The Night Shift (2014) s03e05 Episode Script

1 [Siren wailing.]
It's your first paramedic ride-along, so be chill.
Not so good with the chill.
Yo, "Affluenza," out of my way.
- You, what do we got? - I was at the party upstairs, and I found him out here when I came down.
Did he take something? I don't know.
Probably.
It's a party.
Probably O.
D.
'd.
Give him a shot of Narcan.
- I know.
I got it.
- Mm.
[Radio chatter.]
Guess it's not opiates.
He's got minimal respirations.
Then we better intubate or he won't make it back.
Back these idiots up.
It's not a sideshow! Come on, guys.
Back up.
You heard her.
Back up! Sats are holding.
Run in a liter wide open.
I'll check the blood sugar.
[Thud in distance.]
[Screaming.]
I've got him.
Go.
[Siren wailing.]
What happened? She fell from up there.
I'm gonna need some backup.
I stopped the bleeding finally.
You know, I almost lost two patients this week who wouldn't clot 'cause of that damn medication.
- Blood thinners? - Yeah, but not warfarin.
It's like these these new ones that these drug companies market out to people before there's an antidote.
Anyway, I sutured the laceration, so he should be ready for surgery now.
Okay, I already paged Scott.
Okay.
[Laughs.]
Hey, what are you doing? You can't do that right here in the middle of the ER.
Aw, I just do it it to piss you off.
[Chuckles.]
Yeah, well, nobody wants to see that.
Speak for yourself, Topher.
[Blows kiss.]
Hey, it's the pros from Dover.
You have a lacerated spleen in Trauma 1 ready for surgery.
Probably needs to come out.
All right.
Paul, get him prepped in OR 1.
I'm right behind you, and we'll go over the PowerPoint later.
Yeah, I'm on it.
Uh, Pow-PowerPoint? Yeah.
I've been hounding the folks at Pressler Pharmaceuticals for months to get them to choose us for one of their studies.
They've got this high-tech transcatheter valve gets patients in and out of the hospital - in, like, half the time.
- So what's the holdup? The holdup is they're only giving sample valves to four hospitals nationwide, which means that we all have to bend over and grab our ankles just to get a meeting.
Sounds like a hell of a meeting.
Hi.
Uh, you must be Dr.
Clemmens.
Jessica Sanders, Pressler rep.
Hi.
[Chuckles.]
Don't worry.
I won't make you grab your ankles.
[Laughs.]
Sorry about that.
I thought you were coming tomorrow.
Yeah, change of plans.
I gotta fly out to Denver tomorrow, so I decided to pop by tonight to check out your application.
Yeah, um, well, I've gotta get up to surgery right now, but No worries.
I'll be here when you're ready.
Just hang out with with Dr.
Zia and Dr Callahan.
- H-Have we met? - Uh, no, you'd remember, but you're just the man I wanna talk to.
- [Cellphone vibrates.]
- I just got paged.
I'm gonna go change in the locker room.
Nice to meet you.
Maybe we'll see each other again.
So Dr.
Zia Yes? Who do I have to sleep with to get San Antonio Memorial to switch to our drugs exclusively? Well, it it I technically Oh, no, no, I'm kidding.
I'm kidding.
It's a joke.
I know.
[Chuckles.]
But I'd love the contract, so can we talk business? Huh.
Hannah? Hi.
I'm Dr.
Alexander.
So I hear that you came in with a fever.
That's what they told me over at the Infusion Center.
- Mm-hmm.
- Cancer.
That's where I go for chemo.
The doctor said I spiked a fever and referred me to the ER.
[Thermometer beeps.]
Yeah, still looks a little high.
All right, can you lay down for me? [Sighs.]
Ah, you recently had surgery.
About three weeks ago.
Second time under the knife.
Went in to remove some tumors that metastasized to my liver.
[Whispers.]
Okay.
Any pain or soreness when I press? No.
All right, well, I'd like to give you some Tylenol to bring the fever down, but I also want to run a full septic work-up.
And a CT to look for a post-op abscess? I've been going through this for awhile now.
- Mm.
- I practically live in hospitals.
And I hate these places the smells, the sterile walls, the hum of the fluorescent lights.
[Chuckles.]
Good point.
You know what? I'm out of here.
[Laughs.]
I'm sorry.
I didn't mean to crap on your workplace.
Honey, please.
Last month, we had a guy in here who literally crapped on the place.
Oh, no.
Really? Oh, yeah.
It's the glamour of medicine.
[Laughs.]
- Okay, let's run the tests.
- Mm-hmm.
But FYI, I am not eating the cafeteria food.
Well, FYI, I don't either.
Mm.
Okay, let's listen to your heart.
- Those are pretty necklaces.
- [Whispers.]
Thanks.
- [Siren wailing.]
- Woman: Doctor, over here.
What do we got? Dumb, drunk, rich college kids.
That's what I got.
She fell from a 4-story balcony.
- I didn't want to move her.
- Hey, how's her pressure? 90 systolic, and she's unresponsive.
Alina? Oh, my God! - Uh, I-is this your friend? - Y-Yes, she's my roommate.
[Breathes shakily.]
What happened to her? - I should ask you that.
- I don't know.
She was at a party and called me, told me to get here.
Pelvis feels unstable.
Okay, we'll stabilize it with a pelvic binder.
- Alina! Can she hear me? - I don't know.
Hey, keep going with the trauma survey.
She may have other injuries.
Oh, my God.
Her mom is gonna freak.
Whoa.
We gotta get her back to the ER now.
Hurry up with that backboard! Come on, let's go! On my count.
One, two, three So it looks like there is an abscess in your abdomen, and that's what's causing the fever, so we're gonna get you down to IR, and they can have it drained for you.
- More procedures? - Mm-hmm.
Can't I just go home? Sorry.
Not without taking care of this, or the infection could get worse.
I just can't be in the OR again, staring up at people in masks.
Okay.
Uh, tell you what.
I will drain it myself here in the ER using an ultrasound.
- That'll be quicker anyway.
- Thank you.
I just want to feel good enough to get down to Mexico.
Yeah? What's in Mexico? I rented a house on the Pacific Ocean, this little town on the beach named Zihuatanejo.
- It's from the movie - "The Shawshank Redemption.
" - Oh! - [Laughs.]
- A fellow "Shawshanker.
" - Yeah, I love that movie.
That's the town they meet up after he escapes from prison.
Hey.
Spoiler alert.
Okay, dude, that movie is 20 years old.
If you haven't seen it yet, I doubt you ever will.
But you should.
It's one of the best.
Better than "Fast & Furious 7"? Both: Yes.
"Shawshank" is kind of my inspiration.
Like they say in the movie, "Better get busy living or get busy dying," and that's what I'm ready to do.
What do you mean? I'm done with chemo, done with surgeries.
I have a DNR.
I've made my peace.
It's time to get busy dying.
I don't know.
You tell me.
[Chuckles.]
I asked you I asked you first.
Oh, yeah.
I can absolutely come over later tonight.
Oh, my God.
You're so bad.
[Laughs.]
Why are you so bad? Oh, my God.
Uh, maybe around 10:00? Drew and I have this little errand we gotta run.
Okay.
All right, I'll see you later.
- [Cellphone beeps.]
- Who was that, Barry White? Come on, man.
You know I don't kiss and tell.
- Since when? - Dude, you know Probably means I know her.
Who was it? I didn't say you knew her.
So I don't know her? Is that what you're saying? Hey, I think you took a wrong turn, man.
Where are we? We just gotta take a little detour first.
I gotta drop off Syd's daughter at her jiu-jitsu tournament.
Dude, no.
No, we gotta meet the Craigslist guy for the gym equipment in a half-hour or he's gonna sell it to somebody else.
I-It's gonna take 20 minutes.
There's nothing I can do about it.
Sid sent me an emergency text about an hour ago, saying I had to take her.
I mean, apparently, the grandmother doesn't drive, so, I mean you wanna hear the rest of the story? I didn't want to hear the beginning, man! I just wanna pick up the gym equipment.
That's it.
That's all I wanna do.
Bro, who were you talking to? I'm so mad at you right now.
[Ultrasound whooshing.]
That wasn't so bad, was it? [Monitor beeping steadily.]
So there's this pharma company here tonight, and, uh, they're doing experimental drug trials.
No, thanks.
- [Gloves snap.]
- You didn't even hear me out.
I don't need to.
The last thing I want is another regimen of drugs with unknown side effects.
Come on, Hannah.
You're still laughing and full of life.
Then why are you giving up? I'm not giving up.
I have accepted my fate.
You don't know your fate.
No one does.
I had this college friend of mine, and she refused to accept her fate.
She fought it.
Then she ended up living for another three years.
I mean, she really lived.
Yeah, she saw her niece born, spent two birthdays with her.
She traveled with friends and family, uh, went to the Great Wall of China.
And that's a really nice story, but I have a story, too.
I watched my mother wither away and die from breast cancer, and I fought for her to try everything.
In the end, she suffered through treatment after treatment, to prolong what? Pain and suffering.
Well, we've made a lot of advances in the past few years, and there are some promising drugs, and maybe there's something that you don't know about.
[Sighs.]
Hey, Hannah, there there's gotta be someone to fight for you.
I'm an only child.
There isn't anyone in my life.
I spent my 20s going to school and my 30s taking care of my mother, so there wasn't a lot of time for dating.
[Inhales deeply.]
And now, well, a Tinder profile of cancer, tired all the time, some vomiting, ain't gonna get me "swiped.
" So like I said, I've made my peace.
I'm ready to go.
Okay.
I am gonna go and check your labs.
So you hang in there, okay? Scott: Thank you.
Well, that was fast.
- Color me impressed.
- Thank you.
Been waiting out here the whole time? Dr.
Zia got busy, needed a quiet place to work, so [Inhales deeply.]
Hi.
I'm Jessica.
Uh, yeah, hi.
Uh, Paul Cummings.
She's from Pressler.
A day early.
Oh.
Oh, uh, yes.
So our surgical program performs over 50 mitral valve surgical procedures per year, - which is above or on par w - Paul, Paul, it's okay.
We're not doing that now.
- Okay.
- I get the idea that Jessica here is more about the deal than the presentation.
Am I right? So what do we need to do to make this deal happen for us? Because you guys have been jerking us around for months, and that's time that a lot of my heart patients don't have.
I love the direct approach.
Okay, uh, off the record [Breathes deeply.]
I want your ER to give our company an exclusive contract.
Uh, you want us to only offer - your company's drugs to our patients? - Yes.
Uh, I'll settle for making us your primary supplier.
The profit will pay for the heart valve study.
Okay, well, you'll have to convince a majority of our ER attendings to sign on, and that all starts with Dr.
Zia.
Supposed to give him my pitch when his schedule clears.
He doesn't really seem that motivated to change, though.
I guess I'll have to motivate him.
- Uh, he's married.
- [Sighs.]
He's he's married.
- Actually, he is married.
- He's married.
And he's got a teenage daughter and twin 3-year-olds, and his mother just moved in with him.
The guy is bone-tired and frazzled up to here.
Can you say conference? I like how you think, Doctor.
[Inhales deeply.]
Okay.
I can work with that.
[Siren wailing.]
Suspected O.
D.
No response to Narcan.
Pulse is weak.
Let's get him into Trauma 2.
Where's T.
C.
and Shannon? With the girl that fell from the balcony.
- They're coming in.
- Heather, send off a tox screen.
[Speaks indistinctly.]
Hey, Heather, where's Topher? He just stepped into Trauma 2 with a patient.
[Sighs.]
Yeah.
An over P.
A.
: Blue team to ICU, please.
Blue team to ICU.
Uh, will you excuse me one minute? - Hey, uh, so so, how long - [Cellphone rings.]
How long you been working with Uh, yeah, a-absolutely.
It's all all good.
Talk to you later.
Annie? You okay? Yeah, I'm good.
I brought T.
C.
some tacos from La Gloria.
I've barely seen him all week.
I thought, you know, he could probably use the extra fuel.
Well, since he's not here right now, do you mind if I t Yeah, sure.
No, take them.
It'll be our secret.
Nah.
I'm good.
Thank you.
It's good seeing you outside a meeting.
Yeah, you, too.
Are you well? Yeah, I'm good.
I'm just You know, I'm trying to keep busy.
You know Are you going to the meeting tomorrow? I'm going if you're going.
You bringing the tacos? Well, we always run out of doughnuts.
[Laughs.]
- Incoming.
Patient fell four stories.
- I gotta run.
Unstable pelvis, open tibia fracture.
All right.
Trauma 1.
Paul, you're with us.
- Paul: Got it.
- Annie? What are you What are you doing here? I'm good.
I just brought you a snack.
- Hey, we'll talk later.
Go.
- Uh, okay.
T.
C.
, I'm gonna go check on the O.
D.
Right.
Excuse me, miss, you can't go in there.
Come with me.
It's okay.
- [Flatline tone sounding.]
- All right.
What happened? He coded when we got him in the room.
He's been gone for 10 minutes.
He's gotten epi, amiodarone, and we've shocked him a few times.
Let's go one more time.
Clear? - Nurses: Clear.
- [Electricity crackles.]
Ugh! Whoa! You okay? I'm fine.
[Groans.]
I just I got too close.
- Sorry.
- Stop CPR.
[Flatline continues.]
Time of death 8:24 p.
m.
[Crying.]
Scott: One, two, three.
Okay.
Let's get a sterile gauze on that.
And somebody page ortho.
Alina, I'm Dr.
Callahan.
You suffered a fall.
We're taking care of you.
- [Continues crying.]
It hurts.
- I know.
We're going to give you something for the pain.
- Nurse, push some morphine.
- BP's getting a bit low.
Yeah, the fracture probably tore an artery in her pelvis.
Have you called up the IR? [Monitor beeping erratically.]
Uh, there's no time for that.
Let's get her up to surgery.
Let's go.
[Crying.]
Alina! - I'm sorry.
- We need to get her upstairs.
I'm so sorry.
It's okay.
It's not your fault.
Yes, it is.
I jumped.
I tried to kill myself.
I'm sorry.
I'm so sorry.
I don't get it.
I never saw her unhappy.
I never thought she'd try to kill herself.
[Sighs.]
Sometimes it's hard to tell the people closest to you, you know? You never really know what someone's going through.
I would know, though.
She's my best friend.
It just doesn't make sense.
I'm sorry.
But they're gonna take good care of her.
Is there any family that we can contact? Uh, she's from Delaware.
Her parents still live there.
I-I have her purse back at the dorm.
I can go get it.
That'll be great.
Look, if you do that, I'll go check up on her.
When you come back, I'll have an update for ya.
Okay.
Great.
Good to see you, Annie.
Hey.
Hey.
They're probably cold.
Sorry.
Ugh.
At this point, I'd eat a horse.
You're a lifesaver.
Okay.
Look, uh, why don't you head home? And I'll see you in a couple hours.
I gotta go back to the OR.
Oh, okay.
I'll see ya later.
- All right.
- Topher: You okay? Yeah, just a little ringing in my ears still.
I meant your him.
Your patient.
It can be hard when we lose a patient.
He OD'd.
I did everything I was supposed to do.
I've seen people die before, Topher.
I don't get attached.
I'm okay, really.
Excuse me.
The patient in there, um, have you contacted his family yet? We're still trying to track them down.
I can help.
I do it for the rehab center sometimes.
You You don't have to do that, Annie.
I know, but everyone seems pretty fried, and you've all been so nice to me.
- I'd like to help.
- I could use the help.
Thank you.
I hate making those calls.
Yeah, okay.
Thanks.
So I did a cost analysis, and I think we can match what you're paying or maybe even beat it.
Man, you do not quit.
Look, I get it.
You want the pharmacy contract.
I said I'll read your proposal.
But later, not now.
That's the best I can do.
No problem.
You're exhausted.
Naybe you'll have a clearer mind after an all expenses paid vacation? I'm sorry? Pharmaceutical conferences.
Florida or the Caribbean.
All expenses paid for you and your family.
Or maybe just you and your wife.
Little second honeymoon.
Really? That That's all aboveboard? You're probably the only ER chief in the country who's not taking them.
And you don't have to go to the lectures.
I mean, hell, I never do.
Um Just just out of curiosity, do you ever have one in Hawaii? [Chuckles.]
Oh, yeah.
Really? So hotel is included? Just Okay, are you getting her? Just make sure you're get everything for Syd, okay? I got I got it! Okay, I got it.
Come on, Riley.
I gotta admit, man, this is way more fun than - I expected, man.
- Right? No, no, no! Watch the single leg! Watch the si okay, okay.
That's okay.
Get in the guard! Get in the guard! Get that little Rousey wannabe! Okay, okay, okay.
Patience, okay? Get her! Patience! Look for an opening! Good.
That's okay.
Yes! You got this! The arm bar! [Indistinct shouting.]
She tapped! She tapped! [Laughing.]
- Ha ha! Whoo! - Whoo-hoo! Drew and Kenny: Riley! Riley! Riley! Riley! Whoo! Yeah! - That was awesome.
- That was so awesome.
Thanks, but I think some of the parents are giving you dirty looks, though.
Haters gonna hate.
Exactly.
Okay, but hey, look at me, look at me.
Okay, I scouted your next opponent.
She's bigger than you, so you cannot let her take you down.
- Okay.
- Okay? - What if I just do this? - [Grunts.]
Okay, okay, right.
And then I do this.
Oh, no! You're gonna trip! You're gonna trip! Aah! Ow! - Oh, my gosh.
- Whoa, Riley, you okay? I got her, I got her.
Riley, you - Sorry.
What hurts? - Ow, my elbow.
Ow.
Ow.
- Hey.
- Hey.
You're working tonight? That's four nights in a row, right? Five.
I cannot wait to have a weekend off.
Ooh, speaking of which, I have a buddy who owns a B&B up in Hill Country.
I was thinking we could go there for the weekend.
What do you say? Sounds nice, um, but why don't we stay around here? We can go to the bar.
We can watch a Spurs game.
I could [Clicks teets.]
kick your ass in pool again.
There she goes, swimming under the boat.
I don't know what that means.
When I get you on the line, you run off in a panic.
It's no panic.
I'm just I'm I'm tired.
No, it's cool.
We're just having fun, right? I gotta let out the line a little bit.
No big deal.
Pool it is.
Okay.
[Monitor beeping steadily.]
Scott: Okay, we have to ligate both internal iliacs or she'll start bleeding again.
You got it.
I'll start the Mattox maneuver.
[Buzzer.]
Hey, Doctor.
- How's that poor college girl? - Stable for the moment.
You got two minutes.
You get Dr.
Zia to sign on? Yep, mai tais in Maui.
But only if the other attendings agree to it.
What's my best approach with Dr.
Callahan? Well, besides a short skirt and a bottle of whiskey? I would offer something to the Veterans clinic where he volunteers.
Yeah, that's easy.
It's great PR.
What about Dr.
Alexander? Any idea how to handle her? Not a freaking clue.
[Paul chuckles.]
Sorry.
Inside joke.
Dr.
Alexander is the OCD "A" student who's gonna cross-examine you on the data.
Just overwhelm her with your research.
That'll get her to sign on.
Thanks for the tips.
That heart valve's almost yours.
Paul: I think we might actually get it.
I genuflect in your direction.
What are you talking about? Come on.
Topher and the vacation? T.
C.
and the vets? Jordan and the charts? I mean, you're the the puppet master.
You're the man behind the curtain.
You are Keyser Soze.
No.
Just trying to push things along is all.
That valve would be a game changer for us.
All right.
Let's get the other side tied off, okay? I just grabbed her whole purse.
Her phone should be in there.
- Is this hers? - I guess so.
She seemed fine? Didn't seem depressed? No, not at all.
[Bottle thuds.]
[Typing.]
Toph is, uh, is that pharm rep still here? I-I think she's upstairs observing a surgery.
- But I-I can call up, Tee.
- What is it? Oh.
Hey.
How the hell do you sleep at night? Uh, bourbon, usually.
Sometimes Ambien.
Is something wrong? Yeah, the girl in there, she's on Ruprorin.
Sound familiar? Yeah, it's an acne med we offer.
Works great.
Yeah, it works great for suicide.
Um, what are you saying? Well, that girl she jumped off a balcony, tried to kill herself.
Your drug causes suicidal thoughts.
That's one possible side effect, but her doctor prescribed it, so How about being responsible, not putting out a bad drug? Okay, it's not a bad drug.
All drugs have side effects.
Ibuprofen has side effects.
That girl almost died because your company cares more about the bottom line than about people.
You have no idea if that's why she jumped.
And my company has drugs that curb AIDS, that slows the rate of cancer.
And some of them, guess what? They have side effects that include suicidal thoughts.
So are you against those as well? No, no, I'm against compromising my integrity.
Oh, come on, please.
Like you don't have a smartphone made by child labor in China.
We're all compromising something.
Maybe some of us more than others.
I get it.
You're frustrated.
You're raging against the machine.
But I am not the machine.
No, you work for the machine, and maybe that's worse.
Excuse me.
Excuse me, hi.
I'm Dr.
Alexander.
This might not be the best time, but, uh, can I ask you a couple questions? Sure, if I can ask you one.
Why is that guy such a dick? [Laughs.]
Yeah, that's complicated.
Uh, let me buy you a coffee.
So you met T.
C.
? Is that what they call him? [Doors squeaking.]
- I have to take him downstairs.
- [Door stop thuds.]
Oh, okay.
I've reached out, but I still haven't found any close relatives nearby.
I just didn't like the idea of him laying here all alone without anyone.
I don't think he'd mind, but it's your waste of time.
[Bed thuds.]
Did I do something to offend you? No, not really.
It's just You don't even know this guy.
I don't get why you care so much.
Well, uh, because I'm trying to help.
It's part of the program.
Ah.
One of those.
One of what? 12-steppers? Always preaching the gospel, trying to convert more members to your little cult.
It's not a cult.
What are you, 12? You have no idea what you're talking about.
- If you had any experience - I've had experience with it.
I've seen addiction take a lot of people too soon.
And I've been in the program and seen it fail firsthand.
Well, I'm sorry it didn't work for you, - but it's worked for - Millions? Yeah.
I know the spiel.
Good luck.
I mean it.
10 years? You were with that dude for 10 years? - It was on and off, you know? But - Oh, my God.
In the end, we realized that it wasn't right for us to be together.
So you know, there's this whole other side to him that not a lot of people get to see.
And honestly, you couldn't ask for a more loyal person, to his friends and his patients.
Well, I guess there's something to be said for that, right? And he's not exactly ugly.
No, he's not.
So, uh, do you think you can get Hannah get in on your new study? She won't fit the inclusion criteria.
Trial starts in two weeks.
She's had chemotherapy in the last 30 days.
It disqualifies her.
Okay, so there's nothing you can do? I didn't say that.
There's always something that can be done, but Let me ask you a question.
What would it take to get you to change your ER's pharmaceutical provider? Hmm.
Hey, guys, how's Alina doing? Uh, just took her to recovery.
She's stable for now.
They gotta keep monitoring her crits.
Have you seen T.
C.
? No, I've been looking for him.
I heard he went off on Jessica.
Yeah, the nurses could hear him yelling from the OR.
If he messed up our heart valve Yeah, I know.
I already told Janet about Hawaii.
What? Iit's I'll I'll talk to T.
C.
Yeah, like that'll do any good.
And nothing personal, but the guy doesn't listen to anybody.
Not me, not even you.
And I try and keep the peace with him, you know I do, but sometimes I just wanna Yeah, no, I know.
I get it.
Sor sorry about that.
We just really need that heart valve.
Yeah.
Drew: Over this way to get you x-rayed.
- Hey, what happened? - Riley: Drew broke my arm.
- Maybe you don't say it like that.
- Well, you did.
What who who's that? That's Riley, Syd's daughter.
Who's Syd? Yeah, the doctor Drew was deployed with in Bagram.
Oh.
Uh, we went to her jiu-jitsu tournament tonight, and Drew accidentally fell on her.
[Laughs.]
Wow, that's gonna be a fun call to mom.
Right? [Chuckles.]
Topher.
Hey, Topher.
So, uh, I hear that you're open to switching to Pressler Pharmaceuticals.
- You do the research? - Yeah, you know, it looks good.
Prices are competitive.
Same meds, different names.
Are you open to switching? Yeah.
Yeah, I'm open, if you are.
You know, attacking her like that is completely unprofessional.
Yeah, well, I was I was pissed.
- [Urinal flushes.]
- Well, my twins get pissed, too, but I expect a tantrum from them.
They're 3.
Look, this heart valve study's huge for this hospital.
We'll make a compromise here and there, I think I think we'd do it.
Can you not stand right there? Yeah.
Sorry.
Hey! Hey! - [Urinal flushes.]
- Topher, I'm I'm not gonna apologize.
No, I didn't expect you to, Fonzie.
Just sign on the deal.
Do it for me.
And for the for the hospital.
Do it for the hospital.
If it's not this company, it'll be another one.
All right, fine.
I'll do it.
- Yeah? - Yeah.
Thanks.
Oh, and one more thing.
[Laughs.]
Looks like you wet your pants.
You should change your pants.
You know payback's gonna be a bitch, right? [Sighs heavily.]
Hey.
Fancy meeting you here.
- Hey.
- [Siren wailing in distance.]
What are you still doing here? I-I didn't wanna be alone.
That's why I brought T.
C.
food.
[Sighs.]
That's why I helped Topher with that OD.
Yeah, I get it.
Anything to avoid the middle of the night struggle.
Staring at the ceiling, waiting for the sun to come up.
Pretty much.
I know you two aren't close.
I know about the whole Jordan thing, but he's been amazing to me.
Taking care of me, helping me.
He's been my rock.
That's really great.
Yeah, but it's a lot of pressure, too, you know? I feel like I can't be totally honest with him, like he'll be nervous or get worried or [Voice breaks.]
I just I don't wanna disappoint him.
You know, it's gotta be about you.
That's what scares me.
I keep thinking about that man, that boy who ODed tonight.
I just keep thinking that could've been me.
It's not.
You're here, alive, working your program, step by step.
I know.
But something that Shannon girl said Oh.
Do not listen to her.
- She's mouthy, that one.
- [Laughs.]
[Chuckles.]
Yeah, that's for damn sure.
Still, I just [Sighs.]
What if I relapse? What if I'm not strong enough? Then you get back up and you start over.
Have you ever relapsed? Yeah.
It was last year.
I relapsed last year.
- [Cellphone chimes.]
- [Sighs.]
- [Cellphone closes.]
- I gotta take this.
Paul: Uh, it could be a reaction to the anesthesia? No, she must've had a pleural tear.
And the positive pressure from the vent has caused subcutaneous emphysema.
What does that mean? Is she okay? Air from her lungs is leaking into her soft tissue.
- [Alarm beeping.]
- Uh, guys She's blowing up.
- [Monitor beeping.]
- Her sats are dropping.
Constricting her lungs.
Do something! Help her! We gotta release this air before she codes.
Numb her up.
Alina, can you hear me? Alina! - BP's down to 63 systolic.
- All right, we gotta go.
Stay with us, Alina.
[Monitor beeping.]
[Monitor beeping.]
Pressure's holding.
Okay, I need to make another incision.
All right.
[Gasps.]
So, I, uh, I talked to that pharma rep.
And she's gonna try to get you in on that trial study.
I told you I didn't wanna do that.
Look, you are not gonna make it to Mexico without some help, all right? You fainted, you have a fever.
You need this.
Thank you.
Why can't you just take "no" for an answer? I don't like to quit.
It's not you quitting.
It's me.
Why does that bother you so much? Well, can't someone just care? I mean, come on.
Yeah, but there's always a deeper meaning to it.
What is this, a therapy session? Who's treating who here? I guess I didn't mention what my job was.
- I'm a therapist.
- Oh.
Well, that makes sense.
- Where have you been my whole life? - I'm here now.
So what do you think this not being able to quit is about? Come on, let me feel like I'm helping somebody again.
You really wanna do this? You talk to me I will try your study.
Feeling better now, huh? Yeah.
That was scary.
I bet.
The air will continue to drain, so you might feel a little swollen for a few more days.
And you'll be immobilized for a while with that pelvic fracture.
But she's gonna be okay, right? - T.
C.
: Physically, she'll heal okay.
- [Gloves snapping.]
Alina, we, uh, we need to talk to you about the medication you were taking.
What medication? Ruprorin.
The acne medication.
Yeah, it's got some pretty serious side effects, - including suicidal thoughts.
- It wasn't the pills.
- I hadn't taken it yet.
- What? It's just been really hard for me this year with school and just been feeling alone.
Alina, why didn't you tell me you were feeling that way? Didn't wanna bother anyone.
The second I stepped off the balcony, I changed my mind, but it was too late.
Alina, I've been there.
- [Voice breaks.]
You have? - Yeah.
When I got back from the war, I lost my brother, and I didn't see any reason.
But there was.
And I got help.
That was the best thing I ever did.
I'd like to go get someone to come talk with you.
Would that be okay? Okay.
Are my parents coming? Yeah, they got in the first flight to come see you.
- Can I stay with her? - Yeah, of course.
We'll, uh, we'll check in later.
Okay? [Inhales deeply, exhales slowly.]
I'm just bummed I didn't get to finish the tournament.
I totally would've kicked that girl's butt.
Oh, yeah, if Drew didn't break your elbow, - you would've smoked her.
- Hey, it's not broken.
Okay? Just sprained.
You are gonna have to wear this sling for a week.
What? I don't even get a cool cast for people to write on? Sorry.
And I'm really sorry about all this.
I know it's not the best way to end the night.
It's okay.
I had fun.
And at least my mom will get to see the video of my first match.
Yeah, and she'll get to kill me when she comes home and sees you.
- Yeah.
- [Chuckles.]
Yeah.
You've been a trooper, though.
You're pretty grown up for 13.
I was a little bit of an idiot when I was your age.
Yeah, some say you still are.
- [Laughs.]
Yeah.
- Hey, that's not funny.
- [Cellphone ringing and vibrating.]
- Oh, hold on a second.
This is gonna be ugly.
[Beep.]
Okay, Syd, Syd, before you yell at me, I - Let me talk to her.
- Right.
Yeah, okay.
No, I'm giving you to Riley, okay.
Hi, Mom.
No, I'm fine.
No, it was all my fault.
I know.
I tripped.
I'm a klutz.
But wait until you see the match.
I was awesome.
There have been times in my life my father, uh he's dead, by the way.
And in my personal relationships where I feel like I have quit.
I feel like I [Sighs.]
could've done more to help them.
Um, since I don't have what it takes in my personal life, I make damn sure not to quit in my professional one.
Whoa.
You are messed up.
I'm sorry I asked.
I gotcha, didn't I? Yeah, a little.
Which tells me that you believe that crap.
Which crap? The crap about you quitting on people.
I mean, it's not as simple as it sounds, but you know you bust your ass with your patients.
So why won't you give yourself the same benefit of the doubt with your relationships? I don't know.
Well, then that's what we should be talking about.
Annie: So that's when you relapsed? [Sighs.]
I settled the lawsuit, and I gave them everything I had.
I lost everything.
But I still couldn't stand the guilt.
And I tried to go see him, but they wouldn't let me.
Still won't let me.
And so then I had a drink.
Or 10.
But then you just stopped yourself? Barely.
But it never even should've gotten to that point.
There's always help available, but I ignored it.
I got cocky.
Big-time surgeon, great career.
I figured all my problems, all my issues are behind me.
So didn't have a sponsor, wasn't going to meetings.
Well, I'll tell you what.
The next time you feel like that, you have to call me.
And you'll bring tacos? [Both laugh.]
I will bring you anything you want.
- Hey.
- [Files thud.]
You wanted to see me? Oh.
Yeah.
Good news.
She's in.
Oh, so you got the trial pushed back? Not exactly.
I messed with the dates of your patient's last chemotherapy appointment.
Uh, I didn't ask you to lie.
I mean Do you want her to be in the trial or not? - Well, yeah, but - Well, this is the only way.
I'm going off of her records from the previous month, which gives you the 30-day buffer that she needs.
I never saw the other ones.
You don't have to do anything.
I'm doing it.
Just don't undo it.
Look, I can't guarantee that this ER's gonna go with your company.
It's being considered, but I can't be beholden Stop, relax.
Okay.
I didn't do this as quid pro quo.
Your conscience is safe.
Let's just say I needed a win tonight.
Offset some bad karma.
All right.
Thank you.
I'll go tell her.
Dr.
Alexander! Shortness of breath.
Hannah.
Hang in there.
Everything's gonna be okay.
Got some good news.
We got you in on that trial, huh? How great is that? [Strained voice.]
My chest really hurts.
I can't breathe.
Okay.
I need a crash cart, please.
Acute chest pain and hypoxia.
This is a PE.
I'm pushing tPa.
Page vascular and tell the OR we're on our way.
Jordan, she's DNR.
She doesn't want this.
[Voice breaks.]
I know, but I just Let me go.
Please.
- Jordan - I wanna go.
Please.
[Monitor beeping steadily.]
[Crying.]
Can you get her some morphine, please? Yes.
[Sniffles.]
[Exhales deeply.]
[Breathing raggedly.]
[Flatline tone sounding.]
[Elevator bell dings.]
Hey, uh, Shannon.
Um, I'm glad I caught you.
There's something I-I need to say.
What's up? Um, earlier, when you seemed nonchalant after we lost the patient Topher Just hear me out 'cause this is important.
I know we see some terrible things in this job.
And in order to survive, we do need to be able to compartmentalize certain things and not get too attached.
It's not that.
Look, that kid who overdosed and then seeing that girl jump because I thought she was drunk, it pushed my buttons.
How how so? Where I grew up, drugs and alcohol are everywhere.
So when I see some rich, white college kid who has it all and just throws it away? I worked really hard to get to where I am today and I almost didn't make it.
I would've given anything to have the opportunities he had.
So I'm sorry, but I don't have a lot of sympathy.
Well, there's nothing wrong with being proud of what you've overcome, but you do have to find a way to make an emotional connection with your patients, No matter what biases You might have.
We all bring our own baggage to every case, especially when you first start.
But you have to find a way to put that aside if you ever hope to grow as a doctor.
Okay.
I'll work on it.
Okay.
I will.
[The Escapists' "Church Bells" playing.]
Can't you hear the church bells Coming through my window But they gotta be so loud Nothing to shout about - [Door opens.]
- Jordan? So sorry.
If there's any way I can help in the future, please let me know.
Thank you for everything.
Getting inside my brain You'll be all right Wish I could sleep tonight Uh, and and listen Uh, thank you.
Um [Chuckles.]
I-I just wanted to say that what T.
C.
did was inappropriate and I wanted to apologize on behalf of the entire hos You can stop.
You're getting the heart valve.
What? We are? Truth is, San Antonio Memorial was already one of the hospitals chosen for the pilot program.
I was just kind of trying to squeeze a little extra out tonight, so Okay.
Um, that's great.
[Chuckles.]
Uh, because, you know, uh, we do have a very consistent track record with Paul, learn to take a yes.
- Yes.
- You can go now.
- [Door squeaks.]
- Yes.
Okay.
We got the heart valve, man.
Okay.
So, uh, that's good news.
I was looking for you 'cause, uh, I wanted to apologize for earlier.
Was that it? 'Cause that was pretty lame.
You're not gonna make this - easy for me, are you? - No.
Look, you don't have to apologize.
You're passionate about your patients.
That's more than admirable.
Kinda feel like everyone on this shift is, actually.
Thank you for helping Dr.
Alexander.
I guess I, uh I may have been wrong about you.
I shouldn't have said all that stuff.
[Exhales.]
Actually, you were kinda right.
Selling pharmaceuticals and my soul? It's a BS job.
I hate it.
This was not my life dream.
Got a job out of college and was $150K in debt, student loans, and voilà.
Six years later, here I still am.
Is that yours? Yeah.
[Engine starts.]
You know how to ride that thing? You'd be surprised what I know how to ride.
Can't you hear the church bells Give me a call.
Maybe I can show you a few more surprises.
Getting inside my brain You'll be all right [Engine rumbling.]
Wish I could sleep tonight It'll be all right Wish it was a quiet night Hey.
I heard, uh, I heard what you've been through tonight.
This is just not how I expected things to go.
I mean, we lose patients all the time.
It's just, sometimes there's Yeah, sometimes you just find one that really gets to you.
- [Whispers.]
Yeah.
- I understand.
You know, she wasn't afraid of dying.
She just faced it head on.
I mean, I wish I had that kind of strength.
Hey.
You do.
I've seen it.
It'll be all right Just wish that it was a quiet night Man: It's the fifth day of the worst heat wave in San Antonio's history.
Temperatures will be reaching 102 by 5 p.
m.
, and won't be letting up anytime soon.
I made you an herb omelette.
Ooh.
Again, huh? Two is better than one That's too bad it's gonna get cold.
Better than one Nothing is forever Oh, bye, bye, bye Bye, bye, bye One wants to give, one wants to take One tries to fix me up One is a mistake, my, my, my Oh, my, my, my Shake me up I want you to take me up Wake me up Hey, where are you going? Jessica? Jessica? [Shower running.]
Hey, Jess? Jessica? Hey, I gotta go to work.
Jessica! 102.
Damn, that's hot.
Maybe we should call in sick.
Huh? Stay in this nice air conditioned apartment.
Might look a little suspicious, both of us sick on the same night.
What's the worst that can happen? Rumor mill starts? - The hospital - Hmm? Will make us take a day-long sexual harassment seminar.
And I've got better things to do.
Shake me up I want you to take me up Wake me up Sure we should be doing this in front of your work? [Laughs.]
Never mind.
Hey.
How's it going, T.
C.
? Good.
You? Oh, never better.
[Whistling.]
What's going on with the whistling? Looks like someone's getting a little somethin' somethin' in the bedroom.
Hmm.
That obvious, huh? Talking about Scott, but thanks for the update.
Now we know what you've been up to.
And apparently it was all day, 'cause you look like hell.
Jessica? Wouldn't you like to know, huh? Hey, you're not the only one getting action.
Ever since I started working out, I can't keep my hands off Janet.
- [Siren wailing.]
- It's like this morning, we got busy for, like 10 minutes.
[Wailing stops.]
You wanna hear about my sex life with Rick? This is what we're doing now? Female, 30.
Collapsed during a marathon.
BP's 90 over palp.
Pulse is tachy and irregular.
Temp's 102.
Sounds like heat stroke.
Trauma 1.
Oh, who runs a marathon in this temperature? Charity race.
Lots of heatstroke.
More coming behind us.
Sounds like it's only the beginning.
Temp is still up, but your heart rate's coming down.
Okay.
You feeling better? A little bit.
I've had a fever for a couple of days.
But I just ignored it.
Didn't wanna miss the race.
You're pretty hard-core.
[Scoffs.]
Didn't used to be.
I went through a really bad divorce this year.
I decided I needed to make a change.
I started weight training, exercising.
- I lost 50 pounds.
- Wow.
Congratulations.
Deep breath.
[Inhales deeply.]
- [Exhales slowly.]
- There we go.
Okay.
Didn't realize how depressed I was until my marriage was over.
You find it hard to move on? It's one of the hardest things I've ever done.
I'm training for a Tough Mudder right now.
That's a piece of cake next to my divorce.
[Chuckles.]
How long you had this rash? - About a week.
- Hmm.
I thought it was from all the sweating.
Hmm.
Maybe.
I wanna run some blood work.
Persistent fever, rash.
Ah.
You might have a virus.
[Groans.]
Gotta make sure you're healthy for that Tough Mudder, hmm? All right, Doc.
[Rock music playing.]
Jordan: [Laughs.]
How did you find out about this? Shannon: Some guy from Bumble.
Oh! [Laughs.]
Oh! If you dated around more, you might actually have some fun, Jordan.
Oh! That was just wrong! El Matador is kicking his ass.
El Matador's my cousin.
He specializes in this move called Montezuma's Revenge.
It was made famous by this Cuban wrestler named Konnan.
My cousin does it the best.
Check it out.
He's about to do it.
He lifts El Tigre up, hooks his legs so he can't touch the ground.
And with his free arm, puts El Tigre's head into his armpit, driving El Tigre's head into the mat.
Bam! Yeah! Yeah! [Coughing.]
[Jordan laughs.]
I really wanna be a luchador.
Gotta gain some weight.
I eat all the time.
This doctor told me my metabolism's too high.
I'd give anything to be in that ring.
Only way I'm gonna get a pretty girl like you.
Thanks.
[Cheering.]
- [Bell dings.]
- Yo, I'm I'm Victor.
She has a boyfriend.
Well, technically, Sam's not my boyfriend.
Friend with benefits? I don't I don't know, okay? I'm just gonna figure things out.
Take it a day a time.
You know what I mean, Victor? I can't even get a date.
[Bell dings.]
[Cheering.]
[Bell dings.]
[Smack.]
[Crowd shouting indistinctly.]
Hey, that's an illegal move, ref! He's choking him! Look, look! Look at the chains.
He's choking him! Disqualified! Disqualified! [Woman screams.]
Whoa! All right, we're outta here.
Shannon: Put your hands around your head.
Anyone comes at you, knee to the crotch.
Shannon! [Growls.]
Watch out! [Groans.]
Victor! Victor? You okay? Try to breathe.
[Screams.]
Shannon, call 9-1-1.
- Drew: What do you got? - Female, 20s.
She's moving all extremities.
Tender to palpitation over her second vertebrae.
What does that mean? Am I gonna be paralyzed? We're gonna do some tests, okay? Can you tell me your name? [Crying.]
Emilia.
Please, I have to be able to walk.
Please.
What's going on? We got a C2 fracture.
Let's get some portable C-spine films here.
Yeah, if it's unstable and she moves, she can cut her own spine and lose the ability to breathe.
I saw this in Bagram.
It can go bad fast.
Shannon, can you page Ortho? We need Dr.
Williams right now.
- Got it.
- Okay, on my count.
3, 2, 1.
Let's roll her.
Okay, it's gonna be a while till the on-call Orthopod can get here.
Can you handle this till then? Yeah.
Emilia, I'm Dr.
Alister.
I'm gonna help you, all right? I'm really scared.
I know.
I'm gonna do everything I can for you.
Mid radial fracture, closed.
Possible broken lower ribs.
Give him 100 of fentanyl and order a CT to look at his liver.
All right, buddy.
We're gonna take a look inside and make sure nothing's bleeding.
Jordan, are you gonna be here when I get back, babe? Ah, you're my patient, honey, I'm not going anywhere.
Well, what do you want me to tell Dr.
Zia? You're three sheets to the wind? I don't know what that means.
Oh, you're wasted.
A whole bottle of red wine.
Mm-hmm.
Yeah, you should probably go to sleep.
Little tip prop up your head so you don't choke on your own vomit.
Douche.
What part of "on-call" doesn't he get? Hey.
Hey, I thought you were going to, like, a wrestling match or something? Lucha Libre.
Brawl broke out in the crowd.
Oh, whoa.
You you take a hit? I hope no black eye or anything.
No, just a black soul.
Don't you have any patients? Uh, no, not yet.
[Clears throat.]
Surgeons really have it easy, huh? What? Why would why would you even say that? 'Cause you're just sitting around.
Uh, no.
No, I'm not.
I'm Uh, I'm not sitting around.
Basically, it's just, like, a slow night in surgery.
- Mm-hmm.
- And I almost forgot.
I have a post-op check on one of Scott's patients.
So I'm gonna I'm gonna I'm gonna go do that.
Um [Woman speaking indistinctly over PA.]
Man, you really don't like Paul, do you? I do.
He just he takes himself so seriously.
The guy needs to lighten up.
So why can't he take his mask off? He can't reveal his identity.
Okay So why is he still wearing his leotard and cape? - That I can't answer.
- Ah.
Oh, my God.
It's El Matador.
He's my favorite.
Did he do his Montezuma's Revenge move? - Yeah.
- Oh! You like wrestling, Heather? Like it? Love it.
Maybe he'll give me an autograph.
Okay, um, could you do me a favor and drag El Matador away from his adoring fans so he could cheer up his cousin? I'll get him some scrubs.
Thank you.
[Under breath.]
Such a weird night.
[Metallic thud.]
Son of a bitch.
Did did the air conditioner just stop? Yep.
And I just wanna go on the record, I had the night off.
[Spits.]
[Groans.]
I feel awful.
It's so hot in here.
Yeah.
AC's broken.
I'll get you some more ice packs.
So your viral panel and urinalysis came back negative, but now we got vomiting to add to your symptoms.
Huh.
I have a horrible headache while you're at it.
Hmm.
Might be time for a spinal tap.
I prefer a beer on tap, but something tells me that's not on the menu.
Drew: She's got an Anterior/dislocation fracture of the dens.
Surgery's precarious.
Right.
Well, she's neurologically intact.
Can't we just decompress the spine with traction? Yeah.
You get ahold of Dr.
Williams? We [Scoffs.]
We got ahold of him, but he can't get ahold of himself.
Man has a little problem with alcohol.
Okay, well, Syd, the Orthopod I worked with in Bagram, she was amazing.
I learned a lot from her.
I can set up traction by myself.
I did a few back in country.
Okay.
Okay, I'll help you put her in Gardner-Wells tongs.
Okay.
Emilia, okay, this contraption is gonna look a little scary, but it's gonna help, okay? You just need to be very still.
Emilia: Okay.
[Monitor beeping steadily.]
[Crying.]
What if this doesn't work? [Inhales sharply.]
If I can't walk, then I can't work, and then I can't pay for college.
College.
That's great.
What are you studying? [Inhales sharply.]
I'm in business school.
I wanna be a sports agent.
[Sniffles.]
I'm not just some dumb girl in a bikini.
No one thinks that.
Lots of people do.
[Sniffles.]
I'm only 21.
And what happens if I end up in a wheelchair? You won't.
I promise you're gonna walk out of here.
[Emilia sniffling.]
You're just gonna feel a little bit of pressure.
[Squeaking.]
- It's hot in here, too, huh? - Yeah.
So how you feeling, Victor? - Better after the pain shot.
- [Chuckles.]
Hey, thank you for looking out for me earlier.
I had to get in the way of danger, princesa.
Gotta protect that beautiful face of yours.
You don't give up, do you? I hope someone was recording it so the league can see that I can take a hit.
I got stealth moves, like a cat.
El Gato.
[Laughs.]
I would root for El Gato.
Okay, Victor, so it looks like you have a small laceration on your liver from a broken rib, and a small cyst which is probably a benign adenoma.
What's that? It's a tumor formed from epithelial tissue.
Don't worry.
Don't worry.
You don't have cancer.
You're fine.
[Exhales deeply.]
So, um, what we're gonna do is we're gonna fix up your arm.
But I'd like to keep you overnight to observe that laceration, okay? Yeah, you can keep me overnight, girl.
[Chuckles.]
All right.
I called the day shift Orthopod to come in and take a look at Emilia.
You think you went too far with that promise to her? Maybe I shouldn't have promised her, but I've just seen too many 21 year olds end up in permanent wheelchairs.
I'm not ready to see another one.
You know, um, we haven't really had a chance to to talk since you got back to civilization.
How you how you doing? Some days are a little rocky.
Swerving under bridges, hoping someone doesn't drop an IED on my truck.
That kind of fun stuff.
You know, when I got back from my first tour, I asked our gardener to move the shrubs from the back of the house to the front.
I thought I could create a plant barrier [Chuckles.]
against outside elements.
Right, probably 'cause, you know, a shrub will protect you from a pipe bomb, right? Totally rational.
Something's wrong with your patient.
Hurry up.
I can't feel my legs! I can't feel my legs! Please help me! I can't feel my legs! [Crying.]
You promised me! Traction didn't work.
She needs - surgery now.
- I'll get Scott.
Go, go, go! Emilia, everything is gonna be okay.
That's what you said before.
I need to manually reduce the fragment fracture - and screw it in place.
- [Door opens.]
Day shift Orthopod hasn't called back.
I'm not a spinal surgeon, Drew, and neither are you.
- This is pretty risky.
- Yeah, well, we're not waiting.
If we do nothing, she's paralyzed.
In the war zone, you do a little bit of everything.
You don't wait around for the on-call guy.
I can do this.
Topher, thoughts? Well, Drew worked with an ace ortho at Bagram.
He says he's done spinal surgery before.
I trust he knows what he's doing.
All right.
Drew, this is your show now.
- I will assist.
- [Door opens.]
Woman: Patient sedated and ready.
One wrong move, and we can take out her spinal cord.
Not gonna happen.
[Gloves thud.]
[Faucet running.]
I swear there's a bicep in there somewhere.
Ah, it's in there, okay? You wouldn't be able to move your arm if it wasn't.
Vic, you wanna build some muscle, man? You gotta up your protein.
I already drink, like, two protein shakes a day.
I know, but you eat way too much fat.
Your diet's all messed up.
You should've seen this guy when we were touring in Mexico.
He hit up every taco stand you could find.
[Chuckles.]
Carnitas day and night.
Some people have a high metabolism.
Sometimes it's lifestyle and sometimes it's genetics.
I guess I just didn't get the genes.
I just wish I was more like my cousin.
Strong, intimidating, a winner.
All right.
Okay, so she's ready to shoot.
Let's go stand over here.
You never take that mask off in public? [Chuckles.]
No, especially if I got fans following me around.
Used to wrestle under a different name.
[Whispers.]
El Diablo.
[Chuckles.]
You never heard of me? I'm sorry.
I am I'm a Lucha Libre newbie.
Oh.
Well, the people hated me, and I didn't like it.
So, uh, I laid low for a minute, reinvented myself.
Hmm.
Sounds like something I just did, you know? Went on a sabbatical, disappeared for a while.
- [Coughing.]
- Hey.
Hey, hey.
You're okay.
You're okay.
Excuse me.
Excuse me.
All right, let's do an AP lap of his chest, and page RT for a breathing treatment.
[Continues coughing.]
All right.
Breathe.
Oh, man.
Hey, Heather, it's the last bag of ice.
Thank you.
Every bed is taken with a heat stroke patient.
Can't get a repair man here for another two hours.
But never mind that.
[Laughs.]
I'm Dr.
Zia.
Hi.
Normally, I like to stand up when I meet new people, but there's a needle in my back.
I-I see that.
[Sighs.]
Fever and a rash, headache, vomiting.
Blood work is clean.
Meningitis.
Yeah, sounds like it.
I don't know if it's bacterial or viral.
Let's hope it's the latter.
Yeah, we should isolate her and start her on antibiotics just in case.
Isolate me? No, it's just a precaution.
You know, Georgia here is training to do a Tough Mudder.
Dr.
Zia's trying to get in shape.
Perhaps you could give him some pointers.
- Oh, thanks.
I-I got it covered.
- Really? Yeah, Doc, you look a little scrawny to me.
[Laughs.]
Listen, two months ago, I couldn't run for seven minutes.
Now I can run for 7 miles.
That's pretty good.
But let me guess you hit a plateau.
Come on, give me a break.
I just quit smoking, my mother lives with me.
Oh.
You definitely get a pass.
[Laughter.]
Uh, can you send that up to micro? I'm gonna get the isolation room started.
Okay, thanks.
Georgia, back in a couple minutes.
Hey, hey.
You okay? Yeah, I, uh, I just brought a girl in from the halfway house.
Drying out from, uh, heroin and a heat wave don't mix.
You want me to take a look at her? No, she's just dehydrated.
Kenny's giving her fluids.
I'm gonna grab something from the cafeteria and head out.
I'll see you later.
Okay.
[Woman speaking indistinctly over PA.]
Pfft.
What [Chuckles.]
What what are you doing here? I have an ENT who's using a new laser.
I had to give him a refresher course.
My job is getting old.
I need to find something more challenging.
Mmm, any chance you can sneak away? I just need you for 5, 10 minutes tops.
[Sighs.]
Yeah, I wish, but I got a patient.
Oh.
Well, if you change your mind there is nothing between me and these pants.
Nothing.
I don't need that.
Doc, my cousin's had this cough for the last few weeks.
He went on antibiotics twice and they didn't work.
Yeah, I heard him coughing at the match.
It could be bronchitis or asthma.
Okay.
[Sighs.]
Victor, your x-ray patterns are suggestive of TB.
We're gonna have to get you and anyone else who was on that tour tested.
- That means you, too, Matador.
- Are you serious? I'm always serious.
Shouldn't we isolate both of them? Yeah, but where? Okay, T.
C.
already has a patient in isolation.
And if this is a bunch of people with tuberculosis, we are screwed.
Drew: How does a ring girl get messed up instead of a wrestler? Removing a piece of lamina.
Oh, damn.
Clot and bone fragments are blocking our access.
Scott: Yeah.
All right, let's get it all cleaned out.
It's gonna take too long to clear all this out.
Any delay with this heat, too risky.
Chance of infection's too high.
We need another way in.
I can go through the mouth.
We can bypass the debris and cut the OR time in half.
Through the mouth? Have you done that before? I assisted in the exact same procedure on a corporal in Bagram.
He had a piece of shrapnel lodged on his second vertebrae.
- And It worked? - Yeah.
I'm not gonna lie.
It's pretty tricky.
But if we don't, this girl will never walk again.
Well, you Army docs do stuff on the battlefield every day that we've never tried around here.
Let's do it.
Okay.
Just remind me never to promise a patient anything ever again.
Okay, I need you to check every person in that waiting room who was on that tour - who has TB symptoms.
- Okay.
Hey.
So I saw something you should know about, but you'll be happy you didn't see it.
T.
C.
's hooking up with that new drug rep, the one with the $600 stilettos and Ducati.
Uh that's great.
I'm I'm happy for him.
Hmm.
You know, you shouldn't gossip so much.
You never know if it's gonna come back - and bite you in the ass.
- I wasn't gossiping.
This is all about sisterhood.
I thought you'd wanna know.
Well, thank you.
But, uh, let's keep it between the two of us, okay? And you have a patient.
Sam: 82-year-old female with heat exhaustion and syncope Whoa.
What's going on in here? Dante's nine circles of hell.
Should you guys still be taking patients? Topher's call.
Hey.
Hey.
I thought you had the night off.
I did until the audience decided to join in on the fighting and a crazy fan tried to kick me in the head.
Well, I'm glad you weren't kicked in the head.
Yeah, me, too.
Here, you might need this.
Oh.
That's sweet.
[Chuckles.]
Okay, okay.
All right, I I'm at work.
Gotta go.
Think T.
C.
knows about those two? I-I didn't know, so I-I doubt he has any idea.
Not sure how he's gonna take it.
Oh, he's a big boy.
He can handle it.
Yeah.
Well, I didn't see nothing.
- [Mutters.]
- [Laughs.]
I didn't oh! I didn't see No, man.
[Laughs.]
Are you okay? Yeah, I just got a cramp in my my glute.
[Clears throat.]
Ah! Whoa.
What, uh so speaking of muscles, how's how's your bike training been going? I did 40 minutes on the stationary bike yesterday.
Hey, tomorrow, I'm taking you outside on the terrain.
All right? Stay hydrated.
[Under breath.]
Thank you.
Oh, man.
Hey, uh, Topher.
Hello, Sam.
Should we be rerouting patients to another hospital? Uh I called St.
Luke's.
They're just as slammed.
Could you and a couple of your guys bring as much ice as you can get your hands on? If you have any extra fans at the station, bring those, too.
- Yeah, sure.
- Thanks.
I, uh, I have your patie I-I have your labs.
You're a lab tech now? No wonder you couldn't hack the ER.
I was I was coming to check on You know what? Do you want your patient's TB results or not? 'Cause they're negative.
So I'm good, right? We'll still send this off in case it was a false negative.
Anything else? Maybe you'd like to pull up a chair, play some "Farm Heroes" on your phone? - What - [Coughing.]
Okay.
Help him! Jordan! [Victor continues coughing.]
Okay, I need an ultrasound.
Okay, all right.
[Whooshing.]
His liver's bleeding.
- Let's get him to the OR.
- All right.
Looks like you got your first patient.
Cousin! I'm praying for you, man.
He has a cyst on his liver near the bleeding.
It could complicate surgery.
Paul, take care of this guy, okay? He's special.
I heard that.
You're in good hands, Victor.
I already was.
- Scott's in OR 2.
Grab him.
- OR 2.
Okay, Scott, I got my finger on the anterior tubercle.
Grab it carefully with a Kocher.
Scott: And pull volar traction.
Exactly.
Okay, once that's aligned, I'll place an odontoid screw.
Dr.
Clemmens? You're needed in OR 1 immediately.
Don't worry, Scott.
I got this.
If you need me, I'm 30 seconds away.
All right, nurse.
Hold traction.
- Hey, what are you doing here? - Hi.
Oh, I brought in someone from the halfway house.
Kenny told me I'd find you up here.
Yeah.
Um, I have your wallet.
Oh, you could've given this to me later.
I know.
I just I'm being kind of silly.
I kind of wanted to see you again.
I'm really happy to see you.
But I'm running into surgery.
So why don't you pick me up later and we'll go have breakfast? Okay.
Good? [Woman speaking indistinctly over PA.]
Jordan.
Hi.
Hi.
Scott and I just started dating.
I see that.
It's very new.
We we haven't told anybody yet.
So does that mean T.
C.
doesn't know? I I kind of wanted to wait and see where things were going first.
But I guess it looks like it's going someplace good.
Okay.
Hey.
Brought you another fan.
Oh, point it right at my face.
Georgia, your cerebrospinal fluid was positive.
I have meningitis? Yeah.
We're not sure what kind yet 'cause the cultures haven't come back.
So hopefully, it's just viral and it'll go go away.
- You okay? - [Grunts.]
My chest hurts.
I can't breathe.
[Gasps.]
- What's going on? - She's having a heart attack.
- I'll page cardiology.
- All right.
That's it.
That's it.
Okay.
[Monitor beeping steadily.]
How's Victor's surgery going? We're almost done here.
Repaired the lacerated liver and removed the cyst.
Paul: Blood pressure's down to 72 systolic.
- Scott: He must be bleeding somewhere.
- The field looks dry.
Did you check behind the liver? Yes.
I did already.
He's down to 58, guys.
We're gonna lose him.
Cardiology has somebody in the Cath Lab, but she'll be next.
Just started heparin and a nitro drip.
We're missing something.
Meningitis doesn't cause heart attacks.
Unless the same virus is attacking the heart.
But her viral panel was normal.
Topher.
Look at the skin on her hands.
What the hell? It's peeling off.
Yeah.
Conjunctivitis, skin shedding, strawberry tongue.
This is Kawasaki disease.
The diffuse inflammatory reaction could explain the multiple symptoms.
Yeah, and it causes aneurysms of the coronary arteries, which would explain the heart attack.
Forget cardiology.
Take her to the OR for bypass surgery.
Topher: I'll take her right away.
[Monitor beeping rapidly.]
Crit is stable.
So he's not bleeding.
Levophed is maxed out.
It's not working.
Maybe he's septic? No, white count and temperature are normal.
Could be an adrenal issue.
Let's put the films back up.
Okay, hold on a second.
Um All right, he was traveling in Mexico for about a month.
And his cousin said he was eating pork like it was going out of style.
Parasites? Hand me the specimen container with the cyst.
Look at those suckers.
Unbelievable.
He's in anaphylactic shock from the parasites pouring into his abdomen.
- [Flatline tone sounding.]
- He's crashing.
Scott: We gotta stop this reaction.
We gotta irrigate.
Hand me an epi now.
[Suctioning.]
We're in.
Come on, come on, come on.
- [Monitor beeping steadily.]
- BP's up.
That was close.
It was too close.
All right.
Nice work, Paul.
You good to close? Yep.
Woman over P.
A: Code blue, code blue.
Room 359.
Code blue.
Room 359.
[Sighs.]
Hey.
What's going on? I could be hallucinating from the heat, but I think Drew's doing a spinal surgery through a patient's mouth.
The mouth? Where'd he learn how to do that? It's the Major that he worked with during his last deployment.
She made a real impression.
- Guess our little boy's growing up.
- I guess so.
How's Georgia? So far so good.
Uh, surgeon thinks we got it in time.
Heat wave ended up saving her life.
You know the - the fireman, Sam? - Mm.
Jordan's seeing him.
I didn't want you to hear it from one of the nurses.
Seems like a nice guy.
I-I moved on.
I want her to be happy.
You really moved on? Mm-hmm.
Hardest thing I've ever done.
Hydatid cyst.
It's crazy.
Haven't seen one of those since residency.
Yeah, well, thanks for pulling out all the stops.
Hey, whatever you wanna say, just say it, Jordan.
I think you're making a huge mistake getting involved with Annie.
- Oh, do you? - Yes.
I know that she is sober and she is trying to be a better person, but I have seen her go down that path a hundred times before and it never works out.
So you're an expert on all things Annie? I've known the woman for 10 years.
Okay? She stole from T.
C.
Yeah, and she came back, and she's been trying to make it up to him.
Do you have any idea how hard that was for her to do? She makes me happy, Jordan.
For now.
I'm just worried she's going to break your heart.
Well, you don't have to be a recovering alcoholic to break somebody's heart.
[Monitor beeping steadily.]
Hi, Emilia.
I'm Dr.
Clemmens.
I assisted Dr.
Alister in your surgery.
[Whispers.]
Hi.
Can you try something for me? Can you try wiggling your fingers? What about your left hand? Okay, uh Your toes? I can feel that.
[Chuckles.]
I think that deserves a yay.
Yay.
Oh, I was - You meant from her? - Yeah.
[Laughs.]
With a little rest and rehab, you'll be good as new.
Thank you.
Thank you so much.
How are you feeling? Little out of it, but the pain is better, though.
But you're never gonna eat pork again.
I know I'm not.
[Chuckles.]
Oh, hey.
There's the best doctor in San Antonio.
And the cutest.
[Chuckles.]
No offense.
Oh, it's okay.
I'm saving myself for The One.
Well, obviously, someone is feeling better.
- Hmm.
- Okay, Victor, you are going to have to take an anti-parasitic pill for the next few weeks, but you should make a full recovery.
So the parasite's giving him that cough? Yeah, he had an autoimmune response to the parasite which caused areas of swelling in his lungs.
And, Victor, that parasite in there is why you couldn't gain weight.
Awesome.
So I could put on some muscle now? Yes.
Yes, you can.
[Lowered voice.]
Hey.
Hey, Doc.
So what are the chances that Victor's ever gonna bulk up like me? Slim.
Uh, with his physiology, it would take a lot of work.
He wants to be a luchador so bad.
And after everything he's been through, I just I wish there was something we could do, you know, to make him feel like the man.
You know what I mean? Hmm.
I have an idea.
So my body's attacking itself? Yes, but this medication will stop the process.
And the surgeon said that the damage to your heart was minimal.
We, uh, we rarely see this disease in adults.
So I'm a freak of nature? Oh, I would say you were special.
Okay, can I still train for the Tough Mudder? Because I can't go back to sitting on my couch eating my own weight in Oreos.
Well, you have to keep a close eye on your heart, but it shouldn't stop you from living your life.
You can continue to torment yourself with exercise and clean eating and Dr.
Zia, you need to change your mindset.
Right, Toph.
Once you make a change, you never go back.
Right.
[Laughs.]
- Hey.
- Hi, Toph.
- Hey, T.
C.
- Yeah? You got a minute? Sure.
You all good? - Yeah.
- Okay.
[Giggling.]
Yeah, El Matador.
I love you so much, Matador.
Will you sign my boob? - All right.
- Yeah! Okay, El Matador needs his rest.
Oh, man.
That was the greatest five minutes of my life.
But you could've let me sign her boobies.
[Scoffs.]
Step too far, buddy.
Victor: Thanks, Jordan.
[Laughs.]
All clear? Wait.
You're El Matador? You're El Diablo.
Man, I hated you.
You were the worst.
You see? One good deed.
Yeah, I understand if you're not jumping for joy over this.
But I swear to you, I have Annie's best interests at heart.
Hmm.
And I know this is probably weird for you or awkward or a bunch of other adjectives, I don't know.
But I just wanted to tell you myself, man to man.
And hey, don't try not to be too hard on Annie for not telling you first.
She was just really concerned about how you'd react.
She thinks of you as her only family.
Thanks, man.
Epic save on that C-spine trauma.
Thank you.
You know, we saw some messed up things over there.
At the end of the day, makes us better doctors.
[Woman speaks indistinctly over P.
A.
.]
I'm not moving.
What Did you poison it? [Mouth full.]
I thought about it, but a woman using poison as a murder weapon is so cliché.
Nice job with Victor today.
You know, it may not seem like I do much around here, but surgeons are there when the stakes are the highest.
So Yeah, I know.
Surgeons are kings.
I-I don't know about kings.
I mean, if Jordan hadn't been there to help, we would've lost Victor.
I-I'm just saying that when we're together as a team, that's when we save lives.
What I'm trying to impart is that - Oh, my God.
- Mmm.
Oh oh, my God.
Why would you do that? You said we're a team.
I decided I liked yours better.
You really have to loosen up, Paul.
You're so rigid.
I'm not rigid.
That was that was gross.
Rigid.
Rigid.
Rigid.
Okay, I just This this is my popsicle.
- [Air conditioner turns on.]
- Sure, now it works.
[Applause.]
- Hey.
- No.
No, no, no.
What is Can I talk to you for a second? Yeah.
Things are moving way too fast with Sam.
So about those dating apps that you're using - Mm-hmm.
- Um, can you tell me about them? Oh, I'll text you a list, but basically, here's the deal.
Remember, it's a numbers game, so don't take anything personally.
And always swipe right on the maybes 'cause they may be hotter in person.
And also, only meet for coffee or a drink, but make sure the bar has food in case the guy doesn't suck.
And if you don't wanna slip back into serial monogamy, keep it to a 2-date maximum.
All right.
[Chuckles.]
Time for you to have some fun, Jordan.
Yeah.
I couldn't agree more.
See ya.
So Kawasaki disease in an adult? Yeah.
Hydatid liver cyst.
This night was bananas with a capital B.
Yeah.
So you and Sam? Yeah.
Casual, you know, taking it day by day.
You and Jessica? For now.
You know me.
I do.
So that's happening.
Yeah.
Annie and Scott.
Yeah, he told me, Man to man.
Man to man, huh? How do you feel about it? Oh, I hated it.
[Chuckles.]
- He's arrogant, egotistical.
- Well, hold on.
You know, I used to date the guy.
He happens to be a really great guy.
Annie, however, is a walking therapy session.
Oh, that's my family you're talking about.
All right, so she's not the most stable.
But who is? She stole your TV.
Gave me an excuse to buy a new one.
And all the charm surrounding it I gotta go.
Slowly disappears Yeah.
Me, too.
Could I be looking back too much - Hey.
- Hi.
I think I'm made you too many omelettes.
How do you feel about huevos rancheros? [Car door closes.]
[Sighs.]
Sam, we gotta talk.
And we face destination But look how far I've come