The Poison Inside Us

Air date

November 7, 2018

Runtime

40 minutes

Production information

Series information
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The Poison Inside Us is the seventh episode of Season 4 and the sixty-eighth overall of Chicago Med.

Summary[]

The hospital is forced to evacuate when a toxic chemical is brought into the E.D., leaving patients and staff in grave danger, and leaving Goodwin to make some tough choices. Stuck in an elevator, Dr. Charles and Dr. Manning are forced to take drastic measures with a pregnant woman. Dr. Rhodes discovers a secret that Dr. Bekker has been holding from him.

Cast[]

Main Cast[]

Crossover Cast[]

Recurring Cast[]

Heather Headley as Gwen Garrett
D.W. Moffett as Cornelius Rhodes
Arden Cho as Emily Choi
C.S. Lee as Bernard Kim
Dennis Cockrum as Ray Burke
Devin Ratray as Tommy Burke
Anna Enger Ritch as Agent Ingrid Lee
Cynthia Addai-Robinson as Dr. Vicki Glass
Adam Petchel as Tim Burke
Nate Santana as Dr. James Lanik
Lorena Diaz as Nurse Doris
Casey Tutton as Monique Lawson
Courtney Rioux as Paramedic Courtney
Sarah Charipar as Dr. Deirdre Grant
Sarai Rodriguez as Nurse Denise
Susaan Jamshidi as Rosie Abbasi

Guest Cast[]

Noelle P. Wilson as Claire Burton
Michael Wollner as Jacob Patrick
Michael Kevin Martin as Derek Glenn

Plot[]

The episode opens with Dr. Will Halstead at the home of local businessman and suspect in a federal investigation, Ray Burke, and his sons Tommy Burke and Tim Burke. Ray was feeling unwell, and they asked Will to make a house call instead of calling an ambulance. Will suspects that Ray may have had a stroke, and persuades him to come to the hospital for a quick M.R.I scan. Ray reluctantly agrees, telling Will he has an important bridge game to attend later that night. Will, meanwhile, has lied to his fiancee about his whereabouts, telling her that he is running an errand for his brother, Detective Jay Halstead of the Chicago P.D. At this hospital, Will's fiancee, Dr. Natalie Manning, talks to charge nurse Maggie Lockwood about her concerns regarding Will, telling Maggie that his behavior seems a little off lately, which Maggie dismisses as pre-wedding nerves. Dr. Ethan Choi and nurse April Sexton say goodbye to Ethan's sister, Emily Choi, and her boyfriend Bernard Kim, who are both moving to Las Vegas. Ethan is concerned about both Emily and Bernard, who are recovering alcoholics, and especially Bernard, who is also recovering from pancreatitis, but Emily and Bernard assure him they will be careful. Later, Maggie asks April if she will pick up her former relationship with Ethan, as they had broken up over a dispute concerning Emily, who is now leaving Chicago. April tells Maggie that the dispute over Emily only laid bare other challenges in her relationship with Ethan, and that their relationship is definitively over.

Dr. Connor Rhodes and Dr. Ava Bekker are walking down the stairs of the hospital, chatting, when Connor spots his father, businessman Cornelius Rhodes talking with the hospital's C.O.O. Gwen Garrett. Cornelius tells Connor that he now has a seat on the hospital board. Later, Connor asks Gwen why his father has been given a seat on the board, and she tells him it is because Cornelius is a large donor. Connor realizes that his father is the anonymous donor who provided the funding to set up the new hybrid cardiac operating room that Connor had proposed, and is now in charge of. Connor had previously attempted to find out the donor's identity, but was prevented from doing so by hospital regulations, as Cornelius had expressly asked to remain anonymous. Gwen had disclosed the information to Connor, assuming that he already knew his father was responsible for the donation. Connor is upset, seeing it as another attempt by Cornelius to control him and interfere in his life. He is also upset when he realizes that Dr. Ava Bekker, with whom he has been flirting, and dating, knew that Cornelius was the donor, but withheld the information from him. Ava tries to convince Connor that the identity of the donor does not matter, as long as he is saving lives with the new hybrid O.R.. Connor disagrees, pointing out that Ava lied to him by omission, and further, that he does not like being beholden to his father, which Ava knew. Connor returns to the E.R., where he treats Derek Glenn. Derek had an accident, and has sustained a tear in his spleen, and has been put in Connor's hybrid O.R. as the rest of the E.R. was full. Connor tells Derek that most cases like his resolve by themselves, but that they will monitor Derek closely to see how he progresses in case his does not resolve.

Maggie Lockwood assigns Dr. Natalie Manning to treat Claire Burton, a pregnant bipolar woman who had a car accident during a manic episode, and a previous patient of Natalie's. Dr. Daniel Charles, the Head of Psychiatry, helps administer medication that could calm Claire down so that they can speak with her. Natalie tells Dr. Charles that she had reduced Claire's medication for her bipolar condition as she was pregnant, and Dr. Charles tells her that this likely caused Claire's episode. Natalie is upset, after Dr. Charles informs her that new research shows that she did not need to reduce the dosage of Claire's bipolar medication, despite her pregnancy. They return to Claire, who is now lucid, and realize she is bleeding, likely because of a placental abruption caused by her car accident. They take Claire, who is worried she hurt her baby, up to OB/GYN to deliver the baby at once.

As Dr. Will Halstead enters the hospital, followed closely by the Burkes in another car, he is intercepted by Agent Ingrid Lee of the F.B.I. Agent Lee has been handling Will, who has agreed to be a confidential informant to them in their investigation of the Burkes. Agent Lee tells Will that the 'bridge game' that Ray is attending tonight is a major criminal operation that they are hoping to intercept, and that he cannot miss it. She tells Will to cancel Ray's tests and send him home. Will refuses, telling Agent Lee that he works for the hospital and not the F.B.I., and is not swayed when Agent Lee threatens to make his life hard. Agent Lee leaves before the Burkes arrive, ordering Will to ensure that Ray Burke makes it to his 'bridge game.' Will unsuccessfully tries to convince the technicians to expedite the M.R.I. on Ray Burke.

Charge Nurse Maggie Lockwood tells Dr. Ethan Choi that they have a patient who is insistent on seeing him, specifically. In a treatment bay, the patient, Jacob Patrick, tells Ethan that he had previously treated Jacob's wife, Megan Patrick. When Ethan does not recall her immediately, Jacob tells Ethan that Ethan is the doctor who killed his wife, and holds up a container marked 'Toxic', threatening him. He asks Ethan to tell him exactly what happened, and is not mollified by Ethan's attempts to calm him down. Jacob allows Ethan to look up Megan Patrick's chart. As Ethan recounts the case to Jacob, Maggie Lockwood tells nurse April Sexton that she sensed something odd about Ethan's patient earlier. April offers to go check on them. Entering the room, April asks if Ethan needs her help, but he declines, and Jacob turns his back, hiding the toxic canister. April tells Maggie that there is certainly something suspicious, and Maggie calls security. Ethan recounts to Jacob that his wife came into the hospital with breathing difficulties, and was administered medication but had a cardiac arrest. Ethan unsuccessfully attempted to revive her, but she passed away. Jacob tells Ethan that he wants Ethan to know what his wife experienced, i.e. difficulty breathing, and breaks the toxic container, breaking it. Ethan alerts everyone that there has been a toxic spill, and Maggie, Ethan, and April start evacuating the E.R., implementing internal disaster protocol.

As the E.R. is evacuated, Connor tries to get his patient, Derek, out of the hybrid O.R., assisted by Ava, who has followed Connor there. As Derek seems too fragile to move, Connor instead seals the three of them inside the O.R. as it has positive pressure ventilation, keeping them safe from the toxic contaminant outside, as long as they keep the doors closed. IDr. Daniel Charles and Dr. Natalie Manning find themselves trapped in an elevator with their bipolar pregnant patient, Claire. They manage to get the doors open, although they are stuck on a floor that is being renovated for orthopedics rehab. Ethan lifts up Jacob, who caused the toxic contamination and has collapsed, and lifts him out. Dr. Choi starts coughing, evidently suffering from the spill. Will Halstead joins them outside, as they try and deal with patients who are stuck in ambulances.

Natalie and Daniel realise that they will have to perform a C-section on Claire, as they are trapped with no way out, and she is bleeding badly. Claire blames herself for the situation, and Natalie tells Daniel , that it is actually Natalie's fault. Although Natalie told Claire she could manage the pregnancy, Natalie now has doubts that as a bipolar patient, Claire will manage. Natalie also does not feel confident about performing a C-section, having never done one before (her specialities being pediatrics and emergency medicine). Daniel tells Natalie that they will manage together, and will try and get an OB/GYN doctor on the phone to talk them through it. Claire's bipolar medication is starting to wear off. Daniel remains on the phone with the OB/GYN, who passes on instructions on how to do the C-Section to Natalie with their limited equipment, as Claire grows increasingly more agitated. Natalie struggles with figuring out how to do the C-section and is alarmed when she is told to make the call herself on which way to proceed. Natalie needs Daniel's help, so he gets off the phone with the OB/GYN and assists her. They struggle to get the baby, as Claire screams, but manage to deliver the baby. Natalie struggles to clear the baby's airways, but succeeds, as Daniel tends to Claire. They give the baby to Claire to hold.

Trapped inside the hybrid O.R., Connor and Ava realise their patient, Derek, needs blood. Connor attracts the attention of the decontamination staff, who tell him that he can't leave at once but they will try to get him blood. Ava and Connor try to keep their patient's blood pressure up until they can get blood. Connor and Ava disagree on how to treat Derek, with Connor telling Ava he isn't interested in her opinion. They ultimately determine that they need to remove his spleen, but can't do so without giving Derek blood. Ava, being a universal donor, decides to directly donate to Derek. Connor disagrees, thinking that this might end with both Ava and Derek bleeding out, but seeing no other options, they proceed. Ava transfuses blood directly to Derek as Connor operates. Connor is concerned that Ava will bleed out, but Ava tells him to go on. As Connor operates, Ava gets progressively weaker from blood loss, but tells Connor that she won't stop transfusing until he's finished. Connor rapidly removes the spleen, but Ava faints from blood loss. Connor removes the transfusion tube, as she wakes up again, and tells her that they did it.

Ethan refuses to rest, working with April, Maggie, and Will to treat patients who are stuck inside the E.R. Ray Burke's sons arrive, aggressively demanding that Will should get their father out of the hospital in time for his 'bridge' game. Will tells them he can't, as the hospital is locked down, but is called away by April to tend to Ethan, who has collapsed. As they treat Ethan, April tells Maggie that Ethan was trying to protect her earlier, when he sent her away from the room where he was trapped with Jacob. Both Ethan and Jacob Patrick are having bronchospasms, but there is only one dose of medication available. Sharon Goodwin, the hospital administrator, decides to give the dose to Jacob Patrick as hospital protocol demands, as he is currently in worse condition. April is infuriated, telling Sharon that Jacob doesn't deserve it. April and Will attempt to find a substitute medication for Ethan, but when a firefighter struggles to understand how to locate the medicine, April ignores his protests and goes in and retrieves it herself, exposing herself to the contaminant. Will gives Ethan the medication, while firefighters take April to get decontaminated. Will's brother, Chicago P.D. detective, Jay Halstead, arrives at the hospital and tells Will that the meeting with Ray Burke has been cancelled, thanks to Will's insistence on taking Ray to the hospital, thus jeopardising their investigation. Will tells Jay that Ray needed the scan, and as a doctor, he took an oath to care for his patients. Will also points out that he couldn't have predicted that the toxic spill would occur, but Jay, evidently displeased, walks off.

Outside the E.R., hospital administrator, Sharon Goodwin works with firefighters, police, and special staff to decontaminate the E.R. and identify the contaminant that Jacob Patrick spilled. A Chicago P.D. officer, Hailey Upton, tells Sharon that Jacob worked at a chemical factory and had acesss to a wide range of chemicals. As they manage to narrow down the nature of the spill, April tells Sharon that she didn't fight for Ethan, but Sharon defends herself, saying that she followed the right procedure, as Ethan himself would have done. After decontamination, April monitors Ethan, who is unconscious. Jacob Patrick goes into cardiac arrest, and April and Will work to revive him, but are unsuccessful. Sharon tells them that the toxin that Jacob Patrick spilled has been identified as cyanide, causing April to panic as she runs to Ethan. With the E.R. decontaminated, April, Ethan, and Will move their patients back inside, and administer a preventive dose of medication to everyone affected including Ethan. Will tells April that there is no antidote to cyanide, but they are doing the best they can. Sharon arrives to move Ethan to the I.C.U, and April apologizes for her earlier remarks, agreeing that Ethan would have also wanted the dose to go to Jacob Patrick.

Natalie and Charles move Claire and her baby to the OB/GYN wing, and Natalie goes to thank Dr. Grant for her assistance on the call, who tells her that she did a good job. Dr. Grant is confused, leading Natalie to realise that Daniel was only pretending to be on a call with the OB/GYN to give her the confidence to conduct the C-Section. Natalie is upset, calling Daniel's actions reckless, unprofessional and manipulative. Daniel shows her Claire, who is stable and holding her baby. He tells Natalie that she advocated for Claire, despite her bipolar disorder, and just needs to learn to trust her excellent instincts. Derek wakes up and Connor tells him his surgery got complicated, but that he will be fine. He goes to check on Ava, who is receiving blood donations, and brings her a snack. Connor tells her that she was incredible and that she saved Derek's life. He thanks her. Ava stops him as he's leaving and tries to talk about his father. Connor tells her it doesn't matter, but Ava confesses that she asked his father for the donation, personally, because Connor was planning to leave otherwise, and she didn't want to lose him. They kiss.

Outside the hospital, Will doubles over in pain, vomiting blood and is found by Natalie, who suspects he may have also been exposed to the cyanide. Natalie tells Will in the hospital that he has an ulcer, and confronts him over his strange behavior, asking if there's something Will isn't telling her. Will, continuing to conceal his involvement in the investigation of Ray Burke, lies to her and says no. Meanwhile, April is told by Maggie that Ethan is waking up. As she is going to him, she tells Maggie that she was wrong about her relationship with Ethan being over. Maggie tells her she knew. When Ethan awakes, his ex-girlfriend Dr. Vicki Glass is there. The hospital called her as Ethan forgot to update his emergency contacts after they broke up. Ethan says he's glad to see her, and they catch up, while April watches them, from outside.