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Chicago Med
All S1

S1 E15Unfinished Business

We cannot do this, Ethan.

He was clear in his decision.

Because you pressured him, made him feel like he had to choose right now.

No, I gave him his medical options, and he decided on what was best for him. Don't put this on me.

It is on you. Your hands may have been tied by his advance directive, but giving him heparin knowing it's lethal, that's assisted suicide.

April, we can't save Gary, but one organ donor can save up to eight lives. One tissue donor can improve the lives of up to fifty others. Because of him, fifty-eight people get a second chance. Put in the order for heparin.

Then I'll do it myself.

I spoke to the parents together and independently.

I don't like the stepdad for the guy. He offered to give a polygraph and submit his DNA. Offenders don't usually behave that way.

Any other leads?

Allison's comprehensive tox screen detected trace amounts of triazolam in her blood. That's a benzo, right?

Yeah. A sedative hypnotic with amnestic properties.

The stepdad's an accountant. I don't see him getting his hands on that.

Unless maybe he was prescribed it. I mean, it is sometimes used for insomnia.

Yeah, it definitely puts you out. The hospital uses it mostly to treat patient anxiety, usually before procedures, MRIs scans, things like that.

So she could have gotten it here. Did you give it her before the CT scan?

[checking his tablet] No.

Another doctor then, maybe. Did the mom mention any other recent medical issues?

No, nothing. Other than the symptoms that brought her in today. [remembering something] Braces. Allison did just get her braces on.

Dentists also sometimes use triazolam.

Making a break for it, Keoni? Really?

KKeoni

Seemed like a good idea at the time. Figured Maggie was sending over a shrink.

Oh, no. You get me.

KKeoni

I appreciate the red carpet, but there's nothing you can do. In the back of my mind, I knew it was diabetes. I should've never come to the hospital.

Because what, denial is a good solution?

KKeoni

You don't understand, Sharon. My family, diabetes kills. Now it's my turn.

Your genetics don't doom you, Keoni.

KKeoni

No? I eat healthy. I don't drink the coladas or the daiquiris that I make at the bar. I exercise. Yet here I am. I did what I was supposed to do.

Yeah, and unfortunately, people like you and I have to do that and more to break the cycle. Yes, I have diabetes, too. And I've lost family also.

KKeoni

I didn't know.

Many don't. And it's not because I'm hiding it, but because I've got it under control. And I have for the last fourteen years. There are people in this hospital who have to surrender. You have an opportunity. [handing him a pamphlet] You better take it.

JNJanelle Nicholson

The orthodontist? I was in the waiting room the whole time just checking my e-mails. When she came out, she smiled, showed me her braces, didn't seem any different.

The police suspect instead of nitrous, he used triazolam. It knocked her out, ensured she had no memory of the assault.

KKevin

Sick bastard.

I know this is a lot to process, but once Allison is stronger, the detective would like to come in and ask her a few questions.

JNJanelle Nicholson

Look, Ali just had a brush with death, and all she cares about is if she can still go to the junior high dance. She's so innocent. I don't want to take that from her. One day we'll have to, but not today.

We understand. We'll be back in the morning to check on her.

I have been reviewing Robin's history just to make sure we haven't missed anything, and... well, uh, some of her symptoms, they're not consistent with a psychiatric disorder.

Dr. Reese...

Let her finish.

Two days ago when Robin came to the hospital, she was running a mild fever, 100.2, and her BP was elevated. Now, at the time, we didn't think anything of it...

That's cause it's a very mild fever. And of course her BP was elevated. She was on a forced hold. She was agitated.

But when Robin was brought in today, it seemed she was experiencing visual hallucinations. Now, auditory hallucinations indicate a mental disorder, but visual hallucinations should be considered organic until proven otherwise.

I think we all wish that Robin had a treatable physical condition rather than...

I want to check her ceruloplasmin levels and run an FTA-ABS, as well as an MRI and EEG to rule out scelerosis and epilepsy.

Of course. Do it.

[Dr. Reese leaves]

What's the matter with you?

She's trying to make me feel better. And bless her, but she's grasping at straws. Come on.

Are you so blinded by your fear that Robin inherited her problems from you that you won't even entertain an alternative?

False hope, Sharon. Come on. I don't need any.

You don't know that. Where's the Daniel who leaves no stone unturned when diagnosing a patient? Where's the Daniel who never gives up? Don't you think your own daughter deserves that much?

I was wrong to take Robin out of the hospital. I'm sorry.

Well... I have certainly been wrong, too. Seeing the whole thing through the prism of my own fears.

Since I was a kid, I always wondered if there was something I could've done to stop my mom from killing herself. I obviously couldn't save my mom, but I was sure as hell gonna try and save Robin.

You know, at one point, I considered bringing that up. Decided it probably wouldn't have been helpful.

[they share a snicker] Yeah, probably not.

Well, she's not gonna want to have anything to do with me after all this is over, that's for sure.

Were you aware that Dr. Charles was testifying in Kellogg's defense?

I found out today. Dr. Charles wants him remanded to a psychiatric facility.

Which means he won't go to jail. That's absurd. The man came here and tried to kill a medical health professional because he wanted attention.

Well, I'm as upset as you are. I'm the one who found him bleeding on the sidewalk.

Jack Kellogg is a devious sociopath. He'll con his way out of mental institution and be back on the streets. We have a responsibility, a public responsibility, to make sure that doesn't happen.

Unfortunately, Dr. Reese, there's nothing you or I can do. It's up to the jury.

MMMarshall Matthews

Dr. Charles, prosecution's calling a rebuttal witness. What do I need to know about Sarah Reese?

MMMarshall Matthews

[they see Sarah walk past with Peter Stone] Tell me your own resident isn't here to poke holes in your testimony.

Oh, there you are, Dr. Reese. Uh, you'll be happy to know that Mr. Kellogg was found guilty.

I'm not happy, but I am satisfied with that verdict. He'll still receive treatment in jail.

Through the Department of Corrections? You have any idea what their success rate is? In that environment? His chances of rehabilitation are practically nil. Not that it really matters, because more than likely his temper will get him killed within a week.

Those outbursts are an act calculated to convince you he's crazy.

Is that what he was doing? Dr. Reese, I've been evaluating psychiatric patients for more than thirty years. Is it conceivable to you that I might have more insight into his behavior than you do?

Dr. Rhodes. I've been thinking about your pulmonary thrombectomy. I can't help but wonder if Dr. Bekker didn't... what's the word? Manipulate me for her own gain.

I-I wouldn't worry about it, Dr. Latham.

I know that fellows compete for the most challenging cases to improve their résumés. Perhaps in the end, you fared better than Dr. Bekker.

Is that why you gave me the transplant?

I'm not sure. Sometimes my motivations are a mystery to me, to be honest.

You want to feed a patient against her will.

A pregnant mother who's killing her baby.

We believe she has something called orthorexia, an obsession with healthy living that has limited her diet so severly that it's become dangerous.

And has led to a pathologic distrust of the entire medical system. She won't let us do anything.

Well, is she delusional? Can she make decisions on her own?

No, she is very clear about what she wants and what she does not want.

Well, then we can't prove incompetence, and we can't force her to do anything to her body she doesn't want. The law sides with her.

But there are two patients here.

Yeah, one of whom has no control over what's being done to it.

This is child abuse.

Well, I can convene an emergency ethics committee. It's possible they may find grounds to override her decision.

And in the meantime?

See if you can find a way to help her trust us.

You paged about a consult?

Yeah. Yeah. Um... 50-something guy, post-op after getting shot by a patient.

Is this a joke?

No. I'm serious. Give me your clinical evaluation of my recovery.

No residual anger or fear.

Normal intellectual and emotional functioning. You seem like you have moved on.

Yeah. And you should, too.

Excuse me?

I'm just wondering if today was less about your patient and more about lingering fears for our safety. It is certainly true that a very few patients can be dangerous. But the overwhelming majority are... harmless, and in fact very grateful for our help. Only they can't get that help if you come to work scared.

I'm not scared.

This is not an accusation, Doctor. I just want you to know that every psychiatrist goes through this at some point or another. And then it passes. And it'll pass for you, too.

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