After Christa saves a woman's life, she pleads with Neal to perform a surgery that will ensure the patient's reproductive future. Also, Mario gets into a fight with a patient after he delivers a diagnosis that could imperil the man's hockey career.
As the residents clean the ER, Mario says he's confused about why they're cleaning up the mess from last shift. Jesse says that he's a resident and his mama said to. And as Malaya already knows, when you're part of a team, no job is too big and no job is too small. Jesse says that being an ER physician requires humility and like a firefighter cleans his rig, you clean yours. Center Stage demands respect. He looks over at Christa, who is queasy. He asks if she wants to lie down, if her mama needs to read her a bedtime story. She just says there's a lot of blood on the sheets. Jesse says Buddhists use manual labor as a way to meditate, to bring them closer to the world they inhabit. Or as Mr. Miyagi said, "Wax on. Wax off." Malaya is surprised Angus doesn't know what The Karate Kid is. Mario uses that to make a joke about Christa's age. Jesse says it's Saturday night, which means they're going to see some things before the sun comes up. The first pulse you check is always your own. When it gets rough, breathe. Oxygen is the first drug they give patients. Same for them. Lean on each other, that's what siblings are for. And lean on him. That's what your mama's for. Leanne comes in and says they have two incoming, so they need to clean up, glove up, and go. Jesse tells them to go save the people of Los Angeles.
Mario says he's making a formal complaint about this. Angus asks if he's sure he wants to do that. The last four years, less than half the residents in the program made it. Mario asks how Malaya knows that, but Angus points out that Malaya was at Angels for medical school and her internship. Dr. Rorish likes her. Mario knows that means Malaya was at Angels for Dr. Rorish's accident. It's none of their business, Christa says. Angus didn't know anything about it, but is shocked to learn that Rorish's whole family died.
Jesse asks Leanne if she got any sleep today. She says she did, but he knows she's lying. She has a tell. She asks what her tells is, but he won't tell her, because she'll stop doing it and he won't know when she's lying. She tells him he thinks he's so smart, but he's actually dumb. He tells her she's the dumbest person he knows.
Christa tells them to stop gossiping and Malaya agrees. Leanne comes in and tells them they're going to continue to shadow and assist her and Neal until they're in Code Black. She sends Christa and Mario to be with Neal, who is getting the first patient. Malaya and Angus are with her.
Neal greets Laura Halloran, who was in a car accident. She's in and out of consciousness. He takes her into the ER and starts treating her.
Leanne brings in her patient, who has crepitus throughout the chest and neck. He tells the doctors he's Jake Willis and begs Leanne not to let him die, as he supports his family. His wife takes care of his daughter and doesn't work.
They check out Laura and try to find the source of the bleeding. Her abdomen is clear for bleeding.
Jake's arm swings out and grabs Angus, making him think Jake's awake, but it's just a reflex. Jesse assures Jake that they have him. They put extra sedation to make sure he's out. Leanne sees how Angus is ventilating and tells him to slow down. He was decreasing Jake's ICP by hyperventilating. Jake needs to be taken to surgery.
Laura's maxillary artery is bleeding and Neal works to stop it.
They realize that Jake will die on the way to surgery if they take him as is, so Leanne calls for a thoracotomy tray so she can open his chest in the ER. They start transfusing blood as she makes her incision. Neal helps her by diverting the blood to the brain, but he was in cardiac arrest. They are able to massage his heart to get him back into sinus rhythm.
Neal gets Laura's lab results and is surprised to see a lactate of four, indicating organ death. But the question is which organ. Taylor walks up and asks why Laura is still in Trauma One. Neal greets him and Taylor sarcastically greets Neal back before asking why Laura hasn't been admitted yet. Neal says something's bothering him. Taylor says hemorrhoids are bothering him, but he doesn't get a bed in trauma one. Neal doesn't want to send her up until he knows what's wrong, but Taylor reminds him that they're the first ten minutes and Laura is in minute eleven. Christa goes to do so, but Neal tells her to get a CT instead, because she's their patient.
Leanne calls Mario to help her. He spots Brian Wellborn, a hockey player, coming into the ER. Leanne reminds him that he's just a patient. The medic reports that he was found unconscious at the gym, but awake when they arrived on scene. He denies being unconscious. Leanne asks if it's happened before. She says she's surprised he got into the ambulance, unless he wasn't completely lucid at the time. He says he overdid it getting ready for the new season. Mario wants to examine him and get a history, but Brian doesn't think it's necessary. Leanne tells him that since he's there, they can't let him leave until they've done a basic exam. It's the law. They have to make sure he's not a danger to himself or others. He wants to call his team doctor, but left his phone at the gym. Jesse promises to get him a phone to use. Leanne tells Mario to evaluate and get back to her.
Rollie is examining Ruth, who came in with Lucia Dazo, who takes care of Ruth at her nursing home. Lucia says she's a nice lady, but she's confused and willful. She wanted to go out for the day and wouldn't take no for an answer, so she swallowed a bunch of coins: $3.80. Rollie asks why they didn't just give her a laxative and wait it out. Now that she's at the hospital, they can't discharge her until she passes them. Lucia already knew that, but she has too many patients to be taking Ruth to the bathroom every ten minutes. She tells them to call when she's ready to get picked up.
Becca Willis comes up with her daughter, Tara. She's looking of her husband, Jake. Hannah Reynolds checks the computer and then says she'll get Dr. Rorish. Becca thinks that means something bad, but Hannah says she's just not familiar with the case and she's getting someone who is.
Mario tells Brian he was at a game he played in with a no-look backhander. Brian's impatient to leave. Mario asks him to open his mouth. Brian instead pulls out a large bridge of fake teeth, saying it's an occupational hazard. Mario still needs to look in his mouth. He looks and says Brian didn't pass out. Brian prepares to leave, but Mario says he actually had a seizure and based on the scarring, it's happened before.
Leanne tells Becca that Jake's alive. Becca's relieved. She doesn't know what they'd do if anything happened to Jake. Leanne looks over at Tara and asks if Becca would rather speak privately. Becca says Tara needs her around. She's calm at the moment. Becca asks if Jake's going to be okay. Leanne doesn't know. They just have to wait at this point. Becca says Tara's father left just after she was diagnosed. He said it wasn't what he signed up for. She didn't know what to do. She tried to work, but Tara needed her. She didn't know if they'd make it. Then she met Jake. He was on his way to sign himself and Tara up to take dance classes when he was in the accident. She had told him he didn't have to do that, but he said Tara's his daughter and that's what he signed up for. Becca starts to cry and Leanne comforts her and tells her she'll let them know when Jake's out of surgery.
Angus looks at Ruth's scan, surprised she swallowed so many coins. Rollie writes $3.80 on the white board and tells everyone she leaves when she's empty. He tells Angus he gets to go first. She was given a laxative 30 minutes ago. Jesse gives him a bed pan. Taylor comes by and says the slot machine's about to start paying off.
Laura's CT is showing nothing. Neal asks Leanne, who's walking by, to come look. He sees she's holding a cup and tells Christa not to look as it's a gangrenous toe. Christa says gangrene is her jam. Neal asks Leanne about Laura, showing her the scan. She asks if there's evidence of abdominal trauma. There isn't, so she suggests it wasn't caused by the accident.
Laura says she was on her way to the hospital when she crashed. She had intense, sudden pain. Neal has a hunch and asks for an ultrasound. He looks at her abdomen and sees that she doesn't have a right ovary, just a left. She asks if something's wrong with it. He shows the monitor, which shows no blood flow. Her ovary is twisted, cutting off blood flow. He asks when the pain started. Based on that, she has about three hours left to de-torse her ovary before she'll lose it. Her other ovary was removed due to a teratoma a few years ago. She and her late husband had been having fertility problems. Risa Park tells them no one from OB is available. Neal says she needs to call her own OB, but she's been going back and forth to a place in San Francisco, which is where they stored her husband's sperm before he got sick. She begs them not to let her lose her ovary.
Edward Darius says he wants to see Brian's chart and he wants to see the ER director. Mario asks who he is and he asks who Mario is. He sees that Mario's a resident and asks if he's the one who said Brian was having seizures. Darius says he's Brian's team doctor. Mario understands. Seizures mean he can't play. Brian insists he didn't have a seizure. Darius wants it removed from his chart immediately. Mario says that's against the law and a real doctor would know that. Jesse comes up and introduces himself. Darius says he's checking his patient out, but would like a chart revision first. Mario says they're trying to help Brian, but Brian doesn't think he needs their help. He shoves Mario, who starts to go at him, but Jesse steps between them and tells Mario he doesn't want to do that. Leanne comes up and tells them that's enough. She dismisses Mario. She tells Darius he has zero authority in the ER. He says he plays racquetball with Edward Harbert, the CEO of the hospital. Taylor replies that only 1% of males can perform autofellatio. Leanne tells Brian he has a serious medical issue, but the ER is not a jail, so they can't keep Brian if he wants to leave. Just then, he starts seizing, so they catch him and give him ativan and oxygen.
Outside the hospital, Mario is pacing. Jesse comes out and asks him if he wants to know how Brian is doing. He says he does and Jesse tells him about the seizure. They also kicked Darius out. Jesse asks if he's ever seen "An Officer and a Gentleman," the movie. There's a character they call Mayonnaise, because his name's Mayo and he's white. He joined the Navy to fly jets. He's good at almost everything. If the move was called, "An Officer," he'd be fine, but it's not, which means he has some things to learn, like humility and patience, kindness and charity. Jesse knows the neighborhood Mario came from. The only thing that gets through those walls is a bullet, so he had to become a bullet to get out. He can't be a bullet anymore because he's there now.
Taylor calls out to Christa, calling her "Person." She tells him her name, but he would have guessed Susan. OB called. There's an open OR for Laura. That's great, but there's no surgeon. That doesn't help her, but he's not there to help her.
Malaya subtracts 25¢ from the tally on the board and Jesse says she got off easy. However, it was all in nickels. She adds the coins to the jar.
Neal is examining a patient and asks him to cough, which he does. Christa comes up and explains the situation with Laura. They have about 90 more minutes until she loses the ovary. She and her husband wanted to have children together for twenty years. Neal points out that Laura herself is only 27, but Christa says they met in third grade. Isabel Mendez interrupts with a patient with a laceration. Neal tells her to give the chart to Christa. Christa continues that Noah, Laura's husband, was diagnosed with stage IV lymphoma two years ago. Isabel brings another chart with a dislocated shoulder, which she also hands to Christa. They're in code red. Neal talks to his patient a bit more, then walks away with Christa following, telling him Noah froze his sperm before he started treatment. He died last year and the sperm is all she has left of him. Christa then asks him to do the surgery. He's not a surgeon, but he did a surgical residency. He doesn't have privileges. There's nothing they can do for Laura and Christa has patients.
Leanne calls for Mario. He apologizes to her, but she gives him Brian's CT results. He has parenchymal hemorrhages. She tells him to go tell Brian the news. She asks if he can be professional. He says he can, so she sends him to do his job.
Angus and Malaya go to examine Stan Rocksickler. He has severe back pain and had been waiting for ten hours. It'd been on and off for a few minutes, but got suddenly worse. Malaya notices he's a construction worker and asks if he does a lot of heavy lifting. He does, so she suspects persistent muscle spasm, but Angus doesn't agree. They step away and Angus says he thinks it might be Stan's heart instead, due to a slightly elevated heart rate. Malaya says it's not a zebra. It's a plain old horse. At best, he gets painkillers and maybe a CT of his back. Angus isn't convinced. Leanne comes up and asks them what they have. Malaya explains the cast and her diagnosis. She wants to do a CT. Leanne says to get the scan and let her know what comes back. After she's gone, Malaya asks Angus why he didn't tell her his theory. They go to get the CT.
Mario goes to tell Brian about his condition. It's caused by multiple concussions. Brian says Darius has medications for that. Mario tells him it'll mitigate the symptoms, but it won't reverse the damage that's been done. His next concussion could kill him. He can't ever play hockey again if he wants to live. He apologizes.
Christa explains Laura's case to Leanne, including the lack of surgeon. She asks about Neal. Leanne says he's not a surgeon. Part of their jobs is prioritizing patient need. As long as there's a more critical patient in front of her, she has to wait.
Outside, they greet an ambulance with Harley Garrett. He fell while rock climbing and hadn't stopped bleeding. He's on blood thinners for blood clots on his retinas. They try nasal packs to stop the bleeding. Leanne asks his father if he's blind and learns that he can see shapes. Christa comments about him taking a blind kid rock climbing, but Leanne points out that's not their business. The nasal packs aren't working. The blood bank is out of O-, so they're waiting for more. Harley suddenly sits up and they push him back down. They put in an airway and look for the source of the bleed. She gets the idea to use foley catheters to tamponade the bleed. The blood to transfuse is coming in. They prepare to take him upstairs.
Taylor hands Christa the bed pan. It's her turn. Taylor tells her to hurry.
Leanne sees Becca and Tara waiting on a bench for news.
In the ER, Dane Garrett asks if Leanne thinks he's a terrible father for taking his blind son climbing. She thinks Harley's lucky to have a father who doesn't have a blind con. He just has a son. She tells him to enjoy every minute.
Christa comes up and asks again about Laura. She asks what Leanne would do if she had just one chance to get back what she'd lost. Leanne says they're not there to fix the events of their own lives. You don't want to make it about you. Christa says she doesn't believe that. She talks about what Leanne said and Leanne points out that she didn't say anything. Christa doesn't know anything about her. They're not friends. Christa says she heard her talking to Dane. Neal comes up and asks what's going on. Leanne tells him what Christa wants him to do. Neal and Leanne start to discuss logistics. She tells him not to ask Taylor. It's easier to ask forgiveness than permission. Christa thanks them.
Mario finds Brian outside. Brian says at high school career day, he wasn't there because he was too busy winning state. He doesn't know what to be besides hockey player. Mario says there's a woman at the hospital who just became a doctor at 40. Mario says Brian can do anything he wants if he puts his mind to it. Brian said that. An interviewer asked him if a goal he made was dumb luck. He said it was smart luck, which is when you work your ass off so when the opportunity presents itself, you don't have to pray for dumb luck. He says Brian can be anything he wants to be and Mario's living proof of that.
Hannah tells Malaya and Angus that Stan is going sideways in CT. They rushed to see him. Stan is writhing in pain. They take his pulse on both sides. His right side has a pulse and the left doesn't. Angus was right. Malaya tells them to run the CT since he's already there, but Angus says they don't have time. As the image starts to come up on the screen, Malaya is shocked by what she sees and Angus yells for her to get in there to help him.
Angus and Malaya prepare to do pericardiocentesis. Leanne comes in and asks what they're doing.
Neal is operating on Laura.
Leanne explains what she's doing to Stan, but he's unconscious, which is better. She inserts the needle.
Neal shows Christa the torsed ovary. He gets ready and un-torses it. The color changes as blood flow is restore. He offers Christa the chance to guide the tools. He has her back the camera out. She asks why he left surgery, but he says it's a long story. She pulls the camera out and then the sleeve, but bleeding starts, so Neal steps back in. He says he must have nicked a vessel when he put it in and the sleeve covered it. They have to open her up.
Leanne has the needle in and starts to drain the blood. It's working.
In surgery, Christa suggests using foley catheters to stop the bleeding on Laura, just like Leanne did with Harley. It works and Laura stabilizes.
Rollie tells Ruth if she's ready to go home, he'll call the nursing home. She says growing old is a swirling toilet bowl. The best you can do is cling to the rim. He says she's right. As he walks away, she asks if they have ice cream. He says he can make that happen.
Malaya tells Leanne it's her fault, what happened with Stan. Angus had a feeling and she brushed it off. Leanne tells them to listen closely. There are things you never want to see on a CT and an aortic dissection is one of those. If you took the time to get a CT, you didn't act fast enough. Your instinct has to be sharper than a scalpel and faster than any machine. You ignore instincts are your peril and theirs.
Laura wakes up after her surgery. Christa tells her it worked. She hopes everything works out for Laura. Laura thanks her.
Leanne tells Christa Laura's going to be okay. Christa knows, so Leanne asks why she's crying. Christa denies crying. She says she may be overstepping, but she and Leanne are in the same club and this stuff matters to them.
Leanne is talking to the staff in the ER about instincts and using the last move in your pocket. She says if they hear the voice saying that, they're in the right place, doing the right job. You're home. 24 hours ago, they had a patient like that. They opened his heart right in the ER. He wants to meet them. Jesse wheels in Jake Willis, followed by his wife and daughter. He thanks Leanne.
- Marcia Gay Harden as Dr. Leanne Rorish
- Raza Jaffrey as Dr. Neal Hudson
- Bonnie Somerville as Dr. Christa Lorenson
- Melanie Chandra as Dr. Malaya Pineda
- William Allen Young as Dr. Rollie Guthrie
- Harry Ford as Dr. Angus Leighton
- Benjamin Hollingsworth as Dr. Mario Savetti
- Luis Guzmán as Jesse Sallander
- Kevin Dunn as Dr. Mark Taylor
- K Callan as Ruth
- TJ Linnard as Brian Wellborn
- Rebecca Lowman as Becca Willis
- Dana Davis as Laura Halloran
- Marlene Forté as Lucia Dazo
- JD Cullum as Edward Darius
- Emily Nelson as Hannah Reynolds
- Angela Relucio as Risa Park
- Ellia English as Isabel Mendez
- Regan Burns as Jake Willis
- Devin DiLeo as Tara
- Charles Carpenter as Stan Rocksickler
- Landon Ashworth as Dane Garrett
- Edwin Kho as Medic #1
- Mikaela Rachal as Medic #2
- Theo Breaux as Medic #3
- Neck lacerations
- Torsed ovary
Laura, 27, came into the ER after a car accident. She was in and out of consciousness with some lacerations to her neck, including one large one. In the ER, they found no spinal injury and looked for bleeding in the abdomen. They tied off her bleeding maxillary artery. Laura's labs showed a lactate of four, an indication of organ death, so he ordered a CT. The CT showed nothing and Leanne suggested abdominal damage, but there was no sign of that, so she suggested the car accident didn't cause it. They went back to Laura, who said she was on her way to the hospital because of the pain. Neal did an ultrasound and noticed she only had one ovary and it was twisted, cutting off the blood flow. They had only about three more hours to fix it before she'd lose the ovary. There was an open OR, but no available surgeons, so Christa, remembering Neal had done a surgical residency, asked him to do the surgery. Neal agreed and was able to de-torse the ovary. They had to use a foley catheter to tamponade the bleeding from a lacerated vessel to stabilize her so they could repair the damage. After surgery, she was stable and awake.
- Chest injuries
- Neck injuries
Jake came in after being injured in a car accident while unrestrained. He had injuries to his chest and neck. They intubated him and put in bilateral chest tubes. They did a thoracotomy in the ER to stop the internal bleeding. They were successful, but he was in cardiac arrest. They pushed epinephrine and massaged his heart, which restored sinus rhythm. He was then taken to surgery. After his surgery, he was stable and awake.
- Parenchymal hemorrhages
Brian, 26, a professional hockey player, came into the ER after being found unconscious in the gym. He insisted nothing was wrong with him and he was just sleeping. Mario examined him and saw cuts on his tongue, including some older ones, meaning he'd had a seizure and it wasn't the first one he'd had. Brian's team doctor came in and requested he be discharged and his chart revised to remove mention of the seizure activity. As they spoke, he had another seizure. His CT showed parenchymal hemorrhages, which caused the seizures. The bleeds were caused by his multiple concussions. He was advised that his next concussion could kill him. He was told he needed to quit playing hockey.
- Ingested foreign bodies
- Mild laxative
Ruth, wanting a trip out of her nursing home, swallowed $3.80. In the ER, they gave her a mild laxative and counted the money as it came out. After all the money was collected, she was sent back to her nursing home.
- Neal Hudson (ER physician)
Neal saw a patient in the ER. He asked the patient to cough.
- Leg laceration
Isabel told Neal about a patient with a laceration to the leg. He sent Christa to do the stitches
ER Patient 2Edit
- Dislocated shoulder
Neal sent Christa to reduce a disclosed shoulder.
- Aortic dissection
Stan came into the ER with severe back pain. It'd been off and on for a few months, but suddenly got worse. After learning he was a construction worker, Malaya suspected persistent muscle spasm, but Angus thought it was Stan's heart instead of his back. They got a CT of his beck to check. During his CT, he started writhing in agony. He had an aortic dissection. They did pericardiocentesis to drain the blood.
- Retinal blood clots
- Facial lacerations
Harley, 14, came into the ER after an accident while climbing. He had fallen and hit his face on the ground. His face was bleeding seriously and he was on blood thinners to treat blood clots on his retinas, so his blood wasn't clotting. They used foley catheters up his nose to tamponade the bleeding. Once that was done, they gave him prothrombin complex concentrate, reversed his blood thinners, and took him upstairs.
Notes and TriviaEdit
- This episode scored 6.83 million viewers.
A complete overview of this episode's crew can be found here.
|#01||"Pilot"||#07||"Buen Árbol"||#13||"First Date"|
|#02||"We Plug Holes"||#08||"You Are the Heart"||#14||"The Fifth Stage"|
|#03||"Pre-Existing Conditions"||#09||"The Son Rises"||#15||"Diagnosis of Exclusion"|
|#04||"Sometimes It's a Zebra"||#10||"Cardiac Support"||#16||"Hail Mary"|
|#05||"Doctors with Borders"||#11||"Black Tag"||#17||"Love Hurts"|
|#06||"In Extremis"||#12||"The Fog of War"||#18||"Blood Sport"|
|Season 2 >>|