01x04 - Sometimes It's a Zebra

Episode transcripts for the TV show "Code Black". Aired: September 2015 to July 2018.*
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"Code Black" takes place in an overcrowded and understaffed LA County Hospital emergency room, where the staff treat patients under difficult circumstances.
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01x04 - Sometimes It's a Zebra

Post by bunniefuu »

[ Radio chatter ]

[ Monitor beeping, indistinct talking ]

It's gonna be okay. Just breathe. Just breathe.

Cole: How long have you worked here?

35 years. Not as long as your father.

You're all so nostalgic about this place.

You know, long ago, I had a German prost*tute.

Okay.

You know, she did something to me she called affe geschlecht.

That's the only thing I've ever been nostalgic about.

Dr. Rorish?

Come say hello to Dr. Cole Guthrie.

Oh, Dr. Rorish, it's a genuine pleasure.

Yeah, you too.

Have you seen your father yet?

Uh, no, not yet, but I'm sure I'll run into him.

Dispatch said we have three incoming...

House fire, burns, smoke inhalation.

Saline, burn kits, morphine.

Dr. Taylor will show you where to observe.

Let's go!

Malaya, Angus, Christa, you're with me.

Woman, 20s, ESI-1, severe burns on torso and legs, barely moving air.

Right behind me, 55-year-old male... Breathing difficulty, second- and third-degree burns, arms and legs.

I'll take the male!

Dr. Pineda, go with Dr. Guthrie.

Angus, over here. We've got the female.

5-month-old infant... Smoke inhalation.

Dr. Lorenson, with me.

Barely responding, ESI-1.

Let's go! Let's go!

Step aside! Step aside!

Let's go, folks!

Stand right behind you.

Airway evals first. Strip and switch.

t*nk 'em with fluids and keep 'em warm.

Okay.

See these singed hairs here? See the black soot?

What does that tell us?

Bro, do not pass out.

Angus?

Uh, i-i-if the nasal hairs are b*rned, we must also assume that her vocal cords are, as well.

That's right.

They could swell at any moment and seal off her airways.

We need to intubate immediately.

Neal: Airway seems clear... Increased respiratory rate.

Slight tachycardia. Why isn't he waking up?

CO2 exposure. Push O2 and fluids.

Every time I try to get a line, it creates a bleed that won't stop.

That shouldn't happen... Not with a burn.

Well, it is happening.

Deep breath and try again.

[ Sighs ]

This is where medical students observe?

Yeah, and interns, sometimes E.M.T.s.

Doesn't seem particularly sterile.

Well, neither is a taxicab, but many a baby have been born there.

How's my daughter, my grandson?

Sir, we're doing everything we can.

Tina? Tina?!

Sir, I'm gonna need you to calm down.

Can't get the I.V. through this burn tissue.

All right, Dr. Pineda, let's put in a central line.

Isabel, triple lumen, and I'll need the ultrasound.

No ultrasound. Use the anatomy.

Dr. Guthrie, this isn't 1973.

Ultrasound is standard in central line placement.

Dr. Pineda, listen to your attending and get that line in now.

Dr. Pineda, what is your surface landmark?

One finger breadth medial to the femoral artery.

Good.

Okay.

And...

I'm in.

I couldn't have done better myself...

Back in 1973.

Dr. Leighton, can you give me a TBSA assessment of her burns, please?

Uh, 60%, mostly partial to full thickness.

Good. Okay, what does she need now?

The parkland formula would suggest that she needs, um, a-at least 10 liters of fluid.

Good. Do it.

[ Sighs ] I can't... I-I can't... I can't...

I can't get a line. I'm sorry.

Easy, Dr. Lorenson.

It's his vessels that are constricted. What's plan "B"?

Interosseous infusion?

Is that a question or an answer?

We'd have to drill into the baby's leg to get a line.

Exactly. Risa, I need an I-O drill with a pedi cath.

Focus.

How will you know when you've penetrated bone and reached marrow?

[ Heart b*ating loudly ]

[ Baby crying ]

I-it's a baby.

It's a patient.

[ b*ating continues ]

Focus.

[ Crying continues ]

I can't. I just can't. I'm sorry. I can't.

This your first sick baby?

Yeah.

My first was two years ago.

How is that possible?

First since the accident.

First since I-I watched a hapless resident at a third-rate emergency room try and fail to save mine.

You lost a child, Christa.

That means that every child who comes through here is a version of that child.

It's not gonna change.

You need to learn how to deal with it.

How do you deal with it?

[ Sighs ]

I try not to see the sick kid on the table.

I try to imagine...

The child in one piece leaving this hospital...

Put back together.

Has that worked for you?

Not yet.

[ Slurring ] Picasso, your sutures are beautiful!

For your fine work, I'm gonna make you a garganelli with an oxtail ragu!

Make mine extra-spicy, chef.

Of course, mama! Of course!

Your golden window on this is about to close.

Golden window?

If chef goes into withdrawal, you have to keep him in the E.R. for hours while he detoxes.

Because withdrawal can be fatal for alcoholics.

Exactly. Once it starts, we have to keep him here.

But if I get him out now, he'll hit the streets and self-medicate.

Uh, uh, I-I'm not going.

I-I need to sober up.

I'd love to help you out, but we...

We just don't have the beds.

No, no, no.

I need to do it today... Now!

I can get your a referral.

Now, now!

Leanne, leanne!

Hey, there's no need for that.

Leanne, don't... Don't let them kick me out!

Hey, chef, what's all the yelling about?

I have to stay.

I told him we don't have the beds.

Leanne, it's my baby's wedding tomorrow.

I can't go if I'm drunk.

I-I can't do it, I can't do it.

Chef...

Alcohol withdrawal is painful.

I can't embarrass her.

I can't miss my baby's wedding. Come on.

He's just gonna be back in here drunk tomorrow.

Thanks you for your opinion, Dr. Savetti, but we have no choice once withdrawal has begun.

It hasn't.

Dr. Lorenson, come here for a minute, please.

Chef, go ahead... Stick your tongue out.

What do you see?

Tongue fasciculation... most likely from alcohol withdrawal.

Thanks a lot. Tongue fasciculation? Really?

[ Sighs ] She asked me a question.

Not everybody is out to get you.

Not everyone. Just the residents who aren't gonna make the cut.

Children, children, you're both pretty.

Now shut up.

I don't get it.

Rorish is all about the treat 'em and street 'em.

Why is chef any different?

Life lesson...

When your daddy tells you to do something, just do it.

You're holding out.

If I am, it must mean it ain't your business.

Here we are.

[ Scoffs ] This is a storage closet.

You should see where chef normally sleeps.

This is a five-star upgrade.

[ Gasps ]

Hi. I'm Dr. Leighton, and this is Isabel.

Hi. Nothing like this has happened to me before.

Yeah, when did it start?

I was on a... bus with 32 third-graders.

We were coming back from a trip to...

Sacramento.

[ Gasping ]

I'm a teacher.

Okay.

I can, uh, see how that would be, um...

Inconvenient.

Uh, was this proceeded by any sexual activity?

[ Scoffs ] Oh, yeah...

A g*ng bang on the bus with the third-graders.

No!

It just... started...

H-h-happening!

[ Moaning ]

Right. [ Clears throat ]

Um...

W-w-were you drinking or... or taking any dr*gs?

With the third-graders?

Mm-hmm.

Sorry. I'll stop.

Yeah, just put "no."

Uh, any psychiatric history?

Mnh-mnh.

Isabel, uh, maybe you h-have something that y-you might like to add here?

[ Sighs ]

Nope.

You got this, doctor.

Okay. [ Clears throat ]

Have, um...

[ Sighing ]

Have you placed anything in your vaginal canal?

Anything?

Mm-hmm.

Everything!

I have put everything in my vaginal canal.

I ran home, and I tried everything that might work.

I need to...

End this!

[ Moaning ]

Okay, well, I-I should, uh, probably take a look if [Clears throat] if you'll just, uh...

You'll just... Slide back for me here.

All right. [ Sighs shakily ]

And, uh...

O... kay.

Just, uh...

[ Gasps ] Ohhh! Yeah!

Yep. You know what?

I-i-i am gonna step out for just a second and get another opinion.

[ Moaning ]

This one just isn't your thing.

You don't know what my thing is, but go ahead, Romeo...

Take a sh*t.

And remember... one false move, and you lose your license.

Don't worry.

Not worried... hopeful.

[ Joannie moaning loudly ]

Hi. I'm Dr. Pineda.

I'm Shanni.

This is my daughter, Keesha.

She's been throwing up all morning.

[ Vomits ]

Oh, baby girl!

Uh... sorry.

Happens all the time in here.

Can you tell me when this started?

[ Sighs ] The last few days, I've had a headache.

I've been nauseous.

It's been three days.

What about those bruises on your legs?

Just clumsy. That's nothing new.

And no, she's not pregnant.

That's what the nurse out there asked.

You're certain?

It's not possible.

It's something she ate.

Any unusual stress at school?

S.A.T.s, college applications.

What could be stressful about that?

She'll be the first in our family to go to college.

Stanford's top of our list.

I went there.

It's so hard to get in now, but they have an excellent diversity outreach program.

"Diversity outreach"?

That how you got in?

I-i-i-i...

How about we skip to the part where you just do your job and make my daughter better?

I'm sure you're a great student, Keesha.

I'll order a blood sample and run some tests.

Mm.

[ Monitor beeping ]

Doctor?

Be straight with me.

My daughter and her little boy...

Are they gonna make it?

They're both stable but critical.

Uh, Tina's condition is precarious.

The burns on her body are severe and extensive.

We're gonna keep her on a breathing tube and sedated for the next few hours, and then we'll know more.

Will you, uh...

Will you pray with me?

[ Door closes ]

Oh. I hope it's okay.

I was just looking around.

Don't ever countermand an order an attending gives to one of my residents.

Do you understand?

Ah.

It was my father.

Maybe I was, uh, showing off a little.

I apologize.

But I happen to be right.

How so?

The latest data shows that using an ultrasound in the placement of central lines has a 95% efficacy rate.

And when the ultrasound fails or isn't available?

Then you can't get the medicine or fluids to the patient because you never learned how to do it using anatomical markers.

By doing it and not relying on machines, we have a 100% efficacy rate, regardless of circumstances.

No one's efficacy rate is 100%.

And, with all due respect, I don't take orders from you.

And I don't take them from my father.

You have no idea how you got this job, do you?

You think that you just apply to Angels Memorial and you get hired?

700 people applied for that opening.

You got the job for one reason and one reason only...

Your father recommended you.

So next time you feel like embarrassing him, try saying "thank you" instead.

[ Joannie moaning ]

[ Moaning continues ]

Ooh. What happened? Couldn't quite get her there?

[ Joannie whimpering ]

She's obviously faking.

Lot of experience with that, huh?

She needs a psych consult.

All right. Enough is enough.

I got this one.

There you go.

Really? There are ethical guidelines, you know.

Relax.

Mama is in the house.

[ Moaning continues ]

Hi.

Took you long enough, Princess Jasmine.

I was wondering if you might step out while I spoke to Keesha alone?

No. Unh-unh.

I want my mom here. What is it?

As you both know, we ran some tests, one of which was for pregnancy.

I told you that wasn't necessary.

It's standard procedure.

It came back positive.

What?

You saying that...

Keesha is pregnant.

No. How many times did I tell you?!

Mom, mom...

If you want a future... A real future...

I told you to keep your legs closed.

You know what I went through. You know how hard I had it.

Mom, it's impossible.

I'm sorry, Keesha.

You're wrong. I can't be pregnant.

I'm a virgin!

[ Sighs ]

[ Monitor beeping ]

His sats aren't improving.

He's still lethargic, and I have no idea what caused his bleeding issues.

I noticed there isn't any evidence of burns around his nose or his mouth.

I think whatever's wrong may have pre-dated the fire.

Malnutrition?

It's possible.

Could be inborn metabolic disorder.

Wouldn't the mom have noticed that?

You'd think so.

Let's try upping the bolus amounts, and let's see what happens.

Let's also test for coagulopathies and a nutritional panel.

About earlier...

You don't have to say any more.

I want to.

My son was ill.

And...

After two years of medieval t*rture...

The sweetest boy I ever met d*ed in my arms.

Christa, I'm so sorry.

No, no.

I'm not looking for sympathy, and it's not an excuse.

I just...

I wanted you to understand.

Thank you for telling me.

Excuse me.

Fire investigator asked you to give him a call.

He say what for?

He wants to know when he can talk to your patients.

They think Tina might've started the fire.

If Tina was suffering from postpartum depression, the fire could've been a botched su1c1de attempt.

That nearly k*lled her baby?

Keep her away from me if that's true.

It could've been part of a pattern.

If she was abusing or neglecting Tommy, it could help explain his symptoms.

I need to be with her.

You can't, Dennis... Not now.

You're on serious painkillers.

[ Grunts ]

Tina's sedated. She'll be out for the night.

[ Sighs ]

And Tommy? The baby?

He's not doing as well as we would like.

What's wrong with him?

Well, we're not sure.

Was Tommy exhibiting any symptoms before the fire?

Tina never said anything was wrong.

Was the baby's father involved at all?

No, no.

It's just me and Tina and Tommy.

The three musketeers.

I really need to be with her.

You can't... not now.

Now, Dennis, was Tina depressed at all?

Sometimes that can happen to new moms.

My daughter is...

Not perfect, but she is a good girl.

I don't think she would do anything that would hurt Tommy.

Try to get some rest, Dennis, okay?

[ Sighs ]

I heard you had words with my son.

I had words with the new surgical attending.

Leanne, before you're too hard on him, there's something you need to understand.

I wasn't the father that he needed growing up.

I tried to be there for him later, but it's been a struggle.

You don't have to explain yourself to me, Rollie.

He's your son. He's welcome here.

But I can't treat him any differently than I would anyone else.

That's fine.

He doesn't get extra points for being my son.

But I'd prefer that he doesn't lose points for it, either.

Fair enough.

Thanks.

Stay with me, Darrell! What did you take?

Fill me in, Dr. Savetti.

Darrell Bridges... 21, Cal student, overdosed on an unknown drug.

Incoherent, barely responsive.

Found in his apartment with various unlabeled prescription med bottles and a few syringes.

Okay, Fred, give me 0.4 milligrams of Narcan.

That'll wake him right up.

Narcan?

Leanne! Chef needs you!

All right. You got this, Dr. Savetti?

Yeah.

All right.

And find out what he O.D.'d on.

[ Gasps deeply ]

[ Tray clatters ]

Welcome back, Darrell. What did you take?

What did you do?

You're at Angels Memorial, I'm Dr. Savetti, and I need to know what dr*gs you took.

[ Scoffs ]

I know my rights.

I don't need to tell you anything.

I just saved your life. Don't make mine difficult.

Give me a tox panel.

No.

[ Breathing shakily ]

Blood pressure's 151... Way too high.

Oh. Uh, how much Diazepam has he received?

260 milligrams.

Phenobarb?

3 grams.

Wow.

Yeah, it's a lot.

Uh, get me more of both, please.

Leanne?

Jesse, look at him, please.

[ Coughing ]

Okay. Hold on. Just hold on.

I'm trying, I'm trying, I'm trying.

I just need your signatures, and I can discharge Keesha.

I have referrals for ob-gyns and a family-planning clinic.

You can say it.

"I told you so."

My little girl fulfilled all your hood stereotypes.

There'll be no Stanford, just diapers and a minimum-wage job, just like me.

Miss Platt, that's not how I feel about any of this.

Test me again.

I ran the test again... Same result.

I've sacrificed everything to be the best student I could be...

No boys, no parties.

I spend every night and weekend studying.

When could I have gotten pregnant?

You're embarrassing both of us, Keesha!

There's no such thing as a statistical certainty.

Isn't that right?

Couldn't it be something else?

Where do I sign?

I'm sorry. They gave me the wrong paperwork.

Let me get to the bottom of this and get back to you.

Jesse!

You are amazing.

Thank you.

You're welcome, Joannie.

All the best!

Are you kidding me?

What did you do?

It's a gift, bro.

If I did that, I'd be kicked out of here.

If you did what?

"Jesse, you are amazing."

Pepper.

Excuse me?

What does that mean... Pepper?

I put it in her nose.

What?

So she'd sneeze.

She needed a release. I gave her one.

[ Scoffs ] There's no way that worked.

You know, in some psych cases, it doesn't matter what you think will work, only what she thinks will work.

Your O.D., Darrell Bridges, wants to be discharged.

He can't go yet.

You should tell him that.

[ Shouting indistinctly ]

Hey! Calm the hell down, all right?

Talk to me. Talk to me. Hey.

[ Breathing heavily ] I don't belong here!

Yeah?

Okay, convince me.

What happened? What drug did you take?

I don't remember!

You don't remember, or you don't want to remember?

What is the difference?

Has this happened before?

No.

Okay. I know you're a student.

You got some midterms coming up, some tests?

Break up with your girlfriend?

Boyfriend?

[ Spits ]

Can I go now?

You O.D.'d. It's state law that you stay here until I've had someone evaluate your mental state.

I, uh... I hope your restraints won't be too uncomfortable.

Spit mask.

Hey. What are you doing?

Wait, no, no! No, nooo!

No, no, no!

[ Groaning ]

This hurts!

I know.

Okay, just a little bit longer.

[ Breathing heavily ]
Tell me about your daughter.

Well, L-Lindsay's beautiful, you know?

You know, she's got a great spirit.

[ Grunts ]

Crazy laugh.

I don't know. I think you'd like her.

I'm just not a big fan of her politics, you know?

Well, you have to have something to fight about, right?

Yeah, her and her fiance are supporters of Bush.

Jeb?

No, no... George W.

We're out of phenobarb and benzos.

I sent out to central supply, but it's gonna be about an hour.

Okay, okay. Um...

We're gonna hang I.V. ethanol.

Old-school?

Yep.

Oh, you're gonna pump me full of alcohol?

We control the dose, and we barely satiate your receptors.

We wean you off it without getting you hammered.

Trust me... it works.

They need me back out on the floor.

We got this.

What's the dose?

Well, it's more art than science.

[ Pager buzzing, beeping ]

Okay, go. I'm good.

This is the best wedding gift you can give your daughter.

[ Dennis breathing heavily ]

[ Respirator hissing ]

[ Rapid beeping ]

[ Choking ]

[ Grunts ] [ Monitor beeping ]

Don't move, Tina. Don't try to speak.

You'll aggravate your airway.

You're not even supposed to be awake.

So, what's your diagnosis... Immaculate conception?

[ Chuckles ]

Look, I get this girl now.

We're both "A" types with demanding moms.

I was a virgin at her age, so why should it be such a surprise that she is?

All right.

Let's, uh, let's start at the beginning.

Was there anything in her initial exam you might've overlooked?

I don't think so.

Wait.

What?

There were bruises on keesha's legs.

Does that mean something?

It might.

Hey. Hey.

You made it.

Can I go see my daughter now?

Chef, you can't...

Just do it for your daughter.

You've got to do it for you.

You've got to believe you're worth it.

Here's a prescription for librium...

And...

[ Sighs ]

A card...

For our addiction clinic.

Now, you promise me that you will call that number before you take a drink.

I promise you, Leanne...

I'm not gonna blow it this time.

Thank you.

Wait! Keesha!

Shanni, you can't leave.

I want to run one more test.

No more tests.

I think Keesha is telling the truth.

He's spiking a fever, and his blood pressure is starting to drop.

What's going on with you, Tommy, huh?

Give him amp and gent and pan culture prior.

His vitals?

He's tanking, and I have no idea why.

Lethargy, bleeding, now high fever, low blood pressure.

We tried him on a few boluses.

He's been on an NRB for two hours.

Nothing's working.

Whatever it is, this baby had it before the fire.

His grandfather said he had no recent symptoms, like cough, vomiting, or diarrhea.

We have to consider the central nervous system.

Brain infection could be fatal.

And in an infant, we could lose him quickly.

You have to do a lumbar puncture.

With his bleeding issues, if the needle misses the spinal column and hits an internal organ, it could lead to an unstoppable internal hemorrhage.

It's a risk you have to take.

Kayla: I have some other patients to see on the floor.

If you find him, page me. I'll come right back.

Where's your patient?

He was right... here.

Well, he's not there now.

Anyone have eyes on patient Darrell Bridges?

The drug O.D.?

No.

He was restrained.

Restraints aren't foolproof.

Did you assign him a sitter or at least ask one of your fellow residents to look after him?

I didn't know we were supposed to have...

No, you didn't, because you're a first-year resident.

This job requires you to be in several places at the same time.

I have told you... You can't do it alone.

I see he had an I.V. in place, so he could be on the street mainlining his drug of choice.

We are gonna be liable for both the 5150 failure and the I.V. elopement unless we find this guy quick.

Let's get security on it now!

You're enjoying this, aren't you?

Like a tornado loves a trailer park.

I thought you could do the procedure.

[ Inhales deeply ]

I don't want to hurt him. You should do it, please.

Okay, okay.

You hold him.

Yeah.

Tight as you can.

There we go.

Yeah. It's infected.

It's cloudy.

Faster we find out what this is, the faster we can match an antibiotic.

Get this to the lab.

Tell them to put a rush on it.

[ Breathing shakily ]

[ Rapid beeping ]

Tommy?

She's cyanotic.

She can't breathe!

R.S.I. meds. 20 of etomidate, sux 120.

Jesse: I got it.

[ Beeping stops ]

She's out.

Neal: Check her airway.

Nearly a cul-de-sac. The edema's terrible.

I see a pinhole trachea.

Prepare for a cric.

Wait, wait, wait. D-don't... don't cut yet.

Christa, is there a nonsurgical remedy?

A retrograde intubation, but that could take up to four minutes.

Do we have time?

It could work...

If you can do it in less than 45 seconds.

Thanks. No pressure.

Okay, Christa, what am I feeling for?

Uh, cricothryoid membrane.

In success, there shouldn't be any blood.

When we reach the trachea...

We should feel compressed air escaping.

Ah. Okay. [ Air hisses ]

[ Inhales sharply ] I'm in.

Okay, guide, please.

You can see it come out.

Clamp, please.

Great.

There we go.

Feed it, feed it, feed it. There we go.

Okay, now the tricky part...

Threading the tube...

Thanks.

The air tube over the wire.

Okay.

And...

I've got an airway.

With a few seconds to spare.

What do you got, Jesse?

Tina wrote this.

Think she's saying she was kidnapped.

Neal: Where's Dennis?

Oh, my god. This says Tina disappeared two years ago.

She's still listed as missing.

Dennis isn't her father.

Damn it. Where is he?

Leanne is with the police.

They're posting officers at the exits.

[ Sighs ]

Send deputies to the utility corridor.

He's headed for the west exit.

Where are you going, Dennis?!

I needed some air.

Tina okay?

You're a monster.

What?

Tina's not your daughter.

Of course she is.

You're either lying or you're delusional!

Either way, it's over! We know you took her!

You don't know anything.

We're a family. She is mine.

She needed me, and I gave her a reason to live.

She loves me!

What about t-t-he baby she gave me?

Doesn't that prove anything?

You know, I've never hurt another human being before...

She was lost!

[ Voice breaking ] And I saved her.

We got him, sir.

Hands behind your back.

She loves me!

Do it!

She belongs to me!

Let's go, now... walk!

[ Sighs ]

[ Clears throat ]

[ Sighs ]

The cops think that when Tommy got sick, Dennis refused to get help.

Tina was watching her baby die.

So she set the fire to lure rescue.

[ Sighs ]

[ Monitor beeping ]

Miss Platt, Keesha has a growth in her brain.

I don't understand.

There's a rare brain tumor that leaks the same protein that indicates pregnancy.

That's what we think caused the false positive.

It can also affect your balance.

That could be why Keesha's been falling and bruising her legs.

S-so I'm not pregnant?

Is this a tumor? My baby has a brain tumor?

Stay calm. Stay calm.

It's not necessarily what you're thinking.

Now, if this is what we think it is, these tumors are known to be treatable with radiation at a 95% success rate.

An oncologist is coming down to talk to you and do more tests.

I liked it better when I was pregnant.

Can we go back to that?

Let's... let's take it one step at a time.

Okay?

Okay, I want Tommy to be the first thing his mom sees when she opens her eyes.

[ Monitor beeping rapidly ]

What's going on?

We didn't change anything.

Risa, page Rorish and Hudson.

His O2 stat's dropping to the 60s.

What do you want to do, Dr. Lorenson?

Um, um, plug him in.

Pre RS-1 and Miller 1 for intubation.

Take a breath.

Intubate? You sure?

We won't get him off the tube.

Maybe you should scan him first.

I need to scan him.

Looks like fluid.

Pus caused by the meningitis.

He needs a chest tube, but that could cause him to bleed out.

Or he could suffocate.

Do we have an E.T.A. on Rorish and Hudson?

No.

They're not here.

You're his doctor.

Tina?

Tina, stop, stop!

Tina, look at me.

Listen.

I know how much you love your son.

I know what you did to save him.

I'm gonna make sure that you two walk out of here together, okay?

[ Whimpers ]

Okay, please be dry.

Dr. Lorenson?

He's having trouble breathing... Pus in his chest.

I'm gonna insert a chest tube.

Any bleeding issues?

Uh, no, not yet.

Good.

I need a doctor!

Paramedic: Darrell Bridges... 21, found seizing in the street two blocks from here.

His heart rhythm is whack. Blood pressure is 70s over palp.

We pushed ativan I.M. in the field but were unable to stop seizures.

How much benzos?

2 and 4.

Push Keppra and phenobarb.

1, 2, 3.

Page Dr. Savetti. Tell him we found his patient.

I'm here!

Woman: I can't get a line.

Okay, start an E.J. line in his neck.

He's IVDU. Don't mess with a peripheral.

Yes.

Blood pressure's falling.

Okay, start another bolus.

He may need a second line.

What else can we do for him, Dr. Savetti?

Uh...

Quickly, Dr. Savetti.

Okay, okay. Um...

All right, one more option left.

He needs a propofol drip, and we got to intubate him.

Where's the scope?

Insert the Kelly into the chest and make just the quickest of jabs.

What's your goal here?

To just pierce the pocket enough for it to drain without puncturing the lung.

And take your time.

You did it.

Oxygen level's improving.

Good job.

[ Voice breaking ] He's gonna be okay.

He's gonna be okay.

Still seizing.

You got something, Dr. Savetti?

Uh, one minute.

He doesn't have a minute.

Look. Look.

Look at that AVR amplitude. That's not normal.

You may have something.

Where's an older rhythm strip?

His... his heart contractions have become more and more abnormal over the last few hours, especially in the QRS segment.

I got it.

Okay.

80, 130, A.G.

Potassium?

Okay, the overdose is affecting his blood chemistry.

What is one of the dr*gs that can cause abnormal heart rhythms and seizures simultaneously?

TCA poisoning.

He overdosed on his antidepressants.

Uh, if the gap is 20...

Uh, he needs sodium bicarbonate, Isabel... a lot of it.

All right, right away.

Come on.

Come on, buddy.

Slam it.

You got lucky, Dr. Savetti.

I wonder how long that's gonna last.

[ Siren wailing in distance ]

Cole.

So, how was your first day?

When were you gonna tell me you got me the job?

They don't hire people who are not qualified.

But you made a call.

I'm your father, Cole. Of course I made a call.

You feel like getting some coffee?

No.

It's not gonna be like that.

Well, what a shame for you.

A shame?

Yeah... a shame.

You're so busy all these years trying to prove to me what a man you are.

All you end up doing is showing me that you're still a boy.

Night, doc.

See? There you go again.

You're 43 years old, Cole.

It's time to stop blaming me for all your problems.

It's time to stand up, son.

Christa: Tina?

I have someone that wants to see you.

You saved his life.

Mom did good today.

Hell of a shift.

Hell of a shift.

You okay?

Yeah.

I am.

You, uh, you feel like grabbing breakfast across the street?

I'd love that, but I made plans with the other residents.

Oh, right. Another time.

Come with us.

You guys don't want an attending along.

Enjoy yourself. You deserve it.

Thanks.

Rain check?

Sure.

Hey!

Hey.

Doesn't it bother you?

After all you did, he's not even gonna make his daughter's wedding.

His daughter d*ed 10 years ago on her wedding day.

This is what is known as a grief ritual.

Trauma One was the last place he saw her alive.

He's stuck in that moment.

He tries to escape it, but...

He can't.

Can I help?

No. I got it.

But thank you.
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