Hi. I'm Mark Proctor.
Hi. Just moved down from Maryland,
as you can tell from the accent.
Did you get a look at that scar?
What scar?
Sternotomy.
Tissue's still pink.
He had his chest cracked.
Cops have any suspects in our stabbings?
I'm scared.
It's going to be okay, Todd.
Todd Kinney, he's not a mugging victim. He's the attacker.
He's the one who stabbed her.
What are you doing out of bed?
Mr. Kinney?
Stab wound to mid-thorax, but he's not responsive.
If I hadn't saved him, none of this would have happened.
It isn't your fault.
Go on, get out of here!
My...
My Baltimore route.
22 minutes, I would have been
just coming around the Pulaski
and heading south towards the harbor.
Thinking about old times?
Yeah.
This was mistakenly put in my cubby.
You interrupted my run just to give me a package?
Everyone keeps asking.
About, uh... Tuck. I know.
I'm just not sure what to say
about what happens next.
He's getting better.
It's only been a week.
His LFTs...
Are returning to normal.
Yeah, I checked his chart an hour ago.
You and me both.
And Chris and Serena.
Serena's having a rough time.
She didn't do anything wrong.
How would you feel if you saved the lunatic
who put a scalpel through Tuck's heart?
Oh, I thought we did really good work
repairing the stab wound.
As of this morning,
Cardio can have a go
at repairing the rest of the damage
to his heart. Who's on for cardiac surgery today?
Uh, Dr. Sable.
Is she good?
She's the best.
And a piece of work.
You know how people sometimes consider you quirky?
People consider me quirky?
Well, Sable will give you a run for your money.
Plane crash.
In the Everglades.
You get the team ready for multiple criticals,
and I'll have a consult with Sable's team about Tuck's heart.
Hey, happy birthday.
Yeah. Some birthday.
Flight 815 out of Fort Lauderdale.
Small commuter plane.
12 seats, one flight attendant, one pilot,
one copilot.
So, that's 15 possible survivors?
Yeah, but what we heard
from first response, it's not good.
Hey, Lynn, we got an ETA on incoming?
You're still en route to the crash site, right?
Yeah, we're about three minutes out.
We got Doc Warren loaded up and we're ready to go.
Wait. Serena's on the chopper?
On her EMS observation day.
Hey. Top of the morning, Dr. Warren.
Okay, whatever
asinine crack you're about to make, Chris,
ever so kindly stick a bulb syringe in your mouth.
So, how's it going up there?
Well, considering
I just found out that, for legal reasons,
I'm not actually allowed to help out,
I'm having the time of my life.
Well, it ain't called observation for nothing, Doc.
You know, Serena, on, uh... on my observation day,
they were, they were so impressed with my skills
that they let me fly the chopper and...
And what? You were such a hero, they gave you a key to the city?
No, two keys.
Two-- and the garage door opener.
More incoming.
Motorcycle accident with open tib-fib,
head trauma and altered LOC,
eight minutes out. All right.
Gotta go.
And hey, don't let Dr. Warren
puke on your shoes there, Moose.
I'll try to stay fast on my feet.
Thanks for the advice.
Oh, man.
Brian Dempster, 37, rolled his motorcycle.
One head trauma, chest and abdomen contusions
with a tib-fib injury on the left.
Uh, Mr. Dempster, I'm Dr. Deleo.
My bike?
It was a Ducati 999.
Beautiful.
Now scrap metal on I-51.
Okay, send for a trauma panel,
type and cross for three,
and page X ray.
Is this our motorcycle accident?
Yep.
Multiple contusions, open tib-fib,
crush injury to chest and head trauma.
Okay, on my count.
One, two, three.
Grab the ultrasound for a FAST scan.
Decreased breath sounds at the left base.
Let's get going with a chest X ray.
I am in so much trouble.
Not as much trouble as we'll be in,
if we don't make you better, Mr. Dempster.
Free fluid around the bladder.
We think you have bleeding in your belly, Mr. Dempster.
Mr. Dempster?
He's unconscious.
His vitals are stable; probably just fainted.
I want an O.R. prepped.
Can you page Neurosurge and Ortho?
Let's take a look at his chest wound.
If we're going to save this guy,
we're going to need everything and the kitchen sink
and the stove and maybe even a slow cooker.
That is if Mr. Dempster wants us to save his life.
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What are the chances the American Medical Association
accepts a tattoo as a valid DNR?
Could reflect his true medical wishes.
Or a biker handle.
College fraternity prank
gone horribly bad.
Well, let's finish his chest tube.
Can I have some Lidocaine? Mr. Dempster?
Mr. Dempster,
can you hear me?
I'm Dr. Proctor.
You've got a serious accident.
I know.
I fell out of a tree, right?
That's what you get for climbing up with your roller skates on.
No, you didn't fall out of a tree, Mr. Dempster.
You had a motorcycle accident.
And Dr. Deleo and I
have to know if that tattoo on your chest
reflects your true wishes.
Tattoo?
Yeah, the one that says "Do Not Resuscitate."
I don't have a tattoo.
I don't have a motorcycle.
My mom would kill me.
Brian, can you tell me what year it is?
1979.
And how old are you, Brian?
I'm 11 years old.
That's a lot of chest hair for an 11-year-old.
Am I bleeding?
Yes, we think you're bleeding inside your head, Brian.
And we're concerned about bruising
to one or both of your lungs.
We need to take some pictures
in order to figure out how to make you better.
Okay.
Please don't tell my mom.
They just found a survivor from the plane crash.
Flight EMTs and Dr. Warren are transporting her back.
ETA? Less than five.
Uh, you take that with Dr. Zambrano.
I've got to get a consult on Tuck and then
hop back on Mr. Dempster,
based on his scans.
Got it.
Uh, can you page Legal for me?
Uh, call Risk Management.
Call Admin.
Call his mom if she's still alive.
Call anyone who can give me some guidance
on what I'm allowed to do with my patient.
Josephine Wells,
28, plane crash survivor.
Crush injury to chest and abdomen,
with pinal flexion injury upon impact.
Normal neuro exam.
She's going to need a final CT and strict immobilization.
Hey, Moose,
don't think your new flight nurse
should be giving advice
to trauma surgeons.
Not too good at observing, this one.
That's why we love her.
Hey, what's the update on Tuck?
Surgery today.
We'll let you know if there's any more incoming.
Watch it.
All right, Ms. Wells,
we're going to get you right into a trauma suite
and assess your injuries. Can you tell us
what your pain level is? Scale of one to ten?
What's that Josephine?
Okay, hang on, hang on, stop.
Stop, stop, stop, stop.
Stop, stop, stop.
All right, go ahead, we're listening.
Tru-Tru...
Take it slow, Josephine.
Tru-Tru...
I-- T-True? True?
Save your strength.
Okay?
We can see you have
something important to say.
And when you're ready, we're here, okay?
Last contact with the plane was
a distress signal sent three minutes before impact.
So far, we've discovered
13 distinct sets of remains.
And Josephine Wells.
The flight manifest says there were 15 aboard, so...
So one. Yeah.
Yeah, we're looking for one.
O.R. Two is prepped and ready.
So we start by?
Fixing Josephine's ruptured kidneys,
spleen and urethra disruption.
And get new scans to Neurosurge
and a consult from Ortho on her pelvic fractures.
Proctor should get those scans as well.
By the way, it's his birthday.
Really?
Today?
Yeah. And he didn't seem too happy about it either.
How old is His Highness?
I don't know.
Do we get him a present?
I don't know that either.
What if we get him, like, a giant cake?
And we get a big question mark in a bikini,
have it jump out.
Uh, that's just bizarre.
I don't know, I'm riffing here.
Still waiting for the dude to let his guard down.
Patient's name is Tuck Brody.
This is a young athletic guy.
Let's use a pig valve so he doesn't
have to spend the rest of his life on warfarin.
Excuse me, Dr. Sable.
I, uh,
don't have much time.
So, you're the new guy
I've heard so much about, the Brit.
New-ish.
And I just speak this way
because Americans find it appealing.
Can we have the room, please?
Helena Sable.
Cardiovascular surgeon.
Rest assured, your patient is in good hands.
My patient is also my friend.
I don't know if you're aware,
but, um, this is one of my guys.
Charge nurse Tuck Brody.
So I'd like to weigh in on his management
and scrub in on his surgery.
Your team did excellent work on the ventricular wall,
but now we're talking mitral valve replacement,
which is probably a little much to wrap your head around.
I could walk you through the difference
between mechanical valves and tissue valves,
but then I'm not a performing seal.
Is that your rule?
Because my rule is, no one scrubs in on my surgeries.
No one.
If you don't like it, you're welcome to
find yourself another heart surgeon.
I hear you're the best.
Well, if that's what you hear.
That's what I want for Tuck.
Good.
You're welcome to be in the room.
But you're not to touch the body.
So I can look but not touch?
I was just trying to make sure that you weren't the egomaniac
I'm often accused of being.
Welcome aboard, Matthew.
Nobody calls me Matthew.
Over here!
Get some help here?!
I got it!
Put her on there.
Somebody get the EMS over here!
Got it.
She have a pulse?
I need to get a line in her now!
Fixed and dilated.
She's gone.
Our motorcycle accident's left lung is badly lacerated
and contused.
Basically turned to mush.
Probably have to remove the whole thing completely.
Hey.
Hey, where am I?
Can you forward that to Radiology?
And, uh, page Nurse Graceffa for me.
Mr. Dempster?
My bike.
I crashed it, didn't I?
So you do remember you have a motorcycle.
Well, I did till I rolled it.
Oh, I'm hurt pretty bad, aren't I?
You are,
but we're in the process of making you better.
You saw my tattoo, right?
You do know you have a tattoo?
Mr. Dempster, if we're going to continue
to make you better, then we need to...
Wait a minute.
Who's Mr. Dempster?
Sorry?
Who are you?
Where am I?
No. You-you... you hold still.
Really still.
Internal bleeding's getting worse.
I want him prepped for an OR, stat.
Have you had any response from Admin about his DNR?
Called them three times.
Oh.
Now they're gonna hear from me.
Propofol's running.
Should be out in a minute.
Josephine?
We're gonna put you under now
so that Dr. Deleo and I can attend to your injuries.
I know this is a little scary, but...
Tru...
Will you tie my mask?
Tr...
"True."
You said that before.
Truu...
What's true, Josephine?
Tru... man.
Truman?
What, like...
Like a name? That's what you're saying?
Who is Truman?
Was he on the flight with you?
Alive.
Josephine, we haven't gotten news
of any more survivors.
Saw him.
I... saw... him.
After the plane crashed?
Yes.
He's alive.
Okay.
Moose got me a copy of the flight manifest
from the NTSB officials.
What's the name I'm looking for again?
Okay, it's, uh... It's Truman something.
Josephine Wells, a survivor, told us
that she saw somebody named Truman alive
after the crash.
I have it right here.
Looks like her husband.
Mr. and Mrs. Truman Wells seated in and 6B.
So that's good.
I don't think he's alive, Chris.
We've already found 14 victims,
all adults, which means along with Josephine...
Everyone's now accounted for.
Yeah. Of course they haven't
identified anyone yet, but..
Yeah, no, no, no, no.
I, uh. I get it.
Search and Rescue is shutting down now
and NTSB investigators
are starting to take over.
Are you guys headed back?
Yeah. We're packing up right now.
All right.
Okay, fly safe.
All right. Will do.
No more survivors.
Hey, I've been thinking about our, uh,
motorcycle accident.
His confusion could be, uh, trauma-related or
some underlying condition like delirium
or schizophrenia or...
Everything okay?
Still haven't got ahold of the next of kin.
AnAdmin won't take a stand
without a consult with Ethics,
who won't weigh in without precedent from Legal,
They do realize your patient's s are dying by the moment?
I did make that quite clear.
Brian Dempster just put another 500cc's
of blood into the chest tube.
His pressure's dropping.
Anesthesiologist wants to know if you want
to put him on the vent because, technically...
It's a violation the DNR if it's valid.
Put him on the vent.
Let the pencil pushers upstairs clean up their own mess
when they pull their thumbs out of their asses
I can only imagine the speed he was going on that motorcycle.
We got ahold of his next of kin.
His sister, Arianna.
She'll be here within the hour.
Excellent.
Also got his latest brain scans.
I sent copies to Neurosurge,
but I know you also wanted to see them.
Bad to worse.
Brain injuries from the accident? No.
His brain's fine from the accident.
He's got...
He's got diffuse brain atrophy.
He's probably had it for years.
Could be Parkinson's or
Alzheimer's.
Huntington's.
Whatever it is,
he's a 40-year-old with the brain of an 80-year-old.
If my brain looked like that,
I'd have a tattoo on my forehead.
I'm just waiting for the official word
from the NTSB that we're clear,
then we're gonna head out, okay?
Thanks.
You okay?
Nope.
My last shift, I saved a man's life.
Oh. Well, that makes sense.
I can see why you're so upset.
The patient I saved...
is a guy who ended up stabbing Tuck.
I'm sorry.
I wish I hadn't saved him.
Does that sound terrible?
No, it sounds honest.
Today's the end of my first year in Trauma.
'Cause of what happened, I-I...
I don't know if I'm doing more harm than good.
You're saving lives.
That's gotta be good, right?
Let's say it's a drunk, an-and two days later,
that guy goes out and mows over a bunch of people.
Haven't I just-- I don't know-- made the world worse?
My mother, she would say, "Life is not a race,
and nobody's keeping score."
My dad was an accountant.
It was all about
whether you were up or down.
As much as I don't want to be doing it, I am.
I'm keeping score.
I don't know if I'm up or down.
Arianna Dempster?
Brian's sister.
Hi. Matt Proctor. Hi.
How is he?
Oh, he's out of surgery, and he's recuperating in ICU.
Brian had multiple issues.
Uh, most notably, severe pulmonary trauma,
which has caused me
to remove one of his lungs.
His lung?
But with time on a vent
and other artificial assistance,
he can live with one lung.
Can he live longer than he can with early onset Alzheimer's?
Ah.
Our father died of early onset when he was 47.
It was ugly, so...
we both decided to get the genetic test.
I won, Brian lost.
Ever since then, my brother's been all motorcycles,
mountaintops, river rafts.
Brian wanted to make sure he didn't have any regrets...
that he got to keep his dignity.
So the tattoo was his idea?
His first idea was to get his entire living will tattooed,
complete with the words, "More on Back."
So, are you required to turn off the machines
if he wants to die?
I'm required to talk through all his options,
including turning off his vent, yes.
He's my baby brother, my only sibling.
I'm just not ready to give him up.
Look, we'll, um...
find out what he wants to do...
and just have to take it from there.
Okay?
Eva. Huh?
Did you get the page? Yeah.
Josephine Wells is waking up.
I'm heading there now.
Are you going to tell her about her husband?
She's going to ask.
Dr. Zambrano, Dr. C.
Are you going to see Miss Wells?
Yeah. Why?
I think you should hold that thought.
Josephine-- how, uh... how is she?
Uh, I'm sorry. Who are you?
I'm her husband.
I'm, uh, Truman.
Josephine and I were scheduled to fly to Baton Rouge
to see my sister, but at the last minute,
I was forced to stay in town for a conference.
So, your wife was just confused?
Confused about what?
Well, she said she saw you alive after the accident.
Saw me?
Yeah, you-- Truman.
Wait.
My-my son is alive?
They-they told me he was dead.
Truman, Jr. When-when I couldn't go, my wife,
uh, got him out of school.
It was a big deal at the gate-- uh, tearing up tickets,
printing them again, but...
but we managed to get him a seat...
Did Josephine really say she saw Truman alive?
Yes, but I don't know... Wait, wait, wait, wait.
How-how-how old is he?
Your son.
Uh, he's 11 years old.
Just turned 11.
How tall is he?
Uh, 4'10", 4'11".
What does that matter?
All adults.
What are you talking about?
Serena said all adults.
What?!
Okay, you said the remains they found were all adults, right?
They found no children's remains?
We got to go, Dr. Warren!
I think that the manifest could be all screwed up.
Maybe even the numbers are wrong.
It was Josephine's son
who was sitting next to her.
Chris, I gotta stop the helicopter!
You coming, Doc?
There could be one more!
Our patient, your friend.
Tuck. He keep kosher?
I don't think so, no.
Then go with the pig valve.
I hear happy birthday is in order.
Where do you hear that?
Oh, I'm like the CIA meets the KGB
meets that grandmother who always knew what you were up to.
You got your undergrad at Berkeley,
your medical degree at Penn,
you pretend not to know how to play pool
until there's money on the table,
and you're a sucker for caviar.
My grandmother was the last to know.
Let's go make Tuck's heart purr.
Yes, he does.
Hey!
Can we take the helicopter up,
fly overhead, see what we can see from there?
I know I'm only supposed to be observing,
but what better place to observe
than from the sky? Doc...
Come on, Moose.
I'm down on my ledger.
I got to get back to even.
Chris said that boy could be out there.
You know I'm a sucker for those puppy dog eyes.
Okay. We'll go up for an hour,
but after that, we're not going to have enough gas
to get back, even if we find someone, okay?
How are you feeling, Mr. Dempster?
I've taken you off the vent.
But it's only temporary.
The nasal oxygen will buy us
up to five minutes to talk.
Where am I?
You've had a serious accident.
I had to remove one of your lungs.
Do I know you?
Hey, Brian.
Ariel, right?
Arianna, your sister.
When... when I was a kid, I used to climb this walnut tree
in our backyard, and... I had these roller skates,
and you always used to help me down.
That did happen, right?
Yeah. Yeah.
That was me.
What's wrong with me again?
You crashed your motorcycle.
Not that.
Aren't I sick?
You have early onset Alzheimer's.
I have what Dad had.
What he died of, right?
Brian, you have a DNR,
which means, um, you don't want
any excessive measures taken to keep you alive.
But with only one lung,
I'm going to have to put you back on the vent.
I don't want the vent.
Brian.
No vent.
I don't want what happened...
To Dad.
I know.
And are you absolutely sure about that?
Half the time, I don't know what year it is.
What state I'm in.
I don't remember yesterday or the day before, but...
Brian.
She's always trying to protect me.
When I was a kid...
I had these roller skates, and I would climb this tree
in our backyard, and my sister...
I just told that story, didn't I?
My choice.
With dignity.
Can we have a little time to say good-bye?
Should we go a little bit farther?
We're about an eighth of a mile from the impact site.
This is probably as far as anyone could have made it
even if they'd wandered away.
You have to go back, Doc.
Five more minutes.
No, no, do not do that, not the face.
Gas gauges can't be charmed by puppy dog eyes.
I'm sorry, Doc.
Look, I'll make it up to you
when we get back, okay?
Wait.
What's that?
Can we go lower? Yeah, yeah.
Let's go lower.
Oh, my God, oh, my God, right there.
Rescue One to base. Rescue One to base.
We think we found a survivor.
Hurry!
He's in respiratory distress.
Hey, Truman.
Truman, hey.
Hey, I'm Dr. Warren, and I'm gonna take care of you, okay?
Is he a...?
Yes, very much so.
Facial trauma. I'll intubate.
How'd he get this far away from the crash site?
Probably stumbled off trying to get out of harm's way.
Ah, I can't get his jaw wide enough
to see the cords. Here, let me take a look.
I can't get in either.
I'll have to cric him. Wait, wait.
Give me two tongue depressors and some medical tape.
What? His jaw's dislocated.
That's why you can't get it open. I'll reset
the jaw, then we can open up the airway.
With tongue depressors and medical tape?
Manual mandible reduction.
Okay.
Doctor, he's ready.
So, Brian,
I'm going to...
count backwards from five
to one,
and if it's still what you want to do,
we'll turn off the machine.
It is.
Got him?
Hey, Truman, hey.
Now, don't be scared.
This is going to hurt,
but it's also going to help you breathe again.
Five...
...four...
...three...
..two...
one.
Okay.
Thank you.
He's breathing.
Nice work.
I think you're pretty much up right now.
Yeah.
Okay, buddy, we're gonna get you home.
You all right, you okay, buddy, huh?
Okay.
Let's get you home.
On-site mandible relocation
with freaking tongue depressors?
What?!
You are the queen
of EMS observation day.
It's Tuck.
911.
51 seconds.
You guys really care.
Welcome back. How are you feeling?
Like I've been asleep for a week.
Well, that's 'cause you were.
What can we get you?
Three months of bed rest.
And you'll page us if you actually need anything, right?
51 seconds.
Time to beat.
Just got a look
at Tuck's first echocardiogram.
Yeah, his heart's pumping well.
No mitral regurgitation.
So far, so good.
How much of being alive
is wanting to be alive?
'Cause I know some pretty miserable people
whose hearts just keep beating.
Maybe you should try
asking the question the other way around.
Can someone decide to restart their own heart?
Thanks for the update on Tuck.
This one's for free.
The next one-- that'll cost you dinner.
What'd you find, Vince?
Hey, what'd you find, Vince?
Hey, boy, what'd you find?
Oh, man.
Don't worry, buddy, don't worry, just hang on.
I'm gonna get some help, all right?
All right.
A dog, huh? Mm-hmm.
Saved my life,
along with the good people of Baltimore General.
So this isn't your birthday?
No, it's my, uh, my "rebirthday""
I'm two.
You know...
Brian my DNR patient, today
he, um, couldn't remember his past.
Didn't think he had much of a future.
I, on the other hand,
haven't often wanted to remember my past.
But I got everything ahead of me.
So you really were dead, huh? Mm-hmm.
You've never told that story before, have you?
Wait a minute,
so who left you the file?
Who is "Thought you might want this"?
Come on, you tease!
Okay, okay,
let's try this.
Was it my lying eyes or...
did I see you and Dr. Sable chatting it up
in the break room?
It's good to be alive.
It is good to be alive. Cheers.
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