Three Rivers (2009–2010): Season 1, Episode 2 - Ryan's First Day - full transcript

Give me your keys.

Call the police. He took my car.

Please somebody get on the telephone.

(tires screeching)

(engines revs)

Daniel, you...
you coming home for dinner.

No, I'm buying.
What do you want?

No no. I'll cook.

Chinese it is.
Have a gread day at work mom.

(Throws a kiss)

You too.



(crash)

So I talked to my buddies
at the Cleveland Clinic.

Do you have any idea how many
of your sentences start that way?

Shut up.

They got the luxury suite
for the Brown's-Steelers' game,

and they are saving me two spots.

So you in or you are out?

You realize you live
in Pittsburgh now, right?

You realize you live
in a hospital now, right?

I don't live in a hospital.

Oh no, you live in the hotel
which is connected to the hospital.

Come on, it's the Steelers.
You love the Steelers.

I'll check with Riny,
see if we have any plans that weekend.

Oh.



What?

A friend of mine is subletting his apartment,
you should talk to him.

I don't need an apartment,
I have a house.

Dude.

We are gonna work it out.

(Pam sighs)

Miranda, tell Andy
he needs an apartment.

You need an apartment.

Ok, I am your superior.

And you still live in a hotel.

I love hotels.

We are not talking about
your little sleep-overs

with the nursing students, David.

We're trying to get
Andy's live on track.

My life is fine. Thank you.
My life is fine.

Excuse me, do you know
where Dr. Jordan is?

Yes.

Her office is through there.

Andy, committee meeting
rescheduled for 2 pm today.

Dr. Jordan, there is a lost boy
looking for you back there.

Good.

2 o'clock.
Do not be late.

When am I ever late?

Are you the new assistant?

To the transplant coordinator.

Yes, Ryan Abbott.

Dr. Jordan, Head of the Surgery.

Here is the thing, Ryan.

You are hired to help the Coordinator
put together with donor runs,

book the jet,
communicate with the donor hospital

get the organs back safely
for the transplant

However, the Transplant Coordinator
who hired you quit last night,

so we are gonna need you to pick up
some slack until we can replace her.

You are on call 24/7,
so keep your phone on.

That's your desk right there.

I'll check on you later.

Left you a patient.

Dr. Reed,
are you lost again?

I keep telling her
the ER is on the first floor.

Yes, see the difference between
doctors and surgeons

- is that you like to cut them and run,
- hmm.

I like to know they are
actually getting better.

(Miranda)
Ooh, and that round goes to Lisa.

Ouch.

Hey, look who is back. Carson Hayes.

Miranda my girl, I just in Phily

and I checked out DiAngelo's like you said.

Man oh man.

(Miranda)
Was I right? Or was I right?

Hell yeah, that place rocks.

I know.

Hey Coach.

Heard you collapsed
at practice today.

Do not say I told you so.

Well, I did though.
I told you so.

Andy he is having frequent PVCs.

And what does that mean?

Means your heart's skipping.

That's Miranda.
She does that to me.

Okay. Easy, tiger.
Sit forward.

Ok, deep breath.

Are you having
chest pain right now?

No, just short of breath.

That's because
you had angioplasty and stents.

You continue to eat badly,

smoke cigars and
ignore your diabetes.

So you got sicker,
like I said you would.

Now, there is a phrase for that,
isn't there Miranda?

(laughs)
- it's uh...

Oh yeah,

I told you so.

Just shut up and
fix my damn ticker.

Bye.

The flight was great,
the cab brought me straight here.

He drove past the Arts building.

I just wanted to jump out
and get started.

(sighs)

I know... I

I'm not alone dad, I'm fine.

Tell him you gotta go
check out the guys in the quad.

I gotta go now dad.

Ok. I will.
I will call you tonight.

I love you too.

Bye.

Huh... finally.

He's worried.

I've never been away from home.

Well, then it's time
to go a little crazy.

(difficulty breathing)

Are you okay?

I think I need my inhaler.

Oh, you don't look good.

Oh my God, Christine,

are you okay?

Help!

♫ Three Rivers 1x02 ♫
Ryan's First Day
Original Air Date on October 11, 2009

(ambulance siren blaring)

(ER doors opening)

18-year old.
Probably she has asthma.

She has inhaler with her.

Tach at 150, BP 160/100.

Okay... on my count, 1, 2, 3.

Okay, what's her name?

Christy.

Christy, can you hear me?

I'm Dr. Reed.
I'm gonna take care of you.

She's cyanotic
and not moving much air.

Give her a 125 Solu-medrol IV,

albuterol atrovent hand-held nebulizer

- Set me up for intubation.
- Yes, Doctor.

No tube.

During respiratory failure
we need to help you breath.

No tube... BiPAP.

How do you know BiPAP.
You had this before?

(wheezing)

Okay, but If you don't turn around fast,

we're gonna need intubation
and a ventilator.

(wheezing continues)

Okay, put her on BiPAP.

Right away.

(monitor beeps)

(indistinct voice on P.A.)

Miss Noonan.

My name is Salio Warez.

I'm a family care specialist.

I'm very sorry about your son.

The police can't find
the scum that hit him.

He ran away.

People like that...

don't deserve to live.

Have the doctors explain about....

Daniel's condition?

They said he's brain dead.

But he looks like he's sleeping.

The EEG confirmed
his brain function has ceased.

He's on a ventilator and medications
to keep his blood pressure stable.

Did you know that Daniel was
registered as an organ donor?

No.

But I'm not surprised.

He was a good boy.

Always thinking about... other people.

Never any trouble.

Well, not much.

Boys get into things, but...

he was never like his brothers.

I failed with them... but

Daniel was a good boy.

They took...

my good boy.

(crying)

(voice breaking)
My good boy.

(sobbing)

This is the transplant center.

And this is Miranda Foster,
surgical fellow.

David Lee, lowly surgical resident.

And Dr. Andy Yablonski,
attending surgeon.

I'm Ryan Abbott.

And I can not tell you how excited
I am to be working here.

Miranda, may I speak with you.

Yeah.

(Andy clears his throat)

Awh...

sorry. We uh...

we hired a SpongeBob?

He is bright, he's organized,

and he went to a better school
than you, so be nice.

- Miranda.
- Yes.

You are gonna be lead doctor
on the next donor run.

Really.

You're the natural leader,

You're not afraid of tough situations

just...

Remember that you are a guest

in the donor hospital and be professional.

Absolutely.

Don't lose your temper.

No, ma'am.

You'll do great.

- Thank you.
- Umhmm.

(hand slap)

(indistinct voice over P.A.)

Miranda Foster.

Any relation to the Foster
whose name on this building?

Her father was a pioneer
in transplant medicine.

Died last year.

They weren't close,
so I would not ask her about him.

Thanks for the heads-up.

Umhmm.

What are all these maps all about?

(chuckles)

First time in transplant?

When an organ becomes available,

it's offered to the six patients
within certain radius first.

And if there is no match,
they expand that radius.

I thought people who are dying
on the waiting list.

Why wouldn't there be a match?

Blood type, size of the organ,

sometimes by the time an organ
becomes available,

patients are just too sick
for surgery. So

Wow.

So someone can be
on the waiting list for months,

maybe even years
til it becomes available. You know.

You need to go away now.

And put Primanti Brothers
on your speed dial.

I-I'm sorry.

Well, sooner or later we are gonna
have to go in a donor run

and you have the key to the plane.

Primanti Brothers
makes a cheese steak sandwich

and puts the french fries on the inside.

I want that.

Don't judge me.

Girls, say bye to daddy.

Bye sweety.

Kick some butt.

Thank you doctor.

I know, it's hard watching them go.

They got be use to by now.

Dialysis is tough on the body,
and the spirit.

But until a kidney
becomes available for you,

it's the best option.

Got your test result.

You gonna put another stent on it?

No, you are way pass stenting.

You my friend need a double by-pass.

What?

You kidding me?

My jokes are much funny than that.

You have a minor infection,

so we are gonna hit you
with some antibiotics.

How long will I be
out of commission.

6-8 weeks.

And you are gonna need
some help on this one.

So call your family.

Never really been much for a family man.

You are gonna need someone,

this is a major surgery.
You can't do this alone.

Yeah.

(monitor beeping)

What's going on?

BP's falling, 60 palp. Pulse 160.

Okay, get her off BiPAP.

Get me a 14 gauge.

Here you are Doctor.

(monitor rapidly beeping)

Systolic up to 110, pulse ox up to 90.

We need to intubate.

22 french tube, I'll go in mid-apillary

Okay, page Dr. Yablonski
and let's get her up to ICU now.

Let's go over this
one more time, Dr. Reed.

Your suppose to patch them up

and then hand over them
to someone like me.

You don't have to keep following them
around the hospital.

Did I do this?

Do what?

Blow out her lung?

Should have intubated her earlier.

But she wanted BiPAP.
And that's her right.

You didn't do anything wrong.

And intubation would not have changed
the final outcome.

Look at this.

Severe pulmonary fibrosis

She has pulmonary hypertension

and look at that wedge on the CT.

So how can an 18-year girl
have lungs this messed up?

(inhales)

I don't know.

But she's gonna need
a double lung transplant.

We are gonna talk to the committee
today and get her listed.

I'm Manuel Martinez.
I'm Christy's father.

I'm Dr. Yablonski,
this is Dr. Reed.

Oh God! Is she ok?

She's stabilized now.

What is her PAO2 in saturation.

Are you a doctor sir?

No, but we've been down this road
several times before.

I'm gonna need you to fill me in
on Christy's medical history.

Cancer.

She had a carcinoid tumor
on her lung.

Was she treated with a combination
of radiation and chemo?

Yes. And surgery.

She got pneumonia afterward.

Mr. Martinez.

How long has Christy
been in remission?

Three and a half years.

Okay, we'll give you a moment.

(monitor beeping)

What is it?

She needs 5 years cancer free
to be wait-listed for an organ.

She hasn't been in remission long enough,
we can't transplant her.

(ambulance siren blaring)

Christy Martinez.

n stage pulmonary fibrosis

timed vital capacity

less than 50%.

Diffusing capacity for CO...

less than 50%.

By the numbers
she meets the criterion for transplant.

I think we should list her immediately.

The problem is she's only been
in remission for 3.5 years.

You know how this goes.

Hospital policy. She needs 5.

I know, but if we don't transplant her,
she's going to die.

Survival rates within
the 5-year window aren't great Andy.

What we need to do is
get her through this crisis,

and maintain her for 2 years.

2 years?
She's not gonna make 2 weeks.

Now what we need to do
is make an exception,

on the grounds
that post treatment pneumonia

has scared her lungs
and accelerated her disease.

There's been no recurrence of cancer.

The immuno supressing drugs
she'd be on after the transplant

would make it more likely that
the cancer would come back.

We can't waste a good pair of lungs

on a patient who probably won't make it.

I don't think you gonna win
this one Andy.

She's 18 years old. You know.

And were just gonna give up.

She's 18.

I don't understand.

You said she needed a transplant.

If it were just up to me,
I would do it right away.

So what are we suppose to do?

We're gonna lighten your sedation .

I'm gonna get off that ventilator.

I'm gonna keep you
as comfortable as possible.

Keep her comfortable.

I'm gonna do everything I can.

(scoffs)

Christy,

listen to me.

I'm not giving up on you.

But you gotta hang in there with me.

Okay. I need you to hang in there.

Hey, we heard about
the transplant committee meeting.

Yeah, whole thing sucks.

Wasn't much they could do. right?

They gotta follow the hospital guide line.

David.

You're absolutely right.
This whole thing sucks.

Guys.

Guys, I just got my first offer on an organ.

Yeah? Where are we going?

Oh...um

Boston, to get a kidney

for one of Dr. Jordan's patients

Dan Parnell.
(beeping)

ouw, looks like Miranda and I
are taking a little trip to Boston.

(chuckles)
ha, ha.

And I am in charge this time,

so you'd better get used to doing
everything I say.

Do you know how long I've waited
to hear you say those words?

Ryan, who's taking the lungs?

Nobody. They got banged up in the crash.

The PaO2's 502 ratio is under 300.

Lungs aren't assigned?

Looks they offer them down the list
but nobody wanted them.

(clears throat)

(touch tone dialing)

Got good news for you Dan.

I have an offer on a kidney for you.

You serious?

It's a great match.
Blood type, size, energence.

Am I back up again?

Last time they were never got to me.

You are primary.

If you accept this offer,
we will be in surgery in couple of hours,

and you will be off dialysis tonight.

(deeply inhales)
(exhales)

You okay?

I've been on this machine

3 times a week,

8 hours a day for 5 years.

My girls are in high school now.

Are you telling me
I get to have my life back?

If you say yes.

Yes.

Yes.

All right then.

Hey,

Hey.

I'm leaving for Boston,

but I wanna come
and check on you before I left.

What's in Boston?

I am bringing back a kidney
for a patient.

You never brought a kidney back for me.

If only the kidney is only your problem.

(laughing)

You wanted to see me?

- Look at you.
- This is Jeremy, my son.

Hi. I'm Miranda.

I'm one of your father's doctors.
It's a pleasure.

You've gotten tall.

I.. I haven't seen you since you...

No. Let's not do that, okay?

My mom said you want to see me?

And uh... the only reason
I agreed to come here

was to tell you what a pathetic excuse
for a human being you are.

I've barely seen you
since I was 12 years old.

Now that you need something,

you call.

Okay. Jeremy,

I know that you two
have somethings to work out,

but your father's heart
is severely compromised.

You got that right.

And I just ask
that you don't agitate him.

You know what?

I said what I came to say.

Hey, don't go, come on.
You just got here, let's talk.

Wow.

Ready for your first donor run?

Look at me. I'm wearing scrubs!

Very excited.

Are you coming with us?

Oh, Andy doesn't do flights.

He's much to important for that.

Jealousy is an ugly thing David.

What you got there, a to-do list?

Yeah, I got the jet,
the pilot, David's weird sandwich.

You got the cooler?

For the drinks?

The kidney.

Be right back.

Listen guys.

I may need you to bring the lungs
back for Christy,

blood type's good,
the size is acceptable.

Are they even viable?

They're borderline at the moment.

I spoke to the attending,

and asked him
to implement the salt protocols,

to see if they recover.

All right,
but I wouldn't expect too much.

I mean, those numbers are pretty low.

Just do what you can.

This can be Christy's last chance.
All right?

- All right.
- All right.

Let's go.

The temperature is down to 100 even.

Antibiotics worked.

I heard your son came by today.

Just gave me a piece if his mind.

Can't really blame the kid.

Don't know why I called him.

Why, he's your blood.

I never treated him that way.

I barely saw him when I played ball.

Then I retired,
busy partying and chasing tail.

I can fix your heart.

The rest is up to you.

I'm 52 years old.

I've burnt all my bridges.

I don't wanna be that guy.

So, change.

I wouldn't know where to start.

Start by picking up the phone.
Call your son.

Tried that, worked out great.

So try again.

When I 'm done with you,

your heart could go
for another 30 years.

You got a shot
at starting over here man.

Don't waste it.

I can't believe
I'm going on a private plane.

I haven't even flown first class.

Settle down, Jethro.

Oh, ignore him Ryan.
He's only used to fly first class.

That's not true.

I have a little 6 seater I fly
up to Vermont for ski season.

Wow.

Yeah, I'm been trying to get Miranda
to fly up there with me

Cabin with slopes.

Fireplace.

Never gonna happen.

Oh, it's gonna happen.

(airplane engine running)

(jet ascending)

This is the kidney team
from Three Rivers.

Dr. Breslin and the heart team.

How's the blood pressure.

Unstable. We need to work fast.

Well, we may want the lungs.

So once you open,

we're gonna send a live feed
back to our hospital

and let our staff surgeon make the call.

Once I 'm open, I am not stopping
to make a movie.

I got a 32-year old single father
waiting for a heart.

We have a 18-year old girl
suffocating to death.

So we're gonna take some pictures
of the lungs before you cross clamp.

(monitor beeps)

Well make it fast.

- Let's scrub in.
- Yeah

Ryan I want you to start sterile slush.

I'm sorry?

Slush. Start with 3 bags.

(OR doors open)

Why are you standing there.
Start the damn slush.

I... I... I don't know what that is.

psst.

Slush, slush.

Where did you get
your medical training?

Oh, I don't have medical training.

I was hired to assist the person
who had medical training.

What kind of training do you have?

I was a stringer
for a newspaper in Columbus.

And I did the farm report
on a local radio station.

So... So you're a DJ.

No, I did the news.

You wanna take this outside,

so those of us who that have
medical training can do our work?

Can I see the lead doctors
in the waiting room please?

What's going on?

Detective Shanahan, Boston PD.

We're taking possession
of Daniel Noonan.

Like hell you are.
We are about to do a procurement.

This donor is unstable.

If his heart stops,
we are gonna loss those organs.

We need to gather evidence
from the body.

He's a victim of a hit-and-run.

What kind of evidence do you need?

This was found in Noonan's car.

This links him to the murder

of the person this belonged to,

a young woman named Faith.

He is not a victim,
he is a murder suspect.

(camera shutters)

Ma'am.

I need to ask you a few questions

about your son's whereabouts last week.

Hey, what's wrong with you,
she just lost her son.

I got a mother waiting
to find out who killed her daughter,

that's who I answer to.

Okay, okay.
But this woman isn't a criminal.

She raised one.

What kind of heartless moron are you.

Hey, do you wanna cause trouble?

Detective.

He is all yours.

Why, what's going on?

Finger prints matched.

He's the guy we are looking for.

I am so sorry.

Please,

just do what you need to do.

All right, trauma's severe on the right lung?

Show me the contusions.

Left bronchus.

Okay Miranda, give me the numbers.

The ratio is up to 290.

That's an improvement to the last test,

but still marginal.

Bring them.
I'll clear with the OPO and Jordan.

Okay. Copy that.

Call me the minute you land.
I'll start preping Christy for surgery.

I may have a pair of lungs for Christy.

The donor died in a car accident
and the lungs were bruised.

You're not putting broken lungs
into my little girl.

Listen.

There's been success
with these kinds of transplants.

We just need them
to get Christy to the 5-year mark.

But we might be lucky,
these lungs might last.

We haven't been lucky so far.
Sounds too risky.

It is risky.

And you need to understand that.

Without a transplant,
Christy will die within weeks.

But if you agree, and the transplant
fails, Christy could die tonight.

How do you expect me
to make that choice?

It's my choice.

I'm 18.

Listen Christy.

I went through cancer and chemo.

When I went into remission,

I promised myself
I'd never be afraid again.

No more fear.

It's my life.

(labored breathing)

Do the transplant.

(voices on TV)

I wanna know why you left.

(exhales)

Okay.

Let's talk about it.

Andy

Hello

We're bringing in damaged lungs?

How do you heard about that?

Certainly not from you.

I was just on the way to tell you. I
wanted to talk to the patient first.

You talked to the patient before
clearing a risky surgery with me.

Which is risky for the patient.

The hospital has to
live with survival rates.

The San Antonio study showed

no significant difference in
one year survival rates.

I think you're just mad
that I didn't tell you.

I'm just mad
that you didn't tell me.

I should have told you.
I was just

(Interrupting)
Excited.

Overwhelmed by your own genius.

I want to save her life.

So do it.

Is this your approving
the operation?

She's not taking lungs
from another patient.

She agreed to the operation.

Thank you.

Tell me next time.

Yeah, absolutely.

♪ ♪

♪ No need to hear your voice ♪

♪ but see your face ♪

♪ now that you are with me ♪

♪ No need to care for that for ♪

Yeah, it's me.

Yeah. We're landing right now.

Well, the kidneys are in good shape.

But the lungs don't
have much life in them.

So... open Christy up right now. Okay.

We'll be there in 20 minutes.

All right, we'll see you soon. Bye.

♪ just where you want ♪

♪ you're looking down ♪

♪ ♪

(police siren blaring)

(David)
Something is going on.

What is it? An accident?

Whatever it is, it must have just happen.

Local news sites
aren't reporting anything yet.

(Miranda)
Are those helicopters?

What the hell is going on?

Oh my God.

Hey, we need to get to the
other side of town in 10 minutes.

I don't see how. We all
locked in, we can't move.

- Hey, I got something.
- What?

It's a bomb threat
at the federal building.

All the streets are blocked off and
they are closing the bridges right now.

Can I speak to someone in the FBI?

Yes, we are.

No, do not put me on hold.

I gotta call Andy.

(dialing)

(monitor beeping)

Where are you?

Stuck at Liberty and 6th.
Don't open your patient.

Too late. What is your ETA?

I don't know. Ryan
is talking to the FBI.

And they aren't letting
anybody move around.

And I'm worried these lungs
aren't gonna last.

Do what you can before I have to close
her up and lose the lungs.

Yeah. I know. I know. Good bye.

(monitor beeping)

What are you doing?

Gonna run them in.
The hospital's like over a mile.

Running down the street
with 2 coolers

in the middle of a bomb scare
might not be the best plan David.

Wait.

Where are you going?
Where are you going?

I don't think he knows.

(monitor beeping)

(indistinct police radio chatter)

That's it.

What?

I'm taking them in.

No, you are not.

- Yes, I am.
- David, no, you're not.

- Yes, I am.
- David, no, you're not.

Come on, get in the ambulance.

The FBI got us an escort.
These guys don't have all night.

Nicely done, Ryan.

♪ ♪

Carson's crashing.

(monitor beeps rapidly)

There's no pulse. Starting compressions.

We were checking his vitals
and his heart just stopped.

Jeremy. You have to step out and
I am gonna come and find you. Okay?

V Fib. Do we have a line?

Yes.

Charge 200. Everybody off. Clear.

(jolts heart)

Clear.

Okay. Ready to remove the lungs.

Take us in full by-pass.

Yes, doctor.

Okay. We're there.

Right lung coming out.

Your father had a stroke.

And there's nothing that we can do.

I'm really very sorry.

(inhales deeply)

I spent so much time hating him.

I don't even know why I care.

Yeah.

Here we go.
Right lung going in.

Ok Pam, let's get ready to suture.

Looks good. I'm gonna tie this off.

Give me a by-pass please.

Yes, doctor.

Blood pressure is coming back up.

Let's reinflate.

Reinflating.

Come on Christy, breathe.

Breathe.

Breathe.

It's beautiful.

You know you have to
do the other side right?

Jeez.

Can you let me enjoy the moment?

Now?

Now.

Mrs. Parnell. Hey guys.

So the new kidney is in.

And everything went very, very well.

(sighs)

You should be able to see him soon.

- Thank you.
- You're welcome.

- Thank you.
- You're welcome.

Ohh.

Umm.

(siren blaring)

(door opens)

Did you bring me a heart?

(Andy drops cooler)

Kinda.

(bottle cap pops)

Thanks.

(clinking bottles)

You're welcome.

(sighs)

You had a tough day.

Not as tough as Carson's.

Pathology came back.

It was an aneurism.

It blew.

There's was no saving him.

So,

where is this house
you supposedly own?

It's up on that hill there.
Cross the Monongahela.

I thought that was Allegheny.

(chuckles)

Monongahela.

Allegheny.

The Ohio.

You work at a place called Three Rivers,
and you can't even name them.

Only one of the ways I learned to piss
off my father when I came to visit.

(chuckles)

Wow.

I didn't talk to him for 2 years.

And then he died.

I know how Carson's son is gonna feel.

At least he got today
with his father. You know?

And Ben Parnell is off dialysis.

And Christy Martinez is gonna have a
whole life ahead of her.

Let's take those wins and go home.

Or in your case the hotel.

(door opens)

We are gonna work it out.

I thought you guys were up here.

Hey, David.

It's a great day, huh.

Yeah, great day.

Beautiful, isn't it?

What is this?

The names of our organ donors.

We honor them here.

Wow.

I'm supposed to be visiting someone.

A girl named, Christine Martinez.

I'm her doctor.
I'm Andy Yablonski.

How do you know Christy?

My son, um...

She needed a pair of lungs,
my son...

Your her donor's mother.

She's very exicited about meeting you.

(exhales, sighs)

She asked me to come.

To tell her about...
Daniel.. but...

now that I'm here, I don't
know what to say to her.

Uh...

I... I thought he was a good boy

but...

I didn't really know

him.

He saved Christy's life

That matters.

Will Daniel's name be up there?

Absolutely.

This is how will remember your son.

That's nice.

Thank you.

Let's go see Christy.

Yeah.

Okay.

Let's go.

It's you.

I'm so happy to meet you.