ER S4E18 - English Transcript

ER Previously on ER Thank you. Thank you. - So, it's true? - I've been trying to tell you. I'm not renewing my fellowship because I'm applying for an Attending position. You should have had some sense. Call your family! - It was not your decision, John. - Sorry. - And here are some condoms. Use them. - I will. The Bone Marrow Registry found eight people who preliminarily match your marrow type. - David! - I've got something in my eye. Could you? Who the hell was that? "Gut Reaction" Yosh, I need a hand! - What have you got? - Boxes. Antibiotics, clinic expendables. Right here, Jerry. Thank you. Right here. Thanks. Heavy lifting is not in my job description. - Where are we gonna put this stuff? - Put it in the lounge. - Delivery dude's waiting on a check. - I'll be right there. Carol? What is all this? Mrs. Carter came through with another donation for medical supplies. I thought I'd stash them in the lounge until I find a storage space. Far be it for me to want to impede the good work of the clinic. So tonight's the big night, huh? - Need help? - Everything's under control. I'm impressed that you volunteered to do this year's ER banquet. Jerry's been helping me out. What's on the menu? We have herb-roasted chicken. We have scalloped potatoes Dr. Greene, things didn't go quite as planned. - What do you mean? - I didn't want to worry you. You're worrying me. The caterer couldn't do the spread for the money we had. So I had to make alternate arrangements. - I hope it's not a buffet. - It's not. It's a smorgasbord. - Mark, do you have a minute? - Sure. - Smorgasbord? - It'll be great. I got a great Swedish caterer, a friend of my Aunt Gretta's. What was that strange memo from the dean about? Apparently, he wants to explore hiring a Pediatric Emergency Attending. - And whose dumb idea was that? - Doug's. Doug? Doug Ross went to the dean? And the dean thought it was worth investigating. You're telling me that Doug's actually interested in such a position? He might be. We are trained to handle anyone who comes through the door. We do not need a Pediatric Attending here. Don't worry. It won't happen. They'll make a committee, determine that it's not cost-effective. It'll all be history. Ms. Beavans, let us run some tests. - I don't have time. - She's got a fever and she's vomiting. If I don't get to work now, I'm gonna be fired. - Just a few minutes. - The nurse said that an hour ago! She could have a kidney infection or worse. Let us get a urine sample. - I'll bring her back. - I can't let you leave. - You can't stop me! - Police would say I can. - You'd call the cops on me? - Absolutely. For endangering a child. - I'll call the cops for kidnapping. - What's going on? for two days. No source of infection. He threatened to call the cops! - We can work this out without police. - I'm sorry. I'm not letting you leave without giving this child tests. Like hell you won't! Bring her back or you're gonna be sorry! And he wants to be an Attending? Pedialyte. Make sure she gets plenty of that. Ibuprofen for fever. We'll call you with the test results. You don't want me to call your boss? - Don't bother. - Okay. All right. Son of a ***. I hope it doesn't rain tonight. I'm wearing a new dress. Not to worry. It is not going to rain. The Channel 2 news said it was gonna storm. They don't know what they're talking about. No bursitis, no rain. Can I grab a ride with you and Anna to the banquet? - Doug's working late. - I'm not going with Anna. Did you two break up? - We're just friends. - I thought you were dating. No, no, no. I mean, we've gotten really close, but no. - You thought we were dating? - I thought I picked up on something. Something that she said? No. I thought I picked up on some chemistry between the two of you. I mean, there's been moments but you hate to screw up a good friendship. That's lame, Carter. Ask her out. - I hope Romano doesn't page me. - He keeps you on a short leash. I'd cut it in a heartbeat if I weren't afraid of losing my visa. - Morgenstern might sponsor you. - Out of the frying pan! - What do you mean? - He's a strange fish, don't you think? No. Not really. - You respect him? - Yes. Why? I heard he was cutting up cadavers in the anatomy lab. - So? - It's nothing. I suppose I'm looking for a convincing reason not to go back home. Why? Is your fellowship up? No. I've been offered Senior Lecturer at Gloucestershire Royal Hospital. Congratulations. I'm not sure I want to go back into that old boys' network again. - Here a woman has a fighting chance. - Ready? One, two three. Gently. T- *** when a drunk ran a red. No LOC. BP, 150/98. Pulse, 90. - Resps 25. Minor lacs to- - Allison? Look at you! How are you? I'm doing fine, Dr. Corday, thanks to you. She's been on the job three days. Wouldn't know she was a trainee. - How's your leg? - I'm getting the strength back. - I'm thrilled for you. - Can we finish the bullet, please? BP, 150/98. Pulse, 90. Resps, 25. Minor lacs to the head and lower extremities. He noticed chest pains - after hitting the steering wheel. - Well done. Anytime. See you. No evidence of pneumo. Good peripheral pulse without extremity tenderness. Pupils equal, disc margins clear. What are you thinking? Worst-case scenario, cardiac contusion or an aortic tear. - Start with a chest x-ray. - Excuse me? Get a chest film. I've got a paraesophageal hernia. Probably torsed my stomach. - Are you a doctor? - Pathologist. Rule out a volvulus. Lydia, call for a portable chest. Peter, what do you think? I think Dr. Swanson just beat us to the diagnosis. Are you going to this banquet tonight? It sounds kind of hokey. Actually, it was great fun last year. It was a nice dinner. It's good wine. - Everybody ended up doing the limbo. - I don't know. Come on. I guess. If you're gonna go. - Would you like to go together? - Sure. Why not? - All right, I'll pick you up at 8:00. - Great. Why didn't you say there was a deposit? I thought you were taking care of the band. If I had known there was a deposit, I would've paid it. I've got 60 people showing up there tonight. You cannot cancel- - Mark, telephone. - Can you hold on? Is it important? It's the florist. I'll say you're with a patient. What does she want? She tried to deliver your centerpieces to the Shangri Lodge. Nobody was there to receive them. - Have them deliver it here. - To the ER? Look, you've gotta be able to find a band for me tonight. - I have a couple of buddies- - Jerry, get back to work. What's that? The Machine? That sounds good. Fine. Book them. I'll pay the late fee. Damn it! Labs are back on Quinesha Beavans. She's got Gram-negative rods in her urine. Her CBC shows a left shift. - Urosepsis. - Probably. It's good you had Mrs. Beavans stick around so you could run tests. Tell Kerry Weaver about that. Want me to call her and make sure she brings in Quinesha for IV antibiotics? I can be diplomatic, buddy. I know you can. Dr. Swanson made a correct self-diagnosis. He's got a nasty-looking volvulus. He's gonna need a gastrectomy. Have you ever removed the entire stomach? - No. What about you? - In a frog. - Morning, folks. - Good morning, Dr. Morgenstern. - So, what's on the agenda? - A rather fascinating case. Pretty spiffy. Who is this? Lyle Swanson, Swanny? David Morgenstern, Dr. Swanson. I took histology from you. You inspired me to become a surgeon. You made the most beautiful axial slices of the brain. That means a great deal coming from you, sir. Dr. Swanson is a world authority on immunofluorescent tumor stains. I'm afraid you have a gastric torsion. I should've had that damned hernia repaired years ago. Well, I had an Ml six months ago. I ignored the symptoms for weeks. What's your plan? We'll do an open procedure. That way we can explore your belly. Can you operate laparoscopically? I believe your case is too complicated for that. - Nonsense. - A lap volvulus? It's less invasive. The recovery time is quicker. What do you think? Well, it's worth a try. We can always convert to an open procedure. Lily, book an O.R. in my name. Which one of you would like to assist? Elizabeth you're the skeptic. How about it? Terrific. - Isn't a smorgasbord old-fashioned? - It's gonna be great. I'd like to see a menu. We are having pickled herring, Swedish meatballs, limpa bread. And my mom's making a tub of borscht. Wait. Your mother's doing the cooking? She's doing it for free. - Did you page me? - Yeah. Got a bowel obstruction in 2. - You sure it's not just constipation? - Yes, I'm sure. Hell of a job you ER docs have. You scout out the territory and call in the big boys to go in for the kill. - You got a minute? - Sure. The National Bone Marrow Registry called. You gave some blood last week? In the drive for Dr. Anspaugh's son. Don't tell me that I matched. Unfortunately not for Scotty. But you matched an out-of-state patient. Wow! That's great. - That's a tough procedure, isn't it? - It's not too bad. And if I can arrange it for today, would you be willing to do it? That soon? The patient needs the marrow. I'll give you some days off to recuperate. I can perform that procedure after I check out this bowel obstruction. Yeah. And what exactly does it involve? I'll drill about 50 small holes in your pelvis and suck out the marrow. We'll give you an epidural. You won't feel a thing. Piece of cake. - Think about it. - Okay. Be honest with me. Do you think I have what it takes to be an Attending? Of course you do. Think of me as diplomatic? - What does that have to do with it? - Answer the question. It's not the first word that springs to mind. What would the first word be? Stubborn. Opinionated. Insouciant. - Insouciant? - Look it up. You know this one? We've only played it about a billion times. Are you done eating this? - It's not very good. - Yeah, I know. How about I order us a pizza? If you want. Maybe some rocky road for dessert? Is the pain getting worse? This thing isn't working as good as it used to. I'll get Dr. Ross to adjust it for you. Okay? Wait. Don't leave yet. This is the coolest part. Dr. Bad News. How are you feeling, son? Well, me and Jeanie were gonna share a pizza. We We need to talk. Your bone marrow failed to match the last two potential donors. You win some, you lose some. Hey, we'll come up with Plan B. Okay? Your dad and I have discussed some new therapies. There is something called a Phase One chemotherapy trial. But it's highly experimental. At least it's still a possibility, right? Yes. It couldn't be any worse than the nuke juice they've already given me. There could be some severe side effects. And the chemo could Make me croak. We don't have to make a decision right this minute. What do you think, Jeanie? I think it's a chance. Would you stay with me if I got the new chemo? Of course I would. I wanna do it. You sure lucked out getting that lap. - Do you like working with Morgenstern? - Of course. He's one of the best. Why is it I don't feel comfortable around him? Can't imagine. Last week he bolted out midway through a pericardiocentesis. - Claimed he had something in his eye. - Then he must have. It seemed to me like he froze up. I can't believe that. Let me tell you something about Dr. Morgenstern. He's taught me more than all the other Attendings combined. Maybe I'm looking for an excuse to get out of this. I don't have much experience of laparoscopic procedures. See, that's it. Whenever you're nervous you go after the Attendings. Do I really? Well, I guess I do. - Have you ever done a lap volvulus? - No. But I'd love to. In that case, be my guest. Are you serious? Yeah. I'll do your biopsy and then I'll come observe you. Perhaps I'll learn something. Well Okay. I owe you. David? I hope I'm not disturbing you. Oh, heavens, Kerry, you never disturb me. Is that a lap volvulus? Heard you're doing one on Dr. Swanson. Yeah. Just looking at one of my old teaching tapes. Never hurts to review the finer points of establishing a pneumoperitoneum. He told me that you were one of his brightest students. Good old Swanny. He's from the old school of medicine. Cares about the science and the soul. I came up to bring you the minutes of the Blood Utilization Committee. Thought you might be interested now that you're back on staff. You're always looking out for me. Which reminds me, are you coming to the ER banquet tonight? You're part of the family. It sounds like great fun. - Good. I'll see you there. - Right-o. So I spoke to the pain management team. Sorry. - Sorry. - It's all right. We're gonna increase your morphine dosage. Okay. Where's Jeanie? She's probably down in the ER working. No. She promised to stay with me when I get the new chemo. I spoke to your dad about that. He's worried that you may not understand what it means to be in a Phase One treatment study. I know. The chemo could make me a lot sicker. Yeah, it can. You're willing to go through with that? Hey, Jeanie. Where have you been? I was down in the gift shop. I got you a little something. A new Hot Rod. You let me read that when you're done, all right? Scott and I were just talking about the pros and cons of a Phase One study. And I was telling Dr. Ross that we're gonna go for it. - He's a pretty brave guy. - Yes, he is. Very brave. Yes, I'll hold. So I talked to Anna, and we're going together. But don't call it a date. No, no. It's urgent. I have to speak to Mrs. Carter immediately. Well, page her out of her board meeting. - What's going on? - Carol wrote a bad check. Her medical supplies are getting repo'd. Your grandmother wrote me this. Could you please have her call me back? Thank you. She put a stop payment on her foundation check? What did you do? Nothing. Last week we had some bad press. We gave out birth control to teens. Gamma isn't anti-birth control. She does hate publicity, though. What should I do? You could promise that you won't use her money for birth control. I would if I could reach her. Dr. C, eye exam in 1. I'm sure it's just a big misunderstanding. - Is the patient ready? - He's asleep. Okay. The monitor goes at the head of the table. The endoscopic tower's on the wrong side. Dr. Morgenstern requested it this way. - Are you sure? - Yes, doctor. Quite sure. Shirley! How nice to see you! You still collecting old 45s? Just picked up a rare Buddy Holly. It's great to have you back. Well, it's good to be home. Peter? I thought your associate was going to assist. She's doing a biopsy, so she'll be by later to observe. So it's you and me! Just like old times. Shirley, I left a CD of some Peruvian panpipe music by the scrub sink. - Would you mind putting it on? - Not at all, Dr. Morgenstern. You'll like this, Peter. The music is mysterious and yet soothing. You have a scratch on your cornea, Mr. Bartlett. I'll be right back with some antibiotic eye drops for you. - Carter, do you have a minute? - Sure. - Is something wrong? - No. I matched for a transplant candidate from the blood we donated last week. - You're gonna donate bone marrow? - Yeah. - That's great. - Yeah. But I guess I won't make it to the banquet tonight. Yeah. No. You should be sore for a couple of days. Why? It's a simple procedure, right? Not much to it. - Have you ever done one? - About 12 or so last year. Would you do mine? - Really? - Yeah. I don't mean to sound like a wimp. I just feel a little nervous about it. I've never even seen you flinch. - Not even in the bloodiest traumas. - I'm serious. It's different when you're the patient. Just a big chicken, huh? - Don't rub it in, please. - No. Hey, it's just - It's surprising. - If you don't want to do it, fine. I'd be honored. I'll do it as soon as I'm finished with my patient. Okay. Thanks. Appreciate it. Bye. Mark, did Romano see that kid with the appy? Yeah. He's examining him now. - Is everything set for the banquet? - Seems to be moving right along. The University Club put on such a lovely banquet last year. It's too bad it wasn't available. It was. I just thought the Shangri Lodge would be a different choice. You actually chose the Shangri Lodge over the University Club? - A little less pretentious. - Whatever you say. That appy kid's dry as a bone. Buff him up. Give him 200 cc's normal saline every 15 minutes. That's too much fluid for a kid. I already gave him two 500 cc boluses. I want you to give him then send him up to the O.R. - You fluid-overload these patients. - Follow my orders on the chart. In my ER, I'll manage the patients the way I see fit! Hey, Greene! I guess you got some stones after all. You're the boss. We'll free up the esophagus with a harmonic scalpel. When I was a Resident, we didn't have cautery. We had to tie every vessel. Tell me, Peter. Where do you find the branches of the vagus at this level of the esophagus? They become the anterior and posterior. You cut them, the stomach won't empty. Right you are. Speaking of "empty" and "stomach," anyone try that new Mexican restaurant? I heard they make a great chimichanga. Shirley, turn down the thermostat. Right away, sir. - Are you okay? - Of course. I was doing laps back when those monitors were still black-and-white. - Dr. Morgenstern? - What? You're dissecting the edge of the esophagus. Thank you, doctor, but I don't need instruction. Boy, that phrenic ligament is really fibrous. Are you sure it's not mucosa? Damn it! Peter, your job is to assist me. Anticipate my moves. I am. But he's got varices. You could nick one. Turn the music off. Don't pull so hard with the Babcock. You'll tear the gastric artery. - I'm not pulling. - The hell you're not! Dr. Morgenstern, you're obscuring my field. Oh, son of a ***! You tore the left gastric. - I wasn't anywhere near it. - Suction. Give me a 10 mm sucker, open-ended. Let's move. - I can't see what I'm coagulating. - All right. We have to open. No, no, no. We can control the bleeding. Every time I suck, the abdominal wall collapses. I can't see a thing. Well, then stop sucking. - What are you wearing? - My velvet dress. The one you wore last year? I didn't pass out and rip mine in the parking lot like someone I know. Jeanie, you going to the banquet? No, I'll finish some charts and stay with Scott. - No luck with a donor match? - No. Hey, Jeanie. Can I talk to you? I'm concerned about Scott. You sure he wants this experimental treatment? - Why? Did he say he didn't? - No. - What are you concerned about? - He's got this crush on you. Doug, the boy is 12 years old. He'll do anything to please you. He just wants a chance to get better. - Have you seen how he looks at you? - You overreact. He lights up when you're around. I think that he's taking the chemo because he thinks you want him to. No. I want him to make his own decision. I know that you do. I don't know that he can. Pressure's dropping. - He's lost too much blood. Let's open. - Let's do a midline. Instrument tray. Two more units of cross-matched. Let's move. - Scalpel. - Hemostat. He's a bloody mess. - Get that liver out of the way. - Deaver retractor. Let's move. - His varices are bleeding. - Suction! - See the bleeder? - Not yet. - Bradying down. - Two more units of blood. - Okay, we gotta crack him. - Let me suture. - We've gotta stop the bleeding. - Shove your hand in there and squeeze. - We're losing him. - I can't find the bleeder. We've gotta crack him. It's these damn varices. Doctor, it's been three minutes. Damn it! He's dying. Move! Rib-spreader! Damn it, I said rib-spreader! Let's move, people! Satinsky. Okay, aorta's clamped. Do we have a pulse? No pulse. He's in V-fib. All right. I'm starting internal massage. Still in V-fib. The lungs aren't expanding. Increase the volume. Lap pad. I can't get a grip. Still no pulse. Give me the epi. Come on! Let's move! Let's go! The tray is ready. Here are your gloves. - Thanks, Kit. - Call me if you need anything. Carter, are you ready? Epidural didn't hurt a bit. I told you, you had absolutely nothing to be nervous about. Sure. That's what they told me when I had my tonsils out. I was 12. I was in terrible pain after the operation, so they gave me Dilaudid. They gave me too much and I couldn't wake up. It was really weird, you know. I could hear the nurses' voices. And I couldn't speak or move. I thought I was gonna die. And then I made a promise to God. And I said, "If you let me live I'll be a good person for the rest of my life. " And you came to and decided to devote your life to medicine? Something like that. I'm really relieved you're doing this. Thanks. Don't tell me when you'll stick the needle in. I won't. I'll prep with a little Betadine. All right. Your drape fell off a little bit. All right. Here comes the Betadine. I can't let you examine him until after the autopsy. I know. I just want to review the anatomy. That's quite an unusual request. Why are you so interested? Well, you know, it all happened so unexpectedly. I just I've known Dr. Swanson for 20 years. It's not easy for me either. So do you think it would be possible to sit in on the autopsy? Sure. Tomorrow, 4 p. m. Thanks. You down here checking on the Swanson autopsy? Yeah. I assisted on the case. I know. David Morgenstern filled me in. Alice, when do you expect to have the report? In a couple of days. The sooner the better. I'm sorry about what happened. - Is there a problem? - No. Not really. I spoke to David about the argument in the O.R. He downplayed it. Right. Understand Dr. Swanson had cirrhotic liver, varices, secondary to hep B. Yeah, he did have varices. No wonder you couldn't stop the hemorrhaging. We'll run an M and M, see if we can learn something from this tragedy. Why don't you take charge? Gather all the charts and the tape. The tape? We often tape laparoscopic procedures. See if the operation was recorded. If it was, you can take us all through it step by step. We shouldn't leave these here. - What are these? - It's a miniature stethoscope. It's a theme. Dumb idea? No. Just tacky. - Did you talk to Gamma yet? - She never returned my call. - This might not be about you. - What? - I'll go talk to her after I get off. - Thanks. And by the way, Anna said she'd call you later. She was in a lot of pain, took a taxi home. Guess she's gonna miss the banquet. Viper convertible. It's pretty cool, huh? Yeah. I'm gonna get one just like it. Cobalt blue with a white racing stripe down the middle. Think you can handle it? You'll see when I take you for a ride. You haven't mentioned your friends lately. You want me to give them a call and maybe have some guys come visit? Not really. They're I don't know, just kids. I'd rather be with you. Look at those wheels. Magnesium. - What are you doing? - Applying for a loan. What? If I can't depend on the foundation and until I get some new grants I'm taking out a loan to keep the clinic open. - Am I losing my mind? - Maybe. Six-month-old twins in respiratory distress! Parents said they have the flu. They're down in the waiting room. Get me a Pediatric crash cart and clear Trauma 2! I got him. Come on. Come on. I know. Shirley, can you help me? I gave the nursing notes to Dr. Morgenstern. Was there a tape made? I didn't make one. But if there was a tape made, where would it be? Try the O.R. The equipment's still in there. Thank you. Check the video recorder. Damn it! - Draw a racemic epi. - Yosh, help Doug. I'll help Mark. - Need a hand? - Yeah. Get the O-2. - Carol, I need the line. - This one is wheezing and retracting. Pulse ox, 92. Yosh, get me albuterol nebulizer, She's not breathing. Lily, intubation tray. Carol, I need that line. - I can't get a vein. - I'll go in interosseus. All right. Let's move her up. - How's the other one? - Stable. Yosh, move her out of here. I can't see the cords. - Laryngeal edema. - Probably syncytial virus. She's cyanotic. Trach tray, suction. - Hold the suction. Hang on. - What? Wait for an air bubble. Follow it down with the tube. - Okay. - All right? I see the bubble. I'm in. Bag her. Peter I've been looking for you. You're one of the finest Residents I've ever worked with. What happened today has no bearing on those feelings whatsoever. I plan to support you in any way I possibly can. Support me? I'm prepared to review this case strictly on medical facts. Of course. I believe Dr. Swanson died from ruptured varices. That's not what happened. What do you think happened? Well You accidentally cut the gastric artery. I've been a surgeon for 20 years. I've never accidentally cut anything. Then how did he bleed out? You avulsed the left gastric with your clamp. No, I didn't. The tape of the procedure will show that. What tape? I was hoping you made one. Sorry. Let's not let this escalate, Peter. I could make this an issue of your insubordination. I don't want to do that. I would've never taken over if I- You did more than that! You pushed me away from the operating table! That's grounds for dismissal. If a man's life wasn't at stake- A man's life was at stake. And that life was lost. I'd appreciate it if your preparation for M and M focused on the medicine and not hypotheticals and accusations. Dr. Swanson deserves at least that measure of dignity. The clinic's done a lot of good work in the family's name. I'm glad you feel that way. So doesn't it make sense to continue funding it? I think it's time Carol Hathaway looked for other funding sources. She's worked very hard to make a go of this clinic. It's not fair to pull the rug right out from underneath her. I'm surprised at your interest in the foundation. How many years have I tried to involve you in our family's charitable activities? This isn't about the foundation. What is it about? You're angry with me about Chase. You're taking it out on the clinic. I am angry that your cousin will be debilitated for the rest of his life. It's not something I would take out on others. Chase barely accepted my help! He didn't want the family to know. None of you wants the family involved in your lives. That's unfair. I care about the family. You certainly care about the money. What? You live off a family trust, John. Gamma, if that is all you think of me, then you can keep your money. As you wish, John. David? Hi. You know, I heard about Dr. Swanson. Hard losing Swanny like that. Why don't you come with me to the banquet? Thank you, Kerry. I just want to go home. Mark. You know, I've been thinking all day about the proposal for a Pedes Attending. I think we should fight it. I'm a little torn. I just saw Doug Ross save a 6-month-old's life. Doug is a good pediatrician. He's not management material. He's never been interested before. It's not just Doug. It's a policy change that would undermine our authority. I'm not worried about my authority. I think ER Attendings run the best emergency department. I agree. Good. All right, see, watch this. Let me get you right on the I'll be right back. Quinesha came back for IV antibiotics. I was just entertaining her. How's her mom's job? - I called her work. She'll be fine. - Good for you. You would've done the same. Listen, I'm serious about the Attending thing. - You ought to give it a shot. - Yeah? Yeah. Here we go, kiddo. Dr. Swanson taught half the Attendings here. Everybody loved him. I'd get all my ducks in a row if I were you, Peter. I did nothing wrong. - Rumor has it you took over. - I had no choice. That's your opinion. But justified or not, you're a Resident. And Morgenstern's the Chief. I'm sorry. So much for your bursitis. I'm sorry. Look, hot borscht will be up in five minutes, all right? - Has anybody seen the band? - I don't see any food either. Don't they usually serve hors d'oeuvres? Wouldn't wanna spoil your appetite for the smorgasbord. The bartender just asked me for a drink ticket. - I didn't bring any cash. - Here. - One each? - Hey, buddy. Hey! Come here. Come here. Kind of an unusual place. It's different, you know. But it's great. - It's a disaster. - I wouldn't say that. You want another drink? It's really nice, Mark. Mark Greene? I'm The Machine. - Band's here. - Excellent. Great. You guys need some help bringing your stuff in? No guys. Just me. You're The Machine? The whole Machine? Hey! Carter! Over by the moose! I couldn't get my grandmother to listen. Somebody did. She messengered over another check. Whatever you said really worked. Thank you so much. - Come on. - I'm coming. Watch your head on the moose. Why aren't you home in bed? What? And miss my first ER banquet? How's the pain? It's okay now after a couple of Percodan. Makes for a very pleasant banquet. I should pass them around. Well, you look Thanks. So do you. You know, we've kind of been dancing around this thing a little bit. And this afternoon during the bone marrow A couple of points during the year I kind of felt like we had chemistry. - Or not. - No. No, you're right. I mean, there's definitely been, you know All right. Well, let me say this. I haven't made a move because I didn't want to screw up our friendship. Yeah. I know. You've been a great friend. The only real friend I've made here, actually. But? But? But there's this other guy. That guy you told me about in Philly? The guy with the drug problem? Well, I think that's past him now. So I'm We were together for a long time. We've not been together for a while. So it's not completely over. I guess I'm just not quite there yet. You know? - But - Hey, I understand. - You do? - Yeah. Yeah, I understand. What are friends for? Dr. Greene, the crowd's getting restless. Give them some drink tickets while The Machine is setting up. Alrighty. Saved by the smorgasbord! Ladies and gentlemen, dinner is served! - What happened? - He's arrested. - Fever's 104. - Is he septic? That's what happens when they get to this state. - He was about to start a Phase One. - Poor kid. Let's give him two of epi. Would you mind taking over the bagging? Somebody should call his father. Why don't these parents just let these poor kids go? We've got a rhythm. Okay, let's give him tobra and ceftaz. - Do you want hydrocortisone? - Yes, please. Good work, everyone. We have got him back. Carol, are your meatballs frozen? I think they' re just a little cold. What is this? Jerry says it's called pyttipanna. - What's that? - I have no idea. Excuse me. Hello. I just wanted to say thank you for coming tonight. I organized this event in hopes to show my appreciation for all of your great work. So try not to hold tonight against me. Each day we work together as a family. Because we're a family, it's no secret that it's been a rough year for me. So I want to thank each of you for helping me through some hard times. You stuck by me when I needed you. And you've given your best to make our ER a place that we can all be proud of. So thanks for being my family. I couldn't have made it without you. Here we go! I had the Babcock on the lesser curvature of the stomach. There's no way I could've been near the left gastric. Any way you could've caught the artery? No. Morgenstern was dissecting the esophagus. My clamp was on the stomach the entire time. Then it's your word against his. So how much did you see on the monitor? I got there just before you performed the thoracotomy. - In time to see me push him? - Yeah. I'm willing to express my concern about his competency. No, no, no. I don't want you to jeopardize your career over this. I don't know. Maybe my clamp did slip. You just told me you had the clamp on the stomach the entire time. I'm sure I did. Peter, if you're sure that's what happened Yeah. I'm sure. The food was terrible. The music stinks. The drinks are watered down. But you sure know how to throw a great party. - Thank you. - You're welcome. - Are you feeling better? - Yeah. Good. The antibiotics are working. You got a big decision to make. I told you what I want to do. I know. Just hear me out. I'm gonna love you and respect you no matter what you decide. And I'll always be there for you. So if you want to take this chemo, you have to do it for yourself. Not for your dad or for your sister or for me. - Understand? - I think so. A man has to make decisions for himself. I don't want any more chemo. Okay. You know what I want? I want to get in that Viper. Cobalt blue with the racing stripe. Put the top down and drive. And where would we go? California. Surfing? Ride the curl at Zuma Beach. Sounds like fun. And we'll stay for the sunset. Sure.