All language subtitles for chicago med s04e08 play by my rules

.

[indistinct chatter]

[siren wailing]

[suspenseful music]

- I asked you to plant one bug
then walk away.

But no, you couldn't do that.

- Hell, you don't seem
to get it.

As a physician, I have
a responsibility--

- I'm so tired of hearing that.

After the MRI fiasco,
Ray Burke said

he was done with you
and still you called him.

- Well, I need to speak to him
about his MRI results.

I'm concerned.

- Concerned how?

- There are some
subdural hematomas

and plaques in both
his carotids.

It could mean he's at risk
for a stroke.

- Could?

- I can't make a diagnosis

without more of a work-up.

- That case, there's nothing
to report to Ray about.

We could have nailed
that scumbag a week ago

if you hadn't screwed
things up.

No more calls.

- I can't just walk away.

- You can and you will.

It's over, Dr. Halstead.

Hey, you made this mess
when you took Ray's kickback.

This is on you.

[dramatic music]

- Will, who was that woman?

- Oh, just a drug rep.

They just won't leave me alone.

- Really?
I've never seen her before.

- So, listen, the DJ texted me.

The wedding's only
three weeks away.

We haven't given him
a song list.

- What was she pushing?

The drug rep.

- Oh, just some
calcium channel blocker.

Uh, so about the DJ...

- It's Maggie.
- Yeah, me too.

[PA beeps]

- Father and daughter
hit and run victims.

This is Abigail Jones,
two years old.

GCS nine, blunt head trauma
with lacerations.

IO line in the left leg.

- Abigail, it's gonna be okay.

- Where's the father?
- En route.

Other ambo was trying to get
an airway

when we rolled away
from the scene.

They were in crosswalk.
They had the signal.

Car plowed right through them.

- Let's transfer on my count:
One, two, three.

♪

Abigail? Abigail?

She's unresponsive.
I need to intubate.

Broselow tape.

- And a chest X-ray.

♪

- Just about 12 to 14 kilos.

Yellow drawer.

Four etomidate.
20 of sux.

- BP 100 over 70.

Heart rate 136.

Sats 88.

♪

- X-rays in place.
Nat, tell us when.

- All right, I'm in.

Go.

♪

- Clear.

Right side's whited out.

Chest tube.

- Ultrasound.

[machine beeping]

- Sats down to 80.

♪

- Fastscan's negative.
No blood in the belly.

♪

- Tubes in.

- Sats coming back up.
100%.

BP and heart rate's
stabilizing, as well.

- Pupils are reactive
but sluggish.

- Heads up,
paramedics are coming in

with the father right now.

- You go take him.
I'll finish this.

[PA beeps]

- Marc Jones, 32.

GCS 3, intubated in the field.

Suspect a C-spine injury.

There's a step off
on the back of his neck.

- All right.
Let's transfer him.

One...two...three.

♪

Thank you, Cesar.
- Yep.

♪

Good breath sounds bilaterally.

- BP 88 over 58.
Heart rate 120.

Should we start a neo bag?

- Yes, titrate to a pressure
of 110.

Need a chest X-ray
and an ultrasound.

- Yep.

♪

- Oh, my God.

Dr. Halstead.

- Hold on.

♪

[tense music]

.

[muffled phones ringing]

- How's the little girl?

- Her vitals are stable
and no long bone fractures.

But CT Head shows diffuse
intraparenchymal bleeding.

- And what did neuro say?

- I just got off
the phone with them.

They put in a pressure monitor,
and they agreed with me

to treat with hyperventilation
and mannitol

to reduce the intracranial
pressure.

- And what about the father?

- Intubated but unresponsive
without sedation.

- So, a brain injury?
- I'm not sure.

Pupils are equal and reactive,
so that's a good sign.

We're just waiting
on scan results to see

how bad the injuries are.

Look, Marc's stable now,
but what if he goes downhill?

He's wearing a lot of ink.

Is this "Do No Resuscitate"
a legit advanced directive?

- The hospital's got a team
of lawyers

trying to figure that out.

- What about his family?

Do they know if he
meant it or not?

- We're looking for them too.

It seems it's just Mr. Jones

and his daughter, Abigail,
in the world.

- He had on a wedding ring.
There's no wife?

- There was, Melinda.
Legal found an obituary.

She died last year.
Ovarian cancer.

- If his wife had
to be intubated

and wasn't able to get off
the vent,

seeing her like that could be
why he got that tattoo.

- Yeah, maybe that's what
he was feeling then,

but what about now?

He's all Abigail has.

I can't see him not wanting us
to do everything

in our power to keep
him alive for her.

- Well, the truth is,
we don't know why

Mr. Jones got the tattoo
or how he feels about it now.

So, let's not jump
to conclusions

until we have real facts.

- And in the meantime?

- While the hospital does
their due diligence,

err on the side of life.

- Thank you.

[dramatic music]

♪

- Keegan and I have been
neighbors for a few months.

Since I moved back.

- I'm only here 'cause Vicki
talked me into it.

At this point, I've given up
on doctors.

- Whoa, no, no, no.
No more scratching.

- I can't help it.
It's been three years.

Three years.
Never stops.

- And it started with
a MRSA infection?

- The antibiotics to treat it.

- Linezolid.
Side effect was pruritus.

- Bad itch, huh?
- Mm, the worst.

Everywhere.
And I mean everywhere.

- But the reaction went away

when she stopped taking
the pills.

- Except for right here,
and it is killing me

not to scratch it right now.

- The itch never lets up?

In the shower?
When you're sleeping?

- Never.

I've used toothbrushes,

pencils, even steel wool once.

Nothing stops the itch.

- Easy, Keegan.
Keegan.

- Stop.
- I know it's hard.

Just try not to scratch.

- All right,
I'm gonna clean it out

and apply some steroid cream.

Should help calm it down.

- That won't do anything.

I've tried creams and
antihistamines, acupuncture.

I've seen dozens of doctors,
dermatologists, allergists.

Nothing helps.

I--I just can't stop.

[moans]

- D--don't. Don't.
Don't. Don't.

Doesn't that hurt?
- All I feel is the itch.

It's all day, every day.

Please just find it
and cut it out.

- Okay.

Let's get a full set of labs
and go from there.

♪

I'll be back with the results.

No more scratching.

- Thank you.

♪

- I've never seen anything
like this.

She's down to the muscle.

- And she was serious about
trying everything.

I looked inside her
medicine cabinet,

it's like a pharmacy.

I tried to help her,
but she didn't serve,

so I can't bring her to the VA.

- How much do you know about
Keegan outside of the itch?

Is she...

- Crazy?

I don't think so,
but an itch for three years...

- Yeah.

I'm gonna get psych involved.

Thanks for bringing her in.

- Thanks.

- Yeah.

- So, Vicki's here.

- She just brought in
a patient.

- This is the only hospital
in Chicago?

- You trying to tell
me something?

- No.

- Okay.

- April, I appreciate you
covering for me

every time I'm in
the Hybrid OR.

Of course I don't expect you
to know

everything that I've learned,

so I made a reference guide
for you.

- Well, I haven't had
any problems.

- Well, not yet, but it's good
to be prepared.

- "Obligations
and Proficiencies

of the Charge Nurse."

- People don't realize
how complex the job can be.

- How many pages is this thing?

Is there a PowerPoint
presentation to go with it?

- Is that gonna be a problem?

- No problem.

- Vicki brought in the patient.

- Vicki.
Your--uh--your friend, Vicki?

- Former friend.
Yeah.

- Keegan.
I'm Dr. Charles.

How you doing?

- [scoffs]

Of course.
The shrink.

Look, this isn't because
of feelings,

and it's not OCD.

I don't have
delusional parasitosis

or a conversion disorder.

And the itching didn't start
after my dad died

or my boyfriend left me.

Look, I'm not insane.

My head just itches
and I want it to stop.

- Okay.

Well, let's try to make
that happen.

- Really?

Usually docs are writing me
a referral so I'll leave.

- Well, you came to us
for help,

so we're gonna help ya.

Just for now though,
do you think you can

keep your hand away
from the wound?

- I can't help it.

- Okay.

So Dr. Choi told me that
you've tried OTC's,

prescriptions,
host of home remedies.

How 'bout bupivacaine?

- What's that?

- A local anesthetic.

- Five mil should do it.

I'd like to apply a little bit
to the area.

If it provides relief,
it would suggest that

the problem might lie in your
cutaneous nerve endings.

And that would help suggest
a treatment plan going forward.

- Then stop talking
and get to it.

- You're gonna feel a pinch.

- Do it.

- Whoa.

Okay.

It feels different.

- Different how?

- Better.

I mean, it tingles a little,
but it itches less.

- Hmm.
That's a good start.

- Yeah.

We'll check on you in a bit.

♪

- So, anesthetic should
provide relief

for like, three or four hours.

Itch doesn't come back,
then set her up

with some topical patches
to take home.

- Sounds good.

- Mannequins?

- Look, I was a department
store latchkey kid.

So, I took what I could get.

Jenny was basically
my first girlfriend.

Which is why I am such
a good kisser.

- I don't think I know
how to feel about this.

On the one hand,
it's very disturbing.

On the other, I should probably
be thanking Jenny

for those years of practice.

- Hold on.
It wasn't years, okay?

- Dr. Rhodes--was looking
for you.

I wanted to tell you
before you got the memo.

The Hybrid Room will be used

for general surgeries
when needed.

- General surgeries?

- Appendectomies,
gall bladders--

- So, everything but trauma,
which is why

we built it in the first place.

- Look, the Hybrid Room
was expensive.

It came in over budget.

Using it when we can will help
balance the books.

- You mean, pad them?

- Well, profit's not
a bad thing.

- Ms. Goodwin, this is Chicago.

We get six traumas
before lunch.

What are those patients
supposed to do?

I don't know, take a number?

- Well, your displeasure
is noted, Dr. Rhodes.

And overruled.

- When does all this start?

- Today.

In fact, Dr. Lanik
will take the lead.

[dramatic music]

- This is a terrible idea.

It's gotta be Gwen Garrett.

♪

- Let it go.

This isn't a hill to die on.

♪

- Damn it!
[grunting]

- Call Dr. Charles.

[intense music]

Keegan, stop.
Don't scratch.

- Oh, the itch is back
and it's worse than before.

- You have to stop scratching.

- Oh, then you have to tie
me down.

- Five milligrams of diazepam.
- On it.

- [groans]
I can't live like this anymore.

I'd rather be dead.

- What happened?

♪

- Oh, God.

♪

She scratched through
to her skull.

♪

.

[monitor beeping]

- How's Abigail?

- Fighting.
How's the dad?

- Scans are back.

CT brain revealed no bleeding,
and there's no

obvious brain trauma.

- Well, that's good news.

- Yeah, except the CT C-spine

revealed a subluxation
at C3 on 4.

- MRI confirmed?

- Complete spinal cord
transection.

He's paralyzed
from the neck down.

- I'm sorry.

- I just spoke with Jay.

PD caught the driver
who hit them.

He blew through a red light
because he was texting.

[beeping]

- BP's spiked, 146 over 94.
Heart rate's down, 54.

[suspenseful music]

- Cushing's Reflex.

- Her intracranial pressure
is worsening.

She needs more
hyperventilation.

Get her off the vent.

♪

Heart rate's still dropping.

47.

Two milligrams of atropine.

♪

It's in.

Come on.
Come on.

- Heart rate's coming back up.
49....

51...

- Come on.
Come on.

Come on, Abigail.

[melancholy music]

♪

- Dr. Rhodes, you're gonna
bag that.

- Yep.
Talk to me.

- James Brice, 24.

GCS 7.
Hypotensive.

Intubated en route.
Belly's distended.

- What happened?

- He was putting in storm
windows for the nursery.

He fell off the ladder.

- At least 20 feet.

- I was worried the baby
would be cold this winter.

- It's okay.
Don't worry.

It's not your fault.
Maggie?

- I got her.

Mrs. Brice, why don't you
come with me,

and let the doctors work,
okay?

- He keeps trying to die on us.

- All right.
On my count.

One, two, three.

[dramatic music]

♪

Good breath sounds
on the left and the right.

Let's get a chest X-ray.

- Field IV is blown.
We don't have access.

- All right.

Ava, can you get a line in?

- Give me a kit.

♪

- X-ray's up.

- Everybody clear.

♪

Looks good.

♪

Belly's hard as a rock.
Give me a Fastscan.

♪

It's full of blood.

I need to get in there
and find the bleed.

♪

We'll use the Hybrid OR.

- We can make it upstairs.

There are operating rooms
available.

- There's also one right across
the ED.

Much closer.
- Connor, Goodwin just to you--

- I know what she said.

Find Maggie.
Have her page my team.

[pager beeps]

It's probably CT looking
for you.

I got this.

- You're going to get yourself
into trouble.

- I can't worry about that now.

Get James ready to go.

♪

Lanik.
I'm taking the Hybrid OR.

- My patient is on the table.

- His gall bladder can wait.
Bring him back next week.

- I'm not your resident,
Connor.

You can't order me around.

- Is your patient about to die?
Because mine sure is.

[clanging]

♪

Get Dr. Lanik's patient out
and re-prep the room for mine.

♪

- Natalie.

- I just need a moment.

- Yeah, of course.

[solemn music]

- All right.
Thank you.

- April, I'm getting pulled
into surgery.

- Okay, I'll hold it down
out here.

- Oh, and I've got a delivery
of NG Tubes, Hep Locks,

and ABD Pads coming in.

I called it in late last night.

- I'll double check the order
against the invoice,

make sure it's all there.

- All right.
Oh.

And it's payroll week,
so it means that you have--

- All the nurses need
to sign off on their timecards.

Maggie, you're driving me
crazy.

If anything happens,
I'll handle it.

- Okay, and you've got
the reference guide

that I wrote,
so we're all good.

All good.
Good, good, good.

[indistinct chatter]

- You want some company?

I get it if you'd rather
be alone.

- No, I'm glad to see you.

How's Marc?

- No change.
Still unconscious.

- Abigail was only two.

And now she's gone.

All because some guy couldn't
look away from his phone.

[inhales deeply]

But maybe something good
could come from all of this.

I mean, all these kids
waiting for transplants.

There are so few
pediatric donors

in comparison to the thousands
of children in need.

Abigail could be
an organ donor.

- As a minor, you know,
she's gotta get

a parent or guardian
to sign off

before she can donate.

- Yeah, I know that.

And if Goodwin can't track down
any of her other family,

then all that's left
is her father.

Do you think Marc will wake up?

- I've seen patients
in worse shape turn around.

[dramatic music]

♪

- Well, that's a new one.

Usually I have to cut them open
myself to get to the brain.

- So, what do you think?

- Well, for whatever reason,
the cutaneous nerves

in that part of her scalp
went haywire.

Makes them always feel itchy,
so she keep scratching.

- There a fix?

- Yeah, surgery.

Sever the nerve.

No more feeling,
no more itching.

- And no more scratching.

- Yeah, and possible serious,
irreversible side effects.

Facial paralysis,
blurred vision.

Worst case, she ends up
in a wheelchair.

- I'm not cutting her open
in an alley, Daniel.

The risks you're describing
are dwarfed by the reward.

- Yeah, we hope.
- What do you suggest?

Twice a week
counseling sessions?

Of course, we'd have to put
a cone around her neck

to keep her from scratching.

- Sam, all those years
of scratching,

those nerves are shot.

There's nothing left
to go haywire.

- Dr. Charles, if that were
the case,

Keegan shouldn't feel anything.

Let alone an itch.

- If those nerves were active,
that anesthetic would have

provided relief for hours.

It didn't.
- You only used 5 mil.

It wasn't enough.
- I agree.

The anesthetic didn't work
for long, but it did work.

Proves the nerves are involved.

- Great, we have a majority.
Not that I care.

We done?
- Sam?

All I'm saying,
I don't think operating

is gonna do a damn thing.

- [sighs]
Thanks for you input.

But the last time I checked,
I was the neurosurgeon.

Put her on the schedule.

- Isn't surgery supposed to be
the last option?

- Dr. Charles, she scratched
into her skull.

♪

[machines beeping]

- What happened?

- He suddenly went into v-fib.

Shocked him multiple times
and then he went asystolic.

Another round of epi.

♪

- It's in.

- Check for a pulse.

♪

- Nothing.

- Come on, Marc.

Don't you give up.

[beeping]

- Pulse is back.
Sinus tach.

- He's back.

All right.

Prep him to move.

I'll call ICU, tell them we're
sending him up for cooling.

♪

- How long was he asystole?

- Almost ten minutes.

What's your boyfriend thinking?

This guy's not waking up.

♪

.

[indistinct chatter]

- [groans]

- Hey, is your ulcer
getting worse?

- Today's not helping.

- Yeah.

So, I looked at
the Paramedic's report

from the accident scene.

Marc was down at least
five minutes

before help arrived.

And after this last code
it was almost ten.

I mean, that's almost
15 minutes with no oxygen.

- I know.

Increases the chances
the brain function

he has is now compromised.

But we won't know
if that's the case

until he wakes up.

- You think he really will?

After he coded?

- I don't know.

- Maybe it's time to start
thinking about

honoring his
advanced directive.

- Advanced directive?

Nat, it is a tattoo,
not a legal document.

- It might be a proxy to one.

And what if Marc does have
the paperwork to back it up?

I mean, it could be at home
in a file

or in a safety deposit box.

- If something binding exists,

the hospital's lawyers
will find it,

and I'll obey whatever it says.

But until then,
it's just a tattoo,

and one of many.

- Will, Abigail's organs
are still healthy.

But they won't be viable
for long.

Without Marc or any family
to consent,

we can't donate them.

But if we honor his tattoo
and we let him go,

then the hospital can petition
to become

Abigail's legal guardian,
and we can make the decision

to donate her organs
before they go to waste.

- Natalie, you are asking me
to let Marc die.

I can't do that.

- Well, if by some miracle
he does wake up,

it'll be to brain damage,
paralysis,

and the loss of his daughter.

So, please help me understand

why you won't even
consider this.

- I have a responsibility
to my patients

to do everything I can
to save their lives.

Anything less, then I am
failing them.

[dramatic music]

- Okay.

♪

- He's losing blood faster
than I can replace it.

- Massive bleed from behind
the liver.

There must be a hole
in the vena cava.

♪

Long Allis clamps.

♪

Damn it, this isn't working.

I can't reach the tear
without making it worse.

All right, Maggie,
get your hands in here.

Push on these packs.
Press hard.

All right.

That'll buy us some time.

Call Dr. Lanik,
get him in here.

I don't care what he's doing.
Just make sure he's scrubbed up

and ready to work.

Give me an 8 ET tube
and a sternal saw.

- Sternotomy?

You're gonna open up his chest?

- I gotta get to the bleed
somehow.

- Hey, got your page.

- Come on in.

- Dr. Abrams is in surgery
right now.

As soon as he's done,
Keegan's next.

- Uh-huh.

- What's all this?
- It's an experiment.

- For what?

- Well, you don't think that

Keegan can experience her itch
without cutaneous nerves.

And I do.
I think I can prove it.

Have a seat.

- Okay.

- So, can you take
your left arm

and put it on the other side
of the partition here?

Thank you.

- So, is this like
a magic trick?

- Yeah, kinda.

- Okay, so I'm gonna start
to brush your real hand

and the fake hand
simultaneously.

But I just want you to look
at the fake hand.

Okay?

- Whatever you say.

- So, amputees sometimes
still feel

the missing limb, right?

- Yeah.
A phantom limb.

The nerves are transmitting
confusing signals.

- Or do amputees still feel
missing limbs because

the brain is just assuming
that it's still there?

'Cause if that were the case,
the nerves would be irrelevant.

Right?

- So, you're suggesting
Keegan's got a phantom itch?

Her brain is telling her
it's there,

even though it isn't?

- Yeah.

Just like amputees perceive
a limb that used to be there.

Keegan still perceives an itch
that she got three years ago

from a drug reaction.

I mean, the brain's basically
playing a trick on her.

- Interesting theory.

Where are you going
with all this?

- That's not your hand.
Right?

But the more you stare at it,

while feeling me brush
your real hand,

the more your brain might start
to blend them together.

- Well, I guess I can buy that.

- Yeah.

Very powerful, the connection
between what we see

and what we feel.

- But Dr. Charles, I still know
which one's my arm.

- Huh.
Do ya?

- Ah.

Uh, for a second there--

- You felt the hammer.

- Yeah, I did.

- Yeah.

Well, and we both know
there aren't

any nerve endings
in this thing, right?

Amazing the tricks the brain
can play on us.

- Keegan.
Keegan, wait.

I've changed my mind.

I don't think you should have
surgery just yet.

- Oh, here we go.

What crazy idea has
Dr. Charles talked you into?

- It may not be
a nerve problem.

It could be a perception
problem.

In fact, I'm not sure
your itch is real.

- Not real?
Are you two serious?

- Look at me.

I have to be tied to the bed

so I don't scratch
a bigger hole in my head.

If surgery will work,
I have to do it.

- But what if it doesn't?

What if you wake up
and nothing's changed?

- It has to work.

Because I can't live
like this anymore.

I want my life back.

- Surgery will give it to you.

All right, let's go.

- Wait, Keegan.
Wait, wait.

The brain can change.
It responds to experience.

It's called neuroplasticity.

Three years ago,
a drug reaction created

a chronic itch that you can't
seem to satisfy,

because it rewired your brain.

No surgery is gonna fix that.
Trust me.

- Daniel.

- Please.
Please, Keegan.

Let me try something
before you go under the knife.

- It's been three years.

What can you do for me
that no other doctor has tried?

- A trick.

♪

- What the hell is going on?

I was told you needed help
with a liver bleed.

- Retro-hepatic cava tear.

Can't fix anything until I
control the bleed.

I'm gonna do that with
an atrial caval shunt.

- You gotta be kidding.

- Nope, I'm gonna snake
an ET tube

down his heart and bypass
the tear.

- What, you couldn't think
of a riskier move?

Atrial caval shunts have
an abysmal success rate.

- Yep, I'm aware.

- Then you also know that
he's cold and coagulopathic.

So, if you don't pack him up,
and get him up to the ICU

to be warmed, he's gonna
die here on this table.

- At least this gives
him a shot.

If we send him up to the ICU,

he bleeds out
and dies for sure.

Scissors and ET tube.

- If you cut into that heart,
there is no going back.

- Yeah, I know.

- Don't do it.

[dramatic music]

♪

God damn it.

You kick me out of here
only to force me

to help you kill this guy.

You're a prick, Rhodes.

- Yeah, maybe.

.

[monitor beeping]

- If her father doesn't
wake up,

what happens
to Abigail's organs?

- They're no good to anyone.

- Ms. Goodwin, can I speak
to you about something?

♪

- Could've driven a truck
through this hole.

He never would have
survived in the ICU.

This is the right call.

- Don't act like you didn't
get lucky as hell.

- Let's finish this up.

- What do I do?

I don't know how long I can go
without scratching.

- Okay.

I want you to look
at your reflection

and scratch the non-itchy
side of your head.

In the mirror, the image
is gonna be reversed.

It's gonna look like
you're actually

scratching the itchy side.

- Oh, I see it.

But how is scratching
this side of my head

gonna make the itch
go away on the other side?

- Keegan, trust me.

We know that you've been
feeling this thing.

But I just want you to consider
the possibility that maybe,

just maybe that this itch
isn't real.

And no amount of scratching
is gonna satisfy it.

- Well, then what the hell
am I doing?

- Giving your brain new
visual input

to the override the experience
you had three years ago,

so it can begin
to rewire itself.

- Okay, you're losing me.

- By feeling yourself
scratch one side of your head

while you're seeing yourself
scratch the other,

your brain will be tricked.

And realize something's
not right.

Now, hopefully,
that experience will force you

to perceive a new reality.

- A reality in which the itch
doesn't exist.

- So you say,
but nothing's changing.

And I feel stupid.

- The exercise is designed
to confuse your brain,

so don't worry about that.

Just keep scratching.

- Like this?
Harder? Softer?

- Just like you're doing.
- Yes.

- Be patient.

Give it a chance.

- Keegan, we'll be
just outside.

- You're doing great.

[dramatic music]

♪

- How long are we gonna let her
keep scratching?

- She's been dealing with this
for what, three years?

I mean, honestly Ethan,

I don't know how long
it might take.

- If it takes.

The phantom itch theory
makes sense,

but it's still just a theory.

- I just really don't wanna
give her any false hope.

- Dr. Charles.

Something's definitely
happening.

The itch, it's less.

♪

- Okay.

All right, I'll be back
in five.

I'm gonna run these over
to sterile processing.

Hey.
Have you seen April?

I wanted to check in on her.
- Nope.

She's probably putting out
a fire somewhere.

That girl is on it.

- So, things went well
while I was in surgery?

- Yeah, didn't even realize
you were gone.

- Oh.

That's great.

- Yeah.

- Dr. Halstead,
could I have a moment?

- Of course.

- An emergency ethics committee
was formed to evaluate

Marc Jones' current condition
and future prognosis.

- Wait, was formed?
Who asked for that?

- Between his spinal cord
injury and the high probability

for irreparable brain damage,
the committee concluded

with reasonable medical
certainty

that he has no quality of life.

- No.

- Listen, the hospital
will honor

Mr. Jones's tattoo as
an advanced directive.

If he codes again,
you will not resuscitate.

- I cannot just walk away.

- I'm sorry, but it's over,
Dr. Halstead.

- I wanna talk to you.

♪

An emergency ethics committee?

What, I don't bow down
to your decision on my patient,

so you go over me to Goodwin
and bench me?

- You forced my hand.

I tried talking to you.
You shut me down.

- Because you'd already
decided Marc should die.

- He has a tattoo across
his chest that says,

"Do Not Resuscitate."

- We don't know that's
how he feels.

- We don't know he doesn't.

But what I do know is that
if we don't act now,

we will lose Abigail's organs.

Those are children's lives
in our hands.

- No, don't turn this on me.

Don't guilt me into thinking
that I'm the bad guy.

You don't think I know
the stakes of this case?

I am sick of everyone
telling me what I can

and what I cannot do.

I am just trying to save
my patients.

- What are you talking about?

Who is everyone?

♪

- You betrayed me.

How can I ever trust you?

- How can I trust you?

In the past, you have
let patients go

who you knew were hopeless.

But you know what?
It is more than that.

No, look at me.

It is more than that.

You have been acting strange
for weeks.

And this morning,
that ridiculous story

about a drug rep, really?

♪

- Well then, here we are.

And about to get married.

♪

.

- Maggie.
- Yep.

- Thanks for approving my PTO
for next month.

I didn't think there was a way
to make it happen.

- Oh, yeah.
Sure.

April.

Did you sign off on Monique's
paid time off for next month?

- Yeah.

Saw her request had been
siting there for three weeks.

I hate it when I put in

for vacation times
and nothing happens.

- It takes a long time

because someone's always
asking for PTO.

Especially Monique.

She took eight days off
last month.

- Well, her sister is pregnant,
on bed rest and needs help.

So, how could I say no?

- What?
- Lisa.

- I'm talking to you.

I have a system for handling
PTO's.

You can't take time off
if you're out of vacation.

Monique was out.

- Doris gave her some of hers.

- Oh, my God.
You let them swap?

- Doris said she wasn't
gonna use them.

No sense letting them
gather dust.

- You know what's gonna
happen now?

I'm gonna get hammered
with requests from nurses

who wanna swap days.

Thanks a lot.
- You know what?

You don't like the way
I handle things

when I'm doing you a favor...

- A favor?

This is a privilege.

- Give your privilege
to someone else.

♪

[monitors beeping]

[beeping continues]

[solemn music]

♪

- Time of death, 19:22.

♪

- There, he's gone.

You won.

♪

- I was about to give up,

but then there was this moment.

Look at me, I'm not
scratching.

- I am so happy for you.

Dr. Choi, I can keep these
mirrors, right?

It's so much better.

- Of course.
And keep it up.

Over time, they should
fade away completely.

Excuse me.

Dr. Charles, surgery
would have been a mistake.

Good call steering her away.

- Yeah, but, you know,
I certainly understood

her desperation for relief.

Do you know that
scientifically,

itching is ranked as
one of the most

distressing sensations
a human being can experience?

- Really?

You know what, Dr. Charles,
maybe it's not a good idea,

but some itches you just
have to scratch.

Vicki. Hey.

What do you say
we go for a run?

Like old times?

- Sure.

Call me sometime.

- My shift's over.

How 'bout now?

- [laughs]

Okay.
Let's do it.

[dramatic music]

♪

- Okay, look, my way
isn't the only way.

You're doing a good job.

- Thanks.

- And I confess, it sucks
when you realize

that you can be replaced.

- Yeah, I know.

♪

- Oh.

♪

Wanna get a drink?

Maybe two?

♪

Yeah.

♪

- Oh, Sam.

You'll be happy to hear that
Keegan's feeling much better.

- Oh, your smoke and mirrors?

Temporary fix.

She'll be back here
in six weeks

to get that surgery.

- Well, that's the way
you see it,

I, uh, I guess I see it
a little differently.

- Until next time, Daniel.

- Good night.

- An atrial caval shunt.

My cowboy.

- Dr. Rhodes.

Three operating rooms
upstairs were open.

You could have treated
your patient

in any one of them.

- Maybe, but I didn't want
to risk him dying in transit.

That is why we have
a Hybrid OR.

The gall bladder surgery
you interrupted,

I'm rescheduling it
for tomorrow.

In the Hybrid OR.

- Ms. Goodwin, this idea
to repurpose my room

is misguided and reckless.

- Your room?

Well, the board is considering
closing your room

unless it starts proving
its worth.

That's why I'm gonna make sure
it is always earning money.

- Great. Then I'm gonna keep
fighting back,

because I'm not gonna let
Gwen Garrett

turn the Hybrid OR into an ATM.

- Gwen Garrett has nothing
to do with this.

I decided to put
general surgeries in there.

So you pull this
little stunt again,

and I'll show you the door.

[dramatic music]

♪

- I don't care what she says.

I saved his life.
I'd do it again.

- Come here.

♪

[heavy breathing]

We're a lot alike, you know.

You'd do anything
to get what you want.

♪

- You're that bad, huh?

- I'm that bad.

♪

[solemn music]

♪

- Abigail's organs
are off to recipients.

- That's good.

♪

- Maybe you want this back?

♪

- No, I don't.

Natalie, I wanna marry you.

♪