ER s11e16 Episode Script
Here and There
E.
R.
Previously on E.
R.
I'm been deployed to Iraq.
So, how long have you got? On your tour of duty? A year at least.
E.
R.
11x16 "HERE AND THERE" You heard from Gallant? We exchanged some e-mails but he was having some trouble - with the Internet at his CASH unit.
- He okay? You know Michael.
He's not one to complain.
- Tell him we're thinking about him.
- Sure.
Another bad guy saved, huh? Now he'll have to survive the hospital in Karbala.
Need me to redress that? Thanks, I'll get it.
- Dude.
- I'm sorry.
- Hey, Dr.
Neela.
- Hey, Bret.
- Girlfriend kick you out again? - Good one.
No, we broke up.
I burnt this mix for you.
You said you didn't know the blues and that's, like, a crime.
Thank you.
It's all yours, man.
Check it out.
It's cool.
I'm sorry.
I'm used to finding random rockers passed out in our living room.
Bret's cool, okay? He's a good guy.
- You should get to know him a little.
- No, thanks.
- Well, you might like him.
- Does he have a job? Well, I think he likes you.
And I know how hard it is to meet new people in the city.
Especially during the winterti- I guess I'm gonna shut up now.
Dear Michael, it's been months since I've heard from you.
I've been reading the paper watching the news.
It's hard not to worry.
But I'm sure you 're taking care of yourself.
Sorry I've been so out of touch.
They keep me pretty busy here, what with all the parties.
Everyone asks after you and I think about you often.
Even at odd moments: At the market, picking something up or just waiting for my coffee.
I wonder how you 're doing.
You guys probably don't even remember me by now.
I'm the tall, good-looking black guy with the best bedside manner in the place.
Tell Pratt I said that.
And tell everybody I'm still here, still doing the doctor thing.
Neela, Medevac's on its way in.
Double amputation.
I try to imagine what your days are like, how different your life must be.
The days go by some slower than others.
But I'm doing fine.
Incoming.
Dump patrol got ambushed.
I do miss County.
All you guys.
Sometimes in the middle of everything, I kind of wonder if what I'm doing here- Is maybe the same as what you 're doing over there.
It's good to believe it is.
Makes me feel you 're not really as far away as it seems.
And maybe it won't be so hard to get through this.
And that sometime soon we'll see each other again.
Estimated blood loss? As for work, well, some things continue to be a challenge for me.
I know I'm good at some of it.
- Crush injury? - Looks clean.
But I have some deficiencies, a certain ambivalence.
You can put them back on, right? You're gonna be just fine, ma'am.
What's your name? Private Thomas Perry, sir, first of the 12th.
RPG explosion, shrapnel injuries on the right side couple of AK-47 rounds in the thigh.
Hold it! Hold it! - What happened out there? - They ambushed my patrols.
I had three buddies with me.
Did they make it? I thank God for two years at County.
It prepared me for this.
They didn't make it, did they? As much as anyone can be prepared.
Radial artery hasn't clamped down.
- Direct pressure for now.
- How you doing, Doris? I thought I could get in, un-jam it, and get out in a few seconds.
- Un-jam it? - The saddle stitcher.
- You got to do 10 bound books a minute.
- You were inside a binding machine? Somebody must have turned it back on, without realizing I was still in there.
Well, the cuts are clean, so the chances for reattachment are excellent.
Dr.
Lewis, I left the registrar forms at the front desk.
Okay, good.
Gown up.
Rosales, this is Neela.
Neela, your new med student.
I'm not even confident in my own decisions half the time.
Now I'm supposed to orient students.
Neela's our resident brainiac.
Talk about pain management.
The irony is, people think I know all the answers.
We could titrate morphine? Even when I don't.
- Let's do bilateral brachial plexus blocks.
- Twenty cc's of 1 percent with epi? - To Dr.
Pratt and me.
- I'm familiar.
- Seen it performed? - Well- See it before you do it.
BP cuffs as a tourniquet on both biceps, keep inflated over 140.
Still, I feel after all this time, people I work with should have more confidence in me.
But how can they if I don't? Neela, adduct the arm like this.
Ever since med school, it's like I've been sleepwalking.
This is gonna be interesting, huh? Pressure's down.
The abdomen's tender, multiple shrapnel injuries, right flank and pelvis.
Two wounds, right thigh, gross deformity of the femur.
Hanging first unit of type-specific.
I have a lot of responsibility here.
And I gotta admit - I don't mind it.
- Where you from? Burlington, Vermont.
Only one exit wound.
Give another 5 of morphine.
Vermont? It must be freezing there.
- Thank God you're not there, huh? - God or Don Rumsfeld? Go with the Sec Def we got, not the one we wish we had.
Systolic's down to 88.
Throw me a cordis.
I'll put in the subclavian before he goes to O.
R.
I need surgery? They'll stop any bleeding and stabilize your fracture.
I'll keep the leg, right? - The responsibility cuts both ways.
- Sats dropping.
Get him on the nonrebreather.
Set up an airway.
Forget it.
We'll do it in O.
R.
Nineteen-year-old, 11 Bravo, AK-47 times two to- I heard.
O.
R.
's ready.
I'll take him from here.
This is Captain Whitley, 62 Alpha, fresh out of Doha.
Show her the ropes.
Andy, you're with me.
It's strange, afterjust eight months to feel like a veteran.
Michael Gallant.
Welcome to the 57th CASH.
- How long you been here? - Came over last spring.
How long to get used to it? - I'll let you know when I do.
- I mean, the ER's rough.
Lately my mind's somewhere else, you know? - Is it? - Yeah, my wife just had a baby.
January 21st.
Celia.
She's 7 pounds, 2 ounces.
- How old are you? - Twenty-four.
- You? - Twenty-seven.
We want to have three by the time we're 30.
We both grew up in big families.
- How about yourself? - I grew up in a medium family.
No.
I mean, married, kids? I have a lot of catching up to do.
It must be hard balancing an ER residency and a social life.
Yeah.
- This your double amputee? - Arms are here.
They'll take it from here.
Your husband's on his way.
- Thank you.
- Dr.
Rasgotra - come with me.
- I'll be late for rounds.
That's okay.
They'll manage without you.
While Dr.
Lieberman gets consent we'll make sure we have something to work with.
Dr.
Lieberman? I'm Roberto Rosales.
I'm a third-year.
Lieberman's our Plastics guy.
World expert on burn management.
Untoothed forceps and a Kelly.
- Shall I get you a nurse? - No.
You'll do just fine.
I find myself both proud and jealous at times, Michael.
Supple, resilient limbs.
Clean, straight amputations.
I'm saying, if you had to have your arms cut off, this would be the dream scenario.
Yeah, Lieberman's a brilliant guy.
Worked a while in Germany with the military - training combat surgeons in burn care.
- You have a purpose and a role to fill.
- Most days I don't feel like that at all.
- Flexor digitorum superficialis.
Okay.
Hold compressions.
- Back in sinus.
- Get me a chest tube.
Some days are bad.
Some days every victory feels too small.
He's got a pulse.
That was- Wow.
It won't last.
He needs the O.
R.
Tape the tube in, hook him up to suction.
I'll find Kilner.
You're with me.
Let's go.
Where did you learn that? I worked three years at a county ER back in Chicago.
Who do you have back there? Wife? Girlfriend? - Nope, not really.
- Not really? Okay.
Don't ask, don't tell.
I know what a lot of people think about this war.
But when you're here, you have to believe that we're fighting for something real something that matters.
Thought we could save it.
Shattered femur.
Femoral artery was a tattered mess.
He was bleeding out, headed for DIC.
That our guys we can't save and the ones we patch together are heroes, not victims.
Sir, we got a hypotensive Iraqi GSW with exposed bowel.
- Good Iraqi or bad Iraqi? - He's on our side, sir.
Send him here in 10 minutes.
So 20 minutes if he's a bad Iraqi? You have to be careful about human bombs getting in.
A unit in Kirkuk lost some people when a patient blew himself up on the table.
It's crazy what your daily concerns become.
You end up missing the littlest things.
The stuff most of us take for granted.
Hey.
Hey, you get that lady up to Lieberman yet? - The replantation should be underway.
- Good, I gotta get back inside.
Greg, do you miss him? Michael? You were good friends.
We still are.
I keep I don't know, thinking about him.
Nothing wrong with that.
Oh, I'm writing him a letter.
Anything you want to say? - You writing a letter? Sending an e-mail? - An actual letter on paper.
Well, tell him to hurry up and get his ass back here in one piece.
I'm tired of waiting for my rematch.
Now, let's get back inside.
We got things to do.
Pratt says he misses you.
Lots of my time is spent babysitting.
Even here there's all the small stuff right next to the stuff that rips you up.
- Are you feeling better, soldier? - Getting there.
We've had a virus blasting through camp.
Knocks you on your ass for about 48 hours.
Whole kitchen staff came down with it.
That explains why the food suddenly improved.
You want to go back to the days of MREs? We started on rations when we were setting up.
Now it's hot chow three times a day.
Yeah, you're welcome.
When fluid's in, we'll check orthostatics, send you to the border.
Border? It's just for a day or two.
We don't want her infecting the whole DFAC.
- Is there anything I can get you, soldier? - The hell out of here.
They're sending a Medevac.
Shouldn't be too long.
It's tough, enlisted kids who go back with less than they came with.
There are reservists and guardsmen who never expected to be here at all.
They bit the bullet and showed up for duty only to get their tours extended as reward.
Now they're here with no end in sight.
- "Weekend a month, " my ass.
- You got small? - Large.
- Did you get 18s too? Hey, Chicago, for you, I got it all.
Name a tent after you.
Hey, cap! Special pickup for you.
Cubans, illegal in Kuwait.
- What's the word on our Bulls? - Flirting with 500.
You think Jordan's got one more comeback? - You smoke those? - No.
Pregnant lady came here wounded from a building collapse.
- I delivered the baby.
- Hey.
Scorpion sting.
Got a minute? - Scorpion sting? - Yeah, it's pretty common.
No big deal.
Hey, I need some help! - You gonna help me? - Is it always like this? Multiply the usual busload of colds and coughs times 10 because it's February.
Add seasonal complaints, frostbite, sled accidents, tongues frozen to metal poles.
Double the car crashes, add your baseline chest pains, strokes, and GSWs.
And this is what you get: Hell frozen over.
Suzannah Harris.
Rash.
Hello, I'm Dr.
Rasgotra.
Yeah, I've got these red spots all over me and I have never itched so bad.
Looks like insect bites.
- Fleas, maybe? - No, I don't have fleas.
- Have you ever had scabies? - Scabies? They're tiny insects that can cause severe skin reactions.
Oh, God.
Benadryl, Elimite and home.
I know I shouldn't complain to you.
My troubles must seem pretty minor.
Hey, Gus.
How are you doing? - I haven't thrown up in an hour.
- How about the other end? - Slowing down.
- That's what I like to hear.
After the liter's in, PO challenge him, re-check orthostatics.
But I spend 99 percent of the time waiting for the 1 percent where it feels I make a difference.
Neela, waiting time for a bed is up to 18 hours.
Lewis wants to see about dispo-ing the deadbeats out of Chairs.
- We're on that.
- Scorpion must've crawled up my arm.
Never even felt it.
Okay, IV, 500 cc NS bolus.
Oh, hey.
Sergeant Varga's mom sent him a box of Lucky Charms.
Can he eat the crescent moons? Long as he's here, he's NPO.
At Landstuhl he can eat what he wants.
- So no green clovers either? - What is that, a monitor? Larabee.
- Jackson picked it up in Kuwait.
- You can't use that.
You want to borrow it sometime, make calls back home- Will it call Florida? My old lady's in Sarasota.
It's a security risk.
The signal can be picked up by an enemy.
Sir, you really think these insurgents have homing technology? Get a 12-lead, keep him on the monitor.
He's 112 degrees.
Fahrenheit.
I got 98.
With all due respect, ma'am if your boy had a temp of 112, he'd be dead.
Exactly.
Here, show me.
- Excuse me.
- We're not up to you.
- Check with the triage nurse.
- I hurt my back.
I was just tying a shoe.
Here, let me take a look.
- This where it hurts? - Yeah, right there.
- Any meds, medical problems? - No.
- You have a lumbar muscle spasm.
- Oh, no.
A backache.
I probably should stay for a full exam.
Listen, you could go home, take some ibuprofen have a glass of merlot, and get some rest.
Or you could sit here and wait to be seen for 20 hours.
Home sounds good.
Thanks.
These yours? Oh, yeah.
- Neela, did you just send that guy home? - Simple backache.
He still needs a chart.
- Quick exam, pain was musculoskeletal.
- EMTALA violation.
- He left on his own.
- Dr.
Lewis, MI in two is ready to move.
- I thought you wanted me to dispo- - I do.
But I don't want to get us sued.
Please, we need help.
My brother's in the car.
He's very sick.
You do triage outside the perimeter? If they're losing life, limb or eyesight, or are wounded as a result of U.
S.
action - we can bring them in.
- Otherwise, it's off to a civilian hospital.
If we treated every civilian that showed up we'd run out of beds and supplies in half a day.
- No interpreter? - I'm fluent in Arabic.
I was at the Pentagon on September 11th.
On September 12th, I started studying the language.
Over here, hurry.
He's really sick.
They went to the clinic.
They couldn't help her.
Pulse is weak.
Barely moving air.
- They gave her this note.
- Please help him.
"To County General doctor, rule out meningitis.
Please evaluate.
" What? Come on.
- She can't keep anything down.
- That hurt? Bolus her up and send her off to Balad? Yeah, she's only about 5 percent dehydrated.
Not sick enough for us.
Balad.
You have to go to a hospital in Balad.
You know where it is? Hold on.
Hold on.
Hey, this will help.
One cup every hour.
It's good stuff, okay? You drink it.
How is the hospital in Balad? That infrastructure's been neglected for a decade.
Should be able to handle a saline bolus.
It's so tough, turning them away when they're right here.
Even in the States, they wouldn't admit her.
Certainly can't justify treating her at CASH.
Any requests from the big city? Hey, Jackson.
You think you could score me some citrus? - I have a craving for some mangos.
- I don't think mango's a citrus fruit.
- How about some oranges then? - You've got it, Chicago.
See if I can hunt us down some Red Hots too.
- You better get going.
- Okay, Rollins, let's go.
Get down! Get down! Stay here! There might be more! Get them out of the truck! Get them out of the truck! I need two nurses and a Pedes mask! Set up for intubation.
Bolus 500 of normal saline, and we'll need 400 of rectal acetaminophen.
This kid's burning up.
Supply driver's hurt pretty bad.
Get the CASH on the horn! Tell them we got a MASCAL at the gate! - Oh, my God.
- Board and C-spine now.
Right now! - Gross deformity of the right clavicle.
- Oh, God! - Doctor, what antibiotics do you want? - Clinda and Levaquin.
- Pharmacy's out of Levaquin.
- Amp and gent then.
- Blood in the canal.
- Okay, 10 of morphine.
- Let's go! Let's go! - Got it! Captain, we need you here.
CBC, type and cross, get a second IV, call X-ray for chest, abdomen and right shoulder.
- Only 87 percent on nonrebreather.
- Okay.
She's stridor on carbonaceous sputum.
Okay.
Six-O on a mac two.
Okay, the inside of her airway is burned.
We need to get a tube down there before it swells shut.
Six of etomidate, 20 of Roc.
It's a medicine to help her sleep.
Etomidate's in.
Pushing the rock.
- Tube.
- Talk to me.
Sats up to 92 on a 30 per kilo fluid bolus.
CBC, lytes and blood cultures sent.
Chest film's on its way.
Suction.
He still needs a cath, UA and an LP.
Dopamine's at 10 mics and ceftriaxone's infusing.
- How long has he been sick like this? - Two days.
Fever.
Also vomiting.
- I can't get through this.
- Give it to me.
No.
Let's try five and a half.
There are times when all my worries, all the crazy thoughts in my head go away.
All that matters is what I'm doing now: Securing an airway.
Got it.
Bag him.
That's when I know what I'm doing, who I am.
You got a pulmonary contusion.
Some bleeding and bruising in the lungs.
We'll get you stabilized.
You'll be headed off to Landstuhl on your way home.
Home? It'll take weeks for your lungs and the fractures to heal.
Your family will be glad to see you.
I don't wanna ship out like this.
Tech just dropped this off.
Repeat chest on Gopher there.
Okay, let me go take a look at your films.
Take it easy.
- Contusions look worse.
- How are his sats? Holding, barely.
Okay, they'll come back.
Keep a bag mask at the bedside.
Urine dip is positive for leukocytes and nitrates.
Bingo.
Found the source.
- That's my sterile field.
- You can re-prep.
You can be this sick from a bladder infection? If there's hydronephrosis.
Probably septic from pyelo.
- We still need to rule out meningitis.
- It's unlikely.
Kid's vaccinated for H-Flu and pneumococcus.
- Pratt, Ml in 4 is crashing.
- Okay.
Add five of PEEP, start gentamicin, and lean on the PICU.
Let me know about the LP.
What if PEEP doesn't work? In the NICU, we used a high-frequency oscillator.
- I'm not sure if he's too old for that.
- Should I call RT? Let's wait and see what Pratt wants.
Sir, there are no facilities in Iraq with the resources or the training - to take care of this girl.
- True.
But you're telling me to stabilize and discharge her, sir.
I'm telling you we've done what we can, captain.
Move on.
They cannot take care of her in a local hospital.
Sometimes we have to accept our limitations here.
Sounds like a fancy way of saying you don't care, sir.
You've been here what, a year? I've been doing this for 20 so don't lecture me on who cares and who doesn't.
Yes, sir.
Maybe we could check a facility in Kuwait, sir.
See about transferring her to Landstuhl for her recovery.
Captain, Landstuhl's for U.
S.
servicemen.
Maybe some hospital in Egypt or Jordan could take her.
C-130's on the way for Perry and Jackson.
We could get her on the flight.
You need approval to bring that girl into the United States.
I know that, sir.
All right.
See what you can do.
Yes, sir.
Thank you, sir.
Will he sleep in the hospital tonight? In the pediatric ICU, but we'll keep him here until the bed's ready.
- Hey, check this out.
- What's that? - It's a high-frequency- - High-frequency oscillator.
I had a talk with the PICU attending.
He suggested we give this thing a trial.
- It uses high-frequency waves- - To carry oxygen to the alveoli.
Right.
Well, you're the expert.
Tell us what he needs.
Inspiratory time, 33.
Amplitude, 40.
Mean airway pressure, 18.
That's what the PICU doc said too.
- I'll get you set up.
- Cool.
Hey, way to stay on top of his pressure.
One of us should call the state medical board.
- What for? - To report the clinic doc.
You don't know what the kid looked like.
Bad enough the doctor advised to come here with a note to rule out meningitis.
Listen, clinic docs provide essential care in places where there's nothing else.
I'm not sure bad care is preferable to none.
The kid's vaccines are up to date.
Amoxicillin's better than no meds at all.
You shut a guy like this down, you're not doing anybody favors including this family.
What? No, no, no.
It needs to be immediately.
Because this girl can't wait.
Okay.
Can I speak to someone else then? What? No, don't- You okay? Two places in Kuwait said no and the administrator at Landstuhl practically laughed at me.
It's real sweet, what you're doing.
Yeah.
What I'm trying to do.
What's up? She's tachy with a widened pulse pressure.
The Gram's stain was negative.
Still on triples but we'll be out of Flagyl in the morning.
It won't matter if they don't get her skin grafted soon.
That's not gonna happen here.
Urine output's only half a cc per kilo per hour.
"God keep you for what you are doing.
" It's not gonna be so easy.
You want me to tell her that? No.
You send us an unstable patient again, we'll report you to the medical board.
And trust me, Dr.
Lima, you'll lose your license.
Yeah, goodbye to you too! - Did you get it all out? - What? Whatever's been bothering you all shift.
One minute I'm God's gift to medicine the next you're humiliating me.
- Humiliating you? - If you trust me, give me some room.
If you don't, just say so.
- I don't.
- What? Neela, you could be the best doctor here.
Hell, everybody knows that you're five times smarter.
But most of the time you're in your head.
You're right.
I am.
I blow things out of proportion.
I obsess.
- So stop.
- Well, it's just I come here, do my shift.
I go home, I sleep.
I can't believe this is my life.
See? Now, that's the problem.
This cannot be your life.
You need to go out, have fun.
When is the last time you were on a date? Why does everybody seem to think I need to get laid? Trust me on this.
Sometimes it helps.
Colonel Kilner.
This marine woke up with someone's arm draped across his body.
Took out his dagger and started stabbing it.
It was his own arm.
It had fallen asleep and he took it for the enemy.
Sir, I've run into some interference getting things set up.
- Maybe you could extend Jamila's stay.
- Captain.
Just for a few days.
It'll give me more time- We don't have beds to give away.
I want her out of the unit by the morning.
Hey, Larabee.
Hold up.
What did I do now? ER.
Yeah.
Neela, telephone.
Hello.
Is it that clinic idiot again? Hello? Hello? Michael.
That's too bad.
Yeah, okay.
I'll try.
- What's going on? - She's talking to Gallant.
- Really? - When is he coming home? - Sounds like he needs help.
- Don't forget to spread the love.
- Is he okay? - Yeah, they're yakking like teenagers.
What do you suppose a long-distance call from Iraq would run you? More important, what will it run the Army? It's we the taxpayers who are underwriting this little rendezvous.
Yeah, okay.
You too.
- You just hang up? - He couldn't talk.
He said hello.
- Can we call him back? - It was a one-time thing.
- He got access to a phone.
I gotta go.
- Where? I'll be back.
He sounded okay.
How you feeling? You were right.
Time to go home.
Yeah, it'll just be a few days.
Your family will meet you at Walter Reed.
You told them I'd be all right? Yeah.
Somebody contacted them, yeah.
You see that? Picked it up in Mosul for Laura, my little one.
She's gonna love it.
I wonder how cold it is in Joliet.
My wife hates the winter.
Now you make it quick, all right? Because if you get caught, I never knew you.
Looks like you caught them both.
- Is that Lieberman with Dubenko? - They're looking at the lady you brought.
- Doris.
- She's doing well.
- Good.
- I'll tell them you're waiting.
That's all right.
Hello, Doris.
- Dr.
Lieberman, may I have a moment? - Bit busy here.
I'm sorry.
This can't wait.
Wind's kicked up all through the Arabian Sea.
Your flight out should be in tomorrow at the latest, maybe even tonight.
It sucks, but it could be worse.
Mail.
I raided chow supplies for you, Burlington.
Maple syrup? You can take the boy out of Vermont Thanks.
Who wrote you, sir? My folks.
And a friend.
That stuff's like gold, huh? Yes, it is.
Have a minute, captain? Take it easy, soldier.
Congratulations.
A Dr.
Lieberman in Chicago has agreed to underwrite Jamila's care.
It came through.
That's great, sir.
County General? My guess is that's where you used to work.
So how did you plan to get her there? Piggyback her on the transport to Andrews, sir.
And who was gonna get that approved? It's lucky for you that the State Department and the Army okayed it.
C-130 on the airstrip in Baghdad.
We'll helo them over as soon as we get a chopper.
Don't say I never did anything for you.
Yes.
Good news? Yes.
I've got two Heinekens under my bed.
They've been sitting there for weeks waiting for something to celebrate.
We're here, you know? Gotta hold on to the good stuff while you can.
Yeah.
Sure.
Dr.
Gallant! Sergeant Jackson's crashing! Hello? Hello? Oh, hey.
Hot water's out at my place.
Sorry.
Ray said it was okay.
You want? No.
Yeah, sure.
Haven't listened to this CD yet? You familiar with this guy, Robert Johnson? Not really.
Eric Clapton? Jimmy Page? Keith Richards? - Well, yes.
Of course.
- Okay.
There's a direct line between Robert Johnson and every dude who's ever picked up a Gibson.
Robert Johnson is American music.
Is that so? Yeah, that's so.
His sats were trending down.
Had to tube him.
- Getting hard to bag.
- He's bleeding into his lungs.
- Hold compressions.
- Still bradycardic, 48.
Another epi.
Let's go.
Maybe occult pneumothorax.
- Pericardial effusion.
- No.
He's moving air.
No carotid? - Holding compressions.
- Rate, 27.
No pulse.
His heart's not getting any oxygen.
You know, they say he sold his soul to the devil.
Really? Why? Well, he wanted to be the best.
And he was.
So that makes it worth it? Kind of depends on your opinion of the devil.
I think it's a made-up story.
Of course it is.
That's the best kind.
But this guy- I mean, listen to this.
He's actually making a guitar talk.
To play like that, I would give almost anything.
Wouldn't you? It's good you feel that way about what you do.
What way? I don't know.
Passionate? Don't you? I mean, what Ray and you do, that's pretty amaz- - I'm, like, in awe of you guys- - I wasn't talking about me.
All I meant was you seem pretty passionate to me.
Damn it.
Pace at a faster rate.
Not capturing.
Atropine.
- Epi drip.
Wide open.
- Hold compressions.
Asystole.
We haven't been going that long.
You can't reverse this.
Another atropine.
Come on.
Come on! He's had three rounds of meds.
Hold compressions.
Dr.
Gallant.
Dr.
Gallant.
Wait.
Hold on a minute.
I think you're great but - I - Are you laughing? I'm- I'm sorry.
You're- You're great, really.
But I'm just not into it.
Well, you seemed into it a minute ago.
I need to go to bed now, because if I don't go to bed now I'm gonna stay out here with you.
And what would be so bad about that? You know When you have a cut or some injury but all you have in the house is one of those tiny Band-Aids that don't even stay on that don't really help the problem at all This would be very nice, I'm sure.
It already was.
Can you see what I mean? I'm a tiny Band-Aid? I'm in a weird place and I don't want to do something just because I'm lonely.
Isn't the cure for loneliness to be with someone? That is so totally reasonable.
Good night.
She's not stable, sir.
Just get to the C-130.
They'll take it from there.
She's hypotensive and septic.
- You can go up on the pressors.
- She'll blow a pneumo at altitude.
- Fly low and bag her.
- Sir, you're not the one who'll be coding her at 5000 feet.
She could die without the proper burn care.
She can't get that here.
She could die during transport.
I'm not taking responsibility.
Would you take her if a doctor went? You got 72 hours, son.
Get her there.
Thank you, sir.
I try to be positive, Neela, but the truth is, it gets to you.
Even if no one sees that, even if you never admit it.
Sometimes I wish I could just get out wear civvies, drink beer and clear my head for a while.
Then I'd come back and finish the job I started.
There are things I can't say to anyone except in a letter except to you.
Be safe, Michael.
I know I worry a lot about everything.
But most of all I worry about how long it will be before I see you again.
R.
Previously on E.
R.
I'm been deployed to Iraq.
So, how long have you got? On your tour of duty? A year at least.
E.
R.
11x16 "HERE AND THERE" You heard from Gallant? We exchanged some e-mails but he was having some trouble - with the Internet at his CASH unit.
- He okay? You know Michael.
He's not one to complain.
- Tell him we're thinking about him.
- Sure.
Another bad guy saved, huh? Now he'll have to survive the hospital in Karbala.
Need me to redress that? Thanks, I'll get it.
- Dude.
- I'm sorry.
- Hey, Dr.
Neela.
- Hey, Bret.
- Girlfriend kick you out again? - Good one.
No, we broke up.
I burnt this mix for you.
You said you didn't know the blues and that's, like, a crime.
Thank you.
It's all yours, man.
Check it out.
It's cool.
I'm sorry.
I'm used to finding random rockers passed out in our living room.
Bret's cool, okay? He's a good guy.
- You should get to know him a little.
- No, thanks.
- Well, you might like him.
- Does he have a job? Well, I think he likes you.
And I know how hard it is to meet new people in the city.
Especially during the winterti- I guess I'm gonna shut up now.
Dear Michael, it's been months since I've heard from you.
I've been reading the paper watching the news.
It's hard not to worry.
But I'm sure you 're taking care of yourself.
Sorry I've been so out of touch.
They keep me pretty busy here, what with all the parties.
Everyone asks after you and I think about you often.
Even at odd moments: At the market, picking something up or just waiting for my coffee.
I wonder how you 're doing.
You guys probably don't even remember me by now.
I'm the tall, good-looking black guy with the best bedside manner in the place.
Tell Pratt I said that.
And tell everybody I'm still here, still doing the doctor thing.
Neela, Medevac's on its way in.
Double amputation.
I try to imagine what your days are like, how different your life must be.
The days go by some slower than others.
But I'm doing fine.
Incoming.
Dump patrol got ambushed.
I do miss County.
All you guys.
Sometimes in the middle of everything, I kind of wonder if what I'm doing here- Is maybe the same as what you 're doing over there.
It's good to believe it is.
Makes me feel you 're not really as far away as it seems.
And maybe it won't be so hard to get through this.
And that sometime soon we'll see each other again.
Estimated blood loss? As for work, well, some things continue to be a challenge for me.
I know I'm good at some of it.
- Crush injury? - Looks clean.
But I have some deficiencies, a certain ambivalence.
You can put them back on, right? You're gonna be just fine, ma'am.
What's your name? Private Thomas Perry, sir, first of the 12th.
RPG explosion, shrapnel injuries on the right side couple of AK-47 rounds in the thigh.
Hold it! Hold it! - What happened out there? - They ambushed my patrols.
I had three buddies with me.
Did they make it? I thank God for two years at County.
It prepared me for this.
They didn't make it, did they? As much as anyone can be prepared.
Radial artery hasn't clamped down.
- Direct pressure for now.
- How you doing, Doris? I thought I could get in, un-jam it, and get out in a few seconds.
- Un-jam it? - The saddle stitcher.
- You got to do 10 bound books a minute.
- You were inside a binding machine? Somebody must have turned it back on, without realizing I was still in there.
Well, the cuts are clean, so the chances for reattachment are excellent.
Dr.
Lewis, I left the registrar forms at the front desk.
Okay, good.
Gown up.
Rosales, this is Neela.
Neela, your new med student.
I'm not even confident in my own decisions half the time.
Now I'm supposed to orient students.
Neela's our resident brainiac.
Talk about pain management.
The irony is, people think I know all the answers.
We could titrate morphine? Even when I don't.
- Let's do bilateral brachial plexus blocks.
- Twenty cc's of 1 percent with epi? - To Dr.
Pratt and me.
- I'm familiar.
- Seen it performed? - Well- See it before you do it.
BP cuffs as a tourniquet on both biceps, keep inflated over 140.
Still, I feel after all this time, people I work with should have more confidence in me.
But how can they if I don't? Neela, adduct the arm like this.
Ever since med school, it's like I've been sleepwalking.
This is gonna be interesting, huh? Pressure's down.
The abdomen's tender, multiple shrapnel injuries, right flank and pelvis.
Two wounds, right thigh, gross deformity of the femur.
Hanging first unit of type-specific.
I have a lot of responsibility here.
And I gotta admit - I don't mind it.
- Where you from? Burlington, Vermont.
Only one exit wound.
Give another 5 of morphine.
Vermont? It must be freezing there.
- Thank God you're not there, huh? - God or Don Rumsfeld? Go with the Sec Def we got, not the one we wish we had.
Systolic's down to 88.
Throw me a cordis.
I'll put in the subclavian before he goes to O.
R.
I need surgery? They'll stop any bleeding and stabilize your fracture.
I'll keep the leg, right? - The responsibility cuts both ways.
- Sats dropping.
Get him on the nonrebreather.
Set up an airway.
Forget it.
We'll do it in O.
R.
Nineteen-year-old, 11 Bravo, AK-47 times two to- I heard.
O.
R.
's ready.
I'll take him from here.
This is Captain Whitley, 62 Alpha, fresh out of Doha.
Show her the ropes.
Andy, you're with me.
It's strange, afterjust eight months to feel like a veteran.
Michael Gallant.
Welcome to the 57th CASH.
- How long you been here? - Came over last spring.
How long to get used to it? - I'll let you know when I do.
- I mean, the ER's rough.
Lately my mind's somewhere else, you know? - Is it? - Yeah, my wife just had a baby.
January 21st.
Celia.
She's 7 pounds, 2 ounces.
- How old are you? - Twenty-four.
- You? - Twenty-seven.
We want to have three by the time we're 30.
We both grew up in big families.
- How about yourself? - I grew up in a medium family.
No.
I mean, married, kids? I have a lot of catching up to do.
It must be hard balancing an ER residency and a social life.
Yeah.
- This your double amputee? - Arms are here.
They'll take it from here.
Your husband's on his way.
- Thank you.
- Dr.
Rasgotra - come with me.
- I'll be late for rounds.
That's okay.
They'll manage without you.
While Dr.
Lieberman gets consent we'll make sure we have something to work with.
Dr.
Lieberman? I'm Roberto Rosales.
I'm a third-year.
Lieberman's our Plastics guy.
World expert on burn management.
Untoothed forceps and a Kelly.
- Shall I get you a nurse? - No.
You'll do just fine.
I find myself both proud and jealous at times, Michael.
Supple, resilient limbs.
Clean, straight amputations.
I'm saying, if you had to have your arms cut off, this would be the dream scenario.
Yeah, Lieberman's a brilliant guy.
Worked a while in Germany with the military - training combat surgeons in burn care.
- You have a purpose and a role to fill.
- Most days I don't feel like that at all.
- Flexor digitorum superficialis.
Okay.
Hold compressions.
- Back in sinus.
- Get me a chest tube.
Some days are bad.
Some days every victory feels too small.
He's got a pulse.
That was- Wow.
It won't last.
He needs the O.
R.
Tape the tube in, hook him up to suction.
I'll find Kilner.
You're with me.
Let's go.
Where did you learn that? I worked three years at a county ER back in Chicago.
Who do you have back there? Wife? Girlfriend? - Nope, not really.
- Not really? Okay.
Don't ask, don't tell.
I know what a lot of people think about this war.
But when you're here, you have to believe that we're fighting for something real something that matters.
Thought we could save it.
Shattered femur.
Femoral artery was a tattered mess.
He was bleeding out, headed for DIC.
That our guys we can't save and the ones we patch together are heroes, not victims.
Sir, we got a hypotensive Iraqi GSW with exposed bowel.
- Good Iraqi or bad Iraqi? - He's on our side, sir.
Send him here in 10 minutes.
So 20 minutes if he's a bad Iraqi? You have to be careful about human bombs getting in.
A unit in Kirkuk lost some people when a patient blew himself up on the table.
It's crazy what your daily concerns become.
You end up missing the littlest things.
The stuff most of us take for granted.
Hey.
Hey, you get that lady up to Lieberman yet? - The replantation should be underway.
- Good, I gotta get back inside.
Greg, do you miss him? Michael? You were good friends.
We still are.
I keep I don't know, thinking about him.
Nothing wrong with that.
Oh, I'm writing him a letter.
Anything you want to say? - You writing a letter? Sending an e-mail? - An actual letter on paper.
Well, tell him to hurry up and get his ass back here in one piece.
I'm tired of waiting for my rematch.
Now, let's get back inside.
We got things to do.
Pratt says he misses you.
Lots of my time is spent babysitting.
Even here there's all the small stuff right next to the stuff that rips you up.
- Are you feeling better, soldier? - Getting there.
We've had a virus blasting through camp.
Knocks you on your ass for about 48 hours.
Whole kitchen staff came down with it.
That explains why the food suddenly improved.
You want to go back to the days of MREs? We started on rations when we were setting up.
Now it's hot chow three times a day.
Yeah, you're welcome.
When fluid's in, we'll check orthostatics, send you to the border.
Border? It's just for a day or two.
We don't want her infecting the whole DFAC.
- Is there anything I can get you, soldier? - The hell out of here.
They're sending a Medevac.
Shouldn't be too long.
It's tough, enlisted kids who go back with less than they came with.
There are reservists and guardsmen who never expected to be here at all.
They bit the bullet and showed up for duty only to get their tours extended as reward.
Now they're here with no end in sight.
- "Weekend a month, " my ass.
- You got small? - Large.
- Did you get 18s too? Hey, Chicago, for you, I got it all.
Name a tent after you.
Hey, cap! Special pickup for you.
Cubans, illegal in Kuwait.
- What's the word on our Bulls? - Flirting with 500.
You think Jordan's got one more comeback? - You smoke those? - No.
Pregnant lady came here wounded from a building collapse.
- I delivered the baby.
- Hey.
Scorpion sting.
Got a minute? - Scorpion sting? - Yeah, it's pretty common.
No big deal.
Hey, I need some help! - You gonna help me? - Is it always like this? Multiply the usual busload of colds and coughs times 10 because it's February.
Add seasonal complaints, frostbite, sled accidents, tongues frozen to metal poles.
Double the car crashes, add your baseline chest pains, strokes, and GSWs.
And this is what you get: Hell frozen over.
Suzannah Harris.
Rash.
Hello, I'm Dr.
Rasgotra.
Yeah, I've got these red spots all over me and I have never itched so bad.
Looks like insect bites.
- Fleas, maybe? - No, I don't have fleas.
- Have you ever had scabies? - Scabies? They're tiny insects that can cause severe skin reactions.
Oh, God.
Benadryl, Elimite and home.
I know I shouldn't complain to you.
My troubles must seem pretty minor.
Hey, Gus.
How are you doing? - I haven't thrown up in an hour.
- How about the other end? - Slowing down.
- That's what I like to hear.
After the liter's in, PO challenge him, re-check orthostatics.
But I spend 99 percent of the time waiting for the 1 percent where it feels I make a difference.
Neela, waiting time for a bed is up to 18 hours.
Lewis wants to see about dispo-ing the deadbeats out of Chairs.
- We're on that.
- Scorpion must've crawled up my arm.
Never even felt it.
Okay, IV, 500 cc NS bolus.
Oh, hey.
Sergeant Varga's mom sent him a box of Lucky Charms.
Can he eat the crescent moons? Long as he's here, he's NPO.
At Landstuhl he can eat what he wants.
- So no green clovers either? - What is that, a monitor? Larabee.
- Jackson picked it up in Kuwait.
- You can't use that.
You want to borrow it sometime, make calls back home- Will it call Florida? My old lady's in Sarasota.
It's a security risk.
The signal can be picked up by an enemy.
Sir, you really think these insurgents have homing technology? Get a 12-lead, keep him on the monitor.
He's 112 degrees.
Fahrenheit.
I got 98.
With all due respect, ma'am if your boy had a temp of 112, he'd be dead.
Exactly.
Here, show me.
- Excuse me.
- We're not up to you.
- Check with the triage nurse.
- I hurt my back.
I was just tying a shoe.
Here, let me take a look.
- This where it hurts? - Yeah, right there.
- Any meds, medical problems? - No.
- You have a lumbar muscle spasm.
- Oh, no.
A backache.
I probably should stay for a full exam.
Listen, you could go home, take some ibuprofen have a glass of merlot, and get some rest.
Or you could sit here and wait to be seen for 20 hours.
Home sounds good.
Thanks.
These yours? Oh, yeah.
- Neela, did you just send that guy home? - Simple backache.
He still needs a chart.
- Quick exam, pain was musculoskeletal.
- EMTALA violation.
- He left on his own.
- Dr.
Lewis, MI in two is ready to move.
- I thought you wanted me to dispo- - I do.
But I don't want to get us sued.
Please, we need help.
My brother's in the car.
He's very sick.
You do triage outside the perimeter? If they're losing life, limb or eyesight, or are wounded as a result of U.
S.
action - we can bring them in.
- Otherwise, it's off to a civilian hospital.
If we treated every civilian that showed up we'd run out of beds and supplies in half a day.
- No interpreter? - I'm fluent in Arabic.
I was at the Pentagon on September 11th.
On September 12th, I started studying the language.
Over here, hurry.
He's really sick.
They went to the clinic.
They couldn't help her.
Pulse is weak.
Barely moving air.
- They gave her this note.
- Please help him.
"To County General doctor, rule out meningitis.
Please evaluate.
" What? Come on.
- She can't keep anything down.
- That hurt? Bolus her up and send her off to Balad? Yeah, she's only about 5 percent dehydrated.
Not sick enough for us.
Balad.
You have to go to a hospital in Balad.
You know where it is? Hold on.
Hold on.
Hey, this will help.
One cup every hour.
It's good stuff, okay? You drink it.
How is the hospital in Balad? That infrastructure's been neglected for a decade.
Should be able to handle a saline bolus.
It's so tough, turning them away when they're right here.
Even in the States, they wouldn't admit her.
Certainly can't justify treating her at CASH.
Any requests from the big city? Hey, Jackson.
You think you could score me some citrus? - I have a craving for some mangos.
- I don't think mango's a citrus fruit.
- How about some oranges then? - You've got it, Chicago.
See if I can hunt us down some Red Hots too.
- You better get going.
- Okay, Rollins, let's go.
Get down! Get down! Stay here! There might be more! Get them out of the truck! Get them out of the truck! I need two nurses and a Pedes mask! Set up for intubation.
Bolus 500 of normal saline, and we'll need 400 of rectal acetaminophen.
This kid's burning up.
Supply driver's hurt pretty bad.
Get the CASH on the horn! Tell them we got a MASCAL at the gate! - Oh, my God.
- Board and C-spine now.
Right now! - Gross deformity of the right clavicle.
- Oh, God! - Doctor, what antibiotics do you want? - Clinda and Levaquin.
- Pharmacy's out of Levaquin.
- Amp and gent then.
- Blood in the canal.
- Okay, 10 of morphine.
- Let's go! Let's go! - Got it! Captain, we need you here.
CBC, type and cross, get a second IV, call X-ray for chest, abdomen and right shoulder.
- Only 87 percent on nonrebreather.
- Okay.
She's stridor on carbonaceous sputum.
Okay.
Six-O on a mac two.
Okay, the inside of her airway is burned.
We need to get a tube down there before it swells shut.
Six of etomidate, 20 of Roc.
It's a medicine to help her sleep.
Etomidate's in.
Pushing the rock.
- Tube.
- Talk to me.
Sats up to 92 on a 30 per kilo fluid bolus.
CBC, lytes and blood cultures sent.
Chest film's on its way.
Suction.
He still needs a cath, UA and an LP.
Dopamine's at 10 mics and ceftriaxone's infusing.
- How long has he been sick like this? - Two days.
Fever.
Also vomiting.
- I can't get through this.
- Give it to me.
No.
Let's try five and a half.
There are times when all my worries, all the crazy thoughts in my head go away.
All that matters is what I'm doing now: Securing an airway.
Got it.
Bag him.
That's when I know what I'm doing, who I am.
You got a pulmonary contusion.
Some bleeding and bruising in the lungs.
We'll get you stabilized.
You'll be headed off to Landstuhl on your way home.
Home? It'll take weeks for your lungs and the fractures to heal.
Your family will be glad to see you.
I don't wanna ship out like this.
Tech just dropped this off.
Repeat chest on Gopher there.
Okay, let me go take a look at your films.
Take it easy.
- Contusions look worse.
- How are his sats? Holding, barely.
Okay, they'll come back.
Keep a bag mask at the bedside.
Urine dip is positive for leukocytes and nitrates.
Bingo.
Found the source.
- That's my sterile field.
- You can re-prep.
You can be this sick from a bladder infection? If there's hydronephrosis.
Probably septic from pyelo.
- We still need to rule out meningitis.
- It's unlikely.
Kid's vaccinated for H-Flu and pneumococcus.
- Pratt, Ml in 4 is crashing.
- Okay.
Add five of PEEP, start gentamicin, and lean on the PICU.
Let me know about the LP.
What if PEEP doesn't work? In the NICU, we used a high-frequency oscillator.
- I'm not sure if he's too old for that.
- Should I call RT? Let's wait and see what Pratt wants.
Sir, there are no facilities in Iraq with the resources or the training - to take care of this girl.
- True.
But you're telling me to stabilize and discharge her, sir.
I'm telling you we've done what we can, captain.
Move on.
They cannot take care of her in a local hospital.
Sometimes we have to accept our limitations here.
Sounds like a fancy way of saying you don't care, sir.
You've been here what, a year? I've been doing this for 20 so don't lecture me on who cares and who doesn't.
Yes, sir.
Maybe we could check a facility in Kuwait, sir.
See about transferring her to Landstuhl for her recovery.
Captain, Landstuhl's for U.
S.
servicemen.
Maybe some hospital in Egypt or Jordan could take her.
C-130's on the way for Perry and Jackson.
We could get her on the flight.
You need approval to bring that girl into the United States.
I know that, sir.
All right.
See what you can do.
Yes, sir.
Thank you, sir.
Will he sleep in the hospital tonight? In the pediatric ICU, but we'll keep him here until the bed's ready.
- Hey, check this out.
- What's that? - It's a high-frequency- - High-frequency oscillator.
I had a talk with the PICU attending.
He suggested we give this thing a trial.
- It uses high-frequency waves- - To carry oxygen to the alveoli.
Right.
Well, you're the expert.
Tell us what he needs.
Inspiratory time, 33.
Amplitude, 40.
Mean airway pressure, 18.
That's what the PICU doc said too.
- I'll get you set up.
- Cool.
Hey, way to stay on top of his pressure.
One of us should call the state medical board.
- What for? - To report the clinic doc.
You don't know what the kid looked like.
Bad enough the doctor advised to come here with a note to rule out meningitis.
Listen, clinic docs provide essential care in places where there's nothing else.
I'm not sure bad care is preferable to none.
The kid's vaccines are up to date.
Amoxicillin's better than no meds at all.
You shut a guy like this down, you're not doing anybody favors including this family.
What? No, no, no.
It needs to be immediately.
Because this girl can't wait.
Okay.
Can I speak to someone else then? What? No, don't- You okay? Two places in Kuwait said no and the administrator at Landstuhl practically laughed at me.
It's real sweet, what you're doing.
Yeah.
What I'm trying to do.
What's up? She's tachy with a widened pulse pressure.
The Gram's stain was negative.
Still on triples but we'll be out of Flagyl in the morning.
It won't matter if they don't get her skin grafted soon.
That's not gonna happen here.
Urine output's only half a cc per kilo per hour.
"God keep you for what you are doing.
" It's not gonna be so easy.
You want me to tell her that? No.
You send us an unstable patient again, we'll report you to the medical board.
And trust me, Dr.
Lima, you'll lose your license.
Yeah, goodbye to you too! - Did you get it all out? - What? Whatever's been bothering you all shift.
One minute I'm God's gift to medicine the next you're humiliating me.
- Humiliating you? - If you trust me, give me some room.
If you don't, just say so.
- I don't.
- What? Neela, you could be the best doctor here.
Hell, everybody knows that you're five times smarter.
But most of the time you're in your head.
You're right.
I am.
I blow things out of proportion.
I obsess.
- So stop.
- Well, it's just I come here, do my shift.
I go home, I sleep.
I can't believe this is my life.
See? Now, that's the problem.
This cannot be your life.
You need to go out, have fun.
When is the last time you were on a date? Why does everybody seem to think I need to get laid? Trust me on this.
Sometimes it helps.
Colonel Kilner.
This marine woke up with someone's arm draped across his body.
Took out his dagger and started stabbing it.
It was his own arm.
It had fallen asleep and he took it for the enemy.
Sir, I've run into some interference getting things set up.
- Maybe you could extend Jamila's stay.
- Captain.
Just for a few days.
It'll give me more time- We don't have beds to give away.
I want her out of the unit by the morning.
Hey, Larabee.
Hold up.
What did I do now? ER.
Yeah.
Neela, telephone.
Hello.
Is it that clinic idiot again? Hello? Hello? Michael.
That's too bad.
Yeah, okay.
I'll try.
- What's going on? - She's talking to Gallant.
- Really? - When is he coming home? - Sounds like he needs help.
- Don't forget to spread the love.
- Is he okay? - Yeah, they're yakking like teenagers.
What do you suppose a long-distance call from Iraq would run you? More important, what will it run the Army? It's we the taxpayers who are underwriting this little rendezvous.
Yeah, okay.
You too.
- You just hang up? - He couldn't talk.
He said hello.
- Can we call him back? - It was a one-time thing.
- He got access to a phone.
I gotta go.
- Where? I'll be back.
He sounded okay.
How you feeling? You were right.
Time to go home.
Yeah, it'll just be a few days.
Your family will meet you at Walter Reed.
You told them I'd be all right? Yeah.
Somebody contacted them, yeah.
You see that? Picked it up in Mosul for Laura, my little one.
She's gonna love it.
I wonder how cold it is in Joliet.
My wife hates the winter.
Now you make it quick, all right? Because if you get caught, I never knew you.
Looks like you caught them both.
- Is that Lieberman with Dubenko? - They're looking at the lady you brought.
- Doris.
- She's doing well.
- Good.
- I'll tell them you're waiting.
That's all right.
Hello, Doris.
- Dr.
Lieberman, may I have a moment? - Bit busy here.
I'm sorry.
This can't wait.
Wind's kicked up all through the Arabian Sea.
Your flight out should be in tomorrow at the latest, maybe even tonight.
It sucks, but it could be worse.
Mail.
I raided chow supplies for you, Burlington.
Maple syrup? You can take the boy out of Vermont Thanks.
Who wrote you, sir? My folks.
And a friend.
That stuff's like gold, huh? Yes, it is.
Have a minute, captain? Take it easy, soldier.
Congratulations.
A Dr.
Lieberman in Chicago has agreed to underwrite Jamila's care.
It came through.
That's great, sir.
County General? My guess is that's where you used to work.
So how did you plan to get her there? Piggyback her on the transport to Andrews, sir.
And who was gonna get that approved? It's lucky for you that the State Department and the Army okayed it.
C-130 on the airstrip in Baghdad.
We'll helo them over as soon as we get a chopper.
Don't say I never did anything for you.
Yes.
Good news? Yes.
I've got two Heinekens under my bed.
They've been sitting there for weeks waiting for something to celebrate.
We're here, you know? Gotta hold on to the good stuff while you can.
Yeah.
Sure.
Dr.
Gallant! Sergeant Jackson's crashing! Hello? Hello? Oh, hey.
Hot water's out at my place.
Sorry.
Ray said it was okay.
You want? No.
Yeah, sure.
Haven't listened to this CD yet? You familiar with this guy, Robert Johnson? Not really.
Eric Clapton? Jimmy Page? Keith Richards? - Well, yes.
Of course.
- Okay.
There's a direct line between Robert Johnson and every dude who's ever picked up a Gibson.
Robert Johnson is American music.
Is that so? Yeah, that's so.
His sats were trending down.
Had to tube him.
- Getting hard to bag.
- He's bleeding into his lungs.
- Hold compressions.
- Still bradycardic, 48.
Another epi.
Let's go.
Maybe occult pneumothorax.
- Pericardial effusion.
- No.
He's moving air.
No carotid? - Holding compressions.
- Rate, 27.
No pulse.
His heart's not getting any oxygen.
You know, they say he sold his soul to the devil.
Really? Why? Well, he wanted to be the best.
And he was.
So that makes it worth it? Kind of depends on your opinion of the devil.
I think it's a made-up story.
Of course it is.
That's the best kind.
But this guy- I mean, listen to this.
He's actually making a guitar talk.
To play like that, I would give almost anything.
Wouldn't you? It's good you feel that way about what you do.
What way? I don't know.
Passionate? Don't you? I mean, what Ray and you do, that's pretty amaz- - I'm, like, in awe of you guys- - I wasn't talking about me.
All I meant was you seem pretty passionate to me.
Damn it.
Pace at a faster rate.
Not capturing.
Atropine.
- Epi drip.
Wide open.
- Hold compressions.
Asystole.
We haven't been going that long.
You can't reverse this.
Another atropine.
Come on.
Come on! He's had three rounds of meds.
Hold compressions.
Dr.
Gallant.
Dr.
Gallant.
Wait.
Hold on a minute.
I think you're great but - I - Are you laughing? I'm- I'm sorry.
You're- You're great, really.
But I'm just not into it.
Well, you seemed into it a minute ago.
I need to go to bed now, because if I don't go to bed now I'm gonna stay out here with you.
And what would be so bad about that? You know When you have a cut or some injury but all you have in the house is one of those tiny Band-Aids that don't even stay on that don't really help the problem at all This would be very nice, I'm sure.
It already was.
Can you see what I mean? I'm a tiny Band-Aid? I'm in a weird place and I don't want to do something just because I'm lonely.
Isn't the cure for loneliness to be with someone? That is so totally reasonable.
Good night.
She's not stable, sir.
Just get to the C-130.
They'll take it from there.
She's hypotensive and septic.
- You can go up on the pressors.
- She'll blow a pneumo at altitude.
- Fly low and bag her.
- Sir, you're not the one who'll be coding her at 5000 feet.
She could die without the proper burn care.
She can't get that here.
She could die during transport.
I'm not taking responsibility.
Would you take her if a doctor went? You got 72 hours, son.
Get her there.
Thank you, sir.
I try to be positive, Neela, but the truth is, it gets to you.
Even if no one sees that, even if you never admit it.
Sometimes I wish I could just get out wear civvies, drink beer and clear my head for a while.
Then I'd come back and finish the job I started.
There are things I can't say to anyone except in a letter except to you.
Be safe, Michael.
I know I worry a lot about everything.
But most of all I worry about how long it will be before I see you again.