[indistinct speech over PA]
Incoming. Talk to me.
Female, late teens, hypothermic.
GCS of 9.
Can barely feel a pulse. She's really cold.
I got her.
Male, early 20s. Fell off a plane at touchdown.
Go to Trauma 1.
Left chest is crushed. Unable to intubate.
Pale and unresponsive. Get intubation drugs.
20 of etomidate and 100 of succs.
Get a labs and a base deficit and trigger the MTP and start transfusing as soon as the blood shows up.
On my count.
Both: One, two, three.
All right, let's get that board out.
Let's get a CPC and a crit.
Okay, let's roll him over.
Hold him steady.
Right here, Maggie.
What's your name? Can you tell me your name?
ABCs intact. GCS 9.
All right, get warm saline bags in her axillae, groin, and behind her neck.
And let's cover the top of her head to keep whatever heat she has in.
Too much blood in the airway.
Can't see a thing.
Okay. We're gonna crich this guy.
We're gonna need about three more.
Get a core temp.
All right, let's get the X-ray and the FAST scan in here now.
Trach set. Got it?
Got it. I'll bag him.
How's she doing over here?
Heart rate's 50. Temp is 29 Celsius.
Breath sounds bilaterally.
Right is really muffled.
What the hell happened?
Stowaways from Mexico.
He fell out of the plane.
She came out of the wheel well after landing.
All right. Let's get a look at his chest.
Dr. Choi, get a chest tube in on the right.
You got it.
All right. Scanner.
There's blood throughout his belly.
We need to get him up to the OR now.
He's gonna need a lap.
On it. Calling the OR.
Okay. I need to set his leg.
All right, Maggie?
Okay. All right.
You wrap that up for me?
Whenever you're set, go.
What's her core temp?
Still 29 Celsius.
Got the Foley in?
Get 2 of Versed IV.
Get the ECD in and set up for a DPL.
We have a very short window to get her warm.
Go ahead and get me a flush. I need heparin. Ready to travel.
All right, let's go.
Start the infuser and set it to warm.
Give me the big needle.
Just use the level one to warm.
Do not pressure infuse.
ECD warming to 46 degrees.
Core temp's 35 and rising.
Heart rate's up, 60.
That should stabilize her for now.
Good work, everyone.
I'm afraid she's not out of the woods yet.
Hypothermia and hypoxia?
That's like hibernation.
It's, like, minus 60 to 70 up there.
What kind of screwed up life did she have that she took a risk like that?
Hey, no offense, but not everyone's born a Rhodes.
Thanks. I keep forgetting that.
Can you lift your arm?
I... I can't.
Can you hold it out in front of you?
Does this hurt?
He was playing in the backyard, tripped and fell.
Dad says I'm clumsy.
You just need to watch where you're going.
I think Parker has fractured his left clavicle, but we need to get an X-ray to make sure.
The tech will be right in.
Why you think he gave us all that money?
You mean he's not honoring his late wife?
I doubt it's a coincidence Cornelius Rhodes gave to the hospital where his son works.
Man who likes to be in the center of attention.
Freaking world-class narcissist, that guy.
Yeah, and what better way to steal the spotlight from his son than by donating a million dollars?
Whatever his motives, the money's green.
And I get a new psych ward!
Good morning. How you feeling?
Wonderful, you know, considering the fact that I can't sleep longer than 15 minutes, and when I do actually get comfortable, I have to pee.
Did you try that pillow I gave you?
I added to the 20 other pillows that aren't helping me sleep, but thank you.
Sarah's got a kid with a fractured clav in Treatment 1 for you.
I'll just hit the bathroom and then waddle my way over there.
Talk to you later.
How's she doing?
Still in and out of consciousness.
Temp's back to normal.
Still waiting on her charts.
Soy El Doctor Rhodes.
ÿCómo se siente?
Her name is Maria Gonzalez.
Miguel is her brother.
He was the one that was brought in with her.
Maria... your brother was very seriously injured.
Yes. He is.
Pero está en terapia intensiva.
Va a necesitar soporte vida.
El estaba tratando de salva.
Why was he trying to save you?
Our father... is narco...
Not good man.
Want to sell me.
Pero... mi hermano,
Miguel, protect me.
He get me out.
Por favor, cuida a Miguel.
Cuida a Miguel.
Haremos todo lo Que podamos por él.
Sorry, I have to go.
Respira otra vez.
On the day you were born, the Earth turned.
The moon pulled.
The sun flared.
And then, with a push, you slipped out of the dark quiet, where suddenly you could hear.
Parker's fracture is aligned, which means he will not need surgery.
Are you gonna put a cast on?
I want a cast!
Oh, sorry, all you get is a sling.
Hi, I'm Dr. Manning.
Hey, well, I heard someone broke his collarbone this morning.
I was just telling them that their son won't need surgery.
All right, well, let me take a look.
Do you mind if I check your pulse?
All right, I'm just gonna take a little peek in here... see what's going on...
What's happening to him?
Give me 1 milligram of Ativan.
He's having a seizure.
Does he have epilepsy?
Any history of seizures?
You're okay, honey!
Oh, my God.
What just happened?
I'm not sure, but I don't think it's related to his clavicle.
With your permission, I'd like to run some tests and see what's going on.
[knock on door]
Thanks for coming, Dr. Rhodes.
These are agents McManus and Ramirez from Homeland Security.
Dr. Rhodes, you have a female patient, a stowaway?
Yes, Maria Gonzalez.
And she was brought in with a companion?
Miguel, her brother.
We understand he's unconscious in the ICU.
We would like to talk to Miss Gonzalez.
Well, I'm afraid that she's barely conscious herself.
She's in no condition to be questioned right now.
Any idea when we'd be able to talk to Miss Gonzalez?
It's too early to say.
This woman is a victim.
Her father is a narco.
He was planning on selling her.
Her brother was only trying to save her.
Sounds like you had extensive conversations with the semi-conscious Miss Gonzalez.
No, that's all I know.
Dr. Rhodes, you realize we wouldn't be here if this weren't a matter of great concern?
Yes, and he'll let you know as soon as you can speak to her.
We'll be back.
And you can count on that.
I'm trying to make this look pretty, Cedric, but I'm afraid you're still gonna have a scar.
That's a good thing, Doc.
Bigger the better. Makes my case.
What do you mean?
Well, you see, my pops doesn't want me to have a car.
Now I can say, "See, if I had been in my ride instead of on my bike, I wouldn't have this scar."
Or if you'd been wearing your helmet.
Doc, don't confuse the issue.
What do you think?
That gonna do the trick?
That's a Honda scar.
We aim to please.
You are good to go.
No problem. She'll sign you out.
Dr. Choi to ICU.
We lost him.
Time of death: 11:32.
Want me to tell his sister?
No, I will.
ÿDónde? Mis piernas!
What's going on?
Hard as a rock.
She must have injured her leg when she was unconscious in the plane.
I don't feel a pulse.
Get me a Stryker needle.
Let's evaluate the pressure.
No, no, no, we are past that.
She needs all four compartments released right now, or she's gonna lose this leg.
Call the OR and tell 'em we're on our way up now.
100 mics. We need repeat labs stat.
CBC, lytes, and a CPK.
ORs are busy, at least a two-hour wait.
That's too long.
We're gonna do the fasciotomies here.
Draw up to syringes of ketamine, 70 milligrams apiece, and get me 2 of Versed.
Whoa, wait. You're not gonna intubate her?
We can do this with deep sedation.
The ketamine won't give you much time.
Well, then I will be fast.
Mi hermano Miguel.
Give her the Versed, follow it up with the ketamine.
BP's 120 over 82.
Heart rate's 110.
Sat's at 99%.
Here we go.
I'm going for the posterior compartment now.
Keep her still.
I'm telling you we should be in the OR.
Just suction her out.
April, 70 more of ketamine, and then come down here and help hold the leg.
Second dose is... in.
Muscle looks viable, bleeds well.
That should do it.
Wrap her up. Send her up to the ICU.
Let me know when she's alert.
I need to talk to her.
Her brother just died.
You listen to me.
When we are under the gun like that, it doesn't help to keep questioning my decisions.
You follow my lead.
Guy's father writes a big check and he acts like he owns the joint.
How about you cut him some slack today?
Look, my mother died too.
She's not getting commemorated with a new hospital ward, okay?
I thought you said you grew up in Chicago.
And you mean to tell me that you don't know what happened to Connor's mother?
Well, it was 20 years ago.
You were just a kid.
Connor's mom threw herself off the roof of their home.
Connor was just ten.
Are you serious?
It was all over the news back in the day.
And with the reception tonight... lot of stuff that he probably doesn't want to have to think about.
I got Parker's test results back.
You need to take a look.
CT negative. We need to order...
An MRI, I know.
I already did it.
It shows excessive demyelination.
Explains the clumsiness, degeneration of motor skills...
And the seizure.
I don't want to jump to conclusions, but I'm pretty sure he has...
He's eight, so it's late-onset.
Gives him five to seven years before he becomes confined to a bed and completely vegetative.
What do you want to do?
Well, I've got to go talk to the par...
I think my water just broke.
Oh, my God. It did.
I guess this is happening today.
Uh, can we get a wheelchair over here?
Look, I'm sorry, Sarah, but you have to go tell the parents.
What? Me? No. I can't...
You have to.
I don't have the experience.
Go get Dr. Charles.
He will help you.
I have to go have this baby now.
Breathe out. Exhale.
One more time.
How much longer do we have to do this?
Ten more laps.
Make sure everything gets aligned correctly down there.
You know, I am seriously regretting making you my birthing coach.
That means I'm doing my job.
Oh, hey, handsome!
Get yourself over here.
I had to bribe Fromson to cover my shift.
What do you need me to do?
Okay, I need you to walk with her for now and be her rock.
And I will be back as soon as I can.
Wait, you're leaving?
Got to find somebody to cover my desk.
We could be here for the next 30 hours.
Not if you listen to your birthing coach.
I'm not sure how fast a rock is supposed to walk.
You're doing just fine.
Thank you for being here.
It's finally happening!
And you are?
Oh, this is Dr. Halstead.
I work with Natalie.
And this is Helen, my mother-in-law.
I've got this now.
Sorry I'm late.
Thanks for coming, Sharon.
A meeting without a single doctor present?
My guess is this isn't about a medical issue.
Sharon, I know you're not gonna like this...
Neither do we... But we need to discuss our stowaway patient.
Dr. Manning said you could help me.
I have a patient, an eight-year-old boy, Parker Kindler, and... uh...
You know what, let me back up for a second.
Dr. Manning and I were treating Parker, and then she went into labor, and...
Natalie's in labor?
How's she doing?
Fine, I suppose.
Her water broke right in front of me, but that's not what I came to talk to you about.
Dr. Manning and I just diagnosed Parker with a terminal genetic condition called Krabbe Disease, and now she's in labor, and I have to tell the parents that their eight-year-old child is going to die, and that the same thing might happen to their three-year-old.
So I guess I was just wondering... how do... How do I do that?
Have a seat.
In my experience, it's best to be direct and get straight to the point.
When people get bad news like this, they tend to get overwhelmed.
They might ask you to clarify things or repeat them.
They might seem like they have a million questions.
They might want to be left alone to begin to process the grief.
The most important thing is that they need to know that somebody's there who understands what they're going through.
So really it's your compassion that they need to feel.
And after you tell the parents... they might want you there when they tell the child.
They might not.
That's up to them.
Wait. Tell the child?
The child actually needs to know.
Look, Sarah, it's the hardest thing that you'll have to do as a doctor, right?
And it doesn't get any easier.
At least, it hasn't for me.
But we are the ones who have been chosen to do this, and I think that there's a certain nobility in that.
You want me to come along?
That would be great.
Given his current symptoms, Parker has anywhere from five to seven years before the progressively degenerative nature of the disease confines him to a bed and eventually leaves him in a vegetative state.
I mean, there must be some kind of treatment.
At the moment, no.
You mean there's no cure?
There's nothing we can do?
Um... that is correct.
Krabbe is an extremely rare disease.
We can treat his symptoms, but eventually Parker will need to be ventilated to continue living.
There is something else.
Since the disease is hereditary, we need to determine if Seth carries it as well.
Do you know if he's been tested?
I don't remember.
I can find out.
Do I have permission to check his natal records?
What happens if Seth tests positive?
Since he has not yet presented symptoms, the hope is we can treat him with stem cells and stop him from developing the disease.
Why don't we check the records first and... and go from there?
Again, I'm so sorry.
Oz, turn the room over.
Whoa. What happened to my patient?
The Air Ambulance medics came to take Ms. Gonzalez away.
They just left.
Whoa, whoa, whoa!
What are you doing with my patient?
All right, Doc, please, it's best you stay out of this.
No, no, no. She is under my care.
Dr. Rhodes, por favor!
Let's keep him back.
You get off of me.
I'm sorry, but she's being repatriated home.
No, she is barely stable.
She can't go anywhere.
She's stable enough to travel.
She's gonna be accompanied by a doctor and a nurse.
No, no, no. I can't allow this.
Doctor, I'm sorry.
This is not up to you.
[indistinct speech over PA]
You backed me up with Homeland Security.
Yes, I did.
Then why did you let them deport Maria Gonzalez?
Not here, Dr. Rhodes.
Give us the room.
Homeland Security did not deport your patient.
No, no, no. I was outside.
I saw them.
It's the hospital that's repatriating her.
Why... we're doing this why?
Because Maria Gonzalez is undocumented and without medical insurance.
We're legally bound to treat her.
Which we have done.
She is still in critical condition.
We contract with a private ambulance service.
They provide medical personnel for the patient.
That's how you justify it, then?
Look, I wish I could wave a magic wand and fix it, but I can't.
Maria came her for refuge.
Her brother risked everything so that he could help her, and he sacrificed his life.
There was meconium in your water, so we'll want to watch for fetal aspiration during delivery.
Your dilation is 4 centimeters.
So... looks like you're on your way.
Dr. Halstead, you can come in now.
How you doing?
I'm okay. Mm.
All right, I got Betty to cover the desk.
I'm here for the duration.
What do you need?
I'm really thirsty.
I'll get you some ice chips.
Oh, thank you.
All right, thank you.
Let me fluff that pillow for you.
There you go.
Natalie's husband, my son, Jeff... died seven months ago.
Yeah, I'm very sorry for your loss.
Only seven months.
What are you doing?
I'm... just trying to help.
Natalie and I are friends.
And that's it?
I care about her.
Natalie's having a baby.
She's a widow.
Can you just give that to her?
Tell her I'll be back later.
What do we got?
17-year-old involved in a drive-by.
Triple zero. Three entry wounds in the chest.
Multiple exit wounds. He's shredded.
Intubated. 16-gauge IV in the right AC.
Downtime 12 minutes.
Get on his chest. Open the crash cart.
Milligram of EPI. Rapid transfusion line.
All right. Let's call it.
Those are my sutures.
He was here this morning.
I know him.
He fell off his bike.
Parker, honey, you've been asking why Seth had to get a test.
And why your dad and I have seemed so sad...
Is something the matter?
There is, and we need to tell you about it.
We asked Dr. Charles to help us in case we can't explain it very well.
'Cause he's a doctor.
It turns out, honey, that...
You mean this?
You mean, like when I get a cold?
Parker... you are sick in a different way.
So should we check to see if I have a temperature?
Mm, we don't have to.
Does that mean I'm getting better?
No, buddy, it doesn't. I'm sorry.
Unfortunately, you have an illness that we don't have a cure for yet.
Is this like when Finn got sick?
Finn was my dog.
Oh, you had a dog?
Am I gonna die too?
But not for a long time.
Oh, longer than that.
More like five years.
That's a long time.
Will I get to eat ice cream?
I'm guessing... the answer might be yes.
Push! Push, push!
I don't know.
Don't worry. Maggie and I are here with you.
Your BP is rising.
It's still okay, right?
The baby's not descending.
I'm worried that he's occiput posterior and stuck in the birth canal.
What does that mean?
The baby is sunny-side up.
We need to consider a C-section.
Is it that serious? Is the baby in danger?
Ma'am, I'm sorry, but I think it would be better if you waited outside.
No, I'm not leaving.
Helen, it's okay.
I'm fine. I promise.
Okay, if you're sure.
I got this, Helen.
I'll be right outside.
[grunting and moaning]
I don't want a C-section.
I don't blame you.
I think you're being overly cautious.
That 'cause you're treating another doctor?
I treat all my patients the same.
We're not there yet.
Are you questioning my judgment?
I'm her midwife, and I don't think cutting into her is a good idea yet.
Are you going to listen to her or your obstetrician?
Nat, I can turn the baby.
Let her try.
Give me ultrasound.
Heart rate's decelerating.
Baby's still OP.
We should operate.
One more time. Okay, Nat?
Try it now.
I think we have it.
Okay, he's in position.
Give me a push. Now!
That's it. That's it.
The baby's crowning. The baby's crowning.
We're almost there.
I'm so tired.
Listen to me, okay?
You can do this.
Wait a second.
Three, two, one... push!
That's it. That's it!
Okay, that's it. Here he is.
We've got a tight nuchal cord.
Baby's not breathing.
Okay, Nat. Cut.
Tell me what's happening!
Here you go.
Someone tell me what's happening!
Meconium in the airway.
[machine sucking liquid]
I need you to be strong.
They're working on the baby.
Keep it going.
Oh, thank God!
Here's your son.
And you put this lace over this loop.
Tie them together.
Hey, I have good news.
Seth tested negative for Krabbe Disease.
He doesn't have it.
[gasping] Oh, my God.
We're making a movie.
Instructional videos for his brother.
Things that I learned when I was little.
In case I get too sick to teach him.
That's really nice.
Okay. I got something to do...
But I'll be right back.
I know all too well how difficult it is for the loved ones of those who suffer from mental illness.
22 years ago, my wife, Elizabeth, lost her battle with depression... and killed herself, scarring not only me, but our two children.
Sadly, this kind of tragedy is not unique to our family, and therefore, I can only hope that my donation helps to ease the suffering, the feeling of hopelessness, that we and too many others have experienced.
So, in memory of my late wife, I have given $1 million to help build the Elizabeth Rhodes Psychiatric Ward.
Thank you you all very much.
He looks just like his father.
He really does.
I'm gonna name him Owen.
It's Irish for "little fighter."
Given how he came into the world.
I like it.
It was a beautiful speech, Dad.
Why, thank you.
I had this patient today.
She came in with her brother, and he died.
He sacrificed his life for her.
I never should have left Claire.
You shouldn't have.
Hurt her deeply.
You know, I never told her about the night that Mom died, what really happened.
Your mother was disturbed.
She had a mental illness.
You and I both know that that's not the reason she killed herself.
Let me get this for you.
I am really glad that I'm back.
♪ ♪ ♪ ♪
All: To Owen!