Transplant (2020) s02e01 Episode Script
Guardrail
Look out!
You have a hemorrhaging hematoma.
I've specialized as a trauma surgeon and emergency medical doctor in Syria.
We have met before, of course, I interviewed you and then hired you.
I think we need to do it again.
I know I screwed up.
Taking that job without telling you was You are almost in your fourth year, June.
You should consider applying for the Chief Resident position.
All could hear was your voice in my head.
- Telling you what? - That I'm focusing on all the wrong things.
- (GROANING) - Sir! He collapsed and there's not much pulse.
- Ischemic stroke? - Or hemorrhagic.
Charging! I knew he still had symptoms.
Oh, Bash.
Bashir.
Rania! (WIND WHISTLING) Bashir.
(GENTLE MUSIC) Rania.
You were dead.
Everyone thought so.
Rania was always brutally honest with me.
Amira How long have you known we were here? Since you came.
Bash.
Bash, I know you're already clocked-out but we need hands.
Multi-car MVC, they're about to call it! They call you Bash? (LAUGHS) Did you let them? - It's growing on me.
- Go be a doctor.
(GENTLE MUSIC) (SIRENS WAILING) You said this place would swallow me whole if I let it.
And then you went and had a stroke which, let's face it, is a pretty extreme way to make your point.
(SIGHING) (IMITATES BISHOP): "The past is the past, Doctor Leblanc.
What matters now is how you respond.
" Mags.
Code Orange.
All available personnel.
- Mags! - Hey! Do you know what's going on? Just that they're calling everyone.
- Has he said anything yet? - No and the first few hours are critical.
Hopefully he wakes again soon.
- It's Bishop.
He will.
- Yeah.
Also haven't you been working two days straight? Hum.
Says the girl who's about to double her workload by throwing in for Chief Surgical Resident.
Okay, look, I became a surgeon because I prefer my patients unconscious.
I'm not sure I should be managing other people.
Wait! So you're not gonna try because you're afraid to fail? I'm not afraid, Mags, okay I just know what my skills are - and what they aren't.
- Mm-hmm.
Notify the blood bank, prepare for MTP.
- Where do you want Mr.
Kline? - Hallway for now.
We need to make sure all lower-acuity beds are cleared.
Copy that! See if you can put her on three.
Rhoda? - Who's in two? - Migraine, DHE.
Resolving.
Okay, put him somewhere else.
Same with the ankle sprain.
Any idea what we're dealing with? I can call ahead to OR.
All I know is a bus went through a guardrail - on the Bayview extension.
- That's not far from here.
- I can go to the site for triage.
- Good, good.
There's a trauma team en route from St.
Jacobs, Mags - I'm in.
- Update us when you get there.
We run this like he taught us.
(SIRENS WAILING) (DRAMATIC MUSIC) Sorry.
Ahem.
So what's going to happen now? With Doctor Bishop out? Well, the board appoints an Acting Chief until they know his status.
If they're smart, it's Atwater.
If they're stupid Everything changes.
(SUSPENSEFUL MUSIC) (TIRES SCREECHING) (INDISTINCT RADIO CHATTER) Oh, my God.
(INDISTINCT CHATTER) (CRYING, SCREAMING) (BASHIR): Let's assess who's injured then make a plan! Triage everyone coming out of the bus.
Priority on the quiet ones.
If they're crying, they're breathing.
Help's here, guys.
Help's here.
Come on! Emily! Emily! She's not moving, she needs help! Who's not moving? Emily and the other kids in there who can't get out! - Are you the bus driver? - Yeah.
I don't know what happened.
I think I hit black ice or Johnny? She's got a head wound.
Got it! Here, come with me.
If you can crawl to the window, the firefighters will help you! - Are you okay? - Yeah, I'm okay.
Emily! (COUGHING) (PANTING) - What's your name? - Lucas.
It's going to be okay, Lucas.
Where does it hurt most? - (COUGHS) - My neck, real bad.
Where are you coming back from, Lucas? Millwood Arts Camp.
It was winter overnight this weekend, for the counsellors in training.
Any pain besides your neck? My hands kinda tingle.
Squeeze my fingers? Okay.
Good job.
Try to stay very still, okay? - What's his status? - Possible fractured vertebra.
We won't know how bad until we image.
Get him on a spinal board, try to keep him still.
If he decompensates, come and find me.
Okay.
Don't move, everything's gonna be okay.
Who needs help? If you can't speak, raise your hand! Is your name Emily? (COUGHING, GURGLING) Are you okay? Can you get out? - Can you get out? - Mags! She's got a projectile in her neck, right next to her jugular.
We can't move her and we can't intubate around it.
It has to come out.
It's too risky.
We need to protect her airway.
Look, there's no point if she bleeds out.
Hang in there, kiddo.
Even if you remove it cleanly, she's hemorrhaging.
How can you suture a wound that big here? I don't.
Get me the foley cath! I'll remove the projectile and you'll stem the bleeding with that.
- How? - I'll talk you through it but it has to be now.
There's no way I'm leaving her like this.
Morphine, forceps, scalpel.
(DISTANT SCREAMING) (PANTING) Okay, Emily, I'm going to remove the obstruction from your neck to stop the bleeding.
You're gonna feel a sharp pinch and some warm liquid, okay? (SUSPENSEFUL MUSIC) When the debris comes out, the cath goes in - and then inflate with saline.
- How much? Until you feel resistance.
Trust your instinct, okay? - You're ready? - Yeah! Okay.
Okay, go! - There! - Okay.
Okay, good.
Good.
(PANTING) Emily? Can you hear me? Emily? Emily? Open your eyes if you can hear me.
Emily? (GASPING) Okay.
Stay with me, Emily.
(THEME MUSIC) (WHISPERING): Wow, out like a light.
- Should we move them? - No, no.
Just uh just leave them a bit longer.
(PHONE VIBRATING) (EXHALES) You have to go.
I'm sorry! (HUBBUB) - Alright! - Mags! Yeah? Lizzie can't move her leg.
Hey, Lizzie! I'm Doctor Leblanc.
How about your toes.
Can you wiggle them? (MUMBLING) LOC's low.
Knee's dislocated.
Leg has no pulse.
We're gonna have to reduce or she could lose it.
My bracelet, I need to find it.
How about we add this one to your collection for now, okay? Lizzie, we're gonna have to put your knee back into place.
It's gonna hurt but the worst part's over fast.
Okay? You're ready? On three, two, one.
(BONE CRACKING, SCREAMING) (PANTING) You're doing great Emily, I'm not going to leave your side.
- Emily? - Madam, please.
- Let me ride with her! - It's fine, officer, she needs medical attention anyway.
(PANTS) (SIRENS BLARING) We'll be there soon, okay? What happens now? We bought some time, but she lost a lot of blood.
It's okay, M&M, I've got you.
Hmm? I've got you.
I've got you.
Why do I feel like you do more than drive the bus? Hmm I judge talent shows, and paint theatre backdrops.
The kids are all so creative, you know? Her mom owns the camp so, I've watched Em grow up.
All of them, really.
How long have you worked there? Hmm, seven years.
It's near Midland, where I'm from so, not much to see.
I haven't seen anything in Canada outside of Toronto, so - (PANTING) - Hey! Hey! It's okay.
I got one for you.
Why should you never trust atoms? No, no, no, don't.
Don't tell me now.
Tell me later, when you're better, okay? Ooh.
Are you okay? Hum, yeah I'm okay, I'm just, uh dizzy.
You might have a concussion, we'll check you out too - once we get there.
- Mm-hmm.
(MACHINE BEEPING) What's wrong? What's happening? What is it? (SOBBING) Hey, it's okay I'm right here.
(INDISTINCT CHATTER) Lucas? Oh, my God.
Lucas West.
Impact trauma with potential spinal complications.
Alright! I've gotta get him to CT! Emily Parker, projectile removed from her neck to address massive blood loss.
BP's 90 over 60, rate's 90, O2's 80 and dropping.
- Trauma one! - Doctor Hamed, what's happening? Arnold? She might have a concussion.
Oh.
Ma'am, why don't you come with me? Female, impact trauma, dislocated knee reduced on-site.
Rate's stable, BP's 110 over 80.
Come on.
It's gonna be fine, okay? I need one more large bore IV.
Activate MTP.
One gram TXA.
Blood stats are falling fast! One unit O neg, level one! We need to maintain her airway but I'll tell you right now, it will be difficult to visualize her cords.
Get RT on standby.
I will intubate.
- I can handle that, Wendy.
- Hello, Mark.
Rough night here, huh? - Slow up in the ICU? - Not really.
Tube.
(HUMMING SOFTLY) And connecting the vent.
Blood's helping, MAP's at 65.
She's stabilizing O2's coming up.
I'll call vascular, she'll need the OR.
She's gonna need a lot more than that.
Who rigged up the tamponade balloon? - I did.
- Protocol would be to leave the shrapnel in place until she got into surgery.
Protocol would have killed her.
Well, let's just agree then, it was a ballsy move that may have saved her life.
But, still damaged her airway when you blew up the balloon and that's not gonna be good.
What is your name, doctor? Bashir Hamed.
Why don't you get her cleaned up, Dr Bashir Hamed, and we'll let the surgeons tell us what the damage is.
- I'm sorry but who are you? - Mark Novak.
I'm the Acting Chief of this emergency department.
Lucas started gasping for air on the way back from CT.
- Can I get the ultrasound? - Yeah.
(GRUNTING, PANTING) I can't breathe! I can't breathe! We're gonna find out what's going on, okay? There's no lung sliding on the right side.
Traumatic pneumothorax.
Can I get a 24 French and a chest tube tray? We're gonna keep you really still.
Just gonna get your arm out of the way.
It's gonna help you breathe better.
Alright, there you go.
Can I get that tube? Okay.
What's happening? You have a collapsed lung.
But Doctor Curtis is gonna fix that.
Inserting chest tube now.
So what are we looking at, here? And we're in! Hemo-pneumo.
How does that feel Lucas, is that better? My neck really hurts and my feet are tingling.
Positive Babinski sign.
What, you're thinking neuro-dysfunction? His CT should be up by now.
Hey, Lucas, that pain you're talking about is it sharp or dull? - Sharp, it's sharp.
- Okay.
I'm scared.
(HEAVING BREATHING) Hey, Lucas, what's your favorite thing to do at camp? I'm learning drums.
Drums? Okay.
What kind of music do you like? Loud.
(LAUGHS) (WHISPERING): I'll be right back.
What do you got? Look at this.
It's an atlanto-occipital dislocation.
It happens during impact trauma.
His head is only holding on by muscle and skin.
Yeah.
Internal decapitation? He's lucky we didn't intubate.
It's gonna be okay.
We're gonna fix it.
You'll see.
Bash! Didn't you fly home a few hours ago? Yeah, long enough to put the kids to bed.
Hitched a ride back on a patient transpo chopper.
Perks of being an attending now.
How did Mel take you leaving? Hard to argue when a bus full of kids crashes.
That's brutal.
Pedes from all three shifts were called in.
Hey, I heard what you did for Emily Parker.
She's lucky you were there.
Let me know if you need anything.
Oh, sorry, here! Doctor Hunter.
Hey, so three's waiting on casting for her ankle.
She's allergic to morphine so acetaminophen only.
Make sure whoever does Malia's sutures knows to use a five-O, - nothing larger, and uh - Okay.
The boy in four keeps taking his dressings off to post videos so just keep an eye on that.
Okay.
Oh, hey, um what do you know about the new Acting Chief? Uh, he did his residency at Memorial back in 05 under Bishop.
Um, joint specialty in ED-ICU, I believe, then went overseas.
Got back and he's been an attending in our ICU for about a month.
Works mostly nights.
That's Janie, three broken ribs but she's asthmatic so keep her on albuterol and check her breathing every ten.
Every ten (SIGHS) Oh! Bash? Radiologist said to tell you that CT on Allie Watson is normal.
No sign of fracture or bleeding but she did vomit.
Could still have a concussion.
Thanks.
Arnold? Ahem.
Tech wasn't positive, but he said he might have smelled alcohol.
You think she was drinking? I'm just passing along the info.
(SUSPENSEFUL MUSIC) (GROANING, CRYING) How's Em? They're prepping her for surgery.
How's your head feeling? I'm okay.
What about the others? I gave the social worker my phone so she could call the parents.
We're on it.
So what about you, Allie? Is there anyone we can call for you? Family you want down here? Mm It's just my mom and her boyfriend, but we don't we don't talk anymore.
I never really fit in with anyone from home.
But Sandra built this world for kids like I was and and made me a part of it.
She's the one I'd call.
Allie, did you have anything to drink tonight? Coffee before we left and some water.
No alcohol? - A beer with dinner? - No, no, no! You think I was drunk? Because I threw up? No, vomiting can happen as a result of a head injury, but our tech said he smelled alcohol? I'm allergic to alcohol.
I never touch it.
Maybe he mistook disinfectant or hand sanitizer.
Yeah.
The police said they have to do a blood test, so check it if you don't believe me! It's not that, it's the tech smelled it, so I had to ask, okay? So, how angry are you? Oh, maybe he's different now.
You found Lizzie Stahl in the field? - Yeah, her knee was dislocated.
- Do we need to page vascular? She's stabilized after I reduced and we gave her morphine - which really knocked her out.
- Well, BP's ticked down since she got in.
- Was there a lot of blood? - External injuries were scrapes and bruises but it could be the knee? Hematoma from reduction? (SIGHS) That is a lot of bruising for a dislocation.
Yeah.
Is she on blood thinners or anemic? She was worried about a bracelet.
I thought she meant a friendship bracelet but Lizzie? Lizzie, can you look at me? Lizzie, can you hear me? Hi, Lizzie.
Was your bracelet the medic-alert kind? Am I bleeding? Are you hemophiliac? I took it off.
I know it was wrong but I'm Doctor Hunter, Lizzie.
Don't worry.
We're gonna get your bleeding under control.
I'm supposed to tell you I'm type B which means You need clotting factor nine.
- Are you Leblanc? - Yes.
- We need you back out there.
- Right.
Copy that, it's just that we just confirmed that this patient's a hemophiliac so I'm gonna track down her team.
Short of cloning yourself, I don't see how you're gonna do that and clear the orange and green tags.
Also your schedule says that you've been on for two days straight.
- Right, but uh, Doctor Hunter - Will be fine.
Unless he thinks he can't hack this on his own? - He does not.
- Yeah.
Hey, that tamponade balloon, where did you learn that trick? We used that when we couldn't get hospital transport.
I was a trauma surgeon back in Syria.
And now you're a first-year resident here? I ran field hospitals in Gaza, Libya, and Yemen for Doctors Without Borders but, I never made it to Syria.
I know what you're thinking.
Privileged westerner gets to indulge his adrenaline addiction.
And yeah, you wouldn't be wrong but They do important work.
Sir, back in trauma, if I was short with you it's only because I You took a risk to save a kid's life and you didn't realize you were talking to your new boss.
And now you don't know where you stand after breaking protocol Well.
I would say, somewhere between the choice you made and the outcome.
So, let's see how the kid does.
Oh, let me guess.
You want me to rush labs for Lizzie Stahl? Nope.
She is not my patient anymore.
How is the new guy already telling me I got too much on my plate? And you know nothing against Theo, but I'm just saying.
He flew back on a helicopter, after being home for like three hours, and have you ever heard anyone ask him how much sleep he got? - I never have.
- No, exactly.
Geez.
What is it about me that makes people so concerned with how much I take on, you know? It's infantilizing.
What? - You need their approval.
- I don't.
I saw you in Bishop's room, you're wanting him to tell you what to do even when he can't talk.
You look up to him, Mags, but I know him.
He's not God.
He's just another messy human being who is wrong as much as he is right.
That's some light reading.
Studying to be a nurse practitioner.
Masters at Night school, and then a year of clinical.
That's amazing.
You'll be able to order prescriptions, and make diagnoses.
Without needing sign-off on what I already know.
That's nice.
Maybe I should be looking into that Lucas, I'm Doctor Singh.
When you were thrown from your seat, you injured your spinal cord.
Can you undo these? Please.
Uh, you need to keep perfectly still.
No, I can't.
I need to move.
Okay, Lucas, this is really important, okay? Two of the vertebrae in your neck are broken.
So if you move, the part of your spinal cord that's still attached will sever.
Does that mean that if I can't stay still, - it could kill me? - What we're saying, son, is we're gonna take you to surgery to fix this.
- But until we get there - No, no, no, no.
I can't, I can't, I can't.
Prepare two milligrams of Ativan.
Okay, I understand, Lucas, okay, I get it.
Trust me, I hate staying still also and it makes my skin crawls when someone tells me that I have to.
My mother says I never stop moving.
My mom says the same thing.
And then I became a surgeon and other people's lives in my hands, just there's just no room for wrong moves.
So I had to learn how to control that panicky feeling.
I'm pretty sure that if I can do it, you can do it too.
(PANTING) - How? - How? Well, uh, we start by setting the mood.
Get the lights, Doctor Singh.
Please.
So, uh, no talking.
Focus on what you can hear.
Can you hear your heart beating? It sounds like drums, right? Focus on that rhythm, it's a little fast right now.
You need to bring that down.
So see if you can use your breathing, to slow down the rhythm of that beat.
Focus on that rhythm.
Slow down that beat.
You're nailing it.
(GENTLE MUSIC) How is she? You're hurt! They didn't tell me.
I'm okay.
Maybe a small concussion.
I'm so glad you're alright.
Allie, what happened? I don't know.
It was it was all so fast.
Everything was fine and then then it wasn't.
We must have hit ice or Sandra, I'm so sorry.
I'll talk to the parents, okay? Um, Allie, you should be off your feet.
This is the doctor who saved Em.
This is Sandra, Emily's mom.
She owns the camp.
They said that you had to take drastic measures - to save her life.
- Emily was extremely brave.
Uh, Allie, can I speak with you for a moment? I know you said to rest but I I had to see her.
- Allie? - Are you okay? - (BREATHING HEAVILY) - It's weird, my Okay, come with me, Allie.
- What's happening? Is she okay? - My throat feels full.
It's hard to swallow.
Okay, Arnold point three milligrams epi right now.
Sit Breathe calmly, okay? I'm giving you an injection of epinephrine.
You're having an allergic reaction, this will help with the symptoms.
An allergic reaction to what? - Um - Is she okay? Um She will be.
She'll be fine.
She's only allergic to alcohol and she doesn't drink.
She was drinking? Why don't we just let Allie get What happened, Doctor Hamed? Allie, you were drinking? When you knew you were driving our kids? No! No! I would never.
You did a blood test, tell her what it said! He came looking for you because of what it said.
Allie, how could you? There has to be another explanation! - I'm sorry, Allie.
- No! Emily, the kids are everything to me! - You know me! - No! Not anymore! Not the way I thought! - (CRYING) - Sandra! I can't, I can't even look at you.
Please! Please.
(DRAMATIC MUSIC) (SIRENS BLARING) Hey, we're almost there.
Curtis is scrubbing in.
It's There's three teams, Aajay.
It's already pretty crowded.
June made the diagnosis, and the patient is asking for her personally.
Fine.
Observation only.
I'm gonna be with you the whole time.
You're doing great.
Sutton gets a vote on Chief Resident.
Don't keep him waiting.
Admitting needs a detailed projection - of who you're keeping.
- I know.
Just after I get to the four sets of parents waiting for me.
I'll find out what Novak wants for paperwork.
Doctor Bishop likes every intake, every discharge on his desk an hour after your shift.
How's he doing? - Bishop.
- Well, too early to say.
Long night? Emily Parker's in surgery - I'll keep you in the loop.
- Thanks.
(CELLPHONE RINGING) You like it? Just like Mama's.
Amira, it's so late.
You have school tomorrow.
(CHUCKLES) I I have to stay here a little while longer.
You can bring her to the hospital if We're fine.
I promise she'll get some sleep.
Okay, I'll come get you as soon as I'm done.
Go to sleep.
Bashir The surgeons were able to repair the wound to Emily's artery.
But her trachea was damaged when our doctor stopped her bleeding.
Why? Why would he do that? There wasn't any other way? If he'd waited any longer, she would have bled to death.
We've done everything possible to repair the damage.
Now it's up to her to see how she recovers.
I'm sorry I have to say this.
But if her airway doesn't heal, there's a chance that Emily won't be able to breathe on her own again.
The next few hours are critical.
I know it's a lot to take in.
I don't accept any of it.
(SOBBING) Hey, Lizzie.
The firemen found this.
Are your parents around? Probably with my hemophilia team somewhere, deciding all the things I won't be allowed to do anymore.
They only want you to be safe.
The Cabin Five girls were doing a play.
They always say mine are too weird but, this year they chose it.
They all wore five bracelets and You had six.
I just liked to feel normal for once.
Let me tell you something, Lizzie.
Normal is boring.
I know it's hard to see this now or ever, really, but but you know, the things that set you apart, even the hard ones, they're the ones that make you strong.
(COUGHS) You okay? - (COUGHING) - I think something's wrong.
Chest hurts.
I can't Claire! Okay.
I need to look at the site of your bleeding.
Okay, I need a large dose of rtPA, point five milligrams per kilo per hour.
Then page Theo and Heme! What's happening? So a large blood clot formed after your injury.
And it's now travelled to your lungs.
So I'm gonna need to use something called a thrombolytic agent to dissolve it.
A clot-buster? But if we do that, my blood thins, won't that make me bleed more? A clot's a bigger risk.
You can handle this, Lizzie.
Okay? You need to.
- Theo? - Nothing yet.
(COUGHS) It's okay! It's just blood.
We need to do this now.
We can't wait.
Okay, give me your arm.
Lie back.
- Here we go.
- Like this.
Okay? Good.
What now? We wait.
Together.
Hey! New labs on Allie Watson.
But it's weird.
- What? - Her blood alcohol level went up? Like I said.
Weird.
Um.
No way she's had a drink while she's been here.
She may not have had to.
There's a rare bacterial reaction where your GI system creates its own alcohol.
It's called auto brewery syndrome.
Did you have any bread tonight? Pasta? Pizza.
Well, the right carbs at the wrong time and you basically become your own distillery.
But why now? I've always eaten those things.
There are emergent digestive conditions that can trigger it.
Even being on antibiotics for a really long time.
Yeah.
I've been on and off them for sinus infections.
Your stomach continued to produce its own alcohol, which is why your reaction was delayed in the first place.
Thanks, Arnold.
You're on an epi drip now, and we're gonna give you some activated charcoal to drink so that should stop the reaction completely.
It doesn't look very appetizing but I promise it will help.
(SIGHING) Then I was drunk.
Maybe, I didn't realize.
How could I have known? This isn't your fault, Allie.
Okay? And I'm gonna make sure Sandra knows that.
- You must be exhausted.
- Huh.
Were the girls upset I wasn't there when they woke up? Uh A little, but you know a bus full of kids, that has to be more important.
Mel, that's not, that's not what I meant.
Look, good news is, I've already bought my flight pass so I'll be able to go back and forth four, even five times a week.
Theo.
No, I've got it all planned out.
Okay? I'm gonna do my scheduling, and and my charts, I'm gonna do them all on the plane so when I get home, there's no work.
Half the doctors here they commute from the suburbs.
It's like a two-hour drive with traffic, so I mean, this is it's no different.
I'm just not sure that's realistic.
- Look.
- Mel, what I've gotta go.
We'll talk about it later? Okay? - Okay? - Yeah.
Okay.
Bye.
You heard about Allie? Maybe she didn't drink but she must have felt something.
She should have pulled over.
Stopped driving.
I only found Emily in time to save her because of Allie.
She loves her.
She's terrified of losing the life that she's built with you.
I care about her too but She'll have to find a new job.
This is my daughter, who may never breathe on her own again because of what both of you did.
We need to talk about you giving Lizzie Stahl - a thrombolytic agent.
- Well, we paged you.
And we both know that if I'd waited There are two hematologists here from her team, plus two very worried parents - Theo! - And a new acting chief and I had to explain to all of them why this happened without their input.
Theo, I went in to return her backpack - and she crashed because - If I wanted your help and I wanted you to check on my patients, I will ask you! Was Doctor Bishop here during your residency? Has he ever not been here? Doctor Novak, Emily Parker, she's She's touch and go yeah.
I heard.
I also heard what you did for him.
How you saved his life.
You've made some hard choices.
Friends I've had, doctors from overseas who tried to make it over here, those skills, they don't always translate.
You're one of the lucky ones, Bashir Hamed.
(INDISTINCT CHATTER ON PA) I heard Lucas is gonna recover completely.
Yeah, just this kid is like a millimeter from death, and somehow he still manages to hold it all together.
He had some help.
I've been thinking about all the reasons I've been afraid to throw in for Chief Resident.
And I don't know, I guess tonight I realized that none of that really matters.
I want it, you know? So I don't know whatever, I guess I'll just have to learn as I go.
If you get it.
(KNOCKING) Come in, Leblanc.
You changed the lamp.
You moved it.
- There's something you needed? - Um I wanted to tell you that I made the call to give Lizzie Stahl thrombolytics without consulting Doctor Hunter first because It was the right call.
I know.
Okay.
So did you just come here to apologize for making the right call? No.
I heard you when you said that Lizzie was Theo's patient.
But I still went in to check on her because I know doctors like you.
You stay late.
You over-invest, you really truly care about the patients instead of looking at them like they're needy bags of meat.
- And that's admirable.
- Look if you're gonna tell me that I need to find some kind of balance No, I don't care if you work four days straight and don't sleep.
You're a grown-up.
But it doesn't make you any better or smarter - than anyone else here.
- No, I never said that it did.
But you think it.
Don't try to tell me you don't.
And the truth is if you weren't in Lizzie's room Her vitals monitor would have alerted somebody else and they would have made the same call as you did.
I don't care what kind of a doctor you are, Leblanc.
I just need you to do your job, like everybody else.
(GENTLE MUSIC) (SIGHING) She needs a few seconds for the sedation to wear off and then we'll listen.
What happens if she can't get air? We're here.
It's time to see if she can breathe on her own.
Hi, Emily.
Can you breathe for us? (INHALING) There you go.
That's it.
You did it.
Great job.
She sounds perfect.
Oh, my baby, you're so strong! I love you so, so much.
(SOFT MUSIC) Allie! Why should you never trust atoms? Because they make up everything.
Emily wanted me to tell you that.
Thanks.
(EXHALING) (GENTLE MUSIC) One of us should say something.
It's good to hear your voice again, sir.
Huh.
(CHUCKLES) Just ask.
How'd we do tonight? (SOFT CHUCKLES) - Hey! - Hey.
Is it just me or this shift started about a year ago? It definitely is not just you.
Do you wanna celebrate it finally being over with a drink? Uh, um I have to take Amira to school.
Right.
Right it is morning after all.
Oh, it's alright! (CHUCKLES) I've been trying to manufacture a three-day weekend to make up for today but it's impossible.
If you move Petro to Tuesday and convince Levine to pull a double.
- (LAUGHS) - Thank you.
Scheduling sounds like a nightmare.
Yeah Well, I heard you were up for a career bump too so get used to it! They'd be idiots not to pick you.
I was excited for you.
I'm sorry.
(LAUGHTER) Seriously, guys.
Just I don't wanna jinx it.
Well, on that note.
I'm gonna go sleep for 12 hours.
I'll see you later.
Good night! Have a good night! I could really use a greasy breakfast.
Are you hungry? I'm famished.
(LAUGHS) Ow, come on.
You're too late for pizza.
Sorry.
Long night.
We had fun.
I could have.
I wanted to.
For a long time I didn't know where you were, and when I finally heard that you made it, that you came here with your sister for for a new life.
The Bashir I knew would have risked everything to come get me and I didn't want you to make that choice.
So you made it for me? (GENTLE MUSIC) I understand if you can't accept that.
(SIGHING) (SOFT MUSIC)
I've specialized as a trauma surgeon and emergency medical doctor in Syria.
We have met before, of course, I interviewed you and then hired you.
I think we need to do it again.
I know I screwed up.
Taking that job without telling you was You are almost in your fourth year, June.
You should consider applying for the Chief Resident position.
All could hear was your voice in my head.
- Telling you what? - That I'm focusing on all the wrong things.
- (GROANING) - Sir! He collapsed and there's not much pulse.
- Ischemic stroke? - Or hemorrhagic.
Charging! I knew he still had symptoms.
Oh, Bash.
Bashir.
Rania! (WIND WHISTLING) Bashir.
(GENTLE MUSIC) Rania.
You were dead.
Everyone thought so.
Rania was always brutally honest with me.
Amira How long have you known we were here? Since you came.
Bash.
Bash, I know you're already clocked-out but we need hands.
Multi-car MVC, they're about to call it! They call you Bash? (LAUGHS) Did you let them? - It's growing on me.
- Go be a doctor.
(GENTLE MUSIC) (SIRENS WAILING) You said this place would swallow me whole if I let it.
And then you went and had a stroke which, let's face it, is a pretty extreme way to make your point.
(SIGHING) (IMITATES BISHOP): "The past is the past, Doctor Leblanc.
What matters now is how you respond.
" Mags.
Code Orange.
All available personnel.
- Mags! - Hey! Do you know what's going on? Just that they're calling everyone.
- Has he said anything yet? - No and the first few hours are critical.
Hopefully he wakes again soon.
- It's Bishop.
He will.
- Yeah.
Also haven't you been working two days straight? Hum.
Says the girl who's about to double her workload by throwing in for Chief Surgical Resident.
Okay, look, I became a surgeon because I prefer my patients unconscious.
I'm not sure I should be managing other people.
Wait! So you're not gonna try because you're afraid to fail? I'm not afraid, Mags, okay I just know what my skills are - and what they aren't.
- Mm-hmm.
Notify the blood bank, prepare for MTP.
- Where do you want Mr.
Kline? - Hallway for now.
We need to make sure all lower-acuity beds are cleared.
Copy that! See if you can put her on three.
Rhoda? - Who's in two? - Migraine, DHE.
Resolving.
Okay, put him somewhere else.
Same with the ankle sprain.
Any idea what we're dealing with? I can call ahead to OR.
All I know is a bus went through a guardrail - on the Bayview extension.
- That's not far from here.
- I can go to the site for triage.
- Good, good.
There's a trauma team en route from St.
Jacobs, Mags - I'm in.
- Update us when you get there.
We run this like he taught us.
(SIRENS WAILING) (DRAMATIC MUSIC) Sorry.
Ahem.
So what's going to happen now? With Doctor Bishop out? Well, the board appoints an Acting Chief until they know his status.
If they're smart, it's Atwater.
If they're stupid Everything changes.
(SUSPENSEFUL MUSIC) (TIRES SCREECHING) (INDISTINCT RADIO CHATTER) Oh, my God.
(INDISTINCT CHATTER) (CRYING, SCREAMING) (BASHIR): Let's assess who's injured then make a plan! Triage everyone coming out of the bus.
Priority on the quiet ones.
If they're crying, they're breathing.
Help's here, guys.
Help's here.
Come on! Emily! Emily! She's not moving, she needs help! Who's not moving? Emily and the other kids in there who can't get out! - Are you the bus driver? - Yeah.
I don't know what happened.
I think I hit black ice or Johnny? She's got a head wound.
Got it! Here, come with me.
If you can crawl to the window, the firefighters will help you! - Are you okay? - Yeah, I'm okay.
Emily! (COUGHING) (PANTING) - What's your name? - Lucas.
It's going to be okay, Lucas.
Where does it hurt most? - (COUGHS) - My neck, real bad.
Where are you coming back from, Lucas? Millwood Arts Camp.
It was winter overnight this weekend, for the counsellors in training.
Any pain besides your neck? My hands kinda tingle.
Squeeze my fingers? Okay.
Good job.
Try to stay very still, okay? - What's his status? - Possible fractured vertebra.
We won't know how bad until we image.
Get him on a spinal board, try to keep him still.
If he decompensates, come and find me.
Okay.
Don't move, everything's gonna be okay.
Who needs help? If you can't speak, raise your hand! Is your name Emily? (COUGHING, GURGLING) Are you okay? Can you get out? - Can you get out? - Mags! She's got a projectile in her neck, right next to her jugular.
We can't move her and we can't intubate around it.
It has to come out.
It's too risky.
We need to protect her airway.
Look, there's no point if she bleeds out.
Hang in there, kiddo.
Even if you remove it cleanly, she's hemorrhaging.
How can you suture a wound that big here? I don't.
Get me the foley cath! I'll remove the projectile and you'll stem the bleeding with that.
- How? - I'll talk you through it but it has to be now.
There's no way I'm leaving her like this.
Morphine, forceps, scalpel.
(DISTANT SCREAMING) (PANTING) Okay, Emily, I'm going to remove the obstruction from your neck to stop the bleeding.
You're gonna feel a sharp pinch and some warm liquid, okay? (SUSPENSEFUL MUSIC) When the debris comes out, the cath goes in - and then inflate with saline.
- How much? Until you feel resistance.
Trust your instinct, okay? - You're ready? - Yeah! Okay.
Okay, go! - There! - Okay.
Okay, good.
Good.
(PANTING) Emily? Can you hear me? Emily? Emily? Open your eyes if you can hear me.
Emily? (GASPING) Okay.
Stay with me, Emily.
(THEME MUSIC) (WHISPERING): Wow, out like a light.
- Should we move them? - No, no.
Just uh just leave them a bit longer.
(PHONE VIBRATING) (EXHALES) You have to go.
I'm sorry! (HUBBUB) - Alright! - Mags! Yeah? Lizzie can't move her leg.
Hey, Lizzie! I'm Doctor Leblanc.
How about your toes.
Can you wiggle them? (MUMBLING) LOC's low.
Knee's dislocated.
Leg has no pulse.
We're gonna have to reduce or she could lose it.
My bracelet, I need to find it.
How about we add this one to your collection for now, okay? Lizzie, we're gonna have to put your knee back into place.
It's gonna hurt but the worst part's over fast.
Okay? You're ready? On three, two, one.
(BONE CRACKING, SCREAMING) (PANTING) You're doing great Emily, I'm not going to leave your side.
- Emily? - Madam, please.
- Let me ride with her! - It's fine, officer, she needs medical attention anyway.
(PANTS) (SIRENS BLARING) We'll be there soon, okay? What happens now? We bought some time, but she lost a lot of blood.
It's okay, M&M, I've got you.
Hmm? I've got you.
I've got you.
Why do I feel like you do more than drive the bus? Hmm I judge talent shows, and paint theatre backdrops.
The kids are all so creative, you know? Her mom owns the camp so, I've watched Em grow up.
All of them, really.
How long have you worked there? Hmm, seven years.
It's near Midland, where I'm from so, not much to see.
I haven't seen anything in Canada outside of Toronto, so - (PANTING) - Hey! Hey! It's okay.
I got one for you.
Why should you never trust atoms? No, no, no, don't.
Don't tell me now.
Tell me later, when you're better, okay? Ooh.
Are you okay? Hum, yeah I'm okay, I'm just, uh dizzy.
You might have a concussion, we'll check you out too - once we get there.
- Mm-hmm.
(MACHINE BEEPING) What's wrong? What's happening? What is it? (SOBBING) Hey, it's okay I'm right here.
(INDISTINCT CHATTER) Lucas? Oh, my God.
Lucas West.
Impact trauma with potential spinal complications.
Alright! I've gotta get him to CT! Emily Parker, projectile removed from her neck to address massive blood loss.
BP's 90 over 60, rate's 90, O2's 80 and dropping.
- Trauma one! - Doctor Hamed, what's happening? Arnold? She might have a concussion.
Oh.
Ma'am, why don't you come with me? Female, impact trauma, dislocated knee reduced on-site.
Rate's stable, BP's 110 over 80.
Come on.
It's gonna be fine, okay? I need one more large bore IV.
Activate MTP.
One gram TXA.
Blood stats are falling fast! One unit O neg, level one! We need to maintain her airway but I'll tell you right now, it will be difficult to visualize her cords.
Get RT on standby.
I will intubate.
- I can handle that, Wendy.
- Hello, Mark.
Rough night here, huh? - Slow up in the ICU? - Not really.
Tube.
(HUMMING SOFTLY) And connecting the vent.
Blood's helping, MAP's at 65.
She's stabilizing O2's coming up.
I'll call vascular, she'll need the OR.
She's gonna need a lot more than that.
Who rigged up the tamponade balloon? - I did.
- Protocol would be to leave the shrapnel in place until she got into surgery.
Protocol would have killed her.
Well, let's just agree then, it was a ballsy move that may have saved her life.
But, still damaged her airway when you blew up the balloon and that's not gonna be good.
What is your name, doctor? Bashir Hamed.
Why don't you get her cleaned up, Dr Bashir Hamed, and we'll let the surgeons tell us what the damage is.
- I'm sorry but who are you? - Mark Novak.
I'm the Acting Chief of this emergency department.
Lucas started gasping for air on the way back from CT.
- Can I get the ultrasound? - Yeah.
(GRUNTING, PANTING) I can't breathe! I can't breathe! We're gonna find out what's going on, okay? There's no lung sliding on the right side.
Traumatic pneumothorax.
Can I get a 24 French and a chest tube tray? We're gonna keep you really still.
Just gonna get your arm out of the way.
It's gonna help you breathe better.
Alright, there you go.
Can I get that tube? Okay.
What's happening? You have a collapsed lung.
But Doctor Curtis is gonna fix that.
Inserting chest tube now.
So what are we looking at, here? And we're in! Hemo-pneumo.
How does that feel Lucas, is that better? My neck really hurts and my feet are tingling.
Positive Babinski sign.
What, you're thinking neuro-dysfunction? His CT should be up by now.
Hey, Lucas, that pain you're talking about is it sharp or dull? - Sharp, it's sharp.
- Okay.
I'm scared.
(HEAVING BREATHING) Hey, Lucas, what's your favorite thing to do at camp? I'm learning drums.
Drums? Okay.
What kind of music do you like? Loud.
(LAUGHS) (WHISPERING): I'll be right back.
What do you got? Look at this.
It's an atlanto-occipital dislocation.
It happens during impact trauma.
His head is only holding on by muscle and skin.
Yeah.
Internal decapitation? He's lucky we didn't intubate.
It's gonna be okay.
We're gonna fix it.
You'll see.
Bash! Didn't you fly home a few hours ago? Yeah, long enough to put the kids to bed.
Hitched a ride back on a patient transpo chopper.
Perks of being an attending now.
How did Mel take you leaving? Hard to argue when a bus full of kids crashes.
That's brutal.
Pedes from all three shifts were called in.
Hey, I heard what you did for Emily Parker.
She's lucky you were there.
Let me know if you need anything.
Oh, sorry, here! Doctor Hunter.
Hey, so three's waiting on casting for her ankle.
She's allergic to morphine so acetaminophen only.
Make sure whoever does Malia's sutures knows to use a five-O, - nothing larger, and uh - Okay.
The boy in four keeps taking his dressings off to post videos so just keep an eye on that.
Okay.
Oh, hey, um what do you know about the new Acting Chief? Uh, he did his residency at Memorial back in 05 under Bishop.
Um, joint specialty in ED-ICU, I believe, then went overseas.
Got back and he's been an attending in our ICU for about a month.
Works mostly nights.
That's Janie, three broken ribs but she's asthmatic so keep her on albuterol and check her breathing every ten.
Every ten (SIGHS) Oh! Bash? Radiologist said to tell you that CT on Allie Watson is normal.
No sign of fracture or bleeding but she did vomit.
Could still have a concussion.
Thanks.
Arnold? Ahem.
Tech wasn't positive, but he said he might have smelled alcohol.
You think she was drinking? I'm just passing along the info.
(SUSPENSEFUL MUSIC) (GROANING, CRYING) How's Em? They're prepping her for surgery.
How's your head feeling? I'm okay.
What about the others? I gave the social worker my phone so she could call the parents.
We're on it.
So what about you, Allie? Is there anyone we can call for you? Family you want down here? Mm It's just my mom and her boyfriend, but we don't we don't talk anymore.
I never really fit in with anyone from home.
But Sandra built this world for kids like I was and and made me a part of it.
She's the one I'd call.
Allie, did you have anything to drink tonight? Coffee before we left and some water.
No alcohol? - A beer with dinner? - No, no, no! You think I was drunk? Because I threw up? No, vomiting can happen as a result of a head injury, but our tech said he smelled alcohol? I'm allergic to alcohol.
I never touch it.
Maybe he mistook disinfectant or hand sanitizer.
Yeah.
The police said they have to do a blood test, so check it if you don't believe me! It's not that, it's the tech smelled it, so I had to ask, okay? So, how angry are you? Oh, maybe he's different now.
You found Lizzie Stahl in the field? - Yeah, her knee was dislocated.
- Do we need to page vascular? She's stabilized after I reduced and we gave her morphine - which really knocked her out.
- Well, BP's ticked down since she got in.
- Was there a lot of blood? - External injuries were scrapes and bruises but it could be the knee? Hematoma from reduction? (SIGHS) That is a lot of bruising for a dislocation.
Yeah.
Is she on blood thinners or anemic? She was worried about a bracelet.
I thought she meant a friendship bracelet but Lizzie? Lizzie, can you look at me? Lizzie, can you hear me? Hi, Lizzie.
Was your bracelet the medic-alert kind? Am I bleeding? Are you hemophiliac? I took it off.
I know it was wrong but I'm Doctor Hunter, Lizzie.
Don't worry.
We're gonna get your bleeding under control.
I'm supposed to tell you I'm type B which means You need clotting factor nine.
- Are you Leblanc? - Yes.
- We need you back out there.
- Right.
Copy that, it's just that we just confirmed that this patient's a hemophiliac so I'm gonna track down her team.
Short of cloning yourself, I don't see how you're gonna do that and clear the orange and green tags.
Also your schedule says that you've been on for two days straight.
- Right, but uh, Doctor Hunter - Will be fine.
Unless he thinks he can't hack this on his own? - He does not.
- Yeah.
Hey, that tamponade balloon, where did you learn that trick? We used that when we couldn't get hospital transport.
I was a trauma surgeon back in Syria.
And now you're a first-year resident here? I ran field hospitals in Gaza, Libya, and Yemen for Doctors Without Borders but, I never made it to Syria.
I know what you're thinking.
Privileged westerner gets to indulge his adrenaline addiction.
And yeah, you wouldn't be wrong but They do important work.
Sir, back in trauma, if I was short with you it's only because I You took a risk to save a kid's life and you didn't realize you were talking to your new boss.
And now you don't know where you stand after breaking protocol Well.
I would say, somewhere between the choice you made and the outcome.
So, let's see how the kid does.
Oh, let me guess.
You want me to rush labs for Lizzie Stahl? Nope.
She is not my patient anymore.
How is the new guy already telling me I got too much on my plate? And you know nothing against Theo, but I'm just saying.
He flew back on a helicopter, after being home for like three hours, and have you ever heard anyone ask him how much sleep he got? - I never have.
- No, exactly.
Geez.
What is it about me that makes people so concerned with how much I take on, you know? It's infantilizing.
What? - You need their approval.
- I don't.
I saw you in Bishop's room, you're wanting him to tell you what to do even when he can't talk.
You look up to him, Mags, but I know him.
He's not God.
He's just another messy human being who is wrong as much as he is right.
That's some light reading.
Studying to be a nurse practitioner.
Masters at Night school, and then a year of clinical.
That's amazing.
You'll be able to order prescriptions, and make diagnoses.
Without needing sign-off on what I already know.
That's nice.
Maybe I should be looking into that Lucas, I'm Doctor Singh.
When you were thrown from your seat, you injured your spinal cord.
Can you undo these? Please.
Uh, you need to keep perfectly still.
No, I can't.
I need to move.
Okay, Lucas, this is really important, okay? Two of the vertebrae in your neck are broken.
So if you move, the part of your spinal cord that's still attached will sever.
Does that mean that if I can't stay still, - it could kill me? - What we're saying, son, is we're gonna take you to surgery to fix this.
- But until we get there - No, no, no, no.
I can't, I can't, I can't.
Prepare two milligrams of Ativan.
Okay, I understand, Lucas, okay, I get it.
Trust me, I hate staying still also and it makes my skin crawls when someone tells me that I have to.
My mother says I never stop moving.
My mom says the same thing.
And then I became a surgeon and other people's lives in my hands, just there's just no room for wrong moves.
So I had to learn how to control that panicky feeling.
I'm pretty sure that if I can do it, you can do it too.
(PANTING) - How? - How? Well, uh, we start by setting the mood.
Get the lights, Doctor Singh.
Please.
So, uh, no talking.
Focus on what you can hear.
Can you hear your heart beating? It sounds like drums, right? Focus on that rhythm, it's a little fast right now.
You need to bring that down.
So see if you can use your breathing, to slow down the rhythm of that beat.
Focus on that rhythm.
Slow down that beat.
You're nailing it.
(GENTLE MUSIC) How is she? You're hurt! They didn't tell me.
I'm okay.
Maybe a small concussion.
I'm so glad you're alright.
Allie, what happened? I don't know.
It was it was all so fast.
Everything was fine and then then it wasn't.
We must have hit ice or Sandra, I'm so sorry.
I'll talk to the parents, okay? Um, Allie, you should be off your feet.
This is the doctor who saved Em.
This is Sandra, Emily's mom.
She owns the camp.
They said that you had to take drastic measures - to save her life.
- Emily was extremely brave.
Uh, Allie, can I speak with you for a moment? I know you said to rest but I I had to see her.
- Allie? - Are you okay? - (BREATHING HEAVILY) - It's weird, my Okay, come with me, Allie.
- What's happening? Is she okay? - My throat feels full.
It's hard to swallow.
Okay, Arnold point three milligrams epi right now.
Sit Breathe calmly, okay? I'm giving you an injection of epinephrine.
You're having an allergic reaction, this will help with the symptoms.
An allergic reaction to what? - Um - Is she okay? Um She will be.
She'll be fine.
She's only allergic to alcohol and she doesn't drink.
She was drinking? Why don't we just let Allie get What happened, Doctor Hamed? Allie, you were drinking? When you knew you were driving our kids? No! No! I would never.
You did a blood test, tell her what it said! He came looking for you because of what it said.
Allie, how could you? There has to be another explanation! - I'm sorry, Allie.
- No! Emily, the kids are everything to me! - You know me! - No! Not anymore! Not the way I thought! - (CRYING) - Sandra! I can't, I can't even look at you.
Please! Please.
(DRAMATIC MUSIC) (SIRENS BLARING) Hey, we're almost there.
Curtis is scrubbing in.
It's There's three teams, Aajay.
It's already pretty crowded.
June made the diagnosis, and the patient is asking for her personally.
Fine.
Observation only.
I'm gonna be with you the whole time.
You're doing great.
Sutton gets a vote on Chief Resident.
Don't keep him waiting.
Admitting needs a detailed projection - of who you're keeping.
- I know.
Just after I get to the four sets of parents waiting for me.
I'll find out what Novak wants for paperwork.
Doctor Bishop likes every intake, every discharge on his desk an hour after your shift.
How's he doing? - Bishop.
- Well, too early to say.
Long night? Emily Parker's in surgery - I'll keep you in the loop.
- Thanks.
(CELLPHONE RINGING) You like it? Just like Mama's.
Amira, it's so late.
You have school tomorrow.
(CHUCKLES) I I have to stay here a little while longer.
You can bring her to the hospital if We're fine.
I promise she'll get some sleep.
Okay, I'll come get you as soon as I'm done.
Go to sleep.
Bashir The surgeons were able to repair the wound to Emily's artery.
But her trachea was damaged when our doctor stopped her bleeding.
Why? Why would he do that? There wasn't any other way? If he'd waited any longer, she would have bled to death.
We've done everything possible to repair the damage.
Now it's up to her to see how she recovers.
I'm sorry I have to say this.
But if her airway doesn't heal, there's a chance that Emily won't be able to breathe on her own again.
The next few hours are critical.
I know it's a lot to take in.
I don't accept any of it.
(SOBBING) Hey, Lizzie.
The firemen found this.
Are your parents around? Probably with my hemophilia team somewhere, deciding all the things I won't be allowed to do anymore.
They only want you to be safe.
The Cabin Five girls were doing a play.
They always say mine are too weird but, this year they chose it.
They all wore five bracelets and You had six.
I just liked to feel normal for once.
Let me tell you something, Lizzie.
Normal is boring.
I know it's hard to see this now or ever, really, but but you know, the things that set you apart, even the hard ones, they're the ones that make you strong.
(COUGHS) You okay? - (COUGHING) - I think something's wrong.
Chest hurts.
I can't Claire! Okay.
I need to look at the site of your bleeding.
Okay, I need a large dose of rtPA, point five milligrams per kilo per hour.
Then page Theo and Heme! What's happening? So a large blood clot formed after your injury.
And it's now travelled to your lungs.
So I'm gonna need to use something called a thrombolytic agent to dissolve it.
A clot-buster? But if we do that, my blood thins, won't that make me bleed more? A clot's a bigger risk.
You can handle this, Lizzie.
Okay? You need to.
- Theo? - Nothing yet.
(COUGHS) It's okay! It's just blood.
We need to do this now.
We can't wait.
Okay, give me your arm.
Lie back.
- Here we go.
- Like this.
Okay? Good.
What now? We wait.
Together.
Hey! New labs on Allie Watson.
But it's weird.
- What? - Her blood alcohol level went up? Like I said.
Weird.
Um.
No way she's had a drink while she's been here.
She may not have had to.
There's a rare bacterial reaction where your GI system creates its own alcohol.
It's called auto brewery syndrome.
Did you have any bread tonight? Pasta? Pizza.
Well, the right carbs at the wrong time and you basically become your own distillery.
But why now? I've always eaten those things.
There are emergent digestive conditions that can trigger it.
Even being on antibiotics for a really long time.
Yeah.
I've been on and off them for sinus infections.
Your stomach continued to produce its own alcohol, which is why your reaction was delayed in the first place.
Thanks, Arnold.
You're on an epi drip now, and we're gonna give you some activated charcoal to drink so that should stop the reaction completely.
It doesn't look very appetizing but I promise it will help.
(SIGHING) Then I was drunk.
Maybe, I didn't realize.
How could I have known? This isn't your fault, Allie.
Okay? And I'm gonna make sure Sandra knows that.
- You must be exhausted.
- Huh.
Were the girls upset I wasn't there when they woke up? Uh A little, but you know a bus full of kids, that has to be more important.
Mel, that's not, that's not what I meant.
Look, good news is, I've already bought my flight pass so I'll be able to go back and forth four, even five times a week.
Theo.
No, I've got it all planned out.
Okay? I'm gonna do my scheduling, and and my charts, I'm gonna do them all on the plane so when I get home, there's no work.
Half the doctors here they commute from the suburbs.
It's like a two-hour drive with traffic, so I mean, this is it's no different.
I'm just not sure that's realistic.
- Look.
- Mel, what I've gotta go.
We'll talk about it later? Okay? - Okay? - Yeah.
Okay.
Bye.
You heard about Allie? Maybe she didn't drink but she must have felt something.
She should have pulled over.
Stopped driving.
I only found Emily in time to save her because of Allie.
She loves her.
She's terrified of losing the life that she's built with you.
I care about her too but She'll have to find a new job.
This is my daughter, who may never breathe on her own again because of what both of you did.
We need to talk about you giving Lizzie Stahl - a thrombolytic agent.
- Well, we paged you.
And we both know that if I'd waited There are two hematologists here from her team, plus two very worried parents - Theo! - And a new acting chief and I had to explain to all of them why this happened without their input.
Theo, I went in to return her backpack - and she crashed because - If I wanted your help and I wanted you to check on my patients, I will ask you! Was Doctor Bishop here during your residency? Has he ever not been here? Doctor Novak, Emily Parker, she's She's touch and go yeah.
I heard.
I also heard what you did for him.
How you saved his life.
You've made some hard choices.
Friends I've had, doctors from overseas who tried to make it over here, those skills, they don't always translate.
You're one of the lucky ones, Bashir Hamed.
(INDISTINCT CHATTER ON PA) I heard Lucas is gonna recover completely.
Yeah, just this kid is like a millimeter from death, and somehow he still manages to hold it all together.
He had some help.
I've been thinking about all the reasons I've been afraid to throw in for Chief Resident.
And I don't know, I guess tonight I realized that none of that really matters.
I want it, you know? So I don't know whatever, I guess I'll just have to learn as I go.
If you get it.
(KNOCKING) Come in, Leblanc.
You changed the lamp.
You moved it.
- There's something you needed? - Um I wanted to tell you that I made the call to give Lizzie Stahl thrombolytics without consulting Doctor Hunter first because It was the right call.
I know.
Okay.
So did you just come here to apologize for making the right call? No.
I heard you when you said that Lizzie was Theo's patient.
But I still went in to check on her because I know doctors like you.
You stay late.
You over-invest, you really truly care about the patients instead of looking at them like they're needy bags of meat.
- And that's admirable.
- Look if you're gonna tell me that I need to find some kind of balance No, I don't care if you work four days straight and don't sleep.
You're a grown-up.
But it doesn't make you any better or smarter - than anyone else here.
- No, I never said that it did.
But you think it.
Don't try to tell me you don't.
And the truth is if you weren't in Lizzie's room Her vitals monitor would have alerted somebody else and they would have made the same call as you did.
I don't care what kind of a doctor you are, Leblanc.
I just need you to do your job, like everybody else.
(GENTLE MUSIC) (SIGHING) She needs a few seconds for the sedation to wear off and then we'll listen.
What happens if she can't get air? We're here.
It's time to see if she can breathe on her own.
Hi, Emily.
Can you breathe for us? (INHALING) There you go.
That's it.
You did it.
Great job.
She sounds perfect.
Oh, my baby, you're so strong! I love you so, so much.
(SOFT MUSIC) Allie! Why should you never trust atoms? Because they make up everything.
Emily wanted me to tell you that.
Thanks.
(EXHALING) (GENTLE MUSIC) One of us should say something.
It's good to hear your voice again, sir.
Huh.
(CHUCKLES) Just ask.
How'd we do tonight? (SOFT CHUCKLES) - Hey! - Hey.
Is it just me or this shift started about a year ago? It definitely is not just you.
Do you wanna celebrate it finally being over with a drink? Uh, um I have to take Amira to school.
Right.
Right it is morning after all.
Oh, it's alright! (CHUCKLES) I've been trying to manufacture a three-day weekend to make up for today but it's impossible.
If you move Petro to Tuesday and convince Levine to pull a double.
- (LAUGHS) - Thank you.
Scheduling sounds like a nightmare.
Yeah Well, I heard you were up for a career bump too so get used to it! They'd be idiots not to pick you.
I was excited for you.
I'm sorry.
(LAUGHTER) Seriously, guys.
Just I don't wanna jinx it.
Well, on that note.
I'm gonna go sleep for 12 hours.
I'll see you later.
Good night! Have a good night! I could really use a greasy breakfast.
Are you hungry? I'm famished.
(LAUGHS) Ow, come on.
You're too late for pizza.
Sorry.
Long night.
We had fun.
I could have.
I wanted to.
For a long time I didn't know where you were, and when I finally heard that you made it, that you came here with your sister for for a new life.
The Bashir I knew would have risked everything to come get me and I didn't want you to make that choice.
So you made it for me? (GENTLE MUSIC) I understand if you can't accept that.
(SIGHING) (SOFT MUSIC)