ER (1994–2009): Season 6, Episode 20 - Loose Ends - full transcript

[sighing]

(David)
'Mark..'

'Mark, I'm cold.'

Alright, dad.

I'll get you a blanket.

Did you get any sleep?

‐ You look awful.
‐ I'm fine.

I need to turn up
your oxygen, dad.

If you still have
trouble breathing

we'll have to put you on a mask.

‐ No mask.
‐ We'll see.



You ought to go
back to work.

Maybe later.

I wanna make sure
you're comfortable.

In that case,
how about a drink?

What?

I've got a hankering
for a Bloody Mary.

Your mother used
to make them for brunch.

I don't think
that's such a good idea.

Why? You think
it's gonna kill me?

With or without Worcestershire?

Without.

But I'll take a dash of tabasco.

[grunting]

[knocking on door]



‐ 'John?'
‐ Yeah.

‐ What's all the racket?
‐ Oh, sorry.

I'm just trying
to get back into shape.

When did you get
this equipment?

[grunting]

Couple of days ago.
I didn't mean to wake you.

You know me,
I'm up with the birds.

How did you sleep?

‐ Like a baby.
‐ 'Good.'

Well, I'll let you get back
to your regimen.

Toast and coffee for breakfast?

[exhaling]

I feel like pancakes today.

Well, I think
we can manage that.

‐ 'Morning.
‐ 'Morning.

Is everything alright?

I only got your answering
machine the last few days.

Oh, I'm really sorry.

It's been crazy.

Tess had a bad cold.
The kitchen was being repainted.

So we've been staying
at my mom's.

Well, anyway, happy birthday.

Luka, they're beautiful.

I picked them from my garden.

M‐m‐my neighbor's garden,
actually.

How did you know
it was my birthday?

I have my ways.

Dr. Kovac, we need you.
GSW comin' in.

‐ See you later.
‐ Okay.

[exhaling]

[theme music]

[music continues]

You're looking sharp, Carter.
Where you been?

I was actually checking
out condos in Lincoln Park.

‐ Very trendy.
‐ And expensive.

Too many damn yuppies
if you ask me.

‐ You're a yuppie, Dave.
‐ No way.

Young, urban professional,
that's you.

I am not. Hey, chief,
am I a yuppie?

No, but you will be
when you grow up.

Look, Dr. Greene
won't be in tonight.

I need somebody
to cover his shift again.

‐ Carter? Malucci?
‐ All night?

Yeah, you can flip for it.

‐ I'll do it.
‐ You will?

‐ I'm the senior resident.
‐ It's my responsibility.

Thank you, Dr. Carter.
You can take a nap later.

Malucci will cover for you.

Dr. Weaver, your EMS
meeting's been changed to 10:00.

‐ This morning?
‐ Yeah.

‐ Where's Carol?
‐ Uh, over there.

Carol.

Carol!

Hey, Carol, you didn't
hear me call you?

No, what's up?

Okay, I need the paramedic
compliance data

on aspirin and chest pain.

Okay, I'll get to it.

I put a memo
in your box last week.

You didn't see it?

Oh, God, Kerry,
I must've forgot.

The meeting's in two hours,
I know it's a lot

but I need you
to compile the data.

‐ I will, I will get to it.
‐ You'll do it?

I will do it.

I made you some French toast.

'You want the TV on?'

No.

Okay, dad, lean forward.

[groaning]

Are you in pain?

When I take a breath.

[groaning]

Probably pleurisy
from the pneumonia.

‐ We'll try Toradol.
‐ Huh?

This ought to make
you feel better.

There.

Hungry?

No.

Come on, why don't you eat?

For me, huh?

Just take one bite.

Please?

Oh, I'll eat.

His lungs are still wet.
What did you give him?

‐ Lasix, nitro and morphine.
‐ Excellent.

But his blood gas shows
he's acidemic and retaining CO2.

‐ His pulse ox is dropping, 85.
‐ Well, he's tiring out.

Connie, set us up
for an intubation.

Mr. Remmes, we're going
to have to put a tube

down your throat, okay?

Anything to help me breathe.

This one's a little tough.

Have you ever done
a COPDer before?

Never tubed anybody.

Well, time to step up
to the plate.

Hey, I heard you guys had a
patient in respiratory distress.

We're on top of it, Carter,
I was just about

to take Abby
through an intubation.

Good, then we can try
this new airway cam.

Abby, if you don't mind I'll
slip this right around your head

and as she intubates

we'll be able to see exactly

what she sees on the TV
and make any adjustments.

Cool.

You ready, Abby?

‐ Yeah.
‐ Hi, mom.

Dave, why don't
you give your patient

20 of etomidate
and start bagging him.

Yeah. Right.

Everything looks okay.

‐ No bleeding?
‐ Nope.

Good, now I can go home.

You vomited blood
and fainted at work.

The IV needs to stay
in a while longer.

But you said I could leave
if everything checked out.

Yes, but your
potassium level's low.

‐ We need to replenish it.
‐ Where'd you put the lab slip?

Uh, the printer's down.
I got it off the computer.

(Claire)
You've wasted enough
of my time already.

Nurse, get my clothes.

‐ Whoa..
‐ W‐what's wrong?

Uh, nothing. Just a little dizzy
from sitting up too fast.

Your pulse is weak
which means you're dehydrated.

You can go after
this fluid runs in.

Alright, but that's it.

Then I'm outta here.

Okay.

Lydia, can you assist
me in making sure

all of Claire's
discharge papers are in order?

Sure.

Her gag is absent,
her tooth enamel is eroded

she's severely malnourished,
she's anorectic and bulimic.

‐ And I don't want her leaving.
‐ What can we do?

We'll get psych down here
to put a hold on her.

‐ 'What have you got?'
‐ Hammer versus scalp.

‐ We're going up to CT.
‐ Have you seen Carol?

Not since early
this morning. Why?

She's supposed to be working
on my paramedic data.

‐ Did you page her?
‐ Twice.

It's her birthday.

I bet some
of the nurses took her

to Doc Magoos for breakfast.

I certainly hope not.

Alright. Go for it, Abby.

Scissor the mouth apart.

Enter on the right.

Sweep the tongue to the left.

(Dave)
Slide that bad boy
all the way down. Let's go.

Hold on. Just advance slowly
until you see the epiglottis.

‐ 'I see it.'
‐ Yeah, so can we.

A little bit more.

Now lift it up with your tip.

(Dave)
This is pretty cool, Carter,
I gotta admit.

No, wait, wait, lift
in the direction of the handle.

Man, you could have a lot
of fun with this camera, huh?

I see the vocal cords.

Good, now pass the tube.

‐ Good.
‐ That wasn't so hard.

Yeah, it's easy when you
got a good teacher.

You're right.

Dad, you're wheezing again.

You want another
breathing treatment?

No.

Having any chest pain?

No.

That last stuff worked
pretty good.

Just mixing up your antibiotics.

[sighing]

Damn it.

‐ What?
‐ 'It broke.'

‐ Ow!
‐ Now what?

‐ I cut my hand.
‐ You're bleeding on the floor.

Yeah, yeah, I know.

Shouldn't you keep
pressure on that?

I know, dad.

Keep your hand above your heart.

'That's supposed
to stop the bleeding.'

You need stitches.

I'm not leaving you here alone.

You're the doctor.

The circulation in your leg
is poor, Mr. Fulton.

We need an arteriogram
to check your blood flow.

When dad first came here

the doc couldn't
feel a pulse in his foot.

When was that?

About a month ago, right?

Doctor took
the dead skin off his toe

told him to soak it,
gave him some ointment.

(Chet)
'Shoe didn't fit right.'

Rubbed my toe raw.

Well, the toe is gangrenous now.

And you have an ulceration
on your leg.

We will have to operate.

How bad is it?

We'll probably have
to amputate below the knee.

‐ Amputate?
‐ How could this happen?

That first doctor
gave my dad some pills

and told him
to take an aspirin.

We never knew
this could be this serious.

Do you remember
who treated your father?

Some foreign guy.

‐ Kovac?
‐ Yeah.

Dr. Kovac.

‐ Lydia, I'm off to Mark's.
‐ Is it his dad?

No, Mark cut his hand.
He needs sutures.

Peter's covering for me.

Make sure psych comes down here
to see Claire.

Don't worry.
She's not going anywhere.

I put her on a slow drip.

She's got a couple more
hours left on that bag.

Thanks.

Yeah, I'm still
massaging the data.

I‐I'll make
the presentation in June

with three months'
worth of figures.

Okay, thanks.

Carol, where have you been?

Day care. Tess has been
cranky all morning.

I just postponed my meeting

'cause I didn't have
your report.

Aw, I didn't get to finish it.

You're the paramedical
liaison nurse.

You're supposed to stay
on top of the stats.

I know, I've just been
incredibly busy.

Well, then you should
have given the job

to another nurse, Carol.

‐ I can handle it.
‐ Okay, look.

I know your babies
take a lot of time.

So, if you need to cut back
on your responsibilities‐‐

‐ No, I'm fine.
‐ Are you sure?

Because I can't afford to have
things fall through the cracks.

‐ I can handle it.
‐ Good.

‐ Carol?
‐ What?

Delivery guy dropped this off.
I signed for it.

Oh, God, it's, uh, from Doug.

Let's see.
What did he give you?

Animal crackers.

That's a weird birthday present.

No.

It's this thing we used to do.

Whenever he'd go to the store,
he'd come back

with a box of animal crackers

and I'd always put one
in his Christmas stocking.

Kinda like a tradition, huh?

I think I'll take
the foreign body in the eye.

Carter's got it.

Then I'll take
the hip dislocation.

‐ Carter's got that one, too.
‐ You know what? Do me a favor.

Tell Dr. Carter if he
wants to see all the patients

I'll be more than
happy to go home.

He left you
Mr. Barclay in chairs.

‐ Wound check.
‐ Swell.

‐ Mr. Barclay?
‐ Finally.

I've been waiting
out here for three hours.

This thing's been
draining like crazy.

Malucci, your CHF guy
dropped his sats.

Sir, you're gonna have
to go back to chairs.

Well, what the hell's
taking so long?

My patient just
stopped breathing.

Dr. Chen, would
you take this guy?

Yeah, sure.

I burned my arm last week
cleaning out the furnace.

It hurt like
a son of a bitch.

Well, why don't
you remove the gauze

let me take a look.

‐ Hey, doc.
‐ Excuse me.

Kenny Lattimer, four.

Been seizing for 20 minutes.
No response to two of Ativan.

‐ Please help him.
‐ Don't worry, Mr. Lattimer.

We'll take good care of Kenny.

Yosh, prep the pedes ER

and draw up
another two of Ativan.

Hey, I was here first!

‐ Ativan's on board.
‐ Draw a CBC.

Lytes, accucheck
and cath a urine.

Pulse ox is dropping, 92.

Has Kenny ever
had seizures before?

He's always
been perfectly healthy.

Could he have ingested
any medicine, poison?

No, we keep everything
locked up.

He complained of a sore throat
last night, that's all.

‐ Any fever this morning?
‐ Just a little.

I tried to get him
to eat breakfast

but he only wanted to sleep

and then the next thing
I knew, he was shaking.

Push 600 of phenobarb
over ten minutes.

‐ We've got to stop this.
‐ You want to intubate?

Only if his sats keep dropping.

His blood glucose
is really low, it's under 40.

Seizures can lower
the blood sugar.

Push 50cc's of D‐25
and get Weaver, now.

(Peter)
'Dr. Kovac.'

Yes?

Do you remember seeing
a patient, Chet Fulton

African American, early 60's,
came in about a month ago

with vascular insufficiency
and an ulcerated toe?

‐ Do you have his chart?
‐ Uh, yeah.

Mr. Fulton's back with gangrene.

Yes, I remember him.

I debrided the wound
and gave him Trental.

Sorry he's back.

Well, now I have to do a below
the knee amputation

which probably could
have been avoided

if he had been seen
in vascular clinic.

As you can see in the chart
I made the referral.

Uh, he's a high‐risk patient
with no insurance.

He lives alone.
He needed follow‐up.

And I provided that. I made
an appointment with vascular.

I can't be responsible for his
medical care outside the ER.

Right, but did you put him
on the nurses' callback list

or did you phone him yourself?

Do you call back every patient
you see down here?

‐ The ones at high risk, I do.
‐ Really?

Older African American men
are at high risk for amputation

because they're not
treated aggressively.

‐ You should know that.
‐ I do.

‐ Then why didn't you call him?
‐ What are you saying?

I'm saying there's more
to emergency medicine

than treating
and streeting patients.

That's one more thing
you don't have to teach me.

‐ How long's he been seizing?
‐ Over 30 minutes.

Load him with Dilantin,
300 milligrams.

‐ What's his blood sugar?
‐ Still under 40.

‐ Push another 50 of D‐25.
‐ I don't understand.

How can the glucose level
still be so low?

Could be an insulinoma
or maybe a metabolic disorder.

Haleh, get me an ammonia,
an insulin level

and a uric acid.

The seizure stopped.

(Kerry)
'Okay, start him
on a dextrose drip.'

Check the blood sugar
every 20 minutes.

His brain can't tolerate
another seizure.

Why isn't he awake?

It's normal for him to sleep
after something like this.

‐ But he will wake up, right?
‐ Why don't you stay with him?

Otherwise,
he‐he might be frightened

waking up in a strange place.

‐ Thanks
‐ Thank you.

‐ Thanks, doctor.
‐ Thanks.

Get a head CT and an EEG.

‐ What are you thinking?
‐ I don't know.

That D‐25 should
have corrected the hypoglycemia.

Something else must be goin' on.

Check the labs,
make a differential diagnosis.

‐ Start hunting for zebras.
‐ Okay.

Hey, Chuny,
is this your patient?

Nope, he's Carol's.

Can you change the IV bag?
It's empty.

No, I got a guy puking
all over exam two.

Carol, your patient in
curtain three needs a new IV.

Oh, yeah, right.

Hey, Carol, it's not like you
to let an IV run dry.

I'm sorry.

Is there something
bothering you?

‐ I'm fine.
‐ Are you sure?

If you have a problem with me,
Kerry, just go ahead and say it.

Don't get so defensive.

I'm‐I'm just asking
what's goin' on.

I am taking care
of ten patients.

I have two babies up in day care

and you're constantly
on my back.

Stay on top of things
and I won't bother you again.

45‐year‐old guy
crossing the L tracks

trying to beat the train
got knocked down.

‐ But he didn't get run over.
‐ Lucky guy.

Yeah, BP is 80/40

gave a liter of saline
intubated in the field.

When is somebody going
to take a look at my arm?

I came all the way
over here on the bus!

(Carter)
Just take a seat.

And three.

You got a couple
rib fractures here.

BP 75 palp.

Alright, Malik, let's
prep for a central line.

This guy's going
to need some fluid.

Absent breath sounds
on the left.

This dude's got a pneumo.
Hey, man, chest tube tray.

Hold on,
I'm prepping for Carter.

Why does it take so long
for a wound check?

'Cause this guy's trying
to die on us.

Get outta here!

As soon as I pop this baby in
his pressure will shoot back up.

You can't assume that.
He could be losing blood.

Malik, stand by
to fluid resuscitate.

(Dave)
'Did I ever tell you the story
about my first chest tube?'

Love to hear it, but sick
people are waiting. Ciao.

Cliff diver hit the rocks.
What a mess.

I'm in.
You done, Dr. Carter?

‐ Not yet.
‐ Pressure's still 75.

So much for your
chest tube, Dr. Dave.

Could be blood in the belly.
Malik, get me an ultrasound.

‐ That guy just stole my rig!
‐ What guy?

Your wound check patient.

Oh, that sucks.

You're good at this.

Thank you.

The way you did
the sub‐Q layer

you'll hardly need
to close the skin.

That's the point.

(David)
Is he giving you
a hard time over there?

No, David.

He's being
a very good patient.

Okay, we'll remove
those in five days.

‐ Shouldn't leave a scar.
‐ Thanks.

Keep it dry for two days

and put a plastic bag
around your hand

when you take a shower.

‐ I know.
‐ I know you know.

Looks like he's having
difficulty breathing.

(Mark)
Think I should give
him another treatment?

(David)
'I can't breathe'

but I can still hear
every word you say.

Can I make you some lunch?

(David)
'I'm not hungry.'

But stay, have some tea.

I'd like that.

Heard you've got
an unstable patient.

Blunt chest trauma,
tension pneumo.

Still hypertensive
despite a chest tube.

Probably cracked his spleen.

Hold on, Dave,
his neck veins are elevated

and he's got a low voltage
on the EKG.

I'm worried about fluid
around the heart.

You should be worried
about the belly.

Let's check
for cardiac tamponade.

I'd be checking the belly.

You're right, Carter.

He's got a big effusion
around the heart. Go for it.

Dave why don't you
give me a spinal needle

and alligator clip.

Here, now you can check
the belly.

Watch for injury current.

Belly's looking pretty clean.

You're hitting the heart.
Pull back.

I've got good return.

Okay, pulse is stronger.

‐ 'Need another syringe?'
‐ No‐no, I think I'm okay.

Why don't you call
for an ICU bed?

Good job, Carter.

‐ Dr. Weaver.
‐ Yeah?

I just did a medline search

on the boy with seizures.

‐ And?
‐ Hypoglycemia.

Elevated ammonia
and no ketones

are consistent with m‐cad,
a rare metabolic disorder.

Get a genetics consult,
talk to the parents.

Good pick up.

‐ How you doing?
‐ Okay.

Look, uh, I'm sorry
I came down so hard on you

but I depend on you.

You were right. I need
to be more on top of things.

Carol, you're
the best nurse here

but something's
going on with you.

I‐i‐is there anything
that I can do to help?

Not really. I just need some
time to figure a few things out.

I've worked with you
for five years.

I know you.

I hate my life.

I mean, I.. I love my work.

And I love my daughters, but..

How did I end up
raising twins by myself?

It's just..

You know, I think
you need some time.

I think that you
have some sick days?

Used 'em all up.

If you check, I believe you'll
find you have some extras..

...that you can use
whenever you like.

Thank you, Kerry.

(Mrs. Lattimer)
'You said Kenny
would wake up.'

(Jing‐Mei)
'Your son's genetic disorder
prevents him'

from burning fat for energy.

When he got sick

his blood sugar dropped
and that caused his seizure.

Is he gonna
have brain damage?

We should wait for
the results of the EEG.

I don't understand.
Kenny was born here.

Why didn't someone
tell us he had this?

Unfortunately,
Chicago hospitals don't test

for these rare
metabolic disorders.

Are you saying
other hospitals do?

In some states.

If we'd have known

is there anything
we could have done?

Dr. Chen, please tell us.

If you had given
Kenny sugar water

when he first got sick

'you could've
prevented the seizure.'

Sugar water?

(Mrs. Lattimer)
Oh, my God.

Hey, just sent
our patient up to the OR.

Hope you didn't cause
any myocardial damage.

Not to worry, Dave. It was
as easy as threading a needle.

(Joe on radio)
'Hello? I'm in an ambulance
bringing in some sick people.'

‐ What unit is this?
‐ 'How the hell should I know?'

'I was on my way to Mercy
for a wound check'

'when they flagged me down.'

‐ Who is this?
‐ 'Joe Barclay.'

Malucci, that's
your wound check guy.

Hey, this is County General.

‐ What the hell are you doing?
‐ 'Heading back.'

'I got people here
puking their guts out.'

'Ate some bad kielbasa.'

Hey, Is that the jerk
that stole my rig?

‐ Yeah.
‐ Are the patients stable?

'I don't know, man.
They're puking.'

Okay, don't let them puke
on the floor.

I just cleaned my rig.

I'm gonna let you
take this one, Dave.

You've already
established a relationship

with the patient.

Call me if there's any change.

I will.

David, I'm leaving now.

I have to get back
to the hospital.

A doctor's work
is never done.

I'm afraid so.

Wait, I have something
I want to give you.

Mark, get that little green box
out of the top desk drawer.

It's not necessary.

I know.

These belonged to Mark's mother.

I gave them to her
on her wedding day.

I want you to have them.

I can't.

Please.

They're lovely.

Thank you.

Don't just stand there.

'Help her put them on.'

[instrumental music]

She looks...beautiful,
doesn't she, Mark?

Yeah, she does.

‐ Hello, Jing.
‐ Oh, it's Jing‐Mei.

What's the matter?
You seem upset.

Somebody die?

We should be
screening babies here

for rare metabolic disorders.

What are you talking about?

I took care of a little boy
today who had a seizure

because we didn't give him
a $25 test when he was born.

Well, if we tested for every
genetic disorder in the book

we'd be spending
millions of dollars

to identify
a tiny handful of kids.

Oh.

But if I had known
what he had

I would've treated
him differently.

I might've been able to stop
the seizure more quickly.

Don't blame yourself,
it's all a question

of allocation
of precious resources.

We have to draw
the line somewhere.

We should offer the tests.

Well, we can't afford it.

Why don't you explain that
to my patient's family?

They're in the PICU waiting

to see if their son
ever comes out of a coma.

‐ They wouldn't stop puking.
‐ Strong radial pulse here.

‐ This guy is stable.
‐ Belly's soft on this one.

I got a father daughter MVA.

‐ Can you give me a hand?
‐ These guys are fine.

Start a liter of saline
and titrate five to ten

of Compazine,
come on, Abby, let's go.

So why don't you
come in with me?

Can I get my wound checked now?

Oh, yeah, you're gonna
get your wound checked.

Rear‐ended at moderate velocity

while stopped at a red light.

Six‐year‐old girl restrained
in the back seat

complains of neck pains.

I wanna stay
with my daddy.

Dr. Dave is gonna take
very good care of you.

Dave, work her up.
Abby and I will take the dad.

Driver's a 35‐year‐old male,
no seat belt knee vs. dashboard.

‐ Also got a facial lac.
‐ Was the wife informed?

Yeah, they're divorced,
she lives in Pittsburgh.

Daughter was here
visiting for two weeks.

Looks like a dislocated knee.

My knee hurts
like you wouldn't believe.

Had six of MS.

Let's give him
another ten of morphine.

‐ You ever reduce a patella?
‐ No.

Well, you will now.

Did you see my patient?

I'm just finishing the note.

‐ Thank you.
‐ Don't thank me yet.

‐ I'm removing the psych hold.
‐ You can't be serious.

This young woman's
starving herself to death.

She might be, but I can't compel
her to stay against her will.

She has a job,
she's not delusional

and she's not
an immediate threat

to herself
or anybody else.

She could go into kidney
failure, arrhythmia.

What does it take for
her to get treatment?

Her consent.

Lots of people
do bad things to themselves.

They smoke, they drink,
they eat fatty foods

and they drive
without seat belts

but we don't lock them up.

So, we're supposed
to stand by and do nothing?

Claire has the right
to make her own decisions

even if they're bad ones.

Well, there's gotta
be something I can do.

If you can
convince her to stay

I'll admit her
to the psych ward.

Otherwise, you'll have
to discharge her

after you've buffed her up.

Is the water too warm, dad?

No, no.

Where's Elizabeth?

She left a couple of hours ago.

Do..

‐ You have to go to work?
‐ No, dad.

I'm gonna stay right here.

Okay? Here.

Lay back.

Having any pain?

No.

No.

Are you alright?

Yeah.

You look tired.

Wh‐what is that soap?

It's just plain old Ivory.

That's what your mother used.

I remember.

Every night,
when she would tuck me in

she'd give me a kiss

and I could smell
the soap on her face.

This used to be my job.

What's that?

Giving you a bath

when you were a baby.

I didn't know that.

You're a good doctor.

The day you became a doctor..

...was the proudest day
of my life.

Has..

Shh.

It's okay, dad.

You don't have to talk.

Shh‐shh‐shh.

I love you, Mark.

I love you too, dad.

Shh.

Shh.

Shelly, you doing okay?

Yeah. When can I get up?

Well, as soon as they take
a look at your x‐ray.

Lily, send off a CBC,
dip a urine

and check a bedside crit.

Hemocue's in the other room.

‐ That's two of Versed.
‐ It's pretty relaxed.

Alright, I'll keep
the hip flexed now.

Keeping the knee
in extension

you're going to apply gentle
pressure directed medially.

Like this?

Perfect.

How are you guys
doing in there?

Kid's stable.
He's clearing the neck.

‐ What have you got?
‐ Six‐year‐old with a minor MVA.

Probably just a whiplash.

I took a lateral c‐spine

about to do
my secondary survey.

Careful.

‐ Don't!
‐ Oh, it's okay, Shelly.

We just have to examine
you, alright?

We'll‐we'll cover
you with a sheet.

‐ Whoa.
‐ What is it?

She's got bruises on her thighs
and blood in her underpants.

Could be a urethral injury
from a pelvic fracture?

Lily, we need a plain film
and a cystourethrogram, alright?

Hold on, hold on.

Does this hurt, sweetheart?

No.

There's no pelvic fracture.

You've got some blood
in your underpants.

‐ Did you hurt yourself?
‐ I wanna go home.

Um, Shelly,
we're here to help you.

I just need to ask you
a few questions, okay?

Okay.

Has anyone ever touched you
where you go to the bathroom?

(Dave)
'What happened?'

Sometimes, my daddy
plays a game with me.

It's okay. You can tell us.

It hurts.

Don't worry, he's never
gonna hurt you again, okay?

You sick son of a bitch.
What did you do to her?

‐ Hey, easy!
‐ What are you doing?

‐ He molested his daughter.
‐ What?

She's got signs of abuse!

What are you talking about?
I never touched her.

Alright, Mr. Burke, I'm sorry.

Dave, outside.

Abby, Malik,
please keep an eye on things.

You cannot go off like
that on a patient.

‐ He raped his daughter.
‐ You don't know that.

Now call social services
and have Cleo do a pelvic.

Alright, I'll assist.

Not after what
just happened in there.

That little girl trusts me.

I think that's
a really bad idea, Dave.

Well, I'm going to assist.

(Luka)
Okay, you'll feel
a little sting.

I heard Kerry was
out for your blood.

She was pretty upset.

I can talk to her if you like.

Oh, no, we worked it out.

Well, you'd think
she could cut you

a little slack
on your birthday.

Do you have plans to celebrate?

Uh, no, I don't like to leave
the girls with a baby‐sitter

when I've been at work all day.

No problem.

I can cook you
a birthday dinner.

Even do the dishes.

Okay.

I better get these
things to the lab.

Dr. Chen..

Is everything okay?

The doctor upstairs told me

that Kenny may have
permanent brain damage.

I'm so sorry.

This is Kenny's
baby sister, Emma.

The sitter dropped her off.

She's beautiful.

I want you to give her that test
that you talked about.

Please.

I can't force her to stay

but I was hoping that
she'd listen to you.

I love my daughter.
I'd do anything to help her.

I'm sure you would.

She's exhausted
from not eating.

My God.

She's skin and bones.

You told the mother?

‐ I had no choice.
‐ She's over 18.

She has a terrible disease.
I had to do something.

"I would not like them
here or there.

"I would not like
them anywhere.

"I do not like
green eggs and ham.

I do not like them,
Sam‐I‐Am."

You're gonna
feel my hands now.

"Would you like them
in a house?

"Would you like them
with a mouse?

"I do not like them
in a house.

"I do not like them
with a mouse.

"I do not like them
here or there.

I do not like
them anywhere."

It's almost through.

She's got bleeding from complete
transection of her hymen.

Can we keep reading?

Yeah, yeah, of.. Yeah.

"I do not like
green eggs and ham.

I do not like them,
Sam‐I‐Am."

Hey, Carter,
you wanna order dinner?

‐ We're goin' to the Lucky Moon.
‐ Yeah, yeah, yeah.

Get me "kung pao chicken

"mu shu pork"
and a side of "egg rolls."

Wow, you're hungry.

I'm gonna save the moo shu
for later. I'm on all night.

...chest pain. Just dropped
his pressure to 80.

He's got ST elevation
in V‐1 through V‐4.

His lungs are wet.
I'm gonna tube him.

‐ Haleh, get me an 8‐0.
‐ Start dopamine.

‐ Pulse ox is 82.
‐ Alright, I'll bag him.

Do you want me to call
the cath lab?

Yeah. Tell them
we've got a hot MI.

‐ He's tachy at 130.
‐ Damn it.

‐ Get me some suction.
‐ You want cricoid pressure?

Yeah.

Your kid with
bee stings is crashing.

Okay, I'm in. Bag him.

‐ You want me to take it?
‐ No.

Get this guy's pressure up

and take him to the cath lab.

Pressure's down to 75 palp.
Should I increase the dopamine?

No, hold on, there's
a pansystolic murmur

I didn't hear before.

Mitral regurge?

No, he's got
a parasternal thrill.

Could be septal perforation.

Why don't you give me an
eight French cordis introducer.

You're putting
in a central line?

Yeah, and then
I'll float a swan.

We don't do those down here.

‐ We don't have swan modules.
‐ Get one from the ICU.

It's against policy.

I just need to sample
a little blood

from the right side of his heart
to make the diagnosis.

‐ Come on, let's go.
‐ Carter, we can't do this.

Alright, I'll do it myself.

I'm getting Dr. Kovac.

Kerry, did someone page me?

I did.

Mark's father passed away
a little while ago.

‐ How's Mark?
‐ He's alright.

He said that he would call you

as soon as
the funeral home leaves.

I'm going over there
as soon as I finish up.

Uh, Peter's still on call.

Would you mind
asking him to cover?

Not at all.

Dr. Corday, we
need you right now.

(Claire)
'I'm leaving.'

'I want this IV out now!'

Claire, please don't do this.

She won't listen to reason.

Claire, you're anorectic.

You need to be hospitalized.

That's not what
that shrink told me.

He said we couldn't
force you to stay

but you could die
without treatment.

Take this damn thing out!

Alright.

Alright, Lydia,
remove the IV.

I never said that
you could call my mother.

'I'm an adult.'

I can do what I want.

You're right, you're right.
I'm sorry.

I was only trying to save you.

I don't want your help.

A friend of mine died today

fighting for his life.

You want to leave?
Fine, kill yourself.

If you don't give a damn,
neither do I.

Discharge her.

There, I'm in the RV.

Lily, draw blood
from the distal port.

‐ Blood's bright red.
‐ I knew it.

This guy's got a hole
in his heart

leaking oxygenated blood
to the right side.

Pressure's still low.

Alright, start nipride
and call the OR.

‐ Tell 'em we need a heart room.
‐ What are you doing?

I told you to get
this guy to the cath lab.

I'm advancing
to the pulmonary artery.

‐ We don't do swans in the ER.
‐ I told him that.

This guy should be upstairs
getting angioplasty.

Well, he would have died
in the cath lab.

What are you talking about?

I used the swan to sample blood
from the right ventricle.

It's bright red.
Perfed his septum.

What about his MI?

They can bypass him
when they fix the rupture.

Grab those IV's, would ya?
Put them on the pole.

The OR's waiting.

We're supposed to work together.

'Next time you tell me
what you're doing.'

Can't you give me something?

Just as couple more sutures

'then they're
taking you to jail.'

Ow! You're hurting me, damn it.

‐ 'Sorry.'
‐ 'Hey, hey, hey make him stop.'

He's killing me.

Dr. Malucci,
your patient's in pain.

'He needs more Lidocaine.'

Well, I did an
infraorbital block.

You must have missed the nerve.

Infiltrate locally.

Well, if I do that, it will
distort the wound edges.

Infiltrate subcutaneously
or I'm going to take over.

Fine.

You do it.

Dr. Chen, we keep meeting

in such odd places,
you paged me for a consult?

Uh, yes, but first I wanted
you to meet Mrs. Lattimer.

She's the mother of
the little boy I told you about.

Oh, hey, hey.

I'm terribly sorry
about your son.

Thank you.

I told Mrs. Lattimer that

we would test her baby girl.

Oh, that's
an excellent idea.

Dr. Chen was telling me that

if hospitals screened
every newborn

'hundreds of lives
might be saved.'

And since the test
only cost $25‐‐

You know, I'm sorry,
I‐I have a hot appy

waiting for me, so if you can
show me where my consult is.

Oh, this is not
a surgical consult.

‐ It's not?
‐ No.

I'm sponsoring a petition
to have County General

offer expanded newborn
genetic testing.

I told Mrs. Lattimer
and she wanted to meet you.

(Mrs. Lattimer)
'Even though Kenny
didn't get the test'

at least some good will
come out of all this.

Mm‐hmm.

So, Dr. Romano,
if you would just sign

on the bottom page.

Well, like I tell
all my residents

what's good for County,
is good for me.

‐ Kerry, have you seen Carol?
‐ Not in a while.

If you do, please tell her
I'm looking for her.

‐ Okay.
‐ Thanks.

Dr. Carter, I heard you
performed quite a heroic save.

Oh, just doing what I thought
was best for my patient.

Yeah, we have attendings
here for a reason

to supervise the residents.

‐ Fine.
‐ No, it's not fine.

You don't perform
dangerous procedures alone.

‐ Is that clear, John?
‐ Yeah.

(Pamela over radio)
'Start the second IV
en route.'

'ETA is five minutes.'

Copy 43. See you in five.

Okay, I'll be
setting up trauma one.

Hey, we got multiple stab wounds

to the chest coming in,
you interested?

No, thanks.

How's that little girl doing?

The cuts will heal.
I'll see you tomorrow.

See you.

(Luka)
There you are.

I was looking for you.

Are you alright?

‐ I've been up here thinking.
‐ Yeah.

Birthdays can
make you do that.

It's been...quite a year.

Yeah. For me too.

I'm looking forward
to the next one.

Luka, I'm sorry, I don't think

I can have dinner
with you tonight.

‐ Did I do something wrong?
‐ Oh, no.

No, it's not you. Uh..

...it's me.

I'm sorry, I gotta go.

Mark?

Hi.

I'm so sorry.

Can I help with anything?

Not really.

I've called all his navy
pals in San Diego.

I just got off the phone
with Rachel.

I've got some forms to fill out.

His taxes..

Mom used to do his taxes,
so they're kind of a mess

and his house..

...I gotta sell the house.

I promised him
that I‐I wouldn't sell the house

when he came out here..

[sobbing]
But I don't..

...I don't see
a reason to keep it.

[instrumental music]

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