Twist of Fate

Opening Act

Scene opens at the Ross home, interior, night time. Focus on Doug Ross sleeping restlessly in his bed alone. He is tossing and turning, obviously disturbed by his dreams. The red light from the baby monitor shines in the dark beside him on a table but it is very quiet. He awakens suddenly and sits up on the bed, reaching over for Carol, who is not there. He sighs and collects himself together, climbing out of bed and stretching once he is on his feet. He ambles slowly down the hallway and opens the door to Tatiana's room to look in on his daughter. She is sound asleep, with Scrubs the dog at her feet, and her doll tucked under her arm. He smiles and quietly closes her door. He goes on down the hall to the nursery, checking the attic stairway briefly to be sure the light is out in Scott's room. Satisfied that his son is probably asleep, he goes into the nursery to peer into the crib at baby Marc. The baby is sound asleep, with his fist tucked to his mouth. Doug smiles at him and goes on out of the nursery. He starts to go back to his room, but his attention is diverted by a light downstairs. Curiously, he goes down the steps to investigate. He goes down the steps and when he gets to the bottom, he sees Carol sitting on the sofa in the living room reading a medical book. He ticks his head curiously, and walks slowly to the doorway.

Doug (quietly):
Hey.

Carol (looks up, startled):
I didn't want to wake you so I came down here.

Doug (goes in, sits beside her):
What are you reading?

Carol:
Oh, just some stuff I need to know for a test in two days.

Doug:
Can I help?

Carol:
Maybe later...I'll let you drill me...right now I just want to try and absorb some of it.

Doug:
How is your class going?

Carol (puts the book down, turns to him enthusiastically):
Oh, it's great! I'm really learning a lot!

Doug (tries not to burst her bubble):
You know you missed dinner again tonight.

Carol (frowns):
I know. I was in the library working on a paper and I just lost track of the time. You'll have to catch me up on everything that's happening with the kids for a while.

Doug (smiles):
The kids missed you.

Carol (strokes his hair):
What about Dad?

Doug (chuckles):
Dad always misses you...but Dad understands.

Carol (sighs):
I know...you're being so great about all this. I know how much extra work it is for you. And you don't look like you're feeling well, anyway.

Doug:
I'm just tired...putting in long days at the clinic and long nights here. But, I don't mind the work...I can handle all that...

Carol (coaxing him):
But?

Doug (grins):
You always know when something's on my mind, don't you?
(Carol nods with a chuckle)
I'm just worried about Marc...

Carol (very concerned):
Marc? Why? What's wrong with Marc?

Doug:
Nothing's WRONG with him...he's just not getting very much time with his Mommy and that worries me. Babies bond with their parents early in life. I'm afraid he's not going to bond with you and that's going to be a problem later on.

Carol:
Oh, Doug, that's not going to happen. He's only three months old...I've got plenty of time with him! Besides, I had a lot of time with him after he was born...he knows how his Mommy is.

Doug:
How can you be so sure? When was the last time you spent more than two minutes with Marc? When was the last time you took him off someplace private, just the two of you, and fed him? Or just held him?
(Carol doesn't answer, just gives him a long look)
You promised me when you started this that you wouldn't neglect the kids. Lately, they never see you. They're in bed when you leave and they're in bed when you come home. I bet they haven't seen you in two days.

Carol (sighs):
I know...and I honestly don't mean to. I just seem to run out of hours in the day.

Doug (matter of factly):
Then, something needs to give.

Carol:
It's not for much longer...and I'll make up the time on weekends...can't you just be both parents for us for just a little while? This PA title really means a lot to me.

Doug (nods):
I know it does. And I understand that. I promised myself when we got married that I would never stand in the way of your career. I owe you that much. You had your career before you had me...it wouldn't be fair to ask you to choose between us. But, where the kids are concerned...

Carol:
Doug, I will give time to the kids. I promise. And I'll start spending more time with Marc, too. I'll have to start putting him on my chest while I read or something. It'll be all right.

Doug (nods):
I hope so.
(Carol smiles as she looks at him and he grins back at her)
What?

Carol:
I was just thinking that the Doug Ross I met when you first came to County would never be as unselfish about himself as the man I'm married to now.

Doug (grins):
Well, you would never have married that Doug Ross. That's why he had to change.

Carol (closes her book):
What's happened to us, Doug? We used to be wild and spontaneous...when did we settle?

Doug (helps her to her feet):
I don't know...but it's the best thing that ever happened to me.
(he puts his arm around her as they start up the steps and smiles)
You're the best thing that ever happened to me.

He kisses her hair softly and she lays her head on his shoulder. When they get to the top of the steps, the both go into the nursery to check on the baby. Marc is awake this time, but he isn't fussing...just kicking his feet and cooing.

Carol leans down and picks him, cuddling him on her shoulder. He looks over her shoulder and sees Doug and he begins to squirms and grunt and reach for him. When Carol doesn't let him go, he begins to cry, reaching his tiny arms towards Doug. Reluctantly, Carol hands the baby over to Doug. Focus on Carol's hurt expression and Doug's frightened one as he holds the baby and fade into Opening Credits of the Show.

Act One

Scene opens at County C.A.R.E. Center, morning routines. Mark is sorting mail and Doug is looking over files.

Mark (quietly):
Everything OK in the Ross home this morning?

Doug (nods):
Everything's fine.

Mark (looks at him closely):
Are sure you're OK?

Doug (looks at him surprised):
Yeah. Why?

Mark:
You just look like you don't feel very well.

Doug (shrugs):
I'm just tired. I'm taking care of a house, and two kids, and three month old baby...I think I'm allowed to be a little bit tired.

Mark:
No, I think it's more than that. You look bad. You have dark circles under your eyes and your skin is looks funny.

Doug (looks at the back of his hand):
What do you mean my skin 'looks funny'? It looks all right to me. You're just being a doctor, Mark.

Mark (nods):
Yeah...that could be.

Doug chuckles to himself and goes on off with his files. Mark watches him go with a concerned look. Mark is still sorting mail with John Carter comes down from his upstairs apartment. He goes over to the desk with Mark and starts looking over the files.

Mark (quietly, doesn't want Doug to hear):
Carter, do you think I am an overbearing doctor?

Carter (gives him a strange look):
An overbearing doctor?

Mark:
Do you think I see things that aren't there?

Carter (shakes his head):
I don't think I follow you, Dr. Greene.

Mark:
Do you think I would see something wrong with someone if there wasn't something wrong with them?

Carter:
Absolutely not. I think you're a keen eye and spot thins most of the time before anybody else.

Mark:
Do you think Dr. Ross looks OK?

Carter (looks around to see Doug, shrugs):
Dr. Ross? I hadn't paid much attention.

Mark:
Take a good look at him sometime today, OK? And get back with me on it.

Carter (nods):
Sure thing, Dr. Greene.

Mark keeps an eye on Doug most of the morning. Show Doug in various stages of working with patients, but, he seems to be under a bit of stress. Carter also makes a few mental notes and then he and Mark gather together in the lounge for conference.

Carter (quietly):
I got to work with Dr. Ross this morning. I gave him a good look over like you asked.

Mark:
And?

Carter:
Have you noticed his fingernails?

Mark (shakes his head, thinking):
Fingernails...no...can't say that I've noticed them.

Carter:
The nail beds are blue.

Mark (concerned):
Blue?

Carter (nods):
Yeah. I think Dr. Ross is in Renal Failure.

Mark (appalled at this thought):
Renal Failure? No, he's too active...

Carter:
You can be active and still be in renal failure. He's been tired a lot...he may have some edema...we were playing basketball the other day and he had to stop because he was out of breath.

Mark (shocked):
Well, that's a first. That never happens.

Carter:
Anyway we can get some chems on him?

Mark:
Probably not willingly. Let's just see what happens today. I'll talk to him.

Carter (nods):
OK. And if you need me for anything, just let me know.

Carter goes on back to work. Mark goes out and picks up a file to read, but, he keeps an eye on Doug out of the corner of his eye. Finally, Doug comes over to him closely.

Doug:
Can I see you in our office. please?

Mark (nods, follows him):
Sure!

Mark and Doug go down the hall together to their office, go in, and close the door. Once alone, Doug turns around and zeros in on Mark quickly.

Doug:
Is my face on upside down today or something? You have been staring at me all day and it's really starting to get on my nerves! What's going on?

Mark:
I'm concerned about you, Doug! I don't think you're well!

Doug:
I am FINE, Mark. Just a little tired. That's all.

Mark:
Well, I think it might be something else!

Doug:
Listen, Mark, you have just been a doctor so long that you think every little thing is something to worry about. I think I'd know if there was something wrong with me.

Mark:
Maybe. Maybe not.

Doug:
What's that supposed to mean?

Mark:
It just means that you might not notice your symptoms...or you might mistake them for something else.

Doug (starts for the door):
Well, I'll tell you what, Mark, when I need a doctor, I'll let you know, OK?

Mark (nods):
OK.

Doug:
And quit staring at me because you're giving me the creeps.

Doug goes on out, Mark sighs and shuffles his way out behind him.

Cut to show Doug working putting supplies on a shelf. He is working pretty rapidly and reaching up and down. He leans down to put something away and when he stands up, he has to steady himself from an onset of dizziness.

Doug (looks over his shoulder to see where Mark is):
Hey, Mark?

Mark (looks up from his work station):
Yeah, Doug?

Doug (nervously):
Could you come over here, please?

Mark (goes over to him quickly):
What's wrong?

Doug (reaches for Mark's arm):
I'm a little dizzy...could you help me over to a chair?

Mark:
How about I help you to an exam table and take your blood pressure?

Doug (nods):
Yeah, that works too.

Mark takes Doug by the arm and helps steady him to get him over to an exam table. Doug eases himself up onto it and Mark fetches a BP cuff. He slides the sleeve of Doug's scrub top up and secures the cuff on his arm. He positions the digital reading box on the table and starts pumping the bulb. And he just keeps pumping. Doug reacts to the pain of his arm being squeezed and the high pressure Mark is using.

Doug (complaining):
What are you doing?! It's a BP reading not pumping up a weather balloon!

Mark:
I have to pump it until the little heart shows up...it didn't show up yet!

Doug (pales):
Oh, God. That means it must be high...

Mark (rips the cuff off):
Let's do it the old fashioned way...

Mark pushes the digital BP pump aside and takes out an older cuff and a stethoscope. He secures the cuff on Doug's arm again and places the ball of the stethoscope on the underside of his arm, listening carefully through the earpieces and pumping the bulb of the BP cuff. He pumps quite a bit but finally stops pumping and listens carefully. Doug waits nervously for him to give him the numbers. Mark shakes his head unhappily as he takes the earpieces out of his ears.

Doug:
Well?

Mark (taking the cuff loose):
You don't want to know.

Doug:
High?

Mark:
116/85.

Doug (laughing):
What? That's normal.

Mark:
Sure is.

Doug:
Well, that's impossible. My blood pressure hasn't had numbers like that since I was in high school. Take it again.

Mark takes the digital BP cuff and applies the cuff to Doug's arm again. He pumps it only a few times and has no trouble getting a reading this time. He looks at the numbers and turns the box for Doug to see.

Doug (reading from the box):
116/85. That's really weird. Why would I be dizzy if my BP is in a normal range.

Mark (matter of factly):
Maybe it's not your blood pressure. Maybe it's something else.

Doug:
What? That I'm tired?

Mark:
Or something else.
(Mark takes hold of one of Doug's hands and looks at the fingernails)
Noticed your fingernails lately, Doug?

Doug (looks at them, shrugs):
Oh, they do that sometimes.

Mark:
They've done that before?

Doug (nods):
A long time ago...when I was in college.

Mark:
Well, what did they say caused it?

Doug:
I never had it checked. It just went away.

Mark:
Have you ever had any kidney problems?

Doug (laughs):
Kidney problems? No, why?

Mark:
Are you having any problems with your kidneys now? Any trouble urinating or anything?

Doug:
Nope!

Mark:
Will you let me run some blood work just to satisfy me?

Doug:
Not unless you tell me what you think you're looking for.

Mark (professional tone):
Carter said you ran out of steam playing basketball with him the other day. Your fingernails concern me. And your blood pressure in a normal range indicates it might be running low. That's all classic in line with Renal Failure. I want to get some chem numbers on you. Then I'll feel better if they don't support my theory.

Doug (nervously):
What if they do support your theory?

Mark (shrugs, smiles):
Well, then, we'll take it from there, OK?

Doug (nods):
OK.

Doug watches nervously as Mark draws blood for tests. Mark gives him a soft "don't worry" smile, but Doug can't seem to shake it.

Mark (hands vials to Carter):
Dr. Carter, please ask the lab to return these as fast as possible. It's very important. I want them to run a CCP and a CBC and I wan the results sent to me personally.

Carter (nods):
Right away, Dr. Greene.

Mark (softly, to Doug):
Why don't you just lie back and relax a little bit?

Doug (eases himself back onto the exam table):
OK.

Mark:
You need a blanket?

Doug (nods, nervously):
If we've got one.

Mark (grabs a blanket from nearby and spreads it over him):
Just relax, Doug...everything's going to be OK.

Doug nods nervously at him and pulls the blanket up around his shoulders. Mark leaves him there and goes back to his work.

Cut to show time lapse and Carter handing Mark an envelope.

Carter:
Here's the lab results you asked for, Dr. Greene.

Mark (snatches envelope):
Thank you, Carter! Let's see what we have here, OK?
(he takes out the numbers and shakes his head slowly)
Well, I'll hand it to you, Dr. Carter. When you're right, you're right!

Carter (smiles):
I was? About what?

Mark (hands Carter the numbers to see):
About Dr. Ross...a classic case of Renal Failure.

Carter:
Man, look at these numbers...Potassium 12.6? That's really high!

Mark:
Way too high...

Carter:
BUN...102?
(whistles)
Creatine...10.3? Whoa! Damn...I was really hoping I was wrong. This was one time I didn't want to be right. He needs some serious dialysis.

Mark:
Yeah...I'm hoping for the best. I'm gonna go talk to him. Do me a favor, will you, and call County and ask for a transport to come over here and get him? I'm admitting him to the hospital...

Carter:
I don't think he's gonna like that too well...

Mark (sighs):
I think Doug may be in for a lot of things he may not like before this is over.

Mark takes his sheet with numbers and goes back to where Doug is resting. Doug is awake and waiting for him. He gives him a smile as Mark comes in, but, his smile quickly fades.

Doug:
Uh oh. You're wearing that 'serious doctor look' of yours. Are you bearing bad news?

Mark (nods):
Your numbers don't look too good. I'm pretty concerned about you right now.

Doug (reaches for the page):
Can I see?
(Mark hands it over to him and he scans it quickly)
Creatine 10.3? That's pushing into the panic level, isn't it?

Mark:
It is for me. I'm going to send you over to County and admit you. You can get attention there from someone in Nephrology who will know more about what's going on than I do. I've already called for transport. Will you go?

Doug (nods):
With numbers like this, I'd be a fool not to.
(pause)
Doug (continued):
Mark, am I in trouble here?

Mark (shrugs):
I don't think we have enough details to know for sure yet. That's why I want to send you over to County and turn you over to somebody who specializes in this so we can find out what we're dealing with.

Doug (nods):
Will you call Carol for me?

Mark:
Sure...how do I reach her?

Doug (sighs):
She's over at the Junior College...all you have to do is call and ask for the PA class and tell them who you need. It's the only PA class in there.

Mark (nods):
OK. I'll take care of it.

Carter (comes to the station):
Dr. Greene? Your transport is here.

Mark and Doug look into the doorway to find two LifeLine paramedics and a gurney waiting.

Mark (directs them in):
Right this way gentlemen. This is your patient.

Paramedic (surprised):
Dr. Ross? We don't transport many docs!

Doug (starts easing himself up to get to the gurney):
Yeah, well, let's go nice and easy guys...I'm not used to being cargo.

Mark stands by as the paramedics help Doug over onto the gurney and strap him onto it. When they raise the cart to wheel him out, Mark gives him a thumbs up.

Mark:
You want me to go with you?

Doug:
No, I'm OK. Just call Carol.

Mark:
OK, I'll be over to see you later, OK? I'm still your doctor.

Doug (as they wheel him to the door):
Thanks, Mark. Wish me luck.

Mark goes to the door and watches as they wheel Doug to the waiting ambulance and put him in. As they close the doors, Mark closes the clinic door with a sigh.

Mark (softly, under his breath):
Good luck, Buddy.

Mark goes over to the phone and looks up the number for the Junior College. He quickly punches a number and waits. We hear only his one side of the conversation at first.

Mark:
Yes, I need to speak with Carol Ross, please. She's in a Physician's Assistant class. Thank you. (When Carol takes the phone, split the screen to show both sides of the conversation)

Carol (annoyed look from being disturbed):
Yes?

Mark (slowly):
Carol...it's Mark...Doug wanted me to call you...

Carol:
Something's wrong...

Mark:
It's really a long story, Carol. I don't think you want me to go into it right now. Why don't you just meet me at County and we'll talk about it there.

Carol:
Meet you at County? You sent Doug to the hospital?

Mark:
Yeah, I really thought it was best...

Carol:
I'm on my way, Mark! I'll meet you there...

Mark:
Don't panic, OK? He's not in any real danger right now and he's OK.

Carol (coaxing):
But?

Mark:
But, let's just wait and see what they tell us at County.

Carol:
Just tell me if he was conscious or not...that's all I care about right now.

Mark (chuckles):
He was conscious...alert...talking...and joking. He just wanted me to be sure I called you.

Carol (looks at her watch):
OK...I'll leave here and go straight to County. I'm clear across town so it will take me longer to get there than it will you. Where should I meet you?

Mark:
I'll be wandering around down in the ER bugging old staff mates. You can find me there.

Carol (nods):
OK, Mark...see you in a bit.

Carol hangs up quickly and Mark cradles his phone as well.

Mark (takes his jacket):
Dr. Carter...can you hold down the fort here for a while? I have a patient at County I need to attend to.

Carter (smiles):
I'll do my best, Dr. Greene.

Mark (from the doorway):
If you run into anything you can't handle, call David Morganstern. He's out at the Sandbrook County Club probably on the 9th hole by now.

Carter (laughs):
I can handle it, Dr. Greene. Give my best to Dr. Ross.

Mark nods and goes on out the door. Focus on Carter's perplexed look and fade Act One to Black.

Act Two

Scene opens at County Hospital, inside a treatment room. This is not in the ER. Doug is resting in a bed there alone. Cut to show a doctor some through the doors and into the room. He is about Doug's age...maybe a little older...salt and pepper hair and a mustache. He is wearing a lab coat and scrubs and carrying a chart with him. He stops beside Doug's bed and opens his file. Doug reads the name on his name badge as Craig Paddox, MD Nephrology.

Craig (smiles):
Doug Ross?

Doug (nods):
That's me.

Craig:
The infamous County Doug Ross? I don't believe I ever had the pleasure.

Doug:
Well, this wouldn't exactly be the way I'd choose to do it.
(Both chuckle)
How I am?

Craig:
Well, we don't know yet. I want to run some tests and take some x-rays...see what's going on in there. Then we'll know more.

Doug:

OK, what's your preliminary prognosis?

Craig:
Now, Dr. Ross. You know better than that. You wouldn't do that to a patient...you can't expect me to, either.

Doug (grins):
Fair enough.

Craig (closes file):
OK, let's set you up for x-ray and I need some more blood...there's a few more things I want to look at...and then we'll talk again, OK?

Doug:
Yeah, my wife should be here by then, too.

Craig leaves and a nurse comes to take Doug to x-ray. They just take him in his bed, however, not in a wheelchair.

Cut to show Mark coming in the main entrance doors of the ER. He goes over to the desk where Kerry Weaver is working and stops, waiting for her attention. She is in talking with another doctor, giving instructions. As soon as she sees Mark, she gives him her attention.

Kerry:
Well, Dr. Greene! How are things are County C.A.R.E.?

Mark (nods):
Everything's fine. I'm here about a patient.

Kerry (knowing look):
Doug Ross?

Mark:
Yeah...do you know where they sent him?

Kerry (looks at a code sheet):
He wasn't in the ER...they just brought him through here. Looks like they referred him to Craig Paddox up in Nephrology.

Mark:
That's up on 4, right?

Kerry (nods):
Right.

Mark:
This Paddox guy...I'm not familiar with him...

Kerry:
He's new on staff...fairly new to the area...he comes very highly recommended, though. His credentials are outstanding. Doug should be in very good hands with him.

Mark:
OK...well...I'm waiting for Carol, so, I'll just hang around here for a few minutes. It shouldn't be long.

Kerry:
Not a problem, Mark. Always glad to see you here.
(pause)
I always wanted to ask you if you ever miss it?

Mark:
Sometimes...when I think about the headaches I don't have anymore...

Kerry (laughs):
I get your drift.

Carol (comes through the doors in a dead run):
Mark!!
(Mark turns to her quickly)
How's Doug?

Mark:
I haven't been upstairs yet. I just got here myself. Kerry says Doug has been turned over to a Dr. Paddox....I don't know him, but, she says he's very good. So, what do you say we go find him and see what we can find out?

Carol (nods):
Mark, what happened? What's going on?

Mark:
Doug got a little dizzy and I took his BP. It was in a normal range and he thought that was odd...

Carol:
Well, it would be. Doug's blood pressure is NEVER normal. That's why he takes meds for it...

Mark:
Have you noticed him being overly tired lately?

Carol:
Well, he has been tired...but, I just figured with the clinic, and the house, and the kids he was working really hard...

Mark:
What about his fingernails?

Carol (confused):
His what?

Mark:
His fingernails...the nail beds are blue...have you noticed that before?

Carol (hand to her mouth):
No. My God...what kind of a nurse am I? You mean he's been sick for a while and I didn't notice it?

Mark :
Don't feel bad...he's a doctor and he didn't notice it either.
(takes her arm)
Come on, let's go on upstairs.

Mark and Carol go on up the hall to the elevator, punch a button, and wait for the car. They don't talk. They are both nervous. They ride up to the fourth floor in silence, looking at each other and making nervous faces. When the elevator opens on four, they get off and just walk quietly to the nurses station.

Carol:
I need to know which room Doug Ross is in, please? I'm his wife.

Nurse:
He is in 4106, but, he's not there right now. They sent him down to x-ray just a few minutes ago.

Mark:
Well, could you tell us where we could find Dr. Paddox, then?

Nurse:
He's with a patient...but he will be meeting with all of you when Dr. Ross comes back to his room.

Mark (nods, to Carol):
We'll just wait, then. Let's go on down to his room.

Mark and Carol go down to Doug's empty room and Carol goes over to the window to peer out blankly. Mark goes up behind her quietly.

Mark (quiet voice):
Are you OK?

Carol (folds her arms across her chest):
I don't know. I don't know what's happening.

Mark:
I think Doug's Blood pressure may have just gotten a little out of control and this is a warning sign. That's all I think.

Carol:
That's all you WANT to think, Mark. You know there are several other possibilities in this situation...you just don't want to think about any of them.

Mark:
You're right. Doug is my friend. I don't want to see anything be seriously wrong with him.

Carol:
How was he when you sent him here? Was he OK?

Mark (nods):
He was alert and talking to me...he seemed in good spirits.

Carol and Mark are interrupted by Doug being wheeled back into his room. He brightens when he sees them.

Doug (smiles from his bed):
Hey! This is a nice welcoming party!

Carol (goes to him at once):
How are you feeling, sweetheart?

Doug:
I feel pretty good while I'm laying down.
(kisses her lightly)
Thanks for coming. Have you met Dr. Paddox?

Carol:
No, not yet.

Doug:
He's a pretty cool guy...I like him OK.

Mark:
He comes with high honors...supposed to be very good.

Doug:
Let's hope so, huh?

Carol:
Can I get you anything to drink? Do you need anything?

Doug (shakes his head):
No, I'm fine.

The group's attention is diverted by Dr. Paddox coming into the room with all his files and numbers.

Craig:
Well, it looks like everybody is here!

Doug:
My wife, Carol...and this is Mark Greene, my personal physician.

Craig (shakes hands with both of them):
Very pleased to meet you both.

Doug:
So, do we know what we're dealing with now?

Craig:
Well, sort of.

Doug:
Then, let's have it. And give it to me in layman's terms. I want to know exactly what we've got.

Craig (nods):
OK. Well. My first concern is the Potassium and BUN levels. Both of them were very high. That indicates the kidneys are not expelling them for you. That concerns me. Then, there is the Creatine level, which is also high. That indicates to me there may be some kidney damage.

Doug:
How much damage?

Craig:
Well, now, that I don't know. But, as a doctor, you well know, any damage at all is too much. My guess is that the continued untreated high blood pressure has caused this judging from my test results.

Doug:
But, that's impossible. I had a bout with high blood pressure quite a while back when I was still working in the ER downstairs. Mark took care of me then. He put me on meds and I take them religiously! Every morning at breakfast, the kids take their vitamins and I take my meds.

Craig:
I checked your file and I ran a test for the meds in your system. Did you take a pill this morning?

Doug (nods):
Absolutely!

Craig (sad smile):
Not there. Apparently, your system built up a resistance to the meds and rejected it. You had no way of knowing that. This is not your fault.

Doug:
So, I couldn't see this coming? I couldn't stop it?

Craig (shakes his head):
I don't see how you could have, no.

Carol:
Well, what happens now? You said there is kidney damage...

Craig:
Well, we'll see what happens over the next few days with treatment and I'll know more then.

Carol:
But, what can we expect? Is he going to be all right?

Craig:
O, he'll be fine. Even with kidney damage, he can live a long, productive life.

Doug:
I get the feeling there's something you're leaving out here, someplace.

Craig:
Well, I want to set you up for dialysis. A surgeon will be in to insert the catheter later. I think you're going to feel a lot better after a few rounds of dialysis. After that, we'll just have to see.

Doug:
No, I mean, there's something you're really not telling me.

Craig (sighs):
I'd rather not go into any of that unless it comes to that. It would only worry you for no reason.

Carol:
We'd rather know now, if that's OK.

Craig:
OK...if there is kidney damage you will need to go on permanent dialysis. With that, you would need to decide if you want Hemodialysis or Peritoneal Dialysis...

Doug:
Wait and minute....wait a minute....you mean there's a possibility that I'm going to have this problem for the rest of the life?

Craig:
It looks that way right now, yes. But, that's not always the case. If we find something that controls your blood pressure, it could alter this situation completely. At this point, it's too early to tell.

Doug:
But, at any rate, I'm looking at dialysis for a while anyway, right?

Craig:
At least a few weeks until we see what happens.
(Doug gives Carol a blank look and Carol smiles weakly at him)
I'll know more when I see the numbers from some of that, OK? We'll talk again then.

Carol (nods):
OK. Thank you, Dr. Paddox.

Doug (nods sadly):
Yeah, OK. Thanks for being honest.

Craig leaves the group alone in the room and the three of them look back and forth at each other without saying anything at first.

Doug (breaks the silence):
Whoa. Pretty heavy stuff. I guess I better start reading up on kidney problems, huh?

Carol (smiles):
It'll be OK. Everything will work out.

Doug:
What if it doesn't? I'm looking at a disability claim and I lose everything!

Carol:
Not everything! And it doesn't have to that way! There are a lot of options...

Doug:
Then, I guess we better start looking into some of them.
(sighs)
I think I want to try and get some rest.

Carol (nods):
Sure. Get some sleep. You'll feel better when you wake up.

Mark:
We'll just go get some lunch...can we bring you anything?

Doug (shakes his head as he rolls over):
No thanks. I've lost my appetite.

Carol covers him up and kisses him gently, then she and Mark go out of the room. Once the elevator, she covers her face with her hands to ward off the tears forming in her eyes.

Carol:
Oh, my God, Mark! What's happening?

Mark (rubs her shoulders):
It's OK, Carol. Doug is in great hands and everything will be OK...

Carol:
Catheters? Dialysis? Doug GIVES those kind of diagnosis, not gets them!

Mark:
Now, you heard what Craig said...that if they can find something to control his blood pressure, it could turn all this around and he'll be fine!

Carol:
IF they can find something and it MIGHT turn things around. What if doesn't? What if Doug has to go on dialysis for the rest of his life...

Mark:
It wouldn't be for the rest of his life. Only until he got a transplant...

Carol:
Mark, listen to yourself! This is not a patient that came through the doors we're talking about! This is DOUG!

Mark:
Well, Doug isn't any different than anyone else! I would have the same hopes for him that I'd have for anyone else! More so, actually! Hell, if I matched, I'd give him one of my kidneys, and you know it!

The elevator has opened and Mark and Carol are fighting as they go, people watching and whispering. They go down to the cafeteria and sit at a table together, still arguing.

Carol (quietly):
I'm sorry, Mark. I didn't mean to yell at you.

Mark:
Look, both of us are upset right now. Neither one of us wants anything serious to be wrong with Doug. But, if it is, we will deal with it. And we'll have to, to help him deal with it.

Carol:
I don't know how he'll take it if they tell him he has to go on dialysis permanently.

Mark:
He's a doctor. He'll deal with it.

Carol:
Well, I don't know how I'd deal with it.

Mark (shrugs):
Dialysis is no big deal anymore. If it's going to be something long term, Peritoneal Dialysis would allow him to do just about anything he wanted to do...

Carol:
Except work. Kidney patients are automatically disabled. Doug will die if he can't work.

Mark:
There are options to that, too.

Carol:
Like what?

Mark:
Well, I don't know, exactly. I'd have to look into some of them.

Carol:
I don't think I've ever been more scared than I am right now. Doug is only 37 years old...

Mark:
These things have no age brackets...you know that from being a nurse...

Carol:
He's always been the strong one. He's always held me up. I hope I'm strong enough to support him through this. He's going to need it.

Mark (puts his arm around her shoulders):
He'll have support from two sides, Carol. He'll be fine.

Focus on Mark and Carol sitting together and ad lib no audio talking and Fade Act Two to Black.

Act Three

Scene opens in County ER. Dr. Peter Benton is picking up some new order sheets and going over them. He stops at one, reads it carefully again, and shakes his head. He goes through the ER and runs into Mark Greene on his way to the elevator.

Mark:
Hey, Peter! How's it going?

Peter:
Hey, Mark! It's good to see you! I was just looking over some of these orders...I think one of these must be a mistake.

Mark:
How is that?

Peter:
It says here I'm supposed to insert a subclavian catheter in Doug Ross for dialysis?

Mark:
Yeah...and?

Peter:
Well, that's a mistake, right?

Mark (shakes his head sadly):
It's no mistake, Peter. Doug Ross is in renal failure.

Peter (shocked):
What happened?

Mark:
They think his blood pressure has caused it.

Peter:
Well, he's gonna be OK, isn't he?

Mark:
It's touch and go right now. They'll know more after a few rounds of hemo.

Peter (shakes order form):
I'll get this in, right away. It was good to see, Mark.

Mark (as Peter heads down the hall):
Good to see you, too, Peter. Take it easy.

Mark goes his way and Peter gets into the elevator to go on up to Doug's room. He goes in and Doug is resting with his eyes closed, but, he is not sleeping. He opens his eyes when he hears Peter come in and stop beside his bed.

Doug (tries to be cheerful):
I guess you're here to cut me, huh?

Peter:
Do you know the procedure?

Doug:
Only that you stick that thing in my neck.

Peter:
Actually, this goes more in the shoulder. I'll give you a local first...about all you really feel is a little pressure. It's not that bad.

Doug:
OK...you're in charge...you just tell me what to do.

Peter:
Let me get a nurse and we'll get this done.

Peter steps into the hall and summons a nurse. He goes back in and starts lowering Doug's bed so that it is flat.

Peter:
First, we flatten you out...
(once the bed is flat, Peter takes the syringe from his tray)
OK, I'm gonna give you the local now...this is just a shot...
(he scrubs Doug's neck with Betadine and inserts the needle into it. Doug winces, but doesn't complain)
Lidocaine...I guess you already knew that...

Doug (weakly):
I figured.

Peter (takes catheter from his tray):
OK, now, I'm going to put this in...you won't feel any pain, but, you will feel some pressure, OK? If you do feel pain, you say so, and I'll stop. You got that?

Doug:
I got it. Go for it.

Peter takes the catheter and begins to push it into the vein of Doug's shoulder. Doug winces, and groans lightly, but, otherwise doesn't complain much. Once the catheter is in place, Peter treats the area with alcohol and betadine and puts a patch on it.

Peter (cleaning up):
All done. You OK?

Doug (nods shortly):
Yeah. I'm fine.

Peter:
I hope things work out OK for you.

Doug (smiles weakly):
Thanks. Me too.

Peter nods and goes on out of the room. Doug rolls looks down carefully at the catheter his shoulder now sports and closes his eyes, rolling his head away into his pillow with a sigh.

Cut to show time lapse. Show Carol coming up to the nurses station in a bit of a panic.

Carol:
I just came from Doug's room and he's not there, can you tell me where he is?

Nurse:
Yes, Dr. Ross has been taken downstairs for hemodialysis.

Carol:
OK, thanks...

Carol rushes away to the elevator, punches a button, fidgets waiting for the car to come, jumps in, punches another button and fidgets until it opens again. She goes down two hallways and through a set of doors, going directly to a desk.

Carol:
Hi, I'm looking for Doug Ross...he's down here someplace.

Nurse:
Sure...he's behind #3.

Carol:
Can I see him??

Nurse:
Yes, he's been hooked up ... it's safe now.

Carol (nods):
Thank you.

Carol goes directly to area #3 and peers carefully around the curtain. She sees Doug, still in his bed, hooked to a dialysis machine. He is resting and appears to be comfortable.

Carol (cheerfully):
Hey!

Doug (smiles, reaches his hand to her):
Hey.

Carol:
Why didn't you call me and tell me they were taking you?

Doug:
I didn't know. They just came in and said 'we're taking you down to dialysis' and that was it.

Carol (pulls up a chair to sit with him):
How are you doing?

Doug:
OK, I think. My blood pressure dropped a little, but, they said that's normal.

Carol:
Doesn't hurt or anything does it?

Doug:
No...you don't even know anything is happening.

Carol:
How you doing otherwise? OK?

Doug (sighs):
I don't know. I haven't had time to think about it.

Carol:
We'll have plenty of time for all that later.

Doug:
What if this is my life now, Carol? What if this is where I'm heading?

Carol (shrugs):
We'll deal with it, Doug. It doesn't change anything about how I feel about you.

Doug:
What if I can't work anymore? Then what?

Carol:
We'll deal with that, too. We will work out whatever we have to. It'll be all right.

Doug:
I'm not so sure...

Carol:
Well, I don't want you to worry about anything like that right now, OK? Dr. Paddox says he'll know more after you've had a little bit of dialysis...let's wait until we know what we're dealing with before we start dealing with it. OK?

Doug (nods...smiles):
OK.

Carol:
Can I get you anything?

Doug:
Yeah, they said I could have anything I wanted while I was on the machine...I'd really like a Coke.

Carol:
One Coke...coming right up! Anything else?

Doug:
No...
(grins)
...just you.

Cut to show time lapse. Doug is preparing to go home and is sitting on the edge of his bed in his clothes, waiting. Carol and Mark are there with him to take him home and Dr. Paddox comes in with his discharge orders.

Craig:
OK, you're going to do hemo by outpatient...just call them for when you're supposed to come in and they'll take care of it, OK?

Doug (nods):
OK.

Craig:
I want you to go for 10 more days, which is 5 more treatments. At the end of that, we'll run some lab work and I'll see you in my office. I should know everything you want to know by then.

Doug:
Based on what you have now, what do you think you're gonna be telling me?

Craig:
That's not fair, Doug. You know yourself better than that. I don't want to make any predictions either way right now. I will tell you that your lab work looks better and your numbers are getting closer to what I want to see them get to. If that helps you any.

Doug:
I assume I have to stay off work?

Craig:
Right, I am not releasing you for work yet.

Doug (sighs):
Looks like the kids are stuck with Pop again.

Carol (smiles):
I'm sure they won't mind!

With Mark and Carol supporting him, Doug climbs into a wheelchair to be taken out of the hospital.

Doug (as they approach the car):
I'm not used to this kind of treatment.

Mark:
Enjoy it! It may not last long!
(to Carol)
You need me to follow you home?

Carol:
No, I can handle it. Thanks!

Mark:
OK...
(pats Doug on the shoulder)
I'll stop by and see you later, Buddy, OK?

Doug (pats Mark's hand):
OK, Mark. Thanks for everything.

Mark helps Doug into the jeep and closes the door. Doug pulls the seatbelt around him and straps himself in. Carol climbs into the drivers seat to drive them home.

Carol:
Anyplace you want to go? Or do we just go home?

Doug (stares out the window, doesn't look at her):
Just go home.

Carol (concerned):
Are you OK?

Doug (nods slowly):
I'm fine.

Carol shrugs and starts the jeep, driving them off slowly into traffic.

Cut to the Ross home. Doug is resting in bed when Carol comes in carrying Marc.

Carol:
Someone wanted to see you.

Doug (chuckles):
Come here, big guy!
(lifts the baby to him and cuddles him on his shoulder)
Kids in bed?

Carol:
Yeah...but they're going to come in later and tell you good night.

Doug:
I should have talked to them, but, I didn't know what to say.

Carol:
Well, when we have all the details, we'll talk to them. Until then, there's no use getting them worried for nothing yet.

Doug:
I agree.
(pause)
What about you?

Carol:
Me? What about me?

Doug:
How are you with all this? You OK?

Carol:
I'm fine. Nothing's happening to me. Except that I hate watching you go through all this. What about you? Are you OK?

Doug (nods):
I think so. Just got a lot of things on my mind. What if I can't work anymore? What will we do?

Carol:
I'm sure we'll have options. We'll just have to find someone who can tell us what they are.

Doug:
I don't know what I'll do with myself if I can't work.

Carol:
We'll do something. Please try not to worry about it until we have to, OK?

Doug:
OK, let's talk about something else. If I have to go to dialysis on a permanent basis...I don't want to stick with hemo because I really hate it. It really wipes me out.

Carol:
Then, you would opt for Peritoneal?

Doug (shrugs):
Is it the lesser of the two evils?

Carol:
Well, Dr. Paddox gave me a lot of literature about it. It seems like it would fit you better...give you more control...and more freedom. You can do it yourself. And you can do it at home.
(she reaches over and fingers Doug's Catheter gently)

Doug:
Does it bother you?

Carol:
No...does it bother you?

Doug (shrugs):
Hurts a little, but, otherwise, I guess it doesn't bother me much. Does it look awful?

Carol (shakes her head):
You don't even know it's there until you take off your shirt.

Doug (chuckles):
Well, it's better off on, anyway.
(pause)
You were talking about Peritoneal...they put a catheter in your abdomen...what about sex?

Carol (smiles):
According to the book, it won't effect your sex life at all. Just anchor the exchange unit so it doesn't get banged around and everything will be fine.

Doug (smiles):
Already read up on that part, did you?

Carol (laughs):
You betcha!
(she lays down beside him and puts her head on his other shoulder, reaching over and patting Marc on the bottom)
We're gonna be OK, Doug. We just have to stick together.
(Pause)
There's always private practice, you know.

Doug (laughs):
Oh, yeah! Right! Like we've got the money for me to go into private practice!

Carol:
Well, we've got money in our savings! And I'm sure you could get a loan...we could second mortgage the house...

Doug (shakes his head):
Oh, no! We're not going into debt up to our ears just for me to have a job!

Carol:
Well, if you did well, we could probably pay most of it back the first year!

Doug:
I think you're overestimating how good I'd be! Besides, I wouldn't want to do that by myself. I always figured if I went into private practice, I'd have a partner.

Carol:
What about Mark?

Doug:
Naw, Mark loves the clinic. He'd never give up emergency medicine. It's going to kill me if I have to give it up. I went into medicine to help people and save lives. I don't know if I can get used to well baby check-ups and sports physicals.

Carol:
I think you could if you did it a while.

Doug:
Well, what about you? You've put a lot into the clinic. You wouldn't want to leave it would you?

Carol:
If you opened a private practice, I would want to go with you. Maybe that's a cheap shot after they sent me to school and everything, but, you're my husband. And blood is thicker than water. I want to be with you where ever you are.

Doug:
Well, I think it's all star gazing and dreaming. I'm hoping to just go back to working in the clinic when this is all over.

They are startled by a sudden knock at the door.

Carol:
Come in.

Scott and Tatiana come into the room, clad for bed, and come directly over to the bed.

Tatiana:
We came to say goodnight!

Doug (laughing as she climbs up on the bed):
Well, good night already!

Tatiana:
Do you feel bad, Papa?

Doug:
Not bad...just tired.

Carol (hugs Tatiana and kisses her head):
You go on to bed and I'll be in later to tuck you in, OK?

Tatiana (kisses her back):
OK! Good night, Papa!

Doug (hugs and kisses her):
Good night, Punkin. I love you.
(Tatiana scoots away, Doug smiles at Scott)
Good night, Sport. Everything OK with you?

Scott:
Yeah...but I want us to talk later, OK?

Doug (nods):
Absolutely. You just pick the time and place.

Scott (nods):
Yeah.
(leans down and hugs Doug quickly)
Good night, Dad. I love you.

Doug (pats Scott's back):
I love you too, pal. Good night.

Once both children are gone, Carol reaches over and takes the sleeping baby Marc off Doug's shoulder.

Carol:
You know, I've been thinking, I'd like to have another baby, too.

Doug:
Don't you think we should get him out of diapers, first?

Carol:
Well, he'd be almost out of diapers by the time we had another one.

Doug:
You're serious?

Carol:
As a heart attack.

Doug (smiles):
We'll talk about it, OK? I'd like to have more children, too.

Carol:
I better put him to bed, too.

Doug (reaches him to her):
Yeah...

Carol:
You know, I was thinking about what we talked about before...about how I wasn't spending enough time with Marc. If you went into private practice, I'd have more time with the kids. I think I'd like that.

Doug (smiles):
We'll talk about all these things later, OK?

Carol (smiles, cuddles baby):
OK.

Carol carries Marc out of the room and disappears into the hall. Doug reaches over and picks up some of the literature she has gotten from the hospital and begins to read over it as he settles into bed.

Focus on Doug reading and resting and Fade Act Three to Black.

Act Four

Scene opens in Craig Paddox's office. Doug and Carol are seated across from his desk and Craig has a folder open in front of him.

Doug:
OK...let's have it...what are we looking at?

Craig:
The numbers have improved. Postassium is down but still not normal...BUN is down but it's still higher than I want it to be. Creatine...still indicates there is damage.

Doug:
How much damage?

Craig (shakes his head):
There's no way to know.

Doug:
I still have output.

Craig:
I know you do...and that's good. That means the kidneys are still working and they will expel some amounts of toxin. But not all of it. And they need help.

Doug:
So, I need to continue dialysis?

Craig (nods):
Yes.

Doug:
For how much longer?

Craig:
Indefinitely. I can't give you a time frame. We will continue to try and control the blood pressure, but dialysis is going to be a must.

Doug (sighs):
Well, I don't want hemo. I hate it down there. It takes three hours and I'm bored out of my skull. And this catheter doesn't work half the time...my blood keeps clotting in it.

Craig:
Then, we can schedule you for surgery and insert a catheter for Peritoneal whenever you're ready.

Doug (sighs):
Does this mean I can't work now?

Craig:
I will not release you for work right now, no. Your blood pressure problem in only enhanced by the amount of stress in your job. Until we find something to control it, you need as little stress as you can get.

Doug:
I didn't mean right now. I mean ever.

Craig:
I don't see any reason why you can't return to work once you are fully recovered. I don't know exactly what your options are, but, I'm sure you will have plenty of them. This is not a death sentence, Doug. You'll just need to make some changes in your lifestyle.

Doug (nods):
So, that's it? I go to work one day and before that day is over I'm disabled?

Craig:
You are disabled for your condition, Doug...not because you can't do anything. I tend to leave activity up to the individual patient. Everyone is different.

Doug:
OK...so what do I do now?

Craig:
Well, we'll set you for surgery and get you started on PD training. Once that's done, you can pretty much go your own way, just keep in touch with me. Your wife can monitor your blood pressure...she'll know if there's a danger sign.

Doug (nods):
OK.

Craig:
Do either of you have any questions?

Doug (shakes his head):
Nothing that I can think of right now.

Carol:
Nothing comes to mind right now...maybe later after I read some more of the books you gave me.

Craig:
Well, if either of you have any questions, just call me. I'll be glad to go over anything. Doug, do you have any preferences for the surgery?

Doug (shrugs):
Benton...Corday...any of them are fine.

Craig:
OK...I'll set that up for Monday?

Doug:
That's fine. I'll be there.

Craig shakes hands with both of them and Doug and Carol leave the office together. They get to the jeep and get in, but Doug doesn't start the car right away. He sits there quietly while Carol waits.

Carol:
Are you OK?

Doug:
I don't know. I feel like I just had the rug pulled out from under me.

Carol:
Where do you want to go?

Doug:
I think I just need to go someplace alone and think for a while. That be OK? You take the jeep and I'll just walk for a while.

Carol:
I hate for you to be alone right now...

Doug (opens car door):
I need to be alone right now, Carol. I'm OK. I just need to think about this.

Carol:
OK...
(sighs and scoots over to the drivers seat)
I'll see you at home later?

Doug:
I'll be there in time for dinner. I promise.

He walks off slowly and Carol watches him go with a pained look on her face. Finally, once he is out of sight, she starts the jeep and drives away.

Cut to show time lapse. Show an long exterior shot out over the great lake. Pull back slowly to show Doug, standing alone at the rail of the pier, looking out over the lake blankly. Cut to the other end of the pier and show David Morganstern looking down the boardwalk. He smiles slightly, puts his hands in his pockets, and strolls casually down the walk way to come to a stop at the rail beside Doug.

David (chuckles):
Thinking of jumping in?

Doug (doesn't look at, stares straight ahead):
No...not yet.

David (knowingly):
Wondering why this happened to you?
(Doug turns and looks at him quickly)
Carol came by the clinic. She told us what Dr. Paddox told you today.

Doug:
What am I going to do, David? My career is over...

David (shakes his head, cuts him off):
Your career isn't over. Maybe one phase of it is over. But, you have plenty of options left.

Doug:
Name one...

David:
You can still practice medicine and you can still practice emergency medicine. You're certified in emergency medicine. If you went into private practice, there wouldn't be much of anything you couldn't handle except level one trauma! You have any idea what a valued asset that would be to the community? The rest of the time, you're taking care of runny noses and cuts and scrapes. Not a bad life.

Doug:
I can't afford to go into private practice by myself...

David (smiles):
Not many doctors can when they start out. That's why they get a partner. I always kind of thought you and Mark would end up in private practice together...why not ask him?

Doug:
Mark loves what he does, David. He's had chances to leave it before and never did...

David:
Maybe he was just waiting for the right opportunity. You and Mark are a sensational team. You work very well together and you're good friends. A Pediatrician and a General Practioner? Both trained in Emergency Medicine? You'd have a family practice that no one could compete with. I think you should at least talk to him.

Doug (nods):
Yeah, I might. Maybe. Private Practice wouldn't be so bad...I always figured I'd end up there eventually anyway.

David:
You've got a family to consider, Doug. Private practice would be better hours. You'd have more time off. Every weekend off, unless you kept part-time Saturday hours. It's an ideal situation for just about everybody involved. I'd seriously look into it if I were you.

Doug:
But, if Mark and I both leave, what happens to the clinic? It hasn't even been open a year yet...

David (chuckles):
Don't you worry about the clinic! I'm sure the board has plenty of options.

Doug:
Like what?

David:
Well, Carol's free clinic has way outgrown County now. The board has been talking for months now about finding a facility to move it to. Maybe this is giving them a golden opportunity they need.

Doug:
What about Carter? What happens to him if Mark and I leave?

David:
A bright young doctor like John Carter? He won't have any problems. He'll either go back to County or the board will find something else for him to do. Don't worry about him, either. He'll be fine.

Doug:
Why did this happen to me, David?

David:
It's a warning. It's telling you to slow down. You have a family that obviously needs you. Maybe with this, you'll be able to live long enough to enjoy them. The same thing happened to me...

Doug:
Yeah, but, you're older than me.

David:
And my family is grown. Yours is very young. They need you more. It still made me slow down.

Doug (nods):
Yeah...OK...maybe you have a point.

David (slaps him on the back):
Everything will work out all right, Doug. You'll see.
(looks at his watch)
I need to get on back...will we see you later?

Doug :
Eventually, yeah. I'll be in.

David:
You think about private practice, Doug...I think it's just up your alley.

David goes on off down the boardwalk, leaving Doug alone with the breeze blowing his hair and a pondering look on his face.

Cut back to County C.A.R.E. and show David coming in the back door. Carol looks up quickly when she sees him with a hopeful look on her face.

Carol:
Did you find him?

David (nods):
He was right where you thought he'd be...out by the pier.

Carol (smiles):
That's one of his favorite thinking places. Always has been. Did you talk to him?

David:
Yes, and I think I got through to him. He's OK.

Carol (quietly):
Can I talk to you? Privately?

David (nods):
Sure...let's go to my office.

They go down the hall to David's office and Carol closes the door once they are both in. She wrings her hands nervously and paces a bit in front of David.

Carol:
I don't know how to say this, David...I know one of Doug's major options is private practice...

David (smiles, knows):
And if he does, you want to go with him?

Carol (nods nervously):
I guess that makes me awful, doesn't it?

David:
Why would it make you awful?

Carol:
Well, they county just spent all this money to send me to school to get a PA degree...they did that so they could use me...I would be awful if I didn't owe up to it.

David (smiles):
Things change, Carol. No one has any way of predicting what's going to happen. The board has it in their budget for a PA at a clinic...all they have to do is hire one. The fact that they financed your opportunity doesn't obligate you in any way...especially not under the circumstances. If your husband opens a private practice and he wants you to go with him and you want to go, then you take that PA degree and go. No one would blame you.

Carol (sigh of relief):
Are you sure? If it comes to that, it'll really be OK?

David:
It will not be a problem, I assure you. Don't give it another thought.

Carol (nervous smile):
Thanks, David. You've been really great to Doug and me both since we came here. If we end up leaving, I'll really miss this place.

David:
Well, let's just see what happens, shall we? Nothing is written in stone yet.

David smiles and directs Carol out of the office.

Cut to show time lapse. Show Carol coming into the Ross home, early afternoon. Tatiana and Scott are playing a board game in the living room and they ad lib greetings to Carol, who returns them. Carol goes up the steps and into the nursery. She peers into Marc's crib and is startled to find it empty. She thinks for a minute, then smiles, and goes down the hall to the master bedroom. There, she finds Doug taking a nap with Marc on the bed beside him, pillows behind the baby so he can't roll out of bed. She smiles from the doorway and goes over the pull the cover up around Doug's shoulder. The instant she touches him, he wakes up and peers sleepily up at her.

Carol (motions to Marc):
Who's your friend?

Doug:
Bonding time with Dad.

Carol (sits on the bed beside him, he pulls himself into a sitting position):
That's good for him. How are you doing?

Doug:
I'm OK. Did you sic David on me?

Carol:
I only asked him to talk to you. That's all.

Doug:
He did. And I think he made some sense. What do you think about me going into private practice?

Carol:
I think it needs to be what you want to do because it's what you want to do...not because you think it's all you can do.

Doug:
It's something I've always thought about...something I always figured I would do at some point in my career...just maybe a little later than now.

Carol:
So, you start a little earlier. Nothing wrong with that. With your reputation, you'll build clientele quickly.

Doug:
But, I can't do it alone. Do you think Mark would even be interested?

Carol:
You'll never know unless you ask him.

Doug:
Yeah, but what do you think?

Carol:
I think Mark will go anyplace you go. You and Mark are a great team...

Doug (chuckles):
That's what David said...

Carol:
Well, it's true. You and Mark have been close for a long time. You have a trust and bond that you'll never have with another coworker for as long as you practice medicine. I think you need to at least talk to him about this idea.

Doug (nods):
I will.
(baby begins to stir on the bed beside him...he reaches over and pats his stomach)
I've got too much at stake, Carol. I have to do what Craig says. I've got a son on the edge of puberty...he's going into the most trying times of his life and I want to be there to help him through it. I've got a daughter that every day of her life is on borrowed time and I don't want to lose a minute of whatever time we've got with her. And this little guy...
(pats Marc)
...he's only three months old. I want to live to see him grow up. I can't take a chance with my life now, Carol. If I were still single, I wouldn't even be thinking about anything. But, this family...you and these three kids and whatever other kids we have in the future...you are the most important thing in the world to me. And if going into private practice will secure all this, then, there's no question about it. Whatever we have to do to do this, we will. If it means a loan...a second mortgage...or borrowing from someone, we will find a way.

Carol (smiles):
You think there might be a place in your private practice for a PA just starting out with her degree?

Doug (grins, pulls her to him to wrap his arms around her):
Oh, I think I might find someplace for one...provided you know a good one...

Carol (rests in his arms, sighs):
Well, I don't know how good she is, but, I know she works cheap!

Doug (chuckles):
That's the most important part!

Carol:
So, you'll talk to Mark, then?

Doug:
First chance I get. I promise. Maybe I'll take him to breakfast or something and we can talk then.

Carol:
And let me know

Doug (smiles, kisses her hair):
You'll be the first one I talk to. I promise.

Carol (reaches over and picks up Marc):
I think this is a sign for me, too. I need to be with the kids more. This would let me do that. Besides, as soon as we can, I want to have another baby.

Doug:
Well, we'll need to talk to Stephanie about that. You had a lot of trouble with Marc...

Carol (nods):
Right, and they know what to look for now. We can watch for it early and take care of it. If I have to go to bed for the whole nine months to have more children, I will do it. I'd like to have at least two more.

Doug (shrugs):
That's your call, Hon. You're the one who has to do all the work. I'll give you as many as you want.

Carol (satisfied smile):
We'll work on it, then.

Carol cuddles baby Marc and rests back against Doug. He puts his arms around both of them and smiles secure in this feeling.

Focus on this family scene and fade Act Four to Black.

Closing Act

Scene opens at a breakfast place...house of Pancakes type place...early morning. Doug and Mark are having breakfast in a booth together. Mark is having toast and coffee...Doug is having a stack of pancakes and juice.

Doug (quietly):
I need to talk to you.

Mark (grins):
I figured this breakfast was about something. What's up?

Doug (smiles):
I guess you know me too well, don't you? OK...here goes...I'm thinking of going into private practice.

Mark (nods):
That would be a good option for you now. You can work your own hours...pick your days off...sounds like a good plan!

Doug:
But, I can't do it alone. I need a partner. Are you interested? Partner?

Mark:
Me? You want me to be your partner?

Doug:
There's nobody I'd rather work side by side with than you. You know that. Besides...you're the only person I know who can keep me in line when things go heywire!

Mark (chuckles):
You know, I always visioned us working together in an office building someplace. I think we may just be doing it sooner than I thought.

Doug:
Is that a yes?

Mark:
Private practice is something I've always dreamed about. I could be the kind of doctor my parents think I am...the kind that plays golf once a week and goes boating on the weekends...

Doug:
You don't have a boat.

Mark (shrugs):
Maybe I'll buy one. Maybe I'll have time.

Doug:
I didn't think you'd want to give up emergency work...it's going to kill me to give it up.

Mark:
We don't have to give it up. We open as Family Practice and Emergency Care...we can treat most emergencies...and anything we can't, we know how to refer it to County. We're certified and we should use it. We can do this.

Doug:
But what about C.A.R.E.? We just opened that place...what will happen to it?

Mark:
Not our problem. I'm sure David and the board know what they want to do.

Doug:
What about Carter? What do you think he'll do?

Mark (chuckles):
Carter...don't worry about Carter...I just found out Carter has a life we don't know anything about.

Doug:
Oh yeah?

Mark:
Yeah, I'll have to tell you about it sometime. Suffice it to say Carter is married and a father and we never knew it. I guess you and Carol weren't the only ones who sneaked off and got married last year!

Doug:
Speaking of Carol...she wants to have another baby...

Mark:
How do you feel about that?

Doug:
I'm all for it...I just hope it will be OK for her.

Mark:
Carol's tough...and strong...she'll be fine.

Doug:
So, you're sure we want to do this?

Mark:
I'm sure about me...you sure about you?

Doug (nods):
I'm sure. But what about money? Carol and I have some, but not a lot

Mark:
I've got some saved up...and we do have one other person who wants to go into this with us if you're game.

Doug:
And that would be?

Mark:
Nina. She and I have been talking private practice for a long time. I would be the GP and she would be the family counselor...would you object to her joining our project?

Doug (smiles):
Not at all...the more the merrier! Nina is great! And I think she'd be fine working with us.

Mark (nods):
I'll talk to her.

Doug (grins):
Why don't you just marry her and be done with it?

Mark (smiles):
Let's not rush things, Buddy. Everything in it's time.

Cut to show time lapse. Mark is working at County C.A.R.E. when Doug and Carol come in, but they come in the front door, not the staff entrance. David is working with Mark and he smiles to see Doug and Carol.

David:
From the look on your face, I'd say you're coming to give me your decision.

Doug:
Looks like Mark and I will be branching off.

David:
OK, let's sit down together, shall we? I have some things to discuss with all three of you.
(Everybody sits down at a table with him)
OK, first, Carol...I checked with the board about your PA degree. You do not have to reimburse the county for the class and your degree is their gift to you for all you've given the community. It's yours free and clear. Congratulations.

Carol (nods, smiles):
Thanks, David. I really appreciate it.

Doug (kisses her shortly):
Proud of you, Babe.

David:
OK, Doug...Mark...and Doug I also talked to Dr. Paddox about this for you, the county would like to retain both of you for services at County General. That would mean you would refer any admitted patients to there and you would be able to practice there to treat them.

Mark:
That would be fine...pretty much like it was here?

David (nods):
Right, exactly.

Doug:
So, what happens to the clinic?

David:
They're going to move Carol's free clinic to it. And Carol, we'd like you to still be involved...maybe work in it once a week or so?

Carol (nods):
Sure! I'd be happy to.

David:
Doug...Mark...you're welcome to work at the clinic too since it is volunteer service.

Doug:
That would be super...I'd love to!

Mark:
What about Carter?

David:
In charge of the clinic...and I think he'll do a hell of a job!

Mark:
What about you? What will you do now?

David:
I remain a member of the board...on staff at County...and anything else the board wants me to do. I'm fine.

Doug (sighs):
It sounds complicated.

David:
It'll take time to put it all together...but you two will be building your private practice by then.

Doug:
I'll miss this place.

David:
For a while, yes...but in time, it'll just be another memory.

Mark:
Good memory.

David:
Well, everything worked out...Doug...I expect your disability forms...Mark...I expect your resignation...soon. And if I didn't say it before, it was a pleasure working with both of you.

They all shake hands and David walks away. Mark sits quietly for a minute and looks coyly at Doug and Carol.

vv Mark:
So, how soon do you guys want to see the office building I've got my eye on?

Carol:
How about as soon as we can get there?

The trio gets up from the table all smiles and head for the door, Doug in the middle with Mark and Carol both with their arm around him as they go.

Fade into closing credits of the show.

March 2, 1998