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Interview Infirmière - Great Expectations
6x08 "Great Expectations"

Transcribed by Elizabeth []

(We open on Carol's bedroom with the Bruce Cockburn song Wondering Where The Lions Are. An alarm clock beeps and Carol gets out of bed. We see her go into the bathroom, using a mirror to see her weight, and step into the shower. She walks out the door, carrying a pie, and runs to catch the El, and then falls asleep and almost misses the stop for County. Going down the stairs, she drops the pie in the snow and leaves it there after making a hopeless attempt to pick it up. She turns into the ambulance bay and we see Cleo jumping rope.)

CAROL:      I guess winter's here, huh?

CLEO:      Yeah.

CAROL:      Aren't you freezing?

CLEO:      Not once I get warmed up.

CAROL:      I used to be that thin, you know.

(cut to admit area, where Kerry is stitching a laceration.)

PATIENT:     Bitch stabbed me right through the bird.

KERRY:     Excuse me?

PATIENT:     I was stuffing the turkey.

CAROL:     Hey, Kerry.

KERRY:     Hey, Carol. I thought yesterday was your last day.

CAROL:     I know, but I still need to show Lydia how to do the productivity report.

MALIK:     She took off.

CAROL:     What?

MALIK:     Yeah, she's driving to Wisconsin

RANDI:     You were supposed to be here at eight.

CAROL:     I needed to sleep. I thought she had a shift.

RANDI:     Yeah, the night shift.

CAROL:     Why didn't she call me, I came all the way in.

MALIK:     She figured you'd bailed, she didn't want to bother you.

CAROL:     Oh, man.

KERRY:     Don't you feel all right?

CAROL:     No, my back is killing me.

CONNI:     Well, we're about to do the potluck, why don't you stay and rest a while?

CAROL:     No, you know what, I'm gonna go home, take a nap, store up my energy to do up my family.

MALIK:     Wait, hold up, I've got you down for dessert.

CAROL:     Sorry. Casualty of pregnancy.

MALIK:     What, no pie?

(cut to ambulance bay. Carter is having a snowball fight with Chuny)

CHUNY:     (screams) Okay, okay, timeout.

CARTER:     There are no timeouts in a snowball fight.

CHUNY:     No fair! I'm a girl!

CARTER:     Yeah, a girl who tried to ambush me.

CAROL:     That's very mature, Carter.

CARTER:     Oh, you want a piece of this?

CAROL:     Don't even think about it.

CARTER:     (having been attacked again by Chuny) Oh, okay, now you're dead.

(Carol heads back to the El. On her way, she passes a dog who is eating the pie)

CAROL:     Well I'm glad you're enjoying it.

(She gets on the El and sits down. The train pulls away and she looks down.)

     Oh my god!

(cut to opening credits)

(open scene on a different El train. Luka Kovac is on it, reading a newspaper. He looks up and sees Carol sitting on the platform, and gets off the train)

LUKA:     Carol? Carol, are you all right?

CAROL:     My water broke.

LUKA:     How long ago?

CAROL:      Fifteen minutes.

LUKA:     You're already having contractions? How many?

CAROL:     Two.

LUKA:     How far apart?

CAROL:     Seven or eight minutes.

LUKA:     Did anyone call an ambulance?

CAROL:     No, County's just one stop back.

LUKA:     Why didn't you get on that train?

CAROL:     You try walking during labor pain.

LUKA:     Okay. How far along are you?

CAROL:     Thirty-eight weeks.

LUKA:     Was the amniotic fluid clear?

CAROL:     Kind of hard to tell on the El.

LUKA:     So, no meconium then?

CAROL:     I don't think so.

LUKA:     Good, good, good. (looks to see if there is a train coming)

CAROL:     Don't worry, I could be at this a while.

LUKA:     Tell you what. We'll wait for the next train. If it doesn't come in five minutes we'll call an ambulance, okay?

CAROL:     Oh, yeah.

(cut back to the ER. Dave and Malik are playing wheelchair hockey. Dave makes a save using his hands)

MALIK:     Hey, that ain't no fair man, you can't use your hands.

DAVE:     I'm a goalie, man, that's what we do.

MALIK:     It's too easy. Use the chair.

DAVE:     Okay, whatever you say, bro. Hey, Cleo.

CLEO:     Working hard, Dave?

DAVE:     Hey, I'm fast, what can I tell you? (makes a save using the chair, but tilts it too far back and falls out) I'm cool, I'm cool. Hey, Dr Weaver.

KERRY:     Finish your notes, Dr Malucci?

DAVE:     Absolutely, Chief. I was just, um, waiting on a paramedic run. Is it always this slow on Thanksgiving?

KERRY:     Well, if you're bored you can start studying for your national in-service exam.

CLEO:     Wouldn't want to bring down the average.

DAVE:     Ouch, and I thought you liked me.

CLEO:     Whatever gave you that idea?

KERRY:     It'll pick up once people start eating dinner.

CARTER:     Already started. Shelly Robinson, 18, persistent vomiting and diarrhea, hypoglycaemic, altered mental status. Gave her IV fluids and compazine, but her glucose is still 42 after D50.

KERRY:     Did you get an endocrine consult?

CARTER:     Yeah, he's probably at home stuffing his face right now.

DAVE:     Did you get a travel history?

CARTER:     Not outside the US.

DAVE:     How about Florida?

CARTER:     Yeah, actually, she just got back from there, why?

DAVE:     Well, ask her if she ate noylee elwis fruit with black seeds.

CARTER:     What?

DAVE:     Akee fruit. Poisonous before ripe, induces vomiting and low blood glucose by inhibiting hepatic gluconeogenesis. Known as JVS.


DAVE:     Jamaican Vomiting Sickness. But, the akee also grows in Southern Florida.

CARTER:     You're kidding, right?

DAVE:     You better start a D20 infusion, because there's a high fatality rate if it's left untreated. Hey man, if you don't believe me, just check the differentials.

CLEO:     Might be a doctor after all.

CARTER:     Jamaican Vomiting Sickness?

KERRY:     Look it up, John.

CARTER:     Jamaican Vomiting Sickness.

(cut back to Luka and Carol, still on the El platform, now getting on a train)

LUKA:     Okay, a little step

CAROL:     Thank you for doing this.

LUKA:     Not a problem.

CAROL:     Oh, god!

LUKA:     What is it, a contraction?

CAROL:     Oh, yeah!

LUKA:     Okay, sit, sit here

CAROL:     Oh!

LUKA:     So maybe, maybe standing is better, huh?

CAROL:     Yeah.

LUKA:     Okay. Carol, have you taken a birthing class?

CAROL:     Mmm.

LUKA:     Look at something, try and stare at something, stay focused on it, okay?

MAN:     Is…is…is she having a baby?

LUKA:     We're okay, she's just started.

MAN:     Are you sure?

LUKA:     Yeah, it's all right, I am a doctor.

MAN:     She doesn't look all right to me.

CAROL:     (screams)

MAN:     Uh, I think I'd better pull the emergency cord.

LUKA:     No, that stops the train.

MAN:     Well she needs help.

LUKA:     No, we only have to go one stop, it's okay.

MAN:     Better to be safe.

LUKA:     No, no, don't pull the cord.

MAN:     The signs says: Pull in case of emergency.

LUKA:     This isn't that kind of emergency.

MAN:     Police, fire, medical emergency.

CAROL:     Don't pull the damn cord! God!

(cut to a corridor in Elizabeth's apartment building. Mark, his daughter Rachel, and his father David)

DAVID:     Can she cook?

MARK:     Dad, what kind of a question is that?

DAVID:     So she can?

MARK:     I don't know, we eat out a lot.

DAVID:     In my experience with English food, it's always bland.

MARK:     Would you rather I cooked?

RACHEL:     Is she pretty?

MARK:     Yes, she's pretty.

RACHEL:     Prettier than Cynthia?

MARK:     Different kind of pretty.

DAVID:     Beauty is overrated.

MARK:     She's pretty, all right? Jeez. (he knocks on the door, which is answered by Elizabeth)

ELIZABETH:Happy Thanksgiving.

MARK:     See.


MARK:     Nothing. Elizabeth, this is my father, David Greene.

DAVID:     Nice hat.

ELIZABETH:Thank you. Come in.

MARK:     This is Rachel.

ELIZABETH:Hello, Rachel.

RACHEL:     (referring to the hat) You're not supposed to wear those, they're for decoration.

ELIZABETH:Well, I saw it in the drugstore, and I thought it looked…cute.

MARK:     I got the wine.

ELIZABETH:Great, I'll open it.

MARK:     No, no, I got it.

DAVID:     Scotch and soda for me. If you have it.

ELIZABETH:Actually, I think I might. Rachel, would you care for something to drink?

RACHEL:     Can I have some wine?

MARK:     No.

ELIZABETH:I have soda.

RACHEL:     Okay.

DAVID:     Mind if I turn on the game?

ELIZABETH:My telly's broken, I'm afraid.

DAVID:     Doesn't work?

ELIZABETH:Apparently my neighbour was stealing his cable. So the company came and um, they snapped the wrong line.

DAVID:     On Thanksgiving?

ELIZABETH:Oh, no, this was a month ago. I just haven't had time to ring up and complain.

DAVID:     No football.

ELIZABETH:We can play charades, if you like.

(cut to the El platform. Luka and Carol have got off the train)

CAROL:     Let me just sit for a second, okay?

LUKA:     The contractions are too close together, you are in active labor.

CAROL:     Oh, gee, you think? I'm sorry, I just…

LUKA:     You might have progressed more than you think.

CAROL:     I'm okay, it just…hurts.

LUKA:     How dilated were you on your last OB visit?

CAROL:     3 centimeters Monday.

LUKA:     Any back pain?

CAROL:     For the last three months.

LUKA:     Worse lately?

CAROL:     This morning.

LUKA:     Okay, lets go.

CAROL:     Oh, can I have the babies here?

LUKA:     If you wanna make the news.

CAROL:     Oh, god, they feel like they're coming through my knees.

LUKA:     Yep, that's the idea.

CAROL:     Son of a bitch!

LUKA:     Look, come on, okay, focus, focus Carol. Carol… Try, try humming.

CAROL:     Huh?

LUKA:     I know it sounds very strange, but it helped my wife. Okay, just hum. Like this. (hums)

CAROL:     (hums with weird look on her face)

LUKA:     Yeah, that's good. (they hum together) Okay.

(cut to the ER. Chuny and Dave)

CHUNY:     Hey, remember that renal failure patient. Five minute ETA?

DAVE:     Uh, let me guess, they rerouted to Mercy?

CHUNY:     No, she's a trauma patient. Some guy ran into the ambulance.

DAVE:     Ouch.

CARTER:     Hey, Dave. Good call on the Akee fruit. She bought it from a kerbside vendor.

DAVE:     I don't wanna say I told you so, but…

CARTER:     How'd you know about it?

DAVE:     Because I'm a good doctor.

CARTER:     No, really?

DAVE:     Really? And, I might have seen it before.

CARTER:     Where? No, don't tell me, you do the Peace Corps or something?

DAVE:     Yeah, exactly. I spent some time in the jungle, and if you're nice to me I'll even show you my piranha scars.

CARTER:     No, come on, where'd you see it?

DAVE:     Let's just say you owe me a favor.

CARTER:     What is this, a secret? What, are you suddenly sensitive, Dave? Oh, um, you lose a patient to this?

DAVE:     Whatever, I saw it in Grenada, okay?

CARTER:     You did a rotation in Grenada?

DAVE:     No, Sherlock, I went to med school in Grenada.

CARTER:     Oh, uh, your first choice?

DAVE:     I had fun in college. What I can remember of it, my grades sucked, my MCATs were a long story, but I always knew I could be a better doctor than those ass-kissers whose only hard-on was for what was on some test.

CARTER:     Gotcha.

DAVE:     So I did Grenada. It's the Harvard of the Caribbean.

CARTER:     I'm sure that it is.

DAVE:     It still says MD, Carter. See, MD.

CARTER:     I know, I know. Well, now I can appreciate you that much more.

DAVE:     Good.

CARTER:     So, what did you get on your MCATs?

(cut to the top of the El steps. Carol and Luka)

CAROL:     It started snowing again.

LUKA:     Yeah. Are you ready?

CAROL:     I think so. So how long was your wife in labor?

LUKA:     Sixteen hours. For the first one.

CAROL:     How many has she had?

LUKA:     Two. At different times.

CAROL:     Do they still live in Croatia?

LUKA:     No. Not anymore.

CAROL:     Mmm. Oh!

LUKA:     What? Okay, sit, sit down, come on. Don't worry, it's probably a vagal reaction to the contractions. Deep breaths.

CAROL:     I have to go to the bathroom.

LUKA:          We're almost there.

CAROL:     No, I really have to go.

LUKA:     We must hurry, can you stand? (Carol starts humming) What, what is it? Another contraction? Already? Uh, okay. Don't push. Don't push. Listen to me Carol. Carol, don't push. Carol?

(She is unconcious. He looks around for some help, but there is none, so he picks her up and carries her down the street himself)

(cut to the ambulance bay. An ambulance is pulling up with the renal failure/trauma patient that Chuny and Dave were discussing.)

PARAMEDIC:Seventy eight year old woman with chronic renal failure in respiratory distress. Missed her dialysis.

KERRY:     Any other injuries from the accident?

PARAMEDIC:Maybe chest trauma. She responded to ten litres of O2 but decompensated after the crash.

CARTER:     Anyone else hurt?

PARAMEDIC:Yeah, Zadro banged his elbow. The jerk who hit us is right behind, he's faking a heart attack.

LUKA:     (he is still carrying Carol and yells out before falling to his knees) Kerry!

KERRY:     Oh my god!

CARTER:     We need a gurney out here!

(Kerry, Dave and Carter run to help Luka as he puts Carol down in the snow)

KERRY:     What happened?

LUKA:     Vagal reaction to contractions…

(Camera pulls away as Luka runs the bullet. Cut to commercial break)

(Scene opens in admit, Carol is now on a gurney)

CARTER:     Did you get a BP?

LUKA:     She had a syncopal episode.

CAROL:     I'm fine.

KERRY:     How far apart are the contractions?

LUKA:     About three minutes.

CARTER:     Are the babies moving?

CAROL:     All day long.

RANDI:     What's wrong with her?

CARTER:     What do you think?

KERRY:     What's open?

RANDI:     Trauma room…

CAROL:     Oh, no, Kerry, please just take me upstairs to labor and delivery.

KERRY:     Carol, you passed out. I want to check your vitals and your cervix. Who's your OB?

CAROL:     McLucas. Please Kerry. Kerry, just take me upstairs.

KERRY:     Sure. In a minute. Malik! Could you page Dr McLucas.

MALIK:     Is he on the oncall list?

CAROL:     She. OB has it.

CARTER:     Do you want a fetal monitor?

CAROL:     No, no, no, no. She's just going to check me and then I'm going upstairs.

DAVE:     Hey, I could use some help, I've got two here.

KERRY:     Luka, can you help him?

LUKA:     Yeah, uh sure.

CONNI:     Should I call Mark?

KERRY:     He's off.

CONNI:     He's her lamaze coach.

KERRY:     Carol, do you want us to call Mark? Okay. Let's go, nice and easy.

(They wheel her into, what will, for ease of reference, be known as trauma one. The trauma room with Mrs Olson, the renal failure patient, will be known as trauma two)

(cut to Elizabeth's apartment. Elizabeth and Mark are taking a turkey out of the oven)

ELIZABETH:I hope it's done, I'm not used to serving this early in the afternoon.

MARK:     Well we need time to gorge ourselves so we can pass out on the couch.

ELIZABETH:It says a hundred and eighty.

MARK:     Hey, you didn't have to do all this. I mean, the two of them together can be a bit much.

ELIZABETH:Don't be silly. All families are eccentric in their own way.

MARK:     I guess. Okay everybody. Dinner is served.

RACHEL:     Hit me.

DAVID:     You have eighteen.

RACHEL:     Soft eighteen against your nine. Hit me.

MARK:     Dinner's ready you guys. Rachel, can you get the mashed potatoes?

DAVID:     Smells good.

ELIZABETH:I hope it's all right.

DAVID:     What's that on top there?


RACHEL:     Ew, on a turkey?

ELIZABETH:You don't have it that way?

MARK:     Rachel, I said mashed potatoes.

RACHEL:     I didn't think you celebrated Thanksgiving.

ELIZABETH:Well, it's not really my holiday, is it?

RACHEL:     The Pilgrims came here to escape persecution from the British.

ELIZABETH:Yes, so they could go about persecuting the Indians.

MARK:     Okay, everybody. Now. (he begins to carve the turkey)

DAVID:     I can do that.

MARK:     I got it, Dad.

DAVID:     I said I'll do it.

MARK:     Don't worry, Dad. Sit down, relax.

DAVID:     Mark doesn't think I can do things for myself anymore.

MARK:     Be my guest.

DAVID:     Did you tell her you want to put me in a nursing home?

MARK:     It's a retirement community.

DAVID:     A retirement community with nurses.

MARK:     Can we talk about this later?

DAVID:     It's all you wanted to talk about last night.

(they are interrupted by a crash, and the three of them run through to the kitchen, where Rachel has dropped the bowl of mashed potatoes)

RACHEL:     Sorry.

ELIZABETH:It's all right, I think I have instant.

(A pager goes off)

MARK:     Are you on call?

ELIZABETH:     No, no, it's yours. Let's clean this up, shall we?

(cut to trauma two)

LUKA:          Ready, and lift.

LILY:          Lungs are wet, some JVD, not making any urine.

LUKA:          Mrs Olson, why did you miss your dialysis?

MRS OLSON:     I was having my hair done.

LUKA:          Well, it's nice to look good, but your health should come first, huh?

MRS OLSON:     You think I look good?

LUKA:          Yeah, beautiful.

MRS OLSON:     It's for my birthday.

LUKA:          Today?

MRS OLSON:     Yes.

LUKA:          Happy birthday.

MRS OLSON:     Thank you.

LILY:          BPs 102 over 54, pulse 124.

LUKA:          Congestive failure, metcracal's halfway up

LILY:          You want lasix?

LUKA:     No. Start a nitro drip and call the dialysis unit. Can we call a family member?

MRS OLSON:     No, that's all right. Ow.

LUKA:          I'm sorry, I'm sorry. Sternal tenderness.

PARAMEDIC:     See, this is why idiots need to stop for ambulances.

LUKA:          Muffled heart sounds. Check for a pulsisperidoxis.

MRS OLSON:     Heart? What's wrong with my heart?

LUKA:     Mrs Olson, you are fluid overloaded from missing your dialysis. Some fluid is collecting around your heart, it's probably from the renal failure, but it could also be an injury from the accident.

MRS OLSON:     Oh, my.

LUKA:     Enalapril 1.25 IV push and get me an ultrasound.

LILY:     They're using it next door.

LUKA:     Then get me another one.

(cut to trauma one)

KERRY:     Carol, you're pushing, honey, don't push.

CARTER:     Doppel sounds good. Fetal heart films are 140.

HALEH:     BPs 112 over 70

KERRY:     Okay, it's over, the contraction's over. I'm going to check your cervix Carol, relax.

CAROL:     Kerry, what is it?

KERRY:     You're at ten centimeters, Carol. Fully effaced, two plastasian. Haleh, open an OB tray.

CAROL:     No no. Kerry, I don't want to deliver down here. I don't want to deliver in the ER.

KERRY:     Well do you want to deliver in the elevator?

CAROL:     How can I be ten centimeters?

KERRY:     You've probably been contracting all day. Call paeds, lets rotate the gurney and give her some privacy.

CAROL:     No, Kerry, I'll just hold it. I promise I won't push, I won't push.

KERRY:     Let's make a deal. We'll deliver this one down here, and you can have the next one upstairs.

CHUNY:     Okay, lift up your butt, Carol

CARTER:     Okay, I'm gonna need a fetal monitor. We can do the second one on the ultrasound.

CAROL:     Get out of here, Carter.

CARTER:     It's okay, Carol, don't worry about a thing. Give me some sterile gloves.

CAROL:     Carter, get out of here.

KERRY:     John, I got it, why don't you see if Dr Kovac needs some help?

CARTER:     I've delivered babies before!

CAROL:     Not this one.

CARTER:     Dr Weaver?

KERRY:     She knows you, she doesn't feel comfortable.

CARTER:     She just paged Dr Greene!

KERRY:     Yeah, he's not delivering. Get out!

CARTER:     Right, okay, good luck!

KERRY:     Okay, let's take the bed down.

(the camera follows Carter into trauma two)

LUKA:      15 of atomidate, 100 of sux

LILY:     BPs down to 80 systolic

LUKA:     Pericardiocentesis tray and get me an alligator clip

CARTER:     Need some help?

LUKA:     Yes please, intubate.

CARTER:     What is it?

LUKA:     Pericardial effusion, I can't tell if it's a trauma or the renal failure.

LILY:     Pressure's down to 70.

CARTER:     Number 8 ET tube

LUKA:     Push her up on the dopamine. Is she having the babies in there?

CARTER:     At least one of them.

LILY:     V-fib!

LUKA:     Charge the paddles. Carter, CPR, now!

CARTER:     What do you think it is, hyperkalemia?

LUKA:     Probably high potassium. Give an amp of calcium, clear!

LILY:     Still v-fib

LUKA:     300, now.

CARTER:     You want insulin and glucose?

LUKA:     Go ahead. And an amp of, uh, bicarb. Clear!

CARTER:     Nothing.

LUKA:     360. Come on, come on, hurry up, hurry up. Okay, clear.

(scene ends as Mrs Olson goes into normal sinus rhythm. Cut to Elizabeth's apartment, Mark is talking on the phone)

MARK:          Tell her I'll be right there.

ELIZABETH:     What is it?

MARK:          Carol's in labor.

ELIZABETH:     Is she in the hospital?

MARK:          Yeah, and I might miss the first one.

DAVID:     Who's Carol?

MARK:          She's a friend of ours. Uh, Dad, we gotta go.

DAVID:     Why?

MARK:          Well, I'm the lamaze coach, so I've got to talk her through it.

DAVID:     Where's the father?

MARK:          Dad, let's go. Rachel, I'm going to drop you guys off on the way. Come on.

RACHEL:     I'm hungry.

DAVID:     Me too.

ELIZABETH:     Mark, we might as well eat dinner.

MARK:          It could be a while.

ELIZABETH:     Well, I can drive them home.

MARK:          Are you okay with this, Rachel?

DAVID:     She's fine. Go coach. We'll eat.

ELIZABETH:     Here. Take a biscuit. Call with all the details: boys, girls, weights, lengths, all of that.

MARK:          You're sure about this?

ELIZABETH:     Carol needs you. We'll be fine.

MARK:          If they give you any trouble, just lock them in the closet.


RACHEL:     No turkey for me. Animal fat's bad for your heart.

DAVID:     Not today.

(cut to trauma one)

CAROL:     (is screaming loudly)

HALEH:     Push, push, push, push. Good, now Carol.

KERRY:     Okay, crowning.

HALEH:     Just keep breathing, honey.

KERRY:     Okay, Carol, I want you to push hard for ten seconds.


KERRY:     Ten, nine, eight, seven…

CAROL:     Count faster!

KERRY:     Six, five, four, three… Okay, okay. Just relax.

CAROL:     Is it out?

KERRY:     Not yet. Next contraction.

HALEH:     You're doing great, Carol.

CHUNY:     Did you plan natural childbirth?

CAROL:     Hell no.

CHUNY:     Bet you won't forget this Thanksgiving, huh?

KERRY:     Where's paeds?

CHUNY:     I paged them.

KERRY:     Somebody get Cleo in here.

HALEH:     Dr Weaver? Details on twin A.

CAROL:     What? No, let me see.

KERRY:     Okay, get the OB on call, and have L&D bring down a vacuum extraction.

CAROL:     Vacuum? No.

KERRY:     Carol, look at me. It's just for safety. The first baby's heartrate is down to 90, but we're okay over 80, all right?

CAROL:     Okay.

KERRY:     Okay, good. Let's go with a scalp electrode.

CAROL:     Oh, no, do you have to?

KERRY:     It just gives me more accurate monitoring, okay? You rest up. In two minutes you're gonna push this baby out.

(cut to trauma two. Mrs Olson is back in v-fib)

CARTER:     How much atrophine has she had?

LILY:     Two amps.

LUKA:     How long since the last epi?

LILY:     Five minutes.

LUKA:     Check the rhythm.

CARTER:     Asystole.

LUKA:     Okay, that's it. Time of death, 13:17. (the machines are shut off) Happy Birthday.

(cut to trauma one)

HALEH:     Good, Carol. Six, five, four…

CLEO:     How close is she?

KERRY:     She's there.

CHUNY:     Heartrate is 85.

KERRY:     Okay, the head's out. Hold suction. Don't push. Carol, don't push. Don't push, honey.

CAROL:     Is the cord around its neck?

KERRY:     Not anymore. Alright, here we go.

(we see Carol making faces and arching her back and generally giving birth, before hearing a baby cry)

     Take a look at your daughter.

CAROL:     It's a girl.

KERRY:     Yeah, it's a girl.

CLEO:     Congratulations.

CAROL:     Hi. Hello.

KERRY:     Okay, let's check the presentation on twin B.

CLEO:     That's mommy. Looks like about six pounds.

CAROL:     She's so little.

KERRY:     But that's a good sign for a twin.

CLEO:     I have to take her now, Carol.

CAROL:     She's healthy, right?

CLEO:     She's beautiful. There we go.

KERRY:     So have you picked out a name yet?

CAROL:     Tess. I think I'm gonna name her Tess.

CLEO:     Welcome to the world, Tess.

KERRY:     You did great.

(scene fades out on Carol looking at Tess in the baby warmer. Cut to commercial break)

(scene opens on a hallway upstairs. Abby Lockhart takes a drink from the water fountain)

ABBY:     Carol Hathaway? Hi, I'm Abby, I'll be your OB nurse. Heard you had a little excitement downstairs.

KERRY:     Ultrasound showed second twin is vertex and high.

ABBY:     Okay, just relax, Carol, we'll get you through this. Is the bag intact?

KERRY:     Yes.

SANDRA:     Hi, mom, I'm Sandra. I have to tag you and your baby before I can take her to the nursery, okay?

CAROL:     Can't she stay with me?

ABBY:     We'll warm her up, give her a bath, and bring her back, right after this one is delivered.

CAROL:     What if she gets hungry, I'm breastfeeding.

ABBY:     We can supplement a little bit.

CAROL:     Sure?

ABBY:     Yes, I'm sure. Here, I need you to scoot over a little bit.

KERRY:     Nice and easy.

CAROL:     Kerry, could you go with her?

KERRY:     Sure, I'll see that she gets settled in, okay?

CAROL:     Okay.

SANDRA:     35164.

ABBY:     35164, all set.

SANDRA:     Say bye-bye, mommy.

CAROL:     Bye, honey. Thanks Kerry.

ABBY:     Are the contractions still strong?

CAROL:     Well, they're a little spaced out, but yeah.

ABBY:     We'll do another ultrasound, but if the baby's high it could take a while.

CAROL:     Is Dr McLucas on her way?

ABBY:     Yeah, we're working on that. Do you want an epidural?

CAROL:     I can still have one?

ABBY:     Absolutely.

CAROL:     Well, if I wasn't sure before…I am now.

(Mark enters, with an inane grin on his face)

MARK:     Wimp!

CAROL:     Mark!

MARK:     Heard I missed the party.

CAROL:     Oh, god.

ABBY:     I'll call the anaesthesiologist.

MARK:     A girl?

CAROL:     Mmm, a girl.

MARK:     Troublemaker already? You hanging in there?

CAROL:     It's brutal, Mark.

MARK:     One down, one to go.

CAROL:     Uh-uh. I quit.

MARK:     I don't think you have much of a choice.

CAROL:     Well, you know, you could shoot me.

MARK:     Yeah. If it comes to that.

CAROL:     I'm sorry to pull you away from your Thanksgiving dinner.

MARK:     Are you kidding? I'd rather be here.

(cut to Elizabeth's apartment. They have finished dinner, and David is busy re-enacting World War Two)

DAVID:     D-day. Five beaches. The Americans take Utah. There, the potatoes. And Omaha, the squash. The Brits land here, at Juno, the stuffing, with the Knucks.

ELIZABETH:     The Knucks?

DAVID:     The Canadians. Are you with me?

ELIZABETH:     Yes, yes, yes, I'm with you.

DAVID:     All the heavy German resistance is concentrated on the American lines. Massive casualties are suffered by the Americans. Six thousand in the first day.

ELIZABETH:     Well the Brits had their share too, didn't they?

RACHEL:     Shouldn't the gravy go with the potatoes?

DAVID:     Fine. Now instead of pushing forward and cutting off the Germans at Caen, Montgomery, the British general…

ELIZABETH:     Yes, I know who Montgomery is.

DAVID:     Montgomery sat on his ass and had tea.

RACHEL:     I'm going to the bathroom.

ELIZABETH:     Well, the British were fighting the Germans for nearly three years before the Americans. Perhaps they were just a little more cautious.

DAVID:     Cautious is one word for it.

ELIZABETH:     I suppose tea-loving would be another.

RACHEL:     That's two words!

ELIZABETH:     It's a hyphenate, actually.

DAVID:     Well, anyway, the 86th Airborne Divisions…

(cut to OB)

CAROL:     Do you have to use a straight cath?

ABBY:     The epidural numbs your bladder, you won't control your urine.

CAROL:     Great.

ABBY:     Sorry, we do it for everybody. No catheter, no epidural.

MARK:     Seems like a small price to pay, Carol.

CAROL:     You're not my bladder.

DR BABCOCK:Are we doing this?

ABBY:     Carol?

CAROL:     Yes!

BABCOCK:     All right, all set.

ABBY:     Okay, Carol, you have to sit up.

CAROL:     Can't we do it on my side?

ABBY:     No, it's better upright when you're pregnant.

CAROL:     I'm a nurse, tell me why.

ABBY:          He needs a clear shot at the intervertebral space.

MARK:     Yeah, you don't want them fishing around. Okay, come on, up you go.

CAROL:     You better get it right the first time!

BABCOCK:     I generally do. If the patient cooperates.

ABBY:          Mark, is it?

MARK:          Yeah.

ABBY:     Could you grab her other shoulder? Okay, Carol, lean in to us. A little bit more, keep your back nice and round

BABCOCK:     And you'll feel a little prick.

DR COBURN:     Carol Hathaway? Carol, it's you.

MARK:     Dr Coburn.

COBURN:     Mark. I had no idea, congratulations.

CAROL:     No, he's my lamaze coach.

COBURN:     Oh. How are we doing?

ABBY:     High and intact, six centimeters.

CAROL:     Six?

COBURN:     It's all right, you shrink back down between deliveries.

CAROL:     I know, but six. Aah!

BABCOCK:     Need some more local?

CAROL:     No. Contractraction.

ABBY:     Just hold on, Carol, you're doing great.

COBURN:     Carol, Dr McLucas is in Witchita, she asked me to cover her practice over Thanksgiving, is that all right?

CAROL:     I need to lie down.

ABBY:     No, Carol, he's in the middle of it right now, you have to hold still.

CAROL:     I can't.

MARK:     Yes you can, yes you can, here, hold my hand. You're gonna be much better once we get through this.

CAROL:     It hurts, Mark.

MARK:     I know.

CAROL:     No, I mean it really hurts.

MARK:     I know, I know. Hang in there.

(cut to Elizabeth's apartment.)

DAVID:     One night, standing out on deck, he asked me for a light. I put my hand in my pocket and when I looked up he was gone.

ELIZABETH:     What do you mean, gone?

DAVID:     Gone. He'd fallen overboard.

ELIZABETH:     My god, did he drown?

DAVID:     If the fall didn't kill him.

ELIZABETH:     That's terrible.

DAVID:     Yeah. About the only thing worse than the working conditions on that carrier was the food. Probably took more men than anything.

ELIZABETH:     You mean worse than the English?

DAVID:     I was kidding. This is great, I haven't had a meal like this since…well, for a while.

ELIZABETH:     Since your wife died?

DAVID:     Yeah.

ELIZABETH:     I'm sorry. I can only imagine how difficult it must be.

DAVID:     Well, as difficult as you make it, I guess.

ELIZABETH:     What do you mean?

DAVID:     How's Mark? You know, dealing with it.

ELIZABETH:     In his stride, I suppose. To be honest, he doesn't speak of it much, and I've learned not to force the subject. There are certain things he carries inside. But you must know that.

DAVID:     Don't ask me. His mother was the only one who seemed to understand him.

ELIZABETH:     He's not that big a mystery.

DAVID:     Don't get me wrong, he's a good man. It's just that, with Ruth gone… I don't know. How about some pie?

ELIZABETH:     With his mother gone, what?

DAVID:     Nothing. Just seem to have lost a bridge, I guess.

ELIZABETH:     Maybe you both just miss her. I'll get some plates.

DAVID:     Hey, Rachel. Come get some pie. What's with her? She's been in there a half hour.

ELIZABETH:     I'll check. Rachel, are you alright in there? Rachel? Rachel, are you in there?

RACHEL:     (from inside the bathroom) Go away!

(cut to OB. Mark is flicking through the channels on the TV)

CAROL:     What are you looking for?

MARK:     I don't know.

CAROL:     Am I boring you?

MARK:     No. So, you want to just talk?

CAROL:     Sure.

MARK:     What do you want to talk about?

CAROL:     I don't know.

MARK:     Hey, the post-game show's on.

CAROL:     Woo.

ABBY:     How are you feeling?

CAROL:     I am in love with the epidural man.

ABBY:     You can call him the anaesthesiologist.

CAROL:     Oh, he will always be the epidural man to me.

MARK:     You know what, I'm going to go get a magazine. I should call Elizabeth too, she's probably crawling out on a ledge by now.

CAROL:     Hey, could you also call my mom?

MARK:     Sure. What do you want me to tell her?

CAROL:     Just what you told me. You know, one down, one to go. Her number's in my organizer in my bag.

MARK:     Is there anyone else you want me to call?

CAROL:     No, not yet.

MARK:     Are you sure?

CAROL:     I just wanna get through this first.

(as Mark is heading out, an alarm goes off on the fetal monitor)

CAROL:     What's wrong?

ABBY:     Nothing. Just loss of signal.

CAROL:     Well, where'd it go?

ABBY:     Hold on. (she and Mark start adjusting the monitors on Carol's belly) Sandra, could you call Dr Coburn and bring over the ultrasound.

MARK:     Right there.

ABBY:     Got it.

MARK:     It's above the umbilicus.

CAROL:     What does that mean?

MARK:     Baby could be rotating.

ABBY:     It's fine. Heartrate's 140. Do we have an OR, Claire?

CLAIRE:     I'll see.

CAROL:     Wait. I don't need a c-section, do I?

ABBY:     No, not necessarily, but if the baby turns breech we'll have to labor you in the OR.

MARK:     It's just a precaution, Carol.

CAROL:     Oh, man.

(cut to Elizabeth's apartment. Having determined that cable is not an option, David is trying to get the game with rabbit ears.

DAVID:     What's going on in there? She sticking her finger down her throat?

ELIZABETH:     I'm afraid she's having her first menstrual period.

DAVID:     Menstrual? But she's ten.

ELIZABETH:     It can happen at that age. It's early, but not abnormal. So, one of us needs to go to the store. Now do you want to stay with her, or shall I?

DAVID:     What do you need from the store?

ELIZABETH:     Sanitary napkins.

DAVID:     You don't have that…stuff?

ELIZABETH:     I only have tampons, it's not really the best for a young girl.

DAVID:     Oh. Right.

ELIZABETH:     Listen, there's a drugstore right on the corner.

DAVID:     Sanitary napkins. That's the flat ones?

ELIZABETH:     Ask the clerk.

DAVID:     What if he's a guy?

(cut to OB. Enter Mark, in surgical garb)

MARK:     How are we doing?

ABBY:     We'll move her right after this contraction. The baby's in lotus position.

CAROL:     (realizing that someone is putting a surgical cap on her) What's this for?

ABBY:     We have to prep you for the OR.

CAROL:     What, even if I'm not being operated on?

MARK:     Don't worry, I won't take any pictures.

CAROL:     Ha ha. Uh-oh.

ABBY:     What is it?

CAROL:     I think my water just broke again.

ABBY:     Sure did. Nice and clear. Right, we'll clean you up, once…

CAROL:     What?

MARK:     Baby's heartrate's in the nineties.

ABBY:     Carol, I have to check you.

CAROL:     But we're good till eighty, right?

ABBY:     Just relax, Carol, I have to check you again.

MARK:     What are you looking for?

ABBY:     Hold on. I have to wait until this contraction finishes.

SANDRA:     75

CAROL:     What's wrong?

ABBY:     Damn. She's got a prolapsed cord.

CAROL:     Prolapsed?

ABBY:     Yeah, the cord gets pushed down before the baby.

CAROL:     Cutting off the oxygen?

ABBY:     Page Coburn to the OR, please.

MARK:     All right, fetal heartrate's 65, we have to get this baby out now.

ABBY:     She's only six centimeters.

MARK:     All right, we'll have to crash c-section.

CAROL:     Oh, god!

SANDRA:     The OR's not clear yet.

MARK:     Yeah, we're going.

CAROL:     (to Abby, who is now straddling the gurney) What are you doing?

ABBY:     I'm keeping the baby off its cord.

CAROL:     This can't be happening, this isn't happening.

MARK:     Just try and stay calm.

CAROL:     Oh, my god.

MARK:     I'm right here.

CAROL:     Is the baby hypoxic?

MARK:     We're okay.

CAROL:     What's the heartrate?

MARK:     We're not on a monitor.

COBURN:     What happened?

ABBY:     Prolapsed cord, fetal heartrate 65.

COBURN:     Okay, scrub in, Abby.

MARK:     She's got her hand on the cord, get somebody else.

COBURN:     I've got it from here, Dr Greene.

MARK:     Don't let go.

COBURN:     Okay, do you want to assist on a c-section?

MARK:     Not really.

COBURN:     Then I need ten seconds for her to scrub in. Take over, Sandra.

MARK:     Okay,everybody, on my count, nice and easy, one, two, three. Keep your hand on that cord.

CAROL:     Mark, you've got to save this baby.

MARK:     We will.

CAROL:     No, promise me.

MARK:     I promise. Where's anaesthesia?

SANDRA:     I just paged them.

MARK:     Get anaesthesia down here now.

COBURN:     There's no time, she had an epidural. Keep 100mg of fentanyl standing by.

MARK:     I'll monitor her vitals.

CAROL:     Please save this baby.

COBURN:     Gloves, now.

MARK:     Okay, mom's BP 118 over 84, pulse 102. SATting at 98 on room air.

COBURN:     Okay, nasal oxygen.

MARK:     I'm on it.

COBURN:     One minute from skin to baby. Scalpel. There's skin. Mark the time.

MARK:     Don't worry, don't worry.

COBURN:     Come on, pull.

ABBY:     I'm pulling.

MARK:     Someone working on paeds?

ABBY:     They're on their way. Bladder blade.

COBURN:     Scalpel again. Uteran incision. Another stretch.

ABBY:     The paediatrician's here.

CAROL:     What's happening?

MARK:     I can see the baby.

COBURN:     Blue towel. Looks like a girl.

MARK:     Hear that, you've got another girl.

CAROL:     Is she okay?

MARK:     Hold on.

CAROL:     Please, God, please, please, please.

COBURN:     Shoulders…

CAROL:     Is she out?

MARK:     She's out.

CAROL:     Why isn't she crying?

MARK:     She will.

PAEDS:     I've got her.

COBURN:     How'd we do?

ABBY:          Fifty one seconds.

CAROL:     Mark, she's blue.

MARK:          She'll pink up.

COBURN:     Uterus is boggy, she needs Pit, twenty units.

CAROL:     What's the Apgar?

MARK:          Don't worry.

CAROL:     Mark, what's the Apgar?!

MARK:          Five minute Apgar's more predictive.

(cut to the lobby of Elizabeth's apartment building. David has a nasty looking forehead laceration and is sitting with the doorman)

ELIZABETH:     My god, what happened?

DAVID:     Damn ice, I slipped.

DOORMAN:     It was a pretty bad spill, I saw it from here.

ELIZABETH:     Let me see.

DAVID:     I'm fine. You should throw some salt down there.

ELIZABETH:     Do you know what time it is?

DAVID:     Yeah. Time my ten year old granddaughter started her period.

DOORMAN:     You got this?

ELIZABETH:     Uh, yes, thanks for buzzing me. Right. We need to get you to hospital and stitch that up.

DAVID:     Like hell. It will stop bleeding with a little pressure.

ELIZABETH:     That's a nasty gash. You need sutures and a tetanus booster.

DAVID:     What I need is a bandaid and a drink.

ELIZABETH:     Fine. Well if you sit still you'll even get a lollipop.

(cut to the OR)

MARK:          Five minute Apgar's 8, Carol.

CAROL:     Can I see her?

COBURN:     Hold on, we've got some active bleeding here. What's her pressure?

ABBY:          100 over 60.

(Enter Dr Babock, the anaesthesiologist)

COBURN:     What took you so long?

BABCOCK:     They just paged me.

COBURN:     Well, she delivered five minutes ago. Profuse bleeding, uterus is still boggy.

BABOCK:     How much Pitocin has she had?

MARK:          40 units in.

ABBY:          Another .2 Methergine.


COBURN:     No. More suction.

ABBY:          She's oozing everywhere.

COBURN:     Sponge stick. Take another pressure.

CAROL:     Oh my God. I'm bleeding out.

MARK:          There always looks like more than there is. How are we doing?

BABCOCK:     Pressure's down. 80 over 40.

MARK:          All right. Pop in some saline. I'll put in another line.

CAROL:     I want to see my baby.

MARK:          You will, Carol, just a little while.

PAEDS:     I'll take her to the nursery.

BABCOCK:     We're at 70.

COBURN:     Give me some - Type and cross for 4.

MARK:          Three litres are up.

COBURN:     Intubate. 2.5 IM.

SANDRA:     The blood'll be here in ten minutes.

ABBY:          We don't have ten minutes.

COBURN:     Open a hysterectomy tray.

CAROL:     A what?

MARK:          Hold on, are we there yet?

COBURN:     Carol, your uterus is atonic. It's not firming up, and you're losing a lot of blood in spite of all the medication we're giving you.

CAROL:     Don't do a hysterectomy.

COBURN:     We may not have a choice.

CAROL:     Don't, don't, please.

MARK:     What else can we do?

ABBY:     Uterus is still boggy, another 500ccs of blood loss.

MARK:     There must be something short of a hysterectomy.

COBURN:     Yes. Losing the patient.

MARK:     Can't you clamp off an artery?

COBURN:     Step out, Dr Greene.

MARK:     At least try. It's only thirty seconds.

COBURN:     It's thirty seconds she may not have.

MARK:     She doesn't want it. She's a nurse, she understands the risks. Respect her decision.

BABCOCK:     O-neg is up and ready.

MARK:     Hold the transfusion.

COBURN:     What's the pressure?

BABCOCK:     Systolic is 80.

(screen fades to white, then fades back in on the youngest twin yawning. Mark is holding Tess. Carol opens her eyes)

MARK:     She needs a name. Tess needs to know what her little sister's name is.

CAROL:     Is she alright?

MARK:          She's perfect. They are both perfect.

CAROL:     What happened?

MARK:     You gave us a bit of a scare, but you toughed it out. Yeah, you still have your uterus.

ABBY:          You're up. How are you feeling?

CAROL:     A little groggy.

ABBY:          Any pain?

CAROL:     Actually no. For the first time today.

MARK:          Drugs. Enjoy them while they last.

ABBY:     I wouldn't repeat this outside of this room, but you owe your friend here your future children.

MARK:     You know, they both came out so well, you gotta think about doing it again.

CAROL:     Yeah, I'm gonna get right on that.

MARK:          So what's her name?

CAROL:     Do you wanna name her?

MARK:          Me?

CAROL:     What was your mom's name?

MARK:          Ruth. (Carol makes a face) Middle name Katherine.

CAROL:     Kate. I like that. (phone rings) Kate.

ABBY:          Dr Greene, they need you downstairs.

MARK:          What for?

ABBY:          They brought your dad in for a laceration.

CAROL:     What happened?

MARK:          I don't know. I'll be right back.

CAROL:     Mark? Thank you.

MARK:          You did good, mom.

(Mark puts Tess down and leaves)

CAROL:     Can you, uh, call long distance on this phone?

ABBY:          I don't know, you might need a calling card. Where are you calling?

CAROL:     Seattle.

(cut to the ER. Elizabeth is suturing David's laceration)

DAVID:     You come in handy.

ELIZABETH:     Thank you.

DAVID:     How many stitches do you think?

ELIZABETH:     Six, maybe seven.

MARK:          Dad, what happened?

DAVID:     It's nothing.

ELIZABETH:     He slipped on the ice.

DAVID:     I would have caught myself if I hadn't been carrying such a big bag. How many different kinds of sanitary napkins do they make? Thin, maxi, mini…

MARK:     What is he talking about?

ELIZABETH:     Rachel started her period.

MARK:     What?

DAVID:     …wings, non-wings, scented, unscented; I had to buy every kind they had.

MARK:     Hold on. Can I talk to you for a second?

DAVID:     They couldn't just have regular.

MARK:     Rachel had a period?

ELIZABETH:     I was as surprised as you are.

MARK:     Where is she now?

ELIZABETH:     She's on the phone in the lounge talking with her mom. She wants to go back to Saint Louis.

MARK:     Why'd you let him go out in this kind of weather?

ELIZABETH:     You'd prefer I had left him alone with your menstruating daughter?

LUKA:     Excuse me, Dr Greene? Did she have the other baby? Carol Hathaway.

MARK:     Yes.

LUKA:     And what was it?

MARK:     A girl. Two girls.

LUKA:     And everything's all right?

MARK:     Everything's fine now.

LUKA:     Good. Thank you.

ELIZABETH:     Here. You stitch up your father, I'm going to say hello.

DAVID:     I like her.

(cut to Carol's room in OB. Abby is giving her a breastfeeding lesson)

ABBY:     Sometimes you'll have to tickle her feet to wake her up, because new babies can be sleepy. Wait until she opens her mouth really wide. That's it. Make sure her mouth covers the whole areola.

CAROL:     Aah. She's a baraccuda.

ABBY:     She's a natural. Now listen for the swallowing. You hear it? Okay, I have to go. Your postpartum nurse will take over from here.

CAROL:     You're leaving?

ABBY:     Yeah, you'll be fine. Congratulations.

CAROL:     Thank you so much.

ABBY:     You're welcome. You were very brave.

CAROL:     I don't know about that.

ABBY:     Oh. Trust me. Good night.

CAROL:     Goodnight.

ABBY:     Happy Thanksgiving!

CAROL:     Happy Thanksgiving.

(scene ends with Carol feeding one baby, while the other starts to cry. Fade to black. Ending credits)

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