ER 7x1

1. Previously on ER…

2. There's a drug rehab center in Atlanta,

3. that specializes in treating doctors with addiction.

4. Forget it.

5. - This is your only chance, Carter. - All right, I quit.

6. You'll end up like your cousin, some babbling gork in a nursing home.

7. It's all right, man.

8. - Hi. - Name?

9. Dr. Carter. Somebody should have called ahead.

10. Okay. All the information is confidential, and you can have a seat over there.

11. - Thank you. - Mmm-hmm.

12. Ninety days? This is a three-month program?

13. Yeah, I guess so.

14. Can you send me some clothes or do they issue prison garb here?

15. - You okay? - This pen doesn't work.

16. Do you have a pen?

17. - He's diaphoretic. - We'll take care of it.

18. - When? - Soon.

19. - He's got tremors. He needs something. - You should go now.

20. What?

21. It's important that he checks himself in.

22. - Right. - Mmm-hmm.

23. Here.

24. You, uh… You good from here?

25. Yeah, I guess so.

26. Carter, you can do this.

27. Hey, you got any Compazine?

28. I'll give you some after group, if you're still nauseous.

29. - "Group"? - Yeah. Group therapy.

30. - When is that? - Now.

31. In the middle of the night?

32. The entire group meets whenever a new patient arrives.

33. - Ready? - No, I need to lie down.

34. - You'll make it. - Group therapy is not what I need now.

35. If you want to be in the program, do the program.

36. Otherwise, you can leave.

37. And when you want a fix, you can score down on 10th and Piedmont.

38. Which is six blocks down, one block over. Those guys are out there all night.

39. John Carter?

40. Yes.

41. Security! Security!

42. - Put the needle down! - No needles!

43. - I told you to put him in restraints. - I did.

44. - Lily, could you get extra security? - On their way.

45. Give him Haldol!

46. - The toilet's clogged. - So unclog it.

47. No plunger. Maintenance closet's locked.

48. Hey, Malucci. What is Mr. Hunter still doing out here?

49. Transpo's backed up.

50. Half their guys staged a sympathy stakeout to support the janitors.

51. Then you take him down there yourself.

52. Why can't we just give these guys their raise?

53. Yeah, I'll recommend you for the negotiating committee.

54. What about the maintenance closet?

55. I don't know, Malik. Pick the lock. Take a fire ax to it. I really don't care.

56. Oh, my God. Can somebody please put Mr. Spencer in an Exam Room?

57. - Excuse me. Excuse me. - What?

58. We've been waiting here for a while.

59. - Shouldn't we be doing something? - Any plumbing experience?

60. What happened?

61. You know what, Mark, just don't start with me, okay?

62. - Custodial staff is on strike. - So they had to destroy the admit desk?

63. This is a remodel. Open floor plan. It's supposed to be safer.

64. - I've scratched myself on a nail twice. - Make sure you update your tetanus.

65. - Where are my fans? - Working on it.

66. What's the deal?

67. I don't know. The construction workers won't cross the picket line.

68. Oh, you mean those three guys I saw out there with signs?

69. - Mark, how was your vacation? - It was good.

70. - Go anywhere? - Wisconsin Dells. Camping.

71. I just drove back this morning.

72. - Where's the board supposed to go? - Don't ask.

73. They weren't supposed to take out this wall.

74. And we're not supposed to talk about it.

75. - Cleo, you got that covered? - Yeah.

76. - I hate needles! - Hi, Dr. Greene.

77. Hey, hi.

78. Is it me, or do those med students look like 12-year-olds?

79. - How long they been waiting? - Three hours.

80. - Two and a half. - I'll take them.

81. Be my guest. But make sure you see some patients.

82. - Malik? - What?

83. Malik.

84. Strong, steady heartbeat. The amount of amniotic fluid is normal.

85. Everything looks fine.

86. I've got a good angle here if you wanna know the sex.

87. Sure.

88. You are having a boy.

89. Congratulations.

90. Thank you.

91. Your blood-sugar level is normal. But you're a little anemic.

92. - You taking any iron? - Yes.

93. You arrange with Kerry to take some time off after the baby's born?

94. Oh, um, no, not yet.

95. You still have time.

96. Actually, I haven't told anyone yet.

97. I think you may want to.

98. I don't see how you can keep this a secret much longer.

99. Yeah.

100. So, what are you supposed to talk about in an exit interview anyway?

101. - That you don't have all the answers. - No argument there.

102. You scared?

103. I don't remember the last time I wasn't scared.

104. Good.

105. What, that's it? "Be afraid. Be very afraid"?

106. We're like the Army, okay? We break you down,

107. make you face your addiction, then we build you up.

108. You start to function. Feel healthy, confident.

109. Don't worry. Pride's what got me into this.

110. Yeah. And deep down, you feel like this is something that just happened to you.

111. No, I took responsibility. I take responsibility.

112. But I'm gonna get my life back. It's not gonna beat me.

113. Yeah, that's what I thought. First three times.

114. But I hope you do.

115. Day or night. If you ever need to talk.

116. - Are we done? - You're just getting started.

117. Is this where I'm supposed to say thank you?

118. - Some people do. - Thank you.

119. You're welcome.

120. - Someone's still on vacation time I see. - Sorry.

121. Peter was just helping me hang this straight. How's that?

122. Great.

123. - Did you finish the interview? - We're just getting there.

124. Okay, so where were we before we left off last time?

125. You were just about to give me the job.

126. Developing a sense of humor, Peter? That's progress. You get points for that.

127. Uh, why don't we discuss faculty responsibilities?

128. Peter, as an attending, you'd be responsible

129. for supervising resident research.

130. - I look forward to that. - Liar.

131. - I like working with residents. - You mean you like abusing them.

132. You don't have the best track record in the research department.

133. - That can change. - Uh-huh. Where else have you applied?

134. - What? - Where else did you apply?

135. You can't ask me that.

136. Oh, no. Someone call the interview police.

137. Has anyone offered you anything?

138. You're not supposed to ask me that either.

139. Come on, Peter. It's a simple question.

140. I've looked elsewhere as a backup.

141. But I'd like to stay here as an attending.

142. Okay. Was that so difficult? Elizabeth, what are you doing?

143. Uh, my hands itch for some reason.

144. Well, cut it out. It's distracting.

145. Linear vesicles. Probably a phytodermatitis.

146. Are you allergic to any plants?

147. - I don't think so. - You have a garden?

148. I went camping.

149. Tell me you know what poison ivy looks like.

150. Poison ivy? Is that in Wisconsin?

151. Oh, boy. Sorry, Peter, I gotta run.

152. - We'll have to finish this later. - When?

153. Uh, my office will reschedule. Good luck with that, Lizzie.

154. He's never gonna give me this job.

155. Of course he will. He's just being Robert.

156. Don't scratch. You should put some hydrocortisone TID on it.

157. If it gets any worse, get a shot of steroids.

158. It won't spread, will it?

159. Well, that depends on what you touched last

160. before you washed your hands.

161. Oh, dear.

162. These are your orientation packets.

163. Why don't you guys have a seat over there and read them over, okay?

164. Then we'll give you the tour.

165. We'll go over charts, order sheets and discharge instructions.

166. Any questions?

167. Remember, you're students. The only stupid question is the one you don't ask.

168. - Dr. Greene? Well, I have a question. - What?

169. Something wrong with the Australian boys?

170. - Who? - You're scratching "down under."

171. Oh, yeah. Doesn't make a good first impression.

172. - Pickman, what do you got? - Mike Palmieri, 17. Wide receiver.

173. Got hi-lowed in midair. Brief LOC. Complains of neck and chest pains.

174. Can he move extremities?

175. Yeah but because of the numbness in the hands,

176. we didn't want to take the helmet off.

177. Hey, Malucci, I got it. Why don't you give the med students the tour?

178. - I gave it last rotation. - Then you're getting good at it.

179. Okay, Mike, I'm Dr. Greene. Can you squeeze both my hands?

180. - My neck's not broken, is it? - Now we're gonna check you out.

181. - Mike, does your chest hurt? - A little.

182. The safety speared me with his helmet on the way down.

183. - He's tachy at 120. BP's 110/68. - Good breath sounds bilaterally.

184. It's illegal. Second play of the game.

185. - Let's get him on a pulse ox. - They were looking to take me out.

186. - Who's that? The other team? - They're our rivals.

187. - It's their homecoming. - You want to push any drugs?

188. Sure. One amp of epi and a mg of atropine.

189. Does she have a pulse?

190. - Oh, she's dead. - I know.

191. Like, blue dead.

192. - Pulse ox, 65. - That's because she's dead.

193. Her husband drove her in.

194. - Oh. Right. - Luka, you okay in here?

195. - Yeah, I've got it, Kerry. - Still asystole.

196. As long as we're faking it, can one of the med students practice CPR?

197. No. Go outside and tell him we are doing everything we can

198. - but that his wife is very sick. - She can't get any sicker.

199. Malucci, please. Go on.

200. Go on. Give the poor man some time to prepare himself.

201. No problem, chief. I can act with the best of them. Watch this.

202. Still flat line. Want to do a fluid bolus?

203. No, that's okay.

204. - Abby? Abby! - Yeah?

205. The registrar didn't put your name on my roster.

206. - You sure you're back on ER rotation? - That's what my schedule says.

207. Okay. They must be backed up because of the strike.

208. - Checking out? - Yeah.

209. Dr. Benton called to confirm your flight and said he'd pick you up at the gate.

210. Thanks.

211. - Goodbye, Margaret. - Good luck, Dr. Carter.

212. Where did he go?

213. He was in the hallway with Malucci a minute ago.

214. Here's her medication. I forgot it in the car.

215. She's on Elavil, and codeine for arthritis.

216. Have a seat, Mr. Bristo.

217. You don't need these?

218. Mr. Bristo, your wife has suffered a massive heart attack.

219. We exhausted all medical resources available to us.

220. But the damage to her heart was beyond our capabilities to save her.

221. She died, Mr. Bristo. I'm sorry.

222. You see? I should have called the ambulance sooner.

223. I should have gotten her here quicker.

224. There's nothing you could have done differently that would have saved her.

225. It was just her time. Would you like to see her?

226. Okay.

227. How was I supposed to know?

228. - Excuse us. - Sorry.

229. Haven't you ever heard of "leaves of three, let it be"?

230. What?

231. "Leaves of three, let it be." As in, don't touch.

232. Sorry. We don't have poison ivy in England.

233. "Leaves of three" or any other kind.

234. - Oh, man. - Let me see.

235. - No, no. - Mark, don't be shy.

236. - You've done enough damage. - Well, do you have it?

237. Yes, I have it.

238. Who picks poison ivy?

239. I was making a wildflower bouquet.

240. - C-spine's back on the football player. - Thanks.

241. When you went skinny-dipping in the lake, I got bored.

242. You remember what happened after you got out of the water?

243. - Yeah. It's a big price to pay. - Mark.

244. I have to start worrying about where you've been?

245. - It's not that horrible. - You've only got it on your hands.

246. - Mike, X-ray is normal. - His mom's here, out in Chairs.

247. Okay. Why don't you get off the helmet and pads and I'll be right back?

248. - Does that mean I can go? - Not yet.

249. So, do you want the cream or the shot?

250. - Probably both. - Fine. I'll get them.

251. - Mrs. Palmieri? - Yes?

252. Hi. I'm Dr. Mark Greene. Good news.

253. Mike's neck X-ray came back normal. No fractures or swelling.

254. Why were his hands numb?

255. He was probably hyperventilating. That can cause numbness.

256. But no nerve damage?

257. No. No broken bones, no spinal-cord injury, no paralysis.

258. Thank you. Thank you. Can I see him?

259. Sure. Here you go.

260. - What's your name again? - Priya Shailendra.

261. Priya, do you remember where Trauma 1 is?

262. I think so.

263. - Could you take Mrs. Palmieri? - Certainly.

264. This way, please.

265. - Malucci? - Hey, Dr. Greene. How's that jock itch?

266. I thought I told you to supervise the med students.

267. You told me to give them the tour. I did.

268. Well, why don't you show them the charting system?

269. - I'm juggling eight patients here. - Have them help you.

270. Hold this.

271. Hey, Cleo. You're up with the med students.

272. - Says who? - Dr. Greene.

273. Then Dr. Greene can ask me.

274. It's not infected, Mr. Fletcher, but I'm gonna have to débride it again.

275. No. Leave it alone.

276. I would if you changed the dressing four times a day like I told you.

277. I'm not a damn nurse.

278. - How'd it go? - It didn't. Romano postponed.

279. - Again? What's wrong with him? - He's a maniacal sadist.

280. - What did you call me? - Not you, Mr. Fletcher.

281. Is this machine working? I feel like I'm drowning.

282. It takes longer when you're fluid-overloaded.

283. This happens when you're three days late for dialysis.

284. I told you my son didn't have time to drive me to the clinic.

285. What's wrong with this picture?

286. Those med students. Not a black face in the bunch.

287. That doesn't concern you?

288. I see five. Not exactly a representative sample.

289. - Glad you take such an active interest. - Ow!

290. You're gonna have to hold your foot still, Mr. Fletcher.

291. She your wife?

292. Hmm? No. No, no, no, no.

293. - She talk like she your wife. - Yes, yes, yes, yes, yes.

294. Brought you a chair, Mr. Bristo.

295. Someone will be by to take her downstairs but it could take a while.

296. Do you have a funeral home you'd like to use? I could call them.

297. We have two plots. But Florence took care of it. I forget the name.

298. Okay, well, if you remember.

299. - Can I stay with her? - As long as you like.

300. It was very decent of you to work on his wife like that.

301. Part of the job.

302. Well, no. I mean, he's really shaken.

303. It could be worse if he thought he was responsible.

304. He does. He's alive, she's not.

305. - Wonder how long they were married. - I don't know. Forever, probably.

306. - How long have you? - What?

307. - Been married. - I'm not.

308. I thought someone told me you were married.

309. I was. But my divorce became final last month.

310. - Sorry. - Don't be. I'm not.

311. - Lockhart, is that your name or his? - It's his. But I'm keeping it

312. because it's the only good thing I got out of the whole mess.

313. - Why? What was your name before? - Wyczenski.

314. Right. Lockhart is better.

315. - Have you seen Dr. Greene? - Suture Room, I think.

316. - Oh, Dr. Weaver's looking for you. - Me?

317. Yeah.

318. Dr. Greene… Sorry. Sorry.

319. - That's okay, Haleh. Just getting a shot. - I didn't say anything.

320. What's up?

321. Oh, Mike Palmieri is having trouble breathing.

322. Complained of chest pains when we removed the pads.

323. All right. I'll be right there.

324. - You done? - All done.

325. - Keep laughing, flower girl. - You're welcome.

326. Thanks a lot.

327. - Mike, how's your breathing? - A little sore.

328. Okay. Tell me if this hurts.

329. BP's stable. 115/70. Satting at 98.

330. - There. - Okay. Any belly pain?

331. - No. - Are you sure?

332. - A little. - Okay.

333. Haleh, book a CT. And let's sit him up.

334. - Where's your mom, Mike? - She went to check on the score for me.

335. If we're losing, I need to get back.

336. We need to take another picture of your chest and belly

337. - just to make sure everything's okay. - How long does that take?

338. Relax, Mike. You're gonna be with us for a while.

339. - Mrs. Palmieri? - What happened?

340. Nothing serious. Mike might have a broken rib.

341. And I need a CAT scan, just to make sure that it didn't nick his liver.

342. His liver? What does that mean?

343. Well, it all depends. But it's really a remote possibility.

344. I just want to make sure.

345. I knew something like this was gonna happen.

346. I hate that he plays football. I hate it.

347. But it keeps his grades up. He's not a great student

348. but he has to keep good grades to play, so I let him play.

349. I'm sure everything is gonna be just fine, okay?

350. I'll check back with you after the scan.

351. Chen?

352. - Chen! - Yes.

353. - You okay? - Uh, yeah. Great.

354. Can you find Dr. Corday and have her meet me in CT?

355. - Uh-huh. No problem. - BP, 136/88. Pulse, 125.

356. They nailed me after the play. The refs didn't even call it.

357. Draw up some Demerol. Open tibial fracture.

358. Titrate 100, slow IV push.

359. 55. That's the number of the guy who hit Mike.

360. - It was a clean hit. - GSW on the way. Crashing in the rig.

361. Frank. What's open?

362. Stiff in Trauma 2. Other than that, we're booked.

363. - Clear it. Take this guy. - Got it.

364. You led with your helmet. You're not supposed to lead with your helmet!

365. Ma'am, you have to wait back in Chairs.

366. - It was an accident. - It was a cheap shot.

367. What do you call breaking my leg on purpose?

368. Payback!

369. Thank you.

370. Sir? Sir?

371. - Oh, thank you. - Can I get a gin and tonic, please?

372. - Anything for you, sir? - No, thank you.

373. From Atlanta or Chicago?

374. Uh, Chicago.

375. - Atlanta on business? - No.

376. Vacation?

377. I was just visiting a friend.

378. - So, what do you do for a living? - I'm a teacher. High school English.

379. Wow. And you fly first class, huh?

380. They must pay teachers pretty well in Chicago, huh?

381. Excuse me.

382. Mr. Bristo?

383. They needed the room.

384. Oh, okay. Well, don't worry. We'll find her another room.

385. - Are they coming to get her? - Yeah. Soon. They're coming soon.

386. - Lost the pulse! - Starting compressions.

387. What's on the monitor?

388. - P.E.A. - Epi. Squeeze in the blood.

389. Dr. Weaver, Malucci has an assaulted cheerleader coming. Bat to the face.

390. - Okay. Get Mark. - He's in CT.

391. Got a pulse.

392. Increase dopamine. Get him up to the O.R.

393. You finished in the Trauma Room?

394. Yeah. Abby, I'm glad I saw you. I need to talk to you.

395. Somebody find Kovac, please!

396. This man's wife died. We told him he could wait until Transpo picks her up.

397. We'll lean on them. I checked with the medical-school registrar…

398. - and they… - Out of the way!

399. - Retracted your clerkship… - What?

400. Is that from the football game too?

401. Yeah, someone jumped her in the bathroom.

402. - Dr. Weaver? - Something about delinquent tuition.

403. My ex-husband was supposed to pay that. I apologize.

404. - No need to apologize. - I'll get it paid by tomorrow.

405. Abby, you don't understand. You need to go home.

406. - You're not covered to work. - I'll work it out with the registrar…

407. Once a clerkship is pulled, it's pulled.

408. Nothing I can do. You have to wait till the next academic quarter.

409. - In three months? - Sorry. Dean's decision.

410. - We got a blown pupil! - Turn in your lab coat and ID to Frank.

411. Heart rate's dropping. Okay! Prep for an intubation.

412. Hang the mannitol. 40 of Lasix. She needs a Foley.

413. Give me some gloves, somebody! Move!

414. Pressure's sky-high. 180/120.

415. Bolus her with 100 of lidocaine, 75 of sux…

416. - What's this for? - Whoa. Whoa.

417. Sorry. Sorry.

418. Abby, what's wrong? Abby?

419. Abby?

420. - You got cleaned up. Looks good. - Thank you.

421. I'd choose the fish if I were you. The steak looks, "Ugh."

422. I'm not hungry.

423. Excuse me, Dr. Carter. Were you smoking in the lavatory?

424. Yes.

425. Then you're in violation of federal law, punishable by a $2000 fine

426. and imprisonment.

427. Do I need to have the marshals meet us at the gate?

428. No. It won't happen again.

429. Do you have the butt with you?

430. All right then.

431. Doctor, huh?

432. Mrs. Palmieri?

433. What is it?

434. Apparently, the blow to Michael's chest caused a little internal bleeding.

435. Some of it in the sac surrounding his heart.

436. - Oh, God. That sounds serious. - It can be

437. but right now there's only a small amount. But we need to operate…

438. to drain the blood before it restricts function.

439. Open-heart surgery?

440. No. We go through the upper abdomen, very small incision.

441. It's a really simple procedure. I just need you to…

442. - Now? - I just need you to sign the consent.

443. You're gonna do the surgery now?

444. Right now Mike's blood pressure is stable, which is a good sign.

445. But more blood could accumulate. We need to do the operation immediately

446. to avoid an emergency procedure down here.

447. You just need one signature, right?

448. I… I couldn't find his father if I wanted to.

449. - One is enough. - All right.

450. - What's the emergency? I'm here. - I didn't call you.

451. Robert.

452. If you're gonna leave messages with my assistant, don't also page me.

453. It gets annoyingly redundant after a while.

454. Sorry to inconvenience you, Robert, but we have a real crisis down here.

455. - Yeah? And? - And it's become a health hazard.

456. If somebody calls the county, we'll be fined.

457. But someone's not going to call the county, is she?

458. Look Robert, housekeeping won't clean any sheets or towels.

459. I need the nurses here.

460. It's not their job anyway to be doing…

461. What do you want me to say? Troubleshoot. It's being a manager.

462. You need to end this strike, Robert.

463. You find me the half-million-a-year it'll take to meet their demands.

464. I'll be happy to do that.

465. - Peter, keeping banker's hours? - I've been on since 5.

466. - Well, you got a sec? - I gotta go pick up somebody…

467. - No, no, come on. Let's finish this. - What?

468. - The interview. Walk with me. - What about Elizabeth?

469. Well, I let her sit in to make her feel important. But it's my decision.

470. Let's talk turkey. I know you've got the surgical skills. I don't question that.

471. - I do, however, question your loyalty. - My loyalty lies with my patients.

472. As it should. But… And don't take this the wrong way, Peter.

473. You have a real propensity for being a pain in the ass.

474. I'm not gonna jump you, you homophobe.

475. - Damn janitors! - You should try paying them.

476. You see? You see, now, that's exactly my point.

477. Instead of trying to understand my problems,

478. you immediately champion the opposition.

479. - The janitors? - Yeah, whoever. Peter, look.

480. If I'm gonna give you a faculty position, I've gotta be sure

481. you're gonna be part of the team. Specifically, my team.

482. - Of course. - Of course what?

483. Of course I'll be a part of the team.

484. Then I can expect your full commitment? No whining, no complaining,

485. no excuses about your kid or your cat or whatever?

486. - I don't have a cat. - Splendid. You're hired.

487. Congratulations. You are a free man, delivered from the shackles

488. of your residency and fellowship.

489. You're gonna have to dry your hands first.

490. Yeah, right.

491. Oh, well. Wasn't me.

492. You selfish son of a bitch.

493. - Well, hello, Abby. - Is this fun for you?

494. Or is it like an addiction? Do you wake up in the morning thinking,

495. "How am I gonna screw Abby today?"

496. Okay. What's the problem?

497. My problem is, I just lost three months of med school.

498. Three months I can't make up…

499. Three months that put me exactly one year behind on my residency.

500. - This is about your tuition. - Yes, it's about my tuition.

501. Will you calm down? I was gonna call you.

502. The IRS disallowed our '97 home-office deduction.

503. I don't want to hear one more lie or lame excuse out of your…

504. They called the IRS. They were gonna hit us with a huge penalty.

505. This was important to me. And you knew it, so you ruined it.

506. Can you be a little more dramatic?

507. I put you through med school. You were gonna put me…

508. I did not say that.

509. You did not put me through med school. My student loans did.

510. - I only fed, clothed, sheltered you. - Loans I'm still paying, along with

511. a house, your condo and two cars.

512. Don't forget the apartment for the whore.

513. I assume you're cheating on the whore with another whore.

514. - All right, just stop it. - No, you stop it.

515. Haven't you done enough already?

516. I didn't make you unhappy, depressed and miserable.

517. You did that all by yourself.

518. - Screw you, Richard. - Right. Screw me.

519. - That's right. Screw you. - Screw me.

520. Screw you!

521. You're the one who decided you wanted more.

522. You're a manipulative, cheating, spineless…

523. - You decided to change your life. - Spiteful ass!

524. - Are you done? - No.

525. You're in violation of our divorce agreement. I am hiring a lawyer

526. and I am getting my tuition money.

527. Hell, Abby, do me a favor.

528. Why don't you take it all? Take the debt with it.

529. Shut up, jag-off.

530. - Hey, Nat. - Hey, Dr. Benton.

531. - Still plugging away, huh? - You know it.

532. - What are you doing? - Go around the other way, would you?

533. - Yeah. Nat, I'm late, man. - The news is here.

534. - All right, brother. Good luck. - Thanks.

535. Chen?

536. I'm on break.

537. Right.

538. You all right?

539. Yeah. Yeah.

540. Peter, good, you're still here. We got a mass "cas" coming in.

541. - Riot at a high school football game. - I was just leaving to pick up someone.

542. Not anymore.

543. Blunt abdominal trauma. BP's low at 90 palp. Give two liters of saline.

544. - What happened? - Bleachers fell.

545. Give two units O-neg. Draw pre-op labs.

546. - Ultrasound? - You bet.

547. Also, I want you to page me if anything changes. All right, go.

548. Drop an NG, check his urine, shoot a chest and pelvis.

549. Sorry.

550. The game was too ugly. Refs called it before the end.

551. And everybody just started swinging.

552. - You okay, Cleo? - Yeah.

553. Doc. They need you. Damn kids jumped a teacher in the parking lot.

554. Head trauma, maybe a collapsed lung.

555. Short of breath. BP, 110/70. Pulse, 120.

556. - Mitch, do you have pain in your chest? - It hurts.

557. Titrate another six of morphine. Page Ortho and Vascular.

558. Elizabeth, what are you doing here? I thought you'd be operating.

559. Mitch, is that you? What happened?

560. They're backed up. Rooms are empty but filthy because of this work stoppage.

561. - Really? - You doing okay?

562. - They got to operate. But who won? - Where are we going?

563. Nobody.

564. Try an Exam Room. Get an EKG, chest X-ray

565. and find me when the femur film's up. How long before you get into O.R.?

566. I don't know.

567. The nurses are cleaning but there's a leaking triple-A going first.

568. We're gonna keep him down here and do a pericardiocentesis.

569. All this so housekeeping doesn't get an extra dollar an hour.

570. - I don't need the operation anymore? - You just have to wait a little longer.

571. Hang in there, Mike.

572. You chucked my guy with your helmet. Don't whine.

573. - Hold still. - You did it on purpose.

574. - You want some more? - Hold still or I'll put you in restraints.

575. - What did they hit you with? - The pavement.

576. - Frank. Frank, what's open? - Nothing. Nothing's open.

577. I can't believe this. I mean, it's just a game.

578. Is the nurse taking me up?

579. We're gonna have to drain some of the blood down here.

580. You said he was going to Surgery.

581. But it can take a while to prep and drape and anesthetize him.

582. His cardiac echo shows the effusion's grown…

583. Crush injury at 70 palp, despite a fluid bolus.

584. - Respiratory status? - Intubated for agonal respirations.

585. Two units of O-neg on the rapid infuser. Set up a supraumbilical peritoneal lavage.

586. I'm never gonna get out of here.

587. - Pulse 140. Satted at 92. - Hey, med student, what's your name?

588. - Ryan Bradford. - Ryan, get over here. I need your help.

589. That's not so bad.

590. This is the little needle to numb you for the big needle.

591. - But you're a tough guy. You can take it. - BP's 90.

592. - I can't believe all this started over me. - You're a popular guy.

593. He looks so pale.

594. Mrs. Palmieri, perhaps you should wait outside during the actual procedure.

595. - I can't stay? - I'm okay, Mom. Just a little tired.

596. - Haleh? - This way, ma'am.

597. - I love you. - I love you too, Mom.

598. Alligator clip.

599. He's in tamponade, Mark.

600. I know. Mike, how are you feeling?

601. Pulse ox down to 78.

602. Mike?

603. Mike? Mike, open your eyes.

604. 8-0 ET tube. I'll intubate.

605. - He's still breathing. - Not for long.

606. - Just keep an eye on the injury current. - Just get that needle in.

607. Dr. Carter? Are you Dr. Carter?

608. - Yeah. - I'm Ryan Bradford. I'm a third-year.

609. The ER got slammed and Dr. Benton asked me to come pick you up.

610. - Oh. Great. - Need a hand with that?

611. - No, no. I got it. - Okay. Right this way.

612. - Where you going? - Pre-op. He needs an ex-lap.

613. - No, no, no. There's no room. - He's stable. He can wait upstairs.

614. - What's his BP? - BP's 140/60.

615. - All right. Grab the head injury in 3. - Malik. You got this?

616. Yeah, I got it. Go on.

617. Hey, sir?

618. Sir, are you all right? Sir?

619. Malik. I need a gurney now.

620. Oh, my God. Malik.

621. - Hey, you. Come here. - What'd I do?

622. Help me move this man. Now. Come on.

623. Sats are up to 92. You want me to try?

624. No. He has weird anatomy. I have to go more anterior.

625. I should be there.

626. - Run of five. Pull back. - Pressure's dropping down to 70.

627. Give him another liter of saline.

628. Look at the monitor. Profound ST elevation.

629. - Damn it. He's having an MI. - More PVCs.

630. A hundred of lidocaine. You must have transected the coronary artery.

631. No, no, no, no, no.

632. It's a known complication. You went in blind. Prep the chest.

633. - He should be upstairs right now. - Mark.

634. Thoracotomy tray.

635. What happened?

636. He swallowed a whole pharmacy in the hall.

637. I found empty bottles of Elavil, codeine and lorazepam.

638. - Did you give him Narcan? - Yeah. Two mgs times two.

639. Sats are dropping. Resps eight and shallow.

640. Add an amp of bicarb. Chem-7, CBC and a tox screen.

641. - Yeah, I'm in. Who's Florence? - What?

642. Well, the pills say "Florence."

643. His wife. She died this afternoon.

644. Pericardium's tight as a drum. Metz.

645. - Okay. Start internal compressions. - Need suction in here.

646. We've got a crowd.

647. Someone close the blinds. Can you see anything?

648. Sponge stick.

649. Right there. Laceration of the L.A.D.

650. Can you repair it? Not without bypass.

651. You got to do something. I am not losing him.

652. Right. Open some sterile IV tubing.

653. The blinds, now.

654. I don't know how you guys do it every day. It's pretty intense.

655. You sure get to do a lot. You know, you just jump right in.

656. I was interested in surgery. But I don't know.

657. Maybe the ER's my thing.

658. I guess if today's any indication, there's never a dull moment, huh?

659. Yeah, right.

660. Tubing's in. There.

661. Hold compressions.

662. - He's in V-fib. - Charge internal paddles to 15.

663. Charging.

664. Clear.

665. Still in V-fib.

666. Charge to 30.

667. Haleh.

668. Clear.

669. - Another amp of epi. - Charge again.

670. 50 of lidocaine. Start a drip at two per minute.

671. Clear!

672. - Still in Torsade. - Three-sixty. Magnesium on board?

673. That's four grams. Isuprel's pouring in.

674. Clear.

675. Asystole.

676. It's the tricyclics. We'll never get a rhythm back.

677. Maybe we could try overdrive pacing.

678. No. He's been down too long.

679. That's it. Time of death, 19:54.

680. Take him downstairs. Make sure he's put beside his wife.

681. You guys done? I've got a stab wound to the thigh.

682. Yeah, we are done.

683. Come on, Mike. Come on.

684. - How many units of blood? - Six so far.

685. The heart's filling well. He's not hypovolemic.

686. - When was the last epi? - Three minutes.

687. - He's had two of atropine? - Both amps are in.

688. Someone should prep the mother.

689. - Dopamine's wide open? - For the last five minutes.

690. - Son of a bitch. - Mark.

691. Let's keep going.

692. You want me to talk to her?

693. No. I should do it.

694. Chen.

695. Can you come take over chest compressions?

696. Okay. Let's go again with the paddles.

697. Charge to 30.

698. Clear.

699. - Hey, man, what's going on? - Is he dying?

700. What's happening to him? Hey, come on.

701. He's our friend.

702. Someone said you had to shock him. Is that true?

703. We've had some complications.

704. What kind of complications?

705. The needle poked a hole in the artery

706. that supplies the blood and oxygen to Mike's heart

707. which caused him to have a heart attack.

708. We opened up his chest to repair the artery.

709. But his heart has been deprived of oxygen for too long and it wasn't beating.

710. Oh, my God.

711. We're giving him intravenous drugs and shocking his heart.

712. - There's been no response. - What does that mean?

713. - What does that mean? - We might not get him back.

714. - What? - He could die.

715. But you said that this was a simple procedure,

716. that he would be fine.

717. That he would sail through this.

718. I know. I know, Mrs. Palmieri. This is an exceedingly rare complication.

719. I don't care. I don't care. You fix him. You fix my son.

720. - We'll try. - No.

721. But…

722. You promised me.

723. I have to go back.

724. You promised me.

725. - Is he gonna be all right? - We're working on him.

726. - You gotta give us room. - Everybody back up. Back up, guys.

727. Let the doctor through.

728. Still in V-fib. Sats are dropping.

729. Carotid pulse with compressions. Clear.

730. Anything? No.

731. Again. How long are we going to go?

732. Until I say stop.

733. Clear.

734. We're out of epi.

735. Chen, I want you to go get some epi.

736. Sure.

737. Crash cart Curtain 3.

738. Clear.

739. Excuse me.

740. The doctor told Mike's mom he was gonna die.

741. Hey.

742. Malucci.

743. You okay?

744. Stop it. Let it go! Let it go! Stop it!

745. Break it up. Break it up. Get off.

746. Security. We've got a problem down here!

747. What is going on out there?

748. I don't know. They just started fighting.

749. Clear.

750. - Chen, are you okay? - Yeah.

751. - Are you okay? - Mark. Mark.

752. - What? - A rhythm. We've got a rhythm.

753. - What's that? - I don't know.

754. - I better get back. You coming in? - No. I'm gonna go home.

755. - Hey, well, it was good to meet you. - Thank you.