ER (1994–2009): Season 9, Episode 21 - When Night Meets Day - full transcript

Previously on ER:

Ah!

It's over.

It's time for me
to cut my losses.

That's my brother.

A bullet ripped
his spleen.

Stay strong, little man, okay?

Where you going, Curtis?

Like I said, fix things.

Now you see why I
want to get the hell
out of this place.

Well, it's not all bad.



You know what I mean.

You know, you can get a job
at Northwestern, too.

You won't see
me for awhile.

I'm going to the Congo,

West Africa.

L'Alliance de Médecine
Internationale.

I thought you said
you weren't going.

Yeah, I'm not.

WOMAN:
Dr. Carter?

Dr. Carter?

( slurred ):
Start dopamine at ten mikes,

and mix up levophed.

Dr. Carter,
you left a note

to wake you if you
weren't up by 7:00.



Do you want
some breakfast?

No. No, thanks.

I'll just
get something there.

( groaning softly )

Dr. Carter?

I'm up.

( clearing throat )

I'm up.

Mmm.

Hey, you're late.

Two minutes.

Late is late.

57-year-old cirrhosis,
vomit and blood,

G.I. lab can
scope him at 9:00.

Can I get
a bagel first?

I haven't had breakfast
yet, either.

You mean dinner.

Yeah, whatever.

16-year-old gangbanger,
GSW to the belly.

O.R. should be
grabbing him
any minute.

You mean like now?

Then there's
the 14-year-old banger

GSW to the upper leg.

Pulse deficit, in
line for angiogram.

Same shooter?

I stopped keeping track.

DVT in Six;
on heparin.

Since midnight?

There's no tele beds.

This gang war's
got every department backed up.

Where's Jimmy Carter
when you need him?

Bus full of Texans
with food poisoning

all puking hash browns.
Good morning.

Yeah, for you, maybe.

Apparently, I'm a vampire.

Oh, wow,
you got it so rough.

Three night shifts
in a row.

I been doing graveyard
two weeks straight.

I did my residency,
thank you.

They're insisting
on being discharged

by 2:16 so they can
see the stupid eclipse.

I thought vampires
liked eclipses.

Ah, the moon blocks
out the sun-- big deal.

I've got a billboard
outside my apartment

does the same thing.

Catch you tonight,
Elvira.

Hey, I thought
this was it for you.

Almost. One more night
slumming here with you cats.

Then I'm heading it uptown.

You're late.

You can tell time.

So can Dr. Carter.

Yeah? So, what's he
going to do, fire me?

Did you catch the eclipse?

What?

The solar eclipse.

A celestial phenomenon

that occurs only
once every 18 years,

11 and a third days.

No, I slept through that.

You slept through it?

I had to sleep sometime.

You couldn't wake
up for ten minutes?

So, big deal--

the moon
blocks out the sun.

I've got a billboard
outside my apartment

that does the same thing.

You don't look so good.

12-year-old near-drowning
in Four.

Intubated and comatose,
no purposeful movements.

Waiting on PICU.

Hey, what's with
all the Buddhists?

They're here for the nun.

What, so now we got
some religious turf war?

Buddhist nun.

Transpo's backed up
taking her to the morgue.

She's dead.

Reincarnated;
a cycle of karma...

Six-year-old gone
respiratory arrest

from cyanide toxicity.

Acidosis is resolved with
induced methemglobinemia.

Also waiting on PICU.

How does a six-year-old
ingest cyanide?

CARTER:
That is the family
of a fatal M.I.

They want to go in
and see their father

after he gets
cleaned up.

You okay?

DVT in Six
is waiting on coags.

Hold on; I gave you DVT
this morning.

The guy's been in there
over 20 hours?

So, take care of him.

All right, see you.

Nice knowing you.

I start at Northwestern
next week.

Tonight's it for me.

That's right. Um...

Good luck, Greg.

Yeah, you, too.

Do you realize

how much ambulance
traffic

we get through
here a day?

I can't go around?

It's equipment
or a huge pile of concrete.

Hey, park the damn thing
sideways...!

What is this?

Weaver's
moving triage.

Something about
four more beds.

Oh, good-- so the patients
can wait lying down?

I don't ask.

I thought you were on vacation.

Tomorrow.

Martha's Vineyard?
Nope.

32-year-old woman
struck by a cab.

The Cape?

Rio de Janeiro.

Ooh-la-la-- string bikinis.

With my father.
Low velocity.

She ran
right into traffic.

There were others;
not just me.

Any head trauma?

Proximal tibia
on the right.

Could all be
supratentorial.

They were forcing us.

They wanted everyone
to go together.

Are you taking
any medications?

It's all ending today;
today's the last day.

Can you tell us your name?

2:16 P.M.-- the
end of the world.

Oh, great-- and I have to work.

I'm always working
when the world ends.

I can't swallow, man.

Belly's soft.

Let's type and
cross for four.

Blood bank's almost empty.

The Red Cross doesn't restock
until 9:00.

Okay, first crit's 30.

Let's stick with saline
for now.

Decreased on the right.

32 French.

Why can't I swallow?

Am I dying?

Not if we can help it,

but if you guys
keep shooting at each other,

we're going
to run out of blood.

I didn't shoot nobody.

Dr. Carter, I think

you should take a look
at this woman.

Been here half an hour.

I got half
a dozen patients.

You're going to have
to be more specific, Gallant.

Buddhist nun,
end-stage breast cancer.

Vomiting pain meds.
Exam Two.

Does this guy
need to go up?

Wouldn't have anywhere
for him even if he did.
Ten blade.

Portable chest,
full trauma panel.

NELSON:
Yo, where you going?

You have a collapsed lung,
Nelson.

Dr. Corday is going
to re-inflate it for you,

and we'll keep an eye on you
down here,

so, try not to bleed too much.

Hey, are you
my doctor?

Not at the moment.
Well, when?

I've been waiting
almost an hour!

Have you come to rescue us?

I'm swamped with
these physical
improvements.

You'll have to take
point down here.

Did you fire Romano?
No. Medical leave.

What, his arm?

I can't really
discuss it.

Carter, you know
if CT's back up yet?

I didn't know
it was down.

I thought she had
a benign abdomen.

Well, now she's
unresponsive.

Should have had
a tox screen.

She may be coming
down from speed
or hallucinogens.

She's nuts, right?
Out of it?

So, I don't have
to check out her story?

What, the end of
the world part?

No, the part about men
trying to kill her.

Yeah, I would
look into that.

Hey, I got chronic
pancreatitis.

It's flaring, and I'm
puking my pain pills.

Let me guess;
you need a shot of Demerol.

If you say so.
Just do it fast.

Mastectomy,
radiation, chemo.

Recurred with a
pathologic fracture.

Does she have an oncologist?

The surgeon's
in Japan.

MAN:
I need it now!

GSW en route,

ten minutes out.

All right, come find me.

Hello. I'm Dr. Carter.

Kito Shunko.

And this is
the Venerable Zuin-an.

I'm sorry, Sister Zui...?

Zuin-an.

Are you comfortable with me
doing a physical examination?

( speaking Japanese )

( quivering moan )

Yes.
Okay.

When was her last chemo?

Three months ago,

but it wasn't working
anymore.

I shouldn't have
even brought her here.

But she's
in terrible pain

and hasn't had
anything to drink in two days.

Well, she'll feel much better
with some intravenous fluids,

some antinausea
and pain medication.

( speaking Japanese )

So much sadness.

PRATT:
Whoa.

Somebody overcooked
their burger.

It's arson--
definitely arson.

LEWIS:
Could be electrical.

The place wasn't
exactly a model of
code compliance.

I've been brown-bagging it
since they closed.

And now the cafeteria
has a monopoly.

Was anybody in there?

CFD did a sweep.

Oh, well, I guess
we're closed now.

Oh, we never close.

Yeah, neither
did Doc Magoo's,

and look what happened.

I wouldn't deprive you
of your last shift.

Oh, come on.

Declare internal
disaster so that we
can all go home.

No, you're
an internal disaster.

That's an external
disaster.

( chuckling )

Hey, Abby,
got any marshmallows?

Mr. Mednick, you need
to be on a monitor.

No, what I need
is some fresh air.

And put out
the cigarette.

I'm almost done.

Put out the cigarette!

You have a bleeding ulcer.

I know what I have,
sweetheart.

Okay, that's fine.

Smoke the whole pack.

I'll be inside.

Come and find me
when you start vomiting blood.

Hey, Abby, Doc
Magoo's is on fire.

Yeah, I can
see that.

Single GSW to the...

( explosion )

Now can we go home?

Lizzie. Come to take
the "before" pictures?

Shouldn't you be in pre-op?

Yeah, well,
some man-hating bovine

threw me out here

when an elective lab nissen
started circling the drain.

Hand me that, will you?

What, the chart?
No, the black marker.

Poor bastard came in

trying to cure
aggravated belching.

His wife's probably
down in the coffee shop

waiting for him
to wake up.

Do me a favor?

Write "not this one, idiot"
on my arm.

Oh, like
it doesn't happen.

I'll be lucky
to get out of there

without both my legs
being amputated.

I should have you
come in with me

to stand guard
over these gargoyles.

You can if you want to,
you know--

if you're bored
or curious.

I'm covering the E.R.

Well, they need you
more than I do.

But I'll scrub in if I can.

You forgot "idiot."

I'll be there, Robert.

Yeah, well, just in case
you're not-- "idiot."

( sighing )

You think I'm doing
the right thing?

It doesn't matter what I think.

Well, that's
a position

I would usually advocate, but...

now I'm asking.

You're doing the right thing.

Yeah.

There's something in my eye--

maybe some metal.

Yeah,
don't touch it.

Why, what's it look like?

C.B.C., chem panel,
chest and carboxyhemaglobin.

Satting at 97.

Can someone check
my daughter's ventilator?
It keeps beeping.

I'll send a nurse.

How bad am
I burned?

Mainly second degree,
but the blast threw you.

I want to ultrasound your belly.

Will they do another EEG?

I'll check the chart.

SonoSite and
a Wood's lamp.

Damn tank
blew my mask right off.

You waiting
for somebody?

My-my husband.

You can check
with the clerk at
the front desk.

No, he died.

He had a heart attack.

Oh. You need someone
to take you to him?

No. He was here.

They took him.

We just... wanted
to stay here a minute.

Pratt, Susan needs your help
with a central line.

Hold on;
is there another room open?

Exam One, maybe.

No, it's all right.

We'll leave.

B.P. 122/78,
pulse 114.

TKO the saline.

Come on, Paul.

Dr. Pratt,
my gang kid's hypotensive.

I need the SonoSite
and an extra pair of hands.

WOMAN:
Come on, Paul.

Paul, now.

Can I install
alcaine?

Yeah, titrate
eight of MS.

And keep his systolic over 100.

Is the lung up?

GSW to the
right shoulder.

Good breath sounds
to the apex.

Can you feel it
when I touch you here?

BOY:
I'm good, I told you.

WRIGHT:
Pulse ox 98
on two liters.

Okay, let's get
a pocket Doppler.

C.B.C. type
and screen.

What is that?

GSW to the belly
last week.

We took out
his spleen.

And you're out
running again?

They killed my brother

and crippled my sister.

Here? We took care
of them here?

It didn't help much, huh?

Was Curtis your brother?

What, you were his doctor?

Dr. Carter-- a pediatric
drowning, full arrest.

WRIGHT:
A sinus tach
on the scope. 110.

How are his pulses?

Okay, let's follow
serial crits,

and then come find
me with his films.

12-year-old girl.

Dad was taking her
on a tour boat.

Fell into the water
when he wasn't looking.

You'll have to
relax and let the
doctor do his job.

How long was she in there?

Don't know.

Search and rescue
found her facedown.

Hold compressions.
PEA. Not perfusing.

Compression can put her
into V-fib

if she's too cold.

Let's do a rectal temp.

How long
since the last epi?

Six minutes.

Push another
point five.

Heated, humidified O2,
warm saline, bear hugger.

Core temp is 86.5.

Good enough;
resume compressions.

Still no pulse.

Mig of atropine.

How long
has she been down?

About 45 minutes.

Okay.

Let's go with

NG and bladder irrigation.

When?

Five minutes.

We deep
suctioned her,

and she started
triggering the vent.

I thought she was decerebrate.

She was.

Wean her down
to 50%.

ABG at 15,
check another set of lytes.

Temperature?
97.1.

That's good, right?

What's her name?

Heather.

Heather, can you hear me?

If you can hear me,
squeeze my hand.

I've got a pulse.

It's faint, but it's a pulse.

Let's try for pressure.

Rate's up to 72.

All right,
suction catheter.

Whoa. Pulmonary edema?

Or river water.

Okay, ectopy on the monitor.

Heart's irritable.

Let's set vent
temp to 42.

Four of peep.

Pupils are fixed
and dilated.

Just follow the light
with your eyes. Good.

Very good.

You're doing great, honey.

B.P.'s steady,
110 over 72.

Sats are 93.

I bet you want that tube out,
don't you?

Okay, when I say "now,"
you take a deep breath,

and you blow
as hard as you can, okay?

All right, deep breath.

LOCKHART:
Ready with five
of albuterol.

And now.

Clear.
( coughing )

No change.

All right, 300.

Stand by
with 50 of lidocaine.

Second bolus of 25 in five.
Clear.

HALEH:
Sinus tach.

Strong pulse.

Heather.
Come on, Heather,

wake up,
open your eyes!

She's posturing.

GCS 131.

PRATT:
Non-rebreather mask,
100% high flow.

Daddy.
Yes, honey?

Try not to talk.
Cough all that stuff up.

Another chest,
and repeat the ABG.

Dad?

Mr. Marks?

Yes. Is she going to be okay?

Your daughter was brought in
in cardiac arrest.

She wasn't breathing on her own.

Your daughter's awake.

She's breathing on her own.

She's on a ventilator,

but we don't know how long
she was in the water,

and her lungs
show signs of damage.

Her lungs are recovering,
and she's oxygenating well.

It's possible that her brain
may have been deprived of oxygen

for a long time.

Oh, God.

Oh, my God.

Her neurologic exam
is back to normal.

You saved her.

I-I saw you
save her.

Yeah, we got her
heartbeat back,

but you need to know

that 30% of all near-
drownings die,

and another 30
suffer permanent
brain damage.

We're just going
to have to wait and see.

( quivering exhale )

She's going to be just fine.

Thank you.

( chuckling ):
You're welcome.

All right.

Yeah, go ahead,
go in and see her.

( chuckling )

The just keep getting
younger, don't they?

Is neuro-vascular intact?

Completely, but I'd observe
for an expanding hematoma.

You could at least
take his staples out.

Or we could implant a zipper--

make it easier
for all concerned.

WYATT:
Hello! Still waiting!

Well, you're making
progress, you got a bed.

Yeah, still in pain.

Malik, I need the EEG.

Neurology's backed up.

Who isn't?

( clears throat )

Is she feeling more
comfortable?

Yes, thank you. She's sleeping.

The dehydration
has resolved.

Her vitals
look better.

She says it won't be long.

She might be right.

If there's anybody
who would want to
say good-bye...

They're coming from the temple.

She has a gift.

She can see inside of people.

She saw inside of me.

She was imprisoned for
demonstrating for human rights

in North Korea.

And I was imprisoned for...
well, for other things.

She saved me.

I took it on myself
to serve her purpose,

but now as I watch her embrace
her death and rebirth,

I truly understand:

only through
our own acceptance

do we realize
our purpose.

Is it scabies?

Impetigo. It's
a bacterial
infection.

What if it spreads?
Gets into his brain?

We'll treat it
with antibiotics.

He must have gotten that
from his friends,

because he did not
get that in my house.

Don't touch your face!

I fell.

Is that how you hurt
your wrist, too?

Yeah.

How did you get
to the hospital?

My boyfriend.

Was he there when you fell?

WOMAN:
Ow! Not so hard! Geez.

It's gallstones, Anna.

No. I don't
have gallstones.

Fatty foods bring
out the pain.

I didn't even eat dinner.
I just had some pie.

How much pie?

You know-- a pie.

You a smoker,

Mr. Dressler?
A little.

Drink alcohol?
Yeah.
Beer, mostly.

Exercise?
Well, I was starting
to get back into shape.

I was doing one of my
wife's exercise videos,

and, uh... I feel
a lot better now.

I wasn't sure if it
was the chicken wings

I had last night,
or a heart attack.

Let's hope it
was the wings.

How long is this
going to stay on?

About four
to six weeks.

I have finals in a month.

Well, you can still
study with a cast on.

Not exams. State finals--
cheerleading.

Well, you might
have to give those
pom-poms a rest.

I'll give you compazine
for the nausea.

You can keep the meds down.

No. My doctor tried
that before.

It doesn't work.

Then why does
he prescribe
Percocet?

That's what
I'm asking you.

Demerol works.
150 milligrams.

Whew, big dose!

It's a big pain.

Okay, one shot, one time,
and then that's it.

I'm flagging your chart.

You're going to have to
see a pain specialist.

Good idea.

Haleh, 125 of
Demerol for Mister...

Dean. John Dean.

Haldeman. Bob Haldeman.

I'm serious,
Mr. Haldeman.

One shot of Demerol,
and that's it.

The ER is not a place
to manager chronic pain.

As soon as my
chiropractor

gets back in town,
I'll get adjusted.

Good, 'cause I'm
flagging your chart.

Abby, flag his chart.

Yes, sir. Oh, and
Mr. Johnson made a biscuit.

A "biscuit"?
He took a dump
in a gurney.

Aw, that's beautiful.

Hey, Jerry,
what's the County

to Northwestern
biscuit ratio?

It's got to be
eight to one.

Oh, odds are in
my favor, baby.

Banger number 17's
rolling up.

Excuse me, the nurse
told me to down here...

Yeah, yeah. Sit right there.
We'll get to you.

The old paint factory on Hudson
was probably the worst.

Hot as hell, and the smoke...

Couldn't see your hand
in front of your face.

Isn't the fire
outside, boys?
It's out.

Really? Then shouldn't you be
rolling up your hoses

and heading back
to the station?

Feeding that
little spotted dog?

Polishing your poles?

Are you cranky
or flirting?
What?

"Polish your poles"?

GSW times two
to the left chest.

Pressure's 100 palp,
we scooped and ran.

Shot in the shoulder, too?

No, that's
an old one.
Old one?

Mom... call my Mom.

We will. Let's get
you inside first.

Steri-strips
on the belly.

Oh, God.
He's a baby.

Yeah, that knows
how to take a bullet.

What's your name?
Turner.

Does it hurt here?

( whimpering ):
Yeah. Oh...

How about here?

CARTER:
You want me
to call your mom?

You don't want
to talk to your mom?

She'll kick
my ass.

Well, maybe
that's what you need.

Look, man, she
don't understand.

I don't understand.

Look, they dropped
my brother.

That's all there is.

No, that is not
all there is.

You're what,
13 years old?

There's a lot more
than that.

Not where I live.

You're not one of those guys.

Not yet.

You don't have to be.

Well, somebody's gotta
take care of business.

Your business is your mother
and your sister.

Who's going to take
care of business

when you get killed?

We need the room now!
In a minute.

Cops found a mass suicide
on Folton.

Two more behind us.

C-spine, chest, pelvis, lumbar
spine series, and right tib-fib.

Why did you jump out
a third story window?

I was about to take it, but then
they started forcing me.

Bone culture, gram
of ancef, 100 of gent.

( groaning )
Hang on, Turner.

My feet-- why can't I feel
my feet?

Don't worry, we're
going to take care of that.

Sats are down to 87.

Up him to 15 liters.
We'll need x-ray
for portable chest.

Will somebody please
call my mom?

No problem. Just hold on.

Here...

write down her number.

All right, set her
for narcan and charcoal.

What did they take?

Drank some kind
of poisoned Kool-Aid.

Throwing PVC's.

Okay, stop.
Pull the ambu bag.

What?
Pull it.

On-scene survivor
said

they were meeting
the eclipse.

Oh, Lord.
It's almond smell.
Cyanide.

Gallant, it's cyanide!

We need the antidote kits, now!

Pulse ox is 99.
She's seizing!

It's all right.
It doesn't matter.

Her cells can't use the oxygen.

ST elevation
on the monitor.

All right,
four of Ativan.

It's lactic acidosis
of the heart.

We need amyl nitrate perles
down the ET tube and bag.

Sodium nitrate
to follow.

Ten cc's I.V. push
over 4 minutes.

Chest tube on the left,

type and cross for six,
and notify the O.R.

We need the room.

Pupils mid-dilated
and nonreactive.

Okay, move him into the
hall and get the Tonopen.

It's closing in... dark.

And page optho.
I'll be right there.

Stats are down to 84.

Rapid induction,
eight-O tube.

Bad stabbing
victim rolling up.

Pratt.
Abby.

Ten blade. Don't worry,
kid. We got you.

Chart still in
the racks. AMA.

32 French.

Okay, is this your
mom's phone number?

Turner?

Turner?! I need a BP.
He's crashing.

He can't count fingers.

It might be
traumatic glaucoma.

Timoptic and pilocarpine drops
after a gram of Mannitol.

All right, repeat ABG, lytes,

lactate, methemglobin,
and cyanide level.

ST segments are down.

First troponin is
elevated on Dressler.

Who?
Chest pain.
in Exam Four.

Call the O.R.
and tell anesthesia

he made need a Greenfield.

Page cards. Inch
of nitropaste,

aspirin, five
of metroprolol.

You might want
to check for acidosis.

I'm more concerned
about fat embolus.

Spontaneous
eye opening.

Sorry, sir. You'll have
to catch the next eclipse.

Lost the pulse.
Crank it.

1500 in
the Thoraseal.

( groans ):
Suction to me.

No tamponade. Looks like
the pulmonary vein.

( grunts ):
Starting internal
compressions.

Hilum's clamped.

Pratt-- penetrating
abdominal trauma, no pressure.

Carter-- two more OD's

with one apneic.

Get Weaver down here.
We need more docs.

Aw, man, what happened?

Oh, God.

Found bleeding
with multiple
stab wounds.

Mom's next door.

They were found
hugging each other.

Is she breathing?
Agonal.

All right, pediatric
intubation tray.

Five and a half ET tube...

Pre-op labs and
four units O-Neg,

and get surgery
down here.

Strong pulse.
They must not've
given her enough.

Must be a couple
of units on the
clothes alone.

There was blood
all over the scene.

Starting compression,
ragged incision.

What'd they use?
A meat cleaver?

Pratt, she's open
all the way down
to the bladder.

Oh, God, who would
do this to their kid?

There were
ten kids.

This is the only
one we found that
had a chance.

That looks like a
pregnant uterus.

Where's
the baby?
What baby?

Oh, God.
What?

Somebody ripped
it out of her.

Okay, I'm in.
Take over.

Call RT, have
them send down
a pediatric vent.

Hemocue's 5.1.

Retinal arteries
and veins are
bright red.

O-Neg wide open.
Feels open to
the spine.

Consistent
with cyanide.

Like a C-Section.
Check ephemerol
with compressions.

Pharmacy only
had one more
cyanide kit.

What?
Dammit.

Hospital only
stocks three
of them.

Lap and pressure.

All right,
we need more kits.

You need to
deliver the
uterus.

Call Mercy, call
Lakeside, call...
Yeah. Right.

Will they get
here in time?

If packing
doesn't work,

just clamp
it off.

Bradying
down.

Okay, okay,
side-biting
clamp.

Give whatever we
got to the daughter.

Mom's pressure's
going down to 80.

Nitrate popper
for each,

then the daughter gets
30 cc's of sodium nitrate.

Maybe the girl
can wait.

Give the mother
whatever we got left.

That's a
Fallopian
tube.

That's an
ineffective
dose.

Uterine artery runs
at the inferior
margin?

She needs
10 cc's.

Right?
Yeah.
Clamp it, now!

Carter...
I know!

I got it...

I think I got it.

All right.
Stop compressions.

I have a little pulse.
Okay.

Okay, trauma kit,
open a cut-down tray,

keep jamming with O-Neg,
and hope she wakes up.

Keep her hemoglobin
level under 40%.

And come back
with her films.

Thiosulfate's
on board.

Call of six
on the mom!

100 of lidocaine.
Did you get another kit?

20 minutes out.

All right, crank
the last amyl nitrate!

Carter!
Hey.

Soft restraints?

Yeah, yeah, yeah.
Purposeful movements.

We're getting some brain
function back.

Hey. Hi, Sweetie...

TURNER:
How's that, huh?!

How's that?!
How's that?!

( screaming )

Turner? Somebody get security!

Clear.

Come on, Turner.
Still in fib.

How many units are in?

Six of packed cells,
one of FFP.

Clear.

( yelling )
Turner!

How's that?!
How's that?!

Drop it!
Drop the scalpel!

How's that?!
Drop it!

Chest tube and intubation tray!

No, wait, Turner--
you're bleeding.

Security!

( equipment clattering )

Good pulse with
compressions.

Epi's had time
to circulate.

Heart's filling well.

Checking the monitor.
Start a second

line of saline,
wide open,

and prep the left chest.

Turner!

( monitor flat-lining )

( sighs )

PRATT:
Time of death, 00:28.

KLINE:
You didn't
call him back?

BJERKE:
I'm sure,
after four weeks?

You don't know that.

Maybe his grandfather died,
or something.

There are phones
in funeral homes.

Can get you a
little Valium

to take the edge off.

Dr. Romano?

What?

Would you like some Valium?

Help you relax.

I don't want to relax.

So you're not going
to call him back?
No way.

I thought you were crazy
about him.
I am.

Make sure I have
some number eight Biogels.

How are we doing, Dr. Romano?

Never better.

SHIRLEY:
Can you scootch
over for us?

KLINE:
Tank him up with a liter.

Who's that scrubbing in?

Uh, Dr. Starkman,
third year.

No. No way.
No residents.

Geez, was this table
in a freezer?

I know.
It can get a little cold.

KLINE:
I'll be doing the
procedure, Robert.

Once you're out,
we'll make

a circumferential
cut around the...

Yeah, I know the routine.

Let's just get on with it.

Okay.
Set up a pre-op Doppler,

sterile Stryker set.

Where's Corday?
I thought she was scrubbing in.

KLINE:
What for?

She was with
an E.R. patient.

You want me
to page her?
No. No.

KLINE:
All right, mix up
a gram of Ancef.

Uh, you may want to put that
on the other hand.

Oh... sorry.

BJERKE:
Count backwards from
ten, Dr. Romano.

Ten...

nine...

( weakly ):
eight...

PRATT:
Hold still.

MARQUEZ:
Tonopen's twenty?

Two drops of iodipine
and pred forte.

I'm losing my sight?

Maybe partly?

Between the burn
and traumatic glaucoma

but only in the one eye.

What's her pressure?

90/60.

And she's waking up.

You need depth
perception

to be a firefighter.

We're not even sure yet.

Where's O.B.?

Coburn came down,
took a quick look
and went to scrub.

Mia, you were stabbed.

We stabilized you but in order
for us to save your uterus

you're going to have
to go into surgery.

ABBY:
Last crit was 19.

Pratt?

Pratt?

We don't know.

CARTER:
Can you tell me

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

How high? Eight.

No, it's nine.

Sorry to tell you this,
Mr. Dressler,

but it looks like you're having
a heart attack.

Oh, God.
We need to take you
upstairs

and unblock the vessel
with a balloon catheter.

HALEH:
Dr. Carter?

Your dad's
on line three.

Okay, thank you.

Do you want us
to call your wife?

No, my wife took the
kids to Lincoln Park

to watch the eclipse.

( grunting ):
I left a message
for her at home.

Okay, not to worry.

They're going
to take you right up.

Integrelin bolus
then 15 migs per hour.

Where's that girl's EEG?

Tech took it up.

Well, then get neurology on it!

Hello.

Hey, Dad.

How are you?
Where are you?

John,
what the hell happened?

Sorry, what?
Where did he get hold
of a scalpel?

Too many patients,
not enough staff

and not enough medicine.

Which is why you prioritize

based on severity
of illness.
Oh, no.

Really?

Well, can't we
just postpone for
a couple of days?

Hey...
I'll just stay
in Chicago.

This woman has
a fatal arrhythmia...

I'm on the phone, Kerry!

I'm sorry.

No, it's just
one of those...

Okay.

Yeah, we can
reschedule.

( hangs up phone )

Fatal arrhythmia.

That's what happens when
you chug too much cyanide.

And are undertreated.

The daughter
was less critical.

And could've died.

The girl didn't
have a choice.

Waiting room rack
is over 30.

I'll take lead
for the rest of the shift.

Good.

Hey, you're bleeding.

What?

Your back.

Hey, Malik, can you draw up
HIV-hepatitis serologies

on the stabbed gangbanger.

Already to him
down to morgue.

Have pathology do it.

Oh, yeah, Cath Lab
said they can take
this guy in 30.

No, now.

He's losing heart muscle.

Push half a dose of TNK.

It's just going to be
one more minute, Mr. Dressler.

Doc... I've got a really
bad feeling here.

Ah, don't worry.

We're going
to take care of you.

No, no.
Do me a favor.

I need a... piece
of paper and a pen.

I want to write
a note to my kids

just in case I, uh...

I mean, you know, in case
they get here and I'm...

Yeah, absolutely.

But we have
a really good chance

of reversing...

Dr. Carter,
we need you!

Is he under?

KLINE:
Well, I hope so.

I'm disarticulating
at the elbow.

Way up there on the bovie.

He was asking for you.

I was detained with
an unstable pulseless tib-fib.

Well,
you're here now.

Two large bore IVs.

Trauma labs, four of O-neg.

Kerry, what
are you doing?

Ten-foot fall
from scaffolding.

Rebar through
the right chest.

Well, C-collar,
backboard and
a gurney.

Let's get him
into... Trauma.

No, can't. Rebar's stuck
in a concrete block.

Must be 500 pounds.

MAN:
Can't we just pull
him off there?

No, he'll bleed to death.

Rebar's compressing
the torn vessels.

All right,
call the fire department.

Have them bring
extrication gear.

Go inside, get
a portable monitor
and an E cylinder.

WRIGHT:
Up there?

Yeah, and get a hemocue.

( strained ):
You can't take it out?

We'll do that in
the operating room.

Do you feel any numbness
or weakness in your legs?

No, not really?

Decreased
on the right

but no JVD
or tracheal shift.

Look.

What?

JERRY:
Dr. Pratt.

Some guy wants to talk
to the doctor

who treated
that pregnant stab victim.

Take a message.

Are you okay? Sir?

Huh? Oh.

Just get
a little winded sometimes.

You ought to get
that thing fixed.

What's your name?

Ray.
Ray Jamison.

Mr. Jamison,
you have any chest pain?

More like palpitations.
Comes and goes.

I've been to
a couple clinics,

but they keep saying
nothing's wrong.

You don't have a doctor?

Medicare kicks
in next year.

Ever have an EKG?

Normal, they said.

But my ticker was on good
behavior at the time.

JERRY:
Dr. Pratt,
I really think

you should take this.

He knows something
about the assault.

And don't eat those.
I can get you something

that at least looks
like food.

You don't need
to do that.

No, I'm your doctor now.

Thanks.

This is Dr. Pratt.

Yeah, who's this?

Yeah, she's alive, why?

What?

CARTER:
Hemocue is 9.4.

WEAVER:
Titrate four of MS.

Where's the O-neg?!

Right here.

Do we need an airbag?

Pretty tight.

How much can we raise him?

Oh, maybe an inch
or two.

What's his pressure?

It's up to
a hundred.

GALLANT:
Dr. Carter.

Exam Two's drowning
in pulmonary edema.

Who?

The Buddhist nun.

I got it.
Go.

In the alley?

The north side.

Why didn't he just
bring it in?

'Cause he freaked out.

His wife came home with a baby

and said she gave birth
while he was at work.

He saw the news and
put it together. Here.

PRATT:
Grab a BOA kit.

ABBY:
Susan, set up
for a neonatal resuscitation.

Where?

Is that for pain?

She's in pain again.

No, this is for the fluid
in her lungs.

I can give her morphine,

but it will suppress
her breathing even more.

( chanting )

( Pratt groans )

Where?

I don't know.
He just said in the alley.

( gasping )

No breath sound
on the right.

WEAVER:
It's a massive hemothorax.

He needs a chest tube tray.

Inflate.

( man cries out )

CORDAY:
I'll retract the supinator,
you divide.

KLINE:
Mosquito.

Radial nerve.

Bone saw.

( saw buzzing )

Four of morphine on board.

( monks chanting softly )

I better check BP.

No.

No more BPs.

Find anything?

No.

Are you sure this
wasn't a prank?

Wait, wait, shh!
Listen.

There must be three
liters in there.

Grab a sterile base,
and the biggest one we got.

Tachy at 140,
barely has a pulse.

Hang another two.

Doc, get rid of the O2.

Make it fast.

Clamping the tube.

( clamp clicking )
Go!

( saw buzzing )

KLINE:
Ring cut through
the periosteum.

You want the
final honors?

No.

( saw buzzing )

( raspy breathing )

( monks chanting softly )

ABBY:
Why didn't he put him

where we could see him?

He didn't want it
to get run over.

Find him?

No.

( saw buzzing )

Slide the backboard up here.
Hurry up.

CHEN:
Pulse ox is down to 83.

Get ready to put
the O2 back on.

He's free.
( sawing stops )

Roll him!
( man groaning )

KLINE:
Through the cortex.

Arm's free.

Rasp back.

Don't want a bone spur.

Take a little more periosteum.

3-0 vicryl.

( raspy breathing )

( sharp inhalation )

( breathing stops )

Hey, over here!

( softly ):
Hey.

There we go.

I got ya.

Hey there, little guy.

( Lewis chuckling )

Can you hear me? Hello?

Yeah, barely.

What's going on?

One of our doctors
was hurt yesterday,

had to be evacuated
to Burundi.

Hurt? How?

We're expecting a fourth,

but they're having
trouble with her visa.

Luka, you got to speak up.

Can your contact

at the State Department
push her visa through?

What contact?

I thought
you knew someone there.

My family had a friend that was
ambassador to Uruguay, but...

Call him.

I don't know him.

Can't the Alliance fix it?

( woman speaking French )

Not enough.

( speaking French )

Okay, I'll be right there.

What?

We're trying
to travel to Matenda,

but the main road is blocked.

There's a cholera epidemic
in the refugee population

and we can't even get them
rehydration solution.

You want someone to come
and pitch in for a couple weeks?

What?

I've already had my shots,
my visa.

I thought you changed your mind.

Yeah, but, you know,
if you're stretched.

( speaking French )

Okay, I got to go.

Can you come now?

Yeah, okay.

Get on a plane.

Charge to 360.
Hello?

When did he
arrest?
Now.

Clear.

Is that my MI?

Dressler.
V-fib.

MALIK:
Bigeminy flipped
into V-tach

when we started rolling.

We never made
the elevator.

How many times
was he shocked?

Third one
coming up.

Amp of epi, I'll intubate.

What the hell's
he still doing down here?

I told you Cath Lab
said 30 minutes.

Clear!

All right, prep 100
of lidocaine.

LOCKHART:
He's a little tachy
at 165.

Slight flow murmur.

Fontanelle's soft,
but sunken.

He's definitely dry.

He's full term.

Mom's in post-op.

Hemodynamically stable,
and they saved her uterus.

How is he?

Heel stick
a glucose,

but I think we have

a healthy baby.

He's a screamer.

Wouldn't you be?

Literally ripped from

your mother's womb
by some lunatic.

Hell of a way
to come into the world.

Yeah, but life
only gets better after that.

I'll bolus
20 per kilo

I'll do it.

What?

If accu-check
is less than 50,

then I need to push D-25.

Whatever you say,
doctor.

Asystole.

Give me the pacing pads.

Let's push
three more of epi.

GALLANT:
Resume CPR.

Family's here.

The, uh, the letter.

What?

The pen and paper.

Did you give him
a pen and paper?

No.

Why not?

What?

He asked for a pen
and some paper

to write a letter to his kids.

He didn't
ask me.

There it is.

It's just a sub-Q bleeder.

Clamp that off.

You want cautery?

No, I'll use the silver
nitrate sticks.

Don't contaminate the field.

Robert?

Bovie that bleeder.

Pick-ups.

Robert,
it's Elizabeth.

Lizzie...

She's one hell of a surgeon.

So beautiful.

Done.

That was just
a small EBL,

but we can order
a post-op CBC

just to be safe.

You're taking good
care of me.

I'm trying, yes.

I love you, Elizabeth.

You need to get
some rest.

Let's put a fresh
pressure dressing on

and I'll check it later.

PRATT:
Hey, you have
a visitor.

Is that...?

It's your baby.

You had a boy.

Is he okay?

He's great.

Active.

Likes to play hide-and-seek.

My baby.

You want to hold him?

Yeah.

Come on, little guy.

I got you, I got you.

Still asystole.

He's had two of atropine?

Oh, yeah.

All right, increase the pulse
duration to 20 milliseconds.

Dr. Carter.

How long we been going?

62 minutes.

All right, stop.

You can stop.

Mrs. Dressler, I'm Dr. Carter.

Your husband
came in with chest pain.

He was having
a heart attack.

He's dead?

We were just about
to move him up to the cath lab

to unblock the main artery when
he went into cardiac arrest.

And I couldn't get him back.

Did he know?

Did he know what
was happening?

Yeah, he wanted me...

to, um, tell you that he loved--

loves you all very much.

Hypertensive encephalopathy
on nipride.

Let me guess.
No ICU beds.

The gang war continues.

Dyspareunia waiting on

gram stain and wet mount.

Dyspareunia's better
than no pareunia.

And we have Mr. Jamison here,

who's back in normal sinus

after yours truly
picked up atrial flutter.

I though heart monitors
did that.

No more Chihuahua?

It's a miracle,
what did you do?

I just flipped
the circuit breaker back on.

But now that we know what it is,

you can be treated
with a simple prescription.

I come see you
at your office?

This is my office.

Or was.

What?

I just work in the hospital.

Well that's
too bad.

You're a fine doctor.

Thank you.

See you, sweetness.

Call you later.

Congratulations,
Greg.

You survived
the County experience.

Oh, no, not just survived it.

I whooped its ass.

Hey.

Hey.

Did you see the eclipse?

Yeah.

Sort of.

Pretty freaky, huh?

Yeah, I guess.

You have a rough shift?

Yeah, there
was this guy, this MI.

Asked me for a pen
and some paper

to write a note
to his kids and...

Couldn't save him,
but I could have...

What?

Nothing.

Nothing's right here.

Hey.

I haven't seen you
in a week.

That's it?

Luka called me...

looking for you.

He was under the impression
I might know where you were.

You're going, right?

To Africa.

It's not Rio, but it's not here.

WEAVER:
Are you supposed
to be in there?

It's a First Aid kit.

Damn near the only
thing that survived.

How was your last shift?

Lots of excitement.

Well, if you're ever bored,
God knows we need the staff.

Yeah.

HALEH:
Dr. Pratt!

You forgot to give Jamison
his "didge" prescription.

Jing-Mei can do it.

.25 or .125?

No, lower dose.

Next available appointment
at the cardiology clinic

is in four months,
that's okay?

( sighs )

Just let me write it.

After care instructions, too.

Return to the ER in a week
for a "didge" level.

Tell him to call Dr. Pratt,
make sure I'm on duty first.

I thought you were going
to Northwestern.

Ah, guess I'm more
of a Southside doc.

You staying here?

What the hell.

This place kind
of grows on you.