By Kim
Previously: Abby wasn't sure if she wanted people to know that she was dating Jake. Pratt met Olivia, a woman who ran a non-violence organization. Abby treated two sisters who panhandle for a living. Susan pooh-poohed Morris's application for Chief Resident.
Chuck (with Cosmo) and Susan discuss the fact that they need to buy a house, but they're not having luck finding a place. Susan is in the midst of getting dressed up for something -- she's wearing a suit. Susan also pronounces "realtor" as "realator," which is one of my pet peeves. Chuck expositions that it doesn't seem fair that Susan had to work all night and now she has to go back in for this meeting. Susan freaks out because she thinks that Chuck is saying she looks tired, and then freaks out again because there's baby detritus on her jacket. Susan explains that it's a tenure meeting. Chuck accuses her of worrying too much, but Susan says that getting tenure would mean financial security for their family. Chuck offers to return to work, and there's a funny sight gag where his pajama pants match Cosmo's high chair, like maybe Chuck has been home too long. Chuck adds that Susan could make more money at a private hospital. Susan checks her look in the mirror and says that she belongs at County, and wants to stay. She kisses Cosmo and Chuck goodbye, and promises to be home after her two meetings of the day. Chuck sadly points out that she has a smudge on the back of her jacket, and Cosmo laughs.
Neela greets the paramedics. Doris gives the bullet: the patient is Jules Rubadoux, age eighty-five, and he fainted. Ruby first doubts Neela's medical credentials, given her young age, and then protests that he was tripped. Doris says that it was "a syncopal event at his bridge club," and that Ruby was unconscious for thirty seconds. Ruby continues being a crotchety old man.
Some teenaged patient screams at Carter, "Get out of here and bring back the omelet! Now! And it better now have spinach in it! I hate spinach!" Hee! Carter closes the curtain and quizzes Abby and Shane (along with an assortment of students) about the case. Shane guesses that the patient snorted antihistamines. Abby gets the correct treatment after some big hints, and the other students chime in with answers.
Ruby is still complaining. He's especially concerned about being at County, yelling, "I don't want this place. And I don't want your doctors." He points at Carter down the hall: "Especially that one. I don't want that one anywhere near me! He killed my wife!" Carter looks around to see whom Ruby's talking about, and everyone avoids his gaze.
Ruby is still complaining. He's especially concerned about being at County, yelling, "I don't want this place. And I don't want your doctors." He points at Carter down the hall: "Especially that one. I don't want that one anywhere near me! He killed my wife!" Carter looks around to see whom Ruby's talking about, and everyone avoids his gaze.
Sam walks behind the desk with a stack of folders. Pratt complains about a patient who's been waiting for Sam to take him to CT for forty minutes, and Sam admits that she totally spaced out on it, and promises to go now. Jerry tells her not to bother, because they're backed up, and when Sam picks up her giant stack of folders (Of Doom!), she knocks over Jerry's coffee. And then she snaps at Jerry. What's up her butt? Pratt tries to get things moving by passing out charts. He gives Shane a transfer from Seashore House -- a patient with fever and incontinence. Shane tries to trade with Abby, who isn't having it. Neela gets Ruby, whom Abby refers to as "the nasty guy that yelled at Carter." Neela's shift is over, so she passes the case off to Abby.
Susan meets with the tenure committee and explains her credentials. Committee members include Dubenko, Kaysen, Anspaugh, and Weaver. Susan talks about her excellence in teaching, and adds that she's helped with admissions. Weaver keeps yelling out more things Susan has done, clearly trying to help. Dubenko and Kaysen point out that Susan has no publications or research on her CV. Susan says that she just submitted an article, and that she's got others lined up once she gets the grant money. Dubenko says something sort of condescending about how it can be "hard to find your niche" in emergency medicine. Susan squints at him. Anspaugh says that they can overlook it in junior faculty members, but that tenured employees need to "pull their own weight." Susan translates this as saying that she needs to earn more grant money. Weaver backs Susan up on her abilities as a doctor and instructor, and adds that they really value those skills. Susan nods at Kerry.
Abby tries to listen to Ruby's lung, but he won't shut up about how he wants to talk to his own doctor. Abby kind of snaps at him and he shuts up. She listens for a moment and then tells him that she thinks he has a heart murmur, and she'd like to run an EKG and a chest x-ray. Ruby says he doesn't want "some nurse calling the shots around here." Abby says with exaggerated patience that she's actually a doctor. Ruby yells that she's not his doctor, and that he doesn't want to do anything until he talks to his doctor. Abby relents, and Ruby yells, "OKAY!" It cracked me up, because he clearly wasn't expecting her to give in so easily.
The paramedics bring in a woman who is bloody and having trouble breathing. Pratt starts to treat her, and she asks if her husband is still alive. Sam assures her that her husband is alive, and right behind them. The woman sits up and starts screaming at her husband for being alive, and threatens to kill him. Meanwhile, Luka gets the bullet on the husband.
In Trauma Yellow, Pratt and Sam start working on the wife, who looks a lot like Jane Wiedlin of the Go-Go's. She explains that her husband cornered her in the kitchen with a knife, so she grabbed a gun. Pratt asks if she's been drinking, so presumably she has alcohol on her breath. He announces that she has a collapsed lung, and that he needs to reinflate it. Chuny walks through and bitches at Sam for not restocking something in the Trauma Rooms, because it was Sam's turn. Sam doesn't remember it being her turn. As Chuny returns to Trauma Green, she bitches about Sam not doing her job, and Luka looks at her sharply, but doesn't say anything. Meanwhile, Jane Wiedlin is still screaming at her husband, Malcolm. Are they sure her lung is collapsed? Because she's able to yell very loudly. Luka intubates while looking over at Sam to make sure she's okay. Dubenko walks in to help out, so Luka walks over to Trauma Yellow. Pratt yells at Sam for not getting the drugs fast enough, and Sam apologizes. Luka offers to help, and Sam yells at him. Pratt asks Jane Wiedlin a series of questions to make sure that she's not delirious or whatever, and finds out that she lives in West Garfield. He comments on it, and Jane snaps, "Do you got a problem with it?" Huh?
Abby reports Ruby's case to Carter, who refuses to check Ruby due to his outburst. Abby says that Carter has to, because Luka's in a trauma and Ruby wants "an experienced physician." After getting the rest of the history, and standing outside sighing for like ten minutes, Carter heads into Ruby's room. Haleh gives them an update on Ruby's tests, and leaves. Carter introduces himself, and Ruby bitches that he didn't forget a thing in ten years, and accuses Carter of treating his wife as "just another old person; give 'em the song and dance and ship 'em off." Carter either genuinely doesn't remember, or acts like he doesn't remember, and tries to change the subject by saying that they're still waiting to hear from Ruby's doctor. Ruby says he knew his wife didn't have much time left, but that he doesn't know why Carter had to put her through so much. Haleh turns and listens. Ruby talks some more about his "sweet Sylvie," and then refuses to let Carter listen to his lungs. Abby says that, as the Attending, Carter has to examine Ruby. Ruby asks if it's a rule or something, and Abby says that it actually is. Ruby reluctantly agrees and tells Carter to make it fast.
Carter listens to Ruby's lungs. He and Abby walk outside, and Abby asks what that was all about. Carter thinks Ruby is "a very unsatisfied customer." Abby says that she called Kaysen for a consult. Jerry interrupts to tell Abby about a phone call regarding another patient. Abby takes off. Haleh walks out of Ruby's room and tells Carter that Ruby is "more of a handful now than before." Carter is surprised she remembers him, and Haleh says, "Don't worry about it, Carter. It was a long time ago, and you were just a student." Carter stares at Ruby and tries to remember. Or tries not to.
Susan walks through the ER, and everyone tries to talk to her about work, even though she protests that she's off. So don't walk through the ER! Find another route. Jerry yells that the Chief Resident meeting got changed to 3:30. Susan is pissed, because it means she can't go home to sleep and see her family. No one cares.
Carter goes down to records to find Mrs. Ruby's old chart. The clerk says it could be a while until she can pull it, and Carter sits down to wait.
Kaysen does an ultrasound on Ruby's chest as they discuss Ruby's doctor, who was apparently Kaysen's teacher. Kaysen starts spouting medical jargon, and when Abby tries to ask a question, Ruby shushes her, saying that he's listening to the doctor. Kaysen decides that there's only one option. He turns to Ruby and announces that he has "critical aortic stenosis." Abby translates that one of the valves in Ruby's heart is narrowed. Kaysen kind of glances at her, and then continues by saying that they have to operate on the valve. Ruby asks when, and Kaysen says they should do it as soon as possible. Kaysen promises that they can do something about it, and orders Abby to run some labs as he jets on out of there.
Abby helps Ruby get his gown back on. Ruby tells Abby that it's nothing personal, but that he likes doctors with experience. Abby pulls up a stool and asks if Ruby understood everything Kaysen said. Well, that won't make him defensive or anything. Who wants to admit that they don't understand? Ruby says that he knows that he needs a heart operation. Abby asks if he has any questions. Ruby shakes his head. Abby says that heart surgery is a big deal. Ruby says he knows, and asks if she thinks he's an idiot. Abby wisely doesn't answer that, and adds that, at his age, the risks are higher. Ruby asks what risks she's talking about, and Abby answers, "Complications." Well, that clears it right up. Abby says she needs to do some lab work to get more information, but that right now, she doesn't know his systems' status. Ruby tells her to come back when she's less confused. Abby sighs and says that she wants to make sure Ruby knows the surgery is serious, and that they don't know yet if he's a good candidate, and that he should consider all of his options. Ruby tells her, "Listen, doll. Can you fix my heart?" Abby admits that she can't, and Ruby says he's going to listen to the guy who can. He sarcastically adds, "Byyeeee!," and turns onto his side, facing away from Abby. She leaves, and Ruby looks a little worried.
Abby and Carter discuss Ruby's case with Kaysen as they walk down the hallway. Carter and Kaysen walk fast, and Abby has to rush to keep up, all the while arguing that Ruby is not a good candidate for surgery due to his weak kidneys and history of heart disease. Carter asks about Ruby's lung function, and Kaysen kind of blows it off, since Ruby's old and likely to have weak systems in general. Abby tries to keep up with them, and keeps running into people and things. Kaysen just wants them to type and cross Ruby's blood. Abby finally catches up and asks, "I'm sorry, but don't you think, just maybe, open-heart surgery might not be such a good idea for this man?" I hate how women (and I realize I'm stereotyping, but I think it's pretty true) have to qualify their statements. Pratt would have just said, "He's not a good candidate for surgery." Kaysen mocks, "Don't you think, just maybe, that's the surgeon's call?" Abby sacks up and says that she thinks it's actually the patient's call. She adds that Ruby could either spend the rest of his life on the beach in Miami or hooked up to a ventilator in the hospital. Kaysen impatiently dismisses her concern, and Carter explains Abby's reasoning away by saying that she's just trying to advocate for her patient. Kaysen suggests that Abby advocate for Ruby to get a bed in the Cardiac ICU, adding that Anspaugh's on his way down. Abby glares at Carter and walks away.
Olivia -- the woman Pratt liked who works for the non-violence program -- finishes talking to Jane Wiedlin. Olivia walks out of the room and tells Pratt that she'd rather deal with a twelve-year-old gangster than a domestic-violence case. Pratt chuckles that when he heard where the patient lived, he thought he should give Olivia a call. Olivia says that they can do a lot for her. Pratt asks how she stays so optimistic. Olivia asks the same of him, and Pratt says that he's "jaded as hell." Olivia says that he just saw a drunk, battered woman who shot her husband and still saw some hope, because he called Olivia. They flirt a little bit, and Olivia says they'll follow up when she gets released. Pratt tries to get her to stick around, but Olivia is sure he can handle it. Pratt asks if she can school him over dinner. Olivia rolls her eyes and smiles, and then tells him to pick her up at her office at 7:00.
Shane West treats Birdie, the panhandler from last week, who has a low-grade temperature and a cough. Birdie and Rebecca rhapsodize over Chuny's caramel skin, and argue over which old-time movie star she most resembles. Shane tells Birdie that she might have a lung infection, so she needs a chest x-ray. Birdie says that Abby didn't mention that, and Shane checks the chart and sees that they were in last week. Rebecca compares Abby to "a young Patty Duke," which is pretty apt, actually. ["If Abby got hooked on dolls and started ripping people's wigs off, I might actually start watching this stupid show again." -- Wing Chun]
Anspaugh and Kaysen explain the heart surgery to Ruby, using illustrations. Abby walks in and asks angrily if they're definitely going ahead with the surgery. Kaysen and Anspaugh just stare at her. Ruby asks the doctors to confirm that surgery is the only way to go. Kaysen and Anspaugh say that they could try to treat Ruby's condition medically, but that "surgery's the only definitive treatment." Abby jumps in and informs Anspaugh of Ruby's kidney problems. Kaysen ignores her and gives his pre-surgical orders. Abby doesn't take the hint and starts blathering about Ruby's decreased lung capacity. She stops when she notices that everyone is staring at her. She says angrily, "What I mean is, shouldn't we be discussing the risks?" Ruby says that they already discussed them, and Anspaugh cheerily says that they'll continue discussing them. Anspaugh asks to see Abby outside.
In the hallway, Anspaugh curtly says, "I take it you have a problem with Mr. Rubadoux's decision to have the surgery." Abby says that she thinks he hasn't made an informed decision. Anspaugh asks if that's because Abby failed to inform Ruby of the risks, and Abby looks down, kind of busted. Anspaugh asks rhetorically why he would operate on someone who didn't want it, and then tells her that if she has concerns, she should ask the consulting doctor to step outside. He works up to a yell as he concludes, "You do not, in front of a patient, attempt to subtly disagree with a senior cardiologist and the Chief of Surgery!" I feel like I'm supposed to think Anspaugh's being an ass, but he's totally right. Abby may be correct about the surgery, but she went about it all wrong. Abby's dressing-down concludes, and she appears chastened. Anspaugh starts to head back into Ruby's room, and Abby finally pipes up, "I have concerns." He stares at her for a minute, and then goes into the room anyway.
Abby sighs, and suddenly someone puts his hands over her eyes. It's Jake, and he guesses that Abby hates it when people do that. Man, talk about your bad timing. Abby says that she really does hate it, and Jake lets go, but asks her if she appreciates that he knew that about her. Abby doesn't answer, and stomps away. Jake chases after her and asks if it's bad timing, and whether she wants to talk about it. Yes, and no, respectively. Jake says that he's back. Abby keeps walking and then stops and turns and apologizes profusely, asking how San Francisco was. Jake was apparently visiting potential employers, and he thinks San Francisco is a long shot. Abby tries to encourage him, but she's distracted by looking for Carter. She never does stop and give him her full attention, or even explain why it's bad timing. Jake says that he might match at County, and asks what that would mean. I think he's talking in terms of their relationship, but Abby either doesn't get it, or pretends not to get it.
Luka, Sam, and Pratt wheel in a guy who was luging down the street and crashed into a wall. Luka and Pratt are interested in the sport, and asking all kind of questions. Sam is pissy because she doesn't think the others are taking the injury seriously. The kid reports that his hands are numb, and Luka gets worried and orders a C-Spine.
Abby finally finds Carter and says she needs to talk to him about Ruby. Shane West totally interrupts to present Birdie's case. Carter checks the chart, and Shane West suggests that Abby take the case for "continuity of care." Abby says it was a different complaint last week. Carter finishes glancing at the chart and tells Shane to let them go if they have family support. Shane is about to follow orders when Abby interjects that they're both panhandlers. Shane says that everybody's got to make a living. Abby asks what's wrong with him. Well, let's start with the excessive eyeliner. Abby says that Birdie won't get better out on the street. Carter tells Shane to call Social Services. Shane says that they wanted to leave, and Carter orders him again to call Social Services.
Abby tries to talk to Carter about Ruby again. She doesn't think anyone is painting him a clear picture of the risks. Carter keeps walking and says that it's Ruby's choice. Abby thinks it's a lousy choice, and wants someone to talk to him. Carter pauses to sign a chart for Chuny, and says that it's Abby's case. Abby doesn't think Ruby will listen to her, because she's young and female. Frank interrupts to ask Carter to buy some Girl Scout cookies. Abby finally gets right in Carter's way and asks why he keeps blowing this off. Carter denies that he is. Abby says she doesn't know Carter's history with Ruby. Carter gets angry and says that sometimes Abby will run into patients who want an older doctor, and that she needs to find a way to get through to them. Abby says she's tried. Carter walks away and yells back that she did her job and should move on. How long has Carter been burned out, anyway? That storyline is getting pretty old.
Jerry wakes up Susan, who is sleeping in an exam room. He reminds her that the Chief Residency meeting is starting. She mumbles something, and he makes sure that she is really awake before he leaves. Susan walks through Trauma Green, where someone is drilling something, kind of ruining her little nap. In Trauma Yellow, she walks past Pratt trying to saw the helmet off the street luge guy. Susan asks what they're doing, and Pratt explains that they couldn't yank the helmet off. Shane West is suddenly there and talking about how cool the case is. Sam makes a bitchy comment, like, what's her problem, anyway? Abby walks in, looking for Carter. Susan says he's probably at the meeting she's headed for, and adds that Luka is supposed to be there, too. Abby says that Anspaugh wants a central line on Ruby. Luka tells Pratt to help her.
Morris, in a suit, prepares for his Chief Resident interview and presentation. Carter compliments his attire, and Morris says it's important for the Chief Resident to be professional. And then he fumbles in his attempt to pull down a projection screen. Susan walks in and apologizes for being late. Morris asks her to hit the lights. Susan yawns and turns them off. Weaver is there as well. Morris begins his presentation, which is apparently done on actual slides, like, I didn't know they still made those. Morris also manages to stand right in front of the screen, so that the slides are partially projected on his face. Morris mentions the length of his presentation, and Susan can't believe that it will last an hour. Girl, I hear you. I sat through two three-hour college orientations today (which I've seen several times before) and a four-hour meeting last night. I'm done with meetings for a while. Morris apparently thinks he has the answer to the ER's scheduling problems.
Shane bursts into the exam room and finds Birdie and Rebecca preparing to leave. He begs them to wait and see Social Services. Birdie promises that they're grateful, and Rebecca adds that they can't miss rush hour at the El. Shane physically tries to block their exit as they apologize for possibly getting him in trouble. Shane uses their guilt to his advantage as he explains that he had two other patients leave last week, and that his boss said they'll give him a demotion to the morgue if any other patients leave on him. Birdie and Rebecca laugh and agree that Shane is clever.
Luka's luge patient is wheeled out. This leaves Luka alone with Sam, and he asks her what's going on. Sam denies that anything is. She then says that she can't believe Luka was encouraging the patient. Luka says he wasn't, and that she's overreacting. Well, that'll make her less defensive. Sam turns and throws some scrubs at Luka's chest. They stare at each other and they both start cracking up. I really liked that scene because it seemed realistic, and they could have gone a much more melodramatic route. Sam rushes over and hugs Luka, and moans that she's having a bad day, and that she had a headache. Luka urges her to go home early, and Sam agrees. Luka kisses her forehead and they touch noses. Sam assures him that she's okay, but after Luka leaves, the look on her face says otherwise.
Pratt helps Abby to put in a central line. Everything seems to be going fine, but then alarms start beeping. Pratt tells Abby to pull back on the wire she inserted, and Abby protests that she's nowhere near the myocardium. More alarms start beeping. Ruby says he doesn't feel right, and asks what's happening. Abby removes the wire and they prepare to move Ruby into a trauma room. Pratt is unable to get a response from Ruby.
Morris is unveiling his scheduling system, which is basically that you work three days, two off, three evenings, two off, three nights, two off. Carter's pager goes off, and he says that it's 911 to the ER. Susan accuses him of lying. Carter apologizes to Morris, who promises to put a hard copy of the presentation in Carter's box. Weaver yells at Morris to get on with it as Carter rushes out.
Shane walks into Birdie and Rebecca's room and finds a younger woman in there with them. They introduce her as their niece, Shelly. They seem anxious and want Shane to confirm that they tried to leave, but that Shane made them stay. Shane confirms that. Now that their niece is there, Birdie and Rebecca want to leave. Shelly asks to talk to Shane outside. Once they're in the hallway, Shane tries to explain that they're waiting for Social Services. Shelly says that she's sure they'll be helpful, but that her aunts are tired and want to get home. Shane doesn't give in. Shelly chuckles to herself and says that her aunts are really stubborn. She's been trying to get them to move in with her, but they want their independence. Shelly gives more details about how she has the room, but she doesn't know how to make them accept family support. Shane agrees to talk to them.
Pratt and Abby are treating Ruby, who is crashing. Carter runs into Trauma Green and takes over chest compressions. Pratt and Abby explain what happened, and they shock Ruby's heart, to no avail. Pratt asks why Anspaugh is even bothering with surgery. No one answers, because they're busy working. Pratt says that if Ruby can't even tolerate a central line, he won't survive the operation. Abby says that Ruby wants the surgery. Pratt asks if that means they have to give it to him. Carter's compressions break one of Ruby's ribs. Pratt tries the paddles again, and this time they get a rhythm. Abby stares at Carter, who stares back at her.
Abby fills in Ruby's chart. Carter stands outside the room and stares through the window. Abby looks up and sees him. Carter runs his hands through his hair, and then walks away.
Weaver and Susan exit the elevator. Weaver is arguing that Morris can handle the Chief Resident position. Susan says that even the students think he's a joke, and that they should look for a candidate externally. Weaver thinks that would be hard on the staff. Not that Weaver knows anything about being hard on the staff. Susan points out that Weaver came from the outside, and Weaver just gives her a look like, "Exactly." Luka walks up and asks how the meeting went. Susan makes fun of Morris's presentation. Luka asks if they're really considering Morris. Weaver says Luka can't have an opinion because he wasn't there. Luka thinks that's ridiculous, and asks what Carter thinks, and then suggests a vote. Weaver says he can't vote because he wasn't there. What is this, fifth grade? Susan says she has to go home, and Weaver is late for something. Luka finds Carter and asks about the meeting. Carter says he left. Luka reports that Kerry wants to hire Morris, and Carter responds, "Yeah? Well, okay." Luka can't believe Carter doesn't care. Carter says they've had worse. Luka wants to continue to argue the point, but Carter is clearly over it. Frank hands Luka a chart for "a haggard mom, five kids" in Exam Three.
Abby walks up and tells Carter that Ruby has recovered, and is complaining about his chest tube. Carter barely responds. Abby says that she told Kaysen and Anspaugh about the broken rib, and that they decided to postpone the surgery for a few days. Abby sarcastically remarks that everyone remains hopeful. Carter doesn't even bother with a response this time, and walks away. Abby watches him go.
Pratt shows up at Olivia's organization's office. A guy asks if he can help. Pratt says he's looking for Olivia, and the guy directs him to the back. Pratt opens a door and finds a meeting going on. A woman finishes telling a story about a successful program, and everyone applauds. Olivia spots Pratt and introduces him to the group. Olivia adds that Pratt gets to see first-hand how senseless shootings affect the city, and invites Pratt to say something about job opportunities in health care. She gives him a big smile. He smiles back, not quite sure how he got sucked into this, and starts talking.
Luka talks to the haggard mom, who doesn't actually look that haggard. I've seen worse. Her kids run wild through the exam room as Luka hands out various prescriptions for the kids. Chuny returns with another one of the kids. Luka puts the kid aside and walks to greet Sam, who was on her way out. He smiles and says he could use a little help. Sam smiles back and counts the five children, and then says she's definitely leaving. Luka invites her to dinner, but Sam says she'd rather stay in tonight. Yeah, you don't get to leave work early and then go out to dinner. Luka gives her a kiss, and as Sam walks away, her whole demeanor changes, and she looks depressed and distracted. It's kind of creepy, actually.
Carter returns from buying a cup of coffee and spots Abby sitting outside. She says that the coffee is awful that time of night, and Carter agrees. There's a bit of silence, and then Carter tells Abby that when he was a surgical student, Ruby's wife was part of a research study. When she was no longer useful to the study, there was pressure to get her out, so he dumped her to a nursing home. Abby asks if she belonged in one. Carter says they figured she'd come back, but that she'd be on medical service instead of surgical, and thus not their problem. Abby doesn't see the big deal, because it happens all the time. Carter dumps out his shitty coffee and says he told Ruby that his wife would get better, and that she would improve, which is what Ruby wanted to heart. Abby just stares. Carter says that when you're a student, you want everyone to like you, including patients and their families, but you also want to be efficient and impress your superiors. Abby says she understands, because she's still there. Carter says that when the Chief of Surgery tells you to get rid of a patient, you do. Abby agrees. Carter says that Mrs. Ruby came back a few days later and died, and that Ruby was really surprised. Carter finishes his tale of woe by saying that ultimately it was the Attending's call and not his responsibility. Abby doesn't look like she buys it. An ambulance pulls in, and Abby and Carter walk over to help.
Pratt talks to a guy after the meeting has broken up. The guy wants to bring a kid from his program down to County for a tour, and Pratt agrees. Pratt says that he never left his neighborhood until he was ten years old. The guy is surprised to hear that Pratt is a hometown boy, and asks if he's related to Charlie Pratt. Pratt looks shocked and says that he doesn't know him, as Olivia adds that Charlie works for Parks and Rec. Olivia babbles on about how she's surprised that Pratt is still speaking to her after she ambushed him, and says that his reward for being a good sport is that she'll have dessert with him. Pratt is barely listening, still reacting to the Charlie Pratt bombshell. When Olivia finally gets his attention, Pratt says that he has to check on a patient. Olivia is disappointed, and Pratt promises to call.
Sam stands in the aisle of a drugstore as "Celebrate" by Kool and the Gang plays on the loudspeakers. She picks up a pregnancy test and takes it to the counter. The clerk rings it up and gives Sam a hopeful smile. Sam just gives her a death glare back. The clerk's smile fades. Heh. All this time I thought Sam had something up her butt, and it turns out that she might have something up her...you know.
Shane tries to walk out the door, but Carter busts him. Shane says he knows he's scheduled for another half-hour, but that he's taken care of everything by filling Abby in. Carter asks if Abby is the Attending. Shane runs through his cases, including Birdie and Rebecca, who left with their niece. Carter asks what Social Services said, and Shane is forced to admit they never saw the ladies. He adds that they had "a strong family support system." Carter asks if they're talking about the panhandlers. Shane tries to explain about the niece. Carter gets angry and asks if Social Services will be following up. Shane says slowly that he'll make those arrangements. Carter yells that he needs to know everything about Shane's patients and concludes, "I'm the Attending! I'm responsible!" Carter stops, realizing what he just said, and how it wasn't true with Ruby that day. Shane blinks his eyes, which are probably irritated by all the eyeliner, and apologizes.
Carter stomps off, blowing off Frank, Chuny, and Haleh as he goes. He stops outside Ruby's room, then opens the door and says hello. Ruby tries to get Carter to leave. Carter comes in anyway and apologizes. Ruby shakes his head and says he couldn't believe it when he saw Carter -- couldn't believe that Carter was still there ten years later. Carter can only say, "Yeah." Ruby says that Carter didn't even remember. He adds that he has six other doctors, so he won't need Carter this time. Carter walks into the room and says that he made a mistake with Mrs. Ruby, and with Ruby, too. Ruby starts crying and says that he knows that, and that every day he regrets bringing his wife there. He mocks Carter's saying that his wife would be dancing again, which I think might be an actual line from that storyline years ago. Carter says that it was a complicated situation, and that he didn't have the experience to handle it. Ruby says, "All you had to be was a human being. You lied to me! And I believed you!" Carter has nothing to say. After a moment, he pulls over a stool and says, "What you have wrong with you, aortic stenosis, can often be corrected with surgery, but that doesn't mean it's the right thing for you. You're eighty-five years old, you have chronic respiratory problems. The chances of you coming through the surgery and getting back to the shape that you're in right now? Pretty slim. If you go ahead with it, there is a good chance that you will never leave this hospital again. You'll be connected to a ventilator, and you will live out the remainder of your life in this hospital. Now, without the surgery, it's true you're not going to get any better. But I believe that you will leave this hospital under your own power, and you will have more time with the people that you love. You will have more time being the person that you are today." Ruby stares at Carter, who concludes, "And yes, ten years ago I lied to you about your wife. But I am not lying to you right now." Ruby stares at Carter hard, and Carter meets his gaze.