The Night Shift (2014) s04e08 Episode Script
R3BOOT
1 [Insects chirping.]
Rick: Hey, we miss you on the raids.
Thought you were never coming back from Syria.
I had to come back here and tie up a few things, but I'm gonna go back in a couple weeks.
Oh, man, I'm never going back there.
Iraq was enough for me.
All right, we're almost there.
Hey, T.
C.
, do the honors? Of course.
Ford, call it.
Oh.
Uh, heads.
[Brakes screech lightly.]
Sorry, man.
Looks like you're first in the breach.
All right, everybody, it's go time.
[Guns cocking.]
Kenny: Wait, you haven't told Rick you applied to Ranger school? You'll be gone like three to six months.
No, because I'm not even sure I want to go.
You've wanted to go since you were 18.
Look.
Everybody in the Army wants a Ranger tab, so you either got your tab, or you got a story.
And right now, my story is I'm not a Ranger because I'm a doctor.
- Pretty good story.
- Yeah.
Truth is, if I go and fail, I'm not sure I could live with that.
When do you have to decide by? Next week.
Jordan says it's cool.
She'll have Cain cover as chief resident for me when I'm gone.
But, anyway, I got a patient up for a CT.
Meet me there in 10.
Paul: Yeah, but weren't you supposed to be in Denver with Scott - for the board meeting? - Bella: Change of plans.
He asked me to stay, keep an extra surgeon on hand, and I don't mind.
I like being here, anyway.
What's up, Cummings Medical Group? Same old, same old.
Hey, Paul, would you mind, uh, signing - some of these patient release forms? - Yeah, not at all.
- [P.
A.
system beeps.]
- Okay.
Woman: Portable X-ray to E.
R.
Portable X-Ray to E.
R.
[Clears throat.]
Vanderpool.
Vanderpool.
Isn't that where you're staying, B? - See, I dropped her off last week.
- Must have dropped it.
Uh Oh, my God.
Oh, my God, you t you are you two are - No.
- Yes.
It's I'm sorry to rip off the Band-Aid this way, - but now that you know - [Exhales sharply.]
Look, I was gonna tell you, man.
Yeah? You were gonna tell me.
So So last week, you weren't crashing with Drew.
You were crashing with my sister.
Bella: [Scoffs.]
Oh, we are grown-ass adults.
We can do whatever we want to do.
- [Pen clatters.]
- Oh, don't even t-talk to me.
So you're saying all staff and resident evaluations? I mean, why? Who would leak that kind of stuff? Scott: Not sure.
Maybe a disgruntled patient or employee.
Okay, so it's Cummings Medical Group wide? Yeah.
It's started causing chaos here in Denver, so get ready.
You might have some angry staffers on your hands.
Jordan! Yeah, I'm sensing that.
I'll call you back.
- [Cellphone beeps.]
- "Dr.
Rivera lacks focus and drive.
Projects personal issues onto patients.
Makes inappropriate and judgmental comments.
" Shannon, I-I was gonna "She may continue her residency program under close supervision.
" - [Wailing siren approaches.]
- Really, Jordan? I was going to schedule a meeting with you so that we could discuss this.
Oh, yeah? What were you waiting for? Fit me in between banging sessions with Cain? Hey.
Right there that's what I'm talking about.
Those are the kind of comments that get you in trouble.
Jordan, I need a room.
I got an active GI bleeder on blood thinners.
Jordan: Let's get her to Trauma 4.
I'll be right there.
I know this patient.
It's Joan Fraley.
I treated her when she got her pacemaker and stent put in.
- That was Cain's patient, right? - Yeah, I'm jumping in on this.
That is, if it's okay with you.
[Sighs.]
BP's 100 over 50.
Pulse is 85.
She had multiple episodes of bloody emesis.
I put in an IV and gave her four of Zofran.
Okay.
Thanks, Sara.
We got it from here.
Uh, send a transfusion panel, and start a Protonix drip.
Ms.
Fraley, I'm Dr.
Rivera.
- I treated you before.
- Oh, no.
Not you.
Where's Cain? Sorry, but he's not here this week.
Uh, but my name is Dr.
Alexander.
I'm the supervising attending.
I hope you call the shots 'cause little miss purple hair here nearly killed me last time.
I don't trust her.
Yeah.
You're not the only one.
I can assure you that Dr.
Rivera is an outstanding doctor, and she is going to give you excellent care.
Just keep an eye on her.
Don't worry.
She is.
Let me know if you need anything.
It's gonna be fine.
[Sighs.]
[Dog barking.]
[Insects chirping.]
Breacher ready.
[Groans.]
Ford! [Officers shouting indistinctly.]
[Bullet ricochets.]
Man: Take cover! Coming in! Watch out! Watch out! Multiple officers down.
I need a helicopter medevac now.
Now! [Monitor beeping rapidly.]
- Kenny, what's going on? - It's the pacer.
It's going faster and faster.
I can't stop it.
- [Paddles whine.]
- Looks like he's about to [Thump.]
[Monitor beeping rapidly.]
All right.
It put him in v-fib! [Blow lands.]
- [Beeping slows.]
- He's got a pulse.
Back in sinus.
Thanks, man.
Yeah.
What the hell happened, Kenny? I don't know.
You saw it.
The machine defibrillated on its own.
Almost shocked me, too.
You're saying it made up its own mind? It's a computer, Kenny.
It doesn't work like that.
Yeah.
That's what I'm saying.
Wait.
What are you saying? I'm saying maybe you should pay attention to your job a little bit more, yeah? [Drawer closes.]
Okay, I don't appreciate what you're insinuating, so I don't appreciate having to save your patients.
Look.
I know you're mad about me and Bella.
No, it's not even about that, man.
How about you just focus on what's most important? [Door opens.]
Shannon: Jordan! What's going on? She was fine one minute, then her blood pressure dropped.
- Is still vomiting blood? - Not since she was medicated.
She's burning up, though.
My back's killing me.
- How's her hemoglobin? - Initially, 7.
The first unit's in.
What?! She was given the wrong blood type! Ow! What are you doing? It says here she's A positive.
No.
She's an O negative.
I remember from before when Cain saved her.
Hypotension, fever, back pain.
She's having a transfusion reaction.
You're right.
There's blood in her urine.
Okay, Jocelyn, IV, normal solution.
Run an LDH and a Coombs panel.
You are the worst doctor I've ever had.
I'm suing all of you.
Mrs.
Fraley, I am so sorry, and I promise I will do everything to make this right, and I will personally investigate this myself.
I did not give her the wrong blood type.
Her records were messed up somehow.
- [Alarms blaring, monitors beeping.]
- You have to believe me, Jordan.
What the All right.
I'll be right back.
- [Blaring, beeping continues.]
- [Telephone ringing.]
Ray, what is going on? It went haywire.
I-I can't make it stop.
Jordan, the Pyxis is freaking out.
The drawers won't stay closed.
Okay, call security.
Have them guard the narcotics.
[Mouse clicking.]
[P.
A.
system feedback screeches.]
- [Evil laughter.]
- Jordan: We have a bigger problem.
The whole hospital's being hacked.
[Evil, distorted laughter.]
[Monitor beeps.]
[Paddles whine.]
[Receiver clacks.]
Jordan, Paul says the CT computers are down, too.
All samples have to be hand-carried to the lab.
Okay.
All right, everybody, listen up.
We've now switched over to our emergency protocol.
Also, very important All of the blood in our bank has been mislabeled.
The Red Cross is sending over O-negative.
Please use it sparingly.
Okay.
Go.
Take care of your patients.
- Thank you.
- Yeah.
What do we have? The Cummings Medical Group has been hacked for a $10 million Bitcoin ransom.
My father called Homeland Security, and they're sending an IT staff to reset our system.
Okay.
Ray? Tell EMS that we're closed due to internal disaster.
No more ambulance traffic.
My father says we're not closing.
- That's caving to terrorists.
- Shannon: You're kidding.
We don't have any blood or diagnostic equipment.
We'll be back online soon.
Yeah, that's not good enough.
All right.
Um, Paul.
I want you to call Presbyterian's ER and see if they can take on any more patients.
I'm gonna go thin out the waiting room.
All non-critical care should go.
- Jordan.
- I don't give a rat's ass about your dad's perception problem.
Neither do I, but this is his hospital.
And this is my ER until they tell me otherwise.
Ray, make the call.
[Indistinct chatter.]
[Telephone rings.]
Paul: Yep.
Thank you, guys.
We'll take all the help we can get.
All right.
[Receiver clacks.]
She's right, but dad's not gonna like it.
Yeah, there's a lot of things Dad's not gonna like.
What's taking so long? When can I get out of this lame-ass ER? Diego, watch your mouth.
- Sorry about that, ma'am.
- Yeah.
- [Curtain opens.]
- Drew: All right, Diego.
We got good news.
Wrist is just sprained.
No fractures, no broken bones.
What about his head, Doc? He took quite a spill at the skate park.
We're on that.
He's next in line for a head CT.
- Have you reached his mom yet? - Not yet.
She must be on the plane.
She's on her way to Cabo for her bachelorette party, so Diego and I get a guy's weekend.
That's what you think this is? M-Molly, will you show Andy where the waiting room is? I'll get Kenny to take Diego to CT.
Yes, Doctor.
I'll try Sharon again.
Be right back, buddy.
Can't wait.
Stepdad seems like a good guy.
Why not be a little nicer to him? He's not my stepdad, okay? He's just Andy.
[Indistinct shouting.]
Rick: T.
C.
, Ford was hit.
- He can't breathe.
- [Gasping weakly.]
- [Gunshot.]
- I'm under fire.
I can't get to you.
I'm gonna throw you an LMA.
[Bullet ricochets.]
[Gunfire.]
[Indistinct shouting.]
999.
Officer down.
Doc needs immediate escort to my 20.
[Gun cocks.]
There's blood spraying out of his neck, T.
C.
.
He's not getting any air.
All right.
I need you to cover me, okay? I got a critical over there.
This guy's stable for backup.
T.
C.
, it's not working! He's dying! Okay, Rick, I need you to get a 7-0 tube ready.
I'm on my way now, okay? Coming straight to you.
[Bullets ricocheting.]
Okay.
[Gunfire continues.]
T.
C.
: Okay, the blast transected his airway.
Man: Move! Move! I've located his trachea.
Hand me a tube.
[Helicopter blades whirring.]
Is he gonna make it? I don't know.
Depends how fast we get out of here.
[Indistinct shouting.]
Chopper's here.
Where's my damn escort? Hand me trauma shears.
The way you put that tube in, I never could have done that.
Sure, you could, man.
It's just battlefield medicine.
You're a Ranger.
Yeah, they never taught us that or the SWAT training, either.
It looks like a bullet hole.
I think it just entered his chest right below the vest.
We got to get him out of here ASAP.
He's gonna bleed out.
[Vehicle approaches.]
[Bullets thudding.]
Let's go.
On three.
- Be careful with his airway, yeah? - All right.
One, two, three.
- Go! - Go.
He started seizing in the CT tube.
Luckily, we got the scan before the system went down, but he's got blood building between his brain and his skull.
So what do you do? Well, we gave him Valium to stop the seizure, and we started him on a new drug, Dilantin, to prevent any more seizures from happening during surgery.
Have you got his mom on the phone? Her plane hasn't landed yet.
Is he gonna be okay? Sharon's gonna want to know.
The earlier we can evacuate the blood, the better.
Good thing you brought him in so quickly.
[Button clicks.]
[Indistinct chatter.]
I've stuck her a dozen times.
I cannot find a vein.
- Yeah, no worries.
I'll put in an EJ.
- What's that? It's an IV in your jugular vein.
My neck? Not her.
You do it.
Only doctors can do it.
It's hospital policy.
I know we got off to a bad start last time.
I'd been working 20 hours straight.
I'm sorry.
It's just a small poke.
Maybe this job's not for you.
How's it going in here? Everything's okay.
I've got this.
- [Electricity powers down.]
- Joan: Oh! [Gasps.]
Jordan: Okay, Mrs.
Fraley, don't panic, all right? - [Flashlight clicks.]
- Uh, everything is under control.
Shannon: Where are the back-up lights? They'll be on in a second.
Don't worry.
Bella: Jordan, maintenance says the back-up gennies aren't kicking in, and they don't know why.
I'll call the fire department for generators, and the IT guy's on the way.
- Okay.
Thank you, Bella.
- I don't feel well.
Something's dripping down my neck.
She's bleeding from her IV site.
It's DIC.
The incompatible blood type has caused her blood cells to rupture.
Her blood can't clot.
Okay, call the Red Cross, ask for universal donor A2 platelets and AB plasma.
Shannon: Jordan! Ms.
Fraley? - Ms.
Fraley.
- She's unconscious.
She has an insulin pump.
Check her blood sugar.
Blood sugar's 28.
Give her an amp of D50.
- Her pump has been hacked, too.
- What the hell? All right, switch her IV fluids to D5NS.
She just got a massive dose of insulin.
Okay.
All right.
That's a good sign.
She's in your hands now.
If anything changes, you tell me.
Yeah.
[Breathing shakily.]
- [Elevator alarm ringing.]
- Drew: Diego.
Diego! Emergency phone's dead.
He's unresponsive.
His pupils are unequal.
His brain's herniating.
What do you want to do? I'm gonna hyperventilate him to lower his intracranial pressure.
Hypertonic will help, too.
Got it.
And if we don't get him out? Cross that bridge when I come to it.
Got him.
[Siren wails.]
Paul: I got a text from Drew.
They're stuck on the elevator.
Kenny's there to help, but Drew says the kid's in bad shape.
All right.
Get them whatever they need.
I want you to call Milorad in Maintenance.
He should have an idea of what to do.
Jocelyn.
I want you double and triple-checking all of the patients' conditions.
- We are not gonna lose anyone tonight.
- Okay.
Bella, talk to me.
This is Pat Perillo, head of our IT Security.
He's working on the problem.
Right.
What are we dealing with? Pat: Well, I figured out how they got into the system.
One of your nurses downloaded a counterfeit copy of Candy Crush from a Romanian website.
They used a screen scraper, stole her passwords.
They can do that? All right, how long until we get the power back on? A while, okay? I'm shutting down the servers, but our backup, also corrupted.
They tricked the backups into thinking everything is normal.
That's why they haven't kicked in.
Level with me.
How bad is this? Think worst-case scenario, then multiply that by a thousand.
- They said you're in charge here? - Yes, sir.
I will be with you in just one moment.
My fiancé's son.
I took the stairs to the O.
R.
to look for him.
He wasn't there.
His name is Diego.
Now, tell me what the hell's going on here.
[Sighs.]
Sir, I am so sorry, but Don't be sorry! Just tell me where my kid is.
We're stuck between the sixth and the seventh floor.
If I pull the emergency brake, we free fall.
They'd wash us out of here with a hose.
Put it like that, I'm good.
Yeah.
You're not the one I'm worried about, though.
Paul: Hey, you guys okay? Paul! Great.
You get everything in my text? Uh, yeah, yeah.
I have mag lights, duct tape, and a portable vent.
All right, send it down.
Is he down there? Diego! Sir, this is an emergency.
Hospital employees only, okay? That's my boy down there.
I'm not going anywhere.
I am never gonna leave his sight again.
Diego?! Kenny: Bella, get us out of here now.
I'm trying, Kenny.
The hack shut down all of our back-up systems.
We can't override the control panel.
Try harder, or this kid is gonna die in this elevator.
Hey.
Any progress? [Scoffs.]
Yeah, I fixed the whole thing.
I just forgot to tell you.
Pat, I will slap that attitude of yours back into next week if you talk to her like that again.
Uh, sorry.
What? Just get back to work.
Our blood supply is getting low, but we're slowly catching up on all the patients.
Good because I don't think we could take on even one more.
[Keyboard clacking.]
I found the bullet hole.
No exit wound.
Wait.
The bullet's still inside? Look, I will find it, Rick, okay? We'll be at SAM in no time.
Different coin flip, this would have been me.
No.
Actually, it wouldn't.
What are you talking about? Look, I already lost too many brothers, all right? Topher, Thad, Mac.
I'm not gonna lose any more.
You rigged the toss? That's not your call, T.
C.
.
You and Drew are parents, all right? I've seen what happens to Janet and the kids after they lost Topher, okay? I'm not gonna let that happen again.
Ford's wife is expecting.
A son.
Drew and I are his godparents.
I didn't know that.
I'm sorry.
Can you attach that to the pleurevac? - Mm-hmm.
- Thank you.
Man: It's attached.
Releasing the clamp.
There's a lot of blood.
- [Helicopter rattles.]
- Yeah.
Hey, what's going on? Are we turning around? San Antonio's E.
R.
is closed, so is Pres.
We're being diverted to HMH.
No, no, no, no, no, no.
Ford needs a thoracotomy now.
We won't make it that far.
Look, I can give an autotransfusion just to replace the blood that he's lost, but that's only temporary.
Won't last long, okay? Look, if he crashes, I don't know if we'll be able to save him.
We don't have enough time.
Override the diversion on my authority! We're going to SAM! Great.
It's your badge, Rick.
[Groans.]
What's going on? The hospital was hacked.
You were unconscious from low blood sugar.
How long have you been on an insulin pump? Since my last hospitalization.
I should have told you.
I wasn't thinking clearly.
Yeah, well, mixing booze and blood thinners will do that to you.
I smelled your breath, ran an alcohol level.
[Monitor beeping steadily.]
I know I'm not the best communicator, but I am one hell of a doctor.
I want to do everything I can to make this right.
You can't.
Well, let me try.
What's been going on? I was sober for 20 years.
Been out of a job for a month.
A lawsuit shut down the amusement park.
I was already living paycheck to paycheck, and now, I got nothing.
Money's tight, and then the medical bills start coming in from my surgery, and So you started drinking again.
Tonight? I had a few beers.
Mm.
By a few, you mean? [Voice breaking.]
Eight or nine.
I don't feel very good.
I think I'm gonna - [Vomits.]
- Oh.
Hey, I need some help in here.
Molly, get her a Zofran.
Jocelyn, did you get the Protonix? Yes, but I think we should transfer her.
I'll get Dr.
Alexander.
No, she's too unstable.
She has massive hematemesis and needs a nasogastric lavage and an EGD.
How? They took power to Trauma 1.
No electricity, no suction.
There is an ambulance.
Grab some ketamine, and I'll meet you there.
Okay.
All right, paramedic transfers for the levels two and threes, taxis for the less urgent.
Hey, hey, hey, check this out.
This dude is a god.
I mean, he or she.
Don't get all Ellen Jamieson on me.
T-They've been hiding in our system for months, just encrypting data.
They They hijacked our Bluetooth gear, our our drug pumps, defibrillators, CT scanners, everything.
I mean, this crypto-ransomware is sick.
What's sick is holding critically ill patients hostage.
This isn't a game, Pat.
You see all of these people? Their lives are in your hands.
How's that? I mean, I'm not a doctor.
Now you know how it feels.
- [Cellphone buzzes.]
- Now get us back online.
- [Cellphone beeps.]
- Hey.
Did he pay it? Not yet.
He has to.
$10 million is a lot cheaper than 10 wrongful death lawsuits.
They're asking $10 million for each hospital Chicago, Denver, Baltimore, Portland, us.
It's 3:00 a.
m.
He doesn't have $50 million lying around the house.
So this is gonna get a lot worse before it gets better, huh? Yeah.
I gotta run.
I got pulled into surgery here.
Long night, Jordan.
Hang in there.
Hey.
What the hell happened? Cummings Medical Group was hacked.
Why are you here? We closed the ER.
Yeah, we know.
So was Pres.
This is my partner, Ford.
Yeah, he took a booby trap to the neck and a bullet to the chest.
He's unstable.
He needs an OR now.
How much longer before the power's back on? I don't know.
We've been like this for hours.
Tee, our blood bank was hacked, too, and we have gone through all of the O negative that the Red Cross has sent us.
- We're waiting for more now.
- What can we do? He can't make another chopper trip.
No.
Okay, so we got no blood, no O.
R.
, no electricity.
[Breathes deeply, exhales forcefully.]
Okay, we're gonna do field medicine in the ER.
Okay, Rick, I need you to get the ambulance lights to shine onto Trauma 1.
Okay, I need you to route the power for the genny so we can have a suction and a vent.
Ray, get all the metal carts and all the metal trays into Trauma 1 right now.
Jordan, find Paul.
I need help with a thoracotomy now.
He's assisting Drew with a surgery in an elevator.
I'll be in when I can, but right now, it's all on you.
Okay.
Let there be light.
Paul: All right, it's coming down, guys.
[Bucket thuds.]
- I got you.
- Decorticate posturing.
The herniation's worsening.
Intracranial pressure's rising.
You gotta be kidding me.
Milorad says the drill's powerful.
The bits are brand-new, still in package.
Yeah, and you've got enough chloraprep to sterilize everything, okay? I got a maintenance man for a scrub nurse.
This is insane.
It'll work.
All right, I sent you a bulb suction tray kit from peds ICU.
You've got a scalpel, retractors, everything you require.
- Anything else? - Yeah, maybe a prayer.
[Drill whirs.]
NG's removed.
Blood is cleared out.
Okay.
Time to fix the bleeder.
[Siren wailing in distance.]
Okay.
Okay, advancing.
Entering the esophagus.
There's the source of the bleeding.
It's a Mallory Weiss tear.
All her vomiting ripped the lining between her stomach and esophagus.
- [Monitor beeping.]
- She's bleeding again.
- [Door opens.]
- Shannon, hey.
What's going on? What's it look like? I'm applying hemoclips.
What she said.
That was a nasty tear.
How did you get all of this equipment? I ran up to the GI lab and got it.
And where did you learn how to do this? Spent the summer volunteering at a gastro clinic on the reservation.
We treated a lot of bleeds.
Your technique is solid.
You just saved this woman's life.
Good job.
Yep.
And all unsupervised.
Kenny: Kid's gonna love his new hair do.
Yeah.
Let's hope he gets a chance.
Chloraprep.
Scalpel.
Scalpel.
What's his end tidal? Steady at 35.
And a little blood.
I got you.
Hold pressure.
All right.
We're good.
We know what comes next.
[Monitor beeping steadily.]
Here we go.
- All right.
- Slow and steady.
Oh! Son of a bitch, that was close.
You're telling me.
What happened? He's progressing to decerebrate posturing.
- Kenny, we don't have a lot of time.
- Wait, wait, wait.
If he keeps posturing, we could give him brain damage.
Then let's give him another dose of paralytics so I can do this.
Drew, we're out.
What now? [Monitor beeping rapidly.]
[Sighs.]
Hey, Julian.
You called for me? Yeah, they were short-handed.
I stepped in and started this triple A, but the portable genny is worthless.
Here.
Let me let me see.
There's not enough juice to power the C-arm.
It's damn near possible not to jail the gate with fluoroscopy.
But come this far.
Maybe we can finish by palpation here.
Yeah, the graft probably deployed too low.
Really? I thought I had it.
Well truth is, I'm not feeling too great.
I've been sick all week.
Yeah, there's some nasty stuff going around.
You know what? I got this.
Why don't you go take a break? It's been a long night.
Julian, go on.
Dr.
Scott Clemmens, San Antonio Memorial.
Ellen Jones.
First-year surgical resident.
Nice to meet you, Ellen.
Man: Pressure's dropping, Doctor.
Okay, buckle up.
We're flying blind.
Graft's not working.
He must have a large endoleak.
I'm converting to an open repair.
You're opening him up? I don't have a choice.
Prep the abdomen.
But when you open him up, won't he bleed out? Our blood bank's still a disaster.
I have done a thousand open triple A's in my career, and lucky for the good reverend, here, I am good, and I am fast.
[Monitor beeping rapidly.]
Okay, look.
The only outcome I can guarantee is if I don't open him right now, he's going to die.
I know I'm not part of your regular team, but right now, this is my O.
R.
, which means you work for me, so get your heads in the game, and let's go.
Scalpel.
Yes, Doctor.
[Sighs.]
Did you find the bullet? No, not yet, and he's bleeding out faster than I can put blood back in.
- How can I help? - Okay, grab a vena cava clamp.
All right, the bullet tore through the lateral wall of the IVC.
Pledgets and 5-0 silk.
Thank you.
You find the bullet, I'll suture the wound.
Gotcha.
Okay, rest of the chest looks clear.
There's still no bullet, and there's no exit wound.
Maybe the bullet embolized to the heart.
Wait.
You're opening his heart? No.
No.
One step at a time.
Please tell me you have a plan.
We don't have enough blood.
You can't go hunting.
Yeah.
Of course I do.
Um Ray! Go find Rob.
Tell him we need his metal detector right now.
- That's one way to do it.
- Yeah.
Right.
Where is it? Where is it? I'm done.
- Removing the clamp.
- Okay, give it to Rick.
Rick, I need you to scan his belly, search for the metal.
Repair holding steady.
I can't I c-can't find any metal.
Where is it? [Monitor beeping rapidly.]
Pushing valium.
- Pressure's dropping.
- Okay.
Oh, no.
Guys, please do something.
[Monitor beeping rapidly.]
- We got this.
We got this.
- Pushing dose epi.
He's lost pulses.
He's in torsades.
Push mag.
Woman: Yes, Doctor.
Pushing mags.
We've got to do a clamshell.
T.
C.
, is this it? No.
No, no, no, no.
We're gonna do everything we can.
[Beeping continues.]
[Drill whirring.]
I just can't do it.
If he keeps moving like this, I'm gonna drill right through his brain.
Do we have time for Paul to bring more paralytics? No.
He's got high blood pressure, bradycardia.
Cushing's reflex.
This kid's gonna die any second.
He's not.
I got him, Drew.
Do it.
Just do it.
All right.
Here we go.
[Drill whirring.]
Penetrating the inner table.
There's the give.
I'm in.
[Suction gurgles.]
There we go.
[Beeping slows.]
Heart rate's coming up.
Blood pressure's normalizing.
Ah.
He's not posturing anymore, either.
You did it, man.
Paul! The kid's gonna make it.
Tell neurosurg to get ready.
Will do.
[Sighs.]
Drew: This kid is never gonna know how lucky he was today.
It wasn't luck, and, yeah, he is gonna know 'cause I'm gonna tell him.
You did it, man.
You saved his life.
Nah.
We did it.
I wasn't alone in this.
- [Chuckles lightly.]
- [Breathing heavily.]
- [Paddles whine.]
- Jordan: Charging to 10 joules.
- [Thump.]
- Shock delivered.
Jordan, I can't find the bullet.
I'm out of ideas.
What if the bullet's not made of metal? Give me some loops.
What are you doing? Trusting my gut.
How much blood was autotransfused? A lot.
Why? Well, we know that a projectile from the blast perforated his IVC, but we don't know where it traveled.
With magnification, I can just make out a small tear in his diaphragm and traumatic pancreatitis.
That combined with the citrate from the auto transfusion dropped his calcium levels.
That's what caused the seizures and the cardiac activity was hypocalcemia.
I don't speak doctor.
Could you translate? Whoa.
What is that? This piece of wood is your bullet.
It's part of the stairs.
It must have blown off after the explosion.
Oh.
We got cardiac activity.
Sorry, I had to be on call for Drew.
He was a total boss.
What's going on here? Jordan and T.
C.
just saved my partner's life.
You guys make a hell of a team.
- Yeah.
- Yeah, we do.
All right, guys.
We're not done here.
There must be at least a dozen splinters.
All right.
It looks like I arrived right on time.
Yes, you did.
[Knock on door.]
Oh.
[Clears throat.]
[Sighs.]
So, um, how's the pastor? I had to open him up, but he's stable.
I think the worst is over for tonight.
Yeah.
Hmm.
I'm glad you were here, Scott.
I-I don't know what happened in there.
You're human.
Sorry to break it to you.
[Chuckles lightly.]
All the stress you've been under, you're lucky it wasn't something worse.
Yeah.
Back-up generator's working? Uh, no.
I, um I paid the ransom.
$50 million? Yeah.
I thought you said you didn't have it.
How'd you swing that? I, um, called some people I shouldn't have called.
There's all these vultures out there who'll loan you whatever you need as long as you're willing to sacrifice your pound of flesh.
Oh.
That had to be very hard, but you saved a lot of lives by doing it.
And yet, we'll lose more in the long run.
Meaning? The, um, loans I agreed to? I'll never have the cash flow to pay 'em back.
I'll lose everything.
No.
You spent more than a decade fighting to provide health care to underserved communities.
You're not just gonna watch that crumble.
Can't you just call banks now in the light of day? The, um, Cummings Medical Group is a financial house of cards.
We're over-extended.
It got a lot worse when I bought SAM.
Well, then, why did you? Because Paul wanted me to save his hospital.
And you wanted to be his hero.
I don't feel much like a hero right now.
[Sighs.]
Do Bella and Paul know? Oh, God, no.
My kids think I'm some self-made genius, the great and powerful Oz.
Now they're gonna see behind the curtain.
There's nothing you can do? Maybe sell off a hospital or two.
- I'm - Including SAM? I don't know.
I'd appreciate it, Scott, if you just kept this between you and me for now.
I can handle losing my empire, but, um, I don't know if I could handle losing the trust and respect of my children at the same time.
Of course.
[Sighs.]
You know, Julian, I've hit rock bottom in my own life, disappointed all the people who needed me most.
And if you're not a damn fool, you learn what matters and what doesn't.
And sometimes sometimes you get to start all over from scratch.
You learn that in rehab? [Chuckles.]
[Chuckles lightly.]
No.
I learned that from my father.
There are lots of other things besides hospitals that you could hand down to your children.
Let me know if I can do anything for you.
Thanks.
Scott? You already have.
[Door closes.]
That was like a weird dream.
More like a nightmare.
How are you feeling, Ms.
Fraley? Like somebody kicked me in the throat.
Well, you're not rid of me yet.
We have some things we need to talk about before you're admitted.
I know.
Thanks for being my doctor tonight.
- You saved my life.
- Just doing my job.
When Dr.
Diaz gets back Yeah? I'm gonna tell him I want you.
[Chuckles.]
[Electricity whirs.]
[Sighs.]
[Indistinct chatter.]
I think I'll be taking the stairs for a while.
[Chuckles.]
I hear that.
But for the record Okay, look.
Those dudes may be faster and stronger in Ranger School Younger.
Don't forget younger.
Okay, Drew, listen to me, okay? None can do what I just saw back there.
I'm not just talking about the surgery, but the way you helped Andy.
You get people, man.
A real leader has that.
Thanks.
So Paul's sister You got her on speed dial? You caught that, huh? Yeah, you like living on the edge.
Yeah, Paul's not too happy about it.
Well, can you blame him? That's his sister.
It's a pretty big secret to be holding back.
You probably should have told him.
Hmm.
So, I'm supposed to tell Paul about his sister, but you don't have to tell Rick about Ranger school.
Isn't that the pot calling the kettle black? It was a hell of a night, huh? - [Staff murmurs in agreement.]
- Seriously, though, you guys, all of you, you went above and beyond, so I just want to say thank you, all right? You were great.
Rest up.
This place is going to be open for business when you get back here tonight, okay? [Indistinct chatter.]
All right.
Thank you.
Hey, Shannon.
I, uh, really want to put this behind us, okay? Part of my job is to give honest feedback.
I understand.
Now can I give you some honest feedback? I know.
All right? I understand as program director, I should have discussed your evaluation with you sooner.
No, as my friend.
Maybe try helping me fix my flaws instead of poisoning my permanent record.
Scott and I are the only ones who see those.
Correction everybody here has seen those.
[Telephone rings.]
Heavy is the head.
Yeah.
Well, she's right.
I could have handled that better.
Well, you know, it's tough being a friend and a boss at the same time.
Yeah.
Speaking of which, what are your plans? Are you going back to Syria any time soon? Yeah, I walked into that one.
Yeah, you kind of did.
I'm leaning that way.
So, you're leaning that way.
It's not 100 percent? There's something I wanted to talk to you about.
Can I walk you out? Bella: Don't worry about it.
So, I don't want to be a pawn in the Cummings family dysfunction.
Don't be so dramatic.
He'll get over it.
Look, Bella.
It's been 10 days.
And don't get me wrong, it's been fun as hell, but you go back to Philly in a week.
I live with Paul.
He's been there for me when I lost my gym, my grandma.
You know, he's like the brother I never had.
I know.
I just [Breathes deeply.]
Let's both talk to him, straighten it all out? Thank you.
In the meantime, want to go back to my hotel, maybe work on some ideas? Oh, ideas, huh? Mm-hmm.
I've got a few.
Can I order room service? I'm hungry as hell.
You can order anything you want.
Ooh, okay.
Hey.
Don't be pissed at Kenny.
Your sister is really cool.
I'm not pissed at him.
I'm pissed at her.
She's gonna hurt Kenny.
No matter what she says, no matter how much they think they're just having fun, she will end up hurting him.
Anyways, I heard you had a hell of a night.
Whoa.
Wait.
You all right? - Hey.
- [Sobs.]
Hey, okay.
Oh.
Okay.
Hey, come come on.
Let's step in here, okay? [Door opens.]
[Elevator bell dings, doors open.]
Hands and hearts Hey.
Hey.
Hey, man, you did it.
You never gave up.
I'm gonna bring Grace to your room as soon as she gets here, okay? Okay.
Planting a dream - Hey.
- Hey.
How are you? I'm good.
I'm all right.
And Ford? Uh, it's gonna be a long road, but he's gonna be okay.
Could have been you lying there.
Yeah, well, if it ever is, I sure as hell hope T.
C.
gets me to first.
Doctor, standing right here, right in front of you.
- Pretty good, right? - Yeah, I-I know, I know.
But honestly, I-I wouldn't want you there.
I mean, you're brave, you're smart, you're a great doctor, but you're not reckless.
T.
C.
was, like he thought he was bulletproof.
He didn't even hesitate out there.
Yeah, that's Yep.
That's your boy.
I swear he's part cat always lands on his feet, and he's used up most of his nine lives.
Which is why I feel so lucky to have you in my life.
You know what's important me, Brianna, your mother, I guess, because it doesn't look like she's leaving any time soon.
Yeah, no, she looks pretty settled, uh, which brings me to something I wanted to Yeah.
Me, too.
Things have been going so great with Brianna, I thought well, I thought maybe we add a baby to the mix.
I'm sorry.
I didn't mean to drop a bomb on you like that.
I I'm just really enjoying having a family.
So am I.
But it's gonna have to wait.
I'm going to Ranger school.
Ranger school? Next month.
There's an open spot.
I'm gonna tell them I'm coming.
Uh, it doesn't really work like that, Drew.
You've got to apply, get accepted.
I was, last month.
And I'm taking it.
And you're just telling me this now? Yeah.
"Yeah"? That's all you have to say about that? Ford would have died on that table without you, and that kid would have died in the elevator without Drew.
And the one thing the two of you have in common is that you're both battle-tested.
So are you, Jordan.
Yeah, look.
[Sighs.]
I've paid my dues, sure, but you guys have this this extra, under-fire experience - that most doctors don't have.
- [Sighs.]
You're bad-ass, veteran doctors.
Jordan, what are you talking about? What if SAM became a combat medical training center, and not just for the military, but for first responders, as well, with you and Syd and Drew as the instructors? You guys have seen and done pretty much everything.
Yeah, I mean, it certainly would have helped - if Rick knew how to place a tube.
- Exactly.
Now, what would you have given to have the knowledge that you have today back when you were first deployed? Everything.
Maybe then, Thad would still be alive.
This hospital was financially unstable before paying the ransom, and now it's in dire straits unless, of course, they can get the DOD to pay for it.
We can train the battlefield doctors of tomorrow and save this hospital, but we can't do it without you.
You're the centerpiece.
Everybody knows you.
[Sighs.]
I don't know, Jordan.
Think about it.
You can always go back to Syria.
- [Cellphone ringing.]
- Yeah, we do good things over in Syria.
- You do.
You do great work.
- Yeah.
If that's what you want.
I got to take this.
- Sure.
- Okay.
I'll talk to you tomorrow, okay? - [Cellphone beeps.]
- Hey.
Ev Everything okay? Brilliant, in fact.
We are so close to getting funding for our medical center in Syria, and I'm leaving him.
You're leaving him? My husband.
We've both been leading separate lives.
Come join me, T.
C.
.
I want to be with you.
And I love our home T.
C.
, you still there? T.
C.
? And I love our home
Rick: Hey, we miss you on the raids.
Thought you were never coming back from Syria.
I had to come back here and tie up a few things, but I'm gonna go back in a couple weeks.
Oh, man, I'm never going back there.
Iraq was enough for me.
All right, we're almost there.
Hey, T.
C.
, do the honors? Of course.
Ford, call it.
Oh.
Uh, heads.
[Brakes screech lightly.]
Sorry, man.
Looks like you're first in the breach.
All right, everybody, it's go time.
[Guns cocking.]
Kenny: Wait, you haven't told Rick you applied to Ranger school? You'll be gone like three to six months.
No, because I'm not even sure I want to go.
You've wanted to go since you were 18.
Look.
Everybody in the Army wants a Ranger tab, so you either got your tab, or you got a story.
And right now, my story is I'm not a Ranger because I'm a doctor.
- Pretty good story.
- Yeah.
Truth is, if I go and fail, I'm not sure I could live with that.
When do you have to decide by? Next week.
Jordan says it's cool.
She'll have Cain cover as chief resident for me when I'm gone.
But, anyway, I got a patient up for a CT.
Meet me there in 10.
Paul: Yeah, but weren't you supposed to be in Denver with Scott - for the board meeting? - Bella: Change of plans.
He asked me to stay, keep an extra surgeon on hand, and I don't mind.
I like being here, anyway.
What's up, Cummings Medical Group? Same old, same old.
Hey, Paul, would you mind, uh, signing - some of these patient release forms? - Yeah, not at all.
- [P.
A.
system beeps.]
- Okay.
Woman: Portable X-ray to E.
R.
Portable X-Ray to E.
R.
[Clears throat.]
Vanderpool.
Vanderpool.
Isn't that where you're staying, B? - See, I dropped her off last week.
- Must have dropped it.
Uh Oh, my God.
Oh, my God, you t you are you two are - No.
- Yes.
It's I'm sorry to rip off the Band-Aid this way, - but now that you know - [Exhales sharply.]
Look, I was gonna tell you, man.
Yeah? You were gonna tell me.
So So last week, you weren't crashing with Drew.
You were crashing with my sister.
Bella: [Scoffs.]
Oh, we are grown-ass adults.
We can do whatever we want to do.
- [Pen clatters.]
- Oh, don't even t-talk to me.
So you're saying all staff and resident evaluations? I mean, why? Who would leak that kind of stuff? Scott: Not sure.
Maybe a disgruntled patient or employee.
Okay, so it's Cummings Medical Group wide? Yeah.
It's started causing chaos here in Denver, so get ready.
You might have some angry staffers on your hands.
Jordan! Yeah, I'm sensing that.
I'll call you back.
- [Cellphone beeps.]
- "Dr.
Rivera lacks focus and drive.
Projects personal issues onto patients.
Makes inappropriate and judgmental comments.
" Shannon, I-I was gonna "She may continue her residency program under close supervision.
" - [Wailing siren approaches.]
- Really, Jordan? I was going to schedule a meeting with you so that we could discuss this.
Oh, yeah? What were you waiting for? Fit me in between banging sessions with Cain? Hey.
Right there that's what I'm talking about.
Those are the kind of comments that get you in trouble.
Jordan, I need a room.
I got an active GI bleeder on blood thinners.
Jordan: Let's get her to Trauma 4.
I'll be right there.
I know this patient.
It's Joan Fraley.
I treated her when she got her pacemaker and stent put in.
- That was Cain's patient, right? - Yeah, I'm jumping in on this.
That is, if it's okay with you.
[Sighs.]
BP's 100 over 50.
Pulse is 85.
She had multiple episodes of bloody emesis.
I put in an IV and gave her four of Zofran.
Okay.
Thanks, Sara.
We got it from here.
Uh, send a transfusion panel, and start a Protonix drip.
Ms.
Fraley, I'm Dr.
Rivera.
- I treated you before.
- Oh, no.
Not you.
Where's Cain? Sorry, but he's not here this week.
Uh, but my name is Dr.
Alexander.
I'm the supervising attending.
I hope you call the shots 'cause little miss purple hair here nearly killed me last time.
I don't trust her.
Yeah.
You're not the only one.
I can assure you that Dr.
Rivera is an outstanding doctor, and she is going to give you excellent care.
Just keep an eye on her.
Don't worry.
She is.
Let me know if you need anything.
It's gonna be fine.
[Sighs.]
[Dog barking.]
[Insects chirping.]
Breacher ready.
[Groans.]
Ford! [Officers shouting indistinctly.]
[Bullet ricochets.]
Man: Take cover! Coming in! Watch out! Watch out! Multiple officers down.
I need a helicopter medevac now.
Now! [Monitor beeping rapidly.]
- Kenny, what's going on? - It's the pacer.
It's going faster and faster.
I can't stop it.
- [Paddles whine.]
- Looks like he's about to [Thump.]
[Monitor beeping rapidly.]
All right.
It put him in v-fib! [Blow lands.]
- [Beeping slows.]
- He's got a pulse.
Back in sinus.
Thanks, man.
Yeah.
What the hell happened, Kenny? I don't know.
You saw it.
The machine defibrillated on its own.
Almost shocked me, too.
You're saying it made up its own mind? It's a computer, Kenny.
It doesn't work like that.
Yeah.
That's what I'm saying.
Wait.
What are you saying? I'm saying maybe you should pay attention to your job a little bit more, yeah? [Drawer closes.]
Okay, I don't appreciate what you're insinuating, so I don't appreciate having to save your patients.
Look.
I know you're mad about me and Bella.
No, it's not even about that, man.
How about you just focus on what's most important? [Door opens.]
Shannon: Jordan! What's going on? She was fine one minute, then her blood pressure dropped.
- Is still vomiting blood? - Not since she was medicated.
She's burning up, though.
My back's killing me.
- How's her hemoglobin? - Initially, 7.
The first unit's in.
What?! She was given the wrong blood type! Ow! What are you doing? It says here she's A positive.
No.
She's an O negative.
I remember from before when Cain saved her.
Hypotension, fever, back pain.
She's having a transfusion reaction.
You're right.
There's blood in her urine.
Okay, Jocelyn, IV, normal solution.
Run an LDH and a Coombs panel.
You are the worst doctor I've ever had.
I'm suing all of you.
Mrs.
Fraley, I am so sorry, and I promise I will do everything to make this right, and I will personally investigate this myself.
I did not give her the wrong blood type.
Her records were messed up somehow.
- [Alarms blaring, monitors beeping.]
- You have to believe me, Jordan.
What the All right.
I'll be right back.
- [Blaring, beeping continues.]
- [Telephone ringing.]
Ray, what is going on? It went haywire.
I-I can't make it stop.
Jordan, the Pyxis is freaking out.
The drawers won't stay closed.
Okay, call security.
Have them guard the narcotics.
[Mouse clicking.]
[P.
A.
system feedback screeches.]
- [Evil laughter.]
- Jordan: We have a bigger problem.
The whole hospital's being hacked.
[Evil, distorted laughter.]
[Monitor beeps.]
[Paddles whine.]
[Receiver clacks.]
Jordan, Paul says the CT computers are down, too.
All samples have to be hand-carried to the lab.
Okay.
All right, everybody, listen up.
We've now switched over to our emergency protocol.
Also, very important All of the blood in our bank has been mislabeled.
The Red Cross is sending over O-negative.
Please use it sparingly.
Okay.
Go.
Take care of your patients.
- Thank you.
- Yeah.
What do we have? The Cummings Medical Group has been hacked for a $10 million Bitcoin ransom.
My father called Homeland Security, and they're sending an IT staff to reset our system.
Okay.
Ray? Tell EMS that we're closed due to internal disaster.
No more ambulance traffic.
My father says we're not closing.
- That's caving to terrorists.
- Shannon: You're kidding.
We don't have any blood or diagnostic equipment.
We'll be back online soon.
Yeah, that's not good enough.
All right.
Um, Paul.
I want you to call Presbyterian's ER and see if they can take on any more patients.
I'm gonna go thin out the waiting room.
All non-critical care should go.
- Jordan.
- I don't give a rat's ass about your dad's perception problem.
Neither do I, but this is his hospital.
And this is my ER until they tell me otherwise.
Ray, make the call.
[Indistinct chatter.]
[Telephone rings.]
Paul: Yep.
Thank you, guys.
We'll take all the help we can get.
All right.
[Receiver clacks.]
She's right, but dad's not gonna like it.
Yeah, there's a lot of things Dad's not gonna like.
What's taking so long? When can I get out of this lame-ass ER? Diego, watch your mouth.
- Sorry about that, ma'am.
- Yeah.
- [Curtain opens.]
- Drew: All right, Diego.
We got good news.
Wrist is just sprained.
No fractures, no broken bones.
What about his head, Doc? He took quite a spill at the skate park.
We're on that.
He's next in line for a head CT.
- Have you reached his mom yet? - Not yet.
She must be on the plane.
She's on her way to Cabo for her bachelorette party, so Diego and I get a guy's weekend.
That's what you think this is? M-Molly, will you show Andy where the waiting room is? I'll get Kenny to take Diego to CT.
Yes, Doctor.
I'll try Sharon again.
Be right back, buddy.
Can't wait.
Stepdad seems like a good guy.
Why not be a little nicer to him? He's not my stepdad, okay? He's just Andy.
[Indistinct shouting.]
Rick: T.
C.
, Ford was hit.
- He can't breathe.
- [Gasping weakly.]
- [Gunshot.]
- I'm under fire.
I can't get to you.
I'm gonna throw you an LMA.
[Bullet ricochets.]
[Gunfire.]
[Indistinct shouting.]
999.
Officer down.
Doc needs immediate escort to my 20.
[Gun cocks.]
There's blood spraying out of his neck, T.
C.
.
He's not getting any air.
All right.
I need you to cover me, okay? I got a critical over there.
This guy's stable for backup.
T.
C.
, it's not working! He's dying! Okay, Rick, I need you to get a 7-0 tube ready.
I'm on my way now, okay? Coming straight to you.
[Bullets ricocheting.]
Okay.
[Gunfire continues.]
T.
C.
: Okay, the blast transected his airway.
Man: Move! Move! I've located his trachea.
Hand me a tube.
[Helicopter blades whirring.]
Is he gonna make it? I don't know.
Depends how fast we get out of here.
[Indistinct shouting.]
Chopper's here.
Where's my damn escort? Hand me trauma shears.
The way you put that tube in, I never could have done that.
Sure, you could, man.
It's just battlefield medicine.
You're a Ranger.
Yeah, they never taught us that or the SWAT training, either.
It looks like a bullet hole.
I think it just entered his chest right below the vest.
We got to get him out of here ASAP.
He's gonna bleed out.
[Vehicle approaches.]
[Bullets thudding.]
Let's go.
On three.
- Be careful with his airway, yeah? - All right.
One, two, three.
- Go! - Go.
He started seizing in the CT tube.
Luckily, we got the scan before the system went down, but he's got blood building between his brain and his skull.
So what do you do? Well, we gave him Valium to stop the seizure, and we started him on a new drug, Dilantin, to prevent any more seizures from happening during surgery.
Have you got his mom on the phone? Her plane hasn't landed yet.
Is he gonna be okay? Sharon's gonna want to know.
The earlier we can evacuate the blood, the better.
Good thing you brought him in so quickly.
[Button clicks.]
[Indistinct chatter.]
I've stuck her a dozen times.
I cannot find a vein.
- Yeah, no worries.
I'll put in an EJ.
- What's that? It's an IV in your jugular vein.
My neck? Not her.
You do it.
Only doctors can do it.
It's hospital policy.
I know we got off to a bad start last time.
I'd been working 20 hours straight.
I'm sorry.
It's just a small poke.
Maybe this job's not for you.
How's it going in here? Everything's okay.
I've got this.
- [Electricity powers down.]
- Joan: Oh! [Gasps.]
Jordan: Okay, Mrs.
Fraley, don't panic, all right? - [Flashlight clicks.]
- Uh, everything is under control.
Shannon: Where are the back-up lights? They'll be on in a second.
Don't worry.
Bella: Jordan, maintenance says the back-up gennies aren't kicking in, and they don't know why.
I'll call the fire department for generators, and the IT guy's on the way.
- Okay.
Thank you, Bella.
- I don't feel well.
Something's dripping down my neck.
She's bleeding from her IV site.
It's DIC.
The incompatible blood type has caused her blood cells to rupture.
Her blood can't clot.
Okay, call the Red Cross, ask for universal donor A2 platelets and AB plasma.
Shannon: Jordan! Ms.
Fraley? - Ms.
Fraley.
- She's unconscious.
She has an insulin pump.
Check her blood sugar.
Blood sugar's 28.
Give her an amp of D50.
- Her pump has been hacked, too.
- What the hell? All right, switch her IV fluids to D5NS.
She just got a massive dose of insulin.
Okay.
All right.
That's a good sign.
She's in your hands now.
If anything changes, you tell me.
Yeah.
[Breathing shakily.]
- [Elevator alarm ringing.]
- Drew: Diego.
Diego! Emergency phone's dead.
He's unresponsive.
His pupils are unequal.
His brain's herniating.
What do you want to do? I'm gonna hyperventilate him to lower his intracranial pressure.
Hypertonic will help, too.
Got it.
And if we don't get him out? Cross that bridge when I come to it.
Got him.
[Siren wails.]
Paul: I got a text from Drew.
They're stuck on the elevator.
Kenny's there to help, but Drew says the kid's in bad shape.
All right.
Get them whatever they need.
I want you to call Milorad in Maintenance.
He should have an idea of what to do.
Jocelyn.
I want you double and triple-checking all of the patients' conditions.
- We are not gonna lose anyone tonight.
- Okay.
Bella, talk to me.
This is Pat Perillo, head of our IT Security.
He's working on the problem.
Right.
What are we dealing with? Pat: Well, I figured out how they got into the system.
One of your nurses downloaded a counterfeit copy of Candy Crush from a Romanian website.
They used a screen scraper, stole her passwords.
They can do that? All right, how long until we get the power back on? A while, okay? I'm shutting down the servers, but our backup, also corrupted.
They tricked the backups into thinking everything is normal.
That's why they haven't kicked in.
Level with me.
How bad is this? Think worst-case scenario, then multiply that by a thousand.
- They said you're in charge here? - Yes, sir.
I will be with you in just one moment.
My fiancé's son.
I took the stairs to the O.
R.
to look for him.
He wasn't there.
His name is Diego.
Now, tell me what the hell's going on here.
[Sighs.]
Sir, I am so sorry, but Don't be sorry! Just tell me where my kid is.
We're stuck between the sixth and the seventh floor.
If I pull the emergency brake, we free fall.
They'd wash us out of here with a hose.
Put it like that, I'm good.
Yeah.
You're not the one I'm worried about, though.
Paul: Hey, you guys okay? Paul! Great.
You get everything in my text? Uh, yeah, yeah.
I have mag lights, duct tape, and a portable vent.
All right, send it down.
Is he down there? Diego! Sir, this is an emergency.
Hospital employees only, okay? That's my boy down there.
I'm not going anywhere.
I am never gonna leave his sight again.
Diego?! Kenny: Bella, get us out of here now.
I'm trying, Kenny.
The hack shut down all of our back-up systems.
We can't override the control panel.
Try harder, or this kid is gonna die in this elevator.
Hey.
Any progress? [Scoffs.]
Yeah, I fixed the whole thing.
I just forgot to tell you.
Pat, I will slap that attitude of yours back into next week if you talk to her like that again.
Uh, sorry.
What? Just get back to work.
Our blood supply is getting low, but we're slowly catching up on all the patients.
Good because I don't think we could take on even one more.
[Keyboard clacking.]
I found the bullet hole.
No exit wound.
Wait.
The bullet's still inside? Look, I will find it, Rick, okay? We'll be at SAM in no time.
Different coin flip, this would have been me.
No.
Actually, it wouldn't.
What are you talking about? Look, I already lost too many brothers, all right? Topher, Thad, Mac.
I'm not gonna lose any more.
You rigged the toss? That's not your call, T.
C.
.
You and Drew are parents, all right? I've seen what happens to Janet and the kids after they lost Topher, okay? I'm not gonna let that happen again.
Ford's wife is expecting.
A son.
Drew and I are his godparents.
I didn't know that.
I'm sorry.
Can you attach that to the pleurevac? - Mm-hmm.
- Thank you.
Man: It's attached.
Releasing the clamp.
There's a lot of blood.
- [Helicopter rattles.]
- Yeah.
Hey, what's going on? Are we turning around? San Antonio's E.
R.
is closed, so is Pres.
We're being diverted to HMH.
No, no, no, no, no, no.
Ford needs a thoracotomy now.
We won't make it that far.
Look, I can give an autotransfusion just to replace the blood that he's lost, but that's only temporary.
Won't last long, okay? Look, if he crashes, I don't know if we'll be able to save him.
We don't have enough time.
Override the diversion on my authority! We're going to SAM! Great.
It's your badge, Rick.
[Groans.]
What's going on? The hospital was hacked.
You were unconscious from low blood sugar.
How long have you been on an insulin pump? Since my last hospitalization.
I should have told you.
I wasn't thinking clearly.
Yeah, well, mixing booze and blood thinners will do that to you.
I smelled your breath, ran an alcohol level.
[Monitor beeping steadily.]
I know I'm not the best communicator, but I am one hell of a doctor.
I want to do everything I can to make this right.
You can't.
Well, let me try.
What's been going on? I was sober for 20 years.
Been out of a job for a month.
A lawsuit shut down the amusement park.
I was already living paycheck to paycheck, and now, I got nothing.
Money's tight, and then the medical bills start coming in from my surgery, and So you started drinking again.
Tonight? I had a few beers.
Mm.
By a few, you mean? [Voice breaking.]
Eight or nine.
I don't feel very good.
I think I'm gonna - [Vomits.]
- Oh.
Hey, I need some help in here.
Molly, get her a Zofran.
Jocelyn, did you get the Protonix? Yes, but I think we should transfer her.
I'll get Dr.
Alexander.
No, she's too unstable.
She has massive hematemesis and needs a nasogastric lavage and an EGD.
How? They took power to Trauma 1.
No electricity, no suction.
There is an ambulance.
Grab some ketamine, and I'll meet you there.
Okay.
All right, paramedic transfers for the levels two and threes, taxis for the less urgent.
Hey, hey, hey, check this out.
This dude is a god.
I mean, he or she.
Don't get all Ellen Jamieson on me.
T-They've been hiding in our system for months, just encrypting data.
They They hijacked our Bluetooth gear, our our drug pumps, defibrillators, CT scanners, everything.
I mean, this crypto-ransomware is sick.
What's sick is holding critically ill patients hostage.
This isn't a game, Pat.
You see all of these people? Their lives are in your hands.
How's that? I mean, I'm not a doctor.
Now you know how it feels.
- [Cellphone buzzes.]
- Now get us back online.
- [Cellphone beeps.]
- Hey.
Did he pay it? Not yet.
He has to.
$10 million is a lot cheaper than 10 wrongful death lawsuits.
They're asking $10 million for each hospital Chicago, Denver, Baltimore, Portland, us.
It's 3:00 a.
m.
He doesn't have $50 million lying around the house.
So this is gonna get a lot worse before it gets better, huh? Yeah.
I gotta run.
I got pulled into surgery here.
Long night, Jordan.
Hang in there.
Hey.
What the hell happened? Cummings Medical Group was hacked.
Why are you here? We closed the ER.
Yeah, we know.
So was Pres.
This is my partner, Ford.
Yeah, he took a booby trap to the neck and a bullet to the chest.
He's unstable.
He needs an OR now.
How much longer before the power's back on? I don't know.
We've been like this for hours.
Tee, our blood bank was hacked, too, and we have gone through all of the O negative that the Red Cross has sent us.
- We're waiting for more now.
- What can we do? He can't make another chopper trip.
No.
Okay, so we got no blood, no O.
R.
, no electricity.
[Breathes deeply, exhales forcefully.]
Okay, we're gonna do field medicine in the ER.
Okay, Rick, I need you to get the ambulance lights to shine onto Trauma 1.
Okay, I need you to route the power for the genny so we can have a suction and a vent.
Ray, get all the metal carts and all the metal trays into Trauma 1 right now.
Jordan, find Paul.
I need help with a thoracotomy now.
He's assisting Drew with a surgery in an elevator.
I'll be in when I can, but right now, it's all on you.
Okay.
Let there be light.
Paul: All right, it's coming down, guys.
[Bucket thuds.]
- I got you.
- Decorticate posturing.
The herniation's worsening.
Intracranial pressure's rising.
You gotta be kidding me.
Milorad says the drill's powerful.
The bits are brand-new, still in package.
Yeah, and you've got enough chloraprep to sterilize everything, okay? I got a maintenance man for a scrub nurse.
This is insane.
It'll work.
All right, I sent you a bulb suction tray kit from peds ICU.
You've got a scalpel, retractors, everything you require.
- Anything else? - Yeah, maybe a prayer.
[Drill whirs.]
NG's removed.
Blood is cleared out.
Okay.
Time to fix the bleeder.
[Siren wailing in distance.]
Okay.
Okay, advancing.
Entering the esophagus.
There's the source of the bleeding.
It's a Mallory Weiss tear.
All her vomiting ripped the lining between her stomach and esophagus.
- [Monitor beeping.]
- She's bleeding again.
- [Door opens.]
- Shannon, hey.
What's going on? What's it look like? I'm applying hemoclips.
What she said.
That was a nasty tear.
How did you get all of this equipment? I ran up to the GI lab and got it.
And where did you learn how to do this? Spent the summer volunteering at a gastro clinic on the reservation.
We treated a lot of bleeds.
Your technique is solid.
You just saved this woman's life.
Good job.
Yep.
And all unsupervised.
Kenny: Kid's gonna love his new hair do.
Yeah.
Let's hope he gets a chance.
Chloraprep.
Scalpel.
Scalpel.
What's his end tidal? Steady at 35.
And a little blood.
I got you.
Hold pressure.
All right.
We're good.
We know what comes next.
[Monitor beeping steadily.]
Here we go.
- All right.
- Slow and steady.
Oh! Son of a bitch, that was close.
You're telling me.
What happened? He's progressing to decerebrate posturing.
- Kenny, we don't have a lot of time.
- Wait, wait, wait.
If he keeps posturing, we could give him brain damage.
Then let's give him another dose of paralytics so I can do this.
Drew, we're out.
What now? [Monitor beeping rapidly.]
[Sighs.]
Hey, Julian.
You called for me? Yeah, they were short-handed.
I stepped in and started this triple A, but the portable genny is worthless.
Here.
Let me let me see.
There's not enough juice to power the C-arm.
It's damn near possible not to jail the gate with fluoroscopy.
But come this far.
Maybe we can finish by palpation here.
Yeah, the graft probably deployed too low.
Really? I thought I had it.
Well truth is, I'm not feeling too great.
I've been sick all week.
Yeah, there's some nasty stuff going around.
You know what? I got this.
Why don't you go take a break? It's been a long night.
Julian, go on.
Dr.
Scott Clemmens, San Antonio Memorial.
Ellen Jones.
First-year surgical resident.
Nice to meet you, Ellen.
Man: Pressure's dropping, Doctor.
Okay, buckle up.
We're flying blind.
Graft's not working.
He must have a large endoleak.
I'm converting to an open repair.
You're opening him up? I don't have a choice.
Prep the abdomen.
But when you open him up, won't he bleed out? Our blood bank's still a disaster.
I have done a thousand open triple A's in my career, and lucky for the good reverend, here, I am good, and I am fast.
[Monitor beeping rapidly.]
Okay, look.
The only outcome I can guarantee is if I don't open him right now, he's going to die.
I know I'm not part of your regular team, but right now, this is my O.
R.
, which means you work for me, so get your heads in the game, and let's go.
Scalpel.
Yes, Doctor.
[Sighs.]
Did you find the bullet? No, not yet, and he's bleeding out faster than I can put blood back in.
- How can I help? - Okay, grab a vena cava clamp.
All right, the bullet tore through the lateral wall of the IVC.
Pledgets and 5-0 silk.
Thank you.
You find the bullet, I'll suture the wound.
Gotcha.
Okay, rest of the chest looks clear.
There's still no bullet, and there's no exit wound.
Maybe the bullet embolized to the heart.
Wait.
You're opening his heart? No.
No.
One step at a time.
Please tell me you have a plan.
We don't have enough blood.
You can't go hunting.
Yeah.
Of course I do.
Um Ray! Go find Rob.
Tell him we need his metal detector right now.
- That's one way to do it.
- Yeah.
Right.
Where is it? Where is it? I'm done.
- Removing the clamp.
- Okay, give it to Rick.
Rick, I need you to scan his belly, search for the metal.
Repair holding steady.
I can't I c-can't find any metal.
Where is it? [Monitor beeping rapidly.]
Pushing valium.
- Pressure's dropping.
- Okay.
Oh, no.
Guys, please do something.
[Monitor beeping rapidly.]
- We got this.
We got this.
- Pushing dose epi.
He's lost pulses.
He's in torsades.
Push mag.
Woman: Yes, Doctor.
Pushing mags.
We've got to do a clamshell.
T.
C.
, is this it? No.
No, no, no, no.
We're gonna do everything we can.
[Beeping continues.]
[Drill whirring.]
I just can't do it.
If he keeps moving like this, I'm gonna drill right through his brain.
Do we have time for Paul to bring more paralytics? No.
He's got high blood pressure, bradycardia.
Cushing's reflex.
This kid's gonna die any second.
He's not.
I got him, Drew.
Do it.
Just do it.
All right.
Here we go.
[Drill whirring.]
Penetrating the inner table.
There's the give.
I'm in.
[Suction gurgles.]
There we go.
[Beeping slows.]
Heart rate's coming up.
Blood pressure's normalizing.
Ah.
He's not posturing anymore, either.
You did it, man.
Paul! The kid's gonna make it.
Tell neurosurg to get ready.
Will do.
[Sighs.]
Drew: This kid is never gonna know how lucky he was today.
It wasn't luck, and, yeah, he is gonna know 'cause I'm gonna tell him.
You did it, man.
You saved his life.
Nah.
We did it.
I wasn't alone in this.
- [Chuckles lightly.]
- [Breathing heavily.]
- [Paddles whine.]
- Jordan: Charging to 10 joules.
- [Thump.]
- Shock delivered.
Jordan, I can't find the bullet.
I'm out of ideas.
What if the bullet's not made of metal? Give me some loops.
What are you doing? Trusting my gut.
How much blood was autotransfused? A lot.
Why? Well, we know that a projectile from the blast perforated his IVC, but we don't know where it traveled.
With magnification, I can just make out a small tear in his diaphragm and traumatic pancreatitis.
That combined with the citrate from the auto transfusion dropped his calcium levels.
That's what caused the seizures and the cardiac activity was hypocalcemia.
I don't speak doctor.
Could you translate? Whoa.
What is that? This piece of wood is your bullet.
It's part of the stairs.
It must have blown off after the explosion.
Oh.
We got cardiac activity.
Sorry, I had to be on call for Drew.
He was a total boss.
What's going on here? Jordan and T.
C.
just saved my partner's life.
You guys make a hell of a team.
- Yeah.
- Yeah, we do.
All right, guys.
We're not done here.
There must be at least a dozen splinters.
All right.
It looks like I arrived right on time.
Yes, you did.
[Knock on door.]
Oh.
[Clears throat.]
[Sighs.]
So, um, how's the pastor? I had to open him up, but he's stable.
I think the worst is over for tonight.
Yeah.
Hmm.
I'm glad you were here, Scott.
I-I don't know what happened in there.
You're human.
Sorry to break it to you.
[Chuckles lightly.]
All the stress you've been under, you're lucky it wasn't something worse.
Yeah.
Back-up generator's working? Uh, no.
I, um I paid the ransom.
$50 million? Yeah.
I thought you said you didn't have it.
How'd you swing that? I, um, called some people I shouldn't have called.
There's all these vultures out there who'll loan you whatever you need as long as you're willing to sacrifice your pound of flesh.
Oh.
That had to be very hard, but you saved a lot of lives by doing it.
And yet, we'll lose more in the long run.
Meaning? The, um, loans I agreed to? I'll never have the cash flow to pay 'em back.
I'll lose everything.
No.
You spent more than a decade fighting to provide health care to underserved communities.
You're not just gonna watch that crumble.
Can't you just call banks now in the light of day? The, um, Cummings Medical Group is a financial house of cards.
We're over-extended.
It got a lot worse when I bought SAM.
Well, then, why did you? Because Paul wanted me to save his hospital.
And you wanted to be his hero.
I don't feel much like a hero right now.
[Sighs.]
Do Bella and Paul know? Oh, God, no.
My kids think I'm some self-made genius, the great and powerful Oz.
Now they're gonna see behind the curtain.
There's nothing you can do? Maybe sell off a hospital or two.
- I'm - Including SAM? I don't know.
I'd appreciate it, Scott, if you just kept this between you and me for now.
I can handle losing my empire, but, um, I don't know if I could handle losing the trust and respect of my children at the same time.
Of course.
[Sighs.]
You know, Julian, I've hit rock bottom in my own life, disappointed all the people who needed me most.
And if you're not a damn fool, you learn what matters and what doesn't.
And sometimes sometimes you get to start all over from scratch.
You learn that in rehab? [Chuckles.]
[Chuckles lightly.]
No.
I learned that from my father.
There are lots of other things besides hospitals that you could hand down to your children.
Let me know if I can do anything for you.
Thanks.
Scott? You already have.
[Door closes.]
That was like a weird dream.
More like a nightmare.
How are you feeling, Ms.
Fraley? Like somebody kicked me in the throat.
Well, you're not rid of me yet.
We have some things we need to talk about before you're admitted.
I know.
Thanks for being my doctor tonight.
- You saved my life.
- Just doing my job.
When Dr.
Diaz gets back Yeah? I'm gonna tell him I want you.
[Chuckles.]
[Electricity whirs.]
[Sighs.]
[Indistinct chatter.]
I think I'll be taking the stairs for a while.
[Chuckles.]
I hear that.
But for the record Okay, look.
Those dudes may be faster and stronger in Ranger School Younger.
Don't forget younger.
Okay, Drew, listen to me, okay? None can do what I just saw back there.
I'm not just talking about the surgery, but the way you helped Andy.
You get people, man.
A real leader has that.
Thanks.
So Paul's sister You got her on speed dial? You caught that, huh? Yeah, you like living on the edge.
Yeah, Paul's not too happy about it.
Well, can you blame him? That's his sister.
It's a pretty big secret to be holding back.
You probably should have told him.
Hmm.
So, I'm supposed to tell Paul about his sister, but you don't have to tell Rick about Ranger school.
Isn't that the pot calling the kettle black? It was a hell of a night, huh? - [Staff murmurs in agreement.]
- Seriously, though, you guys, all of you, you went above and beyond, so I just want to say thank you, all right? You were great.
Rest up.
This place is going to be open for business when you get back here tonight, okay? [Indistinct chatter.]
All right.
Thank you.
Hey, Shannon.
I, uh, really want to put this behind us, okay? Part of my job is to give honest feedback.
I understand.
Now can I give you some honest feedback? I know.
All right? I understand as program director, I should have discussed your evaluation with you sooner.
No, as my friend.
Maybe try helping me fix my flaws instead of poisoning my permanent record.
Scott and I are the only ones who see those.
Correction everybody here has seen those.
[Telephone rings.]
Heavy is the head.
Yeah.
Well, she's right.
I could have handled that better.
Well, you know, it's tough being a friend and a boss at the same time.
Yeah.
Speaking of which, what are your plans? Are you going back to Syria any time soon? Yeah, I walked into that one.
Yeah, you kind of did.
I'm leaning that way.
So, you're leaning that way.
It's not 100 percent? There's something I wanted to talk to you about.
Can I walk you out? Bella: Don't worry about it.
So, I don't want to be a pawn in the Cummings family dysfunction.
Don't be so dramatic.
He'll get over it.
Look, Bella.
It's been 10 days.
And don't get me wrong, it's been fun as hell, but you go back to Philly in a week.
I live with Paul.
He's been there for me when I lost my gym, my grandma.
You know, he's like the brother I never had.
I know.
I just [Breathes deeply.]
Let's both talk to him, straighten it all out? Thank you.
In the meantime, want to go back to my hotel, maybe work on some ideas? Oh, ideas, huh? Mm-hmm.
I've got a few.
Can I order room service? I'm hungry as hell.
You can order anything you want.
Ooh, okay.
Hey.
Don't be pissed at Kenny.
Your sister is really cool.
I'm not pissed at him.
I'm pissed at her.
She's gonna hurt Kenny.
No matter what she says, no matter how much they think they're just having fun, she will end up hurting him.
Anyways, I heard you had a hell of a night.
Whoa.
Wait.
You all right? - Hey.
- [Sobs.]
Hey, okay.
Oh.
Okay.
Hey, come come on.
Let's step in here, okay? [Door opens.]
[Elevator bell dings, doors open.]
Hands and hearts Hey.
Hey.
Hey, man, you did it.
You never gave up.
I'm gonna bring Grace to your room as soon as she gets here, okay? Okay.
Planting a dream - Hey.
- Hey.
How are you? I'm good.
I'm all right.
And Ford? Uh, it's gonna be a long road, but he's gonna be okay.
Could have been you lying there.
Yeah, well, if it ever is, I sure as hell hope T.
C.
gets me to first.
Doctor, standing right here, right in front of you.
- Pretty good, right? - Yeah, I-I know, I know.
But honestly, I-I wouldn't want you there.
I mean, you're brave, you're smart, you're a great doctor, but you're not reckless.
T.
C.
was, like he thought he was bulletproof.
He didn't even hesitate out there.
Yeah, that's Yep.
That's your boy.
I swear he's part cat always lands on his feet, and he's used up most of his nine lives.
Which is why I feel so lucky to have you in my life.
You know what's important me, Brianna, your mother, I guess, because it doesn't look like she's leaving any time soon.
Yeah, no, she looks pretty settled, uh, which brings me to something I wanted to Yeah.
Me, too.
Things have been going so great with Brianna, I thought well, I thought maybe we add a baby to the mix.
I'm sorry.
I didn't mean to drop a bomb on you like that.
I I'm just really enjoying having a family.
So am I.
But it's gonna have to wait.
I'm going to Ranger school.
Ranger school? Next month.
There's an open spot.
I'm gonna tell them I'm coming.
Uh, it doesn't really work like that, Drew.
You've got to apply, get accepted.
I was, last month.
And I'm taking it.
And you're just telling me this now? Yeah.
"Yeah"? That's all you have to say about that? Ford would have died on that table without you, and that kid would have died in the elevator without Drew.
And the one thing the two of you have in common is that you're both battle-tested.
So are you, Jordan.
Yeah, look.
[Sighs.]
I've paid my dues, sure, but you guys have this this extra, under-fire experience - that most doctors don't have.
- [Sighs.]
You're bad-ass, veteran doctors.
Jordan, what are you talking about? What if SAM became a combat medical training center, and not just for the military, but for first responders, as well, with you and Syd and Drew as the instructors? You guys have seen and done pretty much everything.
Yeah, I mean, it certainly would have helped - if Rick knew how to place a tube.
- Exactly.
Now, what would you have given to have the knowledge that you have today back when you were first deployed? Everything.
Maybe then, Thad would still be alive.
This hospital was financially unstable before paying the ransom, and now it's in dire straits unless, of course, they can get the DOD to pay for it.
We can train the battlefield doctors of tomorrow and save this hospital, but we can't do it without you.
You're the centerpiece.
Everybody knows you.
[Sighs.]
I don't know, Jordan.
Think about it.
You can always go back to Syria.
- [Cellphone ringing.]
- Yeah, we do good things over in Syria.
- You do.
You do great work.
- Yeah.
If that's what you want.
I got to take this.
- Sure.
- Okay.
I'll talk to you tomorrow, okay? - [Cellphone beeps.]
- Hey.
Ev Everything okay? Brilliant, in fact.
We are so close to getting funding for our medical center in Syria, and I'm leaving him.
You're leaving him? My husband.
We've both been leading separate lives.
Come join me, T.
C.
.
I want to be with you.
And I love our home T.
C.
, you still there? T.
C.
? And I love our home