Miami Medical (2010) s01e09 Episode Script
Like A Hurricane
The governor has declared a state of emergency, urging residents to evacuate in a calm and orderly fashion.
That's right, idiots, keep honking, 'cause that's gonna save our butts.
It's not nice to say "idiots," Daddy.
Daddy's just tense, honey.
Daniel, please.
Not as tense as Mommy.
One hour buying wood, and another just to get out of this stupid parking lot.
It's not nice to say "stupid," either.
Would you just play with your dog, munchkin? Look, guys, we're just gonna put the boards on the front windows and we'll be on the road to Aunt Lu's in no time.
But Aunt Lu's house smells funny.
Aunt Lu's house is on the Gulf, April; that's all that Matt-- Whoa! (horn honks) What is wrong with these people? No, no, wait! Look, kid, tell your family that they're gonna have to wait in line, just like us.
Hey, look, it's Conner! Oh, my God, Sam, it is.
It's the Fryars.
So, it's the Fryars, so what? They cut us off.
We didn't let them in.
We beeped the horn.
We called them idiots.
Idiots, beep, idiots, beep, idiots, beep! April, Daniel, please stop now! Okay, look, look, I'm letting them in.
Okay, Fryars, go ahead.
By all means.
(indistinct conversations) Have a nice hurricane.
(laughing) (screaming) (screaming) (crashing) Here it comes ââ¢Âª Here it comes ââ¢Âª ââ¢Âª Here comes your 19th nervous breakdown.
ââ¢Âª Are we all staffed up for the hurricane? Yes.
And Bravo's offered to stick around for another half shift, in case we get slammed.
When I was a kid, I used to go to the beach with a kite when the weather got blustery.
First hurricane, Dr.
Proctor? "Blustery" not the right word? St.
Miriam's Hospital's closed, Dade County Medical's down to a skeleton crew.
We're the only level-one trauma center in 200 square miles.
200 square blustery miles.
The hits keep coming, people.
We got a DUI-related multi-car collision.
First two red vans are just four minutes out.
We got one penetrating abdominal injury, and one crushed chest with a severed carotid.
We need blood and lots of it.
Calling the bank as we speak.
Oh, and Dr.
Zambrano, did anyone tell you that your dad is in Trauma 2? My father? Guess that's a no.
This way Yeah.
ZAMBRANO: Papi? What happened? My Melita.
DELEO: Ooh, Melita.
I thought it was Eva.
No, it's short for melocotones.
Peaches.
Ah Ever since this time back in Cuba when she was a little girl No, no, no, not the "Peaches" story.
What happened to your hand? I was boarding up my shop and got a bit careless with the saw.
Careless to the tune of three sutures and counting.
Horizontal mattress sutures.
Which I would never use on a wound like this.
But your father was kind enough to talk me through it.
Oh Gracias, Señorita.
Papi? Hmm? You of all people know that that is not a trauma wound.
Emergency's right next door.
But why not come where I can at least see my own flesh and blood? Yeah, lighten up, Peaches.
So help me, Chris, I will stick you in the peaches with a Foley catheter.
Incoming three minutes.
Oh, Dr.
Proctor, have you had the chance to meet the original Dr.
Zambrano? PROCTOR: Uh, no.
It's a real pleasure.
Hmm So, um, you are the Englishman who took my little girl's job? (whispers): Papi! Well, that's one way of describing my rather awkward ascent.
(beep) MAN (over P.
A.
): Arriving in the ambulance bay, one minute.
Incoming, anyone? Ooh.
(chuckling) (sirens blaring) Eva, why aren't you waiting inside? I'm just getting some air.
Air going 100 miles an hour? There's nothing better.
I met your dad; he seems sweet.
Yep, he sure does.
And what does "Melita" mean? What do we got, guys? Daniel Seaver, 15-year-old male.
Crush injuries.
Six-centimeter laceration over neck with pulsatile carotid bleeding at the scene.
All right, we'll need an intubation tray and two large-bore antecubital lines.
Jennifer Seaver, 36-year-old female.
With multiple lacs and penetrating wound to the abdomen.
The car came out of nowhere.
Okay, Mrs.
Seaver, I got you-- let's go.
On my count.
One, two, three.
JENNIFER: What's happened to my family? Where is April? I didn't see my daughter in an ambulance.
Mrs.
Seaver, Jennifer, Jennifer, look at me.
I'm Dr.
Warren, and I need you to leave your oxygen in.
Is she dead? She's dead, isn't she? I'll find out what happened to your daughter as soon as I get you stable, okay? Okay, how you doing, Mrs.
Seaver? She's hypotensive but alert and awake with GCS of 465.
Okay, start with two units of O-neg, and grab me the ultrasound.
And it says here that the penetrating object was a blade.
I thought this was auto versus auto.
It is-- was.
And there's a blade, all right.
A wiper blade.
Wiper blade must have embedded when she went through the windshield.
Or else the windshield came down on her.
It seems to be resting in her spleen.
You know what? I can't tell if there's any bleeding.
Pulse ox is low on nasal oxygen, but the chest X-ray looks clear.
We need to keep an eye on her lungs.
We should stabilize the wiper blade and keep it from moving.
Scan for other injuries before we take her to O.
R.
Daniel, my son.
Where is Daniel? Daniel, can you hear me? Daniel, we're going to put a tube in you to help you breathe, okay? He's unconscious.
I'm through the cords.
Get him on the vent and let's get that blood running.
Is this the son of the embedded wiper blade? Yeah, crush injury to the chest with a severed carotid.
Where's all the blood? I don't know.
Medic said it was pumping hard at the crash site.
It's not pumping now.
Whoa.
Whoa, indeed.
Is that a sternoclavicular dislocation? PROCTOR: Ever see one before? Only in medical journals.
Probably what kept him from bleeding out at the scene.
But it could kill him now.
We've got to pop those ribs out.
Chris, we'll need towel clips.
And lots of Lidocaine; I'm on it.
ZAMBRANO'S DAD: Oh, you don't see those too often, which is a very good thing.
Sternum separated from clavicle and pushed in, compressing the boy's heart, lungs and blood vessels.
They need to pop it back out, pronto.
(alarms beeping) BP's dropping-- 55 systolic.
Tilt him up for me.
Towel clips.
I hear a DUI did this? Yeah.
See how he digs the clips directly into the skin and onto the bones? DELEO: BP's still falling.
Systolic's 32.
(grunting) Hold him down, hips and shoulders.
(grunting): Come on.
Young lady, you may not want to watch.
There might be a lot of, um blood.
BP's up to 96.
Hand me a hemostat.
Get him to I.
R.
, before he bleeds out.
Man, Proctor Cancel the hurricane.
Gracie shifted course again.
Back to a tropical storm.
Wish she'd done that before this whole family got clobbered.
Poor woman thinks her daughter April might be dead.
You hear anything? Just that red vans are on the way with three black vans at the crash site.
Three dead? Think one of them might be April? (pager beeps) We're about to find out.
Samuel Seaver, 36-year-old male with multiple contusions and a possible C-spine fracture.
BP is 196 systolic.
ZAMBRANO: Mr.
Seaver? Sam? Can you hear me? (groaning) Put him in Trauma 3, watch for any signs of posturing.
Page Neurosurge and make sure we have an intubation tray on standby.
All right, you got it.
TUCK: Please tell me that's April.
Yeah, she's the daughter.
Her mom's going to be happy to see her.
Can't get a word out of her.
Poor kid was the only one conscious while Rescue was cutting her family out of the minivan.
Oh, so she saw everything.
I'll get her hooked up with Family Services No, no, no, I'll take her.
(gently): Hi.
You want to come with me? Come on.
Got her? She's got multiple contusions and a supracondylar fracture above the right elbow, which I know doesn't fit trauma criteria, but Well, you never break up a family.
Glad to hear you say that.
She wouldn't give him up.
Dad's ready in Trauma 3.
All right.
April? This is Nurse Tuck.
He's going to get you a really cool cast for that arm, okay? Listen, I know this is scary.
We're going to do our very best to take care of you and your family, all right? Can you keep an eye on her for me? No problem, Peaches.
Dr.
Proctor? The, uh, son from the car crash-- Daniel? I.
R.
was able to patch his carotid, but they think he had a small stroke from blood loss at the scene.
Thanks for the update.
Yeah.
So, that's not your first sternoclavicular dislocation, huh? Pretty hard-core in there.
I've been up on my fair share of gurneys in my time.
I'll prepare the chart and do the procedure note for you.
I can do that.
Really? 'Cause we're just used to the residents doing all the Scut work? Yeah It's Team Trauma, isn't it? I'm part of the team.
Yeah, well, head of the team.
Yeah.
See, back in GI practice, I got pretty comfortable sitting in my office just signing forms that were slid across my desk to me.
I was pretty isolated, too-- from my patients and from the medicine.
The most challenging part of my day was deciding which of the free pens from the drug companies to use.
(elevator bell dings) I like the ones with the little multicolored clicky things.
What What are you doing? It's okay, Mr.
Seaver, I'm Dr.
Zambrano.
Jennifer My wife She's here.
Just lie still.
You lost some blood, and I had to close up that wound.
Now I'm going to assess your other injuries, okay? My kids They're all here, Sam.
May I call you Sam? Tell CT we'll be up soon.
I'll need a C-spine and a brain CT.
He's got free fluid in there.
Sam, are you experiencing any abdominal pain? Sam? He's got intra-abdominal bleeding.
Hold CT; we're going straight to O.
R.
1.
Got it.
Wiper blade's imbedded in the spleen.
Small subcapsular hematoma.
Sub what? There is bleeding around your spleen, Jennifer, but it's small and contained.
And we're going to fix it right now.
Start two grams of Cefoxitin.
April Where's my family? April's here and she's fine.
Daniel? Your son's having his neck injury repaired and I'll get updates on your husband as soon as I can.
O.
R.
's prepped and ready.
All right, Page Proctor.
Let's move her.
F-Fryars.
What's that? They were in the car in front of us.
Their son Conner-- he waved at us.
They were hit before we did.
Are they here, too? Well, no.
They're Apparently, they, uh they moved on.
"Moved on"? Where were they moved to? No A better place; they-they moved on to a better TUCK: The other family in the Ford died.
All three of them.
I'm very sorry, Mrs.
Seaver.
(elevator bell dings) Get Mrs.
Seaver up to O.
R.
2.
Dr.
Warren will be scrubbing in.
Hey, Polly, where are you going with the girl's dog? Up to Admin.
Something about "unsanitary conditions.
" Come on, cut the kid some slack, huh? Don't shoot the messenger, Tuck.
Poor girl wasn't happy about it, but you can't fight City Hall.
Do you need an assist with the father? It's nothing I can't handle.
But I will need Neurosurg to take a look at his brain scans.
I'll want to see them, too.
Oh, and, uh, speaking of fathers About that crack my dad made Referring to me as an Englishman is hardly a crack.
No.
The part about you taking my job.
It's okay.
We all have fathers.
Yeah, but I don't see yours looking over your shoulder from the bullpen.
You know, Chris referred to your dad as being "the Original Dr.
Zambrano.
" What's that about? He was a surgeon in Cuba.
One of the best.
So why didn't he get his license here? Time, money ego.
"Ego"? Try moving to a country where you don't speak the language, then go back to being a first-year resident.
I see your point.
Look, I I love my dad but he casts a long shadow.
Hard to escape the feeling that he sees my career as an extension of his.
You mean it's not? (pager beeps) More incoming? Yeah.
Can you page Dr.
C to the ambulance bay? Bill Evans, 33-year-old suspected DUI with multiple lacs, head and chest trauma.
BP 105/60, heart rate 112.
In custody of Detective King.
What's this guy drinking, gasoline? KING: That wouldn't surprise me.
More likely the fuel tank emptied out on the son of a bitch when the car flipped onto the van.
(sighs) So this is our guy, huh? Oh, yeah, the cause of it all.
I couldn't get a Breathalyzer, so you'll want to run blood alcohol and LFTs.
Oh, yeah, yeah, yeah, I'll get right on that.
Soon as I frisk him for concealed weapons.
What for? I did my job.
Okay, so let me do mine, Dale.
Okay? One, two, three.
Okay, send a CMP.
Have X-Ray get me a C-spine, chest and pelvis.
The speedometer broke in the crash.
Needle pegged at 74 miles per hour.
He T-bones a family of three in an old Ford.
Never had a chance.
Type and cross for four.
Let's do an EKG and a troponin.
Yeah, have another drink, pal, while the good doctor fixes your boo-boos.
Hey, give me a break, Dale, okay? I don't like this guy any more than you do.
Do me a favor, take the commentary to the bullpen.
Please, please, please Here's the EKG.
Sir, relax.
You've gotta be kidding me.
What? What's going on? On top of everything else, this guy's having a heart attack.
Crash cart and pacer pads.
Please.
Please Let me Let me die.
Prepped in O.
R.
3; start two units of PRBCs.
Your DUI had a heart attack? Traumatic aortic dissection, probably caused by impact with the steering column.
But if it's all the same to you, I'm going to hand his arch repair off to Bravo.
The arch repair too much for you? No, I'm good with the repair part.
It's the DUI I'm not nuts about.
I'm glad to see that your professional objectivity is still intact.
I got family issues, that's all.
And we've got three O.
R.
's running, so Enjoy your arch repair.
PROCTOR: Now clamp across the hilum.
Perfect and pull straight out.
And there's our wiper blade.
Remove your clamp.
And check for bleeding.
Field looks dry.
My first wiper blade.
Mr.
Cellio would be very proud.
Who's he? High school auto shop.
You took auto mechanics? Aced it.
In that case, you close and I'll assist.
(monitor beeping wildly) Or maybe not.
Her oxygen sats are dropping.
Blood loss from somewhere else? There's a piece missing.
A tiny piece.
Which is worse-- could've gone up the splenic vein to the lung.
Causing a pulmonary embolus.
Do you want to open up her chest? No.
So far she's stable, so get her back to CT to make sure it's there before cracking her open.
Let's get her out of here.
(beeping) How goes the big wiper blade search? I wish it was big.
The stupid thing's like the head of a pin.
Could do big damage, though.
Lungs look clear, but something caused her oxygen to drop.
We'll find it.
I know.
I just "They've moved on"? What? What I said to Jennifer when she asked about the family that died in the crash.
Oh, yeah.
Moved on, better place That's kind of abstract.
Last week, I was with a gunshot victim going over test results, which were not good: hypoxia, pancreatic rupture I remember the guy.
And out of nowhere, I just start spouting aphorisms.
"Aphorisms"? "The day is always darkest before the dawn.
" "Every cloud has a silver lining.
" That's a nice weather thing there.
"Never judge a book by its cover.
" You said that? To a patient.
Did it make sense? No! People can tell when you're shining them, Serena.
They can, huh? Trust me.
Comfort is no substitute for the truth.
(beeping) Wait a minute.
There it is.
That little speck? Our lost piece of wiper blade.
Only it's not in her lungs.
It's in her heart.
I'll page Proctor.
Let's get her back up to surgery.
Crazy drunk driver's aorta dissected without even breaking a rib or dropping a lung.
Got your man's liver function test results back.
Not my man.
Thank you.
DUI with an aortic dissection caused by the crash, plain and simple.
Not that simple.
And not a DUI.
LFTs came back negative.
Blood alcohol-- zero point zero.
What? Not a drop in him.
Detective King called him a DUI.
He was wrong.
Okay, soon as we're done here we're going to rerun his tox screen and chemistry.
Because drunk or not you were still going 70 plus down a side street.
Which makes you, what exactly? Can you get these scans to Neurosurg? The pressure's building in Mr.
Seaver's skull and we really can't wait much longer.
Thanks.
ZAMBRANO'S DAD: Stay very still, April.
Hmm.
We want to make sure the breaks in the bone don't shift.
Papi? What do you think you're doing? Melita.
Dr.
Haynes was kind enough to let me observe here.
You know we didn't have such fancy casts like this in my day, April.
Hope you let me sign it when it dries, huh? Papi? Can I talk to you for a minute? Sure, babe.
Thanks.
Listen, um, I didn't think you'd still be here.
You know, the weather's eased up, so That poor girl.
Your bureaucrats upstairs took her dog away.
Yeah, I heard.
How's her father? I just resected his injured bowel.
Did you do a gastric diversion? Duodenal injuries can be unstable.
Yes, Papi, I know that.
I wait.
No.
You are not to discuss the father's condition with anyone.
Much less his daughter.
You think I don't know that.
I only want to help.
Yeah, well, you can't help.
PapÃ, I can barely help.
The mother's about to have an embolism.
The father's bleeding from his brain.
And their son could end up disabled for the rest of his life.
This little girl could lose her entire Eva.
Oh, April.
April.
Sweetheart, come here.
I'm sorry.
I got you.
Based on the scans here, the wiper blade speck appears to be sitting next to the wall on the right atrium.
Did you see Jennifer's medical records? Cancer survivor.
Six years.
If she beat that, she can beat this.
Pericardium's open.
Okay.
So, let's incise the atrium.
Where where is it? Where did it go? It's on the CT.
It is on the CT.
Only other place it could be is her lungs, but her sats are back to normal.
A piece of rubber doesn't just up and disappear.
Didn't disappear.
It's on the move.
There's a hole between the left and right atria of her heart, which means that fragment could be Anywhere inside the 60,000 miles of vessels and capillaries inside the human body.
Still don't feel the wiper blade fragment in the coronary arteries.
Or the pulmonary veins.
What's our time? 18 minutes.
What if we don't find it? Don't wave the white flag just yet.
If the fragment gets lodged in her liver Then her intestines die.
And her kidneys Permanent dialysis.
And if it gets lodged in her brain, she'll have a stroke.
We're in a needle in a haystack situation here.
A needle in a haystack would be considerably less daunting.
ZAMBRANO'S DAD: "She was such a little girl "that one did not expect to see such a look on her small face.
" Hey, quick intermission, April, hmm? What's up, babe? Papi, I just I can't believe I said all that right in front of her.
Ah, you didn't know.
Thank you for helping calm her down.
It wasn't me.
It was old reliable.
Found her in the hospital gift shop.
The first book in English you ever read me.
I was trying to learn the language.
We both were.
ZAMBRANO: She still hasn't said anything? ZAMBRANO'S DAD: Not a word.
All alone, worrying about her family.
Remind you of anyone? You were younger than April.
Perhaps too young to even remember.
Like it was yesterday.
You had the same look.
Helpless.
Hopeless.
Gosh, we had such plans, your mother and I.
Raising our little girl here together.
Failure was not a possibility.
Papi You didn't fail.
Look, why don't you continue reading to her? I know she can use it.
TUCK: Eva? The brother, Daniel, is coming out of anesthesia.
Hey.
Go get it.
Hey.
Look who's back.
Hi, Daniel.
I'm Dr.
Zambrano, and this is Nurse Tuck.
Now, relax.
Relax, it's okay.
You have a tube in your throat to help you breathe.
You won't be able to talk.
You had a stroke from a neck injury.
So you might have a hard time holding things for awhile.
Oh, your mom? She's here.
Mom and Dad both.
And we're taking really good care of them.
Munchkin? (sighs) You mean April? Right next to her big bro.
(Zambrano chuckles) (rapid beeping) We've been searching for a half hour now.
I'm aware of that.
Would you please turn that thing off? (rapid beeping stops) The longer we're at this without finding the piece, the greater her risk of infection.
It could just as easily be in her extremities by now.
Yeah, fine, let's close her up and get her to recovery.
But I want you with her going over every inch with a flow Doppler ultrasound.
Go.
Find that piece.
I'm on it.
Can you page Cardio and tell them we need a consult on a patient? Digging for loose change again? Whatever I find, we'll go halfsies.
How's your DUI? Turns out he wasn't "I" after all.
We've rerun every test.
The guy's clean as a whistle.
Which has you searching his clothing for what exactly? I don't know.
Anything.
Got 12 bucks.
Debit card, license And a number here for SFC Burke 162.
"SFC," Sergeant First Class.
And 162? 162'nd Brigade.
National Guard.
This guy's military? Yeah.
Thanks for coming down, Sergeant.
I should've know something was wrong when Billy didn't report back to the unit.
Where was he headed? Retirement village in North Bay to help them evacuate.
He'd just put in 36 hours stacking sandbags at a couple of shelters.
Did he sleep? No, uh, I just ordered him to get some shut-eye when we got the North Bay call.
Downed a giant coffee and took right off.
Hey, look, Doc, I know what you think.
But there was no booze and no drugs.
We know that, Sergeant.
Billy was a straight arrow.
By the book.
That may be true, but something made him go 70 miles an hour down a side street in the middle of the day.
Question is what? All pulses are normal.
Arterial ultrasound of Jennifer's abdomen shows good flow throughout.
If you were a tiny piece of rubber, where would you hide? Oh, my God.
I'm so sorry.
WARREN: She didn't flinch.
She's unconscious.
It doesn't matter.
She should still have a pain response.
Ice cold-- she's freezing.
She's lost her distal pulse.
Maybe her artery's blocked.
No maybes.
That's got to be it.
Pulse was there 20 minutes ago when I checked.
The fragment must have dislodged and floated down into the leg.
We got to do an emergency embolectomy and get that fragment out.
ZAMBRANO: Proctor, did you get my page? No, I've got one from Dr.
Warren about to perform an embolectomy.
What's yours about? It's about Sam Seaver.
Repeat CT shows an expanding hematoma and shift.
If it keeps growing, he's going to herniate his brain.
Where's Neurosurg? In with the hemorrhagic stroke for at least three hours.
How's your brain surgery? Not being a brain surgeon? About as good as yours.
Well, it's time for us to bone up.
I'm gonna have to start a craniotomy to relieve the pressure inside his skull.
Hope to hell Neurosurg arrives soon.
And if they don't? Well, it's either us or he dies.
Well, not today, he doesn't.
Okay, so now finish by connecting the burr holes to the B-1 footplate drill.
Perfect.
Now lift out the skull fragment.
(monitor beeping) That's it.
Just lift it out.
And then, you use a scalpel to cut the dura in a semicircular flap.
It wasn't ego, by the way.
I'm sorry.
My dad.
What I said about his ego keeping him from practicing medicine here.
Suction, please.
Can't say I'd be too keen to repeat my residency.
Well, that was the excuse he'd point to, but I always knew the real reason.
He was too busy raising a six-year-old.
Our on-call Neurosurg is here.
He's scrubbing in now.
Thanks, Tuck.
Yeah, we're good here.
ZAMBRANO: Clot's out.
Pressure's relieved.
So why don't I cauterize the bleed while you brief Neurosurg? Sounds like a plan.
You were six, huh? Uh, yeah, I was six when we came over from Cuba.
It was 12 days out on the boat.
Well, which was more of a raft, really.
We were dehydrated.
My dad had heatstroke, and, uh, my mom Well, she was fighting a serious infection by the time the Coast Guard brought us all to the INS infirmary.
I was, um I was left alone in the waiting area.
I didn't see either of them for two days.
I was living off sodas and cupcakes from the vending machine.
Until my dad was well enough to get up and tell me that, um, my mother had stopped fighting.
Nice job today.
And I'm sorry.
For praising my work? (laughs) No need to apologize.
(beeping) No significant trauma, no broken ribs.
Still no lung damage.
So how does our non-drunk driver rip his aorta without any chest injury? All due respect, Doc, you've been asking that same question for the last hour.
I don't care how many hours this takes, Davis.
We're gonna go over these pre-op scans until Wait.
Wait a minute.
Wait a minute.
Go back.
Go back there.
Back where? The sagittal images-- one more time.
(sighs) You thought you could hide from me, huh? Blow that up for me.
Print that.
Follow me.
You're gonna want to hear this.
I'll call you back.
Mr.
Evans.
Oh, so it's Mr.
Evans now? It's nice.
I'm Dr.
Deleo.
You've just come out of a very serious heart surgery after your car crash.
I told you to let me die.
Well, I didn't.
But I do want to apologize.
We both do.
Apologize? For what? For things we assumed.
What do you remember about the crash? I was driving down Kendall Road on my way to pick up plywood, and then it's all black.
The next thing I know, I'm upside down in my truck.
And everyone's calling me a killer.
Mr.
Evans What happened? Did I fall asleep at the wheel? No.
You didn't.
You had an aortic dissection.
Which is a tearing in one of the major blood vessels in your heart.
Now, we thought it was caused by the crash, but I found a buildup of scar tissue that wasn't apparent during surgery.
I don't understand.
It's a preexisting condition.
One that you've had for years, like, um It's like a dormant volcano.
And unfortunately, it chose the exact wrong time to erupt.
While I was driving? Right.
So the dissection caused your heart attack, which is why you fainted at the wheel.
You don't have to just say that just because of what I said.
I'm not.
There is nothing you could have done.
(sobbing) Nice work with your very sober DUI.
Here, uh, here's his charts.
Fancy pen.
Yeah.
It was given to my father in honor of his 200th test flight at Edwards.
So a memento from father to son.
Indirectly.
After he started drinking, I picked it up at a pawn shop for 120 bucks.
Like I said, family issues.
You gave us quite a scare, Jennifer.
That tiny piece of wiper blade made its way clear down to one of the arteries in your leg before we could get it out.
My family? Sam is recovering and April has a pretty new cast.
Daniel? Daniel He Well the day is always Daniel suffered a stroke from lack of blood to the brain.
Oh, my God.
His higher brain functions seem unaffected, but he's going to have a long road ahead.
He'll have to relearn his motor skills on the right side, and some of the damage may be permanent.
But he's alive.
Very much so.
(sighs) You all are.
REED: Can you squeeze the ball for me, Daniel? Yeah, that's it.
Nice, Daniel.
Very nice.
He was also wanting to know how his parents were doing earlier.
They're doing okay.
Your mom is in what we call isolated intensive care.
So you and April won't able to see her for a few days.
And your dad-- well, he's still in surgery.
And it went very well.
He'll need a few weeks to recover, but he came through like a champ.
In the meantime, we have someone who came to see you.
Thank you.
You're welcome, April.
(screaming) (laughter) Hey, Peaches.
Peaches.
Hey.
You guys.
Careful with that.
So you never heard of Carlos Finlay? Never.
Well, not only was he the doctor who found the link between mosquitoes and yellow fever, but most importantly he was Cubano Of course.
Drinks with the original Dr.
Zambrano.
Thanks, Peaches.
Yeah, what is this whole Peaches thing? Come on, Alberto, we got to know.
Oh, no, Chris, you don't want to know.
No You see how mad my little girl gets.
I don't want any trouble here.
Oh, what the heck? Papi, go on.
Really? Knock yourself out, but just this once.
Well, my Eva was about seven, and smart and adorable.
And, believe it or not, uh, quite chubby.
(laughter) Yeah, so chubby, in fact, she once ate an entire torta De melocotones-- peach pie-- all by herself, while my back was turned.
And the poor girl was throwing up peaches all night long.
Aw.
That one's gonna stick.
Oh, yeah
That's right, idiots, keep honking, 'cause that's gonna save our butts.
It's not nice to say "idiots," Daddy.
Daddy's just tense, honey.
Daniel, please.
Not as tense as Mommy.
One hour buying wood, and another just to get out of this stupid parking lot.
It's not nice to say "stupid," either.
Would you just play with your dog, munchkin? Look, guys, we're just gonna put the boards on the front windows and we'll be on the road to Aunt Lu's in no time.
But Aunt Lu's house smells funny.
Aunt Lu's house is on the Gulf, April; that's all that Matt-- Whoa! (horn honks) What is wrong with these people? No, no, wait! Look, kid, tell your family that they're gonna have to wait in line, just like us.
Hey, look, it's Conner! Oh, my God, Sam, it is.
It's the Fryars.
So, it's the Fryars, so what? They cut us off.
We didn't let them in.
We beeped the horn.
We called them idiots.
Idiots, beep, idiots, beep, idiots, beep! April, Daniel, please stop now! Okay, look, look, I'm letting them in.
Okay, Fryars, go ahead.
By all means.
(indistinct conversations) Have a nice hurricane.
(laughing) (screaming) (screaming) (crashing) Here it comes ââ¢Âª Here it comes ââ¢Âª ââ¢Âª Here comes your 19th nervous breakdown.
ââ¢Âª Are we all staffed up for the hurricane? Yes.
And Bravo's offered to stick around for another half shift, in case we get slammed.
When I was a kid, I used to go to the beach with a kite when the weather got blustery.
First hurricane, Dr.
Proctor? "Blustery" not the right word? St.
Miriam's Hospital's closed, Dade County Medical's down to a skeleton crew.
We're the only level-one trauma center in 200 square miles.
200 square blustery miles.
The hits keep coming, people.
We got a DUI-related multi-car collision.
First two red vans are just four minutes out.
We got one penetrating abdominal injury, and one crushed chest with a severed carotid.
We need blood and lots of it.
Calling the bank as we speak.
Oh, and Dr.
Zambrano, did anyone tell you that your dad is in Trauma 2? My father? Guess that's a no.
This way Yeah.
ZAMBRANO: Papi? What happened? My Melita.
DELEO: Ooh, Melita.
I thought it was Eva.
No, it's short for melocotones.
Peaches.
Ah Ever since this time back in Cuba when she was a little girl No, no, no, not the "Peaches" story.
What happened to your hand? I was boarding up my shop and got a bit careless with the saw.
Careless to the tune of three sutures and counting.
Horizontal mattress sutures.
Which I would never use on a wound like this.
But your father was kind enough to talk me through it.
Oh Gracias, Señorita.
Papi? Hmm? You of all people know that that is not a trauma wound.
Emergency's right next door.
But why not come where I can at least see my own flesh and blood? Yeah, lighten up, Peaches.
So help me, Chris, I will stick you in the peaches with a Foley catheter.
Incoming three minutes.
Oh, Dr.
Proctor, have you had the chance to meet the original Dr.
Zambrano? PROCTOR: Uh, no.
It's a real pleasure.
Hmm So, um, you are the Englishman who took my little girl's job? (whispers): Papi! Well, that's one way of describing my rather awkward ascent.
(beep) MAN (over P.
A.
): Arriving in the ambulance bay, one minute.
Incoming, anyone? Ooh.
(chuckling) (sirens blaring) Eva, why aren't you waiting inside? I'm just getting some air.
Air going 100 miles an hour? There's nothing better.
I met your dad; he seems sweet.
Yep, he sure does.
And what does "Melita" mean? What do we got, guys? Daniel Seaver, 15-year-old male.
Crush injuries.
Six-centimeter laceration over neck with pulsatile carotid bleeding at the scene.
All right, we'll need an intubation tray and two large-bore antecubital lines.
Jennifer Seaver, 36-year-old female.
With multiple lacs and penetrating wound to the abdomen.
The car came out of nowhere.
Okay, Mrs.
Seaver, I got you-- let's go.
On my count.
One, two, three.
JENNIFER: What's happened to my family? Where is April? I didn't see my daughter in an ambulance.
Mrs.
Seaver, Jennifer, Jennifer, look at me.
I'm Dr.
Warren, and I need you to leave your oxygen in.
Is she dead? She's dead, isn't she? I'll find out what happened to your daughter as soon as I get you stable, okay? Okay, how you doing, Mrs.
Seaver? She's hypotensive but alert and awake with GCS of 465.
Okay, start with two units of O-neg, and grab me the ultrasound.
And it says here that the penetrating object was a blade.
I thought this was auto versus auto.
It is-- was.
And there's a blade, all right.
A wiper blade.
Wiper blade must have embedded when she went through the windshield.
Or else the windshield came down on her.
It seems to be resting in her spleen.
You know what? I can't tell if there's any bleeding.
Pulse ox is low on nasal oxygen, but the chest X-ray looks clear.
We need to keep an eye on her lungs.
We should stabilize the wiper blade and keep it from moving.
Scan for other injuries before we take her to O.
R.
Daniel, my son.
Where is Daniel? Daniel, can you hear me? Daniel, we're going to put a tube in you to help you breathe, okay? He's unconscious.
I'm through the cords.
Get him on the vent and let's get that blood running.
Is this the son of the embedded wiper blade? Yeah, crush injury to the chest with a severed carotid.
Where's all the blood? I don't know.
Medic said it was pumping hard at the crash site.
It's not pumping now.
Whoa.
Whoa, indeed.
Is that a sternoclavicular dislocation? PROCTOR: Ever see one before? Only in medical journals.
Probably what kept him from bleeding out at the scene.
But it could kill him now.
We've got to pop those ribs out.
Chris, we'll need towel clips.
And lots of Lidocaine; I'm on it.
ZAMBRANO'S DAD: Oh, you don't see those too often, which is a very good thing.
Sternum separated from clavicle and pushed in, compressing the boy's heart, lungs and blood vessels.
They need to pop it back out, pronto.
(alarms beeping) BP's dropping-- 55 systolic.
Tilt him up for me.
Towel clips.
I hear a DUI did this? Yeah.
See how he digs the clips directly into the skin and onto the bones? DELEO: BP's still falling.
Systolic's 32.
(grunting) Hold him down, hips and shoulders.
(grunting): Come on.
Young lady, you may not want to watch.
There might be a lot of, um blood.
BP's up to 96.
Hand me a hemostat.
Get him to I.
R.
, before he bleeds out.
Man, Proctor Cancel the hurricane.
Gracie shifted course again.
Back to a tropical storm.
Wish she'd done that before this whole family got clobbered.
Poor woman thinks her daughter April might be dead.
You hear anything? Just that red vans are on the way with three black vans at the crash site.
Three dead? Think one of them might be April? (pager beeps) We're about to find out.
Samuel Seaver, 36-year-old male with multiple contusions and a possible C-spine fracture.
BP is 196 systolic.
ZAMBRANO: Mr.
Seaver? Sam? Can you hear me? (groaning) Put him in Trauma 3, watch for any signs of posturing.
Page Neurosurge and make sure we have an intubation tray on standby.
All right, you got it.
TUCK: Please tell me that's April.
Yeah, she's the daughter.
Her mom's going to be happy to see her.
Can't get a word out of her.
Poor kid was the only one conscious while Rescue was cutting her family out of the minivan.
Oh, so she saw everything.
I'll get her hooked up with Family Services No, no, no, I'll take her.
(gently): Hi.
You want to come with me? Come on.
Got her? She's got multiple contusions and a supracondylar fracture above the right elbow, which I know doesn't fit trauma criteria, but Well, you never break up a family.
Glad to hear you say that.
She wouldn't give him up.
Dad's ready in Trauma 3.
All right.
April? This is Nurse Tuck.
He's going to get you a really cool cast for that arm, okay? Listen, I know this is scary.
We're going to do our very best to take care of you and your family, all right? Can you keep an eye on her for me? No problem, Peaches.
Dr.
Proctor? The, uh, son from the car crash-- Daniel? I.
R.
was able to patch his carotid, but they think he had a small stroke from blood loss at the scene.
Thanks for the update.
Yeah.
So, that's not your first sternoclavicular dislocation, huh? Pretty hard-core in there.
I've been up on my fair share of gurneys in my time.
I'll prepare the chart and do the procedure note for you.
I can do that.
Really? 'Cause we're just used to the residents doing all the Scut work? Yeah It's Team Trauma, isn't it? I'm part of the team.
Yeah, well, head of the team.
Yeah.
See, back in GI practice, I got pretty comfortable sitting in my office just signing forms that were slid across my desk to me.
I was pretty isolated, too-- from my patients and from the medicine.
The most challenging part of my day was deciding which of the free pens from the drug companies to use.
(elevator bell dings) I like the ones with the little multicolored clicky things.
What What are you doing? It's okay, Mr.
Seaver, I'm Dr.
Zambrano.
Jennifer My wife She's here.
Just lie still.
You lost some blood, and I had to close up that wound.
Now I'm going to assess your other injuries, okay? My kids They're all here, Sam.
May I call you Sam? Tell CT we'll be up soon.
I'll need a C-spine and a brain CT.
He's got free fluid in there.
Sam, are you experiencing any abdominal pain? Sam? He's got intra-abdominal bleeding.
Hold CT; we're going straight to O.
R.
1.
Got it.
Wiper blade's imbedded in the spleen.
Small subcapsular hematoma.
Sub what? There is bleeding around your spleen, Jennifer, but it's small and contained.
And we're going to fix it right now.
Start two grams of Cefoxitin.
April Where's my family? April's here and she's fine.
Daniel? Your son's having his neck injury repaired and I'll get updates on your husband as soon as I can.
O.
R.
's prepped and ready.
All right, Page Proctor.
Let's move her.
F-Fryars.
What's that? They were in the car in front of us.
Their son Conner-- he waved at us.
They were hit before we did.
Are they here, too? Well, no.
They're Apparently, they, uh they moved on.
"Moved on"? Where were they moved to? No A better place; they-they moved on to a better TUCK: The other family in the Ford died.
All three of them.
I'm very sorry, Mrs.
Seaver.
(elevator bell dings) Get Mrs.
Seaver up to O.
R.
2.
Dr.
Warren will be scrubbing in.
Hey, Polly, where are you going with the girl's dog? Up to Admin.
Something about "unsanitary conditions.
" Come on, cut the kid some slack, huh? Don't shoot the messenger, Tuck.
Poor girl wasn't happy about it, but you can't fight City Hall.
Do you need an assist with the father? It's nothing I can't handle.
But I will need Neurosurg to take a look at his brain scans.
I'll want to see them, too.
Oh, and, uh, speaking of fathers About that crack my dad made Referring to me as an Englishman is hardly a crack.
No.
The part about you taking my job.
It's okay.
We all have fathers.
Yeah, but I don't see yours looking over your shoulder from the bullpen.
You know, Chris referred to your dad as being "the Original Dr.
Zambrano.
" What's that about? He was a surgeon in Cuba.
One of the best.
So why didn't he get his license here? Time, money ego.
"Ego"? Try moving to a country where you don't speak the language, then go back to being a first-year resident.
I see your point.
Look, I I love my dad but he casts a long shadow.
Hard to escape the feeling that he sees my career as an extension of his.
You mean it's not? (pager beeps) More incoming? Yeah.
Can you page Dr.
C to the ambulance bay? Bill Evans, 33-year-old suspected DUI with multiple lacs, head and chest trauma.
BP 105/60, heart rate 112.
In custody of Detective King.
What's this guy drinking, gasoline? KING: That wouldn't surprise me.
More likely the fuel tank emptied out on the son of a bitch when the car flipped onto the van.
(sighs) So this is our guy, huh? Oh, yeah, the cause of it all.
I couldn't get a Breathalyzer, so you'll want to run blood alcohol and LFTs.
Oh, yeah, yeah, yeah, I'll get right on that.
Soon as I frisk him for concealed weapons.
What for? I did my job.
Okay, so let me do mine, Dale.
Okay? One, two, three.
Okay, send a CMP.
Have X-Ray get me a C-spine, chest and pelvis.
The speedometer broke in the crash.
Needle pegged at 74 miles per hour.
He T-bones a family of three in an old Ford.
Never had a chance.
Type and cross for four.
Let's do an EKG and a troponin.
Yeah, have another drink, pal, while the good doctor fixes your boo-boos.
Hey, give me a break, Dale, okay? I don't like this guy any more than you do.
Do me a favor, take the commentary to the bullpen.
Please, please, please Here's the EKG.
Sir, relax.
You've gotta be kidding me.
What? What's going on? On top of everything else, this guy's having a heart attack.
Crash cart and pacer pads.
Please.
Please Let me Let me die.
Prepped in O.
R.
3; start two units of PRBCs.
Your DUI had a heart attack? Traumatic aortic dissection, probably caused by impact with the steering column.
But if it's all the same to you, I'm going to hand his arch repair off to Bravo.
The arch repair too much for you? No, I'm good with the repair part.
It's the DUI I'm not nuts about.
I'm glad to see that your professional objectivity is still intact.
I got family issues, that's all.
And we've got three O.
R.
's running, so Enjoy your arch repair.
PROCTOR: Now clamp across the hilum.
Perfect and pull straight out.
And there's our wiper blade.
Remove your clamp.
And check for bleeding.
Field looks dry.
My first wiper blade.
Mr.
Cellio would be very proud.
Who's he? High school auto shop.
You took auto mechanics? Aced it.
In that case, you close and I'll assist.
(monitor beeping wildly) Or maybe not.
Her oxygen sats are dropping.
Blood loss from somewhere else? There's a piece missing.
A tiny piece.
Which is worse-- could've gone up the splenic vein to the lung.
Causing a pulmonary embolus.
Do you want to open up her chest? No.
So far she's stable, so get her back to CT to make sure it's there before cracking her open.
Let's get her out of here.
(beeping) How goes the big wiper blade search? I wish it was big.
The stupid thing's like the head of a pin.
Could do big damage, though.
Lungs look clear, but something caused her oxygen to drop.
We'll find it.
I know.
I just "They've moved on"? What? What I said to Jennifer when she asked about the family that died in the crash.
Oh, yeah.
Moved on, better place That's kind of abstract.
Last week, I was with a gunshot victim going over test results, which were not good: hypoxia, pancreatic rupture I remember the guy.
And out of nowhere, I just start spouting aphorisms.
"Aphorisms"? "The day is always darkest before the dawn.
" "Every cloud has a silver lining.
" That's a nice weather thing there.
"Never judge a book by its cover.
" You said that? To a patient.
Did it make sense? No! People can tell when you're shining them, Serena.
They can, huh? Trust me.
Comfort is no substitute for the truth.
(beeping) Wait a minute.
There it is.
That little speck? Our lost piece of wiper blade.
Only it's not in her lungs.
It's in her heart.
I'll page Proctor.
Let's get her back up to surgery.
Crazy drunk driver's aorta dissected without even breaking a rib or dropping a lung.
Got your man's liver function test results back.
Not my man.
Thank you.
DUI with an aortic dissection caused by the crash, plain and simple.
Not that simple.
And not a DUI.
LFTs came back negative.
Blood alcohol-- zero point zero.
What? Not a drop in him.
Detective King called him a DUI.
He was wrong.
Okay, soon as we're done here we're going to rerun his tox screen and chemistry.
Because drunk or not you were still going 70 plus down a side street.
Which makes you, what exactly? Can you get these scans to Neurosurg? The pressure's building in Mr.
Seaver's skull and we really can't wait much longer.
Thanks.
ZAMBRANO'S DAD: Stay very still, April.
Hmm.
We want to make sure the breaks in the bone don't shift.
Papi? What do you think you're doing? Melita.
Dr.
Haynes was kind enough to let me observe here.
You know we didn't have such fancy casts like this in my day, April.
Hope you let me sign it when it dries, huh? Papi? Can I talk to you for a minute? Sure, babe.
Thanks.
Listen, um, I didn't think you'd still be here.
You know, the weather's eased up, so That poor girl.
Your bureaucrats upstairs took her dog away.
Yeah, I heard.
How's her father? I just resected his injured bowel.
Did you do a gastric diversion? Duodenal injuries can be unstable.
Yes, Papi, I know that.
I wait.
No.
You are not to discuss the father's condition with anyone.
Much less his daughter.
You think I don't know that.
I only want to help.
Yeah, well, you can't help.
PapÃ, I can barely help.
The mother's about to have an embolism.
The father's bleeding from his brain.
And their son could end up disabled for the rest of his life.
This little girl could lose her entire Eva.
Oh, April.
April.
Sweetheart, come here.
I'm sorry.
I got you.
Based on the scans here, the wiper blade speck appears to be sitting next to the wall on the right atrium.
Did you see Jennifer's medical records? Cancer survivor.
Six years.
If she beat that, she can beat this.
Pericardium's open.
Okay.
So, let's incise the atrium.
Where where is it? Where did it go? It's on the CT.
It is on the CT.
Only other place it could be is her lungs, but her sats are back to normal.
A piece of rubber doesn't just up and disappear.
Didn't disappear.
It's on the move.
There's a hole between the left and right atria of her heart, which means that fragment could be Anywhere inside the 60,000 miles of vessels and capillaries inside the human body.
Still don't feel the wiper blade fragment in the coronary arteries.
Or the pulmonary veins.
What's our time? 18 minutes.
What if we don't find it? Don't wave the white flag just yet.
If the fragment gets lodged in her liver Then her intestines die.
And her kidneys Permanent dialysis.
And if it gets lodged in her brain, she'll have a stroke.
We're in a needle in a haystack situation here.
A needle in a haystack would be considerably less daunting.
ZAMBRANO'S DAD: "She was such a little girl "that one did not expect to see such a look on her small face.
" Hey, quick intermission, April, hmm? What's up, babe? Papi, I just I can't believe I said all that right in front of her.
Ah, you didn't know.
Thank you for helping calm her down.
It wasn't me.
It was old reliable.
Found her in the hospital gift shop.
The first book in English you ever read me.
I was trying to learn the language.
We both were.
ZAMBRANO: She still hasn't said anything? ZAMBRANO'S DAD: Not a word.
All alone, worrying about her family.
Remind you of anyone? You were younger than April.
Perhaps too young to even remember.
Like it was yesterday.
You had the same look.
Helpless.
Hopeless.
Gosh, we had such plans, your mother and I.
Raising our little girl here together.
Failure was not a possibility.
Papi You didn't fail.
Look, why don't you continue reading to her? I know she can use it.
TUCK: Eva? The brother, Daniel, is coming out of anesthesia.
Hey.
Go get it.
Hey.
Look who's back.
Hi, Daniel.
I'm Dr.
Zambrano, and this is Nurse Tuck.
Now, relax.
Relax, it's okay.
You have a tube in your throat to help you breathe.
You won't be able to talk.
You had a stroke from a neck injury.
So you might have a hard time holding things for awhile.
Oh, your mom? She's here.
Mom and Dad both.
And we're taking really good care of them.
Munchkin? (sighs) You mean April? Right next to her big bro.
(Zambrano chuckles) (rapid beeping) We've been searching for a half hour now.
I'm aware of that.
Would you please turn that thing off? (rapid beeping stops) The longer we're at this without finding the piece, the greater her risk of infection.
It could just as easily be in her extremities by now.
Yeah, fine, let's close her up and get her to recovery.
But I want you with her going over every inch with a flow Doppler ultrasound.
Go.
Find that piece.
I'm on it.
Can you page Cardio and tell them we need a consult on a patient? Digging for loose change again? Whatever I find, we'll go halfsies.
How's your DUI? Turns out he wasn't "I" after all.
We've rerun every test.
The guy's clean as a whistle.
Which has you searching his clothing for what exactly? I don't know.
Anything.
Got 12 bucks.
Debit card, license And a number here for SFC Burke 162.
"SFC," Sergeant First Class.
And 162? 162'nd Brigade.
National Guard.
This guy's military? Yeah.
Thanks for coming down, Sergeant.
I should've know something was wrong when Billy didn't report back to the unit.
Where was he headed? Retirement village in North Bay to help them evacuate.
He'd just put in 36 hours stacking sandbags at a couple of shelters.
Did he sleep? No, uh, I just ordered him to get some shut-eye when we got the North Bay call.
Downed a giant coffee and took right off.
Hey, look, Doc, I know what you think.
But there was no booze and no drugs.
We know that, Sergeant.
Billy was a straight arrow.
By the book.
That may be true, but something made him go 70 miles an hour down a side street in the middle of the day.
Question is what? All pulses are normal.
Arterial ultrasound of Jennifer's abdomen shows good flow throughout.
If you were a tiny piece of rubber, where would you hide? Oh, my God.
I'm so sorry.
WARREN: She didn't flinch.
She's unconscious.
It doesn't matter.
She should still have a pain response.
Ice cold-- she's freezing.
She's lost her distal pulse.
Maybe her artery's blocked.
No maybes.
That's got to be it.
Pulse was there 20 minutes ago when I checked.
The fragment must have dislodged and floated down into the leg.
We got to do an emergency embolectomy and get that fragment out.
ZAMBRANO: Proctor, did you get my page? No, I've got one from Dr.
Warren about to perform an embolectomy.
What's yours about? It's about Sam Seaver.
Repeat CT shows an expanding hematoma and shift.
If it keeps growing, he's going to herniate his brain.
Where's Neurosurg? In with the hemorrhagic stroke for at least three hours.
How's your brain surgery? Not being a brain surgeon? About as good as yours.
Well, it's time for us to bone up.
I'm gonna have to start a craniotomy to relieve the pressure inside his skull.
Hope to hell Neurosurg arrives soon.
And if they don't? Well, it's either us or he dies.
Well, not today, he doesn't.
Okay, so now finish by connecting the burr holes to the B-1 footplate drill.
Perfect.
Now lift out the skull fragment.
(monitor beeping) That's it.
Just lift it out.
And then, you use a scalpel to cut the dura in a semicircular flap.
It wasn't ego, by the way.
I'm sorry.
My dad.
What I said about his ego keeping him from practicing medicine here.
Suction, please.
Can't say I'd be too keen to repeat my residency.
Well, that was the excuse he'd point to, but I always knew the real reason.
He was too busy raising a six-year-old.
Our on-call Neurosurg is here.
He's scrubbing in now.
Thanks, Tuck.
Yeah, we're good here.
ZAMBRANO: Clot's out.
Pressure's relieved.
So why don't I cauterize the bleed while you brief Neurosurg? Sounds like a plan.
You were six, huh? Uh, yeah, I was six when we came over from Cuba.
It was 12 days out on the boat.
Well, which was more of a raft, really.
We were dehydrated.
My dad had heatstroke, and, uh, my mom Well, she was fighting a serious infection by the time the Coast Guard brought us all to the INS infirmary.
I was, um I was left alone in the waiting area.
I didn't see either of them for two days.
I was living off sodas and cupcakes from the vending machine.
Until my dad was well enough to get up and tell me that, um, my mother had stopped fighting.
Nice job today.
And I'm sorry.
For praising my work? (laughs) No need to apologize.
(beeping) No significant trauma, no broken ribs.
Still no lung damage.
So how does our non-drunk driver rip his aorta without any chest injury? All due respect, Doc, you've been asking that same question for the last hour.
I don't care how many hours this takes, Davis.
We're gonna go over these pre-op scans until Wait.
Wait a minute.
Wait a minute.
Go back.
Go back there.
Back where? The sagittal images-- one more time.
(sighs) You thought you could hide from me, huh? Blow that up for me.
Print that.
Follow me.
You're gonna want to hear this.
I'll call you back.
Mr.
Evans.
Oh, so it's Mr.
Evans now? It's nice.
I'm Dr.
Deleo.
You've just come out of a very serious heart surgery after your car crash.
I told you to let me die.
Well, I didn't.
But I do want to apologize.
We both do.
Apologize? For what? For things we assumed.
What do you remember about the crash? I was driving down Kendall Road on my way to pick up plywood, and then it's all black.
The next thing I know, I'm upside down in my truck.
And everyone's calling me a killer.
Mr.
Evans What happened? Did I fall asleep at the wheel? No.
You didn't.
You had an aortic dissection.
Which is a tearing in one of the major blood vessels in your heart.
Now, we thought it was caused by the crash, but I found a buildup of scar tissue that wasn't apparent during surgery.
I don't understand.
It's a preexisting condition.
One that you've had for years, like, um It's like a dormant volcano.
And unfortunately, it chose the exact wrong time to erupt.
While I was driving? Right.
So the dissection caused your heart attack, which is why you fainted at the wheel.
You don't have to just say that just because of what I said.
I'm not.
There is nothing you could have done.
(sobbing) Nice work with your very sober DUI.
Here, uh, here's his charts.
Fancy pen.
Yeah.
It was given to my father in honor of his 200th test flight at Edwards.
So a memento from father to son.
Indirectly.
After he started drinking, I picked it up at a pawn shop for 120 bucks.
Like I said, family issues.
You gave us quite a scare, Jennifer.
That tiny piece of wiper blade made its way clear down to one of the arteries in your leg before we could get it out.
My family? Sam is recovering and April has a pretty new cast.
Daniel? Daniel He Well the day is always Daniel suffered a stroke from lack of blood to the brain.
Oh, my God.
His higher brain functions seem unaffected, but he's going to have a long road ahead.
He'll have to relearn his motor skills on the right side, and some of the damage may be permanent.
But he's alive.
Very much so.
(sighs) You all are.
REED: Can you squeeze the ball for me, Daniel? Yeah, that's it.
Nice, Daniel.
Very nice.
He was also wanting to know how his parents were doing earlier.
They're doing okay.
Your mom is in what we call isolated intensive care.
So you and April won't able to see her for a few days.
And your dad-- well, he's still in surgery.
And it went very well.
He'll need a few weeks to recover, but he came through like a champ.
In the meantime, we have someone who came to see you.
Thank you.
You're welcome, April.
(screaming) (laughter) Hey, Peaches.
Peaches.
Hey.
You guys.
Careful with that.
So you never heard of Carlos Finlay? Never.
Well, not only was he the doctor who found the link between mosquitoes and yellow fever, but most importantly he was Cubano Of course.
Drinks with the original Dr.
Zambrano.
Thanks, Peaches.
Yeah, what is this whole Peaches thing? Come on, Alberto, we got to know.
Oh, no, Chris, you don't want to know.
No You see how mad my little girl gets.
I don't want any trouble here.
Oh, what the heck? Papi, go on.
Really? Knock yourself out, but just this once.
Well, my Eva was about seven, and smart and adorable.
And, believe it or not, uh, quite chubby.
(laughter) Yeah, so chubby, in fact, she once ate an entire torta De melocotones-- peach pie-- all by herself, while my back was turned.
And the poor girl was throwing up peaches all night long.
Aw.
That one's gonna stick.
Oh, yeah