01x06 - In Extremis

[bunniefuu]

[ Elevator bell dings ]

[ Monitor beeping ]

I said "no sh*ts"!

Did you hear me?

"No" means "no."

Guy's got no game with kids.

So, what does everyone think about Dr. Guthrie Jr.?

He's hot.

What? He is.

Had you met him before?

Guthrie mentioned him a few times.

Never met him, but they say he's a good surgeon.

Our two Dr. Guthries are a bit of a mystery, aren't they?

You're not gonna s*ab me with that.

Little buddy, we're just gonna count to three and it'll all be over.

It's over right now, little buddy.

You know, it's just a little prick, and then before you know it, the pain just... pff.

Disappears.

I'm not 5. I'm 11.

That's called the French drop.

The coin's in your other hand.

Good luck with global warming, kid.

She can give me that sh*t.

Seriously? Why her?

Dat ass.

Hey!

All right. Who's next?

What happened to that kidney stone?

Four of morphine and discharged.

You call her a cab?

I don't call cabs for people.

My bartending days are over.

Bartender.

Were you any good at it?

Whiskey neat.

Moscow mule.

What are we talking about?

Chocolatini.

It was happy hour, Mario.

That 11-year-old was just trying to look down my shirt.

It's hard being a guy. That's all we think about.

Vodka Martini, just a little dirty.

Malaya: What about Dr. Hudson?

Beer... low carb.

[ Christa laughs ]

Call her a cab.

Malaya.

Dr. Niven... Back in the house!

Hey, mama.

Deep... breath.

[ Sighs ]

Hi, Malaya.

You're pregnant.

Wow.

[ Man singing in Spanish ]

Is it mine?

Oh. [ Chuckles ]

Well, at least you have a sense of humor about it.

How did this happen?

It's really nice to see you, too, Malaya.

Why are you here?

Look, I-I felt a sharp pain a couple of weeks ago, okay?

After yoga.

I thought it was just a subscapularis tear.

I put an Ace bandage on it. It should be healed by now.

Probably a fracture near the humeral head.

You could be right.

I am right.

Okay, well, I just would like an M.R.I. to confirm.

There's no M.R.I. at West Harbor?

I'm not gonna go get scanned at the hospital where I work.

I mean, the radiology department, they're like TMZ.

So you come to Angels E.R. at night.

I'm supposed to believe...

I came because I thought you could be a friend.

You didn't want to be friends.

Remember?

[ Scoffs ]

"I need to find myself and be alone," which meant that you really needed...

[ Voice breaking ] Malaya, I just need to know what this is, okay?

Okay.

Okay.

It may take a few hours.

[ Siren wails ]

I thought they weren't supposed to use sirens on the ramp.

They're not.

[ Alarm buzzing ]

Homeboy drop-off?

Not with sirens.

Red on blue! Gloves, gurneys! Let's move it... now!

Tom?

Leanne!

My partner's hit. He's bleeding real bad. You got to help.

I've got the passenger, Leanne.

b*llet went right through the radio.

I couldn't even call it in.

Whoa, whoa, whoa. You've been sh*t, too, Tom.

Dr. Leighton, over here!

Some gangbanger just rolled up out of nowhere.

We never saw him.

Sir? Can you tell me your name?

He just started sh**ting.

He's got a head wound. Looks like it's just a graze, though.

I know I got him. I hit him. He's hit.

I got him. I sh*t him. I sh*t him.

Tom, listen. Listen.

Hey, you got to let me take care of you now, all right?

Can you hear me?

I need you to calm down.

And I'm gonna help you, all right?

Barnes. Scott Barnes.

Okay, Scott, we're gonna get you out of here.

Oh!

Come on. Come on.

Okay.

I'm telling you I am fine.

Will you just help Scott?

Okay.

I'm fine. I am fine!

Will you please just help him?!

Tom. Stop.

We got your partner. We got you, okay?

Scott, you hang in there, man!

You're gonna be okay! Hear me?

Scott, you're good. They got you.

Okay. Let's go.

You're gonna be okay, man.

Scott, you're gonna be... You're gonna be okay.

Aah!

42-year-old male, GSW to the proximal leg.

Dry wound, no active bleeding on the ramp.

X-ray chest, pelvic, and scout of the right leg.

Scott, you with me?

Notified sheriffs. Security posted on all doors.

What?

Rolling.

Gangbangers have come in here before to finish each other off.

These guys are cops.

No exit. Malaya, get your finger in that wound.

See if the femoral's intact.

[ Grunts ]

Why isn't... Why isn't he talking?

Tom, stop moving.

Scott.

Clear for X-ray. Aprons?

Angus, apron... now.

Your swimmers will thank me later.

Clear!

[ X-ray beeping ]

There. b*llet shattered the femur.

That's your clue. Check distal pulses.

Doctors! He's getting up.

Scott, talk to me.

Tom, stop moving.

Dr. Pineda, explain to Officer Moreno what that b*llet did.

It sent a hydrostatic shock wave that likely did organ damage, but it also released adrenaline and endorphins that hide that damage from you.

And from us.

You might have more injuries than you're aware of, so settle down and let us work.

B.P.'s holding 110 over 90.

Two b*llet wounds, and this guy's blood pressure's normal.

You're a superhero, man.

Trauma labs, chest, and plain films.

Mario, Christa, close the scalp wound, please.

Weak distal pulse.

Still here, buddy. You with me, Scott? Talk to me. tom, your leg is fractured. We need to splint it now.

[ Monitor beeping ] Whoa, whoa, whoa.

His blood pressure just went off a cliff.

What's happening to him? What's happening to him?

We're taking care of him.

Young bodies do a better job of managing blood loss, sometimes to their own detriment.

His blood pressure was a mirage.

Like a Ferrari red-lining on fumes.

120 miles an hour, then it stalls.

Angus, get the splint now.

Four liters of normal saline, another level-one, another six pack of blood, please.

All right, he's stable. Let's move him.

[ Grunting ]

Wires up.

Scott.

Here's the saline. Thank you.

[ Man screams ]

What was that?

Leanne: Well, that's not a gangbanger.

We've got this. Malaya, go see what that is.

[ Man screams ]

My son! He sh*t himself!

My son sh*t himself!

Give him to me.

Sir, let us help him.

He sh... my boy.

Let us help him. Let us help him.

I got him. I got him.

Is he...

I've got him. I've got him.

Help my boy.

Dr. Pineda, I could use some help.

Victor!

Risa, call O.R.

Get somebody down here now.

B.P. 80 over 60. Pulse 110.

Sat 93%.

Too much blood. Suction, please.

Woman: Surgery's here.

Jesse.

This is not the case for Cole.

Okay. And you want me to...?

What do we got?

Someone want to run this down for me?

GSW past the platysma. Hematoma in the neck.

Dr. Pineda, you got that tube in yet?

Trying. The hematoma's expanding.

Self-inflicted?

Dr. Guthrie, I can't get in.

Okay, we need to aspirate the hematoma.

She can do it. You don't need to be here.

No, no, no. Watch and learn. Be ready.

Once we drain this, we're gonna have just enough time to pass the tube.

Victor? How is he? Como esta?

No puedes estar aqui, senor.

Es mi hijo. How is he?

Senor, por favor.

My son!

Get him the hell out of here!

I got him! I got him!

Victor!

You okay?

Fine.

Malaya: That's arterial blood.

Damn it. Hole in the artery must be huge.

Okay, we need to get inside.

Prep a cric.

No, 10 blade.

Forceps. Get some suction in here.

[ Suction ]

Dr. Guthrie, a cutting suture?

Suture now, please.

He's ready. Intubate him.

Some fancy fingerwork there, doctor.

Not fancy enough.

Pupils fixed.

No motor response. He's 1-1-1.

[ Monitor beeping ]

Father's in the family room.

Dr. Guthrie?

I'll tell him.

You?

I've had to call a parent before.

A call to come down here is not the same as this, Malaya.

Not the same at all.

She has to do it sometime.

I'll go with her.

Keep your own emotions out of it.

It'll feel blunt, but clarity is what they need.

[ Sighs ]

This should help you rest.

That kid's strong as a horse.

He had one of the fastest times in the Baker to Vegas race this year.

I mean, if that were me, I'd have plastered it across the Hollywood sign.

He's got family in Austin, you know?

Did... did you... did you...

They've been contacted.

Okay.

Guy just came out of nowhere.

Leanne, we were just sitting in our unit and...

[ Sighs ]

Did you hear anything about him, about the sh**t?

No.

'Cause I hit him.

I know I did. I definitely hit him.

He...

He has to be dead by now.

[ Exhales deeply ]

He has to be.

His partner's in sutures.

He nearly bled out, but we were able to stabilize him.

Your friend saved his life by coming here immediately.

That's what he does.

How do you know him?

He's a family friend.

Right.

Maybe we should bring Tom's partner in here next to him.

Sure. I'll take care of it.

Hold your stethoscope so you have something to do with your hands, okay?

Look him in the eye till you're done speaking.

Don't look at me.

It'll make you seem unsure.

[ Door closes ]

Mr. Jasso...

We did everything we could.

But the injuries were too severe.

No.

I'm sorry.

Your son is brain-dead.

[ Crying ]

No.

Is there anyone you would like us to contact?

His mother?

She... she's gone.

[ Screaming ]

No!!

[ Sobbing ] My... my boy!

[ Crying ]

We brought you some clean clothes to change into.

[ Sobbing continues ]

And then we'll take you to your son.

[ Indistinct P.A. announcement ]

[ Sniffles ]

What'd you do, Vic?

Que tontito eres.

Que hiciste?

[ Crying ]

I'd like to tell you it gets easier.

It doesn't.

Cole. You all right?

Yeah. Why?

You know why.

No. No, you don't get to talk about this.

Come on. Don't do that.

You weren't there, so you don't get to talk about it.

It's been so many years. Aren't you tired?

You find your mother with her brains on the bathroom wall and a g*n in her hand, and it's never "so many years."

It's yesterday.

I can't change the past.

But one day, this moment right here is gonna be the past, too.

[ Siren wails ]

Emt: 18-year-old male found in his apartment with a GSW, upper left chest.

Stray b*llet from the cop sh**ting.

Heart rate 118, blood pressure 92 over 58.

Sating 91%.

Hey, hey. The mask is helping you breathe.

[ Straining ] My heart.

What's he saying?

Pacemaker.

Pacemaker?

Defibrillator, too?

He has an arrhythmia. Risa, get him on an E.K.G.

Chest X-ray, please. Christa?

K.U.B., basic labs. Type and cross-match two units.

Let's roll him.

Nice and easy.

[ Groans ]

Exit wound posterior.

Looks like the b*llet could've passed through the upper lobe.

And how do you know that isn't another entry wound?

That would radically alter your treatment algorithm, wouldn't it?

Looks pretty obvious.

We tell you to trust your gut, but a b*llet's trajectory in the body is anything but obvious.

Two ways to k*ll your patient... What you don't know and what you think you know but isn't so.

E.K.G.'S normal. Get him an X-ray.

I'll call cardiology for a consult.

Reporter: When the alleged sh**t walked up and began f*ring into the vehicle, hitting both officers.

Reports are still sketchy, but it seems that one or both of the officers returned fire, possibly injuring the assailant...

Woman: Can this be considered a hate crime?

Taylor: Excuse me.

Members of the press.

Doctor, can you clear some things up?

We're getting conflicting information.

This is a working hospital, not a press conference.

We need to have this area open.

Whose injuries are more severe?

Is if the black officer or the white officer?

Please.

On a scale from 1 to 10?

11!

Please stop.

Started two days ago.

Anything happen two days ago that may have precipitated the pain?

I played tennis against the Passionino brothers.

Notorious cheats.

[ Chuckles ] And you fell?

No. I got all worked up. I had to get a release.

So... you...

I went to Dr. Wu.

The acupuncturist.

He left the needles in me.

I-I-I don't see or, uh, feel any needles.

There's no redness or irritation.

I'm telling you, it's gonna be the death of me.

I'm not going to let that happen, Mr. Pollen.

"Henry."

Okay, Henry.

We're gonna get you some X-rays and find those needles.

Isabel: Dr. Pineda, radiology on the line.

They have the films on Carla Niven.

Tell them I'll be right up, please.

Woman: Sarah Shaw.

Sarah Shaw?

What's up?

Not sure.

What are you doing in here?

I did this.

Jamal?

What do you mean you did this?

I told you to stay away from him.

Mr. Jasso, please.

Hey, hey, hey, hey. What's going on?

I told you. Now he's dead.

My son is dead because of you!

No, he can't be dead, because he's right there!

No, no, no. Mr. Ja... Just calm down. Calm down.

You couldn't leave him alone, could you?

No, you just had to keep coming around, didn't you?

No, please! He can't be dead!

Get out of here.

Please don't say that he's dead!

Get out of here.

I don't want you around him anymore.

Come on, Mr...

Get out of here!

Mala suerte.

That's directed at me? I'm bad luck?

I was in code red.

You walked up... Code black.

Do the math.

I'll bring some sage in.

Do that.

I'll tell you where you can shove it.

Dr. Rorish. We need you in sides.

B.P. is 90 or 60, sat 92.

White cell 12, lactate 6, bicarb 14.

Whoa. Whoa, whoa.

Christa: Can I help?

Check his films, please.

[ Groans ]

[ Sighs ]

[ Grunting ]

It's good to see you working again.

Can you sit up for me, please?

[ Grunting ]

Leanne, I'm sorry I didn't stay in touch after the trial.

What do you see, Dr. Lorenson?

Opacity on the left. Could be atelectasis.

She's onto something.

No, his breath sounds are too strong.

Dr. Guthrie, you are here to tell us that an O.R. has opened up?

Unfortunately, no.

Dr. Baker had a stent placement go aorta rupture, so...

He'll have his hands full for a couple hours.

Okay, thanks for the update. We got it.

Is this the leg GSW?

Yes. Sats dropping. He started vomiting.

His belly's distended and tense.

[ Inhales sharply ]

[ Groans ]

Listen to this.

Can you hear that?

I do... bowel sounds.

Why are we hearing bowel sounds in the chest?

The b*llet must've ricocheted...

You tell us, Dr. Lorenson.

A... diaphragm rupture?

If the b*llet perforated the diaphragm, it could allow a portion of the bowel to herniate into the chest.

And now his bowel is kinked like a garden hose, cutting off his blood supply.

You've just become our priority patient.

You get the first O.R. available.

Not the lottery I want to win.

Four of zofran stat.

I.V., not the pill.

Oxygen, type and cross, and coags.

Is there a problem?

No problem.

Nice catch.

That nurse does not like me.

You bark out orders as if he doesn't know.

I'm making my orders clear.

He's not gonna give a vomiting patient a pill just to have him throw it back up.

That nurse has been doing this job since you were in diapers.

Respect him.

Understood.

Now, if you really want to help me, clear an O.R.

A strangled bowel becomes a dead bowel, and a dead bowel becomes a dead patient.

Hey.

No, stop. Please.

Victor... he's never gonna wake up, is he?

I can't give you that information.

I'm sorry.

What did you mean before when you said you did this?

I can't give you that information. I'm sorry.

I'm not your enemy, Jamal.

That's your name, right?

I'm Dr. Pineda.

Were you there when it happened?

No. A neighbor told me about it.

Then why are you blaming yourself?

Fine, fine. You want to know?

It's not like it matters anymore.

We were hanging out, playing video games.

A few days ago.

[ Sighs ]

He was laughing at some dumb joke that he made.

His laugh, man.

When he laughs, you have to laugh.

It just gets you.

I kissed him.

Best moment of my life.

But I regretted it as soon as it happened.

Did he get mad?

Not mad... scared.

His father doesn't know.

You've seen his father.

That look like a guy who don't know?

I loved him.

I knew him in a way that his father didn't.

He was safe with me.

Or at least I thought he was safe with me.

The X-ray from the young man with the stray b*llet.

It hit his defib implant.

You were right, Dr. Savetti. Well done.

It was a single b*llet.

Looks like the implant deflected it away from his heart.

We have to assume it's not functioning, right?

We need a cardiologist to assess it, and they're swamped.

Hello, James. I'm Dr. Hudson.

When am I getting out of here? I got class in the morning.

Your defibrillator implant sustained damage.

It may not be functioning normally.

I can survive without it.

Do you know the cause of your arrhythmia?

Congenital dilated cardiomyopathy.

The defib just keeps my heart in check.

How soon can I leave?

My E.K.G.'s normal.

Yeah, it is.

Then I need to be out of here by the A.M.

My cardiologist is at U.S.C.

I can check in with her. I promise.

I know that this is serious, but, uh, so is school.

Christa: We'll call over.

Is there anyone else we can call?

Your parents?

Not around.

They were bangers.

Funny, right?

I do everything to stay out of the path of the b*llet.

The b*llet finds me anyways.

Your implant actually deflected the b*llet away from your heart.

You're a lucky guy.

For real?

You're also lucky 'cause you have Dr. Lorenson and Dr. Savetti to take care of you.

I'll be back in a bit.

What are you studying?

Electrical engineering.

It's a miracle I got in the program.

Which is why I can't afford to miss a day.

You were sh*t in the chest, James.

You're gonna be here a while.

What, like... overnight?

You've got at least two surgeries in front of you.

One to repair the damage from the b*llet, recovery time, and then another to replace the implant.

Are you saying that I'm out for the semester?

Looks like that, yeah.

Can I just, uh...

Just have a minute?

Yeah.

You were right to be honest.

Took a b*llet to the chest, and all he wants to do is get back to school.

Dude's my people.

You see? Your X-ray is clear.

Not an acupuncture needle in sight.

That's impossible. Machine's out of whack.

Do something!

Help me!

Okay, Henry.

Sorry it took so long.

Hold a stethoscope so you've got something to do with your hands.

[ Breathes shakily ]

I remember that lesson.

Um...

The M.R.I. showed a small lesion in your upper humerus.

Your white count is 57.

Oh, my god.

You should talk to our radiologist.

A radiologist?

Are you seriously talking to me like this?

Give me that.

The blood smear indicated acute lymphoblastic leukemia.

Cancer...

I know what leukemia is.

No, what I was gonna say is that cancer isn't always...

This can be treatable.

I have a baby inside of me, Malaya.

Many treatments don't affect the unborn fetus.

Angels has an excellent oncologist...

Can you stop? Please, will you just stop?

On staff.

Stop. Stop talking. Please.

Maybe with surgery and chemo, we can...

[ voice breaking ] I'm doing this all wrong.

Doing what all wrong?

Being a doctor or being a human?

Kid that was hit by the stray...

Was it one of ours?

Medic said the guy was on the second floor.

I was sh**ting in that direction, Scott.

Let's wait for forensics before...

Oh!

Take it easy.

You need to make it out of here, unlike that piece of crap that sh*t us.

Hope that guy's bleeding out in a hole somewhere.

Hey, you both need to stop talking and rest.

Officer Barnes, we're gonna take you up to I.C.U.

What about him? He getting his O.R.?

Soon.

Hey, I'll see you after my surgery, pal.

[ Grunts ]

He's gonna be okay, right?

He's tough as hell.

So are you, Tom.

I need you to hang in there. It's not gonna be long now.

What about that other kid they brought in?

The one that was hit through the wall.

He's stable.

If that kid dies... he's not gonna die.

How long have you and Scott been partners?

[ Grunts ]

A few weeks.

A few weeks?

Yeah. Why?

You just seemed so distraught, I assumed...

He's my partner. Why wouldn't I seem distraught?

Of course. Of course.

That guy came out of nowhere, Leanne.

I told you... I never saw him.

If you never saw him, how do you know he was a gangbanger?

What the hell is this? You questioning me?!

No, no, he isn't.

[ Groans ] Tom, I need you to rest.

Easy.

Jesse.

[ Gloves snap ]

Are... Are you a cop now?

Do you believe him?

That man pulled every one of us out of that wreck.

My whole body was broken. I couldn't move.

I know.

No, you don't.

You don't know 'cause you weren't there.

No one was there but that man and me.

It was an eternity before help came, and he listened to every command I gave as he tried to save them.

He did everything right.

But it didn't matter.

When we finally got to that hospital and... they d*ed one by one...

He stayed with me.

I was in the darkest place any human could ever be, Jesse.

And he never left my side.

I don't know what would've happened to me if he had.

So, do I believe him?

That he and his partner got sh*t, that he sh*t the guy who did it?

You're the best diagnostician I know.

I'm just asking, do you think you're hearing the whole story?

I'm just asking, Leanne.

[ Monitor beeping ]

Guthrie: Mr. Jasso?

You wanted to see us?

He's never gonna wake up, right?

No, sir.

So, uh... no more Dodger games with the old man.

[ Voice breaking ] No taco trucks at Mariachi Plaza.

Just this.

A pump making his heart b*at.

[ Inhales sharply ]

I'm ready to take him off the machines.

[ Voice breaking ] My son's gone.

Mr. Jasso, I spoke to Victor's friend Jamal.

He'd like to see Victor.

No.

He wants to say goodbye.

No.

Dr. Pineda, a word.

Jamal is grieving for his friend.

I don't want him here.

But he...

I said no!

Dr. Pineda. Now, please.

[ Sighs ]

What do you think you're doing in there?

Our patient is dead. His father wants to grieve.

They were in love, and he didn't approve.

That's the reason why Victor...

We don't know why that boy did that to himself.

But how that man feels right now, I know something about that.

I can't judge him now, Malaya.

And neither should you.

Hey.

Hey.

How you feeling?

I don't mind the morphine. I'll tell you that.

Am I gonna make it?

If I could do the surgery myself, I would.

But it's beyond what we're capable of down here.

That's not what I asked you.

Yeah, you're gonna make it.

Thanks for the lie.

What? What is it?

Nothing.

Now who's lying?

Mm-hmm.

Tom.

I'll never forget what you did out there on that highway.

I didn't do enough.

You saw me at the lowest point in my life.

I know.

Am I seeing you at the lowest point in yours?

What are we talking about?

What really happened out there tonight?

I told you... Guy came up...

Out of nowhere.

Out of nowhere.

You never saw him.

What are you doing? What is this? What...

Wait.

Just wait, wait, wait, wait. Okay.

Do you think this is one of those things.

"Cop sh**t an unarmed man" kind of thing?

Because my partner and I got b*llet holes in us that tell a different story.

Okay, settle down.

I thought you and I had something in the bank here, Leanne.

We do.

We do.

Dr. Rorish. You have a second?

They found the sh**t... Multiple GSWs.

[ Radio chatter ]

On my count. One, two, three.

Dr. Pineda. Get in here.

Two large bores, both arms.

Malaya, prep an airway.

He's positive for blood in Morrison's, at the spleen...

Even the bladder.

Leanne: Continuous boluses.

Six units of O-neg.

Dr. Pineda, next move?

Uh, R.S.I. etomidate, 20 milligrams, and sux 140, please.

Malaya, what next?

Um, TTA, page surgery, an ex-lap.

First things first. Get him intubated.

Sats are down to 85.

Malaya, get him intubated.

Come on. What's the problem?

[ Monitor beeping ]

He's de-satting. Let me in there.

Tube, please.

Malaya, this was not a difficult intubation.

Where's your head?

[ Grunts ]

Let's go.

All right.

Behind you.

[ Groans ]

Officer Moreno, I'm Dr. Guthrie.

Is that him in there? Is that the bastard who sh*t us?

What are you talking about? Just tell me what's going on in there.

Whoa. Whoa. Settle down.

Now, you cannot stand.

Trust me.

We're taking you to the O.R.

He's pumping through a lot of blood, boss.

[ Echoing ] He needs to go upstairs right now.

[ Echoing ] Is he gonna live?

That piece of crap gonna live?

[ Groaning ]

Get Dr. Hudson in here.

What?

Get Neal, Jesse.

Now, please.

[ Breathing raggedly ]

What's going on?

His defibrillator just shocked him twice in 10 seconds.

Heart rate's 160. It's malfunctioning.

Make it stop before it happens again.

Take it easy. Try and calm down.

Do something!

Deep breaths.

Tracing is normal. It shouldn't be shocking him.

Please! Please! Please!

[ Grunts ]

[ Thump ]

[ Flatline ] He's asystolic!

What do you have?

Multiple g*nsh*t wounds to the abdomen.

He's already lost two liters.

He needs an O.R.

So does Tom.

This guy has five minutes.

Tom has 20.

So, what's the call?

You tell me.

If this guy goes upstairs, he's in the O.R. for eight hours.

Tom dies.

What are you asking me?

You know exactly what I'm asking you!

I can't make the call.

My judgment is...

You have to call it.

What's going on? This the guy who the cops sh*t?

This is the guy who sh*t the cops.

This patient needs an ex-lap.

We need to take him up to the O.R.

I'm here for the cop.

This man's injuries are more emergent.

You're not serious.

Malaya.

You're gonna give him an O.R. in the middle of code black over the cop he sh*t?

You're not needed here right now, Dr. Pineda.

Take a break.

Truth is, he's not stable for transport.

His pulse doesn't seem to agree. He's alive.

Whose patient is this?

Mine.

Then why am I talking to him?

We decide who we send up.

No, actually, I do, and I don't perform surgery in an elevator, which is about as far as this guy's gonna make it.

So you're just gonna let him die?

I'm gonna save the one I can save.

What happened?

He's asystolic.

His implant is defibrillating him randomly.

I'm taking the cop up.

If you won't do the ex-lap, then I will.

I'm not just gonna stand by and...

Just let him die!

Tom!

Can we get another bed in here?!

[ Monitor beeping ]

Man: Make some room!

[ Camera shutters clicking ] Reporter: Is he officially under arrest?

Hey, hey! Guys, we need you to move back.

Move back, people.

Jesse: Your ex-lap tray is right here.

Let's start the procedure now, please.

Cole: You're gonna do it on your own? He won't make it.

We'll do it together. Dr. Leighton will assist.

You're one clown short of a three-ring circus.

Well, actually, we have more than enough clowns.

We got 50 photographers out there just dying to get a picture of a white cop in between two black men he sh*t.

I'll stabilize this one for transport.

I'm here to help.

Good. Glove up and get over here.

I'm sorry. I brought my baggage in here.

You're not the only one.

Breath sounds almost absent.

Could be pneumo.

Could be bowel.

Neal: Magill, please.

Nice technique.

Forceps.

Load it.

Christa, Mario.

You need an I.C.D. magnet to deactivate the implant.

Cardiology's got them both.

How do we shut down the implant without the magnet?

You have to stop it manually.

Cut the wire leading to the heart.

She'll be electrocuted, won't she?

You just have to time it.

Go help them. We got this.

No. They're both very good.

Christa, I'll walk you through it.

I need you to extend an incision in between the third intercostal space.

Got it. [ Thump ]

I think this is a mix of air and bowel.

No. Bulging neck veins.

It's a tension pneumo.

Mama, 14-Gauge, extra-long. Throw it to me.

Okay, come on.

Vitals improving.

Let's get him upstairs.

Cole?

Take him up. I'm right behind him.

[ Thump ]

This is insane.

Focus. We got this.

Find the subclavian vein where the lead threads into the heart.

I see it.

Be careful.

That's the lead.

[ Flatline ] Angus: He's flatlining.

[ Thump ] Oh, god.

Hang in there. You got this.

[ Thump ] Do it.

Cut it now! [ Electricity crackles ]

Christa?

Are you okay?

Yeah.

His pulse is back.

[ Monitor beeping steadily ]

Nice job.

[ Chuckles ]

[ Flatline ]

No pulse.

Any other suggestions?

Time of death... 1:44 A.M.

[ Click, flatline stops ]

You were right.

You're a good surgeon.

So are you.

But I actually am a surgeon.

What are you doing down here?

I got acupuncture needles in me!

I told him there are no needles, but he won't leave.

That's because he's got needles inside of him.

The pain is unbearable!

Would you step out of the way, please?

I went to an acupuncturist long ago for fertility...

Dr. Ho.

He inserted one needle, and before you know it, I had my very own millennial, which is Latin for "unemployed."

Do you know where Dr. Ho stuck that needle?

Right in the scrotum.

Voila.

[ Chuckles ]

I didn't feel a thing.

Thank you, doc. Thank you very much.

My pleasure.

You'll find two syringes without those in the cart.

What was that?

What's that say?

"Dr. Mark Taylor, director, emergency department."

That's right.

I've been doing this longer than you've been manscaping.

The old man... his mind was playing tricks on him, so I played a trick on his mind.

Okay?

We stabilize and vaporize.

Just get him a referral and ship him out.

[ Monitor beeping, ventilator hissing ]

Dr. Guthrie? Could you wait a moment?

Dr. Pineda...

Someone needs to speak for Victor.

Your son would've wanted Jamal here.

You don't know anything about my son.

Dr. Pineda, outside, please.

I-I didn't have to know Victor to know that the single hardest thing for him...

For any child to do is...

What? Tell your father you're gay?

No.

To disappoint him.

I had to tell my parents who I was.

It took me years to find the courage.

And even then, I couldn't do it alone.

I brought my girlfriend with me, and she ended up doing most of the talking.

He wasn't an unhappy child.

I'm sure he wasn't.

In fact, there's a boy out there who made him very happy.

You think that Jamal is so different from you, but you're the same in the most important way of all.

You both loved your son more than anything in this world.

[ Breathing shakily ]

[ Voice breaking ] I'm so sorry, Victor.

[ Crying ] I'm so sorry.

Did he know you loved him?

I think so.

Good.

[ Chuckles ]

Explain this world to me, mama.

You know what a covenant is?

It's a sacred agreement.

People come here at their very worst, which means that no matter what, we have to be at our very best.

No one said it was easy.

That's the covenant.

You'd already diagnosed yourself.

That's why you came to me.

I feel awful.

I just...

Seeing you again, I was trying to keep my emotions out of it.

I wasn't at my best.

Why'd you come up here?

To find me?

This is where it all started.

You were so scandalized.

You were a senior resident, and I was...

You were nervous.

It was adorable.

I didn't think there could be anything worse than saying goodbye to you.

This is definitely worse.

[ Chuckles lightly ]

Not by much.

How's my partner doing?

He's stable.

And the kid that got hit by the stray?

He's gonna pull through.

And the sh**t?

You afraid of what he might say?

Look, whatever you're thinking, whatever they're thinking out there, that's not it.

I took money from a guy that you don't take money from.

He said he would come for me.

And he did.

He's dead.

So, it's up to you whether you tell the truth or not.

But I'll tell you this...

The guilt never goes away.

I'll let you get some rest.

Leanne.

What do you have to feel guilty about?

That I survived.