This episode of Chicago Med was one that not only showed the realism of the negative impact from disruptions when any essential team members at the hospital are absent, but also we saw a lot about managing risks, whether fiscal, political, patient and family related or related to personal choice and patient rights.
Dr. Charles, Liliana, Dr. Cuevas and David Sullivan
Dr. Charles is supporting Liliana and the housekeeping staff who are on strike on his day off and picketing. This was such a sweet scene, where you can see that despite his role in the hospital, Daniel wants to be there on his day off to support the person he cares about.
David Sullivan is brought into the ED with his parents and Dr. Asher meets the ambulance. They say he is not eating or drinking and he has stopped taking his meds. They call in Dr. Cuevas because she has seen him in the past. David says he does not want them to check him out because he is dead. He says he is dead because they made him take medicine. Despite her best effort to establish trust by not challenging his delusions, Dr. Cuevas does not seem to be able to make any progress with David. This was certainly sad to see as she has definitely developed over her time with Dr. Charles and certainly is a much more effective psychiatrist than she was at the beginning of the season.
David also is over 18 now and therefore is responsible for his own decisions and he is refusing to take any medications. Dr. Cuevas goes to get Dr. Charles. We then see Dr. Charles use his amazing knowledge and skill to connect with David in his delusion and build trust, and use his delusion to help suggest David to try ECT. His parents are very concerned but Dr. Charles reassures them and he and Hannah deliver the treatment. Afterwards David’s symptoms are improved and he seems to potentially have found a good treatment solution. Dr. Charles is certainly such a unique and special character, and is portrayed so beautifully by Oliver Platt. It is such a treat to see a physician who is so skilled at listening and connecting with people and truly meeting them where they are at and helping them navigate the best way forward. If only Dr. Charles was a real person…certainly we would all line up to see him.
Afterwards, he goes out to see Liliana and she and her friends are going to celebrate the strike being settled and she says he has to go because he is her boyfriend. His reaction to this comment was so adorable, and clearly he is very happy for her to be formalizing their relationship.
Dr. Halstead, Dr. Song, Doris and Walter
Walter comes in and is diabetic and has had a fever. He has just returned from a trip and says he is happy to have a hospital he can trust with his chronic conditions. Dr. Halstead starts to treat him for an infection in his ankle and then he gets an itchy red rash on his upper back. Dr. Halstead and Dr. Song try to diagnose what it is and are concerned it is a more rare infection, as there was a reported case near where he was hiking.
Will is talking to Doris when he notices her scratching and he sees a rash on Doris’ neck that is the same as Walters, but she says she has been changing beds and turning over rooms and has not been near his patient. Dr. Halstead realized what the rash is and takes a picture to send to Goodwin of eggs from bed bugs in the laundry because the temporary custodial staff are not properly cleaning.
They give Walter some cream for the itching but he is upset and says the hospital is certainly not what it used to be. Goodwin comes down and Will tells her that the patient is upset, and she tells him that the contract is settled and the housekeeping staff will be back tomorrow. However this is little consolation to Walter at this point.
This really shows the importance of the cleaning needed to keep patients safe in the ED, and I personally would be horrified if a situation like this happened at a hospital where I was a patient. Sharon was absolutely correct that the negative impact not only to patient care, but to reputation and potential media issues were absolutely a huge risk when it came to the work disruption at Gaffney.
Dr. Marcel, Maggie and Abby Hawking
Abby Hawking is brought in by helicopter. She had caught her leg in some machinery while working on the family farm and she arrives with Dr. Johnson, her local doctor, who was also once a flight paramedic and is staying with her until her parents can arrive. Dr. Marcel takes her to OR 2.0 as he feels using the diagnostics in there will be quicker than getting all the separate scans she needs to diagnose everything that is going on. Dr. Crockett feels that he will have to amputate her foot due to low blood flow. However, during the surgery, the vessel spasm in her leg relaxes and the blood flow improves and Dr. Marcel is able to save her leg and foot.
Crockett feels that her accident is the result of neglect or abuse and he reports it to DCFS. Maggie tells Madeline (from DCFS) that she will track down Dr. Marcel and call her when she finds him and goes to speak to him in the OR. She tells him perhaps he needs to get more information first, as once an investigation starts, families can be pulled apart for no reason, but he seems determined to report his concerns. When her parents arrive after the surgery and he learns the full story, and that her father had told her to stay back and she chose not to listen, Dr. Marcel realizes that he was wrong. Madeline comes back and Dr. Marcel tells her that he did not have all the information and that he was sorry to waste her time.
Clearly, while he had good intentions, Dr. Marcel learned an important lesson that jumping to conclusions, even when you have good intentions, can be a recipe for disaster. Crockett has always been very protective of pediatric patients, perhaps related to the loss of his own infant daughter, so perhaps he has still not moved past wanting to save every sick child (like he could not do for his daughter) and having these feeling clouds his vision. It will be interesting to see if he is ever able to take a more balanced approach with a pediatric case in the future.
Goodwin, Jack Dayton and Dr. George Thomas
Goodwin tries to convince Dayton that he needs to settle the strike because it is negatively affecting patient care but he will not budge so she goes to Dr. Thomas to try to convince him about the patient care concerns she and the staff are seeing. She gets the text message and picture from Halstead and shows the picture to George and he goes to talk to Dayton to help him understand what is at stake in the way of patient and reputational risk. Ultimately the strike gets settled and staff will be back to work tomorrow.
It was lovely to see the relationship between Goodwin and Dr. Thomas growing and that he seems to be a really great addition to the Board. And after all she has been through, it would be lovely to perhaps see a little bit of romance blossoming for Sharon in the future too…we will just have to wait and see.
Sean, Dr. Archer, Dr. Cuevas and Deana
Dr. Archer is having coffee with Sean and he is following his steps and tries to make amends. He asks about his mother also and if Dean has any contact with her and Dean leaves abruptly. It is quite clear from this interaction that his wife is a real area of tension for Dr. Archer and definitely something he keeps very guarded.
Deana has been vomiting and nauseated for a while and also very little appetite and has lost quite a bit of weight. She says she has been stressed out because her daughter Olivia has been staying with her and has been ill for a while. Based on her test results, Dr. Archer has to take her to the OR and removes a huge bezoar from her stomach which is a big ball of hair, and he calls Dr. Cuevas to consult. However Deana absolutely denies that she has been eating her hair and become angry.
Her daughter arrives and she is bald from chemotherapy and tells them that she has breast cancer. Dr. Archer and Dr. Cuevas seem to think they know perhaps what is going on after speaking to Olivia and when they speak with Deana, they find out she has been eating her daughter’s hair as it fell out because it made her feel better. She tells her daughter what has been happening finally. This was such a great example of how when family members become ill, the stress of that illness can also have significant effects on the family members who are caring for them. It was also interesting to see how the stress manifested so differently for this woman based on what was the unique situation was in her home. Truly, this is an example that how stress and anxiety present will always be unique to the individual.
Dean goes to see Sean where he is living and tells him about what happened with his mother and how that affected him and that he is sorry that he wasn’t there for him. Sean tells him he is there now and they hug. This was such a beautiful scene, as it is so rare until this season to see any true emotion from Dean Archer. Perhaps the new relationship and respect he has developed with Dr. Asher has also allowed him to be able to start to tap into some of his emotions, and now he is able to start to show some of them and know that is okay, and allow him to reconnect with Sean. It will be exciting to see if we will finally start to see a more compassionate and kind Dr. Archer…although we likely need to prepare ourselves for a slow progression based on past experience with Dean. But considering he has been the doctor we have all loved to hate for some time, any positive change would like be welcome.
What did you think of this episode of Chicago Med? Share your thoughts in the comments below.
