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Chicago Med – The Apple Doesn’t Fall Far From the Teacher – Review

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This week we see a lot about how creative the medical profession can get when the chips are down, and also how our friends at Gaffney are often willing to do anything to help a patient, despite personal risk.

Dr. Marcel, Dr. Blake and the Subway Crash

Dr. Marcel arrives late and apologizes to Dr. Archer, stating it was a traffic issue. Dr. Archer says it is because of them building a new hypertrain. As they discuss the new train, Dr. Marcel notices that Dr. Blake’s locker is empty. Dean tells Crockett that she has resigned and taken a job in Boston. Crockett says he needs to talk to her and leaves, stating he will be back in an hour.

Crockett is trying to get through but the sidewalk is closed for construction, when suddenly the ground shakes and people start coming out of the underground tunnel and state the train jumped the tracks. Dr. Marcel jumps the barrier and goes down into the tunnel to try to help the injured. He climbs through some fallen rocks into the train car, and finds the proprieter of the train system, Jack Dayton and the driver both injured. Dayton had his leg trapped and his knee is injured, but the train driver, Nathaniel, is severely injured, and Dayton says he was struck in the chest. They move him somewhere where Dr. Marcel can work on him. He has broken ribs and blood collecting which is causing his lungs to collapse. Dayton wants to try to take him out, but Dr. Marcel says that the tunnel is to unstable and they need to wait for the Fire Department.

Severide and Hermann make a guest appearance when they come to assist him, and Crocket asks them to bring him some items from the ambulance and from Chicago Med to help treat the conductor. Hermann sets up a pull line for him to get supplies through, and after the first bag, the second one gets stuck and as Crockett pulls, the tunnel collapses more, trapping him arm out the window of the train car. Crockett realizes that the only way to get his arm out is to pop his shoulder out of the socket. He gets his arm free and then has Jack help him pop his shoulder back in and then he goes to treat Nathaniel with Jack’s help. He starts a line, gives him blood and fluids, and intubates him, and hooks him to the portable ventilator and puts in a chest tube.

As they sit waiting for CFD to get them out, Jack asks Crockett why he ran in after the collapse and Crockett says he doesn’t know, he just did. Jack tells Crockett he told everyone he developed the train to change the world, but he realizes that money and ego are behind almost every decision he has made. He feels that every good deed he has done has been self-serving, but not like Crockett. Crockett tells him that he has also been far from self-less in his life. Suddenly, Hermann opens the top hatch and asks them if they want to get out of there.

The ambulance arrives with Nathaniel, and Dr. Archer says he will take him. He has Dr. Choi meet Jack Dayton’s ambulance and Sharon Goodwin is there. Jack tells them that Dr. Marcel said he would need an MRI and Ethan says that will not be a problem. They ask where Dr. Marcel is and Kai asks if he is okay. Dayton says that he said he had to see someone and it could not wait.

Crockett shows up at Pamela’s house, and her daughter is there and says she left that morning and she is shipping things to her. He says he needs to tell her something, and her daughter says she saw he called but she did not want to talk to him. He asks her daughter to tell her he has not been entirely honest with her or himself and that he made the decision he wanted anyway when she was on the table, even though it was not what she would have wanted. He says he was being selfish because he did not want to lose her, but he ended up losing her anyway.

This storyline has shown just how much Crockett has grown as a person and character since joining Chicago Med. His relationship with Natalie seemed to really make him grow, and his recent situation with Dr. Blake has only served to help him develop further. That guarded player that joined the team after Dr. Rhodes left has really become a grounded and caring professional, who is really developing a selfless side. It will be fun to see where the writers take his storyline this year.

Dr. Halstead, Dr. Taylor, Rose and Emmanuel

Rose has been feeling poorly and has Type 1 Diabetes and Hypertension. She has had a chronic UTI and her internist has prescribed her several rounds of antibiotics, which have not helped. Dr. Taylor sent a urine test with cultures, which shows a multi-resistant fungal infection. Dr. Halstead suggests an antibiotic for her, but it is on the shortage list. The only other medication option would destroy her kidneys so it is not an option. Dr. Taylor says every hospital is out of the medication, which is why she asked Dr. Halstead to consult.

They go to speak to Sharon Goodwin about the problem and that the drug they need is unavailable in all of Chicago, and Sharon says she will reach out to suppliers and that they should try the military branches to see if they have any and do what they can for her in the meantime. They start her on blood pressure medication to keep her BP up and Sharon asks Will about Jay re-enlisting.

Sharon comes to tell them the medication is not available anywhere because of an issue with the manufacturer. Goodwin asks what they can do for Rose right now, and says she will keep searching on her end while they provide supportive care. Vanessa says she would not mention it if they were not desperate, but she has a friend in medical school who could get pharmaceutical grade drugs. Will asks how they would even know the drugs were legitimate, and Vanessa says that he has a relationship with a pharmacist and the quality of the medication is not an issue. Will says they could lose their licenses or even go to jail over this, and that as much as he wants to help Rose, they cannot do this.

Rose’s septic shock is getting worse and her husband is extremely distraught and wants to know if there is nothing else they can do for her. Vanessa calls her friend to inquire about the medication Rose needs.

Vanessa brings Will the medication that she obtained from her friend, and Will asks how they will explain it in her chart. Vanessa says she would not document it, but Will says there is only one way to do this, and asks the nurse to give him a moment with her family. He tells Emmanuel that the medication is what she needs, but he cannot give it to her because the medication was not acquired through the proper channels, so he cannot legally give them to her, and he leaves the meds in the room and says that it is his choice and he can give her the medication, even though they cannot. Will leaves and Emmanuel draws the curtain to the room.

Rose improves and Dr. Halstead says they will have to wait for the cultures to come back but it looks like the infection is resolving. Emmanuel says he cannot thank them enough. Will tells Vanessa that no one can ever know about what they did ever.

This was a very interesting development for Dr. Halstead, who is our notorious rule breaker for the greater good. He has never been shy about owning up to his wild-west ways, but it seems that he is more reluctant of late. Perhaps though this is also his protective side, as he does not want Vanessa to get into any trouble. Will has always been a sucker for taking the heat for a “woman in trouble”. With the supply issues only getting worse, it will be interesting to see what further steps Will has to take to save his patient’s and protect his peers.

Dr. Charles, Dr. Greenwell and Dr. Hudgins

Dr. Charles is talking to his new therapist, Dr. Greenwell, about his daughter and that he is having difficulty delivering bad news, when suddenly he starts to get chest pain and collapses through the coffee table.

Dr. Hudgins says Dr. Greenwell is not having any cardiac issues but he did tell him he is not sleeping. Dr. Charles goes in to see him and asks about if maybe he had a panic attack and asks about his sleep and what stressors might be causing him an issue. When Daniel discusses that they were talking about giving bad news to patients, Dr. Greenwell has another episode.

Daniel comes back to speak with him, and says it is hard to ignore that he is triggered talking about giving bad news. Dr. Greenwell says that he reads a lot of journals and recently read about Sporadic Fatal Insomnia (SFI), and that it is a non-genetic variant of a familial version that starts with mild insomnia and eventually robs you of your faculties and kills you. He tells Daniel he is afraid he has it and is too afraid to be tested. Daniel talks to him about how the test would assist him to gain clarity for the situation, whether positive or negative, and he agrees to get the scan.

Daniel comes back with the results, which are negative, and Dr. Greenwell is extremely relieved. He thanks Dr. Charles, but says he thinks they should stop seeing each other professionally, as this is a huge breach of professional boundaries. Dr. Charles wants to continue, because the experience has only humanized him and says that all he saw today was the kind of humanity that makes him want to keep working with him, if he is okay with it. Dr. Greenwell agrees.

It is wonderful to see Dr. Charles finally finding a new therapist that he can connect with. This will only serve to make him that much better prepared to help all the patients at Chicago Med.

Dr. Asher, Dr. Archer and Candice

Dr. Asher goes in to see a pregnant patient names Candice, who has been having sharp lower back pain, and her OBGYN told her to come in. Dr. Asher puts her on the monitor and checks her out. When she comes out of the room, Dr. Archer reminds her she needs to do her weekly urine test, which she indicates she has been doing for 6 months now.

Dr. Asher consults with Dr. Archer as her patient’s urine test was “dirty” and she wants to get a CT scan, but with the shortages needs sign off for the procedure. Dr. Archer wants Hannah to ultrasound her for a kidney stone first, but Hannah says the presentation of kidney stones in pregnancy does not fit her symptoms. Dr. Asher says ultrasound is also not as sensitive for kidney stones and a CT would give her a better picture of what is going on. Dr. Archer says if the ultrasound is not conclusive then they can order the CT. He also tells her that she should start on antibiotics in case it is a kidney infection.

Dr. Archer joins Dr. Asher for the ultrasound, and her left kidney is swollen. Dr. Archer feels it is a kidney infection and she should see Urology, but Dr. Asher tells him that hydronephrosis is common in pregnancy and does not confirm the diagnosis of a kidney infection and she still feels she needs the CT scan. He says if the antibiotics do not work or the pain gets worse then she can have the CT. Hannah says she feels like she is never going to pass whatever test it is he seems to have for her and he says he has shortages to manage and leaves.

Candice starts to vomit severely and has a fever, and Dr. Archer finally approves the CT scan. The scan show retro-cecal appendicitis, and he says to have her prepped for a Laparoscopic Appendectomy and Dr. Asher says she will join him to monitor the pregnancy.

After the surgery, he tells Dr. Asher she did nice work today and that Candice was lucky that she had a good doctor, and that they can dispense with the weekly drug tests from now on. This was real progress for Dr. Archer, who seems to be showing a more human side this season, even if it is just in little ways. It poses the question with his reconnection with his son if we will see more changes to Dr. Archer this season. Although he is the man we all love to hate, it would be nice to see him work in a less tense way with the rest of the department.

Dr. Choi and Dr. Tanaka-Reid

The ambulance bring in Trey Russo, who fell off a ladder. They do a chest x-ray and he has a hemo-thorax, but they cannot put in a chest tube as they do not have a drainage system, because Archer sent the last one out to Crockett at the tunnel collapse. Dr. Tanaka-Reid says that is ridiculous and that Crockett should not be putting in a chest tube in the field as it is not sterile, and Dr. Choi and Dr. Archer tell him to watch and he might learn something today. Ethan heads to central supply as Kai looks on, seemingly confused about what is happening.

Dr. Choi walks Dr. Tanaka-Reid through the process of why we put in a chest tube and then explains the system he has rigged up with 3 sterile glass bottles, and how it works like a commercial drainage system if you don’t have one and have to make one. Kai says it is somewhat primitive, but Maggie says it works and that is what matters. Dr. Choi has Dr. Tanaka-Reid put in the chest tube and they hook it up to the system.

Dr. Archer tells Dr. Tanaka-Reid that he showed Dr. Choi how to make a drainage system with the bottles in Afghanistan, and Dr. Choi says Dr. Archer is a good teacher, and so is Dr. Marcel. This was a great moment to see Kai be humbled by the expertise of these other doctors, as he constantly acts like he knows and can do it all, even though he is just an intern. It is nice to see them be able to put his attitude in check, and show him he still has a lot to learn. We can only hope this is a turning point for him, and we may see improvement in his attitude as he moves forward.

Overall, this episode was an exciting journey into field medicine, how to work with scarcities and how far our Med doctors are willing to go to help a patient when the odds are against you. I cannot wait to see what our Med writers have in store for us next.

What did you think of this episode of Chicago Med? Share your thoughts in the comments below.

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