Recap / ERS 1 E 18 Sleepless In Chicago

Season 1, Episode 18:

Sleepless in Chicago

I lost her... is there something wrong with me?

Having missed his mother's birthday party the week before, Benton is revealed to have traded off two shifts to spend more time with her — in exchange for working a marathon 48-hour shift at Cook County. Unfortunately, it leads to Benton being snappy and irritable, as Susan finds out first-hand when he rails at her for authorizing a surgical procedure without checking in with him. Carter does his best to keep up with him as he tells Susan that "Payback rolls downhill."

Carol visits the group home where Tatiana is staying, and the administrator excitedly tells her that her application to adopt the little girl was fast-tracked. Carol sits with Tatiana, who tells her she's homesick and hopes Carol's house has a VCR.

Back at County, Doug and Mark have an impromptu conversation in the washroom where the latter confirms that he's decided to accept Morgenstern's offer to become the Attending Physician, a remark Doug has heard rumors about and congratulates his friend for. The conversation turns to Jen, who Mark notes has accepted a year-long extension to work in Milwaukee. Like Carol, he gets a Hope Spot in the form of believing he'll be able to make his marriage work despite the demands on their time...

As Carter keeps Benton up-to-date on various procedures and charts, Dr. Hicks approaches them in the hallway, prompting Benton to rail at her for not scheduling him for helping on a bowel-removal surgery. Hicks chastises him for working 48 hours without much of a break, noting that it's not a "competition" to see who can get the most procedures done. She orders him to rest for two hours before storming off.

The morning begins proper with Doug being informed by Jerry that Diane wants to speak with him, Carter attempting to tell Benton to get some rest, and Susan sorting through the medication of a patient who arrived after suffering a seizure (and worked as a "guinea pig" for various pharmaceutical companies to get cash). The staff's attention is diverted by a number of arrivals — Doug and Carol diagnose a young girl named Bonnie who burned her hand on a radiator, Susan receives a patient suffering from a seizure (accompanied by a man who tries to get her to pay the man's breakfast tab) and Mark and Haleh receive a trauma victim who fell down a flight of stairs.

The trauma victim, Joseph Klein, is in fragile condition as Benton, Carter, Mark and Haleh begin to assess his injuries. Klein has a gallery of injuries and existing problems — blind in one eye, suffering from a collapsed lung and possible broken ribs, is missing his voicebox due to previous surgery, and he can't hear what any of the doctors are saying. While they manage to stabilize Klein's condition, but Benton is pulled off the procedure by Hicks, who once again tells him to get some sleep, while the staff learn that Klein doesn't want to be resuscitated due to having terminal cancer. Soon after, Carter attempts to connect with Klein, who he can't understand. Klein eventually writes out on a notepad that he wants to see his son, Roger, and Carter says he'll try to get in touch.

Elsewhere, in a nearby exam room, Susan manages to ascertain that her "seizure" patient was Playing Sick, as he opens one eye during an examination — and later opens his eyes for real when Susan threatens to get a rib spreader. She comments that it was a "hell of a way to get a free meal." Afterwards, Carol meets with Lydia and suggests that the latter take the reins as charge nurse, due to planning to cut back her hours to take care of Tatiana. Realizing that the situation is not likely to last given that Carol and Tag would be married and acting as foster parents, Lydia keeps silent on the matter.

Doug and Carol receive word soon after that Bonnie was admitted to a neighboring hospital previously for the same star-shaped burnmark, prompting them to question her mother, Ms. Howe. She tells Carol that she burned Bonnie for exhibiting signs of sexual behavior, reasoning that it was okay to do so because her own mother did it to her. Doug and Carol are able to stall her long enough to get Bonnie away from her grasp before the police arrive to arrest her, but she attacks and hits Doug before she's detained.

Benton gets more and more stressed as the day progresses. He asks Carter to notify him of any incoming patients, then attempts to diagnose and send a man suffering from a gallstone to surgery without running it by Mark first, prompting the latter to dress him down in front of Susan and another doctor named "Koch", who is overseeing the hospital for research regarding a new model for hospital teams. Even worse, Benton's gallstone patient passes the stone right before the surgery is set to begin, prompting him to leave in frustration. Soon after, he rails at Carter for not getting to a patient fast enough and asks why he's spending time with a "DNR" (Klein), despite being in a surgical rotation. Carter admits that Klein likely won't make it through the night, and that a doctor can be compassionate while still doing their job. Benton nods loudly before walking off to his next case.

Doug and Carol have a brief conversation where she patches up the injury caused by Mrs. Howe — scratches on the side of his neck. When he asks about her plan to adopt Tatiana, she wonders aloud if he's going to try and dissuade her, but he comments that she would make a great mother before he's called away. Outside the hospital, Doug and Mark take a break, and Mark expresses joy that he didn't think of the idea to move to Wisconsin, before the discussion turns to Diane, who Doug admits he's afraid to ask out because one of her friends was someone he once dated. Mark suggests going for it before they're drawn to the arrival of a gunshot victim brought in by ambulance.

Together with Carol, the two men wheel the victims in — a 16 year-old robber and a cop who shot each other during a convenience store robbery. Benton (who's briefly fallen asleep while stitching up a patient) is called to help with the victims. Together, they manage to stabilize both victims, and Hicks (who's just arrived) thanks Benton for his help, believing he'd had a few hours of sleep in the interim.

Carol leaves for the night, with plans to head to the group home to see Tatiana again, while Doug runs into Diane near the front desk — and she chastizes him for getting into another incident after she'd just finished the paperwork on the father he beat up the week before. After giving him some paperwork to fill out, Doug offers to take her out for dinner, but she comments that it "wouldn't be a good idea" before heading back to her office. Soon after, though, Diane returns to the room where Doug is filling out the paperwork and asks him out. They agree to go out the following week.

Morgenstern arrives to tells Mark that he's accepted a residency program at Harvard and will not be immediately available for some time, but that he has given his recommendation that Mark be made the new Attending, commenting that it's "almost a lock". However, Mark is left confused, as Morgenstern tells him that the "new" Chief will make the final call, before leaving.

As evening looms, Benton meets with Carter and asks if he's finished the day's paperwork yet. Carter comments that he's just started, noting that he spent time with Klein — who died ten minutes beforehand. Benton asks him why he wants the subeye surgical internship if he's going to spend his time doting on patients instead of emergency patients, and Carter tells him that both of them don't think the same way, but he still wants to try for it. Elsewhere, Dr. Koch is lecturing Susan about getting his new hospital plan approved and asks her if she'd like to take a job there... only for it to be revealed that "Koch" is not a doctor, but a patient who dresses up as a doctor, as revealed when two representatives of the hospital's psych ward come to bring him back to the other wing. He futilely protests before being led away while Susan looks on in surprise.

Carol heads back to the group home and spends some more time with Tatiana... but she's called away soon after by a representative from the adoption agency, who tells her that due to her suicide attempt the year before, they cannot approve the adoption papers. Left distraught, Carol wanders the streets of Chicago while crying.

Benton returns home and finds Walt, who congratulates him on being on time for once. He tells him that the rest of the family is planning a fishing trip to Lake Erie, and reminds him that Mae wakes up at 6 a.m. and to be there for her. Benton tells him that everything will be fine before the latter heads out for the weekend, and he crashes on the couch to get some much-needed rest.

At Doug's apartment, he's woken up by a knocking at the door. Upon answering it, he sees Carol, still distraught over losing the adoption for Tatiana. She refers to herself as "defective" and believes that everyone only thinks of her as someone who tried to commit suicide. In a moment of weakness, she nearly kisses him before he tells her it wouldn't be a good idea, and says he'll drive her home as she breaks down crying in his arms...

Mark also arrives home and finds Jen, who tells him that she can't keep living the same way anymore. Mark tells her about his "compromise" to live in Kenosha, but Jen tells him that it's just as bad, and laments Rachel not having the opportunity to "grow up without her father". Incensed at Mark's refusal to compromise, she tells him that she's leaving him, causing him to reel in response and nearly shut down...

Benton awakes with a stat in the middle of the night to pleading cries from Mae to help her. Rousing himself from the couch, he looks around before he spots her — collapsed at the bottom of the stairs. Horrified by what's happened, he frantically checks her condition before calling an ambulance. At County, Carter and Susan are shocked to see Benton trailing his mother on a stretcher. As they diagnose her, noting she may have fractured her hip, both Carter and Susan attempt to ask Benton what happened, but he's too shocked to speak...

Tropes:

• Above the Influence: Doug doesn't take advantage of Carol's sadness, despite having pined away for her over the past year.
• Abusive Parents: Bonnie Howe, who has been repeatedly burned by her mother (with a star-shaped paperweight) for exhibiting signs of sexual behavior. When questioned, Ms. Howe admits that her mother did the exact same thing to her, complete with showing off a star-shaped scar on her hand.
• Almost Kiss: Doug and Carol, the latter of whom is still hurting over losing the adoption bid for Tatiana.
• Artistic Licence Medicine: Apparently, "Dr. Koch" (the psych ward patient) is not only explained as having assisted in the delivery of children in the maternity ward (an act that could have disastrous consequences for County if the patient(s) knew), but he's able to roam around the ER all day annoying and distracting doctors before the psych ward reps locate him. Either one of those incidents is a malpractice suit waiting to happen.
• Be Careful What You Wish For: Walt Robbins expresses happiness that Peter arrived on time for once (after missing Mae's birthday party in the previous episode) and heads out for his fishing trip, telling Benton to enjoy the weekend. Immediately after this, Mae breaks her hip, with Walt (and Jackie) unable to intervene due to being on vacation in Lake Erie.
• Big Damn Kiss: Subverted; after a half-season of playing Will They or Won't They?, Carol comes to Doug in a moment of weakness and attempts to rekindle their affair — but he refuses, instead telling her he'll drive her back to Tag's.
• Brick Joke: At the opening of the episode, Carter places a jar with a removed bowel at the front desk, where it remains through the majority of the episode. Midway through, the staff also place the gallstone removed from Benton's patient and draw the doctor's attention to it, prompting him to ask if they have anything better to do.
• But Now I Must Go: After a half-season of being the Big Good on staff, Morgenstern informs Mark that he's accepted leadership of a residency program at Harvard and will not continue in his role at County (though later circumstances will bring him back to County).
• The Cameo: Baseball player J.T. Snow makes a brief cameo in this episode.
• Chekhov's Gun: It turns out that a potential adoptive mother who tried to take her own life may not be the best candidate, as Carol learns by the end of the episode.
• Chick Magnet: Defied; Doug is not only concerned (and acting like a schoolkid) because he doesn't want to ask out Diane, but when he has a chance to rekindle his feelings for Carol (who seems to be looking for Sex for Solace in the wake of losing the adoption bid), he refuses, instead kissing her on the forehead and giving her a drive back home to Tag. Even when Diane asks him out, he expresses reservations about it.
• Continuity Nod:
  • When Mark asks Doug why the latter is afraid to ask out Diane Leeds, Doug tells him that one of her friends was someone he dated in the past, referring to Doug and Diane's first conversation several episodes prior (and her cool treatment towards him since then).
  • Diane points out to Doug when she first sees him that she just finished doing up the paperwork on Wilson, the father who Doug attacked after finding out he abused his daughter in the previous episode.
• Cycle of Revenge: It's implied that the Howe family has a history of seriously burning their own daughters for exhibiting signs of sexual behavior — Mrs. Howe's mother did it to her, and she does it to her own daughter, Bonnie. When Bonnie is taken away from her grasp, she freaks out and attacks Doug before the police arrest her.
• Defrosting Ice Queen: After several episodes of rebuffing Doug's advances, Diane finally warms up to him after seeing him defend another child and agrees to go on a date.
• Determinator: Benton plows through a 48-hour shift, helping all manner of patients (and fighting the urge to rest, and Dr. Hicks' demands) as he goes. This trope then becomes a case of reality when he becomes so tired that he's unable to help his mother, who falls down the stairs at home and may have broken her hip.
• Downer Ending: Half the main characters end up worse off than they started the episode as — Jen tells Mark that she wants a separation, Carol is distraught after losing the adoption bid for Tatiana, and Benton's mother has suffered a critical accident, leaving him speechless as a result.
• Family Versus Career: Explored with Mark and Benton, whose decision to commit to the work at County leads to disastrous consequences for both of them (Jen asking for a separation, and Benton's mother being injured because of his inability to be there for her).
• Field Promotion: Mark is all-but-confirmed as the new Attending Physician at County, as Morgenstern tells him he's made plans to move to Harvard to oversee a residency program.
• Foreshadowing:
  • Bonnie's star-shaped burnmark, shown in the opening, is eventually revealed to have been caused by her mother in retaliation for the former exhibiting signs of sexual behavior. Doug figures out that something is wrong early on, but it isn't confirmed until an investigation later on in the episode.
  • Carter's kindness towards patients is brought up by Benton towards the end of the episode, who pointedly asks him why he's going for a subeye surgical internship. This conversation will come up multiple times over the next two-and-a-half seasons, finally culminating in a major decision by Carter in the third-season finale.
  • Lydia comments that she's "not very good on the subject of marriage" for Carol's benefit. However, as of the end of the series, she (along with Al Grabatsky) is one of only two main couples (the other being Doug and Carol) introduced in the first season to remain Happily Married through the entirety of the series.
  • Doug appears to be the only doctor in the ER who's supportive of Carol's decision to adopt a child, noting that he thinks she would make "a great mother". A few seasons later...
  • Jen Greene comments that her marital life with Mark is "bad enough without (Rachel) growing up without her father." Considering what happens a few seasons later...
  • Benton browbeats Carter for being too empathic towards patients, reasoning that it's not the right mindset for someone pursuing a surgical internship. When Mae is rushed to County at the end of the episode, Benton (in shocked silence) watches as Carter attempts to talk to Mae and reassure her.
• Getting Sick Deliberately:
  • Susan's test subject patient, who's revealed to be a mooch who takes clinical trials to bilk drug companies out of money. Malik asks him at the end of his first scene how much he gets paid per year for such procedures.
  • The seizure patient, who pretends to have gone comatose so he can get out of paying a restaurant bill. On his way out of the ER, he cons a few dollars from Jerry and Mark (even stealing the latter's wallet, to boot).
• Hope Spot:
  • Mark seems to be a state of delusion that everything will work out with Jen's marriage, even convincing himself that things will get back to normal when he manages to land a shot in a nearby garbage bin with a paper towel. Soon after, though, he's informed by Jen that their marriage is more-or-less over, as she's unwilling to compromise on her job.
  • Despite getting her adoption request expedited, Carol's hopes are dashed when a Family Development rep tells her that the former's suicide attempt has functionally made her ineligible.
  • Benton seems to be happy for the first time in a while after completing his marathon shift, with Walt even congratulating him for being on time. It doesn't last — shortly after falling asleep, Benton is roused by his mother, who's fallen down the stairs at their home and broke her hip. She's rushed to County for treatment, with Benton looking on in shock.
• Humiliation Conga: Benton's decision to take part in a marathon 48-hour shift (done so he could spend some time with Mae) leads to him being repeatedly chastized by Dr. Hicks for refusing to take a break, being mocked by a patient after he dozed off while suturing a wound, being yelled at by Mark in front of other staffers for taking a case without consulting him first, and being kicked off a separate trauma case by Hicks (to say nothing of the staff mocking him by taking the gallstone from a patient he was set to work on and displaying it as "Benton's Stone", to his chagrin). Finally, when he gets home for the night, he gets a brief Hope Spot with Walt before things get bad again when his mother falls down the stairs, forcing him to rush her to County.
• Hypocrite:
  • Dr. Hicks, who spent the previous episode browbeating Benton over missing too many shifts and more-or-less threatening his residency prospects, has to browbeat him to get some sleep in the midst of a marathon 48-hour shift, and is completely dismissive when he points out that he had to trade shifts to keep up with the demands of the job.
  • Jen complains that she wants to separate from Mark because it's "bad enough without (Rachel) growing up without her father," a strange notion coming from someone who should logically be wanting their daughter to spend more time with her father, not less. It's revealed a couple episodes later that Jen has been cheating on him with her co-worker, Craig, meaning her explanation was likely projection to cover for herself.
  • She also refuses to consider moving to a neutral location so that they can live together as a family again, after having spent months complaining that he's the one who isn't willing to move for her.
• Insistent Terminology: After Jerry leads Doug on by claiming Diane wants to go out with him.
  Doug: Jerry, did I ever tell you that you're my least favorite clerk?
  Jerry: I'm not a "clerk", I'm an emergency services coordinator.
• Ironic Echo: Carol's visit to Doug at his apartment (and their Almost Kiss, coupled with Can't Spit It Out) evokes a similar situation that occured in "Day One", when Doug visited her at her mother's house, and a similar awkward conversation (with Carol being distraught and the subject matter concerning her suicide attempt) played out.
• It's All My Fault: Carol comes to hold this attitude regarding the failed bid to adopt Tatiana (tying it back to her suicide attempt in the pilot episode), prompting Doug to comment that it's not the case and that she'll make a great mother.
• Jerkass Has a Point:
  • Despite her abrasive attitude and seeming inability to understand Benton's situation, Hicks points that anyone who's been working for 48 hours straight should not be allowed to take part in procedures.
  • Jen Greene points out in the middle of her "separation" speech that, despite Mark's claim that he can take care of Rachel on his own, there's no way he'd be able to do so given the demands of his job.
• Karma Houdini: The "seizure patient" who was brought from a restaurant after eating breakfast not only gets away scot-free with skipping out on the bill, but he manages to steal money from both Jerry and Mark on his way out of the hospital.
• Laser-Guided Karma: Benton's decision to run a marathon shift in the ER has momentous consequences when he goes home, as he's unable to help his mother immediately, causing her to fall down the stairs at home and break her hip. When she's wheeled in to County, Benton is reduced to shock and doesn't answer Susan and Carter's questions.
• Nice Job Breaking It, Hero: Benton's stubborn refusal to have his ailing mother sent to a nursing home leads her to suffer a serious injury when he's not immediately around to help her.
• O.O.C. Is Serious Business: For the first time in the series, the normally-unflappable Benton is rendered speechless when a family member is injured — in their own home, no less. When Susan attempts to talk to him at the end of the episode, he can't even respond, only looking around in a daze.
• Playing Sick: Susan's seizure patient, who's revealed to have faked a seizure in order to duck out of paying an expensive restaurant bill.
• Ship Tease: As part of the Almost Kiss moment above, Doug and Carol very nearly rekindle their feelings towards each other when she turns to him for comfort after losing the bid to adopt Tatiana.
• Shout-Out: The title of this episode is a play on the title of the 1993 film Sleepless in Seattle, which starred Tom Hanks and Meg Ryan.
• Spotting the Thread: Doug figures out that Bonnie's burn injury is not what it seems by pointing out immediately that he's never heard of a "star-shaped radiator". It's revealed later that Bonnie's mother has deliberately burned her in retaliation for the latter exhibiting signs of sexual behavior.
• Take a Third Option: Dr. Koch, the "physician" touring Cook County in hopes of gathering research for a hospital modernization project (actually a psych ward patient) suggests to Mark that he and Jen Greene move to Kenosha, Wisconsin, which is a middle point between both workplaces and would cut down on travel time for both of them. Perhaps as a nod to this (and to how Koch is an unreliable patient), Jen points out that she'd still be travelling two hours to work, even with the locale change.
• Tempting Fate: Benton ignores both Dr. Hicks' and Mark's advice to get some rest and stop looking after patients when he tries to pull a marathon shift. This culminates in Benton becoming so tired that he's not immediately able to help his mother, leading to fall down a flight of stairs at her home]].
• Unwanted Assistance: Dr. Koch, the researcher from MIT who goes around incessantly chatting with the main characters in order to get more information regarding a new hospital model he's creating. Eventually subverted when it's revealed that "Koch" is a psych ward patient who likes to pretend to be a doctor, and has been doing so for months.
• Wham Episode: This episode sets the stage for the rest of the season, as nearly all of the main characters go through a major (potentially life-changing) circumstance. Carol's quest to adopt Tatiana fails (and nearly leads her to rekindle her romance with Doug), Benton's mother is injured (possibly critical) after he fails to get up in time to help her, and Jen Greene announces she wants to separate from Mark.
• Written-In Absence: Deb (Ming-Na Wen) is not present in the episode, with Carter excusing her absence by stating that she's fallen sick and can't make her shift.

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