I like to call it exactly what it is: low ovarian reserve.
I'm the reason we haven't gotten pregnant.
Look, I just want to make sure I'm not the problem.
I don't even know if I want a baby anymore.
Look, I don't know what's going on between us, but maybe it's a good thing I'm going away.
You told me to get out of your life.
We can figure We aren't good for one another.
I'm sorry, Natalie.
Hey, I'm alive.
I want you to remarry.
She wants you to remember her the way she is tonight.
But, Dad, I'm never gonna see her again.
Do you want me to come with you?
Nah, it's just a blood draw.
So, big day, huh?
- First day of radiation.
3:00 in the basement.
So I'll stick around then.
- You don't have to.
- You don't have to.
- You don't have to.
You going to Lainey's thing tonight?
I haven't decided yet.
I mean, you were always closer to her than I was.
You don't have to tiptoe around me.
I mean, if you want to go to the party, you should go to the party.
Sure, of course.
Look, I'll, uh I'll see you there.
I'd like us to be friends again if that's something you want to, of course.
[KNOCKING ON GLASS]
Yeah, I would.
I really hate to break this up, but I got a ped's burn in treatment four.
- Got it.
- You, too, Will.
Mom's a little agitated.
Trainee thinks she's on something.
I don't seem to have my insurance card with me here right now.
I know I'm in the system, though.
- You can look it up.
- That's okay.
- We can deal with it later.
- Hi, Ms.
Manning, and this is Doctor Dr.
I told you I was here before.
He's the one that saw me.
- Of course, I remember.
So, uh, understand Jesse here had an accident.
Yeah, he, um he was nuking some water in the microwave to make some oatmeal, and I told him that he shouldn't do that.
If I wasn't there with him sorry.
I'm sorry, Mommy.
You know, I just turned around for a second.
- I swear.
- It's okay.
You are very brave, Jesse.
I can't believe you're only six.
How about we give Dr.
Manning some I'm sorry.
Just give her a little space to examine No, I need to be here with him.
I'm so sorry, I'll get That's okay.
Uh, your finger's injured.
How'd that happen?
Oh, I must have done it when I was trying to get in my car.
How about we go next door?
I'll take a look at it.
I I want to be here with him.
We'll be right in there.
You can keep your eye on him through the window.
- How's that sound?
Baby, I'm gonna be right here.
All right, you're doing so well, Jesse.
- There you go.
All right, you can have a seat on the the bed there.
Let's take a look at that finger.
- I know.
Yeah, it's dislocated.
I I had to get us to the hospital.
My keys were locked in the car and, uh, thought I'd smash the window.
I finally realized I have a spare in the kitchen drawer.
Tell me, Lynne: you under the influence of drugs right now?
There are a number of treatment programs I can recommend if you're struggling with addiction.
You didn't really recognize me in there, did you?
Five milligrams of Oxy eight times a day.
You said, "Should be fine.
That was four years ago.
You wanna point the finger at someone?
Try looking in the mirror.
3% to 4% superficial partial thickness on the shin, ankle, and foot.
All right, let's prep to wash and debride.
Is it bad?
It is not as bad as it looks, all right?
And if we take really good care of it, it'll be better in no time.
So when the accident happened with the microwave, where was your mommy?
Was she sleeping?
My mom works really hard.
It makes her tired.
I didn't want to wake her up.
It's all right, Jesse.
Well, you're right.
I saw you a little over four years ago.
You were complaining of post-surgical complications with your left knee, and you stated then your pain level was a nine on a one-to-ten scale.
I wasn't lying.
No, I'm not saying you were.
If you didn't believe me, you shouldn't have written a prescription.
You all were handing these things out like candy, and now that you've decided there's a problem, I'm left to fend for myself.
You think I like having to score drugs out on the street?
It shouldn't have happened.
Maybe I should have been, uh, more careful.
But I want to help you now, and I'm sorry I didn't recognize you.
I got high this morning instead of getting my boy ready for school.
How can anything be more important to me than him?
I'm I'm so ashamed.
It's all right.
We need to talk.
I'm all ears.
- [INDISTINCT CHATTER]
- [PHONE RINGING]
What's with the cloak and dagger?
Ethan is coming home from deployment tomorrow.
I take it you two haven't spoken.
Yeah, well, he's been incommunicado.
It's Navy protocol.
Look, I have been agonizing over this for six weeks.
I don't know what I'm gonna say.
How about, "Ethan, so glad to see you"?
I mean, you and I agreed what happened was a mistake, right?
Crockett, I kissed you.
Yeah, for like three seconds.
Because you stopped me.
I don't even know what would have happened if Don't make yourself crazy over this.
Okay, I have to tell Ethan.
You're going to Baghdad.
- You good, Dr.
- Yeah, yeah, I'm good.
- Okay, with me.
- 33-year-old male.
Side impact; high-speed motor vehicle collision.
- GCS 15.
- Can you tell me your name?
- Okay, Alex, I'm Dr.
This is Dr.
Sexton and Nurse April.
We're gonna get you patched up, okay?
Nice and easy, folks.
We go on my count.
One, two, three.
- Nice and easy.
- [COUGHING, WHEEZING]
All right, got a deformity of the left arm.
- BP: 104/62.
Heart rate: 100.
Hurts to breathe.
Poor breathe sounds in the left side.
- Probable pneumothorax.
- Chest, Mike.
- April, April, help.
Hey, Alex, you gotta lay down for us, okay?
[MACHINE WHIRS, SNAPS]
Good call, Dr.
It's your show.
Chest tube tray.
Wait, what are you doing?
One of your lungs has collapsed.
I need to insert a tube to reinflate it.
Oh, my God, you're gonna put me under?
Just numb you up.
Give you something for the pain.
100 of fentanyl, 10 CCs lidocaine.
Ultrasound to me.
Okay, I'm seeing some free fluid.
Hang a unit of blood and plasma and draw trauma labs.
- Call upstairs for a panscan.
- What's happening?
We're sending you upstairs to get a clearer picture of what's going on.
Once we get that sorted, we're gonna have ortho set that arm of yours, all right?
Alex, you're in good hands here.
- Just sit tight, bud, okay?
Excuse me, Lynne?
I just wanted to give you an update on your son.
The debriding went well, um, and Jesse's wounds don't appear to be infected.
Um, will there be scarring?
Well, every patient's different, but, um, with proper care and follow-through, it should be greatly minimized.
How are you feeling?
I'm fine, um so what about scarring?
You just asked me that.
So, uh, tell me what I need to do.
I want to write it a-all down.
Sure, um you know, I'm gonna go compare notes with Dr.
Halstead real quick, and then I'll be right back.
In about an hour, my patient will be ready to be discharged, but I have to say, I have some serious concerns - about his after-care.
Jesse's wounds will need constant maintenance.
He might even need pain meds, and I just really don't feel comfortable releasing him - Into an addict's care.
I'm gonna go call Child Protective Services and Whoa, hold on.
Instead of discharging Jesse, how about we admit him to the PICU?
The hospital can act as his guardian, and I can help Lynne get ready to take care of him.
But he doesn't need intensive care.
That's against protocol.
If you recommend inpatient care, no one's gonna second-guess your judgment.
[HISSES THROUGH TEETH]
I'm sorry, Will, but no.
I can't do that.
That kid is all she has, Natalie.
I gotta do whatever I can to keep her from losing him.
That is the longest I can justify keeping him here.
But you're just kicking the can, Will.
There is no way she's gonna be completely clean by then.
[KNOCKING ON DOOR]
I'm sorry, um you weren't answering my pages, and I've got a patient who needs a consult.
Kwon on call?
Yeah, but he's busy on the floor.
Um, I brought the chart.
Maybe you could review it here.
Um, her EKG and her blood work came back normal.
No indications of cardiac syncope.
She's been diagnosed with panic disorder?
Mm-hmm, she was prescribed fluoxetine.
Been on it for about two weeks.
So she had another panic attack.
But how do we know if her regimen is effective?
I I guess I thought that maybe you could speak with her.
Ms. Curry, antidepressants often take several weeks to kick in, right?
So I would tell Ms.
Patel that you understand her frustration, to be patient, and stick with the prescription.
Yes, um, panic attacks have triggers, right?
Negative words or or thoughts.
Well, there's this theory that by repeatedly vocalizing those triggers, you can decouple them from their power.
- Like cognitive defusion.
- There's an app.
Basically, you record your anxieties, and the app then turns them into songs.
I think it's admirable that you want to do everything you can to help your patients, but offering up gimmicks in an emergency setting I just I really don't see the benefit.
You know, the best care for Ms.
Patel is with her regular psychiatrist.
So I suggest that you discharge her, and that you follow up with whoever that might be.
[TENSE, MELANCHOLY MUSIC]
How's he doing?
Yeah, well, no solid organ entry, but I'm not liking this free fluid in his abdomen.
Hmm, well, his blood pressure's steady.
Doesn't seem like he's actively bleeding.
Could be nothing, or it could be a bleed we can't see on CAT scan.
Let's get Mr.
Minguez in for a diagnostic laparoscopy.
See if we can find out what's bleeding and how badly.
Well, couldn't we just watch and wait?
And risk an open procedure if he goes downhill?
I don't think so.
Surgery's the only play.
Wait, you're not gonna lay out his options?
He might not need surgery.
Well, you saw how he acted earlier.
He's afraid of going under, we give him an out and he'll take it.
No, he needs this.
We don't know what he needs.
It's a surgery to see if he needs surgery.
As much as I value your input, Nurse Sexton, I am the surgeon, and this is the plan.
All right, if you'll excuse me.
Wait, you you want to keep my kid here?
No, no, no, no.
She said that I could take him home.
So that's what I'm gonna do.
I'm doing that.
Whoa, whoa h-here's the story, um If you insist on discharging your son, we're gonna be left with no other option than to call Child Protective Services.
Child ser why?
You're not currently capable of taking care of your child.
I told you, this was the only time that this has ever happened.
Lynne, you know I'm right.
Is there anyone else we can call?
An aunt or uncle?
It's just us.
- Well - Oh, my God.
My baby's gonna be taken away from me.
Not if we get you in a better place.
You said you've attempted to get clean before.
What treatments have you tried?
Uh, methadone and and NA, and, uh, cold turkey.
- Nothing works.
- Ever tried a detox protocol?
That's a month in a facility.
Who's gonna take care of my kid?
What if we sped things up?
It's called rapid detox.
Yeah, now, I normally wouldn't suggest it, but we don't have much time.
We push you through withdrawal under sedation to manage the symptoms, and in 24 to 48 hours, you'll be down the road to treating your addiction.
The last time I went through that, it almost killed me.
It is not without risk, but I don't know what I can do to keep you together.
- Can I say good-bye to my son?
- Of course.
Looks like we're gonna stay here for a couple days.
It'll be fun.
Remember, like [LAUGHS]
When we had that leak in the bathroom?
We had to go stay in that hotel.
What was that secret handshake we we made up?
Well, you be good for the doctors, okay?
So they're really gonna stick a camera inside me?
It's a lot less dramatic than it sounds.
That's what they told my dad when he needed a new heart valve.
He had a stroke under anesthesia.
Never woke up.
Alex, I am so sorry.
You know, this procedure is minimally invasive, very safe, and Dr.
Marcel is a great surgeon.
I'm sure he is, but it's it's just hard not to think about.
If you have any questions, I can track him down.
I just is this really my only option?
How how's she doing?
Okay for now.
Got the dexmedetomidine flowing.
- Ativan at the ready.
- She still rousable?
I need you to swallow this pill.
What is it?
Naltrexone, to prevent you from relapsing.
Will, what are you doing?
Starting her on a rapid detox protocol.
Has this been authorized?
You said we were all kosher here.
Asha, don't worry we are.
Plenty of clinics are doing this, Nat.
- We're not off the reservation here.
- Does she understand the risks?
- She does.
- Even if she gets through this even if the procedure's a success addiction is not something that can be cured rapidly.
There are a host of triggers that Lynne's gonna have to overcome.
Of course, and this will be a head start.
Get her past the cravings, the withdrawals - I don't know.
- I can't be the reason she loses her kid.
I gotta make this right.
The hell'd you do?
My patient just backed out of his laparoscopy.
Alex was concerned about the procedure.
- I just answered his questions.
- But he already consented.
Because you made him believe he didn't have a choice.
And you may be okay keeping people in the dark, but you can't just assume that I am.
"In the dark"?
What are we talking about here?
- Our patient or Ethan?
I just want to make sure Alex knows his options.
He has no options, April.
This procedure gets riskier every minute we wait.
When we're rushing this man to the OR in shock, it's on you.
- [INDISTINCT CHATTER]
- [PHONE RINGING]
So you wanna tell me what's going on with you and Dr.
There's nothing going on.
Hey, I can't have my sister and my mentor slugging it out every day.
- Noah - Give it up.
If you're looking for something to do, Dr.
Lanik has a forearm laceration that needs stitching.
[INDISTINCT ANNOUNCEMENT OVER PA]
- Thank you.
Maybe something you wanna talk about with a girlfriend?
[DOOR HISSES, CLOSES]
I kissed Crockett.
It it was a mistake.
I had I had just found out some really bad news.
I was feeling worthless, I What news?
Ethan and I have been trying for a baby and I found out that I may not be able to have any.
I'm sorry, Ms.
So that's it?
You're sending me home?
Medically speaking, there is no reason to keep you in the hospital.
You're telling me there's nothing you can do?
Um no, no, there is one thing we can try.
It's it's not a proven therapy, but it's been working for me.
All right, what whatever gives you anxiety, you speak it into this app, and it turns those words into a song.
The the theory is that when you sing it back, you uncouple the words from the influence that they had over you.
Disrupt the cycle of negative thinking.
I what do I say?
Oh, I don't know, anything.
Anything that stresses you out.
Am I good at my job?
I think I am, but it's hard to know.
[PHONE BEEPS, CHIRPS]
Great, now sing it back.
- Um - Am I good at my job?
I think I am No, I I can't do this.
- I I feel stupid.
- No, that was good.
- Just try it.
- No, I I don't want to.
- Oh, God.
All right, yeah, no.
We can try that later.
You know what, if taking my antidepressants is all I really need to do, then I'm just gonna do that.
No, no, I wouldn't take your meds off-schedule.
God, I just want to get out of here.
[MONITOR BEEPING RAPIDLY]
Look at you.
Come on, give it to me.
- Give it to me, huh?
Working that gown.
They let you wear whatever you want during chemo.
Well, the good news: radiation goes by a lot quicker.
The bad they don't got those plush La-Z-Boys.
And we can't go in together [STIRRING MUSIC]
Heard you were down here.
Hey, Doctor Singh.
I didn't know you sat in during these things.
I'm here to see Ben, actually.
I wanted to do this in person.
Is it okay that Maggie's here?
I reviewed your bloodwork, and it seems that whatever jumpstarted your immune system to fight off the measles had the added benefit of putting your cancer in remission.
You're kidding, right?
No, I'm not.
Oh, my God.
Oh, my God, Ben.
I'm so happy for you, Ben.
- Let's go!
This is the best day ever.
Thank you, Dr.
Okay, I'm, um I'm really sorry that I couldn't do more for you.
Hey, Priya, are you okay?
My throat - What?
- I can't [GASPING]
I I can't I need the response team out here!
- Hey, Priya, can you hear me?
Lanik's on his way.
Okay, I need epi.
- [BREATHING HEAVILY]
- It's okay.
You're gonna be okay.
What the hell happened?
I I don't know.
[MONITORS BEEPING, BLARING]
She's going through withdrawal.
- Push another five of Ativan.
- I already did.
- Seizure's not breaking.
- BP's spiking 180/100.
She needs a propofol bolus, Will.
- We gotta snow her.
- All right, do it.
Gotta protect her airway.
Jesse, what are you doing here?
Why is she shaking like that?
- [GROANING, GASPING]
- Put him on a mask.
Belly's distended and tender.
- Heart rate's up to 120.
He's in hemorrhagic shock.
Two units on the rapid transfuser.
- Can we still scope him?
- No, too unstable.
We have to open him up.
Open up the hybrid room!
- Let's move.
- [GROANING, GASPING]
- [INDISTINCT CHATTER]
- [MONITOR BEEPING]
How's your patient?
Oh, uh, she had another panic attack, but, uh, she's stable.
Dr. Lanik just ordered repeat labs.
She had another one?
Any ideas on the trigger?
Charles, I'm really sorry.
I I couldn't send her home with nothing.
So I I had her try the singing.
And you think that that's why she had another episode?
Yeah, well, she she got really anxious, and then she took another anti-depressant, and I I don't know.
I think this is my fault.
Wait, wait, wait she took a second dose on top of her regular prescription?
- When exactly did she do that?
Maybe 20 minutes before she collapsed.
But panic attacks are typically an immediate response to a stressor not time-delayed.
And an extra antidepressant wouldn't provoke a toxic response anyway.
Look, why don't we add an FBC and tryptase to her blood work?
What what are you thinking?
Eh, I I don't know yet, but I'm not positive we're looking at panic attacks here.
Your mom told me that you kept some of your favorite books in here.
Why don't you pick one out for us to read?
Why was that doctor sticking something down my mommy's throat?
To help her breathe.
It's 'cause of that stuff she takes, isn't it?
Have you ever heard of a bad habit?
So I used to bite my nails all the time, and that's a bad habit.
And sometimes it's really hard to stop when you're so used to doing it.
My mom has a bad habit, doesn't she?
And it's making her sick.
Is that why I have to stay here tonight?
Well, it's a little more complicated than that, Jesse.
'Cause I can take care of her.
I know what to do.
You have Narcan in your backpack?
My mommy gave it to me.
And you know how to use it?
If I find my mom and I can't wake her up, I tilt her head back and squirt one of these in her nose.
I've done it before.
- You have?
- A couple times.
You don't need to worry about my mom 'cause I can take care of her.
Please don't take her away from me.
Lot of blood.
- What's that grey patch?
- Ischemic bowel.
Can we salvage that?
If we got in here three hours ago.
All right, let's get control of this bleeding.
April, hemostat times two.
Sexton, clamp under me.
Marty, how we looking?
A little tachycardic, but pressure's holding.
Hang another unit of blood and plasma.
Mesentery's clamped off.
You ever resect a bowel before?
- Lucky you.
GIA 80 to Dr.
Let's get to work.
How do you feel?
Like a rotisserie chicken.
Listen, Maggie I wanna apologize for earlier, when I got the news about my cancer, I just I went a little wild.
For good reason.
But still, it was selfish, given where you are in your fight.
I don't want to go out and celebrate.
Not until we both can declare victory.
How lucky am I to have found you?
You give me hope, Ben.
- [CLEARS THROAT]
- How do you feel?
My throat is sore [CLEARING THROAT]
But overall I'm sorry, I'm so hoarse.
Could I have some water, please?
You see that?
Hand's pretty darn steady.
Is there a chance this detox might work?
Excuse me, Ms. Driscoll.
I'm Sharon Goodwin, executive director of patient services here; and this is Madeline Gastern from Child Protective Services.
What's going on?
I regret to inform you, Lynne, that the department will be taking medical custody of your child until we can determine your fitness as a parent.
- I don't understand.
You promised not to do this if I went through the detox.
Lynne, I didn't do this.
You lied to me.
Why did you lie to me?
You called in Protective Services.
- We had a deal.
- The terms changed.
When did that happen?
When Jesse told me that his neglect was not just a one-time occurrence.
That kid's living situation is far more dire than your patient led you to believe.
Charge nurse asked me to tell you: your patient, Lynne Driscoll, just left AMA.
So how is he?
We'll keep him under observation for about a week, but he should be fine.
Oh, yeah, so I am gonna go check on some paperwork uh, down in the E. D.
Look, Crockett, about today I am sorry.
I shouldn't have pushed so hard.
You were just trying to do the best thing for your patient.
I've been thinking about it, and, um I think maybe you were right.
Sometimes people don't need to know everything.
I don't think I should tell him.
- Uh, "systemic" what?
It's a genetic condition.
Okay, but what about my panic attacks?
Shortness of breath, elevated heart rate, loss of consciousness all symptoms of panic attacks and mastocytosis.
Except mastocytosis can actually be made worse by taking antidepressants.
So the fluoxetine was not only not treating anything, but that extra dose you took?
Probably what made you pass out in our waiting room.
Oh, but m-my stress is real.
Probably just good old fashioned job-related stress.
Look, we're going to check in with your psychiatrist, but in the meantime, what we want to do is swap out your antidepressants for antihistamines.
Uh, thank you.
- You bet.
- What are you doing?
- Deleting this app.
It doesn't work.
Mastocytosis should have been on my differential from the start, but I got so focused on this app that I I totally missed it.
Don't be so hard on yourself.
Look, you came up with a creative idea to solve a tricky problem.
It didn't happen to work, but, I mean, look at it this way: if you hadn't of tried it, Priya would have gone home thinking she still had a panic disorder.
Because she rejected my bad idea.
Like you said, it's just a gimmick.
You can't sing away your problems.
- [KEYS JINGLING]
- [DOOR LATCH CLICKS]
I thought you were coming home tomorrow!
I shipped out early.
- I wanted to surprise you.
Baby, I, um look, I didn't like how we left things.
I've been thinking about it a lot over the last six weeks.
Um you and I, we've been working so hard and trying to start a family, and I think I got caught up in planning and I forgot what the objective of the mission really was.
I'm sorry, I didn't want to make it sound like a briefing.
But you [SIGHS]
But you need to know [TENDER MUSIC]
That I [SIGHS]
I love you and I love your passion and your loyalty.
And I don't want to go another six weeks without you in my life.
So [INHALES DEEPLY, SIGHS]
April Sexton [GASPS]
Will you marry me?
This a good silence?
Before I answer that, um [SNIFFLING]
I need to tell you something.
It might change your mind.
I I got tested and I don't think I can have kids.
- I'm sorry.
- Baby, no.
No, I'm sorry.
But, hey, that's okay.
Look, I love you no matter what, okay?
We'll figure this out together.
I love you so much.
So is that a yes?
[CHEERS AND APPLAUSE]
[LIVELY MUSIC PLAYING OVER SPEAKERS]
I'm glad you came out tonight.
You know, I figured CeCe probably would have approved.
Sure she would have.
All right, thank you all for coming tonight.
I'm gonna miss you all so much.
We'll miss you too, Lainey!
All right, all right.
Up next, Dr.
Let's make some noise!
[CHEERS AND APPLAUSE]
Seriously, you're gonna sing?
He's gonna sing?
A a friend of mine told me that, uh, you can't sing away your troubles.
[EVA CASSIDY'S "IT DOESN' MATTER ANYMORE" PLAYING]
Well, I guess we're about to find out.
There you go and baby Here am I Well, you left me here So I could Sit and cry Golly gee, what have you done to me?
Well, I guess it doesn't matter anymore Do you remember, baby Last September, how you [CHOKING UP]
Held me tight Each and every night And, oh, baby, how you Drove me crazy Well, I guess it doesn't matter anymore [LOCKER DIAL CLICKS]
A little help?
Found down, unresponsive.
- Looks like an OD.
- No response to Narcan.
She's shocked and epi'd once already.
On my count.
One, two, three.
[SUSTAINED HIGH-PITCHED TONE]
She's in V-fib, no pulse.
Charge to 200.
All right, let's go.
We are not losing her.
- [ELECTRICITY ZAPS]
- [ALARM CHIRPS]
- No pulse.
- Continue CPR.
Another round of epi.
- [ELECTRICITY ZAPS]
- [ALARM CHIRPS]
Come on, Lynne.
[SUSTAINED HIGH-PITCHED TONE]
It's been 11 minutes now without one.
Halstead pronounce her.
Time of death: 20:43.