ER (1994–2009): Season 7, Episode 2 - Sand and Water - full transcript
A young couple cope with their baby being premature; Greene and Corday struggle with their relationship.
Previously on "ER.."
Abby, you're seein' things.
Maybe you're on drugs.
Yeah, I think I saw you
with a needle once.
I'll work it out
with the registrar.
Once a clerkship is pulled,
it's pulled. Nothing I can do.
You have to wait till
the next academic quarter.
I just lost three months
of med school.
‐ Three months I can't make up.
‐ This is about your tuition.
Yes, it is about my tuition!
If‐if I'm gonna give you
a faculty position
I've gotta be sure that you're
gonna be part of the team.
'You are having a boy.
Congratulations.'
Thank you.
‐ Did you catch her?
‐ Oh, yes, I caught her.
But once she starts writing,
she can't stop. Heaven forbid.
I should have jammed that pen
into her carotid artery.
Hmm, I think they double
the fine once you draw blood.
You need a building
with guest parking.
‐ Take my spot.
‐ I don't want your spot.
Damn!
What?
No milk.
‐ Want some of mine?
‐ A grown man.
You put an empty milk carton
back into the refrigerator.
It's not empty.
Now it's empty.
Not that it chills
anything cooler
than room temperature,
anyway.
‐ It's just a parking ticket.
‐ It's not just the ticket.
It's that I had to go
chasing down there
half‐dressed
with my hair wet.
‐ I said I'd go.
‐ Yeah, but you didn't, did you?
‐ You didn't give me a chance.
‐ You weren't fast enough.
Look, I'll pay the ticket.
Okay?
Calm down.
I paid the other ones.
What?
Let's just say
it wasn't your first ticket.
You stole parking tickets
off my windshield?
Just two.
And paid them
without telling me?
Well, I was trying to avoid..
...this.
Well, that's it then.
I'm not staying here anymore.
‐ Here we go.
‐ Every faucet leaks.
‐ Your toilet actually rocks.
‐ I kinda like that.
And there are creatures
scurrying about in the walls.
Do you know what scurries
about in walls, Mark?
Uh, bunnies?
Do you wanna take the El train,
or shall we drive?
‐ Hey, is this the AA meeting?
‐ How did you guess?
‐ I'm Brant. What's your name?
‐ Hi, I'm John.
Ah, thanks, John. Welcome.
'...came to believe that
a power greater than ourselves'
'could restore us to sanity.'
Step three, made a decision
to turn our will..
‐ That's a lot of coffee.
‐ This is backup.
‐ First time?
‐ Here? Yeah. It's a good group.
...a searching and fearless
moral inventory of ourselves.
Step five, admitted to God,
to ourselves
and to another human being
the exact nature of our wrongs.
Step six, were entirely
ready to have God
'remove all of these
defects of character.'
'Step seven, humbly asked Him
to remove our shortcomings.'
'Step eight, made a list of all
persons whom we have harmed'
'and became willing
to make amends to them all.'
'Step nine'
'made direct amends to such
people wherever possible'
'except when to do so
would harm them or others.'
'Doc, can you take this guy?'
‐ He is driving me crazy.
‐ Same here.
‐ Oh, no.
‐ Shunt's clotted.
He missed his dialysis
appointment yesterday.
Mr. Fletcher,
only one day late, huh?
‐ You? No, not you.
‐ You know him?
Yeah, he's one
of our favorites.
‐ I don't want you.
‐ Hey, Cleo?
Can you, uh, take Mr. Fletcher,
please?
I see you called 911 again.
They're faster
than the El train.
‐ My arm stopped buzzing.
‐ No thrill, no bruit.
Talk English.
‐ Mark, you ready?
‐ In a second.
‐ Raise your right foot.
‐ I‐I can't.
You know what? I don't
wanna keep him waiting.
I'll be right there.
Okay.
'Have they started
teaching rounds yet ?'
'No, the residents are waiting
for you in the ICU.'
Alright, tell them
I'll be there in a minute.
And you need to schedule
the surgical
service committee meeting.
‐ Tomorrow afternoon.
‐ You have a mastectomy.
‐ Well, whenever.
‐ Dr. Benton.
Hey, Carter.
What are you doing here?
‐ I have a meeting.
‐ Oh, right.
‐ Hi, Shirley.
‐ Hi, Dr. Carter.
I need you to sign off on last
month's OR expenditure report.
‐ 'I've never done that.'
‐ 'You do now.'
'I take care of it.
You just sign it.'
Suit yourself.
I need it by 4:00.
It's good to see you, Carter.
Important attending stuff?
‐ Oh, yeah, well.
‐ Congratulations.
Thanks.
Oh, man, you look good.
Couldn't look much worse
than the last time you saw me.
‐ He's gotten big.
‐ Yeah.
‐ Hi, Reece.
‐ Hey.
Well, hey,
you're in a hurry..
Yeah. I'll, I'll see you later,
alright?
I don't know. Maybe.
We'll see.
Ah! Good luck, Carter.
‐ 'When does he wanna start?'
‐ As soon as possible.
I don't think
that's a good idea.
Sixty two year old female,
altered LOC
slurred speech, also weak grip
in her right hand.
‐ Any history of stroke?
‐ Yes, a lacunar infarct.
She got much worse
this morning.
He's eager
to get back to work.
So we're just gonna
throw him in the deep end?
No, of course not,
we'll start him on half‐shifts
limited responsibilities
once or twice a week.
In the same place
where he started using.
Mark, he's doing
the program every day.
Good. Make him take time.
He can afford it.
Okay, we'll monitor
his progress.
And if he gets into trouble,
we'll just cut back.
If he gets into trouble,
it's too late.
Please, please, somebody!
‐ What is it?
‐ I'm having contractions.
‐ Are you pregnant?
‐ Only 22 weeks.
Come here.
Try to relax, okay?
Here, you're gonna sit down.
Sit here.
Wait one second, okay?
Dr. Chen, I need you over here.
No, now.
‐ How did you get here?
‐ 'Taxi.'
‐ 'I was shopping downtown.'
‐ What is it?
She's having contractions.
‐ How far along are you, ma'am?
‐ Twenty two weeks.
Oh, that's much too early,
you're probably having
what are called
Braxton Hicks contractions.
They're coming
every three minutes.
Get a gurney, clear a trauma
room, start an IV and call OB.
Okay.
‐ What's your name?
‐ Regina.
Okay, Regina, don't push.
Whatever you do,
don't push. Okay?
‐ How much?
‐ Four, almost five.
No, that can't be right.
I was four centimeters
two hours ago.
‐ You're doing fine.
‐ Can Dr. Coburn take a look?
She was called in
to do a C‐section.
‐ How long will that take?
‐ We have plenty of time.
Why don't we roll you
back on your side
get you more comfortable?
Abby, they need someone
downstairs.
‐ Where?
‐ 'ER.'
‐ 'They have a preterm labor.'
‐ Get a resident.
Simons and Perry
are in delivering twins.
Lift your leg.
Where's Dana?
'She's on break.
Not back for another five.'
‐ You're not leaving, are you?
‐ It sounded urgent.
Do you know where you are,
Mrs. Walton?
Let the doctor
check you out first.
‐ What does she say?
‐ She wants to go home.
Pulse ox is 92.
She's in A‐fib.
It probably triggered
the new stroke.
‐ Do you provide 24‐hour care?
‐ Yes.
‐ Does she have any family?
‐ No.
Not that she's in contact with.
‐ Connie, call Psych.
‐ Psych?
After this stroke,
she might not be competent
to make her own
medical decisions.
‐ Preterm labor?
‐ Next door.
EKG, Chem‐7, UA, culture urine,
blood and sputum.
Your husband's on his way,
okay?
‐ Okay.
‐ How far along?
Twenty‐two weeks.
‐ Let's hope it's a couple more.
‐ 'Stop it, please, stop it.'
‐ Where's the resident?
‐ 'You got me instead.'
Okay, well,
membranes are intact
but she's fully effaced
and dilated to six centimeters.
‐ Can you stop it?
‐ Uh, what's, what's her name?
‐ Regina.
‐ Regina.
Did you have any ultrasounds
during your pregnancy?
About a month ago. My doctor
said everything was okay.
‐ Who's your doctor?
‐ He's in Indianapolis.
‐ We're confirming her dates.
‐ Why is this happening?
Sometimes, women go
into preterm labor
for no apparent reason.
I shouldn't have come.
I should've stayed home.
Point 25 of sub Q terb,
monitor her pulse..
We're giving you medicine
to stop the contractions.
Your membranes haven't ruptured
yet which is a good sign
but just in case,
we're also giving you
something to help
your baby's lungs mature.
Oh, no!
I feel pressure!
‐ Strong contraction.
‐ She's leaking amniotic fluid.
Make them stop.
You gotta make them stop.
Two grams of amp and
a loading dose of gentamycine.
Get a baby warmer
in here.
No! It's too early!
Random urine tests.
'Yes.'
And I get to pay
for them too, I see.
Is that a problem?
No.
In addition to the
State Caduceus meetings
we'll require 90 NA
or AA meetings
during the first 90 days.
That's not a problem.
I'm going anyway.
Good. Good.
And the three of us will meet
once a week just to..
...you know, check in. Make sure
you're handling the stress.
Alright.
I came prepared.
The naltrexone binds
to your opiate‐‐
I know what it does.
It protects you.
It blocks the euphoric effects
of the narcotics.
It protects all of us.
You need to, uh, begin today
'if you wanna begin work
next week.'
You want me to take it
in front of you?
Yeah, we'll periodically
monitor your regimen.
‐ How much?
‐ Fifty milligrams a day.
‐ Sorry. That was, uh..
‐ 'It's okay.'
It's gonna be difficult
at first.
So, we'll work it out.
Alright, so we'll put you on the
schedule for next week. Tuesday.
Start out very light.
No trauma.
Whatever you say.
‐ Kerry, I gotta go.
‐ Yeah.
‐ See you next week, Carter.
‐ Welcome back.
'Thank you.'
‐ Thank you both.
‐ Sure thing.
Baby's cephalic.
Normal anatomy.
‐ Progressed to eight.
‐ Oh, God, please stop it.
‐ Father's here.
‐ Regina, what‐what happened?
I was at the mall.
It started hurting.
‐ I, I didn't know what to do.
‐ Uh, is she in labor?
‐ Yes.
‐ My water broke.
'Her OB's office confirms
previous ultrasounds'
'put her at 21 weeks
five days.'
‐ That's way too soon, right?
‐ She's got rales.
Okay, pulmonary edema.
No more terbutaline.
Wh‐what's wrong?
Uh, the medication
we're giving you
is causing your lungs
to fill with fluid.
I don't care, I..
Stop the contractions!
I can't have this baby.
Okay, I'll try 50 mgs
of indomethacin.
But if the baby's born now,
can it survive?
‐ Joseph, it's coming!
‐ The baby's crowning.
Regina, you're gonna
deliver this baby.
‐ No! No!
‐ Yes.
There's nothing else
we can do.
‐ What have we got?
‐ A preemie. Under 22 weeks.
'Okay, Regina,
go ahead and push.'
No! No!
‐ You okay there, Dr. Chen?
‐ Mm‐hmm. The head's out.
‐ Whoa.
‐ Oh, my God!
‐ Oh, my God!
‐ It's a boy.
‐ Is he breathing?
‐ Yes, he's breathing.
‐ Can someone please help me?
‐ You okay?
Dilute it in 1000 cc's,
100 drops per minute.
'I don't hear anything.
Is he alive?'
Yes. Let's get a weight.
‐ He's so little.
‐ 'BP, 100/60.'
'Okay. Let's give the mom
40 of Lasix. Take her temp.'
'Please save him.
Please save my baby.'
You're doing charts?
Yeah, I needed to catch up.
Um, look,
I'm‐I'm really sorry about, um..
...with the baby.
It's alright. Our reactions
can surprise us sometimes.
But you need to go back in there
and manage your patient.
Um, I‐I can't.
Jing‐Mei, you should know
that you're being considered
for chief resident
next year.
'People need to be able
to look to you for leadership.'
I'm pregnant.
I‐I didn't know what to do
and then, eight weeks
became 12
and 12 became 20.
So you're,
you're 20 weeks pregnant?
Twenty two.
You know, that baby
was the size of mine.
Oh, sweetie.
Why did you wait so long
to tell me?
My parents are gonna kill me.
‐ You should go home.
‐ No.
Go home. I'll cover
the rest of your shift.
'We'll work out
your schedule tomorrow.'
Okay.
'Good.'
No. Not fair.
Not in the workplace.
I found a soft spot.
I'm going to exploit it.
‐ I'll exploit you.
‐ Mm‐hm.
‐ You know I will.
‐ Bring it on.
Time and place.
Clotted‐off fistula
needs a new shunt.
‐ Renal failure?
‐ Missed his dialysis.
‐ Mr. Fletcher?
‐ Who else?
Uh, no.
Give him somebody else.
I got stuck with him.
Why shouldn't you?
The last time, the man
yelled at my stethoscope.
And he grabbed my ass.
Suck it up.
‐ Uh‐uh.
‐ Come on. Be a man.
‐ That's not right.
‐ Oh, you crying now?
That's not right.
‐ You guys got a baby down here?
‐ Twenty two week preemie.
‐ Still breathing?
‐ For now.
‐ Oh, man.
‐ What took you so long?
I need to take a dump.
It's good to see you too,
Mr. Fletcher.
‐ Is he hypothermic?
‐ Yeah.
‐ Okay. Order another lamp.
‐ It's on its way down.
‐ What's his pulse?
‐ Down to 90.
This is some heated saline
to keep him warm
while you hold him.
‐ Did your husband leave?
‐ He went to call a priest.
We wanna baptize our baby.
There's a priest on call
with the hospital
unless you had someone
specific in mind.
No, we're just in town
for a few days.
My doctor said I could travel
during my second trimester.
Well, Regina, this probably
would have happened
whether you were
traveling or not.
We tried for, um..
...almost two years
to get pregnant..
...and finally gave up.
And then suddenly, I was.
Look at him.
He's hanging on.
I counted ten little fingers
and ten little toes.
'He looks perfect.'
He's just a little small.
Even if your baby
was a few weeks older
and somehow managed
to survive‐‐
I know that
that's what you say
because that's
what you've seen..
...but maybe he's meant
to be a miracle.
Sometimes you have
to help a miracle along.
And sometimes
you have to let go.
What took so long?
They had eight of us
in the holding pattern.
‐ Are we still in trauma one?
‐ Yeah, sure.
How bad is it?
I'm not sure I should
discuss this with you.
Why?
I can't share
medical information
with anyone
but a family member.
‐ Glenda and I are family.
‐ I thought you were her nurse.
No, I'm, um..
We're partners.
Oh, right.
We should sit down.
Hey.
You're safe.
I've had my coffee.
Good.
How about a date tonight?
Sure, as long as
it's at my place.
I was thinking about
the going‐out kind.
‐ We're going out Friday.
‐ I moved up a reservation.
‐ What reservation?
‐ It's a surprise.
Look, Mark, I'm fine.
I just had an episode
this morning, that's all.
I know. I know.
I'm used to them.
Six o'clock. Trust me.
You'll like the place.
Hey, by the way, your patient
has an abscess around L4 and L5.
‐ Who?
‐ Patterson.
I was in Radiology
when they flagged his film.
‐ Ah, suddenly bored?
‐ What?
Poaching my patients?
There can be
some improvement
in the first 24 hours
after a stroke.
But in Glenda's case, I'm afraid
there's too much brain damage.
‐ So, she'll never recover?
‐ Maybe slightly.
Dr. Kovac?
Her sats are dropping to 86.
‐ Glenda?
‐ 'Yes.'
What does that mean?
She's not
getting enough oxygen.
‐ Eight ET tube, ten cc syringe.
‐ BP's 110/90. Pulse is 110.
Put her on a 100 percent
non‐rebreather.
This your patient?
Large CVA
with dense hemiparesis.
Chest X‐ray shows
an aspiration pneumonia.
Ma'am, we may have to
put a tube down your throat
to help you breathe.
Do you know where you are?
Psych saw her.
Note says she's not competent.
I think she's just confused.
Does she have
an advance directive?
What do you mean?
Like a Do Not Resuscitate
order.
I don't think she'd wanna
be put on a ventilator
if that's
what you're asking.
Suction.
I'll put in an oral airway.
‐ Are you a family member?
‐ 'No, she's her..'
They're together.
‐ Do you have power of attorney?
‐ No, I guess I should..
‐ We didn't do that.
‐ 'Sats are climbing.'
Okay, let's keep her
on 50 liters by mask.
‐ She's okay?
‐ For now.
But if the pneumonia progresses,
we'll have to intubate her
unless a family member
directs us not to.
‐ Or a spouse?
‐ One recognized by law.
‐ Can you do it by phone?
‐ Yes.
Yes, if you can verify
an out‐of‐town relative.
She has a brother
in Houston.
I've never seen one
so small.
You can practically
hold it in one hand.
I delivered a 700‐gram baby
in med school.
Had a brain‐bleed.
I don't even wanna look.
Randi, can you page
the chaplain on call?
I did. The baby's father
already asked.
Uh, he's gonna be a few hours.
Well, we don't have a few hours.
He needs to get here.
Well, he's helping
talk down a jumper
from the states‐through bridge.
I..
Okay, then start
calling parishes
till you can find someone
who can get over here.
You want me
to cold‐call priests?
‐ Yes. Now, please.
‐ 'Okay, okay.'
I got the CBC and lytes.
No, I just need the coags.
Dr. Benton?
Look, I don't care
what the computer says.
‐ I'm trying to pre‐op him.
‐ Is this about Mr. Fletcher?
You know what?
Okay, I'll tell you what.
When they're ready,
page me, alright? Thank you.
Maureen Conway,
Financial Services.
We can't admit Mr. Fletcher.
Why not?
He's got Medicare.
Which he sold
to a bankrupt HMO.
Oh, come on.
That's not his fault.
True but in the nine months,
they've not paid claims
Mr. Fletcher has run up
over $200,000
in avoidable
unrecouped charges.
He needs
a new dialysis shunt.
You know, Dr. Romano left
strict orders not to admit
these patients. Now you can
stabilize in the ER and then‐‐
Whoa, whoa, whoa.
Wait a minute. Wait a minute.
Do you have an MD
behind your name?
Yet you're gonna try to tell me
how to treat my patients?
I appreciate
your frustration‐‐
I've got a pheochromocytoma
down the hall.
Fifty three‐year‐old male.
How do you suggest I treat him?
Do whatever you think
is medically necessary
but we won't admit Mr. Fletcher.
Now, if you have any concerns,
you can take them up
with Dr. Romano.
We took Regina
to get cleaned up.
'Believe it or not,
a shower can help.'
She did everything right.
She read that damn
"Expecting" book every day.
Well, it's important that
she knows it's not her fault.
‐ What happened? Did he die?
‐ No. Uh, you wait here.
Did they find something
that might help him?
Someone from Neonatology
has to examine
every premature baby
born in the hospital.
‐ So they might do something?
‐ Will you wait here, please?
Note how the thinness
of the fetal tissue
makes thermoregulation
impossible.
‐ The eyes remain closed‐‐
‐ What are you doing?
We heard you had
a micro‐preemie‐‐
This isn't show‐and‐tell.
No, it's a teaching hospital.
As you can see, the heart, limbs
and palate are fully formed.
With the transparent skin
we might even be able
to see the heart beating.
Okay, uh, put him down.
‐ Excuse me?
‐ Put him down.
He is not
a science experiment.
No, he isn't,
but I need to examine
every birth
for congenital anomalies.
‐ You should've called‐‐
‐ Well, now you've examined him.
‐ Now go.
‐ When I'm finished.
The father
is standing outside
thinking that
you are saving his baby.
How long would you like
to torture him?
Are there any questions?
No? Good.
Transfer him
to the fifth floor.
No.
Well, you can't keep him
down here.
I'm not sending
those parents upstairs
to see a bunch
of nursing mothers.
‐ Fine. The NICU then.
‐ No.
He's staying here
with his mother and his father
so they can have
some privacy.
‐ In the ER?
‐ Yes.
‐ Is there anything you can do?
‐ No. I'm sorry. He's too young.
Chuny, could you get
Mr. Morgan a chair
so he can sit
next to his son?
Sure.
I know this is difficult.
Don't be afraid
to touch him.
He's not suffering,
is he?
No.
Abby, we gotta clear
the trauma rooms.
'We got multiple MVAs
coming up.'
‐ 'Yeah. Find someplace else.'
‐ 'This is a trauma room.'
I don't care.
This room's off‐limits.
Titrate the phentolamine to
a MAP of 120 and get them up.
Don't worry, Mr. Robertson,
you are in good hands.
‐ Dr. Romano.
‐ Hello, Peter.
I heard you're hoarding
the field down here.
An attending
for a week and already
you're stealing
the fascinomas, huh?
Uh, you can have him.
Ha! I wasn't asking
your permission.
We have a problem with
a dialysis patient, and he's‐‐
Why do you say we?
Because financial services
won't let me admit him.
Don't let those geeks
push you around, Peter.
Show a little backbone,
before you come crying to me.
Otherwise they'll never
respect you.
Yeah, they're blocking him
on your orders.
Oh, that's different.
Let's take a look.
I've cleared him for surgery.
I can have him out in 24 hours.
Mm‐hmm. Mm‐hmm.
28 admissions
for renal failure?
He frequently misses dialysis.
Yeah, apparently.
Well, street him.
I am done
carrying these parasites.
‐ That's an EMTALA violation.
‐ No. He's had a screening exam.
‐ And he's not emergent.
‐ Well, how do you know?
You haven't looked at him.
Okay, Peter.
Let's take a look.
Where is he? Curtain two.
Too late, Lizzie.
‐ I already grabbed the pheo.
‐ What?
‐ Nothing.
‐ Listen, have you seen Mark?
He has a spinal abscess patient
for me. He's gone missing.
He said something
about Radiology.
Hi, Mr. Fletcher.
I'm Dr. Romano.
‐ How are you feeling today?
‐ Like crap.
Yeah, I'm sorry to hear that.
Can I take a look
at your fistula?
You're the seventh person
to take a look.
‐ What am I, a freak show?
‐ Hmm.
Why did you miss
your dialysis appointment?
‐ I was busy.
‐ Uh‐huh. Doing what?
None of your business.
Hm. More important things
to do I imagine, huh?
I don't like you.
I didn't like you the time
you sliced my foot open
and I don't like you now.
‐ Oh, I'm hurt, Mr. Fletcher.
‐ Uh‐huh.
What about my pain pill?
I need my damn pain pill!
The nurse is gonna bring it,
Mr. Fletcher.
'She's too slow.
I need a new nurse.'
‐ Put him on a bus to Milwaukee.
‐ He's fluid‐overloaded.
Oh, no, he's got
a few crackles.
This guy knows exactly
what's gonna happen
if he misses his dialysis,
and he still blows it off.
He is not gonna stop
abusing the system
until we draw the line.
‐ What's this?
‐ This is for his bus ticket.
‐ You serious?
‐ Absolutely.
New state,
new Medicaid program
and a whole new set of doctors
to piss off.
He lives in Chicago.
‐ Cry me a river.
‐ Oh, man.
Please call back immediately.
Thank you. Machine.
'Do you have a pager number
or a‐a cell phone?'
‐ No.
‐ Okay, a next door neighbor?
Or another relative?
No.
Well, her breathing
has stabilized for now.
How long have you
been together?
Twenty seven years.
Kerry?
Could you excuse us
for a moment?
Sure.
What are you doing?
She talked to her brother
twice in ten years.
Yes, and she didn't grant
her partner power of attorney.
I'm trying to find a legal way
to fulfill her wishes.
Twenty seven years, Kerry.
That should count for something.
The woman has a reasonable
chance of survival.
But what kind of life?
Intubation
is an appropriate step
unless she has
an advance directive.
The only person who can change
that is the next of kin.
She is the next of kin.
'They lived
their lives together.'
'We should treat them
like a couple.'
I agree.
The law doesn't.
If her sats drop below 80
before their brother
calls back, tube her.
No.
What?
If you wanna manage it this way
then you should manage it.
Okay. Fine.
Give me the chart.
Thank you.
I just, I need a picture.
I understand.
‐ Should we use the name?
‐ You don't want to?
No, I, I think we should.
There's only one boy's name
that we could agree on.
What's that?
Julian.
‐ It's a nice name.
‐ Yeah.
How much longer?
I don't know.
It could be a few minutes.
It could be a few hours.
Let's take him outside.
What?
We'll take him to a,
a lake or a park.
If he's gonna die,
I don't want him to die in here.
We have to wait
for the priest.
Is he coming?
I'll check again.
Abby.
Excuse me.
I'll be right back.
I paged you three times.
We had a 22‐week birth down
here. The baby's still alive.
You had a patient upstairs
who needed you.
‐ Did she deliver?
‐ Yes, she delivered.
Shoulder dystocia.
Is the baby okay?
Well, apart
from a broken clavicle
he'll be fine.
She was really scared
and she was asking for you.
Look, if you wanna take shifts
as an OB nurse
I need you to work
as an OB nurse.
You cannot let these women
grow dependent on you
and then‐then just walk out
when you got an excuse
to come back
and work in the ER.
I was not looking
for an excuse.
I was taking care
of this woman and her baby.
There are other people
down here who can do that.
Your job is upstairs.
Janet, I'm sorry,
it was my call.
I asked Abby to stay.
'These parents are
completely distraught.'
'There's nothing
we can do for the baby'
but they need support
and Abby's been with them
since the birth.
‐ Just don't ignore my page.
‐ Sorry.
Thank you.
No, you're doing
the hard part.
‐ Is he still breathing?
‐ Agonally.
Let me know when
you need to pronounce.
Okay.
Last time I got heated blankets
and an extra pillow.
What's open, Shirley?
Depends on what you have.
Revision of an AV graft,
left forearm.
‐ Patient named Fletcher?
‐ Yeah, how do you know?
Dr. Romano warned me
you'd try to bring him up.
Yeah, well, it's my call.
Just, uh, give me a room.
I'm sorry,
Dr. Benton, I can't.
I'll be in and out
in less than an hour.
He actually said
he'd fire me.
Okay. Okay, well, please hurry.
Thank you.
That was the priest.
He finally talked that woman
down from a ledge or whatever
and he's gonna get over here
and baptize this baby.
How long has it been?
Almost five hours.
Oh, he's really hanging on.
Maybe the mother's right.
'Maybe he is a miracle.'
In ten, fifteen years,
we might be able to help.
You know,
they wanted to try.
We could intubate him,
just in case.
‐ Abby..
‐ I know.
It's his time on Earth
'and all you can do
is make it a good time.'
I think he stopped breathing.
Here we go.
‐ That's not a respirator?
‐ No.
It provides positive pressure
to her lungs
so she won't have to work
so hard to breathe.
Her father died
of lung cancer.
I remember
Glenda and her brother
fighting outside the ICU.
Danny couldn't let go
and Glenda couldn't watch
her father suffer like that.
You know, all those tubes.
After her first stroke
Glenda made me promise to
never let her die like that.
We'll do everything we can
to reach her brother.
He doesn't know her
like I do.
I love her.
I don't wanna lose her,
but I know what she wants.
'His breathing just
slowed down for a second'
and then it just,
it stopped.
Please, if you
could do anything..
Is there a heartbeat?
No.
You wanna to call it?
Oh, God.
‐ Abby?
‐ Yeah.
Is‐is that it?
Time of death is‐‐
Wait!
His chest moved.
'Is‐is he still alive?'
'Got a heartbeat.'
Yes, yeah, but your sister
has an aspiration pneumonia.
If we put her on a ventilator,
she may never come off it.
Possibly, possibly.
But she's suffered
a massive stroke
from which she probably
will not recover.
Mr. Walton,
I cannot give you percentages.
Extremely unlikely.
We‐we understand
your sister's wishes
are not to be kept alive
by artificial means.
Ju‐Judy.
Would you like to talk to her?
Yes, if we don't intubate her,
she will die
but the chances of a mean..
The chances of a meaningful
recovery are ex..
'I understand.'
Yes. Goodbye.
Hey, you, uh, Malatucci,
come here.
‐ Malucci.
‐ Yeah, whatever, look.
Have you seen the OIG officer
down here?
Who?
Deputy Inspector General
regulates our Medicare
compliance.
I, uh, heard
she was snooping around.
A short battleaxe,
no sense of humor?
‐ Curtain two.
‐ That's her. Thank you.
'Dr. Benton told you
you needed surgery?'
'Uh‐huh, he brought me
upstairs.'
Why didn't he operate?
The nurse wouldn't
let him in.
He tried to tell me
they didn't have a room ready
but I could tell,
she kicked him out.
'Okay, Mr. Fletcher,
we're ready for you.'
‐ Sandy.
‐ 'Hello, Robert.'
What an unexpected, uh, visit.
Well, actually,
I'm investigating
a possible
EMTALA violation.
Really? What patient?
Mr. Fletcher.
Some sort of spot audit?
No, we got a call that
you were trying to bounce him.
‐ From whom?
‐ Anonymous.
Well, fortunately, anonymous
does not equal reliable.
I was just coming down to take
Mr. Fletcher up to surgery.
The OR's ready, Peter.
Let's go.
Is that true, Dr. Benton?
I'm sure Dr. Romano's
found a room.
This is a consent form,
Mr. Fletcher.
'I'll explain it to you
on the way up.'
Yeah, yeah.
I know the drill.
Robert, please tell me
you don't have policy
to redirect all non‐paying
Medicare HMO patients.
How could we?
We're a county hospital.
‐ Good, I'm glad to hear that.
‐ Always a pleasure, Sandy.
'I'm sure.'
As long as I'm here,
I think you should know
that I will be auditing
all of your patient transfers
from the last month.
Audit away.
No skeletons here.
I hope so.
Dr. Romano,
I thought I had to‐‐
Not a word, Peter.
Not a...single word.
You're not gonna
leave a scar, are you?
The hack that first put
this in left a big scar.
Shut up.
I'd have had better exposure
and direct visualization
without beaming a‐a gigavolt
of radiation
into the poor man's spine.
A gigavolt?
Yeah, you know what I mean.
And I could have completely
evacuated
all the infected tissue.
These guys are going in
half‐blind.
Fine. Whatever.
Next spinal abscess
is all yours, I promise.
Where is this place,
anyway?
You'll see.
‐ These are houses, Mark.
‐ Uh‐huh.
Oh!
Oh, Mark.
Oh, it's beautiful.
'See, I have some taste.'
Can you afford it?
I've been living cheap.
Besides, I'm gonna
have a roommate.
That's awfully
presumptuous of you.
Well, I could
take out an ad.
You will not!
I love it!
Check out the refrigerator.
It's nice and cold.
Look at this deck!
I knew you'd love that.
Oh, when can we move in?
When can you pack?
It has an ice‐maker.
These floors are gorgeous.
You should check it out.
‐ 'What?'
‐ The ice‐maker.
'It's lovely.'
You have, you have to open it.
It has a special ice feature.
What, does the ice
come in
different shaped cubes
or something?
Oh, my God.
Mark..
I'm a little nervous,
so, uh..
Uh, let me, let me say it.
Elizabeth, I love you.
I was hoping you'd give me
the joy and honor..
...of being your husband.
Oh!
Is that a yes?
Yes.
♪ All alone I ♪
♪ Didn't like the feelin' ♪
♪ All alone I ♪
♪ Sat and cried ♪
Do you believe in God,
the Father Almighty
the creator of Heaven and Earth?
♪ Had to find some meaning ♪
'Do you believe in Jesus Christ,
His only son'
'who was born
of the Virgin Mary'
'who suffered, died, rose'
'and now sits
at the Father's right hand?'
‐ I do.
‐ I do.
Do you believe
in the Holy Spirit
the Lord, the giver of life..
♪ Came in to this world ♪
♪ All alone I will ♪
♪ Someday die ♪
♪ Solid stone is just ♪
♪ Sand and water baby ♪
♪ Sand and water ♪
♪ And a million years
gone by ♪
I'm sorry.
♪ I will see you
in the light ♪
♪ Of a thousand suns ♪
♪ I will hear you ♪
♪ In the sound
of the waves ♪
♪ I will know you when I come ♪
♪ As we all will come ♪
♪ Through the doors
beyond the grave ♪
Hi, could I get a coffee
with cream
no sugar to go, please?
'Sure.'
Hey.
Hey.
You back already?
No, not for another week.
What, are you just hanging out?
'No, I have a diversion meeting
at 9:00.'
You look much better.
Thank you.
Yeah, I like your hair.
Thank you.
Those are nice scrubs. You
picking up some extra shifts?
No, I was suspended.
Oh?
‐ Didn't kill anybody, did you?
‐ No.
I wanted to.
My‐my ex‐husband was supposed
to pay my tuition
he didn't pay it
so, uh..
Ouch.
I'm on the bench
for a while.
But it certainly didn't seem
like that today. Oh, thank you.
Hey, I got that. Would you
put that on my bill?
‐ That's okay.
‐ Hey, it's a cup of coffee.
Sit down,
it's the least I can do
after acting
like a complete jerk.
When?
Three months ago.
You know,
you might have saved my life.
If you hadn't stopped me
when you did
I could be dead now.
I'm working on my steps here.
You're up to nine already?
Well, more or less.
I forgive you.
Do you mind?
I'm sorry.
I really have to quit.
Again, thank you.
Keep it.
Long day?
Yeah.
Twenty two‐week‐old preemie
survived almost nine hours.
I just finished the death kit.
‐ Wow.
‐ Yeah.
I don't know why I do this.
Sometimes,
I think I should just
go be an accountant
or something.
Hmm. That's an option.
Yeah, if I could balance
a checkbook.
What about you?
A lot of waiting.
A lot of meetings.
Yeah, you get
kind of meetinged out.
Aren't you gonna ask?
What?
What I was doing there
this morning?
You only go for one reason.
I figured I'd keep going
and eventually
you'd stand up and share.
It's not that interesting.
I'm a drunk.
How long have you been sober?
Almost five years.
So you could sponsor somebody?
‐ Yeah, I guess.
‐ Have you?
No.
'Cause I'm, uh,
supposed to find a sponsor.
Don't look at me.
No?
No, I'm barely holding
my own life together
right now, trust me.
'Cause it would be..
...great to have somebody
at the hospital.
And since you did sort of start
me on my road to recovery..
And men and women aren't
supposed to sponsor each other.
Don't worry about it.
Thanks.
Come on.
You're not gonna make me
ask a total stranger, are you?
I mean, the only person
I met at the meeting
was the coffee guy.
Okay. Okay.
I will work the steps with you
until you find
a permanent sponsor.
Fair enough.
I'll start by setting
a good example.
Besides, I don't think
coffee and cigarettes
are gonna do it
for me tonight.
‐ No?
‐ No.
I'm getting...a hot
fudge sundae.
‐ Mmm.
‐ Would you like one?
Uh‐mm. I got enough vices.
No, I think part
of the rules should be
that you have to splurge
with me.
Is that how it works?
♪ All alone I will ♪
♪ Someday die ♪
♪ Solid stone is just ♪
♪ Sand and water baby ♪
♪ Sand and water ♪
♪ And a million years
gone by ♪
Abby, you're seein' things.
Maybe you're on drugs.
Yeah, I think I saw you
with a needle once.
I'll work it out
with the registrar.
Once a clerkship is pulled,
it's pulled. Nothing I can do.
You have to wait till
the next academic quarter.
I just lost three months
of med school.
‐ Three months I can't make up.
‐ This is about your tuition.
Yes, it is about my tuition!
If‐if I'm gonna give you
a faculty position
I've gotta be sure that you're
gonna be part of the team.
'You are having a boy.
Congratulations.'
Thank you.
‐ Did you catch her?
‐ Oh, yes, I caught her.
But once she starts writing,
she can't stop. Heaven forbid.
I should have jammed that pen
into her carotid artery.
Hmm, I think they double
the fine once you draw blood.
You need a building
with guest parking.
‐ Take my spot.
‐ I don't want your spot.
Damn!
What?
No milk.
‐ Want some of mine?
‐ A grown man.
You put an empty milk carton
back into the refrigerator.
It's not empty.
Now it's empty.
Not that it chills
anything cooler
than room temperature,
anyway.
‐ It's just a parking ticket.
‐ It's not just the ticket.
It's that I had to go
chasing down there
half‐dressed
with my hair wet.
‐ I said I'd go.
‐ Yeah, but you didn't, did you?
‐ You didn't give me a chance.
‐ You weren't fast enough.
Look, I'll pay the ticket.
Okay?
Calm down.
I paid the other ones.
What?
Let's just say
it wasn't your first ticket.
You stole parking tickets
off my windshield?
Just two.
And paid them
without telling me?
Well, I was trying to avoid..
...this.
Well, that's it then.
I'm not staying here anymore.
‐ Here we go.
‐ Every faucet leaks.
‐ Your toilet actually rocks.
‐ I kinda like that.
And there are creatures
scurrying about in the walls.
Do you know what scurries
about in walls, Mark?
Uh, bunnies?
Do you wanna take the El train,
or shall we drive?
‐ Hey, is this the AA meeting?
‐ How did you guess?
‐ I'm Brant. What's your name?
‐ Hi, I'm John.
Ah, thanks, John. Welcome.
'...came to believe that
a power greater than ourselves'
'could restore us to sanity.'
Step three, made a decision
to turn our will..
‐ That's a lot of coffee.
‐ This is backup.
‐ First time?
‐ Here? Yeah. It's a good group.
...a searching and fearless
moral inventory of ourselves.
Step five, admitted to God,
to ourselves
and to another human being
the exact nature of our wrongs.
Step six, were entirely
ready to have God
'remove all of these
defects of character.'
'Step seven, humbly asked Him
to remove our shortcomings.'
'Step eight, made a list of all
persons whom we have harmed'
'and became willing
to make amends to them all.'
'Step nine'
'made direct amends to such
people wherever possible'
'except when to do so
would harm them or others.'
'Doc, can you take this guy?'
‐ He is driving me crazy.
‐ Same here.
‐ Oh, no.
‐ Shunt's clotted.
He missed his dialysis
appointment yesterday.
Mr. Fletcher,
only one day late, huh?
‐ You? No, not you.
‐ You know him?
Yeah, he's one
of our favorites.
‐ I don't want you.
‐ Hey, Cleo?
Can you, uh, take Mr. Fletcher,
please?
I see you called 911 again.
They're faster
than the El train.
‐ My arm stopped buzzing.
‐ No thrill, no bruit.
Talk English.
‐ Mark, you ready?
‐ In a second.
‐ Raise your right foot.
‐ I‐I can't.
You know what? I don't
wanna keep him waiting.
I'll be right there.
Okay.
'Have they started
teaching rounds yet ?'
'No, the residents are waiting
for you in the ICU.'
Alright, tell them
I'll be there in a minute.
And you need to schedule
the surgical
service committee meeting.
‐ Tomorrow afternoon.
‐ You have a mastectomy.
‐ Well, whenever.
‐ Dr. Benton.
Hey, Carter.
What are you doing here?
‐ I have a meeting.
‐ Oh, right.
‐ Hi, Shirley.
‐ Hi, Dr. Carter.
I need you to sign off on last
month's OR expenditure report.
‐ 'I've never done that.'
‐ 'You do now.'
'I take care of it.
You just sign it.'
Suit yourself.
I need it by 4:00.
It's good to see you, Carter.
Important attending stuff?
‐ Oh, yeah, well.
‐ Congratulations.
Thanks.
Oh, man, you look good.
Couldn't look much worse
than the last time you saw me.
‐ He's gotten big.
‐ Yeah.
‐ Hi, Reece.
‐ Hey.
Well, hey,
you're in a hurry..
Yeah. I'll, I'll see you later,
alright?
I don't know. Maybe.
We'll see.
Ah! Good luck, Carter.
‐ 'When does he wanna start?'
‐ As soon as possible.
I don't think
that's a good idea.
Sixty two year old female,
altered LOC
slurred speech, also weak grip
in her right hand.
‐ Any history of stroke?
‐ Yes, a lacunar infarct.
She got much worse
this morning.
He's eager
to get back to work.
So we're just gonna
throw him in the deep end?
No, of course not,
we'll start him on half‐shifts
limited responsibilities
once or twice a week.
In the same place
where he started using.
Mark, he's doing
the program every day.
Good. Make him take time.
He can afford it.
Okay, we'll monitor
his progress.
And if he gets into trouble,
we'll just cut back.
If he gets into trouble,
it's too late.
Please, please, somebody!
‐ What is it?
‐ I'm having contractions.
‐ Are you pregnant?
‐ Only 22 weeks.
Come here.
Try to relax, okay?
Here, you're gonna sit down.
Sit here.
Wait one second, okay?
Dr. Chen, I need you over here.
No, now.
‐ How did you get here?
‐ 'Taxi.'
‐ 'I was shopping downtown.'
‐ What is it?
She's having contractions.
‐ How far along are you, ma'am?
‐ Twenty two weeks.
Oh, that's much too early,
you're probably having
what are called
Braxton Hicks contractions.
They're coming
every three minutes.
Get a gurney, clear a trauma
room, start an IV and call OB.
Okay.
‐ What's your name?
‐ Regina.
Okay, Regina, don't push.
Whatever you do,
don't push. Okay?
‐ How much?
‐ Four, almost five.
No, that can't be right.
I was four centimeters
two hours ago.
‐ You're doing fine.
‐ Can Dr. Coburn take a look?
She was called in
to do a C‐section.
‐ How long will that take?
‐ We have plenty of time.
Why don't we roll you
back on your side
get you more comfortable?
Abby, they need someone
downstairs.
‐ Where?
‐ 'ER.'
‐ 'They have a preterm labor.'
‐ Get a resident.
Simons and Perry
are in delivering twins.
Lift your leg.
Where's Dana?
'She's on break.
Not back for another five.'
‐ You're not leaving, are you?
‐ It sounded urgent.
Do you know where you are,
Mrs. Walton?
Let the doctor
check you out first.
‐ What does she say?
‐ She wants to go home.
Pulse ox is 92.
She's in A‐fib.
It probably triggered
the new stroke.
‐ Do you provide 24‐hour care?
‐ Yes.
‐ Does she have any family?
‐ No.
Not that she's in contact with.
‐ Connie, call Psych.
‐ Psych?
After this stroke,
she might not be competent
to make her own
medical decisions.
‐ Preterm labor?
‐ Next door.
EKG, Chem‐7, UA, culture urine,
blood and sputum.
Your husband's on his way,
okay?
‐ Okay.
‐ How far along?
Twenty‐two weeks.
‐ Let's hope it's a couple more.
‐ 'Stop it, please, stop it.'
‐ Where's the resident?
‐ 'You got me instead.'
Okay, well,
membranes are intact
but she's fully effaced
and dilated to six centimeters.
‐ Can you stop it?
‐ Uh, what's, what's her name?
‐ Regina.
‐ Regina.
Did you have any ultrasounds
during your pregnancy?
About a month ago. My doctor
said everything was okay.
‐ Who's your doctor?
‐ He's in Indianapolis.
‐ We're confirming her dates.
‐ Why is this happening?
Sometimes, women go
into preterm labor
for no apparent reason.
I shouldn't have come.
I should've stayed home.
Point 25 of sub Q terb,
monitor her pulse..
We're giving you medicine
to stop the contractions.
Your membranes haven't ruptured
yet which is a good sign
but just in case,
we're also giving you
something to help
your baby's lungs mature.
Oh, no!
I feel pressure!
‐ Strong contraction.
‐ She's leaking amniotic fluid.
Make them stop.
You gotta make them stop.
Two grams of amp and
a loading dose of gentamycine.
Get a baby warmer
in here.
No! It's too early!
Random urine tests.
'Yes.'
And I get to pay
for them too, I see.
Is that a problem?
No.
In addition to the
State Caduceus meetings
we'll require 90 NA
or AA meetings
during the first 90 days.
That's not a problem.
I'm going anyway.
Good. Good.
And the three of us will meet
once a week just to..
...you know, check in. Make sure
you're handling the stress.
Alright.
I came prepared.
The naltrexone binds
to your opiate‐‐
I know what it does.
It protects you.
It blocks the euphoric effects
of the narcotics.
It protects all of us.
You need to, uh, begin today
'if you wanna begin work
next week.'
You want me to take it
in front of you?
Yeah, we'll periodically
monitor your regimen.
‐ How much?
‐ Fifty milligrams a day.
‐ Sorry. That was, uh..
‐ 'It's okay.'
It's gonna be difficult
at first.
So, we'll work it out.
Alright, so we'll put you on the
schedule for next week. Tuesday.
Start out very light.
No trauma.
Whatever you say.
‐ Kerry, I gotta go.
‐ Yeah.
‐ See you next week, Carter.
‐ Welcome back.
'Thank you.'
‐ Thank you both.
‐ Sure thing.
Baby's cephalic.
Normal anatomy.
‐ Progressed to eight.
‐ Oh, God, please stop it.
‐ Father's here.
‐ Regina, what‐what happened?
I was at the mall.
It started hurting.
‐ I, I didn't know what to do.
‐ Uh, is she in labor?
‐ Yes.
‐ My water broke.
'Her OB's office confirms
previous ultrasounds'
'put her at 21 weeks
five days.'
‐ That's way too soon, right?
‐ She's got rales.
Okay, pulmonary edema.
No more terbutaline.
Wh‐what's wrong?
Uh, the medication
we're giving you
is causing your lungs
to fill with fluid.
I don't care, I..
Stop the contractions!
I can't have this baby.
Okay, I'll try 50 mgs
of indomethacin.
But if the baby's born now,
can it survive?
‐ Joseph, it's coming!
‐ The baby's crowning.
Regina, you're gonna
deliver this baby.
‐ No! No!
‐ Yes.
There's nothing else
we can do.
‐ What have we got?
‐ A preemie. Under 22 weeks.
'Okay, Regina,
go ahead and push.'
No! No!
‐ You okay there, Dr. Chen?
‐ Mm‐hmm. The head's out.
‐ Whoa.
‐ Oh, my God!
‐ Oh, my God!
‐ It's a boy.
‐ Is he breathing?
‐ Yes, he's breathing.
‐ Can someone please help me?
‐ You okay?
Dilute it in 1000 cc's,
100 drops per minute.
'I don't hear anything.
Is he alive?'
Yes. Let's get a weight.
‐ He's so little.
‐ 'BP, 100/60.'
'Okay. Let's give the mom
40 of Lasix. Take her temp.'
'Please save him.
Please save my baby.'
You're doing charts?
Yeah, I needed to catch up.
Um, look,
I'm‐I'm really sorry about, um..
...with the baby.
It's alright. Our reactions
can surprise us sometimes.
But you need to go back in there
and manage your patient.
Um, I‐I can't.
Jing‐Mei, you should know
that you're being considered
for chief resident
next year.
'People need to be able
to look to you for leadership.'
I'm pregnant.
I‐I didn't know what to do
and then, eight weeks
became 12
and 12 became 20.
So you're,
you're 20 weeks pregnant?
Twenty two.
You know, that baby
was the size of mine.
Oh, sweetie.
Why did you wait so long
to tell me?
My parents are gonna kill me.
‐ You should go home.
‐ No.
Go home. I'll cover
the rest of your shift.
'We'll work out
your schedule tomorrow.'
Okay.
'Good.'
No. Not fair.
Not in the workplace.
I found a soft spot.
I'm going to exploit it.
‐ I'll exploit you.
‐ Mm‐hm.
‐ You know I will.
‐ Bring it on.
Time and place.
Clotted‐off fistula
needs a new shunt.
‐ Renal failure?
‐ Missed his dialysis.
‐ Mr. Fletcher?
‐ Who else?
Uh, no.
Give him somebody else.
I got stuck with him.
Why shouldn't you?
The last time, the man
yelled at my stethoscope.
And he grabbed my ass.
Suck it up.
‐ Uh‐uh.
‐ Come on. Be a man.
‐ That's not right.
‐ Oh, you crying now?
That's not right.
‐ You guys got a baby down here?
‐ Twenty two week preemie.
‐ Still breathing?
‐ For now.
‐ Oh, man.
‐ What took you so long?
I need to take a dump.
It's good to see you too,
Mr. Fletcher.
‐ Is he hypothermic?
‐ Yeah.
‐ Okay. Order another lamp.
‐ It's on its way down.
‐ What's his pulse?
‐ Down to 90.
This is some heated saline
to keep him warm
while you hold him.
‐ Did your husband leave?
‐ He went to call a priest.
We wanna baptize our baby.
There's a priest on call
with the hospital
unless you had someone
specific in mind.
No, we're just in town
for a few days.
My doctor said I could travel
during my second trimester.
Well, Regina, this probably
would have happened
whether you were
traveling or not.
We tried for, um..
...almost two years
to get pregnant..
...and finally gave up.
And then suddenly, I was.
Look at him.
He's hanging on.
I counted ten little fingers
and ten little toes.
'He looks perfect.'
He's just a little small.
Even if your baby
was a few weeks older
and somehow managed
to survive‐‐
I know that
that's what you say
because that's
what you've seen..
...but maybe he's meant
to be a miracle.
Sometimes you have
to help a miracle along.
And sometimes
you have to let go.
What took so long?
They had eight of us
in the holding pattern.
‐ Are we still in trauma one?
‐ Yeah, sure.
How bad is it?
I'm not sure I should
discuss this with you.
Why?
I can't share
medical information
with anyone
but a family member.
‐ Glenda and I are family.
‐ I thought you were her nurse.
No, I'm, um..
We're partners.
Oh, right.
We should sit down.
Hey.
You're safe.
I've had my coffee.
Good.
How about a date tonight?
Sure, as long as
it's at my place.
I was thinking about
the going‐out kind.
‐ We're going out Friday.
‐ I moved up a reservation.
‐ What reservation?
‐ It's a surprise.
Look, Mark, I'm fine.
I just had an episode
this morning, that's all.
I know. I know.
I'm used to them.
Six o'clock. Trust me.
You'll like the place.
Hey, by the way, your patient
has an abscess around L4 and L5.
‐ Who?
‐ Patterson.
I was in Radiology
when they flagged his film.
‐ Ah, suddenly bored?
‐ What?
Poaching my patients?
There can be
some improvement
in the first 24 hours
after a stroke.
But in Glenda's case, I'm afraid
there's too much brain damage.
‐ So, she'll never recover?
‐ Maybe slightly.
Dr. Kovac?
Her sats are dropping to 86.
‐ Glenda?
‐ 'Yes.'
What does that mean?
She's not
getting enough oxygen.
‐ Eight ET tube, ten cc syringe.
‐ BP's 110/90. Pulse is 110.
Put her on a 100 percent
non‐rebreather.
This your patient?
Large CVA
with dense hemiparesis.
Chest X‐ray shows
an aspiration pneumonia.
Ma'am, we may have to
put a tube down your throat
to help you breathe.
Do you know where you are?
Psych saw her.
Note says she's not competent.
I think she's just confused.
Does she have
an advance directive?
What do you mean?
Like a Do Not Resuscitate
order.
I don't think she'd wanna
be put on a ventilator
if that's
what you're asking.
Suction.
I'll put in an oral airway.
‐ Are you a family member?
‐ 'No, she's her..'
They're together.
‐ Do you have power of attorney?
‐ No, I guess I should..
‐ We didn't do that.
‐ 'Sats are climbing.'
Okay, let's keep her
on 50 liters by mask.
‐ She's okay?
‐ For now.
But if the pneumonia progresses,
we'll have to intubate her
unless a family member
directs us not to.
‐ Or a spouse?
‐ One recognized by law.
‐ Can you do it by phone?
‐ Yes.
Yes, if you can verify
an out‐of‐town relative.
She has a brother
in Houston.
I've never seen one
so small.
You can practically
hold it in one hand.
I delivered a 700‐gram baby
in med school.
Had a brain‐bleed.
I don't even wanna look.
Randi, can you page
the chaplain on call?
I did. The baby's father
already asked.
Uh, he's gonna be a few hours.
Well, we don't have a few hours.
He needs to get here.
Well, he's helping
talk down a jumper
from the states‐through bridge.
I..
Okay, then start
calling parishes
till you can find someone
who can get over here.
You want me
to cold‐call priests?
‐ Yes. Now, please.
‐ 'Okay, okay.'
I got the CBC and lytes.
No, I just need the coags.
Dr. Benton?
Look, I don't care
what the computer says.
‐ I'm trying to pre‐op him.
‐ Is this about Mr. Fletcher?
You know what?
Okay, I'll tell you what.
When they're ready,
page me, alright? Thank you.
Maureen Conway,
Financial Services.
We can't admit Mr. Fletcher.
Why not?
He's got Medicare.
Which he sold
to a bankrupt HMO.
Oh, come on.
That's not his fault.
True but in the nine months,
they've not paid claims
Mr. Fletcher has run up
over $200,000
in avoidable
unrecouped charges.
He needs
a new dialysis shunt.
You know, Dr. Romano left
strict orders not to admit
these patients. Now you can
stabilize in the ER and then‐‐
Whoa, whoa, whoa.
Wait a minute. Wait a minute.
Do you have an MD
behind your name?
Yet you're gonna try to tell me
how to treat my patients?
I appreciate
your frustration‐‐
I've got a pheochromocytoma
down the hall.
Fifty three‐year‐old male.
How do you suggest I treat him?
Do whatever you think
is medically necessary
but we won't admit Mr. Fletcher.
Now, if you have any concerns,
you can take them up
with Dr. Romano.
We took Regina
to get cleaned up.
'Believe it or not,
a shower can help.'
She did everything right.
She read that damn
"Expecting" book every day.
Well, it's important that
she knows it's not her fault.
‐ What happened? Did he die?
‐ No. Uh, you wait here.
Did they find something
that might help him?
Someone from Neonatology
has to examine
every premature baby
born in the hospital.
‐ So they might do something?
‐ Will you wait here, please?
Note how the thinness
of the fetal tissue
makes thermoregulation
impossible.
‐ The eyes remain closed‐‐
‐ What are you doing?
We heard you had
a micro‐preemie‐‐
This isn't show‐and‐tell.
No, it's a teaching hospital.
As you can see, the heart, limbs
and palate are fully formed.
With the transparent skin
we might even be able
to see the heart beating.
Okay, uh, put him down.
‐ Excuse me?
‐ Put him down.
He is not
a science experiment.
No, he isn't,
but I need to examine
every birth
for congenital anomalies.
‐ You should've called‐‐
‐ Well, now you've examined him.
‐ Now go.
‐ When I'm finished.
The father
is standing outside
thinking that
you are saving his baby.
How long would you like
to torture him?
Are there any questions?
No? Good.
Transfer him
to the fifth floor.
No.
Well, you can't keep him
down here.
I'm not sending
those parents upstairs
to see a bunch
of nursing mothers.
‐ Fine. The NICU then.
‐ No.
He's staying here
with his mother and his father
so they can have
some privacy.
‐ In the ER?
‐ Yes.
‐ Is there anything you can do?
‐ No. I'm sorry. He's too young.
Chuny, could you get
Mr. Morgan a chair
so he can sit
next to his son?
Sure.
I know this is difficult.
Don't be afraid
to touch him.
He's not suffering,
is he?
No.
Abby, we gotta clear
the trauma rooms.
'We got multiple MVAs
coming up.'
‐ 'Yeah. Find someplace else.'
‐ 'This is a trauma room.'
I don't care.
This room's off‐limits.
Titrate the phentolamine to
a MAP of 120 and get them up.
Don't worry, Mr. Robertson,
you are in good hands.
‐ Dr. Romano.
‐ Hello, Peter.
I heard you're hoarding
the field down here.
An attending
for a week and already
you're stealing
the fascinomas, huh?
Uh, you can have him.
Ha! I wasn't asking
your permission.
We have a problem with
a dialysis patient, and he's‐‐
Why do you say we?
Because financial services
won't let me admit him.
Don't let those geeks
push you around, Peter.
Show a little backbone,
before you come crying to me.
Otherwise they'll never
respect you.
Yeah, they're blocking him
on your orders.
Oh, that's different.
Let's take a look.
I've cleared him for surgery.
I can have him out in 24 hours.
Mm‐hmm. Mm‐hmm.
28 admissions
for renal failure?
He frequently misses dialysis.
Yeah, apparently.
Well, street him.
I am done
carrying these parasites.
‐ That's an EMTALA violation.
‐ No. He's had a screening exam.
‐ And he's not emergent.
‐ Well, how do you know?
You haven't looked at him.
Okay, Peter.
Let's take a look.
Where is he? Curtain two.
Too late, Lizzie.
‐ I already grabbed the pheo.
‐ What?
‐ Nothing.
‐ Listen, have you seen Mark?
He has a spinal abscess patient
for me. He's gone missing.
He said something
about Radiology.
Hi, Mr. Fletcher.
I'm Dr. Romano.
‐ How are you feeling today?
‐ Like crap.
Yeah, I'm sorry to hear that.
Can I take a look
at your fistula?
You're the seventh person
to take a look.
‐ What am I, a freak show?
‐ Hmm.
Why did you miss
your dialysis appointment?
‐ I was busy.
‐ Uh‐huh. Doing what?
None of your business.
Hm. More important things
to do I imagine, huh?
I don't like you.
I didn't like you the time
you sliced my foot open
and I don't like you now.
‐ Oh, I'm hurt, Mr. Fletcher.
‐ Uh‐huh.
What about my pain pill?
I need my damn pain pill!
The nurse is gonna bring it,
Mr. Fletcher.
'She's too slow.
I need a new nurse.'
‐ Put him on a bus to Milwaukee.
‐ He's fluid‐overloaded.
Oh, no, he's got
a few crackles.
This guy knows exactly
what's gonna happen
if he misses his dialysis,
and he still blows it off.
He is not gonna stop
abusing the system
until we draw the line.
‐ What's this?
‐ This is for his bus ticket.
‐ You serious?
‐ Absolutely.
New state,
new Medicaid program
and a whole new set of doctors
to piss off.
He lives in Chicago.
‐ Cry me a river.
‐ Oh, man.
Please call back immediately.
Thank you. Machine.
'Do you have a pager number
or a‐a cell phone?'
‐ No.
‐ Okay, a next door neighbor?
Or another relative?
No.
Well, her breathing
has stabilized for now.
How long have you
been together?
Twenty seven years.
Kerry?
Could you excuse us
for a moment?
Sure.
What are you doing?
She talked to her brother
twice in ten years.
Yes, and she didn't grant
her partner power of attorney.
I'm trying to find a legal way
to fulfill her wishes.
Twenty seven years, Kerry.
That should count for something.
The woman has a reasonable
chance of survival.
But what kind of life?
Intubation
is an appropriate step
unless she has
an advance directive.
The only person who can change
that is the next of kin.
She is the next of kin.
'They lived
their lives together.'
'We should treat them
like a couple.'
I agree.
The law doesn't.
If her sats drop below 80
before their brother
calls back, tube her.
No.
What?
If you wanna manage it this way
then you should manage it.
Okay. Fine.
Give me the chart.
Thank you.
I just, I need a picture.
I understand.
‐ Should we use the name?
‐ You don't want to?
No, I, I think we should.
There's only one boy's name
that we could agree on.
What's that?
Julian.
‐ It's a nice name.
‐ Yeah.
How much longer?
I don't know.
It could be a few minutes.
It could be a few hours.
Let's take him outside.
What?
We'll take him to a,
a lake or a park.
If he's gonna die,
I don't want him to die in here.
We have to wait
for the priest.
Is he coming?
I'll check again.
Abby.
Excuse me.
I'll be right back.
I paged you three times.
We had a 22‐week birth down
here. The baby's still alive.
You had a patient upstairs
who needed you.
‐ Did she deliver?
‐ Yes, she delivered.
Shoulder dystocia.
Is the baby okay?
Well, apart
from a broken clavicle
he'll be fine.
She was really scared
and she was asking for you.
Look, if you wanna take shifts
as an OB nurse
I need you to work
as an OB nurse.
You cannot let these women
grow dependent on you
and then‐then just walk out
when you got an excuse
to come back
and work in the ER.
I was not looking
for an excuse.
I was taking care
of this woman and her baby.
There are other people
down here who can do that.
Your job is upstairs.
Janet, I'm sorry,
it was my call.
I asked Abby to stay.
'These parents are
completely distraught.'
'There's nothing
we can do for the baby'
but they need support
and Abby's been with them
since the birth.
‐ Just don't ignore my page.
‐ Sorry.
Thank you.
No, you're doing
the hard part.
‐ Is he still breathing?
‐ Agonally.
Let me know when
you need to pronounce.
Okay.
Last time I got heated blankets
and an extra pillow.
What's open, Shirley?
Depends on what you have.
Revision of an AV graft,
left forearm.
‐ Patient named Fletcher?
‐ Yeah, how do you know?
Dr. Romano warned me
you'd try to bring him up.
Yeah, well, it's my call.
Just, uh, give me a room.
I'm sorry,
Dr. Benton, I can't.
I'll be in and out
in less than an hour.
He actually said
he'd fire me.
Okay. Okay, well, please hurry.
Thank you.
That was the priest.
He finally talked that woman
down from a ledge or whatever
and he's gonna get over here
and baptize this baby.
How long has it been?
Almost five hours.
Oh, he's really hanging on.
Maybe the mother's right.
'Maybe he is a miracle.'
In ten, fifteen years,
we might be able to help.
You know,
they wanted to try.
We could intubate him,
just in case.
‐ Abby..
‐ I know.
It's his time on Earth
'and all you can do
is make it a good time.'
I think he stopped breathing.
Here we go.
‐ That's not a respirator?
‐ No.
It provides positive pressure
to her lungs
so she won't have to work
so hard to breathe.
Her father died
of lung cancer.
I remember
Glenda and her brother
fighting outside the ICU.
Danny couldn't let go
and Glenda couldn't watch
her father suffer like that.
You know, all those tubes.
After her first stroke
Glenda made me promise to
never let her die like that.
We'll do everything we can
to reach her brother.
He doesn't know her
like I do.
I love her.
I don't wanna lose her,
but I know what she wants.
'His breathing just
slowed down for a second'
and then it just,
it stopped.
Please, if you
could do anything..
Is there a heartbeat?
No.
You wanna to call it?
Oh, God.
‐ Abby?
‐ Yeah.
Is‐is that it?
Time of death is‐‐
Wait!
His chest moved.
'Is‐is he still alive?'
'Got a heartbeat.'
Yes, yeah, but your sister
has an aspiration pneumonia.
If we put her on a ventilator,
she may never come off it.
Possibly, possibly.
But she's suffered
a massive stroke
from which she probably
will not recover.
Mr. Walton,
I cannot give you percentages.
Extremely unlikely.
We‐we understand
your sister's wishes
are not to be kept alive
by artificial means.
Ju‐Judy.
Would you like to talk to her?
Yes, if we don't intubate her,
she will die
but the chances of a mean..
The chances of a meaningful
recovery are ex..
'I understand.'
Yes. Goodbye.
Hey, you, uh, Malatucci,
come here.
‐ Malucci.
‐ Yeah, whatever, look.
Have you seen the OIG officer
down here?
Who?
Deputy Inspector General
regulates our Medicare
compliance.
I, uh, heard
she was snooping around.
A short battleaxe,
no sense of humor?
‐ Curtain two.
‐ That's her. Thank you.
'Dr. Benton told you
you needed surgery?'
'Uh‐huh, he brought me
upstairs.'
Why didn't he operate?
The nurse wouldn't
let him in.
He tried to tell me
they didn't have a room ready
but I could tell,
she kicked him out.
'Okay, Mr. Fletcher,
we're ready for you.'
‐ Sandy.
‐ 'Hello, Robert.'
What an unexpected, uh, visit.
Well, actually,
I'm investigating
a possible
EMTALA violation.
Really? What patient?
Mr. Fletcher.
Some sort of spot audit?
No, we got a call that
you were trying to bounce him.
‐ From whom?
‐ Anonymous.
Well, fortunately, anonymous
does not equal reliable.
I was just coming down to take
Mr. Fletcher up to surgery.
The OR's ready, Peter.
Let's go.
Is that true, Dr. Benton?
I'm sure Dr. Romano's
found a room.
This is a consent form,
Mr. Fletcher.
'I'll explain it to you
on the way up.'
Yeah, yeah.
I know the drill.
Robert, please tell me
you don't have policy
to redirect all non‐paying
Medicare HMO patients.
How could we?
We're a county hospital.
‐ Good, I'm glad to hear that.
‐ Always a pleasure, Sandy.
'I'm sure.'
As long as I'm here,
I think you should know
that I will be auditing
all of your patient transfers
from the last month.
Audit away.
No skeletons here.
I hope so.
Dr. Romano,
I thought I had to‐‐
Not a word, Peter.
Not a...single word.
You're not gonna
leave a scar, are you?
The hack that first put
this in left a big scar.
Shut up.
I'd have had better exposure
and direct visualization
without beaming a‐a gigavolt
of radiation
into the poor man's spine.
A gigavolt?
Yeah, you know what I mean.
And I could have completely
evacuated
all the infected tissue.
These guys are going in
half‐blind.
Fine. Whatever.
Next spinal abscess
is all yours, I promise.
Where is this place,
anyway?
You'll see.
‐ These are houses, Mark.
‐ Uh‐huh.
Oh!
Oh, Mark.
Oh, it's beautiful.
'See, I have some taste.'
Can you afford it?
I've been living cheap.
Besides, I'm gonna
have a roommate.
That's awfully
presumptuous of you.
Well, I could
take out an ad.
You will not!
I love it!
Check out the refrigerator.
It's nice and cold.
Look at this deck!
I knew you'd love that.
Oh, when can we move in?
When can you pack?
It has an ice‐maker.
These floors are gorgeous.
You should check it out.
‐ 'What?'
‐ The ice‐maker.
'It's lovely.'
You have, you have to open it.
It has a special ice feature.
What, does the ice
come in
different shaped cubes
or something?
Oh, my God.
Mark..
I'm a little nervous,
so, uh..
Uh, let me, let me say it.
Elizabeth, I love you.
I was hoping you'd give me
the joy and honor..
...of being your husband.
Oh!
Is that a yes?
Yes.
♪ All alone I ♪
♪ Didn't like the feelin' ♪
♪ All alone I ♪
♪ Sat and cried ♪
Do you believe in God,
the Father Almighty
the creator of Heaven and Earth?
♪ Had to find some meaning ♪
'Do you believe in Jesus Christ,
His only son'
'who was born
of the Virgin Mary'
'who suffered, died, rose'
'and now sits
at the Father's right hand?'
‐ I do.
‐ I do.
Do you believe
in the Holy Spirit
the Lord, the giver of life..
♪ Came in to this world ♪
♪ All alone I will ♪
♪ Someday die ♪
♪ Solid stone is just ♪
♪ Sand and water baby ♪
♪ Sand and water ♪
♪ And a million years
gone by ♪
I'm sorry.
♪ I will see you
in the light ♪
♪ Of a thousand suns ♪
♪ I will hear you ♪
♪ In the sound
of the waves ♪
♪ I will know you when I come ♪
♪ As we all will come ♪
♪ Through the doors
beyond the grave ♪
Hi, could I get a coffee
with cream
no sugar to go, please?
'Sure.'
Hey.
Hey.
You back already?
No, not for another week.
What, are you just hanging out?
'No, I have a diversion meeting
at 9:00.'
You look much better.
Thank you.
Yeah, I like your hair.
Thank you.
Those are nice scrubs. You
picking up some extra shifts?
No, I was suspended.
Oh?
‐ Didn't kill anybody, did you?
‐ No.
I wanted to.
My‐my ex‐husband was supposed
to pay my tuition
he didn't pay it
so, uh..
Ouch.
I'm on the bench
for a while.
But it certainly didn't seem
like that today. Oh, thank you.
Hey, I got that. Would you
put that on my bill?
‐ That's okay.
‐ Hey, it's a cup of coffee.
Sit down,
it's the least I can do
after acting
like a complete jerk.
When?
Three months ago.
You know,
you might have saved my life.
If you hadn't stopped me
when you did
I could be dead now.
I'm working on my steps here.
You're up to nine already?
Well, more or less.
I forgive you.
Do you mind?
I'm sorry.
I really have to quit.
Again, thank you.
Keep it.
Long day?
Yeah.
Twenty two‐week‐old preemie
survived almost nine hours.
I just finished the death kit.
‐ Wow.
‐ Yeah.
I don't know why I do this.
Sometimes,
I think I should just
go be an accountant
or something.
Hmm. That's an option.
Yeah, if I could balance
a checkbook.
What about you?
A lot of waiting.
A lot of meetings.
Yeah, you get
kind of meetinged out.
Aren't you gonna ask?
What?
What I was doing there
this morning?
You only go for one reason.
I figured I'd keep going
and eventually
you'd stand up and share.
It's not that interesting.
I'm a drunk.
How long have you been sober?
Almost five years.
So you could sponsor somebody?
‐ Yeah, I guess.
‐ Have you?
No.
'Cause I'm, uh,
supposed to find a sponsor.
Don't look at me.
No?
No, I'm barely holding
my own life together
right now, trust me.
'Cause it would be..
...great to have somebody
at the hospital.
And since you did sort of start
me on my road to recovery..
And men and women aren't
supposed to sponsor each other.
Don't worry about it.
Thanks.
Come on.
You're not gonna make me
ask a total stranger, are you?
I mean, the only person
I met at the meeting
was the coffee guy.
Okay. Okay.
I will work the steps with you
until you find
a permanent sponsor.
Fair enough.
I'll start by setting
a good example.
Besides, I don't think
coffee and cigarettes
are gonna do it
for me tonight.
‐ No?
‐ No.
I'm getting...a hot
fudge sundae.
‐ Mmm.
‐ Would you like one?
Uh‐mm. I got enough vices.
No, I think part
of the rules should be
that you have to splurge
with me.
Is that how it works?
♪ All alone I will ♪
♪ Someday die ♪
♪ Solid stone is just ♪
♪ Sand and water baby ♪
♪ Sand and water ♪
♪ And a million years
gone by ♪