During various other time periods in the history of Everything Rehashed, Abby told Carter she'd returned to medical school; Abby and Neela became study buddies; and, even though we haven't seen Sandy in eons and Weaver in almost as long, we're treated to a clip of a just-miscarried Weaver trying to convince her girlfriend Sandy to have a baby. Sandy ardently refuses. She does not want to carry a baby. No way, no how. Under no circumstances. She's a firefighter! That would just be silly. Now, for a thousand points, can you find the sperm haven in this picture?
Tense music kick-starts the episode. Sam and Carter dash down the hall toward Trauma Yellow, where Pratt is trying to intubate a four-day-old infant. Pratt's tube is oversized, though, and he acknowledges this with the swagger of a man who's pretty sure that when he "intubated" Valerie, she delightedly said the same thing. The baby boy is Jacob; his father, Kyle, wrings his hands and hovers nervously. "We just brought him home," Kyle frets. Pratt has to give up, so Carter gently completes the intubation and they bag Jacob just as the NICU folks arrive -- a tall, young, brown-haired guy (third-year pediatrics resident Matt Gillespie,) and his compadres Abby and Neela, who are starting their NICU rotation. So apparently, in the time Neela's done one ER rotation, Abby's done an ER rotation and at least part of a surgical rotation. Okay. Jacob's mother appears so that she might draw out some exposition before the credits hit. Pratt responds to this by informing her that they think the baby has a heart problem. "You think?" Kyle spits, scared. Carter explains that Jacob wasn't getting enough oxygen, and tells Neela to call Cardiology up to the NICU. Matt, Abby, Sam, and Pratt wheel the kid away.
Carter is left with Kyle and Mrs. Kyle. He explains that congenital heart disease is tough to diagnose and doesn't always manifest itself right away, much like his own chronic and seemingly incurable BeeGeeism. Neela tells them that cardiology will meet them upstairs with an echo and something called a rashkind, "just in case." Kyle is completely wigged; Neela breezes past and says that Cardiology will talk to them. "I just want to talk to someone who knows what's going on," Kyle stresses. Carter stops and turns around, as if he's going to step up and fill that position. "He may need a septostomy," he explains, as if that makes any sense to the layperson. Kyle's face says, "That's VERY helpful, pompous dilwad, and we're so pleased that you know multi-syllabic words, but you can take your septostomy and shove it up your rashkind." As Neela catches up to Jacob and Company, who are in the elevator, Carter assures the parents that their son is in good hands. Thanks to this statement, we already know -- from our tangos with Foreshadowing on ER -- that Jacob is more hosed than a golf-course green.
Inside the elevator, Pratt genially asks when Abby and Neela started their rotation. "Five minutes ago," Abby says. Pratt babbles about how awesome the NICU is -- full of umbilical cords and chest tubes and wee little procedures. Sam cocks her eyebrows and twitches as if to add, "And dying babies, which don't make for much fucking fun, because I'm low on Dead Infant jokes." No, wait, that was me who said that. Once they reach the NICU floor, Pratt and Sam stay behind and wave Neela, Abby, and Matt out of the elevator with their patient. "You're gonna love it!" Pratt gushes loudly. Then, to Sam: "Let's get out of here." Sam growls, "I hate the NICU." Pratt finishes, "Those guys are screwed." We smash into the credits wondering why TPTB decided that the best way to sell an entire hour about the NICU would be to lead off with a bunch of comments about how crappy it is there. It's like saying, "American cars suck llama! Wanna rent one?"
"Day One, 8:45 AM." We're in the NICU, presumably filled with babies presumably created in the image of the most deadly and nefarious villain, the cause of all accidents and fatal problems: Rex the Wonder Preemie. A prissy med student is leading Abby through the NICU, giving her the bullet on various patients. "Who names their kid 'Humphrey'?" Abby snarks. This pisses off Miss Priss, who doesn't much care for humor, and from the look on her face seems to hope one of the bullets she's giving will embed itself somewhere terminal in Abby's intestines. She puts Abby in her place by rattling off some confusing jargon that leaves Abby sputtering.
Neela is getting all of Lester's patients. But none of his patience: she had hoped to get flow charts and index cards to keep track of each baby, whereas Lester preferred to file all his information informally in his brain, and this wigs out control-freak Neela to the point where she's a half-second from cracking open Lester's skull and raping it of the relevant portions. Lester shrugs that his final patient doesn't need any paperwork -- he's a vegetable, because Rex the Wonder Preemie decided he wanted a nice crisp salad. The kid's mother is hoping for a miracle, even after two months and $2 million in medical bills. Holy shit, that's an expensive salad. Neela looks over at the kid's incubator, or whatever it is -- I don't know what they're called, so I'm going with that -- and sees a prayer group keeping vigil. "They're here every day," Lester says. "He's a paperweight. There's nothing to do."
Abby grabs Neela for rounds. "Thank you for joining us," drawls a sassy woman who introduces herself as Dr. Raab. She's the NICU Attending, and she lays out the rules: scrub for three minutes before entering; no jewelry allowed; cut your fingernails; etc. Except that they're all already inside, haven't scrubbed for three minutes, and are wearing rings. Yes, those rules are as iron-clad as a peanut-butter sandwich. Dr. Raab then explains that, in 1993, two babies were abducted from the NICU. "That explains the LoJacks around their little ankles," cracks Matt. Raab explains that the NICU requires a code to open the doors -- a code they aren't allowed to reveal to anyone. "I tattooed mine on my scrotum," Matt deadpans, grinning broadly. "No one will ever see it there." Certainly not if he keeps wearing that stellar combination of pink shirt and blue tie. I for one wouldn't tap the ass of a guy dressed like a roll of SweetTarts. Although, come to think of it, my sister really likes SweetTarts.... Raab scolds Matt for his incessant stand-up routine, pointing out that the NICU is a tough room. She apparently doesn't think dying babies are a laugh riot. What is her problem? There is NOTHING funnier than a life snuffed out in its early days. For a second I thought I was watching Scrubs.
Now for rounds: a fellow student named Kate introduces thirty-eight-week-old Lloyd, who has TTN; Abby whispers to Neela that she doesn't know what that is, so Neela not only rattles off the answer but lists the potential problems. Raab hears this and is impressed. As Kate continues presenting, Abby wonders aloud why they're not attempting to speak quietly in the midst of other parents. Raab replies that there's no such thing as confidentiality in the NICU: "The quieter we talk, the harder they listen." Then a sour-faced older blonde nurse nudges in and asks Kate if she's named Lloyd yet. Raab introduces the woman as Virgie, whose ridiculous moniker might explain why she's so obsessed about re-christening people. She scrawls "THOR" onto a piece of tape and slaps it onto Lloyd's incubator. Raab says they like to give all the babies tough-sounding names: "Hard to fight with a name like Lloyd." Lloyd twitches, as if to say, "Fuck THIS noise -- either name is going to get me beaten up in school, so I'm screwed from the start."
A nurse named Tom calls them over to baby Jacob, whose acidosis is worse. "Who picked him up?" Raab asks. Silence. Tumbleweeds. "Lockhart, he's yours. Go examine your patient," Raab says. Abby explains that Cardiology confirmed that he has a narrowing of the aorta, meaning that blood can't get to the lower half of his body. "Why is that bad?" Raab prompts. "His legs...need blood," Abby duhs. "If you don't know, don't guess," crabs Raab. Hey, it sounded right to me. Abby scowls as Raab explains that it's a sign of acidosis. Basically, his plumbing's all fucked up, and he needs cardiac Drano. Abby says that surgery is backed up, but that they can take him in the forty-eight hours. Raab snaps that Jacob can't wait any longer, so if the OR won't take him, the cath lab will. An affronted, admonished Abby explains to Jacob's nervous parents that the cath lab can open the blocked aorta with a stent. "Surgery will cure him?" Kyle twitters. "It should, yes," Dr. Raab says. Anyone want to make a wager? Nah, it's too easy. Vegas is giving 100-1 odds on Jake's survival -- nobody's taking that bet.
As everyone disperses, Abby squeaks in one more disgruntled facial expression, because apparently anyone who corrects her or disagrees with her is wrong and unfair. Raab crossly prods Abby to nickname the kid. "Jake. Sounds tough to me," says Abby. "Jacob to Jake. Very creative," snorts Raab. Abby flinches at her. She knows a dramatic foil when she sees one.
Virgie announces that there's a delivery in progress, so Raab sends the students off to observe it. Abby lingers. "What are you waiting for? Go, learn something," Raab waves her away. Then she shouts out instructions to Tom about Jake's care, and Abby stubbornly stays put, insisting that she can take care of Jake because he's her patient. A hidden, satisfied smile sneaks across Raab's face before she stiffens up and hands over Jake's chart. "Get CT surgery on the phone and tell them that your patient needs the OR right now. Not in forty-eight hours, not sometime today," Raab says. So apparently, Abby is going to display moxie.
Neela trots obediently after Matt on the way to the delivery, asking if they always drop everything and run whenever a phone call announces that tide is high in someone's birth canal. "Yep -- means some sick-ass baby is being born," Matt says glibly. Matt is the King of the Blithe -- Baron von Blasé, ruler of the nonchalant. Neela begs to do the intubation, if it's required. Matt's all, "Yeeeeah, you're hot under the collar for this, baby." "Okay, Little Gunnar, welcome to your first delivery," he says, barging into the birthing room. "Little Gunnar"? What the hell is wrong with these people?
Inside the room, an Asian woman is standing up with difficulty, bracing herself against the bed. A doctor has just caught the fetus that dropped from between her legs and hands it off to Matt. I didn't realize anyone but Terry Jones in Monty Python's The Meaning Of Life gave birth while standing. But then again, his character was doing the dishes when Kid #112 fell out, so I suppose that doesn't really count as a fair comparison. Matt takes Neela through drying off the gunk and warming up the baby so that it breathes and begins to cry. New babies are so gross. As long as I live, I don't want to see a squirming human covered in womb juice. I just don't. As they pink up the little boy, the mother pops out a twin girl. The father pokes his head over near Matt's to exposit that they were visiting from China when the babies came early. Neela has to go grab the second baby, which gets dumped like a limp blue rag into her arms. "This baby's not breathing," Neela gasps. We smash to black pretty sure that it's not breathing because it's a creepy-ass doll baby that looks like it was stolen from Rosemary. The only thing grosser than womb-juice babies are fake premature blue babies.
"Day Eight, 7:30 PM." Raab is back with some more insightful commentary, this time offering up the analogy that working NICU admissions is like running a marathon without training for it. Except not as stupid, and less likely to end in the eventual installation of artificial knees. "It's an endurance test for the patients, the families, and you," Raab says. "Eat when you can, sleep when you can, and when it's time to go home, get the hell out of here." She then grabs everyone for rounds as Veggie Baby's prayer group sings hymns by his salad bowl.
Jiang Han, the Chinese baby boy, is healthy and happy and relatively untouched by the clawed hand of Rex the Wonder Preemie. Unfortunately his sister -- Code Name: Inga -- wasn't so lucky; Rex gave her mouth-to-mouth that pretty much tore up her lungs. That Rex is such a player. Neela hates the name "Inga," but Virgie snippily insists that Neela took too long coming up with one of her own. "I was going to call her Surinder. It's Punjabi for 'warrior,'" Neela says, wounded. "You're thinking too much," sniffs Virgie. I hate Virgie, and not just because her idiotic name sounds more suited to a parrot. "'Inga' doesn't sound tough," grumbles Neela to herself. And neither does Dirk, which is Jiang Han's code name, but no one seems to care since he's mostly fine. Neela presents Inga to Raab: she isn't breathing well because of pneumonia, and Neela thinks she needs ECMO. Everyone looks up as if Neela just said she thinks Inga needs a nationally televised head transplant/exchange with Macaulay Culkin. "Isn't that incredibly dangerous?" Kate gulps. Neela insists that they have to do something before Inga gets brain damage. Raab throws to the class the question of ECMO's risks. "Overwhelming infection?" duhs Kate. "That could happen anyway," Neela says. "Head bleed?" Abby suggests. "Parents could end up with a little potato," Matt replies. I feel like Matt is the writers' answer to the fact that the show didn't rehire Coop. But he's unnecessary. We already had a Coop, and we liked him very much, and at least he didn't look like a reject from the Beverly Hills, "Weenies Donna Martin Can Date" pool of actors. Neela crisply argues that although ECMO is risky, and although no one's explained what the hell it is, doing nothing will surely kill Inga. She's convinced that it will work. "Are you sure?" Raab asks. "How can anyone be sure about something like that?" Abby asks. This is apparently good enough to punctuate the scene, so Raab tells Neela to order up a steaming hot plate of ECMO. Neela thanks Abby for her support. "She already thinks I'm an idiot, so I've got nothing to lose," Abby replies cheerfully. Abby tells Neela to go home and rest, but Neela insists that she needs to talk to Inga's parents about ECMO, which will be great, because as far as I'm currently concerned it stands only for Entirely Confusing Medical Operation.
Virgie minces past Abby and demands to know if she changed someone's diaper. Apparently that's Virgie's job, but Abby went and tossed out the soiled nappy, so she has to fish it out of the trash and weigh it so that Virgie's records are all intact. I guess Virgie's job is keeping track of what the babies take in and what they expel into their Pampers. It's the very definition of a crappy job. Abby -- thrilled as you'd expect her to be at the prospect of rooting through garbage in search of fecal matter -- rolls her eyes and obeys.
The Chinese family, the Tsengs, are in a waiting room with Kyle. As Neela enters to talk to them, an anxious Kyle bogarts her attention and begs her for an update on Jake. Neela promises to send a cardiologist to talk to him. Kyle won't let go -- he wants some answers, he'd like any indication of whether his son's going to be okay, and he's generally agitated and confused and in the dark. Neela sort of curtly tells him that it's too soon to tell him anything, and that the reason he is waiting is that there are no answers yet. Then Mrs. Tseng follows her out of the waiting room. Kyle waylays Mr. Tseng. "How long have you been here?" he asks, desperate for conversation. "Eight days. We were visiting from China when the babies came," Mr. Tseng replies. "Are they doing okay?" Kyle asks. "Our son is very strong," replies Mr. Tseng, before Neela impatiently calls for him to follow her. He leaves, and Kyle runs his hands through his hair, sighing forlornly. The waiting room is empty and fairly boring-looking. I feel like the parents deserve some distractions in there. Ping-pong, the Spice Channel -- anything.
As Raab works on Inga, Neela explains that ECMO stands for "Extra Corporeal Membrane Oxygenation." Luckily, her penchant for overexplanation leads her to detail that a machine pumps out Inga's blood, oxygenates it, and then sends it back, basically doing the work that her heart and lungs can't. "It's her best chance," Neela says. Dad Tseng toddles off to feed Dirk, and Mrs. Tseng -- whose name, we learn, is Mei Fan -- sticks around to watch sadly as her daughter's ECMO treatment begins.
Mei Fan decides that it's time to deliver a monologue, so she tells Neela unbidden that she's amazed Inga's still alive -- were she born in China, she'd surely be dead already, due to a difference in the type of hospitals and medical treatments available. She confesses that they deliberately went into labor in America so that Inga and Dirk would have more options. "And she already does," weeps Mei Fan. They sold everything they owned in China and moved in with her aunt in Chicago. "You're going to start over with nothing?" Neela gapes. "Her life will be better," smiles Mei Fan, tears leaking down her cheeks. "Isn't that why your parents sent you to this country, too?" Neela blinks, bored.
Abby roots around for butterfly bandages and can't find any. "In the cabinet by the sink, on the left," calls out Veggie Baby's mother, adding, "I've been here nine weeks." Well, then, the least she could do is scrub in for the occasional delivery. Abby smiles and thanks her, and then wanders over to where Jake's mother is feeding him. Carter is there, crouched nearby for a visit. "He looks great," Carter says. "His suck is still weak. But Abby tells me to keep trying," Mrs. Kyle says -- at which point Carter actually chucks the kid under his chin and coos in pompous baby-talk, "You! Keep! Trying!" It seems Carter's suck is still strong. My roommate actually covered her eyes. In the face of The Beard, though, baby Jake amazingly doesn't begin to sob. I'm surprised they don't make these people wear hair or beard nets -- Carter could be carrying any number of poisons in that monstrosity. Mrs. Kyle says she heard Jake might need another surgery in a few years. Carter shrugs that a cardiologist might know better, but Abby pipes up that sometimes the area where the aorta repairs gets blocked from scar tissue that can be easily removed in a cath lab. Carter looks impressed, and follows Abby into the NICU staff lounge so that he can better determine whether her ass is still as hot as when she was a nurse and he was trying to bone her.
"Looks like you're doing well here," Carter observes. Abby snickers that he should see her on rounds, where she stinks it up. Carter smiles, and then gingerly offers up that he and Kem took their first tour of the labor and delivery suites. "How can you call one room a suite?" he muses. "Counting the bathroom?" Abby grins. "Ah," Carter laughs. They fall silent, Abby regarding him with a twinkly smile on her face. "You're going to be a dad," she beams. Carter admits that he's a little scared by it all, given how much can go wrong, and how well he knows that. "You're going to be a great father," Abby says with total sincerity. It's a nice moment -- these two were so much better when they were just friends. The NBC Chemists ruin everything.
Virgie yells at Abby to go attend a delivery, so Abby starts to leave; Carter calls after her, "You're going to be a great doctor." Something foreign washes over Abby's face: actual delight. Carter trots off to find the exit by following the trail of beard hair.
Matt can't go with Abby to the delivery because his finger's rammed up some baby's pleuryl cavity, and my God, could they have written that a little less like it was evidence in the Michael Jackson case? He sends Abby off to the delivery alone. "Is that even legal?" she gapes, startled. Matt waves her off and assures her that he'll be right behind her. Neela decides to tag along. "You have to go home," Abby says. "You can't go to a delivery on your own," Neela argues. As they walk, Neela complains that she dreams about blood sugars and dosages. But she then whines that she hasn't slept in days, which calls into question when she had time to have these dreams. Perhaps she's hallucinating them, in which case she should really consider taking some more interesting drugs. Abby grins that Neela had better get used to this if she's planning to go into neonatology, and then encourages her to go home and try to sleep. Neela won't. I'm not sure why. Hooray for her for being a stalwart and everything, but even the Brave Little Toaster needs to be unplugged sometimes.
Neela and Abby cruise into the delivery room to see a woman screaming bloody labor. I think "The More You Know" sponsored this entire episode to encourage girls to use birth control. God, it makes me want to go chug an entire pill pack. "We're almost there," the proud father says. Somewhere, a script writer opens up The Big Book Of Labor and Delivery Jokes and gleefully copies out the oldest one: The mother screaming, "WHAT DO YOU MEAN, 'WE'?" When you're ripping off The Cosby Show -- which itself probably stole from every other labor scene in existence -- then you know you've got originality issues. Anyway, the mother has diabetes and they're delivering with forceps. Abby and Neela stand there helplessly until the screaming, miserable mother squeezes out the limp, bluish kid. Abby carries Repellant Toy Baby over to Neela, where they begin trying to exorcise the spirit of Rex from its struggling ventricles. As the father does annoying paternal things, like trying to videotape two NICU med students slapping the life into his goo-covered offspring, Abby elbows him out of the way until the spell is cast, Rex is banished, and the child starts screaming. Delighted, the father scoops up his kid -- who's called Daphne -- and presents him to the happy and tired mother. "You look just like your Daddy -- except three shades lighter!" he crows. "Babies are supposed to be light when they're born! I told you!" the mom grins, secretly pleased that the baby came out pale, like the mailman, and not Japanese, like that guy from Accounting she met at the company Christmas party when he offered to show her how to use a slide rule. Neela's pager goes off. Something's wrong with Inga.
When Neela gets upstairs, she finds Matt standing over Inga's body. "Major brain bleed," he says. "Are you sure?" gasps Neela. He nods and says they have to take her off the machine, or she'll just get worse. Neela is left staring blankly at Inga, while a concerned Abby waits behind her. "I talked them into it," Neela gasps. Abby points out that, as smart as Neela might be, nothing could convince Dr. Raab to authorize ECMO unless it really was the only thing. I sort of wish Dr. Raab had given us some supporting data as to why they did ECMO, but at the same time, it's a moot point, because Inga's pretty much a carrot now to be used in Rex's tasty Salade NICU-oise.
Inga starts to seize, and Neela tells Virgie to give her a shot of Ativan. Virgie refuses, because Neela's a med student, and Virgie's a stiff. Angrily, Neela points out that both Matt and Raab are away, and that Inga needs the medicine, and they all know it, so Virgie should shut her fat yap and adjust the pole up her ass, thereby making more room for her to shove her useless objections up there. Abby -- gripped by assertiveness and sass -- charges over there and administers the shot herself. "I'm telling Raab," Virgie simpers. "You do that," Abby snaps. "She'll kick you off the rotation," Virgie warns. Abby points out that Raab can kick Abby off, but that Neela didn't do anything wrong. Virgie stalks away as Neela crosses her arms and slumps against the wall, bitterly wondering what she can tell the parents. "Mr. and Mrs. Tseng, I'm sorry, I screwed up. Inga's brain is toast," she cracks. Abby tells her to knock it off, and to go home and let Dr. Raab talk to the Tsengs. "They should hear it from me," Neela says stubbornly. "You're a med student. I think the Attending can handle it. Just GO," Abby barks. Wounded, Neela turns around and wanders aimlessly through the NICU, picking up speed and urgency as she grabs her purse and coat and charges to the doors. Frantically, she punches in her code; it doesn't work. "Excuse me, can someone get the door please?" she says, knocking on the glass as tears trickle from her eyes. "Hello? Anyone?" she gulps, crying in earnest. "Get me the hell out of here!" We fade to black wondering how Neela got this far in medical school if she's so easily bothered by the idea that, sometimes, shit gets fucked up and stays that way.
"Day Seventeen, 3:15 PM." Dirk is ready to go home. As Mr. Tseng fusses over him, Mei Fan stares morosely and vacantly at Inga. Apparently, her lungs are at least getting a little stronger, but they won't know how bad the brain damage is until Rex stops tap-dancing on it. "She's a strong girl," Mei Fan sniffles. "Yes, she is," Neela says firmly.
Abby is giving a new mother a pained look as she explains that, although "Cher" is a lovely name, she might want to reconsider spelling it "Chair." Abby should read some sports rosters -- "Chair" is nothing to "Anfernee." Walking away with a shake of her head, Abby sighs, "Poor Chair." Matt quips, "Unless she meets a nice Ottoman someday." Then he cheerfully asks if anyone's heard any funny dead baby stories lately. Matt is like Coop with half the looks, Lester with half the quirk, and Malarkey with twice the inappropriate. He's a real witch's brew of mediocrity. "Here's a good one," Neela snaps, rattling off all the things that are wrong with Inga. "She's not dead, but she might never wake up. It's a real laugh." Her voice is a knife. "Bad day, Neela?" Raab asks dryly. Neela rants that they spent millions trying to save babies who mostly end up dying anyway. She doesn't know why they bother. Raab explains that forty years ago, Inga wouldn't even have had a chance, and that in many countries that's still the case. "We saved her so she can enjoy a lifetime of seizures, chronic lung disease, cerebral palsy -- it's a real advance," Neela snarks. She's being outright disdainful and completely bitter. It's sort of strange. Raab shrugs that there are no guarantees in this line of work. "If you can't live with that, I suggest you become a bank teller," she says icily. Matt whispers, "Don't listen to her -- my cousin's a bank teller, and she got held up at gunpoint last year."
There's a quick bit here where Abby removes an IV for someone, just to show that she's competent. There's some banter with Virgie, but I've grown tired of her and have decided not to feature her in the rest of the recap. Such is the power on which I'm drunk.
Jacob's sats take a dive, so Mrs. Kyle freaks. Abby examines him, realizes that he's septic, and quickly explains to Kyle and Mrs. Kyle that "sepsis" is a blood infection that can come on quickly. He'll need antibiotics and an intubation. "We were talking about going home," mutters Mrs. Kyle. Abby insists that Jake is tough and that he'll get through it. Man, she knows Fate is trying to lose weight -- why does she insist on waving cake under its nose?
, we're treated to the intercutting of Abby and Jake with Neela getting her photo taken with the joyous Tsengs, as they prepare to take Dirk home. As Raab supervises, Abby swiftly and cleanly intubates. Mr. Tseng smiles to Neela that they're going to keep calling the baby "Dirk," because the name brought him luck. He thanks her, and then sharply calls for Mei Fan to follow him out. She lingers, so he grabs Dirk in an effort to hasten things. Mei Fan shoots a lingering glance at Inga and observes that it will be strange to leave. "It'll be great. You'll love having him home," Neela smiles. "I know you're right. Bye Neela," Mei Fan says pointedly. "See you tomorrow," Neela says, totally missing the fact that Inga's bleeding brain just got smashed by an abandonment anvil. Mei Fan looks back sadly one last time, and then leaves with her husband and Dirk.
Raab shrugs that they can't do much for Jake but wait to see if the medicine works. "I don't know if I can take another round of this," weeps Mrs. Kyle. Jake is like, "Lady? Stuff it. That's my song." Abby pats Mrs. Kyle on the shoulder as Kyle twitches to fight tears. My Bitch Pants wander out from the laundry pile and start snuggling up to my knees, as if to tempt me into employing their services in this relatively kind paragraph.
Neela and Abby are outside getting coffee, the former complaining that she needed a break from the claustrophobic NICU. "Did you eat anything?" Abby asks. Neela absently throws out her coffee and babbles that Raab is right -- she likes science and answers, and can't handle the uncertainty of the NICU. Like that's any less certain than regular medicine. Why she only having this problem now? "It gets easier," Abby promises. Neela frets that she'd planned to be in neonatology since she started, and that she's perplexed to find she doesn't love it. Then she shares that when she was three, her six-day-old brother died in the NICU, and she has no memories of him at all. "The NICU is so sad all the time. How can you stand it?" Neela wonders. Abby thinks for a second. "I don't know," she says. "When I was an OB nurse, the preemies freaked me out. I thought they looked like frogs. I was sure I was going to hate the NICU." But she doesn't, which she says is because it's as much about dealing with the parents as with the kids. "And as it turns out, tragic family dynamics are my specialty," Abby says wryly. Her pager interrupts the moment; there's a delivery.
Smash to Abby, Matt, and Neela entering the delivery room and finding Sandy Lopez there trying to expel a child from her womb. This show sucks. Surprises aren't worth anything if they come at the expense of character, and after going through Kerry's miscarriage and her heartbreak when Sandy refused to get pregnant, it would have meant a hell of a lot more if we'd seen even one tiny bit of dialogue between them that indicated Sandy might come around on the issue. Which forces me to ask: when did Weaver become so unimportant to the show? So tangential? Laura Innes deserves more than to be some jackhole's afterthought. And still she stands there, lovingly stroking Sandy's sweaty brow as their son makes his ER debut and doesn't have the sense to take stock of things and try to kayak right back up the birth canal.
Abby carries the kid over to Neela and Matt, who bag him and try to pink him up. This of course wigs Weaver out, and she tensely watches over their shoulders, pale. "He's too quiet," she chokes. "Give him a minute," Abby promises quietly, competent and calm and reassuring. I like her this way. Sure enough, the kid is fine. Sandy looks delighted. "He's beautiful!" Abby beams. "Is he really all right?" Weaver pales. Abby nods and promises that all the boy needs is some antibiotics for some tiny little thing -- chorio, I think -- but that he's otherwise a rockin' infant. "Love you!" Sandy calls out to Weaver, weepy herself. Abby smirks, "I had no idea!" Weaver lets out a relieved laugh as she admits that no one had any idea. Possibly including the writers. The baby has what looks like a blueberry twizzler sticking out of his belly button. Neela invites Weaver to cut the cord, and a thrilled Weaver takes the snippers and...ohhh, I don't need to see this. When I have a baby, I'm totally going to be one of those mothers that's like, "Don't even SHOW that to me until you've cleaned it up and gotten rid of all the weird bits." Weaver sniffles and mouths, "Hello, Henry!" as we fade to black.
"Day Twenty-One, 5:45 AM." Neela hurries into the NICU with two cups of coffee. What happened to being scared of outside bacteria? Abby has fallen asleep with her head on a table, so Neela nudges her awake and hands her a drink. Abby in turn shares that Jacob got worse that night, and that she had to call the parents back in to tell them that he's heading to the OR again. "Any word from Inga's parents?" Neela frowns. Abby shakes her head.
Elizabeth appears with x-rays that show that Jake's bowels are perfed. She wants him in the OR immediately so that they can save whatever parts remain viable, so they pack him up into a rolling incubator thing and zoom him out toward the OR. Just then, of course, Jake's parents arrive, with a little girl in tow. Elizabeth stiffly introduces herself and explains the procedure, but Abby has more interest in the girl. "Would you like to see your little brother?" she asks, kindly. "Abby," Elizabeth warns. Seriously -- what about "immediately" did she not understand? But Abby knows the value of a good promo scene, so she opens up the incubator and encourages the little girl to squeeze Jake's hand. "I'm your big sister, Miranda," the little girl cutes. Everyone swaps very grave and tragic looks that would fit nicely under the deep intonations of the Promo God, and then they pack Jake up and whisk him away again. I'm briefly distracted by the squabble that ensued when my Bitch Pants attempted to ease themselves onto my body over my pajama pants, which didn't appreciate the coup and forced me to write another paragraph that's generous to Abby.
Veggie Baby's mother is spending another day gazing at her spent infant. Neela greets her quietly. "Where is everyone?" Neela asks, referring to the prayer group. "I told them not to come," the woman replies sadly. "He's three months old today. I thought if I prayed hard enough...if I showed God how much I believed...." Neela gently encourages her to go home. "I don't want him to suffer any more," the mother says, eyes wet. Neela looks sympathetic, because she doesn't want to suffer any more either, and she hates the NICU and all the drama and mixed vegetables therein.
Pratt stalks up into the OR's luxury box in the hope of both figuring out why his patient keeps getting bumped from the surgical schedule, and to capitalize on the free drinks and shrimp buffet. Abby tightly tells him that they're cutting up Jake, whom Pratt doesn't even remember from the beginning of the episode. Elizabeth sadly shouts up to Abby that there's no salvageable bowels at all, forcing them to close up with no success. Abby closes her eyes, pained. "So that's it?" Pratt asks. "Can't live without a gut," Abby chokes. Closing her eyes in grief, she whirls and leaves to tell the family. "Give it a minute," Pratt encourages. "What am I supposed to do, go get a latte while they stand out there?" she wails. Pratt suggests letting the Attending do it. "Is that what you would do?" Abby asks. Oh, God. Don't do what Pratt would do. It invariably involves lube. Silently, Pratt watches as Abby exits the OR. Through the doors, we see Kyle break down upon seeing Abby, and then Mrs. Kyle crumbles. Abby walks over to her and begins speaking, putting her hand on Miranda's head when the curious kid turns up to them. Tears everywhere. I'm not sure why -- they should've been ready for this moment the second anyone told them that Jake was going to be fine.
Neela frantically tries to find an interpreter who can help her communicate with the Tsengs' cousin. Abby, meanwhile, cries silently as she pulls out Jake's tube and wraps him in a blanket. She frustratedly wipes the tears from her eyes, but new ones well up in their place as she tenderly scoops up Jake's dying body and carries him out to the parents. Maura Tierney does an amazing job. My neglected Bitch Pants, frustrated, try to throttle me with the left leg while bitch-slapping me with the right.
Raab and Abby watch as the Kyles say goodbye to their son. Somewhere, Rex the Wonder Preemie is cackling, "GAME ON, LOCKHART! Game fucking ON." Abby wipes the continuing stream of tears from her eyes. "How long will it take?" she whispers. "An hour, maybe longer," Raab says. "You helped that family, Abby. They will remember you for the rest of their lives." Yes. As "that nice young student who really couldn't do that fucking much except pat us on the shoulders." Then Raab asks Abby to consider NICU as her specialty. Abby whirls around with flashing eyes. "Are you mocking me? Because it's really, really not a good time," she spits. Well, that's one way of taking a compliment. She'd been downright likable for most of the episode until that moment; I guess there's not enough acne medication in the world that can clear up all of a leopard's spots. Raab doesn't retract her compliment and tell her she's an ungrateful cow; instead, she tells Abby that she's one of the best students Raab's ever had. Stunned, Abby's mouth opens and closes in mute shock; she walks like a zombie back into the NICU. I buy this in part, because she did pretty well, but she didn't start off too promisingly, and Virgie probably did tell on her about that Ativan shot, so I have a hard time believing Raab wouldn't want to add, "But your attitude occasionally sucks Beard."
Neela hangs up the phone and morosely tells Abby that the Tsengs returned to China with no forwarding address. Inga's alone. "Tell me this is our last day," she beseeches. Abby, still upset, walks away.
Henry is ready to leave, clutched by an ecstatic Sandy. Abby perks up long enough to tell them that all his cultures came back negative. He can go home now if they let them do a spinal tap. Kerry isn't sure, but as she falters, Sandy interjects, "DO IT. We want to take our baby home." But she asks Raab to do it instead of Abby. As Weaver cradles Henry, she whispers, "Let Abby do it." Sandy starts to protest, but since she's the one who overruled Kerry on getting the spinal tap in the first place, I guess it's Kerry's turn to make the call. "It's okay, Sandy," Kerry coos. Abby flashes a proud smile. Good for Weaver for trusting her longtime co-worker, but seriously, I'd be like, "Fuck THAT noise." Whatever! I don't care how much she suddenly likes and trusts Abby -- Weaver would want the best of the best. Which actually makes me wonder, why did she let Sandy have the baby at County? And while we're at it, if Sandy gave birth at County, why didn't anyone know she was pregnant? Wouldn't they have seen her going in and out for prenatal care? Damn you, show! Damn you to the ninth ring of hell!
Neela and Raab argue over Inga's fate -- if she lives, she'll either be adopted or put into a long-term care facility, and Neela figures it's disgusting that the Tsengs abandoned her just because she wasn't normal. Raab wonders if the parents just thought Inga would get better care in America. Which they did, except they also had initially planned to stay in America, so...maybe they just couldn't afford all the extra care? I don't know. Raab is presenting all these options to Neela, who remains staunch in her judgment that the Tsengs are horrible people. "I wouldn't do that and neither would you," she insists. "You can't begin to know what you'd do in that situation, and you don't know the first thing about me," Raab snaps. "People are complicated." Neela thinks that's no excuse for abandonment. Raab warns her, "Neela, if you stay that judgmental, you're going to hate this job." But she'd love this job.
Weaver watches closely as Abby performs the spinal tap. She's impressed that Abby pulled it off so cleanly. If this is a big deal to her, perhaps she should have rethought having a med student perform the procedure. Sandy is grating her teeth. "You should see how good I am when I'm not post-call," Abby jokes. Oh, well done, Abby, way to make a nervous parent feel EVEN BETTER. Sandy, of course, can't believe someone who's been on her feet for thirty-six hours touched her kid's spine. Really, though, at any given time, I'd bet most of those doctors are sleep-deprived. They just get used to it and it stops becoming a big deal -- they learn to work around it. And to put it in terms Sandy would understand, I'd rather have a tired firefighter than no firefighter at all. "Actually, only thirty-one hours," Abby says. Then she finishes triumphantly.
"Day Twenty-Two/Day One." Neela is turning things over to a new med student, revealing that Veggie Baby's mother is finally starting to letgo and needs some support. Abby goes through some of the foreign lingo with her fellow student. "You'll pick it up fast," she smiles. Weaver and Sandy cruise past with the good news that the spinal tap was perfect, and that Henry is fine. "Champagne tap," Weaver grins, handing Abby a bottle. They then take a happy photograph together. "Get your butt back down to the ER where you belong," Weaver smiles, leaving. Abby's done nothing but stink up the ER since becoming a med student, though, so I think Weaver just needs to get some sleep and regain her sanity. If Abby's finally good at something, she should stick with it. Honestly, I'd begun to wonder how she got into med school at all. A glowing Abby congratulates them one more time and then cradles the Polaroid.
We cut to the snapshot up on a wall of like pictures, and pull out to see Neela absently staring at the one of herself, the Tsengs, and Dirk. She tapes it to Inga's incubator, her last act in the NICU. "You all signed out?" Abby asks. "Ever been to the Sky Bar?"
Suddenly we're on the roof, where Neela is choking on cigar smoke. "Disgusting!" she shouts. Abby hops around to keep warm, grinning and chugging from the bottle before passing it to Neela. Thank GOD Neela and Abby get along now. I like them much better as friends than as Smart Girl and Jealous Classmate. "Why are cigars associated with babies?" Neela wonders. "This stinky thing has no place in a nursery." Abby giggles that it's something Freudian about men wanting to have sex with their mothers. Neela rails against Weaver for getting them sparkling cider instead of champagne. "Weaver knows I don't drink champagne," Abby deflects deftly. She does? Maybe she knew Abby was Carter's sponsor, I don't know. Whatever. I don't even care how she knew. Abby then asks Neela if she's still considering neonatology. "Not in a million years," Neela says firmly. "I hope you didn't let Raab discourage you," Abby says. "It's more than that," says Neela distractedly, adding, "She thinks you should go into NICU, you know." Abby nods, but says she doesn't think she'll do it. Neela wonders if every department tries to recruit Abby. "Oh, please. Look who's talking! Your mind's a sponge!" Abby replies, embarrassed. Neela allows for that, but points out that Abby's got some intangibles that are harder to learn. Which we already established in that tiny clip in the "previously on," so I don't know why we needed an entire new episode to dump us back where we already were. "I don't know what it is, but it's harder to learn," Neela sighs. No one mentions that it might be Abby's many years as a nurse that give her a leg up with regard to dealing with patients and using her instincts. Instead, they just act like she was born with The Magic. Abby tsks, "I think all that cider's going to your head," but she looks secretly quite pleased, and swigs some nonalcoholic cider with a tiny little grin on her face, because suddenly she's A Brilliant Doctor despite the fact that she's probably still failing all her tests, and oh, I think my Bitch Pants will be delighted to hear that I feel a swelling in my chest that indicates I'll be wearing them time.