Miami Medical (2010) s01e12 Episode Script

Come on, Baxter! Gotta set this graft before the joint bows.
- Where's my cut man? - Coming.
Some idiot put the Permatex in with the Teflon tape.
Alright, soldering iron, poly tubing, and the missing Permatex.
Which I'm pretty sure Joe was supposed to put away last night.
You hear that, Colin? Baxter's bringing the chin music.
Oh, being that I got three years on you, it ain't chin music.
- Ovaries, Joe, the new balls.
- Joe, you wanna grab the I-beam? - Yeah.
- Good.
Now, we gonna do this right.
Not like these shoddy prefab monstruosities, built by people who don't give a damn.
Okay, give me the heat.
All right.
Now, that's a joint that'll outlive your grandchildren's grandchildren.
All right, now, let's check the supports.
It's our job to "Keep the people safe.
" We've seen the show before, Colin.
What was that? Guys, come on, let's go! Everybody out! Get out! Everybody out of the building! Stop what you're doing and get out! Come on, come on, come on, come on, let's go! Get down! It's a sinkhole! Hey.
I finished the paperwork on our lumbar GSW.
I know you like to do your own charting, but long shift, so I figured I'd lighten the load of it.
Taquito? What do you want, Chris? Just wondering when you're gonna get around to my quarterly evaluation.
Ah.
It's just, you've done Zambrano's and Warren's.
I thought about going in descending order of height, but then I decided on reverse alphabetical order, which makes you next.
Great.
So I'm free now.
You know, if you want to chat Chris, we've got half an hour left of a 36-hour shift.
You're kidding, right? Yeah, yeah, I got it.
Hey, what are you pressing him about? He'll get to it when he gets to it.
Look, clearly he likes you.
You know, he's taken Serena under his wing.
But me-- I have no idea exactly where I stand with Proctor.
You hear what just happened with Bravo? About Ronson being put in charge.
What happened with Anne? I thought she was next in line.
Yeah, like that makes a difference.
Two percent.
The national percentage of female trauma surgeons.
Enough to drive a lesser woman straight into pink medicine.
Pink medicine? Obstetrics.
It's a good thing we don't scare easily.
Case files logged and ready for Bravo Team handoff.
Traumas 2 and 3 are cleaned and restocked.
We got a sinkhole in the financial district caused by a water main crack.
Multiple incoming, six minutes out.
Which means They're ours.
Colin Williams, 42 years old.
Multiple lacs and contusions, abdominal trauma, GCS 15.
Ground just opened up and the whole structure fell in on us.
Lucky for you, Kleebus here runs the best door-to-door service in Miami.
How many more are we getting? So far only two to Trauma, but three DOA at the scene.
What do we have here? We have Colin.
All right, Colin.
Are you in charge? Mm-hmm.
This is Dr.
Proctor, our chief, so you're in good hands.
ABCs are good.
BP's 90/50.
But he's tachy and hypotensive from blood loss.
Let's hang two units of O-neg on the rapid infuser.
Pupils are both equal and reactive.
No head trauma.
Need a suture tray.
Colin, how are you feeling? What's your pain level on a scale from one to 10? Fifteen.
That's the number of my guys in that hole.
Okay, well, as of about 30 seconds ago, you are my guy.
I have to stop your bleeding and see about the damage to your abdomen.
So don't you just lie back and let Dr.
Deleo and me check you out.
Let's get the latest copy of the emergency status report for my friend Colin here and find out how his guys are doing.
The pain level is about a seven.
Okay, let's see if we can cut that in half.
Megan Baxter, 32 years old, BP's 70/30, GCS in the field 3-4-3.
Fell 20 feet in the sinkhole.
Hey, that Baxter out there? Shattered right humerus, multiple rib fractures.
Baxter?! Where are you feeling pain? In my chest.
We'll get you some pain meds, okay, Meg? Breath sounds are good; She's moving air bilaterally.
Your vitals are stable.
You're getting air in both lungs.
Hopefully it's just that her chest wall is bruised.
Eva, flail chest.
What? Baxter! Damn it.
The abdominal lacs have opened up again.
You okay, Baxter? You gotta stop moving, okay? Colin.
I can get her calm.
Open the doors.
I'll re-suture.
Chris, you have a look inside.
Yeah, I'm already on it.
Baxter! Colin? Let them help you, Meg.
What happened to everybody?! Firefighters are getting everybody out.
I saw Toby and Alex in an ambulance.
What about Joe?! Let me worry about that.
Let them take care of you, okay? Oh, God! Come on, Baxter, let the docs do their job.
You hear me?! Okay.
Okay.
I'm gonna let them take care of me.
Okay, all right.
Now, Meg, you have a flail chest.
You broke several of your ribs, and they've separated from your chest wall.
What does that mean? Well, it means you need X rays, and we have to get you into an O.
R.
Will you, uh, set up for the films? I'm gonna page Dr.
Kaye for a consult.
Great, Angry Ortho.
Angry who? Don't worry, Meg.
He's an excellent doctor.
No free fluid in the abdomen; Organs look good.
There's some tenderness in his belly; his pain's increasing.
No rigidity.
There's significant focal tenderness.
Colin, we're gonna have to get you to a C to determine the cause of your pain.
As promised, here's the status sheet from the accident scene.
Thanks.
It lists where all your guys have been taken.
Your hands are shaking.
Is that something new? No, no, no, no, it's a family thing.
My-my dad, my dad's hands shook, so did my granddad's.
Wait, wait, th-there's only 14 names here.
Uh, where's Joe? Joe Halcro, he's not on here.
Where's my walkie? Is it there, Chris? Yeah, here it is.
Hello, anybody there? Joe? Joe, you there? Help, help me That's him, that's Joe.
Joe, Mr.
Halcro, where are you? Make way for the rescue workers.
And make way for the EMS.
They'll get you guys out of there Take him to CT and page us when he's ready.
Firefighters have located the missing guy.
Who, Joe? Mm-hmm.
He's 20 feet down with his leg caught under a girder.
So what? I mean, do they use the Jaws of Life to get him out? No, the ground's not stable enough to get equipment down there to lift the girder off.
They've asked for a trauma surgeon to come and amputate before he bleeds out.
Well, I can go.
You've been on for 36 hours straight.
I had Search and Rescue training a year ago, I'm telling you, I'm your guy.
It's not our case.
No, not technically.
Not in any way.
This guy hasn't even been admitted yet.
Bravo are about to come on call.
But really, I can, I can This is not your job, Chris.
Ah, the flail chest.
Multiple breaks in several adjacent ribs, causing a segment of the chest wall to move independently.
Yes, Dr.
Kaye, they taught me the definition in med school.
Where'd you get your degree, Dr.
Warren? University of Chicago.
A nice, Midwestern school.
You went to Yale, right? Harvard.
Nice Eastern school.
Look, we've got Meg stable, but we need a specialist.
And as that specialist, I'm very aware of that.
One medical victory does not make you the head of Orthopedics.
We're gonna get you into surgery to stabilize your ribs and arm, and if all goes well, you should be in an ICU bed in a few hours.
And the surgery's gonna be done by the Angry Ortho? Dr.
Kaye.
Mm.
As I said before, great surgeon, just a bit lacking in bedside manner.
This will help keep you hydrated.
Bet there are not a lot of women who do what you do, huh? Trauma? No.
No, I, uh, I have Dr.
Warren as a colleague now, but when I came to MT1, it was me and 15 dudes.
When I first started with Biscayne Steel, they used to call me "Flash," as in Flashdance.
All the guys-- they They see you as a potential on-the-job date.
Or the sister they need to protect from potential on-the-job dates.
Mm.
You open up for me? Hmm.
Your airway's inflamed.
Is that a problem? It shouldn't be.
Your lungs were fine in the X ray, but we should still keep an eye on it just in case.
Yeah, but I want you to keep an eye on it.
I'm not trusting anybody whose first name is Angry.
Okay.
Meg's airway's inflamed, and her sats are trending down.
No lung trauma on the X ray? And her heart looked normal, too.
Maybe she inhaled something.
Anyone else from the sinkhole having the same problems? I'll look into it while you scrub in on the surgery with Dr.
Kaye.
Unstable respiratory status means one of us has to be there.
And you two make such a cute couple.
Two hours of verbal abuse from Angry Ortho.
I almost envy Meg.
She gets to be unconscious.
Just think of Kaye as a crazy uncle you have to sit next to at Thanksgiving dinner.
Come on, suck it up.
Fine, but you get Uncle Angry for Christmas.
There was too much artifact on your scan, for a clear read, Colin, but I'm concerned about your aorta.
My heart.
No, your abdominal aorta.
It's the biggest artery in your belly.
It's enlarged.
So what now? We're going to give you an angiogram.
It's more precise.
Pain's really getting worse.
Can you top up the morphine? Dr.
Zambrano's patient has an inflamed airway.
She asked to check if your patient did, as well.
Okay, can you take a look? I want a blood sample for a full chem panel.
Sure, and just so you know, Dr.
C has arrived on-site.
Right.
Wait.
On-site? Where? All right, EMTs are out of the sinkhole.
We did a primary survey on the victim, and now we're ready for the trauma surgeon.
How long until Deleo's ready? We're fitting him with the harness.
Should be less than five.
Whole area's unstable.
So the plan is, you go in, amputate the leg, we bring you both out as fast as we can.
How's he doing down there? Airway and breathing are good, but he's losing a lot of blood.
You ready, Doc? Yeah, you bet.
Right over here.
Anybody down there? Can you hear me? I'm down here.
I'm coming.
Okay.
All right, watch your eyes.
Okay.
You must be Joe, huh? You must be the guy they sent down to chop off my leg.
Eva? Did you approve Chris to go on- site to do the leg amputation? What? No.
Why would I do that? That was my reaction.
What was he thinking? I don't know.
Uh, just to let you know, the redness inside Meg Baxter's throat is isolated.
Colin isn't showing any similar symptoms.
Wait.
Chris is in the sinkhole? I thought Bravo was gonna send someone.
So did I.
I'm going to, uh, get an IV started.
Gonna fill you up with blood and antibiotics.
Once this is into your system, it's gonna help stave off any infection.
Can you make a fist for me? Great.
Now, this is gonna sting a little bit.
Joe, you still with me? Huh? All right, now we start to prep your leg.
Oh, man.
It's real bad, right? It's nothing we can't deal with.
Look out.
Look out.
Look out! Whew.
How'd you get the short straw? Volunteered.
You got some kind of a death wish? More of a savior complex.
If you employ the mesh to repair the chest wall, you'll improves stability and speed recovery, which hopefully, they taught you in that nice Midwestern medical school.
You don't like me, do you? How does my liking or not liking you affect the Earth's rotation? It doesn't.
When I was a resident, I had no idea how my superiors felt about me.
My attending didn't know my name.
I was the tall, awkward one, which was his way of telling me apart from the redheaded one and the one destined to lose his medical license.
It's just impersonal.
As it should be, Dr.
Warren.
Caring is a construct of an age obsessed with feelings.
Feelings don't save lives, don't make people better.
Feelings stand in the way of the simple, objective diagnosis of a patient in crisis Dr.
Kaye? You okay? I'm fine.
I just need He's got no pulse.
I need paddles! Someone monitor the patient for me.
Paddles ready? Come on, help me get this up.
Clear! Pulse is back.
Dr.
Kaye? What happened? He collapsed? What's his rhythm? Just got him back in sinus.
He finished repairing Meg's chest wall, and then, bam, down for the count-- cardiac arrest.
I swear it wasn't my fault.
I only had two Maybe three homicidal thoughts toward him all day.
I'm sure this had more to do with 30 years of plaque buildup than your negative vibes.
I guess, if you want to get technical.
Well, they're setting up a new O.
R.
for Meg, and another ortho's on his way.
Could someone page a lift team to have them take Dr.
Kaye up to Cardio? I'm gonna stay with Meg, okay? Honestly, I don't think I've ever seen him this quiet.
Joe's sats are improving, BP's up, and I've started him on morphine.
We need you out of there.
We'll be good to go in ten.
I'm preparing for the amputation now.
Okay.
How you doing? A little less lightheaded? Yeah.
Now I'm fully aware I'm in a hole with a guy who's gonna cut off my freaking leg.
All right, this little sucker is gonna keep track of your blood pressure.
It's, uh, 78.
Is that okay? You stay above 50, and we'll be great.
A little Betadine to disinfect the site.
I'm gonna make a small incision in your leg, start tying off the arteries.
The morphine should dull the pain, but, uh You might not want to watch.
"Might," he says.
Hey, Joe, do you mind if we, uh, talk about something? 'Cause I I work better with a little chatter.
Yeah, whatever you need.
You got family? Not really.
I got a Got a sister in Arizona.
Yeah? But we don't talk much since she got married.
Oh.
My parents are both dead.
Oh.
Sorry to hear that.
How about you? Uh Got a father.
He's alive.
Not sure that he remembers that I am.
Yeah but, uh, you're a doctor.
He's proud of that, right? Just try and hold still.
The company guys are like family, you know? Yeah? Yeah.
We, um, always do holidays.
Yeah? I spent Easter with my boss Colin, Meg, and this idiot plumber named Chuck that she was dating at the time.
See, I, uh I can't imagine having Easter dinner or Any dinner with my boss.
Why? He an ass? No.
Not at all.
Oh, I'm stuck.
Hey, Rescue, can I get another foot lead on the rope so I can move around down here? Yeah, you got it.
Yeah, see, I-I just can't imagine this guy-- Proctor is his name-- I can't imagine him with a stove or a A dining room table.
It's like he walks out the door, he ceases to exist.
I got to meet this guy.
Well, that's the plan, buddy.
All right.
Joe? Yeah? You okay? Yeah.
Yeah, I think I'm still numb, so that's good.
What about you? I'm fine.
No.
Your arm.
You got hit.
It's my wrist.
I'm fine.
I'm fine.
All right, Colin, we're going to inject the dye now.
It'll feel a little warm.
How does this work? Well, the dye lets us see inside your blood vessels, so we can check for any damage or blockages.
It'll help us find the source of your pain.
My guy, Joe-- he still down in that hole? With my guy, Dr.
Deleo.
How's it going down there? I'm optimistic.
Doc I drink my coffee black.
I shoot tequila-- no lime, no salt, no chaser.
There have been complications.
I've known Joe since he was 19.
Practically taught him how to shave.
Triple A, Colin.
Abdominal aortic aneurysm.
Looks like a big bump.
Well, it is.
It's a blood vessel.
It's damaged, and it's ballooning from the trauma.
The bigger it gets, the more pain you feel.
Schedule an O.
R.
for me.
I wish I was the one down there.
I know what you mean.
We gotta bring you up, Doc.
You got two minutes.
Here we go.
My replacement doc up to speed? He's not gonna have time for a survey.
So, if he's got any questions, now's the time.
The ground's too unstable.
Once you're out, not sure when it'll be safe to get another doc back in.
I'm gonna stop this bleeding, all right? I'm gonna get you out of here.
You're gonna recover.
I don't think so.
Well, I know so.
You're gonna run again.
Gonna get you a kick-ass prosthetic.
You can ski, you're gonna run.
You're gonna do whatever you used to do before.
That's if I did anything before.
Didn't go to college and didn't get married.
I've never even been skiing.
Hell, I'm 29 years old, and I've never even seen snow.
What? That's that's 64.
That's That's not so good.
Joe.
That's just not good.
Dr.
Deleo? Joe! Joe! Dr.
Deleo, we can't wait any longer.
We're pulling you up.
No! Hey! No! No! Do you hear me? Stop! Stop! Dr.
Deleo, come in.
Dr.
Deleo, are you there? Joe? What happened down there? Stay with me.
What are you doing? I'm getting you out of here.
You came through surgery well.
You should be back at work after rehab.
How long will that be? Well, if all goes well, I say, uh, eight to 12 weeks.
Is there any way to speed that up? I got three guys wanting in on my spot.
Doesn't your union protect you? Well, they say that we're all equal, but Can you open up? The swelling in your throat's getting worse.
I need a sample from your lungs to see what's causing it.
So, that means more surgery? No, no, it's called a BAL.
It's a bronchoalveolar lavage.
We put a tube down your throat, look around, and take a wash from the inside of your lungs.
That sounds painful.
It isn't.
Hey, can I get an intubation tray? An-And someone page Dr.
Warren! What are you doing? The debris's ripped open your abdomen.
I'm not sure how deeply you've been cut or if any major organs have been hit, but I'm trying to pack the wound as best I can, and I'm gonna try and stitch it up.
No.
The rope.
Why did you stay? Why did you volunteer? Like I said, you know, "savior complex.
" I don't know.
I guess I just felt like I needed to.
Joe, you okay? We're gonna die down here.
Hey.
Hey, Doc, what you looking for down there? Now that the debris has shifted, I think I might be able to get your leg out.
But my wrist, it's a mess.
I'm gonna need two hands to get us out of here.
So, now we're gonna make a splint for my wrist.
We're gonna? I can't do anything.
No, hey, you can.
No, just too weak.
Hey.
When I was a kid, we used to go visit my aunt in Atlanta.
What? One day I woke up early.
And I don't know, I was like-like seven or something.
I wake up, I go outside.
And all over the ground, there's this-- there's this white stuff.
Snow.
In Atlanta.
I mean, it's a complete freak of nature.
I walk outside, and it is so quiet.
There's no noise.
There's no yelling.
It's like it's a different planet.
I promise you-- you help me with my wrist, I promise you, I will get us out of here.
And I will get you snow.
Yeah? Okay.
That's what I'm talking about.
Sats are still dropping.
Intubation's not helping.
Think an infection's hurting her lung function? Well, we're gonna find out.
We're in.
What've we got? Tissue looks swollen, but I don't see any areas of infection.
Hopefully the lung washing will tell us what's causing the inflammation.
Oh, uh, Cardio called.
Kaye's back in ICU.
Yeah, he had an angioplasty, they put in four stents.
He's got no ICE contact.
Doctor with no "In Case of Emergency"? Three ex-wives, 25 years on staff, and he's got no one.
Hmm.
I guess when you're that angry Or that's why you're that angry.
There's a reason they put rebar in buildings.
Solid stuff.
There's just nothing around here the right size to splint my wrist.
What about my wrench? That's perfect.
It's perfect.
All right.
Oh, you take that.
I want you to tape it up, all right? I can't move.
Like this? Yeah.
Yeah! Nice and tight.
Gotta play it cool.
Not let it know how much you want it.
I want a cookie, not a boyfriend.
Same philosophy.
I can't stop thinking about Chris either.
Um Meg's lavage results came back.
No infection in her lungs.
No autoimmune cause? No injury from the trauma.
Mm-mmm.
But her lungs keep getting worse.
Proctor's patient, the foreman, is he out of surgery? Yeah, they caught the Triple A before it ruptured.
All right, I'm gonna see if he has any more medical history on Meg.
Meg's healthy as a horse.
She never missed a day of work.
Hell of a fabricator, too.
Huh.
She's got a real eye for cutting pipe.
Has she had any recent colds or, uh, muscle weakness? Yeah, she's tired sometimes, but she's been training for a mini-Iron Man.
Does she take any supplements? No.
She-she doesn't even drink coffee.
She tried to get us all into herbal tea last year.
That was a joke.
My wife and I, we never had any kids.
So, the guys on my crew, they're-- five days out of seven.
It adds up.
Yeah.
Yeah, definitely.
So, what do you know? About Meg Baxter? Nothing more than I did five minutes ago.
What do you know about Chris? What about Chris? Why did he risk his life to go down there? Why did he go down that sinkhole? I-- Chris plays blues guitar, roots for the Marlins and has an irrational hatred of salmon.
His, uh-- his dad's a drunk, who considers him holier than thou for having gone to med school.
Guy thinks he works in a clinic, handing out prescriptions.
I also know that it's easy to substitute the approval of a boss for an absentee father.
How's he doing? Resting comfortably.
We're missing something with Meg.
Maybe Maybe something related to her job as a steel worker.
None of her coworkers are having the same breathing issues.
Yeah, but they all do different jobs using different equipment.
She's a fabricator, right? Maybe she was using a blowtorch when the building collapsed? And she fell near some pipes.
Toxic gas exposure.
Heat up PVC, you get chlorine gas.
That would explain the swelling and irritation to her airway.
Okay, let's start her on steroids and albuterol.
Now that your leg's free, I'm just gonna finish packing your abdomen, and we're good to go.
That should do it.
30 more seconds.
Okay.
Okay.
Save me some.
Okay.
Joe? Joe! Joe? My God.
Hey! Hey! We're losing him! You got to get him out now! How are you feeling? Oh, tired, but no more pain.
Well, we've fixed the aneurysm with a graft.
Should be as good as new.
And your recovery will take a few weeks.
But listen I've just got the results of your blood work back, and, um, I think I've discovered why you have hand tremors.
Well, if it's Parkinson's, I don't want to hear.
That's what my dad had.
Manganese poisoning.
Is that what Meg has? No.
No.
This is from years and years of inhaling welding fumes.
Now, the only way to stop the progression The only way is to Quit the welding.
Quit? My-my family's been in the union for three generations.
Then your father probably didn't have Parkinson's, either.
Doctor, we just got a phone call from Emergency Services about Dr.
C and the man in the sinkhole.
BP's 47.
His pulse is thready.
Let's get two more units now and an Ambu bag.
He's got a deep abdominal lac actively hemorrhaging and a crush injury to his tibia with massive vascular damage.
Let's get someone to look at your wrist.
Screw my wrist.
Let's get him in the ambulance, get the blood in him before he bleeds out.
Systolic dropped to 62.
He's already prepped for the leg amputation.
Let's get him to an O.
R.
No, no, no way.
He'll code in the elevator.
Let's get him into Trauma 2.
Get two central lines in for a blood transfusion.
You look like crap.
I want four units on the rapid infuser.
We got an O.
R.
ready? O.
R.
3 is ready.
Damn, you look like crap.
We covered that already.
Systolic is down to 43.
I'm in.
Let's get a crash cart standing by.
My line is ready to go.
Start the blood.
You packed the abdomen and prepped for amputation? Yeah.
You packed it really clean.
Pretty impressive for a guy operating in a hole.
Oh, you know, mad skills.
Can I get a set of gloves? You get a splint for your arm.
Yeah, and get a shower.
Oh, so, I disappear for six hours, and all off a sudden, I got to start taking lip from the resident.
You choose to become a solo act, that's what you deserve.
You look like crap.
It's good to be home.
Pressure's starting to come up.
Hmm.
But the abdomen is still hemorrhaging.
Uh, Eva, can you go ahead and scrub in for surgery? Serena and I will stabilize.
Chris, go get your arm attended to.
Then come and see me.
So, uh, Joe's heading into surgery.
And? It's touch and go.
We're waiting to hear.
Have you decided what you're going to do? About my job? About the manganese poisoning that comes from your job.
Twice a year, I take a few days, drive down to the Everglades.
I got a cousin down there.
We like to fish.
And every time I cross that bridge, I look back at the city, see those skyscrapers rising above the water.
And I think to myself, I did that.
I helped make all those buildings possible.
If I came to you tomorrow and told you you couldn't do what you do anymore I'd think long and hard.
Yeah.
That's what I'm doing.
What's that for? It's for you.
I'm allergic to Mylar.
That's a joke, Dr.
Warren.
You play cards? A little.
Used to have this uncle.
We'd play gin rummy, penny a point.
He let you win? Not even when I was six.
Used to drive me nuts.
But as I got older, became a much better card player.
I bet you did.
So, I was thinking, since you're gonna be here for a while, maybe we could get a game going? Dime a point.
Is she all right? My patient? Meg Baxter? Yeah.
Her arm and ribs are healing nicely.
You did good work.
Considering I almost died.
But you didn't.
Thanks to you.
Oh.
Defibrillator deserves most of the credit, but yeah, I helped.
University of Chicago isn't so bad.
Snow.
It's sodium polyacrylate to be exact, but the experience is not all that different.
Here you go.
How's your wrist? Oh, it's fine.
Uh, your wound looks good, the labs show your blood count's almost back to normal.
And a rehab specialist will swing by later, he'll talk to you about prosthetics and, uh, and then we'll get you out on the slopes.
Hey, um Thanks.
You wanted to see me? Yeah.
Chris, don't ever do that again, 'cause I nearly lost a team member today.
I nearly lost a friend.
So, we're friends, huh? So then that means we could have dinner sometime? At your place? In your kitchen? Hey, you do have a kitchen, right? Weird.