Chapter One: The Times They Are A-Changin'
Author's Note: Who's ready for another installment of Pumping Blood? This season starts off about two or three months after the events of the last season and I highly suggest reading the first two seasons if you haven't yet. As always, I don't own Glee, The Night Shift or any of the characters.
Rachel laid in her bed, wide awake staring at the ceiling, trying to mentally prepare herself for the day. It was the first day she'd be back at the hospital in a few months and she wasn't looking forward to it.
She rolled onto her side and looked at the empty spot next to her and sighed. Well, she wasn't looking forward to one aspect of her first shift back.
Her alarm started going off and she reached over to turn it off. She sat up in bed and rubbed her eyes. She hadn't been sleeping much lately and she could tell it was going to be rough night getting through her shift.
She grabbed her phone and scrolled through her contacts, stopping when she got to Finn's name. She hovered over his number, trying to decide if it was a good idea to call him or not. She heard a knock on her front door and heard someone come in and start yelling. She sighed and pushed herself out of bed, knowing that Santana had just arrived to come check on her.
It was definitely going to be a rough day.
"Bet it was my brother's," Brody said that night at the hospital, walking in the hall with Puck and Finn. "Puck, what are you even doing here tonight? I thought you had the night off," he said as they walked towards the nurses' station.
"I did. I volunteered so we didn't have to use another day shifter to cover for Kurt while he's in Afghanistan."
"You are so full of it," Finn said, pointing at him with a patient chart. "You only volunteered so you wouldn't have to spend an extra night with your mother."
"She's been visiting for almost a month. I'm going to take every shift I can to get a break."
"A month is never enough with your mother." He looked up from the chart and looked across the nurses' station, seeing Rachel and Santana come out of the break room together. He sighed and thought back to one of the last conversations they had.
"I'm asking you, will you marry me?" he asked, pulling out the ring from his pocket as Rachel adjusted how she was sitting on the hospital bed.
"I love you but I can't," she said as she started crying again. "I'm sorry."
"Hey, uh, Finn?" Puck asked, following Finn's gaze. "Did I mention I have you and Rachel working together tonight?"
"No. No, because you said we were on alternate shifts."
"I'm sorry. The schedule – it couldn't be helped."
"You have to rip the Band-Aid off sometime," Brody said, patting Finn on the shoulder.
Puck picked up a patient's chart and looked at Finn. "Oh, this one's serious. I gotta—" he said, walking off and leaving Finn alone.
Across the globe, Kurt and Syd Jennings, the major in the squad he was serving with, were walking around their camp in Afghanistan, talking about their personal lives together. "So then, Blaine emails me this morning and says we now have a dog," Kurt said, showing Syd the picture.
"He's cute," she said, looking at Kurt's phone.
"I'm sure he's great but maybe you don't get a dog when I'm in Afghanistan."
"Well, life goes on back home, Kurt. Your being married doesn't stop that. But I'll check him out when I get back in nine days."
"Blaine or the dog?" Kurt asked with a smile on his face. "Nine days. Don't rub it in. I've still got 104."
"Please. I only have nine days left because I've been here for 171."
"What's the first thing you're going to do when you get back?"
"I'm gonna hug my daughter for about a week," Syd said with a smile on her face. "And then I'm going to take a bath for about a month because I'm a little ripe."
Back in San Antonio, Sam was showing around one of the new interns at the hospital. "So, Kitty, this isn't anyone's favorite thing to do but it's part of a first-year's job. Now, only an M.D. can legally declare someone dead, so the retirement center brings them by. You check for a pulse, then sign the death certificate. Any questions?" he asked as a small crowd started gathering outside.
"Nope, sounds pretty simple," she said, climbing into the back of the hearse.
Sam stepped over to where the night shift was standing and stood next to Rachel. "We're still doing this?" she asked with a slightly incredulous tone to her voice.
"They all have to go through it. So, Santana told me you and Finn haven't spoken for like two months. Is that going to be weird tonight?"
Rachel felt an uneasy feeling in her stomach that hadn't been there for a few years. "Santana tell you anything else you wanna share?" she asked him, giving him a slight death glare.
"Nope. I'm just going to shut up now," he said, turning his attention back to the hearse, where Kitty was pulling back the blanket on what she thought was a dead body.
Instead, Artie popped up and screamed, causing Kitty to scream and she punched him in the face, the side of his head hitting the window.
"She's a feisty one," Sam said. "Guess that's why you hired her."
"What the hell?" Kitty asked. "What are you doing?"
"How was that your first reaction?" Artie asked as they got out of the hearse.
"You jumped me, man."
"Wait, I didn't jump you. It's a practical joke!"
"I didn't know, I just reacted," Kitty said, pointing at him. "Don't pull a tiger's tail if you don't want to get bit!"
"Okay," Sam said, stepping in between the two of them so they wouldn't start fighting. "No harm, no foul. "Everyone, I'd like to welcome our very own Kitty Wilde to the night shift.
Rachel started cheering and looked out of the corner of her eye, seeing Finn and Puck run out of the hospital and towards the helicopter. The two made eye contact and she sighed slightly as he ran past her without saying anything.
"Rachel?" Nurse Mollie said, coming out to where everyone was standing. "Nasty two-car pile accident out on Route 16. Finn and Puck just went out in the chopper. The other patient is five minutes out."
"Okay," Rachel said. "Sam, Kitty, I need you to prep trauma two. Artie, page Brody for a trauma consult."
"Yep," Artie said, touching his hand to his face to see how badly he was bleeding.
Out at the scene of the accident, the chopper was landing in fairly severe weather with thunder and lightning. "Hell of a night for this, gentlemen," one of the EMTs said, opening the door to the chopper. "This dry lightning is a bitch."
"Try flying through it," Puck yelled over the sound of the wings.
"What do we got, Mike?" Finn asked.
"First one's on her way to your hospital. That's her car there. Witnesses said the truck was hauling ass. It flipped through the driver. We started moving it, then we saw her neck hanging by a thread. Literally."
"Where is she?" Finn asked, looking around.
"There," Mike said, pointing to the overpass.
"Where?" Puck asked.
"Right here." The three men walked over and looked over the edge, seeing the woman half dangling over the overpass.
"Son of a bitch," Puck muttered.
"Stand back. Everyone stand back," Mike said.
"Okay, this one's me, Finn," Puck said.
Back at the hospital, Rachel and Kitty ran to the front to grab one of the other victims from where she was getting off the ambulance. "What do we got?" Rachel asked.
"Female, 30s, trauma to her wrists and abdomen from MVA. Vitals unstable," the paramedic said.
"Okay. How low's her pressure?" Rachel asked, putting on her stethoscope.
"Not low, high. Systolic is 190."
"190?" Rachel asked. "Are you sure?"
The patient groaned in pain. "It really hurts."
"Her heart is racing. Let's get her inside," she said as they started moving her into the hospital.
"Kelly, I'm really scared," the patient said.
"It's gonna be okay, Luce."
"Run a trauma panel and type and cross for four," Rachel said.
"Ma'am, I promise your friend is in good hands with Dr. Berry," Kitty said.
"She's not my friend, she's my wife," Kelly said.
"Oh, sorry," Kitty said. "Let me take a look at this cut," she said, peeling back the bandages. "What happened out there?"
"We were headed out to dinner and some nut in a pickup truck just flew by us like 100 miles per hour and we swerved."
"Sam, I'm going to need a lac tray set up with a 4-0 prolene."
"Got it," Sam said. "Let's get you fixed up and I promise we'll let you know everything that's going on with her."
Back at the scene of the accident, Puck was climbing up the ladder to get to their victim. "Puck, be careful."
"You should let us get her down," Mike said. "It's not safe for you with all this dry lightning. And if you guys get hit, it'll be my ass."
"All right, we heard you," Finn said, calling down to him. "We got this." He turned his attention to the victim. "We're here to help you, ma'am. It's gonna be all right."
"I'm Dr. Puckerman," Puck said, getting to the top of the ladder. "That's Dr. Hudson above us. Just hold still, okay? I'm gonna check you out. Then we're going to get out of here." He looked up at Finn. "She's got a strong pulse. Whoa!" he said, moving her head slightly. "There's a big piece of glass at the end of her SCM."
"Be careful," Finn said. "If that glass shifts when we're moving her, it's going to slice her trachea in half."
"Copy that. Throw me some Kerlix and I'll stabilize the piece." Finn tossed him two pieces and Puck groaned, feeling his shoulder jam up. He turned his attention back to the lady and groaned. "Damn it, there's bubbles. Torn lung."
"We're going to have to intubate as soon as we get her down," Finn said.
"Let's get her on the backboard and get the hell out of here."
"Get that backboard ready," Finn yelled down to the firefighters and EMTs.
Over in Afghanistan, Kurt and one of his fellow soldiers were enjoying their down time by playing video games. "Oh, I'm playing dirty now. That's a kick to the nuts," Kurt said, pushing buttons on the controller. "Are you sure you've played this before because you are really—"
"Boom! Roundhouse! Thank you elbow."
"Blocked. You're going down."
Across the room, Syd was Skyping with her daughter on the community laptop. "I had a competition last week and I got second."
"You did?" Syd asked, a smile spreading across her face. "Did Daddy film it?"
"No," she said, sounding disappointed.
"Well, did you do the sparring?"
"Yeah."
"Congratulations, sweetheart. That's amazing," she said as explosions started happening outside.
"Pause, pause, pause, pause," Kurt said quickly as everyone started putting on their helmets. "Game on," he said once his was one but his competitor's wasn't.
"What was that?" Syd's daughter asked.
"It's nothing, sweetheart. It's just fireworks. We set them off all the night. So, show me your yellow belt." Her daughter held it up to the camera. "I'm so proud of you."
Kurt came up to Syd and bent down. "Major, we have casualties," he whispered.
Syd sighed and turned back to the computer screen. "I gotta go. 24."
"Seven," her daughter said, clicking a button on the computer.
"Marquez, let's go," Syd said, leading everyone out of the room.
They all ran out to the camp, watching as a missile flew into the camp Kurt and Syd bent down to protect themselves from the explosion and ran out as soon as it was safe.
"Shrapnel injury to the abdomen," Syd said when she got to one of the soldiers. "Come on, get him to the OR."
"Yes, Major," Kurt said. "Above-the-elbow amputation. Let's get a tourniquet on this and get him inside."
"Kurt, over here," Syd said, already on the move. "Check for shrapnel. I'll apply the tourniquet."
"My leg. How's it look?" one of the soldiers asked.
"It's gonna be alright. Just a little bit of blood," Kurt said.
"Yeah, a badass guy like you, it's just a bee sting," Syd said.
"Docs," Marquez said, coming over to where they were standing. "We got local nationals coming in, hit by our counterfire."
"You're kidding." Syd sighed. "Kurt, you finish this up. I'll take the L.N."
Back at the hospital, Brody walked into the trauma room where Rachel was working on Lucia. "Diffuse guarding. She needs the O.R.," Rachel said.
"That's why I'm here. Get her up."
"There's a hitch. Her BP's up to," Rachel said, looking at the monitor. "Well, now it's at 230 and her heart rate's at 140."
"History of high blood pressure?"
"None reported, but it keeps going up. Even on Nipride."
"What do you think's going on?" Brody asked, looking into Lucia's eyes.
"I don't know. I'm waiting for tox screens."
"Well, she'll never make it through surgery with pressure that high."
"Lab says they're short-handed and running slow," Jocelyn said, covering part of the phone with her hand. "No tox screen results yet."
"I just talked to the cops," Sam said, walking into the room. "Witnesses say she was driving erratic, swerving all over the road."
"Could be meth or coke," Brody said.
"She doesn't seem the type. At least, her partner doesn't."
Brody scoffed. "Come on, Sam. How long have you been working in the ER?"
"It could be stimulants for ADD or something," Rachel said. "Either one would cause the elevated BP, the heart rate, erratic driving. If the labs are running slow, let's talk to her wife and see what she knows."
"Artie just sutured up her arm. She's getting x-rays now. I'll bring her right down," Sam said.
In the locker rooms, Kitty opened a locker, only to see someone's stuff was already in there. "So, Kitty," Artie said. "If you close up a wound like I just did, you end up with a much smaller scar, if there even is a scar. Maybe you can try it next time."
"Really? Gee, thanks," she deadpanned. "Are there any available lockers?"
"Uh, Jesse's. Yeah, that one," Artie said, pointing. "He's actually interning in Dallas to be closer to his kids when his wife took them. Like, it's a whole thing."
"Really great story. You should write a book," Kitty said, putting her stuff in her locker.
"You have an attitude."
"Look who's talking. You know, I'm not some wide-eyed intern you're gonna impress. I might try to listen to you a little more if you didn't try to humiliate me with a practical joke on my first night."
"They did it to me on my first night."
"And I bet they did it even more afterwards, didn't they?"
"Yeah. No. How's that even relevant?"
"Well, I don't let anyone mess with me and after they saw I punched you, no one else will mess with me, either."
"You punched me because you were scared or to send a message?" Artie asked. Kitty gave him a deadpan look and started walking out of the locker room. "Okay, this is a hospital, not a prison. I'm a doctor, you should—" he said, getting cut off by the door slamming. "You should listen to me."
"3, 2, 1," Syd said in Afghanistan, lifting the backboard onto the makeshift hospital bed.
"We know what happened?" Kurt asked, coming up to the bedside.
"She was riding in a taxi that got caught in the crossfire. The driver was DOA and she wouldn't let the medics examine her." She started speaking Pashto to the woman on the gurney.
"I speak English," the girl said. "My name is Sharbat."
"Okay, good. Sharbat, that's a beautiful name. I'm here to help you. Is there anything hurting?"
"My stomach and my chest. It hurts when I breathe."
"Okay, we'll check you out," Syd said, writing something down on a clipboard before handing it off to someone. "How old are you?"
"Fifteen. Can I have my phone? I need to call my brother."
"We'll try to track that down for you," Kurt said.
"Please, I need to talk to him now."
"I understand, but I need to treat you first, okay?" Syd said. "I need to get this off so I can examine you," she said, starting to draw the curtain.
"But he cannot see me."
"Sharbat, I'll turn around, I promise," Kurt said, turning around. "I'm just here to help Dr. Jennings."
Syd started pulling back the sheet and sighed. "Sharbat, you're pregnant. Do you know how many months?"
"I think about eight."
"We're just going to take a look at the baby. Do you have a husband?"
"He was killed by the Taliban. That's why I was leaving my village. They will kill us all." They heard another explosion and the power started to flicker as Syd did an ultrasound on Sharbat. "You have to call my brother. He's the only one that can help me."
"Pause it right there," Syd said, stopping it at a spot. "Dr. Hummel, can you take a look at this?"
"Does he have to?"
"Please, Sharbat, I need his help to make sure you and the baby are safe."
"You're talking about…" Kurt trailed off, pointing to a spot on the screen. Syd nodded. "Sharbat, your baby is okay but you got a small tear in your uterus from the accident. We're going to get an American baby doctor here to come and see you, but it's going to take some time for them to get here."
"Please just help my baby."
"We will, but in the meanwhile, I need to take some pictures of your chest to make sure you're okay."
Back at the hospital, it wasn't going well for Lucia. "I don't understand," Kelly said. "If she needs surgery, why is she still in the ER?"
"We're having trouble getting her heart rate and pressure down," Rachel said.
"We just saw a doctor a couple of weeks ago. Her pressure was fine. Why is it so high now?"
"Well, we were hoping maybe you could tell us," Brody said.
"Is she taking any medication for ADD or narcolepsy?" Rachel asked.
"No."
"Any chance she was using drugs – meth or cocaine?" Brody asked. Kelly turned towards him, looking offended.
"No. God no. she's completely healthy. Lucia won't even take an aspirin. She's strictly vegan."
"Are you sure? Witnesses said she was driving erratically," Brody said.
"She's not on anything. I know my wife.
"We're not suggesting that you don't," Rachel said as Kitty walked into the room. "But any information you have could help save her. Kitty, can you pull the ultrasound?" Rachel asked, turning around to see that she was already doing it.
Artie walked in as Brody started to put the gel on Lucia's stomach. "What are you doing?" Kelly asked.
"Now we need to monitor the bleeding in her kidney," Rachel said. She took the ultrasound wand and started moving it around on the gel as the image appeared on the screen.
"Artie, thoughts?" Brody asked.
"Bleeding is stable, that's good. Any sicknesses lately?" Artie asked.
"No, not really. She's complained of headaches and hot flashes and dizziness. But the doctor just said welcome to menopause."
"Was the doctor a man?" Kitty asked.
"Yeah, he is," Kelly replied as the heart monitors started beeping.
"She's in V-fib. Kitty, paddles," Rachel said.
"Oh my god. What's happening? You have to do something. What's going on?"
They charged the paddles and put them on her chest. "Clear," Rachel said as everyone stepped back. "Still V-fib. Charge. Clear," she said, shocking her again.
Across town, Finn and Puck were flying back to the hospital in less than perfect conditions. "Sounds good. You're in on the left," Puck said, listening to her heart and lungs. He groaned again, feeling slight pain in his shoulder.
"You okay?" Finn asked.
"Yeah, I just tweaked my shoulder a little bit."
"I gotta say, it's good to have you back out here with me, buddy," Finn said.
"It feels good to be back. I get so bored, being charge doc, you know? I spend half the night sitting behind that desk. Why can't I go out sometimes?"
"You know you can go out whenever you want," Finn said. "You're the boss."
"Damn right. I want to get back to who I used to be, instead of this house cat I turned into. Besides, who knows when I can send you and Rachel out together again, right?"
"Yeah, probably best to wait on that. Things are still a little raw." Finn heard something start beeping and looked over at the monitor. "Crap, Puck. Her pressure's dropping."
"She's bleeding out."
"Puck, we've got to pull the glass."
"That's all? Surgery in a flying earthquake."
"If you pull the glass, I'll find the bleeder and clamp it off."
"Let's use the NOD this time," Puck said. "It's hard enough to intubate. We'll never see the bleeder without it," Puck said, putting the night vision goggles onto Finn's head.
"Clamp?" Finn asked, holding out his hand. "Pull it out nice and slow, buddy."
"That's the plan." He pulled it out and held it up. "God, look at this thing. It's like an iceberg. Lucky it didn't take her head off."
"I see the bleeder," Finn said as he started working. Thunder crashed outside and Finn pulled away. "Jesus. Son of a bitch. I got whited out by lightning."
"So you're blind now too?"
"No, I got this. I'm close," he said as he started working. Got it," Finn said, clamping it off. "Bleeding stopped."
"Pressure's going back up," Puck said. "Nice job."
Back at the hospital, Kitty was doing chest compressions on Lucia. "Hold compressions," Rachel said, looking up at the monitor. "I have a pulse."
"We're in sinus. BP and heart rate are coming down. What do you think caused the V-fib?" Kitty asked.
Rachel thought to herself for a second. "It was the F.A.S.T. scan."
"Right," Brody said.
"What do you mean?"
"When Dr. Berry ran the ultrasound probe over the kidney, the heart rate and BP shot up."
"Like this," Rachel said, demonstrating. "Now look here, above the kidney. What do you see?"
"A pheochromocytoma. A tumor of the adrenal gland," Artie said.
"Artie, I was Kitty. I know you know," Rachel said.
"And I knew that," Kitty said as Artie scoffed. "What the hell is your problem?"
"What the hell is your problem?" Artie asked.
"Do you have to be the big man."
"I've been trying to be nice all day."
"Is it because I'm a girl?"
"Hey, hey," Brody said, cutting them off as Rachel pressed her lips together to stop laughing. "The patient. It must have gotten crushed in the accident and released adrenaline into her bloodstream."
"And every time we pushed on it, it had the same effect," Rachel said.
"So it needs to come out," Artie said. "I'll let the OR know we're coming."
"Not so fast," Rachel said.
"Operating on it can release a fatal dose of hormones into her system."
"So, Kitty," Rachel said, turning to the new intern. "What do we do?"
"Put her on alpha and beta blockers for the next few days until it's safe to go into surgery."
"Exactly. And hope she doesn't start bleeding again," Brody said.
In Afghanistan, Marquez came running into the hospital room. "Major! Captain! New development," he said, getting to Sharbat's bed. "Her husband is here for her."
"Her husband?" Kurt asked, turning towards her. "I thought he was dead."
"Sharbat, what is going on?" Syd asked.
"He's got to be somebody important because he walks right through security."
"Where is she?" a powerful voice said, entering the hospital. "What are you doing to my wife?"
"You can't just walk in here," Kurt said.
"Get away from her."
"We are saving her life."
"Kurt!" Syd yelled. "I've got it from here. Leave now. That is an order."
"Listen to her," the man said.
Kurt handed the ultrasound probe to one of the nurses as he walked away, never dropping eye contact with Sharbat's husband.
"He should have never been here," Sharbat's husband said.
"I'm sorry, sir. There was an emergency," Syd said, going back to work on Sharbat. "Your wife was in an accident. There's been some bleeding around the heart that I'm draining now. There also seems to have been an issue with the baby."
"Then she needs a midwife. I'm taking her."
Syd sighed. "She can't go now. She's been sedated and she's too sick for a midwife. Her uterus has a small tear. So far, the baby is okay but we have called in a specialist."
"I make decisions for my wife. Not you."
"She needs medical attention," Syd said.
"You are guests in our country. She's my property and I'm taking her."
"This may be your country but right now, she is my patient. You've got a problem, you file a complaint. Until then, get out of my ER!"
"You will pay for this."
Sharbat waited until her husband was gone before rolling over to face Syd. "You see? Please don't let him take me.
Back at the hospital, it wasn't slowing down for them either.
"Forty-two-year-old female with deep lacerations to her neck causing a tracheal-broncho injury. I had to clamp off her pulmonary vein," Finn said, handing over the patient to Brody.
"ET tube's in the left main bronchus. Stats and BP are stable," Puck said.
"Not bad for being in the field. We got it from here," Brody said, taking the patient up to surgery.
Puck groaned and rolled his shoulder from where he'd hurt it in the field. "You need something for that shoulder, old man?" Finn asked with a smile on his face.
"No, it's just sore," he said, dropping the bag with emergency supplies. "What's this?" he asked, pulling out his phone that started ringing.
"Ten bucks says it's Quinn calling to complain about your mother," Finn said, giving Sam a fist bump.
"Well, you owe me ten because it's my mother, calling to complain about Quinn." He accepted the call and put it up to his ear. "Hi mom."
Finn started walking away, laughing to himself. He turned around and almost ran right into Rachel, who was standing in the hallway of the hospital. "Hey."
"Hey," Rachel said, looking down at her feet.
"You wanna…" Finn asked, nodding towards the break room, hoping they'd be able to talk.
"So I heard there's a bit of a situation out there," Rachel said as Finn opened the door, revealing two of the nurses talking to each other. "I know you're not the biggest fan of lightning," Rachel said as Finn shut the door.
"Yeah, well, you don't have a choice, right? Brody has her now. So how's the other patient? The driver."
"She went into v-fib arrest. Pretty sure she has a bleeding pheo."
"That's not good." Finn and Rachel looked around the hospital, noticing everyone was watching them. "So listen I—"
"Let's talk outside," Rachel said, brushing past him.
"Look, I don't want it to be awkward for us working together for you."
"I don't want it to be awkward for you either but I don't see how it's not going to be." The two of them got outside and saw two ambulances in the ambulance bay, meaning they weren't going to get to talk there either. "I mean, we'll figure it out, right?"
"Yeah," he said, the two of them walking to an empty trauma room to talk.
"Honestly, the best thing we're going to do is face it and eventually we'll get over it. Right?"
"That sounds like you're not thinking about going back to the day shift."
"Why would I?" Rachel asked, turning around to face him. "Why? I love the night shift. Do you want to transfer to the day shift?"
"It might be easier for you. You said you were considering it anyway."
"No. No I didn't," Rachel said, cutting him off. "You suggested it when we broke up but I never said I was going to."
"Yes you did—"
"No I didn't!" She was cut off by a gurney being wheeled into the trauma room and the two of them moved their conversation out into the hallway. "You get an idea in your head of what you want to happen and then you just expect it to happen."
"I'm not the only one who does that."
"Meaning?" Rachel asked.
"Like when I asked you if I could go to Afghanistan. And you said sure. And then I went and came back and you were pissed at me."
"I never said go."
"Yes you did."
"No I didn't. I said I wouldn't stop you because you would have resented me if I did."
"That's the same thing."
"No. It's not," Rachel said, a hard look forming on her face. "Did I want you to go? No. What pregnant woman wants to send the father of their child into a war zone?"
"Then why not just say that?"
"You would have gone anyway," Rachel said, her eyes narrowing.
"Excuse me, doctors," Mollie said, breaking up their argument. "Rachel, there's CBCs back and the lab says to call them ASAP."
Rachel glared at Finn and brushed past him. "Excuse me."
Mollie leaned in towards Finn and dropped her voice. "Give it some time, honey. She just needs time."
"Thanks," Finn said harshly.
In the OR, Brody and Artie started doing the operation on the woman from the scene of the accident. "Gotta say, for a woman who was ejected out of her truck onto a freeway sign, she's doing pretty well," Artie said.
"She's very lucky she had such a great surgeon," Brody said.
"Yeah, you were awesome."
"I was talking about you. Really nice assist here. Like I said, you've got the gift." Brody paused. "All done with the sutures?"
"Yeah."
"Okay. Let's go take a look at the film and make sure there weren't any issues with her other lung before we close her up." The two of them took off their surgical gloves and masks and threw them in the trash. "So, what's going on with you and this new intern, Kitty?"
"She's very annoying and she thinks she knows way more than she actually does."
"So did you, if I remember correctly. But from her work at the reservation clinic, she's coming in with way more experience that most first years. But the bigger issue is, if she's going to rattle you like that, what's going to happen to you when things go south in here?"
"Well that's totally different," Artie said.
"How?"
"I'm in control here. I'm in control in the big stuff like my hand. I almost lost everything but I took it like a man. I did the rehab and I'm here."
"That's true. You did.
"But the social stuff, I've never…been the best at. You know, I've always been the smartest guy in the room. I mean, not to say I'm the smartest guy in this room—"
"Artie, I need you to have the same confidence out there when you're dealing with your bosses and your ex-colleagues and everyone else that you have in here with your surgeries. A night shift at a busy trauma center like this is the wild west and we are the calm in the eye of the storm. You know, we make it all okay for everyone. You get it?" Brody asked as Artie nodded.
Rachel came up and knocked on the OR window. "Brody, I need you."
"Okay, Artie, finish the repair and close up."
Artie nodded and put a mask back on. "6-0 prolene on a needle driver, please."
Outside the OR, Brody and Rachel were wheeling Lucia to another OR. "The repeat blood test shows that her blood count is dropping which means that her tumor is probably bleeding again," Brody said.
"So can't you just fix it?" Kelly asked.
"It's not that simple."
"Normally we can premedicate someone for a couple of weeks with adrenaline blocking medication before operating, but with her bleeding again, we have to go in," Rachel said.
"But you should know there are serious risks taking it out now. But the risks are far more serious if we don't."
"Are you telling me she could die?"
"I'm telling you it's complicated," Brody said, wheeling Lucia into the OR.
"Then uncomplicated it for me," Kelly called after him as Rachel hung behind.
"I wish we could, but we can't. Now, it's risky, but this is her best chance."
"We weren't even supposed to go out tonight but I pushed her because I wanted to," Kelly said. "Maybe if we had just stayed home, this wouldn't have happened."
"Kelly, this is not your fault. Sometimes bad things happen to good people."
"It is my fault. We've been fighting so much lately and in the car I got so mad I asked her for a separation. And she was so upset."
"Okay, why don't we get some coffee?" Rachel asked, trying to settle her down.
In Afghanistan, Kurt and Syd were debating what to do about Sharbat. "If we move her, she doesn't make it. Neither does the baby."
"I'm just telling you what our orders are. I didn't say I agreed with them."
"So we're just going to listen to this bastard who calls this little girl his property? Back in the States, he's in jail for statutory rape."
"Yeah, and you don't think it pisses me off? I've got a daughter two years younger than her." Syd stood up and Kurt did the same as the two of them started walking. "This country is like stepping into the Bible. But as much as we don't like it, we are required by our superiors to follow their rules. This is what victory looks like, Kurt. Get used to it. You're not back in your chummy ER."
"Yeah, back there we'd figure out a way to help her."
Syd sighed as they got to Sharbat's bedside. "Sharbat, how are you feeling?"
"The baby?" she asked.
"He's fine."
"He? It's a boy?"
"Yes. Sharbat, I need you to talk to me about your husband."
"I'm sorry I lied. I just…I didn't want you to contact him. I didn't want him to find me."
"He wants to take you back to the village," Kurt said. "We can delay it but I don't know what else there is we can do."
"You don't know how cruel he is. You don't know how cruel his family is to me. I was sold to him at 13 by my parents."
"I hate this country," Kurt spat.
"He doesn't care about me. He only wants his baby boy. My brother is trying to help me. He made enough money to go to Australia. You have to find him."
"We are trying but it's tricky for us because your husband is right about one thing. We have to follow Afghan laws," Syd said, trying to keep her voice neutral.
"Then I am dead," Sharbat said, laying back against the pillow.
Back at the hospital, Finn, Puck and Kitty were going to the front to get someone from an ambulance. "She said Annie called it in," Puck said.
"Who's Annie?" Kitty asked.
"She's bringing in an OD," Finn said, putting gloves on.
"How's she doing? How'd she sound?"
"She sounded upset," Finn said.
"Who's Annie?" Kitty asked again.
"Finn's sister-in-law," Sam said, meeting them outside. "She disappeared last year and cleaned him out. She turned up a month ago out of the blue."
"Twenty-nine year old man, OD'ed. Pinpoint pupils. BP is 90 over 60," the paramedic said.
"Any idea what he's on?" Puck asked.
"Oxycotin," Annie said, getting out of the ambulance.
"Okay, Kitty, you're with me," Puck said. "Let's put him in curtain two."
"You okay?" Finn asked, helping her out of the ambulance.
"Yeah."
"Yeah?"
"Yeah, I'm good," Annie said, walking into the hospital.
"Okay," Puck said, getting the patient set up in the exam room. "Hypotension with respiratory depression. What do we do?"
"High flow oxygen, IV fluids, Narcan," Kitty said.
"Looks like somebody paid attention in class. Go ahead and do it."
"Two milligram dose," Jocelyn said, handing Kitty the needle.
"Actually, in chronic narcotic users, you should start with a 0.4 milligram does to decrease the risk of flash pulmonary edema," Kitty said, squirting out some of the Narcan.
"Did you just pay attention in class or did you teach it?"
"I've done this a few times before."
"Right, at the clinic."
"Yeah. Plus I had it done to me when I OD'ed," Kitty said, causing Puck to chuckle. "No, I had a pretty bad Vicodin habit in high school. Don't worry, I'm all better now," Kitty said, putting the now-used needle in the can Jocelyn extended towards her.
"Good," Puck said as the patient started to wake up. "Hey. Hello, sir. Welcome back to the world."
The patient growled. "Oh, you son of a bitch," he said, taking off the oxygen mask. "You ruined my high!"
"Actually, we saved your life."
"You ruined my high!" he said, adjusting how he was sitting on the bed. "I'll show you. This is for you, doctor," he said, pulling up his gown in the back. He grunted and started pooping on the bed.
"Clean up on aisle three!"
"For the record, I never did anything like that," Kitty said as Puck walked out of the exam room.
"Is that better, buddy?" Jocelyn asked.
Rachel led Kelly to one of the waiting rooms and sat her down to talk. "The accident is not why she's in surgery," Rachel said. "It's the adrenal tumor. It's a – it's like a time bomb inside of her and it could have happened anytime, anywhere. So that has nothing to do with you."
"I just got so tired of the arguing," Kelly said.
"Okay, I know that you and I don't know each other, but do you mind if I ask…has the fighting been just these last few months, where she's been irritable and had angry outbursts?"
"That's it. She's just been so angry at me."
"Those are all symptoms of adrenaline leaking from the tumor. I'm not saying that it's the cause of your problems."
"But it explains a lot," Kelly said, a look of relief washing across her face. "We've been through so much these past few months. Sometimes it's hard to get past all that pain. You know?"
Rachel felt her heart get heavy and she took a deep breath to try and not start crying.
"The baby?" she asked when she first woke up from the coma. She saw the broken look on Finn's face and started crying.
"Yeah. I've been there. Hell, I think I'm still there. But, you know, you gotta try, because even if it doesn't work out, at least you know you did your best."
"I just…I hope we can get back to where we used to be."
"I hope you can too."
In one of the break rooms, Finn was walking towards Annie with a coffee cup in his hand. "I just don't like you working in a halfway house with addicts," he said, sitting down at the table she was sitting at. "There's lots of temptations and I don't think it's good for you."
"I know you don't. But I told you when I agreed to stay with you that I needed this. I need to see wasted lives and how close I came to being one of them."
"Fine, I'll back off. I've had enough fights with women tonight. Just do what you want," Finn said, taking a sip from his coffee cup.
"Rachel?"
"Yeah. First night back working together. It took about three minutes to get into it."
"Well, you're both hurt. When you're hurt, you lash out. It's easier than feeling pain."
"Well, you could just move on."
"Don't be such a guy, Finn. She lost a child. She lost you. You guys have been together on and off since you for…what? Since you were like 25? Give it some time."
"She went and worked on a reservation for two months. I thought she'd be fine when she got back."
"Fine?" Annie asked incredulously. "She's not sick, Finn."
"So what? You're defending Rachel now?"
"She's figuring her life out. Look, Finn, I love you. You're my family. But sorry, dude. I get it. I see her side of things. You push the edge. You take chances. It's why you can save lives when other people can't. You have a gift and that's an exciting guy to meet and to date."
"But not to marry?"
"But not to marry," Annie repeated.
"That's not new, okay? She knew exactly who I was from the start. And then, all of a sudden, it's 'you can't get a Harley. You can't join SWAT-team training. You can't go to Afghanistan.'"
"No one wants the father of their child going to Afghanistan. You weren't sent over there, Finn. You choose to go."
"To look after my best friend," Finn said defensively.
"And she probably thought she was your best friend. Look, you don't want to change and you shouldn't have to change, but don't blame her because she changed."
"That's very interesting advice coming from the woman who married my crazy ass brother."
"Yeah. And I was a widow at 28."
Across the hospital, Santana and Sam were getting out of the elevator and Santana was looking at something on her phone. "And this one just came in?" Sam asked.
"Yeah. Well, I got the rejection letter from Loyola earlier. Now this one from Seton Hall. That's five law school rejections. Game over," Santana said.
"First of all, it's only four, okay? You got waitlisted at Georgetown."
"Which is a nicer way of saying they rejected me."
"You applied late, okay?" Sam said. "You retake the LSAT. You have time to take one of those test-tutoring courses. Then you'll knock it out of the park. All those law schools will be begging to get you."
"I don't know. Maybe it wasn't meant to be," Santana said, getting dejected.
"Don't go quitting on your dreams now," Sam said. "How many times have you told me about how tired you are of being on this side of those 911 calls? That you wish you could help those women before it's too late."
"About a million gazillion times."
"So it'll take a little longer to be a lawyer than you thought. Buck up."
"You're the best. You know that?" Santana asked, kissing him.
The two of them walked by the nurses' station and smiled at Finn and Puck. "So, um, is Annie okay?" Puck asked.
"Yeah. Thought she'd be more shook up but she's hanging in there. What's the update on the woman we brought in?"
"I heard it went well. Artie's closing up now."
"That's great," Finn said, going back to paperwork.
But in the OR, things were much less than great. "Pressure's dropping," one of the nurses said.
"Yeah, I know," Artie snapped. "More lap pads. I need more lap pads. I took out the packaging to close up, I must have dislodged a clot from the subclavian artery. Clamp," he said.
"Heart rate climbing."
"I know," Artie said as he kept working. "There's too much blood. I can't see."
"You need help."
"I've got this," Artie said.
"I'm paging Dr. Hudson," the nurse said.
A few minutes later, Finn came in after scrubbing in. "What's going on, Artie? Why'd you page me?"
"I've got it. They shouldn't have called you."
"Let me in there. I'll show you," Finn said, standing next to Artie.
"I've got this, Finn."
"Artie…"
"I've said I got this, Finn! I'm the surgeon." He saw the shocked expression on Finn's face and sighed. "I'm sorry. I just – I got this, alright? Vessel loops on the hemostat, Finn, hold the pressure on that side, please."
"Okay. You got it," Finn said, walking around to the other side.
"Hemostat," Artie said. "Hold pressure," he said, looking up at Finn.
"Good job," Finn said, watching him work. "I guess you didn't need me."
"That's what I told them. Let's repair that artery. 7-0 Vicryl to me and Dr. Hudson, please."
"Happy to assist, doctor."
In another OR, Brody was doing surgery as Rachel watched. "And cut," he said. He pulled the tumor out and put in the bowl. "Get that off to pathology."
"Right away, doctor," one of the nurses said.
"Look at that. I could have gone into bomb retrieval."
"Well, there's always time to change careers," Rachel said with a slight laugh.
The monitor started beeping and the three of them looked at it with wide eyes. "BP's back up. It's 170 systolic."
"What the hell," Brody said, looking to see if he missed something.
"Did you tie off all the vessels?" Rachel asked.
"Yes. Yes I did."
"Heart rate's 160," the nurse said.
"She's coding," Brody said as Rachel brought over the paddles. "Get this draping off," he said as he grabbed the paddles. "Charge me up."
Outside of the other OR, Puck ran up to Finn as he left the room. "Everything alright? I heard she was in trouble."
"False alarm. Artie had it all under control. The guy is a rock in the OR. You talk to any of the people yet?"
"No, I left a message, haven't heard back. State police is tracking down the truck registration and see if they can locate any of the family."
"When you do, let me know. It would be nice to give some good news."
Back in the other OR, Brody was still confused as to what was happening. "It doesn't make any sense," he said, looking again to see if he missed something. "I got the whole thing out."
"Brody, what if you didn't get it all out?" Rachel asked.
"I did. I got it all. Look," he said, looking up at the screen. "There's nothing. Nothing's there."
"Okay, but what if there's a second one? 10 percent of all pheos have a secondary tumor outside of the adrenal gland."
"That would explain a lot of this, but where is it?"
Rachel heard the monitors start to beep again and she turned to look at them. "Brody, her blood pressure is still rising."
"Come on, show yourself, you bastard. Release the retractor," he said. "There it is. Just distal to the aortic bifurcation. Clamp," he said, holding out his hand. He clamped it down and twisted and the beeping slowed down.
"There you go. BP's down to 180 over 100," Rachel said.
"Nice save. Very nice. Alright, let's get that sucker out of there." He turned back to Lucia and froze. "Whoa, whoa, whoa, whoa."
"What?" Rachel asked, not liking the sound of that.
Over in Afghanistan, Syd was talking to someone on the phone. "Yes, sir. Yes, sir. I understand, sir. No, sir. Yes, sir. I will. Thank you, sir," she said, hanging up the phone.
"That didn't sound good," Kurt said from where he was working on Sharbat.
"Yeah, it's not. Sharbat's husband is a little more connected than we thought."
"So what does that mean?" Sharbat asked, starting to get anxious.
"It means we're just trying to figure things out," Syd said, trying to comfort her. Leaning in towards Kurt, she whispered "Her father-in-law is on the Provincial Council. He's threatening to close roads, deny access to villages, end the supply chain. He can make life miserable for the base."
"Why are you whispering? What is going on?"
"We're just talking about some medical stuff, Sharbat," Kurt said before turning back to Syd. "Did you tell the general what's at stake?"
"Yeah, I told him. I was the one getting my ass reamed, okay? And here's the big surprise: he doesn't care. He's big picture, solve the problem, keep the place running. The general was very clear about that."
"Are you sending me back with him?" Sharbat asked.
"You're going to have to keep calm for the baby, okay?" Kurt said. "We're going to try and figure this out."
"Don't you promise her anything."
"I'm not. We are trying to figure it out."
"I can't go," Sharbat said as she started crying. "I can't go. I'd rather die than go back there."
"Distant heart sounds," Kurt said as the heart rate monitor started beeping. "Got JVD. She's in cardiac tamponade."
"Looks like the drainage was a temporary fix. She needs a pericardical window. Let's get her to the OR."
Back at the hospital, Rachel and Brody were talking to Kelly about what happened during the surgery. "I thought you got it."
"Dr. Weston removed all of the tumors from Lucia's adrenal gland, but the cancer has spread through her lymph nodes," Rachel said.
"And I'm afraid it's stage IV," Brody said.
"S-so what's the treatment?"
"I'm sorry, Kelly, but there is no treatment at this point. It's a matter of weeks or maybe a couple of months. Right now we need to focus on Lucia's comfort and pain management."
"I just learned that her anger wasn't her fault and I was going to get my Lucia back. And now you're telling me that I'm going to lose her…forever?"
"We're very sorry. There was no way of knowing until we got in there."
"Our last words were a fight."
"Yeah, your last words before the accident," Rachel said. "But now you have a chance to tell her what she really means to you." Rachel started leading her back towards Lucia's recovery room. She smiled at Kitty and Sam as they passed in the hallway.
"Northwestern med school – that's pretty impressive," Sam said. "What made you choose them?"
"I look good in purple. And after I graduated, I met Rachel on the reservation. Not a lot to do around there, so we buddied up pretty quick. She offered me a job and Chicago winter sucks so I ditched that internship and here I am."
"Well, we're glad you did. Anybody that can through a punch like that is going to fight right in on the night shift." They got to the nurses' station and Sam opened his laptop, revealing pictures of him with various workout equipment.
"Somebody's in shape," Kitty said, looking at the screen. "Nice balls, man. Kinda creepy for a desktop."
Sam shut the top of the laptop and gave Kitty a look. "Those are pictures for my brochure. I'm opening up a cross-fit gym. I'm just trying to decide which one I want to use."
"Uh huh," Kitty said as she walked away. "Go with the big balls," she called out as Puck walked up to the nurses' station.
"What's the matter, Puck?" Sam asked, noticing him rubbing his shoulder.
"Yeah, I just pulled a muscle out in the field. Just had a scan, nothing's torn."
"Want me to rub it down for you?"
"Just stay where you are."
"Excuse me," someone said, coming up to the desk. "I'm looking for my son. Francis Watkins? He was brought it with a fever."
Puck and Sam turned to look at the board to see if he was on there anywhere. "I don't see any pediatric fevers on the board," Puck said. "Do you know of any, Sam?"
"No," Sam said, looking through papers to see if he missed something. "Are you sure it was this hospital?"
"Yes. My wife left me a voicemail while I was at work. It's loud machinery so I just got it. She said she was bringing our four-year-old son in. He had a high fever. San Antonio Memorial Hospital. I know what I heard. She was calling from the truck while she was on the way."
"A truck?" Puck asked, his eyes going wide. "Does she drive a green pickup?"
"That's it. An F-150. Why?"
"You sure your son with was with her?"
"Yes, she was bringing him in. That's my point."
"Sam, get the chopper ready to go. Call police, fire department and EMS. Get Finn and Rachel on that chopper. We need everybody out there right now."
"Wait, what's going on?"
"Sir, you might want to sit down for this," Puck said.
"What are you talking about?"
"Your wife was in an accident," Puck said, leading him over so they could sit down and talk. "Your son might still be at the crash site."
Finn and Rachel ran towards the chopper and got in, trying to sit as far away from each other as possible. At one point, his knee accidentally bumped hers and she jumped away. "Sorry," he muttered.
"It's fine," she muttered back, looking out the window the entire flight to the scene of the accident.
Once they landing, they immediately sprang into action. "He's already been out here for almost two hours," one of the paramedics said.
"I can't believe I missed a kid," Finn said.
"Everybody did," Rachel said as they started running. "You were here for the mother. It's not your job to search the field looking for other cases. Everybody, spread out!" she yelled.
"Check over there," Finn said.
"I already did," someone said.
"Well, check again. Frankie!" he called as other people started calling out the kid's name. "Get the chopper to shine its light over there," he said, pointing in a direction.
In Afghanistan, they started prepping Sharbat for surgery. "IV's in, Major. We'll get her under in no time."
"It's going to be okay, Sharbat," Syd said. "We're going to take care of you and your baby."
"Please find my brother," she said as she started to fall asleep.
Kurt came in as they took her to the OR. "Just got some intel on the brother. Looks like he's in the poppy trade."
"Well, that's probably the only way they could afford to pay the smugglers. It's not like there's any jobs here."
"I hope so. To be perfectly honest, though, the only thing I care about right now is her."
"Docs," Marquez said, running into the room. "General Rozenfeld wants to talk to you now."
"Did he say about what?" Kurt asked.
"Yeah, he's always sharing his inner thoughts with me," Marquez said sarcastically. "Hit line two before it blows up."
Syd sighed and walked over to the phone, hitting the button. "General," Kurt said before Syd could say anything.
"What the hell are you doing?" he asked through the phone. "I told you to turn that girl over and now I hear she's headed to your OR. Did you understand that was a direct order to release her? You are to stop immediately."
"Sir, this is Captain Hummel. She's actually not headed to surgery. She's in surgery with Major Jennings."
"Why the hell would you do that?" the general asked as Syd's eyes widened. "I'm going to stomp your ass so hard."
"Sir, her heart was barely beating. She could have died. I thought it was a worse situation to have an Afghan national die on our base so I started on her. Then Major Jennings had to step in and help."
"If she dies, I'm going to fry both your asses. You fix her up and get her off this base ASAP. Do you understand me?"
"Yes, sir." He watched as Syd ended the call. "Major…"
"Don't say a word," she snapped. "You just lied to a general. Get your ass in there and help."
Back at the scene of the accident, they were all still running around, trying to find Frankie. "Hey, Rach? You see that?" he asked, shining his light above him.
She ran over and shined the light next to him. "Is that a car seat?" she asked, squinting.
Back at the hospital, most of the staff was crowded around the nurses' station desk, waiting to hear word on if they found the boy. "They find him yet?" Sam asked, coming up with a clipboard in his hand.
"No," Puck said.
"They will."
"No thanks to me."
"You couldn't go man," Sam said. "You hurt your shoulder."
"I know you're trying to make me feel better, Sam, but it's not helping."
Artie looked up and saw Kitty standing on the other side of the desk. He walked over to where she was and stood next to her. "Look, I read your background. Did a lot of work on the rez clinic. Did a lot of thing that interns don't normally do until their second year. I get it. Doesn't mean you know everything."
"I never said I know everything. Is that your idea of apologizing? Because it's not very good."
"Apology? Why would I apologize? I'm just saying that I'm here to help. If you have any questions, just ask. If I'm too busy on a shift or something, we can meet before or after work—"
"Are you hitting on me?"
"What? No."
"Dude," Kitty said. "Don't hit on women in the workplace. That is so unprofessional."
"That's not even where I was going with it. I was trying…I was trying…"
"I'm messing with you," Kitty said slowly. "I had to get even with you for pranking me. I so had you."
"Yeah, for a second."
"Everybody be quiet!" Puck said, picking up the phone.
"We found him. We found the boy," one of the EMTs said.
"Alright, take him down," Finn said while they were still at the scene. "Pulse is thready and he feels hypothermic."
"He's not responding," Rachel said.
"We gotta get him in the chopper."
They lifted him up and ran towards the chopper, hoping they weren't too late to save his life.
Back in Afghanistan, Syd was starting to operate on Sharbat. "Opening the pericardium now."
"Ready with suction," Kurt said.
"Okay, retract."
"The general wants an update, Major," Marquez said, coming into the OR.
"Could go either way."
The door opened up and Sharbat's husband stormed in. "Sir, you can't come in," Marquez said.
"Give me my wife!"
"You can't do that," Syd said. "She's open on our table and you're not sterile. You need to get the hell out of here."
"Not this time."
"Tommy, call the MPs," Kurt said. "Listen," he said, turning around. "I'm getting real sick of you—" He was cut off by Sharbat's husband pointing a gun at his head.
"Give her to me."
"Why don't you just drop it," Kurt asked as he rushed forward towards her husband to try and get it out of his hands. The gun went off and they both fell to the floor.
TO BE CONTINUED