Previously on ER: A new blonde with the improbable name of "Wendall" showed up and got sassy with Carter. Ray and Abby butted heads in a classic battle of utter buttheads. Neela got hired by Susan as an intern. And Dr. Dubenko, who is all up in the face of progressive medicine, joined the surgical department.
On a Chicago morning of indeterminate temperature and season, Neela is jogging in nothing but tight pants and a sports bra. She is muttering medical things under her breath to keep her memory fresh: "Shock, epi shock, lido shock, static electricity shock, caffeine withdrawal shock, reading your script and finding out you have to jog in spandex shock..."
Cut to a man's bare feet padding in the darkness -- of course -- toward a door; the person opens it and retrieves a paper. We find out it's actually Abby, so oh wow, Maura Tierney has a major set of man-hooves on her. Abby throws the paper atop a massive, messy pile of unread newspapers and sighs. She then (as she stands there trying to wake up without illuminating any of her apartment on this dark morning) notices a dead plant and pours some water onto it, only to give up and hurl it in the trash with another duck-billed breath of frustration.
Cut to Ray pulling on his pants in the dark, until a girl who is clearly a day-player flicks on a light; she hasn't been told about the show's pitch-black mandate, although in this case, I'm thankful for the shadows cast over Ray's unmentionables. "You going?" she yawns, nude but for the bedsheet wrapped around her body. "Rounds start at 7," he says. "Barely even light out," she sniffs. Well, take that up with the sun, honey. 7 is 7. "Nice meeting you," she waves distractedly as Ray exits hurriedly. I suppose that's one way to avoid paying rent or sleeping at the hospital.
As they shuffle up to County, Abby complains to Neela about the schedule and how she has been too busy to pay her bills. Her credit-card company will be so understanding; I know that when I am swamped, I just call and say, "Sorry, guys, work is really hard," and American Express is like, "Take however long you need -- here, wait, we'll just pay it for you, and we'll give you a few hundred bucks for the emotional trauma. Go get a massage." Neela would rather ask technical questions, but Abby wants her to shut up about her own situation and pay attention to Abby's. Such a fun friendship! Neela grumbles, "Am I destined to spend the rest of my life in a fetid, windowless hospital?" OH FOR THE LOVE OF GOD, SHUT YOUR FACE. Maybe she should've done a window check up at Michigan before she stomped out of there in a quarter-life snit. Abby at least has the sense to point out that Neela was unemployed and now she's not, so she shouldn't whine. "Take it," Abby insists. Neela panics that everyone's probably heard all about her meltdown, and to punctuate her unease, Ray passes by and grins, "Dr. Jumbo Mart! How are you feeling?" He's Marty McFly-ing his way to work on a skateboard while clinging to the back of an ambulance. If only he were wearing suspenders with his jeans. But the best part is that when McDie lets go of the rig, he totally fumbles and can't look the least bit like a habitual skateboarder. Heh.
Ray, Neela, and Abby all get called to the rig to help; it's a fifteen-year-old kid with a bullet wound in his chest. As they wheel him inside, they find out that there are no open trauma rooms, and apparently no room for them through the triage barrier. So they stand there in the waiting room and work on the wounded kid, in full view of a lot of traumatized men, women, and children. Were I there, they would not need a vomit comet; I could happily produce all on my own. Abby and Ray snap to it quickly, but a zoned-out Neela needs to be yelled at in order to get going. The kid needs a chest tube, so Ray whips out his handy-dandy scalpel and removes the protective covering. "You carry a scalpel?" Abby blinks. "Bone saw's too bulky," he says. Ray then wants Neela to do something, so she appears to take over digging around in the kid's side until a massive volcano of blood erupts in Ray's direction. "Huge hemothorax," Neela deadpans. Ray is loving being covered in blood, because, like, that's so rock and roll. So Ozzy. Whatever she did worked, though, because the kid has a pulse and Susan arrives right in time to escort them to an empty trauma room. She compliments their initiative as all the squicked-out patients stare at them with jaws hanging open. All three of them pant tiredly, standing in a river of blood down which viewership and fan loyalty is sailing merrily away. Then Ray holds up his bloodied hands. "?" he grins, wiggling them. We smash to the credits willing to concede that Shane West did at least get that one right.
When we return, Susan is at the board rattling off a question to the interns. Neela cracks wise to Abby about the abbreviations Susan is using, so of course, Susan calls on her -- and Neela delivers a perfect, technical answer, as she always did. A nearby Pratt smarms that she's showing them all up despite being a month behind. Here's the first clue that it's still August in Chicago right now: they play pass the buck with the question someone lobs at them, ending with Ray throwing it to a posse of med students "for a new dishwasher and a lifetime supply of Ensure!" They answer it right, everyone's happy, dishes will be clean, and calcium will be supplemented in their diets. Ray gives a dorky fist-tap to his nerdiest student, half of a pair that will be tailing Ray for the day. That leaves Urbanus, who leans forward on the front desk and gazes adoringly at Abby. She winces. "Good morning, Urbanus," she says through a gritty smile. "Guess I'm with you again," he drools. I hate the people at NBC for teasing me with the prospect that hot Eion Bailey (Band of Brothers, Center Stage) would be playing this role. It is not Eion Bailey. My tongue will remain firmly inside my mouth.
Luka announces that they have sixty patients in triage, and Carter assigns Pratt to run the board, I guess because no one can clear a room quite like a self-obsessed nutrag. Who is Chief Resident, by the way? Just wondering. Pratt rubs his hands together and more or less announces that the Court of Asshattery is now in session, with the Honorable Judge Dink presiding. He informs them all that the easy days are over, and that they're expected today to discharge twenty-five patients per shift. Neela and Abby are floored. "Just two an hour," points out Ray sunnily. Pratt doles out a few cases. "We're the only ones left; guess that makes us a team," says a voice behind Neela. She whirls to see Sara "Darlene Connor" Gilbert staring at her. She's a fourth-year med student. Roseanne would be so proud, when she wasn't busy braying or eating babies, or whatever it is she does. "That was quite a flash entrance you made," Darlene says. Neela looks flattered. "With all the rumors going around about how you freaked out, it was great how you came in and set everyone straight," Darlene continues. Neela's expression changes from joyous to queasy, and she excuses herself before she ties her stethoscope in a neat bow around Darlene's neck. Where did that Penny girl go? None of these med students, save Urbanus, are the same. I guess they're finally sending people around on rotations, or something. Hmm. Accuracy. I'm not quite sure how to cope with this phenomenon.
Neela ditches Darlene to have Pratt sign something, using that opportunity to ask him not to go easy on her. As if. Pratt's never gone easy on anyone except a woman he's trying to get in the sack. Malarkey passes through the scene, handing off a pelvic exam he has yet to perform. Wait, is Malarkey ill? You're telling me he had the chance to stare up the business end of a woman's sex pie and he refused it? Someone take his temperature.
Darlene trots up and asks Neela why she got kicked out of Michigan. Except that she just referenced Neela's having a meltdown, so she knows that wasn't the case. Sigh. Ray cuts through the scene with a box of chocolates, and we pick up his trail. He's using them to woo nurses into doing what he needs. What annoys me is that they all go for it, despite weak objections -- especially Chuny, who frets about her diet and then allows Ray to ooze, "You can eat whatever you want" -- and so that Ray gets to strut around like the cock that he is. "Lesson #1: Feed the nurses," he says arrogantly to his med-student posse. Thank you for reducing women to sugar freaks. ["Women, and Malik and Yosh." -- Wing Chun]
Abby is with a redheaded man, whom she informs that he might have tuberculosis. But she doesn't know, and apparently this guy doesn't take well to uncertainty, especially when it comes to his lungs. He starts booming that he wants a real doctor. Abby impatiently tells him that she is a doctor, and that he'll have his tests, and then they'll know. Her bedside manner isn't exactly in the Florence Nightingale vein. Hell, even Florence Henderson would've been a better approach.
On the way out, Urbanus asks Abby a really complicated question and then gushes, "Sorry -- just trying to impress you." The poor kid needs to get back in the cradle, because Abby didn't come to work today in her thieving clothes. They bump into Pratt, who can't answer Abby's unintelligible question, involving lots of acronyms and zero fun. So she tells Urbanus that they'll look up the answer. "No," Pratt snorts, interrupting. "He'll look it up. It doesn't take two of you to open a book. Delegate to your student and find a new patient." Fresh off this lesson, Pratt gazes fondly at Ray, who is getting a big hug from a woman he's discharging. Ray has apparently kicked two out the door already, and Pratt is feeling a stirring in his soul that can only be construed as pride. That, or lust, but I think it's the former, because Ray's rack isn't quite big enough. Neela and Abby silently hate on Ray, because they have taste, while a delighted Pratt tells them that Ray is making them look bad.
Chuny bursts in and calls for a doctor, so Neela and Darlene run over to her. A man fainted in triage, and if it's not a person awash in blood who will gross out the general public and raise sanitation questions, they prefer to keep the show inside the ER. Neela stiffly introduces herself and asks his name. It's Juan, and he claims he just forgot to eat breakfast, while Darlene notices that he's bleeding from the head. No wonder I make it a mission never to skip breakfast. I am sensibly avoiding a hemorrhaging cranium. Neela starts to check him out and notices bruising under his shirt that isn't consistent with falling, or starvation. "I noticed them last night on my legs, but I didn't think anything of them, and then I woke up with more," he says woozily. Neela pauses long enough to show us that she hasn't forgotten the way of things here: she purses her lips and looks quietly yet fiercely concerned, so that we know this man's problems are bigger than lightheadedness, but that our own sudden-onset dizzyness can be pinned to the heavy hand of the editor coming down on our noggins.
Ray's students present a seven-year-old testing high for lead in his system. From the bullet, Ray deduces that the kid has chronic exposure to it and is learning to adapt to dangerous lead levels. "Does this case belong in the ER?" asks Dork #1. "No, but they wouldn't wait eight hours if they had somewhere better to be," Ray says cheerfully. "The system's broken; can't blame the victims." When they go in the room, the kid's father nervously starts spewing information like a fatherly geyser. Ray pretends to listen, scribbles things on the chart, and sweet-talks the kid by pretending he's famous and asking for his autograph on a form of some kind. The poor father just wants some attention from the doctor, but Ray blows him off as glibly as he can. What a jerk. The dad keeps blurting out various things -- the kid was a preemie, he had a seizure once when he was little -- and Ray waves him off and calls the lead clinic, considering this case in the can. He holds out his fist to the kid. "Punch it," he demands. Oh, kid, please punch it, even if "it" isn't quite the "it" I would choose. The boy taps fists with Ray and grins widely when Ray promises to sell his autograph on eBay for millions. The correct response would be to beat the autograph out of Ray's greedy hands, but I guess the kid isn't going to try the odds on that confrontation.
Ray strides out, a red comb sprouting on his head as he crows, "Five-minute discharge, boys. Watch and learn." They gaze at him in awe. Ew. Awe has never offended me so much. One of his students -- Dork #2: The Lesser of the Dorks -- asks Ray whether ex-preemies have problems metabolizing lead. "No," Ray scoffs. "Patients will tell you all kinds of irrelevant crap. They don't know what's important." Yeah. Ha! Stupid patients, always complaining about something. The geeks gush about how great and patient Ray was with that father, as if the father was a gnat that needed swatting. "They key is to look like you're listening," Ray says. The dorks indeed look like they are, and I can only hope this is their first exercise in heeding that acting lesson. A nearby Abby wonders wryly if that is the best possible advice Ray could muster. He shrugs that he already told them about the whole "feed the nurses" racket. I seriously think Abby wants to spit on him. She suggests nicely that perhaps, since they're students, they should focus on learning where the corners even are before learning how to cut them. Ray figures that med school is just one big study in fantasyland, so it's time for the guys to wake up and smell the blood on their hands: "You'll never clear out a waiting room if it takes two hours to work up a slam-dunk case." A passing Carter points out that when you're an intern -- much less a student -- there's no such thing as a slam-dunk case. "Suit up," he tells them. Abby trots obediently after Carter, while Ray takes an extra few seconds to look put-out that Carter didn't get on his knees and smooch Ray's sagacious and highly advanced booty.
The incoming patient is a forty-six-year-old man injured in a jet-ski crash. As they situate the man in Trauma Yellow, we see that his face is completely mangled. It looks like hamburger. Dubenko arrives for a consult, toting a tub of sliced pickles and some ketchup. Carter gives Abby the code to run. Ray responds to this by immediately shouting out orders, talking either in unison with or over Abby's voice. She stops, affronted, and glares at him. Dubenko watches this like an avid sports fan. Ray smoothly orders Abby to call the blood bank while he takes care of all the manly work. Okay, maybe he doesn't use those words exactly, but he's awfully annoying. I do wish Abby would stand up for herself, though, rather than snitting around being glum. She would rather be put-upon and then martyr herself than actually stiffen up and stake out her territory. She gets on the phone with a pout the size of Montana. Dubenko slithers up to her. "What happened there, Doctor?" he whispers. "That was your patient." Abby ignores him and handles her call to the blood bank. Dubenko breathes, "Don’t say 'please' and 'thank you' to the blood bank, and don't let the boys bully you." Abby openly gapes at him as Sam twigs to this and looks up, equally startled. Abby reaches up and runs a hand over her bangs. "I wasn't letting them..." she begins. "You play with your hair when you're nervous," Dubenko says, with a creepy smile. He takes the phone so she can go back on his orders and take the men by the balls, and he can call her voicemail and go, "Hello...Abby," as he cleans off his white rubber mask.
Neela and Pratt finish up with Juan, the bruised guy, by telling him that they'll diagnose him when his test results arrive. Pratt quietly asks Neela if she ordered those tests without consulting him. She replies that Pratt was busy. "I really don't get it -- you're proactive, you're delegating, and yet you're still in last place," he shakes his head. They end the conversation in front of a whiteboard on which Pratt is thoughtfully and tastefully keeping a tallied score. The names on the white board are scrawled in a child's handwriting, which would fit Pratt's sensibilities in this case. I can't believe anyone is supporting them in plowing through cases when they're supposed to be teaching. That just sounds like a lawsuit. Where is the litigation-obsessed Weaver when you need her?
Abby and Ray fuss over the mangled jet-skier. "Jet-skis account for only 20% of boats but are involved in 44% of injuries," Dubenko says, fascinated. "Know why that is? Dr. Lockhart?" Abby spits, "No." Dubenko grins, "'No' is right -- no throttle, no steering, no way to stop." Ray takes time out from this lesson to crike the guy so that he gets oxygen through his throat. Dubenko does some quick calculation and deduces that when pylon met face and they began their grisly tango, the guy's head was subjected to seven Gs of force. "Think about it," Dubenko practically orgasms. Abby snaps that they're doctors, not physicists. Oh, Abby, shut up and let him talk. With number of times you've talked about your personal life or taken calls from your wandering brother in the middle of a trauma, the least you can do is let a guy get his rocks off over the physics of a mangled head. The bleeding man goes into v-tach, and Abby hops up to do compressions. "The impact of nine-hundred-ninety pounds dropped on his head -- that's what you're up against," Dubenko says, eyes wide. "That's not all I'm up against," Abby mutters. Oh, hush. Ray grabs the paddles, so Abby steps away. "Uh-oh, Lockhart, watch yourself," Dubenko coos. "I'm nowhere near the bed," she says, misinterpreting him. "Exactly," he retorts. Abby hisses, "What am I supposed to do, grab them out of his hands?" She futzes with her bangs, which Dubenko notes with glee. We fade to black on Abby's face arranging its features into a murderous expression, while Dubenko titters in the background like a puppetmaster yanking the strings.
Pratt wipes off the board as Darlene natters on about Neela's going through eight years of school and then deciding she didn’t want to be a doctor. "My dad would've ripped my head off," Darlene says in that oh-so-familiar droning monotone. Neela is clearly wondering if that's a viable option for her right now, or if she should wait to decapitate Darlene until after they're away from the hospital and no one's around to reattach it. Pratt interrupts this tender moment by announcing that Ray is in the lead with eleven, Abby is second with seven, and Neela is bringing up the rear with only four dispos. Neela bristles at Ray getting credit for what his two med students are doing, especially when everyone else only has one loyal follower. Pratt gives her the most condescending look as he calls into question her ability to handle two whole students all by her lonesome. Darlene yelps for help at that moment, giving Pratt the perfect opportunity to deploy a knowing nod, the likes of which tend to make me remember with love the time Gallant punched him in the face.
Mangled Man is basically scalped. Abby is tamponading the bleeding, apparently, and I'm lamenting that I've already used all the tamponade jokes I can concoct, short of suggesting that she tape a Kotex pad to his head for extra absorbance. His pressure is dropping. "Why, Lockhart?" asks Dubenko. Um, because he got clocked in the head with something dismembering, and no painkiller in the world can dull the agony? "I take Tylenol for aches and pains, but when my face is torn off and my skull is split open and bits of my brain are making their world debut, I choose Excedrin, the broken head medicine." Ray fields Dubenko's question on Abby's behalf: "Spinal shock." Dubenko keeps asking questions; Abby orders up treatment under her breath; Ray then repeats it as if it were his idea. "Didn't I just say that?" Abby snaps, exasperated. Dubenko salivates that an ischemic brain needs oxygen, but after a traumatic brain injury, any present oxygen creates free radicals. "Mother Nature is such a bitch!" he dribbles. He should watch what he says about her, then: a well-placed lightning bolt could really put a damper on his hard-on for science, if you get my drift.
Meanwhile, the jet-skier is dying. This shouldn't always be such an afterthought, but there it is. Dubenko natters on about the damage done by free radicals, and he's not talking about any proletariat uprising, so I'm not entirely sure what any of it means. "Can we take a break from chemistry to code him?" Abby finally spits. "The difference between a physician and a witch doctor is an appreciation of the science behind the disease," Dubenko says. "This should be automatic." Whereas Abby, just to spite him, is thisclose to cooking up some skin of newt and tongue of frog.
When a man's face is held together by strings of living tissue and he's about to die, the best thing to do is bring in the wife. And so she enters, weeping and freaking. Dubenko makes Ray take over the compressions he was doing so that he and Carter can translate "Your husband is screwed" into something more sympathetic and gentle. Abby fires up the paddles. "I was running this," snots Ray. "I hadn't noticed," Abby rolls her eyes. "Clear!" She shocks the guy. Ray is pissed. He tries to take over and notices Abby's mulish look. "WHAT?" he booms. She purses her lips. "Fine," she quacks. "All yours." She thrusts the paddles at him with a furious glare.
Darlene is nagging Neela again about her dramatic history. Maybe Darlene should be more concerned with patient histories. Or maybe Neela shouldn't act so patient, and instead ought to tell Darlene to shove it up her annals of history. Instead, when Darlene asks Neela why she came back if nothing has changed, Neela offers up a pathetic and grouchy "I don't know." Chuny passes, hands Pratt some paperwork, and tells him crabbily that his interns need to know the difference between milligrams and micrograms. "I can't supervise them all the time," he shrugs. Neela bristles. "Excuse me," she says hotly to Pratt. "If I make a mistake on an order, I'd appreciate it if you'd confront me directly. I'd like to be treated the same as everybody else and subjected to the same scrutiny." It's a lovely speech: blunt, rhythmic. And completely unnecessary, because Pratt wasn't referring to her. "Oh," Neela says, almost disappointed that poor job performance isn't about to screw her back onto the Dole. And I don't mean the one who's on Viagra. [Rimshot!]
They've wrapped jet-ski man's head, so he lies there like a mummy with dilated pupils while his wife tries to contain her jitters. "What now?" Abby whispers to Carter. "We wait," he replies. Dubenko laments that the man's brain is no longer capable of telling the body to die. Before he can bring Newton or thermodymanics into this, Abby volunteers to help Luka in Trauma Green, and flees.
Okay, Luka, this is it. This is your chance. I'm not here much longer, so you really have to get about this business of removing your trousers. Take a lesson from Pratt and Ray, if you have to; just DO IT. Luka's patient is named Elena, she's thirty-two, and she appears to have overdosed but doesn't remember what she took. "Just stuff in my cabinet," she murmurs. Abby orders Urbanus to find out what the paramedics grabbed from her house. Then she rattles off all the right tests; Luka adds that they should call Social Services and Psych. "Elena, were you trying to kill yourself?" he calls out. "I don't know," Elena mutters. Then you probably weren't.
Neela watches the jet-ski man through the Trauma Yellow door, and then turns away. "Looks pretty rough in there," she commiserates with Ray. "The guy is brain-dead," Ray says. "Three [kids]." Neela sucks wind. "You okay?" she asks. "Just part of the job," he says frankly. Darlene drifts past with Juan's CBC results, and Neela studies them with shock. Which is good, since she was rehearsing all those kinds of shock this morning. This one is, "You have to tell a patient he has leukemia" shock. Ray asks if she's ever had to deliver that news before. "Part of the job," she parrots him.
Carter comes out of Trauma Yellow, and Ray tells him that ICU can't find a bed for the jet-ski guy. Carter wants him to call Social Services so that the wife can get some help. Just then, Lead Kid and his father appear with Sam, who needs Carter's signature on the chart in order to discharge them to the lead clinic. Ray presents the case to Carter half-heartedly. "Did you get a repeat level?" Carter asks, furrowing his brow as he flips through the chart. Ray shrugs that he figured the lead clinic would take care of that. There is silence. Sam senses that this is not one of those times when it's okay for the staff to air its dirty laundry in front of the patients, so she carts the father and son away. "Is that cool?" Ray asks, confidence fading a tad. "No, it is not cool," Carter lectures. "You've been a doctor for a month. You can't sign off on a patient unless you run it past an Attending, so get a repeat level and then I'll sign off on the chart." Carter leaves an embarrassed Ray, whose students are watching and thinking they've never seem a man undress another man so adeptly. Oh, and if Ray's only been a doctor for a month and he was a doctor on July 4th, that would make this...August 4th, or thereabouts. Meaning that we're still way back in summer. And yet, how much do you want to bet that the Thanksgiving episode will air in a few weeks without much notable passage of time?
Neela and Darlene enter Juan's room just as he's trying to get himself up to go to church. Neela guides him back to the bed and tells him that he's too ill for this. As he mumbles in Spanish, Neela and her short fuse try to explain to him -- with lots of jargon -- that he's got low platelets and a problem with his white-cell count. He dreamily tells her that he's got one in his..."toe." I will be so thrilled when I am free from this ocular tyranny. He ignores her until she entreats him to listen so that she can help him. "No one can," he says. "Yesterday I hit a man with my car. It was an accident. Today, I wake up like this." Ah, so he thinks he's being punished by God. Better by divine law than by prison law, I guess. How did he hit a guy and walk away from it? Neela tells him with zero reassurance that she'll check his smear, check his labs, and come back to talk to him. As they exit, Darlene wonders why Neela didn't tell him that he has leukemia. Neela chucks the script at Darlene's head and bolts.
Urbanus catches up to Abby and tells her that Elena only had Benadryl and some antacids in her medicine cabinet. If she was trying to kill herself, then, she missed a golden opportunity to guzzle something from her kitchen sink collection.
The redheaded TB guy chases after Abby, angry that he's been there four hours when he feels fine. "We honestly don't know," Abby says irritably. "You could have TB, even though you don't feel sick. We are going to recommend treatment for nine months." Understandably, this sort of answer -- especially shouted -- doesn't sit well with Big Red, who wants to make Abby's big head big dead. "You want me to take meds for a disease you don't even know I've got?" he screams. "You people are something. I want a better doctor!" Enter Pratt, who relishes the chance to prove he is a cut above the rest. He introduces himself and explains that the safest thing for them to do is treat him as if he does have TB: "If I were in your position, trust me, I'd do the same thing." This placates Big Red, although he's still smoking at the ears. Pratt tells Abby that a good doctor -- of which he is the greatest example despite having recently broken a kid's neck -- can make "I don't know" sound reassuring. So a good doctor is a spin doctor? That makes me a little dizzy.
Neela reads up on leukemia on the internet. She wants to understand the treatment options before telling Juan, and she asks Darlene to page Oncology. But I hope she's not using WebMD, because that site will tell you that a stubbed toe is probably going to become gangrenous and fall off, if it doesn't kill you first. Pratt comes on to announce the halftime score; oddly, from this distance, it looks like the names on the board have been rewritten in neater script. Ray has fourteen dispos, and Neela only has seven. "The nurses were all tied up in trauma," Neela says. "You're blaming the nurses while you're surfing Medline," Pratt snorts. "Ray was using the same nurses and he's had twice as many." Ray and Pratt bump fists in that way that shows man-love is being born. Ray delivers a stirringly arrogant speech to his students about how you only ought to spend ten minutes in the room with the patient at first, so at seven you start saying your goodbyes, meaning all business must be done in five minutes or less. I would imagine that he takes the same approach with sex. Pratt is like a proud father, despite the fact that what he's preaching sounds like pretty careless medicine. Ray grabs a chart. "Jammed finger," he says happily. Neela: "How is it that you get lice and athlete's foot, and I get new-onset leukemia, tertiary syphilis, and a referral from Kazakhstan?" Ray's all, "Wow, cool, dude." Darlene trots over with another film from a case that's turned serious, and Neela frowns. "Are you accusing me of cherry-picking charts, Neela? Oh, that hurts," he says, blowing through a list of tough ones he's allegedly had that day. Someone apparently hurled an emesis basin at his head. Would that he or she hadn't missed. "I'm just slow then," Neela snits. "You're not slow, you're just differently abled," Ray brats. "Don't let Pratt get to you." Thanks, Dr. Phil. "At least you're not as bad as Abby," Ray says, as Abby predictably comes up behind him. "Not that they'd call her out on it -- the Attendings love her, the nurses protect her..." Then he turns around and sees her. "Must be nice to be the teacher's pet," he finishes. "Screw you, Ray," she says with real venom. Word. He is such a poisonous little snake.
Dubenko arrives, pleased to see the gang all together. "I didn't get to finish talking about my research with free radicals," he beams. They all stare at him and then slowly try to escape. "Hold up, come one, you might learn something," he says, pulling them off into an exam room or somesuch. He flips on a light board, which they'd normally use to pin up and study x-rays, and begins talking about free radicals and how they're linked to so many things. He quizzes Abby a few times, and she stares at him with her arms crossed, giving him rudely perturbed responses or stone-faced silence. He tries to make her draw an oxygen atom, then gives up and scribbles all over the board and the wall -- complicated equations that tie to his theory. All the while, he comes back to Abby and calls on her more times. Everyone is standing there in uncomfortable silence, and Abby is shooting him genuine daggers. It's sort of sad and sort of appropriate. Dubenko's eyes are all alight with excitement over his research, and all these clods can do is stand there and resent him for it; at the same time, though, his weird obsession with putting Abby on the spot is a little unsettling, and it's either leading to a torrid affair in Trauma Green, or it will go nowhere when his guest-star contract expires and he'll disappear into the wild blue yonder. Earnestly, Dubenko reaches out the marker to Abby to get her to finish the oxygen atom he began drawing for her: "I've done the hard part. All you have to do is add electrons." In my notes, Word AutoCorrected my gibberish version of "electrons" to "erections," which I hope is not a stunningly prescient error teasing the fact that when Dubenko does head off into the wild blue yonder, Abby will be riding him hard all the way there. She glares at him and then hisses rudely, "I have patients to see." As she storms away, we fade to black wondering when everyone on this show went insane and/or developed really bad attitudes: Neela's been surly and ungrateful for the opportunity to pay rent, Abby is blatantly rude to Dubenko here without ever having tried to be polite first, Ray is a cocky asshat, Pratt is running around like the king of the junkyard, and the new med students are boring losers. It's like all the venom and weirdness that went into the Romano character is now being sprinkled around aimlessly to everyone.
After the break, a janitor is painting over Dubenko's scrawlings. Abby mouths off to Neela that she knew how to draw a damn oxygen atom, but that Dubenko just gives her the creeps. She's not entirely unjustified in thinking that, I guess, even though I kind of felt sorry for Dubenko and wanted to hide under my couch when he was standing there trying to reach out to them all and they gave him a brick wall in return. Which he promptly tagged with his Permanent Marker of Scientific Shenanigans. Pratt gives us an update on the score: Abby has seventeen, Neela has twelve, and Ray has twenty-one. Ray wants to go home early if he hits twenty-five before the end of his shift. Abby, at Pratt's prompting, reveals that she has several more on the verge of being discharged. "Abby versus Ray," Pratt sing-songs. "Neela, you're getting your ass kicked. Start making decisions." Then he muses that perhaps twenty-five was too low a target, since Ray has had such an easy time of it. "I'd better up the target to thirty," he decides. Ray grins as Abby and Neela once more unite in mute hatred of the new punk.
Wendall, the bitchfaced social worker who out-ducks Abby, walks up to Ray and identifies herself. "I paged you, like, four times," he crabs. "Yeah, in, like, fifteen minutes," she says. "If I don't answer you right away, there's a reason." Carter looks up sharply from his paperwork, because his blonde radar went off and it's making an unsightly lump in his trousers. "I want you to talk to Trauma [Yellow]'s wife," he says. "Interesting name, 'Trauma [Yellow],'" she sasses. Carter is gripped with the urge to be the teacher's pet, so he all but shoots up his hand and waves it around as he blurts out the name of the woman and the brain-dead man, as well as their shoe sizes, social security numbers, star signs, and wine preferences. "He's an intern," he says to excuse Ray's idiocy. "Oh, referring to a patient by name instead of room assignment is a second-year skill?" Wendall cracks. She turns and asks Ray whether he went through the care pathway with Mrs. Trauma Yellow (my term, not hers). Ray blinks ignorantly. Wendall explains that the care pathway, despite sounding like one of the twelve steps, is actually a checklist one has to go through with a patient's family. "I need a list to check off questions you'd ask anyway?" Ray asks. Wendall smiles sweetly at him, hands him a checklist, and says, "I'll see you when you're done." Carter watches with young stars in his eyes.
As Abby has a minor crisis of confidence -- I suppose brought on by her losing battle with Ray in the trauma, but it's not clear -- Sam hands Abby some test results. "UTI versus kidney failure," Abby says. "If I'm right, she takes antibiotics and gets better. If I'm wrong, she becomes hyperkalemic and dies!" She throws down the test results and smiles through clenched teeth. "I'm trying to embrace uncertainty," she says. "How am I doing?" Urbanus gives her a slow smile and confirms that she's doing terribly. I feel like we're missing a plot point here -- I know the TB guy flipped out at Abby, but it wasn't because she couldn't make a diagnosis; it was because her manner and delivery of the uncertainty were all wrong. Are we missing some other patient this week in which her indecisiveness caused problems? The weird trauma experience wasn't really because of that...sigh, I don't know. "You haven't had anything to eat or drink all shift," Urbanus points out. He then slowly reaches into what I hope is his pocket and whips out a can of Coke, proffering it like it's a gold-plated cure for cancer. She stares at it, and then gets her wits about her and realizes it would be cruel to decline it. "Thanks," she says, and as he turns away to bask in this moment of pure connection, Abby gets in a vicious eye-roll. Honey, there are worse things than being adored. I'm just saying.
Neela sends Darlene off on an errand to get some chemotherapy information. Darlene thinks this is a job for Oncology, and bitches that her ER rotation shouldn't involve making photocopies. Neela just wants to cover her bases before telling a guy he needs radiation treatment, and Darlene sneers her way around Reception.
An EMT wheels in a skater dude who got clipped by a fire truck. Abby and Neela take him. "My med student is driving me mad," Neela grumbles. "Wanna trade?" Abby counters. "Were we that annoying?" Neela asks. "I wasn't," Abby says. Heh. The skater looks like the Unabomber without a beard. Everyone tells him that he's very lucky to get hit by a fire truck and escape with nothing more severe than a broken leg. He ignores them, so Abby pulls back his hood, reveals headphones, and removes them. "We'll try to keep this brief," she says sarcastically.
In Trauma Yellow. Mrs. Mangled Man is zoned out and upset. "My sister is coming," she says to Ray, who flips through his chart and finds the care pathway down which he is about to jet-ski. "How am I going to tell our kids?" she asks emptily. Ray asks if she'd like to speak to a clergyman. She shakes her head absently. "Is it okay if I don't tell them yet?" she wonders. Ray ignores her and asks if she'd consider donating her husband's organs. "It's okay," she says vacantly. Ray nods. "Let them have one last night before their lives change forever," she then breathes. Ray -- because he is insensitive and completely unobservant -- assumes that she has answered his question and figures that he has half-assedly completed yet another job, thrilled to have spared some of his buttocks for after-hours fun.
Abby checks in on Elena to see how she's feeling. Throughout this entire scene, Chuny, Sam, and Pratt all knock on the door to interrupt and ask Abby for things, but she waves them off. I guess we're supposed to see her choosing to take time with her patients even when the ER is overrun, so that we know she's Ray's opposite. At any rate, here is the scene, without the mud left by the footprints of those other characters. "Your tox screen was negative, so from a medical standpoint, you're clear," she says. "I wasn't trying to commit suicide," Elena insists. "I'm not crazy; just stupid." Abby goes to call Psych, but gets no further than picking up the phone. "The condom broke," Elena blurts. Apparently, she is a temp at a commodities firm and she slept with one of the traders; when she woke up, she found a note on her bed telling her to get tested for HIV. Abby sucks air. "Five years of needles and I managed to stay negative," snorts Elena. "I cleaned myself up, turned everything around, and because of one stupid night now I'm going to get AIDS?" She looks frightened as she tells Abby that she can't get sick because she has a daughter. Pratt knocks on the window just as Abby's pager goes off, but she ignores both and pulls up a chair. "Being exposed doesn't mean anything, and the incidence of transfer from one experience is relatively low," Abby begins, trying to make "I don't know" sound reassuring. Instead, she comes off like a PSA that's supposed to make HIV sound kind of friendly.
As Darlene tails Neela into Juan's room, Neela turns around and tries diplomatically to ditch her. "I'd rather tell him alone," she says. "I wouldn't want to cramp your style," snorts Darlene, leaving. Neela takes a breath, enters, pulls the curtain...and sees someone else in Juan's bed. What's more, someone's been eating his porridge. It's a Goldilocks sequel. Neela sprints back out and asks around, but no one's seen Juan. She bursts outside and scans the street; nothing. Ray comes around the corner with a box of donuts. "I'm an idiot," Neela rants to him. "I hadn't even told him he had cancer, but I think he knew. I should've realized he was a flight risk." Well, you can never tell -- when you walk into a room and the patient is actively trying to leave and showing few signs of hearing what you're saying...yeah, it's a tad unclear. Right. Ray figures that it's hard enough to help the people who want to be helped: "Don't beat yourself up over those who don't."
Darlene and the dork patrol greet Ray and Neela by the sliding doors. "[Darlene] is gonna hang with us," says Dork #1. "You seem stressed," Darlene shrugs. Neela glowers. "Time for the nurses' nighttime feeding," Ray grins, wiggling the box of donuts. Shut up, Ray.
In Trauma Green, Luka is fully clothed. Damn you, cotton. We make you the fabric of our lives, and this is how you repay us -- by refusing to disintegrate on the spot? Abby and Luka are resetting the skater dude's fractured leg. She takes a second to listen to his iPod so that we're absolutely clear which personal music player is the choice of the young people these days. As they get to work, she lightly asks Luka whether he's ever heard of anyone prescribing prophylactic triple cocktail after a known HIV exposure. "Sure," Luka says. "Hospitals give it to health-care workers all the time for needle sticks." Abby explains to him that "one of her patients" had an HIV scare, ignoring the fact that Elena used to be Luka's patient as well. Luka tsks that it's only for occupational exposures and isn't to be abused as morning-after medication. They get around the skater's leg and yank the bone back into place so they can set it, Luka, Luka, Luka...I just wanted to get the words "Luka" and "yank the bone" in one sentence, one last time. "We can't give preventive meds to every one night stand, when we still can't treat the people who are actually infected," he says. Abby bites her lip and says she's not talking about everyone, but Luka identifies the slippery slope of this approach and orders her to splint the skater and forget about it. She frowns, because them's fighting words. The gauntlet has been thrown, and it landed on Abby's foot.
Pratt is annoyed with Neela for taking eight hours to tell a man he's got leukemia. "Oncology couldn't get down and I was trying to figure out what to tell him," she argues. "He wasn't going to hear anything after you said 'cancer,'" Pratt says quietly. He tells her that she handled the whole thing wrong and could've gotten a social worker or a guard for the door. "It's about you and your need to be perfect," Pratt says. "You need to stop becoming a slow A-plus and start becoming a fast B." Can't she be a fast A-minus? I really don't know why Pratt wants her to slip a full grade point. As a once and future patient of doctors, I don't really advocate that. "Find him before he bleeds out and dies," Pratt says. I wish Neela had snotted that it would adversely affect her point totals, but instead she slumps away defeated. She needs to smile, and badly. She encounters Abby and remarks enviously that Abby and Ray are so confident in their traumas, and Abby brats that Neela ought to give herself at least a week before becoming better than everyone else again. Bitter much, Abby? "I don't know why I'm here," Neela frowns. Because you need decent money and because you are a gigantic mope who was unhappy at the Jumbo Mart? Because you frown at the idea of doing everything and yet you have no interest in doing what you studied to do? Forget the grass being greener elsewhere -- does she even know what color grass is supposed to be?
Carter sees Wendall sprinting through the ER, so he follows -- puppies do -- and finds her in Trauma Yellow, restraining a screaming and grieving Mrs. Mangled Man. Briefly, he wishes he could be in the middle of that fair-haired sandwich.
Ray hands out donuts like the Pied Piper of cholesterol. "Does he do that every day?" Neela complains. "Twice at the start of each nursing shift," Abby says with disdain. "And that works?" Neela gasps. "Apparently," Abby sighs. Pratt drops in for another helpful reminder that Ray is great and fast, and that everyone else eats his dust like disgusting little maggots. Abby spits that she's in some weird vortex where none of her cases are simple, not even the ones that look on paper like they will be. "All my patients need three consults and a huge workup, and even then, there's no definitive diagnosis," she rants. "I'm not going to pretend they're cut and dried to get a hash mark...I just want one patient today that has a clear problem that I can help!" Pratt is taken aback. "Okay," he says, handing her a chart. "Okay," she exhales.
Ray appears with donuts. He suggests that Abby bribe someone up in CT with a bear claw to get her stuff done faster, and then hands off the box to his students to put in the nurses' station. "Should I make sure someone sees me, so they know who it's from?" the student asks. Ray is proud of this initiative. "You don't find all this wheeling and dealing a little slimy?" Abby asks Sam. "Yeah, but sometimes you have to play some games to get things done," Sam notes. And she's getting donuts out of it. So she's an easy female. Loving this portrayal of nurses, people. Loving. It.
Scorecard Of My Last Nerve: Ray's winning, Abby has nineteen, and Neela has sixteen. The childish capitalized writing has returned. Just as Ray is getting even cockier, a guard calls out that an ER patient is up in the chapel praying. Neela sprints away. "Where you going? You're only at sixteen!" Pratt shouts. Hey, remember when you told Neela to find that guy before he bled out, at all costs? Well, here's the bill, ass-Pratt.
Abby calls the employee health people and lies that she just got stuck by a needle. Faking an HIV scare? Very classy.
Carter corrals Ray and asks whether he properly filled out the post-mortem checklist with Mrs. Mangled Man. "Yeah," Ray says. "Did you actually talk to her, or fill it out yourself to save time?" Carter sneers. Ray gasps, affronted. Carter explains that the woman walked in on the surgeon prepping to harvest her husband's organs, and freaked out because she didn't consent to it and she thought he was getting better. Ray's students are behind him, so the idiot makes the grave mistake of asking Carter with a haughty clearing of his throat whether they can talk about this somewhere else. Carter looks around and then says, "UNOS was on the phone with a kid in Madison who thought she was getting a heart, and you're worried about getting yelled at in front of some med students?" Ray sputters that she said she was fine with it. "No, Ray, she did not," Carter says. "Did you take the time to explain it to her?" Ray, coming unglued, sputters that he asked her... "DID YOU TAKE THE TIME TO EXPLAIN IT TO HER?" Carter yells. Ray decides to take the woe-is-me approach, bitching that it's hard to take care of four patients an hour and actually give them good, caring treatment. "No one said this job was easy," Carter snaps. "When you take shortcuts, you drop details, and people get hurt." We fade to black thinking that Carter should tell that to Pratt, who is demanding that they take the nearest exits off all the care pathways that run through the hospital. And we also want to pat Carter on the back for smacking down the new clown.
Abby gets blood drawn. A nice man gently tells her they'll test her for Hepatitis B and C, and HIV, and that she should be careful about sticking her hand in anything where used needles are lurking. She shrugs sweetly. "Stupid!" she says of her pretend mistake. He hands her a shitload of medicine, tells her how to take it, and says she should check back in two weeks. Abby looks not at all concerned that she's wasted the time of some very nice people with some very powerful medicine.
Neela bursts into the chapel and sees Juan praying. "We've been looking for you," she says. "You have leukemia." But she tells him that it's treatable and that he has an excellent chance of being cured. Juan ignores her, praying fearfully. Neela sits, tired. "I know it feels like something bigger than you is making this happen, but something also led you here," she points out. He turns slowly. "We will help you get through this," she promises. "There is a reason why you came into this hospital today." Juan looks at her, comprehension and hope jointly dawning in his eyes for the first time that day.
Carter stops Abby in the stairwell and kindly says that he heard about her needle stick, and does she want the day off? Abby winces. "I'm fine," she recoils uncomfortably. "I'm fine! Excuse me." Then she bumps into Wendall, who also heard. If word is traveling that fast, then that means Luka will have heard, and wouldn't he put two and two together? Abby had better hope he's as terrible at math as he is hot. Wendall offers a shoulder on which to cry, and smiles supportively. Urbanus rushes over to Abby in a complete tizzy over almost losing the love of his last three weeks. She gets a brainwave and asks him to get her an iced tea from across the street. Off he trots.
Ray stops off in Trauma Yellow because he sees a devastated Mrs. Mangled Man sitting in there, lost. "They took him to the morgue," she says brokenly. "Your sister called -- she took the kids to your house for the night," Ray says. Then he shoves his hands in his pockets. "Hey," he says, affecting a really out-of-place, upbeat tone. "I guess we had some kind of misunderstanding back there. I'm not even sure what it was about..." Liar. HATE. Lame apology. It's hard to like him when he won't ever admit to being wrong. "If there's anything I can do...Can I call you a cab, or something?" She is totally out of it, and Ray finally realizes that this moment is not about clearing his conscience, so he does the smart thing for the first time today and leaves.
Abby uses her Urbanus-free time to corral Ray and ask him if he has any friends in the pharmacy who could forge some labels for her preventative triple cocktail. Ray grabs the bottles and beams slowly. "I think I'm falling in love," he says. I'm not sure if he is directing that at Abby's appealing rebelliousness, or if it means he's about to go flirt up a storm with a pharmacist who will print up the labels if he fixes her paper jam -- wink, wink.
Neela types away on the computer. Carter asks how her first day was. "Hard," she says monotonously. "Gonna come back tomorrow?" he asks. "Yep," she says. He smiles. Wendall trots up on her way out to see if they ever located Juan. "He's starting chemo," Neela says. Wendall is delighted. "Thanks for your help today," Carter says awkwardly. Wendall is surprised. "Sure," she says, turning to leave. As Neela eavesdrops with some discomfort, Carter muddles through asking Wendall if she's leaving, and if she'd stick around so he can walk out with her. "Okay," she says, sort of shell-shocked. I'm all for Carter getting over his pain, but isn't this a little fast? It is still early August, according to the ER clock, and he just lost his would-be fiancée fairly recently. I guess one can never predict the grief cycle of a penis. "I think I hear rounds starting," Neela says, beating a hasty retreat just a tad too late.
Abby sends Elena packing with her medication, satisfied to have bucked the system and lived to tell about it, despite the wretched karma a fake HIV scare will give her. She must figure her karma's already verging on nuclear in its negativity. Urbanus sidles up to Abby and asks if she has dinner plans. "No," she says. Pause. "Maybe that was too subtle," Urbanus says. "It wasn't too subtle," she assures him. He's crushed that her answer is still no. Aw. Except that his open adoration was kind of ooky, but still...rejection sucks. Pratt makes fun of a departing Ray's ripped t-shirt. "I met my discharge quota!" Ray says proudly. "So did I," Sam says, writing "Sam = 75" on the board and circling it proudly. Heh, that's kind of funny. You go, Sam, sticking up for the nurses. Ray wants them all to go out drinking to get over their shift from hell, but Neela hates the idea and Abby quietly refuses. Neela can't fathom how Ray has all that energy. "It's easy when the staff literally eats out of your hand," Abby cracks. She marvels that Ray finishes everything right when his shift is supposed to end. "I have an hour's worth of charting," she sighs. Susan hands out paychecks, Luka starts everyone's rounds, and a weirdly aggressive music cue starts up that makes me want to jig and start moshing all at once. We pull out of the ER and leave for another week.
And, for me, forever.
...Okay, that was deliberately melodramatic. I thought that might fit the occasional tone of the show itself. But it's not a joke: this is my final ER recap, a schedule-dictated decision that was surprisingly hard for me when you consider how this show gives me fits. After three and a quarter years, it's weird to think of not recapping it until it dies, but I just couldn't while retaining my sanity day-to-day. Thank you all so much for your support of me and my recaps; hopefully I'll live to recap another day for this site. I plan on it, anyway, as long as the lovely and talented Wing Chun will have me. ["Of course. Not even a question." -- Wing Chun] Thanks to her for trusting me with this show...and with that, I hand you off to the funny, delightful Kim. Maybe she'll win back some of the Carter lovers by finding his bloat slightly less painful to see than I do. Take care, all! And Goran V. -- now that there is no direct conflict of interest, you are free to call me at will. I can't believe this was my last episode and you were barely in it.