ER 4.14, Family Practice: Remember How Benton Couldn’t Fix His Mother? Same Thing Here

August 20, 2019

ER 4.14, Family Practice: Remember How Benton Couldn’t Fix His Mother? Same Thing Here

These clothes just scream “Dad”

Summary: Mark has just arrived in San Diego to visit his mother, who was injured in a fall at home. David meets him at the airport and tells him his friend is on her way to surprise him. Cynthia has invited herself to come out to California, wanting to help the family. Mark pretends to be happy. The three go straight to the Naval hospital where Ruth is being treated, and Mark learns that there’s more going on than just a knee injury. Ruth has been assigned a neurologist and is exhibiting some strange behavior.

Ruth is happy to meet Cynthia, mostly because she’s not as sour as Jen. (Amen to that.) She thinks Rachel has inherited that characteristic from her mother. Oh, just wait, Ruth. As Mark and Cynthia leave her to sleep, Mark demands a meeting with the neurologist, Sayers. His mother isn’t acting like her usual self.

Mark and Cynthia try to figure out if Ruth could have suffered a head injury when she fell. David wasn’t there and doesn’t know what happened. Mark disagrees with Sayers’ opinion that Ruth’s brain scans are okay. David thinks Sayers is right about her loony behavior just being a side effect of the morphine she was given. Cynthia assures him that Mark will figure everything out. Mark talks to Sayers on the phone, demanding an MRI the next day.

The three head to David and Ruth’s house, where Cynthia is very cheery for someone who just got off a long flight, lost her baggage, and spent some time at a hospital. Mark is sure that David likes her, since what’s not to like? She comments that he’s probably beating himself up for what happened to Ruth. Mark says that would be a first.

Cynthia gives him a backrub and they talk about all the places Mark lived growing up, before the family came to San Diego. (Trivia: He preferred Kate Jackson to Farrah Fawcett, whom he found scary.) Things get romantic, because who doesn’t want to get it on in his childhood bedroom with his father down the hall? They can hear David coughing from his bedroom.

The next morning, Mark and David meet with Sayers, who understands Mark’s concerns. Ruth’s history of high blood pressure puts her at risk for a stroke, but her CT didn’t show anything that worried Sayers. He wants to do a neuro exam before giving Ruth an MRI or any more tests. Mark doesn’t want to delay anything. The men’s conversation is interrupted for a flag raising. Everyone present salutes except Mark.

Mark attends his mother’s MRI while David disappears somewhere. Mark guesses he went home to work on the wheelchair ramp he’s building for Ruth. Ruth starts getting agitated in the MRI and screams for her son to get her out. Everyone watching who’s dealing with aging parents tries not to cry as Mark comforts her.

Back at home, Mark tells David that Ruth’s symptoms indicate that a series of small strokes has caused dementia. The doctors can’t do much for her rather than wait and see. Mark takes out his frustration on a weight bag; apparently he used to box. The next morning, Mark sees that Ruth has been going somewhere every Thursday, but David isn’t sure where. In case it wasn’t already made clear, David is very independent and really doesn’t care what his wife is up to. David ducks out before Mark can start a fight about smoking, even though he’s taken it up again himself.

Sayers performs a neuro exam on Ruth, who can’t remember things he’s asked her to remember or interpret a common saying. Mark sees firsthand that her condition is serious. He goes to the medical library to do some research. Later, back at home, he smokes in the yard, having left Cynthia in bed after some dissatisfying sex. She joins him outside and talks about how generous and considerate he is. Mark sarcastically says he’s a caretaker, “a magnet for needy people. They find me wherever I go.” She thinks he’s including her in that group.

Ruth undergoes a spinal tap so the doctors can rule out encephalitis. Mark’s pushing Sayers for aggressive testing, wanting to make sure they know what they’re dealing with. Sayers says that if his mother were in this position, he’d be horrible at supporting her, since he doesn’t have the temperament for emergency care. Mark says he doesn’t have the temperament for passive treatment. Yeah, Mark, there’s nothing passive about you (*cough* break up with Cynthia already *cough*).

Mark wants a second opinion, so Sayers says he’ll ask the chairman of the neurology department to weigh in. Mark objects, wanting a civilian doctor. He takes Cynthia to a bar, telling her that Ruth’s weekly appointments were with a psychiatrist. An officer at the bar chastises them for coming in alone; they’re supposed to be in the company of a retired officer to be there, and David hasn’t arrived yet. Mark snaps at him, so the officer, Admiral Jackson, says Mark should pay for his drink. He knows who Mark is and says he’s as stubborn as David.

Mark doesn’t remember meeting Jackson previously, when Mark was in high school, considering going to the Naval Academy. Mark says that was his father’s dream. Jackson reveals that David was in line to become an admiral, but he took himself out of the running for his family. He leaves as David arrives. David announces that Ruth is coming home tomorrow, which is news to Mark. The two argue about all the testing, the last straw for David being one for syphilis.

David starts struggling for breath as he yells Mark for thinking so poorly of his parents. Cynthia plays peacemaker, but there’s no making peace between these two. David tells Mark to go back to Chicago and leave them alone. Mark reveals Ruth’s weekly trips to a psychiatrist, which go against the seemingly picture-perfect life David keeps pretending they have. Distressed, David stops breathing and Mark has to give him mouth-to-mouth.

Now both of Mark’s parents are in the hospital, with David under observation in the Naval hosital’s ER for a few hours. He asks Mark not to tell Ruth what happened. Mark half-heartedly apologizes about upsetting his father and says he’s canceled any further testing for Ruth. Now, though, David wants to find out what’s really wrong with her.

Mark chats with Ruth’s psychiatrist, Dr. Black, who was prescribing her Paxil for depression and didn’t know she had hypertension. He’s already met Dr. Hemmings, the second opinion Mark has called in. Black agrees with Sayers’ diagnosis, whether or not Mark wants to accept it. Mark says it’s about her care, not her diagnosis. Black offers to give him any information he wants on Ruth’s depression, since she signed a release for him to do so, but Mark would rather hear it from her.

He gets home from a long run and Cynthia gives him a message that Hemmings wants to push up their meeting. She’s an old friend of Mark’s from med school. She invited Cynthia to join them, but Cynthia thinks Mark wants to speak to Hemmings along. He meets her at a playground where her kids are playing; unlike Mark and Jen, she waited a while to have children. In fact, she’s currently on maternity leave, though she’s happy to help Mark. She speaks highly of Sayers, who hasn’t impressed Mark yet.

Hemmings is surprised that Mark went into emergency medicine instead of family practice. She was a driven student while he was a family man; now she’s enjoying time with her family while Mark is a cowboy. He indicates that he might want a family again someday. Hemmings thinks he means with Cynthia. She finally gives Mark the news he needs to hear: Ruth might never be the person she used to be again.

At the hospital, Mark apologizes to Sayers, who easily forgives him. He knows Mark acts the way he does because his father was in the Navy. Sayers was the same way, though he followed in his father’s footsteps. Suddenly news of a mass casualty, the aftermath of a crashed helicopter. Mark and David try to stay out of the way as patients are brought into the ER. They both give some reassurances to the injured pilot, who keeps saying that he was unable to pull up the…whatever you pull up to make the helicopter fly. Despite not being a doctor, David has better bedside manner than Mark.

The pilot stops breathing, and Mark jumps in to help his medical team. He doesn’t have staff privileges and isn’t licensed in California, but one of the other doctors asks him to walk an intern through inserting a chest tube anyway. He tells her to follow Mark’s orders just like she would any other doctor. David watches as Mark does the same things he does every day, seeing for the first time how his son works.

The next day, David and Ruth both get to go home. Ruth and Cynthia look through some of Mark’s childhood things, like a model plane he wanted because he thought it was the one his father flew. (It wasn’t, and David wasn’t pleased.) Then Ruth starts talking about sex, which is…awkward. But the awkwardness isn’t over: Ruth says sex isn’t enough to keep a marriage together, if they’re counting on that; Mark says they’re not counting on anything; Cynthia finally gets the hint that their relationship isn’t going anywhere; David walks in with pizza all, “What’d I miss?”

So Mark and Cynthia go for a walk, and he dumps her. She feels foolish for coming all the way out to California like she was part of the family. Mark says she means a lot to him, and he didn’t intend to lead her on. He though they were just having fun together. Cynthia’s heard this before, which makes her think she’s the problem. Mark wishes he hadn’t let things go on so long when he knew they weren’t going to last. Cynthia tells him that when he gets back to Chicago in a week, they don’t have to talk.

Mark tends to Ruth like the caregiver he is. He complains that David doesn’t pay enough attention to her to take care of her. He asks if Jackson was telling the truth about David giving up his chance at becoming an admiral. Ruth explains that she asked him to come back to live with the family because Mark was having trouble with a childhood bully. He never complained about derailing his career to be with them.

Ruth says that Black tells her that Mark and David are responsible for their own feelings, but she blames herself for their poor relationship. She didn’t want a baby – she’d only gone on a few dates with David, and it was too soon. She loved Mark after he was born, and she tried to make up for her reservations, but she feels like she’d already ruined his relationship with David.

Mark wakes up in the middle of the night (alone; Cynthia’s already gone back to Chicago) to a crashing noise, then Ruth yelling for her husband. She was trying to cook something and started a fire on the stove, then fell. While Mark is cleaning up after all the disasters, he sees David taking care of Ruth and trying to comfort her.

The next day, Mark takes David to a beach they used to come to when Mark was a child. David announces that he’s stopped smoking, for Ruth. He’s quit a 15-year two-pack-a-day habit cold turkey. Mark asks him about his career working on an aircraft carrier, clearly having never cared before to talk to his father about his life.

David liked the early mornings best; he could watch the sunrise over the ocean and have a few minutes to himself before all the dangerous work began. Like Mark, lives were always at stake for his whole workday. David says he’s proud of Mark, and Mark thanks him for helping him get to where he is. They head back to the house to look after Ruth together.

Thoughts: Sayers is played by Holmes Osborne.

If you haven’t gotten enough of Mark’s parental issues, just wait until season 6.

I found Cynthia annoying during the series’ original run, but all these years later, she’s not as bad as I remember. Yeah, her cheeriness would probably get old after a while, and she’s kind of a mess, but she’s also friendly and compassionate. She would make a good nurse (if she could get it together enough to get through school).

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