November 10, 2020

ER 7.10, Piece of Mind: The Doctor Has Become the Patient

Posted in TV tagged , , , at 4:56 pm by Jenn

At least he didn’t lose much when they shaved his head

Summary: A man named Dan is driving his teenage son Paul somewhere, complaining about how Paul wants to quit playing hockey. A hockey scholarship is the only way Paul will get to go to college, so Dan wants him to keep playing. Paul notes that without devoting all his time to hockey, he would be able to improve his grades and get a scholarship that way. The argument ends when their car gets hit by a truck.

It’s New Year’s Eve, which means it’s time for Mark to have his tumor removed in New York. He’s sent plenty of patients to the OR, but this will be his first time going himself. Elizabeth tries to keep him optimistic. Back in Chicago, Dave is on the scene to help get Paul and Dan out of their upside-down car. A lot of what follows is from Dan’s POV. In the ambulance, he tells Dave that his chest hurts. Dave delivers him to Carter, explaining that he did an ambulance ride-along as part of his residency.

Cleo joins Carter to transport Dan to a trauma room while Weaver tends to Paul. Dave wishes Dan good luck, then heads back out on the ambulance. Carter reinflates Dan’s collapsed lung while Cleo gets information out of him like his family doctor and a person to contact. Paul is in the next trauma room, so Cleo holds the door between the rooms open to let them check on each other. Dan notes that his wife will be mad about the crashed car, and jokes that he’s going to tell her that Paul was driving.

In New York, Mark signs a DNR and gives Elizabeth his power of attorney. Elizabeth won’t accept the responsibility, since she’s positive that he’ll be fine. She thinks his worry that he’ll end up in a vegetative state is just him being “dramatic.” He convinces her to sign anyway. Dan is also signing forms, giving consent for Paul to have surgery on his broken leg. Dan himself needs a head CT, since he lost consciousness.

Abby asks Carter if he told Weaver yet (meaning that he took Vicodin, though she doesn’t say that in front of Dan). Carter says it’s one of his New Year’s resolutions. Elizabeth shaves Mark’s head as he tries to tie up loose ends about their house. He wants her to be in the OR during his operation, though Elizabeth doesn’t think Burke will approve of that. Mark lies that he’ll be fine on his own. He notices his roommate, a little boy, watching him but pretending not to watch him.

After Dan’s CT, Abby tells him that someone is trying to contact his wife, Deborah. He asks to see Paul, but Abby says he might not be able to talk to his son before surgery. Dan learns that on top of his leg injury, Paul also has a head injury. Dan worries that Deborah will be mad at him “again.” 20 years ago, they lost a baby to SIDS. Dan was home alone with the baby at the time and fell asleep. Deborah came home and found the baby dead. She didn’t blame Dan outright, but he knows she believes she could have saved the baby if she’d stayed home.

Burke gives Mark a pre-op exam and asks if he has anything on his mind. “That’s why I’m here,” Mark replies. He wishes Burke good luck, which Burke says they won’t need. Mark’s young roommate, Leo, introduces himself and they start chatting. Leo has a heart tumor and is surprised that Mark, a doctor, is sick enough to need surgery. Mark tries to give Leo a pep talk about his own procedure.

A drunk patient sings “Auld Lang Syne” to Dan, who’s really getting the full ER experience. He tries to get Weaver’s attention as she tells Benton about a patient who needs a pager removed from his rectum. Wow, a late Christmas present for Benton. Dan asks Weaver about Paul, but she doesn’t get a chance to give him details before she’s summoned to stabilize Paul. He passed out while getting x-rays and is now unresponsive. Dan urges him to stay strong.

Dave checks on Dan, who’s going to be admitted for a few days, though his CT is clean. Abby tells him that his brain might be bruised, so he’ll need some more scans. A police officer asks Dan about the accident, but Dan doesn’t remember what happened. The officer tells him he ran a red light. Dan insists that he would never do that, but there are a lot of witnesses who say otherwise.

Mark nervously waits with Elizabeth until someone comes to take him to the OR. He jokingly asks if she’ll go to a movie while he’s in surgery. Then he turns serious, telling her that he’s left her life insurance in case he doesn’t survive. She continues to avoid addressing the possibility that he won’t live. Okay, Elizabeth, there’s optimism and there’s denial. You’re getting waaaaay too close to the latter.

Jesus, the guy transporting Mark, calls him “Mr. Greene” instead of “Dr. Greene” and chats with a co-worker on the way to the OR, as if he doesn’t get how important this day is for Mark. In the operating room, Mark faces scary machines and equipment, like the saw that will open his skull. He casually asks Burke for something to help his anxiety. (If this were me, I wouldn’t even go into the OR without being injected with so much Ativan that I thought I was still home in bed.)

Paul is comatose, but Weaver thinks he can hear Dan, so she encourages him to talk. Dan says that he used to fake being asleep as a kid so he didn’t have to get up for school; he would have to stop when Dan tickled him. In New York, Mark is ready for his procedure, which he’ll be awake for, so they can make sure his ability to communicate stays intact. Elizabeth has come to the OR after all.

Deborah arrives at County just as Paul is about to be taken for surgery on his leg. Dan tells her that the crash was his fault, but still an accident. She’s upset. Dan complains of more chest pain, so Weaver sends him back to bed. A quick exam indicates that the chest pain is more serious than Dan has been leading on.

Mark ID’s flash cards while Burke does some brain mapping. When his language starts to fail, he notes that his thumb is shaking. Elizabeth figures out whatever’s wrong with him, but the doctors don’t fix it before he starts having seizures and flashes of his life up until now. He sees Rachel, Jen, and his parents, but not Elizabeth, which is weird. Mark loses consciousness, and the anesthesiologist can’t get a response out of him when he wakes up. Burke suggests holding off on the rest of the procedure.

Mark starts speaking again and tells Burke to keep going. The doctor keeping track of his language has him name things that start with the letter B. “Brain,” “Burke,” and “Broca” (the area of his brain that they’re mapping) are gimmes. After Burke removes the tumor, which is gross-looking, Mark says “baby” and “boy.” He has a hunch that that’s what they’re having. He switches to listing off boys’ names that start with B. He also suggests Jesus, and Elizabeth is like, “I know you’re having brain surgery but there is no way I’m naming our child Jesus Greene.”

Dan is also stable as Carter ends his shift and hands him off to Luka. Luka tells Dan that he could be at risk for having a heart attack. He asks if Dan passed out while he was driving; his angina could have led to an irregular heartbeat that made him lose consciousness. This means Dan might not be responsible for the accident. That’s the least of his problems, though, since his chest pain gets worse. Luka determines that he’s having a heart attack and needs surgery.

Mark is in recovery and doesn’t seem to be having any complications. Burke tells him everything went great. Kayson and Luka do a procedure to unblock one of Dan’s arteries, though Dan (who’s awake during it) is still more worried about Paul than himself. Luka notes that, as a teenager, Paul wants less to do with his father than ever but actually needs him more than ever. Dan asks if Luka has kids, and Luka says no.

Deborah is allowed in to let Dan know that Paul is awake and doing well. Dan tells her that his heart problem caused the accident. Well, I think the jury’s still out on that, so I wouldn’t get too confident there, buddy. Deborah apologizes for being cold to Dan earlier and tries to keep him from blaming himself for anything that’s happened to either of their sons.

Mark is now confused and thinks he needs to go home. Elizabeth asks a nurse to give him a sedative, but the nurse can’t take her orders, since Elizabeth isn’t on staff there. Romano interrupts Dan’s procedure to whine about not being informed of it. He was supposed to be given the authority to determine if Dan met the criteria for the procedure. There’s a complication involving a tear in a blood vessel, so now Dan needs bypass surgery. Looks like Romano gets to be in control after all.

Mark wakes up from sedation and is now back to his normal self. When Elizabeth leaves the room to talk to Burke for a minute, Mark notices that Leo, who’s also just out of surgery, is bleeding. He tries to alert a nurse, but they don’t notice Leo’s complications until alarms start going off. Mark watches helplessly as the little boy he tried to encourage declines.

Dan panics on his way to surgery, but Romano ignores his request for a second opinion, since he won’t survive long enough to get one. Dan recognizes Benton from the OR but doesn’t ask if he was able to remove the pager from the guy’s rectum, which I would definitely be asking. He has a bad feeling about the operation, which Benton casually dismisses, and asks the surgeons to tell Paul that he loves him and is proud of him.

Burke does a neurological exam on Mark, who’s distracted by the sight of Leo’s mother crying over her son’s condition (it’s not good). Though Mark is doing well physically, Burke wants him to meet with a psychiatrist, just in case he’s experiencing any depression. Mark declines and asks to have his catheter removed so he can start walking around, which will get him out of the hospital faster. Burke tells him he’s lucky and is undergoing the most successful treatment possible for his tumor. If he believes that, he’ll be fine.

At County, Benton declares a patient dead…but it’s not Dan. He thinks the car accident actually saved his life, since it drew attention to a heart problem he didn’t know he had. Paul, who’s being brought to the recovery room, teases that he should get a yearly checkup. He was able to hear Dan while he was comatose and jokingly complains that Dan interrupted his nice nap. Dan says Paul should take the year off from hockey so his leg can heal. Paul suggests that they start running together for exercise.

As midnight approaches, Mark impatiently waits for a nurse to remove his catheter. He asks Elizabeth to do it, and it’s so painful that he’s not sure he can ever order one for a patient again. She helps him to the bathroom as fireworks go off outside the windows to ring in the new year.

Thoughts: Dan is played by Jim Belushi. Paul is played by Jared Padalecki.

’00s music alert: “Butterfly” by Crazy Town. I bet Dave loves that song.

Just for the record, waking up from brain surgery and joking that you’re unfamiliar with your fiancée isn’t funny. If you’re ever in that situation, try to avoid the temptation.

We know Mark and Elizabeth have a girl, so I guess we shouldn’t place too much faith in Mark’s hunches.

1 Comment »

  1. Nick Rivers said,

    First things first… I know they have to showcase Jim Belushi since he was the guest star of the episode and all, but I felt like it was really kind of unrealistic how accommodating everybody was with him and all his questions. I get that most people in the ER aren’t in the mood to ask a ton of questions about what’s going on because in most cases they feel absolutely miserable, but it felt like everyone was doing an inordinate amount of psychological hand-holding with him that they don’t really do with the other patients. It’s natural from the nurses but not from the docs. Romano was the only one who was really natural and himself. Like Malucci would come back and check on him — they’re usually so swamped they don’t have time to follow up on people they’re not treating directly. Anyway, it all felt a little forced.

    Mark’s flashbacks didn’t include Susan Lewis either, or Doug, or Carol, three of the most important people in his life for several years there, so that was a little odd to me too, though I guess they weren’t allowed to use flashback scenes of them from prior episodes. Jen with the terrible haircut was a choice.

    Weird how Carter didn’t catch the angina earlier or realize that maybe the chest tube shouldn’t be causing so much discomfort. I guess being at the end of his shift made him extra tired? Or something. Luka being in the cath lab was super odd. I was glad they had Kaysen there though — that made logical sense. An ER doc, no.

    I guess the point of Mark’s storyline is the doctors-make-the-worst-patients trope, to a degree. He of all people should understand the benefit of therapy under these circumstances and not pooh-pooh it all.

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