ER 10.6, The Greater Good: Policies Schmolicies

January 18, 2022

ER 10.6, The Greater Good: Policies Schmolicies

I wish I could’ve found a good picture of them with the puppy

Summary: Susan is reading The Red Badge of Courage out loud to Ben while he works on his miniatures. So basically, this is a remix of her plotline with Sean. Ben tells her she doesn’t have to keep coming over and hanging out with him. Susan casually says that she doesn’t have the book, as if reading it is the only reason she comes over. Ben says that Stephan Crane died of TB when he was just 29. “Cheery,” Susan and I both say.

Doc Magoo’s is now a kind of combo mini-mart/deli. Like Wawa! I miss Wawa. Frank’s a fan, since they’re giving away donuts to celebrate their opening. As he and Sam are heading back to the hospital after a coffee run, a woman named Denny gets out of a cab, asking for help. She’s 24 weeks pregnant and thinks she’s having a miscarriage. It’s not her first.

Jerry found some golden retriever puppies outside his building and has found homes for five of the six. Chen immediately falls in love with the remaining dog, but she can’t adopt her since her building doesn’t allow pets. Coop can’t have a dog because of his asthma. No one cares, Coop. A woman named Tara comes by with some food and gifts from a drug company, and Jerry gives her a spot where she can set up her stuff. Chen hands the puppy off to Lester, who asks what’s wrong with her, as if he thinks this is his next patient. On this show, that’s a fair assumption.

Pratt, Coop, and Malik are watching a police chase on TV when Sam pulls Pratt away to tend to Denny. Chen tells Lester that they’re hoping the carjacker is able to evade the police for a few more blocks – if he crashes, he’ll be out of their jurisdiction by then and they won’t have to take care of them. He crashes just then, because police chases always end in a crash, and the staff laments that he’ll end up at County.

Abby’s still on her surgical rotation, and she’s having trouble standing up to the ER staff when they try to talk her into taking patients up to surgery. Elizabeth tells her the ER staff is just trying to dump patients off on surgery so they can free up beds. She sends Abby to do a consult, telling her to be strong. In the ER, Luka is doing fast rounds again, and Romano is proud. He tells Luka to bill for plenty of treatments he’s not providing, so the hospital can make money.

Pratt gives Denny an ultrasound that shows that her baby is healthy and she hasn’t miscarried yet, though she’s already dilated two centimeters. Neela presents a case to him as he’s getting ready to tend to the driver from the police chase, Kevin. Kevin a guy who cut him off for ruining his escape. Another driver, Collins, is right behind him.

Susan and Sam notice that a bunch of male staff members are enjoying Tara’s company. One of Sam’s previous hospitals tried to ban these kinds of visits from drug reps, but the residents complained because they wanted the free food. Susan says that’s how the reps get the staff hooked – free stuff. She warns Sam to keep Luka away from Tara, since “he’s been known to give away free physicals.” Heh.

Sam goes back to the triage desk, where an angry guy complains about his bill. She calmly tells him she can’t help him with that. The guy yells that he waited 11 hours for some “quack” to tell him that his kid had a virus and would get better on his own. Sam pointedly asks if the kid did, in fact, get better on his own.

The guy demands to see the doctor whose care he so angrily objects to. It was Carter, so you’d think the guy would have to back down, since no one’s going to call Carter in the Congo and have him work this out. Instead, he slams a trash can against the window separating him from Sam. She continues keeping her calm, telling the guy that’s a bad idea, then waiting until a security guard handles the guy for her.

Paramedics bring in a teen named Zack who fell six feet and hurt his shoulder. He may need stitches in his head, too, and he tells Luka he doesn’t need anything to numb the pain. Pratt and Romano work on Collins, and Pratt asks Abby to start an IV. Abby’s there as a med student, not a nurse, so that’s not part of her responsibilities right now. Romano praises her for holding that boundary.

Next door, Chen oversees Coop and Neela as they work on Kevin. Amazingly, Chen keeps it professional with Neela. She goes to tell Abby that Kevin might need surgery, so Abby says she’ll call Elizabeth. Romano mocks her for calling “Mommy” and says he’ll make the decision. He sends Abby to Kevin instead of letting her intubate Collins. She doesn’t have time to do her consult before Romano comes over, so Romano has Neela join Pratt for something he needs while Abby does her job with Kevin.

Luka chats with Zack until a social worker named Ron arrives and reveals that Zack is a resident in a youth facility. He got hurt trying to run away during an outing. Zack refuses to go back to the facility. Ron says Zack has a conduct disorder and is off his medication. He tells Luka to give Zack Haldol. Zack is definitely angry and probably on the verge of getting violent, but sedation seems a little extreme. He begs Luka not to make him go back to the facility.

Luka gives Zack his stitches, and though Zack might regret not taking anything for the pain, he’s been on so many medications over the past few months that he doesn’t want anything else. This is the first day he’s felt normal in months. Luka can’t tell him whether he’ll help Zack stay out of the facility; he has to wait until Zack’s mother arrives.

Pratt’s waiting for a consult from neurology, but Luka doesn’t think it’s necessary since his patient’s scans are clear. Keeping her there is a waste of time and resources. Pratt’s also tending to the angry guy from the triage area, who’s complaining of chest pain. Luka asks him a few questions and determines that the guy just had an anxiety attack. He looks over his kid’s bill and decides he should have only been charged a few hundred dollars. Well, take it up with Carter.

Romano tells Luka that when insured patients come in, the staff charges for stuff they don’t necessarily need so they can make up for their losses with uninsured patients. “I thought I was his favorite,” Abby quips when Luka joins her at the admit desk. Tara tries to talk to them about an antibiotic she wants the hospital to stock, but Luka isn’t interested.

Susan tells Sam that Ben is coming in that afternoon so she can make sure he’s taking the right amount of his heart medication. Sam should let him in instead of making him wait in triage. Pratt presents Denny’s case to Susan, who thinks Denny is probably going to deliver prematurely, and there’s nothing they can do to stop it. Frank tells Pratt that Chen is flirting with Coop, so Pratt should step in. Apparently Frank’s decades as a cop made him an expert in body language.

As Jerry tries to get Susan to adopt the puppy, Neela presents a patient to Pratt. He agrees with her diagnosis and gives her some instructions, but Luka overrules him. The tests and medication are expensive, and the patient can be released without them. After Luka leaves, Pratt tells Neela to follow his original orders. Neela wisely turns to Susan, who tells her that Luka outranks Pratt.

Collins’ wife Patricia arrives, and Neela offers to take her to see her husband. She mentions organ donation, so now we know how things turned out for him. Abby says Neela’s starting to get on her nerves because she’s so perfect. Susan dismissively says she’s just a med student. Abby reminds Susan that she’s a med student, too. Susan jokes that Neela bugs her, too, and she and Abby can hate Neela together.

Denny’s continuing to have contractions, and Pratt tells her that she’s going to have the baby really early. Denny doesn’t want to have a preemie who will eventually get sick and die. Pratt tries to convince her that her baby has a chance, but Denny says she’s not having the baby this way. Pratt fills in Abby, Susan, and Luka, the latter of whom doesn’t think they should spend money on one baby when they’re shutting down a program to prevent lead poisoning, which would help a bunch of kids.

Pratt doesn’t know what to do, since Denny is adamant about not having the baby. Abby notes that the baby is above the hospital’s viability threshold for weight and weeks of development, so Denny doesn’t get a say anymore. The hospital will try to keep the baby alive no matter what she wants. Luka thinks the policy is ridiculous and Denny should go to a different hospital if she wants something different. Romano tells him this is an instance of natural selection. Susan advises Pratt to make a decision based on what’s in Denny’s best interest.

Luka goes back to Zack, whose mother has arrived. Luka tells her that her son is being overmedicated. She admits that she had a drug problem and let Zack run wild. The facility told her that the medications were necessary. Zack doesn’t think his behavior was bad enough to justify being sent away, but his mother was branded unfit, so it sounds like she overcorrected.

Ben hasn’t come by for his appointment, so Susan tries calling him. Neela tells her that Patricia refuses to agree to have her husband’s organs donated. She’s letting Patricia sit with his body for now. Abby tries to reassure Susan that Ben, who isn’t answering his phone, is fine. A doctor comes down from neonatology, but Denny isn’t in her bed. Pratt thinks Luka talked her into going to another hospital.

A cab driver comes in asking for help with a woman who’s bleeding in her backseat. Pratt and Luka run outside and find Denny there; she was trying to go to another hospital, but she realized the baby’s coming. The guys are mad at each other for following the rules/not following the rules. They rush Denny to a trauma room and quickly deliver the baby, a boy. Denny asks for them to let him die. She says she doesn’t want him.

Pratt wants to start working on the baby, but Luka says he needs to be weighed first – if he’s less than 500 grams, he’s considered unviable and they can let him die. Pratt tells Neela and Malik to prepare for intubation in case the baby’s over 500 grams. He is, so they continue working, even though Denny keeps protesting.

Abby checks on Patricia, who tells her that Collins’ sister is coming to say goodbye. Patricia hears all the action next door, and Abby tells her they’re working on a premature baby. Patricia sadly says that she and her husband were starting to try to get pregnant. Abby gently brings up organ donation, but Patricia doesn’t want to put him through more trauma. Abby tells her that his organs would save a lot of people. Patricia says her husband is very caring and generous, so donation is something he would want. She starts to come around as Abby gives her more details about how he could help others.

Susan calls the police to check on Ben as Alex shows up looking for Sam. He asks if they’ve seen any patients with weird disorders today. He claims he wants to be a doctor, but there’s no way that’s why he’s curious about weird disorders. Frank guesses that Alex is already dissecting neighborhood pets. Jerry offers to let Alex see the puppy, but Alex would rather visit the morgue. This isn’t a new request, and Sam has already told the staff not to take him there. Frank warns Jerry that Alex is probably getting into devil worship, and Jerry should keep an eye on the puppy.

Ben finally shows up, and he’s brought Susan flowers, so she can’t be too mad that he’s late. He also wants to give her The Red Badge of Courage. Susan tells Chen that she wants to make sure Ben is stable from his possible suicide attempt before she cuts off ties with him. Frank notes that the book is a first edition, which makes Chen think that Ben has a crush on Susan. Susan feels bad that he sacrificed everything for his career and has nothing left.

Denny’s not doing well, but OB’s taking their time coming to the ER. Weaver ducks in to complain that Zack is still waiting around. Luka’s been waiting on some labwork, but Weaver tells him it’s in. Luka says he doesn’t want to send Zack back to the facility. People are focusing on policies too much and forgetting that Zack is a human being. Weaver blows off Luka’s concerns and tells Neela to discharge Zack.

An OB finally arrives as Luka hands Denny off to Pratt. Pratt tells Denny that the baby is doing better than expected. Luka rushes to stop Ken from taking Zack back to the facility, but there’s not much he can do. A social worker with privileges at County authorized the Haldol, and Zack is totally out of it. All Luka can do is apologize to him.

Tara chooses this moment to try to talk to Luka again about medications, and since she’s heard about his time in the Congo, she offers to put together some packages for him. Luka asks why the drug company hasn’t been working on new malaria treatments instead of expensive antibiotics. It’s because there’s no profit in malaria drugs. Luka grabs a trash can and starts throwing out Tara’s free giveaways and food while he rants about her company. She says she’ll come back when he’s not as busy.

Susan returns Ben’s book, not wanting to accept such a pricey gift. She tells him it’s not really appropriate. Ben apologizes if he made her uncomfortable, but she assures him there are no hard feelings. Coop tries to chat with Chen again, and for the record, she tells him to call her Deb, even though a couple seasons ago she objected to that nickname. Sigh. Whatever. He wants to go out, but she has to take her parents to the airport.

Sam asks Jerry to find Alex, who definitely shouldn’t be allowed to wander around the hospital unsupervised. And he definitely shouldn’t be out of anyone’s sight long enough to go across the street to the mini-mart, which is where he is. Luka’s there, too, playing a video game that’s not alleviating his stress very well.

Pratt tells Denny that she’s going to be okay, and the baby is about to go up to the NICU. Denny doesn’t want to see him. Elizabeth’s been trying to reach Abby, who’s ignored her pages so she can stay with Patricia. She convinced Patricia to donate Collins’ organs. Elizabeth chastises her for missing out on opportunities related to her surgical rotation because she was doing things nurses usually do. She already does that stuff well. She needs to learn how to distance herself from her patients so she can be a good doctor.

Romano finds the puppy, which Susan has decided to take to Ben as a seeing-eye dog. Without any training. Without giving Ben a heads up. The dog isn’t even housebroken. Come on, Susan. Frank tells Sam that Alex is across the street at the jumbo-mart. That’s not a jumbo-mart, it’s mini! That’s why I called it a mini-mart! Alex is still hanging out with Luka, who bought him ice cream. That’s kind of weird on its own – don’t buy food for kids when their parents aren’t around! – but also a bad idea because it turns out Alex has diabetes. Sam’s understandably ticked at Luka.

Susan takes the puppy to Ben, who asks if she’s stalking him. Denny goes to see her baby, expecting him to die pretty soon, though it doesn’t sound like that’s what’s going to happen. Susan and Ben go for a walk with the puppy and talk about their backgrounds a little. Apparently Susan’s mom died while Susan was off the show.

Ben thinks Susan’s father must be proud of her for being a doctor. She says they’re not close. Ben gets it – he has a daughter he hasn’t spoken to in years. Susan urges him to reconnect with her, but she blames him for things that happened when his wife died. Ben’s wife had cancer, and though they both knew she was going to die, he couldn’t accept the finality of her illness.

Sam continues yelling at Luka in the ER. Neela asks him for instructions for a patient, and he tells her to look at the price list on the back of her chart. She’s already performed a bunch of expensive tests when she could have done a thorough physical and given the patient a very inexpensive medication. Luka, hon, you’re mad at the healthcare system, not Neela.

Pratt’s annoyed that Luka discharged one of his patients without giving her a lumbar puncture. Luka says she didn’t need it. Pratt asks if Luka’s going to keep taking away his patients when Pratt doesn’t do things Luka’s way. Luka says that Pratt’s way of practicing method is inefficient. “And letting babies die is?” Pratt replies. Luka asks if he really thinks he saved the baby. He’ll probably need lifelong care. Will Pratt provide it?

Pratt says they’re not treating patients in a hut like he thinks Luka did in the Congo. They have technology and capabilities to treat patients, so why not use them? Luka says they could have treated a ton of other kids with all the money they would have saved by letting Denny’s baby go. Pratt reminds him that this is Chicago, not the Congo, and maybe Luka should go back to Africa. Luka replies that maybe Pratt should go there. Pratt understandably interprets that as a racist comment, but Luka means that Pratt will learn that there’s more to medicine than policies and bureaucracy.

Abby practices some sutures on Collins’ body after his organs have been harvested. She remembers her conversation with Patricia, and we get to hear more about how Collins’ organs will give other people new chances at life. People will see again, get their health back, and recover from conditions that used to be fatal. I guess you could say that Patricia’s decision to donate her husband’s organs fits with the title of the episode: It’s for the greater good.

Thoughts: Zack is played by Michael Angarano. Tara is played by Sarah Shahi.

Why is Susan getting the same plot she’s already done? Why isn’t her plot about her relationship with Chuck, who’s more interesting than half the main cast? (Okay, it looks like the real answer is that Donal Logue was on another show at the time, but still!)

Remember when Luka tried to force a woman to deliver her baby when she didn’t want to? What a difference three seasons and a trip to the Congo make.

The puppy falls asleep in Bob Newhart’s arms while Susan and Ben are on their walk, and it’s FREAKING ADORABLE.

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