Miami Medical (2010) s01e03 Episode Script
What Lies Beneath
I wanna dress you up You ought to be someone We're gonna live it up Before the livin's done, done, done Get up off the floor (thunder rumbling) (song fades) (rumbling continues) Sir Huh? That's beautiful, but it belongs with the Uh, cocktails and the hors d'oeuvres.
Yes! Yes.
Thank you.
You're welcome.
(wind whistling) It's gonna rain.
And so much wind.
Which is why we have a tent, honey.
Trust me, when you look back on this day, the one thing you won't remember is the weather.
(nervous laugh) But you probably will remember the piece of tissue stuck to your father.
What? Oh, God.
(all laughing) This is why you need to get married.
So you don't leave the house with toilet paper on your face.
Whoa, whoa, Emily.
I'm fine.
Sweetie, if you don't want to do this I'm fine, I'm fine.
It's just nerves, that's all.
(classical music playing) Vivaldi.
That's our cue.
WOMAN: Zander looks so handsome.
(thunder rumbles) (distorted whooshing, slow heartbeat) (guests gasp, shout) Emily! Emily? Someone get some water, please! Give her some room! Emily Are you okay? EMILY: Zan? (moans) Oh, God, is everybody staring at me? I gave them all Sudoku puzzles.
They'll be busy for a while.
(laughs) Oh, goodness.
(both laughing) Want to see if you can try to get up? Yes, please.
All right.
(guests murmuring) (applause) (rumbling, wind gusting) (tinkling) (wind whistling) (people screaming) (yelling) (wind roaring, Emily screaming) (crashing, shattering) Here it comes Here it comes Here comes your 19th nervous breakdown.
Incoming in eight.
Anything good? Hunky high school reunion guy.
Details, Dr.
Warren.
Serve 'em up.
Hey.
(laughs) It started with a cup of coffee, turned into a weekend.
Wow.
I haven't seen a girl blush like that since seventh grade.
Sounds like my kind of weekend.
REPORTER (on TV): This freak weather phenomenon, known as a microburst, is short-lasting, isolated, but can pack winds of over 100 miles per hour.
The same phenomenon struck the Dallas Cowboys' training camp early last year.
Half dozen incoming red-bands four minutes out.
Possible crush injuries, lacerations from debris scatter.
MAN (over P.
A.
): Attention, Alpha Team, incoming, four minutes.
Dr.
Proctor can I get your autograph on these discharge orders.
Sure.
Who should I make it out to? Kathy.
Lipson.
Hey, so, speaking of microbursts, what's Nurse Kathy doing here? Chatty's on loan from Bravo team until Tuck gets back from search and rescue training.
I swear that woman's like a bad case of toxemia.
Always stirring it up.
Can't believe she started that pool.
Pool? What? (pager beeping) Saved by the page.
There's a pool taking bets on when you and I are gonna, you know, play doctor.
(laughs) Well, that's what I call a sucker's bet.
Wait.
Where would they get such an idea, Chris? Uh, don't look at me.
Remember last week, you gave me a ride to work? I guess somebody figured Not the only ride I gave you? Yeah.
Ugh.
Eva You're in the ambulance bay.
Chris, stand by for the second wave.
Got it.
Got it.
Anyway, you know what they say about gossip Underneath, there's usually a kernel of truth.
(chuckles) You can't handle the truth.
(chuckles) Emily Palmer, 23-year-old bride-to-be.
Blunt head trauma and deep forehead lac, altered with GCS of 4-6-4.
Where's my family? Zander? Oh, my God, what's happening? I'm Dr.
Zambrano.
Do you remember what happened? We were at this wedding, and the tent collapsed.
All right, all right.
Oh, my God.
Try and relax; we're gonna take good care of you.
Okay.
On my count.
Ready? One Two, three.
(sobbing) Get me a second large-bore I.
V.
, and a liter of normal saline.
BP, blood count every 15 minutes.
All right, Emily.
It's okay.
(sobbing) Can you tell me where it hurts? (sobbing, gasping): My M-My head is pounding.
(Emily sobbing) (sobbing quiets) You have a deep laceration.
Grab me a six-oh proline on a large needle.
No, not on my-my forehead it really hur Hurts in the back.
Penlight.
Gina, call C and have them bump whomever's next.
We may have a brain bleed.
(exhales, groans) (alarm beeps) Emily.
Pulse is strong.
(alarm stops) She just fainted.
Well, at least now she won't have to see this.
Avert your eyes, ladies.
Hey! Hey, I've got incoming! This is your incoming.
What, are you catering today's trauma? Fortunato Delgado, 39-year-old male with penetrating chest and abdominal injuries.
The guy couldn't fit in the ambulance.
Is he 800 pounds? Not exactly.
Because of the pole into through shoulder and out through his lower flank.
(thunder rumbling) Hello.
Hello.
Why didn't they just cut the pole down in the field? Guess they wanted to save time at the scene, considering the severity of the injury.
Can you prep the O.
R.
? Have at least eight units of O-neg ready.
Primary survey airway clear.
I was just finished arranging the ice sculptures, when the wind comes out of nowhere.
Breathing's shallow but with good air movement.
FORTUNATO: I heard screaming.
I w-went to help, and suddenly, something fell from the sky, and knocked me to the ground.
EKG now, and have a crash cart standing by.
Pulse is strong, BP 120/80.
That's good? That's very good.
Pupils equal and reactive.
GCS, 15.
Perfect.
I'm perfect? That will come as a big surprise to my wife.
Um, e-excuse us.
I'm Dr.
Proctor.
This is Dr.
Warren.
Fortunato Delgado.
I would offer you a hand, but under the circumstances Okay, Fortunato, on a scale of one to ten, how much pain are you in? One.
Maybe one and a half.
All right, what do we got? Henry Palmer, 49-year-old male.
Hypotensive, had to be extricated from the collapsed wedding tent; father of the bride.
Okay, let's get him into Trauma 3 over here.
Wait, wait, wait I'm Edie Palmer.
I'm his wife, and I'd like to know where you're taking him and what tests are being run.
Ma'am, I'm Dr.
Deleo, and I won't know anything until I've examined him.
Okay, well, my-my-my daughter's here somewhere, and so I-I need to know what's going on.
I have a few questions Will you just hold on! Please! Okay, Mrs.
Palmer, Mrs.
Palmer, I understand you have had a rough day.
The best way for you to help your husband is to wait in the waiting room.
You're really very young.
How How old are you? I'm old enough to know that we're wasting precious time.
Please.
(quiet, muffled grunt) Okay.
I promise you I'll take good care of him, all right? Please, help Mrs.
Palmer with any of her questions.
A-And her wrist.
All this on my wedding day.
Where's my family? Where's Zan? I'm going to find out for you as soon as I can, okay? She has a hemotympanum and a battle sign.
Hemo what? What-What does that mean? You have blood behind your eardrum.
What does that mean? Well, we have to do a scan and see what's going on inside your head.
Trust me, no one wants to see what's going on in there.
You fainted at the ceremony.
Yeah.
Do you have any underlying conditions we should know about: Diabetes, heart problems pregnancy? No, no, nothing like nothing like that.
Just, uh nerves, that's all.
Penlight.
Emily, you wouldn't happen to have a cold.
No, I just have this weird stuff coming out of my nose.
Let me see.
Okay, let's do a CBC and a CNP.
And page me when you get the scans back.
No pain how is it possible? He's impaled by a six-ft pole.
E body's in shock.
You get a rge of endorphin which blocks the nerve impulses.
You're more likely to feel pain from a splint than our friend Fortunato does right now.
That's not to say, of course, that that, uh, pole isn't passing through a major organ or two.
He's not gonna fit in a CT.
Yeah, I know.
We still need a map before we go on the road trip.
There's that new laser in the lab.
We could use that to cut down the pole.
(chuckles) Yeah, and kill him for sure.
Extreme heat on galvanized steel releases toxic fumes Something I discovered in Kuwait.
The hard way, unfortunately.
No, we need a specialist.
Get Mike.
Mike from Thoracic? Mike Wiznewski.
Have you seen Mike? Ooh, from Thoracic? Wiznewski.
Try the ladies room.
Thanks.
Mike? You in here? Yeah.
I need you.
Me? What have we got here? Zander Lewis, 24-year-old male hit by flying debris.
Diffuse abdominal pain, trauma to lower left extremity.
BP 100/70.
All right, Zander.
M Dr.
Zambrano.
I'm going to need you to hold still, so I can take a look at your leg.
Where's Emily? She's here.
She's in good hands.
(Zander groans) Patella dislocation.
(gasping) Ten out of ten on the pain scale.
Want five of morphine? No, it'll take too long.
I'm just going to have to pop the knee back in.
(Zander moaning) So, Zander, could you, uh, tell me what you do for a living? Musician.
This hurts like hell.
And how'd you meet Emily? Uh, she's cello, I'm percuss Please just give me something! All right, this will kill the pain in about three seconds.
Okay.
Ready? Squeeze.
One two (cracking, Zander shrieking) All right, we got a large liver laceration and blood pool in the abdominal cavity.
Start two units of O-neg on the rapid infuser.
He's going to need surgery.
(gs) "I'm gaining a son.
Happiest day of my" Is this your wedding toast? (weakly): My only copy.
I'll take good care of it, all right, sir? Sorry about that, but it would've taken another ten minutes for the pain meds to kick in.
(gasping): Thank you.
All right, so, let's see what else is going on with you.
Roll him.
(groans) Can you tell me what happened? It was crazy.
It was like a 747 just crashed on top of us.
One minute, I had Emily in my arms, and then then she was gone.
It's the last thing I remember.
(gasps, groans) Does that hurt? Yeah.
I got nailed by some flying objects.
It was, like, a chair or the minister, or something hit me in the back.
Listen Emily when can I see her? As soon as we take care of you.
Okay? Okay.
Call for an abdominal CT.
So, you're a plumber? WIZNEWSKI: Local 315.
Card-carrying member.
You are worried.
Me? Uh-huh.
No.
She's just making sure your blood pressure remains stable while Mike cuts the pole.
Don't worry I've always been a very lucky man.
WIZNEWSKI: I had an uncle who was lucky.
He once won 10,000 bucks in the lottery.
But then he went to jail for tax evasion, so Okay.
There! I think that's it.
WIZNEWSKI: Okay.
There it is.
Got it.
I had scarlet fever when I was two.
The doctors told my mother I would not make it.
Yet, here I am.
They also said I would never have babies.
Um, the sperm? Bad swimmers.
Today, I have four children.
(chuckles) Very lucky.
Hey, I'm, uh, heading up to O.
R.
To take care of father of the bride's liver lac.
Okay.
Did he just call himself lucky? Well, he is alive.
Pressure's holding.
(alarm beeps) Holy crap.
It-It's bleeding, right? Just a little.
Apply pressure, secure the pipe with Kerlix.
Distal carotid injury? No, no, it's from a vein, not an artery.
The blood is darker and it's oozing;t's not pumping.
Oozing? Is that good? Well, let's just say the other is worse.
Carotid, you die, right? It's not the carotid.
Place some sutures to stop the bleeding, then get him to CT.
Page me when you got some images.
Give me a four-oh nylon and a PS3 needle.
I hate needles.
Yeah? Me, too.
So, Zan's okay? He's conscious, alert, sense of humor intact.
He's got some abdominal injuries and we won't know the full extent until we get his scans back.
What about me? Your CT showed a basilar skull fracture, which explains that slow drip from your nose.
It's actually cerebral spinal fluid.
So my brain sprung a leak? I know it sounds scary, but 70% of skull fractures heal by themselves.
In the meantime, we're going to monitor you closely and give you something to slow that drip.
What if it doesn't heal? Well, as they say in med school, don't put the crash cart before the horse.
(chuckles) (sighs) Well, I got a groom with a spleen injury and a blushing bride with a skull fracture.
How's your impalement case? Surprisingly lucid.
CT just paged me.
His scans are back.
Is that "Hunky Reunion Guy"? C told me you had quite the weekend.
(laughing) What? I just feel funny talking to you about personal nonsense.
Next to Proctor, you're the big cheese around here, so Oh, wait, so you can talk to Chris and not me? Uh, he stopped developing emotionally in, like, the ninth grade.
Well, apparently, so did Hunky Reunion Guy, 'cause I haven't heard from him all day.
Well, the day's not over.
He usually shoots a response back in 30 seconds.
It's our thing.
Sorry.
Exactly what I didn't want to do blather.
Serena, don't apologize for having a personal life.
It's what people are supposed to do.
It's just you would never get stupid like this.
Over a guy.
And why would I never? Oh, it's a compliment.
You-You're not distracted by relationships.
You're a total pro, Eva.
Mrs.
Palmer's out there demanding updates about her husband and her daughter every five minutes.
She still wants to know how old you are.
Yeah, well, Admin will take care of her.
We gotta get .
Palmer up to surgery to repair his liver.
So, you ask me to heli-ski a fresh pack or cave dive at 100 feet? I'm good.
But talk an hysterical wife down? Forget it.
I'm calling in the cavalry.
(alarm beeping) BP's dropping.
(gasping) A major edema? What the He's going into shock.
(gasping) Hey, ts is Dr.
Deleo.
A maWe're coming uto ICU.
I need point-three cc's of epi standing by.
Throat's clong He's gonna code.
Hey, come on! Henry! Hey, stay with me.
Come on, Henry! Point-three cc's epi.
(alarm beeping rapidly) Breathing's returning to normal.
What the hell did we give this guy that sent him intonaphylactic shock? Henry doesn't have any allergies? Uh, antibiotics? Food? Latex? No.
Dad's never been allergic to anything.
What about pain medications? Have any adverse reactions? No, no.
Ten years ago, he was in a car accident.
They gave him all sorts of painkille.
He never had any problems.
Well, we'll keep looking.
Dr.
Deleo, I'm I'm very sorry if I was rude earlier.
You weren't rude.
You were concerned.
Wait, the car accident.
Did Mr.
Palmer have any blood transfusions? I-think so, yeah.
It's the blood.
I need a little more information than that.
Fath of the bride.
He's having a hemolytic transfusioreaction.
His body's rejecting the nor blood.
Multiple prior transfusions.
Causing him to develop antibodies to his own blood type.
And here's the kicker.
He's AB-neg.
That's, like, three percent of the population.
Yeah.
Blood bank's testing samples now, but so far, he's been allergic to everything.
So we need to find not just an AB sample, but one that he doesn't react to.
That's like finding a needle in a millionaystacks.
Okay, so we'll, put out an SOS to every blood bank within a hundred-mile radius, and I'll get Zambrano to test the relatives.
You're going to have to go at the liver without any blood on deck.
Operate without blood? He could crap out on the table.
Wait for blood, he could crap out within the hour.
Can't tell what organ it's hit.
Or the extent of the damage.
But we do know one thing.
That pole is about a 16th of an inch from his heart.
Hey.
How are my pictures? My wife always says that I'm photogenic.
But I think she means on the outside.
(weak laugh) I'm afraid the, uh scans are inconclusive.
So we won't know exactly what's going on until we get you into surgery.
The pipe is Well, it's very close to your heart, Fortunato.
But the good news is you're remarkably stable.
Lucky.
I told you.
Yeah.
Lucky.
Your dad's blood has developed antibodies to multiple minor blood antigens.
In plain English, he's allergic to most of our blood supply.
How is that possible? AB-neg is very rare.
And he's rejected all the AB we have on hand.
There must be something we can do.
We-We are.
We're flying in samples from hospitals all over Florida, but our best chance of a match is from a blood relative.
We've got a bunch of relatives out in the waiting room.
We've got Uncle Joe, Aunt Phyllis But what about me? Sweetie, you're not well enough.
You're not the doctor, Mom.
Um, actually, she is well enough.
What about her skull fracture? The CSF leakage has slowed, and she is the most likely match.
Mom, I'm doing this for Dad.
I'll go organize the relatives.
I-I need to see Zan.
I know.
Tomorrow, when you both are stable.
Emily, Zan has a pretty bad spleen injury, and you Yeah, I know, I'm, uh, I'm brain-leak girl.
(both chuckle) It's been a rough day for you and your mom.
Squeeze.
She didn't want me to get married My mother.
Dad's always been so supportive, but she said we were too young Just starting out in our career "What's the hurry"" I'm 23 years old.
Exactly the same age she was when she got married.
Must be hard getting married when you know your mother doesn't approve.
Understatement of the year.
Zan, you should not be up and around.
Everything okay over here? I want to see my wife almost-wife.
He doesn't have permission to be out of the ICU.
We're ten feet and two minutes away from "I do.
" Haven't you heard the groom's not supposed to see the bride in her hospital gown? (laughs) Tradition has to be respected.
I just want to talk to her.
You know how frustrating it is.
You just want to talk to somebody and you can't.
I do.
But you have got a grade-two spleen injury.
You keep moving around, it turns into a full rupture, which turns into emergency surgery to save your life.
You're in a critical place, Zan.
Will you at least deliver a note? Can you hold that? Whoo! (chuckles) Uh-oh, two of us alone in an elevator? Tongues will wag.
(chuckles) Don't go there.
Well, maybe people sense that, underneath it all, there's heat between us.
Maybe you're just having hot flashes.
See? Now you're flirting.
You're flirting.
I'm riding in an elevator.
The two are not mutually exclusive.
Okay, so what would it look like if I weren't flirting? To the untrained eye, pretty much the same.
So if I stand here staring blankly into space? Flirting.
(chuckles) What's your time frame on the dad's liver surgery? Planning on being in and out in 30 minutes, tops.
Anesthesiologist is in with him right now.
Okay, as soon as you're done, I'm gonna need some extra hands on Fortunato.
Oh, you're a lucky guy.
Okay, hypothetical situation: A guy's standing in line at the bank, and this robber comes in and shoots him in the arm.
Is he lucky or unlucky? Uh, he's unlucky.
He's in the wrong place at the wrong time.
Or lucky it could have been the guy next to him.
Got shot in the head.
Anything else I can help you with, Dr.
Deleo? Yeah, uh, set up, uh, an Ultracision scalpel and find me someone who can explain to me what the hell Proctor's talking about? FORTUNATO: Okay.
(speaking Spanish) Everything okay? Tell me how this will go, friend.
Well, we're doing a laparotomy, which means we open up your abdomen and slide the pole out inch by inch, fix any damage to the vital organs along the way.
If all things go well, we won't have to open up your chest.
Piece of cake, right? Dr.
Proctor what if my luck has run out? Don't worry.
I'm lucky, too.
(sighs heavily) Just finished the dad's liver resect, but he still needs ten to 12 units of blood.
(chuckles) Well, samples from Lauderdale and Boca were non-matches.
Sarasota and Tampa should be here within the hour.
And I just got Emily's blood work back.
Wow.
Wow what? Is she a match? Uh, no.
And based on her blood type she's not his daughter.
Hi.
Is there any news? There's no matches yet, Mrs.
Palmer.
We're still waiting on Tampa and Sarasota.
And, uh, Emily wasn't a match.
ZAMBRANO: Yeah, in the future, for medical reasons, you might want to mention that Emily's adopted.
Emily's not adopted.
When Henry and I first were married, we hit a bad patch.
You don't need to tell us this, Mrs.
Palmer.
I do, please.
We tried to have children, it didn't happen.
And Henry's company sent him overseas.
And I was alone.
Henry and I made peace with it.
(voice breaking): And he has been such a wonderful father and husband.
Um you don't need to tell her this, do you? No, it's not our place.
But you should know her medical history.
We got a tent because we planned for the rain, (laughing): And then the roof just got blown off everything.
(chuckles) (pagers beep) It's Emily.
What happened? Came down to deliver a note from her fiancé.
Heart rate suddenly crashed.
Even after a meg of atropine and pacer pads, she's not responding.
Pressure's only 60 palp.
Pulse is down to 34.
She's crashing.
See any place to central line? I'm gonna float a pacemaker directly into her heart.
Question is what the hell sent this girl's heart rate into the 30s? Cushing's reflex? She does have a skull fracture.
Her brain CT showed no increase in pressure.
Jugular's not showing.
I can't find the vein.
She's close to arrest.
We're losing her.
Easy.
Watch for it on the monitor.
There's the vein.
You're there.
I'm in.
Here we go.
I'm feeding the pacemaker wire right down the central line.
Pacemaker's in.
If this works, it'll stabilize her heart right away.
Okay, punch it.
(whirring, beeping) We got T-waves.
Heart rate's up to 69.
Seventy-six All right, follow up on her tox screen results and talk to her fiancé.
Maybe he knows if she took something.
We better figure this out fast or this girl's not gonna make it to "I do.
" Have you noticed anything going on with Emily recently? Heart palpitations, blood sugar crashes? Nothing, no.
Except, you know, I mean, all this wedding stuff's been making her pretty anxious.
That and mother issues.
Her tox screen came back negative.
Does Emily take any medications or supplements? No.
Anything that her mother might not know about? No, I mean, she doesn't even take anything before performances.
Performances? Yeah, she's a, she's a musician.
What kind of musician? She plays cello in the Miami Phil.
Why? I'll be right back.
Page Dr.
Zambrano.
Tell her to meet me in Emily Palmer's room.
I think she took beta-blockers.
I read about this in med school.
30% of classical musicians take them for performance anxiety.
I need a glucagon bolus ten megs.
Emily, can you hear me? Did you take beta-blockers today? Ten megs of glucagon going in.
Turn the pacer off.
Really? We can always turn it back on again.
It's the only way to know if you found our magic bullet.
Her numbers are going to drop, but if she double-dosed on beta-blockers, glucagon's the antidote.
Should only take a minute to work.
Wait Just wait.
WARREN: Heart rate's at 65 seventy It's working.
Here comes the bride.
(tool grinding) You know, Mike, for a plumber, you're a hell of surgeon.
This is much more interesting than rooting out a sink.
All right, I need an explanation.
That's Mike the plumber.
Yeah, a little more of an explanation.
Mike here is gonna sand away the jagged edges and burrs to prevent the pole from tearing organs as we pull it from the chest.
Oh, so it's just another day at the office.
Yeah.
Ileum is perforated.
See it.
(humming happily) PROCTOR: There's no need explaining (Wiznewski joins in): The one remaining Is somebody I adore I'm looking over a four-leaf clover That I overlooked before.
Emily how many beta-blockers did you take today? I-I-I only take them before a performance.
It calms me down.
Well, the problem is they actually lower the heart rate.
You almost calmed yourself to death.
I took one.
It wasn't working so well, so I took another.
Which explains why you fainted at the ceremony.
But a double dose? We pretend our parents' approval doesn't matter, but how do you walk down the aisle with a smile, knowing your mom is biting her tongue? EMILY: I I started second-guessing myself.
You panicked.
(laughs): Big-time.
Hey.
(sobs) Zan sent this down for you.
"What do you say we go somewhere super-boring for the honeymoon?" Careful Kidney.
On it.
Take it slow.
Pole's out.
That looks like all of it.
Damage seems to have been confined to the lower abdomen.
NURSE: Vitals holding steady.
Abdominal wall muscle looks good.
So let's treat the pipe entry-and-exit wounds to prevent infection, and then we're good to close.
(alarm beeping) NURSE: Chest tube is filling with blood.
BP's down, 50/30.
Something up in his chest must have torn when we pulled the pole out.
Okay, people, prep for a crash thoracotomy here.
We're going to have to crack open his chest.
Let's hope he's still lucky.
I I can't see what's bleeding.
Whole cavity's filled with blood.
More suction.
There.
Look.
The inferior branch of the pulmonary artery on the lower lobe is severely torn.
Satinsky clamp.
Clamp it and remove the lobe.
Bleeding's slowing down.
Tying off the artery.
You holding up? It's been three hours, I can still feel my toes, so, that's good, right? Mrs.
Palmer? I have some good news.
Blood for your husband just arrived from Tampa.
The lab's checking it now.
And Emily's skull fracture is resolving nicely.
Thank you.
She took those blockers.
Beta-blockers.
Because of me, yes? (thunder rumbling) I really screwed up, didn't I? (crying): What kind of mother am I? Well, the kind who cares deeply about her daughter's future.
I just wanted things to be better, easier for her than they were for me.
How do I know that Zan will be there for her when things get rough? Well, you know when Zan found out about Henry, he asked to give blood.
Even though he was told he was too ill, and almost certainly not a match, he insisted.
He somehow snuck down to hematology.
Yeah.
The only way to get him back up to his room was to let him give blood.
He really did all that? (sighs) Zander's a good man.
(laughs) Mom.
I'm sorry that I let my fears get into your head.
Okay.
Now there's something else I need to tell you.
Okay.
This is not easy.
After the day we've had today, I'm pretty sure we can get through just about anything.
We got it.
Blood from Tampa's a match.
Oh, good.
Let's go.
Injured lobe is out.
Bleeding has stopped.
PROCTOR: Ladies and gentlemen, we are, I think, finally good to close.
Poor guy's going to need months of rehab.
(speaking lyrics): I'm looking over a four-leaf clover that I overlooked before.
What are you talking about? Look behind the lung.
What? He's got an AVM.
You gotta be kidding me.
What's this? In this vial is what is known as an arteriovenous malformation AVM.
One of the blood vessels in your lungs had a congenital weakness, and it was like a time bomb waiting to blow.
So this would've killed me.
Could've been tomorrow.
Could've been five years from tomorrow.
Yeah, but had there been no microburst, there would've been no tent pole, no V-fib.
We wouldn't have had to crack your chest, and we wouldn't have found this.
You know what that means? What? You are a very lucky man.
Hey, you gotta help me out here.
After the day that this guy's had, are you just going along for the ride here, or do you really believe that Fortunato is lucky? A 45-year-old male has a heart attack, right? And he he dies on the table.
But he's brought back.
Now, uh, is he unlucky 'cause he lost a year of his life in recovery, or is he lucky 'cause he had the rare opportunity to sort out what's important to him.
You.
ZANDER: To have and to hold, for better or worse, for richer, for poorer, in sickness and in health, to love and to cherish from this day forward, until death do us part.
MINISTER: You may kiss the bride.
ZANDER: I love you.
(applause) 2,000 miles I can hear your laugh Seems we have a match.
Yeah.
We do.
Oh, my dear Let's not waste time chasin' our fear I'll have what she's having.
Hey, nice get on those beta-blockers.
I guess your personal life isn't distracting you from work after all.
You know, for the record there was a guy in med school who I was quite stupid over.
He proposed.
I wavered.
Now he's just the one that got away.
Good ones are hard to find.
True that.
So, any news from Hunky Reunion Guy? Calling him a pig would be an insult to pigs, who are clean and loyal.
And text you back right away.
What's another word for jerkface? Are you sure you should be drinking like that? Ugh.
You haven't slept in a couple days.
I'm Cuban.
Enough said.
Scotch.
The good stuff.
So there was a guy in med school, huh? The onion peels slowly.
I'll wait.
It'll just make you cry.
(phone buzzing) Just so you know, I will miss you more God, how many phones does a girl need? Oh, my God, I have his phone.
(laughs) That's why he didn't text me back.
I have Hunky Reunion Guy's phone.
Maybe "jerkface" was a little strong.
Oh, my God.
Delete.
Where you going? Come on, you don't want to feed the gossip troll, do you? I don't know.
You know, some people say underneath gossip there's a kernel of truth.
I will definitely drink to that.
missed out, so it goes (both snickering) Coffee?
Yes! Yes.
Thank you.
You're welcome.
(wind whistling) It's gonna rain.
And so much wind.
Which is why we have a tent, honey.
Trust me, when you look back on this day, the one thing you won't remember is the weather.
(nervous laugh) But you probably will remember the piece of tissue stuck to your father.
What? Oh, God.
(all laughing) This is why you need to get married.
So you don't leave the house with toilet paper on your face.
Whoa, whoa, Emily.
I'm fine.
Sweetie, if you don't want to do this I'm fine, I'm fine.
It's just nerves, that's all.
(classical music playing) Vivaldi.
That's our cue.
WOMAN: Zander looks so handsome.
(thunder rumbles) (distorted whooshing, slow heartbeat) (guests gasp, shout) Emily! Emily? Someone get some water, please! Give her some room! Emily Are you okay? EMILY: Zan? (moans) Oh, God, is everybody staring at me? I gave them all Sudoku puzzles.
They'll be busy for a while.
(laughs) Oh, goodness.
(both laughing) Want to see if you can try to get up? Yes, please.
All right.
(guests murmuring) (applause) (rumbling, wind gusting) (tinkling) (wind whistling) (people screaming) (yelling) (wind roaring, Emily screaming) (crashing, shattering) Here it comes Here it comes Here comes your 19th nervous breakdown.
Incoming in eight.
Anything good? Hunky high school reunion guy.
Details, Dr.
Warren.
Serve 'em up.
Hey.
(laughs) It started with a cup of coffee, turned into a weekend.
Wow.
I haven't seen a girl blush like that since seventh grade.
Sounds like my kind of weekend.
REPORTER (on TV): This freak weather phenomenon, known as a microburst, is short-lasting, isolated, but can pack winds of over 100 miles per hour.
The same phenomenon struck the Dallas Cowboys' training camp early last year.
Half dozen incoming red-bands four minutes out.
Possible crush injuries, lacerations from debris scatter.
MAN (over P.
A.
): Attention, Alpha Team, incoming, four minutes.
Dr.
Proctor can I get your autograph on these discharge orders.
Sure.
Who should I make it out to? Kathy.
Lipson.
Hey, so, speaking of microbursts, what's Nurse Kathy doing here? Chatty's on loan from Bravo team until Tuck gets back from search and rescue training.
I swear that woman's like a bad case of toxemia.
Always stirring it up.
Can't believe she started that pool.
Pool? What? (pager beeping) Saved by the page.
There's a pool taking bets on when you and I are gonna, you know, play doctor.
(laughs) Well, that's what I call a sucker's bet.
Wait.
Where would they get such an idea, Chris? Uh, don't look at me.
Remember last week, you gave me a ride to work? I guess somebody figured Not the only ride I gave you? Yeah.
Ugh.
Eva You're in the ambulance bay.
Chris, stand by for the second wave.
Got it.
Got it.
Anyway, you know what they say about gossip Underneath, there's usually a kernel of truth.
(chuckles) You can't handle the truth.
(chuckles) Emily Palmer, 23-year-old bride-to-be.
Blunt head trauma and deep forehead lac, altered with GCS of 4-6-4.
Where's my family? Zander? Oh, my God, what's happening? I'm Dr.
Zambrano.
Do you remember what happened? We were at this wedding, and the tent collapsed.
All right, all right.
Oh, my God.
Try and relax; we're gonna take good care of you.
Okay.
On my count.
Ready? One Two, three.
(sobbing) Get me a second large-bore I.
V.
, and a liter of normal saline.
BP, blood count every 15 minutes.
All right, Emily.
It's okay.
(sobbing) Can you tell me where it hurts? (sobbing, gasping): My M-My head is pounding.
(Emily sobbing) (sobbing quiets) You have a deep laceration.
Grab me a six-oh proline on a large needle.
No, not on my-my forehead it really hur Hurts in the back.
Penlight.
Gina, call C and have them bump whomever's next.
We may have a brain bleed.
(exhales, groans) (alarm beeps) Emily.
Pulse is strong.
(alarm stops) She just fainted.
Well, at least now she won't have to see this.
Avert your eyes, ladies.
Hey! Hey, I've got incoming! This is your incoming.
What, are you catering today's trauma? Fortunato Delgado, 39-year-old male with penetrating chest and abdominal injuries.
The guy couldn't fit in the ambulance.
Is he 800 pounds? Not exactly.
Because of the pole into through shoulder and out through his lower flank.
(thunder rumbling) Hello.
Hello.
Why didn't they just cut the pole down in the field? Guess they wanted to save time at the scene, considering the severity of the injury.
Can you prep the O.
R.
? Have at least eight units of O-neg ready.
Primary survey airway clear.
I was just finished arranging the ice sculptures, when the wind comes out of nowhere.
Breathing's shallow but with good air movement.
FORTUNATO: I heard screaming.
I w-went to help, and suddenly, something fell from the sky, and knocked me to the ground.
EKG now, and have a crash cart standing by.
Pulse is strong, BP 120/80.
That's good? That's very good.
Pupils equal and reactive.
GCS, 15.
Perfect.
I'm perfect? That will come as a big surprise to my wife.
Um, e-excuse us.
I'm Dr.
Proctor.
This is Dr.
Warren.
Fortunato Delgado.
I would offer you a hand, but under the circumstances Okay, Fortunato, on a scale of one to ten, how much pain are you in? One.
Maybe one and a half.
All right, what do we got? Henry Palmer, 49-year-old male.
Hypotensive, had to be extricated from the collapsed wedding tent; father of the bride.
Okay, let's get him into Trauma 3 over here.
Wait, wait, wait I'm Edie Palmer.
I'm his wife, and I'd like to know where you're taking him and what tests are being run.
Ma'am, I'm Dr.
Deleo, and I won't know anything until I've examined him.
Okay, well, my-my-my daughter's here somewhere, and so I-I need to know what's going on.
I have a few questions Will you just hold on! Please! Okay, Mrs.
Palmer, Mrs.
Palmer, I understand you have had a rough day.
The best way for you to help your husband is to wait in the waiting room.
You're really very young.
How How old are you? I'm old enough to know that we're wasting precious time.
Please.
(quiet, muffled grunt) Okay.
I promise you I'll take good care of him, all right? Please, help Mrs.
Palmer with any of her questions.
A-And her wrist.
All this on my wedding day.
Where's my family? Where's Zan? I'm going to find out for you as soon as I can, okay? She has a hemotympanum and a battle sign.
Hemo what? What-What does that mean? You have blood behind your eardrum.
What does that mean? Well, we have to do a scan and see what's going on inside your head.
Trust me, no one wants to see what's going on in there.
You fainted at the ceremony.
Yeah.
Do you have any underlying conditions we should know about: Diabetes, heart problems pregnancy? No, no, nothing like nothing like that.
Just, uh nerves, that's all.
Penlight.
Emily, you wouldn't happen to have a cold.
No, I just have this weird stuff coming out of my nose.
Let me see.
Okay, let's do a CBC and a CNP.
And page me when you get the scans back.
No pain how is it possible? He's impaled by a six-ft pole.
E body's in shock.
You get a rge of endorphin which blocks the nerve impulses.
You're more likely to feel pain from a splint than our friend Fortunato does right now.
That's not to say, of course, that that, uh, pole isn't passing through a major organ or two.
He's not gonna fit in a CT.
Yeah, I know.
We still need a map before we go on the road trip.
There's that new laser in the lab.
We could use that to cut down the pole.
(chuckles) Yeah, and kill him for sure.
Extreme heat on galvanized steel releases toxic fumes Something I discovered in Kuwait.
The hard way, unfortunately.
No, we need a specialist.
Get Mike.
Mike from Thoracic? Mike Wiznewski.
Have you seen Mike? Ooh, from Thoracic? Wiznewski.
Try the ladies room.
Thanks.
Mike? You in here? Yeah.
I need you.
Me? What have we got here? Zander Lewis, 24-year-old male hit by flying debris.
Diffuse abdominal pain, trauma to lower left extremity.
BP 100/70.
All right, Zander.
M Dr.
Zambrano.
I'm going to need you to hold still, so I can take a look at your leg.
Where's Emily? She's here.
She's in good hands.
(Zander groans) Patella dislocation.
(gasping) Ten out of ten on the pain scale.
Want five of morphine? No, it'll take too long.
I'm just going to have to pop the knee back in.
(Zander moaning) So, Zander, could you, uh, tell me what you do for a living? Musician.
This hurts like hell.
And how'd you meet Emily? Uh, she's cello, I'm percuss Please just give me something! All right, this will kill the pain in about three seconds.
Okay.
Ready? Squeeze.
One two (cracking, Zander shrieking) All right, we got a large liver laceration and blood pool in the abdominal cavity.
Start two units of O-neg on the rapid infuser.
He's going to need surgery.
(gs) "I'm gaining a son.
Happiest day of my" Is this your wedding toast? (weakly): My only copy.
I'll take good care of it, all right, sir? Sorry about that, but it would've taken another ten minutes for the pain meds to kick in.
(gasping): Thank you.
All right, so, let's see what else is going on with you.
Roll him.
(groans) Can you tell me what happened? It was crazy.
It was like a 747 just crashed on top of us.
One minute, I had Emily in my arms, and then then she was gone.
It's the last thing I remember.
(gasps, groans) Does that hurt? Yeah.
I got nailed by some flying objects.
It was, like, a chair or the minister, or something hit me in the back.
Listen Emily when can I see her? As soon as we take care of you.
Okay? Okay.
Call for an abdominal CT.
So, you're a plumber? WIZNEWSKI: Local 315.
Card-carrying member.
You are worried.
Me? Uh-huh.
No.
She's just making sure your blood pressure remains stable while Mike cuts the pole.
Don't worry I've always been a very lucky man.
WIZNEWSKI: I had an uncle who was lucky.
He once won 10,000 bucks in the lottery.
But then he went to jail for tax evasion, so Okay.
There! I think that's it.
WIZNEWSKI: Okay.
There it is.
Got it.
I had scarlet fever when I was two.
The doctors told my mother I would not make it.
Yet, here I am.
They also said I would never have babies.
Um, the sperm? Bad swimmers.
Today, I have four children.
(chuckles) Very lucky.
Hey, I'm, uh, heading up to O.
R.
To take care of father of the bride's liver lac.
Okay.
Did he just call himself lucky? Well, he is alive.
Pressure's holding.
(alarm beeps) Holy crap.
It-It's bleeding, right? Just a little.
Apply pressure, secure the pipe with Kerlix.
Distal carotid injury? No, no, it's from a vein, not an artery.
The blood is darker and it's oozing;t's not pumping.
Oozing? Is that good? Well, let's just say the other is worse.
Carotid, you die, right? It's not the carotid.
Place some sutures to stop the bleeding, then get him to CT.
Page me when you got some images.
Give me a four-oh nylon and a PS3 needle.
I hate needles.
Yeah? Me, too.
So, Zan's okay? He's conscious, alert, sense of humor intact.
He's got some abdominal injuries and we won't know the full extent until we get his scans back.
What about me? Your CT showed a basilar skull fracture, which explains that slow drip from your nose.
It's actually cerebral spinal fluid.
So my brain sprung a leak? I know it sounds scary, but 70% of skull fractures heal by themselves.
In the meantime, we're going to monitor you closely and give you something to slow that drip.
What if it doesn't heal? Well, as they say in med school, don't put the crash cart before the horse.
(chuckles) (sighs) Well, I got a groom with a spleen injury and a blushing bride with a skull fracture.
How's your impalement case? Surprisingly lucid.
CT just paged me.
His scans are back.
Is that "Hunky Reunion Guy"? C told me you had quite the weekend.
(laughing) What? I just feel funny talking to you about personal nonsense.
Next to Proctor, you're the big cheese around here, so Oh, wait, so you can talk to Chris and not me? Uh, he stopped developing emotionally in, like, the ninth grade.
Well, apparently, so did Hunky Reunion Guy, 'cause I haven't heard from him all day.
Well, the day's not over.
He usually shoots a response back in 30 seconds.
It's our thing.
Sorry.
Exactly what I didn't want to do blather.
Serena, don't apologize for having a personal life.
It's what people are supposed to do.
It's just you would never get stupid like this.
Over a guy.
And why would I never? Oh, it's a compliment.
You-You're not distracted by relationships.
You're a total pro, Eva.
Mrs.
Palmer's out there demanding updates about her husband and her daughter every five minutes.
She still wants to know how old you are.
Yeah, well, Admin will take care of her.
We gotta get .
Palmer up to surgery to repair his liver.
So, you ask me to heli-ski a fresh pack or cave dive at 100 feet? I'm good.
But talk an hysterical wife down? Forget it.
I'm calling in the cavalry.
(alarm beeping) BP's dropping.
(gasping) A major edema? What the He's going into shock.
(gasping) Hey, ts is Dr.
Deleo.
A maWe're coming uto ICU.
I need point-three cc's of epi standing by.
Throat's clong He's gonna code.
Hey, come on! Henry! Hey, stay with me.
Come on, Henry! Point-three cc's epi.
(alarm beeping rapidly) Breathing's returning to normal.
What the hell did we give this guy that sent him intonaphylactic shock? Henry doesn't have any allergies? Uh, antibiotics? Food? Latex? No.
Dad's never been allergic to anything.
What about pain medications? Have any adverse reactions? No, no.
Ten years ago, he was in a car accident.
They gave him all sorts of painkille.
He never had any problems.
Well, we'll keep looking.
Dr.
Deleo, I'm I'm very sorry if I was rude earlier.
You weren't rude.
You were concerned.
Wait, the car accident.
Did Mr.
Palmer have any blood transfusions? I-think so, yeah.
It's the blood.
I need a little more information than that.
Fath of the bride.
He's having a hemolytic transfusioreaction.
His body's rejecting the nor blood.
Multiple prior transfusions.
Causing him to develop antibodies to his own blood type.
And here's the kicker.
He's AB-neg.
That's, like, three percent of the population.
Yeah.
Blood bank's testing samples now, but so far, he's been allergic to everything.
So we need to find not just an AB sample, but one that he doesn't react to.
That's like finding a needle in a millionaystacks.
Okay, so we'll, put out an SOS to every blood bank within a hundred-mile radius, and I'll get Zambrano to test the relatives.
You're going to have to go at the liver without any blood on deck.
Operate without blood? He could crap out on the table.
Wait for blood, he could crap out within the hour.
Can't tell what organ it's hit.
Or the extent of the damage.
But we do know one thing.
That pole is about a 16th of an inch from his heart.
Hey.
How are my pictures? My wife always says that I'm photogenic.
But I think she means on the outside.
(weak laugh) I'm afraid the, uh scans are inconclusive.
So we won't know exactly what's going on until we get you into surgery.
The pipe is Well, it's very close to your heart, Fortunato.
But the good news is you're remarkably stable.
Lucky.
I told you.
Yeah.
Lucky.
Your dad's blood has developed antibodies to multiple minor blood antigens.
In plain English, he's allergic to most of our blood supply.
How is that possible? AB-neg is very rare.
And he's rejected all the AB we have on hand.
There must be something we can do.
We-We are.
We're flying in samples from hospitals all over Florida, but our best chance of a match is from a blood relative.
We've got a bunch of relatives out in the waiting room.
We've got Uncle Joe, Aunt Phyllis But what about me? Sweetie, you're not well enough.
You're not the doctor, Mom.
Um, actually, she is well enough.
What about her skull fracture? The CSF leakage has slowed, and she is the most likely match.
Mom, I'm doing this for Dad.
I'll go organize the relatives.
I-I need to see Zan.
I know.
Tomorrow, when you both are stable.
Emily, Zan has a pretty bad spleen injury, and you Yeah, I know, I'm, uh, I'm brain-leak girl.
(both chuckle) It's been a rough day for you and your mom.
Squeeze.
She didn't want me to get married My mother.
Dad's always been so supportive, but she said we were too young Just starting out in our career "What's the hurry"" I'm 23 years old.
Exactly the same age she was when she got married.
Must be hard getting married when you know your mother doesn't approve.
Understatement of the year.
Zan, you should not be up and around.
Everything okay over here? I want to see my wife almost-wife.
He doesn't have permission to be out of the ICU.
We're ten feet and two minutes away from "I do.
" Haven't you heard the groom's not supposed to see the bride in her hospital gown? (laughs) Tradition has to be respected.
I just want to talk to her.
You know how frustrating it is.
You just want to talk to somebody and you can't.
I do.
But you have got a grade-two spleen injury.
You keep moving around, it turns into a full rupture, which turns into emergency surgery to save your life.
You're in a critical place, Zan.
Will you at least deliver a note? Can you hold that? Whoo! (chuckles) Uh-oh, two of us alone in an elevator? Tongues will wag.
(chuckles) Don't go there.
Well, maybe people sense that, underneath it all, there's heat between us.
Maybe you're just having hot flashes.
See? Now you're flirting.
You're flirting.
I'm riding in an elevator.
The two are not mutually exclusive.
Okay, so what would it look like if I weren't flirting? To the untrained eye, pretty much the same.
So if I stand here staring blankly into space? Flirting.
(chuckles) What's your time frame on the dad's liver surgery? Planning on being in and out in 30 minutes, tops.
Anesthesiologist is in with him right now.
Okay, as soon as you're done, I'm gonna need some extra hands on Fortunato.
Oh, you're a lucky guy.
Okay, hypothetical situation: A guy's standing in line at the bank, and this robber comes in and shoots him in the arm.
Is he lucky or unlucky? Uh, he's unlucky.
He's in the wrong place at the wrong time.
Or lucky it could have been the guy next to him.
Got shot in the head.
Anything else I can help you with, Dr.
Deleo? Yeah, uh, set up, uh, an Ultracision scalpel and find me someone who can explain to me what the hell Proctor's talking about? FORTUNATO: Okay.
(speaking Spanish) Everything okay? Tell me how this will go, friend.
Well, we're doing a laparotomy, which means we open up your abdomen and slide the pole out inch by inch, fix any damage to the vital organs along the way.
If all things go well, we won't have to open up your chest.
Piece of cake, right? Dr.
Proctor what if my luck has run out? Don't worry.
I'm lucky, too.
(sighs heavily) Just finished the dad's liver resect, but he still needs ten to 12 units of blood.
(chuckles) Well, samples from Lauderdale and Boca were non-matches.
Sarasota and Tampa should be here within the hour.
And I just got Emily's blood work back.
Wow.
Wow what? Is she a match? Uh, no.
And based on her blood type she's not his daughter.
Hi.
Is there any news? There's no matches yet, Mrs.
Palmer.
We're still waiting on Tampa and Sarasota.
And, uh, Emily wasn't a match.
ZAMBRANO: Yeah, in the future, for medical reasons, you might want to mention that Emily's adopted.
Emily's not adopted.
When Henry and I first were married, we hit a bad patch.
You don't need to tell us this, Mrs.
Palmer.
I do, please.
We tried to have children, it didn't happen.
And Henry's company sent him overseas.
And I was alone.
Henry and I made peace with it.
(voice breaking): And he has been such a wonderful father and husband.
Um you don't need to tell her this, do you? No, it's not our place.
But you should know her medical history.
We got a tent because we planned for the rain, (laughing): And then the roof just got blown off everything.
(chuckles) (pagers beep) It's Emily.
What happened? Came down to deliver a note from her fiancé.
Heart rate suddenly crashed.
Even after a meg of atropine and pacer pads, she's not responding.
Pressure's only 60 palp.
Pulse is down to 34.
She's crashing.
See any place to central line? I'm gonna float a pacemaker directly into her heart.
Question is what the hell sent this girl's heart rate into the 30s? Cushing's reflex? She does have a skull fracture.
Her brain CT showed no increase in pressure.
Jugular's not showing.
I can't find the vein.
She's close to arrest.
We're losing her.
Easy.
Watch for it on the monitor.
There's the vein.
You're there.
I'm in.
Here we go.
I'm feeding the pacemaker wire right down the central line.
Pacemaker's in.
If this works, it'll stabilize her heart right away.
Okay, punch it.
(whirring, beeping) We got T-waves.
Heart rate's up to 69.
Seventy-six All right, follow up on her tox screen results and talk to her fiancé.
Maybe he knows if she took something.
We better figure this out fast or this girl's not gonna make it to "I do.
" Have you noticed anything going on with Emily recently? Heart palpitations, blood sugar crashes? Nothing, no.
Except, you know, I mean, all this wedding stuff's been making her pretty anxious.
That and mother issues.
Her tox screen came back negative.
Does Emily take any medications or supplements? No.
Anything that her mother might not know about? No, I mean, she doesn't even take anything before performances.
Performances? Yeah, she's a, she's a musician.
What kind of musician? She plays cello in the Miami Phil.
Why? I'll be right back.
Page Dr.
Zambrano.
Tell her to meet me in Emily Palmer's room.
I think she took beta-blockers.
I read about this in med school.
30% of classical musicians take them for performance anxiety.
I need a glucagon bolus ten megs.
Emily, can you hear me? Did you take beta-blockers today? Ten megs of glucagon going in.
Turn the pacer off.
Really? We can always turn it back on again.
It's the only way to know if you found our magic bullet.
Her numbers are going to drop, but if she double-dosed on beta-blockers, glucagon's the antidote.
Should only take a minute to work.
Wait Just wait.
WARREN: Heart rate's at 65 seventy It's working.
Here comes the bride.
(tool grinding) You know, Mike, for a plumber, you're a hell of surgeon.
This is much more interesting than rooting out a sink.
All right, I need an explanation.
That's Mike the plumber.
Yeah, a little more of an explanation.
Mike here is gonna sand away the jagged edges and burrs to prevent the pole from tearing organs as we pull it from the chest.
Oh, so it's just another day at the office.
Yeah.
Ileum is perforated.
See it.
(humming happily) PROCTOR: There's no need explaining (Wiznewski joins in): The one remaining Is somebody I adore I'm looking over a four-leaf clover That I overlooked before.
Emily how many beta-blockers did you take today? I-I-I only take them before a performance.
It calms me down.
Well, the problem is they actually lower the heart rate.
You almost calmed yourself to death.
I took one.
It wasn't working so well, so I took another.
Which explains why you fainted at the ceremony.
But a double dose? We pretend our parents' approval doesn't matter, but how do you walk down the aisle with a smile, knowing your mom is biting her tongue? EMILY: I I started second-guessing myself.
You panicked.
(laughs): Big-time.
Hey.
(sobs) Zan sent this down for you.
"What do you say we go somewhere super-boring for the honeymoon?" Careful Kidney.
On it.
Take it slow.
Pole's out.
That looks like all of it.
Damage seems to have been confined to the lower abdomen.
NURSE: Vitals holding steady.
Abdominal wall muscle looks good.
So let's treat the pipe entry-and-exit wounds to prevent infection, and then we're good to close.
(alarm beeping) NURSE: Chest tube is filling with blood.
BP's down, 50/30.
Something up in his chest must have torn when we pulled the pole out.
Okay, people, prep for a crash thoracotomy here.
We're going to have to crack open his chest.
Let's hope he's still lucky.
I I can't see what's bleeding.
Whole cavity's filled with blood.
More suction.
There.
Look.
The inferior branch of the pulmonary artery on the lower lobe is severely torn.
Satinsky clamp.
Clamp it and remove the lobe.
Bleeding's slowing down.
Tying off the artery.
You holding up? It's been three hours, I can still feel my toes, so, that's good, right? Mrs.
Palmer? I have some good news.
Blood for your husband just arrived from Tampa.
The lab's checking it now.
And Emily's skull fracture is resolving nicely.
Thank you.
She took those blockers.
Beta-blockers.
Because of me, yes? (thunder rumbling) I really screwed up, didn't I? (crying): What kind of mother am I? Well, the kind who cares deeply about her daughter's future.
I just wanted things to be better, easier for her than they were for me.
How do I know that Zan will be there for her when things get rough? Well, you know when Zan found out about Henry, he asked to give blood.
Even though he was told he was too ill, and almost certainly not a match, he insisted.
He somehow snuck down to hematology.
Yeah.
The only way to get him back up to his room was to let him give blood.
He really did all that? (sighs) Zander's a good man.
(laughs) Mom.
I'm sorry that I let my fears get into your head.
Okay.
Now there's something else I need to tell you.
Okay.
This is not easy.
After the day we've had today, I'm pretty sure we can get through just about anything.
We got it.
Blood from Tampa's a match.
Oh, good.
Let's go.
Injured lobe is out.
Bleeding has stopped.
PROCTOR: Ladies and gentlemen, we are, I think, finally good to close.
Poor guy's going to need months of rehab.
(speaking lyrics): I'm looking over a four-leaf clover that I overlooked before.
What are you talking about? Look behind the lung.
What? He's got an AVM.
You gotta be kidding me.
What's this? In this vial is what is known as an arteriovenous malformation AVM.
One of the blood vessels in your lungs had a congenital weakness, and it was like a time bomb waiting to blow.
So this would've killed me.
Could've been tomorrow.
Could've been five years from tomorrow.
Yeah, but had there been no microburst, there would've been no tent pole, no V-fib.
We wouldn't have had to crack your chest, and we wouldn't have found this.
You know what that means? What? You are a very lucky man.
Hey, you gotta help me out here.
After the day that this guy's had, are you just going along for the ride here, or do you really believe that Fortunato is lucky? A 45-year-old male has a heart attack, right? And he he dies on the table.
But he's brought back.
Now, uh, is he unlucky 'cause he lost a year of his life in recovery, or is he lucky 'cause he had the rare opportunity to sort out what's important to him.
You.
ZANDER: To have and to hold, for better or worse, for richer, for poorer, in sickness and in health, to love and to cherish from this day forward, until death do us part.
MINISTER: You may kiss the bride.
ZANDER: I love you.
(applause) 2,000 miles I can hear your laugh Seems we have a match.
Yeah.
We do.
Oh, my dear Let's not waste time chasin' our fear I'll have what she's having.
Hey, nice get on those beta-blockers.
I guess your personal life isn't distracting you from work after all.
You know, for the record there was a guy in med school who I was quite stupid over.
He proposed.
I wavered.
Now he's just the one that got away.
Good ones are hard to find.
True that.
So, any news from Hunky Reunion Guy? Calling him a pig would be an insult to pigs, who are clean and loyal.
And text you back right away.
What's another word for jerkface? Are you sure you should be drinking like that? Ugh.
You haven't slept in a couple days.
I'm Cuban.
Enough said.
Scotch.
The good stuff.
So there was a guy in med school, huh? The onion peels slowly.
I'll wait.
It'll just make you cry.
(phone buzzing) Just so you know, I will miss you more God, how many phones does a girl need? Oh, my God, I have his phone.
(laughs) That's why he didn't text me back.
I have Hunky Reunion Guy's phone.
Maybe "jerkface" was a little strong.
Oh, my God.
Delete.
Where you going? Come on, you don't want to feed the gossip troll, do you? I don't know.
You know, some people say underneath gossip there's a kernel of truth.
I will definitely drink to that.
missed out, so it goes (both snickering) Coffee?