ER 3x18

1. ER

2. Previously on ER...

3. I told you I was pregnant weeks ago. Then nothing.

4. - Perform an embolectomy? - You seem to know what you're doing.

5. I think we should start sleeping together.

6. Why didn't you tell me I could be a lawyer, pilot or astronaut?

7. You wanted to be an astronaut?

8. - Why doesn't she stay with me? - How will you do that and work?

9. I can handle it.

10. "You Bet Your Life"

11. Am I gonna be late again?

12. No. And starting today, we're both gonna be on time.

13. - Who's picking me up? - Tina's mom.

14. You'll play over there, and I'll pick you up after dinner.

15. - I hate Tina. - Don't say that. She likes you.

16. No, she doesn't. Her mom's just doing you a favor.

17. That's not true.

18. - I'm sure the bell just rang. - I hate going in late.

19. I'm sorry, sweetheart. This is the last time. I swear.

20. I can't wait till Mommy gets back.

21. Have a nice day.

22. - Can I help you? - I'm looking for Carla Reece.

23. - She went home last night. - Thank you.

24. What are you doing?

25. I was just going over Carla Reece's discharge summary.

26. - That's confidential. - Yeah, I know.

27. Dr. Coburn

28. I'm the child's father. - She told me.

29. It's still confidential, and you know it.

30. Why did you order a glucose-tolerance test?

31. - I won't answer that question. - Does she have gestational diabetes?

32. Goodbye, doctor.

33. Gestational diabetes can put the fetus at risk of heart or metabolic problems.

34. I have a right to know.

35. If you wanna know what's going on with your child

36. then I suggest you ask the mother.

37. - I thought I'd find you here. - Here I am.

38. It's supposed to be a great weekend. They say it'll get up in the 70s.

39. - Damn it. - You're in a good mood.

40. I was doing fine until the clinic called with my blood-test results.

41. - My viral load's up to 1000. - A thousand is not significant.

42. - It is to me. Perfect timing. - What do you mean?

43. T oday is Al and my anniversary. Would've been nine years.

44. Talk about the gift that keeps on giving.

45. You had the flu last week. That's why your viral load went up.

46. In two weeks, it'll be undetectable.

47. - Think so? - Yeah, and I'm the expert.

48. I also think we should rechristen this date in history.

49. - What do you mean? - I propose April 17

50. be the anniversary of our first weekend getaway.

51. - Keep talking. - All right.

52. How does a suite at Indian Lake Resort sound?

53. Great restaurants, massages in the room. Leave tonight. Back Sunday.

54. - Sounds nice. - It will be. I promise.

55. Hey, stop worrying, okay?

56. Come on, don't lie. You did not buy this car.

57. - Boxster, dude. I'm leasing it. - How?

58. To afford that, you gotta be making some doctor ducats.

59. - Just call me Dr. Markovic. - Okay, doc.

60. - Did that Attending meeting start on time? - Yes. And Anspaugh was looking for you.

61. Don't bother. It ended five minutes ago. Catwoman?

62. Rachel left it. I should call the school to make sure they feed her.

63. - We need to talk. - Sorry about the meeting.

64. The Search Committee received your application for the teaching position

65. along with Kerry Weaver's. - Wasn't she going for research?

66. She is. The teaching job is her fallback.

67. Now, between us, you're the better candidate.

68. Kerry's intellect is superior, but she doesn't have your people skills.

69. The hitch is, you haven't published. Kerry has written seven articles.

70. - Two in the Annals. - Seven?

71. Exactly. Which means you have to find an interesting case and write it up

72. to show the committee you're not illiterate.

73. - A case. - And soon.

74. I went out on a limb to back you. Don't make me look like an idiot.

75. Damn it. Damn it. Damn it!

76. Carol? What are you doing? What is this?

77. You're reading Harrison's Internal Medicine?

78. I'm checking the rate of oxygenated metabolism in hypothyroidism.

79. - This is important to you? - It was on the medical-board exam.

80. I put "above normal. " The answer's "below normal. "

81. Every day I think of another test question. I look it up, and I got it wrong.

82. - I'm sure you did fine. - No, Doug.

83. I've looked up 30 questions, and I missed them all.

84. - I did not do fine. - Okay, you're right.

85. But you do things for people that doctors don't even think about doing.

86. This guy in the hall needs a cleanup. He just did a major Code Brown.

87. You're right. I wipe butts.

88. And take orders from 25-year-old interns.

89. Who's the jockey on Goosebumps? Is that turf or dirt?

90. What's the conditions at the track?

91. Easy.

92. Listen, put me down for a double pop, Goosebumps to win.

93. You want any action? I got the lowdown on the miler.

94. - You a gambler? - Investor. If I wanna gamble

95. I'll play the stock market. This is scientific. What about it?

96. - No, thanks. - Your loss. Doc?

97. Sure. Put me down for 5 bucks.

98. Five bucks! A high roller.

99. - You've been vomiting since yesterday? - I think my cat gave me the flu.

100. We'll run a few tests. Let's get an x-ray of his abdomen.

101. - Can I keep my hat on? - Sure. Why?

102. It's my thing. Once I make a bet, I keep the hat on till the payoff.

103. Scientific, huh?

104. Einstein wore brown socks for luck. Now, who am I to argue with that?

105. Jeanie, some guy dropped this off for you.

106. - Who? - I think it was your ex-husband.

107. - When? - He just left.

108. - Al. - Hi. I see you got the flowers.

109. - What's this about? - Nothing.

110. It's our anniversary, and I thought of you, like it says on the card.

111. - It's inappropriate. - Jeanie, it's no big deal.

112. I don't wanna celebrate a marriage that was a disaster from beginning to end.

113. - I didn't mean to upset you. - Well, here. Just-

114. No. Keep them. Give them to a patient or something.

115. - Oh, God! - Ida Blinnder, 55, acute abdominal pain.

116. - It's like my stomach's exploding. - BP, 100/70. Pulse, 90.

117. - I need surgery. - Draw the usual labs, amylase, LFTs.

118. Call a Surgical consult.

119. - Good Lord. - Looks like a railroad yard.

120. - I see you're no stranger to surgery. - I've had five operations.

121. - They never find anything. - All of these for the same problem?

122. It comes back.

123. Mrs. Blinnder, do you ever suffer the loss of sensation in your arms and legs?

124. - Yes. Yes, I do. - Cancel the surgery.

125. - Why? What's going on? - There's a rare condition called porphyria.

126. It's often misdiagnosed as surgical, but it's a metabolic disease.

127. You mean she had five operations she didn't need?

128. It's possible. This could be the perfect case to write up for the journals.

129. - Let's get a CBC and lytes. - What's happening?

130. Don't worry, Mrs. Blinnder. We'll get to the bottom of this.

131. - Excuse me. A little help! - Malik, get a gurney.

132. I found her in a car outside Grayson's Cemetery, bleeding to death.

133. - These your belts? - All we had for a tourniquet.

134. How much blood has she lost?

135. Not sure. The car had dark upholstery.

136. Let's get her into Trauma.

137. Take the belts off. See if she has an arterial bleed.

138. - No spurting on this side. - Can I get a pulse below the cut?

139. - Must have used a dull knife. - Something ugly is going on.

140. - Think she swallowed something? - See any containers? Poisons? Insecticide?

141. We just scooped and ran.

142. - Her name? - No ID.

143. - Go back and check her car. - Ewald tube and activated charcoal.

144. We gotta pump her out. Could you hold her head?

145. - Here it is. - Oh, the pain!

146. "Unexplained abdominal crisis.

147. Symptoms include absence of fever. " What's her temp?

148. - Normal. - Good.

149. "Porphobilinogen in the urine. " Let's get a UA.

150. You gonna write this up for the Annals?

151. And The New England Journal and maybe The New York Times.

152. Who knows how many needless surgeries are done in cases like this?

153. - " The Hidden Tragedy. " - Am I gonna get an operation?

154. - Absolutely not. - But I want an operation.

155. Mrs. Blinnder, you don't understand.

156. You don't need surgery. You have porphyria.

157. - No, she doesn't. - What?

158. She's Psych.

159. - She enjoys having surgery done on her. - Enjoys?

160. She's convinced five different doctors to cut her. She likes it.

161. It's a lie. I do need surgery. Oh, God. The pain.

162. - Call Psych. Have them bring the net. - And cancel The New York Times?

163. Hey, Carla. It's Peter. Are you there?

164. When you get this, give me a call either at the hospital or at home

165. or page me. 555-0197, okay?

166. I hope you get this, and I hope you call. Bye.

167. - What is it, Carter? - I got a 68-year-old guy

168. with diffuse abdominal pain, no focal tenderness, bowel edema

169. but no acute obstruction and a history of peripheral vascular disease.

170. - I'm thinking about getting an angiogram. - Hand it off to Dixon.

171. - You and I have to cover the wards. - I'd rather stick with him.

172. His temp's up. He's looking gray. I just don't want him to get lost in the shuffle.

173. All right. Stick with him. If he needs surgery, Anspaugh's on call.

174. - Heart rate's 40. - Get 2 more of atropine.

175. Get the contents of her stomach to the lab for analysis.

176. - Cops found empty pill vials in her car. - What kind of pills?

177. - 3TC, ritonavir, AZT. - She OD'd on her AIDS pills?

178. There's more. Valium, desipramine, Prozac and a jar with some kind of mixture

179. smells like Sterno. - I guess she wanted to make sure.

180. - What's the name? - Suzanne Alner.

181. See if she has a chart. Tube's coming out.

182. - Washcloth, please. - Bicarb for that tricyclic

183. Romazicon for the benzos. Narcan to cover the narcotics.

184. If she's positive for methanol, we need to dialyze.

185. - And the AIDS pills? - No idea.

186. - Greg Fischer would know. - Good. I'll call him.

187. Why would you wanna hurt yourself like this?

188. We're talking 200 horses, 0 to 60 in 6. 1 seconds.

189. - ER. Who? - Yeah, I'll let you drive it.

190. Jerry, someone from Cryogen Lab is calling for a Dr. Markovic.

191. Let me call you back. Hello? Yeah, speaking.

192. Monday at 4:30 would be fine. Thank you.

193. - Isn't Cryogen Lab that sperm bank? - Yeah.

194. Don't tell me you're representing yourself as a doctor and trying to sell your sperm?

195. - Just keep it down. - That is reprehensible!

196. What's in a title? Women are paying top dollar for the seed of a tall man

197. with an IQ of 150. - Who took the test for you?

198. - I took it. - Your IQ isn't 150. Mine's only 145.

199. What am I supposed to do, apologize because I'm smarter than you?

200. What?

201. I'm gonna get an IQ test from Psych.

202. If you don't score 150, I'm gonna blow the whistle on you, Dr. Markovic.

203. Tech brought these down.

204. - She's positive for methanol? - Yeah. Dialysis is on the way.

205. Pumping and charcoal is all you can do for the HIV pills.

206. Cops found pictures of a little girl in her car.

207. - Her daughter? - Who knows?

208. Pharmacy has her living in a motel. I called. They say she lived alone.

209. She's got a wedding ring.

210. - Did we find an old chart? - Nothing.

211. - This kid looks familiar. Last name? - Patient's last name is Alner.

212. - Suzanne. - Where am I?

213. - You're in the hospital. - Oh, no.

214. You want us to call someone?

215. - Your husband? - No.

216. We found these pictures in your car. Is she your daughter?

217. - Where is she? - I killed her.

218. - How are you feeling, Mr. Bartok? - Bad. Like after my second heart attack.

219. Well, what you're having is a lot like a heart attack, except to your gut.

220. This artery brings blood into your small intestines.

221. - It's completely blocked off. - Sounds serious.

222. - It's very serious. - Can you fix it?

223. Yeah. We need to get you into surgery right away.

224. What if we don't?

225. - You'll be dead in 72 hours. - Cripes!

226. Don't worry. The chief of staff is on call. You'll get the best care in Chicago.

227. Let's take him to Pre-Op, and stat page Dr. Anspaugh.

228. Where's my phone?

229. It's around here somewhere. This isn't the best time to be calling your bookie.

230. - I want to talk to my daughter. - Yeah. Sure.

231. The doctor ordered a painkiller injection.

232. - Take your best shot. - Marine?

233. - Master gunnery sergeant, 22 years. - This might sting a little.

234. I think I can handle it.

235. - Carol, what are you doing? - You ordered 30 mgs of ketorolac.

236. - He needs it IV. - You didn't say that.

237. He's got kidney stones and COPD. He needs to be hydrated.

238. - I'll start an IV. - Sorry, we got to stick you again.

239. What's another needle? At Fort Bragg

240. my drill instructor hammered my air-assault wings into my chest.

241. - I heard about that on the news. - Sounds awful.

242. Proudest day of my life.

243. If the journalists left my corps alone, we'd all be a lot better off.

244. Caught me off guard there, cookie.

245. Peanut butter and jelly. And a plain doughnut.

246. - Rachel forgot her lunch. - Maybe it was on purpose.

247. - I'm new at this. - How's it going?

248. It's great. I love having her around. We haven't got the routines down yet

249. but she seems happy.

250. - I hear you have a Psych case for me. - Yeah. Curtain Area 3.

251. This lady has a predilection for operations.

252. She's had five surgeries. They've all been completely unnecessary.

253. - Not Ida Blinnder? - Yeah. Is she a patient of yours?

254. T otal fruitcake. You didn't leave her alone, did you?

255. - Why? - When she's rejected from surgery

256. she likes to force the issue. - What?

257. She eats things. Batteries, paper clips, pens...

258. - Then they have to be surgically removed. - Oh, boy.

259. Ida, what have you been doing?

260. - Oh, no. - What?

261. Haleh, did you take all the instruments off this tray?

262. - This was full when I left. - Ida, did you swallow anything?

263. Okay.

264. - Excuse me, is Dr. Coburn around? - She's at the clinic.

265. - Wanna leave a message? - No. Maybe you can help me.

266. I need the ultrasound tape for Carla Reece.

267. We only keep them a week or so before they get recycled. Let's see.

268. You're in luck.

269. You're a surgeon, right? Is she a surgical patient?

270. - How's she doing? - BP's down. Breathing's labored.

271. - She's not responding to anything. - Guess what I found.

272. The chart on the little girl. Katie Alner. Roger. Suzanne.

273. The girl in the picture.

274. Father brought her in last year for recurrent ear infection and flu.

275. - I ran a CD4. She had AIDS. - From her mother?

276. Yeah. Girl died last month. AIDS-related pneumonia.

277. - So that's what she meant. - So sad.

278. - Her ex-husband is on his way in. - Soon, I hope.

279. His celiac is shot. White count's 18,000.

280. - Correct. - He's had two Mls

281. peripheral vascular disease. CO2, 14. Fever, 102. BP's down to 90?

282. I thought we should get him to O.R. right away.

283. He's going into shock. We open him up, he won't get off the table.

284. - Turf him to ICU. - Wait. You're not gonna take him?

285. - He's septic and grossly unstable. - He's infarcting his bowel.

286. - He's not gonna get better in the ICU. - Probably not, but it's his only shot.

287. Don't you think he has a better shot with the operation?

288. There's nothing we can do for this man.

289. We operate, all we get is a mortality statistic.

290. I'm a surgeon, not an executioner.

291. Let's go, doc. I'm dying here.

292. Mr. Bartok, Dr. Anspaugh feels that you won't survive this surgery.

293. - What's that mean? - It means we'll move you up to ICU.

294. - The Intensive Care Unit. - I don't understand.

295. You said if I don't get this surgery right away, I'm through.

296. - That's true. - So? What? Are you writing me off?

297. - Send me to die like some animal? - I am sorry.

298. You're sorry. What the hell is that?

299. You told me I'd get the best care in the city, for God's sake!

300. Should I call Transpo to come get him?

301. You gave me your word.

302. No, keep him here. Give him dopamine. Ten micrograms per minute.

303. Let me have that. I'll be right back.

304. - Holy cow! - Sorry.

305. - Mother! - Damn it! I'm sorry.

306. - What are you doing? - Blood gas. He's a hard stick.

307. - I'll take that as a compliment. - I'll go get an Attending.

308. No, I got it.

309. Kerry, you might want to help Doyle. She's using a patient as a pincushion.

310. - Judas Priest! - Sorry.

311. Gotta learn sometime.

312. I don't see why nurses can't do blood gases.

313. As if we wouldn't do a better job than that.

314. - Sounds like she's got it. - Holy Shih Tzu!

315. I'd say his chances of surviving an anastomosis is slim to none.

316. His collaterals may still be profusing his bowel.

317. - I doubt it. - His BP is up.

318. - He's not a good risk. - Dr. Hicks.

319. Mr. Bartok knows he might not wake up. He wants everything done

320. and I think we should at least try to save his life.

321. If we get in and out quickly, he may have a chance.

322. - That's all he wants. - All right, let's take him.

323. - Good news. You're going to Surgery. - Thanks.

324. My pen. I was wondering where I left it.

325. Scissors, tweezers. She should be in the circus.

326. Nothing's left the stomach. With a rat's tooth and a scope, I can grab it.

327. Well, looks like she's back to being an ER case.

328. "Woman Swallows Medical Instruments. " The journals would love this.

329. - I didn't know you were into publishing. - Yeah, life on the fast track.

330. Publish or perish.

331. - She's throwing PVCs. - Probably the tricyclics.

332. They're cardiotoxic.

333. - Who's talking? - My name is Jeanie.

334. - Where are you? - Can't you see me?

335. No.

336. You're experiencing blindness because of the methanol you ingested.

337. - Papilledema? - Yeah.

338. - Suzanne? - Yeah?

339. - Roger is on his way. - My Roger?

340. Yeah.

341. No. God.

342. What will I say?

343. I don't know. Is there anything you wanna tell him?

344. That I'm sorry.

345. Then that's what you should say.

346. - Dr. Ross. - Jerry! It's a test, not a survey.

347. Doug, got a minute?

348. These kids were going to the prom when she had a gallstone attack.

349. - No big deal. I've had them for years. - Starting early. It's barely 2:00.

350. We had a pre-prom party. Betsy's folks are out of town.

351. - Why would you tell him that? - He's a doctor.

352. - I just need antibiotics. - Let me check you out first.

353. - Let's go to Exam 1. - From now on, let me do the talking.

354. - Excuse me, Mr. Alner? - Yes.

355. - Do you want to see her? - I can see her.

356. - She's dying. - Yes.

357. - Is she in pain? - Some.

358. Good.

359. She cheated on me.

360. Got herself infected with AIDS and gave it to our baby.

361. I've been waiting for this for a long time.

362. Retract the omentum. Let's see what we've got.

363. - Is that gangrene? - From the proximal jejunum

364. to the transverse colon. If we go forward, we'll be here for hours.

365. - He won't have any small bowel left. - I think it's worth a shot.

366. What is it, Carter? He owes you money?

367. All right, let's go. Hemostat and a couple of Scudders for the bowel.

368. - What's going on in here? - What's the problem?

369. I rejected this patient as a poor surgical risk.

370. - Or didn't Dr. Carter tell you? - No, he didn't.

371. I got a 23-year jump on you, kid. You trying to outflank me?

372. - What makes you think you're superior? - I don't.

373. - I don't. I thought the patient- - This has nothing to do with him!

374. This is about the practice of medicine.

375. Interns do not make end runs on the chief of staff!

376. I want you in my office at 5:00 sharp

377. to discuss your future as a surgeon. If you have any hope

378. of continuing in this program, you'll explain your actions

379. with the appropriate degree of contrition and respect

380. and the assurance that nothing like this will ever happen again.

381. - Dr. Hicks. - Scrub out, Carter.

382. - Sign here so we can get our property. - No! I want surgery.

383. - Have you ever had an endoscopy before? - No.

384. I don't think you know what you're missing.

385. Endoscopy is an extremely traumatic and invasive procedure.

386. See, I have to stick this tube with a camera down your throat

387. root around and grab the items you've swallowed

388. and yank them up through your gullet.

389. The best thing is, you'll be conscious the whole time.

390. - You mean, I can watch? - In living color.

391. You got a call from Rachel's school. They want you to come pick her up.

392. - Someone else was supposed to. - Apparently, they didn't.

393. - They're holding. You wanna talk to them? - No. I'll...

394. Tell them I'm on my way.

395. I'll be back in 45 minutes. Don't leave her alone.

396. And don't let anybody else do the endoscopy.

397. - Who's your wife's doctor? - Janet Coburn.

398. - So why are you coming to see me? - You're the expert on fetal anomalies.

399. Since Carla has gestational diabetes, I wanted you to take a look.

400. I can tell you right now, he looks fine.

401. - No cardiac abnormalities? - No.

402. - Macrosomia? - No. How's Janet managing your wife?

403. - Through diet or insulin injections? - I'm not sure.

404. You don't know how your wife's being managed?

405. - Actually, we're not married. - But you talk to her, one would hope.

406. Well, we had a little falling out.

407. You know, I don't really know you

408. and I'm getting the feeling I'm doing something I shouldn't be.

409. And I'm starting to resent it.

410. Bad news. Your gallbladder's gonna have to come out right away.

411. - First thing tomorrow? - Right away.

412. No way. I paid $400 for that dress.

413. I'm sorry, but you're in real trouble here.

414. - Listen to him, Bets. - Shut up, Jeffrey.

415. - I'll come back right after the prom. - No, you'll get septic and die

416. by the end of the night. - I'm willing to risk it.

417. - Give me the antibiotics. - You're going to Surgery.

418. Oh, no. I'm 18 years old. I know my rights.

419. I'm walking out of here, and you can't do squat. Jeffrey, my dress.

420. - Can you be back by 10? - They crown the king and queen at 10.

421. - 10:30, then. - I could leave at 10:30.

422. - Where's the prom? - The Drake.

423. - It's halfway across town. Leave by 10. - Forget it. Jeffrey, zip me.

424. Let's go.

425. Hang on. Wait. I've got an idea.

426. - Mr. Greene. - Hi. Sorry about the mix-up.

427. - It happens. - Where's Rach?

428. She went down to the library. If you have a minute, I'd like to talk to you.

429. - Sure. - I just wanna know if there's

430. anything you need to be careful about with Rachel these days.

431. Such as?

432. - Restricted physical activities, diet? - Why?

433. - Because of her leukemia. - Leukemia? Rachel doesn't have leukemia.

434. - Where did you get that? - Rachel.

435. She told some of her classmates she's sick and not expected to live.

436. - Why would she say something like that? - Rachel's having some trouble socially.

437. - I'm sure you heard about the fight. - No.

438. It was with one of the more popular girls.

439. Since then, Rachel often winds up playing by herself.

440. Feigning an illness, I'm sure, was just a way to get attention.

441. - Hey, Rach. Ready to go? - Are we going home?

442. - I wish. Gotta get back to the hospital. - You can do your math homework.

443. - Big whoop! - Hey! Rachel, that's no way to talk to her.

444. - We'll see you tomorrow. - Say goodbye.

445. - Bye. - Bye-bye.

446. - What's the story? - Keeled over while playing cards.

447. Must have gotten a bad hand. One, two, three.

448. - BP's 80/50. Heart rate's up to 130. - You didn't start an IV?

449. - Blew two on the ride. His veins are shot. - Try a stick on the hand.

450. - I'm hearing rales. - Three-plus pitting edema.

451. - He's got congestive heart failure. - Prep Lasix and dopamine.

452. We need to get the fluid off his lungs. How's that IV coming?

453. - Forget it. His skin's like paper. - I'll do a central line. I need a kit.

454. - Any Attendings around? - Greene left, and Weaver's in Radiology.

455. - Betadine, please. - Page Weaver and call Surgery.

456. - Have them help us put in the central line. - Cancel that. I got it.

457. Give me an 8 French.

458. - Surgeons put in lines all the time. - I said, I got it.

459. - BP's down to 60. - Standing by with dopamine.

460. How long is it gonna be?

461. If you're looking for something to do, grab him a pillow.

462. I'm calling Surgery.

463. Line's in. Run the dopamine, 400 in 250. Titrate the BP to 90.

464. Hold the Lasix until his pressure is back.

465. The ambulance takes you to the dance and picks you up at 10:00 sharp.

466. - Take that. 15.

467. Ten o'clock. No dancing around, keep that IV in, nothing too wild. All right?

468. - Don't worry. - And for her

469. nothing to eat. No alcohol, no smoking. You make sure she's back by 10:30.

470. - Not a minute later. - You can count on me.

471. Bye-bye. Have fun. Be good.

472. Close the door.

473. I have never seen as devious, underhanded

474. and ultimately self-destructive a maneuver as you pulled.

475. What the hell were you thinking?

476. I thought the patient deserved a chance.

477. I had reservations about Dr. Anspaugh's assessment

478. that the patient was unstable for surgery.

479. If I were a patient, I would've liked a second opinion.

480. You led me to believe that mine was the only opinion.

481. If I'd known otherwise, it's unlikely I would've proceeded.

482. Certainly not without consulting Dr. Anspaugh first.

483. Before Dr. Hicks and I decide whether or not to terminate your Residency

484. is there anything you'd like to say? - Yes.

485. I apologize

486. for not being more forceful in making my case to you when I spoke to you.

487. And I apologize to you for not telling you about Dr. Anspaugh's assessment.

488. But I still believe we owed this patient a chance in saving his life.

489. - I'm glad we gave it to him. - Anything else?

490. - I have a question. - What?

491. Did Mr. Bartok survive the surgery?

492. Yes, he did.

493. Labs are back. BUN is 45. Creatine is 3.5.

494. - He's in renal failure. - Anyone page Weaver?

495. - I did. - BP's down to 50.

496. We gotta increase his output. Prep some Vasotec.

497. Ace inhibitors to someone in renal failure?

498. Gotta get his heart pumping. Malik, give him 1.25.

499. It'll shut his kidneys down.

500. Improving cardiac output will help his renal failure. Give the Vasotec.

501. - Want me to read the contraindications? - I can read as well as you can.

502. If we don't get his heart pumping, he's dead!

503. - It's a mistake. - Load the Vasotec.

504. What's going on?

505. Patient is in congestive heart failure and renal failure. BP's crashing.

506. I've ordered 1.25 of Vasotec, but I can't convince the nurses to do it.

507. - Give it to him to get his heart going. - What about his kidneys?

508. Gotta get the heart going first.

509. Where is she? Why didn't you tell me?

510. - Still hanging on? - She's delirious.

511. From what?

512. From organophosphates, methanol, tricyclics. Take your pick.

513. - BP's falling. She's getting shocky. - Better get Kerry.

514. Looks like impending respiratory failure. You may need to intubate.

515. Roger, is that you?

516. She's blind from the methanol.

517. - Roger, I'm sorry. - She thinks you're her husband.

518. Roger, I'm sorry. Forgive me.

519. - Roger's not here. - Please forgive me, Roger.

520. Please. Please, Roger. Please forgive me.

521. - Just say it. - What?

522. - Tell her you forgive her. - Please. Please.

523. - It's not my place to do that. - Just say it. Greg, say it.

524. - Just say it. - Please.

525. - It's okay. - What's her rate?

526. - 140. - Let's tube her.

527. Roger!

528. Hold her.

529. - Hold her. - It's okay, sweetheart.

530. It's okay, sweetheart. It's okay.

531. Seeing as the test was multiple choice with a possible five answers

532. you could guess randomly and expect to score 20 percent. You got 15.

533. - Your days as a sperm donor are over. - But I was nervous.

534. - I don't perform under pressure. - You wanna call, or should I?

535. - Kerry, I'm back on. - Hey, Rachel.

536. Mark.

537. One of your patients, Mrs. Blinnder, was complaining of abdominal pains.

538. I had to scope out her stomach. I believe this is yours.

539. Thank you.

540. I'm thinking we could coauthor an article about her and send it out to the journals.

541. I've even got a title: "The Woman Who Ate the ER. "

542. Great.

543. Fifty-seven, 58, 59, 60, 61-

544. - What's your problem? - Excuse me?

545. The attitude.

546. What are you talking about?

547. You second-guess me, give me a hard time.

548. - What is going on? - Nothing's going on.

549. Don't ever disregard my orders like you did in that trauma.

550. I may be younger than you, but I am the doctor and you are the nurse.

551. Keep that straight.

552. Sweetheart, you gotta do your homework before you watch TV.

553. - I don't want to. - Those are the rules.

554. - Can you help me? - I gotta help some sick people.

555. You're always taking care of sick people.

556. Rach.

557. Mrs. Hilderbrand said you told your friends at school that you were sick. Is that true?

558. - They're not my friends. - You want them to be nice to you?

559. Quality Assurance would like you to finish these charts by 6.

560. Just leave them.

561. People won't like you because you're sick.

562. You help people who are sick.

563. You don't have to be sick for me to love you.

564. I love you more than anything in the world. You know that.

565. - Dr. Anspaugh is on the phone for you. - I'll call him back.

566. - No, wait. I gotta take this. - Please, Daddy!

567. Rachel, I have to do this, okay?

568. We'll talk more when we get home.

569. I'm sorry. I wasn't comfortable pretending to be her husband.

570. You don't have to apologize.

571. It's getting late. If you still wanna go to the lake, we need to leave soon.

572. - I don't think so. - Because of what happened with her?

573. No. I don't know.

574. - I guess I'm not ready. - Okay.

575. No problem. If...

576. Call me if you wanna get together this weekend.

577. - How did it go? - Not bad.

578. We removed most of your small intestine.

579. I'm afraid you're not gonna be able to eat solid food again.

580. - Can I drink? - Yeah, actually.

581. - Smoke? - If you must.

582. I'll be fine.

583. Your daughter is flying in tonight.

584. - Goosebumps. - You want me to get you a blanket?

585. Goosebumps, our horse. How did she do?

586. Oh, I don't know.

587. Never mind.

588. - Would you call the morgue? - I already did.

589. - Who put those here? - I did.

590. Somebody threw them in the trash. They're perfectly fine.

591. Yes, this is Dr. McGrath speaking.

592. - Tuesday at 3 would be splendid. - Go for it, dude.

593. - Who's there? - Hey, it's me. Peter.

594. Peter who?

595. Very funny, Carla.

596. What do you want, Peter?

597. I wanna know how you and the baby are doing.

598. We're fine. See you.

599. Carla!

600. I know things haven't been right between us.

601. But I'm here, and I'm trying to do the right thing.

602. I wanna support you through this. I wanna be a father to my kid.

603. Carla. Excuse me, could you hold that door, please?

604. Thank you.

605. Come by Saturday morning. I could use some help around the house.

606. All right, I'll be here.

607. - Hey. - Hey. You know what I hate?

608. - Maggie Doyle? - I don't hate her. I hate that she's right.

609. - She's younger than me. - Yes, you're right. She is.

610. We grew up in the same neighborhood, and I gotta take orders from her.

611. - You're a very competitive person. - I can't help it.

612. She got through medical school, and I can't even get through the door.

613. - You can get through my door. - Anything in a bra can do that.

614. No, I've reformed. Ask anyone.

615. All right, kids. Right on time.

616. She wanted to stay for the Best Dressed Contest, but I said, "No, Bets.

617. - Your surgery is more important. " - Good man, Jeff.

618. Thanks, Dr. Ross. This was the best night of my life.

619. Me too.

620. - I gotta go. - Good night.

621. - which means if you live close to a river, you need to keep a close eye on this.

622. Rach, come on. It's time to go home.

623. - I'm tired. - I know, sweetheart. It's late.

624. - Can you carry me? - Y eah. Sure. Grab on.

625. We got a great case here, a guy with Takayasu's Arteritis

626. on a dual-chamber pacemaker. Make a good article.

627. Tell Kerry to take it. I'm going home.

628. Carter, you're on probation, but you're still in the program.

629. - Thank you. - Thank Anspaugh. I wanted you out.

630. John Carter's not a law unto himself. I hope you've learned that.

631. You won't get another chance.

632. - Hi. - Hi.

633. - Can I come in? - Sure, come in.

634. - I was just finishing dinner. Hungry? - No, thanks.

635. So

636. you haven't been here. What do you think?

637. Honestly, I'm glad I got the house.

638. - I'm sorry about this morning. - You did a nice thing. I was rude.

639. I'm the one who should apologize.

640. It's okay.

641. You don't really think our marriage was a disaster from start to finish, do you?

642. We had a good beginning.

643. - The middle wasn't bad. - Yeah, we had a pretty good middle.

644. The end was my fault.

645. When I think about it, I don't blame you for hating me.

646. I don't hate you.

647. I don't wanna be angry anymore. I don't wanna be that kind of person.

648. I never meant to hurt you.

649. Hey...

650. Come on. No tears, okay? Because I'll start going.

651. I've missed you.

652. I miss you.