Saving Hope (2012) s01e05 Episode Script
Out Of Sight
Ysidro Pineda.
33.
Migrant worker from Honduras working in a chicken processing plant in north bay.
Both hands amputated by a factory blade.
- Injury occurred at 6:47 this morning.
- Alex, look at me.
He lost a lot of blood and was hypertensive when the paramedics arrived.
You saw me the other day and you said my name.
Every minute of ischemia that his hands suffered Just turn your head and look at me.
Functional outcome.
Clean cut.
Hands put on ice.
What's the timeline on this? We've got 12 hours to replant, from the time of amputation.
Or? Pump all the blood you want back into the hands.
It'll be too late.
Exactly, so minus travel time from North Bay, we have eight hours before this man's hands die.
Dr.
Goran, can you outline our approach? Yes, uh, two teams, one per hand, ortho, vascular, and plastics.
Uh, Dr.
Kinney will lead one team.
I will lead another, but this is Dr.
Kinney's surgery.
Does anyone know how many successful double-hand replantations have been done in this city in the past decade? Reid.
(raised voice) Dr.
Reid.
What? Sorry.
What? The answer is none, Dr.
Reid.
Enjoying your nap? So Dr.
Kinney and I will pick teams.
How long till the patient gets here? Medevac's schedule to land at 11:00.
Then he'll be brought straight here by ambulance.
If you're chosen for a team, you'll get a page.
This is big for Hope-Zee, for all of us.
The clock's ticking.
Don't worry.
You weren't snoring.
Thanks.
Uh, excuse me.
Excuse me.
Dr.
Kinney, I am so, so sorry that I fell asleep.
It won't happen again.
Oh, no biggie.
You know, I fell asleep during a surgery once.
Go home.
Get some rest.
Home.
Right.
Thank you.
That poor guy.
He comes up here to make money to send back to his family, and it costs him both his hands.
That's rotten luck.
You're his only chance at a normal life, Joel.
Oh, me and about nine other men and women.
I would do anything to get in on that surgery.
Anything.
I don't know.
It kinda feels like you're using me here.
Mm.
Yeah.
I am.
For your body.
Seriously, Joel.
I'll do anything.
I don't care how menial the task is.
I will tag the neurovascular structures.
I will do the fasciotomies.
Anything.
Just help me out here, please? I'll see what I can do.
Really? Mm-hmm.
You're the best.
Gotta get back to Kinney.
"Consciousness is eternal.
" "It is not vanquished" "with the destruction of the temporary body.
" Went through a spiritual phase back in my '20s.
Thought it was B.
S.
I may have been wrong.
The nursing home gets a flu outbreak, and it becomes our problem.
He's old.
He can't breathe.
And he's taking a bed away from someone I can actually help.
It's our only empty room.
Sorry, Jackson.
That's okay.
You should hear how my girlfriend barks at me.
"Jackson, do this.
Jackson, do that.
" The doctor's not wrong.
Electricity bills alone, they should've pulled the plug on me years ago, don't you think? That's you? Yeah.
Scott Cockburn.
How ya doin'? Charlie Harris.
You're In a coma.
but, eh, who's counting? Sorry, guys.
Right hand is me.
Simons on ortho.
Reycraft on vascular.
Strong team.
Left hand, I put Carpenter on plastics, you on ortho, and for tying up, I was thinking Perino.
Perino? Yeah.
Yep.
He's okay.
Okay, if not Perino, then who? - Alex.
- Can't.
Gone home to rest.
- You sent her home? - She fell asleep during grand rounds.
So bring her back in.
Joel, I know she's very talented She's more than that.
Alex is born to tie up veins.
Her hands are rock solid.
She's exhausted, and we both know it.
I mean, Charlie and her job, taking extra shifts in the E.
R.
Alex has done electives in microvascular surgery at Emory, Cleveland Clinic, Sunnybrook.
So has Reycraft.
He's not chief surgical resident.
Mm.
Not yet.
What does that mean? It means Perino's your guy.
Okay.
I need help.
I need help.
- You okay? - Please help.
Why don't I take you down to emergency? Someone will be happy to help you over there, all right? All right.
- Okay? - Don't-don't touch me! - Can I get some security here, please? - Did I say you could touch me? Huh? You think you think you wh Aah! Aah! Dr.
Tolliver, what's up? John Doe.
Homeless.
Beaten up and left for dead by a pack of teenagers.
You're kidding.
Your friend Gavin found him.
They patched him up in the E.
R.
, but he came in with preexisting pneumonia.
Okay, uh, but Dr.
Goran promised - to bring me into this big surgery, so - I don't care if he's taking you to Disneyland.
Right now, you're needed for a surgical consult.
Oh, my god.
Some things you can't unsee.
Abscess.
Needs draining.
He's all yours.
How do you do this to another person? Don't know.
Never want to.
Can you get me a surgical tray and a chlorhexidine prep? Yeah, sure thing.
Joel, what Is Charlie okay? I'm not here about Charlie.
She was nice to me.
Something was wrong.
This is all my fault.
What are you talking about? Who falls asleep on the job? So you screwed up.
Pick yourself up and do better.
Well, I can't exactly go waltzing back in there.
You have to.
What's your option? Giving up? I'm not giving up.
Yes, you are.
You're basically handing Reycraft your job, and he will take it.
Dana Kinney scares the hell out of me.
Good, so channel that, and show her exactly why Charlie made you chief resident in the first place.
Oh, Dr.
Reid.
Feeling better? Like a million bucks.
Yeah, I gave Perino the day off.
He was looking a little tired.
Thanks, Joe.
All right, so Simons and I will start prepping the hands in the O.
R.
- We're gonna trim bones, tag tendons - Mm-hmm.
Vessels, nerves, the usual drill.
Let's give this man back his hands.
What else are we looking at besides the hands? Crush injury to the right thigh.
Forklift ran into him, pinned his legs, Pushed him right into the saw.
We're looking at gross contamination of the wounds.
Give him a tetanus booster, crossmatch 4 units of blood and start 2 liters of saline at 200 an hour and hang 2 grams ancef, and some fentanyl.
How long is this gonna take? As long as an I.
V.
takes.
- Doctor.
- Mm? ÿHablas español? Si, un poco.
Mi familia I-I sent to them money, pero pero mis manos Uh, I ÿComo puedo trabajar sin mis manos? Tenemos las manos.
Vamos a They didn't teach me how to say "sew them back on" in high school.
Uh ÿpuede trabajar de nuevo? He's talking about work, I think, if he'll ever work again.
Well, you know, function will be reduced.
I mean, he's never gonna be a concert pianist, but, yeah, if the hands take, he'll work again.
Si, señor Pineda.
Esperamos.
- Gracias.
- Reid.
Yeah.
Joel wants you on this surgery, - but I don't, because right now - Okay.
I think you're a liability.
Oh.
Tell me how you really feel, Dana.
Zach, we've got a problem.
Okay.
Run a dipstick.
That doesn't make any sense.
I thought the trauma was to his leg.
Pissing blood.
No way that's coming from his leg.
I'm still not feeling anything.
Kidney and liver, all normal.
What the hell? All right.
Now his heart is starting to show signs of arrhythmia.
Dipstick's positive for blood.
Yes, but that shouldn't affect his heart.
Gotta be a kidney or bladder injury.
Reid? Come on.
What are we gonna do? Do we need to open him up, take a look? No, no.
Just wait just a minute.
What if it's a false positive? The forklift crushes his leg, causing severe muscle damage, dumping myoglobin into his system.
Myoglobin colors urine red.
It wreaks havoc with potassium levels.
And high potassium levels causes heart problems.
Rhabdomyolysis.
I think so, and if we don't flush this myoglobin out of his system right now, we're looking at total renal failure, and his kidneys will be toast.
Let's not lose him.
Olivia, start saline at Let's get his urine output up to 200, and bicarb 3 amps in 1 liter d5w at 100 milliliters an hour.
Let's get him on some mannitol.
We've got it from here.
Today's not your lucky day, bud.
Go grab a coffee.
I don't need a coffee.
I'm good.
I do.
Black.
One sweetener.
Go.
So we'll irrigate the hands, expose the neurovascular structures and tag 'em, and then I'm gonna trim - about a centimeter of bone off each hand.
- All right.
Yeah.
All scrubbed in and ready to go, Dr.
Goran.
Maggie.
Yeah.
I'm sorry.
Uh I didn't get to ask Kinney about you.
I've been too busy fighting for Dr.
Reid.
Dr.
Reid? Yes.
She has the skills I need for this.
It's not just any old surgery.
I know.
That's why I wanted to be a part of it.
Right.
Well, um, I said I would try, and it didn't work out.
Thanks for your understanding.
Breaking hearts, huh, Dr.
Goran? It wasn't personal.
Mm-hmm.
That's the way it's gotta be.
Do you want to come over and clean my place? Everyone's worried about salmonella, right? There's a whole phylum of contaminants in a food environment, Alex.
There's, uh, campylobacter, listeria, fungi like aspergillus niger.
That can lead to a pretty nasty lung infection, Alex, I'm telling you.
Aspergillosis? I think we're okay.
So, uh, Victor told me you were sent home? I was.
I'm back.
Everything okay? Would you like to talk? About? Anything.
Charlie if you want.
Uh, you know, I'm, uh, I'm a very good listener.
I've already talked your ear off about Charlie.
Not medically.
I mean How are you doing? Me? Well I'm exhausted.
I'm seeing things.
Don't ask.
And I'm fighting for my job, and I'm starting to wonder, what if this is it? So? What if this is it? Too blunt.
Kinda.
Charlie's been in a coma for a few weeks.
You know, comas last for years, decades even.
Uh, I'm not saying to give up hope.
You better not be.
I'm just saying, what if this is it, Alex? I mean, what are you gonna do a week, a month, a year, five years from now, hmm? I think you owe it to yourself to answer that.
Look at this.
So you've been in a coma for 27 years? Yeah.
Almost half my life, but no regrets.
You sound surprised.
No.
I mean, I've heard of comas lasting for decades, but that's not the norm.
It isn't.
I must be lucky.
How'd you bite it? Oh, let me guess.
Car crash, right? Yep.
Yeah.
This is, uh, week five for me.
Oh, well, you'll wake up any day now.
Hello, nurse.
See, the best thing about being invisible is being invisible.
- Hey, wait, wait, wait, wait, wait - Hey.
Listen, uh, you're the first person I met who-who knows more about this than I do.
Help me.
Well, first of all, don't touch the suit.
Secondly, I'm not a "person," and neither are you, and thirdly, would it kill you to have a bit of fun? Come on.
I'm in a coma.
Oh, I get it.
You're feeling bunk and crunchy when you wanna feel ace.
Hey, I got an idea.
Let's let's book and get some air.
Aah! Hey, easy, easy, easy.
It's cool, right? Yeah.
So do you believe what you said about me waking up any day? No.
Come on.
What do you want from me? I see them come and go.
Mostly go, to be honest with you.
Yeah, walking into the light.
It's a very sweet moment when a loved one passes on.
It's very deep.
It's very meaningful.
So no tips on how to wake up? What part of "being in a coma for 27 years" didn't you get? My fiancee saw me the other day.
- Oh, she looked at you? - Yeah.
It's impossible.
You're going nuts, my friend.
It really sucks to be you.
Hey.
Aah! Whoo! We've just stabilized him, Dana.
He can't go under the knife.
This surgery is a one-shot deal.
- I get it.
- Do you? Because if we don't replant the hands now, they die.
Well, it's better that than he crashes during surgery.
It's not gonna happen.
Fine.
Your patient.
Your call.
Thank you.
Guys.
All right.
Take Mr.
Pineda up to O.
R.
three, please.
You can go up with 'em.
I'm part of this surgery? Don't make me regret it.
It's been four hours, and ischemia is a concern, so we need to get that blood flowing.
All right.
We'll do ortho first.
Secure the bones, then arteries, veins, tendons, nerves, in that order.
Okay, teams, let's go.
You looked freakin' terrified.
Come on.
You you you pushed me! You totally thought you were gonna die.
You're already dead.
Come on.
Well, you're sorta dead.
You know what I mean.
Hey, do you wanna go do it again? - No.
- Just for kicks.
Come on.
I, uh, how can you be so cavalier about all this? Well, how can you be so depressed? It's like you're happy being in a coma.
Well, uh, insanity doing the same thing over and over again and expecting different results.
You're quoting Einstein now? No, no, no.
I'm making a point, okay? I don't expect things to change, but you do, so who's crazier here? You've given up.
No.
I've adapted.
That thing back there in the I.
C.
U.
, that old, wrinkled mummy? This is me, and this is you now, chuck, okay? This is your new reality.
Your old life is just a dream, so you just gotta, you know, let it go and everything'll be fine.
I don't believe you.
Well, you should, because I've been to hell and back.
You're-you're happy here? As a clam.
How are you doing? "John Doe.
" That's not a name.
What should I call you? Mr.
Darcy? You're mysterious, aloof.
First name Fitzwilliam.
Not common knowledge, but Am I seeing things, or is his abdomen distended? Yeah, a bit.
How's his urine output? Low? Borderline? It's low.
And his bladder pressure? Is it elevated? Nope.
15.
He's normal.
Huh.
Okay.
Thanks.
Our John Doe is struggling in there.
Antibiotics take a few days.
What if it's pneumonia? I'm not questioning your judgment Glad to hear it.
But he's had a lot of difficulty breathing.
He suffered trauma to his abdomen, received a lot of fluids, and now it's distended, so what if it's A.
C.
S.
, abdominal Compartment syndrome? Have you checked his bladder pressure? And what was his latest I.
A.
P.
? it'd be more like 25 or higher.
Maggie.
Look, I get it.
You're trying to get noticed, but I didn't call you down here to diagnose my patient.
I called you down here to drain an abscess.
Think horses, not zebras.
Okay.
Heparinized saline.
Ron, can you cut this here, please? One more 8-0, Victor.
Rounding the finish line.
One more throw.
Here we go.
And I'm done.
Good work.
All right.
Time to test his pipes.
Deflate the tourniquet and restore the blood flow.
Yes, Dr.
Kinney.
Macara? One hand good.
Two hands better.
It's a marathon, not a sprint.
Doctor, your hand isn't pinking up.
Is the tourniquet Completely deflated.
Blood should be getting in.
It's not.
What's wrong? Maybe there's a clot or arterial spasm.
Done.
Reestablish blood flow, Victor.
You know, instead of trying to go for some suturing record, you might want to think about your patient.
Excuse me? Left hand pinking up nicely, Dr.
Reid.
Patency confirmed.
Yes.
Yeah.
All right.
All right! The zone of the injury must be too big.
That-that's why it's not perfusing.
Okay, we don't have enough time.
Alex, take a look at this, please.
I just told you it's Okay.
Let her in.
Just a fresh set of eyes.
You're up.
Okay.
Talk to me, Reid.
What do you see? Looks like you picked up the back wall, so the artery is constricted and there's no blood flow.
So you hooked up the artery, and you sewed it shut? It happens, Joel.
Back off.
You just need to get in, cut the sutures, redo the anastomosis.
There's still time to save it.
You're not touching that hand.
Reid, patient's yours.
Dr.
Kinney.
Listen, I don't care about feelings.
I care about saving those hands.
You hear me? Loud and clear.
I have a patient who is going to die, but Dr.
Tolliver won't listen to me, because how could I, a lowly surgical resident, possibly know what I'm talking about? Whoa, whoa.
Maggie, slow down.
Okay.
Here's the situation.
My patient looks like he has textbook pneumonia.
But I think it's something way worse.
Way worse how? Well, how much general surgery do you remember? Uh, none.
Those are Reycraft's.
He eats them raw, calls them "nature's energy drink.
" Reycraft is a weirdo.
So here's the dealio.
If my patient has what I think he has, there's this crazy pressure building up in his abdomen.
It's blocking off blood flow to the bowel, to the kidneys.
We're having trouble ventilating him, but it's not because of the pneumonia.
it's because, inside, he's a pressure cooker, and if the pressure isn't released in time Whoa.
He'll explode? No, but he'll suffer multiorgan system failure and then die.
Ask Dr.
Reid.
She's in surgery.
Then go back to Dr.
Tolliver again.
My patient is dying! Are you sure about that? Artery successfully detached.
Time to start all over again.
8-0, Victor.
Okay.
That should do the trick.
Tourniquet down.
- Come on.
Come on.
Pink up.
- Come on.
- Come on.
Pink up.
- Come on.
- What's happening? Blood's still not flowing.
I told you, there has to be something else.
Let's see if gravity will help us.
Victor? - Good? - Yeah, and - Yes.
Nice one, Reid.
- Yes! - Thank you.
- Well done.
Okay.
Let's reattach some veins to establish venus return.
Then we'll do the radial arteries, and then on to plastics.
All right.
Reycraft, come on.
Let the real work begin! It could've happened to anyone.
Don't be so hard on yourself.
- Yeah.
- Sure.
- Reid? - Yeah? Well done.
Thanks.
It can't eat on its own.
It can't breathe on its own.
There's nothing firing in the old cabeza.
You still think that's you, huh? That's been me for the last 40 years.
You gotta move on, man.
Thank you for coming.
Yes.
Well, where is he? You gotta be kidding me.
The nurse says he has pneumonia.
What the hell are you doing here? What no.
Hey, you! - No, you can't you don't let'em in there! - Scott! Hey! Hey! - Stay out! - It's bilateral, meaning in both lungs.
We've given him antibiotics, but due to his age and condition, the prognosis isn't very good.
And there's no one else you could've called, a member of his family? Your wife was listed as Mr.
Cockburn's next of kin.
If he codes, we'll have to revive him, but again, considering his age and his condition Maybe we shouldn't.
Uh, I it would be a blessing.
"It would be a blessing.
" Who is she? She's my wife.
She's my ex-wife.
Don't.
Don't revive him.
Okay.
They forget about you, Charlie.
They always do.
Blood flow is reestablished, bones plated, nerves, tendons hooked back up.
It's in the hands of the hand gods now, huh? I think his chances are good.
Yeah.
Can't ask for much better than that.
Good work, team.
- Thanks.
- Reycraft.
Suck it up.
You picked up the back wall.
It could've happened to anyone.
Didn't happen to you.
So, Alex, we'll all be over for 8:00? What are you talking about? The hero of the surgery buys everyone dinner.
It's Dr.
Kinney's new thing since she became chief.
That's right.
It's team-building.
You order some chinese.
I bring the beer and wine.
Sound good? Sure.
Perfect.
I'm going to accompany Mr.
Pineda up to I.
C.
U.
- Oh, and, Reid? - Yeah? Don't skimp on the general tsao chicken.
Yeah.
Did she just invite half of Hope-Zee to my place? She just did, yeah.
Guess I'll have to go home and clean up.
So I guess I'll See you about 8:00.
Joel? Thanks for the pep talk.
I owe you one.
You wanna talk? No.
Okay.
She's so old.
Melissa.
That happens, Scott.
I put her out of my mind for years, and she shows up here, and I'm looking at her now.
What do I see? I see someone who's had a full life a full life! Without me.
And that hurts.
I mean, what else? What else did I miss? Anniversaries, birthdays we could have had kids.
Wait-wait a minute.
When's the last time you saw her? June 14th, 1987.
She came she spent ten minutes, and then she left.
And then I kept waiting for her to come back, and she never did.
And then two months later, we were divorced.
Yeah, my sister, god rest her she signed the papers for me.
That, uh that totally sucks.
Sorry.
Well, "till death do us part" and all that crap, huh? I fell for that hook, line, and sinker, I tell you.
But Melissa ah, she never loved me.
You don't know that.
How was your day? Disconcerting.
How was yours? 'Cause mine was pretty weird.
I went home.
Our home? I, uh, picked up our mail and tried to sleep, but I couldn't.
Came back in, fought for my job and I sewed a guy's hands back on.
That went pretty well.
Okay.
Um I gotta go, but I will be back first thing in the morning.
And she's gone.
Shahir, you're totally bogarting the beef and broccoli, man.
Mm.
I don't share.
What are you talking about? It's chinese.
That's like saying, "I don't share ethiopian.
" - I don't.
- It's true.
He orders his own loaf of the spongy bread.
- It's called injera.
- Good to know, baby.
That's good.
Yeah.
Excuse me.
Reid.
That was a serious power nap.
What do you mean? Did you take a little something? 'Cause, wow.
Um that's not my thing, Dana.
No, I know.
I'm just I was just kidding, right? Look I'm not so good at the part where I have to be all, like, nice and caring and, you know, supportive, and so that is my way of doing it.
- Okay? - Oh.
O-okay.
Okay? Where is the hot and sour soup? Just gonna grab it.
So, Joel, tell me is there anyone special in your life these days? Uh, none of your business.
Pass the crispy chicken, please.
I'm just making conversation.
Crispy chicken, doctor.
Thank you.
Um, I'm not hurting for company right now.
Oh! Details, please.
Shahir, seriously.
We're sharing here.
This is called sharing.
We share, he doesn't.
Just let it go.
Guys.
Does this remind anyone of anything? I mean, what? What? It's too soon? Hmm? Hmm? Huh? (Shahir) Please.
Anyone need anything? Alex? Uh, no, I'm okay with my water.
Water? Come on.
You're not on call.
Yeah, one beer's not gonna kill you.
Mmm.
Fine.
I-I'll have a beer.
Attagirl.
Team.
Mm-hmm.
To us.
- Yeah, to us.
Cheers.
- Fantastic.
What great work.
It's all right.
Can I? Of course.
Time of death 21:47.
I'm so sorry.
Well, I expected something more exciting, like Stallone in "first blood.
" That's a great flick.
I'm sorry, Scott.
I'm not.
I'm not.
Hey, Charlie, before I go, there's if you really want to get back to her, you gotta try harder, or you're gonna lose her.
So wake up.
I don't know how to, Scott.
I just couldn't let you go, Scotty.
I'm sorry.
I love you so much.
I never stopped loving you.
Never.
Hey.
Don't cry.
You don't have to cry anymore.
No.
if I didn't know what I know So there I am, holding this woman's forehead in my hands and I gotta sneeze.
And you know that feeling where it's right there, - right in the top of your nose, like a lot of little needles - The worst.
- And everything? - Oh.
Yeah.
And I'm doing everything I can not to, and I do exactly the wrong thing.
You looked right into the surgical light? Straight into it! - Oh, my god! - So what? What? It's photoptarmosis.
Overstimulation of the optic nerve triggers the trigeminal nerve, which leads to the photic optic sneeze reflex.
It Yes! Well played! It was the mother of all sneezes, and I had just enough time to drop her forehead into place Oh, my god! - Before I left it rip! - Well, it's better than having to peel her forehead off the ceiling, right? Agreed.
Photoptarmosis is very interesting.
It affects roughly about a third of the population, And the hereditary factors still aren't understood, so Is he always like this? - Always.
- Yes.
Five second rule.
- One, two - No.
Victor.
Oh, dilemma time.
If I eat this last wonton and I really want to eat it Then Shahir won't let me kiss him for like a month, right? So what do I do? - Wonton.
- Wonton.
- Dude, wonton.
- Wonton.
- Wonton! - Wonton! Wonton! - Yes! - Wonton! I'm sorry.
You're okay.
So mad.
You're okay.
if I didn't know what I know if I believe Alex.
What is it? Did someone say something? I forgot about him, Joel.
About Charlie? Ye for a minute When I was laughing just now I felt free.
Dr.
Tolliver! Some help in here, please! Wh-where's Dr.
Tolliver? Patient just died.
She's with next of kin.
- Do you want me to get her? - Just go! Don't die on me, Mr.
Darcy.
It's easy.
Just Okay.
All right.
I got this covered.
Okay.
Okay.
I think you got this.
You can do this.
This is what you do.
Okay.
Okay.
Fat.
Okay.
Skin, fat fascia.
You slicing him open? Oh, my god, oh, my god, oh, my god! Hell no! Those are supposed to be on the inside.
oh, my god.
He's stabilizing.
I did it.
What's going on in here? Okay.
Jackson, grab a bogota bag.
- We need to cover this wound now.
- I'm on it.
It was just like one of those scenes in "Star Trek.
" - "Star Wars.
" - Where Luke Skywalker - Han Solo.
- Cuts into one of those ice horses.
- Tauntaun.
- And all the guts just spilled out erywhere.
But I saved his life! And that trumps a hand replantation any day of the week if you ask me.
Your patient is stable.
Dr.
Tolliver, he never would have made it into the O.
R.
I know.
I told you there was something wrong with him, and you didn't listen.
He almost died.
His pressure told a different story from the one you were hearing, and you didn't listen to me.
Congratulations, Maggie.
You saved a life tonight all on your own, and that's amazing.
But? Graveyards are full of our mistakes.
All of us make them.
You okay? Yeah.
You sure? Yeah, I really am.
I feel I feel like a doctor.
Ysidro, I'm going to check the blood flow in your fingers.
Okay? - Ay, doctor.
- Mm? No sé cómo darle las gracias.
I don't No hablo español.
But that's okay.
I think I get it.
That sounds good.
It's, uh, bueno.
- Si.
- Sounds good.
put your words into the fire watch them burn your heart's desire Alex, what are you doing back here? rise up in the air in a cloud of silk and smoke and dust I had a party at our place.
fade into the night it's a comforting feeling with you at my side And I felt I felt like what it would feel like for life to go on.
My life.
And what terrified me was that it could.
lean our heavy heads You know, I would have made us cappuccinos, but, um, someone and I'm not saying who Never buys any milk.
don't worry about it now Ahh, just the way I like it.
Mmm.
I got you something.
Skim or 2%? No.
For real.
You got me jewelry.
I figured I could return the favor.
Sweetheart those aren't my initials.
I know.
They were my dad's.
I-I didn't really keep anything of his after he died.
Um, my mom didn't want 'em 'cause she was sad, and my brothers would have lost or sold them, so - I love them.
- You don't have to wear them.
- I can buy you something newer - Alex.
- That's nicer - Alex.
Yeah? I love them.
I mean, they're a part of you.
And I'll tell you what.
The very next time we get dressed up for anything, I'm gonna wear them.
But we better put them somewhere where they won't get lost, because, um, someone Not saying who.
Works about a hundred hours a week and, uh, can barely find her own bra in the morning.
Well, that's just because you keep taking it off.
- I do.
- Mm-hmm.
I do that.
Why is that? I don't know, but I think we should be getting you a consult of some kind, maybe like a sex doctor.
- Mm-hmm.
- Crazy.
'cause in the morning they will all just be ashes on the ground so what's been on your mind But it won't.
I won't let it.
eating you inside I will never forget about you, Charlie.
And I will never let you go.
You promise? on this warm summer night put those words down in the fire
33.
Migrant worker from Honduras working in a chicken processing plant in north bay.
Both hands amputated by a factory blade.
- Injury occurred at 6:47 this morning.
- Alex, look at me.
He lost a lot of blood and was hypertensive when the paramedics arrived.
You saw me the other day and you said my name.
Every minute of ischemia that his hands suffered Just turn your head and look at me.
Functional outcome.
Clean cut.
Hands put on ice.
What's the timeline on this? We've got 12 hours to replant, from the time of amputation.
Or? Pump all the blood you want back into the hands.
It'll be too late.
Exactly, so minus travel time from North Bay, we have eight hours before this man's hands die.
Dr.
Goran, can you outline our approach? Yes, uh, two teams, one per hand, ortho, vascular, and plastics.
Uh, Dr.
Kinney will lead one team.
I will lead another, but this is Dr.
Kinney's surgery.
Does anyone know how many successful double-hand replantations have been done in this city in the past decade? Reid.
(raised voice) Dr.
Reid.
What? Sorry.
What? The answer is none, Dr.
Reid.
Enjoying your nap? So Dr.
Kinney and I will pick teams.
How long till the patient gets here? Medevac's schedule to land at 11:00.
Then he'll be brought straight here by ambulance.
If you're chosen for a team, you'll get a page.
This is big for Hope-Zee, for all of us.
The clock's ticking.
Don't worry.
You weren't snoring.
Thanks.
Uh, excuse me.
Excuse me.
Dr.
Kinney, I am so, so sorry that I fell asleep.
It won't happen again.
Oh, no biggie.
You know, I fell asleep during a surgery once.
Go home.
Get some rest.
Home.
Right.
Thank you.
That poor guy.
He comes up here to make money to send back to his family, and it costs him both his hands.
That's rotten luck.
You're his only chance at a normal life, Joel.
Oh, me and about nine other men and women.
I would do anything to get in on that surgery.
Anything.
I don't know.
It kinda feels like you're using me here.
Mm.
Yeah.
I am.
For your body.
Seriously, Joel.
I'll do anything.
I don't care how menial the task is.
I will tag the neurovascular structures.
I will do the fasciotomies.
Anything.
Just help me out here, please? I'll see what I can do.
Really? Mm-hmm.
You're the best.
Gotta get back to Kinney.
"Consciousness is eternal.
" "It is not vanquished" "with the destruction of the temporary body.
" Went through a spiritual phase back in my '20s.
Thought it was B.
S.
I may have been wrong.
The nursing home gets a flu outbreak, and it becomes our problem.
He's old.
He can't breathe.
And he's taking a bed away from someone I can actually help.
It's our only empty room.
Sorry, Jackson.
That's okay.
You should hear how my girlfriend barks at me.
"Jackson, do this.
Jackson, do that.
" The doctor's not wrong.
Electricity bills alone, they should've pulled the plug on me years ago, don't you think? That's you? Yeah.
Scott Cockburn.
How ya doin'? Charlie Harris.
You're In a coma.
but, eh, who's counting? Sorry, guys.
Right hand is me.
Simons on ortho.
Reycraft on vascular.
Strong team.
Left hand, I put Carpenter on plastics, you on ortho, and for tying up, I was thinking Perino.
Perino? Yeah.
Yep.
He's okay.
Okay, if not Perino, then who? - Alex.
- Can't.
Gone home to rest.
- You sent her home? - She fell asleep during grand rounds.
So bring her back in.
Joel, I know she's very talented She's more than that.
Alex is born to tie up veins.
Her hands are rock solid.
She's exhausted, and we both know it.
I mean, Charlie and her job, taking extra shifts in the E.
R.
Alex has done electives in microvascular surgery at Emory, Cleveland Clinic, Sunnybrook.
So has Reycraft.
He's not chief surgical resident.
Mm.
Not yet.
What does that mean? It means Perino's your guy.
Okay.
I need help.
I need help.
- You okay? - Please help.
Why don't I take you down to emergency? Someone will be happy to help you over there, all right? All right.
- Okay? - Don't-don't touch me! - Can I get some security here, please? - Did I say you could touch me? Huh? You think you think you wh Aah! Aah! Dr.
Tolliver, what's up? John Doe.
Homeless.
Beaten up and left for dead by a pack of teenagers.
You're kidding.
Your friend Gavin found him.
They patched him up in the E.
R.
, but he came in with preexisting pneumonia.
Okay, uh, but Dr.
Goran promised - to bring me into this big surgery, so - I don't care if he's taking you to Disneyland.
Right now, you're needed for a surgical consult.
Oh, my god.
Some things you can't unsee.
Abscess.
Needs draining.
He's all yours.
How do you do this to another person? Don't know.
Never want to.
Can you get me a surgical tray and a chlorhexidine prep? Yeah, sure thing.
Joel, what Is Charlie okay? I'm not here about Charlie.
She was nice to me.
Something was wrong.
This is all my fault.
What are you talking about? Who falls asleep on the job? So you screwed up.
Pick yourself up and do better.
Well, I can't exactly go waltzing back in there.
You have to.
What's your option? Giving up? I'm not giving up.
Yes, you are.
You're basically handing Reycraft your job, and he will take it.
Dana Kinney scares the hell out of me.
Good, so channel that, and show her exactly why Charlie made you chief resident in the first place.
Oh, Dr.
Reid.
Feeling better? Like a million bucks.
Yeah, I gave Perino the day off.
He was looking a little tired.
Thanks, Joe.
All right, so Simons and I will start prepping the hands in the O.
R.
- We're gonna trim bones, tag tendons - Mm-hmm.
Vessels, nerves, the usual drill.
Let's give this man back his hands.
What else are we looking at besides the hands? Crush injury to the right thigh.
Forklift ran into him, pinned his legs, Pushed him right into the saw.
We're looking at gross contamination of the wounds.
Give him a tetanus booster, crossmatch 4 units of blood and start 2 liters of saline at 200 an hour and hang 2 grams ancef, and some fentanyl.
How long is this gonna take? As long as an I.
V.
takes.
- Doctor.
- Mm? ÿHablas español? Si, un poco.
Mi familia I-I sent to them money, pero pero mis manos Uh, I ÿComo puedo trabajar sin mis manos? Tenemos las manos.
Vamos a They didn't teach me how to say "sew them back on" in high school.
Uh ÿpuede trabajar de nuevo? He's talking about work, I think, if he'll ever work again.
Well, you know, function will be reduced.
I mean, he's never gonna be a concert pianist, but, yeah, if the hands take, he'll work again.
Si, señor Pineda.
Esperamos.
- Gracias.
- Reid.
Yeah.
Joel wants you on this surgery, - but I don't, because right now - Okay.
I think you're a liability.
Oh.
Tell me how you really feel, Dana.
Zach, we've got a problem.
Okay.
Run a dipstick.
That doesn't make any sense.
I thought the trauma was to his leg.
Pissing blood.
No way that's coming from his leg.
I'm still not feeling anything.
Kidney and liver, all normal.
What the hell? All right.
Now his heart is starting to show signs of arrhythmia.
Dipstick's positive for blood.
Yes, but that shouldn't affect his heart.
Gotta be a kidney or bladder injury.
Reid? Come on.
What are we gonna do? Do we need to open him up, take a look? No, no.
Just wait just a minute.
What if it's a false positive? The forklift crushes his leg, causing severe muscle damage, dumping myoglobin into his system.
Myoglobin colors urine red.
It wreaks havoc with potassium levels.
And high potassium levels causes heart problems.
Rhabdomyolysis.
I think so, and if we don't flush this myoglobin out of his system right now, we're looking at total renal failure, and his kidneys will be toast.
Let's not lose him.
Olivia, start saline at Let's get his urine output up to 200, and bicarb 3 amps in 1 liter d5w at 100 milliliters an hour.
Let's get him on some mannitol.
We've got it from here.
Today's not your lucky day, bud.
Go grab a coffee.
I don't need a coffee.
I'm good.
I do.
Black.
One sweetener.
Go.
So we'll irrigate the hands, expose the neurovascular structures and tag 'em, and then I'm gonna trim - about a centimeter of bone off each hand.
- All right.
Yeah.
All scrubbed in and ready to go, Dr.
Goran.
Maggie.
Yeah.
I'm sorry.
Uh I didn't get to ask Kinney about you.
I've been too busy fighting for Dr.
Reid.
Dr.
Reid? Yes.
She has the skills I need for this.
It's not just any old surgery.
I know.
That's why I wanted to be a part of it.
Right.
Well, um, I said I would try, and it didn't work out.
Thanks for your understanding.
Breaking hearts, huh, Dr.
Goran? It wasn't personal.
Mm-hmm.
That's the way it's gotta be.
Do you want to come over and clean my place? Everyone's worried about salmonella, right? There's a whole phylum of contaminants in a food environment, Alex.
There's, uh, campylobacter, listeria, fungi like aspergillus niger.
That can lead to a pretty nasty lung infection, Alex, I'm telling you.
Aspergillosis? I think we're okay.
So, uh, Victor told me you were sent home? I was.
I'm back.
Everything okay? Would you like to talk? About? Anything.
Charlie if you want.
Uh, you know, I'm, uh, I'm a very good listener.
I've already talked your ear off about Charlie.
Not medically.
I mean How are you doing? Me? Well I'm exhausted.
I'm seeing things.
Don't ask.
And I'm fighting for my job, and I'm starting to wonder, what if this is it? So? What if this is it? Too blunt.
Kinda.
Charlie's been in a coma for a few weeks.
You know, comas last for years, decades even.
Uh, I'm not saying to give up hope.
You better not be.
I'm just saying, what if this is it, Alex? I mean, what are you gonna do a week, a month, a year, five years from now, hmm? I think you owe it to yourself to answer that.
Look at this.
So you've been in a coma for 27 years? Yeah.
Almost half my life, but no regrets.
You sound surprised.
No.
I mean, I've heard of comas lasting for decades, but that's not the norm.
It isn't.
I must be lucky.
How'd you bite it? Oh, let me guess.
Car crash, right? Yep.
Yeah.
This is, uh, week five for me.
Oh, well, you'll wake up any day now.
Hello, nurse.
See, the best thing about being invisible is being invisible.
- Hey, wait, wait, wait, wait, wait - Hey.
Listen, uh, you're the first person I met who-who knows more about this than I do.
Help me.
Well, first of all, don't touch the suit.
Secondly, I'm not a "person," and neither are you, and thirdly, would it kill you to have a bit of fun? Come on.
I'm in a coma.
Oh, I get it.
You're feeling bunk and crunchy when you wanna feel ace.
Hey, I got an idea.
Let's let's book and get some air.
Aah! Hey, easy, easy, easy.
It's cool, right? Yeah.
So do you believe what you said about me waking up any day? No.
Come on.
What do you want from me? I see them come and go.
Mostly go, to be honest with you.
Yeah, walking into the light.
It's a very sweet moment when a loved one passes on.
It's very deep.
It's very meaningful.
So no tips on how to wake up? What part of "being in a coma for 27 years" didn't you get? My fiancee saw me the other day.
- Oh, she looked at you? - Yeah.
It's impossible.
You're going nuts, my friend.
It really sucks to be you.
Hey.
Aah! Whoo! We've just stabilized him, Dana.
He can't go under the knife.
This surgery is a one-shot deal.
- I get it.
- Do you? Because if we don't replant the hands now, they die.
Well, it's better that than he crashes during surgery.
It's not gonna happen.
Fine.
Your patient.
Your call.
Thank you.
Guys.
All right.
Take Mr.
Pineda up to O.
R.
three, please.
You can go up with 'em.
I'm part of this surgery? Don't make me regret it.
It's been four hours, and ischemia is a concern, so we need to get that blood flowing.
All right.
We'll do ortho first.
Secure the bones, then arteries, veins, tendons, nerves, in that order.
Okay, teams, let's go.
You looked freakin' terrified.
Come on.
You you you pushed me! You totally thought you were gonna die.
You're already dead.
Come on.
Well, you're sorta dead.
You know what I mean.
Hey, do you wanna go do it again? - No.
- Just for kicks.
Come on.
I, uh, how can you be so cavalier about all this? Well, how can you be so depressed? It's like you're happy being in a coma.
Well, uh, insanity doing the same thing over and over again and expecting different results.
You're quoting Einstein now? No, no, no.
I'm making a point, okay? I don't expect things to change, but you do, so who's crazier here? You've given up.
No.
I've adapted.
That thing back there in the I.
C.
U.
, that old, wrinkled mummy? This is me, and this is you now, chuck, okay? This is your new reality.
Your old life is just a dream, so you just gotta, you know, let it go and everything'll be fine.
I don't believe you.
Well, you should, because I've been to hell and back.
You're-you're happy here? As a clam.
How are you doing? "John Doe.
" That's not a name.
What should I call you? Mr.
Darcy? You're mysterious, aloof.
First name Fitzwilliam.
Not common knowledge, but Am I seeing things, or is his abdomen distended? Yeah, a bit.
How's his urine output? Low? Borderline? It's low.
And his bladder pressure? Is it elevated? Nope.
15.
He's normal.
Huh.
Okay.
Thanks.
Our John Doe is struggling in there.
Antibiotics take a few days.
What if it's pneumonia? I'm not questioning your judgment Glad to hear it.
But he's had a lot of difficulty breathing.
He suffered trauma to his abdomen, received a lot of fluids, and now it's distended, so what if it's A.
C.
S.
, abdominal Compartment syndrome? Have you checked his bladder pressure? And what was his latest I.
A.
P.
? it'd be more like 25 or higher.
Maggie.
Look, I get it.
You're trying to get noticed, but I didn't call you down here to diagnose my patient.
I called you down here to drain an abscess.
Think horses, not zebras.
Okay.
Heparinized saline.
Ron, can you cut this here, please? One more 8-0, Victor.
Rounding the finish line.
One more throw.
Here we go.
And I'm done.
Good work.
All right.
Time to test his pipes.
Deflate the tourniquet and restore the blood flow.
Yes, Dr.
Kinney.
Macara? One hand good.
Two hands better.
It's a marathon, not a sprint.
Doctor, your hand isn't pinking up.
Is the tourniquet Completely deflated.
Blood should be getting in.
It's not.
What's wrong? Maybe there's a clot or arterial spasm.
Done.
Reestablish blood flow, Victor.
You know, instead of trying to go for some suturing record, you might want to think about your patient.
Excuse me? Left hand pinking up nicely, Dr.
Reid.
Patency confirmed.
Yes.
Yeah.
All right.
All right! The zone of the injury must be too big.
That-that's why it's not perfusing.
Okay, we don't have enough time.
Alex, take a look at this, please.
I just told you it's Okay.
Let her in.
Just a fresh set of eyes.
You're up.
Okay.
Talk to me, Reid.
What do you see? Looks like you picked up the back wall, so the artery is constricted and there's no blood flow.
So you hooked up the artery, and you sewed it shut? It happens, Joel.
Back off.
You just need to get in, cut the sutures, redo the anastomosis.
There's still time to save it.
You're not touching that hand.
Reid, patient's yours.
Dr.
Kinney.
Listen, I don't care about feelings.
I care about saving those hands.
You hear me? Loud and clear.
I have a patient who is going to die, but Dr.
Tolliver won't listen to me, because how could I, a lowly surgical resident, possibly know what I'm talking about? Whoa, whoa.
Maggie, slow down.
Okay.
Here's the situation.
My patient looks like he has textbook pneumonia.
But I think it's something way worse.
Way worse how? Well, how much general surgery do you remember? Uh, none.
Those are Reycraft's.
He eats them raw, calls them "nature's energy drink.
" Reycraft is a weirdo.
So here's the dealio.
If my patient has what I think he has, there's this crazy pressure building up in his abdomen.
It's blocking off blood flow to the bowel, to the kidneys.
We're having trouble ventilating him, but it's not because of the pneumonia.
it's because, inside, he's a pressure cooker, and if the pressure isn't released in time Whoa.
He'll explode? No, but he'll suffer multiorgan system failure and then die.
Ask Dr.
Reid.
She's in surgery.
Then go back to Dr.
Tolliver again.
My patient is dying! Are you sure about that? Artery successfully detached.
Time to start all over again.
8-0, Victor.
Okay.
That should do the trick.
Tourniquet down.
- Come on.
Come on.
Pink up.
- Come on.
- Come on.
Pink up.
- Come on.
- What's happening? Blood's still not flowing.
I told you, there has to be something else.
Let's see if gravity will help us.
Victor? - Good? - Yeah, and - Yes.
Nice one, Reid.
- Yes! - Thank you.
- Well done.
Okay.
Let's reattach some veins to establish venus return.
Then we'll do the radial arteries, and then on to plastics.
All right.
Reycraft, come on.
Let the real work begin! It could've happened to anyone.
Don't be so hard on yourself.
- Yeah.
- Sure.
- Reid? - Yeah? Well done.
Thanks.
It can't eat on its own.
It can't breathe on its own.
There's nothing firing in the old cabeza.
You still think that's you, huh? That's been me for the last 40 years.
You gotta move on, man.
Thank you for coming.
Yes.
Well, where is he? You gotta be kidding me.
The nurse says he has pneumonia.
What the hell are you doing here? What no.
Hey, you! - No, you can't you don't let'em in there! - Scott! Hey! Hey! - Stay out! - It's bilateral, meaning in both lungs.
We've given him antibiotics, but due to his age and condition, the prognosis isn't very good.
And there's no one else you could've called, a member of his family? Your wife was listed as Mr.
Cockburn's next of kin.
If he codes, we'll have to revive him, but again, considering his age and his condition Maybe we shouldn't.
Uh, I it would be a blessing.
"It would be a blessing.
" Who is she? She's my wife.
She's my ex-wife.
Don't.
Don't revive him.
Okay.
They forget about you, Charlie.
They always do.
Blood flow is reestablished, bones plated, nerves, tendons hooked back up.
It's in the hands of the hand gods now, huh? I think his chances are good.
Yeah.
Can't ask for much better than that.
Good work, team.
- Thanks.
- Reycraft.
Suck it up.
You picked up the back wall.
It could've happened to anyone.
Didn't happen to you.
So, Alex, we'll all be over for 8:00? What are you talking about? The hero of the surgery buys everyone dinner.
It's Dr.
Kinney's new thing since she became chief.
That's right.
It's team-building.
You order some chinese.
I bring the beer and wine.
Sound good? Sure.
Perfect.
I'm going to accompany Mr.
Pineda up to I.
C.
U.
- Oh, and, Reid? - Yeah? Don't skimp on the general tsao chicken.
Yeah.
Did she just invite half of Hope-Zee to my place? She just did, yeah.
Guess I'll have to go home and clean up.
So I guess I'll See you about 8:00.
Joel? Thanks for the pep talk.
I owe you one.
You wanna talk? No.
Okay.
She's so old.
Melissa.
That happens, Scott.
I put her out of my mind for years, and she shows up here, and I'm looking at her now.
What do I see? I see someone who's had a full life a full life! Without me.
And that hurts.
I mean, what else? What else did I miss? Anniversaries, birthdays we could have had kids.
Wait-wait a minute.
When's the last time you saw her? June 14th, 1987.
She came she spent ten minutes, and then she left.
And then I kept waiting for her to come back, and she never did.
And then two months later, we were divorced.
Yeah, my sister, god rest her she signed the papers for me.
That, uh that totally sucks.
Sorry.
Well, "till death do us part" and all that crap, huh? I fell for that hook, line, and sinker, I tell you.
But Melissa ah, she never loved me.
You don't know that.
How was your day? Disconcerting.
How was yours? 'Cause mine was pretty weird.
I went home.
Our home? I, uh, picked up our mail and tried to sleep, but I couldn't.
Came back in, fought for my job and I sewed a guy's hands back on.
That went pretty well.
Okay.
Um I gotta go, but I will be back first thing in the morning.
And she's gone.
Shahir, you're totally bogarting the beef and broccoli, man.
Mm.
I don't share.
What are you talking about? It's chinese.
That's like saying, "I don't share ethiopian.
" - I don't.
- It's true.
He orders his own loaf of the spongy bread.
- It's called injera.
- Good to know, baby.
That's good.
Yeah.
Excuse me.
Reid.
That was a serious power nap.
What do you mean? Did you take a little something? 'Cause, wow.
Um that's not my thing, Dana.
No, I know.
I'm just I was just kidding, right? Look I'm not so good at the part where I have to be all, like, nice and caring and, you know, supportive, and so that is my way of doing it.
- Okay? - Oh.
O-okay.
Okay? Where is the hot and sour soup? Just gonna grab it.
So, Joel, tell me is there anyone special in your life these days? Uh, none of your business.
Pass the crispy chicken, please.
I'm just making conversation.
Crispy chicken, doctor.
Thank you.
Um, I'm not hurting for company right now.
Oh! Details, please.
Shahir, seriously.
We're sharing here.
This is called sharing.
We share, he doesn't.
Just let it go.
Guys.
Does this remind anyone of anything? I mean, what? What? It's too soon? Hmm? Hmm? Huh? (Shahir) Please.
Anyone need anything? Alex? Uh, no, I'm okay with my water.
Water? Come on.
You're not on call.
Yeah, one beer's not gonna kill you.
Mmm.
Fine.
I-I'll have a beer.
Attagirl.
Team.
Mm-hmm.
To us.
- Yeah, to us.
Cheers.
- Fantastic.
What great work.
It's all right.
Can I? Of course.
Time of death 21:47.
I'm so sorry.
Well, I expected something more exciting, like Stallone in "first blood.
" That's a great flick.
I'm sorry, Scott.
I'm not.
I'm not.
Hey, Charlie, before I go, there's if you really want to get back to her, you gotta try harder, or you're gonna lose her.
So wake up.
I don't know how to, Scott.
I just couldn't let you go, Scotty.
I'm sorry.
I love you so much.
I never stopped loving you.
Never.
Hey.
Don't cry.
You don't have to cry anymore.
No.
if I didn't know what I know So there I am, holding this woman's forehead in my hands and I gotta sneeze.
And you know that feeling where it's right there, - right in the top of your nose, like a lot of little needles - The worst.
- And everything? - Oh.
Yeah.
And I'm doing everything I can not to, and I do exactly the wrong thing.
You looked right into the surgical light? Straight into it! - Oh, my god! - So what? What? It's photoptarmosis.
Overstimulation of the optic nerve triggers the trigeminal nerve, which leads to the photic optic sneeze reflex.
It Yes! Well played! It was the mother of all sneezes, and I had just enough time to drop her forehead into place Oh, my god! - Before I left it rip! - Well, it's better than having to peel her forehead off the ceiling, right? Agreed.
Photoptarmosis is very interesting.
It affects roughly about a third of the population, And the hereditary factors still aren't understood, so Is he always like this? - Always.
- Yes.
Five second rule.
- One, two - No.
Victor.
Oh, dilemma time.
If I eat this last wonton and I really want to eat it Then Shahir won't let me kiss him for like a month, right? So what do I do? - Wonton.
- Wonton.
- Dude, wonton.
- Wonton.
- Wonton! - Wonton! Wonton! - Yes! - Wonton! I'm sorry.
You're okay.
So mad.
You're okay.
if I didn't know what I know if I believe Alex.
What is it? Did someone say something? I forgot about him, Joel.
About Charlie? Ye for a minute When I was laughing just now I felt free.
Dr.
Tolliver! Some help in here, please! Wh-where's Dr.
Tolliver? Patient just died.
She's with next of kin.
- Do you want me to get her? - Just go! Don't die on me, Mr.
Darcy.
It's easy.
Just Okay.
All right.
I got this covered.
Okay.
Okay.
I think you got this.
You can do this.
This is what you do.
Okay.
Okay.
Fat.
Okay.
Skin, fat fascia.
You slicing him open? Oh, my god, oh, my god, oh, my god! Hell no! Those are supposed to be on the inside.
oh, my god.
He's stabilizing.
I did it.
What's going on in here? Okay.
Jackson, grab a bogota bag.
- We need to cover this wound now.
- I'm on it.
It was just like one of those scenes in "Star Trek.
" - "Star Wars.
" - Where Luke Skywalker - Han Solo.
- Cuts into one of those ice horses.
- Tauntaun.
- And all the guts just spilled out erywhere.
But I saved his life! And that trumps a hand replantation any day of the week if you ask me.
Your patient is stable.
Dr.
Tolliver, he never would have made it into the O.
R.
I know.
I told you there was something wrong with him, and you didn't listen.
He almost died.
His pressure told a different story from the one you were hearing, and you didn't listen to me.
Congratulations, Maggie.
You saved a life tonight all on your own, and that's amazing.
But? Graveyards are full of our mistakes.
All of us make them.
You okay? Yeah.
You sure? Yeah, I really am.
I feel I feel like a doctor.
Ysidro, I'm going to check the blood flow in your fingers.
Okay? - Ay, doctor.
- Mm? No sé cómo darle las gracias.
I don't No hablo español.
But that's okay.
I think I get it.
That sounds good.
It's, uh, bueno.
- Si.
- Sounds good.
put your words into the fire watch them burn your heart's desire Alex, what are you doing back here? rise up in the air in a cloud of silk and smoke and dust I had a party at our place.
fade into the night it's a comforting feeling with you at my side And I felt I felt like what it would feel like for life to go on.
My life.
And what terrified me was that it could.
lean our heavy heads You know, I would have made us cappuccinos, but, um, someone and I'm not saying who Never buys any milk.
don't worry about it now Ahh, just the way I like it.
Mmm.
I got you something.
Skim or 2%? No.
For real.
You got me jewelry.
I figured I could return the favor.
Sweetheart those aren't my initials.
I know.
They were my dad's.
I-I didn't really keep anything of his after he died.
Um, my mom didn't want 'em 'cause she was sad, and my brothers would have lost or sold them, so - I love them.
- You don't have to wear them.
- I can buy you something newer - Alex.
- That's nicer - Alex.
Yeah? I love them.
I mean, they're a part of you.
And I'll tell you what.
The very next time we get dressed up for anything, I'm gonna wear them.
But we better put them somewhere where they won't get lost, because, um, someone Not saying who.
Works about a hundred hours a week and, uh, can barely find her own bra in the morning.
Well, that's just because you keep taking it off.
- I do.
- Mm-hmm.
I do that.
Why is that? I don't know, but I think we should be getting you a consult of some kind, maybe like a sex doctor.
- Mm-hmm.
- Crazy.
'cause in the morning they will all just be ashes on the ground so what's been on your mind But it won't.
I won't let it.
eating you inside I will never forget about you, Charlie.
And I will never let you go.
You promise? on this warm summer night put those words down in the fire