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ER 05x01 - Day for Knight

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I called them.
- What happened? Is he okay? - I think he slipped.
No, looks like he fainted.
Okay. Everybody, get back. Get back, okay?
Come on. We got a doctor here.
The hospital's nearby. Some guy ran for help.
My head hurts. This pavement's hard.
All right, I'll help you.
I'll help you.
- You shouldn't move his neck. - God!
- Are you okay? - I just told you my head hurts!
Don't worry. You'll be fine. We'll all help you.
- Want us to do something? - We got to...
- Coming through! - Excuse us.
- Sir, are you okay? - Yeah. Can you help me up?
- We'll check you first. Name? - Barry Mahoney.
- He fell down. - Thank you.
- And he's bleeding a little. - Thanks. We'll take it from here.
- Carol, we need to stabilize his neck. - I'll get a C-collar and a gurney.
Jen's gone for a month?
She's taking depositions in St. Louis...
...and figured it would be easier to stay.
- My head still hurts. - Just a small scalp laceration.
Nothing to worry about.
And she's letting Rachel stay with you?
Reluctantly. Rachel didn't want to miss soccer camp, so she's staying.
Okay, let's get a saline line going. TKO, CBC and a Chem-20.
- Portable C-spine? - Yeah, thanks.
And a 12-lead EKG.
- Can we help you? - Just making sure he's okay.
- Family needs to wait in Chairs. - I was passing by and tried to help.
Didn't do much. Put her coat under my head.
I'm sure he's grateful, but passers-by need to wait out in Chairs too.
Accu-Check, 124. Hemo-Q, 13.8.
I'm supposed to be here. I'm a third-year med student.
I start ER rotation today.
Man, is that today?
- So this lab coat is yours. - Yes.
What should I do?
- Name? - Lucy Knight.
Ms. Knight, welcome to County General.
- You need to wait in Chairs. - I shouldn't do anything?
- Carol? - Left, down the hall, then a right.
Should I at least observe?
Left, down the hall, then a right.
Lucy, you just get here?
Bernard, what are you doing?
What happened?
A fire-twirler burned his butt and the troupe's waiting.
What is all this? You look like some geek, pacing around.
I am a geek pacing around.
- Taking Dr. Weaver's audio tour. - Who's Dr. Weaver?
Kind of short, red hair, uses a crutch.
They have you sitting here?
I don't know what I'm supposed to do.
I gotta get back to my tour.
What are you doing later? I gotta practice drawing blood.
They won't make you do procedures at first. All right, I'll find you.
- Out of the way! - Trauma One's clear.
- What do we got? - Multiple GSWs to the head and chest.
GCS 7, BP 60 palp, two large-bore IVs, normal saline, a liter in the field.
Prep a Thora-Seal and set up for a chest tube.
- Lucy Knight? - Yeah.
Jerry Markovic, service coordinator.
Dr. Greene will show you around as soon as he can.
Just throw your stuff in the lounge and come back to the desk.
- I'm sorry. Did I interrupt? - We thought you were Jerry.
The unit service coordinator. I just met him.
You must be a new med student, right?
Jerry's the desk clerk. He pulls the "unit" thing on newcomers.
It's his birthday.
Don't tell him about the cake.
- Chuny Marquez. - Lily Jarvik.
- Yosh Takata. - Lucy Knight. Should I use a...?
Excuse me, I'm looking for Jerry.
He went down to the roach coach to get his breakfast burrito.
That's why my dad says he's...
- What did you do? - Not much, actually.
I was hoping he knew if there were extra lab coats.
- They keep them under the desk. - Great.
- Your dad works here? - He's one of the bosses.
Well, he used to be the only boss until Dr. Weaver butted in.
Here they are. What's your name?
- Rachel. - I'm Lucy.
- Hello again. - Oh, hi.
- Mark Greene. - Lucy...
Knight. Rachel, why are you still here?
- I'm watching the desk. - Only for a moment.
Mrs. Williams doesn't pick me up until 8:30.
Yeah? It's 8:35. Good luck on your game.
I'll pick you up at the Williams' before dinner.
- Bye. Bye, Jerry, happy birthday. - Thanks, Rach.
- Settling in? - I had a...
Jerry, tell Radiology to hurry up on those films for that clavicle.
I was waiting out in Chairs.
That leg in Four needs sutures.
Doyle or Carter. Yosh Takata, Lucy Knight.
- Hi. We met. - Hi.
Sitting in Chairs? We'd better get you going.
We'll start off with charts, then the board. Quick tour.
Then some patients.
- Am I to be assigned to a Resident? - Later.
Grab a chart, pick up your patient.
No jumping over for a more interesting case.
Put your initials here, patient's name, chief complaint...
...and what labs you've ordered.
- Why don't you try one? - Name is Clements.
- Chief complaint is "mult lac"? - Multiple lacerations. Right.
Waiting on a head CT and suturing.
Doctor is M.D., which doesn't stand for "doctor."
That means Maggie Doyle. Don't worry, you'll catch on.
You're thinking about emergency medicine?
I'm not sure. It's my first rotation.
Curtain Area One. Curtain Area Two. Exam Room One.
This is Exam Room Two.
- And this is Dr. Carter. - What?
Carter's one of our finest Residents even though he sleeps on the job.
Lucy Knight.
- Hi. - Hi. Sorry, Dr. Greene.
I haven't had much sleep since that R.A. Job.
Life in the dorm, huh? Better you than me.
Patients, Carter. Place is full.
Right.
This is Trauma One, which you've seen.
- Who are we saving? - Nobody. He's arrested twice.
Another soldier to the drug war. Tucked away in his pants.
This is Lucy Knight, third-year. Doctors Benton and Weaver.
Nurses Lydia Wright and Malik McGrath.
Two units O-neg on the infuser.
- You know Mr. Gamely? - Yeah, I just saw him.
As soon as he's done with the tour, I'll find you. It's useful.
- BP's 40 palp. - He's flatline.
Thoracotomy tray. Come on, Malik. Let's move.
Trauma Two. Blissfully quiet, which is the way we like it.
This is the Suture Room, where Dr. Doyle is suturing.
- Lucy Knight, third-year. - Hey.
Nice to meet you.
- Who's Sleeping Beauty? - Mr. Clements passed out.
He got drunk and walked through a plate-glass window. You idiot.
Dr. Doyle throws in attitude when presenting a patient.
- He'll be okay? - Oh, yeah.
As long as he doesn't mind gnarly scars.
- Mr. Gamely, I presume? - Yeah.
Drug lockup's in here. Lab is down the hall.
Radiology, around the corner. Exam Room Four.
Sorry to barge in. You got a minute?
Sure. Be right back.
Lucy Knight. Doug Ross, pediatrician.
- Hi, how you doing? - Fine.
All right, Ms. Knight. Why is otitis media found primarily in children?
They have short eustachian tubes and fluid doesn't drain...
...making it perfect for a bacterial infection.
- Okay. Treatment? - Amoxicillin or Pediazole.
We may be over-treating because many of the cases are viral.
Antibiotics aren't necessary and may contribute...
Pretty good. Textbook answer.
You want to see some real Pedes cases, come see me.
- Mark. - Elizabeth, Lucy Knight, third-year.
Dr. Corday, Surgical Resident in cowboy boots.
Aren't they fabulous? Had an interview in Denver.
- How do you do? - How was your trip?
The interview was fine, the mountains are lovely, but the city's flat.
Don't let the Residents abuse you.
You're here to learn, not to be their servant.
See you later, Mark.
- Labs are back on that rule-out MI. - Thanks, Lily.
That's the lay of the land. I'm gonna check on a patient.
- What am I supposed to do? - Grab a chart...
...help someone out, just jump right in.
- Output? - No pulse.
- How many units are in? - Four O-neg. Four type-specific.
Last epi?
Five mgs, three minutes ago.
How long has he been down?
- 25 minutes. - Let's call it.
All right. Time of death 8:49.
Nice try, everybody.
- I gotta get back upstairs. - I'll handle the chart.
You want to wrap?
- I'll do it. - See you.
- Is that it? - I gotta get the death kit.
I'll show you how we do it.
Excuse me. Somebody?
His phone's ringing.
His phone's ringing.
Hello?
No, I'm sorry. He can't come to the phone right now.
Well, yeah. I suppose I could take a message.
Remember where Radiology is.
Continue to your left now...
... on down to the end of the hall.
And proceed seven steps forward.
You have now reached the Admit desk...
... the veritable heartbeat of every emergency room.
- This is not mine. - What is with this thing?
- I'm never where I'm supposed to be. - Neither was I.
When I saw you in Chairs, I was supposed to be in the Suture Room.
- Did we start at the wrong point? - I know I have.
I wanted Medicine rotation.
Dr. Doyle's latched on to me in a big way.
We haven't been assigned a Resident.
Hasn't stopped her from using me as a urine-delivery...
Where is the lab?
It wasn't where it should be.
- Ms. Knight. - See you.
- Dr. Weaver. - The tour's very helpful, isn't it?
Yes, thank you. As Chief, will you be the one assigning us to Residents?
I'm Acting Chief.
- Kerry? - Doug, you were looking for me?
I have to do an LP on a 2-year-old boy in Exam 3.
- Rule out meningitis? - Yes.
- What are the symptoms? - Excuse us.
Just a second.
I'm not presenting a case.
I'm telling you about a procedure that needs to be done.
The parents are waiting if you would like to join us.
Look, Don Anspaugh and Legal mandated the terms of your situation, not me.
Those terms do not include me having to justify a procedure.
Be right there!
Why don't you grab Dr. Carter and see if he can pull you in on patients?
Can you hold this corner up?
- Sure. - Thanks.
I'm getting ready for my surprise birthday party.
This year's surprise: There is no party.
Then why do you have that cake in the lounge?
- I didn't tell. - He sniffs it out every year.
Well, you hide it in the same place every year.
- Patient's 8. - How long has he had the rash?
Three weeks. I'm having a hard time diagnosing it.
- How's it going, Ms. Knight? - Fine.
Dr. Weaver suggested I work with Dr. Carter.
Carter, want to fill her in?
Eight-year-old with erythematous macules and small papules on the back.
- What's the distribution? - Kind of spread out like a fan.
- Does it resemble a Christmas tree? - Yeah, I guess you could say that.
Sounds like pityriasis rosea. Classic Christmas tree pattern on the back.
- I think she's right. - Using a computer.
Why don't you let Dr. Ross take a look?
Then you and Ms. Knight can move on to the gentleman with hematuria.
Okay.
- I'll meet you in Exam Four. - Sure.
Did I say the wrong thing?
It's probably not a good idea to show up the Residents.
- So I should give the wrong answer? - Tricky, isn't it?
Welcome aboard.
When did you first notice blood in your urine?
Just a couple days ago.
Could it be related to exhaustion?
I've been finishing this renovation in Oak Park.
- Working long hours? - Need to bring it in.
- I don't think that's it. Any fever? - No.
- Back pain? - Well, just the usual from work.
How about weight loss?
I always drop at the end of a job.
You know, you skip a meal here and there.
- Is it gonna be much longer? - I'll order some tests.
We'll know more then. Conni?
Let's get a CBC, coag panel. UA, Chem-7.
- You got it. - Peed in this cup for you.
Thank you. We'll be back in a bit.
Sorry about coming up with that rash diagnosis before you.
Fair is fair.
I hope this doesn't mean I won't get to do anything.
I spent two years learning how to do a physical.
- I'm willing to help with patients. - Carter? I'm jammed.
Can you take Mrs. Lydell, a foot ulcer, in Curtain Three?
- Sure. - Thanks.
She's all yours. Do the H and P. Make an assessment.
And then come find me.
- Mrs. Lydell? - Yes, I surely am.
I'm Lucy Knight.
Is it okay if I check you over and ask a few questions?
Child, the good Lord has put me into your hands.
I receive you as He receives us both.
- Order a C-spine and portable chest. - Pelvis?
- Dr. Carter? - I'm busy.
- The labs are back on Mr. Zwicki. - Pulse ox is 92.
- Put them in his chart. - Get a large-bore IV going.
- We need a central line. - I'll do it.
- His crit doesn't look good. - I'll check it soon.
- Go ahead, Carter. I've got it. - No, really. It's okay.
We're covered here. Go on. Go, go, go!
Hematocrit's 30?
So he's pretty anemic, right?
Urinalysis shows too many red blood cells.
- But only two to three WBCs. - BUN and creatinine are normal.
With the hematuria, we definitely need to admit him for more tests.
Can you give me the diagnosis at this point?
Without using the computer.
With weight loss and painless hematuria, cancer's high on the list.
Kidney tumor, carcinoma of the bladder, prostate cancer, renal...
- Good job. - Thanks.
I was just coming to find you. I gotta get going.
My poor wife's been in that waiting room for two hours.
Mr. Zwicki, your lab results are back.
And they indicate that there may be a serious problem.
We'd like to admit you to do a full evaluation.
No, I can't do that. I start a renovation tomorrow.
Townhouse.
- I'm sure it could wait. - No, it can't.
Your condition could be very serious. There's a possibility of cancer.
I really think you should get it checked out.
Look, come on, now.
A buddy found blood in his piss and it turned out to be a urine infection.
- Can't you give me some antibiotics? - Can't really do that.
We should bring your wife up to speed, all right?
- Yeah. Sure. - Okay. We'll be back.
- You'd have to let him go? - Lf he insists.
You gotta know what technique to use for him to stay: His wife.
- Meaning? - We give her the full picture:
The possibility of cancer, the importance of early detection.
Ten minutes alone with him, she'll change his mind.
- Did Dr. Weaver do that central line? - Just about to.
I'm gonna go check with her, see if she needs help.
- I'm looking for Mrs. Zwicki. - Yes.
Mrs. Zwicki?
My name is Lucy Knight and I'd like to talk to you about your husband.
His condition could be very serious.
What do you mean?
Well, with the hematuria there's a chance of renal vein thrombosis...
...polycystic kidney disease, and renal or ureteral...
Wait, I don't understand this.
Your husband wants to leave AMA.
We'd like to check him in and do more tests.
- Tests?! - Do an IVP.
Get an abdominal CT. Check his urine for AFBs.
Maybe check a PSA and possibly do a cystoscopy.
It would just be a couple of days.
I think we're out this way.
- What's going on? - The Zwickis decided to leave.
Mrs. Zwicki, I need to tell you about your husband's condition.
She explained everything. He's incredibly stubborn!
No, look, I am not stubborn. I feel fine.
I got a new job to start.
Summer, that's when I get my work. I can't blow this job off.
No, I'll tell you what.
If this doesn't clear up, then I'll arrange...
...to get with my regular doc, okay?
It'll be okay. Come on, let's go.
- You talked to her? - I thought you said...
- What did you say? - I told her about hypernephroma...
...prostatic carcinoma... - In those words?!
Is there a problem?
- Mark? - Just a second, Carol.
A patient wanted to leave.
Ms. Knight explained his condition in medical rather than layman terms.
Why is a student explaining? Where were you?
I was assisting Dr. Weaver. I didn't tell her to do it.
- Yes, you did. - I hate to break in.
We've got a blunt head trauma.
- You told me to explain. - I didn't mean you!
Ms. Knight, why don't you come with us?
27-year-old firefighter, fell 20 feet onto concrete...
...with blunt head trauma.
BP 150/90. Pulse 60.
Apneic and intubated on scene.
Pupils four millimeters and sluggish.
- You intubated? - We lost the tube.
We didn't have a laryngoscope.
- Why the private chopper? - It was on the scene.
Help! Oh, no! Please, help me! Please!
Please!
8.0 ET tube. Suction.
BP's 160/95. Pulse 62.
Pulse ox 92.
- Stabilize the neck. - What have we got?
Emile Fernandez, 27-year-old firefighter...
...fell 20 feet onto concrete.
- Head trauma, loss of consciousness. - I'll check his belly.
- Get locked out? - Yes.
Happened to me once.
- Eighteen-gauge, left forearm. - Okay, I'm in.
- Good bowel sounds. - Peritoneal lavage?
No, he's hemodynamically stable. Let's get a head and abdominal CT.
All right. Pulse ox 92...
...95, 96.
Good breath sounds. No tracheal shift or jugular venous distension.
- Thank you, doctors. - Call us when the CT's back.
He needs a Foley and an NG tube.
We thought you left on that chopper.
- Sorry. - First hemoglobin is 14.2.
- Why don't you come over here? - I need more tube.
- He was a firefighter? - He is a firefighter.
- Urine's clear. No blood. - Glasgow Coma Scale, how do you do it?
Check for eye-opening, verbal activity, motor response.
- CT's ready. - No verbal with ET.
- Anything in the field? - No.
That would be a one. What about eye opening?
Spontaneous eye-opening is a five.
We definitely don't have that.
Emile, open your eyes! Emile, open your eyes!
- Now what? - Painful stimulus.
No eye-opening with pain. That's a one.
- How much for decorticate posturing? - Two.
That would be four out of 15. He gets a three for being alive.
Pulse ox, 98. ABG.
- Absent corneal reflex means? - No brainstem activity.
Ready for the C-spine.
Back up.
- What are you thinking? - Subdural or an epidural hematoma.
Something we could actually fix.
- What if there's no bleeding? - Brain swelling.
We'd have a chronic vegetative state or a potential organ donor.
Dr. Greene, Captain Matson.
The guys want to know, how he's doing?
Well, it's too early to say. We'll know more when the CT's back.
We screwed up bringing him in on that chopper.
It was the fastest way.
Yeah, but we lost his ET tube. We didn't have equipment.
If you'd waited, it could've been another 15 minutes.
We would've had more supplies.
You didn't screw anything up. You bagged him, kept the airway open.
I probably would've done the same thing.
- Any family? - Wife and two kids.
Thanks, doc.
- You didn't tell them his condition. - I don't know what that is yet.
You're right. I didn't tell them.
Why don't you stick with me on this? I'll call you when the CT comes back.
- We should have the cake at the desk. - No surprise in that.
We could put it in an exam room.
- Didn't we do that last year? - The last two years.
- Kind of noisy, huh? - There's no place to work.
No, but at least you get a locker.
I didn't get one for two months.
Yeah, I guess some Resident left the program or something.
Right. Dr. Del Amico.
She went to Philadelphia to work in the pediatric ER.
We don't have one?
We might get one if Dr. Ross has his way.
Anyway, Anna... Dr. Del Amico...
...thought it was a better opportunity.
Her family's there. It's where she's from.
There was this boyfriend that she was involved with.
You got a locker out of it.
I'm sorry about Mr. Zwicki.
I thought you asked me to talk to his wife.
Sometimes the Suture Room is pretty quiet.
Baker, Shelly, chart number 13940...
...admitted January 12, 1998, with a fever of 102.
Respiratory distress...
It's been a crazy day. I've been swamped.
Reece couldn't get the hearing test?
No, no, no. He had an ear infection.
- That's probably been the cause. - That's good anyway.
He'll be on Augmentin for another week.
Then he'll take the test and clear this up.
What?
I can't believe you're wearing those boots.
When in Rome...
How was Rome?
Denver is not Rome.
I went to a fantastic rodeo, though.
I didn't care for the hospital. It's regimented.
Well, it is a Surgical program.
Look, I want to stay in Chicago.
You know, Cromley may offer me a sponsorship.
Good.
I'm glad you're staying.
Well, trying to stay.
- You are, are you? - Yeah.
I missed you.
Well, that's very nice of you to say, Peter.
I missed you too.
- It was a little... - Cold between the sheets.
Elizabeth, what are you doing?
Stop being so shocked and come over here.
- Has it been six months? - It seems like it, doesn't it?
Lucy, right?
Yeah.
- And you are? - Malik. Carter was looking for you.
He's checking on that pregnant lady in Exam Two.
Thanks.
Exam Two...
- Exam Two? - No, Curtain Three.
- Exam Two is back towards Admit. - Thanks.
- Exam Two? - Past Curtain Two, hang a left.
Exam... Curtain Two. Exam Two.
- Oh, excuse me. I'm sorry. - Are you the doctor?
No. I'm Lucy Knight. I'll be assisting the doctor.
Who'll be here soon.
Hi, Mrs. Draper. I'm Dr. Carter.
You're about nine weeks pregnant?
This is my third pregnancy.
Mrs. Draper's had two previous miscarriages.
I see that you've been experiencing some cramping and some bleeding.
Spotting. I had some spotting yesterday and it's heavier today.
And I passed some clots.
BP's 110/75. Pulse 100.
And how many pads have you used?
One yesterday and four today.
- Have any fever? - No.
- Any burning on urination? - No.
Good.
Let's get a CBC, type and RH...
...dip a urine, and check an ICON.
Are there any family members we can call?
- I've already talked to my husband. - Okay.
We're gonna do a few tests...
...then I'll come back and do a pelvic exam.
Then we'll know better where we stand. Okay?
- Okay. - We'll be right back.
Tell me when the ICON's back.
I should stay out while you do the pelvic, right?
Won't learn much if you do.
I thought she seemed distraught.
It doesn't have anything to do with you being in the room.
The CT's back on that firefighter if you want to see.
- Let me put my stuff down. - Sure.
Okay, tell me what you see. Any intracranial bleeding?
I'll give you a hint. Blood appears white on a CT scan.
- I don't see any. - No subdural or epidural hematoma.
There's nothing they can do surgically.
- That's not good? - That's not good at all.
Look at the ventricles.
The brain is so swollen that they're squashed down...
...along the border of the gray matter.
Tiny, punctate hemorrhages and axonal shearing.
Most of his brain's been destroyed.
- So, what do you do now? - Give steroids, hyperventilate him.
Have Neurosurgery put in an ICP monitor and wait for the wife.
Dr. Greene?
- Not too good, is it? - No.
Thanks for talking with us. The captain and I get into it sometimes.
- Turf war? - I hate to call it that.
You must have worked with paramedics in the field before.
- Mostly in here. - Want to think about doing it?
There's a position open. District medical director for EMS.
- What exactly is that? - Oversee paramedic education.
Help determine new procedures.
- I have a job. - This is a side deal.
- Only a few hours a week. - It can't be much pay.
Pay's nothing.
- And the perks? - There aren't any.
No salary, no perks. Sounds great.
See you.
Hell of a way to get a job offer.
And proceed seven steps forward.
You have now reached the Admit desk...
- You already took the audio tour. - Yeah, I know.
- Dr. Doyle doesn't know that. - Bernard, you owe me.
Okay... Okay.
How many times is he gonna take that thing?
Hey, Carter's about to do that pelvic.
I'm gonna take a look inside with the speculum.
I need you to relax.
There's tissue in the os. Ring forceps.
Let's get that to Pathology.
I need to check your ovaries now.
You tell me...
...is there any pain here?
No.
- How about here? - No.
No adnexal masses or tenderness.
You can put your legs back down, Mrs. Draper.
What is it? What's going on?
I am very sorry, but you have had a miscarriage.
You're sure?
The fetus was pushed out of the womb.
Your bleeding has slowed, but we need to observe you for a little while.
I'm gonna come back and do another pelvic exam...
...to make sure the bleeding's stopped...
...and that the cervix is closed.
A doctor from OB/GYN is gonna stop by.
Ms. Knight, would you stay here until they do?
Of course.
Get some rest, Mrs. Draper.
Rest.
I thought this time it would be all right.
I never made it to nine weeks before.
I don't know why this is happening.
Why is this happening?
I don't know.
I'm sorry.
I don't know.
- What are you doing? - I have no idea.
- Ms. Knight? - Yes. Hi.
I just thought we could... Just excuse me a minute.
Jerry, I thought you notified the morgue for a pickup.
I did. I'm sorry, I'll call them again.
I haven't had a chance to work with you today.
- Everything's going well? - Yes, pretty well for a first day.
So it's been completely hateful.
Kerry, I need to do a needle aspiration on a 15-year-old.
I need the mother's consent.
Yeah, and Ms. Knight was looking for a good case to observe.
The more the merrier. Come on.
You see, now, that's a peritonsillar abscess.
A pocket of pus has collected around the tonsils and we have to get it out.
We'll numb it first and we'll use a needle to draw out the infected fluid.
An alternative is to open it with a scalpel, but that's more invasive.
- The needle aspiration is fine. - Lf you're sure.
You've been a "hit the books" medical student.
- Is there any other kind? - Some are more diligent than I was.
You're a Pediatric Emergency Fellow?
- It's different from an Attending? - Under the boss.
That's why you need an Attending to be your witness?
When you have parents sign consents an Attending needs to witness that.
I performed a procedure on a 7-month-old baby addicted to heroin.
I didn't get his mother's consent.
- What happened? - The powers that be were upset.
So I am now a Pediatric Emergency Fellow on probation.
And the baby isn't addicted to drugs.
Sometimes it's a tradeoff.
Good luck.
Every guy in that gym thought I had a coronary.
They were all over me.
Asking me if they could help, get me some water.
One guy offered to take me to his own doctor.
That's very generous.
What do we have?
Roxanne Please, 25. She was at the gym...
You know, I dropped a darn 15-pound weight on my little toe.
I hope it's not broken.
- Jerry, what's open? - Curtain Area One.
Or maybe Exam One would be better.
We'll check it out and get an x-ray.
A woman's looking for you. A Mrs. Fernandez.
The firefighter's wife.
- We'll get you in the exam... - I can take care of that.
Okay, Jerry. It is your birthday, so...
- Really? Happy birthday. - Well, thank you.
- Mrs. Fernandez? - Yes?
I'm Dr. Greene. This is Ms. Knight.
Where's Emile? We came as soon as we could. We piled in the car.
It'd probably be a good idea if the family stayed here.
Mrs. Fernandez, your husband fell 20 feet onto a concrete surface.
The paramedics were there and brought him right in.
There was no internal abdominal bleeding.
The CT scan of his head showed diffuse brain injury and swelling.
What does that mean? How serious?
He can't breathe on his own. He's on a ventilator.
He can't move any muscles. He's not opening his eyes.
He's in a coma.
Does he need an operation?
Unfortunately, there isn't any that can help.
The prognosis is not good.
We're going to admit him to the ICU, monitor the pressure in his brain...
...and treat the swelling the best we can.
Is he brain-dead, Dr. Greene?
We're gonna have to wait and see.
If the tests show no brain activity over the next few days...
...you're gonna have to think about continuing life support.
Lucy, can you take Mrs. Fernandez to see her husband?
Can he hear anything?
It's possible. There's no way to really know.
You can talk to him.
Do you know what you cut your foot on?
No. I was diving the Wellsburt, a shipwreck out in Lake Michigan...
...when I felt this slice.
What's weird, though, at that depth...
...your blood comes out looking green.
- When was your last tetanus shot? - I don't know.
My mom kept track of that stuff.
Your laceration is superficial, but it'll require a few stitches.
We'll give you a dose of antibiotics beforehand.
Ms. Knight, do you think you can handle the IV?
- Of course. - I'll be back.
You do know how to do this?
Yes.
Oh, could I ask you something for a second?
Sure.
This is my first IV and l...
You don't want to punish the patient.
Something like that.
- Okay. - Thank you.
- Do you want to try? - No, I'll just watch.
All right.
First you're gonna take the tourniquet and tie it into a slipknot, like that.
Ms. Knight, the films came back on that woman who dropped the weight.
Small, non-displaced fracture of the proximal phalanx.
- Fifth toe. Just do a buddy tape. - A buddy tape?
Yeah, you tape the little toe to the one next to it. Okay?
Tell her to expect discomfort for a couple of weeks...
...and to wear hard-soled shoes.
Okay.
When you look at the actuarial tables, term is definitely the way to go.
- Ms. Please. - Oh, please, call me Roxanne.
I've said that my whole life.
Good news. It's just a small hairline fracture.
- How long will that take to heal? - A couple of weeks.
I need to tape you up. And you should wear hard-soled shoes.
- Roxanne sells insurance. - Really?
Yep. Life, disability, umbrella policies, you name it.
- You have insurance? - Just medical through school.
Sorry.
You should start your coverage now. Your age, premiums are incredibly low.
Roxanne says disability is more important than life.
Statistically, you're more likely to be maimed or mutilated than killed.
Really? Who knew?
- Roxanne's also staying for the party. - What party?
Jerry's surprise party. He says they always have one.
Okay. There we go.
That should do it.
Scuba Man is on his way. Only took half a dozen sutures.
- By the way, nice job on that IV. - Good.
No, seriously. I kind of threw you in the deep end there.
I didn't think you'd be able to do it. It's good to know...
...you can swim. - Thanks.
- Can I see you for a minute? - Sure.
Mrs. Fernandez is looking for either you or Dr. Greene.
Okay.
Mrs. Fernandez, can I help you?
I couldn't stay in with Emile. I...
I can't see him that way. I can't talk to him.
- I'm sorry. - You don't have to be sorry.
Look, I need to take my children home.
Tell Dr. Greene that I will come back tomorrow.
And I guess we'll talk about what to do.
Okay. Okay, I'll tell him.
Jerry! Jerry, get over here, please.
I mean what does it take, huh?
How many times have I asked you to get rid of this body?
- I will call them again, Dr. Weaver. - You will not!
You will not call them again. You'll take this poor soul there yourself.
- Dr. Weaver... - Jerry, it's just a corpse.
It's not like you've never seen a dead body before.
- We finally got you at last! - You got me. You got me.
- Blow out the candles. - All right.
- Happy birthday, Jerry. - Thanks.
- I gotta pick up Rachel. - Bring her to our barbecue.
- Really? About an hour? - Yeah.
- Maimed or mutilated, huh? - Yeah, it's not a pretty picture.
No, tell me more.
I can't believe this party. It was a horrible day.
Tomorrow's gonna be even worse. I found out I got assigned to Dr. Doyle.
- When did you hear that? - Dr. Weaver told me.
- You're with Dr. Carter. - Oh, man.
I'd consider yourself lucky.
He thinks I can swim.
At least we survived day one.
Yeah, I basically did nothing and helped no one.
You got to see some patients.
Dr. Doyle won't let me near a single one.
Yeah, I saw some patients.
Want a piece of cake?
Mr. Fernandez.
Emile.
My name is Lucy. I work here.
I met your wife.
I know how much she loves you.
And how much your kids love you.
And how they wish this hadn't happened to you.
How we all wish this hadn't happened to you.
E=mc2
ER 01x01-02 - 24 Hours
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