Original subtitles

- Morning. - Morning.

Uh, do you want me to make you some coffee?

No, I always get one from the cart at work,

unless you're making some for yourself.

Uh, no, actually, the cart sounds good,

'cause I have no idea how to use this thing.

Um, so...

you wanna go straight to work,

or do you need to stop by atour place first or...

I think my fish will survive till I get home tonight.

Though I could go feed them now,

if you wanted to get a drink tonight after work.

Yeah, sure. Uh... uh...

What?

Uh, I actually have plans tonight.

- Plans? - But I can cancel them.

Nope.

Keep your plans. It's fine.

Smooth.

- Hey. - Hey.

- How was the night shift? - Only got puked on twice.

Then it was a good night.

Bye, guys. See you tomorrow.

- Bye. - Night.

Have you contacted your sister yet about meeting up?

Still working on it.

It might actually be better for her

if I keep a little distance.

Better for her or for you?

You know what would be good for me?

Is dinner with you tonight.

- Are you gonna shower first? - Depends on who's paying.

Then it's definitely on me.

- Later. - Bye.

And now she's shivering and... and throwing up,

and I-I don't know what to do.

Deb, what's going on?

Her homeless friend is nine months pregnant

and has a fever. She needs to come in.

- But she won't, right? - No.

Would you come out and help her, please?

Not when she's this far along.

She needs to be monitored and have emergency measures nearby.

Dr. Choi...

Let me get some supplies.

Hey, wait... hey...

you're just gonna go treat a pregnant girl on the streets?

I have met some of these kids.

They're underage. They know that if they come in,

- they'll get put in a system. - Yeah, but she's nine months.

She's gonna have to come in eventually to have her baby.

But she needs to be assessed now.

- Nat, I could use your help. - Seriously?

- Fine. - Thanks.

Text babysitter.

Cold pizza is Owen's favorite breakfast.

There's some in the fridge. Tell him I love him.

- Send. - I'll send your message.

She's over here.

Come on. Come on.

I wrapped her up, but she's still shivering.

Hey.

Laura, I'm Dr. Manning.

I'm gonna take your temperature, okay?

Let me take a look.

103.

You most likely have an infection.

It is very important that we treat it

before you go into labor.

Okay, but my... my water broke, what does that mean?

- When did your water break? - Two days ago.

- Synced and corrected by martythecrazy - - www.addic7ed.com -

- Dr. Reese...

How was your dinner with your dad?

It was good.

Uh, I mean, I'm glad we're talking again.

He's funny, smart.

You don't sound entirely convinced.

Well, it's just kinda hard to look past the last 20 years.

I know he wrote me those letters, but...

there were other ways to contact me if he wanted.

Makes me wonder.

Well, you know what, I've always been

immensely impressed with your instincts,

so... no reason to stop listening to them now.

Yeah, I guess so.

- Courtney? - I've got Luke Wallis.

Cystic fibrosis. No breath sounds on the right.

Tachycardic with BP 122 over 66.

- Satting at 86. - Oh, I know Luke.

- How you doing, buddy? - Been better.

He was just watching TV,

and then suddenly, he couldn't breathe.

Get a stat chest X-ray.

Make it a CT.

And get more information.

On my count, one, two, three.

There we go.

Has his lung function been getting worse?

He's been in the ICU three times in the last five months.

Yeah, Dr. Rhodes has him at the top of

the transplant list for lungs, but so far, nothing.

He's got a pneumothorax on the right,

significant rales on the left.

Set me up for a 16 French chest tube.

That's a little invasive. We can use a pigtail catheter.

His lungs are too stiff. He needs a tube.

Which will only cause additional trauma.

It's bad, isn't it?

The collapsed lung means that your lungs are so scarred

that they can't hold together, so...

Yeah, buddy, it's bad.

Look, as soon as we get your lung re-inflated,

I'm gonna sit down with you and your mom and your dad,

and we're gonna talk about what comes next, okay?

Chest tube, 16 French. Lidocaine?

All right, buddy, you're gonna feel a little pinch,

followed by some pressure, okay?

There you go, buddy.

You're okay, you're okay.

You're doing great, pal.

Mr. Thomas, I'm Dr. Halstead.

I heard you had an incident at work today.

Yeah, I guess I, uh, fell down.

The EMS report says they found you unconscious.

How long you been coughing up blood?

A few weeks.

Some wheezing and stridor. What's his weight?

138.

Doc, I appreciate your concern,

but I'd just as soon go rest up at home.

Yeah, I don't blame ya, but I fear if you go home,

you may have a far worse event

than whatever happened this morning.

That's okay.

Well, you're too dehydrated to walk out of here,

so why don't you let me give you some fluids,

we'll run some tests,

and I promise I'll be back soon?

All right.

Syncope, weight loss, hemoptysis.

He's got cancer, right?

A lot of people are more afraid of

getting the diagnosis than the actual treatment.

Let's get a CBC with diff, EKG,

chest X-ray, and CT.

And then we can try and talk to him again.

So, um, Robert Haywood is here

for a thoracic P.E.T. scan?

Uh, yeah, we're doing a full cardiac workup.

You think you could add a... a head study of that for me?

I just wanna make sure I'm not missing anything on my end.

- Sure, no problem. - Thank you.

Mm-hmm.

Laura...

your membranes ruptured prematurely,

allowing an infection in your uterus.

The longer we go without delivering this baby,

the greater the danger you're both in.

So deliver it then.

We need to do it at the hospital.

No, I told you, I'm not going.

I understand that you don't want to,

but this is a safety issue, okay?

You need to think about your baby.

I said no.

If there are complications, if anything goes wrong...

It's okay, we'll do it here.

You're not seriously thinking about inducing her

right here on the street?

Women deliver outside the hospital all the time.

Yeah, and some of them die.

Listen, I don't like this either, but you heard her.

She's gonna do this with or without us.

And then what? A newborn can't survive out here.

Nat, you don't have to do this, but I'm staying.

I have good news.

They found a pair of lungs in Kansas

that are a perfect match.

We're loading them onto a plane now.

- Oh, my God. - You hear that, Luke?

This is good news, buddy.

Uh, I am gonna have a conversation with Dr. Bekker,

and I'll be back in just a few minutes, okay?

I'll start the transplant protocol.

Hold on.

- We have to put him on ECMO. - What?

He's satting in the 80s and wearing down.

His respiratory muscles are going to give out.

But ECMO could introduce an infection.

It's a partial contraindication to surgery.

And Kansas is a two-hour flight.

We have to keep him oxygenated till the lungs get here.

Those lungs only last four hours.

If anything goes wrong before they get here,

and he's stuck on ECMO,

we may not be able to get him off.

He could die.

Then we make sure that nothing goes wrong.

Thank you.

Mr. Thomas...

We found a large growth in your larynx.

It's almost certainly cancer.

All right.

Now, the good news is,

we have an excellent oncology department,

so I'd like to arrange for a biopsy and a consultation,

so they can determine... It's okay.

I'm not interested.

Mr. Thomas, the sooner you begin treatment,

the better your chances of survival.

You don't understand. I'm...

I'm ready to die.

I know it's a lot of information,

and it can seem overwhelming, but I...

I said no.

Can you tell me why you're so resistant to treatment?

Because I've made it 56 years

without molesting a child,

and I can't stand it anymore.

I'm sorry?

I'm a pedophile...

and I wanna die.

Yeah?

Have you seen this yet?

A lawsuit?

An indigent man's claiming an ambulance driver

passed him over to bring in an insured patient instead.

Seems the extra wait time cost this guy his leg.

Oh, that's terrible.

But isn't that the fault of the ambulance company?

Apparently the ambulance driver was following

our hospital's instructions.

Now that's ridiculous.

I never told anyone to pass up uninsured patients.

No, but the claimant states

that an E.D. charge nurse named Maggie Lockwood did.

Give me some time to look into it.

Try to relax, all right?

Look at me, look at me, look at me. Take a deep breath.

104.

The antibiotics aren't working.

We need a couple bags of Flagyl.

- Ethan... - I need more drugs?

Laura, what you need is to go to the hospital, okay?

You're putting yourself and your baby at unnecessary risk.

She can't. They'll put her back into foster care.

I know it's not ideal, but this isn't just about you.

Your baby's gonna need food and a roof over its head.

Unless they keep 'em out in the yard,

feed 'em whatever the dogs don't want.

I'll talk to the social worker,

make sure you find a good home.

No one wants to adopt a 16-year-old.

Even if you do get a good home in foster care,

everyone keeps getting passed along,

until you finally end up some place

where they'd rather cash a check from the state

than feed you.

Yeah, they're the ones who keep you forever.

Nat, we really need those antibiotics.

Okay, I'll be back as soon as I can.

Yeah.

Okay, keep breathing, keep breathing.

Okay? Keep breathing.

- Just try to relax. - It's okay.

Dr. Rhodes?

What's wrong?

Luke's LFTs are rising.

What... what does that mean?

It indicates that he might be in early liver failure.

Unfortunately, if it progresses,

it could prevent him from getting the lungs.

Prevent him?

Fortunately, we can still get him off the ECMO,

while we try to reverse this trend.

However, if we take him off of ECMO now,

it decreases the odds that he survives

until the lungs get here.

I don't understand. Can't you agree on what to do?

It's not a black and white situation.

Uh, you've been treating him, Dr. Rhodes.

What should we do?

We should keep him on the ECMO.

It's still our best chance that he gets those lungs.

Okay.

Yes. That's what we'll do.

All right.

You're being completely irresponsible.

That kid is going to die if he doesn't get new lungs.

Only if your ECMO doesn't kill him first.

He's a snowball rolling down a hill,

and this is our last chance to stop it.

So what are we doing about Mr. Thomas?

Psych's in there right now.

As soon as they declare him incompetent,

I'm gonna call Oncology down here to get started.

Incompetent?

Who cares? The man is a pedophile, okay?

If he wants to die, why don't we just let him?

April, we're going to stop him from dying,

because he's our patient and because we can.

Did you put him on a psych hold?

Uh, I'm not ready to make that decision.

Why? He's suicidal.

He may want to die, but he is lucid

and understands the consequences of his choices.

He... he has a treatable condition.

How lucid can he be if he's not letting us treat it?

If he was depressed, you'd put him on a psych hold

and try and treat his depression.

You're not gonna do the same for pedophilia?

I just don't know that much about pedophilia.

Well, you better find out fast, because he's dying.

Department charge nurse Maggie Lockwood,

especially providing incentive.

- I don't believe this. - All right, take it easy.

What do you know about this patient?

I don't.

And I definitely never told any ambulance driver

to make decisions based on insurance coverage.

All right. This driver, John Gates,

- do you know him? - Yeah, he's a jerk.

Well, do me a favor: Page me when he comes in.

I wanna talk to him.

Sure... if I don't kill him first.

- I need a doctor in here. - Help him!

- He's coagulopathic. - What does that mean?

The combination of his poor liver function

and the anticoagulants that we gave him

has disrupted his ability to clot.

Hang a bag of heparin.

We thinned his blood for the ECMO, we had to,

but his liver is failing more quickly than we expected.

You did this, so take him off that machine!

I am afraid that it is too late for that.

Too late?

Heparin's running.

We're gonna try and reverse the bleeding now.

Run the plasma now.

Hold on that.