A new surgical attending Cole Guthrie joins Angels Memorial with the help of his estranged father and clashes with Leanne over their contrasting approaches to medicine. Also, Christa has a crisis of confidence in the middle of a procedure on her first infant since the loss of her son.
6:31 PM Code: Yellow
As Taylor gives him a tour, Cole Guthrie asks how long he's worked there. He replies 35 years, not as long as Cole's father. Cole says they're all so nostalgic about Angels. Taylor says long ago, he had a German prostitute. She did something called affe geschlecht. It's the only thing he's ever been nostalgic about. He introduced Cole to Leanne. She asks if he's seen his father yet. He hasn't.
Jesse calls that they have three incoming from a house fire. Leanne tells Cole that Taylor will tell him where he can observe. Then she calls for her residents.
Outside, the first patent, Tina, is pulled out of the ambulance. She has severe burns over most of her body. The second ambulance has Dennis, who burns on his arms and legs. A medic comes out of an ambulance with a five month old infant, Tommy, who is barely responsive.
Inside the ER, Leanne calls out to give fluids and keep the patients warm. She then pulls the cover off Tina. Angus correctly says that the singed hair means they need to assume her vocal cords are also singed, which means they need to intubate immediately.
Tommy has carbon monoxide poisoning. Christa is frustrated because she can't get access. Neal tells her to take a breath and try again.
Taylor and Cole watch from above. Cole doesn't think it's very sterile, but Taylor says neither is a taxicab and many babies have been born there.
Dennis asks about his daughter and grandson. They can't get an IV through the burn tissue, so they put in a central line. Malaya wants to use an ultrasound, but Rollie tells her to use the anatomy instead. Cole objects from above, but Leanne tells her to listen to her attending. Rollie coaches her on finding the right landmarks to place the central line.
Angus estimates that Tina has burns over 60% of her body, mostly partial- to full-thickness. She needs 10 liters of fluids.
Christa still can't get a line in. They have to put in an IO line. Christa zones out for a moment, panicked because he's a baby. Neal reminds her he's a patient. She's unable to place the line and leaves Neal to do it.
Leanne asks Christa if it's her first sick baby. Christa says it is and Leanne since her first was two years ago. Christa questions how that's possible and Leanne clarifies that it's the first since the accident. First since she watched a resident try and fail to save her own baby. Christa losing a child means that every child who comes through the OR is a version or her own child. It won't chance, but she has to learn to deal with it. Leanne tries not to see the sick kid on the table. She tries to imagine the child leaving the hospital, put back together. It hasn't worked yet.
Mario is stitching up Chef Holder, who has a cut on his arm. Chef compliments him on his stitches. He promises Mario a meal. Chef is also familiar with Jesse and calls him Mama. Mario and Jesse step aside and Jesse says Mario's golden window is about to close. Chef's about to go in withdrawal and they can't discharge him once he is, until he detoxes. If Mario discharges him now, he'll self-medicate. Chef says he's not going. He needs to sober up, today. He calls for Leanne. Chef says it's his daughter's wedding tomorrow and he can't go if he's drunk. Leanne says withdrawal is painful, but he wants to attend her wedding. Leanne examines him and says they have no choice once withdrawal has begun. Mario says he hasn't, but Leanne calls over Christa, who observes fasciculation, from alcohol withdrawal.
Jesse leads Mario and Christa down the hall as they argue over what Christa said. Jesse silences them. Mario wonders why Leanne cares so much about this, as she's usually the treat 'em and street 'em type. Jesse says when your daddy tells you to do something, you just do it. Mario knows he's holding out, but Jesse says that just means it isn't his business. He opens a storage closet. Compared to where Chef normally sleeps, it's a five-star upgrade.
Angus enters the bay where Joan Wright is writhing orgasmically. It started when she was on a bus back from a field trip with her class. She's tried everything to get release, but nothing worked. Angus goes to examine her, but she moans and he jumps back. He tells her he'll be right back and leaves. Mario teases him for not being able to handle it, so Angus tells Mario to take a shot at it.
Malaya walks up to a bed and introduces herself to Keesha Platt, and her mother, Shanni. Keesha's been vomiting all morning. She's had a headache and nausea for a few days. She has bruises on her legs, but she says she's just clumsy. She insists she's not pregnant, that it's not possible. She's under a lot of stress from school. She'll be first in their family to go to college. Stanford is her first choice. Malaya says she went there. It's hard to get in, but they have a great diversity outreach program. Shanni asks if that's how she got in. Malaya orders tests.
Dennis wakes up in his hospital bed. He asks Neal about Tina and Tommy, if they're going to make it. Neal says they're both critical, but stable. Dennis asks Neal to pray with him.
Leanne sees Cole playing with anatomical models and walks in. She tells him not to question an order an attending gives to one of her residents ever again. He says he was showing off a little because it was his father. He apologizes to her, but says she's right. She says it's better not to rely on machines, because then they know how to do it without them, so they can put in a line no matter what circumstance they're in. He says he doesn't take orders from her or his father. She tells him he got the job because of his father. So next time he feels like embarrassing his father, he should thank him instead.
Mario pulls the curtain aside and leaves Joan. Angus teases him and Mario says she's faking it. She needs a psych consult. Instead, Jesse steps in and says he has it.
Malaya asks Shanni to step out so she can speak to Keesha alone. Shanni refuses and Keesha says she wants her mom there. The tests showed that Keesha is pregnant. Shanni is upset with Keesha, but Keesha maintains that it's not possible. She's a virgin.
Christs checks on Tommy. Neal says he's still lethargic. There's no evidence of burns, so whatever was wrong with him pre-dated the fire. They speculate options, but believe Tina would have noticed it. Neal orders more tests. Christa tells Neal about her son. He was sick for two years before he died. She's not looking for sympathy and it's not an excuse, but she wanted Neil to understand. He thanks her for telling him. Isabel comes up and says the fire investigator wanted Neal to call him. They think Tina might have started the fire.
Neal says that if Tina had postpartum depression, the fire could have been a suicide attempt. Christa says to keep Tina away from her if that's true, because it nearly killed her baby. Neal says if she were abusing or neglecting Tommy, that could explain his symptoms.
Dennis tries to get up because he wants to be with Tina. Neal asks him if something was wrong with Tommy before the fire. Dennis says Tina never said anything. It's just the three of them, the Three Musketeers. Neal asks if Tina was depressed. Dennis says she's not perfect, but she's a good girl. She wouldn't do anything that might hurt Tommy.
Rollie tells Leanne he heard she talked to his son. She says she talked to the new surgical attending. Rollie defends Cole, saying he wasn't the father Cole needed when he was growing up. Leanne says Cole his son and he's welcome there, but he can't get special treatment. Rollie wants to make sure he's not losing points for it either.
Mario is treating Darrell Bridges, who came into the ER with an overdose. Leanne jumps in to help. They don't know what he took. They push narcan. Jesse calls Leanne away to take care of Chef, so she leaves Mario alone with Darrell. Once the narcan is in, Darrell sits up, but refuses to tell them what he took. Mario orders a tox panel.
Chef's blood pressure is elevated. Leanne soothes him and tells him to hold on.
Malaya goes to Shanni to sign Keesha's discharge paper. She has referrals for OB/GYN and a family planning clinic. Shanni says Malaya can tell her she told them. Keesha asks her to run the test again. She already did with the same result. She sacrificed everything to be a good student. She's always studying. She can't be pregnant. She asks Malaya to see if it's something else. Shanni's ready to sign, but Malaya says she has the wrong paperwork, so she goes to straighten it out.
Joan thanks Jesse, kisses him on the cheek, and leaves. Mario says he'd be fired if he did that. Jesse says he put pepper in her nose. She needed release, so he gave her one. In psych cases, it doesn't matter what he thinks will work, only what the patient thinks will work. Risa tells Mario that Darrell wants to be discharged, but Mario says he can't go yet.
Darrell is restrained, but resisting. He says he doesn't belong there. He doesn't remember what drugs he took. Mario asks if it's happened before. Mario asks about stressors in his life. Darrell spits on him and asks if he can go. Mario tells him since he OD'd, it's state law that he has to stay until he's been evaluated. They put a spit mask on him and he starts screaming.
Chef is in pain, so Christa asks him about his daughter to distract him. They're out of the meds Chef needs, so it'll be about an hour before they get more. Leanne hangs ethanol to treat him in the meantime, carefully controlling the dose.
Tina wakes up in the ER. She reaches for a pen at her bedside and uses it to write on a pad of paper. She panics when it falls to the floor. Neal notices that she's awake and rushes to sedate her again.
Angus asks Malaya if she's thinking immaculate conception. Malaya thinks she's similar to Keesha in a lot of ways. Angus says to go back to the start. Is there anything she might have missed? Malaya suddenly remembers the bruises on Keesha's legs. It might mean something.
Leanne checks on Chef, who is sober. He asks if he can see his daughter now. Leanne says he has to get sober for himself. He has to believe he's worth it. She gives him a prescription and a card for their addiction clinic. He promises he'll call the number before he takes a drink.
Malaya stops Shanni and Keesha from leaving. She wants to run one more tests. She thinks Keesha's telling the truth.
Risa says Tommy has a fever. Christa and Neal start working on him. Leanne joins them and says whatever he has, he had it before the fire. They think about options and decide they need a lumbar puncture.
4:21 AM Code: Black Kayla Phelps tells Mario she has other patients to see. If he finds his patient, she says she'll come right back. Leanne sees Mario and asks him where his patient is. She asks if he assigned him a sitter or at least asked another resident to look after him. He didn't. She's told him before that he can't do it all alone. Darrell had an IV, so he could be out there mainlining drugs. They'll be liable for the 5150 failure and the IV elopement if they don't find him quickly. She tells him to get security on it now.
Christa prepares the needle for the lumbar puncture. Neal says she can do it. She steadies herself and then says she can't do it. Christa instead holds Tommy as Neal does the puncture. The fluid that comes out is cloudy. He definitely has an infection. They send it to the lab for testing.
Tina wakes up in the ER again. She reaches up and pulls out her breathing tube and calls for Tommy. They immediately rush to her bedside and sedate her. They look at her airway and she has a very small opening. They prepare retrograde intubation to get a new airway. It's successful. Jesse sees the paper on the floor. It says, "Tina Collins. Kidnapped." They then notice that Dennis has left his bed.
Christa's looking at the computer. She tells Neal over the phone that Tina's been missing for two years. Dennis isn't her father. Neal is frantically searching the hospital for Dennis. They have officers posted at the exits. Neal spots Dennis and goes after him. He says he needed air and asks about Tina. Neal says he knows that Dennis took Tina. Dennis defends his actions. Neal says he's never hurt a human being before. The cops come and arrest Dennis and lead him away. Leanne says the cops think that Dennis refused to get help when Tommy got sick. Tina was watching her baby die, so she set the fire to lure rescue.
Rollie tells Shanni and Keesha that Keesha has a brain tumor. It leaks a protein that indicates pregnancy. It also can affect balance, which is why she's been falling a lot. Shanni is worried about the tumor, but Rollie assures her it's treatable with radiation with a 95% success rate. Keesha wants to go back to when she was pregnant.
Christa puts Tommy's bed by Tina's, because she wants Tommy to be the first thing she sees when she wakes up. Tommy vitals drop. She wants to intubate, but Jesse tells her to take a breathe. If she does that, she won't get him off the vent. She does an ultrasound instead. There's pus build-up from the infection. He needs a chest tube, which could also cause him to bleed out. Christa is waiting for Leanne or Neal, but Jesse says she's his doctor, so she needs to act. She sees Tina's awake, so she tells him she'll make sure they walk out of the hospital together. Christa puts in the tube just as Neal and Leanne arrive.
A medic calls out for a doctor. They found Darrell on the street seizing. They couldn't stop the seizures on the way. Mario comes in. They put a line in his neck. Then they start propofol and intubate him.
Christa is still working on the tube. Once it's in, Tommy improves immediately. Christa tells Tina he's going to be okay.
Darrell is still seizing. Mario looks at his EKG. His heart rate has become more and more abnormal over the last few hours. She does quick math to determine he overdosed on his antidepressants. She orders sodium bicarbonate. Once that's in, Darrell's heart rate improves. Leanne tells Mario he got lucky and she wonders how long that'll last.
Rollie stops Cole on his way out of the hospital. He asks how Cole's first day was. Cole asks when Rollie was going to tell him he got Cole the job. Rollie says they don't hire people who aren't qualified, but admits he made a call. Rollie invites Cole to get coffee, but Cole says it's not going to be like that. Rollie says he's spent all these years trying to prove he's a man, but he's acting like a boy. He's 43. It's time to stop blaming Rollie for all his problems. Cole just leaves.
Christa wakes Tina up. She's holding Tommy. She tells Tina she saved his life. She puts Tommy's head next to Tina's while Leanne watches.
Christa pulls the toy truck out of her locker and says, "Mom did good today," before putting it back and closing the door.
Neal says it was a hello of a shift and Christa agrees. When asked, she says she's okay. He invites her to get breakfast, but she made plans with the other residents. She invites him to come along, but he says they don't want an attending around. She tells her to enjoy herself. She deserves it. She asks for a rain check and he says yes.
Mario sees the other residents leaving together.
Leanne puts stitches in Chef's head. Mario comes up and asks if it bothers her that after all the work she did, he's not going to make his daughter's wedding. Leanne tells him Chef's daughter died ten years ago on her wedding day. It's his grief ritual. Trauma One was the last place he saw her alive. He's stuck in the moment and keeps trying to escape it, but he can't. He offers to help, but she thanks him and says she has it. She continues her stitches.
- Marcia Gay Harden as Dr. Leanne Rorish
- Raza Jaffrey as Dr. Neal Hudson
- Bonnie Somerville as Dr. Christa Lorenson
- Melanie Chandra as Dr. Malaya Pineda
- William Allen Young as Dr. Rollie Guthrie
- Harry Ford as Dr. Angus Leighton
- Benjamin Hollingsworth as Dr. Mario Savetti
- Luis Guzmán as Jesse Sallander
- Cress Williams as Dr. Cole Guthrie
- Glenn Morshower as Dennis
- José Zúniga as Chef Holder
- Angela Lewis as Shanni Platt
- Ajiona Alexus as Keesha Platt
- Kevin Dunn as Dr. Mark Taylor
- Angela Relucio as Risa Park
- Ellia English as Isabel Mendez
- Sigrid Owen as Tina
- Doug Haley as Darrell Bridges
- Stacy Chbosky as Joan Wright
- Tangie Ambrose as Kayla Phelps (voice only)
- Rico E. Anderson as Cop
- Mikaela Rachal as Paramedic
- Andres Perez-Molina as Medic
- Theo Breaux as Medic 2
- Severe burns
- Burn care
Tina, 20s, came into the ER with severe burns on her torso and legs and barely breathing. Her nose hairs were singed, so they figured her vocal cords were burned. They intubated her as a precaution in case they started to swell. They determined she'd been burned over 60% of her body. They gave fluids and kept her sedated. When she woke up, she panicked and wrote something on a pad by her bed. Once the doctors realized she was awake, she was re-sedated. When she woke up again, she pulled the tube out of her throat. She was immediately re-sedated again and then re-intubated.
- Burn care
Dennis, 55, came into the ER with difficulty breathing and second and third degree burns on his arms and legs. Because of the burns, they had to put in a central line to get access. They treated and bandaged his wounds.
- Smoke inhalation
- Chest tube
Tommy, 5 months, came into the ER with smoke inhalation. He was barely responding. He was bleeding uncontrollably from every location they tried to put in a line. They had to put in an IO line, but he wasn't improving. They suspected what was wrong with him pre-dated the fire. He continued to decline, so they decided to do a lumbar puncture to check for a brain infection. He had meningitis. He had pus in his chest from the meningitis, so Christa put in a chest tube to drain the buss and relieve the pressure on his chest.
- Tongue fasciculation
- Alcohol withdrawal
Chef came into the ER drunk with a cut on his arm. He was stitched up, but he was in withdrawal from alcohol, so the had to keep him there until he detoxed. His blood pressure spiked and he was given diazepam and phenobarbital and then used ethanol to ease his symptoms as he detoxed. He was then discharged with a referral to a treatment program.
Joan came into the ER tense and in need of release. She appeared to be on the edge of orgasm. She'd tried to orgasm and release the tension, but was unable to. Angus attempted to examine her, but was startled by her reaction and had to leave the room. Mario was also unable to help and recommended a psych consult, saying it was all in her head. Jesse then stepped in and used pepper to get her to sneeze, which gave her the release she needed.
- Brain tumor
Keesha, was in the ER with pain and vomiting. She said she'd had a headache for a few days. Malaya drew blood to run tests. A pregnancy test came back positive despite Keesha's insistence she couldn't be pregnant. Malaya was about to discharge her, but decided to look for other possible causes of her symptoms. She remembered the bruises from Keesha's initial exam, attributed to clumsiness. She was diagnosed with a brain tumor, which leeched the same protein that causes a positive pregnancy test. It affected her balance, which is why she was falling. They said she could be treated with radiation with a 95% success rate.
Darrell, 21, came into the ER having an overdose. They gave him narcan to stop the overdose, which woke him up. He wouldn't tell them what he took. He wanted to be released, but Mario refused to discharge him. He claimed he didn't remember what he took and denied it happening before. Mario said he needed to have his mental state evaluated before he could leave. He escaped his restraints and left the ER. He was brought back into the ER seizing. They gave him ativan. They then gave him propofol when the ativan didn't work. His heart rate had become more abnormal over the last few hours. They determined he'd overdose on his anti-depressants and gave him sodium bicarbonate.
Notes and Trivia
- This episode scored 7.13 million viewers.
A complete overview of this episode's crew can be found here.
|#01||"Pilot"||#07||"Buen Árbol"||#13||"First Date"|
|#02||"We Plug Holes"||#08||"You Are the Heart"||#14||"The Fifth Stage"|
|#03||"Pre-Existing Conditions"||#09||"The Son Rises"||#15||"Diagnosis of Exclusion"|
|#04||"Sometimes It's a Zebra"||#10||"Cardiac Support"||#16||"Hail Mary"|
|#05||"Doctors with Borders"||#11||"Black Tag"||#17||"Love Hurts"|
|#06||"In Extremis"||#12||"The Fog of War"||#18||"Blood Sport"|
|Season 2 >>|