ER (1994–2009): Season 6, Episode 12 - Abby Road - full transcript

[siren wailing]

One minute I'm freezing,
the next I'm burning up.

I can't keep
anything down.

Sir, it's probably the flu.
It's going around.

I got body aches,
nasty cough.

I really need
to see a doctor.

[sneezes]

Have a seat. We'll get
to you in a minute.

That's what you
said an hour ago!

[coughing]

‐ Hey, I need to go home, chief.
‐ Forget it, Malucci.



‐ We're shorthanded as it is.
‐ No, really.

I just puked up my breakfast.
I got to go.

So did half the
radiology techs.

I got a fever, alright?
Feel my head.

Feel your own head.

Well, cold and flu season
has hit with a vengeance.

Yes, take your pick.

Fever, sore throats

runny noses, assorted aches
and pains, vomiting..

Why don't these
people go home?

Well, my point exactly.
I got it coming out both ends.

Thanks for sharing, Dave.

Okay, the lab
is backed up.

It's taking four hours
to get a CBC.



They're 40 behind
in triage.

You look awful, Kerry.

Yeah, and I look
better than I feel.

No telemetry beds.
We're boarding seven patients.

Carol called in two
registry nurses.

God only knows when
they'll get here.

[coughing]

Nasty cough, Kerry.
You should see a doctor.

I should, too. You don't want me
exposing the patients, do you?

Take some Imodium.
Wear a mask.

[groaning]

Did you touch
the thermostat?

No, I just cleaned out
the sediment.

‐ Morning, Mark.
‐ Morning.

Did you let
the faucets run?

Yeah, for like, ten minutes.
It was freezing cold.

I had to boil
water on the stove

and wash my hair
in the sink.

'I'm going to have to
call a plumber now.'

No, no, no.
Let‐let me look at it again.

A plumber will want
to sell you a new one.

It's old, not dead.

What?

Kovac is fixing
your water heater?

Well, trying to fix it.

He was dropping
me off, Mark.

‐ Oh.
‐ From work.

I was complaining about it
making some noise..

Anyway, why am I even
explaining this to you?

Beats me.

No, it's not
what you think.

And what am I thinking?

I don't know,
but it's not.

It's not what?

It's not anything.

‐ If you've got the flu..
‐ Excuse me.

It's too late
for a flu shot!

Uh, excuse me,
my name is Abby Lockhart‐‐

ER, please hold.
ER, please hold.

I'm supposed to
be here tonight.

ER.

‐ Abby.
‐ Yeah.

Did they send
you down here?

Um, yeah.

Oh God, I was
wondering when

they were gonna
get some help.

‐ Carol.
‐ Hathaway!

You were my OB Nurse.
Thanksgiving.

‐ The girls. How are they doing?
‐ Oh, they're great.

Sleeping through the night.
Just not at the same time.

I don't know
how you do it.

Well, it's not easy,
but neither

is managing 36 patients

when we're short two nurses.

Coming through!

Found him in
the El station.

I asked him to move,
but he couldn't walk.

What's open, Carol?

Uh, if you can find
a bed, grab it.

[vomits]

Sorry, sorry.

Somebody call housekeeping.

Yeah, great. Med students,
they think we're their maids.

‐ We are so swamped.
‐ Right, but actually‐‐

Carol, can you send
Mr. Sranski up for a chest film?

‐ Who's Sranski?
‐ Flu patient.

Oh, that helps.

We're gonna need to
get you some scrubs.

Haleh, do we have
any extra scrubs?

I don't know
and I don't care.

We really do get along.

Hey, Carol, you
believe in zombies?

‐ What?
‐ "Night of the living dead."

Human cadavers walking the
earth after they've died?

No.

Then what's Earl Cartesh's body
still doing in exam one?

I called transport.

What do you want
me to do about it?

Piggyback him to the morgue.
I need the bed.

Residents, they're the only
thing worse than med students.

‐ Right.
‐ Could somebody take this?

I've been waiting
for five minutes.

‐ Did you call ahead?
‐ Yeah.

Todd Sullivan, five
of the Sledding Sullivans.

Good vitals but he took a nasty
header while sledding.

‐ Mom's on her way.
‐ I lost my teeth!

Oh, sweetie,
don't worry.

'I bet they were just
your baby teeth.'

'Hey, Malik,
can you call a doc?'

Yeah, right.
Good luck.

He's avulsed
his front incisors.

We need a C‐spine
and a head CT.

Yeah, if we can find
a doc to order it.

‐ I could do it.
‐ What?

Med students work up
patients, right?

‐ Yeah.
‐ I'm a third‐year.

I start my
ER rotation today.

You're a med student?

Yes.

What can I say? I crossed
over to the dark side.

[theme music]

[music continues]

[music continues]

His facial films are clear
and I paged

an oral surgeon to come
down and take a look.

Luka, do you want me
to update his tetanus?

He had one a year ago.

Uh, guess not.
By the way, I'm Luka Kovac.

Abby Lockhart.
I'm a third‐year.

Another new resident
in the middle of the year.

‐ Well, I'm a med student.
‐ Oh.

Another half
gram of Ancef?

Um, Abby?

Uh, sure.
Sounds good.

Okay, nice job.

Well, we never had doctors
like that up in OB.

‐ Easy on the eyes, isn't he?
‐ I'll say.

Is he single?

He doesn't talk about
his personal life.

Oh. Tall, dark,
handsome and mysterious, huh?

‐ What are you doing?
‐ Cleaning up.

‐ Oh, don't worry, I got it.
‐ Don't be silly.

No, really.
I got it.

Okay.

Um, Carol.

I'd love to see some pictures
of your girls later.

Sure.

He has to take his blood
pressure pills every day.

Well, sometimes
he forgets.

Well, maybe
you can remind him.

S‐sometimes I forget.

Well, maybe you
could put a note

on your medicine cabinet
to remind you.

That's a good idea.

I'll try
to remember that.

Hey, Mark.
I‐I'm feeling horrible.

Could you cover the rest
of my shift?

Must be bad. I don't
remember you taking a sick day.

Well, I'd rather
die at home.

Oh, and we have
a new medical student.

Make sure she doesn't
kill anyone.

Hey, Malucci,
leave her alone.

‐ Abby?
‐ Give me a break, chief.

Yeah, suck it up.

Abby Lockhart, third year.

‐ Mark Greene, attending.
‐ We've met.

Good, good, I'll
see you tomorrow

if I live
through the night.

So she wasn't
hallucinating?

‐ No, I'm a med student.
‐ And an OB Nurse.

Well, I take
a shift occasionally

to pay the bills.

Right. Well, welcome to the
glory that is ER.

Has anybody given you
the three‐dollar tour?

Not yet.

Well, you start here
by signing up

for your patient
on the board.

Grab a T‐sheet based
on the chief complaint.

Nurses orders go here.

Lab and X‐rays go here
for the clerk.

‐ Any questions?
‐ So far, so good.

That's curtain area one.

This is curtain area two.

That's Yosh Takata.

‐ Wave "Hi" to Yosh.
‐ Hi.

That's trauma one,
trauma two.

‐ Haleh.
‐ We've met.

Hi.
Still hurting, Todd?

‐ A little.
‐ Yeah?

Uh, we gave him
four of morphine.

‐ Can we give him two more?
‐ Why not?

‐ You sure you need this tour?
‐ Couldn't hurt.

Then, come on.
The tram doesn't stop.

You want to keep your hands
and arms inside at all times.

What have you got,
Carter?

This is Darnel Smith, 13,
with muscular dystrophy

visiting us today with
a possible forearm fracture.

What happened, Darnel?

Some loser pushed me
down the stairs.

In your wheelchair?

‐ Duh!
‐ He got into a fight at school.

‐ Cleo's got the pusher.
‐ Alright.

Well, let's keep the two
of them apart, shall we?

‐ Oh, that was Carter.
‐ Got it.

And this is the pedes ER.

It's really just
a large exam room

with pediatric equipment
and murals on the wall.

‐ Hey, Cleo.
‐ Hey.

I was going to class and he just
started freaking out on me

in the hallway when I tried
to get past him.

That's no reason to push
a kid down the steps

especially a kid
in a wheelchair.

Come on, I didn't
even push the psycho

until he stabbed me
with his pencil.

What are you looking at?

Darnel, don't be rude.

Well, the good news is
his arm's not broken.

I can't believe
one of his classmates

would be cruel enough
to do this.

Well, I heard that he
might have provoked it.

Darnel, is that true?

No.

He's been acting up lately

at home and at school.

Is he in special ed?

No, he's in
a regular classroom.

We wanted his life
to be as normal as possible.

It says here
you have cancer.

They're gonna chop off
your penis.

‐ 'Darnel.'
‐ Hey, that's enough of that!

He's just kidding.
He's just kidding.

Mrs. Henry, why don't you
go wait in chairs?

Well, I don't like to
leave him alone.

Well, I still need to check him
for other injuries.

Oh, alright.

You behave yourself,
and I'll be right out

in the waiting area if you
need anything, honey.

So, Darnel,
sounds like

you're having a little
trouble in school.

That wouldn't have
anything to do

with your muscular
dystrophy, would it?

So, suddenly,
you don't speak.

I can't feel my toes.

It looks like you have
frostbite, Mr. Clayton.

‐ Do we need to debride?
‐ Is he diabetic?

No, he has
a respiratory infection

and probably the flu
but his lungs are wet.

Hmm, the skin's pliable.

Frostbite's superficial.

Start him on
a rapid rewarm

of 105 degree circulating water
for 20 minutes, okay?

Anybody in this city
not sick?

It's like the damn
plague down here.

I don't suppose you're here to
lend a helping hand, are you?

Why mess with natural selection?

A good influenza epidemic
thins the herd.

‐ Where's Kerry?
‐ She went home sick.

And they wonder why we
call them the weaker sex.

Oh, did you, uh, book
an OR for 3:00?

Oh, yeah, I saw an
opening, so I grabbed it.

I'm assisting Dr. Ashcoff

on a facial
scar revision.

Why can't that be done
in the plastics clinic?

Multiple scars. Ashcoff wants
to do it under general.

And what does that
have to do with you?

Well, the little girl
is a patient of mine

following up on a dog‐bite
trauma from six months ago.

Yeah, so?

Well, Medicaid
won't cover it

so I got Ashcoff
to donate his time.

I was hoping that
the hospital‐‐

Whoa, whoa, whoa,
we provide

medically necessary
services to the poor.

That does not include
cosmetic surgery.

What's next,
liposuction for fat kids?

The little girl
is disfigured.

Look, Peter, I admire
your noble effort

but this is exactly
the kind of thing

that could lose our
state funding, okay?

I'm sorry, big guy.

I won't get lead poisoning,
will I?

You know, from the pencil.

They use graphite
in pencils.

Temp's 99.2.

Did that hurt?

Uh, no, no.

It's just cold.

Oh, sorry.

How did you get
these bruises?

Uh, I don't know.

Who hit you, Marty?

Some kids at school.

‐ Are you sure?
‐ Well, yeah, I'm sure.

I mean, I'm there
when they do it.

‐ Do your parents know?
‐ No.

What about the teachers
or the principal?

Yeah, so that
they can really kill me?

What's this?

Uh, mosquito bites.

In February?

They must be hungry.
You have quite a few.

[sighs]
Look, is my dad coming?

He's on his way.

I'll be back.

Get a CBC.
Chem 20 and a tox screen.

Those are infected
track marks.

‐ What exactly am I looking for?
‐ Top of page four.

I was enjoying my
first free morning in ages.

Sat down with the paper
when I spotted it.

What?

Oh, for Pete's sake!

"The university of Chicago's

"department of Astrophysics.."
blah, blah, blah

"will present a symposium.."
blah, blah.

"Guest speakers include.."

"Isabelle Corday."
Your mother.

Yes.

I see the resemblance.

I look like my father.

So you didn't tell me that
your mother's coming to town.

I didn't know.

It's so like her.

You guys having a fight?

No, no.
She's just being mother.

Now you should call her.

Of course.

I'm supposed to come to her.
That's part of the game.

Or don't call her.

I won't.
I'm not playing anymore.

(male #1)
'Get off me!'

I'll kill you!
I'll kill you!

Yeah, hold still.

Is he trying
to hurt himself?

No, he's just
freaking out.

Is he on any medication?

He's on drugs.
Looks like PCP to me.

What happened?

Jumped out of
a third‐story window.

Let me go!
I'll kill you!

He tried to
walk away from there.

Oh, he'll feel something soon.
Can you get out of the way?

What are you doing?

I wanna tape this
so he can see

what he acts like
on this stuff.

We're trying to help.

Bilateral tibial deformities.

He's broken both legs,
exposed bone.

You ever seen
an open fracture?

Not up close.

Alright, he's taching away.
Pulse is strong.

[screaming]

Give him ten of Haldol IM.
Get those restraints on.

Get that out of here.

Please, sir, can you back up
and let the doctor work?

‐ No, no, this is too good.
‐ Now!

CBC, chem panel

tox screen,
UA and a myoglobin.

I'm gonna kill you,
you bitch!

I need that Haldol now!

What do you want,
restraints or Haldol?

I got it.

Tetanus booster, gram of Ancef
and 100 of gent.

‐ Okay.
‐ Roll him.

Give it in the thigh anterior.

[panting]

Ow!

You okay?

(Elizabeth)
I'm gonna need
a culture swab.

'Set me up
for a PM splint!'

(male #1)
'Uh! Let me go.'

[screaming continues]

‐ You've had Heptovax, right?
‐ Yeah.

Patients generally
don't bite in OB.

That's occupational
hazard down here.

Serologies will
be back tomorrow.

Don't sweat it.

Bet you didn't expect to
be your own teaching case.

Well, I expected the ER
to be different but..

(Malucci)
'Ow!'

If you'd stop squirming

I could get it in.

Could you be any rougher?

Could you whine any more?

Hey, Dave, be glad

she's not putting
in a foley.

We have a tradition
down here

that once you've been
bitten by a raving lunatic

you're ready
to see patients.

I don't know.

Grab a chart, and yell
if you get into trouble.

Okay.

Carol?

Can you keep
an eye on her?

‐ Sure.
‐ Oh, and update her tetanus.

I want you to
press on my hand

like you're
stepping on the gas.

That's good.

Let's do the other foot.

You do much
driving, Darnel?

Okay.

Okay.

Now, I want you
to squeeze my hand

and if you make me scream,
I'll give you a prize.

Give me a break.

He speaks.

Okay, come on.

I wanna see if the MD's
affecting your body.

Duchenne's muscular dystrophy
is an X‐link genetic disorder

characterized by
the progressive wasting

of skeletal muscles.

First you lose your legs,
then your arms

and then you die.

That's how it's
affecting my body.

I want you to hold
his head still.

I'm sorry, he's just
gotten to the point

where he really
hates hospitals.

It's okay, Conner.
Don't be afraid.

We wanna make you better.

He's really a good‐natured
kid, you know

'considering everything
he's been through.'

What kind of surgery
has he had?

He had
a Nissen fundoplication

for gastroesophageal reflux.

He's had a hemicolectomy

and a few laparotomies
for adhesions.

When did he start vomiting?

This morning.

Mucous membranes
are moist.

Were you feeding
him orally

or through his G‐tube?

Well, I gave him a little bit
by mouth last night

but not enough
to induce this.

I'm praying it's
just the flu

but...I'm afraid he's got
another bowel obstruction.

Abby, can you get this?

We have a foreign body
ingestion in exam two.

Sure, just a sec.

‐ Luka.
‐ Hm.

Can I steal
Abby from you?

We're really backing up
out there.

Yeah, it's okay.
Go ahead.

So what do you
think it is?

I'm not sure.

We'll have to take
some X‐rays first.

Carol, uh, can I
get a weight

and a three‐way
abdominal series?

Sure.

‐ He dehydrated or something?
‐ How'd you guess?

Jeremy Barnes, three days
of abdominal cramping

some diarrhea, maybe
a low‐grade fever

with a history of a triple‐A.

How are you
feeling, sir?

Lousy.

Mm‐hmm.
Any vomiting?

No, but I feel
real nauseous.

When was your
aneurysm repaired?

Uh, year and a half ago.

Any complications?

No complications.

I was feeling great
until last week.

Belly's benign.
It's just the flu.

Thank you.

You're welcome.

Maybe he's
telling the truth.

Kids his age, school
can get kind of rough.

This isn't roughhousing.

He has skin‐popping abscesses.

Get a tox screen?

It's negative.
Only the white count's up.

‐ He's clean.
‐ You can't be sure.

Tox screen doesn't
cover everything.

What are you thinking?

I don't know,
but maybe you

can bluff it out of him.

‐ Lucy, you okay?
‐ Somebody stole my patient.

Peter, did you steal
Lucy's patient?

Check the lost and found.

Dr. Benton?

‐ Hi.
‐ Mrs. Fulton.

I took Tia up to
surgery to register

and the nurse said she can't
have her operation today?

Uh, you know, actually,
I tried to call you.

Please have a seat.

Um, there's an availability
problem in the OR.

Mm‐hmm. Did Dr. Ashcoff
change his mind?

No, no, no, no, no.
We just have to reschedule.

Well, we came all
the way down here.

We can wait.

Tia hasn't eaten in
eight hours, like you said.

We can't...do it today.

I'm‐I'm sorry.

I'm not gonna
get 'em fixed?

You waited this long.

A few more days
isn't gonna hurt.

Hold on a minute, honey.

Can we..

It has taken me months

to get Tia to
step out of the house.

I can't give her
false hope.

Now, if this
isn't gonna happen

you need to tell us.

It's gonna happen.

I just need a little
time, that's all.

Thanks.

Mr. Barnes needs
five of Compazine.

Then run a liter
of saline through

and check his electrolytes.

Can't you get
a nurse to do that?

Rumor has it you
used to be a nurse.

Well, that's not
why I'm here.

You're absolutely right.
You're here to learn.

And this is a
great opportunity

for you to learn
how to check

his stool for
fecal leukocytes.

Thanks.

What's his pulse ox?

Down to 82.

And how much O2
is he on?

Ten liters.

The flu is making it
difficult for you to breathe.

[mumbling]

It ain't just the flu.

No, you also have
what's called

congestive heart failure,
and we need to put

a tube down your throat
to help you breathe.

No.

Thank you.

Do you have someone
we can call?

No.

All my friends
is homeless, no phones.

Any family?

No.

Okay.

I really think you need
to go on a ventilator.

No.

Thank you.

Always hoped I might
die in a warm bed

with clean sheets,
if it's all the same to you.

X‐rays show nonspecific
bowel gas pattern.

So it's not
another adhesion?

‐ Right.
‐ Blood gas is back.

PH is 7.38,
PCO2 is 30.

Ah, is it respiratory alkalosis?

Partly, but also an acidosis.

It's, it's complicated.

Are you a nurse?

Oh, no, I've just
read every book

and every internet article
on Chalasia.

Last time, did they
do an upper GI?

Six months ago.

They thought he might have
a gastric outlet blockage.

Why, you're not gonna have
to do that again, are you?

It's the only way to
rule out an obstruction.

Oh, no. Please.
It was horrible.

He couldn't swallow
the barium.

And they had to put
an NG tube up his nose.

He wouldn't stop crying.

Mrs. Brant, I know Conner
has been through a lot

but he has a severe
metabolic disorder.

And we‐we have to find out
what's making him sick.

And I'll be
as gentle as possible.

Okay?

Okay.

I'll be back.

What?

You tell me.

Nothing.

We tested your
blood, Marty.

Yeah?
So?

So where do you get
the dirty needles?

What do you mean?

Marty, I know.

Look, you can't tell my dad.
Please.

I mean, he's not
gonna understand.

You can't use
dirty needles.

You're getting an infection

and if you share,
you could get HIV.

‐ Do you know what that is?
‐ Yeah, yeah.

Don't even worry.

I stole them
from my grandmother.

She's got diabetes.

Why are you doing this?

Kids with crooked teeth
get braces.

And my mom got
laser surgery on her eyes.

Now why can't
I use hormones?

For what?

To grow taller.

You're injecting
human growth hormone?

Where do you get it?

Look, it's not illegal.

You can't get HGH
without a prescription.

Where do you
get it, Marty?

[sighing]

Off the internet.

Then you don't even
know what's in it.

Do you have any idea
what sort of health risks

you've exposed yourself to?

Well, it can't be any worse
than being beat up every day.

I mean, even that stupid kid
in the wheelchair

thinks that
he can pick on me.

Look, if you can get me
the real stuff, I‐‐

Hormone therapy is for
kids who have problems

not for healthy adolescents.

Yeah, well,
I'm not healthy.

You know, I go
to school every day

knowing that
I'm gonna be beat up

or shoved into a locker

or dragged into
the girls shower room.

Do you have any idea

how embarrassing it is
to be stuffed inside a trash can

while the whole cafeteria
is laughing at you?

Hormones aren't going
to help that.

[sobbing]
Yeah?

Well, being bigger will.

[machine beeping]

‐ Hi.
‐ Hi.

‐ You okay?
‐ Oh, yeah.

Have you seen
the Cetacaine?

No.
I haven't used any.

I always keep it
on this counter.

‐ Sorry.
‐ Oh!

Um, Carol..

...are you uncomfortable
with my being here?

Why would I be?

Well, I know sometimes
it's hard for nurses

when nurses
go to med school.

Kind of like
I switched teams or something.

I think I wanna be sick.

No, you know, actually, um

I almost went
to med school myself.

Is it something else?

It's just stupid.

Oh, my God.

Mr. Barnes?
Have you had an ulcer?

Oh, God,
what's wrong with him?

I don't know.
Uh, prep the suction.

‐ I'm gonna go get a doctor.
‐ Okay. I, uh..

‐ I‐I need a Yankauer.
‐ 'Top drawer.'

Peter!

I'm gonna start
a line.

‐ Check his BP.
‐ What is it?

Uh...he had some Compazine.

He just started vomiting
bright red blood.

‐ Okay, what's the history?
‐ Um, uh, looks like a triple‐A.

I‐I think he came in
with nausea.

‐ You think?
‐ He's not my patient.

Okay, here we go.
Here we go.

Alright, set me up
for a central line.

Carol, squeeze in two liters.

Give me four units O‐neg.

‐ Type and cross for eight.
‐ What's wrong with him?

He's bleeding out
through his GI tract.

Come on, somebody
call the OR.

‐ What the hell happened?
‐ 'Aortoenteric fistula.'

(Peter)
'We need an airway.'

Shouldn't we get him
to the OR?

‐ 'No, just tube him.'
‐ Eight‐O‐E‐T.

‐ Ah, damn it.
‐ 'Come on, Malucci, now.'

Why wasn't he
sent upstairs?

‐ Corday said "It was the flu."
‐ His pulse is weak.

BP's 50 palp.

He'll never make it up to OR
unless we stop the bleeding.

Alright, line's in.
What's your name?

Uh, Abby Lockhart.
I'm a med student.

‐ Can you sew this?
‐ Yes. Me, yes.

Uh, just an
interrupted suture?

I don't care as long
as it doesn't pull away.

Let's move.

Uh, prep his belly for a lap.

Uh, you can't do a
laparotomy down here.

We don't have a choice.
Scalpel.

Alright, I'll do
a small midline incision

and clamp below
the diaphragm.

‐ You got that?
‐ Almost.

Alright, let's go.
Let's move.

Pressure's up to 90.

This should hold him,
till we get him upstairs.

Call the OR.
Tell 'em we're on our way up.

Two units of O‐neg in.
I need more.

Operating in the ER, Peter?
Shame on you.

He had an
aortoenteric fistula.

Then why the hell didn't you
admit him to surgery?

Because he presented
with flu symptoms.

Yeah, this look like
the flu to you‐‐

‐ Uh, what your name, Malatucci?
‐ Malucci.

No, but the patient was bleeding
out and if it wasn't for‐‐

Yeah, yeah, yeah, save it for
the disciplinary hearing, kid.

Peter, let's get this guy
up to the OR

before you use up the rest
of our blood supply.

You got to admit, that was

that was pretty cool.

[telephone ringing]

Can I go home now?

Not just yet.

I want you to try
something first.

What?

A computer.

I've seen one or two.

I was thinking
maybe you were having

trouble at school,
'cause the MD's

affecting your
motor skills..

Wrong.

In which case a computer
might help you

keep up with
the other kids.

Who says I want to?

The school's full of losers.

Oh, well, come on.
Just give it a try.

Oops.

‐ Feel better?
‐ A little.

You wanna smash
something else?

Maybe.

Is that the best
you can do?

[panting]

[metal clanking]

Here.

Yeah, that's it, that's it.

[panting]

Now, let me see you
write your name.

[exhales]
Why are you doing this?

I'm trying to help you.

[sobbing]

I'm tired of people tryin'
to help me all the time.

I can do things
for myself.

People tryin' to help you
too much sometimes?

[crying]

I don't need to
be pushed around.

I don't need to
have my food cut.

I don't need my mom giving me
a freaking bath all the time.

I'm not a baby.

No, you're not.

I'm gonna go
talk to your mother.

'Why don't you clean this up?'

[metal clanking]

Me?

(Carter)
'You helped me
make the mess.'

'You can help me
clean it up.'

Okay.

[sniffling]

It's okay, honey.
He's almost done.

There, no more.

Luka, I need to talk
to you for a minute.

Hold on. I have to
give the contrast.

It'll just take a second.

Okay...I'll be right back.

Good boy, good boy.

Yeah, good boy, honey.

I tried contacting
his pediatrician.

‐ Mm‐hmm.
‐ He doesn't have one.

It seemed kind of weird
to me for a kid this sick

so I called around.

I called Northwestern,
Rush, Mercy.

Conner's been admitted
to all three ER's

several times,
multiple admissions

several laparotomies.

I know.
I've seen the scars.

Yeah, but he's only ever
really needed surgery once

for his fundoplication.

All the rest were
exploratory procedures

and they didn't
find anything.

He has
a metabolic disorder

and he is still
at high risk

for adhesions
and obstruction.

But nobody has been able
to document anything

since his first surgery.

I know, but something's
making him sick.

Have you thought
about the mother?

Yeah, what about her?

Well, maybe she's intentionally
inducing his symptoms.

[scoffs]
Carol, she's done
everything she can

to find out
what's wrong with him.

‐ Maybe she likes the attention.
‐ "Attention?"

You mean, she'd hurt her
child for attention?

I've seen parents
do it before.

Okay, how? I mean,
how is she doing this?

I don't know.

Yeah, but you can't say

this kind of thing
without proof.

What happens when
his upper GI

is negative,
CT Shows nothing?

Are you gonna admit
him for surgery?

[exhales sharply]

I've just started
the workup, okay.

G‐g‐give me a chance
to figure it out.

Will you just consider it?

Yeah, I‐I'll consider it.

Okay.

There's nothing
wrong with him.

He's being abused
by his classmates.

So he needs to learn
to fight back.

That's not a solution.

Look, Dr. Finch,
my son's short, so what?

I'm short..

...and, yeah,
I got picked on.

But I learned to deal with it
and so will he.

How? By injecting himself
with God knows what?

That's not gonna
happen again

I can assure you.

Dr. Finch, Marty spiked
a fever of 103.

How are you
feeling, Marty?

[sighs]
Pretty crummy.

What do you expect after pumping
that crap into your body?

Have you had
a fever recently?

Last week,
he had the flu.

There's a pansystolic murmur.

What does that mean?

Has he had a heart
murmur before?

‐ No.
‐ He's got splinter hemorrhages.

(Dorset)
'What's going on?'

(Chuny)
'Yosh, get three sets
of blood cultures.'

We'll start him on
pen, ox and gent

and order a cardiac echo.

‐ 'Okay.'
‐ Is there something wrong?

The needle you kept using
may have put bacteria

into your bloodstream..

'...causing an infection
of your heart.'

Mr. Spencer,
I'm Abby Lockhart.

I need a private room.

‐ I don't think we have any.
‐ Well, there should be.

With this flu epidemic this
place is one big petri dish.

Would you take
a deep breath?

What if somebody
comes in here with TB

or leprosy or something?

What seems to be
your problem today?

‐ I think my pulse is thready.
‐ Really?

My stomach's upset,
my chest feels tight

I'm fatigued.

Ah, my head is pounding

and I can barely
hear anything.

Do your stools glow
in the dark?

What?

Your ears are full
of wax, Mr. Spencer.

Oh, man.

I read somewhere
you can get that

from food additives
or environmental toxins.

‐ I can clean them out for you.
‐ How do you do that?

I was told never to put
anything in my ears

smaller than my elbow.

But, we use a special drill.

‐ A‐a drill?
‐ I'm kidding. I use peroxide.

Mrs. Brant,
radiology's ready.

Okay, okay.
Here we go, sweetie.

What about
my palpitations?

‐ I think I need an EKG.
‐ I'll try to find one.

Carol, where's
the EKG Machine?

Uh, try the trauma rooms.
Do you need me to draw labs?

Nope, I got it.

Uh, we can wheel him out
on the gurney.

No, I'd rather carry
him if that's okay.

Okay, sure.

Dr. Romano, I'm still
on shift downstairs.

Yeah, well, you should
have considered that

before you decided
to turn the ER

into your own private
operating room.

But I'm not doing anything here.

It won't kill you to observe
once in a while, Peter.

You obviously still have
a few things left to learn.

Somebody turn down the heat.
It's a hundred degrees in here.

(Hathaway)
The thermostat said "68."

Maybe you're coming down
with the flu.

I don't get sick.

Maybe you're going
through the change.

‐ Debakey clamp.
‐ I can finish up if you'd like.

What I would like is
for you to stand there

and shut up while I try
to save this man's life.

Suction.

What did you find?

No obstruction.

The study was negative.

[sighs]
So, what do we do now?

We should do a CT Scan.

What about endoscopy?

I don't wanna push
your son through

another invasive procedure
if I don't have to.

[sighs]
Okay, but I feel
we're wasting time.

Shouldn't a surgeon see him?

After the scan.

[exhales sharply]

[whispers]
It's gonna be okay.

Sat's down to 78.

Put him on a 100 percent
non re‐breather mask.

Mr. Clayton,
is there anything else

'I can do for you to make
you more comfortable?'

[exhales deeply]

[machine beeping]

My lunch box.

This?

[panting]
There's $118 in there.

Give it to my friends.

Is there a specific shelter
you want it to go to?

[inhales deeply]

Oh, just...throw it off
the roof.

Throw the money off the roof?

Yeah, they‐they'll find it.

Conner's GI Series
was negative.

You seem surprised.

After you said that
about the mother

I was hoping to find
something wrong with him

but, uh...she wants
an endoscopy.

Almost seemed disappointed
when I wanted to wait

and, uh, I‐I think
you might be right.

Is this gonna hurt?

No.
It's just peroxide.

You might feel
a few bubbles.

"Bubbles?" What if they get
into my bloodstream?

‐ I could get an embolism.
‐ That's not gonna happen.

Um, I forgot a curette.
I'll be right back.

What about my chest pains?

Your EKG was normal.

Yeah, but that doesn't rule
out unstable angina.

Maybe I should have
a stress echo.

I don't think that's
going to be necessary.

Uh, what is
the sense of having

all this
sophisticated technology

if you die before you get
a chance to use it?

'Hey!'

Sorry about that.

That's okay.

How's he doing?

Oh, uh, well,
not so good.

It's the same story.

Lots of tests
and they can't figure out

what's wrong with him.

Well, I'm sure Dr. Kovac
is being as thorough‐‐

Did he call for a
surgical consult yet?

I don't know.
I could check.

‐ Would you?
‐ Sure.

(Romano)
Another 3‐0 prolene.

'Get that rake
out of my way, please.'

Oh, man!

‐ Are you sure you're okay?
‐ Yes.

You just spent
the last 20 minutes

over‐sewing
the duodenal defect.

Well, there's no substitute
for precision, Peter.

Lizzie, come to join
the party?

I heard Mr. Barnes eroded
his aortic graft.

Is he a friend of yours?

Well, I evaluated
him downstairs.

I thought he
had gastroenteritis.

Really? Peter,
you never mentioned that.

How valiant of you to not
have ratted Lizzie out

on her gross oversight.

‐ How's he doing?
‐ 'Fine.'

Now that he's been
competently diagnosed

and brought to
a proper operating room.

Peter, you're dismissed.

‐ Lizzie, scrub in.
‐ Well, I'm off, actually.

No, actually, you're not
anymore. Give me a peanut.

I'm gonna dissect the small
bowel off the aorta now.

You'd be better off
using a metz.

Peter, I'd quit while
I were ahead if I were..

Ow!
Damn it!

‐ Robert?
‐ I'm fine.

Robert?

God, he's burning up.

I got this.
Open up a new tray.

‐ Let's get metz and a pick‐up.
‐ Somebody get a gurney.

He's gotta weak pulse,
tachy at 140.

The suction.
3‐0 prolene.

Let's get ready.

You're not afraid
you'll catch cold?

Hey, if I haven't
caught one by now.

They're not stacking up
again, are they?

No, I think it's over.

Did you figure what was
wrong with that kid?

Yeah, he got tired
of being short

so he injected himself
with bogus growth hormone.

Of course. Why didn't
I think of that?

His echo shows vegetation's
on his mitral valve.

Endocarditis?

Kept reusing grandma's
insulin needles.

What did cardiology say?

They admitted him.

Put him on triple
antibiotics.

Hopefully I caught it
before he needs surgery.

Oh!

All that for a
couple of inches.

Yeah.

You're releasing too early

when you shoot.

Oh, why don't
you show me?

You don't want
any of this.

‐ Oh, I don't?
‐ Trust me.

Okay, show me
what you got.

[laughing]

[grunting]

‐ What is it?
‐ I don't know what's wrong.

‐ His stomach is distended.
‐ Give me a syringe.

I told you to call a surgeon.
He's getting worse.

W‐w‐what are you doing?

Hold on.

(Brant)
'Oh, my God, what is that?'

‐ 'Is he bleeding?'
‐ No.

It's an indicator,
mixed with saline.

Turns red in stomach acid.

What are you talking about?
That's not mine.

That belongs to the doctor
or the nurse..

Whoever it was,
she left it here.

Well, actually,
we had her leave it.

And it's not peroxide,
it's saline.

I don't know what
you're talking about.

Oh, yes, you do,
Mrs. Brant.

You've been
poisoning your son

'and this proves it.'

Okay, okay, wait.
Stop, stop.

I didn't give you permission

to do any of this.
We are leaving.

No, I'm afraid you are not.

I can't allow you
to keep hurting him.

I love Conner.

I would never hurt him.

Mrs. Brant, you need help.

Oh, God.

[whispers]
Okay, sweetie, it's okay.

It's okay, sweetie.

They're not gonna hurt you.

Mommy has you.

Mommy has you, honey.

'It's okay.'

Amira, call transport.

Mr. Clayton in exam one
needs to go to the morgue.

That old guy died?

From the flu?

Went into
respiratory failure.

I knew I should have
gotten that flu shot.

(Malucci)
'Someone give you a tip?'

‐ He had a daughter.
‐ Who?

My homeless man who died
told me he had no family.

And what? You the executor
of his estate?

Something like that.

‐ Hey, Abby.
‐ Hey.

Did you know it's
a tradition for the residents

to take out their students

for a drink after
their first day?

I thought you were sick.

Well, maybe you could
nurse me back to.. Whoa!

Wow.
You, you look, just, wow.

Uh, y‐you know..

What, you have a
date or something?

Maybe.

Excuse me, you're
drooling on my chart.

Sorry. Um..
So..

Yeah.
How about that drink?

You're kidding, right?

‐ How's he doing?
‐ Grouchier than ever.

He has a kidney stone.

Uh, you're kidding.

Not as big as we'd like,
mind you.

He won't need surgery.

Passing through
the old plumbing.

That can't be
a lot of fun.

Thanks for trying
to cover for me.

You didn't have to,
but I really appreciate it.

Anybody could
have missed it.

I hope so.
My mind was elsewhere.

Yeah. Well..

‐ So, you're going in to gloat.
‐ Oh, yeah.

[laughing]

I wouldn't take
too much glee in this

if I were you, Peter.

No, no, no,
I just came to tell you

that Mr. Barnes
is, uh, stable in recovery.

It's a good thing I was
observing when this happened.

I suppose you think this means
I owe you somethin'.

I'll settle for
a "Thank you."

How very gracious
of you, Peter. Thank you.

And the OR time
that I need

for the little girl's
facial surgery.

Look, you finished a repair
and closed for me. Big deal.

I don't understand
how you could be against

a little girl getting
her face fixed.

This is my job.

If word gets out that
I do favors for you

I'll have to do
them for everybody..

[scoffs]

Which is why we never
had this conversation.

[machine beeping]

So that means
I can have the OR.

I don't wanna
know about it. Hmm.

Well, good luck
with that.

‐ Thank you.
‐ You're welcome, Peter.

[groaning]

Abby, thank you for
helping back there.

‐ I know it was bizarre.
‐ Oh, sure.

Did she actually
pour it down his G‐tube?

Yeah, it didn't
take her long.

I bet you were never part of
a sting operation upstairs.

‐ No, this is the first.
‐ Welcome to the ER.

‐ Abby.
‐ Yeah?

Do you have a patient
named "Spencer?"

The hypochondriac, yeah.

‐ He's having a heart attack.
‐ What?

Alright, start him
on dopamine

ten mics per kilo.

‐ Oh, God.
‐ What happened?

‐ Is this your patient?
‐ Yeah.

Did you give him
any medication?

No, I cleaned
out his ears.

BP, 70 palp.

Did he complain
of any chest pain?

Yeah, he complained
of everything

but his EKG was normal.

Not anymore. ST elevation
on the 12‐lead.

‐ He's having an acute MI.
‐ He gotta history of reflux.

There was no
cardiac risk factor.

Hemocue is six.

Hang two units
of packed cells.

He's gonna need nitroglycerin
and a heparin drip.

(Abby)
'I'll start a second line.'

V‐tach.

Charge to 100.
Sync cardio version.

Chuny can get that.
Take those.

It's your patient.

Clear.

Elizabeth.

Hello, mother.

What are you doing here?

Well, I live
here, remember?

Yes.
I meant to call you.

I just got in last week.

Oh, Elizabeth, save
me the pouty face.

I'm not pouting.

I just can't believe
you were going to travel

several thousand miles
and not call me.

Yes. Well, I'm here
now and freezing.

So if we're going to
continue this conversation

could we find
somewhere warm?

Preferably where
they serve alcohol

or have the Americans banned
that together with tobacco?

(Finch)
'Didn't anyone ever tell you
white men can't jump?'

Now, that was a foul.

Oh, I get a foul
because you tripped.

No, you hip‐checked me.

‐ Dr. Greene.
‐ What is it?

You said to call you
if I got into trouble.

Yeah?

Well, um..

[machine beeping]

He was a hypochondriac.
All his tests came back normal.

MI's don't always present
textbook symptoms.

You didn't get
a blood count.

White count was 1800.
Crit was only 18.

What does that mean?

‐ Aplastic anemia.
‐ Bingo.

Decreased oxygen
carrying capacity

is a risk factor.

You're going to need
to get hematology

down here for a consult.

They're gonna wanna
do a bone marrow biopsy.

‐ I'm sorry.
‐ No, I'm sorry.

I should have
protected you more.

It's great that
you were a nurse

but you gotta start thinking
like a doctor, okay?

You don't have
to do it all.

From now on, make sure

that the nurses
order your labs, okay.

They have a standing
order on CBC's.

‐ See you tomorrow.
‐ Okay.

I don't know
how you manage

to keep your complexion
in this city.

Wind, nothing but wind.

I don't work
on a construction site.

Oh, that's right, you cut people
up like your father.

How is Charles?

Happy. We had a lovely time
when he was in town last.

You know, daddy
stays at my place.

How delightful.

Would you like
to come and stay with me?

Whatever for?

Because I have a spare room.

Uh, because I haven't
seen you in three years.

That's not my fault.

I'm just saying,
"I'd like you to come and stay."

Alright. I agree.

I'm honored.

You do look well.

You must have a man.

Do I need a man
to look well?

[chuckles]
It helps.

So...have you?

Yes.

I suppose he's a doctor.

Actually, yes.

His name's Mark

and he's lovely.

[clucking like chicken]

Come on, chicken.

We never finished that game.

You were down
by eight points.

Yeah, well,
I was pacing myself.

‐ Goodnight.
‐ Quitter.

Alright, bring it on.

[ball bouncing]

Goodnight, Mark.

Nice hat.

[vehicles horn blaring]

‐ Hi.
‐ Hi.

Uh, you're the new
med student, right?

‐ Yeah. I'm Abby Lockhart.
‐ Lucy.

‐ Nice to meet you.
‐ How was your first day?

Um...well, let's
put it this way.

I haven't had one
of these in two years.

What happened?

It's more like,
what didn't happen?

[sighs]
I used to work in OB,
and up there

I would deliver a baby,
and then I would deliver a baby

and then I would
deliver a baby.

And today..

...I was puked on,
spit at, bit..

...and then I tricked
a psychotic woman.

And then I almost
killed a guy.

That sounds about right.

Fortunately, in the ER,
"Almost" doesn't count.

What are you doing?

Patient's last request.

Toss some.
You might feel better.

Do you have to say
a "Prayer" or something?

I don't think so.

[instrumental music]

[theme music]

[music continues]