Code Black (2015–2018): Season 1, Episode 3 - Pre-Existing Conditions - full transcript
Amid the chaos and exhaustion of working 36 consecutive hours in Code Black, the doctors must deal with Margaret O'Brien (Gail O'Grady), the distraught mother of two sons who are in a devastating car accident. Also, Mario bullies Angus into performing an unnecessary operation but lets Angus take the blame when Leanne finds out.
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We have a
double MVC trauma en route.
Leanne.
Leanne.
Can you hear me?
Hello?
I'm sorry. What?
Do you smell burnt toast?
- No.
- Huh. Just ruling out an aneurysm.
Stay with me here. I-I need you in dispatch.
They're bringing in two boys, brothers.
- They can't get an airway on the older one.
- Okay.
Now, I don't want to state the obvious,
but we're in the 36th hour of a code black.
Not kosher, I know, but I got to
send the residents into extra innings.
Since when have you ever worried about that?
Well, I'm the boss. I got to
pretend to worry, don't I?
They're kids. They'll be fine.
- Yeah, what about you?
- What about me?
Well, you've worked 13
days in a row, Leanne.
- Yeah. You're welcome, Mark.
- Failed three attempts at E.T.T.
- Did you try a combi-tube?
- Yes, but with an air leak.
Then try an LMA with a strong seal.
Better if it's an intubating LMA.
- He's coding!
- Start compressions.
- How far out are you?
- Five minutes from your ramp.
Got it.
I'm gonna need two beds in there!
45-year-old male
fell off a truck ramp,
complaining of hip and back pain.
Probable chest contusions,
rib and pelvic fractures.
Is he breathing normally?
Is somebody gonna take care of me or what?
He seems to be breathing just fine.
He's gonna need pain meds and
a full blunt-trauma assessment.
Let's get him to the overflow room.
And good morning to you, Dr. Leighton.
Oh, it is morning, huh?
This one needs transport.
Rig's on the way. They want us.
Ugh. Do I have time to go to the bathroom?
Adult diapers. That's what I wear.
This one needs a social worker.
Kidding.
He seems to be getting nothing but worse.
His pressure's dropping.
I need a pelvic plain film,
stat trauma labs, and 8 of morphine.
Don't forget a pelvic binder.
You're gonna need to keep that stable
in case it's an open-book fracture.
I wasn't gonna forget. Thanks, Mario.
What's up with those chest contusions?
He has them... and rib fractures.
I'd concentrate on those, dude.
It's the A-B-C theory...
Airway, breathing, circulation.
Not worth saving a pelvis
if one of those are broke.
Well, look at us... two residents
who learned the same
things in medical school.
His pressure's still dropping.
I need a pelvic ultrasound
and four units of O-neg.
I don't have time to cross-match them.
If I were you, I'd be a lot more
worried about thoracic trauma
than internal pelvic bleeding.
I worry about all of it, okay?
What's coming in?
Two brothers. It's not good.
Come on, come on, come on!
Let's go!
Patrick!
21-year-old male,
multiple chest deformities.
You've got to save my brother!
Please! Please! Please help him!
- It's okay, sir. We're gonna help him.
- Positive PSI.
- Patrick! Patrick!
- Positive L.O.C.
Dr. Pineda! Over here!
Don't stop compressions.
Let's get him intubated now.
How's my brother?
Patrick! Say something!
Hey! Hey! Can you hear me? Is he okay?
- Okay, okay, you need to stay still.
- Patrick!
One of epi, an amp of
bicarb, and pour N.S. in.
Take care of this, please.
10 milligrams morphine I.V.
I'm past the cords.
Breath sounds bilaterally.
Don't stop. Continue
compressions, Dr. Pineda.
Patrick!
Seatbelt sign. Impact bruise from
the belt. What does it tell you?
High likelihood of internal organ injury.
Ultrasound the abdomen, please.
Come on. Come on. Give me something.
Continue CPR.
Come on. Come on.
Lie still for me. Lie still.
Patrick!
Down trending blood pressure.
He's circling now.
60 over 40.
What the hell is going on with this guy?
He's about to code. That's what.
His pelvis is clean.
There is no sign of blood.
That's because his problem's somewhere else.
A pelvic fracture bleeding internally
would be retroperitoneal bleeding.
An ultrasound wouldn't
necessarily detect it.
He's flatlining.
This is your patient, man. You got to act.
They only had two units.
Start compressions. Hang both units.
Run them wide open. Run
fluids at the same time.
What the hell are you doing?
His pelvis was unstable, okay?
It was tender when we put the binder on.
He's clearly bleeding down there.
I don't buy that he's
decompensating this quickly.
It's much more likely a thoracic trauma,
an intercostal artery bleed,
or a hole in his heart.
Okay, okay, let's ultrasound the heart.
Are you crazy? There's no time.
Well, what do you want me
to do, cut open his chest
in the overflow room with no supervision?
How else are we gonna stop the bleeding?
This is Angels. This is what we do.
We are residents... A
thoracotomy is reserved for
the rarest of cases when there
is absolutely no other option.
Is there an option I'm not aware of?
You have about four minutes
to save this guy's life.
No heart rhythm, chest contusions...
A hard indication to open
him up and fix what's wrong,
or he is dead.
What are we even talking about here?
Okay, I get it. I hear you. It's just I...
Stop thinking! This is
how you get into trouble.
This is what you do. You
have to trust yourself.
Angus, make a damn decision. Three minutes.
If you don't do it, I will.
No.
I will do it, and you will assist me.
Come on. Give me something I can shock.
There's a lot of freeflowing
fluid in the abdomen.
Looks like blood.
I need to see my brother.
You can't right now. We
need to get you some X-rays.
Patrick!
Patrick!
Is your patient ready for C.T.?
We're on our way.
Two large 18s in, trauma lab panel,
chest and pelvic X-rays.
Let's go.
- Hey!
- Let's get out of here, please.
Let's go. Hey, what's
happening to my brother?!
Hey! Tell me what's happening to my brother!
Patrick! Patrick!
Dr. Pineda. You can stop now.
There's nothing more we can do.
You can't shock flatline. Why is that?
You can't trigger an
impulse in dead myocardium.
That's right.
Anyone have any suggestions?
Okay, I'm gonna call it.
Time of death... 7:01 A.M.
Back to work, everyone.
It's beating.
When did it start beating again?
I don't know.
The hard reason to do this...
The "no heart rhythm" part...
We don't have it anymore.
No, we don't.
We opened him up for nothing.
Maybe there was a pulse all along
and you just didn't feel it.
Maybe you should have done the ultrasound.
Just shut your face, okay?
Sweet Jesus!
Synced by emmasan
They opened this poor man's chest
expecting to find a swimming pool of blood,
and instead, they find normal anatomy
and a heart happily beating
"nearer my God to thee."
A dry thoracotomy.
That's a real buzzkill, huh?
You know, they're plenty pissed
upstairs. I'll tell you that.
They should be.
Now your patient needs an orthopedic surgeon
to fix his pelvis, a thoracic surgeon
to clean up whatever you left of his chest.
And a lawyer to give us all a colonoscopy.
What were you thinking?!
Um...
"Um"?!
Use your words, Dr. Leighton.
It's a very busy morning.
The patient presented with
pelvic, chest, and rib fractures.
He coded.
I thought maybe it was a thoracic trauma
or maybe it was an intercostal artery bleed.
"Maybe"? You're having trouble
convincing yourself of this.
I was looking for an attending,
but we were in code black, so I...
What the patient needed was
a doctor. Are you a doctor?
Did you ever think to
ultrasound his lungs and heart?
I wanted to, but, uh...
But what?
We didn't think that we had time.
"We"?
Whose patient was it?
Mine.
Wait... how did his heart restart, anyway?
We gave him a couple units of blood.
He was being infused at the same time.
Turns out it was a pelvic
fracture causing the bleeding.
Well, at least you did something right.
Yeah.
We can't waste any more time on this.
We're in day 2 of a code black.
Dr. Savetti, get back to Trauma-1.
Dr. Leighton, go decompress
the waiting room.
We need to free up more space out there.
Really? You just want me
to go out in the waiting...
Really.
It's safer out there.
You know, I once removed the wrong testicle.
If that makes you feel any better.
He had his mother's number on his cellphone.
Her name's Margaret O'Brien.
Lives about an hour away.
She lost a son,
but she still has one hanging on.
She needs to get here quickly.
I don't know what to say, Jesse.
Just tell her to get here.
It's against hospital policy
to say anything specific over the phone.
I know. I know.
Introduce yourself.
Ask who you're speaking with.
Hello.
This is Dr. Pineda at
Angels Memorial Hospital.
May I ask who I'm speaking with?
Your sons, Kevin and Patrick,
were admitted to the hospital this morning.
We need you to come down to
the emergency room right away.
I'm not authorized to give
out any patient information
over the phone.
Could you please just... come down here?
Tell me what's going on!
Why can't you tell me anything?!
It's important that you get here.
I-I'm sorry. That's all I can say.
Good job.
How's his brother doing? Kevin?
He's stable.
Needs a C.T. scan.
Of course, they're down for hours.
I was just noting his chart.
You want to take it over?
I'm slammed anyway.
Thanks. I would.
It would be nice to get
one of them home alive.
You okay?
Okay.
Next time, use your brakes.
I heard I missed the fireworks.
Angus botched a thoracotomy?
It wasn't just him.
Mario is standing there the whole time,
says absolutely nothing
to defend his classmate.
Apparently, he was just following orders.
You don't like him, do you?
He's a gunner, and he doesn't
play well with others.
And what's worse is he likes it that way.
No one's unteachable.
Everyone here is a lock.
You just have to figure
out their combination.
I'm not a teacher. I'm a filter.
No one gets through me
who doesn't deserve it.
Hide your jewelry. Jail bus coming in.
I've got it.
Dr. Lorenson, let's go.
38-year-old male.
Unconscious, labored breathing...
He's uremic. Kidney failure.
I know this guy.
Let's get him set up for an I-stat.
- We need his electrolyte levels.
- Yes, doctor.
What are we most concerned
about in renal failure?
Potassium... if it's too high,
it could be toxic for his
heart or put him into arrest.
Side staff... 20.
How do you know this guy?
He came in with kidney failure.
They gave him a new one in jail.
I don't know who's rejecting who,
but he needs another one now.
What did he go to jail for?
You don't want to know.
He's never getting out,
so you don't have to worry about it, either.
Sheriff.
On me. One, two, three.
Eight.
That's way too high.
This guy is a ticking time bomb.
10 of regular Insulin I.V., an amp of d50,
an amp of bicarb, and some albuterol stat.
We need to lower his potassium levels.
I'm shocked that they would give a kidney
to a guy serving life in prison.
Everyone gets on the list.
It's an 8th Amendment thing...
Cruel and unusual punishment.
I can't find a vein.
He's a former I.V. drug user.
His veins are shot.
Breathing's getting labored.
From edema. He needs dialysis.
Ask them for a machine.
No, we're gonna have to place a vas-cath.
You ever done one before?
No, but I assisted once.
Well, you're gonna do one now.
Take your introducing needle.
Guide it into the right sub-clav.
Look at the screen.
You want to get it into
the vein, not an artery,
or there'll be catastrophic bleeding.
Don't nick the lung.
Note to self... "Don't nick lung."
Okay.
Okay, I'm ready for the cath.
I'm going to thread the
catheter over the needle.
Pull the needle through.
All done.
You just saved his life.
I really don't want to know
what this guy did, do I?
No. And don't Google him, either.
It's an ethical violation
to look up his past.
You got the convict, huh?
Let me know if he gives you any grief.
And what? You gonna come to my rescue?
I heard what happened with Angus.
Oh, my God.
And my eyes are itching me.
I got a sore throat and a runny nose.
- I can see that.
- I need some help!
Hold on, would you, sir?
Do you have allergies, Mrs. Curtis?
Of course.
My prescription ran out,
though. That's why I'm here.
Hey, who do I have to you-know-what
to get a little attention around here?
Be with you in just a second.
You know I have to do a
full physical and history
before I can prescribe anything?
Uh, the hospital's kind of busy today.
I fell off the pole.
The po...
Oh, the pole.
I get it. Uh, you're a stripper.
I teach preschool.
I'm Tiffany. Nice to meet you.
Hey!
Yeah, I-I'm sorr... yes,
I'm sorry. What is it?
My head... it hurts really bad!
And this is really bruised.
I got attacked by some
ISIS people this morning.
They hit me with a golf club.
Oh, that doesn't sound good.
I'll, uh, take a look at
it in just a second, okay?
Oh, it's nothing to look at.
I'm a soldier. I served in desert storm.
I know how to make my wounds disappear.
He's nuts. That don't mean
they don't hurt, though.
Comes in here all the time.
You're new, aren't you?
Yeah.
Must be why they put you out here with us.
Must be.
Just one second, okay?
I just told her they were both brought in.
Nothing else.
It's a tough call to make, I know,
but it's better to do this face-to-face.
Does Kevin know his brother's dead?
Not yet.
Do you want me to do this, Dr. Rorish?
No. It's on me.
Mrs. O'Brien.
Who are you?
I'm Dr. Rorish.
Is someone gonna finally
tell me what happened?
Your sons were in a car accident.
Okay.
How are they?
Kevin is in stable condition.
He's waiting for a C.T. scan.
We'll know more after he gets out.
Your son Patrick was
unresponsive when he came in.
We did everything we could.
Is he dead?
Yes.
No!
No. No!
No. No.
He died at 7:00 this morning.
No. No. No.
I'm so sorry.
It should have been you.
Did you hear me?
You killed him.
You killed your brother!
Tell me he's not dead!
You've got to lie down.
- Mrs. O'Brien...
- No!
I told him not to drive.
I told you not to drive!
- Please tell me he's not dead!
- Mrs. O'Brien,
- you need to step out of the room now, okay?
- I wish you had died!
I wish it was you!
- Jesse.
- I know you were drunk!
Mrs. O'Brien. Come on.
- You killed him!
- Step out.
You were drunk, and you killed him!
- I'm sorry!
- I want Patrick back!
- I want my son back!
- I'm sorry!
Jesse!
This isn't happening.
Should I sedate him?
No. Just make sure he doesn't harm himself.
This is grief. This is what it looks like.
Just let it be.
That went well.
She's upset.
She's got one son dead,
and the other one killed him.
He didn't do it deliberately.
We don't even have the
toxicology report back yet.
I don't think there's a lot
of mystery there, do you?
Where are you going?
Last count, there's about 75 of us
and close to 600 of them.
Hey, you can take a minute with mama.
It's okay. It's allowed.
Drunk drivers.
They... They ought to be...
These things are horrible.
They taste like drywall with cheese.
What do I always say about
that vending machine?
No real food in there.
Yeah, well, the kitchen's out of food,
and you're not one to be giving
nutritional advice, El Gordo.
"El Gordo"?
Look at me.
I could have been a movie
star with this face.
It's not your face I'm worried about.
It's your breasts.
At least they're mine.
Okay. Okay.
Break's over. Let's go.
And these girls are all mine.
Mmmmm-hmm.
Hey. You want an energy drink?
I just put a six-pack on ice in a bedpan.
No, thanks.
Kitchen's out of food.
Taylor ordered a taco truck.
You totally sold him out.
Who? Angus? Did he tell you that?
Everybody's talking about it.
Everybody? Really?
Well, Angus could have
done whatever he wanted.
Guy wasn't even my patient.
We're all gonna be here
for the next three years.
This is how you make friends?
We're in emergency
medicine, not high school.
Look, I'm sorry, but I didn't get this far
taking responsibility for
mistakes I didn't have to.
I'll tell you what the real problem is...
She's into me.
You sure about that?
A guy knows.
I heard there are tacos coming.
Ah, yeah.
I'm not taking orders just yet,
but as soon as it's lunchtime...
Try and keep this elevated
as much as possible.
And don't put any weight on
it for the next few days.
That would basically put
me out of commission.
Okay, you're, uh...
You're all finished.
Sorry.
There's nothing I would love more
than to be out of commission.
I hate that damn pole.
You should, uh, follow up
with your primary-care doctor
in the next couple of weeks.
Why can't I follow up with you?
Because...
Because...
Um, I'm an E.R. doc.
I don't take appointments.
Must be nice to be someone like you.
Yeah. Must be.
What do you got?
19-year-old female, unresponsive.
Her temp was too high to read on the rig.
Are you two with her?
What's she on?
Nothing. We just went to hear some music.
Lying isn't gonna help
your friend right now.
Just some Molly.
"Just"? How much?
MDMA interferes with the
body's temperature control.
Where was the concert?
Palm Desert. We were
there for like three days.
Smart.
- Are you assisting?
- Yes.
Then don't talk till I ask a question.
- 108 degrees.
- 108.
I think she's just really burnt out.
Your friend isn't burnt out.
She has non-exertional heatstroke.
If we don't get her temp down, she'll die.
Let's get an arctic sun blanket on her.
I'm sorry, doctor. They're both in use.
Okay, then we're gonna do it old-school.
Get me 10 bags of crushed
ice from the kitchen, please,
and some fans.
And, you... have someone get the misters
from the entryway gardens, okay?
Uh, take her to the sides.
You following this?
Yes... the cooling effect of evaporation
is one of the fastest ways
to reduce the temperature.
Yeah. And don't think you got
away with anything this morning.
A little advice from your daddy...
The further you go around here,
the more you're gonna need
the people you started with.
Excuse me, Dr. Rorish,
but Kevin O'Brien's
toxicology report came back.
Do we have to tell the police?
Yes.
It's no longer an accident.
It's a crime. That's evidence.
The swelling in
your legs is much better.
We've removed a lot of fluid from your body.
Keep an eye on his electrolytes.
They tend to shift after dialysis.
Listen to his lungs.
Get a BMP now and every four hours.
And prep a syringe of calcium gluconate
in case he goes into cardiac arrest.
So I'm still pretty sick, huh?
Only thing keeping you alive
right now is that machine.
My transplant failed, didn't it?
You never know. Sometimes they come back.
That's what my mother used
to say about her boyfriends.
Unlike my kidneys, I could
have done without them.
Hm.
Oh... God.
You feeling disoriented? Nauseated?
Yeah, I've been throwing up.
Sorry.
And the other kind of fireworks, too.
You mean diarrhea?
You don't need to be embarrassed.
I've seen much worse.
Okay, I want you to take a
deep breath for me if you can.
Well, your lungs sound much better.
So, you the one who saved
my life, put this in?
I was there when they brought you in, yeah.
What's your name?
Dr. Lorenson.
Well, thank you, Dr. Lorenson.
Of course.
God, I used to love this part...
The soft part,
when I knew I'd found
someone who was really nice.
Then later, when they realized
how foolish they were...
I would keep them alive
for as long as I could.
Oh, my God.
I didn't want it to be over...
The screaming...
Or the look on their face
when they were trying to breathe.
Have you ever taken a
bottle out of a baby's mouth
that was still hungry?
It's so desperate.
Christa.
Christa?!
Christa, he's crashing!
All it took was 2 milliliters
of calcium gluconate,
and this monster is still alive.
I'm gonna go throw up.
Thank you.
Uh, Cornelius?
Hey, uh, I don't want to be that guy,
but, uh, the O'Brien mother
is still sitting with her son's body,
and it's been over three hours.
We're as overbooked as a
whorehouse on a Saturday night, folks.
I need the room.
Shame on you.
She didn't come here for
pleasure. Let her be.
I don't need a lecture from you.
I'm just trying to get as many people
out of here alive as possible.
Quiet, both of you.
He's right... Trauma-1 is for the living.
Don't go all soft on me now, mama.
Excuse me, Mrs. O'Brien.
I wanted to let you know that your son Kevin
should be getting a C.T. scan soon.
We'll know a lot more after that.
He's not my son anymore.
I only have one son.
And he died today.
I can only imagine...
how angry you must be.
He was drunk, wasn't he?
Yes.
His B.A.C. was .08...
Just above the legal limit.
Patrick was his little brother.
He worshipped him.
He could do no wrong.
"He just likes to party, mom."
Patrick just...
Just needed to be near him.
He would have done anything for him,
including letting him drive drunk.
My husband died 10 years ago.
I have no one now.
And you think
you can imagine how I feel?
You can't.
I'll leave you alone, then.
Hell of an air-conditioning unit, huh?
She's still unresponsive.
Down to 105 degrees.
Should be doing better than that.
Maybe it's inaccurate.
Whoa!
She came in with hyperthermia.
Oral thermometer showed her at 108 degrees.
I tried to get a line in to infuse fluids,
but she keeps bleeding out at the site.
10 units of FFP, a 6-pack of platelets,
and 10 units of cryoprecipitate.
What's the one organ
that cannot survive heat?
Blood.
And what happens to blood protein
when it's heated for extended periods?
- It denatures... melts, basically.
- It's blood gone bipolar.
One minute, you have uncontrolled bleeding.
The next, you could have
life-threatening clotting.
The blood no longer follows any rules.
Look at the patient... bleeding or clotting?
Bleeding, obviously.
I got nothing. She's cardiac arrest, P.E.A.
You've got everything! It's right here.
What's next?
Uh, ultrasound.
Marked heart strain.
It's a huge blood clot in the lungs.
Pulmonary embolism. Start compressions.
What are our options, Mario?
We can break the clot with alteplase,
but that could also worsen
the bleeding somewhere else.
Our treatment could kill her.
Her blood clot is killing her.
What's the answer?
Right now, she's pulseless.
We got to push the alteplase.
A chance is better than no chance.
My thoughts entirely.
Come on.
Come on.
Yes.
Yes.
Yes, indeed.
You know, I think you
could be a great doctor.
But you know your problem?
You keep score.
Do yourself a favor and stop counting.
We'll all win a lot more games that way.
Get her up to ICU... She
still needs a heparin drip,
antithrombin, and serial coags.
Let's go. Move it. Move it.
Four years of medical school, an internship,
- and I'm waiting tables?
- Patients have to eat, too.
I got to go.
We're down to code red,
which is like saying,
"it's just my arm that's on fire."
For what it's worth, I didn't want to do it.
Savetti just kept pushing me.
My instinct was to hold back.
I figured as much.
So, why did you do it?
'Cause I don't trust myself.
'Cause I'm weak.
It's like I forget who I am.
You just need to find
your voice and let it sing.
Then you'll remember who you are.
I wish it were that simple.
I used to get beaten up by
this boy... Johnny Wexler.
I never fought back.
So, one day, a group of
kids brought him up to me,
they put him up in front of
me, and they said, "hit him.
Make him pay for all that he's done to you."
Mm-hmm.
I couldn't do it.
So they let him go,
and Johnny Wexler punched
me right in the face.
You know, for a psych guy,
you don't understand much.
What do you mean?
You're the hero of that story, young squire.
I'm sorry to bother
you, but he's swirling.
Hypotensive, tachycardic. How long?
Dropped in the last few.
We held his morphine, didn't
want to tank him further.
I really don't like this tenderness.
How soon can he get a C.T. scan?
The scanner was back online,
but I don't think he's stable enough.
I need 2 more liters, another
large-bore, a pressure bag,
- and can you get an attending in here, please?
- Mm-hmm.
Can you hear me?
Uh-huh.
It's okay. We're gonna help you.
Don't.
Don't help me. I don't want your help.
Dr. Rorish, he suddenly went hypotensive.
I'm not sure of the source.
- He didn't get his C.T. scan?
- They were backed up.
He was stable, so we kept him
in here while we were waiting.
That's not gonna be big enough.
Let's pipe a central line.
All right.
Okay, take over the central line, please.
Now transfer the bag to the central line.
Now we got to find out
what the real problem is.
Syringe, please.
Thank you.
And if...
A critical assessment
tool is being repaired,
you improvise.
This isn't as good as a scan, but it'll do.
See that?
Musty red.
Blood. It's a big problem.
He's hemorrhaging somewhere inside.
He needs an exploratory laparotomy.
- Let's get him upstairs now.
- Yes, doctor.
Please, doctor, I want to die.
- Please just let me die.
- I can't.
She will never forgive me.
And neither can I.
I just want to die.
I want to die.
I'm sorry.
We only do one thing here... Save lives.
Let's go.
Dr. Hudson, I don't want
to treat him anymore.
I-I can't do it. I saw evil in there.
I don't want to go back.
Well, I understand that.
I don't have to, right? I
can give him to someone else?
He's your patient. I'm sorry, Christa.
Yes, I understand, but I-I
traded with Malaya this morning.
I'll tell you what my mum used to tell me.
Sometimes the way to be brave
is to pretend to be brave.
So, it's just toenail fungus?
Yep. That's it.
Excuse me.
That doesn't sound so
good. Are you all right?
I've been better.
Does your head still hurt?
You got hit in the head
with a golf club, right?
I don't know. Did I say that?
How long have you had this cough?
It just started.
- You a smoker?
- Yeah.
Do you have asthma?
Maybe.
I'm hearing a lot of wheezing.
We need to get you a chest X-ray, okay?
Anything you want.
You served in Desert Storm, right?
I don't know. Maybe.
I-I can't even remember
if it happened sometimes.
National Defense Service Medal.
Hey, it happened. Okay?
W-what's going on? What are you feeling?
My chest! It's so tight!
Is he all right?
I need a crash cart and a gurney!
What is this?
I-I gave him an energy bar.
The taco truck left before he could get one.
Are you allergic to peanuts?
Donald, can you speak?
Is he okay?
Anaphylaxis. His airway's closing.
Are you sure?
We need to get him into the trauma unit
before he suffocates.
Wait! What are you gonna
do? I'm gonna save his life.
- I need an epi drip! Get access!
- What do you got?
Anaphylactic shock. I gave
him .3 of 1 in a 1,000.
Okay, we've only got seconds, people.
Get the glidescope and a cric kit.
S.A.T... 67 and slipping.
Can't wait for the drip. Go
for the airway. Tube, please.
Okay, doctor?
Okay, doctor, what's the first
thing you check in a code?
Your own pulse.
Steady. Don't rush.
Everything
around the vocal cords
are trigger points for more swelling.
Bump into it, the tissue's
gonna balloon out,
and your opening is gone.
I know, I know... It's
like driving a semitruck
through a narrow lane of eggshells.
You just need to find
your voice and let it sing.
- Don't hit the walls.
- Breathe, stud.
- Steady.
- Then you'll remember.
d Sugar plum fair came
and hit the streets d
d Looking for soul food
and a place to eat d
d Went to the Apollo d
d You should've seen them go, go, go d
d They said, "hey, sugar,
take a walk on the wild side d
d And the colored girls say d
d Doo, do-Doo, do-Doo, Doo-d... d
d Doo, Doo, Doo, Doo, do-Doo d
d Doo, Doo, Doo, Doo-Doo-Doo d
d Doo, Doo, Doo, Doo-Doo-Doo d
d Doo, Doo, Doo, Doo-Doo-Doo d
d Doo, Doo, Doo, Doo-Doo-Doo d
d Doo, Doo, Doo, Doo-Doo-Doo d
d Doo, Doo, Doo, Doo-Doo-Doo d
d Doooooooooo d
The nice ones always wanted to help me.
And that's when they would...
Let me in the door or get in the car.
The fear...
You could smell it.
I used to love that smell.
And I smell it right now.
I'm not afraid of you.
Excuse me, Dr. Rorish.
Kevin O'Brien just got out of the O.R.
They found a serious
laceration of his spleen.
That's not good.
He's lost a lot of blood.
It's unclear if his other
organs were affected.
They said it would be days
in the ICU before we know.
Is his mother still here?
Yeah.
She hasn't moved from Patrick's
bedside for four hours.
It's like she can't say goodbye.
Maybe he's not the one
she can't say goodbye to.
You still have one son.
I know...
How hard it must be to
forgive him right now.
I can't... do it.
I can't.
But you want to, or you
wouldn't still be here.
I was in a car accident
with my husband and two children.
We were hit by a drunk driver.
They all died.
For reasons I will never
understand, I was spared.
Kevin feels the way any decent person would
in this circumstance.
He wants to die.
The one thing I hold on to...
Death isn't the answer to anything.
I wouldn't be here otherwise.
I wouldn't be a doctor. That's for sure.
The only time machine we have in this life
is the one we're born in,
and it only goes forward.
Kevin needs a reason to live.
Don't lose him, too.
Bring him home.
Yeah, everything's going great.
I'm a doctor, grandma.
Pretty amazing, huh?
Yeah, I'm rockin' it.
Sure I'm making friends.
Of course. How could I not?
Spending so much
time with these people.
Everybody loves me.
All right, listen, I got to go.
I'll talk to you later, okay?
I love you.
Hey, man.
If you're mad at me, let's
just talk about it, okay?
I know you may find this hard to believe,
but you are the last person
on my mind right now.
How long have we been here?
I don't remember being anywhere else,
if that's what you mean.
She's here for me.
Tiffany. You're, uh, still here.
Yeah.
And... spoiler alert...
My name's not Tiffany.
I figured.
It's my phone number.
You're a doctor.
I'm a stripper.
Not gonna happen... unless I make it happen.
Uh, I think there are policies
about me fraternizing.
Fraternizing?
You know, uh, with patients.
Oh.
You can consider me discharged.
Could you open your eyes wider?
They're vibrating a little, horizontally.
It's called nystagmus. Could
be a sign of a bad concussion.
You're kidding me.
No. You could have hurt
your head in the fall.
We need to get you a scan.
No... Really?
Yes. Trust me.
I'm a very good doctor.
- Come with me.
- Thank you.
Hey. Headed home?
Just waiting for my ride.
How's the brother? Did he make it?
Still don't know.
See you tomorrow.
Hi, Eva!
At least somebody has a life, right?
I killed him.
Shh.
I'm sorry.
Shh.
I killed him. Shh.
You're my baby boy.
Shh.
I love you.
You are my son.
You are my son.
Sprinkles on your dreams, baby boy.
Shh.
Go to sleep.
So, you're finally going home.
Believe it or not, I am.
Adios.
You look like you could use a Walker.
You look like you could use a wheelchair.
You look like you could use a gurney.
You look dead.
Synced by emmasan
_
__
_
We have a
double MVC trauma en route.
Leanne.
Leanne.
Can you hear me?
Hello?
I'm sorry. What?
Do you smell burnt toast?
- No.
- Huh. Just ruling out an aneurysm.
Stay with me here. I-I need you in dispatch.
They're bringing in two boys, brothers.
- They can't get an airway on the older one.
- Okay.
Now, I don't want to state the obvious,
but we're in the 36th hour of a code black.
Not kosher, I know, but I got to
send the residents into extra innings.
Since when have you ever worried about that?
Well, I'm the boss. I got to
pretend to worry, don't I?
They're kids. They'll be fine.
- Yeah, what about you?
- What about me?
Well, you've worked 13
days in a row, Leanne.
- Yeah. You're welcome, Mark.
- Failed three attempts at E.T.T.
- Did you try a combi-tube?
- Yes, but with an air leak.
Then try an LMA with a strong seal.
Better if it's an intubating LMA.
- He's coding!
- Start compressions.
- How far out are you?
- Five minutes from your ramp.
Got it.
I'm gonna need two beds in there!
45-year-old male
fell off a truck ramp,
complaining of hip and back pain.
Probable chest contusions,
rib and pelvic fractures.
Is he breathing normally?
Is somebody gonna take care of me or what?
He seems to be breathing just fine.
He's gonna need pain meds and
a full blunt-trauma assessment.
Let's get him to the overflow room.
And good morning to you, Dr. Leighton.
Oh, it is morning, huh?
This one needs transport.
Rig's on the way. They want us.
Ugh. Do I have time to go to the bathroom?
Adult diapers. That's what I wear.
This one needs a social worker.
Kidding.
He seems to be getting nothing but worse.
His pressure's dropping.
I need a pelvic plain film,
stat trauma labs, and 8 of morphine.
Don't forget a pelvic binder.
You're gonna need to keep that stable
in case it's an open-book fracture.
I wasn't gonna forget. Thanks, Mario.
What's up with those chest contusions?
He has them... and rib fractures.
I'd concentrate on those, dude.
It's the A-B-C theory...
Airway, breathing, circulation.
Not worth saving a pelvis
if one of those are broke.
Well, look at us... two residents
who learned the same
things in medical school.
His pressure's still dropping.
I need a pelvic ultrasound
and four units of O-neg.
I don't have time to cross-match them.
If I were you, I'd be a lot more
worried about thoracic trauma
than internal pelvic bleeding.
I worry about all of it, okay?
What's coming in?
Two brothers. It's not good.
Come on, come on, come on!
Let's go!
Patrick!
21-year-old male,
multiple chest deformities.
You've got to save my brother!
Please! Please! Please help him!
- It's okay, sir. We're gonna help him.
- Positive PSI.
- Patrick! Patrick!
- Positive L.O.C.
Dr. Pineda! Over here!
Don't stop compressions.
Let's get him intubated now.
How's my brother?
Patrick! Say something!
Hey! Hey! Can you hear me? Is he okay?
- Okay, okay, you need to stay still.
- Patrick!
One of epi, an amp of
bicarb, and pour N.S. in.
Take care of this, please.
10 milligrams morphine I.V.
I'm past the cords.
Breath sounds bilaterally.
Don't stop. Continue
compressions, Dr. Pineda.
Patrick!
Seatbelt sign. Impact bruise from
the belt. What does it tell you?
High likelihood of internal organ injury.
Ultrasound the abdomen, please.
Come on. Come on. Give me something.
Continue CPR.
Come on. Come on.
Lie still for me. Lie still.
Patrick!
Down trending blood pressure.
He's circling now.
60 over 40.
What the hell is going on with this guy?
He's about to code. That's what.
His pelvis is clean.
There is no sign of blood.
That's because his problem's somewhere else.
A pelvic fracture bleeding internally
would be retroperitoneal bleeding.
An ultrasound wouldn't
necessarily detect it.
He's flatlining.
This is your patient, man. You got to act.
They only had two units.
Start compressions. Hang both units.
Run them wide open. Run
fluids at the same time.
What the hell are you doing?
His pelvis was unstable, okay?
It was tender when we put the binder on.
He's clearly bleeding down there.
I don't buy that he's
decompensating this quickly.
It's much more likely a thoracic trauma,
an intercostal artery bleed,
or a hole in his heart.
Okay, okay, let's ultrasound the heart.
Are you crazy? There's no time.
Well, what do you want me
to do, cut open his chest
in the overflow room with no supervision?
How else are we gonna stop the bleeding?
This is Angels. This is what we do.
We are residents... A
thoracotomy is reserved for
the rarest of cases when there
is absolutely no other option.
Is there an option I'm not aware of?
You have about four minutes
to save this guy's life.
No heart rhythm, chest contusions...
A hard indication to open
him up and fix what's wrong,
or he is dead.
What are we even talking about here?
Okay, I get it. I hear you. It's just I...
Stop thinking! This is
how you get into trouble.
This is what you do. You
have to trust yourself.
Angus, make a damn decision. Three minutes.
If you don't do it, I will.
No.
I will do it, and you will assist me.
Come on. Give me something I can shock.
There's a lot of freeflowing
fluid in the abdomen.
Looks like blood.
I need to see my brother.
You can't right now. We
need to get you some X-rays.
Patrick!
Patrick!
Is your patient ready for C.T.?
We're on our way.
Two large 18s in, trauma lab panel,
chest and pelvic X-rays.
Let's go.
- Hey!
- Let's get out of here, please.
Let's go. Hey, what's
happening to my brother?!
Hey! Tell me what's happening to my brother!
Patrick! Patrick!
Dr. Pineda. You can stop now.
There's nothing more we can do.
You can't shock flatline. Why is that?
You can't trigger an
impulse in dead myocardium.
That's right.
Anyone have any suggestions?
Okay, I'm gonna call it.
Time of death... 7:01 A.M.
Back to work, everyone.
It's beating.
When did it start beating again?
I don't know.
The hard reason to do this...
The "no heart rhythm" part...
We don't have it anymore.
No, we don't.
We opened him up for nothing.
Maybe there was a pulse all along
and you just didn't feel it.
Maybe you should have done the ultrasound.
Just shut your face, okay?
Sweet Jesus!
Synced by emmasan
They opened this poor man's chest
expecting to find a swimming pool of blood,
and instead, they find normal anatomy
and a heart happily beating
"nearer my God to thee."
A dry thoracotomy.
That's a real buzzkill, huh?
You know, they're plenty pissed
upstairs. I'll tell you that.
They should be.
Now your patient needs an orthopedic surgeon
to fix his pelvis, a thoracic surgeon
to clean up whatever you left of his chest.
And a lawyer to give us all a colonoscopy.
What were you thinking?!
Um...
"Um"?!
Use your words, Dr. Leighton.
It's a very busy morning.
The patient presented with
pelvic, chest, and rib fractures.
He coded.
I thought maybe it was a thoracic trauma
or maybe it was an intercostal artery bleed.
"Maybe"? You're having trouble
convincing yourself of this.
I was looking for an attending,
but we were in code black, so I...
What the patient needed was
a doctor. Are you a doctor?
Did you ever think to
ultrasound his lungs and heart?
I wanted to, but, uh...
But what?
We didn't think that we had time.
"We"?
Whose patient was it?
Mine.
Wait... how did his heart restart, anyway?
We gave him a couple units of blood.
He was being infused at the same time.
Turns out it was a pelvic
fracture causing the bleeding.
Well, at least you did something right.
Yeah.
We can't waste any more time on this.
We're in day 2 of a code black.
Dr. Savetti, get back to Trauma-1.
Dr. Leighton, go decompress
the waiting room.
We need to free up more space out there.
Really? You just want me
to go out in the waiting...
Really.
It's safer out there.
You know, I once removed the wrong testicle.
If that makes you feel any better.
He had his mother's number on his cellphone.
Her name's Margaret O'Brien.
Lives about an hour away.
She lost a son,
but she still has one hanging on.
She needs to get here quickly.
I don't know what to say, Jesse.
Just tell her to get here.
It's against hospital policy
to say anything specific over the phone.
I know. I know.
Introduce yourself.
Ask who you're speaking with.
Hello.
This is Dr. Pineda at
Angels Memorial Hospital.
May I ask who I'm speaking with?
Your sons, Kevin and Patrick,
were admitted to the hospital this morning.
We need you to come down to
the emergency room right away.
I'm not authorized to give
out any patient information
over the phone.
Could you please just... come down here?
Tell me what's going on!
Why can't you tell me anything?!
It's important that you get here.
I-I'm sorry. That's all I can say.
Good job.
How's his brother doing? Kevin?
He's stable.
Needs a C.T. scan.
Of course, they're down for hours.
I was just noting his chart.
You want to take it over?
I'm slammed anyway.
Thanks. I would.
It would be nice to get
one of them home alive.
You okay?
Okay.
Next time, use your brakes.
I heard I missed the fireworks.
Angus botched a thoracotomy?
It wasn't just him.
Mario is standing there the whole time,
says absolutely nothing
to defend his classmate.
Apparently, he was just following orders.
You don't like him, do you?
He's a gunner, and he doesn't
play well with others.
And what's worse is he likes it that way.
No one's unteachable.
Everyone here is a lock.
You just have to figure
out their combination.
I'm not a teacher. I'm a filter.
No one gets through me
who doesn't deserve it.
Hide your jewelry. Jail bus coming in.
I've got it.
Dr. Lorenson, let's go.
38-year-old male.
Unconscious, labored breathing...
He's uremic. Kidney failure.
I know this guy.
Let's get him set up for an I-stat.
- We need his electrolyte levels.
- Yes, doctor.
What are we most concerned
about in renal failure?
Potassium... if it's too high,
it could be toxic for his
heart or put him into arrest.
Side staff... 20.
How do you know this guy?
He came in with kidney failure.
They gave him a new one in jail.
I don't know who's rejecting who,
but he needs another one now.
What did he go to jail for?
You don't want to know.
He's never getting out,
so you don't have to worry about it, either.
Sheriff.
On me. One, two, three.
Eight.
That's way too high.
This guy is a ticking time bomb.
10 of regular Insulin I.V., an amp of d50,
an amp of bicarb, and some albuterol stat.
We need to lower his potassium levels.
I'm shocked that they would give a kidney
to a guy serving life in prison.
Everyone gets on the list.
It's an 8th Amendment thing...
Cruel and unusual punishment.
I can't find a vein.
He's a former I.V. drug user.
His veins are shot.
Breathing's getting labored.
From edema. He needs dialysis.
Ask them for a machine.
No, we're gonna have to place a vas-cath.
You ever done one before?
No, but I assisted once.
Well, you're gonna do one now.
Take your introducing needle.
Guide it into the right sub-clav.
Look at the screen.
You want to get it into
the vein, not an artery,
or there'll be catastrophic bleeding.
Don't nick the lung.
Note to self... "Don't nick lung."
Okay.
Okay, I'm ready for the cath.
I'm going to thread the
catheter over the needle.
Pull the needle through.
All done.
You just saved his life.
I really don't want to know
what this guy did, do I?
No. And don't Google him, either.
It's an ethical violation
to look up his past.
You got the convict, huh?
Let me know if he gives you any grief.
And what? You gonna come to my rescue?
I heard what happened with Angus.
Oh, my God.
And my eyes are itching me.
I got a sore throat and a runny nose.
- I can see that.
- I need some help!
Hold on, would you, sir?
Do you have allergies, Mrs. Curtis?
Of course.
My prescription ran out,
though. That's why I'm here.
Hey, who do I have to you-know-what
to get a little attention around here?
Be with you in just a second.
You know I have to do a
full physical and history
before I can prescribe anything?
Uh, the hospital's kind of busy today.
I fell off the pole.
The po...
Oh, the pole.
I get it. Uh, you're a stripper.
I teach preschool.
I'm Tiffany. Nice to meet you.
Hey!
Yeah, I-I'm sorr... yes,
I'm sorry. What is it?
My head... it hurts really bad!
And this is really bruised.
I got attacked by some
ISIS people this morning.
They hit me with a golf club.
Oh, that doesn't sound good.
I'll, uh, take a look at
it in just a second, okay?
Oh, it's nothing to look at.
I'm a soldier. I served in desert storm.
I know how to make my wounds disappear.
He's nuts. That don't mean
they don't hurt, though.
Comes in here all the time.
You're new, aren't you?
Yeah.
Must be why they put you out here with us.
Must be.
Just one second, okay?
I just told her they were both brought in.
Nothing else.
It's a tough call to make, I know,
but it's better to do this face-to-face.
Does Kevin know his brother's dead?
Not yet.
Do you want me to do this, Dr. Rorish?
No. It's on me.
Mrs. O'Brien.
Who are you?
I'm Dr. Rorish.
Is someone gonna finally
tell me what happened?
Your sons were in a car accident.
Okay.
How are they?
Kevin is in stable condition.
He's waiting for a C.T. scan.
We'll know more after he gets out.
Your son Patrick was
unresponsive when he came in.
We did everything we could.
Is he dead?
Yes.
No!
No. No!
No. No.
He died at 7:00 this morning.
No. No. No.
I'm so sorry.
It should have been you.
Did you hear me?
You killed him.
You killed your brother!
Tell me he's not dead!
You've got to lie down.
- Mrs. O'Brien...
- No!
I told him not to drive.
I told you not to drive!
- Please tell me he's not dead!
- Mrs. O'Brien,
- you need to step out of the room now, okay?
- I wish you had died!
I wish it was you!
- Jesse.
- I know you were drunk!
Mrs. O'Brien. Come on.
- You killed him!
- Step out.
You were drunk, and you killed him!
- I'm sorry!
- I want Patrick back!
- I want my son back!
- I'm sorry!
Jesse!
This isn't happening.
Should I sedate him?
No. Just make sure he doesn't harm himself.
This is grief. This is what it looks like.
Just let it be.
That went well.
She's upset.
She's got one son dead,
and the other one killed him.
He didn't do it deliberately.
We don't even have the
toxicology report back yet.
I don't think there's a lot
of mystery there, do you?
Where are you going?
Last count, there's about 75 of us
and close to 600 of them.
Hey, you can take a minute with mama.
It's okay. It's allowed.
Drunk drivers.
They... They ought to be...
These things are horrible.
They taste like drywall with cheese.
What do I always say about
that vending machine?
No real food in there.
Yeah, well, the kitchen's out of food,
and you're not one to be giving
nutritional advice, El Gordo.
"El Gordo"?
Look at me.
I could have been a movie
star with this face.
It's not your face I'm worried about.
It's your breasts.
At least they're mine.
Okay. Okay.
Break's over. Let's go.
And these girls are all mine.
Mmmmm-hmm.
Hey. You want an energy drink?
I just put a six-pack on ice in a bedpan.
No, thanks.
Kitchen's out of food.
Taylor ordered a taco truck.
You totally sold him out.
Who? Angus? Did he tell you that?
Everybody's talking about it.
Everybody? Really?
Well, Angus could have
done whatever he wanted.
Guy wasn't even my patient.
We're all gonna be here
for the next three years.
This is how you make friends?
We're in emergency
medicine, not high school.
Look, I'm sorry, but I didn't get this far
taking responsibility for
mistakes I didn't have to.
I'll tell you what the real problem is...
She's into me.
You sure about that?
A guy knows.
I heard there are tacos coming.
Ah, yeah.
I'm not taking orders just yet,
but as soon as it's lunchtime...
Try and keep this elevated
as much as possible.
And don't put any weight on
it for the next few days.
That would basically put
me out of commission.
Okay, you're, uh...
You're all finished.
Sorry.
There's nothing I would love more
than to be out of commission.
I hate that damn pole.
You should, uh, follow up
with your primary-care doctor
in the next couple of weeks.
Why can't I follow up with you?
Because...
Because...
Um, I'm an E.R. doc.
I don't take appointments.
Must be nice to be someone like you.
Yeah. Must be.
What do you got?
19-year-old female, unresponsive.
Her temp was too high to read on the rig.
Are you two with her?
What's she on?
Nothing. We just went to hear some music.
Lying isn't gonna help
your friend right now.
Just some Molly.
"Just"? How much?
MDMA interferes with the
body's temperature control.
Where was the concert?
Palm Desert. We were
there for like three days.
Smart.
- Are you assisting?
- Yes.
Then don't talk till I ask a question.
- 108 degrees.
- 108.
I think she's just really burnt out.
Your friend isn't burnt out.
She has non-exertional heatstroke.
If we don't get her temp down, she'll die.
Let's get an arctic sun blanket on her.
I'm sorry, doctor. They're both in use.
Okay, then we're gonna do it old-school.
Get me 10 bags of crushed
ice from the kitchen, please,
and some fans.
And, you... have someone get the misters
from the entryway gardens, okay?
Uh, take her to the sides.
You following this?
Yes... the cooling effect of evaporation
is one of the fastest ways
to reduce the temperature.
Yeah. And don't think you got
away with anything this morning.
A little advice from your daddy...
The further you go around here,
the more you're gonna need
the people you started with.
Excuse me, Dr. Rorish,
but Kevin O'Brien's
toxicology report came back.
Do we have to tell the police?
Yes.
It's no longer an accident.
It's a crime. That's evidence.
The swelling in
your legs is much better.
We've removed a lot of fluid from your body.
Keep an eye on his electrolytes.
They tend to shift after dialysis.
Listen to his lungs.
Get a BMP now and every four hours.
And prep a syringe of calcium gluconate
in case he goes into cardiac arrest.
So I'm still pretty sick, huh?
Only thing keeping you alive
right now is that machine.
My transplant failed, didn't it?
You never know. Sometimes they come back.
That's what my mother used
to say about her boyfriends.
Unlike my kidneys, I could
have done without them.
Hm.
Oh... God.
You feeling disoriented? Nauseated?
Yeah, I've been throwing up.
Sorry.
And the other kind of fireworks, too.
You mean diarrhea?
You don't need to be embarrassed.
I've seen much worse.
Okay, I want you to take a
deep breath for me if you can.
Well, your lungs sound much better.
So, you the one who saved
my life, put this in?
I was there when they brought you in, yeah.
What's your name?
Dr. Lorenson.
Well, thank you, Dr. Lorenson.
Of course.
God, I used to love this part...
The soft part,
when I knew I'd found
someone who was really nice.
Then later, when they realized
how foolish they were...
I would keep them alive
for as long as I could.
Oh, my God.
I didn't want it to be over...
The screaming...
Or the look on their face
when they were trying to breathe.
Have you ever taken a
bottle out of a baby's mouth
that was still hungry?
It's so desperate.
Christa.
Christa?!
Christa, he's crashing!
All it took was 2 milliliters
of calcium gluconate,
and this monster is still alive.
I'm gonna go throw up.
Thank you.
Uh, Cornelius?
Hey, uh, I don't want to be that guy,
but, uh, the O'Brien mother
is still sitting with her son's body,
and it's been over three hours.
We're as overbooked as a
whorehouse on a Saturday night, folks.
I need the room.
Shame on you.
She didn't come here for
pleasure. Let her be.
I don't need a lecture from you.
I'm just trying to get as many people
out of here alive as possible.
Quiet, both of you.
He's right... Trauma-1 is for the living.
Don't go all soft on me now, mama.
Excuse me, Mrs. O'Brien.
I wanted to let you know that your son Kevin
should be getting a C.T. scan soon.
We'll know a lot more after that.
He's not my son anymore.
I only have one son.
And he died today.
I can only imagine...
how angry you must be.
He was drunk, wasn't he?
Yes.
His B.A.C. was .08...
Just above the legal limit.
Patrick was his little brother.
He worshipped him.
He could do no wrong.
"He just likes to party, mom."
Patrick just...
Just needed to be near him.
He would have done anything for him,
including letting him drive drunk.
My husband died 10 years ago.
I have no one now.
And you think
you can imagine how I feel?
You can't.
I'll leave you alone, then.
Hell of an air-conditioning unit, huh?
She's still unresponsive.
Down to 105 degrees.
Should be doing better than that.
Maybe it's inaccurate.
Whoa!
She came in with hyperthermia.
Oral thermometer showed her at 108 degrees.
I tried to get a line in to infuse fluids,
but she keeps bleeding out at the site.
10 units of FFP, a 6-pack of platelets,
and 10 units of cryoprecipitate.
What's the one organ
that cannot survive heat?
Blood.
And what happens to blood protein
when it's heated for extended periods?
- It denatures... melts, basically.
- It's blood gone bipolar.
One minute, you have uncontrolled bleeding.
The next, you could have
life-threatening clotting.
The blood no longer follows any rules.
Look at the patient... bleeding or clotting?
Bleeding, obviously.
I got nothing. She's cardiac arrest, P.E.A.
You've got everything! It's right here.
What's next?
Uh, ultrasound.
Marked heart strain.
It's a huge blood clot in the lungs.
Pulmonary embolism. Start compressions.
What are our options, Mario?
We can break the clot with alteplase,
but that could also worsen
the bleeding somewhere else.
Our treatment could kill her.
Her blood clot is killing her.
What's the answer?
Right now, she's pulseless.
We got to push the alteplase.
A chance is better than no chance.
My thoughts entirely.
Come on.
Come on.
Yes.
Yes.
Yes, indeed.
You know, I think you
could be a great doctor.
But you know your problem?
You keep score.
Do yourself a favor and stop counting.
We'll all win a lot more games that way.
Get her up to ICU... She
still needs a heparin drip,
antithrombin, and serial coags.
Let's go. Move it. Move it.
Four years of medical school, an internship,
- and I'm waiting tables?
- Patients have to eat, too.
I got to go.
We're down to code red,
which is like saying,
"it's just my arm that's on fire."
For what it's worth, I didn't want to do it.
Savetti just kept pushing me.
My instinct was to hold back.
I figured as much.
So, why did you do it?
'Cause I don't trust myself.
'Cause I'm weak.
It's like I forget who I am.
You just need to find
your voice and let it sing.
Then you'll remember who you are.
I wish it were that simple.
I used to get beaten up by
this boy... Johnny Wexler.
I never fought back.
So, one day, a group of
kids brought him up to me,
they put him up in front of
me, and they said, "hit him.
Make him pay for all that he's done to you."
Mm-hmm.
I couldn't do it.
So they let him go,
and Johnny Wexler punched
me right in the face.
You know, for a psych guy,
you don't understand much.
What do you mean?
You're the hero of that story, young squire.
I'm sorry to bother
you, but he's swirling.
Hypotensive, tachycardic. How long?
Dropped in the last few.
We held his morphine, didn't
want to tank him further.
I really don't like this tenderness.
How soon can he get a C.T. scan?
The scanner was back online,
but I don't think he's stable enough.
I need 2 more liters, another
large-bore, a pressure bag,
- and can you get an attending in here, please?
- Mm-hmm.
Can you hear me?
Uh-huh.
It's okay. We're gonna help you.
Don't.
Don't help me. I don't want your help.
Dr. Rorish, he suddenly went hypotensive.
I'm not sure of the source.
- He didn't get his C.T. scan?
- They were backed up.
He was stable, so we kept him
in here while we were waiting.
That's not gonna be big enough.
Let's pipe a central line.
All right.
Okay, take over the central line, please.
Now transfer the bag to the central line.
Now we got to find out
what the real problem is.
Syringe, please.
Thank you.
And if...
A critical assessment
tool is being repaired,
you improvise.
This isn't as good as a scan, but it'll do.
See that?
Musty red.
Blood. It's a big problem.
He's hemorrhaging somewhere inside.
He needs an exploratory laparotomy.
- Let's get him upstairs now.
- Yes, doctor.
Please, doctor, I want to die.
- Please just let me die.
- I can't.
She will never forgive me.
And neither can I.
I just want to die.
I want to die.
I'm sorry.
We only do one thing here... Save lives.
Let's go.
Dr. Hudson, I don't want
to treat him anymore.
I-I can't do it. I saw evil in there.
I don't want to go back.
Well, I understand that.
I don't have to, right? I
can give him to someone else?
He's your patient. I'm sorry, Christa.
Yes, I understand, but I-I
traded with Malaya this morning.
I'll tell you what my mum used to tell me.
Sometimes the way to be brave
is to pretend to be brave.
So, it's just toenail fungus?
Yep. That's it.
Excuse me.
That doesn't sound so
good. Are you all right?
I've been better.
Does your head still hurt?
You got hit in the head
with a golf club, right?
I don't know. Did I say that?
How long have you had this cough?
It just started.
- You a smoker?
- Yeah.
Do you have asthma?
Maybe.
I'm hearing a lot of wheezing.
We need to get you a chest X-ray, okay?
Anything you want.
You served in Desert Storm, right?
I don't know. Maybe.
I-I can't even remember
if it happened sometimes.
National Defense Service Medal.
Hey, it happened. Okay?
W-what's going on? What are you feeling?
My chest! It's so tight!
Is he all right?
I need a crash cart and a gurney!
What is this?
I-I gave him an energy bar.
The taco truck left before he could get one.
Are you allergic to peanuts?
Donald, can you speak?
Is he okay?
Anaphylaxis. His airway's closing.
Are you sure?
We need to get him into the trauma unit
before he suffocates.
Wait! What are you gonna
do? I'm gonna save his life.
- I need an epi drip! Get access!
- What do you got?
Anaphylactic shock. I gave
him .3 of 1 in a 1,000.
Okay, we've only got seconds, people.
Get the glidescope and a cric kit.
S.A.T... 67 and slipping.
Can't wait for the drip. Go
for the airway. Tube, please.
Okay, doctor?
Okay, doctor, what's the first
thing you check in a code?
Your own pulse.
Steady. Don't rush.
Everything
around the vocal cords
are trigger points for more swelling.
Bump into it, the tissue's
gonna balloon out,
and your opening is gone.
I know, I know... It's
like driving a semitruck
through a narrow lane of eggshells.
You just need to find
your voice and let it sing.
- Don't hit the walls.
- Breathe, stud.
- Steady.
- Then you'll remember.
d Sugar plum fair came
and hit the streets d
d Looking for soul food
and a place to eat d
d Went to the Apollo d
d You should've seen them go, go, go d
d They said, "hey, sugar,
take a walk on the wild side d
d And the colored girls say d
d Doo, do-Doo, do-Doo, Doo-d... d
d Doo, Doo, Doo, Doo, do-Doo d
d Doo, Doo, Doo, Doo-Doo-Doo d
d Doo, Doo, Doo, Doo-Doo-Doo d
d Doo, Doo, Doo, Doo-Doo-Doo d
d Doo, Doo, Doo, Doo-Doo-Doo d
d Doo, Doo, Doo, Doo-Doo-Doo d
d Doo, Doo, Doo, Doo-Doo-Doo d
d Doooooooooo d
The nice ones always wanted to help me.
And that's when they would...
Let me in the door or get in the car.
The fear...
You could smell it.
I used to love that smell.
And I smell it right now.
I'm not afraid of you.
Excuse me, Dr. Rorish.
Kevin O'Brien just got out of the O.R.
They found a serious
laceration of his spleen.
That's not good.
He's lost a lot of blood.
It's unclear if his other
organs were affected.
They said it would be days
in the ICU before we know.
Is his mother still here?
Yeah.
She hasn't moved from Patrick's
bedside for four hours.
It's like she can't say goodbye.
Maybe he's not the one
she can't say goodbye to.
You still have one son.
I know...
How hard it must be to
forgive him right now.
I can't... do it.
I can't.
But you want to, or you
wouldn't still be here.
I was in a car accident
with my husband and two children.
We were hit by a drunk driver.
They all died.
For reasons I will never
understand, I was spared.
Kevin feels the way any decent person would
in this circumstance.
He wants to die.
The one thing I hold on to...
Death isn't the answer to anything.
I wouldn't be here otherwise.
I wouldn't be a doctor. That's for sure.
The only time machine we have in this life
is the one we're born in,
and it only goes forward.
Kevin needs a reason to live.
Don't lose him, too.
Bring him home.
Yeah, everything's going great.
I'm a doctor, grandma.
Pretty amazing, huh?
Yeah, I'm rockin' it.
Sure I'm making friends.
Of course. How could I not?
Spending so much
time with these people.
Everybody loves me.
All right, listen, I got to go.
I'll talk to you later, okay?
I love you.
Hey, man.
If you're mad at me, let's
just talk about it, okay?
I know you may find this hard to believe,
but you are the last person
on my mind right now.
How long have we been here?
I don't remember being anywhere else,
if that's what you mean.
She's here for me.
Tiffany. You're, uh, still here.
Yeah.
And... spoiler alert...
My name's not Tiffany.
I figured.
It's my phone number.
You're a doctor.
I'm a stripper.
Not gonna happen... unless I make it happen.
Uh, I think there are policies
about me fraternizing.
Fraternizing?
You know, uh, with patients.
Oh.
You can consider me discharged.
Could you open your eyes wider?
They're vibrating a little, horizontally.
It's called nystagmus. Could
be a sign of a bad concussion.
You're kidding me.
No. You could have hurt
your head in the fall.
We need to get you a scan.
No... Really?
Yes. Trust me.
I'm a very good doctor.
- Come with me.
- Thank you.
Hey. Headed home?
Just waiting for my ride.
How's the brother? Did he make it?
Still don't know.
See you tomorrow.
Hi, Eva!
At least somebody has a life, right?
I killed him.
Shh.
I'm sorry.
Shh.
I killed him. Shh.
You're my baby boy.
Shh.
I love you.
You are my son.
You are my son.
Sprinkles on your dreams, baby boy.
Shh.
Go to sleep.
So, you're finally going home.
Believe it or not, I am.
Adios.
You look like you could use a Walker.
You look like you could use a wheelchair.
You look like you could use a gurney.
You look dead.
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