Heavy Is the Head

**Heavy Is the Head** is the third episode of Season 4 of *Chicago Med*.

## Summary

When a sick boy is brought in, Ethan is faced with a tough decision that quickly escalates into a complicated and dangerous situation. Connor and Maggie are put to the test, while Natalie and Ethan aren't sure what to make of Elsa, the new third-year medical student.

## Cast

### Main Cast

* Nick Gehlfuss as Dr. Will Halstead
* Yaya DaCosta as April Sexton
* Torrey DeVitto as Dr. Natalie Manning
* Colin Donnell as Dr. Connor Rhodes
* Brian Tee as Dr. Ethan Choi
* Marlyne Barrett as Maggie Lockwood
* Norma Kuhling as Dr. Ava Bekker
* S. Epatha Merkerson as Sharon Goodwin
* Oliver Platt as Dr. Daniel Charles

### Crossover Cast

* Marina Squerciati as Kim Burgess
* Jesse Lee Soffer as Jay Halstead

### Recurring Cast

* Heather Headley as Gwen Garrett
* Molly Bernard as Elsa Curry
* Nate Santana as Dr. James Lanik
* Peter Mark Kendall as Joey Thomas
* Dennis Cockrum as Ray Burke
* Devin Ratray as Tommy Burke
* Adam Petchel as Tim Burke
* Jeremy Shouldis as Dr. Marty Peterson
* Casey Tutton as Monique Lawson
* Amanda Marcheschi as Nurse Dina
* Sarai Rodriguez as Nurse Denise
* Kroydell Galima as Gene Pineda
* Ron E. Rains as Father Brady

### Guest Cast

* Bess Rous as Lisa Harris
* Dan Waller as Chris Davis
* Brian King as Matt Harris
* Glenn Harston as Bill Nevins
* Kayden Alexander Koshelev as Ben Davis
* Hugh Callaly as Mr. Donovan
* Kathleen Lawlor as Mrs. Donovan
* Brian Noonan as Crony
* William Eric Bramlett as Piano Teacher
* Elic Bramlett as Drinking Bud
* Ron L. Haynes as Police Officer
* Mark Harper as Security Guard Chuck

## Plot

The episode opens at the funeral of Pat Halstead, the father of Dr. Will Halstead and Chicago P.D. officer, Jay Halstead. Jay is devastated at the funeral, standing in a corner and drinking alone while Will is comforted by Dr. Natalie Manning, his girlfriend. An old friend from Will's childhood neighborhood, Canaryville, Tommy Burke, talks to Will. Tommy Burke asks if Will can make a house call and see Tommy's father, Tim Burke, who has been feeling unwell, but refuses to go to hospital. Will initially refuses as he only does emergency medicine, but later changes his mind, telling Tommy that he will drop by. He asks Tommy if his father is still managing a local event hall. At the hospital, Dr. Ava Bekker watches as Dr. Connor Rhodes sets up his new cardiac hybrid ICU room. She notes that Connor looks nervous, which is unusual, and Connor tells her that there is a significant amount of preparation to do before the hybrid ICU opens in a few days. Dr. Ethan Choi and April Sexton treat a young boy who has been suffering from kidney disease, and is brought in by his father, who is very concerned. Maggie Lockwood takes Ethan and April aside and tells them that there is an arrest warrant out for the boy's father, as he kidnapped his own son and is on the run. The father does not appear to have any information on his son's medical history. Sharon Goodwin is taken aback when Gwen Garrett informs her that Dr. James Lanik is the new Head of the ICU, as she was not consulted. Gwen tells Sharon that she will continue to not consult Sharon until Sharon stops resisting Gwen's efforts to streamline and reduce hospital costs.

In the ICU, Dr. Connor Rhodes attends to a patient, Mr. Bill Nevins, who is experiencing back pain. Connor tells Bill Nevins that he has an aortic dissection, consisting of a small tear, and hopefully they can stabilize it with medication. While Bill takes the medication, he begins experiencing acute abdominal pain. Connor finds that Bill needs a stent to stop the hole from his aorta from enlarging, but is informed by Maggie that there is no operating room available. Connor decides to take Bill to his new hybrid operating room. Maggie warns Connor that the room isn't ready, that it is not fully stocked, that the equipment isn't fully installed and the staff isn't fully trained, or available. He ignores her warnings, and takes Bill to the hybrid ICU for surgery. As they enter, Connor discovers that Nurse Beth is in another surgery, leaving them short-staffed. During the surgery, they run into several problems, having difficulty locating equipment, getting their monitors to be operational, and setting up. When Maggie helps troubleshoot, he convinces Maggie to scrub in, despite the fact that Maggie is now a charge nurse and no longer scrubs in to surgery. In the E.R., as Connor struggles to repair the tear, finding that the aneurysm is enlarging, and will require open heart surgery instead of a catheter procedure. Maggie is alarmed because the O.R. isn't ready and they don't even have perfusion facilities there as yet, but Connor insists.

As they conduct the procedure, Dr. Ava Bekker, now an attending cardio-thoracic surgeon, comes into the room and tells Connor he shouldn't have opened the patient's chest in those circumstances. She tells Connor that she advocated for hybrid E.R. program, and for him personally, and that he's putting the entire program at risk. Connor again refuses to move the patient into the cardiac wing, even as Ava warns him that the procedure is too complicated and cannot be done with their current facilities. She tells Connor she will scrub in to help, but he refuses the offer, proceeding on his own. During the procedure, the patient codes, and Connor makes Maggie give the patient manual cardiac massage, keeping the heart beating with her hands. They successfully save the patient, and later Connor asks Maggie if she would consider joining his team full-time to work in the operating theatre. Maggie tells him it would be a demotion from her current position as charge nurse, but Connor asks her to think about it. Connor goes to Ava and offers to buy her a drink as a peace offering, apologizing for throwing her out of the E.R. and informing her of the successful outcome of the case. Ava tells him that while she's glad the patient is doing well, she thinks that Connor's arrogance has put the entire hybrid E.R. program at risk, and that she wants no part in celebrating that.

Dr. Natalie Manning supervises Elsa Curry, a medical student, and allows her to take the lead on a case concerning a woman, Lisa Harris, who is at the hospital with her husband, Matt. Lisa is 13 weeks pregnant and has abdominal pain. Lisa and Matt Harris tell the doctors that Lisa had a very difficult time conceiving, because of anatomic difficulty. As religious people, they have a 'miracle baby'. Natalie is taken aback by Elsa's apparently cold and abrupt bedside manner. Natalie and Elsa discover that Lisa has an ectopic pregnancy, and that the fetus has implanted on the vena cava instead of the uterus wall, which has resulted in internal bleeding. Elsa tells Lisa that they will have to repair the bleeding, but that it will probably result in the loss of the baby. Lisa refuses surgery, telling them that the baby is a miracle and God will take care of it. Elsa asks Dr. Daniel Charles to consult on the surgery, but is displeased when Dr. Charles tells her that the patient is sane and appears reasonable and that they can't force her to have the surgery. Elsa finds the woman's actions illogical and unreasonable, and is not pleased when both Dr. Charles and Dr. Manning tell her that they have to respect the patient's wishes and religious beliefs. Dr. Charles is not impressed by Elsa's dismissive attitude, as Elsa describes the patient's attitude as "ridiculous". Later, encountering Elsa in the cafeteria, Dr. Charles learns that she is an MIT grad who plans to work on creating a biomolecular scaffolding to replicate human organs in vitro, after she graduates. Dr. Charles tries to speak to her about her handling of of the Lisa Harris case, but Elsa excuses herself to go check on Lisa's labs.

Lisa refuses the surgery again, and tells the doctors that God would have taken the baby away if he wanted her to have the surgery. Elsa asks Lisa if she would allow the surgery if, hypothetically, the fetus died, implying that God would have taken the baby away. Lisa, her husband Matt, and Dr. Natalie Manning are all shocked by Elsa's tactlessness, but Lisa agrees that in theory, she would allow the procedure if she lost the baby. Natalie rebukes Elsa. Later, Lisa's internal bleeding worsens, and Natalie tries to convince her to take the surgery, but Lisa refuses. Meanwhile Elsa scans Lisa and tells them that there is no heartbeat, indicating that Lisa's baby has died. Lisa breaks down, but agrees to let them perform the surgery, as her child is no longer at risk. Later, Dr. Natalie Manning tells Dr. Daniel Charles that when they operated on Lisa, her baby actually still had a heartbeat, and that the scanner evidently malfunctioned earlier. Lisa loses the baby during the surgery, and Natalie informs them of the loss, as Lisa breaks down. Dr. Charles speaks with Elsa, who tells him that the ultrasound machines can be delicate and easily damaged. Dr. Charles tells her that he knows that Elsa tampered with the machine, and that he can't prove it, but he will be watching her very closely and monitoring all her patients and cases. Elsa denies tampering with the machine but insists that the operation was the right thing to do despite the patient's wishes.

Dr. Ethan Choi and April Sexton treat Ben Davis, a young boy with kidney failure, who is brought into the hospital by his father after he collapses. Ben's father, Chris Davis, does not seem to be well-informed about his son's condition, but is extremely concerned for his health. Maggie Lockwood informs April and Ethan that there is an arrest warrant out for Chris, as he kidnapped his son, violated a restraining order, and his parole conditions. Ethan finds Ben has an arrhythmia and is behind on his dialysis, leaving Chris very worried. The police arrive, and Kim Burgess takes Chris in, but Ethan asks if they can allow Chris to wait at the hospital while they treat Ben, moved by Chris's tender goodbye to his son. Dr. Lanik, who has taken over as temporary Head of the E.R., is not pleased about having Chris Davis wait in the E.R. Ethan tells Chris that if he had not brought Ben in, putting himself under arrest, then Ben would have died. While they are waiting for test results, Ethan receives a call from his sister, Emily Choi, who has accidentally set his microwave on fire. Ethan and April argue about whether Ethan should be giving Emily another chance, as his sister has struggled with drug addiction, and recently was caught stealing medicines from the hospital. Ethan tells April that he can't win with her, as she earlier rebuked him for not being involved with his family, but is now upset because she thinks he is too involved with his family.

Ethan discovers that Chris Davis is a transplant match for his son, and has agreed to donate a kidney. Dr. Lanik stops them, saying he has orders not to allow the transplant. Sharon Goodwin talks to Gwen Garrett about the transplant, and Gwen tells her that they cannot allow the father to make the donation, as he is unlikely to make a good recovery in jail afterwards. If he dies, it negatively affects the hospital's statistics. Gwen tells Sharon that while she regrets that it impacts Ben Davis, a child, she has to maintain the statistics in order to keep the hospital's status as a top-rated transplant center for the entire region, and tells Sharon that this should be her priority as well. Ethan, Sharon, and April try to find an alternative donor for Ben, without success. As they take Chris away, Ben starts coding, and Ethan and April revive Ben's heartbeat, as he watches. Ethan tells Chris that treating Ben is getting more difficult, and is unlikely to survive. Chris begs to be allowed to see Ben, and on Sharon and Ethan's insistence, they remove his handcuffs and allow him to say goodbye to his son. Chris tells Ben he will be okay and that he loves him, before kissing him goodbye. Then, Chris attacks his guards, taking one of their guns and holding one of them at hostage. He demands that Ethan conduct the transplant immediately. The other guard shoots Chris, causing him to collapse. They perform the transplant, and Sharon later tells Gwen and Dr. Lanik that a local hospital informed her that they would have done the transplant, which would have allowed both Ben and Chris to live, instead of just Chris. Dr. Lanik is remorseful, but Gwen tells him she does not doubt her decision is correct, despite the fact that the outcome is not something she would have preferred.

Dr. Will Halstead pays a house call to Ray Burke, after being requested to do so as a favor, by Tim's son, Tommy Burke, a childhood friend of Will's from his old neighbourhood of Canaryville. Will examines Tim, who has been having dizzy spells, and finds that Tim has a slight murmur. He takes some blood for testing, and tells Ray that he needs to keep an eye on the murmur. Will mentions to Ray that he is getting married, and that Ray owns the Union, a large hall which serves as a wedding venue. Ray realises that Will wants a favor, and tells Will he understands, as Will is there paying a house call on his day off. He lets Will have the venue. Natalie is pleased by the news that they have a venue, and that he got the place at cost. He tells Natalie that Canaryville works by exchanging favors, and that he did a house call and got reasonable rates in return. Will takes Ray's samples to the lab to have them tested, but Joey Thomas in the lab tells Will that he cannot test samples that don't belong to patients of the hospital, and that the field is highly regulated and will result in trouble for both of them if he breaks the rules. Will convinces Joey to do the tests in return for not doing the paper work on some medication that he prescribed the previous week for Joey, thereby allowing Joey to avoid claiming on his insurance. Joey agrees to run the tests. Will collects the results and calls Ray on his cellphone, telling him that Ray has a heart murmur and should consult a cardiologist. Will is heard explaining to Ray that he cannot advise Ray as his own specialty is emergency medicine, and that he appreciates Ray's generosity in letting them have the wedding hall for his wedding. From Will's conversation, it is evident that Ray has insisted on seeing Will and not a cardiologist, and that Ray has agreed.

Later, as Will leaves the hospital, he sees his brother, a Chicago P.D. detective, Jay Halstead, sitting in a car waiting for him. Jay calls Will over and asks him what he knows about Ray Burke. When Will tries to explain that he paid Ray a house call, and got a discounted rate for renting Ray's hall for his wedding in return, Jay plays him a recording of the conversation he had with Ray, indicating that he already knows. He tells Will that Ray is under surveillance by the Chicago P.D. and the F.B.I. have been investigating him for two years, and that is involved in money laundering, fraud, embezzlement, and that now Will is involved with him. When Will protests, Jay tells him to stay away from Ray Burke, infuriating Will.