?

In a frog.

Morning, folks.

Good morning,
Dr. Morgenstern.

So, what's on the agenda?

A rather fascinating case.

Pretty spiffy.
Who is this?

Lyle Swanson, 71‐year‐old
physician who presents with‐‐

Swanny?

David Morgenstern, Dr. Swanson.
I took histology from you.

In fact, you inspired me to
become a surgeon.

You made the most beautiful
axial slices of the brain.

That means a great deal
coming from you, sir.

Dr. Swanson is a world authority

on immunofluorescent
tumor stains.

I'm afraid you have
a gastric torsion.

I should have had that damned
hernia repaired years ago.

Well, I had an MI
six months ago.

I ignored the symptoms
for weeks.

What's your plan?

Well, we'll do
an open procedure.

That way we can
explore your belly.

Can you operate
laparoscopically?

I believe your case
is too complicated for that.

‐ Nonsense.
‐ A lap volvulus?

It's less invasive.

The recovery
time is quicker.

Peter, what do you think?

Um, well, it's worth a try.

We can always convert
to an open procedure.

Lily, book an OR in my name.

Which one of you young
turks would like to assist?

Elizabeth?

You're the skeptic,
how about it?

Terrific.

Isn't a Smorgasbord
kind of old‐fashioned?

Oh, it's gonna be great.

I'd like to see a menu.

We're having pickled Herring

Swedish meatballs,
limpa bread

and my mom's making
a tub of borscht.

W‐wait, your mother's
doin' the cooking?

‐ She's doin' it for free.
‐ Did you page me?

Uh, yeah. Got a bowel
obstruction in two.

You're sure it's not
just constipation?

Yes, I am certain.

Hell of a job you ER docs have.

You have to scout out
the territory

and then call in the big boys
to go in for the kill, huh?

‐ Anna, you got a minute?
‐ Sure.

Listen, I got a call from the
national bone marrow registry.

You gave some blood last week?

Uh, yeah, in the drive
for Dr. Anspaugh's son.

Don't tell me that I matched.

No, uh, unfortunately,
not for Scotty

but you did match
an out of state patient.

Wow. That's great.

That's kind of a tough
procedure, isn't it?

It's not too bad, and if
I can arrange it for today

would you be willing
to do it?

That soon?

The patient needs the marrow
as soon as possible.

I'll give you a few days off
to recuperate.

I could perform
that procedure

after I check out this
bowel obstruction if you want.

Yeah, and what exactly
does it involve?

I'll drill about
50 small holes

in your pelvic girdle
and suck out the marrow.

Uh‐huh.

We'll give you an epidural.

You won't feel a thing.

Piece of cake.

‐ Think about it.
‐ Okay.

Hey, be honest with me.

Think I have what it
takes to be an attending?

‐ Of course you do.
‐ Thank you.

Think of me as diplomatic?

What does that have
to do with it?

Answer the question.

Well, it's not the first word
that springs to mind, no.

What would the first word be
that would spring to mind?

Um, stubborn.

Opinionated, insouciant.

‐ Insouciant?
‐ Look it up.

♪ It's in your mind ♪

♪ Hang 'em on a shelf
and good times ♪

♪ Tattoos and memories
and dead skin on trial ♪

♪ For what it's worth
it's worth all the while ♪

♪ It's somethin' unpredictable ♪

♪ And in the end it's right ♪

♪ I hope you had
the time of your life ♪

You know this one?

You've only played it
about a billion times.

Are you done eating this stuff?

‐ It's not very good.
‐ Yeah, I know.

How about I order us a...pizza?

Uh, if you want.

Maybe some rocky road
for dessert?

What is this,
the pain getting worse?

This thing isn't working
as good as it used to.

Okay, I'll, uh,
I'll get Dr. Ross

to adjust it for you, okay?

Wait. Don't leave yet.

This is the coolest part.

♪ It's somethin' unpredictable ♪

♪ But in the end is right ♪

Mm‐hmm.

Dr. Bad News.

How you feeling, son?

Well, me and Jeanie
were gonna share a pizza.

We, uh, we need to talk.

Your bone marrow failed to match
the last two potential donors.

Win some, you lose some.

Hey, we'll, uh,
we'll come up with plan B.

Okay? Your dad and I have
discussed some new therapies.

There is something called a...
phase‐one chemotherapy trial.

But it's...highly experimental.

At least it's still
a possibility, right?

Yes.

Couldn't be any worse

than the nuke juice

they've already given me.

There could be
some severe side effects.

‐ And...the chemo could‐‐
‐ Make me croak.

We don't have to make a decision
right this minute.

What do you think, Jeanie?

I think it's a chance.

Would you stay with me
if I got the new chemo?

Of course I would.

I wanna do it.

You sure lucked out
getting that lap.

You like working
with Morgenstern?

Of course.
He's one of the best.

Why is it I don't feel
comfortable around him?

Hmm, can't imagine.

You know, last week
he bolted out

midway through
a pericardiocentesis.

Claimed he had
something in his eye.

Well, then he must have.

It seemed to me
like he froze up.

Ah, you can't believe that.

Let me tell you something
about Dr. Morgenstern.

He's taught me more than all
the other attendings combined.

Yeah. Maybe I'm looking for
an excuse to get out of this.

I don't have much experience
with laparoscopic procedures.

Ah! Now, see, that's it.

You know, whenever
you're nervous

you go after the attendings.

Do I really?

Well, I guess I do.

Have you ever done
a lap volvulus?

Oh no, but I'd love to.

In that case, be my guest.

‐ Are you serious?
‐ Yeah.

I'll do your biopsy and then
I'll come and observe you.

Perhaps I'll learn something.

Well...okay.

Um...I, uh,
I owe you.

David.

I hope I'm, uh,
not disturbing you.

Oh, heavens, Kerry,
you never disturb me.

Is that a lap volvulus?

Heard you're doing one
on Dr. Swanson.

Yeah, just looking at
one of my old teaching tapes.

Never hurts to review
the finer points of establishing

a pneumoperitoneum.

He told me that you were
one of his brightest students.

Aww, good ol' Swanny.

He's from the old
school of medicine.

Cares about the science
and the soul.

Well, I, came up
to bring you

the minutes of the blood
utilization committee.

Thought you might be interested,
now that you're back on staff.

You're always
looking out for me.

Which reminds me, are you coming
to the ER banquet tonight?

After all, you're
part of the family.

Well, it sounds like great fun.

Good. I'll see you there.

Righto.

So I spoke to the
pain management team.

It's alright.

‐ Sorry.
‐ It's alright.

We're gonna increase
your morphine dosage.

Okay.

Where's Jeanie?

Jeanie, well, she's probably
down in the ER, working.

No. She promised to stay with me
when I get the new chemo.

So I spoke to your dad
about that.

He's a lil' worried
that you may not understand

what it means to go into
a phase‐one treatment study.

I know.

The chemo could make
me a lot sicker.

Yeah. It can.

And you're willing
to go through with that?

‐ Hey.
‐ Hey.

Hey, Jeanie.
Where have you been?

I was down in the gift shop
and I got you a lil' something.

The new hot rod.

You let me read that
when you're done, alright?

So, uh, Scott and I
were just talkin'

about the pros and cons
of the phase‐one study.

And I was telling Dr. Ross
that we're gonna go for it.

Yeah, we are.
He's a pretty brave guy.

Yes, he is. Very brave.

Yes, I'll hold.

Hey, so I talked to Anna
and we're going together

but don't call it a date.
I'm not callin' it a date.

No, no, it's urgent.

I‐I have to speak
to Mrs. Carter immediately.

Well, page her out
of her board meeting.

‐ What's goin' on?
‐ Carol wrote a bad check.

And our medical supplies
are getting repo'd.

Your grandmother wrote me this.

Could you please have her
call me back? Thank you.

She put a stop payment
on her foundation check?

‐ Yep.
‐ What did you do?

Well, uh, nothing, you know
last week we had some bad press.

We gave out
birth control to teens.

I don't think Gamma's
anti‐birth control.

She does hate publicity, though.

What should I do?

Maybe you could promise that

you won't use her foundation
money for birth control.

Yeah, well, I would if
I could reach her.

Dr. C, eye exam in one.

Hey, I'm sure it's just
a big misunderstanding.

‐ Is the patient ready?
‐ He's asleep.

Okay. The monitor goes
at the head of the table.

And the endoscopic tower's
on the wrong side.

Dr. Morgenstern
requested it this way.

‐ Are you sure?
‐ Yes, doctor. Quite sure.

Shirley, how nice to see you.

You still collecting old 45's?

Just picked up a rare buddy
holly that's swab neat.

It's great to have you back.

Well, it's good to be home.

Peter..

...I‐I thought your associate
was going to assist.

Uh, she's doing a biopsy.

So, she'll be by later
to observe.

So it's you and me.

‐ Mm‐hmm.
‐ Just like old times.

Shirley, I left a‐a CD
of some Peruvian panpipe music

by the scrub sink.
Would you mind putting it on?

Not at all, Dr. Morgenstern.

You'll like this, Peter.

The music is mysterious,
and yet soothing.

You have a scratch
on your cornea, Mr. Bartlett.

I'll be right back with some
antibiotic eyedrops for you.

Hi, Carter, do you
have a minute?

Sure.

‐ Somethin' wrong?
‐ Uh, no.

Well, actually I matched
for a transplant candidate

from the blood that
we donated last week.

You're gonna
donate bone marrow?

‐ Yeah.
‐ That's great.

Yeah, but I guess I won't make
it to the banquet tonight.

Yeah, no, you should be
sore for a couple of days.

Why? It's a simple
procedure, right?

Not much to it.

Have you ever done one?

Hmm, about 12 or so,
last year.

Would you do mine?

Really?

Yeah.

I don't mean to
sound like a wimp.

I'm just, I just feel
a little nervous about it.

I've never even seen you flinch.

Not even
in the bloodiest traumas.

I'm serious. It's different
when you're the patient.

Just a big chicken, huh?

Don't rub it in, please.

No, no. Hey, it's just, um...
I think it's surprising.

If you don't
want to do it, it's fine.

No, no, I'd be honored.

I'll do it as soon as
I'm finished with my patient.

Okay. Thanks.

Appreciate it. Bye.

Hey, Mark. Did Romano
see that kid with the appy?

Uh, yeah,
he's examining him now.

So, is everything set
for the banquet tonight?

Seems to be moving right along.

The university club put on such
a lovely banquet last year.

It's too bad
it wasn't available.

It was. I just thought
that the Shangri lodge

would be a, you know,
different choice.

And you actually chose
the Shangri lodge

over the university club?

Yeah, little less pretentious,
don't you think?

Uh, yeah, whatever you say.

That appy kid's dry as a bone.

Do me a favor,
buff him up, Greene.

Give him 200 cc's normal
saline every 15 minutes.

Uh, that's way too much
fluid for a kid.

I already gave him
two 500 cc boluses.

Well, that's nice.

I want you to give him 200 cc's

every 15 minutes for an hour

and then send him up to the OR.

You guys are always
fluid‐overloading these‐‐

Just follow my orders
on the chart, please.

Look, this is my ER

and I'll manage the patients
down here the way I see fit.

Hey, Greene..

I guess you got
some stones after all.

You're the boss.

I'll free up the esophagus
with the harmonic scalpel.

When I was a resident,
we didn't have cautery.

We had to tie every vessel.

Tell me, Peter.

Where do you find
the two branches of the vagus

at this level of the esophagus?

They rotate and become
the anterior and posterior.

If you cut them,
the stomach won't empty.

Right you are.

Speaking of empty and stomach

anyone try that new, uh,
Mexican restaurant on Dearborn?

I heard they make
a great chimichanga.

[sighing]

Shirley, could you turn
down the thermostat?

'Right away, sir.'

‐ You okay?
‐ Of course.

I was doing laps
back in the days

when those monitors
were still black and white.

‐ Uh, Dr. Morgenstern.
‐ What?

Uh...you're dissecting
near the esophagus.

Thank you, doctor, but
I don't need instruction.

That phrenic ligament
is really fibrous.

Are you sure it's not mucosa?

Damn it!

Peter, your job is to assist me
anticipate my moves.

I am, but he's got varices.
You could nick one.

Turn.. turn the music off.

Don't pull so hard
with the babcock.

You'll tear
the gastric artery.

‐ I'm not pulling.
‐ The hell you're not.

Dr. Morgenstern,
you're obscuring my field.

Oh, son of a bitch!

You tore
the left gastric.

I wasn't anywhere near it.

Suction.

Give me a ten‐millimeter
sucker, open‐ended.

Give me more suction. I can't
see what I'm coagulating.

‐ Alright, we have to open.
‐ No, no, no, no.

We can control the bleeding.

Every time I suck,
the abdominal wall collapses.

I can't see a thing.

Well, then stop sucking.

What are you
wearing tonight?

My velvet dress.

The one you
wore last year?

I didn't pass out and rip mine

in the parking lot
like someone I know.

Hey, Jeanie, you coming
to the banquet?

No, I'm gonna finish up some
charts and stay with Scott.

Oh, no luck with
the donor match?

‐ Nope.
‐ Jeanie, can I talk to you?

Yeah.

I'm concerned about
Scott Anspaugh.

You sure he wants
to go through

this experimental
treatment?

‐ Why? Did he say he didn't?
‐ No.

Then what are you
concerned about?

Well, he's got this big‐time
crush on you, right?

Doug, the boy's 12 years old.

12‐year‐olds get
big‐time crushes.

He'll do anything
to please you.

No. He just wants
a chance to get better.

You seen the way
he looks at you?

You're overreacting.

He lights up
when you're around.

I'm just saying, I think
he's taking the chemo

because he thinks
you want him to.

I want him to make
his own decision.

I know that you do.

I don't know
that he can.

(anesthesiologist)
'Pressure's dropping.'

We've lost too much blood.
We've got to open.

Let's do a mid‐line.

Shirley,
instrument tray.

Two more units of
cross‐matched.

‐ Scalpel.
‐ Hemostat.

He's a bloody mess.

Get that liver
out of the way.

Deaver retractor.

The varices
are bleeding.

‐ Suction.
‐ 3‐O silk on a pass.

‐ Can you see the bleeder?
‐ Not yet.

Bradying down.

Two more units
of blood.

We've got to crack him.

Let me suture.

(Benton)
'No, we've got to
stop the bleeding.'

We're losing him.

I can't find the bleeder.

Alright, we've got to crack him.

It's those damn varices.

Dr. Morgenstern,
it's been three minutes.

Damn it.

He's dying! Move!

[instrument tray clattering]

Rib spreader.

Damn it! I said rib spreader!
Let's move, people.

Statinsky.

'Okay, aorta's clamped.
Do we have a pulse?'

'No pulse. He's in v‐fib.'

I'm starting internal massage.

Still in v‐fib.

The lungs aren't expanding.

Increase the volume.

Lap pad.
I can't get a grip.

'Still no pulse.'

Give me the epi.

'Come on, let's move.
Let's go.'

Tray's ready.
Here are your gloves.

Thanks, Kit.

Call if you
need anything.

‐ 'Carter, are you ready?'
‐ Uh‐huh.

Epidural didn't hurt a bit.

'See, I told you
you had absolutely nothing'

'to be nervous about.'

Sure. That's what they told me
when I had my tonsils out.

I was 12 and, um..

I was in terrible pain
after the operation

so they gave me dilaudid.

Trouble is they gave me too much
and I couldn't wake up.

'It's really weird, you know.'

I could hear the
nurses' voices and, uh..

I couldn't speak
or move.

I thought I was
gonna die.

And then I made
a promise to God

and I said, "If
you let me live

I'll be a good person
for the rest of my life."

Then you came to
and decided to devote

your life
to medicine?

Something like that.

Hey.

I'm really relieved
you're doing this. Thanks.

Oh, hey.

Okay, don't tell me

when you're gonna
stick the needle in.

‐ Okay?
‐ I won't.

I'm just gonna prep
with betadine.

Alright.

Your, uh, drape fell off a bit.

Oops.

Alright, here comes
the betadine.

I can't let you examine him
until after the autopsy.

I know. I just want
to review the anatomy.

That's quite an
unusual request.

Peter, why are you
so interested?

Well, uh, you know, it all
happened so unexpectedly.

I've known Dr. Swanson
for 20 years.

It's not easy
for me, either.

So do you think
it would be possible

to sit in
on the autopsy?

Sure.

Tomorrow, 4 p. m.

Thanks.

You down here checking
on the Swanson autopsy?

Yeah. I assisted on the case.

I know.

David Morgenstern
filled me in.

Alice, when do you expect
to have the report?

In a couple of days.

Sooner the better.

I'm sorry about what happened
with Dr. Morgenstern.

‐ Was there a problem?
‐ No, not really.

Anesthesiologist said there was
a disagreement in the OR.

But when I spoke to David
he downplayed it.

Right.

I understand Dr. Swanson
had a cirrhotic liver

and varices,
secondary to Hep B.

Yeah, he did have varices.

No wonder you couldn't
stop the hemorrhaging.

We'll run an M&M.

See if we learn something
from this tragedy.

Why don't you
take charge?

Gather all the charts
and the tape.

The tape?

We frequently tape
laparoscopic procedures.

See if the operation
was recorded.

If it was, you can
take us all through it

step by step.

Chuny, can you give me
a hand with these?

‐ Shouldn't leave 'em out here.
‐ What are these doohickeys?

It's a miniature
stethoscope.

It's a theme.
Dumb idea?

No. Just tacky.

Hey, did you talk
to Gamma yet?

No, she never
returned my call.

This might not
be about you.

What?

I'll go talk to her
after I get off.

Thanks. Oh, and by the way,
Anna said she'd call you later.

‐ Oh?
‐ She was in a lot of pain.

Took a taxi home. Guess
she's gonna miss the banquet.

Viper convertible.

It's pretty cool, huh?

Yeah, I'm going to get one
just like it.

Cobalt blue, with a
white racing stripe

down the middle.

Yeah. Think you
can handle it?

You'll see when I
take you for a ride.

You haven't mentioned
any of your friends lately.

You want me
to give them a call

maybe have some guys
come visit?

Not really.

They're...I don't know..

...just kids.

I'd rather
be with you.

Look at those wheels.
Magnesium.

What are you doing?

Applying for a swing loan
against the equity of my house.

If I can't depend
on the Carter foundation

and until I get
some new grants

I'm taking out a loan
to keep the clinic open.

‐ Am I losing my mind?
‐ Maybe.

(Greene)
Six‐month‐old twins
in respiratory distress.

Parents said they had the flu.

Went down
in the waiting room.

Give me a pediatric
crash cart.

Clear trauma two. I got him.

Come on.

[baby crying]

Ah, hey, Shirley,
can you help me?

If it's about the case

I gave the nursing notes
to Dr. Morgenstern.

Actually, I just need to know,
was there a tape made?

I didn't make one.

Okay, if there was a tape made,
where would it be?

Try the OR. The equipment's
still in there.

Thank you.

Check
the video recorder.

Ah, damn it.

Draw up racemic epi.

(Hathaway)
Yosh, you help Doug.
I'll help Mark.

‐ 'Need a hand?'
‐ 'Yeah, get the O2.'

Carol, I need the line.

This one's wheezing
and retracting.

Pulse ox 92.

Yosh, give me
albuterol nebulizer

.5 cc's in two of saline.

She's not breathing.

Lily, intubation tray.

Carol, I need that line.

I can't get a vein.

I'll go in interosseous.

Let's move her up.

How's the other one?

Stable. Yosh, move her
out of here.

I can't see the cords.

Laryngeal edema.

Probably syncytial virus.

She's cyanotic.

Trach tray.
Suction.

‐ Hold the suction. Hang on.
‐ What?

I'm going to compress
the chest.

Wait for an air bubble
and follow it

down with the tube.

‐ Okay.
‐ Alright.

I see the bubble.

I'm in.

Bag her.

Okay?

Peter?

I've been looking
for you.

You're one of the finest
residents I've ever worked with

and what happened today

has no bearing
on those feelings whatsoever.

I plan to support you
in any way I can.

Support me?

When it comes time
for M&M

I'm prepared
to review this case

strictly on medical facts.

Of course.

I believe Dr. Swanson died
from ruptured varices.

That's not
what happened.

What do you think
happened?

Wha..

You accidentally cut
the gastric artery.

I've been a surgeon
for 20 years.

I've never "accidentally"
cut anything.

Well, then,
how did he bleed out?

You avulsed the left
gastric with your clamp.

No, I didn't.

The tape of the procedure
will show that.

What tape?

Well, I was hoping
you made one.

Sorry.

Let's not
let this escalate, Peter.

As chief of surgery

I could make this an issue
of your insubordination.

I don't want to do that.

I would have never taken over
if I didn't believe‐‐

You did more
than take over, Peter.

You pushed me away from
the operating table.

That's grounds
for dismissal.

If a man's life
wasn't at stake‐‐

A man's life was at stake.

And that life was lost.

I'd appreciate it if
your preparation for M&M

focused on the medicine

and not hypotheticals
and accusations.

I think Dr. Swanson
deserves at least

that measure of dignity.

The clinic's done
a lot of really good work

in the family's name.

I'm glad you
feel that way.

So doesn't it make sense
to continue funding it?

I think it's time
Carol Hathaway

looked for other
funding sources.

She's worked very hard
to make a go of this clinic.

I don't think it's fair

to pull the rug right out
from underneath her.

I'm surprised at your interest
in the foundation.

How many years
have I tried to involve you

in our family's
charitable activities?

This isn't about the foundation.

What is it about, John?

You're angry with me
about Chase

so you're taking it out
on the clinic.

I am angry that your cousin
will be debilitated

for the rest of his life.

It's not something I would
take out on others.

Chase barely accepted my help.

He didn't want
the family to know.

None of you wants the family
involved in your lives.

That's unfair.
I care about the family.

You certainly care
about the money.

What?

You live off
a family trust, John.

Well, Gamma, if that is
all you think of me

then you can keep your money.

As you wish, John.

[door shuts]

David.

Hi. You know, I heard
about Dr. Swanson.

Hard losing Swanny
like that.

Yeah. Why don't you come with me
to the banquet tonight?

Thank you, Kerry.
I just wanna go home.

Mark...you know,
I've been thinking all day

about the dean's proposal
for a pedes attending

and I think we
should fight it.

I'm a little torn,
I just saw Doug Ross

saving a six‐month‐old's life.

Good. Doug is a
good pediatrician.

He's just not
management material.

He's never been
interested before.

This isn't just
about Doug.

It's a policy change

that would undermine
our authority.

I'm not worried
about my authority.

I think ER attendings

run the best
emergency department.

‐ I agree.
‐ Good.

‐ Good.
‐ Okay.

(Ross)
'Alright, let's see now.
Watch this.'

[chuckling]

Hey, I'll be right back.

Quinesha came back
for IV antibiotics.

I was entertaining her
a little bit with the..

Uh, how's her mom's job?

It's good. I called work.
She's going to be fine.

‐ Good for you.
‐ Yeah.

Listen, I'm serious about
the attending thing.

You ought to give it a shot.

Yeah? Yeah.
Here we go, kiddo.

Dr. Swanson taught half
the attendings here.

Everybody loved him.

I'd get all my ducks in
a row if I were you, Peter.

I did nothing wrong.

Rumor has it
you took over.

I had no choice.

That's your opinion

but justified or not,
you're a resident

and Morgenstern's the chief.

(Jerry)
Oh, I'm sorry.

So much for your bursitis.

I'm sorry, I'm sorry.

Look, hot borscht will be up
in five minutes, alright?

(Greene)
Hey, has anybody seen the band?

Uh‐uh. I don't see
any food, either.

Don't they usually serve
hors d'oeuvres at these things?

Wouldn't wanna spoil your
appetite for the smorgasbord.

Mark, the bartender asked
me for a drink ticket.

I didn't bring
any cash.

‐ Um, here.
‐ One each?

Hey, buddy, come here.

Kind of an unusual place.

It's great.

It's different, you know,
but it's great.

It's a disaster.

I wouldn't say that.

Here, you want
another drink?

‐ No, no.
‐ It's really nice, Mark.

‐ Mark Greene?
‐ Yeah?

I'm "The Machine."

‐ Band's here.
‐ Excellent. Great.

You guys need help
bringing your stuff in?

No guys. Just me.

You're "The Machine?"

The whole machine?

(Hathaway)
Hey...Carter...
over by the moose.

I'm sorry. I couldn't get
my grandmother to listen.

Well, somebody did.

She messengered over

another check
this afternoon.

Whatever you said
really worked.

Thank you so much.

‐ Come on, come on.
‐ I'm coming. See you.

Watch your head
on the moose.

‐ Hi.
‐ Why aren't you home in bed?

What, and miss my
first ER banquet?

[laughs]

How's the pain?

Oh, it's okay now

after a couple
of percodan.

Ah.

Makes for a very
pleasant banquet.

I should pass them around.

Well, you look..

Thanks. So do you.

Yeah, you know,
we've kind of been

dancing around this thing
a little bit, you and I

and, uh, this afternoon,
during the bone marrow..

Actually, a couple points
during the year

I kind of felt like
we had a chemistry.

‐ Or not.
‐ No. No, you're right.

I mean, there's definitely
been a...you know..

Alright, well,
let me say this.

Uh...I haven't made a move

because I didn't want
to screw up our friendship.

Yeah. No, you've been
a great friend.

The only real friend
I've made here, actually.

But?

But?

But there's this other guy.

Ah, yeah. The guy you
told me about in Philly?

Yeah.

The guy with the, uh,
drug problem?

Well, I think that's
past him now, so, um..

but we were together
for a really long time

and, uh, we've not been
together for a while.

Just not completely over.

I guess I'm just not
quite there yet, you know.

But, uh..

Hey, I understand.

You do?

Yeah. Yeah, I understand.

What are friends for?

Hey, Dr. Greene,
the crowd's getting restless.

Why don't you give them
some drink tickets

while the, uh,
machine is setting up.

Alrighty.

Ah, ah, saved
by the smorgasbord.

Ladies and gentlemen,
dinner is served.

(all)
Yes! Whoa! Yeah!

‐ What happened?
‐ He's arrested.

‐ Fever's 104.
‐ Is he septic?

That's what happens when
they get to this stage.

I'm surprised
he's not DNR.

He's about to start
a phase‐one protocol.

Poor kid.

Still no rhythm.

Okay, let's give him
two of epi.

Would you take over
the bagging, please?

Somebody should
call his father.

What is it
with these parents?

Why don't they
just let these poor kids go?

We've got a rhythm.

Okay, let's give him
tobra and ceftaz.

‐ You want hydrocortisone?
‐ 'Yes, please.'

'Good work, everyone.
We have got him back.'

♪ When the moon hits your eye ♪

♪ Like a big pizza pie ♪

♪ That's amore ♪

♪ When the stars
seem to shine ♪

♪ Like you've had
too much wine ♪

♪ That's amore ♪

Carol, are your
meatballs frozen?

No, I think they're
just a little cold.

What is this?

Jerry says it's
called pittapatta.

What's that?

I have no idea.

(Greene)
Excuse me. Hello.

Uh, I just wanted to say
thank you for coming tonight.

Uh, I...organized
this event

in hopes to show
my appreciation

for all of your
great work.

So try not to hold
tonight against me.

Each day, we work together
as a family.

Because we're a family

it's no secret that it's been
a rough year for me.

'So I want to thank each
of you for helping me'

through some hard times.

You stuck by me
when I needed you

and you've given your best

to make our ER a place
that we can all be proud of.

'So thanks for
being my family.'

'I couldn't have
made it without you.'

Thanks.

Hey!

Here you go, here you go.

Hey.

♪ When the moon hits your eye ♪

♪ Like a big pizza pie ♪

♪ That's amore ♪

Come on, everybody.

♪ When you walk
down the street ♪

♪ With a cloud at your feet ♪

♪ You're in love ♪

♪ When you walk in a dream ♪

♪ But you know ♪

♪ You're not dreaming, signore ♪

♪ Scuzza me, but you see ♪

♪ Back in old Napoli ♪

♪ That's amore! ♪

[laughter and cheering]

'I had the babcock on the lesser
curvature of the stomach.'

I wasn't pulling hard.

There's no way I could've
been near the left gastric.

Is there any way you could
have caught the artery?

No. Morgenstern was
dissecting the esophagus.

My clamp was on the stomach
the entire time.

Then it's your word
against his.

So, um...how much did
you see on the monitor?

I got there just before you
performed the thoracotomy.

Mmm. In time to see me push him.

Yeah.

Look, I'm willing
to express

my concern about
his competency.

Oh, no. The last thing
I want you to do

is jeopardize
your career over this.

[sighs]

I don't know, maybe
my clamp did slip.

You don't believe that.

You just told me
you had the clamp

on the stomach
the entire time.

I‐I'm sure I did.

Peter, if you're sure
that's what happened..

Yeah.

I'm sure.

♪ All the races like banana ♪

♪ Banana ♪

♪ Mexico like it ♪

Banana!

♪ Namibia like it ♪

Banana!

♪ Russia like it ♪

Banana!

♪ Middle East like it ♪

Banana!

♪ All the nations like banana ♪

Banana!

♪ All the races like banana ♪

Banana!

[laughing]

The food was terrible,
the music stinks

the drinks are watered down

but you sure know how
to throw a great party.

‐ Thank you.
‐ You're welcome.

[both laughing]

So you feeling better?

Yeah.

Good.

The antibiotics
are working.

You've got a big
decision to make.

I told you
what I want to do.

I know. Just
hear me out.

I'm gonna love you
and respect you

no matter what
you decide

and I'll always
be there for you.

So if you want
to take this chemo

you have to do it
for yourself.

Not for your dad
or for your sister

or for me.

‐ Understand?
‐ I think so.

A man has to make
decisions for himself.

I don't want any more chemo.

Okay.

You know what I want?

I want to get in that Viper.

Cobalt blue with
a racing stripe.

Put the top down and drive.

And where would we go?

California.

Mmm. Surfing?

Ride the curl at Zuma Beach.

Sounds like fun.

And we'll stay
for the sunset.

[softly]
Sure.

[theme music]