Previously on ER: Susan let Luka know that it wasn't necessary to "boff [a] patient's mother in the storage closet." Elizabeth told Romano she was sorry, and Romano asked if he was sorry about her arm or sorry that she wasn't there. Weaver made Abby the nurse manager whether she liked it or not, which doesn't quite seem legal, but whatever. I also wanted to note that all of my medical knowledge comes from watching this show, so that means I don't know much, and you'll see a lot of lines like, "Kerry orders some drugs" or "Luka orders some procedure." I'm sure that the very knowledgeable people on the forums can help you out if you need more specific information than that.
Elizabeth conducts surgical rounds with her medical students, one of who is in that commercial I hate about the lawyer with the MasterCard who is going to use his cash-back bonus to buy an engagement ring someday. Anyway. Elizabeth is peppering them with questions about symptoms, none of which they can answer. It's 5:07 PM on Halloween. Elizabeth resorts to giving them the first letters of the answers for which she is searching. When they guess "neck" and "navel" instead of the correct answer -- "nail bed" -- she sighs in frustration and tells them to go home, and return for rounds the morning at 7 AM. She murmurs to herself, "So much for the future of medicine," because she was apparently never a clueless medical student. She announces that she's going trick-or-treating, and that Ella is going to be a cow. A nurse asks if Ella was a cow last year, and Elizabeth says that Ella was Dorothy, she was the Cowardly Lion, and Mark was...she pauses here, realizing that Mark isn't around anymore. Come on, what was Mark? A flying monkey? A member of the Lollipop Guild? Toto? No, apparently Mark was the scarecrow, which is kind of funny considering that the scarecrow lacked a brain and Mark died of a brain tumor. The nurse is like, "Sorry I asked." Elizabeth says she's going to be a farmer this year. A nurse stops Elizabeth on her way out and says that her medical student -- the one who didn't show up today -- called. His name is Nathan, and he'll be there in a few minutes to speak to her. Elizabeth says that it's too late. The nurse says that Romano also wants to speak with her. Elizabeth wants the nurse to tell Romano that she couldn't be found, but the nurse is holding a phone, and Romano's on the line. He yells, "I heard that!" The nurse hands Elizabeth the phone.
A skeleton walks into the ER. Seems like it's a little too late for him to be seeking out treatment. Okay, it's actually just Carter in a skeleton costume, and everyone teases him. He finds Abby, who is dressed in an old school nurse's outfit, complete with white dress, little hat, and white pumps. Carter thought everybody was getting dressed up today, and Abby says that they were supposed to. Carter is pissed that Abby didn't call and warn him that no one else came in costume, and Abby says then she would have been the only one in costume. Carter pulls on a lab coat and asks Frank where his costume is. Frank says he doesn't "observe Pagan holidays that celebrate devil worship." Abby grabs a bowl of candy from him, saying that it's only for Satanists. Carter smirks at Abby and tells her that the costume is "kind of working for [her]." I think he means that it's working for him. Abby giggles and tells him to shut up.
Chuny and Luka come down the hallway. Chuny is whining (and I usually like Chuny, but she's totally whining) that if Luka gives her an order she thinks is wrong, she'll ask him to clarify. Luka says, "Not in front of the patient." Chuny says that he's screwed up dosages before, and Luka yells, "I have not!" Then Chuny yells, "Nanny nanny boo boo!" and Luka retorts, "I am rubber, you are glue!" Carter asks if there's a problem. Luka tells Carter that he has no guts, which is not even a good joke, despite its double meaning. Chuny says that she won't work with Luka because he treats nurses like idiots. Luka yells after her, "If your boots fit..." Abby corrects him, saying that it should be, "If the shoe fits." Luka lasciviously asks if Abby is really wearing that outfit for her shift. Abby reminds him that it's Halloween, and that Jerry sent out a memo about wearing costumes. Knowing Jerry, it was probably all an elaborate joke that will completely backfire. Susan walks in and coos, "Ooh, naughty nurse!" Abby denies that she's a naughty nurse; she claims that she's an old-fashioned nurse. Maybe she should button up one more button on the top half of her uniform, then. Frank says that it looks naughty to him. Shut up, Frank. Luka asks if she's a kurva nurse (and I'm just going by the captioning for the spelling since I don't know Croatian). Abby asks what it means, and Luka says that it's a "a slut. You know, like a tramp, a whore." When did Luka turn into such a lecher? Abby says that maybe she should've worn the schoolgirl outfit that Luka bought her, and walks away. Luka chuckles and turns to find Frank and Susan staring at him. He tries to tell them that Abby was joking.
Cut to Romano in the operating room. What, he's operating already? One-handed? Elizabeth walks into the room and asks what he's doing. Romano tells her the name of the operation; when Elizabeth expresses shock, he adds that "this poor swine was full of stones." Just when you think it's just Romano being insensitive about patients again, Elizabeth walks over to the table and realizes that Romano is operating on a pig. This whole scene is so dumb, and maybe it's supposed to be a homage of sorts to the time that Romano operated on his dog, but I just can't see County General letting Romano use up valuable, expensive resources to operate on a pig. Like, we get that Romano wants to get back to doing surgery by whatever means necessary, and I don't know that the pig was needed to make that point. Romano claims that he needs to keep up his skills, and that he's a better surgeon one-handed "than the rest of the hacks in this hospital." Elizabeth reminds him that he's not cleared to do surgery, "even on barn animals." Okay, so I guess County doesn't know about it, but it's still dumb. Romano changes the subject by asking whether Elizabeth knew that Kerry put forth a proposal to let PAs do post-surgical rounds. Elizabeth thinks it's a good idea. Romano says the point is that no one ran it by him, and that he's still the head of both surgery and the hospital. Elizabeth starts to say something else, but Romano interrupts by exclaiming over the size of the pig's gallbladder, which he has just removed. I freaking love Romano. He continues, "Look, I know Weaver's been forming alliances with some of the tribal elders while I was recuperating, but I would have expected a little bit more loyalty from you, Lizzie. Just rewrite the proposal as if it were generated from us and keep me abreast of any other covert Weaver ops, okay? The last thing I need is Mata Hari leading another palace coup." During this last part, Elizabeth notices that the pig's tail is moving, and then it starts squealing. Apparently, the anesthetic has worn off. Romano, Elizabeth, and the rest of the surgical team struggle to restrain the pig. Now there's a sentence I never thought I would write in an ER recap.
7:06 PM. In the darkest office ever, Romano gets the range of motion tested on his arm. His elbow is up to ninety degrees. Romano murmurs that he's not worried about his elbow. The doctor measures his wrist, and says that it can flex ten degrees. Romano insists that the doctor's calculation is wrong, and makes the doctor check it again. The doctor does, and comes up with ten again. Romano says that it was fifteen last week. The doctor tells him that fluctuations are normal, and that Romano's got to give himself at least nine months to recover. The doctor starts to help Romano to put his arm brace back on, but Romano grabs it and puts it on himself. I thought that was a nice, subtle indication of Romano's attitude -- much better than having him operate on a pig. Romano asks how it affects his odds. The doctor deflects the question, but Romano insists on an answer. The doctor tells him that the odds for "full flexion, extension, and opposition of the digits" are 20%. Romano looks up, shocked at the low number. The doctor continues, "But even then, without radial and ulnar deviation of the thumb, I'm not sure you'll be able to operate." Romano looks crushed. The doctor reminds Romano that he can still be Chief of Staff, and that most of his job is administrative anyway. Romano is now wearing his robot arm brace -- which is super-cool -- and he says, "Thanks for the pep talk, there, Marty!" and extends his middle finger. Despite his chipper Romano-esque brusqueness, his eyes look sad.
Don Cheadle walks into Surgery, looking for Elizabeth. Romano asks if he's a bill collector or a suitor, and Don Cheadle explains that he's a medical student who was supposed to start his surgical rotation today. Ah, so he's the mysterious Nathan. Romano notes that Nathan is a little old to be a med student, and Nathan says that it's a career change. They get into the elevator. Nathan asks about Romano's arm, and he claims that it's tennis elbow.
A paramedic helps Susan and Abby wheel in a patient. The paramedic explains that there was a fire at a Halloween party, and that there are at least thirty victims. The victim on the gurney is a Jane Doe, a young woman who has burns over much of her body. Abby asks how she's doing, and the woman gasps, "Not...good." Susan gets a first name (Amy), but not a last name. Amy says there was a fire at the party downstairs. Susan asks if Amy has anyone with her, and the paramedic says that the whole building was on fire and that there was a great deal of confusion. Nathan lurks outside, watching. Abby notes that Amy has soot in her nostrils and intraoral burns. Susan tells her to get an intubation tray, and to get Corday to look at the crushed pelvis. Nathan tries to ask Susan where Elizabeth is, but Susan brushes him off.
Another paramedic wheels in a man dressed as a woman and gives Susan the bullet. It's Ed Jemena, age thirty-five, and he has "full thickness burns to the hands and forearms." Ed says that a guy was on fire, and that he tried to put it out with his hands. Susan asks Luka to take over. Luka asks Chuny for a trauma room, and Chuny snots that he's lucky to get a bed.
Susan finally gets back to Nathan. After determining that he's a medical student, she hands off a chart for a guy with "cellulitis of the leg after a bug bite to the ankle." Bug Bite Guy is in the same room as Ed Jemena. Nathan asks what he should do, and Susan tells him to trace the leading edge of the rash with a marker so that they can see if it's spreading. She tosses a marker to him, which falls to the floor, and adds, "Nice catch." Man, is she going to feel like an asshole later.
Carter wades through the hallway, trying to reach the Admit desk. Waiting patients holler questions after him, and he tells them that they have to wait in chairs, because if a doctor or nurse can't find them, it could cause a delay in their treatment. Shouldn't all of their new security measures be helping out here? A woman wants to know what's happened to her things, because her apartment was on the fourth floor and the fire was on the second. I don't know why she thinks Carter would have any freaking clue -- ask a fireman, lady! Another woman wants to know whether they'll be allowed to go home after leaving the hospital, and whether anyone knows how the fire started. Again, those would be questions for the fire department, not Carter. Someone calls Carter away, and he takes off. Some old homophobe claims that the fire was started because "the fruits upstairs were smoking dope." A guy dressed as a gladiator denies that anyone was smoking anything.
Nathan traces the edge of the rash with a marker as instructed. Bug Bite Guy asks what it's for. Nathan explains that it's to keep an eye on the infection. His girlfriend, Not Martha Plimpton, asks what drugs they're administering; Nathan checks the IV bag and says that it's an antibiotic to stop the infection. Luka calls over and asks if Nathan is a doctor. Nathan says that he's a med student. Luka orders Nathan to roll over the Mayo stand for Ed's hands. Nathan does, and Luka just leaves, despite Nathan's protests. Ed asks what the doctors are going to do, and Nathan says they'll make him better. Ed asks why he can't feel his hands, and Nathan explains that the burns damaged his hands. Ed asks if it's permanent, and Nathan admits that he doesn't know.
Pratt and Corday work on a guy who keeps asking for his partner, Terry, who is dressed like a jungle girl. Romano wanders in and asks what's going on. Elizabeth explains that a rubber mask melted onto the guy's face, and they can barely open his mouth in order to intubate. Romano thought Elizabeth already left. Elizabeth says that she's supposed to be trick-or-treating. Romano affectionately says that she's a little old for that, but Elizabeth is too busy trying to intubate to respond to his flirtations, so Romano makes himself useful by picking up a crike tray. He tries to open it and fails, so he starts to bring it over to the table, ordering them not to open it unless the intubation fails. When he turns, Lily is walking by, and she bumps into his bad arm. Romano screams in pain as Lily apologizes all over the place. Pratt continues to run the medical procedures as Elizabeth repeatedly asks Romano if he's okay. Romano tamps the pain deep down inside with the rest of his tender emotions and says tightly that he's okay, and that as long as Elizabeth has it under control, he's going to check on everyone else.
Romano walks out into the hall, his mouth still a grim line. He comes up on Chen, who is treating a victim of smoke inhalation, and gets the bullet from her. Chen says that the guy may needs a chest tube. Romano asks the patient's vitals and Chen lightly says that she's got it under control. Romano spits, "Yeah, I'm sure you do. Get a chest x-ray and show it to me." Chen looks after him like, "What's his problem?" but hello? It's Romano. Even if he didn't just suffer an excruciatingly painful blow to the arm, do you expect him to be nice and pleasant? Romano walks into another exam room, where he finds Luka doing something to Ed's hands that looks really painful. I think it involves slicing them open with a scalpel or something and I just don't need to know any more about that procedure. Romano observes for a moment and, after Luka confirms what he's doing and says that the left hand needs the same, just adds, "I agree." Poor Romano. No one needs him. I need him! The viewers need Romano!
Carter works on Amy Doe, who has been intubated. He asks Abby how old she thinks Amy is. Abby gently unfolds Amy's hand and pulls out a peace sign necklace, at which she replies, "Young." Carter calls out to Elizabeth, who asks what they have. Abby says that Amy's urine is "sixty an hour, but it's bloody." Carter adds that she has 80% burns, and that she's going to need twelve liters in the first eight hours. Elizabeth orders a CT, abdomen and pelvis, because she still needs to get an airway on Melted Mask Man. Nathan walks in and introduces himself to Elizabeth, who walks away dismissively. Carter tells Nathan that Elizabeth has a critical patient door. Nathan nods and asks where he should put the supplies that he's carrying. Abby points out the right place, and Nathan puts them down.
Nathan walks door, where Elizabeth and Pratt are prepping for an intubation on Melted Mask Man. Elizabeth reminds Nathan that rounds started at 7 AM. Nathan starts to explain, but Elizabeth says that she's not interested in excuses. Nathan asks if Elizabeth got his letter. Before she can respond, Frank pokes his head in and tells Elizabeth that her nanny is on the phone. Elizabeth tells Frank to take a message. Frank says that the nanny wanted him to remind Elizabeth that she has to catch a flight at 10:30 PM. Elizabeth snarks that she can't leave now, and tells Frank to have the nanny bring Ella to the hospital. Frank reminds Elizabeth that the daycare is closed, and Elizabeth yells, "I know!" The patient is a drama queen who chooses the moment to start throwing PVCs, and Pratt recommends that they crike him. Nathan asks if he can do anything, and Elizabeth tells him that he can be quiet. Nathan and Pratt exchange looks. Elizabeth tells him that if he wants to make it up, he can go out and work up patients. Nathan offers up some feeble protests, but he is no match for Elizabeth the Shrew Who is Having Child-Care Issues Because of Her Dead Husband.
Nathan walks out of the trauma room and takes some medication. Not Martha Plimpton yells to Nathan that Bug Bite Guy's x-rays are back. Nathan asks how Bug Bite Guy is doing, and Not Martha Plimpton says that he's doing better than most, so you know he's about to crash or die or something. Nathan checks out the x-rays as Bug Bite Guys says that he'll wear long pants and bug repellent the time he goes hiking. After seeing what happens to him, I'm just never going hiking again. Nathan tells Bug Bite Guy that his infection is spreading. Bug Bite Guy asks what that means. Nathan finds Romano nearby and asks him to take a look at Bug Bite Guy. Nathan says that it's "a rapidly spreading cellulitis." He shows Romano the line he drew twenty minutes earlier, and points out "some sub-q air consistent with nec fash" on the x-ray. Romano says that it's a nice catch, and prepares to take Bug Bite Guy up to surgery. Not Martha Plimpton is all confused, as is Susan. Romano tells out to Susan, "Newbie caught a nec fash." Susan explains to Not Martha Plimpton (and the rest of us) that Bug Bite Guy may have "necrotizing fasciitis," which is "a virulent skin infection." It's also commonly referred to in the media as flesh-eating bacteria. Not Martha Plimpton asks why the antibiotics aren't helping, and Susan says that the infection is spreading too fast. Bug Bite Guy asks Romano what they are going to do. Romano rolls him into the elevator and says that they're going to remove the infected tissue; he then orders everyone off the elevator. Romano explains that if they don't remove the infected tissue, Bug Bite Guy could develop an overwhelming infection that would lower his blood pressure, and that he could die. The elevator doors close. Nathan asks Susan if she thinks they caught that in time. Susan hopes so, and introduces herself. Nathan shakes her hand with his left. Susan asks if he's coming. Nathan says it'll be a minute because sometimes it takes him a while to get going. He adds, "I have Parkinson's Disease." Susan looks at him like, "Man, am I regretting that 'Nice catch!' remark right now."
8:07 PM. On speakerphone, Romano yells at Elizabeth to get up to surgery. Elizabeth yells back that she'll be there as quickly as she can, and that she's with a critical patient. Romano yells at her to find someone else now. Melted Mask Man has apparently stabilized, and Elizabeth tells Carter to run some additional tests and find him a burn-unit bed. Carter asks, "What about him?" and gestures to Nathan. Elizabeth says, "Yeah, what about him," and brushes past Nathan on her way out. Nathan hurries after her and gives her some test results for Melted Mask Man; he then asks whether she's headed up to surgery on the nec fash. Elizabeth says that she is. Nathan guesses that he can go home, then. Elizabeth says that she's done, but that he still owes eight hours. Nathan says that he's on rounds at 6 AM, but Elizabeth tells him, as she gets in the elevator, "Welcome to Surgery." The elevator doors close, and Nathan gives a tired sigh, then stretches his jaw muscles.
The other elevator doors open, and Terry (Melted Mask Man's partner) walks out. He tells Nathan that he's looking for someone who was brought in, and Nathan tells him to go to Admit. Terry looks confused, so Nathan offers to show him. Nathan asks who he's looking for, and Terry says he's looking for Melted Mask Man. Things are still very busy at Admit, where a nun asks Pratt to be directed to the victims of the fire. Pratt says, "Keep your habit on, my man. You'll get to be with your drag queen friends soon enough." The nun explains that she has food and housing vouchers for the displaced. Pratt apologizes. Nathan gets Pratt's attention and explains that Terry is with Melted Mask Man. Pratt gives a disgusted sigh. Could it be any more predictable that Pratt is a homophobe? Wouldn't it have been more interesting to have Gallant, or Luka, or someone who the audience doesn't already hate, exhibit homophobic tendencies?
Up in surgery, Romano observes Edson operating on Bug Bite Boy. Romano asks for some oil of wintergreen to mask the smell of rotting flesh, and then orders Edson to start cutting faster to stay ahead of the infection. Romano observes that the infection is in the muscle, and proceeds to backseat-operate. When Edson makes an incision that is too long for Romano's liking, he asks for Elizabeth, who is scrubbing up. Romano thinks she might be able to "debride this guy's wound without using a chainsaw." In the scrub room, Elizabeth calls her nanny and asks if the nanny can take Ella to her house while she finishes packing; Elizabeth promises to be home in an hour. Romano knocks on the window and makes angry gestures. Elizabeth settles things with the nanny while she scrubs up, and then drops her wedding ring down the drain. She tries not to panic as she asks a nurse to call Engineering. Dude, just tape off the drain and then remove the trap later to get the ring. Unless hospital have special non-trap pipes or something, it's not that difficult. Who has never dropped an earring or something down a sink drain? A nurse puts Romano on speakerphone, and he yells, "Lizzie, get your ass in here." Elizabeth explains that she's lost her wedding ring, and Romano replies, "Oh, boo hoo! This guy's about to lose a leg! I'd say chop chop, but that would be in extremely bad taste." I love Romano. Elizabeth asks a nurse to tape off the drain, and then screams at Romano that she's on her way in.
Pratt explains to Terry that Melted Mask Man has 20% surface burns, mainly on his upper body. Pratt says that they can provide ventilation support until his lungs heal, and then extubate in a week or less. Terry asks about Melted Mask Man's face. Pratt says that he'll need grafts, and that there will definitely be some scarring. Terry starts crying. Nathan looks on compassionately. Terry tells his partner that he's right there. Pratt says that Melted Mask Man can't hear him because he's sedated. Nathan tells Terry that he should have his eye looked at. Terry promises to do so later, and then asks if he can touch his partner. Pratt spits, "I wouldn't," and then calls Nathan to follow him out. Once (barely) outside, Pratt orders Nathan to "check jungle perv's eye with a slit lamp," because "he may have a corneal burn." Nathan asks Abby what a slit lamp is and how it works. Abby says that it's in Exam Three, and that he should try to the on/off switch. Abby notices Carter walking by with scrub pants on, and scolds him for removing his costume. Abby says that her outfit bugs her, too, but that they agreed to stay in costume all day. Carter claims that he's still in costume, but Abby says that it's only half a costume, so it's "like 50% commitment." Carter asks if she's serious, and reminds her of the ribbing (har har) he's been taking all day. Abby reminds him that she's wearing pumps. Carter pulls down his scrubs to reveal the rest of his costume and calls out, "I'm a skeleton! Look at me! Rrrrr!" That cracked me up for some reason.
Luka helps to roll a gurney down the hallway as he comments, "Carter really likes Halloween." Doris gives the bullet: "Perpetual erection. Accidentally drank his daughter's mandrake smoothie. Police found him chasing women down the street." Is this supposed to be a metaphor for Luka's current problem? Or is it just another wacky ER patient? On the gurney, an old man with a...well, perpetual erection bounces and grunts. Abby says that Curtain Three is open, and the patient asks if she's open. Luka chuckles as he orders some tests. Abby and Chuny struggle to get the guy's pants down and get him into restraints as he yells out that he's the Marquis de Sade. Chuny asks how she's supposed to pass a catheter, and Luka tells her to inject phenylephrine. Abby asks, "Into the shaft?" The guy yells that he's Rod Stewart. Chuny doesn't think the guy will sit still long enough for a blood draw, much less let her touch his penis. The patient says that Abby can touch his penis. Chuny and Luka argue over the proper course of treatment until the patient grabs Chuny's ass. Luka repeats his drug order and Chuny says that Abby can handle it because she's done; she walks out. Abby tells Luka that he could be a little more sensitive. Luka's all, "What?" The patient starts singing, "Do Ya Think I'm Sexy" and Abby disgustedly pushes his face away from her.
Up in Surgery, Elizabeth comments on how fast the infection spreads. Edson asks how he got it, and Romano says that it could have been a cut or a scratch. Romano tells Elizabeth to take it easy. Elizabeth asks if it's just her, or if the constant commentary is "rather distracting." Edson says it's not just her. Romano says that they should just remove the infected tissue and let antibiotics and hyperbaric oxygen therapy do the rest. Elizabeth is shocked at the order, because his tissues are "necrotic soup." Mmm, soup. Romano says that his way will "give the guy a chance of a functioning leg." Ah, so Romano is taking it personally. Of course.
At Admit, the workers gossip about Nathan. Pratt wonders how he got into medical school, and Frank opines that there's a disability quota. Shut up, Frank. I have a stupid racist desk clerk quota, and you just exceeded it. Abby wonders how Nathan expects to practice, and Frank says that he wouldn't want Nathan taking out his appendix; Frank then demonstrates that it takes a very steady hand. Susan thinks Nathan has it under control. Luka reminds her that Parkinson's is a progressive disease, and wonders what Nathan will be like in ten years. Pratt says, "Could be dead." Abby adds, "Or want to be." Susan notes how "happy Abby" always looks on the bright side.
Frank sees Weaver walk in, and says that he thought she was out sick. Or directing the episode. Weaver says that she came in to help out with the apartment-fire patients. Susan thanks her for coming in, and Weaver snarks that she shouldn't have answered her phone. Frank offers her messages, but she snaps at him and then yells that she wants the air conditioning turned on because it's hot in there. Luka notes that it's freezing in there. Frank says that Halloween is the "biggest holiday of the year for her kind." Pratt asks, "Lesbians?" Frank meant Wiccans, and adds that Weaver is "probably riding that crutch around like a broom." Frank, didn't I already tell you to shut up? Pratt says that all women get like that when they're going through The Change. Susan is shocked that Pratt would make such a sexist remark. Is she new? Has she met Frank? Pratt says that Weaver is having hot flashes and that she's moody. Susan says that Weaver's too young, and Pratt says that it's early onset. Abby retorts, "You've got early onset." That was a terrible comeback in an episode full of terrible comebacks. Pratt checks out Abby's ass and says, "Whatever you say, Nasty Ratched." Abby says, "It's nurse, okay? Not nasty, not naughty, not wet, and certainly not head. Just nurse." Despite her protestations that she's not "head" nurse (heh), Abby then agrees to talk to Luka on Chuny's behalf. Abby answers the radio as Nathan walks up and reports that he finished with the slit lamp. Weaver asks who Nathan is, and Pratt fills her in. Nathan explains that he's making up time for Elizabeth. Abby announces that they have to clear trauma for a "BOA with newborn hypoxia." Weaver doesn't really care what Nathan has to say, and orders him to follow her. Abby pulls on a sweater over her costume and assures Nathan that Weaver "doesn't bite...much."
Outside, Abby and Weaver get the bullet from the paramedic: "Simone Phipps, forty-two, had a home birth. Newborn in respiratory distress." Weaver asks Simone if she had complications, and Simone says that she didn't even tear. The midwife walks out of the ambulance holding the baby. Simone asks what's wrong with her baby, and Weaver promises to find out, then orders someone to take the baby to Trauma One. The midwife hands the baby off to Nathan, and Abby immediately steps in and grabs the baby away. Nathan tries to resist, but Abby's not having it. I was kind of hoping for the return of Rex the Wonder Preemie, but no such luck.
Inside, Weaver tells Simone that she's lost a lot of blood. Simone keeps asking what's wrong with her baby, and worries that she should have had him in a hospital. The midwife assures Simone that she did everything right. Gallant gives the vitals. Hey, Gallant! Kerry orders them to squeeze in another two liters of blood. Gallant explains to Simone that she's losing a lot of blood due to a retained placenta. Kerry promises that Luka is taking good care of the baby, and says she needs Simone to focus.
door, Luka orders up a pedes intubation tray. Nathan listens to the lungs and reports wet crackles throughout. Luka says that there is fluid in the alveoli. Luka intubates while explaining the procedure to Nathan. Abby tells Nathan how to bag the baby in order to help out with breathing. Luka intubates. Nathan tries to put the bag onto the tube, but his hands are shaking too hard. Luka orders up a pedes vent. Abby watches as Luka helps Nathan make the connection while telling him kindly to relax because the hard part is over. Nathan squeezes the bag. Luka tells Abby to notify the NICU team. Abby asks what she should tell them is wrong, and Luka admits that he has no idea.
Back in Surgery, Elizabeth says that it's no good, and that they are into the quads. Romano tells them to keep debriding. Elizabeth says that if they treat this conservatively and it spreads, they'll have to do a hip disarticulation. Romano thinks it's worth the risk. Elizabeth asks, "Of his being non-ambulatory?" Edson adds that with an above-the-knee amputation, the patient can use a prosthetic. Elizabeth says that if the infection gets into his hip, it will spread to the abdominal wall and he'll get septic. Romano says he's trying to save the man's leg. Edson asks, "What about his life?" Romano snaps, "He's young. It's the same thing." Elizabeth thinks that's ridiculous, and points out that it's "a hopeless wound." Romano looks down sadly and quickly orders Elizabeth to take the leg. On his way out, Romano commits the hallmark act of someone who is Taking! It! Personally! By angrily knocking some equipment down.
9:09 PM. Nathan -- who is having a lot more trouble walking and standing steadily than he was earlier -- tells a young patient that he can go home. As Nathan walks away, the young patient loudly asks his dad what's wrong with Nathan, and the dad says that they'll talk about it later. Abby -- who has changed into sneakers instead of pumps -- overhears the exchange. She follows Nathan, and finds him sitting on a bench, jerking and listing sideways. She asks if he needs anything, and he tells her that "the robot" can go home. I have to assume he's referring to a patient's Halloween costume, unless they are actually treating a robot, which would be kind of cool. Abby offers to get him a cup of coffee, and he quickly declines, but then adds that he likes her costume because it's "retro." Abby thanks him, and then says if he ever needs anything...she lets the offer hang there. Nathan quips, "Like a straitjacket?" Abby chuckles, and then asks if his dyskinesia is usually this bad. Nathan says that he doesn't want to freeze up at work, so he ups the medication, and then the dyskinesia gets worse. He adds that it dispels the myth. Abby looks at him questioningly and he adds, "We don't all have rhythm." I understand the intent of joking about his situation from a storyline standpoint, but couldn't they have made Nathan a little funnier? ER needs a script doctor. Stat! Abby says that if she were in Nathan's shoes, she would go on a world cruise, not go to med school. Nathan stands up and walks with Abby down the hallway as he says that he's already seen the world; he was in Italy when he first noticed the symptoms of his disease, but he thought it was from "living on espresso and martinis." Abby asks how he found out that wasn't the case. Nathan says he hated doctors, so it took a while for him to find out, but that once he was diagnosed, it put things in perspective. Abby says that being sick does that. They both stop as they reach the Simone's room. Nathan says that Simone's baby isn't doing well, and Abby confirms it.
Abby asks Simone how she's doing, and Simone dreamily says that she thinks her baby is doing better. Abby tells Luka about the maintenance fluids being administered to the baby. Simone says that her own mother gave birth to Simone at home, so she thought it would be good for her baby. Luka interrupts to say gently that the tests came back, and that the baby has a disease called sialidosis. Simone asks what that means. Luka sits down, glances at Nathan, and says that the baby's body lacks an enzyme that breaks down waste products from the cells, and that there is already extensive damage to the liver, bones, and nervous system. Simone gasps and says slowly that she's been staring at her baby for over an hour now, and she still can't figure out what to call him. Luka notices that Nathan is jerking around, and asks him to leave. Nathan walks out. Luka tells Simone that children with sialidosis are mentally retarded and often blind. The baby will never speak or walk, and his life expectancy is less than two years. A nurse comes in to tell Luka that the NICU is on line one. Luka excuses himself. Abby takes off her costume hat and asks Simone gently if there's anyone she can call. Simone says quietly that it's just her and her baby.
Abby finds Luka talking on the phone. She asks if he's having a bad night, and he says it's no worse than usual. Abby says, "That was a little bit insensitive, don't you think?" Luka says that he had to tell a mother that her baby was going to die, and that he didn't need an audience. Abby's all, "Oookay." She says that she's starting to get complaints about him. Luka asks if they are from patients. Abby says they are from nurses. Luka walks away silently. Abby tells him sarcastically not to look so concerned, and says that first he called Chuny an idiot and then later when Abby herself was sexually harassed... Luka interrupts to scoff at calling what happened with the permanent-erection guy "sexual harassment." Abby says that it was, and Luka says that the guy was harmless. Haleh stalks by and hands off a chart to Abby, saying that the guy with the boner grabbed her boob. Abby asks what the patient's status is. Haleh replies, "He's going to die if he tries that again: that's his status." Abby points out to Luka that all of the nurses complain to her. Luka says that complaining is part of their jobs, and that everyone does it. Abby says that it's part of her job as Nurse Manager to counsel him. Luka starts to walk away. Abby tells him that he can give nurses orders, but that he can't critique their work, and that if he has a problem with a nurse, he has to come to Abby. Luka asks whom he complains to if he has a problem with Abby. Abby suggests that he try fighting for the nurses instead of with them. Luka leers that Abby should sew some swastikas on her costume and be "a naughty Nazi nurse." Abby tells him that he totally sucks. Luka yells after her that she's creating a hostile work environment. Ugh. This Luka storyline is what totally sucks. I can buy that he bought that car and started having one-night stands. I can't buy that he turned into an asshole. I understand that he was in danger of turning into Saint Luka and the writers had to do something to humanize him a bit more, but is this the best they could do? Naughty Nazi nurse? Girl, please.
Nathan asks Kerry where Luka is, because the baby with sialidosis has spiked a fever. Kerry yells over to ask Chuny where Luka is, and Chuny says that she's doesn't know and doesn't care. Kerry and Nathan run out. As they enter the trauma room, Simone says that the baby feels like he's on fire. Kerry asks why the baby hasn't gone up to the NICU. Chuny says that they'd have to ask Luka. Simone begs them to do something for her baby. Kerry listens to the baby's lungs and orders up some drugs. Chuny reminds her that the baby has sialidosis, and Kerry says that he also has an infection. Kerry tells Simone that she'll make arrangements for the baby to be sent to the neonatal unit, and that they'll do everything they can for him.
Romano sits in his darkened office, sulking. Elizabeth walks in and doesn't see him, so she starts to make a phone call. She notices him and asks why he's still there. He snarks that his piano recital was cancelled. Elizabeth tells her nanny that she's on the way home, and hangs up. She tells Romano that he did the right thing. Romano asks if she's trying to convince him or convince herself. Elizabeth says that she went through a period of adjustment after having Ella, and every time she had to treat a child, but that she got over it. Romano spits, "Spare me the two-dollar psychoanalysis, Lizzie." Elizabeth starts to leave. Romano stops her and says, "I know most people don't like me. I don't care. I don't like most people. But I'm good at what I do. I save people's lives. Every day. People who no one else can help. If I can't do that..." Romano chokes up. Elizabeth walks over and kneels in front of him. She says that she knows he's frustrated, but that he's an excellent surgeon, and she promises that he will be again. Romano looks at her, then reaches out with his good hand and strokes her cheek. Elizabeth kind of recoils and says that she's being paged. Romano sleepily says, "Elizabeth?" She runs out of the room, then stops in the hallway and thinks about how her loins are burning for Romano. That might just be my interpretation. I love Romano, and I used to like Elizabeth before she got involved with Mark. I don't know that I want the two of them to get involved, but at least we'd get to see more facets of Romano's character, since I think he's the most interesting character the show has these days. Plus, Paul McCrane is the best actor on the show.
Elizabeth's nanny walks into the ER with Ella (in costume) in tow. She hands off Ella and says that she has to go to the airport now. Elizabeth asks if there's a later flight, and the nanny says that this is the later flight. I thought Elizabeth was just leaving anyway. Elizabeth thanks the nanny, and the nanny leaves. Elizabeth brings Ella into Amy Doe's trauma room, where Abby and Carter are working on Amy Doe, because her blood pressure dropped. Too late, Elizabeth shields Ella's face from the horror that is Amy Doe. Lily takes Ella out of the room. Abby says that they haven't found any family yet. Elizabeth asks if it's hemorrhagic. Carter thinks it's hypoxia, but that if they don't find any family soon, they're just going to be IDing the body. Elizabeth says that Amy needs suctioning, so Abby goes door to find the proper equipment.
Simone's baby is door. Abby asks Nathan where Simone went, and Nathan says that she's in the washroom. Is he Canadian? Luka walks in and asks Chuny what she's doing. Chuny says that Weaver ordered antibiotics. Luka is pissed because it's his patient. Nathan explains that the baby spiked a fever; Luka says that the baby is in "a chronic vegetative state," and that they're just prolonging the suffering of both baby and mother. Chuny argues that they still treat kids like that. Luka says that they should have asked him. Nathan says that they couldn't find him. Luka reminds Nathan that this is not his case. Abby warns, "Luka," but has to leave because Elizabeth is shrilling for her.
Abby returns with the supplies. Elizabeth wants to know what was going on door, but Abby doesn't answer. Carter tries to get Nathan involved in the case. Chuny bursts in and says that she's filing a grievance against Luka. Abby tells her, "Not now" and comments that Amy needs a fresh IV. Nathan offers to get it. Haleh runs in with some test results, and Elizabeth orders more drugs. Nathan can't spike the IV due to his shaking hands. He ends up puncturing the bag. Elizabeth yells at him, but Abby says that it's okay. Elizabeth tells Nathan to go and see if Frank has found Amy's family. Nathan says that he'll start another IV, and asks where the saline is. Elizabeth tells him to find the girl's family, and prepares to shock Amy's heart. Abby thinks that Elizabeth was being a little hard on Nathan. Elizabeth asks what she's talking about. Abby thinks that Nathan is doing a pretty good job, considering. Elizabeth still doesn't get it, so Abby tells her that Nathan has Parkinson's. I refuse to believe that someone besides Nathan wouldn't have informed Elizabeth of that. It just seems like having a student with Parkinson's Disease doing a surgery rotation is just a lawsuit waiting to happen, and that some lawyer somewhere would have made sure Elizabeth knew exactly what procedures Nathan was cleared to do before he walked in the door.
10:09 PM. Carter does chest compressions on Amy Doe. Elizabeth shocks her again, with no change. Elizabeth asks how long it's been, and Abby says that it's been twelve minutes. Elizabeth shocks her again, and they get a sinus rhythm. Carter reports that there's a good femoral pulse. Elizabeth gives some orders and leaves.
Chuny walks by Luka and throws the baby's labs at him. He sarcastically calls after her, "Thank you!" Abby walks in and says she's glad to see that they've made up. Luka claims that he's being professional, and that Chuny is the one having trouble even though he warned her. Abby wonders what he warned her about. Luka doesn't answer and Abby realizes that Luka slept with Chuny. She asks what his problem is. Luka says it was only one time. Abby says it was one time with Chuny and one time with that patient's mom. Luka says that Abby never complained, and Abby says that she never let it affect her work and that Luka and Chuny need to figure it out. Luka asks what she wants him to do, and Abby says that she doesn't know. She adds that maybe he should tell Chuny he's sorry, or that he was wrong, but that he just needs to fix it. Luka sneers that he's not going to kiss Chuny's ass, and Abby says that is how the whole problem got started. Again, not a good comeback.
Pratt wheels Melted Mask Man into the elevator. Terry follows alongside and promises to wait right there, and that he loves MMM. The elevator doors close, and Terry sighs that he should have told them he was MMM's brother. Pratt says that ICU has strict rules, and starts to walk away. He advises Terry to go home, and that ICU will probably let him see MMM in the morning. Terry chuckles dryly that his whole life was in the apartment that burned, and now all he has is the dress he's wearing. Come on, Pratt. Give a brother some scrubs or something.
Simone watches over her baby. Luka walks in. Simone tells him that the baby's heart rate goes down when she touches him, which she thinks is proof that the baby knows that she's there. Simone asks if the fever has gone down, and Luka admits that it has a little bit. Simone says that she waited five years for her baby, and that she had two miscarriages and an in-vitro procedure, and lost two boyfriends because she wanted a baby so badly. I just can't relate to that deep of a desire for a child, so I'm not going to say anything about it, because I know that any remark I make will be insensitive. Simone was about to give up, and then she got pregnant. Luka says they'll keep treating the infection, but that the baby will go into organ failure soon, and his systems will shut down. Simone doesn't seem to hear him, and she tells her baby that he's beautiful. Luka yells out that the baby's heart might stop and he needs to know what Simone wants them to do. Luka is just pulling out any reason he can think of so that he can kill this baby. Luka hates this baby! He's like, "This baby will grow up to be horribly deformed and he will kill you in your sleep! And he might be fat and annoying!" Simone doesn't know what she wants. Luka says they might have to open the baby's chest and shock him to keep him alive. Simone tearfully says that she doesn't know.
Elizabeth and Carter wheel Amy down the hallway. They see Nathan sitting with Ella on a gurney. Elizabeth says that she wishes Nathan had told her about his disease, and Carter says that it's not an easy thing to lead with. Elizabeth steels herself and walks up to Nathan, who stands with Ella in his arms, and explains that Lily had to run up to the lab. Elizabeth could not be more anxious to get Ella away from him. Nathan asks about Amy, and Elizabeth says that she'll still need dialysis; she then practically snatches Ella away. Nathan says that he couldn't reach Amy's parents, because she was only in the building as a babysitter. Elizabeth non-sequiturs that Nathan could have told her sooner about his condition in order to save Elizabeth some embarrassment. Nathan says, "Well, I certainly didn't mean to embarrass you." Heh. Good one, Nathan. Elizabeth asks how long it's been. Nathan says that it's been eight years, but that he was misdiagnosed for the first two. Elizabeth asks why he was late today, and Nathan says that he had to get an MRI. Elizabeth apologizes and says that she wouldn't have made him stay if she'd known. She offers him a fresh start; she tells him to make as many rounds as he can, complete the required reading, and take the exam. Nathan says that he's been doing all of that for two years, and that this is supposed to be his hands-on training. Elizabeth reminds him that it's the surgical rotation, and that it's "the most physically demanding, emotionally exhausting, stressful six weeks any physician ever experiences." Nathan says that it's part of being a doctor. Elizabeth says that she's offering him a pass, and that he should take it. Nathan says that he's there to treat patients. Elizabeth reminds him that he has "a degenerative neurological disease." Nathan says he knows it, but that it doesn't mean he needs a pass. He says that he doesn't want special treatment, and that he wants to learn like the other students. Elizabeth says he's not like other students, and Nathan says that he's older and smarter. Frank tells Elizabeth that the burn unit needs her. Elizabeth wants him to take a message, but he says that it's about Melted Mask Man. Elizabeth says she'll be right there. She tells Nathan to go home and think about it, and then report back the day after tomorrow. Nathan insists that he's fine, but Elizabeth doesn't think it's very practical. I have to agree. It's like if I wanted to be a WNBA player, and I could do everything but dribble. But they offered to make me a substitute foul shot shooter, and I'd never have to dribble the ball. Or something. That metaphor sucked, but I've been working on this recap for like six hours. Cut me some slack.
Kerry slumbers peacefully in an exam room until Abby wakes her up to pronounce a patient. Kerry says that she was just going to lie down for a second, but gets up to help Abby out. Kerry asks if they ever heard back from the NICU. Abby says that they didn't, but before she can explain, Kerry starts going off about what an outrage it is. Kerry stops short when she sees that Simone's baby is the patient she's about to pronounce. Abby softly says that the baby died of cardiac arrest thirty minutes earlier. Kerry excuses herself and asks Abby why she didn't come get her, and how long Luka worked on the baby. Abby says that Simone signed a DNR. Kerry wants to talk to Luka, but Abby says that he went home when his shift ended at 10:00 PM. Kerry wants to let Simone sit in a quiet room, and asks Abby to call a social worker and get some referrals for grief counseling.
Abby asks Carter if he's leaving soon. Carter says he just needs to finish up with his current patient. The patient tells Abby that she's the most beautiful nurse in the hospital, and that she has class. Abby thanks him. He then slurs drunkenly, "Can I play with your breasts?" Abby seems more amused than offended. The patient claims that he's dying, and asks Abby to grant a dying man's last wish. Carter says that the patient is drunk, not dying. The patient wants to go to heaven "on the bosom of a beautiful woman." Abby doesn't think his HMO covers that. Okay, that comeback was sort of funny. Carter finishes up and they walk off. Carter asks how much longer she has the outfit, because he thought maybe he could talk her into giving him a sponge bath. Abby asks, "What in it for me, Bony Boy?" Carter says, "Oh, I'll give you a bone, you nasty, naughty little nurse." Ew. EWWWWWW! Couldn't they have cut the scene, like, one second earlier?
Elizabeth finally heads home, Ella in tow. Romano calls after her, and she tries to get out without talking to him. He catches up to her and hands over her wedding ring, which he fished out "with a laparoscopic camera and a snare." People. The trap! Remove the trap! Of course, I guess Romano might have some trouble using a wrench. Romano gives the cutest little wave to Ella. I think I have a crush on Romano now. He starts to walk off, and then says, "Look, about today..." Elizabeth says, "Let's not." Romano says that it was a momentary weakness on his part, and that it won't happen again. Aw. How sad. Elizabeth tells him that he'll work through it. Romano curtly replies, "Of course I will. Good night."
"The Promise" by Tracy Chapman plays on the soundtrack as Elizabeth and Ella get on the El. Elizabeth snuggles her daughter and they both fall asleep. The camera pans over to the window, which goes by office buildings and such, and the light slowly comes up. The morning, we see Elizabeth and Ella, once again sleeping on the El. The train comes to a stop, and Elizabeth carries her daughter off. She leads rounds with her pathetic medical students. She asks them a question, and Nathan calls out the answer from behind her. She scolds him for being tardy, but seems happy to see him. She asks a follow-up question and then continues leading rounds while he answers.
week: Carter and Nathan argue over a young woman's right to die. Luke gets suspended. Chen gets threatened by a patient and hooks up with Pratt.