Épisode Rechute S02E10 - Chicago Med Saison 2

Parking

Jeff Clarke: Hey, Natalie. I was hoping I could catch you before my shift started.

Natalie Manning: Well, you caught me.

Jeff Clarke: So, you want to do something later? Maybe grab some dinner?

Natalie Manning: Ah, I was up all night prepping for the M&M today. By the time my shift's over, I'm gonna be running on fumes.

Jeff Clarke: We can keep it mellow. Make some spaghetti, watch a movie.

Natalie Manning: Uh, maybe. We'll see.

Maggie Lockwood: Okay, everyone, heads up! CPD! Dr. Choi?

Paramedic: Auto versus ped. Officer Kate Windham found unresponsive in her driveway.

Maggie Lockwood: Who?

Paramedic: Officer Kate Windham. Down for an unknown period. Tubed in the field.

Ethan Choi: Mags?

Maggie Lockwood: Baghdad.

Ethan Choi: She was hit in her own driveway?

Paramedic: Freak accident. Parking brake gave out. Her SUV rolled into her. BP 111 over 77, heart rate 136. Dropped to 32, and then shot back up.

Trauma

Jeff Clarke: Cushing's response. Brainstem herniation?

Ethan Choi: Let's not go there yet. Transfer on my count. Ready? One, two, three. Any sedation or paralytics in the field?

Paramedic: No.

Jeff Clarke: Pupils are fixed and dilated.

Ethan Choi: Not initiating a breath. Resume bagging… No corneal reflex.

Jeff Clarke: What's with Maggie?

April Sexton: Officer Windham arrested Maggie last year.

Ethan Choi: Lieutenant Windham, as I explained, your wife's CT showed massive bleeding. The tests confirm she's not responsive to stimuli, and her blood flow study indicates that the pressure in her brain is greater than her blood pressure. She has no blood flow to her brain. Unfortunately, all of these things tell us that your wife is brain dead… I'm very sorry.

Darryl Windham: You're telling me she's dead? My wife's dead.

Trudy Platt: We're right here for you, Darryl.

Darryl Windham: She was just walking to the mailbox.

Trudy Platt: Mm-hmm.

Darryl Windham: I don't understand. I don't get it. She was... She was walking to the mailbox.

Ethan Choi: I know this must be a terrible shock for you… Lieutenant, I did see on her records your wife is a registered organ donor.

Darryl Windham: Yeah.

Trudy Platt: Kate was all about helping others.

Ethan Choi: Our charge nurse will coordinate the donations. Lieutenant Windham, this is Maggie Lockwood.

Darryl Windham: You're the nurse... That's the nurse... That's, um... You're the nurse from last year.

Ethan Choi: Okay. We'll give you some time, Lieutenant. Again, I'm very sorry.

Trudy Platt: I am gonna be right back.

Trudy Platt: Dr. Choi, can I talk to you for a minute? Given the history between your nurse and Officer Windham, we have a problem. It's hard enough on the lieutenant. He doesn't need this.

Ethan Choi: Maggie's a pro. She'll do her job.

Trudy Platt: Doctor, if you're not gonna handle this, I'm gonna go over your head.

Ethan Choi: I understand you're taking care of your own, but I need to do the same. I'll talk with Ms. Goodwin.

Jeff Clarke: Hey. So, why'd Maggie get arrested? What happened?

April Sexton: The charge was interfering with a police investigation. But Maggie was protecting a patient. In my opinion, Officer Windham overreacted.

Stanley Stohl: Dr. Manning, you set for the Morbidity and Mortality Conference?

Natalie Manning: I am, Doc...

Stanley Stohl: Good. See you there. Remember: M&M is non-punitive. It's a learning experience.

Natalie Manning: Okay.

Stanley Stohl: Dr. Halstead?

Will Halstead: Yes?

Stanley Stohl: I expect to see you there too. As her attending physician, you are ultimately responsible for Dr. Manning's actions.

Will Halstead: Right.

Natalie Manning: I am so sorry to put you in this position.

Will Halstead: Oh, I'm not concerned. You did everything right.

Natalie Manning: Except my patient died.

Will Halstead: Natalie, hey, you're being too hard on yourself. You know, sometimes things just don't break the way we want them too.

Jeff Clarke: If you need backup, I'm available.

Natalie Manning: Thanks, um, but I've got it covered.

Will Halstead: Med students don't present, Clarke. Doctors only.

Pathology

Joey Thomas: I knew it. Sawfly larva.

Sarah Reese: Hmm.

Joey Thomas: I ate half of that apple before I saw it crawling out of the core.

Sarah Reese: That's nice.

Joey Thomas: Nice? Sarah, what is the matter with you?

Sarah Reese: I'm sorry. I'm sorry. I didn't get any sleep last night. This neurology rotation I'm doing... Dr. Abrams had me pull a second shift.

Joey Thomas: Tell Abrams that residents aren't supposed to work more than a 12-hour shift.

Sarah Reese: Yeah, well, you tell him. I got to go.

Joey Thomas: Here. I have something.

Sarah Reese: What is that?

Joey Thomas: Espresso beans. Robusta from Brazil. Highest concentration of caffeine. Take five every hour. Chew thoroughly.

Sarah Reese: Really?

Joey Thomas: Yeah.

Sarah Reese: Thanks.

Joey Thomas: Hey.

OB exam room

April Sexton: Abnormal heart tones?

Doctor: No. Heart rate is 150.

Will Halstead: Strong and steady.

April Sexton: How do the measurements look?

Doctor: Give me a second. Crown-to-chin length measurement is 30.9 millimeters. Well within the normal parameters.

April Sexton: So, the TB meds...

Will Halstead: Don't seem to be causing any problems.

Tate: That's great news. You were right.

Will Halstead: I'll see you back downstairs.

Maggie Lockwood: No. The heart recipient has already been notified. I need a echo, bronchoscopy, liver biopsy, standard chest X-ray, and chest CT. Send the results to me, and I'll forward it to the transplant team. Yep. Thank you.

Sharon Goodwin: Maggie, I heard about Officer Windham's accident.

Maggie Lockwood: Yeah.

Sharon Goodwin: I think it's best that we let April be the liaison on this one.

Maggie Lockwood: Oh, no worries. I'm already into it with the labs.

Sharon Goodwin: Even so, I know what a hard time you had with the arrest. Why stir up all those feelings?

Maggie Lockwood: I don't need coddling. I can do my job.

Sharon Goodwin: Maggie, we need to consider the patient's family as well. I think it's better for all concerned that we get in front of this. It's too loaded.

Maggie Lockwood: You're taking me off? Sharon, come on.

Sharon Goodwin: Let April handle it.

Treatment

Will Halstead: Mr. Koslow. I'm Dr. Halstead. You were brought in unconscious. What happened?

Felix Koslow: Ah, I'm laying here practically naked, doc. You could call me Felix. Uh, last thing I remember, I was coming back from a run feeling a little lightheaded.

Will Halstead: Well, according to the paramedics, you were passed out in the bathroom.

Felix Koslow: Yeah. But I'm fine. And I can't stay here. I'm a jockey. Just been busting my ass getting ready for a race at Santa Anita tomorrow, so must have just overdone it.

Will Halstead: Ever happen before?

Felix Koslow: Never. I really don't need to be here.

Will Halstead: Tell me if this hurts.

Felix Koslow: Ah! Ow! Ow! Just kidding.

Will Halstead: When I was a kid, my dad used to take me down to the racetracks at Hawthorne. The man never picked a winner.

Felix Koslow: Most kids dream about playing in the World Series. For me, it's all about the Kentucky Derby. Took years of riding at BS tracks to get over to Churchill Downs. Been working my way up there, but, you know, in the winter the track closes down, so I've been picking up mounts on the West... West Coast.

Will Halstead: Uh-huh. Open wide for me. Very possible this is just a bout of overtraining. You say you're feeling fine. You sure?

Felix Koslow: Little weak, but nothing that's gonna stop me. I'm on a great horse tomorrow.

Will Halstead: Well, let's make sure you're fit to mount up. I'm ordering an EKG and an echo to check your heart. I'm still waiting on those lab results, so for now, sit tight.

Maggie Lockwood: Dr. Manning! Brett, talk to me.

Sylvie Brett: Car crash. 44-year-old female. GCS 14. Large laceration to the head. Pale and sweaty. LVAD keeps alarming.

Natalie Manning: Page Dr. Rhodes and let him know we got an LVAD down here.

Meghan: Bria, honey?

Maggie Lockwood: Copy. You're going to Trauma 1, Dr. Manning.

Natalie Manning: Got it.

Maggie Lockwood: Report.

Paramedic: 17-year-old female. GCS 15. No LOC. Vitals are stable. Hands and feet moving. Complaining of neck pain.

Meghan: Bria!

Bria: Mom?

Maggie Lockwood: Dr. Choi, you're going to Trauma 2.

Ethan Choi: Copy.

Meghan: Bria! Baby!

Bria: Mom!

Ethan Choi: Here we go.

Trauma 1

Natalie Manning: On my count. One, two, three.

Trauma 2

Ethan Choi: Okay, let's transfer on my count. Ready? One, two, three.

Bria: Where's my mom?

Ethan Choi: Easy, easy. Eyes on me. Eyes on me.

Jeff Clarke: She is right next door. You're gonna see her real soon, okay?

Bria: She has a bad heart. They called. We were coming in for a transplant.

Jeff Clarke: Okay. Heart surgeon's on his way down.

Ethan Choi: Can you tell us what hurts?

Bria: My neck. It snapped back after the airbag hit me.

Trauma 1

Meghan: I got a call saying a heart's available, said to get here. Guy ran a red light. Where's my daughter?

Natalie Manning: She is in good hands. Right now we need to worry about you, okay? Let's get her hooked up to the monitor and rapidly transfuse two packed red blood cells and two plasma. Then get X-rays of her chest and pelvis, okay?

Nurse: Okay.

Natalie Manning: All right, I'm gonna take this off now, okay?

Trauma 2

Bria: I tried to swerve, but I was going too fast. Ow! It really hurts!

Ethan Choi: We're gonna give you something for the pain. Then we need to make sure you don't have any fractures, okay? Let's get a CT of her neck and thoracic spine and 0.2 milligrams of hydromorphone.

Jeff Clarke: Got it.

Trauma 1

Natalie Manning: All right, let's give her 50 mics fentanyl IV push.

Meghan: No. No. I'm a recovering alcoholic.

Connor Rhodes: Meghan?

Meghan: Dr. Rhodes. I made it. I'm... I'm ready for the transplant.

Connor Rhodes: Okay, you just try to stay calm, okay? We're gonna figure this out.

Natalie Manning: She's having suction events. She's still hypovolemic, Let's up her volume. I need to close up this head wound. Can you check her LVAD?

Connor Rhodes: Yeah. You got it.

Natalie Manning: Skin stapler?

Nurse: Right away. Here you go.

Meghan: Oh! Where... Aah! Where's Bria? Where's my baby?

Connor Rhodes: We're gonna take care of her, all right?

Natalie Manning: Let's get some pressure on this.

Nurse: Yes, doctor.

Meghan: I'm... I'm okay. I got a hard head.

Connor Rhodes: Just relax.

Connor Rhodes: What happened?

Natalie Manning: Auto accident.

Connor Rhodes: How bad is it? We've got a donor heart in Baghdad. She needs to be able to tolerate the surgery.

Natalie Manning: I'm hoping the head wound is just superficial. We won't know anything until she gets a CT. We're headed up there now.

Connor Rhodes: All right, well, keep your fingers crossed. She's got better odds of hitting the lottery than she does of matching to another heart before it's too late.

Natalie Manning: Yeah.

Trauma

April Sexton: Lieutenant Windham?

Darryl Windham: Yeah.

April Sexton: Hi. I'm April. I'm very sorry for your loss. I'll be handling your wife's care.

Darryl Windham: I thought it was the... Thought it was the other nurse.

April Sexton: I'm coordinating with the transplant teams today. Your wife's organs are in the process of being matched to people in need. Once that's complete, we'll go ahead and schedule surgery. You're free to stay with her throughout the process.

Darryl Windham: And tell me... How many people will she save?

April Sexton: That depends on the organ evaluation results, but she could potentially save seven, eight lives. We've already found a match for her heart.

Darryl Windham: That's Kate. Always going above and beyond.

April Sexton: I'm here for you every step of the way. Please don't hesitate to reach out should you have any questions or need anything.

Darryl Windham: Thank you.

Trudy Platt: Thank you.

Maggie Lockwood: Hey. When you call the lab, make sure you deal with Sue. She gets the blood and tissue samples analyzed faster than anybody else.

April Sexton: All right.

Maggie Lockwood: And once they match the other organs, make sure that you...

April Sexton: Maggie, I know how to do this. I'm sorry if you feel like I'm stepping on your toes.

Maggie Lockwood: You're not stepping on my toes. It's just... It's my responsibility.

Trauma 1

Connor Rhodes: Meghan, we got your test results. Your CT scan looks fine.

Meghan: Then I'm okay to have the surgery, right?

Connor Rhodes: Unfortunately, there's another problem. We do a tox screen as part of your pre-op workup.

Isidore Latham: Your blood alcohol content came back 0.06.

Meghan: No. It can't... That's a mistake. I... I told her not to, but that doctor must have given me pain medication.

Isidore Latham: Pain medication would have no effect on the blood alcohol levels.

Meghan: Check it again! I'm sorry. I screwed up.

Isidore Latham: Can you explain your actions?

Meghan: Margaret Brazetti. She's my age. Three kids. Been on the transplant list two years. Met in a support group. Was always positive. Always laughing. And she got me through some really hard days. She died this morning. I slipped. Two shots. First time in three years. Then I got the call about the heart. I asked Bria to take me. If I hadn't asked her, she wouldn't be hurt.

Isidore Latham: The asking wasn't the problem. The drinking was.

Meghan: Does this mean I don't get the heart?

Connor Rhodes: That's the committee's decision. You should try and get some rest.

Meghan: Rest? Is Bria, um, back from her CT?

Connor Rhodes: We'll have somebody check.

Isidore Latham: As I recall, you vouched for her.

Connor Rhodes: I did.

Isidore Latham: Quite an unfortunate choice.

Maggie Lockwood: All the other matches are in?

April Sexton: Yeah. Got teams flying in from Wisconsin, St. Louis, and Des Moines.

Trudy Platt: April, is it possible for some of us to be in the OR with Darryl during the procedure? He could use the support.

April Sexton: I will have to talk to the surgical charge nurse, but I'm sure we can work something out.

Trudy Platt: Thanks. Excuse me. Excuse me. Um... I was the one who asked for someone else to take charge of this. It really wasn't personal. I was just thinking of the lieutenant. You understand?

Treatment

Felix Koslow: No. Everything's good. Flying out at 9:00. Yeah. I'll see you first thing for the morning workout. Yeah.

Will Halstead: Got your labs back and the results of your echo.

Felix Koslow: Yeah. I'm sure nothing's wrong with me that these bags of fluid haven't fixed.

Will Halstead: Well, you're dehydrated. It will help with that… Felix, your creatinine and sodium are high and your potassium is low, and I noticed enamel erosion around some of your teeth. Now, all these are indicators of bulimia.

Felix Koslow: Bulimia is... Is something girls get.

Will Halstead: Well, actually, 1/3 of those suffering from bulimia are men. Eating disorders are not specific to women, and you should know they're treatable.

Felix Koslow: I don't have an eating disorder. I've got a job that requires me to make weight, or I don't get to ride. All jockeys flip.

Will Halstead: Flip?

Felix Koslow: Yeah. Stick our fingers down our throat. If that ain't enough, some guys sit in the hot box and sweat it out. Some down laxatives. I take diuretics.

Will Halstead: Because of the purging and diuretics, you're considerably underweight, which has caused a mitral valve prolapse, meaning the valve in your heart has become floppy. And it's treatable. I'd like to put a tube through your nose into your stomach to feed you calories. Now, over time, this may reverse the MVP and fatten up your heart.

Felix Koslow: What happens if I don't? Is it gonna kill me?

Will Halstead: With your lifestyle, you are putting yourself at a much greater risk of infection, cardiac arrhythmia, or even heart failure.

Felix Koslow: I've been riding Executive Chef for a year. That's four wins and a place. I am one ride away from that derby mount.

Will Halstead: Felix...

Felix Koslow: No... I'm finishing this fluid, and I'm getting the hell out of here.

Dr. Abrams: We have a pre-op consult upstairs in six minutes.

Daniel Charles: Dr. Reese, Dr. Abrams. How's it going?

Dr. Abrams: I need to break her of all your bad habits. I've found my most successful residents happily volunteer to work well past the standard 80-hour week.

Connor Rhodes: Dr. Charles. Meghan Scott, my transplant patient you evaluated.

Daniel Charles: Yeah.

Connor Rhodes: Turns out that you were right about her. She fell off the wagon.

Daniel Charles: Really? I'm very sorry to hear that.

Connor Rhodes: The way I put you on the spot about your decision... I owe you an apology.

Daniel Charles: No, you don't. I appreciate the gesture, but my evaluation... I vetted her. It was my call… I should, um... I should probably check in with her. The Transplant Committee's gonna want another assessment.

Connor Rhodes: If you'll excuse me, I've got to get to the M&M.

Daniel Charles: Yes. Thank you for telling me.

Connor Rhodes: Of course.

M&M

Natalie Manning: The patient became unstable due to an unrecognized pericardial effusion, which was stabilized by emergent pericardiocentesis.

Stanley Stohl: You presented the images of the MRCP demonstrating cholelithiasis to support your diagnosis of pancreatitis due to choledocholithiasis, but you aren't showing us any images of the lung bases or heart.

Natalie Manning: Those images were not obtained.

Stanley Stohl: Why not?

Natalie Manning: The patient's movement resulted in unreadable images.

Stanley Stohl: Why didn't you repeat the scan?

Natalie Manning: The study captured adequate detail within the area of interest.

Stanley Stohl: So, had you been more vigilant at this juncture, perhaps you would have identified this patient's pericardial effusion and avoided his subsequent cardiovascular collapse.

Natalie Manning: In hindsight, yes. At the time, I believed I had what I needed.

Stanley Stohl: Let's move on. You mentioned placing the patient on BiPAP, which exacerbated cardiac tamponade. How did you respond?

Trauma 1

Ethan Choi: How are you feeling?

Meghan: Like I screwed up two lives.

Ethan Choi: Let's get you two together. I'll have this dividing wall opened up.

Meghan: How is she? Is her neck okay?

Ethan Choi: Good news is there are no fractures.

Meghan: Okay. What's the bad?

Ethan Choi: It's not necessarily bad. It might be minor, but Bria's CT showed a mass in her upper thoracic spine, unrelated to the accident.

Meghan: Oh, God. A mass means tumor, right?

Ethan Choi: It could be a number of things.

Meghan: My poor baby. She's had some back pain in the last few months. She tried to convince me it was nothing. I should've brought her in. This is my fault.

Ethan Choi: Meghan, until we do an MRI to get a better look at what we're dealing with, the best thing you could do is try to stay calm.

Felix Koslow: Son of a bitch! I need this damn thing out!

April Sexton: Mr. Koslow, please, you need to calm down.

Felix Koslow: And you need to take this out of my arm. I'm two pounds over.

Will Halstead: Hey, hey, hey. It's just water weight. That IV is the only reason you're feeling stronger. You need to leave it in.

Felix Koslow: You know, screw this. You're not gonna do it, I'll pull it out myself.

Will Halstead: Whoa!

April Sexton: No, no, no. Please don't do that.

Will Halstead: Okay. Fine. That's what you want, let's get you back to your room.

Felix Koslow: Hell, no! You're gonna try to give me something. I'm done with this crap!

Will Halstead: No! Mister-

Felix Koslow: Get off of...

Will Halstead: Hey.

April Sexton: Now you're bleeding.

Felix Koslow: I'm fine.

Will Halstead: Okay. This is why you need to be treated.

Felix Koslow: I did that, and now I'm too fat to ride.

Will Halstead: You can not take diuretics again. You are playing Russian roulette. There are only so many times you can pull that trigger.

Felix Koslow: Let me go, now!

Trauma 2

Bria: Mom, I'm fine!

Meghan: It's not uncommon for people w-Oh, it's just a blanket.

Bria: I don't need it.

Ethan Choi: Everything okay?

Meghan: Oh, she just seemed cold.

Bria: And you shouldn't be up.

Sarah Reese: Can I help you back into bed?

Meghan: Dr. Reese?

Sarah Reese: I'm doing a rotation in neurocritical care.

Meghan: Oh.

Ethan Choi: The mass we found is not a tumor.

Meghan: Oh, thank God.

Sarah Reese: It's a spinal AVM, which is an abnormal tangle of blood vessels.

Meghan: Is it serious?

Ethan Choi: Bria's probably had it since she was born. Quite often, we don't find it until it starts causing problems.

Bria: What kind of problems?

Sarah Reese: Down the line, numbness, hemorrhage, even paralysis.

Meghan: So, the back pain was a sign. We could've caught this months ago.

Ethan Choi: Let's focus on the fact that we caught it now. It can be treated surgically. Dr. Reese will do a neurosurgery consult with you, and then our head of neurosurgery, Dr. Abrams, will come down and go over the details.

Meghan: I'm so sorry, Bria.

Bria: Stop it. It's not your fault.

Meghan: No. I wasn't thinking about you. I was only thinking about myself.

Ethan Choi: Having an AVM is unfortunate, but finding it now, as early as we have, is the best we could ask for.

M&M

Connor Rhodes: Dr. Manning then paged me to perform a pericardiocentesis.

Stanley Stohl: Did you recommend sending the fluid for analysis and obtaining a CT chest, abdomen, and pelvis?

Connor Rhodes: I did. The CT showed a large mass in the right middle lobe with bulky hilar and mediastinal lymphadenopathy.

Stanley Stohl: And that's when Dr. Manning called for an oncology consult?

Will Halstead: Yes. And their recommendation was chemotherapy.

Stanley Stohl: Dr. Rhodes?

Connor Rhodes: I recommended an alternative course of therapy: since the primary mass was resectable, I thought it best to move forward with surgery without delay.

Stanley Stohl: And Dr. Manning disagreed?

Natalie Manning: I thought the radiation would give the pancreatitis time to cool down.

Stanley Stohl: What was his Ranson's score?

Natalie Manning: It was...

Jeff Clarke: What difference does that make? There's no reliable way to predict tumor lysis syndrome.

Stanley Stohl: Dr. Manning, if your white knight plans on continuing his medical education at this hospital, I recommend that you advise him to remove himself from my presence… Let's take a five-minute break.

Hallway

Natalie Manning: How dare you?

Jeff Clarke: I know. I shouldn't have said...

Natalie Manning: I am not a damsel in distress, and I do not need you to defend me.

Jeff Clarke: I was only trying to help.

Natalie Manning: You humiliated me in there.

Jeff Clarke: Natalie, I'm sorry.

Will Halstead: If he gets on that horse, he's not only a danger to himself, but every other jockey in the race.

Daniel Charles: I don't disagree.

Will Halstead: Can we keep him on a psych hold?

Daniel Charles: No, we can't. I mean, from everything you told me, his stated intention is to win the race. He didn't say anything about doing intentional harm.

Sharon Goodwin: And if we do hold him, he'd probably sue the hospital, and you personally. If you can't convince him to stay, get him to sign that he's leaving against medical advice.

Will Halstead: Oh, he's already asked for the paperwork.

Sharon Goodwin: Then it's settled.

Will Halstead: Damn it!

Cafeteria

Tate: That ultrasound was a huge relief.

April Sexton: Yeah.

Tate: So, now that we know everything's okay, there's something I'm hoping you'll consider for the baby's sake. Maybe it would be good if you stopped working for a while, just until the kid is born. I know how you feel about your job. I'm not asking you to give that up… But a few months could help to take away some stress.

April Sexton: If it was up to you, there wouldn't even be a baby.

Tate: April, I told you I'm sorry. The only reason I wanted to consider terminating was I thought the baby would have no quality of life. I didn't want to put you... Us through that.

April Sexton: My job's not endangering the pregnancy. The second I feel like work is negatively affecting me, I'll stop. For now, I'm fine. We are fine.

Sharon Goodwin’s office

Sharon Goodwin: So, Dr. Charles, you assessed Meghan Scott today.

Daniel Charles: Yes, I did...

Isidore Latham: I don't understand why we're debating this. An alcoholic must be sober for 18 months before being eligible for transplant... Those are the rules. This patient disqualified herself.

Sharon Goodwin: Dr. Latham, right now in the hospital, we have an excellent match for a heart, an organ which you know has a limited window of viability. We may have to think beyond the rules.

Doctor: What stops her from drinking the next time she gets upset?

Daniel Charles: Ironically, relapse can be a very important part of recovery. Happens to most addicts at some point, and it's very often the utter misery of falling off the wagon that motivates those that suffer to finally get serious about staying sober.

Doctor: And you believe this is the case for Ms. Scott?

Daniel Charles: I also think it's been a very real wake-up call for her. Until the accident, Bria was performing the caretaker role, but now Meghan realizes the importance of stepping up and taking responsibility not just for herself, but also for her daughter.

Doctor: So, bottom line, are you saying the committee should give Ms. Scott the currently available heart?

Daniel Charles: As a human being, I would love to root for Meghan. As a doctor, I'm... I'm just more aware than ever of the power that this disease can have over somebody.

Sharon Goodwin: Dr. Rhodes?

Connor Rhodes: Uh, I was confident when I pushed for Meghan to be put on the list… Regretfully, I am less confident now.

Sharon Goodwin: If there are no more questions, I move the committee take a vote. All those in favour of Meghan Scott receiving the heart, signify with a "yea."

Man: Yea.

Sharon Goodwin: All those against, signify with a "nay."

Doctor: Nay.

Isidore Latham: Nay.

Sharon Goodwin: The nays have it. We'll look for another recipient.

Hallway

Isidore Latham: You remain conflicted about Meghan Scott despite her breaking the clearly defined rulest for being a transplant candidate.

Daniel Charles: Yes. I... I remain conflicted. I've worked with a lot of alcoholics, and I know real regret when I see it.

Isidore Latham: Real regret? Can you elaborate? What exactly did you see in Ms. Scott?

Daniel Charles: Well, I... I saw real sadness. You know, there were tears rolling down her face, and, um, her jaw was clenched, you know, and her body sort of drooped with what looked like shame.

Isidore Latham: That's interesting.

Trauma 2

Bria: Are you sure you're gonna be all right?

Meghan: Sweetie, you need to stop worrying about me. All I want you to think about is how much I love you. And when you wake up, I'll be right there, okay? I love you, baby.

Bria: Love you, too.

Meghan: Please let her be all right.

M&M

Stanley Stohl: While debatable choices were made by all involved, no one physician is to blame. My recommendation is to revisit hospital policy on requiring doctors to be present when radiation is administered. Only with more skilled eyes on the ECG can future incidents of TLS be identified and treated. Hope you've all learned something here today that will make you better physicians. On a personal note, it's ill-advised for residents to date medical students.

Maggie Lockwood: Uh-huh. Is there something that I can help you with?

Darryl Windham: Yeah. I was looking for April.

Maggie Lockwood: She's on a break right now. But I can answer any question you might have.

Darryl Windham: Yeah. Uh, my wife, Kate, has this necklace, and, uh, I think it was a gift from her mother. And, you know, anyways, uh, she always wears it, but the clasp broke, uh, in the accident. And I know she'd want to have it with her. I just...

Maggie Lockwood: I understand. It can be in her hand through the surgery. I can make sure April gets it.

Will Halstead: We can put them back together, but we can't change their behaviour, right?

Daniel Charles: "I am indeed a king because I know how to rule myself." Pietro Aretino. He was a 16th century poet.

Will Halstead: What are you getting at, doc?

Daniel Charles: Well, put it this way: in this case, the king might be in for a rude awakening when they drug test him before the race.

Will Halstead: Yeah, if he gets tested. Testing's random.

Daniel Charles: I don't know. I mean, somebody could make an anonymous phone call, you know, tipping off the track that he took a diuretic. You never know. Somebody maybe already did.

Isidore Latham: Dr. Charles. Those signs that you talked about earlier... The sadness in the eyes, the clenched jaw... I don't see them. I'd like to know why they elude me.

Daniel Charles: You know, I might have some literature in my office that could illuminate some of this stuff for you. You got a couple minutes?

Isidore Latham: Mm.

Observation room

Ethan Choi: How's Bria?

Sarah Reese: Dr. Abrams just started cauterizing the AVM. He's a really good surgeon. I just wish he wasn't such a dick.

Ethan Choi: Keep me posted.

Sarah Reese: Mm-hmm.

Connor Rhodes: Rough day, huh?

Daniel Charles: Yeah. Grab a bite?

Connor Rhodes: I'd like that.

Sharon Goodwin: Dr. Rhodes, Daniel. We found another recipient for Officer Windham's heart, but the woman lives in San Diego, and that's at least a four-hour flight. If there were a delay, we couldn't guarantee the heart's viability, and we cannot postpone harvesting due to the needs of the recipients of her other organs.

Daniel Charles: So, therefore?

Sharon Goodwin: Meghan Scott will be receiving Officer Windham's heart. Due to the circumstances, it's the only option we have.

Daniel Charles: I guess dinner will have to wait.

Connor Rhodes: Yeah.

Maggie Lockwood: Sharon?

Sharon Goodwin: Yeah?

Maggie Lockwood: Can we talk?

Sharon Goodwin: Of course. That's the form.

Maggie Lockwood: Here, take this.

Treatment

Sharon Goodwin: What's up?

Maggie Lockwood: Sharon, I want to take over Kate Windham's care.

Sharon Goodwin: Come on, Maggie. We've been through this. You know my concerns.

Maggie Lockwood: Yes, and I respect them… But it's closure for me, and in a way for Kate Windham, too.

Sharon Goodwin: And what about her husband? What about his feelings?

Maggie Lockwood: I promise you, I'll make sure he feels comfortable… I need to do this.

Sharon Goodwin: All right. All right. I'll talk to April.

Maggie Lockwood: Okay.

Maggie Lockwood: Can I speak to you, Lieutenant Windham?

Trudy Platt: You good?

Darryl Windham: Okay.

Maggie Lockwood: When I became a nurse, I took an oath. I swore to devote myself to the welfare of those committed to my care. That's my job.When your wife arrested me, she was doing her job… I bear her no ill will… I'm very sorry for your loss… But I want to honour your wife, if you'll allow me.

Darryl Windham: Yeah.

Trauma 1

Meghan: No. No!

Nurse Doris: Ms. Scott, we need to get you upstairs.

Meghan: No... I don't care. I'm not going anywhere until I find out about Bria.

Ethan Choi: She's still in surgery, but doing well. Right now, the best thing you could do for your daughter is to take care of yourself.

Trauma

Maggie Lockwood: We'll be right back with someone to take her up to the OR.

Locker room

Natalie Manning: Hey.

Will Halstead: You know today wasn't a defeat, right?

Natalie Manning: I guess… The whole experience has been a lesson in humility.

Will Halstead: Humility. Always been a tough one for me.

Natalie Manning: Good night.

Will Halstead: You know, Clarke... He was out of line today. But he was really in your corner.

Natalie Manning: Yeah.

Parking

Natalie Manning: Hey, Jeff! You want to get a drink?

Jeff Clarke: I'll meet you over there.

Natalie Manning: Okay

Sharon Goodwin: A nice move, Daniel. Anonymous phone call.

Daniel Charles: We do what we can, sister.

Sharon Goodwin: Yes, we do.

Molly’s

Natalie Manning: So, the M&M. Stohl called you my white knight.

Jeff Clarke: I know, Nat, and I feel terrible. And I... And I heard what he said about dating.

Natalie Manning: No, Jeff. I can handle that.

Jeff Clarke: I'm just really sorry.

Natalie Manning: It should be me apologizing to you.

Jeff Clarke: Why? I'm the one who made everything worse.

Natalie Manning: I haven't been fair to you… Stohl also said that he hoped we all learned something today. And I did… When Jeff died, it created this void, this hole in my life, and in my heart. I needed someone to fill that void... To take the pain away… And there you were. I feel like I used you. You gave me the illusion that my life was fixed and whole. But it doesn't work that way.

Jeff Clarke: It can, though, Natalie. It can work that way. And look, I want to be...

Natalie Manning: Jeff, I think you're a great guy. You're just not the great guy for me.

Jeff Clarke: This is it?

Natalie Manning: Yeah.

Main: Dispatch to 2436. Dispatch to Officer Windham. Dispatch to Officer Kate Windham. Officer Windham, your work here is done. Officer Kathryn Windham graduated the Chicago Police Academy in 2008. She served with distinction, receiving the 21st District Officer of the Month three times, two department commendations, and in 2014, received the Lifesaving Award for pulling the driver from a burning vehicle. Officer Windham is survived by her parents, Robert and Felicia, her brother, Richard, and her husband, Darryl. We thank you for your dedication, loyalty, and years of exemplary service to the Chicago Police Department, the citizens of Chicago, Illinois, and the United States of America. Know that your strength and love lives on in your husband and family, and your honour will live on in all of us… End of watch, January 12, 2017. Officer Kate Windham, star number 2436, is 10-7. Gone but never forgotten. Rest in peace, dear friend, and protect us from above.