Summary: Romano has decided to get back in the “trenches” with the “little people,” so he’s working in the ER for the day. He immediately has something chaotic to deal with when two men crash through the ER doors, trying to beat each other up after an incident of road rage. Neither is badly injured, at least until one of them, Terry Waters, grabs a pen from Romano’s pocket and jams it in the other guy’s cheek. Romano is more worried about the state of his pen than he is about the guy’s face.
Mark accompanies David to an appointment, mostly to make sure he keeps using his oxygen tank. David is still resistant to having his cancer treated and is considering moving out of Mark’s apartment if he won’t stop pressing for treatment. Luka examines a patient who’s at County to get a kidney transplant he’s been waiting for a long time. He’s grateful for the kidney but not happy about much else. The words “cranky old man” come to mind.
Chen stitches up Waters as his daughter, Jo, learns what happened. Waters accidentally knocks over a cup of water and gets agitated about it. Outside the room, Jo tells Chen that this kind of aggression isn’t typical for Waters. In the week she’s been there to visit him, he’s been lashing out at people and losing his balance. Chen decides he needs some tests.
Cleo brings Benton to examine a man named Hal who may have a bowel obstruction. Luka’s patient is in the next bed, complaining about being hungry, since he’s not supposed to eat before his transplant. Benton determines that Hal doesn’t need surgery and writes a prescription for medication that will help relieve his symptoms. A woman named Mrs. Dwyer brings in a teen named Angie who has Sanfillipo disorder, a metabolic condition that affects the brain. Angie can’t do anything for herself, so Mrs. Dwyer is her full-time caregiver. She’s as familiar with her treatment as any doctor would be and clearly cares a lot about her.
Remember Eddie, the diabetic kid whose chart Carter falsified? Looks like his grandmother’s insulin hasn’t helped him, because he’s being brought in by ambulance. While rushing to get back to Eddie, Cleo quickly gives Hal his prescription and send him home. She doesn’t recognize him from his last visit and is shocked by how high his blood sugar is; he must have been sick for a while. She tells Yosh to page Carter so he can answer some questions about Eddie’s previous care.
Elizabeth returns to Chicago after flying to another state to get Luka’s patient’s kidney, but there’s a problem: The patient developed unstable angina and can’t have the transplant today. There’s another possible recipient on her way to the hospital. Cleo tells Carter that Eddie’s been admitted, but Carter doesn’t remember him, either. She accuses him of doctoring Eddie’s chart to hide his diabetes. She’s furious that Carter let him go without a treatment plan – he could have died.
Luka examines the second possible kidney recipient, Sonya, who’s also been waiting a long time for the surgery. She’s basically the opposite of a cranky old man. Mrs. Dwyer brings a bunch of dolls and stuffed animals to Angie’s room so she’ll be more comfortable. Weaver and Carol want to insert a central line so they can give Angie medications without having to insert IVs, since her veins are difficult to deal with. Mrs. Dwyer admits that she can’t approve the procedure. She’s Angie’s foster mother, not her legal guardian. She wants to adopt Angie, but her medical needs are too expensive. Her guardianship is through Social Services.
Carter asks Eddie’s father, Mr. Bernero, why he didn’t do more to make sure Eddie was healthy. Mr. B says the insurance has been worked out, but obviously his medical care hasn’t. Mr. B says Carter didn’t tell him how bad things could get. He insists Eddie’s been doing great, though Cleo said earlier that he’s been sick for a while. Carter can’t believe Mr. B is trying to pretend he doesn’t have any responsibility here.
Adele gets in touch with Angie’s guardian, who has no familiarity with her care or with medical issues in general. Since Angie’s condition isn’t life-threatening, he won’t approve the central line. Weaver asks if he’s ever even seen Angie. Of course not! Why would he do that? Even Weaver can’t get through to him, so no central line.
Luka discovers through Sonya’s pre-op exam that she’s eight weeks pregnant. She and her husband have been trying to conceive for almost two years. The drugs she’ll have to take after the transplant could cause a miscarriage, so she can either have the baby or the transplant, but not both. Sonya’s husband hasn’t arrived at the hospital yet, and she has to make a decision quickly, so she’ll have to choose on her own. Sonya opts for the baby.
David runs into Elizabeth after his appointment and she offers to go get something to eat with him. Mark is discussing Waters with Chen; both of them think he has a neurological issue. David confides in Elizabeth that he has a hard time discussing his condition with Mark. He knows Mark wishes he could have control over the situation. David doesn’t want to be a burden to Mark, but Elizabeth says he’ll want to take care of David no matter what. David is willing to go to a hospice in Chicago, which he thinks is a good compromise.
Mark and Chen tell Waters that they think he has Huntington’s, which not only causes mood changes and jerking movements, but also eventually leads to dementia. Oh, and there’s no cure. Have a great day, Mr. Waters! His father killed himself when Waters was a teenager, and Mark guesses that it’s because he also had Huntington’s. Waters realizes that he might have passed the disorder to his daughter.
Cleo goes over Eddie’s case with someone from his insurance company to verify the reason for his admission to the hospital. She glosses over the details of Eddie’s previous visit, not wanting to admit that she and Carter both knew Eddie had diabetes months ago but didn’t ensure that he would get treatment. Mark joins the conversation and tells the insurance rep that he’ll look into things. He guesses that Cleo’s hiding something, but she just tells him that Eddie is Carter’s patient.
Elizabeth tells Mark that a hospice center is going to be contacting him about David. Mark’s upset that the two of them discussed hospice behind his back. Elizabeth doesn’t think Mark will be able to handle the level of care David will need as his condition declines, even with nursing support while Mark is at work. He tells her not to interfere. Elizabeth asks if he’s doing what’s best for David or what’s best for himself.
Steve, the third potential transplant recipient, arrives to try his hand at getting the kidney. Chen gets Waters an appointment with a geneticist the same day he’ll need to appear in court for the road-rage incident. Chen points out that his anger is a symptom of Huntington’s, so the incident might not be his fault. Waters doesn’t think that’s a great excuse, though.
He hasn’t told Jo that she might have Huntington’s, since his father never told him and he’s glad not to have known. Chen says Jo has the right to know, but Waters disagrees, since she can’t do anything about it. Chen says that Jo might make different decisions about her life if she knew how she could end up – she might choose not to work or have children. Waters replies that she might not get married or have a life. Chen says she needs to know that she could pass Huntington’s to her own children. Waters wants Jo to stay happy for as long as possible.
Weaver makes arrangements for Mark to be able to override Angie’s guardian’s decision about the central line. Mark is reluctant but eventually approves it. When Weaver returns to Angie’s room, she finds Romano there. He confronts her for circumventing the system to try to improve the quality of life of a teen who’s never going to recover. Weaver argues that Angie’s condition could be life-threatening, and all she needs is a central line.
Romano accuses her of letting her sympathy for Mrs. Dwyer override the system. He overturns Mark’s approval of the central line and slams Weaver for being unprofessional. Weaver argues that she’s just supporting Mrs. Dwyer’s decision, which should be seen as the same as any other parent’s decision, since she’s Angie’s mother in every way but the legal one. Romano says Angie has no quality of life, so they shouldn’t waste their resources or money on her.
Hal is brought back to the ER after collapsing at home. He’s having heart difficulties, though he’s never had them before. Cleo, Carter, and Romano realize that he was given the wrong medication. Luka gets stunning news about Steve while Chen tells Mark that she wants to go against Waters’ wishes and let Jo know she could have Huntington’s. But since Jo isn’t Chen’s patient, she can’t tell her anything. Luka confronts Steve about his lab work, which shows that he used cocaine. Since that’s what destroyed his kidneys the first time, Luka won’t approve him to get a new one he’ll just destroy again.
Jo introduces Chen to her fiancé, Glen, who thinks Waters might be suffering from depression. He offered to pay for Jo and Glen’s wedding, and he might be feeling down about the expense. Chen just says that might be the case. She lets Waters go without revealing his secret to Jo. Carol catches Weaver inserting a central line in Angie and offers to help, but Weaver doesn’t want to get her involved. I wonder what Doug would say if he knew Weaver was going rogue just like him.
Romano gathers Carter, Cleo, and Benton to try to figure out what happened with Hal’s prescription. Benton thinks his handwriting is clear, but Carter says he can see where the pharmacist might have misread it. If it wasn’t clear, though, the pharmacist should have called to clarify. Romano pulls Abby in for an objective opinion, but she can’t read the writing, either.
Benton won’t admit that he might have done something wrong, and Cleo knows what he prescribed, so she won’t go against him. Romano gets her to admit that she didn’t read the label clearly when she gave Hal the medication. Carter tries to speak up but Romano tells him this has nothing to do with him. Then why is he there? Poor Abby asks if she can leave.
Romano criticizes the level of incompetence in the ER, but he’s in charge, so what does that say about him? Abby runs away before he can stop her. Romano tells Benton and Cleo they’re forbidden from writing prescriptions for the foreseeable future. Carter can write any they need. Carter smirks a little, because what’s a little potentially fatal error when it means Carter gets to exercise some superiority? Benton seems to be chalking this up to another Romano tantrum that will eventually pass, but Cleo’s upset.
After Benton dismisses Carter, he asks Cleo if she really handed over the medication without reading the label. She tells him his writing wasn’t legible, but Benton argues that he shouldn’t be writing prescriptions for her patients anyway. Yeah, buddy, she didn’t ask you to – you just did it. He reminds her that one of the first lessons of med school is double-checking labels. Yeah, thanks, Benton.
Luka has contacted UNOS, the national transplant-coordination organization, since there are no qualified recipients in the area. The next one is coming in 40 minutes, which will put them past the mark for the kidney’s viability. Elizabeth is upset that Luka called UNOS without consulting her. She thinks Steve should get the kidney. Their choices are putting a healthy kidney in a questionable person or giving it to no one. Luka would rather let it go to waste than let Steve ruin it. Elizabeth tells him she’ll wait 30 minutes for the next recipient. If she’s not there in time, Steve gets the kidney.
Romano checks up on Angie, actually listening when Mrs. Dwyer talks to him about Angie’s condition and how much Mrs. Dwyer loves her. Is that…a glimmer of sympathy? From Robert Romano? No, I must be imagining things. He confronts Weaver for inserting the central line against his orders, then suspends her and sends her home. Weaver thinks it’s ridiculous but she doesn’t fight him. She probably thinks it was worth it.
As Carter and Mark get ready to leave for the day, Carter mentions that he’s moved in with his grandparents. Mark asks about a hypothetical patient fitting Eddie’s description, wondering what Carter would do to find out what’s wrong with him. Carter pretends that he forgot to order a test back when Eddie was first seen. Mark is totally on to him, but since Carter won’t admit to the deception, there’s nothing Mark can do.
The fourth potential transplant recipient doesn’t make it to County within Elizabeth’s window, so Steve is the lucky winner of the kidney. Benton goes to Cleo’s place to try to make up with her without actually apologizing. He just tells her he doesn’t blame her for the error. Oh, isn’t that nice? He doesn’t hold her responsible for a mistake they both made! How sweet! Cleo calls him out for his weak apology, which in no way expressed any regret, but obviously it’s not a big deal to her, since she wants to get naked with him.
At home, Mark tells David that he checked out the hospice center David wants to go to, but there are no spots available. David will just have to keep living with Mark. Luka wants to have a cookout in Carol’s backyard, even though it’s cold out. It seems like they’ve been spending a lot of time together, since he knows about the girls’ personalities. Carol teases that if Luka can’t successfully grill his steaks, she has a steak and kidney pie in the freezer. She tells him the nurses thought Luka would have to take the kidney home with him. She thinks Luka scared Steve into rehab. The cookout ends abruptly when it starts snowing, even though it’s April.
Thoughts: Waters is played by Walter Skinner himself, Mitch Pileggi.
Remember Carol’s clinic, which treated uninsured patients? Why didn’t Cleo and Carter send Eddie there originally?
I’m surprised Romano approved when Lucy fought to get Valerie a heart – a much riskier situation than Angie’s – but fights Weaver over a simple central line.
Cleo, do you really want to be with someone who can’t admit when he might have made a mistake?
'90s Flashback 
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