ER (1994–2009): Season 5, Episode 3 - They Treat Horses, Don't They? - full transcript
Benton performs dangerous surgery on a bomb-carrying man who was shot at a factory. Dr. Ross receives some good news that Dr. Weaver doesn't embrace, but she has no recourse. Rachel encourages Dr. Greene to help a horse that is in...
Previously on "ER"
Thanks for covering for me.
If you don't know
something, ask.
Hold on, are you telling me
the EMS medical director
is a real person?
He's an ER doc.
I thought it was
just a name they
stuck on the top of memos.
Not when I do it.
You're a pediatric
emergency fellow, right?
Yep, one rung under the boss.
You're not thinking
of starting all over again?
It's a means to what
I really want to do
which is to stay here.
I am an ER doc just like you.
Not like me, Doug.
You acted without the consent
of your colleagues.
If Reese can't hear talking
or the telephone
it's a severe to profound loss.
Excuse me. You going
to be in here long?
No, almost done. Just a minute.
Why are you starting
with the copy room?
Got a work order.
Yeah, well,
other rooms in the ER
need paint more than this one.
Lady, I just do what
they tell me to do.
[indistinct chatter on TV]
So how was your skating party?
You have fun?
Yeah.
Mostly kids from
your soccer camp?
Some.
Uh, Juliette?
It's Julienne.
And she wasn't there.
So who was there?
Just kids.
[telephone ringing]
Hello.
Oh, hi, mom.
I just knew it was you.
Yeah.
Oh, no, I had a great time.
Oh, you'll never guess
who was there.
'Well, Stephanie she had
this sort of yellow sweater.'
'Well, remember that time
I went to the mall with you'
'and I saw that orange sweater'
'that really matched
my blue skirt?'
'Well, this one
looks even better.'
Interim?
Yes.
Well, has there been any change
in my responsibilities?
No. It's just, around the table
we felt that interim
was a more accurate term.
So, uh, you're
the interim chief, Kerry.
Fine.
But you know, Don,
it has been over 90 days
since Dr. Morgenstern resigned.
Then policy dictates that
a permanent chief be named.
It's all in the process.
We've put out
feelers and thus far
we have four
outstanding candidates.
We're forming
a committee right now.
So four candidates including me?
Actually, you make it five.
Just one more thing.
You know, I did
a performance review
of Doug Ross.
You already gave me
an evaluation
of the ultra‐rapid detox.
Yeah, this is an overall
evaluation of his work
to help in deciding
whether he should be made
uh, ER pedes attending.
I'll pass it along.
Thank you.
Dr. Carter.
Ethan Luitly, remember?
The guy next door was playing
pumpkins at volume 11
‐ I couldn't study.
‐ Oh, yeah, I talked to him.
He said he'd stop.
The volume's down
now but I'm very sensitive‐‐
I'm running late.
Can we talk later?
(male #1)
'Oh God. Log jam.'
(male #2)
'Oh, dude,
it's flooding my stall.'
Not again.
Alright, I'll fix it.
Come out, I'll fix it.
Shut off the water
before it floods the hall.
No, it's quicker
to lift the lid.
Hey, I've done this before.
Just pull the chain.
No. Maintenance says..
...the shut‐off valve.
[theme music]
(John)
'Randi, have you
seen my student?'
She was just here
looking for you.
What?
You're starting
to look kind of mythical.
Carter, curtain four,
LOL, weak and dizzy.
Hey, Mark, what does, uh..
What does interim mean to you?
Uh, in‐between?
Do you think that's
a stronger word than acting?
Oh, your new title?
I liked acting better.
They're forming a committee
to review candidates.
Yeah. Anspaugh told me.
He asked me to be on it.
Do you think that's a good idea?
Why not? I can be impartial.
But since my hat's in the ring
and we work together,
I‐I would hate
for there to be any
suggestion of favoritism.
You don't think I should?
Well, I just wanna be fair.
No problem. I'll pass.
Hey, sneak away for lunch?
Rosebud? On me?
‐ What's the occasion?
‐ A chance to talk.
About what?
Over lunch.
Okay, sure.
Hi. Is Carol around?
Uh, yeah. She's just..
Hey, you're back!
Yeah. I'm reborn.
‐ Oh, god, you look great.
‐ Thanks.
Where was it you went again?
The Laurentian Wilderness.
Ooh, I think I'd stay
away from any place
that had wilderness
attached to its name.
Actually, it was great.
I was in a music camp.
We jammed all night
long every night.
It was great. Rock,
salsa, gospel, whatever.
‐ What‐‐
‐ That kind of wild?
I can get with that.
Ah, Jeanie Boulet,
this is Lynette Evans
the clinic's own
nurse practitioner.
Oh, great. Welcome.
I'm not on until noon, guys.
I'm just doing some paperwork
so if you need
some help, lemme know.
Volunteering?
Oh, you did just come straight
from the wilderness.
Well, here you go.
How about John Esmond
seven years old, losing weight
no insurance, curtain two?
‐ You got it.
‐ Thank you.
Hello.
Do you know how long
we waited out there?
Sorry about that.
Hey, John. My name is Jeanie.
Now, I need to put this
thermometer under your arm.
I want you to hold
it there for me.
There you go. Has he complained
of cramps or diarrhea?
No, but look what he threw up.
‐ What are those?
‐ Roundworms.
‐ 'Worms?'
‐ Yeah.
How's everything going?
Oh, you know,
back to civilization.
(male #1)
'My findings
are nearly identical'
'to those of the audiologist.'
With the results
of both tests being so close
I'd say this is
very reliable data.
You know,
I've been doing research
on the cochlear implants,
how they've restored hearing
to people that are totally deaf.
Yes, but implant surgery
requires destruction
of residual hearing.
Okay, but what difference
does it make
if the surgery will
allow him to hear?
Given the FDA criteria
he's not a candidate
at this time.
Your son can be helped
by less invasive methods
hearing aids.
The new digital hearing aids.
Coupled with intensive
speech therapy.
What about, uh, sign language?
Why limit him to signing
when we can teach him
to hear and speak?
Okay.
So, what do we do, uh,
to get this digital hearing aid?
So I do this thing
with scallops
in a white wine sauce‐‐
Doug, what is this lunch about?
‐ Mm, all in good time.
‐ Why don't you just tell me?
You're terrible at keeping
secrets, come on.
No. I'm in complete control.
It's a new me.
‐ Really?
‐ Mm‐hmm.
What could the new you
see a kid in a clinic?
He's got a parasite infection.
I have ten minutes.
I got some paperwork.
‐ Okay.
‐ Is it bad?
Well, it might kill your
interest in the scallops.
[chuckles]
Hey, I found these
in the copy machine.
Hey, throw that
in Dr. Ross' box.
Dr. Carter, do you remember me?
Roxanne? I spoke to you
at Jerry's surprise party.
You were selling
disability insurance.
Right.
I'm more likely to be maimed
than killed?
Sorry, I didn't mean
to pressure you.
Actually, I'm here today
to sign up one of your nurses
but my toe is still
a little bit sore..
the one I dropped the weight on?
Would you mind taking a look?
Sure. Hop up here.
So, did I tell you?
I'm also selling
mutual funds now.
I just started.
It's such an exciting arena.
Ah, yeah. A little
tender right there.
Sorry.
Are you selling straight funds
or variable annuities?
You know about annuities?
Sure. Once you max out
your Keogh
you need a vehicle
for tax‐deferred income.
Yeah, but the problem is
most people can't lock up
their money till retirement.
That's where muni bonds come in.
This is healing.
It's just gonna take probably
a little more time.
Avoid stomping your feet
and everything
should be alright.
So, no slam dancing
to the beastie boys?
Slow dancing.
Well, whatever you
say, Dr. Carter.
Thank you.
(Elizabeth)
'This is rather nostalgic.'
My last day
as a surgical fellow.
At least it's beginning
with something
rather substantial.
A gastroplasty on
a 400‐pound gentleman.
Did I make the wrong choice?
It's not for me to say.
Still, I wouldn't mind
hearing your opinion.
Is there some ominous portent
in that long pause?
I just can't imagine
being an intern again.
Well, I'm determined
not to whine about it
and I feel very good
about not leaving the hospital.
You might as well
take a coffee break, Peter.
My patient just expired
in the SICU.
‐ What is this?
‐ Rodney McMullen, 48.
‐ Oh, God.
‐ Can you believe this?
Carving knife versus forehead.
But good vitals.
Amazingly, no visual complaints.
He's drunk, combative
and strong‐‐
Lucy, come on.
We got a good one.
Damn beans! You give 'em work
they don't care! Son of a bitch!
Alright, everybody.
We're going to be
nice and gentle.
On my count
one, two, three.
Pancho must die!
I'll blow his brains out!
Alright, hold him,
hold him down.
I got his legs.
Lucy, get his left arm.
I'll get the restraints.
CBC, chem seven
PT, PTT, type
and cross for two units.
Pupils are equal
and react to light.
‐ Sir, you gotta hold still.
‐ Just let me get up!
How do I tie him?
Once around the wrist,
twice around the frame.
Gram of Ancef?
Sir, do you have any
allergies to medicine?
No. Just let me up!
Go with the Ancef.
Carol, can you get over here
and hold his head?
I just wanna look
at the open mouth.
Sir, I need to you
to open your mouth.
He's tied!
Okay, Lucy, take a look.
The tip of the blade
is in the oropharynx.
It's still penetrated
the frontal sinuses.
Missed the eyes completely.
Son of a bitch!
‐ 'Whoa, whoa, whoa.'
‐ Hey!
Lucy! Lucy, you tied him
to the rail, not the frame!
You don't listen!
Hey, hey, don't spit!
Carol, give him
five of Haldol, IM.
Sir, don't spit!
Put this on.
Not you, Lucy, him!
[grunting]
Hey. Dana, this is Dr. Ross.
(Doug)
'Hi, Dana.'
'How are you feeling?'
I'm okay.
Hmm? Any more pain?
It's still there a little bit
but I don't mind.
Oh, then, well, let's take
a look at the damage here.
Now, how exactly
did this happen?
I moved up for the goal
and had a sidekick
right in the net
Mm‐hmm.
and as soon as my foot
touched the ball
I heard a crack.
Then I went to take a step
and it just gave out
and it started hurting.
Mm‐hmm. Okay, did you
collide with anybody?
Anybody fall on top of you?
‐ No.
‐ Anybody kick you in the shin?
No.
All I did was kick the ball.
‐ Mm‐hmm.
‐ What's wrong?
It's just that it's
a severe break.
I want to understand
how it happened.
Ah, okay, we're going to get you
some more pain medication
and we're going
to run some tests.
Alright?
Okay.
Okay.
‐ Did you see that?
‐ Yeah.
The bone looked like it exploded
from the inside.
Yep. I want to get
a CT‐guided needle biopsy.
Tumor?
I think there's
a remote possibility
it's an infection.
Did you talk to the parents?
Well, one of the mothers
from the soccer club
is trying to reach them.
We'll need their
consent for biopsy.
[sighs]
Dr. Benton, you have
a call on 3‐5.
A Mr. Davidson from
some insurance company
calling you back.
What is this?
I found that in the copy room.
I didn't leave it there.
'It's got your name on it.'
Alright, thanks.
He has the same coverage I have.
What do you mean,
no health insurance covers it?
You mean, if I needed them,
you wouldn't buy them?
Well, that's not
acceptable. Listen..
...uh, can I speak
to your superior, please?
Fine. Fine, I'll call him back.
Problem, Peter?
[groans]
It's just bureaucracy
drives you crazy.
So I'm supposed to be treating
this McMullen
with a knife wound?
Ah, It's not just
a knife wound, but no hurry.
I gave him five of Haldol.
Dr. Greene, a call just came
on a hostage crisis
and shoot‐out.
They might need
a triage officer.
Yeah, they probably want
somebody
with more experience than me.
You know, I start tomorrow.
Hey, this is the rush..
The best part of the job.
Maybe we'll see you on TV.
‐ A shoot‐out?
‐ Yeah, wild west.
How about it, doc?
Tell Dr. Weaver
that I'm going on a run.
[snoring]
800...850...920 dollars.
Malik, could I ask
you a question?
Which do you think
is the better vein?
Let's see.
That's the one.
‐ Big and stringy.
‐ Good.
Just slide it in.
He can't feel anything.
Alright.
Going in.
Got a flash.
I'm advancing.
Sapphire pinkie ring.
This man ain't got no class.
Hooked up the line.
Got the tape.
How come it's not running in?
It's infiltrated.
You went all the way
through the vein.
No, I was really careful.
Well, Lucy, you gotta be
kind of Zen with it, okay?
Now watch the master, okay?
It's not about seeing,
it's not about feeling
it's about knowing.
Malik, you got
a phone call in admit.
Okay, it's in.
‐ Okay.
‐ Now finish it up.
‐ Mm‐hmm.
‐ I'll take it out there.
‐ Okay?
‐ Yep.
Keep an eye on this guy, too.
Lucy, when you finish
there's a head lac
to irrigate in curtain two.
Okay.
Wow.
Oh, The knife tip is posterior
to the uvula in the oropharynx.
Huh.
So, everything
under control in here?
It's fine.
I asked Malik for some
help with the IV
Good.
Use the nurses.
That's an important lesson.
[snoring]
[indistinct chatter]
We had an exchange of gunfire.
The assailant's down,
the bomb squad's checking him.
Bomb squad?
He took four employees hostage
with a suitcase
full of explosives.
‐ What's his problem?
‐ Guy works here.
I guess he didn't like it.
The docs are here.
How's he doing?
(Clark)
'The guy's covered in dynamite.'
He's got chicken wire
all over his body.
Lots of blood
coming out of his neck.
How long's he been down?
‐ Maybe ten minutes.
‐ Can we get in there?
Not until we've cleared
the explosives.
Clark, can I send
a doc in there?
Well, I've cut the main fuse
but it's not safe
without a seven‐b suit.
‐ What's that?
‐ A bomb suit.
Put me in that thing.
Wait. Wait a minute.
If anybody goes in there,
you should go in.
You're the doctor.
I'm not trying
to put any pressure
on you, if the guy dies
it wouldn't ruin my day
but it just looks bad
on the evening news.
Sure. I'll go in.
‐ Jeanie, hey.
‐ Yeah?
The pathology about Dana
the full workup
will take a few days
but it looks like
Ewing's sarcoma.
If you wanna beg off on this‐‐
No, no, no I wanna help.
Good.
77‐year‐old female,
fell unconscious
in her apartment.
Her name is Emily Holmes.
She always said she had
very good health coverage.
We found her with
BP 90/60, pulse 120.
Started a line.
‐ She arrested en route.
‐ Any history?
No meds in the bathroom.
Do you know if she has
any medical problems?
Oh, I'm just her neighbor.
She always seemed alright,
just forgetful.
(Carter)
'Okay, let's get
her on a monitor.'
'7.5 ET tube.'
There were three days
of newspaper on her doormat.
That's how I knew
something was wrong.
(Carter)
'Alright, I'm in.'
'Let's bag her.'
[monitor beeping]
Hold compressions.
V‐fib, no pulse.
Charge. 200.
Is she dead? What's happening?
‐ Can I help with the‐‐
‐ Everybody clear.
Clear.
(Chuny)
'Sinus tach.'
I got a pulse.
'Why do you think
she arrested?'
Uh, elderly woman,
could have had an MI
Could be septic, hypoxic,
electrolyte imbalance..
BP's 90 palp.
Okay, let's start
her on Dopamine
and let's get a 12 lead.
She's not out of the woods yet.
Ah...does that mean
she's going to die?
That's a possibility.
Are you in touch
with her family members?
Oh, I never saw anyone
come to see her.
I only ask because..
My sister's on a waiting list
for an apartment
in the building.
I don't really understand
why a biopsy was done
for a broken leg.
We looked at the fracture.
It didn't seem
to go with the way
that Dana said it happened.
It seemed unusual.
How?
The fracture may have
been caused by a tumor.
‐ A tumor?
‐ Mm‐hmm.
'It would weaken the bone.'
We still have to do some tests
but the biopsy
showed blue cells,
malignant cells.
Are you saying she has cancer?
Well, everything is still
in the diagnostic stage.
So you don't know, you're
not certain about anything.
Well, the indication is
that there's a sarcoma
so we're gonna have you
speak with an oncologist.
Oh, no. I don't believe this.
Now, here she is.
Hey, honey, how you feeling?
Ah, did you hear
how it happened?
It was so stupid..
(Mr. Ellis)
'I'm sure you
played a hard game.'
(Mark)
'How much longer?'
(Clark)
We got detonators,
all this damn wire..
I hate amateurs.
Wacko must have spent
hours wrapping this.
Ah, God...his guts.
His guts are coming
out of this stuff.
Whoa, whoa, whoa.
Don't cut anymore, okay?
Okay, that's small intestine.
Well, it's all wrapped up
in the wire.
Alright, listen,
his pulse is getting weaker.
We gotta get him to the ER
Is that black box a bomb?
Uh, probably not.
I got rid of the dynamite
but let's play it safe.
We'll wrap him up
in a ballistic blanket.
If anything blows, no one gets
hurt except Boris here.
Okay, Zadro.
'Get the gurney down here now.'
'We're moving him out.'
Dr. Olivas said that with
these digital hearing aids
basically he'll be able
to understand and talk
as well as you and I.
So he won't be deaf?
Well, his residual hearing
is something
that we can work with, you know
if he, you know,
does the treatment
twice a week for an hour
but one of us has to
be there with him.
‐ I can do that.
‐ Yeah, well, so can I.
I mean, this treatment,
it's natural‐hearing input.
Basically, the more
we talk to him
the better his speech
will develop.
It's going to be okay, honey.
You hear that?
You're going to be okay.
Of course he is.
Yeah!
There is one thing, though.
Um, this hearing aid
is expensive,
and I just found out
that my insurance
won't cover it.
‐ Why won't they?
‐ They don't cover anybody.
That way, they don't have
to pay for the elderly.
Oh, that's so low.
Yeah. I hate asking this, but..
this thing is $5,000 and I've
only got 2,700 in the bank
so I was..
Peter, I said that
we share everything
and I meant everything, okay?
That means we share everything.
Don't worry about it, alright?
'Let's just be happy that
something can be done, okay?'
[baby cooing]
Hey.
[laughing]
pH 7.32, PO2 345 on 100%.
Good. Good, turn down to 50%
and check another gas
in a half an hour.
Okay.
Is this Emily Holmes?
Yes.
John Carter.
She was found in her apartment.
Margo Aikin, I authorize
admissions for Blue Beacon
her HMO
This lady's a DNR.
She came in full arrest.
She didn't have any papers.
'Or any family.'
Let's, uh, step outside.
I don't know what your plans are
but I can't admit her.
This patient's critical.
Dr. Carter, I can't
justify an expenditure
of $5,000 a day on a patient
who should not be alive
who does not want to be alive.
Well, I wasn't
gonna let her die.
That's not what we do here.
Her choice was not
to be resuscitated.
That's what is in the HMO file.
That's the guideline
I have to follow.
Look, She's on a vent.
You have to take her.
No, I don't.
You tubed her, you take her.
[chuckles]
(Peter)
'Four units O‐neg.'
What's his airway?
‐ Intubated in the field.
‐ Hey, what's going on?
GSW, bomb squad's
coming with him.
Bomb squad?
(female #1)
'That's the guy
with the dynamite?'
(Mark)
'They took it off him.'
‐ Yeah, should be safe.
‐ Should be safe?
Gunshot wound to
the neck and abdomen.
Last BP was 100 palp.
Very gently, on my count.
One, two, three.
Open this blanket nice and easy.
Ho‐ho, eviscerated bowel.
CBC, chem panels
coags, type and cross
for four. Let's move.
Gram of Cefotetan.
Pressure's down to 85 systolic.
I'll throw in a Subclavian.
‐ You want O negative?
‐ Yeah. Hang two units.
(Benton)
'His bowel's wrapped around'
this chicken wire..
What is this box?
It might be a detonator?
I don't know till I open it up.
Can that thing go off?
Well, It might
have a blasting cap.
Just don't mess with it.
You should be fine.
Alright, Jeanie,
Let's irrigate with saline.
Let's get some sterile lap pads.
Come on, oh, man,
we're going to have to resect
this whole mess up in the OR.
You, you're coming with us.
Alright, Someone get
scrubs for Officer Clark.
(Yosh)
Okay, I'm in.
Hook me up. Pulse ox 98.
Lemme get this under there.
Okay, Come on,
come on. Clean it out.
'Good.'
Hey, hey, that thing's shorting!
'You got about five seconds!'
'Everybody out of here!'
‐ Out! Now!
‐ Let's go!
2,000!
3,000!
4,000!
[explosion]
[coughing]
Alright!
We've got an open bowel in here!
Let's move, people!
Let's get him up to the OR!
Let's go!
[indistinct chatter]
Here you go.
So, this is shrimp
and what's the red
shredded stuff?
Uh, that's Maui onions.
No, uh, pepperoni,
cheese, tomatoes‐‐
It's gourmet pizza. The mad
bomber spoiled my gourmet lunch.
So, so, the heroics
give you an appetite?
Uh, no. The running from the
trauma room gave me an appetite.
‐ Doug..
‐ Hmm?
'What is this lunch about?'
Yeah, what's going on?
Alright, okay.
First, a reading.
Uh, "Performance review,
Dr. Douglas Ross
"by Kerry Weaver, MD"
Where did you get that?
Oh, it was found
in the copy machine.
Uh, "Dr. Ross
repeatedly demonstrates
"a complete disregard for
hospital policies
"and procedures.
'"For example, in regard'
'"to a patient discharge.."'
'It's a, Okay, here it is.'
'Uh, "In spite of'
"mandatory counseling to correct
"the history of disrupting
workplace behavior
"Dr. Ross exhibits ongoing
problems with impulse control."
that's right, Kerry,
I'm a psycho.
Doug, she could've given that
to the pedes review committee.
Mm‐hmm. It's too late.
'Cause I brought you here
'cause I wanted you to toast
the new pedes ER
attending, me.
[Doug chuckles]
‐ Really?
‐ Yeah.
Buddy of mine
is on the committee
and told me
at 6 a. m. this morning.
I'm approved.
They're telling Anspaugh
right now at a faculty lunch.
I am so proud of you.
I am so thrilled.
Aren't you thrilled?
He's got his doubts
a little bit, right?
Hey..
whatever my doubts were
in all honesty
I'm very happy for you.
Happy for both of you.
[laughs]
oh, uh...Mark, Rachel's here.
She wants to see you.
Sure.
She seems a little upset.
Hey, honey, what's up?
Dad, can you come outside?
‐ There's sort of a problem.
‐ Yeah.
I knew he wasn't feeling
right when we left vermillion
and we got a rodeo
in Louisville 8 a. m. tomorrow.
It's colic for sure,
'cause I ain't seen
a load in over 12 hours.
Don't worry.
My dad can help him.
He's a doctor.
Honey, I'm not a vet.
Last time he got impacted
mineral oil enema did the trick.
We just don't have the
facilities here to treat animals
but if you come inside,
I'm sure we can find you a vet.
Nearest large animal
man's in buffalo grove.
That's two hours
in this traffic.
Dad, you got to
help him, please?
He's one of the finest
roping horses there is.
Poor thing.
If he goes down
in the trailer, he could die.
That's right, miss.
He sure could.
That'd be tragic.
What's his name?
Cherry Blossom.
Say hi, Cherry.
Hi, cherry.
Don't worry. My dad's
gonna make you all better.
It's clean.
There's no money in tobacco
polluting chemicals, mining..
it's like giving money
to a charity
but it's an investment.
‐ It's called a White Hat Fund.
‐ And what's the return?
Well, over the past five years,
it's been about 7.9%.
You got anything that's maybe
dirtier with a better upside?
Sure. Here you go.
Pure petrochemicals,
17.4% return.
‐ Alright.
‐ Dr. Carter?
My toe is feeling
so much better
since you retaped it.
Oh, good.
Yeah, I was wondering
if you and I could
get together sometime
maybe a little hot talk
about dollar‐cost averaging.
Well, I tell you, I'm really not
much of a customer these days.
This isn't really a sales pitch.
You work out?
Um...yeah.
I mean, when I,
when I can find the time.
Well, it's hard to find
the time, but look
I get free passes for myself
and a guest to the Artemis club.
That's good for one
workout and a sauna.
I'm there every night about 7.
Thanks. Be careful
with your toe.
Yeah. Yeah, just exercycle,
light weights
you know, great therapy
after a hard day
but it's much more fun
when someone else is there.
‐ Makes the time fly.
‐ Sure.
Well, today is not really
a good day for me.
Um...but some other time,
I'll come by.
Whenever.
Is that moving any air?
Pulse ox 88.
We gotta tube him.
How much do you weigh?
Two‐sixty.
Yosh, 180 of Ketamine,
180 of Sux.
Connie, 8.0 ET.
I can't breathe.
Tad, we need to put a tube
in your throat
to help you breathe.
We'll give you medicine to make
you sleep. Try to relax.
‐ Meds on board.
‐ Let's put him down.
Connie, we need a vent in here.
‐ I need suction.
‐ Pulse ox is falling, 85.
I don't really need
this distraction.
Yosh, give me crichoid pressure.
Damn, I can't see the cords.
[monitor beeping]
Bag him. Connie, give me
a number four Macintosh.
His neck's too big.
Pulse ox 89.
We don't have
a number four blade.
Anesthesia will have one.
‐ 'He's paralyzed.'
‐ Yeah, keep bagging him.
His pulse ox is up to 90.
Dr. Greene, they sent
this down from surgery.
Can I keep it?
Uh, we'd better keep that here.
The cops will want it.
Hey, how's it going?
Oh, Weaver's having trouble with
an intubation in trauma two.
Needs a bigger blade.
‐ Is everything okay?
‐ Status asthmaticus.
Needs intubation. Bull neck so
I sent for a number four blade.
Mind if I take a look?
Could deprive him
of oxygen, Mark.
Okay.
Okay, yeah, you're right.
It's a tough one.
Yosh, crichoid pressure.
We tried that.
Pulse ox is falling.
‐ 'Get out, Mark.'
‐ Okay.
Backwards. Upwards.
To the right.
I can see.
Good. Okay, I'm in.
Bag him.
Don't let them bag him too fast.
He's got a long
expiratory phase.
‐ Dr. Weaver?
‐ Yes.
They told me
that you could sign off
on this work order.
Where did you put
the copy machine?
It's not going back in there.
They're gonna convert
that room to a pediatric exam.
See, we're taking out a wall.
Look real good.
Thank you.
‐ Dr. Weaver?
‐ What do you want, Carter?
I wanted to tell you
what's going on
with that patient in trauma one.
Yeah, why is she still here?
‐ We need the bed.
‐ I know.
I tried to get her
admitted to the unit
but it turns out she's a DNR.
And her HMO doctor was here but
she won't authorize admission.
If she can't stay in the ER
either get her admitted
or get her transferred.
Well, she's, she's intubated
so she's not stable‐‐
You know what, Carter, if you
wanna be a chief resident
you can't continue to run to
me when things don't work out.
Deal with this yourself.
Improve your
problem‐solving skills.
Randi, get me Dr. Anspaugh.
Hello, Peter.
Hey.
I suppose we should talk.
Elizabeth, this isn't
a good time for me.
Yeah, I know. I know
it's been, um..
It's been a rough day
with the bomber and, uh..
I'd like to get something
out in the open.
I know it's not been easy
being with me, but, uh..
if it's not working out
and if you and Carla
are getting back together
I'd appreciate hearing
it from you.
What?
What are you..
Elizabeth, it's got
nothing to do with that.
Well, you've been avoiding me,
so what's happened?
I haven't been avoiding you.
I've just got some things
to deal with, okay?
Well, what things? What is it?
Reese is hearing impaired.
‐ How bad?
‐ He's profoundly deaf.
Peter, I'm so sorry.
Listen, I didn't
tell you about it
because it's private.
And I haven't been
avoiding you, Elizabeth.
It's just that, you know what?
I don't know
how to talk about that.
(Mark)
'Easy, boy. Easy, boy.'
How's he doing, Rachel?
He's okay.
Have you been
around horses much?
'Sure got a way with them.'
Okay, keep him nice and still.
I'm gonna put the tube in now.
Jerry, if you can hold the tail.
Just..
Okay, easy. Easy, boy.
Okay, good. Tube's in.
Uh...Jerry,
why don't you go ahead
and squeeze the lavage bag.
I'm not going
to get kicked, am I?
Kicked? No.
He's as sweet as they come.
Nice and easy.
Don't worry, boy.
'We're not going to hurt you.'
Nothing's going to come
shooting out of his...
No, it shouldn't, you know.
Not for a while.
Okay. Here it goes.
Nice and easy.
Good.
'Nice even flow.'
Hey. How you doing?
What's an oncologist?
It's a doctor that deals
with abnormal cell growth.
It's a cancer doctor.
Why can't you be honest with me?
My parents were talking to an
oncologist outside the room.
He said something about
amputation.
They're with him right now.
There were indications
in your biopsy.
You may have a tumor.
That means
they'll cut off my leg?
Specialists are gonna
look at all their options
and then make a decision soon.
Stop ducking my questions.
Can't you be honest?
Alright.
Okay. Amputation
offers us the best choice.
I don't want to live
without my leg.
I'd rather be dead.
They haven't finished diagnosis.
They're gonna talk about
all available treatments.
Treatments that could
save my leg?
The kind of tumor
that you have..
Amputation offers us
the best chance.
If they amputate
is it certain I'll live?
No.
'But it's your
best shot, kiddo.'
'If you were my daughter'
I would try to persuade
you to do it.
Would you still do it
if I said no?
When you get all the facts.
Then it's a decision
that you and your parents
are gonna have to make together.
[sighs]
okay?
You have power of attorney
for over 700 clients?
So you've never
actually even met her.
Yes.
Yeah, any information that you..
Could you fax it over?
I guess that's what we'll do.
Thank you very much.
Everything okay, Carter?
Hmm..
Yeah, I intubated a DNR Patient.
HMO won't admit her. No family.
Only a lawyer with durable power
and he's never even met her.
What are you thinking about?
I don't know.
I mean, should I extubate?
It just seems kind of wrong.
DNR means she did not
want heroic measures.
The real question is whether
or not you're ready to do it.
Have you ever done it?
Yeah. Once,
but I had family support.
Her vitals are stable.
Pulse ox 98.
I've weaned her
off the Dopamine.
I'm going to, uh..
...turn off the vent.
Do an apnea test.
Should I get an attending?
I already talked to Dr. Greene.
She's a DNR.
She didn't want this.
[monitor beeping]
Spontaneous respiration.
Just one breath.
That might be it.
No. She's breathing on her own.
I'm going to extubate.
[coughing]
Let's give her
five liters of oxygen.
Hey, any luck?
Dr. Greene wants
an enema update.
Nah, No movement yet.
I'm learning all about
taking care of horses.
You know, it might not hurt
to let him out a bit.
Let him walk around. I mean...
...movement's good for colic.
You wanna get
in there and just, uh
give him a pat,
help me ease him out?
Uh...well, I..
I don't have
any experience with horses.
I‐I‐I never even touched
one before today.
Look, you're gonna be fine.
Just don't let him
know you're scared
and don't worry
about showing him
who's boss, alright?
Come on now, Blossom.
You got all these nice
folks concerned about you.
'Let's go. Come on.'
'Come on.'
Come on. Come on, good boy.
'Come on.'
[farting]
[laughing]
'Hey now.'
You brought us
some good luck, son.
[horse neighing]
Hey, Mark.
Can...can we talk?
Uh, I was just going
out to see the horse.
Yeah. It's, uh, it's important.
What's up, Kerry?
Let's go in the lounge.
Did you know that Doug Ross
was made a pedes attending?
That they're fixing up
a suite of rooms for him?
Yeah, he told me at lunch.
Really. Oh, well, uh..
I was told by the painters.
I had to read it on a work form.
Wh‐wh‐what's going
on around here?
What do you mean?
Why was I left out of the loop?
Kerry, Ross is
the new pedes ER attending.
That's a fact of life.
We should learn to accept it
and move on, okay?
Wait a...but how can I move on
when you express disfavor
about Ross as an
attending to my face
and then celebrate his dubious
achievement behind my back?
Is this really about Ross?
Yes.
Yes, it's about Ross.
Bottom line, I don't
think he's qualified.
The hospital doesn't agree.
And, you know, I don't think
you're angry about Ross.
I think this is more about you
obsessing over some silly title.
I wish you'd make
a decision, Kerry.
You wanna be a doctor
or an administrator?
I'm gonna go examine a horse.
I finished my write‐ups
on the chest pain
the altered mental status
and the ankle sprain.
I need you to co‐sign
these charts before I go.
Yeah.
Are those PVCs?
That's right.
Shouldn't we give
something for that?
No.
(female #2)
'V‐tach.'
You shock that, right?
Not this time.
[dramatic music]
Watch. V‐tach.
'V‐fib.'
[flatline]
Then asystole.
She's not suffering.
It's what she wanted.
[music continues]
I'll sign those charts now.
Dr. Ross.
Our daughter said you spoke
to her about her treatment.
She's very upset. Why would
you do something like that?
You had no right to advise
her against amputation.
I didn't advise
against amputation.
I told her it offered
the best chance to survive.
Yeah, but you gave her
other alternatives.
We want her to live.
I want her to live
but she's going
to have to accept
what's going to happen to her
not end up fighting some edict
that gets handed down.
No, no, no.
This is our decision, not hers.
She's 15 years old.
She's old enough
to be involved in decisions
about her own health.
Stay away from her.
You don't speak
to her again, understood?
All right.
To survive,
she needs your support.
She has to feel
that you are working for her
not against her.
Let's go.
So, on search committee
for chief
have you set the calendar
for meetings?
Yes, and I was sorry to get
your message this morning
that you won't have time
to be part of the process.
Well, actually, I've been
able to make some room.
Really. Well, we're
getting together
Tuesdays and Thursdays
at 6 p. m., if you can make it.
Yes, I would like
to be involved.
Good.
I've lived in worse
places than this.
It just needs some fresh
paint, some posters..
I can live anywhere
as long as I've got music.
You sure you're up for this?
I told you
I worked for best buy.
I assembled systems
all day long.
Come on, what have you got?
Bose, top of the line.
It's a very expensive system.
I guess these are the, um..
...these are the cables
that go with that?
Oh, actually,
those are RCA cables.
You must have hooked up
your VCR through your amplifier.
I don't know.
Some guy just came to my
apartment and hooked it all up.
Huh.
You got a CD?
We could try this out.
Yeah, sure.
Jimmy Smith.
‐ Jazz?
‐ Jazz.
Organ.
[jazz music]
I like it.
You know...my doctor said
that slow dancing is okay.
Yeah, it might
even be therapeutic.
[music continues]
[theme music]
Thanks for covering for me.
If you don't know
something, ask.
Hold on, are you telling me
the EMS medical director
is a real person?
He's an ER doc.
I thought it was
just a name they
stuck on the top of memos.
Not when I do it.
You're a pediatric
emergency fellow, right?
Yep, one rung under the boss.
You're not thinking
of starting all over again?
It's a means to what
I really want to do
which is to stay here.
I am an ER doc just like you.
Not like me, Doug.
You acted without the consent
of your colleagues.
If Reese can't hear talking
or the telephone
it's a severe to profound loss.
Excuse me. You going
to be in here long?
No, almost done. Just a minute.
Why are you starting
with the copy room?
Got a work order.
Yeah, well,
other rooms in the ER
need paint more than this one.
Lady, I just do what
they tell me to do.
[indistinct chatter on TV]
So how was your skating party?
You have fun?
Yeah.
Mostly kids from
your soccer camp?
Some.
Uh, Juliette?
It's Julienne.
And she wasn't there.
So who was there?
Just kids.
[telephone ringing]
Hello.
Oh, hi, mom.
I just knew it was you.
Yeah.
Oh, no, I had a great time.
Oh, you'll never guess
who was there.
'Well, Stephanie she had
this sort of yellow sweater.'
'Well, remember that time
I went to the mall with you'
'and I saw that orange sweater'
'that really matched
my blue skirt?'
'Well, this one
looks even better.'
Interim?
Yes.
Well, has there been any change
in my responsibilities?
No. It's just, around the table
we felt that interim
was a more accurate term.
So, uh, you're
the interim chief, Kerry.
Fine.
But you know, Don,
it has been over 90 days
since Dr. Morgenstern resigned.
Then policy dictates that
a permanent chief be named.
It's all in the process.
We've put out
feelers and thus far
we have four
outstanding candidates.
We're forming
a committee right now.
So four candidates including me?
Actually, you make it five.
Just one more thing.
You know, I did
a performance review
of Doug Ross.
You already gave me
an evaluation
of the ultra‐rapid detox.
Yeah, this is an overall
evaluation of his work
to help in deciding
whether he should be made
uh, ER pedes attending.
I'll pass it along.
Thank you.
Dr. Carter.
Ethan Luitly, remember?
The guy next door was playing
pumpkins at volume 11
‐ I couldn't study.
‐ Oh, yeah, I talked to him.
He said he'd stop.
The volume's down
now but I'm very sensitive‐‐
I'm running late.
Can we talk later?
(male #1)
'Oh God. Log jam.'
(male #2)
'Oh, dude,
it's flooding my stall.'
Not again.
Alright, I'll fix it.
Come out, I'll fix it.
Shut off the water
before it floods the hall.
No, it's quicker
to lift the lid.
Hey, I've done this before.
Just pull the chain.
No. Maintenance says..
...the shut‐off valve.
[theme music]
(John)
'Randi, have you
seen my student?'
She was just here
looking for you.
What?
You're starting
to look kind of mythical.
Carter, curtain four,
LOL, weak and dizzy.
Hey, Mark, what does, uh..
What does interim mean to you?
Uh, in‐between?
Do you think that's
a stronger word than acting?
Oh, your new title?
I liked acting better.
They're forming a committee
to review candidates.
Yeah. Anspaugh told me.
He asked me to be on it.
Do you think that's a good idea?
Why not? I can be impartial.
But since my hat's in the ring
and we work together,
I‐I would hate
for there to be any
suggestion of favoritism.
You don't think I should?
Well, I just wanna be fair.
No problem. I'll pass.
Hey, sneak away for lunch?
Rosebud? On me?
‐ What's the occasion?
‐ A chance to talk.
About what?
Over lunch.
Okay, sure.
Hi. Is Carol around?
Uh, yeah. She's just..
Hey, you're back!
Yeah. I'm reborn.
‐ Oh, god, you look great.
‐ Thanks.
Where was it you went again?
The Laurentian Wilderness.
Ooh, I think I'd stay
away from any place
that had wilderness
attached to its name.
Actually, it was great.
I was in a music camp.
We jammed all night
long every night.
It was great. Rock,
salsa, gospel, whatever.
‐ What‐‐
‐ That kind of wild?
I can get with that.
Ah, Jeanie Boulet,
this is Lynette Evans
the clinic's own
nurse practitioner.
Oh, great. Welcome.
I'm not on until noon, guys.
I'm just doing some paperwork
so if you need
some help, lemme know.
Volunteering?
Oh, you did just come straight
from the wilderness.
Well, here you go.
How about John Esmond
seven years old, losing weight
no insurance, curtain two?
‐ You got it.
‐ Thank you.
Hello.
Do you know how long
we waited out there?
Sorry about that.
Hey, John. My name is Jeanie.
Now, I need to put this
thermometer under your arm.
I want you to hold
it there for me.
There you go. Has he complained
of cramps or diarrhea?
No, but look what he threw up.
‐ What are those?
‐ Roundworms.
‐ 'Worms?'
‐ Yeah.
How's everything going?
Oh, you know,
back to civilization.
(male #1)
'My findings
are nearly identical'
'to those of the audiologist.'
With the results
of both tests being so close
I'd say this is
very reliable data.
You know,
I've been doing research
on the cochlear implants,
how they've restored hearing
to people that are totally deaf.
Yes, but implant surgery
requires destruction
of residual hearing.
Okay, but what difference
does it make
if the surgery will
allow him to hear?
Given the FDA criteria
he's not a candidate
at this time.
Your son can be helped
by less invasive methods
hearing aids.
The new digital hearing aids.
Coupled with intensive
speech therapy.
What about, uh, sign language?
Why limit him to signing
when we can teach him
to hear and speak?
Okay.
So, what do we do, uh,
to get this digital hearing aid?
So I do this thing
with scallops
in a white wine sauce‐‐
Doug, what is this lunch about?
‐ Mm, all in good time.
‐ Why don't you just tell me?
You're terrible at keeping
secrets, come on.
No. I'm in complete control.
It's a new me.
‐ Really?
‐ Mm‐hmm.
What could the new you
see a kid in a clinic?
He's got a parasite infection.
I have ten minutes.
I got some paperwork.
‐ Okay.
‐ Is it bad?
Well, it might kill your
interest in the scallops.
[chuckles]
Hey, I found these
in the copy machine.
Hey, throw that
in Dr. Ross' box.
Dr. Carter, do you remember me?
Roxanne? I spoke to you
at Jerry's surprise party.
You were selling
disability insurance.
Right.
I'm more likely to be maimed
than killed?
Sorry, I didn't mean
to pressure you.
Actually, I'm here today
to sign up one of your nurses
but my toe is still
a little bit sore..
the one I dropped the weight on?
Would you mind taking a look?
Sure. Hop up here.
So, did I tell you?
I'm also selling
mutual funds now.
I just started.
It's such an exciting arena.
Ah, yeah. A little
tender right there.
Sorry.
Are you selling straight funds
or variable annuities?
You know about annuities?
Sure. Once you max out
your Keogh
you need a vehicle
for tax‐deferred income.
Yeah, but the problem is
most people can't lock up
their money till retirement.
That's where muni bonds come in.
This is healing.
It's just gonna take probably
a little more time.
Avoid stomping your feet
and everything
should be alright.
So, no slam dancing
to the beastie boys?
Slow dancing.
Well, whatever you
say, Dr. Carter.
Thank you.
(Elizabeth)
'This is rather nostalgic.'
My last day
as a surgical fellow.
At least it's beginning
with something
rather substantial.
A gastroplasty on
a 400‐pound gentleman.
Did I make the wrong choice?
It's not for me to say.
Still, I wouldn't mind
hearing your opinion.
Is there some ominous portent
in that long pause?
I just can't imagine
being an intern again.
Well, I'm determined
not to whine about it
and I feel very good
about not leaving the hospital.
You might as well
take a coffee break, Peter.
My patient just expired
in the SICU.
‐ What is this?
‐ Rodney McMullen, 48.
‐ Oh, God.
‐ Can you believe this?
Carving knife versus forehead.
But good vitals.
Amazingly, no visual complaints.
He's drunk, combative
and strong‐‐
Lucy, come on.
We got a good one.
Damn beans! You give 'em work
they don't care! Son of a bitch!
Alright, everybody.
We're going to be
nice and gentle.
On my count
one, two, three.
Pancho must die!
I'll blow his brains out!
Alright, hold him,
hold him down.
I got his legs.
Lucy, get his left arm.
I'll get the restraints.
CBC, chem seven
PT, PTT, type
and cross for two units.
Pupils are equal
and react to light.
‐ Sir, you gotta hold still.
‐ Just let me get up!
How do I tie him?
Once around the wrist,
twice around the frame.
Gram of Ancef?
Sir, do you have any
allergies to medicine?
No. Just let me up!
Go with the Ancef.
Carol, can you get over here
and hold his head?
I just wanna look
at the open mouth.
Sir, I need to you
to open your mouth.
He's tied!
Okay, Lucy, take a look.
The tip of the blade
is in the oropharynx.
It's still penetrated
the frontal sinuses.
Missed the eyes completely.
Son of a bitch!
‐ 'Whoa, whoa, whoa.'
‐ Hey!
Lucy! Lucy, you tied him
to the rail, not the frame!
You don't listen!
Hey, hey, don't spit!
Carol, give him
five of Haldol, IM.
Sir, don't spit!
Put this on.
Not you, Lucy, him!
[grunting]
Hey. Dana, this is Dr. Ross.
(Doug)
'Hi, Dana.'
'How are you feeling?'
I'm okay.
Hmm? Any more pain?
It's still there a little bit
but I don't mind.
Oh, then, well, let's take
a look at the damage here.
Now, how exactly
did this happen?
I moved up for the goal
and had a sidekick
right in the net
Mm‐hmm.
and as soon as my foot
touched the ball
I heard a crack.
Then I went to take a step
and it just gave out
and it started hurting.
Mm‐hmm. Okay, did you
collide with anybody?
Anybody fall on top of you?
‐ No.
‐ Anybody kick you in the shin?
No.
All I did was kick the ball.
‐ Mm‐hmm.
‐ What's wrong?
It's just that it's
a severe break.
I want to understand
how it happened.
Ah, okay, we're going to get you
some more pain medication
and we're going
to run some tests.
Alright?
Okay.
Okay.
‐ Did you see that?
‐ Yeah.
The bone looked like it exploded
from the inside.
Yep. I want to get
a CT‐guided needle biopsy.
Tumor?
I think there's
a remote possibility
it's an infection.
Did you talk to the parents?
Well, one of the mothers
from the soccer club
is trying to reach them.
We'll need their
consent for biopsy.
[sighs]
Dr. Benton, you have
a call on 3‐5.
A Mr. Davidson from
some insurance company
calling you back.
What is this?
I found that in the copy room.
I didn't leave it there.
'It's got your name on it.'
Alright, thanks.
He has the same coverage I have.
What do you mean,
no health insurance covers it?
You mean, if I needed them,
you wouldn't buy them?
Well, that's not
acceptable. Listen..
...uh, can I speak
to your superior, please?
Fine. Fine, I'll call him back.
Problem, Peter?
[groans]
It's just bureaucracy
drives you crazy.
So I'm supposed to be treating
this McMullen
with a knife wound?
Ah, It's not just
a knife wound, but no hurry.
I gave him five of Haldol.
Dr. Greene, a call just came
on a hostage crisis
and shoot‐out.
They might need
a triage officer.
Yeah, they probably want
somebody
with more experience than me.
You know, I start tomorrow.
Hey, this is the rush..
The best part of the job.
Maybe we'll see you on TV.
‐ A shoot‐out?
‐ Yeah, wild west.
How about it, doc?
Tell Dr. Weaver
that I'm going on a run.
[snoring]
800...850...920 dollars.
Malik, could I ask
you a question?
Which do you think
is the better vein?
Let's see.
That's the one.
‐ Big and stringy.
‐ Good.
Just slide it in.
He can't feel anything.
Alright.
Going in.
Got a flash.
I'm advancing.
Sapphire pinkie ring.
This man ain't got no class.
Hooked up the line.
Got the tape.
How come it's not running in?
It's infiltrated.
You went all the way
through the vein.
No, I was really careful.
Well, Lucy, you gotta be
kind of Zen with it, okay?
Now watch the master, okay?
It's not about seeing,
it's not about feeling
it's about knowing.
Malik, you got
a phone call in admit.
Okay, it's in.
‐ Okay.
‐ Now finish it up.
‐ Mm‐hmm.
‐ I'll take it out there.
‐ Okay?
‐ Yep.
Keep an eye on this guy, too.
Lucy, when you finish
there's a head lac
to irrigate in curtain two.
Okay.
Wow.
Oh, The knife tip is posterior
to the uvula in the oropharynx.
Huh.
So, everything
under control in here?
It's fine.
I asked Malik for some
help with the IV
Good.
Use the nurses.
That's an important lesson.
[snoring]
[indistinct chatter]
We had an exchange of gunfire.
The assailant's down,
the bomb squad's checking him.
Bomb squad?
He took four employees hostage
with a suitcase
full of explosives.
‐ What's his problem?
‐ Guy works here.
I guess he didn't like it.
The docs are here.
How's he doing?
(Clark)
'The guy's covered in dynamite.'
He's got chicken wire
all over his body.
Lots of blood
coming out of his neck.
How long's he been down?
‐ Maybe ten minutes.
‐ Can we get in there?
Not until we've cleared
the explosives.
Clark, can I send
a doc in there?
Well, I've cut the main fuse
but it's not safe
without a seven‐b suit.
‐ What's that?
‐ A bomb suit.
Put me in that thing.
Wait. Wait a minute.
If anybody goes in there,
you should go in.
You're the doctor.
I'm not trying
to put any pressure
on you, if the guy dies
it wouldn't ruin my day
but it just looks bad
on the evening news.
Sure. I'll go in.
‐ Jeanie, hey.
‐ Yeah?
The pathology about Dana
the full workup
will take a few days
but it looks like
Ewing's sarcoma.
If you wanna beg off on this‐‐
No, no, no I wanna help.
Good.
77‐year‐old female,
fell unconscious
in her apartment.
Her name is Emily Holmes.
She always said she had
very good health coverage.
We found her with
BP 90/60, pulse 120.
Started a line.
‐ She arrested en route.
‐ Any history?
No meds in the bathroom.
Do you know if she has
any medical problems?
Oh, I'm just her neighbor.
She always seemed alright,
just forgetful.
(Carter)
'Okay, let's get
her on a monitor.'
'7.5 ET tube.'
There were three days
of newspaper on her doormat.
That's how I knew
something was wrong.
(Carter)
'Alright, I'm in.'
'Let's bag her.'
[monitor beeping]
Hold compressions.
V‐fib, no pulse.
Charge. 200.
Is she dead? What's happening?
‐ Can I help with the‐‐
‐ Everybody clear.
Clear.
(Chuny)
'Sinus tach.'
I got a pulse.
'Why do you think
she arrested?'
Uh, elderly woman,
could have had an MI
Could be septic, hypoxic,
electrolyte imbalance..
BP's 90 palp.
Okay, let's start
her on Dopamine
and let's get a 12 lead.
She's not out of the woods yet.
Ah...does that mean
she's going to die?
That's a possibility.
Are you in touch
with her family members?
Oh, I never saw anyone
come to see her.
I only ask because..
My sister's on a waiting list
for an apartment
in the building.
I don't really understand
why a biopsy was done
for a broken leg.
We looked at the fracture.
It didn't seem
to go with the way
that Dana said it happened.
It seemed unusual.
How?
The fracture may have
been caused by a tumor.
‐ A tumor?
‐ Mm‐hmm.
'It would weaken the bone.'
We still have to do some tests
but the biopsy
showed blue cells,
malignant cells.
Are you saying she has cancer?
Well, everything is still
in the diagnostic stage.
So you don't know, you're
not certain about anything.
Well, the indication is
that there's a sarcoma
so we're gonna have you
speak with an oncologist.
Oh, no. I don't believe this.
Now, here she is.
Hey, honey, how you feeling?
Ah, did you hear
how it happened?
It was so stupid..
(Mr. Ellis)
'I'm sure you
played a hard game.'
(Mark)
'How much longer?'
(Clark)
We got detonators,
all this damn wire..
I hate amateurs.
Wacko must have spent
hours wrapping this.
Ah, God...his guts.
His guts are coming
out of this stuff.
Whoa, whoa, whoa.
Don't cut anymore, okay?
Okay, that's small intestine.
Well, it's all wrapped up
in the wire.
Alright, listen,
his pulse is getting weaker.
We gotta get him to the ER
Is that black box a bomb?
Uh, probably not.
I got rid of the dynamite
but let's play it safe.
We'll wrap him up
in a ballistic blanket.
If anything blows, no one gets
hurt except Boris here.
Okay, Zadro.
'Get the gurney down here now.'
'We're moving him out.'
Dr. Olivas said that with
these digital hearing aids
basically he'll be able
to understand and talk
as well as you and I.
So he won't be deaf?
Well, his residual hearing
is something
that we can work with, you know
if he, you know,
does the treatment
twice a week for an hour
but one of us has to
be there with him.
‐ I can do that.
‐ Yeah, well, so can I.
I mean, this treatment,
it's natural‐hearing input.
Basically, the more
we talk to him
the better his speech
will develop.
It's going to be okay, honey.
You hear that?
You're going to be okay.
Of course he is.
Yeah!
There is one thing, though.
Um, this hearing aid
is expensive,
and I just found out
that my insurance
won't cover it.
‐ Why won't they?
‐ They don't cover anybody.
That way, they don't have
to pay for the elderly.
Oh, that's so low.
Yeah. I hate asking this, but..
this thing is $5,000 and I've
only got 2,700 in the bank
so I was..
Peter, I said that
we share everything
and I meant everything, okay?
That means we share everything.
Don't worry about it, alright?
'Let's just be happy that
something can be done, okay?'
[baby cooing]
Hey.
[laughing]
pH 7.32, PO2 345 on 100%.
Good. Good, turn down to 50%
and check another gas
in a half an hour.
Okay.
Is this Emily Holmes?
Yes.
John Carter.
She was found in her apartment.
Margo Aikin, I authorize
admissions for Blue Beacon
her HMO
This lady's a DNR.
She came in full arrest.
She didn't have any papers.
'Or any family.'
Let's, uh, step outside.
I don't know what your plans are
but I can't admit her.
This patient's critical.
Dr. Carter, I can't
justify an expenditure
of $5,000 a day on a patient
who should not be alive
who does not want to be alive.
Well, I wasn't
gonna let her die.
That's not what we do here.
Her choice was not
to be resuscitated.
That's what is in the HMO file.
That's the guideline
I have to follow.
Look, She's on a vent.
You have to take her.
No, I don't.
You tubed her, you take her.
[chuckles]
(Peter)
'Four units O‐neg.'
What's his airway?
‐ Intubated in the field.
‐ Hey, what's going on?
GSW, bomb squad's
coming with him.
Bomb squad?
(female #1)
'That's the guy
with the dynamite?'
(Mark)
'They took it off him.'
‐ Yeah, should be safe.
‐ Should be safe?
Gunshot wound to
the neck and abdomen.
Last BP was 100 palp.
Very gently, on my count.
One, two, three.
Open this blanket nice and easy.
Ho‐ho, eviscerated bowel.
CBC, chem panels
coags, type and cross
for four. Let's move.
Gram of Cefotetan.
Pressure's down to 85 systolic.
I'll throw in a Subclavian.
‐ You want O negative?
‐ Yeah. Hang two units.
(Benton)
'His bowel's wrapped around'
this chicken wire..
What is this box?
It might be a detonator?
I don't know till I open it up.
Can that thing go off?
Well, It might
have a blasting cap.
Just don't mess with it.
You should be fine.
Alright, Jeanie,
Let's irrigate with saline.
Let's get some sterile lap pads.
Come on, oh, man,
we're going to have to resect
this whole mess up in the OR.
You, you're coming with us.
Alright, Someone get
scrubs for Officer Clark.
(Yosh)
Okay, I'm in.
Hook me up. Pulse ox 98.
Lemme get this under there.
Okay, Come on,
come on. Clean it out.
'Good.'
Hey, hey, that thing's shorting!
'You got about five seconds!'
'Everybody out of here!'
‐ Out! Now!
‐ Let's go!
2,000!
3,000!
4,000!
[explosion]
[coughing]
Alright!
We've got an open bowel in here!
Let's move, people!
Let's get him up to the OR!
Let's go!
[indistinct chatter]
Here you go.
So, this is shrimp
and what's the red
shredded stuff?
Uh, that's Maui onions.
No, uh, pepperoni,
cheese, tomatoes‐‐
It's gourmet pizza. The mad
bomber spoiled my gourmet lunch.
So, so, the heroics
give you an appetite?
Uh, no. The running from the
trauma room gave me an appetite.
‐ Doug..
‐ Hmm?
'What is this lunch about?'
Yeah, what's going on?
Alright, okay.
First, a reading.
Uh, "Performance review,
Dr. Douglas Ross
"by Kerry Weaver, MD"
Where did you get that?
Oh, it was found
in the copy machine.
Uh, "Dr. Ross
repeatedly demonstrates
"a complete disregard for
hospital policies
"and procedures.
'"For example, in regard'
'"to a patient discharge.."'
'It's a, Okay, here it is.'
'Uh, "In spite of'
"mandatory counseling to correct
"the history of disrupting
workplace behavior
"Dr. Ross exhibits ongoing
problems with impulse control."
that's right, Kerry,
I'm a psycho.
Doug, she could've given that
to the pedes review committee.
Mm‐hmm. It's too late.
'Cause I brought you here
'cause I wanted you to toast
the new pedes ER
attending, me.
[Doug chuckles]
‐ Really?
‐ Yeah.
Buddy of mine
is on the committee
and told me
at 6 a. m. this morning.
I'm approved.
They're telling Anspaugh
right now at a faculty lunch.
I am so proud of you.
I am so thrilled.
Aren't you thrilled?
He's got his doubts
a little bit, right?
Hey..
whatever my doubts were
in all honesty
I'm very happy for you.
Happy for both of you.
[laughs]
oh, uh...Mark, Rachel's here.
She wants to see you.
Sure.
She seems a little upset.
Hey, honey, what's up?
Dad, can you come outside?
‐ There's sort of a problem.
‐ Yeah.
I knew he wasn't feeling
right when we left vermillion
and we got a rodeo
in Louisville 8 a. m. tomorrow.
It's colic for sure,
'cause I ain't seen
a load in over 12 hours.
Don't worry.
My dad can help him.
He's a doctor.
Honey, I'm not a vet.
Last time he got impacted
mineral oil enema did the trick.
We just don't have the
facilities here to treat animals
but if you come inside,
I'm sure we can find you a vet.
Nearest large animal
man's in buffalo grove.
That's two hours
in this traffic.
Dad, you got to
help him, please?
He's one of the finest
roping horses there is.
Poor thing.
If he goes down
in the trailer, he could die.
That's right, miss.
He sure could.
That'd be tragic.
What's his name?
Cherry Blossom.
Say hi, Cherry.
Hi, cherry.
Don't worry. My dad's
gonna make you all better.
It's clean.
There's no money in tobacco
polluting chemicals, mining..
it's like giving money
to a charity
but it's an investment.
‐ It's called a White Hat Fund.
‐ And what's the return?
Well, over the past five years,
it's been about 7.9%.
You got anything that's maybe
dirtier with a better upside?
Sure. Here you go.
Pure petrochemicals,
17.4% return.
‐ Alright.
‐ Dr. Carter?
My toe is feeling
so much better
since you retaped it.
Oh, good.
Yeah, I was wondering
if you and I could
get together sometime
maybe a little hot talk
about dollar‐cost averaging.
Well, I tell you, I'm really not
much of a customer these days.
This isn't really a sales pitch.
You work out?
Um...yeah.
I mean, when I,
when I can find the time.
Well, it's hard to find
the time, but look
I get free passes for myself
and a guest to the Artemis club.
That's good for one
workout and a sauna.
I'm there every night about 7.
Thanks. Be careful
with your toe.
Yeah. Yeah, just exercycle,
light weights
you know, great therapy
after a hard day
but it's much more fun
when someone else is there.
‐ Makes the time fly.
‐ Sure.
Well, today is not really
a good day for me.
Um...but some other time,
I'll come by.
Whenever.
Is that moving any air?
Pulse ox 88.
We gotta tube him.
How much do you weigh?
Two‐sixty.
Yosh, 180 of Ketamine,
180 of Sux.
Connie, 8.0 ET.
I can't breathe.
Tad, we need to put a tube
in your throat
to help you breathe.
We'll give you medicine to make
you sleep. Try to relax.
‐ Meds on board.
‐ Let's put him down.
Connie, we need a vent in here.
‐ I need suction.
‐ Pulse ox is falling, 85.
I don't really need
this distraction.
Yosh, give me crichoid pressure.
Damn, I can't see the cords.
[monitor beeping]
Bag him. Connie, give me
a number four Macintosh.
His neck's too big.
Pulse ox 89.
We don't have
a number four blade.
Anesthesia will have one.
‐ 'He's paralyzed.'
‐ Yeah, keep bagging him.
His pulse ox is up to 90.
Dr. Greene, they sent
this down from surgery.
Can I keep it?
Uh, we'd better keep that here.
The cops will want it.
Hey, how's it going?
Oh, Weaver's having trouble with
an intubation in trauma two.
Needs a bigger blade.
‐ Is everything okay?
‐ Status asthmaticus.
Needs intubation. Bull neck so
I sent for a number four blade.
Mind if I take a look?
Could deprive him
of oxygen, Mark.
Okay.
Okay, yeah, you're right.
It's a tough one.
Yosh, crichoid pressure.
We tried that.
Pulse ox is falling.
‐ 'Get out, Mark.'
‐ Okay.
Backwards. Upwards.
To the right.
I can see.
Good. Okay, I'm in.
Bag him.
Don't let them bag him too fast.
He's got a long
expiratory phase.
‐ Dr. Weaver?
‐ Yes.
They told me
that you could sign off
on this work order.
Where did you put
the copy machine?
It's not going back in there.
They're gonna convert
that room to a pediatric exam.
See, we're taking out a wall.
Look real good.
Thank you.
‐ Dr. Weaver?
‐ What do you want, Carter?
I wanted to tell you
what's going on
with that patient in trauma one.
Yeah, why is she still here?
‐ We need the bed.
‐ I know.
I tried to get her
admitted to the unit
but it turns out she's a DNR.
And her HMO doctor was here but
she won't authorize admission.
If she can't stay in the ER
either get her admitted
or get her transferred.
Well, she's, she's intubated
so she's not stable‐‐
You know what, Carter, if you
wanna be a chief resident
you can't continue to run to
me when things don't work out.
Deal with this yourself.
Improve your
problem‐solving skills.
Randi, get me Dr. Anspaugh.
Hello, Peter.
Hey.
I suppose we should talk.
Elizabeth, this isn't
a good time for me.
Yeah, I know. I know
it's been, um..
It's been a rough day
with the bomber and, uh..
I'd like to get something
out in the open.
I know it's not been easy
being with me, but, uh..
if it's not working out
and if you and Carla
are getting back together
I'd appreciate hearing
it from you.
What?
What are you..
Elizabeth, it's got
nothing to do with that.
Well, you've been avoiding me,
so what's happened?
I haven't been avoiding you.
I've just got some things
to deal with, okay?
Well, what things? What is it?
Reese is hearing impaired.
‐ How bad?
‐ He's profoundly deaf.
Peter, I'm so sorry.
Listen, I didn't
tell you about it
because it's private.
And I haven't been
avoiding you, Elizabeth.
It's just that, you know what?
I don't know
how to talk about that.
(Mark)
'Easy, boy. Easy, boy.'
How's he doing, Rachel?
He's okay.
Have you been
around horses much?
'Sure got a way with them.'
Okay, keep him nice and still.
I'm gonna put the tube in now.
Jerry, if you can hold the tail.
Just..
Okay, easy. Easy, boy.
Okay, good. Tube's in.
Uh...Jerry,
why don't you go ahead
and squeeze the lavage bag.
I'm not going
to get kicked, am I?
Kicked? No.
He's as sweet as they come.
Nice and easy.
Don't worry, boy.
'We're not going to hurt you.'
Nothing's going to come
shooting out of his...
No, it shouldn't, you know.
Not for a while.
Okay. Here it goes.
Nice and easy.
Good.
'Nice even flow.'
Hey. How you doing?
What's an oncologist?
It's a doctor that deals
with abnormal cell growth.
It's a cancer doctor.
Why can't you be honest with me?
My parents were talking to an
oncologist outside the room.
He said something about
amputation.
They're with him right now.
There were indications
in your biopsy.
You may have a tumor.
That means
they'll cut off my leg?
Specialists are gonna
look at all their options
and then make a decision soon.
Stop ducking my questions.
Can't you be honest?
Alright.
Okay. Amputation
offers us the best choice.
I don't want to live
without my leg.
I'd rather be dead.
They haven't finished diagnosis.
They're gonna talk about
all available treatments.
Treatments that could
save my leg?
The kind of tumor
that you have..
Amputation offers us
the best chance.
If they amputate
is it certain I'll live?
No.
'But it's your
best shot, kiddo.'
'If you were my daughter'
I would try to persuade
you to do it.
Would you still do it
if I said no?
When you get all the facts.
Then it's a decision
that you and your parents
are gonna have to make together.
[sighs]
okay?
You have power of attorney
for over 700 clients?
So you've never
actually even met her.
Yes.
Yeah, any information that you..
Could you fax it over?
I guess that's what we'll do.
Thank you very much.
Everything okay, Carter?
Hmm..
Yeah, I intubated a DNR Patient.
HMO won't admit her. No family.
Only a lawyer with durable power
and he's never even met her.
What are you thinking about?
I don't know.
I mean, should I extubate?
It just seems kind of wrong.
DNR means she did not
want heroic measures.
The real question is whether
or not you're ready to do it.
Have you ever done it?
Yeah. Once,
but I had family support.
Her vitals are stable.
Pulse ox 98.
I've weaned her
off the Dopamine.
I'm going to, uh..
...turn off the vent.
Do an apnea test.
Should I get an attending?
I already talked to Dr. Greene.
She's a DNR.
She didn't want this.
[monitor beeping]
Spontaneous respiration.
Just one breath.
That might be it.
No. She's breathing on her own.
I'm going to extubate.
[coughing]
Let's give her
five liters of oxygen.
Hey, any luck?
Dr. Greene wants
an enema update.
Nah, No movement yet.
I'm learning all about
taking care of horses.
You know, it might not hurt
to let him out a bit.
Let him walk around. I mean...
...movement's good for colic.
You wanna get
in there and just, uh
give him a pat,
help me ease him out?
Uh...well, I..
I don't have
any experience with horses.
I‐I‐I never even touched
one before today.
Look, you're gonna be fine.
Just don't let him
know you're scared
and don't worry
about showing him
who's boss, alright?
Come on now, Blossom.
You got all these nice
folks concerned about you.
'Let's go. Come on.'
'Come on.'
Come on. Come on, good boy.
'Come on.'
[farting]
[laughing]
'Hey now.'
You brought us
some good luck, son.
[horse neighing]
Hey, Mark.
Can...can we talk?
Uh, I was just going
out to see the horse.
Yeah. It's, uh, it's important.
What's up, Kerry?
Let's go in the lounge.
Did you know that Doug Ross
was made a pedes attending?
That they're fixing up
a suite of rooms for him?
Yeah, he told me at lunch.
Really. Oh, well, uh..
I was told by the painters.
I had to read it on a work form.
Wh‐wh‐what's going
on around here?
What do you mean?
Why was I left out of the loop?
Kerry, Ross is
the new pedes ER attending.
That's a fact of life.
We should learn to accept it
and move on, okay?
Wait a...but how can I move on
when you express disfavor
about Ross as an
attending to my face
and then celebrate his dubious
achievement behind my back?
Is this really about Ross?
Yes.
Yes, it's about Ross.
Bottom line, I don't
think he's qualified.
The hospital doesn't agree.
And, you know, I don't think
you're angry about Ross.
I think this is more about you
obsessing over some silly title.
I wish you'd make
a decision, Kerry.
You wanna be a doctor
or an administrator?
I'm gonna go examine a horse.
I finished my write‐ups
on the chest pain
the altered mental status
and the ankle sprain.
I need you to co‐sign
these charts before I go.
Yeah.
Are those PVCs?
That's right.
Shouldn't we give
something for that?
No.
(female #2)
'V‐tach.'
You shock that, right?
Not this time.
[dramatic music]
Watch. V‐tach.
'V‐fib.'
[flatline]
Then asystole.
She's not suffering.
It's what she wanted.
[music continues]
I'll sign those charts now.
Dr. Ross.
Our daughter said you spoke
to her about her treatment.
She's very upset. Why would
you do something like that?
You had no right to advise
her against amputation.
I didn't advise
against amputation.
I told her it offered
the best chance to survive.
Yeah, but you gave her
other alternatives.
We want her to live.
I want her to live
but she's going
to have to accept
what's going to happen to her
not end up fighting some edict
that gets handed down.
No, no, no.
This is our decision, not hers.
She's 15 years old.
She's old enough
to be involved in decisions
about her own health.
Stay away from her.
You don't speak
to her again, understood?
All right.
To survive,
she needs your support.
She has to feel
that you are working for her
not against her.
Let's go.
So, on search committee
for chief
have you set the calendar
for meetings?
Yes, and I was sorry to get
your message this morning
that you won't have time
to be part of the process.
Well, actually, I've been
able to make some room.
Really. Well, we're
getting together
Tuesdays and Thursdays
at 6 p. m., if you can make it.
Yes, I would like
to be involved.
Good.
I've lived in worse
places than this.
It just needs some fresh
paint, some posters..
I can live anywhere
as long as I've got music.
You sure you're up for this?
I told you
I worked for best buy.
I assembled systems
all day long.
Come on, what have you got?
Bose, top of the line.
It's a very expensive system.
I guess these are the, um..
...these are the cables
that go with that?
Oh, actually,
those are RCA cables.
You must have hooked up
your VCR through your amplifier.
I don't know.
Some guy just came to my
apartment and hooked it all up.
Huh.
You got a CD?
We could try this out.
Yeah, sure.
Jimmy Smith.
‐ Jazz?
‐ Jazz.
Organ.
[jazz music]
I like it.
You know...my doctor said
that slow dancing is okay.
Yeah, it might
even be therapeutic.
[music continues]
[theme music]