A
man named Charlie Metcalf sits in the waiting room looking at other patients.
Ray seems not entirely thrilled as he watches some workmen putting up a sign
that says ‘Patients will be seen in order of arrival’. The workmen seem to be
making a lot of noise so Ray lets his head hang. A man listens to a radio
while a baby starts to cry. A European woman voices her rage about getting
into seeing a doctor. Sam tends to a boy named Jeremy who is clutching a
bloody towel to his head. His sister is with him but he asks if his father has
arrived. Sam tells him no but he is on his way. As she walks by with the boy
Charlie stops her and asks if he gives his ticket to her. Sam removes his hand
and tells him it will be a bit longer.
Sam hands Jeremy
to Pratt and tells him he has multiple head laceration from a TV falling on
him. Pratt tells her he will get to him soon. A med student, Jane puts Jeremy
in a wheelchair and wheels him away annoyed at Pratt’s attitude. Luka
overhears her and tells her to get started and Pratt would be right there.
Sam tells Pratt about Charlie, describing him with ‘belly pain and bad
breath.’ Pratt recommends they let him sober up first. He says this because
his shift ended soon. Sam urged that he needed to be seen. Luka tells them
both that he will do the exam on Charlie and take the chart. Sam tells him she
thinks Charlie believes he’s in an airport. Luka asks if he’s altered. Abby
asks Luka to sign off on some charts. Abby asks someone to draw her blood and
Chuny tells her she would do it. Ray asks if this is because of her ‘needle
stick’ and Abby affirms it. Ray orders pizza for the staff, tells them the
time and bets that it will be late, meaning he wouldn’t have to pay. While Ray
is explaining the free pizza to Pratt, Sam notices Charlie slump in his chair
and fall to the floor. Sam yells for Luka’s help. The put him on a gurney and
wheel him to an exam room.
Luka
asks Abby to wait on her blood draw and help. They remove Charlie’s coat and
he struggles. Luka hands Jane a clipboard and tells her to document
everything. Jane argues that the job he assigned her was that of the nurses
and Sam tells her there is a nurse shortage.
As
Abby and Luka are talking, Charlie interrupts to tell them his name.
Beside Charlie’s bed is Jeremy. He yells at Pratt to not give him a needle and
Pratt tells him he won’t hurt him. While the women are gowning Charlie, Luka
walks over to Pratt. Pratt tells him that Jeremy has a possible tendon
laceration on his ankle. Luka asks Jeremy where his father was and the boy
answers that his father had to work and they couldn’t afford the sitter. Pratt
sends Jeremy off to X-rays. Luka returns to Charlie and he apologizes to Luka
for his behaviour. Charlie tells them that he has a pain whenever someone
touches his stomach. Luka asks if Charlie has seen a doctor lately or even has
a primary care physician. Charlie tells him no. Abby asks if Charlie even
remembers the name of the last doctor he saw and he tells her that he doesn’t
remember a name but remembers it was in a town called Taylorville. Pratt looks
up and asks if he was in prison there and Charlie affirms. Pratt tells him he
knows someone that was there too.
Abby tells
Charlie that there is fluid in his belly. Pratt continues questioning Charlie
about prison. When Pratt asked him what he was in for, Charlie told him he
killed a man for asking too many questions. Pratt continues to treat Jeremy
and when Charlie calls out for the boy Pratt tells Jeremy not to listen. Luka
tells Charlie that he is bleeding internally, most likely from an ulcer. Abby
asks him if he drinks and Charlie laughs. Charlie tells them he used to drink
‘Pruno’ in prison. But since he’s gotten out he drinks whatever he can get.
Luka asks about pruno. Charlie explains they would take bread and fruit from
the cafeteria, put it in a garbage bag with toilet water and let it ferment.
They would then strain it through their socks and drink it. Luka tells Charlie
that in order to check for blood loss Luka had to do a rectal exam. Charlie
tells them no way and exclaims it’s ‘exit only’. Luka tells him its imperative
and Charlie relents. Charlie notices Jeremy and calls out to him. Jeremy
changes into another boy and then back again. Charlie tells him the doctors
are mean and want to make them cry. But if Jeremy wouldn’t cry then Charlie
wouldn’t either. Luka tells Charlie they need to put a tube down his nose to
find out where the blood is coming from. Charlie begins to tell Sam that he
was once an artist. Sam inserts the tube and tells Charlie to swallow. He gags
but it goes in. Blood starts flowing from the tube. Luka notices the blood is
too dark to be from an ulcer. Charlie vomits up very dark blood, he asks them
to take it out because it makes him feel worse. Sam tells Luka Charlie’s blood
pressure is dropping. Luka orders more tests and Abby suggests they put him in
his own room. Abby asks about any family and Charlie tells her there is no
one. They
take Charlie to a trauma room.
Once
in trauma, Pratt asks them what the point of moving him was if Charlie was so
close to death. Sam tells him if he doesn’t want to help to just leave. Sam
informs Jane that the first unit of blood went up and Jane writes it down.
Luka questions if Charlie is on any medications as Abby checks out his
suitcase. She finds a bottle of liquor. Pratt makes a remark and again asks
why they are wasting their time with someone in end stage liver failure. Luka
tells him to get out, which Pratt does. Abby continues looking through
Charlie’s suitcase and finds a family picture with his wife and son, a journal
and a painting. Pratt and Luka argue about Charlie outside trauma. Sam finds a
phone number for a man named Bobby and asks Charlie if he would like her to
call him. He tells her no, not to call him; he doesn’t want to see him. Luka
tells Charlie that his oesophagus is bleeding badly. He
also adds that Charlie only has a 50% chance of survival. Charlie is shocked
and asks just how long Luka thinks he has. Luka tells him not long. Pratt asks
him if he wants heroic measures to be taken. Charlie does not understand so
Pratt breaks it down for him. Charlie understands now that he is going to die
that day and panics. He tells them he has things to do and he wasn’t ready to
die yet. Someone comes down for a consult and ask how bad Charlie is. Pratt
tells him they have two and a half litres of output. Charlie asks what is
happening and Abby tells him they will try to fuse the veins back together in
his oesophagus to stop the bleeding. The tech asks why there is no suction and
Abby checks and it isn’t working. Neela and Ray are working on a patient in
the next room. Abby asks them to check their suction it works fine. Abby asks
Ray if their patient is stable to move. Ray carries on about his pizza and
asks Abby if she likes pepperoni. She accuses him of having ADD and demands he
changes rooms. Sam and Luka wheel Charlie in, while Ray moves his patient out.
As they prep Charlie for the procedure, Sam asks Charlie if the boy in the
photo is Bobby. He says it is. She asks him if he would like her to call his
wife. He explains Bobby is 20 and in college. Charlie tells Sam that it’s been
a long time since he’s last talked to Bobby. Sam pushes Charlie to agree to
call him. Luka removes his suction.
As the procedure
is being done, Sam calls Bobby. He is sleeping and Sam asks for him to be
woken up. When Bobby comes onto the phone, Sam introduces herself and tells
him they have his father there. Charlie listens as the procedure is being done
and Bobby asks Sam to talk with his father. She tells him he can’t talk
because of the procedure, but they put Bobby on speakerphone. Charlie tries to
talk through the bite guard. Bobby asks if Charlie is dying. Charlie tells him
no. Bobby asks Sam and she tells him he is very ill. Bobby tells him it’s been
a long time and then stops himself. He says a final goodbye and hangs up.
Charlie cries, which made it hard for the tech to continue. Charlie looses his
vitals and crashes. Charlie begins hallucinating. He is seen walking through
the desert calling out for Bobby, who is only a boy. Bobby is carrying a
fishing rod, and racing ahead of Charlie. Pratt tells everyone in trauma that
Charlie is bleeding out. Charlie hallucinates that his wife is sitting on a
pier overlooking some water. She tells him to come in, that the water was
warm. The trauma team desperately try to revive him. Again Charlie has visions
of himself when he is put in jail. He calls the younger Charlie out. The team
starts compressions and Sam feels for a pulse.
Charlie regains
consciousness. He asks if Bobby is coming. Pratt tells him no. Jane notes
Charlie’s blood pressure and adds that to her report. Pratt and Charlie talk
over having kids and being there for them. Luka tells Charlie that there is
another procedure that might help. Charlie is up for it, saying he has nothing
to lose. Charlie begins to tell them what happened to his wife. It was Bobby’s
8th birthday, and Charlie’s wife asked him to pick something up for
the party. Charlie wanted to stay back and work on Bobby’s present some more,
so his wife went. His wife was hit by a car and died. Charlie was left with
the job of raising their son. Charlie began drinking and one night at a bar,
stabbed a man for no apparent reason. Bobby was sent to live with his wife’s
parents while Charlie went to jail. Charlie panics and tells them something is
wrong and he doesn’t feel well. Luka announces to call renal, that Charlie’s
kidneys were shutting down. Pratt suggests TIPS, another procedure. Luka
explains the treatment and Charlie asks how much more time that would give
him. Pratt tells him it was too hard to tell. Sam reports no urine output,
which suggested that his kidneys were failing fast. Abby’s says he needs
dialysis.
Ray
and Chuny receive a GSW victim. The try the trauma room that Charlie is in and
Luka tells Ray to go somewhere else. Chuny tells him there is nowhere else to
go so they move Charlie over and wheel the gun shot patient in. The patient
complains that he was shot for stealing his own drugs. Abby picks up Charlie’s
suitcase to move it out of the way and it gets dumped. In his things, Abby
picks up a painting.
Charlie
tells her that he painted it one summer when they rented a lake house. Dr.
Dubenko arrives and Luka fills him in on Charlie. Ray’s patient gets taken up
for x-rays and surgery. Pratt tells everyone that the consults are on their
way. Abby notices Charlie trembling and he tells them he hasn’t had a drink
since the day before. Luka says he is in alcohol withdrawal. Ramirez, a
dialysis tech comes down and starts to med speak. Charlie wants to know what
is going on, and Abby tells him that Ramirez is there to do the dialysis they
discussed. Charlie tells them he never discussed it. Another doctor comes in
to perform the TIPS procedure and again Charlie asks what is happening and he
is ignored. Abby tells him he will need dialysis three times a week for the
rest of his life. Charlie asks about his liver and Luka tells him he needs a
liver transplant. Charlie asks about those odds and Luka tells him that the
odds are not good, considering he is an alcoholic. Charlie questions Luka
about leaving the hospital. Luka tells him it won’t happen. Charlie thinks
everything over and decides he does not want anything. Luka breaks it all
down, telling him that there will be no effort to save him at all. Charlie
agrees and Luka asks Jane to add it to the time report that Charlie is a DNR.
Jane times it and writes it down. Luka walks out and Pratt goes after him
saying that Charlie is not competent to make that decision. Charlie asks for
something to stop the shakes and Abby asks if they can put him on an alcohol
IV. Charlie chuckles saying that they are going to get him drunk. Luka assures
him it’s just to stop the trembling. Pratt asks Charlie to reconsider and do
the TIPS procedure. Charlie asks Sam to call Bobby again, because he will come
to County if he knows Charlie is walking the line.
Sam
phones for Bobby, but he is already in classes. His roommate goes to find him.
Charlie asks that
the tube with the inflated balloon be taken out. He also asks if the window
could be opened so he could get some air. Sam opens it as Pratt removes the
tube. In the next room Charlie sees the European lady from the waiting room
screaming that she wants to see a doctor. Charlie stares at her. Charlie
enters another hallucination, where he is at a train station. The European
lady is still yelling asking when is it going to be her turn. He sees himself
in a reflection and he looks groomed and clean-shaven. There is a person
making an announcement but he is calling out vitals instead of arrivals and
departures. Charlie walks up to a kiosk, and Abby is busy punching tickets.
Charlie moves back and forth from hallucinating to what is real time. Abby
leaves, telling Charlie that he won’t be alone.
Charlie asks Sam
if he will touch his face. She doesn’t understand at first but takes off her
gloves and strokes his cheek. Charlie enters another hallucination. He is on a
boat with Bobby and Sam and they are looking for a good spot to fish. Charlie
states they should anchor and Sam asks what he means. Again he reverts back
and forth from dream to reality. Sam strokes his face more as she says she
doesn’t know. Charlie asks her what she thinks Bobby would want; Sam replies
that she doesn’t think Bobby knows. Bobby plays in the water over the side of
the boat and in reality a nurse drops something and in Charlie’s vision, both
Sam and Bobby disappear.
Sam adjusts
Charlie’s’ IV, and he states he feels drunk again. Luka tells him that they
will keep the heart monitor on and the drip for Charlie’s comfort. Luka also
tells Charlie that they will remove the other life support measures and
Charlie nods. Charlie tells Luka the he never believed in God, and he wondered
if God would forgive him. Luka tells him God will get over it. Soon after
Charlie’s heart stops. Charlie is in another hallucination. He is in the
desert and a bus stops and he gets on. He sees others from the waiting room
aboard. In reality, Neela comes in asking if she can take the heart monitor.
Luka tells her she can. In Charlie’s mind he sees Luka wearing a green hat. He
asks Luka what he can take. Luka realizes that Charlie isn’t gone yet because
he just talked and tells Neela she can’t take it yet. Speaking aloud through
his hallucination, Charlie asks Luka what it will be like. Luka tells him that
it’s peaceful. Charlie notices his wife walking in the other direction of the
bus, he calls out to her. Pratt tries to calm him down and Charlie asks that
his son Bobby gets his things, especially the painting. Charlie looks up at
Pratt and asks ‘You never knew your father’ Pratt tells him no. Charlie tells
him it’s too bad. Pratt replies that he doesn’t let it bother him. Charlie
tells him ‘I bet it bothers him.’ Pratt looks over at the painting.
Charlie
hallucinates again. This time he is standing in front of the house in the
painting. He walks towards it and tries to get in but the doors are locked. He
looks inside and he sees Bobby blowing out birthday candles on his cake. He
tries a different window, but when he looks inside the house is bare, with no
sign of Bobby. In the trauma room Charlie whispers out ‘Let me in’. Charlie is
back in the desert and Bobby looks over him. Bobby asks Charlie if he can hear
him. Charlie smiles and tells him that he is happy to see he made it. He asks
Bobby how he thinks Charlie looks. Bobby tells him he looks all right. Charlie
tells Bobby he is very sorry. Back in trauma, Pratt stands over Charlie with a
tear in his eye. Charlie begins to cry and Pratt tells him not to think about
that. Charlie flat lines and Pratt calls time of death. He grabs Charlie’s
painting and suitcase and heads out.
Ray scoffs at
Pratt for being in too long with one patient. Pratt tells him to do as he says
and not as he does. The pizza’s arrive and to Ray’s delight they were free.
Ray asks Pratt if Charlie died and Pratt nods. Ray says he seemed like a nice
guy. Pratt responds by saying he was just a drunk.
Reviewed by Kristyna on December
22,
2004
