ER 3x16

1. Mom?

2. Oh, did I wake you?

3. What are you doing?

4. I'm making you breakfast.

5. Where's the coffee?

6. How are you feeling?

7. Sleeping okay?

8. Like a baby.

9. No nightmares?

10. No.

11. It would only be natural.

12. Mom... I see worse stuff at work every day.

13. Today's the big day, right?

14. The test?

15. No. Find out about your job.

16. Mom, they suspended me.

17. I might not get my job back.

18. Those eggs done?

19. No, still too runny.

20. I like them runny.

21. Another couple minutes.

22. What test?

23. Medical school admissions test, Mom.

24. I thought you gave up on that.

25. No.

26. Hmm, big commitment.

27. Here we go.

28. Perfect.

29. Hmm... doctor...

30. That would be something.

31. I could do it.

32. I know you could.

33. I could.

34. I said so.

35. Why do you always do that?

36. Do what?

37. Make me feel

38. like I'm incapable, stupid.

39. I said I thought you could do it.

40. I just wish that for once you would believe in me.

41. I believe in you.

42. You're always criticizing, belittling, making me feel

43. like I can't do anything.

44. That's not true.

45. Why didn't you ever tell me

46. I could be a lawyer or a pilot or a damn astronaut?

47. You wanted to be an astronaut?

48. No, but I wanted you to tell me I could.

49. Fine. Go be an astronaut.

50. I'm your mother.

51. I love you, whoever you are...

52. doctor, nurse, housewife...

53. Oh, right... housewife.

54. You hold you back, not me.

55. You're the one that always

56. quits everything,

57. always frightened that you're not good enough.

58. I finish things.

59. Ballet, cheerleading, uh... the flute.

60. I was 13.

61. Business school...

62. your own wedding.

63. I finished nursing school, didn't I?

64. Right.

65. Exactly.

66. You've got a great job you're good at,

67. so why is the grass suddenly greener?

68. You have a good life.

69. I'm proud of you.

70. Why aren't you proud of yourself?

71. Carla! Carla!

72. Hey, Carla.

73. I was coming to see you.

74. I didn't know you had to be to work this early.

75. I don't.

76. Look, uh...

77. Carla, I'm sorry I haven't called.

78. This... lot of stuff came up.

79. Uh-huh.

80. I just had a lot of stuff going on, you know?

81. I had minor surgery and all this other...

82. Sorry to hear that.

83. Are you okay?

84. Yeah, it was just my appendix.

85. I mean, I'm still a little sore, but I'm okay.

86. How about you? You okay?

87. Peter, what do you want?

88. Well, we need to talk.

89. Uh-uh.

90. I told you that I was pregnant weeks ago, okay?

91. Then nothing... no phone calls,

92. no coming by to see how I was doing.

93. Silence.

94. I got the point.

95. It's cool, I got it.

96. Look, I wasn't trying to make a point.

97. Look...

98. Carla...

99. I realize there's going to be a baby here.

100. He's going to be as much my responsibility

101. as he is yours.

102. I just needed some time to think about this thing.

103. I mean, no, it's not the way I would've planned it,

104. but I'm not going to let you

105. go through this thing by yourself.

106. You going to marry me, Peter?

107. That's not what I'm saying.

108. So what are you saying? What?

109. You're going to stop by every so often

110. and change a few diapers,

111. bounce the baby on your knee

112. for a couple of Kodak moments?

113. The child's going to need a good school,

114. a nice place to live.

115. And you're saying I can't provide those things?

116. I'm saying I can help, Carla.

117. Money.

118. So that is what this is all about.

119. Yeah, that, among other things.

120. The child's going to need a man in his life.

121. Well, who says that this baby

122. will not have a man in his life?

123. So what are you saying?

124. You seeing somebody else?

125. Peter, you know, you and I...

126. We've known each other for a very long time.

127. I never expected you to marry me.

128. I never expected a damn thing from you.

129. You care about you.

130. And that is the way it has always been.

131. But, you know, it's comforting, really.

132. It's one of the few constants in my life.

133. You don't have to worry about it, Peter.

134. This baby's going to be fine.

135. Plenty to eat, nice clothes, good man around to call Daddy.

136. I'm going to take care of all those things.

137. You go back to worrying about yourself,

138. because that's what you do best.

139. Dr. Benton! First day back, huh?

140. How's the incision healing? Any discharge?

141. It's fine, Carter.

142. You know, you really shouldn't be back on your feet

143. for extended periods of time yet.

144. Did you finish that whole course of antibiotics?

145. You don't want to develop resistance.

146. Peter, how's the scar?

147. Is it itchy yet?

148. I made a Rocky-Davis incision,

149. running stitch, McBurney's point.

150. You know, when the hair starts to grow back,

151. that's when the itching gets worse.

152. You going to show us your scar, Peter?

153. Come on, let's see.

154. Yeah, come on, let's take a look.

155. I did it one-handed, you know.

156. Come on, Carter, stop.

157. Carter, Carter!

158. You know, that's really a shame,

159. because it's a great job.

160. Good thing I took pictures, huh?

161. What is that, a mole?

162. Yeah, a big one, too.

163. Good morning, everybody.

164. What are you doing?

165. Ooh, yikes, what is that?

166. That's Benton's appendix in a jar on my mantel.

167. Wow! They really shaved him good.

168. Somebody got carried away.

169. Dr. Carter, you're still backed up.

170. Okay, on my way.

171. Carter looks beat.

172. Yeah, he was on again last night.

173. Surgical interns are still covering

174. all Dr. Gant's shifts.

175. What is that, like a 90-hour week?

176. More like 95.

177. Thank God for Pediatrics.

178. Jerry, what is that all about?

179. Oh, nurses and management are still at the table.

180. Their contract expires at midnight.

181. Mark, paramedics are pulling up with a 35-year-old female...

182. Respiratory failure.

183. Duty calls.

184. Hey, lunch?

185. Only if you're buying.

186. Carol finds out today, right?

187. Yeah, the investigation is done,

188. and nursing has the report.

189. You've seen it?

190. No, and I haven't heard anything

191. on the grapevine either.

192. How's she doing? She okay?

193. Yeah, she claims she's fine.

194. Okay, thanks. Nothing yet.

195. They're still at it.

196. Oh, man, I do not want to walk a picket line.

197. Not in February, that's for sure.

198. Hey, we stand firm.

199. That's easy for you to say.

200. You've got a husband with a job.

201. Believe me, they'll settle.

202. They can't run this place without us.

203. That's what the air traffic controllers said

204. before they started parking cars for a living.

205. One, two, three.

206. 37-year-old Down's patient.

207. Her mother found her in bed in respiratory distress.

208. Resps shallow at 30.

209. BP's 100/50.

210. Mom said she had a respiratory infection

211. a couple of weeks ago, never fully recovered.

212. Where's the mother now?

213. She went to gather up some of her stuff.

214. Said she'd follow in her car.

215. Two-plus pitting edema.

216. Hi, Louise.

217. I'm Dr. Greene.

218. You having a little trouble breathing?

219. Mm-hmm.

220. We'll make you feel better, okay?

221. She's sweet,

222. scared, held my hand

223. all the way over.

224. Louise, can you tell me what day it is?

225. No, you can't tell me?

226. No. Okay.

227. Dr. Doyle, why don't you take a listen,

228. tell me what you hear?

229. Chuny, come hold Louise's hand.

230. You bet.

231. CBC lytes, EKG, chest film,

232. O2, six liters by mask.

233. Hi, Louise.

234. My name's Chuny.

235. S3 gallop and mitral regurg.

236. Indicating?

237. Possible cardiomyopathy, probably from that viral infection.

238. Hey, Mark, I think she's trying to say something.

239. Hey, Louise.

240. Louise, you need something?

241. Huh?

242. Louise, what's wrong?

243. Where's my mom?

244. Your mom?

245. Your mom

246. is coming real soon, okay?

247. Don't you worry.

248. So you can just relax.

249. You're doing great.

250. Okay?

251. Human Resources, Carol, reviewed your incident report

252. in the ER procedures,

253. and they passed their recommendations,

254. along with mine, on to the Safety Committee.

255. And?

256. And they agreed with us... That your mistake

257. was a result of systems problems

258. and not of negligence.

259. There will be a written warning

260. placed in your file for one year,

261. and the three weeks you missed due to your suspension

262. will be deducted from your vacation time.

263. And that's it?

264. You preferred a public flogging?

265. You can start back today.

266. You don't have to start back today.

267. No, thanks, I'm okay.

268. I, uh... I'd better get back to work.

269. La Bohème? Don't say it

270. like it's a new strain of resistant bacteria.

271. What is it, like five hours long?

272. Forget it, really. I wouldn't take you now if you begged me.

273. It's just that I've never been much of an opera fan.

274. Now, if you had Marcus Roberts tickets,

275. I would be there in a flash.

276. I got it, Greg.

277. You don't want to go, fine.

278. Is La Bohème the one where they, like,

279. lop off all the nuns' heads at the end?

280. It's set in Paris.

281. They're star-crossed lovers and artists.

282. Artists?

283. Jeanie, hang on a second. Look, I'm sorry.

284. If you really want to go... we'll go.

285. Don't do me any favors, Greg.

286. I-I'd love to go.

287. What time's it start?

288. I just thought we could do something

289. spontaneous, something romantic, fun.

290. Opera?

291. I have to get back to my patient.

292. Jeanie, let's hang out anyway, okay?

293. Look, we'll order take-out.

294. The Bulls/Warriors game is on channel nine...

295. You think you're charming, but you aren't.

296. Good-bye, Greg.

297. Lunch, then?

298. At least let me buy you lunch.

299. Hey, Jeanie?

300. That's one big, boggy heart.

301. God, it's taking up most of her chest.

302. EKG shows ST and T wave changes and PVCs.

303. What do you want to do?

304. Get an echo and page Cardiology.

305. Okay.

306. Mark, Louise's mother's here.

307. Hi, Mrs. Cupertino.

308. I'm Dr. Mark Greene.

309. How's Louise?

310. Not good.

311. Her heart isn't pumping well,

312. and her lungs are filling with fluid.

313. Can I say hello?

314. Yeah, sure.

315. Hello, Louise.

316. It's Mommy.

317. Hi, Mommy.

318. You okay, baby?

319. You're not scared, are you?

320. Oh, baby...

321. I, uh... I brought some of her things,

322. uh... just to make her feel more at home.

323. I'll just put this quilt on her,

324. make sure she's good and warm.

325. Mrs. Cupertino,

326. can I speak to you for a minute?

327. She had trouble understanding me earlier.

328. Can she communicate?

329. Oh, yes.

330. She likes to talk.

331. Is she suffering from any dementia or Alzheimer's?

332. No, no, she's a good girl.

333. Okay.

334. Echo's on its way.

335. Is she competent to make her own medical decisions?

336. No, I'm her guardian.

337. Louise can't make decisions on her own.

338. You are aware that Louise's condition

339. is very serious.

340. I'm worried that Louise

341. may need a heart transplant.

342. Is she already on the UNOS waiting list?

343. The list? No.

344. She's not?

345. They wouldn't do it.

346. Wouldn't do what?

347. Put her on the list.

348. They wouldn't put Louise

349. on the heart transplant list?

350. No. Why not?

351. My daughter is mentally retarded, Doctor.

352. Peter, sorry to keep you waiting.

353. Welcome back.

354. Thanks.

355. We've missed you.

356. I was surprised not to see my name

357. on today's schedule anywhere.

358. How are you feeling?

359. Well rested?

360. Yeah.

361. And mentally?

362. Feeling sharp?

363. No postoperative depression?

364. No.

365. No depression of any kind?

366. Dr. Hicks, if you're asking

367. if I can perform my duties adequately, I can.

368. I'm asking how you are, Peter.

369. I'm fine.

370. Okay, then.

371. Let's see what we've got.

372. There's two portacaths, a circumcision

373. and a nevus removal.

374. A mole?

375. UNOS can't refuse to put her on the list

376. just because she has Down's.

377. I'm sure there are other mitigating circumstances.

378. She's a retard, so why bother, right?

379. Dr. Kayson, do you know Dr. Doyle?

380. Echo shows left ventricular dilatation

381. with an ejection fraction of 18%.

382. There are also signs of wall motion abnormality.

383. I'm worried about her breathing.

384. We've given her 40 Lasix, and she's still struggling.

385. I'd like to try a vasodilator.

386. Sure, do whatever you can to make her comfortable

387. before you release her.

388. Release her?

389. Louise will be much happier

390. at home with her mother.

391. She needs a heart transplant, right?

392. That would be the standard operative course, yes.

393. Louise's mother told us

394. that she's not on the transplant list.

395. That's correct.

396. UNOS can't refuse to put a dying patient

397. on the list because of a congenital birth defect.

398. UNOS didn't refuse

399. to put her on the list.

400. We did.

401. Cardiology?

402. Hospital Transplant Committee.

403. She was evaluated

404. and we chose not to submit her name to UNOS.

405. That's a death sentence.

406. She's a 37-year-old Down's patient.

407. She's lucky to have lived

408. this long.

409. Down's patients can live into their 60s easy.

410. That's extremely rare.

411. What are you, an intern?

412. First-year resident, yes.

413. Why don't we just step in here?

414. Dr. Kayson,

415. Dr. Doyle, I think

416. is just expressing a frustration that we probably all feel.

417. It seems that Louise would be an obvious candidate

418. for the UNOS transplant list.

419. I'm a cardiologist.

420. I'd like nothing better than to give her a new heart.

421. If you have a problem with the decision,

422. take it up with the rest of the committee.

423. Short of that...

424. send her home.

425. Nice guy.

426. Yeah.

427. Carol? You back?

428. Yeah.

429. Thank you, Jesus.

430. Hey, y'all, Carol's back.

431. Carol!

432. You're back.

433. Yeah, starting now.

434. Man, did we miss you.

435. We didn't think we were going to make it.

436. Hi.

437. They dock your pay?

438. No, just some vacation time.

439. It's been a disaster around here without you.

440. A complete zoo.

441. Hey, I didn't do that bad a job.

442. Oh, no, girlfriend, you did worse than bad.

443. If you need to call a union meeting, Haleh,

444. do it after work, please.

445. No union... Carol's back.

446. Oh, thank God.

447. We'll talk to you at lunch.

448. Yeah, we'll catch up later, girl.

449. See you.

450. We're glad to have you back.

451. Thank you.

452. You okay?

453. Yeah, you know,

454. I'm sorry to disappoint everyone's expectations,

455. but I'm fine.

456. Oh, it started a few hours ago after breakfast.

457. It's a sharp pain?

458. No, sort of all over.

459. I just started my morning walk.

460. Any recent illness?

461. I take digoxin for atrial fibril...

462. I never say that word.

463. Fibrillation?

464. Anything else?

465. No.

466. What did you have for breakfast this morning?

467. Oh, the usual...

468. Three fried eggs, bacon, glass of buttermilk,

469. toast and jam.

470. Oh, the American Heart Association breakfast.

471. Don't lecture me, Doctor.

472. My mother had the exact same breakfast

473. every day of her life.

474. Died last year at 96.

475. Car accident.

476. Vitals?

477. 130/90.

478. Heart rate 110, resp 24.

479. Did Dr. Weaver get a CBC?

480. Yep, crit's 53, white count's 12.2.

481. You drinking enough fluids, Mrs. Jarnowski?

482. Is that what's wrong with me?

483. It's too early to tell.

484. Um... chest film?

485. Not back yet.

486. Okay, I'm going to call for another surgical colleague

487. to come down and take a look.

488. Her breathing's improved.

489. Hi, Louise.

490. You feeling better?

491. For you.

492. Oh...

493. She likes to share.

494. Malibu Barbie was my favorite, too.

495. I was kind of partial to Ken.

496. Ken?

497. You don't like Ken?

498. Too pretty.

499. I'm with you, Louise... Ken's trouble.

500. Louise, can you hold on to her for me

501. while I do my work?

502. Okay.

503. Thanks.

504. She misses her friends.

505. Since she got sick

506. and had to move back into the house,

507. it's been hard for her.

508. She had her own place?

509. Uh-huh, an apartment above the garage,

510. and she had a job at the Jewel

511. helping people with their groceries.

512. Father even let her

513. be an altar girl at the church.

514. Everybody loves Louise.

515. Excuse me, Dr. Greene...

516. got that list from upstairs.

517. Thanks.

518. Transplant Committee?

519. Yeah.

520. Who are the bastards?

521. Excuse us.

522. Doctor, your attitude can get in the way

523. of achieving your goals.

524. What? You're not going to vote for me

525. for Homecoming Queen this year?

526. Like that, you mean?

527. Recognize any names?

528. One.

529. Hey.

530. The vanquished return victorious.

531. Hi, Doug. You miss me?

532. You have no idea.

533. I hear they clipped you for some vacation time.

534. I never take it anyway.

535. I have a couple of years saved up.

536. This place is a mess.

537. How you doing?

538. No complaints.

539. Today's the 20th, isn't it?

540. I think so.

541. MCATs are this afternoon, aren't they?

542. You going?

543. Got to work.

544. With all that saved-up vacation time?

545. You know, it was a stupid idea.

546. I mean, four years of med school,

547. if I ever get in,

548. all that debt.

549. I'd be about 50 by the time I got out.

550. What's the point?

551. Well, I could bring you coffee

552. in the middle of the night to the med library,

553. and I could teach you how to cheat

554. on the biochem exams.

555. Doug, they need you upstairs in Pedes.

556. Mm-hmm, okay.

557. Think about it.

558. Carter, where you been?

559. Getting some food.

560. You don't have a spoon on you, do you?

561. On me? No. Anspaugh's in with your patient.

562. Anspaugh? Why?

563. Said you paged him.

564. No, no. I paged Dr. Hicks.

565. Well, you got Anspaugh,

566. and he dragged down all the surgical rounds...

567. What do you hear, Edson?

568. Rales at the base of the lungs.

569. Dr. Anspaugh, I'm sorry to have dragged you all the way down here.

570. I actually called Dr. Hicks

571. just for a consult.

572. Dr. Hicks is in surgery,

573. and we were on the prowl

574. for an interesting teaching case.

575. I heard that you had a surgical abdomen.

576. Yes, at least that's my suspicion.

577. Pain vague and diffuse,

578. very little tenderness to palpation.

579. The, uh... chest films show bi-basilar effusions.

580. Rales heard on auscultation.

581. Would you consider this

582. a surgical patient, Dr. Edson?

583. No, I'd bet on CHF.

584. Yeah, yeah, but, uh...

585. I was more concerned with... with the CBC.

586. Previously diagnosed

587. atrial fibrillation?

588. Her diet?

589. I'd assume that she, uh...

590. went into fib or ate a salty meal

591. and that was enough

592. to push her into congestive heart failure

593. as demonstrated by the rales and chest effusions.

594. The diffuse abdominal pain is probably due to congestion

595. in the liver, secondary to CHF.

596. In other words, boys and girls,

597. congestive heart failure, secondary to a-fib.

598. Wouldn't you agree, Dr. Carter?

599. Yeah, yeah, that sounds about right.

600. Is Dr. Pomerantz available?

601. And you are?

602. Mark Greene from the ER.

603. She knows you?

604. Yeah, Steph, I do.

605. It's okay. Hi.

606. Hi. You got a minute?

607. Sure.

608. Just move those.

609. Put them anywhere.

610. What can I do for you?

611. You're on the committee

612. that evaluates prospective transplant patients?

613. Yeah.

614. I have a patient dying downstairs... Louise Cupertino.

615. Dr. Kayson tells me

616. that she was denied access to the UNOS list.

617. Yeah.

618. Kayson says he wanted to do it,

619. so it doesn't sound like she was excluded

620. for medical reasons.

621. What do you want, Mark?

622. There are five people on the committee.

623. Kayson's already a "yes."

624. If I can get you and one other person to sign on,

625. Louise can get a new heart.

626. Our decisions have to be unanimous.

627. But I'm the one that turned Louise down.

628. Why?

629. Do you know how many people die each year

630. because an organ doesn't become available for transplant?

631. 3,500.

632. She had a job, an apartment, a mother who loves her.

633. Is her life somehow less valuable

634. than a businessman with a wife and kids

635. and a two-pack-a-day cigarette habit?

636. Don't patronize me, Mark.

637. I agonized over this.

638. Louise has an IQ of 40.

639. She can't comprehend the surgical risks.

640. Yes, she had a job, sure, but she was always late.

641. Do you know why?

642. Because she doesn't know how to tell time.

643. How is she going to adhere to the rigors

644. of the posttransplant regime?

645. Her mother will make sure she gets her meds,

646. get her where she needs to go.

647. She's a 120-pound eight-year-old, Mark.

648. We do the operation, and assuming she doesn't die

649. for lack of postoperative care,

650. she's in a state home in two years,

651. and her mother is adamant she not end up in a home.

652. Those are all bureaucratic perfectly logical reasons

653. we give ourselves so that we can sleep at night.

654. Louise can make people smile.

655. She can laugh, cry, touch or hold someone.

656. I have an eight-year-old,

657. and if she never grew a day older,

658. I would still cherish every moment we spent together.

659. It's not our place to decide whether Louise lives or dies.

660. She has as much right to be here as you do or I do.

661. Nina, don't let her die.

662. I'm freezing.

663. I thought you liked picnics.

664. I love picnics.

665. I'm just not used to breathing on my sandwich

666. to try and thaw it out so I can eat it.

667. Where's your sense of spontaneity?

668. This isn't what I meant.

669. Your sense of romance?

670. The dip is frozen solid.

671. It's pâté.

672. It's a brick.

673. Okay, I'm sorry.

674. I'm sorry.

675. I was wrong.

676. You're very romantic.

677. You're very spontaneous,

678. and you're very crazy.

679. So please put your parka on before you freeze to death.

680. I'm fine.

681. You can't be fine. It's ten degrees out here.

682. I think we should start sleeping together.

683. What?

684. Sex.

685. I think we should have some.

686. In fact, I think we should have a lot.

687. Are you sure?

688. Hell, yeah, I'm sure.

689. This isn't a joke, Greg.

690. No, it isn't.

691. Jeanie Boulet...

692. would you please sleep with me?

693. Hi. How's she doing?

694. Her breathing's worse.

695. The resp's up to 36.

696. How's the pain?

697. It hurts.

698. It's bad.

699. Hi. Who are you?

700. Her daughter, Yolanda.

701. She's so stoic,

702. if she says it hurts, it must be awful.

703. Okay, let's take a look.

704. Oh, God!

705. Ooh.

706. Uh... okay.

707. I need to order a repeat CBC and a blood gas.

708. You want me to page Dr. Anspaugh again?

709. No. God, no.

710. Uh, call Dr. Hicks.

711. Don't page her... call her...

712. And when you get her on the phone,

713. tell her that I need her down here right away.

714. My fiancée's been begging me for years

715. to get this thing taken off.

716. Betadine.

717. I'm not very religious, but her family...

718. Oh, boy!

719. They wouldn't even consider letting us get married

720. if I didn't convert.

721. Whoa!

722. Whoa.

723. Stuff's cold.

724. I probably wouldn't have started dating her

725. if I'd known this was going to be part of the deal.

726. Lidocaine. You'll feel a small prick

727. in the area that I'm going to anesthetize.

728. Please, do not move.

729. Oh, good, you haven't started yet.

730. I have three eager students

731. visiting today from Evanston.

732. I thought they might enjoy watching you

733. perform a circumcision.

734. Don't mind us, sir.

735. I'm converting to Judaism for my fiancée.

736. She must be quite a girl.

737. Dr. Hicks, you've got a phone call from the ER.

738. Peter, make them

739. feel welcome.

740. You're in very capable hands.

741. Number 15 blade.

742. I'm Dr. Ross from the ER.

743. Someone page me?

744. I paged you.

745. Hi. Samantha Ewing.

746. I got a CF kid up here.

747. Jad Heuston. Know him?

748. Yeah.

749. He's been on respirator

750. last couple of weeks at his mother's request.

751. I know. I'm the one who put him on it.

752. Yeah, well, today's his 18th birthday,

753. and he wants off.

754. So why page me?

755. He wants you to be the one to do it.

756. Hi, Norma. Hi, Katy.

757. Happy birthday, Jad.

758. Jad's first act as an adult

759. was to sign a DNR

760. and demand we remove him from the respirator.

761. I've explained the dangers to him,

762. but he's insistent.

763. You still sure?

764. I've explained to him

765. that with the advanced nature of his disease

766. and the number of weeks he's been dependent on the machine,

767. he's unlikely to live more than a couple of minutes.

768. I was hoping you might talk him out of it.

769. What's his tidal volume?

770. 350. PCO2 38,

771. pO2 120.

772. This is what you really want?

773. Okay, then.

774. You said your good-byes?

775. Yes.

776. Okay.

777. All right, buddy.

778. You know the drill, right?

779. I'm going to count to three.

780. And you're going to take a deep breath,

781. and you're going to blow out while I pull, all right?

782. Can you give me a hand

783. with this, please?

784. I love you.

785. All right, here we go, buddy.

786. Okay, on three.

787. Ready?

788. One, two,

789. three... blow!

790. Blow, blow, blow.

791. Okay.

792. Is he going to be okay?

793. Good afternoon, Doctor.

794. What could be so important

795. to call me off the surgical floor?

796. 64-year-old woman,

797. onset of abdominal pain five hours ago.

798. Pain was vague and diffuse.

799. Belly wasn't too tender.

800. She takes Digoxin

801. for a previously diagnosed atrial fib.

802. Rales, chest X ray

803. show basilar infiltrates bilaterally.

804. Dr. Anspaugh came down for a consult,

805. and he diagnosed congestive heart failure

806. with diffuse abdominal pain

807. due to congestion of the liver

808. secondary to the CHF.

809. We gave her 40 of Lasix.

810. That's a good story.

811. What's the problem?

812. I think Dr. Anspaugh's wrong.

813. Page Dr. Anspaugh, please.

814. I think he's still eating lunch in the lounge.

815. Get him quickly.

816. You have a better story?

817. Mm-hmm. Her abdominal pain is worsening.

818. Her resps are up to 39, and she's acidotic.

819. When she came in here, she was dehydrated,

820. so why was there fluid on her lungs?

821. And the pain isn't really explained

822. by congestive heart failure.

823. It doesn't all add up.

824. And what is your thinking?

825. I'm thinking that she's suffering

826. from atrial fibrillation,

827. which puts her at risk for developing clots.

828. And she threw an embolus,

829. and it's blocking her small valve.

830. What the hell is going on in here?

831. Dr. Carter believes you have diagnosed this patient incorrectly.

832. He what?

833. Her pain is worsening,

834. her resps are up to 39, and she's acidotic.

835. CHF made sense at the time,

836. but I believe she has

837. ischemic small bowel disease,

838. secondary to an embolism in the mesenteric artery.

839. Pretty good story, don't you think?

840. Damn it!

841. I diuresed her.

842. All right, normal saline, 200 cc's per hour.

843. Call the OR, book a room.

844. We're moving her right now.

845. What's happening?

846. Your mother needs immediate surgical attention.

847. An operation?

848. Yes, but she's going

849. to be just fine.

850. Dr. Anspaugh, can I assist?

851. Assist? You're going to do it.

852. Perform an embolectomy?

853. You're damn right.

854. You're the only one around here today

855. that seems to know what the hell they're doing.

856. It's going to fall.

857. It's not.

858. Yes, it is.

859. No, it's not.

860. Hmm.

861. She looks like she's feeling better.

862. Yeah. She ate a little bit.

863. Seems to be breathing okay.

864. Who's her friend?

865. That's my brother.

866. I had my mom bring him down.

867. I figured Louise could use some company.

868. Hey, Jimmy.

869. Say hi to Dr. Greene. That's my boss.

870. Hey, Dr. Greene.

871. Hi, Jimmy. How are you?

872. What'd they say?

873. Good.

874. Come here.

875. Psych feels that she's incapable

876. of handling the post-op regime,

877. and they don't think

878. the mother's going to be around long enough

879. to get her through it.

880. That's a lot of crap.

881. She could go to a group home.

882. Jimmy takes classes

883. out at Glenkirk, and they have a great program.

884. Mom doesn't want her in a home,

885. and she has guardianship.

886. I've called Loyola and Rush.

887. They both have transplant centers.

888. Maybe we can get them to get her on the list.

889. Mark?

890. Dr. Doyle, this is Dr. Pomerantz from Psych.

891. She's the one who evaluated Louise.

892. Hi, Louise. Hi.

893. How are you doing?

894. Mrs. Cupertino.

895. She's doing better.

896. She's out of heart failure.

897. You need to fill this out.

898. What is it?

899. Transplant Candidate Registration Form.

900. I can't get her on the network without it.

901. Kayson filled out most of it,

902. but I need today's history so that I can rank her.

903. So you have to get this back to me

904. as soon as you can, okay?

905. Nice meeting you, Doctor.

906. Nina?

907. Thank you.

908. Jad... why don't you come and go?

909. You take off during the day.

910. You do whatever the hell you want to do

911. and you come back at night.

912. We hook you up with I.V. antibiotics.

913. We get PT to pound your chest in the morning.

914. No, thanks.

915. You'd be a lot more comfortable.

916. You might even... you know, squeak out

917. a couple extra weeks out of this thing.

918. I said, no, thanks.

919. All right.

920. This is my beeper number.

921. That is my home number.

922. You call me anytime,

923. day or night, all right?

924. Let's go.

925. Thanks.

926. Where are you going?

927. Anywhere but here.

928. Whoa!

929. Sorry, Dr. Ross.

930. I raided the cafeteria.

931. Bought every piece of cake they had.

932. Ladies, here's your cake!

933. What's going on?

934. The nurses got their new contracts.

935. Did they get everything they asked for?

936. Current employees are protected,

937. but the hospital won the right to replace existing RNs

938. with unlicensed technicians through attrition.

939. Technicians?

940. It's the wave of the future, I'm afraid.

941. Come on, Doctor, dance.

942. No. No, thank you.

943. I'll get the next song. I'll get the next song.

944. Have you seen Carol?

945. Hathaway?

946. She changed her mind about working today.

947. Went home before lunch.

948. I'm starving. Want a piece of cake?

949. No, thanks.

950. Hey.

951. I just dropped off all the paperwork

952. with Nina Pomerantz.

953. Louise should be on the transplant list tomorrow.

954. All we have to do is wait and hope.

955. Where's your brother?

956. In the lounge, watching TV.

957. She won't sign the release.

958. Louise's mother...

959. She won't sign the surgical release.

960. Kayson was just down here.

961. She doesn't want Louise to have the transplant.

962. Kayson explained to her

963. that Louise will die without the operation?

964. Twice. Then I tried.

965. She wants to take her home.

966. Ms. Cupertino...

967. you don't want Louise to have the operation?

968. I was, uh... 41

969. when Louise was born,

970. and I knew right away that something was wrong.

971. I couldn't see Louise, but I could see the doctor.

972. He was frowning and snapping his fingers

973. over the little bassinet.

974. And, uh... they took her away

975. before I ever got a chance to see her,

976. and I thought maybe she'd died.

977. Maybe that umbilical cord had gotten wrapped

978. around her neck.

979. Nobody told me anything, and then...

980. then they put me in another room

981. with mothers with their babies,

982. and I waited there for hours

983. until the doctor finally came back and...

984. he looked very sad.

985. And he told me Louise was Mongoloid.

986. And he said that I should put her

987. in a state hospital and never ever see her again.

988. She will die

989. if she doesn't have this operation.

990. We all die, Doctor.

991. Louise has been

992. the light of my life for 37 years.

993. God blessed me with this... this wonderful girl,

994. and I wouldn't change a thing.

995. I'm not going to be here much longer, and...

996. I'm her whole life, just as she's always been mine.

997. There are group homes...

998. Places where she can make friends,

999. enjoy life, even if it's only for a few more years.

1000. I went to a home 20 years ago when my husband died

1001. and I was afraid that if something happened to me,

1002. who would... who would take care of Louise.

1003. And there were women there like her with Down's...

1004. wandering around half naked.

1005. They didn't even know their own names.

1006. I couldn't put Louise in a place like that.

1007. You want to save people, Doctor?

1008. If my daughter dies, you lose.

1009. But I'm not afraid of death.

1010. Jesus is there waiting for us

1011. to hold us and bring us into the light,

1012. to show us the kingdom of Heaven.

1013. And if Louise dies before I do,

1014. I know where I'll see her next, with angels where she belongs,

1015. because she's an angel...

1016. my angel.

1017. Something new?

1018. Mesenteric embolectomy.

1019. Who's doing it?

1020. Dr. Carter.

1021. Dr. Carter?

1022. Just rolled the woman into 3.

1023. Sweet God in Heaven,

1024. I hope somebody's helping him.

1025. We're putting in a portacath... a catheter used

1026. to deliver chemotherapy.

1027. Should you pursue a career in surgery,

1028. you'll perform this procedure dozens of times

1029. in your first year of residency.

1030. And this can be done in the patient's room,

1031. but you need to check the position of the catheter

1032. with the fluoroscope.

1033. Does everyone know what a fluoroscope is?

1034. This is a fluoroscope.

1035. Dr. Benton, can I steal Debbie?

1036. We can use her in OR 3.

1037. What's going on?

1038. Dr. Carter's performing

1039. a mesenteric embolectomy.

1040. By himself?

1041. Anspaugh and Hicks are supervising.

1042. What's the score?

1043. Bulls are down by one.

1044. Oh, that was a nice shot.

1045. So I let a kid with CF leave the hospital today.

1046. He's 18 years old.

1047. Went off to die with his girlfriend.

1048. Didn't want any of my help.

1049. Is there anything you could have done for him?

1050. No, not really.

1051. I spent the day

1052. trying to get a CHF patient with Down's

1053. on the UNOS list for a heart transplant.

1054. Any luck?

1055. Mother wouldn't sign the surgical release.

1056. Fine couple of doctors we are, huh?

1057. Remember when we were going to change the world?

1058. No, I was always in it for the money.

1059. All right.

1060. I'll see you later.

1061. You want to grab a pizza?

1062. No, I can't.

1063. I got to be someplace.

1064. Anybody I know?

1065. No, just helping out an old friend.

1066. See ya.

1067. Hi.

1068. Are you ready to go?

1069. Go where?

1070. Dinner at Morton's

1071. and then La Bohème.

1072. I already told Kerry

1073. that we couldn't use the tickets.

1074. I told her you were wrong.

1075. But I'm not dressed.

1076. We'll stop by your place.

1077. We'll be late.

1078. If we miss a little bit,

1079. you can tell me what happened.

1080. What about the basketball game?

1081. Taping it.

1082. You know, Greg,

1083. you don't have to prove anything to me.

1084. I don't?

1085. I mean, this has all been pretty fast.

1086. You know, we can slow it down, make sure it's right.

1087. So this means we don't have to go

1088. to the opera.

1089. No, seriously.

1090. Can we just slow it down?

1091. Sure.

1092. Okay.

1093. Hey. What are you doing here?

1094. Waiting for you.

1095. You been waiting long?

1096. Uh... a while.

1097. Ah.

1098. So you took it, didn't you?

1099. Ha-ha, yeah, I did.

1100. And?

1101. Well, I knew a lot more than I thought I would.

1102. There were a lot of people taking it... kids.

1103. I felt about a hundred years old.

1104. They all seemed so confident and smart.

1105. I guessed a lot.

1106. I bet you did great.

1107. Thanks.

1108. Was your day okay?

1109. Oh, you know...

1110. just saving lives, as usual.

1111. Have you seen my mom lurking around here at all?

1112. No, I banged on the door,

1113. and nobody answered, so...

1114. Well, you want to come in?

1115. I'll make you some coffee, burn some eggs.

1116. No, I can't.

1117. I'm up early. I'm going to go home.

1118. Okay.

1119. All right.

1120. See you tomorrow, then.

1121. Yeah.

1122. Doug?

1123. Mm-hmm?

1124. I know everyone's worried about me,

1125. but I'm fine.

1126. I mean, I was scared in that store,

1127. but I'm okay now.

1128. So why'd you go ahead and take it?

1129. The MCATs?

1130. Mm-hmm.

1131. For me.

1132. Just wanted to see if I was good enough.

1133. You are.

1134. I love this place.

1135. You should.

1136. You're a wonderful surgeon.

1137. You belong here.

1138. You know, you were right this morning.

1139. I haven't slept much the last few months

1140. since Gant's dying.

1141. And before that, me almost killing that baby

1142. and then Keaton not recommending me, and...

1143. Six months ago, I thought I was invincible.

1144. And now I don't even...

1145. I don't even know.

1146. I guess life isn't working out the way I thought it would, huh?

1147. You're not responsible

1148. for Dr. Gant's death, Peter.

1149. Yeah, but I could have stopped it, maybe.

1150. You know, told him he was doing well...

1151. Encouraged him.

1152. You know, Dr. Hicks,

1153. I wish I could tell you that it was all intentional...

1154. That it was a part of some master plan

1155. that I had going on, but...

1156. truthfully, I never even thought about Gant.

1157. I mean, he was just an intern,

1158. and I was more involved with my career, my... ambitions.

1159. We all have to find our own way, Peter.

1160. You're not invincible.

1161. You're a young doctor, learning, making mistakes,

1162. saving lives.

1163. It takes a lifetime.

1164. You just have to have faith.

1165. Go home.

1166. You've got a busy day tomorrow.

1167. More circumcisions and portacaths?

1168. No, I've signed you up for a lap chole at 6:00

1169. And I'd appreciate if you'd assist me

1170. on a splenectomy at 11:00.

1171. Thank you, Dr. Hicks.

1172. You're welcome, Peter.

1173. See you in the morning.