ER
Maggie Lockwood: Whoa, whoa, whoa, we're live. Naima?
Naima: 22-year-old male, gunshot wound to the abdomen. GCS 15.
Maggie Lockwood: Dr. Choi, GSW!
Ethan Choi: On it!
Naima: BP, 100 over 50.
Maggie Lockwood: Oh, wait a second. Wait a sec. Whoa.
Ethan Choi: Get this one up to surgery.
Maggie Lockwood: All right, let's go. Okay, here we go. Dr. Choi, you're good?
Ethan Choi: Good.
Maggie Lockwood: All right, Monique... Seven treatment rooms on the East side, four trauma bays on the West. Bays three and four combine to treat gunshot wounds, a place affectionately known as Baghdad. 4,000 shootings in Chicago. Some days, we get... A dozen… Drug dispensers are in the North and South end of the E.D, extra gurneys, isolations suites in the ambulance bay. Uh, Band-Aid, wound dressings, gauze, and extra weaponry are in the supply closet next to the elevator, which brings us right here to the command center.
Doris: Deer in the headlights.
Maggie Lockwood: Mm-hmm.
Doris: Nursling?
Maggie Lockwood: Monique Lawson. She's got her Pediatric Advanced Life Support certification, and is doing her E.D. check-off skills training with yours truly.
Doris: Be careful, she bites.
Maggie Lockwood: Monique, Doris, move.
Monique Lawson: I hardly slept last night. I couldn't stop thinking. I mean, so many people coming in, horrible injuries.
April Sexton: And this isn't even a busy day.
Monique Lawson: I just hope I'm up to it.
Maggie Lockwood: Quick, nurses' credo?
Monique Lawson: Uh, cure sometimes, treat often, comfort always.
Maggie Lockwood: Uh-uh. Don't kill your patient...
All: Because that's the doctor's job.
Natalie Manning: I heard that. Maggie, what you got for me?
Maggie Lockwood: Alzheimer's patient, here from long-term care facility. Hypotensive and high fever in Treatment 2.
Natalie Manning: Any family? Advanced directives?
Maggie Lockwood: No, surrogate just passed away, and no one else was designated, so it's going to be our call. Okay, and you need to be initiating catheter duty. Patient in Treatment 6. Have a stab at her.
Natalie Manning: Wait, we need to page Will.
April Sexton: What is it?
Natalie Manning: This is Bella Rowan... Dr. Rowan. She was Will's teacher, his mentor.
April Sexton: Okay.
Treatment 2
Will Halstead: Lungs are wet. Does this hurt, Dr. Rowan?
Bella Rowan: Oh...
Will Halstead: Okay, all right, all right.
Bella Rowan: Who are you?
Will Halstead: I'm Dr. Halstead.
Bella Rowan: Oh...
Will Halstead: I'm gonna help Dr. Manning here take care of you. Is that all right?
Bella Rowan: Oh, good.
Will Halstead: Okay.
Bella Rowan: Gotta go.
Will Halstead: Why is that?
Bella Rowan: Mm, miss my bus.
Will Halstead: Oh, where are you going?
Bella Rowan: What?
Will Halstead: Okay, okay, okay... Tell you what, Dr. Rowan... We promise to do our best, to get you out of here so you can catch that bus. How's that sound?
Bella Rowan: Good.
Will Halstead: Good.
Bella Rowan: Good.
Will Halstead: All right. I'll be back to check on you in a few minutes.
ER
Will Halstead: I'm pretty sure she's got aspiration pneumonia.
Natalie Manning: Yeah.
Will Halstead: You start antibiotics?
Natalie Manning: Vanc and Zosyn, plus Levophed to maintain her pressure. Metabolic panel, urine analysis, and blood cultures are all pending.
Will Halstead: She's obviously been sick for days. Why did they wait so long to bring her in?
Natalie Manning: I'm sorry, Will.
Sharon Goodwin: Dr. Halstead, I came as soon as I heard. I was an O.R. nurse under Dr. Rowan when I was starting out. How is she?
Will Halstead: Not good, and we're playing catchup… All right, let's put in a central line and get a chest X-Ray, and I wanna keep close tabs on her volume status. Please, keep me updated every 20 minutes.
Natalie Manning: Of course.
Elevator
Connor Rhodes: Hey, we went to Joe's last night. My sister loves stone crab.
Hallway
Connor Rhodes: It was nice. I mean, there were a lot of years when Claire wasn't speaking to me.
Robin Charles: Eh, I'm sure she had very good reason.
Connor Rhodes: Well, she can tell you all about it herself.
Robin Charles: What do you mean?
Connor Rhodes: She wants to meet you. She wants to have you over for dinner.
Robin Charles: By meet, you mean grill? Make sure I'm worthy of a Rhodes?
Connor Rhodes: No, that's more my father. Claire's not like that. She's happy if I'm happy, and I'm happy.
Robin Charles: I'm not sure if I'm ready to, uh, meet the family.
Leah Bardovi: Morning, Dr. Rhodes. Robin...
Robin Charles: Leah.
Connor Rhodes: Dr. Bardovi, are you ready for your first coarctation repair?
Leah Bardovi: I've been studying cases all week.
Connor Rhodes: Good.
Leah Bardovi: Course there's nothing like watching the maestro.
Robin Charles: I will catch you at lunch, Maestro.
Connor Rhodes: We'll continue this conversation later. Let's go.
Leah Bardovi: Patient's 13. Pretty late to get a coarctation diagnosis.
Connor Rhodes: Uh, his dad's an oil worker. He did a stint in Nigeria. Nobody there caught it.
Pre op room
Connor Rhodes: Knock, knock?
Mitch Jacobs: Dr. Rhodes.
Connor Rhodes: Mitch, how are you doing? This is Dr. Bardovi. She's gonna be assisting me in the surgery. Brandon, how are we doing this morning, bud?
Mitch Jacobs: We are both looking forward to getting on the other side of this thing. Ain't that right, buddy?
Brandon Jacobs: Uh, yeah, sure. Hey, are you guys gonna have to saw me open to do this?
Connor Rhodes: Yes. Yes, we are.
Brandon Jacobs: I'm not scared. I'm just wondering if Halloran's gonna have a cool scar after the battle of Madigan.
Leah Bardovi: Halloran?
Mitch Jacobs: It's a character in some dumb online game that he plays.
Brandon Jacobs: Dad, it's not a game. It's fan fiction. I published a chapter today, and my followers are gonna wanna know what happens to Halloran after he slays the High Locust. That's you.
Connor Rhodes: All right, then. Well, I am honoured. And yes, Halloran's gonna have a pretty gnarly battle scar.
Brandon Jacobs: Sweet.
Mitch Jacobs: Well, at least one of us isn't nervous.
Connor Rhodes: So, coarctation repair. It sounds complicated, but it's actually a relatively simple procedure. Uh, I'm gonna make an incision in Brandon's left chest. We'll place him on partial bypass, and then resect, or cut out, the narrowed portion of his aorta, and place a graft. Now I know all this is a lot, but any questions, feel free.
Mitch Jacobs: Uh, yeah, I was doing some research online, and it seems that, uh, Brandon's chicken legs and his puny size are because of his condition? I mean, any chance that that'll change?
Connor Rhodes: Uh, obviously, Brandon's health is our primary concern, uh, but yes, he may grow at a more rapid rate once the blood flow issue is corrected.
Mitch Jacobs: Good. Okay.
Connor Rhodes: All right, Brandon, see ya on the battle field.
Terrace
Daniel Charles: Dr. Reese? You didn't answer your page.
Sarah Reese: Oh, sorry. I... I was just... Uh... When Jason Wheeler jumped, do you think he was scared? Was... I mean, was... Was he at peace? Right before he stepped off, was there a moment of regret? I just... I just can't stop thinking about him.
Daniel Charles: Yeah.
Sarah Reese: But see, I... I don't want to, and then I feel guilty, because I don't.
Daniel Charles: The thing about suicide, it's never really a lone act. It tends to leave a lot of victims in its wake. I'd be lying if I said I'd been sleeping too well recently… But, um... But you and I... We've got work to do.
Treatment 4
Ethan Choi: Excuse me.
ER
Ethan Choi: Sean Adams, formal Naval aviator, now flies for a private charter company. And he was doing his pre-flight check and felt faint. Co-pilot brought him in. Says it's not the first time. Now I checked Mr. Adams out. Can't find anything wrong. Probably just dehydrated and overworked. Says he feels fine and wants to go.
Daniel Charles: So, um... So why are we here?
Ethan Choi: Charter company wants a psych evaluation.
Daniel Charles: Uh-huh.
Ethan Choi: Co-pilot says he's also been acting different. Doesn't go out with the boys anymore, naps a lot, seems to be low energy. Huh.
Sarah Reese: Sounds like depression.
Daniel Charles: Possibly.
Ethan Choi: In any case, the company won't let him fly till you sign off.
Daniel Charles: Why don't we have a little chat?
Ethan Choi: Thanks.
Hallway
Maggie Lockwood: Code blue!
Training room
Maggie Lockwood: Unresponsive two-year-old. Quick, what do we do first?
Monique Lawson: Check pulse, start compressions.
Doris: There is no pulse.
Maggie Lockwood: Compressions at what rate?
Monique Lawson: 150 beats per minute.
Maggie Lockwood: Good. You got a team behind you. What's next?
Monique Lawson: I tell them to start bagging. Pulse check.
Maggie Lockwood: Okay, but there's still no pulse. Patient's dying. What now?
Monique Lawson: Use the paddles to do a quick look.
Maggie Lockwood: Shows v-fib. She's coding, so?
Monique Lawson: Need to shock at 4 joules per kilo?
Maggie Lockwood: Well, move then. You're losing her. Charge to 28 joules.
Monique Lawson: I'm shocking the patient.
Doris: Great. You just killed me.
Monique Lawson: I did?
Doris: Mm-hmm.
Maggie Lockwood: You forgot to yell "clear" before shocking. Just one of those minor details. Reset. Let's take it from the top. Come on.
Treatment 4
Sean Adams: It just seems like everyone's overreacting.
Daniel Charles: But you can see their point of view. I mean, people put their lives in your hands.
Sean Adams: And I'm fine. I've answered your question. I know what today is. I know where I am.
Daniel Charles: Aside from lack of energy, your co-pilot says that at times you seem mildly confused.
Sean Adams: I have no idea what he's talking about. Maybe he's the one that's confused.
Sarah Reese: Mr. Adams, I imagine there's a lot of pressure at your job.
Sean Adams: I used to land F-14s on an aircraft carrier. That's pressure.
Sarah Reese: Have you ever had thoughts of hurting yourself?
Sean Adams: What? No.
Daniel Charles: Let's see here. Are you on any medication?
Sean Adams: You mean do I take anything that might affect my performance? No. I take a statin, like 10 million other Americans. And no, I don't drink, if that's your next question.
Daniel Charles: All right, Mr. Adams, well, thank you for your time.
ER
Daniel Charles: Getting, um, a little ahead of yourself. Don't you think?
Sarah Reese: Well, he is exhibiting signs of depression, and there is a high rate of suicide among pilots.
Daniel Charles: Dr. Reese, trust me, I understand what's on your mind, but suicidality should not necessarily be a default diagnosis.
Ethan Choi: So what do you think?
Daniel Charles: I think that Mr. Adams is linear, lucid. I mean, he's certainly not confused.
Sarah Reese: Are you gonna sign off on him?
Daniel Charles: Well, I didn't say that. I mean, I thought he was a little defensive around the medication issue.
Ethan Choi: Well, the man has to prove himself to keep his job. That would make me defensive.
Daniel Charles: And you know what, that could be all there is to it. But look, he's a pilot. Let's just take the extra step. You know, run a tox screen, make sure he's clean.
Ethan Choi: Okay.
Daniel Charles: To your point, depressives often self-medicate, so I'm not ruling out the diagnosis.
Treatment 2
Natalie Manning: Dr. Rowan's LFTs are high, her creatinine's through the roof.
Will Halstead: Kidneys are struggling. White cell count's high too.
Natalie Manning: Multiple organ failure and pending respiratory failure.
Will Halstead: We need to intubate her.
Natalie Manning: What... At her age?
Will Halstead: Nurse!
Natalie Manning: No, mm, Will... You know what this means. She might never get off. What if we bridge her with BiPAP? That'll take the stress off the lungs, until the infection cools.
Will Halstead: We'd still wind up intubating her, and we'd have lost time.
Sharon Goodwin: Dr. Halstead... There's a Mr. Sherwood here from the nursing home. He wants to know how Dr. Rowan is doing.
Will Halstead: I'll be happy to tell him.
ER
Will Halstead: Sherwood, is it? You mind telling me how you and your staff let a textbook case of aspiration pneumonia go unattended?
Ryan Sherwood: I-I don't think that happened.
Will Halstead: You don't? Then... Then how was she allowed to aspirate in the first place?
Sharon Goodwin: Dr. Halstead...
Will Halstead: 'Cause I... I visited her every month. I knew she had trouble swallowing. Your staff knew she had trouble swallowing.
Ryan Sherwood: Okay, I-I promise you I'll look into this.
Sharon Goodwin: I'm sure you will.
Will Halstead: Oh, you better. I mean, that she... That Dr. Rowan should come to this, all because you denied her the most basic... Hey!
Sharon Goodwin: Dr. Halstead... Thank you, Mr. Sherwood.
Natalie Manning: Will...
Will Halstead: They're criminals. I mean, we should call IDPH, have their license revoked.
Doctor Lounge
Bella Rowan: You've all achieved something very special today. Now you're physicians, doctors. In a few months, you'll begin your residencies, caring for people in need. If you take one thing away from me today, let it be this. Treat the patient, not the disease.
Nina Shore: Brought you some Vitner's.
Will Halstead: Ah...
Nina Shore: Triple cheese.
Will Halstead: Thanks.
Nina Shore: Dr. Rowan? I'm really sorry, Will. I know how hard it'll be...
Will Halstead: No. No, if we can get her temp down and her sats up, I think we'll be over the hump.
Nina Shore: Hm. Kay… I just remember when my grandma got sick, how tough it was for my mom. The options, decisions... Seeing my grandma so ill. It was awful.
Will Halstead: Yeah, I hear what you're saying. But, Nina, she can beat this. Dr. Rowan gave me so much. Getting her through this, it's the least I can do.
ER: desk
Maggie Lockwood: Enter the patient's first and last name, select an urgency level, pick your labs, and then hit submit.
Monique Lawson: Okay.
Mrs. Adams: Excuse me...
Maggie Lockwood: Yep.
Mrs. Adams: I'm looking for my husband, Sean Adams.
Maggie Lockwood: He's in Treatment 4. I'll page his doctor.
Mrs. Adams: Thank you.
PICU
Mitch Jacobs: How's it look?
Connor Rhodes: Systolic's still 50 higher in the arms, but that's not uncommon right after surgery. It should come down in the next 24 hours or so… It looks like Halloran slayed the High Locust after all.
Mitch Jacobs: Hey, um, so how much longer before he's up and running around?
Connor Rhodes: Uh, well, over the next few months, you should see an increase in energy and some improvement in muscle development.
Mitch Jacobs: Oh, thanks. I can't tell ya. I've been dreaming about the day I could get out in the yard and toss a football with my son, like my dad did with me.
Connor Rhodes: Well, hopefully that'll happen. Right now, why don't you just let him get some rest?
Treatment 4
Daniel Charles: See, Mr. Adams, as part of our evaluation, we run a toxicology screen, and I'm happy to say that yours was normal.
Sean Adams: I told you I don't take drugs.
Ethan Choi: However, we did find something else. Profound anemia.
Mrs. Adams: Anemia?
Ethan Choi: It could explain your feeling faint.
Sean Adams: Okay, I-I guess I gotta eat more steak.
Ethan Choi: It's actually more serious than that. We need to transfuse you with several units of blood right away. We also need to find out what's causing it, so I'd like to admit you for a battery of scans and tests.
Sean Adams: Uh-uh, I've got my own doctor. I'll make an appointment with him.
Ethan Choi: Mr. Adams, we don't want you to leave in this condition. You're not well.
Sean Adams: I feel fine.
Mrs. Adams: Sean, are you sure about that?
Sean Adams: Yes, and a car ride home and sleeping in my own bed isn't gonna hurt me.
Daniel Charles: That may not be true. I-I emphatically recommend that you take Dr. Choi's advice.
Sean Adams: As far as the psych evaluation goes, am I in the clear?
Daniel Charles: Well, not listening to your physician isn't the greatest sign to me.
Sean Adams: Well, you're not the only psychiatrist in Chicago. I'll get a referral from my primary.
Mrs. Adams: Sean...
Sean Adams: Viv, we're going. Hand me my clothes. Please get me whatever paperwork I need to sign, so I can get out of here.
Ethan Choi: I'll be back shortly.
ER
Sarah Reese: Something's just not right with him.
Daniel Charles: I agree.
Ethan Choi: But is it physical or mental?
Daniel Charles: Your guess is as good as mine. Unfortunately, we have no grounds to hold him.
Ethan Choi: I'll get the paperwork ready.
Training room
Maggie Lockwood: Okay, so your patient is in SVT. What do you do?
Monique Lawson: Um, cardiovert at 7 joules.
Maggie Lockwood: Right. So she's back in sinus rhythm. What now?
Monique Lawson: Check her vitals...
Maggie Lockwood: Mm-hmm.
Monique Lawson: Establish IV access, provide fluids if her BP drops below 75 systolic.
Doris: And? The adenosine? You got a dose?
Monique Lawson: Um... Adenosine is scratched out.
Maggie Lockwood: Calculate then. Your patient's gonna revert back to SVT. Come on.
Monique Lawson: Um...
Maggie Lockwood: It's a life and death situation here.
Monique Lawson: 6.5 milligrams of adenosine.
Maggie Lockwood: It's 0.65, not 6.5. Here.
Monique Lawson: Oh... I'm sorry.
PICU
Connor Rhodes: What happened?
Mitch Jacobs: He can't feel his left arm.
Connor Rhodes: All right, left BP is 80 over 30. Check the right. Sat's at 70. Hey, Brandon, can you squeeze my hand?
Brandon Jacobs: No. No, I can't.
Connor Rhodes: Okay.
Leah Bardovi: Right arm's 150 over 100.
Mitch Jacobs: What's... What's going on?
Connor Rhodes: All right, legs are cold. We need a CT angio now!
Nurse: Got it!
Brandon Jacobs: Dad?
Mitch Jacobs: What is happening?
Connor Rhodes: Brandon's not getting blood to his left arm, but I need a picture of it to see. It's possible that the graft we put in has become occluded.
Mitch Jacobs: Occlud... Occluded? What does that mean?
Connor Rhodes: The first surgery may not have worked.
Mitch Jacobs: So you have to do it again?
Connor Rhodes: It may be more complicated than that.
Treatment 2
Natalie Manning: She's in v-fib!
Will Halstead: Paddles. Start compressions.
Natalie Manning: Will, I'll break her ribs.
Will Halstead: Charge to 200 joules. Star compressions now!
Natalie Manning: Are you sure? I... Out of my way.
April Sexton: No, Will.
Will Halstead: Are we charged?
April Sexton: 200 joules.
Will Halstead: Holding the CPR. Clear… One milligram of epi, charge to 200 again.
April Sexton: 200.
Will Halstead: All right, clear… Pulse is good.
Maggie Lockwood: Hey.
Sharon Goodwin: Dr. Halstead decided to intubate. You know, this woman is the reason I stayed in nursing. My first year as an O.R. nurse, I actually thought about quitting.
Maggie Lockwood: You?
Sharon Goodwin: Oh, I had a rough time. There was this, um, surgery I scrubbed on. I think it was a vascular case. The resident asked for a ten blade scalpel. It slipped out of my hand, dropped in the incision.
Maggie Lockwood: Oh, my God.
Sharon Goodwin: It didn't hurt the patient, but that resident reamed me out. Dr. Rowan stepped in, called him out, said everyone in the O.R. deserved civility. Everyone. Bella Rowan… Wonderful woman. Extraordinary teacher.
Waiting room
Mrs. Adams: Sean? Sean, oh, my God. Oh, my God. Uh, help, someone! Help my husband, please.
Maggie Lockwood: Okay, hey, I need a gurney here.
Ethan Choi: Whoa! Mr. Adams, can you hear me?
Mrs. Adams: What's wrong with him?
Ethan Choi: Unresponsive, has a pulse. Let's get him in a room.
Maggie Lockwood: Bring it over here.
Ethan Choi: Let's transfer on my count. Ready, one, two, three.
Maggie Lockwood: Here we go.
Ethan Choi: All right, he's not breathing. Get a laryngoscope and a 7.5 ET tube.
Mrs. Adams: Sean!
Maggie Lockwood: Trauma 1 to prep.
ER
Ethan Choi: He's totally flaccid. Don't need drugs.
Trauma 1
Maggie Lockwood: Monique, you start the IV.
Monique Lawson: Okay.
Mrs. Adams: Sean...
Maggie Lockwood: Okay, you stand right here.
Mrs. Adams: Okay.
Ethan Choi: He's got a massive upper GI bleed. His stomach's filling with blood. I'm in. April, listen to his lungs.
April Sexton: Yep. Good breath sounds bilaterally.
Ethan Choi: All right, hang two units of blood and get another four ready.
Mrs. Adams: What's going on? Why... Why is this happening?
Ethan Choi: I don't know, but we're gonna find out.
Monique Lawson: Hang saline.
Nurse: Saline's up.
Monique Lawson: All right, stay on it.
Treatment 2
Will Halstead: Got your page.
Natalie Manning: Dr. Rowan's latest labs. I am so sorry. She's in acute renal failure. Hyperkalemic and still acidotic.
Will Halstead: All right, we'll start her on low flow dialysis. It should correct her electrolytes and PH.
Natalie Manning: Will...
Will Halstead: I won't stand by and let her die… Tell April to call renal.
PICU: desk
Leah Bardovi: Graft occlusion is a possible outcome of any vascular surgery. It's nobody's fault. Okay, so there are two options, right? We could either...
Connor Rhodes: Just let me handle this, okay? Mitch, a moment?
Mitch Jacobs: Uh... What is it?
Connor Rhodes: So the CT revealed that the graft I placed in Brandon's chest kinked, causing re-coarctation, or essentially a, uh... A narrowing of his aorta.
Mitch Jacobs: Like before?
Connor Rhodes: I'm sorry.
Mitch Jacobs: So... So what? We're just back at square one?
Connor Rhodes: Yes, but this time, things are more complicated. Now I can repair the graft by placing a stent, and we would do that in the cath lab. But the stent will cover the opening of his left subclavian artery. That will cut off circulation to his left arm, meaning Brandon will lose that arm.
Mitch Jacobs: Lose his arm?
Connor Rhodes: Mm-hmm.
Mitch Jacobs: Uh, no. No... He can't. He can't. It... There must be something else you can do.
Connor Rhodes: I'm sorry, but no. I'm afraid this is our only viable option.
Mitch Jacobs: Oh, God.
Connor Rhodes: Hey, look, Mitch, why don't you go be with your son, okay? We'll take him up to surgery soon. I'm very sorry.
Leah Bardovi: Pardon me, Dr. Rhodes. I know you must've had a very good reason, but you didn't present the other option, the carotid subclavian bypass. Wouldn't that preserve Brandon's arm?
Connor Rhodes: Dr. Bardovi, 20 to 30% of young patients will stroke out and possibly die when you clamp their carotid. It's too big of a risk.
Leah Bardovi: Okay, but still-
Connor Rhodes: It's too big of a risk.
Robin Charles: What was that all about?
Connor Rhodes: Look, this boy's father... I know the type. I grew up with one. He wants his son to be something he isn't. He'll choose the bypass. It's too dangerous.
Robin Charles: But it's his decision, not yours.
Connor Rhodes: I already opened Brandon up once. I'm not gonna do it again. I'm not gonna risk this boy's life just to save his arm.
ER
Ethan Choi: Huge gastric ulcer. That's where all the blood was coming from.
Sarah Reese: Were you able to stop the bleeding?
Ethan Choi: Yeah, GI cauterized it, but that's not the headline. Sean's endoscopy shows chronic caustic esophageal erosions. And his chest X-Ray...
Daniel Charles: Pneumonitis.
Ethan Choi: Yeah. This is a pattern suggestive of ingesting some sort of hydrocarbon.
Sarah Reese: Isn't that in cleaning products?
Daniel Charles: And lighter fluid, motor oil, gasoline. Extremely toxic, so we must be talking about low doses over a long period of time.
Sarah Reese: So I was right. We should be concerned he's suicidal.
Ethan Choi: Why assume he's doing this to himself?
Sarah Reese: Well, what, you think someone's poisoning him?
Ethan Choi: I don't know. It's possible. I had a case where a wife was slipping something into her husband's food.
Sarah Reese: So you think it's his wife?
Daniel Charles: You know, hydrocarbons are extremely noxious, so he would've smelled it.
Ethan Choi: Not necessarily. They're all over any aircraft hanger. With constant exposure, he could be nose blind.
Daniel Charles: I don't know. Suicide? Attempted murder? I think it might be something else altogether.
Roof
Sharon Goodwin: I just checked in on Dr. Rowan. I heard you ordered dialysis.
Will Halstead: She's in renal failure. That's the appropriate treatment.
Sharon Goodwin: I understand the medicine, doctor. Even if you dialyze her...
Will Halstead: I am.
Sharon Goodwin: Even if you dialyze her, she's unlikely to come off the vent. That means she'll be bedridden. Eventually, she'll need a tracheostomy… You've already broken her ribs. Now she'll have bed sores, a feeding tube. Shouldn't quality of life be a consideration?
PICU
Mitch Jacobs: I mean, remember that ballplayer I told you about? He was a pitcher with one arm. He was one of the best. All right, so, you know, be strong. We can do this. I mean, the important thing is that you're gonna be alive. And healthy. We'll figure out the rest, okay? Together.
Connor Rhodes: Mitch...
Mitch Jacobs: Yeah.
Connor Rhodes: Guys, if you can hold on for a second. Have a word with you?
Mitch Jacobs: Okay, buddy.
Connor Rhodes: So, I've been thinking about Brandon's case, and there is something else we can try.
Training room
Maggie Lockwood: Wrong angle. You need to go in perpendicular, or you'll stay in the cortex.
Monique Lawson: Okay.
Maggie Lockwood: You're too shallow. You need to keep on drilling until you hub the needle.
Doris: Not like that. Who taught her how to do an IO? An orangutan?
Maggie Lockwood: Okay. She'll get there. We've all gone through this. Just take it slowly… Go ahead… There you go.
Bathroom
Leah Bardovi: White board says carotid subclavian bypass. It's just, I thought...
Connor Rhodes: I presented both options to the patient's father. As I suspected, he chose the carotid subclavian bypass.
Leah Bardovi: And you're gonna do a great job, Dr. Rhodes. You're an exceptional surgeon, and it is an honour to be...
Connor Rhodes: Dr. Bardovi, you don't have to do that. You're a fine surgeon, and trust me, I'm a less than perfect teacher.
Trauma 1
Daniel Charles: Mr. Adams, can I ask you, um... You ever find yourself doing something that you know you shouldn't, but you just can't stop?
Sean Adams: I have no idea what you're talking about. My wife would say that I... I watch too much football.
Daniel Charles: Can I tell you my dirty little secret? I went through this phase where I would come home every night, cut my nails every night, like down to the quick. Hm, couldn't stop. On some level, I must've been satisfying some urge, but my hands were bleeding. It wasn't good.
Sean Adams: And the point of this?
Daniel Charles: The point is that I understand compulsive behaviour. You know, it's not rational. You can't explain it. You just... You just do it. Yeah, but eventually, like with me, your fingers bleed, or something similar. And it just starts to... To cost you too much, and you wanna stop. I mean, you realize that it's interfering with your life, and you... You just really, really wanna stop… Sean, I think you have a compulsion, and you're tired, and you're also getting scared. I mean, who wouldn't be scared? All that... All that blood? All that vomiting?
Sean Adams: Yes. I'm tired.
Sarah Reese: Mr. Adams, we think you're ingesting something very harmful. Can you tell us what it is? Mr. Adams, please, we can help you.
Sean Adams: Gasoline.
Daniel Charles: I'm sorry? Say again?
Sean Adams: I drank gasoline.
Meeting room
Mrs. Adams: Is my husband crazy? Why would anyone drink gasoline?
Daniel Charles: I know it's very difficult to fathom, but I'm quite sure that your husband is suffering from a psychiatric disorder known as Pica, which involves the compulsive consumption of non-nutritive, and sometimes even hazardous, substances.
Sarah Reese: For some, it's paint chips. For others, dirt. For your husband, it's gasoline.
Mrs. Adams: Why?
Daniel Charles: There's no unified theory as to the cause. All we know is that it manifests itself as a compulsion, an irresistible urge, against one's conscious wishes.
Mrs. Adams: Can he stop?
Daniel Charles: Probably not on his own, but if he'll allow us, we can help him.
Mrs. Adams: Okay. We'll do whatever it takes to get him healthy.
Ethan Choi: Before we discuss the course of psychotherapy, I'd like to talk to you and your husband about repairing the physical damage.
Mrs. Adams: Of course. Thanks.
Ethan Choi: Yes.
Sarah Reese: He could've killed himself. Sometimes we get a win, right?
Daniel Charles: Sometimes we get a win.
Doctor Lounge
Bella Rowan: If you take one thing away from me today, let it be this: treat the patient, not the disease.
Treatment 2
Will Halstead: Good. You haven't started.
Natalie Manning: Just finished the line. Why?
Will Halstead: You were right. We shouldn't do this.
Natalie Manning: What changed your mind?
Will Halstead: Treat the patient, not the disease… Our patient wouldn't have wanted this. April, 10 milligrams of morphine, and hang a drip, please… Dr. Rowan... I'm going to extubate you. I promise you won't feel any pain.
Natalie Manning: I'll let you two be alone with her now.
OR
Connor Rhodes: Okay, going to start the carotid anastomosis. Everybody get ready. We're going to clamp the left carotid. Carla, tell me if you see any change on the EEG.
Carla: Right.
Connor Rhodes: Peripheral cross clamp times two? Carotid is cross-clamped.
Carla: Brain waves look good.
Connor Rhodes: Okay, eleven blade, followed by 5-0 prolene… Let's sew this graft in quickly.
Carla: Brain waves flattening on the right. He's impending infarct.
Marty Peterson: We only have four minutes of hypoxia before deficits occur.
Leah Bardovi: Do we unclamp him? We can still call this off and take him to the cath lab. It's safer. Dr. Rhodes...
Connor Rhodes: No. This kid's not losing his arm. Coming around the front wall now.
Marty Peterson: Left side brain's 50, right side's 70.
Connor Rhodes: Dr. Bardovi, follow me. Eyes on the field.
Marty Peterson: Dr. Rhodes, you need to get those clamps off.
Connor Rhodes: Thank you, Marty, I'm almost there.
Marty Peterson: Left side's 30, right side's 50.
Connor Rhodes: Okay, done. Coming off cross clamp. Cross clamps are off. I've reestablished flow.
Carla: EEG is normalizing. You have a good wave pattern.
Leah Bardovi: He's good.
Marty Peterson: Nice work, Dr. Rhodes.
Connor Rhodes: Okay, everyone, let's get set up for the stent.
Outside the hospital
Sarah Reese: Good night.
Daniel Charles: Good night.
Mrs. Adams: How could you do this to us?
Sarah Reese: Uh, excuse me?
Mrs. Adams: My husband told me. He'll lose his pilot's license. We'll lose everything.
Daniel Charles: I'm very sorry. Uh, I had no choice. I am legally obligated to report him.
Mrs. Adams: It's his life.
Daniel Charles: I called the FAA. I had to. Every time he gets on a plane, he puts his own life and the lives of all of his passengers at risk… I know this wasn't, um, necessarily the win that you were looking for, but at least we saved a man's life. See you in the morning?
Hallway
Robin Charles: I heard the surgery went well.
Connor Rhodes: Yeah, thankfully.
Robin Charles: Yeah, don't worry, I won't tell anyone.
Connor Rhodes: Tell 'em what?
Robin Charles: Mm, that you were scared.
Connor Rhodes: Oh, that's what you think, huh?
Robin Charles: Yeah.
Connor Rhodes: Man, you're definitely a Charles. You're very perceptive.
Robin Charles: Hm.
Connor Rhodes: I was after that first time. I was... I was afraid. I was afraid I was gonna lose him.
Robin Charles: I have fears of my own, you know.
Connor Rhodes: Cholera? Typhus?
Robin Charles: Yeah. And relationships. There are a lot of pitfalls in dating a surgeon. It's crazy hours, stress of the job...
Leah Bardovi: Great case, Dr. Rhodes. Very impressive. And thanks for the vote of confidence.
Robin Charles: Fawning women falling at your feet. Yeah, I don't know if I can compete with all of that.
Connor Rhodes: You don't have to compete. I'm all in.
Robin Charles: So your sister... Let's see, is she a red or white wine drinker?
Connor Rhodes: Mm, white. Not Chardonnay. Uh, Sauvignon Blanc.
Doctor Lounge
Natalie Manning: Will? Hey. I'm... I'm so sorry for your loss.
