03x05 - Cabin Pressure

[bunniefuu]

[SIRENS WAIL]

[TELEPHONE RINGS]

WOMAN: Angels Base, this is dispatch.

Get ready over there. We're
transferring calls to you now.

GIRL ON PHONE:
‭Mom? Mom! Wake up! Please!

I don't know what's wrong with her!

Okay, I need you to calm down for me.

Where are you?

Um, I don't know.

I just see lots of buildings all around.

♪

Please, ‭I don't know what to do.

I really need someone to help me!

[CRYING]

MARIO: Stay calm.

Do you know how to play gin rummy?

Mrs. Edith in Sides is
looking for another mark.

You seen Leanne?

I haven't seen her. Why?

Hey, today's shift, you're
staying out of East, okay?

You're the boss.

Hey, Mario needs you.

Dr. Savetti needs me.

In Dispatch. It's an emergency.

Everything around here is an emergency.

Why did Jesse banish me from East?

East is oncology.

They have their own set of volunteers.

No. ER stripers rotate there.

Only when they're shorthanded.

You can't keep me from seeing Max.

I'm not saying you can't see him.

So admit it. You had
Jesse do your wet work.

Max is sick...

Oh, so, because he's sick,
we can't be friends?

Is that how it works?

[CRYING] Are you still there?

[SIREN WAILS]

-year-old girl on a small plane.

The pilot... her mom... is unconscious.

It's just them.

Well, h-how did that call get here?

She called from her cellphone,

and they patched her over to us.

GIRL: Hello? Is there anyone there?

I'm here. I need you

- to stay on the line.
- [TAPPING ON WINDOW]

I got ATC on the phone.
They want to talk to her.

What do I do?

I told you it was an emergency.

[SIREN CHIRPS]

Let me ask you something.

You're good at this.

You got great instincts, good hands.

Why didn't you go to medical school?

Not an option in my
neighborhood. Or my family.

[DOOR CREAKS]

- Where is he?
- Who?

Called ? A guy passed out?

Not me. And I'm the only one here.

Uh, I'm gonna call dispatch, see
if they screwed up the address.

The pilot is hurt or something.

Little girl on the plane. It's crazy.

[INDISTINCT CONVERSATIONS]

Can you to divert all calls to...

ATC wants to take over the call.

This is a -year-old girl
up there, Campbell.

I don't want her to panic.

They have to know how much
fuel is in that plane.

Okay, okay.
One thing at a time, Campbell.

Hey, hey, hey. Our chopper
pilot's on the roof right now.

Get him down here.

This is a scared little girl up there.

She doesn't need , people
talking at her, okay?

I'm gonna put her on speaker,

and the only voice
that she's gonna hear is mine.

MEDIC: Clear the way. -year-old
female passed out at work.

History of COPD, low O sats.

- Mario, take it.
- Okay, Center Stage. Let's go.

[SIREN WAILS]

Hello. This is Dr. Leanne Rorish.

Can you hear me okay?

GIRL: Sort of. I only have one bar.

Okay, well, I'm here to help.
What's your name?

Ruby.

Okay, Ruby. What happened?

My mom was flying but she got dizzy.

- She keeps passing out.
- I understand. Hold on.

Okay, can you put your hand
above your mother's mouth?

Can you tell me if you
feel her breathing?

♪

Yes! She's breathing real fast.

Leanne, it appears
the plane is on autopilot,

cruising at , feet
near Van Nuys Airport.

They need to know how much fuel
she's got left.

They're not gonna wait any longer.

They're gonna cut the call
if they have to.

Okay. Ruby, you're doing great.

Can you tell me how much fuel you have?

I don't know. Which one is it?
There's so many dials.

- Where's the pilot?
- He's on his way down.

Get him down here now. It's too slow.

Yeah, and can you call Willis, please,

and tell him to get out there now?

I understand. I'm working on it.

Okay, um, we're gonna figure this out.

Just give us a second, okay, Ruby?

[DOOR CREAKS]

Yeah, you know, it was the only thing

that was really drummed into me.

What?

Well, my dad. "You will be a doctor."

Well, I got, "You'll marry a doctor."

So your aunt really likes me.

[CELLPHONE RINGS]

Willis.

We got a small plane with a sick pilot.

Yeah, I know, we just saw it.
In Van Nuys, right?

Yep. If we can get them down,
we're gonna need a doctor.

How are you gonna get them down?

We're gonna try to wake up the mother.

She's our pilot.

And if you can't?

There is no can't.

All right, we're on our way.

Guess ‭we're going to Van Nuys.

[g*n COCKS]

Easy.

I guess we know who called .

All right, if you want dr*gs...

Shut up and drive.

[INDISTINCT TALKING]

[ELEVATOR BELL DINGS]

ATC told me they're
in a Piper Chieftain .

- Are you familiar with it?
- Very.

Can you talk her through a landing?

A -year-old girl with no
flight experience? Not likely.

Because we're the closest
Level Trauma Center.

Yeah, we got a chopper
standing by for the passengers

coming here as soon as they land.

- You guys know Randy Woodman.
- Hey, come on in, Randy.

Look, we've got ATC Van Nuys
live on the second radio now.

They're clearing air space
around the plane.

But they need bearing
and fuel status now.

Okay, so, just hold on.

We've got the girl on this channel, okay?

So she just needs to know
where the fuel gauge is.

You tell me, I'll tell her.

- What's our plan?
- Let me draw it for you.

The plan is, if we can't get
the mom healthy,

- ATC takes over.
- What's their plan?

RANDY: Fuel gauge is on the
left, second from the bottom.

Hey, Diego, you got to keep
a lane clear out here.

You want me to help her breathe
or do crowd control?

This is Angels. You got to do both.

Two needles,
‭one on either side of the gauge.

Ruby, I want you to look
all the way to your left,

second gauge down. There are two needles

on either side, pointing to the middle.

RUBY: I see it.

We need to know exactly what number

is the needle pointing to on each side?

. . On both sides.

♪

minutes of flight time, tops.

Are they gonna crash?

If you don't get that pilot conscious,

- they're both going down.
- Over a city of million.

CONTROLLER: Angels Base,
Angels Base. ATC Van Nuys.

We need that fuel check now.

ATC Van Nuys, this is Angels Base.

Randall Woodman, LAFD Air Ops.

The aircraft is currently
flying at right, left.

Speed and altitude put it
at approximately minutes.

Ruby, now we need to know

exactly what's going on with your mom.

So I want you to take her wrist
and turn it over

so that the palm is facing upwards.

- Are you with me?
- RUBY: I'm with you.

Great, now take two fingers
and put it right there

at the base of her wrist so you
can feel the blood pumping.

You feel it?

Yeah. It's fast.

- Okay.
- It's really fast.

Okay. That's okay, honey.

I need you to help me help her, okay?

So I'm gonna count to

and I want you to tell me
how many pumps you feel.

Are you ready? Okay, go.

♪

♪

How many did you count?

.

Heart rate's .

Could be V-tach, A-fib, SVT.

She's altered. Our only option
is to shock the heart.

Dr. Campbell, I need you
for a surgical consult.

I-I can't. I...

Okay, you go. I've got this... sort of.

- Are you sure?
- Yes. I think so.

- Did you get Willis?
- He headed to Van Nuys now.

RUBY: Hello? Hello? Are you still there?

Hey, Ruby, I'm right here.

Is my mom gonna die? [CRYING]

Tell... to wait,
‭come back and check with me.

Ruby, honey. Calm down now.
I want you to listen to me.

You and me.

We're gonna get through this.

I promise you.

Okay?

[SIREN WAILS]

Okay, see you in three weeks.

But you can ride that bike today.

- Dr. Guthrie.
- Hmm?

- Can we talk?
- Sure. What's on your mind?

That's the, uh, third cast
I've put on today,

and I've seen cases
of flu-like symptoms.

Feels like I'm in the penalty box.

No. No penalty box down here, Dr. Kean.

But if you think people have forgotten

what happened, you're wrong.

I gave a patient painkillers
who shouldn't have them.

It was an honest mistake.

Or you were distracted...
is another theory.

By what?

Oh, you think this is about me and Mario?

We're doing great.

And down here, he's a third year
and I'm a second.

We've got it figured out, really.

Sounds like you've been rehearsing that.

I'll tell you what. Show me something.

If your heart is in this, prove it.

In the meantime, -year-old
male, flu-like symptoms.

♪

- [ELEVATOR BELL DINGS]
- Mr. Barnes,

‭your appendix is about to blow.

We need to get you to the OR
to remove it right away.

But he'll be doing the surgery, right?

Dr. Leighton is my resident.
He'll be assisting me.

I'd rather give the kid a sh*t.

Dr. Campbell is chief of OR and the ER.

You hit the jackpot.

Look, everything I got in my life,

I got from trusting my gut.

And my gut's saying to take the kid.

No disrespect... my man.

Anesthesiologist is on his way in.

As soon as the OR opens up,
we'll get you prepped.

[GASPING]

Dr. Leighton, come on.

[CHIMES JINGLING]

[DOG BARKING]

She's in there.

[GRUNTING AND PANTING]

♪

♪

Open airway.

Decreased chest rise on the left side.

Breath sounds on the same side.
Let's lie her flat.

See, baby, I told you I was
gonna take care of you, huh?

Hey, you want to take care of her?

Stop pointing that g*n at us, all right?

The second I put this g*n down,
I'm not in charge and she dies!

You sh**t my partner, she dies anyway

'cause I can't do this alone.

♪

[BREATHING HEAVILY]

Obvious entry wound in the chest.

♪

No exit wound.

So take the b*llet out, man!

The b*llet isn't gonna k*ll her.

The trauma to her internal organs will.

We need a chest tube kit.
It's at the hospital.

We can save her. But we can't do it here.

No hospital. [BREATHING HEAVILY]

That's the deal.

♪

- Do something!
- All right! All right.

♪

Rox, prepare the Betadine.

All right, your girlfriend is
having trouble breathing.

We need to check her lung

and make sure the b*llet didn't hit it.

What's your name?

Maya.

Now, Maya, this is definitely gonna hurt.

♪

Scalpel.

[BREATHING HEAVILY]

[GROANS]

Forceps.

[SCREAMS]

All right.

[SCREAMS]

Whoa, whoa, whoa, whoa, whoa!
What is she doing, man?

She's checking
‭the chest cavity to make sure

the lung is still inflating.
If it is, we're good.

What if it isn't?

All right, she's gonna bleed.

Not because of what we're doing,
but because of the b*llet.

♪

- Aah!
- What'd you do?!

I told you she was going to bleed.

Well, then fix her!

Maya's losing too much blood.
She needs some fluids in her.

We're treading water.
We need a chest tube kit.

Okay. Hanging a liter.

Okay.

Listen, we have minutes, not hours.

We got to get her to a hospital.

Whatever rig you need, you'll
just have them bring it here.

That's not gonna happen.

[g*n COCKS]
- [LAUGHS]

You sh**t him and she dies.

♪

♪

[TELEPHONE RINGS]
- Angels.

WILLIS: Hi, Diego. It's Willis.

Um, I got hung up on a call.

Patient is emergent,
and I need a chest tube kit.

Okay, I-I can send you another rig.

No, don't. Don't send another rig.

[PHONE BEEPS]

He brings it, drops it off and goes.

♪

RUBY: She's getting worse!

Her eyes are closed
and she's barely breathing!

Okay, Ruby, I need you to calm
down and listen to me, okay?

She's dying, isn't she?!
I know she's dying!

There's no defib on board, she's
been in V-tach for minutes.

She's going into arrest.

I need to get her to calm down.

ARIEL: Let me talk to her.

- What are you gonna say to her?
- Girl talk.

Huh. Get in here.

Sit down. Push that button.

Uh, Ruby, hi. My name's Ariel.

RUBY: Are you a doctor?

No. I'm a volunteer.
I just started ninth grade.

We really don't have time for this.

We need a plan, but first,
we've got to be able to get her

to calm down enough to carry it out.

Uh, where were you flying?

RUBY: Catalina Island.
We fly there every year.

We were going camping.

Oh, I've never been camping.

I've never even thought about camping.

It's fun.

Precordial thump.

What's a precordial thump?

It's a... It's a hard
thump with your fist,

right in the middle of your sternum.

Sometimes it'll jumpstart the heart.

But it has to be really hard
in order for it to work.

The girl's not strong enough to do this.

Jesse, I'm out of options on this one.

- RUBY: Are you still there?
- Just let her try it.

- What do we have to lose?
- This is crazy.

- I know.
- Okay, Ruby, you got to punch

your mom in the chest
really freaking hard.

- Why?
- Restart her heart or something.

Hard as you can. It won't hurt her.

Ruby, this is Dr. Rorish.

I want you to find the bone

right in the middle of your mom's chest.

That's the sternum. Do you feel that?

- Uh-huh.
- Now I want you to take

your fingers and walk them
three inches to the right,

then I want to raise your hand
above your head,

make a fist and now bring it down

as hard as you can, right on that spot.

Okay.

♪

Nothing's happening.

Okay, you can do better
than that, Ruby. Try again.

This time, hard as hell!

[STATIC]

Nothing.

- Hello?
- [FEEDBACK]

- Ruby?
- Are you still there?

Ruby!

Ruby?

- I think we lost her.
- Yeah, I know.

MAN: ...tracking the plane over
the San Fernando Valley.

WOMAN: ...live coverage where
a pilot of a twin-engine plane

bound for Catalina Island
lost consciousness

- just after take-off.
- Nothin' on us, baby.

Every channel's got that dumb plane.

- Good.
- ...but for how long?

Okay, so, new plan. We got
the chest kit on the way.

We stabilize her here,
take her to Angels.

And it's not too late
for you to walk away.

[SCOFFS]

You must really think I'm stupid.

It doesn't matter what we think, okay?

The smart move is to go back.

Hey, I can't leave her. We k*lled a guy.

What? It was her idea...
medical marijuana shop.

The guard sh*t us first.

The hell did he think was gonna happen?

Shhhhh...

- [KNOCK ON DOOR]
- DIEGO: Willis! It's me!

He drops it off and he leaves.

Hey, here's your stuff, dude.

Thanks.

Whatever's going on in there,

I want to film it. Quid pro quo.

No. You get the hell out of here.

Whoa.

Now.

Now. Now.

[SPEAKING INDISTINCTLY]

Are you a doctor?

Uh, I'm just... I'm just an intern, man.

So, you can help them.

- I...
- This is not part of the deal.

♪

Yeah, ‭nobody's going anywhere.

♪

- ...what you did.
- I'm not gonna stop.

I'm not blaming Ariel. You think
I'm blaming Ariel for this?

- RUBY: Can you hear me?
- She's back!

Ruby? We hear you now. How are you doing?

It didn't work. My mom's not moving.

Okay. Is she still breathing?

♪

Yes. Really fast.

She needs a defibrillator.

How we gonna get it there?
Carrier pigeon?

Oh... Oh, could she make one?

Do you know what a defibrillator is?

Yes. I'm , I'm not an idiot.

It's the thing that
restarts the heart, right?

- Yes.
- Well, she can't build one.

Why not? ‭They're on vacation, right?

They have phones, computers, batteries.

The Piper's got two AC wall plugs.

It's a Hail Mary.

Our specialty.

Ruby, I want you to gather together

all the electrical devices
that you can find...

computers, phones, whatever.

Then we have to gather all
the same stuff she has there

and build it here, okay?

Got it.

Okay, let's get this girl home.

This is routine surgery.
Laparoscopic appendectomy.

Leighton can handle it.

- Yeah.
- Supervised.

But the patient doesn't
want me in the room.

Look, Will, if you're asking me
as a senior attending,

I'd tell you the rules say

that if a patient tells you
don't touch him...

- You don't touch him.
- ...you don't touch him, right?

But if you're asking me as a man

who has been a doctor almost
as long as I've been black,

I say you don't give up your power.

You supervise your resident.

You make sure he doesn't k*ll anyone.

[CHUCKLES]

♪

That's my OR.

This is my OR.

Yeah.

[SIGHS]

I know you're sick of it.

I'm sick of being sick of it.

♪

Yeah.

Okay, what does she have up there?

She has three batteries, two
chargers and one camping Kn*fe.

Okay, we don't need this.
We don't need this.

You got to move fast. You guys ready?

Okay, Ruby, are you with me?

- Yeah.
- Okay. Just listen.

You have to slice the casing
off your laptop charger cord.

Inside are two wires. Pull them apart.

Wait, where do I slice it?

Okay, you know what? I'll text
you a picture right now.

- Okay. Send it.
- Here's the number.

[CELLPHONE CHIMES]

- Okay, did you get it?
- I got it. I see the wires.

Okay. Okay, great.

Um, now take your Kn*fe

and start cutting the casing off them.

Guys, we can't let her use
this on her mother

without testing it here first.

Uh, Ariel, stand up. Mario, sit down.

You're kidding.

Sit your ass down, Doctor.

Let's go. Let's do this. Come on.

It's live.

All right. ‭Take your shirt up, please.

- Lift up.
- All right.

- Just give me a second.
- No seconds.

Diego, I need you to start another line.

We need to re-transfuse the blood.

MAN: ...first responders are on standby.

Uh... I'll try.

[TELEVISION PLAYS INDISTINCTLY]

♪

He's not gonna let us go.

We've seen his face. He has to k*ll us!

Okay, if I can stay calm, so can you.

Look, just focus on the medicine.

Steady your hands.

♪

It's bright red and it's pumping fast.

Yeah. It's blood.

It's arterial blood.

I don't know what that means.

It means she's bleeding. A lot.

We're gonna need to do a blood
transfusion. Right now.

♪

[SIGHS]

We need to test her blood.

And hopefully, one of us is a match.

Test her blood? Here?

Yes, here.

I'm gonna get a testing kit
out of my bag.

♪

♪

[ELECTRICITY CRACKLES]

♪

- [ELECTRICITY CRACKLES]
- Aah! Geez! Aah!

Hurts like hell.

Didn't stop your heart.

That's what you were hoping for?

We'd have gotten you back.

They got minutes of fuel left.

ATC wants a status update.

Ruby, are you with me?

RUBY: Uh-huh.

Okay, do you have the wires

- stripped like in the picture?
- Yes.

Ask them if they have any kind
of lotion up there.

Do you have any lotion or hand sanitizer?

Lotion. In my bag. Why?

It helps the conductivity.

So now, grab that and I want you
to unbutton your mom's shirt

because the wires have to
touch bare skin.

Okay? Now rub some lotion on
to her chest and her left side.

Okay, then plug the cord in,

but don't touch the wires,
just the casing.

And then, when you're ready,
I want you to touch the wires

to the side of the chest
at the exact same time.

Um, I don't think I can do this...

Listen, Ruby, it's like
that "She Rap" song...

If you wanna be big, you gotta stand up.

Okay, it's plugged in. Now?

Now, Ruby.

Mom? Can you hear me?

She's not answering!

Try it again.

♪

There's not enough charge.

Wake up, Mom! Please wake up!

Wake up, Mom.

♪

Please, Mom, please wake up!

♪

ROX: Maya is AB-negative.
None of us are a match.

But, uh, hopefully you will be.

♪

[CELLPHONE RINGS]

It's the hospital.

If I don't answer it,
they'll know something's up.

They're gonna send somebody.

[RINGING CONTINUES]

Don't get tricky.

Where the hell are you?

You're supposed to be
at Van Nuys airport.

WILLIS: Car trouble.

No, no, no. No car trouble today.

Listen, Leanne is trying to wake
the pilot up to land the plane.

She's gonna need a doctor there.

Yeah, this isn't the best time for me.

No, no, no, no. No, listen.

You're my doctor on the field.
I need you right now, okay?

Okay, um, I'm almost done here.
I'll call you when I can.

Thank you.

[PHONE BEEPS]

How are we doing on the blood
test? We're running out of time.

Um, he's a match.

Maya's AB-negative, and so are you.

It's a rare type.

You're damn right it is.

Probably why you guys love each other.

Back up off me, dude!

I wasn't doing anything.

All right, fine. Hook it up.

Good. Let's do this.

LEANNE: I know, but if we boost...

I think we need to try it again,

- but we'll have each...
- Did you get Willis?

Yeah. He's not gonna make it to Van Nuys.

- Why not?
- Dr. Savetti...

take Ariel for a walk.

What? Why?

Please.

Come on, g*ng. Come on. Let's go, guys.

What's up?

ATC has a new plan.

Did they figure out
how to land the plane?

No. They don't think they can
teach her how to land.

♪

They do think they can teach her
how to fly it out

over the desert.

What the hell good is that?

♪

She'll crash it out there
without k*lling anybody else.

♪

When?

She's almost out of fuel.
We need to do it now.

♪

Let's go.

- No! No.
- Leanne...

No! Ruby, I want you to try
something else.

We're gonna combine the electrical shock

that you did with that chest thump.

RUBY: Will that work?

Yes. It might shock you
a little bit, but that's okay.

I want you to grab both wires
and hit her in the chest, okay?

But when you hit her, Ruby,
you have to hit her hard.

Okay, honey, do it right now.

Okay. One, two, three.

♪

Mom?

Mom! Her eyes are open!

Okay. Elizabeth.
‭Elizabeth, can you hear me?

Elizabeth, are you there?

ELIZABETH: Hello? Yes, I-I can hear you.

Okay. This is Dr. Leanne Rorish

speaking from Angels Memorial Hospital.

You've had a coronary event.

We will treat you on the ground,

but you need to land that plane first.

♪

Elizabeth, are you there?

I don't have enough fuel
to make it back to the airport.

Ruby, honey, go back
to your seat and buckle up.

- Your bird still on the roof?
- Yes, sir.

- Get out there. Go.
- Let's go.

♪

Dr. Savetti, you're with me.

♪

WOMAN: Sources confirm
the plane is out of fuel

and set to make a crash landing
near Van Nuys.

Oh, snap! The plane's going down!

[CHUCKLING] It's gonna crash!

...and any bystanders
affected by the crash.

Aah!

[GROANING]

♪

[SIRENS WAIL]

Ruby? Is that Ruby?

Elizabeth, it's Dr. Rorish.

Please, take care of my daughter!

Mario, start the primary exam on the mom.

- On it.
- We need a medic over here!

Is that Ruby?

Bring her out! Bring her out!

Okay, how are you? Bring her out.

[WAILING CONTINUES]

Breath sounds clear bilaterally.

[CRYING] ‭I was too slow. We crashed.

You did it. You were great, Ruby.

You were great. You did it.

I just need you to be brave
a little bit longer, okay?

Ruby! Where's my daughter?

Ruby, Mommy's right here, baby.

I'm okay, Mom.

Mario!

Yeah?

How is she?

Chest pain, but vitals are stable.

EKG shows a STEMI.
‭She's gonna need the cath lab.

Medics are loading her up now.

We're gonna need to...

We're gonna need to secure that
before we move her.

It's okay. We've got you.

Ruby! I'm not going anywhere
without my daughter.

We're right behind you, Elizabeth.

- We're right behind you.
- Ruby!

Ruby? Ruby? Dr. Rorish,
she's unconscious.

Okay.

Breathing's shallow.

Let's get her back to Angels. Now!

Let's go, boys. Now!

CAMPBELL: How are you doing?

I should ask you that question.

Dr. Leighton, sedation's up,
patient's ready to prep.

Where are you gonna place the ports?

mm camera port in the umbilicus,

and mm trocars
in the lower left quadrant

and the suprapubic midline.

- Good.
- You should be doing this.

Dr. Leighton, mark the patient
for incision.

You know, you shouldn't back
down from a guy like this.

Is that so?

You're ready, Dr. Leighton.

Incision.

[SIGHS]

[YELLS]

Yeah, this hurts like a bitch!
You gotta help me!!

- Just relax.
- How much longer?

Maya's doing better.
She just needs more blood.

WILLIS: It's through and through.
Just missed the bone.

I'm getting... dizzy... getting dizzy...

D-Diego!

He's probably passing out
from hyperventilating.

His pulse is strong.

He's fine.

Take care of Maya.

We have two patients now.

♪

♪

♪

Hey.

♪

Hey! What the hell's...
What the hell is this?!

♪

[GRUNTS]

You must really think I'm stupid.

We were counting on it.

MEDIC: Easy. Easy.

Where is she? Where is my daughter?

She's in the ER, ma'am, with
the best doctors that we have.

And we need to get you to the cath lab

so we can check out
your heart, all right?

Don't worry. You're gonna see her soon.

- She saved me.
- We know.

You know?

The whole city knows. Ruby's famous.

Sully's got nothing on her.

- Okay, guys, here we go.
- She's tanking!

Get me a central line kit

and transfuse two more units of PRBCs.

Need a portable chest x-ray now!

- Wait, wait, wait.
- Incoming.

[INDISTINCT TALKING]
- Where the hell have you been?

- Long story.
- GSW to the chest.

She's lost two liters of blood.
Get the thoracotomy tray.

Nope. Sedation is wearing off.

Hold her down.
It's got to stay in her mouth.

Don't let her pull it out!

- I mean it.
- Don't pull out the tube.

- Aaaah!
- Ready?

- One, two...
- What did you do to my resident?

I put him somewhere
he shouldn't have been.

Got a GSW to the thigh,
through and through.

I need mg of morphine. Now!

[GROANS]

Is she alive? Is my daughter alive?

Please, I need to see her!

She's peritonitic.

FAST exam shows free fluid
in all four quadrants.

No, that's got to be wrong.

There's fluid everywhere.

I think she has a gastric rupture.

She needs an ex-lap.

[BREATHING HEAVILY]

Gastric injuries are very rare,

and they hardly ever present
this quickly.

You saw the FAST. What else could it be?

She doesn't drink, her labs are normal.

There shouldn't be free fluid.

[MONITOR BEEPS RAPIDLY]

All right, let's get her to an OR now!

Disconnecting.

Must have hit a vessel.
Abdomen's full of blood.

She's in hemorrhagic shock.
We're losing her.

Hang in there, Ruby. Hang in there.

Need clear saline now.
Let's get her ready to move!

Dr. Campbell, it's the mother
from the plane.

They're bringing her in to OR now.

They landed. I need to step out.

I got this.

I'll let you know
‭if I run into any problems.

We cannot control
this bleeding, so, look,

if we pull the shard out, she's
gonna bleed out right down here.

We need to get her to the OR now.

OR is full! Ten minutes!

Get on the phone and tell Campbell

it's the little girl
from the plane, okay?

Her mother's up there already.
They're prepping her now.

Dr. Rorish,

this has to happen now.

No, no, no, guys. I'm not a surgeon.

We can't do this here.

After everything
she's done to get in here,

we don't want to fail her, okay?

She could die
‭in the elevator up to the OR.

♪

Daddy... what are we doing here?

[INDISTINCT TALKING]

[MONITORS BEEPING]

ARIEL: What's your name?

RUBY: Ruby. Are you still there?

Mom?

On the base of the renal artery.

♪

ROX: Okay, I got it.

I need hands. Come on. Jump in here.

Get in here.

The bleeder's right here
on the hilum of the left lung.

All right, you take the suction,
I'm gonna clamp the artery.

We've already filled a quarter
of the suction container.

We need to hang more blood.

♪

Do what she said.

Come on. Let's get two units
right away. Let's go.

- Come on.
- Got it.

I don't know why they're working
so hard. She k*lled a guy!

And her psycho tweaker boyfriend
almost k*lled me!

Hello? Hello? Are you still there?

Ruby, I'm right here.

- Leanne?
- I can't see.

Oh, my God. She needs the OR.

There's no OR, Leanne. Be brave.

Is anyone there?

Dr. Rorish?

- She's not answering!
- Dr. Rorish?

Dr. Rorish!

Teach me something.

♪

Teach him, Leanne.

♪

Okay.

We're gonna pull this,

and she's gonna bleed from the aorta.

And that's like a firehose. Understood?

Got it. Then what?

Okay, then we're gonna have to

throw some sutures around it fast.

- Are you fast?
- I practice stitches every day.

- Let's do this.
- Okay, Jesse, clear and pull.

I want you to be ready
to do suction. On my count.

Are you ready? One, two... and three.

Ah! She's bleeding.

- Got it?
- Come on. Suture it.

- It's in the renal side.
- Yep.

- Move your finger.
- I got it.

Okay, throw another suture
around the clamp.

Got it. Yep.

Steady.

[MONITOR BEEPING]

She's stabilizing.

She's stabilizing.

Okay. Thank you.

RISA: All right, BP rising.

I've got an open chest here, Risa.

ORs and should be open by
the time you guys get there.

Okay, great. ‭Let's get Ruby upstairs.

- Mine, too.
- What do we do about Diego?

I'll take him to sides.

- Suck it up.
- [GROANS]

He'll limp for a while,
but he'll be fine.

I think those gentlemen might
want to have a word with us.

You up for it?

Do I have a choice?

Hey, you saved our asses today.

You were great.

Good team.

Great team.

We didn't catch the fluid
on the initial exam.

It's blunt trauma, but we can't
tell where the damage is.

I looked at her scans.
Didn't see anything obvious.

She's peritonitic.

I don't know where it's coming from,

but I think it's a gastric injury.

What else would explain the free
fluid on the ultrasound?

She needs an ex-lap.

Dr. Kean, Dr. Guthrie, you'll assist.

Scalpel.

And just like that...
out of the penalty box.

You said there was no penalty box.

[LAUGHS]

ANGUS: ‭Let's see what we have here.

The anatomy looks good.

- [MONITOR ALARMS BEEPING]
- Whoa.

BP's dropping. Heart rate s.

All right, he perforated on the way up.

There's pus and stool everywhere.

- BP / .
- Go get Dr. Campbell.

He's in an emergency surgery.

Don't you think I know that!

Dr. Campbell, Dr. Leighton
needs to speak with you.

Put him on speaker.

NURSE: BP's dropping!
Call the blood bank.

ANGUS: Dr. Campbell,
we need you in here now!

He perf'd. His bowel is split.

You need to clean him out.

Dr. Campbell, what is your ETA?

Leighton, clamp the bowel, wash him out.

I'll join when I can.

Focus.

- [BREATHING HEAVILY]
- Pressure's down / .

Dr. Leighton, you have to do something.

Do you want pressors?

Okay, we're about to do this
the old-fashioned way.

Let's get the scope out.

You're opening him up?

You don't think I should?

Do you know what you're doing?

♪

Yeah. Definitely. Totally.

Come on. Let's go.

Where's Dr. Campbell?

♪

Gastric contents.

You were right.

♪

One liter saline.

Suction.

Dr. Kean, let's retract that stomach

and locate this tear.

There we go. Suture.

I can't see in here. More suction.

Pressure's dropping. over .

CAMPBELL: Dr. Leighton, report.

I didn't have the skill
to do it laparoscopically,

so I just opened him up.

- What?
- I had no choice!

I'm about to do the primary
closure of the bowel.

Kelly's and a needle driver. Let's go.

I need two more units.

Sponges. Forceps.

Here. Hold these.

The suture is tearing the bowel.

over . Heart rate .

I can't irrigate the abdominal cavity

and close the bowel at the same time.

He's septic. Damn it!

- What happened?
- I wasn't ready for this.

That's what happened.

- over .
- Start pressors.

♪

Dr. Leighton, get back here.
This is your patient.

No, actually, this is your patient!

Get your hands in there.
You are about to mend

the two ends of this ruptured colon.

Are you really not gonna touch

- him because he told you not to?
- Hands! Now!

♪

Sutures.

Suture to Dr. Leighton.

You've done this stitch
how many times now?

, .

, right there.

Keep going. You're not done yet.

♪

You're not done yet.

Keep going.

- [SPEAKING INDISTINCTLY]
- Vitals stabilizing.

- Huh?
- And look at that.

No more bleed.

Can you close him up,
or do you want me to do it?

I can do it.

My point exactly.

You have something you want to say to me?

[KEYBOARD CLACKING]

Say it.

Fine.

I don't think that you should
let a r*cist

dictate what you can
and cannot do in there.

- He could have d*ed.
- First of all, I stayed back

because I believed you could do it.

We both know I could not have
done it without you.

Second, the minute I feel
the need to justify my worth

to any man, I've surrendered it.

Now, you saved that man's life today.

Own... that... power.

Because if you don't,

there's always gonna be someone
who will take it from you.

♪

So we're not gonna say anything?

What did I say about discipline

and what you can and cannot control?

Follow up with your patient. That's all.

That's all, Dr. Leighton.

♪

♪

Look at those stitches.

Like the backseat of a Porsche.

No signs of peritonitis.

I know what you're thinking.

I'm not a r*cist.

I just sometimes

don't know which one
I'm getting, you know?

The one who worked for it
or the one who didn't.

Excuse me?

Ah, you know what I'm talking about.

Some people get in the room

because they checked the box,
filled a quota.

I'm not saying that's your guy.

[SNIFFS] Maybe he's the other kind.

Maybe he's the kind who qualified

because he actually worked for it.

But I needed a doctor right then.

How the hell was I supposed to know?

I see. You...
‭You only wanted the best care.

That's all.

[SIGHS] Nope. Nope.

Hold on.

Um, let me tell you how
I got this job, genius.

My father's on the hospital board.

I was a C student, and I still am.

But a couple of hours ago,

I was up to my elbows in your breakfast.

And those stitches that are barely
holding you together right now?

Well, I learned how to do those
about a week ago.

So, good luck with that.

[GROANS]

Dr. Leighton.

Did you not listen to a word I said?

Is this how you think a surgeon behaves?

Still a resident. Still learning.

[DOOR OPENS]

[DOOR CLOSES]

[SCOFFS]

♪

♪

♪

♪

Who is that? Another patient?

♪

That's my daughter.

♪

♪

♪

♪

♪

Hey.

He's fine.

[SIGHS] Good.

How about you?

♪

We barely made it out of there alive.

♪

But we did make it out.

♪

DIEGO: That's a pretty long hug.

♪

♪

♪