ER (1994–2009): Season 7, Episode 5 - Flight of Fancy - full transcript

[theme music]

(male narrator)
Previously, on "ER."

I was hoping you'd
give me the joy and honor

of being your husband.

I can't find
a decent position.

Stay local,
or you give up custody.

I am willing to offer
you a per diem position.

‐ Per diem?
‐ Yeah.

Give me the purse!

[grunts]

(Lockhart)
'Stop.'



Luka, stop!
Stop it!

[siren wailing]

[phone ringing]

What can I tell you?
I'm short‐staffed.

Hey, I can't
go on a transport.

Connie, can you clear
this TIA in six?

She's waiting
for her daughter.

Yeah, well,
that's what chairs are for.

And give a gram of unasyn

to the dog bite in four.

Mark, they need
you at the MICN.

Why don't you try Mercy Air?

Maybe they can pick him up.

‐ Mark?
‐ What?



Paramedics have a guy with chest

pain won't get in the ambulance.

Okay, we'll explain the risks

and make sure he signs out AMA.

What are his vitals?

He's refusing to sign the form.

Mark, you gave
my patient cefoxitin.

‐ Who?
‐ Bovard. Uh, Appy.

Hold on. Uh, yeah, listen,
he needed antibiotics.

Yeah, cefotetan's a better drug.

‐ Peter, I'm a little busy.
‐ I know, that's not my problem.

You should've
at least called me.

Did you get through?

No, no answer at his hotel room

and I stat paged him twice.

Well, try his cellphone.

Any response to Lasix?

Mark, the AMA?

Well, get him on the radio
and try and convince him.

What about
a nitro drip?

Greene, I need you to buff up

a recurrent bowel obstruction

I have on the way.

What are we, Jiffy Lube?

I need a sugar tong splint
in Three.

‐ Kovac still MIA?
‐ Uh‐huh.

‐ Kovac missed his shift?
‐ I'm sure he's on his way.

‐ Where's, uh, Kerry?
‐ It's her day off.

She's at a Chrysanthemum Show.

Great, the one day I need her

she's playing Martha Stewart.

Hold on just a second,
I'm sorry.

Uh, listen, I've got
a helicopter transport.

We're gonna have
to call in backup.

Uh, why don't you
wait till 8:30?

‐ He's never late.
‐ Peter, what's this?

‐ Hot Appy. OR's ready.
‐ Great, I'll take him.

Dr. Greene needs
your help here.

Trauma coming in?

No, you're gonna cover
the whole ER.

‐ What?
‐ Yup.

Ah, this'll get you started.

Diarrhea, ear pain
and weak and dizzy all over.

Oh, wait a minute,
wait a minute.

Weak and dizzy wasn't a part

of our per diem agreement.

Sure, it is. Per diem
means "per my discretion."

(Greene)
'Okay, I'm on my way.'

I haven't done primary
care since med school.

Don't worry, Peter. You just got
to cover until Kovac gets here.

‐ When's that?
‐ Uh, I hope soon.

Andrazak in Four,
check his lytes in an hour.

Oh, and look at a post‐reduction
shoulder film on Quintano.

‐ How long's your flight?
‐ I don't know.

Well, where are you going?

[helicopter whirring]
Grass Creek, Indiana.

The wedding coordinator's
coming at noon.

I know.

Mark, we canceled her
once already.

Well, go ahead and talk to her.
You can handle it.

I don't want
to handle it.

I want you to share
in what kind

of invitations,
menu, flowers.

I know,
I'm stuck, I'm sorry.

Well, at least try
to get back on time.

I'll call you.

‐ Have a safe flight.
‐ What?

Nothing.

[helicopter whirring]

'Lifeguard Five‐Seven‐David.'

'Landing‐pad zone
is clear. Over.'

[theme music]

Alright,
I've got the earache.

That's a Pedes case.

Yeah, well, Romano has me

seeing everything today.

And that's a complete waste
of your brilliance.

Look, I've apologized.

If you can't accept it

let's at least call a truce

so we can work together.

You are amazing.

First you dump me,
then you expect me‐‐

Whoa, whoa, whoa,
I did not dump you.

Then what do you call it?

You were gonna move
to Philadelphia

without saying a word to me.

Yeah, but I didn't, did I?

I stayed here and I took
this damn per diem job.

And I'm supposed to believe
you did that for me?

That's what I thought.

Hi, I'm Dr. Benton.

So, uh, Jason,
how long has he been sick?

Well, it started last week
with an earache

and then he had a fever
and now he's coughing.

Well, let's take
a look here, okay?

You don't think he's got
pneumonia?

One thing at a time.
Here we go.

‐ Get away from me!
‐ Hey!

Jason. Be nice.

‐ The doctor wants to help you.
‐ Ow! Hey, whoa, hey.

‐ I said be nice.
‐ Alright, Jason.

Look this isn't gonna
hurt, okay?

Just, uh...just be still.
Here we go.

No, no, no!
I want to go home!

Okay, it's okay.
It's not gonna.. Jason.

That's right, Jason,
go to mommy.

Uh‐huh. Why don't you
put him on your lap

and give him a nice big hug

and if Jason is real still

'I'm going to
give him a sticker.'

(Greene)
'How are his sats?'

Up to 98, but his ejection

fraction's less than
ten percent.

Mr. Coggins?

‐ Call me Tom.
‐ I'm Mark Greene.

We're gonna have to lie you down
to load you on the chopper.

My first helicopter ride.

I'm gonna miss the scenery.

‐ What's his BP?
‐ Ninety over seventy.

It's always that low.
There's not much heart muscle.

‐ Can you keep trying Janet?
‐ Sure, Tom.

That's my fiance. She's
flying in from Montreal today.

Let me know if you feel dizzy
or have any shortness of breath.

I'm okay as long
as I lie still.

Bright side is I get bumped up
on the transplant list, right?

You bet. Gordon,
how are we for oxygen?

Four E cylinders,
all full.

Ready? Let's go.
One, two, three.

Alright, let's get a full trauma
panel. Type and cross for eight.

Let's get the bypass team
on standby. Move.

Oh, somebody
stabbed him?

No, he tripped near
a pencil sharpener.

Yeah, Mr. Zuckerman,
our office manager

wanted to pull it out,
but I wouldn't let him.

Decreased breath
sounds on the left.

Set me up with
a chest tube.

‐ I'll do it.
‐ No, I'll do it.

Uh, excuse me, excuse me,
this is a teaching hospital.

Exactly. Go find
another patient to learn on.

Pulse ox down to 91.

Okay, let's get
one percent with epi.

Peter, heard you had
a good one.

Oh! And indeed, you do.

He needs a CT.
Let me get a ten blade.

No, no, no,
don't bother.

I'll throw the tube in

and take him right up to the OR.

Don't worry, sir,
you are in excellent hands.

That's okay,
I've got this.

No, no, this is
a surgical case, Peter.

You are an ER doc
today, remember?

There's a guy puking out in the
hall. Go see what you can do.

Excuse me.

‐ I need a 30 feet..
‐ Sir, are you okay?

‐ Aah! Whoa, whoa!
‐ What does it look like?

Alright, let me get
some compazine here.

Sir, you're gonna have
to aim for the basin.

I heard it, but
I didn't believe it.

Carter, get me
some gloves.

Dr. Peter Benton,
ER attending.

Got kind of
a nice ring to it.

‐ You want this?
‐ Oh, no, no, no.

Looks like
you're doing just fine.

‐ Trent?
‐ Yeah.

I'm Dr. Carter. What
happened to your hand?

I have this stupid art class.

We were carving some duck decoy.

Huh.

Most exciting thing
that we ever did

I think was macrame.

Um, how many stitches,
you think?

How many do you want?

Enough to get me
out of art class.

Well, ten ought to do it.

Dr. Carter, can you
step out for a second?

Yeah, after
I suture this.

No, it's important.

I'll be right back.

Don't pick your nose.

‐ What?
‐ The boy's grandmother.

She wants to talk with you.

Why don't you just bring her in?

No, no, she asked
to see you alone.

Alright.

Hello, I'm Dr. Carter.

Oh, I'm sorry,
I came as soon as I could.

‐ Is Trent alright?
‐ Oh, yeah.

Just a few stitches,
he'll be good as new.

Um, doctor, there's something
you need to know.

Trent's mother died of AIDS
when he was two.

He tested HIV positive.

‐ You need to be careful.
‐ He didn't say anything.

He doesn't know.
We never told him.

What?

We just wanted him to be normal

like other kids.

What do you tell him
about the medications?

Oh, he thinks he has
a vitamin deficiency.

And your doctor
plays along with that?

Well, he understands.

Trent needs to know.

Yes, when he's older,
when he can better understand.

Well, your grandson could be
sexually active right now.

He's not.
I've asked him.

Are you sure that
he's telling you the truth?

Doctor, I know
my grandson, you don't.

Mrs. Larson,
I have a legal right

to tell Trent
that he's HIV positive.

You have no right
to interfere in our lives.

HIV's a sexually
transmitted disease.

And if he's having
unprotected sex

he could be putting
others at risk.

Well, I think we better leave.

Well, he can't leave.

‐ Let me by.
‐ Chris?

‐ Let me by.
‐ Doc.

Could you please escort

Mrs. Larson to the chairs?

‐ This way, ma'am.
‐ Don't touch me.

Don't do this.

(Eddie)
'Pulse ox 94 on two liters.'

‐ What's your hurry?
‐ Huh?

You keep checking your watch
every ten seconds.

‐ I'm just charting.
‐ I don't think so.

You're late for something.

I'm supposed
to meet my fiance.

You got a lunch date?

Well, we're meeting
the wedding planner.

You're taking the plunge.

‐ It's a great feeling.
‐ Yeah.

What's your fiance's
name again?

Janet.

I'm calling the ER.

See if they can get ahold of her
and she can meet us there.

That'd be great.

‐ Hi, Randi?
‐ 'Yeah.'

Yeah, it's Mark Greene
up in the helicopter.

‐ Who's around?
‐ Dr. Corday's right here.

‐ It's Dr. Greene.
‐ I don't care.

I need to speak
to him right away.

Hi, Mark,
is everything alright?

Yes, Dr. Dietrich, this is

Dr. Carter at County General.

Listen, I just
repaired a laceration

on your patient Trent Larson.

Yeah, certainly, I'll try
and get ahold of her.

No, yeah, he's
a great kid.

Uh, listen, if I was
to get a needle stick

is there anything
I should know?

Randi, did you get in touch
with the hotel?

There's still no answer
in his room.

Could you call
the manager's office

and see if they could
send somebody up there?

[pager beeping]

Detective.

Oh, you keep coming by

I've to get you
a badge and gun.

So, is there anything..

Oh, Dr. Kovac, now you know

the minute there's anything new,
I'm gonna call you.

We take photos for
the medical record.

I thought
it might help.

His morgue photo's already
on the police bulletin.

Maybe you could go back to where
it happened, show this around.

We've done our interviews, doc.

No one knows him.

What about fingerprints?

Have a seat.
Have a seat, doc.

Look...I understand
how you feel, okay?

But the fact is,
you're probably better off

if no one ID's this guy.

No family member's gonna come
crawling out of the woodwork

with some wrongful death suit.

I don't care. I just need
to know who he was.

Take my advice, doc.

You were
defending yourself.

Dedicate yourself
to believing that.

Alright, keep that
clean and dry.

Alright, cool.

Hey, Dr. Carter,
is my grandmother here yet?

Um...yeah, but first
we need to talk.

Why? It's just a cut.

Uh, yeah...actually,
I need to ask you something.

Alright.

[clears throat]

Um..

It's about your mother.

Uh, how much do you
remember about her?

Nothing.

You sure?

Yeah, uh, she's...she's dead.

She was a loser,
a heroin addict.

She died of AIDS.

And she had the virus when
she was pregnant with you

and the virus can pass
from the mother...to the baby.

Wait a second.
So...I have AIDS?

No, you have HIV,
and you're healthy.

Because you've been
taking medication.

Uh, no, no, no. See, I just take
a bunch of vitamins, that's it.

No, you've been taking
medication to combat the virus.

No, no, they're just
vitamins, man.

No, your grandmother told me

and I confirmed it
with your doctor.

Why wouldn't she tell me?

I think she wanted
to protect you.

And, um..

But you need to know.

[sighs]

So, my whole life,
everybody's lied to me.

I'm not lying to you.

(Tom)
'How much longer, do you think?'

Gordon, what's our ETA?

Well, there's
the Kankakee River.

About 20 minutes.

You alright?

It's, uh, just
a little chest pain.

‐ I'll be okay.
‐ Nitro spray.

Open your mouth.
Under your tongue.

On a scale of one to ten,
how bad is the pain?

Big time ST elevation
on the monitor.

Find the tenecteplase.
I'll do the heparin.

Ah, wha‐what's going on?

You're having
a heart attack

but we're giving you
clot‐busting medicine.

Pulse ox down to 82.
Do you want to intubate?

Not if I don't have to.

Let's get him
on a mask, 15 liters.

Maybe we should land.

No, Dr. Greene.

Dr. Greene, you'll
get me there, right?

Yeah, I'll get you there.

Do you have a girlfriend?

Because, if you've
slept with anybody

they'll have
to be tested.

It's important, Trent.

You have to use condoms.

Yeah.

Can I go now?

Yeah.

Yup, your grandmother's
waiting.

So, a case manager's
gonna phone you tomorrow.

Just to see how you're doing.

You've got an appointment

next week with
the Teen HIV Center.

And you can always
reach me here.

ER always knows
where to find me.

‐ Alright?
‐ Alright.

Yeah.

Trent?

Thank you, doctor.

(Coggins)
'"Hog butcher for the world,
toolmaker, stacker of wheat.'

Player with
railroads.."

"City of the Big Shoulders."

You know Sandburg's poetry.

Just that one.

After teaching English
for ten years

I know them all.

Looks like you're
feeling better.

ST segments are back down.

[phone ringing]

Hello.

Yeah, we're about
five minutes out.

Well, that's good.
Hold on.

‐ Janet's on her way in.
‐ Thanks.

Listen, we're gonna
need a gurney and..

What the hell's that?

It's the main rotor.

'I got metal fragments
in the gearbox.'

What's wrong?

Mark! Mark, are you there? Mark!

Mayday. Mayday. Mayday.

This is Lifeguard
Nine‐Seven‐Kilo

'on emergency descent.'

Cinch him in tight.

'I'm gonna shut down
for auto rotation.'

‐ Crash?
‐ No, we're gonna make it.

Mark, can you hear me?

‐ What's going on?
‐ I don't know.

There were horns, shouting,
now there's nothing.

Mark?

(Gordon)
VFR position.

Industrial area..

'A scrap yard
near 95th and Commercial.'

'Now, when I get
enough rotor speed'

I'm going to pull on the pitch.
That should cushion our landing.

‐ 'We're falling.'
‐ Hang in there, Tom.

(Gordon)
Here we go.

Okay, everybody out.

Get out now.

‐ Take the monitor.
‐ 'Got it.'

‐ 'Pumps are down.'
‐ Let's go. Let's go. Move away.

‐ Airway kit.
‐ You got the feet?

(Gordon)
I got the feet.

Alright.
Let's go together.

Alright, we gotta move.
We gotta move.

‐ How far?
‐ Just keep going.

I'll tell you when.

[grunts]

You alright?

Yeah, yeah, yeah.
Let's go, come on.

‐ Tom, how you doing there?
‐ SATs are down to 78.

Alright, I got
to tube him.

Alright, alright.
This is far enough.

This will shield us
if the fuel tank blows.

Give me four of Versed,
100 of sux.

‐ Right.
‐ Tom.

We gotta stick a tube
down your throat.

Help you breathe.

‐ Do they know where we are?
‐ Yeah, yeah, I called it in.

They'll find us.

'I'm giving some medicines'

'to relax you, Tom.'

‐ I got it.
‐ Do they know anything?

ATC's got a mayday
call with location.

EMS and fire
are rolling.

‐ Are there any injuries?
‐ They didn't say.

Well, call them
back, damn it.

‐ What's going on?
‐ Ah, Mark's chopper went down.

‐ What?
‐ They crashed?

It was an emergency landing.

We don't know that.
We don't know anything.

Randi, call County Dispatch.

They don't know anything
more than I told you.

‐ I don't care!
‐ Whoa, whoa.

Hey, hey, look. I can't have
this place fall apart now.

Elizabeth, get on and stay on
with CDO and keep us posted.

‐ Randi, how are we doing?
‐ Nineteen patients waiting.

Alright, Malucci,
grab some charts.

Abby, draw some labs, start some
IVs for anyone who needs one.

Get Carter to order x‐rays
from triage, alright?

Let's move, people, now.

Where the hell is Kovac?

We're still trying.

Very nice.

Appreciate it.

You play here a lot?

Yeah, I work here
in the Navy Pier.

What about at night?

Yes, sometimes
for the after‐dinner crowd.

Have you...ever seen this man?

No, I would remember
a guy like that.

You don't seem like a cop.

I'm‐I'm a doctor.

Try the tour boat ticket guy.

He's here all the time.

I did. Thanks.

Sorry, I can't help you.

[siren wailing]

(Greene)
Good breath sounds.

Keep him on high flow oxygen.

Fifteen more minutes
and he sucks the tank dry.

‐ Where's EMS?
‐ They sound close.

Yeah, but they can't see us.

They're gonna have
to call in a police chopper.

Well, we can't wait.
Do you have any flares?

(Gordon)
'There's a Very pistol
in the chopper'

'but I can barely walk.'

I'll get it.

'Left side behind
the pilot seat.'

[siren wailing]

Luka, it's Abby.

Um, could you call me
when you get this message

'cause I've been trying
to reach you everywhere

and I'm getting
a little bit worried, so..

‐ Abby.
‐ Okay, call me.

Miss Skye here
complains of abdominal pain.

Well, it's not
really my abdomen.

[chuckles]
Oh, I can't believe
I'm actually embarrassed.

Well, we see
everything here.

Okay.

I got a roll of money
stuck up my..

...birth canal?

Look, could you hurry up?

I got a cab waiting with

the meter running, okay?

Dr. Benton, I need
you right now.

Six month baby boy,
respiratory distress.

Alright, Abby.

Uh...just hold on one second.

Temp's 103.
Coarse crackles bilaterally.

Pulse ox is only 75.

It's alright, let's take a look.

Sounds like pneumonia.

Now, let's get a pediatric
intubation tray.

‐ Move now, people.
‐ We got a line.

I'll draw CBC
and blood cultures.

Damn, I don't even do
pediatric intubations.

‐ Where's Cleo?
‐ She took a kid to PICU.

Get her down here now.
What size tube?

We use two and a half
in the delivery room.

No, I think I need
something bigger.

Uh, three, three
and a half?

I don't know.

(Abby)
'Got the labs.'

Move.

Uh, he's clamped down.
I can't get the blade in.

‐ Paralyze him.
‐ What's the dose?

You need his weight.

He's vomiting.
Suction. Come on.

Pulse ox is dropping.

What do we have?

Uh, difficult intubation.

I‐I can't dose him
without a weight.

That's what the Broselow
tape is for.

Okay, we're
in the red zone.

2.6 of Etomidate,
18 of sux.

Premedicate with .17
of atropine, 14 of lido.

Bag him. Keep some
cricoid pressure.

I couldn't see the cords.

That's because you had
the wrong blade

and the wrong tube.

‐ Thanks for coming down.
‐ Drugs are on board.

‐ He's loose.
‐ Okay, here we go.

‐ 'Dr. Benton?'
‐ Hold on, hold on.

(Finch)
Okay.

I'm in, bag him.

Dr. Benton, do you wanna

close to paramedic traffic?

I've got this.

Hang 400 of ceftriaxone.

Vent settings will be tidal
volume and 90 cc's..

No monitored beds and we're
boarding five ICU patients.

‐ Alright, close to paramedics.
‐ You sure you wanna do that?

We've been getting
a lot of bad press lately.

Media's been tracking
all of our closures.

‐ What would you do, Carter?
‐ I don't know. Tough call.

Dr. Benton, South Side Urgent
Center wants to send a patient.

Haleh says we're
closed to transfers.

It's just a backache.
Their x‐ray machine's down.

‐ I got the other doc‐‐
‐ Fine, fine! Send him.

So, do we close?
And don't ask me.

They don't pay me enough
to run this place.

Paramedics found them
on the South Side.

‐ No casualties, thank God.
‐ Thank you.

Well..

‐ Well..
‐ Uh, thank you.

Trent?

Hey, they told us to wait

because you were busy.

Is she a friend of yours?

Uh...she's my girlfriend.

Your girlfriend?

Thought you said
you didn't have one.

I brought her here, man.
You think that was easy?

You gotta be
honest with me.

‐ Is she the only one?
‐ Yes, the only one.

I've kissed other girls though.
Is‐is that a problem?

‐ No sex with anyone else?
‐ No, no.

And you didn't use condoms?

I love her, man.

Alright, okay.

Let's run some tests.

We'll see where we are.

‐ You wanna ride up front, doc?
‐ No, I'm staying with Tom.

Nearest facility's Oakdale
Community, seven minute ETA.

‐ Nope, we're going to County.
‐ That's 20 minutes away.

Dispatch doesn't want us
to leave our catchment area.

Alright, I'll take
responsibility.

Easy now.

Roy, the doctor says
we go to County.

‐ Can't. County's closed.
‐ What?

They just closed
to ER saturation.

That's okay.
I'm an attending there.

They'll take us.
Let's go.

Patch me through
to the ambulance?

Dr. Corday, surgical

consult in Exam Four.

I'll be there.

Just give me the number.

Excuse me.

Uh, I'm looking
for Dr. Corday.

Are you Janet?

‐ Yeah.
‐ Elizabeth Corday.

‐ 'Oh, hi.'
‐ We expect them very soon.

‐ How's Tom doing?
‐ Quite well, I understand.

Apparently, no one
was hurt in the landing.

What landing?

Just something minor
with the helicopter.

So, how long have you
two been engaged?

Oh, three years.

So, he's not
in the helicopter?

No, in an ambulance.

Um, my goodness, three years.

That seems
like a long time.

Right after he gave me the ring,
he got the flu.

We thought
it was no big deal

but then the virus
went to his heart.

We spend a lot
of time in hospitals.

Have you seen
the incarcerated hernia yet?

‐ In a minute.
‐ No, no, no, no. Now.

EKG on a new
chest‐pain patient.

‐ Alright, let me see it.
‐ I got a guy on a backboard.

He's been there for two hours.
When you gonna clear his neck?

‐ Oh, when I get there.
‐ You want me to call Weaver in?

‐ No.
‐ Are you ever gonna sew me up?

You know what, we're busy.

Just wait right there.
What's this?

Second board.
We're totally backed up.

Four patients just left
without being seen.

(Dave)
'Oh, oh, oh, I know
what the solution is.'

We see them, send off
labs and x‐rays

and have them wait in chairs.

Come on, are you crazy?

We need monitoring,
IVs, medication.

The problem is, you doctors
order too many damn tests.

You should be reviewing their
charts, keeping things moving.

Stroke patient needs
a monitored bed.

‐ Peter.
‐ We don't have them.

Tell them we'll put him
in the hall.

Peter, none of my nurses
have even had lunch.

Ambulance dropped off
a stab wound to the belly.

Alright, alright,
alright, alright.

That's it, that's it.

Get me the phone.

[siren wailing]

(Eddie)
'Heart rate is 40
after two of atropine.'

Amp of epi.

He needs a pacemaker,
Dr. Greene.

We should be in a hospital
right now, any hospital.

[phone rings]

Rescue 82.

BP is down to 60 palp.

‐ Open up the dopamine.
‐ It's for you.

Hello. Yeah, we're almost there.

'No, he can't
talk right now.'

'He's out.
I can't feel a pulse.'

I got to go.

Starting chest compressions.

We could have been
at Oakdale ten minutes ago.

I'm going on record that you
overrode our policy.

There's going to be an incident
report on this.

Shut up!

Get back to work.

Hang in there, Tom.

You're going to make it.

Janet's there.

She's waiting for you.

‐ How long's he been down?
‐ He never arrested.

He just needs help
maintaining a pulse.

You look exhausted.

He wouldn't let
us relieve him.

Come on,
I'll take over.

Coming through,
we're coming through here.

This is Janet Wei, his fiance.

Tom had a heart attack.

We need to put
in a pacemaker.

You can take his hand.

Hey, Tom, it's me, I'm here.
Can he hear me?

(Greene)
'Keep talking to him.'

It's Janet.
He's squeezing my hand.

(Corday)
'What's his BP?'

Uh, 70 systolic

on 20 mics
of dopamine.

How about
a intra‐aortic balloon?

Not a bad idea.
Oh, what's going on?

‐ We need the room.
‐ Everything's backed up.

We're supposed to be
closed to paramedics.

Chuny, get that patient
out of there.

Wait, the rapid infuser.

‐ Oh, my god.
‐ Clamp the central line.

(Corday)
'Turn it off!'

‐ I'm sorry.
‐ Any housekeeping in here?

(Chuny)
'We need another two units
from the blood bank.'

What the hell's going on?

I just got back
from transport.

‐ I left Benton in charge.
‐ Benton?

Mortimer goes to x‐ray.

Put the rectal bleed in Exam
Three.

Hey, hey, I got a patient who
says her tongue is too smooth.

Tell her to get a life.

A smooth tongue can be a sign

of pernicious anemia,
iron deficiency.

I can't leave for a day

without this place going
to hell in a handbasket.

I've never seen it
this busy before.

And it's like this every day.

Peter, I just heard
from the trib.

Tell me we're not
closed to trauma.

We're not.
As of now, we're open.

How can we? We can't see
another critical patient.

Abby, get me
the nursing supervisor.

I want every remotely stable
patient moved out of the ICUs.

(Romano)
'I was under
the mistaken impression'

'you could manage an ER.'

I was the only attending.
Kovac never showed up.

‐ He didn't show?
‐ He might have switched his..

In 20 years, I have never
been late for surgery.

But I guess you people work
on a different standard.

And, Peter, based on
your performance today

maybe you're not the guy
for the per diem job.

Oh.

‐ Dr. Carter?
‐ Yeah.

Lab results
on Emma Miller.

‐ Oh, man.
‐ That's tough.

She's 15 years old.

Pacer is capturing well.

Setting the rate at 80.

I got your
transducer here.

(Greene)
'How you doing?'

Passing a 40 cc balloon.

I need to check position
with fluoro.

Janet, why don't you
come talk to me outside?

This pump should bring
his blood pressure up.

Will he live long enough
to get the heart transplant?

I don't know.

I want to marry him.

I don't know if he's gonna be
able to leave the hospital.

Can we do it here?

We could try and arrange it.

I think if we got married,
it might help.

What if they made a mistake?

I wouldn't tell you
if I wasn't certain.

But I don't feel sick.

You should do
the test again.

Emma, if you start
taking medication

right now..

...you could stay healthy.

No, I know what happens.
Everybody dies.

That's not true.

That's not..
look at Trent.

He's had HIV his whole life.
Look at him.

I wish we'd
never had sex.

Emma, I didn't
know, I swear.

Dr. Carter,
tell her, please.

This is a lot.

This is a lot
for you to handle.

And you're both
gonna need some help.

So before you go,
I would like you both

to talk to a counselor.

‐ Hey, hey, Emma.
‐ Hold on, you two. Hold on.

I'll leave you two alone
for a little while.

But before you do
anything...talk it over.

Definitely, thanks.

Hey, hey, come on.

Why is Mr. Chang still here?

He's waiting
for a second CBC.

Okay, do another hemocue.
If it's over 11, send him home.

Torelli's cardiac enzymes.

Great. Alright,
she's out of here.

Clears up
another monitored bed.

You know,
Romano was out of line.

[chuckles]
When isn't he?

It's wrong to throw you into the
deep end and expect you to swim.

Nobody masters ER management
on their first day.

‐ What's this?
‐ Back pain.

‐ Collapsed at triage.
‐ Both trauma rooms are full.

Send him to Curtain Two.
Move him out of there. Go!

‐ I need a central line kit now.
‐ BP 60 palp.

Could be a ruptured aneurysm.

Alright, CBC, coag,
type and cross for eight.

Four units of O‐neg.
Let's prep the neck. Move.

I feel a pulsatile mass.

Hey, Malik, is there
any history on this guy?

I need a trauma kit.

This is a triple
lumen CVP. Here.

History of hypertension
and high cholesterol.

Give me an NG and a Foley.
I need a Sonosite.

'Dr. Benton, it says
here that you accepted'

this patient from
an urgent care center.

What, and he's
been waiting in chairs?

For two hours.

I can't find
the subclavian.

Put him in
Trendelenburg.

Look, they said
it was just a back sprain.

The doctor told you that.

Well, I, uh...I didn't exactly
talk to the doctor.

Oh, great, and now
he's bleeding out.

Take a deep breath.

MAP is 78 with the pump.

Is that good or bad?

It took you out
of heart failure

and got you off
your breathing tube.

Sats are up to 99.

Okay, let's get him
on five liters, nasal cannula.

Connie, why don't you
grab a blood‐gas kit?

Where's Janet?

She's trying to get
a clerk from City Hall

to come issue
a marriage license.

[chuckling]
That's crazy.

People in love do crazy things.

'I wanted to wait
for a transplant'

so I could chase
her down the aisle.

I didn't want her to marry
a cardiac cripple.

If you get a heart, she won't.

If one's available,
if the tissues match.

How long can I last
on this pump?

Couple of weeks.

Pretty lousy odds.

They were worse when you
were having a heart attack

and the chopper was going down.

‐ See any zephirin?
‐ Yeah, top shelf.

Hey, I heard about
your teenagers.

They're so young.

It's pretty rough.

‐ Are you okay?
‐ Yeah, I think so.

Do you wanna
take a break?

I'm going to plug in
two new patients.

I'll come find you.

‐ Talk to Kovac?
‐ Not yet.

'Dr. Kovac?'

Yeah?

We finished the autopsy.

I can review some
of the pertinent findings.

Mm‐hmm.

There were
multiple contusions

to the occipital cortex

with herniation
to the foramen magnum.

And if you'll take
a look here

you'll see
numerous fractures

consistent with
repetitive blunt trauma.

I know how he died.

Well, I can tell you
that he was a smoker

based on the lung findings.

Also, he probably once lived
in Central California.

There were foci
of pulmonary fibrosis

consistent with
coccidioidomycosis.

It's endemic
to the San Joaquin Valley.

That's an agricultural area.

Maybe he grew
up on a farm.

Well, I don't know.

There's grease
under the fingernails

and a biker club tattoo.

'He could be just a drifter,
but we'll probably never know.'

'Happens all the time.'

Not such a smart idea

to take your Razor down

a flight of stairs, huh?

Were you wearing a helmet?

Yeah, what do you
think I am, stupid?

Ooh. Well, we'll see
after the x‐ray.

Right wrist film, something
for the pain, maybe half of a‐‐

It happened so fast.

We were having a fight

and he ran into the street

and a car hit him.

We're doing
everything we can.

‐ Dr. Carter?
‐ What's the rhythm?

V‐fib.
Charge to 360.

Trent, don't die.
Trent.

Ready.
And clear.

(Emma)
'Please don't let him die.'

(Marquez)
'Still V‐fib.'

‐ Hey, doc.
‐ Hey, thanks for coming down.

Sure. What do you need?

Thirty‐one‐year‐old patient

end‐stage heart failure.

He may not make it
to transplant.

What denomination?

‐ I don't know.
‐ Can he speak?

For last rites,
I really need to know that.

No, no. He and his fiance,
they wanna get married.

‐ Tonight?
‐ He's too sick.

We can't get him movin'.
We got to do it here.

Were you able
to get a license?

Oh, I tried,
but City Hall's closing.

You don't have
a marriage license?

Can you do it anyway?

I'm sorry,
but a marriage isn't

legally binding without a
license. How about tomorrow?

Come here. He may not
make it till tomorrow.

Can't you help these people?
They want your blessing.

They have
very little time.

Well, as long as
everyone understands

it won't hold up in court.

Yeah, yeah.

You ready to tie the knot?

Come on, let's go
talk to Tom.

Dr. Kovac,
did you trade your shift?

‐ No.
‐ Hey, where have you been?

I heard they
couldn't reach you

and you didn't
answer your page.

What‐what's the problem?

That I had to come in
today and cover for you.

‐ I thought I was on tonight.
‐ No. You were on today.

Then‐then I'm sorry.
There must've been some mistake.

There was no one with enough
experience to cover for you.

We almost lost two patients.

Luka, this is grounds
for dismissal.

Fine, Kerry, fire me.

Look, I know that
you've been through a lot.

If you need to take some time
off, you should tell me.

But you can't miss
anymore shifts.

I can work tonight.

We don't need you tonight.

You should go home.

Go on. Go.

‐ Luka, wait.
‐ What?

Wait a minute.
Don't walk away.

Where have you been?

Abby, please.

I‐I wanna help.
Just talk to me.

There's nothing to say. Okay?

"To have and to hold,
to love and to cherish

"as long as you
both shall live.

"The union of husband of wife
in heart, body and mind

"is intended by God
for their mutual joy

'"for the health and comfort
given to one another'

"in prosperity and adversity

"and, when is God's will,
for the procreation of children

and their nurture.."

You can stay as long
as you want, okay?

Emma, I am so sorry.

Get out of here.

‐ Emma.
‐ It's your fault.

By the power vested in me

I pronounce you
husband and wife.

Go ahead and kiss
your bride, Tom.

[chuckles]

‐ Congratulations.
‐ Congratulations.

I'm gonna break
all the rules

and allow you to have
one sip of champagne.

Thanks.

Well, since this is
the honeymoon suite

I think you're entitled
to a little privacy.

We're very grateful.
Thank you.

(Tom)
'Yeah.'

For everything.

Nice folks.

Tell them to get a license
and I'll do it again. No charge.

‐ Okay.
‐ Thanks.

So, what about
our wedding coordinator?

[gasps]
I totally forgot
to call and cancel.

‐ Oh, she'll be furious.
‐ Well, blame it on me.

I mean, it was
a medical emergency.

Oh, the hell with her.

‐ Excuse me?
‐ This is all so silly.

I don't want a rose‐entwined
arbor with trained doves.

I don't want champagne
served out of crystal flutes.

I understand.

Who cares about
a bloody ice sculpture?

Not me.

I just want
to get married

in a simple ceremony.

I don't know. I was looking
forward to those doves.

[both laughing]

So, I spoke to the OR.

The aneurysm repair
is going well.

‐ I'm glad to hear it.
‐ Yeah.

I think it's
best for now

if you just see
patients. Here.

If that's
what you want.

Peter, you're
an excellent surgeon

but ER management is not
the best use of your skills.

Leave that to us.

[sighs]

Hello, Mrs. Barnwell.
I'm Doctor Benton.

So, I understand
you have a pain in your hip.

That's right. And I've been
lying here for three hours.

Oh, well,
I'm very sorry about that.

Pardon me for asking,
but are you an intern?

No, no, no.
I'm a faculty physician.

Oh. Your mother
must be very proud.

Yeah, she was.

So, how long
have you had this pain?

Before we get
much further

I'd like to say
that I would be more at ease

with another doctor.

Excuse me?

You look like a fine young man

but, uh, I've always had
white doctors.

I've always felt
more comfortable that way.

So, you're saying that you only
want to see a white doctor?

[chuckles]
If it's alright with you.

It's fine.

You'll just have to wait
another three hours.

‐ What happened to him?
‐ I don't know.

Hey, uh, have
you seen Abby?

I saw her punch out.

Hey, Carter,
you got a minute?

Uh, actually, I'm
just on my way out.

Carter, wait.

John, you had a bad day.
We all have bad days.

Look at me.

You have to make
tough choices.

Do what you think is right
and accept the outcome.

‐ I shouldn't have told him.
‐ You had to.

‐ See you tomorrow.
‐ Hey.

I'm off in 20 minutes.

You wanna get some dinner?

I got an AA
meeting at 9.

You'll make it.

Can I join you?

It's a counter, Peter,
you can sit anywhere.

So you survived.

[chuckles]

Weaver said
I was incompetent.

Really?

Well, I mean, that's
what she implied.

The per diem job is
just temporary

until you get back
into surgery.

Yeah, but I needed
to show them

that I can run the ER.

Why? It has no bearing
on your surgical career.

Yeah, but it
reflects on me.

You know, I should've
been able to handle it.

Can't be perfect
at everything.

Yeah, but, Cleo, I can learn
the job, if I can do it well.

So do you feel better having
said this to a sympathetic ear?

Yeah. Yeah, yeah, I guess so.

Thanks.

You know,
I've had some problems

and I haven't had anyone
to talk to.

Are you ever
going to be there for me?

Because you sure as hell
haven't been.

[sighs]

(Kovac)
'Who is it?'

It's me.

Can I come in, please?

Sure.

‐ Abby..
‐ You don't have to talk.

[theme music]