ER

Season 12 Episode 17

Lost in America

0
Aired Thursday 10:00 PM Mar 23, 2006 on NBC

Episode Recap

Teaser Fade in on Ray, sleeping. He is awakened by clatter coming from the living room, and finds Neela frantically gathering materials for a conference presentation. She explains she's pulled an all-nighter, doesn't feel prepared, and is usually more in control. Ray reassures her, then tidies her jacket collar, leading to a tense moment as their eyes meet.

Luka and Abby argue companionably as the walk from the El. Luka is explaining why he thinks the baby should be baptized, as he and all his family were. Abby resists the idea, then uses an exchange with the catering truck owner to try to change the subject. Luka persists, insisting it's "a little water, a little prayer and a change to make a lot of people happy," but Abby isn't convinced.

Clemente sits in a clinic waiting room; he's there for a urine test, which must be supervised. As the female clerk gives him a deadpan stare, he defiantly unzips and offers up, inviting her to have a look. Cut to credits.

Act One Luka strides through a swinging door with Frank alongside, reviewing his schedule and his messages as they walk. Luka finds a message from Carter, then somewhat tersely orders Frank to send personal calls to him and he'll decide what's important. Abby calls to him, updates him on Kerry's surgery, then asks him to sign a card to go with flowers the department is sending, which pleases Luka. As he walks away, Morris approaches, needing a Spanish translator, and is surprised when Luka tells him to get Clemente, who is due in soon.

We follow Morris to the desk as he, Ray, Sam and Frank gossip about where Clemente has been, his time in rehab, and his being under house arrest. Morris assigns cases, giving Abby a patient with a rash, then exchanging it for another in order to protect "our baby," who he calls the ER mascot. Abby takes the original case, insisting the baby is nobody's mascot. As she walks away, Clemente arrives with bags of bagels, but the response from Ray, Morris and Frank is a chilly one.

Ray and Sam treat a patient (Sadler) who claims to have committed suicide with an overdose of Tylenol. As Sam takes his vitals, Sadler explains why he chose an overdose over a gun, then asks Ray for a three-day hold so he won't have to die alone. Ray and Sam exchange a "not a bad idea" look, and Ray tells Sadler he'll call a psychiatrist.

We see Luka's hand on the door release to chairs. The paramedics bring in a 21-year-old woman found in her dorm room by her boyfriend, Frick, with multiple stab wounds to the neck and shoulders. As Luka examines the girl on the way to Trauma One, he passes Clemente talking with Abby. Clemente makes a side remark about "the elusive Dr. K" as Luka asks Abby to join him, then tells Clemente they'll have to catch up later, and to run the board. As we enter the trauma room, the girl tells Abby that her name is Nimet, and that she can't breathe.

In Trauma One, Luka barks orders as they transfer Nimet. Abby appraises the wound, and Sam notes Nimet's sats are dropping. The police arrive, wanting a statement; Luka encourages Frick to do what he can to help the police while they care for Nimet. Abby prepares to intubate her, but Luka stops her when she asks for paralytics, stating the intubation will be tough with them. Abby wonders if he wants to make it tougher, and persists, despite Luka's explanation they might have to intubate through the laceration.

Neela wanders among vendors at the surgical conference. She soon finds herself overwhelmed by the hard sales pitches many use to sell drugs and equipment.

Abby is still trying to intubate Nimet, now using a fiber-optic scope, struggling impatiently, even with Haleh and Luka's help. As Nimet's sats get dangerously low, Abby asks for a trache, but Luka takes over firmly. Abby begins moving equipment, but Haleh quickly does it for her. When Nimet's pulse drops, Abby begins compressions. When Sam offers to do them, Abby snaps they all need to "get over" the fact that she's having a baby and let her do her job. Luka looks up at her quickly, but says nothing.

Clemente runs the board. Ray and Morris are cooperative, but not listening as they discuss Morris' odd case, which Clemente thinks is psychiatric, not medical. Clemente tries to talk to them about his situation, but a patient with angina arrives, interrupting them. Ray and Morris take the patient, dismissing Clemente's suggestions they take a twelve-lead and call the Cath lab, calling the case "cookbook."

In Trauma One, Abby continues compressions as Luka finishes intubating Nimet through the laceration. Sam wonders when surgery is coming. As Luka encourages Nimet, Chuny updates Abby on another patient. Abby barks orders for GI, then tells Luka the patient needs central access. Luka, mindful of her mood, gently suggests she see to her other patient, that they're okay without her. She hesitates, then leaves. Luka briefs Frick before sending Haleh to try to get a head and neck surgeon as Nimet's mother and brother arrive.

Nimet's mother, Riza, hurries to Nimet's side, clearly distraught, as Luka gently introduces himself. Mahir, her brother, asks angrily why Frick is there, then dives at him. The two begin to fight and Mahir is thrown against a wall. Luka moves to quickly separate them, stopping the fight. Mahir demands Frick leave, and Riza tells him to show some respect as we fade out.

Act Two Abby and Clemente walk through chairs and out the ambulance bay door. She asks about his first day back; he says it's good, but doesn't really mean it. Abby begins to tell Clemente about losing her temper in the code, but Clemente's not listening, and cuts her off, talking instead about how his own life was in control one minute, then totally out of control the next. As they talk, Abby tries to share her own similar experiences as Clemente continues to cut her off, and she realizes he's too wrapped up in himself to hear her.

In Trauma One, Riza gently strokes Nimet's hand as Luka stands near her head, adjusting a dressing. As the camera pans up to Riza's face, we see Mahir, pacing, in the adjoining examining room. Riza wonders why men must always resort to violence to settle their differences. She explains that Mahir idolizes his sister, but does not like her boyfriend. Very much the doctor, Luka briefs Riza, explaining Nimet is next for surgery. The phone rings and Sam takes the call, angrily responding to the caller before hanging up with a bang. Sam wonders why she got a personal call in the trauma room, and Luka explains it's his fault, then asks if everything is okay. Sam apologizes to Riza, and explains she's leaving to treat Mahir's cuts as Luka charts Nimet's progress.

Riza talks to Nimet, assuring here she'll stay until they can walk out together, before looking to Luka for validation. She tells Luka Nimet's name means "blessing." Looking up briefly from the chart, Luka says it's lovely. Quietly Riza tells Luka about Nimet's father, who was a journalist killed by the Turkish Hezbollah when she was pregnant with Mahir. Luka swallows heavily, listening to the too-familiar story. Riza continues; she came to the US so she could raise her children in a country where they wouldn't be killed for speaking the truth, speaking very little English and having to work two jobs. Luka tells her he understands trying to adjust and fit in but he's struggling to keep some distance. Riza smiles; it was worth it, she says, because Nimet thrived and earned a scholarship to study journalism like her father. Luka quietly assures her she's done well by her children.

Neela meets Dubenko at the conference, and he proudly points out her presentation title on a large poster. A colleague, Dr. Weiner, calls out to Dubenko, subtly needling him for not appearing on a trauma panel Weiner is mediating. He leaves, and Dubenko tells Neela there's always someone in the audience determined to look smarter than everyone else. As they walk to her presentation, Dubenko gives Neela a few presentation tips, including that she should cite Weiner, assures her she'll be fine, and offers her a beta-blocker for her nerves, which she takes.

Ray is checking Mr. Lemoyne, who has returned with the infection caused by his gold jewelry. Ray tells him it needs to air his wounds at least a month, but Mr. Lemoyne insists he's "got to be me, man." Chuny summons Ray with a message from Neela: she needs Weiner's paper faxed to her, and will watch any 70's movie with him if he does it. Ray heads out to see Mr. Sadler after Chuny gives him the lab results. It seems his acetaminophen levels are nearly undetectable, but he wants a hold anyway.

Sam asks Mahir what happened in the trauma room as she tends to his cuts. He tells her Nimet shouldn't be with someone like Frick, who is a jerk. Mahir explains that Frick lives in the jock dorm, where a girl was gang raped. Sam wonders aloud if Frick was involved, then excuses herself. She walks through the door to Trauma One, where Luka is working on Nimet. We see Riza outside. Sam asks where Frick is, and Luka explains he's staying away out of respect for the family. Sam tells Luka that Mahir doesn't think he's a good guy, and Luka reassures her the police are investigating all possibilities. Luka asks about her phone call. Sam explains she maxed out a credit card paying for a tutoring program for Alex, and now she's late with the rent. Luka offers to help, but she assures him they're okay.

Ray stands over the fax machine, which has been sending for 20 minutes. He asks Frank to deliver a document, explaining he's got six patients to dispo and needs to present. Clemente hears this, and is ready to sign off on Ray's cases. Ray says it's okay, claiming he started with Kovac and will wait for him. Clemente calmly confronts Ray about his attitude. He starts to explain what he did, sure that Ray must understand. Ray insists it's his business, but Clemente knows better -- that Ray is judging him. Clemente continues to explain his drug use as going a little wild, but never worked high, likening it to Ray drinking, which Ray doesn't buy. Clemente grows angry, demanding Ray evaluate a patient, present to him in ten minutes, and show him some respect, because he's back at County. Cut to black.

Act Three Ray walks away from Sadler, talking to Dr. Nelson, the psychiatrist. Nelson feels Sadler is not actively suicidal, and is releasing him. Ray asks for outpatient counseling, and Nelson tells him the next appointment is in 14 weeks.

A redheaded girl approaches Ray, then Frank. She's looking for a doctor named Archibald Morris, along with three other kids, all redheads. Frank stares in amazement: what's this about?

Luka walks along a corridor, giving treatment orders to Chuny. They pass Clemente working on a chart; Luka hesitates, then walks over to Clemente and asks how it's going. Sarcastically, Clemente says it's going great, and thanks Luka for "easing his re-entry." Not rising to the bait, Luka tells Clemente it's good to have him back. Still sarcastic, Clemente's glad to hear it; he thought Luka was avoiding him. Luka calmly explains he's not, just bouncing between patients and "administrative crap." Clemente cuts him off – he knows Luka's important. Struggling to be patient, Luka apologizes for not rolling out the red carpet for Clemente, but gets no further when Sam arrives to tell him Nimet is failing again. Luka looks at Clemente as if to say, "I've got to take care of this." Clemente hesitates a moment, then follows him.

Luka crashes through the trauma room door, followed closely by Clemente. Haleh calls out Nimet's sats. Luka orders suction and briefs Clemente as he examines Nimet; Riza wants to know what is happening. Clemente explains the hematoma has expanded, blocking her airway and shifting the tube; he wants to crike her. Luka says no, there's risk of cutting into the lesion, causing her to bleed out. Clemente agrees, thinks a moment, then has a Plan B: they're going to put Nimet on a cardio-pulmonary bypass. Sam protests: they need an OR. Clemente defends his idea. Luka agrees with him: they can avoid hypoxic damage if they work quickly, and orders Sam to get the resident. Riza asks what's happening, and Luka explains the procedure will buy Nimet more time until she can get to surgery, then asks for consent. Riza trusts Luka and will do what he thinks is best. As Haleh start compressions, Riza begs Nimet not to leave her.

Morris approaches the kids in the chairs area, wanting to know what their visit is about – he's a busy doctor. The oldest girl suggests he sit down, then explain each of them lives with a different family, but share a father, a sperm donor. Once they found each other, then hacked into the sperm bank files to find their father: Archibald Morris. Morris is confused at first, until it slowly dawns on him. He's their daddy!

Ray tells Mr. Sadler the psychiatrist believes it's safe for him to go home, and he's being discharged. Sadler doesn't want to go – he insists he was suicidal, and now homicidal. They have to keep him. Ray gently coaxes the truth from him: he's in love with his best friend's girlfriend, and doesn't trust himself not to object at their wedding. If he's in the hospital, he doesn't have to go. Ray agrees to talk to psych again, and see what he can do. Does she know? Ray asks Sadler. Sadler laughs; he'd have to be crazy to tell her.

Sam continues compressions on Nimet, who is now in PEA. Luka and Abby quickly prepare Nimet for the bypass. Abby asks Luka if he's done the procedure before; Luka hasn't. Clemente and the profusion team arrive. Over all the activity, Riza talks to Nimet, telling her to listen to her mother's voice, but growing increasingly fearful. Abby feels the bypass is unconventional, but Clemente insists there's no alternative. As Clemente explains what the procedure will do, Abby demands surgery, and Luka tells her they can't wait, Riza continues to talk to Nimet about the bride's maids dresses she's making, fighting off the panic that is gradually overtaking her. Clemente starts the bypass, and Luka notes Nimet's color is improving. Clemente is pleased, and Abby explains to a grateful Riza that Nimet is improving.

Neela's talk is underway, and going smoothly, until a computer glitch prevents her next slide from appearing. Unsure what to do, she tries keep talking and get her slide to work at the same time. When that doesn't work, she freezes, then asks for A/V help. Suddenly, a red paintball hits the podium, and three protesters begin chanting "Rats have rights!" Neela faints.

Ray walks down a hallway and into Morris, who introduces his "kids," leaving Ray nearly speechless and looking for a quick escape. As Morris shows his kids around, they run into Abby, who brushes him off as she walks into Trauma One.

In Trauma One, Sam is with Nimet as Abby checks on her status. Sam tells her Nimet is stable, and she made the family get something to eat. Abby scans her chart, hesitating as though preparing to do something difficult. Abby quietly acknowledges she snapped that morning, which Sam gently attributes to hormones. Abby hates that excuses; she apologizes and Sam accepts is. Moving to Nimet's other side, we see Luka through the glass in the next room, and Abby tells Sam it's difficult for her pregnancy to be so public. Sam suggests she's lucky others want to share it with Abby – Sam's own pregnancy was treated as shameful and hidden away. Abby stands quietly for a moment, thinking, then glances down at Nimet, and sees her nose has begun to bleed. She turns and calls for Luka.

Clemente runs toward Trauma One, gloves in hand. Riza frantically asks what is happening. Luka checks Nimet's signs while Abby and Sam work on transfusing her. Frantic, Clemente demands to know if the heparin is off; Luka shouts it is. Tension runs high and Riza wants to know what is happening. Clemente barks orders as Abby calmly tries to explain what has happened. Sam hands Clemente test results as Luka checks her reflexes; the news is not good. As Clemente frantically looks for an explanation, Mahir quietly begins to pray in Arabic, his voice slowly rising. Riza quiets him to hear Abby's further explanation; Nimet is bleeding into her brain, and it cannot be reversed. Desperate to hear there is some chance Riza looks to Clemente, who explains Nimet is brain dead, then leaves in anger. Mahir continues to pray, louder and louder, as Riza begs Clemente to stop and do something more. As she tries to quiet Mahir, he explodes, insisting Nimet would never have been hurt had Riza made her stay at home. Near hysteria, Riza looks to Abby for some hope, then to Luka, whose face tells her its over. Cut to black.

Act Four Clemente leans on a gurney in Trauma Two, clearly angry at the outcome of Nimet's case, as Luka enters from Trauma One behind him. Luka quietly tells him it was a good idea, but Clemente turns and qualifies the statement: if it had worked. Undeterred, Luka tells Clemente he gave Nimet her only chance. Clemente doesn't believe him, and leaves, still angry, as Luka, watches him go.

Dubenko and Neela sit at the hotel bar, martinis in front of them, Neela holding an ice pack to her head. Dubenko apologizes for giving her the beta-blocker, but Neela assures him it makes the whole adventure into a better story. Dubenko shares his tale of presenting after eating a hash brownie. Neela soon decides the day's events are the story of her life; she appears to be spontaneous, but would actually prefer to hang out at home with her roommate.

Luka and Abby stand looking in the door of Trauma One where Riza sits with Nimet's body. Abby observes the bypass was worth a try, and Luka quietly agrees. He tells Abby he has to stay and handle some final details with Riza, but doesn't want to rush her, then suggests Abby go home. Abby hesitates, then tells him she's been thinking, and she's okay with baptizing the baby. Her light tone hiding a more serious message, she assures him a little holy water can't hurt. He shows little on his face, but touches her gently, rubbing her shoulder, as she puts her hand on his, sharing a moment of closeness.

Morris' kids prepare to leave. He tries to talk about getting together, but it's clear they want to go, quickly, and plan to be busy in the future. Morris manages to delay them long enough for Frank to take a "family" portrait.

Sam arrives at Elliott's house. She's ready for an interview, but he thought they'd already done that. He's ready for her to move it, which surprises her.

Ray cooks stir-fry as Neela arrives home. He chats lightly about the movies he's rented, as she tries to get his attention; something's on her mind. Finally she blurts it out – she thinks she should move out. Surprised, Ray asks why, but Neela thinks they both know why. Ray's face shows he does, indeed, know.

Riza sits quietly, still praying over Nimet's body as Luka enters, holding a clipboard. He stands over her, and gently asks about Mahir, then reassures her he'll be all right with time. He apologizes for bothering Riza with paperwork, and we see Riza is clearly not able to cope, but instead looks to him for understanding, and perhaps comfort. Luka looks down, his jaw tightening, then slowly reaches for a stool, drawing it alongside Riza and sitting down. Defenseless, Luka talks to her as one parent to another about the most difficult experience a parent can have. Her face showing tears of pain, Riza wonders how to protect children from all the evil in the world, but Luka knows it can't be done. Through her tears, Riza explains that after 9/11, Mahir chose only fundamentalist friends after being beaten up and called a terrorist at school, and wanted the same for his sister. Sadly, Riza remembers them as children in the park, playing on the swings, then covers her face as she cries even harder before apologizing to Luka. He gently reassures her, obviously affected, as she continues: her wish for them to have justice and freedom has now cost her two children. Luka quietly tells her Mahir will be all right, but Riza knows better. Mahir loved his sister, but thought she was disgracing the family. Luka slowly realizes what she is telling him. She asks Luka to tell the police to look in Mahir's room for the knife that killed Nimet. His worst fears realized, Luka asks hesitantly if Nimet's was an honor killing. Riza acknowledges that it's called that, but knows there is no honor in it, and Luka's face reflects his own remembered grief.

Morris sits staring at his laptop in the lounge as Clemente enters. He shows Clemente the picture of his kids. Clemente suggests dinner, but Morris is in a rush to get home. He asks about Clemente's apartment, which Clemente says is fixed. Morris leaves, and Clemente goes to his locker, removing a pillow, blanket and book before stretching out on the couch and turning out the light. Cut to end credits.
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