June 21, 2022

ER 11.6, Time of Death: 42 Minutes

Posted in TV tagged , , at 5:05 pm by Jenn

This episode came around at a bad time

Summary: The Rolling Stones’ “Out of Time” plays as a man named Charlie Metcalf sits in County’s waiting area at 11:22 a.m. He watches as a man bangs on a soda machine and listens to a baby crying. “Who do I gotta screw to get some health care around here?” a Russian woman asks Sam. Um, maybe Ray? Charlie asks Sam if she’s the person he should give his ticket to. He wants to make sure he’s not too late, since his baggage has already gone through. Sam just tells him he’ll need to wait a little longer.

She takes a boy named Jeremy to Pratt and Jane, then assigns Pratt to take care of Charlie. Pratt doesn’t want to take care of a creepy homeless man, though Sam doesn’t think he’s homeless. Luka offers to take care of him. Pratt thinks they should have one line for “legitimate patients” and another for everyone else. Shut up, Pratt.

Abby mentions needing to have blood drawn to follow up on her “needle stick” and possible exposure to HIV. Ray orders a bunch of pizzas, anticipating that they’ll arrive by 12:03 (if they don’t arrive in 40 minutes, they’re free). He guesses that the delivery guy doesn’t know that there’s a bunch of traffic and a closed road, so there’s little chance of him arriving in time.

Sam watches Charlie closely in the waiting area and notices the second he passes out. Well, that’s one way to be seen in a timely matter. Charlie was stable when he came in but has declined over the past two hours. The Russian woman complains about him skipping the line, like he might have had a heart attack on purpose just to see a doctor. Charlie wakes up confused, still thinking he’s waiting for a flight. He tries to fight the staff, who promise that they’re just trying to help him. He gets Luka and Abby’s attention so he can tell them his name and remind them that he’s not just a faceless patient.

Pratt calls Luka over to the next bed to help him with Jeremy, who was injured when his sister, Steffie, pulled a TV down on him. Pratt grumbles that they can afford a big TV but not a babysitter. Shut up again, Pratt. Steffie informs him that they have three TVs. Ha! Rock on, Steffie. Luka returns to Charlie, who apologizes for being difficult earlier. He hasn’t seen a doctor in a while, since he was in prison. Pratt starts judging him more and asks why Charlie did time. Charlie says it was a mistake, then clarifies that he killed someone.

Jeremy asks if his dad has arrived yet. Charlie tries to talk to him but Pratt tells Jeremy to ignore him. Luka and Abby determine that Charlie’s anemic and might have a bleeding ulcer. He’s an alcoholic and didn’t stop drinking when he was in prison. He doesn’t think Abby gets what it’s like to want a drink so badly that you’ll ferment anything you can get your hands on.

Charlie objects to getting a rectal exam from Luka but gives in when he’s told that it’s necessary to determine whether he’s bleeding internally. In the next bed, Jeremy’s upset about needing a shot. Charlie suddenly starts seeing Jeremy as another child, one he calls Pally. He tells Jeremy that doctors can be mean, but if Jeremy doesn’t cry, Charlie won’t, either. They can both be brave. Jeremy calms down and takes his shot like a champ.

Luka tells Charlie that they need to put a tube down his nose into his stomach. As Luka, Sam, and Abby work on him, he chats with Abby about how he used to be an artist and carpenter. He knows he was confused before but says he’s better now. Sam mentions that he thought he was going on a trip. This happens a lot to Charlie. As the doctors confirm that Charlie’s bleeding, he starts coughing up blood. He orders them to remove the tube from his stomach, but instead, Luka wants him restrained.

Luka enlists Pratt to help take Charlie to a trauma room for a transfusion. Pratt doesn’t see the point in giving Charlie the treatments Luka prescribes since his chances of recovery are low. Jane can’t believe he’s that close to death. Pratt replies that Charlie’s close to the edge and just needs a push. Sam tells him to leave, and Pratt asks if she’s an attending now. He wonders if all the nurses are going to become doctors, like Abby. Sam calls him a prick but Luka calls for peace before things can escalate.

Sam checks Charlie’s suitcase, finding a bottle of alcohol inside. Pratt thinks they’re wasting their time on an alcoholic with end-stage liver failure. Luka snaps that if he wants to leave, he can go. “I don’t do lost causes on Friday,” Pratt declares as he walks out. Sam finds a picture of Charlie with people she guesses are his wife and son. Charlie’s altered again and asks for his shoes and passport.

Luka goes after Pratt, asking what his problem is. Surprisingly, Pratt admits that he was out of line. However, he still thinks they shouldn’t waste their time on Charlie. Luka points out that they get patients like Charlie every day. Pratt says that maybe he needs a day off. Luka guesses that there’s something here that’s triggering Pratt personally. If so, Luka doesn’t want to hear about it. Pratt thinks that Luka likes getting on his case. He’s been bugging Pratt since his intern days. Luka says that Pratt is good but could be better.

Sam finds the name Bobby and a phone number in Charlie’s things and asks if they should call him. Charlie says firmly that no one should contact Bobby. Pratt returns as Luka tells Charlie that his condition gives him less than a 50 percent chance of survival. If he does survive, he won’t make it more than a few months. Pratt asks if he wants a DNR, making Charlie realize that he could die today. He’s not ready, so Pratt says they’ll do whatever they can to save him if he declines.

A doctor named Adler comes to do a procedure to stop Charlie’s bleeding. Abby goes to the next trauma room for a piece of machinery, but mostly so we can hear Ray say that there are 23 minutes left before the pizzas are supposed to arrive. Abby kicks him, Neela, and their patient out since Charlie needs the machinery in there. Sam asks if Bobby is Charlie’s son and if the woman in the picture is his wife. Charlie says his wife, Evelyn, is gone and he hasn’t spoken to Bobby since he was little. Sam gently presses him to let them call his son.

She reaches Bobby, who’s in college, as Adler does Charlie’s procedure. Bobby asks to talk to his father, so Sam puts him on speaker. Bobby confirms that Charlie’s sick but can’t think of what to say to the father he hasn’t heard from in years. “Nice knowing you,” is what he lands on. Everyone in the room feels bad (except Pratt, probably). Charlie’s not surprised that this happened.

They lose his pulse, and Charlie sees memories of going fishing with Bobby, meeting Evelyn on a dock by a lake, and his younger self being taken away to prison. The staff revives him and has to tell him that Bobby isn’t coming to see him. Sam asks how long they’ve been out of touch. Charlie says they haven’t spoken since he went to prison. Pratt comments that Bobby was still Charlie’s child, prison or no prison. WE GET IT, PRATT. YOU HAVE DADDY ISSUES. THIS ISN’T ABOUT YOU. Charlie tells him he doesn’t know how quickly things can change.

Adler hasn’t been able to control Charlie’s bleeding, so Luka wants to try a procedure that involves putting a balloon in his stomach to put pressure on the bleeding and hopefully make it stop. Charlie tells the staff that his life fell apart the day of Bobby’s eighth birthday party. Evelyn went to get the cake and was hit by a car. Charlie couldn’t handle the loss and started drinking. His life spiraled until he ended up killing someone in a bar fight.

The staff does the balloon procedure as Luka asks who took care of Bobby while Charlie was in prison. He was with his grandparents, who brought him to visit Charlie for a while, then slowly stopped. Pratt suggests another procedure to stop the bleeding, but now there’s another problem: Charlie’s kidneys are failing.

There’s a man with gunshot wounds who needs the trauma room so the staff moves Charlie to the side for him. The gunshot victim complains that he doesn’t get his own room. Abby gives Charlie a small painting from his suitcase, which Charlie painted of a vacation home long ago. She notices that he has tremors now, which are a result of alcohol withdrawal.

When two doctors arrive to give Charlie dialysis and a procedure to stop his bleeding, Charlie gets annoyed with them for not speaking to him directly like the rest of the staff has been. Even with their treatment, Charlie’s prognosis isn’t great, and he decides he’s done. “Just stop everything,” he says. He clarifies that he’s a DNR.

Pratt argues that Charlie isn’t competent to make that decision but Luka disagrees. Abby suggests putting him on an alcohol drip to stop his tremors. Pratt tries to convince Charlie to change his mind. Charlie asks the staff to call Bobby again, thinking he’ll come to the hospital if he knows his father is dying. But Bobby went to class, so his roommate will have to go find him.

Charlie asks to have the tube removed from his stomach and to have a window opened so he can get some fresh air. The room fills with sounds of the city. Sam comments that she’s worked at County for a year and never really thought about what’s on the other side of the window. Charlie says he doesn’t want anything to separate him from what’s happening. He won’t run and hide.

He continues that his brother Lou died when they were kids. His mother told him that Lou was going on a long trip. Charlie hears the Russian woman in the next room, demanding a doctor. He sees himself in a bus terminal full of patients waiting for their turn to see a doctor. Abby’s voice reads his vitals like she’s making announcements over a PA system. Charlie sees a reflection of himself as a younger man. He goes to Abby to get his ticket and asks if it’s time to go.

The Russian woman keeps complaining next door. Abby assures Charlie that he won’t be alone when he dies. Sam agrees to stay with him, and he asks her to touch his face. She touches him comfortingly, like she probably does to Alex when he’s sick. Charlie imagines them on a boat and asks if they should drop the anchor or keep going. Sam doesn’t know. Bobby’s in the boat, too; he’s the boy Charlie thought Jeremy was earlier. Charlie asks Sam what Bobby wants, but Sam isn’t sure he knows. Charlie worries that it’s too late, but Sam says it doesn’t have to be.

There’s a splash as Bobby goes overboard. Charlie’s suddenly alone in the boat. Thanks to the alcohol drip, he feels drunk again, which he appreciates. Luka announces that he’s going to remove Charlie’s last support measure. It won’t take long for him to die. Charlie worries good-naturedly that his atheism is going to come back to haunt him now. “God will get over it,” Luka tells him.

Charlie imagines himself boarding a bus in the middle of the desert. The other riders are patients from the waiting area. He takes a seat near Luka and asks what it will be like when they get where they’re going. “Peaceful,” Luka tells him. The bus starts moving and they pass Evelyn. Charlie calls out for her. He asks Pratt if all his stuff is there; he wants Bobby to have it. He gives Pratt the painting for Bobby as well.

Charlie guesses that Pratt never knew his father, which Pratt confirms. Charlie feels bad about that but Pratt says he doesn’t let it bother him. Charlie thinks it bothers his father. He imagines himself approaching the vacation house from his painting, first walking and then running. Bobby’s inside, blowing out his birthday candles. “Let me in,” Charlie whispers, unable to get into the house. Bobby suddenly disappears. “Open up. Let me in,” Charlie says, only heard by Pratt.

Bobby comes to Charlie, who’s on the ground in the desert. He’s happy to see his son, who doesn’t seem to feel the same. Charlie says he’s sorry. Pratt cries a little and tells him to relax. Charlie flatlines while telling Pratt that it’s okay. Pratt collects himself to declare Charlie’s time of death at 12:04. Only he and Jane are in the room.

Pratt takes Charlie’s suitcase and chart to the admit desk as Ray notes that the staff spent 45 minutes with the same patient instead of treating and streeting people like they’re supposed to. He asks if things went south for Charlie and says he was nice. “Just a drunk,” Pratt replies. The pizza’s there, but the delivery guy was a minute late, so it’s all free. Pratt holds off on eating, wanting to check on Jeremy first.

Thoughts: Charlie is played by the late Ray Liotta, who won an Emmy for this episode. (And yes, it was awkward to recap this so soon after his death.)

The episode takes place in real time, which I think is a much better gimmick than any others the show tries over the years.

I think I said this before but I want Romano to rise from the dead for five minutes and spend at least four of those minutes yelling at Pratt.

The respect the other staff members show Charlie is really touching. Luka keeps calling him Mr. Metcalf, something he wouldn’t have heard a lot as a prisoner and then as an ex-con. Sam is patient and gentle with him every time she speaks to him. When he talks, everyone listens, even as they continue to do their jobs. Regardless of whether Pratt feels that Charlie deserves this kind of care, the staff treats him like he does.

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