Miami Medical (2010) s01e06 Episode Script

Oh, my God, he's home.
You have to get out of here.
What? Who's home? Go, go.
Out the window.
Hey! Hey, who just left? No one.
No one just left.
Yeah? I just saw him go right out the window.
He just went out the window.
You're a dead man! Excuse me.
Excuse me.
Gotta get to work.
Excuse me.
Yeah, yeah, gotta get to work.
Thanks.
Excuse me.
Damn.
Damn.
Listen, buddy, I had no idea Please Help me, please.
Oh, my God.
Okay, listen, don't worry, buddy.
I'm a doctor.
Mmm, you want some pollo versailles? - For breakfast? - Uh-huh.
I think I just caught the Calle Cubana fiebre.
The fever? Please.
What was once a legitimate celebration of Cuban culture is now just an excuse for idiots to get drunk and stupid.
Not that you're an idiot.
When I was in Rio, I went to the carnival.
And in Pamplona, I ran with the bulls.
And in Rome Yeah, well, Rome had better crowd control.
Calle Cubana is totally out of control.
It's like Mardi Gras, carnival and spring break all wrapped up in one during a full moon.
And don't forget the tourists.
Not that you're a tourist.
Incoming four minutes out.
Stabbing victim.
Dr.
C called it in.
What do you mean, called it in? Guess he found the guy.
Uh, what's with the chicken suit? Patient from bravo shift.
Apparently, the guy inside took a leap off a parade float.
Got his drumstick run over.
Everyone knows chickens can't fly.
Poor pollo muerte.
Probably sacrificed for your versailles.
Mmm, delicious.
What do we have? Todd Kinney, 31 years old, stab wound to the abdomen, BP's 70/40 and falling.
And you're bringing him in because? Long story.
Poor guy got mugged at Calle Cubana.
GCS in the field was 4-3-4.
Why are you only wearing one shoe? Also part of the same long story.
Todd, we're gonna get you fixed up and back to salsa dancing in no time.
I'm not much of a dancer.
Mr.
Kinney here fought off three guys, didn't you, buddy? Three guys, big knife.
You're very cute.
Thanks.
He's loaded up on morphine for the pain.
Hey, no excuses necessary.
Is she old enough to be prescribing narcotics? I checked her license this morning.
Perfectly legal.
And fully qualified from the University of Chicago.
Can I get a bootie? On my count.
One, two, three.
This might hurt a little bit, Mr.
Kinney.
"Todd," please.
Do you have any medical conditions we should know about? Just a shrimp allergy.
You're in luck then.
Stopped using IV shrimp just last week.
Cute and funny? oh, no.
The laceration doesn't look too deep.
Ultrasound? The wound is jagged, uneven.
That was one hell of a knife.
That's from a single stab.
Looks like you put up quite a fight there, Todd.
The bastard wanted wanted my wallet.
I had photos in there of my wife and my son.
I lost them in a fire two years ago.
Then I lost everything.
We're gonna give you something for the pain, Todd, help take the edge off.
- Thank you.
- Okay, I think - we're short on - Betadine in trauma three? Did that already.
- And the crash cart? - In trauma one? Had it restocked and fixed the wheel.
What would we do without you, Tuck? Hmm, should I ask? Girlfriend of flying chicken.
Homeboy express.
Hey! Hey! Can you hear me? I'm Dr.
Zambrano.
You got a name? He's not giving up anything.
Got massive head trauma, possible altered mental status.
We need a gurney out here.
Head and body trauma.
We'll a staple setup and a stock of 4x4s.
- I'm on it.
- What is this? I didn't get a page.
'Cause he was dumped from a moving car.
Did you get his name? Not yet.
Airway's clear.
There's a lot of blood loss.
Abdomen's tender.
Need ultrasound and x-ray.
My head! You got quite a shiner.
You want to follow my finger? Follow my finger.
He's got eye muscle entrapment.
Whoever did this to him meant business.
Let's get a portable CT and call Call neurosurge for a consult.
I'm on it.
Six-centimeter head lac.
Crackles developing and fluid on the lungs.
No! Listen we need to see what's going on in your chest and abdomen.
No! How many are you wearing? Four, five - What is this? - Stop! You don't need to look buff here.
See, this is the problem with Calle Cubana.
all these guys want to do is drink and Fight.
Apparently, he isn't one of those guys.
Our young lady's lungs look bruised, but there's no pneumo, which is great news.
Now Dr.
Zambrano is gonna take a closer look, right? See what's going on inside.
Sorry.
The pressure's gonna hurt a bit.
I'll be quick.
I can handle it.
I bet you can.
"Fia Roja.
" You have a family we can call, Fia? No.
Come on, Fia.
You're 16.
You're a minor.
Must be someone.
No one who will bother.
You go to Tamiami High.
No, I go to Eloise School For Girls.
I just like Tamiami's ID.
Well, apart from her lung bruising, the organs look good.
So we'll keep her oxygenated, have a better look at her head.
Can you increase the oxygen flow? Help out her lungs a bit.
All right, Fia, you hang in there.
You're doing great.
Tough little girl.
In her neighborhood, she has to be.
You know the neighborhood? Tamiami High School's around Southwest Fourth and Walsh, just west of Ronselli Park.
Keep your head down, take any crap that comes your way, and you wear six shirts so you don't catch the eye of some homegirl's boyfriend.
Well, no wonder she didn't want to give up her number.
Maybe we should call the school for the next of kin and Miami PD.
Another stabbing, six minutes out.
It's gonna be a long shift.
I'll get the incoming.
Todd, Dr.
Deleo is numbing your wound before we suture.
Okay, try try and hold still, all right? How long you been in Miami, Todd? Just moved.
It's a new start.
Well, I hope this doesn't leave a bad impression.
There's a lot of good things in Miami, good people.
The jury's still out.
Can you open up for me? He's got blood in his airway.
Can't be from the stab wound.
Could be a preexisting condition ulcer, liver failure? I'm hearing Precordial crackles? Yeah.
Did the muggers catch you in the throat? Maybe hit you with an elbow something? Force from a blow to the throat might have torn his esophagus.
I'll CT to confirm, get him to the or if his scans are positive.
Nice work.
Two more saves, you'll get yourself an official Dr.
C merit badge.
You're in good hands here with this one, Todd.
Hmm.
The good news is, Fia, that you didn't fracture your skull.
The bad news is there's some bleeding and brain swelling we've got to keep an eye on.
Am I gonna be okay? You took quite the beating.
But we're monitoring your head and your lungs, and if the swelling in your brain continues, we're gonna put a little tube in to release the pressure.
Tube in my head? It's not as bad as it sounds, especially 'cause we caught it early.
People that dropped you off probably saved your life.
Though they also probably did this to you, huh? You know them? Kids from the neighborhood? Hey, they ever fix the, uh, bent basketball hoop in the gym at Tamiami? Or the clock in B hall, is it still set to 6:66? How do you know about that? Well, back in the day, I also went to Eloise School For Girls.
Get the scans of our stabbing victim? His name's Todd.
CT's backed up an hour.
Apparently, Calle Cubana is Spanish for "internal injuries.
" Okay, well, let me know if you need an assist on Todd's surgery.
Sure.
Soon as you let me know what you were doing this morning before you rolled in, sans footwear.
I'm guessing hasty exit.
Look, I was minding my own business.
When some strange woman dragged you to bed.
She was my waitress from Casa de Tula, okay? And you just ordered a little somethin' somethin' to go? The conversation clicked hey and one thing led to another.
She invites me home, we get a little, uh, momentum going and - Husband walks in.
- Husband, boyfriend I don't know.
Whoever came through that door, pretty unhappy.
- Chris.
- I didn't know! Two consenting adults.
No harm, no foul.
No shoe.
You're seriously lucky you're not laying in one of those trauma slots.
CT's open.
Hey, page me when you get those scans.
My throat, it's killing me.
Morphine's probably wearing off.
Try not to talk.
Speaking of morphine, hey, when I rolled in here, did I call you cute? Yeah, you sort of did.
Sorry about that.
Why does everybody keep making excuses for calling me cute? No Seriously, no more talking.
Just hard to impress a girl when the back of your hospital gown keeps flapping open, you know.
Okay.
You want to impress me? Take direction.
Stop talking.
Shh.
Lisa Johnson, 27 years old.
Multiple lacs.
Unresponsive but showing purposeful movement in all her extremities.
- What does that mean? - Means that her brain is still speaking to her body, which is very good news.
Police found her in an alleyway about a block away from our other stabbing victim, Todd Kinney.
- You have to help her.
- Yeah.
That is our plan, Miss, um Johnson.
Susan Johnson.
I'm her sister.
Nurse Tuck will be able to find you someone who can - answer your questions.
- Where are you taking her? That's Dr.
Proctor, our trauma chief.
Trust me, Lisa's in great hands.
I feel so helpless.
Come here.
Now, does Lisa have any allergies, any, uh, medical conditions, she taking any drugs? No, nothing like that.
She's perfectly healthy.
We're gonna take good care of Lisa, okay? Right now, I'm gonna take you up to the waiting room so you can speak to the police.
As soon as I know anything, I'll come back.
She's my baby sister.
- Please help her.
- Right now, that's our only job.
I've been thinking.
Stabbings might be related.
Does seem a bit of an odd coincidence.
See these cuts on her hands? She fought back hard.
Then let's make sure that her valiant efforts were not in vain.
This is really odd.
Got something stuck in the wound track.
Can you grab the x-ray? Wow.
Wow what? Wow that.
Think we found our knife.
Hey.
Got your page.
What are we Wow.
Already covered that.
Blade must have hit bone to break off like that.
Among other things.
You grab the ultrasound and look inside.
Yeah.
Thank you.
She unconscious the whole time? Yeah.
She's breathing on her own.
Blade missed the spleen and bladder.
Somehow.
Didn't miss much else.
Some free fluid around the liver.
Bleeding where's that from? I can't tell on the monitor.
Okay, let's prep her for the OR.
Got to find out where this bleeding's coming from.
Cops have any suspects in our stabbings? Not yet, but I hear they're on the lookout for a missing shoe.
Who needs TMZ? We've got the MT1 gossip circle.
Leather wingtips are a dead giveaway.
Lost and found.
What, do they clash with my scrubs? Fia, let me see what's going on.
I can't see! - Let me see what's going on.
- I can't see.
CT showed a large retrobulbar hematoma.
Fia, you have, uh, bleeding behind your eye.
It's impressing a nerve and impairing your sight.
Am I gonna be blind? If we're gonna save your eye, we need to cut, now.
On my eye?! Cut a tendon next to the eye.
It'll stop the pain, save your sight.
- Can't.
No.
- We need to do it before the nerve damage is permanent.
I need Lidocaine with epi, iris scissors and a hemostat.
I'm gonna be here with you, okay? Be right here.
I want you to do it, no one else.
Okay, Dr.
Zambrano will take care of you.
Okay.
- Fia? - Mm-hmm? I need you to stay very, very still.
This will only take a minute, Todd.
And there's a microphone in here if you need me.
Hey, is it true you can't get scanned if you have a tattoo? Uh, that's only a problem with MRIs.
And only if the tattoo is homemade.
Why, you have skin art? I do.
She dances.
Hula girl.
Nice.
But you're gonna have to tell her to take a stool at the bar so we can get you both scanned.
Good to go.
I'm scared.
You're gonna be okay, Todd.
We just scan the tear and then we stitch it up.
We good? Stay very still, Todd.
I don't feel so good.
Skip the scan.
Page OR two, tell them we're on our way.
How's it going with Fia? Doing the best I can.
You okay? I hate days like today.
Everything feels out of control.
That's not always a bad thing.
In Pamplona, they, uh they let the bulls loose for one final run of freedom.
The road goes straight to the bull ring.
Where they're slaughtered by matadors.
When I ran with them, it was, um, it was crazy.
Bulls gaining ground and people scrambling around and it was chaos.
And I just stopped.
You stopped? Just let everything flow around me, like I was a a rock in a great rushing river.
I just let go.
You could've been killed.
But I wasn't.
Fia? How's the pain in your eye? It hurts.
Let me see.
All right.
I can see.
Good.
When the swelling goes down, we'll reattach the tendon.
We're gonna keep watching your brain for swelling.
Your sats are dropping.
Let's check your lungs.
Where's that other guy? Dr.
Proctor? You think I hurt his feelings? Proctor? No.
Not a chance.
What is he, like, bulletproof? Yeah, something like that.
Okay, take a deep breath for me.
Your lungs are getting worse.
I'm gonna have to intubate you.
Put a tube down your throat to help you breathe.
It won't hurt.
You'll be okay.
It's still bent.
What? The basketball hoop at Tamiami.
Cost us the championship.
Us, too.
Look, Fia, I I know it's important to keep your mouth shut and your head down.
I've been there.
But sometimes you have to take a chance.
Who did this to you? Was it a gang initiation? Were they jumping you in? I'm not a gangbanger.
I'm more like target practice.
It's a tough neighborhood, I know.
But you got out.
Yeah.
I transferred to a magnet school after tenth grade.
Maybe one day I could get out, too.
Thank you.
Got an update on your sister.
Lisa is unconscious but stable.
That's great.
We just have one final procedure to do.
The docs found a knife blade broken off in her abdomen.
Oh, my God.
They just have to remove the blade, and she'll be fine.
Is there anything else I can do? I don't think so.
Not unless you work for the police, too.
They didn't have any information on the attackers? I don't know.
They questioned a few suspects, and then they let them go.
They won't tell me anything else.
This is the number to a Detective Bridgman.
Call him up.
Ask for Scooter.
That way he knows you came through me.
He's good? The best.
He'll fill you in on everything you need to know.
- Thanks.
- Have you eaten anything? The cafeteria is on the second floor.
Not yet, but I will.
You won't, but you should.
I had to intubate Fia.
But it's not helping because her lungs are getting worse.
The problem with her lungs means that she's not stable enough for the brain surgery to relieve the pressure building inside her head.
Why aren't you on the roof? There's better lift here.
I need, uh, an equal pressure above and below the wing.
Any luck finding the family? No.
And how can that be? She has to have someone.
Maybe she's a street kid.
No.
This girl's smart.
She even worried about hurting your feelings.
What if we add peep to her vent to help her lungs work? That intracranial pressure is already sky-high.
Adding peep would only make it worse.
So if we treat her lungs, she could be brain-dead, but if we treat her brain and delay the lungs She could be dead-dead.
It's quite a conundrum.
Even if she walks out of here tomorrow, what are her chances? Life expectancy in that neighborhood is 17, maybe? Well, there are some things we can't control.
But there are some things we can manipulate.
Where are you going? It's a temporary fix.
Decadron and mannitol.
Steroids and diuretics? Mm-hmm.
To flush the fluids from her tissues.
Including her brain.
The intracranial pressure should drop for long enough to let us put her on peep and then stabilize her lungs.
And if this works, she gets her surgery? Mm-hmm.
Whatever happens next is up to her.
Is that supposed to make me feel better? It's meant to give you perspective.
Hey.
Our mugging victim make it up to ICU yet? Yeah.
And what's up with patient services? I've called them twice for Todd.
Someone is going way out of her way for a patient.
He doesn't have anybody and he hates Miami.
So now you're our Goodwill ambassador.
I'm just trying to show him that there are nice people here.
Nurses are nice.
And they can take care of him, too.
Aren't you always encouraging me to connect with my patients? Because if you're actually flirting Then one day, I might show up to work in one shoe? So, now now I've lost all my leverage, haven't I? Well, her vitals are improving.
She put out two liters already.
That's a good sign.
Almost stable enough for brain surgery.
Book an OR.
If she keeps improving, we'll be able to take her up soon.
Is that Fia Roja? Um, look, Officer Diego Ramirez.
Where are you taking her? Officer Ramirez, this girl's very sick.
So why don't you wait until we're sure she's not going to die before you arrest her? I'm not here to arrest her.
I'm her father.
Fia took quite a beating.
We're doing everything we can to get her lungs stable so we can treat her brain injury.
I tried to deal with those kids.
Fia wouldn't let me.
I'm not sure a cop talking to gang kids would have helped.
After her mother died, Fia's grandparents took her when I was at work.
Now I'm trying to get her out of that neighborhood.
I was raised by a single dad.
It's hard.
He used to have to take me to work with him.
I don't have that option.
Diuretics aren't enough anymore she's posturing.
Prep or 2 and page neurosurge.
What's happening? You see her limbs flexing? It means the pressure in her brain's getting too high.
She needs surgery.
But you said she wasn't ready.
Now we have no choice.
We've taken Lisa up to surgery to remove the knife blade.
She'll be okay? Her vitals are steady.
She's young and strong.
Egg salad.
Lots of protein for the brain and muscles, a little bit of fat to keep you going.
No bread, so you don't get that carbo crash in a few hours.
Water to keep you hydrated.
You've done this before.
A few thousand times.
Do you have siblings? Two younger brothers.
When Lisa's husband left her, I thought it would be a good idea to bring her down here to have some fun.
I'll never forgive myself.
Yes, you will.
We're going to find a way to make your sister better.
And when we do, your face will be the first one she sees when she opens her eyes.
Two seconds for some guys to embed a knife in her and two hours to remove.
Doesn't seem quite fair.
I think it's her transverse colon.
That's where the that's where the blood's coming from.
But I don't think it's sliced all the way through.
If we can get the blade out, I think we'll only need to repair the, uh the wall.
All right.
Wow.
I think our assailant was a fan of the Marquis De Sade.
That blade definitely could have caused the shredding we saw in our first patient, Todd Kinney.
One blade, two victims.
Todd said there were three guys.
Maybe now he's stable enough to give a description.
Let's hope so.
Chris, I'll close.
You tell the police about that.
All right.
Give her 100 grams of mannitol.
And page anesthesiology.
Mr.
Ramirez, I'm sorry, but you're going to have to stay here.
I'm her father.
I'm supposed to protect her.
I know that, but right now, you can't.
Fia's strong.
She's still a little girl.
Um, I'm sorry.
I have to go to surgery.
You can be with her afterwards, okay? How'd Lisa's surgery go? Did you remove the blade? Yeah.
Got it out free and clear.
Just getting it to the cops now.
Any internal damage? Minimal, considering what it could have been.
Glad you didn't make a liar out of me.
Come on, now, wouldn't do that to you.
You're our first line of defense.
So what does that make you, quarterback? No.
Wicketkeeper.
Proctor's English.
I'm going to tell Susan the good news.
Your vitals are looking good.
And your wound is healing nicely.
I hope you're not just doing a great job to get rid of me.
Yeah, you have me figured out.
I'm usually a terrible doctor.
Are you feeling well enough to have visitors, Todd? I don't really know anyone in Miami.
Except you.
Um, well, the police would like to interview you.
It looks like your attackers may be the same guys who stabbed another patient here, a woman.
Really? Is she is she okay? She was in pretty bad shape, but her surgery went well.
But she'll live? Yeah.
I'm not the only good doctor here.
If only I'd fought back harder, maybe she maybe she wouldn't have been hurt.
Or you could have been killed.
The important thing now is that you're both going to be okay.
The police will be here in about an hour.
Try to get some rest.
She's doing well.
Vitals are strong.
Surgery was successful.
She looks so peaceful.
When Fia's doing better, you should come find me.
I'd like to write her a letter of recommendation to the Magnet School I attended.
I still have friends on the school board.
You would do that? Someone helped me, and it changed my life.
I can do the same, cross that line for her.
That would mean so much to us.
And to me.
How you feeling, Lisa? Weak.
Yeah.
Well, your vitals are strong.
We're not out of the woods yet.
It's it's gonna be a long recovery.
It's a great excuse to let your sister do the heavy lifting for a while.
Just milk it.
Do the police know anything yet? We think that whoever assaulted Lisa also attacked another patient here.
Police will get a description from him, so maybe that will help.
Lisa H h What was that? Hula Hula? Hula dancer.
His arm.
His arm? Like, a tattoo? A hula dancer tattoo? Oh, my God.
This is Dr.
Warren.
I need security in ICU 9.
Code Grey, ICU 9! Todd Kinney isn't a mugging victim he's the attacker.
Yeah.
His injuries are from Lisa fighting back.
He's the one who stabbed her.
Hey, can you take this cart down to peds? Mr.
Kinney, what are you doing out of bed? How long has he been here? I called when I found him.
Tuck! Tuck? Tuck, can you hear me? What happened? He's got a stab wound to mid-thorax and he's not responsive! You got a pulse? It's weak and thready.
All right, Tuck, hang in there, buddy.
Come on.
We need blood and a thoracotomy tray.
BP's really low.
Systolic 50 palp.
- Somebody call the or! - Already did.
Okay, let's get him onto the gurney.
Come on! Ready? One, two, three.
Diminished heart sounds, elevated jugular pressure.
He's bleeding around his heart.
Must have hit the ventricle.
Needs his chest opened now.
Let's move him.
Move him! Does anybody know his blood type? I lost his pulse.
Damn it! You gotta get the head of the bed down.
- I'm trying.
- It's already down.
I need a central line kit.
Just wait with that.
Okay, everybody, stop, all right?! This is not Tuck our friend.
This a trauma patient just like any other.
Now, we've all fixed hearts before, and we're gonna do the same right now.
We're not gonna make it to the O.
R.
We're gonna open up here.
- In this room? - Yep.
We know where we're starting, and we know where we're going.
We will get the heart fixed! Scalpel.
The pericardial sac's filled with blood.
We gotta get it open.
There's too much blood.
I don't see the hole.
I'll get a suction.
There's no time.
I'll find it by feel.
Did you find the hole? Not yet.
If you don't find it I got it.
Hand me a suture.
Don't have any.
Stick your finger in! All right, let's go.
A lie.
It was all a lie; losing his wife and kid and moving to Miami, and I believed it.
- Serena - I'm the one who figured out his esophageal tear.
I fixed it.
If I hadn't saved him, none of this would've happened.
Serena, listen to me.
I need you to follow up with the police, get a consult with Dr.
Blair in cardio-thoracic and prep a room in ICU for Tuck's post-op, okay? Dr.
Warren, I wanted to thank you and Dr.
Deleo for what you did for my sister.
Oh, of course.
Oh, and nurse Tuck, he was such a great comfort.
If he has any time, maybe you can ask him to stop by? Yeah.
Thanks.
Tuck's out of surgery.
- Is he? - We put him into a medically-induced coma to help him heal.
But we don't know how long his brain was without oxygen, how much damage was done, so I'll, uh I'll page radiology.
I'll order a brain scan.
Maybe there's some sort of therapy we can start.
It isn't your fault.
But Your shift is over.
If you really want to help Tuck, then go home, hmm? Try and get some sleep.
You just scared the hell out of me.
Sorry.
Any news on Todd? Cops get him? Well, they got a good description and he's got a bellyful of stitches, so he's not gonna get far.
Never thought I'd hope for a post-op infection.
I finally meet a real person, and he turns out to be a psycho.
God, if I hadn't misjudged him You gonna be okay? Yeah.
I'm fine.
I just can't get my car open.
Let me do it.
Let me try.
Why don't I, uh why don't I drive you home? We can hang out, we'll watch old movies.
You don't have to do that, Chris.
To be completely honest I could use the company, too.
All right.
He's gonna be okay, you know? You're braver than I am.
Well, I doubt that.
You ran with the bulls, you fought in Iraq.
You stuck your finger in your friend's heart.
Rock in the middle of the river, huh? On a day like today, I doubt that's possible.
I brought you pollo versailles.
It's not 'cause I care.
It's cause you have to eat.
Thank you.
Mmm.
It's pretty good.
It is.