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.
- My son, 15 years ago, I lost him to drugs.
I just don't know where he is.
- You have a call from... - Sean Archer.
- An inmate at Cook County Jail.
- Dad?
- You have a relationship with our perfect daughter.
I'm married, and I love my husband.
And I can't be a part of that.
- [coughing]
- You all right?
- All my clothes, everything, it's gone.
- Jessa Rinaldi, I'm placing you under arrest.
You're charged with aggravated arson
and one count of attempted murder
against Dr. Will Halstead.
- Hey, are people still coming in and out of here?
- Yeah, my contractor came by last week
to work up an estimate.
You know, he thinks we can salvage a lot of this.
Now I'm just waiting on the friggin' insurance company
to approve my claim.
- Well, you're in violation of building code
sections 13-117-12 and 125.
And until such a time they're remedied,
a fine of $700 will be assessed daily.
- Oh, hey, hey, hey.
Can you give me a break here?
I don't know what I'm supposed to do.
- Hey, if it were up to me, I'd call in a wrecking ball
and get it over with.
[tense music]
[buzzer blares]
♪
- You got old.
- Yeah, it's been a while, so...
- 15 years.
I wasn't sure you were coming in.
- Well, I would have come earlier,
but it turns out that
it takes a while to get...
granted visitation.
So I was talking to your lawyer.
A Lisa Bly?
From the public defender's office?
- Mm-hmm. - She said something
about a plea deal. - Yeah, we talked it over.
She didn't think it was a good idea to fight this.
- Doesn't sound like she fills you with confidence, does she?
I'm gonna get you a new lawyer,
somebody who knows what the hell they're doing.
- It's OK. I'm cool with it.
- You're cool with it, just staying in prison?
That can't possibly be what you want.
- Can we change the subject, please?
- Oh, for Christ's sake!
Sean, you've been like this since you were a kid.
You're always giving up on things too easily.
- Kind of like how you gave up on me.
- Are you still using?
- [scoffs] - Hmm?
- You know what? This was not a good idea.
- Hey, I'm just trying--
- I'm hanging up now, Dad.
We should do this again sometime,
maybe in another 15 years.
- Wait a second. I'm just trying to--
♪
[buzzer blares]
- $700 a day.
Can you believe that?
It's like I just got hit by a truck and they want me
to donate the little bit of blood I have left.
- Maybe you should just tear it down like the guy said.
- Are you kidding me?
Hannah, I got way too much invested.
No, screw them. I'm gonna file an appeal.
- It's been, what, like, a month since the fire?
- Yeah, and? - I'm feeling like you're
embracing this modern-day Job thing a bit too vigorously.
- Hey, we could use the two of you.
- So do you think I'm acting like some kind of martyr?
- I'm just saying that the sooner you let this go,
the sooner you can move on with your life.
- Nine-year-old male, 25 mile per hour motor vehicle crash.
Mom and son both restrained and stable.
No loss of consciousness.
Kid complaining of pain in right arm.
- Mom has no vocal complaints.
She's coming in right behind us.
- I got Mom.
- It looks like they might be living out of their car,
for what it's worth.
- Good to know. Thanks.
Hey there. I'm Dr. Halstead.
Actually, I'm Will.
What's your name? - Henry.
- Can I ask what you got in that jar?
- It's a chrysalis.
One day, it's gonna turn into a butterfly.
- That is super cool.
Would it be all right if Nurse Doris here holds on to it
while I look at your arm? - Thanks.
- Let's get X-ray in here. - Yeah.
- Now let's look at this arm.
Does it hurt? - [strains] Yes.
- I know. I'm sorry, buddy.
OK, that's it.
Anything else hurt?
- No. - Good.
Now, do you remember what happened?
- We were looking for a new parking spot,
and I don't know,
Mom just kind of drove off the side of the road.
- OK. We're gonna get a quick picture of your arm, all right?
Hey, you're being really brave.
- All right, X-ray up.
- Well, now that doesn't look too bad.
All right, Henry, I'm gonna go talk to your mom for a minute.
I'll be right back.
- Here you go.
- How are we looking?
- X-ray is clear.
Beyond a scrape or two,
I'd say she's doing all right.
- Ms. Mitchell, I'm Dr. Halstead.
I just saw your son.
He's fine, except for some arm pain.
The X-ray showed a nondisplaced distal radius fracture,
just a fancy way of saying he broke his arm.
- What?
- It'll heal quickly with a simple cast.
I just need your consent to treat him.
- No.
- Excuse me?
- What have you done with my boy?
- Henry's right next door.
- Who are you? What am I doing here?
- Jenny, you had a car crash. - I don't believe you.
- You've been brought to Chicago Med.
I'm Dr. Asher. This is Dr. Halstead.
- You're with the collection agency, aren't you?
I told you already. You can't have our souls.
- OK, whoa, whoa, whoa. - OK, all right.
- Give five of Haldol.
Jenny-- - Let me out of here!
- It's OK, Jenny. - Right now!
- Calm down. Let us help you.
- Nobody touches my son!
No. [sobbing]
♪
.
- Hey, can I get everyone's attention, please?
Thank you.
I'm sure that you have all noticed lately
that we are running low
on a number of key supplies--
dialysis tubing, contrast dye, syringes.
And I am just as frustrated as all of you are
at the seemingly intractable
and unpredictable supply chain disruptions,
but we are working to find solutions.
Meanwhile, I'd like to remind you
that we are all in this together.
Be mindful of that, all right?
Let's all get back to work.
- Are you two looking for a consult?
- Yeah, I got a nine-year-old in three with a broken arm
whose mom won't give us consent to treat him.
- Her behavior suggests some kind of psychiatric disorder.
- We were forced to sedate her. - What did you give her?
She still seems pretty animated.
- Five of Haldol.
Maybe she's a little resistant to it.
- Yeah, at least now you can go speak with her
and convince her to let us help her son.
- You know, I'd rather wait for the labs
and see what the tox screen says.
- What about the boy?
- I'll go talk to him.
Any other family around? Father, grandfather?
- No, none that we could find.
- OK, I'll report back.
- Ah, there's a vaguely familiar face.
You're finally back from vacation, I see.
You know, for a second there, I thought we lost you for good.
- Hey, I came in early to get a coffee with you.
You weren't in.
- Yeah, I had to get my oil changed,
but you look well-rested.
- No cell service, no Wi-Fi.
Just surf, sand, and the stars for two weeks.
- Yeah. - I am, as they say,
totally chill.
- Excuse me, Dr. Archer.
I was wondering if I could go over this patient with you.
- First year resident, Dr. Zach Hudgins.
Allow me to introduce you to one of your attendings,
Dr. Ethan Choi.
I'm sure Dr. Choi would be, like, totally happy to assist.
- Pleasure to meet you, sir.
- Hi, Zach. What do we got here?
- 51-year-old male, progressive cough,
congestion in his chest.
His sats are kind of crappy.
- Crappy, you say?
- Low 90s, high 80s. - Did you get a chest X-ray?
- That's happening now, but here's the thing.
The patient has advanced stage ALS.
- Kind of a detail you might want to lead with, Zach.
What's the patient's name? - Albert.
Albert Marrero.
- Ooh, let me see that.
Albert Marrero.
[machinery beeping]
- Take a deep breath.
- [labored breathing]
[typing] All I have.
- Well, I think you're holding out on me, Al.
- So I understand you two go back a ways.
- Dean...first to diagnose.
- It's a little over six years ago now.
I won that bet, by the way, Al.
- Check's in the mail. [laughter]
- Well, I don't think you have a pneumonia yet.
Your X-ray is OK,
but these things can lag by a day or two.
- Oh, goody.
- But your lungs do sound a little junky.
You're just not clearing your secretions adequately.
- ALS can weaken your diaphragm,
and thus, your cough just isn't strong enough.
- We call it plugging,
but it could be a little difficult to clear.
- Right, which is why I think it would be prudent
to just run a bronchoscope down there and clear it all up.
No muss, no fuss.
- Would you need to put me under?
- Light sedation, so as to make it easier to intubate.
- No.
- Al, it would only be temporary.
It's not as invasive as it sounds.
- I have a DNI.
I don't have control
over what this disease is doing to my body.
I, at least, want to keep control over how I die.
- Al, look, we're getting way too ahead of ourselves here.
We're just talking about clearing some mucus.
- Dean, can I talk to you?
- Sure.
- Excuse us.
Hey, Dean, I think we can clear the plugging
without bronching him. - Eh, doubtful.
- Put the percussion vest on him, chest BT,
breathing treatments, just like a CF patient.
Come on. It's worth a shot.
- Yeah.
- Huh, only a two?
It's OK if it hurts more than that, you know?
Matter of fact, what I'm hearing is
that the higher the number,
the more likely the nurses are to bring you some ice cream
from the cafeteria.
I'm just saying.
- My arm really doesn't hurt that bad.
- OK.
- Are you here to take me away from my mom?
- No, Henry, I'm not.
Why are you-- why are you asking me that?
- A lot of people have been talking about that.
- What I really want to talk to you about
is this beautiful chrysalis you have.
How long have you had it for?
- Maybe a month or so.
- Your mom get that for you?
- Mm-mm-mm.
- Has she been going through a bit of a tough time recently?
- See those markings at the bottom of the wings?
And that means it's a girl.
- No kidding?
You know, I didn't know that.
- She might not look so good now,
but pretty soon, she's gonna break out
and be beautiful again.
I know it.
- I tell you what, that's one gutsy little kid in there.
Look, far as I can tell, his mom started to act out around,
I don't know, 1st of the year.
- Psychotic break?
- I don't think so.
I mean, bipolar, schizophrenia,
they just rarely present this late in life.
- Mm. - Tox screens come back yet?
- Clear. Nothing in the blood or urine.
- OK, well, I want to take a look
and then maybe try and have a conversation with the mom.
- Mm-hmm. - So what about Henry?
- His arm is stable, right?
I mean, not getting any worse. We got a bit of time.
- How long is a bit?
I mean, this kid needs our attention
in more ways than one.
Mom clearly can't help him.
They're living out of their car.
I think we should double doc his consent
or get a court order.
- In order to do that, though, Will,
I've got to declare her
incapable of caring for her child,
which means put her on a psych hold,
which means getting DCFS involved.
Look, I'm worried about the kid too.
I just really want to make sure we're right before we go there.
- Yeah, of course. - OK.
- OK.
- Maggie? Maggie? - Yeah.
- Grant, what are you doing here?
Is everything OK? - Look.
Keith here had an accident on the worksite.
They asked us to wait for an intake nurse,
but I was hoping maybe I had enough pull to cut the line.
- I don't know. We kind of have a system here.
- Hey, Grant. What's up?
- We've got a bit of a situation here, V.
- OK, yeah, let's take a look.
Room five is OK, isn't it?
- Sure. - OK, come on.
- We were doing some site prep for a new sports therapy clinic
I designed down in Hyde Park.
Anyway, the team was clearing some dead trees, and--
- OK. OK, how about I take a look?
Let's see.
Don't touch it, OK?
Let's just have you chill here for a second
while we come up with a game plan.
- Thanks, Vanessa, Maggie.
- We're gonna need a CT of this.
- Put the order in. I'll call CAT scan.
- OK.
- [straining] - Dr. Choi!
- What's going on? - He's really struggling.
O2 sats 82 and falling. - Nasal cannula.
- You can't clear the mucus. Don't worry, Al.
We'll get you through this. - Help me sit him forward.
Now bang on his back.
- No, use your fist!
Pound with your first hard! - Sats at 70s.
- I don't want to hurt him. - For Christ's sakes.
Get out of here.
- [retches]
- There it is.
[tense music]
I'm not losing this one, not today.
♪
.
- I know it might not seem like it at the moment,
but you, Keith, are a lucky guy.
Somehow this stick managed to lodge itself cleanly
along the side of your orbit
without penetrating your eyeball.
So we can just go ahead and take it right out.
- Right now? - It'll be fine.
- Are you sure you're qualified to do this?
- Well, she finished top of her class, Keith.
- I can give you something to calm your nerves,
if you'd like.
- No, no, just get it over with.
- OK.
Hold still.
There. All done.
Thank you.
How does it feel?
- It still hurts a ton,
but yeah, better than a second ago.
- Yeah, we'll give you something for the pain.
In the meantime, if you could just follow my finger.
- Yeah.
- Did you just see that, how steady her hand is
and how confident? - I know.
- It's like we created some kind of Jedi Knight.
I'm honestly just blown away.
She's your spitting image, Maggie.
It's crazy how that works.
- Any word yet from ophthalmology?
- They're swamped.
They say they'll be down this afternoon.
- I really don't want to discharge Keith
until they see him.
If you've got to get back to work,
I can call you when we're done here.
- Oh, no, Keith's worked for me
for, like, 15 years.
I'm staying until he's cleared to go.
But maybe we can all have lunch together.
- Yeah, that's a great idea.
- I don't know. I don't think I can get away.
- Oh, come on, Maggie. It'll be fun.
- I'm sorry. Crockett, Kai, we have incoming.
- Please, Maggie. Could you just for me?
- OK, but not for another hour.
- Let's go!
- We're going to Baghdad. What do we got?
- Julián Sanchez, GSW.
Two holes, left thigh, maybe through and through.
Moderate blood loss in the field.
- Put a pressure dressing on it,
but not actively bleeding now.
Dropped his pressure in the ambo.
Gave him a liter of fluid.
BP now 100 with a heart rate of 125.
- OK, Julián, I'm Dr. Marcel.
We're gonna take good care of you, OK?
Hang in there, bud.
OK, everyone. Nice and easy.
On my-- - On my count.
One, two, three.
- Easy, easy.
- Let's get him up on monitors.
- OK, DP and PT pulse has diminished.
Let's strip and flip him, make sure there's no other holes.
OK, here we go.
One, two, three.
Easy, easy.
- Just two in the thigh. No active bleeding.
OK, let's have X-ray get us a quick chest and pelvis, OK?
- Why do we need a chest X-ray? He was only shot in the leg.
One whole bullet in, one whole bullet out.
- Make sure they connect. He was shot twice.
Bullets travel in unexpected ways, right?
How would you feel if you left a bullet in his chest?
- X-ray is ready. - OK, you know what?
Why don't you go tell Maggie that we're gonna need an angio
to find where the injury to the artery is.
I'll finish up here.
[exhales sharply]
- Jenny?
How are you doing?
I'm Dr. Charles.
- They sent you in here to get my consent, didn't they?
- Who's "they"?
- The other ones pretending to be doctors.
That redheaded one tried to convince me
my son had a broken arm.
- You know, Dr. Halstead is, in fact, a doctor.
And you know, Jenny, he wasn't lying.
I mean, I can show you the X-ray.
- You think I can't tell a fake?
I want to see your supervisor, or I swear, I--
- Jenny?
You all right? What's going on?
- Who are you again?
- I'm Dr. Charles,
and we were just talking about Henry, about your son.
- I already told you.
I'm not giving anyone permission
to treat my son.
- Well, you know what?
I'd like to get your permission to treat you,
if that's OK.
- Me?
There's nothing wrong with me.
- But unfortunately, we can't release you or Henry
before we rule out any trauma from the car crash.
So if it's OK,
I'd just like to send you upstairs for a quick scan.
- And as soon as that's done, I'm free to go?
- I tell you what, how about we do the scan
and see what it tells us and then go from there?
Does that sound like a plan?
- OK.
- Did you get her consent?
- Not exactly.
I want to send her upstairs for a head CT with contrast.
And also, can you tell Sam I want his eyes on this too?
- Roger. - So what's going on?
- You know, it just doesn't seem like
a garden-variety psychosis, you know?
There's this odd rhythm to it.
And she had this temporary loss of mentation.
And I really think we could be looking
at something neurosurgical.
- Let me guess. Henry's broken arm has to wait?
- Well, just bear with me, buddy.
Let's take a look at this scan, and I think
we're gonna get some clarity.
- We can continue riding out the percussion vest and nebs.
With a little more time, there's a chance it could work.
- But not a good enough chance.
The only way to clear the plugging for sure
and restore your breathing is with a bronchoscope.
[typing] - No intubation.
- I think we've established by now, Al,
that I'm no alarmist,
so believe me when I say this.
This thing will kill you today,
right here in this room.
- If it does, I'm OK.
I'm ready.
- Really?
Just like that? Really?
You can honestly tell me
that you've got nothing left to live for?
Your son, how's he doing?
- Wife's pregnant again.
My second grandchild.
- See?
That's something to look forward to, isn't it?
- It's my biggest fear, Dean,
being stuck helpless on a vent.
[machinery beeping]
- I promise you, Al.
I will not let that happen.
- Hey, what's going on here?
Why isn't my patient prepped for angio?
- You're not gonna believe this.
Apparently, they can't find any contrast dye.
- Are you kidding me?
We need to look at the femoral artery.
His AVIs are at 0.7.
- Hey, man, it's not my fault. Talk to this guy.
- All right, keep an eye on his vitals.
I'll see if radiology has any.
- You lucked out.
This is literally the last drop of contrast we got.
- You're kidding.
- Blame COVID or the war in Ukraine.
I don't know.
- She had no response to the Haldol?
- Nada, and these weird lapses in awareness.
- Hmm.
- And as you know, resistance to antipsychotics
can sometimes mean...
- Something's going on with her neurotransmitters.
- Yeah.
- Hey, Gene? - Yeah?
- I was told you might have some contrast dye left.
- Not after the scan, I don't.
- Oh, no, no, no, no. Stop, stop.
I need that dye.
[tense music]
♪
.
- I honestly don't even know why we're having
this conversation.
This is triage 101, head over leg.
- With all due respect, Sam,
perhaps it's not so cut and dry in this case.
- What happens, Dr. Marcel,
if you're not able to perform your angiogram?
- Well, I'll probably have to filet the poor guy's thigh open
in order to find and fix the damage.
It'll be a much bigger surgery
with more blood loss and a greater risk.
- Dr. Charles?
- You know, truthfully, I'm not completely comfortable
making the case that our patient
is of any greater need than Dr. Marcel's.
- Well, I am. Look, Sharon.
If I'm being asked to follow the breadcrumbs
of Ms. Mitchell's symptomology,
I'm suspecting she might have an astrocytoma
or maybe a leaking aneurysm.
Now, there's no way of knowing for certain, however,
without a CT with contrast.
But I can assure you, if those are the possibilities,
without intervention, her outcome is gonna be
a whole lot worse than a limp for a few months.
- I'm sorry, but that sounds so nebulous.
I mean, we know precisely
what we have to lose or gain with our patient.
You're just on a fishing expedition.
- Who's this guy? - Kai Tanaka-Reed.
First year surgical resident. It's a pleasure to meet you.
- You're a intern, Kai.
Learn not to speak unless spoken to.
- OK, can't we just dilute the dye enough for two procedures?
- We could, but we risk the chance
of neither scan being adequate.
Look, there's no ideal option here,
but for now, head over leg.
The hospital is going to prioritize
the CT scan for Ms. Mitchell.
- Once again, Sharon, you've proven yourself
wise beyond your years.
I'll see you up in radiology.
- Well, this sucks. - It is what it is.
Have Maggie prep an OR.
[machinery beeping]
- Where are we? - Just getting the RSI drugs.
- All right. Let's tube him.
- Yes, sirree. Let's--let's do that.
- You all right? Your hands look a bit shaky.
- Just feel like I'm auditioning here.
[tense music]
♪
- That's not the trachea.
Neither is that.
- What's taking so long?
- Zach is having a little difficulty.
- It's just not lining up for some reason.
- What's the matter? You've never done one of these before?
- No, I haven't.
- Are you kidding?
- My med school all but shut down during the pandemic.
Said it was too big a liability
to have us interact with patients,
so we did everything online.
But I'm a fast learner.
- Yeah, I don't have time for handholding.
I'll do it myself. Get out of the way.
No, I'm gonna need to use a GlideScope.
Keep bagging him until I get back.
Bag him! Bag, go!
These kids, I swear. - Yeah.
Hey, before you get started,
I wanted to tell you about a book I picked up on the beach.
It's about a death doula.
- Nancy, where'd that GlideScope blade go?
- It's over there in the cabinet.
- It's all about helping people transition
from one plane of existence to the next.
- Uh-huh.
- I'm wondering if we're doing that with Al.
- What?
- Honoring his journey.
- You want to translate that into English for me?
- I don't think we should be doing this bronchoscopy.
- Wait, you don't think we should be doing
everything we can to keep him alive?
- Not if he doesn't want us to.
- So what, you catch a few juicy waves,
and all of a sudden, you're preaching palliative care now?
- Maybe. When it's appropriate.
- This is an ED, Ethan. We save lives here.
We don't end them, at least not on purpose.
Maybe you should have stayed on that beach.
♪
- Mm-mm, mm-mm.
Don't change a thing, 'cause you look fine as you is.
- Ben, what are you doing here? - You remember?
My biannual to check my blood markers.
- Right. - Yeah.
I was supposed to get in and out,
but they said something about a shortage on syringes.
Can't get to me till later this afternoon.
- Oh.
- But the good news is that I am free for lunch.
You want to grab a sandwich? - Mm-hmm.
[indistinct chatter]
You know what, I am tired of the same old, same old.
There is a food truck out there that I'd like to try.
- OK.
♪
- Where's my angio patient?
- Are we all good?
OK, let's do a run.
- What's going on here?
- Trying to get an angio done.
- I thought we already established
we can't do that without contrast.
- I found a workaround using CO2 instead.
- CO2?
- It works a lot like a contrast.
- Yes, I'm aware, but it's ten times as dangerous.
If a gas bubble finds its way up to his heart--
- We're injecting into the arterial system, Crockett,
below the diaphragm.
We're all good.
- Hold on. - CO2 has been delivered.
- Look, right there. That's the injury.
Should we stent or go and open?
[rapid beeping] - Damn it, drop the head.
- Sats are plummeting here, guys.
80 and falling. - What's going on?
- Vapor lock. Move the C-arm.
Move it. Move it.
A gas bubble is occluding the venous return
to the heart. - But that's impossible.
- Well, clearly not. - Now down to 79.
He's getting super tachy.
- Let's wire a catheter up to his heart.
- No, no time. We have to change his position.
See if we can get the blood past the bubble.
Hope the CO2 reabsorbs.
Put your hand on his back. Give him a couple of pats.
Right there.
That's it.
Come on, Julián.
Come on, Julián. Stay with me.
- Sats are back up. 91 and climbing.
- Vapor lock cleared.
Oh, man.
You're lucky that didn't kill him.
Let's set up to open.
- I don't get it, Crockett.
How the hell did that bubble find its way to his heart?
- We'll find out,
but it's Dr. Marcel.
- I'm not sure I'm reading this right,
but her scan looks completely clear.
- Yeah, it's a surprise to me too.
I was convinced we'd find something.
I'm so seldom wrong.
- Where is my son? Where is he?
- Jenny, Jenny. - Come on.
We're gonna get out of here. - Jenny.
Henry has a broken arm.
Your son has a broken arm, Jenny.
- We need some help here! - Jenny, listen--
- You said if I agreed to that test, I'd be done.
I am tired of waiting.
- You've got to let us take care of your son.
Four of Versed IM. - Please!
Listen to the doctors! - Security!
- Just do as I say.
- Mom! My chrysalis!
- For God's sake. - Whoa, whoa.
Jenny, careful, careful. - [groans]
- Watch it.
Hurry up.
- No, let go of me!
- Let's put you back in the bed, bud.
- It's okay. She's okay. You're okay.
- No! - It'll be okay.
- No, no, no.
[whimpering]
- Are you finally gonna give me my court order?
♪
.
- So DCFS will take temporary custody of the boy
until the mother's deemed ready
to resume her parental responsibilities.
How long do you plan to hold her for?
- 72 hours, for now.
- Well, we'll just take it day by day then.
- Dr. Asher, let's get her prepped for transfer upstairs.
- OK, Henry, we are ready to put a cast on that arm.
Really important question.
What color would you like?
We can do green, purple, blue.
- Blue, I guess.
- Blue coming right up.
- Where did those people take my mom?
- So your mom is gonna be resting here in the hospital
for a little while, but when we're finished here,
this nice woman is gonna find you
a cozy place to sleep tonight.
How does that sound?
- Hi, Henry. My name is Madeline.
- You know, we can put that in a specimen cup, if you like.
[gentle music]
♪
- I promise to keep it safe.
[machinery beeping]
- Chest X-ray looks better.
Airway pressures are down.
It looks like the bronch did the trick.
- Just like we should have done from the beginning.
Let's lighten his sedation.
Come grab me when he's ready to have the tube taken out.
- You got it.
- Hey, Maggie. - Oh, hey.
Hey, sorry about lunch. I just couldn't pull away.
- Yeah, I saw you and Ben head out.
Looked like you were trying to keep him and Grant apart.
- That's 'cause I was.
I haven't told Ben about Grant yet.
- Oh.
I feel bad for pressuring you to join us earlier.
It wasn't very sensitive of me.
Look, I really don't want to make anything strained
between you and Ben.
- It's not your fault.
It's just something I have to deal with.
- OK, let's see how bad the damage is.
[machinery beeping]
- Oh. - Oh, man.
- Clamps.
Suction.
Okay.
Yep, here's how the bubble got to his heart.
A fistula. - What? Where?
- Do you see the mix of dark and bright red blood?
So the bullet hit both the artery and the vein
when it went between them, fusing them together.
Look. You see that?
- That's how the CO2 got up there so fast.
- Yeah, like a superhighway straight to the heart.
- Well, nobody could have foreseen that.
- So the delusions, the volatile mood swings.
We could be looking at some kind
of atypical bipolar disorder.
- I mean, at this point, it very well could be.
- We could start her on a course of olanzapine
and see how she responds.
- You're moving her upstairs? - Yeah.
Millie, we might as well get that going.
- OK.
- Hey, listen, I pulled the tape
from when Jenny had that episode.
You see how everything just kind of falls
off the ledge here, her heart rate sats, her BP?
Whatever's happening with her
just has to be physiological, right?
- It's what I've been saying all along,
but you know, the scan came back clean.
- Well, we took this X-ray of her chest upon intake.
And you see this area of haziness
around her mediastinum?
Is it just me, or does that appear to be abnormally wide?
- It's definitely wide. - And there's no certain way
to tell without more detail, but...
- Often caused by a tumor.
- And that can trigger an autoimmune response
in the brain, right, like psychosis?
- Absolutely, and would completely explain
these dropouts she's been having.
Hey, Dr. Cuevas, could we hold off on that transfer, please?
Dr. Asher, nice work.
- Ophtho cleared you to go home.
I made you a follow-up appointment
a week from now, but from what she says,
you shouldn't have any long-term issues
with your vision.
The patch stays on, though, for now.
- Thank you, Dr. Taylor. - Yeah.
OK, let's go over your at-home and care instructions.
- Excuse me. - Yeah.
- Hey.
I wanted to thank you again for helping Keith out here.
- This is an ED, Grant.
We would have done that for anybody.
- Still, I just wanted to let you know
how much I appreciate it.
The world works in funny ways, doesn't it?
- You know, I really got a lot of work to get done
before my shift ends, so...
- Hey, Grant. We're a little understaffed.
Do you mind helping out and wheeling out Keith for me?
- That's OK. I can walk.
- Hospital policy, sorry. - No worries.
I got it, Taylor. - Thanks.
- All right, let's get you home.
Excuse me.
- Please, after you.
Vanessa.
So I'm finally done.
Should I stick around and give you a ride?
- Sure. Thanks, babe.
- Al, can you hear me?
OK.
OK, we're gonna take this tube out now
by putting you on a spontaneous breathing trial.
So I want you to give me some slow, deep breaths.
All right?
OK, that's right. Slow and deep.
- [labored breathing]
- Slow and deep. Don't chase after it.
The air will come.
Just slow and deep.
That's right.
What's his RSBI reading? - 130.
- Are you sure you're reading that right?
- The vent says so, and I calculated it as well.
- OK.
OK.
- Hey, maybe we should stop. - No, no, no, no, he can...
He'll get there.
- [labored breathing]
- All right.
- Let's put him on a rate.
We'll resedate him.
- I'm sorry, Al.
It's too soon to take you off.
So we're gonna take a couple of steps back,
and we'll try again a little later, OK?
Please don't, Al. Al.
No, no, no, no, Al. Al, don't.
- Get self-restraints, please. - Al, stop.
Put him back on Precedex.
I'm sorry, Al, we're gonna have to resedate you
to ease your discomfort.
[tense music]
♪
I'm gonna get you off this thing.
I promise.
♪
.
- So am I gonna be able to walk?
- Walk, run, jump, whatever.
- [chuckles]
When the ambo was bringing me in,
I didn't think I was gonna make it.
Thank you, Dr. Marcel.
- Let's not have to do this again, all right?
- Thank you so much.
- You bet.
- So is this how it's gonna be?
- How what's gonna be?
- You taking credit for everything.
I was just as responsible as you
for saving that guy's life, maybe more so.
- Really? After that stunt you pulled?
- That stunt pointed us directly to the problem
and saved his leg.
All day long, you've been talking down to me.
I was right about the bullet holes.
You never gave me props for that.
And then, you left it to me to duke it out with Abrams
over the contrast dye.
- You can't be serious right now.
- All I'm asking for is credit where credit's due.
It's not that big a deal.
- You're right.
I should have given you credit.
I was very impressed
with the way you nearly killed our patient.
[tense music]
♪
[machinery beeping]
♪
- Did I tell you lately how much I love you?
- Ben, I need to tell you something.
- I know. I know, you don't really want to go bowling.
- No. - I can tell.
You were a little lukewarm. - No, it's not about that.
About a month or so ago,
I helped Vanessa
with finding and reaching out to her biological father.
His name is Grant Young, and he's an architect in town.
- OK.
- I didn't want to tell you about it earlier
because I didn't know how you were gonna take it.
- I'm just wondering why you're telling me this now.
- Because he came in as a patient today.
Not as a patient. It was one of his employees.
- So he was here, and you didn't mention that?
- Listen, I made it very clear to Grant
that I am not interested in reconnecting with him
in any way, shape, or form.
Ben.
- You felt the need to tell him that?
- No, I didn't want there to be any confusion.
And it's going good between him and Vanessa.
She seems happy.
- Glad to hear it.
- Dr. Marcel? - Hey.
- I was wondering how today went
with young Dr. Tanaka-Reed.
- Yeah, fine.
- Not according to him.
He filed a complaint with HR and claimed
you were disrespectful and condescending.
- Did he now?
- And we are required to take every complaint seriously,
though I suspect he must have done
something pretty egregious to raise your hackles.
You care to file a countercomplaint?
- No.
- You sure?
I could have him reassigned.
- No, not necessary.
I'm sure Dr. Tanaka-Reed and myself
will find some common ground moving forward.
Like you said, we're all in this together, right?
- Hey, Doris said something about Jenny being in surgery.
- Yeah, we located a small tumor on her mediastinum.
Daniel thinks that might have been
what caused the psychosis.
- Really?
[footsteps approaching]
- Mommy!
- My baby boy! [sighs]
Oh, look at your arm.
I'm so sorry.
I'm so sorry.
- It's OK. It's OK.
I'm OK.
- I thought you were trying to hurt me and Henry.
I'm--I didn't understand. - It's all right.
You're not gonna have to worry about that anymore.
- Mommy, look, my chrysalis.
It turned into a butterfly.
- [sniffles] It's so beautiful.
[gentle music]
♪
- What's that?
- Your new best friend for the next two weeks.
Welcome to boot camp.
♪
- I'm sure you already know this about your old man,
that...
I've got a tendency to override everything
but the sound of my own voice.
I don't know if you have anything
that you want to say to me after all this time,
but if there is...
I'd like to try my best to listen.
♪
[dramatic music]
♪
[wolf howls]
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