ER (1994–2009): Season 12, Episode 20 - There Are No Angels Here - full transcript
Dr. Pratt settles into his new job in Darfur but is troubled by the huge number of people needing care. A sheik and his pregnant wife arrive looking for treatment. Carter and Dakarai work on fixing the man's wound, but they are interrupted by government officials trying to arrest the man. Pratt and Dakarai are forced to make journey to a hospital at the risk of getting stopped by the Janjaweed. Meanwhile, Debbie tries to convince Dr. Dakarai to get treatment for his medical condition.
Previously on ER:
You sending me
to Africa?
I thought
you could use a change
of perspective.
DEBBIE:
Mouthwash? You gotta
be kidding me.
You're a weird
dude, Pratt.
So Debbie and Dakarai, huh?
Yeah, they're an item.
We're on our way
to the Dumtala camp
to help the sick people.
We are only here to help.
Generally, they do not
hurt the doctors,
but one never knows
what might happen.
( clamoring )
Welcome to Darfur.
( trucks rumbling )
( Dakarai speaking Arabic )
PRATT:
Well, we got our problems.
You ever heard of Katrina?
If the US does not lead
the way, who else will?
( Dakarai speaking Arabic )
Huh? Without international
intervention,
nothing will change here.
Ask him if he's been
taking the amoxicillin.
( speaking Arabic )
Listen,
even with intervention,
a year after us being here,
the whole world will be
screaming for us to get
the hell out of Sudan.
Oh... Pratt, I expected
so much more from you. Ahh.
Why? 'Cause I'm black?
No, because you are smart.
Yeah, well,
but I'm also American.
I did not realize
these things
are mutually exclusive.
He says yes,
he's feeling better.
Okay, good.
Listen, all I'm saying is that
it's a lot more complicated
than that.
Too many times
and way too quick getting in the
middle of other people's fights.
Fine. When the solution
does come to Darfur,
it is not going to be quick.
Yeah, well,
where I'm from,
gangs get into it all the time.
Sometimes all the cops can do
is step back
and wait
for it to end.
"Step back and wait."
You know, that sounds like
an excellent foreign policy
where people are sitting
and suffering.
Dakarai, stop ragging
on my country, okay?
There's plenty of Americans
helping out.
You see me here, right?
Yes.
And quite frankly,
I'm beginning to wonder why.
( sighs )
( speaking Arabic )
What?
She says the baby
won't move.
Okay, just show me where.
And you are moving
pretty fast for
an isolationist.
They told you
a brother was coming,
so you were expecting
Marcus Garvey?
Don't think
we have any more
in common than
you and Carter.
I don't.
In fact, I think Carter is more
African than you are.
Ah. Assalamu alaikum.
Alaikum assalamu.
( continues speaking Arabic )
How long has he been like this?
Um...
Has he had fever?
Diarrhea?
( speaking Arabic )
Baby no cry.
Yeah, he's too sick to cry.
Listen, we need
to bring him back with us.
Look, your baby
needs medicine.
We have to get him
to the hospital.
( speaking Arabic )
Where is that other doctor?
Tired.
Tired?
Okay, wait right here.
Dakarai,
what are you doing, man?
( retching )
Whoa! What the hell?
You all right?
Varices,
varices getting worse.
( retching )
You told me your IV was
for a little stomach virus.
Scarring in my liver.
Schistosomiasis
when I was a child.
Damn.
Well, congratulations.
You just became the proud winner
of a bed in tent #3.
( retching )
( groans )
Rashida Fallad.
She's 26 weeks pregnant,
and she has hepatitis E.
Hepatitis E?
I thought our
water was clean.
Mm-mm, they go outside the camp,
drink from other sources.
It shouldn't
be long now.
I think
you're overreacting.
The mortality rate
for hep E
isn't very high.
It is in pregnant women,
especially in Darfur.
Over 30% of people who contract
the disease will die.
Rashida.
Uh-huh.
Rashida.
Encephalopathy is worse.
She's pretty jaundiced.
Scleral icterus.
She's in hepatic coma.
Ask her if she's been eating
or drinking.
( speaking Arabic )
Tell her that we've been giving
her antibiotics and glucose
from an NG
feeding tube.
What did she say?
She wants to know if...
if her daughter will die
today or tomorrow.
Tell her I'm not sure.
She wants to know if
we'll need the bed.
No, no, we can wait.
( speaking Arabic )
PRATT:
Got a minute?
Mm-hmm.
So, this baby I
brought in yesterday,
she's not doing so good.
I'm having trouble
finding an IV site,
and this kid is
getting pretty dry.
Stop trying
to be so tough.
I am tough.
I'm just trying
to look out for you.
I don't need a wife.
I've already had three.
Stephen, you feeling
any better?
I don't want to be babied.
I am fine.
Why don't you stay in bed
a little longer.
I'm ready to work.
You're having
a paracentesis.
Don't be an idiot.
That's sound
medical advice.
She has no bedside manner.
Will you
talk to him?
Stay in bed until I sign off
on your chart.
When?
When I get to it.
DAKARAI:
This is why
people hate doctors.
He needed a
paracentesis?
Took five liters
off his belly.
Five liters?!
Had him on Lasix
all night.
We had to limit his sodium.
CARTER:
Good.
The man shouldn't be working.
He shouldn't even
be here.
Dr. Dakarai is very committed.
Uh-huh.
This is Mahdi,
his mom and sister.
I'm Dr. Carter.
Can you tell her
that we're gonna try
and give some fluids
to her baby?
MAN:
Dr. John!
They're bringing a man
from outside.
They say he's been shot.
Okay, 20 gauge in the femoral,
and I want you to call me
if you need me, okay?
CARTER:
Ishaak?!
PRATT:
What?
His name is Ishaak.
( Ishaak groaning )
What happened?
We got two bullets
to his chest and leg.
DAKARAI:
Look, I'm going
to help you.
No, we got it!
We handle gunshots
differently here.
We know that.
Get back in bed!
( groaning )
CARTER:
I got an entrance wound,
right chest.
Okay, belly
seems clear.
Ishaak, you left
the compound.
( grunts ):
Just to the perimeter...
to help a family get water.
He's got a strong carotid.
Okay, try for that BP.
Men on horses--
they shot me.
Let me guess: Janjaweed.
Through-and-through,
left calf.
100/60.
Why are you always
where the trouble is?
I try to help.
Ishaak is a sheik.
PRATT:
What do you mean--
like with a harem?
No, I mean
like a leader.
He's recognized as someone
the other IDPs
can look up to.
He's trying
to make a difference.
He's trying to get people here.
Yeah, well, he
should stop that.
Why say such
a thing?!
Because it's making people
want to kill him.
Give me two liters
of saline wide open.
Okay, got a good vein
in the antecube.
I'm going in with the 18.
Ishaak, we need
to move you to town.
You need more surgery
than we can do for you here.
I... I can't breathe.
We have the oxygen extractor?
ZAHRA:
Yeah, on its way.
You treating a man
with a gunshot wound here--
Ishaak Alazhari?
Not sure-- I'd have to
check with the doctors.
You can't just come
in here like this.
As long as there's no violation,
we'll leave.
( speaking Arabic )
DEBBIE:
Officer, please.
Please wait outside.
I'll look around for you.
We look for ourselves.
DAKARAI:
You cannot be in here
with those weapons.
You know the agreement
that the Alliance has
with your government!
We'll go where we need to go
and do what we need to do.
Look, the NGO rules
apply even in Darfur.
Debbie.
Ishaak, this is oxygen that
should help you breathe.
How are you doing, man?
Feeling pain when I breathe.
This man's been shot.
Yeah, that's right.
He's bleeding internally.
He needs immediate attention
and transport
to a surgical
facility.
Ishaak Alazhari, did you report
this injury to my office?
Come on.
He can do that later.
Without a Form 8, he's got
no right to medical attention.
He's got to fill out
a form first?
PRATT:
It's not gonna help much
if he's already dead.
No, no, come on.
Wait a minute.
Take it easy.
( all shouting )
PRATT:
What are you doing?!
What the hell
is the matter with you?
CARTER:
He's gonna die if you do this.
OFFICER:
He's guilty
of a Form 8 violation,
which requires that all gunshot
injuries be reported...
PRATT:
He's here now!
Please don't do this!
DAKARAI:
If you are going to do this...
Stephen!
Wait, you can't just
come in here shoving...
( Pratt shouts )
I'll send you a document
re-clarifying
the Form 8 regulation,
so this does not happen again.
Good day, Doc.
Okay, okay, let's see.
Damn!
How does that feel?
Feels like I got hit in the head
with a rifle butt.
Better to be hit with
one than shot with one.
You want something
for the pain?
No, no, no,
I'll be fine.
I've had hangovers
worse than this.
Perhaps you should
drink less mouthwash.
( sighs )
So what's going to happen
to that guy they took?
Ishaak. They'll probably
bring him back for treatment
when they are finished
interrogating him.
He could be dead
by then.
Oh, yes, I'm sure
they are aware of that.
Hey.
You should go back
to the compound.
No, I'm okay.
It's almost quitting time.
He's bradycardic, 58...
0.5 epi.
He's already had two doses.
He's not responding.
Because he's hypoxic
and acidotic.
All right, give him another
bolus and find me a bag mask.
Nope.
He'll turn around
once the antibiotics kick in.
I can bag him
through this.
By yourself? All night?
It could take days.
Pulse is down to 40.
I'm doing compressions.
Are we just going
to watch him die?
No, that's what his mother does.
We have other patients.
That's messed up.
Would you please tell her
that we're very sorry?
( speaking Arabic )
CARTER:
Tell her that I know how
difficult it is to lose a child,
that my own son died when he
was very young in hospital.
She finds it hard
to believe
that babies die
in Western hospitals.
You should not have
let them take him away.
We didn't have
a choice.
Hey.
This is Ishaak's
wife, Sittina.
Hi.
You treated my husband.
I tried,
but they took him
because he didn't
fill out some form.
No! They took him away because
he tells people the truth,
that it is not safe to go back
to the villages.
People listen to him. He...
Sittina?
You okay?
Maybe you
should sit down.
Are you having
contractions?
How far apart?
( screaming )
She's eight centimeters,
100% effaced.
She's definitely having
this baby tonight.
It'll be dark soon.
Well, taking her back
to the residential compound.
She can't have it here?
She can, but we can't
stay with her.
There's electricity
back at the compound.
The only place I am going
is to the police station
( grunts ):
to get my husband.
You want the police
to deliver your baby?
( groans ):
But Ishaak...
Let's worry about the baby
first, okay?
I'll have Ibrahim
bring the truck around.
Here you go.
Grab the OB pack.
Here we go.
( panting )
Take it easy, nice and slow.
I got this.
You're late.
It's cinema night.
We're moving
to the rec room.
Gregory wants us to watch
Deuce Bigalow again.
See if you can keep
everybody in there for
a little while, all right?
Is everything all right?
Yeah, it'll be fine.
They turn the generators off
in the compound at night.
The only power in the clinic
is used for cold storage.
She would've had to deliver
the baby alone in the dark.
Try and relax, huh?
You okay?
She's progressing
very well.
She can probably start
pushing within the hour.
Talking about you.
I am tired.
I've been on my feet all day.
You are not tired?
I am tired.
I'm tired of you lying to me.
I'm tired of you ignoring
a life-threatening illness,
which needs to be treated.
Hey, hey, I promise...
if I get any worse,
I will do IV, diuretics
and sodium restrictions and
I will dry out my ascites.
It's not good enough.
You need the procedure.
Carter, what is it
he needs?
A transjugular intrahepatic
portal-systemic shunt.
Yes, well,
interventional radiology
is a little hard
to come by
when we do not even have
an X-ray machine.
Which is why you need to go
to Khartoum or Nairobi.
And when I'm lying in bed
for a month,
who is going to take care
of my patients?
Don't know. Who's going
to take care of them
when you're dead?
( sighs )
Long day, huh?
The only thing longer than the
days out here are the nights.
I'm okay, Carter. Really.
Could have fooled me.
This is nothing.
It's my weekly ritual.
Only way to get through
the pain and suffering
that surrounds this place
is to...
allow myself a good cry
every now and then.
I feel better already.
So this has nothing
to do with Stephen?
Stephen makes me angry.
He doesn't make me cry.
You tell me. You're a doctor.
What's gonna happen
if he doesn't get treated?
His condition's gonna get worse.
It's already worse.
( vehicle approaching )
It's the police. Hide her.
What? Where?
CARTER:
What's going on?
It's the police.
We got to hide her.
( groaning )
Another contraction?
Where?
Let's put her
in the bathroom.
Are these the same men
that took my husband?
I don't know.
Ask them. I want to know
what they have done with him.
Just make sure you
keep her quiet.
( screams )
Okay, okay...
Just breathe.
( speaking Arabic )
What's going on?
He is searching
for Ishaak's wife.
I told him come
in the morning,
search the camp.
( speaking Arabic )
He thinks we brought her here.
No, we don't, we don't
treat patients here.
I told him that.
( speaking Arabic )
Now he wants
to search the house.
No.
The housing unit--
that's off-limits.
( speaking Arabic )
Hey, come on,
you guys.
Do you know
what time it is?
Everybody's sleeping inside.
Okay, okay...
They're in the house.
( agonized scream )
You have to keep her quiet.
She's in labor.
Try to breathe
through the pain.
Breathe, breathe,
breathe, breathe...
Shh, shh,
shh, shh, shh...
( rap music playing )
Hey, what's up, fellas?
Whoa, whoa, sorry.
I'm next.
And I don't think
it's gonna leave a scar.
Thanks for asking.
( pounding on door )
( pounding, speaking Arabic )
Look, I've been standing out
here for 20 minutes, okay?
DAKARAI:
Pratt.
All right.
( music stops )
What the hell are you doing?!
Get out!
Get out!
Your superiors are going
to hear about this.
( panting )
Something is wrong.
( screaming )
Hang in there.
Hang in there, Sattina.
You're doing great.
I feel the head.
PRATT:
I see thick meconium.
Deceleration,
a long one.
How low?
Low.
Occiput's posterior.
We do not have time
for the baby to turn.
Prep for a C-section?
Are you out
of your mind?
All right, Sittina,
your baby is showing signs
of very serious distress.
A vaginal delivery is
gonna be too dangerous.
We need
to do a Caesarean.
No, please... save it.
I'm going to put some
anesthesia in your back.
You will lose feeling
from the waist down.
Okay, come on. Ready?
Ishaak! Oh, Ishaak!
Give me some more
counterpressure there, Pratt.
Yep.
Debbie, will you get
a blanket?
Okay, I got it.
Here we go.
( grunting )
Got it.
It's a girl, Sittina.
DAKARAI:
Allah has blessed you
with a healthy child.
( baby crying )
SITTINA:
Get her to my husband.
There's a lot of
blood in the pelvis.
CARTER:
All right, try a little
uterine massage in there.
I am. I got no suction.
I can't see where
she's bleeding from.
SITTINA:
Ishaak?
I need some sterile
four-by-fours, and keep them
coming.
If they find out who we are,
they will kill him.
Who you are?
We helped to form the HRD.
What's she talking about?
HRD-- it's a human rights group
based in Khartoum.
"Human Rights
for Darfur."
They will kill him
if they know.
Please...
Oh, man, she's bleeding out.
This was a bad idea.
We've got no blood,
no pressors, no pit,
no methergine.
What are we
supposed to do now?
She needs a
hysterectomy.
We'll bring her to a
hospital in Alfashir.
It's too late to drive.
She'll have to go tomorrow.
Because of a bunch
of thugs on camels.
They also have
trucks and guns.
Lots and lots of guns.
I think I can tie off
the uterine arteries.
That'll buy us
some time.
Give me some O-chromic
on the longest
needle we got.
Not enough time.
Couple of hours, her uterus
will start to become ischemic.
That is the best chance
that we got right now.
I grew up in Detroit.
I can be in Alfashir
in two hours.
You didn't even want
to bring her here.
PRATT:
I know,
and I made a mistake.
If we'd left her back there,
she never would've
delivered safely--
baby would've died.
Slow down, Pratt.
Okay, the uterine arteries
are tied off.
This is the only chance
she's got, you know it.
She may not
even survive the trip.
Yeah, but she's dead
if she stays here.
If she dies making
the journey,
well, at least we tried.
Okay. I'll go with you.
No, John,
you and Debbie should go
to the police.
Find Ishaak.
You have a much better
chance of getting
him out of there.
He and I, we'll close,
and then we will bring
her on to the hospital.
All right.
Okay.
Assalamu alaikum.
( speaking Arabic )
We'd like to see
Ishaak Alazhari.
No.
You can't see him.
Why not?
He's under arrest.
On what charge?
He's been shot, he needs
medical attention.
CARTER:
I'm a doctor.
I would like to evaluate
his medical condition.
How's she doing back there?
She is breathing.
What the hell is that?
Janjaweed.
We must go back.
Oh, we got a traffic jam.
If we stop,
they will take the truck...
leave her to die,
or worse.
Okay. All right,
then we don't stop.
Just cover her up and hold on.
Now, hold on, Dakarai!
Pratt!
Hold on!
( gunshots )
Look out!
Oh!
Get down, Dakarai!
( Sadig speaking Arabic )
Did you tell him that we work
for the Alliance?
The Ramalah Camp.
Mm-hmm.
All right, look,
is it money?
'Cause I can get some.
( speaking Arabic )
You must leave now.
Oh, no, I want... I would
like to speak to your boss.
Very busy.
Should I tell him
that you walked in
on this American woman
while she was bathing?
Or should I tell
the consulate
that an American woman's
privacy was violated?
How much money?
DEBBIE:
Ishaak? Ishaak, can you hear me?
I need to see him.
No, I need to go in there.
( coughs )
He's not responding.
He's dead.
The tire is flat.
Yeah. I think they hit the
oil pan and the radiator, too.
She's getting pretty hot.
What is that?
Lasix for...?
Prozac for your driving.
How fast can a horse go
with a rider?
I don't know,
maybe 30 miles an hour.
Okay.
So, we'd be going
45 miles an hour
right before the, uh,
tire blew out.
It's more like 50.
Okay, good.
Then we've got enough time.
For what?
To change the tire.
Maybe somebody in that village
can help us out over there.
( scoffs ):
Maybe...
Ah!
If there were somebody
living there.
( groans )
You all right?
DAKARAI:
Yes.
( engine shuts off )
( door slams )
( panting )
The people we treat every day...
it is places
like this from
which they come...
before the Janjaweed
burn them out.
( panting ):
Oh.
( horn honking )
He's got agonal respirations
and a thready pulse.
He's alive?
Barely.
Don't tell the police.
You ready to lift?
One, two, three, go!
All right, Zahra,
I want you to get
another IV started
and get him
back on oxygen.
What can I do to help?
You can transfer
a unit of O-neg
out of the fridge,
and when she's done, you can
squeeze in a liter of saline.
He's got decreased breath sounds
on the right.
Possible hemo-pneumo.
He'd going to need a chest tube.
I'll get it.
Where do you keep them?
We don't.
Uh, we're going
to have to improvise.
Get me a scalpel
and a curved Kelly
and a... NG tube.
As soon as the blood
that's compressing his lung
is removed, his pulse
should get stronger.
DEBBIE:
What about the bleeding?
Should stop.
If it doesn't?
Why don't you see if you
can go radio Dakarai?
They should be
in Alfashir by now.
Ow!
Do we have any extra water?!
DAKARAI:
No.
What about saline?
Four liters.
Okay, toss me one.
Ah!
Yeah.
I got to say,
this is the first time
I've ever given a bolus
to a truck before.
( chuckles )
( shouting Arabic )
PRATT:
Take it easy, man.
( shouting Arabic )
( speaking Arabic )
We just want to get her
to the hospital.
Please tell him that.
I'm trying!
( speaking Arabic )
No!
( horse neighing )
( panting )
His friends will not be
far behind.
If you try
and save him,
we will never get
away from here.
There is nothing
you can do for him now.
Come on. Get up.
Come on!
Watch your step!
All right, go.
Oh! Oh, damn!
What?
The engine has seized.
We're going to
have to hoof it.
We got to walk from here.
DAKARAI:
I can't!
Why the hell not?!
I don't think
I can walk,
and I will only
slow you down.
I can't leave you here.
You have to.
No way.
Why don't you
leave me the rifle?
Then perhaps I can
occupy his friends
while you get
to Alfashir.
How far away's the city
from here?
It is still several miles,
but you can get there.
And you really think
she's going to make it?
She will die if you don't.
You ever fire one of these?
I have never held a weapon.
PRATT:
Just point and shoot.
Okay, Sittina.
We're going to go on foot patrol
from here on in.
I'm going to give you
a little something
for the pain, okay?
( speaking Arabic )
( speaking Arabic )
What... what the hell
is she saying?
She called us angels.
I said there are no angels here.
Speak for yourself.
( gunshots )
( rapid gunfire )
You ever been to Mozambique,
Sittina?
Hear they got
great beaches there.
White sands,
cool waters...
Yeah, I definitely got
to get me to Mozambique.
( rumbling in distance )
( panting )
Okay.
Either those are the good guys,
and we're saved...
or they're bad guys,
and we're dead.
Either way...
I'm done walking.
( groans )
Very sick.
That's right.
( speaking Arabic )
I tell him fast.
Good.
You're English?
James Bond? 007?
( hums theme song ):
Duh-duh-duh-duh.
Duh-duh-duh-duh.
No.
American? Rambro?
( imitates gunfire )
Yeah. Rambro.
Good stuff.
Help me! Please! Please!
I need a doctor!
Please!
( strained grunting )
( Pratt speaking Arabic )
Please!
( breathlessly ):
She needs saline, blood,
antibiotics and a surgeon.
Hurry!
( panting )
( baby crying )
Good stuff.
( quietly ):
Yeah.
Good stuff.
( panting )
( panting )
CARTER:
Ishaak's doing much better.
The bleeding's stopped.
That's good.
He keeps asking
for Sittina.
No word yet.
Did you try the radio?
They stopped answering
the radio hours ago.
Still...
There's no signal, John,
and I haven't resorted
to sending smoke signals yet.
Okay.
Sorry.
Come on.
Let's go introduce him
to his daughter.
PRATT:
Whoa! Stop! Stop! Stop!
Careful! Careful!
( panting )
( panting )
( blowing )
( tapping object )
Come on. Let's go.
Let's go.
We had hoped to be back in our
village before the child came.
To be born in this place--
it wasn't what we
wanted for our child.
( baby fussing )
Now I can only hope that
before she is grown up,
we can go back to our village.
( baby quiets )
( clears throat ):
We tried calling the hospital
in Alfashir,
but we haven't been able
to find out anything yet.
She's there.
I'm sure of it.
ZAHRA:
Dr. Carter.
Greg, you gave us
quite a scare.
The van broke down.
Turns out even in Africa,
cabs don't stop for a brother.
Sittina?
She's going to be okay.
They're working
on her in town.
She should be able
to come back in a few days.
( speaks Arabic )
You guys fixed him up
pretty good.
Nice job.
Greg, where's Stephen?
He couldn't keep going...
and Sittina...
Tell me.
I left him on the road.
Where?
At a
burned-out village.
I went back for him,
but by the time
I got there,
I could tell the
Janjaweed had been there.
They torched the truck.
Here.
I'm sorry.
We need to go out
and look for him.
No, it's too late.
Be dark by the time
we get there.
I'll take you out first thing
in the morning.
PRATT:
Debbie.
We didn't have a lot of options.
I mean, if we stayed,
we'd all be dead.
He made me keep going.
You did what you had to do.
So did Dakarai.
Can you work?
Yeah, in a minute.
Okay.
Did you name her yet?
Yes.
Amala.
That's beautiful.
It means "hope."
( sighs )
( children chattering )
*
( indistinct conversations )
DAKARAI ( breathlessly ):
Yes, it is good to see you.
( Pratt laughing )
( Dakarai panting )
After they had
burned the truck,
I saw no reason to stick around.
( speaks Arabic )
( speaks Arabic )
Anyway, it was safer to walk.
Especially after
all of your driving.
( both laughing )
Well, I'm glad
you made it back...
You are well?
I am now.
( both laughing )
Why didn't you go to
Alfashir, you dummy?
They could've
treated you there.
Maybe next week.
Ibrahim, let's take
him to the clinic.
Tell Zahra to start him
on lactulose and saline.
( chuckles )
Careful.
Careful.
Careful.
PRATT:
That's one stubborn
son of a bitch.
CARTER:
I know the type.
You know, Carter...
( sighs )
I know I got my way of being.
That damn sure doesn't mean
I don't see or...
feel everything
that's going on around me.
Tell you the truth,
I never wanted to be around
this type of suffering.
I mean, who would?
But I am glad I came here.
I'm glad you came, too.
'Cause I sure as hell
am not going to take
the blame for that van.
Oh, gee, thanks.
It's okay. They'll take it
out of your paycheck.
What do you mean?
We actually
get paid for this?
Whoa! Hey!
Okay. Where we going?
( Pratt chuckles, boy chatters )
You sending me
to Africa?
I thought
you could use a change
of perspective.
DEBBIE:
Mouthwash? You gotta
be kidding me.
You're a weird
dude, Pratt.
So Debbie and Dakarai, huh?
Yeah, they're an item.
We're on our way
to the Dumtala camp
to help the sick people.
We are only here to help.
Generally, they do not
hurt the doctors,
but one never knows
what might happen.
( clamoring )
Welcome to Darfur.
( trucks rumbling )
( Dakarai speaking Arabic )
PRATT:
Well, we got our problems.
You ever heard of Katrina?
If the US does not lead
the way, who else will?
( Dakarai speaking Arabic )
Huh? Without international
intervention,
nothing will change here.
Ask him if he's been
taking the amoxicillin.
( speaking Arabic )
Listen,
even with intervention,
a year after us being here,
the whole world will be
screaming for us to get
the hell out of Sudan.
Oh... Pratt, I expected
so much more from you. Ahh.
Why? 'Cause I'm black?
No, because you are smart.
Yeah, well,
but I'm also American.
I did not realize
these things
are mutually exclusive.
He says yes,
he's feeling better.
Okay, good.
Listen, all I'm saying is that
it's a lot more complicated
than that.
Too many times
and way too quick getting in the
middle of other people's fights.
Fine. When the solution
does come to Darfur,
it is not going to be quick.
Yeah, well,
where I'm from,
gangs get into it all the time.
Sometimes all the cops can do
is step back
and wait
for it to end.
"Step back and wait."
You know, that sounds like
an excellent foreign policy
where people are sitting
and suffering.
Dakarai, stop ragging
on my country, okay?
There's plenty of Americans
helping out.
You see me here, right?
Yes.
And quite frankly,
I'm beginning to wonder why.
( sighs )
( speaking Arabic )
What?
She says the baby
won't move.
Okay, just show me where.
And you are moving
pretty fast for
an isolationist.
They told you
a brother was coming,
so you were expecting
Marcus Garvey?
Don't think
we have any more
in common than
you and Carter.
I don't.
In fact, I think Carter is more
African than you are.
Ah. Assalamu alaikum.
Alaikum assalamu.
( continues speaking Arabic )
How long has he been like this?
Um...
Has he had fever?
Diarrhea?
( speaking Arabic )
Baby no cry.
Yeah, he's too sick to cry.
Listen, we need
to bring him back with us.
Look, your baby
needs medicine.
We have to get him
to the hospital.
( speaking Arabic )
Where is that other doctor?
Tired.
Tired?
Okay, wait right here.
Dakarai,
what are you doing, man?
( retching )
Whoa! What the hell?
You all right?
Varices,
varices getting worse.
( retching )
You told me your IV was
for a little stomach virus.
Scarring in my liver.
Schistosomiasis
when I was a child.
Damn.
Well, congratulations.
You just became the proud winner
of a bed in tent #3.
( retching )
( groans )
Rashida Fallad.
She's 26 weeks pregnant,
and she has hepatitis E.
Hepatitis E?
I thought our
water was clean.
Mm-mm, they go outside the camp,
drink from other sources.
It shouldn't
be long now.
I think
you're overreacting.
The mortality rate
for hep E
isn't very high.
It is in pregnant women,
especially in Darfur.
Over 30% of people who contract
the disease will die.
Rashida.
Uh-huh.
Rashida.
Encephalopathy is worse.
She's pretty jaundiced.
Scleral icterus.
She's in hepatic coma.
Ask her if she's been eating
or drinking.
( speaking Arabic )
Tell her that we've been giving
her antibiotics and glucose
from an NG
feeding tube.
What did she say?
She wants to know if...
if her daughter will die
today or tomorrow.
Tell her I'm not sure.
She wants to know if
we'll need the bed.
No, no, we can wait.
( speaking Arabic )
PRATT:
Got a minute?
Mm-hmm.
So, this baby I
brought in yesterday,
she's not doing so good.
I'm having trouble
finding an IV site,
and this kid is
getting pretty dry.
Stop trying
to be so tough.
I am tough.
I'm just trying
to look out for you.
I don't need a wife.
I've already had three.
Stephen, you feeling
any better?
I don't want to be babied.
I am fine.
Why don't you stay in bed
a little longer.
I'm ready to work.
You're having
a paracentesis.
Don't be an idiot.
That's sound
medical advice.
She has no bedside manner.
Will you
talk to him?
Stay in bed until I sign off
on your chart.
When?
When I get to it.
DAKARAI:
This is why
people hate doctors.
He needed a
paracentesis?
Took five liters
off his belly.
Five liters?!
Had him on Lasix
all night.
We had to limit his sodium.
CARTER:
Good.
The man shouldn't be working.
He shouldn't even
be here.
Dr. Dakarai is very committed.
Uh-huh.
This is Mahdi,
his mom and sister.
I'm Dr. Carter.
Can you tell her
that we're gonna try
and give some fluids
to her baby?
MAN:
Dr. John!
They're bringing a man
from outside.
They say he's been shot.
Okay, 20 gauge in the femoral,
and I want you to call me
if you need me, okay?
CARTER:
Ishaak?!
PRATT:
What?
His name is Ishaak.
( Ishaak groaning )
What happened?
We got two bullets
to his chest and leg.
DAKARAI:
Look, I'm going
to help you.
No, we got it!
We handle gunshots
differently here.
We know that.
Get back in bed!
( groaning )
CARTER:
I got an entrance wound,
right chest.
Okay, belly
seems clear.
Ishaak, you left
the compound.
( grunts ):
Just to the perimeter...
to help a family get water.
He's got a strong carotid.
Okay, try for that BP.
Men on horses--
they shot me.
Let me guess: Janjaweed.
Through-and-through,
left calf.
100/60.
Why are you always
where the trouble is?
I try to help.
Ishaak is a sheik.
PRATT:
What do you mean--
like with a harem?
No, I mean
like a leader.
He's recognized as someone
the other IDPs
can look up to.
He's trying
to make a difference.
He's trying to get people here.
Yeah, well, he
should stop that.
Why say such
a thing?!
Because it's making people
want to kill him.
Give me two liters
of saline wide open.
Okay, got a good vein
in the antecube.
I'm going in with the 18.
Ishaak, we need
to move you to town.
You need more surgery
than we can do for you here.
I... I can't breathe.
We have the oxygen extractor?
ZAHRA:
Yeah, on its way.
You treating a man
with a gunshot wound here--
Ishaak Alazhari?
Not sure-- I'd have to
check with the doctors.
You can't just come
in here like this.
As long as there's no violation,
we'll leave.
( speaking Arabic )
DEBBIE:
Officer, please.
Please wait outside.
I'll look around for you.
We look for ourselves.
DAKARAI:
You cannot be in here
with those weapons.
You know the agreement
that the Alliance has
with your government!
We'll go where we need to go
and do what we need to do.
Look, the NGO rules
apply even in Darfur.
Debbie.
Ishaak, this is oxygen that
should help you breathe.
How are you doing, man?
Feeling pain when I breathe.
This man's been shot.
Yeah, that's right.
He's bleeding internally.
He needs immediate attention
and transport
to a surgical
facility.
Ishaak Alazhari, did you report
this injury to my office?
Come on.
He can do that later.
Without a Form 8, he's got
no right to medical attention.
He's got to fill out
a form first?
PRATT:
It's not gonna help much
if he's already dead.
No, no, come on.
Wait a minute.
Take it easy.
( all shouting )
PRATT:
What are you doing?!
What the hell
is the matter with you?
CARTER:
He's gonna die if you do this.
OFFICER:
He's guilty
of a Form 8 violation,
which requires that all gunshot
injuries be reported...
PRATT:
He's here now!
Please don't do this!
DAKARAI:
If you are going to do this...
Stephen!
Wait, you can't just
come in here shoving...
( Pratt shouts )
I'll send you a document
re-clarifying
the Form 8 regulation,
so this does not happen again.
Good day, Doc.
Okay, okay, let's see.
Damn!
How does that feel?
Feels like I got hit in the head
with a rifle butt.
Better to be hit with
one than shot with one.
You want something
for the pain?
No, no, no,
I'll be fine.
I've had hangovers
worse than this.
Perhaps you should
drink less mouthwash.
( sighs )
So what's going to happen
to that guy they took?
Ishaak. They'll probably
bring him back for treatment
when they are finished
interrogating him.
He could be dead
by then.
Oh, yes, I'm sure
they are aware of that.
Hey.
You should go back
to the compound.
No, I'm okay.
It's almost quitting time.
He's bradycardic, 58...
0.5 epi.
He's already had two doses.
He's not responding.
Because he's hypoxic
and acidotic.
All right, give him another
bolus and find me a bag mask.
Nope.
He'll turn around
once the antibiotics kick in.
I can bag him
through this.
By yourself? All night?
It could take days.
Pulse is down to 40.
I'm doing compressions.
Are we just going
to watch him die?
No, that's what his mother does.
We have other patients.
That's messed up.
Would you please tell her
that we're very sorry?
( speaking Arabic )
CARTER:
Tell her that I know how
difficult it is to lose a child,
that my own son died when he
was very young in hospital.
She finds it hard
to believe
that babies die
in Western hospitals.
You should not have
let them take him away.
We didn't have
a choice.
Hey.
This is Ishaak's
wife, Sittina.
Hi.
You treated my husband.
I tried,
but they took him
because he didn't
fill out some form.
No! They took him away because
he tells people the truth,
that it is not safe to go back
to the villages.
People listen to him. He...
Sittina?
You okay?
Maybe you
should sit down.
Are you having
contractions?
How far apart?
( screaming )
She's eight centimeters,
100% effaced.
She's definitely having
this baby tonight.
It'll be dark soon.
Well, taking her back
to the residential compound.
She can't have it here?
She can, but we can't
stay with her.
There's electricity
back at the compound.
The only place I am going
is to the police station
( grunts ):
to get my husband.
You want the police
to deliver your baby?
( groans ):
But Ishaak...
Let's worry about the baby
first, okay?
I'll have Ibrahim
bring the truck around.
Here you go.
Grab the OB pack.
Here we go.
( panting )
Take it easy, nice and slow.
I got this.
You're late.
It's cinema night.
We're moving
to the rec room.
Gregory wants us to watch
Deuce Bigalow again.
See if you can keep
everybody in there for
a little while, all right?
Is everything all right?
Yeah, it'll be fine.
They turn the generators off
in the compound at night.
The only power in the clinic
is used for cold storage.
She would've had to deliver
the baby alone in the dark.
Try and relax, huh?
You okay?
She's progressing
very well.
She can probably start
pushing within the hour.
Talking about you.
I am tired.
I've been on my feet all day.
You are not tired?
I am tired.
I'm tired of you lying to me.
I'm tired of you ignoring
a life-threatening illness,
which needs to be treated.
Hey, hey, I promise...
if I get any worse,
I will do IV, diuretics
and sodium restrictions and
I will dry out my ascites.
It's not good enough.
You need the procedure.
Carter, what is it
he needs?
A transjugular intrahepatic
portal-systemic shunt.
Yes, well,
interventional radiology
is a little hard
to come by
when we do not even have
an X-ray machine.
Which is why you need to go
to Khartoum or Nairobi.
And when I'm lying in bed
for a month,
who is going to take care
of my patients?
Don't know. Who's going
to take care of them
when you're dead?
( sighs )
Long day, huh?
The only thing longer than the
days out here are the nights.
I'm okay, Carter. Really.
Could have fooled me.
This is nothing.
It's my weekly ritual.
Only way to get through
the pain and suffering
that surrounds this place
is to...
allow myself a good cry
every now and then.
I feel better already.
So this has nothing
to do with Stephen?
Stephen makes me angry.
He doesn't make me cry.
You tell me. You're a doctor.
What's gonna happen
if he doesn't get treated?
His condition's gonna get worse.
It's already worse.
( vehicle approaching )
It's the police. Hide her.
What? Where?
CARTER:
What's going on?
It's the police.
We got to hide her.
( groaning )
Another contraction?
Where?
Let's put her
in the bathroom.
Are these the same men
that took my husband?
I don't know.
Ask them. I want to know
what they have done with him.
Just make sure you
keep her quiet.
( screams )
Okay, okay...
Just breathe.
( speaking Arabic )
What's going on?
He is searching
for Ishaak's wife.
I told him come
in the morning,
search the camp.
( speaking Arabic )
He thinks we brought her here.
No, we don't, we don't
treat patients here.
I told him that.
( speaking Arabic )
Now he wants
to search the house.
No.
The housing unit--
that's off-limits.
( speaking Arabic )
Hey, come on,
you guys.
Do you know
what time it is?
Everybody's sleeping inside.
Okay, okay...
They're in the house.
( agonized scream )
You have to keep her quiet.
She's in labor.
Try to breathe
through the pain.
Breathe, breathe,
breathe, breathe...
Shh, shh,
shh, shh, shh...
( rap music playing )
Hey, what's up, fellas?
Whoa, whoa, sorry.
I'm next.
And I don't think
it's gonna leave a scar.
Thanks for asking.
( pounding on door )
( pounding, speaking Arabic )
Look, I've been standing out
here for 20 minutes, okay?
DAKARAI:
Pratt.
All right.
( music stops )
What the hell are you doing?!
Get out!
Get out!
Your superiors are going
to hear about this.
( panting )
Something is wrong.
( screaming )
Hang in there.
Hang in there, Sattina.
You're doing great.
I feel the head.
PRATT:
I see thick meconium.
Deceleration,
a long one.
How low?
Low.
Occiput's posterior.
We do not have time
for the baby to turn.
Prep for a C-section?
Are you out
of your mind?
All right, Sittina,
your baby is showing signs
of very serious distress.
A vaginal delivery is
gonna be too dangerous.
We need
to do a Caesarean.
No, please... save it.
I'm going to put some
anesthesia in your back.
You will lose feeling
from the waist down.
Okay, come on. Ready?
Ishaak! Oh, Ishaak!
Give me some more
counterpressure there, Pratt.
Yep.
Debbie, will you get
a blanket?
Okay, I got it.
Here we go.
( grunting )
Got it.
It's a girl, Sittina.
DAKARAI:
Allah has blessed you
with a healthy child.
( baby crying )
SITTINA:
Get her to my husband.
There's a lot of
blood in the pelvis.
CARTER:
All right, try a little
uterine massage in there.
I am. I got no suction.
I can't see where
she's bleeding from.
SITTINA:
Ishaak?
I need some sterile
four-by-fours, and keep them
coming.
If they find out who we are,
they will kill him.
Who you are?
We helped to form the HRD.
What's she talking about?
HRD-- it's a human rights group
based in Khartoum.
"Human Rights
for Darfur."
They will kill him
if they know.
Please...
Oh, man, she's bleeding out.
This was a bad idea.
We've got no blood,
no pressors, no pit,
no methergine.
What are we
supposed to do now?
She needs a
hysterectomy.
We'll bring her to a
hospital in Alfashir.
It's too late to drive.
She'll have to go tomorrow.
Because of a bunch
of thugs on camels.
They also have
trucks and guns.
Lots and lots of guns.
I think I can tie off
the uterine arteries.
That'll buy us
some time.
Give me some O-chromic
on the longest
needle we got.
Not enough time.
Couple of hours, her uterus
will start to become ischemic.
That is the best chance
that we got right now.
I grew up in Detroit.
I can be in Alfashir
in two hours.
You didn't even want
to bring her here.
PRATT:
I know,
and I made a mistake.
If we'd left her back there,
she never would've
delivered safely--
baby would've died.
Slow down, Pratt.
Okay, the uterine arteries
are tied off.
This is the only chance
she's got, you know it.
She may not
even survive the trip.
Yeah, but she's dead
if she stays here.
If she dies making
the journey,
well, at least we tried.
Okay. I'll go with you.
No, John,
you and Debbie should go
to the police.
Find Ishaak.
You have a much better
chance of getting
him out of there.
He and I, we'll close,
and then we will bring
her on to the hospital.
All right.
Okay.
Assalamu alaikum.
( speaking Arabic )
We'd like to see
Ishaak Alazhari.
No.
You can't see him.
Why not?
He's under arrest.
On what charge?
He's been shot, he needs
medical attention.
CARTER:
I'm a doctor.
I would like to evaluate
his medical condition.
How's she doing back there?
She is breathing.
What the hell is that?
Janjaweed.
We must go back.
Oh, we got a traffic jam.
If we stop,
they will take the truck...
leave her to die,
or worse.
Okay. All right,
then we don't stop.
Just cover her up and hold on.
Now, hold on, Dakarai!
Pratt!
Hold on!
( gunshots )
Look out!
Oh!
Get down, Dakarai!
( Sadig speaking Arabic )
Did you tell him that we work
for the Alliance?
The Ramalah Camp.
Mm-hmm.
All right, look,
is it money?
'Cause I can get some.
( speaking Arabic )
You must leave now.
Oh, no, I want... I would
like to speak to your boss.
Very busy.
Should I tell him
that you walked in
on this American woman
while she was bathing?
Or should I tell
the consulate
that an American woman's
privacy was violated?
How much money?
DEBBIE:
Ishaak? Ishaak, can you hear me?
I need to see him.
No, I need to go in there.
( coughs )
He's not responding.
He's dead.
The tire is flat.
Yeah. I think they hit the
oil pan and the radiator, too.
She's getting pretty hot.
What is that?
Lasix for...?
Prozac for your driving.
How fast can a horse go
with a rider?
I don't know,
maybe 30 miles an hour.
Okay.
So, we'd be going
45 miles an hour
right before the, uh,
tire blew out.
It's more like 50.
Okay, good.
Then we've got enough time.
For what?
To change the tire.
Maybe somebody in that village
can help us out over there.
( scoffs ):
Maybe...
Ah!
If there were somebody
living there.
( groans )
You all right?
DAKARAI:
Yes.
( engine shuts off )
( door slams )
( panting )
The people we treat every day...
it is places
like this from
which they come...
before the Janjaweed
burn them out.
( panting ):
Oh.
( horn honking )
He's got agonal respirations
and a thready pulse.
He's alive?
Barely.
Don't tell the police.
You ready to lift?
One, two, three, go!
All right, Zahra,
I want you to get
another IV started
and get him
back on oxygen.
What can I do to help?
You can transfer
a unit of O-neg
out of the fridge,
and when she's done, you can
squeeze in a liter of saline.
He's got decreased breath sounds
on the right.
Possible hemo-pneumo.
He'd going to need a chest tube.
I'll get it.
Where do you keep them?
We don't.
Uh, we're going
to have to improvise.
Get me a scalpel
and a curved Kelly
and a... NG tube.
As soon as the blood
that's compressing his lung
is removed, his pulse
should get stronger.
DEBBIE:
What about the bleeding?
Should stop.
If it doesn't?
Why don't you see if you
can go radio Dakarai?
They should be
in Alfashir by now.
Ow!
Do we have any extra water?!
DAKARAI:
No.
What about saline?
Four liters.
Okay, toss me one.
Ah!
Yeah.
I got to say,
this is the first time
I've ever given a bolus
to a truck before.
( chuckles )
( shouting Arabic )
PRATT:
Take it easy, man.
( shouting Arabic )
( speaking Arabic )
We just want to get her
to the hospital.
Please tell him that.
I'm trying!
( speaking Arabic )
No!
( horse neighing )
( panting )
His friends will not be
far behind.
If you try
and save him,
we will never get
away from here.
There is nothing
you can do for him now.
Come on. Get up.
Come on!
Watch your step!
All right, go.
Oh! Oh, damn!
What?
The engine has seized.
We're going to
have to hoof it.
We got to walk from here.
DAKARAI:
I can't!
Why the hell not?!
I don't think
I can walk,
and I will only
slow you down.
I can't leave you here.
You have to.
No way.
Why don't you
leave me the rifle?
Then perhaps I can
occupy his friends
while you get
to Alfashir.
How far away's the city
from here?
It is still several miles,
but you can get there.
And you really think
she's going to make it?
She will die if you don't.
You ever fire one of these?
I have never held a weapon.
PRATT:
Just point and shoot.
Okay, Sittina.
We're going to go on foot patrol
from here on in.
I'm going to give you
a little something
for the pain, okay?
( speaking Arabic )
( speaking Arabic )
What... what the hell
is she saying?
She called us angels.
I said there are no angels here.
Speak for yourself.
( gunshots )
( rapid gunfire )
You ever been to Mozambique,
Sittina?
Hear they got
great beaches there.
White sands,
cool waters...
Yeah, I definitely got
to get me to Mozambique.
( rumbling in distance )
( panting )
Okay.
Either those are the good guys,
and we're saved...
or they're bad guys,
and we're dead.
Either way...
I'm done walking.
( groans )
Very sick.
That's right.
( speaking Arabic )
I tell him fast.
Good.
You're English?
James Bond? 007?
( hums theme song ):
Duh-duh-duh-duh.
Duh-duh-duh-duh.
No.
American? Rambro?
( imitates gunfire )
Yeah. Rambro.
Good stuff.
Help me! Please! Please!
I need a doctor!
Please!
( strained grunting )
( Pratt speaking Arabic )
Please!
( breathlessly ):
She needs saline, blood,
antibiotics and a surgeon.
Hurry!
( panting )
( baby crying )
Good stuff.
( quietly ):
Yeah.
Good stuff.
( panting )
( panting )
CARTER:
Ishaak's doing much better.
The bleeding's stopped.
That's good.
He keeps asking
for Sittina.
No word yet.
Did you try the radio?
They stopped answering
the radio hours ago.
Still...
There's no signal, John,
and I haven't resorted
to sending smoke signals yet.
Okay.
Sorry.
Come on.
Let's go introduce him
to his daughter.
PRATT:
Whoa! Stop! Stop! Stop!
Careful! Careful!
( panting )
( panting )
( blowing )
( tapping object )
Come on. Let's go.
Let's go.
We had hoped to be back in our
village before the child came.
To be born in this place--
it wasn't what we
wanted for our child.
( baby fussing )
Now I can only hope that
before she is grown up,
we can go back to our village.
( baby quiets )
( clears throat ):
We tried calling the hospital
in Alfashir,
but we haven't been able
to find out anything yet.
She's there.
I'm sure of it.
ZAHRA:
Dr. Carter.
Greg, you gave us
quite a scare.
The van broke down.
Turns out even in Africa,
cabs don't stop for a brother.
Sittina?
She's going to be okay.
They're working
on her in town.
She should be able
to come back in a few days.
( speaks Arabic )
You guys fixed him up
pretty good.
Nice job.
Greg, where's Stephen?
He couldn't keep going...
and Sittina...
Tell me.
I left him on the road.
Where?
At a
burned-out village.
I went back for him,
but by the time
I got there,
I could tell the
Janjaweed had been there.
They torched the truck.
Here.
I'm sorry.
We need to go out
and look for him.
No, it's too late.
Be dark by the time
we get there.
I'll take you out first thing
in the morning.
PRATT:
Debbie.
We didn't have a lot of options.
I mean, if we stayed,
we'd all be dead.
He made me keep going.
You did what you had to do.
So did Dakarai.
Can you work?
Yeah, in a minute.
Okay.
Did you name her yet?
Yes.
Amala.
That's beautiful.
It means "hope."
( sighs )
( children chattering )
*
( indistinct conversations )
DAKARAI ( breathlessly ):
Yes, it is good to see you.
( Pratt laughing )
( Dakarai panting )
After they had
burned the truck,
I saw no reason to stick around.
( speaks Arabic )
( speaks Arabic )
Anyway, it was safer to walk.
Especially after
all of your driving.
( both laughing )
Well, I'm glad
you made it back...
You are well?
I am now.
( both laughing )
Why didn't you go to
Alfashir, you dummy?
They could've
treated you there.
Maybe next week.
Ibrahim, let's take
him to the clinic.
Tell Zahra to start him
on lactulose and saline.
( chuckles )
Careful.
Careful.
Careful.
PRATT:
That's one stubborn
son of a bitch.
CARTER:
I know the type.
You know, Carter...
( sighs )
I know I got my way of being.
That damn sure doesn't mean
I don't see or...
feel everything
that's going on around me.
Tell you the truth,
I never wanted to be around
this type of suffering.
I mean, who would?
But I am glad I came here.
I'm glad you came, too.
'Cause I sure as hell
am not going to take
the blame for that van.
Oh, gee, thanks.
It's okay. They'll take it
out of your paycheck.
What do you mean?
We actually
get paid for this?
Whoa! Hey!
Okay. Where we going?
( Pratt chuckles, boy chatters )