08x18 - I Could See the Writing on the Wall

[bunniefuu]

Told him I needed dialysis.

Left it pretty vague.

It's a good thing you told him, though.

Not just for his sake.

Hey, Grace. Over here.

Word is she's single.

Maybe I could buy you a cup of coffee.

What about a drink instead?

We can help a lot more people

with Jack's vision

and money in our corner.

Dayton says from now on, 2.0

is for paying customers only.

When Jack wants something, he

can be like a dog after a bone.

Yeah, well, that has

been my impression as well.

[LAUGHTER]

Ooh.

Who are the flowers from?

Guess.

Oh, your not-so-secret admirer,

Dr. George Thomas.

Oh, orchids.

- The man's refined.

- No.

The man is persistent.

[LAUGHS] Come on.

Tell me you're not

a little bit flattered.

Well, it's a bit much, don't you think?

I think George has a crush.

Well, I think he needs to take a hint.

He's asked me out for drinks again.

Why won't you go?

He's on the board, Maggie.

You work here every day.

Where else you supposed

to meet somebody?

Well, I just think it's not a good idea

- to mix business with pleasure.

- Fine.

Sure, but when has that

ever worked for anyone?

I mean, take the ED, for example.

You've got Ethan and April.

You've got Will and Natalie.

You've got Will and Hannah.

- You got Will and

- Okay, all right.

Spare me the update

on Dr. Halstead's love life.

- There could be

- Go to work.

- Goodwin and

- Bye.

[LAUGHS] [DOOR SHUTS]

I'm surprised you've got the guts

to show your face this morning,

305 to 146.

Glad to see last night's win

didn't go to your head.

Did you memorize our Scrabble scores?

Do you think it's some kind of record?

Largest spread ever recorded.

Well, someone's extra snarky

this morning.

- What's in that thermos?

- Oh.

Well, there were four sh*ts of espresso.

- It's empty now.

- Whoa. Where's the fire?

My pilot program launches today.

That's right. I totally

forgot about the big day.

The ED gets a technological facelift.

New software, diagnostic tools,

system upgrades.

Be honest. People are not gonna

like all the changes, right?

- They'll be resistant.

- Of course they will be.

At first, but once

they give it a sh*t

They're gonna see the tech is

gonna help them with their work

and work better and work

for them and not against them.

And you can tell I've had

four sh*ts of espresso

- on an empty stomach.

- Yes.

- Let's get you a muffin.

- Yes, let's.

A blueberry muffin, chai latte.

Okay. Yeah, sure.

- Grace?

- Mm-hmm.

- Grace.

- Mm-hmm. Mm-hmm, yeah.

[BOTH INHALE DEEPLY, EXHALE]

Thanks. Come here.

Hey, look.

You've been helping me do my

job better since you got here.

Today's gonna go great.

Thank you.

I

couldn't help it.

No need to help it.

- That was a close one.

- Thank you so much.

- I appreciate it.

- Have a good day.

Lifesaver.

Hey, got your own

personal valet now, hotshot?

Your son is a lifesaver.

Apparently, my car

was about to be towed,

and he offered to move it for me.

That's the least he could do.

What do you mean?

You've take him under your wing.

You set him up with a sponsor.

You sent that valet gig his way.

You've been a really positive influence.

And now that I've laid it on thick,

can I ask a favor?

Should've seen that coming.

I need an attending

to cover for me next week

at a department meeting,

and you're the only one

around here I trust.

What's going on?

So I'm being evaluated

for the transplant list.

Dr. Cameron feels it's time

seeing as I'm officially

in end stage renal disease.

Dean, I'm sorry.

And the kicker is,

even if I get on the list,

it might not be an easy match.

I've got this high cPRA.

What about Sean?

Isn't he getting tested?

Mm, no, that's not an option.

But he would be

your best possible donor match.

Yeah, Sean needs to focus

on his own health now, not mine.

Sean's coming up

on one year of being sober.

He's in a really good place.

Donating could be a really

positive experience for him.

I'm not taking my son's kidney, Hannah.

- Dean

- Incoming!

- Dr. Archer, you're with me.

- Yeah.

- I'm right there.

- It's your son.

He should be given

the opportunity to help

if he wants to.

I don't mean to be patronizing,

but you'll get it when you have a kid.

Going to T3.

Kurt Leger. 36-year-old male.

Was ejected from his wheelchair.

Fell down a flight of stairs.

Vitals are stable.

My wheel got caught in an uneven tile.

And I went flying.

I'm okay, though, really.

Just knocked the wind out of me.

How long you been in a wheelchair?

- Huh?

- How long

have you been in a wheelchair?

Told us he's got

a T-10 spinal cord injury.

Got bucked off a horse in high school.

Is this a complete injury, Kurt,

or is this paralysis

from the waist down?

- Waist down, yeah.

- Okay.

On my count. One, two, three.

- Oh, God.

- Okay.

Okay.

Okay, breath sounds clear bilaterally.

Okay. Let's take this board out.

Kurt, we're gonna roll you

over for just a moment, okay?

Okay.

All right.

[GROANING]

All right, let's hold off

on clearing C-spine just yet.

Give him 100 of fentanyl.

That'll help take the edge off.

Okay. And we'll be back shortly.

[GROANING]

You were pressing way below T-10.

How could he feel that?

Well, no clue. Could be referred pain.

We'll know more once we see imaging.

Has trauma ever reversed

permanent paralysis?

What, from a complete

spinal cord injury? No.

No, never. No.

[TENSE MUSIC]

♪

Hello.

- Good morning.

- Oh.

- Hey there.

- Hi.

Please sit.

- Sit.

- Okay.

I have news. Big news.

Oh, how exciting.

My coworker, Vanna

She's moving to Florida

to live with her daughter.

Yeah, you remember.

- Yeah.

- Good.

Well, I might buy her house.

Wow.

- Yeah.

- Okay.

It is small, but it's just me.

So it will be perfect.

- And, I mean, that's great.

- Yeah.

And you can afford it,

I mean, obviously.

Well, I will have to use

all of my savings

for the downpayment

and take out a mortgage,

but I can do it.

And Vanna is offering it to me

off market

for a very fair price.

Well, that's so exciting.

You know it's a fair price because

you looked at some comps

in the neighborhood?

- Comps?

- Comparable properties.

Comps, yes. Well, no.

- I haven't yet, but I will.

- No, not yet.

- Yeah.

- And I trust Vanna.

Yeah.

You don't think this is a good idea.

Oh, gosh, I don't mean

to give that impression at all.

- I don't.

- Oh, okay.

I just think, you know,

you have to be

I don't know, always when you

make a big move like this,

you gotta ask the question,

is now the best time to buy?

You know, and if you're

gonna wipe out your savings

for the downpayment, I mean,

maintenance issues will come along.

You might want to do a renovation.

You just gotta make sure

Hey, look, I really

I don't mean to be a downer

about this at all.

- I really don't.

- No, it's okay.

There's a lot to think about.

- I'm still thinking about it.

- Okay.

You want to go somewhere

and talk about it some more?

Get a cup of coffee or something?

I can't. I have errands to run.

And I will see you later, Daniel.

Okay.

Hey, congrats.

Congrats.

The new system automatically

updates room availability

and displays room assignments

on all the monitors.

Maggie, now you won't

have someone asking you

every two minutes, "Where am I going?"

No, that'll still happen.

Okay, everybody.

Let's get back to work.

Thank you very much.

No, no, it won't happen because now

they can just look at the monitors

I understand that they can,

but will they?

These folks are creatures of habit.

Well, it'll become habit over time.

Okay, well tell me more

about these lights.

Are they part of a room triage system?

So no, these are actually noise sensors.

They monitor volume levels

throughout the ED.

When it gets too loud,

they start flashing.

What happens when they do?

Noise police just pops out? Oh.

Well, no.

Hopefully it's a gentle reminder

to anyone in the vicinity

to lower their voice.

- Yeah, I'm

- Research shows

that excessive noise

in the emergency room

increases patients' stress and anxiety,

raises their cortisol levels.

Well, I'm for the reminder to the staff

that they must keep unnecessary

noise at a minimum.

I mean, it's what I do every day.

Which you shouldn't have to.

You got enough on your plate, Maggie.

Adults should be able to self-monitor

with a simple visual cue, right?

I guess, Grace. We'll see.

[KNOCKS AT DOOR]

- Hello, Ms. Palmer.

- It's Alicia.

Hi, Alicia. I'm Dr. Halstead.

I see you've been experiencing

frequent headaches lately.

Yeah, two to three a week

for the last month.

The one I'm currently having

is the longest so far.

Going on 29 hours.

This should all be in my chart.

I gave the nurse a record of my att*cks.

Yes, I'm seeing that here.

And a list of conditions and diseases

that include my symptoms.

I'm obviously not a doctor.

I'm not trying

to insult your intelligence.

No offense taken.

I just read that people get misdiagnosed

in the emergency room every year.

Well, I can tell you

a misdiagnosis tends to happen

when a patient's presentation

is atypical.

Yes, that is what the article said.

But here at Med,

we've actually got a new

Well, really new, like, as of today

AI-based diagnostic tool

that helps us make sure

we don't miss anything.

There's a lot more to it,

but the gist is

it creates a differential

for the doctor to compare

against their own.

Differential. That's the list of things

that could be wrong with me, right?

So it's like having a colleague

double-check your work.

A colleague that scans

every medical database

and journal in an instant.

Okay, yeah.

Let's definitely use the robot.

Well, because we're

in the pilot phase still,

I'm gonna need you

to sign a consent form.

I'll grab it and be right back.

- Thanks.

- All right.

I'm sorry I didn't put on the gown.

I know I'm supposed to,

but it would take me forever

at the moment.

I'll cut you some slack.

I'm also kind of hoping

this won't take long.

Ryan has had perfect attendance

all year.

Oh, well as an alumna

of the perfect attendance club,

I will do my best

to get you both out the door.

So, Sarah, you got dizzy

driving to school today?

For, like, a few seconds.

Yeah, I pulled over

to study myself for a moment.

And then I felt fine.

But my worrywart over here

begged me to turn around and come here.

She gets dizzy a lot.

Sometimes she has trouble

catching her breath.

- Hmm.

- I have to park on the street.

I get a little winded sometimes

walking from our apartment to the car.

Every day?

I tried to explain to Ryan it's normal.

Well, your ankles are swollen.

And your breathing still seems

a bit labored, even at rest.

- [PHONE CHIMES]

- Yeah, I had swollen ankles

and I was panting all the time

when I was this big with Ryan too.

Just ask my ex.

Oh, wait. He's nowhere to be found.

Well, these all could be symptoms

of third trimester pregnancy, I agree,

but I'd still like to do

a full workup just to be safe.

I've got an appointment

with by OB on Monday.

I'd really prefer if we

could just check you out now.

Mom, look at this text

you got from Ms. Goto.

It says as long as I get back

before lunch is over,

it won't mess up my record.

So let the doctor

run tests and stuff, please.

Okay, okay.

Yes, run all the tests and stuff.

Hey, I'm just fine.

We'll make sure your baby

sister is feeling good, okay?

Dr. Archer, Kurt Leger's scans are up.

Okay.

Yeah, unstable burst fracture

at T-12 from the fall today.

What?

Well, it isn't a medical miracle

he's got feeling below T-10.

What do you mean?

Well, no evidence of

prior trauma at the vertebrae.

Yeah, this guy's not paralyzed.

Kurt.

Wanted to review your imaging.

To start with,

you don't have an injury at T-10.

I'm guessing this isn't news to you.

Do I need to repeat that?

I didn't think the scans would

What, blow your cover?

Okay, but what's really pressing

I'm not trying

to get disability benefits

or better parking.

- That's not why.

- Sure, sure.

- Of course, yeah.

- I don't want you to think

Hey, it really doesn't matter

what I think.

What does matter: your tumble today

caused an unstable burst fracture

in your T-12 vertebrae,

and that's gonna require surgery to fix.

And without surgery?

There really is not another option.

If your fracture was stable,

I would say you can try a brace.

No, no, I'm not asking

about other options.

If I don't treat this, what will happen?

You're gonna end up

actually needing a wheelchair.

You're gonna be looking at weeks in bed.

Chronic back pain.

Weakness in one or both of your legs.

Numbness.

Even paralysis.

I don't want the surgery.

So I really appreciate you giving

me access to your psychiatric records.

- It's very helpful.

- Of course.

How about I just, you know, give you

my understanding of what I read,

and then you let me know

if I missed anything.

Does that sound okay?

All right, so you were diagnosed

with body integrity identity

disorder eight years ago

but experienced symptoms

from early childhood.

Since I was at least five, yeah.

And for you, BIID presents itself

in the form of a very strong

desire to be paralyzed?

It's all I think about.

It dominates every aspect of my life.

But it seems like

a wheelchair gave you some relief.

Some, but I can still feel my legs.

And for reasons I can't explain,

that's an extremely distressing feeling.

I've had therapists tell me it's due

to repressed childhood trauma,

neurologists who think it's

a glitch in my cerebral cortex.

A psychic told me

it was linked to a past life.

Right.

Yeah, I mean,

I can see that you've tried

a number of different

therapeutic approaches here

You know, kind of behavioral therapy,

antidepressants, muscle relaxants.

Even hypnosis.

Nothing's worked.

I wish I had something

special in my toolkit for you,

but, I mean, frankly,

these are all the therapies

I would recommend myself.

Must be very frustrating for you.

Yeah.

And honestly,

today's the most hopeful I've

felt in a really long time.

I want the tests.

Okay.

- Hey, Grace, you got a sec?

- Hey.

So I don't know if there's,

like, a formal suggestion box

during this pilot phase.

I'm the suggestion box. What's up?

New software.

It included giant cell arteritis

in my patient's differential.

Your patient with the headaches.

- Exactly.

- GCA's pretty rare.

It presents in 5 out of

every 10,000 people, I think.

And testing for it requires

a number of expensive labs.

The patient's insurance

is gonna cover it,

but I don't like

ordering unnecessary tests.

I prefer to rule out horses

before chasing zebras.

Of course, but you

don't have to order the labs.

A doctor can override any

suggestion on the differential.

Right, but before

the doctor can do that,

the differential's

automatically uploaded

to the patient's chart.

Which the patient can view in real time

by logging in to the online portal.

Which my patient did.

And now, she's insisting

I order all these unnecessary labs.

So your suggestion is

to lose a*t*matic upload,

which we can't because when the

patient signs the consent form,

they're guaranteed access

to the full results.

Ah, I see.

Well, you know what?

Better safe than sorry.

- Right?

- Yeah.

Absolutely, and it'll

ease the patient's mind too.

Well, let me know how it turns out.

Hello, Baylin. Remember me, Maggie?

Baylin drove himself to the ED

because he feels like

his heart is pounding.

I'm sorry to hear that.

You want to take a walk with me, okay?

We're going right down here to three.

Thanks, Leah.

[PANTING] The CIA is following me.

I think I saw one of them

in the waiting area.

But I can't be sure.

He's always changing his appearance.

All right, I won't let anyone come

into your room without your permission.

Trini here

is gonna help you get situated.

Hi, Baylin.

Why don't you take a seat on the bed?

I'll grab a gown.

- Trini.

- Yeah?

Baylin's a frequent flier

with schizophrenia

with a complex PTSD,

and psych's backed up.

Got it.

Do you mind keeping him

company for a bit?

- Not at all.

- Thank you.

Hi.

Hi, Sarah. This is Dr. Marcel.

- Hi.

- Hey, Sarah.

Um, I see surgery

on your scrubs, Dr. Marcel,

and it's making me nervous.

Well, I tend to have

that effect on people.

Well, Sarah,

before we go over your results,

we were gonna see if Ryan here

wanted to go to the rec room.

There's all kinds of video

games and snacks down there.

Yeah, that's a great idea.

Why don't you check it out, kiddo?

No, I'm staying with you.

Ryan, this is a conversation

between grown-ups.

I'll be quiet. I promise.

It's just us two.

There's no keeping anything

from him anyway.

Go ahead.

Okay, so I asked Dr. Marcel to consult

because your echocardiogram

revealed you have a condition

called peripartum cardiomyopathy,

or PPCM.

It's often missed,

because as you experienced,

it mimics the symptoms of pregnancy.

So, Ryan, it's really good that

you brought your mom in today.

Great job, buddy.

That's heart disease, isn't it?

It is. Yours is a very rare form

that can occur at the end of pregnancy

or shortly after giving birth.

Now, I reviewed your echo

with Dr. Asher,

and we can treat you with medicine.

Oh, thank goodness.

We will have to admit you overnight.

Wait. To the hospital?

We'll start you on medications

to help your heart function better

and get rid of any fluid

that's causing discomfort.

If I'm just taking medication,

why can't I do that at home?

Well, it's recommended

that you stay in the hospital

for monitoring

and so you can rest,

at least until

the acute symptoms subside.

I can't.

I don't have anyone

to watch Ryan, and

I really can't afford

a hospital stay right now.

I'm saving up to send Ryan

to private school next year.

Speaking of, kiddo,

we gotta get you to school.

Lunch period is gonna be over soon.

Mom, I don't care.

What do you mean you don't care?

This kid has perfect attendance.

And if he keeps it up,

he is gonna get an award

at the end of the year.

Stop it, Mom! I don't care

about the stupid award!

Hey, you don't speak to me like that.

Just get me the prescription

so I can leave.

I really can't recommend that.

I understand.

Please get me the prescriptions.

I know we've had

disagreements in the past

around this topic,

but this is a no-brainer.

This guy wants to be paralyzed.

How can he have decisional capacity?

Well, because like a vast

majority of people with BIID,

he's aware and oriented, right?

He understands the risks of the surgery

as well as the alternatives.

- You know, he's of sound mind.

- Sound mind?

What about the fact that he

flung himself down the stairs?

No evidence

that the fall was intentional.

Come on, man. How could there not be?

Well, according to the paramedics,

there were several witnesses

who confirmed it was an accident.

Not to mention,

no history of self-harm

or reckless behavior.

Actually was able

to get ahold of his shrink

who assured me he never even considered

trying to paralyze himself.

Well, maybe he just never discussed it.

- Dean.

- Yeah?

Even if the fall were intentional,

we still can't force a surgery on him.

No, but a court order could.

But we don't have the grounds

to petition a judge, right?

Because he competent.

I don't like it either, okay?

But he has the right

to refuse the surgery.

Okay, all right.

And once again,

you're keeping my patients

from getting the care they need.

Hey, so what gives?

What are you talking about?

You didn't see

this impromptu board meeting

added to your calendar?

I mean, do you have any idea

what this is about?

I didn't even know it was happening.

Okay, well, it's an impromptu meeting

with the entire board,

plus C-suite, okay?

I mean, that can't be good.

Look, I don't like

being blindsided either,

but don't get all fatalistic.

Yeah, well,

when I talked to Jack about it,

he wouldn't share any details,

and he told me not to worry.

That makes me worry.

Well, you're in fairly regular contact

with his lawyers, aren't you?

Well, see if he has any

significant filings in motion,

and I'll put a call out to George.

Maybe he has some intel.

George?

Yeah, Dr. Thomas,

our newest board member.

Oh, yeah, I didn't realize

that you and George

were getting so chummy.

I'll go find some other

business to stick my nose into.

[DISTANT CHATTER] [MACHINERY BEEPING]

Red light.

[WHIMPERS]

Red light! The CIA's found me!

The signals are moving!

They're gonna be here any minute.

- Let's get back in bed, okay?

- Oh, no.

They flash the red lights

when they got you cornered like a rat.

That's their signal to move in!

Maggie, I could use a hand.

- No, no, no, no.

- Baylin.

Baylin, I need you to calm down.

Breathe. Breathe. I need you to breathe.

These light,

I'm turning them off right now.

- I'm turning them off.

- Yeah, I'm sorry!

- I have to go!

- Baylin.

- Baylin. Baylin.

- They're gonna k*ll me!

Security, stop him

from leaving right now.

Page Dr. Charles.

Let me go! Let me go!

[SOBBING]

I gotta go, please.

Looks like our old buddy, Baylin,

went off his meds a couple weeks ago.

Good news: he's agreed

to check into the psych ward

for a couple of days

until he gets back on regimen.

Great.

So these are what set him off?

And why were they installed again?

To make patients more comfortable.

The genius of Jack Dayton.

They got to go.

Mm-hmm.

Maggie, I heard what happened.

So you'll understand

why I want the lights removed.

Red was a poor color choice.

I'll reprogram the lights to

something more neutral tonight.

I want them gone, please, Grace.

Not reprogrammed. Just gone.

You agreed that monitoring

noise levels in the ED

is important for patient care.

And I do a damn good job of it.

I'm not suggesting that you're not.

I don't need any assistance.

[KNOCKS AT DOOR]

So good news.

All your labs came back normal.

Your ESR was mildly elevated,

but that's nothing

to be concerned about.

What is ESR? What does it test for?

Erythrocyte sedimentation rate.

It measures inflammatory

activity in the body.

- And mine's elevated?

- Mildly.

And it can be elevated

for a number of reasons.

I mean, something like

stubbing your toe will do it.

What if you have What is it called

- Giant cell

- Arteritis.

Right. Would your ESR be elevated then?

Yes, but much higher than yours.

How much higher?

Off the top of my head, I believe,

typically 50 or above.

- And mine was 31.

- Correct.

And you never see GCA in

a patient with an ESR below 50?

There have been cases, similar ones,

but those patients all had symptoms

of the condition you do not have.

Uh, it's far more likely

you have a headache disorder.

I suspect migraines

or cluster headaches.

I'd like to refer you to a specialist

Whoa, your system says here,

if it is GCA,

it should be treated

right away to prevent

vision loss or a stroke?

It could be weeks

before I see a specialist.

Alicia, the gold standard

for diagnosing GCA

is a temporal artery biopsy.

Neurosurgeon makes an incision

above your temple

and removes a piece

of your blood vessel.

A surgeon?

Yes, we're talking

about an actual procedure here.

But I'd be out for the whole thing.

They put me to sleep, right?

No, it's only used with light sedation

under local anesthetic.

You'd be awake the whole time.

Look, I know headaches

are extremely frustrating

and you want answers, but let's start

with giving you some relief.

I'm gonna put you on triptan.

It's a class of drug used

I'm not gonna feel any relief

until I know definitively

this isn't GCA.

Alicia, it's just you have

so few of the symptoms

You said misdiagnoses happen

when a patient's presentation

is atypical.

I want the biopsy.

Sarah, I really wish

you'd reconsider staying.

Just let me get him to school.

If I have another spell,

I'll come right back.

Oh! [WATER BREAKS]

Wait. Did my water just break?

Let me check.

Yes, it did. Okay, it is time.

- What? But it's so early.

- You're 38 weeks.

Yeah. Ryan was two weeks late.

Every baby comes on their own timeline.

Let's get you up to labor and delivery.

Wait. What about Ryan?

My sister's in Michigan.

It'll take her six hours to get here.

- Mom, I want to stay with you.

- No, you don't.

A delivery room is no place

for an 11-year-old boy.

- You'll be scarred for life.

- If it's okay with Ryan,

I don't mind hanging with him

here at the hospital.

I don't have anywhere to be.

No. No, I can't ask you to do that.

You didn't. I offered.

- Thank you.

- Yeah.

Hey, you listen to Dr. Marcel, okay?

- Okay, ready?

- Yeah.

All right, bud.

Bye.

Come on.

Dr. Archer, hi.

I know it's not my place

But you are giving something up

that you cannot get back.

I understand that.

And if you change your mind

down the road

I'm not gonna change my mind.

Hmm.

When you lose control of your

bladder for the first time,

you'll feel differently.

Not to be disrespectful,

but I went over all of this

with Dr. Charles,

and he was satisfied.

Because you told him what

you knew he needed to hear.

- Excuse me?

- Oh.

I think you knew exactly

what you were doing today.

Dr. Archer,

can I get a word, please?

You think I don't know when I'm

getting played by a patient?

It wasn't a comment on your skill.

Dean, what are you thinking, man?

I need to remind you of all

people that bullying a patient

into a procedure

might get you in real trouble?

Somebody needed

to talk some sense into this

All right, this is

an unprecedented situation.

- No, it's not.

- It absolutely is.

Maybe some more opinions in the mix.

Oh, you want to get another

psychiatrist to weigh in?

- I think it'd be wise.

- Great idea.

It would cover ourselves legally.

Whoa. You're getting loud, Doctors.

Dr. Kwon's on call.

Say hi for me.

All right, lidocaine and

a gram of cefazolin, please.

Thank you.

What's that for again?

It's an antibiotic to prevent

infection post-procedure.

Scalpel. All right, Alicia.

You're gonna feel a little pressure

as I make my incision, okay?

Just breathe.

- How you doing, Alicia?

- Mm.

Feels a little weird, but I'm okay.

All right. Not too much longer, Alicia.

Almost to the vessel.

You're doing great.

Yeah, biopsy's nearly complete.

Dr. Halstead, I

I can't swallow.

Is this from the anesthesia?

No, it wouldn't affect your airway.

Maybe you're just

feeling a little nervous.

- Take a deep breath.

- [WHEEZES]

I can't. My throat is closing in.

- [MACHINERY BEEPING RAPIDLY]

- Sats at 86%.

Epi one milligram IV. 125 solumedrol.

I can't I can't

Alicia, you're having an

allergic reaction to something.

There were no indications

in her chart, right?

None, and she didn't

mention any allergies.

[WHEEZING]

I need you to keep that on for me.

Where's that epi?

It's right here.

Okay, Alicia, hang on.

You're gonna be okay.

You're gonna be okay.

- Hey.

- Hey, I got your text.

- Sarah's baby is breech?

- Mm?

Just scanned her a few minutes ago.

If it were up to me, we'd

proceed with a vaginal delivery

and use pipers to pull the head out.

But let me guess,

Sarah wants to do a C-section

because it's safer for the baby?

But far riskier for Sarah, as you know,

given her heart condition.

I hated to pull you out of the ED,

but I could really use

an extra set of hands in there.

Yeah, of course, I'll

scrub and meet you in the OR.

Great.

I shouldn't have

talked to her like that.

Well, the thing about moms is

they have this funny way of

knowing what's in our hearts,

even when we don't say it

or if we say something we don't mean.

They know better.

Dr. Marcel,

do you think I stress my mom out?

I mean, she's always

doing everything for me.

Maybe that's why she's sick.

No way.

Look, Ryan,

there's not a lot of stuff we can say

with complete certainty in medicine,

but this I can say

with total confidence:

you did nothing

to cause your mom's condition.

Hey, you want to get something

from the gift shop there?

For your mom and baby sister?

My mom would like it

if I wrote her a card

telling her I'm sorry.

Okay, then let's go.

Come on.

So turns out

you're allergic to cefazolin.

It's recorded in your chart now,

but it's still something

for you to be aware of.

Cefazolin. Cefazolin, cefazolin.

Can you tell me how to spell that?

Sure. Let me know when you're ready.

You know what? Never mind.

Maybe I shouldn't research everything.

Clearly it doesn't always

lead to the best decisions.

Hey, absolutely nothing wrong

with wanting to be informed.

You are your own best advocate.

Mm, I think

I think my headache's gone.

The medicine's working.

- Excellent news.

- Yeah.

Well, I'll let you get some rest.

Thank you, Dr. Halstead, for everything.

- Hey.

- What's up?

I heard what happened.

Is your patient okay?

Yeah, she's gonna be fine.

And the biopsy?

Well, pathology won't get

the results for at least a day,

but Dr. Gordon said the vessel

looked totally healthy.

What a waste of time and resources.

If you want to join me,

I'm planning on paying Goodwin a visit.

What do you mean? Why?

To let her know what

a disaster these upgrades are

before they get past the pilot phase.

Mags, come on.

Don't you think that's overkill

involving Goodwin?

Will, patient care has been compromised

- on multiple fronts today.

- Not intentionally.

And Grace, she's still

working out the kinks.

Well, I'm not trying

to sabotage Grace's efforts,

but I'm also not gonna stand by

while Dayton tries to

automate us all out of a job.

[KNOCKS AT DOOR]

Yeah?

Yeah, uh

so Dr. Kwon agrees that

Kurt has decisional capacity.

- Got it.

- Yeah.

And he's signing the paperwork

to leave AMA.

Appreciate the update.

So, uh

I'm tied to a dialysis machine

most nights.

And I'm currently being evaluated

for the transplant list.

- I didn't know you were

- That bad off?

Yeah, me neither.

Yeah, and once

I'm on the transplant list,

I need to be within a certain radius

of the hospital at all times.

But suddenly my life and my plans

are being dictated by my health.

And so, when I see this young guy,

this picture of health,

willingly giving it up,

I made it personal,

which you already probably

knew that I was doing

because you're excellent

at what you do, Dan.

And I shouldn't have implied otherwise.

All right.

Hi.

Oh, hey.

Um

Your assistant let me in.

I hope you don't mind.

No, not at all, and

thanks again for the flowers.

They're lovely

but really quite unnecessary.

- Sure.

- Thank you.

Mm-hmm.

[CLEARS THROAT]

All right.

I-I got your voicemail.

Well, you know

you could've just called me.

You didn't have to make the trip over.

Yeah.

After hearing your message,

I called Jack, and I asked him

what this surprise

board meeting was about.

All right.

Jack has a proposal on the table

that would drastically change

Med's future.

Mm-hmm.

Okay.

First arm out.

Towel.

Here she comes.

- And there she is.

- [SOBBING]

Okay.

All right, you have

a beautiful baby girl, Sarah.

She is so excited to meet her mama.

[MACHINERY FLATLINING]

I can't find a pulse. Her heart stopped.

Pack her abdomen.

I'll start compressions.

Come on, Sarah.

Stay with us.

Charge to 200.

Come on, Sarah.

Come on.

[PENSIVE MUSIC]

♪

Oh, man.

How's Ryan's aunt?

She wanted to stay back in the nursery

with the baby a bit longer.

- How's he doing?

- Yeah.

About what you'd expect.

Oh, poor kid.

His aunt and uncle seem really great.

- Mm-hmm.

- Gets along with his cousins.

Yeah, Ryan and his baby

sister will be loved to pieces.

His aunt made that very clear.

Hey, walk with me.

You know you did

everything you could, right?

Sarah's heart was worse off

than we thought.

Nothing we could've done to change that.

Sad truth.

Only thing that

would've made a difference

is if Sarah had come in earlier

when she first started

experiencing symptoms.

You know, my sister,

Elizabeth Lizzy

She, uh

She was Ryan's age when our mom d*ed.

I didn't know

you lost your mom as a kid.

Lizzy and Matt

That's my brother

They had it the toughest

'cause they really remembered her.

I never got to meet her.

She d*ed in childbirth with me.

- Aortic stenosis.

- Mm.

Undiagnosed.

I'm sorry to hear that.

The doctor said that he thought

she was suffering with symptoms

during her pregnancy

but she just downplayed it.

Yeah, because like Sarah,

she wanted to be the best mom

that she could be.

To her, that meant

putting her kids first

and herself last.

Swallowing any pain or discomfort

so that she wouldn't burden her kids.

And still, to this day,

I am so angry at her for it.

I'm so angry because

I never got to have my mom.

I don't get to remember her.

- It's okay.

- [SOBBING]

It's all right.

It's okay.

Oh, hey, Lil.

Liliana.

- Oh, you're still here.

- Yeah.

I was actually I was kind of

hoping that I'd catch you.

- How's your day?

- Fine.

You've given any more thought

to Vanna's house?

Oh, yes. Maybe not the best idea.

Why? 'Cause of what I said?

You made some good points.

No.

No, I made some self-interested points.

What do you mean self-interested?

You walked in here

this morning all excited

about a beautiful little house

you'd found, right?

Your dream house.

And what I heard was

that maybe you were

planning a future that didn't

You know, that didn't involve me, so

Owning my own home has been

a goal for a long, long time.

And the reason that I feel ready now

to take this leap of faith is

Is really all your fault, Daniel.

Because of you,

I now know I want

to put down roots in Chicago.

Despite its miserable winters.

Remember, I'm from Poland.

- Yeah.

- [CHUCKLES]

[TENDER MUSIC]

♪

Yes, it's Sharon Goodwin.

[INDISTINCT CHATTER]

I'd appreciate it if you

could get back to me tonight,

if at all possible.

Yes, I'll be up late. Thank you.

What's going on?

We're trying to reach

every member of the board

before Jack can get to them first.

He wants to convert Med

into a for-profit hospital.

Turn it over to investors.

- Can he do that?

- Well, he can certainly try.

He wants to put it to a board vote.

I mean, if Jack succeeds,

there goes Med as we know it.

Vital services that don't

generate enough income cut.

We're gonna have to discharge

patients that can't pay.

Yeah, I know. That's why

we're doing everything we can

to make sure he does not succeed.

Look, I need to make this next call.

- Did you need something?

- Oh, no.

- No, it can wait.

- You sure?

- Yeah.

- All right.

Hello? [DOOR SHUTS]

Hey. Thanks for meeting me.

Of course.

Rough day?

Yeah, rough day.

What's going on?

I

I need to tell you something.

Okay.

It's about your dad.

And he can't know that you

learned this from me, but

Look, if it was my parent,

I'd want to know, so

What is it?

[SIGHS]

Hannah, please.

His health is getting worse.