ER
The Domino Heart

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The Domino Heart

Get a job, Shania. You too, Maury.

Carter and Chen, soaked from the water pouring out of the truck, and Mark follow Curt into a trauma room. Carter says Curt will need a couple of chest tubes; Mark announces that he'll intubate and tells Michael he needs to wait outside. Michael watches through the trauma room's window as the team gets ready to do a thoracotomy, and Mark asks, "He just backed into him?" and Carter says incredulously, "Yeah -- actually pinned him up against the water trough." Well, that answers that question, but it brings up a new question: the captioning says "trough," but I heard Carter say "truck." Whatever. The team tries to relieve the pressure on Curt's insides, but the ThoraSeal doesn't work, as Chen explains, because the suction is generated by the flow of water, and since they don't have water, they don't have suction. Curt's blood pressure and pulse ox continue to drop, and he goes into cardiac crisis as Chen and Carter jury-rig a suction device using the maintenance guy's wet vac and a bunch of sponges. The device works, and Chen and Carter give each other "nice going" looks; Mark nods at them, "Good save." See? See how well they work together? Any bets on how long it takes them to get naked? I give it two more episodes. ["Two more episodes and a bottle of peroxide, maybe." -- Wing Chun]

From outside Valerie's room, Lucy watches Peter examine Valerie as ominous strings hum in the background. Romano bustles around a corner; Lucy begins, "Dr. Romano," but he blows her off tersely: "Just a second, Ms. Knight." He goes into the room to talk to Peter. Lucy heaves a sigh. Although we can't really hear what they say on the soundtrack, the captioning says, among other things, that Romano asks, "Spontaneous respiration?" and Benton answers, "No. No brain stem activity." Romano thanks Peter and leaves the room, and before he can even close the door behind him, Lucy says flatly, "It was a stroke." Romano says yes, and that their attempts to open up the blocked vessel failed. Lucy asks if Valerie can recover. "The truth?" Romano asks, then says more gently than usual, "She's in a permanent vegetative state." Angry with herself, Lucy says, "It was the L-VAD, wasn't it? Threw a clot to her brain," but Romano tells her not to blame herself: "This was not your fault. I'm the one that put the thing in, remember?" Almost tenderly, he continues, "We make these medical decisions all the time, nothing's risk-free." Lucy stares at him for a moment before casting her eyes downward and muttering, "I'd better go talk to her mother." Shouldn't a doctor who's actually graduated from med school talk to the family? Just wondering. Romano tells Lucy to hold up a minute: "UNOS has identified a potential recipient in Milwaukee." Lucy, softly: "What are you talking about?" Romano explains, "A domino heart procedure -- we take out Valerie's new heart and give it to someone else who needs it. You need to get consent from the family." He hands her Valerie's chart. Lucy looks downright disgusted by this and says numbly, "But she'll --" Romano cuts her off as he hands her a pen: "She is already dead, Ms. Knight." Lucy stares at him, mutely takes the pen, and zombie-walks out of the room.

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