ER Episode 15.19 Old Times

On a wintry day, a 17-year-old woman rides the El with a coffee-colored baby in her lap. Determined but nervous, she debarks the train, walks through the ambulance bay into the waiting room and knocks on the glass window. Chuny tells the young woman to hang on, but she's adamant: the baby is dying. The young woman tells Banfield that she found the baby in the vestibule of her apartment house.

Banfield, Morris and a nervous Daria get busy checking out the baby boy, putting him into an infant warmer. Someone tied his umbilical stump with a string, but it's clean, though his fontanelle is sunken. Thinking the baby is surely dehydrated, Banfield turns to ask the young woman if there was a note, but she's nowhere to be found. The team swings into action as the baby starts seizing.

Carter wakes up to the slam of breakfast on his tray table. A curt Dr. Claypool enters to take stock of Carter's condition, cutting off all his questions. After informing Carter that he'll probably be discharged this afternoon, Claypool hurries off. Carter is just about to take a swig of his coffee when rude and imperious Dr. Kurtag blows in with his transplant team. UNOS may have located a kidney, and Carter is not to eat or drink anything in anticipation of possible surgery.

Carol Hathaway enters a room filled with teams waiting for the organs of a 16-year-old hit by a drunk driver. Nurse Hathaway lets them know that there is a holdup. The grandmother of the victim originally gave permission for organ donation, but when she went to see him and squeezed his hand she got a "spinal cord reflex" which made her think he was squeezing back. Dr. Ross, attending physician at Seattle Hospital, enters to alert the team that he will be conducting a few tests on the boy and for everyone to sit tight.

Carol visits the grandmother. Billy's test results should be back soon, but Carol warns her not to get her hopes up. Even if Billy squeezed her hand, it was probably a spinal cord reflex. All the other tests indicate no brain stem activity. Back at County, Daria wonders why the baby is seizing. Morris prompts her to think of the answer herself, but Banfield suggests it's a rare case of inborn errors of metabolism. When tests indicate low sodium levels and dehydration, Banfield decides to correct sodium levels slowly, so as to avoid brain damage.

Brenner finds Lucy doing her homework at Joanie's side, and delivers the news that a new heart is on its way. When Lucy remains silent, Brenner advises her to act like she's running a marathon: one step at a time, one day at a time, and some day, she'll finish the race. Meanwhile, the baby perks up after hydration and starts crying hungrily. Haleh hands a bottle to Morris, who hands it to Daria. Impatient, Banfield grabs the bottle and starts feeding the baby, who grasps her finger and holds on for dear life.

Sam and Neela wait for Joanie's heart at the Seattle hospital. Carol stops by to ask if they'll transport a kidney, which just got matched to a patient at Northwestern. Dr. Ross shows the grandmother the test results from her grandson, which shows that he is in fact brain dead.

Carter is hungry and thirsty, but Kurtag will only allow him to have ice chips. The kidney has been delayed, but Kurtag brusquely informs that he has no other information. He many not even transplant today since the kidney will last two days once it's removed from its donor. Carol and Dr. Ross speak in the hallway regarding the boy's situation. The grandmother won't sign off on the donation until she can reach his mother, which has delayed the process further. Dr. Ross then grabs a cup of coffee and chats with Neela and Sam about his time at County.

A nervy Daria moans to Gates about missing a diagnosis which should have been obvious. As an ambulance rolls in, Gates encourages Daria not to be too hard on herself, then tends to elderly Marjorie, an 84-year-old MS patient, who's been vomiting with fever for two days. Marjorie's husband Paul explains that she doesn't talk much, but she's still sharp as a tack. He's been gently attending to her every need at home.

Carter is chowing down on ice chips when an old friend enters his room. Benton saw Carter's name on the board and figured he would check in on him. Carter asks if Kurtag is any good, and Benton allows that he's well trained, but a bit nasty. The guys catch up; now that Reese is 13, Benton has moved back to the city with Cleo to work at Northwestern. Carter explains that he's married "in theory" with no children. Benton takes off to tend to a hernia case, promising to stop by later.

Carol fills Dr. Ross in on the latest family dynamics. Apparently the boy's mother split about six or seven years ago. She was addicted to meth and the family's neighbor doesn't think the grandmother has seen her since. Dr. Ross speaks to the grandmother, shows compassion and eventually she agrees to donate her grandson's organs. They remind her that this will change the lives of several people.

The grandmother takes a moment to say goodbye to her grandson before they take him in to harvest his organs. It's a touching moment that is not lost on Dr. Ross or Carol.

Gates informs Paul that Marjorie has a urinary tract infection which has spread to her kidneys. She needs to be admitted for intravenous antibiotic treatment. Paul knows that Marjorie prefers to remain at home, and Gates promises to see what he can do. Daria lays into Gates for letting Marjorie leave with an infection that's treatable. Gates maintains that Marjorie and Paul know what they're asking. If Marjorie wants to die at home, who are they to say she can't?

Liz Dade meets with Banfield. She's started a search for the parents of the baby boy. If no one shows up in time for discharge, the baby will go to a foster home. Is Banfield willing to be the baby's protective custodian while he's in the hospital? Banfield shakes her head no, but says yes. Back in Seattle, Neela and Sam run for the airport, transplant organs in hand. When they reach the hangar, they're amazed to find that their plane is gone!

At the flight counter, attendant Kennedy explains that there are no planes available. She can try to get a flight crew together, but they won't show up for about three hours. Hoisting her heart on the counter, Neela explains that she only has eight hours to transplant it into a dying woman's chest. Kennedy rushes Sam and Neela to the runway, and puts them on a plane with a reggae band.

Benton returns to hang out with Carter -- where are Carter's friends and family? Carter admits that his parents are in the Bahamas, and they got rid of their private jet. When Benton asks about his ex, Carter explains that Kem isn't his ex-wife yet, and is in Paris tending to her sick mother. Suddenly, the transplant team rushes in to bundle Carter off to surgery. Benton can't resist tagging along. Back at County, no one says a word to Lucy as her mom Joanie is wheeled away for her heart transplant surgery.

In the elevator, Benton advises Carter to call Kem. With Carter on his deathbed, she could swoop in to be by his side, very romantic. Jokingly, Benton promises to stick around for the surgery to ensure that Kurtag gets all the sponges out. Fully prepped, Carter lays in the operating theater, but no one knows when his kidney is arriving. Carter whines about being cold and exposed, and Benton tells him to stop being a baby. When Kurtag finally enters in a rush, Benton claims that Carter asked him to observe.

Benton insists that Kurtag run through the safe surgery checklist. Kurtag is rude and impatient to start the surgery, but Benton presses on, discovering that the nurses lack reperfusion solution. Kurtag claims they won't need it, but the scrub nurse sends for some anyway. Back at County, heart transplant Dr. Stofsky is doubtful. The heart isn't in such great condition, and they're almost out of time. Neela suggests a surgical workaround; if they leave Joanie on ECMO any longer, she'll die.

Kurtag is about to close Carter up, but Benton interrupts -- shouldn't the transplanted kidney be pinking up? Alarms sound. There's a clot in the renal artery. Kurtag needs to remove the kidney, eliminate the block and start over. Now the kidney needs to be flushed with heparin and reperfusion solution. Luckily, the scrub nurse has it in hand; had they not run through the surgical check list, it would have taken 15 minutes to get the solution, and the kidney would have died.

It's been over nine hours, and Joanie's heart is finally being transplanted. Everything looks good, but the heart fibrillates, and Neela has to shock it several times. Banfield spies the young woman, who has returned to stare at the baby boy. Relieved that the baby is okay, the young woman turns to leave. She tried to take care of her son, but she just can't. Banfield begs the woman to stay, offering to help, but she runs off, asking Banfield to make sure the baby has a good home.

Lucy is just panicking that Joanie's surgery is taking too long when Neela arrives with good news. Joanie is conscious and Lucy can see her now. Lucy is overjoyed to be able to say hi to her mother. In tremendous pain, Carter opens his eyes, grateful to see Benton doing charts at his bedside. Benton smiles, holding up Carter's catheter bag, full of 800cc of liquid gold -- the surgery was a success! Carter tearfully asks Benton for his cell phone and calls Kem with the good news.

Carol gets a call at home while in bed. It's Dr. Ross, letting her know that the heart transplant successfully saved a woman and that the kidney went to a doctor.