Recap / ERS 1 E 19 Loves Labor Lost

Season 1, Episode 19:

Love's Labor Lost

It's all my fault.

Doug and Mark are seen playing a game of catch near the subway line situated near County in the afternoon, when their attention is distracted by a vehicle driving erratically. The driver nearly hits Doug (causing him to leap over the hood of a nearby car to escape) before dumping his passenger onto the street in front of the ambulance bay. As they go to grab a stretcher for the unconscious man on the street, Doug pointedly says he doesn't want to play catch with Mark anymore. They wheel the victim into the ER, nearly bowling over Chen (and spilling her tray) in the process, and diagnose that he was shot in the back of the neck during an altercation before scheduling a surgery.

Peter and Haleh are still trying to calm down Mae Benton, who fell down a flight of stairs at her home the night before. When Haleh attempts to take Mae's clothes off, she protests that she doesn't want her son to see her that way, prompting him to sheepishly wait outside. Soon after, a "Dr. Wilson" arrives and sees that Mae will need hip surgery — but he pointedly refuses to let Benton tag along, even telling him to "back off" when the latter tries to crowd into the elevator with him.

While Mark conducts a seemingly-routine examination with Jodi O'Brien, who is pregnant and accompanied by her husband, Sean, he diagnoses that she may have a bladder infection and prescribes medicine and rest before they leave. Benton waits anxiously for news about Mae's condition. Jackie, who's arrived with her kids Jesse and Stephen, tells Peter to shut up and sit down when he tries to goad her into telling him how it's all his fault. Soon after, Benton attempts to scrub in on Mae's surgery — only to be told point-blank by Dr. Wilson to back off and wait outside, lest he end up "on my wall".

As the "graveyard" nighttime shift looms, Doug, Mark and Haleh treat a boy who seemingly feel unconscious at his father's workplace, leading the latter to think his son has been drinking and taking drugs. It's only when the boy becomes unresponsive and Mark asks where the father works that the latter tells him it's a greenhouse — leading the staff to realize the boy has insecticide poisoning. Luckily, they're able to catch the problem in time and begin a course of treatment.

The staff are diverted when Sean O'Brien runs back into the ER and yells for Mark, telling him that Jodi went unconscious in their vehicle. Carter, Chen and Carol (who just arrived at County) grab a stretcher and rush out to bring her in. At the nearby trauma room, Sean frantically asks what's happening as Mark diagnoses that Jodi likely has pre-eclampsia (seizures associated with pregnancy). After explaining this to both Sean and Carter, Mark says that they will likely need to induce labor soon, as Jodi's condition could cause a lack of oxygen to the baby's brain if she has another seizure — which happens right on cue, prompting some frantic delivery of meds to stabilize her.As Mark's shift is supposed to be ending, Susan asks if he wants to let her take over the procedure, but he refuses, noting that he wants to see the case through because of making a mistake earlier when he let them go. Mark tells them everything will be fine, and pages the head of the Obstetrics Unit, Dr. Coburn... only to find out that she won't be at County for at least another hour. When asked, Mark offers to deliver Jodi's child, and she and Sean pick out a name ("Jared").

The treatment continues for several hours as the staff monitor Jodi's condition and wait for the OB Unit to take her up. An OB rep named Drake comes down to aid them with monitoring, but is soon called back up to his wing, leaving Mark to lead on the case. At the same time, Mae is wheeled out from surgery, and Jackie comments to Benton that she expected it was only a matter of time before Mae fell or was injured.

As Jodi's treatment continues, it appears everything is progressing normally... but after another 45 minutes, it becomes clear that Dr. Coburn still hasn't arrived, forcing Mark to make the call to deliver the baby in the ER itself. After Mark sends Carter up to the OB Unit to find someone to help, Jodi's condition begins to worsen, with the baby's heart rate going down slightly and an epidural they gave Jodi wearing off, causing her to snap at her husband.

Several of the staff, including Carter, Chen, Lydia, Susan and Carol, all pitch in to help with the delivery, but it becomes clear after several hours (and frequent pushes by Jodi) that their efforts aren't working. Midway through the night, Mark tells Carter to run upstairs and drag Drake back down if he has to — but Carter rushes back a few moments later to tell him that every member of the OB Unit is currently tied up with multiple C-section procedures. After another attempt to push the baby out, Mark realizes they'll have to go for a c-section too (as the baby's shoulders won't pass via normal delivery), and pledges to see the case through despite Susan telling him to leave it in her hands. With Sean snapping at him and claiming he doesn't know what he's doing, Mark elects to move Jodi to a nearby trauma room and prep for surgery.

Jodi is wheeled into the trauma room, where tensions run high as her condition worsens. When Chen (in a moment of panic) knocks over a tray full of equipment, Mark orders everyone to take a deep breath for a moment. A few moments later, he orders one of the nurses to physically drag one of the OB Unit members down to the ER, and rallies the rest of the group to begin the c-section. Sean watches, horrified, from outside the door as Mark opens Jodi's chest and (still stressed out) has to be reminded by Susan how to conduct the procedure. Carter (aiding Mark) and Chen (watching from the sidelines) are horrified when they see what's happening in front of them.

With Jodi's condition continuing to worsen, and Susan snapping at him to hurry, Mark manages to cut through Jodi's uterus and bring the baby out — which is unresponsive. As others begin to work on resuscitating the newborn, Mark conscripts Carter to help stabilize Jodi's aorta while he helps Susan, Lydia and Carol intubate the baby. Together, they manage to stabilize its condition, with Sean watching outside breathlessly.

Soon after, Dr. Coburn arrives in the ER — and is horrified at the situation. After Mark explains the steps he took to save the baby and try to stabilize Jodi, she accuses him of not doing enough to get a handle on the situation while calling for the neonatal ICU (NICU) to come down. Soon after, Coburn tells Mark to talk to Sean as the baby is wheeled up to the NICU, and he rails at Mark for not having a handle on things. Mark reassures him that Jodi is stabilized, and that the baby will be fine before the latter goes up in the elevator. Coburn continues to blast Mark for missing several aspects of Jodi's case, while Susan comes out of the trauma room and tells Mark not to blame himself, reasoning that Coburn is trying to cover herself for not getting to County sooner.

Their attention is diverted when one of the nurses runs out and tells them that Jodi's vitals are crashing again. Inside, they start chest compressions on her, but it soon becomes clear that Jodi has died. Despite Coburn calling time of death, Mark continues to try chest compressions for several minutes afterwards... until Susan gives him a look that confirms to him that there's nothing more that can be done.

Mark angrily rips off his bloodied gown and gloves and storms out of the room. Upstairs, he makes the long walk to the nursery and meets Sean, telling him behind closed doors what happened. Sean reels in shock and sadness at the news. Afterwards, Carter finds Mark back in the trauma room staring at Jodi's body, and tells him that his actions were incredibly heroic. Mark, now in the midst of a full-blown Heroic BSoD, says nothing and walks out of the room.

Now early morning, Susan accompanies Mark back to the subway station and offers to ride with him back home. Mark tells he just wants to ride alone, and excuses her offer by saying he has a number of things to think about before getting on the subway alone. Onboard, he slumps into his seat, and for the first time, breaks down as the weight of what's happened hits him...

Tropes:

• All Part of the Show:
  • Mark likens the ER experience to "being in a circus" for Carter's benefit — just as they see a patient, sitting in a stretcher and dressed in a gold tutu with pink frills, get wheeled out of the elevator.
  • When Mark asks if Carter can observe Jodi's dilated cervix, she nonchalantly agrees, saying everyone's going to look anyway — and then she asks if he's "enjoying the show?"
• Artistic Licence Medicine: This episode (partially based on a true story) led to producers having to reassure the public after a wave of female viewers freaked out because of the... less-than-stellar treatment plan seen in this episode: At least one OB/GYN pointed out the problems associated with Jodi's treatment:
  • Eclampsia is a serious medical situation, and it's highly unlikely that Mark and the others wouldn't have begun a c-section immediately if they knew the situation was going to get so bad. Nor is it possible that things would have continued past an hour once the diagnosis was made before OB got involved (the non-appearance of Drake notwithstanding) — and the excuse that the OB Unit was slammed for 10-plus hours with otherwise-routine c-sections doesn't fly.
  • An ER doctor would never put forceps on an unborn baby — even trained obstetricians wouldn't consider such a thing due to the inherent risk, unless it was a last resort.
  • There is no way an OB/GYN wouldn't have taken over the case, especially since it was a high-risk matter. Not only is Mark's treatment of the woman woefully incompetent, it went on for the better part of 12 hours, enough time to call in an OB/GYN from another hospital or practice or even another city if necessary.
• As You Know:
  • Briefly in the opening, as Carter relays the details of Mae's accident for the benefit of Susan.
  • Mark explains what eclampsia is, both for Sean's benefit (as her husband) and for Carter's (as a med student).
• Bait-and-Switch: Midway through the episode, the plot changes gears from the standard A-B-C case-of-the-week style story exhibited throughout the season, in favor of a story involving a single patient (Jodi), whose situation dominates the back half of the episode and results in disastrous consequences.
• Birth-Death Juxtaposition: Jodi, who dies just after her child is removed via c-section.
• Bittersweet Ending: Within a hairbreadth of being a Downer Ending. While Mark does manage to deliver Jodi's child — it's at the cost of her dying due to the trauma and blood loss, leaving her widower husband distraught. He gets raked over the coals by Dr. Coburn (with the implication that he'll undergo a case review like Susan did with the Vennerbeck case) and the weight of Jen's separation finally catch up with him, leading to a breakdown onboard the subway home.
• Bloodier and Gorier: This trope is invoked in-universe when Coburn arrives and likens the current situation (blood is soaked all through the sheets surrounding Jodi, and the doctors are covered in it) as being like a "chainsaw".
• Book Ends: The episode starts and ends with a subway train — in the beginning, a train passes as Mark plays catch with Doug (and hasn't told him about Jen's separation) and ends with him on the same train back home, breaking into tears because of the weight of Jen's actions and Jodi's case.
• Break the Haughty: The Episode. Mark Greene goes through a day-long breakdown that sees him botching a pregnancy case despite his best efforts, and being reduced to tears by the end after the weight of recent developments finally hits him on the way home from work. This is invoked in a TV Guide feature written about the episode in 2015:
  Lance Gentile (Writer): Dr. Greene had been a little too successful and perfect, and so John (Wells, executive producer) said, "We need to shake him up a little bit." That was my assignment: Shake up Dr. Greene.
• Butt-Monkey: Chen's only appearances in the episode are when she's dropping trays, making silly comments (asking Carter why the hospital is full of "old and sick" people) and reacting in shock and horror to Jodi's treatment in the trauma room. It's not even clear why she was allowed in the room to begin with, as her presence adds more stress to the situation (e.g. her dropping the tray full of implements).
• Closest Thing We Got: Carter is ordered by Mark to hold Jodi's aorta closed until the baby can be stabilized and someone can get in to help. When Coburn arrives, she looks at him first and asks who he is, prompting him to state (to an incredulous reaction), "John Carter, med student."
• Death by Childbirth: Jodi, who dies from complications after her baby is delivered via c-section.
• Decoy Protagonist: It appears that Benton is being set up as the lead for the episode, as a handful of scenes focus on his Determinator tendencies to be present for Mae's surgery. Then, he disappears at the midway point of the episode, and Mark, Susan, Carol and a few others are left to try to handle Jodi's case on their own. When Mark tries calling for Benton, he's not on rotation.
• Determinator: For the better part of 12 hours, the staff give it their all to try and save Jodi and her unborn child. Despite saving the baby (and even that was a close call), they are unable to prevent Jodi from dying after losing too much blood.
• Foreshadowing: Mark does a pop quiz on proper treatment of the unconscious man dumped from the car in the opening sequence for Carter and Chen's benefit, and mocks them for getting the answers wrong. During Jodi's botched delivery later in the episode, Dr. Coburn mocks him in the exact same way for not taking the correct course of action.
• Formula-Breaking Episode: "Love's Labor Lost" uses the Bait-and-Switch plot to focus on a single patient (Jodi) for the back half of the episode, in contrast to every other episode up to this point. It also is the first to feature timestamps that are relevant to the plot (demonstrating the length of Mark's treatment). Compare to "Into That Good Night", which also features timestamps, but those don't have any particular relevance to a specific case.
• Freeze-Frame Bonus: Morgenstern (William H. Macy) can be seen milling around behind a window in the background of the ER during the opening sequence, as Mark diagnoses the gunshot victim's condition.
• From Bad to Worse: Jodi's treatment, which starts with an otherwise routine-checkup and progresses to a situation that gets more and more grave as Mark tries to employ his Determinator tendencies in an attempt to treat her. While it results in Jodi's baby being saved, she dies from a combination of blood loss and trauma, Dr. Coburn is aghast at the situation and everyone is left shocked and drained by the preceding 12 hours.
• Honor Before Reason: Mark is given the opportunity to bow out of Jodi's case (twice, in fact) by Susan, who offers to take up the case, but he refuses both times because he wants to "see it through".
• Hope Spot: Several, befitting the tragic nature of Jodi's case.
  • Mark initially presumes that Jodi has a bacterial infection, has a nice chat with her and Sean and sends them on their way with a prescription for medicine and rest... and then Sean runs back in moments later, revealing Jodi had a seizure as they drove away from County.
  • After Jodi has another seizure, her condition stabilizes enough for Mark to reassure them that everything will be okay, and they even have time to see the baby on ultrasound to reassure her, and even name the baby ("Jared"). Then the planned natural birth goes south...
  • After the traumatic c-section, Mark reassures Sean that even though the situation looks grim, the baby will be safe and Jodi has stabilized... and as soon as he leaves, Jodi flatlines once again, passing away soon after.
• Hypocrite: Dr. Coburn rails at Mark for not calling her early enough to diagnose Jodi's condition... even though he and the other nurses called the Obstetrics Unit multiple times throughout the episode in an attempt to reach someone to help. When Coburn calls for Drake (after several hours of not getting a response from him), Mark and Susan share a knowing glance.
• Immediate Sequel: This takes place right after "Sleepless In Chicago" (Benton's mother fell down the stairs at the end of the previous episode and is being treated in the trauma room at the beginning of this one).
• Informed Attribute: Dr. Coburn, whose actions in this episode set a precedent for the rest of her appearances in the series — she simply isn't around when you need her.
• It's All My Fault: This attitude, coupled with Coburn blaming him for what happened, leads Mark to break down on the subway ride back home, despite Carter and Susan praising his efforts.
• Manly Tears: After losing the patient, and consoling her husband, it takes Mark until the subway ride back home before he finally breaks down and starts crying over what's happened.
• Mass "Oh, Crap!": The entirety of the on-call staff in the ER get this once it becomes clear that (a) no one from the OB Unit is going to help them, and (b) Jodi's condition is getting steadily worse.
• Naïve Newcomer: Invoked, oddly enough, with Chen, who complains about County being full of "sick and old" people they have to treat after several weeks on the job. Carter tells her that's the point of the hospital.
• P.O.V. Cam: Between Carter and an elderly patient who jokes with him by pulling his dentures out and offering them up, in a shot-reverse shot format.
• Rule of Symbolism:
  • The episode deals with Mark (who just had his wife announce she wanted a separation at the end of the previous episode) losing nearly everything — first, he temporarily loses one of his closest supporters (Doug doesn't want to play catch with him anymore because of the location), then he has no one to oversee or stop his treatment of Jodi, and despite saving her child, he loses Jodi as well. It takes until the ending of the episode for him to finally break down when the weight of what's happened hits him.
  • This episode also contrasts two cases that the doctors overseeing them have very similar reactions to — Benton trying to micromanage his mother's hip surgery, and Mark trying to micromanage Jodi's complications from pregnancy. However, whereas Benton is repeatedly stopped from getting involved in Mae's hip surgery, Mark doesn't take the same hint and continues to treat Jodi, even after the situation spirals downwards and her condition worsens.
• Shout-Out:
  • The episode title is a riff on the Shakespeare play of a similar name (Love's Labor's Lost).
  • There is a Blooper from the episode (seen on the DVD set) that shows Anthony Edwards (Mark) pulling out the "alien baby" puppet from V: The Final Battle (another Warner Bros. production) in order to lighten the mood amid the intense shooting of the c-section scene.
• Tempting Fate: Despite having an opportunity to pass Jodi's case to Susan when he has the opportunity, Mark refuses to sit idly by and continues to take an active role in the surgery — which has fatal consequences for Jodi.
  Mark: (talking to Dr. Coburn) I feel very comfortable... I've only delivered a couple hundred babies.
• Wham Episode: Like "Blizzard", the episode shakes up the normal A-B-C episode format by focusing on a single case (that goes in a tragic direction) for the back half of the plot. Unlike "Blizzard", the consequences of this episode deeply affect Mark and set the stage for the rest of the season. This episode was one of the most critically-praised installments of the show's run, picking up five Emmy Awards, a Writers' Guild of America award, an American Cinema Editors Award and was named the third-best TV Episode of All Time by TV Guide in 1997.
• What Happened to the Mouse?:
  • The mystery of who the gunshot victim was in the opening sequence, and who dumped him out of the moving vehicle, is never answered due to the plot moving on quickly to the Jodi case. Similarly, Doug's patient who ingested pesticide also vanishes once the focus shifts to Jodi.
  • Drake (the OB attending) disappears midway through the episode and doesn't show up again, even when Coburn tries paging him down to the ER.
  • Despite the episode taking place after "Sleepless In Chicago", there's no mention of Carol's attempt to foster Tatiana—she walks into the ER as bright and cheery as ever—nor of her attempt to seek emotional and physical comfort from Doug (they never even interact).
• What the Hell, Hero?: Mark is repeatedly yelled at by Sean (and later, Coburn), who keeps asking him if he actually knows how to practice medicine. This, combined with Jodi's condition fading and the desperation to get the baby out, plays a significant toll on his psyche.
• With Friends Like These...: Invoked in the opening sequence, when Doug comments on a patient (who was thrown out of a moving vehicle travelling towards County at high speed), saying "That's what friends are for."
• Worst Aid: By most modern metrics, Jodi's pregnancy and rapidly-deteriorating condition is caused by a domino effect of errors on both the ER and OB Unit's part: not moving her up to OB when they had a chance, no obstetrician being called down to help, characters not wearing surgical masks in an operating room, med students being conscripted to help (or compromising the situation due to stress), the OB only arriving 11 hours after the fact, etc.

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