1 00:00:01,269 --> 00:00:01,402 . 2 00:00:01,435 --> 00:00:02,336 - I respect LeBron James. I admire LeBron James. 3 00:00:04,238 --> 00:00:05,639 But compare him to Michael Jordan? 4 00:00:05,673 --> 00:00:07,275 Come on! - You only think that 5 00:00:07,308 --> 00:00:09,210 because you're a Chicago chauvinist. 6 00:00:09,243 --> 00:00:11,445 - Oh, no. No, I'm completely objective. 7 00:00:11,479 --> 00:00:14,182 Stats, clutch playing, it's Jordan all the way. 8 00:00:14,215 --> 00:00:16,184 - Will, you are a very good doctor, 9 00:00:16,217 --> 00:00:18,786 but very limited on your understanding of basketball. 10 00:00:18,819 --> 00:00:20,388 - Give me a kiss. - [giggles] 11 00:00:20,421 --> 00:00:22,090 - Dr. Manning, radiology called. 12 00:00:22,123 --> 00:00:23,791 Your scans are up on the computer. 13 00:00:23,824 --> 00:00:24,792 - Okay. - I got it. 14 00:00:24,825 --> 00:00:26,227 - Thank you. 15 00:00:27,595 --> 00:00:30,331 - Morning, Connor. - Good morning, Will. 16 00:00:30,364 --> 00:00:33,167 - Hey, how's Robin? - She's much better, thanks. 17 00:00:33,201 --> 00:00:34,602 Yeah, she's shopping like a fiend. 18 00:00:34,635 --> 00:00:37,071 She left me about a foot of space in the closet, 19 00:00:37,105 --> 00:00:39,640 and three hangers. - Uh-oh. 20 00:00:39,673 --> 00:00:42,176 - Excuse me. 21 00:00:42,210 --> 00:00:43,677 Maggie. - Yeah? 22 00:00:43,711 --> 00:00:45,446 - Do me a favor. Call CT, tell them I had to leave. 23 00:00:45,479 --> 00:00:46,847 I'll be back as soon as I can. 24 00:00:46,880 --> 00:00:49,250 - You got it. 25 00:00:49,283 --> 00:00:52,420 [ominous music] 26 00:00:52,453 --> 00:00:59,460 * 27 00:01:15,809 --> 00:01:17,578 - Hey, Darren. 28 00:01:17,611 --> 00:01:19,313 - Sorry about this, Dr. Rhodes. - No, I appreciate the text. 29 00:01:19,347 --> 00:01:20,448 Where is she? - This way. 30 00:01:20,481 --> 00:01:21,682 - Okay. 31 00:01:21,715 --> 00:01:23,617 - One of my guys caught her trying to walk out with this. 32 00:01:23,651 --> 00:01:25,453 Had no idea who she was. 33 00:01:25,486 --> 00:01:27,488 We would have called P.D. if your dad hadn't been here. 34 00:01:27,521 --> 00:01:28,622 - Appreciate that. 35 00:01:29,890 --> 00:01:31,459 Did you really have to lock her in? 36 00:01:31,492 --> 00:01:33,427 - Standard procedure, Dr. Rhodes. 37 00:01:33,461 --> 00:01:36,530 - [sighs] 38 00:01:39,633 --> 00:01:41,502 Robin. 39 00:01:43,671 --> 00:01:46,274 - I don't know what's the matter with me. 40 00:01:46,307 --> 00:01:48,209 - Shh, come here, come here. 41 00:01:48,242 --> 00:01:51,179 It's gonna be all right, honey. 42 00:01:51,212 --> 00:01:53,247 It's gonna be all right. 43 00:01:53,281 --> 00:01:56,250 [dramatic music] 44 00:01:56,284 --> 00:01:59,153 * 45 00:01:59,187 --> 00:02:01,155 - I hear Mama hollering from the bathroom 46 00:02:01,189 --> 00:02:02,790 and I run in and find her on the floor. 47 00:02:02,823 --> 00:02:04,358 That's when I called 911. 48 00:02:04,392 --> 00:02:06,594 - Told her a bus would suit me just fine, 49 00:02:06,627 --> 00:02:09,330 instead of wasting all that money on a ambulance. 50 00:02:09,363 --> 00:02:11,765 - Well, I'm glad you did decide to come in, Ms. Buckley. 51 00:02:11,799 --> 00:02:13,667 Luckily, it's only your wrist that's broken, 52 00:02:13,701 --> 00:02:17,205 but your X-ray shows what we call a Colles' fracture. 53 00:02:17,238 --> 00:02:18,939 So we need to reduce it, re-align your bones, 54 00:02:18,972 --> 00:02:20,908 and then we can put you in a splint. 55 00:02:20,941 --> 00:02:22,676 - If you say so. 56 00:02:22,710 --> 00:02:25,679 - Okay. April, draw up 10 milligrams of lidocaine 57 00:02:25,713 --> 00:02:27,348 for a hematoma block. 58 00:02:27,381 --> 00:02:29,850 So, let me guess. Virginia? 59 00:02:29,883 --> 00:02:31,785 - North Carolina. - Mm. 60 00:02:31,819 --> 00:02:35,223 - We've been here 20 years. Guess the Tar Heel never goes. 61 00:02:35,256 --> 00:02:37,157 - [chuckles] 62 00:02:38,426 --> 00:02:43,297 - You all right? - Yeah, it's nothing. 63 00:02:43,331 --> 00:02:45,199 - Okay, now this is gonna hurt. 64 00:02:45,233 --> 00:02:47,968 So I'm gonna have you take some deep breaths for me, okay? 65 00:02:48,001 --> 00:02:49,503 All right, you ready? - Mm-hmm. 66 00:02:49,537 --> 00:02:51,405 - Okay, take a deep breath. - [inhales] 67 00:02:51,439 --> 00:02:52,806 - Good job. Now I'm gonna have you 68 00:02:52,840 --> 00:02:56,410 take one more really big deep breath for me, okay? 69 00:02:56,444 --> 00:02:58,946 Ready? One, two, three. 70 00:02:58,979 --> 00:03:01,649 [bone cracks] - Ah! 71 00:03:01,682 --> 00:03:04,218 - All right, the hard part's over. 72 00:03:04,252 --> 00:03:06,387 Great job. 73 00:03:06,420 --> 00:03:08,389 - Thank you. - Mm-hmm. 74 00:03:08,422 --> 00:03:09,923 Orthopedics will be down later 75 00:03:09,957 --> 00:03:12,760 to set you up with a cast, okay? 76 00:03:14,695 --> 00:03:17,831 - Thank you. - Sorry. Thank you. 77 00:03:17,865 --> 00:03:19,800 How's Noah doing? 78 00:03:19,833 --> 00:03:22,536 He's gonna have a black eye for a couple days, 79 00:03:22,570 --> 00:03:25,573 but he'll be okay. He'll be in later today. 80 00:03:25,606 --> 00:03:28,476 - Glad to hear it. 81 00:03:30,010 --> 00:03:31,812 - Honey, this is the encephalitis. 82 00:03:31,845 --> 00:03:33,581 This isn't you. 83 00:03:33,614 --> 00:03:36,450 - You don't know how it feels. It is humiliating. 84 00:03:36,484 --> 00:03:38,719 - Things like this, they're gonna pass. 85 00:03:38,752 --> 00:03:40,821 You know that. 86 00:03:40,854 --> 00:03:43,357 You're already better than you were a month ago. 87 00:03:43,391 --> 00:03:44,858 - Am I though? 88 00:03:44,892 --> 00:03:47,261 Really? 89 00:03:47,295 --> 00:03:50,464 God, I've got to pull myself together. 90 00:03:54,868 --> 00:03:56,537 - Dad. 91 00:03:56,570 --> 00:03:58,472 Thank you for not calling the cops. 92 00:03:58,506 --> 00:04:02,610 - Connor, this friend of yours, she's a kleptomaniac. 93 00:04:02,643 --> 00:04:03,677 - No, she isn't. 94 00:04:03,711 --> 00:04:05,613 She's recovering from an illness that makes her 95 00:04:05,646 --> 00:04:07,615 do things she wouldn't otherwise do. 96 00:04:07,648 --> 00:04:10,718 - Well, still, you have to admit she's unstable. 97 00:04:10,751 --> 00:04:11,785 - You don't know her. 98 00:04:11,819 --> 00:04:13,954 You don't know anything about her. 99 00:04:13,987 --> 00:04:15,856 - So what she did was sane, reasonable? 100 00:04:15,889 --> 00:04:17,391 - After what happened to Mom, 101 00:04:17,425 --> 00:04:18,892 I would say that you are the last person 102 00:04:18,926 --> 00:04:20,628 that should be discussing anybody's mental health. 103 00:04:20,661 --> 00:04:21,762 - You're making this about your mother? 104 00:04:21,795 --> 00:04:23,030 - Yes, I am. 105 00:04:23,063 --> 00:04:24,632 - She's been gone for 20 years. 106 00:04:24,665 --> 00:04:26,367 Time to move on, don't you think? 107 00:04:26,400 --> 00:04:30,037 - Yeah, it took you what, a week? 108 00:04:30,070 --> 00:04:31,672 - Okay, listen to me. 109 00:04:31,705 --> 00:04:36,510 If she's not unstable, she's a criminal. 110 00:04:36,544 --> 00:04:41,349 Either way, fatherly advice: 111 00:04:41,382 --> 00:04:43,317 Get rid of her. 112 00:04:43,351 --> 00:04:45,786 [footsteps] 113 00:04:45,819 --> 00:04:48,789 [tense music] 114 00:04:48,822 --> 00:04:55,829 * 115 00:05:02,035 --> 00:05:03,971 - Good morning. - Morning. 116 00:05:04,004 --> 00:05:06,607 - Hey, so you and April? 117 00:05:06,640 --> 00:05:07,741 - Yeah. 118 00:05:07,775 --> 00:05:09,810 - How long has that been going on? 119 00:05:09,843 --> 00:05:11,745 - About six months. 120 00:05:11,779 --> 00:05:14,682 - You managed to keep it quiet for six months in this place? 121 00:05:14,715 --> 00:05:15,849 - It wasn't easy. 122 00:05:15,883 --> 00:05:19,487 On several occasions, we came close to blowing our cover. 123 00:05:22,456 --> 00:05:23,824 - Sharon? - Yeah? 124 00:05:23,857 --> 00:05:25,759 - I'm a charge nurse, and I'm hanging IV bags. 125 00:05:25,793 --> 00:05:27,728 - I know, Maggie. You're short staffed. 126 00:05:27,761 --> 00:05:29,963 - For a month. When are we gonna hire more nurses? 127 00:05:29,997 --> 00:05:31,999 - We can't afford it. It's not in the budget. 128 00:05:32,032 --> 00:05:34,968 - Sharon, we are required to have one nurse for two beds. 129 00:05:35,002 --> 00:05:38,906 That's 12 nurses per shift. Four shifts, that's 48 nurses. 130 00:05:38,939 --> 00:05:40,474 Right now, I only have 42. 131 00:05:40,508 --> 00:05:42,142 - Well, even it out with overtime. 132 00:05:42,175 --> 00:05:43,544 - Time and a half? 133 00:05:43,577 --> 00:05:44,612 How is that supposed to save us money? 134 00:05:44,645 --> 00:05:45,746 - It doesn't, but overtime 135 00:05:45,779 --> 00:05:47,515 comes out of a different account. 136 00:05:47,548 --> 00:05:49,417 We still look good. Work with me. 137 00:05:49,450 --> 00:05:52,753 - Dr. Halstead, incoming. 138 00:05:52,786 --> 00:05:56,824 - Arlo Littman, 20 years old. Delusional and combative. 139 00:05:56,857 --> 00:05:57,958 Says he's radioactive. 140 00:05:57,991 --> 00:06:00,461 - You can't let anyone touch me, make them stay away! 141 00:06:00,494 --> 00:06:02,129 - Negative on radiation poisoning. 142 00:06:02,162 --> 00:06:04,598 He hasn't vomited or been nauseated. 143 00:06:04,632 --> 00:06:06,934 Too agitated to get vitals, restrained in the field. 144 00:06:06,967 --> 00:06:08,469 - He on something? 145 00:06:08,502 --> 00:06:09,637 - Roommate says no, he doesn't do drugs. 146 00:06:09,670 --> 00:06:11,472 - No one touch me! No one touch me! 147 00:06:11,505 --> 00:06:12,873 - Karen, page Psych. 148 00:06:12,906 --> 00:06:14,608 All right, let's get him on the bed. 149 00:06:14,642 --> 00:06:16,710 Arlo, I'm Dr. Halstead, I'm gonna help you. 150 00:06:16,744 --> 00:06:18,546 - I'm death, don't touch me. 151 00:06:18,579 --> 00:06:19,713 - Yeah, let's get him on the bed. 152 00:06:19,747 --> 00:06:21,449 - Uh-huh. - One, two, three. 153 00:06:21,482 --> 00:06:23,150 - Get away from me, no! - Restraints. 154 00:06:23,183 --> 00:06:25,686 Courtney, get his left leg. - Yup. 155 00:06:25,719 --> 00:06:27,555 - You'll die, you will all die! 156 00:06:27,588 --> 00:06:28,622 - All right. - All right. 157 00:06:28,656 --> 00:06:30,691 - [frantic breathing] 158 00:06:30,724 --> 00:06:33,093 - Let's move him up a little bit. 159 00:06:33,126 --> 00:06:36,630 Spontaneous movement in all four limbs, anyone disagree? 160 00:06:36,664 --> 00:06:39,967 - [frantic breathing] 161 00:06:40,000 --> 00:06:42,436 - Pupils equal, round and reactive. 162 00:06:42,470 --> 00:06:44,137 - Don't touch me, save yourselves. 163 00:06:44,171 --> 00:06:46,039 - Hey! - Okay, easy, buddy. 164 00:06:46,073 --> 00:06:47,508 - Try and relax. 165 00:06:47,541 --> 00:06:51,679 - [frantic breathing] 166 00:06:51,712 --> 00:06:53,681 - Yeah, I didn't sedate him, didn't want to over-snow him. 167 00:06:53,714 --> 00:06:55,048 Thought you'd want to hear his spiel. 168 00:06:55,082 --> 00:06:57,050 - Five diazepam, five olanzapine. 169 00:06:57,084 --> 00:06:58,652 - Got it. 170 00:06:58,686 --> 00:07:00,921 - Hey, I'm Dr. Charles, I'm here to help you. 171 00:07:00,954 --> 00:07:03,190 - I'm death. 172 00:07:03,223 --> 00:07:05,158 - Let's get him on the monitors. 173 00:07:05,192 --> 00:07:07,160 U-tox, blood alcohol, CBC and CMP. 174 00:07:07,194 --> 00:07:11,064 You want the restraints off? - Eh. 175 00:07:11,098 --> 00:07:12,933 Let's leave them on for now. 176 00:07:12,966 --> 00:07:14,668 See what his state of mind is when he wakes up. 177 00:07:14,702 --> 00:07:16,169 - All right, he's all yours. 178 00:07:16,203 --> 00:07:19,106 - Thanks, Will. - Yup. 179 00:07:19,139 --> 00:07:21,675 - Initial thoughts? 180 00:07:21,709 --> 00:07:23,877 - Schizophrenia usually manifests at his age. 181 00:07:23,911 --> 00:07:27,214 - Mm-hm. Doris, could you give us a second, please? 182 00:07:27,247 --> 00:07:28,982 - Sure. 183 00:07:32,753 --> 00:07:34,622 - You okay? - Yes. 184 00:07:34,655 --> 00:07:36,490 - All right, just making sure 185 00:07:36,524 --> 00:07:38,091 you're comfortable treating the patient. 186 00:07:38,125 --> 00:07:39,727 - Yeah, absolutely. 187 00:07:39,760 --> 00:07:43,030 - I'll be here if you need me. 188 00:07:43,063 --> 00:07:46,033 [somber music] 189 00:07:57,911 --> 00:07:58,045 . 190 00:07:58,078 --> 00:07:58,378 - Hey, you. 191 00:08:00,881 --> 00:08:03,183 I got to get back to work. 192 00:08:03,216 --> 00:08:05,919 Uh, there's leftovers in the fridge, if you want. 193 00:08:05,953 --> 00:08:09,056 Turkey, asparagus-- - I'm not hungry. 194 00:08:09,089 --> 00:08:12,960 - Robin, you should eat. You'd feel better. 195 00:08:15,295 --> 00:08:18,165 - You take good care of me. 196 00:08:18,198 --> 00:08:20,834 I guess you do that for all your patients. 197 00:08:20,868 --> 00:08:22,836 - Whoa, whoa, whoa, hey, hey, hey, hey. 198 00:08:22,870 --> 00:08:26,907 You are not my patient. 199 00:08:26,940 --> 00:08:28,141 I love you. 200 00:08:28,175 --> 00:08:32,680 - Do you? Because I wouldn't love me. 201 00:08:32,713 --> 00:08:35,182 I'd get rid of me. 202 00:08:40,053 --> 00:08:43,824 - Listen, my dad is a son of a bitch. 203 00:08:43,857 --> 00:08:46,159 He likes to destroy things. 204 00:08:46,193 --> 00:08:49,262 - And you, you like to fix things. 205 00:08:50,864 --> 00:08:54,635 People with blocked arteries 206 00:08:54,668 --> 00:08:58,038 or leaky valves. 207 00:08:58,071 --> 00:09:02,275 Unhinged girlfriends who like to shoplift. 208 00:09:02,309 --> 00:09:04,612 - Meaning? 209 00:09:04,645 --> 00:09:07,815 - Wanting to save someone, 210 00:09:07,848 --> 00:09:10,818 needing to save someone, 211 00:09:10,851 --> 00:09:14,154 it's not the same as loving. 212 00:09:14,187 --> 00:09:18,325 - Robin, your illness, it gives you a distorted view of things. 213 00:09:18,358 --> 00:09:20,828 - Right. Unhinged. 214 00:09:20,861 --> 00:09:24,064 - No. 215 00:09:24,097 --> 00:09:27,334 It is a matter of brain chemistry. 216 00:09:27,367 --> 00:09:30,270 And obviously, right now it's not being addressed properly. 217 00:09:30,303 --> 00:09:33,974 So I am going to make sure that it is. 218 00:09:34,007 --> 00:09:37,044 - You're my knight in shining armor. 219 00:09:38,278 --> 00:09:40,714 - I'll be home as soon as I can. 220 00:09:40,748 --> 00:09:47,955 * 221 00:09:54,261 --> 00:09:56,664 - And this one too. - Yep. 222 00:09:58,298 --> 00:10:00,100 - Dr. Halstead, you're back on. 223 00:10:00,133 --> 00:10:02,035 You're going to treatment four. Hey, Monique? 224 00:10:02,069 --> 00:10:03,370 - Jessie Rowe, mid-twenties. 225 00:10:03,403 --> 00:10:04,938 Shortness of breath, abdominal pain. 226 00:10:04,972 --> 00:10:06,006 - I'm her husband. 227 00:10:06,039 --> 00:10:07,307 - Okay, I'm Dr. Halstead. 228 00:10:07,340 --> 00:10:09,109 Any idea what might be causing this? 229 00:10:09,142 --> 00:10:10,878 Something you ate? Did you fall? 230 00:10:10,911 --> 00:10:13,146 - No. - Might be the IVF therapy. 231 00:10:13,180 --> 00:10:14,715 We've been trying to get pregnant, 232 00:10:14,748 --> 00:10:15,949 Jessie's had three rounds. 233 00:10:15,983 --> 00:10:17,851 Embryo transfer two weeks ago. 234 00:10:17,885 --> 00:10:19,987 - Okay, let's see what's going on. 235 00:10:22,055 --> 00:10:23,991 I'm hearing a slight crackle. - I got it. 236 00:10:24,024 --> 00:10:25,392 Pam, we need an X-ray in here. - Yes, Maggie. 237 00:10:25,425 --> 00:10:27,728 - How long you been feeling this way? 238 00:10:27,761 --> 00:10:29,196 - Been bloated a couple days. 239 00:10:29,229 --> 00:10:31,264 Shortness of breath just this morning. 240 00:10:31,298 --> 00:10:35,736 - Heart rate 86, BP 124/73. 02 sat's at 93%. 241 00:10:35,769 --> 00:10:38,305 - That's a little low. Put her on a nasal cannula. 242 00:10:38,338 --> 00:10:41,842 Jessie, I'm gonna ultrasound your belly. 243 00:10:41,875 --> 00:10:43,276 Thank you. 244 00:10:43,310 --> 00:10:45,045 Your ovaries are somewhat enlarged, 245 00:10:45,078 --> 00:10:46,947 but that can happen after IVF. 246 00:10:46,980 --> 00:10:49,149 - Can you tell? Am I pregnant? 247 00:10:49,182 --> 00:10:51,018 - Uh, too early for that to show. 248 00:10:51,051 --> 00:10:52,285 We need a chest. - Yes, doctor. 249 00:10:52,319 --> 00:10:54,287 - Wait, what if she is pregnant? 250 00:10:54,321 --> 00:10:56,389 - The lead apron will protect her. 251 00:10:56,423 --> 00:10:58,325 Stand back, everybody. 252 00:11:03,196 --> 00:11:05,165 I'm seeing some congestion in the lungs, 253 00:11:05,198 --> 00:11:07,067 but not enough to concern me. 254 00:11:07,100 --> 00:11:08,736 This could all just be in response to the IVF, 255 00:11:08,769 --> 00:11:09,937 but we're gonna make sure. 256 00:11:09,970 --> 00:11:11,739 Hopefully you'll feel better soon. 257 00:11:11,772 --> 00:11:15,108 And we'll all cross our fingers the embryo transfer took. 258 00:11:18,511 --> 00:11:21,982 - Mr. Janichek, I'm Dr. Choi. I understand you cut yourself. 259 00:11:22,015 --> 00:11:24,017 - Yeah, and maybe someone can finally tell me why. 260 00:11:24,051 --> 00:11:25,352 - I see this isn't the first time. 261 00:11:25,385 --> 00:11:27,154 - It's been happening a lot lately. 262 00:11:27,187 --> 00:11:29,122 I drop things, I fall down. It's not like me. 263 00:11:29,156 --> 00:11:30,190 - Basic vitals are all normal. 264 00:11:30,223 --> 00:11:31,959 - You know, I don't care. 265 00:11:31,992 --> 00:11:35,128 Something's wrong with me, and no one can figure out what. 266 00:11:35,162 --> 00:11:38,165 - Well, let's take a look, huh? 267 00:11:42,235 --> 00:11:43,904 Put your index finger and thumb together 268 00:11:43,937 --> 00:11:45,939 to make a circle. 269 00:11:45,973 --> 00:11:48,876 Try not to let me break it. 270 00:11:48,909 --> 00:11:51,011 Good. Relax. 271 00:11:51,044 --> 00:11:52,780 Can you feel this? 272 00:11:52,813 --> 00:11:56,049 This, this, this, this? 273 00:11:56,083 --> 00:11:57,217 Your tendons and nerves are intact. 274 00:11:57,250 --> 00:11:58,485 A gram of ancef, draw up lidocaine, 275 00:11:58,518 --> 00:12:00,153 and give me the suture kit. - Yep. 276 00:12:00,187 --> 00:12:01,955 - That's it? You're just gonna sew me up? 277 00:12:01,989 --> 00:12:04,157 - Well, I don't see anything else that needs treating. 278 00:12:04,191 --> 00:12:05,292 - You're just like all the other docs. 279 00:12:05,325 --> 00:12:06,459 You don't care. You don't listen. 280 00:12:06,493 --> 00:12:08,061 You just want to get me out of here. 281 00:12:08,095 --> 00:12:09,096 - I am listening to you, Mr. Janichek. 282 00:12:09,129 --> 00:12:11,398 - I feel crummy. - Crummy? 283 00:12:11,431 --> 00:12:14,234 - Yeah, pretty much all the time. 284 00:12:14,267 --> 00:12:16,403 - Doris, let's get a CBC and CMP. 285 00:12:16,436 --> 00:12:17,237 - Yes, Dr. Choi. 286 00:12:17,270 --> 00:12:19,739 - Now can I sew you up? 287 00:12:22,409 --> 00:12:24,845 - Hi. A nurse is gonna come by 288 00:12:24,878 --> 00:12:26,479 to start your discharge paperwork. 289 00:12:26,513 --> 00:12:29,917 - Nance, look up the bus schedule, will you, hon? 290 00:12:29,950 --> 00:12:31,852 - Yeah. Ah! - Honey? 291 00:12:31,885 --> 00:12:34,387 - Nancy, are you okay? 292 00:12:34,421 --> 00:12:37,490 Let me check your abdomen, if you don't mind. 293 00:12:37,524 --> 00:12:40,160 How long have you had this pain? 294 00:12:40,193 --> 00:12:42,162 - Uh, I don't know. A few days? 295 00:12:42,195 --> 00:12:43,263 - Is there anything in particular 296 00:12:43,296 --> 00:12:45,132 that makes it hurt worse? 297 00:12:45,165 --> 00:12:47,534 Eating, twisting, lying down? 298 00:12:47,567 --> 00:12:49,536 - Hurts just the same. 299 00:12:49,569 --> 00:12:51,271 [winces] Oof. 300 00:12:51,304 --> 00:12:53,273 - Yeah, seems like appendicitis to me. 301 00:12:53,306 --> 00:12:55,508 - I had my appendix out when I was 14. 302 00:12:55,542 --> 00:12:58,946 - Any other surgeries? C-section, any kids? 303 00:12:58,979 --> 00:13:03,150 - No, I always wanted them, but it never panned out. 304 00:13:03,183 --> 00:13:05,352 - Well, it might be a hernia, 305 00:13:05,385 --> 00:13:07,020 but I'd like to get you into a bed 306 00:13:07,054 --> 00:13:08,421 and examine you more thoroughly. 307 00:13:08,455 --> 00:13:10,390 Run some tests. 308 00:13:10,423 --> 00:13:12,092 - It's probably just a bellyache. 309 00:13:12,125 --> 00:13:14,361 - Listen to the doctor, hon. 310 00:13:14,394 --> 00:13:16,897 - You'll be all right? - Of course. 311 00:13:16,930 --> 00:13:19,933 Well, go on. 312 00:13:19,967 --> 00:13:22,269 - Come on. 313 00:13:22,302 --> 00:13:24,804 Thank you. Right this way. 314 00:13:26,940 --> 00:13:28,575 - Reese. 315 00:13:28,608 --> 00:13:30,477 When was the last time Robin had a full work-up? 316 00:13:30,510 --> 00:13:32,179 - Just before she was released from rehab. 317 00:13:32,212 --> 00:13:33,847 - That was almost two months ago, 318 00:13:33,881 --> 00:13:38,418 how about a little follow-up with your patient? 319 00:13:38,451 --> 00:13:40,988 - She is not asymptomatic, 320 00:13:41,021 --> 00:13:42,455 but that's to be expected. 321 00:13:42,489 --> 00:13:44,391 Recovery does not happen overnight, it's a process-- 322 00:13:44,424 --> 00:13:46,026 - So you reviewed her medication? 323 00:13:46,059 --> 00:13:47,427 - Yes. - With her neurologist? 324 00:13:47,460 --> 00:13:49,329 - And her internist, and her pharmacist. 325 00:13:49,362 --> 00:13:51,431 I've been monitoring Robin very carefully. 326 00:13:51,464 --> 00:13:54,401 - Maybe somebody else should. Someone with more experience. 327 00:13:54,434 --> 00:13:56,303 Maybe a little more familiarity with her condition. 328 00:13:56,336 --> 00:13:58,872 - All right, if Robin wants to change physicians, 329 00:13:58,906 --> 00:14:00,307 that is her right. 330 00:14:00,340 --> 00:14:02,275 But that should be her request, not yours. 331 00:14:02,309 --> 00:14:04,044 - I'm bringing her in tomorrow. 332 00:14:04,077 --> 00:14:05,979 She's gonna get a full neuro work up, 333 00:14:06,013 --> 00:14:09,082 plus labs, plus scans. Understand? 334 00:14:09,116 --> 00:14:14,021 * 335 00:14:14,054 --> 00:14:15,422 [knocking] 336 00:14:15,455 --> 00:14:17,490 - Jessie, I have news for you. 337 00:14:17,524 --> 00:14:20,360 Some of which will make you very happy. 338 00:14:20,393 --> 00:14:22,996 So we ran a test to check on your hCG level-- 339 00:14:23,030 --> 00:14:24,564 that's pregnancy hormone-- 340 00:14:24,597 --> 00:14:27,400 and it indicates that indeed, you are pregnant. 341 00:14:27,434 --> 00:14:29,202 - [exhales] - [laughs] 342 00:14:29,236 --> 00:14:32,205 - That's great! Honey, we did it. 343 00:14:34,074 --> 00:14:35,608 - But? 344 00:14:35,642 --> 00:14:38,645 - The other tests show that you're hemoconcentrated. 345 00:14:38,678 --> 00:14:40,513 And that's a thickening of the blood. 346 00:14:40,547 --> 00:14:43,150 It's a symptom of a condition called OHSS, 347 00:14:43,183 --> 00:14:45,485 Ovarian Hyper Stimulation Syndrome. 348 00:14:45,518 --> 00:14:48,655 Now this can occur when the hCG from the IVF treatments 349 00:14:48,688 --> 00:14:52,192 and your pregnancy interacts adversely with your estrogen. 350 00:14:52,225 --> 00:14:55,128 - So because she got pregnant, she got sick? 351 00:14:55,162 --> 00:14:57,530 - Yes. - Is it serious? 352 00:14:57,564 --> 00:15:00,100 - The concern is that you're more likely to clot. 353 00:15:00,133 --> 00:15:02,169 And possibly throw a clot. 354 00:15:02,202 --> 00:15:04,171 So we'll monitor you carefully, 355 00:15:04,204 --> 00:15:06,506 but I think we can resolve the OHSS. 356 00:15:06,539 --> 00:15:09,309 We'll continue to hydrate you, and start you on blood thinner. 357 00:15:09,342 --> 00:15:11,611 - So everything's gonna be fine. 358 00:15:11,644 --> 00:15:13,680 - Well, you're still a little short of breath, 359 00:15:13,713 --> 00:15:15,415 so I'd like to send you for a CT scan 360 00:15:15,448 --> 00:15:18,285 just to play it safe. 361 00:15:18,318 --> 00:15:20,053 - Okay. 362 00:15:20,087 --> 00:15:21,921 - All right. 363 00:15:25,025 --> 00:15:26,559 - Hey, Barry, you're going to treatment three. 364 00:15:26,593 --> 00:15:29,662 Doctor Choi? - You guys--you guys are-- 365 00:15:29,696 --> 00:15:31,231 Hey, I'm okay. 366 00:15:31,264 --> 00:15:33,366 - 33-year-old male, found in the park. 367 00:15:33,400 --> 00:15:36,103 Alcohol on the breath, the GCS is 13. 368 00:15:36,136 --> 00:15:38,071 He's a little groggy but improving. 369 00:15:38,105 --> 00:15:39,406 Minor head laceration. 370 00:15:39,439 --> 00:15:41,008 - I got it, Barry. Thanks. - You got it. 371 00:15:41,041 --> 00:15:42,509 - Mags, how about a nurse? 372 00:15:42,542 --> 00:15:45,512 - I have no nurses, I'll be in in a sec. 373 00:15:45,545 --> 00:15:48,148 This patient. Indigent, no insurance? 374 00:15:48,181 --> 00:15:49,716 - Afraid so. 375 00:15:49,749 --> 00:15:51,051 - The hospital's gonna have to eat up the cost. 376 00:15:51,084 --> 00:15:52,485 - What are you gonna do? 377 00:15:52,519 --> 00:15:54,221 - We'll give him the best care humanly possible, 378 00:15:54,254 --> 00:15:57,190 no expense spared, but you know, it would sure be nice 379 00:15:57,224 --> 00:16:00,327 to balance patients like him with a few that have insurance. 380 00:16:00,360 --> 00:16:01,461 So maybe we can hire a few nurses. 381 00:16:01,494 --> 00:16:02,695 - Maggie-- 382 00:16:02,729 --> 00:16:04,397 - Next time you're in the Gold Coast, 383 00:16:04,431 --> 00:16:06,599 picking up an MI with a fat wallet, 384 00:16:06,633 --> 00:16:09,069 how about bringing them here? 385 00:16:09,102 --> 00:16:11,371 Just as close as anyplace else. 386 00:16:15,508 --> 00:16:17,510 - Nancy Buckley's results? 387 00:16:17,544 --> 00:16:20,013 - Yeah, it's not a hernia. 388 00:16:20,047 --> 00:16:23,316 It's what I thought, her CT shows appendicitis. 389 00:16:23,350 --> 00:16:25,118 - But her charts said her appendix was removed 390 00:16:25,152 --> 00:16:26,553 when she was a teenager. 391 00:16:26,586 --> 00:16:28,355 - That's not the only thing that's off. 392 00:16:28,388 --> 00:16:31,391 Tubal ligation clips. She had her tubes tied. 393 00:16:31,424 --> 00:16:33,393 Why wouldn't she put that in her history? 394 00:16:33,426 --> 00:16:35,262 - Maybe she didn't want her mom to know. 395 00:16:35,295 --> 00:16:36,763 Might be a touchy subject for them. 396 00:16:36,796 --> 00:16:38,431 - You know what, Nancy said she always wanted kids. 397 00:16:38,465 --> 00:16:40,267 This doesn't feel right. 398 00:16:40,300 --> 00:16:42,102 - Well either way, she's going to need surgery. 399 00:16:42,135 --> 00:16:45,272 - Yeah, on an organ she thinks she doesn't have. 400 00:16:45,305 --> 00:16:48,275 [tense music] 401 00:16:48,308 --> 00:16:52,712 * 402 00:16:52,745 --> 00:16:57,150 Ms. Buckley, your scan clearly shows an inflamed appendix. 403 00:16:57,184 --> 00:16:58,251 We need to get you up to surgery 404 00:16:58,285 --> 00:16:59,419 right away before it ruptures. 405 00:16:59,452 --> 00:17:01,088 - Well, how can it be inflamed? 406 00:17:01,121 --> 00:17:03,523 I had it out when I was a kid, you saw the scar. 407 00:17:03,556 --> 00:17:06,459 - Yeah, I understand that this is very confusing, 408 00:17:06,493 --> 00:17:09,462 but that scar is actually from a different procedure. 409 00:17:09,496 --> 00:17:11,631 - No, I ain't had no other surgeries. 410 00:17:11,664 --> 00:17:13,433 Ask my mama, she'll tell you. 411 00:17:13,466 --> 00:17:18,138 - Dr. Manning. BP is 75/20 and dropping. 412 00:17:18,171 --> 00:17:21,141 - Ms. Buckley? Nancy? 413 00:17:21,174 --> 00:17:24,544 - BP's still dropping. Heart rate spiking to 145. 414 00:17:24,577 --> 00:17:26,813 - Her appendix is ruptured, we need to get her to surgery. 415 00:17:26,846 --> 00:17:29,316 Get her IV wide open, and call up to the OR 416 00:17:34,421 --> 00:17:34,721 . 417 00:17:34,754 --> 00:17:35,355 - What's wrong with my Nancy? 418 00:17:37,124 --> 00:17:38,391 - I'm afraid we had to send your daughter up 419 00:17:38,425 --> 00:17:40,160 for an emergency appendectomy. 420 00:17:40,193 --> 00:17:43,296 - Appendectomy? - Yes, her appendix burst. 421 00:17:43,330 --> 00:17:45,265 - Oh. 422 00:17:45,298 --> 00:17:46,799 - Ms. Buckley. 423 00:17:46,833 --> 00:17:48,701 Your daughter believes that she had her appendix out 424 00:17:48,735 --> 00:17:50,703 when she was 14 years old. 425 00:17:50,737 --> 00:17:52,205 Why would she think that? 426 00:17:52,239 --> 00:17:56,543 - W-- That's what the doc said back then. 427 00:17:56,576 --> 00:17:57,744 - Well, she does have a scar, 428 00:17:57,777 --> 00:18:00,680 but it's not from an appendectomy. 429 00:18:00,713 --> 00:18:02,482 - Well, uh... 430 00:18:02,515 --> 00:18:04,784 I don't know what to say. 431 00:18:04,817 --> 00:18:10,290 - Her appendix is not the only thing we saw on her scan. 432 00:18:10,323 --> 00:18:11,758 She was a minor. 433 00:18:11,791 --> 00:18:14,327 You would have had to give consent. 434 00:18:18,731 --> 00:18:22,302 - Back home, in Blue Ridge country, 435 00:18:22,335 --> 00:18:25,538 I was young and poor when I had her. 436 00:18:25,572 --> 00:18:29,876 Nancy was a wild teenager, always getting into trouble. 437 00:18:29,909 --> 00:18:32,845 Finally, this judge who practically ran the county, 438 00:18:32,879 --> 00:18:36,449 he told me if I wanted to keep Nancy out of jail, 439 00:18:36,483 --> 00:18:38,618 I had to make a choice. 440 00:18:38,651 --> 00:18:40,720 - So you agreed to have her tubes tied? 441 00:18:40,753 --> 00:18:42,389 - The way she was going, 442 00:18:42,422 --> 00:18:45,925 she'd have been pregnant by the time she was 15, 443 00:18:45,958 --> 00:18:50,397 dropped out of school, come to nothing. 444 00:18:50,430 --> 00:18:52,332 That was my life. 445 00:18:52,365 --> 00:18:56,569 I wasn't about to see my daughter turn out the same. 446 00:18:56,603 --> 00:18:58,471 - Ms. Buckley, 447 00:18:58,505 --> 00:19:02,409 don't you think your daughter deserves to know the truth? 448 00:19:02,442 --> 00:19:05,412 - Well, I-I thought about it. 449 00:19:06,913 --> 00:19:12,485 W-What good would it do? What's done is done. 450 00:19:12,519 --> 00:19:15,922 She always wanted to have kids. 451 00:19:15,955 --> 00:19:17,757 Knowing what her mama did to her 452 00:19:17,790 --> 00:19:21,761 only bring her more misery. 453 00:19:21,794 --> 00:19:25,332 Please don't tell her. 454 00:19:25,365 --> 00:19:28,301 [somber music] 455 00:19:28,335 --> 00:19:30,537 * 456 00:19:30,570 --> 00:19:33,540 - Hi, Arlo, I'm Dr. Reese. I'm here to help you. 457 00:19:33,573 --> 00:19:37,710 - Please, don't touch me. You'll be contaminated. 458 00:19:37,744 --> 00:19:39,579 - Uh, contaminated with what? 459 00:19:39,612 --> 00:19:40,913 - Radium. 460 00:19:40,947 --> 00:19:43,550 - How were you exposed to radium? 461 00:19:43,583 --> 00:19:47,354 - My professor, he works for the CIA. 462 00:19:47,387 --> 00:19:49,689 He put it in my food. 463 00:19:49,722 --> 00:19:51,658 - I see. I see. 464 00:19:51,691 --> 00:19:54,327 Do you mind if I take a seat? 465 00:19:56,696 --> 00:19:59,332 - J-Just don't touch me. 466 00:19:59,366 --> 00:20:00,900 - All right. 467 00:20:04,804 --> 00:20:06,739 - Be careful. 468 00:20:09,041 --> 00:20:12,812 - Arlo, I, uh--I appreciate your concern for me, 469 00:20:12,845 --> 00:20:15,915 but I understand the risk that I'm taking. 470 00:20:15,948 --> 00:20:19,386 Uh, I just want to help you, if you will let me. 471 00:20:21,721 --> 00:20:24,223 - My arms hurt. 472 00:20:25,858 --> 00:20:31,498 - I'm sorry. [exhales] 473 00:20:32,465 --> 00:20:35,268 Uh, we can remove the restraints 474 00:20:35,302 --> 00:20:39,839 if you can stay calm. Can you do that? 475 00:20:39,872 --> 00:20:43,910 - Just don't touch me. 476 00:20:43,943 --> 00:20:47,480 - We will only touch the restraints. 477 00:20:58,891 --> 00:21:01,328 - I said be careful! - [gasps] 478 00:21:02,429 --> 00:21:03,996 Okay. 479 00:21:06,699 --> 00:21:09,669 [tense music] 480 00:21:09,702 --> 00:21:16,909 * 481 00:21:38,765 --> 00:21:40,500 - Thank you. 482 00:21:40,533 --> 00:21:44,337 * 483 00:21:44,371 --> 00:21:46,773 - Then make room in the schedule, okay? 484 00:21:46,806 --> 00:21:49,842 She's getting that scan tomorrow. 485 00:21:49,876 --> 00:21:51,077 - Connor. 486 00:21:53,713 --> 00:21:55,548 You okay? 487 00:21:57,650 --> 00:22:01,020 - Yeah, uh... 488 00:22:01,053 --> 00:22:03,923 Robin's not having a good day. 489 00:22:03,956 --> 00:22:07,660 - Sorry to hear that. 490 00:22:07,694 --> 00:22:10,963 Look, I need a consult, but I'll ask someone else. 491 00:22:10,997 --> 00:22:13,433 - No, I'm good. 492 00:22:18,170 --> 00:22:20,373 - Jessie, this is Dr. Rhodes. 493 00:22:20,407 --> 00:22:21,708 He's a cardiothoracic surgeon. - Hi. 494 00:22:21,741 --> 00:22:23,643 - What did you find? 495 00:22:23,676 --> 00:22:26,613 - So the scans showed us this. 496 00:22:26,646 --> 00:22:27,947 What you're looking at is 497 00:22:27,980 --> 00:22:30,650 a partially obstructing saddle pulmonary embolism. 498 00:22:30,683 --> 00:22:32,084 It's a blood clot. 499 00:22:32,118 --> 00:22:34,587 Now, because of the location of the clot, 500 00:22:34,621 --> 00:22:36,623 surgical intervention may become necessary. 501 00:22:36,656 --> 00:22:37,990 But not yet. 502 00:22:38,024 --> 00:22:40,993 The clot is small, so I'm hoping that if 503 00:22:41,027 --> 00:22:43,496 we up the dose of the anticoagulants, 504 00:22:43,530 --> 00:22:45,698 switch to a heparin drip... - Mm-hmm. 505 00:22:45,732 --> 00:22:47,166 - That may take care of it. 506 00:22:47,199 --> 00:22:48,501 - Okay. 507 00:22:48,535 --> 00:22:49,769 - We'll bring you back down to the ED 508 00:22:49,802 --> 00:22:50,937 and keep a close eye on you. 509 00:22:50,970 --> 00:22:53,139 Thanks. - You got it. 510 00:22:54,073 --> 00:22:56,843 - Mr. Janichek, I have your test results, 511 00:22:56,876 --> 00:22:58,911 and everything is normal. 512 00:22:58,945 --> 00:23:01,614 You're mildly anemic, hemoglobin's at 9.5, 513 00:23:01,648 --> 00:23:04,584 but that'll resolve if you just eat more red meat. 514 00:23:04,617 --> 00:23:05,852 - Nothing else? 515 00:23:05,885 --> 00:23:07,654 - You look like a healthy man to me. 516 00:23:07,687 --> 00:23:11,658 - Well, what about my symptoms? The clumsiness, feeling lousy? 517 00:23:11,691 --> 00:23:14,193 - I don't see a medical reason for any of that. 518 00:23:14,226 --> 00:23:15,828 Have you been getting enough sleep? 519 00:23:15,862 --> 00:23:17,464 - Oh, forget it. 520 00:23:17,497 --> 00:23:18,665 I've been through this dog and pony show before. 521 00:23:18,698 --> 00:23:19,866 - I understand it's frustrating 522 00:23:19,899 --> 00:23:21,634 not to get a definitive diagnosis. 523 00:23:21,668 --> 00:23:23,636 - Just let me get out of here, that's all you want anyway. 524 00:23:23,670 --> 00:23:25,538 - Hold on, hold on, hold on. 525 00:23:25,572 --> 00:23:28,875 I don't want to send you home feeling that way. 526 00:23:28,908 --> 00:23:31,478 I can call for a neuro consult if you want. 527 00:23:31,511 --> 00:23:33,946 - Yes, anything. 528 00:23:33,980 --> 00:23:36,649 - Okay. 529 00:23:36,683 --> 00:23:39,619 [knocking] - Come in. 530 00:23:39,652 --> 00:23:40,987 - Sharon? 531 00:23:41,020 --> 00:23:43,590 - Hey. - Hey. 532 00:23:43,623 --> 00:23:44,991 I've been thinking about 533 00:23:45,024 --> 00:23:47,894 how we can hire more nurses for the ED. 534 00:23:47,927 --> 00:23:49,896 - Maggie, I've already told you-- 535 00:23:49,929 --> 00:23:51,464 - I know, I know. No money. 536 00:23:51,498 --> 00:23:54,501 But if the ED had more patients, 537 00:23:54,534 --> 00:23:57,970 hopefully with insurance, that would mean more money, right? 538 00:23:58,004 --> 00:24:00,072 - Yeah. - So who brings us patients? 539 00:24:00,106 --> 00:24:03,042 The paramedics. And if they liked coming to Med, 540 00:24:03,075 --> 00:24:07,113 if they were motivated to come to Med, that's what they'd do. 541 00:24:07,146 --> 00:24:09,148 They'd bring us more patients. 542 00:24:09,181 --> 00:24:10,817 - And how do you propose 543 00:24:10,850 --> 00:24:13,786 to motivate the paramedics, Maggie? 544 00:24:13,820 --> 00:24:17,557 - That's really pretty simple. 545 00:24:24,697 --> 00:24:27,066 - Hey. What's going on? 546 00:24:27,099 --> 00:24:30,537 - Sorry, um... 547 00:24:30,570 --> 00:24:34,507 Did you know that up until 1973 in North Carolina, 548 00:24:34,541 --> 00:24:35,942 women could get sterilized 549 00:24:35,975 --> 00:24:37,243 without their knowledge or consent? 550 00:24:37,276 --> 00:24:39,078 My patient had her daughter's tubes tied 551 00:24:39,111 --> 00:24:41,514 when she was 14. 14. 552 00:24:41,548 --> 00:24:44,283 All because a judge thought it would be good for her. 553 00:24:44,316 --> 00:24:45,752 - Man. 554 00:24:45,785 --> 00:24:47,219 - The daughter always wanted to have kids, 555 00:24:47,253 --> 00:24:48,855 and never knew why she couldn't. 556 00:24:48,888 --> 00:24:52,058 - She never went to a doctor? - No, too poor. 557 00:24:52,091 --> 00:24:54,126 Can you believe they could do that? 558 00:24:54,160 --> 00:24:56,929 Deprive a woman of her ability to have children, 559 00:24:56,963 --> 00:24:58,931 something so fundamental. 560 00:24:58,965 --> 00:25:01,033 - This woman who was sterilized... 561 00:25:01,067 --> 00:25:03,102 How do you break news like that? 562 00:25:03,135 --> 00:25:05,738 - I'm asking myself the same thing. 563 00:25:10,910 --> 00:25:13,245 - Mr. Janichek's not exhibiting any neurologic deficits. 564 00:25:13,279 --> 00:25:14,847 - And what about his clumsiness? 565 00:25:14,881 --> 00:25:16,616 - Awfully vague complaint, hardly warranted a consult. 566 00:25:16,649 --> 00:25:18,117 - It's just the patient's desperate. 567 00:25:18,150 --> 00:25:19,285 He insists there's something wrong with him. 568 00:25:19,318 --> 00:25:20,787 - Since when do we listen to patients? 569 00:25:20,820 --> 00:25:22,221 - Maybe some sort of heavy metal poisoning, 570 00:25:22,254 --> 00:25:24,256 lead or mercury-- - [sighs] Dr. Choi, 571 00:25:24,290 --> 00:25:26,125 if you want to was the time and money ordering those tests, 572 00:25:26,158 --> 00:25:28,127 you be my guest, but I'm done here. 573 00:25:35,201 --> 00:25:36,903 - I just got a call from Robin. 574 00:25:36,936 --> 00:25:38,004 She was arrested for shoplifting? 575 00:25:38,037 --> 00:25:39,639 - No, she wasn't arrested. 576 00:25:39,672 --> 00:25:40,873 She got caught trying to leave the store, 577 00:25:40,907 --> 00:25:42,609 but I took care of it. 578 00:25:42,642 --> 00:25:44,343 - Well, apparently it's been going on for a while, though. 579 00:25:44,376 --> 00:25:46,879 - I realize that now, but I had no idea. 580 00:25:46,913 --> 00:25:49,348 - Have there been any signs? Like, at home, or-- 581 00:25:49,381 --> 00:25:53,319 - Dr. Charles, a woman has new clothes and that's suspicious? 582 00:25:53,352 --> 00:25:56,022 She's not a prisoner, I can't keep her locked up. 583 00:25:56,055 --> 00:25:57,757 She's got a life of her own. [pager buzzing] 584 00:25:57,790 --> 00:25:59,325 I have a patient to see. 585 00:25:59,358 --> 00:26:04,130 - Connor, I-I appreciate that you're doing the best you can, 586 00:26:04,163 --> 00:26:06,999 but given the all-consuming nature of-- 587 00:26:07,033 --> 00:26:09,035 - Dr. Charles, Robin and I are fine. 588 00:26:09,068 --> 00:26:11,804 I'm gonna see her through this. 589 00:26:13,673 --> 00:26:15,107 [alarm blaring] - Will? 590 00:26:15,141 --> 00:26:16,943 - Heart rate's 140, BP's down to 90/70. 591 00:26:16,976 --> 00:26:18,010 - Keith. - I'm right here, honey. 592 00:26:18,044 --> 00:26:19,779 - 02 sat's down to 85. 593 00:26:19,812 --> 00:26:21,814 Heparin's not working. She's continuing to embolize. 594 00:26:21,848 --> 00:26:23,650 - She's in respiratory failure. - Why? What's happening? 595 00:26:23,683 --> 00:26:25,317 - The clot in her lung has progressed. 596 00:26:25,351 --> 00:26:27,153 It's cutting off blood flow and straining her heart. 597 00:26:27,186 --> 00:26:29,822 - BP's down to 60/30. Sat's at 75. 598 00:26:29,856 --> 00:26:32,358 - Okay, we need to intubate. 20 of etomidate, 100 of sux. 599 00:26:32,391 --> 00:26:33,826 - Maybe you want to wait outside? 600 00:26:33,860 --> 00:26:35,161 - No, I'm not leaving her. 601 00:26:35,194 --> 00:26:36,696 - All right, tell the OR we're on the way up 602 00:26:36,729 --> 00:26:38,197 and to prep the hybrid room. - Yes, Doctor. 603 00:26:38,230 --> 00:26:39,899 - Your wife needs surgery now. 604 00:26:39,932 --> 00:26:41,333 We need to remove the clot from her pulmonary artery, 605 00:26:41,367 --> 00:26:42,969 otherwise it could kill her. 606 00:26:43,002 --> 00:26:44,336 - Just save her, please! 607 00:26:44,370 --> 00:26:46,038 - I'm in. - All right, let's go. 608 00:26:46,072 --> 00:26:49,041 [tense music] 609 00:26:55,648 --> 00:26:55,815 . 610 00:26:55,848 --> 00:26:56,883 - We're in a good position. Let's start the extraction. 611 00:26:58,718 --> 00:27:01,087 - Pressure's a little soft, 80/50. 612 00:27:01,120 --> 00:27:02,922 - I've been working on that. 613 00:27:02,955 --> 00:27:05,324 Gas looks fine, but I've given a half liter of crystalloid 614 00:27:05,357 --> 00:27:07,660 to minimum effect. Starting Neo now. 615 00:27:07,694 --> 00:27:09,896 You let in the anesthetic? - Already done. 616 00:27:09,929 --> 00:27:11,798 [machine beeping] - She's still dropping. 617 00:27:11,831 --> 00:27:13,833 - The catheter must be obstructing the outflow tract. 618 00:27:13,866 --> 00:27:16,002 Her heart's failing, we need to open her chest. 619 00:27:16,035 --> 00:27:17,670 Bring in the bypass machine. Marty, start a second pressor 620 00:27:17,704 --> 00:27:19,171 to buy me some time. 621 00:27:19,205 --> 00:27:21,007 - I put in the catheter, did I make a mistake? 622 00:27:21,040 --> 00:27:23,342 - Nope, it's not your fault, it happens sometimes. 623 00:27:23,375 --> 00:27:25,745 Scalpel and sternal saw. Let's move. 624 00:27:25,778 --> 00:27:26,979 - Sternal saw. 625 00:27:27,013 --> 00:27:28,380 [machine beeping] [drill whirs] 626 00:27:30,482 --> 00:27:33,319 - [sobs quietly] 627 00:27:33,352 --> 00:27:37,323 I'm just out of control. 628 00:27:37,356 --> 00:27:39,826 - It's okay. 629 00:27:39,859 --> 00:27:43,395 It's okay, it's okay. 630 00:27:43,429 --> 00:27:45,164 - I don't know what to do. 631 00:27:45,197 --> 00:27:49,101 And I feel like I will never get past this. 632 00:27:49,135 --> 00:27:51,003 - What, your illness? Of course you will. 633 00:27:51,037 --> 00:27:53,005 You just--you've had a setback. That's all it is. 634 00:27:53,039 --> 00:27:55,708 - No, Dad. It's more than that. 635 00:27:55,742 --> 00:27:59,245 It's about what I have become to Connor. 636 00:27:59,278 --> 00:28:03,783 And to everyone, it's like I'm someone to be pitied. 637 00:28:03,816 --> 00:28:07,386 Or taken care of. And I am drowning. 638 00:28:07,419 --> 00:28:09,455 - No, no, honey. Come here, sweetie. 639 00:28:09,488 --> 00:28:11,858 It's okay, I'm here. 640 00:28:11,891 --> 00:28:15,061 I'm gonna help you, okay? - No, Dad. 641 00:28:15,094 --> 00:28:18,397 Don't you see that I don't want to be helped? 642 00:28:18,430 --> 00:28:23,202 I am tired of being a disease. 643 00:28:23,235 --> 00:28:27,974 I want to be a person again. - Okay. 644 00:28:28,007 --> 00:28:30,476 Okay, so, um, 645 00:28:30,509 --> 00:28:32,311 so how you want to do that? 646 00:28:32,344 --> 00:28:39,285 * 647 00:28:39,318 --> 00:28:41,053 - Mr. Rowe. 648 00:28:43,055 --> 00:28:45,758 So we tried to remove the clot from your wife's lung 649 00:28:45,792 --> 00:28:47,293 with a minimally invasive procedure. 650 00:28:47,326 --> 00:28:49,829 Unfortunately, her heart couldn't tolerate it, 651 00:28:49,862 --> 00:28:52,231 So we did have to open her chest. 652 00:28:53,833 --> 00:28:56,002 Now, the important thing is, 653 00:28:56,035 --> 00:28:59,038 we were able to remove the clot successfully. 654 00:28:59,071 --> 00:29:02,008 Her pulmonary artery pressures have already come down, 655 00:29:02,041 --> 00:29:04,043 and I have every reason to believe 656 00:29:04,076 --> 00:29:06,779 that she's gonna make a quick and full recovery. 657 00:29:06,813 --> 00:29:08,514 - [exhales heavily] 658 00:29:11,150 --> 00:29:13,219 And the baby? 659 00:29:13,252 --> 00:29:17,323 - No indication that the pregnancy was affected. 660 00:29:17,356 --> 00:29:21,093 - [heavy exhales] 661 00:29:28,200 --> 00:29:31,537 Thank you, Dr. Rhodes. 662 00:29:31,570 --> 00:29:34,006 I don't know what else to say. 663 00:29:34,040 --> 00:29:36,475 - Keith. 664 00:29:36,508 --> 00:29:39,411 - I'm right here, honey. 665 00:29:39,445 --> 00:29:42,781 You're gonna be fine. 666 00:29:51,157 --> 00:29:52,391 - It's all good. 667 00:29:52,424 --> 00:29:56,362 - Great. Thanks, Connor. 668 00:29:56,395 --> 00:29:58,364 - Nice people. 669 00:29:58,397 --> 00:30:03,235 - Yeah, they've really been put through it today. 670 00:30:03,269 --> 00:30:04,904 - Kinda makes you realize 671 00:30:04,937 --> 00:30:08,007 how small your own problems are, huh? 672 00:30:08,040 --> 00:30:11,310 - And that sometimes, things work out. 673 00:30:16,916 --> 00:30:19,952 - Who's got three? Where's Monique? Monique? 674 00:30:19,986 --> 00:30:21,988 I need you to turn over three and get it cleaned up. 675 00:30:22,021 --> 00:30:23,122 Here are the files, here. 676 00:30:23,155 --> 00:30:24,924 - Yes, ma'am. - Oh! 677 00:30:24,957 --> 00:30:28,394 Ladies and gentleman, by unanimous decision, 678 00:30:28,427 --> 00:30:29,962 and still retaining his title 679 00:30:29,996 --> 00:30:32,364 as welterweight champion of the world, 680 00:30:32,398 --> 00:30:34,400 Noah "The Doctor" Sexton! 681 00:30:34,433 --> 00:30:37,836 [cheers and applause] 682 00:30:38,470 --> 00:30:40,172 Welcome back. 683 00:30:47,279 --> 00:30:48,547 - Are you sure you should be at work? 684 00:30:48,580 --> 00:30:50,382 You don't look very good. 685 00:30:50,416 --> 00:30:52,985 - Thanks. You look good. 686 00:30:56,355 --> 00:30:58,157 - She's doing well. 687 00:30:58,190 --> 00:31:00,893 They're weaning her sedation and should extubate soon. 688 00:31:00,927 --> 00:31:03,162 - Good. Now here comes the hard part. 689 00:31:03,195 --> 00:31:04,964 - You mean you're gonna tell her? 690 00:31:04,997 --> 00:31:06,999 - It's her body, April. 691 00:31:07,033 --> 00:31:09,635 It's her life. She has every right to know. 692 00:31:09,668 --> 00:31:11,637 - These two women only have each other. 693 00:31:11,670 --> 00:31:15,241 We drop this on Nancy, she may never forgive her mother. 694 00:31:15,274 --> 00:31:18,044 - I understand, but we are legally bound to tell her. 695 00:31:18,077 --> 00:31:20,046 - We're gonna destroy this family 696 00:31:20,079 --> 00:31:22,581 over something they can't do anything about? 697 00:31:22,614 --> 00:31:24,951 - That is for Nancy to decide. 698 00:31:24,984 --> 00:31:27,653 She has been denied a choice her entire life. 699 00:31:27,686 --> 00:31:29,188 We cannot change her past, 700 00:31:29,221 --> 00:31:32,224 but at least we can give her a say in her future. 701 00:31:37,629 --> 00:31:41,033 - 75 inches? 60 wasn't big enough? 702 00:31:41,067 --> 00:31:43,202 - You know how it is. It's never big enough. 703 00:31:43,235 --> 00:31:45,171 - Accounting is gonna raise hell. 704 00:31:45,204 --> 00:31:47,073 - Well, we've got to spend money to make money, right? 705 00:31:47,106 --> 00:31:48,674 - Eh, well, let's hope so. 706 00:31:48,707 --> 00:31:50,542 - Mm-hm. - This for the doctor's lounge? 707 00:31:50,576 --> 00:31:52,078 - This way. - Nope. 708 00:31:52,111 --> 00:31:53,946 I'm sorry, it's for the pizza room. 709 00:31:53,980 --> 00:31:58,150 - What's a pizza room? - Motivational tool. 710 00:32:01,687 --> 00:32:04,090 - Has he been agitated? - No. 711 00:32:04,123 --> 00:32:06,092 - Any need to put him back in restraints? 712 00:32:06,125 --> 00:32:07,459 - No. 713 00:32:07,493 --> 00:32:09,395 - Good, let's transfer him up to the Psych Ward. 714 00:32:09,428 --> 00:32:12,064 - Do you want to examine him before we do? 715 00:32:12,098 --> 00:32:14,700 - Uh, no, no. I'll check on him upstairs. 716 00:32:14,733 --> 00:32:16,402 - Okay. - Okay. 717 00:32:18,237 --> 00:32:21,173 - Hey. 718 00:32:21,207 --> 00:32:22,975 Sarah. 719 00:32:23,009 --> 00:32:24,576 I got this patient in six-- 720 00:32:24,610 --> 00:32:27,179 ataxia, clumsiness, general malaise. 721 00:32:27,213 --> 00:32:30,182 I can't find anything, and Abrams cleared him. 722 00:32:30,216 --> 00:32:32,651 - Do you want a psych consult? 723 00:32:32,684 --> 00:32:34,186 - The guy's convinced he's sick, 724 00:32:34,220 --> 00:32:36,122 and wasn't happy when his labs came back normal. 725 00:32:36,155 --> 00:32:38,124 Adamant we keep testing. 726 00:32:38,157 --> 00:32:41,160 - Maybe factitious disorder; likes being in the hospital, 727 00:32:41,193 --> 00:32:44,063 doted on, needs people to believe he's sick. 728 00:32:44,096 --> 00:32:45,664 - Want to take a run at him? 729 00:32:45,697 --> 00:32:47,766 Otherwise, I got no reason to keep him. 730 00:32:47,799 --> 00:32:49,635 - Sure. 731 00:32:49,668 --> 00:32:52,038 - Thanks. 732 00:32:53,705 --> 00:32:56,042 - Mr. Janichek? I'm Dr. Reese. 733 00:32:56,075 --> 00:32:58,144 I'd like to ask you a few questions. 734 00:32:58,177 --> 00:33:01,413 - What kind of doctor are you? - I am a psychiatrist. 735 00:33:01,447 --> 00:33:04,216 - A shrink? You think I'm crazy? 736 00:33:04,250 --> 00:33:06,752 - No, we just can't find a, uh, physical reason 737 00:33:06,785 --> 00:33:08,554 for the symptoms you're describing. 738 00:33:08,587 --> 00:33:10,456 - Which means you think I'm crazy or I'm making it up. 739 00:33:10,489 --> 00:33:12,424 - No, we just want to explore all the possibilities. 740 00:33:12,458 --> 00:33:15,461 - I don't believe you people. I'm a sick man. 741 00:33:15,494 --> 00:33:18,564 I come here looking for help, and no one believes me. 742 00:33:18,597 --> 00:33:20,032 How many doctors do I have to go to? 743 00:33:20,066 --> 00:33:21,567 - Mr. Janichek, please back away. 744 00:33:21,600 --> 00:33:23,302 - What do I have to do, huh? Why won't you help me? 745 00:33:23,335 --> 00:33:25,704 - Mr. Janichek! - Ahh! Ah! 746 00:33:25,737 --> 00:33:28,707 [groaning] 747 00:33:28,740 --> 00:33:31,710 * 748 00:33:31,743 --> 00:33:34,246 - Sarah, what happened? - My eyes! 749 00:33:34,280 --> 00:33:36,582 She sprayed me! Ah. - Oh, my God. 750 00:33:36,615 --> 00:33:38,584 - Get me some water. 751 00:33:38,617 --> 00:33:40,186 - Ah, my eyes! [grunts] 752 00:33:40,219 --> 00:33:41,753 - Sarah, you should go. 753 00:33:44,223 --> 00:33:46,192 Go! 754 00:33:55,667 --> 00:33:56,202 . 755 00:33:56,235 --> 00:33:56,802 - Dr. Charles isn't answering. 756 00:33:58,404 --> 00:34:01,240 Where are we on this, Dr. Choi? 757 00:34:01,273 --> 00:34:02,408 - We flushed Mr. Janichek's eyes. 758 00:34:02,441 --> 00:34:04,210 There's no sign of external injury. 759 00:34:04,243 --> 00:34:06,145 His vitals are stable. He's lucid. 760 00:34:06,178 --> 00:34:08,147 - And extremely pissed off. 761 00:34:08,180 --> 00:34:12,184 A doctor attacking a patient, really? 762 00:34:12,218 --> 00:34:13,585 - Go on, Dr. Choi. 763 00:34:13,619 --> 00:34:15,254 - Mr. Janichek hit the gurney when he fell, 764 00:34:15,287 --> 00:34:16,688 so we're ordering an abdominal CT 765 00:34:16,722 --> 00:34:18,590 to make sure there's no internal injuries. 766 00:34:18,624 --> 00:34:21,693 - Did he hit his head? Are you ordering a head scan? 767 00:34:21,727 --> 00:34:24,230 - There's no head injury. No indication of concussion. 768 00:34:24,263 --> 00:34:26,432 - Dr. Choi, this is CYA time. 769 00:34:26,465 --> 00:34:28,567 It's bad enough he sues us for the pepper spray, 770 00:34:28,600 --> 00:34:30,336 If we miss something... 771 00:34:30,369 --> 00:34:32,204 - Order a pan scan. 772 00:34:32,238 --> 00:34:34,506 - Yes, ma'am. - Thank you, Dr. Choi. 773 00:34:34,540 --> 00:34:37,176 - Dr. Stohl, Peter. 774 00:34:42,781 --> 00:34:46,552 Can you give me any explanation for your behavior? 775 00:34:46,585 --> 00:34:49,555 [somber music] 776 00:34:49,588 --> 00:34:52,758 * 777 00:34:52,791 --> 00:34:55,627 - I'm sorry. 778 00:34:55,661 --> 00:34:58,830 * 779 00:34:58,864 --> 00:35:03,735 - Dr. Reese, you're suspended until further notice. 780 00:35:03,769 --> 00:35:05,604 I need your pass. 781 00:35:05,637 --> 00:35:12,678 * 782 00:35:15,614 --> 00:35:16,782 Go home. 783 00:35:16,815 --> 00:35:22,454 * 784 00:35:22,488 --> 00:35:26,792 - So this is what? A ploy to woo the paramedics? 785 00:35:26,825 --> 00:35:29,161 - Pretty much, yeah. 786 00:35:30,696 --> 00:35:33,199 - It'll work. 787 00:35:33,232 --> 00:35:35,801 Mmm, pepperoni and sausage. 788 00:35:35,834 --> 00:35:37,603 - Mm-hmm. - Nice. 789 00:35:40,606 --> 00:35:41,640 Mmm! 790 00:35:42,974 --> 00:35:45,744 - Sterilized? 791 00:35:45,777 --> 00:35:48,380 When? But how? 792 00:35:48,414 --> 00:35:49,815 - When you were 14. 793 00:35:49,848 --> 00:35:53,352 When they said they were taking out your appendix, 794 00:35:53,385 --> 00:35:54,786 they were actually doing a procedure 795 00:35:54,820 --> 00:35:57,289 called tubal ligation. 796 00:35:57,323 --> 00:35:59,558 Your tubes were tied. 797 00:36:02,461 --> 00:36:07,333 - They did this without asking me? 798 00:36:07,366 --> 00:36:09,835 Did Mama know? 799 00:36:09,868 --> 00:36:13,339 - You'll have to ask her that. 800 00:36:13,372 --> 00:36:15,841 - Oh, my God. 801 00:36:15,874 --> 00:36:18,844 [somber music] 802 00:36:18,877 --> 00:36:22,781 * 803 00:36:22,814 --> 00:36:24,950 - I'll give you two some time. 804 00:36:24,983 --> 00:36:32,358 * 805 00:36:41,533 --> 00:36:44,503 - How could she ever forgive her mom? 806 00:36:46,872 --> 00:36:52,478 I lost my baby, but I can still have another. 807 00:36:52,511 --> 00:36:55,347 If that were taken away from me, 808 00:36:55,381 --> 00:36:58,016 I don't know that I could forgive. 809 00:36:58,049 --> 00:37:00,619 - I don't know. 810 00:37:00,652 --> 00:37:03,422 People can sometimes surprise you. 811 00:37:03,455 --> 00:37:10,662 * 812 00:37:17,969 --> 00:37:20,372 - Robin? 813 00:37:25,811 --> 00:37:27,913 Robin? 814 00:37:27,946 --> 00:37:30,916 [tense music] 815 00:37:30,949 --> 00:37:38,324 * 816 00:37:54,105 --> 00:37:55,874 - Thanks, Dad. 817 00:37:57,709 --> 00:38:00,011 - It's gonna be very hard on Connor. 818 00:38:00,045 --> 00:38:01,780 He cares about you a lot. 819 00:38:01,813 --> 00:38:03,515 - I know. 820 00:38:03,549 --> 00:38:07,386 But I have to do this. I have to get away. 821 00:38:09,821 --> 00:38:12,424 - Gonna miss you. 822 00:38:12,458 --> 00:38:15,594 - I'm gonna miss you too, Dad. 823 00:38:16,962 --> 00:38:20,832 - Make sure you remember to say hi to your mom for me, okay? 824 00:38:20,866 --> 00:38:22,934 Good-bye, honey. 825 00:38:26,472 --> 00:38:28,006 - Bye, Dad. 826 00:38:28,039 --> 00:38:31,009 [somber music] 827 00:38:31,042 --> 00:38:36,715 * 828 00:38:36,748 --> 00:38:39,585 [knocking] - Come in. 829 00:38:42,020 --> 00:38:44,456 - Mr. Janichek's scans were negative for concussion 830 00:38:44,490 --> 00:38:45,657 or any other acute injury. 831 00:38:45,691 --> 00:38:47,526 - All right, dodged that bullet. 832 00:38:47,559 --> 00:38:48,727 - But we did notice something else 833 00:38:48,760 --> 00:38:51,129 unrelated to his being sprayed. 834 00:38:51,162 --> 00:38:52,698 - An enlarged spleen? 835 00:38:52,731 --> 00:38:55,801 - Yes. - This our fault? 836 00:38:55,834 --> 00:38:57,503 - No. 837 00:38:57,536 --> 00:39:00,105 I ordered an enzyme activity level test to follow up. 838 00:39:00,138 --> 00:39:01,740 It showed Mr. Janichek is suffering 839 00:39:01,773 --> 00:39:04,576 from a genetic disorder called Gaucher's disease. 840 00:39:04,610 --> 00:39:06,445 An enzyme deficiency which presents 841 00:39:06,478 --> 00:39:08,013 with a vague constellation of symptoms; 842 00:39:08,046 --> 00:39:10,749 malaise, anemia, low platelets. 843 00:39:10,782 --> 00:39:12,551 - Please tell me there's a treatment. 844 00:39:12,584 --> 00:39:13,885 Because we cannot assault a man 845 00:39:13,919 --> 00:39:17,055 and then inform him he has an incurable disease. 846 00:39:17,088 --> 00:39:18,990 - His spleen is dangerously enlarged, 847 00:39:19,024 --> 00:39:20,659 so it has to be removed, 848 00:39:20,692 --> 00:39:22,728 but the deficiency itself is easily treatable 849 00:39:22,761 --> 00:39:25,096 with regular enzyme replacement infusions. 850 00:39:25,130 --> 00:39:27,499 - All right, you'll inform the patient. 851 00:39:27,533 --> 00:39:30,636 - Yes, ma'am. - Thank you. 852 00:39:30,669 --> 00:39:32,103 - I should say that Mr. Janichek 853 00:39:32,137 --> 00:39:34,039 will find this to be good news. 854 00:39:34,072 --> 00:39:35,774 - A genetic disease? 855 00:39:35,807 --> 00:39:37,509 - He's been suffering a long time, 856 00:39:37,543 --> 00:39:39,911 unable to find a diagnosis. 857 00:39:39,945 --> 00:39:44,683 In fact, I was ready to send him home. 858 00:39:45,951 --> 00:39:47,586 We never would have ordered that pan scan 859 00:39:47,619 --> 00:39:51,523 if Dr. Reese hadn't done what she did. 860 00:39:51,557 --> 00:39:53,124 She might have saved his life. 861 00:39:53,158 --> 00:40:00,566 * 862 00:40:06,237 --> 00:40:08,474 - Hey. 863 00:40:08,507 --> 00:40:11,610 I got home, and I found this from Robin. 864 00:40:11,643 --> 00:40:13,078 Did you know that she was planning on leaving? 865 00:40:13,111 --> 00:40:15,013 - Connor, she just made the decision today. 866 00:40:15,046 --> 00:40:17,048 She doesn't feel like she can get well here. 867 00:40:17,082 --> 00:40:18,750 - And nobody thought to involve me in this discussion? 868 00:40:18,784 --> 00:40:20,552 - Well, she didn't want to tell you 869 00:40:20,586 --> 00:40:21,687 because she knew you'd try and change her mind. 870 00:40:21,720 --> 00:40:24,122 - You're damn right I would! 871 00:40:24,155 --> 00:40:25,957 Where is she? 872 00:40:25,991 --> 00:40:27,793 - It's really up to Robin to reveal that, I think. 873 00:40:27,826 --> 00:40:29,661 - No, you have no right to keep this from me. 874 00:40:29,695 --> 00:40:31,463 - She asked me not to tell you. 875 00:40:31,497 --> 00:40:33,164 Look, Connor, she promised me she'd call you 876 00:40:33,198 --> 00:40:34,800 as soon as she is feeling better. 877 00:40:34,833 --> 00:40:36,201 - Oh, man, I bet you love this, don't you? 878 00:40:36,234 --> 00:40:37,703 - What? - You didn't want me 879 00:40:37,736 --> 00:40:39,170 to be with her in the first place. 880 00:40:39,204 --> 00:40:40,739 You didn't think I was good for her. 881 00:40:40,772 --> 00:40:42,974 In fact, I bet this was all your idea. 882 00:40:43,008 --> 00:40:46,678 - Connor, whatever reservations I had about your relationship 883 00:40:46,712 --> 00:40:48,880 are long past, okay? 884 00:40:48,914 --> 00:40:51,016 I promise you, this was all Robin's decision. 885 00:40:51,049 --> 00:40:52,584 - Fine. I don't care 886 00:40:52,618 --> 00:40:53,852 if you don't want to tell me where she is, 887 00:40:53,885 --> 00:40:55,487 because I'm gonna find her, 888 00:40:55,521 --> 00:40:57,122 and I'm gonna bring her back. 889 00:40:57,155 --> 00:41:04,563 * 890 00:41:13,204 --> 00:41:15,974 - Hey, Dr. Charles. 891 00:41:22,614 --> 00:41:24,650 - Thanks, Noah. 892 00:41:46,204 --> 00:41:49,240 - What have I done? 893 00:41:49,274 --> 00:41:52,243 [somber music] 894 00:41:52,277 --> 00:41:59,685 * 895 00:42:46,732 --> 00:42:49,935 [wolf howls]