- He cut me open
and rewired my circuitry.
- Dean, we don't medicate patients
to get the answers we want.
- At the end of the day, it's my word versus Neil's--
the guy who thinks this whole thing is a game of Tetris!
- Enough. Dean, take a walk.
- If I told Vanessa the truth-- that I'm her mother...
- I don't know, Maggie.
Once you take that step... - I know.
- Got my interview for
Med's nurse practitioner program today.
You forced me into a procedure
that I am not supposed to do.
- As a nurse practitioner,
I thought you'd welcome the challenge.
- How'd your interview go? - Oh, my God.
♪
- Who gave an unauthorized patient
our trial drug? - Me.
- You realize you have compromised the trial?
Not to mention your career.
- I stole meds from Will's trial,
and now my mom is dying in there,
and she needs a new heart.
♪
- Hey, Nat. Hey.
We found a donor heart for your mom.
It's on the way. - Really?
- Yeah. But it's not perfect.
Come on. I'll explain.
♪
So the donor is a 50-year old woman,
type AB like your mom,
and her thoracic cavity was very similar in size.
- Good. - There are issues.
The heart has already been refused
for several recipients by their physicians.
- Why? - The organ
has a intracardiac tumor in the left ventricle.
- Sarcoma? - No, myxoma.
- Benign, okay.
Well, then you can remove the myxoma
before Dr. Latham implants the heart.
That's doable.
- Yes, but there's another issue.
- The heart was harvested in Los Angeles.
Under normal circumstances, by the time it arrived,
it would be outside the window or viability.
- Then why are we even suggesting this?
- Because of how it's being transported.
- Warm perfusion, an experimental procedure
still in its trial phase.
A machine profuses the donor heart with warm blood.
Ergo the name.
- It should prevent tissue damage, keep it functional.
- "Should"?
You're already suggesting a dicey heart
that could turn out to be useless.
- We'll apprise your mother of all the risks.
- But her blood type is rare, Nat.
Even though she's high on the list,
it'd be unlikely to find a heart that matches.
- Highly unlikely.
- Okay.
♪
- Got a 70-year old male, Pavel Zorin,
came in last night,
minor injuries after assaulting his landlord.
Claimed there were rats in his apartment.
Agitated, combative, probably delusional.
- "Probably"?
- Well, most of the time, he was babbling in Russian,
no one around to translate.
When he came in, he was clutching these.
Psych resident sedated him, put him on a 72-hour hold,
and now, they're just taking him upstairs.
- Lease, naturalization papers,
a bunch of old documents in Russian.
Unfortunately my Cyrillic's a little rusty.
- Well, I'm sure I could find a translator for you.
- I'm actually thinking about Mischa Lankov.
- Didn't he retire? - Well, he's in the process of,
but something tells me he'd want to help out
a fellow countryman. Why don't we give him a call?
- All right.
- On our way home, we pass by that Jamaican place,
pick up some jerk chicken?
- Sure.
♪
Today's her last day here.
- You're doing the right thing, Mags.
- - You can't tell her.
- I know.
- I've got to go to work.
♪
I will see you later.
- Okay.
♪
- Hi.
♪
- Just one second, okay? One second.
Are you ready, Mom?
- Oh.
This was my mother's
and I want you to have it.
- You're gonna be okay, Mom.
How about this? I will keep it for you.
- Okay. - Okay.
Let's go.
♪
I'm right here with you, Mom. - Okay.
♪
- Thanks, guys. All right, thank you.
- You okay?
Just one second. I love you, Mom.
- I love you.
♪
- There it is.
Nat, it's gonna work out.
Okay?
♪
Okay.
- Dr. Marcel, Mrs. Conte is prepped.
Please start on the myxoma.
- Okay.
♪
- I'm so sorry for missing yesterday's appointment.
I got caught up with a case.
I really appreciate you seeing me today.
- April, you're a very good candidate
for our nurse practitioner program,
and most of your recommendations are excellent.
- Most? - Well, there was one.
- What was the issue?
- An ED doc had some concerns about your judgement.
- Look, Ms. Scott, I think I know who that is,
and I just want to say-- - No need to explain, April.
Trauma surgeons can be a prickly bunch.
- So it was a trauma surgeon? - Let's put that aside.
I see that we've received all of your transcripts,
so I think I have everything I need.
- Apparently the episode was triggered
when he saw a rat in his apartment.
- Mr. Zorin, in September of 1980,
was committed to the Leningrad Special Psychiatric Hospital.
- "Special"? What's that,
for bigwigs, for party members?
- No, it's more likely for a particular type
of mental illness.
It says here he suffered from--
How would I say it,
sluggish schizophrenia?
- "Sluggish"? I'm--
I'm not familiar with that-- that particular diagnosis.
Are you? - Not really.
I mean, I've heard the term back then
when I was a psych resident in Moscow, but sorry.
I wish I could have been more help.
- Misha, could you just give me a few more minutes?
Help me talk to the patient.
- Daniel, I-- - Five minutes tops.
I just-- I might need a translator.
Mr. Zorin, I'm Dr. Charles, and--and this is Dr. Lankov.
How are you feeling?
Mr. Zorin, do you understand me?
Do you speak English? -
- Mr. Zorin, you're safe here.
- - You are absolutely safe here.
Mischa?
- Five of haldol, five of haldol please.
- Got it. -
♪
- Mischa, you all right?
- Hey. Morning.
- Morning.
Look, Dean. We need to talk.
- Uh-oh. Am I that late?
- This is really tough,
but I've got serious concerns about our working together.
- Really? Why?
- It's a lot of things.
Look, I know we got off to a rocky start,
and I take full responsibility for that.
But I--I don't know.
I thought you and I were in a good place now.
- Take yesterday for example,
the way you lied to the patient.
- Oh, come on, man.
I was just trying to establish a rapport so I can treat her.
There's nothing in the Hippocratic Oath
that says I can't do that.
- That's just the latest. - Tell me something.
Is there something going on with you, Ethan,
that I don't know about?
I mean, this is all so out of the blue.
- Don't do that. Don't make this--
- No, no, no. Come on.
Because you ambushed me right here,
and you lay this whole thing on me.
- We were going to have this conversation somewhere.
I thought it would be better out here.
- All right, I've got to be honest with you, Ethan.
I'm getting the feeling here, and I hope I'm wrong,
but maybe you just hired your old CO
so you could knock him down a few pegs, maybe.
- That's not true, and you know it.
- Is it?
- Tell me it's not a game. Here you are.
Here I am. You think that just happened?
- You remember Mr. Dietrich.
He's my patient with appendicitis.
- I do. - I wasn't sick.
I was about to wake up. I was about
to see the real world, but then you NPCs took the red pill out.
- All we did was removed your ruptured appendix.
- Yeah, to save your life.
- Yeah, more lies. - Hey, hey.
Take it easy, okay? Let's talk about this.
- Yeah, what's the point?
Everything that you say is programmed.
- Hey, hey, hey, hey, over here, over here, over here.
- Whoa, whoa, whoa, whoa, whoa.
- I'm the one who took out the red pill.
- No, no, no, no, no. I'm the Chief of the ED, okay?
I'm responsible for everything that happens there.
- It doesn't matter, okay?
You're both the same, but guess what?
I'm not one and zeroes. I'm real!
- Okay.
- And you're deleted.
♪
- Ethan, Ethan? -
- Maggie, I've got a GSW in staff parking
and another person with head trauma.
I need two stretchers and the rapid response team stat.
- There's no exit wound. The bullet is still in you.
How you doing, Ethan? Talk to me.
- Okay. - No, Ethan.
- Dr. Archer, Baghdad's ready. Dr. Halstead.
- I'm on it. - I'm right here, okay?
I'm right here.
- Ethan?
♪
- So...
what--what happened down there?
- It's a hiatal hernia.
Acts up sometimes.
- Oh, really? You know, I thought--
I thought maybe it had something to do with something,
you know, that Mr. Zorin said.
- Well, sometimes the stress
of dealing with the patient can set it off.
- What was that word that he kept on repeating?
It's Russian slang for a psychiatric hospital.
- Huh. - And I'm guessing
that's where he developed his phobia to rats.
- So rats in a hospital?
- Do you have something stronger?
- Are you sure that's a good idea,
I mean, for hiatal hernia?
- No, of course not.
- Oh, boy. You know what?
There's an emergency down in the ER.
- Sure. - You going to be all right?
- Oh, yeah, yeah.
- Do you mind just waiting a few more minutes
until I get back?
I just had a couple more questions about the patient.
Oh, you know what?
I'll get you some Lansoprazole, make you feel better.
All right? Be right back.
- Hang a unit of O blood, and trigger the MTP.
- Satting at 85.
- He's not protecting his airway.
Start bagging. I'll intubate.
Twenty of etomidate, 100 of SUX.
- X-ray.
♪
- Ethan, you're going to be all right.
- Okay, I'm in. - BP, 90 over 55.
Heart rate, 119. Blood's going in.
- Clear.
We have left side hemothorax.
I'll put in a tube.
- No, I'll do it.
♪
Okay, hang two more units on the rapid transfuser.
- BP 100 over 70. Heart rate, 110.
- Better. Let's take him to CT.
- Oh, my-- what happened?
- He got shot by this guy.
- Right with me, trauma two.
- Neil Dietrich, 25-- - Go away.
- GS 13. Suspected concussion.
- He took the red pill away. Delete.
- You know he was here a couple weeks ago, right?
Patient of Dr. Archer's. I consulted on the case.
Completely delusional,
thinks he's living in some kind of computer simulation.
- He took the red pill away!
- Image is lousy, too much scatter from the bullet.
We need an MRI.
- No, can't. The bullet is pseudoferrous.
It will heat it up. All right.
We can assume he's got a cord hematoma.
He needs surgery. - Well, hold on.
The hematoma may or may not be a problem.
- All right, look. The bullet is near the cord.
All right? This can be more than just spinal shock.
Early decompression is the right course of action here.
- Well, what if you injure the cord, create a CSF leak?
Then he's paralyzed.
Profusion precautions in the ICU,
hematoma could very well resolve on its own.
- Yeah, unlikely. All right.
And I've spent a career treating gunshot wounds.
- I think my tenure in the ED in Chicago
gives me some insight into GSW.
- Your animosity towards Dr. Choi is well-known.
You've resented his authority ever since he was made chief.
I don't think you're capable
of making an impartial clinical assessment.
- Whatever my issues with Ethan might be...
- They aren't affecting his clinical judgement.
- As if you're in a position to judge.
I am taking him into surgery.
- Hey, surgery is a neurosurgeon's decision,
not yours. - That's right.
- Okay.
Okay. Fine.
Call neurosurgery, but know this, both of you,
that every minute we delay surgery
puts Dr. Choi at greater risk.
♪
- Mischa, I am so sorry.
♪
- Dr. Marcel, I have a patient on bypass.
Her chest is open. Where is my heart?
- Dr. Latham, I thought I mentioned the myxoma invaded
the interior mitral leaflet.
- Yes, but the clock is ticking.
How much longer? - Hold on.
♪
- Dr. Marcel?
- I'm still repairing the leaflet.
Okay. Here we go.
It's all yours.
Let's proceed. - Okay.
Thank you.
Where would you like to begin?
- On the kidney. - Okay.
- All right, lighten the sedation.
- Ethan, can you hear me?
- Ethan?
- Ethan, this is Sam. Can you blink your eyes?
Ethan, can you blink?
Okay, good.
Can you wiggle your toes?
- Ethan, come on. Try to wiggle your toes.
- Okay.
- It's clear there's a weakness in his lower extremities.
- Perhaps my input's not needed.
- Sam, what do you suggest?
- Well, if we don't take him to be operated on
as soon as possible, then it will only get worse.
- Why don't I just go home? - Laminectomy, right?
- Yes, laminectomy.
- Maggie, would you please open the hybrid OR?
- Unless you want to take him upstairs.
- It's better for the patient to avoid the trip.
Hybrid OR will do.
- Where is he? - Treatment five.
- Mischa?
- He was found in the parking garage,
seems to have fallen down the stairs.
Respiration is 10, smells of alcohol.
- He lose consciousness?
- Can't say, but you see the head injury.
- Mischa, can you tell me what happened?
Mischa, can you hear me? Do you know where you are?
- We need to clear a C Spine. - Leave the collar on.
Send him up for head and neck CT.
Hang in there, buddy.
We'll get you all fixed up, okay?
- Bullet's accessible.
- I just heard about Ethan. How's he doing?
- They got the bullet.
- Hematoma is minimal. You can close.
- Hold on, there are retropulse bone fragments.
- Yeah, I'm aware of that. - But we need to extract them.
- His spine is decompressed. That's all we need to do.
Any damage from the fragments already been done,
and we'll only make things worse, going after them.
- No, listen, we're here. We're open.
Let's find the fragments, and then we'll fuse the spine.
- That's a longer, riskier, more invasive surgery.
- But it will allow Ethan
to begin the recovery process immediately.
- Yeah, if he isn't paralyzed.
Chasing bone fragments is more dangerous than it's worth.
- Dr. Abrams makes a good point.
- That is so distracting. Would you turn that off please?
- You should close him and start--
Damn it.
- Maybe Ethan needs a neurosurgeon
who's more confident in his abilities.
- That person doesn't exist.
- Well, then.
- What do we know about Dr. Choi?
- He's still in surgery.
- Okay, listen. He e-mailed me last night
and said, from among the med students auditioning,
he decided to go with Vanessa Taylor
to come back and rotate in the ED.
- Oh.
- At first I thought about quashing it,
but then that wouldn't be fair to Ms. Taylor.
- No. - I take it
you haven't told her who you are.
Good.
I'm counting on your professionalism
to treat her like any other med student.
- Absolutely. - I mean it, Maggie.
No favoritism, no special treatment.
Dr. Virani, a word, please?
- Of course.
- How are you feeling? - Terrible.
- Well, I mean, you did drink
almost 800 milliliters of 90 proof whiskey.
- I'm so sorry about the whiskey.
I normally don't drink that much.
- Look, I'm sorry, again, for dashing out on you like that
and leave you hanging for so long,
but it turns out that a member of our staff was shot
by a delusional patient.
Yeah, he's in surgery now.
- Oh, my God.
- Mischa, here's what you can do for me, all right?
You can tell an old friend... what's really going on here?
- Your Mr. Zorin was never psychotic,
and the worst thing you can do for him
is confine him to the psychiatric ward.
- Do you know him?
- No, not personally, but I have known others like him.
The sluggish schizophrenia is a phony diagnosis,
which was given
to political dissidents
in order to incarcerate them,
and specific psychiatric hospitals
were nothing more than prisons,
awful places,
and that's why Mr. Zorin reacted so violently
when he woke up
his worst nightmare.
Yeah. In the Soviet Union,
psychiatry was weaponized.
It was used to punish.
- So, Mischa, were you already practicing at this point?
- You're asking, did I participate?
You can't understand that we were trained
that Soviet Union
was the most perfect form of government,
and if someone was against it,
they had to be insane.
Political deviance was a failure to grasp reality.
- Oh.
I mean, still though,
that must have been very difficult.
- It was a different world.
It's like this man who shot your colleague.
We were all delusional.
- The heart is in place.
- Okay, steroid. - Dosing.
Remove the cross clamp.
- Okay.
♪
- It's not beating. - Give it a moment.
♪
- I need to step out.
- Come on.
- Hey, she's good.
- We were able to pace the heart,
and once we got it jump-started,
it continued on its own.
- Oh, my God. - Yeah, contractions were good.
The repaired mitral valve is working well.
She's going to be okay. They're closing her up now.
- Crockett, thank you. - Yeah.
- Thank you.
Oh, God.
I wasn't fair to you.
I wasn't fair, and I wasn't honest.
- Look, I understand why you cut me out.
I just wish you felt you could've trusted me.
- How is that for irony?
I was always talking to you about commitment,
that you needed to trust. - Yeah.
Look, Natalie. I want you to know...
Regardless of everything,
I'll always be grateful to you.
- Why?
- Well, my life was pretty empty till I met you.
Closed off, a lot of fears.
You showed me what could be,
how to take a chance.
♪
- Any news?
- Still too soon.
Everything all right with Goodwin?
- BP 90 over 48,
heart rate 50,
85 over 42. Heart rate, 45.
- He's in shock. Betty, what's going on?
We haven't lost any blood. - Oh, God...
- I didn't give him anything different.
It's not a reaction to the meds.
- Volume status?
- Good, and he was ventilating fine.
- It's not cardiac or pulmonary.
- Ventral and lateral cords are well-decompressed,
no active bleeding.
- It's neurogenic shock.
Something must be pushing on the cord ventrally.
- 81 over 40, heart rate 39.
- Betty, up his meds and pressers.
- On it.
- Okay, paddles ready in case he codes.
- Heart rate's down to 35. - He's bradycardic.
- Dean's brilliant idea is going to kill Ethan.
- Dopamine drip, Riluzole 50 milligrams down the NG tube,
and start the Solumedrol protocol.
- You need to decompress the other side of the spine.
- I know what I need to do.
- Still falling, 73 over 39, heart rate 33.
- Goddammit.
- Rod distractor and set screwdriver.
Distracting the spine now.
- He's gonna code any second.
- Done.
- Vitals improving.
90 over 55, heart rate 43.
Now 110 over 65, heart rate 60.
- Drill. Get the second rod in.
Then you can close.
- We'll need O-Maxon and a large needle driver.
There. All worked out.
- They did it.
- And?
- He pulled through.
- Thank God.
This day...
- I got to see Ms. Goodwin.
I'll be right back.
- It's my understanding that you took drugs from the trial
and gave them to Dr. Manning's mother without authorization.
- That's correct.
- As a result, Dr. Halstead,
Kender has pulled the trial from this hospital,
which you know has major financial implications.
There's the immediate loss of revenue, of course,
but it's also safe to assume that Kender will be reluctant
to run trials here in the future.
You have anything to say?
- Ms. Goodwin, I was trying
to help a patient in desperate need.
- At the expense of the trial
and all the other patients that might benefit from it.
You know, you asked me last summer
why I didn't name you as chief of the ED,
and it's precisely this kind of reckless behavior
that, at this point, I have no choice but to address.
You're fired, Dr. Halstead.
♪
- Heard you're going to be joining us.
Congratulations. - Thank you.
- Believe me, you're gonna get an education.
- I know. - Congratulations, Vanessa.
- Thank you!
- I heard. Congratulations.
- Thank you.
We need to talk after work.
- Okay.
♪
- Ethan?
Hi.
- April. - How you doing?
- I'm okay.
- You would say that if you were lying on a bed of nails.
♪
The bullet was lodged at T6. You had a laminectomy.
Dr. Archer insisted on a corpectomy
to remove bone fragments, and...
it was the right call.
They say you'll need PT
but that eventually you'll have a very good outcome.
Ethan...
ever since you and I broke up...
I've tried really, really hard to move on from us.
But seeing you brought in this morning on that gurney...
Everything just came back to me...
Just how much I love you.
♪
- Come in.
- Ms. Goodwin. - Dr. Archer.
I understand you did yeoman's work
treating Dr. Choi today.
- Oh, I just did what I thought he'd want.
- I assume he'll have a protracted convalescence.
You know, when Dr. Choi hired you, he sang your praises.
He had great faith in your abilities,
and everything that I've seen lately only supports that.
So, if you're willing...
I'd like to name you interim chief of the ED
until Dr. Choi can resume his duties.
- Well, I'd be honored,
and I'll do my best to
maintain the standards he's set.
- Good. I think he'd be pleased.
- Yeah, thank you. Thanks.
♪
- It doesn't matter what happens
or where you take me, okay? It's all fake.
My real body is floating in a tank, drugged,
interfacing with the master computer.
Are you listening to me?
- How did we get here?
There's just so many troubled, lost souls.
- Mischa, do you remember the delusional patient
I was telling you about,
you know, the one who shot my colleague?
- Yes.
- Well, you compare yourself to him,
saying that living in the Soviet Union
was like living in a different reality, right?
- Mm-hmm. - And I was thinking,
the difference is is that this guy,
I mean, he's insane. He's clinically delusional,
whereas you and your colleagues--
- Daniel, why do you torture me with this?
- Oh, Mischa, I'm so sorry. That's not at all my intention.
I'm actually trying to figure out a way
that we might help Mr. Zorin.
- "We"?
How can I possibly help this poor man?
- You know what?
I think that you might be ideally suited to the task.
♪
- I think...
these were a mistake. Let's get them off.
♪
- April? This just came in for you.
- From the NP admissions department.
- Yep.
- Oh, boy. Okay.
- I got accepted!
- Of course you did! How about that?
♪
- Hey.
- Listen, I--
I love my parents.
They're caring, wonderful people.
They adopted me when I was an infant.
But you know that.
You know, I...
I kept wondering why you were so interested in me,
why you would look at me the way that you do.
You know, my parents, they always said to me
that they would help me find my birth mother,
but I wasn't interested.
I mean, I was happy. What would've been the point?
Anyways, it...
it wasn't difficult for me to find out who you were.
- Oh, Vanessa, I-- - I've worked my whole life
to get where I am.
If anybody thought I was accepted here
just because I'm your daughter...
- I--no.
That was entirely on your own merit, honestly.
I had nothing to do with it.
- I hope so,
because I'm not going to give up this opportunity.
- You shouldn't. There's no reason to.
- I don't want anyone to know about us.
♪
- Of course, and...
they won't.
- What did you want, Maggie?
- I just...
I wanted to meet you.
- It wasn't right.
You coming into my life like this,
it--it just wasn't right. - I know, I--
♪
- Mom? - Natalie.
- Hi.
- Am I alive? -
Yes. You are alive,
and you are going to live for a long, long time.
- Mrs. Conte.
- Thank you?
Who was that?
- He is the best CT surgeon in Chicago.
- Wow. - Hmm.
- Hey, Carol. You did great.
Nat, can I see you a sec?
- Sure. - Yeah.
- Mom, I'll be right back, okay?
- Okay.
- It's about Will. - What about him?
♪
- Goodwin fired you?
- Just let it go, Nat.
- Because of my mom's pills?
Will, did you tell her you took them?
Answer me! - I had to.
- Why?
♪
- It's everything, everything we've been through,
everything we've been to each other.
What else could I do?
- Tell the truth.
- No, I think a change will do me good.
- No, Will, I'm sorry. I cannot let you do this.
- Nat, I'm okay. Really.
- Will, please don't do this.
- It's done, Nat, so...
it's done.
- Hey.
You up for a little visit?
- Yes, ma'am.
- No, no, please don't.
You know, when I saw you get shot this morning,
I immediately thought, "Hate crime,"
and I've since learned that wasn't the case.
- No.
- But that's exactly where my mind went.
This has been a difficult year,
the madness, the heartache.
I have to admit, Dr. Choi, I'm a little bit shell-shocked.
- I know.
- Yeah. I'm sure you do.
Well, I'll let you rest.
You need to heal.
- We all do.
Ms. Goodwin? - Mm-hmm.
- I may be down, but I want to get back up.
- I'm counting on that, Dr. Choi.
I'm counting on that.
♪
- Ms. Goodwin? - Yeah.
- You have got to reinstate Dr. Halstead.
- Dr. Manning, I realize that you two are close...
- No, you don't understand.
I was the one who stole the trial meds for my mom.
I am the reason the trial was canceled, not Will.
He said that to protect me.
♪