Alone In A Crowd

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Kim: B+ | Grade It Now!
Alone In A Crowd

Ellie is getting a head CT when she wakes up. She wonders if she's dead, but then realizes that something's wrong because she can't open her eyes or move at all. The examining neurosurgeon tells Sam and Abby that there's no sign of a tumor, so it must be a clot. Abby asks if it's too late for TPA, and the neurosurgeon says that it can cause brain bleed if it's done after three hours. Given the timeline they have, it's too risky. Would they really let Sam observe this whole thing? Don't they need her down in the ER? Abby asks what the other options are. The neurosurgeon says that they can hope that collateral flow develops, and get her into physical therapy. He adds that the chances of a meaningful recovery aren't good. Almost as an afterthought, he says that they could also try "the MERCI." Sam doesn't know what that is, so the neurosurgeon explains that they would use a catheter inserted in the groin to retrieve the clot. Abby asks if it reverses the stroke completely, and the neurosurgeon says it has risks, and that they would need the family's consent.

Ellie is moved out of the CT machine as she screams inside her head that she's blind and begs for someone to help her. Sam, Abby, and the techs move her to the gurney. Sam and Abby start to take her vitals in preparation for transport. Sam asks Abby if she's ever asked Luka about his kids. Abby says she did once. Sam starts to explain the situation, but she stops when she notices that Ellie is crying. A monitor starts beeping because Ellie's heart rate and blood pressure are rising. Sam asks what's going on, and Abby asks when they intubated. Sam says it was ten minutes ago. Abby says that she thinks the etomidate wore off before the sux, so Ellie is conscious but paralyzed.

Shane helps the paramedics wheel in a young African-American male who got hit with tear gas when a non-violent demonstration turned violent. Malarkey grabs the chart as the patient says that he was just picking up his grandmother's medicine at the pharmacy and got stuck in the middle. The paramedic reports that they have other victims coming right in. Malarkey guesses that the mob torched some cars and broke some glass. Shane says that the patient has good vitals after four of morphine. The patient says he still has pain and asks for more, and Malarkey replies, "Soon as we can make sure you're actually hurtin', dude."

Susan and Luka overhear that last bit, and Susan asks disgustedly if Malarkey actually just withheld pain meds. Luka thinks they can remove him from the Chief Resident short list, but Susan says it's too late because he's officially applied. She runs down a list of the other candidates, but Luka has reasons against all of them. Susan thinks the pickings are slim. Luka brings up Pratt, and adds that he's the best they've got. Susan says she has "serious caveats." Luka points out that students and interns already go to him with their questions, but Susan says, "Doesn't make him a leader."

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