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Spoilers: эпизод 12.13 - "Body and Soul"



22.11.2005
DeeDee http://www.erforums.com/forum

Director: Paul McCrane.

Work dates: 12/5 - 12/14

The James Woods episode.

Woods' character is named Nate Lennox. Not much detail on this yet -- just a role for his doctor, and for a couple of students enthralled by his genius in a biochemistry lecture. If they're even doing a flashback and are going to try to pass The Abster off as twenty-five, they really shouldn't go there.




02.12.2005
Daisy http://p086.ezboard.com/baeb

This is not the first time Nate is treatet by County General's finest. We see Pratt, Neela, and Abby in Nate's flashbacks.

Now, ready for this?

We see Anspaugh in another flashback.. and.... Anspaugh talks about Romano!

It's very simple sweetheart. It's a flashback episode and they've all treated Nate before, Luka, Abby, Pratt, Neela.

In one of the past episodes, Anspaugh talk about Romano, and Pratt talks about Mark.

We also see Pratt talking about going to Northwestern and Neela saying surgeons are evil jerks.

In the present, Luka, Ray, Sam and Abby treat Nate.

Snif. It's sad, kids, Horrible disease. Snif.

Fran's his caregiver and also the woman of his life, though Nate decided that he had to devote himself to science and had no time for such things like love and enjoying life.

In one of the flashbacks we see Nate telling Luka something along these lines, and Luka saying people can manage to balance carreer and personal life. Poor Luka put his foot in his mouth assuming Fran and Nate were married.

Nate's condition is worse than the last time he was brought to County, and they have to decide if they are going to just let him go or try some medical procedures. Fran says she knows what he wants, and there's some discussion about what he wants. Abby pushes for surgery and Luka supports her.

Nate didn't want to be kept alive.

Luka supports Abby because he thinks that if there's the smallet chance Nate wanted to go through any procedure that could give him more time, they should do it.

Neela and Dubenko performs Nate's surgery. But, sweethearts, this daisy knows nothing about the medical aspects of this show, someone else's going to explain this for you, ok?

In one of the flashbacks, Nate asks Luka if he's married and he just shakes his head, no.

Nate wanted a Nobel and he wanted to push the frontiers of science. He was brilliant and named the Teacher of the Year. He was praised by his pears and loved by his students. He lives in a weelchair and needs a computer to talk.

Lily and Malik are there.




02.12.2005
Doc Sharon

We see Nate at the major milestones of his illness turning up in the ER. He slips and falls on the stairs, breaking his wrist and we hear that he can no longer navigate stairs successfully and should really be using a wheelchair. Luka treats him then, but doesn't remember it later. Pratt later treats him when he chokes on some food and he needs a feeding tube inserted. This occurs on the day he wins Teacher of the Year from the med school where Anspaugh is presenting. It's mentioned that Romano will do the surgerey. Pratt remarks that the ER is understaffed because as many as possible are attending a memorial service for Mark. We also see Nate when his speech has gotten so bad that he needs to start using the electronic device.

His final appearance in the ER occurs when he is found at an ice rink, without a coat, disoriented. Turns out he has pneumonia and his pulmonary function is poor. There's some question as to how alert he is, he doesn't always respond appropriately, and,since he's both oxygen deprived and septic, most of the staff don't really seem to think he is aware enough to give consent. Initially, Luka, Sam and Nate's friend, Fran, who has durable power of attorney, discuss whether it might be best to let nature take its course at this time rather than doing anything heroic. However, Abby walks in, pitches a fit and immediately starts to intubate him despite Luka and Fran telling her they're not sure that's what Nate would want. Fran actually seems pretty sure that it isn't and she is present at every other ER visit over the years and seems to know him pretty well.

Abby is unable to intubate and they can't get a line into Nate either. She also discovers that his Gtube is malfunctioning and needs replaced so he can be fed. Abby pushes for fixing all of these things right away, she asserts that Nate's poor lung function is due to the pneumonia and not the ALS, so she's sure he will get better once the pneumonia's treated. Ray points out that this is the very best case scenario and it is more likely that his lungs are not going to get better and he will spend the rest of his life in the ICU. Fran is pretty savvy about the lung parameters and points out that she knows that at the numbers Nate currently has, ALS patients are placed into hospice and made comfortable, not subjected to aggressive treatment.

Abby asks Nate if he wants the tracheostomy. He answers, "I'm OK" which she decides means he wants the procedure while Fran thinks he means he is OK as he is and doesn't want anything else done. Abby overrules her and Ray, who also thought the same thing. Luka arrives and Abby tells him they must do everything because Nate wants it. Luka agrees that if there is any doubt, they have to do everything, although Abby seems to be the only one who thinks this is what Nate was saying. There's a fair amount of evidence from his previous visits to the ER that he was not particularly interested in the length of his life as much as the quality.

They replace his Gtube, put in a central line and then Neela and Dubenko do the trach. There is major hemorrhage and concern that they will have to open his chest to control the bleeding due to some unusual anatomy, but it looks like they get it under control without anything more than making a huge incision in his neck.

Initially, Nate is slow to wake up and there is concern he has brain damage. His caregiver wants to take him home and care for there, telling Abby that this is what Nate always wanted. Abby continues to insist he be admitted to ICU because he is going to get over the pneumonia and things will be great. She lays a little guilt trip on Fran, asking 'Don't you want him to get better?'.

Nate wakes up and maked it clear that he never wanted the trach, as Fran indicated. He wants it removed immediately, but, of course, Abby tells him that is impossible. He also points out that his facial muscles are getting weaker and weaker and very soon he will be unable to blink or trigger the electronic voice box, so he will be 'locked in' and unable to communicate, he is ready to die. Nate wants to go home right away but Abby has a fit about that, he wants to invite his poker buddies over for one last game. Abby wants him to play poker with them in the ICU.

Nate insists on going home even though Abby tells him she's not 'comfortable' with it. He tells her it's more important that he's comfortable. He also indicates that he intends to turn off the vent at bedtime and die in his sleep that night. Abby's not happy about that, either but she doesn't really have any choice and it looks like he leaves.




02.12.2005
DeeDee http://www.erforums.com/forum

Nate (Woods' character) has been in and out of the ER over the years, and several of the staff know him. We get a flashback to the day of Mark Greene's funeral when Pratt treated him, for example. (Pratt mentions that they're short-staffed because everyone's at the funeral.)

His current trip to the ER is because he's deteriorating rapidly from pneumonia. I had to almost laugh a little at one point because sure enough, Luka (a.k.a. The Grim Reaper) wants to withhold treatment immediately, saying in effect that this might be the time for Nate to die. Abby ignores him and does some suction on Nate's throat. He improves somewhat. She insists over Nate's caregiver's wishes that he needs a surgical procedure to further improve his breathing. Nate's unable to give clear consent (the caregiver thinks he hasn't, Abby thinks he has), and Dubenko proceeds. It doesn't go smoothly, and when Nate is awake and alert, he's clear he did not want it, wants the vent removed, and to die at home.

There's a great part for Fran, his caregiver, who's been with him for over twenty years. This is Woods' spotlight so I can't see them going for another star name, but it'll be interesting to see the actress they cast.

(I didn't see any mention of Clemente or Weaver in this, but everyone else makes an appearance. Anspaugh's even there in one of the flashbacks, and he and Nate mention Romano.)

Nate is at crisis point *before* the surgery is mentioned, due to a mucus/phlegm plug in his throat. Luka doesn't want to do anything then, the caregiver is uncertain, Ray and Sam are standing by. Abby takes charge and uses suction to clear Nate's throat to ease his breathing a bit, in contradiction of what Luka tells her to do (nothing), and over Ray and Sam's reluctance to get involved. It's that scene where she's in defiance of the attending's orders, but does what she thinks is right over his objections.

In that part, it's pretty clear cut that Abby was right. In the next, when she insists on surgery that the caregiver is sure Nate wouldn't want (and later says he didn't), she's in the wrong.

1. Nate is unable to breathe, his oxygen level is falling, the alarm is going off.

2. Abby walks in, quickly assesses the situation, and successfully suctions Nate's throat over Luka's repeated objections and without assistance from the others.

Luka tells Abby to stop, not to do anything + Abby's action in spite of his instructions = Abby defying the attending.

She seems in agreement enough with the attendings over the surgical procedure -- certainly enough for Dubenko to perform it. The person she defies there is his caregiver, who knows what Nate's wishes were.




13.12.2005
AzizalSaqr http://www.shoothemoon.com/Bleuprofond/Messageboard

Luka arrives after Nate has been brought in, he asks Ray to present to him, seems not to recognize Fran as she stands there. She tells him that he saw Lennox a few years before. Luka doesn't remember him.

Luka draws Ray, Sam, away from the bed, tells them they made need to make a decision on intubation and ventilation.

Fran thinks he might reover from the pneumonia. Ray thinks it could turn worse. Sam adds that he doesn't have a reserve to fight it. Luka summarizes that it may be the natural end point of his disease.

Abby enters and goes to Nate, his stats begin to drop and she wants to intubate.

Luka lowers the head of the bed as he brings Abby to speed on their discussion. Abby continues to prep. Fran doesn't think he'd want her to continue. Luka says that a decision on how to proceed hasn't been made but Abby continues, suctioning phlegm, the alarm silences and they buy more time.

Kovac tries a sternal rub on Nate there is no response and the first Act ends.

As Act Two opens Luka, Sam, and Ray are placing a PICC line while Abby and Fran watch.

Flashbacks to 2002
Back in the present Luka re-enters. Abby tells him they have consent for a trake tube. Sam and Fran disagree. Abby persists and Luka points out that Fran has durable power of attorney, it's her decision. Abby pushes again. He expressed his wishes.

Director's note: There is no easy answer. Everyone looks to Kovac."

He decides that if there is a chance that Nate asked for the procedure then they have to do it. As Ray begins to protest Luka calls him off to help with another patient and the two leave.

Flashback to 2001 and we see that Luka was indeed involved in an earlier ER visit, a broken wrist. He is talking on the phone as Malik pushes morphine. He's been consulting with the personal physician who feels it's time for Nate to go to a wheelchair. Fran leaves to get more information from him, leaving Luka and the man alone.

They talk about the couple...

Luka asks if she drives him to all of his visits.

Nate tells him she just drives him crazy.

Asks how long the two have been together.

They haven't, she just works for him.

Luka is surprised

They have been together 15 years.

Luka observes that she seems to know him well, he just assumed...

Nate is quick to protest..."No, no, no." Says it almost happened, then asks if Kovac is married.

Luka shakes his head no. Nate explains how there wasn't time for marriage, grows heated in pushing his lifestyle choice until hit by a wave of nausea. Luka gives compazine and we return to the present.




19.12.2005
http://www.spoilerfix.com

12/19 - Episode 12.13 - Body & Soul: Part of this episode will feature flashbacks of previous years to tell the story of a man named Nate Lennox. Nate, who is a doctor, has speech problems. He'll also be in a wheelchair for at least part of the episode. We will see him in the ER at various times and witness the change in his health. Neela, Ray, Haleh, Sam, Abby, Pratt, Dubenko, Malik, Anspaugh, Kovac, Jarvik will be in this episode. Chen and Romano will be mentioned but it doesn't seem they will appear.



14.01.2006
NBC:

"Body And Soul"

A LONG GOODBYE- JAMES WOODS AND ALLY WALKER GUEST STAR-- When an abandoned ALS (Lou Gerigs disease) patient arrives at the ER, many of the doctors are shocked when they recognize the former medical school professor (Guest star James Woods) Abby (Maura Tierney) and Kovac (Goran Visnijic) try to understand Dr Lennox's wishes for his life after the professor is struck with pneumonia as well as the nerve degenerating disease As the disease continues to cripple Dr Lennox, Abby struggles with the possibility of losing the professor that was responsible for making her a doctor. After a controversial decision to attach a trake to help Dr Lennox breathe, Abby and Fran, (Guest star Ally Walker) wonder if they made the right decision Mehki Phifer, Parminder Nagra, Linda Cardellini, and Scott Grimes also star.


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