Sam patches up Thomas while Wendall assures him that no one will be mad at him if he tells them what happened. Sam tries to encourage him to speak up. Thomas opens his mouth, and then looks at his brother and shuts up. After a moment, Thomas says that he was climbing the fence at school and he slipped and hurt himself. He says that he didn't want to admit it because he ripped his shirt, which belonged to his brother, Casey. Wouldn't someone notice a bloody, ripped shirt? Like a teacher or something? The Stepmonster starts to get mad, but Casey assures her that he doesn't care about his shirt. Wendall watches them argue, and then asks to speak to Thomas alone. The Stepmonster asks if it's "absolutely necessary," because she really needs to get to work. Sam points out that they can't leave until they get the results of the strep test anyway. Wendall gets a page and leaves, promising to return.
Abby examines Mrs. McDow and says that she has "a right bundle branch." Jake assures the patient that it's pretty common, since he has it too. He adds that he also has "an aberrant re-entrant conductance pathway." Abby jokes that it explains a lot. Jake says that his EKG is "kind of wild." Haleh brings them back to the present by asking a question about treating, you know, the patient in front of them. Abby tells Mrs. McDow that her EKG is consistent with ischemia, meaning that her heart muscle isn't getting enough blood. Mrs. McDow is worried, and Jake says they'll check another EKG to see if it's progressed. Mrs. McDow thanks him.
Abby walks out of the room. Susan tells her that she's asking all of the residents to keep track of the amount of time spent on each patient. Abby asks if she's thinking of switching to an automated system. Susan says she'd like to if they had the money, and then asks Abby to get everyone on staff to fill out some forms and collect them when they're completed. Susan unloads a giant stack of folders on Abby, and walks off without waiting for a response, probably wisely.
Carter sneaks up behind Susan and asks what the time survey is about. Susan says she's applying for an informatics grant from a pharmaceutical company. Carter gets his knickers in a twist, because he thinks residents should be treating patients instead of doing free research for drug companies. Susan says that might be possible if someone hadn't dissed a drug company on television. Carter insists that he was right. Susan explains what the drug companies' money can do for the hospital, as well as how screwed they are without it. Carter snips, "So you're just going to go to another drug company? Can't we be a little more creative than that?" Oh, whatever, Richie Rich. If you feel so strongly about it, why don't you ask to be considered for Susan's job, and come up with your own creative solution to the problem? Or better yet, why don't you just give the hospital a grant from the Foundation of Carter's Enormous Inheritance? He's such a bitch. Susan says that drug companies are pretty much County's only chance. Carter thinks the money carries strings, and represents "a serious conflict of interest." And while I'm sure he's ethically in the right, his superior attitude and condescending delivery are mega-annoying. Susan agrees sadly, "Yeah. And I never thought I'd be kissing corporate ass when I went to medical school. Welcome to adulthood." Carter isn't ready to give up, and says, "We owe it to our patients." Susan agrees: "To keep our doors open." Carter smugs that this compromises their independence. Susan, fed up, says, "Oh, you know what? Most of us had to make compromises just to get through med school and residency. That's probably a foreign concept to someone who's never had to worry about money a day in their life. It must be nice." Yeah! Exactly. You go, Susan. Unfortunately, Carter is still all smirky, and also wearing corduroy pants, like, when did he become a middle-aged college professor? Wasn't there a time when Noah Wyle was supposed to be one of the hospital's resident hunks?