03x05 - Mountains and Molehills

[bunniefuu]

This is kinda fun, right? It's like being in high school again, sneaking around to avoid getting caught.

Next, staying out past curfew.

Ow! Aah! Are you okay?

Yeah, I'm fine. Will you just... Are you sure?

Is this thing poured in concrete?

Let me do it.

All right. Now where were we?

(CAR ALARM BLARING)

Just block it out. Block it out.

(TOY SQUEAKS)

What is that?

Maybe a rain check?

Wasn't this our rain check?

I hope you brought your dancing shoes, lady, ‘cause it's gonna get lit.

I know this promoter.

He's getting us a table at the club.

You're gonna wanna Uber. Sounds great.

Dr. Choi, you coming to my birthday party tonight?

Don't think I'm gonna make it, Doris.

Happy birthday, though. Hmm.

To be honest, I don't really care if he comes or not.

That was just a courtesy invite.

I can't wait for you to meet my cousin Paul.

Newly single.

Wait, you're not going to Doris' party?

What're you gonna be doing?

Literally, anything else.

Why you care what Doris thinks is beyond me.

Do I really have to explain myself again?

You wanna keep us a secret at work, fine.

But I'm not gonna spend my off-time pretending, too.

But hey, go have fun with cousin Paul.

Dr. Choi, April, look alive.

You're going to treatment six.

(ALARM BLARING)

Abena Kwemo, early-20s. Found dizzy and disoriented.

BP 150 over 95. Temp 103.

She's having a seizure. Give her two Ativan IV, stat.

Called East Mercy first, they said they were full up.

Diverted us here.

There you go.

All right, let's get her in the bed.

Let's transfer on my count.

Ready. One, two, three.

CHOUT: Nice job. ETHAN: Yeah.

Where am 1? Abena, hey, I'm Dr. Choi.

You're at Gaffney Chicago Medical Center.

You just had a seizure. Has that ever happened before?

Let's get her a liter bolus of normal saline.

Order a CBC with diff, CMP, utox and draw blood cultures.

Also, let's get a chest X-ray and a head CT.

Got it.

Dr. Choi.

I noticed these when I was starting to gown her.

They're on her back, too.

Abena, has a doctor ever spoken to you about these lesions?

I can't remember.

Abena, these are most likely Kaposi Sarcoma lesions.

KS is an AIDS-defining illness.

I'd like to run atest for HIV.

No, no, no.

Mmm, no.

Look, I know it sounds scary, but AIDS is a manageable disease.

ETHAN: With antiretroviral therapy, we can prevent disease progression.

But first, we need to confirm you have HIV.

No.

Thank you, Doctor. No test.

I can't have AIDS.

Turns out Abena has been to East Mercy multiple times over the past six months for AIDS-related complications.

Pneumonia, meningitis, candidiasis.

But she's consistently refused HIV testing.

DR. STOHL: CT says she has toxoplasmosis of the central nervous system.

If we admit her, that's a week-long stay, at least.

What do you mean, "if we admit her"?

What else would we do?

Turf her back to East Mercy.

For the record, I'm not suggesting we do that.

Of course not.

Dr. Stohl, we are not turfing someone we know has AIDS.

Ms. Goodwin, we both know how this story ends.

She dies, after countless complications and tests and treatment, none of which change the inevitable.

So why not put our limited resources behind the ones we actually have a sh*t at saving?

Because I'm not ready to accept that we can't save her.

Toxoplasmosis can cause cognitive impairment, no?

Mmm-hmm.

So it's possible that she lacks capacity to give us informed consent.

She was confused when she came in.

I supposed we could pull psych in.

Thank you.

Hey, got your...

I already took my pills, but thank you.

All right, then.

Wow, new dress, new earrings.

What's the occasion? No occasion.

Just an impulse buy.

Felt like I needed a fresh start.

You know what?

It might look a little better on the floor.

No, no, no, no. I can't, I can't.

I gotta get moving.

Doesn't your shift start at 9:00?

Yeah, but I'm on trauma call today, so they can wait.

Ah! Is that how trauma works?

Come on, whatever happened to channeling your impulsivity into other activities?

Wait, wait, wait, wait. My impulsivity?

So what, when I initiate sex, it's just a symptom of my illness?

Okay, yes.

Sometimes I still wonder if I'm getting Robin or if I'm getting...

Okay, I get it. I get it.

But just so you know, I am feeling more and more like myself every day.

Well, then, how about dinner and a movie tonight?

Uh, how about dinner and no movie?

(BOTH CHUCKLING)

Please, I need someone to see my daughter.

She can barely walk in a straight line, her foot keeps dragging, she's bumping into things...

Ma'am, please take a seat. As soon as I have a doctor...

Denise, come over here, honey.

Do you see what I mean?

Oh, my God.

NURSE: Need some help over here!

We got her. Mom!

Hi, there. I can't feel my leg.

Okay. I'm Doctor Halstead.

We're gonna figure out why that is, all right?

Okay. Thank you so much.

She started complaining on the plane ride home from Australia.

She said that her feet were tingling, that her legs hurt.

I thought it was just from sitting so long.

Did Denise do any outdoor activities while you were there?

Hiking, swimming? No, no hiking.

We picnicked a couple of days.

Deep tendon reflexes are absent.

Okay, I'm gonna ask you to close your eyes super tight for me, all right? No peeking.

And when I tap you on the leg, will you point to which side I'm tapping on?

Yeah.

Normal sensation to light touch.

All right, can you lift your legs for me now?

That's all I can do. Okay.

Let's get a CBC, CMP, ESR, utox, and a brain and spinal CT and MRI.

And do a full body scan for rashes and insect bites, okay?

Is she paralyzed?

Let's not get ahead of ourselves, okay?

While she is showing signs of paralysis, it's most likely temporary.

It's probably a nerve compression injury from the long flight.

We're gonna run these tests, and we'll take it from there.

We'll be back soon.

DANIEL: Dr. Reese.

Dr. Charles, I thought you weren't back till tomorrow.

How're you doing? How's it all been going on the floor?

Uh, actually, I've been doing research projects the past couple of weeks.

Huh. Um...

So you, uh... You haven't been seeing any patients?

Figured I'd wait till you got back.

Dr. Charles, welcome back. Mind if I put you to work?

We need a psych evaluation to determine decisional capacity.

Catch up later?

Oh. Oh, hey, Sarah.

I was looking for you, um...

I don't know if you heard or not, but Doris, she's having a thing tonight, and...

Dr. Sexton, Dr. Rhodes needs a resident right now.

MVC incoming.

Okay, uh, think about it?

I'll check your temp later.

Dr. Sexton, now!

Yes, ma'am.

Spencer Bouren. 16-year-old male.

Lost control on a patch of ice.

Head-on collision with another vehicle.

Second driver's en route. All right.

MAGGIE: You're going to Trauma 1. Yep.

He was unconscious till he woke up in the ambo.

GCS, 15. BP 124 over 88. HR, 118.

Uh, sats 100%.

Complaining of right hip pain.

All right, transfer on my count.

One, two, three. (GROANS)

Let's get a chest and pelvic X-ray.

APRIL: On it. We need a fourth one.

Second driver's rolling in now, we need you, Dr. Rhodes.

Somebody else has gotta be avail.

I wouldn't tap you out if there was.

1 got him, go. MAGGIE: Desmond.

Female, mid-30s. Unrestrained.

Hypotensive in the field, gave her a liter.

GCS, 8. Tubed.

All right, let's get her in.

Buckles off. All right.

Gently on my count. One, two, three.

Is she gonna be okay?

Try to relax, bud. Just try to relax.

(SPENCER GROANS)

Lungs are clear.

Clear breath sounds bilaterally.

Trigger the MTP, hang two of O-neg.

And give me a kit.

I'm gonna get a cordis in the groin.

Chest X-ray's negative.

What about the pelvis?

Doing it now.

Up.

Dislocated hip.

Must've jammed it when he slammed on the brakes.

And the longer it's out?

The higher the risk of avascular necrosis.

CONNOR: Exactly.

Get me the FastSCAN.

You ever reduce a hip?

I've seen it done a bunch of times.

I'll talk you through it.

70 milligrams of ketamine.

You're gonna pull on that hip until you feel it pop back into the socket.

Relax, relax, relax, relax. (GROANS)

Hold tight. (SCREAMING)

(BONE CRUNCHING)

It popped back in. CONNOR: Good work.

Her belly's full of blood.

BP's dropping. All right, Maggie.

Call the OR, tell them we're on our way up.

Copy.

Oh, my God. Did I k*ll her?

DANIEL: Next one is, if I were very sick, I would like to do everything possible to prolong my life.

Very true, mostly true, you don't know, mostly false...

That's very true. Very true.

Yeah, the doctors did explain to you the benefits of antiretroviral therapy, didn't they?

That it would prolong your life.

They say I won't get sick anymore.

So could you tell me then, why it is that you don't wanna take an HIV test?

ABENA: Auntie.

What are you doing here?

You should be at work.

Are you the doctor?

I am a doctor, yes. I'm Dr. Charles.

What's wrong with her? My baby is always getting sick.

I told you on the phone, Auntie.

It's just the flu.

I'm going to get better soon.

Right, Doctor?

We are working on it.

All done. You were so brave.

Okay, Mom, we should have the results back within an hour or two.

Um, I don't understand. You said her tests were normal.

They were, but... But she's getting worse.

She can't move her legs at all anymore.

We'll have a much clearer picture once we receive the results back on Denise's cerebrospinal fluid.

And we'll ask the lab to put a rush on these, okay?

Thank you.

WILL: Yeah. NATALIE: Of course.

Will, you saw that girl's CSF. It was crystal clear.

The lab's not gonna tell us anything we don't already know.

And it's obviously not encephalitis, meningitis, Guillain-Barré syndrome... Hold on.

Let's not rule out GBS.

It fits her clinical presentation almostto aT.

I mean, normal blood work, ascending symmetrical paralysis, absent reflexes.

Let's just do one more round of labs first.

All right, test for heavy metal poisoning, exotic infection, and if we don't get anything from those, I'm all for treating it as GBS, okay?

All right. Okay.

You're supposed to steer into the skid.

Okay, can you flex your knee for me?

Never slam on the brakes. Why couldn't I remember that?

Now bring it to your chest for me.

(COUGHS) There we go.

Dr. Sexton, this is Spencer's mother, Candace, and his brother, Terrance.

Goodness.

Is he gonna be okay?

Dislocated his hip, but other than that, just scrapes and bruises.

We did a CT of his abdomen, pelvis, and head.

All negative for internal bleeds and fractures.

Thank you. Doctor Sexton.

Shouldn't have let you drive by yourself.

He just got his license last week.

Yeah. Took him five tries.

Mom, I hit someone.

A pedestrian?

No, the driver, they just brought her in here.

She was right over there. She was bleeding real bad.

She's in surgery. Is she gonna be all right?

I told Spencer the best trauma surgeon in Chicago is working on her. What if she doesn't make it?

Don't worry, she... She'll make it.

CONNOR: Small liver lac.

Spleen is shattered.

Looks like a Grade 4.

Actively bleeding from the hilum.

Short gastrics are avulsed, as well.

Hey, Dr. Rhodes, it's Noah.

CONNOR: I'm a little busy here, Noah. What do you need?

Yeah, I just wanted to check in on the status of the patient.

I don't know yet.

NOAH: Okay, yeah, sure.

It's just, um, the kid who hit her is really freaking out.

Yeah, I can't help that, Noah.

Well, if I could just tell them that she's gonna be okay...

No.

Don't ever do that.

Wait a minute, she won't consent to being tested because she'd rather die than have her family find out that she has AIDS?

And you're saying she's capable of making rational decisions?

Just because you don't like the decision she's making, doesn't mean she's incapable of making it.

Growing up in Africa, HIV-related stigma and discrimination was probably something she witnessed on a daily basis.

Is that her aunt? DANIEL: Vera.

Abena lives with her.

Rest of the family is back in Ghana.

Well, she knows she's not being forced to tell her aunt, right?

She understands we have strict privacy rules here.

Doesn't matter.

She's convinced that if she takes the test, starts the antiretrovirals, that they'll figure it out.

But the lesions won't give her away.

Come on, she's living under the same roof, for chrissakes.

If she wants to continue concealing this, she needs to start treating it. Well, you gotta convince her.

You have to convince her.

I'm sorry, I can't just rubberstamp this.

Dr. Choi, Abena is complaining of nausea.

Great, now she'll need a Gl consult.

Just add it to her tab.

Her tab? (SCOFFS)

Sharon, I know you're under a lot of pressure, but...

Daniel, we're trying to save her life.

Look, just for argument's sake, let's say the toxo is causing impairment, and we force the test. Then what?

Somebody shoves pills down her throat every day for the rest of her life?

I mean, no court is ever going to mandate...

JUDY: Please someone help! Please!

My daughter, she can't breathe.

NATALIE: Okay.

WILL: Hey, Denise. Look at me.

Deep breaths for me, okay? In and out.

Can you squeeze my hand? (COUGHS)

Can you lift your arms for me?

What's happening?

The paralysis is moving up her spine.

10 of etomidate and 50 of sux.

We're intubating.

JUDY: You're gonna put that down her throat?

Okay, why don't we give the doctors some room to work?

No, please, please, I wanna stay with my daughter.

MAGGIE: It's okay, we'll stay right here.

Okay.

Couldn't do much of a neuro exam with her sedated and intubated, but if I had to guess, I'd say she's paralyzed.

Thanks, Sam.

Doing the hokey pokey there, Halstead?

Huh? Your foot.

Oh. Yeah, it just fell asleep.

Kinda banged it this... No, never mind.

You were right.

We should have started IVIG and plasma exchange way earlier.

It was a mistake to wait.

No, you called it. I don't think it is GBS anymore.

It's progressing too rapidly. Nothing else it could be.

I mean, GBS is the only thing on our differential that makes a modicum of sense.

When did ED doctors get so polite with each other?

Are you two dating or something?

Never mind.

Start with IVIG and plasmapheresis.

At this point I'm ready to throw the kitchen sink at this thing.

Page me when her sedation wears off.

You okay? Yeah.

Keep your head still.

Eyes forward for me.

(KNOCK AT DOOR) Hey there, folks, I'm Dr. Rhodes.

Spencer, we met when you first came in...

Did she make it?

Due to patient confidentiality, I can't give you any details, but I did wanna let you know, she pulled through. (SIGHS)

Can I visit her?

Please, I just wanna tell her that I'm sorry.

Would that be all right?

I'll tell you what, I'll check with her husband.

She's just coming off of anesthesia, but maybe in an hour or two.

Mom, an hour or two?

Coach will have my head if I'm late.

Oh, big game?

Regionals.

We can't leave your brother here alone.

Spencer's fine.

Really, and I'll keep an eye on him while you're gone.

Yeah.

Go. Stay for the game.

Are you sure you're gonna be okay, honey?

I'm fine.

Thank you, Dr. Sexton.

Thanks, Doc. Of course.

Excuse me, Dr. Reese.

You drive a silver Nissan Versa, right?

Yeah, that's my car. Why?

That's all that's missing?

Just my gym bag. Nothing of any value.

You know, I know who did this.

Um, her name is Edith Lake. She slashed my tires, too.

Hold on a sec.

You witnessed this person slashing your tire?

No, no, but she... And how do you know her?

She came into the ED a few weeks back.

Uh, assaulted me.

Did you report it?

I am reporting it now.

SECURITY GUARD: Dr. Reese, I don't think it was that lady.

This is the fourth break-in we've had this month.

Whoever did this probably wasn't targeting your car in particular.

Well, aren't you gonna dust for fingerprints?

Here's the address of the website to retrieve your police report.

You can use it to file a claim with your insurance.

We know she has AIDS. She knows she has AIDS.

Her aunt must know on some level, this isn't the flu.

Yeah, but there's a difference between knowing something and saying it out loud.

You say it out loud, and it's real.

April, it's real whether it's said or not.

(ALARM BEEPING)

(ABENA COUGHING)

She's having trouble breathing.

Ma'am, please step back.

Ma'am, please put these on. Why?

Is she contagious?

It's a universal precaution.

She's got fluid in her lungs.

Sats down to 86.

Okay, let's get her on a mask with 15 liters.

Let's get a sputum sample and another chest X-ray.

And call pulmonology.

Excuse me.

Ma'am, please put these on before you touch your niece.

I'm doing everything I can.

Any improvement?

Denise's Hughes functional grade is still at 5.

Is she triggering the vent? No.

The IVIG isn't working.

It's way too soon to know that. Give it some time.

I think we need to try immunosuppressant...

Are you okay? What the...

What happened?

I don't know.

My foot went numb, and just gave out.

And I can't move my foot.

All right.

Where are we going, Doc?

Dr. Rhodes got the A-okay from Melody's husband.

Is that the name of the woman I hit?

Melody? Yeah.

Okay, ready to roll? Yeah.

All right, so now you can be honest.

One on one, you or your brother?

Definitely me.

You okay, buddy?

Yeah.

I can get you a Tylenol. Tylenol, please.

Nah, nah. It's...

It's just a...

Stress headache.

Hey, he , hey, hey, h Spencer?

Spencer.

No pulse. I need a crash cart over here.

NURSE: Coming right away. Here we go.

CONNOR: Left pupil's blown.

Start bagging, amp of epi. What happened?

I don't know, he was talking one second, said he had a headache, and then he started slurring his words.

All right, charge to 200.

Charging.

Clear.

Resume compressions. Another amp of epi.

Charge 200 again.

Charged.

Clear.

Asystole.

Come on, bud. Come on.

Come on.

Noah.

Hey, come on, Spencer.

Noah, stop.

Time of death, 16:29.

We won't know for sure until we get the ME's report, but from the looks of it, I'd say it was a delayed epidural hematoma.

But Spencer's... Spencer's CTs were clean, and...

Must've developed after the initial scan.

It happens sometimes, Noah. There's no way to predict or prevent it.

Maggie, let's get the mom in here so we can break the news.

I told her Spencer was gonna be okay.

I don't know what I'm gonna say to her now.

I can break the news, if you want.

No.

I appreciate the offer, Dr. Rhodes, but I really should do it.

I'll go lean on the ME for a cause of death.

No.

I can't feel anything, Sam.

All right, press down on the gas pedal as hard as you can.

Have you been ill at all recently?

Is it possible you're immunocompromised?

How about any interactions with the patient?

Any needle sticks?

Is there a chance you exchanged fluids somehow or...

The only direct contact I had with the patient was when she collapsed. I carried her into the ED.

How about you? Are you experiencing any numbness or tingling in your lower extremities?

No.

We haven't even established what Denise has yet, let alone if it's contagious.

You think it's a coincidence, your paralysis?

Where are you with your differential?

We were operating under the hypothesis that she had Guillain-Barré syndrome.

Well, that's obviously a dead end.

GBS isn't contagious.

I'm gonna get started on the LP.

Collect everything you've got thus far on the girl.

Every test you gave her, you give him.

See if we can find any patterns.

Now, Dr. Manning.

Let's give her another bolus of fluids.

She's still pretty dehydrated.

Sats aren't improving much.

Dr. Choi.

How is Abena doing?

ETHAN: Now it looks like she's developing a pulmonary...

VERA: Mr. Doctor.

My niece isn't getting any better.

How can this be the flu?

Ma'am, I completely understand your frustration.

Don't think I don't know what's going on here.

We are immigrants with no insurance, so you think you don't have to give us your best care.

Ms. Kwemo, I assure you we're doing everything in our power...

Are you?

I don't believe that.

You're right, Ms. Kwemo. There's more we could do.

There are other tests we could run.

Tests we need Abena's consent for.

Dr. Choi, I need to speak with you in private for a moment.

Excuse us, please.

You know, Dr. Choi, there's a pretty important statute, known as the HIPAA privacy rule, that protects every patient's personal health information from being shared with anybody else.

You heard her, Ms. Goodwin.

She wants us to help her niece.

Still, it's not for you to tell her.

That's the rule.

With all due respect, if all we were gonna do is follow the rules, we should've done what Stohl wanted, and turfed her back to East Mercy.

Hey, Maggie told me about your car.

Those punks.

You know, I've got this great guy, glass, body, repairs.

Do you wanna give him a call?

I should really call my insurance company.

Hold off on that.

Come on, join me on rounds.

Take your mind off of it for a bit.

I want you to meet this Jane Doe.

You were supposed to stay with him. You were the one that was...

You were supposed to stay with him...

You know what?

I really should get a head start with the insurance.

It always takes forever to reach a human.

All right.

JANE DOE: When you were knocking on the other side of the bathroom...

Spencer's family just got here.

They already suspect it's bad news.

Just don't keep them waiting too long.

Okay. Okay.

Something happened to Spencer, didn't it?

He suffered a cardiac arrest.

We think there might have been an acute hemorrhage in his brain.

What are you saying?

That he's dead?

We tried our best to resuscitate him, but there was nothing we could do.

Oh... Oh, my God.

My...

My baby boy.

Oh, God. Oh!

NOAH: Ma'am.

I... 1 am so sorry for your loss.

You said he would be okay.

At the time, given the information that I knew...

You k*lled him.

I had every reason to believe...

I'm sorry! You k*lled my baby brother.

You k*lled him! Stop, stop, man.

CANDACE: Terrance, stop!

Security! Someone, we need help!

CONNOR: Hey! Hey! (APRIL YELLING)

CONNOR: Get off, get off, get off.

Oh, my God! Easy, easy, easy, easy. Shh, shh.

APRIL: Are you okay?

That kid got you pretty good.

Yeah.

You're looking at two, three stitches, tops.

PD wants to know if you wanna press charges, Noah.

Well, of course he does. He was assaulted.

I asked Noah.

Nah, I don't wanna press charges.

That family has already been through enough.

Okay.

You're gonna let him get away with this?

Sarah, he just found out his brother d*ed.

How is he supposed to respond? Not like that.

Maggie. Mmm-hmm, wait a second...

Maggie, why wasn't security in the room from the start?

That's not the established protocol.

Well, it should be, okay?

Reactions to a loved one's death can be unpredictable.

There should always be a guard nearby when a family member is being informed.

How are we supposed to do our jobs if we don't feel safe and protected?

Hi, do you mind if I come in?

My name is Sharon Goodwin.

I'm in charge of Patient and Medical Services here at Gaffney.

Are you the boss?

Uh, something like that. (CHUCKLES)

Where's your aunt? Cafeteria.

Went to get dinner. Ah.

Uh, I'd like to share something with you.

Okay.

Marie Castilla.

Very bright.

Expert Scrabble player.

b*at me every time.

That's Danny Dimoulas.

Had this big baritone laugh.

It would just shake the floor.

Sometimes I still hear it.

Felix Ramadei.

He was a huge sci-fi nerd.

Wouldn't have much to say, but if you got him talking about galaxies and space travel, well, there went your whole afternoon.

These are your patients?

They were my patients, yes.

They d*ed in the "80s.

I was their nurse.

It was a terrifying time.

Some days we lost two, three patients.

See, we barely understood what AIDS was back then, let alone how to treat it.

I don't want to see these anymore.

I know. It's hard, isn't it?

I could only imagine who they might've been, what they might've done with their lives, if they had a chance.

They had such promise.

These patients, how many of them d*ed alone without their families?

Far, far too many.

I don't want to live without my family.

And I'm sure they don't want to live without you.

I can see it in your aunt's eyes.

I know that look.

She's terrified of losing you.

You're so young, Abena.

Don't rob yourself of a future that these young people could only dream about.

I lost a lot of patients.

I don't wanna add you to this folder.

April, Abena is asking for you.

I'll take the test.

Abena, I need verbal confirmation as to what test.

I want to take the HIV test.

These just came in from Radiology.

Finally. Thank you.

Damn, I'm not seeing anything.

Why was Will getting a brain MRI?

What's going on, Natalie?

Is he okay?

Dr. Manning. Yeah.

The PICU called. It's your patient, Denise.

They need you upstairs.

All of a sudden I saw her leg move, and then she reached out for me.

Reflexes are all back to normal.

Denise, I'm gonna have you stand for me now, okay?

That's great.

All right, now I'm gonna have you walk to me, and I'm gonna let go, all right?

Okay. Let's go.

Sam, what am I missing?

Best guess? Some kind of toxin needed to work its way out of her system.

But how that got to Will? I have no idea.

Contagion is one thing, but this is more like a game of tag.

Thank you, Dr. Manning.

Well, tag, now you're it.

Nat, what are you doing? You shouldn't be...

Just look at your MRI.

You see that bump above your coronal suture?

Yeah.

First I thought it was a mole, but...

What is it?

Ah, there it is.

There what is?

Nat.

Gotcha. ow!

What is that? A tick? Uh-huh.

Wait, is this Lyme disease?

Nope. Tick paralysis.

The salivary gland produces a nerve toxin.

This guy came all the way from Australia, courtesy of Denise.

It must've detached from her scalp, but stayed in her hair, and when you picked her up, it attached to you.

But if it was off her by the time we got Denise into the ED, how come the paralysis kept moving up her body?

It typically worsens for a few hours, once the tick is removed.

So I'm not out of the woods yet.

Nope, but the paralysis is mass-dependent, so it shouldn't move as quickly up your body.

But you still have to spend the night in the ICU.

I gotta get this to Serology.

Don't move.

Ha-ha.

Hey, you need aride somewhere?

No, no, thank you. (STAMMERING) I have a ride.

You know, I've been wondering about something you said earlier today about...

About not feeling safe in the ED.

It was just an innocuous comment.

Heat of the moment.

Reese, you and me, we're both...

We're both psychiatrists, right?

"Innocuous comment,” really?

Dr. Charles, I know today was not my finest hour, but...

What with my car getting broken into and Noah getting punched...

Sarah, I get it.

You know, this can be a very chaotic, often downright scary work environment.

And you know what? It's not necessarily for everybody.

I chose emergency psychiatry because it was the right thing for me at the time.

I'm sorry, are you reassigning me?

Of course not.

I'm just saying there are other options...

No. Not for me.

I want to be in the ED.

Okay.

Look, I promise we won't need to have this conversation again.

I had a bad day. That's all.

It's nothing I can't deal with.

1 got lucky, I guess.

My paralysis hasn't progressed up past my knees.

Lucky?

Getting latched on by a tick?

(LAUGHS)

Must've been the red hair.

There's not a creature in the world that can resist this.

(NATALIE LAUGHS) That's very true.

I gotta go.

Doris is gonna k*ll me if I'm late to her party.

Thanks, Maggie. Have fun.

Bye.

Well, you know what the best part about being in an isolation room is?

The privacy.

I don't have to be home for another couple of hours.

Oh, really? Mmm-hmm.

Hmm.

So, you can still feel everything above the knees?

We should probably make sure.

ETHAN: How do you think it's going in there?

I can't tell.

I mean, Vera's still in there.

She hasn't left.

That's a good sign, right? Yeah.

Coming, April?

APRIL: Yeah, um, my boyfriend and I will meet you there.

Good for you.

Pick up your jaw, Doris.

What changed?

Good night.

Noah.

Are you okay?

You're still up for Doris' party?

Nah, I'm... I'm just gonna head home.

We're the next party of two.

That's pretty. You should get it.

Meh, I have more than enough scarves.

(BUZZING)

Oh, this is us. Oh.

You coming?

Yeah.

Could I help you, ma'am?

Um, yeah, can you unlock this case?

Sure. You have a FOID card?

A FOID card?

A Firearm Owners Identification card?

The application takes a couple of months to process.

That long? It's required.

Uh, we could start the paperwork tonight, but in the meantime, pepper spray can make a gal feel safe.

(THEME MUSIC PLAYING)