02x03 - Natural History

[indistinct chatter]


[relaxed music]

[indistinct chatter]



That's my uncle Miles on the grill.

Uncle Miles?

Is that gingerhead with you?


Oh, is that my baby girl Becca?

Can you believe how big she's gotten?

Hey, Grandma.

Hey, sweetie.

This is Will.

Hi, Will.

Hi. Nice to meet you.

Why don't you go see your uncle Will?

Okay, hi.

Stay with Will.




Hey, Mags.

I didn't think you were gonna come.



Just decided to fly in at the last minute.

Well, I'm glad you did.

Will Halstead, come over here and meet my sister, Denise.

Okay, let me hand her over.

I'll take her.

Yeah, nice to meet you.

Come on, sweetie.


Hi, Denise.

So are you to blame for the big mouth on this one?

Please, Maggie's been sassy ever since she could talk.

It's not my fault; I was born that way.

So what should we do?

I'm off on Monday and the weather's supposed to be great.

I'm actually flying back to Dallas in a few hours.

I got to be back at the makeup counter tomorrow.

Well, let's make the most of it, then.


Come on, let's go say hi to everybody.


Morning, Ms. Goodwin.

Good morning.

What brings you in on a Saturday?

I could ask you the same thing.

I'm filling in as trauma attending.

We haven't had an elective heart surgery in a week.

Yes, I know we've had some cancellations since Dr. Downey died, but we can't expect to rebuild a destination program overnight.

We've got a great team.

Word will spread.

Connor! Incoming.

With you.

Patient name: Glenn Simon.

57-year-old male.

GSC 15, vitals stable.

Got knocked off his horse at the polo ground.

Gross deformity to the right femur.

All right, let's go to T3.

Mr. Simon, can you tell us what happened?

My buddy Harvey is a cheater.

That's what happened.

Tried to pull a 90-degree ride-off.

Knocked me clear off my pony.

All right, let's get an X-ray and call Ortho.

Got it.

All right, let's move him on my count.


One, two, three.


Mr. Simon, any pain?

Not there.



Oh, ho, ho.

Looks like we found it.


Let's get him off the board.

All right, on my count: one, two, three.


Gently. There we go.


[laughs nervously]

Get an IV started.

Hang a bolus of saline.

Five milligrams of morphine for the pain.

We're gonna get you fixed up, Mr. Simon.

I never like to admit that my wife was right, but I'd be in a lot less pain if I stuck to golf like...

[slurring] she asked me to...

Mr. Simon? Mr. Simon, can you hear me?

He's stroking.

All right, give 20 milligrams of labetalol.

Let's get him to CT and echo now.

Maybe I'll come and visit in Dallas.

I can use some primping.

You know, I actually might be out of town a bit over the next two months.

But after that, yeah.



So, uh, how long's she been living in Dallas?

I don't know.

She moved maybe nine, ten years ago.

Let me guess... Because of a guy?

Something like that.

[tires screeching, crash]


Whoa, easy, Denise.

Denise? Okay.

You're okay.

I'm right here. I'm right here.

Are you okay?

I can't see.

Okay. Okay, okay, okay.

Okay, breathe. Breathe.

I can't see.


[indistinct chatter, phones ringing]

What's gotten into you?

What? Nothing.

Okay, something's different.

You look happy.


I'm just glad to have a weekend shift.

Looking forward to a quiet day.

Hey, Nat.


Will has the day off.

Thought Jeff could follow you.



[alarm beeps]

Announcer: All attending to...

[radio chatter]

What've we got?

Mid-20s male.

Found him down by the train station.

GCS 14.

Fever's 103. BP's 160 over 90.

Heart rate 110.

Sir, can you tell us what happened?

I don't think you'll get very far.

He doesn't speak a word of English.

No ID... this is everything we found on him.

[speaking foreign language]

It's a foreign currency.

Let me see that.

Yeah, it's Thai.

If he just arrived to the U.S., he could have brought whatever this is with him.

Let's track down a translator online.

Right. Let's get him to T2.

Mr. Simon, we're taking you up to the surgical ICU.

You understand?

Glenn, honey.

I'm here.



Mrs. Simon?

Why isn't my husband saying anything?

Mrs. Simon, I'm Dr. Rhodes.

I'm taking care of your husband.

Why don't we find somewhere where we can talk?

So your husband has what is called a bifurcated vena cava.

It allowed the emboli from his leg fracture to bypass his lungs and go straight into his brain.

With your consent, I would like to operate.

I'd like to get a second opinion.

Glenn has a partner who's on the board at the Mayo Clinic, and I'm sure he could refer us to a cardiologist there.

I understand.

As long as he has the fracture, he's at risk of having another stroke.

And we can't fix his leg until I fix his heart.

Waiting could put him in even greater danger.

Fool still thinks he's 25 years old.

I came here to give him a piece of my mind, and now this.

Mrs. Simon.

We have a great team here at Gaffney.

I believe when your husband comes out of surgery, he's gonna be good and ready to receive a piece of your mind.


Will, uh... Dr. Halstead...

Gave her a dose of IV steroids.

Now her vision is starting to return.

Any idea what may have caused this?

Not yet.

Can we get you anything?

No, you both got enough on your plate.

And I'm fine... really.

Denise, I would really encourage you to stay.

[stammering] I'm okay.


Where you going?

If I leave now, I can still catch my flight.

But a second ago, you couldn't see your hand in front of your face.

Yeah, and now I can.

Thanks for the great care.

Don't be stubborn, Denise.

You know I've always had migraines.

This is just another passing episode.

Transient blindness can actually be caused by a number of things.

We should run some more tests.


What happens next time that you have one of your passing episodes, and you're driving on the expressway?

Fine. Fine.

Can we make this quick?

Ah... this is what I get for trying to take on a 12-pound pot roast.


Good news is, it's just a second-degree burn.

Might blister and swell a bit, but you'll live to cook another day.

Okay, BP's 160 over 90.

Let's page OB... Have them take a look.

You're, uh, seven months along?

Yeah, why?

Honey, are you okay?

Everything's okay.

Your wife's blood pressure is slightly elevated.

I'd like to get some labs and an ultrasound just as a precaution.

Is that necessary?

I've been seeing my doula regularly, and she says everything's good.

I'm right on track for home birth.

I know you must think we're some granola-fed hipsters, but that's not it.

My sister miscarried after an amnio, and I promised myself I would do everything as natural as possible.

That includes protecting my baby from the harmful sound waves.

I understand completely.

But in some cases, high blood pressure can affect fetal growth.

I just want to rule out any possible complications.

Well, I guess it's good to be on the safe side.

Right, honey?

[speaking foreign language]

The patient's not speaking Thai.

If I had to guess based on his inflection, it's an Indonesian dialect.

If you want, I'll contact the network administrator...

See who they have in Jakarta.

Please. Thank you.

Thank you.

Okay, so, Mr. Clarke...

Fever, chills, vomit, diarrhea.

Chikungunya, Dengue.

Yellow fever?

Maybe... that or one of 100 other diseases.

Welcome to the future.

Migration, climate change...

The whole world is on our doorstep.

So what do you do when you have an infectious disease of an unknown origin?

I'd start with CBC, CMP, blood, sputum, urine cultures... uh, rapid mono and strep.


You start the H&P, and I'll put in the order and hang some IV metronidazole.

Will do.

Actually, totally my fault.

Overdid it on the PT...

Had to do that last leg lift, and this is my reward.


Am I boring you, Doctor?

Oh, no, sorry.

I stayed up all night attacking the library...

Got all the way to Bowlby.

Bowlby? Great stuff.


Made Charles Darwin the fascination of an entire generation of shrinks.

Bowlby said that Darwin had a panic disorder.

Oh, yes, ma'am. Charlie had a dark side.

Wait till you get to Barloon and Noyes.

Dr. Charles, Dr. Reese, thanks for coming down.

What's up, Ethan? What do you got?

Amanda Kendrick-Dobbs.

Seven months pregnant, gravid belly, history of fetal movement and Braxton Hicks contractions...

All signs of a normal pregnancy.

So what's the issue?

There's no baby.

Dr. Rhodes?

I'm Leah Bardovi.

I'm starting my surgical residency here.

Welcome to Chicago Med.

So clinically speaking, the patient will be dead?

Just long enough for me to do the repair on his aorta.

And then we will warm him up and restart the heart.


Did a lot of these under Dr. Downey?

A few.

You know, he's the reason I applied here.

When I got my match, I told my dad that I'm going to be training under the greatest surgeon in the world.

And now...

I'm just honored to be learning from his protégé.


Cooling jackets prepped?

Standing by.

Then let's do this. Scalpel.

Appreciate the visit, but we just want to make sure the baby's okay.

Why are you here again?

Oh, we try and look in on all our expectant mothers as part of a routine wellness assessment.

It was actually Dr. Reese who flagged your high blood pressure.

Have you been under any stress lately?

Maybe something at work?

Oh, I'm not working.

Uh, I haven't been since we moved here last year.

Yeah, when my firm transferred me from Denver, we thought it'd be a good time for Amanda to stay at home and focus on the baby.

Where did you say Dr. Choi was again?

Pretty sure he's just waiting for the rest of your blood work.

We will go check in with him right now.

Thanks both for your time.

Good luck to you.

Thank you.

Notice how she didn't ask about any test results or anything?




That's 'cause on some level, she knows the truth.

So what are we looking at?

I don't know, Reese, what are we looking at?

Uh, well, no grandiose delusions or other signs of underlying psychiatric illness, so I think we can rule out psychosis.

Then how is this even possible?

Well, in a lot of cases, the anxiety produces a hormonal reaction...

Causes all of the physical signs of pregnancy without a growing fetus.

We need to figure out why having a baby's so important to her.

Or more specifically, why being pregnant is so important to her.


So what do we do now?

I see no value in withholding this from them any longer.

So what do you say, Doctor?

You want m... Me to break the news?

No, don't worry, Grandma.

No, I'll let you know as soon as the tests come back.

Me too.




How's your sister?

Stubborn as ever.

I am here for you if you need anything.


Thank you.

Dr. Manning?

Hey, Mags.

Uh, the translator in Jakarta struck out.

Apparently there are over 700 languages in Indonesia.

What about his fever?

He's up to 104.

Let's get him into a negative pressure room.

Hang some IV Tylenol, and let's see if there's any way we could put a rush on those labs.



What was that?

What was what?

You, Jeff, the body language, the touching on the shoulder.

Something is definitely up.


You mean I'm right?


Do you think it's weird?

What, you hooking up with your late husband's best friend?

Not "hooking up."

Whatever you want to call it.

You're asking me if it's weird.


Eh, a little.


Don't stress out about it.

I learned a long time ago that you have to do what makes you happy, even if some people think it's strange.

Dr. Manning.


[alarm blaring]


What's happening?

He's in bronchospasm.

Let's bag him and get some racemic epi and 125 milligrams of solumedrol IV.

Sats are still dropping.

I need a better airway.

Let's tube him. 20 of etomidate, 100 of sux.

You're gonna intubate?

Here you go.

He won't be able to speak to a translator if we do that.

We don't have to worry about a translator if he stops breathing.


Dr. Manning.

I'm in.

Start a Neb treatment. I got it.

Sats are coming up.

There's got to be someone somewhere in this city who can communicate with this guy.

All right, I'm on it.

Placement's good.


It felt like I second-guessed you there.

Let's get him moved, okay?

Yes, Doctor.

Call upstairs.

All right, go on bypass.

Cool to 20, but do not crash cool.

Find me when he gets to 32 degrees, and we'll arrest the heart.

Yes, Dr. Rhodes.

So far, so good.

He's taken well to the anesthetic.

We should be able to start the repair in an hour or so.

Thank you, Dr. Rhodes.

Mrs. Simon was just telling me how impressed she was with your confidence.


Could you excuse us, please?

I need a quick word with Dr. Rhodes here.

Where's Dr. Latham?

I was just about to page him.

You signed up for a high-risk surgery without consulting an attending?

All I did was open him up and cannulate.

It is the Sabbath.

I didn't want to bother Dr. Latham until I had to.

Glenn Simon is a man with lots of connections.

You were worried before about the state of the department.

You'll have even more to worry about if you don't pull this off.

Page Dr. Latham now.


These machines are the worst. [chuckles]

You obviously haven't seen the ones down in pathology.

I'd kill for a bag of Vitner's.

Don't overthink it.

Go for the next best thing.

Hey, Will, you got a second for a curbside?



Rapid strep and mono were negative, LP normal.

I'm afraid it's something exotic, but we won't have the cultures back for another couple of days.

And now with the bronchospasm...

Yeah, it could be almost anything.


I gotta confess, I am at a complete loss.


Well, whenever I find myself in the weeds, I go back to something one of my clinical attendings used to say...

The answer is always in the history.

That's your pearl of wisdom?

We can't get a history.

We're lost in a maze.

Then retrace your steps.


Every decision you made, each path you took or didn't take.

Examine it all.

Sorry, Nat.

Will, what do the presence of retinal autoantibodies indicate?


This mean what I think it means?


I have cancer?



We don't know for sure.

There's a chance that your loss of vision was caused by your body fighting some kind of tumor.

Is there any history of cancer in your family?

I don't know.

Uncle Paul. He's fighting bladder cancer right now.


Any other medical history I should know?

Any injuries or any illnesses or surgeries?




I'm gonna send you over for a CT scan.

In the meantime, let's take a quick look.

[knock on door]


[door opens]

If you require lights, you'll have to turn them on yourself.

Sabbath rules.

Dr. Latham, I understand I should have consulted you before recommending surgery, but I'd developed a rapport with Mrs. Simon, and I thought since you observe the Sabbath...

Pikuach nefesh.

A man's life always takes precedence.

So you plan on opening up the heart, tying off the bifurcated branch, and closing everything back up in 30 minutes?


Any longer and there could be significant cognitive deficits.

I understand.

If you don't over-sew the connection, he could develop a deadly pseudoaneurysm.

That might take an even experienced surgeon an hour.

Pardon me, Dr. Rhodes.

The patient's temp is down to 32 degrees.

Thank you, Leah.

You realize that by waiting as long as you did to call me, you've given us no other surgical option.

I thought this was our best course.

30 minutes.

I can make it in time.

I've done surgeries equally as challenging before.

While assisting Dr. Downey.


In the cockpit, a copilot's seat is right next to the captain's, but the view out of the window is surprisingly different.

Our... our bodies are complicated.

Sometimes signals get crossed, and our... our brains say one thing and our bodies hear something else.

I don't understand.

Is there something wrong with the baby?

Yes. Well... not exactly.

It's complicated.

What exactly are you saying?

[exhales sharply]


Well, is there someone here who can actually explain to us what's going on, please?

If you give Dr. Reese a minute, I think that you'll find that she has an excellent grasp of...

So go ahead.

Explain, Dr. Reese.

I am sorry, but there is no baby.

We lost the baby?

No. You never had one.

You don't know what you're talking about.

No, see, the... the evidence is actually right here.

You have a condition called pseudocyesis.

You may have heard it referred to as a hysterical pregnancy.

Are you saying my wife is crazy?

No, she's not. She's not saying that at all.

She's saying that sometimes the mind has the ability to play tricks on the body.

I can feel my baby. I don't care what this ultrasound shows.

It... Your machine must be broken.

I can assure you it's not.

Your blood test confirms it.

Well, then your lab's broken, too.

I'm pregnant. I am!

Honey. Hey, hey, hey.

No! No.

Back off.

No! No!

Honey, honey.

No! Get away from her!

Get me out of here!

We need some help in here!

[screams and cries]

Shh. It's okay. It's okay.


Hey, hey, hey!

No! [crying]

Where are we?

Body temperature's at 20 degrees Celsius.

Flow down.



Clamp is on. Give cardioplegia.

Plegia's on.

Heart's arrested.

Start the clock. Stage is yours, Dr. Rhodes.

Metz and DeBakey.

Here you go, Doctor.


Upper abdomen looks clear.

Wait a minute. What's this?

I think this thing is acting up again.

Maggie, do me a favor and reboot it.

I had it serviced last week. It should be fine.

Yeah, but right here.

[breathes heavily]

It's my prostate gland.

My doctor recommended not removing the prostate 'cause the surgery would be too complicated.

Well, it's definitely enlarged.

Before I send you over to the scan, I'm gonna need to order another panel.

Maggie, run down to phlebotomy and have them draw up a CMP and check her PSA levels?

Tina can do that for you. I'm a civilian today.

But you have much more sway with the lab.

I'll be right back, okay?

If you want me out of the room, just say so.

Well, excuse me.

Why didn't you tell me your sister used to be a man?

It's not my place. It's up to the patient.

Then you should've gotten her to tell me.

This is crucial medical history.


How long ago did she transition?

About nine years ago.


Was it hard for you?

Harder for her.


If it were my family... she would have been disowned.

Well, it's taken time.

We had a lot to learn.


Mr. Dobbs, please calm down. We just want to help you.

You've done enough.

The second she wakes up, we're outta here.

I think that would be a mistake, but I'm not gonna stand in your way.

We're done.


He's taking her home as soon as the sedative wears off.

We're gonna let them leave?


We can't put her on a psych hold?

Doesn't meet the criteria.

I mean, is she a danger to herself or others?

Is she unable to take care of her basic needs?

I've been doing some reading.

There was this one case where they put a woman under anesthesia and her belly deflated and... and she thought she had a miscarriage.

Whoa, whoa, whoa, whoa, whoa, whoa.

Are... are you actually suggesting that we do that?

I'll go get her discharge started.

So we're giving up?

When's the last time you had some sleep?

Are you sending me home?

No, I just think it might be a good idea to get some rest.

You know? You've been up all night.

Come back tomorrow, start fresh.

Yeah, you're...

You're... you're right.

I should get out of here.

Do you know how many cases we're looking at yet?


One second.


Yes, I will test him right now and send over the results as soon as we get them.

Thank you.

Who was that?

Health department.

Looks like our John Doe might have the measles.

Measles? But he doesn't have any Koplik's spots.

Doesn't always present that way.

Well, then how did you figure...


It's a belt buckle.

Flip it over.

"I survived the Stampede"?

It's a roller coaster.

That amusement park down in Champaign, they just confirmed that they had an outbreak of the measles.

Five cases, kids who were never vaccinated.

This whole time we were assuming that he brought this exotic disease into the country with him.

And now, it actually looks like he caught it here.

The labs will confirm it.


No, I've known you all these years and I never realized how genius you are.

I'm serious.

How did you even think to look at the belt buckle?

When you're in the weeds, always go back to the history.

No, no, wait! Wait for me!



My husband just went to go get the car, so...

I'm really sorry.

I wish I had done a better job explaining things.

Explain what?

That I'm hysterical?

That I'm not carrying a baby?

I'm sure my boss is regretting ever offering me this position, and I really wanted to be good at it, and now, well, again, I'm...

I'm really sorry.

You're lucky.

What? I'm lucky?

You care about what you do.

You know what I did before I moved here?

I was a skier, an extreme skier.

Wow, sounds like quite an adrenaline rush.

Yeah, but it was more than that.

It wasn't just something that I did.

But it was who you were.


What you said about my baby, is it true?



What happened?

She wouldn't let me examine her.

She's leaving.


Did you know it was offensive to use the word "transgender" as a noun?


I-I'm sorry. I didn't know.



What happened?

Exactly what I should have expected from a dude from Canaryville.

Oh, come on, Denise, he's a little awkward and all, but he's good people.

And a great doctor.

You know what?

I'll have my prostate checked when I get back.

No! You're not leaving, not without a definitive diagnosis.

You need to have all this checked out annually, Denise.

You want to know why I don't come back that much?

I don't always need everybody judging my choices, okay?

Please, the family? They embrace you.

I'm not talking about the family.

I'm talking about you.

The second I see you at the family reunion, you're...

You're throwing shade about how you were born this way.

I was mocking myself.

Just admit it.

You hate what I've done to myself.

I miss my brother. Is that such a bad thing?

Well, he's gone, damn it!

Not to me!

Not totally!

Look, I'm sorry that I hurt you, but I'm not gonna lose you.

So if I have to drag you kicking and screaming into that CT scanner, that's what I'm gonna do.

I'm scared.

We'll get through this.


Six minutes.


6 minutes, 11 seconds.

You still have another layer to go.

Damn it. More suction.

You have a clear line to the vessel.

Suction is not your problem.

You're not gonna make it.

I have plenty of time.

Not at the pace you're going.

You've done 57% of the work in 81% of your allotted time.

You are not gonna get there.

Your nonstop number crunching isn't helping.

30 minutes. That's what we agreed.

That's what you promised.


I'm taking over. Step aside, Dr. Rhodes.

I can do this.

Step aside!

Dr. Downey may have been quick to put his faith in you, but my faith takes longer to earn.

I've spent nearly my entire life feeling at war with my gender.

It figures, the one piece I didn't get rid of is what's gonna kill me.

[knock on door]

Your biopsy came back.

Pretty much what we suspected.

You have prostate cancer.

With treatment, I am hopeful it can be cured.

But you'll need to see a urologist as soon as you get home.

Thank you.

You're welcome.

There is a second option.

You could stay in Chicago and let us take care of you.

I'd like that.




Hey, you tracked down a translator?

No. That's his cousin, Farah.

Turns out his name is Pitopang.

He speaks Mamuju.

Came here from West Sulawesi a month ago to work in his uncle's restaurant.

Always wanted to ride a roller coaster.

Wow. Nice, April.


Hi, I'm Doctor Manning.

Your cousin has the measles, but he should make a full recovery.

[speaking Mamuju]

[speaking Mamuju]

My cousin said thank you, and he thinks you two make a great couple.

And yes, ladies, he is fluent in Spanish.

[speaking Spanish]

You think he hired a publicist?

Doesn't need to. He's a Rhodes.

Plus, he looks like that.


There's our rising star.


What are you talking about?

"40 Rising Stars Under 40"?

Yeah, you're number 11.

Hey, don't feel bad. There's always next year.

Or maybe the cover of "People."

[laughs sarcastically]

I swear, I knew nothing about this.

If you say so.


By the way, how'd the surgery go?

Yeah, it was... It was good.

Thought you were going home.

I was just going back over Darwin.

According to Hayman, Darwin's issues might have been entirely physiological.

Perhaps some kind of mitochondrial disorder.



You don't say.


Yeah, I ran into Amanda on my way out, and I found out that she used to be an extreme skier.



I don't know, maybe being pregnant was her way of replacing what she had left behind.

Nature abhors a vacuum, I guess.

Speaking of which... you mind?

[knock on door]

Ms. Goodwin?

Dr. Rhodes.

I don't know if you've seen this, but there's a new issue out.


I had no idea that I was gonna be a part of this article.

No one called or contacted me, and... and if they had, I never would have...

I approved it.

You did?

It's good publicity.

Yes, but did you actually read this?

I mean, "Dashing young surgeon" is poised to lead Chicago Med into the future."

No, I have no problem with that.

Ms. Goodwin, look, the surgery today...

Dr. Latham was right, I wasn't gonna make it.

I thought I was more ready than I am.

So if you're looking to promote the department, you should look to him.

I mean, he is a great surgeon.

Latham is a great surgeon, but they wanted someone under 40.

Stay humble, Dr. Rhodes.

Your time will come.

Huh? What do you think?

Too big?

No, you'll grow into it.

You are now an honorary member of the Lockwood tribe.

Thank you.

I will wear it with pride.

Who are you looking at?

No one.

Oh. That cute pathologist, Dr. Shore.





Well, don't feel like you have to stay here and entertain me.

I've seen enough of you for one day.


How do I look?


You know, when I think about Malcolm, it's times like these that I miss the most.



Go on.



You ever figure out what you wanted?


Yeah, I think I did.

At Johns Hopkins they have a Shabbat elevator.

It stops on every floor.

No need to press a button.

What can you do?


Good Shabbos, Dr. Latham.

Shabbat shalom, Dr. Rhodes.