ER 7x22

1. Previously on ER…

2. We had something.

3. - Are you his mother? - Next door neighbor.

4. He's a friend of my son.

5. Any way to contact the parents?

6. He just has a father. I left him a message.

7. We found some unusual bruising on your son, Mr. Fossen.

8. - Do you know about that? - No.

9. I'm afraid Ben's gonna have to stay here for a few days, Mr. Fossen.

10. What? You're not doing this.

11. You're not doing this to us.

12. - No, Dad, please. Please. - Bastard!

13. You're returning my application?

14. Did you honestly think that you'd make the first cut?

15. How'd she do?

16. Up from 3:30 to 6:00. Then she wanted to feed at 7:00.

17. Lie down. Take a nap.

18. - Are you leaving? - Yeah.

19. Please don't go.

20. I have to.

21. I want you to stay.

22. So do I.

23. Can't you call in sick?

24. - I wish I could. - Just do it.

25. I'll leave the van.

26. What was that?

27. It's eight o'clock. They're demolishing the old textile building on State.

28. That'll wake you up.

29. Exactly our problem. They blow up a manufacturing plant to build a mall.

30. What's wrong with a mall?

31. Fifty cents.

32. All we do is buy and sell. We don't produce nothing.

33. See? What do you do?

34. - What? - For a living?

35. I'm a doctor.

36. Okay. Bad example.

37. What are you talking about? You're the guys building the mall.

38. Not for long.

39. Martin Ainsley, 12-years-old. GSW through the upper left arm.

40. - Is the neuro-circ still intact? - Yeah. Complains of pain and paresthesia.

41. - Can you squeeze my hand, Martin? - It hurts.

42. - Carter, what happened? - Some guy opened a fire

43. - in a foster-care facility. - Foster care?

44. Yeah, twelve down. I don't know how many we are getting.

45. - Can you feel this? - A little.

46. - Think about a vascular study. - Got it.

47. Mark! Mark! Take that one. Go!

48. It's still in me. It still hurts. We're gonna help you out.

49. Entrance wound only. Palpable in the sub-Q. You got this, Dave?

50. As long as there's no compartment syndrome.

51. I can't breathe.

52. All right, just try to slow your breathing down.

53. Maria Fredrikkson, shot in the right foot with some limited blood loss.

54. BP is 90/palp. Tachy at 120.

55. - Any belly pain, ma'am? - No. My leg is cold.

56. Foot pulses are diminished. Did they get him?

57. - Who? - The man with the gun.

58. - I don't know. Did you see him? - We were hiding in a closet.

59. - But he just shot through the door. - Foot is pale. Poor capillary refill.

60. Trauma one, coming through! Who's on for Trauma?

61. - We're bringing everybody in! - Try and give him two more of saline,

62. - order pre-op labs. - Doesn't she have an ischemic leg?

63. Get through to surgery first!

64. Dr. Greene, we have an eight-year-old girl in arrest.

65. - Where was she hit? - Shot in the head.

66. Intubated for agonal respiration. Bradyed down to 30, then lost her pulse.

67. - Pupils fixed and dilated. - Let's get her epi.

68. - You just get here? - Yeah.

69. Nice way to start.

70. Well, I was gonna call in sick.

71. Dr. Weaver, gluteal gunshot wound. He needs a cystourethrogram.

72. - Try a rigid sigmoidoscopy. - He should see a surgeon.

73. Yeah, get in line. Where's Benton?

74. Charge to 60. Did you get a rhythm?

75. Degenerated into V-fib. Clear.

76. Another 120. Looks like brain-stem failure.

77. Dr. Weaver, 104's on the radio with the last one. GSW to the chest.

78. - Is he hypotensive? - No change.

79. - 120 again. - No.

80. - Fine. Bring him in. - Is it the same gunman?

81. Yeah. He shot the gardener on his way out.

82. Clear.

83. - Surprised he had any bullets left. - Push another 0.3 of epi.

84. Want to try mannitol? Couldn't hurt. 30 grams.

85. Do you need an angiogram? No, I don't think so.

86. No bruit or thrill.

87. Is that Helen?

88. - Who? - Helen. She's new.

89. Foster-mom bailed on her.

90. Uh… I don't know.

91. Clear! Expanding hematoma.

92. No pulse deficit. They catch the guy yet?

93. - No. Dispatch doesn't know anything. - He was mad at Mrs. Buckley.

94. What's that?

95. He was waving the gun at Mrs. Buckley, and yelling, and then shot her.

96. - Did we get a Mrs. Buckley? - DOA.

97. Gram of cefazolin, follow with neuro exam.

98. We've also got a GSW to the lateral malleolus in Exam two still waiting.

99. - Yeah. - Portable X-ray and a doppler scope.

100. Let's make sure the bullet didn't damage the bone.

101. Go ahead. I got this.

102. Let's get an AP lateral to the left humerus.

103. - Hey, did you turn it in? - What's that?

104. Weaver said my application was incomplete. I'm missing my peer reference.

105. - Oh, right, yeah. I'll do that today. - It's due today.

106. - Yeah. I'll do it. - Okay, thanks.

107. Peter, I need you down here!

108. Femoral artery's pumping blood. I can't control it without my finger in it.

109. And get me some surgeons. I got three unstable patients

110. and a fourth coming in.

111. All right. Anspaugh's gonna take this one. I'll be right back.

112. Dr. Weaver? Yeah.

113. Officer Napolitano. I need someone to pull out a bullet for the crime lab.

114. - Which patient? - Calf wound.

115. He's stable. We'll get to him as soon as we can.

116. - As long as we get evidence. - Just find the shooter.

117. We'll get him.

118. I was in the bathroom. I heard a loud explosion.

119. It scared me for a second.

120. But then I remembered that they were tearing down that building.

121. But then I heard all this screaming, and…

122. BP, 132/78. Pulse, 96. He was out front in the bushes.

123. Took us a while to find him. We were working on the people inside.

124. - Kerry, what happened? - Lunatic started shooting

125. at a foster-care facility.

126. - Why? - Who knows? Go. Curtain three. Go!

127. You were right.

128. I should've gone to help. Should have done something.

129. No. You did the right thing. I'll be right back.

130. Can I get a cigarette? I need a cigarette.

131. Yeah. I'll see what I can do.

132. Kerry, I've got a hypertensive social worker. Probably just stress

133. - but you should check it out. - Okay, thanks.

134. Hello. Uh-huh.

135. - I read your letter. - Good. I was wondering.

136. Dr. Legaspi, Dr. Romano, line three, for you.

137. Tell him I'll call him back.

138. She's gonna have to call you right back.

139. Anyway, um, I appreciate the sentiment.

140. - Will give her the message. - "Sentiment?"

141. He says for you to get your ass on the line now.

142. He needs to talk to you about a transfer.

143. Frank, she's busy. He should be, too.

144. We could have as many as eight GSWs going.

145. Nine. Carjack victim.

146. Okay. We're swamped with this. Tell them to divert to Mercy.

147. - Mercy said no ETAs nine to ten. - Why do they bother calling?

148. Um… Anyway, thank you…

149. But I don't think that anything's changed.

150. Right. Okay.

151. Okay. I should get back.

152. Yeah.

153. Chuny, grab Cleo. The kid she's with isn't gonna make it.

154. Clear.

155. Asystole.

156. - How long has she been down? - At least an hour since the shooting.

157. Dr. Finch, can you take a carjack victim rolling up?

158. Go ahead. This is a fatal wound.

159. - What is it? - GSW to the abdomen.

160. Someone should have told me that today was gun day.

161. Time of death, 9:12.

162. - This the carjacking? - Yeah. Mr. Jeffries.

163. GSW to the left lateral abdomen.

164. - You need to be careful. - He has AIDS.

165. - How's his pressure? - 140/82.

166. - Okay, good. That's good. - What do you got?

167. Entrance wound below the costal margin and the anterior axillary line.

168. No exit. Mr. Jeffries is HIV-positive.

169. I was getting out of the car. He shot me anyway.

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

171. - I got a GSW. - Don't make you special today.

172. Mark called in. Trauma one.

173. All right, that's fine. Let's go.

174. Let's set him up. Get him a portable chest.

175. - Hey! Hey! - Roger?

176. - Stay away from my wife! - What?

177. You stay away from my wife! She told me. She told me everything.

178. You had your chance. You blew it. She's my wife now.

179. I don't know what the hell you're talking about.

180. I'll take care of Carla. You stay away from her.

181. - All right, Frank, call Security! - Get him out of here! Get him moving.

182. - Stay away from my wife! - I haven't touched your wife!

183. I'll kick your ass! Knock it off.

184. Nothing happened.

185. Chuny, get a trauma panel. Type and cross for four.

186. - He really nailed you. - Shut up and mind your business.

187. - Is this the carjacking? - Yes.

188. - Sir, I'm sorry about that. - Sir? Sir, I'm Officer Napolitano.

189. You told the officer on sight that your assailant was Caucasian?

190. - Yeah, that's right. - Did he wear a yellow windbreaker?

191. Uh, yeah, you know. How did you know that?

192. I think he might have shot some people at a foster-care facility two blocks away.

193. - Same guy? - And… three.

194. Can you remember your license plate number?

195. - No. - Pressure's down to 90.

196. Two liters saline, wide open.

197. - But it's a black Acura Legend, correct? - What's wrong?

198. You know what, you'll have to do this later. Check with DMV.

199. - You might be bleeding in your abdomen. - How do you know for sure?

200. All right, let's get an ultrasound in here.

201. It's a black Acura Legend?

202. What? Yeah.

203. We have to put a tube in your chest to help you breathe.

204. Prep the chest.

205. You okay from here? Got it.

206. - Lidocaine. - Pulse ox is 98.

207. - You almost missed your deadline. - What?

208. I was eating breakfast and I saw your med school reinstatement form

209. on your counter.

210. - What did you do? - Ten blade.

211. You were lucky. The lady in the registrar's office

212. has a daughter who is a nurse.

213. - The registrar's office? - Yeah.

214. I told her you had a bunch of night shifts and she slipped it in with the others.

215. - Thirty-two French. - Wait.

216. - You handed it in? - Yep. This morning.

217. - Luka, why'd you do that? - It was due Monday.

218. - Well, I didn't want to turn it in. - I thought you forgot.

219. - No. I changed my mind. - Why?

220. You know, now they'll come after me for summer tuition.

221. - I can help you with the money. - I don't want help with the money.

222. - I just wanted to let it go. - Then why did you fill it out?

223. I'll get you some xeroform.

224. There, lesion by the shoulder. The bullet passed mid-shaft.

225. This is much more proximal.

226. Look at the lateral. It's in front of the bone.

227. - Could be soft-tissue sarcoma. - Get a biopsy.

228. Carter, is your kid stable? Yeah, I just have to do a FNA.

229. Okay, clear the room. Next round coming in.

230. Two more gunshot wounds. One chest, one neck.

231. Two more? It's not even ten o'clock.

232. - It's the same guy again. - What?

233. CPD tracked a carjacked Acura to a private residence.

234. Found a mother and son shot inside.

235. - Did they get the shooter? - Not yet.

236. - Do we have the ORs? - Cleaning two now.

237. Peter still needs to go up.

238. That leaves one. And Anspaugh should be finishing soon.

239. Psych nurses aren't trained to handle ostomy care.

240. If they need ostomy care, he can check his own damn bag.

241. Robert, we need you.

242. - Two more GSWs rolling up. - In a minute.

243. Abby, let's go outside.

244. And when I call you, you get on the damn phone!

245. She was helping with the mass casualty.

246. - We needed her down here. - And I needed to clear Recovery

247. for the barrage of gunshot wounds you keep accepting!

248. I'm not taking responsibility for post-op complications in the psych ward!

249. Oh, really? Okay, well, then we'll have to find somebody

250. - who's interested in responsibility. - What is that supposed to mean?

251. I'll tell DeRaad, he can finish your shift.

252. - What? - Nice knowing you.

253. GSW through the right lateral neck. Airway's clear.

254. - What's his pressure? - 110/70.

255. - Hi. What's your name? - Ted.

256. - Hey, Ted, can you swallow for me? - Where's my mom?

257. - Is all this his? - Dr. Greene?

258. No. His mom was wrapped around him.

259. Looks like the bullet went through her into his neck.

260. - Mommy! - Dr. Greene.

261. Get Dr. Weaver to scope him. He may need an esophagram.

262. We're gonna take you inside. Okay, Ted?

263. I think this is the lady that brought in your abused kid last week.

264. Single gunshot wound to the back. BP, 128/74.

265. - Mrs. Shayatovich. - Where's Ted? Where's Ted?

266. He's gonna be okay. There's another doctor looking at him.

267. Please, help him. He was bleeding. His neck was bleeding.

268. Who shot you, Mrs. Shayatovich?

269. Derek. I told the policeman it was Derek Fossen.

270. Your neighbor.

271. He was looking for Ben. I told him I didn't know where he was.

272. And he said if I was gonna take his boy away from him,

273. he was gonna take mine away from me.

274. Please, please help him. He was bleeding.

275. We're gonna take care of him. Let's get a HemoCue and a pulse ox.

276. Roll her, roll her, roll her!

277. Oh, God! That looks like about two liters.

278. Maybe an aorta-esophageal fistula.

279. - She's out. - Okay, bag her.

280. I'll intubate her inside.

281. Get a thoracotomy tray and all the O-negative we got.

282. Fossen. Derek Fossen. F-O-S-S-E-N.

283. Looks like it was contained until it blew through the esophagus.

284. - Do you have an address? - He lives next door to her.

285. - Can't get a pressure. - Ten blade. Squeeze in two units of O-neg.

286. I'm in.

287. We put his son into protective custody. His name is Ben.

288. He should be somewhere in the foster-care system.

289. - Lost the pulse. - All right. Rib spreader.

290. You need to find the son. That's who he's looking for.

291. Abby, get the infuser.

292. Pressure's up to 120 after two liters.

293. - Do you need this? - No.

294. Liver and spleen are intact.

295. So maybe I'm not bleeding.

296. No. You've got a slow leak from a small vessel.

297. - You're gonna need surgery. - I don't want surgery.

298. Well, you know, look, we'll make a midline incision,

299. we'll find the bleeding artery and then we'll tie it off.

300. Doc, I'm already dying.

301. Your infection might slow your recovery, but its routine surgery.

302. People live with HIV.

303. I know that. I've been fighting this disease since 1986.

304. I responded to the AZT, and the protease inhibitors were a miracle.

305. They gave me an extra five years.

306. But my T cells have been dropping since July.

307. And my viral load's gone right through the roof, even with all these antivirals.

308. Mr. Jeffries, I need your consent.

309. No.

310. I had pneumocystis three months ago.

311. If we don't operate, you'll die.

312. I am already dead, Doc.

313. This may just allow me to skip a very painful end.

314. - Another Satinsky. - Unit number eight is up.

315. - Heart's not filling. Clamp the aorta. - Greene, the injury is high and posterior.

316. You want me to clamp the arch?

317. - Just trying to bring you more light. - Oh, that'll help.

318. - Can't you get your finger in the hole? - If I could see it.

319. More light.

320. - Just call for FFP and platelets. - Forget it, forget it.

321. - I can't close this defect. - Another amp of epi.

322. She'll go out of thoracic aorta and exsanguinate in seconds,

323. we are not gonna get her back.

324. - Let's try bypass. - It's too late for that. Call it.

325. Time of death, 11:40.

326. Zero for two and it's not even lunch.

327. We pull the sample out with a needle. And then we look under a microscope.

328. - You think it's cancer? - No, it could be scar tissue.

329. It could be a cyst.

330. Cancer's only one possibility.

331. My mom died of cancer.

332. - How old was she? - Thirty-five. I'm 12.

333. Okay, let's see the biopsy first.

334. That way we can talk about what we know

335. as opposed to what we don't know.

336. Do you have anybody that you'd like me to call?

337. - I'm in foster care. - Yeah, I know. Foster parents?

338. - No. I'm between homes. - Right.

339. - Did she make it? - No.

340. - Scary. This guy's on a rampage. - They didn't catch him yet?

341. I don't know. They're gonna go to his house.

342. So much violence, huh?

343. - Were you gonna tell me? - Tell you what?

344. - I heard a rumor. - Oh, yeah? A good one?

345. Dr. Rosen called.

346. You know, from the emergency department at Northwestern.

347. - You took the message? - Yeah, he wanted to set up an appointment.

348. - Just looking at options. - Are you leaving?

349. I still have to make up three months of my residency.

350. - Well, after that? - I don't know.

351. I'm not even being considered for Chief Resident.

352. I have to write this damn peer review for Chen.

353. They're not even talking me about an Attending position.

354. Sometimes you gotta read the writing on the wall.

355. Well, have you talked to Weaver about an Attending position?

356. - No. - Why not?

357. Because if she wanted me, she would have asked me about it.

358. Maybe she doesn't think you're interested.

359. Maybe I'm not.

360. Carter, is your cirrhosis patient ready to go to the floor?

361. No. I have to do a paracentesis first.

362. - We need the bed. - Got it.

363. What's the chest tube output on the gardener?

364. 300 cc's. He's third in line for a tele.

365. - You still angry at me? - I wasn't angry.

366. - You seemed angry. - No, it's my fault.

367. I should have ripped it up.

368. I thought you wanted to go back to school.

369. Maybe I do. Just not now.

370. - What happened? - Nothing.

371. You don't want to be a doctor anymore?

372. I don't know.

373. - You don't know? - I don't know.

374. It's $40,000 in tuition. It's lost wages.

375. It's another six years of me killing myself.

376. Then it's over and you'll be doing what you want.

377. Maybe I'm doing what I want right now.

378. If that were true, you would have never started.

379. Maybe I realized being a nurse is good enough for me.

380. Is it not good enough for you?

381. No, no. It's fine.

382. Okay. You did great, Ted.

383. The bullet went through a muscle in your neck. But you're gonna be okay.

384. - Can I see my mom now? - Uh, let me find out.

385. Now, do you know your dad's phone number at work?

386. - No. - Okay. Do you know where he works?

387. - Abysco. - Abysco? Is that a company?

388. - He makes binders. - He makes binders. All right.

389. You want to draw some more?

390. - Yeah. - I'll be right back.

391. - The mom didn't make it? - The proximal aorta was shredded.

392. I have to track down his father. What do you want to tell the boy?

393. - I'll stall. - Dr. Greene?

394. This him?

395. Yeah. He has a record?

396. One arrest. Domestic dispute. He hit his girlfriend.

397. He wasn't at his house?

398. I'll let you know when we have him in custody.

399. What about his son?

400. We tracked down the foster parents. A patrol car's picking him up now.

401. - I think he's coming here. - What?

402. Well, he was pissed at the neighbor for bringing him to the ER.

403. I mean, you took his kid away from him, right?

404. - Right. - Thanks, Frank.

405. I'll send in some extra units.

406. Mark, he couldn't come here. He knows there's too many cops around.

407. He hasn't displayed a lot of sound judgment so far.

408. - What is he shooting with? - Semi-automatic pistol, 13-round clip.

409. He's been reloading.

410. He probably picked it up at Kmart on the way over.

411. - It's not the guns. People kill people. - Yeah, right.

412. - But not as fast. - He would have found another weapon.

413. Fourteen shots so far, Frank. Six deaths.

414. You can't affect mass murder with a Chinese throwing star.

415. Rescue 78 coming in with an injured cop. Motorist dragged him for half a block.

416. See, there you go. He hit him with a car.

417. - That's assault with a deadly weapon. - Frank, shut up!

418. Free air under the diaphragm. Must have nicked the bowel, too.

419. His crit's down to 23. I can't dilute him much further.

420. I checked his viral load. It's over 50,000.

421. He'll die of an opportunistic infection within a year.

422. Well, that doesn't mean we should help him commit suicide.

423. He didn't shoot himself.

424. If we let him refuse surgery, it's the same thing.

425. - Get a court order then. - He'll be dead by the time it's approved.

426. Then it's his choice.

427. All right.

428. I went over there.

429. She was upset. She was crying.

430. She came on to me. I didn't do anything.

431. I didn't want to do anything.

432. Now, maybe she felt guilty and she told Roger and she put a spin on it.

433. - And you wouldn't put a spin on it. - No.

434. Then why didn't you tell me?

435. - To avoid this. - What?

436. You looking at me like I did something wrong.

437. I see. You didn't trust me and I'm supposed to trust you.

438. - I didn't think it was worth getting into. - Good, at least I know where I stand.

439. Cleo, that's not what I meant and you know it.

440. - Peter, his pressure's dropping. - Go.

441. Run in another liter of saline.

442. - Any chest pain or dizziness? - No.

443. All right, let's get two units from the blood bank

444. and transfuse each over an hour.

445. No, no, no. I don't want a blood transfusion.

446. Your hematocrit is drifting to a dangerously low level.

447. I understand.

448. No. Thank you.

449. What about your family?

450. I mean, if you don't care about yourself, what about them?

451. I haven't spoken to my mother in over 30 years.

452. I outlived the two people that I loved in the world.

453. I've lived longer than I expected.

454. Just let me go.

455. I'm ready.

456. - Hi. - Hi.

457. How are you feeling?

458. My neck hurts.

459. I'll ask one of the nurses to come give you some medicine.

460. Can I see my mom?

461. Not yet. I'm trying to reach your dad.

462. Can I stay with her until you do?

463. I don't think so. She's having an operation right now.

464. Is she okay?

465. We're having a little trouble

466. trying to get the bleeding stopped around her heart.

467. - She was hurt bad. - I know.

468. - You hungry? - No.

469. Where is all this blood coming from?

470. - Part of his ear. - You have to give him more pain medicine.

471. Okay, titrate ten of morphine. Sir, did you lose consciousness?

472. - I don't think so. - You got him, Luka?

473. Yeah. Trauma panel…

474. - Did you get a good look at him? - Not really.

475. Yellow windbreaker?

476. Yeah. Called to say he saw blood on the collar.

477. Whoa, whoa, whoa, wait a second. This is Fossen?

478. Just a minute, please, doc.

479. Colby asked him to step out of the vehicle.

480. When he opened the door, the guy punched and reversed,

481. smashed our unit and took off.

482. Colby's jacket must've got snagged.

483. He was screaming. He got dragged forever. But son of a bitch didn't stop.

484. - Where did he get the car? - Probably boosted it off the streets.

485. Jeep Grand Cherokee, first three license numbers G74?

486. - That's all I got down. - Could it be G79?

487. - You got him? - Shots fired at 823 Piedmont.

488. Jeep Grand Cherokee parked to the corner. License number G79-6L5.

489. - Woman found down inside. - Oh, God. Here we go.

490. Easy. Is she dead? Called in the paramedics.

491. We're all overworked, Robert.

492. But you can't insinuate that you're gonna fire someone

493. - every time you get frustrated. - I'm not insinuating. She's fired.

494. - Robert. - Cleaning out her locker now.

495. You can't do that.

496. - I just did. - This is a county facility.

497. Employees cannot be summarily fired.

498. Well, Dr. Legaspi was already on probation for that other matter.

499. Yeah, and she was exonerated.

500. And since then she's had a history of violation of institutional policy.

501. - Like what? - What do you care?

502. - It's not your department. - I deal with that department.

503. - She's a good doctor. - A good doctor who has had as many as

504. thirty delinquent charts

505. - awaiting discharge summaries. - And so does half the staff.

506. She used the county telephone watch line

507. - for personal non-business calls. - Oh, you gotta be kidding me!

508. She yelled at a patient in a public setting.

509. You're trying to find a way to fire her.

510. There's plenty of documentation that has been reviewed

511. by the disciplinary committee.

512. - Dr. Weaver. - Give me a minute.

513. - It's Adele. She's been shot. - What?

514. Adele Neuman. That maniac shot her at her house.

515. The social worker?

516. Chest X-ray, T and I spine.

517. Let's set up an ultrasound. Can you feel this?

518. - Yeah. - Miss, did you get a look at the man

519. - who shot you? - Yeah, he looked familiar.

520. He said something about his son.

521. We put his son Ben into protective custody last week.

522. - Oh, my God. - Okay. Adele, can you feel this?

523. No.

524. Cord injury, 1.8 grams Solu-Medrol over 15 minutes.

525. Hi, Adele.

526. - Hi. - She was shot in the back.

527. She can't move her legs.

528. Was it a white male, late 30s, yellow windbreaker?

529. Uh, yeah. I think so.

530. - Any pain in the belly? - BP, 92/65. Pulse, 110.

531. - Adele, any pain in your belly? - Not really.

532. - Could be a pneumothorax. - Lungs sound good. Pulse ox is 99.

533. - For an intra-abdominal bleed? - There's spinal shock.

534. - How'd he know where I lived? - What?

535. How did he know where I lived? I only saw him at the hospital.

536. They can find anything on the damn Internet now.

537. What?

538. - Get someone over to my house. - What?

539. Send someone over to my house now. 1211 Dupont Drive.

540. Still hypotensive. Want dopamine?

541. Start her on five mics.

542. Come on, Elizabeth. Pick up.

543. Pick up.

544. Does this feel sharp? Yes.

545. - What's her crit? - Working on it.

546. - How about here? - Yes.

547. - Do you have voice mail or machine? - Machine.

548. - Would she hear you leaving a message? - I don't know.

549. - How about here? - No.

550. Were you already home or was he waiting for you?

551. He came in. I was sitting at my desk doing my bills.

552. Patellar reflexes are absent.

553. Dr. Greene, no one's answering the door. Do you want them to search the house?

554. - Yeah. - They'd have to force entry.

555. - Search the house! - 942, go ahead.

556. - Still hypotensive. - Up her to ten mics.

557. - She needs volume. - I'm not in yet.

558. Adele, can you bend your knee?

559. - I can't, I can't move it. - Look, I don't care.

560. We may have an emergency laminectomy. Fine. Check. Go.

561. Doc, they'll call it in when they have it secured.

562. - Am I paralyzed? - Hopefully, it's only temporary.

563. - That's it. Give me a new kit. - Check for sacral sparing.

564. Come on, now. Now.

565. Okay, good. All right, set up the microscope. We're coming up.

566. Maybe she went out, went to the store.

567. - Did you page her? - What?

568. - Did you page her? - No.

569. I need you to page Dr. Corday.

570. I don't… I know that! Page her!

571. Mr. Jeffries. Mr. Jeffries.

572. - What's his HemoCue? - Down to five.

573. - Barely responds to painful stimuli. - Hang two units of blood.

574. He doesn't want that.

575. Call the OR. Where's the surgical consent form?

576. - On the cart. - You can't take him up. He didn't give it.

577. Well, he's unable to give consent now.

578. I just need two physicians' signatures for emergency surgery.

579. No.

580. - You'd have him die? - I'll respect his wishes.

581. Good, Adele. The spinal injury is incomplete. We can operate.

582. - I need an emergency signature. - Not now, Peter.

583. IJ's in. Let's get another chest.

584. - He's bleeding out. - Run the Solu-Medrol. 325 an hour.

585. - Gunshot wound to the belly… - Yeah, yeah. Whatever. Whatever. Go.

586. Systolic's up to 100.

587. All right. Let's get him up. Can you get a repeat CBC?

588. - Whatever you want, Peter. - I've got my two signatures.

589. He made himself clear.

590. Look, he has advanced AIDS. He probably has an HIV encephalopathy.

591. No. He was alert and oriented.

592. - You should have called Psych. - I did. They never showed up.

593. - Laura called. They're still… - Ow!

594. - What? - Damn it!

595. - Oh, God! I'm sorry. - Hold on. Did you cut yourself?

596. I don't think so. The glove just tore there.

597. - Peter. - Hold on. Hold on.

598. Let me get some gauze pads. Come on.

599. Let me see it, all right?

600. - Oh, God. - Keep irrigating it.

601. Where are the Zerowets? Bottom left drawer.

602. Pharmacy? Yeah, this is Dr. Benton. I need you to pull a PEP kit for me.

603. All right. And use two liters.

604. What? No. Look, I'm on my way up there right now.

605. - What about the patient? - Keep transfusing him.

606. - Talk to Neuro? - They're doing a craniotomy.

607. - Kerry. - Watch it, Peter.

608. Tell him I need some help with a thoracic decompression.

609. Adele, there's a piece of bone in your ninth vertebrae mid-back,

610. that's pressing on your spinal cord.

611. That's why I can't move my legs?

612. Yes. But if they remove the fragment, you may recover.

613. Doc, no one's at your house. We did a thorough sweep.

614. - Check my garage? - Yeah, yeah. Nothing.

615. - Call me if you find her. - Still a chance of you paralyzed?

616. Not if I can help it.

617. - Hey, Robert, I still need to talk to you. - Drop it, Kerry. It's over.

618. - Is my van still there? - What?

619. - The garage. Was my van there? - Yeah. Yeah.

620. - But you have two cars, right? - Hers is in the shop.

621. - Does she take the baby out? - She's been going for walks,

622. usually around 3:00.

623. - It's 1:05. - It depends on the baby's schedule.

624. Can you keep a unit there until she gets home?

625. - Yeah. - Nick.

626. - Yeah. - Nick, listen.

627. Shot in the head from the back.

628. Looks like the guy was riding in the back seat.

629. Cab driver on Roosevelt.

630. Roger that, 27. Rescue's en route.

631. Okay, that'll be us. Can you give it to Luka? I have to go upstairs.

632. - You think it's him? - Yeah, that's him.

633. Dr. Greene, I can't reach this boy's father.

634. - And I think he's figuring it out. - Who?

635. The neck wound. His mother died. You need to talk to him.

636. I'll be right there.

637. Carter, we got a GSW to the head coming in.

638. I want you to prep Trauma one.

639. - Get some dilantin, mannitol and decadron. - ETA?

640. - Check the dispatch. - Ewing seems pretty aggressive.

641. We'll need a chest and abdominal CT to rule out metastatic disease.

642. - You sure? It's a soft-tissue mass. - Extra-osseous. It's rare.

643. You might want to write it up.

644. - Thank you. - Want me to talk to the parents?

645. He doesn't have any parents.

646. Where is she? Where is my mom? Where is this operation?

647. The bullet… uh…

648. She was shot in the back.

649. The bullet passed through her heart.

650. She lost so much blood that her heart stopped beating.

651. We opened up her chest for an emergency surgery.

652. We gave her blood transfusions.

653. The best surgeon in the hospital did it.

654. She wasn't in any pain. She didn't suffer.

655. We worked on her for a long time.

656. We couldn't stop the bleeding.

657. And we couldn't get her heart to beat again.

658. Ted, your mother died.

659. I'm sorry.

660. Here. You need to take these now.

661. - Shouldn't we draw baseline labs first? - No. Now. The sooner the better.

662. Peter, two units are in. I can't get his pressure above 80.

663. - All right. Hold on. - He's already drug-resistant.

664. - You don't have a large viral load. - He does.

665. Cleo, listen to me. The conversion rate with meds is less than three in 1,000.

666. Peter. Crit is 14. If he's going, he has to go now.

667. Okay?

668. All right. Uh, get another two units. I'll meet you at the elevator.

669. Call Infectious Disease. See if they need to modify the post-exposure regimen.

670. I'm surprised my code still work.

671. - It's not gonna happen, Kim. - What isn't?

672. They can't let you go, not legally.

673. No. They always intended to fire me.

674. They would have done it sooner, if they could have,

675. but they needed to build up a nice thick Human Resource file first.

676. Which is completely bogus. They'll never get away with it.

677. - They already have. - Only if you let them.

678. It's not worth the effort.

679. I'm not interested in working for a place that doesn't want me here.

680. No, you have the right to due process. We can find a civil-rights attorney.

681. We?

682. It's not right, Kim.

683. You know why they're firing you.

684. You have to fight it. You have to fight this.

685. I'm supposed to fight?

686. You're hiding but I'm supposed to fight.

687. Well, I'm sorry but I don't want to fight.

688. I just want to move on. So should you.

689. Hey, Chris and Hillary. It's Mark Greene from down the street.

690. I'm looking for Elizabeth.

691. If you see her, could you ask her to give me a call?

692. - Dr. Greene! We got him. - Thanks.

693. - Where? - He opened fire in Lincoln Park.

694. He shot three people before being taken down by a civilian packing a 9mm.

695. - Is he still alive? - So far.

696. What's he had? Two amps of epi and atropine.

697. Is this the cabby?

698. Yeah. Point-blank range to the base of his skull. Asystole since we found him.

699. Cleo, why don't you jump in on this?

700. Cervical injury. Probably blew out his brains.

701. Cleo! Uh… Any vitals in the field?

702. - No. Just lots of brain matter. - Darcy, Darcy, any witnesses?

703. - No. But we think it was Fossen. - Well, why?

704. 1211 Dupont was the last entry on the driver's log at 1:14 p.m.

705. - What? - The house you had searched.

706. Fossen must have been on his way over there.

707. Cabby probably heard his description on the radio or something.

708. - Dr. Greene? - Bang. Fossen blew his brains out.

709. Dr. Greene? Don't worry, Doc.

710. - That means he never got there. - Dr. Greene! He's coming in.

711. Was that a record number of gunshot wounds for one shift?

712. By the same guy? Absolutely.

713. He has a good chance. Like you said, you found it early.

714. Nah, it's more that he has to go through it alone, you know?

715. As if having cancer as a kid wasn't bad enough.

716. He could get passed over for Chief Resident.

717. That's true.

718. Or he could get kicked out of med school and be forced to work as an ER nurse.

719. - I was not kicked out. - Oh, really? What would you call it?

720. Suspended for being a deadbeat.

721. Do you know he offered to pay my tuition?

722. - Who? - Luka.

723. And I know he means well. It's just frustrating for me sometimes

724. because I have to explain my every feeling to him.

725. And normally when you're with someone for a while,

726. they get to know your moods.

727. - But he doesn't do that. - You know what?

728. - Stop it. - What?

729. Don't talk to me about Luka.

730. I'm not your girlfriend.

731. And I shouldn't really even be here with you.

732. Why not?

733. Because I don't want to wish bad things for you and Luka.

734. And I don't want to sit on the sidelines waiting for you two to break up.

735. And I don't want to be your friend.

736. It might be convenient for you, but it's not doing much for me.

737. What are you… What are you talking about?

738. Where did you put him? Where did you put my son?

739. How much O-neg do you want? Four units.

740. - You can't take me from him! - Quiet! So we can listen!

741. Two entrance wounds on the right.

742. - One on the left. - Another two in the belly.

743. - A total of five. - You. You did this.

744. Set up for bilateral chest tubes and a central line.

745. - You are him. - Systolic's low at 80.

746. - I'll intubate. - This is your fault!

747. - Ready for the chest tubes. - Now. Paralyze.

748. One of pavulon, 100 of sux.

749. You stole my son. You destroyed my family.

750. Ambu-bag.

751. He's my son! What gives you the right to…

752. You can't take my son away!

753. It starts with one bad cell that multiplies.

754. And then it grows out of control and you usually don't even know it's there

755. until the massive bad cells is big enough that it causes pain.

756. We're very lucky that we found it today.

757. So you're saying I'm lucky I got shot.

758. In a way, yeah.

759. It's just gonna take longer to die.

760. No. That's what I'm telling you.

761. Since we caught it early, there's a good chance that you're not gonna die.

762. What's a good chance?

763. Seventy percent.

764. - You know what 70 percent is? - Yeah. It leaves 30.

765. Well, let's concentrate on the 70, okay?

766. - Dr. Carter, GSW's rolling in. - Okay. Be right there.

767. So, what happens to me now?

768. Now I'm gonna have a cancer doctor, an oncologist,

769. to come down and take a look at you.

770. No. I mean, where do I live?

771. Oh. I don't know. I'll find out.

772. When was your last tetanus booster?

773. I don't know. Do I need an X-ray?

774. - No, it looks like just a graze. - Is that the guy?

775. Yes. Multiple GSWs to the chest and abdomen.

776. At the range, they teach you to shoot for the center mass.

777. It's not always fatal but it takes him down.

778. - You shot him? - I got mugged last year.

779. Same park. I don't go there now without protection.

780. He started shooting people! Someone had to do something!

781. Yeah, we should arm the whole city.

782. Hey, I stopped him. He would have kept going.

783. - You're lucky. - Lucky I was packing.

784. - Carter, you free? - Uh, sort of.

785. GSW to the right flank.

786. Vitals are stable, but I need you to check for gross hematuria.

787. Okay. I'll be right there.

788. - I handed it in to her. - What?

789. Your reference. Should put you over the top. All fives.

790. - Wow! Thanks. - I had to lie.

791. - Now, Carter. - Coming.

792. First two are in.

793. Another subclavian. Put the next two on the infuser.

794. - How's the chest tube output? - Couple hundred cc's.

795. - Only 50 on my side. - Is he gonna make it?

796. Probably. Didn't hit any vital structures.

797. - After five shots? - Some guys get lucky.

798. Nineteen shot. Eight, maybe nine dead. He's lucky we didn't take him down.

799. - Dr. Greene, Dr. Corday's on line four. - Could you get it for me?

800. - Pressure's up to 85. - 3-0 nylon. What's in the Foley?

801. Seventy cc's. Dips are negative for heme.

802. - Dr. Corday? Hold on. - Can you cut this? Elizabeth?

803. - Mark, what's going on? - Where were you?

804. I was at the Farmer's Market.

805. I came home, there were police in the house,

806. and the front door's been kicked in.

807. - Yeah. I told them to. - Why?

808. Uh… Long story. Vaseline gauze.

809. You're not gonna tell me what happened?

810. Nothing. It's just a bit of a scare.

811. - You're all right? - Yeah, I'm fine. Uh… Call you later?

812. I told the policemen to stay with me until I called you.

813. Yeah. Yeah, he can go now.

814. You're not gonna tell me what's going on?

815. Not right now. Everything's okay.

816. Okay, then.

817. - Will you be off at 7:00? - Yes. I will be there.

818. Okay.

819. - I love you. - Me too.

820. Elastoplast.

821. Get ready for a portable chest.

822. Keep the dopamine at ten mics. I want neuro checks, 30 minutes.

823. And a CBC in an hour.

824. - Any cord contusion? - No, extrinsic hematoma.

825. - Did they find Elizabeth? - She's fine.

826. - Oh, good. - What about her paralysis?

827. - Ask me in 24 hours. What's this? - GSW to the renal parenchyma.

828. Marge, clear OR two. We got another customer.

829. I'll be right back.

830. - Robert, I need to talk to you. - Yeah, sure. Anything but Legaspi.

831. You're making a mistake.

832. Look, my main mistake was not firing her three months ago when I first found out.

833. - Find out what? - That she is incompetent.

834. - That's not what you were gonna say. - Oh, really?

835. Wow! In addition to your finely home diagnostic skills,

836. you're a mind reader now.

837. You're trying to get rid of her because she's gay.

838. Oh, of course I'm not.

839. That would be wrong or at least politically incorrect.

840. I want to get rid of her because she's a pain in the ass.

841. Like Maggie Doyle was?

842. - Okay, Kerry, let's stop right there. - And avoid your history of discrimination?

843. If you don't rethink this, Robert, there's a good chance

844. you'll be the one out of a job.

845. Dr. Legaspi has demonstrated not only poor judgment,

846. but a reckless attitude towards her patients,

847. contempt for her colleagues and a blatant disregard for authority.

848. She's out. She's fired. End of discussion.

849. - If she goes, I go. - What?

850. You heard me.

851. - Are you giving me an ultimatum? - I swear to God, Robert.

852. - I will walk out if you don't back off. - I do not respond well to ultimatums!

853. You had better choose your battles very carefully!

854. You're the Chief of Emergency Medicine, not the county's lesbian advocate.

855. That's where you're wrong, Robert. Because I am both.

856. I am the Chief of Emergency Medicine, and I am a lesbian.

857. And if you pursue this matter any further,

858. I will take it to the County Board of Supervisors,

859. the ACLU, the press, and anyone else who will listen!

860. So I suggest you choose your battles very carefully!

861. BP's 100/60. Going in the right direction.

862. - Last HemoCue? - 9.5.

863. You want me to bring him up?

864. - Mark? - What?

865. - You want me to bring him up? - No, no. I got it.

866. They are sending cross-matched blood to the OR.

867. Good.

868. Can you bring the copy of the chart back down

869. - so I can write my note? - Sure.

870. He's gonna need some more Pavulon.

871. Damn it! I forgot the drug box. Be right back.

872. Whoa.