(male narrator) Previously on "ER.."
Anything changes with Jody, call me.
- Or just call me. - I will.
Who's going to Johns Hopkins?
- Dr. Rasgotra. - I'm just looking.
You keep mumbling
about the hiring freeze at County
pushing me to do interviews all over.
I've realized that we have something worth saving.
Did you realize that before or after
you had sex with Daria?
I..
...want to be with you.
There, I said it.
You can go ahead and gloat now.
I'd rather do something else.
Frank, we got to get these tele admits up.
I'm all over it.
There's at least 30 in the rack.
What were you guys doing last night?
Playing guitar hero and doing Jell-O shots.
- Two messages from Kelly. - Kelly who?
She said you'd know. That's her phone number at Swiss Hotel.
Car crash victim coming in.
Oh, okay, clear trauma one and get surgery.
- We're gridlocked. - Quick dispo in curtain one.
- Grady? - I'm off duty.
And going to jumbo mart for enough caffeine
to get me through my charting.
Who else is on?
Well, we got, uh, Brenner, Morris and..
What do you need?
That's okay.
I haven't picked up a patient yet.
No, go, uh, meet the trauma.
It's busy. I got time.
Okay, fooling around with her boyfriend
and they lost the condom.
She's fully dressed in the middle of the ER.
She should be in a gown in a private room
with a chaperone for a pelvic.
Yeah. There's no need, actually.
What?
Go on. Go get the history.
Hello. I'm Dr. Gates.
Tammy.
So, the, uh, proverbial lost condom?
Yeah. It's kind of embarrassing.
Well, don't worry. Tell me what happened.
The condom came off, and I couldn't reach it.
My boyfriend tried to help, but he's useless.
I went to the bathroom
and-and gagged myself
but I couldn't vomit it up, either.
I'm not gonna... suffocate, am I?
Dr. Rasgotra.
Dr. Brenner.
Mm.
How was your night?
Four hours of sleep.
Well, you would've got a lot less than that
if you were in my bed.
Next time... you should spend the night
with me in the call room.
What, you mean on a twin bed with scratchy sheets
and phone interruptions every hour?
That's kind of hot.
[chuckles]
You know, I was thinking of, um
getting Neil Young tickets for Saturday.
That sounds good.
- You like him? - Yeah, I love him.
- Especially his early stuff. - Really?
Yeah. "Old man" "Only love can break your heart."
- "Heart of gold." - "Heart of gold."
Neela.
Uh, trauma coming in.
Thank you.
Um, are we out of sugar?
I don't think so.
[police car siren]
What are they doing?
Our old medical records are going in remote storage.
Let me ask you something..
...kind of man to man.
Do you believe in the three-date rule?
You seeing someone new?
I don't know if we're actually seeing each other.
We had lunch together in the cafeteria.
I bought her a burger, one night at Ike's.
Wow, sounds serious.
I like her.
I just can't tell if she's interested in me.
Well, I'm pretty sure I'm not the right guy
to ask for relationship advice.
[dramatic music]
[music continues]
[music continues]
Hey.
The run got diverted to Mercy.
Whoa. Whoa-whoa-whoa.
- Uh. - Hey. You alright?
Tony.
'Archie, I need some help.'
Grab a gurney.
Looks like this guy got beat up.
What's your name, sir?
- Oliver. - Oliver what?
- No wallet, no ID. - Pupils are equal.
- You know where you are? - Hospital.
Oriented to place. What year is it?
'Who's the president?'
Sir, do you know who the president is?
[crowd chanting] Hey, hey, LBJ
how many kids did you kill today?
- Hey, hey..! - Chicago is a police state!
- ...our constitutional rights. - Let's go. Come on. Move.
- Come on. - Hey, hey, LBJ..
(Gates) You don't have to talk we'll takegood care of you.
Relax, brother, enjoy the ride.
[theme music]
Decent breath sounds.
'Looks like he got kicked a bunch of times.'
Yeah, or fell.
He looks too good to be homeless.
No blood in the belly.
Abrasion where somebody stole his watch.
Definite assault.
We already called in the police.
Chest is normal. The head CT's gonna be normal, too.
Not if there's a brain bleed.
These old altered guys, it's always something metabolic.
Just order some more IV fluids.
- Let me go clear the board. - No. Stay on this.
Buff him up, find out where he belongs.
- Scanner's ready. - Potentially unstable.
Dr. Gates can monitor him in radiology.
Last BP was 110/65.
Hold it, hold it!
Excuse us.
Are you a student driver?
Oh, I'm sorry.
I'm sorry you had to pull me out of my car.
Is the oxygen helping, Donna?
- I think so. - Okay.
Have you ever had any trouble breathing before?
Not till last week.
Mom, I parked the car.
Thanks, honey. That's my son Dylan.
Hey.
She couldn't even talk.
So you were saying about last week?
They told me I had lung cancer.
- Where are you being treated? - Uh, nowhere yet.
We were supposed to go to Northwestern
but in the car her breathing got so bad
'that I-I pulled into here.'
I have papers and X-rays if..
The Willow Ridge Medical Center.
That's our local hospital. That's where they diagnosed me.
Okay. Do you smoke cigarettes, Donna?
Ten to 15%
of lung cancer occurs in nonsmokers.
We've been on the internet a bit.
It's in the left upper lobe.
Liver function tests are elevated.
Okay, and did they explain
the brain CT results to you, Donna?
Two spots.
They thought that, um, surgery and chemo and radiation
could buy me some time.
Uh, stage four lung cancer
has a five-year survival rate of five percent.
- But one in 20 survive. - Okay.
Okay, well, we'll have our surgeons
and oncologists consult.
I was hoping to go to Northwestern.
Yeah, you're too sick to move.
(Dylan) Yeah, I'm gonna cancel the audition, mom.
No, Dylan, you're not canceling anything.
No. Get to orchestra hall on time
and you can stay with Aunt Harriet tonight.
Okay?
Okay.
[buzzing]
Dr. Morris, I'm looking for an old guy, victim of assault.
He should be right back.
Okay.
You know, I could be wrong
but I thought I saw you and Officer Diaz
eating lunch the other day.
Yeah, we-we were on a case together.
Really?
'Cause I 've had cases with you
but we've never had lunch together.
Plus, it must've been a funny case
'cause I noticed a lot of smiling.
Yeah, well, Officer-officer Diaz is a nice lady.
We all know that.
And I know you know that cops stick together.
- Yeah. - So be careful.
If you break her heart
we may have to break you.
Head CT was normal, just as I predicted.
Guess what? He's hypernatremic.
How bad is his sodium?
165. Dry as a bone.
- Does this guy talk? - Not really.
I'll check for missing person reports.
Did you calculate the free water deficit?
- Yep, six liters. - Okay.
Hypernatremia shouldn't be corrected at a rate--
One milli-equivalent per liter per hour.
Need a doctor here.
You can have Dr. Gates.
Well...no, shouldn't I stay here and finish?
No, you've been wanting off this case from the get-go. See ya.
He's starting to open his eyes.
- That's a good sign. - Mm-hmm.
(Morris) 'Oliver...Oliver, try to squeeze my hand.'
'Oliver'
Curtain three is open.
- 'Hi, I'm Dr. Gates.' - Damien.
- My wife Corazon. - Hello.
Sam, did you ever call Kelly?
I didn't think so, 'cause now she's coming to see you.
Let me know when she gets here.
You don't see many of these.
It's a negative pressure ventilator.
When the air is sucked out of the chamber
it flows into his lungs.
I had polio when I was three.
Don't breathe too well on my own.
Is that why you're here today?
Uh, no. Fever, abdominal pain
'possible appendicitis.'
I'm a retired RN.
I need to get a BP.
Yeah, and I'm gonna need to examine his belly.
There are portholes on the side.
Just stick your arms through the neoprene.
Oh. Alright.
Hmm.
Are you, uh, in this all the time?
Oh, we have three kids, so, no, not all the time.
I use it 18 hours a day.
How long have you guys been together?
Forty five years.
(Rasgotra) I got an e-mail from Yale.
They want another two letters of recommendation.
Well, that seems a bit pointless
if Dubenko can offer you a position here.
I'm not sure he thinks I'm right for the job.
- Oh, man. - That's the head CT.
This must be the lung mass.
Yikes. Where's the patient?
LFTs and CBC.
Looks like the horse is out of the barn.
Mm. Son's at bedside.
No, dad.
Donna, this is Dr. Rasgotra, Dr. Dubenko. Her son.
- Dylan. - Hello.
- Hi. Nice to meet you. - Um..
I 've reviewed the films, and I'm sorry to say
that the tumor is far too advanced for surgery.
Are you sure?
(Dubenko) With cancer in the liver
the brain, and bones
'I'm afraid that an operation'
'would only mean pain and suffering'
without prolonging your life.
It's in my bones?
We think so.
What about chemotherapy?
(Dubenko) 'It's possible, but, um--'
We'll see what the, uh, oncologists say.
Have you thought about your wishes for life support?
(Rasgotra) 'Perhaps this is better discussed later.'
(Donna) 'I made a living will about ten years ago.'
I don't want to be kept alive if I have a terminal illness.
Mom..
Then you might want to explore the hospices..
Okay, we-we don't need to talk--
What's a hospice? What is that?
It's a way to keep people comfortable
in the final stages of their illness.
Um, are you saying that, uh..
Look, um, we're gonna come back, um..
...after you've had a little bit more time to consider.
- Yeah. - Okay.
Doctor?
- What are you doing? - What?
I asked for a surgical opinion.
- Not for the grim reaper. - I was being truthful.
They have barely processed
the cancer diagnosis and you walk in there--
What, do you want me to sugar coat it? You want me to lie?
No I want you to give them a little bit of hope.
Well, maybe there is something positive to offer
a thoracentesis?
Yes, that's a good idea.
That should make her feel better.
Good. Why don't we lead with, uh..
[sighs]
Frank said you guys have fresh coffee.
I hope you have half-and-half.
Crap! Okay..
I'll just just make a...fresh pot.
Oh, okay.
Hi, I'm Kelly.
Hi, I'm Dr. Gates.
Oh. What kind of a doctor are you?
Well, this is an ER, so..
(Kelly) 'That must be complicated.'
You got to know a lot of stuff about everything.
How long you worked here?
- A couple years. - Cool.
Yeah, I 've only been in town for two nights
and I'm craving deep-dish pizza.
Oh, Lou Malnati's.
Oh, yeah?
Yeah, that sounds great.
What are you doing for dinner?
No. I don't think that would be such a good idea.
Why not?
I just got out of a relationship.
Oh. When you fall off a bike
you get right back on it.
Got a sesame seed..
Kelly?
Sammy.
Wha..
- What are you.. - Oh, my God!
- Hi. - What are you..
Oh, my God. Look, look at you.
Look at you. Hi.
I'm really sorry to just barge in on you at work.
(Sammy) 'I, uh, you know, I got your message,'
'but I 've been busy at work and-and..'
(Kelly) 'That's fine.'
So, how do you two know each other?
Uh, Tony, this is my sister Kelly.
[chuckles]
If I can tie up a few loose ends, I could take a break.
I'll be fine, just, you know, me and the home shopping network.
'Ortho's on line four..'
...and they need you at the lung tap.
Go save some lives.
Stay out of trouble.
That's your sister, huh?
- She seems very nice. - Yeah.
- 'Ortho?' - 'Got a perilunate..'
Sam, cytology and culture on this.
Take a deep breath.
[breathing deeply]
- Much easier. - Good.
We can pull three liters.
Dylan, it's late, you should go.
I'm not going.
He has an audition today for the Juilliard School
in New York.
Impressive.
What instrument?
English horn.
I used to play the viola.
The English horn is lovely.
Honey, they're only here once a year.
You might never get another shot.
I'm much better.
You think it's okay if he goes?
Yeah, I don't see why not.
I think it'd be best to stay.
With the extent of your disease
'things could suddenly take a turn for the worse.'
You mean that could happen today?
That's pretty unlikely.
Yeah, I should, I should stay.
- Dylan.. - Mom...I'm staying.
Let's wait a bit and see how she's doing, okay?
Sam, you seen the old guy?
Not in a while.
Oxygen's off, so are the monitors.
Looks like he eloped.
- Great. - What happened?
- I think we lost a patient. - Check the bathroom.
(Dubenko) 'Sam, we can see your polio guy now.'
I'm gonna need you on a paramedic run.
Hey, Frank, tell my sister it's gonna be a while.
I got to find a demented grandpa
pick up an incoming off a rig
and pull a patient out of an iron lung.
* Truckin' like the do-dah man *
* Once told me you've got to play your hand *
* Sometimes your cards *
* Ain't worth a dime if you don't lay'em down *
(male #1) 'April Robinson, syncopal episode at Walgreen's'
- Still altered. - Any seizure activity?
- No. - What's up with the handcuffs?
'She passed out after getting busted for shoplifting.'
- 'How convenient.' - 'No, she's real.
(Zadro) 'Blood sugar's over 400.'
12 lead EKG, negative for MI, I gave a liter of saline
'and got her sats up with suctioning.'
What do we have?
'This lady fainted at Woolworth's!'
- Any heart history? - You got me.
- She doesn't have a pulse. - 'When did she stop breathing?'
(Zadro) Doc, they pay me to drive them to the hospital, that's it.
She's lucky I had an oxygen tank.
She needs a cardiac arrest cart.
It may be too late for that.
* What a long strange trip it's been **
(Rasgotra) 'Dilated appendix, non-compressible.'
So I 'll need surgery?
Yes, most definitely.
Can it be done with the laparoscope?
We'll try.
Sometimes, though, we have to convert
to a conventional procedure.
- You mean opening up my belly? - Yeah
I use my abdominal muscles to help me breathe.
His friend had colon surgery and ended up traked for life.
Alright, well, we'll do the best we can.
Dr. Rasgotra will be back
with the consent form.
You know, he's a perfect candidate for notes.
What?
Natural orifice trans luminal
endoscopic surgery.
You want to remove his appendix through his mouth?
Well, in his compromised state he needs
the least invasive procedure, and notes is it.
Yeah, we don't do that here. It's experimental.
But there's a Dr. Horta from San Diego doing clinical
trials at Northwestern. He's had over 50 cases.
You're cutting a hole in his stomach, Neela.
You're setting yourself up for peritonitis.
It's a two-millimeter incision that's occluded
by a balloon and transport.
When you're done, you close immediately with G-Prox.
They've had great success.
You want to call this guy in?
Well, it's a chance to be state of the art.
See if he's willing to help and available today.
Long shot.
Blood sugar's down to 350.
'Neela wants me in curtain two.'
Drop the insulin to five an hour before you go.
What's going on here?
Your diabetes is out of control.
Paramedics brought you to the ER.
Think of it as a pit stop before jail.
- What are you talking about? - Why don't you take it easy?
Why don't you step out until she's medically cleared.
I didn't do anything.
Well, surveillance camera shows you
pocketing a lipstick and mascara.
I was gonna to pay for that. I got distracted.
You can't keep me. My daughter needs me home with her.
Well, you should of thought about that before
you pinched Maybelline.
(Morris) 'Hey, come on, officer.'
Can I ask you a question?
"I was gonna pay for it."
A load of crap?
You know
she doesn't seem like a crook.
- Does she have any priors? - Any priors?
You havebeen hanging out with Claudia.
(Gates) Hey, Morris, we found him.
Excuse me.
Outside, barely conscious.
Pulse ox 78 on room air.
Probably blossoming some pulmonary
contusions from the trauma.
Alright. Open an airway tray at 8-0.
- Where's Sam? - On her way.
- Are we really gonna do this? - Yeah.
This guy could be sharp as a tack
once his sodium's normal.
- What do you need? - Sublingual captopril.
Four of morphine.
- Hey, Sammy. - Yeah.
(Kelly) 'I've been here for like, two hours.'
- It's kind of a bad time. - I know.
I just, I can't really wait around.
I've got a bunch of appointments.
Ma'am, can you just let us--
(Gates) Has everyone met Sam 's sister?
I didn't know you had a sister.
- Hello. - Hi.
(Gates) 'Sam..'
...take a break. Chuny'll take over.
Yeah, you know, looks like you could use one.
Hey, doc, we busted the mugger.
I got an empty wallet..
...and a retirement watch from County.
- Maybe he worked here. - Suction on high.
Call for a vent!
(Gates) 'End tidal co2 detector.'
(Kelly) 'You look good.'
I mean, considering the last time I saw you
we were both in pigtails.
Yeah...yeah, it's been a really long time.
Mm. We got some catching up.
You want to go to dinner? I get off at 8:00.
Uh, no, you know, my flight's at 7:30
and I 've got my last meeting at 5:00.
What kind of meetings?
Uh, well, I'm here for the apparel show.
Oh, my God, I remember those dresses you used to make
for your cabbage patch kids!
Oh, my...well, you actually turned that into a job?
Yeah.
Uh...my clothing line just got bought by billabong
for about $2 million.
- You're kidding. - No.
You're kidding me.
Yeah, it's, uh..
...well, I-I've got to travel to Europe and Japan
to launch the new collection.
Wow!
Wow, what did you...just come
all the way from Dallas to rub it in my face?
No. No, um..
...I-I came to talk about mom.
I had to move her to assisted living.
You know, her emphysema ...got worse.
Yeah, well, three packs a day will do that.
She also had a stroke.
[sighs]
You know, I-I visit her, like, twice a week.
And it's not a lot, but it makes her happy.
And I'm going to be traveling for months at a time, so..
...you know, I...I want to move her to Chicago.
No. Don't. Please don't.
Look, I 'll pay for everything her moving expenses..
...her living expenses, all you've got to do
is just go visit her.
Look...I've been doing this
for a really long time now, okay?
- I think it's your turn. - No, it's not.
Look, she's your mother.
You know, even after everything, she's still your mother.
Who I haven't spoken to since I was 15.
Well, you know, maybe it's time that changed, too.
Alright, I'm in. Bag him.
Ac 14, tidal volume 500.
Have Frank check personnel records
see if we can figure out who he is.
(Rasgotra) Post-expansion pulmonary edema.
Let's get her son back over here now.
- He went to his audition. - I thought he was gonna stay.
- Well, I told him he could go. - How soon can he get back?
I don't know.
'We need a bipap'
and set up for an intubation.
- Intubation? - She has a living will.
She asked for no heroic measures.
Okay, Donna, Donna. I need to ask you a question.
- Donna? Donna? - I should call her son.
Exactly what I didn't want to have happen.
Okay, start with the bipap.
It's noninvasive
in the spirit of her wishes.
That's a good idea.
This isn't a surgical problem, Dr. Brenner.
You're the primary physician
on the case, so you call it.
Let's go, Neela.
Did you reach the son?
- No. - I might have to intubate.
W-with a DNR? Can you even do that?
Well, temporarily. I can always remove it later.
I promised her son that she would be alive when he got back.
I see.
(Brenner) 'There's fluid around the heart.'
We can drain that, buy her some time.
(Frank) Neela. Dr. Horta's here on your porta-lung appy.
Peri-vac kit. Betadine.
Well, um, good luck.
- 'Serum ketones are negative.' - Is that a problem?
(Morris) 'Well, medically, it's good news.'
But it means we have no reason
to keep you in the hospital overnight.
So I'm going to jail?
I think they let you out if you pay a fine.
I don't have the money.
What about a loan?
They won't give you credit if you don't have a job.
Ever since I got laid off, I've been cleaning houses.
Barely covers the rent.
- My daughter.. - Your daughter?
Pregnant.
On bed rest.
I'm trying to buy her a crib and stuff.
You could talk to a social worker
about getting some help?
I have worked hard my whole life.
'I've raised two babies.'
'Never been on welfare.'
I had to get my medicine.
So, why would you..
Steal a tube of lipstick?
I return it for store credit.
Use the credit..
...to buy my insulin.
It works.
Dr. Morris.
We're making some progress ID'ing your old guy.
There's a patient missing from a nursing home on Dearborn.
Fits his age and description.
You hear that, Oliver?
Sounds like we found out where you belong.
Systolic's down to 80.
- Run in a liter. - 'You need a hand?'
I just need to thread the catheter
over the guide wire.
[machines beeping]
[beeping continues]
'There's the pericardial fluid.'
It should help.
I'll check another blood pressure, doctor?
[slapping rail]
(Gates) 'What's wrong?'
What do you need? You in pain?
Relax. You're okay.
Hit him with some versed, Tony.
(Gates) "TB."
TB?
By any chance, does your lady have tuberculosis?
No, she has cancer.
You sure?
Do you have confirmation on the path report?
It'd be unusual
but...TB could explain everything.
'Infection in the lung..'
'...the bone, liver, the brain, around the heart.'
You need a sputum stain for AFB.
(Chuny) Better get a mask on her.
You think your guy was a doctor?
Oliver..
...were you a doctor?
I'm sorry, I wouldn't have pulled you out
if it wasn't important. Real quick.
What's the fine for shoplifting?
And the maximum jail time?
[sighs]
No, the guys didn't put me up to this.
Thank you. Get back to class.
You don't look like you have good news.
- Could be up to six months. - Oh.
You know, all the jails are overcrowded.
It won't be that long.
No, her daughter's having her baby
next week!
Hey, Morris.
Okay, I will be back as soon as I can.
Excuse me, my captain wants to know
how much longer she's gonna be.
Uh..
...this needs to run in over an hour.
I thought she was ready.
Yeah, if I discharge her too soon
she'll bounce right back.
I got to call the station.
You know what sucks?
There are guys out there stealing cars
and shooting guns, and you're here all day
baby-sitting a decent lady.
I'm just doing my job.
Where's Brenner?
(Chuny) He ran to the lab.
We think this lady has TB.
Yeah, and this guy
might have figured it out.
Really?
How long does an AFB stain take?
Less than an hour.
(Morris) "To OMK. 35 years of service."
Oh, my God.
Do you know who this is?
Yeah, this is-this is Dr. Oliver Kostin.
As-as in "Kostin 's Textbook of Emergency Medicine."
He's a legend.
- Dr. Morgenstern. - The one and only.
Hey, Chuny. So good to see you.
So good to see you.
This is Dr. Morris and Dr. Gates.
- Hi. - Hello.
(Frank) Dr. Morgenstern ran this place
back in the day.
What are you doing here?
I got a call from the nursing home..
Ollie...you gotta stop wandering.
Are you his doctor?
No. His proxy.
His wife died a few years ago. They never had any children.
So I got a durable power of attorney for health care.
You must have been close.
He taught me everything.
Treated me like a son.
He knows you're here.
Then he's having a good day.
What's his baseline?
Multi-infarct dementia, and going downhill fast.
Ooh...he had a great mind.
Now there's nothing left.
Well, something's going on in there.
He thinks that lady has tuberculosis.
[chuckles]
Does she?
(Chuny) We don't know yet.
(Morgenstern) The...the swelling
behind the right ear.
Could be scrofula.
(Morgenstern) It's a TB infected lymph node.
Used to be in the textbooks, it's not anymore.
So if he's right, he's still capable..
No.
It's a flash of an old memory.
Every once in a while, a stimulus
a sight or a sound, brings up something from the past
but it doesn't last long.
For all intents and purposes
he doesn't interact with the present.
He hardly speaks.
I brought a copy of his DNR order.
So we shouldn't have tubed him?
He never wanted to end up like this.
Could we take him off the vent?
Maybe...move him into a private room?
Sure.
What about trauma one?
He might be getting a few visitors.
'You know, the ER.'
Used to end right here.
He designed your trauma rooms.
And got 'em built 40 years ago.
Dr. Horta cleared his entire schedule
to come operate on you.
- Thanks, doc. - My pleasure.
We'll see you upstairs.
I'll be right behind you, honey.
I'm...really looking forward to this.
It's gonna blow your mind.
Oh, Lucien.
This is Dr. Horta from San Diego.
Oh, um, hi. Yeah, I've heard all about you.
So, um, this thing's really gonna happen?
- We're all set to go. - Well, you should scrub in.
I-I can't, I 've got a couple of cases
pre-op cases to check in on.
- Let the residents do it. - You go ahead.
I'll-I'll be in and out, you guys.
- Let's take the stairs. - Okay.
- Nice to meet you. - Yeah.
Lucien, heard about the notes appy.
- Pretty cool. - Yeah, it is...pretty cool.
Excuse me, officer.
How can I stay at home
when they're sending you off to jail?
You need to be on bed rest.
This is crazy, mom. This isn't you.
Dr. Morris, this is April 's daughter Kendra.
- Hello. - Hello. Is she okay now?
Her diabetes is back under control.
Mom. Why would you do something like this?
I don't know, I guess I wasn't thinking.
Your mother was trying to help.
This is between her and me, thank you.
(Kendra) Mom, talk to me.
- BP 's way up, 170/100. - We should let her rest.
Yeah, I think you're upsetting her.
What do you think she's doing to me?
Sam, cycle the dinamap.
Ow!
- Ah. - Is that a contraction?
Kyle, grab a gurney, let's get her up to OB.
- No problem. - Slow, deep breaths.
I'm okay. I don't need all that.
No, we have to monitor your baby.
Morris, positive AFB.
Whoa!
Well, the whole ER 's been exposed.
Everybody needs testing and follow-up.
We all assumed it was a tumor
but the other hospital cytology was equivocal.
Chuny, we're intubating.
- You are? - Positive TB stain.
She doesn't have cancer, she has a treatable infection.
(Marquez) Alright. Glide-scope's ready.
Good call, Oliver.
TB is the great imitator. That's what he taught us.
(Brenner) '20 of etomidate, a hundred of succinyl choline.'
(male #2) 'Dr. Kostin, are you mad?'
'Dr. Kostin.'
You can't give succinyl choline down here.
I just did.
(male #2) 'Paralytics and intubation'
'require an anesthesiologist.'
I'll keep that in mind.
Your patient's too sick for the emergency ward.
Patients like this die
in the elevator when we try to move them
up to the ICU without an airway.
Okay, gentlemen.
My work is done.
(Brenner) 'Beautiful shot of the cords.'
'Passing the tube.'
Nice.
Stats are fine.
(Morris) Cuff is down.
Alright.
Deep breath in, Oliver.
And out.
[Oliver coughs]
David.
Where do we start rounds?
Right here, Ollie.
You're right where you need to be.
Look. I, I have to get back.
But I'm really glad you got in touch.
Yeah.
Yeah, you know, I've been
trying for 15 years.
Hasn't been easy.
You know, one day, I had a big sister
and then, the next day, you took off
just pregnant by some dude.
I didn't take off.
Mom kicked me out of the house.
Well, you could have called.
She wouldn't let me talk to you.
Written a letter.
I did.
She must have tore them up.
I, I-I never knew that.
I had a baby.
I had to work.
After a while, I just stopped trying.
I figured you probably hated me.
I didn't.
Um, you know
um, after you left, this is
the only guidance that I got.
- My diary? - Yeah.
Yeah, you must have left in a hurry, 'cause I found
it underneath your mattress.
Oh, my God, are you kidding me?
What? Did you read this?
Yeah, of course. Like a 100 times.
You taught me how to..
'...how to French kiss'
how to pierce my ears
how to roll a joint.
- Six Flags. - Yeah.
When I was seven, that was like the happiest
day of my entire life.
Oh, my God.
Mom took us home early
because you puked your funnel cake all over Shock Wave.
Ah! You are so wrong.
No, she-she took us home
because, when she went to the bathroom
you went and tried to bum a cigarette off the hot dog guy.
- I did not. - Yes, you did.
Geez.
You were grounded for an entire week.
Oh.
I was so stupid.
So, she's really bad, huh?
Yeah, it won't be long.
(Frank) 'Well, ICU could take trauma one.'
Okay, let's move Dr. Kostin.
Dylan, how'd it go?
It's okay. Where's my Mom at?
She's in a different room on a breathing machine
but, um, something amazing happened.
It turns out your mom doesn't have cancer.
Are you serious?
It's tuberculosis.
Um, they-they told us that..
The cells from the other hospital
were suggestive of cancer, but they weren't definitive.
So, we ran a special strain
and we found TB.
Um, thank you.
Thank you. That's incredible.
She's not out of the woods yet.
If it's a drug-resistant strain
then she's gonna have a very rough course.
But it's better than cancer, right?
I mean, her prognosis, it's good?
Now, we're gonna have to keep you
I-in, isolation for a couple of days
until we find out you're not infectious.
Not a problem.
Donna, there's someone here to see you.
Mom, I heard the great news.
I kind of rocked it.
They're not supposed to give you any feedback
but the head of the woodwind department said
"See you in September."
Sam, ah, I'm gonna be up in the OR for a bit.
Prescription for insulin
and, uh, an appointment with a diabetes clinic.
- Where you taking her? - County Jail.
Are you okay?
I got some medicine to stop the contractions.
I have to wait a week till the baby's ready.
- We should be going. - Hold on.
You've got nothing to say?
'You're not gonna explain this to me?'
Maybe later. She's had kind of a rough day.
I thought I was gonna have some help with this baby
but I'll do it on my own.
I just thought you wanted to be a part of it.
But if this is how you want it, fine!
Come here, you know what, come here.
- What are you doin'? - Please, come with me.
What's goin' on?
I need you to understand
what your mother has been doing.
Shoplifting make-up.
To trade for insulin.
'She loves you, she's made a lot of sacrifices'
for you and your baby, she almost died today
because she ignored her own health
to buy you a crib.
I didn't know.
Yeah, she's too proud to say it.
I know it's hard, but try to appreciate what you have.
Stump is tied off.
Endo-shears.
Nicely done.
Tension as you pull, Neela.
(Brenner) 'They're still at it.'
Yeah, you're just in time for the big finish.
(Rasgotra) Appendix is out.
How cool was that?
Very.
- You heard about the TB case? - Yeah.
(Horta) 'G-prox, please.'
Yeah, we were all guilty of diagnosis momentum.
Despite incomplete evidence, we heard the word cancer
and we all ran down the wrong path.
It's a glimpse of the future in there.
Yeah, I wasn't on board at first
but Neela persisted, so..
Well, that's a good quality to have.
Especially in an attending.
There are a lot of candidates this year, you know.
It's going to be very competitive.
Well, whoever gets her will be lucky.
Think he's really mad at me?
Well, it did undermine his authority.
But it was in the interest of the patient.
Yeah, I agree.
I think he must be in trauma one.
I just hope it doesn't hurt my chances here.
Well, if it does, then they're all crazy.
I can't imagine anyone more brilliant and skilled
and compassionate and sexy.
And you'd better take a nap because
you're gonna need it for later.
(Morgestern) I was pre-med, volunteering at the hospital
when they made him Chief in '68.
Back then, the ER was a glorified walk-in clinic
where you were seen by unsupervised interns
and residents with no training.
And the community ER's were even worse
staffed by moonlighting dermatologists
psychiatrists or drunks
who'd been banned from private practice.
'There's no 911.'
'No paramedics.'
And if you needed an ambulance
you called a funeral home.
[playing the English horn]
What the hell is that?
Hmm.
Ollie once said
"You stand a better chance
"of surviving a gunshot wound in Vietnam
than a car crash in Chicago."
[music continues]
'But he changed all that.'
He developed the 911 system
he trained thousands of paramedics
and started one of the finest
residency programs in emergency medicine.
You're all here 'cause of this guy.
[music continues]
Gunshot wound to the left chest
dumped from a moving car.
- Lost the pulse. - Starting compressions.
- Thoracotomy tray. - I'll tube him.
- Four of O-neg and betadine. - Yankauer!
(Taggart) Rapid infuser is primed.
- Prep for a subcalvian. - Hold compressions.
(Rasgotra) 'Okay, opening the chest, now.'
Shot in the chest outside of a liquor store.
(Kostin) Ready...and lift.
Hold an elevator!
He's gotta go right up to the trauma ward!
Someday we're gonna take care of guys like this down here.
The surgeons will never sign off on that.
You wait and see.
Dream on, Dr. Kostin.
(Rasgotra) 'Foley's in the heart defect.'
(Brenner) 'Inflating to 20 cc's.'
(Taggart) 'Bleeding's slowing down.'
'He's had six of O-neg, six of FFP.'
(Gates) 'I got a pulse, strong pulse.'
(Rasgotra) 'Okay, cardio-thoracic team's here.'
(Morris) 'Take him away, guys.'
(Taggart) Door to OR, 12 minutes.
- Not bad. - Yep.
Could walk out of the hospital.
[heavy breathing]
How you doing, Ollie?
Another two of morphine.
Got it.
Let's TKO his fluids.
[machine beeping]
He's bradying down.
Might as well turn off the alarm.
[sighs]
[machine beeping]
[instrumental music]
[theme music]