1 00:00:04,395 --> 00:00:06,199 - You have to work out whatever feelings you're having 2 00:00:06,223 --> 00:00:07,853 about Dr. Marcel. 3 00:00:07,877 --> 00:00:09,159 Fast. 4 00:00:11,707 --> 00:00:12,858 - Give me a Narcan inhaler. 5 00:00:12,882 --> 00:00:14,425 ♪ 6 00:00:16,190 --> 00:00:18,255 - You overdosed, but you're gonna be all right. 7 00:00:18,279 --> 00:00:20,126 - You're letting this get way too personal, Will. 8 00:00:20,150 --> 00:00:21,171 It's never a good idea. 9 00:00:21,195 --> 00:00:22,694 - For God's sake, isn't it personal? 10 00:00:22,718 --> 00:00:24,478 You lost a brother to drugs. 11 00:00:24,502 --> 00:00:25,697 - Enough! 12 00:00:25,721 --> 00:00:28,004 ♪ 13 00:00:28,028 --> 00:00:29,092 - I met you this morning. 14 00:00:29,116 --> 00:00:30,745 I'm gonna try to turn things around. 15 00:00:30,769 --> 00:00:31,769 - Good. 16 00:00:37,559 --> 00:00:38,710 - Hey. 17 00:00:38,734 --> 00:00:40,431 Hi. 18 00:00:50,224 --> 00:00:51,418 I love you. 19 00:00:51,442 --> 00:00:52,637 - Easy. - Oh, God, sorry. 20 00:00:52,661 --> 00:00:53,681 - It's only me. 21 00:00:53,705 --> 00:00:55,553 - I wasn't expecting that. 22 00:00:55,577 --> 00:00:58,469 - Hey, I know work's not the place for ambush affection, 23 00:00:58,493 --> 00:01:00,079 but I couldn't help myself. 24 00:01:00,103 --> 00:01:01,602 - I won't hold it against you. 25 00:01:01,626 --> 00:01:03,430 What's up? 26 00:01:03,454 --> 00:01:06,607 I haven't seen a smile this big since Navy beat Army. 27 00:01:07,676 --> 00:01:10,263 Just thinking about being a dad. 28 00:01:10,287 --> 00:01:12,961 Birthday parties, coaching teams. 29 00:01:12,985 --> 00:01:16,791 - It's a decade down the road. We are three weeks into IVF. 30 00:01:16,815 --> 00:01:18,054 - You know what they say. 31 00:01:18,078 --> 00:01:20,080 "You blink and the kids are grown." 32 00:01:22,212 --> 00:01:23,798 Hey. - What up? 33 00:01:23,822 --> 00:01:25,800 Pelicans covered the spread. 34 00:01:25,824 --> 00:01:28,151 - How many rings do the Pelicans have? 35 00:01:28,175 --> 00:01:29,761 Go Bulls. 36 00:01:29,785 --> 00:01:31,787 - Yeah, we'll see. 37 00:01:37,009 --> 00:01:38,770 - I'm a horrible person, aren't I? 38 00:01:38,794 --> 00:01:41,816 - No, you're human. 39 00:01:41,840 --> 00:01:43,253 What can I do to help? 40 00:01:43,277 --> 00:01:44,800 - You got a time machine? 41 00:01:48,412 --> 00:01:49,911 - Hey, you. - Hey. 42 00:01:49,935 --> 00:01:51,609 - Date last night. Spill it. 43 00:01:51,633 --> 00:01:53,132 - It was nice. 44 00:01:53,156 --> 00:01:57,310 He was polite, handsome, smart, but I don't think so. 45 00:01:57,334 --> 00:01:59,573 - Huh, well, polite, smart, and handsome. 46 00:01:59,597 --> 00:02:00,748 Sounds awful. - All right. 47 00:02:00,772 --> 00:02:03,490 The real reason, he's a psych professor. 48 00:02:03,514 --> 00:02:05,623 I mean, the way he looked at me, I just couldn't shake 49 00:02:05,647 --> 00:02:07,233 the feeling that I was being analyzed. 50 00:02:07,257 --> 00:02:08,321 - This is the fourth first date 51 00:02:08,345 --> 00:02:10,106 without even considering a second. 52 00:02:10,130 --> 00:02:11,890 - Well, I'm glad you're counting, Mom. 53 00:02:11,914 --> 00:02:13,326 It doesn't matter 54 00:02:13,350 --> 00:02:15,763 because none of those guys were gonna work out anyways. 55 00:02:15,787 --> 00:02:18,766 - Wow. ESP. 56 00:02:18,790 --> 00:02:20,725 Say, 57 00:02:20,749 --> 00:02:23,945 do you know when the Saints are gonna win another Super Bowl? 58 00:02:23,969 --> 00:02:25,295 All right, well, 59 00:02:25,319 --> 00:02:27,582 let me know if you get another vision. 60 00:02:29,149 --> 00:02:32,302 - All I'm saying is the right second date is out there 61 00:02:32,326 --> 00:02:35,000 and I'll know it when I meet him. 62 00:02:35,024 --> 00:02:37,045 - Help, please! My son! 63 00:02:37,069 --> 00:02:39,483 - I got him. Where am I going? 64 00:02:39,507 --> 00:02:41,311 - Trauma 1. - Help my husband and son! 65 00:02:41,335 --> 00:02:44,270 Help, help, help, help, help! 66 00:02:46,688 --> 00:02:49,299 - Help him. I-I didn't know what to do. 67 00:02:51,910 --> 00:02:56,306 Ow, ow! 68 00:02:58,265 --> 00:03:00,417 - Bruising on his neck. Protect it and bag him. 69 00:03:00,441 --> 00:03:02,854 Hold C-spine. What's his name? 70 00:03:02,878 --> 00:03:05,073 - Jamie. - Jamie? 71 00:03:05,097 --> 00:03:09,208 Hey, Jamie, can you hear me? Okay, okay, take it easy. 72 00:03:09,232 --> 00:03:10,905 You're okay. Take it easy. 73 00:03:10,929 --> 00:03:12,864 What happened? - It was an accident. 74 00:03:12,888 --> 00:03:14,822 Um, I choked him out. 75 00:03:17,066 --> 00:03:18,763 I had to. 76 00:03:20,765 --> 00:03:24,987 ♪ 77 00:03:35,867 --> 00:03:37,845 - It all happened so fast. 78 00:03:37,869 --> 00:03:39,804 I didn't realize. I just wanted it to stop. 79 00:03:39,828 --> 00:03:42,067 Jamie was screaming, Dylan was crying, and... 80 00:03:42,091 --> 00:03:43,286 - Gordon. 81 00:03:43,310 --> 00:03:44,939 I want you to take a deep breath, okay? 82 00:03:44,963 --> 00:03:47,290 Take a deep breath. 83 00:03:47,314 --> 00:03:49,422 All right. 84 00:03:49,446 --> 00:03:50,684 Have a seat. Sit down. 85 00:03:51,709 --> 00:03:53,731 Okay. 86 00:03:53,755 --> 00:03:55,689 And, um... 87 00:03:55,713 --> 00:03:58,866 I, uh, I just want you to tell me... 88 00:03:58,890 --> 00:04:00,128 Tell me what happened. 89 00:04:00,152 --> 00:04:01,478 - Okay. 90 00:04:01,502 --> 00:04:03,784 So I was driving, 91 00:04:03,808 --> 00:04:05,569 talking with Bella, my wife. 92 00:04:05,593 --> 00:04:08,136 The, um, the boys were in the back. 93 00:04:08,160 --> 00:04:10,400 Jamie was playing with his iPad. 94 00:04:10,424 --> 00:04:15,492 Dylan grabbed it from him, but wouldn't give it back. 95 00:04:15,516 --> 00:04:16,971 Jamie can't control his anger. 96 00:04:16,995 --> 00:04:18,799 He started punching Dylan, 97 00:04:18,823 --> 00:04:21,193 got out of his seat belt, got on top of him. 98 00:04:21,217 --> 00:04:23,761 He kept pounding. 99 00:04:23,785 --> 00:04:25,700 Bella couldn't pull him off. 100 00:04:27,354 --> 00:04:29,332 ♪ 101 00:04:29,356 --> 00:04:34,337 I could hear Jamie's fists cracking against Dylan's face. 102 00:04:34,361 --> 00:04:39,279 He was screaming for help, so I pulled over. 103 00:04:41,237 --> 00:04:42,823 Just threw myself on top of Jamie. 104 00:04:42,847 --> 00:04:44,129 I wrapped my arms around him 105 00:04:44,153 --> 00:04:46,479 and held him as tight as I could. 106 00:04:46,503 --> 00:04:51,832 ♪ 107 00:04:51,856 --> 00:04:53,181 When he gets like this, the bear hugs 108 00:04:53,205 --> 00:04:55,271 are the only thing that bring him back. 109 00:04:55,295 --> 00:04:58,665 - Bring him back? - From his dark place. 110 00:04:58,689 --> 00:04:59,840 ♪ 111 00:04:59,864 --> 00:05:03,844 - Uh-huh. Okay. 112 00:05:03,868 --> 00:05:05,368 Will you, um, 113 00:05:05,392 --> 00:05:08,003 will you excuse me for a moment, Gordon? 114 00:05:09,526 --> 00:05:13,114 ♪ 115 00:05:13,138 --> 00:05:17,380 - We're gonna take care of you little, man, okay? 116 00:05:17,404 --> 00:05:18,709 All right. 117 00:05:23,540 --> 00:05:25,039 Ordered a CT. 118 00:05:25,063 --> 00:05:26,302 But I'm almost positive 119 00:05:26,326 --> 00:05:28,695 there's a bilateral mandible fracture. 120 00:05:28,719 --> 00:05:30,895 Gonna need surgery to wire it shut. 121 00:05:33,245 --> 00:05:36,423 Man, Ethan. Kid's only six years old. 122 00:05:37,685 --> 00:05:38,947 Jamie? 123 00:05:40,470 --> 00:05:45,146 - He's stable but tormented. Dad choked him out. 124 00:05:45,170 --> 00:05:49,063 - Probably so he couldn't defend his little brother. 125 00:05:49,087 --> 00:05:50,959 Sometimes I hate the ED. 126 00:05:52,439 --> 00:05:56,114 ♪ 127 00:05:56,138 --> 00:06:00,031 - Jamie, how are you doing? I'm Dr. Charles. 128 00:06:00,055 --> 00:06:03,730 Um, would you mind if I looked at your hands? 129 00:06:03,754 --> 00:06:09,345 ♪ 130 00:06:09,369 --> 00:06:11,912 - Fifth metacarpal is broken on each hand. 131 00:06:11,936 --> 00:06:14,088 - That's really gotta hurt. 132 00:06:14,112 --> 00:06:17,918 Um, look, we're gonna get you completely fixed up. 133 00:06:17,942 --> 00:06:21,424 Okay? It was nice to meet you. 134 00:06:24,775 --> 00:06:26,516 This is not child abuse. 135 00:06:38,398 --> 00:06:39,940 - Thanks, man. 136 00:06:39,964 --> 00:06:41,507 - You know, one of the volunteers works 137 00:06:41,531 --> 00:06:43,248 at a rehab center. 138 00:06:43,272 --> 00:06:45,990 If you'd like, she can tell you about their program. 139 00:06:46,014 --> 00:06:49,385 - Yeah. Sure. 140 00:06:49,409 --> 00:06:50,975 Maybe another time. 141 00:06:54,501 --> 00:06:56,198 - If you change your mind, we're here. 142 00:07:01,508 --> 00:07:03,442 - Will. - Yeah? 143 00:07:03,466 --> 00:07:08,055 - You have been here for hours. Go home, get some rest. 144 00:07:08,079 --> 00:07:10,797 - Yeah, I could use some sleep before I start my shift. 145 00:07:10,821 --> 00:07:12,843 Ah, damn it. It starts in a half hour. 146 00:07:12,867 --> 00:07:14,061 Uh, okay. All right. 147 00:07:14,085 --> 00:07:15,846 That woman over there, her name's Susan. 148 00:07:15,870 --> 00:07:17,413 When she comes down, she's gonna be hungry. 149 00:07:17,437 --> 00:07:19,502 I stashed some protein bars... - I know, I saw. 150 00:07:19,526 --> 00:07:22,267 The electrolyte drinks too. Get to work. 151 00:07:24,008 --> 00:07:25,508 - I'll be back later, you call me 152 00:07:25,532 --> 00:07:28,119 if you need anything. 153 00:07:28,143 --> 00:07:32,166 That's the cry, that one. 154 00:07:32,190 --> 00:07:35,256 It's not "I'm hungry" or "I'm tired." 155 00:07:35,280 --> 00:07:37,041 It's new. 156 00:07:37,065 --> 00:07:39,826 - Okay. I know, I know, Axel. 157 00:07:39,850 --> 00:07:43,526 You're in pain and my touching you is only making it worse. 158 00:07:43,550 --> 00:07:45,702 Any changes in his sleep pattern? 159 00:07:45,726 --> 00:07:47,486 - No. Every baby book I read said 160 00:07:47,510 --> 00:07:49,532 put your child on a schedule and stick to it. 161 00:07:49,556 --> 00:07:51,447 - Been there. My son's almost four. 162 00:07:51,471 --> 00:07:54,580 I know, I know. Almost finished. 163 00:07:54,604 --> 00:07:56,843 Okay. What about diet? 164 00:07:56,867 --> 00:07:58,758 - I had to start using formula. 165 00:07:58,782 --> 00:08:00,194 Just not enough hours in the day 166 00:08:00,218 --> 00:08:03,807 to pump, work, nurse, do laundry, pump again. 167 00:08:03,831 --> 00:08:07,071 - Single mom? Yeah, me too. 168 00:08:07,095 --> 00:08:09,880 Dad still in the picture? - No, but I'm okay with it. 169 00:08:11,665 --> 00:08:13,686 - Well, I'm not seeing anything out of the ordinary. 170 00:08:13,710 --> 00:08:15,427 I mean, the switch from breast milk to formula 171 00:08:15,451 --> 00:08:17,429 could be upsetting Axel's stomach. 172 00:08:17,453 --> 00:08:19,431 Have you noticed any diarrhea since the change? 173 00:08:19,455 --> 00:08:20,824 - Here and there. 174 00:08:20,848 --> 00:08:23,435 But this cry has been consistent for the last month. 175 00:08:23,459 --> 00:08:26,699 - I'll test for allergies, but infants and crying... 176 00:08:26,723 --> 00:08:28,309 - Don't say colic. 177 00:08:28,333 --> 00:08:30,050 I've been to three pediatricians. 178 00:08:30,074 --> 00:08:32,400 They all diagnosed colic and sent me home. 179 00:08:33,425 --> 00:08:36,230 No. Something else is going on. 180 00:08:36,254 --> 00:08:39,582 Run tests, X-rays, scans. Just please, figure it out. 181 00:08:39,606 --> 00:08:41,235 - Okay, well, why don't we start 182 00:08:41,259 --> 00:08:43,261 with some basic labs and go from there? 183 00:08:45,916 --> 00:08:47,503 Is that okay? 184 00:08:47,527 --> 00:08:49,354 - Sure. Thank you. 185 00:08:50,704 --> 00:08:53,271 - I'll send a nurse in to get started. 186 00:08:57,101 --> 00:08:59,210 - Thank you. 187 00:08:59,234 --> 00:09:02,367 Hey, Jamie, you hungry? Thirsty? 188 00:09:04,413 --> 00:09:07,435 I know your casts are bulky. I can help you. 189 00:09:07,459 --> 00:09:09,636 I'll leave the tray right here just in case. 190 00:09:14,945 --> 00:09:18,098 - Hi. Nice to meet you. 191 00:09:18,122 --> 00:09:19,994 - They're talking about me. 192 00:09:24,128 --> 00:09:26,653 About what I did to my little brother. 193 00:09:28,959 --> 00:09:30,657 I didn't mean to hurt him. 194 00:09:32,484 --> 00:09:33,461 I'm so sorry. 195 00:09:33,485 --> 00:09:35,618 - It's okay. Okay, okay. 196 00:09:42,973 --> 00:09:45,299 - Well, after two miscarriages and five failed IVF attempts, 197 00:09:45,323 --> 00:09:46,562 we'd had enough heartbreak. 198 00:09:46,586 --> 00:09:49,565 - We adopted Jamie when he was a few days old. 199 00:09:49,589 --> 00:09:51,567 Best day of our lives. 200 00:09:51,591 --> 00:09:53,917 - Do you know anything about his birth parents? 201 00:09:53,941 --> 00:09:58,269 - Nothing really. Mom was young, in foster care. 202 00:09:58,293 --> 00:09:59,444 We don't know anything about dad. 203 00:09:59,468 --> 00:10:00,924 - Well, Jamie's 11 now, 204 00:10:00,948 --> 00:10:03,883 so how old was he when he first started acting out? 205 00:10:03,907 --> 00:10:05,972 - As an infant, he didn't like being held. 206 00:10:05,996 --> 00:10:09,672 Was always fidgety. - Hmm, how about as a toddler? 207 00:10:09,696 --> 00:10:12,457 - Sitting still, taking turns, following directions, 208 00:10:12,481 --> 00:10:14,154 they were all a challenge. 209 00:10:14,178 --> 00:10:17,027 - When did Jamie's behavior start becoming aggressive? 210 00:10:17,051 --> 00:10:18,768 - Elementary school. 211 00:10:18,792 --> 00:10:21,684 Fights with classmates and teachers. 212 00:10:21,708 --> 00:10:23,424 We're homeschooling now. 213 00:10:23,448 --> 00:10:26,819 - And your other son, Dylan, is he adopted as well? 214 00:10:26,843 --> 00:10:28,386 - Yeah. - Mm-hmm. 215 00:10:28,410 --> 00:10:31,563 It was initially Jamie's idea. He wanted to be a big brother. 216 00:10:31,587 --> 00:10:34,958 - And in the beginning, Dylan's presence seemed to calm Jamie. 217 00:10:34,982 --> 00:10:37,917 He would push his stroller, feed him his bottle, 218 00:10:37,941 --> 00:10:39,397 let him climb all over him. 219 00:10:39,421 --> 00:10:43,836 - They are so... were so close. 220 00:10:43,860 --> 00:10:46,012 - I'm assuming that Jamie's been evaluated 221 00:10:46,036 --> 00:10:47,318 by a psychiatrist. 222 00:10:47,342 --> 00:10:48,536 - Several. 223 00:10:48,560 --> 00:10:51,017 They all just head to the diagnosis. 224 00:10:51,041 --> 00:10:53,193 Intermittent explosive disorder, 225 00:10:53,217 --> 00:10:55,805 comorbid ADHD, 226 00:10:55,829 --> 00:10:58,808 disruptive mood dysregulation disorder. 227 00:10:58,832 --> 00:11:01,854 - Tell me, what meds is he on right now? 228 00:11:01,878 --> 00:11:05,945 - Risperidone, valproic acid, lithium, Adderall, Tenex. 229 00:11:05,969 --> 00:11:08,818 They all work for a bit, but then... 230 00:11:08,842 --> 00:11:10,994 - He always ends up in his dark place. 231 00:11:11,018 --> 00:11:12,299 - Yeah. 232 00:11:13,977 --> 00:11:16,216 - Mr. and Mrs. Shaw, Dylan's out of surgery. 233 00:11:16,240 --> 00:11:17,914 I'll take you to recovery. 234 00:11:17,938 --> 00:11:19,698 - Look, what I'd like to do 235 00:11:19,722 --> 00:11:21,918 is admit Jamie for a five day hold. 236 00:11:21,942 --> 00:11:24,007 That'll give us a chance to assess the situation 237 00:11:24,031 --> 00:11:25,965 and come up with some treatment options for you. 238 00:11:25,989 --> 00:11:28,228 - Anything. Please, just help him. 239 00:11:28,252 --> 00:11:29,360 - Yeah. 240 00:11:32,387 --> 00:11:33,930 ♪ 241 00:11:34,824 --> 00:11:36,106 - Shh. He's out. 242 00:11:36,130 --> 00:11:38,891 Cried himself to sleep. What'd the tests say? 243 00:11:38,915 --> 00:11:40,763 - The labs were normal. 244 00:11:40,787 --> 00:11:43,287 But the babygram revealed a mild bowel distention. 245 00:11:43,311 --> 00:11:44,592 There are no obstructions. 246 00:11:44,616 --> 00:11:47,334 However, the stool in Axel's diaper was watery. 247 00:11:47,358 --> 00:11:49,075 That suggests a GI issue. 248 00:11:49,099 --> 00:11:50,903 - Okay. What do you do for that? 249 00:11:50,927 --> 00:11:51,817 - Endoscopy. 250 00:11:51,841 --> 00:11:53,384 So under a general anesthesia, 251 00:11:53,408 --> 00:11:55,734 a surgeon will guide a camera down Axel's throat 252 00:11:55,758 --> 00:11:58,215 into his GI tract to search for abnormalities. 253 00:11:58,239 --> 00:12:00,696 And if necessary, we'll do a colonoscopy as well. 254 00:12:00,720 --> 00:12:02,591 - Mm. Can I be there? 255 00:12:03,810 --> 00:12:05,396 - I wouldn't recommend that. 256 00:12:05,420 --> 00:12:09,313 I mean, seeing the scope inside Axel, it might be upsetting. 257 00:12:09,337 --> 00:12:12,316 - No, I really wanna be there. - Are you sure? 258 00:12:12,340 --> 00:12:14,927 Because I can't overstate how distressing 259 00:12:14,951 --> 00:12:17,060 this procedure can be for a parent to watch. 260 00:12:17,084 --> 00:12:19,410 I mean, seeing your child on the table, unconscious... 261 00:12:19,434 --> 00:12:22,239 - I'll be okay. 262 00:12:22,263 --> 00:12:23,457 - All right. 263 00:12:23,481 --> 00:12:25,546 Techs will be by shortly to bring up Axel. 264 00:12:25,570 --> 00:12:26,963 I'll be there as well. 265 00:12:29,618 --> 00:12:32,012 - Signed. - Thank you. 266 00:12:34,449 --> 00:12:35,861 - Hey, Doris. 267 00:12:35,885 --> 00:12:38,777 Julia, the mom in Treatment III, did you get a read? 268 00:12:38,801 --> 00:12:40,344 - I like her. 269 00:12:40,368 --> 00:12:43,521 I wish all parents would handle the ED that smoothly. 270 00:12:43,545 --> 00:12:45,175 - You don't think she's too composed? 271 00:12:45,199 --> 00:12:47,046 I mean, her son is clearly in distress 272 00:12:47,070 --> 00:12:48,352 and she hasn't even broken a sweat. 273 00:12:48,376 --> 00:12:50,658 - Oh, there's that Manning ESP again. 274 00:12:50,682 --> 00:12:52,269 - Okay. 275 00:12:52,293 --> 00:12:55,141 She asked me to run more tests on her baby than necessary, 276 00:12:55,165 --> 00:12:57,361 and now she wants to be front row when he gets scoped. 277 00:12:57,385 --> 00:12:59,319 You don't think that's a little odd? 278 00:12:59,343 --> 00:13:01,955 - Uh, if you say so. 279 00:13:03,739 --> 00:13:05,108 - Call Dr. Frisch. 280 00:13:05,132 --> 00:13:07,327 I wanna put Axel on today's schedule for an endoscopy. 281 00:13:07,351 --> 00:13:09,634 - She's busy. Omphalocele repair. 282 00:13:09,658 --> 00:13:11,157 Gonna be locked away all day. 283 00:13:11,181 --> 00:13:13,420 But I'm free to take care of it right now if you'd like. 284 00:13:13,444 --> 00:13:15,596 - Okay. Thanks. 285 00:13:15,620 --> 00:13:18,425 - Meet you upstairs. Ms. Doris? 286 00:13:18,449 --> 00:13:20,514 - Thank you. - Sure. 287 00:13:20,538 --> 00:13:22,671 Nurse April. - Dr. Marcel. 288 00:13:26,327 --> 00:13:28,653 - Okay, stomach and esophagus appear normal. 289 00:13:28,677 --> 00:13:30,418 Let's reset for a colonoscopy. 290 00:13:32,942 --> 00:13:35,138 - Julia, are you okay? 291 00:13:35,162 --> 00:13:36,792 You don't have to keep watching, you know. 292 00:13:36,816 --> 00:13:38,141 - No, I'm okay. 293 00:13:38,165 --> 00:13:39,838 It's just I have a scrape on my stomach. 294 00:13:39,862 --> 00:13:41,100 I forgot to change the bandage 295 00:13:41,124 --> 00:13:42,885 and it's beginning to slide around. 296 00:13:42,909 --> 00:13:44,582 - Why don't I have a nurse change that out for you 297 00:13:44,606 --> 00:13:45,844 when we're back in the ED? 298 00:13:45,868 --> 00:13:48,499 - Oh, okay. Yeah. 299 00:13:48,523 --> 00:13:50,022 Thanks. - Yeah. 300 00:13:50,046 --> 00:13:52,285 - Somehow I keep scraping myself right there. 301 00:13:52,309 --> 00:13:54,834 I don't know how. Mom brain, I guess. 302 00:13:59,055 --> 00:14:01,381 - Ooh, ooh. Right there. 303 00:14:01,405 --> 00:14:03,993 - Okay. Sharp or dull pain, Chloe? 304 00:14:04,017 --> 00:14:06,256 - I think both. Is that even possible? 305 00:14:06,280 --> 00:14:08,021 - Unfortunately. 306 00:14:14,723 --> 00:14:16,179 How long have you been feeling off? 307 00:14:16,203 --> 00:14:18,442 - I don't know. A couple weeks? 308 00:14:18,466 --> 00:14:20,879 - Three months. She downplays everything. 309 00:14:20,903 --> 00:14:24,143 We just got married. 310 00:14:24,167 --> 00:14:26,102 I figured the pain was just nervous energy, 311 00:14:26,126 --> 00:14:29,757 but the wedding's behind us now and I still feel "blah." 312 00:14:29,781 --> 00:14:31,107 - Any constipation? Bloating? 313 00:14:31,131 --> 00:14:34,371 - She hasn't pooped in a week. 314 00:14:34,395 --> 00:14:36,373 - So Chloe, I'm gonna need to take a closer look 315 00:14:36,397 --> 00:14:37,678 to see what's going on. 316 00:14:37,702 --> 00:14:40,203 We'll get some X-rays, a pelvic and a rectal. 317 00:14:40,227 --> 00:14:42,379 - Just keeping the sexy flowing, aren't I? 318 00:14:42,403 --> 00:14:45,208 - Till death do us part. 319 00:14:45,232 --> 00:14:47,210 - Well, a nurse will come in and get things going. 320 00:14:47,234 --> 00:14:49,366 Congratulations, Mr. and Mrs. James. 321 00:14:51,499 --> 00:14:52,737 - Crockett. - Yeah? 322 00:14:52,761 --> 00:14:53,912 - Perfect timing. 323 00:14:53,936 --> 00:14:55,392 Single vehicle accident landing now. 324 00:14:55,416 --> 00:14:57,698 Massive trauma. I'll have Baghdad ready. 325 00:14:57,722 --> 00:14:58,898 - Got it. 326 00:15:00,987 --> 00:15:03,008 What do you got? - Lucy Seaver, 20. 327 00:15:03,032 --> 00:15:05,402 GCS 3. Intubated in the field. 328 00:15:05,426 --> 00:15:07,970 Bilateral femur fractures and traction splints. 329 00:15:07,994 --> 00:15:10,146 SATS 100% on oxygen. 330 00:15:10,170 --> 00:15:12,713 - Okay, Lucy, don't be afraid. You're in the ED. 331 00:15:12,737 --> 00:15:13,976 We're gonna take good care of you. 332 00:15:14,000 --> 00:15:15,542 - Parents should be here any second. 333 00:15:15,566 --> 00:15:16,804 They were on the scene. 334 00:15:16,828 --> 00:15:18,067 They were in the car behind Lucy. 335 00:15:18,091 --> 00:15:20,243 - They saw the crash? - And the aftermath. 336 00:15:20,267 --> 00:15:22,767 Lucy's car was so mangled, it took us 20 minutes 337 00:15:22,791 --> 00:15:24,943 to extricate her and get her in the ambo. 338 00:15:24,967 --> 00:15:26,075 - Okay, all right. Here we go. 339 00:15:26,099 --> 00:15:28,797 On my count. One, two, three. 340 00:15:30,320 --> 00:15:31,384 - All right. 341 00:15:34,368 --> 00:15:36,041 ♪ 342 00:15:36,065 --> 00:15:38,111 - Good breath sounds bilaterally. 343 00:15:41,853 --> 00:15:44,484 Belly's hard as a rock. - BP's 70s. 344 00:15:44,508 --> 00:15:46,225 - Two of plasma, two of blood on the transfuser. 345 00:15:46,249 --> 00:15:48,556 Trigger the MTP. Let's fast her. 346 00:15:51,994 --> 00:15:55,974 Ton of soft tissue damage. Glass everywhere. 347 00:15:55,998 --> 00:15:58,020 All right, no, scrap the X-ray. No time. 348 00:15:58,044 --> 00:15:59,219 Give me that wand. 349 00:16:01,525 --> 00:16:04,896 ♪ 350 00:16:04,920 --> 00:16:06,376 Fast is positive. 351 00:16:06,400 --> 00:16:07,986 Yeah, I gotta get into her belly. 352 00:16:08,010 --> 00:16:11,729 All right, let's go. Let's open up the Hybrid OR! 353 00:16:11,753 --> 00:16:12,904 All right. - Oh, my God. 354 00:16:12,928 --> 00:16:14,166 - Get her prepped, all right? - Lucy! 355 00:16:14,190 --> 00:16:17,430 - Let's get her on the move. All right. 356 00:16:17,454 --> 00:16:20,042 Mr. and Mrs. Seaver, if you will. 357 00:16:20,066 --> 00:16:21,782 Your daughter's been seriously injured. 358 00:16:21,806 --> 00:16:24,263 She needs immediate surgery to control internal bleeding. 359 00:16:24,287 --> 00:16:26,135 - It's fixable? She's gonna live? 360 00:16:26,159 --> 00:16:28,335 - We will do everything we can. 361 00:16:29,684 --> 00:16:34,099 ♪ 362 00:16:39,911 --> 00:16:41,324 - Huh. 363 00:16:41,348 --> 00:16:43,587 So, uh, so what is your favorite sport? 364 00:16:43,611 --> 00:16:46,155 - Football, I guess. 365 00:16:46,179 --> 00:16:49,027 - Bears fan? - My dad likes them. 366 00:16:49,051 --> 00:16:51,812 I like the Chiefs. - Oh, really? 367 00:16:51,836 --> 00:16:54,163 Oh, how'd that happen? - The quarterback. 368 00:16:54,187 --> 00:16:56,861 I saw a video of him throw the ball out of the stadium. 369 00:16:56,885 --> 00:16:59,820 That was cool. - I saw that clip too. 370 00:16:59,844 --> 00:17:02,823 And you're right. It was cool. 371 00:17:02,847 --> 00:17:06,131 You know, I was wondering if we could talk a bit about... 372 00:17:06,155 --> 00:17:08,090 about what happens. 373 00:17:08,114 --> 00:17:12,205 You know, about how it feels when you start to get upset. 374 00:17:14,772 --> 00:17:16,905 - I don't know. Kind of... 375 00:17:18,820 --> 00:17:20,145 It's fuzzy. 376 00:17:20,169 --> 00:17:25,411 - Fuzzy. So kind of like, um, like a dream? 377 00:17:25,435 --> 00:17:27,500 - I guess. 378 00:17:27,524 --> 00:17:30,895 - And... and when it happens, I mean, what does it, uh, 379 00:17:30,919 --> 00:17:32,375 what does it feel like? 380 00:17:32,399 --> 00:17:34,855 I mean, like, you know, in here? 381 00:17:34,879 --> 00:17:38,076 I mean, do you feel anything in your body? 382 00:17:38,100 --> 00:17:40,818 - Feels like I'm gonna explode. 383 00:17:40,842 --> 00:17:42,080 - Wow. 384 00:17:42,104 --> 00:17:45,649 I'm sorry. That must be really scary. 385 00:17:45,673 --> 00:17:47,216 Do you want to take a little break? 386 00:17:47,240 --> 00:17:48,521 - I want this off. It's sticking to me. 387 00:17:48,545 --> 00:17:50,349 I can't stand it. - Okay, okay. 388 00:17:50,373 --> 00:17:52,264 - Don't touch me! Don't touch me! 389 00:17:52,288 --> 00:17:54,049 I hate you! I hate you! 390 00:17:54,073 --> 00:17:56,007 Let go! Stop it! 391 00:17:56,031 --> 00:17:58,053 Go away! Stop it! 392 00:17:58,077 --> 00:17:59,358 Go away! - Two of haldol! 393 00:17:59,382 --> 00:18:01,186 - Go away! Stop it, no! 394 00:18:01,210 --> 00:18:03,667 No, I don't want meds! Stop! 395 00:18:03,691 --> 00:18:06,757 Stop it, no! Stop! No! 396 00:18:06,781 --> 00:18:08,174 I don't want meds, stop! Stop it! 397 00:18:13,266 --> 00:18:15,983 - I wish I could tell you exactly what happened in there, 398 00:18:16,007 --> 00:18:17,594 what triggered Jamie, but honestly, I can't. 399 00:18:17,618 --> 00:18:19,030 I have reviewed his medical records, 400 00:18:19,054 --> 00:18:20,553 I've spoken with several of his doctors, 401 00:18:20,577 --> 00:18:23,861 and what is clear to me is that your son is struggling 402 00:18:23,885 --> 00:18:27,908 with multiple impulse control and mood regulation disorders. 403 00:18:27,932 --> 00:18:30,041 - So what do we do? We just want to help him. 404 00:18:30,065 --> 00:18:31,912 - Well, it's the hospital's recommendation 405 00:18:31,936 --> 00:18:35,133 that Jamie be admitted to a residential facility 406 00:18:35,157 --> 00:18:38,223 where he can receive sustained clinical care 407 00:18:38,247 --> 00:18:40,617 as well as supportive therapy. 408 00:18:40,641 --> 00:18:42,532 - A residential facility? - Mm-hmm. 409 00:18:42,556 --> 00:18:45,230 - Yeah. Mrs. Shaw, Jamie is 11. 410 00:18:45,254 --> 00:18:46,579 Puberty is fast approaching. 411 00:18:46,603 --> 00:18:48,190 And that surge of hormones 412 00:18:48,214 --> 00:18:52,368 is just gonna undoubtedly exacerbate his conditions. 413 00:18:52,392 --> 00:18:54,761 It'll just make him more difficult to treat in general. 414 00:18:54,785 --> 00:18:56,763 You know, find the right balance of meds. 415 00:18:56,787 --> 00:18:58,983 - And a specialized setting like this will have 416 00:18:59,007 --> 00:19:03,118 the behavioral resources Jamie needs for the future. 417 00:19:03,142 --> 00:19:07,252 And it'll be a safe place for him right now. 418 00:19:08,495 --> 00:19:10,690 - Anything for our son. - All right. 419 00:19:10,714 --> 00:19:13,195 I'll take care of all the arrangements. 420 00:19:17,808 --> 00:19:20,222 - Okay. Looking good. 421 00:19:20,246 --> 00:19:22,833 Four tears in the small bowel mesentery tied off. 422 00:19:22,857 --> 00:19:26,010 Liver's packed and hemostatic. 423 00:19:27,122 --> 00:19:28,122 - Pressure's no good. 424 00:19:29,733 --> 00:19:31,668 - We maxed out on pressors? 425 00:19:31,692 --> 00:19:32,756 - Yeah, and I've given ten units of blood 426 00:19:32,780 --> 00:19:34,105 and ten of plasma. 427 00:19:34,129 --> 00:19:36,523 She's still bleeding somewhere. - I don't... 428 00:19:38,394 --> 00:19:40,111 Hematoma on the pelvis. 429 00:19:40,135 --> 00:19:41,895 Bigger than my first look and growing. 430 00:19:41,919 --> 00:19:43,810 Gotta assume the pelvis is shattered and bleeding. 431 00:19:43,834 --> 00:19:45,421 Okay, team, new deal. Preperitoneal packs. 432 00:19:45,445 --> 00:19:46,552 Let's go. 433 00:19:50,319 --> 00:19:51,818 - Hey, Chloe. How you feeling? 434 00:19:51,842 --> 00:19:53,646 - Like a stuffed turkey. 435 00:19:53,670 --> 00:19:56,475 - X-rays show your bowel is FOS. 436 00:19:56,499 --> 00:19:58,564 - Full of... - Stool. 437 00:19:58,588 --> 00:20:01,176 The pelvic suggests your uterus is enlarged. 438 00:20:01,200 --> 00:20:03,352 So I suspect a fibroid is sitting on the uterus, 439 00:20:03,376 --> 00:20:05,005 putting pressure on the rectum. 440 00:20:05,029 --> 00:20:06,485 - You were right. 441 00:20:06,509 --> 00:20:08,226 The last few weeks, she was scouring the web 442 00:20:08,250 --> 00:20:11,403 with her symptoms, and fibroid fit the bill. 443 00:20:11,427 --> 00:20:13,013 - Yeah, we're trying to have a baby. 444 00:20:13,037 --> 00:20:15,712 Internet says fibroids hinder the ability to conceive. 445 00:20:15,736 --> 00:20:18,149 - Not all fibroids are created equal. 446 00:20:18,173 --> 00:20:19,759 Hey, I'm gonna order a pelvic ultrasound 447 00:20:19,783 --> 00:20:21,326 and a gyne consult. 448 00:20:21,350 --> 00:20:23,589 I'll check back soon. And no more Googling, okay? 449 00:20:23,613 --> 00:20:24,832 Doctor's orders. 450 00:20:26,660 --> 00:20:28,203 - How's it going with your six-month-old? 451 00:20:28,227 --> 00:20:29,334 - Dead end. 452 00:20:29,358 --> 00:20:31,031 Nothing's jumping out in any of the labs 453 00:20:31,055 --> 00:20:33,599 and the endoscopy and colonoscopy report. 454 00:20:33,623 --> 00:20:35,340 I'm starting to wonder if it's really baby Axel 455 00:20:35,364 --> 00:20:36,689 who's the one that's sick. 456 00:20:36,713 --> 00:20:38,125 - What do you mean? 457 00:20:38,149 --> 00:20:40,693 - The mom, she's just... She's got this air about her, 458 00:20:40,717 --> 00:20:42,913 this nonchalance that screams, 459 00:20:42,937 --> 00:20:45,524 "Yeah, my baby's in the ED, but it's just another day." 460 00:20:45,548 --> 00:20:47,744 - Well, it wouldn't be the first time we see a parent 461 00:20:47,768 --> 00:20:50,355 pretend their child was sick to get attention. 462 00:20:50,379 --> 00:20:52,923 - Yeah, unfortunately. 463 00:20:52,947 --> 00:20:55,404 Have you seen Dr. Charles? - He's upstairs. 464 00:20:55,428 --> 00:20:56,448 I'll page him for you. - Thanks. 465 00:20:56,472 --> 00:20:57,841 - Yeah. 466 00:20:57,865 --> 00:21:00,060 - Dr. Manning, it's Julia. 467 00:21:00,084 --> 00:21:01,695 There's something you need to see. 468 00:21:03,566 --> 00:21:04,804 - You know, I had my appendix taken out 469 00:21:04,828 --> 00:21:06,197 when I was in 10th grade. 470 00:21:06,221 --> 00:21:07,764 - All right. Well, let's take a look. 471 00:21:07,788 --> 00:21:09,505 ♪ 472 00:21:09,529 --> 00:21:13,291 Oh, my God. This is a fistula. 473 00:21:13,315 --> 00:21:17,513 Basically a tunnel between your small bowel and your skin. 474 00:21:17,537 --> 00:21:19,950 The green fluid is leaking from your intestines. 475 00:21:19,974 --> 00:21:21,647 - Seriously? - Mm-hmm. 476 00:21:21,671 --> 00:21:23,301 - I've been getting these scrapes for years. 477 00:21:23,325 --> 00:21:24,520 They heal up. 478 00:21:24,544 --> 00:21:26,957 It's been my intestines oozing out? 479 00:21:26,981 --> 00:21:29,264 - The tissue sample taken during Axel's endoscopy, 480 00:21:29,288 --> 00:21:30,656 I'd like it biopsied. 481 00:21:30,680 --> 00:21:32,745 - Biopsy? You're testing for cancer? 482 00:21:32,769 --> 00:21:34,007 - No. Something new. 483 00:21:34,031 --> 00:21:36,488 And now I'm thinking you may have it as well. 484 00:21:36,512 --> 00:21:37,794 The test that I ran on your son, 485 00:21:37,818 --> 00:21:40,666 I'd like to run on you as well. 486 00:21:40,690 --> 00:21:42,929 Okay. 487 00:21:42,953 --> 00:21:45,367 - All right. Pelvis is packed. 488 00:21:45,391 --> 00:21:47,282 Bleeding's under control. 489 00:21:47,306 --> 00:21:49,936 Call ICU and tell them Lucy's coming up to rewarm. 490 00:21:49,960 --> 00:21:52,025 - Something's wrong. Pressure's still in the toilet. 491 00:21:52,049 --> 00:21:54,811 74 over 38, falling. - What? 492 00:21:54,835 --> 00:21:57,292 - She's peri-arrest. - She's still bleeding? 493 00:21:58,708 --> 00:22:01,687 The abdomen is dry. Pelvis is contained. 494 00:22:01,711 --> 00:22:03,776 I mean, we're hemostatic, Marty. 495 00:22:03,800 --> 00:22:04,864 - She's bradying down. 496 00:22:06,412 --> 00:22:07,737 No pulse. - Come on. 497 00:22:10,764 --> 00:22:11,871 ♪ 498 00:22:11,895 --> 00:22:13,157 Milligram of epi. 499 00:22:16,422 --> 00:22:17,616 - Epi's in. Pulse check? 500 00:22:17,640 --> 00:22:18,815 - Go. 501 00:22:20,251 --> 00:22:21,251 - Still nothing. 502 00:22:23,167 --> 00:22:24,928 - Come on, Lucy. 503 00:22:24,952 --> 00:22:26,345 - Hold compressions. 504 00:22:29,348 --> 00:22:30,348 - Be good. 505 00:22:31,915 --> 00:22:34,938 - Asystole. - Come on. 506 00:22:34,962 --> 00:22:37,312 Come on, Lucy. Come on. 507 00:22:40,663 --> 00:22:43,033 ♪ 508 00:22:43,057 --> 00:22:44,057 Damn it. 509 00:22:46,930 --> 00:22:54,024 ♪ 510 00:22:57,811 --> 00:23:01,162 Time of death, 16:17. 511 00:23:03,817 --> 00:23:07,797 Okay, everyone, clear the room, please. 512 00:23:07,821 --> 00:23:09,866 I'd like a moment alone with my patient. 513 00:23:15,829 --> 00:23:20,921 ♪ 514 00:23:23,271 --> 00:23:25,641 - What's going on? 515 00:23:25,665 --> 00:23:27,207 - There's room for Jamie at Meyerbrook, 516 00:23:27,231 --> 00:23:28,861 which is the only residential facility 517 00:23:28,885 --> 00:23:30,559 capable of handling his needs. 518 00:23:30,583 --> 00:23:33,039 Unfortunately, neither his private insurance 519 00:23:33,063 --> 00:23:34,606 nor state Medicaid is gonna cover the cost. 520 00:23:34,630 --> 00:23:37,043 - What about an individual care grant from the state? 521 00:23:37,067 --> 00:23:38,436 - I already looked into it. It's no help. 522 00:23:38,460 --> 00:23:39,872 - Yeah, the grant's so underfunded, 523 00:23:39,896 --> 00:23:42,309 it wouldn't come close to what's needed. 524 00:23:42,333 --> 00:23:43,615 - So what's plan B? 525 00:23:43,639 --> 00:23:46,357 - Well, you know, I'm gonna just try and use 526 00:23:46,381 --> 00:23:48,881 the five-day hold to normalize his meds as best I can. 527 00:23:48,905 --> 00:23:51,101 And I do know a brilliant guy who specializes 528 00:23:51,125 --> 00:23:52,842 in these kind of disorders I want to refer him to. 529 00:23:52,866 --> 00:23:54,887 - An outpatient service? 530 00:23:54,911 --> 00:23:56,498 Jamie pummeled Dylan over an iPad. 531 00:23:56,522 --> 00:23:59,501 The kid's jaw's wired shut. He's only six years old. 532 00:23:59,525 --> 00:24:01,503 He's going to invade his brother's space again. 533 00:24:01,527 --> 00:24:05,594 And when that happens, and Jamie loses his temper, 534 00:24:05,618 --> 00:24:07,247 I'm worried he could kill Dylan. 535 00:24:07,271 --> 00:24:08,727 - I don't like it either, Ethan, 536 00:24:08,751 --> 00:24:10,947 but I mean, you know, I can't hold him here forever. 537 00:24:10,971 --> 00:24:14,864 - I get it, but we have an obligation to protect Dylan. 538 00:24:14,888 --> 00:24:16,890 And he needs our help just as much as Jamie. 539 00:24:25,246 --> 00:24:27,485 - Dr. Halstead, the gyne attending on-call 540 00:24:27,509 --> 00:24:28,834 came down a few minutes ago. 541 00:24:28,858 --> 00:24:32,098 She's with Chloe right now. - Great, thanks. 542 00:24:32,122 --> 00:24:34,187 - If you feel comfortable with that. 543 00:24:34,211 --> 00:24:35,972 Yeah. 544 00:24:35,996 --> 00:24:40,106 ♪ 545 00:24:40,130 --> 00:24:42,959 -Dr. Hannah Asher, gynecology. 546 00:24:45,135 --> 00:24:48,158 - Will Halstead. - It's nice to meet you. 547 00:24:48,182 --> 00:24:50,290 - Yeah. Likewise. 548 00:24:50,314 --> 00:24:52,467 - I was just explaining to Chloe and David 549 00:24:52,491 --> 00:24:54,251 that I reviewed her pelvic ultrasound. 550 00:24:54,275 --> 00:24:56,601 Considering the location and size of the fibroid, 551 00:24:56,625 --> 00:24:58,211 I believe removing it surgically 552 00:24:58,235 --> 00:24:59,430 is the best course of treatment. 553 00:24:59,454 --> 00:25:02,128 - A myomectomy? By who, when? 554 00:25:02,152 --> 00:25:05,349 - Me. Today. 555 00:25:05,373 --> 00:25:08,570 - Chloe, David, you should know this surgery can be risky. 556 00:25:08,594 --> 00:25:11,529 - Yes, I've explained the pros and cons, Dr. Halstead. 557 00:25:11,553 --> 00:25:13,792 Was clear that while this is a big operation, 558 00:25:13,816 --> 00:25:15,446 it's also a common one. 559 00:25:15,470 --> 00:25:18,928 - Nevertheless, complications could rise. 560 00:25:18,952 --> 00:25:21,147 So I would suggest non-surgical options. 561 00:25:21,171 --> 00:25:23,846 Hormone therapy will shrink the fibroid. 562 00:25:23,870 --> 00:25:25,325 - Well, that's what Dr. Asher said. 563 00:25:25,349 --> 00:25:27,980 But to ensure that it doesn't grow back, 564 00:25:28,004 --> 00:25:29,416 Chloe would have to go on the pill. 565 00:25:29,440 --> 00:25:31,375 - We're anxious to start a family. 566 00:25:31,399 --> 00:25:33,159 The pill takes that off the table. 567 00:25:33,183 --> 00:25:35,292 - In the short term, yes. But not permanently. 568 00:25:35,316 --> 00:25:37,599 - Actually, it kind of does. 569 00:25:37,623 --> 00:25:39,339 I'm 41, Dr. Halstead. 570 00:25:39,363 --> 00:25:41,820 Our window for getting pregnant is already closing. 571 00:25:41,844 --> 00:25:45,084 If I choose hormones, I might as well slam it shut. 572 00:25:45,108 --> 00:25:47,957 - We appreciate your passion, Dr. Halstead. 573 00:25:47,981 --> 00:25:51,177 But surgery is the best for us. 574 00:25:51,201 --> 00:25:52,788 - I'll get that started. 575 00:25:52,812 --> 00:25:55,442 It was so nice meeting both of you. 576 00:25:55,466 --> 00:25:56,748 Doctor. 577 00:25:59,253 --> 00:26:01,797 - Excuse me just a moment. 578 00:26:01,821 --> 00:26:04,214 Doctor Asher? Doctor. 579 00:26:05,651 --> 00:26:06,845 - Hmm? 580 00:26:06,869 --> 00:26:08,151 - You can't perform this surgery. 581 00:26:08,175 --> 00:26:09,326 - Hmm? 582 00:26:09,350 --> 00:26:10,936 - I mean, you shouldn't even be working. 583 00:26:10,960 --> 00:26:12,982 - Look, thank you for your help last week, but I'm better now. 584 00:26:13,006 --> 00:26:14,636 I'm over that hump. 585 00:26:14,660 --> 00:26:16,246 - So heroin addiction is like a cold? 586 00:26:16,270 --> 00:26:17,943 What, you just get over it? 587 00:26:17,967 --> 00:26:19,510 What I saw at that injection site... 588 00:26:19,534 --> 00:26:21,207 - Was me having a bad day. 589 00:26:21,231 --> 00:26:22,469 - A bad day? - Mm-hmm. 590 00:26:22,493 --> 00:26:24,191 - You... 591 00:26:26,410 --> 00:26:28,911 You OD'd. 592 00:26:28,935 --> 00:26:30,652 For all I know, you're high right now. 593 00:26:30,676 --> 00:26:31,957 - Right. 594 00:26:31,981 --> 00:26:33,698 But how many all-nighters you pull over there 595 00:26:33,722 --> 00:26:35,657 since I saw you last, huh? 596 00:26:35,681 --> 00:26:39,443 Three? Four? 597 00:26:39,467 --> 00:26:41,706 Maybe I should be the one worried about your judgment. 598 00:26:41,730 --> 00:26:42,925 - Don't twist this. 599 00:26:42,949 --> 00:26:45,667 I'm not an addict about to operate. 600 00:26:45,691 --> 00:26:48,278 You step into that OR, you put Chloe's life in jeopardy. 601 00:26:48,302 --> 00:26:51,435 - I would never risk the well-being of a patient. 602 00:26:53,176 --> 00:26:57,243 Not that it is any of your business, I'm sober now. 603 00:26:57,267 --> 00:26:59,356 - I'd expect an addict to say that. 604 00:27:01,184 --> 00:27:03,360 - Chloe is in good hands with me. 605 00:27:05,536 --> 00:27:09,149 ♪ 606 00:27:14,284 --> 00:27:17,002 - Axel has Crohn's disease? But he's only six months old. 607 00:27:17,026 --> 00:27:19,570 - Well, it's rare in children, let alone infants, 608 00:27:19,594 --> 00:27:21,137 but not unheard of. 609 00:27:21,161 --> 00:27:22,442 - Isn't Crohn's a diet thing? 610 00:27:22,466 --> 00:27:24,488 I mean, Axel's barely started on solids. 611 00:27:24,512 --> 00:27:25,794 - Well, diet aggravates Crohn's, 612 00:27:25,818 --> 00:27:27,056 but it's not the cause. 613 00:27:27,080 --> 00:27:28,100 Genetics is. 614 00:27:28,124 --> 00:27:30,407 Crohn's tends to cluster in families. 615 00:27:30,431 --> 00:27:32,409 - Whoa, my test results... 616 00:27:32,433 --> 00:27:34,019 - Show that you have Crohn's as well. 617 00:27:34,043 --> 00:27:36,674 The fistula is just evidence of the severity. 618 00:27:36,698 --> 00:27:37,936 - This doesn't make sense. 619 00:27:37,960 --> 00:27:39,721 If I've got Crohn's badly enough 620 00:27:39,745 --> 00:27:42,898 to burn a hole in my skin, shouldn't it bother me? 621 00:27:42,922 --> 00:27:44,900 - Well, fistulas themselves are painless, 622 00:27:44,924 --> 00:27:48,381 but yes, a Crohn's flare-up is excruciating. 623 00:27:48,405 --> 00:27:50,601 You should be in pain. Agony. 624 00:27:50,625 --> 00:27:54,605 - Yeah, well, I don't feel a thing. 625 00:27:54,629 --> 00:27:57,303 This is weirding you out, isn't it? 626 00:27:57,327 --> 00:27:58,740 - It's definitely unusual. 627 00:28:01,984 --> 00:28:04,093 ♪ 628 00:28:04,117 --> 00:28:10,621 Or actually, maybe it's... maybe it's rare. 629 00:28:10,645 --> 00:28:11,927 Let me ask you a question. 630 00:28:11,951 --> 00:28:16,279 What emotion are you feeling right now? 631 00:28:16,303 --> 00:28:17,759 - I'm not sure what you mean. 632 00:28:17,783 --> 00:28:19,499 - Well, I just told you that you and your son have 633 00:28:19,523 --> 00:28:21,501 an inflammatory bowel disease. 634 00:28:21,525 --> 00:28:23,199 What are you feeling? Stress? 635 00:28:23,223 --> 00:28:25,375 Anxiety? Fear? 636 00:28:25,399 --> 00:28:29,031 - Confusion, that's for sure. 637 00:28:29,055 --> 00:28:31,686 - You know, I'd like to run one more test. 638 00:28:31,710 --> 00:28:32,948 Okay? - Okay. 639 00:28:32,972 --> 00:28:33,973 - Okay. 640 00:28:39,805 --> 00:28:42,131 - Bea, it's taking too long. Check with Dr. Asher. 641 00:28:42,155 --> 00:28:43,567 - Again? 642 00:28:43,591 --> 00:28:45,090 I've already gone in there twice for you, Dr. Halstead. 643 00:28:45,114 --> 00:28:47,136 - Please, I'm treating Chloe in the ED. 644 00:28:47,160 --> 00:28:48,746 I just want to make sure Dr. Asher's 645 00:28:48,770 --> 00:28:50,530 got everything under control. 646 00:28:50,554 --> 00:28:52,861 - Fine. - Thank you. 647 00:28:57,083 --> 00:29:01,193 ♪ 648 00:29:01,217 --> 00:29:04,283 - Dr. Asher said, "Go away." 649 00:29:04,307 --> 00:29:06,005 - Nope, staying right here. 650 00:29:12,489 --> 00:29:14,816 - Hey, I got your page. 651 00:29:14,840 --> 00:29:16,624 - You have a new plan to help Jamie? 652 00:29:17,930 --> 00:29:20,759 - Yeah. Yep, I do. 653 00:29:23,457 --> 00:29:24,782 So, Mr. and Mrs. Shaw, 654 00:29:24,806 --> 00:29:27,176 I have given this a tremendous amount of thought. 655 00:29:27,200 --> 00:29:30,527 I've consulted with... With numerous colleagues, 656 00:29:30,551 --> 00:29:31,833 with social workers, 657 00:29:31,857 --> 00:29:35,706 with our Executive Director of Patient Services. 658 00:29:35,730 --> 00:29:38,056 Jamie needs to be at the Meyerbrook 659 00:29:38,080 --> 00:29:39,492 Residential Facility. 660 00:29:39,516 --> 00:29:41,538 - So the insurance companies, they agreed to pay? 661 00:29:41,562 --> 00:29:43,018 - No. 662 00:29:43,042 --> 00:29:46,369 Both your private insurance and Medicaid won't budge. 663 00:29:46,393 --> 00:29:49,372 - Then I'm confused. 664 00:29:49,396 --> 00:29:52,027 - There is a way to force Medicaid 665 00:29:52,051 --> 00:29:55,073 to cover Meyerbrook's cost in full. 666 00:29:55,097 --> 00:29:56,814 It's called a psychiatric lockout. 667 00:29:56,838 --> 00:29:58,511 But it will require you 668 00:29:58,535 --> 00:30:01,166 to surrender Jamie to this hospital. 669 00:30:01,190 --> 00:30:04,953 - Surrender? I don't understand. 670 00:30:04,977 --> 00:30:08,260 - If you were to leave Jamie here and refuse to come back, 671 00:30:08,284 --> 00:30:11,307 Child Protective Services would have to take custody of him. 672 00:30:11,331 --> 00:30:14,963 Then, as a ward of the state, legally, Illinois would have 673 00:30:14,987 --> 00:30:18,662 to provide him with the mental health services that he needs. 674 00:30:18,686 --> 00:30:21,883 - Meyerbrook? - This is insane. 675 00:30:21,907 --> 00:30:24,668 We're not doing this. - So there's no other way? 676 00:30:24,692 --> 00:30:27,976 - I'm so sorry, but there just isn't. 677 00:30:28,000 --> 00:30:30,195 We would absolutely find a way for you to maintain contact 678 00:30:30,219 --> 00:30:31,893 with Jamie, but you also need to know 679 00:30:31,917 --> 00:30:35,287 that legally, you won't have any say in his care. 680 00:30:38,271 --> 00:30:40,205 ♪ 681 00:30:40,229 --> 00:30:42,207 - We're still his parents. 682 00:30:42,231 --> 00:30:43,992 This doesn't change that. Nothing changes that. 683 00:30:44,016 --> 00:30:45,994 - No. No, no, no. 684 00:30:46,018 --> 00:30:47,952 We're not abandoning our son. 685 00:30:47,976 --> 00:30:50,737 - Mrs. Shaw, you will not be abandoning him. 686 00:30:50,761 --> 00:30:53,068 This... this won't be forever. 687 00:30:55,027 --> 00:30:56,811 - Jamie needs us to do this. 688 00:31:06,168 --> 00:31:07,754 - When? 689 00:31:07,778 --> 00:31:09,887 - I cannot imagine how agonizing 690 00:31:09,911 --> 00:31:12,542 this decision must be. 691 00:31:12,566 --> 00:31:15,937 But the sooner Jamie starts to heal, 692 00:31:15,961 --> 00:31:17,939 the sooner you all can look forward 693 00:31:17,963 --> 00:31:19,941 to becoming a family again. 694 00:31:19,965 --> 00:31:22,141 Bella. 695 00:31:24,491 --> 00:31:26,058 It's to save him. 696 00:31:29,670 --> 00:31:36,155 ♪ 697 00:31:59,787 --> 00:32:01,983 - Everything is going to be okay. 698 00:32:02,007 --> 00:32:03,810 - Hey, buddy. It's gonna be okay, buddy. 699 00:32:03,834 --> 00:32:05,464 Right now, it's the best thing. 700 00:32:05,488 --> 00:32:07,858 You'll be better, and so you're just gonna stay 701 00:32:07,882 --> 00:32:10,382 with the doctors. 702 00:32:10,406 --> 00:32:12,210 - You're okay, baby. - No, no. 703 00:32:12,234 --> 00:32:13,777 Please. I'll be better. 704 00:32:13,801 --> 00:32:15,997 I didn't mean to! - It's okay. 705 00:32:16,021 --> 00:32:18,913 - Please, I want to go home. I want to go home. 706 00:32:18,937 --> 00:32:20,895 Please, Mom. 707 00:32:24,551 --> 00:32:30,359 ♪ 708 00:32:33,560 --> 00:32:39,479 ♪ 709 00:32:53,928 --> 00:32:55,210 - Dr. Marcel? 710 00:32:55,234 --> 00:32:58,213 Lucy's parents are still in the waiting room. 711 00:32:58,237 --> 00:33:00,563 You haven't told them... - She should be alive. 712 00:33:00,587 --> 00:33:02,260 - Well, it's been over an hour. 713 00:33:02,284 --> 00:33:05,220 They need to know that their daughter has passed. 714 00:33:05,244 --> 00:33:09,833 - I won't speak to them until I can explain how she died. 715 00:33:09,857 --> 00:33:11,467 Why I couldn't save her. 716 00:33:20,781 --> 00:33:23,716 Can you give me some light? 717 00:33:23,740 --> 00:33:24,915 Right here. 718 00:33:27,527 --> 00:33:31,768 Every other injury was either a tear or a rip in the skin. 719 00:33:31,792 --> 00:33:33,359 This one's a hole. 720 00:33:35,709 --> 00:33:37,730 Something embedded inside. 721 00:33:37,754 --> 00:33:39,776 - More shrapnel from the windshield? 722 00:33:39,800 --> 00:33:41,430 - It doesn't really feel like glass. 723 00:33:41,454 --> 00:33:44,326 Can you, uh, swing that X-ray machine around? 724 00:33:52,465 --> 00:33:54,617 ♪ 725 00:33:54,641 --> 00:33:55,990 Go ahead. 726 00:34:00,299 --> 00:34:03,843 ♪ 727 00:34:03,867 --> 00:34:06,020 That's a bullet. 728 00:34:06,044 --> 00:34:08,133 - Lucy was shot? 729 00:34:09,917 --> 00:34:12,572 ♪ 730 00:34:17,794 --> 00:34:20,556 - Lucy was shot? How? 731 00:34:20,580 --> 00:34:24,777 She was driving down the highway alone in the car. 732 00:34:24,801 --> 00:34:26,997 - The steep angle of entry shows that the bullet struck 733 00:34:27,021 --> 00:34:29,956 from above and launched into Lucy's pelvis. 734 00:34:29,980 --> 00:34:33,090 It severed her external iliac artery. 735 00:34:33,114 --> 00:34:35,701 - Shot from above? - Yes. 736 00:34:35,725 --> 00:34:37,964 Now, the police will run ballistics. 737 00:34:37,988 --> 00:34:40,576 But they believe, and science backs it up, 738 00:34:40,600 --> 00:34:42,665 that someone, somewhere in the city, 739 00:34:42,689 --> 00:34:44,449 fired a gun into the air. 740 00:34:44,473 --> 00:34:48,018 And when that bullet came down, 741 00:34:48,042 --> 00:34:50,281 it struck Lucy. 742 00:34:50,305 --> 00:34:53,632 - Someone. Somewhere. 743 00:34:53,656 --> 00:34:56,006 And now our daughter is dead? 744 00:34:58,139 --> 00:34:59,532 - I'm so sorry. 745 00:35:01,795 --> 00:35:05,340 The nurse will come to take you to see Lucy. 746 00:35:05,364 --> 00:35:06,906 Excuse me. 747 00:35:09,890 --> 00:35:12,129 ♪ 748 00:35:12,153 --> 00:35:16,829 - Hey, the additional blood work you ordered on Axel's mom. 749 00:35:16,853 --> 00:35:18,788 - Oh, wow. 750 00:35:18,812 --> 00:35:22,183 This whole time, my take on Julia has been off. 751 00:35:22,207 --> 00:35:23,730 Way off. 752 00:35:26,080 --> 00:35:28,841 - ♪ We love fun 753 00:35:28,865 --> 00:35:31,975 ♪ We're going out and having some ♪ 754 00:35:31,999 --> 00:35:34,586 ♪ We love fun 755 00:35:34,610 --> 00:35:37,502 ♪ You know we're gonna have a ton ♪ 756 00:35:37,526 --> 00:35:39,591 - Never heard that song before. 757 00:35:39,615 --> 00:35:42,159 - "We Love Fun" by The Bouncing Souls. 758 00:35:42,183 --> 00:35:45,206 I don't know any real lullabies. 759 00:35:45,230 --> 00:35:47,904 - Julia, all day, I've been troubled by your demeanor 760 00:35:47,928 --> 00:35:51,037 because you didn't seem worried about Axel. 761 00:35:51,061 --> 00:35:54,302 But now I know you really aren't worried. 762 00:35:54,326 --> 00:35:57,914 And I suspect you've never felt anxious, depressed, 763 00:35:57,938 --> 00:36:00,830 or even afraid your entire life, have you? 764 00:36:00,854 --> 00:36:03,528 - No, not really. 765 00:36:03,552 --> 00:36:05,685 - Same goes for physical pain, doesn't it? 766 00:36:07,034 --> 00:36:09,360 - Kind of feels like this is a trick question or something. 767 00:36:09,384 --> 00:36:11,667 - No. Okay. 768 00:36:11,691 --> 00:36:15,453 So when I had my son, labor was a beast. 769 00:36:15,477 --> 00:36:18,674 Intense pressure, cramps, spasms. 770 00:36:18,698 --> 00:36:20,241 But you didn't feel any of that, did you? 771 00:36:20,265 --> 00:36:21,416 - Nope. 772 00:36:21,440 --> 00:36:23,940 Whole thing just kind of tingled. 773 00:36:23,964 --> 00:36:27,204 But I've always had an extremely high pain tolerance. 774 00:36:27,228 --> 00:36:28,379 I know. 775 00:36:28,403 --> 00:36:29,859 There's something wrong with me, right? 776 00:36:29,883 --> 00:36:32,514 My friends have been saying it forever. 777 00:36:32,538 --> 00:36:35,430 Wait, is there something wrong with me? 778 00:36:35,454 --> 00:36:36,822 - No. 779 00:36:36,846 --> 00:36:38,955 No, but there is something missing from you. 780 00:36:38,979 --> 00:36:41,653 So we all have what's called a FAAHP1 pseudogene. 781 00:36:41,677 --> 00:36:44,352 Your preliminary blood work shows that you have a rare 782 00:36:44,376 --> 00:36:47,355 microdeletion which affects your insensitivity to pain. 783 00:36:47,379 --> 00:36:48,530 - When I was a kid, 784 00:36:48,554 --> 00:36:50,706 my dad would say everyone else were wimps. 785 00:36:50,730 --> 00:36:55,014 That we were a hardy breed, that pain was just a word. 786 00:36:55,038 --> 00:36:58,148 - Well, microdeletion is a genetic thing. 787 00:36:58,172 --> 00:37:00,455 So it's likely that your father and other family members 788 00:37:00,479 --> 00:37:01,479 have it as well. 789 00:37:04,265 --> 00:37:06,069 ♪ 790 00:37:06,093 --> 00:37:07,921 Julia? 791 00:37:10,358 --> 00:37:12,597 ♪ 792 00:37:15,189 --> 00:37:16,906 - What's wrong? 793 00:37:16,930 --> 00:37:19,735 - I passed Axel the gene for Crohn's, 794 00:37:19,759 --> 00:37:22,999 but not the one so he won't be tortured by it. 795 00:37:23,023 --> 00:37:25,088 And if I didn't know when I hurt myself, 796 00:37:25,112 --> 00:37:27,743 I wouldn't have known when I hurt my son. 797 00:37:27,767 --> 00:37:30,093 I probably made the bath too hot. 798 00:37:30,117 --> 00:37:32,574 Didn't dress him warm enough... - Hey. 799 00:37:32,598 --> 00:37:34,663 You knew it wasn't colic. 800 00:37:34,687 --> 00:37:38,754 You knew to bring your son into the ED. 801 00:37:38,778 --> 00:37:41,539 You may not feel everything he feels, 802 00:37:41,563 --> 00:37:43,019 but you're his mother. 803 00:37:43,043 --> 00:37:45,959 You'll always know what he needs. 804 00:37:47,439 --> 00:37:54,054 ♪ 805 00:37:55,795 --> 00:37:57,773 - Uh, keep going. Grab her husband. 806 00:37:57,797 --> 00:37:59,146 I'll meet you in recovery. 807 00:38:01,931 --> 00:38:03,866 Wonderful. You're still here. 808 00:38:03,890 --> 00:38:06,303 - Is Chloe okay? - Yeah, she's fine. 809 00:38:06,327 --> 00:38:08,914 Operation was flawless. 810 00:38:08,938 --> 00:38:12,135 - This time. 811 00:38:12,159 --> 00:38:14,311 - How about you and I keep our distance from one another? 812 00:38:14,335 --> 00:38:15,443 - Yeah, fine. 813 00:38:15,467 --> 00:38:17,445 Just as soon as you stop treating patients 814 00:38:17,469 --> 00:38:18,620 and seek treatment for your addiction. 815 00:38:18,644 --> 00:38:19,969 - Screw you, Halstead. 816 00:38:19,993 --> 00:38:21,623 - In that case, I'm going to submit a letter 817 00:38:21,647 --> 00:38:23,146 to the hospital's Chief Medical Officer. 818 00:38:23,170 --> 00:38:24,582 And that decision will be made for you. 819 00:38:24,606 --> 00:38:26,628 - That's a stupid idea. 820 00:38:26,652 --> 00:38:29,500 You out me, I out your own involvement 821 00:38:29,524 --> 00:38:32,198 in a not-quite-legal injection site. 822 00:38:32,222 --> 00:38:34,462 So if I go down, so do you. 823 00:38:34,486 --> 00:38:36,290 ♪ 824 00:38:36,314 --> 00:38:40,076 So if you want to report me, 825 00:38:40,100 --> 00:38:41,730 have at it, cowboy. 826 00:38:44,713 --> 00:38:46,691 ♪ 827 00:38:50,110 --> 00:38:52,218 - Hey. - Hey. 828 00:38:52,242 --> 00:38:54,003 - Heard you had a rough one today. 829 00:38:54,027 --> 00:38:56,745 You all right? - Yeah. 830 00:38:56,769 --> 00:38:58,660 The little boy and his mom. 831 00:38:58,684 --> 00:39:01,663 Your, uh, ESP pan out? 832 00:39:01,687 --> 00:39:04,167 - Not even close. 833 00:39:06,082 --> 00:39:08,844 ♪ 834 00:39:08,868 --> 00:39:12,369 - I'll see you tomorrow. - Night. 835 00:39:15,396 --> 00:39:20,793 ♪ 836 00:39:22,534 --> 00:39:23,926 - Hey. 837 00:39:26,973 --> 00:39:28,646 Today sucked. 838 00:39:28,670 --> 00:39:31,432 Yes, it did. 839 00:39:31,456 --> 00:39:36,437 - We just don't have enough psychiatric resources for kids. 840 00:39:36,461 --> 00:39:39,091 - And unfortunately, the Shaws won't be 841 00:39:39,115 --> 00:39:41,877 the last family to face a lockout. 842 00:39:41,901 --> 00:39:46,316 But Jamie will get the help he needs. 843 00:39:46,340 --> 00:39:48,255 And that's a good thing. 844 00:39:51,519 --> 00:39:57,569 ♪ 845 00:40:05,533 --> 00:40:08,754 - Hey, buddy. Come on, let's go. 846 00:40:57,890 --> 00:41:05,027 ♪