The Night Shift (2014) s04e04 Episode Script
Control
1 Previously on "The Night Shift" His intestine is twisted and his bowel is dying.
We need to open him up.
He needs to go to the O.
R.
now.
On the base? That's impossible.
- Duke, all we need is a ride.
- I already said no.
As far as you're concerned, I'm your final say on transport.
It's a security risk.
You need to let this go, Callahan, because it's not gonna happen.
So you're just gonna let him die? Sorry, Doc.
It's out of my control.
Okay, Doc.
Lucky day.
Mama must've had something real.
Amira: I can't believe you told the mother to give false intel.
- T.
C.
: So what? - Amira: If she set up an ambush or if she's acting on some old vendetta, that's on you.
Later, ladies! - [Gunfire.]
- It's a setup! - Now! - [Man shouting indistinctly.]
Man on radio: Duke's MIA! [Siren wailing.]
Mid-30s, rock climber, no I.
D.
, fell close to a hundred feet.
Cain, I need a hand here.
Fire up the ultrasound.
He's got multiple leg fractures, a chest wall deformity with progressive shortness of breath.
Any neuro? Intact.
GCS 15.
Lucky and stupid.
He was wearing a helmet, wasn't using ropes.
On three, okay? One, two, three.
[Man groans.]
We've got a flail chest.
Okay, sir, my name is Dr.
Alexander.
Dr.
Diaz.
And we're gonna take care of you.
- Let's get an ultrasound.
- C-spine is clear.
[Velcro rips.]
Jordan: Okay, Martin, just keep breathing and try to relax.
[Machine beeping.]
Flail chest with a pneumothorax.
- Get a chest tube started.
- Yep.
Okay, sir, you have multiple fractured ribs and a collapsed lung.
Dr.
Diaz is going to insert a tube in your chest to reinflate your lung.
Why anyone would want to climb without ropes is beyond me.
Some people think it's a form of meditation.
- It's called free soloing.
- Don't tell me you do it.
Whenever I get a chance.
Another adrenaline junkie in the E.
R.
Surprise, surprise.
Pulse ox is down to 80.
- You need help with that chest tube? - Nope.
I got it.
Flail chest is painful, so I gave him a nerve block.
And chest tube's in.
He's stabilizing.
All right.
Good job.
Let's find out what his name is and get him upstairs for a C.
T.
and X-ray.
- This guy's in the military.
- Well, he's in the right place.
- Hello, Ms.
Mills.
- Hi.
I'm Dr.
Rivera.
What brings you in today? Isn't it obvious? Let me examine it.
How long have you had it? Ever since I can remember.
Everyone calls me "The Freak.
" Any headaches, blurred vision? Any previous treatments? Well, we don't have many doctors in Faywick, Texas.
It's a desert town.
Every once in a while, we get a roaming clinic.
One of the nurses suggested I come to SAM.
I know Faywick.
It's a 6 1/2 hour drive from here.
8 hours by bus.
That's why I need you to help me now.
I-I can't get off of work again.
- And where do you work? - A grocery store.
I, uh, do the restocking.
I could make more as a checker, but the manager says that the customers don't want to have to look at me while they're buying food.
What an ass.
- Sorry, that just - No, he is.
Just please, help me get this thing off.
Let's get a surgical consult, and then I'll put you in line for an MRI.
But if it all checks out like I think it will, you won't have to worry about this anymore.
Thank you.
[PA tone chimes.]
Woman over PA: Central Supply to Nurses Station - [Yawns.]
- You and Rick out late? Ha.
Yeah, good one.
Barely slept in two weeks.
Brianna's homework? It's, like, three hours a night.
Plus dance lessons, plus physical therapy.
It's, like, I'm not getting any sleep.
- Not good, man.
- Don't get me wrong.
I love being a parent, but it is kicking my ass.
- Man needs his sleep.
- [Yawns.]
Uh-huh.
Tell you what, I'll throw you the easiest case tonight.
Maybe if it's slow, you can grab some shut-eye.
Oh, I owe you.
And maybe some nights, I can crash on your couch.
I'm sleep-deprived, too, listening to the headboard slamming against the wall all night and other high-pitched squeals.
- And I'm talking about Paul.
- [Laughs.]
Oh, hey, Kenny.
Enema.
Curtain 4.
They're waitin' on ya.
Yeah, I'm on it.
I freakin' hate that guy and his little kit.
Guy's always making these wooden carvings for the nurses.
Good point.
What a dick.
No, my my point is, it's all a show.
I mean, who the hell wants these stupid little animal carvings anyway? So I guess I shouldn't show you the adorable dolphin he made for Brianna? That wouldn't be good? It's really cute.
Look, you guys got off to a rough start.
All right? Just chill, and everything will work itself out.
Yeah, sure.
Anyway, 44-year-old male in Trauma 4, uh, with epigastric pain, normal EKG.
I think all he needs is the GI cocktail.
Man on radio: Spartan 2, we have located Duke.
Repeat, we have located Duke.
Got it.
Got it.
Area's being prepped now.
Saddle up, ladies.
[Guns clicking, men speak indistinctly.]
We got Duke's signal and a location on him.
- Moving out now.
- [Radio static.]
I'd like to be included in the extraction.
My name's - I know who you are, Callahan.
- Oh.
You're the idiot who got Duke jacked up with that bogus intel.
- No, that's not what - Save it.
I don't have the time.
I have my best friend a man who's had my back for five years and he's out there alone.
- You've done enough.
- Hey - Greggs.
- Sir.
You're taking Callahan.
He's a doc.
He could be useful to us.
We don't know his condition.
Yes, sir.
[Pats arm.]
Some nerve going over my head.
You can thank me later.
Hey, look, I'm not just some pouge doctor, okay? - I was a Ranger.
I - Then you should know better.
You put another one of my men in harm's way, this war party comes back a little smaller.
I will bury you out there.
We S.
P.
in nine minutes.
Have your candy ass on the truck by then or it leaves without you.
I didn't ask you to do that.
That's a funny way of saying thank you.
Look, you wanted to go, and now you're going.
And I can take care of myself.
You did that before, and now Duke is MIA.
And if it weren't for me, you'd be at the business end of a beating.
Nothing I haven't worn before.
Not at the hands of men like these.
- Okay.
- Yes, okay.
You better kit up.
You've only eight minutes left.
And you better hope they find Duke.
Hey, Dr.
Alexander, meet former Marine Martin Easton.
Hey, there, Martin.
How are you feeling? Still in pain, but better.
So where were you deployed? Did two tours, ma'am.
Last one in Fallujah in '04.
Mm.
Fallujah that was a hot spot.
- I'm not looking to go back.
- Yeah.
So you were free soloing? Is that something that you do a lot? All the time.
I find it meditative.
That's exactly what I was telling Dr.
Alexander.
There's nothing like it, right? You know, all things considered, you're very lucky.
You know, I had a friend who took a 70-foot fall.
He, uh, hit the ground like an accordion.
Crushed every bone in his body.
It's a miracle that he lived.
You had your own little miracle today.
Sure doesn't feel like it.
This effin' hurts.
[Laughs.]
I'm sorry about the "effin'," ma'am.
It's okay.
Hey, did your friend ever climb again? No.
But you, I think you, uh, have a pretty good shot.
Take those to get sterilized.
[Loud clatter.]
- [Breathing rapidly.]
- Martin.
- No.
No.
- Martin, hey, hey, hey.
- No! - Whoa, whoa, whoa, whoa.
- Mollie, I need Ativan now.
- Martin, look.
We got you.
- No, no, no, no, no, no.
- Stop! Stop it! Stop it! He pulled out his chest tube.
- Stop it! Stop it! - Calm down.
- Stop.
- Pushing 1 milligram of Ativan.
Stop it! We've got you.
[Breathing heavily.]
It's gonna be okay.
[Monitor beeping steadily.]
I think it's clear there's more than just broken bones here, huh? Yeah.
Tina, this is Dr.
Clemmens and Dr.
Cummings with surgery.
Hi, Tina.
Wanna let you know, we took a look at your MRI, and it's clear, which is really good news.
But before we move forward, I wanted to take a look at your neurofibroma, which is a fancy way of saying - This thing on my face.
- Yeah, I'll go with that.
All right, let's see.
Yeah.
Dr.
Rivera, I believe your initial diagnosis is correct.
This does not look like it extends beneath the surface layer.
Which means we can take it off for you.
Which I was getting to, Paul.
- Thank you.
Thank you.
- [Laughs.]
- Thank you.
- [Knock on door.]
Excuse me, Doctors, this is Tina's grandfather, Carl Mills.
You left without telling me.
I knew you wouldn't let me.
Whoa, whoa, whoa.
What's going on here? This is my granddaughter, and I want her discharged now.
Come on, get up.
We're leaving.
We're leaving.
Get up.
No! I can't.
Mr.
Mills, your granddaughter is a grown adult.
I think she can make her own decisions.
Grown? Is that what she told you? Tina is 16 years old.
Go on, tell 'em.
Tell 'em how old you are, Tina.
Tell these people.
I'm sorry I lied.
I just want this thing off of me.
Come on, let's go, baby.
Come on, get your things.
I can't! Grandpa, I can't! Come on, let's go.
We're gonna get out of here.
Okay, sir, sir.
Sir, I understand that you're upset.
And I don't mean to interfere with your personal life, but Tina came here because she's suffering.
You're only given what you can handle.
- We're leaving.
- Mr.
Mills, so if this if this has anything to do with money, we can absolutely make arrangements.
It's nothing to do with money.
She knows that.
We're Jehovah's.
We don't want any surgeries that require blood transfusions.
Shannon: It's not about you.
It's about her.
She wants to lead a normal life, - and the only way she can do that is - Okay.
Dr.
Rivera.
Dr.
Rivera.
If I need a transfusion, just do it! Tina! There are things we can discuss.
There are ways to restrict and limit blood loss during surgery.
Can you promise she won't need a transfusion? Then I'm taking her home! - And I said I'm not going! - Tina, what are you doing? - I want it off! - Paul: Hey, okay.
Okay.
I'm not! [Crying.]
Come on, all right.
Just calm down.
Aah! - No, no! - Mollie: I'll go get a gurney.
- Oh, my God.
Oh! - I got you.
- Oh, my God.
- Shannon: We need help in here! - Tina.
- Oh, my God.
Tina! - She's unresponsive.
- Tina! Crash cart.
Prepare for intubation.
What have you done, Tina? Mr.
Mills, for everyone's safety, I need you wait outside.
Help her.
No, no, help her! Tina! Tina! I need you to wait outside.
Shannon: I'm in.
Sats are going up.
This bleeding's out of control.
The tumor is hyper-vascular.
We gotta get to the source.
- BP is 68 over 35.
- The O.
R.
is ready.
She'll never make it up to the O.
R.
We gotta do this here.
Trauma 2.
Now.
Let's go! Good evening, Mr.
, uh, Wilson.
I'm Dr.
Alister.
[Strained voice.]
Call me Arthur.
This cramping in my stomach hurts really bad.
How long have you felt it? Since I had some Alamo Peppers two days ago.
- You take anything for it? - No, no.
This hurts much worse than indigestion.
This could be gallstones or an ulcer.
[Inhales sharply.]
Maybe even a heart attack.
All right, let's not jump to extremes quite yet.
Can you sit back for me, please? It's hard not to.
I have a long medical history dating back to 1993 when I had my first surgery.
Uh, which was for what? Ah! An undescended testicle.
I'm pretty sure your current discomfort is unrelated.
Now who's jumping to extremes? [Groans.]
I cannot believe you free soloed El Sendero Luminoso, man.
- Even I wouldn't touch that.
- [Chuckles.]
Hey, sorry to interrupt.
Martin, how you feeling? A little sleepy, but less pain.
Okay, good.
I'm glad that you're feeling more comfortable.
Okay, um [Sighs.]
so your chest C.
T.
shows signs of a bruised lung.
And your X-rays found multiple leg fractures, which Orthopedics will resplint after their consult.
But before we get to all of this, I wanted to ask you about the incident that happened earlier.
What incident? After the surgical tray crashed to the floor, you started screaming.
I don't remember that.
Well, you were yelling and screaming at us to stop.
You got so agitated that we had to sedate you.
[Sighs.]
Told you, I don't remember.
Okay.
How's your sleep? Fine.
Any, um, memories or nightmares of your time in service? - No.
- Lingering anger, irritability? - Stop, please.
- Stop what? You're asking me the same PTSD questions those Navy shrinks asked me years ago.
Let me guess what's next.
Any psychological numbing, too? Right? Look, I'm gonna tell you the same thing that I told them.
I don't have PTSD and I'm really tired of people telling me that I do.
Well, I didn't say that you did.
But you're thinking it.
Look, I like to climb alone.
That's it.
- Okay, okay.
We get it.
- You don't get it.
You don't get it.
So just fix my broken bones and leave my head out of this, okay? Any ideas? Yeah.
I'm gonna contact someone who I think can help.
Okay.
Greggs: Duke's signal is within a hundred meter perimeter.
- Get ready to move.
- [Radio static.]
- Hey, where are we go - You don't speak, Cinderella.
You stay shush in here and wait for your glass slipper.
- You come when we call you.
- Smoke out! [Gunshot.]
[Explosion, gunfire, men shouting indistinctly.]
This is Spartan 6.
We're under heavy contact.
Contact, front! Move, move! - [Men shouting indistinctly.]
- Aah! Man: Greggs is hit! Greggs is hit! [Gunfire continues.]
I told you to stay back.
Shut up and do what I say if you wanna live.
Man: Spotted Duke.
Need more fire power.
He's pinned down.
- [Groans.]
- [Speaks indistinctly.]
You're hit in the femoral artery.
Think I don't know? Another inch, and my nards would've been ribbons.
You lose your balls, you'd still be alive.
This bleed may kill you.
Okay, look, I gotta stop the bleeding.
- This is gonna hurt, okay? - Just do what you gotta do.
- You sure? - [Grunts.]
- Ready? - Uh-huh.
[Screaming.]
Don't move.
My knee's keeping you from bleeding out.
- Keep your head down.
- You're no good to me dead.
Aah! [Groans.]
[Monitor beeping steadily.]
Even with the clotting agent and clamping, I can't control the bleeding.
If we can embolize the artery, the bleeding will stop.
BP is down again.
Hemoglobin is down 5 points.
Draw up push dose epi, get a level one infuser and start the massive transfusion protocol.
Just throwing it out there, she's Jehovah's No, she isn't.
Her grandfather is.
The law says parents may be able to martyr themselves, but not their children.
When Tina cut herself, she was trying to take control of her life.
I intend to give it back to her.
She's bradying down.
Pulse is 56.
All right, paradoxical bradycardia.
Give her .
5 milligrams of atropine.
Line secure.
Ready for embolization catheter.
Doctor, she lost her pulses.
- Call a code blue! - [Flatlining.]
- She's in v-fib.
- Starting CPR.
Put the pads on.
Charge it to 200 joules.
- Give 1 milligram of epi.
Let's go! - [Defibrillator whines.]
- Charged.
- Clear! All: Clear.
[Paddles thunk.]
[Monitor emitting continuous tone.]
Another milligram of epi.
Start amiodarone 300 milligrams, charge it to 200.
- Charged.
- Clear! Shannon and Jocelyn: Clear.
[Paddles thunk.]
[Panting.]
She's been down for 15 minutes.
[Monitor emitting continuous tone.]
Don't watch the clock, Kenny.
Just keep pumping.
All of our blood products have been transfused.
- We're on our last unit of RBCs.
- Scott: Switch out.
I can't embolize the bleeder.
She's moving too much from the CPR.
We can't hold a compression for that long.
We can and we will once she's on ECMO.
Where the hell is it, Jocelyn? They said it's on the way.
The elevators are slow.
Are you kidding me? Tell security to hold all traffic on those damn elevators until the ECMO's in this E.
R.
- Go.
Go, go, go! - Okay, okay.
Got it.
Kenny, I need you on the phone with the blood bank.
Tell 'em what they sent over won't be enough.
On it.
You really think Tina's still got a chance? She's with me.
She's got a chance.
It is my understanding that your granddaughter is still fighting.
That's all you got to say? What does that mean? I know.
It's not a lot to go on.
But I can promise you that she has the best surgeon in the state, and he will not give up.
I must also inform you that they are going to need to perform transfusions.
I clearly told that doctor I did not Mr.
Mills, I was told that she understood the risks of a transfusion.
And there is no other way.
She will not survive without them.
It's grounds for disfellowship.
Do you know what that means? Yes.
I do.
My father he was a Christian Scientist.
And I've learned that beliefs can cause you to lose someone who is very dear to you, which is something that I haven't stopped regretting since the day he died.
I will never regret my beliefs, Doctor.
Do you have a chapel? Yes.
I do.
It's down the hall and to the left.
Mm.
And we will update you regularly.
- Mm.
- Cain: Hey.
- [Gloves snap.]
-I see Martin's V.
A.
records are up.
- You might wanna take a look.
- Okay.
All right.
Uh, he was diagnosed with PTSD and refused treatment.
- Yeah.
- When does he get out of C.
T.
? They said they were gonna bring him down in a couple minutes.
Hey.
Have you guys seen my wood? Excuse me? My wood.
It's it's missing.
Vicki, have you seen this man's wood? I certainly have not.
Doctor, you might wanna, you know elaborate.
Oh.
No, my iron carving wood.
I-I-I left it right here.
- Oh.
Hmm.
- Hey, Jordan Hey, Kenny, did you take my carving wood? I don't know what you're talking about.
No, it was right here.
The the wood's valuable to me.
It's not easy to find.
Well, then, maybe you should keep better track of it.
I'm busy saving lives, not worried about your toys.
- Jordan, you got a minute? - Yeah.
Cain, could you just excuse me for a moment? Where's my wood? All right, look, Tina's been down for 25 minutes, and Scott's starting ECMO.
And you're telling me this because Look, I know I'm not a doctor.
I'm just saying we have a whole room full of patients and we're using all the blood in town.
And Scott I don't know.
He just seems agitated, not himself.
And I thought, maybe with his past Okay.
Yeah, I'll check in on him when I have a second.
- Okay, thank you.
- Thank you.
Great news.
Your test came back negative.
- There's nothing wrong with me? - Mnh-mnh.
Then why do I feel like this? - Have you been under stress lately? - No more than usual.
I mean, I am a very anxious and neurotic person.
- Oh.
- But who isn't nowadays? Yeah, uh, I'm gonna write you a prescription for Xanax.
That should take care of it.
Then I want you to follow-up with your primary care doctor - in a couple days.
- [Groans.]
Oh, gosh.
My stomach it's twisting and turning.
Please don't quit on me.
Everyone always quits on me.
Okay.
Uh, okay.
We'll we'll run a scan.
Okay.
Thank you.
[Sighs.]
Thank you.
[Exhales deeply.]
Still working on that same patient? - Thought he was a simple G.
I.
- Yeah, so did I.
Part of me thinks he's just a hypochondriac, but I'm so exhausted, maybe I am missing something.
I'm gonna run the test again just to be sure.
- [Monitor emitting continuous tone.]
- H&H is still dropping.
Where the hell is our blood? Finally! All right.
When she's on bypass, we can stop compressions and block the artery.
Even if we get the ECMO working, it isn't recommended for hemorrhagic shock.
Sometimes medicine isn't black and white, Paul.
Sometimes you gotta find the grays.
So stop debating me and ready the art-line, - or I'll come do it myself.
- Of course.
You're in your second year of surgical residency.
You should know by now that impossible is for other people, not for surgeons.
- You almost done? - Securing the line.
[Monitor emitting continuous tone.]
Prime the circuit.
Set the flow to 3 liters per minute.
[Machine whirring.]
She's on ECMO.
Okay, we can stop compressions now.
Okay.
Let's embolize the artery.
And if it doesn't work? Then we go to plan "B.
" Okay, listen up, hey! Everybody, listen up! We are not giving up on Tina.
You understand me? I don't want any more second guessing.
If you can't handle it, tap out, and send somebody in here who can.
Let's go.
[Monitor emitting continuous tone.]
[Siren wailing in distance.]
- Hey.
- Hey.
Thank you for coming in.
I hope I didn't wake you.
No.
I was doing physical therapy.
Mm.
You'd be proud of me.
I can jump a whole half inch now.
Baby steps, all right? It's gonna take a little time.
All right, enough with the pep talk.
I gotta sit down.
- All right.
- [Grunts.]
So you said you needed my help with a vet.
Yeah.
Uh, Marine.
Fallujah '04.
- Mm.
- Yeah, he survives that hell, and he comes back and climbs mountains without ropes.
He takes a hundred-foot fall like a boss, but metal tray gets knocked over, and he freaks out and says he doesn't remember anything.
What do you think? I went through the PTSD checklist and he doesn't present any of the classic symptoms, but he's been through the V.
A.
system, and they say that he does.
So they tried to get him Turn him into a zombie.
Yeah, he won't take medication.
Now he insists that's okay, but I know that he's not.
So I was hoping maybe you would talk to him, vet to vet.
Why me? Why not Drew? Any of the other vets you got here? I thought that maybe I'd get as much out of it as he would? Yeah.
You're not gonna stop trying to save me, huh, Jordan? A girl can dream.
All right.
[Grunts.]
- I'll talk to him.
- Thank you.
Yeah, yeah.
Beats sitting at home trying to touch my toes, which, you know, hell, I wasn't doing before the tumor.
[Gunfire, men shouting indistinctly.]
Aah! No, Greggs, stay with me, buddy.
Spartan 2, we cleaned them out.
We got Duke.
- [Loud groan.]
- That's Greggs.
- T.
C.
: One, two, three.
- [Panting.]
[Grunts.]
- Man: Just get out of here.
- Is he okay? He's lost a lot of blood.
I need every medication you got in your kits.
He dies, Callahan, you're a dead man.
- I'm in.
- Good.
Okay, now release the Gelfoam, followed by the microcoil.
[Monitor beeping steadily.]
You did it, Paul.
The bleeding stopped.
- [Claps hands.]
- We got it.
How long has she been down? 41 minutes.
But does she have any brain activity? Did you run an EEG? Jordan, if you're here to tell me to call it, I'm not going to, so save your breath.
- Scott, a moment.
- No.
This is my patient and I've got my hands full, so please step out.
You're right.
She's your patient.
- [Monitor beeping rapidly.]
- She's in v-fib again! Charge to 200.
Give 1 milligram of epi, 150 of amiodarone.
- [Defibrillator whines.]
- Paul: Yeah, we're charged.
Arthur, I misread one of your tests.
We gotta get you dialyzed immediately, or your kidneys will shut down.
- But you said it was fine.
- Yeah, I was wrong.
Okay, Nurse Mollie's gotta place a large Foley catheter - in your penis.
- My penis? It should only take a few tries, but I'll get it in there.
Wait! Stop! This shouldn't be happening.
- [Spritzing.]
- See? The sweat is fake.
This whole thing is fake.
I-I'm just an actor.
I'm pretending.
- Yeah, we know.
- I Googled you.
I love the Google.
Tell him what we found, Drew.
Besides a lot of dinner theater and a steampunk musical in '07 that flopped, we learned you work for a company called Treatment Strategies, Inc.
Yeah, they get people to pose as patients so they can review the customer service of a hospital.
My cousin down in Galveston said people got fired at her hospital.
Okay.
Okay.
Okay, you got me.
I'm sorry.
It's a job.
But you were just kidding about the penis, right? Yeah.
Arthur, we were.
You're healthy.
And I spent all that extra time trying to get to the bottom of your symptoms, trying to help you.
And meanwhile, we got real patients here with real problems who need real help.
You understand that?! Get the hell outta here! - Is there a bathroom? - Yeah, it's right down the hall.
[Telephone ringing in distance.]
So you and Mac go way back? Yeah, I mean [Sighs.]
when someone saves your life, you tend to form a quick bond.
Hmm.
Plus he saved T.
C.
and Topher in Afghanistan a year ago.
So this is payback? Yeah, you can say that.
Hmm.
What's with you and free soloing? Yeah, it seems a little crazy to me.
The same as Martin.
It, um, gives me peace.
But you weren't in Fallujah.
No.
You know that friend I told you about that took that fall? That was my cousin.
Actually, more like a brother to me.
He was this amazing musician.
Anyway, I found him at the bottom of that cliff.
He was a mess.
They reconstructed his spine, but his mind, they could not fix.
He just sits in a room now, stares at a wall like a robot.
- That's terrible.
- You know what's terrible is that he wasn't climbing.
He was thrown off.
God.
So who would do that? Got in with the wrong people.
So while I feel for your friend and Martin, there are other types of wars in this world that make people want to meditate and climb.
I'm sorry.
Yeah.
No, no, we all are.
Excuse me.
[Monitor emitting continuous tone.]
She's still in v-fib.
We'll shock again at 200.
Another round of epi.
- Paul: Charging.
Clear.
- [Defibrillator whines.]
All: Clear.
[Paddles thunk.]
[Tone continues.]
That was the fifth shock.
Still no cardiac activity.
Jocelyn, get me another defibrillator.
- And a second set of pads? - Yes.
Double dose of electricity? I've seen it work before.
- Charge both machines to 200.
- [Defibrillators whine.]
- Charged.
- Clear? All: Clear.
Three, two, one.
[Paddles thunk.]
[Monitor emitting continuous tone.]
Recharge.
Scott? The grandfather's getting antsy.
He wants a progress report.
[Defibrillators whine.]
Okay, both machines charged to 200.
Tell him she's still fighting, and so are we.
- Three, two, one.
- [Paddles thunk.]
[Siren wailing in distance.]
Hey, I'm not bothering anybody out here.
I'm just waiting for a ride.
For what it's worth, I'm really sorry I wasted your time.
Relax.
Arthur, I shouldn't have yelled at you earlier.
Truth is, I just became a new dad, and you probably got the brunt of my sleep deprivation.
Oh.
Oh, I get the sleep thing.
I have two girls, which is why I do this job, which I hate.
[Chuckles.]
Yeah.
So, um, your new kid, is it a boy or girl? Uh, teenage girl.
- Oh.
- [Cellphone beeps.]
13.
Me and my husband adopted her a few months ago.
Just managing the time thing, you know, two jobs, her stuff.
No grandparents helping? I mean, my mom she watches my kids after school.
It's a huge help to me and my wife.
That'd be nice, but, uh, it's not gonna happen.
Oh.
Your folks they're not around to help? Ah, it's a little more complicated than that.
Let me guess.
Your parents, probably your dad, doesn't approve of you being gay, so you have an estranged relationship.
And your mom, even though she's old-school, she sides with him out of a sense of wifely duty even though it hurts her not to have a relationship with her new grandchild.
Hell of a guess, Arthur.
You're freaking me out.
[Laughs.]
It's the actor in me.
We study the human condition.
Drew, Scott needs you.
All hands on deck.
Ah, coming.
Uh, and, Arthur, it's been interesting.
- Yeah.
- Good luck to you.
All right.
Cool.
Don't you dare go back in there.
Oh, no, I wasn't.
I was just I was [Bracelet thuds.]
[Siren wailing in distance.]
[Touchscreen clicking.]
Reaper Base, Reaper Base, this is Spartan 2.
We are 8 mikes out with one emergent surgical.
Hang on, buddy.
We're gonna get you there.
- Duke, I'll check you out - I'm fine.
You just save Greggs.
Put these on and give me your hand.
[Gloves snap.]
Okay, you're gonna put your finger in the wound and rest your right hand on the artery.
And don't move or he'll bleed out.
Okay? I'm putting Celox in the wound to tamponade the bleeding.
- It'll hold for a little while.
- [Grunts.]
Move your finger.
He's soaking through the Celox.
I gotta change it out.
Okay, hold right there again while I do that and start an I.
V.
- [Groaning.]
- It's gonna be okay, Greggsie.
You're gonna be back in Tampa in no time.
See Cindy and the boys, huh? Go to a Bucs game.
Watch 'em blow a fourth quarter lead again? [Thump.]
Look, we're still 6 klicks from Yuma, okay? He loses any more blood, he won't make it another 2.
Keep it tight! Have Amira prep the O.
R.
We're coming in hot.
Three, two, one.
[Paddles thunk.]
- [Monitor emitting continuous tone.]
- How can I help? Anything to get her heart beating.
Uh, what about esmolol? I just read about it stimulating Esmolol.
That's a good idea.
25 milligrams of esmolol and hang a drip.
[Lowered voice.]
Hey, how long has this been? 53 minutes.
At what point do you stop? I think we passed that point a while ago.
Recharge.
[Defibrillator whines.]
[Beeps.]
[Door squeaks.]
[Pills rattle.]
T.
C.
: Amira! Amira! Amira? Glove up.
It's Greggs.
He's bled out.
We had a bumpy ride.
His wound cavity's expanding.
GSW to the left femoral artery.
- Thank you.
- What happened out there? Well, turns out, Syria's not very friendly.
Can you prep while I intubate? Transfuse 4 units of O-neg and a 1,000 milligrams of tranexamic acid.
Okay.
I'm in.
I'll place a ER-REBOA catheter while you harvest the saphenous vein for a graft.
Okay.
Let's go.
After all this, I don't wanna have to tell these Navy SEALS that their boss didn't make it.
[Monitor beeping steadily.]
[Monitor beeping steadily.]
- A moral injury? - Yeah.
It's a new diagnosis.
It's different than PTSD.
It's when you do something you wouldn't do in your regular life, you know.
Maybe you were ordered to.
Maybe you had no choice.
Isn't that a lot of what war is? I Yeah, pretty much, but this is more personal.
Say you're driving an M35 through a crowded marketplace, and ambush comes out of nowhere.
Bullets are pinging off the metal.
Put your foot on the gas to bolt, and next thing you know, you're rolling over a woman.
You see her face before you hit her, the pleading, the fear in her eyes.
She knows she's about to die in front of her kids, but what are you gonna do? You gotta do it.
You know, you gotta save your guys.
Is that Martin's story? No.
That's someone else's.
Anyways Martin's gonna join a support group, and, uh, maybe someday, he'll be strong enough to tell you his story, but that's his call.
Do you want a job? [Scoffs.]
Nice segue.
Yeah, how 'bout tight end for the Bears? They could totally use one, but actually, um, I was thinking about here at SAM.
We can start an outreach program for veterans, give them a place to go, give them the care that they deserve.
I'll think about it.
Right.
Okay, yeah.
Just, uh you know, let me know.
All right.
I thought about it.
I'm in.
What else am I gonna do with my time? Ah.
Yeah.
there's the positive spirit that I love.
[Laughs.]
All right.
Well, do you wanna get a coffee? Nah, I'll wait here till he wakes up.
I can't be slacking on the job.
All right.
Hey, Jordan? Yeah? Thanks.
We're square.
How is she? I'll be honest with you, sir.
It's not looking good.
But she's fighting hard.
I just don't get why she would try to kill herself.
She didn't try to do that.
She was trying to get rid of the tumor.
Two very different things.
Kids don't think these things through.
I gave her a home, clothing, food.
I was already retired when I took her in.
Her mother? Oh.
Her mother was a wild thing.
I just tried to give Tina some structure in her life.
Maybe this is God's way of telling me I need to do more.
Or maybe it's God's way of telling you that you can't control everything.
I know I can't.
Are you a Christian man? I was certainly raised one.
Would you pray with me? I could use all the help I can get.
Sure.
[Phillip LaRue's "How Do You Say Goodbye" playing.]
How do you say goodbye? Will anybody teach me? I can barely hear the choir sing And the melody is fading If I could build a tower to Heaven, I would Maybe build a ladder Recharge.
past the sky Look God in the eyes Try to change his mind Maybe he will let you Come back to me tonight - [Monitor emitting continuous tone.]
- What's done is done [Monitor beeping steadily.]
Oh, my God.
She has normal sinus rhythms.
Yes! Yes! Good cardiac motion on ultrasound.
[Applause.]
Welcome back, Tina.
61 minutes.
She was dead for 61 minutes, and you brought her back.
Everybody, stay focused.
We're not done yet.
Let's get her up to the O.
R.
and finish this.
[Monitor beeping steadily.]
[Indistinct conversations.]
Your granddaughter's going to be okay.
It was a complicated surgery, but she will regain all of her functions.
And we removed her tumor.
Thank you.
This was truly a miracle.
In a way it was, Mr.
Mills.
I just knew if I prayed hard enough, you and the good Lord would come through for us.
Well, whatever you did worked, so thank you for your prayers.
I'm feeling sad knowing what she's given up.
Given up? She has been saved, but that transfusion cost her eternal life in Paradise.
[Coughs.]
There's my baby.
Grandpa? Grandpa.
[Alexander Biggs' "Tidal Wave" playing.]
You take some time.
I'll be back in a moment.
[Door creaks.]
[Voice breaks.]
Grandpa? I'm so sorry.
You are needed now - While you're far away - [Monitor beeping steadily.]
I can feel you frown Hey.
Like I feel you pulling all your strings You did it.
You saved him.
Should never have been in this situation in the first place.
You were right.
I almost cost Duke and Greggs their lives.
Well, perhaps you've learnt a lesson, then.
Maybe.
Right now I just want a drink.
[Sighs.]
Yeah? You buying or me this time? It's on me.
Oh, really? - That's a change.
- Don't push it.
- I am far away - [Telephone ringing in distance.]
Oh.
I see my things are back.
Somebody must've misplaced 'em.
Yeah, somebody.
Glad you put them back.
Now that's the Kenny I know.
I don't know what you're talking about.
I'm talking about maintenance telling me they saw you digging through the garbage out back.
Mm.
Must've been some other handsome man.
But I will say this after what I've seen tonight, life's too short to worry about the petty stuff.
[Groans.]
That was a hell of a night, Molls.
What Scott did? I may never see anything like that again.
- I did my part.
- Oh.
- Meanwhile, you - Hmm? left your cellphone out in the bay.
Damn thing's been buzzing for the past hour.
Hmm.
Thanks.
[Beep.]
Hi, Drew.
It's Mom.
I'm so excited to meet Rick and Brianna.
Thank you for inviting me.
Your text really moved me.
It was so beautifully written.
I had no idea you could write like that.
- [Beep.]
- You're welcome.
You left your phone on the bench outside, so I took the liberty of texting your mother, letting her know how hard it was for you and Rick and how much you need her.
You what? Do you want her in your life or do you not? Yeah, but you Again, you're welcome.
Now I stuck around to see your reaction, so can you give me a ride home? You are the moon Sure, let's go.
[Chuckles.]
Thank you for letting me witness that, Scott.
I'll never forget it.
And you shouldn't.
Anything's possible.
More than anything 61 minutes.
I don't [Chuckles.]
I don't even know what to say to you.
What what made you keep going? What did you see that made you think that you could actually save her? Was it an EEG? Was it a test? I mean No, I didn't see anything.
I just knew that I could.
I felt a special power tonight, Jordan, one that I haven't in a long time.
Which was what? [Sighs.]
Which was me taking control of who I really am.
When Tina cut herself tonight, she took control of her life.
And in that moment, I realized that I haven't.
Ever since I moved here, I've just been losing control and taking steps backwards and walking around here on eggshells Ragosa's rules, the mess with you and me and T.
C.
, everyone else here being a vet and me feeling inadequate about that because I never served.
That doesn't make you inadequate.
No, I know that, but that's how I felt.
I gave away my confidence.
And then Malik and falling off the wagon But tonight, tonight, that person that I always was, who never takes no for an answer, who's always in charge, tonight, I'm him again.
I'm back.
[Sighs.]
Jordan, I can do things that other people can't.
And I won't be walking around here on eggshells anymore.
This is my O.
R.
This is my hospital.
And we're gonna be doing things my way.
Okay, then.
And I'm a tidal wave Yeah, the nights are wild And the morning is a slow decay
We need to open him up.
He needs to go to the O.
R.
now.
On the base? That's impossible.
- Duke, all we need is a ride.
- I already said no.
As far as you're concerned, I'm your final say on transport.
It's a security risk.
You need to let this go, Callahan, because it's not gonna happen.
So you're just gonna let him die? Sorry, Doc.
It's out of my control.
Okay, Doc.
Lucky day.
Mama must've had something real.
Amira: I can't believe you told the mother to give false intel.
- T.
C.
: So what? - Amira: If she set up an ambush or if she's acting on some old vendetta, that's on you.
Later, ladies! - [Gunfire.]
- It's a setup! - Now! - [Man shouting indistinctly.]
Man on radio: Duke's MIA! [Siren wailing.]
Mid-30s, rock climber, no I.
D.
, fell close to a hundred feet.
Cain, I need a hand here.
Fire up the ultrasound.
He's got multiple leg fractures, a chest wall deformity with progressive shortness of breath.
Any neuro? Intact.
GCS 15.
Lucky and stupid.
He was wearing a helmet, wasn't using ropes.
On three, okay? One, two, three.
[Man groans.]
We've got a flail chest.
Okay, sir, my name is Dr.
Alexander.
Dr.
Diaz.
And we're gonna take care of you.
- Let's get an ultrasound.
- C-spine is clear.
[Velcro rips.]
Jordan: Okay, Martin, just keep breathing and try to relax.
[Machine beeping.]
Flail chest with a pneumothorax.
- Get a chest tube started.
- Yep.
Okay, sir, you have multiple fractured ribs and a collapsed lung.
Dr.
Diaz is going to insert a tube in your chest to reinflate your lung.
Why anyone would want to climb without ropes is beyond me.
Some people think it's a form of meditation.
- It's called free soloing.
- Don't tell me you do it.
Whenever I get a chance.
Another adrenaline junkie in the E.
R.
Surprise, surprise.
Pulse ox is down to 80.
- You need help with that chest tube? - Nope.
I got it.
Flail chest is painful, so I gave him a nerve block.
And chest tube's in.
He's stabilizing.
All right.
Good job.
Let's find out what his name is and get him upstairs for a C.
T.
and X-ray.
- This guy's in the military.
- Well, he's in the right place.
- Hello, Ms.
Mills.
- Hi.
I'm Dr.
Rivera.
What brings you in today? Isn't it obvious? Let me examine it.
How long have you had it? Ever since I can remember.
Everyone calls me "The Freak.
" Any headaches, blurred vision? Any previous treatments? Well, we don't have many doctors in Faywick, Texas.
It's a desert town.
Every once in a while, we get a roaming clinic.
One of the nurses suggested I come to SAM.
I know Faywick.
It's a 6 1/2 hour drive from here.
8 hours by bus.
That's why I need you to help me now.
I-I can't get off of work again.
- And where do you work? - A grocery store.
I, uh, do the restocking.
I could make more as a checker, but the manager says that the customers don't want to have to look at me while they're buying food.
What an ass.
- Sorry, that just - No, he is.
Just please, help me get this thing off.
Let's get a surgical consult, and then I'll put you in line for an MRI.
But if it all checks out like I think it will, you won't have to worry about this anymore.
Thank you.
[PA tone chimes.]
Woman over PA: Central Supply to Nurses Station - [Yawns.]
- You and Rick out late? Ha.
Yeah, good one.
Barely slept in two weeks.
Brianna's homework? It's, like, three hours a night.
Plus dance lessons, plus physical therapy.
It's, like, I'm not getting any sleep.
- Not good, man.
- Don't get me wrong.
I love being a parent, but it is kicking my ass.
- Man needs his sleep.
- [Yawns.]
Uh-huh.
Tell you what, I'll throw you the easiest case tonight.
Maybe if it's slow, you can grab some shut-eye.
Oh, I owe you.
And maybe some nights, I can crash on your couch.
I'm sleep-deprived, too, listening to the headboard slamming against the wall all night and other high-pitched squeals.
- And I'm talking about Paul.
- [Laughs.]
Oh, hey, Kenny.
Enema.
Curtain 4.
They're waitin' on ya.
Yeah, I'm on it.
I freakin' hate that guy and his little kit.
Guy's always making these wooden carvings for the nurses.
Good point.
What a dick.
No, my my point is, it's all a show.
I mean, who the hell wants these stupid little animal carvings anyway? So I guess I shouldn't show you the adorable dolphin he made for Brianna? That wouldn't be good? It's really cute.
Look, you guys got off to a rough start.
All right? Just chill, and everything will work itself out.
Yeah, sure.
Anyway, 44-year-old male in Trauma 4, uh, with epigastric pain, normal EKG.
I think all he needs is the GI cocktail.
Man on radio: Spartan 2, we have located Duke.
Repeat, we have located Duke.
Got it.
Got it.
Area's being prepped now.
Saddle up, ladies.
[Guns clicking, men speak indistinctly.]
We got Duke's signal and a location on him.
- Moving out now.
- [Radio static.]
I'd like to be included in the extraction.
My name's - I know who you are, Callahan.
- Oh.
You're the idiot who got Duke jacked up with that bogus intel.
- No, that's not what - Save it.
I don't have the time.
I have my best friend a man who's had my back for five years and he's out there alone.
- You've done enough.
- Hey - Greggs.
- Sir.
You're taking Callahan.
He's a doc.
He could be useful to us.
We don't know his condition.
Yes, sir.
[Pats arm.]
Some nerve going over my head.
You can thank me later.
Hey, look, I'm not just some pouge doctor, okay? - I was a Ranger.
I - Then you should know better.
You put another one of my men in harm's way, this war party comes back a little smaller.
I will bury you out there.
We S.
P.
in nine minutes.
Have your candy ass on the truck by then or it leaves without you.
I didn't ask you to do that.
That's a funny way of saying thank you.
Look, you wanted to go, and now you're going.
And I can take care of myself.
You did that before, and now Duke is MIA.
And if it weren't for me, you'd be at the business end of a beating.
Nothing I haven't worn before.
Not at the hands of men like these.
- Okay.
- Yes, okay.
You better kit up.
You've only eight minutes left.
And you better hope they find Duke.
Hey, Dr.
Alexander, meet former Marine Martin Easton.
Hey, there, Martin.
How are you feeling? Still in pain, but better.
So where were you deployed? Did two tours, ma'am.
Last one in Fallujah in '04.
Mm.
Fallujah that was a hot spot.
- I'm not looking to go back.
- Yeah.
So you were free soloing? Is that something that you do a lot? All the time.
I find it meditative.
That's exactly what I was telling Dr.
Alexander.
There's nothing like it, right? You know, all things considered, you're very lucky.
You know, I had a friend who took a 70-foot fall.
He, uh, hit the ground like an accordion.
Crushed every bone in his body.
It's a miracle that he lived.
You had your own little miracle today.
Sure doesn't feel like it.
This effin' hurts.
[Laughs.]
I'm sorry about the "effin'," ma'am.
It's okay.
Hey, did your friend ever climb again? No.
But you, I think you, uh, have a pretty good shot.
Take those to get sterilized.
[Loud clatter.]
- [Breathing rapidly.]
- Martin.
- No.
No.
- Martin, hey, hey, hey.
- No! - Whoa, whoa, whoa, whoa.
- Mollie, I need Ativan now.
- Martin, look.
We got you.
- No, no, no, no, no, no.
- Stop! Stop it! Stop it! He pulled out his chest tube.
- Stop it! Stop it! - Calm down.
- Stop.
- Pushing 1 milligram of Ativan.
Stop it! We've got you.
[Breathing heavily.]
It's gonna be okay.
[Monitor beeping steadily.]
I think it's clear there's more than just broken bones here, huh? Yeah.
Tina, this is Dr.
Clemmens and Dr.
Cummings with surgery.
Hi, Tina.
Wanna let you know, we took a look at your MRI, and it's clear, which is really good news.
But before we move forward, I wanted to take a look at your neurofibroma, which is a fancy way of saying - This thing on my face.
- Yeah, I'll go with that.
All right, let's see.
Yeah.
Dr.
Rivera, I believe your initial diagnosis is correct.
This does not look like it extends beneath the surface layer.
Which means we can take it off for you.
Which I was getting to, Paul.
- Thank you.
Thank you.
- [Laughs.]
- Thank you.
- [Knock on door.]
Excuse me, Doctors, this is Tina's grandfather, Carl Mills.
You left without telling me.
I knew you wouldn't let me.
Whoa, whoa, whoa.
What's going on here? This is my granddaughter, and I want her discharged now.
Come on, get up.
We're leaving.
We're leaving.
Get up.
No! I can't.
Mr.
Mills, your granddaughter is a grown adult.
I think she can make her own decisions.
Grown? Is that what she told you? Tina is 16 years old.
Go on, tell 'em.
Tell 'em how old you are, Tina.
Tell these people.
I'm sorry I lied.
I just want this thing off of me.
Come on, let's go, baby.
Come on, get your things.
I can't! Grandpa, I can't! Come on, let's go.
We're gonna get out of here.
Okay, sir, sir.
Sir, I understand that you're upset.
And I don't mean to interfere with your personal life, but Tina came here because she's suffering.
You're only given what you can handle.
- We're leaving.
- Mr.
Mills, so if this if this has anything to do with money, we can absolutely make arrangements.
It's nothing to do with money.
She knows that.
We're Jehovah's.
We don't want any surgeries that require blood transfusions.
Shannon: It's not about you.
It's about her.
She wants to lead a normal life, - and the only way she can do that is - Okay.
Dr.
Rivera.
Dr.
Rivera.
If I need a transfusion, just do it! Tina! There are things we can discuss.
There are ways to restrict and limit blood loss during surgery.
Can you promise she won't need a transfusion? Then I'm taking her home! - And I said I'm not going! - Tina, what are you doing? - I want it off! - Paul: Hey, okay.
Okay.
I'm not! [Crying.]
Come on, all right.
Just calm down.
Aah! - No, no! - Mollie: I'll go get a gurney.
- Oh, my God.
Oh! - I got you.
- Oh, my God.
- Shannon: We need help in here! - Tina.
- Oh, my God.
Tina! - She's unresponsive.
- Tina! Crash cart.
Prepare for intubation.
What have you done, Tina? Mr.
Mills, for everyone's safety, I need you wait outside.
Help her.
No, no, help her! Tina! Tina! I need you to wait outside.
Shannon: I'm in.
Sats are going up.
This bleeding's out of control.
The tumor is hyper-vascular.
We gotta get to the source.
- BP is 68 over 35.
- The O.
R.
is ready.
She'll never make it up to the O.
R.
We gotta do this here.
Trauma 2.
Now.
Let's go! Good evening, Mr.
, uh, Wilson.
I'm Dr.
Alister.
[Strained voice.]
Call me Arthur.
This cramping in my stomach hurts really bad.
How long have you felt it? Since I had some Alamo Peppers two days ago.
- You take anything for it? - No, no.
This hurts much worse than indigestion.
This could be gallstones or an ulcer.
[Inhales sharply.]
Maybe even a heart attack.
All right, let's not jump to extremes quite yet.
Can you sit back for me, please? It's hard not to.
I have a long medical history dating back to 1993 when I had my first surgery.
Uh, which was for what? Ah! An undescended testicle.
I'm pretty sure your current discomfort is unrelated.
Now who's jumping to extremes? [Groans.]
I cannot believe you free soloed El Sendero Luminoso, man.
- Even I wouldn't touch that.
- [Chuckles.]
Hey, sorry to interrupt.
Martin, how you feeling? A little sleepy, but less pain.
Okay, good.
I'm glad that you're feeling more comfortable.
Okay, um [Sighs.]
so your chest C.
T.
shows signs of a bruised lung.
And your X-rays found multiple leg fractures, which Orthopedics will resplint after their consult.
But before we get to all of this, I wanted to ask you about the incident that happened earlier.
What incident? After the surgical tray crashed to the floor, you started screaming.
I don't remember that.
Well, you were yelling and screaming at us to stop.
You got so agitated that we had to sedate you.
[Sighs.]
Told you, I don't remember.
Okay.
How's your sleep? Fine.
Any, um, memories or nightmares of your time in service? - No.
- Lingering anger, irritability? - Stop, please.
- Stop what? You're asking me the same PTSD questions those Navy shrinks asked me years ago.
Let me guess what's next.
Any psychological numbing, too? Right? Look, I'm gonna tell you the same thing that I told them.
I don't have PTSD and I'm really tired of people telling me that I do.
Well, I didn't say that you did.
But you're thinking it.
Look, I like to climb alone.
That's it.
- Okay, okay.
We get it.
- You don't get it.
You don't get it.
So just fix my broken bones and leave my head out of this, okay? Any ideas? Yeah.
I'm gonna contact someone who I think can help.
Okay.
Greggs: Duke's signal is within a hundred meter perimeter.
- Get ready to move.
- [Radio static.]
- Hey, where are we go - You don't speak, Cinderella.
You stay shush in here and wait for your glass slipper.
- You come when we call you.
- Smoke out! [Gunshot.]
[Explosion, gunfire, men shouting indistinctly.]
This is Spartan 6.
We're under heavy contact.
Contact, front! Move, move! - [Men shouting indistinctly.]
- Aah! Man: Greggs is hit! Greggs is hit! [Gunfire continues.]
I told you to stay back.
Shut up and do what I say if you wanna live.
Man: Spotted Duke.
Need more fire power.
He's pinned down.
- [Groans.]
- [Speaks indistinctly.]
You're hit in the femoral artery.
Think I don't know? Another inch, and my nards would've been ribbons.
You lose your balls, you'd still be alive.
This bleed may kill you.
Okay, look, I gotta stop the bleeding.
- This is gonna hurt, okay? - Just do what you gotta do.
- You sure? - [Grunts.]
- Ready? - Uh-huh.
[Screaming.]
Don't move.
My knee's keeping you from bleeding out.
- Keep your head down.
- You're no good to me dead.
Aah! [Groans.]
[Monitor beeping steadily.]
Even with the clotting agent and clamping, I can't control the bleeding.
If we can embolize the artery, the bleeding will stop.
BP is down again.
Hemoglobin is down 5 points.
Draw up push dose epi, get a level one infuser and start the massive transfusion protocol.
Just throwing it out there, she's Jehovah's No, she isn't.
Her grandfather is.
The law says parents may be able to martyr themselves, but not their children.
When Tina cut herself, she was trying to take control of her life.
I intend to give it back to her.
She's bradying down.
Pulse is 56.
All right, paradoxical bradycardia.
Give her .
5 milligrams of atropine.
Line secure.
Ready for embolization catheter.
Doctor, she lost her pulses.
- Call a code blue! - [Flatlining.]
- She's in v-fib.
- Starting CPR.
Put the pads on.
Charge it to 200 joules.
- Give 1 milligram of epi.
Let's go! - [Defibrillator whines.]
- Charged.
- Clear! All: Clear.
[Paddles thunk.]
[Monitor emitting continuous tone.]
Another milligram of epi.
Start amiodarone 300 milligrams, charge it to 200.
- Charged.
- Clear! Shannon and Jocelyn: Clear.
[Paddles thunk.]
[Panting.]
She's been down for 15 minutes.
[Monitor emitting continuous tone.]
Don't watch the clock, Kenny.
Just keep pumping.
All of our blood products have been transfused.
- We're on our last unit of RBCs.
- Scott: Switch out.
I can't embolize the bleeder.
She's moving too much from the CPR.
We can't hold a compression for that long.
We can and we will once she's on ECMO.
Where the hell is it, Jocelyn? They said it's on the way.
The elevators are slow.
Are you kidding me? Tell security to hold all traffic on those damn elevators until the ECMO's in this E.
R.
- Go.
Go, go, go! - Okay, okay.
Got it.
Kenny, I need you on the phone with the blood bank.
Tell 'em what they sent over won't be enough.
On it.
You really think Tina's still got a chance? She's with me.
She's got a chance.
It is my understanding that your granddaughter is still fighting.
That's all you got to say? What does that mean? I know.
It's not a lot to go on.
But I can promise you that she has the best surgeon in the state, and he will not give up.
I must also inform you that they are going to need to perform transfusions.
I clearly told that doctor I did not Mr.
Mills, I was told that she understood the risks of a transfusion.
And there is no other way.
She will not survive without them.
It's grounds for disfellowship.
Do you know what that means? Yes.
I do.
My father he was a Christian Scientist.
And I've learned that beliefs can cause you to lose someone who is very dear to you, which is something that I haven't stopped regretting since the day he died.
I will never regret my beliefs, Doctor.
Do you have a chapel? Yes.
I do.
It's down the hall and to the left.
Mm.
And we will update you regularly.
- Mm.
- Cain: Hey.
- [Gloves snap.]
-I see Martin's V.
A.
records are up.
- You might wanna take a look.
- Okay.
All right.
Uh, he was diagnosed with PTSD and refused treatment.
- Yeah.
- When does he get out of C.
T.
? They said they were gonna bring him down in a couple minutes.
Hey.
Have you guys seen my wood? Excuse me? My wood.
It's it's missing.
Vicki, have you seen this man's wood? I certainly have not.
Doctor, you might wanna, you know elaborate.
Oh.
No, my iron carving wood.
I-I-I left it right here.
- Oh.
Hmm.
- Hey, Jordan Hey, Kenny, did you take my carving wood? I don't know what you're talking about.
No, it was right here.
The the wood's valuable to me.
It's not easy to find.
Well, then, maybe you should keep better track of it.
I'm busy saving lives, not worried about your toys.
- Jordan, you got a minute? - Yeah.
Cain, could you just excuse me for a moment? Where's my wood? All right, look, Tina's been down for 25 minutes, and Scott's starting ECMO.
And you're telling me this because Look, I know I'm not a doctor.
I'm just saying we have a whole room full of patients and we're using all the blood in town.
And Scott I don't know.
He just seems agitated, not himself.
And I thought, maybe with his past Okay.
Yeah, I'll check in on him when I have a second.
- Okay, thank you.
- Thank you.
Great news.
Your test came back negative.
- There's nothing wrong with me? - Mnh-mnh.
Then why do I feel like this? - Have you been under stress lately? - No more than usual.
I mean, I am a very anxious and neurotic person.
- Oh.
- But who isn't nowadays? Yeah, uh, I'm gonna write you a prescription for Xanax.
That should take care of it.
Then I want you to follow-up with your primary care doctor - in a couple days.
- [Groans.]
Oh, gosh.
My stomach it's twisting and turning.
Please don't quit on me.
Everyone always quits on me.
Okay.
Uh, okay.
We'll we'll run a scan.
Okay.
Thank you.
[Sighs.]
Thank you.
[Exhales deeply.]
Still working on that same patient? - Thought he was a simple G.
I.
- Yeah, so did I.
Part of me thinks he's just a hypochondriac, but I'm so exhausted, maybe I am missing something.
I'm gonna run the test again just to be sure.
- [Monitor emitting continuous tone.]
- H&H is still dropping.
Where the hell is our blood? Finally! All right.
When she's on bypass, we can stop compressions and block the artery.
Even if we get the ECMO working, it isn't recommended for hemorrhagic shock.
Sometimes medicine isn't black and white, Paul.
Sometimes you gotta find the grays.
So stop debating me and ready the art-line, - or I'll come do it myself.
- Of course.
You're in your second year of surgical residency.
You should know by now that impossible is for other people, not for surgeons.
- You almost done? - Securing the line.
[Monitor emitting continuous tone.]
Prime the circuit.
Set the flow to 3 liters per minute.
[Machine whirring.]
She's on ECMO.
Okay, we can stop compressions now.
Okay.
Let's embolize the artery.
And if it doesn't work? Then we go to plan "B.
" Okay, listen up, hey! Everybody, listen up! We are not giving up on Tina.
You understand me? I don't want any more second guessing.
If you can't handle it, tap out, and send somebody in here who can.
Let's go.
[Monitor emitting continuous tone.]
[Siren wailing in distance.]
- Hey.
- Hey.
Thank you for coming in.
I hope I didn't wake you.
No.
I was doing physical therapy.
Mm.
You'd be proud of me.
I can jump a whole half inch now.
Baby steps, all right? It's gonna take a little time.
All right, enough with the pep talk.
I gotta sit down.
- All right.
- [Grunts.]
So you said you needed my help with a vet.
Yeah.
Uh, Marine.
Fallujah '04.
- Mm.
- Yeah, he survives that hell, and he comes back and climbs mountains without ropes.
He takes a hundred-foot fall like a boss, but metal tray gets knocked over, and he freaks out and says he doesn't remember anything.
What do you think? I went through the PTSD checklist and he doesn't present any of the classic symptoms, but he's been through the V.
A.
system, and they say that he does.
So they tried to get him Turn him into a zombie.
Yeah, he won't take medication.
Now he insists that's okay, but I know that he's not.
So I was hoping maybe you would talk to him, vet to vet.
Why me? Why not Drew? Any of the other vets you got here? I thought that maybe I'd get as much out of it as he would? Yeah.
You're not gonna stop trying to save me, huh, Jordan? A girl can dream.
All right.
[Grunts.]
- I'll talk to him.
- Thank you.
Yeah, yeah.
Beats sitting at home trying to touch my toes, which, you know, hell, I wasn't doing before the tumor.
[Gunfire, men shouting indistinctly.]
Aah! No, Greggs, stay with me, buddy.
Spartan 2, we cleaned them out.
We got Duke.
- [Loud groan.]
- That's Greggs.
- T.
C.
: One, two, three.
- [Panting.]
[Grunts.]
- Man: Just get out of here.
- Is he okay? He's lost a lot of blood.
I need every medication you got in your kits.
He dies, Callahan, you're a dead man.
- I'm in.
- Good.
Okay, now release the Gelfoam, followed by the microcoil.
[Monitor beeping steadily.]
You did it, Paul.
The bleeding stopped.
- [Claps hands.]
- We got it.
How long has she been down? 41 minutes.
But does she have any brain activity? Did you run an EEG? Jordan, if you're here to tell me to call it, I'm not going to, so save your breath.
- Scott, a moment.
- No.
This is my patient and I've got my hands full, so please step out.
You're right.
She's your patient.
- [Monitor beeping rapidly.]
- She's in v-fib again! Charge to 200.
Give 1 milligram of epi, 150 of amiodarone.
- [Defibrillator whines.]
- Paul: Yeah, we're charged.
Arthur, I misread one of your tests.
We gotta get you dialyzed immediately, or your kidneys will shut down.
- But you said it was fine.
- Yeah, I was wrong.
Okay, Nurse Mollie's gotta place a large Foley catheter - in your penis.
- My penis? It should only take a few tries, but I'll get it in there.
Wait! Stop! This shouldn't be happening.
- [Spritzing.]
- See? The sweat is fake.
This whole thing is fake.
I-I'm just an actor.
I'm pretending.
- Yeah, we know.
- I Googled you.
I love the Google.
Tell him what we found, Drew.
Besides a lot of dinner theater and a steampunk musical in '07 that flopped, we learned you work for a company called Treatment Strategies, Inc.
Yeah, they get people to pose as patients so they can review the customer service of a hospital.
My cousin down in Galveston said people got fired at her hospital.
Okay.
Okay.
Okay, you got me.
I'm sorry.
It's a job.
But you were just kidding about the penis, right? Yeah.
Arthur, we were.
You're healthy.
And I spent all that extra time trying to get to the bottom of your symptoms, trying to help you.
And meanwhile, we got real patients here with real problems who need real help.
You understand that?! Get the hell outta here! - Is there a bathroom? - Yeah, it's right down the hall.
[Telephone ringing in distance.]
So you and Mac go way back? Yeah, I mean [Sighs.]
when someone saves your life, you tend to form a quick bond.
Hmm.
Plus he saved T.
C.
and Topher in Afghanistan a year ago.
So this is payback? Yeah, you can say that.
Hmm.
What's with you and free soloing? Yeah, it seems a little crazy to me.
The same as Martin.
It, um, gives me peace.
But you weren't in Fallujah.
No.
You know that friend I told you about that took that fall? That was my cousin.
Actually, more like a brother to me.
He was this amazing musician.
Anyway, I found him at the bottom of that cliff.
He was a mess.
They reconstructed his spine, but his mind, they could not fix.
He just sits in a room now, stares at a wall like a robot.
- That's terrible.
- You know what's terrible is that he wasn't climbing.
He was thrown off.
God.
So who would do that? Got in with the wrong people.
So while I feel for your friend and Martin, there are other types of wars in this world that make people want to meditate and climb.
I'm sorry.
Yeah.
No, no, we all are.
Excuse me.
[Monitor emitting continuous tone.]
She's still in v-fib.
We'll shock again at 200.
Another round of epi.
- Paul: Charging.
Clear.
- [Defibrillator whines.]
All: Clear.
[Paddles thunk.]
[Tone continues.]
That was the fifth shock.
Still no cardiac activity.
Jocelyn, get me another defibrillator.
- And a second set of pads? - Yes.
Double dose of electricity? I've seen it work before.
- Charge both machines to 200.
- [Defibrillators whine.]
- Charged.
- Clear? All: Clear.
Three, two, one.
[Paddles thunk.]
[Monitor emitting continuous tone.]
Recharge.
Scott? The grandfather's getting antsy.
He wants a progress report.
[Defibrillators whine.]
Okay, both machines charged to 200.
Tell him she's still fighting, and so are we.
- Three, two, one.
- [Paddles thunk.]
[Siren wailing in distance.]
Hey, I'm not bothering anybody out here.
I'm just waiting for a ride.
For what it's worth, I'm really sorry I wasted your time.
Relax.
Arthur, I shouldn't have yelled at you earlier.
Truth is, I just became a new dad, and you probably got the brunt of my sleep deprivation.
Oh.
Oh, I get the sleep thing.
I have two girls, which is why I do this job, which I hate.
[Chuckles.]
Yeah.
So, um, your new kid, is it a boy or girl? Uh, teenage girl.
- Oh.
- [Cellphone beeps.]
13.
Me and my husband adopted her a few months ago.
Just managing the time thing, you know, two jobs, her stuff.
No grandparents helping? I mean, my mom she watches my kids after school.
It's a huge help to me and my wife.
That'd be nice, but, uh, it's not gonna happen.
Oh.
Your folks they're not around to help? Ah, it's a little more complicated than that.
Let me guess.
Your parents, probably your dad, doesn't approve of you being gay, so you have an estranged relationship.
And your mom, even though she's old-school, she sides with him out of a sense of wifely duty even though it hurts her not to have a relationship with her new grandchild.
Hell of a guess, Arthur.
You're freaking me out.
[Laughs.]
It's the actor in me.
We study the human condition.
Drew, Scott needs you.
All hands on deck.
Ah, coming.
Uh, and, Arthur, it's been interesting.
- Yeah.
- Good luck to you.
All right.
Cool.
Don't you dare go back in there.
Oh, no, I wasn't.
I was just I was [Bracelet thuds.]
[Siren wailing in distance.]
[Touchscreen clicking.]
Reaper Base, Reaper Base, this is Spartan 2.
We are 8 mikes out with one emergent surgical.
Hang on, buddy.
We're gonna get you there.
- Duke, I'll check you out - I'm fine.
You just save Greggs.
Put these on and give me your hand.
[Gloves snap.]
Okay, you're gonna put your finger in the wound and rest your right hand on the artery.
And don't move or he'll bleed out.
Okay? I'm putting Celox in the wound to tamponade the bleeding.
- It'll hold for a little while.
- [Grunts.]
Move your finger.
He's soaking through the Celox.
I gotta change it out.
Okay, hold right there again while I do that and start an I.
V.
- [Groaning.]
- It's gonna be okay, Greggsie.
You're gonna be back in Tampa in no time.
See Cindy and the boys, huh? Go to a Bucs game.
Watch 'em blow a fourth quarter lead again? [Thump.]
Look, we're still 6 klicks from Yuma, okay? He loses any more blood, he won't make it another 2.
Keep it tight! Have Amira prep the O.
R.
We're coming in hot.
Three, two, one.
[Paddles thunk.]
- [Monitor emitting continuous tone.]
- How can I help? Anything to get her heart beating.
Uh, what about esmolol? I just read about it stimulating Esmolol.
That's a good idea.
25 milligrams of esmolol and hang a drip.
[Lowered voice.]
Hey, how long has this been? 53 minutes.
At what point do you stop? I think we passed that point a while ago.
Recharge.
[Defibrillator whines.]
[Beeps.]
[Door squeaks.]
[Pills rattle.]
T.
C.
: Amira! Amira! Amira? Glove up.
It's Greggs.
He's bled out.
We had a bumpy ride.
His wound cavity's expanding.
GSW to the left femoral artery.
- Thank you.
- What happened out there? Well, turns out, Syria's not very friendly.
Can you prep while I intubate? Transfuse 4 units of O-neg and a 1,000 milligrams of tranexamic acid.
Okay.
I'm in.
I'll place a ER-REBOA catheter while you harvest the saphenous vein for a graft.
Okay.
Let's go.
After all this, I don't wanna have to tell these Navy SEALS that their boss didn't make it.
[Monitor beeping steadily.]
[Monitor beeping steadily.]
- A moral injury? - Yeah.
It's a new diagnosis.
It's different than PTSD.
It's when you do something you wouldn't do in your regular life, you know.
Maybe you were ordered to.
Maybe you had no choice.
Isn't that a lot of what war is? I Yeah, pretty much, but this is more personal.
Say you're driving an M35 through a crowded marketplace, and ambush comes out of nowhere.
Bullets are pinging off the metal.
Put your foot on the gas to bolt, and next thing you know, you're rolling over a woman.
You see her face before you hit her, the pleading, the fear in her eyes.
She knows she's about to die in front of her kids, but what are you gonna do? You gotta do it.
You know, you gotta save your guys.
Is that Martin's story? No.
That's someone else's.
Anyways Martin's gonna join a support group, and, uh, maybe someday, he'll be strong enough to tell you his story, but that's his call.
Do you want a job? [Scoffs.]
Nice segue.
Yeah, how 'bout tight end for the Bears? They could totally use one, but actually, um, I was thinking about here at SAM.
We can start an outreach program for veterans, give them a place to go, give them the care that they deserve.
I'll think about it.
Right.
Okay, yeah.
Just, uh you know, let me know.
All right.
I thought about it.
I'm in.
What else am I gonna do with my time? Ah.
Yeah.
there's the positive spirit that I love.
[Laughs.]
All right.
Well, do you wanna get a coffee? Nah, I'll wait here till he wakes up.
I can't be slacking on the job.
All right.
Hey, Jordan? Yeah? Thanks.
We're square.
How is she? I'll be honest with you, sir.
It's not looking good.
But she's fighting hard.
I just don't get why she would try to kill herself.
She didn't try to do that.
She was trying to get rid of the tumor.
Two very different things.
Kids don't think these things through.
I gave her a home, clothing, food.
I was already retired when I took her in.
Her mother? Oh.
Her mother was a wild thing.
I just tried to give Tina some structure in her life.
Maybe this is God's way of telling me I need to do more.
Or maybe it's God's way of telling you that you can't control everything.
I know I can't.
Are you a Christian man? I was certainly raised one.
Would you pray with me? I could use all the help I can get.
Sure.
[Phillip LaRue's "How Do You Say Goodbye" playing.]
How do you say goodbye? Will anybody teach me? I can barely hear the choir sing And the melody is fading If I could build a tower to Heaven, I would Maybe build a ladder Recharge.
past the sky Look God in the eyes Try to change his mind Maybe he will let you Come back to me tonight - [Monitor emitting continuous tone.]
- What's done is done [Monitor beeping steadily.]
Oh, my God.
She has normal sinus rhythms.
Yes! Yes! Good cardiac motion on ultrasound.
[Applause.]
Welcome back, Tina.
61 minutes.
She was dead for 61 minutes, and you brought her back.
Everybody, stay focused.
We're not done yet.
Let's get her up to the O.
R.
and finish this.
[Monitor beeping steadily.]
[Indistinct conversations.]
Your granddaughter's going to be okay.
It was a complicated surgery, but she will regain all of her functions.
And we removed her tumor.
Thank you.
This was truly a miracle.
In a way it was, Mr.
Mills.
I just knew if I prayed hard enough, you and the good Lord would come through for us.
Well, whatever you did worked, so thank you for your prayers.
I'm feeling sad knowing what she's given up.
Given up? She has been saved, but that transfusion cost her eternal life in Paradise.
[Coughs.]
There's my baby.
Grandpa? Grandpa.
[Alexander Biggs' "Tidal Wave" playing.]
You take some time.
I'll be back in a moment.
[Door creaks.]
[Voice breaks.]
Grandpa? I'm so sorry.
You are needed now - While you're far away - [Monitor beeping steadily.]
I can feel you frown Hey.
Like I feel you pulling all your strings You did it.
You saved him.
Should never have been in this situation in the first place.
You were right.
I almost cost Duke and Greggs their lives.
Well, perhaps you've learnt a lesson, then.
Maybe.
Right now I just want a drink.
[Sighs.]
Yeah? You buying or me this time? It's on me.
Oh, really? - That's a change.
- Don't push it.
- I am far away - [Telephone ringing in distance.]
Oh.
I see my things are back.
Somebody must've misplaced 'em.
Yeah, somebody.
Glad you put them back.
Now that's the Kenny I know.
I don't know what you're talking about.
I'm talking about maintenance telling me they saw you digging through the garbage out back.
Mm.
Must've been some other handsome man.
But I will say this after what I've seen tonight, life's too short to worry about the petty stuff.
[Groans.]
That was a hell of a night, Molls.
What Scott did? I may never see anything like that again.
- I did my part.
- Oh.
- Meanwhile, you - Hmm? left your cellphone out in the bay.
Damn thing's been buzzing for the past hour.
Hmm.
Thanks.
[Beep.]
Hi, Drew.
It's Mom.
I'm so excited to meet Rick and Brianna.
Thank you for inviting me.
Your text really moved me.
It was so beautifully written.
I had no idea you could write like that.
- [Beep.]
- You're welcome.
You left your phone on the bench outside, so I took the liberty of texting your mother, letting her know how hard it was for you and Rick and how much you need her.
You what? Do you want her in your life or do you not? Yeah, but you Again, you're welcome.
Now I stuck around to see your reaction, so can you give me a ride home? You are the moon Sure, let's go.
[Chuckles.]
Thank you for letting me witness that, Scott.
I'll never forget it.
And you shouldn't.
Anything's possible.
More than anything 61 minutes.
I don't [Chuckles.]
I don't even know what to say to you.
What what made you keep going? What did you see that made you think that you could actually save her? Was it an EEG? Was it a test? I mean No, I didn't see anything.
I just knew that I could.
I felt a special power tonight, Jordan, one that I haven't in a long time.
Which was what? [Sighs.]
Which was me taking control of who I really am.
When Tina cut herself tonight, she took control of her life.
And in that moment, I realized that I haven't.
Ever since I moved here, I've just been losing control and taking steps backwards and walking around here on eggshells Ragosa's rules, the mess with you and me and T.
C.
, everyone else here being a vet and me feeling inadequate about that because I never served.
That doesn't make you inadequate.
No, I know that, but that's how I felt.
I gave away my confidence.
And then Malik and falling off the wagon But tonight, tonight, that person that I always was, who never takes no for an answer, who's always in charge, tonight, I'm him again.
I'm back.
[Sighs.]
Jordan, I can do things that other people can't.
And I won't be walking around here on eggshells anymore.
This is my O.
R.
This is my hospital.
And we're gonna be doing things my way.
Okay, then.
And I'm a tidal wave Yeah, the nights are wild And the morning is a slow decay