Trauma s01e16 Episode Script

Frequent Fliers

How do you want it? You know how I like it.
Hey, Marisa, come on, it's Dude! What? Come on, we got a call.
Jeez! What? Nothing.
You all right? Yeah.
Let's go, then.
Come on.
Okay, yeah.
Nancy did not get Joe fired.
He brought it on himself, you know? Mmm-hmm.
And Joe was always lax with the rules, so, God love him, this time he got caught.
What, you think I'm wrong? Okay.
Hey, hey, Marisa.
Earth to Marisa.
Come in, Marisa.
Oh, hey, no touching! Oh, okay.
Got my gloves on.
You stay over there.
All right.
Glenn, come on, eyes.
Oh, my bad.
Here, you're good.
Diana just texted me.
She said the new trauma chief's a real hard ass.
Oh, yeah? "Dismissive, condescending, manipulative.
I want to die.
" Sounds about right.
You know who it is.
This is Helen Seiger, she's 35, had some bad seafood.
Suffering from nausea, vomiting, diarrhea, treated with nasal cannula and NS.
Okay? Why is it a secret? Give up.
You guys see the new guy? No, he's in administration.
Guys, wouldn't it be cool if the new guy was Dr.
Joe's twin brother and they were completely opposite, but then later, we reveal that it's actually Dr.
Joe? He doesn't have a twin.
Does that make sense? Played by Al Pacino.
Or Nancy could tell us.
She knows who it is.
What? Nance? Nah.
Right? What? Come on, Nance.
Don't be holding out.
You told Glenn? I did not tell Nancy, a word.
Hi, Dad! Wow.
Dad? You okay? Yeah.
You know what? I'm excited.
You're all gonna see, firsthand, why I'm so completely screwed up.
Not that I needed to see why, but Why didn't you This is your Nance.
Unbelievable, guys.
Have a seat.
New look.
It's very, uh, formal.
Thank you.
It wasn't exactly a compliment, Dad.
Nancy, in the ward, you need to refer to me as Dr.
Yes, I'm sorry.
Okay? I couldn't resist it, that's all.
Of course.
So, how's it going? Well, you know, emergency medicine is not my specialty, and it's been a while since I've been this, um This hands-on, but Yeah, it feels Feels good.
Listen, uh Dr.
Joe left a lot of slack for me to pick up.
Slack? Yeah, well, this trauma center's become like flypaper to adverse legal action.
So, the board's asked me to fix it.
And I was hoping the paramedics would respect that.
That it? Yes, that's it.
Listen, Nance, uh I always hoped that one of my kids would actually work in this hospital.
Of course I thought it would be Peter or Troy, but I must say that I'm glad it's you.
Thanks, Dad.
Uh, Nancy.
" I'm sorry.
You got it.
This is Christine Vanderos reporting live in front of yet another medical marijuana facility shut down by the federal government.
The battle between federal and state laws continues to play out in the most unlikely of ways.
Okay, let's go grab that.
If it speeds, it leads.
I'll get 'em on the scanner.
They're taking a right on Lincoln.
All right.
You ready? Ready.
Here we are live, in hot pursuit of a police chase.
Sorry, we have to cut.
We're getting some beeping sound.
Doug, what's beeping? Oh, damn it! Hold up.
All right, let's make sure we set that perimeter up on the curb, all right? Good? Yeah, yeah, I'm good.
Grab this reducer, and I'm all set.
Hey, wait! Wait! What? Wait until the scene is secure.
Rule number one, never become the victim.
Rule number two, refer to rule number one.
Yeah, we call those "Nancy-isms.
" I know.
Power's off.
I repeat, power's off.
Okay, we're good? Okay, scene's secure, let's go.
Let's go, guys.
All right.
Okay, Glenn, take his vitals.
Yeah, yeah.
Sir, how many people are in the car? Three.
Can you hear me? You got to please help her.
Yeah? Help him on a C-spine, okay? Hey, he's in pretty bad shape.
You got his head? Miss, can you hear me? Hey, boss.
Okay, we need to get her out of here.
Can you hear me? What's your name? Doug.
How we doing, Doug? Fine.
Are you in any pain? No, I'm not in any.
What happened, Doug? I don't know.
I screwed up.
I wrecked the van.
Where the hell is Rabbit? Do I have great timing or what? What do we got? You take the guy on the windshield.
Hey, guys.
Hey, miss? Hey, Nancy, need a hand? Yeah, we need to get her out of here.
Hey, Doug, hang in tight, all right? Awesome, guys.
Right down here.
That's it.
All right, I think we got a pulse.
On three.
One, two, three.
Okay, we're good.
Watch your step.
Got it.
Oh, wow, welcome back.
Aren't you the cameraman? Yeah.
Yeah? I hope you got all this.
One, two, three! Go.
Good morning, Mrs.
Hey, guys.
Hey, George, how you doing? Can't complain.
Yeah? Yeah.
Hey, you been losing weight? I'm trying, man.
What are you doing? Pilates.
Pilates? Nude Pilates? Hey, you guys know the way.
I hate Pilates.
Ah, yes, we do.
You wish it was nude.
Yo, did they repaint? They did repaint.
This used to be purple.
Is that new? Hurry.
There's not much time.
I'm dying, I know it.
This is it.
I'm absolutely sure.
Absolutely sure? You said that last time, Ira.
And the time before that.
No, no, no, but this time I'm feeling it on the inside.
It's like Like I'm breathing through a straw.
I've got some Stay Awake in the fridge.
My energy drink? Yeah, I saw you drinking it last time, so I stocked up.
Ira, you are awesome, man.
Ira, I hate to disappoint you, but I don't think you're dying today.
I'm not? At least not from natural causes.
Now, if you want to speed up the process, we could take you down to the Tenderloin.
No, but I'm having trouble breathing.
It's like I got a golden retriever on my chest.
Golden retriever.
That's very descriptive, Ira.
Let's see Huh? Better? Yeah.
Yeah? Yeah, that's better.
All right.
Can I still have a ride to the hospital with you guys? You know the magic words.
Ask and you shall receive.
Ah, I gotta say, Ira, you have got to be our most frequent, frequent flier.
"Frequent flier"? Yeah.
A frequent flier is the guy who knows my favorite energy drink.
All righty.
Oh! Hey, why are you walking so fast? I'm not walking fast.
You're just walking slow.
Oh, right, so I just need a jolt then, huh? Coffee, yes, perfect.
I'll get some.
How do you want it? Uh, you know how I like it.
What? Nothing.
Hey, what's up? Hey, getting a jolt? Already heard that one.
Oh, damn.
Hey, you mind if I ask you a weird question? Yeah, that's my favorite kind.
Has Boone ever been in your dreams? Oh, yeah.
Yeah? Yeah.
Like, in what way? Um, well I had the body of a sheep, and my head was the same, and then Boone was off to the side as this Bo Peep figure in a pink dress Have you ever had a sex dream about Boone? Wait a minute.
You had a sex dream about Rabbit.
Ow! Shut up, you idiot! Okay, I'll use my inside voice.
Look at me.
Look at me in the eye.
You had a sex dream about Rabbit.
It's freaking me out, okay? I'm messing up my call today.
I can't do this.
It's totally unprofessional Okay, okay.
and I don't know what to do.
Okay, I'm sorry.
Look, look, sweetheart, honestly, these dreams, okay, they're up for interpretation.
It's symbolism.
It's about intimacy.
You're getting closer as partners.
You're bonding.
Okay? Yeah.
Yeah, no, I guess that makes sense.
I mean, and while we're at it, I mean, how big would you say the symbolism was? Stop me when Ow! That's tender.
The same spot you hit me Good.
Ow! Same Hey, this is Christine Vanderos, 31.
She's got second-degree electrical burns to the face and right arm, third-degree burns to her right upper chest.
Burn scale estimate, 18%.
Two liters saline and prior to airway management.
Where are we going? Right there.
Thank you.
Got it? Okay, ready to transfer.
On three.
One, two, three.
Get back to Station 4, restock the rig.
Hold on, hold on.
This run report's incomplete.
Well, we filled out all the information that we had available to us.
Well, it's lacking a full set of vitals.
The patient's personal information is not on here.
It's kind of hard to get all that when she's got an endo-trach down her throat.
Well, you can get it now.
Call her workplace and see what you can find out.
Okay? Call her workplace? Are you serious? Yeah, I take my job very seriously.
Do you? Look, Dr.
Carnahan, we're very tight on rigs.
So, if you keep us back from a call to do paperwork Then I will have done my job, as I expect you guys to do yours.
So, just don't leave the hospital until it's done.
What have we got here, folks? Wow.
You know you got to take your shoes off, right? What? Why I got to take my shoes off? You cannot go in there with your shoes on.
I Dude, no.
I'm not taking my steel toes off.
Those are my steel toes.
What if one of those Buddha heads falls off the altar thingies when they're praying, fall on my crushed toes, man.
I got crushed toes all day.
Do you have any idea how many things you got wrong in that one sentence? Uh, no, but I'm sure you'll tell me.
Anybody call for help? Yes, I did.
For my mother.
I'm sorry, sir, I don't Dad, please.
What's going on? Please.
My wife, you cannot touch.
Not when jum'ah prayers.
He says she has these fainting spells all the time.
How often? She's had them twice already during prayers, but she wants to keep praying.
Okay, but we should still examine her.
Dad! Go.
I'm sorry.
They're very traditional.
After she's done praying, can we check her out? Yes, yes.
So, what? We're supposed to sit here and wait for them to finish a prayer? Yeah.
She doesn't look critical.
Let's just wait in the rig.
When was the last time we filled out paperwork like this? It's ridiculous.
It's insulting is what it is.
And you're just gonna let him treat you like this? Hey, you ever play Little League? Yeah.
Your dad ever coach you? Yeah.
Did he ever ride you harder than he did anybody else? Yes.
And what did you do? I shut up and took it.
Your timeline's inconsistent with the injuries sustained.
Try it again.
Thank you, Doctor.
Oh, hello, Nurse Gina.
Yeah, thanks for the warning.
Oh, what? What did I do wrong now? You could've told us Nancy's dad was the prince of darkness.
Is that Ira? Yep.
Ira! Rabbit.
My favorite frequent flier.
How are you, man? I'm dying.
Well, when you got to go, you got to go, right? You eating those? No, no, help yourself.
I got no appetite.
I can't keep anything down.
Everything keeps coming up.
Yeah? Let me have a look.
Like I'm bungee jumping.
You seem fine.
I missed you, man.
You had to become some hotshot flight medic.
Well, you know, the times, they are a-changing.
You and Nancy made a nice team.
We still are, if you know what I mean.
No! I knew it.
I knew there was something going on with you two.
Oh, yeah? What do you know? Yeah.
The way you used to look at her, like she was a bright window in a dark, dark room.
Stop it! Oh, it's a shame you're dying.
I mean, how about we catch up later on? I'll take you out for a drink.
Sadly, I will have to decline the invitation.
Mmm? Because, uh, I'll be dead.
Oh, Ira.
Come on.
Palchuck? Yeah? Mr.
Palchuck, a word.
Look, if you find yourself alive, 10:00 at The Cove.
All right? You got it.
How do I say this, Reuben? This is not gonna be good, is it? I don't want to see you in this ward unless you're bringing in a patient or you're unfortunate enough to actually be a patient.
Wow, laying down the law, huh? Yeah, well, somebody's got to.
All right.
Oh, and Dr.
Joe gave me the same speech.
Yeah, well, Dr.
Joe didn't have the board behind him, nor the balls to back it up, and I do.
Goodbye, Reuben.
Man, if this is about throwing the book at me, okay, I get it.
But if this is about my relationship with Nancy and you not approving, come on, we got to have a whole different conversation here.
Okay, by the look on your face, you have no idea about me and Nancy.
I'm going to go.
Come on, man! This isn't a vacation! Pick it up! It's Friday! I wanna get out of here! Yeah, I bet you haven't picked it up in, like, 20 years.
That's Hey, why don't you come over here and help me with this pipe? Angel Rescue 2, respond to a 48-year-old male, two-story fall victim, Richmond District.
Today's the day.
You could have called in sick, huh? You're telling me.
All right, so got any neck or back pain? No, just my legs.
Okay, so on a scale of one to 10, what's your pain level? Ten.
Tell everyone I said four? You got it.
Okay, he's satting at 94.
Pulse, 110.
Okay, good.
Get him some oxygen.
You want something for that pain? Does anyone ever say no? All right, pinch the tube off for me.
Here we go.
Come on.
Look, I don't know what I did to you, but don't bring it here, all right? Let's just kiss and hug and make up, and try to rock this thing the right way.
Okay? Yeah.
Let's get out of here.
And we're good to go.
I had a sex dream about you.
This is Angel Rescue 2, departing Richmond en route to City.
Copy, Angel Rescue 2.
No, seriously, how long does a prayer take? I don't know.
Do I look like Malcolm X to you? No, seriously, why are we humoring them? I mean, we're not living in the Stone Ages anymore, okay? That woman actually could be in trouble.
Yeah, but this is a holy place, man.
You gotta just chill.
Holy place.
Let me see, last time I was in church, I pretty much acted this way, if not worse.
You know? There's nothing sacred to you, right? Yeah, my steel-toed boots, my rabbit's foot, and the New Orleans Saints.
Seriously, man, you should give church No, no, no, no.
I gave up on church the second the church gave up on me.
She fainted again.
Please, come quickly, please.
Tyler, your shoes, man.
No, no, I'm not playing that game anymore.
Excuse me, ladies.
No, please, you cannot.
All right, she's unresponsive.
Tell him to stop.
Please, tell him to stop.
Listen, sir, I'm a man of faith, too.
Please, let me help your wife.
I promise to respect your beliefs.
Abbu, let him pass.
Ammi needs their help.
He'll be respectful.
Okay, go, go.
Seriously, huh? You're actually putting the leads on blind? We've done enough damage.
I don't wanna make it any worse.
Hey, I'm impressed.
Okay, you got it? All right, she's brady.
Okay, no go, no go.
The IV's clotted.
All right, I'm gonna What does that mean? What's it I'm gonna push a Heparin flush.
No, you can't.
Why? Look on the bottle.
Okay, it's Porcine Heparin.
It's made out of pig.
No, saline flush.
Thank you.
See, Abbu? All right, we're clear.
I'm pushing atropine.
What's happening? Why is she shaking? All right, she hasn't been fainting.
She's having a seizure.
Hey, Ms.
That man should be ashamed of himself.
You want us to take your blood pressure on the way out? Well, that would be very nice, Nancy.
Thank you.
I'm running a fever.
Orally, I'm 100.
Under the arm, 98.
But rectally, it's 101.
Please tell me he's using three different thermometers.
At least two.
Ira, those numbers really aren't so bad.
I know, but I know you're dying.
Oh, I got you some of those biscotti from Cavalli in North Beach, the kind you like so much.
Ira, you're spoiling me.
You gotta be kidding me.
What? Tell me, what? What is it? Is it serious? When was the last time you had an electrocardiogram? Jeez, I don't know.
What What time is it? Nance Glenn, just put them on.
I heard about you and Rabbit.
Oh, God.
Insane news travels fast, huh? Yeah, congratulations.
Well, thank you.
It's ridiculous.
It's like he's being vandalized by the medical community.
What's the heart rate, Glenn? It's fine.
He's fine.
Okay, good, then we're all doing our job properly.
So, I'm not dying? No.
Ira, no, you're not dying.
Listen, when you call us, you're taking our help from someone who actually might be dying.
So the next time you get the inclination to call, just Just think about it, okay? I'm sorry.
Ira, it's fine.
It's okay.
You called us, we came.
Do you still want to go to the hospital? Yeah.
You know, I just want to be sure.
Okay, give me your best potshots.
I want to get this over with.
You know what? The whole dream thing, it's getting in the way of the work.
Let's forget it.
Okay? We're done.
Forget it.
Let it go, move on.
I'll never mention it again, okay? I promise.
Really? Yeah.
You're not messing with me? Nope.
Thanks, man.
All right.
All right.
So, was I good? What? Was I good? No.
You were the worst lay I've ever had, real or imagined.
She was just dreaming.
You know the drill.
Welcome back, Ira.
Bye, Nan.
Bye, Ira.
Did you look at the chart, Diana? Because that's why we have them.
I looked at the chart, and I saw that he was given Then it was either carelessness or willful negligence.
Which was it? He was given three doses.
I know what was on the chart.
The question is, why didn't you? And then I dosed him with amiodarone.
Carelessness or willful negligence? I was careless.
Thank you for clearing that up for us.
People, carelessness is actually worse than willful negligence because by definition, it can happen at any time, and it does.
So, be careful.
Read the chart.
All right? Now, does anybody want to give me the protocol for cardiogenic shock? Maybe you can shut up and take it, but the rest of us shouldn't have to.
All right, we got a 53-year-old female, hypertensive crisis with reoccurring seizures.
BP 210 over 130.
GCS started at eight en route, deteriorated to five.
One, two, three.
Cover her, please! Guys, guys, guys, she's a devout Muslim, all right? Hey, we got this.
Hey, hey, hey.
I am, I'm trying.
I'm sorry I'm sorry, sir.
Farooq, come on.
Ayesha! She's fine.
She's gonna be good, but, Farooq, you need to wait out here, okay? Hey.
Go away.
It's okay.
It's just me.
I know.
I don't want you to see me like this.
Like what? I don't know.
Upset? Yeah.
Come on, Di, that's absurd.
He's an incredible surgeon.
He's on the board at this hospital, and he can make or break my career with a phone call.
I know.
But he's a dick.
Glenn, I'm serious.
I am, too.
The guy's a total douche bag.
So, what am I supposed to do? You stand up to him.
I can't.
I'm not that strong.
Yes, you are.
I know you are.
What do you mean? I know that when you don't like a movie, you walk out.
Don't you? I know that when I mess up, I do something stupid, you call me out on it, right? And I know that when you're backed into a corner or even the supply closet at the hospital, you come out swinging.
Don't make me start crying again.
Come here.
It's okay.
Hold me.
It's okay.
Take it easy, boy.
Can't you just hold him still? Easy, boy, easy.
Keep your horse under control.
Come on.
All right, boy.
Take it easy, baby.
Now stand still.
All right.
Come on, boy.
Oh, my God.
Are you all right? Angel Rescue 2, please respond to a 40-year-old male with severe facial trauma in Marin.
Hey, what do we got, Mark? Blood pressure 134 over 84.
Respirations are at 10.
He's currently satting at 77%.
Let's get him out of here.
Yeah, I got a 45-year-old male, multiple facial fractures.
BP dropping.
Got him on blow-by.
Yeah, suction and pressure to control the bleeding.
Put him in a MAST suit.
Ah, well, no disrespect, Doc, but we stopped using MAST suits a few years back.
It was causing major complications.
Yeah, a bolus of saline and monitor the airway.
Get him in here.
Copy that.
MAST suit? Yikes.
Oh, you talking to me now? Mmm-hmm.
Can I help you? Yes, sir, if it's all right, we'd like to talk to you about a patient we brought in.
You know, from what I understand, you bring 'em in, drop 'em off, job done.
Correct? Sir.
Sir, listen.
Okay, our patient is Muslim.
The treatment that she received here is not consistent with her beliefs.
My doctors gave her the best possible treatment.
That's the problem.
It may not be good enough.
I don't understand exactly what you're trying to say here.
Oh, God, what he What we are trying to say is that if we were you, we would hook her up with a private room, a Muslim or female doctor, and make sure all her meals are It's Halal.
'Cause if the hospital doesn't do that, it is quite possible that she'll file a complaint alleging discrimination.
And then you'd have a lawsuit on your hands, so Right.
It's just the right thing.
911, what is your emergency? Hi, this is Ira Finkle at 121 North Piedmont, And I'd like to I'd like to, um Mr.
Finkle? Ira, do you need help? No.
No, thank you.
No, I'm fine.
Thank you.
Thank you very much.
All right, the guy's a farrier, got kicked in the face by a huge freaking horse.
Positive LOC, labored breathing, O2 sat's 90.
And his face was too rearranged for us to get any tubing done in the field.
Got it.
Thank you, Rabbit.
Let's get some fresh vitals.
Yes, Doctor.
Van Dine, what does one do here? Check the airway before resuscitation and treatment of facial injuries.
On three.
One, two, three.
Let's get him into imaging and see what's going on.
He's not breathing, Doctor.
Let's tube him.
Sat's 97.
prep both a Mac 3 and Miller 4.
Sat's 92.
Sat's 89.
Silence the alarm and call respiratory for a vent, stat.
I can't visualize the vocal cords.
Suction, please.
Sat's 87.
Tachy at 140, BP 90 palp.
That's good.
All right, I need imaging here.
There's no time.
Call anesthesia and prep for a cric.
That's the wrong procedure.
I can't do that.
Excuse me? That's the wrong procedure.
Van Dine There's not enough time, and she knows it.
Stay out of this, Nancy.
If you wait for an anesthesiologist, he'll die.
He needs a retrograde intubation.
She's right.
Stay out of this, Nancy.
Carnahan! Dad! Dr.
He needs a retrograde intubation now.
I've never done one.
I have.
You have? On a cadaver.
Just give me the okay.
Do it.
Get me a central line kit.
And some gloves.
Nancy, get out of here.
Sterile needle on a 10 cc syringe.
How's the O2 sat? Palpating landmarks.
Puncturing the cricothyroid membrane.
Prep for Seldinger technique.
O2 sat's holding at 89%.
Still tachy at 140.
Hold the needle.
Got it.
I'm gonna start feeding it in.
Can you see it? No.
Okay, I can't go any further.
Air bubble.
I see it.
Visualizing the guide wire, piercing the air bubble.
Securing the tip.
Advancing the wire with gentle traction.
ET tube.
I can feel the tube passing through the cords.
Removing the J-wire.
Bag him.
Good job, Diana.
And this thing you've got here.
Hey, guys.
Excuse me.
You're a good man.
Anyone dial 911? I got Brought these in case you wanted to pray or something.
There you go.
You got it.
What? The hospital floors are filthy.
Come on, Rabbit, it was a dream.
Yeah, I know.
But what if it gets out? I think you're taking this way too seriously.
Really? Yes.
Really? Yes.
Okay, so what if there were a whole bunch of men in the hospital dreaming about you having sex, and they were saying that you were no good? How about that? Well, first of all, that would never, ever happen.
But yes, that would be a bummer.
Okay, fine, you know what? My Catholic guilt is getting to me.
You were amazing.
You were 100% out of this world.
My body and loins were vibrating, amazing.
You happy? Okay.
That's better.
All right, guys, hitting The Cove.
Ah, I wish.
Oh, rain check, man.
I'm gonna change your name to rain check, sir.
Nancy? Uh, I'm gonna turn in early, I think.
Yo, Mike.
One of ours? Ira Finkle.
What? What happened? They suspect Legionnaire's Disease.
Doc says there was no way to know.
It looks like he got his frequent flier card.
I'll take that drink.
All right, I'm buying.
Me, too.
Yeah, I'm in.
Bye, guys.
Nancy? I'll see you guys down there.
Ready? Yep.
Yeah, I've got it right here in front of me.
Come in.
Have a seat.
No, I don't think so, Dad.
Robert, uh, I'm gonna need to call you right back.
You're upset.
I think everyone who works for you is, uh, upset, to say the least.
Well, so long as the hospital's protected and the patients are treated, that's a tradeoff I can live with.
You're treading on everybody's toes.
And you are overstepping your bounds.
Admit it, you froze in there.
Nancy, you do not assist doctors with procedures.
That man was gonna die.
He needed a retrograde intubation.
You couldn't do it.
Well, thank goodness we have a doctor in this hospital who could.
We should not get into this.
Look, there's something else There's something else we need to talk about.
I heard that you and Rabbit are seeing each other again.
And I have to say, I'm very disappointed in your choice of Of mate.
And I thought you should know.
No, you don't get to do that.
What, I can't have an opinion about my little daughter, my only daughter? No, you do not get to treat me like an employee one minute and then your little girl the next.
Oh, Nancy, come on.
I kept my mouth shut all day out of respect for you.
I see, so now you, uh Now you no longer respect me.
Okay, when I was a little girl, and I needed you, I needed my dad, you hid behind this hospital.
No, that's not fair.
Now when all I'm expecting is to be treated like a professional, you can't help but act like my disappointed father.
Yeah, but, honey Honey, I care for you.
Oh, you keep saying that.
No, no, no.
What do you mean by that? Tell me.
Forget it.
It's fine.
No, please.
No, it Dad, it's fine.
Tell me.
Okay When Mom was alive, she would put me to bed at night and she would say, "Your father loves you very much.
" She had to say it, because she had to convince me.
Otherwise I'd never have known it was true.
You know, this is not the time, nor the place for this discussion.
I agree.
So, either you treat me like the damn good paramedic that I am, or we cannot work together.
I don't think that we can work together.
'Cause you're always gonna be my little girl.
I can't help it.