Original subtitles

[theme music]

(male narrator) Previously on "ER."

When you're waiting on a patient's results

it's not necessary for you to boff

that patient's mother in the storage closet.

I'm so sorry, Robert.

What about my arm, or about my being there?

‐ A memo from Weaver. ‐ What?

(Kerry) 'I've made Abby the new nurse manager.'

The job is yours, like it or not.

"Like it or not"?

I don't care to argue about it.

Duroziez's sign is a to and fro murmur

when the stethoscope is placed over the femoral artery.

What's another peripheral sign of aortic insufficiency?

‐ Weak pulse. ‐ No.

‐ Poor cap refill. ‐ No.

Those are both signs of shock.

It begins with "Q." Anyone?

‐ Dequervain's. ‐ No, that begins with a "D."

Although there is a "Q" in it so, you're getting warmer.

Does Quinke's sign ring any bells?

And it manifests itself how?

With a visible. Puh..

‐ Pulsation. ‐ Correct. Where?

On the...nnn.

‐ Neck. ‐ Navel?

Nail bed.

Goodnight.

(Elizabeth) 'Go home.'

Rounds start at 7:00 A. M.

Be sure to read Sabiston's chapter

on the acute abdomen.

So much for the future of medicine.

Jacy, would you be sure to ring Mr. Ingles?

Remind him not to eat anything after midnight.

I don't want to have to reschedule his hernia yet again.

‐ Mm hmm. ‐ I'm going trick‐or‐treating.

‐ Oh, what's Ella this year? ‐ A cow.

Wasn't she a cow last year?

No, last year she was Dorothy

I was the cowardly lion, Mark..

‐ Mark was the scarecrow. ‐ Right.

I get to be a farmer this year.

Happy Halloween.

‐ Dr. Corday. ‐ Yeah.

Your med student called, Nathan.

What, the one who didn't bother to show up today?

He said he'd be here in a few minutes to speak with you.

Well, it's too late.

Dr. Romano would also like to

talk with you before you leave.

Tell him you couldn't find me.

(Robert) 'I heard that!'

(male #1) 'Check this guy out.'

(Frank) 'What the hell are you supposed to be?'

Hey, you want a candy, little fella?

(Frank) 'Put some meat on those bones.'

Hi, thought everybody was getting dressed up today.

We were supposed to, there was a memo.

I didn't bring anything to change into.

Well, neither did I.

Yeah, but you're still a nurse.

You should have called me.

What, and then I would be

the only one in costume?

I don't think so.

Frank, where's your costume?

I don't observe pagan holidays

that celebrate devil worship.

Well, this is only for Satanists.

‐ What? ‐ It's kind of working for you.

[chuckling] Shut up.

(Chuny) 'If you give me an order and I think it's wrong'

'I'm going to ask you to clarify it.'

Not in front of the patients.

I only questioned the dosage.

‐ You made mistakes in the past. ‐ I have not.

‐ 'Is there a problem here?' ‐ Yeah, you've got no guts.

‐ I'm not working with him. ‐ Why?

Because he treats nurses like idiots.

(Luka) If your boots fit..

‐ Shoes. ‐ Whatever.

You wearing that for your shift?

Yes. It's Halloween.

(Abby) 'You know, Jerry sent out a memo.'

Ooh, naughty nurse.

‐ Not a naughty nurse. ‐ I like it.

Umm, like a, it's an old fashioned nurse.

Looks naughty to me.

So, you're what, like a kurva nurse?

What's that?

How do you say, a slut?

You know, like a tramp, a whore..

Yeah, I got it.

You know, maybe I should have worn

that schoolgirl outfit you bought me.

[chuckling]

She's making a joke.

Cautery.

Robert, what you doing?

A laparoscopic cholecystectomy.

But you can't be.

(Robert) 'I had no choice.'

'This poor swine is full of stones.'

Oh, for heaven's sake, it's a pig.

I hope you're not expecting me to scrub in.

No, just giving my right hand a workout.

It's been five months. So, I gotta keep my skills up.

Stapler, though, even with one arm

I'm a better surgeon than the rest of the hacks

in this hospital.

Robert, you're not cleared to do surgery

even on barn animals.

Were you aware that Weaver put through a proposal

to hire PAs to cover afternoon rounds

for post‐call surgical residents? Grasper.

Yes, I thought it was a very good idea.

That's not the point.

Point is, nobody talked to me about it

and last time I checked, I was still head

of both surgery and this hospital.

The residency review committee‐‐

Oh, sweet Mary and Joseph will you look at the size

of that gallbladder?

Geez, you could feed a small Amish

family, for a week with that thing.

Look, I know Weaver's been forming alliances

with some of the tribal elders while I was recuperating but

'I would've expected a little more loyalty from you, Lizzie.'

‐ Robert. ‐ 'Just rewrite the proposal.'

'As if it were generated from us'

'and keep me abreast of any'

'other covert Weaver ops, okay?'

'The last thing I need is Mata Hari'

'leading a palace coup.'

‐ What the hell? ‐ He's extubated.

Up, get him back under. 100 of Brevital.

Hold him down! Lizzie, hold him down!

(Robert) 'Bloody hell. He's a pig, grab a horn Lizzie.'

[theme music]

[music continues]

(Marty) 'Flex, flex, keep going.'

90 degrees, that's good.

Not my elbow I'm worried about.

What the hell is going on

down there, Brenda?

Alright, the wrist.

And flex.

Keep going.

A little bit more.

Ten degrees.

Wrong, check it again.

Ten.

It was 15 last week.

Fluctuations are normal, Robert.

With this type of injury you've got to give yourself

at least nine months.

How does this affect my odds?

You've still got a long way to go.

Yeah, I know. The odds.

For full flexion, extension

and opposition of the digits, 20%.

But even then, without radial and ulnar deviation

'of the thumb, I'm not sure you'll be able to operate.'

But you could still be chief of staff.

Most of your job is administrative anyway.

Thanks for the pep talk there, Marty.

[door shuts]

Excuse me.

I'm looking for Dr. Corday.

(Romano) 'Yeah, aren't we all?'

You a bill collector or a suitor?

Med student.

You must be a slow learner.

It's a career change.

Cowboy and fireman didn't work out, huh?

I'm supposed to start my surgical rotation today.

‐ I'm Paul Nathan. ‐ Dr. Romano.

‐ What happened? ‐ Tennis elbow.

(female #1) 'Fire at a Halloween party, at least 30 victims.'

‐ Gave ten of morphine IM. ‐ How you doing?

Not...good.

‐ What's your name? ‐ Amy.

Last name?

There was a fire at the party downstairs.

‐ What's your last name? ‐ Was anybody with her?

(female #2) 'Hard to say, the whole apartment building's burning'

'there's a lot of confusion.'

(Abby) 'Soot in the nostrils'

'and intraoral burns.'

I'm gonna need an intubation tray.

Get Corday on that crushed pelvis.

‐ Excuse me. ‐ Not right now.

Ed Jemena, 35.

Full thickness burns to the hands and forearms.

This guy was on fire, I tried to put him out

but I didn't have anything to use but my hands.

‐ Luka, can you get this? ‐ Yeah. What's open?

‐ Curtain two. ‐ I need a trauma room.

You're lucky to get a bed.

‐ 'Okay, yes?' ‐ Oh, Paul Nathan.

‐ Radiology? ‐ No, um, surgery.

‐ Resident? ‐ Med student.

Okay, good enough Cellulitis to the leg after

a bug bite to the ankle.

Well, what do I do?

Mark the leading edge

with the marker.

(Susan) 'Nice catch. Whoa, we're full in here.'

‐ 'What do you have?' ‐ 'Doctor, excuse me!'

You all need to stay in your assigned spots.

If a doctor or a nurse can't find you

it's gonna cause a delay in your treatment.

Doctor, doctor, can you tell me what's happened to my things?

My apartment's on the fourth floor.

I'll see what I can find out for you.

‐ And the fire was on two. ‐ Will they let us go home?

Check with the fire department.

What did they say how it started?

‐ Was there a gas leak. ‐ I'm sorry, I don't know.

(female #3) 'Carter, we need you!'

The fruits upstairs were smoking dope, that's what.

No one was smoking anything, alright?

What's that for?

It's to keep an eye on the infection.

And what are they giving him to stop it?

Uh, excuse me. Unasyn.

And that will get rid of the infection?

Well, it should. It's an antibiotic.

‐ Hey, are you a doctor? ‐ Med student.

I need that mayo stand.

Put it under his arm.

Got this?

‐ I'm supposed to be‐‐ ‐ Good.

‐ I need a cut down.. ‐ What are you going to do?

We're gonna make you better.

Why can't I feel my hands?

Uh, the burns have damaged your nerves.

Is it permanent?

I don't know.

‐ Where's Terry? ‐ 'Who's Terry?'

My partner.

He's dressed like a jungle girl.

Etomidate's on board.

I need to see Terry.

Trauma panel, ABG and carboxyhemoglobin.

‐ Prime a line of ringers. ‐ What is this?

(Elizabeth) 'Rubber mask melted to the face.'

I can barely open the mouth.

Better try fiber optic. I got the subclavian.

‐ I thought you left, Lizzie. ‐ Me, too.

I'm supposed to be trick‐or‐treating.

A little old for that, don't you think?

Open a crike tray just in case.

Guide wire's passing well.

Preload an eight‐o tube on a scope.

(Lily) 'Pulse ox down to 85.'

(Gregory) '15 blade.'

(Elizabeth) 'Turn cc syringe.'

'Let's check the balloon.'

(Lily) 'I need a different light source.'

Don't open the tray unless the intubation fails.

‐ We don't want this...oh! ‐ I'm sorry, sorry.

Got the line. Run the first liter wide open.

Robert, you okay?

‐ Oh silk, Neosporin and opsite. ‐ Robert?

‐ I'm okay. ‐ Keep bagging on 15 liters.

‐ Get the sats above 90. ‐ If you've got this, Lizzie

I'm gonna go check on the rest of the kids.

(Jing‐Mei) 'Take slow, deep breaths.'

‐ 'I'm trying.' ‐ 'Have you ever had asthma?'

‐ 'No.' ‐ What's this?

Smoke inhalation with wheezing.

Increased breath sounds?

On the right possible pneumothorax.

‐ May need a chest tube. ‐ Vitals?

‐ I've got it. ‐ Yeah, I'm sure you do.

Get a chest X‐ray and show it to me.

Digital escarotomy.

Yeah, he needs the same on the left.

I agree.

How old do you think she is?

(Abby) 'Uh.'

Young.

Hey, Dr. Corday?

Yeah? What have you got?

Urine 60 an hour, but it's bloody.

80% burns, she's gonna need 12 liters in the first eight hours.

Okay, send her for CT abdomen and pelvis.

'I still need to do an airway in here.'

‐ Dr. Corday? ‐ Yes?

Oh, uh, I'm Paul Nathan. I was supposed to begin

'my surgical rotation with you today.'

Yes, you were.

She's got a critical patient next door.

‐ Where should I put these? ‐ Here. Put them right there.

(John) 'No free fluid.'

Liver and spleen look okay.

Scope is prepped.

Standing by with the number five Shiley.

‐ Rounds started at 7:00 A. M. ‐ I know I was‐‐

Not interested in excuses, thank you.

‐ Did you get my letter? ‐ Yep.

Dr. Corday, your nanny is on the phone.

For God's sake, Frank, take a look around.

Take a message.

I did, she said to remind you she

has a flight to catch at 10:30.

Well, I can't leave now, can I?

What do you want me to tell her?

Tell her to bring Ella here.

(Frank) 'Day care's closed, you know.'

I know.

Pulse ox 81.

He's throwing PVCs We should crike him.

Is there anything I can do?

Yes. Be quiet.

(Elizabeth) 'Okay, bag him.'

You really want to make up for it

go out there and work up some patients.

‐ Yeah, but shouldn't I‐‐ ‐ You wanna be a doctor?

‐ That's why you're here. ‐ Yes, but‐‐

Then grab a patient, do an H&P

and present the case to an attending.

(female #4) 'I told Martin 100 times'

'you need to put new batteries in the smoke detector.'

'No, no.'

'God forbid he should spend $3 on a nine‐volt.'

'The whole building could have burned down.'

‐ Um, his X‐rays are back. ‐ Oh, okay, good.

How's he doing?

Better than most by the looks of things.

Yeah.

Okay, next time I go hiking

I'm wearing long pants.

And bug repellent.

Your infection's spreading.

Uh, is everything okay?

I'll be right back.

‐ Excuse me, you're a surgeon? ‐ That's the rumor.

Uh, I think there's something here you should see.

You're a med student, you haven't learned to think yet.

I've got a rapidly spreading cellulitis.

Excuse me. How rapid?

Well, I just drew this 20 minutes ago.

[whistles]

And look, this looks like Sub Q air

consistent with neck fash.

Yeah, nice catch. Let's roll.

Alright, get that side. We gotta take your boyfriend upstairs.

‐ Upstairs? ‐ Yeah, to surgery.

‐ What's he on? ‐ 'Three grams of Unasyn.'

Okay, switch it to six million units

of Pen G and 900 of Clinda.

Where's he going?

Newbie caught a neck fash.

‐ What? ‐ What's that mean?

Your boyfriend may have what we call necrotizing fasciitis.

It's a virulent skin infection.

But they gave him antibiotics. He said it would help.

The infection's spreading too fast.

So, wait wh‐what are you gonna do?

We're gonna take you up to the OR.

‐ To Remove the infected tissue. ‐ What?

Alright, everybody off, off, off, the elevator.

Take the stairs next time you'll live longer, come on move it.

If we don't stop this it will continue to move along

and you will develop an overwhelming infection

which will lower your blood pressure.

You could die.

Oh, my God.

‐ Think we caught that in time? ‐ I hope so. Thank you.

I'm Susan Lewis.

Paul Nathan.

You coming?

‐ In a minute, yeah. ‐ You okay?

Yeah, it's just

it takes me a moment to get going sometimes.

Uh...I have Parkinson's disease.

(Robert) 'Lizzie, get up here!'

I'll be up in five minutes, Robert.

'You said that ten minutes ago!'

I'm with a critical patient.

Find somebody else now, Lizzie!

Good ET Placement. No infiltrates.

Check ABG, repeat CBC, and work on a burn unit bed.

What about him?

‐ Who? ‐ Him.

Yeah, what about him?

Pardon me.

I found your CPK, lytes and UA results.

You headed up to surgery on the "neck fash"?

Yes, as a matter of fact.

Okay, well... I guess we're done here.

I am. You still owe eight hours.

I'm on rounds at 6:00 A. M.

Welcome to surgery.

Excuse me. Uh, where can I find somebody who was brought in?

Admit.

Come here. Follow me.

Who you looking for?

Wynn Mathison. He's in a tiger costume.

Excuse me, could you please direct

me to the victims of the fire?

Keep your habit on, my man.

‐ Excuse me? ‐ Yo, Dr. Pratt?

You'll get to be with your drag queen friends soon enough.

I have food and housing vouchers for the displaced.

Oh, I‐I'm sorry, sister.

Can someone please tell me what room he's in?

‐ Dr. Pratt? ‐ What?

He's with the guy in the tiger mask.

Can we get some oil of wintergreen in here?

I hate the smell of rotting flesh.

Suction.

Especially when it's increasing by the minute.

Come on, that bacteria's moving

faster than you are, Edson.

‐ Bovie. ‐ Systolic's down to 95.

Bolus 500. Lap pad.

Still not bleeding. Myonecrosis.

‐ Yeah, it's in the muscle. ‐ Ten blade.

Okay, if it's vascularized, don't cut it.

That's my plan.

Start there and carry the incision

four centimeters inferior.

No, that's eight. God damn it!

We need clean borders.

‐ Where the hell is Corday? ‐ She's in the scrub room.

(Dale) 'If I don't remove enough tissue the infection'

'could be left to smolder inside.'

Get her the hell in here!

Maybe she can debride this guy's

wound without using a chainsaw. Hey!

'Chris, it's me, Elizabeth.'

Listen you needn't come here.

I shouldn't be longer than an hour.

Dr. Corday, he's asking for you.

Be right there.

(Elizabeth) 'Okay, Chris, but could you possibly'

'take Ella to your house to finish packing?'

Yeah, I could pick you both up after work.

I could drive you to the airport.

Save you the cost of cab fare.

Yeah. Okay. Thank you. Thank you so much.

Yeah, I'll see you soon.

Corazon, uh, would you mind taking the phone?

Not at all.

[metal clinking]

Oh.

Damn.

Was that your wedding ring?

Yep. Yep.

I can't see it. Can you call engineering?

They're closed till morning.

I'm sorry.

No, it's not your fault.

Don't hate me. He wants to talk.

(Robert) 'Lizzie, get your ass in here!'

I've lost my wedding ring.

'Oh, boo‐hoo, this guy's about to lose a leg!'

I'd say "chop‐chop," but that would be in extremely bad taste.

Can you call someone

get them to tape this off for me?

Make sure no more water is run down it?

Sure.

(Robert) 'Would somebody please call Tiffany's'

'search and rescue team?'

I'm coming!

He's got 20% surface area burns, mainly upper body.

‐ Oh, God. ‐ 'Decent prognosis.'

(Gregory) 'We provide ventilatory support until the lungs heal.'

Then we extubate him. Might take a week, maybe less.

What‐what about his face?

He'll need skin grafts.

There will definitely be some scarring.

[sobbing]

Wynn. Wynn, it's me, Terry.

(Terry) 'I'm right here.'

He can't hear you. He's sedated.

You should probably have your eye looked at.

(Terry) 'Later, okay?'

Can I touch him?

I wouldn't.

Yo, newbie. Come on.

[machine beeping]

Check jungle perv's eye with the slit‐lamp.

He may have a corneal burn.

‐ Where's that? ‐ 'You still here?'

Yeah, uh, slit‐lamp. Where is it? How does it work?

Exam three. Try the on/off switch.

Hey, hey.

‐ You changed. ‐ What?

I just put on some scrub pants.

Oh, come on.

You know, Carter

my outfit is really starting to bug me, too.

But we agreed to stay in costume the entire shift.

Yeah, I am.

No, you're not.

It's half a costume.

It's always, like, 50% commitment.

Are you serious or you kidding?

Do you even know what I've been dealing with down here?

Yeah, me too. In pumps.

Wanna see the whole costume?

‐ No. ‐ Here's the whole costume.

‐ Forget it. ‐ I'm a skeleton! Look at me!

Carter really likes Halloween, huh?

Perpetual erection.

Accidentally drank his daughter's mandrake smoothie.

Police found him chasing women down the street.

‐ Where do you want him? ‐ In a cold shower.

Curtain three's open.

Okay, get a line in and push four of Ativan.

Are you open, baby?

[lecherous laughter]

Perfect.

[laughing] Whoo!

First day labs, charcoal and a Foley for the tox screen.

Release me! I'm the Marquis De Sade!

How am I supposed to pass a catheter through that?

‐ Inject phenylephrine. ‐ Into the shaft?

I'm Rod Stewart!

He won't hold still long enough for a blood draw

much less let me touch his penis.

Oh, she can touch it!

(Luka) 'Or we can wait for the'

'mandrake to metabolize.'

Why not just give him Haldol

make it easier on everybody?

It might make his symptoms worse.

‐ Hey! ‐ Hey, hey.

He just grabbed my ass.

Well, I couldn't reach hers.

I said four of Ativan.

‐ Ask Abby. I'm done. ‐ Oh.

Okay, you could be a little bit more sensitive.

To what?

[laughing]

♪ Choo choo choo choo choo ♪

(Elizabeth) 'It's amazing how quickly this spreads.'

(Dale) 'Any idea how he got it?'

(Elizabeth) 'A cut, a scratch, some other trivial injury.'

Dopamine's at ten mikes.

More suction.

‐ Scalpel. ‐ Easy, Lizzie.

Just me, or is this constant commentary rather distracting?

It's not you.

Just remove the infected tissue

and let antibiotics

and hyperbaric oxygen therapy do the rest.

‐ You're not serious. ‐ Hell, yes, I am serious.

I'm already into the posterior compartment.

It's still necrotic soup.

Six hours in the chamber will increase his oxygen saturation.

‐ Create a bacteriocidal effect. ‐ Robert.

And give this guy a chance of a functioning leg.

Do you two have a problem with that?

How's a guy with Parkinson's get into med school?

Probably some kind of disability quota they have to fill.

Forget med school. How's he expect to practice?

Wouldn't want him taking out my appendix.

He seems to have it under control.

You know, it's a progressive disease.

What's he gonna be like in ten years?

‐ Could be dead. ‐ Or want to be.

Happy Abby, always looking on the bright side.

Dr. Weaver, I thought you were out sick.

I was until an apartment fire set us back 30 patients.

(Pratt) '35, if you count the bad popcorn balls.'

‐ Oh, wonderful. ‐ Thanks for coming in, Kerry.

Yeah, I shouldn't have answered my phone.

‐ Want your messages? ‐ No!

I want the air conditioning on!

I'm sweating like a pig!

It's freezing in here.

That's what you get for bringing Weaver in on Halloween.

You know it's the biggest holiday

of the year for her kind.

‐ Lesbians? ‐ Wiccan.

She's probably riding that crutch around like a broom.

Oh, come on, Frank.

All women get like that when

they're going through the change.

‐ Pratt! ‐ What?

She's having hot flashes, she's moody.

‐ That is so sexist ‐ 'And stupid.'

‐ She's too young. ‐ Early onset.

You've got early onset.

Whatever you say, nasty ratchet.

It's nurse, okay?

Not nasty, not naughty,

not wet, certainly not head.

Just nurse.

Abby, you're gonna talk to Kovac, right?

Yes.

County general on bravo one.

I finished with the slit‐lamp.

I numbed him with Alcaine.

Who are you?

Meet Nathan our newest oldest med student.

I'm on surgical rotations with Dr. Corday.

We have to clear trauma. BOA with newborn hypoxia.

She asked that I stay and assist in any‐‐

Good. Follow me.

Don't worry. She doesn't bite.

Much.

Simone Philip, 42.

Had a home birth, newborn in respiratory distress.

(Weaver) 'Simone, did you have a difficult or complicated labor?'

No, it went well. I didn't even tear.

One minute Apgar with seven, but he had a little.

‐ Who are you? ‐ I'm the midwife.

What's wrong with him?

We're gonna find out, alright?

Take him to trauma one.

‐ Wh‐where is that? ‐ 'I'll take him.'

‐ No, I...it's okay. ‐ I got it, I got it.

I got it.

Simone, you've lost a lot of blood.

Something's wrong with my baby, I know it.

Lily, stirrups. Gallant, labs.

Oh, maybe I should have had him in a hospital.

Simone, you did everything right.

(Michael) 'CBC, PT/PTT'

DIC screen, type and cross for four units.

We're taking care of your baby. Let's help you now.

BP is 80/60.

‐ Squeeze in another two liters. ‐ What's happening?

You're losing a lot of blood from a retained placenta.

No, I mean with my baby.

Dr. Kovac is taking good care of your son.

I'm gonna pull gently on the umbilical cord.

Simone?

I need you to stay with me.

Oh.

Pulse ox is 82. He's retracting.

Pedes intubation tray, number three ET uncuffed.

What do you hear?

Wet crackles throughout.

(Luka) 'Fluid in the alveoli.'

'Okay, let's have a look.'

Unhook the bag from the mask.

You can bag the ET once I'm in.

I've never done that.

Squeeze the bag every two seconds

just like he was doing.

Never pass the tube till you see the cords.

Okay. I'm in.

Call for a pedes vent and set me up for an umbilical line.

Relax. Relax, the hard part's over.

Good.

Notify the NICU team.

What do I tell them is wrong?

I have no idea.

(Elizabeth) 'It's no good. We're into the quads.'

(Dale) 'We'll have to do an AKA.'

'Keep debriding. We're not there yet.'

If we treat this conservatively, and it spreads

we're committed to a hip disarticulation

'to stay ahead of the bacteria.'

It's worth the risk.

Of his being no ambulatory?

With an above‐the‐knee amputation at least

he can use a prosthetic.

And if it gets into his hip

it'll spread to the abdominal wall

and he'll get septic.

I am trying to save this man's leg.

‐ Dry the field. ‐ What about his life?

He's young. It's the same thing.

Oh, come on, Robert, of course it's not.

(Elizabeth) 'Look, this Kelly'

'slices through Sub Q fat like butter.'

Alright, fine, keep cutting until you hit viable muscle.

It's above the distal third of the thigh.

It's a hopeless wound.

Fine, take it.

‐ 'Robert.' ‐ I said take the leg.

[slams equipment]

Bovie, pickups.

[man and boy laughing]

Tommy.

How are you feeling?

He seems, he seems a lot better, thanks.

Good, well, uh just keep him on clear fluids tonight

and I'll have a nurse sign you out.

Okay. Thanks.

‐ What's wrong with him? ‐ Shh, shh.

We'll, uh, we'll talk about it later.

[indistinct chattering]

How you holding up?

I'm good. Uh, I think the robot can go home.

Okay. I'll get Carter to dispo him.

Okay.

Can I get you a cup of coffee or something?

No, fine, thank you.

‐ Uh, I like your outfit. ‐ Mm‐hmm?

It's very retro.

[chuckles] Thank you.

Um, listen, if..

...if you ever need anything.

‐ Uh, ‐ Like a straitjacket?

[both chuckling]

Is your... dyskinesia usually this bad?

I don't wanna freeze up when I'm at work

so I up the medication, and this is what you get.

At least it helps to dispel the myth.

You know, we don't all have rhythm.

[both chuckling]

If that happened to me I'd probably jump on a world cruise

not go to med school.

I already saw the world.

In fact, I was in Italy

when I first realized that I had a problem.

I was sipping wine in this little cafe in Florence

and I noticed that my little finger was shaking.

I just figured it was from living on espresso and martinis.

How did you find out it wasn't?

Well, I used to hate doctors

so it took a while for me to check it out

but, once I did, it really put things in perspective.

Yeah, I guess being sick does that.

Her baby's not doing well, huh?

No.

‐ How you doing, Simone? ‐ Good. He seems better, huh?

Maintenance fluids are at 5cc's per kilo per hour.

My mother had me at home.

I thought it would be good for him.

Um, his tests came back.

I'm afraid your baby has a disease called sialidosis.

What's that?

His body lacks an enzyme that breaks down

the waste proteins inside the cells

and there is already extensive damage to the liver

the bones and the nervous system.

[sighs]

I've been staring at him

for over an hour now and..

(Simone) 'I still..'

'...can't figure out what I want to call him.'

Would you excuse us, please?

Uh, yeah. Sure.

[Luka sighs]

Children with, uh, sialidosis

are mentally retarded..

(Luka) '...often blind.'

'He'll never speak or walk.'

His life expectancy is less than two years.

(female #5) 'Dr. Kovac, NICU's on line one.'

Thanks.

[sighs] Excuse me.

Is there anyone you'd like me to call?

[sighs]

[quietly] No. There's just us.

I don't think it will be necessary.

Thank you.

You having a bad night?

No worse than usual.

That was a little bit insensitive don't you think?

Hey, I had to tell a mother her baby was gonna die.

I didn't need an audience, okay?

Okay.

I'm starting to get some complaints about you.

‐ From patients? ‐ Nurses.

Don't look so concerned about it.

Okay, first you accused Chuny of being an idiot

and then later when she was sexually harassed by a patient‐‐

Sexually harassed?

The guy grabbed her butt!

Yeah, that's sexual harassment, Luka.

Oh, come on, Abby, you were there.

The guy's intoxicated with mandrake, he's harmless.

This one's all yours.

‐ What patient? ‐ Mr. Hard‐on.

I was checking his vitals and he grabbed my boob.

Okay, what's his status?

He's gonna die if he tries

that again, that's his status.

See, every time a nurse has a problem

she complains to me.

Everyone complains, it's part of the job.

Yes, and it's part of my job as nurse manager to counsel you.

What?

You can give nurses orders, you cannot critique their work.

If you have a problem with a nurse you have to come to me.

Okay, what about you?

Who do I complain to if I have a problem with you?

Well, here's an idea, maybe you

should try fighting for the nurses

instead of fighting with them.

Hey, maybe you should sew some swastikas on that costume.

You could be a naughty Nazi nurse, huh?

You totally suck, you know that?

Hey, careful, creating

a hostile work environment!

‐ Where's Dr. Kovac? ‐ I don't know page him.

The baby with sialidosis is febrile to 102.

Chuny, where's Kovac?

Don't know, don't care.

He feels like he's on fire.

Why hasn't he gone up to the NICU?

You'd have to ask Dr. Kovac.

Can you do something for him?

He needs to be pan‐cultured.

‐ How much does he weigh? ‐ 3 kilos.

Okay, 150 milligrams IV.

Piggyback of cefotaxime and amp.

Set up for a spinal tap.

He has sialidosis.

Yeah, and he also has an

infection 60 migs of Tylenol.

I'll make arrangements for your baby

to be sent up to the neonatal unit.

We're gonna do everything we can for him.

Thank you.

Why are you still here?

Uh, my piano recital was canceled.

Hey, it's me, Elizabeth. I'm on my way home now.

I'll see you soon. Bye.

We did the right thing.

Trying to convince me or you?

Look, I went through a period of adjustment..

...when I became a mother every time I had to treat a child.

(Elizabeth) 'You get over it.'

Oh, please, spare me the two‐dollar

psychoanalysis, Lizzie.

Fine.

Hey, look, look, look.

I know most people don't like me, I don't care.

I don't like most people.

But I'm good at what I do.

I save people's lives.

Every day.

People who no one else can help.

If I can't do that..

Robert.

I know you're frustrated.

You're an excellent surgeon, and you will be again

I promise you.

You will be.

I'm being paged.

Elizabeth?

Uh..

(Elizabeth) 'I'm being paged.'

[door opens]

[phone ringing]

[indistinct chattering]

(Female #6) 'Elizabeth.'

‐ I‐I just tried calling you. ‐ I'm sorry, I couldn't wait.

I have to leave for the airport now.

Well, what about a later flight?

‐ This is the later flight. ‐ Oh.

I threw her pajamas

some crackers, a couple toys in here

just in case she had to stay for awhile, I'm sorry.

No, no, no, it's alright, it's my fault. We got slammed.

I'm back Sunday night, so I'll see you Monday morning.

Yeah, yeah. Have a safe flight.

‐ Okay, bye, Ella. ‐ Bye.

Hey, did Chris take you trick‐or‐treating?

[alarms sounding]

What is it?

Dropped her pressure to 60 palp.

'Dopamine is up, we've got two liters going'

and I'm working on an art line.

(John) 'Any word from her family yet?'

No, we still don't have a last name.

‐ Lily, could you? ‐ Oh, sure.

‐ There, it's okay. ‐ Hello, little cowgirl.

I'll be with you soon, alright?

Could it be hemorrhagic?

(John) 'CT was negative I'm thinking hypoxia.'

If we don't find her family soon

they're just going to be ID‐ing the body.

Her pulse ox is only 82 on 100%.

She needs suctioning, Abby.

Set up ultrasound she may have thrown a clot.

(John) 'I don't know, second crit was only 32.'

‐ What happened to mom? ‐ In the washroom.

Where are the suction catheters?

Try the cabinet.

What are you doing?

Weaver ordered antibiotics.

No. Who did the LP?

She wanted a full septic workup.

‐ This is my patient. ‐ The baby spiked a fever.

This baby is in a chronic vegetative state.

You are prolonging his suffering and the suffering of the mother.

We still treat kids like this.

‐ You should have asked me. ‐ We couldn't find you.

I told you to leave once already this is not your case.

‐ Luka. ‐ Abby!

(Luka) 'You need to check with me before'

'you push meds on my patients.'

I have to do a cut‐down here.

Morrison's pouch looks dry

but it could be retroperitoneal.

What the hell was all that about?

You want peep on the vent?

Not until we get her pressure up.

(John) Nathan, why do you think she's hypotensive?

‐ Blood loss? ‐ Not in this case.

Hypoxia can cause myocardial dysfunction.

That's it I'm filing a grievance against him.

Not now, Chuny. IV's dry, she needs a fresh one.

I'll get it.

Panic value potassium's 8.2.

Damn it, that's rhabdo from the

crush injury 10cc's of calcium gluconate.

(Elizabeth) 'PVC's.'

(John) 'Let's push bicarb ten units of'

'regular insulin an amp of D‐50.'

Get me kayexelate and call renal she may need dialysis.

‐ What the hell are you doing? ‐ I accidentally‐‐

It's okay.

Go see if Frank's found the girl's family.

No, I'll start another one.

(John) 'Line's in, is the transducer ready?'

‐ Where's the saline? ‐ I said, go find the family.

‐ 'Run of five.' ‐ '100 of Lidocaine.'

Prep the groin for a Quinton catheter.

Sats are falling, 79.

Pressure's down to 50.

Being a little hard on him, don't you think?

V‐tach, charge to 200. What are you talking about?

Nathan, he's doing a pretty good job, considering.

‐ Considering what? ‐ He has Parkinson's.

Excuse me?

(Elizabeth) 'Clear.'

Still V‐tach.

Procainamide's on board.

Stand by with amiodarone.

Clear.

No change.

How long?

‐ How long? ‐ Uh...12 minutes.

Clear.

‐ Sinus tach. ‐ Alright.

Way to go.

Good femoral pulse.

Set up a Pronestyl drip, then a repeat K.

Labs on your baby.

Thank you.

Glad to see you two have made up.

Hey, I'm being professional.

She's the one having trouble.

I warned her.

Warned her about what?

[sighs] Nothing.

Oh, my God.

You're such a jerk.

‐ What? ‐ You slept with her?

[scoffs]

That's what this is all about.

What's your problem?

‐ One time. ‐ One time. One time with Chuny.

One time with a patient's mother in radiology.

Hey, you never complained.

Yeah, I never let it affect my work.

You two need to figure this out.

‐ So, what do you want me to do? ‐ I don't know.

Tell her you're sorry. Tell her it was wrong.

‐ Just fix it. ‐ I'm not gonna kiss her ass.

That's how this whole problem started.

Have them check a gas on 50%.

I'm gonna wait right here for you, Wynn.

Don't worry about anything.

I love you.

[sighs]

I should've told them I was his brother.

ICU has strict rules.

He'll need around‐the‐clock attention tonight

but his lungs are rebounding.

You know what, you should probably go home.

They'll let you see him in the morning.

Home?

Our whole lives were in that apartment.

This dress is all I have.

I've been watching his heart rate.

It goes down when I touch him, when he knows I'm here.

Has his fever gone down?

A little.

I waited so long for him.

Five years.

Two miscarriages, in vitro.

I lost two boyfriends

because I was so determined to have a child.

I was about to give up..

...and then suddenly..

...he was here.

He's here.

We'll keep treating the infection

but he could start going into organ failure soon.

(Luka) 'His systems will shut down.'

[quietly] You're so beautiful.

You're my baby.

His heart could stop beating.

(Luka) 'I need to know what you want to do'

'if something like that happens.'

I don't know.

To keep him alive, I may have to open his chest.

'Maybe even shock him.'

And I'm not sure you want me to do something like that.

No.

[quietly] I...I don't know.

(Simone) 'I don't know.'

Tell the unit I flushed the Quintin.

He's tenacious. You've gotta give him that.

(Elizabeth) 'I wish he'd told me.'

Not an easy thing to lead with.

Oh, there's mommy.

There's mommy.

Hi, uh, Lily had to run Wynn's ABG up to the lab.

Thank you.

Did you reverse her hyperkalemia?

Yeah, just enough to get her to dialysis.

She still has the burns, though.

Yeah, but you got her back.

May I? Oh, I'm sorry, yeah.

Hey. Thank you.

So, did we reach the parents?

No, uh, the girl was actually baby‐sitting.

Wasn't even her building.

You know, you might have told me sooner

saved me some embarrassment.

About your condition.

Well, I certainly didn't mean to embarrass you.

How long has it been?

Eight years. I was misdiagnosed for the first two.

And you were late today because?

My neurologist wanted an MRI.

I'm sorry.

I wouldn't have made you stay.

What the hell, fresh start.

Try to make as many rounds as you can

complete the required reading

take the exam.

I've been reading and taking tests for two years.

This is my hands‐on training.

‐ It's a surgical rotation. ‐ I understand that.

Probably the most physically demanding

emotionally exhausting

stressful six weeks

any would‐be physician ever experiences.

Part of becoming a doctor.

I'm offering you a pass, Mr. Nathan.

Trust me, you should take it.

I'm here to treat patients.

You have a degenerative neurologic disease.

I know what I have. It doesn't mean I need a pass.

[phone ringing]

(Frank) 'ER.'

I don't want special treatment.

I just want to learn like other students.

You're not like other students.

‐ No, I'm older and smarter. ‐ 'Okay, Dr. Corday.'

(Frank) 'Burn unit needs you.'

I'm on my way out, Frank.

It's your melted mask guy.

Okay. I'll be right there.

She's on her way.

Look, go home, think about it.

Report back day after tomorrow.

(Elizabeth) 'I'm sure you could use the rest.'

I'm fine.

It's just not very practical.

Okay, let's go.

Dr. Weaver?

What?

‐ What time is it? ‐ Are you okay?

Yeah, yeah, I was..

I was just gonna lay lay down for a second.

Can you pronounce a patient?

Did we ever hear back from the NICU?

‐ Uh, no, there was no need. ‐ Oh, come on.

It's been three hours.

We can't board their patients.

They have to call in a nurse from home

or if they won't, I want to speak to their medical director.

Weaver.

Cardiac arrest half hour ago.

Excuse us.

You should've come to get me.

How long did Dr. Kovac work on him?

He didn't. She signed a DNR.

Where is he?

‐ Who? ‐ Kovac.

He's home. His shift ended at ten.

Alright, I'm gonna move her to a quiet room.

Call the social worker

get her referrals for grief counseling.

(Abby) 'Are you leaving soon?'

I'm just, uh, finishing up with Woody here.

You're the most beautiful nurse in this hospital.

Well, thank you.

(Woody) 'You've got class.'

‐ May I play with your breasts? ‐ Hey!

‐ Excuse me. ‐ 'Please?'

Last request of a man on his deathbed.

You're not dying, Woody, you're drunk.

I wanna go to heaven on the bosom of a beautiful woman.

I don't think your HMO covers that.

How much longer you have that outfit for?

Tomorrow at noon, why?

Thought maybe I could talk you

into giving me a sponge bath.

What's in it for me, boney boy?

Oh, I'll give you a bone, nasty, naughty little nurse.

(Robert) 'Elizabeth!'

Uh...Robert, can we talk tomorrow?

I really have to get Ella home.

I thought you might want this before you left.

It's my ring.

Amazing what you can do with a laparoscopic camera and a snare.

Thank you.

De nada.

Uh..

...look, about, uh, about today.

uh, let's not.

It was a momentary..

...weakness on my part.

It won't happen again.

You'll work through this, Robert.

Of course I will.

‐ Goodnight. ‐ 'Night.'

[instrumental music]

♪ If you ♪

♪ Dream of me ♪

♪ Like I ♪

♪ Dream of you ♪

♪ In a place that's warm ♪

♪ And dark ♪

♪ In a place where I ♪

♪ Can feel the ♪

♪ Beating of your heart ♪

♪ Remembering ♪

♪ Your touch ♪

♪ Your kiss ♪

♪ Your warm embrace ♪

♪ I'll find my way ♪

♪ Back to you ♪

♪ If you'll be waiting ♪

[instrumental music]

(Elizabeth) The patient has gastroenteritis

vomits to excess, has hematemesis

no history of PUD.

What are you thinking?

Well?

(Nathan) 'Mallory‐Weiss tear.'

Laceration of the distal esophagus

results in an upper GI bleed.

You're both correct and tardy.

Sorry.

Don't be sorry, be punctual.

What if that patient vomits and develops chest pain?

Boerhaave's syndrome.

Spontaneous rupture of the esophagus

associated with retching.

Usually tears into the left pleural space.

♪ Your touch ♪

♪ Your kiss ♪

[theme music]