August 23, 2022

ER 11.15, Alone in a Crowd: Have MERCI

Posted in TV tagged , , , , at 5:03 pm by Jenn

Another excellent performance by a guest star

Summary: Sam and Luka are walking to work when they pass some students getting off a bus. One of them bumps into Sam and apologizes, calling her “ma’am.” Sam’s surprised that she’s aged out of the “miss” category. She asks if Luka would guess that’s old enough to have a fifth-grader if he didn’t know her. He says he can see here with a toddler, but she’s not interested in doing the whole baby thing all over again. She asks if Luka thinks about having kids. It’s not something she can imagine doing at this point in her life.

A woman named Ellie Shore is trying to wrangle her kids for their after-school activities. Her sons, Christopher and Lucas, are fighting, and her teenaged daughter, Erin, gets annoyed when Ellie says she can’t go to a friend’s house. Ellie sends the kids off with their father, Dan, then goes to the kitchen to clean up. She suddenly collapses on the floor.

In an ambulance, Ellie tries to convince the paramedics that she doesn’t need to go to the hospital. They don’t listen. We see things from Ellie’s point of view as Luka, Abby, and Sam start caring for her at County. She continues insisting that she doesn’t need medical attention. But a shot of Ellie shows that she definitely does – she can’t move her face, and all the things she thinks she’s said out loud have been garbled.

Neela gets ready for work while Ray and his band have a loud jam session in the living room. Ray offers to give her a ride in, since he’s also working, despite their attempts to work opposite shifts. He had to switch with someone because the band has a gig coming up. He asks if Neela’s okay with some of the guys staying there, but he doesn’t wait for her to answer. One of the guys asks if she plays an instrument. Yes – the viola. Well, at least they’re nice.

We’re back in Ellie’s POV as she wonders why no one’s listening to her when she says she’s fine. She decides to talk louder, which doesn’t have any effect on her speech. Luka tells her she’s at County, which Ellie isn’t happy about. She starts to realize that things aren’t actually okay when Luka tells her to squeeze his hand and she finds that she can’t feel half of her body. Sam removes Ellie’s clothes, which distresses her more, since she didn’t plan to stay in the hospital.

Carter and Wendall go for a run together, something she does all the time that he clearly doesn’t enjoy. She notes that they’ve been seeing each other for three months. Back at County, Jane and a couple other students ask Pratt questions (two about patients, one about dating on a low budget). He’s obviously starting to embrace his role as a kind of mentor. He even agrees to attend some sort of dinner to accept an honor County is receiving. Morris thinks he’s sucking up to Susan, but Pratt says he would never do that.

Morris invites anyone who’s interested to go out for drinks after work. He wants to celebrate the fact that Weaver’s on vacation, as well as gain some allies, since he wants to eventually become chief resident. Neela agrees to go, since it’s better than going back to her apartment and dealing with Ray’s bandmates. Pratt also accepts Morris’ invitation, and they scamper off when Susan asks if the “big kids” are being excluded.

Ellie realizes that she’s not actually able to say anything out loud. She doesn’t know what could be so wrong with her, since she’s healthy and only 35. She starts worrying about her kids, who will need to be picked up, but all she can do to get the staff’s attention is gesture like she wants to write something. Sam notices and brings her a pen and paper. However, her writing is illegible. Luka tells her that she probably had a stroke, and it’s affecting her ability to communicate. Ellie thinks that the effects have to be temporary, since only old people have strokes.

Abby runs into Jake, and Chuny gives her a pointed smile when she spots them together. Abby’s getting self-conscious, so she wants to spend a little less time with Jake when they’re at work. She says she’s only told one person about them (Neela), and he claims he hasn’t told anyone. Speaking of Neela, she seems to be contemplating moving back in with Abby, since her place is quieter than Ray’s.

Neela goes to the waiting area for her next patient, a little boy named Clayton who got some minor injuries from falling off the kitchen counter. His brother and sister, Tucker and Bridget, are with him; Tucker, the oldest, is probably no older than 13. He says their father went to get coffee, then leaves to find him while Neela takes Tucker and Bridget into the ER.

As a neighbor of Ellie’s brings her kids in, Sam gives Ellie a blanket and a comforting smile, which makes Ellie think that her condition isn’t that bad after all. Then again, Sam’s a nurse, so maybe she doesn’t know what’s going on. Abby’s a doctor and isn’t smiling as much, which could mean it’s bad. As for Luka, he’s tall and handsome. Yeah, you lucked out here, Ellie.

Her kids come in to see her, and she’s concerned by how worried they are about her. Erin says she was fine the last time they saw her. Ellie starts coughing, and Sam and Abby send the kids away so they can help her. They wind up putting her on a ventilator. When she wakes up from sedation for her intubation, she’s distressed because she can’t move.

A CT doesn’t show any hemorrhaging in Ellie’s brain, so a neurologist named Medford guesses she has a clot. Abby suggests TPA, but if Ellie’s stroke happened more than three hours ago, the treatment could cause a brain bleed. Her best outcome is the restoration of collateral flow. Then she can have physical therapy. Medford tells Abby and Sam that patients in Ellie’s condition don’t often make a meaningful recovery. There’s one other option, though: a procedure called MERCI, where a catheter is inserted in the brain to remove the clot. It basically reverses the stroke, but there are major risks.

Ellie’s getting more distressed, since she can’t see now and she can’t let anyone know. (It looks like the issue is just that she can’t open her eyes, not that she’s blind.) While Sam and Abby are examining her, Sam asks if Luka has ever talked to Abby about his kids. She notices that Ellie’s crying. Abby thinks that one of the sedatives they gave her wore off before the other medication, which means she’s still paralyzed but is now conscious enough to realize it. Ahhh! Nightmare!

Paramedics bring in a man named Kevin who got caught in the middle of a riot while running an errand for his grandmother. Susan overhears Morris saying he can’t have any more pain medication until they make sure he’s actually hurt. Well, the paramedic said he had burns, and you can’t exactly fake those, so…I’d say he’s hurt.

Luka tells Susan they should remove Morris from their list of potential chief residents. There aren’t any better candidates, though. Luka thinks Pratt could do it, and he points out that med students and interns already go to him when they have questions. Susan has a lot of reservations about him and hasn’t seen him demonstrate the leadership qualities a chief resident needs.

Abby and Sam take Ellie back to the ER as Ellie internally begs for someone to help her. Luka reassures her that she’s experiencing a normal side effect of her treatment, and they’ve given her something to calm her down. When she wakes up, she’ll be able to open her eyes again. Dubenko pulls Abby away to tell her that a patient they treated the day before was experiencing abdominal pain because of a condom full of cocaine. He suggests that she write up the case for publication. He’ll help her. Abby protests, since she doesn’t like him, but he talks her into it.

Neela examines Clayton, whose injuries aren’t serious. He and Bridget mention that they were making dinner when he fell. Neela praises them for being grown-up and helping their parents. Tucker brings in their father, Mr. Davis, and Neela smells alcohol on him. He says he just had a beer. She goes to Pratt for guidance, but he’s already helping a bunch of people. He reminds Neela that he’s not the only third-year resident she can turn to. Yeah, but isn’t Morris her only other option? No one wants his help.

Ellie wakes up and is relieved that her condition has improved – well, improved so that she’s back to where she was when she was brought in. Sam kindly talks to her like she can hold up her end of the conversation. She even senses when Ellie has caught a whiff from a nearby patient who’s soiled herself. Sam treats that patient nicely as well, but Ellie must be worrying that she’ll also end up unable to care for herself.

Ray, Morris, and Chuny treat Kevin, skeptical when he says he wasn’t part of the riot. Outside the room, Morris tells Ray not to worry if he’s unable to spot con artists. It took Morris until his second year to get good at it. Ellie sings “I Think I Love You” in her head as Luka examines her. She notices that he’s not wearing a wedding ring and has a sexy accent. Then she’s embarrassed for feeling like a teenager with a crush. Her heart starts racing and she gets dizzy. She flatlines, but they stabilize her.

Dan arrives and Luka tells him what they’ve figured out: Ellie’s stroke was probably caused by an abnormal heart rhythm, which sent a clot to her brain. He apologizes for the pain Ellie just went through, but the good news is that they can give her the right medication. Ellie’s happy to see her husband and wants to comfort him more than she wants his comfort.

Luka and Abby tell Dan that they want to try the MERCI procedure. Ellie’s on board, but Dan’s hesitant because of the risks involved. Doing nothing will keep her alive, but not the kind of alive Ellie wants to be. She wishes they could hear her giving consent. She’s able to move her arm, and when Dan comes to her bedside, she tries to communicate to him that she wants the procedure. Something gets through to him and he gives his consent.

Neela updates Mr. Davis on Clayton’s condition as he scarfs down a meal tray the hospital provided to him and the kids. They took the El in to the hospital, so Neela offers them a cab voucher. Bridget’s really excited about that. Morris signs off on Neela’s treatment, but she thinks there’s something strange going on with the family. Morris dismisses her concerns about Mr. Davis having had what he said was only one beer.

Sam and Abby take Ellie for the MERCI procedure while gossiping about Medford, who’s rumored to be sleeping with a med student. Hmm, he and Abby have something in common! They say goodbye to Ellie, who’s not happy about being left with strangers now that she’s come to like the ER staff. She’s also not happy that the procedure, which involves a catheter being inserted through her groin, requires her to have some of her pubic hair shaved.

Abby goes to Dubenko’s office so they can work on her paper together. He wants to work over dinner in a restaurant. Um, red flag. Speaking of dinner, Carter and Wendall have attempted to cook something, but they end up ordering a pizza instead. Wow, they’re so interesting, aren’t they? Kevin’s grandmother arrives and confirms his story that he went out to run an errand for her, not to take part in a riot. Pratt isn’t happy to hear that Morris accused Kevin of lying.

He pulls Morris out of the room to confront him. Morris doesn’t think he was out of line, since people lie all the time about this sort of thing. But Kevin’s Black, so Pratt thinks Morris made a racist assumption. Susan listens in as Pratt tells him to go apologize to Kevin and his grandmother. She praises him for showing some leadership and tells him that Carter and Luka want him to apply to be chief resident. Pratt isn’t interested.

Luka and Sam meet with Ellie’s family to talk about her condition. Luka tells them to support each other and send her good thoughts. Erin’s upset because she was nasty to her mother earlier, but Luka assures her that Ellie knows she didn’t mean what she said. He tells the family he’ll check on Ellie for them. As the MERCI procedure starts, Ellie focuses herself by thinking about her kids’ births. Luka comes in so she’ll have someone familiar with her.

Abby and Dubenko go to dinner, and he tries to make small talk when it’s clear she just wants to get started on her paper. This is obviously a date disguised as work. Ellie’s feeling down, and as the doctors find the clot, she contemplates just letting go. Carter and Wendall have followed up dinner with sex, and she settles in at his place for the night without any discussion about whether she’ll stay.

Ray and Neela shop together at the mini-mart, discussing the possibility that Morris will be chief resident. Neela thinks it should be Pratt. Mr. Davis comes in alone and Neela asks where the kids are. Clayton has a concussion, so he needs to be monitored all night. Mr. Davis ignores her, then finally reveals that he doesn’t have any kids. Tucker paid him a few dollars to pretend that he was the kids’ father.

Ellie revisits some happy memories as the procedure continues. Even the noisy, messy times were good. Neela returns to the hospital and tries to find a social worker to help her with the Davises. Six hospitals are sharing two for the night shift, so it could be a while. Ray thinks that Tucker is responsible enough to look after Clayton for the night. Neela wonders why he lied about his father. They guess that the address he wrote on the paperwork is right, though, so Neela decides to go over and check on the family. Pratt approves her request to leave, telling her to take Ray with her.

Carter wakes up to a phone call from Kem. Ooooooh. Wendall gets dressed and leaves, understandably not wanting to lie in bed next to her boyfriend while he talks to his ex. Carter follows her out and apologizes for being rude. Wendall asks if she’s just a diversion for him until he and Kem are in the same country.

Carter paints this like he’s just being nice because he and Kem had a child together, as if he doesn’t still love her and want to be with her. And let’s not forget that he’s living in the house he bought for them to live in together. Wendall’s annoyed that Carter didn’t tell Kem he was in bed with someone else. (That would have been weird, but he could have at least left the room for the call.) He tries to assure her that he’s committed to their relationship, but he can’t say what she wants him to say. He just apologizes again. She appreciates his honesty, but she’s done with him.

The doctors doing the MERCI procedure are able to reach the clot, and the retrieval goes perfectly. Luka decides to take Ellie back to the ER to take her off the ventilator, to be on the safe side. Neela and Ray go to the Davises’ apartment, and Tucker wakes up his brother and sister, expecting that they’re going to be split up and sent to different foster homes. Their mother is the only parent around, and she’s in a bedroom with a towel tucked under the door. Neela and Ray quickly determine that she’s dead. Tucker says she got sick a week ago.

Jake, Jane, Abby, and a couple other students show up to Morris’ get-together. Morris offers himself up as a mentor to the others, but I don’t think anyone’s interested. Pratt skips the gathering and goes home, perfectly content to drink beer and watch sports by himself. Ellie returns to the ER, now showing no signs that she had a stroke. When she’s extubated, the first thing she says to Luka and Sam is, “Thank you.” They look on happily as her family comes in to see her.

Thoughts: Ellie is played by Cynthia Nixon. Bret, one of Ray’s bandmates (who says and does nothing in this episode but is in a couple more after this), is played by Misha Collins. Camryn Grimes, who plays Erin, is Scott Grimes’ (Morris) niece.

This episode highlights again what a good nurse Sam is, but we also get to see Luka shine in the bedside-manner department – not because he’s warm and fuzzy but because he explains things so patients understand them and helps keep them from worrying when they don’t need to.

I love when Ellie can’t think of the rest of the chorus of “I Think I Love You” – Cynthia Nixon’s delivery of “I don’t know the rest” is hilarious.

1 Comment »

  1. Patrick Sullivan said,

    When Carter is at home with Wendell he says into his phone, “Deep dish pizza Chicago,” and Wendell goes, “That’s creepy,” when today that’s totally normal technology. Ha ha.

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