Previously on E.R.:
- I am no longer Chief of Staff. - I need my job back!
Kovac is going to offer you the job.
- We're colleagues. We're contemporaries. - Hey, no touch, no touch.
Every day, I keep thinking they're going to come and arrest me.
Well, just stop worrying about that.
- Just focus on Alex. - He knows his dad is gone.
No, no, no, Gates! You cannot put in an EJ.
E.R. said okay on the EJ!
- I told you not to do that! - You're dead.
Take it easy! All right! Okay, okay, okay!
But you're in my E.R. now, so put on the damn coat.
You're a new intern?
Resident in-service exam is Friday.
Practice questions and instructions are in the packet.
We just got here, boss.
Shouldn't we learn something before you start testing us?
It's to get a baseline. We'll retest you at the end of the year.
Um, is there a makeup date?
'Cause Friday's my day off. I volunteer at Big Sister/Little Sister.
Yeah, well, I'm post-call, which means I volunteer to sleep all day.
Too bad. Conference Room, 8:00 a.m.
Come on, guys.
All right. Who else is on?
Weaver's on at 12:00. Until then, you're in charge.
What about Morris?
He just called.
He's running late. Says to start without him.
Late? For his first shift as an Attending? Did he say why?
I couldn't really understand him. It was windy, and the music was loud there.
Windy ?
# Believe it or not, I'm walking on air I never thought I could feel so free #
# Flying away on a wing and a prayer... #
Rat-bite kid is in bed C.
Waiting on a shot of penicillin and a piece of pizza.
- Ah! The surgeon is in. - I think I left my badge here.
Are you nervous?
No, I'm okay. Happy rounding.
First day on rotation. Don't let those eggheads haze you!
Sidewalk was crooked, damn it! I want to talk to Johnnie!
Ma'am! You're gonna have to call them back later!
Look here, J-Lo! I got ten minutes left on my card,
and I ain't signing anything until I talk to my attorney!
Don't you tell me that Johnnie Cochran's dead!
- Lady, give me a break. - What about Al Sharpton?
- It's not heavy. - They found some bad wiring after the shootout.
Turns out the whole place is like a tinderbox.
Really? Got a light?
James Anderson, shortness of breath, history of congestive heart failure.
Gave Nitrospray and 40 of Lasix.
40? The guy's a chronic CHF'er. 40 won't do the trick. He needs 80.
Protocol says 40. Not that I'd expect you to know, or give a damn.
Picked him up in the hall of his apartment.
- All right, on the count. Ready? - Place had some wild stuff--
- feather boas, stiletto heels, wigs. - One, two, three!
Sounds like your locker. What meds is he on?
It's right there on the paramedic sheet, which is also part of the...
Protocol. Right. I smell a theme.
80 of Lasix.
Sats suck.
- Must have a bad lead. - Oh, yeah, he does. Look at this.
It's on his chest hair. Is that part of the... what do you call...
protocol?
Isodril, Bumex, Glyburide...
Benzoin for the chest lead.
All right. Protonix, Diovan, Carvedilol.
Let me help you.
- All right, sats are up. - Lasix in.
Hey, can you look at me?
That's good.
Saved your ass again, Zades.
Hey, where's that famous sense of humor of yours?
It was bad enough before.
Now I got to roll in here and have you playing me
'cause somebody was dumb enough to give you a white coat?
- What are you so pissed off about? - I'm on probation!
For a month!
Limited shifts, no extra runs, and one wrong move, I'm finished.
What? Those two drunk guys outside of Ike's? They press charges?
No. The bar manager filed a complaint, so Chief's got to make sure I feel it.
I didn't hear anything about it.
Well of course not. You're Mr. Teflon.
- Only now it's Doctor Teflon. - This is no big deal.
- What's probation a month? - It's my job, man! My job.
You know, the one good thing about you working here,
you may just have to listen to somebody besides yourself once in a while.
And I can't wait to see those sparks fly.
I'll catch you later, killer.
Well, he didn't mean "killer" killer. He meant...
You know.
All right, back to work, everyone.
Barack! Barack Obama!
Don't waste my time! Put him on!
Benny?
Your neighbor's on the phone.
Something about Jim.
Triage desk.
I know, I'm here for someone. James Anderson.
They brought him in about an hour ago, I think.
Triage desk.
- Hello. I... - Fill out this form, sir.
I'm here to see a patient.
Oh. Okay. Then try this one.
Easy, now. We got enough patients already.
- Charity, I got one for you. - Um... Hope. My name is Hope.
Right. Eight-year-old girl fell off her bike.
Oh, poor little angel.
- Hey, think fast! - What's this?
It's your lucky day. Residents get to wear the new transport beeper.
Wait a minute. If this thing goes off,
I can sign out my patients and go, right?
Well, if your Attending-- i.e. me-- agrees that the patient is critical
and needs a physician transport, then yes, Ray, you may go.
Sweet. I'm going to go check the transport locker.
Is Dr. Kovac around?
Hey, how you doing?
I think Dr. K ran upstairs,
but I'm pretty sure I can help you with anything you need.
You represent this hospital, and that's how you approach people asking for help at this desk?
Angela, I was waiting for you upstairs. I'm sorry. My train was late,
but I had the lovely opportunity to meet Dr. Pratt.
Impressive.
- Got a minute? - Yeah, sure.
Haleh, what the hell just happened?
I think you got served.
Greg Pratt, Timmy Rawlins.
- He's going to be filling in for Jerry. - Really ?
In fact, he was Jerry before Jerry was Jerry.
Back in the mid-'90s, I got stuck in a rut. I had to get out of here.
- Out of the hospital? - No. Out of Chicago.
I lived in the Kalahari for a while, selling biltong outside of Kakamas.
Then I spent a couple years mining uranium in the Siberian tundra.
Ran into a misunderstanding in Thailand.
That landed me in a Bangkwang prison.
- But most of the '90s are still a blur. - Wow. Sounds rugged.
Hell, I'd take Bangkwang over E.R. this time of year.
I hear that.
Yeah. You know, them new interns will mess you up worse than Chinese hash.
Ain't that the truth.
It's about the Curtis Ames case.
Risk management wants to meet tomorrow at 9:00 a.m.
Curtis Ames?
Left-sided paralysis following an embolic stroke.
You placed a central line for pneumonia, and he boarded down here for three days.
February of '04.
Oh, oh, oh. But I thought the case had no merit.
- The guy wants his day in court. - But the lawyers said...
I mean, it's been over a year since my deposition.
Excuse me? Are you Angela from Staff Affairs?
- "Ms. Gilliam." - Ms. Gilliam,
there's a Dr. Tremons on the phone.
He says his privileges have been suspended.
Tell him the Anesthesia Chair has to keep his ACLS current
just like every other physician in this hospital.
Okay. I got you, baby.
Look, malpractice suits are a waste of time and resources,
but it happens to almost every doctor at some point.
It doesn't reflect on your abilities as a physician.
See you tomorrow.
Ultrasound confirmed cholecystitis.
Hang a bag of ertapenem, and send her up to surgery.
- I'll give the nursing report. - Scaphoid fracture.
Thumb spica. In bed A.
- Discharge with clinic referral. - No problem.
This one over here?
Curling iron upper inner thigh.
Dressing, tetanus, and send her on her way.
- How do you even do that? - Don't ask, don't tell.
Pratt, sign Gates up for some more.
- Man knows how to clear a bed. - Really?
So why do I have two patients with blank charts,
and I haven't heard about your CHF guy yet?
He's stable. We're waiting on labs.
- Sats are 91. He's hypoxic. - That was before oxygen and lasix.
- Well, what's the EKG show? - Nothing to worry about.
This gentleman is here for James Anderson.
You family?
We're business partners. My name's Cray. Bennett Cray.
All right, Dr. Gates can take you in. But keep me apprised.
All right.
We're waiting on some test results, but...
we could use some more information on his medical status.
Yes, I can help that. I brought in his meds.
Your, uh... mascara's running.
It was a long night.
You round twice a day, 5:30 a.m. and 7:30 p.m.
In between, you'll cover floor patients and consults.
And, hopefully, scrub in on a few cases.
Sure.
Neela, this is Jill Connely and Ken Maser, your fellow interns.
This is Dr. Crenshaw.
- Dustin? Dustin? - No, I don't think so.
What I asked for was a freakin' ginger ale!
Dr. Crenshaw is our new Chief Resident.
Neela Rasgotra.
Put in two years in the E.R., then defected to become a real doctor.
Wow! Took you that long to figure out you were wasting your time?
- Well, I don't think of it that way. - Really? And why is that?
I developed clinical and procedural skills.
I became proficient at ultrasounds,
central lines, chest tubes, cut downs.
You know what worries me?
Maybe all of this is going to seem too easy.
You think? Maybe there's a chance you might actually be...
oh, I don't know, what's the word, um...
bored... by what we do up here?
I don't think so.
Good.
Good. Then I think I'll leave you all to it.
Bye.
Someone want to explain to our international prodigy here how we do wound rounds?
Mr. Cray.
Doctor.
His oxygen level is up. He should be waking soon.
Is there any family he'd like here?
Uh, just me. That's all.
It's just the two of us.
We each come from a long line of homophobes and bigots.
The closet reflex dies hard.
How long have you two been together?
It's been over 15 years now.
We found each other late.
He thought no one would ever love him,
and I'd already resigned myself to being a lonely old drag queen.
In the right light, he looks like Barbara Stanwyck in The Lady Eve.
To you, maybe.
Now I look more like Mrs. Doubtfire.
I'll let you two talk, and I'll be back as soon as I know anything, okay?
Hey, Luka.
Can you sign a wrist X ray order for the Obama lady?
Sure.
I hear the baby's doing well.
- He's starting to hold his head up. - Ah, that's great.
You know, we never got to talk about everything that happened.
It's not your fault, Sam.
- If it wasn't for me... - If it wasn't for you, I'd be dead.
How is everything?
It's good.
You know, pretty good. I, uh...
Alex is seeing this shrink lady, but he's not really into it.
You know how he is. He keeps everything bottled up...
I meant with you.
I'm fine. Really.
You want me to try talking to Alex?
No. You've got enough on your plate.
- But thank you. - Sam, hey.
Just don't beat yourself up.
You did what you had to do. It was self-defense.
Born in a poor village in central Guatemala,
Soledad Gutierrez is a deeply devout immigrant who works cleaning houses.
She's had a hard time adjusting to life in the U.S.
Wow, you really bonded with her.
Okay, Felicity, come on, hurry up and get to the point, will ya?
Soledad is worried every day
and prays all the time for her husband and four-year-old son
back in their hometown of... "Chichicastenango."
Oh, sure I got down to Chichi for el dia de los muertos back in '96.
Still, there's no denying that.
...of the boy, but she's getting older now and might not be able to...
Look, look, look, look.
I don't need her whole life story.
Why is she in the ER today?
Well... she had a great-uncle who died of a heart attack.
His wife and children were left without anyone to care for them,
so they actually had to move in with her parents, which was weird, because...
All right, stop, stop, stop.
What brought her to the ER?
Her heart.
- It's her heart. - Good.
So do you think it's an MI? Pericarditis? Dysrhythmia?
Well, she's been unable to find a suitable church,
so I believe that she feels so alone in this world
that her heart is aching for her family and her homeland.
Okay, okay, well, diagnostically, what you just said is nothing.
- Need a hand here! - Group home resident, 23 years old.
Release me, you merchants of destruction!
- You need to stay in bed, Ernie. - Good to see you.
Pleasure's all mine.
The home thinks he might have ingested something.
All right, ten of Haldol and two of Ativan I.M.
Oh, this is Rodney King all over again.
- Hey, lady, no pictures in here. - You ain't fooling nobody, brother.
- Harriet, get back to your bed. - Obama going to see this.
How you feeling, Mr. Anderson?
Better.
Tell him he can go.
He's got a show tonight.
We're having a fund-raiser for the Chicago HIV-AIDS Coalition.
And I don't want you missing it on account of me.
He never misses a show.
All right, listen, we have some test results
and the good news is, you did not have a heart attack.
Oh, thank God.
But you're not making urine, which means your kidneys aren't working
so you'll have to go on dialysis.
I don't think so.
- Jim... - It's pretty urgent.
I've been to enough doctors already.
I've had enough tubes and machines and treatments.
No, I'm not going to do it.
- Don't ask me... - It's okay, Jim. It's okay.
So what else can we try? What are his other options?
His options?
He'll die. Very soon.
- No, it's enough already. - Jim, there's no choice.
Dialysis can substantially prolong your life.
I've already got the bad heart.
I'm sick of being sick.
I'm not going to be some broken-down cripple.
You're tired, I know that...
- But remember what we always said-- - It's enough, it's enough.
- Whatever's going to happen... - You choose more life
- no matter what, remember? - I don't want to do this to you.
More life, no matter what.
You promised.
Okay.
But you've got to do something for me.
Call Lorraine, and tell her what's going on.
- Jim... - Call her.
Just tell her to bring the boy.
I want to see him.
It's not a good idea.
Don't get into it all.
Don't try to explain it.
Just tell her I want to see them.
It's been too long.
Please, Benny.
You... you got do...
Okay.
His sister and her son.
I've never met them.
So, dialysis?
Yeah. Let's get him up as soon as we can.
I'll make the call.
He was already 50 by the time he figured it out.
He wanted to tell his family, but they shut him down.
So he just left.
Disappeared one day.
Found me.
No openings now. I told them we could start him down here.
His Serum K level is still high.
All right, amp of bicarb, 25 grams of D50, ten units of regular insulin.
May I use that phone?
Sure. There's one down the hall if you want more privacy.
Thank you.
Oh, excuse me.
Gates, rheumatology came down on your polymyositis patient
and there was no H and P on the chart.
Didn't get to it yet.
No, that's not good enough. Sam, you got this?
- You come with me. - All right.
Give me an ETA on the dialysis.
Listen, I've got enough problems without you pissing off
the other departments by not keeping current on your charts.
- I'm just trying to use my time well. - No, not well enough.
Get that up to date.
Oh, thank God, someone who understands this game.
- Rough morning, Greg? - I'm glad to have you on the floor.
Dr. Pratt, will you come check my vertical mattress?
I think I everted the edges too much.
Not until he listens to my bronchiolytic.
You try a neb yet?
Don't worry, I'll show you.
Uh, I'm with Dr. Pratt today.
Okay.
And I still need to present my barbell-on-the-toe guy.
Well, I can help you with that.
Hey, guys, this is the esteemed Dr. Weaver in the house, okay?
So take advantage-- present to her.
- Soak up all her decades of experience. - Decades? What am I, a fossil?
All right, go, run and hide, all right? We'll be in there in a minute.
You know what, I'm fine.
I'll push charts, help clear some beds.
- I hope this isn't awkward. - What?
- That you and I are equals now? - I guess.
Hector Rodriguez, 38, found down on the sidewalk.
Hey, there's Tony... Tony man!
- Cue Ball, what are you doing here? - Some kind of misunderstanding.
- History of ETOH. - Yeah, we know.
- Did you vomit any blood? - Not this time, bro.
I was just sleeping and some skank called 911.
- Where do you want him? - Did you fall?
No, no, that's old.
A junkie rolled me a couple of weeks ago.
Occupational hazard.
- Get this dude to Exam Three. - I got him. I know him.
Check a crit and look for signs of occult trauma.
- Yes sir, Dr. Pratt. - I can get him.
You finish that.
Is that the bleeding heart of Jesus?
Sure is.
Isn't God great?
You ain't so bad yourself, honey.
There are no open spots upstairs, so we're starting him on dialysis here.
Is that Uncle Jimmy in there?
Hello. Lorraine?
You're the man I talked to on the phone?
Bennett Cray.
My brother Harold and my son Brian.
James asked you to call us?
He wanted to see his family.
Now, like this?
That's par for the course, I guess.
He's having ectopy.
Damn it. Get Gates and Pratt in here. His K's going up again.
Ejection fraction is ten percent.
What does that mean?
It means his heart's not pumping well enough.
Does he have an advanced directive?
You mean like a DNR?
No. I talked to the other doctor about this.
Why are you asking about a DNR?
We need to know how far he'd want us to go.
- Whatever you can do. - We knew he was sick, but...
I talked to him on the phone. He said he was having...
problems with his diabetes and having some trouble with his congestive something.
He called you?
- In June, when I graduated. - What are his chances?
Well, it's possible if we put him on dialysis,
- and avert a cardiac incident... - Can he take all that?
He's very resilient. He's been through a lot.
He's been sick for years.
He's not the type to want to be kept alive on machines.
Your brother and I have discussed these matters quite a bit.
Look, we need a few minutes to figure this out.
Sure.
Maybe I can be of some help. Jim and I are good friends.
We've been working together for quite awhile now.
Thank you. This is a family matter.
We appreciate all you've done.
We'd like some privacy now.
Oh, yes, all right, I'll... I'll just step outside.
- QRS complex is widening. - Ready to start the run.
Wait a minute, hold on.
Sam.
Where the hell is Gates, and why is this chart blank?
He goes fast. He probably fills out the paperwork later.
You got this guy's meds in your nursing notes?
Okay, amp of calcium chloride.
- We doing this? - In a minute.
I'm going to give him calcium to stabilize his heart.
Once we do that, we'll figure out what's next.
Okay.
Hey, Haleh, can you pass me a head sheet and a three-pack of Vicodin?
I'm getting him started on something for the pain.
Sorry. We got rid of head sheets about a year ago.
And we're not allowed to dispense meds from the ER anymore.
So what's a patient supposed to do if they can't get to a pharmacy?
You are preaching to the choir, sister.
I liked it better when you ran the joint.
- Charged. - Clear.
Still v fib. Resuming compressions.
- What happened? - Amp of epi.
Why isn't he dialyzed?
QRS widened, we gave him calcium, now he's crashing.
- Is-Is-Is my uncle dying? - What's that alarm?
It's time for his meds.
He gets afternoon doses of Glyburide, Lasix and Didge.
What? Did you say Didge?
Digoxin. 0.25 milligrams. It's right here.
Okay, can everybody step back for a minute while we work on him, please?
Charge to 360 again.
You help my brother with his medications?
Sometimes, yes.
No one said anything about Didge. You showed me Diovan, Sam.
- That's what I was told. - By who? The paramedic?
What's Zadro's sheet say?
Digoxin.
- You don't look at his med bottles? - We didn't have them yet.
Here's the deal--
he has high levels of intracellular calcium from the Didge,
and I pushed a whole bunch more--
enough to stop his heart-- why?
Because you couldn't slow down enough to read the med sheet right.
Can you tell me what's going on?
The drugs we gave him to treat his QRS has irritated his heart.
Clear. Clear
- No change. - Uh, so what now? What else can we do?
What about Digibind?
Depends on his DNR status. Have you all come to a decision?
We've decided it's enough now.
- It's time to let him go. - What? No.
Our brother's an old man.
- He's been very sick for a long time. - No, no, no. He wants to fight.
- He's got no one to look after him. - He has friends,
- he has a support system. - And who's gonna take care of him, you?
- I always have. - But we're his blood,
and we don't think he'd want to suffer through all this for a little extra time.
Well, you don't know that, because you don't know him, but I do.
- And that was his choice, not ours. - I know him, I live with him. I...
...love him.
I love him.
I asked you once politely to go.
You have no part in this.
We could treat your brother with something called Digibind.
It'll give him a fighting chance. Pratt.
He's been in arrest for seven minutes.
His heart isn't salvageable. I'm sorry, Mr. Cray, but...
- this is what his family wants... - Please, wait.
We'll continue CPR as long as there's hope for a meaningful recovery, but...
You can all come closer if you'd like to be with him.
Call it in five minutes.
Excuse me.
I'll be right back.
Hey, we caused this to happen.
- No, you caused this to happen. - All right, so give me a shot at fixing it.
You're never gonna save him.
The family are not the caretakers here--
- ...that man is. - There's no living will, no durable power.
- You gotta go with the blood relatives. - We have a chance.
- This is a teaching hospital. - Teach me.
Oh, you want to learn. Okay. Well, here you go--
that man's gonna die.
That's what needs to happen right now. So forget about the Digibind.
Lidocaine, one more round of epi and then you can pronounce him. Understood?
You need a break?
Sure.
All right, 100 of lidocaine, get ready for some more epi.
And, uh...
ten vials of Digibind.
Wait, I thought the other doctor said...
Your brother expressed a clear desire for resuscitation earlier.
This is a fixable condition, we're gonna give it a go.
Did you discuss this with Pratt?
Yes. We discussed it.
Am I going blind?
Oh, bless your heart.
First thing-- check the intra-ocular pressure with a Tonopen.
- I'm not sure how to use that. - All right, I'll be right back.
- So how's that new intern doing? - She's very, uh... devoted.
Diligent, inquisitive, likes to discover new things--
all attributes I like in a newbie. Ugh.
God, you're disgusting.
Who left this here?
- Ray. - Whoa, what?
If I get a page, I got less than five minutes to get on the roof.
Where's the Tonopen?
Had two stolen, wound up on eBay.
JAY-CO makes us lock everything up now.
Syringes, eye drops, even Quaiac Developer.
- Only Attendings get a key. - I am an Attending.
Make sure you check under the hood.
Hey, look... is there any rule about desk clerks dating doctors?
Shut up, Not-Jerry. I got dibs.
Oh, sweet.
There's a pile-up in Northbrook.
I am so out of here.
Let's see what we got.
Sinus tach at 110.
- Got a pulse with that? - Strong carotid.
Excellent. Cycle the Dynamap.
We got him back for now.
Jimmy...
I'm right here, Jimmy.
BP's 105 over 62.
That's good enough for dialysis. Get the tech back down here.
Mr. Cray, there are two friends of yours here.
Would you tell them I'll be out in a minute.
Uh, they work with us.
Our brother was a lot more screwed-up than we realized.
- I'm sorry he never told you. - We knew he was an oddball, anti-social.
We thought he just fell into some sad, lonely life. We never realized he was...
- a degenerate. - Harold...
He's not a degenerate.
And his life hasn't been a waste.
I know it would be easier for you to believe that.
- He lied to us for years. - He didn't want to--
he didn't see any other way.
You need to go now.
I'm not going anywhere.
You want to take care of him?! Fine.
It doesn't have to be like this.
We need another doc in here, this guy is crashing!
All right, call for a vent. 100%, AC 14, tidal volume 600.
Yo, Cue Ball, what's up?
Oh, that didn't sound good.
Pressure dropped to 80.
All right, normal saline wide open, five liters O2.
What is she doing?
I think it's the 23rd Psalm.
- He doesn't have a line. - Why doesn't he have a line?
Will you stop that, please?
His vitals were stable, crit's 32. His only complaint was shoulder pain
- and the x-ray was negative. - Wait, wait, calm down, calm down.
- Did you just say shoulder pain? - Yeah.
Type and cross four units.
What happened?
Alcoholic with distant trauma history presents with shoulder pain and hypotension.
Prep the belly for ultrasound.
I thought you said you were coming alone.
- Oh, come on, it's me-- Uncle Archie! - Oh, he's so cute.
He looks more like Kovac.
They say they usually look more like the father in the beginning.
It's nature's way of making sure daddy doesn't get all insecure and club us both to death.
Can I hold him? Sure, he wants me to hold him.
Oh, a little spit-up there. No problem.
Whoa... little bit more.
- I missed this part with my kids. - Oh, I'm so happy to see you.
I was going stir crazy in the apartment, so I thought I'd take a walk
and try paging you. How's surgery?
Well, I thought it would be nice to get back to work, and
distract myself from stuff, but my new chief is such rectal tissue, it's all misery.
Okay, you better take him. It's starting to get gross.
- Thanks a lot, Morris. - Here you go.
So, are you loving motherhood?
Yeah, it's a... it's bizarre.
- Sore nipples? - Shut up.
- Oh, I think he's hungry. - Yeah, maybe.
Oh, damn it. I've got to get back.
- Well, thank you for coming. - Well, it's very nice to see you.
And nice to see you.
- And, uh, call me if you need anything. - Okay. I'll be back to work next month.
- Okay, I think I need to feed him. - Yeah, I'm down with that.
Breast feeding is a beautiful, natural thing, nothing to be ashamed of...
You're not sneaking a peek at my tits, Morris.
- Come on, Mr. Rodriguez, wake up. - Got a 14 gauge in the right wrist.
You got a 14 gauge in? Gonna have to teach me that one.
This the ruptured spleen?
Foley's in.
- Who's touching my dick? - Ah, not me, Cue Ball.
That was only one time when I was extremely lonely.
It's a catheter, Mr. Rodriguez.
Abdomen's flat.
Pressure's up to 100 systolic.
Hey... angel face. What's going on?
I'd like to ditto that-- what is going on?
I thought we were going upstairs, no?
Dr. Gates discovered that there was some internal bleeding.
- Based on Kehr's sign. - You caught that?
That's my boy. Everybody knows, you be tripping on some fent-laced powder.
Tony's the one you want pushing that Narcan.
- High praise indeed. - Check him out now with his fancy MD.
Chest sounds clear.
- What do you think you're doing? - Examining him.
Yeah, it's a little crowded.
Step back. Write up the H & P.
- Well, I can't do that unless... - I will dictate to you.
Chest clear...
Cardiac S1, S2 without murmur, rub or gallop.
Am I going too fast for you?
Hey, I heard Faith's guy was crashing.
Her name is "Hope."
I think it's okay.
Good. Well, we're done in there. You guys called it?
Uh, no, actually. The Digibind worked.
Neela, check a quick rectal.
You want me to do the rectal exam?
What part of "no Digibind" did you not get?
- It worked. - So what?
You got his heart back, but his brain is shot.
Now he'll be comatose in the ICU for three weeks
- until every one of his organs fail. - You don't know that for sure.
- What'd you just say to me? - I'm an intern, not an idiot, all right?
- I've been patching up guys from... - Then maybe next time
you'll know the difference between diovan and Didge.
..if what I'm told doesn't make sense to me, you got that?
I've been in this ER for five years working my way up as an Attending,
so if you think that you're gonna stand there
and spout some crap like that to me,
oh, then we got a lot more to talk about.
Now get the hell out.
Okay, I was out of line. Can I just check...
- Get the hell out of here, Gates! - We're working on this guy!
Not anymore.
- Shift's over. - Oh, yeah?
- Pressure stable. - OR is ready.
Sats 92 on four liters.
- Stool is brown, guaiac negative. - Good, let's squeeze in two units,
portable monitor, let's move him up.
Thank you, Jesus.
I thought you were gone.
Working on my charts.
So, I know I made a mistake, but that guy would've needed calcium anyway.
And if I'd known about the Didge, I would've used a much lower dose,
- pushed it very slowly.
I said I was wrong-- what do you want from me?
How about "I won't ever again flat-outisregard
something you tell me to do or not do, Dr. Pratt"?
He would've wanted the Digibind-- his partner wanted it.
- So what? - So what? It's got to matter.
It was a judgment call that wasn't yours to make.
If you can't give way to my judgment on a patient that I've been treating...
What?
No.
No, no, no, go ahead, finish the sentence.
Nope.
Yeah.
From now on, you chart as you go.
No more of this saving the paperwork for the end of the day.
And the next time you don't do what I tell you to do,
or any other Attending tells you to do,
you're gonna find yourself getting bum-rushed right out of this program.
I realize I was wrong from your point of view...
From my point of view?
But because of the Digibind, that guy has a chance.
You really think that you saved him, is that what you think?
Oh, then he's got to have a corneal reflex.
No.
- Cold calorics? - Absent.
And negative doll's eyes, right?
That means no sign of brain activity, no chance for recovery.
So as your, uh, your favorite new mentor, let me just say, great save, Dr. Gates.
Hey.
How's your first day going?
Guy comes in with a few scrapes, ends up with a spleenectomy.
Well, sounds like a good case.
Yeah, it does.
Sounded like one.
Unfortunately, I wouldn't know, because Dr. Crenshaw won't let me scrub in.
Sent me to do dressing changes on the floor.
Yeah, he's a stern taskmaster, that Dusty.
I'm an intern, Lucien.
Nurses do wound changes.
You know what? Uh... That's his call.
You know, you assured me this would be a step up.
Two months ago, I was harvesting saphenous veins for a CABBAGE procedure.
Now I can't hold a friggin' retractor?
It's only the first day.
Well, why recruit me to this program if you won't allow me to do anything?
Look, he's tough, I know that, but his methods work, okay?
He needs to break you down in order to unlearn you of your bad habits.
Wha-What am I, a pony?
I don't need to be broken, and I'm not gonna learn
or unlearn anything by standing out in the hall.
Neela, you're in a different culture now.
This is how we...
shake the E.R. out of you and build you up again as a surgeon.
Well, does it have to be so humiliating?
No. It's just much more effective that way.
I was wondering where you went.
Yeah, I was taken off the case.
Yes, I thought I detected some tension.
Where are the Andersons?
Oh, they won't stay as long as I'm here.
Even Brian.
Well, it's nice your friends came.
They want me to go to the club, do the show.
Well, you know they're gonna move him to ICU.
We won't know anything for 24 hours. Maybe you should... go.
He's not coming back from this, is he?
Mr. Cray, there's something I should tell you.
You made a mistake, got something wrong about the Didge.
It contributed to his heart problems-- I've...
been around hospitals long enough to get that much.
- I'm so sorry. - No.
You treated him well.
Both of us.
We appreciate it.
Maybe they were right.
Maybe he was ready.
This has been coming for a long time.
But here's the thing--
as bad as it all may sound, I belong to a rare tribe,
constitutionally incapable of giving up on fantasy.
I can get up like a lady, and... sell a torch song to a crowd.
And I sure as hell can hold on to the hope that maybe...
somehow Jimmy's gonna be okay.
You make me wish I were a drag queen.
Ah, we are all liars, just like they said.
The makeup, the wig, the padded dress.
All a beautiful lie we tell ourselves.
But it makes us feel better.
Nothing wrong with that.
No. Nothing at all.
Thank you, Doctor.
Hope.
Impacted cerumen needs a washout in one,
and migraine lady needs an H and P--
the abridged version, please -- in curtain four.
Oh, and hey, uh... you know, once we're done here,
maybe-maybe we could go over some procedures and stuff,
help orient you... maybe over dinner.
You're asking me out?
No, no, not... not exactly.
I mean, you know, yeah.
Have you accepted Jesus in your life?
Jesus in Accounting, or...?
Oh. Yeah, well, sure.
Yeah, I mean, I've thought about it.
- You haven't, have you? - Yes, yes, I have.
Jes-Jesus is totally... cool.
I mean, to me anyway.
You should come to my Bible group sometime.
I think you'd really like it.
Bible group?
Okay.
Great. Next one's Wednesday night.
Wednesday.
Bible group.
That... that's hot, right?
Trust me, carrot boy, you ain't anywhere near tapping that.
You know, if there's... anything you need...
I mean, if I can help make your adjustment smoother... in any way...
I'll let you know.
Um... things are a bit complicated right now.
Yeah, for me, too.
But maybe we can... get some...
- Coffee. - Coffee, something...
- ...sometime. - Coffee would be good.
Okay, then.
Good... good night.
Hey, kiddo.
Hey, Mom.
I, uh, talked to Dr. Alice today.
She said you were quiet.
Do you not like her?
Scoot.
Now, you been through a lot, you know.
We both have.
I just wanted you to have her to talk to.
I can't.
Yeah, you can--
- that's what she's there for. - No, Mom, I can't.
I saw.
You know, Dad on the ground just sleeping.
I saw what you did.
Did you remember the wine?
I knew there was a reason I let you live here.
So, were you the best one there?
How many people did you save ?
Did you rock?
# You're nobody till somebody loves you #
# You're nobody till somebody cares #
# You may be king # # You may possess #
# The world and all of its gold. #
# But gold won't bring you happiness. #
# When you're growing old. #
# The world is still the same. # # You'll never change it. #
# As long as the stars shine above. #
# You're nobody till somebody loves you #
# So find yourself somebody. #
# Get yourself somebody. #
# Find yourself somebody to... love. #