S02.E14: Cold Front

[WendyCR72]

Based on the description, I am getting a serious ER "Blizzard" (from S1) vibe here, but we'll see:

The doctors and nurses of Chicago Med brace for an influx of trauma patients when a pre-dawn pileup finds the hospital in full scramble mode. With Dr. Rhodes and Dr. Latham handling duties in triage, difficult decisions are made. As a result of the storm and emergencies, supplies become limited and Goodwin, Dr. Manning and Dr. Halstead must deal with making an impossible decision. Meanwhile, Dr. Choi handles a severely burned patient who has one final request. Dr. Charles deals with an agitated patient who makes his presence known in the waiting room.

[BooksRule]

I was curious as to why they waited so long to start a blood drive.  As soon as they said something about having to use the personnel that were already there, and would have to make do with the supplies on hand, and they were expecting lots of seriously injured people coming in I would have thought that the idea that they might need some extra blood would cross someone's mind.  Or, at least as soon as they had to make a decision about who would get the blood I wondered why they didn't start asking all of the people just milling around to give blood.  

For some reason, the whole scene with the patient who faked his suicide and Dr. Charles really gave me a huge sense of deja vu.  I don't know if I saw a similar scene on another show or what, but it was a weird feeling that I had seen that entire scene (minus Reese) before.  Really odd.

The whole storyline with Dr. Choi was so sad.  

[LittleIggy]

This show had me crying again with that poor burned man trying to stay alive to say goodbye to his wife. OMG, when he reached up to touch Dr. Choi's arm to tell him it's okay to stop...

That poor woman who now thinks she's a bad mother because of what her asshole husband said! 

I agree about "why didn't they start a blood drive earlier."

Where was the Troll?

[NJRadioGuy]

And this episode is why I could never work in the E.D. I had to safeword on the burn vic. Not a bad episode overall but the squick factor was higher than I liked, and I can generally take a lot.

[Dowel Jones]

In addition, I rather wondered why it took 9+ hours to get supplies in to the hospital (Pre-dawn accident, burn victim died at 3:30pm). 

I'd like to buy Dr. Charles a drink.  That Xanax prick deserves a 72 hr. hold, in addition to a PD investigation for making a false report.  Even if it isn't chargeable, a suit should talk to him. 

[Driad]

Did both boys actually have type O negative blood? I didn't hear one way or the other. In an emergency you can start with O neg but someone should have tested their actual blood types. 

[NJRadioGuy]

2 hours ago, Driad said:

Did both boys actually have type O negative blood? I didn't hear one way or the other.

That was the whole storyline. Both were O-neg, which I imagine is a zebra situation. Rh- blood types are only supposedly 15% of the population. With two children in urgent need there's no way it would take 10-15 hours for someone to get donations set up. I can imagine the PA announcement, too: "We have two critically-ill little boys with life threatening conditions, and we desperately need two or more units of O negative blood. due to the storm, we cannot get an outside blood supply. Please come to room X on the first floor to donate." You'd have 'em lined up out the door and halfway to O'Hare in 2 minutes because that's what real people do when kids are sick.

Now that said, I don't care how bad a snowstorm is, even at 3" per hour, any decent Jeep with a skilled driver can navigate those conditions and deliver much-needed supplies. Might be delayed due to traffic, but if you know the city you can get through. I'm sure a nearby hospital could have gotten some blood over, but then what fun would that be.

Edited February 17, 2017 by NJRadioGuy

[SunnyBeBe]

I missed some of this episode, but, did see the part about removing the burn victim from the respirator.  Did they discuss the legality of this? Man, it sounds really outrageous.  I am not one who normally supports keeping people who are brain dead on life support, but, this was not the case. What gave them the right to remove life support from a conscious patient who wants to live, at least for another few hours?  I mean an emergency.....that guy had an emergency too.  That just ticked me off and I would not have participated. 

I really prefer that the show stick with events and cases in the hospital.  All this out of the hospital catastrophes really annoy me.  You'd think that with so much experience, they'd be prepared, instead of always being so ill prepared. 

[Dowel Jones]

Most tv hospitals spend so much of their time putting out bush fires from the interpersonal relationships that they don't have any time for disaster preparedness. /snark. 

That's a good point about the legality of removing the ventilator.  In any case, Dr. Choi could have found someone else to do the manual ventilation.  That doesn't require an MD and it would have freed him up.  I realize that he feels ultimately responsible for the patient's death, but he should have directed the wife to go ask the triage doctor (forgot his name) why it was done that way.  That guy needs more experience in people skills.

[bounnatalie]

Spoiler

 

Was it plausible that they would put a patient under anesthesia and then stop the surgery? I would think it would be more dangerous to put the patient under anesthesia twice. Also, they must have more than a couple of OR's.

[starri]

I don't know why they didn't try to BiPAP the guy first.  I don't know that it necessarily would have bought him more time, and it would have robbed us of the scene with the patient telling Ethan it was okay to stop.  That part of the story really got to me.

7 minutes ago, bounnatalie said:

Was it plausible that they would put a patient under anesthesia and then stop the surgery? I would think it would be more dangerous to put the patient under anesthesia twice. Also, they must have more than a couple of OR's.

I actually have seen that happen.  Not because they needed the space, though.

I do love a good mass casualty episode.  It's something that's a lot more fun to watch on a screen than to live through.  We had a mass casualty (or, we call it a Code Green) drill a few days ago.  When they called the code, they neglected to announce that it was a drill, so half the doctors in the hospital ran for the trauma bays.  I know it sounds exciting, but we were doing it as a mass shooting, and some of the makeup they had on the actors was a little too realistic.

[Sandman]

2 hours ago, Dowel Jones said:

Most tv hospitals spend so much of their time putting out bush fires from the interpersonal relationships ...

Or, in the case of The Night Shift, staff haircare emergencies ("Team to breakroom, stat! Code L'Oréal!")

[NJRadioGuy]

1 hour ago, starri said:

I do love a good mass casualty episode.  It's something that's a lot more fun to watch on a screen than to live through.  We had a mass casualty (or, we call it a Code Green) drill a few days ago.  When they called the code, they neglected to announce that it was a drill, so half the doctors in the hospital ran for the trauma bays.  I know it sounds exciting, but we were doing it as a mass shooting, and some of the makeup they had on the actors was a little too realistic.

I was just thinking something similar. The makeup job on that crispy critter was pretty amazing when you stop and think about it. Say what you will about the cheese and cornball plots on this show, once the fecal matter strikes the rotary oscillator, I have complete willing suspension of disbelief.

I don't mind mass-casualty scenes if they get the details even close to right, which TV never does. An MVA of that magnitude would have half the CFD, CPD and ISP on scene by the time patients were being extricated and treated. It would be a sea of red and blue lights. But fake cop cars, FD apparatus and ambulances cost a ton of money and add very little to the plot except to people in the know, so I get it.

[Sandman]

Starting a blood drive within the ED wouldn't have been practical earlier (and probably not that realistic even after the emergency conditions eased), but organizing one through the hospital more generally certainly seems like it could have been an option -- it wouldn't surprise me to learn that there were contingencies or disaster protocols set up for this kind of worst-case situation.

Also: I'll line up to buy Dr. Charles a drink, too.

Edited February 18, 2017 by Sandman

[spunky]

8 hours ago, Dowel Jones said:

Most tv hospitals spend so much of their time putting out bush fires from the interpersonal relationships that they don't have any time for disaster preparedness. /snark. 

That's a good point about the legality of removing the ventilator.  In any case, Dr. Choi could have found someone else to do the manual ventilation.  That doesn't require an MD and it would have freed him up.  I realize that he feels ultimately responsible for the patient's death, but he should have directed the wife to go ask the triage doctor (forgot his name) why it was done that way.  That guy needs more experience in people skills.

Dr. Latham has Autism, so his cold demeanor is something that he can not help. Everything is factual to him, there is no grey area, it's either black or white. In this case he couldn't understand why Dr. Choi would use resources on someone who was about to die when someone who can live needed the respirator.

[spunky]

This was one of the best episodes of the season. Dr. Choi's patient broke my heart. I can understand why Dr. Latham was put in charge of triage. His ability to remain focused and of course his inability to feel empathy worked to a point. The fact that he couldn't understand why Ethan had so much compassion for his patient made him come across as heartless. Hopefully his treatment works. Dr. Charles' psych patient, reminded me of clients I had in the past, he manipulated the situation to get his medicine, but ended up not being able to for sed the consequences of his actions. Sara should have mentioned doctor what's his face asking for psych meds, like Noah he isn't cut out for the ED. 

Edited February 18, 2017 by spunky
Spelling error

[Sandman]

I'm assuming that Wheeler's storyline will involve his little teeny tiny bit of an addiction problem. (Showing up to work with alcohol poisoning AND later drug-seeking behaviour? Damn.)

[Sandman]

48 minutes ago, spunky said:

The fact that he couldn't understand why Ethan had so much compassion for his patient made him come across as heartless.

Empathy and compassion are related, but not identical -- which was the comment that Latham made to Rhodes. It's not that Latham doesn't understand how or why Ethan or Connor experiences compassion. It's empathy that Latham doesn't fully experience.

Edited February 18, 2017 by Sandman

[Driad]

At least they had enough staff during the storm, which in my experience is realistic for medical personnel. When a major storm is predicted, many hospital workers go to their hospital prepared to spend several days there. News broadcasts sometimes show "dormitories" where hospital workers are camping for the duration of a storm.

[statsgirl]

I kept wondering why they didn't start a blood drive earlier, and then I realized it was because they needed it to be Manning who saved the day.  Because everyone else in that hospital, including Sharon, is too stupid to think of it.

I really like this show but this is by far the worst episode they have ever done because it was so stupidly melodramatic and manipulative for feels starting with the whole hospital, a large one in Chicago, just having to happen to have limited supplies of everything that night from blood to ventilators.  (And as @starri said, they should have tried BiPAP.  Or did they run out of those too?)

Asking the mother to decide who should live, her son or her nephew was cruel. And since she had also been in the car accident and in injured and in shock and probably not capable of making such a decision at the time,, good luck trying to defend that decision in court.

On 2017-02-17 at 1:26 AM, Dowel Jones said:

I'd like to buy Dr. Charles a drink.  That Xanax prick deserves a 72 hr. hold, in addition to a PD investigation for making a false report.  Even if it isn't chargeable, a suit should talk to him. 

I understand wanting to punish the guy for pulling that stunt but it's not fair to either any other people who need to be hospitalized or the insurance company who has to pay $1000 a day, to tie up the hospital bed.  He's not suicidal, just manipulative.  The diagnosis of narcissistic personalty disorder is probably right, and that's not going to be affected by 72 hrs in the hospital.  In fact, that attention just might make him worse.

The only scene I liked in the whole episode was Rhodes telling Latham that he envied him is dissociation from his Aspergers.

Edited February 18, 2017 by statsgirl

[spunky]

8 hours ago, Sandman said:

Empathy and compassion are related, but not identical -- which was the comment that Latham made to Rhodes. It's not that Latham doesn't understand how or why Ethan or Connor experiences compassion. It's empathy that Latham doesn't fully experience.

True. I misspoke. He did state that. I like that the show has created a character who is on the Autism spectrum, and is doing it correctly. 

[spunky]

8 hours ago, Sandman said:

I'm assuming that Wheeler's storyline will involve his little teeny tiny bit of an addiction problem. (Showing up to work with alcohol poisoning AND later drug-seeking behaviour? Damn.)

I'm thinking the same thing.  He came to work drunk, now he's asking Sara for drugs. I'm guessing he can not handle the stress of working in the ED.

[Tiger]

Xanax Prick and Blood Dad were such bad actors.  

I really liked Reese back in the ED.

[tvfanatic13]

Wow- this episode brought the gore.

[MakeMeLaugh]

Great names, Tiger. 

I finally saw this episode last night. The whole storyline felt so contrived to me. And reminiscent of the early episode when Manning and Rhodes, I think it was, fought over the only oxygen tank in the city of Chicago. The blood drive was interesting (everyone could take a break at the same time from the disaster to give blood for thirty minutes?)  and without Choi being the right type with prescreened blood, would have been futile anyway. Of course. 

I hope Wheeler's character gets treated with support vs becoming a villain--Rhodes looks at him with a lot of judginess in his eyes.

I made Mr MML rewatch Manning's dramatic overexpressive face when Blood Mom asked her if she was a bad mother/what would she tell her son. The silent range of emotions was pretty funny imo. And she never did answer her. She's so bad. 

I think it's time to bring Choi in from the military and let him just be a doctor without the constant comparisons to medicine on the frontlines. We get it, Show, and we love him anyway. Or just spin him off to a new show, like Chicago Army. I'm sure all the staff would have kept Burn Victim alive if they could til his wife arrived. 

I want Reese back as a regular doctor. At least Xanax Prick took his sarcasm pills.

When Latham was formally labelled as autistic and wanted the shock therapy a few weeks ago, I was disappointed that his diagnosis wasn't presented as an asset, something that could make him a better doctor, so I was really glad this episode showed that. 

[starri]

4 minutes ago, MakeMeLaugh said:

I want Reese back as a regular doctor

Psychiatrists are regular doctors.

[MakeMeLaugh]

6 minutes ago, starri said:

Psychiatrists are regular doctors.

I know, I said that wrong. Sorry. Maybe generic, as all the other docs' specialties except Charles's and now Reese's seem to get blurred into general emergency medicine--S'epatha asked Charles's permission to use Reese for the disaster victims. Maybe they can spin off into Chicago Psych.

Edited February 20, 2017 by MakeMeLaugh

[statsgirl]

I'm pretty sure Reese is going to be back in the ER next season.  Watching how psychiatric work isn't interesting enough to have two characters do it.

I'm not sure what Choi's specialty is but Rhodes is firmly established in thoracic/cardiac surgery and Manning gets all the kids to get judgey over so I"m pretty sure they haven't forgotten that she's in paeds.

[MakeMeLaugh]

13 hours ago, statsgirl said:

I'm pretty sure Reese is going to be back in the ER next season.  Watching how psychiatric work isn't interesting enough to have two characters do it.

I'm not sure what Choi's specialty is but Rhodes is firmly established in thoracic/cardiac surgery and Manning gets all the kids to get judgey over so I"m pretty sure they haven't forgotten that she's in paeds.

I believe Manning has recently treated an adult kidney patient with HIV brother, a college student with surprise cancer, and the car accident woman who just happened to have mirror girl for a daughter. She is all over the place so she can be judgey with everyone! Rhodes like Manning gets his specialty patients when they have plotlines but otherwise is often outside his specialty too. Only Dr Charles, and now Reese mostly, sticks with psychiatry (probably the least typical primary reason for which a patient goes to the ER, vs pediatrics, which must be a much higher percentage) virtually every episode. I wonder if the original idea was to make this less of an ER show but here we are.  (Mr MML has had cardiac surgery at surprise! a big Chicago hospital that is not Med-ish and doubtful his docs could go near a non-cardiac patient, what with liability and area of expertise issues). Maybe Halsted and Choi are trauma docs? Not a big deal.

[Sandman]

Pretty sure Choi is a trauma specialist, and I think trauma medicine/emergent care is supposed to be Red Halstead's specialty, too.  On the other hand, Wheeler's area of specialization, along with Noah's, appears to be screwing up.

[SnarkySheep]

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Now that said, I don't care how bad a snowstorm is, even at 3" per hour, any decent Jeep with a skilled driver can navigate those conditions and deliver much-needed supplies. Might be delayed due to traffic, but if you know the city you can get through. I'm sure a nearby hospital could have gotten some blood over, but then what fun would that be.

This was my major peeve. Especially considering that this is CHICAGO, a city that is well versed in extreme winter conditions, it just seemed a bit too contrived that they wouldn't have been better prepared for the storm and that someone could have gotten more supplies in. After all, the patients themselves were somehow coming in, weren't they??

 

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Asking the mother to decide who should live, her son or her nephew was cruel. 

IMO it might have been more interesting if the two boys had been brothers instead of cousins. What would the husband have said then?

 

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I can understand why Dr. Latham was put in charge of triage. His ability to remain focused and of course his inability to feel empathy worked to a point.

Right. But the man himself just recently said that he can't deal with change very well...making me wonder why on earth he's working where he is. IMO a place like the ED would have something unexpected happening every day, making it extremely difficult to have any sort of predictable routine as Latham seems to want and need. 

 

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I'm pretty sure Reese is going to be back in the ER next season.  Watching how psychiatric work isn't interesting enough to have two characters do it.

I don't know about that...I think the dynamic between Reese and Dr Charles is interesting in and of itself. That said, I still don't know how Reese is able to be a practicing doctor, considering all the hoopla last season about how she was breaking her agreement by not working in the lab. So how is it ok for her to work in psychiatry but not in the ED? Was it simply because Dr. Charles took her as an intern and not an official doctor? If so, that can't go on too long.

[Lady Calypso]

That's a shitty thing to do, to ask a poor mother who just went through a trauma--and is still going through one-- to make the decision between her son and nephew. I know they might have felt the need to inform her, but it still feels wrong. The whole situation felt melodramatic as well, and this show has tried to stray from total melodrama. 

Man, that psychotic patient had no empathy for the emergency, didn't he? I get that he was itching for drugs, but damn, the way to go about getting some attention because he felt like he deserved it above all others. Good thing Dr. Charles put him in his place. 

I felt so bad for the burn patient. He knew he was dying and even with Choi trying so hard to save him, he was the one to tell him to let him go, because he knew Choi needed to help others. This show does make me at least tear up every couple of episodes. But he did get to save that little boy, so...good job, Choi! On another note, I'm happy Connor spoke to the wife of the burn patient after his death. I think he felt guilty that he couldn't help save him and that he had to take the ventilator away. He didn't even have to speak to her. I also loved the conversations between Latham and Connor about compassion vs empathy, and Connor's envy that Latham can handle these situations so well because of his Asperger's. 

So, we're getting a nice, small arc with new character Wheeler, who we've only really seen a few episodes of. Now I'm wondering if HE'S the upcoming death that's supposed to happen. 

[starri]

12 hours ago, SnarkySheep said:

So how is it ok for her to work in psychiatry but not in the ED? Was it simply because Dr. Charles took her as an intern and not an official doctor? If so, that can't go on too long.

Med apparently had an open spot in its psychiatry program, and presumably didn't in the emergency medicine one.

Every year, not every single person gets matched to a residency in the formal process, so there's a second round (actually, there are multiple rounds but it's super complicated) where those who didn't attempts to get into a slot that didn't get filled.  Match Day is March 17 this year, so if you live near a medical school, expect to see a lot of happy, drunken people out and about.

So, Sarah and Wheeler are first year residents in Psych and Emergency Medicine (you could call them interns, but please don't).  They have the least amount of autonomy.

Choi is a third-year resident, which is the usually the last year for ER doctors.  He has more, but still can't work completely independently.  

Natalie is theoretically a Pediatric EM fellow.  She's finished her main residency and is attempting to become a sub-specialist.  That lasts an additional year or two.  She basically works on her own.

Connor is a cardiothoracic surgery fellow.  He's also done with his residency.  He still has to have a senior doctor in the operating room with him, but would be progressively doing more of the actual surgeries by himself.

Will, Charles, and Latham are attendings.  They work independently, supervise the residents, and may or may not be on the faculty of the med school.

[statsgirl]

On 2017-03-01 at 4:57 PM, SnarkySheep said:

This was my major peeve. Especially considering that this is CHICAGO, a city that is well versed in extreme winter conditions, it just seemed a bit too contrived that they wouldn't have been better prepared for the storm and that someone could have gotten more supplies in. After all, the patients themselves were somehow coming in, weren't they??

Right. But the man himself just recently said that he can't deal with change very well...making me wonder why on earth he's working where he is. IMO a place like the ED would have something unexpected happening every day, making it extremely difficult to have any sort of predictable routine as Latham seems to want and need.

Latham is a cardio-thoracic surgeon.   For some ploty reason I can't remember he was in charge of the ER this episode, maybe because not enough doctors could get in because of the storm, but it's not where he usually works.

There were two months this year (I think December and January) where there was no snowfall at all in Chicago. (Let's not talk about climate change.)