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Chicago Med – We All Know What They Say About Assumptions – Review

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This episode allowed us to really see the passion of our team at Chicago Med, whether it is a passion for excellence in patient care, a passion for technology and new opportunities or a passion for love. And in some cases even a passion for distain for certain things…well, we all have to be passionate about something.

Dr. Charles, Liliana, Dr. Tanaka-Reed and Richard Wyatt

Liliana is nervous for open mic night at the club where they met and Daniel provides her with support and says he will be there to cheer her on right down front. There is no way you cannot love Dr. Charles and how kind and supportive he is, and it is so wonderful to see him in love again. Daniel introduces Liliana to Peter Kalmick. She appears uncomfortable when it seems like people are watching them and heads off to work.

Kai asks Daniel for help with a patient. Richard Wyatt, who is running for political office, was supposed to do an interview and his campaign manager found him with slurred speech and disoriented with a bruise on his head, but his workup is normal except for the combination of alcohol and benzodiazepines, and Dr. Tanaka-Reed is not sure if it was accidental or not. When Daniel goes in to speak with him, he and his campaign manager are anxious to leave, and Dr. Charles asks the manager to leave. Mr. Wyatt keeps insisting he needs to leave, but Dr. Charles talks to him about the lethal combination that meds and alcohol can be, and he insists it was an accident. Dr. Charles asks why he was prescribed the benzos to begin with, but he keeps asking for his discharge paperwork. Daniel tells Kai that he wonders if he has anxiety and is self-medicating, and they discuss that they have no reason to hold him. Daniel gives him some referrals and Richard does not want them but then the press arrives and he gets upset and begins to have a panic attack and Daniel has to call him down. It is so great seeing Dr. Charles in action and how great he is at calming people in emotional distress.

Richard shares with Daniel that the catastrophizing he was experiencing is happening all the time and he is worried what if someone sees him melt down like that in public, and that he will never win a position in office if this gets out. Daniel tells him that over 20% of Americans struggle with anxiety. He shares with him that he was diagnosed with depression and he tells him how to reframe the diagnosis. He tells him he is not crazy, and that he is making assumptions about what other people will think. This was such a touching scene. It is so wonderful how well Dr. Charles’s character is written, and that he has the ability to normalize and humanize mental health conditions and people with that diagnosis. If only we could have more physicians like this in the real world!

After helping Richard, Daniel finds Liliana cleaning an office and mentions how uncomfortable she seemed with people looking and she said she was and asked if he was also. She asks why he told Peter that she was a singer and was it so that he would not think she was “just a housekeeper”. She asks if who she is will be enough for him and he kisses her. It is so wonderful to see Daniel being able to open up, challenge any perceived stigma and just allow his feelings for Liliana to flow. And the Dr. Charles’ fan club will be waiting on the edge of our seats to see what is next.

Maggie, Sharon, Dr. Marcel, Dr. Archer, Rose Howard and Paula Rivera

Dean goes to see his specialist and there is fluid build-up (pulmonary edema) in his lungs. All his lab work and vital signs show he is having fluid retention, and they decide to start him on low dose diuretics to try to keep his kidneys from failing. While Dr. Archer has been the resident antagonist for some time in Chicago Med, and the man we all love to hate, it is definitely sad to see him struggling with his health to such a significant degree, and it will be interesting to see if we will see more of his son in the future (possible kidney transplant this season)?

Jack arrives in the ED and introduces Crockett to Grace Song, who he says is also an incredible surgeon. Crockett asks about training other surgeons on the OR 2.0 and he agrees.

Dr. Archer tells them that he does not believe they need to come up with high tech solutions to problems that do not exist and Dr. Song says it is exciting because they are creating tech that is empowering and does not make people want to pull their hair out.

Sharon comes to pick up Maggie as her car is not working. She tells Sharon that Ben usually takes care of these things but she is trying to give him some space. Sharon reassures her that time is a great healer. There is no way that as a fan of the show you cannot love the friendship between these two women. They really have been there for each other through divorces, illness and times of emotional distress. As they are going to get into the car, they hear an accident and find a woman who has been hit by a car. Sharon and Maggie try to provide help while they wait for an ambulance.

The ambulance arrives and they help get her into the ambulance and to the hospital. Paula Rivera, who was with Rose Howard when she was hit, is not able to ride in the ambulance and they offer to send another unit for her, but she refuses and Sharon and Maggie offer to take her to the hospital and they can also get her checked out and she agrees. You could not ignore the calm strength Sharon displayed as she took control of the situation, calmed the woman down and they offered to help, in true Goodwin style. There is no other way to describe Sharon Goodwin than to call her “a class act”.

Dr. Marcel meets the ambulance with Dr. Archer and they check out Rose and see she has a good amount of fluid in her belly and also has a pelvic fracture. They take her up to surgery and Dr. Marcel suggests using 2.0 but Archer says it is not time to play with his fancy toys and they will deal with the abdominal bleeding first. It is clear that Dr. Marcel wants Dr. Archer to embrace and try out the technology and that Dean, as only he can do, is ready to protest as it is not a traditional way to do things.

In the car, Paula says it is her fault and that they were arguing and Rose turned to walk away and she tried to grab her and that is when the car came out of nowhere. Paula suddenly has severe difficulty breathing. They ask her if the car hit her too and she says yes but she didn’t think it was that bad, but it looks like she has a collapsed lung – Maggie does a needle decompression to her chest and relieves the pressure. The way that Maggie and Sharon are able to stay so calm and do what needs to be done really shows how professional and knowledgeable they are, and how lucky Chicago Med is to have them.

Paula Rivera arrives at the ED with Maggie and Sharon and Dr. Hudgins meets them and they let him how she had a delay pneumothorax and that they needle decompressed her in the car. Sharon tells Maggie that the team has her and she needs to take a breather and that she did a good job.

Crockett and Dean are in the OR and get the bleeding under control in Rose’s abdomen and then they plan to take her to the ICU, and Crockett wants to take her to the OR 2.0 to use the imaging sensors to rule out an aortic injury, and Dean agrees to take her there after they close. While it seems like he may have been just appeasing Crockett, perhaps our old dog Dean may be intrigued with the new technology in some way.

Dr. Archer and Dr. Marcel take the patient to the OR 2.0 suite and they do the stent for the patient, but Dean hates using the system, as it provides its analysis and critics as they are doing the procedure, and he knocks one of the instrument sensors away. They complete the procedure and Dr. Archer says that the OR 2.0 is a backseat driver, and that he will not abdicate to a machine. Jack Dayton comes along and tells Dean he broke part of the 2.0 on purpose, and even though Crockett tells him it was an accident, Dayton tells Dean that he is fired.

Sharon goes to speak to Jack Dayton about Dr. Archer and says if he goes, she goes. Dayton says if he steps out of line again that it will be her on the line. This is definitely another example of how classy Goodwin is, and how she will always stand up for her staff.

Rose and Paula are reunited and Paula apologizes. Maggie watches and reflects and goes to Ben’s school to apologize. She says she can’t let a stupid mistake ruin the best thing that has ever happened to her and she is not giving up on them because their love is stronger than this. Ben says nothing in response and Maggie leaves, looking sad. Surely the Chicago Med fandom is hoping to soon see a reconciliation between these two, as their love and relationship has become a “shipper” favorite in the last few seasons, and it would be heartbreaking if they are unable to reconcile. I guess time will tell.

Dr. Halstead, Dr. Song, Jason, Connie and David Robbs

Dr. Asher approaches Jack Dayton about the email she sent him and he says he has not had a chance to read it yet, and tells her she will have to wait a moment while he makes an announcement, and he announces that he realizes he has a lot to learn about medicine and wants to turn to the experts and therefore he has asked Dr. Grace Song to observe in the ED to find ways to make their jobs easier and more efficient, so to feel free to discuss with her any concerns.

Dr. Song uses Dr. Halstead as an example and says he could be dictating his notes instead of typing them out, and Will says after he sees a patient that is how he has always done it. Will says it has not been a problem and allows him to wrap himself around patient histories and lab results and Dr. Song says he could be spending that time with more patients. Dr. Archer tells Will there is a patient waiting for him in Exam room 4. It is clear that both Dr. Halstead and Dr. Archer are not sold on the idea of new technology replacing traditional processes, and it is an interesting dynamic to see them finally agreeing on something, when usually we would find them at odds with each other.

Will comes in to examine Jason Robbs and he is confused and does not know where he is. His parents said he was irritable and fatigued, but they thought he was just tired. They tell Will that they lost their son Axel just before his first birthday, 12 years ago, with crying, weakness and seizures. They never figured out what it was and how to help him. Will says that he likely has an infection but he will cast a wide net to figure this out. In traditional Halstead fashion, we immediately see the compassion he has for the family and that Halstead determination to find an answer, no matter what. Unfortunately, in the past, that has sometimes lead to Will’s undoing and gotten him into trouble, but luckily this week this is not so much the case.

After the initial testing, Will tells the Robbs that he cannot offer any thoughts on a diagnosis yet as Jason’s lab work is all normal. Will tells them he is still thinking it is an infection but it may be hiding in his spinal cord or his brain, and he wants to do a CT scan and a spinal tap, when suddenly he starts seizing. They give him Ativan and his seizure stops. His parents are beside themselves as they feel what happened with their first son is happening again, and the terror in the room is palpable.

Dr. Song comes to ask Dr. Halstead why he ordered DNA sequencing on his patient and says it is an unusual order in the ED. Will tells Grace about Axel and reviews that the scan shows epileptic encephalopathy but he has ruled out every other cause other than genetics. Will says it is going to take forever to track down the diagnosis, but Grace offers to construct a neural network using existing DNA databases, but it could give him a highly probably diagnosis much quicker. Will thanks her but says he needs to figure it out the best way he knows how, again showing his distrust of the newer technology.

Jason has another seizure and is on the edge of needing intubation, and Will finally seems to realize that perhaps he was wrong and asks Grace if she built the network even though he said not to and she says yes. He says he will send her Jason’s DNA but it will take an hour for an answer and Will is worried Jason does not have an hour so they ask Jason’s parents if they would consent to a medically induced coma, to reduce the likelihood of another seizure. They tell them this is the best chance for a swift diagnosis and they agree. The compassion that Will shows the family and how carefully he explains the need for this treatment is one of qualities that we have all come to love about him over the years.

Jason is in the coma but has another seizure. Dr. Song comes in and has a diagnosis for them and they tell them what the treatment will be and that he will be fine.

Will thanks Grace and asks to be trained on the new system and she says she will be tweaking it, to allow for better patient interaction first. So it seems that Will has learned to be open to new technology, and Grace has reflected on the need to be human and engage with patients and family from Will.

Dr. Asher, Laura Wilson and Jack Dayton

Dr. Asher meets the ambulance for a young woman, Laura Wilson who has just had her first baby and is day 9 after giving birth and she has been passing large clots. Dr. Asher believes she has retained placenta and is able to confirm with an ultrasound and gets consent from the husband and asks them to open the hybrid OR for an emergency D&C. Hannah is so calm in the face of these emergency situations, and it is so wonderful to see how well she is doing in her recovery and being able to really prove herself as the asset she is in the ED.

Dr. Asher goes in to see Laura and her husband once Laura is awake and let them know the piece of retained placenta has been removed which should resolve the bleeding. She asks if she will still be able to get pregnant again and Hannah says she should be fine. Laura says she would like to leave but Hannah says she wants to monitor her a bit longer since she had heavy bleeding for 9 days, and her husband says they called the doctor’s office about the bleeding and they said it was fine. They discuss that bleeding can be objective and difficult to assess especially over the phone, as Laura said she did feel off but did not know if what she was seeing was normal to the doctors. She suddenly has a gush of blood and asks if she should still be bleeding and Hannah orders some medications and she tells them they will handle it.

Dr. Asher is called back into the room by Doris, and Laura is continuing to bleed heavily. Hannah explains she has what is called uterine atony and her uterus cannot contract enough to compress the blood vessels, so she will keep bleeding until she dies unless they act quickly and the only option left is a hysterectomy. She tells them a hysterectomy is the only way she can guarantee to save her life and Hannah promises she will get her home to her baby. Seeing the sadness and distress in Dr. Asher’s face, it was clear that this was not the outcome she was expecting for her patient, and that she is frustrated that the lack of follow up caused the situation to escalate to this point.

Dr. Asher bursts into a meeting with Jack Dayton and tells him she will paraphrase her email. She tells him that there is a new public health program checking on mothers and newborns and they need to join. Dayton says it is too costly now and they can revisit it again in the future. She tells him that it has already proven its worth and tells him she just did a hysterectomy on a 26-year-old who almost died and will now never be able to have more children because she was bleeding so heavily for 9 days and no one saw her. If she would have had this program, she never would have never had to have this happen. Jack Dayton seems stunned, and then agrees to enroll Med in the program. It seems that when physicians show their passion for their patients, it really seems to push the right buttons with Dayton, and that may be something good for the team to know moving forward now that he is in charge.

So as this episode drew to a close, we saw love blossom, love remain strained, and the never ending advocacy at Gaffney continue, whether for a fellow employee, technological advancements or for overall excellence in patient care. I don’t know about you, but I cannot wait to see what is next to come!

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

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