Saving Hope (2012) s02e07 Episode Script
Bed One
Yes, I'm fine.
Just getting home now.
Thanks for checking, Ruth.
Have a good night.
She heard a commotion in the apartment.
Thinks we're fighting.
Wait here.
Freeze! Oh.
Okay, are you happy? I've soiled myself.
Oh, my god.
Luke! I was gonna clean this up before you got home.
And yet here we are.
Look, my shift ran late.
Some old lady tripped down some stairs in the blackout.
It took two hours to get admitted.
The point is, hey, voilà , salade du jour.
Looks like compost.
That hurts.
Although I will say, I did raid your cupboards, and I saved a few things from your fridge.
You're welcome.
But try it.
I think you'll be surprised.
- That seems unlikely.
- Look, I came by unannounced.
The least I can do is make you some dinner.
Mmm.
What is it? Is this a fingernail? Slivered almonds that's what that is.
We don't have almonds.
Well, then, that's weird.
Oh, my god.
Go.
Go.
Clean this up.
Pack your bags.
One more night.
I'll be gone by morning.
You won't even know that I'm here.
Okay? Look, I'm cleaning.
I need caffeine.
We can't make coffee.
The power's still out.
Hey, is there actual coffee in coffee cake? I don't think so.
I thought he was leaving.
So did I.
Luke, what are you still doing here? The key to battling the extreme heat, girlie, is do nothing.
Mm.
That's your specialty.
And a good morning to you, as well, chuckles.
You're back at work.
You should be looking for your own place.
Oh, I will, believe me.
As soon as I get my first paycheck, I'm out of here.
And take those crotch peas with you.
"Record-breaking temperatures expected to continue all week.
" "No word on when this blackout is going to end.
" - My phone, please.
- Okay.
Okay, the A.
C.
has conked out at Western Gen.
All E.
R.
patients are being rerouted.
Rerouted to Hope Zion.
We got to go, Alex.
Hey, whoa.
Can I get a ride to work? You're not dressed.
- It'll take me like five seconds.
- Gotta go.
Hey, mom, dad, remember, be the heat.
Shut up.
Shut up.
- Hey, guys, I was, uh - Morning, Joel.
I need to oh, I'm sorry.
Hello, Melanda.
Okay, I understand.
It's not ideal.
I just Life at the top.
I don't miss it.
All right, well, I will be up there very shortly.
Um, I need you to lead a trauma team today.
- Okay.
- No, I was talking to Alex.
O kay.
Zach's pulled three graveyards in a row.
You've led the team before.
- I have.
- Not under these circumstances, she hasn't.
This is a blackout, which means more mvcs, which means more traumas.
I can handle it.
I'm sorry, I have to Hello.
E.
R.
gonna be jumping.
Be the heat.
- See ya.
- See ya.
Got an MVC on the way.
One minute out.
Hello, gentlemen.
Hey.
- Good.
- He made you trauma leader.
He did.
Do you want to go home, get some rest? Um, you know, I'm a divorced guy living at the motor lodge.
No, I think I'd rather stay here.
- At least there's a minibar.
- Amen to that.
All right, team, listen up.
The heat isn't doing us any favors, but if we all stick together, work togeth And there it is.
Bonnie Drummond, 32, high-velocity MVC versus median.
She lost control of her convertible.
Airbag facial trauma.
Gcs is 12.
BP is trending down.
Bonnie, can you hear me? Jackie? I'm gonna do a F.
A.
S.
T.
Reid, hand over the wand.
You're team leader.
- Right.
Okay, S.
A.
T.
S? - 85.
- Air entry? - Yes.
Charlie, what do you see? Got swelling in her left arm and no distal pulse.
Looks like compartment syndrome.
Yeah, she's gonna need a fasciotomy or she's gonna lose the arm.
Okay, Reycraft, talk to me.
Free fluid in the F.
A.
S.
T.
She's bleeding internally.
Let's get her to an O.
R.
right away.
Charlie and Reycraft, I want you both working at the same time.
Go.
And get her cross-matched for 6 units of packed cells.
- Come on.
- Yeah.
You're team leader.
Run the show.
Don't be the show.
Easier said than done.
You ready for the next one? Do I have a choice? This is Beth Brady, mid-30s.
I'm guessing, narcotics overdose.
Rooming-house neighbor found her groggy with dilated pupils.
To bed 4.
Jackson, .
1 milligrams of naloxone.
You got it.
Okay, let's run a tox screen and urinalysis.
Welcome back.
Beth, can you tell us what you took? I'm gonna get her some activated charcoal just in case.
- I'll grab a barf bucket.
- Man: 1 2 3.
Thought your station was across town.
Heat wave's got all the hospitals jammed.
Your E.
R.
's got the most beds, so you get the overload.
- Perfect.
Got it? - Yeah.
Hey, so, uh, how long will it be until my O.
D.
gets admitted? I have no idea.
It's a full house.
Right.
I need to get back on the road.
Can you just do me a solid and admit her, please? We have got a system here, Luke.
I need a doctor!! Find a bed for me.
Let's get him on the floor.
Hey, do you need some help? Just lay him down.
Here we go.
How did this happen? I found him found him in the pool in my condo.
He was floating facedown.
I tried CPR.
Okay, how long has he been unconscious? - I don't know.
- Somebody get me a crash cart! Luke! Bed's here.
Help me out here.
Does he have a name? - Okay, here you go.
- He's not gonna die, is he? Not if I can help it.
Is he gonna be okay? He needs a chest X-ray to make sure his lungs are clear, but he's stable for now.
Looks like you hit your head pretty hard.
Ah.
Yeah, I kind of knocked it on the ladder when I was dragging him out of the pool.
Well, I'd like to have a look at it, okay? Here you should probably have a C.
T.
scan before you go.
Can you tell me your name? Uh, Graham Kennedy.
And your friend's name? He's not my friend.
He's just a bum.
I see him every day outside my building, begging for change.
You having trouble breathing? Aw, I'm just just a little winded from carrying him.
You carried him? Yeah, 12 blocks.
I couldn't get a cab.
So Smile, Mr.
Kennedy.
You just saved a man's life today.
You're a hero.
Yeah.
Her liver's intact.
Uh spleen, too.
Well, she's bleeding from somewhere.
Put a stitch in it.
I will if you find it.
Suction.
There it is.
She's got a tear in her inferior vena cava.
- 3-0 prolene? - Make it a 4-0.
- How's the arm? - Um, good.
Muscle bellies are loose.
No digital swelling.
And CVP is sky-high.
I'm having trouble oxygenating.
Reycraft? It's not me.
My sutures are tight.
Blood around the heart? Yeah.
Could be a bleed in her aorta, but I'd need to do an echo to confirm.
Whoa.
Is that me? Dude, am I dead? Um, we can't wait.
Somebody page Dr.
Bell, please.
Okay, well, the O.
R.
s are full.
We need to free up some beds for the post-op patients.
The best I can do is move the more stable patients up to general medicine.
And how many beds will that give me? - Four, max.
- That's not enough.
Joel, I know you're under a ton of pressure, so I say this with love and the utmost respect.
If you need more beds, you're gonna have to pull them out of your Good morning.
Don't worry, I'm not gonna sneak into the O.
R.
I know that I'm suspended.
Shouldn't you be studying for your boards? Well, I figured I could study here, where the A.
C.
is pumping, or in my boiling-hot apartment.
Oh, well, since you're here, why don't you lend a hand and check in on your favorite post-op patient? Happy to.
Morning, Roddy.
Good morning, Maggie May.
- You and your Rod Stewart.
- Oh, come on, you have to respect any man who can achieve superstardom with that hair and that mole.
Flash cards.
How's the studying going? If by "studying," you mean staring at my flash cards with fear and dread Well, then flash-card me.
Let me quiz you.
- Okay.
- Come on.
You know it helps.
All right, question one "what's the best way to detect early iron overload?" Don't overthink it.
Just blurt out the first answer that comes to your mind.
Do an iron stain of a bone-marrow aspirate.
Okay, second answer that comes to mind.
Liver-biopsy specimen.
There you go, Dr.
Lin, huh? Kickin' ass, takin' names.
Okay, one of those? We're good with that.
Yeah? You think the leg's gonna be okay? Yep, edges look good.
Tissue's pink and healthy.
Keep healing like this, you'll be good as new in a couple months.
Ooh, nice.
Okay, good.
I got a mustang fastback '67 waiting at home for me.
Oh, yeah, yeah.
Put it together with my own hands, too.
You do know they sell cars that are already put together, right? No, when you get your hands in there, you learn how something works, what it can do, how far you can push it.
Mm.
My dad used to say the same thing about becoming a surgeon, which is the one thing I won't be when I fail my boards.
Okay, all right, well, then, next question.
Um, ooh, "why does a patient with," uh, uh, "the nec" Necrotizing fasciitis.
Flesh-eating disease "need dialysis?" Too much potassium in the blood.
Dialysis is the only way to get rid of it all.
- There you go.
- Speaking of which, it's about that time.
Want me to walk you down? Walk? I'm gonna walk? Really? Let's jog.
Yeah.
Oh, oh, tease, taunt.
Nice.
Okay, it's a torn aorta.
I'm trying to locate the hole.
Suction? I'm working on it.
All right, we're gonna have to go on pump to fix this.
Let's go on circulatory arrest.
- You want to freeze and flatline her? - Yeah.
Kill her to save her life.
Put her in a hypothermic state, stop her heart, drain her blood.
Gives me a clear view of the tear, gives her a shot at living.
- Could work, but - Could also cause brain damage if we don't work fast enough.
Also, we don't have a perfusionist.
What? Larry's kid has heatstroke.
He's at home with her.
You got to be kidding me.
Yeah.
No, this is part of my stand-up routine.
How's my timing? We can't run a bypass without a perfusionist.
Okay, so, aside from the patient bleeding to death, does anyone else have an alternative? I've been searching my whole life for the perfect high, but I have never had a rush like this.
I'll run the pump.
Seriously? Yeah, hell, why not? Larry can do it.
How hard can it be? Hey, Larry, it's Charlie.
Yeah, how's the kid doing? Good.
Listen, um, I'm going to use the pump to do a circ arrest with Dr.
Bell.
Think you can talk me through it? Pump is primed and circulated.
I'll run it, you hook it up.
Since you guys got it under control, I'm gonna go use my skills elsewhere.
- So good luck.
- Thank you.
My body is buzzing.
I feel electric.
This is it, Charlie.
Crikes, I'd give anything to feel like this forever.
This had better work.
Let's get her hooked up.
Okay, if you will just put this around your neck, - we will be with you as soon as we can.
- Woman: Okay.
Got two more ambulances coming our way gunshot wounds.
Crazy from the heat.
How's your MVC patient? Charlie and Dr.
Bell have it under control.
All right, then.
Page more junior residents.
We need more bodies.
So bossy.
I have a body.
What? Before you say anything, my O.
D.
is stable.
I was just with her.
Okay, then what do you want? Well, since I'm stuck here until my O.
D.
gets admitted, maybe I can help.
Or I could just sit here and not use my advanced medical training.
Want to pass out triage tags? I do.
Green is for the walking wounded.
Yellow for the serious, red for "oh, my god, he's bleeding out," black for "don't bother.
" I do this for a living, too, girlie.
- Alex: Stay out of trouble.
- Yes, ma'am.
Okay.
So, your neck, right? This looks like the organic salmon I bought last week.
A.
C.
T.
is 450 and climbing.
Okay, we're at 450, Larry.
Turning pump sucker on.
How's it look? Like someone pulled out the stopper.
A.
C.
T.
is 480.
Okay, Larry, our numbers are good.
I'm going on pump.
The blood is being cooled and then fed back into her body.
She should be one cold salmon.
Uh, internal temperature is 30.
8 degrees.
Victor, how'd you cook that salmon? Larry wants to know.
Cedar plank.
Cedar plank.
Yeah.
Uh, 30.
4 degrees.
This is taking forever.
Someone get Dr.
Bell a magazine.
Hey, let me give you a hand with it.
Sure, thanks.
Roddy Gray, this is Joel Goran, our illustrious chief of surgery.
How you doing? Being pushed by the chief that's not too shabby.
Let me guess.
You drive a classic BMW? Actually, I did have a 635.
Oh, silver? It was gray.
What, did she tell you that? Oh, no, I've just been able to tell what kind of car people drive.
That's impressive.
What else can you tell about me? You make more money than I do.
Graham? Hi, I'm gonna need you to put this around your neck.
And your wait isn't going to be the shortest.
There's a long line-up for the C.
T.
scanner.
That's all right.
I thought you might want to know, the guy you brought in I think he might have a couple of broken ribs.
- Did-did I break his - No, no, you didn't.
It's a common injury with CPR, but it's worth it.
Broken ribs, we can deal with.
The not breathing, not so much.
Anyway, he's stable and sedated, so he's not in any pain.
How long will he get to stay? Until he gets better.
Because I think he was in the pool trying to cool down.
We'll make sure he gets hydrated before we discharge him.
And after that? We will call a social worker, see if we can find a shelter bed.
Yeah, guys like that, they don't like going to shelters.
- You know? - Unfortunately, no.
I wish there was more I could do.
You saved his life.
That's pretty good for one day.
We're out of triage tags.
I'll get you some in a second.
Okay.
I should get back to work.
Or you could stay here in this lovely air-conditioned waiting room until I make sure that your head's okay.
I'm just I'm a lawyer.
Days off make me nervous.
I understand that, but if you could just hang out a little bit longer.
Okay.
Great.
You know what they say about lawyers, right? It's like a pie-eating contest with a prize of more pie.
That man carried a stranger 12 blocks.
He can have as much pie as he wants.
I don't think you're getting it.
The pie is a bad thing in the scenario.
You understand? I understand what you mean, but I like pie.
I thought we had backup power.
We did.
You got to be kidding me.
Just sit back, all right? Just sit back here.
All right.
I need to get you some Emergency lights are not great for the trauma bay, but we'll manage.
This is so bad.
The ventilators are dead.
We're gonna have to bag every trauma that comes in here.
Yes, but the monitors and defibs are on battery backup, and those will last us until the generators kick back in.
Maybe we should shut down the E.
R.
, transfer patients.
Where to? Every E.
R.
in the city is backed up.
Drink up.
Hydration is key.
Right.
There was a small fire, and the backup generators are fried.
We're working on getting everything back online.
How long will it take? Um, should be anytime now.
Okay, we have a dialysis patient here, so tell them to step on it.
How are you doing, Roddy? Honestly? I'm not feeling so great.
Well, hang in there, sir.
It shouldn't be too long.
Left? Yeah.
That's good.
Can someone get Joel on the phone? Find out what the hell is going on, please.
The heater/cooler doesn't have backup power.
Yeah, I can see that.
Thank you.
She's still at 22 degrees, and we still have 4 to go.
Okay, well, we can still do the surgery.
We just have to do it faster a lot faster.
How are we gonna warm her back up with the power still off? We'll cross that bridge when we get to it.
I'd rather build that bridge right now, Dawn.
Well, she's frozen, and her heart has stopped beating, so we can't exactly change horses midstream.
If you're not up for it No, it's not that.
I just, um Charlie, I got to say, this whole whatever this thing is, you know, kind of killing my buzz.
You're just what? I'm just not sure we have a lot of time.
Hey.
Scans came back from your drowning victim.
Check it out.
Wow.
Two badly healed arm fractures and a broken clavicle.
These scans look like a rodeo rider's.
Mm-hmm.
Sorry to interrupt.
Beth's fishing out again.
Fishing out? It's a St.
Catharine's thing.
Means she's O.
D.
'ing.
Yes, I know.
Did she have any more drugs stashed on her? I'm a medic, not a cop.
- 2 milligrams of naloxone.
- No, stay.
I already tried naloxone.
It ain't gonna work this time.
Her pupils are pinned.
Beth? Okay, let's get a bolus of saline Where did she get these drugs from? She's a junkie in a hospital.
She probably stole a bottle of pills.
She's going into defib! Let's get the crash cart over here! How about insulin? Uh, Jackson! I worked with a guy in Ajax who would carry a syringe of insulin out with him every Friday night.
It'll work on an O.
D.
, Alex.
Luke, leave it.
I'm not giving her three times the therapeutic dose unless I'm absolutely sure.
- Out of the way! - Charge it to 200.
- Clear! - Alex, move.
- Luke, what are you doing? You've got to clear.
- Don't worry.
- What the - It's okay.
What did you just do? And we're back.
You need to get back on the road now.
Push 1 amp of d50, Let's even out this insulin.
Wow.
Angry and quiet.
That's the best kind - What the hell was that? - Okay, let's get her to the ICU.
We had a problem.
I-I solved it.
No, you could have killed her.
But I didn't.
I know what I'm doing.
No, you don't, Luke.
Actually, you have no idea what the hell you're doing.
Right.
I'm the disaster.
You're the genius.
I forget that sometimes.
I'm sorry.
- That's not what this is about.
- Whatever you say.
You know, it's a hard enough day without you flying in here like a bat out of hell, leaving me to clean up your messes.
You need to leave right now.
How's she doing? She's good.
He's bradycardic, and his radial pulse is thready.
Yeah, his potassium levels must be through the roof.
What are my numbers? Uh, they'll be a lot better once we get you down to dialysis.
Hey, Gav, when are they getting us out of here? They're working on it.
I need you to find a way to get me 1 amp d50, and 1 amp bicarbonate.
Are you okay? I'm fine, but my patient could use a little help.
Okay, how am I gonna get these drugs to you? Tell him to get a Gavin, go up to the fourth floor and try and pry open the elevator doors on the right-hand shaft, and drop the drugs down like that, okay? - Did you get that? - Yeah, got it.
You rock.
All right, Roddy, um I'm formulating a magnificent plan called I'm gonna stand on your bed.
Hey, whatever you need, boss.
- All right.
- Watch his leg.
It's locked.
Do you have a hairpin? Uh, no.
It's probably a good thing.
I wouldn't know what to do with it anyway.
Think you can bust through that thing? I can give it a try.
You know, I think I might just lie here while you two do your superhero thing, if that's okay.
Joel? Yeah, tell Gavin not to bother.
There's no way we're getting through that thing.
I don't know what it is.
Um, I kind of feel like Like maybe I'm not supposed to be here.
You know, like, uh like maybe I'm missing something.
Charlie, I'm kind of freaking out here.
I have this feeling I forgot something.
Dawn? Yes, distract the heart surgeon while she's working in the dark.
I'm gonna do something a little odd here.
I'm going to talk to the patient as though she could hear me.
You know, there's rumors going around that you're getting really flaky.
Yeah, tell me about it.
Hey, Bonnie, um, listen, The reason you're so cold is because we made you hypothermic.
Why? So that your brain cells would slow down enough that we could fix your heart without giving you a stroke.
I don't think that's what it is.
I think I I kind of screwed up years of my life.
I feel like I got this weight, like right square on my chest.
I can't breathe.
Dawn, I'm gonna step outside for five minutes.
- No, you're not.
- Yep, got to go.
Carol, you watch the pump for me.
- If anything changes, page me.
- Charlie! Bonnie, I just want you to know you're gonna be okay.
Dr.
Bell has done this surgery many times before.
I don't care.
Whatever you're doing to me, I want you to undo it, okay? Because I was perfectly happy before all of this.
You know, I-I went for a drive.
Yeah, and you crashed into a median and tore your heart open, which is exactly what we're trying to fix right now.
No.
No.
I went and I-I-I gassed up the car, and I-I went for a drive with Jackie and Where's Jackie? I forgot about Jackie.
Who's Jackie? Jackie's my girlfriend.
She was in the car with me.
Uh, as far as I know, the paramedics brought you in alone.
That means that she's just out there somewhere.
- She's out there.
- I don't know.
Okay, well, you got to find out.
You are my priority right now, okay? And in case you haven't noticed, you are a ghost, which which carries with it a number of problems.
So, I need to get back to your surgery before we run out of time.
No.
No! No! Okay.
It was-it was my idea, okay? It was my idea to go for a drive in the middle of the night in the blackout.
You know, drive down Rosedale Valley with the lights off and I'm always the one that's, you know, forcing her to take these stupid risks.
Jackie only did it because I asked her to, because she knew it would make me happy.
You got to help me find her.
Please.
I really need you to help me find her.
Oh, my god.
What if the woman that you loved was lying in a ditch somewhere, you know, because of something you did? Hey.
Charlie, w-what are you doing out here? Um, our MVC patient from this morning, - did anyone else come in with her? - Just the medics.
Any other MVC trauma come in, like a woman named Jackie, perhaps? No.
Why? Which one of you brought in Bonnie Drummond, the MVC from the Rosedale Valley? I did.
You left someone behind.
- No.
The cops - Was it pitch black outside? - Yeah.
- Go back and look.
There was another woman in that car.
Her name is Jackie something.
Go! Go back and look! All right.
All right.
Hey.
Hey, Charlie.
What was that about? Long story, and I have to get back to the O.
R.
- He's hyperkalemic.
- Listen to me.
I can't think of any way to get his potassium down.
He needs dialysis in the next half an hour.
We can't lose him, Joel.
I know.
Oh, please.
Don't let me die in an elevator.
Don't be silly, Roddy.
That's not gonna happen, okay? W-what is the status on those generators, please? You still have a couple of hours to get to dialysis.
You're going to be fine.
You hear me? Okay.
I'll be okay.
Your scan came back clear.
I am sorry about the wait, but I wanted to be sure.
Haven't been off the grid this long since law school.
Tell you what I'll write you a note.
"Graham couldn't come to work today.
" "He was too busy saving a man's life.
" Aah.
How's he doing? Your father? How'd you find out? He woke up and told us his name.
You must think I'm a bad person.
No.
No, I don't.
Look.
Last time I took him in, I found him on the floor in my 3-year-old's bedroom.
My kid was asleep.
He'd smashed the piggy bank.
He was down on all fours sifting through the change saying, "god, kid, couldn't you throw a buck in there from time to time?" I didn't break his rib, did I? No.
It was an old injury.
Someone else did it.
He doesn't deserve that.
He was an awful father.
You turned out okay.
Well, the jury's still out on that one.
Graham, are you having trouble breathing? - I thought it would pass.
- Okay.
Your pulse is racing.
Zach! Graham, did you breathe in any water while you were rescuing your father from the pool? I don't remember.
It's the chlorine.
Zach! Whoa, whoa, whoa, whoa, whoa! What happened? What happened? His lungs are inflamed from the water.
He's drowning.
S.
A.
T.
S are low, pressure is tanking.
We had equal bilateral breath sounds.
Now I'm squeezing and nothing's happening.
Air's not getting into his lungs.
Intubation must have caused a tension pneumothorax.
We need to do a needle thoracostomy.
Ready, ready? All right.
Betadine and a 12-gauge.
Okay.
Here we go.
Come on, Graham.
Take a breath, Graham.
Come on.
Okay.
Plan "B.
" Jackson, get me a chest tube.
Any kind of tube.
Get me a pleur-evac box.
I'll have to call upstairs.
J-j-just just a sec.
Here.
I got it.
Okay.
Scissors.
Give him 100 micrograms of fentanyl.
Okay.
Knife.
Kelly.
Okay, Zach, when I hear that pop, I want you to have that tube ready.
All ready.
Almost there.
I'm in the parietal pleura.
Just a little further.
Okay.
Chest tube.
This is gonna work, right? Water pressure creates a seal.
Air comes out but not in.
So we don't kill our patient.
Unclamp.
Pulse is stabilizing.
Good work, Reid.
You, too, Zach.
The repair is holding.
So now we just got to warm her up.
Okay, so, let's run through our options.
Warming blankets.
- Carol? - Carol: I'll see what I can find.
Okay.
What else do we have that works? We still have oxygen, running water.
Okay, well, hot water bottles aren't sterile, so what else do we have that's warm? - Saline.
- Saline.
Okay, somebody get me 4 liters and a sterile bowl.
On it.
Remember that big blackout like 10 years ago? We just sat on the patio, drank wine, lit candles.
Remember that couple on their patio beside us arguing? Oh, yeah.
About Mike Tyson.
One of the great intellectual debates of our time.
Well, it wasn't much of a debate.
I mean, he bit the guy's ear off.
Oh, please.
It wasn't the whole ear.
Okay.
Where are we at? Um, 27 degrees.
She's getting warmer.
Keep the saline coming.
You've got time, Roddy, okay? You're gonna be fine.
You should be studying your flashcards.
Save your strength.
I can study later.
Joel, quiz her.
She's gonna need help.
Give me the cards.
Get the cards.
All right, let's quiz her, Roddy.
Let's see what we've got here.
Okay, Maggie, "which of the following clinical scenarios" "is least likely to describe paraneoplastic syndrome" "resulting from small-cell tumors of" Roddy? Roddy! Roddy.
No way.
No, no, no.
Okay.
Let me clear his head.
Give me a second.
- Give me a second.
- Get it down.
Come on! There's no pulse.
Maggie.
Hey.
Maggie.
Maggie.
We were 10 feet away from saving his life.
Okay, saline worked.
Take her off the pump.
Okay.
We've done our job.
Let's see if she's up for it.
Going down to half flow.
The heart's swelling.
It's too weak to pump the blood.
Going back to full flow.
Start again.
Okay, the heart muscle is too weak.
They should have found her by now.
Charlie, you want to try your flaky talky thing? Now's the time.
Come on, Bonnie.
Give us a hand here.
It's too late.
I killed her.
Going to full flow.
I'll be back.
Charlie! - Hey! - Paramedic: Hey.
Found her in a ditch I don't know how she lasted this long.
- They found her? - How are her vitals? When we found her, she was hypotensive, bradycardic.
Her S.
A.
T.
S were 84.
We got them up to 95 with a high-flow mask.
Okay.
Thanks.
Nice nice work.
No.
What does that mean? What did he just say? Is that good or bad? Do you know where you are? - Why isn't she answering? - She should be.
Miss, do you know your name? Jackie! Your name is Jackie! Okay, we can't wait for him anymore.
Give me the paddles.
I'm gonna shock her.
We're gonna try again.
- Carol, can you man the pump? - Yes, I can.
Miss, do you know your name? Where's Bonnie? - Do you know your name? - Jackie.
- Jackie? - She's gonna be okay? Okay.
That's good.
No signs of concussion.
No long-bone fractures.
Vitals in the q5, but let me know if anything changes, okay? I'll never forget this.
You will.
That is one healthy-looking heart.
Charlie, welcome back.
All right, let's do a little housekeeping and close her up.
Heart's beating on its own? Gave it a little jolt.
That must have been it.
Wow.
Looks like someone forgot to sing the clean-up song.
It's pretty great.
Not if you're the janitor.
No, I mean it just shows how full of life this place was today, how hard we worked to keep it together.
Is it kind of weird that I just want to leave it like this? I mean, at least for a few more minutes.
Zach, are you okay? I think I just miss my house, my kids, you know, running around, spilling things.
I just the motor lodge is surprisingly neat and tidy for a motor lodge.
Do you want to stay over tonight? Is that a good idea? I promise not to take advantage of you in your time of need.
Unless you ask politely.
Yeah.
I can live with those terms.
My place is a mess.
You'll be right at home.
Your son is doing well, Mr.
Kennedy.
Nobody's called me that in a very long time.
How are you feeling? If I'm being honest? Like I need a drink.
There's a long-term subsidized hospice affiliated with the hospital.
I think you'd be an excellent candidate.
I'd like to put your name forward.
Why would you do that for me? 'Cause you need to be somewhere safe.
Mm.
I-I don't think I should go in.
He won't want to see me.
He saved your life.
I think he might.
Mr.
Kennedy, your son is a good person.
He's the best thing I ever did.
So maybe you should be there when he wakes up.
Yeah, I'd like that.
Okay.
There you are.
You press the call button if you need anything, okay? Hey.
Hey.
That was quite a surgery, huh? What's going on with you, Charlie? You know that I believe in a lot of things that other surgeons discount, right? Yeah, like crystals and dream catchers and not shopping when you have PMS, right? I'm worried about you.
Ever since your coma, you do strange things.
I mean, you don't tell people why.
I I think you're having a breakdown.
You don't have to worry about me, Dawn.
Well, I do.
And I can't stop.
Don't do that.
I'm in love with Alex.
Does she know what a mess you are? Maggie.
I'm lifting your suspension.
You can start back in the O.
R.
tomorrow, okay? Do you even care that he died? I'm sorry that we lost someone today.
'cause you just jump back into chief mode as if nothing happened.
Look.
This person was a patient.
He wasn't a friend of ours.
I think you should probably recognize the difference between the two.
You wanted him to live as much as I did.
Hey, Maggie.
What? I don't think I ever told you how sorry I was your father died.
Thank you.
Okay.
So, I'm gonna go ahead and blame my behavior on the heat.
This uniform is hot.
I'm used to being naked lately - and the A.
C.
in my rig wasn't working.
- Stop it.
Please? Bed one.
What are you talking about? - You don't remember? - No.
You were eight.
I was six.
And we were lying awake on these bunk beds the ones on McDonald ave.
See, how do you remember those things? Mom was on a bender.
Right.
And I I promised you I-I would never be like her.
You were just a kid.
She was bed one, the sickest patient our whole childhood.
And she sucked up all the attention, all the worry.
I promised you I'd never do that.
It's just what you do when you're a kid, okay? You make all these promises about things you won't do when you grow up.
I also promised that I would never spit on a hanky and then rub it on your face, and I did that, too.
Or eat that cake with the nuts in it.
I promise I'll never wear two rings on one finger like uncle Ralphie.
Hey.
- You're not a burden to me.
- Yeah, I am.
I am.
I could change.
Yeah.
It's gonna change.
Okay.
- But you were great today! - Oh, no, no, no! - Please, don't do that! - I promise I'll change! - Why do you always have to hug? - I'm a human emotional blanket.
It's too hot.
It's okay.
I don't like forest-hug time! All right, break it up.
Chuckles, now, I know you're gonna try to talk me out of it, but I have to move out.
Whatever.
I'll believe it when I see it.
One for you.
Six for us.
We'll need it.
Mm-hmm.
Just getting home now.
Thanks for checking, Ruth.
Have a good night.
She heard a commotion in the apartment.
Thinks we're fighting.
Wait here.
Freeze! Oh.
Okay, are you happy? I've soiled myself.
Oh, my god.
Luke! I was gonna clean this up before you got home.
And yet here we are.
Look, my shift ran late.
Some old lady tripped down some stairs in the blackout.
It took two hours to get admitted.
The point is, hey, voilà , salade du jour.
Looks like compost.
That hurts.
Although I will say, I did raid your cupboards, and I saved a few things from your fridge.
You're welcome.
But try it.
I think you'll be surprised.
- That seems unlikely.
- Look, I came by unannounced.
The least I can do is make you some dinner.
Mmm.
What is it? Is this a fingernail? Slivered almonds that's what that is.
We don't have almonds.
Well, then, that's weird.
Oh, my god.
Go.
Go.
Clean this up.
Pack your bags.
One more night.
I'll be gone by morning.
You won't even know that I'm here.
Okay? Look, I'm cleaning.
I need caffeine.
We can't make coffee.
The power's still out.
Hey, is there actual coffee in coffee cake? I don't think so.
I thought he was leaving.
So did I.
Luke, what are you still doing here? The key to battling the extreme heat, girlie, is do nothing.
Mm.
That's your specialty.
And a good morning to you, as well, chuckles.
You're back at work.
You should be looking for your own place.
Oh, I will, believe me.
As soon as I get my first paycheck, I'm out of here.
And take those crotch peas with you.
"Record-breaking temperatures expected to continue all week.
" "No word on when this blackout is going to end.
" - My phone, please.
- Okay.
Okay, the A.
C.
has conked out at Western Gen.
All E.
R.
patients are being rerouted.
Rerouted to Hope Zion.
We got to go, Alex.
Hey, whoa.
Can I get a ride to work? You're not dressed.
- It'll take me like five seconds.
- Gotta go.
Hey, mom, dad, remember, be the heat.
Shut up.
Shut up.
- Hey, guys, I was, uh - Morning, Joel.
I need to oh, I'm sorry.
Hello, Melanda.
Okay, I understand.
It's not ideal.
I just Life at the top.
I don't miss it.
All right, well, I will be up there very shortly.
Um, I need you to lead a trauma team today.
- Okay.
- No, I was talking to Alex.
O kay.
Zach's pulled three graveyards in a row.
You've led the team before.
- I have.
- Not under these circumstances, she hasn't.
This is a blackout, which means more mvcs, which means more traumas.
I can handle it.
I'm sorry, I have to Hello.
E.
R.
gonna be jumping.
Be the heat.
- See ya.
- See ya.
Got an MVC on the way.
One minute out.
Hello, gentlemen.
Hey.
- Good.
- He made you trauma leader.
He did.
Do you want to go home, get some rest? Um, you know, I'm a divorced guy living at the motor lodge.
No, I think I'd rather stay here.
- At least there's a minibar.
- Amen to that.
All right, team, listen up.
The heat isn't doing us any favors, but if we all stick together, work togeth And there it is.
Bonnie Drummond, 32, high-velocity MVC versus median.
She lost control of her convertible.
Airbag facial trauma.
Gcs is 12.
BP is trending down.
Bonnie, can you hear me? Jackie? I'm gonna do a F.
A.
S.
T.
Reid, hand over the wand.
You're team leader.
- Right.
Okay, S.
A.
T.
S? - 85.
- Air entry? - Yes.
Charlie, what do you see? Got swelling in her left arm and no distal pulse.
Looks like compartment syndrome.
Yeah, she's gonna need a fasciotomy or she's gonna lose the arm.
Okay, Reycraft, talk to me.
Free fluid in the F.
A.
S.
T.
She's bleeding internally.
Let's get her to an O.
R.
right away.
Charlie and Reycraft, I want you both working at the same time.
Go.
And get her cross-matched for 6 units of packed cells.
- Come on.
- Yeah.
You're team leader.
Run the show.
Don't be the show.
Easier said than done.
You ready for the next one? Do I have a choice? This is Beth Brady, mid-30s.
I'm guessing, narcotics overdose.
Rooming-house neighbor found her groggy with dilated pupils.
To bed 4.
Jackson, .
1 milligrams of naloxone.
You got it.
Okay, let's run a tox screen and urinalysis.
Welcome back.
Beth, can you tell us what you took? I'm gonna get her some activated charcoal just in case.
- I'll grab a barf bucket.
- Man: 1 2 3.
Thought your station was across town.
Heat wave's got all the hospitals jammed.
Your E.
R.
's got the most beds, so you get the overload.
- Perfect.
Got it? - Yeah.
Hey, so, uh, how long will it be until my O.
D.
gets admitted? I have no idea.
It's a full house.
Right.
I need to get back on the road.
Can you just do me a solid and admit her, please? We have got a system here, Luke.
I need a doctor!! Find a bed for me.
Let's get him on the floor.
Hey, do you need some help? Just lay him down.
Here we go.
How did this happen? I found him found him in the pool in my condo.
He was floating facedown.
I tried CPR.
Okay, how long has he been unconscious? - I don't know.
- Somebody get me a crash cart! Luke! Bed's here.
Help me out here.
Does he have a name? - Okay, here you go.
- He's not gonna die, is he? Not if I can help it.
Is he gonna be okay? He needs a chest X-ray to make sure his lungs are clear, but he's stable for now.
Looks like you hit your head pretty hard.
Ah.
Yeah, I kind of knocked it on the ladder when I was dragging him out of the pool.
Well, I'd like to have a look at it, okay? Here you should probably have a C.
T.
scan before you go.
Can you tell me your name? Uh, Graham Kennedy.
And your friend's name? He's not my friend.
He's just a bum.
I see him every day outside my building, begging for change.
You having trouble breathing? Aw, I'm just just a little winded from carrying him.
You carried him? Yeah, 12 blocks.
I couldn't get a cab.
So Smile, Mr.
Kennedy.
You just saved a man's life today.
You're a hero.
Yeah.
Her liver's intact.
Uh spleen, too.
Well, she's bleeding from somewhere.
Put a stitch in it.
I will if you find it.
Suction.
There it is.
She's got a tear in her inferior vena cava.
- 3-0 prolene? - Make it a 4-0.
- How's the arm? - Um, good.
Muscle bellies are loose.
No digital swelling.
And CVP is sky-high.
I'm having trouble oxygenating.
Reycraft? It's not me.
My sutures are tight.
Blood around the heart? Yeah.
Could be a bleed in her aorta, but I'd need to do an echo to confirm.
Whoa.
Is that me? Dude, am I dead? Um, we can't wait.
Somebody page Dr.
Bell, please.
Okay, well, the O.
R.
s are full.
We need to free up some beds for the post-op patients.
The best I can do is move the more stable patients up to general medicine.
And how many beds will that give me? - Four, max.
- That's not enough.
Joel, I know you're under a ton of pressure, so I say this with love and the utmost respect.
If you need more beds, you're gonna have to pull them out of your Good morning.
Don't worry, I'm not gonna sneak into the O.
R.
I know that I'm suspended.
Shouldn't you be studying for your boards? Well, I figured I could study here, where the A.
C.
is pumping, or in my boiling-hot apartment.
Oh, well, since you're here, why don't you lend a hand and check in on your favorite post-op patient? Happy to.
Morning, Roddy.
Good morning, Maggie May.
- You and your Rod Stewart.
- Oh, come on, you have to respect any man who can achieve superstardom with that hair and that mole.
Flash cards.
How's the studying going? If by "studying," you mean staring at my flash cards with fear and dread Well, then flash-card me.
Let me quiz you.
- Okay.
- Come on.
You know it helps.
All right, question one "what's the best way to detect early iron overload?" Don't overthink it.
Just blurt out the first answer that comes to your mind.
Do an iron stain of a bone-marrow aspirate.
Okay, second answer that comes to mind.
Liver-biopsy specimen.
There you go, Dr.
Lin, huh? Kickin' ass, takin' names.
Okay, one of those? We're good with that.
Yeah? You think the leg's gonna be okay? Yep, edges look good.
Tissue's pink and healthy.
Keep healing like this, you'll be good as new in a couple months.
Ooh, nice.
Okay, good.
I got a mustang fastback '67 waiting at home for me.
Oh, yeah, yeah.
Put it together with my own hands, too.
You do know they sell cars that are already put together, right? No, when you get your hands in there, you learn how something works, what it can do, how far you can push it.
Mm.
My dad used to say the same thing about becoming a surgeon, which is the one thing I won't be when I fail my boards.
Okay, all right, well, then, next question.
Um, ooh, "why does a patient with," uh, uh, "the nec" Necrotizing fasciitis.
Flesh-eating disease "need dialysis?" Too much potassium in the blood.
Dialysis is the only way to get rid of it all.
- There you go.
- Speaking of which, it's about that time.
Want me to walk you down? Walk? I'm gonna walk? Really? Let's jog.
Yeah.
Oh, oh, tease, taunt.
Nice.
Okay, it's a torn aorta.
I'm trying to locate the hole.
Suction? I'm working on it.
All right, we're gonna have to go on pump to fix this.
Let's go on circulatory arrest.
- You want to freeze and flatline her? - Yeah.
Kill her to save her life.
Put her in a hypothermic state, stop her heart, drain her blood.
Gives me a clear view of the tear, gives her a shot at living.
- Could work, but - Could also cause brain damage if we don't work fast enough.
Also, we don't have a perfusionist.
What? Larry's kid has heatstroke.
He's at home with her.
You got to be kidding me.
Yeah.
No, this is part of my stand-up routine.
How's my timing? We can't run a bypass without a perfusionist.
Okay, so, aside from the patient bleeding to death, does anyone else have an alternative? I've been searching my whole life for the perfect high, but I have never had a rush like this.
I'll run the pump.
Seriously? Yeah, hell, why not? Larry can do it.
How hard can it be? Hey, Larry, it's Charlie.
Yeah, how's the kid doing? Good.
Listen, um, I'm going to use the pump to do a circ arrest with Dr.
Bell.
Think you can talk me through it? Pump is primed and circulated.
I'll run it, you hook it up.
Since you guys got it under control, I'm gonna go use my skills elsewhere.
- So good luck.
- Thank you.
My body is buzzing.
I feel electric.
This is it, Charlie.
Crikes, I'd give anything to feel like this forever.
This had better work.
Let's get her hooked up.
Okay, if you will just put this around your neck, - we will be with you as soon as we can.
- Woman: Okay.
Got two more ambulances coming our way gunshot wounds.
Crazy from the heat.
How's your MVC patient? Charlie and Dr.
Bell have it under control.
All right, then.
Page more junior residents.
We need more bodies.
So bossy.
I have a body.
What? Before you say anything, my O.
D.
is stable.
I was just with her.
Okay, then what do you want? Well, since I'm stuck here until my O.
D.
gets admitted, maybe I can help.
Or I could just sit here and not use my advanced medical training.
Want to pass out triage tags? I do.
Green is for the walking wounded.
Yellow for the serious, red for "oh, my god, he's bleeding out," black for "don't bother.
" I do this for a living, too, girlie.
- Alex: Stay out of trouble.
- Yes, ma'am.
Okay.
So, your neck, right? This looks like the organic salmon I bought last week.
A.
C.
T.
is 450 and climbing.
Okay, we're at 450, Larry.
Turning pump sucker on.
How's it look? Like someone pulled out the stopper.
A.
C.
T.
is 480.
Okay, Larry, our numbers are good.
I'm going on pump.
The blood is being cooled and then fed back into her body.
She should be one cold salmon.
Uh, internal temperature is 30.
8 degrees.
Victor, how'd you cook that salmon? Larry wants to know.
Cedar plank.
Cedar plank.
Yeah.
Uh, 30.
4 degrees.
This is taking forever.
Someone get Dr.
Bell a magazine.
Hey, let me give you a hand with it.
Sure, thanks.
Roddy Gray, this is Joel Goran, our illustrious chief of surgery.
How you doing? Being pushed by the chief that's not too shabby.
Let me guess.
You drive a classic BMW? Actually, I did have a 635.
Oh, silver? It was gray.
What, did she tell you that? Oh, no, I've just been able to tell what kind of car people drive.
That's impressive.
What else can you tell about me? You make more money than I do.
Graham? Hi, I'm gonna need you to put this around your neck.
And your wait isn't going to be the shortest.
There's a long line-up for the C.
T.
scanner.
That's all right.
I thought you might want to know, the guy you brought in I think he might have a couple of broken ribs.
- Did-did I break his - No, no, you didn't.
It's a common injury with CPR, but it's worth it.
Broken ribs, we can deal with.
The not breathing, not so much.
Anyway, he's stable and sedated, so he's not in any pain.
How long will he get to stay? Until he gets better.
Because I think he was in the pool trying to cool down.
We'll make sure he gets hydrated before we discharge him.
And after that? We will call a social worker, see if we can find a shelter bed.
Yeah, guys like that, they don't like going to shelters.
- You know? - Unfortunately, no.
I wish there was more I could do.
You saved his life.
That's pretty good for one day.
We're out of triage tags.
I'll get you some in a second.
Okay.
I should get back to work.
Or you could stay here in this lovely air-conditioned waiting room until I make sure that your head's okay.
I'm just I'm a lawyer.
Days off make me nervous.
I understand that, but if you could just hang out a little bit longer.
Okay.
Great.
You know what they say about lawyers, right? It's like a pie-eating contest with a prize of more pie.
That man carried a stranger 12 blocks.
He can have as much pie as he wants.
I don't think you're getting it.
The pie is a bad thing in the scenario.
You understand? I understand what you mean, but I like pie.
I thought we had backup power.
We did.
You got to be kidding me.
Just sit back, all right? Just sit back here.
All right.
I need to get you some Emergency lights are not great for the trauma bay, but we'll manage.
This is so bad.
The ventilators are dead.
We're gonna have to bag every trauma that comes in here.
Yes, but the monitors and defibs are on battery backup, and those will last us until the generators kick back in.
Maybe we should shut down the E.
R.
, transfer patients.
Where to? Every E.
R.
in the city is backed up.
Drink up.
Hydration is key.
Right.
There was a small fire, and the backup generators are fried.
We're working on getting everything back online.
How long will it take? Um, should be anytime now.
Okay, we have a dialysis patient here, so tell them to step on it.
How are you doing, Roddy? Honestly? I'm not feeling so great.
Well, hang in there, sir.
It shouldn't be too long.
Left? Yeah.
That's good.
Can someone get Joel on the phone? Find out what the hell is going on, please.
The heater/cooler doesn't have backup power.
Yeah, I can see that.
Thank you.
She's still at 22 degrees, and we still have 4 to go.
Okay, well, we can still do the surgery.
We just have to do it faster a lot faster.
How are we gonna warm her back up with the power still off? We'll cross that bridge when we get to it.
I'd rather build that bridge right now, Dawn.
Well, she's frozen, and her heart has stopped beating, so we can't exactly change horses midstream.
If you're not up for it No, it's not that.
I just, um Charlie, I got to say, this whole whatever this thing is, you know, kind of killing my buzz.
You're just what? I'm just not sure we have a lot of time.
Hey.
Scans came back from your drowning victim.
Check it out.
Wow.
Two badly healed arm fractures and a broken clavicle.
These scans look like a rodeo rider's.
Mm-hmm.
Sorry to interrupt.
Beth's fishing out again.
Fishing out? It's a St.
Catharine's thing.
Means she's O.
D.
'ing.
Yes, I know.
Did she have any more drugs stashed on her? I'm a medic, not a cop.
- 2 milligrams of naloxone.
- No, stay.
I already tried naloxone.
It ain't gonna work this time.
Her pupils are pinned.
Beth? Okay, let's get a bolus of saline Where did she get these drugs from? She's a junkie in a hospital.
She probably stole a bottle of pills.
She's going into defib! Let's get the crash cart over here! How about insulin? Uh, Jackson! I worked with a guy in Ajax who would carry a syringe of insulin out with him every Friday night.
It'll work on an O.
D.
, Alex.
Luke, leave it.
I'm not giving her three times the therapeutic dose unless I'm absolutely sure.
- Out of the way! - Charge it to 200.
- Clear! - Alex, move.
- Luke, what are you doing? You've got to clear.
- Don't worry.
- What the - It's okay.
What did you just do? And we're back.
You need to get back on the road now.
Push 1 amp of d50, Let's even out this insulin.
Wow.
Angry and quiet.
That's the best kind - What the hell was that? - Okay, let's get her to the ICU.
We had a problem.
I-I solved it.
No, you could have killed her.
But I didn't.
I know what I'm doing.
No, you don't, Luke.
Actually, you have no idea what the hell you're doing.
Right.
I'm the disaster.
You're the genius.
I forget that sometimes.
I'm sorry.
- That's not what this is about.
- Whatever you say.
You know, it's a hard enough day without you flying in here like a bat out of hell, leaving me to clean up your messes.
You need to leave right now.
How's she doing? She's good.
He's bradycardic, and his radial pulse is thready.
Yeah, his potassium levels must be through the roof.
What are my numbers? Uh, they'll be a lot better once we get you down to dialysis.
Hey, Gav, when are they getting us out of here? They're working on it.
I need you to find a way to get me 1 amp d50, and 1 amp bicarbonate.
Are you okay? I'm fine, but my patient could use a little help.
Okay, how am I gonna get these drugs to you? Tell him to get a Gavin, go up to the fourth floor and try and pry open the elevator doors on the right-hand shaft, and drop the drugs down like that, okay? - Did you get that? - Yeah, got it.
You rock.
All right, Roddy, um I'm formulating a magnificent plan called I'm gonna stand on your bed.
Hey, whatever you need, boss.
- All right.
- Watch his leg.
It's locked.
Do you have a hairpin? Uh, no.
It's probably a good thing.
I wouldn't know what to do with it anyway.
Think you can bust through that thing? I can give it a try.
You know, I think I might just lie here while you two do your superhero thing, if that's okay.
Joel? Yeah, tell Gavin not to bother.
There's no way we're getting through that thing.
I don't know what it is.
Um, I kind of feel like Like maybe I'm not supposed to be here.
You know, like, uh like maybe I'm missing something.
Charlie, I'm kind of freaking out here.
I have this feeling I forgot something.
Dawn? Yes, distract the heart surgeon while she's working in the dark.
I'm gonna do something a little odd here.
I'm going to talk to the patient as though she could hear me.
You know, there's rumors going around that you're getting really flaky.
Yeah, tell me about it.
Hey, Bonnie, um, listen, The reason you're so cold is because we made you hypothermic.
Why? So that your brain cells would slow down enough that we could fix your heart without giving you a stroke.
I don't think that's what it is.
I think I I kind of screwed up years of my life.
I feel like I got this weight, like right square on my chest.
I can't breathe.
Dawn, I'm gonna step outside for five minutes.
- No, you're not.
- Yep, got to go.
Carol, you watch the pump for me.
- If anything changes, page me.
- Charlie! Bonnie, I just want you to know you're gonna be okay.
Dr.
Bell has done this surgery many times before.
I don't care.
Whatever you're doing to me, I want you to undo it, okay? Because I was perfectly happy before all of this.
You know, I-I went for a drive.
Yeah, and you crashed into a median and tore your heart open, which is exactly what we're trying to fix right now.
No.
No.
I went and I-I-I gassed up the car, and I-I went for a drive with Jackie and Where's Jackie? I forgot about Jackie.
Who's Jackie? Jackie's my girlfriend.
She was in the car with me.
Uh, as far as I know, the paramedics brought you in alone.
That means that she's just out there somewhere.
- She's out there.
- I don't know.
Okay, well, you got to find out.
You are my priority right now, okay? And in case you haven't noticed, you are a ghost, which which carries with it a number of problems.
So, I need to get back to your surgery before we run out of time.
No.
No! No! Okay.
It was-it was my idea, okay? It was my idea to go for a drive in the middle of the night in the blackout.
You know, drive down Rosedale Valley with the lights off and I'm always the one that's, you know, forcing her to take these stupid risks.
Jackie only did it because I asked her to, because she knew it would make me happy.
You got to help me find her.
Please.
I really need you to help me find her.
Oh, my god.
What if the woman that you loved was lying in a ditch somewhere, you know, because of something you did? Hey.
Charlie, w-what are you doing out here? Um, our MVC patient from this morning, - did anyone else come in with her? - Just the medics.
Any other MVC trauma come in, like a woman named Jackie, perhaps? No.
Why? Which one of you brought in Bonnie Drummond, the MVC from the Rosedale Valley? I did.
You left someone behind.
- No.
The cops - Was it pitch black outside? - Yeah.
- Go back and look.
There was another woman in that car.
Her name is Jackie something.
Go! Go back and look! All right.
All right.
Hey.
Hey, Charlie.
What was that about? Long story, and I have to get back to the O.
R.
- He's hyperkalemic.
- Listen to me.
I can't think of any way to get his potassium down.
He needs dialysis in the next half an hour.
We can't lose him, Joel.
I know.
Oh, please.
Don't let me die in an elevator.
Don't be silly, Roddy.
That's not gonna happen, okay? W-what is the status on those generators, please? You still have a couple of hours to get to dialysis.
You're going to be fine.
You hear me? Okay.
I'll be okay.
Your scan came back clear.
I am sorry about the wait, but I wanted to be sure.
Haven't been off the grid this long since law school.
Tell you what I'll write you a note.
"Graham couldn't come to work today.
" "He was too busy saving a man's life.
" Aah.
How's he doing? Your father? How'd you find out? He woke up and told us his name.
You must think I'm a bad person.
No.
No, I don't.
Look.
Last time I took him in, I found him on the floor in my 3-year-old's bedroom.
My kid was asleep.
He'd smashed the piggy bank.
He was down on all fours sifting through the change saying, "god, kid, couldn't you throw a buck in there from time to time?" I didn't break his rib, did I? No.
It was an old injury.
Someone else did it.
He doesn't deserve that.
He was an awful father.
You turned out okay.
Well, the jury's still out on that one.
Graham, are you having trouble breathing? - I thought it would pass.
- Okay.
Your pulse is racing.
Zach! Graham, did you breathe in any water while you were rescuing your father from the pool? I don't remember.
It's the chlorine.
Zach! Whoa, whoa, whoa, whoa, whoa! What happened? What happened? His lungs are inflamed from the water.
He's drowning.
S.
A.
T.
S are low, pressure is tanking.
We had equal bilateral breath sounds.
Now I'm squeezing and nothing's happening.
Air's not getting into his lungs.
Intubation must have caused a tension pneumothorax.
We need to do a needle thoracostomy.
Ready, ready? All right.
Betadine and a 12-gauge.
Okay.
Here we go.
Come on, Graham.
Take a breath, Graham.
Come on.
Okay.
Plan "B.
" Jackson, get me a chest tube.
Any kind of tube.
Get me a pleur-evac box.
I'll have to call upstairs.
J-j-just just a sec.
Here.
I got it.
Okay.
Scissors.
Give him 100 micrograms of fentanyl.
Okay.
Knife.
Kelly.
Okay, Zach, when I hear that pop, I want you to have that tube ready.
All ready.
Almost there.
I'm in the parietal pleura.
Just a little further.
Okay.
Chest tube.
This is gonna work, right? Water pressure creates a seal.
Air comes out but not in.
So we don't kill our patient.
Unclamp.
Pulse is stabilizing.
Good work, Reid.
You, too, Zach.
The repair is holding.
So now we just got to warm her up.
Okay, so, let's run through our options.
Warming blankets.
- Carol? - Carol: I'll see what I can find.
Okay.
What else do we have that works? We still have oxygen, running water.
Okay, well, hot water bottles aren't sterile, so what else do we have that's warm? - Saline.
- Saline.
Okay, somebody get me 4 liters and a sterile bowl.
On it.
Remember that big blackout like 10 years ago? We just sat on the patio, drank wine, lit candles.
Remember that couple on their patio beside us arguing? Oh, yeah.
About Mike Tyson.
One of the great intellectual debates of our time.
Well, it wasn't much of a debate.
I mean, he bit the guy's ear off.
Oh, please.
It wasn't the whole ear.
Okay.
Where are we at? Um, 27 degrees.
She's getting warmer.
Keep the saline coming.
You've got time, Roddy, okay? You're gonna be fine.
You should be studying your flashcards.
Save your strength.
I can study later.
Joel, quiz her.
She's gonna need help.
Give me the cards.
Get the cards.
All right, let's quiz her, Roddy.
Let's see what we've got here.
Okay, Maggie, "which of the following clinical scenarios" "is least likely to describe paraneoplastic syndrome" "resulting from small-cell tumors of" Roddy? Roddy! Roddy.
No way.
No, no, no.
Okay.
Let me clear his head.
Give me a second.
- Give me a second.
- Get it down.
Come on! There's no pulse.
Maggie.
Hey.
Maggie.
Maggie.
We were 10 feet away from saving his life.
Okay, saline worked.
Take her off the pump.
Okay.
We've done our job.
Let's see if she's up for it.
Going down to half flow.
The heart's swelling.
It's too weak to pump the blood.
Going back to full flow.
Start again.
Okay, the heart muscle is too weak.
They should have found her by now.
Charlie, you want to try your flaky talky thing? Now's the time.
Come on, Bonnie.
Give us a hand here.
It's too late.
I killed her.
Going to full flow.
I'll be back.
Charlie! - Hey! - Paramedic: Hey.
Found her in a ditch I don't know how she lasted this long.
- They found her? - How are her vitals? When we found her, she was hypotensive, bradycardic.
Her S.
A.
T.
S were 84.
We got them up to 95 with a high-flow mask.
Okay.
Thanks.
Nice nice work.
No.
What does that mean? What did he just say? Is that good or bad? Do you know where you are? - Why isn't she answering? - She should be.
Miss, do you know your name? Jackie! Your name is Jackie! Okay, we can't wait for him anymore.
Give me the paddles.
I'm gonna shock her.
We're gonna try again.
- Carol, can you man the pump? - Yes, I can.
Miss, do you know your name? Where's Bonnie? - Do you know your name? - Jackie.
- Jackie? - She's gonna be okay? Okay.
That's good.
No signs of concussion.
No long-bone fractures.
Vitals in the q5, but let me know if anything changes, okay? I'll never forget this.
You will.
That is one healthy-looking heart.
Charlie, welcome back.
All right, let's do a little housekeeping and close her up.
Heart's beating on its own? Gave it a little jolt.
That must have been it.
Wow.
Looks like someone forgot to sing the clean-up song.
It's pretty great.
Not if you're the janitor.
No, I mean it just shows how full of life this place was today, how hard we worked to keep it together.
Is it kind of weird that I just want to leave it like this? I mean, at least for a few more minutes.
Zach, are you okay? I think I just miss my house, my kids, you know, running around, spilling things.
I just the motor lodge is surprisingly neat and tidy for a motor lodge.
Do you want to stay over tonight? Is that a good idea? I promise not to take advantage of you in your time of need.
Unless you ask politely.
Yeah.
I can live with those terms.
My place is a mess.
You'll be right at home.
Your son is doing well, Mr.
Kennedy.
Nobody's called me that in a very long time.
How are you feeling? If I'm being honest? Like I need a drink.
There's a long-term subsidized hospice affiliated with the hospital.
I think you'd be an excellent candidate.
I'd like to put your name forward.
Why would you do that for me? 'Cause you need to be somewhere safe.
Mm.
I-I don't think I should go in.
He won't want to see me.
He saved your life.
I think he might.
Mr.
Kennedy, your son is a good person.
He's the best thing I ever did.
So maybe you should be there when he wakes up.
Yeah, I'd like that.
Okay.
There you are.
You press the call button if you need anything, okay? Hey.
Hey.
That was quite a surgery, huh? What's going on with you, Charlie? You know that I believe in a lot of things that other surgeons discount, right? Yeah, like crystals and dream catchers and not shopping when you have PMS, right? I'm worried about you.
Ever since your coma, you do strange things.
I mean, you don't tell people why.
I I think you're having a breakdown.
You don't have to worry about me, Dawn.
Well, I do.
And I can't stop.
Don't do that.
I'm in love with Alex.
Does she know what a mess you are? Maggie.
I'm lifting your suspension.
You can start back in the O.
R.
tomorrow, okay? Do you even care that he died? I'm sorry that we lost someone today.
'cause you just jump back into chief mode as if nothing happened.
Look.
This person was a patient.
He wasn't a friend of ours.
I think you should probably recognize the difference between the two.
You wanted him to live as much as I did.
Hey, Maggie.
What? I don't think I ever told you how sorry I was your father died.
Thank you.
Okay.
So, I'm gonna go ahead and blame my behavior on the heat.
This uniform is hot.
I'm used to being naked lately - and the A.
C.
in my rig wasn't working.
- Stop it.
Please? Bed one.
What are you talking about? - You don't remember? - No.
You were eight.
I was six.
And we were lying awake on these bunk beds the ones on McDonald ave.
See, how do you remember those things? Mom was on a bender.
Right.
And I I promised you I-I would never be like her.
You were just a kid.
She was bed one, the sickest patient our whole childhood.
And she sucked up all the attention, all the worry.
I promised you I'd never do that.
It's just what you do when you're a kid, okay? You make all these promises about things you won't do when you grow up.
I also promised that I would never spit on a hanky and then rub it on your face, and I did that, too.
Or eat that cake with the nuts in it.
I promise I'll never wear two rings on one finger like uncle Ralphie.
Hey.
- You're not a burden to me.
- Yeah, I am.
I am.
I could change.
Yeah.
It's gonna change.
Okay.
- But you were great today! - Oh, no, no, no! - Please, don't do that! - I promise I'll change! - Why do you always have to hug? - I'm a human emotional blanket.
It's too hot.
It's okay.
I don't like forest-hug time! All right, break it up.
Chuckles, now, I know you're gonna try to talk me out of it, but I have to move out.
Whatever.
I'll believe it when I see it.
One for you.
Six for us.
We'll need it.
Mm-hmm.