ER 1x25

1. Carter?

2. Carter? Carter, wake up!

3. GSW coming in. Benton's in surgery and Greene's got an Ml.

4. Carter! Let's go!

5. Put a.357 in his mouth and pulled the trigger.

6. Two large bore lVs, 15 liters O-2, BP 80 over 50, pulse 56.

7. GCS 10. He's cyanotic. Blood loss at least a liter.

8. - Where's Benton? - Still up with that knife wound.

9. - He's hard to ventilate. - No gray matter.

10. Pupils sluggish. Thought you were out of here.

11. This is my last day.

12. - Where's his face? - On the dining room wall.

13. - Oh, sweet Jesus. - Help her to the waiting room.

14. - Oh, God. God! - Ma'am, please.

15. I didn't think he knew where I kept my gun.

16. Pulse ox 70. He's gonna need an airway.

17. You've done it before. Get somebody down here.

18. - Who? - Tackle anyone in a white coat.

19. Oh, boy. I hope medical malpractice covers this.

20. 7.5 ET tube. Suction.

21. No, no. Damn it, I can't see a thing. Bag him.

22. PCO-2's 60, PO-2's 55, pH is 7.20.

23. - Diminished breath sounds. - Where is everybody?

24. - He needs a crike. - I can't do it.

25. Really, I can't.

26. Somebody do something.

27. All right, get the crike tray.

28. - Versed? Norcuron? - No, no.

29. if I paralyze him and don't get the crike he dies.

30. Drape! Can someone please hand me a sterile drape?

31. Is that the membrane? Horizontal or vertical?

32. Horizontal. No, vertical skin incision first.

33. Then cut horizontally through the membrane. I'm sure.

34. Thyroid's gotta be in there somewhere.

35. - Okay, horizontal. - All right, give me the bullet.

36. Fourteen-year-old male with self-inflicted GSW to the mouth.

37. He's had four units. BP's 70 over 50.

38. Pulse is 54. Tried to intubate, but there's too much blood.

39. - I started a cricothyroidectomy. - Did you paralyze him?

40. - No. - Good boy. Good boy.

41. All right.

42. Get a hook. Come on. 6.0 trach tube. Let's move.

43. Call Radiology, tell them we're on our way.

44. Bag him. Come on, let's move.

45. Let's pack it, stop all this bleeding.

46. - So you were gonna do the crike? - Yeah.

47. - All right. Malik? - Yo?

48. Get Head and Neck out of bed. This is their lucky day.

49. - Wrong choice? - Nope. Come on, let's get him up.

50. Last day, right?

51. Don't forget to turn in your lab coat and I.D. You get your deposit back.

52. Chloe, you need to do the laundry. The detergent's in the closet.

53. Oh, my God. Chloe, can you hear me, please?

54. - She's finally asleep. - Were you up all night again?

55. Oh, gosh, I hope it stops raining before the wedding.

56. I don't think I'm gonna make it.

57. Yes. Chloe, yes you are.

58. - I'm not strong enough, Susie. - Chloe, you're doing great.

59. I'm late. Please do the laundry. The machines are in the basement.

60. The wedding starts at five, so I have to be back here by three.

61. Bye, little one.

62. - Three o'clock. - Three, yeah.

63. Single car TC, no seat belt.

64. Complaining of chest pain, lV started.

65. Go see her. Tell her how you feel.

66. - I have to know how I feel. - Oh.

67. Yeah. "Oh."

68. - Maybe it's for the best. - Except for Jake.

69. - Yeah, and except for Rachel. - Yes.

70. - Who are they? - Ah, new meat!

71. Medical students. This way, children.

72. Mark, a drunk MVA in Trauma One.

73. Carter, get the attempted suicide's mother up to the O.R.

74. - How is he? - Just tell her he's in surgery.

75. - Peter, I'm sorry about your mother. - Yeah, thanks.

76. Carter, I need your course evaluation by noon.

77. Your assessment of your ER trauma rotation.

78. - I get to grade you? - Put it in Dr. Hicks' box.

79. Is he joking? Oh, there is a God.

80. - Pulse, thready 120. Resp 36. - She's in shock. BP 70 over 50.

81. Hit a parked car. No seat belt. Bent the steering wheel.

82. - Name's Bonnie Curtis. - No sign of head trauma.

83. Pulse ox is only 85. Blood glucose is normal at 1 1 0.

84. Bonnie? Bonnie, do you know where you are?

85. - God . . . . - She's drunk.

86. - I need a cigarette. - Do you know where you are?

87. Get me a damn cigarette!

88. CBC, Chem-7, cardiac enzymes, EKG.

89. - Blood alcohol? - Sure. Get a chest and C-spine now.

90. "The resident helped you achieve competency with procedures."

91. Yes, he did. That's a four.

92. "The resident made himself available to answer questions."

93. - No. Two? - I'd go for one.

94. - Seems kinda harsh. - We're talking about Benton here.

95. One.

96. "The resident gave you constructive criticism of your performance."

97. Constructive?

98. - Do they have negative numbers? - There's a zero.

99. Zero it is.

100. - That's it. - What's the total?

101. - Sixteen. - Out of a possible . . . .?

102. Forty. Maybe I ought to go a little easier on him.

103. He turned in his evaluation of you last week.

104. Sixteen it is. Where's Dr. Hicks' box?

105. - What've you got? - Single-car accident, no seat belt.

106. Hit the steering wheel, drunk.

107. - She's shocky. - lnternal bleeding?

108. Abdomen soft, non-tender, no rebound or guarding.

109. Normal bowel sounds. Pulse ox is 85, but she's a smoker.

110. PO-2 is 70 on room air, resps are high.

111. No widened mediastinum. Ruptured aorta is highly unlikely.

112. Could be mild cardiac contusion or Ml.

113. I'm thinking pulmonary embolus. Resps are high, tacky, low PO-2.

114. She's drunk at seven in the morning. It's probably cardiomyopathy.

115. - I want a VQ scan. - You're grasping at straws.

116. Give her thiamine, folate, multi-vits. Rehydrate with D5 NS.

117. Support her pressure with dopamine and admit to Telemetry . . .

118. . . . for serial EKGs and enzymes.

119. Get her to Radiology and get a VQ scan.

120. Do Swift's orders and scan her anyway.

121. Hi, Caleb. I'm Dr. Ross. This is Dr. Carter.

122. - You have a fever. - 101. No cough, no abdominal pain.

123. - I feel okay. - He's just finished a round of chemo.

124. Look for a bacterial infection.

125. - You been around any sick people? - It's probably just the Hickman.

126. - Catheter? Is it sore? - Yeah.

127. It's always sore. Sarah just freaks out.

128. - I'm scared, Caleb. - Did you call your parents?

129. Sarah's right. After chemo your body doesn't want to fight infection.

130. CBC plus differential, blood cultures times three . . .

131. . . . urine culture, throat swab, chest film. What else?

132. - I'll do an LP. - I don't want a spinal tap!

133. - I just had one. - Why a tap, Carter?

134. lrritability and/or lethargy are early signs of meningitis.

135. The deal is this, Caleb.

136. You're not lethargic, but you are irritable.

137. That could either be meningitis or just your personality.

138. We're gonna wait and take a look at some tests . . .

139. . . . and if you're still a pain in the ass we'll do the tap, okay?

140. - Broad-spectrum antibiotics? - Yep.

141. Gentamicin 80 migs, oxacillin one gram and piperacillin 1.5 grams lV.

142. Find out who's on call for Oncology.

143. Peter!

144. I called you. You get my messages?

145. Yeah. Sorry, I've been working a lot.

146. And you really shouldn't call me at home.

147. - We need to talk. - All right.

148. Lunch? All right, we'll talk.

149. - Yeah. - Okay. See you then.

150. - You paged me, doctor? - Saddle embolus.

151. You ordered pulmonary angiography?

152. Before or after you scanned her?

153. BP was falling, increased respiratory rate.

154. Rising PCO-2, falling PO-2 and pH.

155. S1 -Q 3 on the EKG.

156. Did you book an O.R.?

157. What are you waiting for?

158. Go ahead, move her. Go, go!

159. - Good work. - Thanks.

160. We got served today on your preeclampsia. Malpractice.

161. - Jodi O' Brian? - Yeah.

162. Wrongful death, pain and suffering, the usual.

163. - What? You didn't think they would? - I wasn't sure.

164. Come and see me later, we'll talk it out.

165. What medication are you taking, Mr. Allison?

166. DdC, Bactrim, AZT, fluconazole and rifabutin.

167. Let's start hydration with D5 NS, 300cc's.

168. - What've you got? - End-stage AlDS patient.

169. Multiple meds, temp 101, tacky.

170. History of Gl lymphoma, PCP pneumonia, Kaposi's . . .

171. . . . AlDS dementia, oral thrush and cryptococcal meningitis.

172. High pitched bowel sounds, tenderness, distention . . .

173. . . . hepatosplenomegaly, positive guaiac, no recent stool or gas.

174. Vomiting blood and bile. Started a 300cc fluid challenge.

175. Okay. Let's get a KUB, lateral decubitus, chest films . . .

176. . . . blood cultures including mycobacterium, fungal, CMV . . .

177. . . . CBC, Chem-24, urine and let's get an NG tube down now.

178. - He's all yours. - Morphine 4, lV.

179. We suspect a bowel obstruction from enlarged lymph nodes . . .

180. . . . due to recurrent lymphoma.

181. This is Dr. Benton. He's the surgical resident.

182. - Is he gonna need surgery? - Maybe.

183. We'll try drugs and hydration first.

184. Okay, let's get some Neupogen to stimulate neutrophil growth.

185. Let's try and get some of those good white blood cells going again.

186. I know what neutrophils are.

187. - Do I have to stay in the hospital? - It's too early to say.

188. We have to see how you respond to the antibiotics.

189. - Let me know in a couple of hours. - Dr. Carter will keep an eye on you.

190. Last time I got a rash from my antibiotics.

191. - You need anything? - You don't have to leave too?

192. - He's trying to be nice. - Shut up, Fat Sarah.

193. I don't have to be anywhere. It's my last day. I can be anywhere I want.

194. Okay, see you later.

195. I'm bored.

196. Well, I could get you a VCR. You can watch a video.

197. I don't wanna watch TV. I'm sick of TV.

198. Last chance.

199. Suit yourself.

200. Temp's 102. BP's still 70 over 50.

201. We're not seeing much progress, Mr. Warren.

202. Do you have power of attorney to make decisions for Thomas?

203. - No, his mother does. - We should call her.

204. I already have.

205. - What do you want to do? - We may have to treat it surgically.

206. - A colostomy? - Yes.

207. We've had a lot of friends go through this.

208. How soon can his mother get here?

209. What? Can't it wait?

210. Not long, no.

211. I'll call her again.

212. - Thought you were a bridesmaid. - On my way out.

213. - An afternoon wedding? - As if you didn't know.

214. Got an unconscious geezer in Two . . .

215. . . . four-martini lunch with a bellyache in Five.

216. Carter, I have a drunk in Five.

217. Whatever happened to the practice of pediatrics around here?

218. I turned in my course evaluation, it's in Dr. Hicks' box.

219. Wilkins chose Orthopedics, so the surgical sub-l is left open.

220. - You want it or not? - In the ER?

221. - Yeah. I'm in a hurry. Yes or no? - I got it?

222. Yeah, I definitely want it.

223. September 5, five a.m. Don't be late.

224. Okay. Thank you!

225. Excuse me.

226. - Get drunk for me. - Free champagne? Count on it!

227. Rolando? What happened to all the stuff in Dr. Hicks' box?

228. My course evaluation that I turned in this morning is gone!

229. She cleaned out her box a couple of minutes ago.

230. - Have fun! - You know we will, girl.

231. ls anybody not going to the wedding?

232. Just us. The sick, the lame, the uninvited.

233. Oh, I'm a dead man.

234. Here it is.

235. - Do I need an attorney? - Hospital will handle it.

236. My wife's an attorney, she may want someone to look at it independently.

237. It's your money.

238. Thanks.

239. - Is that it? - No.

240. I've decided to sign off on you as attending for next year.

241. A show of appreciation is customary.

242. - I have to talk to my wife. - Fair enough.

243. I need to know by tomorrow.

244. Thank you.

245. I didn't get a chance to say goodbye.

246. - She knew, Peter. - Yeah, but . . . .

247. Sorry.

248. I can't do this.

249. - Do what? - I like you, Peter, but I don't know.

250. I think this is about your mother.

251. We'd like to think that, huh?

252. Chloe, I'm so late. Could you grab a half-slip and some hose out of . . . .

253. Oh, gosh, I think they're in the second drawer.

254. Oh, Chloe! I asked you to do the laundry.

255. I don't even have a dry towel.

256. Chloe?

257. Chloe?

258. Chloe!

259. Of course. Perfect.

260. Oh, my . . . .

261. Oh, yeah, it's okay. It's all right.

262. - Yes? - Dr. Hicks?

263. - I'm John Carter, Dr. Benton's student. - Come on in.

264. I turned in my course evaluation this morning . . .

265. . . . and I was wondering if I might make some revisions?

266. Yes, I've read it.

267. A sixteen. Sounds like you had a disappointing experience.

268. Would you like to hear what he said about you?

269. Sure.

270. Carter, John Truman.

271. " Exceptional student. Well-trained . . .

272. . . . superior diagnostic skills. Fast learner, dedicated, selfless.

273. Excellent bedside manner with patients.

274. Far better at dealing with patients' emotional needs than this instructor.

275. Highly intelligent." You wanna hear more?

276. He concludes:

277. "One of the finest students I've had the opportunity to work with.

278. Recommend High Honors."

279. He gave me High Honors?

280. I was upset that he didn't give me the surgery sub-l.

281. Did he tell you Wilkins dropped out and you had the surgical sub-l?

282. So you came up here to get this back?

283. This is what you thought of Dr. Benton?

284. No. He was hard on me, and demanding, but I learned a lot.

285. Why don't you take another crack at this evaluation?

286. Thank you.

287. And, Carter, I don't want it back at a forty.

288. - Be honest. Fair. - Right.

289. - Thirty-eight okay? - Yes, something like that.

290. With you ever so near me

291. My baby, do go to sleep

292. Bye, bye, my babykin, bye

293. Why won't you shut your eyes?

294. Bye, bye, my babykin, bye

295. Why won't you shut your eyes?

296. Mrs. Allison? Hi. I'm Dr. Benton.

297. We need your permission to perform an emergency colostomy.

298. The lymphoma?

299. This could be a very painful way for him to die.

300. Can't be any worse than what he's already been through.

301. I won't put him through it.

302. Okay.

303. We'll try to make him as comfortable as possible . . .

304. . . . and maybe the current treatment will resolve the obstruction.

305. Four more morphine, lV.

306. Marjorie decided against the surgery, didn't she?

307. I knew she would. It's what Thomas would've wanted.

308. That's why he chose her. He knew I wouldn't have the strength.

309. Can I take him home?

310. I wouldn't.

311. if he regains consciousness it could be rough.

312. Here we can manage his pain.

313. You know, we've already said our goodbyes.

314. But I guess you're never really ready.

315. Back to the deathwatch.

316. Mr. Hahn? I'm Dr. Ross.

317. - ls Caleb okay? - How's his temperature?

318. - Down to 99. - It's not the chemo.

319. Caleb has a temperature from an infection.

320. The antibiotics are working, but we'll keep him for a couple of hours.

321. Mr. Hahn, there's a call from a Dr. Bernstein.

322. - You can take it out here. - Our oncologist.

323. I'll be back. Why don't you and your daughter get something to eat?

324. Bring it back for Caleb. Cheeseburger and fries, am I right?

325. Be right back.

326. - Still bored? - What do you think?

327. Mortal Combat. I stole it from a hemophiliac up in Pediatrics.

328. - You stole it? - Well, rented it. Cost me ten bucks.

329. I'm pretty good, and it's more fun than feeling sorry for yourself.

330. Come on, you can be anybody you want.

331. - Johnny Cage. - What?

332. - I get to be Johnny Cage. - Okay. Right.

333. - You said you knew how to play. - I do.

334. - I know them more by their colors. - Dime a match.

335. - How much will that cost me? - Depends on if you can really play.

336. All right, you're on.

337. Mark!

338. Hi, everybody. Mark and Jennifer, could you take the baby, please?

339. Don't ask. The bottle's in the pouch, and I just changed her.

340. - Where's Chloe? - Who knows?

341. I gotta go.

342. I'm sorry. Thanks. Chloe stuck me with the baby.

343. - How do I look? - Like a big peach snow cone.

344. Oh, oh, here she comes.

345. Come on, girlfriend.

346. Oh, Carol.

347. - So? - You look great.

348. Oh, God, I'm really nervous.

349. - Time to seat the bride's mother. - I'm not going to cry.

350. Now remember, not too many petals at once.

351. I know how to do it.

352. - You all set, Carol? - Yep. Uncle Michel, you're on.

353. Well, Father, we're all set. Let's go.

354. Yep. All we need now is the groom.

355. How's Thomas doing?

356. Temp's up to 103, BP's 65 over 50.

357. Tag? What are you doing?

358. It's beautiful here, isn't it?

359. Yeah, it is.

360. Tag, we've got a whole church full of our friends and family waiting.

361. Are you scared?

362. A little.

363. Me too.

364. I was thinking maybe you don't love me enough.

365. Tag, I love you.

366. Do you really?

367. I was waiting in the sacristy . . .

368. . . . and I was thinking that you really don't love me.

369. And I've known it all along and I've just been kidding myself.

370. I wouldn't be marrying you if I didn't love you.

371. I wake up every morning and thank God for bringing you into my life.

372. I wake up in the middle of the night sometimes just to watch you sleep.

373. When we're at the movies and . . .

374. . . . your hand brushes against mine I can hardly breathe.

375. Do you love me like that, Carol?

376. if you care at all about me . . .

377. . . . please tell me the truth.

378. No.

379. I don't.

380. But I do love you, Tag.

381. And I wanna be with you.

382. Thank you.

383. After six.

384. Should be " Dr. and Mrs. Taglieri" by now.

385. Connie, did anyone ever tell you you're a truly evil person?

386. - Somebody's waiting for you. - I've got a patient.

387. He's been waiting awhile.

388. - Was it something I did? - No, you were great.

389. This is all me.

390. - Maybe we can fix it. - I don't think so.

391. - We can try. - Jake, look, I did something bad . . .

392. . . . and I hurt your mother, okay?

393. - What did you do? - Come here. Sit down.

394. I know that you think that I'm a good guy . . .

395. . . . but I'm not really. I . . . .

396. I don't know why l hurt people sometimes.

397. I did something with another woman that I shouldn't have done.

398. Your mother found out and now she doesn't want me to come around.

399. Oh.

400. You and I can't hang out.

401. I never meant to hurt you.

402. The one with the nice clothes and all the hair?

403. The one with all the hair.

404. I'm sorry, buddy.

405. I gotta go. My mom'd be mad if she knew I was here.

406. Show me how you rip the guy's head off and set him on fire.

407. - Up, right, kick, kick, down, block. - Wait. Up, up . . . .

408. Up, right, down, down, kick.

409. Die, you bastard. Yes!

410. Triple power move and a fatality.

411. You're pretty rough on your sister.

412. You've got A.L.L., right?

413. My brother, Bobby had leukemia.

414. Yeah?

415. He used to pick on me all the time.

416. Come up and hit me when I wasn't expecting it, for no reason.

417. Come on.

418. He hated my mom for babying him.

419. He just wanted to be a regular kid.

420. So he took it out on me.

421. He was just pretending that he could still do everything he used to.

422. But, you know . . .

423. . . . he couldn't. Your turn.

424. Did he make it?

425. No, he died.

426. But he had AML, which is a lot harder to beat.

427. It was a long time ago. Medicines are a lot better now.

428. And the kids are a lot tougher.

429. - Where's Carol? - Talking to her mother.

430. - How is she? - We took her shoelaces and belt.

431. - Somebody ought to shoot him. - Amen.

432. - What'll they do with the food? - Give it to a shelter or something.

433. Alkies can barely keep down a peanut butter sandwich.

434. How're they gonna hold on to Lobster Newburg?

435. - They got lobster? - Big ones. Size of your head.

436. - You guys are gonna eat? - Only a couple of plates' worth.

437. - Mommy, I'm hungry. - Come on, Rach.

438. - Mark . . . . - She's hungry.

439. Anybody want a drink?

440. - Gin and tonic. - Chivas straight up.

441. You in one piece?

442. Yeah, never been better.

443. So I thought I was having a bad day.

444. What's that?

445. They went ahead with the reception. You know my family.

446. What's a little humiliation when there's free food and drink?

447. What's wrong with me?

448. Why can't I fall in love with a nice guy?

449. Someone who loves me, who wants to be with me, is honest and decent.

450. - And boring. - God, he was dull.

451. All that talk about fly-fishing and bowling.

452. And playing football in college.

453. - Bowling? - Yeah.

454. I just want to be happ y.

455. - And I'm so afraid I never will be. - You will.

456. You will.

457. Dr. Benton?

458. I just want to say thank you for everything.

459. I learned a lot.

460. - Have a good summer. - You too.

461. - You're gonna make a good doctor. - Thanks.

462. Carol!

463. Carol?

464. Speech! Speech!

465. - Come on. Speech! - Oh, please.

466. Okay.

467. I'm sure all this'll hit me tomorrow.

468. Wait till you get the bar bill.

469. No, that's going to Tag.

470. I don't know what to say.

471. I don't know what the future holds.

472. I guess I'm just lucky to be alive . . .

473. . . . and have so many good friends who care for me.

474. It's been a wonderful year because of all of you.

475. May I have a dance?

476. - You bet. - Music! We need music!

477. And I need your I.D. badge.

478. - Dr. Carter? - Hey, Sarah. I thought you guys left.

479. What you did for my brother today . . . .

480. I hope that just once in my life . . .

481. . . .l can make a difference like that in someone else's life.

482. - Thanks. - No, Sarah, thank you.

483. - What's this? - Your deposit. Lab coat.

484. Hey, don't be a stranger. Come by and see us.

485. No, I'm coming back in the fall.

486. All right, I'll see you then.

487. - What've we got? - Fifteen-year-old GSW to the head.

488. Tried to hold up a 7-Eleven. Ten liters O-2. BP's 90 over 60, pulse 120.

489. We started two large bore lVs . . . .