Chicago Med · Season 1
How'd that metal detector thing turn out?
I changed my mind.
Really?
Yeah. I saw a woman today who almost killed her baby because she didn't trust us. And I thought "How can we encourage people to trust us more if we don't show them trust first?".
Couldn't agree more.
Why is Mr. Willis insisting on surgery? Despite my explicit recommendations to the contrary?
Dr. Latham, I...
Did you go behind my back?
No. He asked if he had options. So I told him. I, in no way, suggested...
[muttering in frustration] You've shown extremely poor decision-making today. From this point on, you are not to set foot in the O.R. until I deem you ready to return. Do you understand?
You're benching me?
For the foreseeable future. Yes.
Fearing for your baby's safety is the most natural thing in the world. When I was pregnant, I lost my husband. I was afraid of a lot of things. And then one day, after I had my son, I was up in a high-rise building on the balcony and suddenly had this vivid image of myself falling over the railing. And my first thought was what would happen to my son if I wasn't here for him? And the craziest part is my favorite thing in the world had always been Ferris wheels and roller coasters and being up in the air. But from that day on, I had this totally irrational fear of heights. It is really scary being solely responsible for that tiny, defenseless person inside of you. But you are letting your fear win. And it's gonna end badly.
Just a head's up: the board is gonna push you for more growth. The bottom line has them concerned.
When hasn't it? Can set my watch over their money worries. I'll be fine.
It's different this time. C-Suite feels we can better recognize how medicine and business are one and the same.
Ah, let me guess. Um, scale back on outreach, combine responsibilities, outsource. So, basically, sacrifice patient care? I won't do that, Peter.
Well, Sharon, you have to do something, because the ED is hemorrhaging cash, and if the bleeding doesn't stop, it is not gonna be good for anybody.
So, what are you thinking?
Schizophrenia.
Yeah, that was my initial thought, but now I'm not so sure.
Seriously? His, uh, paranoia that there's something living inside him, and his attempt to remove it, is literally a textbook definition of a somatic delusional disorder.
I'm stuck on the level of premeditation. You know, sterilization with Betadine, the clean incision, doing it near a hospital... all that kind of forethought, it's just not consistent with schizophrenic psychosis.
So he's a germaphobe with a steady hand. It doesn't mean he's not schizophrenic.
Mm, could be true, too.
So, um... start him on anti-psychotics and reassess when his mind's clear?
I'm just not there yet. My gut tells me it's chemical. You know, like maybe a methamphetamine overdose. Before we go any further, let's run a tox screen, see if he's just... high.
Hey, Nat, I was speaking with Eric; the drugs, he's self-medicating. Since he was a kid, he's gotten sick after eating protein. Myra was a vegan; avoided protein.
You're thinking that's what made her sick, too?
Last month, when Myra was feeling confused, she was fasting while studying.
Ketosis. Her body was starving, so it started digesting muscle as fuel, which released protein into her blood. Okay, well, that explains what made her sick last month, but what about today?
The fellowship.
She probably wasn't eating again.
I think this is OTC. A metabolic disorder fits.
You were right. The visits were connected.
A metabolic... disorder caused her death?
The precise term is "ornthine transcarbamylase deficiency", or OTC. You see, Myra's liver was missing a vital enzyme that helps break down protein.
Something as simple as eating a burger could cause toxic levels of ammonia to build up in her blood and attack her nervous system.
But Myra was a vegan.
Which is how she was able to avoid symptoms for so long, but when she pushed herself and didn't eat - finals, the fellowship - her body started breaking down muscle, which released protein into her blood.
So, you mean she'd be alive right now if she'd just... eaten?
If this disease is genetic, that means one of us gave it to her.
Yes. Um, it is passed through the X chromosome, from mother to child, but...
OTC sufferers exhibit totally normal liver function. That's why all of Myra's tests came back clean.
Yeah. We were only able to diagnose her once Eric explained his lethargy and sickness after eating. We believe he has the defect, as well, and has been self-medicating with drugs.
What happened back there... sometimes when people are grieving, they last out.
Yeah, no, that's... that's how my folks always are. Man, they-they-they think I'm, uh... I'm worthless. I don't know. May-maybe I am, but they think I want to be like this, and-and I really don't. Uh, you know, My-Myra, she was the only one who ever, like... like, really... like, like, saw me. You know?
Yeah.
And now it's...
What do you want, Eric?
I want to get clean. You know, I wanna, like, wake up and just feel clear.
Okay. We'll set you up with a social worker, get you in a program.
Was... seriously?
Yeah. You'll get the support you need, but it's up to you to come through.
Why are you doing this for me?
I guess I'm seeing that there's a difference between a crutch and a helping hand.
But you have to tell me.
And violate the sacred oath?
[laughing] It's not like you're guarding the Holy Grail. It's a holiday gift exchange.
That we call "Secret Santa", because we're supposed to keep it a secret.
Okay, so who is it? Is it April?
I'm not gonna tell you.
Fine. Don't tell me. But it's only a matter of time before you crack.
Not a chance.
I heard about Jack Kellogg. I am so sorry. It's exactly what you said would happen.
Uh, he was a very troubled man who brought things on himself.
Yes, but if he had been remanded to a psychiatric facility, like you wanted, uh... I-I-I just feel so awful.
Listen, Dr. Reese, if you're thinking that in some way this might've been your fault, it just wasn't. He was a very self-destructive guy, and there's just no guarantee the outcome would've been any different no matter where he ended up.
How's Shannon's husband?
Bruce Kim? Turns out he wasn't in Buffalo. He was in Aruba with another woman. Tested inconclusive for Zika.
What? Well, we have to tell Shannon.
We can't. Not without violating his confidentiality. He refuses to tell her.
That's ridiculous. I mean, if he was HIV positive, we could break confidentiality. Doesn't Zika get the same exemption?
No. Unfortunately, Zika's so new, there's no legal precedent.
But what if they have sex? What if he infects the fetus? I mean, you've seen babies with microcephaly.
Natalie, I have spent the last hour trying to find a way around HIPPA. I've got nothing. He'll come after the hospital, and my license, incidentally.
So you're just giving up?
There's nothing we can do. We can't justify breaking the law over an inconclusive test result.
[she sighs, and he sees the gears in her head turning]
I know what you're thinking. Don't do anything.
What did you do?
I made some calls. Since Zika's a public health emergency, the CDC has to investigate all inconclusive test results.
I'm impressed.
Natalie, back there, were you gonna...?
Let's just say it is a good thing you showed up when you did.
So, uh... yeah, things got a little... out of hand today, and, um... you know, if the offer's still good, I was thinking that... maybe I could use a few days off.
The offer's still good.
Okay. Thank you.
You're welcome.
[he turns to leave]
Don't stay away too long. We need you here.
Tough day?
We billed $16,000 to a family of a man who died in the waiting room. I managed to quash it, but... the system's broken, Daniel.
Well... don't know anybody better with a glue gun than you.
Wait a minute, she won't consent to being tested because she'd rather die than have her family find out she has AIDS, and you're saying she's capable of making rational decisions.
Just because you don't like the decision she's making doesn't mean she's incapable of making it.
We know she has AIDS. She knows she has AIDS. Her aunt must know on some level, this isn't the flu.
Yeah, but there's a difference between knowing something and saying it out loud. You say it out loud, and it's real.
These quotes come from Wikiquote's Chicago Med pages and are available under the Creative Commons Attribution-ShareAlike License.
