September 20, 2022

ER 11.19, Ruby Redux: The Weight of Responsibility

Posted in TV tagged , , , , , at 5:01 pm by Jenn

May we all make it to our 80s sharp enough to memorize all the dialogue Red Buttons has in this episode

Summary: Susan and Chuck have been looking for a house, but they haven’t found anything they like yet. She’s getting ready for an interview that she hopes will let her secure tenure. Chuck is willing to go back to work, and he suggests that Susan get a job at a private hospital to make more money. Susan doesn’t care that much about the money, though, and she likes working at County. She feels like she belongs there. She finally finds an outfit she thinks is right for her interview, but it has a stain on the back. Cosmo laughs at her.

Ruby Rubadoux, who we last saw all the way back in season 2, has been brought to County after fainting, though he denies that he fainted. He’s skeptical about Neela being his doctor, since she doesn’t look old enough to be one, or even have a high school diploma. Ruby’s 85 now but still as mentally sharp as he was almost ten years ago.

Carter’s rounding with the interns, and it looks like he’s built up a good rapport with them. Ruby’s not happy to be at County, but Neela doesn’t get that it’s because of his history there. When he spots Carter, he says he doesn’t want Carter anywhere near him – Carter killed his wife. The interns scatter as if he’ll kill them, too. Carter seems confused.

Neela’s shift is over, so she hands Ruby off to Abby. Meanwhile, Susan has her tenure interview, which is conducted by a panel of six people, including Anspaugh, Weaver, Dubenko, and her onetime rival Kayson. She’s won a teaching award three times, but she’s only been published four times, which is why she’s been working with Morris on a paper. Since she hasn’t brought in grant money, she hasn’t quite met the bar the panel has set, despite her rave reviews as a doctor and instructor.

Abby detects that Ruby has a heart murmur, so she wants to run some tests and take an x-ray. He thinks Abby’s a nurse, so he doesn’t want to listen to her. She tells him she’s a doctor, but since she’s not his doctor, that doesn’t change his attitude toward her. She agrees to let a more experienced doctor take over his care. She’s probably happy to have an excuse to avoid him for a while.

Paramedics bring in a woman named Mary who was stabbed by her husband. She retaliated by shooting him. Sam forgot that she was supposed to stock something in a trauma room, and Chuny’s not happy about it. Sam’s been having a hectic morning, and she’s not in a good mood, so of course she takes it out on Luka. Pratt calms Mary while asking her questions, and he perks up when he learns what neighborhood she lives in.

Abby tells Carter about Ruby’s condition, but Carter doesn’t want to get involved in his case. Abby talks him into it. Ruby’s not happy about that, and it just gets worse when he realizes that Carter doesn’t remember him or his wife, Helen. Ruby says he knew that she didn’t have much time left, but he’s upset that Carter put her through everything he did. He refuses to let Carter examine him until Abby tells him it’s necessary.

After the examination, Haleh comments to Carter that Ruby is more of a handful than he was all those years ago. She doesn’t think Carter should spend too much time worrying about what happened back then, since he was just a student. Susan passes through the ER, trying to get out and go home without getting bugged, but Jerry tells her that a meeting she’s supposed to attend got moved to 3:30. She just worked a night shift and doesn’t want to hang around that long.

Carter looks up Helen’s chart in the hospital’s records department while Kayson examines Ruby and determines that he needs surgery for a narrowed heart valve. Kayson is the first doctor to gain Ruby’s respect, though he’s warmed a little toward Abby. She clarifies that he understands the risks of having heart surgery at the age of 85. He might not be a good candidate, and he needs to consider all his options. Ruby calls her “doll” and dismisses her concerns, since she’s not the one who can fix his heart. Okay, maybe he hasn’t warmed toward her after all.

Abby talks to Carter and Kayson about Ruby’s shaky health, which she thinks should rule him out as a good surgical candidate. Kayson, of course, doesn’t value her opinion. She reminds him that Ruby gets to make the decision here. Carter defends her attempts to advocate for her patient, but Kayson is still dismissive. He’s the surgeon, so he makes decisions about surgery.

Pratt has called Olivia in to talk to Mary, since her neighborhood is one that Ceasefire serves. Olivia’s surprised that Pratt was able to find some hope in Mary’s situation. Then again, she knows that he’ll take advantage of any excuse to spend time with her. He asks her to have dinner with him, supposedly so she can teach him about domestic violence counseling. She agrees to meet him at her office that evening.

Birdie and Rebecca are back in the ER, this time because Birdie’s sick. Ray thinks she has a lung infection, but Birdie says that when she came in a week ago, Abby didn’t mention anything about that. As Anspaugh is explaining Ruby’s condition and the surgery to him, Abby interrupts to ask if they’re really going forward with this. Anspaugh says that it’s the only way to definitively treat Ruby’s condition at this stage. Abby makes an argument against surgery, but Anspaugh seems satisfied that he’s been fully informed of the situation and possible consequences. He’s unhappy that she disagreed with senior staff in front of a patient.

Jake surprises Abby by coming up behind her and covering her eyes, even though he knows she must hate that. Nice. What does she see in this guy? He’s just returned from a trip to San Francisco to check out a hospital he might work at after he’s done with med school. He’s also considering staying at County, which would conveniently allow him to stick close to Abby.

Paramedics bring in a teen named Dirk who crashed while street luging. Pratt and Luka seem impressed, while Sam is like, “Congratulations, you’re an idiot.” He might have a spinal injury. While Abby’s trying to talk to Carter about Ruby, Ray tells them that Birdie and Rebecca are back. Carter thinks he can discharge Birdie, since she has family who can help take care of her, but Abby objects. Carter defers to her and tells Ray to call a social worker, since the sisters are panhandlers.

Abby finally gets to tell Carter that she doesn’t think Ruby has been fully informed of his options. Carter says she should talk to him, then, but she knows he won’t listen to her. Carter isn’t fully listening (to be fair, the lure of ordering Girl Scout cookies is hard to resist), and Abby calls him on it. She insists that he talk to Ruby, no matter what happened with them in the past. He tells her that this is an obstacle she’ll face as a doctor – trying to get through to a patient who doesn’t want a young, female doctor. If she can’t succeed with Ruby, she should move on.

Jerry wakes Susan from a nap she wasn’t really able to take before her meeting. She checks in on Pratt, Luka, Ray, and Sam, who are sawing through Dirk’s helmet to remove it. She then goes to her meeting, which is Morris’ presentation about why he should be chief resident. There are slides. No way is Susan going to stay awake the whole time.

Ray catches Birdie and Rebecca trying to leave before a social worker can talk to them. They tell him it’s important for them to leave now so they can be near the El during rush hour. They offer to write a note so he doesn’t get in trouble for not being able to keep them around. They’re kind of awesome. Ray lies that his boss is mad at him for letting too many patients go. He’s at risk of being demoted and sent to work in the morgue. Birdie and Rebecca see through his story but admire the attempt.

After Dirk is taken away for scans, Luka asks Sam what’s up with her. She’s mad that he seemed to be encouraging Dirk’s dangerous activities. He tells her he wasn’t and she’s overreacting. She throws a couple of towels at him, but instead of the fight escalating, they both start laughing. She apologetically says she’s having a rough day and has a headache. He tells her she can leave early, and if anyone has a problem with that, they can complain to him.

Pratt helps Abby insert a central line in Ruby. Even though they seem to be doing everything right, his heart becomes unstable. Morris pitches a scheduling system that has something to do with circadian rhythms. Carter gets a page and claims he has to go help in the ER (Susan doesn’t believe him). Birdie and Rebecca’s niece, Shelley, arrives and tells Ray that she’s been trying to get them to move in with her. They value their independence too much to accept her support.

Carter’s page was real, and he rushes to help Abby, Pratt, and Haleh stabilize Ruby. Pratt notes that if he can’t tolerate a central line, he won’t survive heart surgery. Abby says he wants it, which Pratt doesn’t think is a good enough reason. Weaver is okay with naming Morris chief resident, especially since it’s better and easier than hiring someone from the outside. Susan notes that Weaver came from the outside. Luka joins them, agreeing with Susan that Morris would be a bad choice. He tries to get Carter on his side, but Carter has enough on his plate and is staying out of this.

Thanks to Ruby’s instability, as well as a broken rib and complications he suffered while receiving chest compressions, his surgery has been postponed. Abby’s a little smug about it, but honestly, I think she should be. Pratt goes to Ceasefire, where Olivia’s leading a community development meeting. She puts him on the spot, making him talk about jobs in health care.

Luka tries to chat with a woman with five kids, none of whom seems to have ever sat still for more than a minute at a time. Sam teases him a little before leaving for the night. Something’s definitely up with her, as her mood goes south as soon as she leaves him. In the ambulance bay, Carter tells Abby what happened with Helen years ago. He felt pressured to move her along, so he had her dumped in a nursing home. Abby doesn’t think it’s that big a deal, since they dump patients in other departments all the time. Carter admits that he told Ruby what he wanted to hear about his wife instead of the truth.

As a student, Carter wanted everyone to like him, but he also wanted to impress his superiors. Abby gets that. Plus, Carter’s orders to get rid of Helen came from the chief of surgery, so he had no choice but to comply. When Helen died a few days later, Ruby was surprised. Carter tries to push responsibility off on his attending, since he didn’t have any authority as a student.

Pratt chats with some attendees after the meeting, and one asks if he’s related to Charlie Pratt, a parks and rec employee. Pratt says no. (He’s lying, and we’ll meet Charlie in a few episodes.) Olivia’s pleased that he finally came to see what her work is like, and she’s going to reward him for being a good sport by having dinner with him. Now, though, he’s not in the mood.

The thing on Sam’s mind is her period, it seems, because she goes to a drugstore to buy a pregnancy test. The clerk who rings her up makes an “isn’t this exciting!” face. Sam makes an “I could kill you with my bare hands right now” face. Carter catches Ray leaving early and busts him for letting Birdie and Rebecca go without speaking to a social worker. He doesn’t think sending them home with Shelley is good enough. Ray hasn’t done everything he’s supposed to, and he hasn’t told Carter enough about his patients for Carter, the attending, to be responsible for everything he’s supposed to.

A light bulb goes off in Carter’s head and he goes to Ruby’s room. All he says is that he’s sorry. Ruby can’t believe that Carter’s still working at County almost ten years after Helen’s death, and he didn’t even remember her. Carter says he made mistakes with both Helen and Ruby. Ruby knows, and he regrets bringing his wife there. He scoffs when Carter says he tried.

Carter notes that he wasn’t experienced, and the situation became more complicated than he was equipped to handle. “All you had to be was a human being,” Ruby says. Carter lied to him and Ruby believed him. Then he lost the woman he loved. Carter sits down by his bed and tells him that while his condition can be fixed with surgery, it might not be his best option. His chances of fully recovering are small, and there’s a big possibility that he’ll never leave the hospital. Without surgery, he won’t get better, but he’ll have more time with his loved ones. Carter lied about Helen all those years ago, but he’s not lying now.

Thoughts: Paul McCrane (Romano) directed this episode.

Katie Mitchell, who plays Shelley, is married to Michael B. Silver, who plays Myers.

This was Red Buttons’ (Ruby) last action role, and it looks like he’d basically retired a few years before this, so it’s nice that he came back for one of Noah Wyle’s last episodes as the star of the show.

Birdie thinks Abby looks like a young Patty Duke. She’s absolutely right.

1 Comment »

  1. Patrick Sullivan said,

    I thought Noah Wyle was terrific in this episode. There are very few shows that can so adeptly pull off a 10-year story arc. The Patty Duke comparison is interesting because not only does she look like Abby but she famously was bipolar like Abby’s mother in the show.


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