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The Providers

One for the Road
Damaged
Try Carter
Fear
An Intern's Guide to the Galaxy
Time of Death
White Guy, Dark Hair
A Shot in the Dark

'Twas the Night
Skin
Only Connect
The Providers
Middleman
Just As I Am
Alone in a Crowd
Here and There
Back in the World

Refusal of Care
Ruby Redux
You Are Here
Carter est Amoureux
The Show Must Go On

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Buy the Season 11 DVD

Episode 235 "The Providers"
Original Air Date: January 27, 2005
Written by: David Zabel
Directed by: Christopher Chulack
Guest Stars:

  • Tom Irwin - Gabriel Milner
  • Megan Henning - Katie Millner
  • Laura Leigh Hughes - Hannah Milner
  • Ed Bernard - Mr. Klossey
  • Emily Kosloski - Amanda Field
  • Brady Smith - Rodney Dixon
  • Adam Conger - Guidry
  • Teri Gamble - Cashier
  • Kurt Larson - Phil
  • Louie Liberti Bridget Sienna - Hernandez
  • Holly Joy - On-Camera Reporter
  • Larry Bagby III - News Reporter #2
  • Peter Spellos - Trib Reporter

Staff:

  • Chad Lowe - Dr. George Henry
  • Leland Orser - Dr. Dubenko
  • Eion Bailey - Dr. Jake Scanlon
  • Yvette Freeman - Haleh

  • Lily Mariye - Lily

  • David Joyner - Tech

  • Monte Russell - Paramedic Zadro

  • Louie Liberti - Paramedic Bardelli


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Luka is sitting having coffee and reading the paper as Sam calls out to Alex that he better hurry up or he’ll miss his bus to school. She asks Luka if Neela is working and he tells her that he thinks she is. She tells him that its funny that it keeps working out that way, to which he asks her what she means. She tells him that Neela is young and single and most likely lonely. Luka tells her that Neela is his student and is just trying to learn. Sam makes a comment that everyone can see it, and he asks who. She begins telling him some names and he makes an amused sound. Sam tells him it’s not funny and that he is just encouraging it, and he tells her that’s not true. Sam adds that it better not be or she would have to get into some ‘nasty chick fight’ with Neela. Luka tells her not to hurt her as she comes close to him. She tells him the only person that will end up getting hurt is him. Neela and Abby are sitting in the lounge preparing for work and discussing who they last slept with. Abby reiterates that neither of them had partners in a ridiculously long time, while Neela gets optimistic that at least they have their jobs to keep them distracted from men, romance and sex. Luka arrives in the lounge as the ladies turn and say hello. Luka tells them there is a multiple MVA on it’s way in. Susan walks in telling whoever is listening that patient satisfaction scores are up. Carter asks her if that is a good thing and she replied that it is and she wants to post the scores. She tells him that she knows her promotion to ER Chief was a rough transition but she really appreciates his support. Carter tells her that he couldn’t ask for a better boss. EMT’s bring in a 16 year old that backed into a utility pole. Carter and Ray take the 16 year old, and ask what happened. The medic tells them that the father, who was walking along with them also that he was trying to teach his daughter how to parallel park. Father tells them she just got her learners, while the girl tells Carter that she got dizzy and mixed the pedals up. Susan posts the scores, while Neela and Abby step up. Neela asks about them as Susan proudly says ‘We don’t suck as much as we used to and maybe in two weeks we’ll suck a little less.’ Abby says it must be Susan’s motivational speeches. Susan tells them both that they are pairing interns with residents and tells Neela she is with Luka, and that a double MVC is on it’s way in. Susan sees Jake standing behind Abby and tells her that Jake is with her. Neela, Abby and Jake head outside to greet the ambulance, which is already unloading a gurney with a woman straddled over a man. Medic tells the ER staffers that the patient and his mistress were having sex in the back of his car when it was rear-ended. Medic tells Abby that they tried to disengage them at the scene but ‘broken pelvis plus uncontrollable desire equals..’ Abby looks at the medic while Neela tries to stifle her amusement.

   

Abby, Neela and Jake bring in the lovers. Neela disappears to go find Luka. As Neela approaches Luka at admit, she tells him that Susan paired them up for their shifts. Luka looks at her in disbelief, while Neela asks if Luka can show her the procedure they discussed last shift. He replies that it depends if they get a patient that needs central access. As Luka goes to get Neela her first case, she comes in right behind him. He turns to hand her the chart, almost bumping into her. She apologizes as he looks away uncomfortably. Ray examines Katy Milner, the 16-year old girl who backed into the utility pole. Ray asks Mr. Milner if Katy was on any medications. As Mr. Milner is telling him, it comes to light that Katy had a kidney transplant the year before. Mr. Milner says that he was the one that donated his kidney to her, while Carter looks at him impressed. Haleh comes in and tells Katy that her mother was on her way in. Ray notices something and brings it to Carters attention. Carter thinks Katy’s body is rejecting the kidney. Mr. Milner can’t believe it. Luka interrupts and Carter excuses himself to go and talk to Luka. He asks Carter if he has anyone with him, and Carter tells him he has Ray. Luka asks him to take Neela as a favor to him and Carter asks why and if there is a problem. Luka asks him to just do it for him this once and Carter tells him to send her his way. Neela brings Luka the charts on the patients she saw and he tells her there is a change in plans and that she is going to be with Carter for the rest of her shift. She watches him confused as he walks away. Abby and Jake go over the films on the male lover. Jake tells him that no cast is needed but some pain medication and lots of rest is his treatment. Abby fills out his prescription and tells him to also abstain from sexual intercourse for a couple weeks. The man looks at her in disbelief, while Abby tells him he cannot put any pressure on his pelvis or he would just end up back there in the hospital. The mistress non-chalantly asks if other positions are alright and Abby tells them to go for it, and walks away. Katy is stabilized as her mother comes in and hugs her daughter. As Mr. And Mrs. Milner start arguing about the driving, Carter interrupts asking for them to join him outside so he could get some more history from them. Mr. Milner goes over some of Katy’s past medications. Carter asks if they changed any of them recently and he tells him that 3 months prior they started Katy on a drug called Zirictal. Carter hasn’t heard of it, but Mrs. Milner tells him that it is a new drug and is very expensive and they’re Medicare doesn’t cover it. Mr. Milner explains that he took another job on to help pay for the Zirictal, and Katy has been seizure free since she started taking it. Carter asks if they had adjusted this new drug and Mr. Milner says it’s been steady since the beginning. The Milner’s begin fighting again and Carter interrupts asking if Katy has a neurologist. Mr. Milner tells him she does and Carter asks him to phone him because he wants to discuss the meds with him.  Carter and Neela leave him to make the call and walk towards admit. He asks her to find out more information on Zirictal. Neela tells him one of her patients in med school was on the drug. He tells her that he has never heard much about it. She tells him it’s quite new, expensive but highly effective for seizure control. He asks her to do a search on the internet for any relation to renal dysfunction associated with Zirictal.  Jake presents a patient with skin breakdowns around the shaft of his penis to Abby. She begins to examine the problem when the patient asks if it could be from masturbation. Neela tells Carter that she found a case report that correlates renal failure and Zirictal. He tells her that is not much to go on but Neela reaches behind her and grabs another paper. She tells him that she also found that the Department of Health Services forwarded another 3 cases to the FDA. Carter is much more interested now and makes note that 4 cases might be a pattern. Neela gets on the phone and calls up the pharmaceutical company that makes Zirictal to try and find out anything else. She hands him the phone as it starts ringing. He gets put on hold and Haleh alerts Carter that Katy was in distress. Neela tells him she will wait on hold and he rushes off to get back to his patient. As he’s treating her he chalks it up to Katy rejecting the kidney because of an excess of potassium that aggravating her heart. Katy goes into v-fib and they start compressions.

 

They continue to resuscitate Katy, bring her back with the paddles. Carter orders dialysis and Mr. Milner asks if that is really necessary. He tells him it will get rid of any extra potassium in Katy’s body. Mrs. Milner asks if her daughter will need another transplant and Carter tells her it is a possibility. Neela informs Carter that the makers of Zirictal will get back to them within a week and this doesn’t please him. Mr. Milner asks what is going on and Neela tells him that they contacted the pharmaceutical company that makes the drug. Mrs. Milner asks if the Zirictal is causing this and Carter says that with the timing of the med change that is also a possibility. George Henry, Katy’s neurologist arrives, and Carter tells them they should head to the family room, and George leads the way. Jake tells Abby that he discharged the rash from earlier. He asks her if she is okay and she says she is fine. Jake tells her that when he ran into her on the EL platform a couple weeks back, he had no idea of the situation she went through. Abby plays dumb and dances around the subject. She assigns him a new patient and walks away. Abby approaches admit where Susan is and asks who assigned Jake to her. She goes on to explain that she doesn’t like med students and prefers to fly ‘solo’. Susan asks her if she likes Jake and then notices Abby blushing and laughs. Carter tells Neela he posted questions on the Medline Message Board about Zirictal. Neela tells him that could cause a bit of a stir. He agrees and tells her to go back and change it to the right questions to ask that will better help them understand Katy’s condition. Carter enters the family room and tells the Milner’s that someone was coming down from dialysis. George attempts to sway them to approve a biopsy so they can find out if it is indeed caused by the Zirictal. He tells them if it is that another transplant is imminent, but that other medications could reverse the rejection. Mr. Milner agrees with the biopsy. Carter tells him he will get that started and asks to speak with George outside. Carter walks with him telling him that they have found 3 cases of renal failure in patients using the same drug. George explains that is insignificant while Carter looks at him in disbelief. George continues to say that it was sent as a phase 3 tested drug and the FDA would never have approved it if they thought it would harm more then heal. Haleh tells Carter dialysis had arrived and he asks her to page Dubenko to do a biopsy. George tells Carter that he is surprised to see him still working at County. Carter asks him why and George says that he just thought he would’ve moved on. They chat about George and how he changed his specialty. George tells him that he was married with 2 little ones and that his priorities changed what he could do. He asks Carter if he was married with kids yet and Carter tells him ‘no, not yet’. Carter pats his back and tells George that he would come find him when the surgeon came down. Neela is waiting for a fax as Susan passes by Sam and says good morning. Sam looks under the counters for the nursing schedule and notices it over by Neela, who has her coffee sitting on it. She snaps at Neela telling her it’s not a cocktail napkin. Luka and Ray meet a patient who fell from a ladder while taking his Christmas lights down. Neela asks them if she can give them a hand and Ray says sure but Luka asks her if Carter needs her. She tells him not at the moment, while running with them to the trauma room. As they work on the patient Luka tells his crew that they need to do a saphenous cut down. Neela asks about doing a femoral tear, since it would be easier to find. Ray agrees while Luka tells them they both do the same thing, but they could do the femoral instead. Ray seems excited since he had never done the procedure yet. Luka tells him the procedure will go to Neela. Confused, Ray objects saying that Neela was only along for the ride. He tells Ray that he promised Neela as she gloves up and starts the procedure. Luka must get close to her to assist. Sam enters their trauma asking for a skin marker, then back away to watch Neela and Luka. Luka sees that she’s watching and asks her to tell Dubenko to come over once he is finished with the biopsy. She politely, yet sarcastically tells him ‘Yes sir, Dr. Kovac’. While Dubenko is performing the biopsy, Sam answers the phone telling Carter it is Weaver. After he is finished, Dubenko goes over to Luka’s patient and takes him up to the OR immediately. Carter asks George where he heard about the Zirictal and George tells him that he was at a luncheon and overheard another neurologist talk about it. Mr. Milner interrupts to ask what the possibility would be of him donating his other kidney to Katy. George tells him that he would have to be on dialysis for the rest of his life. Carter explains that he doesn’t think it’s ethical and didn’t know of a doctor that would agree to do it. George tells Mr. Milner to go and be with his daughter. As he walks away, Lily hands Carter a fax from another doctor. Carter tells him it’s from the pharmaceutical company affirming isolated incidents of renal failure. George tells him he knows and it also required monthly monitoring of renal activity, which he had been doing with Katy. Carter asks him if he received the same fax and George affirms saying Carter did and so did every other physician in America. Kerry interrupts asking Carter if he posted a topic on an internet message board and he admits he did, and that he was just doing it to get more information on the drug. Kerry tells him she received a lot of calls about it. Carter defends himself saying he only did it to be better informed. They get into a heated argument over medications in general and Kerry tells him that most of the drugs help people and the ratio to medications that harm is peanuts compared to how many they actually help. Susan, who seems to be in the middle watches on as Kerry tells John that his job is to take care of his patients and not start a crusade. She walks off as Susan tells Carter ‘No more computer access for you.’

 

Neela and Abby grab coffees from the grocery mart across from County. Abby seems shocked that the crush Neela seemed to have was on Luka. They converse on they’re way back to the hospital. Sam buzzes through admit busily while Luka asks her to tend to a patient and she snaps at him. Carter asks her about the biopsy results and she pleasantly tells him that Dubenko has them. While Carter and Dubenko discuss the results, it comes to light that Katy’s body wasn’t rejecting the kidney. Carter asks if it’s the Zirictal and Dubenko tells him that its probable but he didn’t want to encourage him. They walk into the trauma room where Katy is to tell them about the results. George explains that Katy wasn’t rejecting the kidney; it was the drug that damaged her kidney irreversibly. Mr. Milner gets angry, saying that he took 2 jobs for nothing, and walks away. Jake and Abby do a procedure together. As Abby is walking him through it, Jake looses sight of the spot and Abby sneaks in to assist him. Sam, who’s assisting also seems to have been forgotten and clears her throat telling them the suction is ready. She notices Luka in the other room with Neela and wonders out loud if someone slipped something into the water. Luka is reviewing Neela’s notes on the femoral she did with him earlier. He corrects her on some things and tells her to rewrite it and hand it in. Before Neela leaves, Luka says to her that he hoped he didn’t give her the wrong idea, and that he just wanted her to learn. Uncomfortable, Neela tells him she understands and walks off to check on Katy. Mrs. Milner sits and watches over her sleeping daughter ands says that Mr. Milner went into work. She goes on to say that he has changed so much since Katy got the transplant. Neela tells her a lot of good things could still happen and to remain optimistic. Ray questions the code ‘MVC’ and Susan tells him its new hospital protocol and there was no such thing as an MVA anymore. Ray pouts saying he enjoyed saying the code ‘MVA’ and Susan smiles stating she likes to take walks in the spring. George admits to Carter that he knew of the potential toxicity levels of Zirictal. He also adds that he was being paid to help the pharmaceutical company test the drug on patients. This shocks Carter as he gloves up for the incoming trauma. Carter heads outside and George follows him. Mr. Milner sits a bit away, but hears the 2 doctors conversing. Ray approaches Carter and George and motions over to where Mr. Milner is sitting. Carter walks to him and sees how very distraught he is over Katy’s condition. He tells Carter that he was on his way to work and at the last minute wondered why. He flashes a gun and begins moving it around in front of the 2 doctors. George tells him to put the gun away. Mr. Milner tells George that he had faith in him. George replies anxiously that Katy could still live a long productive life on dialysis. Mr. Milner points the gun in his face, while Carter tries to reason with to go inside and be with his family. Milner tells Carter that he wants his daughter to have his other kidney. Carter who is obviously trying to negotiate with him, so no one gets hurt tells him that he can do that. Milner calls his bluff and tells Carter he’s lying. In the same breath he backs off a bit, putting the gun down. He cries to Carter saying ‘Fix her’ and as Carter looks at the other 2 men beside him, Milner places the gun in his mouth and pulls the trigger.

 

As Neela tries to intubate, the crew try to keep the rest of his body alive. Dubenko tells them he is brain dead. Carter prepares to tell the wife and George slips in saying that he is their doctor and he will do it. Carter watches as Mrs. Milner receives the news and almost collapses into George’s arms. A representative from the hospital says that UNOS still hasn’t given them the go ahead to do the transplant and to just do his best at keeping Mr. Milner’s organs alive. Kerry tells Susan there is some press people outside that want a statement and she should find someone that worked on Katy to do it. Susan tells Carter he is the one that will speak to the press and Carter questions her why. Susan tells him that he treated them. Neela and Sam continue to monitor Mr. Milner’s organs. Neela says they need to talk but Sam thinks not. Neela explains that Luka made the transition after returning to County easy for her, and that she just got confused. Sam states that she gets confused every time she looks at Luka and then changes the subject. Carter answers the press’s questions outside while Jake calls out to Abby as they are leaving for the night. He asks her if she wants to go out and Abby says no and not to take it personally and begins to walk away. Jake explains that he felt a ‘thing’. Abby doesn’t deny the thing and that nothing will come of it. She tells him there are many reasons why but the big deal breaker was that he was her student. He laughs and tells her that if he took a failing mark would she reconsider, and jokes that he was going to drop out of medical school. Susan watches the Carter interview on the TV with him standing beside her. Carter says something wrong on the interview and Susan gets upset. Carter says the family already knew everything already. She tells Carter that he may have cost the hospital millions in pharmaceutical dollars. He gets angry asking for what and points out ‘for coffee cups and pens?’ Susan follows him saying no, while Haleh interrupts and tells Susan that Kerry was on the phone for her. Luka asks Carter if it was true and tells him he did a good thing. Carter looks back saying ‘You say that like it matters’. The representative tells Mrs. Milner that UNOS finally gave them the go ahead for the transplant. Mrs. Milner asks them not to say that the new kidney was her father's.  As the rep and Mrs. Milner go in to see Katy, George asks Neela if she’s new. She tells him she is a 1st year resident and he asks her how it is going. She tells him that some days are better then others and then asks what he thinks they will tell Katy. He sighs and tells her that they will most likely tell her that her father loved her. Then adds ‘almost too much’. Carter wipes a name off the board, when George comes to say goodbye. He tells John that he can’t take responsibility for how the system works, but that he will try and take better care of his patients. Carter says that is all anyone can do. Carter tells him they will see each other again under more favorable circumstances and shakes George’s hand. Susan tells Carter that there will be a meeting in the morning with the two of them, Kerry and Anspaugh and hands him a chart for a patient needing sutures in his hand. Carter apologizes to her for anything that may roll back on her. He tends to a Mr. Kraussy who cut himself while cross-country skiing. He tells Carter that he hadn’t done in it for ten years and Carter asks him why he stopped. Mr. Kraussy tells him that he had arthritis bad. Carter then asks the old man what he did about it and Kraussy tells him he was watching TV and saw a drug and asked his doctor about it. He says that since then he feels like a brand new man. Carter thinks about it while Mr. Kraussy utters the words ‘Damn miracle of medicine’.

Reviewed by Kristyna on February 28, 2005

NBC Review

A FATHER'S DESPERATE ACT IS THE ONLY THING THAT CAN SAVE HIS LITTLE GIRL - When a sixteen-year-old girl who had received a kidney transplant from her father arrives at the ER feeling dizzy, Carter (Noah Wyle) traces the problem to a new drug called Zarictal that the girl was taking to control seizures related to her kidney dysfunction. Her father feels guilty because he was the one who pushed for her to take the new drug and its side effects may mean his daughter will have to go back on dialysis. Carter asks Neela (Parminder Nagra) to post questions about the drug's side effects on the internet, which causes an uproar when the pharmaceutical company finds out. After Abby (Maura Tierney) and Neela complain about their lackluster dating lives, they end up assigned to work with Jake (Eion Bailey) and Kovac (Goran Visjnic) whom they each seem to have a crush on. Also starring Sherry Stringfield, Laura Innes, Mekhi Phifer, Linda Cardellini, Shane West.