All language subtitles for Chicago Med s10e18 Together One Last Time.eng

- My mother died
of prion disease

when she was 45 years old.

My father took his own life
three hours later.

- Why'd you share this with me?

- I knew you wouldn't pity me.

When it comes to surgery,

you have to think
three steps ahead.

- She is one of the best
and brightest I've seen.

And that's a testament
to your mentorship.

- I've been accepted
into Gaffney's

cardiothoracic residency program.

- Something I've been working
on for the last year or so,

doing IVF.

- I wanted to give you this.

- 25 grand?

- It would be a tragedy
if you never got to be a mom.

[dramatic music]

- [laughs]

- Look at her go.

And, of course,
the younger one gets the doll.

- Sharing is caring.

Am I right?
- Mm-hmm.

I used to hate it
when you would take my things.

- Oh, I know.

- Hey, what is up with you?

You've been smiling like
a schoolgirl all morning.

- What do you mean?

- Did you and Mitch
hook up again?

- What?
- I mean, I wouldn't blame you.

He's beautiful.

- I did not hook up
with Mitch again.

Though, I think we do need
to have a conversation.

- About what?

- I Kind of told him
I loved him

when he was stuck in the well.

- Oh, my God, Hannah.
- I meant it.

I meant it, though.

You know, I got caught up
in the moment.

I thought he was
gonna die, Lizzy.

- It's like a soap opera
with you two.

- It's-
[sighs]

It's not.
- [groans]

- You all right?

- Yeah. No, it's nothing.

Been having this wicked
indigestion lately.

- Lately?

Well, how long has that been?

- I don't know, about a week.
- OK.

Well, let's get you
into Gaffney...

- No.

- Get a little looksie,
just in case.

- It's nothing.
Please, Hannah, no.

- I am not taking no
for an answer.

- I'm sorry, Dr. Charles.

I know that cardiac workups
aren't your normal domain,

but we're a bit shorthanded
at the moment.

- Yep, yep, yep, yep.

- 49-year-old male
collapsed in a stairwell.

Lenox says she'll be in
to do an echo

as soon as she's out
of her budget meeting.

Oh, and evidently, the wife
is a bit of a character.

Treatment 3.

- [laughs]

- I'm not actually sure
what happened exactly.

I just know that it was
getting hard to breathe,

and then my heart
started beating fast.

- Like palpitations?
- Yeah.

- Ever had those before?

- I used to get them
every now and then,

but it's been quite a while.

- So the paramedics said that
they found you in a stairwell.

- He kind of
just collapsed in my arms.

- Yeah, thankfully,
Cynthia was with me.

- Uh-huh.

Cynthia is your... wife?

- Ex-wife, actually.

We were attending
our class reunion.

- That's where we met,
Northwestern.

- I did a summer session there
myself during undergrad.

It's a great school.
I'm Dr. Lenox.

I've been looking over
your chart, Mr. Parker,

and it seems your enzymes
came back negative,

so I think we can rule out
a heart attack.

There was a tiny irregularity
in your EKG, however,

but that could just be
the result of overexertion.

They tell me you were
in University Hall

when it happened?
- Mm-hmm.

- Were you trying to climb
the clock tower?

I'm not sure you can actually
reach it from the stairs.

- [chuckles]

No, I wasn't
taking the stairs.

- So why were you
in the stairwell?

- Uh, Cynthia and I
just reconnected

a little over a month ago.

- After five years apart.

- Actually,
more like nine, babe.

- Nine?
No, that's not right.

- I got the canceled
alimony checks to prove it.

[chuckling]

- Are we still talking
about the stairs?

- Oh, my God,
we were having sex.

[soft dramatic music]

Might that explain
the overexertion?

- It might.

Let's do an echocardiogram
to take a closer look.

- You see what you do
to me, baby?

You literally make
my heart race.

- [laughs]
- Get over here.

?

- You know what?

It is time
for my midmorning coffee.

Cynthia, would you like
to join me

while Dr. Lenox finishes
examining Ron?

?

- Don't do anything
I wouldn't do.

- Oh, I know.
Oh, God, it is crowded.

OK, you wait here, and I will
go check on a room, OK?

- Ooh, ooh.
- Oh, oh.

- Sorry.

- Hi, Mitch.

- Lizzy, good to see you.

- Likewise.

- Uh, I thought you were off
today-everything OK?

- Yeah, just getting
my sister checked out.

You're-you're running again?

- Yeah.
- That's great.

- Yeah, I guess.

I'm still trying to get
my wind up though.

- Yeah, it's the last time.

Last time I'm running
with this maniac.

Hey, hi.
Sorry.

I'd give a proper hello-

cardiac event, I'm pretty sure.

Sorry.
- Mm-hmm.

[laughs]
- [panting]

- I've-I've been meaning
to talk to you.

- Yeah, me, too.

Maybe once you get
your sister settled

and I change into some scrubs?

- Yeah.
- OK.

- Help!
Please!

- He's barely breathing.
- It's our son.

- Anybody, please!

- Let me take him inside, OK?
OK?

- OK.
- I got him.

- Right this way.
Come on.

- Hey, we need a nurse
and a tech, and call RT.

- Gotcha, Trauma 1.
- OK.

Let's put him on a monitor.

[tense music]

- Mommy, I can't see.

It's all blurry.
- It's OK.

Mommy's right here.
- Ma'am? Ma'am? Excuse me.

What happened?

- We were at
our old farmhouse

we're renovating
out in Kankakee,

and Miles was playing
in the hayloft.

- He was fine until
we started driving back,

but he said he felt dizzy
and that his stomach hurt,

so we headed straight here.

- Sudden lethargy
and difficulty breathing.

- Toxidrome.

OK, he must have gotten
into something.

- Organophosphate, maybe?

Do they grow crops there?

- Uh, we don't know for sure.

- Maybe an anticholinergic?

Could he have gotten into
any medications-

antihistamines, antidepressants?

- It can't be that either.

I mean, he's drooling.

Look at all the saliva.

- BP 74 over 48.
- OK.

We need to intubate.

Give me a 5.0 cuff to ET tube
and a Mac 2 scope.

Draw up 5 of etomidate
and 17 of rocuronium.

- Let's think about it,
all right?

Lethargic, hypotensive,
drooling, dilated pupils.

- And out at a barn.

?

- OK, I'm not seeing
anything over here.

- What are you looking for?

- No.

- Hey.

?

[together]
Snakebite.

?

- Good morning.

- Hey.

What's-what's with the box?

- It's my last day
in the ED, remember?

I start up in cardiothoracic
next week.

- Yeah, that's right.

- I'm inviting everyone
to Molly's after work

to celebrate.

- Oh, yeah. Thanks, no.

Big send-offs
aren't really my thing.

However, I do have the
perfect parting gift for you,

a patient all to yourself.

- Is anyone gonna bring me
an extra pillow?

My neck is killing me!

- What's the catch?
- There's no catch.

Murph comes in every few months
with some mysterious ailment.

You'll love him-
maybe not today but eventually.

- OK.
Good to know.

Thank you.

I'll get changed
and get right on it.

- OK.

- You know, if you would have
told me a year ago

that I would all of a sudden
find my ex-husband

attractive again,
I would have said

you need your head examined.

And yet here I am back again
with a schoolgirl crush.

Do you know he's taking me
to Norway tomorrow

to see the northern lights
for my birthday?

- Lucky you.
- [laughs]

Yeah.

[sighs]

- PayDay, huh?
That is a classic.

- It's funny.
I loved to use these back-

I love-to use-

I love to use these-

I used to love these
back in the day.

They helped me get through
my senior thesis.

I don't know why I find myself
craving them again.

- Maybe that's like a-
I don't know-

a theme for you right now,
rekindling old loves?

- Hmm?
What?

- The candy bar,
your ex-husband.

- And since when is
nostalgia a crime?

- Could you excuse me
a quick second?

I'll be right back.

Hey, what do you think?

- Well, with Ron,
I'm not entirely sure.

His symptoms suggested
congestive heart failure,

but his echo looks pretty good.

So I'm gonna talk to Dr. Hayes,
see what he thinks.

And maybe you want
to debrief the ex-wife.

I'm not sure she approves
of my bedside manner.

- Yeah.
My pleasure.

- Thanks.

- We're administering
what's known

as a polyvalent antivenom.
It's called CroFab.

- It'd cover the handful
of venomous snakes

endemic to the area.

- There's four, actually-
the copperhead,

cottonmouth,
timber rattlesnake,

and eastern massasauga.

Someone from the Home Team
sent it to us.

- Home Team?
- What we call our followers.

We were live streaming
when it all happened,

so we've been getting
nonstop messages.

- Yeah, I'd stay out
of the comment section

when it pertains to medicine.

- No, our people haven't
steered us wrong yet.

We started doing
home improvements

on social media 11 months ago.

Our channel just took off
with their help.

- That's great.
I just-

I would rather focus
on your son right now

and not the Home Team.

- Are you accusing us of
not caring about our child?

- Absolutely not.

Honestly, we'll take
all the help we can get.

We'll just keep
our fingers crossed now

that the antivenom
can do its job

and bring Miles' swelling down.

We'll check back soon.

[tense music]

- Lizzy, you remember Dean.

- Hi.
- Hey.

- Hey.

- Sorry,
finally found a window.

- Oh.
- Is, uh-is this a bad time?

It's OK if it is.

- Oh, um-
- Oh, no.

- I've got-

- You two should talk already.

Dean here can get me
started, right?

- Yeah, I think
I can manage it.

- Good.

- After you.
- Sure.

- Mm.

- I know I've given you
some mixed signals lately,

first breaking up with you
and then telling you

that I love you too-
- Hannah,

you don't have
to explain yourself.

I'm not gonna hold you
to something

you said when I was
on the verge of dying.

- Oh, Mitch, that's not-

- Hey, hey, it's all right.

I've been doing a lot
of thinking lately,

and, um,

you were right,

what you said about me
when we broke up,

about my anger issues,
about me not knowing

how to be in
a healthy relationship,

all of it.

- I said a lot of that
when I was angry.

- And you had
every right to be.

- [sighs]

[soft dramatic music]

?

- I threw away a winning
lottery ticket with you,

and I'm gonna have to live
with that the rest of my life.

?

I just hope, at the very least,

you'll be able to forgive me.

?

- Your heart rate
sounds normal, Murph.

- Well, it was beating
like crazy this morning,

when my arm started hurting.
- OK.

So what other symptoms
have you been experiencing?

- Well, last night, my stomach
started hurting so bad,

it was like I couldn't see.

And then this morning,
the pain went into my chest.

And now it feels like
it's more in my neck.

Well, like I said,
sharp pain on and off.

And my hand gets tingly.

You think maybe it's a stroke?

- No.

- You think I'm crazy,
don't you?

- Nope, I do not.

- Look, we can just
slip past all of this,

and you can just
slide me some meds,

and I can just get
a decent night's sleep.

Dr. Archer is-he is stingy
with the good stuff.

- I'm sorry,
but I can't do that, Murph.

- Why do I waste my time?

- What I am going to do
is try to figure out

what's causing your pain.

So I'll run some tests and see
what we can come up with, OK?

- You're probably just
trying to cover your ass

so I give you a good review.

- Hey.

So how did it go?

You didn't
take him back, did you?

- No, of course not.

Weirdly, it seems like
Mitch is actually-

actually changing.
- Oh.

- Hmm.
- What?

- In my experience,
people's changes

tend not to last.

Eventually, everybody goes back
to being who they are.

- Well, I don't know
about that, Dean.

- [sighs]

Oh, my God, look at that.

- That is your baby girl.

- It's a girl?
- You get a girl.

- [laughs]

- I'm no obstetrician,
but I'm pretty sure

those are her feet.
- Yep.

She'll start kicking about now
and making facial expressions.

- You know,
I wonder if she's learned

how to roll her eyes yet.
- OK.

Let's hear that
little heartbeat.

[ominous music]

?

- Something wrong?
- Let me see that.

- Yeah.
- [clears throat]

?

- Why don't I hear a heartbeat?

?

- Lizzy, I'm so sorry.

There is no heartbeat.

?

- [cries]
What? No.

[sobbing]

- Well, you were right,
guy's a conundrum.

How'd he get short of breath
and syncopize

with a good ejection fraction
and normal valves?

- My thought, exactly.

- Maybe it was an arrhythmia?

Let's keep him on the monitor,
slow him down with metoprolol,

and repeat his EKG.
- OK.

Thank you, Dr. Hayes.

- You know, usually, you'd want
to consult with a cardiologist

for symptoms like these-

not that I'm complaining.

You know I always love these
little meetings of our minds.

Speaking of meetings,
are you going

to the leadership conference
in Myrtle Beach next month?

- I don't know, those things
aren't really my cup of tea.

- Oh, they're not meant
to be your cup of tea.

They're meant to be
your frozen margarita

with a salted rim
and a mezcal float.

- Oh, you mean a boondoggle?

- Mm, I like to think of it
as some well-needed R&R

to recharge the batteries.
- Mm-hmm.

- Come on.
It's a free weekend in the sun.

Relax by the pool,
get a massage,

maybe let your hair down.

- You seem to have me
confused with someone

who's able to do that.
- Do what?

- Uh, let your hair down.
That's not me.

I'm not that kind of person.

- Oh, I think you're wrong.

- You're being
very presumptuous.

- Oh, um,

I didn't mean any offense.

- It's probably best
if we keep our interactions

focused solely on work
moving forward.

- Yeah, message received.

I should know more about
your patient within the hour.

- I just keep playing it all
over and over in my mind.

Should I not have been walking
around in the cold today?

Did that somehow harm the baby?
- No.

No, Lizzy, listen to me.
Listen to me.

You cannot blame yourself, OK?

- [sighs]

- Sometimes these things,
they just-

they happen.

And based on the measurements,
been about a week

since the baby had a heartbeat.

- A whole week?

How could I not have felt that?

- Hey,
I know that this is hard.

OK?

But the fact that you got
pregnant the first time

means that you can do it again.

- I'm not so sure anymore.

After all I've been through,
the IVF rounds, I just-

- Stop that, Lizzy.
You will be a mother.

I truly believe that.

[soft dramatic music]

- [sighs]
All right.

So what happens now?

- Well, we'll need to perform
a D&E to remove the fetus,

which I know
it can sound kind of scary,

but it's very safe,
very standard.

- And you will be
doing it, right?

- Lizzy, no.
I'm sorry.

It's against hospital policy

for doctors to operate
on family members.

- What?
No, no.

Hannah, please.

I need to know
someone I trust is there.

[tense music]

?

- How's your sister?

- She asked
if I could do her D&E.

- Mm, yeah.

It's gonna be hard
to get by Legal.

- I know.

I already told her.

- Let me talk to Kalmick.

Lizzy may have
to sign a waiver,

but we'll figure it out.

?

- Hey, guys,
I could use some extra eyes.

My patient, Murphy Costello-
- Oh, Murph.

- Oh, what's his problem today?

- Trying to score
some pain meds off of you?

- Well, I initially thought
a herniated disk,

but his MRI came back clear.

- You sent him for an MRI?
- Yeah. Why?

- Well, Accounting's
gonna have a conniption,

but, hey, it's not my money.

- What about nerve impingement?

Did you do a Neer's test?
- Yes.

And a Hawkins-Kennedy
and a Jobe,

and those were negative
as well.

- OK, well,
maybe it's just

all in his head again,
like last time.

Um, do you think you maybe

want to, like,
hot potato him over

to Dr. Charles 'cause he's-
- No, no, no.

There's got to be something
I'm missing.

It's my last day.
I want to go out with a win.

- Fair enough.

- You wanted to know when
the fifth vial of CroFab

had been administered?

- Yeah.

- The antivenom's
still not taking.

- BP's still softer
than we hoped for.

- Darla, let's double it up.

Give him another
five vials please.

- Whoa, that seems like a lot
for a little kid.

- The dose is actually
for the amount of venom

coursing through his body,
not his size.

- And what if it weren't one of
those four snakes that bit him?

- Well, in that case,

we'll have a much steeper hill
to climb.

- I'll go call Animal Control

and see if they've spotted
any other venomous species

in that area.

- We'll be back with you
in a minute, all right?

- You heard that, Home Team.

Just to update you, Miles is
doing worse than we thought.

We really need everyone's
strength and prayers right now.

- Excuse me.

What are you doing?

- We're just giving
our followers

an update on Miles' condition.

- Your followers?

Does this seem like
an appropriate time

or place to be doing that?

- Look, I know what
this must look like, but look-

- No, what it looks like
is you are exploiting

your son's life-threatening
condition to get more views.

- No, no, that's not
our intention at all.

- You are aware
that you're the reason

he is in this position, OK?

Because you were
not watching him

when you were supposed
to be watching him.

He's your son, OK?

You're supposed to be there for
him to protect him, all right?

So the least you can do
right now

is put the phone away and
be present with him here.

- Dr. Frost.

[tense music]

Perhaps you should
go clear your head

for a minute,
give these parents

some time alone with their kid.

- Yeah.

?

- But what's it called, WPW?

- Wolff-Parkinson-White
syndrome, yes.

It's a heart rhythm
disorder characterized

by an extra electrical pathway
in the heart,

a congenital defect.

- You've essentially
had it all your life.

That's what's been causing
the intermittent tachycardia

over the years.

- It just didn't reveal
itself until now.

- OK, so what happens now?

- Well, correcting
the arrhythmia

is pretty straightforward.

We'll send a catheter
up through your veins

and ablate the extra
electrical pathway.

- So what's the recovery time
on this, usually?

- About a week or two.

- Well, so if we wanted
to travel tomorrow-

- I'd recommend against that.

- Well,
I can just postpone this

until we get back from Norway.

- Ron, don't be stupid.

- It's your birthday, babe.

It's a big one.

This trip can't be rescheduled.

Look, there's gotta be
some kind of Band-Aid

you could put on it, get me
through the next few weeks,

right?
- Oh, my God.

You've lost your mind.

- We could prescribe
an anti-arrhythmia

medication temporarily.

- And so has this one.
What is wrong with all of you?

I'm surrounded by morons!

- What's gotten into you?

- God, I need somebody here
who knows something.

Dr. Charles,
can you get in there?

I-my idiot-my-

my-

he needs a shrink, and so
might every single one of them.

- OK. OK.

?

- What are you all looking at?

?

- Cynthia.

Ron wanted me to find you
and tell you that he's decided

to go ahead with the surgery.

And Dr. Hayes is taking him
upstairs right now.

- OK, well, my little fet-

my-my little effect

had the desired show-

effect, then.

[sighs]
You know what I mean.

- I hope you don't mind
me observing

that that's not the first time
that that's happened today.

- Well, it's been
a stressful few hours,

and I'm turning 50
in a couple of days,

so it's probably
just a senior moment.

- Maybe.

But, you know,
in my line of work,

when those senior moments
are accompanied by

fine motor skill issues
and sudden flashes

of irritability, disinhibition,

I get concerned.

And something tells me that,
I don't know,

maybe you're starting to get
a little concerned yourself.

- You know the best part

about reconnecting
with an old love?

- Tell me.

- It's the way
they look at you,

as if you haven't changed.

- I am familiar
with that phenomenon.

- I mean, Ron was never
the most observant partner

to begin with,
but it's really sweet.

He's so smitten,
he doesn't see.

- You know, if you want,
we could just run some tests,

you know,
while they're working on him.

[soft dramatic music]

- [sighs]

OK.

You know,

for a second there,

I was really, really looking
forward to this birthday.

- Murph, please,

I just need 20 minutes.
That's all.

- Enough.
You're not listening to me.

Fix what's wrong,
and let me go-

let me-
just let me go home.

- Just give me 20 minutes, OK?

20 minutes.

[sighs]

- Why hasn't Murph
been discharged?

He came in hours ago.

- I've been trying
to make a diagnosis,

but it's been elusive.

My most recent hypothesis
was that

it might be
an unusual presentation

for pronator teres syndrome,

but the pain's
not localized enough.

I-

I confess, I'm stumped.

- I appreciate
your thoroughness,

but we need
to open up that bed.

So if you can't figure it out
and it's not emergent, move on.

- Got it.
Oh, speaking of moving on-

- I know.
It's your last day.

I'm sorry,
but I'm not available

to come to Molly's tonight.

- Um, that's OK.

I know you're busy.

- Listen, whatever Murph
came in here to complain about,

he's gotten it off his chest,

so don't beat your head
against the wall.

Just cut him loose.

- He's gotta get something
off his chest.

- I just said that.
- Thank you, Dr. Lenox.

I need to do an ultrasound.

- Hey, Renee?

Is Trey around?
- He-he left.

He was a little worked up and
said he didn't want to talk.

- About that,
uh, we wanted to apologize

for what transpired earlier.

You guys are going through
a tough time right now,

and, well, anyway,
I think what Dr. Frost

and I are trying to say is-
- I had-

I had no right
to lecture you like that,

and I apologize.

- No, you were right.

This social media thing was
supposed to be something fun

for our family to do together,

but now I'm afraid that
I let it become our identity.

Swelling hasn't
subsided yet, has it?

- No, not like we would
want to see right now.

- But we are nowhere near
giving up hope.

We're actually in consultation
with a transfusion specialist,

and we might be able to try an
experimental plasma exchange.

- I got it!

- Whoa! Hey!
- Whoa!

I got it.
I got it.

- What did you do?

- I killed that son of a bitch.
That's what I did.

- What?

- Your words kept ringing
in my head, Dr. Frost,

my boy lying there
suffering and helpless,

and here I am on my phone,

instead of doing
something about it.

- Uh-huh.

- So I went back to that barn,

and I tore it apart
until I found this bastard

up in the hayloft.

I picked up a shovel,
gave it a good whack,

knocked him out cold.

- You brought a live snake
into the ED?

OK, this is good.

Um, you know, we can get
Animal Control to ID it now,

so...
- OK.

Yeah, here, look.

- Careful.
- I am.

[ominous music]

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

- Are you sure
you brought it in?

- Uh, yes.
Yes, I am.

OK, I felt it in the bag
when I walked in,

and security was giving me
a hard time with my ID,

so I put it down, and-

- Oh, my God.
Trey, tell me you didn't.

- Oh, damn.

Oh, damn.
- OK, don't panic.

It's OK.
Just-

Hey, at least we know
it's in the hospital.

?

- I checked the waiting room,

the trauma rooms, nothing.

- And you didn't tell
anyone else, right?

- Well, not yet.
Why?

- Ironically, the protocol
for a snake being on the loose

in the hospital is to not tell
anyone a snake is on the loose.

- What kind of sadist writes
these protocol manuals?

- We have to project
an air of calmness.

Security and maintenance
and every other spare body

is searching high and low,

and Animal Control
is on the way.

- Hey, hey.

So I spoke with the dad.

He said it was red with
black and yellow bands.

- That sounds
like a coral snake,

which is an elapid,
not a pit viper,

and that would explain
why the polyvalent antivenom

didn't work, because
they're not normally found

in this part of the country.

[soft dramatic music]

- I'm not even gonna ask
why you know that.

- I'll call the zoo,
see if they can

send over some antivenom.

- I'll notify security.

Keep me posted.

- Uh, I'll-

- OK.

That's just about everything.

- Well, you heard the boss.

Let's wrap it up
and dial her down.

- Hey, thanks for talking
Kalmick into letting me

take the lead on this one.

It meant a lot to Lizzy-

and to me.

- Don't mention it.

He's actually
really understanding

once you've signed
all the releases.

- Hold on.

- What is it?

[vitals monitors beeping]

- That's strange.

She's still bleeding.

[tense music]

?

Her uterus is boggy.

It's not contracting
down at all.

She's starting to hemorrhage.

Give her 250 micrograms
Hemabate, IM.

- Do you need
a balloon catheter?

- No, that won't work
quickly enough.

We need to open her up.

?

- Oh, hey.
- [gasps]

Ah.

- Hi.
Yeah, sorry, yeah.

- Sorry, didn't mean
to scare you.

- No, no, no.

I was actually just
about to come find you.

Mr. Parker's ablation
went swimmingly.

We can notify the ex-wife.

- Oh, great.
- Yeah.

- Um, I wanted to get
your take on a scan.

- Yeah.

There appears to be
a pattern of atrophy

on the frontal
and temporal lobes.

It's a tad asymmetrical,
so I would favor

frontotemporal dementia
over Alzheimer's

if I was doing a differential.

Why? Whose image is that?

- Cynthia's.

- That would explain
the disinhibition.

- Among other things.

- You suspect
behavioral-variant FTD?

- I do.

And she doesn't
want Ron to know.

- Well, a terminal diagnosis
like that

is hard enough to contextualize
for yourself

without dumping it on
someone you care about.

- Dumping?

That's an interesting
choice of words.

- The knowledge of
a terminal diagnosis

is like its own disease,
Daniel.

Once someone knows,
they're infected

with all of the pain
that comes with it,

and that pain can be worse
for those that have

to watch their loved ones
suffer than it even is

for the patient themself.

So Cynthia is protecting Ron
by not telling him.

She's shielding him
from a slow-moving tragedy.

- Oh.

It sounds like you've had
some experience in this area-

similar cases is what I mean.

- Doesn't every doctor?

You know, I'm just saying,
Cynthia has a point.

That's all.

- OK, what are you
looking for again?

- The anterior scalene muscle.

If my theory is correct,
that's where the bulk

of the problem lies.
- Wait.

You're injecting me with what?

- A mix of a numbing agent,
Marcaine,

and a steroid that will help
reduce any inflammation.

- Yeah.
Did I mention I hate needles?

- Relax, Murph.

This will only pinch a bit.

Just, please,
look at the monitor.

- [gasps]
What the hell?

- Thank you.

- Oh!

- How do you feel?

- I feel...

Nothing-

[sighs]

In a good way.

- Yeah.
- Wait.

What-what did you say
this was again?

Because I couldn't
concentrate before.

- It's called thoracic
outlet syndrome.

It's when the nerve
or blood vessel

gets compressed between
the space in the first rib

and your collarbone.

In your case,
both are being squeezed,

which is why your symptoms
were so varied.

But that injection
should ease your pain

temporarily, until you can
have more definitive treatment.

But I'll refer you to
a specialist moving forward.

- It's been,

like, forever
since I haven't had any pain.

I mean,
I've seen so many doctors.

I-I had given up hope.

I'm sorry
for being such a jerk.

- That's OK.

It's totally understandable.

- You are a saint

and a genius,

and I am so grateful to you,
Dr. Howard.

Thank you.
Thank you.

Thank you.

- What's the matter, Murph?

Your pain's not back, is it?

[gasps]

[screaming]

Snake!

- Are you OK?

- So there's a snake in the ED.

- Nice.

Oh, but you're not supposed
to say that part out loud.

- Can someone get an ETA
on Animal Control?

- I can do that, yep.
- OK.

[soft dramatic music]

- Tissue looks awfully gray.

Is it necrotic?
- Partially.

- Well, that explains
the bleeding.

What do you want to do now?

- Sounds like the uterus
should come out.

- No.

We do a wedge resection.

We lose the necrotic pieces
and salvage the rest,

keep her ability
to have a baby.

Get me a Bovie.

- Well, is it even salvageable?

- In theory, it could work.

The necrosis is
localized enough.

- BP's moving in
the wrong direction.

- Then hang another
couple of units.

We need to get this bleeding
under control.

- OK, I'll try a uterine
artery ligation-

0 Vicryl suture.

- All right.

- The bleeding's not slowing.
I can't see.

- Suction.

- The sutures keep
tearing through.

The tissue's too soft.

I need to try the other side.

[machine beeps loudly]

- Pressure's getting harder
to stabilize, guys.

If I were you, I would think
about cutting and running.

- Yeah, well,
you're not her, Marty.

Just do your damn job.

- We might need to resect more.

[beeping]

- It's your call, Doctor.

What do you want to do?

[beeping]

- We keep going.

I can make this work.

[beeping]

- What's up, dude?

You had us really
worried there, bud.

- Yeah.
How are you feeling?

Are you hungry?

- Do they have any ice cream?

[laughter]

- We just might be able to
find you something, buddy.

- The hospital is gonna want
to keep Miles overnight,

but we're confident
he'll make a full recovery.

- Thank you both
for everything.

- Of course.
- You're welcome.

- Ooh!

I like playing with this bunny.

- Hey, Home Team.
- Yeah.

- Look who we have here.

- Say, "What's up, Home Team?"
- What's up?

- Yeah.

- See?

People like that don't change.

They're just not capable of it.

[soft dramatic music]

?

- Wait.
Degenerating?

What do you mean?

- My cognition,
my balance, everything, me.

It's all going away.

- What are you trying to say?

You've got dementia?

- Sorry.

I was just coming in
to do a post-op eval.

I will come back later.

Here are your things.

- Do you know anything
about this MRI?

- Not really my specialty.

- No, I told you this is
something I was talking

to Dr. Charles about.

I wasn't even gonna
say anything to you.

- What? Why?

- Because I was afraid.

I don't know how long I'm gonna
be this version of myself,

and I totally understand
if you don't want

to be with me anymore.

- I can't believe you.

[sighs]

I just can't believe you think

you can get rid of me
that easy.

Babe, these last few weeks
have been some

of the happiest of my life.

?

I'm not gonna give that up.

?

All right.

Listen, I wasn't gonna do this
till Norway, but-

- I'll give you some privacy.

- No, no, no, no.

Stay, Dr. Lenox.

I need a witness.

- [crying]

- Will you marry me,
Cynthia Maude Parker,

again?

Come on.
Say yes.

- Babe, I'm so scared.

- Yeah, me, too.

But look, no matter what,

we're gonna get through this
together, OK?

- OK.
- Yeah.

- Hey, Doris, have you seen-

- Your box?

You mean the one
you left in the middle

of the nurses' station?

I put it in
the doctor's lounge,

where it should have been
in the first place.

- Thank you.

[exhales]

- Wait.
Ooh, wait.

- Surprise!

- So you all didn't forget.

- No.

- Congratulations, Dr. Howard.

- Whoo!

[applause]

- Naomi,
you brought a high degree

of positivity and
intelligence to the ED,

and you will be missed.

- Oh.

- Aw.

- OK, OK.

Can we cut the cake, please?

- Thank you.

- OK.

Well, I'm gonna go
finish my rounds.

Doris, great cake.

- Nicholas, one second.

I was giving our earlier
conversation some thought,

and...

Myrtle Beach might be
a welcome diversion.

- Oh.

- Though I should warn you
I prefer my margaritas

on the rocks, no salt.

- Well, that's OK.

I can probably be salty
enough for both of us.

I look forward
to seeing you poolside.

?

- I know this residency
with Dr. Hayes

is like a dream come true,
but I'm actually

really gonna miss the ED.

We see people when
they're at their lowest,

and sometimes-
well, sometimes-

we're able to turn things
around for them.

And we do an awful lot
of good down here.

- Yeah, I like to think so.
- Yeah.

And, well,
the people aren't half bad.

- Is it just me, or does this
taste like toothpaste?

- Well, Doris made it,
so who knows?

I think it's actually
pretty thoughtful.

- It's actually inedible.

- Uh-oh.

You all right?

- I don't know.
You tell me.

- Well, what's going on?

- I'm sorry.

Dr. Charles, I don't mean to
take you away from the party,

all right?
I'm fine.

I'm not asking
for help right now.

Thank you.
- OK, sure.

- What is this?

Did Ripley put you up to this?

- What?
No.

Put me up to what?

- Nothing, all right?
Whatever.

I don't need you shrinking me
right now, OK?

I'm good.

- Well, that's good because
I don't shrink colleagues.

I do check in with my friends
every now and then

when they're having a bad day.

But if they get all huffy
with me,

I tend to leave it alone.

Good night.

- [sighs]

- Hey.

Hey.

- Oh, hey.

How did everything go?

- It went, um...

Well, you see, there were-

There were some
unforeseen complications.

And...

- Um...

After we performed the D&E,

you started to bleed profusely,

and when we opened you up to
locate the source of the bleed,

we found that your uterus
was necrotic.

?

- [gasps]

Necrotic?

- There was a lot
of dead tissue.

We tried to resect
what we could to save it,

but, ultimately, we needed to
perform a total hysterectomy.

?

- You took my uterus
without my consent?

- We had no choice.
You'd have died otherwise.

- Becoming a mother
was the most important thing

in the world to me,
the only thing I ever wanted,

and now that is gone,
Dean, because of you.

- No, Lizzy, Lizzy, Lizzy.

I made the decision
for the hysterectomy.

I made that decision.

- What?

[crying]

- I couldn't lose you.
- How could you?

- I couldn't lose you.

Hey.

I couldn't lose you.

- [crying]

- I couldn't lose you.

- [crying]
Oh.

[dramatic music]

?

[wolf howls]

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