ER (1994–2009): Season 6, Episode 11 - The Domino Heart - full transcript

Lucy's patient finally gets the call to receive a heart transplant, but there are complications. Greene interferes in a gay couple's domestic situation. Corday tricked her patient who murdered several women and now he's being tran...

(male on TV)
'...area that's been
bringing some snow'

'to those Southern Plains
and rain to Texas.'

'And it's heading
toward the Northeast.'

'You see the trough here,
that's allowing'

'some cold air
to come down tonight.'

'And then the snow,
the moisture intermingling'

'with snows in
the Western part of Kansas.'

'But this low, as it moves
toward the Northeast'

'is gonna to pull up some
Gulf of Mexico moisture..'

‐ 'Dad?'
‐ Hey, Mark.

You're up early.



Might snow later.

Fifty percent chance.

Dad, it's a little loud.

You ought to have a door
to that bedroom of yours.

No, I don't want a door.

I can build you one.

Dad, I don't want a door.

Can you turn that thing down?

[phone ringing]

Hello?

Yeah.
No, I'm sorry.

My‐my dad's visiting.

Yeah.
No, won't happen again.

Who the hell's calling
at this hour?



My neighbor.
You woke her, too.

(David)
'It's no wonder. The walls in
this building are paper thin.'

'By the way,
we're out of coffee.'

So I see.

(David)
'There was only a little
dibble‐dabble left.'

Barely able to get a cup
out of it myself.

I think I'll just get
dressed and go to work.

‐ This early?
‐ Yeah, this early.

I like that weather channel.

There's no sense in trying
to watch it in San Diego.

"Clear and sunny,
clear and sunny.

Chance of a cloud,
mostly sunny."

Hey, Chuny.

Carol.
Welcome back.

‐ Thanks.
‐ How are the twins?

Oh, they're doing great.

I don't know
how I'm gonna do,

this is my first
whole day without them.

Seems pretty quiet, though.

Actually, uh, no.

Oh, great.
Back to work.

‐ See you in a minute.
‐ I'm right behind you.

Vito Camporsero,
29, acrobat.

Rehearsing on the trapeze.

He slipped off the platform.

‐ How far did he fall?
‐ About five feet.

But he was up 50.

He caught his armpit
on a cable.

‐ That's what saved him.
‐ He's not so bad.

[speaking Italian]

‐ Carol, welcome back.
‐ Thanks.

Deep laceration
to the left axilla.

Three liter blood loss.

BP's low, 60 palp.

Okay, ready, steady..

...lift.

Get four units of O‐neg.

Hi, I'm Mark,
you must be the new nurse.

Hey, Mark.
It's good to be back.

‐ 'I need a pulse ox probe.'
‐ 'A gram of Ancef.'

We don't have any water here.

Does anybody know
anything about this?

‐ 'No.'
‐ I just got on.

Alright, I'm gonna go
check it out.

‐ Luca, you alright?
‐ All set, thanks.

Pressure is crashing.

Carol, prep for a subclavian.

Two liters
on the rapid infuser.

‐ Are you hurt?
‐ Uh, no, it's Vito's blood.

Dominic carried
him down the..

‐ Come si chiama.
‐ The ladder.

Pulse is 124,
satting at 94.

‐ 'Carol, the Betadine.'
‐ Oh, yeah, I got it.

It's okay if you're
a little rusty.

I'm fine, thank you.

Flying Camporseros.

I didn't know the circus
was in town.

Laceration of
the axillary artery.

‐ He's shocky.
‐ I'm Dr. Romano from surgery.

‐ Hello.
‐ Please help my brother.

Check the crits first.

I haven't been
gone that long.

Okay, absent wrist pulses.

Let's have a look.

‐ Oh. Whoa.
‐ Easy, easy.

‐ Take it easy.
‐ You're hurting him.

‐ Give him some morphine.
‐ His pressure's too low.

‐ Stop it, please.
‐ Almost done. Hold on.

You can hold on longer.

[speaking Italian]

Please step back
a little bit.

Get these guys out of here.

Okay, please. Stop it.

[speaking Italian]

Hey, hey, what the hell
do you think you're doing?

Let go of me.
Call security.

What do you think you're doing?
Get your hands over here.

[theme music]

[music continues]

[music continues]

Put at least four liters
at every sink.

‐ What's going on?
‐ Oh, a water main broke down.

Gonna fix it,
but it could be a while.

You're not on
till tonight.

I know. Valerie Page
called me at home.

The girl you ordered
the LVAD for?

Yeah, they found a match.

She's on her way in
for a heart transplant.

That is great.

Carter, they said they're
getting stacked up at chairs.

Oh, I'm sorry.

I'm on the code team today

and I just got paged for

a respiratory arrest
in the cafeteria

that was a false alarm.

Okay, what have we got?

Carter, your amoebic
dysentery patient

just used the toilet.

‐ So?
‐ No water.

‐ We can't flush.
‐ Oh, well, sorry.

I've got another case.

Put the "Out of order" sign
on the door.

Call housekeeping.

Amira, can you see
if we can get a couple

of portable toilets
for the ambulance bay

and maybe some air freshener.

You have a lot of calamities
at the circus, huh?

No, no, not usually,
but Peng, she's afraid

that she won't be able
to perform tonight.

No, no.
The laceration is not bad.

Now, tell her
she'll be fine.

[speaking Chinese]

Thank you.

How did this happen?

Uh, one of the platforms,
she broke.

A piece of wood
fell right on top of her.

Yes, but if the wood
fell from above

how did it, uh..

...hit the bottom
of her foot?

[speaking Chinese]

‐ 'Like this, you see?'
‐ Wow.

You know what? I think I'll go
see that circus of yours.

Here's one of them.

Get him out of here.

My mother's had Parkinson's
almost 15 years.

Hmm. Has her condition
recently changed?

Well, in the past
couple of days

she's been so weak
that she can't use her walker.

‐ I'm worried she had a stroke.
‐ Hmm.

Oh, no, no, no.
Let us help.

No, I don't mind.
I do it every day.

Good for my..

...health, right, mom?

To tell you the truth,
I‐I'm a burden.

'Louise has to lift me
onto the toilet'

and sponge‐bathe me.

Oh, come on, mom, stop it.

She gets dizzy

when she sits up.

Could it be her heart?

Well, we'll check.

Maybe‐maybe
the Parkinson's

is getting worse.

I don't feel worse.

Well, you might not,
Mrs. Duffy

but I'm gonna
examine you

run some tests

and find out
what's going on.

[sighs]

You okay?

Oh, yeah, fine.

‐ Okay.
‐ 'Carol.'

You got an IV cefotaxime order
ready for exam two?

‐ I'll get to it when I can.
‐ Been in the rack for an hour.

I just checked the rack.

Was it in the wrong slot?

Doesn't matter.
Lady's got pneumonia.

And this gentleman
has chest pain.

I can only do
one thing at a time.

Mark, I'm moving
as fast as I can.

I know you are, Carol.
I know it's your first day back.

And I know you're gonna
take a little while

to get back
into the flow.

I don't think any of
my patients have suffered

from my being "A little rusty"
as Dr. Kovac puts it.

‐ I didn't mean to imply that.
‐ Hey, Mark, give me the chart.

Why wasn't I paged
for the water crisis?

I mean, we have
a comprehensive plan

for internal disaster.

I mean,
I'm on the committee

that developed
the protocol.

Well, there isn't
a crisis, Kerry.

We've got two portable
toilets coming in.

We have plenty
of bottled water.

Everything seems to be
under control.

Yes, except
that the OR

can't sterilize
their instruments.

They've canceled
all elective surgery

and I've closed
us to trauma.

Well, that sounds
like a good idea.

And if the patients
can't quite

make it outside,
or if they don't want to freeze

their butts off,
we can use water

from the physical therapy pool.

A two‐gallon dump
gives you a solid flush.

‐ Ooh.
‐ Careful, Kerry.

Thanks for
the information though.

‐ Sure.
‐ That's good to know.

‐ Hi.
‐ Hi.

Oh, God, I was just about
to have some pancakes

when my pager went off.

Just about jumped
out of my seat.

They said I had
one hour to get here.

I think this is news,
worth missing breakfast for.

I'm so glad you called me.

I packed so fast
I forgot my slippers.

We'll get you a new pair
to go with your new heart.

Keeping you up, Carol?

Oh, God.

Have you seen the old records
on my syncope patient?

Yeah, file room's
bringing 'em up.

‐ You fax his EKG to his PMD?
‐ Yes.

He said he'd call
after he got it.

Well, maybe he's busy.

Ah, here's the problem.

Paper jam.

Fax it again,
will you, Carol?

Anyone seen the X‐rays

on that ankle in exam four?

Hmm.
Don't hold your breath.

Radiology can't process
the film without water.

Don't know how long
it's going to be.

This water shortage keeps up

some of us might
get out of here in time

to go grab
something to eat.

Sounds like fun.

Yeah?

Have a good time.

Michael Mueller, 28.
Had a seizure while driving.

Crashed into a wall,
his airbags deployed.

He's post‐ictal, good BP,
tachy at 120.

We were on our way
to our hockey practice

and he just started
to shake.

Scared the crap out of me.

Curt Obarr,
front seat passenger.

He was up and walking
with a forehead lac.

Curt, you know if Michael's
had seizures before?

‐ 'Not that I know of.'
‐ Okay, everybody.

Nice and easy.
On my count.

One, two, three.

Let's get a trauma panel.

C‐spine, chest and head CT.

They can't develop X‐rays.

Alright, let's get
the Fluoroscan.

Sinus tach 130.
BP's 124 over 78.

Pupils are equal.

Do you know if he's had
any medical problems?

Uh, he uses one
of those asthma inhalers.

Old bruises. You guys
play pretty rough, huh?

He got checked,
pretty bad, last week.

Did he hit his head?

‐ I don't think so.
‐ Temp's normal, 98.8.

Whoa. Let's roll him.

Add a theophylline level.

‐ 'What's that?'
‐ Asthma medication.

You take too much,
this can happen.

Louise?

Hey, everything
looks okay.

Head CT, EKG,
and the blood tests

are all essentially normal.

Then why can't she walk?

Well, most likely
it's the Parkinson's.

But I'm sure her neurologist

can adjust her medication

as an outpatient.

Could we talk outside?

Oh, yeah, sure.

Of course.

And you're, uh,
not going to admit her?

Not when there's
no reason to.

Look..

Please, I love my mother

but I can't take her home

and care for her

when she can't walk.

I mean, I'm just
too exhausted.

Well, maybe you need
a home aide.

But I can't afford a home aide.

I mean, she needs
to be in the hospital

for a few days, where..

So you can adjust her meds

and get a little stronger.

Unfortunately, we can't
admit her for that.

I'm‐I'm asking you.

Please.

I'm‐I'm just
so tired right now.

It's been such
a difficult few weeks.

If‐if‐if she could
just stay

for a couple of days.

Well, I‐I wish
I could help you

but unfortunately
the hospital doesn't allow

for that kind of admission.

‐ I'm really sorry.
‐ Yeah.

Okay. Thanks.

These are..

Ridiculous...
would be one word?

That would be
one word, yes.

Best the gift shop
had to offer.

(Valerie)
'And I'll take them,
thank you.'

You're welcome.
I got a hold of your mom.

And she is on her way here.

And your dad is..

Not around, never has been.

I know that story.

Hello.

‐ Hi.
‐ Dr. Weaver.

Valerie, how are you doing?

Oh, the proverbial
"Couldn't be better."

Good.

Lucy, do you
have a moment?

‐ Sure.
‐ Excuse us.

Be right back.

Um...I've looked
over the chart

and...Valerie
has a fever.

A temperature of 100.9.

It's pretty low‐grade,
that could just be a cold.

Yeah, she needs to go
on high dose

immuno‐suppressive agents

so she won't reject
the new heart.

With a weakened immune system

even a cold could be fatal.

What are you saying?

We need to notify
the transplant coordinator.

We may have to
decline the heart.

Is there anything
we can do?

It'll be their decision

but in all
likelihood I think

that's what's gonna happen.

I can't believe this.

She was so close.

Want me to tell her?

‐ No, no, I'll tell her.
‐ Okay.

[slow instrumental music]

(Greene)
'Shooting.'

Yeah. Definitely got
a fracture on your hand.

Just below the pinkie.

Move your hand back.

It's gonna need a cast.

I guess I'm lucky.
It could have been worse.

How's Curt?

Well, he's fine.

Forehead's being sutured up

and, uh..

...actually I'm..

...more concerned
about you.

I feel fine.

You know, your seizure
was caused

by an overdose
of theophylline.

An overdose?

Were you trying to, uh,
hurt yourself?

No, I just..

My asthma flares up
whenever I'm stressed out.

So I‐I took
a few extra pills.

Stressed at work?
At home?

I'm a landscaper.

January's a tough time.

Work stops,
the bills don't. So..

Why the third degree?

Under the circumstances

I, uh, have to ask
about depression.

Trust me, if I
wanted to kill myself

I'd find a better way.

All fixed up.

Do you know
what was wrong?

Yeah, I took too much
asthma medicine.

Busted up my hand.

We're gonna have
to find somebody new

to play left wing.

He gonna be okay?

Yeah, should be.

Hey.

How's the car?

It's totaled.

Don't worry,
you're insured.

Is it alright to use
one of these things in here?

‐ Sure.
‐ I'll just get a rental.

When was the last time
you passed gas?

About an hour ago.

No fever or vomiting.

Well, Peter, I agree
with your assessment.

Mr. Hoyt, you are full of stool.

Dr. Benton will see
that you get an enema.

‐ Excuse me, doctor.
‐ Not now, we're busy.

Unless somebody's dying,
come back later.

Okay, Peter, who's next?

Splenectomy, from last week.
Mr. Jabour.

Valerie page is here
for a heart transplant.

Old news. The transplant
service already called me.

I make it my business
to stay informed.

‐ Then you know she has a fever.
‐ I wasn't aware of that.

Have you called
the transplant coordinator?

Peter, give the coordinator
a buzz.

Let her know we're gonna
pass on that heart.

‐ You're not gonna examine her?
‐ What's the point?

Can't operate
if there's a fever.

But her white count,
chest X‐ray

and urine are all normal.

Well, I give you
a gold star for effort.

But in my book, a fever
still spells infection.

You're right,
and I think it's a

driveline infection
of her LVAD.

I did research on Medline

and I from articles
from Pittsburgh and Stanford.

The treatment is,
give antibiotics

remove the device

then give the new heart.

Peter, go work her up.

I'll talk to
the transplant service.

Ms. Knight, you are like

a crazed Energizer bunny
on this one.

You just keep going
and going and going.

Thank you.

Carol, we're out of
I and D kits in examine two.

I'll check the suture room.

No, I‐I don't need one.

I just‐I just wanted
to let you know.

Oh, I'm‐I'm sorry, Kerry.
Big trauma came in.

I haven't been able
to check all my rooms.

Hey, no,
I'm not criticizing you.

I'll get to it
as soon as I can.

Yeah, I know you will.

Must feel strange
coming back

after being off
for six weeks.

Not really.

If you need to take
an extra break..

Why would I need
to take a break?

You might not be
getting enough sleep.

Oh, I'm getting
plenty of sleep.

Thanks, Kerry.

[speaking Spanish]

Dr. Malucci,
is there a problem?

Uh, yeah, chief, there is.

Check this out.

‐ Dolison.
‐ Mm‐hmm.

Her husband's been
popping these puppies

for three weeks,
now he's vomiting blood.

I'm not that familiar
with this medication.

They're from Mexico.

Combo painkiller
and steroid.

‐ Anyone can buy them.
‐ Unbelievable.

Okay, be sure ICU
gets him on a steroid taper.

Okay.

‐ Cleo?
‐ Yeah?

Alright, so

when I said I was,
uh, you know

trying to get out
of here early

and going to grab
a bite to eat.

Yeah, I wish I could
get out early.

Mm‐hmm. So, what if
we made it later?

I never know
when I can get out.

‐ Don't wait on me.
‐ Uh‐huh.

Carol?

You alright?

Oh, I'm fine.

You don't look fine.

No, really.

I am really fine.

First day back
must be tough.

Why don't you just leave?

No, I'm just going
to sit here

and I'm gonna
have a good cry.

And then I'm going
to feel better.

That's what I do at home.

You see, I am..

...I'm better already.

Thanks, Elizabeth.

Carol, are you okay?

(Carol)
'Oh, I'm fine.'

It's her first day back.
She's a little overwhelmed.

I don't blame her.

Between the diapers
and the dishes?

The feedings, laundry.

(Chuny)
'Then coming here
for a 12‐hour shift.'

(Corday)
'I don't know how
she's gonna do it.'

Trying to stay focused
with the patients.

All she wants to think about
are her babies.

Carol..

...if there's anything
we can do.

[sobbing]
Okay.

[blowing nose]

I'm really confused.

You were all set
to cancel the transplant

and now you say
I can have the heart.

With the driveline infection

you need a day or two
of antibiotics

before you can get
the transplant.

So I lose
the heart after all.

Not necessarily.

You have a very low fever

and we think that we can
clear up the infection

with a few doses
of antibiotics

and still do the transplant.

What if the antibiotics
don't work?

‐ Worst case?
‐ Yeah, worst case.

After surgery,
you could develop

a life‐threatening infection.

What would you do?

It's your decision, Valerie.

I know, but would you
have the surgery?

The risk is small.

And you've waited
a long time.

I would go for it.

How long have you and Curt
been together?

‐ A while.
‐ Everything okay?

Yeah.

What happens
when the two of you fight?

What makes you think
we fight?

Well, everybody
has arguments.

You got bruises,
stressed out

you OD'd on
your medication.

I'm just trying
to put it all together.

It's not uncommon for..

[clears throat]

...fights to turn physical.

People don't mean
for it to happen, it just does.

No, no, I‐I know they don't.

Something just sets it off.

That ever happen to you?

Forgot to pick up
the dry cleaning.

He, uh..

He hit me,
and‐and he said he was sorry

and he promised
he'd never do it again.

Has he?

So there have been
other times.

Yeah.

I'd like you to talk
to a social worker.

They have experience
at dealing with these things.

Okay?

I don't know.

I don't know.

Dr. Corday?

Lindsay.

How are you?

I'm alright.

Um..

It was my sister's
funeral yesterday.

I just‐I wanted to thank you.

You really don't have to.

The police said that, um..

...that he finally
told you where he..

...left Jenny.

Yes.

Um, I'm trying to forget him.

I‐I just hear his voice
all the time

and..

...it's very gentle

but it's just saying
these awful things.

Now you listen to me.

That's what he wanted.

To make you suffer.

But you don't let him win.

He's nothing.

He can't hurt you anymore.

I know.

I know.

It's okay.

[elevator dings]

How long is the operation?

Four, five hours.

Do they let med
students watch?

Only if they're on
the transplant service.

So, that means
you can't stay?

No, I gonna talk them
into making an exception.

‐ Thanks.
‐ Yeah

‐ Oh, would you do me a favor.
‐ Sure.

‐ I forgot to feed Spoony.
‐ Spoony?

It's my cat.
Would you tell my mom.

‐ Yes.
‐ Okay.

I'm gonna go change.

I'll see you.

[buzzing]

Can I have a moment with him?

I knew you'd come.

‐ Did you?
‐ Mm‐hmm.

You know, when I woke up

and found you hadn't done
what you'd said

you'd do...I was glad.

The fact that you were a coward
never even occurred to me.

Your conscience
is bothering you...isn't it?

It is, actually.

Why, because
you nearly killed me?

Or because you didn't
have the guts to?

Because I enjoyed the power
I had over you

when I could have let you bleed
to death at the crash

when your heart stopped
while I was operating

when the morphine
took you under.

I held your every breath
in my hands

and I so wanted to repay
some of the pain you caused.

But then I looked
at your sad little body

and I saw what
a pathetic man you are.

And I realized, I didn't want
power over you at all.

And my job,
for better or worse

was simply to put
you back together.

See, I don't give a damn
if you go to the chair

or if you spend the rest
of your life in prison.

My job's done.

'You were my patient,
you were sick.'

You're better.

Good‐bye, Mr. Rollins.

‐ You can take him now.
‐ Come back here.

[buzzing]

I haven't finished
with you yet.

Get back here, Corday.

'Corday.'

Any chest pain or
shortness of breath?

‐ Maybe a little lightheaded.
‐ Oh, my God, what happened?

The parking lot attendant's
idea of a code blue.

‐ What?
‐ She slipped on the ice.

I was helping mom
into the car.

My wheelchair fell over.

Did you hit your head
or lose consciousness?

Louise, did she
lose consciousness?

I don't think so, but I fell
first so I don't know.

Put her on a monitor.

You want this one, Dr. Chen?

I just discharged her.

I'm a firm believer
of continuity of care.

No head trauma, check
hip and pelvis. Bye.

‐ I'm so sorry, mom.
‐ I'm alright.

The BP is 170 over 95.

‐ Is that bad?
‐ It's a little high.

Why don't we get
a CBC chem panel

cardiac enzymes,
EKG and postural vitals.

I'm fine.

I'm just so...so tired.

What was, uh,
she here for?

Weakness, exacerbation
of Parkinson's.

She hasn't been able
to walk for three days.

It's getting harder
for me to take care of her.

Her head CT was normal.

I see.

Right atrial cannulation
is complete.

Umbilical tape.

How long does
the LVAD stay on?

‐ Until we go on bypass.
‐ Right.

The aortic cannula
is looking good.

Here we go.
Kill the air pump.

Clamp the aortic graft, Peter.

Okay, and...got it.

Open the venous line.

[machine whirring]

Anyone looking for a heart?

You're early, Shirley,
making me look bad.

Sorry, Dr. Hanover.
Take it up with the FAA.

Is it too early?

No, no, no, it can
wait on ice for a while.

‐ Wow, that's her new heart.
‐ Yeah.

Sure is.

He denied everything?

Claimed the boyfriend
never even touched him.

I thought he was
ready to talk.

Well, it's not uncommon for
victims to change their minds.

He probably loves the guy
and wants to protect him.

Sure, he's afraid.
You're gonna be around all day?

Yeah. Why? Thinking about making
another run at him?

‐ Maybe.
‐ Well, give me a call.

Okay, thanks.

Carol, how are you feeling?

Four hours
and 43 minutes to go.

You know, counting the
minutes is not a good sign.

Can someone take this
ingrown toenail?

She's been whining
for over an hour.

‐ Real bitch.
‐ Carol.

‐ The woman is exhausted.
‐ I know that, John.

So she needs a break,
a couple of days.

‐ I can't.
‐ How's the parking lot?

They lived.
You can't or you won't?

Both.

Just say that you're
ruling out a stroke.

I can't lie
about a diagnosis.

Sometimes we make what's
called a "Judgment call"

if the rules need to be bent
a little bit, we bend them.

I bent them last week, John,
and I got into a lot of trouble.

Well, if you're afraid
of getting yelled at

maybe you're
in the wrong department.

Listen, everybody
does soft admits.

It's just part
of the drill.

Look, I know what you're saying
but I'm not admitting her.

She's my patient,
it's my call.

Okay.
Okay, you're right.

‐ Yeah?
‐ Not about the patient.

I don't agree with you but..

...you got to do whatever
you think is best.

Well...thanks
for your input.

Any time.

Hey, Amira, I need a telemetry
bed for Louise Duffy.

Wait, you're admitting
the daughter?

Yeah. Her hypertension's
out of control.

‐ I wanna rule out an MI.
‐ You're kidding, right?

She's syncopal.
She might have unstable angina.

She slipped on some ice.
You said so yourself.

Well, when it's my patient,
It's my call.

And where's the mother
supposed to go?

That's your patient.
That's your call.

You must have misunderstood.

A bunch of us got into a fight
at the hockey rink.

Michael, we both know
you're not gonna be safe

until you get out
of this relationship.

I'll just wear
more pads next time.

Most domestic homicides have
a history of physical abuse.

What, are you trying
to scare me?

Yes. You need to
get away from him.

Okay, I got the rental.
We're all set.

‐ You okay?
‐ Yeah, fine.

‐ Is he ready to go?
‐ No, we need a CT scan.

‐ What for?
‐ Previous head trauma.

I told him we play
a lot of hockey.

I wanna clear him medically
before he plays again.

I'd like to take him home.

Michael, I think
you should stay.

'I want you to understand
the risk that's involved.'

‐ He understands them.
‐ I'm not so sure.

Why don't we
let Dr. Greene just‐‐

Mike, shut up.

If you need him to sign
something he'll sign it

won't you, Mike?

‐ Yeah.
‐ You don't have to go.

It's your decision.

Thanks.
Uh, I feel better now, really.

‐ We should get home.
‐ Yeah.

One more dispo,
and I'm outta here.

What's that?

All that's left
in the vending machine.

What's wrong with
the cafeteria?

No water.
Can't cook.

Then don't eat.
That stuff will kill you.

Has anyone seen Chuny?

I've been waiting
a half hour for a translator.

‐ Sorry.
‐ 'What's the problem?'

Father‐daughter combo,
present with aplastic anemia.

‐ Both of them?
‐ Yeah, it's strange.

‐ No history of toxic exposure.
‐ Let me see.

Bone marrow's
not making squat.

‐ Are they in here?
‐ Yeah, why?

‐ What are you doing?
‐ I've got a hunch.

Hola.
Soy Dr. Dave.

[speaking foreign language]

‐ Dave, what are they saying?
‐ Hold on.

[speaking foreign language]

‐ Son of a bitch.
‐ What is it?

[speaking foreign language]

What are they saying?

Last month, they got a bunch
of shots for their colds.

Did you get the name
of the doctor?

No doctor.
They went to a pharmacy.

What kind of pharmacist
gives a shot?

The bad kind.
It's a backroom clinic.

They smuggle drugs up
from Mexico.

‐ Oh, God.
‐ Mmm‐hmm.

Plenty of stuff that could
give you aplastic anemia.

What are you doing?

They gave me the address.

Wait, hold on.
We should call the police.

Yeah, they see a squad car
they'll bolt in two seconds.

Cleo, we could
use you out here.

Go ahead.
I got this.

Dave, these are my patients.
I can handle it.

Yeah, they're all yours.

‐ What are you going to do?
‐ Don't worry about it.

Trevor, my name is Carol

and we're gonna take
good care of you, sweetheart.

‐ Femur fracture?
‐ Auto versus pedestrian.

No head trauma.
He was all by himself.

‐ Call my mom, please.
‐ We already have, sweetheart.

Shoot, someone call
housekeeping.

Amira, can you call ortho

about the trimalleolar
in four?

‐ You gonna be able to walk?
‐ Yeah, I'm good.

No, I'll pull
the car around.

Water's all hooked up.

Oh, finally.

Somebody's gotta sign this.

Dr. Greene, would you mind
signing for the water?

Sure, why not.

Does this mean
the water's turned back on?

Not yet.
Gotta check the pressure.

I'll be in the ambulance bay.

Hey, Dr. Greene,
can we page

an individual beeper
on the code team?

If you know the number.

Isuprel's down
to four mikes per minute

less than 50cc's
from the mediastinal tube.

‐ Wow.
‐ What?

It's weird, there's
someone else's heart

keeping her alive right now.

‐ Yeah, kind of cool, huh?
‐ Yeah.

Makes you wanna
be a surgeon?

Vent settings?

Tidal volume,
700, AC of 14

FI 02.5.

Shouldn't she be breathing
on her own soon?

General anesthesia lasts
longer in some patients.

Dr. Benton, her gaze is
deviated to the right.

Valerie, squeeze my hand.

Kit, we're going to CT.
Call radiology.

Lucy, unhook her.
Let's bag her, let's go.

'Come on, people, let's move.'

You sure you paged
the right number?

I hope so.

He's coming, he's coming.

[laughing]

Aah.

Oh, my God.

Oh, my God, John.
Are you alright?

[groans]

‐ Are you alright?
‐ Yeah.

Now that's a ten.

[laughing]

Looking good there, Carter.

‐ So, no code?
‐ Hmm, no code.

[chuckles]
You okay?

That's very funny.

‐ I could have killed myself.
‐ Oh.

It's payback time,
just take it like a man.

‐ Payback for what?
‐ For blackmailing me.

I admitted Mrs. Duffy.

‐ Really?
‐ You're surprised.

You think I'm so heartless
I'd ship an old lady

to a nursing home
against her will?

I thought you were heartless
to discharge her the first time.

Oh, John, if I were really
heartless I wouldn't bother

to tell you that you've got
toilet paper stuck to your shoe.

[laughing]

[loud crash]

What was that?

Somebody help.

What happened?

He was trying to put
our stuff in the trunk.

We should move him.

No, not until we get
a backboard and a c‐collar.

Yeah, looks like a flail chest.

Malik, go get an airway kit,
and get Dr. Greene.

You got it.

Tell the driver
to turn this water off.

I thought I had
it in first gear.

Just went backwards.

‐ He's not moving much here.
‐ My God, I'm sorry.

Don't worry, bud, we got it.
Just stand back.

This guy's going to need
a couple of chest tubes.

Hey, I'll intubate.
Eight‐o tube.

Michael, you need
to wait out here.

(Chen)
'I'm losing the pulse.'

(Greene)
'Okay, set up
the rapid infuser'

'and prep for
a thoracotomy.'

Decreased breath
sounds bilaterally.

Prep both sides of the chest.

‐ He just backed into him?
‐ Yeah.

Actually pinned him up
against the water trough.

‐ Tachy at 128.
‐ Pressure's down to 70.

Let me have the ten blade.

Set up two thoraseals
and two suction lines.

Okay, I'm in.
Bag him.

32 French. Let's go.
Let's go.

Curved Kelly.

Pulse ox dropping
to 82.

‐ Okay, mine's in.
‐ Hook it up.

‐ Uh, chest tube.
‐ Thoraseal's not bubbling.

Pressure's down to 60.

Hold on.
There's no suction.

Alright, try the other one.

‐ Nope.
‐ What's going on?

Wall suction's generated
by the flow of water.

No water, no suction.

Chuny, go to the central
and get a portable suction.

‐ Run.
‐ I'm in.

Pulse ox, 75.

'Systolic's 50.'

We need to re‐expand his lungs.

Yeah, we're waiting
on suction.

What about, uh, what about
that vacuum cleaner?

What?

The guy was
using it at admit.

‐ Lydia.
‐ Got it.

We'll need something
to make a seal.

Something like clay.

Merocel sponges.

We'll need about 20 of them.

He's bradying down.
Amp of atropine.

‐ Get the crash cart.
‐ Found him.

He was just down the hall.

Bring him down here
and give me some water.

Lost his pulse.
We're in PEA.

Okay, amp of epi.

Start chest compressions.

Sats are down to 72.

Pour it.

Keep going, keep going,
keep going.

Okay, okay, here we go.

Hold compressions.

[machine whirring]

Yep.

I hear breath sounds.

Pulse ox up to 85.

Ninety two.

Good save.

‐ Dr. Romano‐‐
‐ Just a second, Ms. Knight.

[indistinct chattering]

Thanks, Peter.

It was a stroke?

Yes.

They tried streptokinase
couldn't open up the vessel.

‐ Can she recover?
‐ The truth?

She's in a permanent
vegetative state.

‐ It was the LVAD, wasn't it?
‐ We don't know that for sure.

‐ Threw a clot to her brain.
‐ Don't blame yourself.

This is not your fault.

I'm the one who put
the thing in, remember?

We make these medical
decisions all the time.

Nothing is risk‐free.

I better go talk to her mother.

Yeah.
No, hold on.

Uh...Unos has identified

a potential recipient
in Milwaukee.

What are you talking about?

A domino heart procedure.

We take out
Valerie's new heart

and give it to someone else
who needs it.

You need to get consent
from the family.

‐ But she'll‐‐
‐ She's already dead.

‐ Hey, where's he going?
‐ Four east. ICU.

Right, thanks.

‐ Is he gonna be okay?
‐ We'll see.

You wanna tell me
what happened?

He asked me to pop the trunk
so he could put the bags in.

I was trying to pull forward
to give him room.

I thought I had it in first.

You went backwards.

I'm not used to
driving a stick.

Thought they had to admit me
for hypothermia.

Do you wanna use this?

I'm okay.

Cool trauma.

Yeah, it's not so bad
when two doctors work together.

Assist the patient,
come up with a plan of action.

John, are you still angry
about the way

I handled Louise
and Mrs. Duffy?

No.

Then you're mad
about the practical joke.

No, I like a good
joke now and again.

You know, I'm just disappointed
that you couldn't

come right out and admit
that you made a mistake.

That your way of dealing with it
was to devise some silly gag.

You're right.

Things will go a lot easier
for you around here

if you just deal
with things honestly.

John...thank you.

Oh, and, um, no more
practical jokes.

That's a good idea.

She said yes.

Hey, Lucy.

I'm sorry.

[machine beeping]

Dr. Chen, I got X‐rays
on that belly pain in one.

Finally.

Water's been back
for almost an hour.

‐ What takes them so long?
‐ I don't know.

‐ Oh, my God.
‐ What?

My patient ate nails.

Chuny, call OR and get surgery
down here right now.

What are you doing?

[laughs]

So, you made it
through the day, huh?

‐ Just about.
‐ Carol, good to have you back.

Thanks.

You're lucky to be alive,
you know that?

Hey, Malucci,
what did you do?

Uh, nothing, chief.

It was just
a sucker punch bar fight.

Any broken bones?

Short a few brain cells,
but otherwise okay.

Okay, guard with your
left next time.

Right. Thanks, chief.

So, anyway, I go in, I tell
them I have a sore throat.

Guy doesn't even
look in my mouth.

Dipyrone.

FDA banned this
20 years ago.

It gets better. Then he brings
out a vial and a syringe

wants to give me a shot.

‐ Chloramphenicol.
‐ You didn't.

What do you think? I'm stupid.
I grabbed the vial and I ran.

That's pretty much when things
got a little violent.

Hope it was worth it.

I got evidence now.
They're going down.

Hey. Excuse me, Cleo,
you got a minute?

Sure.

Hold that.

So, you, uh, you going
to be able to get off?

Yeah, looks like it.

You wanna go
grab some dinner?

Where you guys going?

Actually, it's just
you and me.

What happened
to everybody else?

That's what I was
trying to explain.

Peter, you asking
me out?

Yeah.

‐ What do you think?
‐ He's pretty shaken up.

Yeah.

‐ He had a seizure?
‐ That's right.

Well, they revoke your driver's
license for seizures.

‐ You cleared him to drive?
‐ He doesn't have epilepsy.

Too much asthma medicine.

But he didn't have any in his
system when he left.

Okay, anything else
I should know?

No, that's it.

Okay, thanks.

Hey, everything okay?

Police seem satisfied
with your story.

Guess you got
what you wanted.

How's that?

I'll be safe at home tonight.

Social worker's
gonna be around.

Why don't the three
of us talk?

No.
No, I'm alright now.

Dr. Greene, your pops
is on line two.

He locked himself out
of your apartment.

Okay, Malik.

Thanks, Dr. Greene.
I appreciate your encouragement.

Lucy, you look like
you're freezing.

What?

It started snowing

and you look like
you're very, very cold.

I am.

‐ No, no, that's okay.
‐ No, come on.

I'm European.
We like to be gallant.

Thanks.

So, are you off?

I've got two tickets
for the circus.

No, actually,
I'm just coming on.

Then what were you
doing here all day?

Not enough,
as it turns out.

It's never been very
easy for me to be here.

Sometimes, I felt like
I would never fit in.

That's something
I know about

but then I've moved
around a lot

and now
I'm used to it.

But at the beginning
of every day

I've been grateful
that I'm walking in here

of my own choosing.

I'm not carried in
on some gurney.

And at the end of every day,
if I have helped just one person

it's been worth it.

And that didn't happen today
and that makes me sad.

Hey, your day
is not over.

Maybe this is
your one person.

I doubt it.

Yes, but, uh, let's see
if I'm right, huh?

And miss the circus?

You know what? I've had
enough circus for today, huh.

Come on.

What have you got?

Paul Galinski, 36,
put his snowmobile into a tree

ejected with multiple
facial fractures.

Tried but couldn't tube him.
Too much blood.

He's all yours.
You can intubate.

Looks like
a difficult one.

Yeah, I'll talk
you through it.

You ever use
a trach light?

‐ No.
‐ Okay, I'll show you how.

[instrumental music]

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