Extreme Measures

Extreme Measures
Air date	October 20, 2016
Runtime	41 minutes
Production information
Directed by	Daisy von Scherler Mayer
Written by	Shelley Meals Darin Goldberg
Teleplay by	Diane Frolov
Series information
Previous	Brother's Keeper
Next	Alternative Medicine

Extreme Measures is the fifth episode of Season 2 of Chicago Med. It aired on October 20, 2016.

Summary

A car accident at the Chicago Marathon leaves a victim in critical condition and tests the mettle of Dr. Halstead, April and her fourth-year medical resident brother Noah, who must perform a difficult procedure in the field. Dr. Manning deals with a mother who brings in her 8-year-old daughter who is experiencing sudden hearing loss. Dr. Choi deals with Olga, a woman who is malnourished, prompting him to bring in Dr. Charles to help assess the case. Goodwin takes measures to get her personal life in order.

Cast

Main Cast

• Nick Gehlfuss as Dr. Will Halstead
• Yaya DaCosta as April Sexton
• Torrey DeVitto as Dr. Natalie Manning
• Rachel DiPillo as Dr. Sarah Reese
• Colin Donnell as Dr. Connor Rhodes
• Brian Tee as Dr. Ethan Choi
• Marlyne Barrett as Maggie Lockwood
• S. Epatha Merkerson as Sharon Goodwin
• Oliver Platt as Dr. Daniel Charles

Crossover Cast

• Elias Koteas as Alvin Olinsky

Recurring Cast

• Jeff Hephner as Jeff Clarke
• Peter Mark Kendall as Joey Thomas
• Roland Buck III as Dr. Noah Sexton
• Marc Grapey as Peter Kalmick
• Patti Murin as Dr. Nina Shore
• Branscombe Richmond as Keoni
• Lawrence Grimm as Lawrence Dayle
• Lorena Diaz as Nurse Doris
• Cesar Jaime as Paramedic Cesar

Guest Cast

• Betty Buckley as Olga Barlow
• Anita Gillette as Ruth
• Tai Davis as Michelle Kastpen
• Maddi Clarke as Phoebe
• Steve Casillas as Ignacio
• Kayla Carter as Lana
• Tony Lawry as Driver
• Kara Davidson as Woman
• Steve Lords as Puking Man

Plot

The episode begins with April Sexton and Noah Sexton staffing a first aid booth at the Chicago marathon, during record heat and power outages. Dr. Nina Shore and Dr. Will Halstead are also participating in the marathon, and discuss plans for later. At the booth, a volunteer calls April and Noah to help with a man, Ignacio, who has been run over. The driver tells them that his brakes failed. April calls for help but because of the marathon traffic, they may not have assistance. The patient needs a chest tube, something neither April nor Noah are authorised to do, as a nurse and a medical student each. Sharon calls Will and sends him to assist April and Noah, telling them not to treat the patient without Will. April tries to discourage Noah from going ahead with putting in a chest tube, but Noah goes ahead, as the patient is not well. Noah manages to get the tube in, but it results in bleeding. He struggles to intubate the patient. Will and Nina arrive, and Will intubates the patient, telling him Noah should have waited. Nina, April, and Noah are in favour of opening the patient's chest and addressing the bleed, and not waiting, while Will is reluctant, saying he has been down the road of attempting extreme measures before. They tell Will the patient might die, noting that he is temporarily stable, and he agrees to go ahead with the procedure.

Jeff Clarke treats a 74 year old woman, Olga Barlow, who has a history of heart trouble and is experiencing difficulty breathing. Clarke initially diagnoses her with heat exhaustion, and orders fluids, but when Dr. Ethan Choi arrives, he checks Olga's medicine and finds she has pulmonary hypertension. Ethan tells Jeff that the fluids he ordered could have given Olga heart failure, and takes over the case, giving Olga painkillers and medication. He tells Jeff to do a complete history and medical assessment before making a diagnosis. A little later, a code blue is called and Ethan responds along with Natalie and Jeff. Jeff goes to place an oral airway, but Ethan takes over. Ethan says he can't understand the patient's reaction. Jeff apologizes to Ethan for his previous mistake, and Ethan tells him he is here to learn and mistakes will happen.

At the hospital, Dr. Charles tells Sharon that her estranged husband, Bert, called him asking to meet for drinks and asks if she would be okay with that before he responds to Bert. Sharon tells Dr. Charles to make the decision, and that she is fine. She later goes to Peter Kalmick, the hospital's counsel, and asks for the number of his husband, who is a divorce attorney. Dr. Natalie Manning treats a child, Phoebe, who is experiencing intermittent hearing loss in both ears. Phoebe's mother tells Natalie that Phoebe has had trouble hearing for a while, and Natalie orders tests. Dr. Connor Rhodes tells Sharon Goodwin that he performed seven surgeries for trauma the night before, and that the hospital is over-scheduling doctors. Sharon tells Connor that she will look into it, and advises him to go home, but he tells her he has to back to the E.R. and deal with a consult. Dr. Sarah Reese and Joey Thomas arrive at the hospital together, and Joey asks if bringing flowers to Sarah's mother at dinner that night will be too much. Sarah tells him that her mother cancelled dinner, as she was busy, and sent Sarah a cheque instead; something that has happened before. Joey tells Sarah that his mother would have baked cookies, but Sarah tells him baking cookies takes more time than just placing a call to your accountant.

At the marathon, Will cuts open the patient, Ignacio, and finds that a rib perforated the patient's aorta. They have nothing to clamp it with and end up stopping the bleed manually but need to get the patient on blood. Will suggests a portable bypass, which has been used before, but in France. Back at the hospital, Maggie Lockwood sends Jeff Clarke to run to Will, April and Noah with the portable bypass machine. Jeff seems taken aback by the request, but goes. Sharon Goodwin tells Connor that Will is placing a patient on portable bypass, and Connor is taken aback, telling her that you can't regulate blood flow to the brain with a portable bypass. Sharon tells him he can debate it with will when they get to the hospital, and Connor says he will. Jeff arrives with the portable bypass machine. Natalie orders tests on Phoebe, her young patient with hearing loss. Phoebe is fractious, asking for her father, who is at work. Natalie takes Phoebe's mother aside, asking why Phoebe would want to call her father, as the patient history indicates he is deceased. Phoebe's mother tells her that she hasn't had the heart to break the news of her husband's death to Phoebe, and Natalie says they have a doctor at the hospital who might be able to help.

Ethan talks to Olga and tells her that her reaction to pain medication was surprising and asks if she's been taken her medication regularly. Olga tells him that she accidentally spilled some of her medicine and missed a few doses. Ethan tells her it might have caused the bad reaction, and asks her if she's eating well. When she says she hasn't as she is not a good cook, Ethan advises to wait until she's tried hospital food. He asks Dr. Charles to evaluate her, noting that she lives alone, is undernourished and isn't taking her medication. Dr. Charles goes to meet Olga, who tells him it has all been a big mistake. She talks to Dr. Charles about her travels with her husband in the past, and about how people today don't value style like they used to. Dr. Charles tells Ethan that she is competent, not suicidal, and nostalgic, but it doesn't explain why her charts indicate that she's apparently eating cat food. Dr. Charles tells Ethan that all the medications she's on have a high street value, suggesting she might have sold them, and that she might be struggling financially. At the marathon, April tells Will that paramedics are near. They have him on portable bypass, but he has been clamped for twenty-four minutes, which concerns Will. They move the patient back to the hospital, and are met with Connor. Connor asks Will if the portable bypass was his call, and Will says it was their only option. Connor takes over the patient. Will watches Connor scrub in, and asks Connor what he thinks. Connor says it is unusual to see a rib pierce the aorta, and he'll try to repair it, but they cannot tell if the patient's brain activity will be affected. He tells Will that he must be "one hell of a poker player," for taking such a gamble. Nina tells Will later that they did the right thing, but Will isn't sure, asking, "Did we?"

In her office, Sharon meets with Lawrence Dayle, who is a divorce lawyer, and Peter Kalmick's husband. Lawrence asks Sharon if she is sure she doesn't want to attempt a reconciliation with her estranged husband, Bert, and that legal separation is a big step. Sharon tells him that they are well past reconciliation. Lawrence takes Sharon through the terms of the proposed separation, and Sharon says she doesn't want any maintenance. Lawrence hands over the papers, and Sharon prepares to sign them. Meanwhile, Sarah Reese and Dr. Charles talk to Phoebe's mother, Mrs. Kastpen, offering to sit down with Phoebe and break the news of her father's death. Mrs. Kastpen declines and puts off the offer. Sarah tells Dr. Charles that Mrs. Kastpen's body language indicates she might be lying or hiding something. Dr. Charles responds that most of the 'body language' information is a "bunch of hooey," but agrees that Mrs. Kastpen is not being straightforward.

Dr. Choi goes back to meet Olga, and talk to her about her health. He tells her the labs show she is undernourished. Olga is defensive, telling Ethan that she is not struggling financially and isn't selling her medicines. He tells her that there are resources available to support her, but she insists it is all just a mistake. Olga's neighbor, Ruth, comes to meet her and tells her that she fed Princess, Olga's cat. Ethan tells Dr. Charles that Olga won't admit to her situation, and Dr. Charles tells him that it is unsurprising, given that people are sensitive on the subject of money. Sarah tells Dr. Charles that there is no one in Chicago with Mrs. Kastpen's name, and that it might be a false name. Natalie also arrives with Phoebe's CT scan results, which show that Mrs. Kastpen hasn't given them a full and accurate history. They sit down with Mrs. Kastpen and tell her that the scan shows several healed skull fractures, which explain the hearing loss and may also indicate child abuse. Mrs. Kastpen tells them she would never hurt her child, but Dr. Charles tells her that without an alternative explanation, they may have to contact child services. Mrs. Kastpen says she is divorced, and it was her ex-husband who hurt Phoebe. She couldn't afford the kind of legal support he had, so she took Phoebe and fled. She begs them to not call the police, as they will take Phoebe back to her ex, who might hurt her again. Sarah, Dr. Charles and Natalie go to Sharon Goodwin, who insists on reporting it as they are required to. Dr. Charles also warns Sarah that Mrs. Kastpen may not be telling the whole truth.

Ethan runs into Ruth, Olga's friend, and helps her get some snacks out of a vending machine. He compliments Ruth on her jewellery and bag, and on the bag she brought for Olga. Ruth tells him that Olga and she both "like nice things." Ethan expresses his concern that Olga is having financial issues. Ruth says that she has noticed that Olga's pantry seemed less well-stocked, and is concerned that she might have given Olga the impression that she has more money that she does, as her son sends her expensive gifts. Ethan tells Ruth to tell Olga the truth, to relieve her of trying to keep up with Ruth. Dr. Charles tells Ethan that he made a good catch, identifying the issue and they watch Ruth and Olga talk. Ethan says pride can literally kill you, but Dr.Charles tells him that sometimes pride is literally all that people have left.

Natalie tells Phoebe's mother that they made the call and that they should prepare Phoebe for what comes next. While talking, Natalie notices Phoebe is having difficulty coloring, and Phoebe tells her she used to be able to color better before. Natalie runs blood tests and finds that Phoebe has osteopetrosis, a genetic condition that her parents may have passively carried and passed on to her. The condition explains Phoebe's hearing loss, as well the weakness in her hands. Natalie tells Phoebe's mother that they have some success in treating it with bone marrow transplants. She also tells Phoebe that it may have caused frequent bone fractures, so it is possible that Phoebe's father did not abuse her. Phoebe's mother is shocked, asking "What have I done?" as Detective Alvin Olinsky arrives with Child Services to speak with her. Phoebe's mother leaves with the police as Phoebe cries out, asking for her to come back. Reese tells Natalie that Phoebe did the right thing, and Natalie says that she should have consulted a doctor before going on the run.

Will heads back up to check on his marathon patient, Ignacio, who hasn't woken up yet. Connor comes in and they both check on him, but the patient does not respond. Will is concerned, asking Connor what he's done to the patient. Connor reassure Will, telling him that they should wait a little more while. They both return to check on the patient, with Will becoming increasingly distressed as Ignacio fails to wake up. When he does, Connor talks to Ignacio, who is able to follow with his eyes and squeeze his hands, but not to move his legs. He is able to move his toes, however, indicating that he is recovering well. Relieved and emotional, Will walks out, weeping, and Nina moves to comfort him, thinking it is bad news, but Will tells her he was just so relieved. They both embrace. Connor tells Jeff that he did a good job getting the bypass to them. Noah hugs April, who tells him that he did a good job and that she's proud of him. Sarah calls her mother to thank her for the check, and Joey comes in, asking why Sarah called, as he thought Sarah was angry with her mother. Sarah says she was, but her mom was just doing the best she could.

As they leave the hospital, Natalie congratulates Jeff on saving his patient. Jeff is dismissive, saying anyone could have carried equipment, but Natalie tells him that he saved a life, and that counts. Connor stops by Sharon's office to tell her that Ignacio survived, and she tells him to go home and rest after his marathon shift. He tells her has something different in mind, and asks her what her plans are. Sharon, who is looking over the separation papers, which she has just signed. Sharon says she is just going to go home. Connor is about to leave, but asks if she wants to join, as he going to do something fun. He takes her to a Hawaiian bar that Dr. Downey introduced him to, and Sharon gets a real lei around her neck, as Connor introduces her to the owner. Connor tells her that "Aloha," means to consciously manifest joy in the present and they toast each other, saying "Aloha." Will and Nina go back and walk through the end of the marathon, so that they can 'officially' finish it. He holds up a torn ribbon for her to run through, and kisses her.

Gallery

• Promotional Images