All language subtitles for Chicago.Med.S02E23.720p.AMZN.WEBRip.x264-GalaxyTV

.

[siren wailing]

- Get them off!
Get them off of me, please!

Get them off of me!

They're on me!
Get them off of me!

Get them off of me!

- Robin Charles, early 30s.

Delusional and combative.

Lacerations on the soles
of her feet.

- Treatment 6.
- She's on 4 milligrams

of risperidone--
nothing given in the field.

- Vitals?
- No. Too agitated.

Couldn't get her hooked up.

- Get them off of me!

- Are we set? On my count.
One, two, three. Gentle.

- Robin, do you know where you
are? Do you know who I am?

- Help me! Help me, please!
- We need to sedate her.

- 5 of olanzapine,
50 of Benadryl.

- [screaming]
- Shh.

- 2 of Ativan. 2 of Ativan!

- [breathing heavily]

[crying out]

No! No!
[crying]

[shouting and crying stops]

- Dr. Rhodes?

So, you, um--
you starting to figure out

why I didn't want her
leaving the hospital?

- She was rational.
She was lucid.

- I warned you.
- Robin was fine, okay?

Suddenly she just--

- Suddenly, look at her now!

This is on you.

You did this.

[dramatic music]

*

- I gave her 5 milligrams
of olanzapine,

and she responded well,

so we're gonna titrate
up to 10 a day.

- Past that,
Med isn't the place for her.

Robin belongs in a long-term
locked facility.

[phone buzzes]

- Dr. Latham.

- Go, Dr. Rhodes. We'll text you
if there's any change.

Go.

- Okay.

- Thank you.

Daniel...

You should go home
and get some rest.

You have to take care
of yourself.

Are you taking your meds?

Well, at least go up
to your office and lie down.

- You see this?

Mandatory penis examinations.

Under Illinois state law,

all male emergency department
workers are required

to have a yearly penis exam,
to be administered by Dr. Stohl.

Please contact him directly.

- Want me to prep you
a treatment room?

- Ugh.

Graduation week.

Childish pranks,

not to mention
the binge drinking

and the stunts!

Every year, we have an ED
full of morons.

- Youth, Dr. Stohl.

[phone buzzes]

- Yeah.

No. No, there are no exams.

It's a practical joke!

- Dr. Shore, Dr. Halstead,
don't forget--

Keoni's Luau tonight,
my grad party.

- We'll be there.
- Absolutely.

- Great.

- Mai Tais and poke.

- Piña colada for me.

- See you later.
- Hey.

You and Nina look happy.
- Yeah.

- Hey, you two need to know
that...

[quietly]
Robin Charles is in 6.

- What happened?

- Psychotic break.
- Oh, my God.

- You're up. Incoming.
Poly trauma.

[alarm sounds]
Go, go, go, go, go.

- 22-year-old male,
peds versus auto.

GCS 12, BP 100/70,
heart rate 125.

- Got a student ID.
Kid's name is Marwan Haddad.

Hit-and-run. The car
dragged him, like, half a block.

- Sexton, fast his belly.
- On it.

- Need X-rays: chest and pelvis.

- And left lower leg.
Probably a tib-fib fracture.

Let's move him.

One, two, three.

- Poor breath sounds
on the left side.

- Christina.
- It's okay. It's okay.

I'm Dr. Manning.
This is Dr. Halstead.

We're gonna take
really good care of you, okay?

- Christina.

- Easy. Easy.

- Belly's clear.

- He's shocky. I'm intubating.

- Bilateral rib fractures.
Bilateral pulmonary contusions.

- And hemothorax on the left.
Sexton, chest tube.

Doris, hang two units of O-neg
on the level one.

- Got it.
- We got a medical history?

- No. I spoke to his roommate.
Marwan's a Syrian refugee.

He's here to go to school.
That's about all the guy knows.

His parents are on a plane.
They're flying in from Germany

to go to his graduation.
- Poor guy.

- Chest tube's in.
- Good work.

- Can you imagine? The kid
survives cluster bombs in Aleppo

just to come to Chicago
and get hit by a car.

Let me know when he wakes up,
all right?

I want to get a statement,
figure out who did this.

- Absolutely. Thanks, Jay.

- Dr. Rhodes,
I have news for you.

Oh, I should say
"good morning."

- Good morning, Dr. Latham.
- If I'm not mistaken,

you don't seem to be
your usual self.

Tired?
- No. I'm all right. Thanks.

- Okay. Good.
- Did you page me?

- Yes. You remember
when I told you

that you weren't my first choice
for this fellowship?

- Yeah.
- It was a South African woman

from Groote Schuur.

Well, the hospital has
allowed for another

second-year CT fellow,
so she's here,

joining our team.

Dr. Rhodes, meet Dr. Bekker.

- Ava.
- Connor.

- I'm sure you two will enjoy
working together.

I'll leave you two
to get acquainted.

- He's very odd.
Asperger's?

- Dr. Latham is a great surgeon,
teacher, and friend.

- Oh. Loyal.
That's sweet.

- You know what, Dr. Bekker?
I'm not sure

we will enjoy working together.

- Leah?

- [whispers indistinctly]

- Okay.

Mr. Kellogg,
I'm the charge nurse.

- Is Dr. Charles ready
to see me?

I texted him I was coming.

- He may not be
checking his messages.

He had a family emergency.

- He told me that I could
see him any time. He promised.

- I'm sorry. But I can have
one of his residents see you.

- I'm not talking
to some underling.

Is Dr. Charles here?

- Yes, but I don't think he's
going to be available.

- You tell him that I'm not
gonna be treated this way.

I'm gonna stay right here
and wait until he comes out.

- Okay.

- Hey, get me a cup of coffee.

- The vending machine's
right there.

- April, about last night--

- No. It's just as much
my fault.

It never happened.

- Dr. Choi, April, you're up.

[alarm sounding]

Cesar?

- Don Crocker, 47-year-old male,

shortness of breath,
chest pains.

- You're going to Treatment 4.

- Passed out on the stairs.
Neighbor found him.

- Lucky.
- BP 90/70.

Heart rate's at 110.
12 lead in the ambo.

- All right, Mr. Crocker,
I'm Dr. Choi.

We're gonna take good care
of you, all right?

- Okay.

- Let's transfer on my count.
Ready? One, two, three.

12 lead shows a stemi.
Activate the team.

Mr. Crocker,
you're having a heart attack.

- Aspirin?
- Yeah. 81 milligrams

and 4 of morphine.

- Mr. Crocker, is there anyone
we should call?

Friends? Family?

- No.
- Someone at work?

- Work from home. Most days
don't even leave the apartment.

- So, no one?
- No.

- All right, Mr. Crocker,
you've got fluid backing up

into your heart and lungs--
that's why you're

having difficulty breathing.

April, let's give him
10 milligrams of Lasix

and place a Foley--
we're gonna get the excess water

out of your system.

- Okay.

- Mr. Crocker?
- He's lost consciousness.

- All right, I've got a pulse.
Take him up to the Cath Lab.

I'll intubate him there.
Page Cardiology.

Ready?
- Yep.

- Why'd she do it?
Cut her hair.

A woman changes her hair like
that, it's a big deal, right?

It means something.

- Absolutely.

- Yeah. So?

- Well, don't ask me.

- [gasps] Oh, my God.
What?

- Are you coming to my party
tonight?

- I don't know.
I haven't thought about it.

- Okay. Well, it won't be
the same without you.

- All right.
Look, I'm busy, okay?

- Okay. But you are...

coming to my party.

- Hey.
- Hm.

- Glad you took my advice.

She's sleeping. At least let me
buy you some breakfast.

- Cup of coffee, maybe.

- Dr. Charles?

I have been reviewing
Robin's history

just to make sure
we haven't missed anything,

and, well,
some of her symptoms--

they're not consistent
with a psychiatric disorder.

- Dr. Reese--
- Let her finish.

- Two days ago when Robin came
to the hospital,

she was running a mild fever,
100.2,

and her BP was elevated.

Now, at the time,
we didn't think anything of it--

- That's 'cause it's
a very mild fever.

And of course her BP was
elevated.

She was on a forced hold.
She was agitated.

- But when Robin was
brought in today,

it seemed she was experiencing
visual hallucinations.

Now, auditory hallucinations
indicate a mental disorder,

but visual hallucinations should
be considered organic

until proven otherwise.

- I think we all wish
that Robin had a treatable

physical condition rather than--

- I want to check her
ceruloplasmin levels

and run an FTA-ABS
as well as an MRI and EEG

to rule out scelerosis
and epilepsy.

- Of course. Do it.

What's the matter with you?

- She's trying
to make me feel better.

And bless her, but she's
grasping at straws. Come on.

- Are you so blinded
by your fear

that Robin inherited
her problems from you

that you won't even entertain
an alternative?

- False hope, Sharon. Come on.
I don't need any.

- You don't know that.

Where's the Daniel
who leaves no stone unturned

when diagnosing a patient?

Where's the Daniel
who never gives up?

.

- Hey, what are we looking at?
- He needs a new valve.

- Ava Bekker, CT fellow,

Ethan Choi,
Chief Resident of the ED.

- So, we crack his chest,
replace the valve.

- Well, we don't need
to crack his chest.

Mr. Crocker's been assessed
as intermediate risk,

and transcatheter aortic
valve replacement, TAVR,

is now FDA approved
for patients at that level.

- We get excellent results with
open aortic valve replacement.

With TAVR, you're just
inviting complications.

- I don't agree.
Why put the patient

through a long operation
and a long pump run?

He can have a functional heart
again in under two hours.

- The less invasive, the better.
- Exactly.

- Excuse me. You're
an emergency medicine resident.

Why are you even talking?
- Excuse you?

- Because I value
Dr. Choi's opinion.

And I think you'll find
that Dr. Latham will

back me on the TAVR.

- Fine.

- I'm sorry you got brought
into this.

I didn't know about Robin. I'm
sure you want to be with her.

- Yeah, I'm all right,
but thanks.

This won't take long.

I'll let you know how he does.

- Thanks, man.
- Mm-hmm.

- What level of oxygen is he on?
- 100%.

- Left upper lobe is
segmentally collapsed.

- Probably plugged up
from a clot in his airway.

- Yeah.
Let's get a bronchoscopy.

- Yeah, clear out
any obstructions.

- Hey, I never asked,

why'd you decide
to cut your hair?

- Time for a change.

- Oh.

- I'm looking for Marwan Haddad.

- Oh, are you family?
- We go to school together.

- Well, he's being treated
right now.

Why don't you wait in the lobby,
and I'll tell you

when you can see him, okay?

- Oh, Dr. Choi,

take a look at this girl in 2.

Probable distal radial fracture
and concussion.

This young genius tied a rope
around a rafter

and tried to swing across
the school cafeteria.

- What?
- You'll see.

Oh, by the way,
I'm missing my coffee mug.

Yeah, some cretin
obviously thought

it would be amusing to steal it.

- I'll make sure to look out
for it, Dr. Stohl.

- Thank you.

- Closed distal radius fracture.

- Monkey suit.
- Uh-huh.

- Of course.
Swinging from the rafters,

got to have a monkey suit.
- So stupid.

- No. You should've seen
people's faces

when they saw you.

It was so clutch.

Senior prank. We're graduating
from high school.

- We'll need
the Ortho resident to see her.

- I'm afraid we're gonna have to
cut this suit to set your arm.

- No! It's a rental.
- I'm sorry.

- Your friend lost consciousness
when she fell?

- Yeah. I was kind of worried.

- Concussion is
always a concern.

I want to get a CAT scan,
head and neck,

just to be sure.

- Don't worry. You'll be
out of here in no time.

I'll call Ortho.

- Oh, Dr. Choi, you're coming
to my party tonight, right?

- Uh...

thanks, but I'm not gonna be
able to make it.

Early call tomorrow.

- You sure? One Mai Tai.

- Sorry.

- Okay.

- The valve is
in position and open.

Injecting dye now to check it.
- Fluoro.

Left coronary artery looks good,
but I'm not seeing the right.

- Could be occluded.
Can you get the wire in?

- Let me try and cannulate
the right coronary artery.

Can't, the lumen's blocked.

- There's no flow
on the right side.

- Seeing right side ST changes.

Calcium deposit
must have broken off

from the old valve
and occluded the RCA.

- His heart is dying.
We've got to open him up now.

- What we should have done
in the first place.

- And we're already making calls
to find her another bed.

We'll keep Robin here
until we can get her transferred

to a long-term facility.

We'll take good care of her.

I've dialed back
on her sedation.

- Robin? Honey?

- Get away from me. Get away.

Get away from me.
Get away from me!

Make him go!

- Dan, Dan, Dan,
we got this.

- You were right.

The tests I ran--
there's no indication

of any organic medical
condition--I'm sorry.

- Robin's showing dyskinesia.
Did you notice that before?

The jerky movements?

- Yeah, I assumed it's
from the antipsychotics.

- Yeah. It could be.

Did you order
a paraneoplastic panel?

- For auto-antibodies? Why?

.

- Graft is in place.
Let's get him off of bypass.

- Unclamping the aorta.

- Let's get his heart beating
on its own. Defibrillate.

- Clear. Sinus rhythm.

- Cut to 2 liters.

- Hold on.
His right heart is ballooning.

- Back on full support.
Marty, what's he on?

- Dobutamine at 8,
dopamine at 5.

- Give him a milrinone
loading dose, epinephrine bolus

of 50 micrograms,
and start inhaled nitric.

- That's not gonna cut it.
His heart isn't coming back.

He's not leaving this room
without ECMO.

- Won't that just set him up
for complications later?

- Why do all the residents
in this hospital

think they can offer
their opinions?

- No ECMO. His heart is strong
enough to come back on its own.

- I disagree.

- Noted, but this is my case.

All right, cut to 2 liters.

- The heart's coming back.

Septum is midline,
SVR acceptable.

- Pressure's holding.
- Good call, Dr. Rhodes.

- Yeah.

- Let's decannulate.

- His sats are down to 80.

There's his latest X-ray.

- No improvement.

- How much vent support
are we giving him?

- Maxed out.
- He's on bronchodilators,

and he's still not getting
enough oxygen.

- 75%.

If we don't correct his hypoxia,

we're looking
at anoxic brain injury.

- Mm-hmm. Let's get him
up to the ICU

and put him
on cardiopulmonary support.

- Right.

- Your patient has a friend
here. Girlfriend, maybe.

- Oh, good. I'll go talk to her.
- Okay.

- Thanks, Nat.

- How long you been waiting?

- I don't know--
about an hour.

- [scoffs] Typical.
They lie to you here.

Stand up for your rights.

- Hi. Are you Marwan's
girlfriend?

Is your name Christina?

- Yes.

How do you know my name?

- When he first came in,
he called out for you.

Do you know anything
that may help me treat him?

Any medical history?
Medications?

- We haven't known each other
that long.

- Okay. We're taking Marwan up
to the Intensive Care Unit.

If you want,
you can come wait up there.

All right. I'll have someone
come grab you, okay?

- Dr. Stohl,

I, uh--I found your mug.

- Where?

Thank you.

- I'll, um, call maintenance
to get it down.

[phone buzzes]

- Hello?

It's a joke.
There are no inspections!

It's a joke!

- Get me maintenance.

- Here's the paraneoplastic
panel.

- Wow. Look at that.

You were right, Dr. Reese.

It is objective.
It's physical.

Well done.

Where's the tumor?

- There.

- It's so tiny.

And all that.

Page Dr. Latham.

- Good news.
Your CT was negative.

- You're gonna be fine.

- See? I told you!

- It isn't that.

- She never does anything wrong.

Straight As, all honors.

She got into Harvard.

- Well, we'll start
the discharge paperwork.

Parents on their way?

- Yes. The school had trouble
getting ahold of them, but yeah.

- Hey.

So, what's with you
and Dr. Choi?

- Nothing.
What are you talking about?

- Oh, come on, April.

I'm your brother.

- No. There's nothing
with me and Dr. Choi.

I--
Noah!

I just broke up with Tate.

You think I'm gonna jump
into another relationship?

- Let me just say:
maybe Dr. Choi is

no All-Pro football player,
but he is one hell of a doc...

with decent earning potential--
I'm just saying.

- Maggie, where's Robin?
- Let me call you back.

They took her upstairs.
She's getting a scan.

Doctor--

- I saw Robin's scheduled
for surgery.

- She has anti-NMDA Receptor
Encephalitis.

It's very rare. Dr. Charles had
the idea to test for it.

- It's some autoimmune response?

- Gone awry. Robin has
a mediastinal teratoma--

a benign one, but her body's
attacking the tumor,

and it's also attacking
the brain.

- Yeah, and the resulting
inflammation is

what's caused
her psychiatric symptoms.

- So, when the tumor's removed?

- Hopefully the psychosis should
resolve itself.

- Wait. What's going on?

.

- I'll remove the teratoma
via mediastinoscopy,

a minimally invasive procedure.

Shouldn't take more
than 90 minutes.

- You're gonna be okay.

I love you.

Dr. Latham,
I would like to assist.

- Absolutely not. Given your
relationship to the patient,

it would be inappropriate
and ill-advised.

I do not want you in my OR.

- It would still be
your surgery.

I just want to be there.

- Dr. Rhodes,
my understanding

of human behavior may be
limited,

but you are not acting
in the professional manner

that I am accustomed to.

Like any other friend
or family member,

you will sit
in the waiting room.

Dr. Bekker will assist.

- As soon as your parents
get here, you can go.

- How can I explain what I did?

I don't even understand it
myself.

- I do.
You got into Harvard.

Sometimes we work so hard,
hold ourselves so tight,

when we finally reach our goal,
we go a little crazy,

swing from the rafters.

- I don't know.

- Listen to me. You're gonna go
to a fantastic school,

get a great job,
and ten years from now,

you'll just think of this
as a happy memory.

Uh, Noah says you're not coming
to his party?

I'd really like it if you did.

- Should be done soon.

I was wrong to take Robin
out of the hospital.

I'm sorry.

- Well,

I have certainly been wrong too.

Seeing the whole thing through
the prism of my own fears.

- Since I was a kid,
I always wondered

if there was something
I could've done

to stop my mom
from killing herself.

I obviously couldn't save
my mom,

but I was sure as hell gonna
try and save Robin.

- You know, at one point
I considered bringing that up.

Decided it probably wouldn't
have been helpful.

[chuckles]

- Yeah, probably not.

- [sighs]
Well,

she's not gonna want
to have anything to do with me

after this is all over--
that's for sure.

- Any word?

- No, not yet.

- Everything okay?

- Yeah.
- Yeah.

- She did well.
The tumor's out.

Now we just have to rid
Robin's body of the antibodies

with plasmapheresis.

Should take two hours,
and hopefully she'll be okay.

- Hey, Reese,
been looking for you.

I thought you might
want this back.

- It was a gift.
Why would I want it back?

- You know, when people
break up, you give stuff back.

- It's a Rubik's cube, Joey.
Not a diamond ring.

Keep it.

- One more thing.

I'm dating Valerie.
I just thought you should know.

- I'm glad you found someone.

- Thanks.

- Christina?

How are you doing?

- [crying]

- We are doing everything we can
for Marwan.

- I'm pregnant.

We didn't mean it to happen.

We thought
we were being careful.

We were going to get married
after graduation.

Nobody knows.

- You haven't told
your families?

- We were going
to tell his parents tonight.

- I am so sorry you both have
to suffer like this.

- [crying]

- Dr. Choi?

- Mr. Crocker.

They did have to open
your chest,

but you came through just fine.

- Thank you.
- Sure.

- For--for caring.

- Hey.
- Hey. How's Robin?

- She's good. Thanks.
You saw Mr. Crocker?

- Yeah. Pretty young to have
that kind of heart trouble.

- Could be genetics, or--

he said he's alone, right?

He's not married.
No friends. No family.

- No.
- Loneliness puts you at risk

for heart disease.
- That for real?

- Yeah. I think we all know
that love can hurt, right?

But loneliness--
that'll kill you.

- What is it, Natalie?

- Look at his X-rays.

- Diffuse airway disease.

- Even with CPS, his lungs are
getting worse. Fast.

- This poor kid.

What, his parents
just flying here to bury him?

Why can we not figure out
what's wrong with him?

- We've been so focused
on his injuries.

Maybe there's
an underlying condition

not related to the accident

that we don't know about.

- When Marwan got
his bronchoscopy,

his tidal volume dipped--
it shouldn't have.

- Right.
The paralytics should've

relaxed his chest wall,

so why are his airways
still so constricted?

Why can't he breathe?

- What if it's as simple
as Marwan's got asthma?

- That would make sense.
He needs steroids.

- Natalie, if we're wrong,
that'll put him at risk

for infection and myopathy,

and that could wind up
killing him.

- Well, we are out of options.

If we don't do something now,
he will die.

.

- Dr. Halstead, Dr. Manning?
The patient's parents are here.

They just arrived.

- Great.

Hi.
- Hello.

- Thank you for
taking care of him.

- How is he?

- He was seriously injured,
and our main focus right now is

his lung function.

- Tell me: is Marwan
by any chance asthmatic?

- Yes, yes,
since he was a child.

It comes and goes.

- His X-ray is ready.
- Please, come with us.

- Oh, oh, my God.

- Bilateral consolidation's
markedly improved.

- His airway pressures are
coming down.

- What does that mean?
- It means

we think your son's
gonna be all right.

- [crying]
- Thank you.

- Mm-hmm.

Candace, let's start weaning him
off cardiopulmonary support.

- You can stay with your son.

Marwan's recovering.

You should go
introduce yourself.

- I don't know.

- They should know who you are.

- Are you good?

- Yeah.

- Some days,
I really love my job.

- Asthma. Astute diagnosis, doc.

- Hey, don't give me
all the credit.

I wouldn't have gotten there
if it wasn't for you.

You're the genius.

- Marwan's awake.
I got a statement from him.

- Great. I'll go check on him.
- Thanks, Nat.

- So, it's Noah's
graduation party tonight.

- Yeah. Should be fun.
- Yeah.

Natalie asked me
to go with her.

You mind?

- No. Of course not.

- You sure?

- Yeah.

- All right, you know,
I'll tell her I pass.

You need to get your act
together.

- Hey.
- Is it time to go?

- Nina?
I haven't been fair to you.

You deserve someone as committed
to you as you are to him,

and I haven't been that person.

- This is about Natalie,
isn't it?

You lied to me.

You said there was nothing
between you.

- I don't know if she has
feelings for me,

but I have feelings for her,
and I can't go on pretending.

- All this time?
Pretending?

- Nina, I care about you--

- Get out of here, Will.

Go!

- I'll get my stuff
out of your apartment.

- Sooner the better.

- There are balloons
in my office.

Hundreds of them.
I can't get in.

- Oh. I'll call housekeeping.

- Maggie...

Do people hate me?

- No, Dr. Stohl.

It's quite the reverse.

- Then why?

- You know the saying:

"You only hurt
the ones you love."

- [sighs]

A tumor?

- Yeah.

Reaction to your antibodies

caused your
psychiatric symptoms.

- So, I was crazy,

but I wasn't crazy?

- [chuckles]
Yeah, something like that.

- Okay.

- You should know something.

It was your dad that came up
with the diagnosis.

Robin, he's hardly
left your side.

You should talk to him.

- Hi, sweetie.

Honey.

Robin, I--I--

[crying]

[both crying]

- So, I think we can call today
a draw.

- Didn't realize we were
in a competition.

- Oh, come on.

You know, you're quite
the gossip magnet.

Your mother committed suicide,

you drove your girlfriend crazy,

and you murdered your attending,
Dr. Downey.

- Well, then, you'd better
watch yourself, hadn't you?

- I like dangerous men.

[dance music playing]

*

[cheers and applause]

- I want you.

- Come on.

- April.

- Dr. Choi.

Ethan.

- You're still here?
- Five minutes, and I'm gone.

It's so good
to hear about Robin.

- Yeah.

- Well, we made it
through another year, Daniel.

Gonna get a new bunch
of residents to drive us crazy.

- Le plus ca change, baby.

- [laughs]
- Le plus ca change.

Good night, Sharon.

- Good night.

- Dr. Charles.

- Mr. Kellogg?

- I've been waiting here
all day.

You haven't answered
any of my messages.

- I'm very sorry.
I've had a, uh--

an unusual day.

Is there any way we could talk
first thing in the morning?

- Liar!

[gunshot]

[gunshot]

.

[dramatic music]

*