ER 7x5

1. Previously, on "ER."

2. I was hoping you'd give me the joy and honor

3. of being your husband.

4. I can't find a decent position.

5. Stay local, or you give up custody.

6. I am willing to offer you a per diem position.

7. - Per diem? - Yeah.

8. Give me the purse!

9. 'Stop.'

10. Luka, stop! Stop it!

11. What can I tell you? I'm short-staffed.

12. Hey, I can't go on a transport.

13. Connie, can you clear this TIA in six?

14. She's waiting for her daughter.

15. Yeah, well, that's what chairs are for.

16. And give a gram of unasyn

17. to the dog bite in four.

18. Mark, they need you at the MICN.

19. Why don't you try Mercy Air?

20. Maybe they can pick him up.

21. - Mark? - What?

22. Paramedics have a guy with chest

23. pain won't get in the ambulance.

24. Okay, we'll explain the risks

25. and make sure he signs out AMA.

26. What are his vitals?

27. He's refusing to sign the form.

28. Mark, you gave my patient cefoxitin.

29. - Who? - Bovard. Uh, Appy.

30. Hold on. Uh, yeah, listen, he needed antibiotics.

31. Yeah, cefotetan's a better drug.

32. - Peter, I'm a little busy. - I know, that's not my problem.

33. You should've at least called me.

34. Did you get through?

35. No, no answer at his hotel room

36. and I stat paged him twice.

37. Well, try his cellphone.

38. Any response to Lasix?

39. Mark, the AMA?

40. Well, get him on the radio and try and convince him.

41. What about a nitro drip?

42. Greene, I need you to buff up

43. a recurrent bowel obstruction

44. I have on the way.

45. What are we, Jiffy Lube?

46. I need a sugar tong splint in Three.

47. - Kovac still MIA? - Uh-huh.

48. - Kovac missed his shift? - I'm sure he's on his way.

49. - Where's, uh, Kerry? - It's her day off.

50. She's at a Chrysanthemum Show.

51. Great, the one day I need her

52. she's playing Martha Stewart.

53. Hold on just a second, I'm sorry.

54. Uh, listen, I've got a helicopter transport.

55. We're gonna have to call in backup.

56. Uh, why don't you wait till 8:30?

57. - He's never late. - Peter, what's this?

58. - Hot Appy. OR's ready. - Great, I'll take him.

59. Dr. Greene needs your help here.

60. Trauma coming in?

61. No, you're gonna cover the whole ER.

62. - What? - Yup.

63. Ah, this'll get you started.

64. Diarrhea, ear pain and weak and dizzy all over.

65. Oh, wait a minute, wait a minute.

66. Weak and dizzy wasn't a part

67. of our per diem agreement.

68. Sure, it is. Per diem means "per my discretion."

69. 'Okay, I'm on my way.'

70. I haven't done primary care since med school.

71. Don't worry, Peter. You just got to cover until Kovac gets here.

72. - When's that? - Uh, I hope soon.

73. Andrazak in Four, check his lytes in an hour.

74. Oh, and look at a post-reduction shoulder film on Quintano.

75. - How long's your flight? - I don't know.

76. Well, where are you going?

77. Grass Creek, Indiana.

78. The wedding coordinator's coming at noon.

79. I know.

80. Mark, we canceled her once already.

81. Well, go ahead and talk to her. You can handle it.

82. I don't want to handle it.

83. I want you to share in what kind

84. of invitations, menu, flowers.

85. I know, I'm stuck, I'm sorry.

86. Well, at least try to get back on time.

87. I'll call you.

88. - Have a safe flight. - What?

89. Nothing.

90. 'Lifeguard Five-Seven-David.'

91. 'Landing-pad zone is clear. Over.'

92. Alright, I've got the earache.

93. That's a Pedes case.

94. Yeah, well, Romano has me

95. seeing everything today.

96. And that's a complete waste of your brilliance.

97. Look, I've apologized.

98. If you can't accept it

99. let's at least call a truce

100. so we can work together.

101. You are amazing.

102. First you dump me, then you expect me—

103. Whoa, whoa, whoa, I did not dump you.

104. Then what do you call it?

105. You were gonna move to Philadelphia

106. without saying a word to me.

107. Yeah, but I didn't, did I?

108. I stayed here and I took this damn per diem job.

109. And I'm supposed to believe you did that for me?

110. That's what I thought.

111. Hi, I'm Dr. Benton.

112. So, uh, Jason, how long has he been sick?

113. Well, it started last week with an earache

114. and then he had a fever and now he's coughing.

115. Well, let's take a look here, okay?

116. You don't think he's got pneumonia?

117. One thing at a time. Here we go.

118. - Get away from me! - Hey!

119. Jason. Be nice.

120. - The doctor wants to help you. - Ow! Hey, whoa, hey.

121. - I said be nice. - Alright, Jason.

122. Look this isn't gonna hurt, okay?

123. Just, uh... just be still. Here we go.

124. No, no, no! I want to go home!

125. Okay, it's okay. It's not gonna.. Jason.

126. That's right, Jason, go to mommy.

127. Uh-huh. Why don't you put him on your lap

128. and give him a nice big hug

129. and if Jason is real still

130. 'I'm going to give him a sticker.'

131. 'How are his sats?'

132. Up to 98, but his ejection

133. fraction's less than ten percent.

134. Mr. Coggins?

135. - Call me Tom. - I'm Mark Greene.

136. We're gonna have to lie you down to load you on the chopper.

137. My first helicopter ride.

138. I'm gonna miss the scenery.

139. - What's his BP? - Ninety over seventy.

140. It's always that low. There's not much heart muscle.

141. - Can you keep trying Janet? - Sure, Tom.

142. That's my fiance. She's flying in from Montreal today.

143. Let me know if you feel dizzy or have any shortness of breath.

144. I'm okay as long as I lie still.

145. Bright side is I get bumped up on the transplant list, right?

146. You bet. Gordon, how are we for oxygen?

147. Four E cylinders, all full.

148. Ready? Let's go. One, two, three.

149. Alright, let's get a full trauma panel. Type and cross for eight.

150. Let's get the bypass team on standby. Move.

151. Oh, somebody stabbed him?

152. No, he tripped near a pencil sharpener.

153. Yeah, Mr. Zuckerman, our office manager

154. wanted to pull it out, but I wouldn't let him.

155. Decreased breath sounds on the left.

156. Set me up with a chest tube.

157. - I'll do it. - No, I'll do it.

158. Uh, excuse me, excuse me, this is a teaching hospital.

159. Exactly. Go find another patient to learn on.

160. Pulse ox down to 91.

161. Okay, let's get one percent with epi.

162. Peter, heard you had a good one.

163. Oh! And indeed, you do.

164. He needs a CT. Let me get a ten blade.

165. No, no, no, don't bother.

166. I'll throw the tube in

167. and take him right up to the OR.

168. Don't worry, sir, you are in excellent hands.

169. That's okay, I've got this.

170. No, no, this is a surgical case, Peter.

171. You are an ER doc today, remember?

172. There's a guy puking out in the hall. Go see what you can do.

173. Excuse me.

174. - I need a 30 feet.. - Sir, are you okay?

175. - Aah! Whoa, whoa! - What does it look like?

176. Alright, let me get some compazine here.

177. Sir, you're gonna have to aim for the basin.

178. I heard it, but I didn't believe it.

179. Carter, get me some gloves.

180. Dr. Peter Benton, ER attending.

181. Got kind of a nice ring to it.

182. - You want this? - Oh, no, no, no.

183. Looks like you're doing just fine.

184. - Trent? - Yeah.

185. I'm Dr. Carter. What happened to your hand?

186. I have this stupid art class.

187. We were carving some duck decoy.

188. Huh.

189. Most exciting thing that we ever did

190. I think was macrame.

191. Um, how many stitches, you think?

192. How many do you want?

193. Enough to get me out of art class.

194. Well, ten ought to do it.

195. Dr. Carter, can you step out for a second?

196. Yeah, after I suture this.

197. No, it's important.

198. I'll be right back.

199. Don't pick your nose.

200. - What? - The boy's grandmother.

201. She wants to talk with you.

202. Why don't you just bring her in?

203. No, no, she asked to see you alone.

204. Alright.

205. Hello, I'm Dr. Carter.

206. Oh, I'm sorry, I came as soon as I could.

207. - Is Trent alright? - Oh, yeah.

208. Just a few stitches, he'll be good as new.

209. Um, doctor, there's something you need to know.

210. Trent's mother died of AIDS when he was two.

211. He tested HIV positive.

212. - You need to be careful. - He didn't say anything.

213. He doesn't know. We never told him.

214. What?

215. We just wanted him to be normal

216. like other kids.

217. What do you tell him about the medications?

218. Oh, he thinks he has a vitamin deficiency.

219. And your doctor plays along with that?

220. Well, he understands.

221. Trent needs to know.

222. Yes, when he's older, when he can better understand.

223. Well, your grandson could be sexually active right now.

224. He's not. I've asked him.

225. Are you sure that he's telling you the truth?

226. Doctor, I know my grandson, you don't.

227. Mrs. Larson, I have a legal right

228. to tell Trent that he's HIV positive.

229. You have no right to interfere in our lives.

230. HIV's a sexually transmitted disease.

231. And if he's having unprotected sex

232. he could be putting others at risk.

233. Well, I think we better leave.

234. Well, he can't leave.

235. - Let me by. - Chris?

236. - Let me by. - Doc.

237. Could you please escort

238. Mrs. Larson to the chairs?

239. - This way, ma'am. - Don't touch me.

240. Don't do this.

241. 'Pulse ox 94 on two liters.'

242. - What's your hurry? - Huh?

243. You keep checking your watch every ten seconds.

244. - I'm just charting. - I don't think so.

245. You're late for something.

246. I'm supposed to meet my fiance.

247. You got a lunch date?

248. Well, we're meeting the wedding planner.

249. You're taking the plunge.

250. - It's a great feeling. - Yeah.

251. What's your fiance's name again?

252. Janet.

253. I'm calling the ER.

254. See if they can get ahold of her and she can meet us there.

255. That'd be great.

256. - Hi, Randi? - 'Yeah.'

257. Yeah, it's Mark Greene up in the helicopter.

258. - Who's around? - Dr. Corday's right here.

259. - It's Dr. Greene. - I don't care.

260. I need to speak to him right away.

261. Hi, Mark, is everything alright?

262. Yes, Dr. Dietrich, this is

263. Dr. Carter at County General.

264. Listen, I just repaired a laceration

265. on your patient Trent Larson.

266. Yeah, certainly, I'll try and get ahold of her.

267. No, yeah, he's a great kid.

268. Uh, listen, if I was to get a needle stick

269. is there anything I should know?

270. Randi, did you get in touch with the hotel?

271. There's still no answer in his room.

272. Could you call the manager's office

273. and see if they could send somebody up there?

274. Detective.

275. Oh, you keep coming by

276. I've to get you a badge and gun.

277. So, is there anything..

278. Oh, Dr. Kovac, now you know

279. the minute there's anything new, I'm gonna call you.

280. We take photos for the medical record.

281. I thought it might help.

282. His morgue photo's already on the police bulletin.

283. Maybe you could go back to where it happened, show this around.

284. We've done our interviews, doc.

285. No one knows him.

286. What about fingerprints?

287. Have a seat. Have a seat, doc.

288. Look... I understand how you feel, okay?

289. But the fact is, you're probably better off

290. if no one ID's this guy.

291. No family member's gonna come crawling out of the woodwork

292. with some wrongful death suit.

293. I don't care. I just need to know who he was.

294. Take my advice, doc.

295. You were defending yourself.

296. Dedicate yourself to believing that.

297. Alright, keep that clean and dry.

298. Alright, cool.

299. Hey, Dr. Carter, is my grandmother here yet?

300. Um... yeah, but first we need to talk.

301. Why? It's just a cut.

302. Uh, yeah... actually, I need to ask you something.

303. Alright.

304. Um..

305. It's about your mother.

306. Uh, how much do you remember about her?

307. Nothing.

308. You sure?

309. Yeah, uh, she's... she's dead.

310. She was a loser, a heroin addict.

311. She died of AIDS.

312. And she had the virus when she was pregnant with you

313. and the virus can pass from the mother... to the baby.

314. Wait a second. So... I have AIDS?

315. No, you have HIV, and you're healthy.

316. Because you've been taking medication.

317. Uh, no, no, no. See, I just take a bunch of vitamins, that's it.

318. No, you've been taking medication to combat the virus.

319. No, no, they're just vitamins, man.

320. No, your grandmother told me

321. and I confirmed it with your doctor.

322. Why wouldn't she tell me?

323. I think she wanted to protect you.

324. And, um..

325. But you need to know.

326. So, my whole life, everybody's lied to me.

327. I'm not lying to you.

328. 'How much longer, do you think?'

329. Gordon, what's our ETA?

330. Well, there's the Kankakee River.

331. About 20 minutes.

332. You alright?

333. It's, uh, just a little chest pain.

334. - I'll be okay. - Nitro spray.

335. Open your mouth. Under your tongue.

336. On a scale of one to ten, how bad is the pain?

337. Big time ST elevation on the monitor.

338. Find the tenecteplase. I'll do the heparin.

339. Ah, wha-what's going on?

340. You're having a heart attack

341. but we're giving you clot-busting medicine.

342. Pulse ox down to 82. Do you want to intubate?

343. Not if I don't have to.

344. Let's get him on a mask, 15 liters.

345. Maybe we should land.

346. No, Dr. Greene.

347. Dr. Greene, you'll get me there, right?

348. Yeah, I'll get you there.

349. Do you have a girlfriend?

350. Because, if you've slept with anybody

351. they'll have to be tested.

352. It's important, Trent.

353. You have to use condoms.

354. Yeah.

355. Can I go now?

356. Yeah.

357. Yup, your grandmother's waiting.

358. So, a case manager's gonna phone you tomorrow.

359. Just to see how you're doing.

360. You've got an appointment

361. next week with the Teen HIV Center.

362. And you can always reach me here.

363. ER always knows where to find me.

364. - Alright? - Alright.

365. Yeah.

366. Trent?

367. Thank you, doctor.

368. '"Hog butcher for the world, toolmaker, stacker of wheat.'

369. Player with railroads.."

370. "City of the Big Shoulders."

371. You know Sandburg's poetry.

372. Just that one.

373. After teaching English for ten years

374. I know them all.

375. Looks like you're feeling better.

376. ST segments are back down.

377. Hello.

378. Yeah, we're about five minutes out.

379. Well, that's good. Hold on.

380. - Janet's on her way in. - Thanks.

381. Listen, we're gonna need a gurney and..

382. What the hell's that?

383. It's the main rotor.

384. 'I got metal fragments in the gearbox.'

385. What's wrong?

386. Mark! Mark, are you there? Mark!

387. Mayday. Mayday. Mayday.

388. This is Lifeguard Nine-Seven-Kilo

389. 'on emergency descent.'

390. Cinch him in tight.

391. 'I'm gonna shut down for auto rotation.'

392. - Crash? - No, we're gonna make it.

393. Mark, can you hear me?

394. - What's going on? - I don't know.

395. There were horns, shouting, now there's nothing.

396. Mark?

397. VFR position.

398. Industrial area..

399. 'A scrap yard near 95th and Commercial.'

400. 'Now, when I get enough rotor speed'

401. I'm going to pull on the pitch. That should cushion our landing.

402. - 'We're falling.' - Hang in there, Tom.

403. Here we go.

404. Okay, everybody out.

405. Get out now.

406. - Take the monitor. - 'Got it.'

407. - 'Pumps are down.' - Let's go. Let's go. Move away.

408. - Airway kit. - You got the feet?

409. I got the feet.

410. Alright. Let's go together.

411. Alright, we gotta move. We gotta move.

412. - How far? - Just keep going.

413. I'll tell you when.

414. You alright?

415. Yeah, yeah, yeah. Let's go, come on.

416. - Tom, how you doing there? - SATs are down to 78.

417. Alright, I got to tube him.

418. Alright, alright. This is far enough.

419. This will shield us if the fuel tank blows.

420. Give me four of Versed, 100 of sux.

421. - Right. - Tom.

422. We gotta stick a tube down your throat.

423. Help you breathe.

424. - Do they know where we are? - Yeah, yeah, I called it in.

425. They'll find us.

426. 'I'm giving some medicines'

427. 'to relax you, Tom.'

428. - I got it. - Do they know anything?

429. ATC's got a mayday call with location.

430. EMS and fire are rolling.

431. - Are there any injuries? - They didn't say.

432. Well, call them back, damn it.

433. - What's going on? - Ah, Mark's chopper went down.

434. - What? - They crashed?

435. It was an emergency landing.

436. We don't know that. We don't know anything.

437. Randi, call County Dispatch.

438. They don't know anything more than I told you.

439. - I don't care! - Whoa, whoa.

440. Hey, hey, look. I can't have this place fall apart now.

441. Elizabeth, get on and stay on with CDO and keep us posted.

442. - Randi, how are we doing? - Nineteen patients waiting.

443. Alright, Malucci, grab some charts.

444. Abby, draw some labs, start some IVs for anyone who needs one.

445. Get Carter to order x-rays from triage, alright?

446. Let's move, people, now.

447. Where the hell is Kovac?

448. We're still trying.

449. Very nice.

450. Appreciate it.

451. You play here a lot?

452. Yeah, I work here in the Navy Pier.

453. What about at night?

454. Yes, sometimes for the after-dinner crowd.

455. Have you... ever seen this man?

456. No, I would remember a guy like that.

457. You don't seem like a cop.

458. I'm-I'm a doctor.

459. Try the tour boat ticket guy.

460. He's here all the time.

461. I did. Thanks.

462. Sorry, I can't help you.

463. Good breath sounds.

464. Keep him on high flow oxygen.

465. Fifteen more minutes and he sucks the tank dry.

466. - Where's EMS? - They sound close.

467. Yeah, but they can't see us.

468. They're gonna have to call in a police chopper.

469. Well, we can't wait. Do you have any flares?

470. 'There's a Very pistol in the chopper'

471. 'but I can barely walk.'

472. I'll get it.

473. 'Left side behind the pilot seat.'

474. Luka, it's Abby.

475. Um, could you call me when you get this message

476. 'cause I've been trying to reach you everywhere

477. and I'm getting a little bit worried, so..

478. - Abby. - Okay, call me.

479. Miss Skye here complains of abdominal pain.

480. Well, it's not really my abdomen.

481. Oh, I can't believe I'm actually embarrassed.

482. Well, we see everything here.

483. Okay.

484. I got a roll of money stuck up my..

485. birth canal?

486. Look, could you hurry up?

487. I got a cab waiting with

488. the meter running, okay?

489. Dr. Benton, I need you right now.

490. Six month baby boy, respiratory distress.

491. Alright, Abby.

492. Uh... just hold on one second.

493. Temp's 103. Coarse crackles bilaterally.

494. Pulse ox is only 75.

495. It's alright, let's take a look.

496. Sounds like pneumonia.

497. Now, let's get a pediatric intubation tray.

498. - Move now, people. - We got a line.

499. I'll draw CBC and blood cultures.

500. Damn, I don't even do pediatric intubations.

501. - Where's Cleo? - She took a kid to PICU.

502. Get her down here now. What size tube?

503. We use two and a half in the delivery room.

504. No, I think I need something bigger.

505. Uh, three, three and a half?

506. I don't know.

507. 'Got the labs.'

508. Move.

509. Uh, he's clamped down. I can't get the blade in.

510. - Paralyze him. - What's the dose?

511. You need his weight.

512. He's vomiting. Suction. Come on.

513. Pulse ox is dropping.

514. What do we have?

515. Uh, difficult intubation.

516. I-I can't dose him without a weight.

517. That's what the Broselow tape is for.

518. Okay, we're in the red zone.

519. 2.6 of Etomidate, 18 of sux.

520. Premedicate with.17 of atropine, 14 of lido.

521. Bag him. Keep some cricoid pressure.

522. I couldn't see the cords.

523. That's because you had the wrong blade

524. and the wrong tube.

525. - Thanks for coming down. - Drugs are on board.

526. - He's loose. - Okay, here we go.

527. - 'Dr. Benton?' - Hold on, hold on.

528. Okay.

529. I'm in, bag him.

530. Dr. Benton, do you wanna

531. close to paramedic traffic?

532. I've got this.

533. Hang 400 of ceftriaxone.

534. Vent settings will be tidal volume and 90 cc's..

535. No monitored beds and we're boarding five ICU patients.

536. - Alright, close to paramedics. - You sure you wanna do that?

537. We've been getting a lot of bad press lately.

538. Media's been tracking all of our closures.

539. - What would you do, Carter? - I don't know. Tough call.

540. Dr. Benton, South Side Urgent Center wants to send a patient.

541. Haleh says we're closed to transfers.

542. It's just a backache. Their x-ray machine's down.

543. - I got the other doc— - Fine, fine! Send him.

544. So, do we close? And don't ask me.

545. They don't pay me enough to run this place.

546. Paramedics found them on the South Side.

547. - No casualties, thank God. - Thank you.

548. Well..

549. - Well.. - Uh, thank you.

550. Trent?

551. Hey, they told us to wait

552. because you were busy.

553. Is she a friend of yours?

554. Uh... she's my girlfriend.

555. Your girlfriend?

556. Thought you said you didn't have one.

557. I brought her here, man. You think that was easy?

558. You gotta be honest with me.

559. - Is she the only one? - Yes, the only one.

560. I've kissed other girls though. Is-is that a problem?

561. - No sex with anyone else? - No, no.

562. And you didn't use condoms?

563. I love her, man.

564. Alright, okay.

565. Let's run some tests.

566. We'll see where we are.

567. - You wanna ride up front, doc? - No, I'm staying with Tom.

568. Nearest facility's Oakdale Community, seven minute ETA.

569. - Nope, we're going to County. - That's 20 minutes away.

570. Dispatch doesn't want us to leave our catchment area.

571. Alright, I'll take responsibility.

572. Easy now.

573. Roy, the doctor says we go to County.

574. - Can't. County's closed. - What?

575. They just closed to ER saturation.

576. That's okay. I'm an attending there.

577. They'll take us. Let's go.

578. Patch me through to the ambulance?

579. Dr. Corday, surgical

580. consult in Exam Four.

581. I'll be there.

582. Just give me the number.

583. Excuse me.

584. Uh, I'm looking for Dr. Corday.

585. Are you Janet?

586. - Yeah. - Elizabeth Corday.

587. - 'Oh, hi.' - We expect them very soon.

588. - How's Tom doing? - Quite well, I understand.

589. Apparently, no one was hurt in the landing.

590. What landing?

591. Just something minor with the helicopter.

592. So, how long have you two been engaged?

593. Oh, three years.

594. So, he's not in the helicopter?

595. No, in an ambulance.

596. Um, my goodness, three years.

597. That seems like a long time.

598. Right after he gave me the ring, he got the flu.

599. We thought it was no big deal

600. but then the virus went to his heart.

601. We spend a lot of time in hospitals.

602. Have you seen the incarcerated hernia yet?

603. - In a minute. - No, no, no, no. Now.

604. EKG on a new chest-pain patient.

605. - Alright, let me see it. - I got a guy on a backboard.

606. He's been there for two hours. When you gonna clear his neck?

607. - Oh, when I get there. - You want me to call Weaver in?

608. - No. - Are you ever gonna sew me up?

609. You know what, we're busy.

610. Just wait right there. What's this?

611. Second board. We're totally backed up.

612. Four patients just left without being seen.

613. 'Oh, oh, oh, I know what the solution is.'

614. We see them, send off labs and x-rays

615. and have them wait in chairs.

616. Come on, are you crazy?

617. We need monitoring, IVs, medication.

618. The problem is, you doctors order too many damn tests.

619. You should be reviewing their charts, keeping things moving.

620. Stroke patient needs a monitored bed.

621. - Peter. - We don't have them.

622. Tell them we'll put him in the hall.

623. Peter, none of my nurses have even had lunch.

624. Ambulance dropped off a stab wound to the belly.

625. Alright, alright, alright, alright.

626. That's it, that's it.

627. Get me the phone.

628. 'Heart rate is 40 after two of atropine.'

629. Amp of epi.

630. He needs a pacemaker, Dr. Greene.

631. We should be in a hospital right now, any hospital.

632. Rescue 82.

633. BP is down to 60 palp.

634. - Open up the dopamine. - It's for you.

635. Hello. Yeah, we're almost there.

636. 'No, he can't talk right now.'

637. 'He's out. I can't feel a pulse.'

638. I got to go.

639. Starting chest compressions.

640. We could have been at Oakdale ten minutes ago.

641. I'm going on record that you overrode our policy.

642. There's going to be an incident report on this.

643. Shut up!

644. Get back to work.

645. Hang in there, Tom.

646. You're going to make it.

647. Janet's there.

648. She's waiting for you.

649. - How long's he been down? - He never arrested.

650. He just needs help maintaining a pulse.

651. You look exhausted.

652. He wouldn't let us relieve him.

653. Come on, I'll take over.

654. Coming through, we're coming through here.

655. This is Janet Wei, his fiance.

656. Tom had a heart attack.

657. We need to put in a pacemaker.

658. You can take his hand.

659. Hey, Tom, it's me, I'm here. Can he hear me?

660. 'Keep talking to him.'

661. It's Janet. He's squeezing my hand.

662. 'What's his BP?'

663. Uh, 70 systolic

664. on 20 mics of dopamine.

665. How about a intra-aortic balloon?

666. Not a bad idea. Oh, what's going on?

667. - We need the room. - Everything's backed up.

668. We're supposed to be closed to paramedics.

669. Chuny, get that patient out of there.

670. Wait, the rapid infuser.

671. - Oh, my god. - Clamp the central line.

672. 'Turn it off!'

673. - I'm sorry. - Any housekeeping in here?

674. 'We need another two units from the blood bank.'

675. What the hell's going on?

676. I just got back from transport.

677. - I left Benton in charge. - Benton?

678. Mortimer goes to x-ray.

679. Put the rectal bleed in Exam Three.

680. Hey, hey, I got a patient who says her tongue is too smooth.

681. Tell her to get a life.

682. A smooth tongue can be a sign

683. of pernicious anemia, iron deficiency.

684. I can't leave for a day

685. without this place going to hell in a handbasket.

686. I've never seen it this busy before.

687. And it's like this every day.

688. Peter, I just heard from the trib.

689. Tell me we're not closed to trauma.

690. We're not. As of now, we're open.

691. How can we? We can't see another critical patient.

692. Abby, get me the nursing supervisor.

693. I want every remotely stable patient moved out of the ICUs.

694. 'I was under the mistaken impression'

695. 'you could manage an ER.'

696. I was the only attending. Kovac never showed up.

697. - He didn't show? - He might have switched his..

698. In 20 years, I have never been late for surgery.

699. But I guess you people work on a different standard.

700. And, Peter, based on your performance today

701. maybe you're not the guy for the per diem job.

702. Oh.

703. - Dr. Carter? - Yeah.

704. Lab results on Emma Miller.

705. - Oh, man. - That's tough.

706. She's 15 years old.

707. Pacer is capturing well.

708. Setting the rate at 80.

709. I got your transducer here.

710. 'How you doing?'

711. Passing a 40 cc balloon.

712. I need to check position with fluoro.

713. Janet, why don't you come talk to me outside?

714. This pump should bring his blood pressure up.

715. Will he live long enough to get the heart transplant?

716. I don't know.

717. I want to marry him.

718. I don't know if he's gonna be able to leave the hospital.

719. Can we do it here?

720. We could try and arrange it.

721. I think if we got married, it might help.

722. What if they made a mistake?

723. I wouldn't tell you if I wasn't certain.

724. But I don't feel sick.

725. You should do the test again.

726. Emma, if you start taking medication

727. right now..

728. you could stay healthy.

729. No, I know what happens. Everybody dies.

730. That's not true.

731. That's not.. look at Trent.

732. He's had HIV his whole life. Look at him.

733. I wish we'd never had sex.

734. Emma, I didn't know, I swear.

735. Dr. Carter, tell her, please.

736. This is a lot.

737. This is a lot for you to handle.

738. And you're both gonna need some help.

739. So before you go, I would like you both

740. to talk to a counselor.

741. - Hey, hey, Emma. - Hold on, you two. Hold on.

742. I'll leave you two alone for a little while.

743. But before you do anything... talk it over.

744. Definitely, thanks.

745. Hey, hey, come on.

746. Why is Mr. Chang still here?

747. He's waiting for a second CBC.

748. Okay, do another hemocue. If it's over 11, send him home.

749. Torelli's cardiac enzymes.

750. Great. Alright, she's out of here.

751. Clears up another monitored bed.

752. You know, Romano was out of line.

753. When isn't he?

754. It's wrong to throw you into the deep end and expect you to swim.

755. Nobody masters ER management on their first day.

756. - What's this? - Back pain.

757. - Collapsed at triage. - Both trauma rooms are full.

758. Send him to Curtain Two. Move him out of there. Go!

759. - I need a central line kit now. - BP 60 palp.

760. Could be a ruptured aneurysm.

761. Alright, CBC, coag, type and cross for eight.

762. Four units of O-neg. Let's prep the neck. Move.

763. I feel a pulsatile mass.

764. Hey, Malik, is there any history on this guy?

765. I need a trauma kit.

766. This is a triple lumen CVP. Here.

767. History of hypertension and high cholesterol.

768. Give me an NG and a Foley. I need a Sonosite.

769. 'Dr. Benton, it says here that you accepted'

770. this patient from an urgent care center.

771. What, and he's been waiting in chairs?

772. For two hours.

773. I can't find the subclavian.

774. Put him in Trendelenburg.

775. Look, they said it was just a back sprain.

776. The doctor told you that.

777. Well, I, uh... I didn't exactly talk to the doctor.

778. Oh, great, and now he's bleeding out.

779. Take a deep breath.

780. MAP is 78 with the pump.

781. Is that good or bad?

782. It took you out of heart failure

783. and got you off your breathing tube.

784. Sats are up to 99.

785. Okay, let's get him on five liters, nasal cannula.

786. Connie, why don't you grab a blood-gas kit?

787. Where's Janet?

788. She's trying to get a clerk from City Hall

789. to come issue a marriage license.

790. That's crazy.

791. People in love do crazy things.

792. 'I wanted to wait for a transplant'

793. so I could chase her down the aisle.

794. I didn't want her to marry a cardiac cripple.

795. If you get a heart, she won't.

796. If one's available, if the tissues match.

797. How long can I last on this pump?

798. Couple of weeks.

799. Pretty lousy odds.

800. They were worse when you were having a heart attack

801. and the chopper was going down.

802. - See any zephirin? - Yeah, top shelf.

803. Hey, I heard about your teenagers.

804. They're so young.

805. It's pretty rough.

806. - Are you okay? - Yeah, I think so.

807. Do you wanna take a break?

808. I'm going to plug in two new patients.

809. I'll come find you.

810. - Talk to Kovac? - Not yet.

811. 'Dr. Kovac?'

812. Yeah?

813. We finished the autopsy.

814. I can review some of the pertinent findings.

815. Mm-hmm.

816. There were multiple contusions

817. to the occipital cortex

818. with herniation to the foramen magnum.

819. And if you'll take a look here

820. you'll see numerous fractures

821. consistent with repetitive blunt trauma.

822. I know how he died.

823. Well, I can tell you that he was a smoker

824. based on the lung findings.

825. Also, he probably once lived in Central California.

826. There were foci of pulmonary fibrosis

827. consistent with coccidioidomycosis.

828. It's endemic to the San Joaquin Valley.

829. That's an agricultural area.

830. Maybe he grew up on a farm.

831. Well, I don't know.

832. There's grease under the fingernails

833. and a biker club tattoo.

834. 'He could be just a drifter, but we'll probably never know.'

835. 'Happens all the time.'

836. Not such a smart idea

837. to take your Razor down

838. a flight of stairs, huh?

839. Were you wearing a helmet?

840. Yeah, what do you think I am, stupid?

841. Ooh. Well, we'll see after the x-ray.

842. Right wrist film, something for the pain, maybe half of a—

843. It happened so fast.

844. We were having a fight

845. and he ran into the street

846. and a car hit him.

847. We're doing everything we can.

848. - Dr. Carter? - What's the rhythm?

849. V-fib. Charge to 360.

850. Trent, don't die. Trent.

851. Ready. And clear.

852. 'Please don't let him die.'

853. 'Still V-fib.'

854. - Hey, doc. - Hey, thanks for coming down.

855. Sure. What do you need?

856. Thirty-one-year-old patient

857. end-stage heart failure.

858. He may not make it to transplant.

859. What denomination?

860. - I don't know. - Can he speak?

861. For last rites, I really need to know that.

862. No, no. He and his fiance, they wanna get married.

863. - Tonight? - He's too sick.

864. We can't get him movin'. We got to do it here.

865. Were you able to get a license?

866. Oh, I tried, but City Hall's closing.

867. You don't have a marriage license?

868. Can you do it anyway?

869. I'm sorry, but a marriage isn't

870. legally binding without a license. How about tomorrow?

871. Come here. He may not make it till tomorrow.

872. Can't you help these people? They want your blessing.

873. They have very little time.

874. Well, as long as everyone understands

875. it won't hold up in court.

876. Yeah, yeah.

877. You ready to tie the knot?

878. Come on, let's go talk to Tom.

879. Dr. Kovac, did you trade your shift?

880. - No. - Hey, where have you been?

881. I heard they couldn't reach you

882. and you didn't answer your page.

883. What-what's the problem?

884. That I had to come in today and cover for you.

885. - I thought I was on tonight. - No. You were on today.

886. Then-then I'm sorry. There must've been some mistake.

887. There was no one with enough experience to cover for you.

888. We almost lost two patients.

889. Luka, this is grounds for dismissal.

890. Fine, Kerry, fire me.

891. Look, I know that you've been through a lot.

892. If you need to take some time off, you should tell me.

893. But you can't miss anymore shifts.

894. I can work tonight.

895. We don't need you tonight.

896. You should go home.

897. Go on. Go.

898. - Luka, wait. - What?

899. Wait a minute. Don't walk away.

900. Where have you been?

901. Abby, please.

902. I-I wanna help. Just talk to me.

903. There's nothing to say. Okay?

904. "To have and to hold, to love and to cherish

905. "as long as you both shall live.

906. "The union of husband of wife in heart, body and mind

907. "is intended by God for their mutual joy

908. '"for the health and comfort given to one another'

909. "in prosperity and adversity

910. "and, when is God's will, for the procreation of children

911. and their nurture.."

912. You can stay as long as you want, okay?

913. Emma, I am so sorry.

914. Get out of here.

915. - Emma. - It's your fault.

916. By the power vested in me

917. I pronounce you husband and wife.

918. Go ahead and kiss your bride, Tom.

919. - Congratulations. - Congratulations.

920. I'm gonna break all the rules

921. and allow you to have one sip of champagne.

922. Thanks.

923. Well, since this is the honeymoon suite

924. I think you're entitled to a little privacy.

925. We're very grateful. Thank you.

926. 'Yeah.'

927. For everything.

928. Nice folks.

929. Tell them to get a license and I'll do it again. No charge.

930. - Okay. - Thanks.

931. So, what about our wedding coordinator?

932. I totally forgot to call and cancel.

933. - Oh, she'll be furious. - Well, blame it on me.

934. I mean, it was a medical emergency.

935. Oh, the hell with her.

936. - Excuse me? - This is all so silly.

937. I don't want a rose-entwined arbor with trained doves.

938. I don't want champagne served out of crystal flutes.

939. I understand.

940. Who cares about a bloody ice sculpture?

941. Not me.

942. I just want to get married

943. in a simple ceremony.

944. I don't know. I was looking forward to those doves.

945. So, I spoke to the OR.

946. The aneurysm repair is going well.

947. - I'm glad to hear it. - Yeah.

948. I think it's best for now

949. if you just see patients. Here.

950. If that's what you want.

951. Peter, you're an excellent surgeon

952. but ER management is not the best use of your skills.

953. Leave that to us.

954. Hello, Mrs. Barnwell. I'm Doctor Benton.

955. So, I understand you have a pain in your hip.

956. That's right. And I've been lying here for three hours.

957. Oh, well, I'm very sorry about that.

958. Pardon me for asking, but are you an intern?

959. No, no, no. I'm a faculty physician.

960. Oh. Your mother must be very proud.

961. Yeah, she was.

962. So, how long have you had this pain?

963. Before we get much further

964. I'd like to say that I would be more at ease

965. with another doctor.

966. Excuse me?

967. You look like a fine young man

968. but, uh, I've always had white doctors.

969. I've always felt more comfortable that way.

970. So, you're saying that you only want to see a white doctor?

971. If it's alright with you.

972. It's fine.

973. You'll just have to wait another three hours.

974. - What happened to him? - I don't know.

975. Hey, uh, have you seen Abby?

976. I saw her punch out.

977. Hey, Carter, you got a minute?

978. Uh, actually, I'm just on my way out.

979. Carter, wait.

980. John, you had a bad day. We all have bad days.

981. Look at me.

982. You have to make tough choices.

983. Do what you think is right and accept the outcome.

984. - I shouldn't have told him. - You had to.

985. - See you tomorrow. - Hey.

986. I'm off in 20 minutes.

987. You wanna get some dinner?

988. I got an AA meeting at 9.

989. You'll make it.

990. Can I join you?

991. It's a counter, Peter, you can sit anywhere.

992. So you survived.

993. Weaver said I was incompetent.

994. Really?

995. Well, I mean, that's what she implied.

996. The per diem job is just temporary

997. until you get back into surgery.

998. Yeah, but I needed to show them

999. that I can run the ER.

1000. Why? It has no bearing on your surgical career.

1001. Yeah, but it reflects on me.

1002. You know, I should've been able to handle it.

1003. Can't be perfect at everything.

1004. Yeah, but, Cleo, I can learn the job, if I can do it well.

1005. So do you feel better having said this to a sympathetic ear?

1006. Yeah. Yeah, yeah, I guess so.

1007. Thanks.

1008. You know, I've had some problems

1009. and I haven't had anyone to talk to.

1010. Are you ever going to be there for me?

1011. Because you sure as hell haven't been.

1012. 'Who is it?'

1013. It's me.

1014. Can I come in, please?

1015. Sure.

1016. - Abby.. - You don't have to talk.