1. Previously on ER…
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2. So, the baby is a girl today.
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3. You turned me in?
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4. There's a guy from the medical board here
questioning my competence.
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5. Minority kids don't have the same access
to academic opportunities.
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6. You want to address that by
advancing under qualified applicants
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7. at the expense of
our integrity and theirs?
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8. I want him to have an interview.
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9. Everyone deserves to be
comforted in their darkest hour.
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10. Too bad you weren't there to
comfort the little girl he killed.
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11. - I didn't mean to be. God was there.
- Was he?
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12. Mr. Stewart, can you hear me? Call 911.
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13. Again.
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14. It hurts when I breathe.
Could it be my heart?
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15. Something wrong?
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16. - Hey.
- What?
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17. - Is there something wrong with my heart?
- No, probably a bruise to your chest wall.
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18. We'll get an X-ray to make sure.
You were lucky.
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19. We'll probably be sifting
through the walking wounded
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20. until morning, but I think
we're over the hump.
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21. Carter just brought up the last critical.
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22. - How many came in?
- Thirty-seven. Five in surgery.
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23. Only two ER deaths.
That's not too bad, considering.
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24. If you don't count the DOAs.
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25. You did a great job.
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26. You should go home.
We got it from here.
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27. - The board's backing up.
- We're fine. Go home.
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28. We'll see you tomorrow.
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29. Hey. You leaving?
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30. Uh, no, I thought
I'd check on the bishop.
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31. - Another critical come in?
- No. That's it.
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32. Is she stable?
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33. - Yeah. After three rounds of terbutaline.
- Good.
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34. - It was scary, though.
- Yeah.
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35. So are you heading home soon?
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36. Um…
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37. I don't know.
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38. You okay?
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39. Yeah.
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40. - Any change?
- He didn't want the breathing mask.
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41. - Has he been awake?
- Napping on and off.
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42. What time is it?
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43. 11:30.
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44. You're here late.
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45. You'll have to be intubated soon.
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46. On a ventilator?
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47. Your oxygen level is down to 65
on 100% oxygen…
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48. I've seen what happens
after a ventilator.
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49. - If it drops below 50…
- Thanks. But no thanks.
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50. Anyway, my bags are packed.
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51. Water! I need water.
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52. - Mr. Martin!
- Oh, it stings!
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53. Mr. Martin, I told you,
just give it a few seconds.
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54. No, it stings.
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55. Give it a few seconds
and the pain will fade.
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56. - Need some help?
- No.
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57. I just put in a drop of Alcaine.
Come on.
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58. Mr. Martin fell asleep
under a tanning lamp.
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59. I wasn't tanning. I was depressed
due to lack of sunlight.
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60. Tell me about it. Just got back from lunch
and it was already getting dark.
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61. UTI in four is gone.
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62. Did the groundhog see
its shadow this year?
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63. Seeing his shadow has absolutely nothing
to do with how much sunlight we get.
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64. Yes, it does.
Six more weeks of winter.
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65. Seven-year-old with diarrhea
and wheezing.
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66. Ordered Solu-Medrol
and breathing treatments.
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67. - Any history of asthma?
- Nope.
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68. - Fever or cough?
- Nothing.
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69. - Carter, want to figure this one out?
- Bring it on.
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70. Okay, that's it. Weaver's on at six.
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71. Could you tell her
that I'm finished testing tonight
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72. so she can stop avoiding me?
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73. How'd your personality test go?
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74. I scored somewhere between
serial killer and talk-show host.
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75. - I thought they were memory tests.
- That was Monday.
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76. What's next, Rorschach? Spelling bee?
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77. Swimwear competition,
sudden-death Twister.
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78. Who knows? Maybe a chili cook-off.
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79. The needle goes in, but you can
squeeze on the owie ball. See that?
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80. - What's up?
- Won't you hold that for me?
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81. Kid freaked out when I tried
to start an IV.
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82. And then the needle comes out…
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83. - Who's…
- She's a new intern for Pedes.
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84. …to give you medicine.
And then it won't hurt anymore, okay?
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85. Hey, Jason. I'm Dr. Carter. I understand
you're having some trouble breathing.
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86. - You mom?
- Yes.
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87. - Any history of asthma here?
- No.
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88. Mrs. Fabrone works
as a cleaning lady at a church.
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89. She found a bottle of holy water
in the sanctuary and she thought
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90. - it might help with Jason's diarrhea.
- Holy water, huh?
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91. Only it tasted funny. When Jason started
coughing, she checked. It was lamp oil.
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92. - He aspirated holy oil?
- I guess so.
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93. That's the common duct.
We don't cut that. What time is it?
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94. 4:55.
No. Your interview tomorrow.
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95. Oh. 10:00 a.m.
Get there by 9:30.
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96. Right.
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97. So why do you wanna be a doctor?
What?
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98. It's a common question
in the interview.
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99. Oh, yeah.
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100. Clips. So, what's the answer?
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101. I wanna help people?
Oh, man.
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102. No?
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103. All right. Now we dissect
the gallbladder from the liver.
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104. What's the right answer?
You tell me.
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105. The money?
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106. I wanna be a role model.
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107. You know what,
if you're not gonna take this seriously…
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108. I am. I just don't know.
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109. - I guess I always thought it'd be cool.
- Well, at least that's honest.
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110. So I should say that?
Of course not.
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111. Dr. Benton, how much longer
do you have?
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112. Are you timing me, Shirley?
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113. Mass-cas called in.
They need you downstairs.
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114. What happened?
They didn't give me details.
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115. All right. Let me get some
more suction. I'll be maybe 15 minutes.
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116. Okay.
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117. You should hang out.
You never know what you'll see.
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118. Great job, Jason.
I'll stop by and see you later, okay?
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119. - You're admitting him?
- Yeah, just for a day.
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120. Keep him on continuous nebs
and monitor his sats.
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121. - Where's mom?
- She went to go talk to her priest.
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122. Could've used you, actually.
She got a little upset after you left.
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123. About her kid
or because she stole from the church?
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124. My friend, Tony, he used to lift
communion wine for us.
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125. He just went to confession.
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126. - What about you?
- Me? I just got sick.
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127. - So you're a heathen.
- Protestant.
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128. Is there a difference?
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129. - Uh, will you sign this for me?
- What is it?
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130. It's for my supervisor. If you think
I did a good job with the kid.
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131. "Child Life Specialist."
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132. Intern. First day.
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133. Oh, yeah? Hey, welcome. John Carter.
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134. Rena Trujillo. Nice to meet you.
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135. And you.
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136. - Don't forget your voodoo doll.
- It's a procedure doll.
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137. They make them life-size
for really big kids?
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138. - Why, you lonely?
- Yeah. I work a lot.
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139. That's too bad.
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140. - John, Luka needs you.
- Abby, this is Rena.
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141. Hi. A train derailed by Lakeshore.
They're declaring a NBI.
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142. They need to set up a triage center.
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143. Excuse me.
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144. - Any passenger cars?
- It was a commuter train.
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145. - How many?
- They don't know.
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146. They're just pulling bodies out.
They need docs on-site.
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147. Prep the trauma rooms, set up
Curtain two and three for majors
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148. and pull everybody in.
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149. - Carter, let's go.
- Is the chopper already here?
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150. - Yeah, they'll meet us on the roof.
- We don't have an attending.
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151. Kerry's due in 15 minutes. Call me
on the chopper if you have any problem.
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152. Four units of O-neg.
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153. Move all stable patients into the hall.
Double up the rooms.
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154. Anyone walking waits in Chairs.
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155. Put all surgical teams on alert
and notify the O.R.
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156. - Already did. We're low on vents.
- Well, then grab some from the ICU.
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157. - Found it.
- Randi, call the nursing supervisor
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158. - and float some nurses from the unit.
- They'll need them up there.
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159. - Get them from Med-Surg.
- Oh, my God.
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160. Captain Davis, incident commander.
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161. We were evacuating the first batch
of the car when it rolled.
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162. I got a man crushed underneath.
His legs are pinned.
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163. Fourteen DOAs so far,
we're still pulling them out.
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164. - Two middle cars are the worst.
- What happened?
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165. An automobile stalled
on the tracks.
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166. We think the brakes on the back passenger
cars failed when the train tried to stop.
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167. Blunt chest trauma over here,
dropping his pressure!
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168. I've got it.
You take the crush injury.
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169. - What's on the monitor?
- Sinus tach.
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170. - Vitals?
- BP, 90/60. Pulse is 120.
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171. I was supposed to fly.
My damn flight was canceled.
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172. Okay. Rales on the left.
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173. My chest.
Feels like something tore inside.
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174. Try a 14-gauge and bolus
a liter of saline.
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175. Mitch! Mitch, I'm sorry, man!
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176. Don't apologize to me.
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177. I didn't know it was gonna
tip over like that.
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178. BP, 85/60. Pulse, 110.
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179. Doc, I need something more
for the pain. This doesn't work.
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180. - What did you give him?
- Ten of morphine.
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181. I had to hold off
when he dropped his pressure.
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182. I'll give him five more,
but after the liter.
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183. - How long till you can get him out?
- We couldn't lift it with the jacks.
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184. - We're bringing him out…
- How long?
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185. How long do you have?
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186. Get a jack on this.
That's not gonna hold.
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187. - She conscious?
- Yeah.
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188. - I'm Dr. Kovac. What's your name?
- I couldn't get out.
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189. - Your name? Do you know your name?
- Shannon.
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190. Okay. Does your neck hurt?
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191. - No.
- Hey, Luka!
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192. - What?
- We may need a surgeon.
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193. Call it in.
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194. We might not be able to get him out.
I need a surgeon
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195. - with a field amputation kit.
- He's on stand-by.
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196. No, not on stand-by. Here now.
He's losing a lot of blood.
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197. Help.
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198. - Ma'am, has someone examined you?
- They're looking for my son.
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199. He wanted to go to the bathroom
by himself.
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200. - Okay, let's get you out.
- I can't move my legs.
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201. - Does your neck hurt?
- Please, you have to find my son.
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202. - Okay, lean forward.
- I can't!
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203. Doris!
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204. Are you allergic
to any medicines?
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205. - No.
- He's wearing a blue sweater.
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206. - Doris!
- In a sec!
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207. I need a line and a set of vitals!
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208. He's seven.
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209. He wanted to go
to the bathroom by himself.
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210. Saline, wide open. Nasal O-2,
and get me if she's hypotensive.
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211. Please, you have to find him!
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212. - Are you looking for a little boy?
- He's pinned.
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213. - We have to cut him free.
- Can you get a BP?
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214. No room. Pulse is thready.
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215. - How do I get in there?
- The roof.
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216. Systolic's 95.
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217. Make it two liters. Radio the IC.
I need the metal cut before we transport.
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218. - Did they find him?
- I think so.
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219. - Is he okay?
- I don't know yet.
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220. - What's his name?
- Myles.
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221. - Where is he?
- Over here.
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222. - Got an airway?
- Breathing on his own.
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223. We're waiting on a circular saw.
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224. Myles? Myles, can you hear me?
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225. Pupils are poorly reactive.
Looks like a closed head injury.
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226. - We need to get him out.
- I told you,
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227. - equipment's on its way.
- Get it here, now!
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228. She's throwing PVCs.
Do you want us to treat?
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229. - What?
- Ectopic beats. Can we give lidocaine?
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230. - What's the injury?
- Train hit her car.
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231. - Possible pubic ramus fracture.
- No, not at her age.
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232. Just get her to County.
Where's the amputation?
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233. - I don't know.
- Over here.
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234. We've got a crush injury to the legs.
BP's 90/65 with fluids.
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235. I don't know how much longer
we can keep it that way.
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236. - They can't get him out?
- They're trying to, but…
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237. - You all right? You okay?
- Damn it.
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238. Ah, I'm fine. I'm fine.
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239. - What's his name?
- Who?
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240. - The firefighter.
- Lorcan.
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241. I had to inflate two BP cuffs to use
as tourniquets. Watch your step.
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242. Right.
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243. You okay?
Yes.
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244. Lorcan, I'm Elizabeth Corday.
I'm a surgeon.
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245. You gonna cut them off?
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246. Only if I have to. Now, listen.
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247. We can't give you more pain medication,
because we need to keep
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248. your blood pressure up. So I'm going
to give you a nerve block. Okay?
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249. Do it fast.
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250. Prep the groin area. Betadine.
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251. - How much fluid in?
- Three liters saline, two of O-neg.
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252. Twenty-gauge for the injection.
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253. These cuffs aren't holding.
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254. I'm gonna reinflate them
and then clamp them.
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255. - Lorcan, you want me to call Patty?
- No!
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256. - You sure?
- I'm not dying, man.
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257. - All right, buddy.
- Who's Patty?
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258. Patty's my ex-wife.
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259. Guys and I were going out after the shift
to celebrate my divorce going through.
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260. Okay, everybody, get back.
We're gonna hammer through this concrete.
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261. - Just a second!
- Come on, let's do this!
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262. Hold on, Lorcan.
Get me out!
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263. Got it?
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264. - Done.
- Thanks.
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265. That's it!
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266. Okay, on three.
One, two, three…
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267. Where's the backboard?
Paramedics are bringing it in.
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268. All right.
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269. Is he still breathing?
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270. Yes. Good air entry.
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271. How many did you say we could take?
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272. I didn't. They're transporting
all over the city.
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273. We're two docs down
and a surgeon in the field.
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274. - You want me to page Dr. Greene?
- He's at his competency testing.
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275. Okay, find out how many
they're sending us.
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276. Malucci's on his way down
with the first air-evac.
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277. Possible aortic rupture.
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278. - Peter, you're up first.
- Got it.
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279. No, elevator. Call CT.
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280. Have them cancel all elective cases.
I don't want them jamming up on us.
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281. Stay close to me.
If you have any questions, ask.
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282. I might not be able
to answer it immediately.
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283. Also don't be surprised if the nurses push
you out of the way. It's their job.
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284. Just try not to knock anything over, okay?
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285. - I don't need to stay?
- Only if you want to.
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286. Blunt chest trauma, asymmetric BPs.
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287. Dropped his pressure en route.
60 palp. Tachy at 120.
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288. - Sir, do you know where you are?
- I was taking a plane.
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289. - Oriented times one only.
- Marked tachypnea. Pulse ox, 88.
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290. - Heart sounds are muffled.
- What's that mean?
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291. - He trashed his aorta.
- It's the major artery from the heart.
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292. - Neck veins are distended.
- He's in tamponade.
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293. Have the O.R. prime bypass.
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294. - You our new third-year?
- No, I'm just applying.
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295. Come on. Get over here.
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296. - Move!
- Prep for pericardiocentesis.
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297. Too late. Lost the pulse.
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298. Don't worry. Thoracotomy tray.
You better put on a gown.
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299. It's gonna get bloody in here.
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300. - What do you got?
- We got abdominal wound.
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301. BP's 120/90.
We're taking her to Lakeshore.
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302. What are you kidding me?
She needs a trauma center.
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303. All right. Reroute to County.
Give her ten more of MS.
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304. - Do it!
- We're supposed to rotate…
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305. Doc! Doc!
Yeah?
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306. Tracheal shift to the left.
I need to stick him.
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307. - What's his pulse ox?
- Eighty-eight on high-flow O-2.
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308. I can't hear anything with all this noise.
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309. Did you get it?
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310. I don't know.
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311. - Are these all ours?
- No, it's the damn news.
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312. Okay, he's moving air.
Take him to County.
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313. Not Lakeshore. County. Tell them
he needs a chest tube, maybe a vent.
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314. Oh!
Stop! Stop!
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315. - I told you to stop!
- You okay?
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316. I think I may have strained my back.
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317. Come on! Keep digging!
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318. We can't. We keep digging,
the weight of the train
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319. - will shift on you.
- Is that crane coming?
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320. - From Indiana.
- What?
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321. - It's on its way, Lorcan.
- What's his pressure?
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322. Eighty-five palp. Pulse 110.
Four units in.
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323. - Can you assist?
- Yeah. I can start.
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324. Lorcan, listen to me. I'm gonna have
to proceed with amputating both your legs.
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325. No! I've had people trapped
for hours before we got them out!
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326. I appreciate that.
But you've lost too much blood.
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327. If I don't amputate and control
the bleeding, you're going to die.
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328. Okay, then. I'm gonna start.
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329. Do you understand? I have to start now.
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330. Prep the area.
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331. Ten blade.
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332. Can you tell my fortune with these?
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333. Pick up each card from your pile
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334. and put it under the card
to which it belongs.
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335. Is that the death card?
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336. I'll tell you if you're right or wrong.
Are you ready to begin?
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337. - Hit me.
- Begin.
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338. No. No, just try the next card.
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339. No.
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340. - Yes.
- Third one's a charm.
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341. Yes.
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342. Yes.
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343. - Yes.
- Look, two hands.
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344. Yes.
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345. - No.
- No?
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346. No.
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347. No.
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348. Do you ever say anything
besides yes or no?
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349. No.
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350. I've isolated the femoral artery.
Retract distally.
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351. Got some oozing from the SFA.
Mitch?
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352. Can't do much about that
in the field.
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353. Mitch!
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354. - I'm right here, buddy.
- I think maybe you should get Patty.
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355. - You got it.
- I need to dissect this vessel.
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356. Metz.
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357. - What? What is it?
- Carter, quick. Clamp that. Clamp it.
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358. - What, what, what, what?
- Medial to the muscle bed. Clamp it now.
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359. - Is it your back?
- It's coming and going.
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360. - Intermittent pain?
- Yes.
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361. - How often?
- Ah!
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362. What's her pressure?
Dropping. 80 palp.
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363. - Myles.
- Start her on dopamine. Titrate to 100.
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364. Save him, please.
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365. - How long till you are through?
- I don't know. Ten minutes, maybe.
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366. Pupils are still sluggish.
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367. Okay. 0.3 of atropine.
Do you have any mannitol?
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368. On board.
Hang 40 grams.
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369. - He's hypertensive and bradying down.
- I know.
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370. He could have a bleed.
You're not coming with us?
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371. Okay, load him. I'll be right back.
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372. Carter, I have to take this boy in.
There is a woman back there impaled
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373. with spinal shock. And I want
you to stay with… What is it?
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374. - She's having contractions.
- What?
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375. - She's having contractions at 25 weeks.
- I need tocolytics and a fetal monitor.
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376. I can keep on going
if I can just get them to stop.
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377. - You have any terbutaline?
- No.
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378. - In the rig?
- We don't carry it.
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379. Okay, you should fly back with us.
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380. Carter, take the mother.
The woman down there.
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381. What about him?
We just opened the interior compartment.
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382. - Call another surgeon!
- We're out of O-neg.
Copy !req
383. We have to finish him now.
Copy !req
384. If we put you on the chopper, could you
monitor this boy on the flight back?
Copy !req
385. Yes. But he could exsanguinate
from his left leg.
Copy !req
386. - You were a surgical resident, yeah?
- Interned. For a year.
Copy !req
387. Trauma panel in chest
and palp is getting HemoCue.
Copy !req
388. Sinus, rate of 95.
Copy !req
389. - Any chest pain?
- No.
Copy !req
390. Mild guarding. No rebound.
Set her up for a CT and put in a Foley.
Copy !req
391. - Is that man from the train?
- Yeah.
Copy !req
392. - Is he dying?
- I don't know.
Copy !req
393. Abby, could you shut the doors, please?
Type and cross for four. Dip a urine.
Copy !req
394. More O-neg on the infuser.
The heart's not filling.
Copy !req
395. Unit seven going up.
Got it. Cut.
Copy !req
396. Okay, come on, you're done.
We gotta shock him.
Copy !req
397. Hold on. Couple more sutures.
Copy !req
398. Dr. Benton, Dr. Finch needs you.
Bad leg injury.
Copy !req
399. Got it.
Copy !req
400. Clear!
Copy !req
401. All right, Dr. Malucci, he's all yours.
If you get a rhythm, send him up.
Copy !req
402. - White, you're coming with me. Go.
- Still in V-fib.
Copy !req
403. Another amp of epi.
Stand by with lidocaine. Clear.
Copy !req
404. Peter, I have a right orbital trauma
with loss of vision.
Copy !req
405. Set up the slit lamp, tetracaine
and fluorescein. I'll be right there.
Copy !req
406. Dr. Benton, blunt abdominal trauma.
Possible liver injury.
Copy !req
407. - What's the crit?
- Thirty-four, but he's pretty tender.
Copy !req
408. - Do an ultrasound. If you see fluid…
- Chuny, I need vitals now.
Copy !req
409. - Coming.
- Traumatic extrusion of the tibia.
Copy !req
410. - You call Ortho?
- Yes, but he's looking pretty dusky.
Copy !req
411. Hold on, that's my bone!
Copy !req
412. All right. All the major vessels
seem intact. Just try to get him up.
Copy !req
413. Peter, Carter is on the radio
and needs to talk to you.
Copy !req
414. Not now!
Copy !req
415. He's performing a double
amputation by himself.
Copy !req
416. - What? Don't worry.
- A guy pinned under a train.
Copy !req
417. - Don't worry. That can be reattached.
- Give another 20 MS.
Copy !req
418. Okay, he's on Bravo Three.
Copy !req
419. - Carter, what are you doing?
- Left anterior thigh.
Copy !req
420. I've incised through the fascia
and muscle planes.
Copy !req
421. I need to isolate
the neurovascular bundle.
Copy !req
422. - Hold on! I thought Corday went with you.
- She did.
Copy !req
423. What is she doing?
Copy !req
424. We've got to control his airway.
Copy !req
425. BP's rocketing, 240/120.
Pulse, down to 30.
Copy !req
426. Another mig of atropine
and mix Nipride.
Copy !req
427. - He's in respiratory distress.
- I'll intubate. 6.5 ET tube.
Copy !req
428. - Should we stay on the ground?
- No, let's go.
Copy !req
429. - Fifty of lido, one of Pavulon, 50 of sux.
- You okay?
Copy !req
430. No.
Copy !req
431. Using the dull edge of the Metz
Copy !req
432. let your finger continue blunt dissection
of the artery
Copy !req
433. from the neurovascular bundle.
Copy !req
434. - What?
- Blunt dissection…
Copy !req
435. You're gonna have to shout.
I can barely hear you.
Copy !req
436. Do you know what you're doing?
Does anybody know what they're doing?
Copy !req
437. - What's he down to now?
- 190/100. Pulse, 44 after two migs.
Copy !req
438. - Try 80 of Lasix.
- Let them take him downstairs.
Copy !req
439. Go! Go straight to CT.
Copy !req
440. `There's a case on the table.
Copy !req
441. - He probably has an epidural.
- I'll tell him.
Copy !req
442. - How often you been having back pain?
- Every four or five minutes.
Copy !req
443. When's the last time
you felt the baby move?
Copy !req
444. I don't know. I haven't.
Copy !req
445. Okay.
Copy !req
446. Got it!
Copy !req
447. Can you call on the radio
and see how he is?
Copy !req
448. - We'll be there soon.
- BP, 95/65. Pulse is 110.
Copy !req
449. - Am I gonna die? Am I?
- We'll get you out.
Copy !req
450. If I die before I get there, you have
to make sure they take care of Myles.
Copy !req
451. - They will.
- He's seven.
Copy !req
452. I know.
Copy !req
453. His father's in Kansas City on business.
We were coming back from visiting him.
Copy !req
454. I thought it'd be fun
for Myles to take the train.
Copy !req
455. What about the sciatic nerve?
Copy !req
456. Pull it down as far as possible,
then apply an Ochsner clamp.
Copy !req
457. That one. Third to the right.
Copy !req
458. - Okay. I got it. Now what?
- Right.
Copy !req
459. Put a second clamp
five millimeters distally.
Copy !req
460. We're gonna get you through this,
all right, Lorcan?
Copy !req
461. We're gonna get you through.
You're gonna be all right. Okay?
Copy !req
462. Remove the proximal clamp
and ligate the crushed area.
Copy !req
463. - 0-Vicryl?
- No, no, no. Nonabsorbable.
Copy !req
464. Peter, we need you.
This boy's herniating.
Copy !req
465. Use silk if you've got it.
Copy !req
466. - Okay. Done that. Now what?
- Peter, we've got to drain the hematoma.
Copy !req
467. You know what, Carter, I've gotta go.
Call me on your cell phone.
Copy !req
468. I don't have it. It's in my locker.
Copy !req
469. - Well, find one.
- Peter, now.
Copy !req
470. - Keep bagging him.
- What do I do about this nerve?
Copy !req
471. Step off in the parietal region.
Copy !req
472. Dr. Benton?
Pulse ox is dropping.
Copy !req
473. Dr. Benton!
Copy !req
474. - What is it?
- You have a cell phone?
Copy !req
475. - No.
- Do you?
Copy !req
476. No.
Copy !req
477. - Terbutaline's on board.
- I'll repeat in another hour.
Copy !req
478. - You sure McLucas hasn't answered?
- We just paged her. Give her a second.
Copy !req
479. - What about Mark?
- He's on his way.
Copy !req
480. Okay. You're about 25% effaced.
But dimpled, not dilated.
Copy !req
481. - Okay? We can control that.
- You think so?
Copy !req
482. - An OB resident's on his way.
- I don't want a resident!
Copy !req
483. Elizabeth, you have to calm down.
And focus, okay?
Copy !req
484. - Give the terbutaline a chance to work.
- Mark's on the phone.
Copy !req
485. - What line?
- Three.
Copy !req
486. - Climbing again, 220/115.
- Blown right pupil.
Copy !req
487. All right, he needs a burr hole.
Now, where's your perforating drill?
Copy !req
488. - Haleh! Is one open?
- Yeah. Malucci's calling it.
Copy !req
489. Connect the chisel bit. Let's keep
hyperventilating. Let's move!
Copy !req
490. - Coming through!
- Hold on. I gotta move this guy.
Copy !req
491. No, no, no. Shove him up
against the wall. Move!
Copy !req
492. All right. Let somebody shave his head.
Give me 8.5 gloves.
Copy !req
493. Let's move, people.
Sit him up to 30 degrees.
Copy !req
494. Peter, Carter's on line three.
He needs to talk to you.
Copy !req
495. White, get over here and hold
the phone up to my ear. Ten blade.
Copy !req
496. - Pressure's to the roof. 260/140.
- Not good. Up the Nipride to three mics.
Copy !req
497. Come on, put my glasses down.
Carter, talk to me. Where are you?
Copy !req
498. - Sciatic nerve.
- All right, good. Cut proximally
Copy !req
499. and let the muscle retract
into the muscle belly.
Copy !req
500. Lorcan, they found Patty.
They're gonna send a truck
Copy !req
501. - to take her straight to the hospital.
- No, no. Forget it.
Copy !req
502. Okay. Cutting now.
Copy !req
503. Okay. Good. Now, make sure you use
a scalpel instead of scissors.
Copy !req
504. - Otherwise you'll get a neuroma.
- Listen, she's already on her way.
Copy !req
505. Okay? She wants to come.
Copy !req
506. - No! No! Not now!
- Would you please hold him still!
Copy !req
507. - Okay, now what?
- Fine, now, take two Kellys
Copy !req
508. and clamp the femoral artery
and vein together.
Copy !req
509. - I don't want her to see me like this!
- Can you give him something?
Copy !req
510. - Whoa, whoa, whoa. He's seizing!
- Five of Ativan.
Copy !req
511. Five of Valium.
Put the phone right here.
Copy !req
512. I don't want her to see me!
Copy !req
513. You gotta hold him still
until it kicks in.
Copy !req
514. - You're almost free.
- All right, is that two clamps each
Copy !req
515. - or two clamps altogether?
- Two clamps altogether!
Copy !req
516. - Two of Ativan?
- Five.
Copy !req
517. Am I clamping the vein
and the artery separately?
Copy !req
518. Carter, clamp the vessels
as one unit at both ends.
Copy !req
519. Ativan's on board. Still seizing.
Copy !req
520. All right. You know what?
I gotta go in. Just reparalyze him.
Copy !req
521. - Wait, both proximally…
- Don't do it!
Copy !req
522. - and distally or one proximally…
- Carter, just clamp the damn vessels!
Copy !req
523. All right? Go.
Copy !req
524. - How many liters in?
- Two and a half. Lost a pulse.
Copy !req
525. - She's in V-fib. Charge to 200.
- Do you want to run her inside?
Copy !req
526. No, here. Paddles.
Copy !req
527. Charging.
Copy !req
528. Clear!
Copy !req
529. - Still in V-fib.
- Charge to 300. Clear.
Copy !req
530. Mark, penetrating back injury.
Needs to go straight to the O.R.
Copy !req
531. All right, I'll tell Randi.
Copy !req
532. Mark.
Copy !req
533. - You feeling any more contractions?
- I'm sorry.
Copy !req
534. Don't be.
Copy !req
535. I slipped and fell.
I thought it was just backache.
Copy !req
536. - Did you give her terbutaline?
- Ten minutes ago.
Copy !req
537. Fetal heart tones?
Copy !req
538. - One fifty-five. No decels.
- Well, that's good.
Copy !req
539. - They haven't stopped.
- You gotta give it some time to work.
Copy !req
540. Or maybe we should try magnesium.
Copy !req
541. We will if we have to. Okay?
Let's just wait and see.
Copy !req
542. It's okay. It's okay.
No, no, no. It's okay.
Copy !req
543. - Irrigate.
- More Ativan?
Copy !req
544. No. Stopped seizing once he relieved
intercranial pressure.
Copy !req
545. Suction catheter.
Carter, are you through the tibia yet?
Copy !req
546. Done. Almost there, Lorcan.
Copy !req
547. Good. Use the rongeur
to bevel the anterior apex.
Copy !req
548. Where is that?
Copy !req
549. It's the sharp edge
at the end of the bone.
Copy !req
550. - What's his pressure?
- Down to 170/60.
Copy !req
551. They're all sharp! Damn it!
Copy !req
552. It's the anterior surface
that you care about.
Copy !req
553. Dr. Weaver, I need you in here.
Copy !req
554. - What patient?
- The girl whose car got hit by the train.
Copy !req
555. - I'm sorry. What?
- The anterior surface.
Copy !req
556. - Get him upstairs. Peter, let's go.
- Carter, you're almost there.
Copy !req
557. When you're done,
use the rongeur to crack the fibula.
Copy !req
558. Wait, wait, wait!
Hold on! Hold on!
Copy !req
559. Dr. Benton!
Copy !req
560. Dr. Benton!
Copy !req
561. Good luck.
Copy !req
562. BP's a little low. Want me to put
the dopamine back on?
Copy !req
563. - Hold the elevator!
- No. This one goes in to the O.R.
Copy !req
564. No, this one goes straight up.
Status, post-cardiac arrest.
Copy !req
565. I just opened up this kid's head.
Copy !req
566. Did you evacuate the clot?
Copy !req
567. Yeah, but there's still
active bleeding at the site.
Copy !req
568. She's in shock.
He's lucky to get her back the first time.
Copy !req
569. All right, go.
Copy !req
570. No. Take the boy first.
Copy !req
571. Call Neurosurg, tell them
we're on our way up.
Copy !req
572. I need two units of FFP
and an ICP monitor.
Copy !req
573. Eighty-five palp.
Copy !req
574. Start the dopamine.
Copy !req
575. - What is it?
- I wanted to ask you something.
Copy !req
576. He die?
Copy !req
577. - Who?
- That man.
Copy !req
578. They cut open his chest,
but he died.
Copy !req
579. - Yes. He had a fatal injury.
- What about the boy?
Copy !req
580. He went up to surgery.
Copy !req
581. - Is he going to die?
- I don't know.
Copy !req
582. Is there someone we can call for you?
Your mom or dad?
Copy !req
583. They won't understand.
Copy !req
584. Won't understand what?
Copy !req
585. I thought it would be painless.
The train would hit my car,
Copy !req
586. I'd just be gone.
Copy !req
587. Yeah, don't talk to me about saturated.
You haven't seen saturated.
Copy !req
588. Chuny, I need a trauma panel.
What's open?
Copy !req
589. I don't care. I'm admitting them!
Copy !req
590. Carter, they're holding O.R. six for you.
Copy !req
591. - You go straight up.
- I was just up there.
Copy !req
592. - There's no surgeon up there.
- Is he stable?
Copy !req
593. Yeah, he's BP's stable by 100
Copy !req
594. but I had to sedate him
with ten of Valium.
Copy !req
595. - Dr. Carter, are you deaf?
- What?
Copy !req
596. I keep shouting, you keep
getting on the elevator?
Copy !req
597. - I'm sorry.
- Is this the pre-op amputation?
Copy !req
598. No.
This is the post-op amputation.
Copy !req
599. - What, in the field?
- Yeah. He was trapped in…
Copy !req
600. What did they use, a chain saw?
Copy !req
601. - Dr. Benton talked me through it.
- You did this?
Copy !req
602. - There was nobody else to do it so I…
- Oh, well, no one else could do it.
Copy !req
603. Well, by all means then,
let's get whoever's available.
Copy !req
604. - Well, you ought to try it next time.
- Maybe if you'd respond to your page…
Copy !req
605. I can't wear my pager in the dojo.
Copy !req
606. Brenda knew where I was.
You should have called her. Let's go.
Copy !req
607. - What the hell happened anyway? You…
- Dr. Weaver…
Copy !req
608. Dr. Weaver, flail chest in four
just dropped his pulse ox down to 81.
Copy !req
609. Carter, can you take this?
Copy !req
610. Oh, yeah, why don't you just give him
Copy !req
611. - another surgical procedure.
- Maybe I should have just let him die.
Copy !req
612. Stop crying, I'll clean up after you.
Copy !req
613. - Good work, Carter.
- I know.
Copy !req
614. Really. He was lucky
that you were out there.
Copy !req
615. - Thank you. I'm coming!
- Carter!
Copy !req
616. Kerry?
Yeah.
Copy !req
617. - You have a suicidal ideation?
- Young girl in Trauma two.
Copy !req
618. - Does she have a plan?
- Parked her car in front of a train.
Copy !req
619. Oh, I suppose that qualifies.
She's also in a major depression.
Copy !req
620. - Flat affect?
- No real remorse.
Copy !req
621. - About the suicide attempt?
- For the train wreck.
Copy !req
622. Oh, my.
Copy !req
623. D you think you're gonna get off
before 12?
Copy !req
624. - No, probably not.
- Okay.
Copy !req
625. - Uh, I'll try to be quiet.
- No. Wake me.
Copy !req
626. Something wrong?
Copy !req
627. Hey.
Copy !req
628. - What?
- Is there something wrong with my heart?
Copy !req
629. No. Probably a bruise to your chest wall.
We'll get an X-ray to make sure.
Copy !req
630. - You were lucky.
- We're still sifting through
Copy !req
631. the walking wounded,
but I think we're over the hump.
Copy !req
632. - Carter just took the last critical.
- How many came in?
Copy !req
633. Thirty-seven. Five up in surgery.
Only two ER deaths.
Copy !req
634. - That's not bad, considering.
- If you don't count the DOAs.
Copy !req
635. You did great work today.
You should go home. We got it from here.
Copy !req
636. - Board's backing up.
- That's all right.
Copy !req
637. We got it. Go home.
See you tomorrow.
Copy !req
638. - Shirley called for you.
- What?
Copy !req
639. O.R. nurse. You asked her to call
when the mom and son came out of surgery.
Copy !req
640. - Did they?
- Yeah. They're in recovery.
Copy !req
641. The mom's got sensation in her legs,
and the kid's neurologically intact.
Copy !req
642. - That's good, right?
- Yeah. That's good.
Copy !req
643. Ah, you still here, huh?
Copy !req
644. The nurses put me to work,
thought I was a volunteer or something.
Copy !req
645. Good.
Copy !req
646. Now you've got an experience
to talk about in your interview.
Copy !req
647. - I don't know.
- It's yours. You might as well use it.
Copy !req
648. - I mean, I don't know if I want to.
- Want to what?
Copy !req
649. What I saw tonight.
Copy !req
650. Most people go their whole lives
without seeing stuff like that.
Copy !req
651. Drilling into a little boy's head.
Guys having their legs cut off.
Copy !req
652. - People dying right in front of you.
- You get used to it.
Copy !req
653. Yeah. That's what I'm afraid of.
Copy !req
654. - But thanks for helping me find out early.
- Go to the interview.
Copy !req
655. - Dr. Benton…
- Go to the interview.
Copy !req
656. You may feel differently in a few days.
Copy !req
657. - I know, but…
- Hey, give yourself options.
Copy !req
658. Anything?
Copy !req
659. No contractions
since the third round.
Copy !req
660. Fetal heart rate looks good.
Copy !req
661. - So it's over.
- Aside from bed rest.
Copy !req
662. How long do you think?
Copy !req
663. You can catch me up on my soaps.
Copy !req
664. It'll be okay.
Copy !req
665. When I felt the baby move before,
obviously I knew it was in there, but
Copy !req
666. - suddenly this feels real, you know?
- Yes, Mom.
Copy !req
667. OB's waiting, and Transpo promises
they'll be down soon to take you up.
Copy !req
668. - Thanks, Abby.
- The monitor stays on
Copy !req
669. - for at least 24 hours.
- I'll keep it on until I give birth.
Copy !req
670. You just have to slow down.
No more helicopters.
Copy !req
671. Right.
Copy !req
672. - Hey.
- Hey.
Copy !req
673. - You leaving?
- Uh, no.
Copy !req
674. I thought I'd check on the bishop.
Copy !req
675. - Another critical come in?
- No. That's it.
Copy !req
676. Is she stable?
Copy !req
677. Yeah. After three rounds of terbutaline.
Copy !req
678. - Good.
- Yeah. It was scary, though.
Copy !req
679. Yeah.
Copy !req
680. You heading home soon?
Copy !req
681. Um, I don't know.
Copy !req
682. - Are you okay?
- Yeah.
Copy !req
683. Any change?
Copy !req
684. He didn't want the breathing mask.
Copy !req
685. Has he been awake?
Napping on and off.
Copy !req
686. What time is it?
Copy !req
687. - 11:30.
- You're here late.
Copy !req
688. - You'll have to be intubated soon.
- On a ventilator?
Copy !req
689. No.
Copy !req
690. Your oxygen level is down to 65
on 100% oxygen.
Copy !req
691. I've seen what happens
after the ventilator.
Copy !req
692. - If it drops below 50…
- Thanks, but no thanks.
Copy !req
693. Anyway…
Copy !req
694. My bags are packed.
Copy !req
695. How long do I have?
Copy !req
696. Maybe hours.
Copy !req
697. - Then I'd better hear it now.
- Hear what?
Copy !req
698. - Your confession.
- Bishop, I don't think…
Copy !req
699. That's what you came up here for,
isn't it?
Copy !req
700. - I wanted to check on you.
- You're searching for your faith.
Copy !req
701. You think you lost it
but you only buried it.
Copy !req
702. It's never left you.
Copy !req
703. In the name of the Father, of the Son
and of the Holy Spirit.
Copy !req
704. Amen.
Copy !req
705. May God, who enlightens every heart
Copy !req
706. help you to know your sins
and trust in his mercy.
Copy !req
707. - Father, I can't…
- Luka.
Copy !req
708. Your heart is burdened, Luka.
Copy !req
709. Talk to me.
Let me take that burden with me.
Copy !req
710. I don't know. I, uh…
Copy !req
711. Lost my family.
Copy !req
712. Danijela, my wife, she, uh…
Copy !req
713. Wanted to move out of Vukovar.
But I had to finish my internship.
Copy !req
714. And soon, it was too late.
It wasn't safe to move.
Copy !req
715. I was gonna get some supplies and…
Copy !req
716. I made them stay behind.
Copy !req
717. I was just crossing the street when the…
Copy !req
718. Mortar shell hit the apartment building.
Copy !req
719. Go on.
Copy !req
720. I ran inside.
Copy !req
721. There were my neighbors. Hurt.
Bleeding. Dying. But I passed them by.
Copy !req
722. I had to get to my family.
Copy !req
723. Danijela!
Copy !req
724. Danijela!
Copy !req
725. Danijela!
Copy !req
726. Danijela!
Copy !req
727. Luka.
Copy !req
728. Luka…
Copy !req
729. Marko…
Copy !req
730. A piece of shrapnel had torn
into Danijela's spleen
Copy !req
731. and she was bleeding to death.
Copy !req
732. When I turned back to my daughter,
she wasn't breathing.
Copy !req
733. I lost her pulse.
Copy !req
734. But as long as I kept doing CPR
and breathing for my daughter,
Copy !req
735. I thought she had a chance.
Copy !req
736. I could only pray that someone
would get there to help.
Copy !req
737. If I had picked up Danijela
at that moment
Copy !req
738. and gotten her to the hospital,
she could have had surgery.
Copy !req
739. You know, she could have lived.
Copy !req
740. But I couldn't leave my little girl.
Copy !req
741. I waited and prayed.
Copy !req
742. I prayed someone would come.
Copy !req
743. And no one came.
Copy !req
744. No one came.
Copy !req
745. Jasna. Jasna.
Copy !req
746. I called out for hours
as I stayed there,
Copy !req
747. breathing for her, doing CPR.
Copy !req
748. I finally had to stop from exhaustion.
Copy !req
749. I lost them all.
Copy !req
750. You couldn't sacrifice the one
to save the other.
Copy !req
751. Even if you had,
you'd still blame yourself.
Copy !req
752. These things can't be explained.
Copy !req
753. Why it happens.
Copy !req
754. The providence of God
and the mysteries of life and death
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755. are the very fiber of our faith.
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756. They were gifts of love and life.
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757. You are a gift of love and life.
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758. Don't turn your back on them.
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759. God, father of all mercies,
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760. through the death and resurrection
of your only begotten Son…
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761. Was reconciled himself to the world
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762. and sent the Holy Spirit among us
for the forgiveness of sins.
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763. Through the ministry of Holy Church,
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764. may God give you pardon and peace.
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765. And I absolve you of all your sins
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766. in the name of the Father
and of the Son
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767. and of the Holy Spirit.
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768. Amen.
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