Three Rivers (2009–2010): Season 1, Episode 11 - Every Breath You Take - full transcript
Dr. Jordon, Miranda, David, Andy and the others deal with the captain of a firehouse who needs a lung transplant. One of his firefighters must make the tough decision of whether or not she wants to be a living donor. Meanwhile, Andy faces a personal and professional dilemma when his uncle comes to Three Rivers for treatment from a stab wound, but requests that Andy keep it to himself.
Previously on Three Rivers:
Andy, what's a counselor going to tell us?
That you're not a doctor
and I'm not a cop?
You save lives, Andy.
What's more important
than that?
Having one.
When did you get out?
Well they paroled me six months ago.
I'd like to earn a place
back in your life.
I have amazing news.
People have donated
over $150,000?
Kuol, this is a game-changer.
And all it took was a photograph
of the great Dr. Yablonski.
The bulk of a the money came
from an anonymous donor.
What do you know about the donor?
Just that he sent the money
through a lawyer in Mt. Washington.
That's your old neighborhood, right?
What exactly do you think
th money's going to buy you, Michael?
Your patient needed help.
So I helped him,
because I'm your friend.
'Cause I know that if I ever
needed your help,
you'd be a friend to me.
You should get some rest
before your meeting.
Yo, take it easy, man.
Hey.
Hi.
Hey.
And hi again.
Excellent conversation skills.
Uh, what can I do for you?
I called you about
Robert Dowd's chart.
Early stage cad.
Oh, yeah, yeah.
Right. I-I'll check it out.
Who did you say his
doctor was at county?
Uh, I said St. James, not county.
St. James?
We talked about this.
I know.
But you distracted me a little bit
and have made it hard
to stay focused.
Should we talk about
the other night?
I'd rather do that over a drink.
I'll think about it.
Okay.
How about tonight?
That's you thinking about it?
Tonight would be great.
Mm-hmm.
By the way,
your Uncle is waiting for you
in your office.
Inhalation Therapy, 4-West.
Inhalation Therapy, 4-West please.
Hey, Andrew.
Good to see you.
What are you doing here?
I, uh...
I got a little problem.
Do we know if we still
have anyone inside?
Incident commander is about
to initiate a sweep.
Tell him we got it.
Theo!
All right.
Sir.
I need you to take four men
to the back with engine 45.
See if you can get some water
up through the higher windows.
Let's keep the roof dry
until we're out.
Yes, sir.
Tommy, Anthony, Henry,
with me. Let's go.
Okay, listen up.
I need three to go with me
and a do a primary search
for survivors.
See if we can find
the seed of the fire.
Marco, Peter, Jimmy.
The rest of you put
as much water
into this place as you can.
Let's kill this thing.
Fire Department!
Anybody here?!
Fire Department...
Hold it.
Hold on.
Marco, Jimmy.
She's alive.
Come on, get her out.
She's alive.
Anybody here?
Fire Departm...!
Jimmy?
Hold on, Jimmy.
Dispatch.
Dispatch, I need help in here.
15 yards back.
Roger that.
Get somebody in here. Help!
I'm here, Captain.
Quick! Quick!
We'll get you out
of here, Jimmy.
Lift!
Captain, I have experience
and seniority
over Jimmy, sir.
Your point?
Why did you take him and not me?
It's just who I picked, Gwen.
It's not just who you picked, sir.
Look, if you're not strong enough
to haul a body
out of a burning building,
then we have nothing.
No crew, no trust, nothing.
It's about having
each other's back.
I have their backs, sir.
You almost couldn't
lift up that beam.
But I did lift it, didn't I? Sir.
Engine Five, we have a 911 call
from somebody still
inside the building.
It's a first floor bathroom.
Take your mask.
The caller's name is Patrick Moss,
African-American... you're going in.
Trick Moss?
Help.
Can you hear me?
Help me, please!
I hear him. Stop.
This way.
I'm in here.
Please
Right here?
Yeah, I think so.
I found it.
Say something, Patrick!
I can't breathe.
Help me, please.
All right. Ready?
Yeah.
On three.
One... two... three.
Patrick?
Down here!
How deep is it?
This is truck five.
We need assistance on
the first floor.
Engine nine copies that, you
have Tommy coming to you now.
You should get out of there
as fast as you can.
The place could come down
any second.
Heads up, Gwen.
Hold on, I gotta mask up.
Let's go!
Captain?
Captain, are you okay?
Lance?
Lance?!
Hey, where's the cap?
Lance, I need a sit rep.
I got him harnessed.
Gwen, you got help?
Cap, I'm here.
Okay, pull him up.
Okay. Gwen.
Ready? On three.
Ready.
One, two, three.
One, two...
One, two, three, pull!
Come on!
Keep pulling!
Ready? One...
Pull! Pull!
All right.
Flip him over, flip him over.
The Captain gave him his mask.
We gotta get him out of there,
there's too much smoke.
Help me pull him out of the way.
Gwen, Tommy, we're going to need
you guys out of there right now.
We got beams collapsing
on every floor.
Come on, ready?
On three.
Ready.
One, two, three.
One, two...
One, two, three, pull!
I got him!
Flip him over.
Captain? Captain?
He's not breathing.
Let's get him out of here.
All right, get him out.
♫ Three Rivers 1x11 ♫
Every Breath You Take
Original Air Date on June 19, 2010
Ow!
Oh, hold still.
What are you doing coming
in here with a stab wound?
You know full well
that I'm obligated by law
to report this to the police.
Look, all I'm gonna say is
I was a victim here,
okay?
This could be a violation
of my parole.
They're going to end up
sending me back to jail.
Come on, Andy.
We're family.
Damn it, Michael,
this is my medical license.
Hey, buddy... hey,
sweetheart.
Hi, Michael.
Hey.
Hi.
You here in an official capacity,
Detective Yablonski?
Hold that.
What happened?
I was just telling
your husband here,
this guy came up
behind and stuck me.
Asked for my money.
Violence these days,
you know, it's crazy.
Did you see who did it?
No.
I tell you one thing,
if I was younger man, he'd be
in a lot of trouble right now.
So what brings you here,
sweetheart?
We got a report you were stabbed.
I knew where you'd go.
Were there any witnesses?
You know, you used
to call me Uncle Mikey.
Were there any witnesses,
Uncle Mikey?
No, I was alone.
Andy was just about
to write all that down
in his the report.
I got to go.
Thanks, Andy.
Bye.
The detectives are going to want
a statement from you.
I'll wait with you
till they get here.
Yeah, I figured.
Let's go, let's go, let's go!
I got a 23-year-old firefighter,
Jimmy Hanks.
Vitals stable, pulse ox 98
on two liters.
Chest and head trauma, looks
like a right femur fracture.
Move these rigs out of here,
we got more coming in.
Complaining of left b pain.
He's had ten of morphine,
pain's down to two over ten.
Right, I got this one.
Next one's yours.
Okay.
19-year-old male, severe
circumferential chest burns.
Pulse ox only 79,
pulse 135, bp 90 palp.
He's on ten liter,
non-rebreathing mask,
complaining about
difficulty breathing.
Okay Bay four,
priority, super stat.
Okay, your name is Patrick?
Yeah.
Okay.
Please, call my mama.
Okay, what do we got?
Captain Lance Carlisle.
Severe smoke inhalation, minor
partial thickness burns.
Pulse ox 85,
diffuse wheezing.
We gave albuterol Neb times
two and put him on ten liters.
He has a history of lung
problems from smoke inhalation.
Take him into Bay Three,
he's not moving much air.
Pull an RSI Kit.
I may need to intubate him.
Can you sit up for me?
I... can't... breathe.
All right, we're working
on it, buddy.
Okay, portable chest
and blood gas.
O2 at ten ters,
albuterol/atrovent nebulizer.
What happened
to your hands, Patrick?
I tried to open the door,
but it was too hot.
He found some-- what were they?
Rubber, like, cleaning gloves?
Dish gloves! I tried
to open the door with them.
The heat from the fire
melted the gloves to his hands.
We peeled off the rubber
and dressed them in the rig.
Okay, we got a lot
of burn eschar on his chest.
It's pretty bad.
All right. You're
going to be okay.
The floor fell in
when the lights went out.
Okay, okay, okay. Patrick,
you're going to be okay.
He's bradycardic.
Pulse down to 40.
Get a point two
oftropine, please.
Right away.
He's out. Give him the sux.
He has extensive airwaburns,
at least down through the larynx.
You said he's suffered
smoke inhalation in the past?
20 years of it.
Pulse ox down to 70.
Well, they all count.
Okay, I'm in.
Good bilateral
breath sounds. Okay.
Put him on 100% o2,
get me a blood gas,
chest X-ray, CBC,
chem panel and coags.
And get him up to the ICU
right away, please.
Right away, doctor.
Hey.
Hang in there, Jimmy.
Shooting.
Okay, step back, please.
How's he doing?
After we clear his cervical spine
and make sure he's stable,
I'm sending him to radiology
to ct his head, chest and neck,
just to make sure
there's no internal injuries.
We'll know more
after that, okay?
Pulse ox is cratering.
Okay, let's up the o2
to ten liters, and get
a gas going, please.
Yes, doctor.
Patrick, did you take any drugs?
No.
Already ran a drug screen.
Patrick, did you take any drugs?
Oh, my God!
Oh, God.
Is he going to be okay?
Mama, it hurts.
Mama, it hurts.
Okay, okay.
Patrick. Patrick.
Tell me what hurts.
What hurts?
My knees and my shoulders.
Mama!
Okay, Patrick.
Do you know
what day it is today?
Don't know.
I don't know.
Okay.
Can you please give him
something for the pain?
Ma'am, we have to be careful. Your son
may have taken a narcotic.
My son doesn't do drugs.
Yeah, but if he did
and we give him
any pain medication,
it could make him stop breathing.
Po2 is only 60 on ten liters.
Pco2 is high-- it's 55.
Okay, he's in
respiratory failure.
I'm telling you, he's been
clean and sober for two years.
Ma'am, he was at a rave-- there
were a lot of drugs found there.
We're just testing everyone.
Dr. Foster, Dr. Lee.
I pulled the bandage
back and saw this.
Look at those track marks.
All right.
Give him two amps of narcan.
It's a drug that'll reverse
the effects of heroin
and other...
I know exactly what narcan is.
Lord, this can't be happening.
Dr.Ganty, please report
to burn unit stat.
Dr. Ganty, please report...
Thanks.
Lance is in bad shape.
The doctor said his
lungs aren't working.
How bad?
They don't know yet.
What about Jimmy?
Hmm?
He's not so good.
His leg's broken, his ribs.
They're checking his head.
Unbelievable.
They'll know more soon.
You should have
gone in there.
Talk to your Captain.
I wanted to go.
This is exactly the problem
with having you on the crew.
It was Lance's decision.
If Lance had any confidence
in you,
Jimmy wouldn't have been
in there, you would have.
Go to hell, Tommy.
Why don't you get me
transferred, Gwen?
You're pretty good at that.
Enough. Enough.
It always has to come to this?
If it was me lying in there,
I guess everybody
would be happy now.
Gwen, that's not true.
Speak for yourself.
Nice.
Why don't you just tell us where
Jimmy and the Captain are?
Pulse ox is down to 72.
The ER's covered.
Do you need me in here?
Yeah, I do.
He's got smoke inhalation
on top of chronic lung disease.
You going to be able
to buy him time for
his lungs to heal?
I don't know.
You know, Andy,
he saved that kid's life,
gave him his mask.
His lower airways aren't burned.
Yeah, so what are you thinking?
Stay with him.
Hey, can we see our guys?
This is the doctor?
Not yet.
I need to get in touch with
Lance's family immediately.
There's none here.
He's got some in Maine.
Look, is he going
to be all right?
He's got no family
anywhere in the area?
100 miles?
150 miles?
You're looking at it.
Sit tight.
Hey. Listen up.
Priority number one,
I need you to get on the UNOS
boards, find a pair of lungs
for an adult male,
blood-type ab-positive.
How long do we have.
Hours.
Just try.
All right.
So, his lungs are really okay,
so it's got to be the drugs, or...
Or maybe the skin around
his chest is tightening up.
Okay. Well, a couple more
kids came in from the club.
So, I'll go see
what other drugs were going around.
Okay.
Tell me what you took.
I didn't take anything.
Tell the truth, now.
The doctors need to know,
so that they can help you.
I'm telling the truth, mama.
I promise I'm with God, mama.
I didn't take anything.
He won't tell me what he took.
Okay, well,
the narcan isn't working.
So, he might've
taken a non-opiate drug.
Do you know... do you know
what he's taken in the past?
Rock cocaine.
Same as me.
When he was 15, I found
rock in his backpack.
I realized
he stole it from me.
We got clean together.
We were doing so good.
Okay.
Okay.
Lo, I know you're busy.
It's okay, I got a minute.
The detectives from organized
crime think that Michael
was stabbed by a wise
guy named Paul Tieri.
Paul Tieri?
Do you know him?
Well, I did ten years ago.
Paul Tieri and my uncle
used to steal cargo
from PIT International,
fenced it in Philly.
Your uncle isn't retired.
He's doing deals with Tieri,
even from prison.
Well, I'm not surprised.
What did Michael
tell you about Tieri?
Damn it. Nothing. I mean,
he's not gonna tell me anything,
he knows better than that.
You sure he didn't
tell you anything?
You think I'd lie to you
to protect him?
You know, he's a thief.
That's all.
I won't help him, I'm not part
of his life anymore.
Dr. Yablonski?
I have to go.
Yeah?
There are no lungs for Lance.
Let me show you.
I went as far West as Utah
and as far South as Texas
and Florida.
There's just not enough time.
Yes?
Okay, I'll be there in a minute
keep trying.
Nurses said you might want
a second opinion
about whether to take him
off the ventilator.
I'm not there yet.
What do you want to do?
Let's put him on ecmo.
It'll give us a little more time.
Ecmo's a temporary measure.
It'll chew up his blood cells,
he'll be dead in a week,
two at the most.
Or it' buy us enough time
for a pair of lungs
become available.
Come on, Andy.
You know UNOS
isn't gonna give lungs
to somebody this sick,
with the smoke damage
he sustained.
And he's not going
to get better on an ecmo.
He risked his life
for a kid downstairs.
No, what you need to do
is talk to the patient's family.
His crew is his family.
They're not going
to give up on him.
Neither am I.
Hey.
Hey.
Drug screen's back.
Okay.
No drugs.
Patrick's completely clean.
The drug screen covers greatest
hits of recreation drugs, right?
Cocaine, heroin, LSD.
Right.
He still has track marks.
Well, who knows what he
could've stuck in his arm.
I want to check mething.
Hey, Tina, emts still here?
I think Lori's in the supply room.
All right.
Hey, Lori.
Hey, how's the kid doing?
Not good.
We found a bunch of track marks.
Right arm?
That was me--
I was trying to get an IV in
but I couldn't find the vein.
It was a mess,
he wouldn't stop bleeding.
No, no, it's okay.
It's all right.
Happens to the best of us.
Thanks.
The nurse said
you saw his drug screen.
Your son didn't take drugs.
Thank God.
Then why can't he breathe?
Okay, ecmo's in.
Close him up, please.
I'll take care of it, doctor.
Thank you.
Let me have a 4-0.
Hey, how's he doing?
Well, we put the ecmo in.
If we're really lucky,
it'll act as his lungs
for a couple of days.
Did you find anything?
I stopped looking.
UNOS can't give lungs to someone
with this much preexisting damage.
Yeah, I had to...
I had to give it a shot.
I'm gonna try something.
Lance is dying.
His lung
after years of smoke inhalation,
have been pushed over the edge
from this final exposure.
Without a new pair of lungs,
he will die within a day or two.
Can't you transplant
new lungs into him?
I just found out he's too sick
to get that priority.
So, what are we talking about?
There's a new procedure
they've pioneered at USC.
Each lung has multiple lobes.
You've got three on the right
and two on the left.
What we do is we take one lower
lobe from one living donor.
And another lower lobe
from another living donor,
and we put them both into Lance.
They'll be big enough?
Yes.
The lobes are elastic
so they'll expand
and fit his chest.
His firefighting days
would be over but he'll live.
You need donors.
You want us give
part of our lungs.
Yeah.
You'll lose roughly ten percent
of your lung capacity.
Will we still be able
to be firefighters?
A lot of guys lost more than
that from smoke already,
they're still in the department.
Well, depending on the damage YT
your ability to do your job.
Plus, this is major surgery.
You'll be out of work
for at least two months.
And we need to test you
to even know
if you're a match.
I'll do it.
Me, too.
I'm in.
Everybody?
Yeah.
Okay.
We need to go fast.
Pulse ox only 70,
pulse 155, bp 80 palp.
Okay, it's the scar tissue
around his chest.
What's happening to him?
Burnt skin is tightening as it dies.
We need to incise the burned skin
so his chest can expand
and he can breathe.
All right, well,
let's put him under.
Let's start
with 50 of etomidate,
hang diprivan
and prep and drape
for escharotomy.
You should step outside for this.
What are you gonna do to him?
We have to make longitudinal
incisions through
his chest burns
so his lungs can expand.
Okay? You don't want
to see this.
Nurse, take her out, please.
He's out.
Come with me, ma'am.
Bp's dropping.
Okay. Incising now.
Bp's dropping.
Henry.
You're up.
Yeah.
Right this way.
Hey.
How's my man?
Well, so far,
Jimmy's doing okay.
Still some tests to...
You hear that?
You are doing okay.
Yeah, if "okay" means
a fractured femur,
broken ribs, a concussion
and ten percent
partial thickness burns.
But there is
hemorrhagic shock.
Nurse with an attitude.
Nice.
She's the doctor.
Who knew?
Sorry.
Uh, Marco, you're next.
You guys okay?
We're all doing fine.
Captain's not so good.
Needs part of someone's
lung to survive.
Yeah. We're all being tested
to see if any of us are a match.
Well, I want in.
Jimmy, you're stable,
but your body's still traumatized.
I would not recommend undergoing
major surgery right now.
I'm not gonna be the only one
who's not doing this.
Yeah, but you're
the only one who's badly injured.
So let me be clear.
If you do this,
you risk your leg
not healing properly.
Now, you need
all the lung capacity
to ensure a full recovery.
It's my body.
Test me.
Who's next?
He's of sound mind...
medically speaking.
You can test him.
Actually,
you know what?
I think we're running
out of time.
I think we should double up.
I'm gonna take Gwen.
All right?
Miranda
guys you work with.
Yeah, I live with them 24/7.
It's not easy.
Tell me about it.
When I have to go on these
procurement runs to some
of the smaller hospitals,
if my scrubs get dirty,
the only replacements they have
for me are nurse's colors.
And I'm a surgeon,
so nobody knows who's in charge.
It's stupid.
I had a little trouble
with a lieutenant.
Guy's name was Bill Brin.
He kept coming on to me,
wouldn't take no for an answer.
So I complained,
got him transferred out.
Now I'm the black sheep.
I'm sorry.
Yeah.
Funny thing is
all I ever wanted to be
was a firefighter.
Look, we're gonna
get these results back
for you really soon, okay?
Of course.
Pulse ox is
down to 55.
He's still not getting enough oxygen?
No.
You cut him for nothing?
He would have died
if we hadn't.
There's something else
going on here.
Is there anything in his
medical history that would have
affected his lungs?
Chemical exposure,
pneumonia, asthma?
No, nothing that I know of.
Is my son gonna die?
Can't keep going on
like this much longer.
I can't lose him now.
Not after all we've been through.
I didn't say we were giving up.
Okay?
All right.
Okay.
I want to redo the blood studies
and chem panel on Patrick Moss.
So what'd the test say?
You match.
That's great.
You have an option
not to do this.
I mean, we can say
you weren't a match,
and no one will ever know.
This is... this is
completely confidential
really?
Is there another donor?
We're still waiting
for all the results.
Nobody will know, right?
No.
Look, I can't do it.
I got two kids at home,
and I...
Maybe I'm just scared.
I don't know.
But I can't do it.
Hey, it's okay.
Thank you.
Hey.
Hey.
Hey.
How you doing?
What's it say?
You are a match.
Wow.
That's great.
And understand, you have
an option not to do this.
Oh, hell, yeah, I'm doing it.
I mean, Captain's like
a father to me.
Only he beats me less.
Okay.
Well, uh, go ahead
and wait at the front.
If we get another donor,
I'll get you admitted
and prepped for surgery.
That's it?
Well, that and a bunch
of paperwork.
Awesome.
All right, thanks.
Okay, there's more coming in.
Good.
Wait a minute.
We're testing Jimmy Hanks?
He's just had major trauma.
Listen, I told him that,
but it's his choice.
Hey may not even match.
Well, maybe
we won't need him.
Here's another one.
Figures it'd be me.
If you choose
not to donate,
we'll just tell them
you weren't a match.
We do it with family
members all the time.
Your privacy will be
completely protected.
You know that guy
I told you about?
Lieutenant Brin.
Yeah.
He did more than
come on to me.
One ght, I'm coming out
of the bathroom,
and the other guys
were downstairs.
Lieutenant Brin
pushed me back inside
and kissed me.
I pushed him away.
He pulled my shirt over my head.
I couldn't see.
He covered my mouth,
my nose, I couldn't breathe...
Gwen, please.
You don't have to justify
your decision.
I slit his face with my razor.
He would have beat
the hell out of me,
but Jimmy walked in.
Did you tell the cops?
I told Lance.
He said the department would
see it as a "he said, she said""
that if I didn't say anything
to anybody,
he'd transfer Brin
to another crew.
The only person who knows
anything about it is Jimmy
and you.
What happened to the lieutenant,
was he charged?
A month ago, I found out
when Brin was transferred,
he received a raise in rank.
Wow.
And now I'm just supposed
to give a part of my body
to the guy
that let him get away with that.
I think you should take
a little more time
with this.
No.
No, I don't need more time.
Lance can go to hell.
I'm not doing it.
Bp's crashg.
Why the hypetension?
You see this? See that?
Suaclavicular cyanosis?
Yeah, what do you think,
pericardial tamponade?
It would explain the hypotension.
Yeah, but not the
organs shutting down.
Bring the ultrasound over here.
Thank you.
Yolanda, I need you
to step away for a second.
Oh, please, lord,
I'm asking you.
Deliver my child.
300cc's
squeezing his heart.
What's happening?
The sac around his heart
is filling up with blood.
It's not allowing
his heart to beat.
We need to drain this.
Prep and drape for
pericardiocentesis.
Bring me the PC kit.
You want this one?
Okay.
Hear my cry, lord.
Heal my child.
Deliver him.
45 degree angle.
Draw back as you advance.
Run of five.
Okay, back off, back off.
Aim a little right.
Okay.
Okay, got it. That's it.
All right.
Okay, that's supposed
to be blood.
What the hell's going on?
Hey.
Hey, girl.
I just wanted to make sure
you're okay.
You know,
got everything you need.
Mm. I'm good.
You okay?
Heard a couple of the guys
are giving you a hard time.
Mm. It's nothing new.
Don't worry about me.
We should just
tell them, Gwen.
They wouldn't be so rough
on you if they knew...
No, no.
There'd be
a department investigation.
No other crew would have me.
My career would be over.
Got to get you
ready for surgery,
Mr. Hanks.
Surgery?
I'm a match.
It came down to
me and Tommy.
I'm giving a lobe to Lance.
You can do that
after what you went through?
They said there's a chance that
my leg might not heal right.
The bone might be too weak.
That could be your career.
You'd be done.
That might not happen.
Besides, it's the Captain.
I got to do it, right?
Okay. He's got effusion,
not blood, in his pericardium.
There's got to be some
underlying disease
causing that.
His pulse is down to 110,
but his breathing
is still labored.
There's something systemic going on.
Start over. Let's forget about the fire.
What do we know?
Pericardial effusion,
multiple organ failure.
What is it?
What is it, Patrick?
His knees. His knees.
His knees and his shoulders--
he's been complaining
about them for months now.
He was complaining
about that earlier.
Joint inflammation.
Joint inflammation.
Rising hepatic enzymes.
And what did the EMT say?
She said that when she tried to
start an IV on Patrick, that...
He was bleeding all
over the place. Okay.
Exactly.
All right.
Well, forget the scan for now.
I want to look at him
under a bright light.
Thank you.
Turn this on.
I want to look at him
under a bright lightYeah.
Okay, there-- you see
these bumps on his shins?
Erythema nodosum?
I think so.
Yeah, they're usually
harder to see
on a person with dark skin.
Yeah.
Looks like superficial
skin burns.
Here, on his right leg--
do you see that?
Yeah.
So, joint inflammation,
erythema nodosum,
rising enzymes.
Pericardial effusion...
And bleeding easily.
His hands.
We didn't see his hands.
What's it got to do with his hands?
You see how his fingers are
gettg all blunt and stubby?
I never noticed that.
Well, these three symptoms--
the bumps on his leg, the clubbing
and the joint pain-- are what's
called lofgren's syndrome,
and it's an indication of...
Sarcoidosis.
It's an autoimmune
inflammatory disease
that affects the lungs--
makes it hard to breathe.
It's also causing everything
we're seeing here
from his enzyme elevation
to the fluid accumulation
around his heart to the bleeding.
It's a preexisting condition.
The fire and the burns on
the chest just exacerbated it.
Let's get him started with
250 milligrams of solu-cortef.
Is he going to be okay?
If we're right... yeah.
Time to go, buddy.
Go get 'em.
We'll be waiting for you.
Jimmy, you're the best.
I'm doing it.
Not Jimmy.
What are you talking about?
I just heard I'm a match.
You're not 100%.
Means I'm best man for the job.
You sure about this?
I wouldn't let my Captain die
in a fire.
Not gonna let him die here.
It's how we do it.
It'll be just a minute.
It's cold.
Yeah.
It is.
Hey, Gwen.
I just want to tell you I think
it's a hell of a
thing you're doing.
It took this, Tommy?
Me giving a piece
of my body?
It was all stupid, Gwen.
It was so stupid.
I'm sorry.
This scares the hell out of me.
Hey, guys.
We're okay?
Yeah.
Okay.
Ready when you are.
Hey, Tommy.
Let's kill this thing.
♪ That age-old look ♪
♪ is in your face ♪
♪ it's been there a while ♪
♪ tries not to say ♪
♪ that you've had your day ♪
♪ but you have a faith ♪
♪ that looks both ways ♪
♪ look in your eyes ♪
♪ we'll last a lifetime ♪
♪ so when you reach ♪
♪ the end of the road ♪
♪ it still leaves somewhere ♪
♪ to go ♪
♪ at the end of the road ♪
♪ but I won't try to live ♪
♪ side by side ♪
♪ and I won't try ♪
♪ when you can take me
back in time ♪
♪ that charmless look ♪
♪ upon your face ♪
♪ found its way ♪
♪ through the smallest things ♪
♪ that have changed ♪
♪ so when you reach ♪
♪ the end of the road ♪
♪ It still leaves somewhere ♪
♪ to go ♪
♪ you don't look for signs ♪
♪ at the end of the road ♪
♪ won't try ♪
♪ when you can take me
back in time ♪
You never know who's
going to have your back.
Why don't you go say...
Thank you?
I owe her a lot more
than that, doc.
I'm afraid she's not going
to accept it.
I say man up and give it a try.
♪ But I won't t to live ♪
♪ side by side ♪
♪ and I won't try ♪
♪ when you can take me
back in time. ♪
Well, took long enough
to get this drink.
It'll be worth it.
Really?
For who?
For the bartender.
I'm thirsty,
and I'm a good tipper.
This is awkward.
Little bit.
I'll wait for you side.
Okay.
Okay.
Sorry to interrupt, Andy.
What's going on?
Nobody can know I talked to you.
An organized crime
Detective
recognized you and came to me
out of professional courtesy.
So, they... they have a photo
of me and my Uncle.
So what?
Paul Tieri,
the guy who stabbed your uncle,
was found shot in the face
on a rooftop
in Northview Heights.
Michael's a murderer.
They know he's
been laundering money.
Listen, this has got nothing
to do with me, Rena.
And that he recently
donated a large sum
for a Sudanese patient
of yours, Kuol.
Okay.
That donation
was 100% legitimate.
They know you have
a relationship with him.
Wh-what, do they want me
to rat him out?
I'm not going to do that.
If you don't, they're going to seize
the money for Kuol.
Rena, you...
you can't let this happen.
Okay, Kuol needs that heart.
He's going to die without .
It's not up to me.
I'm just looking out for you.
Yeah, you always did.
Your date's waiting.
Andy, what's a counselor going to tell us?
That you're not a doctor
and I'm not a cop?
You save lives, Andy.
What's more important
than that?
Having one.
When did you get out?
Well they paroled me six months ago.
I'd like to earn a place
back in your life.
I have amazing news.
People have donated
over $150,000?
Kuol, this is a game-changer.
And all it took was a photograph
of the great Dr. Yablonski.
The bulk of a the money came
from an anonymous donor.
What do you know about the donor?
Just that he sent the money
through a lawyer in Mt. Washington.
That's your old neighborhood, right?
What exactly do you think
th money's going to buy you, Michael?
Your patient needed help.
So I helped him,
because I'm your friend.
'Cause I know that if I ever
needed your help,
you'd be a friend to me.
You should get some rest
before your meeting.
Yo, take it easy, man.
Hey.
Hi.
Hey.
And hi again.
Excellent conversation skills.
Uh, what can I do for you?
I called you about
Robert Dowd's chart.
Early stage cad.
Oh, yeah, yeah.
Right. I-I'll check it out.
Who did you say his
doctor was at county?
Uh, I said St. James, not county.
St. James?
We talked about this.
I know.
But you distracted me a little bit
and have made it hard
to stay focused.
Should we talk about
the other night?
I'd rather do that over a drink.
I'll think about it.
Okay.
How about tonight?
That's you thinking about it?
Tonight would be great.
Mm-hmm.
By the way,
your Uncle is waiting for you
in your office.
Inhalation Therapy, 4-West.
Inhalation Therapy, 4-West please.
Hey, Andrew.
Good to see you.
What are you doing here?
I, uh...
I got a little problem.
Do we know if we still
have anyone inside?
Incident commander is about
to initiate a sweep.
Tell him we got it.
Theo!
All right.
Sir.
I need you to take four men
to the back with engine 45.
See if you can get some water
up through the higher windows.
Let's keep the roof dry
until we're out.
Yes, sir.
Tommy, Anthony, Henry,
with me. Let's go.
Okay, listen up.
I need three to go with me
and a do a primary search
for survivors.
See if we can find
the seed of the fire.
Marco, Peter, Jimmy.
The rest of you put
as much water
into this place as you can.
Let's kill this thing.
Fire Department!
Anybody here?!
Fire Department...
Hold it.
Hold on.
Marco, Jimmy.
She's alive.
Come on, get her out.
She's alive.
Anybody here?
Fire Departm...!
Jimmy?
Hold on, Jimmy.
Dispatch.
Dispatch, I need help in here.
15 yards back.
Roger that.
Get somebody in here. Help!
I'm here, Captain.
Quick! Quick!
We'll get you out
of here, Jimmy.
Lift!
Captain, I have experience
and seniority
over Jimmy, sir.
Your point?
Why did you take him and not me?
It's just who I picked, Gwen.
It's not just who you picked, sir.
Look, if you're not strong enough
to haul a body
out of a burning building,
then we have nothing.
No crew, no trust, nothing.
It's about having
each other's back.
I have their backs, sir.
You almost couldn't
lift up that beam.
But I did lift it, didn't I? Sir.
Engine Five, we have a 911 call
from somebody still
inside the building.
It's a first floor bathroom.
Take your mask.
The caller's name is Patrick Moss,
African-American... you're going in.
Trick Moss?
Help.
Can you hear me?
Help me, please!
I hear him. Stop.
This way.
I'm in here.
Please
Right here?
Yeah, I think so.
I found it.
Say something, Patrick!
I can't breathe.
Help me, please.
All right. Ready?
Yeah.
On three.
One... two... three.
Patrick?
Down here!
How deep is it?
This is truck five.
We need assistance on
the first floor.
Engine nine copies that, you
have Tommy coming to you now.
You should get out of there
as fast as you can.
The place could come down
any second.
Heads up, Gwen.
Hold on, I gotta mask up.
Let's go!
Captain?
Captain, are you okay?
Lance?
Lance?!
Hey, where's the cap?
Lance, I need a sit rep.
I got him harnessed.
Gwen, you got help?
Cap, I'm here.
Okay, pull him up.
Okay. Gwen.
Ready? On three.
Ready.
One, two, three.
One, two...
One, two, three, pull!
Come on!
Keep pulling!
Ready? One...
Pull! Pull!
All right.
Flip him over, flip him over.
The Captain gave him his mask.
We gotta get him out of there,
there's too much smoke.
Help me pull him out of the way.
Gwen, Tommy, we're going to need
you guys out of there right now.
We got beams collapsing
on every floor.
Come on, ready?
On three.
Ready.
One, two, three.
One, two...
One, two, three, pull!
I got him!
Flip him over.
Captain? Captain?
He's not breathing.
Let's get him out of here.
All right, get him out.
♫ Three Rivers 1x11 ♫
Every Breath You Take
Original Air Date on June 19, 2010
Ow!
Oh, hold still.
What are you doing coming
in here with a stab wound?
You know full well
that I'm obligated by law
to report this to the police.
Look, all I'm gonna say is
I was a victim here,
okay?
This could be a violation
of my parole.
They're going to end up
sending me back to jail.
Come on, Andy.
We're family.
Damn it, Michael,
this is my medical license.
Hey, buddy... hey,
sweetheart.
Hi, Michael.
Hey.
Hi.
You here in an official capacity,
Detective Yablonski?
Hold that.
What happened?
I was just telling
your husband here,
this guy came up
behind and stuck me.
Asked for my money.
Violence these days,
you know, it's crazy.
Did you see who did it?
No.
I tell you one thing,
if I was younger man, he'd be
in a lot of trouble right now.
So what brings you here,
sweetheart?
We got a report you were stabbed.
I knew where you'd go.
Were there any witnesses?
You know, you used
to call me Uncle Mikey.
Were there any witnesses,
Uncle Mikey?
No, I was alone.
Andy was just about
to write all that down
in his the report.
I got to go.
Thanks, Andy.
Bye.
The detectives are going to want
a statement from you.
I'll wait with you
till they get here.
Yeah, I figured.
Let's go, let's go, let's go!
I got a 23-year-old firefighter,
Jimmy Hanks.
Vitals stable, pulse ox 98
on two liters.
Chest and head trauma, looks
like a right femur fracture.
Move these rigs out of here,
we got more coming in.
Complaining of left b pain.
He's had ten of morphine,
pain's down to two over ten.
Right, I got this one.
Next one's yours.
Okay.
19-year-old male, severe
circumferential chest burns.
Pulse ox only 79,
pulse 135, bp 90 palp.
He's on ten liter,
non-rebreathing mask,
complaining about
difficulty breathing.
Okay Bay four,
priority, super stat.
Okay, your name is Patrick?
Yeah.
Okay.
Please, call my mama.
Okay, what do we got?
Captain Lance Carlisle.
Severe smoke inhalation, minor
partial thickness burns.
Pulse ox 85,
diffuse wheezing.
We gave albuterol Neb times
two and put him on ten liters.
He has a history of lung
problems from smoke inhalation.
Take him into Bay Three,
he's not moving much air.
Pull an RSI Kit.
I may need to intubate him.
Can you sit up for me?
I... can't... breathe.
All right, we're working
on it, buddy.
Okay, portable chest
and blood gas.
O2 at ten ters,
albuterol/atrovent nebulizer.
What happened
to your hands, Patrick?
I tried to open the door,
but it was too hot.
He found some-- what were they?
Rubber, like, cleaning gloves?
Dish gloves! I tried
to open the door with them.
The heat from the fire
melted the gloves to his hands.
We peeled off the rubber
and dressed them in the rig.
Okay, we got a lot
of burn eschar on his chest.
It's pretty bad.
All right. You're
going to be okay.
The floor fell in
when the lights went out.
Okay, okay, okay. Patrick,
you're going to be okay.
He's bradycardic.
Pulse down to 40.
Get a point two
oftropine, please.
Right away.
He's out. Give him the sux.
He has extensive airwaburns,
at least down through the larynx.
You said he's suffered
smoke inhalation in the past?
20 years of it.
Pulse ox down to 70.
Well, they all count.
Okay, I'm in.
Good bilateral
breath sounds. Okay.
Put him on 100% o2,
get me a blood gas,
chest X-ray, CBC,
chem panel and coags.
And get him up to the ICU
right away, please.
Right away, doctor.
Hey.
Hang in there, Jimmy.
Shooting.
Okay, step back, please.
How's he doing?
After we clear his cervical spine
and make sure he's stable,
I'm sending him to radiology
to ct his head, chest and neck,
just to make sure
there's no internal injuries.
We'll know more
after that, okay?
Pulse ox is cratering.
Okay, let's up the o2
to ten liters, and get
a gas going, please.
Yes, doctor.
Patrick, did you take any drugs?
No.
Already ran a drug screen.
Patrick, did you take any drugs?
Oh, my God!
Oh, God.
Is he going to be okay?
Mama, it hurts.
Mama, it hurts.
Okay, okay.
Patrick. Patrick.
Tell me what hurts.
What hurts?
My knees and my shoulders.
Mama!
Okay, Patrick.
Do you know
what day it is today?
Don't know.
I don't know.
Okay.
Can you please give him
something for the pain?
Ma'am, we have to be careful. Your son
may have taken a narcotic.
My son doesn't do drugs.
Yeah, but if he did
and we give him
any pain medication,
it could make him stop breathing.
Po2 is only 60 on ten liters.
Pco2 is high-- it's 55.
Okay, he's in
respiratory failure.
I'm telling you, he's been
clean and sober for two years.
Ma'am, he was at a rave-- there
were a lot of drugs found there.
We're just testing everyone.
Dr. Foster, Dr. Lee.
I pulled the bandage
back and saw this.
Look at those track marks.
All right.
Give him two amps of narcan.
It's a drug that'll reverse
the effects of heroin
and other...
I know exactly what narcan is.
Lord, this can't be happening.
Dr.Ganty, please report
to burn unit stat.
Dr. Ganty, please report...
Thanks.
Lance is in bad shape.
The doctor said his
lungs aren't working.
How bad?
They don't know yet.
What about Jimmy?
Hmm?
He's not so good.
His leg's broken, his ribs.
They're checking his head.
Unbelievable.
They'll know more soon.
You should have
gone in there.
Talk to your Captain.
I wanted to go.
This is exactly the problem
with having you on the crew.
It was Lance's decision.
If Lance had any confidence
in you,
Jimmy wouldn't have been
in there, you would have.
Go to hell, Tommy.
Why don't you get me
transferred, Gwen?
You're pretty good at that.
Enough. Enough.
It always has to come to this?
If it was me lying in there,
I guess everybody
would be happy now.
Gwen, that's not true.
Speak for yourself.
Nice.
Why don't you just tell us where
Jimmy and the Captain are?
Pulse ox is down to 72.
The ER's covered.
Do you need me in here?
Yeah, I do.
He's got smoke inhalation
on top of chronic lung disease.
You going to be able
to buy him time for
his lungs to heal?
I don't know.
You know, Andy,
he saved that kid's life,
gave him his mask.
His lower airways aren't burned.
Yeah, so what are you thinking?
Stay with him.
Hey, can we see our guys?
This is the doctor?
Not yet.
I need to get in touch with
Lance's family immediately.
There's none here.
He's got some in Maine.
Look, is he going
to be all right?
He's got no family
anywhere in the area?
100 miles?
150 miles?
You're looking at it.
Sit tight.
Hey. Listen up.
Priority number one,
I need you to get on the UNOS
boards, find a pair of lungs
for an adult male,
blood-type ab-positive.
How long do we have.
Hours.
Just try.
All right.
So, his lungs are really okay,
so it's got to be the drugs, or...
Or maybe the skin around
his chest is tightening up.
Okay. Well, a couple more
kids came in from the club.
So, I'll go see
what other drugs were going around.
Okay.
Tell me what you took.
I didn't take anything.
Tell the truth, now.
The doctors need to know,
so that they can help you.
I'm telling the truth, mama.
I promise I'm with God, mama.
I didn't take anything.
He won't tell me what he took.
Okay, well,
the narcan isn't working.
So, he might've
taken a non-opiate drug.
Do you know... do you know
what he's taken in the past?
Rock cocaine.
Same as me.
When he was 15, I found
rock in his backpack.
I realized
he stole it from me.
We got clean together.
We were doing so good.
Okay.
Okay.
Lo, I know you're busy.
It's okay, I got a minute.
The detectives from organized
crime think that Michael
was stabbed by a wise
guy named Paul Tieri.
Paul Tieri?
Do you know him?
Well, I did ten years ago.
Paul Tieri and my uncle
used to steal cargo
from PIT International,
fenced it in Philly.
Your uncle isn't retired.
He's doing deals with Tieri,
even from prison.
Well, I'm not surprised.
What did Michael
tell you about Tieri?
Damn it. Nothing. I mean,
he's not gonna tell me anything,
he knows better than that.
You sure he didn't
tell you anything?
You think I'd lie to you
to protect him?
You know, he's a thief.
That's all.
I won't help him, I'm not part
of his life anymore.
Dr. Yablonski?
I have to go.
Yeah?
There are no lungs for Lance.
Let me show you.
I went as far West as Utah
and as far South as Texas
and Florida.
There's just not enough time.
Yes?
Okay, I'll be there in a minute
keep trying.
Nurses said you might want
a second opinion
about whether to take him
off the ventilator.
I'm not there yet.
What do you want to do?
Let's put him on ecmo.
It'll give us a little more time.
Ecmo's a temporary measure.
It'll chew up his blood cells,
he'll be dead in a week,
two at the most.
Or it' buy us enough time
for a pair of lungs
become available.
Come on, Andy.
You know UNOS
isn't gonna give lungs
to somebody this sick,
with the smoke damage
he sustained.
And he's not going
to get better on an ecmo.
He risked his life
for a kid downstairs.
No, what you need to do
is talk to the patient's family.
His crew is his family.
They're not going
to give up on him.
Neither am I.
Hey.
Hey.
Drug screen's back.
Okay.
No drugs.
Patrick's completely clean.
The drug screen covers greatest
hits of recreation drugs, right?
Cocaine, heroin, LSD.
Right.
He still has track marks.
Well, who knows what he
could've stuck in his arm.
I want to check mething.
Hey, Tina, emts still here?
I think Lori's in the supply room.
All right.
Hey, Lori.
Hey, how's the kid doing?
Not good.
We found a bunch of track marks.
Right arm?
That was me--
I was trying to get an IV in
but I couldn't find the vein.
It was a mess,
he wouldn't stop bleeding.
No, no, it's okay.
It's all right.
Happens to the best of us.
Thanks.
The nurse said
you saw his drug screen.
Your son didn't take drugs.
Thank God.
Then why can't he breathe?
Okay, ecmo's in.
Close him up, please.
I'll take care of it, doctor.
Thank you.
Let me have a 4-0.
Hey, how's he doing?
Well, we put the ecmo in.
If we're really lucky,
it'll act as his lungs
for a couple of days.
Did you find anything?
I stopped looking.
UNOS can't give lungs to someone
with this much preexisting damage.
Yeah, I had to...
I had to give it a shot.
I'm gonna try something.
Lance is dying.
His lung
after years of smoke inhalation,
have been pushed over the edge
from this final exposure.
Without a new pair of lungs,
he will die within a day or two.
Can't you transplant
new lungs into him?
I just found out he's too sick
to get that priority.
So, what are we talking about?
There's a new procedure
they've pioneered at USC.
Each lung has multiple lobes.
You've got three on the right
and two on the left.
What we do is we take one lower
lobe from one living donor.
And another lower lobe
from another living donor,
and we put them both into Lance.
They'll be big enough?
Yes.
The lobes are elastic
so they'll expand
and fit his chest.
His firefighting days
would be over but he'll live.
You need donors.
You want us give
part of our lungs.
Yeah.
You'll lose roughly ten percent
of your lung capacity.
Will we still be able
to be firefighters?
A lot of guys lost more than
that from smoke already,
they're still in the department.
Well, depending on the damage YT
your ability to do your job.
Plus, this is major surgery.
You'll be out of work
for at least two months.
And we need to test you
to even know
if you're a match.
I'll do it.
Me, too.
I'm in.
Everybody?
Yeah.
Okay.
We need to go fast.
Pulse ox only 70,
pulse 155, bp 80 palp.
Okay, it's the scar tissue
around his chest.
What's happening to him?
Burnt skin is tightening as it dies.
We need to incise the burned skin
so his chest can expand
and he can breathe.
All right, well,
let's put him under.
Let's start
with 50 of etomidate,
hang diprivan
and prep and drape
for escharotomy.
You should step outside for this.
What are you gonna do to him?
We have to make longitudinal
incisions through
his chest burns
so his lungs can expand.
Okay? You don't want
to see this.
Nurse, take her out, please.
He's out.
Come with me, ma'am.
Bp's dropping.
Okay. Incising now.
Bp's dropping.
Henry.
You're up.
Yeah.
Right this way.
Hey.
How's my man?
Well, so far,
Jimmy's doing okay.
Still some tests to...
You hear that?
You are doing okay.
Yeah, if "okay" means
a fractured femur,
broken ribs, a concussion
and ten percent
partial thickness burns.
But there is
hemorrhagic shock.
Nurse with an attitude.
Nice.
She's the doctor.
Who knew?
Sorry.
Uh, Marco, you're next.
You guys okay?
We're all doing fine.
Captain's not so good.
Needs part of someone's
lung to survive.
Yeah. We're all being tested
to see if any of us are a match.
Well, I want in.
Jimmy, you're stable,
but your body's still traumatized.
I would not recommend undergoing
major surgery right now.
I'm not gonna be the only one
who's not doing this.
Yeah, but you're
the only one who's badly injured.
So let me be clear.
If you do this,
you risk your leg
not healing properly.
Now, you need
all the lung capacity
to ensure a full recovery.
It's my body.
Test me.
Who's next?
He's of sound mind...
medically speaking.
You can test him.
Actually,
you know what?
I think we're running
out of time.
I think we should double up.
I'm gonna take Gwen.
All right?
Miranda
guys you work with.
Yeah, I live with them 24/7.
It's not easy.
Tell me about it.
When I have to go on these
procurement runs to some
of the smaller hospitals,
if my scrubs get dirty,
the only replacements they have
for me are nurse's colors.
And I'm a surgeon,
so nobody knows who's in charge.
It's stupid.
I had a little trouble
with a lieutenant.
Guy's name was Bill Brin.
He kept coming on to me,
wouldn't take no for an answer.
So I complained,
got him transferred out.
Now I'm the black sheep.
I'm sorry.
Yeah.
Funny thing is
all I ever wanted to be
was a firefighter.
Look, we're gonna
get these results back
for you really soon, okay?
Of course.
Pulse ox is
down to 55.
He's still not getting enough oxygen?
No.
You cut him for nothing?
He would have died
if we hadn't.
There's something else
going on here.
Is there anything in his
medical history that would have
affected his lungs?
Chemical exposure,
pneumonia, asthma?
No, nothing that I know of.
Is my son gonna die?
Can't keep going on
like this much longer.
I can't lose him now.
Not after all we've been through.
I didn't say we were giving up.
Okay?
All right.
Okay.
I want to redo the blood studies
and chem panel on Patrick Moss.
So what'd the test say?
You match.
That's great.
You have an option
not to do this.
I mean, we can say
you weren't a match,
and no one will ever know.
This is... this is
completely confidential
really?
Is there another donor?
We're still waiting
for all the results.
Nobody will know, right?
No.
Look, I can't do it.
I got two kids at home,
and I...
Maybe I'm just scared.
I don't know.
But I can't do it.
Hey, it's okay.
Thank you.
Hey.
Hey.
Hey.
How you doing?
What's it say?
You are a match.
Wow.
That's great.
And understand, you have
an option not to do this.
Oh, hell, yeah, I'm doing it.
I mean, Captain's like
a father to me.
Only he beats me less.
Okay.
Well, uh, go ahead
and wait at the front.
If we get another donor,
I'll get you admitted
and prepped for surgery.
That's it?
Well, that and a bunch
of paperwork.
Awesome.
All right, thanks.
Okay, there's more coming in.
Good.
Wait a minute.
We're testing Jimmy Hanks?
He's just had major trauma.
Listen, I told him that,
but it's his choice.
Hey may not even match.
Well, maybe
we won't need him.
Here's another one.
Figures it'd be me.
If you choose
not to donate,
we'll just tell them
you weren't a match.
We do it with family
members all the time.
Your privacy will be
completely protected.
You know that guy
I told you about?
Lieutenant Brin.
Yeah.
He did more than
come on to me.
One ght, I'm coming out
of the bathroom,
and the other guys
were downstairs.
Lieutenant Brin
pushed me back inside
and kissed me.
I pushed him away.
He pulled my shirt over my head.
I couldn't see.
He covered my mouth,
my nose, I couldn't breathe...
Gwen, please.
You don't have to justify
your decision.
I slit his face with my razor.
He would have beat
the hell out of me,
but Jimmy walked in.
Did you tell the cops?
I told Lance.
He said the department would
see it as a "he said, she said""
that if I didn't say anything
to anybody,
he'd transfer Brin
to another crew.
The only person who knows
anything about it is Jimmy
and you.
What happened to the lieutenant,
was he charged?
A month ago, I found out
when Brin was transferred,
he received a raise in rank.
Wow.
And now I'm just supposed
to give a part of my body
to the guy
that let him get away with that.
I think you should take
a little more time
with this.
No.
No, I don't need more time.
Lance can go to hell.
I'm not doing it.
Bp's crashg.
Why the hypetension?
You see this? See that?
Suaclavicular cyanosis?
Yeah, what do you think,
pericardial tamponade?
It would explain the hypotension.
Yeah, but not the
organs shutting down.
Bring the ultrasound over here.
Thank you.
Yolanda, I need you
to step away for a second.
Oh, please, lord,
I'm asking you.
Deliver my child.
300cc's
squeezing his heart.
What's happening?
The sac around his heart
is filling up with blood.
It's not allowing
his heart to beat.
We need to drain this.
Prep and drape for
pericardiocentesis.
Bring me the PC kit.
You want this one?
Okay.
Hear my cry, lord.
Heal my child.
Deliver him.
45 degree angle.
Draw back as you advance.
Run of five.
Okay, back off, back off.
Aim a little right.
Okay.
Okay, got it. That's it.
All right.
Okay, that's supposed
to be blood.
What the hell's going on?
Hey.
Hey, girl.
I just wanted to make sure
you're okay.
You know,
got everything you need.
Mm. I'm good.
You okay?
Heard a couple of the guys
are giving you a hard time.
Mm. It's nothing new.
Don't worry about me.
We should just
tell them, Gwen.
They wouldn't be so rough
on you if they knew...
No, no.
There'd be
a department investigation.
No other crew would have me.
My career would be over.
Got to get you
ready for surgery,
Mr. Hanks.
Surgery?
I'm a match.
It came down to
me and Tommy.
I'm giving a lobe to Lance.
You can do that
after what you went through?
They said there's a chance that
my leg might not heal right.
The bone might be too weak.
That could be your career.
You'd be done.
That might not happen.
Besides, it's the Captain.
I got to do it, right?
Okay. He's got effusion,
not blood, in his pericardium.
There's got to be some
underlying disease
causing that.
His pulse is down to 110,
but his breathing
is still labored.
There's something systemic going on.
Start over. Let's forget about the fire.
What do we know?
Pericardial effusion,
multiple organ failure.
What is it?
What is it, Patrick?
His knees. His knees.
His knees and his shoulders--
he's been complaining
about them for months now.
He was complaining
about that earlier.
Joint inflammation.
Joint inflammation.
Rising hepatic enzymes.
And what did the EMT say?
She said that when she tried to
start an IV on Patrick, that...
He was bleeding all
over the place. Okay.
Exactly.
All right.
Well, forget the scan for now.
I want to look at him
under a bright light.
Thank you.
Turn this on.
I want to look at him
under a bright lightYeah.
Okay, there-- you see
these bumps on his shins?
Erythema nodosum?
I think so.
Yeah, they're usually
harder to see
on a person with dark skin.
Yeah.
Looks like superficial
skin burns.
Here, on his right leg--
do you see that?
Yeah.
So, joint inflammation,
erythema nodosum,
rising enzymes.
Pericardial effusion...
And bleeding easily.
His hands.
We didn't see his hands.
What's it got to do with his hands?
You see how his fingers are
gettg all blunt and stubby?
I never noticed that.
Well, these three symptoms--
the bumps on his leg, the clubbing
and the joint pain-- are what's
called lofgren's syndrome,
and it's an indication of...
Sarcoidosis.
It's an autoimmune
inflammatory disease
that affects the lungs--
makes it hard to breathe.
It's also causing everything
we're seeing here
from his enzyme elevation
to the fluid accumulation
around his heart to the bleeding.
It's a preexisting condition.
The fire and the burns on
the chest just exacerbated it.
Let's get him started with
250 milligrams of solu-cortef.
Is he going to be okay?
If we're right... yeah.
Time to go, buddy.
Go get 'em.
We'll be waiting for you.
Jimmy, you're the best.
I'm doing it.
Not Jimmy.
What are you talking about?
I just heard I'm a match.
You're not 100%.
Means I'm best man for the job.
You sure about this?
I wouldn't let my Captain die
in a fire.
Not gonna let him die here.
It's how we do it.
It'll be just a minute.
It's cold.
Yeah.
It is.
Hey, Gwen.
I just want to tell you I think
it's a hell of a
thing you're doing.
It took this, Tommy?
Me giving a piece
of my body?
It was all stupid, Gwen.
It was so stupid.
I'm sorry.
This scares the hell out of me.
Hey, guys.
We're okay?
Yeah.
Okay.
Ready when you are.
Hey, Tommy.
Let's kill this thing.
♪ That age-old look ♪
♪ is in your face ♪
♪ it's been there a while ♪
♪ tries not to say ♪
♪ that you've had your day ♪
♪ but you have a faith ♪
♪ that looks both ways ♪
♪ look in your eyes ♪
♪ we'll last a lifetime ♪
♪ so when you reach ♪
♪ the end of the road ♪
♪ it still leaves somewhere ♪
♪ to go ♪
♪ at the end of the road ♪
♪ but I won't try to live ♪
♪ side by side ♪
♪ and I won't try ♪
♪ when you can take me
back in time ♪
♪ that charmless look ♪
♪ upon your face ♪
♪ found its way ♪
♪ through the smallest things ♪
♪ that have changed ♪
♪ so when you reach ♪
♪ the end of the road ♪
♪ It still leaves somewhere ♪
♪ to go ♪
♪ you don't look for signs ♪
♪ at the end of the road ♪
♪ won't try ♪
♪ when you can take me
back in time ♪
You never know who's
going to have your back.
Why don't you go say...
Thank you?
I owe her a lot more
than that, doc.
I'm afraid she's not going
to accept it.
I say man up and give it a try.
♪ But I won't t to live ♪
♪ side by side ♪
♪ and I won't try ♪
♪ when you can take me
back in time. ♪
Well, took long enough
to get this drink.
It'll be worth it.
Really?
For who?
For the bartender.
I'm thirsty,
and I'm a good tipper.
This is awkward.
Little bit.
I'll wait for you side.
Okay.
Okay.
Sorry to interrupt, Andy.
What's going on?
Nobody can know I talked to you.
An organized crime
Detective
recognized you and came to me
out of professional courtesy.
So, they... they have a photo
of me and my Uncle.
So what?
Paul Tieri,
the guy who stabbed your uncle,
was found shot in the face
on a rooftop
in Northview Heights.
Michael's a murderer.
They know he's
been laundering money.
Listen, this has got nothing
to do with me, Rena.
And that he recently
donated a large sum
for a Sudanese patient
of yours, Kuol.
Okay.
That donation
was 100% legitimate.
They know you have
a relationship with him.
Wh-what, do they want me
to rat him out?
I'm not going to do that.
If you don't, they're going to seize
the money for Kuol.
Rena, you...
you can't let this happen.
Okay, Kuol needs that heart.
He's going to die without .
It's not up to me.
I'm just looking out for you.
Yeah, you always did.
Your date's waiting.