ER (1994–2009): Season 10, Episode 8 - Freefall - full transcript

Previously on ER:

What are you doing?!
Cut the hell out!

What are you doing?
He just grabbed my ass.

What are the odds we're going
to find someone better?

We're at that point
where we should be spending

either all our time together

or none at all,

and I'm kind of leaning
towards none at all.

Sign it.
So, what, this goes up
to Human Resources now?

It stays with me until
I have a fat enough file

to pull the
trigger. Bang.



Sinus tach, 130.

BP's up. 220/140.

Come on. He's going
to blow an O-ring.

Let's try Nipride.

Oh, what? How did the
paramedics miss this?

Cocaine?

Could be.
Okay, hold the Nipride.

He needs a beta-blocker.

Five of metoprolol, IV push.

Heart rate's up to 140.

Metoprolol's in.

He's seizing.

Okay, two of Ativan.

ROMANO:
Hey, Abby, what are



the physiological effects
of cocaine?

It's a sympathetic stimulant.

Alpha or beta?

NEELA:
Both.

SAM:
V-tach.

Starting compressions.

Uh, charge to 200.

Check for pulse
with compressions.

Clear.

V-fib.

Charge to 300.

Amp of epi.

The beta-blocker made him worse.

Clear.

No change.

360. Maybe he's allergic.

I doubt it.

By blocking beta,
you've left alpha unopposed.

His BP's going
through the roof

and he's bleeding in his brain.

Clear!

Asystole.

Amp of atropine.

Okay, what should she give?

Phentolamine
and esmolol.

Gold dot for your forehead.

I've seen beta-blockers

work before.
Oh, I'm sorry.

I forgot you have nursing
experience, which means

that you can handle 90% of
patients. Unfortunately,

it also means you might kill

the other ten percent.
He's not dead yet.

Another amp of epi.
Forget it. That's it.

Stop compressions.

Just another dead junkie.

Congratulations, Abby.

You managed to kill
the practice dummy.

Okay, reset for
the next student.

Shame we have to work
the holiday.

You got family in town?

No.

Your overdose
was much harder

than my dialysis patient
with hyperkalemia.

I need a room to hold
an ICU admit.

CHUNY:
Sorry, bad
MVA coming in.

So where do I put him?

Anywhere, as long
as it's in the hallway.

Come on.

Can't you just get me
some pills?

That wouldn't be safe.

Mr. Garland has
pneumonia with hypoxia.

You need IV antibiotics.

I need to be with my family
for Thanksgiving.

They can come
and visit you here.

How was the mock code?

Fine.

So Romano humiliated you?

I looked like an idiot.

He does that to everyone.

Or maybe I just
don't get it.

You'll catch on.

It just takes
a little time.

Stay up there, turkey.
Come on.

Son of a bitch.

Better call the coroner
on that one.

The damn night shift
was supposed

to take care
of all of this.

I'm just in charge
of the potluck.

Well, my yams
are in the lounge.

How many admits
are we holding?

You don't want to know.

No, there's a sandwich
in the fridge.

And don't answer the door
until I get home.

All right. See you soon.

Everything okay?

Yeah, I had to leave Alex
at home for the day.

Oh, he'll be all right.

It's just until 3:00.

I'm finally going to
get to make my kid

a real Thanksgiving dinner.

Most years I've
had to work.

That's Lily's.

I thought it was
for the potluck.

There's a coffee club.

Yeah, you have to pay
every month.

Sorry. How much?

It's a nurse's coffee club.

Okay, time to stamp out disease.

Hand lac for Coop.

Hit me again.

Oh, one per customer.

Asthma for Neela.

Vag bleeding for Abby.

Lovely.

And "bugs are crawling
under my skin" for Lester.

Cool.

Hey, Pratt, will you take
the incoming trauma?

Yeah. Hey, Frank.

What's up with the
stupid parade, man?

Put the game on.

Hey, kickoff isn't till 12:30.
My brother-in-law is marching

with the Brundy County
Sheriff's Posse.

Oh, yeah, what's that?
Some sort of clan?

Hey, Morris.

What do you think
you're doing?

Picking up a patient.

You just skipped over
"bloody diarrhea"

for... "eye pain."

FRANK:
Smile!
Frank?

Sorry, I didn't think
this old thing would still work.

1t was in
last year's box.

Couple of shots left.

What do you figure
is on there?

Might be Romano and Weaver
in a compromising position.

I'll get double prints then,
just in case.

ABBY:
October 14.

Six weeks and three days.

So I'm still pregnant?

We'll check an ultrasound.

How heavy is the spotting?

Uh... couple
of pads so far.

Are you taking
any medications?

Prenatal vitamins, AZT,

3TC, and indinavir.

You're HIV-positive?

Yeah, for ten years.

Never shared a needle,
no blood transfusions.

Just a loser boyfriend

with too many chicks
on the side.

Anyone here with you today?

Yeah, My fiancé.

He's driving up from Iowa City.

This guy's the real deal.
( knocking )

Abby?

Excuse me.

Three sick calls
for night shift.

( chuckles ):
Right, sick.

On Thanksgiving.

Call the registry.

We really need someone
who knows the floor.

No.

No way.

I'm on all day as a med student.

I only work nursing shifts
on weekends.

I can let you off
your rotation

at 5:00
so you can take a nap.

Can you take one
for the team?

No.

Okay, fine. Only if you
can't find anybody else.

Thanks.
Okay.

MORRIS:
So you're not
using the eyedrops?

My nephew gave me
an herbal medicine.

What, some sort
of homeopathic crap?

Morris, come on, man.
Trauma's here.

I think it's called Kona Gold.

Morris, grab some four-by-fours.

Uh, yeah.

Okay, this is pretty deep.

I wanted to use
the carving knife.

She made me use
the other thing.

( knife buzzing )

It's from Germany.

PRATT:
Morris!

Morgan Westbrook, traffic
collision with intrusion.

BP: 80 palp

with obvious
pelvic fracture.

O2 SATs: 98. No
significant head trauma.

Didn't get altered
until he dropped his pressure.

On the phone to his doctor
when we pulled up.

Drives a Bentley.
Oh, nice.

Okay, prime
the rapid infuser.

Come on. Let's go.

Here we go. On my count.

Uno, dos, tres.

( grunting )

How do we tell pelvic bleeding

from intra-abdominal?
MORRIS:
CT scan.

What if the
patient's unstable?

Uh, ultrasound?

No, suprapubic
mini-lap and DPL.

Which you can assist on.

Pupils equal and reactive.

Looks like we got some
sewing for you, too.

Can you two handle this?

Oh, I should hope so.

Good. I need to get back
to my glaucoma patient.

Morris, this is
a primo teaching case.

I'm worried about angle closure.

No hemotympanum.

I need to check eye pressures.

( sighs )

Equal breath sounds.

Is he squeamish?

No, just stupid.

Frank, where are the nurses?

With patients.

I need a chaperone.

Sam, can you help me
with a pelvic?

After I hang
blood in trauma.

Can we bring a few
patients back?

Eventually.

I've done solo pelvics.

I could help,
if you'd like.

That's okay. Thanks.

No, no, we are boarding
five ICU players

and it's total gridlock.

I'll give you an hour.

Mr. Garland, looks like you
might be with us for a while.

Not a problem.

What's that?

"Turducken."

What?

It's chicken stuffed in a
duck, stuffed in turkey.

You want a taste?

Maybe later.

( moans )

Sorry.

( sighs )

No, no, it wasn't you.

Just a cramp.

There's a little bit
more bleeding than I expected.

And the cervix is open.

Meaning?

With the cervix open,
you can't maintain a pregnancy.

I'm sorry.

I had a feeling.

( groggily ):
I woke up and something...

something was strange.

We've been trying
to get preg... pregnant...

For how long?

Loren?

Loren?

Damn it.

( beeping )

FRANK ( on speaker ):
Can I help you?

This is Abby.
Who's at Admit?

Just me and the food.

Well, my patient's bleeding out.

I'll see who I can rustle up.

Could use a little help here!

Systolic's 110
after two units.

Spontaneous
eye movements.

( man groaning )

Mr. Westbrook?

Where am I?

You're at County General.

You got clipped
by a tow truck.

( groans )
Try not to move your leg.

What do you think you're doing?

I'm calling my lawyer.

I'd rather not be treated here.

You may have internal bleeding.

I'll take my chances.

Your cell phone interferes
with our equipment.

Hello.

It's Morgan Westbrook...

Hey, I said no cell phones!

Hello, Mr. Westbrook.

I'm Robert Romano,

Chief of Emergency Services.

I just got off the phone
with our CEO, Peter Fenwick.

Oh, Peter was in my class
at Wharton.

Yeah, so I heard.

I think your employees

need a lesson
in customer service.

This one stole my phone.

Well, he's not long
for this hospital.

We're taking him up to CT.

Great. After a few tests,
we'll work on a transfer.

Thank you.

You're welcome.
And don't worry.

You are in excellent
hands with Dr. Corday.

Believe me, I envy you.

Hey.

Come here.

That guy is the biggest real
estate developer in Chicago.

Yeah, more like
the biggest prick.

Now, when you get a
VIP patient, sometimes...

You treat them the same
as everybody else.

He's not stable.

Well, if he has no solid organ
injuries, I say he is stable.

Well, then you're making
a big mistake.

He could have
ongoing hemorrhage.

My only mistake was
continuing to allow you

to practice medicine, Pratt.
Wait a minute.

You're willing
to compromise patient care

just so you can suck
up to some rich guy?

No, we will
determine objectively

if he's able to be
transferred...

I'm not signing
any transfer papers.

Well, you don't have to

because you're no longer
on the case.

Well, great. Then my name
won't be mentioned in
your malpractice suit

when he bleeds to death.

Yeah, and as far
as I'm concerned,

you no longer work here.

Right.

No, I'm serious, Pratt.

You just pissed me off
for the last time.

Second liter's in.
Pressure's 100/60.

LOREN:
Whoa.

Hey, Loren.

Gave us a little scare.

You passed out
from blood loss.

That doesn't sound good.

Well, there can be
retained tissue
that keeps bleeding.

Hemoglobin's 9.4.

Okay, type and
cross for two.

How do you stop that?

With a D and C.

We clean things out,
and then you're back to normal.

Abby...

Let's get you
a fresh gown.

I'll be right back.

There is no retained tissue.

She has multiple
uterine fibroids.

It's not going to be
as simple as a D and C.

You should be careful
what you say.

Most of the time,
it's retained...

Not in her case.

Transfuse two units
and call GYN.

We have to get
this bleeding to stop.

Next time, wear oven
mitts before you take
out the turkey, okay?

Oh, there.

Hey, Frank, what's the score?

First quarter,
zero-zero.

Oh, you're back
from the scan?

Bilateral pubic rami
fractures and a
shattered acetabulum.

Ouch.
And we've got Todd
Corbett on stand-by

at the Mayo Clinic.

Hey, you think
I'll be able to run

the Marathon
next October?

I'd say there's
a good chance.

That guy could put Humpty Dumpty
back together again.

I'll be right there.

All right, what part
of "You're off the case"
do you not understand?

I'm just looking out
for the best interests
of the patient.

Did you send off
another CBC?

Keep it up, Pratt.

What, another letter
in my file?

No, you and I are
meeting with Weaver
and Anspaugh

at the end of
your shift.
On Thanksgiving?

That's right.

Well, I guess it saves you
from spending it alone.

Did you call Psych
about your bug guy?

No, he really
has scabies.

My asthma girl's worse.

Call RT for heliox.

Lewis, get coverage
for Pratt's shifts
starting tomorrow.

Complex laceration?

I repaired the
extensor tendon with
a figure of eight.

Looks nice.

Yes... very tidy.

Abby, where's the abductor
pollicis brevis insert?

You know its innervation?

Smile!

My patient needs blood.

Okay, just put your
dirty clothes in the hamper.

Did you check your sugar
at noon?

Timoptic, one drop
two times a day.

What about the other stuff?

You don't need it.
It's illegal...

Just say "no."

Just say no to what?

Altar boys.

Look at this rack.

Do I have to?

We need to treat patients
in Triage again.

Meet 'em and street 'em.

Whoa, not so
fast, Luka.

Couple of problems
in the hall.

Jeffries spiked to 104.

Tylenol, blood cultures
and a gram of Cefotetan.

When can he go up?

Fifth in line
for med-surg...

Mrs. Paulson's
now altered.

Two tele admits
in front of her.

How are you doing, ma'am?

30cc's of lactulose,
and, uh, draw

an ammonia level.
And Mr. Garland's BP
is down to 90 systolic.

Start Dopamine
at five mikes...

Sorry for the delay, sir.

That's okay.
I like to people-watch.

Can you help us
at Triage?

No.
Why not?

'Cause you just gave me
about an hour's worth of orders.

This is ridiculous.

We have no
beds, no staff,

and we're doing the work
of the entire hospital.

Yep, welcome to my world.

I need hard restraints
for Mr. Garland.

Garland? He's a pussycat.

The kind that lock.

Have you ever had
any problems with
general anesthesia?

Hepatitis?

No, they check my liver enzymes
on the triple cocktail.

I need you to sign
a consent form

for exploratory surgery
and a possible hysterectomy.

Hysterectomy?

Only as a last resort.

Nobody said anything
about a hysterectomy.

Well, it may be
our only option

if we can't control
the bleeding.

No. I want to have kids.

I appreciate that.

Dr. Coburn, do you
have a minute?

Hang two more units

and check another
hemoglobin.

Um... why do a hysterectomy
for fibroids?

Because it might
save her life.

Well, there are other options.

I usually don't justify my
operative approach to a nurse.

I'm a fourth-year med student.

Well, we consent
for all contingencies.

Are you even going
to attempt embolization?

That would take hours.

Okay, I'm not sure
I'm getting your point.

She's bleeding out.

She's on her fourth unit,
and she's not stable

for embolization.
Uh-huh, and maybe
she would be

if she wasn't HIV-positive?

What are you accusing me of?

Ladies, please,

let me settle
this catfight.

Abby, you're wrong.

We were discussing
uterus-sparing procedures.

On an HIV-positive
woman? Why?

Yeah, thank you, Robert.
I can handle this.

She wants to have a baby.

Well, maybe this is God's way
of saying, "Bad idea."

With a low viral load,
transmission rate is less
than three percent.

Uh-huh, and the kid'll
be motherless by age ten.

I'll attempt
a myomectomy,

but I can't make
any promises.

Probable rotator
cuff tear.

I thought it was a game
of touch football.

My sister-in-law
doesn't like to lose.

Happy Thanksgiving,
Dr. Lewis.

Excuse me.

Uh, thank you.

Don't thank me.
Thank some dead guy from Mercy.

Very romantic.

So, you in the mood
for some late-night pumpkin pie?

Um... you know what?
I'm beat.

I'll bring the whipped cream.

Maybe another time.
You okay?

Yeah, I'm just tired.

Of me?

FRANK:
GSW to the face

en route.

Morris, you're with me.

Talk to you later.

Two liters NC,
TKO the saline.

Five-minute ETA on
the private chopper.

I'm Chuck.
I'm Dr. Hewitt
from Northwestern.

I'll be flying with you.

Hands inside the car, man.

I appreciate everything
you've done, Dr. Romano.

My pleasure.

Are you coming up to
the copter with us?

Oh, well, I'd like to,
but, as you can see,

we are completely
swamped, so, uh...

I don't know
how you do it, Robert.

Aw, I guess
it's just my calling.

Thanks a lot. Take care.
Have a good flight.

WESTBROOK:
Thank you.

Hold that elevator.

So you still think
there's still a chance?

Yeah, I do. A good one.

Abby, Mrs. Marshall
is praying

to the porcelain
God again.

Uh, okay.

Reglan and Tagamet.

My fiancee's
coming to the ER.

Okay, um, I'll bring him up,

and I'm going to scrub in,
make sure you're okay.

This is for painkillers.

Keep them. After ten years
of marriage, I'm immune to pain.

Helium gets deeper
into the lungs.

I won't float away,
will I?

No, but you may
talk funny.

Frank, Pedes ICU have a bed yet?

In your dreams.

Hey, chow-line's open.

Yeah, I think you
forgot something.

What?
Emesis basins.

Shouldn't you be
on the roof?
No.

Mr. Moneybags left his Rolex
in the Trauma Room.

So have one of the
nurses take it up.

They're busy.

Hey, Indira,

take that up
to the helipad.

How do I get there?

Look, I don't blame you
for being scared.

Last thing you need is to lose
another limb up there.

Come on.
I'll take you up.

Someone stole
my medicine.

Talk to the hand.

What kind of medicine?

For my glaucoma.

Who was your doctor?

Young guy, red hair,
and goatee.

GSW to the mid-face.
Where the hell is Morris?

( horn honks, siren blares )

KOVAC:
So, uh, about tonight--

It's okay that I'm coming
for dinner?
What?

Alex invited me.

What is this?

Septic pneumonia patient.

We don't have
any beds.
Neither do we.

You said they accepted him.

You can't just come
up here without
calling report.

Here is your report.

72-year-old
pneumonia patient

on Cefotaxime, five mikes

of dopamine, and six

liters of O2.
He might leave AMA.

What are you doing?

Take it easy.

He's a troublemaker.

This is really stupid.

You have more nurses.

We can't take
extra patients.

Why not?
We do it all the time.

Now you can't

send him back.

Are you coming?

Dr. Romano?

Are you coming?

Here, take it.

Patient forgot

his watch.
Thank you.

Keep your head down.

I know the drill.

This isn't your flight.

FRAN:
Dispatch sent me.

There's only room
for two attendants.

Right, me and the doc.

No, I have to go.
Insurance requirement.
She's off the flight.

Hey!

What the hell do you
think you're doing?

Uh, nothing.

Give me that.

Uh, it's not
what you think.

Yeah. Get your ass
back inside,

sit down at Admit,

and do not move
until I come get you.

( grunts )

The strap

is caught.

Fine. Just call the
nursing supervisor.

You're not helping

to solve the problem.

( screams )

( screams ):
No!

( grunting )

Open up four ORs
and get every surgeon down here.

Done.

COOP:
Three criticals out here.

Yeah, copy that. Mike?
Yo.

O2 and IVs outside.
Let's go.

Lester, we need backboards, man.

( knocking on glass )
Dr. Pratt?

From the roof.
( sighs )

Morris, get busy.

I can't.

NEELA:
Decreased breath sounds.

Weak carotid pulse.
What's open?

Trauma Two.
Chest tube.

ET and two
large-bore IVs.

Send X-ray

down here for a portable.

Should I set up a thoraseal?
No, no. I need
you to triage.

Go. We got this. Go!

Neela, grab a box.

What is it?

Mass-casualty bins
and lots of morphine.

How much longer?

Soon as I get this crike.
What happened?

Helicopter crash.

Up on the roof?
In the bay.

Any survivors?

I don't know.

Find out! Go!

FRANK:
I closed us
to internal disaster.

NEELA:
What should I be doing?

Grab this gurney.

Okay. Put one of these
on every patient.

Fill in vitals,

injury, and tear off
the triage category.

Morris!

Romano told me
to wait here.

Green for minor,
yellow, delayed,

red, immediate,
black, dead.

Green and yellow stay in Chairs.

Bring back
red right away.

What about black?

Cover them
with a sheet.

Where should I start?

Anywhere.

We need two more gurneys.

How bad is it?

( sirens wailing )

You okay?

Just a little dizzy.

Backboard!

( man coughing )

( woman groaning )

Did they pull anyone out?

Not yet. Meet Reina Flores.

Came in for
heart failure,

and now she
needs ortho.

It hurts quite a bit.

( people groaning )

LEWIS:
Abby, morphine.

All right.
What about him?

I'm fine. Take care of her.

Chest pains, broken ribs.

COOP:
Abdominal pain

and weak pulse.

Abby, I need four of morphine.

Susan, you should go inside.

We got this covered.

Oh, her lungs are wet.

She needs a
nitro spray,

40 of Lasix, and dopamine
to keep her systolic above 90.

Are you all right, dear?

Yeah, it's just the smoke.

( fire alarm blaring )

Hey, get me out of here!

Get me out of this!

You're okay,
Mr. Garland.

We have to move patients
to the ER.

No, they'll be swamped.

We can treat them here.

I'll call down for help.

No. The phones
are dead.

Get him to the other side.

I can't find the key.

You're going to
be okay, ma'am.

Not if I don't make it
to my granddaughter's wedding.

When's that?

Two weeks.

Hypotensive with a rigid belly.

Call Corday.

Blunt chest, good vitals.

Okay.
How is my wife?

Who's in charge?

Uh, Dr. Lewis.

Right here.

Fire's just
about out.

I got nothing
for you.

But I got four
for the coroner.

You know, Luka's on.

I can get him
to cover for you.

No.

Abby, respiratory arrest
in Curtain One.

( woman whimpering )

Hey, nurse, I'm chained
to the wall here.

SAM:
Double up
the patients,

two per slot.

Sam, I need some help over here.

Get an E cylinder
for every vent

before you move them.

The fire melted her ET tube.

I have to reintubate.

Burned her
central line, too.

Oh, Doc, get me loose.

Get me loose.

Here you go, 8-0.

I'm not ready
for the tube yet.

You said you
wanted to intubate.

I think she aspirated
the short end into her lungs.

I need something
to fish it out.

You want a MacGill?

Keep pressure on the
subclavian. I'll see

what I can find.

Help! Somebody, help!

Ready with a backboard
and splint.

How are you doing, Reina?

Better than the poor souls
in that helicopter.

PICKMAN:
Pulse ox
down to 88.

LEWIS:
Put her up to ten liters.

Susan?

Kerry.

Susan, are
you okay?

Were you hurt?

No, no. I'm fine.

Okay, who are the
other attendings?

Um, uh...

Luka and Romano.
I don't know where they are.

You shouldn't get tied
up with one patient

when you're the
incident commander.

You've got to keep your
eye on the big picture.

Chuck's on the chopper.

Oh, God.
I'm so sorry.

She's more hypoxic.

How's your breathing, Reina?

We're having

212 wedding guests.

Can you imagine? Oh.

LEWIS:
She's altered.
She needs an airway.

WEAVER:
Curtain Two.

COOP:
Both traumas are going up
to the OR.

Stay with Dr. Lewis.
This one has
a flail chest.

Okay, Trauma
Two with me.
Got it.

Abby, you and Pratt take
the yellows to Exam Three.

Pulse ox dropped
to 88 on five liters.

Is there blood in the belly?

That's my wife.

We're taking her up to the OR
for an ex-lap.

Berta.

WEAVER:
She's in good hands.

Oh, Happy Thanksgiving,
Dr. Weaver.

Yeah, you, too.
Didn't get past the relish tray.

This was a tough one.

Had to tube this lady
on her side.

LOCKHART:
Hey, Pratt,
you're with us.

Do you know
how to debride?

I've done it once.

All right,
let's go.

Hey, what happened, man?

I don't know.
Bad concussion.

Neuro check's, 215.

I fell to my hand.

You lifted patients
like that?
Yes, doctor.

Damn, you are one
tough muchaca.
Yes, doctor.

CHUCK:
I need a doctor here.
All right.

Through-and-through
penetrating neck.

I tubed him
for an expanding hematoma.

On the roof?

Weren't you the flight nurse?

Supposed to be.

Lily, Trauma One.

500cc's in.

Mm-hmm. You
started a line?

Yeah, 14-gauge
in case he needed blood.

Is that Mel?

Yeah, trauma panel,
type and cross

for six, lateral c-spine
and let's get surgery down here.

Nice and easy.

CO2 detector
is yellow.

We need to tube you, too?

I thought he was dead.

How long
until we check

an ABG?

Baby, I had to tube this guy,
and there was no suction...

Whoa, whoa, hey.

It's not that
big a deal.

I thought you were
on the chopper.
Oh, God, no.

They brought their
own flight nurse,

and the bitch wouldn't
let me fly.

Oh, that bitch saved your life.

Dr. Lewis, multifocal PVCs.

I know, I know.

Oh, I thought you were dead.

Hey, hey.

I scraped my back
a little, see?

( laughs )

Okay.

The MacGill won't
fit through.

It's all we have.

I need something
thinner.
Like what?

Anything.

Dr. Kovac,
I need you over here.

Where are your doctors?

Coming from home.
It's Thanksgiving.

Damn, I am so late.

I've got to call a neighbor.

Can we focus on this?

Curved vascular clamp.

Get ready with the ET tube.

Tube her fast.
Sats are dropping.

Bag her.

This guy needs the OR.

If we still have one.

Keep pressure on the liver.

Where are you going?

To the OR. We
need Vicryl mesh.

Okay, and bring a surgeon.

A little cold
on your chest.

Hard-hard to breathe.

Because you collapsed a lung.

How is Berta?

She's in the OR.
We'll get an update.

You have a cordis introducer?

What's going on, Pratt?

Penetrating neck developed
a dense right-sided paralysis.

Vascular needs
to repair his carotid.

No, that won't work.

Ten blade.
Call surgery.

The injury is too high.
Yeah? Let them decide that.

32 French.

Get me a c-arm
and a radiologist.

No, your patient needs
to go to the OR.

He'll be dead
by then.

( alarms blaring )
V-tach.

Charge to 200.

Don't do it, Pratt. Clear.

( zap )

( coughing )

Run of six.

That's another 50 of lidocaine.

She's about to arrest.
Where's the heliox?

Mix up the procainamide.

You think it's rhabdo?

Yeah, the crushed muscle cells
are getting

into her central
circulation.

She needs an amputation.

( high voice ):
An operation would kill her.
Her heart's too weak.

I don't know
about that wedding.

I need ice, lots of it.

LESTER:
Subtract seven from 100.

Uh, 93.

Seven from 93.

What are you doing?
Mental
status exam.

Serial sevens.

Neuro checks are pupils,

orientation, and
grip strength.

That's it.
You've got ten

other patients
who need you.

Excuse me.
86.

That's good
enough for now.

We've got a foot
lac to suture

before it's six hours
old, and we have to...

Chuck?
What is it?

Chuck?

Move the arm guy
into a chair.

Neela, go get a doctor

and a SonoSite.

Lester,
help me lift him.

One, two...
Wait.

Hold it. Hold it. Hold it.

Okay, roll him.

( alarms blaring )

Suction.

Open the
internal paddles.

We need a doctor
in Exam Three.

Try next door.
Start internal compressions.

PRATT:
The guy is stroking out.

I'd start with an angiogram.

The injury is at the base
of the skull.

The surgeons can't
get distal control.

Dr. Pratt, can you come
to Exam Three?

Does it look like it?

If you don't put a stent
in this guy, he's going to die.

I'm taking the SonoSite.

Clear.

Fine. Then let's
just sit around
until he's dead.

Got ultrasound,
but no one's available.

Hard to bag.
Try a jaw thrust.

He stopped breathing?
Yeah.

He needs intubation.

Prep an 8-0 ET tube.

Abby?

I think the damn cords
are too anterior.

You want me to try?
( gurgling )

Oh. Roll him.

Roll him. Roll him.

Yankauer.

His sats are dropping.

Why isn't this...?
Can you turn it on?

Turn on the wall suction.
Thank you.

Heart rate's down to 40.

Okay, stand by with atropine.

Maybe you need a straight blade.

Give me your hand.

I'll open the crash cart.

Backwards

and to the right.

Right...

there.

Hold it right there.

Got it.

Bag him.
Neela, tape.

He's got a laceration
on his back.

It could be an entrance wound.

Sats are coming up.

It looks like he has

a metal fragment in his spleen.

Lester, get me the rapid infuser

and two units of O-neg.

What are you doing?

He needs a central line.

Shouldn't an
attending be here?

Yup. You see anyone around?

The liver is wrapped,
still bleeding.

Purse string it with 2-0.

How do you know this?

I used to be a
surgical tech.

Oh, my,
what have we here?

Liver lac.

Hemostasis with Vicryl mesh.

Excellent. Well,
I've got an open OR.

Let's get him upstairs.

Looks like
I'm eating cold turkey tonight.

What time is it?

Almost 5:00.

Oh, man.

Hey, you got a bolt cutter?

Not up here,
but I'll get you one.

Oh.

You're lucky, Mr. Garland.

Your burns are only minor.

I liked it better downstairs.

Only had pneumonia downstairs.

Charged to 30 and clear.

Asystole.

Resuming
compressions.

How long's it been?

35 minutes.

Okay, that's it.

Time of death: 17:09.

Close the thoracotomy
and find the family.

His wife's in surgery.

Hey, what did Vascular say?

They never came down.

There you go. Leave
three centimeters

to cover the defect,

one intracranial.

Stent is in place.

What did I tell you?

To do the right thing.

No. I want a surgery...

Hey, look at this.

Motor function in
the upper extremity.

Blood flow is restored
to the brain.

Everything's
good, Mel.

Where's Dr. Lewis?

Clear.

( zap )

( beeps )

Sinus tach.
Got a pulse.

Try for a pressure.

Reina? Open your eyes, Reina.

You think she'll wake up?

I hope so.

We still need an attending.

Which patient?

The flight nurse guy. Chuck?

What?

Abby?

Occult splenic injury.

He had a slow leak,
took him about an hour

to drop his pressure.
He's intubated

with a central line.

Who did this?

If you sign here,
we can say you did.

It was either that
or let him die.

This the spleen for the OR?

Yup.
It's Chuck.

What, your ex-husband?

Yeah.

Do you want
to observe?

Um, I-I can't,
but I can bring him up.

LOCKHART:
Last crit was 26.

He's type and crossed

for another four.

BP's 110/70

after two
units.
Abby, thank you.

Is it over?

Did he drop his pressure again?

Any additional transfusions?

Okay, good. Thanks.
Chuck?

Yeah, he's doing well.
They're closing.

And we're opening
to Trauma.
What?

Sent nine to the OR,
five to telemetry,

four to med-surg, and
I've monitored beds.

Too bad it takes a disaster

to whip this
place into shape.

Ruptured globe's
going up to surgery,

and the supracondylar girl
can follow.

Okay, good.

Abby.

The fibroids involved
the uterine artery.

I attempted
a myomectomy, but
there was no way.

You did a hysterectomy?

Yeah.

She's stable now.

Heard you had
your hands full

down here.

Good night.

Hey, can I sign out?

What?!

You're a night shift nurse.

Not until 7:00.

Well, it's a quarter till.

I don't believe this.

I wrote these orders
six hours ago.

Mom. Hey, Mom.

Where's Helene?

She couldn't pull in.

Are those body bags out there?

Did you see the crash?

Well, it looks like

home cooking's
out of the question.

You want to go
to Ike's?

Ike's?

It's across the street.

We're going out to dinner.

You're still
coming, right?

I don't think so.

Why not?

Alex, we're fine on our own.

Mom, you said
I could bring a friend.

Besides, it's boring
if it's just us.

You're welcome to join us.

No, I-I don't have to.

No. Come on.

Are you ready?

Yeah, last stitch.

Where is Romano?

I haven't seen him,

but I need to get
this guy up to CT.

Let the nurses handle it.
Come on.

Why in God's name would he
insist on meeting tonight?

I really couldn't say.

Time for our little
sit-down, Kerry.

I'm a little
tied up in here.

Where is Robert?

I thought he was up
in the OR with you.

Well, I thought
he was down here with you.

Just fill me
in later.

Ah, come along,
Dr. Pratt.

Best if we deal
with this right now.

Romano sent me a file
of your disciplinary letters.

Yeah. Sometimes we don't
see eye-to-eye on things.

Well, there's enough
documentation here

to merit a suspension,

I guarantee you that.

Offending patients,
contradicting consultants,

refusing to comply
with attending's treatment plan.

Do you care to respond?

Look, I may have been
out of line, maybe...

Oh, baloney.

Excuse me?

I don't give any credence
to these allegations.

If any of this
were true,

I would get complaints
from other attendings,

and obviously,
Robert doesn't care enough

about this
to even show up.

I saw you in action today.

You're an excellent physician.

Thank you.

Give this to Romano
when you see him.

Can I have French toast?

No.

Why not? It says
all-day breakfast.

Because it's Thanksgiving.

You're having turkey.

Would you rather have
French toast or turkey?

Um, I-I don't like French toast.

Why not?
You like pancakes.

Yeah.

So... so does my mom.

You guys

can have pancakes;
I'll have French toast,

and then we can share
some turkey sausage.

Alex.

Why would you do that?

Payback.

I'm sorry
I didn't get home in time

to cook you Thanksgiving dinner.

Excuse me.
I'll, uh, wash up.

Why did you invite him?

Because he's my friend.

Well, you shouldn't have friends
who are over 30.

Why not?
Because you're a kid.

So? I like him.
He's cool.

I know what you're trying to do.

I'm not.

And...

I'd rather not be going out
with someone right now, okay?

You're probably not his type.

Besides, he's my friend,
not yours.

Hello, Mrs. Marshall.
I'm back.

The nurse came
with my medicine.

That's okay.
I'm your nurse now.

I thought you
were my doctor.

That was
this morning.

Now, I'm your nurse.

This is a very
strange hospital.

Tell me about it.

Abby, I'm about to suture
an arm lac.

5-0 nylon.

I thought so.

Abby, how much angulation
is acceptable

on a fifth metacarpal fracture?

More than 60 degrees
needs reduction.

Hey, do you know who gets
the Blue Beacon admissions?

Sessa, beeper number

2956.

Never received?

No way. I brought
that down myself!

Look, I said I looked
in the Records room,

and it's not there.

Yeah, well, Happy Thanksgiving
to you, too, jagoff.

Hey, did Detroit win?

I have no freakin' idea.

Well, what about Dallas?

Don't make me come over
there and smack you.

One for Dr. Pratt.

( women chuckling )

Hey, Morris.

What have you been doing
all day?

Romano told me
to wait here.

So you just
sat on your ass

through
a mass casualty?

Yeah.

Your shift's over, man.
Go home.

I can't!

Are those
from Christmas?

Uh, last year?

The year before.
Dr. Greene.

Mmm.
Which one's
Dr. Greene?

I'm going to need
a massive amount

of caffeine if I'm going
to make it to sunrise.

Here you go, Abby.

Ew.

( all chuckling )

Shred it.

Ooh, look at this one.

That's definitely 2001.
The Secret Santa party.

Anybody hear
from Carter?

He sent us a postcard
about a month ago.

You should put that
up in the lounge.

How's he doing?

( file slaps table )

I don't know.

What are you
thinking about?

Mm... nothing.

Come back to bed.

( singing softly )

Hey.

Hey.

I should fake my death
more often.

I knew it.

What?

That we'd end up together
tonight.

( chuckles )

This your idea of a hot date?

Yeah, yeah.

It's dark.
The nurses are busy...

You just had
your spleen removed.

Yeah... you know what they say--

when you lose an organ,
the other ones get stronger.

( chuckles )

Hey. What are you
still doing here?

Waiting on a few labs.

I hate to pass on patients
when it's busy.

Ah, that will change.

Today was
pretty amazing.

I've never seen anything
like it.

I didn't think
we could handle it, but we did.

We did really well.
We saved lives.

It was like
a roller-coaster.

I've always hated
roller-coasters, but...

I sort of can't wait
for the next ride.

Just as long as it's not
in the next 12 hours.

You want a coffee?

I'm not in the club.

I got an extra.

Thanks.