ER s12e20 Episode Script

There Are No Angels Here

Previously on E.
You're sending me to Africa? But I thought you could use a change of perspective.
Mouthwash? You've gotta be kidding me.
You're a weird dude, Pratt.
- Debbie and Dakarai, huh? - Yeah, they're an item.
We're on our way to the Dumtala Camp to help the sick people.
We're only here to help.
Generally, they do not hurt the doctors.
One never knows what might happen.
- Janjaweed.
He is Janjaweed.
- Welcome to Darfur.
12x20 "THERE ARE NO ANGLES HERE" Subtítulos subXpacio Your government promised $50 million in aid only to pull it away.
Yeah, well, we got our own problems.
You ever heard of Katrina? If the U.
does not lead the way, who else will? Without international intervention, nothing will change here.
Zahra, ask him if he's been taking the amoxicillin.
Listen, even with intervention, a year after us being here the world will be screaming for us to get out of Sudan.
Oh, Pratt, I expected so much more from you.
- Why? Because I'm black? - No, because you are smart.
Yeah, well, I'm also American.
I did not realize these things were mutually exclusive.
- He says, yes, he's feeling better.
- Okay, good.
Listen, all I'm saying is that it's a lot more complicated than that.
We been too quick getting in the middle of other people's fights.
When the solution does come to Darfur, it is not going to be quick.
Yeah, well, where I'm from, gangs, they get into it all the time.
All the cops can do is step back and wait for it to end.
Step back and wait? That sounds like an excellent foreign policy while people are suffering.
Dakarai, stop ragging on my country.
There's plenty of Americans helping.
You see me here, right? Yes and quite frankly, I'm beginning to wonder why.
- What? - She says the baby wasn't moving.
Okay, just show me where.
And you are moving pretty fast for an isolationist.
They told you a brother was coming, you expected Marcus Garvey? We don't have more in common than you and Carter.
I don't.
In fact, I think Carter is more African than you are.
How long has he been like this? Um, has he had a fever? Diarrhea? Baby no cry.
Yeah, he's too sick to cry.
Listen, we need to bring him back with us.
Look, your baby needs medicine.
We have to get him to the hospital.
Where is that other doctor? - Tired.
- Tired? Okay, wait right here.
Dakarai, what are you doing, man? Whoa.
What the hell? You all right? - Varices.
- Varices? Getting worse.
You told me your IV was for a little stomach virus.
Scarring in my liver.
Schistosomiasis when I was a child.
Well, congratulations.
You just became the proud winner of a bed in tent number three.
Rashida Fallad.
She's 26 weeks pregnant and she has hepatitis E.
Hepatitis E? I thought our water was clean.
They go outside the camp, drink from other sources.
It shouldn't be long now.
I think you're overreacting.
Mortality rate for hep E isn't high.
It is in pregnant women, especially in Darfur.
Over 30 percent of people who contract the disease will die.
The encephalopathy is worse.
She's pretty jaundiced.
Scleral icterus.
She's in hepatic coma.
Ask her if, um, she's been eating or drinking.
Tell her we've been giving her antibiotics and glucose through an NG feeding tube.
What did she say? She wants to know if her daughter will die today or tomorrow.
Tell her I'm not sure.
She wants to know if we need the bed.
Got a minute? So this baby I brought in yesterday, she's not doing so good.
I'm having trouble finding an IV site and this kid is getting pretty dry.
- Stop trying to be so tough.
- I am tough.
- I'm just trying to look out for you.
- I don't need a wife, already had three.
- Steven, you feeling any better? - I don't want to be babied.
I'm fine.
- Stay in bed a little longer.
- I'm ready to work.
- You have paracentesis.
Don't be an idiot.
- Sound medical advice.
- She has no bedside manner.
- Talk to him.
- Stay in bed until I sign off on your chart.
- When? - When I get to it.
- This is why people hate doctors.
- He needed a paracentesis? - Took five liters off his belly.
- Five liters? - Had him on Lasix all night.
We have to limit his sodium.
That man shouldn't be working.
He shouldn't even be here.
- Dr.
Dakarai is very committed.
- Uh-huh.
This is Mahdi, his mother, sister.
I'm Dr.
Can you tell her that we're gonna try to give some fluids to her baby? Dr.
John, they're bringing a man from outside.
They say he's been shot.
Okay, 20 gauge on the femoral, I want you to call me if you need me, okay? - Ishaak.
- What? His name is Ishaak.
Why won't you get this treated? - What happened? - Two GSWs, chest and leg.
- I'm going to help.
- We got it.
- We handle gunshots differently- - We know that.
Get back in bed.
An entrance wound, right chest.
Okay, belly seems clear.
Ishaak, you left the compound.
Just to the perimeter, to help a family get water.
He's got strong carotid.
Okay, try for the BP.
Men on horses.
They shot me.
Let me guess, Janjaweed.
Through and through left calf.
One hundred over 60.
- Why are you always where the trouble is? - I try to help.
- Ishaak is a sheik.
- Like, with a harem? No, like a leader.
He is recognized as someone the other IDPs can look up to.
Trying to make a difference, get people together.
- Yeah, well, he should stop that.
- Why say such a thing? - It's making people wanna kill him.
- Give me two liters of saline, wide open.
Okay, I got a good vein in the antecube.
I'm going in with the 18.
Ishaak, we need to move you to town.
You need more surgery than we can do for you here.
I- I can't breathe.
- Do we have the oxygen extractor? - Yeah, on its way.
Treating a man with a gunshot wound? Ishaak Alazhari? I'd have to check with the doctors.
You can't just come in.
As long as there is no violation, we'll leave.
Officer, please, please, wait outside.
I'll look around for you.
- We'll look for ourselves.
- You cannot be here with those weapons.
You know the agreement the Alliance has with your government.
We'll go where we need to go, do what we need to do.
Look, the NGO rules apply, even in Darfur.
Ishaak, this is oxygen.
This should help you breathe.
- How are you doing, man? - Feeling pain when I breathe.
This man's been shot.
- Yeah, that's right.
- He's bleeding internally.
He needs immediate care and transport to a surgical facility.
- Did you report this to my office? - Come on.
He can do that later.
Without a form eight, he's got no right.
He's gotta fill out a form? It's not gonna help much if he's already dead.
- Come on.
- Wait a minute.
Take it easy.
What's the matter with you? What are you doing? Are you nuts? - What's the matter with you? He'll die.
Guilty, form-eight violation.
Requires gunshot injuries- - He's here now.
Please, don't do this.
- If you are going to do this - Steven! - You can't come in here- Unh.
I'll send you a document re-clarifying the regulation so this does not happen again.
Good day, doc.
Okay, okay.
Let's see.
How does that feel? Feels like I got hit in the head with a rifle butt.
Better to be hit with one than shot with one.
- You want something for the pain? - No, I'll be fine.
I've had hangovers worse than this.
Perhaps you should drink less mouthwash.
What's gonna happen to the guy they took? They'll probably bring him back when they are finished interrogating him.
- He could be dead by then.
- Oh, yes, I'm sure they are aware of that.
- You should go back to the compound.
- No, I'm okay.
It's almost quitting time.
He's bradycardic, 58, 0.
5 epi.
He's already had two doses.
He's not responding.
Because he's hypoxic and acidotic.
All right, give him another bolus and find me a bag mask.
He'll turn around once the antibiotics kick in.
I can bag him through this.
By yourself? All night? - It could take days.
- Pulse is down to 50.
I'm doing compressions.
Are we just gonna watch him die? No, that's what his mother does.
We have other patients.
That's messed up.
Would you please tell her that we're very sorry.
Tell her that I know how difficult it is to lose a child that my own son died when he was very young in a hospital.
She finds it hard to believe that babies die in Western hospitals.
You should not have let them take him away.
- We didn't have a choice.
- Hey.
- Ishaak's wife, Sittina.
- Hi.
You treated my husband? Tried, but they took him, he didn't fill out some form.
No, they took him away because he tells people the truth.
That it is not safe to go back to their villages.
- The people listen to him, he's- Ah.
- Whoa.
You okay? Maybe you should sit down.
Are you having contractions? How far apart? She's eight centimeters.
One hundred percent effaced.
- She's definitely having this baby tonight.
- It'll be dark soon.
- Take her to the residential compound? - She can't have it here? She can, but we can't stay with her.
There's electricity back at the compound.
The only place I am going is to the police station to get my husband.
Do you want the police to deliver your baby? - Unh.
But Ishaak- - Let's worry about the baby.
Ibrahim, bring the truck.
Here we go.
- I'll grab the OB pack.
- Passing through.
Here we go.
I got it.
Go ahead.
You're late.
It's cinema night.
We're moving to the rec room.
Gregory wants us to watch Deuce Bigalow again.
Keep everybody in there for a little while, all right? - Is everything all right? - Yeah, it'll be fine.
They turn the generators off in the compound at night.
The only power in the clinic is used for cold storage.
She would have to deliver the baby alone in the dark.
Try and relax, huh? You okay? She's progressing very well.
She can start pushing within the hour.
I'm talking about you.
I am tired.
Been on my feet all day.
- You are not tired? - I'm tired.
Tired of you lying to me ignoring a life-threatening illness which needs to be treated.
Hey, hey.
I promise if I get any worse, I will do IV diuretics and sodium restrictions - and I will dry out my ascites.
- It's not good enough.
You need the procedure.
Carter, what is it he needs? A, uh, transjugular intrahepatic portosystemic shunt.
Well, interventional radiology is hard to come by if you don't have x-ray machines.
You need to go to Khartoum, Nairobi.
When I'm in bed, who's going to take care of my patients? Don't know.
Who's gonna take care of them when you're dead? Long day, huh? Only thing longer than the days here are nights.
I'm okay, Carter.
You could have fooled me.
This is nothing.
It's my weekly ritual.
Only way to get through the suffering that surrounds this place is to allow myself a good cry every now and then.
Feel better already.
So this has nothing to do with Steven? Steven makes me angry, he doesn't make me cry.
You tell me, you're a doctor.
What happens if he doesn't get treated? His condition is gonna get worse.
It's already worse.
It's the police.
- Hide her.
- What? Where? - What's going on? - It's the police.
Gotta hide her.
- Contraction? - Where? Let's go to the bathroom.
Are these the men that took my husband? - I don't know.
- Unh.
Ask them.
- I want to know what they've done.
- Keep her quiet.
Just breathe.
What's going on? He is searching for Ishaak's wife.
I told him come in the morning, search the camp.
He thinks we brought her here.
- No, we don't treat patients here.
DAKARAl: I told him that.
Now he wants to search the house.
A housing unit, that's off-limits.
It's off- Hey, come on, you guys.
You know what time it is? Everybody's sleeping inside.
Hey, hey, hey.
- They're in the house.
- No! Shh.
You have to keep her quiet.
I can't.
She's in labor.
Try to breathe through the pain, Sittina, good girl.
Breathe, breathe, breathe.
Breathe, breathe, breathe.
Hey, what's up, fellas? Whoa, whoa.
Sorry, I'm next.
And I don't think it's gonna leave a scar.
Thanks for asking.
Look, I've been standing out here for 20 minutes, okay? Pratt! All right.
What the hell are you doing? Get out! Get out! Your superiors are gonna hear about this.
Something is wrong.
- Hang in there.
You're doing great.
- I feel the head.
- I see thick meconium.
- Deceleration.
A long one.
- How low? - Low.
I think the occiput's posterior.
We don't have time for this baby to turn.
- Prep for c-section? - Are you out of your mind? All, right, Sittina, your baby is showing signs of very serious distress.
Vaginal delivery is too dangerous.
We need to do a cesarean.
No, please, unh, save it.
I'm gonna put some anesthesia in your back.
- You'll lose feeling from the waist down.
- Okay, come on.
Oh, Ishaak.
Aah! Ishaak! - Give me more counter pressure.
- Yep.
Debbie, can you get a blanket? Okay, I got it.
Unh, here we go.
- Got it.
- It's a girl, Sittina.
Allah has blessed you with a healthy child.
Get my husband.
- There's blood in the pelvis.
- Try uterine massage.
I am.
I got no suction, I can't see where she's bleeding from.
Oh, Ishaak.
Give me some sterile four-by-fours and keep them coming.
If they find out who we are, they will kill him.
- Who you are? - We helped to form the HRD.
What's she talking about? HRD.
It's a human rights group based in Khartoum.
Human Rights for Darfur.
They will kill him if they know.
Oh, man, she's bleeding out.
This was a bad idea.
No blood, no pressors, no pit, not Methergine.
What are we supposed to do now? She needs a hysterectomy.
Bring her to the hospital in Al-Fashir.
It's too late to drive.
She'll have to go tomorrow.
Because of a bunch of thugs on camels.
And they also have trucks and guns.
- Lots of guns.
- Okay, I can tie off the uterine arteries buy us time.
Give me O chromic on the longest needle we got.
Not enough time.
Couple hours, the uterus will become ischemic.
That is the best chance we got right now.
I grew up in Detroit, I can be in Al-Fashir in two hours.
- You didn't wanna bring her.
- I made a mistake.
If we'd left her, she'd never be able to deliver safely.
- This baby would have died.
- Slow down, Pratt.
Okay, the uterine artery is tied off.
- Only chance she's got, you know it.
- She may not survive the trip.
Yeah, but she's dead if she stays here.
If she dies making the journey, well, at least we tried.
Okay, I'll go with you.
No, John, you and Debbie should go to the police.
Find Ishaak.
You have a much better chance of getting him out of there.
He and I, we'll close and then we will bring her on to the hospital.
- All right.
- Okay.
We'd like to see Ishaak Alazhari.
No, you can't see him.
Why not? He's under arrest.
On what charge? He's been shot.
He needs medical attention.
I'm a doctor.
I would like to evaluate his medical condition.
How's she doing back there? She is breathing.
What the hell is that? Janjaweed.
Let's go back.
Oh, we got a traffic jam.
If we stop, they will take the truck, leave her to die, or worse.
Okay, all right, then we don't stop.
Just cover her up and hold on.
- Now, hold on, Dakarai.
- But- Hold on! Get down, Dakarai.
Did you tell him that we work for the Alliance? - Dumtala camp.
- Mm-hm.
All right, look, is it money? Because I can get some.
- You must leave now.
- No, I would like to speak to your boss.
Very busy.
Should I tell him you walked in on this American woman while she was bathing? Or should I tell the consulate that an American woman's privacy was violated? How much money? Ishaak? Ishaak, can you hear me? I need to see him.
No, I need to go in there.
Not responding.
He's dead.
The tire is flat.
I think they hit the oil pan and the radiator too.
She's getting pretty hot.
What is that? Lasix for the ascites? Prozac.
Keep driving.
How fast can a horse go with a rider? I don't know, maybe 30 miles an hour.
Okay, well, we've been going 45 miles an hour, maybe 40, our tire blew out, so - It's more like 50.
- Okay, good.
We've done enough time.
For what? To change the tire.
Maybe somebody in that village can help us out over there.
Aah! If there was somebody living there.
- You all right? - Yes.
What? The people we treat every day it is places like this from which they come before the Janjaweed burned them out.
- Agonal respirations and a thready pulse.
- He's alive? - Barely.
Ready to lift? One, two, three.
- Don't tell the police.
Zahra, get an IV started and get him back on oxygen.
- What can I do? - Transfer 0-neg from the fridge.
And when she's done, you can squeeze in a liter of saline.
He's got decreased breath sounds on the right.
Possible hemo-pneumo.
He's gonna need a chest tube.
- Where do you keep them? - We don't.
Uh, we're gonna have to improvise.
Get me a scalpel and a curved Kelly and a NG tube.
When the blood compressing his lung is removed, his pulse should get stronger.
- Bleeding? - It should stop.
If it doesn't? Why don't you see if you can radio Dakarai? They should be in Al-Fashir by now.
Do we have any extra water? No.
- What about saline? - Four liters.
All right, toss me one.
I gotta say, this is the first time I've ever given a bolus to a truck before.
Take it easy, man.
We just wanna get her to the hospital.
Tell him that.
I'm trying.
- Aah! - No.
His friends will not be far behind.
If you try and save him, we will never get away from here.
There is nothing you can do for him now.
Come on, get up.
Come on.
Watch your step.
- Okay.
- All right, go.
- Aw, damn! - What? The engine is seized.
We're gonna have to hoof it.
- Gotta walk from here.
- I can't.
- Why the hell not? - I don't think I can walk.
- And I will only slow you down.
- I can't leave you here.
- You have to.
- No way.
Why don't you leave me the rifle and perhaps I can occupy his friends while you get to Al-Fashir.
How far away is the city from here? It is still several miles.
But you can get there.
- You really think she's gonna make it? - She will die if you don't.
You ever fire one of these? - I've never held a weapon.
- Just point and shoot.
Okay, Sittina, we're gonna go on foot patrol from here on in.
I'm gonna give you a little something for the pain, okay? Wha-? What the hell is she saying? She called us angels.
I said there are no angels here.
Speak for yourself.
You ever been to Mozambique, Sittina? Yeah, they got great beaches there.
White sands, cool waters.
Definitely gotta get me to Mozambique.
Okay, either those are the good guys and we're saved or the bad guys and we're dead.
Either way I'm done walking.
Very sick? That's right.
- I tell him faster.
- Good.
You English? James Bond, 007? Do-doo-do-doo? - No.
- Do-doo-do-doo? American "Rambro"? Yeah, "Rambro.
" Good stuff.
Help me.
I need a doctor.
She needs saline, blood, antibiotics and a surgeon.
Good stuff.
Good stuff.
Ishaak's doing much better.
Bleeding stopped.
Keeps asking for Sittina.
No word yet.
Did you try the radio? They stopped answering the radio hours ago.
- Still- - There's no signal, John.
And they haven't resorted to sending smoke signals yet.
Come on.
Let's go introduce him to his daughter.
Stop! Stop! Stop! Dakarai.
Come on, let's go.
We had hoped to be back in our village before the child came.
To be born in this place it wasn't what we wanted for our child.
Now I can only hope that before she's grown up we can go back to our village.
We tried calling the hospital in Al-Fashir but we haven't been able to find out anything yet.
She's there.
I'm sure of it.
Greg, you gave us quite a scare.
Van broke down.
Turns out even in Africa cabs won't stop for a brother.
She'll be okay.
They're working on her in town.
She should be ready to come back in a few days.
- Allah is with her.
- You guys fixed him up pretty good.
Nice job.
Greg, where's Steven? He couldn't keep going.
And Sittina, she Tell me.
I left him on the road.
- Where? - At a burned-out village.
I went back for him, but by the time I got there I could tell the Janjaweed had been there.
They torched the truck.
Here, his medicine.
- We need to go out and look for him.
- No, it's too late.
It'd be dark by the time we get there.
I'll take you first thing in the morning.
We didn't have a lot of options.
I mean, if we'd stayed, we'd all be dead.
He made me keep going.
You did what you had to do.
So did Dakarai.
Can you work? - Yeah, in a minute.
- Okay.
Did you name her yet? Yes.
That's beautiful.
It means hope.
After they had burned the truck, I saw no reason to stick around.
Anyway, it was safer to walk, especially after all of your driving.
Ah, I'm glad you made it back, brother.
- You all right? - I am now.
Why didn't you go to Al-Fashir, you dummy? They could have treated you there.
Maybe next week, huh? Ibrahim, let's take him to the clinic.
Tell Zahra to get him started on lactulose and saline.
He's one stubborn son of a bitch.
I know the type.
You know, Carter, I got my own way of being.
But it damn sure doesn't mean I don't see or feel everything that's going on around me.
To tell you the truth, I never wanted to be around this type of suffering.
I mean, who would? I'm glad I came here.
I'm glad you came too.
Because I am not gonna take the blame for that van.
Oh, gee, thanks.
That's okay.
They'll take it out of your paycheck.
What do you mean? We actually get paid for this? Whoa.
Okay, where are we going?