ER S3E22 - English Transcript

Previously on ER Tell me what's going on. - What happened? - My God! Where do I find a C-collar? A garage-door opener. Go ahead and try it. - You carry a gun? - Under the front seat of my car. So what is all this about? This little dance you did today. If I can find a way to do what my patient wants then I think that's what I should do. I shouldn't cut somebody open just because I can. - It's still raining, I see. - It's Bangladesh out there, Jerry. - How are you? - You go for a swim? Something like that. - You're in early. - I couldn't sleep. The couple next door at the motel were working on a record. - Motel? - I haven't had time to find a place. I heard the West Side's nice. Not too pricey. - Internships still at poverty wage? - Twenty-seven grand. But second year, it jumps all the way to 30 grand. Twenty-eight. Carol grew up on the West Side. She can tell you where to look. - Thanks. - Okay. Dr. Benton? - What time is it? - It's 5. How long since you've been home? Has Tabash been down yet? He rounds at 7. Why don't you go home and take a shower? I scrub in in 30 minutes. Do me a favor. If there are any changes, page me, okay? What are you doing? Watching you sleep. For how long? I don't know. It's raining. You're beautiful. Good morning, doctor. Early bird catches the worm, huh? I was waiting for Mrs. Ginsburg. I was hoping to talk with you today. Marla doesn't get in until 7. What's on your mind, doctor? Now? I was hoping for an appointment this afternoon. There's no time like the present. I'd prefer to come back later, if that's okay with you. Are you intentionally trying to irritate me, Dr. Carter? No, sir. Then speak up. I've been contemplating leaving the Surgical Program. I've been considering it for quite some time, and I feel that I've made an error in selecting surgery as my specialty. For the most part, the training has been excellent but I just feel that ultimately I don't belong in surgery. And I would suspect that you would agree with me. I certainly do not! You don't? You entered into a contract, doctor. A contract with this institution. We agreed to give you the finest surgical training in exchange for six years of your best effort. I understand, but I think I do not give a damn what you think! This is not summer camp. You cannot just run home to mommy. You're going to suck it up and stick to it! That's what men do. Are we communicating here? - Yeah. - Good! And if I ever hear this crap coming out of your mouth again the only medicine you'll be practicing is picking out a cough suppressant for yourself down at the Jewel! Hey, Dr. Greene, Dr. Weaver's looking for you. Dr. Greene, you okay? I'm fine, Jerry. Thanks. West Town's great. A lot's been bought up by lawyers and bankers. You can still find a place. - How much do you want to spend? - Six hundred, tops. Have you ever thought of finding a roommate? You'll get more space. I'm living by myself. Four years undergrad, four med, three Pedes. - Shared a bathroom the entire time. - I grew up with two sisters, one sink. Seven brothers. Seven? - Where are you in the lineup? - Oldest. I wrap a mean diaper. You? Youngest. Wow, eight kids! - Was your dad independently wealthy? - Mailman. So, Mrs. Martinez, Chuck has some pain in his right hip? Yes. He's been home from school all week. He's getting over a cold. Okay, Chuckie-boy, let's take a look at this, okay? You like sports? You slide into home trying to beat the throw from center field? His temp's 99.8. Did you fall off your skateboard? Anything that might've hurt your hip? I don't have a skateboard anymore. He wouldn't wear his wrist pads, so I took it away. Your mom's right about that. Licorice? Has he had any kind of penetrating wound or injury? Been in the woods camping, nature hikes at school, anything? CBC with a diff, Chem-7, sed rate, ultrasound, blood cultures. - And let's get an arthrocentesis. - I'm gonna have to call down Ortho. I don't think it's any big deal. We just gotta make sure. I talked to Dr. Weaver. Did she tell you about it? Talked about what? I'm hoping to leave my Surgical Residency. You're what? I'd like to be considered for Emergency Medicine. - What did Anspaugh say? - He was less than enthusiastic. Doyle has a chest pain in Curtain 2. You've missed this year's match. I was hoping for a spot outside the match. And that you'd put in a good word with Anspaugh. Was Dr. Weaver supportive? Weaver has a better relationship with Anspaugh. She could probably be more persuasive. - Thanks. - Tell me how it goes. Sure. Retract the liver inferiorly, and rotate it medially. Peter? - The coronary ligament. - Right. Mobilize the right lobe, exposing the vena cava. - You all right? - A vascular clamp. Yours? Shirley, can you check that page on the table, please? I'll suture. You retract. Six-two-three-seven. Problem, Peter? Dr. Hicks, look I'm sorry, but I've gotta go. What? I'm sorry. Shirley, call Dr. Pitard to assist. I think he's in Recovery. Thirty-nine-year-old male experienced the onset of chest pain. Mr. Munder has a family history of coronary disease. My dad died at 36. Vitals are normal, BP's 100/50, pulse is 48. - Pulse ox, 99. - So you were at the gym, Mr. Munder? Yeah, weight circuit. I was on the bench press when it started. - What happened when you stopped? - It went away. - Do you smoke? - Hell, no! - His BP and pulse are low. - Yeah, but he's an athlete. Am I having a heart attack? It's probably just muscle strain. But with your family history, we're not taking any risks. Hep-Lock, CBC, Chem-7, cardiac enzymes portable chest and an EKG. Don't forget the low-tech approach. Give him an aspirin. Your husband looks a little thin, Mrs. Curwane. Has he been eating? Whatever he wants, I give to him. Abdomen's distended. See if there's a surgeon around. No guarding or rebound. No palpable organomegaly. - I can't find a vein. - Was your husband on any medications? CBC, lytes, LATS amylase and an abdominal series. Tenormin, hydrochlorothiazide, Altace, Thorazine Burt. Burt, honey. You be strong now. You be strong. Mommy's here. Mommy's here. Hey, Carol. Somebody may call. I put you as a character reference. - You're kidding, right? - It's this Big Brother thing. - The thing with the kids? - One kid. - You don't see enough here? - A couple hours a week. Good for you, Doug. What are you doing tonight? You wanna get some oysters at Shaw's? Sorry. I have a date. Oh, yeah? Who's the lucky guy? Toby Minz up in Hemo/Onc. Yeah, Toby. Good. He's a great guy. A little lacking in the hair department. Except for his arms. You ever seen his arms? Ortho called. They'll be an hour before they can do the arthrocentesis. Thanks. Arthrocentesis? Eight-year-old kid with hip pain. Del Amico's worried it might be septic arthritis. A lot of tests for a kid getting over an upper-respiratory infection. She was being overly cautious. Hold everything except for the CBC and diff, and I'll check him out. Toby Minz? You get any sleep last night? On and off. He's off the oscillating vent. The nitric oxide worked, so we moved him onto the respirator. And? The ultrasound showed no hemorrhage or dilatation of ventricles. And the CT revealed no evidence of periventricular leukomalacia. - What's he saying? - The structures of the brain are okay. Thank God. So there'll be no developmental problems or disabilities, right? Well, there can be problems associated with anoxia. What's anoxia? Your baby was deprived of oxygen in the womb. So there's always the possibility that there could be brain damage. Will he be able to play with other kids and learn to read? If you're asking will he be a doctor or a lawyer I can't say. Chances are, your baby will be fine. But a certain percentage do have neuro-developmental problems and/or learning disabilities. What percentage? Infants delivered at 32 weeks with no complications have a better than 98 percent chance of being normal. What about the ones with complications? Your child had several serious complications at birth. No one can give you an accurate percentage. It's not an exact science. Babies are resilient. We'll just have to wait and see. - You're buying a gun? - I'll feel safer. - What are you getting? - SIG Sauer.9 mm. The guy at the shop tried to sell me a Colt.45. A lot of weapon for a beginner. Stick to the SIG. I'm gonna check on her chest pain. How's the hand? Itches like hell. - You weren't gonna let anybody sign it. - Rachel's Brownie troop. A detective from CPD called and said he'd come by with pictures. - I thought this circus was over. - Maybe they caught somebody. Hey, how's Rachel doing? Jennifer's back, so Rachel's with her. Listen, Doug, could you write me a scrip for some Percodan? - Ribs still sore? - The pain keeps me up at night. - When do you see that hand guy again? - Monday. I could write you for five or six, tide you over. Mark, we need you over here. I could use a few more than that. ST elevation in 2, 3, and A-VF. Malik, one over 150, nitro sublingually. Is he having a heart attack? - It really hurts! - How's his BP? BP's 125 over 80. All right, 5 mgs morphine. IV push every 15. Start a nitroglycerine drip. Is he having a heart attack? - Mrs. Munder. - I'm afraid so. - Oh, God! I knew it. - Heart rate's down to 45. - Looks like a block. - Second-degree Mobitz type II. Atropine, .5 mgs. - Don't let me die! - I'm hearing rales. Lasix, 40 mgs, IV push. He's going into failure. Let's set up for a transcutaneous pacemaker. What's up? Ninety-two-year-old man. History of vomiting and dehydration. He's agitated, abdomen's distended. No bowel sounds. Could be a small bowel obstruction. Meds? Hydrochlorothiazide, Thorazine, Altace and Tenormin. Kerry. - It's bedsores. - Sacral area too. - He's coming in from a nursing home? - His wife's been taking care of him. Not very well. Abdominal series back yet? Any minute. - Can I talk to you for a minute? - Sure. - I talked to Dr. Anspaugh. - Is he gonna let you out? A few words from you would help. You're still interested in pursuing Emergency Medicine? Yeah. I asked Dr. Greene about it. He seemed supportive but he thought it might be difficult to find a spot. I've got an LOL in 6. Weak and dizzy all over. I'll be right there. Dr. Greene's probably right about finding a slot. We only have so much salary budgeted for next year. That's okay. You don't have to pay me. You don't need a salary? No, I'm fine. So you'll put in a good word with Dr. Anspaugh? - Sure. - Thanks. Did the kid with the hip get moved? I don't know. Check the desk. Carol, do you know where Chuck Martinez and his mom got moved to? Doug Ross released him. He didn't talk to you about it? No. Do you have any idea where he is? I think he's in the lounge. I said, "Put your head down." So he looks me in the eye, and he pukes. Everywhere. On the floor, on my shirt You had no right to release my patient without consulting me first. - What are we talking about? - My 8-year-old with the sore hip. You ordered $4000 worth of tests for a child with - He was my patient! - I game him Advil. I supervise you. - It could have been septic arthritis. - I looked at the CBC. - It was synovitis. - What if it's early-stage? You want to put an 8-year-old boy through a painful procedure on the remote possibility he's suffering from a rare diagnosis your tests don't even indicate. You can gamble with your patients' lives, but don't do it with mine. - He's in heart block! - Pulse ox? - Eighty-eight. - Is he dying? He's dying. - We need you to stand over here. - It's not capturing. Get the transvenous pacemaker and the fluoroscope now. - What's open? - Trauma One. All right. Let's go! You want me to call Cardiology? If they want the procedure, they'd better run. Abdominal series doesn't show obstruction. So it's not surgical. Probably an ileus. - Crit's 51. Potassium's 2.1. - Let's get some potassium going. Put 40 milli-equivalents in a liter of saline, run it over two hours. What about the bedsores, malnutrition, dehydration? Does she have any help at home? She doesn't look like she can take care of herself. Mrs. Curwane your husband's not going to require surgery. He has an ileus. A section of his intestinal tract is paralyzed and that's making him sick. Paralyzed? It could have been caused by one of his medications. So we're gonna work on that. Does your husband get enough to eat? I cook for him every day. All his favorites. We're sure you do, but does he eat it? He's fine. We're just getting older, that's all. We're also concerned that he might not be getting enough exercise. Does he have a walker so he can get out of bed and move around? He's been sick. When he's feeling better, he's out in the yard all day with his roses his vegetables. We had the most lovely beets and beans last season. Just lovely. Mrs. Curwane I think maybe it's time to consider placing your husband in a nursing home or a rehabilitation facility. I take good care of him. You've done a wonderful job, but now he needs more than you can give. We've lived in our house for 48 years. Burt loves that house. You just fix him up and I'll take him home. That's where he belongs. Found her at Grant Park, face down in the mud. Fourteen, maybe 15. BP's 90 over 50. Pulse 56. Temp's 101. Skin's clammy, cool, slightly dusky. Two IVs going. Glucose 120 and two of Narcan. - Vomited on herself, track marks. - Any I.D.? No way I stick my hands into these pockets! - What do we got open? - They're clearing Trauma 2. Lot of kids squat by the baseball fields. Carol, better take a look. Oh, damn it! Lilly, get Dr. Ross! - Trauma 2, tell him. - I can handle it. Coming through! Get out of the way! O-2, 10 liters by mask. Two more mgs Narcan, IV. Prep for gastric lavage. I've run hundreds of ODs. I don't need Ross. I didn't call him to babysit. She's his patient. Her name is Charlie. Sorry to keep you waiting. We picked up a guy at Mercy. Mugged a doctor in the parking lot. - We thought it might be your guy. - I don't remember much. Just look them over, and tell us what you can. He was black? Just tell us if you recognize any of these men. Take your time. I don't know. I think maybe this guy. I've seen him before. He could've been a patient or something. - Thanks for your help. - Is that the right guy? You know, I remember the pants. I saw the pants. - Dark blue, and the shoes were black. - Yeah. We got that in the report. You know, that might be the right guy. I just didn't see much. It happened so fast. Is there a pop machine around here somewhere? Yeah, that's across the hall by the chairs. - Thanks. You want anything, Ford? - No, thanks. I'm okay. This guy knocked you around pretty good. I can give you a couple of names. Some victims' groups. - People that handle these things. - I'm fine. Thanks. Sure. Son of a ***! Damn! *** it! She was face down in the mud, OD'd. She's got track marks, skin pops, cellulitis. We're lavaging her. - CBC, Chem-20, tox screen? - And blood alcohol. - Foley's in. - Antibiotics going? Be my guest. Ancef, one gram. Gentamicin, 50 milligrams, IV. How old? Fourteen. Going on 40. I'll call her mother. A miracle, huh? Have you held him yet? No. Small but strong. You name him? We haven't even talked about it. We thought it would be bad luck. I think it's safe now. I gotta get back. You coming? In a bit. In a bit. - Someone gonna get the phone? - I got it last time. - You did not. - Did too. - You never answer it. - I always answer it. ER. It's Gerontology. How's it coming with Mr. Curwane? I got Social Work coming down. Waiting for P.T. And Nutrition. - This is Dr. Carter. - Yeah, I'm still holding. I hate talking to these caseworkers. So Mark busted a chair in the lounge? Smashed the coffee pot, mugs. A real mess. - Where is he? - He had to run an errand. I need to talk to you. Anybody want to help me out? - What's up? - I'm looking for somebody. The ambulance guys brought her here. Does she have a name? Yeah, Charlie. I don't know her last name. - Who are you? - A friend. - A close friend. - And you don't know her last name? I'm not that kind of friend. - You gonna tell me where she is? - Her mom's coming. Ask her. Oh, her mom. She ain't coming. She's in jail. Possession. Well, then Charlie goes to DCFS. Fine, whatever. Just tell her Tommy stopped by. I'll be on the corner after 10. I'll make sure she gets the message. Charlie's coming around. Jerry, I'm on the line with DCFS. Page me in Trauma 2 if they ever pick up. Gerontology's all backed up. I'm gonna see if I can grab somebody. Dr. Weaver? You should've warned me about Dr. Anspaugh. - What happened? - He wouldn't even discuss it. I'm sorry. I thought maybe you could turn him around. I would love to have you in Emergency Medicine but whatever your difficulties with Dr. Anspaugh are you have to solve them yourself. Tox screen came back. Positive for ***, benzos, opiates. Blood alcohol's.23. CBC shows a white count of 15.5. Hemoglobin's 9.8. Crit 28. Elevated AST and bilirubin. - Hepatitis? - Restraints? - I don't want her to bolt. - Take them off. - She's still my patient. - I understand that. She won't want to talk if she's wearing restraints. - Just don't leave her alone - You know what? I'll deal with it. Hey, you. I saw your bellybutton ring was infected. Did you do it yourself with a rusty nail? I don't feel so good. Yeah, well, we pumped your stomach found more chemicals in there than a toxic-waste dump. I was just partying with friends. So you graduated to smack now, did you? When can I go home? Where's that? With my mom. We hear your mom's in jail. - I won't go back to foster care. - Is that where you were? The guy was trying to do me, and his wife was a drunk. Sounds rough. - You gonna let me go? - Where? I've got friends. I know. Friends you can share a dime bag with if you want. Who's the cheerleader? That's Dr. Del Amico. She took care of you when you came in. Is she the one who ruined my high? You like her? I'll call your caseworker, and we'll get you into rehab get you dried out. Or you can keep screwing up your life and end up dead in some alley. That'll be your choice. I'm pretty tired. What are you doing here? Our job site's on the other side of Wells. I wondered what time you'll be home for dinner. Jeanie, an MVA pulling up. A guy got T-*** by a semi on the Kennedy. Kerry, this is Al Boulet. We met last year. Hi. Here they come! I gotta go. I'll be home around 8. You're cooking? I've got all sorts of surprises lined up. - No frozen dinners, please. - I'll see you at 8. Home by 8, huh? I guess we got some catching up to do. When did you start smoking? I bummed one from Doyle. I hear you had a meltdown today. You picked a fight with the lounge. Feel better? Not really. I'm not writing you that prescription for the Percodan. You need help. I'm fine. Taking a chair to the lounge isn't fine It's never happened to you. You don't know. I'll get someone else to write me the Percodan. If you ever want to talk, you know where to find me. Dr. Carter. Dr. Anspaugh. Dr. Weaver just dragged me down here for a Surgical consult. You were nowhere to be found. I came as soon as I was paged. Want me to take it? No, thank you, doctor. I'll see you upstairs for rounds. You got a bunch of people waiting on you in Curtain 3. - Said you called them down - Right, right. Thank you. - Sorry to keep you waiting. - Carla Kramer, Social Work. Daniel Shaw, Dietary. Ann Ferguson, Physical Therapy. So you've all had a chance to see Mr. Curwane, review the chart? Why don't we take a step outside? Hey, Peter. Move over. - How'd you find me? - It wasn't hard. It's what you used to do when you were little. Whenever you got in trouble, you'd go down to the church. You knew if Daddy found you, he'd figure you were repentant and wouldn't take the belt to you. You're saying I was that calculating as a kid? Mommy thought so. Me, I think Daddy was right. You were harder on yourself than any of us could have ever been. Carla said she hasn't seen you since this morning. I didn't know it was gonna be this hard. What? The baby may have brain damage developmental problems, autism, retardation. They can't even say. Or he might be fine, right? Either way, you're gonna love him more than you can even imagine. I can't handle it. Sure you can. You'll have to. That's your son up there. The world is hard sometimes. It can't always go the way you want it to go. I miss Dad. Is there any chance there might be someplace that can take both of them together? Does she need nursing care? She may have a little dementia. She seems a bit out of it. Time for rounds. Alden-Lakeland will accommodate couples. Great! Great! I'm sorry. I have to go. Rounds. I'll be back in an hour. You're the one with the relationship with the wife. We won't get far without your involvement. This is ridiculous. - I'm not coming. - You're what? A patient needs my attention. Rounds are a requisite for this program! So is patient care. Come to rounds now, or don't ever come again! I'll be there if and when I can! All right, doctor. Anyone for cocktails? I gotta pick the kids up at my sister's. - I'm in. - Me too. - You got any money? - Better than money, girl. Credit. Charlie's caseworker finally showed up. This ought to be fun. Girl, you look great! Thank you. If Dr. Minz calls, I'm on my way out. Okey-dokey. - Good night. - Good night. - You know Miss Neuman from DCFS? - Yes, I do. How are you? Charlie's resurfaced again? Yeah. Poly-drug OD. ***, ***, ***. She ran away from the foster home. She said that she was molested. - Charlie says a lot of things. - Yes, she does. *** it! I'm out of here. If anybody asks, I left hours ago and you haven't seen me. Pacer's capturing, vitals normal, tapered off the dopamine. Mr. Munder is going up for a permanent pacemaker. Doing better? Much. Thanks. Great. Take care. - Doctor? - I'm sorry. I'm off duty. If you need a physician, someone at the desk I'm Judy Munder. I wanted to thank you for saving my husband's life. It must be incredible, making a difference in people's lives. Good night, E-Ray. Good night. I hate this. She's gonna need money to get high. This is the fastest way. That *** guy said he'd be on a corner? Yeah. He didn't say what corner. And how do you know he's a ***? Dealer, whatever. He's out here somewhere if she is. Pull over. Pull over. We'll ask around. Someone's gonna know a dealer named Tommy, hangs out with Charlie. Someone wants to steal your car, that alarm won't stop them. So what are we doing out here? She reminds me of somebody. Who's that? Me. So you headed home for a special dinner and some surprises? Probably just a potpie and a video. Al's not much of a romantic. You guys are back together? You don't approve. I don't know. Does it matter if I approve? It does to me. It would help if I understood. I don't know if I do. You know, it's funny. I'm happy. I'm happier than I've ever been. How can that be? And that's because of Al? No, it's because of me. I'm not afraid anymore. Of death? Of living my life. I see things now I didn't see before. I know what's important. I know what isn't. I've been in love with Al Boulet since the first time I saw him. I was 16 years old. I know he's been in love with me. Good night. Good night. - Hey, baby! What's up! - Can I have your name? This party gonna be booming. What's up with that party? Let's go, man. Let's go, man. Look who's up. You're not sleeping. I seen you. Wakey-wakey. Wake up! He's awake now. Yo, bro. Lend me $ 20. - I don't have any money. - Sure you do. I don't have any money. - We gotta get us something to eat. - Let's go. Shut up, ��sse. I'm talking to my friend here. Glasses Man, we're hungry. You don't want us hungry, do you? This is my stop. You don't wanna give me some money? Yo! We're getting off. - What? - This is our stop. We're getting off. Back off! Back off! It's cool, man. Get on the train! Get on the train! - Get back on the train! - Be cool! - Shut up! - Be cool! Shut up! - Be cool, Glasses Man. - Shut up! Chill out, Glasses Man. Be cool. Chill out. Later. - Anything? - No. You? That kid with the hair saw Charlie yesterday. Said Tommy's usually around, but she hasn't seen him tonight. Heard he and Charlie scored some hash and a good squat. Anything else? That 15-year-old with leather pants said she'd do you for nothing. That's something. - So what now? - Come back tomorrow night. If they got a decent squat, they won't come out until they need to score. All right. You want to get something to eat? As in "something to eat," or as in something to eat that leads to something else? As in "something to eat." When did you and that nurse break up? A long time ago. How about this? How about you drop me back at my motel and we hit some takeout drive-thru on the way? Sounds romantic. I'm late for dinner, Dr. Carter. Good night. Please. It'll only take a minute. This is not the time or the place. It's not that I dislike surgery. It's been incredibly challenging. The training has been excellent. You're a wonderful teacher. Get to the point. I admire surgery, but it's not the type of medicine I want to practice. I can be a competent surgeon. I can learn the techniques, the mechanics. But I'll never be a great surgeon. Dr. Anspaugh, I can be a great doctor. A doctor who spends time with his patients. Who's there for them. I'm good at it. Really good. I can make a difference in people's lives. Don't make me give that up. Please don't make me waste it. I've often wondered over the years if I made the right decision in becoming a surgeon. But you seem so certain. What are you? Twenty-six? - Twenty-five. - Twenty-five. What happened to your patient? The one you missed rounds for? Mr. Curwane. I got him and his wife into a nursing home. Together. It's supposed to be nice. I'm sure it is. You find me in the morning. We'll see if we can work something out. So Toby doesn't get to come inside? God, you scared me! I was hiding over there under the El tracks. You're lucky the neighbors didn't call the cops. What are you doing here? So Toby doesn't get to come inside? It was only the third date. Toby definitely doesn't get to come inside. What? What? Sit in the rocker. All you have to do is hold him. Support his head. There you go. There. Now just rock.