ER (1994–2009): Season 5, Episode 1 - Day for Knight - full transcript

[theme music]

[train chugging]

[alarm blaring]

[indistinct chattering]

What happened? Is he okay?

I think he might have slipped.

No. It looks to me
like he fainted.

Okay, alright, every.. Get, get
back, everybody, get back. Okay?

Okay. Come on now. Come on.
We got a doctor here.

The hospital's right
around the corner.

Some guy ran to get help.



My head hurts.

This pavement's hard.

Alright. I'll help you.
I'll help you.

Hey, you shouldn't move
his neck like that. Should you?

Oh, God. Are you okay?

I just told you. My head hurts.

Okay, uh, don't worry.
You're gonna be fine.

We're all gonna help you.

‐ You want us to do something?
‐ We've got to.

(Carol)
'Coming through.'

Hey, sir, are you okay?

Yeah. Can you help me up?

We're gonna check
you over first.

‐ What's your name?
‐ Barry Mahoney.



‐ He fell down.
‐ Thank you.

And he's bleeding a little bit.

Right. Thanks.
We'll take it from here.

(Mark)
'Carol, we need to
stabilize his neck.'

(Carol)
'I'll get a C‐collar
and a gurney.'

(Carol)
So Jen's gone for a month?

(Mark)
She has to take a couple
hundred depositions

in St. Louis, so she figured

it'd be easier just
to stay down there.

(Barry)
My head still hurts.

It's just a small scalp
laceration, Mr. Mahoney.

Nothing to worry about.

(Carol)
And she's letting Rachel stay
with you the whole time?

No. Reluctantly, Rachel
didn't wanna miss soccer camp

so she's staying.

Okay, let's get
a saline line going

TKO, CBC, and a CHEM 20.

Want a portable C‐spine?

Yeah. Thanks. And a 12‐lead EKG.
Can we help you?

Just wanted to make
sure he was okay.

Family needs to
wait out in chairs.

Oh, I'm not family. I was
passing by and tried to help.

Didn't do much.
Just put her coat under my head.

Sure Mr. Mahoney
is very grateful.

But passersby need
to wait out in chairs, too.

Accu‐check, 124,
hemocue, 13.8.

No, actually,
I'm supposed to be right here.

I'm a third‐year
medical student.

I'm starting my
ER rotation today.

Oh, man, is that today?

So this lab coat
must be yours.

'Yes. So what should I do?'

‐ What's your name?
‐ Lucy Knight.

Well, Miss Knight,
welcome to County General.

You need to check in,
so, I think

you should probably
wait out in chairs.

You don't want me
to do anything?

Carol?

Uh, left down the hall,
and then a right.

Should I at least observe?

Left down the hall,
and then a right.

[beeping]

[theme music]

[baby crying]

Hey, Luce,
did you just get here?

Bernard, what are you doing?

What happened?

Oh, some fire twirler
burned his butt

and the whole troupe's
waiting for him.

What is all this?

You look like some
geek pacing around.

I am a geek pacing around.

Taking Dr. Weaver's
audio tour of the ER.

Who's Dr. Weaver?

Kind of short,
red hair, uses a crutch.

Oh. So, what, they just
have you sitting here?

Yeah, I don't know
what I'm supposed to do.

No one told me anything.

Well, I gotta get
back to my tour.

Oh, Bernard,
what are you doing later?

I have to practice
drawing blood.

They're not gonna make you
do procedures at first.

Alright. I'll find you.

‐ Come on! Out of the way!
‐ Trauma one's clear.

'What've we got, Peter?'

(Peter)
'Multiple GSWs,
head, face and chest.'

GCS 7, BP 60 palp, two
large‐bore IVs, normal saline

a liter and a half
in the field.

(Peter)
'Prep a Thora‐Seal
and set up for a chest tube.'

‐ Ha ha. Lucy Knight?
‐ Yeah, yeah.

Jerry Markovic,
Unit Service Coordinator.

Listen, Dr. Greene's
gonna show you around

as soon as he
finishes with a patient.

So, why don't you throw
your stuff in the lounge

and then come on
back to the desk.

(Lucy)
Oh, I'm sorry.
Did I interrupt something?

We thought you were Jerry.

Oh, the Unit Service
Coordinator. I just met him.

[chuckles]
You gotta love that.

You must be
a new med student. Right?

‐ Yeah.
‐ Jerry's the desk clerk.

He only pulls that
unit thing on newcomers.

(Takata)
'It's his birthday.'

Don't tell him
about the cake. Okay?

Oh, no. Of course not.

‐ Chuny Marquez.
‐ Lily Jarvik.

‐ Yosh Takata.
‐ Lucy Knight.

Uh, should I use a lock..?

[telephone ringing]

Excuse me.
I'm looking for Jerry.

Oh, he went down
to the roach coach

to get his
Breakfast Burrito.

And that's why
my dad says he's..

‐ Ha ha ha.
‐ Oh, what did you do?

Um, not much, actually.

I was hoping Jerry knew

if there were any
extra lab coats around.

Oh, they keep them
under the desk.

Great. So your
dad works here?

Yeah. He's one of the bosses.

Well, he used to
be the only boss

until Dr. Weaver butted in.

Oh, here they are. Thanks.

‐ What's your name?
‐ Rachel.

‐ I'm Lucy. Oh, hi.
‐ Hello again. Mark Greene.

‐ Lucy.
‐ Knight. I remember.

Rachel, what are you
still doing here?

I'm watching the desk for Jerry.

Uh, only for a moment.

Mrs. Williams doesn't
pick me up until 8:30.

Yeah? Well, it's 8:35.

Good luck on your game.

I'll pick you up at
the Williams' before dinner.

‐ Okay. Bye.
‐ Okay. Bye.

‐ Bye.
‐ Bye, Jerry. Happy birthday.

Thanks, Rach.

‐ Settling in?
‐ Well, actually, I haven't‐‐

Jerry, would you call
radiology and tell them

to hurry up on those films
for that clavicle in two?

I was waiting on chairs
just like you said.

That leg lac
in four needs sutures.

Doyle or Carter.

Yosh Takata, Lucy Knight.

‐ Hi.
‐ We met.

Sitting in chairs, huh?
Well, we better get you going.

We'll start off with charts,
then the board, quickie tour.

And then we'll see if you're
ready for some patients.

Aren't I supposed to be
assigned to a resident?

Later. First grab a chart
and pick up your patient.

No jumping over for
a more interesting case.

Then put your initials here,
patient's name, chief complaint

and what labs
or films you've ordered.

Why don't you try one?

Uh, patient's name is Clements

and chief complaint
is "mult lac?"

Multiple lacerations, right?

Waiting on a head CT
and suturing.

Doctor is MD, which doesn't
actually stand for "doctor."

That means "Maggie Doyle."

Don't worry. You'll catch on.

So you thinking about emergency
medicine for your residency?

I'm not sure.
This is my first rotation.

Curtain Area 1,
Curtain Area 2.

Exam Room 1,
this is Exam Room 2.

‐ Oh, and this is Dr. Carter.
‐ What?

Carter's one of our finest
second‐year residents.

Even though he does appear
to be sleeping on the job.

Lucy Knight,
third‐year med student.

‐ Hi.
‐ Hi. Sorry, Dr. Greene.

I haven't been getting much
sleep since I took that RA job.

Uh, life in the dorm, huh?

Better you than me.

Patients, Carter.
The place is lousy with them.

Right.

Hey, hey, hey,
hey, hey, hey, hey.

This is trauma one,
which I think, you've seen.

‐ Who're we saving?
‐ Nobody. He's arrested twice.

Another soldier to the drug war.
Tucked away in his pants.

(Mark)
I'd like you to meet
Lucy Knight, third year.

Doctors Benton and Weaver.

Nurses Lydia Wright
and Malik McGrath.

Two units O‐neg on the infuser.

Do you know Mr. Gamely?

Bernard? Uh, yeah,
I just saw him.

As soon as he's done with
the headset tour I'll find you.

‐ Think you'll find it useful.
‐ Okay.

BP's 40 palp.

(Lydia)
'He's flatline.'

(Peter)
'Thoracotomy tray.
Come on, Malik. Let's move.'

(Peter)
'Need another test‐tube.'

Trauma two, blissfully quiet,
which is the way we like it.

This is the suture room
where Dr. Doyle is suturing.

Lucy Knight, third year.

‐ Hey.
‐ Hey. Nice to meet you.

Oh, who's Sleeping Beauty?

(Maggie)
Uh, Mr. Clements passed out.

He got way too drunk
and walked through

a plate glass window.
You idiot.

Dr. Doyle likes to throw
in a little attitude

when presenting a patient.

Is he gonna be okay?

Oh, yeah, as long as
he doesn't mind

some big, gnarly scars.

‐ Mr. Gamely, I presume?
‐ Yeah.

Alright. Drug lockup's in here.

Lab is down the hall.
Radiology around the corner.

Exam Room 4.

[clears throat]
Sorry to barge in.
Hey, you got a minute?

Sure. Be right back.

Lucy Knight, third year,
Doug Ross, pediatrician.

‐ Hi, how you doin'?
‐ Hi, fine.

Uh, alright, Miss Knight

why is otitis media found
primarily in children?

Because they have
short Eustachian tubes

so the fluid doesn't
drain properly and makes it

the perfect medium
for bacterial infections.

Okay. Treatment?

Um, Amoxicillin or Pediazole

although current thinking holds
that we may be over treating

because many of
the cases are viral.

So antibiotics aren't necessary
and may contribute to‐‐

Uh. Okay. Pretty good.
Textbook answer.

You wanna see some real Pedes
cases, you come see me. Okay?

‐ Mark.
‐ 'Elizabeth.'

(Mark)
'Lucy Knight, third year.'

Dr. Corday, surgical
resident in cowboy boots.

Aren't they fabulous?

Just back from
an interview in Denver.

‐ How do you do?
‐ Nice to meet you.

How was your trip?

Oh, the interview was fine,
the mountains are lovely.

But the city's
a bit flat, isn't it?

Now, don't let the
residents abuse you.

You're here to learn, not
be their indentured servant.

‐ See you later, Mark.
‐ Thank you.

Mark, labs are back
on that rule‐out MI.

Uh! Thanks, Lily.

Okay. well, that's about
the lay of the land.

So, I'm gonna go check on a
patient. I'll find you later.

‐ What am I supposed to do?
‐ Well, grab a chart.

Help someone out.
Just jump right in.

[indistinct chattering]

(Lydia)
'Uh, 5 mgs three minutes ago,
total of 8.'

‐ How long has he been down?
‐ Twenty‐five minutes.

Let's call it.

Alright. Time of death, 8:49.

Nice try, everybody.

(Peter)
'I gotta get back upstairs.'

(Kerry)
'Yeah. I'll handle the chart.'

Hey, you wanna wrap, or shall I?

‐ I'll do it.
‐ See ya.

‐ Is that it?
‐ I gotta get the death kit.

Hang out. I'll show you how we
do it.

[phone ringing]

Uh, excuse me?

Somebody?

Um, his phone's ring..

His phone's ringing.

[ringing continues]

Hello.

Um...no, I'm sorry.

He can't come
to the phone right now.

Well, yeah. I‐I suppose
I could take a message.

(Kerry on tape)
'Remember where Radiology is.'

'Continue to your left now'

'on down to the end of the hall'

'and proceed
seven steps forward.'

'You have now reached
the admit desk.'

'The veritable heartbeat
of every emergency room.'

'We'll return for
a complete orientation..'

Oh, it's not mine.

Bernard, what is with
this thing?

I'm never where she
says I'm supposed to be.

Neither was I.
You know what?

This morning when
I saw you in chairs

I was supposed to be
in a suture room.

Do you think we're starting
at the wrong point?

[chuckles]
I know I have.

I wanted medicine rotation.

This Dr. Doyle has latched
on to me in a big way.

And we haven't even been
assigned a resident yet.

Hasn't stopped her from turning
me into a urine delivery serv..

Can you remember
where the lab is?

All I know is it wasn't
where it was supposed to be.

‐ Miss Knight.
‐ See ya.

Oh, Dr. Weaver.

Yeah, the tour's
very helpful, isn't it?

Yes, thank you.

Um, as chief will you be the one
assigning us to residents?

‐ I'm acting chief.
‐ Oh.

Kerry.

Yeah, Doug,
you were looking for me?

Yeah. I have to do an LP

on a two‐year‐old
boy in Exam 3.

Rule out meningitis?

‐ Yes.
‐ And what are the symptoms?

Excuse us for a second?

Just a second.

Kerry, I'm not here
to present the case.

I'm here to inform you about a
procedure that needs to be done.

The parents are out waiting,
if you'd like to join us.

You know what, Don Anspaugh
and legal mandated the terms

of your situation, not me.

Mm‐hmm. Well, and those
terms do not include me

having to justify a procedure.

Be right there.

You know, why don't you finish
the tour, grab Dr. Carter

see if he can pull you
in on some patients.

[indistinct chattering]

Hey, can you hold this
corner up for a second?

‐ Sure.
‐ Thanks.

Getting things ready for
my surprise birthday party.

This year's surprise,
there is no party.

[chuckles]
Then why do you have
that cake in the lounge?

‐ I didn't tell him.
‐ I know.

He sniffs that out every year.

Well, you hide it in
the same place every year.

Patient's eight.

Huh, how long has he
had the rash?

His mom say
for about three weeks.

I'm having a hard time
diagnosing it.

‐ How's it going, Miss Knight?
‐ Uh, fine.

Uh, Dr. Weaver suggested
I work with Dr. Carter

on some of his patients.

Carter, you wanna fill her in?

Eight‐year‐old
with erythematous macules

and small papules
on the trunk and back.

‐ Okay. What's the distribution?
‐ Kinda spread out like a fan.

Does it resemble
a Christmas tree?

Yeah. I guess
you could say that.

Sounds like pityriasis rosea.

Classic Christmas tree
pattern on the back.

I think she's right.

Using a computer.

Ahem, why don't you
let Dr. Ross take a look

and then you and Miss Knight

can move on to
the gentleman with hematuria.

Okay.

‐ I'll meet you in Exam 4.
‐ Sure.

Did I say the wrong thing?

In general
it's probably not a good idea

to show up the residents.

So I should give
the wrong answer.

Tricky, isn't it?

Welcome aboard.

And when did you first notice
blood in your urine, Mr. Zwicki?

Just a couple days ago.

Listen this couldn't be
related to exhaustion, could it?

I've been finishing up
this renovation

on a two‐story in Oak Park.

Working long hours?

Ha ha. Needed to bring
it in before the penalty.

I don't think that's it.
Any fever?

‐ No.
‐ Back pain?

Well, just the usual from work.

How about weight loss?

Um, I always drop a little
at the end of a job. You know?

You skip a meal here and there.

Mm‐hmm.

Is it gonna be much longer?

‐ I'm gonna order some tests.
‐ Mm.

We'll know more then.

Connie, let's get a CBC,
coag panel, UA, CHEM 7.

You got it.

‐ Peed in this cup for you.
‐ Thank you.

We'll be back in a bit.

I'm sorry about
coming up with

that rash diagnosis
before you did.

No problem.
Fair is fair.

I just hope this doesn't mean

I'm not gonna get
to do anything.

I've spent two years learning

how to take a history
and a physical.

I'm willing to help
with patients.

Oh, hey, Carter,
I am jammed.

Can you take Mrs. Lydell

a foot ulcer in Curtain 3?

‐ Sure.
‐ Thanks.

She's all yours.

Do the H&P, make an assessment
and a plan, then come find me.

[humming]

‐ Mrs. Lydell?
‐ Yes, I surely am.

I'm Lucy Knight.

Uh, would it be okay
if I just check you over

and ask you a few questions?

Child, the good Lord has seen
fit to put me into your hands.

Now, I receive you just as
he receives us both.

Order a cross table,
C‐spine and portable chest.

‐ Pelvis?
‐ Sure.

‐ Dr. Carter.
‐ I'm a little busy.

Labs are back on Mr. Zwicki.

‐ Pulse ox is 92, BP 90 palp.
‐ Put them in his chart.

Let's get another
large‐bore IV going.

After that we may
need a central line.

‐ I'll do it.
‐ His crit doesn't look good.

I'll check it
as soon as I can.

‐ Go ahead, Carter. I've got it.
‐ No, really, it's okay.

(Kerry)
We're covered here.
Come on, go, go, go. Go!

[beeping]

(Kerry)
Seven gloves,
betadine and a spiral..

Hematocrit's 30?

So he's pretty anemic, right?

Yep.

Urinalysis shows red blood cells

too numerous to count,
but only two to three WBCs.

BUN and creatinine are normal.

Ah, with the gross
hematuria and the anemia

we definitely need
to admit him for more tests.

Hey, can you give me
the differential diagnosis

at this point?
Without using the computer?

Um, with weight loss
and painless hematuria

cancer's high on the list.

Uh, kidney tumor,
carcinoma of the bladder

prostate cancer,
renal tuberculosis‐‐

‐ Good job.
‐ Thanks.

Oh, good. Listen,
I was just coming to find you.

I gotta get going.

You know, my poor wife,
she's been in that waiting room

for the last two hours.

‐ Your lab results are back.
‐ Yeah.

And they indicate that
there may be a serious problem.

We'd like to admit you
for a few days

to do a full
diagnostic evaluation.

No, I can't do that.

I start a huge
renovation tomorrow.

Townhouse on the Gold Coast.

Well, I'm sure it could
wait a couple of days.

No, it can't.

Your condition
could be very serious.

There is a possibility
of cancer.

And I really think
you should get it checked out.

[chuckles]
Now, look, come on now.

A buddy of mine found
a little blood in his piss

and it turned out
to be a urine infection.

So, can't you just
give me some antibiotics?

Can't really do that.

We should bring your wife up
to speed, if that's alright?

‐ Yeah. Yeah.
‐ It's okay? We'll be back.

You have to let him go?

If he insists,
but you have to know

what technique to use
to get him to stay.

In this case, we use his wife.

What do you mean?

We'll give her
the full picture.

The possibility of cancer

the importance
of early detection.

Ten minutes alone
with him in the room

she'll change his mind.

Lydia, did Dr. Weaver
do that central line yet?

Just about to.

I'm just gonna
go check with her.

See if she needs any help.

I'm looking for Mrs. Zwicki.

Yes.

Mrs. Zwicki?

My name is Lucy Knight.

And, uh, I'd like to talk
to you about your husband.

His condition could
be very serious.

What do you mean?

Well, with the
painless hematuria

there's a chance
of renal vein thrombosis

polycystic kidney disease,
glomerulonephritis

and renal or ureteral calculi‐‐

Wait. I don't understand this.

Well, your husband would
like to leave AMA.

But we'd like to check him in
and do some more tests.

Tests?

Do an IVP,
get an abdominal CT.

Check his urine for AFBs

maybe check a PSA,
and possibly do a cystoscopy.

(Lucy)
I don't think this
is a good idea.

It would just be
a couple of days.

‐ I think we're out this way.
‐ What's going on?

The Zwickis have
decided to leave.

Mrs. Zwicki, I need to tell you
about your husband's condition.

Look, she explained everything.

He's incredibly stubborn.

No, look, I am not stubborn.

I feel fine and I got
a new job to start tomorrow.

You see, summer, that's
when I get my work.

And I can't blow this job off.

‐ Uh, Mr. Zwicki...please.
‐ No, I'll tell you what.

Let me tell you,
if this doesn't clear up

then I'll make arrangements to
get with my regular doc, okay?

It'll be okay. It'll be okay.
Come on, let's go.

‐ You talked to her.
‐ I thought you said to go‐‐

What did you say?

I told her about the chances
of hypernephroma, prostatic‐‐

‐ In those words?
‐ Yes.

Is there a problem, Carter?

‐ Mark.
‐ Just a second, Carol.

The patient wanted to leave AMA.

Miss Knight mistakenly
explained his condition

in medical rather
than layman terms.

Why is a third‐year medical
student doing explaining?

(Mark)
'Where were you?'

I was assisting
Dr. Weaver in the Trauma.

‐ I didn't tell her to do it.
‐ Yes, you did.

Look, I hate to break in,
we've got a helicopter

landing with a
blunt head trauma.

You told me to
give her the full picture.

I didn't mean you!

Miss Knight, why don't
you come with us?

[helicopter whirring]

27‐year‐old firefighter.

Fell 20 feet on to concrete
with blunt head trauma

and loss of consciousness.

BP 150 over 90, pulse 60.

Apneic and intubated on scene.

Pupils four millimeters
and sluggish.

I thought you said
you intubated.

We lost the tube
en route.

We didn't have
a laryngoscope up in the air.

Why the private chopper?

It was already on the scene.

[helicopter whirring]

[whirring continues]

Help. Oh, no.

Please, help me.

Please!

Please!

[whirring continues]

[beeping]

8.0 ET tube, suction.

BP's 160 over 95,
pulse 62, pulse ox 92.

‐ Carol, stabilize the neck.
‐ What do we got?

Uh, Emile Fernandez,
27‐year‐old firefighter.

Fell 20 feet on to concrete.

Blunt head trauma,
loss of consciousness.

(Peter)
Alright. I'll check his belly.

‐ Did you get locked out?
‐ Yes.

Pretty miserable.
Happened to me once.

(Takata)
'Second line is in.
18 gauge, left forearm.'

(Greene)
Okay. I'm in.

‐ Good bowel sounds.
‐ Peritoneal lavage?

(Peter)
No. He's hemodynamically stable.

Let's get a head
and abdominal CT.

Alright. Pulse ox...92

95, 96.

(Elizabeth)
Good breath sounds bilaterally.

No tracheal shift
or jugular venous distention.

Thank you, doctors.

Alright. Call us
when the CT's back.

He needs a Foley and an NG Tube.

[clears throat]
We thought maybe you decided
to leave on that chopper.

‐ Sorry.
‐ 'First hemoglobin 14.2.'

Why don't you come over here?

‐ I need more tubes.
‐ Yeah.

‐ He was a firefighter?
‐ He is a firefighter.

(Carol)
'Urine's clear,
dip's negative for blood.'

Glasgow Coma Scale,
how do you do it?

Uh, check for eye opening
verbal activity, motor response.

‐ CT's ready.
‐ No verbal with ET.

‐ Or anything in the field?
‐ Nothing at all.

Alright. That will be a one.

What about eye opening?

Um, spontaneous eye
opening is a five.

Alright. Well, we definitely
don't have that.

Emile, open your eyes.

Emile, open your eyes!

‐ Now what?
‐ Painful stimulus.

Eh. No eye opening with pain.

That's a one.

Okay. How much for
decorticate posturing?

Two.

That would be 4 out of 15.

You get a three for being alive.

(Carol)
'Pulse ox 98. ABG.'

[clears throat]
Absent corneal reflex.

‐ What does that indicate?
‐ No brain stem activity.

(Takata)
Ready for the C‐spine.

[beeping]

Back up.

(Mark)
So what are
you thinking?

‐ Subdural or epidural hematoma.
‐ That would be great.

Something we could actually fix.

What if there's no
bleeding in the skull?

Diffuse brain swelling.

So, we'd be looking
at a chronic vegetative state

or a potential organ donor.

Dr. Greene, Captain Matson.

The guys wanna know.
How's he doing?

Well, it's, uh,
it's too early to say.

We'll know more
when the CT comes back.

We screwed up, didn't we?

Bringing him in
on that private chopper?

The airfield was there.
It was the fastest way.

Yeah, but we lost his ET tube.
We didn't have any equipment.

If you waited for the Medevac

it could have been
another 15 to 20 minutes.

'Yeah, at least we would
have had more medical supplies.'

Guys, guys, come on,
you didn't screw anything up.

(Mark)
'You bagged him,
kept the airway open.'

Truth is, I probably
would have done the same thing.

Any family?

Wife and two kids.

Thanks, doc.

You didn't tell
them his condition.

Well, I don't really
know what that is yet.

You're right.
I didn't tell them.

Why don't you stick
with me on this case?

I'll call you when
the CT comes back.

[siren wailing]

We should just have
the cake at the admit desk.

'No surprise in that.'

You could put it
in an Exam Room

have him check on a patient.

‐ 'Didn't we do that last year?'
‐ The last two years.

[women laughing]

‐ Kind of noisy, huh?
‐ No place to work around here.

Nope. But, hey,
at least you get a locker.

I didn't get one for the first
two months I was here.

Yeah. I guess some resident
left the program or something.

Right.
Dr. Del Amico.

She went back to Philadelphia
to work in the pediatric ER.

We don't have one here?

Mm‐mm. Might get one
if Dr. Ross has his way.

Anyway, Anna...Dr. Del Amico

thought it was a better
opportunity for her.

Her family's there.

That's where she's from.

There was this boyfriend
that she was involved with.

Hmm.

Anyway, you got
a locker out of it.

I'm sorry about Mr. Zwicki.

I really thought you asked
me to talk to his wife.

Sometimes the Suture Room
is pretty quiet.

Baker, Shelly,
chart number 13940.

Admitted January 12, 1998,
with a fever of 102.

Respiratory distress.

(Peter)
Oh, it's been a crazy day.
I've been swamped.

(Elizabeth)
So Reese couldn't even
get the hearing test?

(Peter)
'No, no, no,
he had an ear infection.'

(Peter)
'That's probably been the cause
of all this stuff anyway.'

(Elizabeth)
'Oh. That's good, anyway.'

(Peter)
'Yeah, so he's gonna be on
Augmentin for another week.'

(Peter)
'Then he'll take the test
and clear this thing up.'

(Elizabeth)
'Mm‐hmm.'

[Peter laughing]

(Elizabeth)
'What?'

(Peter)
I, uh, I can't believe
you're wearing those boots.

[Elizabeth laughs]
'When in Rome.'

[Peter laughs]
'So...whoo! How was Rome?'

[Elizabeth laughs]
'Denver is not Rome.'

(Peter)
'Mm‐mm.'

I went to
a fantastic rodeo, though

'but, uh, I didn't really
care for the hospital.'

(Elizabeth)
'Let's say,
it's rather regimented.'

(Peter)
'Mm‐mm. I heard,
there's a surgical program.'

Look, I want to stay in Chicago.

You know, Cromley may
offer me a sponsorship.

(Peter)
Good.

I'm glad you're, uh, staying.

Well, trying to stay.

‐ Hmm, you are, are you?
‐ Yeah.

Ah! I missed you.

(Elizabeth)
'Well, tha‐that's very nice
of you to say, Peter.'

I missed you, too.

Yeah. It was a little, uh..

‐ Cold between the sheets.
‐ Uh‐huh.

Elizabeth, what are you doing?

Stop being so shocked
and come over here.

[scoffs]

Has it been six months?

‐ It seems like it, doesn't it?
‐ Mm‐hmm.

(Malik)
Lucy, right?

Yeah.
And you are?

Malik. Yeah, Carter
was looking for you.

He's checking on that
pregnant lady over in Exam 2.

Thanks.

Exam 2.

‐ Exam 2?
‐ Unh‐unh. Curtain 3.

Exam 2 is back towards admit.

Thanks.

‐ Exam 2?
‐ Just past Curtain 2.

Hang a left.

Curtain 2.
Exam 2.

Oh, excuse me. I'm sorry.

Are you the doctor?

No. I'm Lucy Knight.

I'll be assisting the doctor.

Oh.

Who should be here any second.

Hi, Mrs. Draper, I'm Dr. Carter.

I understand you're
about nine weeks pregnant.

This is my third pregnancy.

Mrs. Draper's had
two previous miscarriages.

Mm. I see that you've
been experiencing some..

...cramping and some bleeding.

Spotting.
I had some spotting yesterday.

And it's heavier today
and I passed some clots.

(Carol)
BP's 110 over 75, pulse a 100.

And how many pads have you used?

Um, one yesterday
and four today.

‐ Any fever?
‐ No.

‐ Any burning on urination?
‐ 'No.'

Good.

Let's get a CBC, type and RH.

Dip a urine and check an ICON.

Are there any family members
we can call for you?

I've already talked
to my husband.

Okay.

(John)
'Okay, we're gonna
do a few tests.'

[clears throat]
Then I'm going to come back
and do a pelvic exam.

Then we'll know better
where we stand, okay?

‐ Okay.
‐ We'll be right back.

‐ Tell me when the ICON's back.
‐ Okay.

I should probably stay out
while you do the pelvic, right?

Aren't gonna learn
much if you do.

Yeah, but I just thought
she seemed really distraught.

Yeah, she is.

But it doesn't have anything to
do with you being in the room.

Miss Knight, CT's back on that
firefighter if you wanna see it.

Alright. Yeah,
let me put my stuff down.

Okay, tell me what you see.

Any intracranial bleeding?

I'll give you a hint.

Blood appears white
on the CT scan.

‐ I don't see any.
‐ Right.

No subdural or
epidural hematoma.

Which means there's
nothing they can do surgically.

‐ That's not good, huh?
‐ It's not good at all.

Look at the ventricles.

The brain is so swollen that
they're all squashed down.

All along the border of
the white and gray matter.

Tiny punctate hemorrhages
from the axonal shearing.

Most of his brain's
been destroyed.

So, what do you do now?

Give him steroids,
hyperventilate him.

Have Neurosurgery put
in an ICP monitor

and wait for the wife.

Dr. Greene?

‐ Not too good, is it?
‐ No.

Thanks for talking
with us afterwards.

The captain and I
get into it sometimes.

‐ Your basic turf war?
‐ I hate to call it that.

You seem like
you must have worked

with paramedics
in the field before.

Bah! Mostly just in here.

You wanna think about doing it?

There's a position opening up.

District Medical Director
for EMS.

And what exactly is that?

Oversee paramedic education,
ride‐alongs.

Help determine new procedures,
that kind of thing.

‐ I've already got a job here.
‐ This is a side deal.

Only a few hours a week.

Can't be much pay.

It pays nothing.

And the perks?

There aren't any.

No salary, no perks,
sounds great.

See ya.

Hell of a way
to get a job offer.

(Kerry on tape)
'And proceed
seven steps forward.'

'You have now reached
the admit desk..'

You already took
the audio tour.

Yeah, I know, but Dr. Doyle
doesn't know that.

Bernard, you owe me.

Okay...okay.

How many times is he
gonna take that thing?

Hey, Carter's about
to do that pelvic.

We're going to take a look
inside with this speculum.

I need you to relax.

[softly]
There's tissue at the Os.

Ring forceps.

[softly]
Ah.

[softly]
Let's get that to pathology.

I need to check
your ovaries now.

You tell me, uh..

...is there any pain here?

‐ Mm‐mm. No.
‐ Mm‐hmm.

How about here?

Uh, no.

Okay. No adnexal masses
or tenderness.

You can put your legs
back down, Mrs. Draper.

Mm, what is it?
What's going on?

I am very sorry, but you
have had a miscarriage.

You sure?

Mm‐hmm.

(John)
'The fetus was pushed
out of the womb.'

Your bleeding has slowed

but we need to observe you
for a little while.

I'm gonna come back.

And then I'm gonna
do another pelvic exam.

Make sure the bleeding
has stopped

and that, uh, the
cervix is closed.

A doctor from OB/GYN
is gonna stop by.

Miss Knight, would you
stay here until they do?

Of course.

Get some rest, Mrs. Draper.

Rest. Huh!

[sobbing]
I thought this time
it would be alright.

I never made it
to nine weeks before.

[sobbing]

I don't know why
this is happening.

Why is this happening?

I don't know.

I'm sorry.

(Lucy)
'I don't know.'

Bernard, what are you doing?

I have no idea.

‐ Miss Knight.
‐ Yes. Hi.

I just thought we could,
just, uh, excuse me a moment.

Jerry, I thought you were
gonna notifying the morgue

for a pick‐up.

I did. Sorry, Dr. Weaver,
I'll call them again.

So, I haven't had much of a
chance to work with you today.

I trust everything
is going well?

Yes. Pretty well
for a first day.

In other words, it's been
completely hateful, huh?

Kerry, I need to do
a needle aspiration

on a 15‐year‐old with a PTA.

I need the mother's consent if
you're available.

Yeah. Of course. Miss Knight was
looking for a case to observe.

The more the merrier. Come on.

(Doug)
'You see that, now, that's
a peritonsillar abscess.'

Large pocket of pus,
collected around the tonsils.

And we have to get
that fluid out of there.

We gonna numb it first

and we're gonna use a needle
to draw out the infected fluid.

Now, an alternative is to
open the pocket with a scalpel

but that's more invasive.

The needle aspiration
should do fine.

‐ If you're sure?
‐ Mm‐hmm.

You've obviously
been a hit‐the‐books

kinda medical student.

Is there any other kind?

Well, some are more
diligent than, say, I was.

You're a Pediatric
Emergency Fellow, right?

‐ Yep.
‐ Which is not an attending?

One rung under the boss.

So that's why you need
an attending to be a witness?

I mean, when you have
parents sign a consent form

one of the attendings
needs to witness that.

I recently performed
a procedure

on a seven‐month‐old baby
who was born addicted to heroin.

I detoxed him. I didn't
get his mother's consent.

What happened?

Well, the powers that be
were a little upset.

So, I'm now
a Pediatric Emergency Fellow

on probation

and the baby isn't
addicted to drugs.

Sometimes it's a trade‐off.

Good luck.

Every guy in that gym must
have thought I had a coronary.

They were all over me
like white on rice.

Asking me if they could help,
get me some water.

One guy even offered
to take me to his own doctor.

‐ Oh, that's very generous.
‐ Yeah.

(Mark)
'Miss Knight, what do we have?'

Roxanne Please, 25.
She was at the gym‐‐

You know, I dropped a darn
15‐pound weight on my toe.

I really hope it's not broken.

Jerry, what's open?

Uh, Curtain Area 1.

Or, uh, uh, maybe Exam 1
would be better.

Okay, we'll check it out
and get an x‐ray.

There's a woman looking for you.
A Mrs. Fernandez.

Firefighter's wife.

Oh, okay. We'll get
you in the Exam Room.

You know, I can, uh,
I can take care of that.

Okay, Jerry.
It is your birthday, so..

‐ Really?
‐ Mm‐hmm.

‐ Happy birthday.
‐ Oh, thank you.

[siren wailing]

‐ Mrs. Fernandez.
‐ Yes?

I'm Dr. Greene.
This is Miss Knight.

Where is Emile?

We came as soon as we could.

The whole family,
we just piled in the car.

Ah, I think it would
probably be a good idea

if the family stayed here
in the waiting room.

[speaking in Spanish]

[Mark clears throat]

Mrs. Fernandez,
your husband fell 20‐feet

on to a concrete surface.

The paramedics were there
and they brought him right in.

There was no internal
abdominal bleeding

but the CT scan of his head

showed diffuse brain injury
and swelling.

What does that mean?
How serious?

He can't breathe on his own.

He's on a ventilator.

He can't move any muscles.

He's not opening his eyes.

He's in a coma.

Well, does he need an operation?

Unfortunately,
there isn't any that can help.

The prognosis is not good.

We're going to
admit him to the ICU.

Monitor the pressure
in his brain

and treat the swelling
the best we can.

Is he brain dead, Dr. Greene?

We're gonna have
to wait and see.

If the tests show no brain
activity over the next few days

you're gonna have
to think about..

...continuing life support.

Lucy, can you
take Mrs. Fernandez

to see her husband?

Can he hear anything?

Uh, it's possible.

It's...no way
to really know.

You can talk to him.

Do you have any idea
what you cut your foot on?

No, I was diving the Wellsburt.

It's a shipwreck
out in Lake Michigan.

Uh, when I felt a slice
across my foot.

What's weird, though,
at that depth

the water filters
out all the red

so your blood comes
out looking green.

When was your last tetanus
shot, Mr. Reinhart?

I don't know. My mom used to
keep track of all that stuff.

Well, your laceration
is superficial.

'But it's gonna require
a few stitches.'

We'll give you a
dose of antibiotics

before we do
the sutures.

Miss Knight, do you think
you can handle the IV?

Of course.

(John)
'I'll be back.'

You do know how
to do this, right?

Yes.

Oh, uh, could I ask you
something for a second?

‐ Sure.
‐ Um.

It's just that this
is my first IV, and I‐‐

You don't wanna
punish the patient.

‐ Something like that.
‐ Okay.

Thank you.

You wanna give it a try?

Oh, no,
I'll just watch this time.

Alright.

First you're gonna
take the tourniquet.

And you're gonna tie it
into a slip knot...like that.

[indistinct chattering]

Miss Knight, films came back

on that woman
who dropped the weight.

Small non‐displaced fracture
of the proximal phalanx.

Fifth toe.
Just do a buddy tape.

‐ A buddy tape?
‐ Uh‐huh.

Yeah, you tape the little toe
to the one next to it. Okay?

Tell her she can
expect some discomfort

for the next couple of weeks

and to wear hard‐soled shoes.

Okay.

When you look
at the actuarial tables

term is definitely
the way to go.

Hmm.

‐ Ms. Please.
‐ Oh, please, call me Roxanne.

Been saying that
my whole life, haven't I?

Well, good news. It's just
a small hairline fracture.

Well, how long
will that take to heal?

A couple of weeks.

Um, I need to tape you up

and you should wear
hard‐soled shoes.

‐ Roxanne sells insurance.
‐ Really?

Yup. Life, disability,
umbrella policies, you name it.

You, uh, you have insurance?

Just medical, through school.

‐ Oh!
‐ Sorry.

You should start
your coverage now.

Your age, premiums
are incredibly low.

Roxanne says disability
is more important than life.

Yeah. Statistically
you're much more likely

to be maimed
or mutilated, than killed.

Really? Who knew?

Roxanne's also staying
for the party.

What party?

Jerry's surprise party.

He says they always have one.

Okay. There we go.

That should do it.

(John)
'Scuba man is on his way.'

(John)
Only took a half
a dozen sutures.

By the way,
nice job on that IV.

Good.

No, seriously, I kinda threw
you in the deep end there.

I didn't think you'd
be able to do it.

‐ Good to know you can swim.
‐ Thanks.

‐ Can I see you for a minute?
‐ Sure.

[clears throat]
Mrs. Fernandez is looking
for either you or Dr. Greene.

Okay.

Mrs. Fernandez, can I help you?

I‐I, I couldn't
stay in with Emile.

I‐I, I can't see
him that way.

I can't talk to him.

‐ I'm sorry.
‐ You don't have to be sorry.

Look, I need
to take my children home.

Tell Dr. Greene that
I will come back tomorrow

and, and I guess we'll
talk about what to do.

Okay. Okay, I'll tell him.

(Kerry)
'Jerry?'

(Kerry)
'Jerry, get over here, please.'

I mean, wh‐wh‐what
does it take, huh?

I'm, I'm sorry.

How many times
have I asked you

to get this body
to the morgue?

I will call them
again, Dr. Weaver.

No, you will not! No!

You will not
call them again.

You will take this poor soul
over there yourself.

‐ Oh, Dr. Weaver, I'm not‐‐
‐ Jerry, it's just a corpse.

It's not like you've never
seen a dead body before.

[laughing]

♪ Happy birthday to you ♪

♪ Happy birthday to you ♪

♪ Happy birthday dear Jerry ♪

♪ Happy birthday to you ♪

[all cheering]

You got me, you got me.

Light the candles.
Somebody cut the cake.

‐ Alright. Thanks.
‐ Happy birthday, Jerry.

Uh, I gotta go pick up Rachel,
get her some dinner.

Why don't you bring
her over to our house?

‐ We're having a barbecue.
‐ Really? About an hour?

Yeah.

Maimed or mutilated, huh?

Yeah, I know it's not
a pretty picture, huh?

No, no, no, tell me more.

(Lucy)
'I can't believe
they're having a party.'

It was such a horrible day.

Yeah, well, tomorrow's
gonna be even worse.

I just found out I got
assigned to Dr. Doyle.

‐ When did you hear that?
‐ Dr. Weaver told me.

‐ You're with Dr. Carter.
‐ Oh, man!

No, if I was you
I'd consider yourself lucky.

He thinks I can swim.

Well, at least we
survived day one.

Yeah, I was incredibly busy.

I basically did nothing,
and helped no one.

Well, at least you got
to see some patients.

Dr. Doyle won't let me
near a single one.

Yeah, I saw some patients.

Hey, you want a piece of cake?

[laughter]

(Chuny)
'We love you, Jerry!'

Mr. Fernandez?

Emile?

My name is Lucy. I work here.

I met your wife.

I know how much she loves you.

And how much your kids love you.

And how they wish
this hadn't happened to you.

How we all wish
this hadn't happened to you.

[theme music]