Season 2, Episode 13: ‘7:00 A.M.’
We have come to it at last. In episode after episode, Dr. Michael Robinavitch has dropped hints, given warning signs and generally worried his friends and colleagues with his increasingly frazzled demeanor. Now, in this episode’s cliffhanger moment, he says what everyone has been thinking: His impending sabbatical might be permanent.
The moment arrives when an exasperated Dana pulls Robby aside to confront him about his behavior. Just today, he has publicly shamed both McKay and Mohan. He speculates about a patient’s potential suicide attempt where anyone can hear. His buddy Duke’s life-threatening condition leaves him slamming his clipboard and shouting obscenities.
If her kids behaved this way, Dana says, she’d give them a time out. Robby shuts that line of discussion down by revealing his own mother left him. Surely it’s no coincidence that he then runs down an entire list of people he feels he can’t leave behind.
“I’m not sure that Al-Hashimi is fit to run this place,” he tells an incredulous Dana. “I also don’t know if Langdon is going to relapse. I don’t know if Whitaker’s going to be able to take care of my [expletive]. I don’t know if Javadi’s going to give up on what she’s good at or if Samira’s going to flame out because of some [expletive] with her mother.” Robby concludes his litany of complaint cum concern by turning his attention to Dana herself. “I don’t know about you running around with a full syringe of Versed in your pocket.” Given enough time, I’m guessing he would have a similar line about every employee in the department.
“We’ll all manage until you come back,” Dana assures him. “We always do.”
Then he hits her with the question the show has hinted at all season long. “Yeah? What If I don’t come back?” The line leaves Dana uncharacteristically speechless, her mouth and body hanging slack. With that one comment, she goes from the E.R.’s den mother to looking like a scared, sad little girl. (This is Dana, however, so I expect her to snap out of it by the time the next episode begins.)
The episode also sees an influx of new staffers as the night shift takes over. Familiar faces here include Dr. Abbot, Dr. Ellis, Dr. Shen (Ken Kirby) and Nurse Mateo. We also meet Dr. Crus Henderson (Luke Tennie), the night shift’s revered senior attending, who’s an ace with the ultrasound, and Nazely Toomarian (Sofia Hasmik), a new intern on her first rotation. Nazely’s brief conversation in Armenian with Dr. Al earns a disapproving shake of the head from Monica, the retired clerk, who radiates “This is America, speak English” vibes.
Dana helps catch the new crew up on the news of the day, including Nurse Jesse’s arrest by I.C.E. and Nurse Emma’s assault by a patient. Dr. Abbot breaks the news to the day shift that they’re responsible for scanning and double-checking the analog paperwork they did while the computers were down. So much for the “sign-out” aspect of sign-out rounds, during which the daytime doctors and nurses bring their nocturnal replacements up to speed on the day’s cases.
One such case is Digby, the homeless man whose hygiene and maggot-infested arm brought him in, but who is otherwise a nice guy to be around. Dana and Emma give him a shave and a haircut, a makeover so spiffy that the newcomer Nazely no longer recognizes him. When he worries his family might have similar trouble if they come looking for him, Emma reassures him no daughter will ever forget the face of the father with whom she danced at her wedding, as Digby’s daughter did with him. That kind of bedside manner is hard to teach.
So is Javadi’s skill in the E.R., which leaves Robby chagrined when he sees her decline to participate in a procedure with the hospital’s chief of neurosurgery (Mary McCormack). He effectively forces her into it, telling her he doesn’t want to come back from his sabbatical to find out she’s now a dermatologist.
Santos’s real talent is for figuring out “the weird stuff,” as McKay puts it. It helps her solve a jaundice case brought on by medically inadvisable amounts of turmeric, consumed at the advice of online health influencers. Santos’s trick, she says, is simple: Think of the stupidest thing people can do, then assume that’s what they did. It’s not as though they can turn to the C.D.C. for good advice anymore, Santos says, calling the MAHA-ified department’s webpage “a medical toxic waste site.”
In a new case, an asthmatic boy whose lung collapses because his family cannot afford inhalers nearly undergoes a risky procedure at Langdon’s urging, only for Dr. Henderson to step in with the right diagnosis at the last moment. This emergency room drama obscures the underlying cause of the boy’s condition. His family lost Medicaid coverage after a re-determination notice was sent to an old address and not forwarded. It’s an illustration of how onerous bureaucracy leads to cuts in social services by making them difficult or impossible for the people who need them to obtain.
Did a lack of health insurance cause Mohan’s patient Orlando Diaz’s brain-injuring fall? There’s no sign that the diabetic man’s decision to leave the E.R. against medical advice had anything to do with it. Perhaps it was the day’s intense heat that triggered his 20-foot plunge … or, as Robby callously suggests, perhaps it was a desperate man’s attempt to spare his family further medical debt on his behalf.
Orlando’s plight leaves Mohan snapping at her colleagues, which for her is as out of character as her earlier panic attack. Hearing Robby’s girlfriend, Noelle, tell the family that things will now be easier since they’ll qualify for government health coverage upsets her as well. “Perhaps this isn’t the best time,” she says, understating things. When she learns that a patient she helped treat died during surgery, it feels like it could be the final straw for her career in emergency medicine.
Seemingly not content to badger Mohan over her own fitness for the E.R., Robby also asks her about Al-Hashimi’s. Samira and Dr. Al were colleagues at the V.A., but Mohan tells Robby she never noticed anything unusual … until this morning, when she saw Al-Hashimi zone out while attending to Baby Jane Doe.
There’s one last case of potential burnout to address in the E.R. — or technically outside of it, since the student doctor in question never makes it back through the doors. Ogilvie was called in on that surgery, because it was his misdiagnosis that caused the man’s condition to worsen. He returns from the unsuccessful surgery in shock.
When Whitaker comes to speak with him, he is sitting in the ambulance bay, covered in the man’s blood and his own tears. He tells Whitaker he doesn’t think he has another day like today in him, and that perhaps he’ll seek an assignment in a less chaotic department.
Whitaker says that kind of gig would bore him out of his mind. “I like the challenge of undiagnosed illness, of quick decisions, of lifesaving procedures,” he tells Ogilvie. “And I like being here for people on the worst days of their lives.”
For certain kinds of people, that’s an unimpeachable case for the value of working in the E.R. I’d say Whitaker should find Robby and tell him all this, but I suspect Robby already knows, and that these are the reasons that some day, he’ll ride that motorcycle right back to work.
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