Previously: Carter asked Susan how she wanted to define herself as chief. Neela thought she sucked, and Luka comforted her. Not like that. Although she wishes. Abby insisted she was doing fine after her abduction, and connected with Jake.
Luka and Sam's place. Luka is finishing breakfast, and a teakettle whistling signifies the tension in the household as Sam's not dissimilar voice shrieks at Alex to hurry up or he'll miss his bus. After discussing their work schedules, Sam asks cheerfully if Neela is working with Luka today, and Luka, clueless, says she might be. Sam keeps needling him until she finally just says it: "She's got a crush on you." Luka insists that he's just Neela's teacher, and Sam says that everyone (Pratt, Frank, Jerry, Malarkey, Chuny, Haleh, and Murray the guy from the Roach Coach) can see the relationship is more than that. Sam also thinks that Luka is encouraging it. Which would be a fine thing for Sam to say if she were concerned about Neela's feelings getting hurt, but she's really saying it because she honestly seems to think that Luka's going to throw her over for Neela. Although with the way Sam's been acting lately, could you blame him if he did? Sam jokingly asks if she's going to have to get into "some nasty chick fight" with Neela, then adds that Luka will be the one getting hurt if anything happens. Yeah, keeping your loved ones close with threatened violence. Great strategy, Sam. Maybe if you stopped being such a crotch and grew up a little, Luka would want to stick around. I like Linda Cardellini a whole lot, and I liked the character of Sam in the beginning, but her relationship "skills" suck and it makes me hate her.
Abby and Neela discuss the last time they each got laid. Abby says it was in April, with the guy who drove a motorcycle. Neela says it was her gross anatomy instructor. Abby is surprised that Neela slept with a teacher, and then concludes that they're both facing a long dry spell. Neela says that they can use work to keep their minds off sex. So, of course, Luka walks in and announces that a multiple MVA is on the way in. Neela gazes at him adoringly.
Susan announces that patient satisfaction scores are up a bit, so she's happy. And I guess that plotline is finished now. She tells Carter that she's going to post the new scores, and then thanks him for taking what could have been an awkward situation (having your friend and ex-girlfriend as your boss, although she doesn't mention the ex-girlfriend part) and making it go smoothly. Carter says that he can't think of anyone else he'd rather have as a boss. Susan kind of squints at him as the EMTs roll in a girl who backed into a utility pole while her father was teaching her to drive. Susan fires a parting shot when she tells Carter not to call her Susan at work.
Carter gets the bullet on the young girl. Hey, her dad is Graham Chase! So I'm just going to call the young girl Angela. Angela explains that she got dizzy while driving and might have gotten the pedals mixed up, causing the accident.
Susan posts the patient satisfaction scores as Abby and Neela walk up. Susan cracks, "We don't suck as bad as we used to. And maybe by week, we'll suck a little less!" Abby jokes back, "Must be your motivational speeches." Susan announces that they're pairing Attendings with interns, and that Contrivance has paired Neela and Kovac, as well as decreed that Abby will be teaching Jake. It's bad enough that they seem to pair couples together on this show by drawing names out of a hat at six-month intervals, but now they've got to come up with completely forced ways to make them interact? This is almost (but not quite) as bad as that horrible episode with Luka, Abby, Carter, Susan, and Gallant at the sexual harassment seminar. Neela smirks about Abby having to work with Jake as she walks off.
Abby, Neela, and Jake head out to meet the ambulance. Abby asks Jake if he knows how to clear a C-spine, and he doesn't. The paramedics roll in two people on one gurney; it's a man and a woman, naked, and, shall we say, engaged. And I don't mean in the "to be married" sense. It seems they were having sex in a car when they were rear-ended. Which might not be the best term to use when you're talking about someone having sex. Apparently, the dude has a broken pelvis, and they later reveal that he took Viagra so that means that his erection can't go down. I still don't get why the woman is stuck, though. Did it swell? It's not like he has a (squeamish people skip to the paragraph) grappling hook at the end of his penis that hooks into her cervix or something (I warned you). Abby and Neela are semi-amused as the couple is wheeled inside.
The sex couple is brought into a curtain area. Jake is impressed that the couple was in the back of some tiny sports car. Neela is not so impressed. Sex Lady asks what they were supposed to do, since her husband was home. Neela asks Abby if she has this, and Abby says she's all over it. Neela glances at Jake, chuckles, and leaves. Jake says that they'll give Sex Guy morphine to help with his pain until his Viagra wears off. Still don't get why the woman is stuck. Is it because he has a fractured pelvis, and it's unstable, so if she moves it could cause further damage? That makes no sense though, because her weight and jostling around can't be making things any better. I know. I'm overthinking it.
Neela walks up to Luka and breathily says that Susan ordered her to present to him today. Luka curtly says, "Okay." Neela wonders if he'll show her the femoral tear procedure he mentioned, and Luka awkwardly grabs a chart. Neela stands so close to Luka that he bumps her when he turns around, and then sends her off to deal with the most unsexy chart he could find: infected anal fissure. Works for me. I mean, that it's not sexy, not that I like infected anal fissures. Although that is totally the name of my all-girl punk band.
Shane West and Carter examine Angela, as Graham complains that his wife (Patty, natch) is going to kill him. Patty is overprotective, and she and Graham are separated. Shane West asks if Angela takes any medications, and Graham reels off a whole list, and then it comes out that Angela has polycystic kidney disease and had a kidney transplant the year. Um, wouldn't that be something you'd mention up front? It seems pretty major. Graham explains that Angela was on the UNOS list for seven years, but that she has a rare blood/antigen type, and then she finally got big enough that Graham could donate his own kidney to her. Carter is impressed that Graham did that. Shane West asks about any other medications, and Graham says she's on an anti-seizure drug because her kidney disease caused an aneurysm. Haleh says that Patty is on her way there. Carter listens to her chest and hears crackles. Shane West looks at the EKG with concern, and Carter starts ordering drugs. Graham asks what's going on, and Carter says that she might have hyperkalemia. Graham doesn't think it's possible, since she had a transplant so that her kidney function should be fine. Luka pokes his head in and asks to see Carter.
Outside, Luka asks if Carter will trade Shane for Neela. Carter, of course, wants to know why, and Luka just asks Carter for a favor. Carter is fine with taking on "the Punjabi Powerhouse" (a phrase which seems more than a little forced). Carter leaves, and Neela approaches. Luka informs her that she'll be working with Carter today. Neela doesn't understand, and Luka just says she's needed in Trauma, and runs away quickly. Neela looks disappointed.
Abby and Jake examine Sex Guy's x-ray (say that three times fast) and confirm a pelvic fracture. Sex Guy asks if he'll be okay, and Jake tells him that he doesn't need a cast or surgery, but will require rest and pain medicine. Abby tries delicately to say that he'll have to be "careful" for a few weeks. Like he needs to use a condom? You're a doctor, Abby. Spell it out. She does, clarifying that he'll need to be abstinent. Jake adds that it's the safest sex of all. Sex Guy can't believe it, like, is he an animal? It's just a few weeks. He'll be so doped up on pain meds that he won't care anyway. Abby explains that any pressure on his pelvis will mean a return trip to the hospital. Sex Girl latches onto this explanation, and asks if they can try other positions. Buy a vibrator, honey. Or, you know, go back to your husband. Abby smiles but snips, "Get yourself a sex-pack, a copy of the Kama Sutra, and shoot out the lights." She walks off and Sex Guy asks if she's offended. Probably more like grossed out.
Angela has stabilized. Graham asks if it's definitely a kidney problem, and Carter explains that it looks that way, but that they won't know for sure until they get the lab results. Patty runs in and immediately starts a fight with Graham over the stupidity of letting Angela drive. Carter asks the parents to step outside so that he can take a medical history and Angela can rest. Once her parents are gone, Angela says that her illness is too much for her parents to take.
Outside, Graham explains that Angela didn't like taking Dilantin because it changed her appearance and had seizures. Patty insists that it was fine, but Graham says it wasn't. Graham adds that they changed her medication to something called Zorictal. Carter isn't familiar with it. Patty interjects that they couldn't afford it. Graham says he took a second job to pay for it. Patty says that they lost their apartment. Wow, you can feel the love between these two. Graham thinks it's worth it, because Angela has been doing great. Carter asks about side effects, and both Graham and Patty say that she's been stable. Patty starts in again, and Graham raises his voice to say that Angela just wanted to drive like other kids. Patty yells that they almost lost her once, and that her life is more important than getting a license. Carter raises his eyebrows, and Patty apologizes and says that they need to accept the fact that Angela will never be totally healthy. Graham won't accept that. Patty walks off in a huff. Carter asks if Angela has a neurologist, and Graham agrees to call him so that Carter can discuss this new medication. Neela walks up, and Carter tells her to look into Zorictal. Neela's heard of it, and Carter is impressed. He tells her to research any renal dysfunction associated with the drug.
Jake presents a case to Abby -- a guy named George with skin breakdown around the shaft of his penis. Oh, for crying out loud. Jake and Abby already have nice chemistry. Do we really need eight sex cases to underline the tension? Abby asks a few questions and finds out that George doesn't have any other symptoms, and that his girlfriend broke up with him a few months ago. Abby dons some gloves and takes a peek at the goodies. George asks if this could be from too much...he won't say, but he means masturbation. Abby asks about frequency, and George says it's been six or seven times a day. Are they putting something in the Chicago water supply?
Neela reports to Carter that she found a suggested correlation between renal failure and Zorictal. Carter thinks it's less than conclusive. Neela shows Carter some more evidence, and then calls the physician relations number of Zorictal's manufacturer. Carter explains the situation to the operator and gets put on hold. Haleh tells to Carter that there's a problem with Angela's heart rate, so Neela agrees to wait on hold while Carter takes care of it.
Carter runs into Trauma Yellow and tells Patty that the elevated potassium levels might be irritating Angela's heart. Haleh calls out some levels, and Carter murmurs that Angela might be in kidney failure. Graham and Patty watch anxiously as Carter shocks Angela's heart with the defibrillator, and we go to break.
After the commercials, Carter gets Angela's heart rhythm back and tells someone to set up dialysis. Haleh nudges Angela back into consciousness. Graham asks if Carter is sure Angela needs dialysis. Carter says it's the best way to remove the excess potassium. Patty asks if her daughter needs another transplant, and Carter says it's "a distinct possibility." Graham and Patty look devastated. Neela enters and says that the drug company will contact Carter within a week. Carter is annoyed at the delay, and Neela says it's standard procedure. Graham asks what they're talking about, and Neela explains. Patty asks if the kidney failure is due to the drug. Carter says that's his hypothesis, given the timing of the med switch, but they need more proof. Before Patty can blame Graham for the whole thing, George Henry (Chad Lowe) walks in. He's their neurologist. For those of you who missed Chad Lowe's first appearance on the show, which was before we started recapping it, he played a student of Carter's who was more interested in theoretical laboratory work than in treating patients, and who was trying to skim through his ER rotation without doing any actual procedures or talking to any patients. Of course, Carter had no time for that, and their relationship was a bit prickly. Graham introduces Carter to Henry, and Carter recognizes Henry, but doesn't seem pleased to see him. Carter asks Henry to take Graham and Patty to the family room.
Jake tells Abby that he gave Masturbation Boy some Neosporin and the number of a therapist. Abby approves. Jake asks Abby if she's all right, and Abby is curious as to why he asked. Jake explains that he just found out about Abby's "situation." As they talk, Susan totally listens in. Jake explains that he didn't want Abby to think he was insensitive, but that he didn't know about it when they met on the El platform. Abby says she was actually glad to avoid talking about it. Jake asks if she's sure there's not anything he can do. Abby stammers and stutters and then hands him a chart to handle before practically sprinting away.
Abby walks up to Susan and asks why Jake was assigned to her. Susan wonders when everyone became "such schedule divas." Is she new? No one in that ER can just work a regular shift without some sort of complaint. Abby says she doesn't really want a student. Maybe she should get a job somewhere besides a teaching hospital. Abby continues to stammer, and Susan realizes that Abby has a crush on Jake. Abby denies it, and Susan laughs and points and asks, "Hey, haven't you had enough of doctors?" Hee. I like Susan.
Carter orders Neela to post something on various medical newsgroups asking if anyone else has seen evidence that Zorictal causes kidney damage. Neela opines that it might "cause a bit of a stir." Carter realizes she's right, and tells her to "ask for any information that might help [them] determine the best course of treatment."
Carter pushes into the family room, where Graham and Patty are arguing over whether the Zorictal is to blame for Angela's condition. Henry thinks there are other options. Carter says they're setting Angela up for dialysis, and he called UNOS to get Angela put back on the transplant list. Henry thinks it's premature, and explains to the Chases that they could do a biopsy to see if it's a case of organ rejection (which could be reversed with more drugs) instead of kidney failure (which would require a transplant). Graham wants to do the biopsy, and Carter reluctantly agrees and asks to speak to Henry outside.
Carter waits until they are well away from the Chase family and then fills Henry in on Neela's research. Henry defends the drug, saying that if there were any real risk, the FDA wouldn't have approved it. Carter chuckles condescendingly and brings up Vioxx. Henry continues to sing the praises of Zorictal. Haleh tells Carter that dialysis is ready. Carter asks her to page Dubenko to do a biopsy, and then tells Henry in his faux-jovial voice that he hopes Henry is right, and that it's not kidney failure. Henry says he wants to be certain, and then says he's surprised that Carter is still working in the ER, because he thought Carter would have moved on by now. Carter mumbles that he's "just a masochist that way," and Haleh smirks. Carter says he thought Henry was going into research. Henry says he got tired of it. Carter thinks Henry was good at it. Henry says he's married with two kids, which changed his priorities. Carter asks if he's talking about money, which seems like kind of an obtrusive question. Henry admits that his practice offers him three times the salary of an academic position. Haleh eyeballs him, like, "Child, you did NOT just say that to someone who is currently in an academic position, namely Carter." Yes, Haleh can say all that by moving her eyes slightly. She's that good. Henry asks Carter if he has a family. Carter says briefly, "Not yet." Haleh gives him a look like, "I'm sorry this guy is a dillweed." Carter promises to find Henry when Dubenko arrives and claps him on the back. As soon as Carter turns to walk away, his face falls and the faux-joviality is gone. It was a nice moment by Noah Wyle, whose acting choices I don't always like.
Susan asks Neela, who is printing out a bunch of stuff, if she's moonlighting as a word processor. Neela explains her research. Sam walks in and says hello, then bitches at Neela for using the nursing schedule as a coaster for her coffee mug. Neela apologizes. Hey, if it's that important a document, don't leave it lying on the counter. It's an ER. She's lucky it wasn't puked on.
Luka and Shane West wheel in a guy who fell from the roof while taking down his Christmas lights. Neela offers to help, and Luka reluctantly agrees. Once they are in Trauma Green, Luka announces that they need to perform a saphenous cutdown. Neela thinks this would be a perfect opportunity to learn that femoral tear technique Luka told her about earlier, and Luka once again reluctantly agrees. Shane thinks he's going to do it, but Luka explains that he promised Neela. Once everyone is gloved, Neela starts cutting. Luka pries apart the dude's thigh (ew!), which requires him to squish closer to Neela. So, of course, Sam walks in at that moment looking for something and gives Luka the stink-eye, like, he's doing a MEDICAL PROCEDURE, so back off! It's not like he's giving Neela a hand massage or something. Plus, you've told him about the crush, so if he chooses to encourage it after your threatened violence, well, I guess he doesn't really like you that much. Either way, chill out. Neela can't get the access she needs, and ends up having to duck under Luka's arm so that he's practically embracing her. She stares into his face, mesmerized, and Luka tells her to focus on the field. Luka tries to break the tension by asking Sam (who's doing nothing but glaring at them) to ask Dubenko to come over when he's available. Sam, dripping with sugar/venom, says, "Yes, sir, Dr. Kovac." God, she's bugging me. Grow up, Sam.
Sam busts into Trauma Yellow, where Dubenko is performing Angela's biopsy. As she offers up a purple marker to tag the biopsy spot, Angela asks what this will do, and Henry explains the procedure as her mother reassures her. Dubenko takes the biopsy. Sam takes a call and tells Carter, "Dr. Weaver's on the phone. She sounds kinda..." Carter asks her to finish the sentence, and Sam comes up with, "Weaver-like." Carter says he'll call back. Dubenko finishes his procedure and tells Angela that he likes azure better than purple. She doesn't know what color that is (has she never had a box of crayons?), and Dubenko explains that it's "like [her] eyes." I'm sure I'm supposed to find that charming, but she's sixteen and looks younger, and it creeps me out that he's flirting with her. ["I'm more disturbed that she's sixteen and doesn't know the word 'azure.' Did her aneurysm turn her stupid?" -- Wing Chun] Dubenko orders the necessary tests on the biopsy sample and leaves. Graham exhales like he's been holding his breath the whole time, as Dubenko heads out.
door in Trauma Green, Shane explains to Dubenko that the patient needs a head CT, and Dubenko starts wheeling him upstairs. Neela his finished her procedure and the patient is stable. Everyone clears out, leaving Neela and Luka alone. Neela starts to say something, then seems to change her mind, and instead remarks upon the swiftness of the transfusion. Luka responds tersely and practically runs out of the room.
Carter asks Henry why he recommended Zorictal. Henry says he heard a lecture at Northwestern, and Carter thinks the lecturer was on the drug company payroll. They continue debating as Graham runs up and asks if he can donate his other kidney to his daughter if she needs one. Henry explains that he would have to be on dialysis for life. Graham knows. Carter doesn't think it would be ethical for them to perform such an operation on him. Graham asks if it's possible. Carter says that no doctor would agree to do it, and he seems to be almost laughing about it, like, way to take your patient's concerns seriously, dude. Henry says that he knows Graham is scared, but that they should wait for the biopsy results first. Graham agrees, but doesn't seem satisfied.
Lily walks up and hands Carter a fax from an area doctor. It's a generic letter from the Zorictal drug company. Carter reads it and says that there have been "isolated cases of renal failure on Zorictal." Henry already knows, and also knows that it recommends monthly monitoring, which he did. Carter is shocked that Henry already knew. Henry says every doctor got one, and he followed the recommendations. Carter can't believe Henry is pretending it might be organ rejection when he knows otherwise, and Henry says he's still hoping for organ rejection.
Weaver and Susan show up and pull Carter aside to ream him for posting publicly about the Zorictal issue. Carter says he just asked for information. Weaver says he's created a kafuffle, and he's jumping to conclusions based on skimpy evidence. Carter points out that Angela needs a new kidney, but Weaver continues to defend the research. Weaver and Carter continue to raise their voices at each other while Susan listens and looks uncomfortable. Weaver babbles on about clinical trials and the FDA while Carter screams, "Are you telling me how to do my job? Are you TELLING ME how to DO MY JOB?!?" Susan tries to get them to shut up, and finally Weaver realizes that they are creating a scene, and pulls Carter into the drug lockup. She orders him to choose a bottle. He picks one at random, and Weaver talks about how many lives that drug has saved. She picks up a few other bottles and goes over the effects they have on people's lives. Susan quietly says that Carter gets it, and Carter angrily agrees. Weaver speechifies that the drugs save lives, and that the manufacturing companies donate a lot of money to the hospital. Carter asks if it's okay to suppress negative test results. Weaver doesn't think that's what happened here, and says that no advancement comes without experimentation. Carter thinks she's being naïve. Weaver says forcefully, "Your job is to take care of your patients, not start a crusade." Susan rubs her temple. Weaver walks out and tells Susan to keep Carter under control. Susan looks at him archly and says, "No more computer access for you!" Carter punches the door because he is a MAN! I hate when I agree with a character philosophically, and yet he annoys me so much that I'm forced to go against him.
Neela and Abby are at the Jumbo Mart. Is that even what it's called, or did I just make that up? You know what? I don't care. Anyway, Neela is complaining about how idiotic she felt for mooning over Luka that way. Abby thinks Neela's crush is weird. Neela argues that crushes are, by nature, idealized and unrealistic. Abby reminds Neela of her crush on her instructor that ended up in S-E-X. Neela says dryly, "My God, you're right. It's a pattern. I'm a slut for authority." I love when Neela is sarcastic. Neela asks Abby about Jake, and Abby denies that there's anything going on. They realize that Neela's hung up on her supervisor and Abby's hung up on her subordinate, and Abby comments that she is the "yin to [Neela's] yang." Neela wonders what they should do, and Abby suggests that they ignore it and hope it goes away. She concludes (not believing it herself), "Denial works!"
Luka tells Sam to administer a drug to a patient. Sam, who is running around with an armload of charts, snarls at him that she'll get to it later. Carter asks if Angela's biopsy results are in yet, and Sam says more kindly that Dubenko is on his way down. Neela walks in and asks about some more test results, and Sam bitches that they've been sent off, and runs out of Admit. Wow, she's pleasant to work with. Luka watches her go and sighs. Break up with her! You don't make each other happy! You don't even like each other! She's not that pretty and she's not that special!
Dubenko presents the results of the biopsy to Carter -- Angela has kidney failure due to drug toxicity, and she needs a new kidney. Dubenko asks Carter if he's really been posting shit about Zorictal on the internet; Carter says he was just trying to be thorough. Dubenko advises Carter, "Don't piss off the money people."
Carter and Dubenko enter Trauma Yellow and deliver the bad news to the Chase family. Graham makes sure he understands that it's not rejection. Henry says that the kidney is irreversibly damaged. Graham asks if it's because of the Zorictal. Henry suggests that it could be another drug she's been taking, but Dubenko shoots him down. Graham really wants to drive home how badly this sucks: "So this drug that I've been working two jobs to pay for, just to make her life better, has ruined her donated kidney." Yep, now we're all caught up. Patty cries silently to him. Graham wonders why Henry didn't warn them about this, and Henry insists that it couldn't have been anticipated. Patty asks if they're back to waiting for a donor, and Carter says that UNOS will prioritize Angela. Graham shouts that it will take three or four years to find a kidney donor. Henry, the master of poor timing, recommends that they have a surgeon down to install a forearm shunt to make dialysis easier. Yeah, that's just what her parents want to decide right now. Graham yells that Angela will be on dialysis all through high school and college. Carter tries to suggest that they could get lucky with a kidney donor. Graham reminds him that they never found one the first time, because Graham donated his kidney. Everyone is silent. Graham stares at Henry and says, "We have given up a lot. Made a lot of sacrifices. You told me this drug was worth it." Henry looks like he's going to start sobbing like his wife just won a Golden Globe or something.
Jake, Abby, and Sam are putting in a chest tube. Abby supervises while Jake inserts. And if you think that was a double entendre, wait until the rest of the scene. The whole thing somehow turns into some sort of sexy-sexy thing with fingers being inserted and whatnot. It's gross, and poor Sam has to witness the whole thing. Sam spots Neela talking to Luka and asks, "Somebody put something in the water today?"
Luka corrects Neela's trauma report, and then returns it to her. As she starts to leave, he says awkwardly, "I hope I didn't give you the wrong impression. You're a resident and I'm an Attending." Neela tries to shut him up quickly and end this nightmare by stuttering that she understands. She runs out. Luka turns and sees Sam glaring at him from the room. Shut up, Sam.
Neela goes to check on Angela, who is getting dialysis. And hey, it's the same dialysis tech that Abby called in on Christmas Eve! Nice continuity. Neela tells Patty that Angela's potassium levels are getting lower. Patty says that Graham went to work at his second job, which he got just to pay for everything, and that nothing means more to him than Angela's getting well. Patty cries a little and says that Angela's illness changed Graham and ruined their marriage. Neela says it's important to stay optimistic, and that a lot of good things could still happen. Even Neela looks like she doesn't really believe that.
Susan marches through Admit and announces an incoming MVC. Carter says that he and Shane will take it. Shane asks what an MVC is, and Susan says it's a Motor Vehicle Collision; they aren't allowed to use MVA anymore, because "there's no such thing as an accident."
Henry runs up to Carter and asks to talk. Henry says that he was aware of the potential for toxicity in Zorictal, but it was only one case report in an obscure journal. Carter suggests "a simple Medline search." Henry thinks that's unrealistic and adds that he has twenty patients on the drug who are all doing well. Carter wonders if the drug company is paying Henry something. Henry admits that he's given a stipend for reporting on the progress of the drug. Carter chuckles that it sounds like a malpractice suit waiting to happen. Henry insists that it's fine, and that he's helping to monitor a new drug, but Carter thinks the company only looks at the data they like and discards the rest.
Carter and Henry end up in the ambulance bay, waiting for the MVC to show up. Unbeknownst to them, Graham is standing nearby, listening in on their conversation. Their argument continues in the same vein, where Carter is all anti-drug company and Henry is defending himself. Shane walks up and points out Graham standing nearby. Who knew Shane would end up being the most sensitive person in any scene, ever? Carter walks over to Graham and says hello. Graham has changed into his security officer uniform, and he's clearly losing it. His mind, not the uniform. He says that he was going to work, and wondered what the point was. The doctors notice that Graham is holding a gun and slowly back away. Henry tells Graham to put the gun away. Graham cries, "I put everything in your hands. Everything. And you let her down." Henry tries to give Graham the company line about Angela's living a long, productive life on dialysis. Graham points the gun at Henry and asks why he shouldn't shoot him. Carter says soothingly that they should go inside and see Graham's family. Graham starts sobbing and lets the gun drift down. He tells Carter that he wants to give his kidney to Angela. Carter nods and says okay -- that he might have been wrong about that. Graham knows he's lying, mostly because that was the most unconvincing delivery ever. Graham asks Carter to fix his daughter. Carter turns to Henry and Shane to try to get them to agree that they'll fix Angela, and while his head is turned, Graham puts the gun in his mouth and pulls the trigger. I, unfortunately, read the episode thread before I actually watched the episode, so I was spoiled for that moment. But I don't think I would have seen it coming. I would have been too excited about the possibility of seeing Shane West get shot. Or realistically, I would have thought Henry would be shot.
Graham is in Trauma Green. Neela tries to intubate, but there's too much blood. Monitors are beeping all over the place. Carter asks someone to find Patty, and orders someone else to block Angela's view of her father's trauma, even though Angela is asleep now. Dubenko reports that gray matter is all over the place (except he says that using medical terminology), and that the pupils are fixed and dilated. Shane wonders why Graham would do this, and Henry says that he was distraught. Neela reports that there is no gag reflex, and Dubenko sticks a swab in Graham's eye and reports that there's no corneal reflex either. Dubenko concludes, "He's as brain dead as they come."
A nurse brings Patty over, and Carter heads out to talk to her. Henry stops him and says that he wants to do it. He heads out into the hall, and we don't hear what he says, but we see Patty starts screaming and crying. Sam reports that the transplant coordinator has arrived. Everyone looks sober as Henry holds Patty up in the hallway.
The transplant coordinator tells Carter that UNOS are the only ones that can approve this transplant. Carter explains that Angela has a rare blood type, and that Graham is a perfect match. The coordinator promises to try her best, and tells Carter to keep Angela and Graham on standby for transplant.
Weaver deals with some reporters by screeching at them to get out, and castigating them for letting their paper endorse Bush. And while I wholeheartedly agree with Weaver's political leanings, that seemed more than a little out of place. Susan wonders what could go wrong , and Weaver reports that someone has to go talk to the press. Like, I don't know, the hospital's media relations person? Or someone from the public relations office? I do know that in a delicate situation like this, no major institution would ever let anyone without media training talk to the press. And yet, Susan suggests that Carter, known loose cannon, take care of it. She reminds him to say that they are respecting the privacy of the family and can't release any details. Carter isn't excited about the idea, but does it anyway.
Neela and Sam care for Graham in the darkest room outside of Luka's apartment. Neela asks if they need to talk, and Sam insists that they don't. Neela tries to explain why she fell for Luka, and ends up saying, "I got confused." Sam chuckles and allows, "I get confused every time I look at him." She changes the subject by asking if Neela worked on the Chase family. Neela did. Sam says she's sorry.
Carter fields questions from the media in the ambulance bay. They know about Carter's internet activities. While Carter continues to struggle, Jake calls out to Abby as they are both leaving for the day; he asks her to get something to eat. Abby says no, and tells him not to take it personally. She walks away and he chases after her. Jake laughs that he was under the impression there was sort of a thing going on between them. Abby agrees, but says nothing can happen. She adds that there are many reasons, but that she doesn't feel like going into her checkered past or various neuroses. But she has one big reason. Jake guesses that she misses his beard. Jake, no one misses the beard. Abby says that he's her student, and that she has to give him a grade. Jake laughs, and Abby tells him good night. As she walks away, Jake yells after her that he's willing to take an F, and then tries to say that he's dropping out of medical school.
Everyone stands in Admit and watches Carter's taped interview on the television. A reporter asks, "Don't you think it's incumbent on you to share the information on the possible fatal side effects of a popular new drug?" Carter hems and haws and then says that he believes that Zorictal ruined Angela's kidney. Susan snaps off the TV and wails to Carter that he should have kept his trap shut. Carter thinks the reporters already knew everything. Susan says that Carter's potential slander could cost the hospital millions in pharmaceutical dollars. Carter gets pissy and asks if Susan is worried about free pens and coffee cups. Susan reminds him of research educational grants and patient confidentiality. Carter yells at Susan that she should have talked to them, since it's her ER. Word, Carter. Although dial down the hissy a bit there, Junior. Haleh tells Susan that Weaver's on the phone. Luka stops and tells Carter that he did a good thing. Carter sighs and says, "You say that like it matters." Luka and Sam head out.
The transplant coordinator tells Patty and Henry that UNOS gave them the okay to do the transplant. Patty heaves a big sigh and thanks God. Patty tells them that she hasn't told Angela yet where the kidney is coming from, and Patty and the transplant coordinator head into the room to talk to the anesthesiologist. Henry asks Neela how her education is going. Neela says some days are better than others, but that she likes it well enough. Neela asks what they'll tell Angela. Henry thinks they'll tell her that her father loved her, maybe too much.
Carter writes something on the board. Henry walks up and reports that the transplant surgery is underway. He hesitates, and then says that he can't take responsibility for the way the system works, but that he can try to do his job better. Carter says lightly that it's all anybody can do. Henry adds that he shouldn't have been surprised to find Carter still at County, and I think that was supposed to be a compliment. Carter hopes they see each other again under more favorable circumstances. Henry thinks Carter was always good to him when he was a student. They shake hands and Henry leaves. Carter watches him walk out. Susan stomps up and reports that Anspaugh wants to see them in his office in the morning. Carter sincerely says, "If any of this rolls back onto you, I'm sorry." Susan half smiles and leaves.
Carter heads over to a curtain area to do some sutures on an older black man. Hey, he's old and he's black, so I bet he has some wisdom to impart! Because while older black women like to sing about Jesus, older black men like to tell some home truths and folksy yarns. Anyway, this dude had severe arthritis, but thanks to some wonder drug, now he can cross-country ski. And I appreciate the effort to be even-handed, but they didn't also have to be ham-handed.