April and Tate’s home
Tate: April.
April Sexton: Huh?
Tate: Cutting board?
April Sexton: Corner cabinet by the lazy Susan.
Tate: Yeah.
April Sexton: And you still haven't weighed in on the paint choices that I asked you about.
Tate: Uh, what room is that for again?
April Sexton: The den. Come on, Tate. I've been working on this remodel for weeks.
Tate: I know. I know. I'm sorry, babe. I love that you're making my house our house. I love that we set a date for the wedding.
April Sexton: But I'm driving you crazy.
Tate: Yep. You know what? Stuck in a house on TB leave... I get it.
April Sexton: I mean, I've been trying to keep busy, 'cause when I'm not, I can't help but worry.
Tate: First ultrasound today.
April Sexton: Yeah.
Tate: It's gonna be perfect.
Outside Chicago Med
Natalie Manning: Are you crazy? Where's your jacket?
Jeff Clarke: Don't need it. I love the crisp winter air.
Natalie Manning: Yeah, right. I can see your goose bumps.
Jeff Clarke: Oh, you mean my pilomotor reflex?
Natalie Manning: Oh, good God.
Jeff Clarke: Anyway, this weather is balmy. Do you remember that February when you and Jeff and me and Lisa we rented that cabin at Lake Mendota?
Natalie Manning: Yes.
Jeff Clarke: And then we got hammered on that box of wine we found in the pantry.
Natalie Manning: Which led to the hot tub.
Jeff Clarke: Which led to you sneaking a peek.
Natalie Manning: I did not! Did you?
Jeff Clarke: No. Course not.
Natalie Manning: You're terrible. Ugh! Seems like a lifetime ago. How'd we lose touch for so long?
Jeff Clarke: I'm not sure… Life of a med student. Lunch'll wait.
ER
Paramedic: Ricky Wade, GCS 15, vitals stable.
Maggie Lockwood: You're going to Treatment 4, Dr. Choi.
Paramedic: Trauma to the left ear with hematoma, multiple dislocated fingers, expanding hematoma of the anterior thigh. Refused the board and collar.
Ricky Wade: I'm not a cripple. I could'a walked.
Ethan Choi: I know. MMA. Feel no pain, right? Any loss of consciousness? Dizziness?
Treatment 4
Ricky Wade: Hell no. That bitch barely connected.
Paramedic: Cage doc called the fight. Said it was a freakin' bloodbath.
Ethan Choi: All right. Let's get an IV in him, then a gram of Ancef.
ER
Ethan Choi: The opponent?
Maggie Lockwood: Yep. You're going to Treatment 3.
Ethan Choi: Thanks.
Paramedic: Cyrus Hammad. GCS 15. Significant swelling to his left eye and bruising on the right flank. No loss of consciousness, but the fight doc wanted to have him looked at anyway.
Ricky Wade: You're lucky that doc stopped the fight. I would've pounded you into a living...
Treatment 4
Ethan Choi: Hey! Not in the cage anymore, huh? Give it a rest.
ER
Ethan Choi: History and physical and a detailed neuro exam.
Jeff Clarke: Got it. I'll shout if I need you.
Ethan Choi: Yeah.
Aamir Hammad: Excuse me.
Maggie Lockwood: Yes?
Aamir Hammad: I'm looking for my brother, Cyrus Hammad.
Ike: Cheating-ass punks. What did you do? Grease some palms? You know your bro was getting his ass beat.
Maggie Lockwood: I'm gonna need security in the ED.
Fight
Maggie Lockwood: Dr. Choi! Stop him!
Aamir Hammad: Come on! Come on! Come on!
Maggie Lockwood: Chill out!
Jeff Clarke: Walk away… You okay?
Maggie Lockwood: Yeah.
Treatment 4
Ethan Choi: It's swollen. Let's get some ice on his thigh and hands.
Ike: Had that A-rab eating mat in the first round. Should'a stomped him into oblivion.
Ethan Choi: You've got a lot of blood in your ear, Mr. Wade. I need to release the pressure around the cartilage or it will cauliflower.
Ricky Wade: Skip the lido. Last thing I need's a mile-long hospital bill.
Ethan Choi: You're gonna feel it. You sure? Suit yourself.
Ricky Wade: Damn it, that hurts like a mother.
Ike: Bastard was all about cheap shots.
Ricky Wade: Towel head. What do you expect?
Ethan Choi: Gonna put a dressing on the ear and get a CT head and face. Also some X-rays of the hands.
Treatment 3
Ethan Choi: What have we got?
Jeff Clarke: Moderate swelling in his left orbit, probable fracture.
Aamir Hammad: Inbreds. Always go for the low-hanging fruit.
Ethan Choi: Elbow strike?
Cyrus Hammad: Hammerfist. Sounds bad. I know. But it was a legal shot.
Ethan Choi: May have a couple fractured ribs.
Jeff Clarke: CT orbits and facial bones to start, chest X-ray for the ribs?
Ethan Choi: Thanks.
Aamir Hammad: I should hit up Rasheed. Get these jackasses in the parking lot, show them how the towel heads do it.
Cyrus Hammad: Aamir, let it go.
Aamir Hammad: This is why you fight, Cyrus.
Cyrus Hammad: Not anymore. You can't control ignorance, only how you react. Surah Al shura verse 40 [speaking Arabic].
Ethan Choi: Scans may take a while. Moving around's gonna hurt like hell. How's a bit of morphine sound?
Cyrus Hammad: Like heaven.
ER
Sarah Reese: Findings showed that people with higher confidence tend to use open, expansive postures.
Daniel Charles: Sure. Runner crosses the finish line, throw their hands up in victory.
Sarah Reese: Exactly. Conversely, those who are timid or defensive make themselves small. They'll slouch in their seats, cross their arms, their legs, and actually what is really cool is, um...
Daniel Charles: Hey. How you guys doing?
Connor Rhodes: Good, good.
Robin Charles: So far, so good. You know, just another day… Um, so, dinner tonight? Our usual spot?
Connor Rhodes: You got it.
Robin Charles: Good. Bye.
Connor Rhodes: I will catch you guys later.
Sarah Reese: Crossed arms.
Daniel Charles: What?
Sarah Reese: Crossed arms… Sorry.
Sharon Goodwin: Hey, Daniel? I need you to evaluate a potential organ recipient to see if she's a candidate for transplant. Her name's Meghan Scott. LVAD. Still in SICU. I know it's delicate, but if you could get it back to me by the end of the day?
Daniel Charles: I will do my very best.
Sharon Goodwin: Thank you.
ER office
Will Halstead: Yeah. For two at 8:00 p.m. Great. Thank you.
Maggie Lockwood: Look at you, all smiles. Hot date?
Will Halstead: Surprise date.
Maggie Lockwood: Oh, shh.
Will Halstead: I'm taking Nina to this French restaurant on Monroe, Cochon Volant Brasserie.
Maggie Lockwood: Nice.
Stanley Stohl: Actually, it's Cochon Volant Brasserie.
Will Halstead: Dr. Stohl.
Stanley Stohl: Personally, I prefer Alinea. It's American molecular gastronomy at its finest. Highly ranked on the S.Pelligrino list.
Will Halstead: Didn't realize you were back from your sabbatical already.
Maggie Lockwood: Or that you spoke French.
Stanley Stohl: Enough to get by.
Will Halstead: Something I can do for you, Dr. Stohl?
Stanley Stohl: My "sabbatical" was a World Health Organization assignment. I advised nongovernmental emergency medical teams on how best to respond and treat SODs… Sudden Onset Disasters… We should sit down and talk about it.
Will Halstead: Sure. Sounds great.
Jeff Clarke: Who is that?
Will Halstead: The troll.
Maggie Lockwood: Our beloved Chief of Emergency Medicine.
Jeff Clarke: Okay.
Will Halstead: Talk about sudden onset disasters.
Meghan Scott’s room
Meghan Scott: I've been sober almost three years. It's... It's not been easy. Temptation never really goes away.
Bria Scott: But you've done it, Mom.
Daniel Charles: Um, you been going to meetings?
Meghan Scott: Alcoholics Anonymous? I tried, but the endless talk about hitting rock bottom... I know it's supposed to be cathartic, but it just put me in a worse mental space.
Daniel Charles: So, no meetings, no therapy. Um, any relapses? Wow. Well, it's remarkable that you've been able to stay sober. Congratulations.
Meghan Scott: Thank you… I... I started meditating and setting small, achievable goals, and of course, Bria.
Bria Scott: The crew Mom used to hang with... I helped her see they were bad influences. She dropped them all. No more bars, nightlife… She's a homebody now.
Sarah Reese: It's senior year. Must be nice to have Mom home more.
Daniel Charles: Is college in the picture?
Meghan Scott: Yes. But not right away.
Bria Scott: We've agreed I'd take a year off before applying.
Meghan Scott: I'm sorry. A bit parched… I just... I just want this to be over.
Daniel Charles: It's just important that you understand that... This would be a life-changing event, the surgery, and could really shake up your and Bria's routine, so it's very important that you... You have a postsurgical plan in place.
Meghan Scott: I plan to keep doing what I've been doing. Going solo has worked. I need to make sure it keeps working.
ER
Ethan Choi: What's the status with the room change, Maggie? These guys next-door to each other are like napalm.
Maggie Lockwood: I'm working on it, Dr. Choi.
Ethan Choi: Thanks.
Ethan Choi: Hey, man. Where you headed?
Ike: To grab a pop.
Ethan Choi: Vending machine's in the waiting room, that way.
Ike: So that's how it's gonna be? Whatever.
Jeff Clarke: Hey, don't let those ass-wipes get to you. Just trying to be tough guys.
Ethan Choi: No, Jeff. It goes deeper… Not many families with the last name Choi where I grew up. Know the type all too well.
Maggie Lockwood: Dr. Manning, you're going to Trauma 3.
Natalie Manning: Got it.
Paramedic: Ted Baylor. 21-year-old male. Friends found him in his dorm room hooked up to the Xbox and unresponsive. Gave him fluids and oxygen in the field.
Natalie Manning: Glucose level?
Paramedic: Blood sugar's 800.
Jeff Clarke: That's sky-high.
April Sexton: See the train kept rolling without me.
Maggie Lockwood: Yep. Welcome back. We missed you.
Treatment 3
Natalie Manning: All right. On my count. One, two, three.
Jeff Clarke: Mr. Baylor? Mr. Baylor? He's out. Sternal?
Natalie Manning: Yep.
Jeff Clarke: There he is. Mr. Baylor, do you know where you are?
Ted Baylor: Hospital.
Jeff Clarke: Okay. He's able to speak and protect his airway.
Natalie Manning: Good breath sounds. Lungs are clear.
Nurse Doris: Maintaining oxygen saturation.
Natalie Manning: All right, let's keep him on the O2, bolus another liter of fluid, and start an insulin drip.
Nurse Doris: Labs?
Natalie Manning: What do you think?
Jeff Clarke: Likely diabetic ketoacidosis, so, CBC, CMP, VBG, hemoglobin, A1-C, and another Accu-Chek. For cardiac, troponin and an EKG.
Natalie Manning: Nice job.
ER
Aamir Hammad: Help! Help! Something's wrong!
Ethan Choi: I got it. What happened?
Treatment 4
Ethan Choi: What happened?
Aamir Hammad: He was talking, and then his eyes rolled back. I... I don't...
Nurse Doris: Get a right away.
Jeff Clarke: Got a pulse, but he can't protect his airway.
Ethan Choi: We need to intubate. Draw up meds. 20 of etomidate, 100 of sux.
Aamir Hammad: Is he gonna be okay?
Ethan Choi: We'll see… Hold the meds. Don't need them. No gag reflex. I'm in. Bag him. Let's get an OG tube down to decompress his stomach.
Jeff Clarke: Pupil's blown.
Ethan Choi: Must have a head bleed. Page neurosurgery. We need a stat head CT.
Treatment 3
Natalie Manning: Hi.
Ted Baylor: Dr. Manning, I presume? I know. Corny.
Natalie Manning: A little. But making jokes? Feeling better?
Ted Baylor: Compared to before? I mean, it still feels like I got hit by a truck. What happened?
Natalie Manning: Your body wasn't producing enough insulin to control your blood sugar, so it spiked and it knocked you out.
Ted Baylor: Is it diabetes?
Natalie Manning: Yes.
Ted Baylor: Ugh.
Natalie Manning: But the crisis period is over. Your blood sugar levels are improving… You okay?
Ted Baylor: It's just a little tender.
Natalie Manning: Do you mind if I take a look?
Ted Baylor: Oh!
Natalie Manning: Pain scale, one to ten?
Ted Baylor: 12.
Natalie Manning: Okay. How long has your stomach been hurting?
Ted Baylor: A few days. I mean, it's winter break. Just more cheap beer and pizza than usual. I figured it was just indigestion. Is it the diabetes?
Natalie Manning: No. Gallstones… I would like to run some additional blood tests and get an MRCP, a more detailed scan of your stomach, okay?
Ted Baylor: Mm-hmm.
Natalie Manning: Is there anyone I can call for you?
Ted Baylor: No. My dad's on his way.
Natalie Manning: All right.
Ted Baylor: He had them… Gallstones. They're a fat person's problem, aren't they?
Natalie Manning: They are often tied to obesity. Diabetes as well. But, you know, with lifestyle changes, these things are manageable.
Ted Baylor: You mean like diet and exercise?
Natalie Manning: You're only 21. It'd be easier than you think. I'll be back shortly.
Observation room
Ethan Choi: Massive hemorrhaging in his brain. Trying to get the swelling under control.
Jeff Clarke: Decompressive craniectomy. Opening up the skull should relieve the pressure.
Ethan Choi: Yeah, but right before they put him under, he had a Cushing's reflex. Dropped his heart rate, and his BP went through the roof.
Jeff Clarke: Hang in, man.
Cafeteria
Robin Charles: Mm-hmm. Yeah… All right, I'll check… Sure. Uh-huh.
Sarah Reese: Everything okay?
Daniel Charles: Yeah. Why wouldn't it be?
Sarah Reese: So, uh... So, Meghan Scott.
Daniel Charles: I got to say I have some reservations.
Sarah Reese: But she's three years sober and committed to staying clean.
Daniel Charles: Yeah. Without a plan or strategy to avoid relapse. Addiction is never conquered. Only managed.
Sarah Reese: But she's got a support system in her daughter. Bria's involved.
Daniel Charles: Maybe too involved. I mean, by delaying college, she is valuating her mother's life over her own, and as admirable as that may seem, it just doesn't tend to last.
Sarah Reese: Meghan's sick. It makes sense that she'd want to take care of her.
Daniel Charles: There's a very fine line between a healthy support system and an unhealthy dependence. I mean, did you see during the evaluation Meghan needed her daughter's help to reach a glass of water that was literally right in front of her? Look, it's a gut-wrenching process, and we just have to remember that we give Meghan a heart, we could be denying one to somebody who is just as deserving and might have a better chance of success.
Sarah Reese: So Meghan's a no?
Daniel Charles: No, I didn't say that. I just... I just want to sit with it a little longer.
Sarah Reese: Okay.
ER
Will Halstead: That gallbladder's really inflamed. It's full of stones. But it doesn't look like any have dropped into the common bile duct.
Natalie Manning: Oh, but it's only a matter of time before one does and causes a major obstruction.
Will Halstead: Right. Well, play it safe, remove the gallbladder?
Natalie Manning: Yes, except his latest labs. Calcium's low. Amylase, lipase, white cells are all through the roof.
Will Halstead: Gallstone pancreatitis. Man.
Natalie Manning: The swelling is really bad… Right now I think we should up his IV fluids and start a course of IV nutrition.
Will Halstead: Should buy him a few days, give his pancreas time to cool off. Good idea.
Natalie Manning: Good.
ICU
Omid Hammad: What does this mean? His pupils are nonreactive?
Ethan Choi: The bleeding in Cyrus's brain has caused significant injury. Despite the surgeon's best efforts, Cyrus has slipped into a persistent vegetative state.
Mrs Hammad: A coma?
Omid Hammad: But he can wake up, no? It's possible?
Ethan Choi: I'm sorry, but it's more likely he stays like this or devolves to brain death.
Aamir Hammad: That referee... He should've stopped the fight earlier. Cyrus was dominant.
Omid Hammad: The crowd... They cheered for blood… They wanted to see the Muslim boy get killed.
Outside the Chicago Med
Jeff Clarke: Hey.
Natalie Manning: Hey. Oh! All bundled up? You... You realize your pilomotor reflex is the first step towards frostbite?
Jeff Clarke: Yeah. Something like that.
Natalie Manning: So you know, I've been sitting on this for a while now, and, uh, it might sound silly, but I believe if couples are good travel partners, then they have what it takes to have a future. So what do you think? New Orleans? Drinks, food, music.
Jeff Clarke: I... "I sometimes imagine it was the other way around: that Lisa was your wife and Natalie was mine."
Natalie Manning: What are you talking about?
Jeff Clarke: I said that to Jeff. That's why we all lost touch. He didn't want us to hang out anymore.
Natalie Manning: I don't understand.
Jeff Clarke: Right when Lisa and I started to go sideways, you and Jeff met me out at Twin Anchors for moral support.
Natalie Manning: Yeah. I remember.
Jeff Clarke: You were up at the bar ordering a round, and I was looking at you, and I just said it.
Natalie Manning: Why?
Jeff Clarke: 'Cause my marriage was falling apart and I was a little bit drunk, and right at that moment, it was true… Jeff, of course, flipped out, and I mean, if you weren't there, it might've gotten ugly.
Natalie Manning: And you're just telling me this now?
Jeff Clarke: I know. I should've told you this morning when you asked.
Natalie Manning: This morning? How about when you showed up as a med student? Or before we slept together, or before I let you into my life? Unbelievable.
Treatment 3
Natalie Manning: Hi.
Ted Baylor: Setting up grocery delivery. Farewell, supermarket temptations.
Natalie Manning: Well, that's a good first step.
Ted Baylor: Mm-hmm.
Natalie Manning: You know there's some great apps for tracking calories too.
Ted Baylor: That's way down the line. I mean, after I get a handle on GMOs, gluten, organic versus farm-fresh. I... It's why I like fast food. It's simple.
Natalie Manning: You know what? Why don't I page the hospital's nutritionist, have her come in for a consult? You okay?
Ted Baylor: I've just been feeling a little bit short of breath, and...
Natalie Manning: Just come on now?
Ted Baylor: A couple minutes ago. Is it a reaction to all the meds, or...
Natalie Manning: No. They're just sparking your immune system. It shouldn't affect your breathing… Sit up for me? Lungs are clear. Is the extra oxygen helping?
Ted Baylor: No, not really.
Natalie Manning: Will? Will, I need a hand. Stat portable chest X-ray.
Will Halstead: What's going on?
Natalie Manning: Blood sugar's normal. White cells, amylase, lipase... They're all down. Everything's good, except now he can't breathe.
Ted Baylor: What's happening?
Natalie Manning: Your blood pressure and oxygen levels keep dropping, so we're gonna take a chest X-ray to try to figure out why.
Will Halstead: Mass in the lung.
Natalie Manning: I'm hearing a rub. It wasn't there before.
Will Halstead: All right. Let's get an echo.
Ted Baylor: I can't breathe.
Natalie Manning: O2 keeps dropping. Switching to a full face mask.
Will Halstead: Pericardial effusion.
Ted Baylor: What does that mean?
Natalie Manning: Keep this on. There's fluid built up around your heart. It's constricting it from beating. Bolus another liter of fluid. Get 125mg Solu-Medrol IV and a Levophed drip.
Nurse: Yes, Doctor.
Natalie Manning: Page Dr. Rhodes. We need to tap this fluid off his heart… Five minutes ago he was getting better, and now he's sicker than when he came in.
Connor Rhodes: Okay. So the fluid's from acute pericarditis.
Natalie Manning: Stemming from the mass in his lungs.
Connor Rhodes: Drain's a temporary fix, but his heart is really struggling. CT chest will show exactly what we're dealing with.
Natalie Manning: He presented with hyperglycemia and gallstone pancreatitis. There was absolutely no evidence of a heart problem.
Connor Rhodes: My time with Dr. Downey, now Dr. Latham the one constant: cardiac events can strike without warning.
Jeff Clarke: Thought he was on the mend.
Natalie Manning: So did I.
Jeff Clarke: Look. About earlier...
Maggie Lockwood: Dr. Manning?
Natalie Manning: Yeah?
Maggie Lockwood: Ted's father has arrived. I can fill him in.
Natalie Manning: No. I'll do it.
Entrance
Natalie Manning: Hi. Dr. Manning.
Treatment
Ethan Choi: Okay. Hard part's done. Big muscle bleeder down deep. Stick tying it now.
Ricky Wade: The A-rab, Cyrus… You wheeled him out of here, but he never came back. What happened?
Ethan Choi: Turn for the worse.
Ricky Wade: He knew the risk when he stepped inside the cage. It's the cost of doing business.
Ethan Choi: Shower and change the dressing every day. It'll take at least two to three weeks to heal… Pack the wound. Get him out of here.
ER
Connor Rhodes: Bulky, swollen lymph nodes and a clear primary mass in the right lower lobe of the lung.
Natalie Manning: Non-small cell lung cancer?
Connor Rhodes: The biopsy results are pending, but I'm almost certain they'll confirm it. I'm gonna talk to Dr. Latham about surgical options.
Natalie Manning: All right. I'll consult with oncology, get their opinion as well.
Connor Rhodes: Yeah. Hey. Sorry, Nat.
Natalie Manning: Thank you.
Connor Rhodes: Yeah…
Connor Rhodes: Hey, Dr. Charles. Um, speak with you a second?
Daniel Charles: What's up?
Connor Rhodes: Yeah, so, my... My heart patient Meghan Scott... I hadn't heard anything, so is there something going on with the transplant eval?
Daniel Charles: Well, I know you know that we're not supposed to be talking about this, but unofficially, her history of addiction makes her very high risk.
Connor Rhodes: Wh... I understand her history, but we're talking about her future here.
Daniel Charles: Well, her future's precisely the issue… I'm sorry, Dr. Rhodes, but the... The clearance process... It's unforgiving.
Connor Rhodes: No, no, no, no. Dr. Charles, you spent what? All of an hour with her? I've known Meghan and her daughter Bria for months now.
Daniel Charles: You've known her within a controlled environment. The invasive surgery, the powerful opiates for pain management, the rigorous medication schedule, the constant check-ups to make sure she's not rejecting the organ.
Connor Rhodes: So you're gonna seal her fate with a checklist, then? She doesn't get a heart, she dies. She's looking at six months, maybe a year.
Daniel Charles: Do you honestly think that I don't know that? Someone's got to make the tough decisions here, Dr. Rhodes. I'd thank you to let me do my job.
April’s ultra sound
Dr. Lee: Amniotic fluid level looks okay. Same with nuchal translucency. Fetal heart rate is 180, nice and strong.
Tate: Aw, yeah, that's a boy. What's up, little man? Already looking like a linebacker.
April Sexton: Um, she looks like a scientist to me… Dr. Lee? Something wrong?
Dr. Lee: At 12 weeks, optimal crown chin length is 26 millimeters. Your fetal measurement is 23.
April Sexton: Is that still within the normal range?
Dr. Lee: Yes, but on the low end. Something we need to keep an eye on.
Tate: Low measurement... What does it mean?
Dr. Lee: The main concern is anencephaly, a neural tube defect that can cause the brain to develop abnormally.
April Sexton: Is it because of my TB meds?
Dr. Lee: Possibly. We can't really know for sure.
Park
April Sexton: TShe said the TB meds could possibly be affecting the baby. That doesn't mean...
Tate: I know. But what if they are? You can't stop taking them. So, where does that leave us? Look. You're 12 weeks. If we're considering...
April Sexton: We're not.
Tate: April, it's not what I want either, but if your health is in question, the quality of life of our baby is threatened, I... We need to understand this gets riskier, more complicated after 14 weeks.
April Sexton: Tate, I am Catholic.
Tate: April, it's my baby too. Don't I at least get to discuss this?
April Sexton: We are not terminating this pregnancy.
Treatment 3
Ted Baylor: So how long would I have to do chemo for?
Natalie Manning: That's up to the oncologist. Generally, it's given in cycles between one and four weeks long followed by a period of rest.
Mr. Baylor: How many cycles?
Natalie Manning: One average, four to six.
Mr. Baylor: What about side effects? The Internet lists thousands.
Natalie Manning: It all depends on how Ted's body reacts. But yes, the side effects can add up. And because of the gallstone pancreatitis, they may even be exacerbated.
Ted Baylor: Well, all of this sounds awful. Um, what am I looking at with surgery?
Connor Rhodes: Removal of the mass via thoracotomy. I'll open your chest and peel away the growth from whatever it's attached to.
Ted Baylor: But my pancreatitis... A few... A few hours ago it was too dicey for gallbladder surgery. How is it okay with all of this?
Connor Rhodes: Your cardiac function is compromised. Preventing heart failure has to be our chief concern.
Ted Baylor: Dad, I don't know what I'm gonna do. I feel like if I make the wrong decision right now I'm gonna... I'm gonna die.
Mr. Baylor: Do you need an answer right now?
Connor Rhodes: Ted, look, I understand this is all overwhelming, but you're very sick. The sooner we start fighting back...
Natalie Manning: Emergency radiation. Yeah, a single dose intended only to stabilize the mass in your lung. It'll give the pancreatitis a few more days to heal, and it'll give you and your dad more time to decide on a treatment.
Ted Baylor: And if I still choose surgery after, it'll be safer, right?
Connor Rhodes: Theoretically, yes.
Ted Baylor: When can I do it? The radiation.
Natalie Manning: Today. I will set it up with the radiation oncologist.
Daniel Charles’s office
Daniel Charles: You gonna just stand there staring, or are you gonna come in? I can't get this frickin' coffee ring off of... What's on your mind?
Sarah Reese: I know you have reservations, but I've been reading about how others have managed addiction in unorthodox ways… There's meditation. Meghan already does that. Predicting your weak spots. She's cut off friends that were bad influences.
Daniel Charles: The problem with these techniques is that they're all solo endeavours. What Meghan needs is the support of a sober community.
Sarah Reese: But she's been successful without one. And she's got Bria, all the reason in the world to stay sober.
Daniel Charles: Won't be enough. I've been treating addiction for over 20 years. And trust me. I know of what I speak. My brother lost his battle with addiction about 14 years ago.
Sarah Reese: I am sorry.
Daniel Charles: I want Meghan to succeed just as badly as you do… But I look at her, and I... I see my little brother. He tried to do it solo too. It just doesn't work… And I can't in good conscience recommend her to the Transplant Committee without one good, solid, clinical reason that might give her a chance to succeed. I've been looking for it. Just... I just can't find it.
Sarah Reese: Okay.
ICU
April Sexton: Hey. Okay to discharge the asthmatic in Treatment 2?
Ethan Choi: Yeah. Prednisone and albuterol scrips are with the clerk… They've been going for the last several hours, trading places.
April Sexton: They believe prayer can bring him out.
Ethan Choi: What are you doing over here?
Ricky Wade: I just, um... I'm not sure.
Ethan Choi: You've been discharged. Go home.
Aamir Hammad: You're showing your face around here?
Ricky Wade: Is he gonna wake up?
Aamir Hammad: Like you care. You did this to him. Murderer!
Ricky Wade: It's not my fault. We b... We both wanted to win.
Ethan Choi: Go home, Ricky.
Aamir Hammad: God will punish you. You will burn in hell!
Omid Hammad: Aamir! Enough… Come… Pray with us.
Ricky Wade: I'm s... I'm sorry.
ER
Stanley Stohl: Dr. Halstead, a moment.
Will Halstead: Yeah?
Stanley Stohl: Dr. Manning's patient Ted Baylor... I understand surgery was proposed, but that radiation will be tried first.
Will Halstead: As a short-term measure.
Stanley Stohl: Yeah, well, it's the size of the mass that's killing him. Radiation only stalls its growth. It doesn't... Doesn't shrink it.
Will Halstead: Well, Dr. Manning's opinion and mine is that radiation is a much safer option right now.
Stanley Stohl: Well, you're the attending. Keep me posted.
Sharon Goodwin: Hey, Daniel, I haven't gotten your report on Meghan Scott. How's it going?
Daniel Charles: Still dotting the Is, crossing the Ts.
Sharon Goodwin: You know, I know these evaluations are difficult, but if you're looking for something and not finding it, maybe it's not there.
Daniel Charles: I said I'd have it for you before the end of the day, and I will.
Sharon Goodwin: Okay.
Radiation’s room
Ted Baylor: From now on, clean nutrition, lots of cardio, diet and exercise. My dad, too.
Natalie Manning: That's the enthusiasm I was hoping to hear.
Ted Baylor: I'm getting a second chance. I'm not wasting a day of it.
Natalie Manning: Good for you.
Ted Baylor: Okay, let's do this.
Hallway
Jeff Clarke: Natalie, hey… I am so sorry that I didn't say something sooner. I was afraid I'd lose you… Say something, please.
Natalie Manning: I was terrified to move on from Jeff. Even more afraid to get involved with you, my husband's best friend. And yet I thought there is no one Jeff would approve of me being in a relationship with more than you. And you let me think that.
Oncologist: He's coding! I need help!
Radiation’s room
Natalie Manning: What happened?
Oncologist: He just dropped.
Natalie Manning: Take over compressions.
Jeff Clarke: Got it. I got it. I got it.
Natalie Manning: No pulse. V fib. Charge 200.
Nurse: Charging.
Natalie Manning: Hold compressions. Clear… Resume compressions. Another milligram epi. Charge to 300.
Nurse: Charging.
Natalie Manning: Hold compressions. Clear.
Nurse: Asystole.
Oncologist: You gonna call it?
Natalie Manning: Time of death 17:32.
ER
Natalie Manning: He was dead before the first alarm even went off. C.O.D. tumour lysis syndrome.
Will Halstead: No way.
Natalie Manning: You know, the radiation was supposed to stabilize the mass. Instead it caused it to burst… I might as well have just given Ted a lethal injection, because that is essentially what happened.
Will Halstead: Natalie, this is not on you. There are no predictors for tumour lysis syndrome. It is monumentally rare... Even more so in young people. And the few times that it does occur, overwhelmingly, it's a reaction to chemo, not radiation.
Natalie Manning: It still feels like I missed something.
Will Halstead: Well, you didn't. No doctor sees gallstone pancreatitis with diabetes and thinks volatile cancerous chest mass.
Natalie Manning: And yet here it is.
Will Halstead: Ted's death is not your fault.
ICU
Sarah Reese: You just get good news or bad news?
Ethan Choi: My coma patient... This morning, he mentioned a Qur'an verse: Surah Al shura 40. "The recompense of an evil deed can only be an evil equal to it; but whoever pardons and makes reconciliation, their reward is due from God."
Sarah Reese: In the psych world, it's called complementarity. You know, kindness begets kindness. Hostility, hostility.
Ethan Choi: Yeah. An hour ago, those two hated each other, but then his father extends a hand.
Sarah Reese: Dr. Charles calls it "flipping the script."
Ethan Choi: Don't know if I could've done it.
Sarah Reese: Yeah. Not many people can.
Cafeteria
Robin Charles: Okay, what is with you? No invitation to sit down? Usually I can't sneak past you.
Daniel Charles: I'm just a little preoccupied. I... I got to figure something out fast, and I'm at a roadblock, and I can't find my way around it.
Robin Charles: Okay. I... I will leave you to it. Hey, uh, if you're going through hell, keep going. Isn't that what you always taught me?
Daniel Charles: Well, technically it was Winston Churchill, but...
Robin Charles: Well, still, it's never let me down.
Daniel Charles: Hm. Good.
Meghan Scott’s room
Bria Scott: Mom.
ICU
Sarah Reese: You're recommending Meghan to the hospital's Transplant Committee.
Daniel Charles: Uh-huh.
Sarah Reese: Well, what happened?
Daniel Charles: Well, if you must know, a member of my junior staff drew my attention to the fact that, um, I was so focused on her risk factors that I was blind to the one personality trait that my late brother did not have.
Sarah Reese: What?
Daniel Charles: Grit.
Sarah Reese: One's ability to persevere in the face of obstacles... A clean clinical reason.
Daniel Charles: I mean, the stressors are still there, as are significant future challenges, but I like to think that the determination that's kept her clean the past three years is gonna help her go the distance.
Sarah Reese: Mm-hmm… Hey, what made you think of grit?
Daniel Charles: Fatherhood.
Break room
Sharon Goodwin: Rough one today, huh?
Natalie Manning: To say the least.
Sharon Goodwin: Well, not to pile on, but Dr. Stohl just informed me that he'd like to use you case for the next Morbidity and Mortality Review, trace your steps.
Natalie Manning: An M&M? Oh, my God.
Sharon Goodwin: Well, it's not an inquisition. It's just a learning tool for the medical staff.
Natalie Manning: You tell Dr. Stohl that? Okay, night.
Sharon Goodwin: All righty. Good night.
Waiting room
Ike: What now? Can't kick me out of here too.
Ethan Choi: I'm not here to do that. I was thinking we got off to a rough start. Let me make it up to you.
Molly’s
Ethan Choi: Two beers. My tab.
