Combat Hospital (2011) s01e02 Episode Script

Enemy Within

Six! Jeez! Run me over, why don't you? Bring him over there.
Trauma bay 3.
Let's go, people.
He's like a furnace.
He's burning up.
Get me vitals.
Rebecca.
You ever see anything like this? - No.
You? - No.
- Vivid skin markings.
- Massive swelling.
- Temp's 105.
2.
- Okay, I need ice.
A lot of ice.
Let's hang 2 liters of ringers, wide open, squeeze the bag.
Hey, we need a terp.
We need to get these guys out of here.
Good.
You understand English.
Are you his commanding officer? All right, then let me tell you something.
Not only did you almost kill me, but you almost killed him by not getting him in sooner.
Rebecca-- No, Bobby.
He almost ran me over.
Now because of your irresponsibility, this man could die.
He better not.
You're American? Okay, one in each armpit, one in the groin.
Nice and easy.
He says it's too cold.
Man, I know, but we gotta get this fever down as quickly as we can.
He's shivering! It's a paradoxical effect of the fever.
Okay? With a temperature this high, he could have a stroke or a seizure.
- Raise your arm above your head.
- What?! Raise your arm! Keep it elevated! - You're bleeding all over the floor.
- Let's move him to I.
C.
U.
We'll start him on pip/tazo, After we get him stable, can you do an ultrasound on the swelling? - Sure, and I'll get some blood for the lab as well.
- Okay.
Well, let's just hope it stays that way.
Vans.
What have I told you about using these computers? You said not to.
Which means? Not to, sir.
Uh, uh, no, he's in good hands, okay? And there's nothing more you can do, so let's take a look at that arm.
I tried to keep pressure on it, but it was too tough to do that and drive.
Okay, well, that explains you nearly running me over.
I'm sorry.
Yes, Doctor.
So what's the story behind your friend? His name is Hamasa.
Mm-hmm.
He never mentioned being sick, but when he passed out and flipped the truck he's Afghan national army, doctor Gordon.
Rebecca Gordon.
And you are? I can't tell you.
You're joking, right? Okay.
You're special operations.
Undercover.
Wait.
What does the army call you guys? Snake eaters.
They call us a lot of things.
What should I call you? George Washington.
Too presidential.
Lord Byron.
Pretentious.
You can call me Joe.
Joe.
Joe works for me.
It's got a nice ring to it.
Has anybody ever told you about your eyes? They're amazing.
I'm serious.
So am I.
Believe me.
That's funny coming from a man who won't even trust me with his real name.
Well, you know the saying.
- If I had to tell you, I'd have to kill you.
- Oh, don't tell me.
In your case, it's not just a saying? Why do you dress like that? Or am--am I not allowed to ask? No, I can tell you that.
Uh, those men outside.
They're A.
N.
A.
Special forces.
It's my privilege to train and fight alongside them also.
Good enough explanation? For the time being, yeah.
All right.
You're done.
With his temperature elevated but generally stable at 103 degrees, we were able to discontinue external cooling.
Mm-hmm.
He continues to receive I.
V.
fluids while we treat this unknown infection empirically with systemic antibiotics.
All right.
Thank you, Doctor.
Good report.
Your prognosis.
Cautiously optimistic, sir, subject to further analysis of this pathogen.
All right.
The labs here can tell whether it's gram-negative or positive.
But they're not equipped for more complex microbiology, so you're sending samples to Landstuhl? They're on the plane to Germany.
Good.
- Dr.
Gordon.
- Yes, sir.
You mind not passing notes during rounds? It's distracting.
Sorry, sir.
Surgeons.
I expect you to have read these notes from Walter Reed and Edmonton go, oilers! About fasciotomy procedures.
I don't want any of you sobbing after Thursday's conference call because you got chewed out by head of U.
S.
trauma.
That includes you, too, Dr.
Hill.
You're not immune to his wrath.
Well, I will make sure I do my homework, Colonel.
That'll be a first.
Let's rock 'n' roll.
Hey.
Thanks for making me look like an idiot during rounds.
Our pleasure.
Happy to oblige.
Mm.
Have you seen Bobby? Uh, yeah.
We passed him at the coffee shop.
Actually, the coffee there is quite drinkable.
It's gourmet, unlike the stuff they serve at D-fac.
- Gourmet coffee in Kandahar? - Yeah, the Americans-- they, um, they like to bring a taste of home.
Weren't you looking for Bobby? Yes, I was.
You're right.
Good luck.
Thank you.
I was talking to Beverly.
I'm not sure she likes me.
Good.
What, are you jealous? Hell, yeah.
Perfect.
Thank you.
Okay.
Here you go--coffee.
Now do you need sweetener or sugar? Quit stalling.
I know you got my test results.
So let's have it.
It's good news.
All right? There's nothing wrong.
Your hormone levels are normal, your thyroid and liver enzymes are fine.
I missed my period.
It's not that uncommon to miss a period.
Stress-- Don't say "stress," because my entire life has been nothing but stress, okay? Even when I was doing night shifts at Miami general with a cold sore and the flu, I-I wasn't late.
See, I-I am never late.
Well, besides missing your period, can you think of another reason why you might be pregnant? I mean, I didn't think it was immaculate conception Or anything like that.
I mean, I-I had sex, if that's what you're asking.
- I don't-- - And you know what? It was stupid, okay? Without protection.
I mean, I-I thought that I was in--in love, and--and I just didn't even think about it.
I'm like, you know what? I-if it happened, it happened, and he dumped me ooh.
At my favorite restaurant because he thought that I wouldn't make a scene.
You-- He was wrong, because I made a scene And now I can't ever go back there.
That answer your question? Actually, that wasn't my question.
Oh, sorry.
Oh.
I thought that you-- No, it's fine.
I just wanted to know if--if maybe there was another symptom you haven't told me about.
No.
Then there's nothing wrong with you.
You're just not pregnant.
Nothing wrong with not being pregnant.
No, not in your case.
I'm sorry, honey.
I'm gonna have to call you back.
His fever's spiked at We sent vans running back to D-fac to get some more ice.
Try 800 milligrams ibuprofen I.
V.
Where's that lab report? These meds aren't working, Bobby.
They're not working at all.
Lab report, sir.
Gram-negative rods or variant strain.
That narrows it down to about a billion.
I would've thought the pip/tazos would've been effective.
What now? We'll just have to try another cocktail.
What about the third- and fourth-generation cephalosporins.
Do you concur? Bobby's the diagnostician.
Yeah.
Okay, let's do it.
Graham.
- Dr.
Tarzi may be out of Kandahar, but call him, see how fast he can get here.
- Yes, sir.
Oh.
I think that's yours.
Come on.
You don't want to miss your plane.
It's okay.
My flight's not till the day after tomorrow, so we have another night together.
Oh, actually, I'm on call tonight.
That's okay.
I'll-- I'll be around later.
Oh, I'm sorry.
I've got a, um, poker game with Mehra and Ford.
It's the last stage of the tournament.
It's all right.
I'll see you around.
Okay? There you are.
I thought you'd forgotten about our trip.
No, of course not.
Your women's clinic, right? Not my clinic.
Actually, it was Major Samizay's idea.
But I bet you ran with it-- I'm guessing.
All the female staff at the hospital have chipped in.
There's no heart strings involved.
The Afghan women really need our help.
I hope when you see it, you'll feel the same way.
I'm in.
Oh, enthusiasm.
Good.
Especially if you're in for the long haul.
Let's see what we've got.
Get Captain Trang and Colonel Marks.
The infection has spread to another patient.
[ _ .]
Good to see you.
Major Samizay.
Not many patients here today, but, uh, I hope we haven't wasted your time.
How many women do you usually see? But the rocket attacks have kept many way.
Well, let's get started.
It is gonna take a lot of paint to fill these holes.
Well, as long as it's safe and discrete, that's all that matters to them.
This patient came in with no signs of infection.
He had an open compound fracture to the tib-fib.
Was he in the I.
C.
U.
? Was he next to Hamasa? No, he was in the trauma bay, and then O.
R.
1, then recovery, and then to the patient ward.
Then his fever spiked, and that's when we brought him back here to monitor him.
We've got a highly contagious, antibiotic-resistant infection, which he may have contracted from Hamasa.
We have to isolate these two patients.
Trace back where they've been, decontaminate it all.
That could be half the hospital, Doctor.
Okay, Rebecca took Hamasa to the O.
R.
2 for a washout.
Both 1 and 2 have to be closed.
It's essential.
Seal off everything with plastic and be aggressive with whatever antibiotics we got.
Yes, sir.
- Any word from Tarzi? - No, sir.
Not yet.
Dr.
Tarzi could be our only hope.
All right.
Just keep trying.
Okay.
What's her name? Afsoon.
- Does she have any family here? - She came alone.
That takes some courage.
Please tell Afsoon that I need to look into her mouth at her throat.
I think she may have a serious infection.
Mm.
Doctor It's a peritonsillar abscess.
It's gonna need to be drained.
We'll have to get back to the O.
R.
at base.
She says no base.
If her father finds out or if she is seen and it gets back to the family, she could be killed.
She has a seriously infected tonsil that needs to be drained.
Can't you give her medication? No, she needs surgery.
Can you, um, ask Afsoon if she would like to recover? Good.
Then this might help.
What is it? It's Lorazepam.
It's just a mild sedative.
- For an abscess? - No, it's just to relax her a little bit until we can get her into surgery.
Rebecca I understand that there are risks.
I do.
But without an operation, she could die of an easily treated infection.
But how do you propose getting her onto base? It's a huge risk.
I think we'll enlist Afsoon into the army.
How many times have I told you, this is a classified area? Colonel, he was actually helping Hannah to reboot some software.
Vans is not here to help talk with I.
T.
He's a translator.
He translates Pashto, Dari to English.
Now I don't ever want to see him this side of the desk again, ever.
Do I make myself clear? As a bell, sir.
Don't worry about it, kid.
He'll get over it.
Now make yourself scarce.
Wait.
Okay? Graham, do we have a free O.
R.
? Yeah, O.
R.
2 is, but-- Good, can you ask Major Marin to anaesthetize? Major, shouldn't you check with the Colonel first? Believe me, Graham.
I can get her in and out in under five.
Major.
It seems we're double booked.
Uh, not at all.
I'm done.
Uh, take her to recovery, and I'll join you momentarily.
Recovery's quarantined.
So is I.
C.
U.
I have two patients infected with enterobacter.
We cannot have a free-for-all going on here.
We've set up some screens in the main ward.
Take her over there.
It's a little noisy, but it'll have to do.
Yeah, well, don't worry, 'cause she's not gonna be there long.
- Is that right? - Well, I could use some help here, Major, if you're not too busy.
Of course.
All right.
This foreign contractor's had 20,000 volts passed through him working on the city grid.
Lungs popped, intubated, stabilized arrhythmias.
Now I need another surgeon to check the burns on his limb.
And since you are here So your last patient was from the women's clinic? She had a seriously infected tonsil that needed to be drained.
You decided to bring her here on your own? She needed urgent surgery.
So does he.
Yes, sir.
He needs a Let's prepare for that.
Colonel, that young woman would've died without an operation.
- It was my duty to treat her, to do everything within my power that I possibly c-- - Within your power? What do you think this is, huh, role play? You brought that girl into this hospital without my consent, without her consent most likely.
So you saved her life.
Congratulations.
Have a cookie.
Now I have a responsibility to save lives, too-- servicemen and women, Afghans, as well as foreign contractors, aid workers, journalists.
You name it, we fix it, if we can.
Now I got two patients who are down with the same bacterial infection and we have no idea where it came from, what it is, or how to stop it from spreading.
But now you bring in an unauthorized admission into this hospital, and you endanger the lives of every patient in here.
Look, I get your point, Colonel.
I do.
But I did not know that there was only one O.
R.
available.
No, no, actually, Major, I don't think you "get" what I'm saying at all.
It doesn't matter whether there's one operating room or five.
You have no right to commit our scarcest resources without consulting me.
Do you understand that? - Do you understand that? - Understood, sir.
You do that one more time, and I will personally escort you onto the next plane out.
Do you understand that? Understood, sir.
Had you planned to get that young girl off the base when she recovered? Yes, Major Pedersen's standing by to drive her back to the clinic.
Good.
Lecture's over.
Sir.
We located Tarzi.
He's an hour out.
All right.
Heard about what happened.
Sometimes you get the bear.
Sometimes the bear gets you.
I would've done the same thing as you.
I just wouldn't have let him catch me.
So, um, snake eater, how well do you know Colonel Marks? Right.
'Cause if you tell me, you'd have to kill me.
Yes.
You must be a blast on a date.
Try me.
Oh.
Okay.
Yeah.
Uh, we can, uh, we could always get something to drink.
I don't drink, except Chai.
Chai? Chai is nice.
What's up? He's tachycardic.
130.
B.
P.
'S 183 over 98.
Temperature is 104.
Okay, let's break out the ice again.
Whatever this damn thing is, let's give the fluoroquinolones one last try.
Yes, Colonel.
What's happened? Her father found out she's here.
He's on his way.
Oh, Jeez.
Major Samizay's found a safe house where she can stay.
All right.
Well, let me just check her really quickly before she goes.
How's that? Good.
Good.
Okay, go before I get you in any more trouble.
Thank you, Major.
Good girl.
I appreciate everything you've done for me in the past.
And one day, I'd like to repay those debts.
Look, it's crucial for me that Hamasa pulls through.
Well, I've got a local G.
P.
-- Dr.
Tarzi.
He's coming in from Helmand.
Now when it comes to treating regional disease, this guy is the man.
Look, if you want me to go get him, just say the word.
He'll be here within the hour.
If anything happens, you will be the first to know.
Vans.
He wants to talk to you.
I told him you were busy.
Okay, can we help this gentleman? He says he heard what you did to Afsoon.
Well, tell him I am sorry, please, and tell him to not blame his daughter.
If he wants to blame anyone, you blame me, okay? Because I wanted to treat her and-- he thanks you from the bottom of his heart for saving her life.
The fluoroquinolones are not working.
We're down to one option.
Double amputation? He's too unstable.
He's gonna die if we don't operate now.
Resuming C.
P.
R.
No vitals.
Five, six He didn't convert.
Still a flatline.
No.
Ideas? Anyone? Okay, Doctor, I think we can call it.
Doctor.
Time of death-- Now we've had one fatality from this unknown infection.
Farrin arrested on his way to surgery.
Hamasa is holding on, but barely, and he's not responding to any of the antibiotics.
Well, what's been tried? Everything on the shelf.
Can we push the lab report from landstuhl? I call every half-hour, they give me the same response "we're working on it.
" Now the only thing that we can do to stop this contamination is to clean everything.
We've been doing that, sir.
We're scrubbing everything, 10% bleach.
Well, we're gonna have to do it again.
So I'd be grateful if you all committed yourselves to at least two cleaning details.
Graham, you got the list? Uh, yes, sir.
Oh, the mop thing again.
We're looking for volunteers for the first shift.
Those off duty are Larry Alexander, Pam Everwood, Bobby Trang, Simon Hill Simon? What's the matter? Are you following me? I wasn't following you.
Okay.
My mistake.
I'll see you later.
Wait.
I thought we liked each other.
Yes, we did.
Uh, we do.
And that's it? Of course.
Look, we had fun, okay? We had lots of fun, and, you know, I enjoyed every moment of it, every minute.
It was But you're-- you're getting on a plane.
This is about that new Doctor, isn't it? What, Rebecca? No, I'm not her type.
Look, let's just keep this memory sweet, shall we? And-- Beverly, just grow up.
All right? Just grow up.
He's asking me to say good-bye to his family.
He says thank you all for trying.
He's proud to have served with us.
Tell him to rest.
Okay? Tell him to save his strength for the infection.
Out here, you learn real fast It's not the guns or the airpower that-- that save you.
Guys like Hamasa Without him, I'd be dead.
That's certainly not in the manual.
Dr.
Tarzi wrote his own manual.
I think I've nailed the bugger.
Judging by the distinctive odor, the inflammation, and the redness, it's pseudomonas, all right? A common occurrence here in Southern Afghanistan which, as you know, causes lots of misery.
But you won't lick him with your fancy quinolones or your third-generation cephalosporins.
He's been exposed to those and eats them for breakfast.
What you need are some good, old-fashioned polymyxins.
I thought that stuff went out with the ice age.
But never too late for a comeback.
Thank you.
Graham, get on to the other coalition m.
T.
F.
S in Afghanistan-- bastion, etcetera.
See if anyone's carrying stocks of old-school polymyxins, and get Mehra and Ford on standby to go fetch.
One more thing, Colonel.
Shoot.
You can't mess with this guy.
It can live on practically any surface, in any environmental condition, and it's very hard to kill.
- You're bleach cleaning everything? - Everything.
You may have to do it over and over again, until you're sure it's gone.
A mosquito's eyelash can carry enough pseudomonas to shut down the whole base.
And keep the I.
C.
U.
and O.
R.
S sealed until you're sure those older 'biotics work.
The skin rash? Vinegar.
5% strength.
Works better than any topical treatment and is a hell of a lot cheaper.
Yeah.
Thank you, Doctor.
My pleasure, Colonel.
I'll pop back later, see how you're getting on okay.
He's quite a character.
Excellent backgammon player, too.
Mosquitoes have eyelashes, sir? Dr.
Tarzi's approach, you get local knowledge and poetry.
No patients pending? Mnh-mnh.
Then go, clean.
Colonel, bastion and the other m.
T.
F.
S have nothing.
And all the nearest fobs recycle their stocks every three months.
Ah, no, no.
We can't sit around to empty the phone book.
Let's try spin Boldak.
Three international aid agencies operating out of there.
Let's see what they've got buried in their freezers.
All right? Where we headin', sir? - Southeast border.
- Any place in particular? That's kind of a big spot to land on, sir.
No, we're gonna let you know when you're in the air.
Okay, so what are you waiting for? Let's go.
Go! Go! Go! Go! So what are we doing? A little sightseeing, shopping, no rush.
- Girls in bikinis steaks by the swimming pool, a little water polo.
- Polo? Yeah.
- Someone mentioned that they had a casino.
- Oh, yeah? Oh, mama, look at me As happy as a boy can be Oh, now I can't decide Just fill me up and blow my mind Now take a ride with me And tell me how it's gonna be Oh, no, you can't decide And you thought the mop routine was a joke? Simon's version, not mine.
- All right, the ward and the hallway are clear, so let's seal it off.
- What, we can't use it? No.
We're gonna keep this whole area completely sterile until our patient's infection's reversed.
Hold it.
Hold it.
We got a contamination in here.
Leave the casualties out here.
Colonel, what are we gonna do, huh? Can't take 'em back inside.
Trauma's closed.
Well, first, let's see what we got.
Simon? Okay, we've got a neck wound, shrapnel near the spine.
Abcs are fine.
Patient conscious and responsive.
Great.
D-fac.
- What? - You heard me.
Dining facility.
Move! Pam, Suzy, get the equipment over to D-fac.
Yes, sir! Colonel, we got a bleeder.
Follow Simon.
D-fac, right away.
Will? Nothin' doin', boss.
Patient's dead.
Will, take him inside.
And call the padre, please.
Yes, sir.
I was thinking about ordering in tonight.
Pulse 148.
What, are you afraid of a little blood in your food? Well, it's not the blood that bothers me.
It's what lives in it.
You know there's ten times more bacteria in the body than-- than there are cells.
Yeah, yeah, yeah.
Labs confirmed it's a real nasty pseudomonas strain, unique to Afghanistan.
And Landstuhl is alerting R.
C.
South and advising them to shut down all surgical operations here.
So, colonel, what do we do if we get a mass Cal? I don't know.
It's unthinkable.
I mean, we'd have to turn away our own injured soldiers.
The truth is, with this infection gone unchecked, we can't dispense anything more complex than a band-aid.
Simon, we're using the ready room as temporary in-patient ward.
One of my nurses was just crying right now.
- She wouldn't tell me why.
- Oh, I'm sorry to hear that.
You know, you can screw the Doctors, and they can screw you, too, for all I care.
But you leave my nurses alone.
Whoa, whoa.
Wait, wait, wait.
Hold on, guys.
- Are you talking about Beverly? - Yeah, you know I am.
Oh, look, she was scheduled to go home, okay? - She must have known it wasn't gonna go anywhere.
- Oh, you think she did? Come on.
Look she knew exactly what she was getting into.
Okay, if I was to promise you that I would never sleep around again, would you believe me? No.
Well, there you go.
Whoo, yeah.
Caesars Palace, baby.
Jackpot, sir.
We got your meds.
Way to go.
If the meds don't work straight away, we're gonna have to put him on a ventilator.
I want him to know that that means inducing a coma.
And there's no guarantee of a return ticket? Believe me, it's his best chance.
Okay.
All right? Are you kidding me? Put some spirit into your swing, Simon.
This I do not believe.
- This is heaven, man.
- There is a God, and we get to live happily ever after.
- Okay If you want to see the pot for last Saturday's game, I suggest you delete those.
Mission success? Good work, guys.
You should be suited and booted with those stitches.
I'm gonna be okay.
You know you'll have to stay in there until I know.
Don't let the bear get you, Joe.
Colonel, we got a result.
Well, I think we're nearly out of the woods.
Polymyxins finally seem to be kicking in.
What about our friend? He'll have to strip down completely before he gets out and take a long, sterilizing shower.
He looks like he could use a good scrub down anyway.
I'd like to reopen the I.
C.
U.
If I had the luxury of an I.
C.
U.
, I'd never close it.
What about the risk of contamination? Well, you'll never be completely rid of this infection in Kandahar.
You know have to balance such concerns with staying open for business.
True.
I just don't ever want to be in a position where we're having to turn our own men away.
Well, there you go.
Decision made.
Open for business, people! Your new roommate? Come in.
Don't mind me.
I'm sorry.
I made a real mistake.
I thought You cared about me.
I I was being silly.
Oh, now you are being silly.
I do care about you.
I just Look I'm a neurosurgeon, okay? We don't do ordinary.
It's like the mop thing.
You know, you Romance okay? That--that's--that's great for other people.
It's just Not me.
Look, what you need to do is you need to go home And you need to find someone who's right for you.
Okay? Vans.
I want you to have this.
Is it broken, Colonel? I can try and fix it.
No, it's not broken.
I want you to keep it.
- All right? - All right.
Thank you, sir.
This is awesome.
Just stay out of toc.
It's a restricted area.
You clean up good.
Thank you kindly, ma'am.
Well, I always go for a man in uniform.
What, this old thing? - It's just till I get it to the end and pass.
- And then? Back in the fray.
Oh.
So no Chai.
Can I take a rain check? By the way, Hamasa wants to thank you all.
I'm also grateful.
I gotta go.
Catch you later? Sure.
For that cup of Chai.
Visiting hours over? Ugh.
I don't know.
I apologized to bev, told her the truth-- you know, that I'm a bastard.
I don't think she believed me.
Hmm.
Well, I can't imagine why.
Well, thank you.
That's most kind.

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