June 16, 2020

ER 6.11, The Domino Heart: If the ER Is a Circus, Chen and Carter Are Both Clowns

Posted in TV tagged , , , , , at 4:57 pm by Jenn

Poor Valerie

Summary: David has moved in with Mark and is up early, watching the weather channel…loudly. He wakes both Mark and his neighbor. Also, he drank all the coffee. Mark’s like, “Well, I wanted this,” and just goes to work. Carol is already there, back for her first shift since having the twins. She’s barely there for 20 seconds when a patient is brought in. A trapeze artist named Vito fell while practicing his circus act and has a deep cut. Mark comes in to join the trauma and notices that the water in the trauma room isn’t working.

Vito starts declining, thanks to blood loss, and Carol struggles a little to get back into the rhythm of the ER. Luka tells her she can start off slow if she needs to; he seems amused when she insists that she’s okay. Romano joins the group, familiar with Vito and his brother Dominic’s trapeze act. He does something to Vito that agitates him, so Dominic and another guy drag him out of the trauma room.

Mark has bottled water brought into the hospital since there’s a water-main issue that won’t be fixed for a while. Lucy comes in hours ahead of her shift, having been summoned by Valerie – a heart has been found for her, and she’s coming in for a transplant. Lily discovers another downside to not having water: They can’t flush the toilets. Mark requests some Port-a-Potties for the ambulance bay, and maybe some air freshener.

Another circus performer is in the ER, a young acrobat named Peng who hurt her foot. Dominic explains to Luka that when Vito’s trapeze broke, the pieces fell on Peng. Luka’s confused, since her injury is to the bottom of her foot. Peng clears things up by doing a one-handed handstand. Luka’s impressed and decides to get himself some circus tickets. Romano ruins the vibe by having security remove Dominic from the hospital.

Chen’s patient is Mrs. Duffy, an elderly woman with Parkinson’s who may have had a stroke. Her daughter, Louise, takes care of her at home, and though Mrs. Duffy sees herself as a burden, Louise is fine tending to her. Chen notices that Louise seems tired, but she says she’s okay.

Mark bugs Carol about falling behind on patients, and she gets defensive about it. Weaver interrupts to ask Mark why she wasn’t told about the water issues. Mark says he handled everything, though he didn’t think of the fact that without water, surgeons can’t sterilize their equipment. Weaver has canceled all elective procedures and decided to use water from the physical-therapy pool to flush toilets.

Lucy welcomes Valerie back to the hospital, thrilled to be there for Valerie’s transplant. Carol is annoyed to have to fax stuff for Dave. Shouldn’t the file clerks do stuff like that? Cleo can’t get an x-ray back for her patient because the radiologists can’t process the films without water. Benton wonders if they might be able to leave work early, since they can’t do their full jobs. He hints that he’d like to get something to eat with Cleo, but she doesn’t take the bait.

Paramedics bring in a man named Michael who had a seizure while driving. His boyfriend, Curt, isn’t aware of Michael ever having seizures before. His only known medical problem is asthma. Mark notices bruises on Michael’s chest, which Curt says must be from playing hockey. Mark thinks Michael’s condition might be the result of taking too much asthma medication.

Mrs. Duffy’s tests come back normal, so her declining health is probably due to her Parkinson’s. Louise asks Chen to admit her anyway; she can’t care for Mrs. Duffy if she can’t walk. Chen recommends a home aide, which Louise can’t afford. She wants Mrs. Duffy to be admitted for a few days so her medications can be adjusted and she can regain her strength. Chen apologetically says they can’t do that. Louise begs Chen to do something so she can get some rest, but there’s nothing Chen can do.

Lucy buys Valerie some Tweety Bird slippers, since Valerie packed for the hospital so fast that she forgot her own slippers. Weaver pulls Lucy aside to tell her that Valerie has a fever of 100.9. She’ll need immunosuppressants after the transplant, which will weaken her immune system so much that even a small cold could be fatal. Weaver warns that they may have to decline the heart. The transplant committee will probably decide to give it to someone else.

Michael’s stable now and only has a minor hand injury, but Mark is concerned about his mental health. He thinks Michael might have intentionally overdosed on his medication. Michael says he took some extra pills because stress makes his asthma flare up, but he wasn’t trying to hurt himself. Curt checks in and Michael doesn’t mention anything about Mark’s suspicion that he’s depressed.

As soon as Romano and Benton hear that Valerie has a fever, they agree that she can’t have the transplant. Lucy argues that all her tests have come back normal, which means she must have an infection in her LVAD. All she needs is antibiotics. Once the LVAD is removed (which is necessary anyway to do the transplant), she can get the new heart. Romano seems annoyed by Lucy’s persistence, but he probably also admires it.

Carol gets defensive again about criticism that isn’t really criticism. Weaver wants to make sure she’s getting enough sleep. With two babies and no partner to help her? I’m sure she’s getting eight hours every night, Weaver. Dave brings her into a case involving a man who’s been taking some kind of medication that has led to him vomiting blood. Weaver isn’t familiar with the medication, which Dave says is a combination painkiller and steroid easily available in Mexico.

Benton decides to be more straightforward with Cleo and…kind of, sort of ask her out. She casually tells him she’s never sure when she gets off work, so if he wants to have dinner, he shouldn’t wait for her. Elizabeth finds Carol crying in the lounge and suggests that she go home. Carol admits that sometimes she just has a good cry at home, then feels better and goes back to whatever she was doing. She appreciates Elizabeth’s concern. Chuny comes in and Elizabeth tells her that Carol’s feeling overwhelmed. They talk about Carol’s struggles as if she’s not in the room.

Lucy tells Valerie that they think they can clear up her infection with antibiotics and still do the transplant. Valerie worries that the antibiotics won’t work, which could lead to a life-threatening infection. She asks what Lucy would do in her position. Lucy thinks the risks are small and Valerie should go ahead with the transplant.

Mark asks Michael about his relationship with Curt, suspecting that Curt is abusive. Instead of insisting that everything’s fine, which is usually what happens with abuse cases on this show, Michael admits that he and Curt had an argument that turned physical. Mark suggests that he talk to a social worker, but Michael isn’t sure if he wants to take that step.

Linsey Cordova comes to see Elizabeth and lets her know that they held Jenny’s funeral yesterday. She’s grateful that Elizabeth got Dean to tell her where Jenny’s body was. Linsey’s trying to forget him, but she hears his voice all the time – gentle, but telling her horrible things. Elizabeth tells her that Dean wanted her to suffer, but he can’t hurt her anymore, so she shouldn’t give him any more thought.

Valerie heads to surgery, asking if Lucy can observe. Lucy says med students can only watch if they’re on the transplant service, but she’s going to talk her way into having an exception made. If anyone can do it, it’s Lucy. Valerie realizes she forgot to feed her cat and asks Lucy to let her mom know.

Elizabeth goes to the prison ward to see Dean, whom she didn’t euthanize after all. He admits to being glad when he realized she didn’t follow through on her part of the bargain; he never thought she might turn out to be a coward. He thinks her conscience is bothering her. Elizabeth says it is, but not because she almost killed him. It’s because she enjoyed how much power she had over his life.

She could have easily killed him and repaid the pain he’s caused others, but she realized how pathetic he was and didn’t want that power. Elizabeth’s job is done – she made her sick patient better. Now he gets to suffer in prison. Elizabeth saunters out, ignoring Dean when he yells after her that he’s not finished with her yet. Fortunately, this is his last episode, so we’re finished with him. Yay!

Louise slipped on some ice in the parking lot while getting her mother into their car, so she’s back in the ER. In addition, Mrs. Duffy’s wheelchair fell over, so she might need medical attention again. Carter wants to do some tests on Louise, whose blood pressure is high. He’s judgmental about Chen’s decision to let Mrs. Duffy go instead of getting her further care.

Lucy observes Valerie’s transplant, much more in awe of the sight of the new heart than Benton is (though, to be fair, he probably sees this a lot. Also, he’s a robot). Michael agreed to talk to a social worker, but when Mark brought in Adele, he changed his mind. Adele tells Mark that this is common; Michael probably wants to protect his boyfriend. Mark thinks he can eventually get Michael to talk to someone.

Carter argues with Chen about admitting Mrs. Duffy so Louise can get some rest. Chen sticks to the rules, refusing to take Carter’s suggestion to lie that Mrs. Duffy had a stroke. She reminds him that she bent the rules with Alyssa, which got her into trouble, and she doesn’t want to take any more chances. Carter – who, remember, just lied on kid’s chart a couple weeks ago – thinks she should worry less about getting in trouble. Everyone admits people who don’t necessarily need to be admitted. Chen puts her foot down, saying that Mrs. Duffy is her patient, so it’s her call. Carter responds by having Louise admitted for high blood pressure.

Michael has changed his story, telling Mark that his bruises are from hockey. Mark worries about Michael’s safety in his relationship, noting that most people who are killed by their partners have experienced physical abuse. Curt comes in to get Michael, but Mark delays his discharge, saying he wants to run some more tests. Michael is about to give in when Curt tells him to shut up. Mark tells Michael he doesn’t have to go – it’s his choice. Michael chooses to leave with Curt.

Dave clears out the vending machine, knowing there won’t be any good food in the cafeteria since there’s no water to cook with. Cleo mentions that she’s treating a Spanish-speaking father and daughter who both have aplastic anemia. Dave realizes they must be tied to his earlier patient who took the Mexican meds. He knows enough Spanish to be able to communicate with Cleo’s patients, who tell him they got shots from a pharmacist who works out of a backroom clinic. Cleo wants to call to the police, but Dave would rather confront the pharmacist on his own.

Mark looks on silently as Michael leaves with Curt. The water has finally been fixed, but the pressure hasn’t been tested yet, so everyone still needs to use the Port-a-Potties. Chen asks Mark if it’s possible to page an individual beeper for someone working on the code team. The answer is yes. P.S. Carter’s on the code team today.

Valerie comes out of surgery fine, and Benton finally acknowledges Lucy’s awe over the idea of using someone else’s heart to keep a person alive. He wonders if she might want to go into surgery now. Lucy notices that Valerie’s eyes aren’t normal, and she doesn’t respond when Lucy says to squeeze her hand. Benton rushes her to CT.

Chen and some nurses watch gleefully as she pages Carter, who runs out of a Port-a-Potty to answer a code in the ER. He slips on a wet floor and falls, making Chen feel a little bad about her prank. He quickly realizes that she was messing with him, which she calls payback for what she considers blackmail. It worked, though, since she finally admitted Mrs. Duffy. She hopes Carter doesn’t see her as heartless.

They hear a crash outside and run to the ambulance bay, where Michael has crashed his car into the truck driven by the guy fixing the water main. Now Curt’s the one who needs medical attention – Michael thought he was in drive, not reverse, and ran him over. Mark, Carter, and Chen work on Curt in a trauma room but can’t use a piece of equipment for suction because it needs water they don’t have. Carter and Chen come up with a makeshift replacement involving a vacuum hose and sponges.

Romano checks in with Benton, who’s examining Valerie, then tells Lucy that she’s in a permanent vegetative state. Lucy blames the LVAD, but Romano says they can’t be sure what happened, so she shouldn’t feel guilty. After all, he approved the LVAD implantation. Surgeons know that nothing is risk-free. The positive news is that there’s a patient in Milwaukee who’s a match for Valerie’s new heart. Valerie’s not going to recover, so they can remove the heart and give it to someone else who can use it.

Once Curt has been stabilized, Michael tells Mark that the accident was just that, an accident. If I were Mark, I would be very skeptical. Carter is snarky with Chen over their different approaches to taking care of the Duffy women, like, let it go already. He’s disappointed that Chen can’t admit that she made a mistake. He tells her that things will go a lot easier for her if she can deal with them honestly. Chen agrees not to play any more practical jokes.

Lucy speaks with Valerie’s mother, who agrees to donate Valerie’s new heart. Chen examines an x-ray she’s been waiting on and sees a bunch of nails in her patient’s stomach. As she runs off to check on him, Carter stops Chuny from calling any surgeons. He lifts his shirt and shows her that he’s taped nails to himself so he could mess with Chen by giving her a fake x-ray. What a great use of expensive hospital equipment!

Carol’s made it through her first day back and heads home to her girls. Dave returns from the clinic with some bruises from his confrontation with the pharmacist. He tells Cleo he got a prescription by claiming he had a sore throat; the pharmacist didn’t even examine him. Dave grabbed a vial of some medication no one should take and just ran. Now he has evidence to get the clinic shut down.

Benton grows a very, very small spine and quietly asks Cleo if she wants to get dinner with him. It turns out she thought he was inviting her on a group outing, but he admits that it’s just going to be the two of them. She definitely seems interested. Mark speaks with a cop who talked to Michael about the crash, but doesn’t bring up Curt’s abuse. Michael notes that Mark is getting what he wants – Michael will be safe at home tonight. Mark offers to call Adele in again, but Michael still isn’t ready for that.

Luka finds Lucy sitting on a bench outside the ER and gives her his coat, since it’s started snowing. He offers her a ticket to the circus. Lucy says she’s on duty now, after having been at work all day but not technically working. They bond over feeling out of place at County, though Luka’s used to it, having moved around a lot. Lucy feels grateful every day to be able to walk in on her own rather than be brought in as a patient. At the end of every day, she hopes she’s helped even one person, but today that didn’t happen.

Luka reminds her that her day’s not over. Maybe the person just now being brought in by ambulance is the one person she’s going to help. Luka offers to stay behind and find out. He’ll skip the circus, since working in the ER is enough of a circus for him. They receive the patient and Luka offers to walk Lucy through a procedure she’s never done before.

Thoughts: Mark again demonstrates great leadership skills in handling the water problem. He stays calm and makes decisions quickly. Harriet the disaster coordinator would be proud.

Abuse storylines featuring same-sex couples are extremely rare, so good for this show for doing one.

Not one person suggests that Carol get screened for postpartum depression. Good job, medical professionals.


  1. Nick Rivers said,

    Oof, the postpartum thing, can’t believe they missed that. Especially Mark, what the hell!

    Chen was right (though she could have called Adele to come offer some advice on caregiver fatigue and help Louise find some alternative options), and Carter bends the rules too much. Didn’t he learn anything from the time he got kicked off of Dr. Hicks’ surgical team for screwing with the rules? We’re supposed to see their practical joke war as amusing, right? I don’t get it. But I hope they start showcasing Chen’s strengths because I’m not getting a good handle on her forte right now.

    I appreciated the DV storyline with the same-sex couple and once again ER shows how it was willing to be groundbreaking in some of their storylines. And we weren’t beaten over the head (pardon the bad pun) with their relationship — it was just there, like all relationships are, and nobody made a big deal about it.

    The Lucy/Valerie storyline was heartbreaking, but I did like how Romano was sensitive to her emotional connection to the patient and involvement in the case. Also, he handed her his Mont Blanc to get the family’s consent for Valerie’s heart donation… and it doesn’t seem like Lucy gave it back. That’s a pricy pen! Petty cash for Romano, but still.

    Still finding Malucci obnoxious and Cleo dull. Ugh.

  2. Patrick Sullivan said,

    The scene in the lounge where Elizabeth kisses Carol on the top of the head when she was crying was nice, especially since they were never really close friends.

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