Chapter Two: Back At The Ranch
Author's Note: Here is Chapter Two of the newest installment of Pumping Blood! I apologize for the very rudimentary Spanish that is in this chapter. I took four years of French in high school and used Google Translate for help. So if it's wrong, I'm sorry. As always, I don't own Glee, The Night Shift, or any of their characters.
"Hey Finn!" Puck said at the beginning of their shift that happened to be one of Finn's first shifts back. "Listen, about Rachel…"
"Listen, we're taking it slow. Just one day at a time," Finn said, trying to reassure his best friend.
"I don't care about that. I just want to know if she plans on taking this job back."
"I don't know. I mean, I know she prefers look after patients than running the night shift but she likes being in charge. Wait, you want the job. You're starting a coup."
"No, I'm not starting a coup. I hated the job at first, but Quinn wants to stay home with the twins and I think this would make that possible."
Finn nodded and looked his best friend in the eyes. "So you're starting a coup."
"Stop saying that. That's not my intention here."
"Whatever you say," Finn said with a chuckle. "Just ask her."
"You know, I would. But I don't want it to get weird between me and her so I was hoping you would ask her. That way if she wants—"
"Whoa, whoa, whoa. I'm not getting in between the two of you," Finn said.
"Help! Help me!" someone said from the entrance of the hospital.
"Good luck with talking to Rachel," Finn said, giving Puck a pat on the shoulder before springing into action. "I need a gurney here. What happened?" Finn asked the husband as he laid her down on the gurney.
"A couple of weeks ago, I had some cattle stolen so when I heard a noise in the barn…"
"You shot her?" Finn asked.
"It was an accident! She was supposed to be at her book club. I didn't mean to shoot her; she came home early."
"What's her name?" Finn asked as he started putting on the medical gloves.
"Melissa."
"Okay, sir, I need you to stay here," Finn said, pointing to the space outside of the trauma room. "Sam, I need two large-bore IVs and lets unbundle her. Artie, let's go," Finn said.
"Stats are only at 84 percent," Sam said.
"Okay. Melissa? Can you hear me?" Finn asked. "Everything is going to be all right. Your husband is outside and he's waiting to take you home. We just need to fix you up a little bit. I need you to fight with me, okay?"
"It was a good book," Melissa wheezed.
"Yeah?" Finn said, hoping that her talking was a good thing.
"The Great Gatsby."
"Really? Tell me all about it. Keep talking to me," Finn said, checking to make sure her pupils weren't dilating at all. "I've never seen it."
"Better than the movie."
"I think we got a GSW to the left chest. Sam, open a chest tube tray and prep for a thoracotomy," Finn said, moving around the gurney.
"There's no breath sounds on the left side," Artie said from where he was standing. "It's a collapsed lung, right?"
"No, it's worse. We have a tension pneumothorax. We have a shifted trachea and extended neck vein. I need a 10 blade," Finn said to Sam. "Set up for intubation; I can't feel a pulse."
The husband, standing outside and hearing all of this, rushed in to the trauma room. "It was an accident!"
"Sam, Sam! Get him out of here."
"Sir, I know this is tough, but you have to wait outside. I know, I know," Sam said, ushering him out of the trauma room so Finn and Artie could work on saving her life.
In the lobby of the hospital, Mercedes stepped out of the elevator and almost ran into Chavez. "There you are," he said, getting off the skateboard. "We have a pancreatic tumor with our name on it."
Mercedes' eyes widened. "A pancreaticduodenectomy?"
"Yeah, but we just call it a whipple. But I love the enthusiasm. I'll see you in 30 minutes?"
"I'll grab us coffees!" Mercedes said, taking off down the hallway.
Puck was walking the hallways of the hospital when Kurt came up to him. "What's going on in there?" Kurt asked, seeing the room with Melissa in it.
"Husband accidentally shot his wife."
"If anyone can save her, it's Finn," Kurt said, giving his friend a vote of confidence.
"Don't put that kind of pressure on him. He already does enough of that himself. Why are you here on your night off?" Puck asked, watching Kurt stock up on medical supplies.
"Signed up for vet duty."
"Well aren't you dedicated."
Kurt sighed. "To be honest, I was itching to get out of the house."
"You and Blaine are still…"
"Yeah, it's just…tough right now. It's just wearing me down because he's so negative all the time and it's just hard to be around. I get it completely but it's just tough."
"You can't blame the guy. I mean, my back pain – it makes me want to punch somebody. I can't imagine if I lost my leg."
"Me neither. He just needs to see a specialist at the intrepid and then everything will be better once he gets his new prosthetic and he starts rehab."
"When's that?"
"Ah, that's the million dollar question," Kurt said. "We're waiting for a referral from this Doctor Lincoln at the VA. Could be tomorrow, could be when pigs fly."
Over the PA system, Rachel got called to the trauma room where Finn was working and she burst through the doors while tying back her hair. "Rach, good, I need another set of hands," Finn said, trauma gown covered with blood.
"Where are you?" Rachel asked, stepping behind Artie and Finn.
"Three units of blood, fiver internal defibrillations, four rounds of epi, two bicarb, still no response," Artie said.
"No cardiac activity?" Rachel asked.
"Not for the last 15 minutes."
"I'm repairing the ventricle now. If we could just clamp the aorta—" Finn said.
"Got it," Rachel said, moving around him to get in a better position. "The ventricle's shredded."
"Clamp across the artery. There," Finn said.
"Okay. Clamp is on," Rachel said. "It's not working."
"I'm done," Finn said as the heart monitor continued to beep.
"Finn, there's still no cardiac activity."
"No, I just need the paddles," Finn said. "I need two more units of blood. Clear," Finn said as he shocked the heart. "Okay good. I need saline wide open. I need five units of epi. I'm going to put it straight into her heart. Paddles again, paddles again."
"Finn," Rachel whispered. "She's gone. You need to call it."
Finn pulled the paddles out of the woman's heart and shot a glare in Rachel's direction. "Time of death, 19:05," Finn ripped off the surgical gloves and walked out of the trauma room.
"That was brutal." Artie said.
Rachel sighed. "He hasn't lost anyone in a long time." She looked out of the trauma room and saw the woman's husband start crying as Finn tried to comfort him.
After he had a little time to cool off, Rachel found him in the break room, listening to music on his phone and tossing the cue ball from the pool table. "Hey. Finn," He looked up at her and kept the headphones in. "You want some company?" Finn looked back down at his phone and Rachel sat down next to him. He took out his headphones and turned his attention to her. "You okay?"
Finn chuckled as he stood up. "I've seen a lot of people die. But you never get used to it. You learn to deal with it."
"Finn, you did everything you could."
"See, if I did everything I could, then I would have saved her. Did you see the look on her husband's face? Being responsible for someone else's death—"
Finn was cut off by the door to the break room opening. "Hey we just got a call. Ranch party outside of Yocum. High school kids, booze, and drugs. Multiple injuries. Paramedics just arrived and Santana said there's one patient she can't move. She asked for you, Finn."
"I'm on it," Finn said.
Rachel sighed and pushed herself off the couch. "Wait, Finn," She followed him out of the break room to the nurses' station. "Please remember you can only do your best."
"Let's just hope it's good enough," Finn said, grabbing the medical bag and jacket as he started walking off.
A girl wearing an evening gown and a large tiara stumbled into the hospital as Finn was leaving. "Look," Rachel said to Sam, nodding towards the girl. She bit her lip and gave her a small wave.
The girl gave her a glazed over wave back. "Can you…" she started before collapsing on the floor.
"We should probably see what that's all about," Rachel said.
"Gurney!" Sam called.
At the scene of the accident, Finn had just arrived when Santana started giving directions. "Over here and this way. Finn, follow me. Two kids pile onto the ATV and tried to outrun the cops. The driver lost control and ran into the barbed wire. I didn't know what to do but I figured you must have seen something like this in Afghanistan."
"Yeah, I did see something like this in Afghanistan. Didn't end well. We need to get this barbed wire out of him or he's going to bleed out."
"Can I get an officer to move these kids out of here, please?" Santana said, trying to give Finn as much space to work as possible. "Everybody back up."
"I need bolt cutters to get most of these barbs out. I could pull the wire trimmer and save the small bowel."
One of the drunk girls finally noticed what was going on. "Oh my God, what happened to Brian?" she asked with a laugh.
Santana rolled her eyes and turned around. "Ladies, I need you to step back and sit down, alright?" She turned her attention back to Finn. "IV is in."
"Thanks Santana," Finn looked up at the friend of the guy he was working on. "So, buddy. What's your names?"
"Terrence. And that's Brian."
"Good, Terrence. Can you hold that IV for me?"
"We took off when the cops got here," Terrence said, walking around to hold the IV bag. "I swerved when we saw the barbed wire but Brian flew straight into it."
"Let me take a look at your shoulder," Santana said. "I think you dislocated it."
"No, I don't even feel it," Terrence said. "Just fix my friend. Please."
"How long have you guys been buddies? Tell me about it," Finn said.
"We've been playing ball together since we were like eight years old. A coach from Arizona State came by to watch us play tonight."
"How'd it go?" Santana asked.
"He offered us both scholarships. All we ever wanted was to play ball in college together. And now I messed it up."
"Santana, I need some irrigation," Finn said. He turned to Brian. "Hey, I know it hurts, but you're tough as nails. Push another five of morphine."
"Brian this is going to help," Santana said as she gave him the morphine. "You're doing great, okay?" Santana looked up at Finn. "The guy in Afghanistan? He worse than this?"
"He's different. About the same age as this kid, except he had a few live RPGs in his gut."
Santana's eyes widened. "Oh my God."
"You know what he said to me? He said he was sorry for getting me into this mess. He was afraid of getting me killed."
"You must have been scared to death."
"Well, actually, the only thing I could think of was 'Well, if this goes off, there'd be nothing left of me to send home to Rachel and my mom'," Finn said as he started laughing.
"You're lucky it didn't go off," Santana said.
"Oh no, it did. I stepped away for a few seconds to talk to Puck. He was going to help me take the RPG out. Lenny Ross. Nice kid from Philly. I can still see the pimples on his chin. But, you know, there's no RPG here, right? Get another five of morphine ready."
"Standing by," Santana said.
"Hey, Puck!" Jesse said, coming up to him during one of his first shifts as a physician's assistant. "I finished all your paperwork, and I was just wondering if there's a chance I get to work on actual patients tonight. I'm not just a secretary, you know. I do have four years of med school."
Puck rolled his eyes before turning back to Jesse. "I know you have four years of medical school. You remind us every chance you get. I will get you some patients, but first, I lost my thera-strap. Could you find one for me? I need a number 10."
"Thera-strap…" Jesse said.
"You didn't study that in your four years of med school?" Puck asked. He looked up from the paperwork he was filing out. "Never mind. Hey Molly, I need a number 10 thera-strap for my back."
"Oh, okay, right away Puck," Molly said.
"No, it's fine. I'll get it. Thera-strap. Coming right up," Jesse said, smiling at the two of them before walking off.
Puck waited until Jesse was out of earshot before turning back to Molly. He smiled at her and she smiled back. "Thera-strap. It almost sounds like a real thing," she said, trying to hold back laughter.
"Just getting him back for all those years of torturing us. We've got to break this pony and put a saddle on him. You down for some hazing?" Puck asked, handing Molly a prescription for a patient.
"Oh Puck, honey, I am always down for some hazing."
"Spread the word," he whispered.
In the trauma room with the girl from the pageant, Rachel and Sam were trying to figure out what was happening to her. "BP is 90 systolic, heart rate is up to 120 and glucose is 168," Sam said, reading her labs.
"So she's not hyperglycemic but her heart rate is out of control," Rachel said, trying to figure out what's going on.
"Rachel, I have a patient, so tell me what's going on if you need me," Sam said.
"Okay thanks," Rachel said before turning to the patient. She took a deep breath, trying to remember Spanish from high school. "Hola. Como se llama?"
"Sandra."
"Sandra, Doctor Berry. Uh, por favor, puedes cambiar su vesitdo?" Rachel asked, hoping she was saying the right words.
"Oh no, I want to leave my dress on."
"You speak English, great. Well, we need to do an EKG so we're going to need you to trade this gown for this gown. Sorry. Alright, let's see what we got here. Okay Sandra, are you currently on any medication?" Rachel started listening to her heart as Sandra shook her head. Rachel's eyebrow quirked. "Are you in any pain?"
"This was a mistake, I don't know why I came here," Sandra said, sitting up from the hospital bed. "I really have to go, someone's waiting for me and he will be worried."
Joey was outside of the trauma room and heard the fuss so he came in. "Looks like someone made the evening gown round."
"Yes, this is Sandra, she came in here tachy and hypotensive and I am guessing by her attire that maybe she took some diet pills."
"Yes, yes I did for the competition," Sandra said. "And I didn't win."
"Sandra, your heart is beating way too fast so we're going to give you some fluids and give you a sedative to calm down."
"My sister used to be involved in all this pageant craziness so she's probably taken a lot of diuretics too," Joey said.
"Yeah, I'll run a metabolic panel," Rachel said, feeling like her turf was being invaded. She watched Joey walk out of the room and turned back to her patient. "Sandra, you know you don't have to look like these women in the magazines."
"But that's how you win and that's how I can get money for college."
"I get it," Rachel said, trying to be assuring. "But you still have to take care of yourself. I'll be back to check on you," she said with a soft smile.
Sandra waited until Rachel left the room before pulling out her cell phone to start texting someone.
In the waiting room, Mercedes was walking towards the elevators with two coffees in her hand. Sam walked out of a supply closet and saw here. "Mercedes, wait up," he said, jogging to catch up to her. "I noticed you were gone when I woke up this morning."
"Yeah, I just had to go back to my apartment and grab my gym stuff."
Joey saw Mercedes talking with Sam in the hallway and walked up to her. "Is this coffee for me? Great," he said, taking it out of her hands. "Chip chop, we've got work to do."
Mercedes turned back to Sam with a sheepish look on her face. "Yeah, I'm just trying to kiss some ass."
"I'm fine with kissing ass. As long as it's not literally," Sam said, making the two of them start laughing as Mercedes pushed the button for the elevator. "You know you can leave some stuff at my place," Sam said as the smile on Mercedes' face started to slip. "I'll clean out a drawer for you."
"A drawer is never just a drawer," Mercedes said. The elevator doors open and she walked into them as Jesse walked out.
"That's cool, it'll save me some time. I'll see you."
"Yeah, see you," Mercedes said with a smile.
"Wow, legs like a gazelle on that one," Jesse said as the elevator doors closed and he started walking away.
"Th-that's incredibly inappropriate."
"I'm not the boss anymore. I am a physician's assistant now," Jesse said as the door behind him opened. Kurt saw that Jesse was standing there and ushered the man back inside before he could see what was going on.
"Emphasis on the word assistant," Sam said, trying to turn Jesse's attention away from the door. "Puck's looking for you," Sam said before he started walking away.
Jesse silently cursed himself. "Thera-strap."
In the room with the vets, Kurt was tapping on a woman's face. "You have a sinus infection. I'll write you a prescription for Augmentin. Take it two times a day for ten days and use the nasal spray at bed time." He felt his phone start to vibrate in his pocket and pulled it out. "Excuse me," Kurt said, seeing it was a call from Blaine. "Hey. I know the Vicodin makes you nauseous. That's why you should take the Zofran." Kurt sighed. "No, his office hasn't called. Blaine, it's the middle of the night. His office is closed and I can't make him call me. Okay. I love you too. I gotta go," Kurt said, hanging up the phone. He turned back to the vets and sighed. "Does anyone know a Doctor Lincoln at the VA?"
"He's my friend's doc," one of the patients said. "She calls him Doctor Black Hole. It took six months for her to get a referral for a podiatrist."
"Did she try changing primary physicians?"
"She tried but they told her she'd go to the back of the line."
"Great," Kurt said.
Back at the ranch, they were working on getting Brian to the ambulance to take him back to the hospital. "Damn it," Finn said. "Barbs are imbedded too deeply in this section of the small bowel. Every time I try to cut the ends, he bleeds."
"Let's get him to the hospital. Get me a board," Santana said to the other paramedics. "The bleeding's getting worse. We're losing him."
"He's not going to make it like this. I have to stop the bleeding. Let's get him into the ambulance and I'll start the surgery."
"You want to do surgery in the ambulance?" Santana asked incredulously.
"No, but it's that or he dies," Finn said as they loaded him in.
"He's got a pulse and shallow breathing," Santana said, informing the paramedics for the ambulance.
"Let's go," Finn said, climbing into the ambulance with Terrence right behind him. "We need to get him on high flow oxygen. Damn it, he's hemorrhaging. I can't figure out what's bleeding."
"So what do we do?" Santana asked.
"It's his iliac artery. Hand me my suture kit. I need something to clamp the distal and the proximal to the tear."
"Hemostats?"
"Yeah, place them right there. See, there's the laceration."
Back at the hospital, Rachel went into the trauma room to check up on Sandra. "Hey Sandra. How're you feeling?" She looked at her blankly. "Okay. Well, just so you know, I did some research online and I found a few organizations where you can apply for college scholarships and—"
"You don't know anything about my life," Sandra said, cutting her off.
"You're right, I don't. I just—"
"You're just a rich, pretty, American doctor. You don't know me or what I have to do. So don't pretend like you can come in here—"
"Her heart rate is up in the 150s," Sam said, turning to Rachel.
"That's really strange. She's gotten worse with the benzos." Rachel took her stethoscope off from around her neck and put it to Sandra's heart. "She's in atrial fibrillation. Sam, bolus her five of metoprolol. Sandra, we're going to give you new medication. Sorry that I meddled."
"All set," Sam said when he got the medicine added to the IV.
"Okay, let's check on her every 15 minutes," Rachel said as she left the trauma room.
In the lobby, Puck was making an announcement to everyone coming in from the ranch party. "Ladies and gentlemen, welcome to our PSA on how not to party. These guys are tripping out on 'shrooms, this guy fell off a barn hiding from the cops and has blunt head trauma and open forearm fracture. These girls are blind drunk, someone get the vomit buckets. I want 'shrooms in three, drunkies in exam one and two, Artie, you're on broken arm anywhere that's open. Ah, Jesse," Puck said, holding out an arm to stop him. "It's your moment to shine. Forget about the thera-strap for now. Place some IV and hang some fluids."
"I am all over it. Oh, Puck, I should order tox screens and alcohol levels too, right?"
"Gold star for you."
"I need a trauma panel and four units of O-negative. Molly, notify Doctor Chavez and tell him he has an emergency case. I repaired the iliac but he needs a formal laparotomy. Push two grams of cefotetan," Finn said, coming into the hospital.
"Good job out there, Finn," Santana said, handing him some papers.
"What's happening, is he getting operated on?" Terrence asked Finn.
"Yeah, they're just prepping for the OR. Don't worry about it."
"It's all my fault. I dragged him to the party."
"Are you telling me that he had no interesting in partying with hot chicks and he just wanted to stay home and play chess? We have our top surgeon working on it. He'll be fine, I promise."
"Can't you do it?" Terrence asked.
"No. It's not my job." Finn said, signing the paperwork from Santana. He handed it to one of the nurses and turned back to Terrence. "Look, if it makes you feel better, I'll go keep an eye on him. Yeah?" Finn looked around the ER. "This is Sam," he said, gesturing for Sam to come over. "He's going to look after you and set you for your shoulder."
"Terrence, right? I've been to a couple of your games. My little cousin's on the team. Ray Evans?"
"Ray Ray? He's one of my best linebackers."
"He's alright, but you…you're the man."
"Thanks," Terrence said. "Ray said something about you. You played in college, right?"
"Yeah, something like that." Sam said, leading him into an exam room.
"Too bad you're old now," Terrence said with a slight chuckle. "Think you could still play? You look to be in okay shape."
"Okay? Don't let the scrubs fool you," Sam pulled him his scrubs top to show Terrence his abs. "You can crack an egg on these bad boys." Sam laughed as he dropped the top. "Look, I have to finish up some paperwork then I'll be back in a second. Sound good?"
Back at the nurses' station, Rachel was doing some paperwork and Puck was coming up to talk to her. "So, what's the story with the beauty queen?"
"She's in a-fib. I have her on beta blockers to rate control. I also managed to insult her by giving her advice that she certainly didn't ask for nor am I qualified to give."
"Well that's what you're good at," Puck said before realizing what he'd said. "Giving advice. I mean, you're not afraid to…I'm gonna go back to my reports."
"So, what's the deal with that? Every time I look up, you're buried in paperwork," Rachel said, gesturing to the growing pile on the desk.
"You know, it really sucks. You are going to hate it. When they didn't replace Jesse, all this work fell on me. And eventually you. You know, when you…you take your job back."
Rachel gave Puck a weird look and saw an opportunity to escape when she saw Kurt walking by. "Kurt! I didn't know you were here tonight," Rachel said, brushing past Puck.
"Yeah, working with the vets. That's the seventh time Blaine has called me. I don't even know what to say to him anymore. I can't force his VA doctor to see him."
"It's a mess over there."
"And it's driving me crazy. I'm a problem solver. I'm the guy who builds your IKEA furniture, I figure out what's wrong with your car, but the stuff with Blaine…I don't know how to fix."
"He probably wants you to be there for him," Rachel said. "Like a shoulder to cry on." Rachel's pager went off and she fished it out of her pocket and sighed. "It's my beauty queen. I'm sorry. Why don't you have breakfast with us after the shift? We'll work it out."
In the room with the two drunk girls, Jesse was trying to stick an IV in one of their arms. "I don't understand," she said, looking at what Jesse was doing.
"What are you doing?" Molly said, coming into the exam room.
"Starting an IV," Jesse said as if it were the simplest thing in the world.
"No, you're stabbing this girl all over the place. You're lucky she's too drunk to know the difference. Give me that." Molly said, taking the needle from Jesse.
"I'm not drunk," the girl slurred
"Of course. That's right baby," Molly said.
"What's going on in here?" Artie asked as he walked in.
"Jesse's slashing this girl like Jason from Halloween."
"It wasn't that bad," Jesse said.
"I love Halloween," the drunk girl said from bed.
"Well, if you want, I can show you," Artie said. "Molly, I got it."
"Bye Molly. I'll miss you."
"So, my trick is, here you go," Artie said, handing the girl a soft ball to squeeze. "I have them squeeze the ball."
"That's what she said."
"No, you mean that's what he said," the other drunk girl said.
Back in Sandra's trauma room, Rachel was trying to get up to speed. "What's wrong?"
"She got three liters of saline and two rounds of metoprolol but her heart rate keeps going up."
"Okay, get me another EKG and start her on amiodarone."
In another exam room, Puck was doing an ultrasound on an expectant mother. "Everything's great. Baby's heartbeat is fine. I think you're just having a little indigestion." He heard the door open and turned around to see Jesse. "Hey. Becca, this is Jesse. Do you need something?"
"I've done five IVs, ordered tox screens on everybody, cleaned up a lot of vomit."
"But still no thera-strap?"
"No. PT says they need to order it."
"They always say that," Puck said.
"It's just…when you gave me this job, you said I'd be doing medicine."
"Well, that list you gave me seems pretty substantial for a physician's assistant. I mean, five IVs means five patients. Why don't you be responsible for them and check their blood work?"
Jesse nodded. "Right."
Puck listened for the door to shut and turned his attention back to the patient. "We love messing with that guy."
In Brian's trauma room, he was still getting prepped for surgery. "Antibiotics are running in," the nurse said.
"Good. Blood pressure's up to 90 over 45. That's good news."
"I heard you performed an iliac repair in a moving ambulance," Chavez said to Finn when he got to the trauma room. "That's very impressive."
"It wasn't my first choice but the packing wasn't slowing down the bleeding."
"So he would have bled out. It was a good call," Chavez took a look at the wound on the patient. "I can work with that. Let's get him to the OR."
"I'll be right behind you," Finn said, working on getting the bed rails put up to move the patient to the OR.
"You wanna observe?" Chavez asked, slightly confused as to what was going on.
"Oh no. I'm gonna help you out."
"Heather, let's get Brian prepped for surgery and I'll be right behind you," Chavez said to the nurse. He waited until Heather left the room before turning back to Finn. "I heard about how you banged heads with Brody. I know you even fought."
"Well, I wouldn't listen to what he says about me," Finn said.
"No, I know it's personal. Guy moves down here to be with his girlfriend only to find out she's in love with her old boyfriend? I mean, I'd be pissed too."
"Is there a point here?" Finn asked.
"The point is, that's not our history. We have more in common. We both served, we both saw some things we wish we didn't see…I just like to think we have a bond in that."
"Is this your way of telling me you don't want me in the OR?"
"Nope. I just don't want the usual ER/surgery conflict. You're welcome to come up there anytime. You just have to respect that I'm in charge, just like I respect that you're in charge down here. You trust my leadership the way I trust yours," Chavez said.
"Hey, Finn," Sam said from the door to the trauma room. "You got a sec? Rachel needs you."
"Yeah," Finn said, winking at his friend.
"See, there's already not enough of you to go around," Chavez said with a slight laugh. "Come on up if you're able to."
When Finn got to the trauma room, things weren't going well with Sandra. "I have a young healthy female in a-fib. Cardiac markers and electrolytes look normal. She's been given three rounds of beta blockers plus amiodarone and she's just getting worse," Rachel said.
"Look at her BP," Finn said.
"I know. That's after 15 metoprolol. It doesn't make any sense," Rachel said as she started to pump oxygen for Sandra.
Finn pulled back her blankets. "Hey, Rach?"
Rachel looked down and saw all the blood. "What? There was no chest trauma."
"Let's go. Strip and flip," Finn said to Sam.
"Sandra, we're going to figure out what's going on with you," Rachel said. She looked at Sandra's chest once the hospital gown was off. "Are those implants? God, they look like they were done by a butcher."
"Bargain basement cosmetic surgery." Finn said.
"Implants shouldn't make her this sick, this fast."
"Is she getting septic?" Finn asked.
"She doesn't have a fever and her blood pressure is going up, not down," Rachel said. "She's seizing. Give me a bite block," Rachel said.
"Grab at least 10 milligrams of diazepam," Finn said to Sam as he left the trauma room.
"Stats are dropping. Hand me a non-rebreather," Rachel said.
"Hey, Rach, there's something in there," Finn said.
Rachel got the mask on her and looked. "Oh my God."
"She's crashing," Finn said.
"Push the diazepam. We need to get whatever's inside of her out now," Rachel said.
"Diazepam going in," Sam said.
"Scalpel," Rachel said. She cut along the suture lines that were still there. She pulled something out and handed it to Finn. "That is not an implant."
"Is that cocaine?" Sam asked.
"Yeah. Must have leaked into her system," Finn said. "That explains the crazy vitals. She's got a highway of cocaine flowing into her bloodstream."
"Give her IV phentolamine," Rachel said, trying to get more of the cocaine out. "This explains why the beta blockers were making her worse. Who the hell would do this to her?"
"BP is coming down."
"Finally," Rachel sighed.
"What happened to the good ole days of just hiding drugs up your butt?" Sam asked. Both Rachel and Finn gave him weird looks.
Jesse walked into the exam room with the two drunk girls and turned off the lights. "Ooohhh," one of them said.
"Shut up," Jesse said.
"What the hell are you doing now?" Molly asked.
"I just got the girls' blood work back. Their alcohol level is zero, but there's an anion gap acidosis. Look at them. They're completely wasted. Check this out," Jesse said, flashing a UV light on the urine same.
"Damn," Molly said. "That is weird."
"See how the urine glows?"
"How's it going?" Artie said, coming into the room.
"Jesse's a pee detective now."
"See this?" Jesse said. "I think it's antifreeze. I bet they made their own moonshine. Our alcohol test only checks for ethanol, but antifreeze has ethylene glycol which would explain the acidosis."
"So you're a toxicologist now?" Artie said.
"No. We just covered toxic alcohols in my board review class if you must know."
One of the monitors started beeping like crazy. "Whoa," Artie said. "They're both crashing. Molly, get Puck."
"There you are." Finn said a little bit later, finding Rachel in the break room. "What are you doing?"
Rachel was hanging off one of the couches while eating a bag of Doritos. "I used to do this all the time in college when the answer was right in front of me and didn't think of it. Just ask Santana."
Finn chuckled to himself and went over to the couch. He sat down next to Rachel's feet. She sat up and extended the bag of Doritos towards him. "Where'd you find these? I thought the Doritos were all out."
"They are. I buy large bags of them and leave them in random places," she said, biting into one of the chips. "Don't tell anyone."
"I wouldn't dream of it," Finn said, taking a handful and putting them all into his mouth at once.
"That's disgusting," Rachel said as she started laughing. "Finn, I'm sorry about your patient earlier. I probably could have handled that a little better."
"Yeah, well I probably could have done the same. It just hit hard, you know?"
Rachel frowned and pushed a lock of hair out of his eyes. "Yeah, I do," She ran her hand down his cheek and gave him a quick kiss. "I shouldn't hang off the couch for so long. I'm a little dizzy now."
"And here I thought it was because you're in my presence," Finn said with a smirk. He heard his pager go off and brushed the cheese dust from the Doritos off his hands. "Puck needs me. You going to be okay?"
"I'm fine. I could be asking you the same thing," Rachel said.
"I'm fine too. I'll see you later, okay?" Finn said, standing up. He pressed a quick kiss to her head and left.
Rachel watched him walk off and stuck another Dorito in her mouth.
After Finn's talk with Rachel, he met up with Puck in the exam room. "You needed me?"
"Yeah, I need you to help me put this shoulder back in. Lie back, Terrence. This is a tough kid," Puck said. "He doesn't want to take a sedative for this procedure."
"You're going to regret that," Finn said, taking the dislocated shoulder while Puck wrapped a blanket around Terrence's chest.
"Heard it was crazy out there," Puck said.
"Like Lenny Ross without the RPG." Finn said.
"Oh wow, Lenny Ross. He'd be like, what, 28 by now?"
"Something like that. Okay Terrence. Puck's gonna brace you and I'm gonna pop your shoulder back in. You should have seen this kid out there, Puck. Really held it together for his buddy," Finn said, twisting his arm to get his shoulder back into socket.
"You okay?" Puck asked.
"Think so. Can I see Brian now?"
"No yet. He's still up in surgery." Puck said.
"I'll check in on him soon," Finn said. "You'll be in rehab for a few weeks and be in a sling but then you'll be good as new and ready to kick ass as ASU next year."
"Great, more reason for you to bet," Puck said with a joking tone in his voice. "This guy is out of control," Puck said, turning back to Terrence.
"I gotta give Finn props. He did a pretty good job considering the guy was ripped up by barbed wire," Chavez said to Mercedes in the OR.
"Well he was an Army doc. He's used to doing whatever it takes," Mercedes said.
"That's the problem with battlefield docs. They think they can do anything."
"Aren't you a battlefield doc?"
"I used to be," Chavez said, correcting her. "I used to be a lot of things. But, I want to know more about Doctor Mercedes Jones. No boyfriend, wants to be in emergency medicine, Dad's a doctor, both went to Harvard. How I'm doing?"
"I went to Stanford," Mercedes said with a smile. "On scholarship. And my father installs air conditioning systems, thank you very much."
"I stand corrected."
"And, uh, I wanted to be a doctor since I was nine."
"What, your hamster die and you couldn't save him?" Chavez said as he started laughing.
"My mother died of breast cancer," Mercedes said flatly, making Chavez immediately stop laughing.
"I'm sorry. I didn't know that. You had the genetic screening, right?"
"Uh, no," Mercedes said, started to get a little flustered.
"You should get that done. For all the people that care about you."
"Yeah well I've been a little busy," Mercedes snapped.
"For 20 years? What are you waiting for?" Chavez asked.
"Hey bud," Sam said to Kurt, meeting up with him at the nurses' station.
"Hey," Kurt said, not taking his eyes off the computer screen. "You know, it's amazing what you can find out about people on the internet."
"People post all kinds of weird stuff," Sam said, working on some paperwork. "What are you looking at? Anything juicy?"
"Just found the home address of Blaine's VA doctor. I'm gonna pay him a visit tonight and make him sign Blaine's referral request. And if that doesn't work, I found the name of his kid, so I'm just gonna call him and pretend he had an accident. Then he'll come down to the hospital and I'll make him sign them here."
"Yeah, that's great idea. When you get arrested for assault and battery, will you sell me your condo? Wait, no. You'll probably be dead from him shooting you."
"He wouldn't shoot me."
"What, are you new? Come on, let's take a walk. Now," Sam said.
Back in the exam room, the monitors were still beeping like crazy. "They have a wide anion gap acidosis," Puck said.
"So is it possible they drank the antifreeze?" Molly asked.
"It's very possible. They're in renal failure. Get me IV of fomepizole."
"We don't carry that in the ER," Jesse said.
"I can page a central pharmacy tech but it's going to take over an hour," Molly said.
"There's no time. We need beer," Puck said.
"Beer?" Artie asked.
"Jesse, someone has to have beer in their trunk. This is Texas. Go ask," Puck said.
Back in the lobby, Kurt and Sam were walking and talking. "Look, I know how you feel, okay? Me and my mom took care of my grandma. God knows I loved that woman like nobody's business. I mean, she was everything to me. But it was hard and nasty. No one prepares you for what it's like taking care of a sick family member. It makes you crazy, and right now, you're crazy," Sam said.
Kurt sighed. "Maybe it's not the best plan."
"It's a stupid plan."
"It's not a stu—"
"It's a stupid plan. You need to chill. You need to take care of yourself first. It's like you're on an airplane and they tell you to put your oxygen mask on first and then take care of your kid. Because if something happens to you, then what happens to them?"
"Did you just come up with that?"
"Maybe."
"That was good."
"Hey, Ray Ray's uncle?" Terrence said, coming up to Kurt and Sam. "Any chance I can get some more of those pain killers?"
"What's wrong?" Sam asked.
"I have a real bad headache and—" he leaned over and threw up and crashed to the ground. Sam and Kurt went over to make sure everything with him was okay. "Get Finn," Sam said to one of the nurses.
"Everybody swears he doesn't drink or do drugs," Sam said when he got back to the trauma room.
"They're right," Finn said, doing an exam on Terrence. "He's got increased pressure on his brain but no sign of trauma."
"He had a game earlier today. He plays running back. He's probably been hit on the head 50 times. Maybe it's a concussion," Sam said.
"Yeah, but one concussion wouldn't do this to him." Kurt said.
"It could be second impact syndrome. If he had a concussion and didn't have time to recover from it, the hits he took today would explain the swelling from a hematoma," Finn said. "Push 100 grams of mannitol."
"Why would they play him if he's still recovering?" nurse Heather asked.
"This kid's an all star. He's never coming out of the game. Probably wouldn't tell them either since he's going for a scholarship," Sam said.
"Right pupil is dilating, call neurosurgery to get him up there," Finn said.
"He's posturing," Kurt said.
"His brain's already herniating. He needs a Burr hole to drain the hematoma," Finn said as they worked on getting the hospital bed flat. "Scalpel."
"This is nurse Sam Evans in the ER. I need neurosurgery. Doctor Johnson. It's 911," Sam said as Finn started drilling into Terrence's skull.
"I'm almost throw," Finn said, drilling a little more. "Okay, that should do it."
"Neurosurgeon is 15 minutes out."
"We need to get him to the OR now." Finn said as Sam took the brakes off the bed and they started running to the elevators.
In the other exam rooms, Puck and Jesse were injecting beer into the IVs to give to the drunk girls. "The alcohol competes with the ethylene glycol for the receptors," Puck said.
"Which stops the toxic conversion," Artie finished.
"Yeah, and it's a good excuse to always have a six-pack in your trunk. Good catch Molly." Puck said as Jesse's eyes narrowed.
"What?"
"Yeah, Molly said she's brushing up on her toxicology and figured it all out," Puck said.
"I got lucky I guess," Molly said.
"That wasn't luck; that was knowledge." Puck said, enjoying the look of disgust on Jesse's face. "You've got a bright future, Molly. Now, how are you doing?" Puck asked, turning back to the patient. "Do you have a bright future?" She gave him a drowsy thumbs up. "Good. Jesse, I'd watch out for this one. She might be gunning for your job."
Molly smirked at him as her and Puck walked out of the exam room and Jesse turned to Artie. "Did that really just happen?"
"Yeah. Sorry about that. You know, a thera-strap…it's not really a thing. But you didn't hear that from me," Artie said.
Back in the trauma room with Sandra, Rachel was talking to her. "I heard you were asking for food, but unfortunately we can't let you eat until after the plastic surgeon fixes your sutures. Just try not to move around too much."
"Are you going to call the police?" Sandra asked weakly from the bed.
Rachel sighed. "I had to. I'm sorry. All you have to do is just tell them what happened." Rachel smiled at her and started walking away. "I'm going to say this because I just can't help myself." She turned around and walked back towards Sandra. "If you need a lawyer, I have a friend and she owes me a favor. I could talk to her and I'm sure she could take your case for free."
"Thank you. I know you're just trying to help."
"I'm gonna go call her," Rachel said.
Finn was walking the corridors with one of the nurses after getting Terrence to surgery. "Just keep me updated on his condition and let me know when his parents get here. I'm gonna check on his buddy Brian."
He walked into the OR and saw Joey and Mercedes working on Brian, seeming like they had everything under control. At least until the monitors started beeping like crazy. "Belly's filling," Joey said.
"He's getting tachy," Mercedes said, looking at the heart monitor.
"What's happening?" Finn said, coming into the OR.
"We don't know. We're trying to figure it out," Joey said.
"I'm scrubbing in."
"I'd be shocked if you didn't."
Back at the nurses' station, Jesse slammed a plunger down on the paperwork Puck was working on. "I found your thera-strap. Number 10. Hope you enjoy it and I hope everyone had a good laugh," Jesse said.
"We did have a good laugh," Molly said, not bothering to hold back her laughter anymore.
"Tell him the save was my idea," Jesse said.
"She gave you credit right from the top," Puck said with a smile on his face. "This is a big team, Jesse. We're just trying to help you fit in."
Jesse curtly nodded and walked off.
"Sandra, I—" Rachel said, walking into the trauma room where Sandra was. Only Sandra wasn't there and the bed sheets were crumpled at the edge of the bed. Rachel walked in and saw the hospital gown and the pads to stop the bleeding tossed on the floor. "Oh my God."
In the OR, Finn and Joey were talking and getting to know each other a little better. "It's been one of those nights. I must have been sloppy, suturing in the ambulance."
"You stopped the bleeding, you just accidentally cut off the blood flow."
"I screwed up, I should have just repacked the abdomen."
"Finn, I know vascular surgeons that have made the same mistake. And they didn't have the excuse of being in a moving ambulance. I just need to cut the suture and it'll pink right up. Trust me. Let's get the bowel reperfused," Joey said.
"More Motown? Do you ever listen to anything else?" Mercedes asked as the music kept playing in the OR.
"Not when I'm working," Joey said.
"It's not so bad," Finn said.
"Okay, needle driver to Doctor Hudson," Joey said with a nod.
Back in the lobby the elevator opened and Molly stepped out. "Anything?" Rachel asked.
"Nothing."
"Molly!" Rachel called, walking around the nurses' station. She looked down at a blood trail and started opening the doors around to see if she could find Sandra. The two of them followed the blood trail to the nursery, where they found bloody handprints on the door. Rachel pushed the door open and saw Sandra curled up on the floor. "Honey, let me see you," Rachel said. She gently took one of Sandra's hands and pulled it away from her chest. It was covered in blood. "You tore your stitches. Molly, can you get a gurney please?" She took a deep breath. "Honey, I don't know your life, but I know that running away is not going to help you."
"He said he would take those things out but I started to get sick in the car ride on the way to the place. And they pushed me out on the street corner and now I'm going to jail." Sandra said as she started to cry.
"He's your boyfriend, isn't he?" Rachel took her silence as confirmation. "Here's how I see it. He let someone mutilate your body, he asked you to commit a crime for him, and then he left you alone to die. You don't deserve this. You're going to be okay," Rachel said, pushing the hair back from Sandra's face.
After Brian's surgery, Finn and Joey were coming out of the OR. "Great job in there," Finn said.
"Thanks. But you saved his life. All we did was a bit of housekeeping," Joey said, taking off the trauma gown and his surgical gloves.
"It was more than that. Thanks for letting me assist."
"Thanks for pissing Brody off and opening up this job for me," Joey said with a slight laugh.
"No problem on that one. I'm gonna go talk to the mom," Finn said, taking off the gloves and walking away.
"That was nice of you," Mercedes said.
"I heard he lost a patient earlier. I used to know a lot of guys like him. Hell, I used to be like him. Take losses pretty hard. I'm just trying not to be a dick. That's my mantra."
"I think you and Finn have a budding bromance," Mercedes said as they started walking. "He clearly likes you."
"He's not the one I'm concerned about liking me," Joey said, making Mercedes' eyes widen. "Don't panic, I wasn't talking about you. I was thinking about asking Rachel out. I don't think the two of them are right for each other."
"You know, um, I'm not sure that—" Mercedes stuttered.
Joey cut her off with him laughing. "Look at your face. I got you."
"Oh my God," Mercedes said, rolling her eyes. "It was just for a second."
"It still counts," Joey said. "I'll see you later. Oh, for the coffee next time, no sugar. It's the silent killer." He pushed open the doors to the OR floor and left.
Back at the nurses' station, Jesse came up with a box and Rachel stood next to Puck while they both worked on paperwork. "Present for you," she said, laying another file folder on Puck's already massive pile.
"Thanks a lot."
"No problem."
"How'd it work out with the runaway beauty queen?"
"We'll see. I'm not too optimistic about her future if that's her taste in men. What about you? How you feeling? Ready to leave the desk work behind?"
"I'm definitely feeling better but being the boss does not suck."
Rachel tucked a piece of hair behind her ear and turned to face Puck. "You've been hinting at something all night. What gives?"
"We've known each other for a long time. I just don't want things to get weird between us."
Rachel raised an eyebrow. "You want to keep the job. Is that it?"
"Not if…not if you want it."
"You're saying you only want it if I don't want it." Rachel asked, trying to get to the bottom of this.
"I don't want it if you…let's do this. Count of three, we both say what we want. Okay? One, two, three. I want the job," Puck said.
"I don't want it," Rachel said, a smile appearing on her face. "Congratulations, you're the boss."
"I'm so glad we got to work this out like grownups."
"Definitely," Rachel said. "Oh, Puck? Why do you have a plunger?"
"Well, this used to be a plunger. Now…it's a scepter!" Puck said, raising it like a sword.
"Oh boy. Word of advice: don't let the power go to your head."
"It is too late, my friend," Puck said, tripping over something. He looked down and noticed a bunch of bedpans chained to his leg. "Very funny. Prank the boss."
"Wasn't me," Rachel said before she started walking away.
"I wonder who did that," Sam said.
"Oh yes, I wonder," Jesse said.
"Wait, you did that? It's not bad," Sam said, giving him a high five. His eyes widened when he saw a "Kick Me" sign tapped to the back of Molly's scrubs.
"That was me too," Jesse said, smiling after his work. "I can play just as hard as they can."
"I'd keep that quiet. Nobody messes with Molly."
Finn walked into Terrence's hospital room. "How are you doing?"
"Didn't you hear? They say I'll never be able to play ball again."
"I did hear. It's a tough break."
"You think? They told me Brian's gonna be fine."
"He'll make a full recovery. And you helped with that. I'm sorry. I wish you could—"
"Hey, Finn, I got this one," Sam said, coming into the recovery room. Finn nodded and Sam came into the room. "You know, I've been where you are. I have a five-star recruit, all American, 20 some odd scholarships…"
"I don't want to hear about your stupid glory days," Terrence said.
"That's true. My glory days. My glory days ended my freshmen year when I fractured my back in training camp. Never got to play a game. I spent an entire year in traction so trust me, I do get where you're coming from."
"Great. So this is what I have to look forward to. Being a nurse. Maybe I can clean some bed pans."
"I'm sorry. You may not want to talk right now, and I get that. If you change your mind, and want to talk about anything at all, I'm around. I'll let you get some rest and I'll check on you later. Just don't forget what I said."
At the end of the shift, Santana came up to Rachel at the nurses' station. "Please tell me you're done with those forms. I had 10 runs in four hours and I need food."
Rachel put her pen down and looked for something. "Here you go, darling. Put this in your piehole and give me another minute."
"I'm not a huge fan of cranberry," Santana said, looking at the wrapper.
"Eat it." Rachel said.
Finn came out from an exam room and walked over to where Rachel was. "Hey, you up for breakfast?" Rachel asked, putting her hand over Finn's.
"Not today," Finn said, giving her a kiss on the forehead. "I just need to be on my own for a little bit. I'll call you later."
"You sure you're all right?" Rachel asked in a concerned voice.
"Yeah, I just keep thinking about the woman I lost today."
"Worst part of the job."
"I'll be okay," Finn said, tapping the desk. "I promise." Finn said, holding out his knuckles for Rachel to tap.
Mercedes walked into the break room at the end of the shift to get her stuff. "So, that kid brought back some memories, huh?"
"Oh yeah. So much I wanted to tell him. He's just not ready to hear it yet."
"Like what?"
Sam shrugged. "Nothing big. Some little stuff."
"You can tell me. Like what?" Mercedes said.
"Well, when they told me I couldn't play anymore, I thought my life was over. But it wasn't. Before I got hurt, I thought nurses just cleaned up after patients. But they were so much more. I was lucky if I saw the doctor once a day. It was the nurses that took care of me. The nurses talk me to walk away. They make the hospital run. That's why I became one. So, in a weird way, that accident was the best thing that ever happened to me."
"Why haven't you ever told me this?"
"I don't know. Maybe because you never tell me anything personal about yourself. Just keeping it light."
Kurt ran into the break room and wrapped his arms around Mercedes. "Let me guess, you got a call from the intrepid?" Mercedes asked with a smile.
"Blaine has an appointment on Tuesday. How the hell did you pull that off?"
"I found out this guy I went to med school with is on staff there and he's doing me a solid."
"You guys must have been really tight."
"Yeah, we were…" Mercedes trailed off, looking back at Sam. "Yeah. But you are so very welcome," Mercedes said, giving him another hug.
"I love you, Mercedes Jones," Kurt said.
"Love you too," Mercedes said, watching Kurt run off again.
Puck shut the fridge in the break room as he was talking to Quinn. "That's right, you're still talking to the boss. So you can stay home with the kids. What do you mean? I thought that's what you wanted." Puck said, walking out of the break room.
Across town, Finn was sitting in a bar with a beer in front of him. "Are you going to drink that or stare at it all day, Finn?" the bartender asked.
"Can I just get a cup of coffee?"
"Coming right up," he said, taking the beer away. "You look like you had a rough night. Wanna talk about it?"
"Nope. Just want to read my book if you don't mind me sitting here for awhile. Not drinking."
"Sit all you want. The Great Gatsby? That's a good one. Better than the movie."
"So I've heard," Finn said with a small smile.