Code Black (2015) s01e05 Episode Script

You guys have any restaurant recommendations? Whenever my parents come to town, I always take them to Sethi's House of Curry.
Or Roshan Khazana is also good if they like tandoori.
I'm sorry to say, my parents don't like Indian food.
Seriously? My mum left India when she was 2 years old and never looked back.
Now she's a fully assimilated, very proud subject of the British crown.
Believe it or not, her ringtone is "God Save the Queen.
" Wow.
Yeah.
So I'm leaning toward Italian.
Somebody help me here, please! - I need help! - Let's go.
I don't know what's wrong.
She can't breathe.
Okay.
What's her name? Susan.
Okay, Susan.
I've got you.
Can you hear me? Don't don't try to talk.
Can you tell me what happened? She didn't feel well this afternoon.
We thought maybe it was a cold or the flu.
We were going to dinner, and she started coughing and having trouble breathing.
- How long ago was that? - 30 minutes.
She wouldn't let me call an ambulance.
I don't know why I listened to her.
Dr.
Leighton? Come with us, please.
We got an incoming K-Bob.
Patient is a 53-year-old construction worker.
Fell backwards off a roof, impaled himself through his keister on a piece of steel rebar.
Like you do.
- What's a K-Bob? - Shish.
- Oh, sorry.
- No, shish.
- K-Bob.
- Kbob.
53-year-old male, 20-foot fall impaling to the right groin.
Vitals stable, pulse is good, little confused.
E.
B.
L.
in the field? Nada.
No blood just metal.
What, the fire department couldn't clip that thing off? Their bolt cutters were crap.
They had to use a hacksaw to get him off the concrete footing.
It was pretty ugly.
Well, somebody tie a red rag on the end of that thing.
I'm Dr.
Rorish.
Do you remember what happened? No.
I woke up when they were putting me in the ambulance.
What's the last thing you remember? This morning.
I had a fight with my daughter.
I'm not gonna die, am I? We have to run a few tests before I can say anything for sure, but I doubt it.
I think you're gonna be fine.
This degree of amnesia is not typical for a fall with a minor concussion.
We need to run a head C.
T.
, as well.
He's not gonna fit in the C.
T.
machine until we cut the rebar.
I already called maintenance.
Thanks, mama.
Okay, on my count, guys.
One, two, three.
Airway's intact, breath sounds equal bilaterally.
Distal pulse is two-plus up top.
Angus, ultrasound, please.
Mario, what you got down there? Two-plus bilaterally.
Ultrasound is negative for blood.
All right.
Let's bring the transducer up here, Angus.
I want to try to visualize the femoral.
Wait, wait, wait, wait.
- 8 of morphine, please.
- Copy that.
Prepare for a crash intubation.
Malaya, what are your meds? R.
S.
I 30 of etomidate, 120 of sux.
Good.
Push them now.
Malaya, tell me what you see.
- Malaya? Cords or no? - It's in.
Malaya, you must tell me what you see and when you see vocal cords.
You're my extension, but if you don't communicate, I can't know.
- I don't have a pulse.
- Do you understand me? Malaya, bag her up.
1 of epi, 1 of calcium, 1 of bicarb.
Her compliance is terrible.
Does she have asthma? COPD? Is she a smoker? No.
No.
She's a doctor.
Okay, I'm gonna need a complete secondary survey on this, Mario.
Get him ready for a pan scan.
Thank you.
And if maintenance doesn't come in the next 30 seconds, I'm calling the hardware store.
Dr.
Rorish.
Sorry, Mr.
Gable.
We need to turn you over, and we need to check your back.
I'll try to make it quick, okay? On the count of "three.
" One, two, three.
That's it.
That's it, that's it, that's it.
Aw, dude, you skipped his inner ears.
Could be blood in there.
I'll get to that.
I have my own order to things.
No, head-to-toe, top-to-bottom.
That way, you never miss anything.
The last time I listened to you, I got my ass handed to me, so I will work with you if I have to, but don't tell me what to do.
Whatever, man.
Get over it.
All right, children.
No hacksaws.
The sawing motion causes more tissue damage.
Bolt cutters.
I need bolt cutters.
Why don't you just pull it out of me? I want it out of me! We will as soon as we can.
We have to get you a C.
T.
scan to make sure you haven't injured any major arteries or organs.
Then we got to get you up to surgery.
They'll put you under anesthesia, and then they'll pull it out.
Trust me you don't want to be awake when it happens.
Damn it.
Still nothing.
Malaya, take over compressions.
Another round of epi.
1 of vasopressin.
1 more of bicarb.
Another amp of D-50.
Doc! Please don't put me out till I talk to my daughter.
We had a bad fight.
I said some awful things.
She's on a flight to New York.
She won't land until midnight our time.
Is there someone else we can call for you? No.
She's all I have.
Okay.
Still nothing.
A.
C.
L.
S.
meds times three.
Ultrasound, please.
Gel.
Gel.
No cardiac activity.
Any objections? Time of death 5:42 P.
M.
I'm sorry.
We did everything we could.
Is there anyone we can call to be with you? Uh n-no.
W-we're here from out of town.
We're staying at the hotel.
I'm so sorry.
All right, let's go, guys.
Right up to triage.
What is this, prom night? Respiratory distress, double header.
Both sats in the 80s, not coming up on room air.
Same.
50-year-old male, sick as hell.
They came from the same hotel.
We need to isolate these patients until we know what kind of contagion we're dealing with.
Wait, wait! Stop! Don't go any farther in.
Bring all the respiratory patients to this side.
Yeah, do it now.
5-foot radius around those gurneys, precautionary.
You too, guys.
You just stay over there.
Let's treat this like an M.
C.
I Triage and go stepwise.
I want early intervention for respiratory distress.
Whatever this is, we need to get ahead of it.
Oh, my god.
Look.
Oh, no.
What? My parents were at that conference.
Uh, q-quiet! Quiet, please! Mum? All right, there's a protocol to follow here, people.
Let's remember our practice drills.
Anybody who was within 2 meters of any one of these patients, get on that side.
Those of you not familiar with the metric system, that's 80 inches.
Also the height of Kobe Bryant.
Dr.
Hudson? Aren't you wearing some P.
P.
E.
? A mask or shield? I mean, shouldn't we take precautions? You're welcome to if it'll make you feel better, but at this point, that's about all it'll accomplish.
We've both been exposed.
Okay.
Five R.
S.
I.
kits.
Prepped airways.
How many more? 10 more from upstairs.
And vents, too.
Nurse, do I have to do the 12-lead myself? We've been waiting for 10 minutes.
Hang this up for me, please.
Who's that jackass ordering the nurses around? That would be my father.
What the hell's going on? What's wrong with all those people? Am I gonna catch some sort of disease here? Let's get him out of here.
Take him up to Radiology, and let him wait there.
And find out what's taking so long with those damn bolt cutters.
How my nurses doing? You okay? What do you need? - A.
B.
G.
Kits.
- I.
V.
Bags.
More vents coming in.
Nebulizers and central line kits.
All right, that's it.
Doors are closing.
Time to zip it up.
Oh, wait, wait, wait! One more thing.
Albuterol, atrovent, some duo-nebs times three.
I warned you I wanted to spend more time with you while we were in town.
This might be a little extreme.
Next time, just send passiveaggressive e-mails, like other people's mothers.
All right, all right, all right, all right.
We're gonna get you something to help you breathe a little easier.
How are you holding up? I'm fine.
Honestly, I don't know how you manage to work surrounded by all this chaos and all these people.
It's rather like practicing medicine in the middle of Waterloo Railway Station.
One certainly has to learn to focus if one's gonna survive here.
Yes, and give up anything resembling delicacy or finesse.
Don't be so sure.
We have our moments.
I've been thinking I have an old pal from medical school who has a very successful pulmonology practice in Beverly Hills.
I'm going to call him and get his opinion of our situation here.
I really don't know how you put up with him.
He just likes to feel like he's in control, even if he isn't.
Especially if he isn't.
All right, all right.
That's enough conversation for now.
Here.
Here.
Thank you.
Okay.
You try to rest.
The health department sent a team to the hotel to test for Legionnaire's.
And they're making noises about shutting us down.
It may be the first time in the 85-year history of this place we closed our doors.
I'd rather it didn't happen on my watch.
Leanne? I'm talking to you.
I know.
I know.
I hear you.
It's not Legionnaire's.
Aerosolized disease isn't selective.
Neal's father's perfectly fine.
There'd be symptoms if it was Legionnaire's.
I'd guess bacterial pneumonia, but it doesn't make sense that it spread so quickly.
Well, for our sake, for Neal's sake, we better pray that first fatality was an anomaly.
How's your mom? She's holding her own for now.
How are you doing in there? I've done three intubations so far, with a couple more in the bubble.
I'm double-sealing blood and sputum specimens and leaving them in the utility-hall barrier That's not what I asked.
How are you doing? I'm fine.
Thanks for asking.
Um, Mark I hate to tell you this, but I just heard There was a group at that conference from South Korea.
So now we have to wonder if it's MERS? Wow.
That's just peachy.
Oh, look from your mouth to the CDC's ears.
Prepare for code brown, where the CDC crawls so far up my colon, I'll be crapping federal bureaucrats for a week.
Yeah, this is Taylor.
God.
What took you so long? Hey, man, I had to go down to the basement to get this thing.
It's frickin' scary down there.
Is he asleep? Yeah, finally.
Give me these.
Okay.
Let's see.
Seriously? That is just sad.
You might want to try going to the gym occasionally.
Oh.
How about this? I'll go to the gym when you get some therapy.
- Oh, therapy? - Yeah.
Okay, I'm not the one who needs therapy.
First of all, those aren't sharp enough, - and, second, you're a jerk.
- Knock it off! Mr.
Gable, it's time to prune your rebar.
Past time.
All right? Dr.
Leighton and Dr.
Savetti will apply equal pressure to either side of the bolt cutter while I hold this rod steady.
Okay? Ready? On my count.
One two Three.
Well done.
Now can you pull it out? Not yet.
You still need the scan.
But it won't be long now.
You don't know if I'm gonna die? That scan is gonna give us verification of what I already suspect, which is that you are one tough customer.
Get that scan and page me.
Okay, it appears we're gonna need volunteers to help out in the quarantine area.
Obviously, we've got an unknown, potentially fatal respiratory illness with the possibility of contagion, so please think long and hard before you answer.
I'll go in.
Thank you, Dr.
Lorenson.
That's very selfless of you.
You can enter through the utility corridor.
I mean, I'd go myself, but I'm uncomfortable around sick people.
The sign at the entrance to the hospital said that no person who is suffering will be without care.
You walk the walk, doctor.
I salute you.
Does it count that I'm scared half out of my mind? It counts double.
Here you go.
Put this on.
You look very nice.
It accentuates your eyes.
Go.
Shouldn't be too much longer.
You can take a nap if you want.
Have I told you about my daughter? Yes Theresa.
She's an artist.
So talented.
She's having her first big gallery opening.
I should be there.
But her mother insisted on inviting her new husband.
The rat bastard who broke up our marriage.
I told Theresa, there's no way I'm going if Harry Herpes is gonna be there.
Can you blame me? No, not at all.
Anyway, I said a few things I shouldn't, Theresa said some things, and somewhere in the middle there, My lovely daughter said she hated me.
I'm sure she didn't mean it.
I know she didn't.
But that's not enough.
I have to Talk to her personally.
Un Unless I die.
In which case You have to.
You never interacted with the guests directly Just prepared the food? Where was the food set up? In the banquet hall? In a tent.
You were outside? By the pool.
Was there anything unusual about the food or the preparation? Please.
I can't breathe.
I'm scared.
Okay.
Don't try to talk anymore.
I know it's hard, but try to relax.
I'll give you something to help you breathe.
No, no, no, no.
It's okay.
Lie down, sir.
Lie down! - It's okay.
- Christa! Oh, my god! - Oh, oh, oh, oh! - Hey.
1 of ativan, please, Amy now.
Christa, I'm so sorry.
We can send out for another clean mask right away.
No, it's okay.
That thing was too hot, anyway.
You sure? Yeah, I'm okay.
Would you like me to get you an intubation tray, Dr.
Hudson? Thank you.
Okay, looks like we're up next.
Oh, my god.
Oh, my god.
He's in cardiac arrest! What the hell? What did you do? I didn't do anything.
All of a sudden, he headed south.
He's vomiting.
I know, and not the way living people do.
No way this should be happening.
Groin impalement doesn't cause cardiac arrest.
You must have done something.
Just shut up and see if you can get a rhythm.
Hurry.
- On? - Yeah.
Oh.
Thank god.
Look at that burn.
Where? That's it.
What's it? He told me he's an electrician.
That burn is an exit wound from an electrocution.
We missed it because the rebar went right through it.
That's why his heart stopped He got electrocuted, and that is what caused the delayed arrhythmia.
Yeah.
Okay.
That'd explain the earlier amnesia, too.
I just want to take a moment here to say "booyah.
" All right, all right.
You're a genius.
Now let's get the damn scan and get out of here.
Stop.
Holy crap.
Look at that.
That thing's right next to his artery.
I think we moved it when we rolled him over.
And he's waking up.
Mr.
Gable, listen to me.
Whatever you do Don't move! I've been watching all your colleagues over there.
It's very hands-on, isn't it? When you trained with me, we worked in the world of millimeters.
This is almost like medicine as manual labor.
I suppose it's not as elegant as neurosurgery, but I can do more good and save more lives here.
Fair enough.
I can understand why you might choose to commit your professional life to something so completely different, but it seems a bit excessive that you also felt you had to move to the other side of the world in order to do it.
I needed to challenge myself.
I came here because I wanted to learn from the best.
Then I found I didn't want to leave.
It started to feel like home.
Okay, okay, okay.
Pulse is rapid and irregular.
Mum, mum, mum.
Just try and breathe.
Breathe slowly for me, okay? Breathe slowly.
She needs an EKG, stat.
No, she doesn't.
Ignore that.
I can tell her rhythm from the monitor.
Christa, what am I looking at? She's gone into a-fib RBR.
Hypoxia could have triggered it.
That's right.
You're teaching?! For god's sake, have you lost your mind?! We need to get her heart rate down.
Ice.
Sarah, ice pack, please.
Ice pack? She needs diltiazem, not first aid.
Malaya, why do I want ice? Ice over her eyes might trigger her vagal nerve, which would slow down her heart and break the rhythm.
B.
P.
dropping 60/30.
Oh, this is insane.
Prep 10 of diltiazem! Hold that.
Christa, what's the problem with diltiazem? It could tank her blood pressure even more.
She can't afford to lose any more reserve.
Okay, mum? I need you to bear down like you're in labor, okay? Bear down for me.
Peter.
Rhythm converted.
All right.
You've converted back into sinus rhythm.
Just breathe easy for me now as best you can.
Don't ever do that to me again.
Hi.
I'm Dr.
Lorenson.
Are you having chest pains? I'm afraid so.
And how long has this been going on? It started shortly after my wife died.
Everyone else is so sick, I didn't want to make a fuss.
I'm gonna listen to your heart for a minute, okay? Yeah.
Okay.
Big breath.
Your wife was a a neurologist? Yes.
Yes.
We were at the same conference as everyone else.
She was gonna accept an award Lifetime achievement in clinical education.
Sounds like a cruel joke now, doesn't it? What was her name? Susan.
Susan Evans.
Did she teach at Mass General? Yes.
Did you know her? No, no, but I I studied her research.
She was a brilliant doctor.
Yes, she was.
Thank you.
I've got a possible catastrophic respiratory outbreak to the city of Los Angeles, I got an attending whose mother is hypoxic, and I got three pathologists in head-to-toe hazmats touching every drop of bodily fluid in these patients, and all they can tell me so far is what it isn't.
Uh, we tested for bacterial pneumonia, MERS, A.
F.
B.
, enterovirus.
The results are gonna take a week? Frankly, that's a week that I don't have.
No.
No new cases in the last three hours.
Pardon me? My pulmonologist friend just got back to me.
I told him the situation.
He has privileges at a top-notch private hospital in Beverly Hills, and he wants to move your mother there.
No.
No, no.
You want to move her there.
Let's not split hairs, Neal.
We both think it is the right thing to do.
Listen to me It's never gonna happen.
Son, I know you are very proud of everything you've managed to accomplish here with limited resources, but as far as your mother's health is concerned, I have to go with the best.
Beyond the fact that you can't leave There's a way of getting around that.
You have no idea what's best for her.
If she ever gets a brain tumor, then, by god, you can be in charge and call all the shots.
But right now, I'm the doctor she needs, not you, and this is the best place for her.
Now, if you want to be helpful, go and sit with her and try and make her more comfortable.
And don't you dare upset her with this nonsense, - or I swear - Dr.
Hudson! Pulmonary edema.
Malaya, intubate.
20 of etomidate, 120 of sux.
I can't see anything.
I need suction.
There you go, doctor.
- This is gonna be a blind pass.
- Here.
Use this.
You stick it in until you feel the vibration of the tracheal rings.
Old-school, but the best when you can't see down there.
I feel it.
Pass that into the vocal cords.
Got it.
I'll bag.
That's better.
Guys, I don't think we have a pulse here.
P.
E.
A.
Malaya, bag.
Christa, I need you here to start compressions.
Amy, 1 of epi.
Slam it.
Yes, doctor.
Oh, you have been busy.
Electrocution, cardiac arrest, possible femoral perforation.
Anything else? I think that's it I hope.
Me too.
- So, is he stable? - Yes.
- Is he in the scanner now? - Yes.
- Did you page vascular? - Yes.
All right.
Good.
With that hinky femoral Did you guys hang blood? Malaya, squeeze harder.
I literally can't.
Is the tube kinked? It's her lungs.
They're stiff with infection or toxin.
Does she have a pneumo? Breath sounds are equal but shallow almost nonexistent.
It's classic for A.
R.
D.
S.
, but none of this adds up.
Pulse check.
I got nothing.
None here, either.
Don't ever do that to me again.
As far as your mother's health is concerned, - I have to go with the best.
- Neal.
Neal? Neal.
Um Any objections? No? - No.
- No.
Time of death 10:23 P.
M.
I'm starting to doubt it's contagious.
Everybody who came in with it is getting worse, but nobody else who's been exposed shows any symptoms.
I've been hoarding ICU beds for you.
But we got to get you out of this bubble.
I mean, how many you got on ventilators now? Five.
And close on a few more.
Any of them your mother? I'm hoping it doesn't come to that.
Listen, Neal It hasn't escaped my notice that the woman in that bed over there is the woman who gave birth to you, so Anything you need, you ask, and it's yours.
All of the resources of this hospital are here for you And I'm here for you.
Anything.
Well, I'm happy to tell you that you're not having a heart attack.
You have a temporary condition brought on by stress.
And given what you've gone through today, I would say that was entirely normal.
Just try to rest.
Um, he has apical ballooning, classic for takotsubo cardiomyopathy.
It's a disease where emotional stress causes the heart to become enlarged.
It's also known as broken-heart syndrome.
Well, what's the treatment? There isn't one, really.
Just supportive care.
Unfortunately, we're a little shorthanded for that at the moment, aren't we? But, um, we'll do the best we can.
Oh, my god.
We got the images off, then he started bleeding out.
Did you see the recon? Yeah, this thing went right through his femoral.
All right, it was only a matter of time before the arterial injury overwhelmed the rod.
Okay, everyone.
On my count.
Watch his head.
And one, two, three.
I'm dying, aren't I? You've got an hour and a half before your daughter's plane lands.
I want you to hang on so that you can talk to her, okay? Grab that.
An hour and a half.
Mario, manual tamponade.
Copy that.
Center stage.
Let's go now.
Unlock it.
Let's go! Push it, push it, push it! I need a curved kelley, suction, and O-silk.
Mario, you got the M.
T.
P.
? Uh, he's got it.
Six of them coming in.
Jesse, what's the E.
T.
A.
on vascular? - Five minutes.
- That's not good enough.
We've got two choices.
What are they? Pull the rod, potentially worsen the hole, but that might give us a chance to fix it.
- Or? - Or leave it in and we're limited to external techniques.
Which is the better choice? "Neither is a good choice" is the answer, but we're gonna leave it in for now unless his B.
P.
crashes.
Jesse, tell vascular we need them to get down here now.
Got it.
We can't put this off any longer.
We need to intubate.
30 milligrams etomidate, 120 milligrams of sux.
Wait! You're rushing this.
At the very least, we need an arterial blood gas before you intubate electively.
It's hardly elective.
It's time.
She's tiring out.
I think a proper CO2 level from the lab would inform us whether she's tiring out or not.
If I wait for lab results, I risk worsening hypoxia when we already know her heart's struggling.
I know it.
I sense it.
I don't need a lab value for that.
And I need more than your gut! You could be sentencing her to a lifetime tied to that machine.
You think this is easy for me? You sit down and let me treat my patient.
Mum.
I know you're scared.
I'm gonna do a procedure to help you breathe.
I'm gonna give you two drugs One to put you to sleep and the other one to temporarily paralyze you so that we can place a tube in your lungs that will attach to a ventilator.
You have to know there's a chance that tube may never be able to be removed.
We still don't know what's wrong with you, so you have to understand If it gets worse You may never wake up.
I trust you.
Mm.
I love you.
I love you so much.
Neal.
I'm sorry.
I'm so sorry.
I know how much you love her.
I can't lose her.
Neither can I.
Dr.
Hudson? Hi.
I'm Dr.
Lorenson.
I just want to say I read all your papers, and I think your work is just brilliant.
Thank you.
That's very kind of you.
I think there's someone here that you might like to meet.
Are you familiar with Dr.
Susan Evans' work? Yes, of course.
Everyone in neurology owes her a great debt.
Lawrence Evans? This is Dr.
Peter Hudson.
I worked with your wife many years ago when she had a fellowship at Oxford.
Her death is a great loss to the profession and to her patients.
Thank you.
She loved her year at Oxford.
She was a fine scientist and a first-rate doctor.
Her breakthroughs in transpetrosal surgery changed the profession.
How did she do it? She cherished those friendships.
Thank you.
B.
P.
is down.
60/40.
Uh, s-still no sign of vascular? No.
Okay, we got to move on it.
Angus, get suction ready, please.
Mario, cordis to the left subclavian and prep an M.
T.
P.
, please.
Let's move.
Thank you.
Let's pull this thing out now.
Okay, got it.
Uh, more suction, please.
Kelley and forceps.
Copy that.
B.
P.
is 50/30.
I can't get access.
His vessels are collapsing.
Damn it.
His volume's down.
What do you want, doc? We need to go analog.
I need a tourniquet, please.
Here.
No, no, no.
That's too small.
Mario, find the largest blood-pressure cuff you can and bring it over here.
Suction, please.
Bring it over.
Come on! Come on, come on! Out of the way.
Get it over tight.
Okay, squeeze it up.
- Ready? - Squeeze it up.
Still bleeding.
Okay, plan "C.
" I need to create some tension around the leg.
I need something like a fulcrum.
This ought to work.
I'll take that.
And I need a line to wrap the leg with.
How about a, uh, a B.
P.
wire? Get it.
Let's Pressure, pressure.
Pressure, pressure.
Okay, single line under, please.
Got it under? Bring it up.
Okay, now take it off.
Okay.
Come on.
Come on.
Come on.
We're good.
We're good.
It's working.
It's working! The hemorrhage has stopped.
It's only temporary.
His leg is getting no profusion.
Vascular team is in the house.
All right, we've got a right femoral arterial injury.
Following foreign body and electrocution.
Estimated blood loss 2 liters.
Transfusing as much right now.
Got some battlefield medicine going on here, I see.
Yeah.
It's been that kind of night.
Tourniquet time less than 5.
Okay, let's move, let's move! You two Earned your boy scout badges tonight.
Good job.
Mama.
Can I get a rag? Something? Thank you.
It's the same problem with all of them.
The air's hardly going in.
Looks like breath stacking.
But why? You know, nothing we've tried is working.
When I was in med school Back in the dark ages The received wisdom was, it's never a good idea to treat your own family members.
It's easier in theory than in practice, and everybody does it eventually, especially for the small stuff.
And in extreme situations, like the one you're in right now, you have no choice.
You're the only one who can help her.
The tragedy is When you're absolutely the finest, most skilled doctor there is, and you have to turn them over to people less skilled than you.
So you're lucky.
Your mother is lucky.
Because there is no one anywhere better equipped to save her than you.
You have the opportunity to do what I couldn't do with my own family.
I envy you that.
So don't waste it questioning yourself.
You know what to do.
Malaya? Can I see your notes on the caterer again? Of course.
She has to be the key.
She was young and healthy, but it hit her harder than everyone else.
Did mum swim today at the hotel? She swims every day.
Chlorine.
The caterer was in a tent by the pool.
If there was a leak from a chlorine-gas tank nearby, the gas would have collected in the tent, I-I need a fiber-optic laryngoscope.
I need to look at the trachea below the vocal cords.
Sloughed epithelium.
Tons of it.
Burns.
That's it.
Burns? From the pool? Chlorine gas is intensely toxic to airway mucosa in high concentrations.
Airway burns trap air inside the lungs.
They're effectively suffocating, with air trapped inside them, unable to exchange with fresh oxygen.
Jesse! It's not contagious! Tear down the plastic! These patients are air-trapping! We need to compress the air out of them! Press firmly on their chests for five seconds, and then you'll hear it! There it is.
That's the sound of all these people getting better! Please, Neal Let me do it.
I need manual respirations on everyone no vents With an I-to-E ratio of 1 to 5 at least! Let's get humidified O2 ready, solumedrol, and no pneumos, please.
Ask for help if you need it.
Dr.
Lorenson and Dr.
Pineda can show you how it's done.
Thanks.
I'm a little rusty.
You got it.
Leanne.
Talk to me.
Chlorine-gas airway burns.
Not contagious.
Thank god.
We need ICU beds, Mark.
I cleared all the beds you need.
Okay, let's bag 'em up and move 'em out! Nice work, doc.
Not every day you save your mother's life and your boss's ass at the same time.
Okay! 4th floor ICU! Bwah! You were great, man.
You nailed that electrocution diagnosis.
Well, you saved my ass on that code.
Phew.
If you hadn't shown up, I was in big trouble.
Don't tell anybody I said this, but if I could press replay, do the whole thing again from beginning to end, I would.
Me too.
Totally.
Hey, um Why did you turn your back on me when the thoracotomy went wrong? I honestly thought that they were gonna throw us both out of the program.
So you hung me out to dry all by myself.
You, Malaya, and Christa Nah, if you weren't here, I could see any of you with a practice in internal medicine or pediatrics or psych Whatever you wanted.
That doesn't work for me.
I'm never gonna be that guy with the white coat, you know? With the office in the medical-arts building.
You know, half the time, when I tell people I'm a doctor, they don't even believe me.
If I fail at this If I can't do emergency medicine, I got no place else to go.
I just got scared.
I'm sorry.
Okay.
I'm scared all the time.
Just so you know.
Angus.
We're sprung.
You ready to go? No, I, uh I'm gonna take Mario out for a beer and, uh Just let him tell me how great I am.
It could take all night.
You're paying.
She's doing much better.
Her O2 sats are improving by the hour, and her color's much better, too.
Good.
I'll be back in a bit.
Wait.
Neal.
If there's a silver lining to this dreadful night, it's that I got to watch you work.
I have to tell you in my practice, I don't get many moments like that Putting my hands on patients, literally keeping them alive, breathing for them with just my hands.
I I have to admit It was exhilarating.
The exhilaration helps balance the exhaustion, so Earlier, you said that you came here to learn from the best, and that afterwards, you decided to stay.
You humbly left out the middle part You learned from the best, and then you became the best.
I'm sorry I couldn't see that till now.
And you gave me back my wife.
Well, we English are not very demonstrative, so I guess I'm American now.
after everything he's been through today.
Sometimes, that's what gets you through.
His phone.
It's his daughter.
I promised I would wake him up when she called.
Mr.
Gable.
It's for you.
Hello? Ohh! I'm so sorry.
I I shouldn't let any of that bother me.
I'm so sorry.
Do you know how many times I've dreamed of that call? You're the most important thing in the world to me.
And I love you.