ER (1994–2009): Season 7, Episode 15 - The Crossing - full transcript

[theme music]

(female narrator)
Previously on "ER.."

So the baby's a girl today.

You turned me in?

There's a guy from
the medical board here

questioning my competency?

(Peter)
Minority kids
don't have the same

access to academic opportunity.

You want to address
that by advancing

under qualified applicants
at the expense

'of our integrity and theirs.'



I want him to have an interview.

Everyone deserves to be
comforted in their darkest hour.

Too bad you weren't there

to comfort the little
girl he killed.

I didn't need to be.

‐ 'God was there.'
‐ Was he?

Bishop Stewart?

Can you hear me?

Call 911.

Again.

It hurts when I breathe.

Could it be my heart?

Something wrong?

‐ Hey?
‐ What?



Is there something
wrong with my heart?

No, probably a bruise
to your chest wall.

We'll get an X‐ray to make sure.

You were lucky.

We'll probably be sifting
through the walking wounded

until morning, but I think
we're over the hump.

Carter just brought up
the last critical.

How many came in?

37. Five in surgery.

Only two ER deaths.

That's not too bad considering.

If you don't count the DOAs.

You did a great job.

You should go home.
We got it from here.

‐ The board's backing up.
‐ We're fine. Go home.

We'll see you tomorrow.

[humming]

[siren wailing]

[dramatic music]

Hey. You're leaving?

Uh, no, I‐I thought
I'd check on the bishop.

Another critical come in?

No, no. That's it.

‐ Is she stable?
‐ Yeah.

After three rounds
of Terbutaline.

‐ Good.
‐ It was scary though.

Yeah.

So are you heading home soon?

Uh, I don't know.

You okay?

Yeah.

[elevator bell dings]

Any change?

He didn't want
the breathing mask.

Has he been awake?

Napping on and off.

[groans]

Hi.

What time is it?

11:30.

You're here late.

You'll have to
be intubated soon.

On a ventilator?

Your oxygen level
is down to 65 on 100% oxygen.

I've seen what happens
after a ventilator.

If it drops below 50..

Thanks, but no thanks.

[beeping]

'Anyway..'

...my bags are packed.

[theme music]

Water! I need water!

‐ Mr. Martin.
‐ Oh, it stings.

Mr. Martin, I told you,
just give it a few seconds.

No, it stings.

Just give it a few seconds
and the pain will fade.

‐ Need some help?
‐ No.

I just put in a drop of Alcaine.

Mr. Martin feel asleep
under a tanning lamp.

I wasn't tanning.

I was depressed due
to lack of sunlight.

Tell me about it.
I just got back from lunch.

It was already getting dark.

UTI in four is gone.

Did the groundhog see
its shadow this year?

Seeing its shadow has
absolutely nothing to do

with how much
of sunlight we get.

Yes, it does.

Six more weeks of winter.

Seven‐year‐old with diarrhea

and wheezing,
ordered Solu‐Medrol

and breathing treatment.

‐ Any history of asthma?
‐ Nope.

‐ Fever or cough?
‐ Nothing.

Carter, you wanna
figure this one out?

Bring it on.

Okay, that's it.
Weaver's on at 6:00.

Could you tell her that
I'm finished testing tonight

so she can stop avoiding me.

How'd your personality test go?

I scored somewhere between

serial killer
and talk show host.

I thought they
were memory tests.

‐ That was Monday.
‐ What's next?

Rorschach? Spelling bee?

Swimwear competition,
sudden‐death twister, who knows?

Maybe a chili cook‐off.

The needle goes in

but you can squeeze
on the owie ball.

‐ See that?
‐ What's up?

Kid freaked out when
I tried to start an IV on him.

And then the needle comes out.

‐ Who's that?
‐ Yeah.

She's a new intern from pedes.

They hook up this tube
to give you the medicine.

Then it won't
hurt anymore, okay?

Hey, Jason, Dr. Carter.

I understand you're having
a little trouble breathing.

‐ Are you mom?
‐ Yes.

‐ Any history of asthma here?
‐ Uh, no.

Mrs. Fabrone works as
a cleaning lady at a church.

She found a bottle of
holy water in the sanctuary

and she thought it might
help with Jason's diarrhea.

‐ Holy water, huh?
‐ Only it tasted funny.

When Jason started coughing,
she checked. It was lamp oil.

‐ He aspirated holy oil?
‐ 'I guess so.'

[sobbing]

That's the common duct.
We don't cut that.

‐ What time is it?
‐ 4:55.

No, no, no,
your interview tomorrow.

Oh, 10:00 a. m.

Get there by 9:30.

Right.

So why do you wanna
be a doctor?

What?

It's a common question
in the interview.

'Oh, yeah.'

Clips.

‐ 'So what's the answer?'
‐ I wanna help people.

Oh, man.

No?

Alright.

Now we dissect the gallbladder
from the liver.

‐ What's the right answer?
‐ You tell me.

The money?

I wanna be a role model.

You know what, if you're not
gonna take this seriously..

'I am. I just don't know.'

I guess, I always
thought it'd be cool.

Well, at least that's honest.

‐ So I should say that?
‐ Of course not.

Dr. Benton, how much
longer do you have?

‐ Are you timing me, Shirley?
‐ 'The mass‐cas called in.'

'They're gonna
need you downstairs.'

‐ 'What happened?'
‐ 'They didn't give me details.'

Alright, let me get
some more suction.

I'll be maybe 15 minutes.

Okay.

You should hang out.

You never know what you'll see.

Great job, Jason. I'll stop
by and see you later, okay?

‐ You're admitting him?
‐ Yeah, just for a day.

Keep him on continuous nebs
and monitor his stats.

Where's mom?

She went to go
talk to her priest.

Could've used you, actually.

She got a little
upset after you left.

About her kid or because
she stole from the church?

My friend Tony Cirasolo

he used to lift
communion wine for us.

He just went to confession.

Uh, what about you?

Me, I‐I just got sick.

So you're a heathen.

Protestant.

[scoffs]
Is there a difference?

‐ Uh, will you sign this for me?
‐ 'What is it?'

It's for my supervisor.

And if you think I did
a good job with the kid.

Child life specialist.

Intern. First day.

Oh, yeah? Hey, welcome.

John Carter.

Rena Trujillo. Nice to meet you.

And you.

‐ Don't forget your voodoo doll.
‐ Oh, it's a procedure doll.

Yeah, they make them
life‐size for really big kids?

‐ Why, you're lonely?
‐ Yeah, I work a lot.

That's too bad.

‐ John, Luka needs you.
‐ Abby, this is Rena.

Hi. A train derailed
by Lakeshore.

They're declaring an MVI. They
need to set up a triage center.

Excuse me.

‐ Any passenger cars?
‐ It was a commuter train.

‐ How many?
‐ They don't know.

They're just pulling bodies out.
They need doctors on site.

Prep the trauma rooms. Set up
curtain two and three for majors

and call everybody in.
Carter, let's go.

‐ Is the chopper already here?
‐ They'll meet us on the roof.

‐ We don't have an attending.
‐ Kerry's due in 15 minutes.

Call me on the chopper
if you have any problems.

Four units of O‐neg.

Move all stable patients
into the hall.

Double up the rooms.
Anyone walking waits in chairs.

Put all surgical teams
on alert and notify the OR.

Already did. We're low on vents.

Well, then grab
some from the ICU.

Found it.

Randi, call the
nursing supervisor

and float some
nurses from the unit.

They'll need 'em up there.

‐ Get 'em from med‐surg.
‐ Oh, my God!

[helicopter whirring]

[siren wailing]

[indistinct chatter]

Captain Davis,
incident commander.

We were evacuating
the first passenger car

when it rolled, I got
a man crushed underneath.

His legs are pinned.

'14 DOAs so far,
we're still pulling them out.'

‐ Two middle cars are the worst.
‐ What happened?

(Davis)
An automobile
stalled on the tracks.

We think the brakes
on the back cars failed

when the train tried to stop.

(Harms)
Blunt chest trauma over here.

‐ 'Dropping his pressure.'
‐ 'I've got it.'

'You take the crush injury.'

[siren wailing]

‐ What's on the monitor?
‐ Sinus tach.

‐ Vitals?
‐ BP 90/60, pulse's 120.

I was supposed to fly.

My damn flight was cancelled.

(Luka)
'Okay. Rales on the left.'

My chest feels like
something tore inside.

(John)
Try a 14‐gauge
and bolus a liter of saline.

(Lorcan)
'Mitch, Mitch, I'm sorry, man.'

(Davis)
'Don't apologize to me.'

Yeah, I didn't know it was
going to tip over like that.

BP 85/60, pulse 110.

Doc, I need something
more for the pain.

This isn't working.

‐ What did you give him?
‐ Ten of morphine.

Had to hold off when
he dropped his pressure.

Alright, give him five more
but after the liter!

[gasping]

How long till we
can get him out?

We couldn't lift it
with the jacks‐‐

‐ How long?
‐ How long do you have?

‐ Get a jack on this.
‐ That jack's not gonna hold.

‐ Is she conscious?
‐ Yeah.

I'm Dr. Kovac. What's your name?

‐ I couldn't get out.
‐ Your name?

‐ Do you know your name?
‐ Shannon.

‐ Okay, does your neck hurt?
‐ No.

(John)
'Hey, Luka.'

‐ What?
‐ We might need a surgeon.

Call it in.

We might not be
able to get him out.

I need a surgeon
with a field amputation kit.

‐ 'He's on standby.'
‐ No, no, not on standby!

Here now!
He's losing a lot of blood.

[indistinct chatter]

[helicopter whirring]

[helicopter whirring]

[siren wailing]

[gunfire]

(female #1)
'Help.'

Ma'am, has someone examined you?

They're looking for my son.

He wanted to go to
the bathroom by himself.

Okay, let's get you out.

I can't move my legs.

Does your neck hurt?

Please, you have to find my son.

Okay, lean forward.

I can't.

[groans]

Doris!

(Doris)
'Are you allergic
to any medicines?'

He's wearing a blue sweater.

‐ Doris!
‐ 'In a sec.'

I need a line
and a set of vitals.

He's seven.

He wanted to go to
the bathroom by himself.

Saline, wide open, nasal O2

and get me if she's hypotensive.

Please, you have to find him.

Hold on.

Are you looking
for a little boy?

(male #1)
'He's pinned.
We have to cut him free.'

Can you get a BP?

No room. Pulse is thready.

‐ 'How do I get in there?'
‐ The roof.

‐ Systolic's 95.
‐ Make it two liters.

Radio the IC. I need a metal
cut before we transport.

‐ Did they find him?
‐ I think so.

Is he okay?

I don't know yet.

‐ What's his name?
‐ Myles.

[dramatic music]

[siren wailing]

‐ Where is he?
‐ Over here.

[music continues]

‐ Got an airway?
‐ 'Breathing on his own.'

(male #2)
'We're waiting
on a circular saw.'

Myles?

Myles, can you hear me?

Pupils are poorly reactive.

Looks like a closed head injury.
We need to get him out.

I told you,
equipment's on its way.

Get it here now!

[helicopter whirring]

She's throwing PVCs.
Do you want us to treat?

‐ What?
‐ A couple ectopic beats.

‐ Can we give Lidocaine?
‐ What's the injury?

Train hit her car.
Possible pubic ramus fracture.

No, no, not at her age.

Just get her to County.
Where's the amputation?

‐ I don't know.
‐ Over here.

We got a crush
injury to the legs.

BP's 90/65 with fluids.

But I don't know how much
longer we can keep it that way.

‐ They can't get him out?
‐ They're trying to.

But these things
weigh like..

[Elizabeth screams]

‐ Oh!
‐ You alright?

‐ You okay?
‐ Oh, dammit.

‐ Come on.
‐ Ah!

I'm fine, I'm fine.

[groans]

‐ What's his name?
‐ Who?

‐ The firefighter.
‐ Lorcan.

I had to inflate two BP
cuffs to use as tourniquets.

Watch your step.

Right.

‐ You okay?
‐ Yes.

Lorcan, I'm Elizabeth Corday.
I'm a surgeon.

‐ You going to cut them off?
‐ Only if I have to.

Now listen, we can't give
you much more pain medication

because we need to keep
your blood pressure up.

So I'm going to give
you a nerve block, okay?

Do it fast!

Prep the groin area. Betadine.

‐ 'How much fluid in?'
‐ Three liters saline.

‐ Two of O‐neg.
‐ 20‐gauge for the injection.

These cuffs aren't holding.

I'm gonna re‐inflate them
and then clamp them.

Lorcan, you want
me to call Patty?

‐ No.
‐ 'You sure?'

I'm not dying, man.

Alright, buddy.

‐ Who's Patty?
‐ Patty's my ex‐wife.

'Guys and I were going
out after the shift'

to celebrate
my divorce going through.

Okay, everybody, get back.

We're gonna hammer
through this concrete.

Just a second!

Come on. Let's do this!

‐ Hold on, Lorcan.
‐ 'Get me out.'

You get it?

Done.

Thanks.

‐ 'That's it.'
‐ 'Okay, on three.'

'One, two, three.'

Where's the backboard?

'Paramedics are bringing it in.'

[indistinct chatter]

Is he still breathing?

Yes. Good air entry.

How many did you
say we could take?

I didn't. They're transporting
all over the city.

Yeah, we're two docs down
and a surgeon in the field.

You want me to page Dr. Greene?

He's at his competency testing.

Okay, find out how many
they're sending us.

Malucci's on his way down
with the first air‐evac

a possible aortic rupture.

Peter, you're up first.

‐ I got it.
‐ No, elevator.

Call CT. Have them
cancel all elective cases.

I don't want them
jamming up on us.

Stay close to me.
If you have any questions, ask.

I might not be able
to answer immediately.

Also don't be surprised if the
nurses push you out of the way.

It's their job. Just try not
to knock anything over, okay?

‐ I don't need to stay?
‐ Only if you want to.

Blunt chest trauma.
Asymmetric BPs.

Dropped his pressure en route.

60 palp, tachy at 120.

Sir, do you know where you are?

I was taking a plane.

Oriented times one only.

Marked tachypnea. Pulse ox 88.

‐ Heart sounds are muffled.
‐ What does that mean?

He trashed his aorta.

Alright, it's the major
artery from the heart.

‐ Neck veins are distended.
‐ He's in tamponade.

‐ Have the OR prime bypass.
‐ You our new third year?

‐ No, I'm just applying.
‐ 'Come on, get over here.'

Move.

Alright, let's prep
for pericardiocentesis.

(Haleh)
'Too late. Lost the pulse.'

Alright, thoracotomy tray.
You better put on a gown.

It's gonna get
bloody in here.

‐ What do you got?
‐ We got abdominal wound.

BP's 120/90.
We're taking her to Lakeshore.

What, are you kidding me?
She needs a trauma center.

Alright, reroute to county.

Give her ten more of MS
and watch the pressure.

‐ We're supposed to rotate‐‐
‐ Just do it.

‐ Doc! Doc!
‐ Yeah.

Tracheal shift to the left.
You need to stick him.

‐ What's his pulse ox?
‐ 88 on high flow O2.

I can't hear anything
with all this noise.

Did you get it?

I don't know.

[helicopter whirring]

‐ Are these all ours?
‐ No, it's the damn news.

Okay, he's moving air.

Take him to county,
not Lakeshore. County.

Tell them he needs
a chest tube, maybe a vent.

Alright.

[screaming]

‐ Stop! Stop!
‐ 'No, don't you stop!'

I think I may have
strained my back.

‐ Go on. Keep digging.
‐ We can't.

If we keep digging the weight
of the train will shift on you.

‐ Is that crane coming?
‐ From Indiana.

‐ What?
‐ It's on its way, Lorcan.

‐ What's his pressure?
‐ 85 palp. Pulse 110.

'Four units in.'

‐ Can you assist?
‐ Yeah, I can start.

(Elizabeth)
'Lorcan, listen to me.'

I'm gonna have to proceed with
amputating both your legs.

No, no!

I've had people trapped for
hours before we got them out.

I appreciate that
but you've lost too much blood.

If I don't amputate
and control the bleeding

'you're going to die.'

Okay then,
I'm gonna start.

Do you understand?

'I have to start now.'

Prep the area.

Ten blade.

[grunting]

Can you tell my
fortune with these?

Pick up each card from your pile

and put it under the card
to which it belongs.

Is that the death card?

I'll tell you
if you're right or wrong.

Are you ready to begin?

‐ Hit me.
‐ Begin.

'No.'

'No, just try the next card.'

'No.'

Yes. Third one's a charm.

'Yes.'

'Yes.'

‐ 'Yes.'
‐ Look, two hands.

'Yes.'

‐ 'No.'
‐ No?

No.

No.

Do you ever say anything
besides yes or no?

No.

(Elizabeth)
'I've isolated
the femoral artery.'

'Retract distally.'

(John)
'I've got some
oozing from the SFA.'

(Elizabeth)
I can't do much about
that in the field.

‐ Mitch!
‐ I'm right here, buddy.

I think maybe you
should get Patty.

You got it.

I need to dissect
this vessel out.

Metz.

[groans]

‐ Oh!
‐ What? What is it?

‐ Carter, quick, clamp that.
‐ What, what, what?

Medial to the muscle bed.
Clamp it now.

Is it your back?

It's coming and going.

Intermittent pain?

‐ Yes.
‐ 'How often?'

[groans]

‐ What's her pressure?
‐ Dropping, 80 palp.

Myles.

(Luka)
'Start her on dopamine,
titrate to 100.

Save him, please.

How long till you're through?

I don't know. Ten minutes maybe.

(McManus)
'Pupils are still sluggish.'

(Luka)
'Okay, 0.3 of atropine.'

‐ 'Do you have any Mannitol?'
‐ On board.

Hang 40 grams.

He's hypertensive
and bradying down.

I know.

He could have a bleed.

You're not going with us?

[sighs]

Okay, load him.

I'll be right back.

Carter, I have to
take this boy in.

There's a woman back there
impaled with spinal shock

and I want you to
stay with. What is it?

‐ 'She's having contractions.'
‐ What?

She's having
contractions at 25 weeks!

I need tocolytics
and a fetal monitor.

I can keep on going if
I can just get them to stop.

‐ Do you have any Terbutaline?
‐ No!

‐ In the rig?
‐ We don't carry it.

Okay, you should
fly back with us.

Carter, take the mother,
the woman down there.

What about him? We just opened
the anterior compartment.

‐ Call another surgeon.
‐ We're out of O‐neg.

We have to finish him now.

If we put you on the chopper
could you monitor

this boy on the flight back?

Yes, but he could exsanguinate
from his left leg.

You were
a surgical resident, yeah?

Intern, for a year.

Trauma panel.
Chest and pelvis. Get a HemoCue.

Sinus, rate of 95.

‐ Any chest pain?
‐ No.

(Kerry)
'Mild guarding. No rebound.'

'Set her up for a CT
and put in a Foley.'

‐ Is that man from the train?
‐ Yeah.

‐ Is he dying?
‐ I don't know.

Abby, could you
shut the doors, please?

Type and cross for four,
dip a urine.

More O‐neg on the infuser.
The heart's not filling.

(Haleh)
'Unit seven going up.'

Got it. Cut. Okay,
come on, you're done.

‐ We've gotta shock him.
‐ Hold on, couple more sutures.

Dr. Benton, Dr. Finch
needs you. Bad leg injury.

‐ Got it.
‐ Clear!

(Peter)
'Alright, Dr. Malucci,
he's all yours.'

If you get a rhythm send him up.
White, you're coming with me.

‐ 'Still in V‐fib.'
‐ 'Another amp of epi.'

Stand by with Lidocaine. Clear!

Peter, I have a right orbital
trauma with loss of vision.

Set up the slit lamp, Tetracaine

and fluorescein,
I'll be right there.

Dr. Benton, blunt abdominal
trauma, possible liver injury.

‐ What's the crit?
‐ 34, but he's pretty tender.

‐ Alright, do an ultrasound.
‐ Chuny, I need vitals now.

'Coming.'

Traumatic extrusion
of the tibia.

You call ortho?

Yes, but it's
looking pretty dusky.

‐ Hold on, that's my bone!
‐ Alright.

All the major
vessels seem intact.

Let's try to get him up there.

Peter, Carter's on the radio.

‐ Needs to talk to you.
‐ Not now.

He's performing a double
amputation by himself.

‐ What?
‐ 'A guy pinned under a train.'

Don't worry, sir.
That can be reimplanted.

Okay, give another 20 MS.

(Chuny)
'Okay, he's on bravo three.'

Carter, what are you doing?

'Left anterior thigh.'

I've incised through
the fascia and muscle planes.

'I need to isolate
the neurovascular bundle.'

Whoa, whoa, wait, hold on,
I thought Corday went with you.

‐ 'She did.'
‐ Well, what is she doing?

'We've got to
control his airway.'

BP's rocketing. 240/120.

Pulse down to 30.

Another mig of atropine
and mix Nipride.

He's in respiratory distress.

I'll intubate.

6.5 ET tube.

Should we stay on the ground?

No. Let's go.

50 of Lido, one of
Pavulon, 50 of sux.

‐ 'You okay?'
‐ No!

[dramatic music]

(Peter)
'Using the dull edge of
the Metz or your finger'

'continue blunt
dissection of the artery'

'from the neurovascular bundle.'

‐ What?
‐ 'Blunt dissection.'

'Is the clamp in place?'

You're going to have to shout!
I can barely hear you!

'Do you know what you're doing?'

Does anybody know
what they're doing?

‐ What's he down to now?
‐ 190/100. Pulse 44.

‐ After two minutes.
‐ Try 80 of Lasix.

Let them take him downstairs.

No, go straight to CT.

There's a case on the table.

[groaning]
He probably has an epidural.

I'll tell 'em.

How often have you
been having back pain?

Every four, five minutes.

When's the last time
you felt the baby move?

[gasps]
I don't know.

I haven't.

Okay.

Got it!

Can you call on the radio
and see how he is?

We'll be there soon.

BP 95/65. Pulse is 110.

[gasps]

Am I gonna die?

Am I?

We'll get you out.

If I die before I get there

you have to make sure
they take care of Myles.

‐ They will.
‐ 'He's seven.'

'I know.'

His father's in
Kansas city on business.

We were coming back
from visiting him.

I thought it'd be fun for
Myles to take the train.

What about the sciatic nerve?

(Peter)
'Pull it down
as far as possible.'

'Then apply an Ochsner clamp.'

That one, third to the right.

‐ Okay, got it. Now what?
‐ Alright.

Put a second clamp
five millimeters distally.

We're gonna get you
through this, alright, Lorcan?

'We're gonna get you through.
You're gonna be alright, okay?'

Remove the proximal clamp
and ligate the crushed area.

‐ 'O‐Vicryl?'
‐ No, no, no. Non absorbable.

Peter, we need you.
This boy is herniating.

‐ Use silk if you've got it.
‐ 'Okay, done that!'

Peter, we've got to
drain the hematoma.

You know, Carter, I've gotta go.
Call me on your cellphone.

I don't have it!
It's in my locker!

‐ Well, find one!
‐ Peter, now! Keep bagging him.

(John)
'What do I do
about this nerve?'

Step off in
the right parietal region.

‐ 'Dr. Benton?'
‐ Pulse ox is dropping.

Dr. Benton!

‐ What is it?
‐ Do you have a cellphone?

‐ No.
‐ Do you?

No.

Terbutaline's on board.

(Jing‐Mei)
'Repeat in another hour.'

Are you sure McLucas
hasn't answered?

Well, we just paged her.
Give her a second.

‐ What about Mark?
‐ He's on his way.

Okay, you're about 25% effaced.

But dimpled, not dilated.

Okay? We can control that.

‐ You think so?
‐ An OB resident's on his way‐‐

‐ I don't want a resident!
‐ Elizabeth!

You have to calm down
and focus, okay?

Give the Terbutaline
a chance to work.

Mark's on the phone.

‐ What line?
‐ Three.

‐ Climbing again. 220/115.
‐ Blown right pupil.

He needs a burr hole now.
Where's your perforating drill?

‐ Haleh, is one open?
‐ Yeah, Malucci's calling it.

Connect the chisel bit.
Let's keep hyperventilating him.

Come on, people. Let's move!

‐ 'Coming through!'
‐ 'Hold on, hold on.'

No, no, no, shove him up
against the wall, move!

Alright. Alright, let
somebody shave his head.

Give me 8.5 gloves.
Let's move, people.

‐ Sit him up to 30 degrees.
‐ Peter, Carter's on line three.

‐ He needs to talk to you.
‐ White, get over here.

Hold the phone up to my ear.
10‐blade.

'Pressure's through the roof.
260/140.'

Not good.
Up the Nipride to three mics.

Come on, put my glasses down.
Alright, Carter.

‐ 'Talk to me. Where are you?'
‐ Sciatic nerve!

Alright, good, cut proximally

'and let the muscle retract
into the muscle belly.'

Lorcan, they found Patty.

They're gonna send
a truck to take her

straight to the hospital.

‐ No, no, forget it.
‐ Okay, cutting now!

Okay, good.
Now, make sure you use a scalpel

instead of scissors.
Otherwise, you'll get a neuroma.

Listen, she's already
on her way, okay?

She wants to come.

No, no, no!

Would you please
hold him still?

‐ Okay, now what?
‐ Alright, now take two Kellys.

Clamp the femoral
artery and vein together.

I don't want her
to see me like this!

‐ Can you give him something?
‐ Whoa, whoa. He's seizing.

(Kerry)
'Five of Ativan.'

Give him five of Valium.

Put the phone right here.

'I don't want her to see me!'

You got to hold him
still until it kicks in.

You're almost free.

Is that two clamps each
or two clamps altogether?

Two clamps altogether!

‐ Two of Ativan?
‐ Five.

Am I clamping the vein
and artery separately?

Carter, clamp the vessels
as one unit at both ends.

Ativan's on board.
Still seizing.

Alright, you know what?
I got to go in.

'Just‐just re‐paralyze him.'

'Both proximally..'

Don't do it!

...and distally
or one proximally?

Carter, just clamp the damn
vessels, alright? Go.

‐ How many liters in?
‐ Two and a half.

Lost the pulse.

She's in V‐fib. Charge to 200.

Do you want her
to run her inside?

No, here. Paddles.

Charging.

‐ Clear.
‐ Still in V‐fib.

Charge to 300.

Clear.

Mark, penetrating back injury.

Needs to go straight to the OR.

Alright, I'll tell Randi.

Mark.

Feel any more contractions?

I'm so sorry.

Don't be.

I slipped and fell.

I thought it was just backache.

Did you give her Terbutaline?

Ten minutes ago.

Fetal heart tones?

155. No decels.

Well, that's good.

They haven't stopped.

You've gotta give it
some time to work.

Well, maybe we should
try magnesium.

We will if we have to, okay?

Let's just wait and see.

It's okay. It's okay.

Oh, no, no. It's okay.

‐ Irrigate.
‐ More Ativan?

No, stopped seizing
once he relieved

the intracranial pressure.

Suction catheter.

Carter, are you
through the tibia yet?

[grunts]

Done. Almost there, Lorcan.

'Good. Use the rongeur to
bevel the anterior apex.'

Where is that?

It's the sharp edge
at the end of the bone.

‐ What's his pressure?
‐ Down to 170/60.

They're all sharp. Argh! Dammit!

It's the anterior surface
that you care about.

‐ Dr. Weaver, I need you here.
‐ What patient?

The girl whose car
got hit by the train.

I'm sorry. What?

The anterior surface.

Get him upstairs.
Peter, let's go.

Carter, you're almost there.

When you're done, use the
rongeur to crack the fibula.

Wait, wait, wait!
Hold on! Hold on!

'Dr. Benton?'

'Dr. Benton?'

Good luck.

BP's a little low. You want
me to put the dopamine back on?

No. Wait till she's in the OR.

No, this one goes straight up.

Status, post‐cardiac arrest.

I just opened up
this kid's head.

Did you evacuate the clot?

'Yeah, but there's still
active bleeding at the site.'

'She's in shock. He was lucky
to get her back the first time.'

(Peter)
'Alright, go.'

No, take the boy first.

Call neurosurg.
Tell them we're on our way up.

I need two units of FFP
and ICP monitor.

85 palp.

Start the dopamine.

‐ What is it?
‐ I want to ask you something.

‐ He die?
‐ Who?

That man.

They cut open his chest.

But he died.

Yes, he had a fatal injury.

‐ What about the boy?
‐ He went up to surgery.

‐ Is he going to die?
‐ I don't know.

Is there someone
we can call for you?

Your mom or dad?

They won't understand.

Won't understand what?

I thought it would be painless.

The train would hit my car..

...I'd just be gone.

[dramatic music]

[indistinct chatter]

Yeah, don't talk to
me about saturated.

You haven't seen saturated.

Chuny, I need a trauma panel.
What's open?

I don't care.
I'm admitting them.

‐ Carter, they're holding OR‐‐
‐ I was just up there.

‐ There's no surgeon up there.
‐ Is he stable?

Yeah, his BP's stable to 100

but I had to sedate
him with ten of Valium.

‐ Dr. Carter, are you deaf?
‐ What?

I keep shouting, and you
keep getting on the elevator?

‐ I'm sorry.
‐ Is this the pre‐op amputation?

No, this is
the post‐op amputation.

‐ What, in the field?
‐ Yeah. He was trapped.

Oh, what did they use,
a chain saw?

You did this?

There was nobody else to do it‐‐

Well, by all means,
let's get whoever's available.

‐ You ought to try it next time.
‐ Yeah, maybe

If you'd respond to your page.

I can't wear
my pager in the dojo.

Brenda knew where I was.
You should have called her.

Let's go. What the hell
happened anyway?

Dr. Weaver, flail chest in four.

Just dropped his
pulse ox down to 81.

Carter, can you take this one?

By all means give him
another surgical procedure.

Stop crying.
I'll clean up after you.

‐ Good work, Carter.
‐ I know.

Really, he was lucky
that you were out there.

‐ 'Carter!'
‐ I'm coming.

‐ 'Kerry?'
‐ Carter!

Yeah, you have
a suicidal ideation?

‐ Young girl in trauma two.
‐ Does she have a plan?

Parked her car in
front of a train.

Oh, I suppose that qualifies.

She's also in
a major depression.

‐ Flat affect?
‐ No real remorse.

About the suicide attempt?

For the train wreck.

Oh, my.

Do you think that you're
gonna get off before 12:00?

Hmm, probably not.

Okay.

Uh, I'll try to be quiet.

No. Wake me.

(male #3)
'Something wrong?'

‐ Hey.
‐ What?

Is there something
wrong with my heart?

No. Probably a bruise
to your chest wall.

We'll get an X‐ray to make sure.
You were lucky.

We're still sifting
through the walking wounded

but I think we're over the hump.

Carter just took
the last critical.

How many came in?

37. Five up in surgery.

Only two ER deaths.
That's not bad considering.

Yeah, if you don't
count the DOAs.

You did great work today.
You should go home.

‐ We got it from here.
‐ The board's backing up.

That's alright. We got it.
Go home. See you tomorrow.

‐ Shirley called for you.
‐ What?

OR nurse, you asked her
to call when the mom

and son came out of surgery.

‐ Did they?
‐ Yeah, they're in recovery.

The mom's got
sensation in her legs

and the kid's
neurologically intact.

‐ That's good, right?
‐ Yeah. That's good.

[sighs]

‐ Ah, you still here, huh?
‐ Nurses put me to work.

Thought I was
a volunteer or something.

Good. Now you've
got an experience

to talk about in your interview.

I don't know.

Hey, it shows.
You might as well use it.

I mean, I don't
know if I want to.

Want to what?

What I saw tonight.

Most people go their whole lives
without seeing stuff like that.

Drilling into
a little boy's head.

Guys having their legs cut off..

People dying
right in front of you.

You'll get used to it.

Yeah. That's what I'm afraid of.

But thanks for helping
me find out early.

Go to the interview.

‐ Dr. Benton‐‐
‐ Go to the interview.

You might feel
differently in a few days.

‐ I know, but‐‐
‐ Hey, give yourself options.

Anything?

No contractions
since the third round.

Fetal heart rate looks good.

So it's over?

Aside from bed rest.

How long do you think?

[clears throat]
You can catch me up on my soaps.

It'll be okay.

When I felt the baby
move before

obviously I knew
it was in there

but suddenly this
feels real, you know?

Yes, mom.

OB's waiting,
and Transpo promises

they'll be down
soon to take you up.

Thanks, Abby.

And the monitor stays on
for at least 24 hours.

I'll keep it on
until I give birth.

You just have to slow down.

No more helicopters.

Right.

‐ Hey.
‐ Hey.

You're leaving?

Uh, no, I‐I thought
I'd check on the bishop.

Another critical come in?

No. That's it.

'Is she stable?'

Yeah, after three rounds
of Terbutaline.

‐ Good.
‐ Yeah, it was scary though.

‐ Yeah.
‐ You're heading home soon?

Uh, I don't know.

Are you okay?

Yeah.

[elevator bell dings]

Any change?

He didn't want
the breathing mask.

‐ 'Has he been awake?'
‐ 'Napping on and off.'

[groaning]

What time is it?

11:30.

You're here late.

You'll have to
be intubated soon.

On a ventilator?

Your oxygen level is down
to 65 on 100% oxygen.

I've seen what happens
after the ventilator.

If it drops below 50‐‐

Thanks, but no thanks.

Anyway..

...my bags are packed.

How long do I have?

Maybe hours.

Then I'd better hear it now.

Hear what?

Your confession.

[scoffs]
Oh, bishop, I don't think‐‐

That's what you came
up here for, isn't it?

I wanted to check on you.

You're searching for your faith.

You think you lost it,
but you only buried it.

It's never left you.

"In the name of the Father

and of the Son
and of the Holy Spirit."

Amen.

"May God, who enlightens
every heart

"help you to know your sins
and trust in His mercy."

‐ Father, I‐I can't‐‐
‐ Luka.

Your heart is burdened, Luka.

Talk to me.

Let me take that burden with me.

I don't know. I, uh..

...lost my family.

Danijela, my wife, she, uh..

...wanted to move out
of Vukovar but, um..

...I had to finish
my internship and, uh..

...soon it was too late,
it wasn't safe to move.

I was gonna
get some supplies

and, um..

...I made them stay behind.

I was just crossing the street
when the..

...mortar shell hit
the apartment building.

Go on.

I ran inside.

There were my neighbors..

[grunting]

...hurt, bleeding, dying

but I‐I passed them by.

I‐I had to get to my family.

Danijela!

Danijela!

Danijela!

Danijela!

(Danijela)
'Luka!'

Luka.

Marko, Marko.

Marko!

'Luka, Marko!'

Marko!

[groaning]

[speaking in foreign language]

[speaking in foreign language]

[speaking in foreign language]

[speaking in foreign language]

A piece of shrapnel had torn
into Danijela's spleen

and she was bleeding to death.

When I turned back
to my daughter

she wasn't breathing.

I lost her pulse.

But as long as I, uh,
kept doing CPR

and breathing for my daughter

I thought she had a chance.

I could only pray that..

...someone would get
there to help.

[speaking in foreign language]

If I'd picked up
Danijela at that moment

and gotten her to the hospital
she...could have had surgery.

You know, she could have lived

but I couldn't
leave my little girl.

Danijela?

[speaking in foreign language]

I waited and prayed.

I prayed someone would come.

[speaking in foreign language]

And no one came.

No one came.

Jasna.

Jasna.

I called out for hours
as I stayed there.

Breathing for her, doing CPR..

I finally had to stop
from exhaustion.

I lost them all.

You couldn't sacrifice
the one to save the other.

Even if you had,
you'd still blame yourself.

[sobbing]

These things
can't be explained..

...why it happens.

The providence of God

and the mysteries
of life and death

are the very fiber of our faith.

They were gifts..

...of love and life.

You are a gift of love and life.

Don't turn your back on them.

"God, Father of all mercies

"through the death
and resurrection

"of Your only begotten Son..

"...was reconciled
Himself to the world

"and sent
the Holy Spirit among us

"for the forgiveness of sins

"through the ministry
of Holy Church..

"...may God give you
pardon and peace.

"And I absolve you
of all your sins.

"In the name of
the Father, and of the Son..

"...and of the Holy Spirit."

Amen.

[flatline]

[theme music]