All language subtitles for er.1011-med

E. R.

Previously on E. R.

You guys met my sister, Val?

I was diagnosed with MS when I was 22
and before that, I was a normal girl.

- How advanced is it?
- I'm still fully functional.

Look, I know I said
I didn't need any help, but...

...tonight I did.
Thanks for the help.

Hey, Abby.
Did you get your trinket from Carter?

Gone-native junk for everybody.

It was my father's.
I want you to have it.

I want you to come back
to the States with me.

I want our baby to be born in America.

E. R. 10x11 "TOUCH AND GO"

Remind me to put the clock
on your side of the bed.

Hey, Kem? You down here?

- Been in the kitchen since dawn.
- She's still adjusting to the time change.

- Insisted on making me eggs again.
- Well, that's nice.

That's not nice?

- Good morning.
- Hey.

Good morning.

You know, you have got 20 types
of tea, like, six sets of china...

...and glasses for every possible drink.

Did you have trouble sleeping again?

I had trouble finding the kitchen again.

- I need a map.
- You get used to it.

You'll be sliding in the hall
in socks in no time.

- Oh, and that wouldn't offend anybody?
- Nope.

Although, you should probably
stop making breakfast for Emily.

She doesn't like my cooking?

Doesn't like feeling insecure
about her employment.

I'm gonna miss you today.

You want George to show you
the sights after your appointment?

- Do some shopping, go to a movie?
- I might take a walk.

Would you rather I not work
while we're here?

Because I don't have to.

What I'd rather you do...

...is give me your socks.

What are you doing?

What are you doing?

So where is the bedroom, again?

You coming or what?

Abby, sorry. It took forever
to get Alex out of the house.

- Don't worry.
- You already sign out?

Yes. Too bad I can't leave.
Lelma Ramirez in 1, vomiting times three.

- Tolerating sips after 10 of Reglan.
- Stomach-flu season?

Dr. Lewis would have us believe.
She called in sick.

- Really? How'd she sound?
- Better than she should have.

Repeat EKG and troponin
on Mr. St. John at 8 a. m.

Lewis probably has that flight nurse
in her bathrobe.

- Is he pain-free?
- Mrs. Clark's had three nebs.

- She may need continuous.
- Should I call in another Attending?

No. Carter's on. We're good.

So, what's his story?

Richer and better-looking
than you or I will ever be. The end.

I just wanna know if the guy's a jerk.

- Is he?
- She's not the best one to ask.

- There a problem with the narcotics?
- Missing 10 migs of Valium.

- If you sign off, the night nurses can go.
- Yeah. Or they could just learn to count.

My onset-seizure guy went to Medicine.
Rack is empty. And I am off the board.

Good. Go home.

- Saying I can leave early?
- I'm saying it's slow and you're an intern.

- We'll be fine.
- Alrighty, then.

- Get some rest, Mike.
- Yeah. Hope it stays slow for you.

- What have you got?
- "Gome" from the home.

- An elderly patient from a nursing home?
- Breakfast special.

Staff went to check Granny's vitals
first thing. She didn't have any.

Hey, sis.

Hey, you wanna turn that down?

Valerie, it's 7:00 in the morning.

Mike.

- You're home early.
- Baby, you have another razor?

This one's dull.

Good morning, Mike.

- How many times?
- What?

- How many times has he been here?
- None of your damn business.

It's only my bedroom.

Just a few.

Now I know why you're interested
in my schedule.

- Is there any coffee?
- No.

Yes.

I'm on the clock anyway.
I'll see you later?

Peace, Mike.

- What time you gotta be at the airport?
- My flight leaves at 2.

Wake me up at noon.

- Thought you were off.
- Not until she balances her narc count.

- You wanna see me?
- January 18.

Forget it. I've already got two Attendings
requesting Super Bowl Sunday off.

- My last day here.
- Africa?

I have to admit I'm surprised
you're still going back.

Dr. Weaver!

- She pulled out her Foley.
- Kovac will be there.

Mrs. Webster's a boarder
being managed by Cardiology.

Congestive failure and some dementia.

Check her potassium and hit her again
with Lasix before she goes up.

- So you'll notify Administration?
- About what?

- My resignation.
- No.

You will. Put it in writing
and leave it on my desk.

I'll bring it to the Medical Executive
Committee in the morning.

For the record, we need you here
as much as they do there.

- Dr. Kovac.
- You're late.

- Power outage at the Armitage station.
- Valerie again?

I was gonna put a Swan-Ganz
in my cardiomyopathy guy.

After load, reduce with enalapril.

- How are you doing, Mrs. Webster?
- I wanna go home.

- A mig of Bumex and 40 of K.
- I'm on it.

Pressure's borderline.
I can't manage him without a Swann.

- How are you doing?
- Give the ACE inhibitor.

And support for dopamine.

I love you.

Thanks.

If I know his wedge pressure,
I can do what I need.

Dr. Kovac.

My kids finished the chelation
therapy today.

- They are coming home.
- That's good.

You are going to be our only doctor
from now on, okay?

Anyway, the Swann tells me
his output and PVR.

Do walk rounds with the med students,
and I'll talk to you about it later, okay?

- Patients really respond to him.
- Yeah.

Give the differential diagnosis
of peripheral edema.

- Cirrhosis.
- CHF.

Thrombophlebitis.

Lockhart.

You belong to me at 4. You better
be sharper than that. Come on.

What was that all about?

Could this day suck more?

Sign-in sheet's over there.

- I'm not a patient.
- Hey, Dr. Carter.

Nice to put a face to the name.

- She with you?
- Yeah.

Call me John. This is Kem.

Hi. Sam.

Pleasure to meet you.

- So this is it?
- This is it.

Double MVA, two minutes out.

- Hey, stranger!
- How are you?

Hi, everybody.

- Hey, Malik.
- Welcome back, doc.

- Good to see you.
- I heard you were coming in today. Hi.

- And who is this lovely lady?
- Everybody, this is Kem Likasu.

She's visiting from the Congo.

- Welcome.
- Nice.

- Good to meet you.
- Nice to meet you.

Kem has an appointment
with Dr. Subramanian upstairs.

Dr. Subramanian from OB?

Prenatal checkup. Second trimester.

- Congratulations.
- That's so great.

- Hey.
- Hey, Pratt. How are you?

Life is good.
But I see it's better for you.

- How are you doing?
- Hey.

- So are you back on shift yet?
- About five minutes ago.

- Can somebody show Kem upstairs?
- Okay, this way.

- You're coming, right?
- Yeah, yeah. Start the paperwork.

- I'll be right there.
- Okay.

- Behind you.
- What do you have?

Larry Brodie, 44-year-old passenger.
Single car versus telephone pole.

May have had a syncopal episode.

- Bad bruising to the chest and belly.
- Who's worse off?

- Dad by a long shot.
- Four units of O-neg...

- ... and a portable chest, and an EKG?
- Sure.

- Cool.
- I'm a second-year Resident too.

- Barely.
- Pratt, take the driver.

- Tell me his story.
-19-year-old restrained driver.

Trying to wake his old man up
when he crashed.

BP, 128/74.

Cracked a few ribs. Got 6 of morphine.

- What's with the collar?
- Custom-made by Dad.

- What for?
- Ankylosing spondylitis.

- Equal breath sounds.
- HemoCue's only 8.5.

Well, he's profoundly anemic.
He's bleeding somewhere.

- Pressure down to 76.
- You're back.

- Where's my son?
- Let's squeeze in both units.

- I've been holed up at the house.
- And not alone, either.

Central-line kit and size 8 gloves.
Kem, right?

- Cordis introducer gives more volume.
- Excellent, Morris.

She was setting up the ARV therapy
in Kinshasa.

Where's my son?

- He needs help.
- Don't worry, Mr. Brodie.

Your son's in good hands.
Someone you want us to call?

- Your wife?
- No.

- She died.
- One percent lido.

- Did you ever meet her?
- Nope. Must've gotten past me.

Set up for ultrasound.

- Good to be home.
- Need another doc in here.

Here.

Is my dad next door?
I can't turn my head.

- He's hanging in there.
- How's he doing?

Probable rib fracture. The neck film
shows fusion and a bamboo spine.

- Ankylosing spondylitis.
- Unusual bone disease at his age.

Similar to juvenile arthritis.
Weakens the spine, though.

Sucks living life in bubble wrap.

Also has a big pulmonary contusion
and a small pneumo on the right.

- What?
- There's a bruise on your lung.

- You're having trouble breathing.
- May need to tube him.

Give my dad another reason
to keep me inside.

Call Anesthesia. They can do an LMA
or awake naso-tracheal while he's stable.

You wanna call in the whole team. Your
African buddy wants to ban all tests.

- What should I do?
- Isn't he the Attending?

Hey, Taggart. Principal at your kid's
school wants you over there lickety-split.

- What for?
- Don't know. Can't be good.

Hey, you find another nurse
to cover for you.

- Let's try nasal BiPAP. Thank you.
- I'll get it.

- Where are the BiPAP masks?
- Bottom right drawer.

Got the EKG.
Pressure's up to 100 systolic.

- Neela, read it for me.
- I can do that.

Left bundle branch block.
Can't see the ST segments.

Probably not an acute MI,
but send a troponin.

Can't visualize Morrison's pouch
with all this fat and air.

- Where does it hurt, Mr. Brodie?
- Everywhere.

Stay ahead four units of type-specific.
Hope his pressure stays up for a CT.

He's fragile.

- Is he mad?
- Who?

My dad. I talked him into
letting me drive today.

Oh, I'm sure he's not mad.

Rales are worse.
Sats are down to 88.

Might need to think about an airway.

There's plenty of room to move
on BiPAP.

Up his inspiratory pressure to 10.

Dr. Carter, Kem called.
Dr. Subramanian's seeing her now.

- She took her in early.
- Go. We're all over this.

Okay, I'm only covering for Sam
until Severa gets here.

What?

- Kem.
- Look.

Normal extremities.
Good fetal movement.

- Any neural-tube defects?
- No. Looks great.

It's our son.

I couldn't help it. I wanted to know.

He's beautiful, isn't he?

A son?

- Well?
- Count's the same.

- Abby, that's totally wack.
- Don't make me call the union rep.

Okay, I'm gonna call Weaver at home,
see if she'll cut us a break.

It's ringing.

Hi.

- Dr. Weaver?
- Yeah?

It's Abby.

- Yeah, we found the missing Valium.
- It was Weaver?

Yeah. Someone actually left it
in their lab coat pocket.

I'll pass that along.
Says whoever did it is an idiot.

- I'm out of here.
- Make that a double.

- Hi.
- Hey.

- Hey, how are you?
- I'm good.

- I'm Abby.
- Kem. Good to meet you.

You too. Welcome. And welcome back.

- How have you been?
- Good.

- I'm back in med school.
- Really?

What's this?

That's an ultrasound.

- Congratulations.
- Thank you.

Must be Kem.

- Are you Luka?
- Yeah.

- Wasn't for you, we wouldn't have met.
- Yeah.

So boy or a girl?

- It's-
- It's a boy.

- Handsome.
- Like his daddy.

Well, I should probably...

...get back to work.
Come on. I'll walk you out.

- Sure. Good to meet you both.
- Bye.

They got together after I left.

- You okay?
- Yeah.

Okay.

What? Did he knock her up
the minute he got there?

- Going home?
- No.

On-call room. Same thing.

Got a messy one here!

- Let me go!
- What happened?

Two stab wounds to the upper left thigh.
Tachy at 120. BP 90 palp. Lost 2 liters-

- Back off, man!
- Easy. Even with direct pressure.

- Over the femoral artery?
- Okay, let's have a look.

- Can we fit a BP cuff above it?
- The injury's too high.

- Undo my belt.
- What?

He needs a tourniquet now.

- Mine's thinner and cheaper.
- Leave me alone.

- Leave me alone!
- Okay, wrap it as high as you can.

Leave me alone!

I can't get it tight enough.

Got it.

- Let's get him in Trauma 1.
- Get off me, man.

- Where did you learn that?
- Sitting on a patient?

- Congolese nurse named Mwadi.
- You getting down?

- Get off me, man.
- Not until he's restrained or sedated.

Stab wound. Out of the way, please.

- You taking Mr. Brodie to CT?
- No. Chuny is. Why, you need help?

Your patient's pressure is borderline.
Two units and a med student with you.

Mrs. Webster, this is a busy road.

- How do I get out?
- By getting treated and released.

Now, let's get you back into bed before
another gurney comes around the corner.

Oh, you're a good boy.

That's what all the ladies say.

Thirty-year-old mom
with a history of migraines.

- Neuro exam is normal.
- No neck stiffness or fever. Good vitals.

- Morris, you all right?
- Yeah.

Mrs. Hulsey, are you still going
to the headache clinic?

No money for a sitter or anything.
I had to bring my kids.

Any chance they can get
something to eat?

- Sure.
- Maybe hamburgers or hot dogs?

- For breakfast?
- Just something hearty, you know?

Like mashed potatoes, gravy and giblets?

Sorry.

Think you should be working?

Yeah. Maybe I should call
somebody else in?

Sympathy hurl.

Even a sandwich would be okay.

We're not picky.

Mrs. Hulsey, when's the last time
you had anything to eat?

I know he's not happy,
but he can't be an ordinary boy.

Man.

Martin's 19. You need to let
the guy live a little.

- Does he need oral contrast?
- No. Just IV.

We'll be right on the other side
of the glass, Mr. Brodie.

All right, fire it up.

His son's the one with
all the osteophytes?

It's not like he wants to play football.
Just wants to get out once in a while.

Make sure you stay still, okay?

- Mr. Brodie?
- His pressure's down.

- Pull him from the tube.
- Define his pathology.

- How fast can you do this? Come on.
- Well, fast, but-

- Wait, what are we doing?
- Getting the scan.

- Hey, you need to wear lead.
- He's not wearing lead.

- He's only getting one scan.
- I do this every day?

Ladies first. Leave that alone.

Spike another unit and squeeze it in.
Hurry up.

And page Corday.

- They your patients?
- Mom was.

Thought her migraines were kicking up.
Then I noticed the hair and nails.

Dermatitis, loss of fat from the cheeks.
She and the kids are starving to death.

They'll get sick if we increase
calories too rapidly.

Yeah, I'm admitting to Pedes
for slow re-feeding.

She's beautiful, by the way.

- So when are you going back?
- Two weeks.

On my way up to Weaver's office...

...to drop off my resignation letter.
How long you gonna stay?

Kem's gonna go back and see her family
for a couple weeks.

Then come back here and have the baby.

- She miss home?
- Yeah, we both do.

Hey, give yourself a week of hot showers
and an unlimited glove supply...

...you'll miss it less.

Dr. Carter. Martin's respiratory distress
is worse.

- I thought Anesthesia was coming down.
- I paged. Apparently, he's at a pain clinic.

- What's his pulse ox?
- Eighty-six and dropping.

- How are you doing, Martin?
- Not so good.

Let's up his inspiratory pressure at 15
and give him 5 of albuterol.

I'll be back with an anesthesiologist
if I have to pull one out myself.

Heart rate's down to 58.

Come on, you got a kid who needs you.
Push the drugs.

- Start the scan.
- Need to get your hands out of there.

Atropine's in.

Go.

- How long is this gonna take?
- Twenty seconds, tops.

I thought this was
a third-generation scanner.

Another 10 seconds.

What in God's name are you doing?

Keeping this guy alive so we can get
the CT and show you where to cut.

- Systolic's down to 90.
- Come on. Have we got soup yet?

There. Eight-centimeter Triple-A.

He would've bled out while I focused
on the liver and the spleen.

It's all in the wrist.

Dr. Carter? My patient's
in respiratory failure.

No.

Dr. Carter is not in here.

- Sats are 82.
- I can't find Dr. Kovac either.

- Martin, stay with us.
- What the hell's going on?

- Progressive hypoxia despite inspiratory-
- Meaning he's not breathing. Bag him.

- Bradying down to 52.
- Carter call Anesthesia?

- An hour ago.
- Forget them coming to the rescue.

Mig of atropine. Twenty of etomidate.
120 of sux.

- We're supposed to wait.
- Lost the pulse.

No, can't wait anymore.

- Amp of epi.
- What are you doing?

- He needs oxygen.
- Sats are dropping. Seventy-four.

- Is the stiffness part of his disease?
- Pull his arms down, 100 of lido.

I can't visualize squat.

Dr. Pratt, are you sure?

- Lido onboard.
- Stop compressions.

- Pratt.
- I think I got it.

Oh, God.

- Hook up the ambu-bag.
- Pulse is strong and regular.

Did he break his neck?

Sats are good, 98 with 5 of PEEP.

There's still no motor tone in the legs.

It's probably the intubation meds.

Sux only paralyzes for 10 minutes.

Could be a slow metabolizer.

- I just broke off a bone bridge, that's all.
- No withdrawal to pain.

Well, even if his neck is broken,
doesn't mean he's paralyzed.

Hang the steroids. And we'll take him
up to MRI. We'll know for sure.

It's okay, baby.

Mrs. Webster, you have to
get back in bed before you get hurt.

I know you're busy.

Severa, can we get her some
soft restraints for her protection?

- Yes, doctor.
- But Mama still loves you.

- Hey, you're back.
- Not quite.

- Go wait in the lounge.
- Hi, Chuny.

- Hey, Alex.
- Mommy dearest, Nursing director called.

You're one emergency break away
from probation.

- Perfect.
- Everything okay with Alex?

- No school today?
- Nope. Excuse me.

Dr. Carter?

- Start with 25 of meclizine. Yep?
- I know we just met, but...

- ... I wondered if you could do me a favor.
- Yeah.

35-year-old female with AIDS-related
lymphoma, shortness of breath...

- ... and hypotension.
- HIV status was diagnosed but untreated.

- Hospice care?
- Lives alone at home.

- How long have you had AIDS, ma'am?
- Too long.

One, two, three.

Any advanced directive?

- Hypotensive, 78/52.
- Hey, what are you doing here?

I guess someone bought into the idea
Morris was really sick.

A hundred percent 02
and mix up dobutamine.

- Who's your doctor, Ruthie?
- Don't have one.

EKG, ABG and a portable chest.
Sorry about this morning, man.

You didn't look too sorry.

Lungs are wet and there's a harsh
systolic murmur.

- Could never get an appointment.
- Aortic stenosis?

More like mitral regurge.
We need an echo ASAP.

Got it.

- How's Val getting to the airport?
- Cab.

We'll take care of you, Ruthie, okay?

I can't believe he sutured himself.

Edges are everted.
Nice wound approximation.

- Hurt much when you did it?
- I numbed it with an ice cube.

- That was good thinking.
- Don't encourage him.

I'm gonna put in another stitch
just to be on the safe side.

And I think you'll find that lidocaine
works much better than ice cubes.

- I didn't have any.
- Sutures stay in for about seven days.

And then I'm sure Mom
can take them out for you.

- I can do it.
- I don't think so.

- I appreciate your doing this.
- No problem.

You ever seen a kid do something
this crazy before?

To be honest...

Pressure's up to 100.
Try a nitro spray.

- She's a grown woman.
- We work together.

Some respect would've been nice.
No acute ST changes.

Some respect for the fact that we're
consenting adults would be nice.

Hey, enough. Take it outside.

Just when it was getting good.

- It's not like I don't want her to date.
- You just don't want her to date me.

- Look, man, this is not personal.
- You thinking I'm not good enough isn't?

I got news for you, Mike.
It's not your call.

I give up.

- You barely know her.
- Yeah, no thanks to you.

MRI called. They finished
with the neck-fracture guy.

Ruthie, it appears as though
you have a tumor in your heart.

It's gonna require a surgery.

Why?

Because the tumor will eventually
make it impossible for your heart-

That'll keep me in the hospital,
what, a month?

- Maybe longer.
- Now you wanna spend money on me.

- Ruthie-
- Just save it for the next patient.

Too late for this one.

Okay, how about a little
cramping and dizziness to ease back in?

- I thought you weren't on until 4.
- I'm not. But since I couldn't sleep...

...I figured I'd make myself useful.

Hey...

...do you know much about
our insurance policy?

Does it cover...

...therapy?

Physical or psychological?

Like couples or family counseling.
You know, nothing serious.

I think it's 80 percent,
but there's a max per year.

Excuse me.

Hey.

- Can you tell me where I can find-?
- Hey, Valerie.

- What are you doing here?
- I'm looking for you.

Yeah, right. Have you seen
Pratt anywhere?

He's up in MRI.
You want me to call him?

- I thought your plane left at 2.
- It does.

You come all the way down to see him
before you leave?

- It's gonna take an hour just-
- I came to see you, Mike.

I didn't wanna leave things this way.

For real?

You're my brother.
That's gotta come first.

- I'll be more considerate next time, okay?
- Yeah.

- Need me to get you a cab?
- No, I got one waiting.

- I'll call you when I get in?
- Okay.

- Don't be so serious all the time.
- Have a safe flight.

- Cord edema and contusion at C-5.
- That can resolve with decompression.

Not with this degree of hemorrhage.
Kid thought he had it bad before.

Broke it in an MVA, right?

Pratt, Mr. Brodie's in recovery.
I've repaired his abdominal aneurysm.

And he's gonna be just fine.
How's his son doing?

- You don't wanna know.
- I do. His father's asking about it.

Complete cervical-cord injury
with quadriplegia.

His neck snapped during an intubation.

Performed by whom?

Me.

I'm sorry.

- You okay?
- Yeah.

Hey.

Hey! Taxi!

Hey!

Taxi! Hey.

Greg? Unlock the door.

Hey, if I'd known you were coming,
I would've stayed downstairs.

Come on. Let me help you out.

- You all right?
- Yeah. It's just a rough day, that's all.

You know, it's been good with you.

- Very good.
- Yeah, it has.

Look, I got four days off next week.
How about I come out to D.C.?

- We hang out, have a good time.
- That's sweet.

- I'm serious.
- I'm sure you are, but...

But what?

Greg...

...it's been fun, you know, a total blast.

But...

...this has been like being on vacation
for me, you know?

What?

Bye, baby.

I thought he needed to be reminded.

- No chips?
- Carrot sticks are better for you.

- I got this. Thanks.
- Yeah. Look, he told me what he did.

Really?

I just wanted you to know
that I didn't show him how.

I know. I did.

Didn't think he'd ever try it.

I guess that wasn't such a good idea.

I'm trying to call Sharon,
see if she'll babysit...

...but I haven't heard from her yet.

Okay.

Eat.

- She's, like, wigging out over nothing.
- Hey, just do as your mother says, okay?

- Did he seem okay to you?
- Yeah. Why?

It's just really hard doing it all
by yourself, you know? I mean, I try.

- You're doing great.
- Everyone says my kid's a freak.

People talk. So what?

I stuck tweezers into an electrical socket
when I was his age.

- And I knew better.
- Then why did you do it?

Because I was a kid.
Kids do stupid things sometimes.

- You think maybe he needs-?
- Hey, he'll be fine.

- Severa, where's Mrs. Webster?
- Who?

Older black woman, wanderer.
She finally go up to Cards?

Had to park her in the hall.
Morgue hasn't come yet.

- Didn't think she was your patient.
- She wasn't.

Damn.

16-year-old male, multiple GSW
to the chest and abdomen.

- Lost his pulse en route.
- Is he a gang kid?

Whatever happened to playing cops and
robbers? Two dead, another on the way.

Open up!

- Trauma 2's clear.
- Hey, I got another one behind me.

Come on, Sheila, Lester, go with Carter.
Neela, stay with me.

- Where do I go?
- They need hands in 2.

9- year-old caught in the crossfire.
Shotgun wound, pressure steady...

- ... 92/64 after a liter.
- Sam, prime the rapid infuser.

- What's your name, big guy?
- David.

Don't be scared, David.
Dr. Kovac is one of the best here.

Martin.

Your dad's gonna be okay.

I need to talk to you
about your intubation.

There was...

...a problem involving
your spinal cord.

And it seems as though
you're gonna be paralyzed.

- V-tach.
- All right, shock him once before we cut.

Two hundred. This guy's got an entrance
wound for every two years of his life.

Missed one in the right axilla.

- Charged.
- Clear.

- It's no change.
- Give me a 10 blade.

Two units of O-neg infusing.

Suction.

Rib spreader.

All right, everybody. Watch your feet.

All right, four units of O-neg,
then type-specific.

Come around here
and do internal compressions.

The most survivable lesion is myocardial
penetration with tamponade.

- Heart's empty.
- All right, Satinsky.

You want FFP too?

- Why FFP?
- If you get a dilutional coagulopathy...

...after five units.

- Aorta is cross-clamped.
- Big hole in the left ventricle.

- Let's plug it with a Foley, 30 cc balloon.
- That'll work?

- Paramedics said he had a pulse.
- It's worth a try.

Fifty mics of fent. He's out.

Vascular's in the O.R. with a fem-pop.
It'll be a while.

He doesn't have a while.

The longer we wait,
the greater loss of arm function.

- Get me a vascular clamp.
- From where?

Thoracotomy kit.

Neela, I'm rolling back with pressure.

When you see the end of the artery,
press down hard with your finger.

- Have an 0-silk stitch ready on a driver.
- Wound's down through the biceps.

I see humerus.

- Can a vascular clamp repair that?
- It's our best shot.

If the arm is ischemic too long,
we'll have to amputate.

All right, hold compressions.

- V-fib.
- Charge to 30.

- You gotta let go of the Foley.
- No, no. It won't conduct.

Still fib. Shock again?

No. Resume compressions.

Hold this. And give me a 10 blade.

Heart won't respond to defibrillation
until you've restored volume until it's full.

- So, what are you doing now?
- It's called a clamshell incision.

- He must be bleeding in the right chest.
- Six units in so far.

Keep them coming.

- Got it.
- Clamp.

Push me the pad and get me
some IV tubing.

I'll tie the proximal end,
you do the distal.

- Purse-string it with 0 silk.
- That gonna hold a high-pressure artery?

Just a bridge until Vascular can do
a real repair.

- And this won't clot off?
- By then he will be in the O.R.

Releasing proximally.

A little oozing.

- Nails are pinking up.
- Palpable radial-ulnar pulse.

Didn't think you could do that.

- Fine V-fib.
- Been five minutes since the last epi.

Okay, push another amp.

Clear.

- Asystole.
- All right, another mig of atropine.

- Is the heart filling?
- Yeah.

After eight units, packed cells,
two FFP and a ton of platelets.

Okay, that's it.

- Pretty big mess.
- Can't say we didn't try.

I'll get Housekeeping on it.

I'm glad you went back.

To med school?

Yeah. Me too.

You never should have left.

Well...

...timing is everything, right?

What?

- Nothing.
- What?

You seem happy.

Right back at you.

So we're okay?

We're okay.

Good. Because Kem and I,
we're gonna go get some dinner later.

Wanna come with us?

Well...

...I'm not that okay.

- See you tomorrow.
- Yeah.

Ready to go?

Alex.

Come on. It's time to go home.

You can bring your car around.
I can help you carry him.

He's pretty out of it.

- You should have waited in the car.
- I haven't seen snow since I was a kid.

- Did you arrange for it?
- Yeah.

- Think it's too much?
- I think it's damn cold.

- God, it's a good thing I love you.
- You want me to stop?

Not necessarily.

- We should go.
- Put him in the back seat.

- Good night.
- Good night.

- Thanks.
- Anytime.

- You off now?
- Yep.

You need a lift?

I have something to take care of first.

Okay.

- What are you doing?
- Need to fix my resignation letter.

- So you broke into my office?
- The door was open.

- I'm changing the date on my last shift.
- Let me guess. Sooner?

Actually, later.

You wanna be a little more specific?

No.

- Not right now, anyway.
- Well, let me know when you decide.

See you tomorrow, Kerry.

Stay out of my inbox.

You'll have another?

Bring it on.

Come by to give me some more?

- Hey, I'll take one of those.
- You got it.

To tell you the truth,
I'm really not in the mood.

Yeah, I heard about that neck thing.
That's some hard stuff, man.

Look, we got a big family, okay?
Lots of boys. Val's the only girl.

So we all tend to be a bit
overprotective.

I ever tell you my mom died
when I was 12?

No, you didn't.

That's some hard-ass stuff right there.

You have to get used to being by yourself
when that happens.

What about your father?

The truth is...

...all anybody's got is themselves.

I'm not sure I agree with that.

Look...

...just say what you have to say
and leave me at peace, okay?

- My sister-
- Played me.

She played me.

Well, you can't say I didn't warn you.

So you were protecting me, huh?

Look, anyway, I'm sorry.

No worries.

Okay, then.

Have a good night.

No, leave it.

I'll drink it.

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[ENGLISH]