ER 10.17, The Student: The Sweetest, Dumbest Thing

April 5, 2022

ER 10.17, The Student: The Sweetest, Dumbest Thing

This is why I could never be a doctor. No one dies if I screw up my job

Summary: Weaver has gathered senior ER staff – Luka, Carter, Susan, and Chen – in the lounge to discuss med students and their performance to date. They like Lester but don’t think he should work with patients. They’re polite about Abby, not wanting to say that she lacks confidence. Weaver just wants to know if she’d be okay specializing in emergency medicine. Susan says she’s uncertain.

Neela gets high marks for her academic skills, but she’s not a good fit for the ER. Carter loves her and notes that she saved Frank. He thinks she’ll improve over time. Susan points out that the med students have only four months left before they’re full-fledged doctors. Carter’s the only one who thinks Neela should stay at County (if she matches there), so Weaver tells him to change everyone else’s minds before her list is finalized.

Carter tells Susan he’s heading to the Congo to visit Kem. She asked him to bring a suitcase full of Ho-Hos. Heh. Jerry tells Susan that Chuck is waiting for her outside. She jokingly calls time of death on chivalry. Neela comes to get Carter for help with a patient who’s been waiting hours for a reason Carter doesn’t think justifies the wait. He might have an uphill battle convincing everyone that Neela should be in emergency medicine.

Chuck and Susan head to Ike Ryan’s because he wants a burger, even though it’s 8:00 in the morning. He thinks he’s having sympathy pregnancy cravings. In the restaurant, a guy (no name; I’ll call him Peter after the actor playing him) strikes up a conversation with Susan about her pregnancy. He tells her pregnant women are beautiful, and she in particular is sexy. He starts getting inappropriate, so she decides to walk away. Peter asks to touch her belly, which is when she really wants to end the conversation. Chuck ends it for real by punching the guy in the face. “Must be the hormones,” he tells Susan.

Peter ends up in the ER, fighting with Susan over whether Chuck was justified in hitting him. Peter tries to invoke the First Amendment, so I automatically want to side with Chuck. I think Luka agrees; he wishes Chuck had punched Peter in the teeth so he wouldn’t be able to talk. Chuck asks Susan if Peter apologized. Nope! He called the cops.

Sam’s trying to figure out what to do for Alex’s birthday the next day. His only friend won’t be in town for a party Sam hasn’t organized yet. Luka suggests getting him a clown. Luka, have you met Alex? Carter advises Neela to be more proactive in treating patients. Everyone likes her, but they need to see her make more decisions. He tells her that for the next four hours, she’s going to be a doctor and take charge of all her cases. She’s a shark. She has to keep swimming or she’ll die.

Abby announces that some victims from a car accident are coming in; a couple are patients from a nursing home. Pratt’s on his way out, and he hands off a patient to Gallant, telling him not to “TUBE” her. TUBE stands for totally unnecessary breast exam. Shut up, Pratt. Chen also hands off patients to Gallant, then gets a visit from her father’s home nurse, who wants to resign because Chen’s father treats her badly. Chen says he’s not acting like himself, but that doesn’t really matter to the woman who’s getting stuff thrown at her at her job.

Neela and Gallant wait for an ambulance as she vents about how difficult things are for her in the ER. Not that she’s found another specialty she likes more. Gallant says she just needs to learn to ride the rough days. He was “young, dumb, and scared” when he arrived (you weren’t dumb, Gallant! You were super-smart!), so he didn’t have it any easier than Neela. At least she has book smarts. He confirms that he likes emergency medicine; he wouldn’t have stuck with it if he didn’t.

The ambulance arrives transporting a man named Luis who’s much younger than the doctors were expecting a nursing-home resident to be. He suffered a head injury months before, and the paramedic isn’t sure if his current mental state is regular for him. Gallant and Neela aren’t sure what kind of medications they can give him since they don’t know his allergies or what he’s already taking. Neela goes to call the nursing home to find out.

Chuck refuses to apologize to Peter, even if that will keep him from pressing charges. Neela can’t get a hold of Luis’ nurse from his nursing home, so she asks someone else there to fax or read his chart to her. Whoever she’s talking to isn’t in the mood to be helpful. Sam and Luka continue brainstorming party ideas until paramedics bring them a new patient, Lucy. Luka suggests paintball for Alex. Sam objects to giving her son a weapon, but I think it’s a good fit.

Neela tells Carter the problem she and Gallant have run into with Luis’ medical history. Carter’s busy, so he doesn’t give her any advice. He sends her to help Sam with Lucy, who accidentally pulled out the trach tube she came in with. Neela replaces it, hesitant at first to do it but confident when she gets started. Sam comments that they can get by just fine without doctors.

Neela goes back to Luis, having received a discharge summary from his last hospital visit three weeks ago. It’s the best she and Gallant are going to get right now, so he okays giving Luis morphine. Neela realizes that he had a bad reaction to it the last time he received it. As Chuck finally agrees to give in and apologize to Peter, Neela goes looking for a fax from the nursing home, but nothing’s come in.

She gives Sam instructions for a patient, then takes a syringe of Demerol that Sam was going to give him and goes to give it to Luis instead, knowing he’s had it before and isn’t allergic. Since everyone’s super-busy, Neela winds up being the only person in the room when she gives him the medication. Meanwhile, Chuck’s apology turns into another fight, and Susan and Jerry have to pull him off of Peter.

Carter approves of Neela’s treatment of Luis and tells her to keep up the good work. Weaver tells Chuck that Peter is threatening a bunch of lawsuits and she needs them to go away. Susan volunteers to talk some sense into him. Neela’s confidence grows as she presents various patients to Carter and juggles all their needs. She even treated a little girl for a virus and got her in out of the ER in less than an hour. Luka has now come over to Carter’s side of things and sees how great Neela is.

Abby asks Elizabeth about her date with Lawson the night before. Elizabeth just says it was “splendid.” Abby wants more details later. Luka has found a haunted-mansion restaurant called Mr. Hyde’s Tavern, where all the dishes have gross names. In other words, it’s perfect for Alex. Sam doesn’t think it’s special enough. Then you should have started planning more than a day in advance!

Sam and Luka tend to a teen named Frederika who hurt her ankle during tennis practice. Well, sort of. She admits that a flasher has been visiting her team’s practices, eluding the cops when the coach, Sister Margaret, calls them. Today the girls got fed up and ran after him. They used some self-defense moves their coach taught them to beat him up. “I’m pretty sure we kicked his a%$,” Frederika says. Awesome.

Luis has a high fever and is unresponsive. He starts seizing, and Neela sees from his medication list, which has finally arrived, that he’s on an antidepressant. Carter figures out that it reacted badly with the Demerol – in fact, the combination can be fatal. Neela’s horrified at the realization that an innocent mistake might lead to a patient’s death.

Weaver tells Chuck that Susan got Peter to drop everything simply by letting him hug her stomach. Susan, get him a psych consult. She’s not happy with Chuck. Luka and Sam move on to a patient named George who was injured during a mugging. Luka asks him to remove his trenchcoat for his exam, but he’s hesitant because he’s naked underneath. He says unconvincingly that his muggers stole his clothes. Sam sees a mark on his face that could have only been made by a tennis racket.

Carter, Neela, Gallant, and Abby continue treating Luis. Neela takes full responsibility for giving him Demerol, but Gallant lies that he gave the order for it. He first ordered morphine, then saw that Luis had a bad reaction to it in the past and changed it to Demerol. Neela quietly tries to speak up, but Carter doesn’t hear her.

Luka tells George he’ll need to talk to the police. You know, about his mugging. Chuck now has to apologize to Susan, who’s just more convinced than ever that men are horrible. George tries to sneak out through the waiting room, but Sister Margaret and Frederika’s teammates are all there, and one of them spots him. The girls chase him outside and beat him again.

Carter asks why Gallant’s medication orders for Luis aren’t on his chart. Gallant says he was too busy, then writes in the order for Demerol. Neela asks to talk to him privately, but he ignores her. She gets shaken when Chuny announces that Luis’ wife and young daughter have arrived. Sam and Luka move George to the “perv ward,” where he can hang out with Peter. Peter objects, calling Sam “honey.” She warns that if he does it again, she’ll give him “the longest Foley catheter in the world.”

Luka has another idea for Alex’s birthday, and this one is a surprise. I can’t believe they’re not going to the gross restaurant. Frank comes by the ER after a rehab session upstairs. He’s doing really well and claims not to miss working. Since Pratt isn’t there, Frank asks Carter to tell him that Frank owes him a beer. Uh, you owe Neela something, too. Start with an apology for being racist. Frank tells everyone that he won’t be able to come back to work for a while, but he misses everyone.

Paramedics bring in a four-year-old named Tevin who has a stomachache and is altered. Luka tells his father, Mr. Walker, that his spleen is enlarged and is impeding his circulation. He’ll need blood transfusions to stabilize him until they can figure out what caused his condition. It may be from a genetic disease. Mr. Walker says his wife has the trait for sickle cell anemia, but Mr. Walker doesn’t.

Gallant and Neela tell Luis’ wife that the Demerol caused some serious complications. He has a 30% chance of dying, but his wife wants to focus on the 70% chance of him living, since he’s already beaten the odds by waking up after the fall that caused his brain injury. Neela has a hard time not watching the couple’s daughter, whose father she may have accidentally killed.

Once they’re alone, Neela asks Gallant why he took responsibility for the medication error. Gallant says he’s partly to blame, and it doesn’t change what happened, so it’s not a big deal. He doesn’t want this to affect Neela’s chances of matching at County. She doesn’t want a match if she doesn’t deserve it. Gallant says she does, so he’ll take the blame.

After he leaves, Carter tells Neela that Luis is stable and things look good. He thinks Neela wants to tell him something. She says no, but she’s not very convincing. Carter says Gallant should have known better than to prescribe Luis a drug without knowing what he was already taking. Neela blurts out that she did it. Carter confirms that she took charge of the case just like he told her to.

Sam checks in with Neela about a patient whose condition has improved just as Neela predicted. This was the patient Sam was going to give Demerol, so she asks Neela to give the drug back so she can return it to the drug lockup. Neela says she gave it to someone else. Tevin’s doing a lot better, but he has sickle cell anemia. Mr. Walker knows that’s impossible since he’s not a carrier, and a child can only have the disease if both parents are. So either Mr. Walker’s test was wrong or he’s not Tevin’s biological father. Luka offers to test Tevin again, and Mr. Walker asks to be tested, too.

Gallant tells Neela that Carter wants to talk after his shift. Neela admits that she told Carter the truth about the Demerol. Luis’ wife yells for help, and they run in to find him with an unstable heart rhythm. Carter joins them but after 42 minutes, they haven’t been able to stabilize him. Weaver makes the call that they need to pronounce him dead, then have a meeting about the case.

Luka tells Mr. Walker that the second test confirmed that Tevin has sickle cell anemia. Before he can reveal Mr. Walker’s results, Mr. Walker asks if they showed anything concerning about his health. Luka says no, so Mr. Walker declines to hear any more. He doesn’t care what the results say about biology. He and his wife broke up for a few weeks years ago, and she got pregnant right after they got back together, so Mr. Walker may have always suspected that he wasn’t Tevin’s biological father. They’ve been happy since then. He says he’ll tell his wife that he’s a carrier. The important thing is that Tevin’s okay.

Alone with Luka, Sam asks if Mr. Walker is Tevin’s father. Luka pretends to glance at the results before saying yes and throwing them away. She tells him she didn’t mean to throw cold water on his Mr. Hyde’s plan. She just wants to give Alex something special. Luka promises that his secret plan will be. He just has to go pick something up first.

Weaver gathers Carter, Neela, Gallant, and Abby to determine what went wrong with Luis’ care. Carter wants a chance to review everything, but Weaver just asks if the medication list was updated. Neela says she tried to check with the nursing home. Weaver comes down on Abby, who should have double-checked for possible allergies or interactions, even though she wasn’t even in the room. Carter says it was just an instance of not having all the information they needed.

Neela again takes responsibility for changing the order to Demerol and administering it herself. Weaver isn’t happy that a med student was making decisions and giving medications. Gallant says she was following his orders. Neela tries to correct him, so Weaver asks if they need a few minutes to get their stories straight. They both stay silent.

Weaver asks what the chart says. Gallant tells her, since the chart makes it look like his story is accurate. When Weaver asks if it is, Carter says yes, as far as he knows. Neela and Gallant are silent again. Weaver admonishes the staff for losing a patient whose condition could have been prevented with one phone call. Next time they might as well send the family a blank check.

Oh, yay, Alex is here. Luka’s rented an RV and arranged a camping trip. Stuck in the woods with Alex for a weekend? Sign me up! Sam’s happy and Alex is even happier, so I guess it’s a win. Well, assuming Luka can back the RV out of the ambulance bay. Back inside, Elizabeth tells Abby she’s meeting Dave for a date. She’s not fully comfortable with spending the night with one man and then going out with another the next night, but Abby notes that guys do it. It doesn’t make her slutty. Elizabeth says she just won’t sleep with Dave. “Women plan, God laughs,” Jerry comments. Abby asks when she became “the guru of sluttiness.”

Neela is considering not putting emergency medicine on her match list. Carter notes that she only made one mistake; he pushed her too hard. But Neela knows the others were right about her failure to be more proactive. She doesn’t feel like all her successes on this shift indicate that she belongs there. Carter says she was too cautious yesterday and too reckless today, so now she can find a balance.

Neela spots Gallant looking sad in Luis’ trauma room and goes to talk to him. He regrets leaving her alone with a patient who wasn’t stable. Neela tells him that taking the fall for her was the “sweetest, dumbest” thing anyone has ever done for her. Gallant just didn’t want to derail her career. His punishment will be light and he’ll get past this. He admits that when they were chatting that morning, he was thinking about asking her out. “I was thinking of saying yes,” she replies. But instead, she leaves the room crying and snaps at Chuny when she offers her help. She definitely needs to work on her people skills.

Elizabeth has dinner with Dave, then tries to make a quick exit before things turn romantic. It doesn’t happen. Back at County, Carter admonishes Gallant for not telling him what really happened. He backed Gallant up with Weaver because he didn’t want Gallant to get fired. Gallant appreciates that, especially since falsifying the chart is a felony. Yikes! He wants to tear it up and talk to Weaver again, but Carter says it’s too late.

Gallant rants at Carter for pushing Neela. She screwed up because the senior staff made her think she wasn’t good enough. Carter quietly says this is about Gallant now. Gallant replies that he just wasn’t thinking. Carter leaves, all, “I’m better than you because I would never make a mistake like that,” even though it’s exactly something he would have done as a med student and similar to something he definitely did when he knew better. Meanwhile, Neela collects herself and goes back to work.

Thoughts: Peter is played by Peter Jacobson.

Paul McCrane (Romano) directed this episode.

I love the patient in the room with Chuck and Peter, egging on their fight. Free entertainment is free entertainment, right?

I like the plot with Mr. Walker and Tevin. It’s like a mini version of Benton and Reese’s paternity arc.

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