Miami Medical (2010) s01e07 Episode Script
Man on the Road
Hi.
I'm Mark Proctor.
Hi.
Just moved down from Maryland, as you can tell from the accent.
WARREN: Did you get a look at that scar? ZAMBRANO: What scar? Sternotomy.
Tissue's still pink.
He had his chest cracked.
Cops have any suspects in our stabbings? I'm scared.
It's going to be okay, Todd.
Todd Kinney, he's not a mugging victim.
He's the attacker.
WARREN: He's the one who stabbed her.
What are you doing out of bed? Mr.
Kinney? (stabbing) (groaning) Stab wound to mid-thorax, but he's not responsive.
If I hadn't saved him, none of this would have happened.
It isn't your fault.
("Forget Myself" intro playing) They're pacing Piccadilly in packs again And moaning for the mercy of a never-come rain (dog barking) The sun's had enough And the simmering sky Has the heave and the hue of a woman of fire (barking) Get out of here! (growling) Go on, get out of here! All scented and descending from the satellite towns All right.
(hisses) The neon is graffiti singing make a new start (fading out): So I took for a plot (gasping) (groaning) But I'll forget myself (grunting weakly) The man on the door has a head like Mars Like a baby born to the doors of the bars And surrounded by steam with his folded arms (fading out): He's got that urban genie thing going on (clears throat loudly) I was just rounding Patterson Park.
What's that? My (treadmill beeps) My Baltimore route.
22 minutes, I would have been just coming around the Pulaski and heading south towards the harbor.
Thinking about old times? (panting) Yeah.
This was mistakenly put in my cubby.
You interrupted my run just to give me a package? Everyone keeps asking.
About, uh Tuck.
I know.
I'm just not sure what to say about what happens next.
He's getting better.
It's only been a week.
His LFTs Are returning to normal.
Yeah, I checked his chart an hour ago.
You and me both.
And Chris and Serena.
Serena's having a rough time.
She didn't do anything wrong.
How would you feel if you saved the lunatic who put a scalpel through Tuck's heart? Oh, I thought we did really good work repairing the stab wound.
As of this morning, Cardio can have a go at repairing the rest of the damage to his heart.
Who's on for cardiac surgery today? Uh, Dr.
Sable.
Is she good? She's the best.
And a piece of work.
You know how people sometimes consider you quirky? People consider me quirky? Well, Sable will give you a run for your money.
(pagers beeping) Plane crash.
In the Everglades.
You get the team ready for multiple criticals, and I'll have a consult with Sable's team about Tuck's heart.
Hey, happy birthday.
Yeah.
Some birthday.
(monitor beeping) FLIGHT MEDIC (over radio): Flight 815 out of Fort Lauderdale.
Small commuter plane.
12 seats, one flight attendant, one pilot, one copilot.
So, that's 15 possible survivors? Yeah, but what we heard from first response, it's not good.
Hey, Lynn, we got an ETA on incoming? You're still en route to the crash site, right? Yeah, we're about three minutes out.
We got Doc Warren loaded up and we're ready to go.
Wait.
Serena's on the chopper? On her EMS observation day.
(groans) Hey.
Top of the morning, Dr.
Warren.
WARREN: Okay, whatever asinine crack you're about to make, Chris, ever so kindly stick a bulb syringe in your mouth.
So, how's it going up there? Well, considering I just found out that, for legal reasons, I'm not actually allowed to help out, I'm having the time of my life.
Well, it ain't called observation for nothing, Doc.
You know, Serena, on, uh on my observation day, they were, they were so impressed with my skills that they let me fly the chopper and And what? You were such a hero, they gave you a key to the city? No, two keys.
Two-- and the garage door opener.
(pager beeping) More incoming.
Motorcycle accident with open tib-fib, head trauma and altered LOC, eight minutes out.
All right.
Gotta go.
And hey, don't let Dr.
Warren puke on your shoes there, Moose.
I'll try to stay fast on my feet.
Thanks for the advice.
Oh, man.
Brian Dempster, 37, rolled his motorcycle.
One head trauma, chest and abdomen contusions with a tib-fib injury on the left.
Uh, Mr.
Dempster, I'm Dr.
Deleo.
My bike? It was a Ducati 999.
Beautiful.
Now scrap metal on I-51.
Okay, send for a trauma panel, type and cross for three, and page X ray.
Is this our motorcycle accident? Yep.
Multiple contusions, open tib-fib, crush injury to chest and head trauma.
Okay, on my count.
One, two, three.
Grab the ultrasound for a FAST scan.
Decreased breath sounds at the left base.
Let's get going with a chest X ray.
(groaning): I am in so much trouble.
Not as much trouble as we'll be in, if we don't make you better, Mr.
Dempster.
Free fluid around the bladder.
We think you have bleeding in your belly, Mr.
Dempster.
Mr.
Dempster? He's unconscious.
His vitals are stable; probably just fainted.
I want an O.
R.
prepped.
Can you page Neurosurge and Ortho? Let's take a look at his chest wound.
If we're going to save this guy, we're going to need everything and the kitchen sink and the stove and maybe even a slow cooker.
That is if Mr.
Dempster wants us to save his life.
Here it comes Here it comes, here it comes Here it comes Here comes your 19th nervous breakdown What are the chances the American Medical Association accepts a tattoo as a valid DNR? Could reflect his true medical wishes.
Or a biker handle.
College fraternity prank gone horribly bad.
Well, let's finish his chest tube.
Can I have some Lidocaine? Mr.
Dempster? Mr.
Dempster, can you hear me? I'm Dr.
Proctor.
You've got a serious accident.
I know.
I fell out of a tree, right? That's what you get for climbing up with your roller skates on.
No, you didn't fall out of a tree, Mr.
Dempster.
You had a motorcycle accident.
And Dr.
Deleo and I have to know if that tattoo on your chest reflects your true wishes.
(groans) Tattoo? Yeah, the one that says "Do Not Resuscitate.
" I don't have a tattoo.
I don't have a motorcycle.
My mom would kill me.
Brian, can you tell me what year it is? And how old are you, Brian? I'm 11 years old.
That's a lot of chest hair for an 11-year-old.
Am I bleeding? Yes, we think you're bleeding inside your head, Brian.
And we're concerned about bruising to one or both of your lungs.
We need to take some pictures in order to figure out how to make you better.
Okay.
Please don't tell my mom.
They just found a survivor from the plane crash.
Flight EMTs and Dr.
Warren are transporting her back.
ETA? Less than five.
Uh, you take that with Dr.
Zambrano.
I've got to get a consult on Tuck and then hop back on Mr.
Dempster, based on his scans.
Got it.
Uh, can you page Legal for me? Uh, call Risk Management.
Call Admin.
Call his mom if she's still alive.
Call anyone who can give me some guidance on what I'm allowed to do with my patient.
MOOSE: Josephine Wells, 28, plane crash survivor.
Crush injury to chest and abdomen, with pinal flexion injury upon impact.
Normal neuro exam.
She's going to need a final C and strict immobilization.
Hey, Moose, don't think your new flight nurse should be giving advice to trauma surgeons.
Not too good at observing, this one.
That's why we love her.
Hey, what's the update on Tuck? Surgery today.
We'll let you know if there's any more incoming.
Watch it.
All right, Ms.
Wells, we're going to get you right into a trauma suite and assess your injuries.
Can you tell us what your pain level is? Scale of one to ten? (inaudible) What's that Josephine? (inaudible) Okay, hang on, hang on, stop.
Stop, stop, stop, stop.
Stop, stop, stop.
All right, go ahead, we're listening.
Tru-Tru Take it slow, Josephine.
Tru-Tru I-- T-True? True? Save your strength.
Okay? ZAMBRANO: We can see you have something important to say.
And when you're ready, we're here, okay? (helicopter rotor whirring) (man shouting in distance) (dog barking) Last contact with the plane was a distress signal sent three minutes before impact.
So far, we've discovered 13 distinct sets of remains.
And Josephine Wells.
The flight manifest says there were 15 aboard, so So one.
Yeah.
Yeah, we're looking for one.
O.
R.
Two is prepped and ready.
So we start by? Fixing Josephine's ruptured kidneys, spleen and urethra disruption.
And get new scans to Neurosurge and a consult from Ortho on her pelvic fractures.
Proctor should get those scans as well.
By the way, it's his birthday.
Really? Today? Yeah.
And he didn't seem too happy about it either.
How old is His Highness? I don't know.
Do we get him a present? I don't know that either.
What if we get him, like, a giant cake? And we get a big question mark in a bikini, have it jump out.
Uh, that's just bizarre.
I don't know, I'm riffing here.
Still waiting for the dude to let his guard down.
Patient's name is Tuck Brody.
This is a young athletic guy.
Let's use a pig valve so he doesn't have to spend the rest of his life on warfarin.
(clears throat) Excuse me, Dr.
Sable.
I, uh, don't have much time.
So, you're the new guy I've heard so much about, the Brit.
New-ish.
And I just speak this way because Americans find it appealing.
Can we have the room, please? Helena Sable.
Cardiovascular surgeon.
Rest assured, your patient is in good hands.
My patient is also my friend.
I don't know if you're aware, but, um, this is one of my guys.
Charge nurse Tuck Brody.
So I'd like to weigh in on his management and scrub in on his surgery.
Your team did excellent work on the ventricular wall, but now we're talking mitral valve replacement, which is probably a little much to wrap your head around.
I could walk you through the difference between mechanical valves and tissue valves, but then I'm not a performing seal.
Is that your rule? Because my rule is, no one scrubs in on my surgeries.
No one.
If you don't like it, you're welcome to find yourself another heart surgeon.
I hear you're the best.
Well, if that's what you hear.
That's what I want for Tuck.
Good.
You're welcome to be in the room.
But you're not to touch the body.
So I can look but not touch? I was just trying to make sure that you weren't the egomaniac I'm often accused of being.
Welcome aboard, Matthew.
Nobody calls me Matthew.
(dog barking) MAN: Over here! Get some help here?! I got it! Put her on there.
Somebody get the EMS over here! Got it.
She have a pulse? I need to get a line in her now! Fixed and dilated.
(exhales) She's gone.
(garbled radio chatter) Our motorcycle accident's left lung is badly lacerated and contused.
(exhales) Basically turned to mush.
Probably have to remove the whole thing completely.
Hey.
Hey, where am I? Can you forward that to Radiology? And, uh, page Nurse Graceffa for me.
Mr.
Dempster? (distorted): Mr.
Dempster? My bike.
I crashed it, didn't I? So you do remember you have a motorcycle.
Well, I did till I rolled it.
(wry chuckle) Oh, I'm hurt pretty bad, aren't I? You are, but we're in the process of making you better.
You saw my tattoo, right? You do know you have a tattoo? (distorted): Mr.
Dempster, if we're going to continue to make you better, then we need to Wait a minute.
Who's Mr.
Dempster? Sorry? Who are you? (rapid beeping) Where am I? No.
You-you you hold still.
Really still.
(rapid beeping) Internal bleeding's getting worse.
I want him prepped for an OR, stat.
Have you had any response from Admin about his DNR? Called them three times.
Oh.
Now they're gonna hear from me.
(slow, rhythmic beeping) Propofol's running.
Should be out in a minute.
Josephine? We're gonna put you under now so that Dr.
Deleo and I can attend to your injuries.
I know this is a little scary, but Tru Will you tie my mask? Tr "True.
" You said that before.
Truu What's true, Josephine? Tru man.
Truman? DELEO: What, like Like a name? That's what you're saying? Who is Truman? Was he on the flight with you? Alive.
Josephine, we haven't gotten news of any more survivors.
Saw him.
I saw him.
After the plane crashed? Yes.
He's alive.
(indistinct shouting) WARREN: Okay.
Moose got me a copy of the flight manifest from the NTSB officials.
What's the name I'm looking for again? Okay, it's, uh It's Truman something.
Josephine Wells, a survivor, told us that she saw somebody named Truman alive after the crash.
I have it right here.
Looks like her husband.
Mr.
and Mrs.
Truman Wells seated in and 6B.
So that's good.
I don't think he's alive, Chris.
We've already found 14 victims, all adults, which means along with Josephine Everyone's now accounted for.
Yeah.
Of course they haven't identified anyone yet, but.
.
Yeah, no, no, no, no.
I, uh.
I get it.
Search and Rescue is shutting down now and NTSB investigators are starting to take over.
Are you guys headed back? Yeah.
We're packing up right now.
All right.
Okay, fly safe.
All right.
Will do.
(elevator bell dings) No more survivors.
Hey, I've been thinking about our, uh, motorcycle accident.
His confusion could be, uh, trauma-related or some underlying condition like delirium or schizophrenia or Everything okay? Still haven't got ahold of the next of kin.
AnAdmin won't take a stand without a consult with Ethics, who won't weigh in without precedent from Legal, They do realize your patient's s are dying by the moment? I did make that quite clear.
(elevator bell dings) Brian Dempster just put another 500cc's of blood into the chest tube.
His pressure's dropping.
Anesthesiologist wants to know if you want to put him on the vent because, technically It's a violation the DNR if it's valid.
Put him on the vent.
Let the pencil pushers upstairs clean up their own mess when they pull their thumbs out of their asses (slow rhythmic beeping and whooshing) I can only imagine the speed he was going on that motorcycle.
We got ahold of his next of kin.
His sister, Arianna.
She'll be here within the hour.
Excellent.
Also got his latest brain scans.
I sent copies to Neurosurge, but I know you also wanted to see them.
(sighs) Bad to worse.
Brain injuries from the accident? No.
His brain's fine from the accident.
He's got He's got diffuse brain atrophy.
He's probably had it for years.
Could be Parkinson's or Alzheimer's.
Huntington's.
Whatever it is, he's a 40-year-old with the brain of an 80-year-old.
If my brain looked like that, I'd have a tattoo on my forehead.
(overlapping chatter) (indistinct radio chatter) I'm just waiting for the official word from the NTSB that we're clear, then we're gonna head out, okay? Thanks.
You okay? Nope.
My last shift, I saved a man's life.
Oh.
Well, that makes sense.
I can see why you're so upset.
The patient I saved is a guy who ended up stabbing Tuck.
I'm sorry.
I wish I hadn't saved him.
Does that sound terrible? No, it sounds honest.
Today's the end of my first year in Trauma.
'Cause of what happened, I-I I don't know if I'm doing more harm than good.
You're saving lives.
That's gotta be good, right? Let's say it's a drunk, an-and two days later, that guy goes out and mows over a bunch of people.
Haven't I just-- I don't know-- made the world worse? My mother, she would say, "Life is not a race, and nobody's keeping score.
" My dad was an accountant.
It was all about whether you were up or down.
As much as I don't want to be doing it, I am.
I'm keeping score.
I don't know if I'm up or down.
Arianna Dempster? Brian's sister.
Hi.
Matt Proctor.
Hi.
How is he? Oh, he's out of surgery, and he's recuperating in ICU.
Brian had multiple issues.
Uh, most notably, severe pulmonary trauma, which has caused me to remove one of his lungs.
His lung? But with time on a vent and other artificial assistance, he can live with one lung.
Can he live longer than he can with early onset Alzheimer's? Ah.
Our father died of early onset when he was 47.
It was ugly, so we both decided to get the genetic test.
I won, Brian lost.
Ever since then, my brother's been all motorcycles, mountaintops, river rafts.
Brian wanted to make sure he didn't have any regrets that he got to keep his dignity.
So the tattoo was his idea? His first idea was to get his entire living will tattooed, complete with the words, "More on Back.
" (laughs) So, are you required to turn off the machines if he wants to die? I'm required to talk through all his options, including turning off his vent, yes.
He's my baby brother, my only sibling.
I'm just not ready to give him up.
Look, we'll, um find out what he wants to do and just have to take it from there.
Okay? Eva.
Huh? Did you get the page? Yeah.
Josephine Wells is waking up.
I'm heading there now.
Are you going to tell her about her husband? She's going to ask.
Dr.
Zambrano, Dr.
C.
Are you going to see Miss Wells? Yeah.
Why? I think you should hold that thought.
Josephine-- how, uh how is she? Uh, I'm sorry.
Who are you? I'm her husband.
I'm, uh, Truman.
Josephine and I were scheduled to fly to Baton Rouge to see my sister, but at the last minute, I was forced to stay in town for a conference.
So, your wife was just confused? Confused about what? Well, she said she saw you alive after the accident.
Saw me? Yeah, you-- Truman.
Wait.
My-my son is alive? They-they told me he was dead.
Truman, Jr.
When-when I couldn't go, my wife, uh, got him out of school.
It was a big deal at the gate-- uh, tearing up tickets, printing them again, but but we managed to get him a seat Did Josephine really say she saw Truman alive? Yes, but I don't know Wait, wait, wait, wait.
How-how-how old is he? Your son.
Uh, he's 11 years old.
Just turned 11.
How tall is he? Uh, 4'10", 4'11".
What does that matter? All adults.
What are you talking about? Serena said all adults.
What?! Okay, you said the remains they found were all adults, right? They found no children's remains? We got to go, Dr.
Warren! I think that the manifest could be all screwed up.
Maybe even the numbers are wrong.
It was Josephine's son who was sitting next to her.
Chris, I gotta stop the helicopter! You coming, Doc? There could be one more! Our patient, your friend.
Tuck.
He keep kosher? I don't think so, no.
Then go with the pig valve.
I hear happy birthday is in order.
Where do you hear that? Oh, I'm like the CIA meets the KGB meets that grandmother who always knew what you were up to.
You got your undergrad at Berkeley, your medical degree at Penn, you pretend not to know how to play pool until there's money on the table, and you're a sucker for caviar.
My grandmother was the last to know.
Let's go make Tuck's heart purr.
In this life we live, we're only returning home In this life we live, we're only returning home Can you take my hand? And together we can sure try Can you take my hand? And together we can sure try In this life, we are only returning home Your friend's got a good heart.
Yes, he does.
WARREN: Hey! Can we take the helicopter up, fly overhead, see what we can see from there? I know I'm only supposed to be observing, but what better place to observe than from the sky? Doc Come on, Moose.
I'm down on my ledger.
I got to get back to even.
Chris said that boy could be out there.
You know I'm a sucker for those puppy dog eyes.
Okay.
We'll go up for an hour, but after that, we're not going to have enough gas to get back, even if we find someone, okay? How are you feeling, Mr.
Dempster? I've taken you off the vent.
But it's only temporary.
The nasal oxygen will buy us up to five minutes to talk.
Where am I? You've had a serious accident.
I had to remove one of your lungs.
(raspy breathing) Do I know you? Hey, Brian.
Ariel, right? Arianna, your sister.
(sighs heavily) When when I was a kid, I used to climb this walnut tree in our backyard, and I had these roller skates, and you always used to help me down.
(chuckling) That did happen, right? Yeah.
Yeah.
That was me.
What's wrong with me again? You crashed your motorcycle.
Not that.
Aren't I sick? You have early onset Alzheimer's.
I have what Dad had.
What he died of, right? Brian, you have a DNR, which means, um, you don't want any excessive measures taken to keep you alive.
But with only one lung, I'm going to have to put you back on the vent.
I don't want the vent.
Brian.
No vent.
I don't want what happened To Dad.
I know.
And are you absolutely sure about that? Half the time, I don't know what year it is.
What state I'm in.
I don't remember yesterday or the day before, but Brian.
She's always trying to protect me.
When I was a kid I had these roller skates, and I would climb this tree in our backyard, and my sister I just told that story, didn't I? (gasping) My choice.
With dignity.
(sobbing quietly) ARIANNA: Can we have a little time to say good-bye? WARREN: Should we go a little bit farther? We're about an eighth of a mile from the impact site.
This is probably as far as anyone could have made it even if they'd wandered away.
You have to go back, Doc.
Five more minutes.
No, no, do not do that, not the face.
Gas gauges can't be charmed by puppy dog eyes.
I'm sorry, Doc.
Look, I'll make it up to you when we get back, okay? Wait.
What's that? Can we go lower? Yeah, yeah.
Let's go lower.
Oh, my God, oh, my God, right there.
Rescue One to base.
Rescue One to base.
We think we found a survivor.
Hurry! He's in respiratory distress.
Hey, Truman.
Truman, hey.
(whimpering) Hey, I'm Dr.
Warren, and I'm gonna take care of you, okay? Is he a? Yes, very much so.
Facial trauma.
I'll intubate.
How'd he get this far away from the crash site? Probably stumbled off trying to get out of harm's way.
Ah, I can't get his jaw wide enough to see the cords.
Here, let me take a look.
(Truman wheezing) (grunts) I can't get in either.
I'll have to cric him.
Wait, wait.
Give me two tongue depressors and some medical tape.
What? His jaw's dislocated.
That's why you can't get it open.
I'll reset the jaw, then we can open up the airway.
With tongue depressors and medical tape? Manual mandible reduction.
Okay.
(heart monitor beeping rhythmically) Doctor, he's ready.
(sighs) So, Brian, I'm going to count backwards from five to one, and if it's still what you want to do, we'll turn off the machine.
(inhales deeply) (muffled): It is.
(sniffs) (Truman wheezing) Got him? Hey, Truman, hey.
Now, don't be scared.
This is going to hurt, but it's also going to help you breathe again.
PROCTOR: Five four three .
.
two one.
(beeps) (sniffs) (gasping) (exhales) (wheezing) Okay.
(muffled grunt) (jaw cracks, Truman groans) (labored breathing) (gasping for air) (exhaling) (gasping) (exhaling) Thank you.
(gasping, then exhaling) (gasping) (exhaling) (wheezing) He's breathing.
(sighs) He's breathing.
(heart monitor beeps once, then stops) (heart monitor flatlining) Nice work.
(chuckles) I think you're pretty much up right now.
Yeah.
(chuckles) Okay, buddy, we're gonna get you home.
You all right, you okay, buddy, huh? Okay.
Let's get you home.
On-site mandible relocation with freaking tongue depressors? What?! You are the queen of EMS observation day.
(phones ringing) It's Tuck.
(elevator bell dings) (phone beeps) 51 seconds.
You guys really care.
Welcome back.
How are you feeling? Like I've been asleep for a week.
Well, that's 'cause you were.
What can we get you? Three months of bed rest.
And you'll page us if you actually need anything, right? 51 seconds.
Time to beat.
Just got a look at Tuck's first echocardiogram.
Yeah, his heart's pumping well.
No mitral regurgitation.
So far, so good.
How much of being alive is wanting to be alive? 'Cause I know some pretty miserable people whose hearts just keep beating.
Maybe you should try asking the question the other way around.
Can someone decide to restart their own heart? Thanks for the update on Tuck.
This one's for free.
The next one-- that'll cost you dinner.
(barking) (grunting weakly) (panting) MAN: What'd you find, Vince? Hey, what'd you find, Vince? Hey, boy, what'd you find? Oh, man.
Any minute now Don't worry, buddy, don't worry, just hang on.
I'm gonna get some help, all right? (barks) All right.
My ship is coming in A dog, huh? Mm-hmm.
Saved my life, along with the good people of Baltimore General.
So this isn't your birthday? No, it's my, uh, my "rebirthday"" I'm two.
(chuckles) You know Brian my DNR patient, today he, um, couldn't remember his past.
Didn't think he had much of a future.
I, on the other hand, haven't often wanted to remember my past.
But in my dreams But I got everything ahead of me.
I slew the dragon So you really were dead, huh? Mm-hmm.
You've never told that story before, have you? Wait a minute, so who left you the file? Who is "Thought you might want this"? Come on, you tease! (laughter) Okay, okay, let's try this.
Was it my lying eyes or did I see you and Dr.
Sable chatting it up in the break room? Your mask is wearing thin It's good to be alive.
(laughs) Let me throw one more dice (glasses clinking) It is good to be alive.
Cheers.
(laughter) I'm waiting for my real life to begin.
I'm Mark Proctor.
Hi.
Just moved down from Maryland, as you can tell from the accent.
WARREN: Did you get a look at that scar? ZAMBRANO: What scar? Sternotomy.
Tissue's still pink.
He had his chest cracked.
Cops have any suspects in our stabbings? I'm scared.
It's going to be okay, Todd.
Todd Kinney, he's not a mugging victim.
He's the attacker.
WARREN: He's the one who stabbed her.
What are you doing out of bed? Mr.
Kinney? (stabbing) (groaning) Stab wound to mid-thorax, but he's not responsive.
If I hadn't saved him, none of this would have happened.
It isn't your fault.
("Forget Myself" intro playing) They're pacing Piccadilly in packs again And moaning for the mercy of a never-come rain (dog barking) The sun's had enough And the simmering sky Has the heave and the hue of a woman of fire (barking) Get out of here! (growling) Go on, get out of here! All scented and descending from the satellite towns All right.
(hisses) The neon is graffiti singing make a new start (fading out): So I took for a plot (gasping) (groaning) But I'll forget myself (grunting weakly) The man on the door has a head like Mars Like a baby born to the doors of the bars And surrounded by steam with his folded arms (fading out): He's got that urban genie thing going on (clears throat loudly) I was just rounding Patterson Park.
What's that? My (treadmill beeps) My Baltimore route.
22 minutes, I would have been just coming around the Pulaski and heading south towards the harbor.
Thinking about old times? (panting) Yeah.
This was mistakenly put in my cubby.
You interrupted my run just to give me a package? Everyone keeps asking.
About, uh Tuck.
I know.
I'm just not sure what to say about what happens next.
He's getting better.
It's only been a week.
His LFTs Are returning to normal.
Yeah, I checked his chart an hour ago.
You and me both.
And Chris and Serena.
Serena's having a rough time.
She didn't do anything wrong.
How would you feel if you saved the lunatic who put a scalpel through Tuck's heart? Oh, I thought we did really good work repairing the stab wound.
As of this morning, Cardio can have a go at repairing the rest of the damage to his heart.
Who's on for cardiac surgery today? Uh, Dr.
Sable.
Is she good? She's the best.
And a piece of work.
You know how people sometimes consider you quirky? People consider me quirky? Well, Sable will give you a run for your money.
(pagers beeping) Plane crash.
In the Everglades.
You get the team ready for multiple criticals, and I'll have a consult with Sable's team about Tuck's heart.
Hey, happy birthday.
Yeah.
Some birthday.
(monitor beeping) FLIGHT MEDIC (over radio): Flight 815 out of Fort Lauderdale.
Small commuter plane.
12 seats, one flight attendant, one pilot, one copilot.
So, that's 15 possible survivors? Yeah, but what we heard from first response, it's not good.
Hey, Lynn, we got an ETA on incoming? You're still en route to the crash site, right? Yeah, we're about three minutes out.
We got Doc Warren loaded up and we're ready to go.
Wait.
Serena's on the chopper? On her EMS observation day.
(groans) Hey.
Top of the morning, Dr.
Warren.
WARREN: Okay, whatever asinine crack you're about to make, Chris, ever so kindly stick a bulb syringe in your mouth.
So, how's it going up there? Well, considering I just found out that, for legal reasons, I'm not actually allowed to help out, I'm having the time of my life.
Well, it ain't called observation for nothing, Doc.
You know, Serena, on, uh on my observation day, they were, they were so impressed with my skills that they let me fly the chopper and And what? You were such a hero, they gave you a key to the city? No, two keys.
Two-- and the garage door opener.
(pager beeping) More incoming.
Motorcycle accident with open tib-fib, head trauma and altered LOC, eight minutes out.
All right.
Gotta go.
And hey, don't let Dr.
Warren puke on your shoes there, Moose.
I'll try to stay fast on my feet.
Thanks for the advice.
Oh, man.
Brian Dempster, 37, rolled his motorcycle.
One head trauma, chest and abdomen contusions with a tib-fib injury on the left.
Uh, Mr.
Dempster, I'm Dr.
Deleo.
My bike? It was a Ducati 999.
Beautiful.
Now scrap metal on I-51.
Okay, send for a trauma panel, type and cross for three, and page X ray.
Is this our motorcycle accident? Yep.
Multiple contusions, open tib-fib, crush injury to chest and head trauma.
Okay, on my count.
One, two, three.
Grab the ultrasound for a FAST scan.
Decreased breath sounds at the left base.
Let's get going with a chest X ray.
(groaning): I am in so much trouble.
Not as much trouble as we'll be in, if we don't make you better, Mr.
Dempster.
Free fluid around the bladder.
We think you have bleeding in your belly, Mr.
Dempster.
Mr.
Dempster? He's unconscious.
His vitals are stable; probably just fainted.
I want an O.
R.
prepped.
Can you page Neurosurge and Ortho? Let's take a look at his chest wound.
If we're going to save this guy, we're going to need everything and the kitchen sink and the stove and maybe even a slow cooker.
That is if Mr.
Dempster wants us to save his life.
Here it comes Here it comes, here it comes Here it comes Here comes your 19th nervous breakdown What are the chances the American Medical Association accepts a tattoo as a valid DNR? Could reflect his true medical wishes.
Or a biker handle.
College fraternity prank gone horribly bad.
Well, let's finish his chest tube.
Can I have some Lidocaine? Mr.
Dempster? Mr.
Dempster, can you hear me? I'm Dr.
Proctor.
You've got a serious accident.
I know.
I fell out of a tree, right? That's what you get for climbing up with your roller skates on.
No, you didn't fall out of a tree, Mr.
Dempster.
You had a motorcycle accident.
And Dr.
Deleo and I have to know if that tattoo on your chest reflects your true wishes.
(groans) Tattoo? Yeah, the one that says "Do Not Resuscitate.
" I don't have a tattoo.
I don't have a motorcycle.
My mom would kill me.
Brian, can you tell me what year it is? And how old are you, Brian? I'm 11 years old.
That's a lot of chest hair for an 11-year-old.
Am I bleeding? Yes, we think you're bleeding inside your head, Brian.
And we're concerned about bruising to one or both of your lungs.
We need to take some pictures in order to figure out how to make you better.
Okay.
Please don't tell my mom.
They just found a survivor from the plane crash.
Flight EMTs and Dr.
Warren are transporting her back.
ETA? Less than five.
Uh, you take that with Dr.
Zambrano.
I've got to get a consult on Tuck and then hop back on Mr.
Dempster, based on his scans.
Got it.
Uh, can you page Legal for me? Uh, call Risk Management.
Call Admin.
Call his mom if she's still alive.
Call anyone who can give me some guidance on what I'm allowed to do with my patient.
MOOSE: Josephine Wells, 28, plane crash survivor.
Crush injury to chest and abdomen, with pinal flexion injury upon impact.
Normal neuro exam.
She's going to need a final C and strict immobilization.
Hey, Moose, don't think your new flight nurse should be giving advice to trauma surgeons.
Not too good at observing, this one.
That's why we love her.
Hey, what's the update on Tuck? Surgery today.
We'll let you know if there's any more incoming.
Watch it.
All right, Ms.
Wells, we're going to get you right into a trauma suite and assess your injuries.
Can you tell us what your pain level is? Scale of one to ten? (inaudible) What's that Josephine? (inaudible) Okay, hang on, hang on, stop.
Stop, stop, stop, stop.
Stop, stop, stop.
All right, go ahead, we're listening.
Tru-Tru Take it slow, Josephine.
Tru-Tru I-- T-True? True? Save your strength.
Okay? ZAMBRANO: We can see you have something important to say.
And when you're ready, we're here, okay? (helicopter rotor whirring) (man shouting in distance) (dog barking) Last contact with the plane was a distress signal sent three minutes before impact.
So far, we've discovered 13 distinct sets of remains.
And Josephine Wells.
The flight manifest says there were 15 aboard, so So one.
Yeah.
Yeah, we're looking for one.
O.
R.
Two is prepped and ready.
So we start by? Fixing Josephine's ruptured kidneys, spleen and urethra disruption.
And get new scans to Neurosurge and a consult from Ortho on her pelvic fractures.
Proctor should get those scans as well.
By the way, it's his birthday.
Really? Today? Yeah.
And he didn't seem too happy about it either.
How old is His Highness? I don't know.
Do we get him a present? I don't know that either.
What if we get him, like, a giant cake? And we get a big question mark in a bikini, have it jump out.
Uh, that's just bizarre.
I don't know, I'm riffing here.
Still waiting for the dude to let his guard down.
Patient's name is Tuck Brody.
This is a young athletic guy.
Let's use a pig valve so he doesn't have to spend the rest of his life on warfarin.
(clears throat) Excuse me, Dr.
Sable.
I, uh, don't have much time.
So, you're the new guy I've heard so much about, the Brit.
New-ish.
And I just speak this way because Americans find it appealing.
Can we have the room, please? Helena Sable.
Cardiovascular surgeon.
Rest assured, your patient is in good hands.
My patient is also my friend.
I don't know if you're aware, but, um, this is one of my guys.
Charge nurse Tuck Brody.
So I'd like to weigh in on his management and scrub in on his surgery.
Your team did excellent work on the ventricular wall, but now we're talking mitral valve replacement, which is probably a little much to wrap your head around.
I could walk you through the difference between mechanical valves and tissue valves, but then I'm not a performing seal.
Is that your rule? Because my rule is, no one scrubs in on my surgeries.
No one.
If you don't like it, you're welcome to find yourself another heart surgeon.
I hear you're the best.
Well, if that's what you hear.
That's what I want for Tuck.
Good.
You're welcome to be in the room.
But you're not to touch the body.
So I can look but not touch? I was just trying to make sure that you weren't the egomaniac I'm often accused of being.
Welcome aboard, Matthew.
Nobody calls me Matthew.
(dog barking) MAN: Over here! Get some help here?! I got it! Put her on there.
Somebody get the EMS over here! Got it.
She have a pulse? I need to get a line in her now! Fixed and dilated.
(exhales) She's gone.
(garbled radio chatter) Our motorcycle accident's left lung is badly lacerated and contused.
(exhales) Basically turned to mush.
Probably have to remove the whole thing completely.
Hey.
Hey, where am I? Can you forward that to Radiology? And, uh, page Nurse Graceffa for me.
Mr.
Dempster? (distorted): Mr.
Dempster? My bike.
I crashed it, didn't I? So you do remember you have a motorcycle.
Well, I did till I rolled it.
(wry chuckle) Oh, I'm hurt pretty bad, aren't I? You are, but we're in the process of making you better.
You saw my tattoo, right? You do know you have a tattoo? (distorted): Mr.
Dempster, if we're going to continue to make you better, then we need to Wait a minute.
Who's Mr.
Dempster? Sorry? Who are you? (rapid beeping) Where am I? No.
You-you you hold still.
Really still.
(rapid beeping) Internal bleeding's getting worse.
I want him prepped for an OR, stat.
Have you had any response from Admin about his DNR? Called them three times.
Oh.
Now they're gonna hear from me.
(slow, rhythmic beeping) Propofol's running.
Should be out in a minute.
Josephine? We're gonna put you under now so that Dr.
Deleo and I can attend to your injuries.
I know this is a little scary, but Tru Will you tie my mask? Tr "True.
" You said that before.
Truu What's true, Josephine? Tru man.
Truman? DELEO: What, like Like a name? That's what you're saying? Who is Truman? Was he on the flight with you? Alive.
Josephine, we haven't gotten news of any more survivors.
Saw him.
I saw him.
After the plane crashed? Yes.
He's alive.
(indistinct shouting) WARREN: Okay.
Moose got me a copy of the flight manifest from the NTSB officials.
What's the name I'm looking for again? Okay, it's, uh It's Truman something.
Josephine Wells, a survivor, told us that she saw somebody named Truman alive after the crash.
I have it right here.
Looks like her husband.
Mr.
and Mrs.
Truman Wells seated in and 6B.
So that's good.
I don't think he's alive, Chris.
We've already found 14 victims, all adults, which means along with Josephine Everyone's now accounted for.
Yeah.
Of course they haven't identified anyone yet, but.
.
Yeah, no, no, no, no.
I, uh.
I get it.
Search and Rescue is shutting down now and NTSB investigators are starting to take over.
Are you guys headed back? Yeah.
We're packing up right now.
All right.
Okay, fly safe.
All right.
Will do.
(elevator bell dings) No more survivors.
Hey, I've been thinking about our, uh, motorcycle accident.
His confusion could be, uh, trauma-related or some underlying condition like delirium or schizophrenia or Everything okay? Still haven't got ahold of the next of kin.
AnAdmin won't take a stand without a consult with Ethics, who won't weigh in without precedent from Legal, They do realize your patient's s are dying by the moment? I did make that quite clear.
(elevator bell dings) Brian Dempster just put another 500cc's of blood into the chest tube.
His pressure's dropping.
Anesthesiologist wants to know if you want to put him on the vent because, technically It's a violation the DNR if it's valid.
Put him on the vent.
Let the pencil pushers upstairs clean up their own mess when they pull their thumbs out of their asses (slow rhythmic beeping and whooshing) I can only imagine the speed he was going on that motorcycle.
We got ahold of his next of kin.
His sister, Arianna.
She'll be here within the hour.
Excellent.
Also got his latest brain scans.
I sent copies to Neurosurge, but I know you also wanted to see them.
(sighs) Bad to worse.
Brain injuries from the accident? No.
His brain's fine from the accident.
He's got He's got diffuse brain atrophy.
He's probably had it for years.
Could be Parkinson's or Alzheimer's.
Huntington's.
Whatever it is, he's a 40-year-old with the brain of an 80-year-old.
If my brain looked like that, I'd have a tattoo on my forehead.
(overlapping chatter) (indistinct radio chatter) I'm just waiting for the official word from the NTSB that we're clear, then we're gonna head out, okay? Thanks.
You okay? Nope.
My last shift, I saved a man's life.
Oh.
Well, that makes sense.
I can see why you're so upset.
The patient I saved is a guy who ended up stabbing Tuck.
I'm sorry.
I wish I hadn't saved him.
Does that sound terrible? No, it sounds honest.
Today's the end of my first year in Trauma.
'Cause of what happened, I-I I don't know if I'm doing more harm than good.
You're saving lives.
That's gotta be good, right? Let's say it's a drunk, an-and two days later, that guy goes out and mows over a bunch of people.
Haven't I just-- I don't know-- made the world worse? My mother, she would say, "Life is not a race, and nobody's keeping score.
" My dad was an accountant.
It was all about whether you were up or down.
As much as I don't want to be doing it, I am.
I'm keeping score.
I don't know if I'm up or down.
Arianna Dempster? Brian's sister.
Hi.
Matt Proctor.
Hi.
How is he? Oh, he's out of surgery, and he's recuperating in ICU.
Brian had multiple issues.
Uh, most notably, severe pulmonary trauma, which has caused me to remove one of his lungs.
His lung? But with time on a vent and other artificial assistance, he can live with one lung.
Can he live longer than he can with early onset Alzheimer's? Ah.
Our father died of early onset when he was 47.
It was ugly, so we both decided to get the genetic test.
I won, Brian lost.
Ever since then, my brother's been all motorcycles, mountaintops, river rafts.
Brian wanted to make sure he didn't have any regrets that he got to keep his dignity.
So the tattoo was his idea? His first idea was to get his entire living will tattooed, complete with the words, "More on Back.
" (laughs) So, are you required to turn off the machines if he wants to die? I'm required to talk through all his options, including turning off his vent, yes.
He's my baby brother, my only sibling.
I'm just not ready to give him up.
Look, we'll, um find out what he wants to do and just have to take it from there.
Okay? Eva.
Huh? Did you get the page? Yeah.
Josephine Wells is waking up.
I'm heading there now.
Are you going to tell her about her husband? She's going to ask.
Dr.
Zambrano, Dr.
C.
Are you going to see Miss Wells? Yeah.
Why? I think you should hold that thought.
Josephine-- how, uh how is she? Uh, I'm sorry.
Who are you? I'm her husband.
I'm, uh, Truman.
Josephine and I were scheduled to fly to Baton Rouge to see my sister, but at the last minute, I was forced to stay in town for a conference.
So, your wife was just confused? Confused about what? Well, she said she saw you alive after the accident.
Saw me? Yeah, you-- Truman.
Wait.
My-my son is alive? They-they told me he was dead.
Truman, Jr.
When-when I couldn't go, my wife, uh, got him out of school.
It was a big deal at the gate-- uh, tearing up tickets, printing them again, but but we managed to get him a seat Did Josephine really say she saw Truman alive? Yes, but I don't know Wait, wait, wait, wait.
How-how-how old is he? Your son.
Uh, he's 11 years old.
Just turned 11.
How tall is he? Uh, 4'10", 4'11".
What does that matter? All adults.
What are you talking about? Serena said all adults.
What?! Okay, you said the remains they found were all adults, right? They found no children's remains? We got to go, Dr.
Warren! I think that the manifest could be all screwed up.
Maybe even the numbers are wrong.
It was Josephine's son who was sitting next to her.
Chris, I gotta stop the helicopter! You coming, Doc? There could be one more! Our patient, your friend.
Tuck.
He keep kosher? I don't think so, no.
Then go with the pig valve.
I hear happy birthday is in order.
Where do you hear that? Oh, I'm like the CIA meets the KGB meets that grandmother who always knew what you were up to.
You got your undergrad at Berkeley, your medical degree at Penn, you pretend not to know how to play pool until there's money on the table, and you're a sucker for caviar.
My grandmother was the last to know.
Let's go make Tuck's heart purr.
In this life we live, we're only returning home In this life we live, we're only returning home Can you take my hand? And together we can sure try Can you take my hand? And together we can sure try In this life, we are only returning home Your friend's got a good heart.
Yes, he does.
WARREN: Hey! Can we take the helicopter up, fly overhead, see what we can see from there? I know I'm only supposed to be observing, but what better place to observe than from the sky? Doc Come on, Moose.
I'm down on my ledger.
I got to get back to even.
Chris said that boy could be out there.
You know I'm a sucker for those puppy dog eyes.
Okay.
We'll go up for an hour, but after that, we're not going to have enough gas to get back, even if we find someone, okay? How are you feeling, Mr.
Dempster? I've taken you off the vent.
But it's only temporary.
The nasal oxygen will buy us up to five minutes to talk.
Where am I? You've had a serious accident.
I had to remove one of your lungs.
(raspy breathing) Do I know you? Hey, Brian.
Ariel, right? Arianna, your sister.
(sighs heavily) When when I was a kid, I used to climb this walnut tree in our backyard, and I had these roller skates, and you always used to help me down.
(chuckling) That did happen, right? Yeah.
Yeah.
That was me.
What's wrong with me again? You crashed your motorcycle.
Not that.
Aren't I sick? You have early onset Alzheimer's.
I have what Dad had.
What he died of, right? Brian, you have a DNR, which means, um, you don't want any excessive measures taken to keep you alive.
But with only one lung, I'm going to have to put you back on the vent.
I don't want the vent.
Brian.
No vent.
I don't want what happened To Dad.
I know.
And are you absolutely sure about that? Half the time, I don't know what year it is.
What state I'm in.
I don't remember yesterday or the day before, but Brian.
She's always trying to protect me.
When I was a kid I had these roller skates, and I would climb this tree in our backyard, and my sister I just told that story, didn't I? (gasping) My choice.
With dignity.
(sobbing quietly) ARIANNA: Can we have a little time to say good-bye? WARREN: Should we go a little bit farther? We're about an eighth of a mile from the impact site.
This is probably as far as anyone could have made it even if they'd wandered away.
You have to go back, Doc.
Five more minutes.
No, no, do not do that, not the face.
Gas gauges can't be charmed by puppy dog eyes.
I'm sorry, Doc.
Look, I'll make it up to you when we get back, okay? Wait.
What's that? Can we go lower? Yeah, yeah.
Let's go lower.
Oh, my God, oh, my God, right there.
Rescue One to base.
Rescue One to base.
We think we found a survivor.
Hurry! He's in respiratory distress.
Hey, Truman.
Truman, hey.
(whimpering) Hey, I'm Dr.
Warren, and I'm gonna take care of you, okay? Is he a? Yes, very much so.
Facial trauma.
I'll intubate.
How'd he get this far away from the crash site? Probably stumbled off trying to get out of harm's way.
Ah, I can't get his jaw wide enough to see the cords.
Here, let me take a look.
(Truman wheezing) (grunts) I can't get in either.
I'll have to cric him.
Wait, wait.
Give me two tongue depressors and some medical tape.
What? His jaw's dislocated.
That's why you can't get it open.
I'll reset the jaw, then we can open up the airway.
With tongue depressors and medical tape? Manual mandible reduction.
Okay.
(heart monitor beeping rhythmically) Doctor, he's ready.
(sighs) So, Brian, I'm going to count backwards from five to one, and if it's still what you want to do, we'll turn off the machine.
(inhales deeply) (muffled): It is.
(sniffs) (Truman wheezing) Got him? Hey, Truman, hey.
Now, don't be scared.
This is going to hurt, but it's also going to help you breathe again.
PROCTOR: Five four three .
.
two one.
(beeps) (sniffs) (gasping) (exhales) (wheezing) Okay.
(muffled grunt) (jaw cracks, Truman groans) (labored breathing) (gasping for air) (exhaling) (gasping) (exhaling) Thank you.
(gasping, then exhaling) (gasping) (exhaling) (wheezing) He's breathing.
(sighs) He's breathing.
(heart monitor beeps once, then stops) (heart monitor flatlining) Nice work.
(chuckles) I think you're pretty much up right now.
Yeah.
(chuckles) Okay, buddy, we're gonna get you home.
You all right, you okay, buddy, huh? Okay.
Let's get you home.
On-site mandible relocation with freaking tongue depressors? What?! You are the queen of EMS observation day.
(phones ringing) It's Tuck.
(elevator bell dings) (phone beeps) 51 seconds.
You guys really care.
Welcome back.
How are you feeling? Like I've been asleep for a week.
Well, that's 'cause you were.
What can we get you? Three months of bed rest.
And you'll page us if you actually need anything, right? 51 seconds.
Time to beat.
Just got a look at Tuck's first echocardiogram.
Yeah, his heart's pumping well.
No mitral regurgitation.
So far, so good.
How much of being alive is wanting to be alive? 'Cause I know some pretty miserable people whose hearts just keep beating.
Maybe you should try asking the question the other way around.
Can someone decide to restart their own heart? Thanks for the update on Tuck.
This one's for free.
The next one-- that'll cost you dinner.
(barking) (grunting weakly) (panting) MAN: What'd you find, Vince? Hey, what'd you find, Vince? Hey, boy, what'd you find? Oh, man.
Any minute now Don't worry, buddy, don't worry, just hang on.
I'm gonna get some help, all right? (barks) All right.
My ship is coming in A dog, huh? Mm-hmm.
Saved my life, along with the good people of Baltimore General.
So this isn't your birthday? No, it's my, uh, my "rebirthday"" I'm two.
(chuckles) You know Brian my DNR patient, today he, um, couldn't remember his past.
Didn't think he had much of a future.
I, on the other hand, haven't often wanted to remember my past.
But in my dreams But I got everything ahead of me.
I slew the dragon So you really were dead, huh? Mm-hmm.
You've never told that story before, have you? Wait a minute, so who left you the file? Who is "Thought you might want this"? Come on, you tease! (laughter) Okay, okay, let's try this.
Was it my lying eyes or did I see you and Dr.
Sable chatting it up in the break room? Your mask is wearing thin It's good to be alive.
(laughs) Let me throw one more dice (glasses clinking) It is good to be alive.
Cheers.
(laughter) I'm waiting for my real life to begin.