ER 3x9

1. Meckel's is like a rose-colored index finger

2. protruding from the antimesenteric border...

3. Then you bake it in a 400-degree oven for an hour...

4. Occasionally attach itself

5. to the umbilical area, producing...

6. Fresh rosemary, a little pepper...

7. which is a, uh, pipe connecting Meckel's

8. to the outside world.

9. Clove of garlic under the skin.

10. You know, excuse me.

11. I'm trying to visualize here, all right?

12. You might want to visualize setting up soon.

13. Your intern's late.

14. Gloves and gown for Dr. Keaton.

15. What size gloves does she wear?

16. I don't keep a chart.

17. Good morning, Dr. Benton.

18. Carter, you're late.

19. Two minutes.

20. You're supposed to set up for Keaton.

21. Okay.

22. You know what size gloves she wears?

23. Seven and a half, no powder.

24. "A man pushes a vacuum cleaner

25. "with a force of 70 Newtons at a 45-degree angle

26. "and moves the vacuum cleaner

27. "a distance of five meters.

28. How much work has he done?"

29. Well, let's start with the unlikelihood

30. of a man pushing a vacuum cleaner.

31. Work equals force times distance.

32. I thought work equaled one-half

33. of MV squared.

34. It's both.

35. Oh, God, I'm never going to pass.

36. It's just a midterm.

37. It's one-half of our grade.

38. You have all day to study.

39. No, William. I have to go to work now.

40. So, you're not going to eat that?

41. Okay, the daily specials are...

42. Doubled-over gas pains in two,

43. hemorrhoids in three.

44. It's a below-the-belt kind of day.

45. I know the feeling.

46. Oh, and a puking toddler in five.

47. 'Tis the season.

48. Everybody have their flu shots?

49. I'd rather puke.

50. Gant, can you handle a hemorrhoid?

51. Not in this life.

52. Hey, that leg ulcer in one is getting cranky.

53. Yeah, I'm getting to it.

54. Poor kid.

55. Got the dark cloud today, huh?

56. 12 patients already

57. and he's got a rule-out appi in four

58. and a rigid abdomen in six.

59. Hey, where's Mark?

60. Getting ready for a staff meeting.

61. Oh, I can't wait.

62. Weaver and the sound of her own voice.

63. A love story.

64. Dr. Greene called this one.

65. Mark called a meeting?

66. Do I look delusional?

67. Meckel's diverticulum.

68. Start with the rule of twos.

69. Uh, yeah, go.

70. Okay, Meckel's occurs in two percent of the population

71. of which only two cases are symptomatic.

72. The diverticulum is located

73. approximately two feet from the ileocecal valve.

74. Diagnosis?

75. Technetium pertechnetate imaging.

76. Complications?

77. Intestinal obstruction, hemorrhage, volvulus

78. inflammation and perforation.

79. Treatment?

80. Excision.

81. You know this stuff cold.

82. Yeah, right.

83. Only if Keaton thinks so.

84. They have to give me time off for my honeymoon.

85. It's not like I get married every year.

86. Just every other year.

87. Well, I worked extra hard for this one.

88. I deserve a reward.

89. Honey, your man is your reward.

90. That's right. 40 years of snoring, hairs in the bathtub

91. and "Honey, can you find my...?"

92. Okay, I'll bring it up

93. at the re-engineering committee today, but no promises.

94. Hey, Gant is screaming for a suture kit.

95. I put it right under his nose.

96. That child needs a honeymoon.

97. Hey. Hey.

98. Have you seen Mark? Is he okay?

99. Let me put it this way: He called a staff meeting.

100. Mark Greene?

101. Yep.

102. Glasses, receding hairline, broken heart?

103. That's the one.

104. Scan demonstrated a diverticulum.

105. And what caused this one to bleed?

106. Presence of aberrant gastric mucosa

107. in the Meckel's.

108. Very good, Peter.

109. There's the Ileocecal junction.

110. Uh-huh. I see it.

111. Now, follow my motion

112. as I move the bowl proximally.

113. Got it.

114. There's the Meckel's.

115. You've done your prep

116. on this one, haven't you?

117. Just your standard visualizing.

118. Sorry to interrupt, Abby, I got to steal Dr. Benton.

119. For?

120. Perfed ulcer.

121. Dr. Grady was going to assist

122. but his wife's gone into labor.

123. She went from two centimeters to six in record time.

124. Can't argue with Mother Nature.

125. Dr. Morgenstern, I'm not

126. prepped for that.

127. Oh, it's a nothing surgery. You can do it in your sleep.

128. It's okay. Go ahead, Peter.

129. John can take over

130. the camera.

131. Since we're short one resident for now

132. things are going to be a little tight.

133. You might have noticed, what we have is kind of controlled chaos.

134. Yeah, it's not all that controlled, Mark.

135. Yeah, well, we're going to fix that

136. with teamwork and a new schedule, Kerry.

137. Now, what I've made up is a chart here,

138. to help illustrate how it's going to work.

139. Every doctor has been designated a color.

140. Green is obviously taken.

141. Weaver is yellow.

142. Gant, red; Sanders, orange.

143. Ross is blue.

144. Doug, you have a problem?

145. No. Uh, no. You just call me Mr. Blue.

146. All right. This is going to be up in the admit area today.

147. Learn it, know it, do it.

148. This is an excellent starting point, Mark

149. but since we're all together, I'd like to bring up

150. food at the admit desk.

151. Someone spilt guava juice on my labs yesterday.

152. All right then, no uncovered,

153. free-standing liquids in the admit area.

154. All right. That's it.

155. Let's get busy.

156. Did I miss something?

157. You're not the one missing something.

158. Oh, it's going to be a long day.

159. I wonder who drinks guava juice.

160. Mark, wait up.

161. Not now, Doug.

162. The chart was very nice, very colorful.

163. Uh, "free-standing liquids"?

164. Don't start.

165. Think you're going a little overboard?

166. Well, what? If they're spilling liquids everywhere...

167. That's not what I meant.

168. I think your heart is broken and you're overreacting.

169. No. I'm not. I'm doing my job, okay?

170. The last few months, I've been distracted.

171. Had other things on my mind.

172. That's right, and despite everything

173. that's going on with Susan

174. you're still getting the job done.

175. No. I'm not.

176. I'm letting Kerry Weaver do my job

177. and that's going to stop.

178. I'm the Senior Attending

179. and it's time for me to take control.

180. So you're going to step back up, so to speak?

181. That's right.

182. Mm-hmm. Okay. Everything else okay?

183. Everything else is fine.

184. All right. If you ever want to talk...

185. Everything else is fine.

186. All right, I've already had four cases of flu this morning.

187. Should I mention the "shot" word?

188. Had mine. Me, too.

189. I'm done.

190. How about you, Randi? I take garlic pills.

191. Good. Very cutting edge.

192. What about you, Carol?

193. Huh?

194. Who's taking this guy the paramedics are bringing in?

195. Is he a child?

196. I'll take it.

197. Malik, hey, where's Dr. Gant?

198. Just took an admit up to O.R.

199. 54-year-old male putting up insulation

200. took a 15-foot fall from the ladder.

201. Alert and oriented times three.

202. Vitals stable, BP's 130/90

203. possible fractured left pelvis and tib fib.

204. Gave six of morphine in the field.

205. Okay, let's get him into trauma one.

206. Page Dr. Gant.

207. Mark, I can use you.

208. Yeah, I'll be there in just a sec.

209. Doug, you're aware that the board is full.

210. Luck of the draw. No pedes.

211. Well, you are aware that the adult anatomy

212. is remarkably similar.

213. I don't know

214. if a 50-year-old with chest pain

215. will be thrilled with having a baby doctor take care of him.

216. Arthritic diabetic in four.

217. Rule out MI in three.

218. If you need any help, just ask.

219. I don't know if I'm color- coordinated enough for this.

220. Doug, can you help me out here?

221. If a red quark is attracted to an anti-red quark

222. is it a gluon or a meson?

223. Thank you, Carol, for pointing out

224. something else I know nothing about.

225. Mostly in my legs today.

226. Chest pains.

227. I'm guessing it's a vaso-occlusive crisis.

228. Sounds like you understand your disease pretty well.

229. I've been living with sickle cell all my life.

230. Temp's 101, BP's 110/80

231. Tachy at 110.

232. What do you take for pain?

233. Darvocet usually does it.

234. Not today.

235. Okay, we'll get you something stronger

236. soon as we get an I.V. going.

237. Thanks.

238. Connie, let's get her changed

239. and get a CBC

240. with retic count

241. chest film, and start a line.

242. O2 two liters by nasal cannula

243. and five migs of morphine.

244. Can you hang on?

245. If you hear me screaming, you'll have your answer.

246. A simple patch closure should do here.

247. So what did I pull you away from?

248. Meckel's.

249. Goodness.

250. Baptism by fire.

251. I was holding my own.

252. Still, it's tough, isn't it?

253. What do you mean?

254. You've chosen

255. the most difficult elective.

256. Many are called, but few are chosen.

257. Did Keaton say something?

258. Retract, please.

259. Uh, I mean, did she say how I was doing?

260. If you're concerned, you should ask her.

261. No, no, I'm not concerned.

262. I just, you know, look, all of my procedures

263. haven't been perfection,

264. but Keaton knows I could've handled that Meckel's.

265. "Man's reach should exceed his grasp,

266. else what's a heaven for?"

267. Browning.

268. Or was it Keats?

269. Ah, well, they're all a bunch of hopheads, anyway.

270. Peter? What are you doing?

271. Oh.

272. Give me a broader scope there.

273. Good.

274. How late are you on, Dr. Carter?

275. Late?

276. Not late, 7:00.

277. Um... big plans?

278. No.

279. Well, uh... maybe.

280. Just dinner... eating.

281. I was thinking of Indian food myself.

282. Indian food?

283. You got a problem, Shirley?

284. You got a problem with Indian food?

285. Oh, I'm sure she doesn't, do you, Shirley?

286. Good for the sinuses.

287. It's that spice they use.

288. Hold still, please.

289. Good.

290. Maybe I'll just order in

291. and rent a movie.

292. My VCR's broken.

293. Which is probably

294. why I'm not going to, uh, myself.

295. Rent a movie, that is... tonight.

296. So maybe you'll just eat

297. and call it a day?

298. Yeah, that's probably what I should do.

299. Just study, prep for tomorrow.

300. Cumin.

301. What?

302. That's the spice... cumin.

303. Oh.

304. Right.

305. BP's 120/80, heart rate's 90, resps 30.

306. He's HIV-positive.

307. Complaining of shortness of breath.

308. Al Boulet?

309. Is he some relative of Jeanie's?

310. Not that I know of.

311. Al Boulet?

312. Dr. Greene.

313. Yeah.

314. Any relation to Jeanie Boulet?

315. We're divorced.

316. Oh. So, you're having trouble breathing?

317. Just a little.

318. No-nothing big.

319. And when did you first test positive for HIV?

320. About six months ago.

321. Mm-hmm.

322. And you're on AZT, 3TC and a protease inhibitor.

323. Your last t-cell count was 200?

324. Yeah.

325. CBC, chest film and sputum induction.

326. O2 nasal cannula, four liters.

327. Bactrim, four amps I.V. piggyback

328. 60 migs solumedrol I.V.

329. And let's admit Mr. Boulet to medicine.

330. Yep. Okay.

331. So, when'd you get divorced?

332. Uh... separated about a year.

333. Uh-huh. Open.

334. Divorce just came through.

335. The new float system seems to be working well

336. across the board.

337. E.R. and ICU both had a few adjustment problems

338. but altogether, I would say things are settling down.

339. From where risk management sits, we're fine.

340. Incident reports haven't increased

341. since the new rotation started.

342. Can you give us an idea

343. how long this floating is going to last?

344. Indefinitely, Carol.

345. This is not a Band-Aid.

346. It's the cure.

347. It's being negotiated into the new contracts?

348. Financial affairs is ever so pleased with this temporary fix,

349. but we still need to cut non-physician related care.

350. Meaning the nurses?

351. Honestly speaking, nurses simply don't generate the revenue.

352. And what about saving lives?

353. They don't tend to do that either.

354. Hold on a minute, Dean.

355. You're just

356. talking statistics, aren't you, Dean?

357. Averages, numbers... Whatever you want to call it.

358. I think you're calling it nurses.

359. And in the E.R.,

360. nurses are in trauma situations every day.

361. It's only going to hurt an emergent patient

362. to have some floor nurse set up the wrong lavage kit.

363. You want a lawsuit over that one?

364. Look, Carol. That's why we're all here.

365. To help iron out these problems

366. before your contract's up.

367. Now, have you got a suggestion?

368. Stop floating them.

369. E.R. nurses

370. are not interchangeable.

371. They work differently.

372. They work longer, and the stakes are higher.

373. So we should show them preferential treatment.

374. We should show emergent patients preferential treatment

375. by giving them nurses trained in handling crises.

376. What do we say to pedes or ob/gyn when they complain?

377. You tell them it's like triage. Critical cases come first.

378. Hey, Jeanie.

379. Hi.

380. I just treated your husband Al.

381. Ex-husband.

382. Still, I-I-I didn't realize

383. that you've been going through all this.

384. Unfortunately, it's Al who's going through it.

385. I mean, I'm doing what I can to help.

386. So I guess you guys have been separated for a while.

387. Yeah, quite a long time.

388. And the marriage was over long before that.

389. I guess you didn't feel any need to get tested.

390. No, no. I did.

391. I got lucky. I was negative.

392. I'm glad.

393. Yeah. I got to get this suture kit to Gant.

394. He is just swamped with patients.

395. Hey, that's a central line kit.

396. You're right.

397. Right. Thank you.

398. Now, Mrs. McCourt, when did the chest pains start?

399. Uh, this morning, right after breakfast.

400. What did you eat?

401. Toast with raspberry jam.

402. Well, those jams can be pretty acidic.

403. Oh, I've eaten toast and raspberry jam

404. every day for 40 years.

405. It doesn't give me heartburn.

406. I know heartburn.

407. Yes, I'm sure that you do.

408. All right, let's get a 12-lead, pulse ox and a chest film.

409. And maybe cardiac enzymes?

410. Oh, uh, yeah.

411. Are you on any medication?

412. Of course I am. I'm 73.

413. Hmm. Uh...

414. Digoxin,

415. for my heart,

416. and allopurinol for my gout,

417. glipizide for diabetes

418. and simvastatin for, um...

419. Ooh, I never can remember this one.

420. What am I taking that one for?

421. Uh... High cholesterol.

422. Oh, yeah, you don't want to skip that.

423. It's very important.

424. Yes, I...

425. And, uh...

426. What a cow. Famotidine.

427. Kerry, you got a minute?

428. Sure. What's up?

429. We might have a problem with Jeanie Boulet.

430. What sort of problem?

431. This morning, I treated her ex-husband Al.

432. He has AIDS.

433. I see.

434. Did she mention anything to you?

435. Why would she?

436. She claims she tested negative.

437. Well, we'll have to take her word on it, won't we?

438. Doesn't this make you uncomfortable?

439. Not especially.

440. She says she's negative.

441. What else can we do?

442. I guess I'm just a little surprised

443. at your lack of concern.

444. It's a lack of alarm, Mark.

445. There's a difference.

446. I'm in the tall grass

447. and so... I take the five iron

448. and I sail that puppy, like, two inches from the cup.

449. It was poetry.

450. It was a sonnet.

451. It was practically a haiku.

452. Excuse me, Dr. Morgenstern.

453. Are we done yet?

454. Looks good to me.

455. Thank you, Peter.

456. What happened to the pelvic pain in two?

457. Ruptured ectopic. OB took her up to surgery.

458. Yeah, well, then why don't you erase the name?

459. Is that too difficult?

460. I was busy calling up the charts you asked for...

461. Al Boulet.

462. He was Kerry Weaver's patient?

463. That's what it says.

464. You're welcome.

465. So you're telling me

466. this Indian food thing has a purpose.

467. I'm just trying to prep myself for Pakistan.

468. Why didn't you tell me sooner?

469. Well, I only found out yesterday afternoon.

470. I haven't told anyone but Anspaugh.

471. You're not sleeping with Anspaugh.

472. Are you?

473. Um, maybe...

474. You know what?

475. We got it. We'll take it.

476. Thank you. Thank you.

477. Listen, it's a great opportunity.

478. Three of us from the U.S. going to teach

479. pediatric surgical techniques to Pakistani surgeons.

480. Think of the help we'll be giving.

481. They don't need that kind of help in, like, Indianapolis?

482. Well, it's only for four months.

483. Thought you said six.

484. Well, you know, it could be six.

485. Well, then that means it could be a year or five.

486. Next thing you know, you're going to become Mother Teresa

487. and start living amongst them.

488. Did you have long-term plans for us, John?

489. Well...

490. I don't... you know...

491. Well, neither did I,

492. so, for the next few weeks

493. why don't we just keep having fun?

494. Same kind of fun, though, right?

495. Yes, the same kind of fun.

496. Okay.

497. I've got a patient

498. present with PCP pneumonia.

499. Been tested positive for HIV six months ago

500. and I'm worried he didn't tell his wife.

501. Uh-huh.

502. I need to see if she was tested.

503. Those are private files, Dr. Greene.

504. In the case of spousal report, I'm allowed to check.

505. In the case of spousal report, you're allowed to tell the other spouse

506. not to look into someone's private files.

507. Give me a break, huh?

508. I don't think this guy's telling her.

509. Okay. Name?

510. Uh, Jeanie Boulet.

511. B-o-u-l-e-t.

512. You know, that re-engineering committee is a joke.

513. It's downsizing in sheep's clothing.

514. I should have spent the time studying.

515. I still don't know iodine from cosine.

516. Okay, well, if memory serves me

517. one is an element that you find in antiseptic

518. and the other has to do with right angles

519. or hypotenuse... Something like that.

520. If that's how your memory serves

521. how did you get through it?

522. Well, they told us we could bring one sheet into the exam

523. with all the formulas written on it.

524. And?

525. I brought in a really big sheet.

526. Have you seen Weaver?

527. What color was she?

528. Never mind.

529. Excuse me. I've been waiting here

530. for two hours

531. and I have a luncheon in less than 20 minutes.

532. Right, well, we'll be right there Mrs. Uh...?

533. Murison. If I don't get my B-12 shot

534. I might as well just resign from my job.

535. Someone is going to help you.

536. Gant, can you...?

537. No, no.

538. Gant, the answer is yes.

539. You give Mrs. Murison a B-12 shot.

540. I've got 17 surgical patients.

541. She's not one of them.

542. I'm sorry.

543. You're going to have to wait.

544. Natalie, you get a lot of ear infections, do you?

545. Can you just give me the amoxicillin?

546. I have a playdate.

547. Mm-hmm.

548. You don't need to look.

549. Just give me the antibiotic.

550. Augmentin will be just fine

551. if you're worried about resistance.

552. You know a lot of things about a lot of things

553. don't you, Natalie?

554. Yes, I do.

555. So, you want to tell Nurse Hathaway

556. about Coulomb's Law?

557. That's the fundamental law of electrostatics

558. which states that the force between two charged particles

559. is directly proportional to the product of their charges.

560. And inversely proportional

561. to the square of the distance between them.

562. Isn't that right, Natalie?

563. You can't give me another shot?

564. You've already had two doses.

565. The attending physician has to approve a third.

566. Jeanie.

567. Mark, I'm glad you're here.

568. I've got a patient in sickle crisis.

569. She's in a lot of pain.

570. I'd like for you to evaluate her.

571. She needs more narcotics, maybe an admission.

572. Right, well, I'll see what I can do.

573. But right now, I need you

574. to cover the waiting room.

575. The waiting room?

576. Yeah, there's about a dozen people need to be triaged.

577. But I'm with a patient.

578. I'm going to handle this from here.

579. Understand?

580. So what kind of movie do you want to get?

581. I was thinking maybe a comedy

582. or maybe a comedy.

583. Forget it.

584. Tonight, you're going to participate

585. in a long-standing Carter family tradition.

586. Sounds painful.

587. Every year, at exactly this time

588. the intrepid Carter male goes into the woods

589. picks out the perfect Douglas fir tree

590. and with his own strong, Protestant hands

591. he cuts it down.

592. We're going to cut down a tree?

593. Not just any tree.

594. The Carter family Christmas tree.

595. Oh, oh, I do not saw after hours.

596. Don't worry.

597. That's my job.

598. Oh, Dr. Benton, how was the ulcer?

599. Uh. Uh... fine.

600. Look, I saw the thyroglossal duct on the board

601. and I was hoping to assist.

602. I haven't had a lot of experience

603. with neck surgery

604. and, you know, considering

605. that I was called out of the Meckel's...

606. Sorry. I already called in Wallace to assist.

607. Yeah, but is there any possibility of rescheduling

608. considering everything that...

609. There'll be plenty

610. of other opportunities, Peter, really.

611. Carter, don't you have something to do?

612. No. Actually, I'm all caught up.

613. What about post-op notes?

614. They're on the charts.

615. I'm done.

616. That's it.

617. I'm done.

618. I'm going to lunch.

619. Here. Earache in four.

620. I'm not going to lunch.

621. Hey, Carter, otitis media in four.

622. Sorry, Doug.

623. I beeped him.

624. You might want to check on your friend Gant.

625. Why? What's wrong?

626. Well, surgical admits

627. are in a holding pattern and piling up.

628. You've got four patients

629. on your service.

630. He's got 20.

631. Give him these... The labs on lung cancer.

632. Hey. You heard I was here, huh?

633. I'm better now.

634. It must be the Jell-O.

635. Why did you tell

636. Mark Greene about me?

637. I didn't.

638. Then how does he know I'm positive?

639. I don't know. We were married.

640. I guess he just assumed.

641. He's not assuming, Al.

642. He knows.

643. Well, it didn't come from me.

644. Did it ever occur to you to go to a different hospital for treatment?

645. My insurance is still a mess.

646. I know the doctors here.

647. I know the doctors here!

648. Well, even if they found out

649. they couldn't fire you, could they?

650. That's not the point, Al.

651. Do you think at all about what I'm going through?

652. This is not just about you.

653. I know this is not just about me.

654. Then act like it.

655. Jeanie.

656. Look, I know how mad you are at me.

657. And you have a right to be.

658. Living with AIDS, that's...

659. nothing, but...

660. knowing...

661. I gave it to you...

662. There's no pill for that.

663. I just have to face it...

664. Every day.

665. Hating me might feel good, but it won't change anything.

666. It doesn't feel good, Al.

667. Nothing about this feels good.

668. I don't see Weaver as yellow.

669. I see her more in the red family.

670. Yeah, something in burnt sienna.

671. Lavender's too pastel for Doyle.

672. She's more like an eggplant.

673. Are you redecorating my board?

674. Just a little constructive criticism.

675. Mark, I need to speak with you.

676. All right, I'll be there in a second.

677. I'll wait outside.

678. What the hell are you doing?

679. Funny, I was going to ask you the same question.

680. Why is Jeanie checking vital signs

681. when we're swamped?

682. Patient safety.

683. She is not a health risk.

684. Oh, maybe you know that

685. but I haven't had the opportunity to assess her condition.

686. Why didn't you tell me that you treated her husband?

687. I didn't think it was relevant.

688. You lied to me.

689. It wasn't any of your business.

690. If someone in my E.R. is HIV-positive

691. I think it's my business.

692. Hey, it's our E.R.

693. and you don't even know if she's HIV-positive.

694. The hell I don't.

695. I checked with medical records.

696. You went into her confidential file?

697. I wouldn't have had to if you had told me the truth.

698. Nice try, Mark, but there's no excuse for what you did

699. and you know it.

700. Hey. I've been looking for you.

701. I heard you could use a hand...

702. That you're getting buried.

703. I'm fine.

704. Yeah, well, I don't mind helping you.

705. You've certainly bailed me out when I've been under.

706. Benton minds. Look, he wants me to pull my weight.

707. I'm damn well going to pull it.

708. I'm not letting him get another shot at me.

709. Gant, lower abdominal pain.

710. Rule out small bowel obstruction.

711. We may have a problem in the E.R.

712. I thought you should know about it right away.

713. Is this going to give me acid reflux?

714. If so, save it until I'm done.

715. I have reason to believe that we may have a worker

716. that's HIV-positive.

717. Say no more.

718. I don't want details.

719. This could have serious ramifications.

720. I've already removed the person

721. from direct patient care.

722. Well, I hope you didn't indicate why,

723. or else we're going to have a discrimination suit slapped on us.

724. No. What is the hospital policy?

725. We'll deal with it.

726. We're not going to race at it

727. like a herd of buffalo.

728. The first thing I want to do is talk to Legal.

729. Does Kerry know?

730. That's part of the problem.

731. I believe Kerry may have known for as long as six months

732. without informing anyone.

733. Good.

734. I want you to be equally discreet.

735. But by keeping this to herself, Kerry may have left us

736. wide open for litigation.

737. I know that all too well

738. but right now, it's just a suspicion, Dr. Greene.

739. And please...

740. don't correct me if I'm wrong.

741. I had a dream like this once.

742. Now it's come true.

743. What happened?

744. We were on our winter nature hike

745. identifying perennials, varieties of moss.

746. One of the boys found a sick bat,

747. brought it back to the van.

748. Before I knew what was going on,

749. he had passed it around.

750. Were any of them bitten or scratched?

751. Maybe. We don't know.

752. Their stories changed

753. when they found out they were going to get a shot.

754. I don't understand it.

755. The bats should be well into hibernation by now.

756. Okay, let's get the bat in the lab and see if it's rabid.

757. Oh, we don't have a bat.

758. No bat?

759. No bat. I threw it out the car window.

760. I'm going to go start some charts.

761. Mm-hmm.

762. It was flopping, drooling.

763. And you panicked.

764. Yes... I suppose I did.

765. All right!

766. Anyone seen Randi?

767. Went to the roach coach for a sandwich.

768. This has to be a mistake. What?

769. "Please observe that all E.R. nurses will be exempt

770. from the flotation schedule currently in effect."

771. No way!

772. Does it say anything about my honeymoon?

773. No, you must be dreamin', girl.

774. What'd you say to them?

775. Who?

776. "No more floating."

777. You must be kidding!

778. Good work, Carol.

779. No wonder management wanted you.

780. I'm not management.

781. Paramedics got a live one coming in right behind me!

782. Haleh, Carol...

783. Bring these to Doug in exam three.

784. Order a series of R.I.G. and rabies vaccines.

785. How many?

786. Eight... no, nine.

787. What happened?

788. Ten-year-old male, vitals stable.

789. BP 100/70.

790. Severe throat pain with bleeding.

791. I took him to the circus.

792. He thought he could be a sword swallower.

793. He tried at home with one of our carving knives.

794. Let's get him into

795. trauma one.

796. Who's covering surgery?

797. Gant, but I think he's in Radiology.

798. Yeah, you know what, you're going to have to wait out here.

799. Page Carter and Benton.

800. Uh... Dr. Keaton

801. I see you're going to have a trisegmentectomy

802. for a hepatoblastoma this afternoon.

803. No. I decided

804. the child needed a course of pre-op chemo.

805. But it's on the board.

806. Well, it shouldn't be.

807. I canceled it.

808. Peter, you were unlucky today

809. but you've already seen more

810. during a single rotation than I ever did.

811. Yeah, I know, Dr. Keaton.

812. I just feel that if I get more experience

813. I'll be better prepared for the future.

814. That's not how you should be looking at it.

815. Damn.

816. Uh... what do you mean?

817. Focus on what's in front of you.

818. Your residency is five years long.

819. It's a marathon, not a sprint. Excuse me.

820. I feel crepitation.

821. He's got subcutaneous air in his neck.

822. Probably perfed his esophagus.

823. I'll start a second line.

824. You want a chest film?

825. And a soft tissue neck.

826. You paged me?

827. Probable perforation.

828. The temp's 100.

829. Let's get a gram of Unasyn.

830. He might be developing an infection.

831. You going to scope him? Yep.

832. I wouldn't.

833. He's obviously perfed.

834. Carol, let's go ahead and set up

835. for endoscopy.

836. This is Jeanie Boulet.

837. I'd like to know if anyone inquired about my file today.

838. Around noon?

839. All right.

840. Thank you.

841. Are you okay?

842. I'm fine.

843. It's so damn swollen in here.

844. Can you visualize the cords?

845. All right, what do we got?

846. Ten-year-old trying to be a sword swallower.

847. Used a carving knife.

848. Vitals are stable.

849. Gave him a gram of Unasyn.

850. We're trying to see if there's a perf.

851. Okay. Carter, what the hell are you doing here?

852. I thought Gant was covering the E.R.

853. Gant's jammed.

854. I paged Carter to help.

855. He's not jammed.

856. The kid is slow and we're not helping him out

857. by picking up his slack.

858. I thought the patient was more important, Peter.

859. Carol made the right call.

860. Well, they're Peter's interns.

861. It's his decision.

862. Well, in any event, he's perfed his esophagus.

863. We all knew that one.

864. Anybody want me to drop an NG?

865. Nope. We'll do it up in the O.R.

866. I'll page Dr. Keaton.

867. No, why don't you stay down here

868. and help your friend. Let's go.

869. All right.

870. Now, next time you see a bat

871. what are you going to do?

872. Leave it alone!

873. All right!

874. Good, good, good.

875. Now, hop out of the way here.

876. Let's send some instructions home with them.

877. We want follow-up injections

878. on days three, seven, 14 and 28.

879. Okay... Mr. Wilbourne.

880. Time for your shot.

881. I barely touched the thing.

882. Well, rabies is nothing to fool around with

883. as you well know.

884. Can we watch?

885. Mark, do you have a minute?

886. What's up?

887. Well, I just wanted to talk to you

888. about the memo I got from the re-engineering committee

889. about floating the nurses.

890. Carol, that's your responsibility.

891. I really need you to handle it yourself.

892. I am handling it.

893. You want me to put a word in?

894. No.

895. You know what I'd really like is just one 24-hour period

896. where no one complains about their job

897. and maybe just one person

898. might appreciate the fact that they have one.

899. Is that too much to ask for?

900. Well, actually, what I was going to tell you is

901. that they agreed to my request

902. and they're going to stop floating the nurses

903. which will make both our jobs a lot easier.

904. I just thought you might want some good news.

905. Thanks.

906. Eh... poor kid.

907. Trying to swallow a knife.

908. I've seen worse.

909. Mobilize the esophagus.

910. Okay. Got it.

911. Debride the wound.

912. Okay.

913. Mm-hmm.

914. And...

915. I'm there.

916. Uh... Dr. Keaton?

917. Mm-hmm?

918. I need to ask you something.

919. Suction.

920. Well, uh...

921. I'm a little concerned about... how Carter's doing.

922. How do you think he's doing?

923. Well, he... had to scramble this rotation...

924. Well, we both did...

925. But, uh... I-I don't know, I-I think he's doing fine.

926. So do I.

927. You know, he had a rough bit in the beginning

928. but he listened, he learned...

929. He's very, very good with kids.

930. Yes, he is.

931. If that's the way you feel about Carter, you should tell him.

932. It's very important for the teacher

933. to keep his intern informed of how he's doing.

934. You-you think so?

935. Absolutely. That way, he knows he's on the right track.

936. It's very easy to get discouraged in a vacuum.

937. I... yeah, I agree.

938. I... yeah, agree.

939. Hey, it looks like snow.

940. Smells like snow.

941. Carol, what does that mean?

942. You can smell snow coming.

943. It has a smell.

944. It smells like burritos.

945. Look, what are we going to do about Mark?

946. Put him on a plane, or have him killed.

947. I don't think I can take this much longer, you know?

948. Maybe you should talk to him.

949. I talked to him once; he said he was okay.

950. If I ask him again, it gets a little weird.

951. Oh, you'd be violating the guy code.

952. The guy code?

953. Yeah, of non-communication.

954. Don't you have a test to study for?

955. You can't let him self-destruct.

956. Well, let him get it out of his system.

957. If he stomps around, acts like a jerk

958. then he'll be back.

959. Yeah, but will he have any friends left?

960. Didn't you get more morphine?

961. He said he would, but never came back.

962. Dr. Greene?

963. I don't even remember.

964. Please, I really can't take this anymore.

965. I know. Okay.

966. Jeanie, what are you doing in here?

967. I hold you to handle triage.

968. Could I speak to you?

969. I'm treating a patient that you've neglected.

970. Do you have any idea how much pain she is in?

971. Yeah, when I assign you to an area

972. that's where you go.

973. Oh, is that how it works? You make the rules?

974. Yeah, that's how it works.

975. And you get to break them

976. by going into my file?

977. I requested that information

978. under the Spousal Report Law.

979. That's a lot of crap, Mark.

980. You wanted to know, and you found out.

981. It was completely unethical.

982. You want to talk ethics?

983. How about you lying to me?

984. Well, I guess the truth

985. is out now, huh?

986. You should've come to me from the beginning.

987. Why, so I can lose my job sooner?

988. No. So I could have dealt

989. with the situation appropriately.

990. No. It's better this way.

991. You know about me, and I know

992. a hell of a lot more about you.

993. Excuse me.

994. I have to attend to a patient.

995. It's not the flu.

996. I'm not saying anything.

997. It's allergies.

998. I didn't say a thing.

999. I'm gone.

1000. Break a leg.

1001. Hey, where you going? We're going to celebrate!

1002. Celebrate what?

1003. It's happy hour! We're not floaters anymore!

1004. First pitcher of margaritas is on us.

1005. Oh, it sounds like fun, but I can't.

1006. I have an appointment.

1007. Oh, come on! What can be that important?

1008. You're the guest of honor.

1009. Sorry. Have fun.

1010. Be right there.

1011. Hey, are you done?

1012. Yeah.

1013. Benton just ripped me a new one.

1014. Huh. About what?

1015. About not being in trauma for the perfed esophagus.

1016. Ah.

1017. Why didn't you come get me out of Radiology?

1018. Hey, they paged me.

1019. Look, I know you were trying to help

1020. but you didn't.

1021. You made it worse.

1022. I'm sorry.

1023. The best thing you can do for me

1024. is to leave me alone.

1025. Mm-hmm.

1026. Anything good?

1027. Just surfing.

1028. Done for the day?

1029. Almost.

1030. Al, about this afternoon...

1031. Hey. No, it's okay.

1032. No, I'm sorry that I jumped to conclusions.

1033. It's just... I get up every morning thinking

1034. "What's going to happen today?

1035. How's this going to get worse?"

1036. What else am I going to do to ruin your life?

1037. No...

1038. Yeah.

1039. Maybe.

1040. I do want to blame you.

1041. I know things happen.

1042. They happen for no good reason.

1043. I see it every day

1044. but when it's happening to you

1045. you want it to be somebody's fault.

1046. I haven't told anybody at work.

1047. Still play poker on Tuesdays.

1048. Shoot hoops on Saturdays.

1049. Some of the guys I could tell, some I couldn't.

1050. But, uh...

1051. none of them would ever treat me the same again.

1052. You don't deserve this.

1053. Neither do you.

1054. So, what's in store for tonight, the usual?

1055. Karate class, a couple of laps around the track...

1056. Actually, my goal

1057. is to stay awake through the 10:00 news.

1058. Ah. How's Susan's apartment working out?

1059. I don't know why I was so worried

1060. about where I was going to live.

1061. I'm never there.

1062. Look, I'm sorry.

1063. Today, I was, uh...

1064. What was I today?

1065. Uh, officious, humorless, pain in the ass.

1066. Yeah. Right. Thanks.

1067. You want to talk?

1068. I want to sleep.

1069. Look, it's... nothing's the same.

1070. You notice that?

1071. It's just not fun in there anymore.

1072. It was fun once?

1073. You know what I mean.

1074. Sun-Times.

1075. It's just...

1076. I'm up to my ears in administrative problems.

1077. Kerry Weaver and I are constantly butting heads

1078. and it's just like...

1079. the whole staff is lying to me.

1080. I used to think of this as a family.

1081. Didn't it feel like that?

1082. Well, you got to remember

1083. my idea of a family is a little screwed up.

1084. Look, Mark, it's okay to miss her.

1085. No. It's more than that.

1086. Well, I think, whatever you do,

1087. you should keep it separate.

1088. My mom, she used to work at this office,

1089. and she never put a picture of me out,

1090. and I asked her why,

1091. and she said, "Never confuse where you work

1092. with where you live."

1093. Your mom didn't work in the E.R.

1094. I just shared with you

1095. a very profound childhood moment...

1096. Okay, I'm sorry.

1097. It's moving, and your mother is a very wise woman.

1098. Thank you very much.

1099. I can't face going home to another frozen dinner.

1100. Do you want to get a burger or something?

1101. I can't tonight.

1102. I got this thing I got to do.

1103. But if you want to talk later, you know where I'll be.

1104. No, I don't know where you are.

1105. Well, at home. After 10:00. Alone.

1106. Dr. Benton. Hi.

1107. Hey.

1108. How was the surgery?

1109. Well, I, uh, missed out on the thyroglossal duct

1110. but then a perfed esophagus fell into my lap.

1111. Good. Great.

1112. Listen, uh...

1113. Carter, I wanted to talk to you

1114. about your work.

1115. I, uh... I know I don't usually give you

1116. a lot of feedback, but...

1117. you know, the fact is...

1118. you're doing good work.

1119. Yeah. I mean, you've, uh...

1120. your work has consistently improved.

1121. You're more confident.

1122. You've become more proactive.

1123. Great.

1124. Yeah. Now, listen, there are still some areas

1125. that need improvement, like focus, you know?

1126. What?

1127. Focus, Carter.

1128. Focus.

1129. Yeah.

1130. Yeah. Anyway, we'll work on that.

1131. Okay, great, good.

1132. Hey... I don't know.

1133. I just wanted to tell you that...

1134. you're doing good work.

1135. Thanks.

1136. Yeah, um...

1137. Listen, I got to run.

1138. Uh...

1139. All right.

1140. All right.

1141. Good night, Carter.

1142. Good night.

1143. Hi.

1144. Okay, you...

1145. you just missed Benton by a second.

1146. I saw him.

1147. I slowed to a stroll.

1148. I can hardly breathe.

1149. It's okay.

1150. Ah.

1151. Jeanie.

1152. About today...

1153. Mark Greene looked in my file.

1154. I know.

1155. I got a memo from Anspaugh this evening.

1156. He set a time for Mark and I to meet

1157. and discuss hospital policy.

1158. Okay.

1159. It's going to remain confidential.

1160. I don't put much faith in that around here.

1161. Maybe it's not going to be as bad as you think.

1162. At least you're dealing with doctors.

1163. There's some degree of understanding

1164. about the disease and how it's transmitted.

1165. Right.

1166. Right.

1167. Mm.

1168. Well... you know what?

1169. I'm starving.

1170. The aroma coming from the cafeteria...

1171. isn't... well, it's not too scary.

1172. Want to join me?

1173. Well?

1174. Hey, what are you doing here?

1175. Hey, I'm invested in this exam.

1176. And I helped you study.

1177. How did we do?

1178. We did pretty good. I think we got lucky.

1179. Ah, luck nothing.

1180. You know what you did?

1181. You earned yourself a night out.

1182. A couple of Manhattans straight up...

1183. Carol! What did you get on that fireman question?

1184. 35 Newtons.

1185. All right!

1186. Doug, you remember William?

1187. How you doing, William?

1188. How's it going, Doug. So...

1189. the entropy question?

1190. Rudolf Clausius.

1191. Yes! Man, I'm starved.

1192. Anybody feel like ice cream?

1193. Lead the way, William.

1194. You all right?

1195. Yup.

1196. Thanks for bringing the extra boots.

1197. I know they're a little big.

1198. Oh, just three or four sizes, that's all!

1199. You want to carry the axe?

1200. No. No, thank you.

1201. Oh! So what are we looking for?

1202. We're looking for that...

1203. A Douglas fir with perfect branches

1204. and a very, very thin trunk.

1205. Uh-huh. Well, are you sure this is legal?

1206. Whose land is this?

1207. It's our land.

1208. What, as in public land?

1209. As in, uh...

1210. see that light coming through those trees?

1211. The smoke coming out of that chimney?

1212. No.

1213. There. Right... there.

1214. No.

1215. No? Well, it's there

1216. and it's the house I grew up in.

1217. Tell me we're not going to have cocoa with your parents later.

1218. No. You're safe.

1219. They're in London.

1220. Oh, look!

1221. Look!

1222. It's the perfect tree!

1223. All right. Stand back.

1224. Did I ever tell you about my lumberjack fantasy?

1225. Abby, this is a very sacred tradition.

1226. Oh, it's a sacred fantasy.

1227. Let me turn you into a little snowman.

1228. Don't you dare!

1229. That is not part of your fantasy.

1230. That is not part of your fantasy!