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Chicago Hope:
Reading Between the Lines

Ever watch tv and wonder what the e.r. physicians are really saying? The producers of Chicago Hope were kind enough to let us translate the final scene from a recent episode. Click on the underlined words below to see the "translations."

EXECUTIVE PRODUCER: JOHN TINKER
EXECUTIVE PRODUCER: BILL D'ELIA
EXECUTIVE CONSULTANT: DAVID E.KELLEY
SUPERVISING PRODUCER: JAMES C. HART
PRODUCER: JOHN HEATH
PRODUCER: ROB CORN
PRODUCER: DAWN PRESTWICH
PRODUCER: NICOLE YORKIN
PRODUCER: TIM KRING
DIRECTOR: BILL D'ELIA
Image from show: the operating table from overhead, with staff close around table
CHICAGO HOPE
"Lamb to the Slaughter"
Teleplay by
A. DeSantis Martin
&
John Tinker
Story by
Zachary Martin, M.D.
&
John Tinker




MCNEIL
You see what I see? Liver looks like ground-round.



NYLAND
Looks more like pate.


MCNEIL
(to Nurse) Suction. Pull back retractor, I can't see anything—too much bleeding.


NYLAND (CONT)
Get me some gel foam. What a freakin' mess... (to Nurse) Keep the clamps coming.


WILKES
(overhearing)
What's the situation down there?


MCNEIL
Not much to work with. Liver's totally blown.
(to Nurse) Sponge sticks. More laps.


NYLAND (CONT)
(to Nurse)
Clamps. Large hemo clips. Soak more gel foam.
(off McNeil's order)
A lot more sponge laps.


WATTERS (VOICEOVER)
The survival rate for this kind of injury in the E.R. is nearly zero.



LAMB (VOICEOVER)
Yes, you've said that.



WILKES
I've got a lacerated pulmonary artery—probably from a bullet fragment. Nyland, I'm gonna need you up here.
(to Nurse)
We have a pulse yet?



NURSE
Yes, but it's thready.



WATTERS (VOICEOVER)
Very weak.


Nyland moves up to chest with Wilkes.


NYLAND
The other vessels seem to be intact .



WILKES
Good, good. Then let's check behind the lung.


Wilkes briefly glances up at monitors, checking levels as Nyland jumps in. To McNeil:


WILKES (CONT)
Jack, you holding up?



MCNEIL
C'mon, you serious?
(to Nyland)
I need some help tying off these vessels.



NYLAND
I'm with you.
(to Nurse)
Bovey.

Image from show: closeup of surgical tools, including retractor, clamps, in chest

Nyland helps McNeil, adding hemo clips, helping with clamps. To Wilkes:


NYLAND (CONT)
You're working with way too many instruments here. I'm getting some of these out of the way.


Nyland, back with Wilkes on Marcus' chest, impatiently removes clamp from thoracic aorta. Wilkes notices. To Nyland:


WILKES
Hold it, what're you doing?



NYLAND
(annoyed)
It's okay.
(sotto; re: Wilkes)
You're unbelievable.



NURSE
Pressure's falling.



WILKES
(loud; to McNeil)
Jack, the aorta's clamped?



NYLAND
I clamped it myself.



NURSE
I'm not getting a reading. I have no pulse.

Image from show: closeup of monitor, showing change in heartbeat

Monitors START SCREAMING. The frenzy begins.


MCNEIL
V-tach.



WILKES
Internal paddles, charge to twenty joules.



WATTERS (VOICEOVER)
They'll try and shock Marcus' heart into beating again. Joules is simply a measure of electricity.



NURSE
Ready.



WILKES
Clear.


Wilkes discharges paddles directly into Marcus' heart as Edna and Nathan re-appear in doorway, both in tears.


EDNA
Help him.



NURSE
Sinus Tach.



WATTERS (VOICEOVER)
He's back to a fast heart beat.



WILKES
What's our B.P.?



NURSE
You have none.



WILKES
I'm watching the heart beat.



NURSE
No pulse.



EDNA
Do something.



WATTERS (VOICEOVER)
Even with all those clamps, there's still a massive bleed somewhere.



WILKES
Nyland, reclamp the damn aorta.


Nyland reclamps, Wilkes' adrenaline racing.


WILKES (CONT)
He's in V-fib.
(to Nurse)
Paddles. Twenty Joules.


Nurse hands internal paddles to Wilkes. Wilkes shocks the heart, looks to monitors, no response.


WILKES (CONT)
Starting direct cardiac compressions. Okay, tell me now, tell me—we got a pulse with that?



MCNEIL
Still nothing.



WILKES
Are the IV's wide open? Ventilation okay? We need more volume, more O-neg blood and lactated ringers.



MCNEIL
Still no pulse.



WILKES
Get the Lidocaine ready and give him one amp Epi and repeat every three minutes 'til we get a pressure.



WATTERS (VOICEOVER)
Lidocaine calms the heart. Epinephrine's a chemical jolt that strengthens the beat.



MCNEIL
Asystole.



WATTERS (VOICEOVER)
No heartbeat. No electrical impulse to make the heart beat.


Edna is breaking down.


WILKES
Nyland, you sure you got a clamp on the aorta?



NYLAND
Anyone else wanna second-guess me?



MCNEIL
He's flatline.



WILKES
Give him one amp of Atropine, another of Epi.

Image from show: staff by the table

Nurse injects Atropine directly into IV.


NATHAN
He'll be okay, Mama.



EDNA
My boy, my boy.



NURSE
Asystole.



MCNEIL
What're we doing, Keith?


An eternal beat of SILENCE, save for the solo TONE of the flatline and Edna's WAILING. All eyes are on Wilkes, waiting.


MCNEIL (CONT)
Wilkes... You're running the code? What about it?



NYLAND
Call it.


Wilkes shoots a look at Nyland. Then, realizing it really is hopeless:


WILKES
Time of death, ten o'clock.


Edna breaks down completely, falling to the floor, Nathan trying, but unable, to comfort her. Wilkes is stunned, without a clue as to what happened. As McNeil reaches up and TURNS OFF EKG, SILENCING TONE.


(special thanks to Beth Zeeman, M.D.)

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