1 00:00:04,395 --> 00:00:06,180 - You have to work out whatever feelings you're having 2 00:00:06,223 --> 00:00:07,833 about Dr. Marcel. 3 00:00:07,877 --> 00:00:09,139 Fast. 4 00:00:11,707 --> 00:00:12,838 - Give me a Narcan inhaler. 5 00:00:16,190 --> 00:00:18,235 - You overdosed, but you're gonna be all right. 6 00:00:18,279 --> 00:00:20,107 - You're letting this get way too personal, Will. 7 00:00:20,150 --> 00:00:21,151 It's never a good idea. 8 00:00:21,195 --> 00:00:22,674 - For God's sake, isn't it personal? 9 00:00:22,718 --> 00:00:24,459 You lost a brother to drugs. 10 00:00:24,502 --> 00:00:25,677 - Enough! 11 00:00:28,028 --> 00:00:29,072 - I met you this morning. 12 00:00:29,116 --> 00:00:30,726 I'm gonna try to turn things around. 13 00:00:30,769 --> 00:00:31,727 - Good. 14 00:00:37,559 --> 00:00:38,690 - Hey. 15 00:00:38,734 --> 00:00:40,431 Hi. 16 00:00:50,224 --> 00:00:51,399 I love you. 17 00:00:51,442 --> 00:00:52,617 - Easy. - Oh, God, sorry. 18 00:00:52,661 --> 00:00:53,662 - It's only me. 19 00:00:53,705 --> 00:00:55,533 - I wasn't expecting that. 20 00:00:55,577 --> 00:00:58,449 - Hey, I know work's not the place for ambush affection, 21 00:00:58,493 --> 00:01:00,060 but I couldn't help myself. 22 00:01:00,103 --> 00:01:01,583 - I won't hold it against you. 23 00:01:01,626 --> 00:01:03,411 - What's up? 24 00:01:03,454 --> 00:01:06,588 I haven't seen a smile this big since Navy beat Army. 25 00:01:07,676 --> 00:01:10,244 Just thinking about being a dad. 26 00:01:10,287 --> 00:01:12,942 Birthday parties, coaching teams. 27 00:01:12,985 --> 00:01:16,772 - It's a decade down the road. We are three weeks into IVF. 28 00:01:16,815 --> 00:01:18,034 - You know what they say. 29 00:01:18,078 --> 00:01:20,080 "You blink and the kids are grown." 30 00:01:22,212 --> 00:01:23,779 Hey. - What up? 31 00:01:23,822 --> 00:01:25,781 Pelicans covered the spread. 32 00:01:25,824 --> 00:01:28,131 - How many rings do the Pelicans have? 33 00:01:28,175 --> 00:01:29,741 - Go Bulls. 34 00:01:29,785 --> 00:01:31,787 - Yeah, we'll see. 35 00:01:37,009 --> 00:01:38,750 - I'm a horrible person, aren't I? 36 00:01:38,794 --> 00:01:41,797 - No, you're human. 37 00:01:41,840 --> 00:01:43,233 What can I do to help? 38 00:01:43,277 --> 00:01:44,800 - You got a time machine? 39 00:01:48,412 --> 00:01:49,892 - Hey, you. - Hey. 40 00:01:49,935 --> 00:01:51,589 - Date last night. Spill it. 41 00:01:51,633 --> 00:01:53,113 - It was nice. 42 00:01:53,156 --> 00:01:57,291 He was polite, handsome, smart, but I don't think so. 43 00:01:57,334 --> 00:01:59,554 - Huh, well, polite, smart, and handsome. 44 00:01:59,597 --> 00:02:00,729 Sounds awful. - All right. 45 00:02:00,772 --> 00:02:03,471 The real reason, he's a psych professor. 46 00:02:03,514 --> 00:02:05,603 I mean, the way he looked at me, I just couldn't shake 47 00:02:05,647 --> 00:02:07,214 the feeling that I was being analyzed. 48 00:02:07,257 --> 00:02:08,302 - This is the fourth first date 49 00:02:08,345 --> 00:02:10,086 without even considering a second. 50 00:02:10,130 --> 00:02:11,870 - Well, I'm glad you're counting, Mom. 51 00:02:11,914 --> 00:02:13,307 It doesn't matter 52 00:02:13,350 --> 00:02:15,744 because none of those guys were gonna work out anyways. 53 00:02:15,787 --> 00:02:18,747 - Wow. ESP. 54 00:02:18,790 --> 00:02:20,705 Say, 55 00:02:20,749 --> 00:02:23,926 do you know when the Saints are gonna win another Super Bowl? 56 00:02:23,969 --> 00:02:25,275 All right, well, 57 00:02:25,319 --> 00:02:27,582 let me know if you get another vision. 58 00:02:29,149 --> 00:02:32,282 - All I'm saying is the right second date is out there 59 00:02:32,326 --> 00:02:34,980 and I'll know it when I meet him. 60 00:02:35,024 --> 00:02:37,026 - Help, please! My son! 61 00:02:37,069 --> 00:02:39,463 - I got him. Where am I going? 62 00:02:39,507 --> 00:02:41,291 - Trauma 1. - Help my husband and son! 63 00:02:41,335 --> 00:02:44,251 - Help, help, help, help, help! 64 00:02:46,688 --> 00:02:49,299 - Help him. I-I didn't know what to do. 65 00:02:51,910 --> 00:02:56,306 Ow, ow! 66 00:02:58,265 --> 00:03:00,397 - Bruising on his neck. Protect it and bag him. 67 00:03:00,441 --> 00:03:02,834 Hold C-spine. What's his name? 68 00:03:02,878 --> 00:03:05,054 - Jamie. - Jamie? 69 00:03:05,097 --> 00:03:09,189 Hey, Jamie, can you hear me? Okay, okay, take it easy. 70 00:03:09,232 --> 00:03:10,886 You're okay. Take it easy. 71 00:03:10,929 --> 00:03:12,844 What happened? - It was an accident. 72 00:03:12,888 --> 00:03:14,803 Um, I choked him out. 73 00:03:17,066 --> 00:03:18,763 I had to. 74 00:03:35,867 --> 00:03:37,826 - It all happened so fast. 75 00:03:37,869 --> 00:03:39,784 I didn't realize. I just wanted it to stop. 76 00:03:39,828 --> 00:03:42,047 Jamie was screaming, Dylan was crying, and-- 77 00:03:42,091 --> 00:03:43,266 - Gordon. 78 00:03:43,310 --> 00:03:44,920 I want you to take a deep breath, okay? 79 00:03:44,963 --> 00:03:47,270 Take a deep breath. 80 00:03:47,314 --> 00:03:49,403 All right. 81 00:03:49,446 --> 00:03:50,665 Have a seat. Sit down. 82 00:03:51,709 --> 00:03:53,711 Okay. 83 00:03:53,755 --> 00:03:55,670 And, um... 84 00:03:55,713 --> 00:03:58,847 I, uh, I just want you to tell me-- 85 00:03:58,890 --> 00:04:00,109 tell me what happened. 86 00:04:00,152 --> 00:04:01,458 - Okay. 87 00:04:01,502 --> 00:04:03,765 So I was driving, 88 00:04:03,808 --> 00:04:05,549 talking with Bella, my wife. 89 00:04:05,593 --> 00:04:08,117 The, um, the boys were in the back. 90 00:04:08,160 --> 00:04:10,380 Jamie was playing with his iPad. 91 00:04:10,424 --> 00:04:15,472 Dylan grabbed it from him, but wouldn't give it back. 92 00:04:15,516 --> 00:04:16,952 Jamie can't control his anger. 93 00:04:16,995 --> 00:04:18,780 He started punching Dylan, 94 00:04:18,823 --> 00:04:21,173 got out of his seat belt, got on top of him. 95 00:04:21,217 --> 00:04:23,741 He kept pounding. 96 00:04:23,785 --> 00:04:25,700 Bella couldn't pull him off. 97 00:04:29,356 --> 00:04:34,317 I could hear Jamie's fists cracking against Dylan's face. 98 00:04:34,361 --> 00:04:39,279 He was screaming for help, so I pulled over. 99 00:04:41,237 --> 00:04:42,804 Just threw myself on top of Jamie. 100 00:04:42,847 --> 00:04:44,109 I wrapped my arms around him 101 00:04:44,153 --> 00:04:46,460 and held him as tight as I could. 102 00:04:51,856 --> 00:04:53,162 When he gets like this, the bear hugs 103 00:04:53,205 --> 00:04:55,251 are the only thing that bring him back. 104 00:04:55,295 --> 00:04:58,646 - Bring him back? - From his dark place. 105 00:04:59,864 --> 00:05:03,825 - Uh-huh. Okay. 106 00:05:03,868 --> 00:05:05,348 Will you, um, 107 00:05:05,392 --> 00:05:08,003 will you excuse me for a moment, Gordon? 108 00:05:13,138 --> 00:05:17,360 - We're gonna take care of you little, man, okay? 109 00:05:17,404 --> 00:05:18,709 All right. 110 00:05:23,540 --> 00:05:25,020 Ordered a CT. 111 00:05:25,063 --> 00:05:26,282 But I'm almost positive 112 00:05:26,326 --> 00:05:28,676 there's a bilateral mandible fracture. 113 00:05:28,719 --> 00:05:30,895 Gonna need surgery to wire it shut. 114 00:05:33,245 --> 00:05:36,423 Man, Ethan. Kid's only six years old. 115 00:05:37,685 --> 00:05:38,947 Jamie? 116 00:05:40,470 --> 00:05:45,127 - He's stable but tormented. Dad choked him out. 117 00:05:45,170 --> 00:05:49,044 - Probably so he couldn't defend his little brother. 118 00:05:49,087 --> 00:05:50,959 Sometimes I hate the ED. 119 00:05:56,138 --> 00:06:00,011 - Jamie, how are you doing? I'm Dr. Charles. 120 00:06:00,055 --> 00:06:03,711 Um, would you mind if I looked at your hands? 121 00:06:09,369 --> 00:06:11,893 - Fifth metacarpal is broken on each hand. 122 00:06:11,936 --> 00:06:14,069 - That's really gotta hurt. 123 00:06:14,112 --> 00:06:17,899 Um, look, we're gonna get you completely fixed up. 124 00:06:17,942 --> 00:06:21,424 Okay? It was nice to meet you. 125 00:06:24,775 --> 00:06:26,516 This is not child abuse. 126 00:06:38,398 --> 00:06:39,921 - Thanks, man. 127 00:06:39,964 --> 00:06:41,488 - You know, one of the volunteers works 128 00:06:41,531 --> 00:06:43,228 at a rehab center. 129 00:06:43,272 --> 00:06:45,970 If you'd like, she can tell you about their program. 130 00:06:46,014 --> 00:06:49,365 - Yeah. Sure. 131 00:06:49,409 --> 00:06:50,975 Maybe another time. 132 00:06:54,501 --> 00:06:56,198 - If you change your mind, we're here. 133 00:07:01,508 --> 00:07:03,423 - Will. - Yeah? 134 00:07:03,466 --> 00:07:08,036 - You have been here for hours. Go home, get some rest. 135 00:07:08,079 --> 00:07:10,778 - Yeah, I could use some sleep before I start my shift. 136 00:07:10,821 --> 00:07:12,823 Ah, damn it. It starts in a half hour. 137 00:07:12,867 --> 00:07:14,042 Uh, okay. All right. 138 00:07:14,085 --> 00:07:15,826 That woman over there, her name's Susan. 139 00:07:15,870 --> 00:07:17,393 When she comes down, she's gonna be hungry. 140 00:07:17,437 --> 00:07:19,482 I stashed some protein bars-- - I know, I saw. 141 00:07:19,526 --> 00:07:22,267 The electrolyte drinks too. Get to work. 142 00:07:24,008 --> 00:07:25,488 - I'll be back later, you call me 143 00:07:25,532 --> 00:07:28,099 if you need anything. 144 00:07:28,143 --> 00:07:32,147 - That's the cry, that one. 145 00:07:32,190 --> 00:07:35,237 It's not "I'm hungry" or "I'm tired." 146 00:07:35,280 --> 00:07:37,021 It's new. 147 00:07:37,065 --> 00:07:39,807 - Okay. I know, I know, Axel. 148 00:07:39,850 --> 00:07:43,506 You're in pain and my touching you is only making it worse. 149 00:07:43,550 --> 00:07:45,682 Any changes in his sleep pattern? 150 00:07:45,726 --> 00:07:47,467 - No. Every baby book I read said 151 00:07:47,510 --> 00:07:49,512 put your child on a schedule and stick to it. 152 00:07:49,556 --> 00:07:51,427 - Been there. My son's almost four. 153 00:07:51,471 --> 00:07:54,561 I know, I know. Almost finished. 154 00:07:54,604 --> 00:07:56,824 Okay. What about diet? 155 00:07:56,867 --> 00:07:58,739 - I had to start using formula. 156 00:07:58,782 --> 00:08:00,175 Just not enough hours in the day 157 00:08:00,218 --> 00:08:03,787 to pump, work, nurse, do laundry, pump again. 158 00:08:03,831 --> 00:08:07,051 - Single mom? Yeah, me too. 159 00:08:07,095 --> 00:08:09,880 Dad still in the picture? - No, but I'm okay with it. 160 00:08:11,665 --> 00:08:13,667 - Well, I'm not seeing anything out of the ordinary. 161 00:08:13,710 --> 00:08:15,407 I mean, the switch from breast milk to formula 162 00:08:15,451 --> 00:08:17,409 could be upsetting Axel's stomach. 163 00:08:17,453 --> 00:08:19,411 Have you noticed any diarrhea since the change? 164 00:08:19,455 --> 00:08:20,804 - Here and there. 165 00:08:20,848 --> 00:08:23,415 But this cry has been consistent for the last month. 166 00:08:23,459 --> 00:08:26,680 - I'll test for allergies, but infants and crying-- 167 00:08:26,723 --> 00:08:28,290 - Don't say colic. 168 00:08:28,333 --> 00:08:30,031 I've been to three pediatricians. 169 00:08:30,074 --> 00:08:32,381 They all diagnosed colic and sent me home. 170 00:08:33,425 --> 00:08:36,211 No. Something else is going on. 171 00:08:36,254 --> 00:08:39,562 Run tests, X-rays, scans. Just please, figure it out. 172 00:08:39,606 --> 00:08:41,216 - Okay, well, why don't we start 173 00:08:41,259 --> 00:08:43,261 with some basic labs and go from there? 174 00:08:45,916 --> 00:08:47,483 Is that okay? 175 00:08:47,527 --> 00:08:49,354 - Sure. Thank you. 176 00:08:50,704 --> 00:08:53,271 - I'll send a nurse in to get started. 177 00:08:57,101 --> 00:08:59,190 - Thank you. 178 00:08:59,234 --> 00:09:02,367 Hey, Jamie, you hungry? Thirsty? 179 00:09:04,413 --> 00:09:07,416 I know your casts are bulky. I can help you. 180 00:09:07,459 --> 00:09:09,636 I'll leave the tray right here just in case. 181 00:09:14,945 --> 00:09:18,079 - Hi. Nice to meet you. 182 00:09:18,122 --> 00:09:19,994 - They're talking about me. 183 00:09:24,128 --> 00:09:26,653 About what I did to my little brother. 184 00:09:28,959 --> 00:09:30,657 I didn't mean to hurt him. 185 00:09:32,484 --> 00:09:33,442 I'm so sorry. 186 00:09:33,485 --> 00:09:35,618 - It's okay. Okay, okay. 187 00:09:42,973 --> 00:09:45,280 - Well, after two miscarriages and five failed IVF attempts, 188 00:09:45,323 --> 00:09:46,542 we'd had enough heartbreak. 189 00:09:46,586 --> 00:09:49,545 - We adopted Jamie when he was a few days old. 190 00:09:49,589 --> 00:09:51,547 Best day of our lives. 191 00:09:51,591 --> 00:09:53,897 - Do you know anything about his birth parents? 192 00:09:53,941 --> 00:09:58,249 - Nothing really. Mom was young, in foster care. 193 00:09:58,293 --> 00:09:59,424 We don't know anything about dad. 194 00:09:59,468 --> 00:10:00,904 - Well, Jamie's 11 now, 195 00:10:00,948 --> 00:10:03,864 so how old was he when he first started acting out? 196 00:10:03,907 --> 00:10:05,953 - As an infant, he didn't like being held. 197 00:10:05,996 --> 00:10:09,652 Was always fidgety. - Hmm, how about as a toddler? 198 00:10:09,696 --> 00:10:12,437 - Sitting still, taking turns, following directions, 199 00:10:12,481 --> 00:10:14,135 they were all a challenge. 200 00:10:14,178 --> 00:10:17,007 - When did Jamie's behavior start becoming aggressive? 201 00:10:17,051 --> 00:10:18,748 - Elementary school. 202 00:10:18,792 --> 00:10:21,664 Fights with classmates and teachers. 203 00:10:21,708 --> 00:10:23,405 We're homeschooling now. 204 00:10:23,448 --> 00:10:26,800 - And your other son, Dylan, is he adopted as well? 205 00:10:26,843 --> 00:10:28,366 - Yeah. - Mm-hmm. 206 00:10:28,410 --> 00:10:31,543 It was initially Jamie's idea. He wanted to be a big brother. 207 00:10:31,587 --> 00:10:34,938 - And in the beginning, Dylan's presence seemed to calm Jamie. 208 00:10:34,982 --> 00:10:37,898 He would push his stroller, feed him his bottle, 209 00:10:37,941 --> 00:10:39,377 let him climb all over him. 210 00:10:39,421 --> 00:10:43,817 - They are so-- were so close. 211 00:10:43,860 --> 00:10:45,993 - I'm assuming that Jamie's been evaluated 212 00:10:46,036 --> 00:10:47,298 by a psychiatrist. 213 00:10:47,342 --> 00:10:48,517 - Several. 214 00:10:48,560 --> 00:10:50,998 They all just head to the diagnosis. 215 00:10:51,041 --> 00:10:53,174 Intermittent explosive disorder, 216 00:10:53,217 --> 00:10:55,785 comorbid ADHD, 217 00:10:55,829 --> 00:10:58,788 disruptive mood dysregulation disorder. 218 00:10:58,832 --> 00:11:01,835 - Tell me, what meds is he on right now? 219 00:11:01,878 --> 00:11:05,926 - Risperidone, valproic acid, lithium, Adderall, Tenex. 220 00:11:05,969 --> 00:11:08,798 They all work for a bit, but then-- 221 00:11:08,842 --> 00:11:10,974 - He always ends up in his dark place. 222 00:11:11,018 --> 00:11:12,280 - Yeah. 223 00:11:13,977 --> 00:11:16,197 - Mr. and Mrs. Shaw, Dylan's out of surgery. 224 00:11:16,240 --> 00:11:17,894 I'll take you to recovery. 225 00:11:17,938 --> 00:11:19,679 - Look, what I'd like to do 226 00:11:19,722 --> 00:11:21,898 is admit Jamie for a five day hold. 227 00:11:21,942 --> 00:11:23,987 That'll give us a chance to assess the situation 228 00:11:24,031 --> 00:11:25,946 and come up with some treatment options for you. 229 00:11:25,989 --> 00:11:28,209 - Anything. Please, just help him. 230 00:11:28,252 --> 00:11:29,340 - Yeah. 231 00:11:34,824 --> 00:11:36,086 - Shh. He's out. 232 00:11:36,130 --> 00:11:38,872 Cried himself to sleep. What'd the tests say? 233 00:11:38,915 --> 00:11:40,743 - The labs were normal. 234 00:11:40,787 --> 00:11:43,267 But the babygram revealed a mild bowel distention. 235 00:11:43,311 --> 00:11:44,573 There are no obstructions. 236 00:11:44,616 --> 00:11:47,315 However, the stool in Axel's diaper was watery. 237 00:11:47,358 --> 00:11:49,056 That suggests a GI issue. 238 00:11:49,099 --> 00:11:50,884 - Okay. What do you do for that? 239 00:11:50,927 --> 00:11:51,798 - Endoscopy. 240 00:11:51,841 --> 00:11:53,364 So under a general anesthesia, 241 00:11:53,408 --> 00:11:55,715 a surgeon will guide a camera down Axel's throat 242 00:11:55,758 --> 00:11:58,195 into his GI tract to search for abnormalities. 243 00:11:58,239 --> 00:12:00,676 And if necessary, we'll do a colonoscopy as well. 244 00:12:00,720 --> 00:12:02,591 - Mm. Can I be there? 245 00:12:03,810 --> 00:12:05,376 - I wouldn't recommend that. 246 00:12:05,420 --> 00:12:09,293 I mean, seeing the scope inside Axel, it might be upsetting. 247 00:12:09,337 --> 00:12:12,296 - No, I really wanna be there. - Are you sure? 248 00:12:12,340 --> 00:12:14,908 Because I can't overstate how distressing 249 00:12:14,951 --> 00:12:17,040 this procedure can be for a parent to watch. 250 00:12:17,084 --> 00:12:19,390 I mean, seeing your child on the table, unconscious-- 251 00:12:19,434 --> 00:12:22,219 - I'll be okay. 252 00:12:22,263 --> 00:12:23,438 - All right. 253 00:12:23,481 --> 00:12:25,527 Techs will be by shortly to bring up Axel. 254 00:12:25,570 --> 00:12:26,963 I'll be there as well. 255 00:12:29,618 --> 00:12:32,012 - Signed. - Thank you. 256 00:12:34,449 --> 00:12:35,842 - Hey, Doris. 257 00:12:35,885 --> 00:12:38,758 Julia, the mom in Treatment III, did you get a read? 258 00:12:38,801 --> 00:12:40,324 - I like her. 259 00:12:40,368 --> 00:12:43,501 I wish all parents would handle the ED that smoothly. 260 00:12:43,545 --> 00:12:45,155 - You don't think she's too composed? 261 00:12:45,199 --> 00:12:47,027 I mean, her son is clearly in distress 262 00:12:47,070 --> 00:12:48,332 and she hasn't even broken a sweat. 263 00:12:48,376 --> 00:12:50,639 - Oh, there's that Manning ESP again. 264 00:12:50,682 --> 00:12:52,249 - Okay. 265 00:12:52,293 --> 00:12:55,122 She asked me to run more tests on her baby than necessary, 266 00:12:55,165 --> 00:12:57,341 and now she wants to be front row when he gets scoped. 267 00:12:57,385 --> 00:12:59,300 You don't think that's a little odd? 268 00:12:59,343 --> 00:13:01,955 - Uh, if you say so. 269 00:13:03,739 --> 00:13:05,088 - Call Dr. Frisch. 270 00:13:05,132 --> 00:13:07,308 I wanna put Axel on today's schedule for an endoscopy. 271 00:13:07,351 --> 00:13:09,614 - She's busy. Omphalocele repair. 272 00:13:09,658 --> 00:13:11,138 Gonna be locked away all day. 273 00:13:11,181 --> 00:13:13,401 But I'm free to take care of it right now if you'd like. 274 00:13:13,444 --> 00:13:15,577 - Okay. Thanks. 275 00:13:15,620 --> 00:13:18,406 - Meet you upstairs. Ms. Doris? 276 00:13:18,449 --> 00:13:20,495 - Thank you. - Sure. 277 00:13:20,538 --> 00:13:22,671 Nurse April. - Dr. Marcel. 278 00:13:26,327 --> 00:13:28,633 - Okay, stomach and esophagus appear normal. 279 00:13:28,677 --> 00:13:30,418 Let's reset for a colonoscopy. 280 00:13:32,942 --> 00:13:35,118 - Julia, are you okay? 281 00:13:35,162 --> 00:13:36,772 You don't have to keep watching, you know. 282 00:13:36,816 --> 00:13:38,121 - No, I'm okay. 283 00:13:38,165 --> 00:13:39,819 It's just I have a scrape on my stomach. 284 00:13:39,862 --> 00:13:41,081 I forgot to change the bandage 285 00:13:41,124 --> 00:13:42,865 and it's beginning to slide around. 286 00:13:42,909 --> 00:13:44,562 - Why don't I have a nurse change that out for you 287 00:13:44,606 --> 00:13:45,825 when we're back in the ED? 288 00:13:45,868 --> 00:13:48,479 - Oh, okay. Yeah. 289 00:13:48,523 --> 00:13:50,003 Thanks. - Yeah. 290 00:13:50,046 --> 00:13:52,266 - Somehow I keep scraping myself right there. 291 00:13:52,309 --> 00:13:54,834 I don't know how. Mom brain, I guess. 292 00:13:59,055 --> 00:14:01,362 - Ooh, ooh. Right there. 293 00:14:01,405 --> 00:14:03,973 - Okay. Sharp or dull pain, Chloe? 294 00:14:04,017 --> 00:14:06,236 - I think both. Is that even possible? 295 00:14:06,280 --> 00:14:08,021 - Unfortunately. 296 00:14:14,723 --> 00:14:16,159 How long have you been feeling off? 297 00:14:16,203 --> 00:14:18,422 - I don't know. A couple weeks? 298 00:14:18,466 --> 00:14:20,860 - Three months. She downplays everything. 299 00:14:20,903 --> 00:14:24,124 We just got married. 300 00:14:24,167 --> 00:14:26,082 I figured the pain was just nervous energy, 301 00:14:26,126 --> 00:14:29,738 but the wedding's behind us now and I still feel "blah." 302 00:14:29,781 --> 00:14:31,087 - Any constipation? Bloating? 303 00:14:31,131 --> 00:14:34,351 - She hasn't pooped in a week. 304 00:14:34,395 --> 00:14:36,353 - So Chloe, I'm gonna need to take a closer look 305 00:14:36,397 --> 00:14:37,659 to see what's going on. 306 00:14:37,702 --> 00:14:40,183 We'll get some X-rays, a pelvic and a rectal. 307 00:14:40,227 --> 00:14:42,359 - Just keeping the sexy flowing, aren't I? 308 00:14:42,403 --> 00:14:45,188 - Till death do us part. 309 00:14:45,232 --> 00:14:47,190 - Well, a nurse will come in and get things going. 310 00:14:47,234 --> 00:14:49,366 Congratulations, Mr. and Mrs. James. 311 00:14:51,499 --> 00:14:52,717 - Crockett. - Yeah? 312 00:14:52,761 --> 00:14:53,893 - Perfect timing. 313 00:14:53,936 --> 00:14:55,372 Single vehicle accident landing now. 314 00:14:55,416 --> 00:14:57,679 Massive trauma. I'll have Baghdad ready. 315 00:14:57,722 --> 00:14:58,898 - Got it. 316 00:15:00,987 --> 00:15:02,989 What do you got? - Lucy Seaver, 20. 317 00:15:03,032 --> 00:15:05,382 GCS 3. Intubated in the field. 318 00:15:05,426 --> 00:15:07,950 Bilateral femur fractures and traction splints. 319 00:15:07,994 --> 00:15:10,126 SATS 100% on oxygen. 320 00:15:10,170 --> 00:15:12,694 - Okay, Lucy, don't be afraid. You're in the ED. 321 00:15:12,737 --> 00:15:13,956 We're gonna take good care of you. 322 00:15:14,000 --> 00:15:15,523 - Parents should be here any second. 323 00:15:15,566 --> 00:15:16,785 They were on the scene. 324 00:15:16,828 --> 00:15:18,047 They were in the car behind Lucy. 325 00:15:18,091 --> 00:15:20,223 - They saw the crash? - And the aftermath. 326 00:15:20,267 --> 00:15:22,747 Lucy's car was so mangled, it took us 20 minutes 327 00:15:22,791 --> 00:15:24,924 to extricate her and get her in the ambo. 328 00:15:24,967 --> 00:15:26,055 - Okay, all right. Here we go. 329 00:15:26,099 --> 00:15:28,797 On my count. One, two, three. 330 00:15:30,320 --> 00:15:31,365 - All right. 331 00:15:36,065 --> 00:15:38,111 - Good breath sounds bilaterally. 332 00:15:41,853 --> 00:15:44,465 Belly's hard as a rock. - BP's 70s. 333 00:15:44,508 --> 00:15:46,206 - Two of plasma, two of blood on the transfuser. 334 00:15:46,249 --> 00:15:48,556 Trigger the MTP. Let's fast her. 335 00:15:51,994 --> 00:15:55,955 Ton of soft tissue damage. Glass everywhere. 336 00:15:55,998 --> 00:15:58,000 All right, no, scrap the X-ray. No time. 337 00:15:58,044 --> 00:15:59,219 Give me that wand. 338 00:16:04,920 --> 00:16:06,356 Fast is positive. 339 00:16:06,400 --> 00:16:07,967 Yeah, I gotta get into her belly. 340 00:16:08,010 --> 00:16:11,709 All right, let's go. Let's open up the Hybrid OR! 341 00:16:11,753 --> 00:16:12,884 All right. - Oh, my God. 342 00:16:12,928 --> 00:16:14,147 - Get her prepped, all right? - Lucy! 343 00:16:14,190 --> 00:16:17,411 - Let's get her on the move. All right. 344 00:16:17,454 --> 00:16:20,022 Mr. and Mrs. Seaver, if you will. 345 00:16:20,066 --> 00:16:21,763 Your daughter's been seriously injured. 346 00:16:21,806 --> 00:16:24,244 She needs immediate surgery to control internal bleeding. 347 00:16:24,287 --> 00:16:26,115 - It's fixable? She's gonna live? 348 00:16:26,159 --> 00:16:28,335 - We will do everything we can. 349 00:16:39,911 --> 00:16:41,304 - Huh. 350 00:16:41,348 --> 00:16:43,567 So, uh, so what is your favorite sport? 351 00:16:43,611 --> 00:16:46,135 - Football, I guess. 352 00:16:46,179 --> 00:16:49,008 - Bears fan? - My dad likes them. 353 00:16:49,051 --> 00:16:51,793 I like the Chiefs. - Oh, really? 354 00:16:51,836 --> 00:16:54,143 Oh, how'd that happen? - The quarterback. 355 00:16:54,187 --> 00:16:56,841 I saw a video of him throw the ball out of the stadium. 356 00:16:56,885 --> 00:16:59,801 That was cool. - I saw that clip too. 357 00:16:59,844 --> 00:17:02,804 And you're right. It was cool. 358 00:17:02,847 --> 00:17:06,112 You know, I was wondering if we could talk a bit about... 359 00:17:06,155 --> 00:17:08,070 about what happens. 360 00:17:08,114 --> 00:17:12,205 You know, about how it feels when you start to get upset. 361 00:17:14,772 --> 00:17:16,905 - I don't know. Kind of... 362 00:17:18,820 --> 00:17:20,126 It's fuzzy. 363 00:17:20,169 --> 00:17:25,392 - Fuzzy. So kind of like, um, like a dream? 364 00:17:25,435 --> 00:17:27,481 - I guess. 365 00:17:27,524 --> 00:17:30,875 - And--and when it happens, I mean, what does it, uh, 366 00:17:30,919 --> 00:17:32,355 what does it feel like? 367 00:17:32,399 --> 00:17:34,836 I mean, like, you know, in here? 368 00:17:34,879 --> 00:17:38,057 I mean, do you feel anything in your body? 369 00:17:38,100 --> 00:17:40,798 - Feels like I'm gonna explode. 370 00:17:40,842 --> 00:17:42,061 - Wow. 371 00:17:42,104 --> 00:17:45,629 I'm sorry. That must be really scary. 372 00:17:45,673 --> 00:17:47,196 Do you want to take a little break? 373 00:17:47,240 --> 00:17:48,502 - I want this off. It's sticking to me. 374 00:17:48,545 --> 00:17:50,330 I can't stand it. - Okay, okay. 375 00:17:50,373 --> 00:17:52,245 - Don't touch me! Don't touch me! 376 00:17:52,288 --> 00:17:54,029 I hate you! I hate you! 377 00:17:54,073 --> 00:17:55,987 Let go! Stop it! 378 00:17:56,031 --> 00:17:58,033 Go away! Stop it! 379 00:17:58,077 --> 00:17:59,339 Go away! - Two of haldol! 380 00:17:59,382 --> 00:18:01,167 - Go away! Stop it, no! 381 00:18:01,210 --> 00:18:03,647 No, I don't want meds! Stop! 382 00:18:03,691 --> 00:18:06,737 Stop it, no! Stop! No! 383 00:18:06,781 --> 00:18:08,174 I don't want meds, stop! Stop it! 384 00:18:13,266 --> 00:18:15,964 - I wish I could tell you exactly what happened in there, 385 00:18:16,007 --> 00:18:17,574 what triggered Jamie, but honestly, I can't. 386 00:18:17,618 --> 00:18:19,010 I have reviewed his medical records, 387 00:18:19,054 --> 00:18:20,534 I've spoken with several of his doctors, 388 00:18:20,577 --> 00:18:23,841 and what is clear to me is that your son is struggling 389 00:18:23,885 --> 00:18:27,889 with multiple impulse control and mood regulation disorders. 390 00:18:27,932 --> 00:18:30,021 - So what do we do? We just want to help him. 391 00:18:30,065 --> 00:18:31,893 - Well, it's the hospital's recommendation 392 00:18:31,936 --> 00:18:35,114 that Jamie be admitted to a residential facility 393 00:18:35,157 --> 00:18:38,204 where he can receive sustained clinical care 394 00:18:38,247 --> 00:18:40,597 as well as supportive therapy. 395 00:18:40,641 --> 00:18:42,512 - A residential facility? - Mm-hmm. 396 00:18:42,556 --> 00:18:45,211 - Yeah. Mrs. Shaw, Jamie is 11. 397 00:18:45,254 --> 00:18:46,560 Puberty is fast approaching. 398 00:18:46,603 --> 00:18:48,170 And that surge of hormones 399 00:18:48,214 --> 00:18:52,348 is just gonna undoubtedly exacerbate his conditions. 400 00:18:52,392 --> 00:18:54,742 It'll just make him more difficult to treat in general. 401 00:18:54,785 --> 00:18:56,744 You know, find the right balance of meds. 402 00:18:56,787 --> 00:18:58,963 - And a specialized setting like this will have 403 00:18:59,007 --> 00:19:03,098 the behavioral resources Jamie needs for the future. 404 00:19:03,142 --> 00:19:07,233 And it'll be a safe place for him right now. 405 00:19:08,495 --> 00:19:10,671 - Anything for our son. - All right. 406 00:19:10,714 --> 00:19:13,195 I'll take care of all the arrangements. 407 00:19:17,808 --> 00:19:20,202 - Okay. Looking good. 408 00:19:20,246 --> 00:19:22,813 Four tears in the small bowel mesentery tied off. 409 00:19:22,857 --> 00:19:25,990 Liver's packed and hemostatic. 410 00:19:27,122 --> 00:19:28,036 - Pressure's no good. 411 00:19:29,733 --> 00:19:31,648 - We maxed out on pressors? 412 00:19:31,692 --> 00:19:32,736 - Yeah, and I've given ten units of blood 413 00:19:32,780 --> 00:19:34,085 and ten of plasma. 414 00:19:34,129 --> 00:19:36,523 She's still bleeding somewhere. - I don't... 415 00:19:38,394 --> 00:19:40,091 Hematoma on the pelvis. 416 00:19:40,135 --> 00:19:41,876 Bigger than my first look and growing. 417 00:19:41,919 --> 00:19:43,791 Gotta assume the pelvis is shattered and bleeding. 418 00:19:43,834 --> 00:19:45,401 Okay, team, new deal. Preperitoneal packs. 419 00:19:45,445 --> 00:19:46,533 Let's go. 420 00:19:50,319 --> 00:19:51,799 - Hey, Chloe. How you feeling? 421 00:19:51,842 --> 00:19:53,627 - Like a stuffed turkey. 422 00:19:53,670 --> 00:19:56,456 - X-rays show your bowel is FOS. 423 00:19:56,499 --> 00:19:58,545 - Full of-- - Stool. 424 00:19:58,588 --> 00:20:01,156 The pelvic suggests your uterus is enlarged. 425 00:20:01,200 --> 00:20:03,332 So I suspect a fibroid is sitting on the uterus, 426 00:20:03,376 --> 00:20:04,986 putting pressure on the rectum. 427 00:20:05,029 --> 00:20:06,466 - You were right. 428 00:20:06,509 --> 00:20:08,207 The last few weeks, she was scouring the web 429 00:20:08,250 --> 00:20:11,384 with her symptoms, and fibroid fit the bill. 430 00:20:11,427 --> 00:20:12,994 - Yeah, we're trying to have a baby. 431 00:20:13,037 --> 00:20:15,692 Internet says fibroids hinder the ability to conceive. 432 00:20:15,736 --> 00:20:18,129 - Not all fibroids are created equal. 433 00:20:18,173 --> 00:20:19,740 Hey, I'm gonna order a pelvic ultrasound 434 00:20:19,783 --> 00:20:21,307 and a gyne consult. 435 00:20:21,350 --> 00:20:23,570 I'll check back soon. And no more Googling, okay? 436 00:20:23,613 --> 00:20:24,832 Doctor's orders. 437 00:20:26,660 --> 00:20:28,183 - How's it going with your six-month-old? 438 00:20:28,227 --> 00:20:29,315 - Dead end. 439 00:20:29,358 --> 00:20:31,012 Nothing's jumping out in any of the labs 440 00:20:31,055 --> 00:20:33,580 and the endoscopy and colonoscopy report. 441 00:20:33,623 --> 00:20:35,321 I'm starting to wonder if it's really baby Axel 442 00:20:35,364 --> 00:20:36,670 who's the one that's sick. 443 00:20:36,713 --> 00:20:38,106 - What do you mean? 444 00:20:38,149 --> 00:20:40,674 - The mom, she's just-- she's got this air about her, 445 00:20:40,717 --> 00:20:42,893 this nonchalance that screams, 446 00:20:42,937 --> 00:20:45,505 "Yeah, my baby's in the ED, but it's just another day." 447 00:20:45,548 --> 00:20:47,724 - Well, it wouldn't be the first time we see a parent 448 00:20:47,768 --> 00:20:50,336 pretend their child was sick to get attention. 449 00:20:50,379 --> 00:20:52,903 - Yeah, unfortunately. 450 00:20:52,947 --> 00:20:55,384 Have you seen Dr. Charles? - He's upstairs. 451 00:20:55,428 --> 00:20:56,429 I'll page him for you. - Thanks. 452 00:20:56,472 --> 00:20:57,821 - Yeah. 453 00:20:57,865 --> 00:21:00,041 - Dr. Manning, it's Julia. 454 00:21:00,084 --> 00:21:01,695 There's something you need to see. 455 00:21:03,566 --> 00:21:04,785 - You know, I had my appendix taken out 456 00:21:04,828 --> 00:21:06,177 when I was in 10th grade. 457 00:21:06,221 --> 00:21:07,744 - All right. Well, let's take a look. 458 00:21:09,529 --> 00:21:13,272 Oh, my God. This is a fistula. 459 00:21:13,315 --> 00:21:17,493 Basically a tunnel between your small bowel and your skin. 460 00:21:17,537 --> 00:21:19,930 The green fluid is leaking from your intestines. 461 00:21:19,974 --> 00:21:21,628 - Seriously? - Mm-hmm. 462 00:21:21,671 --> 00:21:23,282 - I've been getting these scrapes for years. 463 00:21:23,325 --> 00:21:24,500 They heal up. 464 00:21:24,544 --> 00:21:26,937 It's been my intestines oozing out? 465 00:21:26,981 --> 00:21:29,244 - The tissue sample taken during Axel's endoscopy, 466 00:21:29,288 --> 00:21:30,637 I'd like it biopsied. 467 00:21:30,680 --> 00:21:32,726 - Biopsy? You're testing for cancer? 468 00:21:32,769 --> 00:21:33,988 - No. Something new. 469 00:21:34,031 --> 00:21:36,469 And now I'm thinking you may have it as well. 470 00:21:36,512 --> 00:21:37,774 The test that I ran on your son, 471 00:21:37,818 --> 00:21:40,647 I'd like to run on you as well. 472 00:21:40,690 --> 00:21:42,910 Okay. 473 00:21:42,953 --> 00:21:45,347 - All right. Pelvis is packed. 474 00:21:45,391 --> 00:21:47,262 Bleeding's under control. 475 00:21:47,306 --> 00:21:49,917 Call ICU and tell them Lucy's coming up to rewarm. 476 00:21:49,960 --> 00:21:52,006 - Something's wrong. Pressure's still in the toilet. 477 00:21:52,049 --> 00:21:54,791 74 over 38, falling. - What? 478 00:21:54,835 --> 00:21:57,272 - She's peri-arrest. - She's still bleeding? 479 00:21:58,708 --> 00:22:01,668 The abdomen is dry. Pelvis is contained. 480 00:22:01,711 --> 00:22:03,757 I mean, we're hemostatic, Marty. 481 00:22:03,800 --> 00:22:04,845 - She's bradying down. 482 00:22:06,412 --> 00:22:07,717 No pulse. - Come on. 483 00:22:11,895 --> 00:22:13,157 Milligram of epi. 484 00:22:16,422 --> 00:22:17,597 - Epi's in. Pulse check? 485 00:22:17,640 --> 00:22:18,815 - Go. 486 00:22:20,251 --> 00:22:21,165 - Still nothing. 487 00:22:23,167 --> 00:22:24,908 - Come on, Lucy. 488 00:22:24,952 --> 00:22:26,345 - Hold compressions. 489 00:22:29,348 --> 00:22:30,305 - Be good. 490 00:22:31,915 --> 00:22:34,918 - Asystole. - Come on. 491 00:22:34,962 --> 00:22:37,312 Come on, Lucy. Come on. 492 00:22:43,057 --> 00:22:43,927 Damn it. 493 00:22:57,811 --> 00:23:01,162 Time of death, 16:17. 494 00:23:03,817 --> 00:23:07,777 Okay, everyone, clear the room, please. 495 00:23:07,821 --> 00:23:09,866 I'd like a moment alone with my patient. 496 00:23:23,271 --> 00:23:25,621 - What's going on? 497 00:23:25,665 --> 00:23:27,188 - There's room for Jamie at Meyerbrook, 498 00:23:27,231 --> 00:23:28,842 which is the only residential facility 499 00:23:28,885 --> 00:23:30,539 capable of handling his needs. 500 00:23:30,583 --> 00:23:33,020 Unfortunately, neither his private insurance 501 00:23:33,063 --> 00:23:34,587 nor state Medicaid is gonna cover the cost. 502 00:23:34,630 --> 00:23:37,024 - What about an individual care grant from the state? 503 00:23:37,067 --> 00:23:38,417 - I already looked into it. It's no help. 504 00:23:38,460 --> 00:23:39,853 - Yeah, the grant's so underfunded, 505 00:23:39,896 --> 00:23:42,290 it wouldn't come close to what's needed. 506 00:23:42,333 --> 00:23:43,596 - So what's plan B? 507 00:23:43,639 --> 00:23:46,337 - Well, you know, I'm gonna just try and use 508 00:23:46,381 --> 00:23:48,862 the five-day hold to normalize his meds as best I can. 509 00:23:48,905 --> 00:23:51,081 And I do know a brilliant guy who specializes 510 00:23:51,125 --> 00:23:52,822 in these kind of disorders I want to refer him to. 511 00:23:52,866 --> 00:23:54,868 - An outpatient service? 512 00:23:54,911 --> 00:23:56,478 Jamie pummeled Dylan over an iPad. 513 00:23:56,522 --> 00:23:59,481 The kid's jaw's wired shut. He's only six years old. 514 00:23:59,525 --> 00:24:01,483 He's going to invade his brother's space again. 515 00:24:01,527 --> 00:24:05,574 And when that happens, and Jamie loses his temper, 516 00:24:05,618 --> 00:24:07,228 I'm worried he could kill Dylan. 517 00:24:07,271 --> 00:24:08,708 - I don't like it either, Ethan, 518 00:24:08,751 --> 00:24:10,927 but I mean, you know, I can't hold him here forever. 519 00:24:10,971 --> 00:24:14,844 - I get it, but we have an obligation to protect Dylan. 520 00:24:14,888 --> 00:24:16,890 And he needs our help just as much as Jamie. 521 00:24:25,246 --> 00:24:27,466 - Dr. Halstead, the gyne attending on-call 522 00:24:27,509 --> 00:24:28,815 came down a few minutes ago. 523 00:24:28,858 --> 00:24:32,079 She's with Chloe right now. - Great, thanks. 524 00:24:32,122 --> 00:24:34,168 - If you feel comfortable with that. 525 00:24:34,211 --> 00:24:35,952 Yeah. 526 00:24:40,130 --> 00:24:42,959 -Dr. Hannah Asher, gynecology. 527 00:24:45,135 --> 00:24:48,138 - Will Halstead. - It's nice to meet you. 528 00:24:48,182 --> 00:24:50,271 - Yeah. Likewise. 529 00:24:50,314 --> 00:24:52,447 - I was just explaining to Chloe and David 530 00:24:52,491 --> 00:24:54,231 that I reviewed her pelvic ultrasound. 531 00:24:54,275 --> 00:24:56,582 Considering the location and size of the fibroid, 532 00:24:56,625 --> 00:24:58,192 I believe removing it surgically 533 00:24:58,235 --> 00:24:59,410 is the best course of treatment. 534 00:24:59,454 --> 00:25:02,109 - A myomectomy? By who, when? 535 00:25:02,152 --> 00:25:05,329 - Me. Today. 536 00:25:05,373 --> 00:25:08,550 - Chloe, David, you should know this surgery can be risky. 537 00:25:08,594 --> 00:25:11,510 - Yes, I've explained the pros and cons, Dr. Halstead. 538 00:25:11,553 --> 00:25:13,773 Was clear that while this is a big operation, 539 00:25:13,816 --> 00:25:15,426 it's also a common one. 540 00:25:15,470 --> 00:25:18,908 - Nevertheless, complications could rise. 541 00:25:18,952 --> 00:25:21,128 So I would suggest non-surgical options. 542 00:25:21,171 --> 00:25:23,826 Hormone therapy will shrink the fibroid. 543 00:25:23,870 --> 00:25:25,306 - Well, that's what Dr. Asher said. 544 00:25:25,349 --> 00:25:27,961 But to ensure that it doesn't grow back, 545 00:25:28,004 --> 00:25:29,397 Chloe would have to go on the pill. 546 00:25:29,440 --> 00:25:31,355 - We're anxious to start a family. 547 00:25:31,399 --> 00:25:33,140 The pill takes that off the table. 548 00:25:33,183 --> 00:25:35,272 - In the short term, yes. But not permanently. 549 00:25:35,316 --> 00:25:37,579 - Actually, it kind of does. 550 00:25:37,623 --> 00:25:39,320 I'm 41, Dr. Halstead. 551 00:25:39,363 --> 00:25:41,801 Our window for getting pregnant is already closing. 552 00:25:41,844 --> 00:25:45,065 If I choose hormones, I might as well slam it shut. 553 00:25:45,108 --> 00:25:47,937 - We appreciate your passion, Dr. Halstead. 554 00:25:47,981 --> 00:25:51,158 But surgery is the best for us. 555 00:25:51,201 --> 00:25:52,768 - I'll get that started. 556 00:25:52,812 --> 00:25:55,423 It was so nice meeting both of you. 557 00:25:55,466 --> 00:25:56,729 Doctor. 558 00:25:59,253 --> 00:26:01,777 - Excuse me just a moment. 559 00:26:01,821 --> 00:26:04,214 Doctor Asher? Doctor. 560 00:26:05,651 --> 00:26:06,826 - Hmm? 561 00:26:06,869 --> 00:26:08,131 - You can't perform this surgery. 562 00:26:08,175 --> 00:26:09,306 - Hmm? 563 00:26:09,350 --> 00:26:10,917 - I mean, you shouldn't even be working. 564 00:26:10,960 --> 00:26:12,962 - Look, thank you for your help last week, but I'm better now. 565 00:26:13,006 --> 00:26:14,616 I'm over that hump. 566 00:26:14,660 --> 00:26:16,226 - So heroin addiction is like a cold? 567 00:26:16,270 --> 00:26:17,924 - What, you just get over it? 568 00:26:17,967 --> 00:26:19,490 What I saw at that injection site-- 569 00:26:19,534 --> 00:26:21,188 - Was me having a bad day. 570 00:26:21,231 --> 00:26:22,450 - A bad day? - Mm-hmm. 571 00:26:22,493 --> 00:26:24,191 - You... 572 00:26:26,410 --> 00:26:28,891 You OD'd. 573 00:26:28,935 --> 00:26:30,632 For all I know, you're high right now. 574 00:26:30,676 --> 00:26:31,938 - Right. 575 00:26:31,981 --> 00:26:33,679 But how many all-nighters you pull over there 576 00:26:33,722 --> 00:26:35,637 since I saw you last, huh? 577 00:26:35,681 --> 00:26:39,423 Three? Four? 578 00:26:39,467 --> 00:26:41,687 Maybe I should be the one worried about your judgment. 579 00:26:41,730 --> 00:26:42,905 - Don't twist this. 580 00:26:42,949 --> 00:26:45,647 I'm not an addict about to operate. 581 00:26:45,691 --> 00:26:48,258 You step into that OR, you put Chloe's life in jeopardy. 582 00:26:48,302 --> 00:26:51,435 - I would never risk the well-being of a patient. 583 00:26:53,176 --> 00:26:57,224 Not that it is any of your business, I'm sober now. 584 00:26:57,267 --> 00:26:59,356 - I'd expect an addict to say that. 585 00:27:01,184 --> 00:27:03,360 - Chloe is in good hands with me. 586 00:27:14,284 --> 00:27:16,983 - Axel has Crohn's disease? But he's only six months old. 587 00:27:17,026 --> 00:27:19,550 - Well, it's rare in children, let alone infants, 588 00:27:19,594 --> 00:27:21,117 but not unheard of. 589 00:27:21,161 --> 00:27:22,423 - Isn't Crohn's a diet thing? 590 00:27:22,466 --> 00:27:24,468 I mean, Axel's barely started on solids. 591 00:27:24,512 --> 00:27:25,774 - Well, diet aggravates Crohn's, 592 00:27:25,818 --> 00:27:27,036 but it's not the cause. 593 00:27:27,080 --> 00:27:28,081 Genetics is. 594 00:27:28,124 --> 00:27:30,387 Crohn's tends to cluster in families. 595 00:27:30,431 --> 00:27:32,389 - Whoa, my test results-- 596 00:27:32,433 --> 00:27:34,000 - Show that you have Crohn's as well. 597 00:27:34,043 --> 00:27:36,655 The fistula is just evidence of the severity. 598 00:27:36,698 --> 00:27:37,917 - This doesn't make sense. 599 00:27:37,960 --> 00:27:39,701 If I've got Crohn's badly enough 600 00:27:39,745 --> 00:27:42,878 to burn a hole in my skin, shouldn't it bother me? 601 00:27:42,922 --> 00:27:44,880 - Well, fistulas themselves are painless, 602 00:27:44,924 --> 00:27:48,362 but yes, a Crohn's flare-up is excruciating. 603 00:27:48,405 --> 00:27:50,581 You should be in pain. Agony. 604 00:27:50,625 --> 00:27:54,585 - Yeah, well, I don't feel a thing. 605 00:27:54,629 --> 00:27:57,284 This is weirding you out, isn't it? 606 00:27:57,327 --> 00:27:58,720 - It's definitely unusual. 607 00:28:04,117 --> 00:28:06,597 Or actually, 608 00:28:06,641 --> 00:28:10,601 maybe it's-- maybe it's rare. 609 00:28:10,645 --> 00:28:11,907 Let me ask you a question. 610 00:28:11,951 --> 00:28:16,259 What emotion are you feeling right now? 611 00:28:16,303 --> 00:28:17,739 - I'm not sure what you mean. 612 00:28:17,783 --> 00:28:19,480 - Well, I just told you that you and your son have 613 00:28:19,523 --> 00:28:21,482 an inflammatory bowel disease. 614 00:28:21,525 --> 00:28:23,179 What are you feeling? Stress? 615 00:28:23,223 --> 00:28:25,355 Anxiety? Fear? 616 00:28:25,399 --> 00:28:29,011 - Confusion, that's for sure. 617 00:28:29,055 --> 00:28:31,666 - You know, I'd like to run one more test. 618 00:28:31,710 --> 00:28:32,928 Okay? - Okay. 619 00:28:32,972 --> 00:28:33,973 - Okay. 620 00:28:39,805 --> 00:28:42,111 - Bea, it's taking too long. Check with Dr. Asher. 621 00:28:42,155 --> 00:28:43,547 - Again? 622 00:28:43,591 --> 00:28:45,071 I've already gone in there twice for you, Dr. Halstead. 623 00:28:45,114 --> 00:28:47,116 - Please, I'm treating Chloe in the ED. 624 00:28:47,160 --> 00:28:48,727 I just want to make sure Dr. Asher's 625 00:28:48,770 --> 00:28:50,511 got everything under control. 626 00:28:50,554 --> 00:28:52,861 - Fine. - Thank you. 627 00:29:01,217 --> 00:29:04,264 - Dr. Asher said, "Go away." 628 00:29:04,307 --> 00:29:06,005 - Nope, staying right here. 629 00:29:12,489 --> 00:29:14,796 - Hey, I got your page. 630 00:29:14,840 --> 00:29:16,624 - You have a new plan to help Jamie? 631 00:29:17,930 --> 00:29:20,759 - Yeah. Yep, I do. 632 00:29:23,457 --> 00:29:24,763 So, Mr. and Mrs. Shaw, 633 00:29:24,806 --> 00:29:27,156 I have given this a tremendous amount of thought. 634 00:29:27,200 --> 00:29:30,507 I've consulted with-- with numerous colleagues, 635 00:29:30,551 --> 00:29:31,813 with social workers, 636 00:29:31,857 --> 00:29:35,686 with our Executive Director of Patient Services. 637 00:29:35,730 --> 00:29:38,037 Jamie needs to be at the Meyerbrook 638 00:29:38,080 --> 00:29:39,473 Residential Facility. 639 00:29:39,516 --> 00:29:41,518 - So the insurance companies, they agreed to pay? 640 00:29:41,562 --> 00:29:42,998 - No. 641 00:29:43,042 --> 00:29:46,349 Both your private insurance and Medicaid won't budge. 642 00:29:46,393 --> 00:29:49,352 - Then I'm confused. 643 00:29:49,396 --> 00:29:52,007 - There is a way to force Medicaid 644 00:29:52,051 --> 00:29:55,054 to cover Meyerbrook's cost in full. 645 00:29:55,097 --> 00:29:56,795 It's called a psychiatric lockout. 646 00:29:56,838 --> 00:29:58,492 But it will require you 647 00:29:58,535 --> 00:30:01,147 to surrender Jamie to this hospital. 648 00:30:01,190 --> 00:30:04,933 - Surrender? I don't understand. 649 00:30:04,977 --> 00:30:08,241 - If you were to leave Jamie here and refuse to come back, 650 00:30:08,284 --> 00:30:11,287 Child Protective Services would have to take custody of him. 651 00:30:11,331 --> 00:30:14,943 Then, as a ward of the state, legally, Illinois would have 652 00:30:14,987 --> 00:30:18,642 to provide him with the mental health services that he needs. 653 00:30:18,686 --> 00:30:21,863 - Meyerbrook? - This is insane. 654 00:30:21,907 --> 00:30:24,648 We're not doing this. - So there's no other way? 655 00:30:24,692 --> 00:30:27,956 - I'm so sorry, but there just isn't. 656 00:30:28,000 --> 00:30:30,176 We would absolutely find a way for you to maintain contact 657 00:30:30,219 --> 00:30:31,873 with Jamie, but you also need to know 658 00:30:31,917 --> 00:30:35,268 that legally, you won't have any say in his care. 659 00:30:40,229 --> 00:30:42,188 - We're still his parents. 660 00:30:42,231 --> 00:30:43,972 This doesn't change that. Nothing changes that. 661 00:30:44,016 --> 00:30:45,974 - No. No, no, no. 662 00:30:46,018 --> 00:30:47,933 We're not abandoning our son. 663 00:30:47,976 --> 00:30:50,718 - Mrs. Shaw, you will not be abandoning him. 664 00:30:50,761 --> 00:30:53,068 This--this won't be forever. 665 00:30:55,027 --> 00:30:56,811 - Jamie needs us to do this. 666 00:31:06,168 --> 00:31:07,735 - When? 667 00:31:07,778 --> 00:31:09,868 - I cannot imagine how agonizing 668 00:31:09,911 --> 00:31:12,522 this decision must be. 669 00:31:12,566 --> 00:31:15,917 But the sooner Jamie starts to heal, 670 00:31:15,961 --> 00:31:17,919 the sooner you all can look forward 671 00:31:17,963 --> 00:31:19,921 to becoming a family again. 672 00:31:19,965 --> 00:31:22,141 - Bella. 673 00:31:24,491 --> 00:31:26,058 It's to save him. 674 00:31:59,787 --> 00:32:01,963 - Everything is going to be okay. 675 00:32:02,007 --> 00:32:03,791 - Hey, buddy. It's gonna be okay, buddy. 676 00:32:03,834 --> 00:32:05,445 Right now, it's the best thing. 677 00:32:05,488 --> 00:32:07,838 You'll be better, and so you're just gonna stay 678 00:32:07,882 --> 00:32:10,363 with the doctors. 679 00:32:10,406 --> 00:32:12,191 - You're okay, baby. - No, no. 680 00:32:12,234 --> 00:32:13,757 Please. I'll be better. 681 00:32:13,801 --> 00:32:15,977 I didn't mean to! - It's okay. 682 00:32:16,021 --> 00:32:18,893 - Please, I want to go home. I want to go home. 683 00:32:18,937 --> 00:32:20,895 Please, Mom. 684 00:32:53,928 --> 00:32:55,190 - Dr. Marcel? 685 00:32:55,234 --> 00:32:58,193 Lucy's parents are still in the waiting room. 686 00:32:58,237 --> 00:33:00,543 You haven't told them-- - She should be alive. 687 00:33:00,587 --> 00:33:02,241 - Well, it's been over an hour. 688 00:33:02,284 --> 00:33:05,200 They need to know that their daughter has passed. 689 00:33:05,244 --> 00:33:09,813 - I won't speak to them until I can explain how she died. 690 00:33:09,857 --> 00:33:11,467 Why I couldn't save her. 691 00:33:20,781 --> 00:33:23,697 Can you give me some light? 692 00:33:23,740 --> 00:33:24,915 Right here. 693 00:33:27,527 --> 00:33:31,748 Every other injury was either a tear or a rip in the skin. 694 00:33:31,792 --> 00:33:33,359 This one's a hole. 695 00:33:35,709 --> 00:33:37,711 Something embedded inside. 696 00:33:37,754 --> 00:33:39,756 - More shrapnel from the windshield? 697 00:33:39,800 --> 00:33:41,410 - It doesn't really feel like glass. 698 00:33:41,454 --> 00:33:44,326 Can you, uh, swing that X-ray machine around? 699 00:33:54,641 --> 00:33:55,990 Go ahead. 700 00:34:03,867 --> 00:34:06,000 That's a bullet. 701 00:34:06,044 --> 00:34:08,133 - Lucy was shot? 702 00:34:17,794 --> 00:34:20,536 - Lucy was shot? How? 703 00:34:20,580 --> 00:34:24,758 She was driving down the highway alone in the car. 704 00:34:24,801 --> 00:34:26,977 - The steep angle of entry shows that the bullet struck 705 00:34:27,021 --> 00:34:29,937 from above and launched into Lucy's pelvis. 706 00:34:29,980 --> 00:34:33,071 It severed her external iliac artery. 707 00:34:33,114 --> 00:34:35,682 - Shot from above? - Yes. 708 00:34:35,725 --> 00:34:37,945 Now, the police will run ballistics. 709 00:34:37,988 --> 00:34:40,556 But they believe, and science backs it up, 710 00:34:40,600 --> 00:34:42,645 that someone, somewhere in the city, 711 00:34:42,689 --> 00:34:44,430 fired a gun into the air. 712 00:34:44,473 --> 00:34:47,998 And when that bullet came down, 713 00:34:48,042 --> 00:34:50,262 it struck Lucy. 714 00:34:50,305 --> 00:34:53,613 - Someone. Somewhere. 715 00:34:53,656 --> 00:34:56,006 And now our daughter is dead? 716 00:34:58,139 --> 00:34:59,532 - I'm so sorry. 717 00:35:01,795 --> 00:35:05,320 The nurse will come to take you to see Lucy. 718 00:35:05,364 --> 00:35:06,887 Excuse me. 719 00:35:12,153 --> 00:35:16,810 - Hey, the additional blood work you ordered on Axel's mom. 720 00:35:16,853 --> 00:35:18,768 - Oh, wow. 721 00:35:18,812 --> 00:35:22,163 This whole time, my take on Julia has been off. 722 00:35:22,207 --> 00:35:23,730 Way off. 723 00:35:26,080 --> 00:35:28,822 - ♪ We love fun 724 00:35:28,865 --> 00:35:31,955 ♪ We're going out and having some ♪ 725 00:35:31,999 --> 00:35:34,567 ♪ We love fun 726 00:35:34,610 --> 00:35:37,483 ♪ You know we're gonna have a ton ♪ 727 00:35:37,526 --> 00:35:39,572 - Never heard that song before. 728 00:35:39,615 --> 00:35:42,140 - "We Love Fun" by The Bouncing Souls. 729 00:35:42,183 --> 00:35:45,186 I don't know any real lullabies. 730 00:35:45,230 --> 00:35:47,884 - Julia, all day, I've been troubled by your demeanor 731 00:35:47,928 --> 00:35:51,018 because you didn't seem worried about Axel. 732 00:35:51,061 --> 00:35:54,282 But now I know you really aren't worried. 733 00:35:54,326 --> 00:35:57,894 And I suspect you've never felt anxious, depressed, 734 00:35:57,938 --> 00:36:00,810 or even afraid your entire life, have you? 735 00:36:00,854 --> 00:36:03,509 - No, not really. 736 00:36:03,552 --> 00:36:05,685 - Same goes for physical pain, doesn't it? 737 00:36:07,034 --> 00:36:09,341 - Kind of feels like this is a trick question or something. 738 00:36:09,384 --> 00:36:11,647 - No. Okay. 739 00:36:11,691 --> 00:36:15,434 So when I had my son, labor was a beast. 740 00:36:15,477 --> 00:36:18,654 Intense pressure, cramps, spasms. 741 00:36:18,698 --> 00:36:20,221 But you didn't feel any of that, did you? 742 00:36:20,265 --> 00:36:21,396 - Nope. 743 00:36:21,440 --> 00:36:23,920 Whole thing just kind of tingled. 744 00:36:23,964 --> 00:36:27,185 But I've always had an extremely high pain tolerance. 745 00:36:27,228 --> 00:36:28,360 I know. 746 00:36:28,403 --> 00:36:29,839 There's something wrong with me, right? 747 00:36:29,883 --> 00:36:32,494 My friends have been saying it forever. 748 00:36:32,538 --> 00:36:35,410 Wait, is there something wrong with me? 749 00:36:35,454 --> 00:36:36,803 - No. 750 00:36:36,846 --> 00:36:38,935 No, but there is something missing from you. 751 00:36:38,979 --> 00:36:41,634 So we all have what's called a FAAHP1 pseudogene. 752 00:36:41,677 --> 00:36:44,332 Your preliminary blood work shows that you have a rare 753 00:36:44,376 --> 00:36:47,335 microdeletion which affects your insensitivity to pain. 754 00:36:47,379 --> 00:36:48,510 - When I was a kid, 755 00:36:48,554 --> 00:36:50,686 my dad would say everyone else were wimps. 756 00:36:50,730 --> 00:36:54,995 That we were a hardy breed, that pain was just a word. 757 00:36:55,038 --> 00:36:58,128 - Well, microdeletion is a genetic thing. 758 00:36:58,172 --> 00:37:00,435 So it's likely that your father and other family members 759 00:37:00,479 --> 00:37:01,436 have it as well. 760 00:37:06,093 --> 00:37:07,921 Julia? 761 00:37:15,189 --> 00:37:16,886 - What's wrong? 762 00:37:16,930 --> 00:37:19,715 - I passed Axel the gene for Crohn's, 763 00:37:19,759 --> 00:37:22,979 but not the one so he won't be tortured by it. 764 00:37:23,023 --> 00:37:25,068 And if I didn't know when I hurt myself, 765 00:37:25,112 --> 00:37:27,723 I wouldn't have known when I hurt my son. 766 00:37:27,767 --> 00:37:30,073 I probably made the bath too hot. 767 00:37:30,117 --> 00:37:32,554 Didn't dress him warm enough-- - Hey. 768 00:37:32,598 --> 00:37:34,643 You knew it wasn't colic. 769 00:37:34,687 --> 00:37:38,734 You knew to bring your son into the ED. 770 00:37:38,778 --> 00:37:41,520 You may not feel everything he feels, 771 00:37:41,563 --> 00:37:42,999 but you're his mother. 772 00:37:43,043 --> 00:37:45,959 You'll always know what he needs. 773 00:37:55,795 --> 00:37:57,753 - Uh, keep going. Grab her husband. 774 00:37:57,797 --> 00:37:59,146 I'll meet you in recovery. 775 00:38:01,931 --> 00:38:03,846 Wonderful. You're still here. 776 00:38:03,890 --> 00:38:06,284 - Is Chloe okay? - Yeah, she's fine. 777 00:38:06,327 --> 00:38:08,895 Operation was flawless. 778 00:38:08,938 --> 00:38:12,115 - This time. 779 00:38:12,159 --> 00:38:14,292 - How about you and I keep our distance from one another? 780 00:38:14,335 --> 00:38:15,423 - Yeah, fine. 781 00:38:15,467 --> 00:38:17,425 Just as soon as you stop treating patients 782 00:38:17,469 --> 00:38:18,600 and seek treatment for your addiction. 783 00:38:18,644 --> 00:38:19,949 - Screw you, Halstead. 784 00:38:19,993 --> 00:38:21,603 - In that case, I'm going to submit a letter 785 00:38:21,647 --> 00:38:23,126 to the hospital's Chief Medical Officer. 786 00:38:23,170 --> 00:38:24,563 And that decision will be made for you. 787 00:38:24,606 --> 00:38:26,608 - That's a stupid idea. 788 00:38:26,652 --> 00:38:29,481 You out me, I out your own involvement 789 00:38:29,524 --> 00:38:32,179 in a not-quite-legal injection site. 790 00:38:32,222 --> 00:38:34,442 So if I go down, so do you. 791 00:38:36,314 --> 00:38:40,056 So if you want to report me, 792 00:38:40,100 --> 00:38:41,710 have at it, cowboy. 793 00:38:50,110 --> 00:38:52,199 - Hey. - Hey. 794 00:38:52,242 --> 00:38:53,983 - Heard you had a rough one today. 795 00:38:54,027 --> 00:38:56,725 You all right? - Yeah. 796 00:38:56,769 --> 00:38:58,640 The little boy and his mom. 797 00:38:58,684 --> 00:39:01,643 Your, uh, ESP pan out? 798 00:39:01,687 --> 00:39:04,167 - Not even close. 799 00:39:08,868 --> 00:39:12,350 - I'll see you tomorrow. - Night. 800 00:39:22,534 --> 00:39:23,926 - Hey. 801 00:39:26,973 --> 00:39:28,627 - Today sucked. 802 00:39:28,670 --> 00:39:31,412 Yes, it did. 803 00:39:31,456 --> 00:39:36,417 - We just don't have enough psychiatric resources for kids. 804 00:39:36,461 --> 00:39:39,072 - And unfortunately, the Shaws won't be 805 00:39:39,115 --> 00:39:41,857 the last family to face a lockout. 806 00:39:41,901 --> 00:39:46,296 But Jamie will get the help he needs. 807 00:39:46,340 --> 00:39:48,255 And that's a good thing. 808 00:40:05,533 --> 00:40:08,754 - Hey, buddy. Come on, let's go.