HawthoRNe (2009) s02e10 Episode Script

No Exit

You wanted to send something to the lab? I do.
I got a Jane Doe here.
We don't know what's wrong with her.
So, I want you to take this blood and just run it through the gamut.
You got it.
Okay.
Hey, Lana? This is a very sensitive case.
So, uh, when the results come in, make sure I'm the only one that sees them.
My lips are sealed.
Thank you.
How's it going? Splendidly.
Okay.
Can we stop this? Stop what? Being so polite.
Acting like nothing's wrong.
There's nothing wrong.
I thought we were pretty good.
After all, you do have two toothbrushes at my house.
You want me to take them back? Only if you want to.
Are we gonna talk about the fact that someone was convinced you're named Guillaume and you've essentially shut me out ever since? Steve, you can tell me anything.
And you know you can tell me anything, but you don't, do you? What are you hiding? Nothing.
Sara! What happened? I have no idea.
BP's low.
She's got a high fever.
Steve, her throat.
Tracheostomy site's become infected.
Trauma 2.
Yeah.
Wait, what's going on? We don't know, but we're gonna take a quick look.
Okay.
Honey, honey, honey, stay with me, all right? Now that the suite's finished, we can finally install the MRI.
As of March, there were only four of these machines in the US.
And by the end of the week, we'll be the fifth.
And just in time for the joint commission inspection.
You really think the joint commission will care about this? This machine is twice as powerful as the one we have now.
Cuts down scan times by the improved imaging our doctors will now have.
I'm not trying to say that the machine itself is a negative.
Erin's right.
This scanner will pay immediate dividends on multiple levels, and it shows we're committed.
We had all of the best equipment at Richmond Trinity, and they still shut us down.
Point taken.
But we have the scanner now, so we'll showcase it during the inspection.
I get that.
I just think we'll have to showcase a bit more to pass.
Well, then I think we should get back to work, because the inspection could happen any day now.
I should have divorced you before your tuchas hit the floor.
Oh, threats, threats, threats.
Be a man.
Divorce me, already.
Where am I? I'm in a bed recovering from surgery.
You want I should call my lawyer to draw up the papers now? I should be so lucky.
If you were made of money instead of hot air, maybe I would know what luxury was beyond the stringy corned beef at Mort's Deli.
Luxury doesn't have anything to do with a fortune! The seasonings on that corned beef were priceless! They use Mrs.
Dash.
You're meshuga! Says you.
Mr.
Rickles, I'm sorry we had to give your room to another patient, but we're gonna have a bed for you very soon down in medlsurg, okay? Is that blood pressure machine working properly? It should be off the charts by now.
Yeah, Stein, why don't you check on that equipment, huh? Everything is in good working order.
You sure you haven't overlooked something? You have a tendency to spread your attention a bit thin.
I can assure you, Doctor, I checked every detail.
Oh! That's good to hear.
Wasn't sure if you had your hands full with another patient.
I don't.
But if I did, I wouldn't have trouble handling things.
I beg to differ.
You only have so much to go around.
Maybe you haven't seen what I can do.
Hmm.
Maybe not.
But I have seen what you're working with, and there's only so much you can do.
Please promise me we'll never be like that.
I'm not joking.
The patient's septic from the infected tracheostomy.
She's on antibiotics.
Yeah, we should get her up to the ICU because of her labile BP.
Monitor her and order some dopamine.
Hey, Bobbie.
Hi.
I heard Justin Adams is here.
Yeah.
This is his grandmother here.
She was just brought in.
And I think he's seen more than enough for today, and I was just wondering, would you mind hanging out with him? Absolutely.
Thank you.
Okay, we also need to double-check that we're following our chest-pain protocol.
I found that we were not giving our patients aspirin as soon as they were admitted.
And that's something we need to stay on top of.
Okay? All right, you guys.
Thank you for your time.
I got those results.
Thank you.
Here she is.
Christina.
Nurse Hawthorne is our co-director of nursing.
This is Cecil McLinn.
He and the others are from the joint commission.
Hello.
They're here for the inspection.
Nice to meet you.
I've heard a lot about you and all the wonderful improvements you're making here at James River.
Thank you.
Thank you very much.
Uh So, we are doing the inspection today? Is that a problem? No.
Not at all.
Great.
I'm going to leave Mr.
McLinn with you to inspect the ICU, and I'll take Ms.
Yee and Mr.
Jameson to check out the ER and the other floors.
Will that work for you? Sounds good, Mr.
Morrissey.
Thank you very much.
Come with me.
So, okay, I think we'll start with this floor.
Got five rooms here.
Well, this wing has five rooms.
We've upgraded a lot of our equipment here.
And, um Uh, excuse me.
Sir? I'm sorry.
We're supposed to be going this way.
Why is this patient in the hallway? Well, if the patient's in the hallway, I'm sure there's a very good reason for that.
Let me Give me one second.
Ray, please tell me why this patient is in the hallway.
Mr.
Rickles? Yes.
Yeah, he had surgery last week.
He's been recovering, and I had to make room for another patient.
Ray, these are the inspectors, okay? So, I need him moved now.
Now? Yeah.
Got it.
Oh, you got to be kidding me! Puke again? I hate kids.
We hate you, too.
Hey! That's not very nice.
She's not nice.
Oh, it's go time, little man.
Okay.
Here.
Play your game.
I'll be right back.
I'll get you new scrubs.
Don't bother with any pep talk.
I just got puked on.
It's not gonna work.
Malia, why did you become a nurse? Aptitude test said I was a people person.
You know, I try to not see them as kids.
I mean, they're just patients, scared and vulnerable like all the rest.
I try to find out what they're afraid of and then just ease their fears.
Wow.
You're like a kid whisperer.
We plan to have the new MRI scanner installed by today and fully operational by the end of the week.
That sounds like progress, John.
We want to send a new message to the community.
That not only can they get the best care here, but also the most up-to-date.
I have to admit, this is an impressive step forward and a strong statement you're sending to the public.
The community deserves the best.
They demand it.
And we plan to provide it for them, no matter what the cost.
Of course, this is just phase one of our five-year capital plan.
Oh, my God! Look out! Look out! What the hell? Check the other floors, make sure you've isolated the problem.
What is it? Engineers can't guarantee the stability of the ICU.
We need to evacuate the floor.
I need you to coordinate with Gail.
She's prepping the ER as a staging area.
And I need you to help me evacuate the ICU.
Can you talk to our friends over there, John? There's no way we can do this today.
That's not the way it works.
You know that.
You do what you do, and you hope for the best.
Male, 60s, collapsed on the treadmill at the gym.
Looks like bigeminy with some short runs of PVCs.
Didn't you get the call? We're on diversion.
The ER's closed.
You want me to turn around now? No, put him in Exam 5 and get him on a cardiac monitor.
We need to clear the waiting room of all non-criticals to set up triage.
We've got patients coming down from the ICU.
Look, I need a doctor in here.
This guy can't breathe.
Let's take this bed and put it in the elevator right here.
We have room for one more in this elevator.
Oy, gevalt! I'm not leaving my husband.
Oh, stop kvetching, Maureen.
Get your can in the elevator.
I'll be right behind you.
Thank you.
Thank you for your cooperation.
So, the rest of the staff, they took the stairs.
All we have left is Tom and his patient.
You know, Stein can move Mr.
Rickles down if you want some help.
You know what? Just hold the elevator.
I'm gonna go find Tom.
Tom, what are you doing? She's tachycardic, and her blood pressure's bottoming out.
Okay.
We got to keep it moving, 'cause it's not safe up here.
We just heard.
We're evacuating.
I ordered a dopamine drip from the pharmacy.
It's probably at the station.
Can you get it? Can you tell them to let that elevator go? We'll get the next one.
Me? Yeah.
You.
Can you grab me a portable ventilator? Yeah.
Thanks.
Do not re-enter the building until told so by emergency personnel.
Grab this for you.
Okay.
Okay, her BP's coming back up.
We should be good to move her soon.
This reminds me of old times, when you were a hotshot cutter and I was a floor nurse.
We spent a lot of time in the trenches together.
Yeah.
The good, old days.
Only authorized personnel should be in the building.
Oh, my God.
Candy.
There was an explosion stemming from an electrical fire caused by the crash.
We've upgraded to a hospital-wide evacuation.
We need to know how many non-criticals we can send your way.
How accurate is that? No, I don't.
I don't have 10 minutes.
Call me back in five.
I need reports from all area unit leaders ASAP.
Mr.
Jones is the last ER patient.
That double-checks.
ER's clear.
Sir, you can't go in there.
TV room.
The game's about to start.
Sir, the hospital's closed.
Marcus can probably help you out.
Call psych.
Come with me.
Right that way.
The elevator's stuck between floors, and have a patient who's claustrophobic.
So I need you to hurry.
Thank you.
Who the hell is claustrophobic? I was on a sub in Korea before your father even boinked your mother.
I said that so, you know, they'd hurry up.
I'm guessing sometimes you say a lot of stupid things.
You don't know the half of it.
You know, we got time, sweetheart.
Tell me some more about the poofster.
Uh, wait a sec.
Sir, you think I'm gay? Relax, kid.
To each his own.
Yeah, I agree with that.
It's just, my "own" happens to be her right here.
Oh, please.
I only date men, not lying little boys who have Barbie fetishes.
How long are you gonna stay pissed? Hey, hold the salami.
You really went out with this one, huh? Sir, why do you find that so hard to believe? Well, take a look at her.
She needs a mensch, not a shlemiel.
That's sweet.
Thank you.
John, I have an update on the explosion in the ICU.
Firefighters are trying to find a way in.
Engineers are doing a full assessment.
Elevators are stuck, and people are evacuating the building from the north stairwell.
Anybody hurt in the explosion? A nurse.
Candy Sullivan.
How bad? Tom and Christina are up there right now.
They say it's bad.
C- spine's clear.
Let's get that collar off.
Candy, I'm so sorry.
She's got second-degree burns.
I'm gonna get you something for that pain, okay, sweetie? Her sats are 92.
All right, crank up the O2.
Let's give her 10 milligrams of morphine.
Tom, there's another issue.
She's pregnant.
I'm gonna give her an ultrasound and make sure the baby's okay.
All right.
Oh, wow.
Look at that.
Baby's fine.
We have to get Helen and Candy out of here.
How are we gonna do that? Okay, you know something? I screwed up.
You have no idea how much I regret that.
What did he do? Well, he was sleeping with me, but also harboring feelings for this blond, tarted-up nurse.
That's all.
I've been married 48 years.
You look, it's healthy.
You just don't get feelings for them.
That's meshuga.
Thank you for the input.
I spoke to the firefighters.
They have their hands full.
We can't wait for their help.
Very resourceful.
Well, we're nurses.
We have to be.
Do me a favor.
I need you to grab the end of that bed.
Yeah, sure.
We're gonna have to drag her down.
You guys ready? Yep.
You got it? Let's go.
Let's do it.
Morrissey called ahead to other hospitals in case these two need surgery.
It's hot as hell in here! You know what? Why don't we take your socks off? That should help, okay? Damn it! Hello? Somebody down there? Hello! Yes! Yes, it's three of us! Okay, it's Dr.
Marshall, a patient, and Nurse Stein.
Ray? It's Christina! Christina! Thank God.
All right, you got to get us out of here! Ray, it's Tom.
Is anybody hurt? No.
But we're burning up in here, okay? There's no air.
Okay, you know what? There's a, uh There's a panel underneath the buttons.
Open it, and there's a switch.
Flip it, and it'll open the vents and give you air.
Okay, I don't know how you knew that, but if I can still get pregnant, I'm naming my first-born after you.
Whoever you are, you're an angel! How did you know that? It's my job.
I'm supposed to know everything about the hospital.
Ray! In that same panel, there's another switch! Flip it to "inspection.
" You see it? All right, I did it! Okay, now you and Marshall should be able to pry the doors open, but be careful because you might be in between two floors.
Okay.
You need some help? I got it.
I got it.
You know what, Tom? We need a We need something.
We're gonna have to pry this open on our end.
You see something over there? Yeah, this might work.
Okay, good.
Okay, you guys, hold on! Ready to get out of here, Mr.
Rickles? I'll follow you anywhere, sweetheart.
All right, give me a hand.
You guys push, and we'll pull, okay? I've got a bad back.
Yeah, and I got hit by a truck a few months ago.
Let's go.
Okay, let's try and do this on "three," okay? One, two, three! You all right? I hurt my hand.
All right.
Thank you.
Everybody okay? Is that Candy? Ray.
Oh, my God.
What happened? Ray, she was caught in an explosion, okay? She's in shock.
Is she Well, come on.
We can't wait here.
We're not.
We're gonna get her downstairs.
Hey, Tom.
How about you and I taking Candy.
Ray, you and Mr.
McLinn take your patient.
Brenda, do you mind staying here with Helen? Yeah, yeah.
Okay.
You cool with that? All right, let's do it.
Excuse me.
Excuse me! My husband, Mr.
Rickles.
Yeah? Was up in the ICU.
He should have been down by now.
Okay, I'm gonna try and find him for you.
Mr.
Rickles? Yes.
Frank Rickles.
What can we do to help you do this? You need to move your staging area so I can get my trucks in here.
Oh, my God! Got it? Yep.
Oh, please, please.
My son is still inside.
I'm sorry.
You can't come in here.
My mom is here.
It's okay! It's okay.
Bobbie.
Good.
Thank you.
Hey, Sara.
Oh, my God.
I'm going crazy.
You got to try and keep calm.
Justin is with Kelly, so he's in great hands.
The director of nursing is in charge of the evacuation of the ICU, so your mother is getting the best possible care.
Why isn't she outside? I thought they evacuated everybody.
We got to give them some time.
I got to do something.
No, you got to try and let us do our jobs, okay? Come.
Slow it down.
Christina? Kelly, are you still evacuating peds? Malia, Judy, and I are doing the final check.
Okay.
Candy? What happened to my mom? It's okay.
Don't worry.
We'll take care of you.
Okay, listen.
Judy, do me a favor.
I need you to go up to the ICU and help Marshall with her patient.
Me? Yes.
You.
Kelly, stay close.
- All right, Tom.
You ready? - Yeah.
All right, slow it down.
Easy.
Easy.
Hang on, Mr.
Rickles.
One, two, three, go.
I got to get the corner.
Yep.
Hold on.
Hold on.
What? This thing here.
What is Damn it.
What? The emergency exit's blocked.
We have to go back up.
Everyone evacuated? This is pretty chaotic.
We should have a drill prepared for this.
We were supposed to.
What can I do? Uh, check with Gail.
She's supposed to be coordinating.
Where is she? I don't know.
I haven't seen her.
Okay, ready? We're gonna carry her down the stairs? No, we're gonna ride her like a three-man bobsled.
Watch your nails and grab the mattress.
What's going on? Stay right here, okay? Okay.
What happened? The stairway's blocked.
The north stairway has smoke in it.
The fire department is telling us that they're on their way up, but we got to stay put.
You're doing great.
You were never a good liar, Ray.
Tom, her sats are dropping.
It's 85.
Now 79.
Okay, let's intubate.
Kelly, get an intubation tray, please.
Okay.
And let's give her etomidate and succs.
I got it.
No, no, no.
Kelly's got it.
Judy, do me a favor.
Get Justin out of here.
He doesn't need to watch this.
I'm so sorry, Ray.
Is she gonna be okay? Uh, yeah.
Come with me.
We'll find your mom, okay? Got it? Yeah.
Okay.
Okay.
Okay.
I can't see her cords.
There's too much damage.
Okay, well, we've got to make an airway.
What do you want to do? You want to go through her throat? We could do a cric.
Here, in the hallway? That's probably our best shot.
Get me a cric tray.
Yep.
Gail! Have you tried calling her? Twice.
Try again.
It's coming from over there.
Oh, my God.
Gail.
She's unconscious.
Grab her head.
Watch her.
Okay.
Gail? Gail? Gail, can you hear me? We need some help in here! Gail? She's got no pulse.
Grab a defib and some oxygen.
You want to take over? Okay.
Okay.
200 joules.
Okay.
And clear.
Come on, Gail.
Come on.
Clear.
Clear.
Normal sinus rhythm.
She's got an ST segment depression.
I think she's had an MI.
We need to put her on high-flow oxygen.
Okay.
We need IV access to start cardiac workup.
Hey.
Hey.
What are you doing here? My grandma's on another floor.
They're trying to help her.
Well, you're here by yourself? There was another nurse.
And she just left you? Come on, we got to get you out of the building.
No.
I can't go.
I have to stay here and make sure my grandma's okay.
She'll be fine.
No! She's gonna die, and I don't want her to die.
Justin, come on.
Leave me alone.
Justin Whoa.
Is the room spinning? What? No.
Yeah, it is.
Everything's spinning.
What's wrong with you? I feel like I'm on one of those teacup rides, you know? Can you help me sit? Uh, how's that? Better.
Sort of.
I hate spinning.
Do you like getting dizzy? Yeah.
It's cool.
Yeah? What's your favorite dizzy ride? The Tilt-A-Whirl.
Nice.
You okay now? Yeah.
Come on.
Let's go.
Candy's prepped.
Her sats are down to 63.
What are you guys waiting for? Take a deep breath.
Getting crazy is not gonna help.
All right.
Scalpel.
Okay, Helen.
What's going on with you? She's desaturating! Her sats are down to 75! Oy vey.
Is she having trouble breathing? Don't worry.
It's not contagious.
Give me the introducer and tube.
Okay.
Guys, I think I'm gonna need some help over here.
No breath sounds on the left.
She's got a tension pneumo.
Ray, I need a thoracostomy tray.
Ray, come on.
Snap out of it.
Let's go.
Uh, thoracostomy tray coming up.
Hey, Brenda, how's your hand? Can you do this? I can barely move it, but I'm gonna have to try.
I don't like the sound of that.
Yeah.
McLinn's right, way too risky.
Christina, you got to get this.
What about you? My hands are full.
Brenda will walk you through it.
Tom, I can't, okay? I don't believe that for a second, okay? Helen could die.
We owe it to her to do everything we can.
You can do this.
Fine.
No thoracostomy tray on the floor.
Then grab a syringe from the drug box.
Let's go.
Yeah.
Okay, tube's in.
Bag her.
Okay, right here.
Mmm-hmm.
Here you go.
Third intercostal space, okay? Midclavicular line.
Stay perpendicular to the chest wall.
You can do this.
Sats coming up.
Good breath sounds on the left.
Candy's sats are up, too.
Yeah, when this is all said and done, you should consider medical school.
If I left, who would keep all of you in check? Boy, you guys got some chutzpah.
I can take it from here, Kelly.
I should go find Justin.
Good job back there.
Thank you.
You didn't do a bad job yourself.
Her right pupil's blown.
Did she hit her head? She must have.
She has bleeding in her brain.
Classic Cushing's reflex.
We need to decrease her intracranial pressure.
Tom, we can't open her head right here in the hallway.
What other choice do I have? No, no.
You can't be serious, man.
You will kill her.
Ray, just relax, okay? No, I'm not gonna let you do it! Ray She needs it.
She needs it.
No! It's Ray, she needs it.
Tom, look at me.
You sure you want to bore holes in her head right here in the hallway? I'll tell you one thing I'm not gonna do.
I'm not gonna let Candy and her baby die.
All right, I'll get the supplies.
I can't find a drill! I got to get to neuro! Ma'am, we're gonna have to redirect you.
Okay, thank God you guys are here.
Are you okay? Yes, yes! You're gonna be okay, Gail.
Hold the fort down while I'm gone.
I will.
And don't let Christina get her paws on it.
I won't.
I lost my leg when I was 11.
I was in a car accident with my sister.
My leg got pinned.
They had to use the jaws of life to get me out.
By the time I got to the hospital, I was told I had to lose my leg.
My name is Guillaume.
Guillaume Stevens.
I guess "Steve Shaw" is an upgrade.
All this is about a name change? Is "Guillaume Stevens" that bad? It's not about the name.
I've lied to you about who I am.
My father's a criminal.
So are all my brothers.
Pretty infamous in England for, uh, white-collar crime.
But I didn't want to be a part of that life, so one day I just left.
I changed my name so they couldn't track me down, and I came here.
I don't believe it.
You're Guillaume Corleone? Well, I guess you didn't need to keep your leg a secret.
And you didn't have to keep your family a secret.
Does this mean maybe I can keep my toothbrush at your place? Keep everything.
Oh, we have it, sir.
No, I'm going with her.
You can't.
She needs me, man.
And I need you to step back.
I'm sure there's enough work around here to keep you busy.
Come on, man! Just let me go.
Please.
A little professional courtesy.
She's a friend.
Mom! Thank you.
We should go.
Thanks, Kelly.
You're very brave.
I know.
All right.
Mom! You're okay.
I'm fine.
Good.
Um, how can I help? Why don't you find Marcus and see if he needs any help with anything.
Yeah, for sure.
Anything.
Hey.
I love you.
A lot.
I love you, too.
All right.
Got to go.
See you later.
Yeah.
Can we get heightened security around our pediatric patients, make sure that all the parents have wristbands? Thank you.
Hey.
You need any help? Uh, no.
I'm good.
Thanks.
Uh, let's put him on a breathing treatment.
Thanks.
Oh.
So, sorry about your MRI.
I'm getting used to things crashing down around me.
What does that mean? Forget it.
This isn't the time.
Look, Erin, I owe you an apology.
You've been nothing but caring and selfless, and you've helped me through the hardest time in my life.
But But You are a really sweet guy, Tom.
And I thought maybe even Apology accepted.
You deserve better.
If you ever do this to me again, I'll kill you myself! Oh, shut up and kiss me, you old bat! Oh! Sweetheart.
Oh.
Hey, Marcus! Hey! Hey.
Give me that.
I'll help you.
Got a Gates? Gotcha.
Lyons.
This was an act of God.
You can't judge us today.
My mind is made up.
Cecil, thank goodness you're okay.
Yeah, well, my back's a little worse for wear, but we finally made it down all right.
Ms.
Yee is recommending closing James River.
No.
You can't do that.
This hospital is a disaster.
You're lucky no one was killed.
Okay, you know what? We're not perfect.
I'll give you that.
But we've risked so much trying to keep this hospital on its feet.
You can't just shut us down! I'm sorry.
I saw too many hazards here today.
And considering your institution's history, we can't keep turning the other way.
Unbelievable.
This is ridiculous.
You have no idea what you're talking about.
Excuse me? You want to shut this hospital down, you're giving this entire community a death sentence.
Is that what you want? Go right ahead.
Look the other way.
Watch it burn down.
But don't come here and tell us what we did in there today doesn't matter or doesn't make a difference, 'cause that's wrong.
That's 100% wrong.
Wait a minute.
Wait a minute.
This staff went above and beyond the call.
Sure, maybe all their T's aren't crossed.
But I can't imagine a more dedicated group of people.
Thank you.
So, you're not shutting us down? You get a pass for now.
We'll take it.
Good work here, John.
Thank you, Christina.
I'm sorry.
That was inappropriate.
No, Tom.
You know I love you, right? Yeah.
I need you.
I can't be myself without you in my life, Christina.
I'm so tired of playing these games and hurting each other.
Okay, then let's stop.
Okay.
Okay.
I love you.
I love you.
I'm pregnant.