12x02 - Third Rails

[bunniefuu]

Please tell me

you did not leak Theo's
files to save my job.

Taking this deal means
you can pursue employment

elsewhere from Gaffney.

You want me gone.
I still can't figure out why.

Please don't take Miranda's deal.

I leaked the medical file.

I see how it is easy for you

to cast me as the enemy
in your internal drama.

Sloan, you cut multiple
shifts just to save pennies.

Everyone resists change.
You miss Sharon Goodwin.

Oh, Sharon Goodwin's coming back.

[CHUCKLES]

I thought sharing a shower
was about saving time.

You said, and I quote, "all business."

Well, business has a lot of meaning.

[SOFT PLAYFUL MUSIC]

[KNOCK AT DOOR]

Just one second.

Yeah?

Can I get in there to brush my teeth?

[GROANS] Can't it wait?
I need a minute.

- What?
- [KNOCK AT DOOR]

All right, all right, I'm coming.

Hey, man.

Hi. Here you go.

Do you have a girl in there?

[SIGHS] Well, what's with
all the questions?

Look... [CHUCKLES]

When Naomi got that fellowship
in Portland and dumped you...

Easy, easy.

Yeah, mutual breakup,
but sure, go ahead.

I was there for you.

And I have been nothing but
supportive as you've, you know,

gotten back on the horse,
or the whole herd,

the past couple of months.

It feels like there's a but coming.

You're taking some liberties
with the, uh, roommate code.

[SIGHS]

- Okay. Yeah.
- Yeah.

No, that's... that's fair
and I understand.

And I... I will do better.

After this morning?

- See you at the hospital.
- Okay. See you there.

Yeah, okay, so she's got
a change of clothes in the bag.

And I pumped this morning,
which is in the cooler.

- You brought...
- I showed him.

- Okay.
- [FUSSES]

Oh, also, she likes
to be burped on her left side.

Sometimes it takes a little bit.

I promise I got her.

And daycare is great for little tykes.

It gets them used to new faces,
experiences...

Yeah.

No, I've read the... I've read
the literature, Trident.

It's just I'm handing
my heart to a stranger

and I don't want Mabel
to feel abandoned, so...

All right, baby, it's gonna be fine.

A little independence is
gonna be good for her.

Right, yeah.

[BABY CRYING]

- It's okay.
- Oh, my gosh.

- It's okay.
- I got you. I got you.

It's okay, yes.

- Shh, shh, shh.
- [BABY CRYING]

[SIGHS] How are you so calm?

I'm not. I'm pretending for you.

- [SIGHS]
- [CHUCKLES]

Dr. Archer.

Oh, good luck with that.

Thanks.

- Bye.
- Bye.

Hi. So glad I ran into you.

Okay. What's up?

Well, I wanted to let you know

that I'm shifting some resources

to create a dozen new beds.

More people will be admitted faster,

which should clear up
some space in the ED.

Oh, okay.
Uh, that sounds really great.

Thank you.

We're a team, right?

Right.

I knew what Miranda was
trying to do to Dr. Charles.

We all did.

And I felt angry and helpless.

Yeah, I know that feeling.

Then I went to your office to
drop off the staffing report.

You weren't there,
but I happened to see

Dr. Rabari's name on your computer.

His medical records.

I made a snap decision.

I printed them out

and I anonymously
sent them to Miranda.

Sent how?

An envelope I left in the boardroom.

Look, I thought that
I was saving Dr. Charles.

I had no idea that they would
come after you like this.

And now they're trying
to offer you a deal,

wanting to push you out
over something that I did?

I can't just let that happen.

Doris, Doris, I was the one
who asked for the files.

This is on me too.

But you didn't make me send them.

I'm gonna tell Miranda the truth.

I leaked those files.

I understand how you're feeling.

Uh, Miranda makes a lot of threats.

It doesn't mean that
she can prove anything.

But the second you confess,
there's no going back.

Welcome back. How we feeling, Mama?

Oh, a little anxious,
if I'm being honest.

But you know,

it was nice to actually
get dressed this morning.

Ugh, strong disagree.
Pants are for suckers.

[CHUCKLES] Well, either way,

it is nice to see my people again.

Speaking of, have you seen Doris yet?

Late. She said car trouble
or something.

Multiple traumas incoming.

A group of teens were subway surfing.

- Three were thrown off.
- Subway surfing?

Kids are jumping
on top of subway cars,

filming each other
riding through the city.

- Are you kidding me?
- Mm-mm.

Samara West, 19. BP's 110/73.

Found her unconscious, but
she came to on the ride over.

Was complaining of severe neck pain

and lower extremity paresthesias.

Gave 50 milligrams of
fentanyl for the pain

and also possible wrist fracture.

Okay, we're gonna check you out now.

On my count. Gentle.

One, two, three.

Feels like needles in my legs.

Okay, Samara, I'm gonna
feel the back of your neck.

Keep still, okay?

Okay, if you feel any pain
as I'm pressing, let me know.

Ow! Right there.

Okay, I feel a step off at C67.

Let's get a CTC spine,
CTA neck trauma labs,

and page Dr. Abrams.

Nolan Goodland, 14,
fell off the train car.

Made contact with the third rail.

Sustained severe
electrical burns to the chest.

- Was unconscious at the scene.
- Poor kid.

Make sure his parents are notified.

Let's get a crash cart set up
and get a Foley in him.

Send trauma labs, CK,
and I need an ultrasound.

Ready? One, two, three.

- Nolan?
- Abdomen's distended.

Nolan, can you hear me, son? Nolan.

Okay, blood pressure's dropping.

Start a second IV. Hang a liter of LR.

And where's that ultrasound, Nancy?

- Come on.
- Yep.

Christian, I'm Dr. Frost.

We're gonna take
a look at you, all right?

[TENSE MUSIC]

Okay, he has a pretty big
flail segment on the right.

Still tachy and hypotensive.

Hang 1 and 1.

Nolan! Where is he, Nolan?

It's his younger brother.

Hey, Christian, look at me, all right?

You're gonna have to sit still.

We're just trying to help.
It's all right.

- [COUGHING]
- Oh, towel.

[COUGHING]

Hemopneumothorax on the right
with the flail segment.

The mediastinum is widened.

We're gonna have
to rule out an aortic injury.

Yeah, let's get 2 of Versed

and prep for chest tube
before CT scan.

Need another set of hands here!

- Go. Go. I got it. Go.
- [GROANING]

It's okay, Christian. I got you.

- It's all right, okay?
- All right, take over.

Need a gram of calcium and bicarb.

Charge to 200.

- [DEFIBRILLATOR WHIRRING]
- Charged.

Clear.

[DEFIBRILLATOR THUMPS]



[DEFIBRILLATOR THUMPS]

♪ ♪

So Christian, we contacted your dad.

He's on the way.

But you have what is called
an aortic dissection.

It's a tear in the main
blood vessel from your heart.

Sounds bad.

It's a small tear, which is good.

But sometimes those do get
bigger and require surgery.

S-so what do we do?

Well, we admit you

and monitor you for the next 48 hours.

And then we let Vascular take point.

Where's my brother? How is he?

We were able to restart his heart,

but he is also suffering lacerations

to his spleen and his liver.

He'll be okay?

We are doing everything that
we possibly can, Christian.

Please.

[SOBBING] Just tell me the truth.

If he makes it through
the next few hours,

he will have a chance.

It was my idea.

Saw some other kids doing it online.

I mean, the train didn't seem
like it was moving that fast.

Then he slipped.

He hit the rail
and his body just, like...

just, like, seized up.

- Christian.
- [SOBS]

Stop. Hey, hey, look at me.

Look at me, Christian.

I know it's hard, okay?

Nolan is fighting
and that is a great thing.

But for right now, let's just focus

on getting you fixed up, okay?

Can you do that for me?

Okay.

- Where's he going?
- Ellen, I'm Dr. Ripley.

I, uh, I saw that you vomited blood

and passed out this morning?

Uh, I was at the table one minute,

next, I was on the floor.

But Jaxson called 911, thankfully.

Oh, nice work, Jaxson.

Uh, you mind if I examine you?

- Yeah.
- Okay.

And who's that guy?

Captain Super Broccoli.

Captain Super Broccoli?
Never heard of him.

I made him up.

And told stories about him

hoping Jaxson might
eat something green.

He loved the stories.

No luck on the vegetables.

Very cool.

Say "ah" for me.

Ah.

Okay, uh, we'll need to wait
for a CT to confirm,

but your chest X-ray
shows pneumomediastinum.

I suspect you have
a small tear in your esophagus.

It would explain the blood.

Is that bad?

It's not ideal,
something we can repair

with a minor procedure.

My bigger concern is
what caused the tear.

Have you been vomiting frequently?

Any recent illness?

I've been going through
a custody battle with my ex.

That gives me plenty of indigestion.

[CHUCKLES] But I was fine
today until, you know.

Sorry, uh, it says

you went for your physical
three months ago,

and your weight was 145.

Today, your weight is 185.

Is that accurate?

Unfortunately, yes.

You think that has something
to do with this?

It's hard to tell just yet,
but it is concerning.

I was chalking it up to stress.

Stress can certainly wreak havoc.

Uh, why don't we run some tests,

get some more info,

and, uh, try to get
to the bottom of this?

- Okay.
- Okay.

Looks like
your pain level's gone down.

Yeah, those meds did the trick.

Good.

How are those two boys
that came in with me?

They're being worked on now.

Samara, I'd like to
introduce you to Dr. Abrams.

He's a neurosurgeon.

So your CT shows that

you injured both vertebral arteries,

which provide blood to your brain.

And if we don't get them open,

there's very high risk for stroke.

But the arteries were injured

because your spine was dislocated

along with fractures
to the C6 and C7 vertebrae,

which are currently
pinching your spinal cord.

That's why my legs are tingling?

Most likely.

So can we fix that too?

Yes, but it's complicated.

So repairing the arteries is
of course, our first priority,

but it would require
realigning your spine.

It'll restore blood flow

and it will limit the risk
of the stroke,

but it will put increased
pressure on your spinal cord

and it could result

in permanent paralysis
of your lower extremities.

So you're saying
I won't be able to walk?

Nothing is guaranteed.

You know, I'm not even on TikTok.

I don't subway surf to create
content or to get views.

I do it because that feeling
when you're up there,

it's just like, total escape.

[PENSIVE MUSIC]

I need to be able to move.

To get away, to get out of my head.

I'm not doing anything
that's gonna make me paralyzed.

Wait, are you saying no
to the surgery?

Samara, I want you to understand that

if you don't do the surgery,
you could die.

Could isn't certain, though.

You said it yourself.
Nothing's guaranteed, right?

Mom, you asked me to come here today

to help advise you as an attorney.

- I did.
- Mm-hmm.

Then I think I should tell you

if Doris stays quiet
and you turn down this deal,

it is going to turn into
a legal matter

and their attorneys will
start deposing everyone.

Including Doris.

You think she's gonna stay
quiet through that?

No matter what your intentions
were initially,

the fact of the matter is

you did not do what
they're accusing you of.

Because I'm a coward.

Because you're a good person.

What are you saying, David?

What I'm saying is
there's no magic b*llet.

The only real choices
are taking the deal,

making this all go away,
or letting Doris confess.

If Doris confesses,
they'll fire her, David.

And it'll be damn near impossible

for her to find another job
with this on her record.

Look, I'd love nothing more

than for you to walk off
into the sunset

and spend days
with your new grandchild.

But you keep telling me
how hard it is to watch

from the outside while Miranda
tears down what you built.

[APPREHENSIVE MUSIC]

You take this deal,
you're on the outside forever.


in three months. Wow.

Yeah, plus an esophageal perf.

She's headed to surgery
in a few hours to stent it.

Testing's all looking pretty normal.

Yeah, I ran labs,
a full metabolic panel.

Uh, other than, um,
an electrolyte imbalance

and a slightly elevated A1C, nothing.

But now you're thinking it
might be a psych issue.

Uh, maybe.

Binge eating brought on
by stress or depression.

Apparently, she's going through
a pretty nasty custody battle.

Huh.

Let me have a, uh, quick chat,
see what I can suss out.

- Give me, like, ten minutes?
- Yeah. Thanks, buddy.

Yes. From Gaffney Chicago Med.

I'll hold.

Thank you.

Thanks.

Hey.

Heard your patient is,
uh, refusing surgery.

Yeah, I'm trying to track
down her family. [SIGHS]

Find support, see if
they can change her mind.

The file says that
her mom lives in Decatur,

but I have not been able to reach her.

I feel for her and these kids,

but this whole thing
just feels pointless.

Do we really need to tell young people

not to ride on top of subway cars now?

Don't you remember
what it was like being young?

How invincible you feel?

I mean, God knows I did stupid things.

I will be right back.

[SOFT SUSPENSEFUL MUSIC]

Hey. How's Nolan?

There was too much bleeding
from behind the liver.

He kept going into cardiac arrest.

We tried to revive him.
Tried for 30 minutes.

He's gone.

[SOMBER MUSIC]

♪ ♪

[KNOCK AT DOOR]

Ellen, uh, this is Dr. Charles.

- Hey, Ellen.
- Nice to meet you.

Jaxson, uh, one of our nurses

was cleaning out our lost and found

and stumbled across a few toys.

Thought you'd might
like to check 'em out

while your mom chats
with Dr. Charles here.

Yeah? Okay.

Bye.

Must be bad news
if you had to clear the room.

Nothing too scary.
I'm just a psychiatrist.

That sounds a little scary.

Trust me, I'm harmless.

Um, I just thought, you know,

it'd be easier if we talked alone

'cause Dr. Ripley shared
with me you've been

really going through it with your ex.

[SIGHS]

Jaxson's dad was nonexistent

for the first four years of his life

until a year ago when
he moved back to Chicago

with his new wife
asking for full custody.

Oh, man.

And now I can't stop stuffing my face.

Well, I, for one, certainly
understand the stress eating.

But you know what? I'm just curious.

Is this a new
coping mechanism for you?

Because your medical records
are showing

that your weight's always been pretty

steady, you know, until...
until just recently.

I was thinking about trying
to get on a GLP-1, actually.

Is that something you can prescribe?

We can certainly talk about that.

But first, I really wanna make sure

there's nothing else
going on here, you know?

Because right now,

we really need you at 100%
for Jaxson, right?

Of course.

I can't lose my son.

He is the only thing
that matters to me.

Hey, there she is.

Hey, you made it.

Yeah.

Thanks.

I'm gonna give this to her.

Yeah.

Hey, any updates on Samara?

Checking now.
Any luck reaching her family?

No. I've left,
like, a thousand messages,

but nothing back from Mom.

Well, we got another problem.

The trauma Samara suffered

sheared the soft tissue
from her muscle,

causing the blood to pool
beneath her skin.

Won't be long before that tissue dies

and an infection sets in.

And makes the surgery
she needs impossible to do.

Is there any way to fix it?

Yeah, there might be.

Okay, well, that's great.

But why do you look like
you just ate bad yogurt?

The treatment that
might help Samara is

really gross.

It's really gro...
you're a... you're a surgeon.

Yeah, but... [GROANS]

I gotta think about creatures.

Okay, I'm gonna place this one

- on the right side right here.
- Mm.

Crazy Abrams can
cut open a human brain,

but this creeps him out.

Yeah, well, everybody's
got their things that get them.

Mine's clowns. What about you?

Cargo shorts.

Fair.

Hey, can you feel that, Samara?

Samara?

What?

I asked if you could
feel the one I just placed.

A little, maybe.

Why do we have to do this again?

Because modern medicine
has made strides

in arterial revascularization,

but we have not been able
to beat evolution

when it comes to wound care, so
medieval leeches are the best.

God, don't say leeches.

You know, we wouldn't have to try this

if you did the surgery
to repair your blood vessels.

No, I'm good.

Keep going.

Okay, well, we need
to immobilize her neck

without k*lling the leeches,

so jimmy up a dressing
to keep them in place?

Yep.

[SIGHS]

Why isn't this going through?

Why isn't it going through?

Your phone's on the Escape key.

Don't worry. I won't tell anyone.

You know what?

While I have you, can I get
your signature on something?

Yeah.

Thank you.

Uh, wait. What did I just sign?

We're going halfsies on a timeshare.

Uh, sorry, Dr. Archer.
You're being paged to room 132.

Room 132? I never heard of that.

- What is it?
- Beats me.

Uh, I'm Dr. Archer,

and I was paged
to this room for some reason.

We just checked Christian Goodland

and noticed a pulse discrepancy
in his leg.

Okay. [SIGHS]

Hi, Christian. Um...

what are you doing here?

Looking for him.
He's supposed to be in the ICU.

I'm aware.

- How we doing, Christian?
- Leg's kinda throbbing.

Yeah. Cold leg.

His dissection is getting worse.

Bolson, 2,500 units of heparin.

Start a drip.

We need to fix this dissection
before it gets worse.

Wait, wait, wait. Am I losing my leg?

Uh, Dr. Archer?

And where's the vascular
surgeon that's following him?

We paged her, but she's
in clinics and you're closer.

- Dr. Archer.
- What?

I'm just trying to make sure

Christian isn't
getting too upset here.

Okay.

It's gonna be okay. All right?

Not gonna lose the leg.
We're gonna sort this out.

Just give me big, deep breaths.

Try to slow your
heart rate down, okay?

[SOMBER MUSIC]

[BREATHING DEEPLY]

He has monophasic signals.

All right, let's alert IR
and have them get a room ready.

Whoa, what... what... what...
what does that...

what does that... what does that mean?

It's gonna be okay. All right?

What the hell is this place?

♪ ♪

Could you please explain why
I was paged to a room

I never heard of
to deal with a patient

who had already technically
been admitted to the ICU?

- Is that room 132?
- Yes.

Yeah, that's the overflow room.

The what room?

Well, that's how
we solved your problem

with patients stacking up in the ED.

I created an overflow room
so that we can start

servicing in-patient needs
while awaiting a bed upstairs.

Just felt more practical.

Yeah, except practically,
that's not how it works.

Doctors from other floors

can't get to that room
with any urgency.

And then, practically,
what happens next

is that the ED attending gets paged,

which, as a refresher, is me.

- Mm-hmm. I'm aware.
- Yeah?

So what you've effectively done
is given the ED...

again, specifically, me...

more work to deal with, not less.

I hear you. I do.

But maybe... maybe there's
some way that we can

tweak this setup rather than
just scrap it completely.

Oh, tweak.

You've... you've got a tech and a
floor nurse overseeing 14 beds.

So what I could probably do
is hire you another tech,

maybe even a telemetry nurse?

I'm not trying to add
to staff, you understand?

I just want this damn thing gone.

Okay, Dr. Archer.

I'm trying to work with you here.

You said you had patients stacking up.

I provided a solution

and I don't think it's very productive

of you to come in here
and just whine about it.

Wh... I'm... what?

So what I'm saying is

you need to stop
looking to place blame

and get a little bit more creative

about trying to find a solution
like I was.

You know? You gotta think
outside the box.

Did he suffer? Nolan?

Not in the end. No.

Dr. Tanaka-Reed,
this is Stan Goodland,

Christian and Nolan's dad.

Mr. Goodland,
I'm so sorry for your loss.

How's Christian?

Dr. Frost said you were
taking him into surgery.

They're prepping the room now.

Is he gonna make it?

We're gonna place a stent
in the aorta to fix the tear.

But there is no reason to
think Christian won't do well.

Though when the injury
is that close to the heart,

there are always risks.

I... I wanna see him.

Of course.

But that is a little complicated.

It's complicated?

His dissection has gotten worse.

So it is imperative that
we keep his heart rate low,

below 60,
until we get him into surgery.

So we're doing everything
we can to keep him calm.

Which is why we have not
told him yet about Nolan.

And if you go in there
and tell him what happened,

the emotion could
cause his heart rate to spike.

It's just that, um...

[SOMBER MUSIC]

I already lost one son today.

You know?

If I were to lose another one

without at least seeing him?

And look, I won't say anything

except that I...

I love you.

And then I'll go.

But I have to see his face.

I know it's scary, Jaxson,

but, um, the procedure
is only a minor one.

Your mom's gonna be okay.

But she tries very hard.

Well, she's...
she's lucky to have you.

Pretty amazing you called for help.

Not a lot of five-year-olds
would know to do that so fast.

I did what she taught me.

What do you mean she taught you?

[HEART MONITOR BEEPING]

How you feeling, Christian?

Tired.

Well, we're gonna fix you up.

But before we head up to surgery,

there is someone who
would like to see you.

Dad.

Hey, kiddo.

I, uh, only came here for a minute.

I know they need to get you
to surgery,

but I, uh...

I...

I just wanted to say that...

I love you so much.

And, uh, I'll, uh...

I'll be here when you get out.

Uh, hey, Dad?

How's Nolan?

Nolan is fine.

He's resting in the PICU.

Okay, um, well...

Well, when you see him,
can you just...

can you tell him I'm... I'm sorry?

What?

Just... just tell him I'm sorry.

I didn't mean to get him
into this mess.

♪ ♪

Okay.

And tell him I'll drive him
wherever he wants to go

when we get out of here.

♪ ♪

You okay, Dad?

- Uh-huh.
- [MONITOR BEEPING RAPIDLY]

We should get him to IR.

- Yeah.
- Nurse?

Nolan's okay, right?

Nolan is, um...

He's... he's fine.

What is it?

He's, um...

Dad, what is it?

Run ahead and have
some labetalol ready, okay?

- No.
- When we get there.

Dad, what is it?

Okay.

[SOBS] Dad, what is it?

Slow, deep breaths for me, Christian.

It's okay.

[TENSE MUSIC]

Hey, uh,

just had an interesting talk
with Ellen's son, Jaxson.

- Yeah?
- Yeah.

It turns out he's not
just a precocious kid.

Ellen prepped him on how to call 911.

Like really prepped him as if
she knew this might happen.

- Well, that's interesting.
- Yeah.

Look, I...

I don't wanna jump
to any conclusion, but it...

it kind of reminds me of my mom.

How so?

Well, with her drug problem,

she knew she might not
always keep it together,

so she taught me to do things
at a young age.

You know, make dinner when
I was 6, drive when I was 13.

She also taught me to call 911.

She said it was in case of
an accident, but really...

It was in case she OD'd.

Well, do you think that's what
we're looking at here?

- [SIGHS]
- Substance abuse?

Well, like I said, I...

I don't wanna jump to any conclusions.

Excessive drinking could
cause the esophageal tear,

but... but not the weight gain.

Not on... not on that scale, anyway.

Well, maybe she's substituting

one addiction for another?

Oh, man. The GLP-1.

What?

I think I might know
what's going on here.

Hey, what's up with you today?

You seem distracted or something.

Is everything okay at home?

Yeah. Yeah.

I just never realized
how much I love all of this.

Okay, you are really
freaking me out now.

- What?
- Sorry, I...

I'm just feeling a little
sentimental, that's all.

Okay.

- Dr. Asher.
- Yeah?

This is Samara's mom, Rhonda West.

Mrs. West, I am so glad you're here.

Samara's stable now,
though she sustained damage

to her spine
and the blood vessels in her

- neck...
- Wait. So she's alive?

Yes, I am...

I am so sorry if my messages
weren't clear.

Samara is alive and she is awake.

When you said
she was in an accident, I...

I was sure you were calling to tell me

she finally managed to k*ll herself.

Thankfully, that is not the case,

though she does need surgery
to prevent stroke

and currently, Samara is refusing it.

I thought that you could talk to her.

I can't help with that.

I'm sorry? What do you mean?

I tried for years to help Samara.

When she OD'd, when she broke the law,

when she hurt us
in every imaginable way.

I love my daughter and I always will.

But her decisions are her own now.

[SOMBER MUSIC]

So sounds like everything
went off without a hitch.

Thank goodness.

Now we just gotta figure out

what to do about
your alcohol consumption.

- I'm not an alcoholic.
- No.

I'm not here to judge you
or shame you.

I'm wondering if you are
eating to gain weight

so that you can qualify for a GLP-1.

[SCOFFS SOFTLY] That doesn't
even make any sense.

Look, everybody
knows that these drugs,

they help with diabetes, right?

They promote weight loss.

But also, you can't
hit your news feed these days

without reading another story

about some exciting new off-label use,

like for instance, how they
curb compulsive behavior,

alcohol, drug abuse,

addictions that could cause somebody

to lose custody of their child.

I always kept it a secret.

But I've struggled
with drinking since I was 16.

Over time, it got worse
and I couldn't control it.

But then I got pregnant.

So I started going to meetings,
taking care of myself.

Stupidly, I thought
I'd beat it for good.

Then your husband came back to town

and filed for full custody of Jaxson?

And then Jaxson went
with his dad one weekend.

I went on a 48-hour bender.

And I realized that

unless I... I changed something,
I was gonna lose the battle,

so I...

I went online
for any remedy I could find.

I saw GLP-1s helped some people,

but all my money was
going to my lawyer.

Right, so you thought
if you gained enough weight

that your insurance would cover it.

[SIGHS] I know it's insane.

Oh, come on.

When it comes to our kids,
we will do absolutely anything.

[SIGHS]

So... so what now?

Well, I'm actually
gonna prescribe you a GLP-1

because your A1C is dangerously high.

And it's very important
that we bring it down

so you don't become a diabetic.

Okay?

Now, if it happens to help you
in other ways...

Oh, my God. Thank... thank you.

Ellen, listen to me.
This is not a magic b*llet.

No, it... what? What do you mean?

Your five-year-old
terrified son called 911

'cause he walked in the kitchen

and found his mom
under the kitchen table

next to a pool of her own vomit
and blood.

[CRYING]

Something like that
happens again, he's gone.

You gotta face this.

It's the only chance you have
of keeping your son.

[SOFT DRAMATIC MUSIC]

Okay. Okay.

Miranda?

Sharon.

I thought our meeting
wasn't for another hour.

Well, I finally made a decision

and didn't wanna wait any longer.

Fair enough. Well?

Per your offer,

I'm resigning my position
as executive director

effective immediately.

I'm taking the deal.

♪ ♪

Looks like the leeches did the trick.

Hell, yeah.

So now what?

Well, you still have limited
blood flow to your brain,

which means that we'll be
pushing your blood pressure

to make up for it.

Hopefully if you keep your collar on,

some of your fractures will heal,

but they may also deteriorate

and you will be at
constant risk for a stroke,

either of which could prove fatal.

But I'll walk.

After some physical therapy
and rehab, yes.

But you will be a time b*mb.

[HEART MONITOR BEEPING]

I was finally able
to connect with your mom.

Let me guess.
She doesn't wanna see me?

Look, Samara, when I was younger,

I did a lot of things
that pushed people away,

things I am not proud of.

[SIGHS]

I know what it's like
to live for the moment

because you believe that
you don't have a future.

The thing is

the future doesn't care
what you believe.

It comes anyway.

Now, I'm not asking you to

suddenly believe that things
will improve in your life.

[SOFT DRAMATIC MUSIC]

I'm just asking for you
to allow for the possibility

that they might.

You know, to consider the idea
that maybe someday,

you won't feel this way.

It takes a lot of courage
to ride on top of a train.

A lot of courage to turn down
a surgery like this.

Sometimes the bravest thing
that we can do

is choose to survive.

You are making the choice
to die right now.

Is that really what you want?

If I die, no one will notice.

No one will care.

Not even my mom.

That's not true.

I care.

I care if you live or die.

♪ ♪

Okay.

I'll get the surgery.

[SOMBER MUSIC]

♪ ♪

- How's Christian?
- He's just fine.

The surgery went off without a hitch.

We placed the stent
and restored flow to his leg.

He'll need physical therapy
for a couple days,

but he should make a full recovery.

I was so scared that what
I said with...

with his heart that...

He's okay. It didn't hurt him.

And you can see him in a couple hours

when he gets out of recovery.

Oh, my God.

Thank you, thank you. [SNIFFLES]

Of course.

And I... I have to let
the rest of the family know.

[SNIFFLES] Thank you.

[SOFT MUSIC]

♪ ♪

I don't know why
anyone becomes a parent.

[BABBLING]

Hi.

- Oh, my God.
- She did great, Mom.

We did some tummy time.
We sang some songs.

Mabel's an independent girl now.

I'll go get her bag for you.

There's nothing that you could ever do

that would make me give up on you.

[FUSSES]

Hi.

[KNOCK AT DOOR]

[SOMBER MUSIC]

♪ ♪

How could you take the deal?

- Come in.
- [SIGHS]

Dr. Archer.

Mallory.

Uh, I'm actually glad I ran into you.

I, uh... I guess I owe you
an apology for earlier.

- Oh, really?
- Yeah. I was a bit of an a*s.

- And, uh...
- Oh.

Had time to reflect,

and I... I think I could
make this new system work.

I told you I didn't want this.

I wasn't gonna let you

just throw away
everything you've ever done.

I know that, Doris,
but you're too good of a nurse.

[GROANS SOFTLY]

You're too good of a person
to let this define you,

to let my drama
derail your whole life.

Plus this isn't what it looks like.

What do you mean?

Well, how did you solve your issues?

Just did what you said.
Thought outside the box.

There's no non-compete
in the deal I agreed to,

so I won't be
executive director anymore,

but that doesn't mean
I'm done with Gaffney.

I was speaking with a charge
nurse who I used to work with

who was nearing the end of her career,

and, uh, she said she'd
be willing to take this job

at the salary of a telemetry nurse.

I don't think the changes
that Miranda's making

are just about budget cuts.

I think there's a bigger plan here,

but I can't fight it from the outside.

I need access.

Well, I look forward to meeting her.

I promise you this is not over.

[DRAMATIC MUSIC]

[DRAMATIC MUSIC]

♪ ♪

[WOLF HOWLS]