Pratt continues to do compressions and calls for more medication. Carter tells Pratt to hold compressions. The monitors start beeping. The parents look on sadly. Carter calls the time of death. Thomas's dad says, "Please." Everyone looks upset. Pratt resumes compressions and says that Thomas still has a rhythm. Carter says that it's "a non-perfusing rhythm at a rate of 28," which means that the heart isn't pumping strongly or quickly enough to move the blood through all parts of the body. Should I be worried that I'm really starting to understand the medical jargon, to the point that I'm starting to make diagnoses of family members based on this knowledge? Probably. Pratt isn't ready to give up. Carter points out that it's been forty-eight minutes of cerebral hypoxia, meaning that Thomas hasn't been getting oxygen to the brain. Sam and Malarkey list off all the medications they've pushed, but Pratt won't stop the compressions. Carter gently puts his hand over Pratt's and says, "Greg. He's fixed and dilated with a pH that's not compatible with life." Thomas's dad and the Stepmonster start sobbing as Carter extends his condolences. Sam switches off the monitor. Outside, Wendall tries to comfort Casey. Pratt walks off, blinking back tears.
Susan walks into the lounge, where Abby announces that she was just about to turn in her med-student evaluation. Susan asks, "How's it going with him?" Abby says he's thorough, with good knowledge, and Susan says that's not what she meant. Abby blinks and says she didn't get to the surveys. Susan sighs and says that they're so screwed at this point, it probably doesn't matter. Abby asks what's going on, and whether this is really all because of Carter's press conference. Susan says that if one drug company pulls funding, the others will follow suit, because they "don't want to be associated with a department that overreacts to a post-marketing surveillance." Abby says that Admin always seems to find a way to keep the ER open. Susan says she could lose her job. Abby thinks that's ridiculous. Susan says that her tenure's up for review and she's way short. Abby says that they made Susan department head, and that she's proved her worth. Susan yells that the committee is only concerned with how much money she brings in, and that she has to bring in $100K even to be considered. Abby is surprised that there's a quota. Susan says that if you don't bring in the cash, you're out, and pharmaceutical grants are an easy way to raise money fast. Susan's beeper goes off, and as she walks out, she says that she can't lose her job, especially now that she has Chuck and Cosmo to support. And God knows that Cosmo will still be living at home in thirty years, since no self-respecting woman (or man) would date him with that name.