Chapter Eight: Best Laid Plans
Before the shift started, the guys of the night shift were working out together to blow off some steam before the shift starts.
"Alright, Mayweather, where'd you learn to punch like that?" Kurt asked Jesse as they were working on MMA punches together.
"Golden Gloves. From eight to eighteen," Jesse said, wiping the sweat from his forehead.
"You guys need to come chew some of this iron," Sam said where he was lifting weights. "You need some grown man muscles, not those "Body by Jake cardio-kickboxing" bodies you all have."
"Is that right?" Finn said from where he was running on a treadmill.
"Yeah, that's right. Look, I don't mess with any of that zumba, pilates, spin BS. This is a grown ass man workout. And for real, I'm gonna start charging you all for this. People should have to pay to see this," Sam said, gesturing to his abs.
"You know, I think you're right," Finn said.
"Thank you," Sam said. The smile on his face quickly faded as Finn, Jesse, Kurt and Artie piled on top of him.
Outside in the lobby, Rachel and Santana had just arrived and were talking before Santana would get called out on a run. "Have you told Finn you want to move?"
"Yeah. But you know Finn, I mean, he's not a real planner, he's more go with flow."
The two of them stopped walking when they heard cheers coming from one of the break rooms and shared a look with each other. They had to know what was going on in there.
Rachel opened the door to reveal Sam, trying to cover himself with a chair as Artie held onto his shorts.
"Ladies, ladies," Finn said, pulling some money out of his shorts pockets. "Sam says we have to pay to display so this one's on me." Finn started tossing some of the money towards Sam as Artie taunted him with his shorts.
"Give me my shorts," Sam said through gritted teeth.
"What, you mean these?" Artie asked, looking down at the shorts in his hands.
"I swear to god, I will kill you," Sam said as Artie started swinging them around in the air.
Puck held up his phone and started taking pictures to commemorate the moment. "Finn, strike a pose," Puck said, continuing to take pictures. He turned to face Rachel and Santana. "If HR asks, I was not here."
"Not a word," Rachel said. She turned her attention to Santana. "So, uh, you wanna take a closer look?"
Santana shrugged. "I'm good. Nothing I haven't seen."
Rachel's eyes widened as she bumped hips with her best friend. "Oh, you naughty girl."
"I didn't mean to. It just got heated and I hadn't had any in like a year so…" Santana trailed off as they watched Sam try to get his shorts back. "I really wish I hadn't because I don't want him to see me as just a hook up, you know?"
"Oh come on, you know it's not…oh, hey Mercedes," Rachel said, turning around to see Mercedes come into the room.
"Hey Rachel. Santana," Mercedes said, pushing her way past people.
"You think she heard that?" Rachel asked.
"I'm so glad everyone's having a good time," Sam said.
"Hey, guys," Molly said, coming into the room. "Shift starts in five minutes and we already have incoming. Come on, let's go."
There were some grumblings all around as people started filing out of the break room and into the lobby. Artie tossed Sam's shorts to Finn. "Gimme, gimme the shorts," Sam said, reaching over the chair to try and get them.
Finn held the shorts at arm's length as he started walking out of the room. He dropped them a few feet away from where Sam was standing.
"What's your name, sir?" Rachel asked, receiving the first trauma of the night.
"Christian Boone. Just call me Boone. I'm just having a little trouble breathing."
"All right. Well, we're gonna take good care of you. Can you hop on over here?" Rachel asked, rolling the gurney right next to the hospital bed as Finn helped him get onto the hospital bed. "Are you having any chest pain?"
"Yeah, a little."
"Well, we'll run a few tests and see what's going on with you," Rachel said, taking the stethoscope off from around her neck. "Molly, can we get a blood panel, CBC and an EKG?"
Out at the nurses' station, Jesse was coming up to Puck, who was looking at something on his phone.
"You gonna post those photos?" Jesse asked.
"You know I am," Puck said, unable to hold back his laughter. "I love this phone. It takes amazing pictures. I got Beth the same one as a reward for getting straight A's last semester."
"Lucky you," Jesse said dejectedly. "My son's favorite subjects are lunch and recess. I don't see a scholarship in our future. Or a phone in his."
"Puck?" Jocelyn said. "You've got a call."
"Yeah. Jesse, you need parenting advice, you know where to find me," Puck said before walking over to the phone on the desk. "Father of the year. Thanks, Jocelyn," Puck said, taking the phone from her.
"Secret texts from your girlfriend?" Mercedes asked Artie, coming up to meet him outside of the break room.
"Oh, nothing like that. It's the father of my patient that just passed – Oren."
"I'm so sorry. That was the radiation guy, right? He was so sweet."
"Yeah," Artie said, pouring himself a cup of coffee. "Anyways, that's part of the job, right? Have to move on."
"Still doesn't make it any easier. So, are you ready for your surgical rotation?"
"Yeah, I've been studying hard," Artie said, scratching his forehead. "I have to keep up the family name, or so my dad says."
"Brody said your dad's already called three times to find out what you're doing."
"Yeah, and it'll be 20 before the week's over."
"Well, good luck following the last surgical intern. I hear she pretty much killed it."
"Oh, you mean the one that made out with her attending, right?" Artie said.
"Okay. When is that going to die?" Mercedes called after him.
Puck hung up the phone and turned to face his co-workers who were milling around the lobby area. "Attention everybody! I just got off the phone with dispatch. We have a building collapse downtown. We're going to be the major receiving."
"Estimated number of casualties?" Finn asked, coming out of the exam room.
"Up to 50," Puck said. "They're requesting that ER personnel get triage up and running on site."
"I'm on it," Finn said. "Kurt you're with me," Finn said, catching the backpack of emergency equipment and jacket from Sam.
"If anyone wants a ride, train leaves now," Santana said.
In the exam room, Rachel was looking at Boones' EKG. "Okay, Boone. The good news is it's not an acute heart attack. But here's the thing…"
"There's always a thing," Boone said.
"There could be some underlying heart disease. And I'm concerned about your symptoms. You fainted so we need to find out why. Have you been under any stress lately?"
Boone scoffed. "Who isn't under stress these days?"
"True. I want to keep you here overnight for observation. Better to be safe than sorry," Rachel said.
"Doctor, sorry to interrupt," Molly said, coming into the room. "But there's been an explosion in Southtown. It's a mass casualty."
"Southtown? That's where my diner is," Bonne said. "I have to go; my goddaughter works there."
"You have to stay here to rest," Rachel said, trying to calm him down before he had another fainting spell.
"No, I have to get out of here. I have to find out if she's okay."
"Sir, you couldn't get downtown if you tried," Molly said. "It's been zoned off. Just relax."
"I have to call her."
"Of course, we understand," Rachel said, looking over at Molly. "Look, if you start to feel funny, tell Nurse Molly and I'll come back and check on you." Rachel smiled at Boone and left the exam room to find out what was going on with the influx of patients the hospital was about to have. "Puck, what's going on?"
"I've talked to all departments. We've activated disaster protocol. Brody and Artie are prepping all the ORs."
"I pulled the disaster kits," Mercedes said, coming up to talk with Rachel and Puck.
"Great. Triage everyone. Red tag is critical, yellow is urgent, green is walking wounded and black is DOA," Rachel instructed.
"Got it," Mercedes said, taking off.
"Sam, how's the waiting room looking?" Puck asked as Rachel took off to help Mercedes.
"Cleared and ready for the walking wounded."
"I grabbed all the O-neg I could get my hands on," Jesse said, coming back with coolers of blood in his hands.
"We're gonna need more than that," Puck said. "Everybody, be on your toes. It's gonna be messy." He turned his attention to Jocelyn on the phones. "Joce, you get a hold of Finn yet?"
"He just arrived on site," Jocelyn said, handing him the phone.
"Finn, I need to hear something good."
"If I did, I'd be lying to you, brother," Finn said as he started getting ready to triage the victims.
"How bad are we talking?"
"It's gonna be a long night," Finn said, hanging up the phone to go assist with triage.
"Let's roll him on three," Finn said in reference to one of the victims. "One, two, three. Rigid abdomen, BP is 90 systolic, pulse 120. I'm worried about a hot belly."
"I saw him. He saved me," the patient said.
"Who saved you, sir?"
"My guardian angel. He's as big as an ox. He saved me. He pulled me from death."
"I hear you," Finn said. He looked at one of the paramedics. "Let's get him out of here. It's an intra-abdominal bleed. Red tag him for a straight shot to the OR." He got up from where he was with the patient and moved over to where Santana was. "San, what's going on here?"
"Male in his 20s. 14 centimeter full thickness laceration to his left forearm. He's lost a lot of blood. Someone used a belt as a tourniquet."
"You didn't do that?" Finn asked, looking at the belt buckle.
"Wasn't me. It'll probably save his life, though. Take a look at his forehead. I think there's a cross there or something."
"It's not a cross, it's a T. Writing a T in a patient's blood is military shorthand for a tourniquet. There's a medic out here somewhere," Finn said as he started looking around.
"Finn!" Kurt called.
"Go on, I got this," Santana said.
"I got a closed mid-shaft tibia fracture," Kurt said as Finn ran over. "I started two large-bore IVs of LR wide open, going to titrate morphine for pain of three."
"Nice splint, Kurt," Finn said, looking at it when he got over there.
"It was on him when I got here. Someone's getting to the injuries faster than we are."
Finn looked out and saw someone helping one of the victims. "I think I have a good idea who that might be," Finn said, nodding in the direction of someone. "Guy with the hat."
Back at the hospital, it was quickly filling up with patients. Rachel finished working on someone and turned her attention to Jocelyn. "Let's get a dressing on this, okay?" She walked off and took off her trauma gown and gloves before tossing them out.
"How many suture packs have you gone through tonight?" Puck asked.
"I stopped counting at 50. At this pace, we're gonna run out of those and blood."
"I've got Jesse starting a blood bank. I'll have him start replenishing supplies too."
"I have right red tags and thirteen yellow," Mercedes said. "We've had two dozen DOAs. All surgery teams upstairs are working but every department is getting buried. Lots of families with missing people."
"Sam, we need you to run point and get an accurate count of the missing," Rachel said as he passed by. She turned back to Puck. "I'm gonna check on my heart patient. Page me for the next trauma."
Puck nodded and saw another trauma coming in. "I got this one, guys," he said to the paramedics.
"Did you hear about my guardian angel?" the patient asked. "He carried me out."
"I'm gonna have to wait for the movie, sir," Puck said. He looked at the triage tag and saw Artie waiting in the hallways. "Hey, I have your next surgery."
"Artie!" someone called from behind Puck. Puck and Artie turned around to see someone in a suit walking towards them.
"Dad? What are you doing here?" Artie asked.
"Hello, Artie."
"I told you not to come. This is my first night of surgery," Artie said.
"Nonsense. That's exactly why I did come. You really think I'd miss your first night?"
"Doctor Abrams, huge honor. I'm Doctor Puckerman, Artie's attending and night shift chief."
"Of course," Artie's dad said, shaking Puck's hand. "I was in Austin giving a lecture and decided I'd swing by."
"And on any other night, we would roll out the red carpet for you. But as you can see—"
"Oh, I understand. I'll just make myself busy down here. Artie," he said as Artie got in the elevator to take his patient up to surgery. "I'll talk to you later. Don't let me down."
Back at the explosion sight, Finn was directing more people to help with triage. "He's good. I already checked him. Just separate the IV on the way in." The paramedics laid down another victim in front of Finn and Kurt so he could get checked out. "Thanks guys, I've got it from here," Finn said. He looked to his left and saw the guy from earlier working on another victim. "What's going on there?"
"Just wrapping a broken wrist."
"What's your name?" Finn asked.
"Bennett. James Bennett. I was nearby and heard an explosion so I came over to see what happened."
"So you pulled an old man out of the rubble? Put a tourniquet on an arm?"
"Splinted another man's leg," Kurt added from where he was next to Finn.
"Oh man. I'm sorry if I overstepped," Bennett said, taking his hat off to run a hand through his hair. "I was just trying to help out."
"Don't apologize. Army medic, right?" Kurt asked.
"Yes sir. Two tours in Afghanistan."
"Then it looks like it's our lucky night," Kurt said.
"You're an off-duty paramedic?" Finn asked.
"I'm not a paramedic. I wish I was though. I just can't get on any of the crews."
"How long have you been trying?" Kurt asked.
"More than a year. They said I had to take an EMT course but that's ten grand for a cheap one. And I don't have that kind of money."
"They won't transfer over your medic service?" Finn asked. "A guy like you would be an asset to them. You've done this stuff under fire."
"They said I had to start over. I don't mind, I'll do whatever it takes. I just don't have the cash."
"Hey doc, we got another one!" one of the paramedics said.
"Bennett, your service counts with us, okay?" Finn said. "We're a little shorthanded tonight. Do you mind sticking around and helping out?"
"Of course. Anything to help."
"Okay, Bennett. See all those green tags over there?" Kurt asked. "Start treating the walking wounded."
Finn ran over to the next victim that the paramedics found. "Okay, there's a battle's sign and anisocoria. We need to red-tag her to the ER. Bring her to Santana and tell Santana to take her straight to Rachel. There's a possible TBI with a basilar skull fracture."
Back at the hospital, Rachel had finished listening to Boone's heart. "You're still a bit tachycardic."
"My goddaughter still hasn't answered her phone."
"I'm sure she's fine. But you do need to try and relax as much as possible. I'll be back soon to check on you," Rachel said. She left the exam room and started taking off her gloves, stopping when she saw Artie's dad working on patients.
"So, if you're wondering, 'Is that world-renowned neurosurgeon Doctor Julian Abrams working triage in my ER' your eyes do not deceive you," Puck said, coming up beside Rachel.
"Did he really come here to watch Artie on his first night of surgery? Talk about putting pressure on the kid."
"Yeah, but on a night like this, I'll take all the help we can get."
Up in the OR, Brody and Artie were doing surgery on their patient. "This gentleman kept talking about his guardian angel before we put him under. I'm starting to think he might just actually have one," Brody said. "Now, I'm removing the perforated ischemic intestine. Artie, tie off the blood vessel for me."
Artie nodded and grabbed the suture silk. He started tying off the blood vessel as Brody watched with an impressed look on his face. "One handed? I'll have to tell your dad about that. I'm assuming he's the one who taught you."
"Well, some dads teach their sons to play catch. Others teach their sons to tie surgical knots. Guess which one I had?" Artie said, focusing on finishing up tying the blood vessel.
"Incoming!" Santana yelled. "Rachel? Female, 20s, red-tag head trauma," she said, wheeling in the patient that Finn wanted Rachel to take care of. "Finn said possible traumatic brain injury and basilar skull fracture. She's been in and out of consciousness on the ride over," Santana said as they went into a trauma room.
"What's your name, sweetie?" Rachel asked.
"Alex," the girl said weakly.
"Okay, Alex. I need you to stay with me."
"That's her!" Boone said, trying to get into the trauma room. "That's my goddaughter, oh my god."
"Sir, you can't be in here," Santana said, trying to keep him from going into the trauma room.
"It's okay!" Rachel said. "He's my patient. He can talk to her for a minute from there. On three, we're going to move her. One, two, three."
"Uncle Boone?" Alex said from her bed. "Is that you?"
"It's me, sweetie. I'm here for you."
Rachel heard her machines start beeping. "Her BP is falling. I need a chem panel and CBC, crossed and typed."
"I was so worried about you," Alex said to her godfather. "Oh god. Oh god, where are you? What's happening?"
"Alex? Alex, talk to me. What's going on?" Rachel asked her.
"I can't – I can't see anything. I can't see!" Alex said as she started panicking.
"Alex!" Boone said as he came into the trauma room. Santana went over to try and stop him and get him out of the trauma room so Rachel and the nurses could have space to work on Alex.
"Okay, Alex, we're going to figure out what's going on," Rachel said once things died down a little in her trauma room. "Sam here is going to take you to CT, alright?"
"I am right here, Alex. I'm gonna be with you the whole way. Just say my name if you need anything, okay?"
"Okay," Alex said. "Uncle Boone, are you there?"
"I'm right here, baby."
"I'm scared."
"You let them take you, okay?" Boone said, trying to comfort Alex. "They're gonna take good care of you."
"Priority her to CT scan," Rachel whispered. "There could be bleeding in her occipital lobe."
"Front of the line we go," Sam said as he started wheeling her out.
"I've got no pulse!" Bennett yelled as they were out on the scene. He ripped open a guy's shirt and slammed his fist down on the victim's chest.
Finn and Kurt ran over and Finn checked for a pulse. "He's got one now."
"Well, I thought he had a pacemaker, so I did a pericardial thump."
"Good call," Finn said. "Okay. 50s, male, red-tag him to the ER."
"If you can't be a paramedic, you should be a doctor," Kurt said.
"Thanks, but I'll stay with the action," Bennett said. "I gotta be the first guy to help people. It's the one thing I'm really good at."
"Well, if you've got one skill, that's a damn good one to have," Finn said.
"Yellow tag, Doc!" one of the paramedics called.
"You got this?" Finn asked Kurt.
Kurt nodded and Finn ran off. "The adrenaline's hard to replace, huh?" Kurt said, trying to make conversation. "I was a medic in Iraq. Don't know what I'd be doing if I wasn't a doctor."
"Jeez, how'd you go from being a field medic to a doc?" Bennett asked.
"Somewhere along the way, I just caught a lucky break."
"You're like a walking Army commercial," Bennett said as he started laughing. "They make it seem like you serve and you're set for life. I still wouldn't trade it for anything, though."
At the hospital, Artie came out from his surgery and took a deep breath. He did it.
His dad looked up from the patient he was working on and stopped Artie from walking away. "Please tell me it's not like this every night at the hospital."
"Well, no. A mass casualty is actually pretty rare."
"No, I'm talking about the quality of facilities, the protocol, the inefficiencies…"
"Look, can we talk later? I need to get this patient to surgery," Artie said, getting ready to take another victim up for surgery.
"Artie, look, this is simple triage. You want the most critical patient. This is your patient," Julian said, gesturing to the patient he was working on.
"Look, I'm just trying to follow Doctor Weston's orders."
"Then Doctor Weston is wrong."
Brody stepped off the elevator and saw Artie talking with his father. "Artie, what's the hold up? I need my patient up in surgery."
"Right. My father and I are having a minor difference in opinion as to who we should bring up to surgery."
"You have got to be kidding me. Doctor Abrams, I'm Doctor Weston," Brody said, reaching out to shake Julian's hand.
"This patient is your next surgery," Julian said. "She was incorrectly yellow'ed. Her crush injury is now presenting as an extended abdomen." He started pressing down on the patient's stomach to prove his point. "Consider a ruptured discus or hemoperitoneum."
Brody did the same actions as Julian and sighed. "He's right. Artie, let's prep this patient for surgery. Thank you for your input, Doctor Abrams."
"I would love to observe. How about I sit in on this one?"
Brody's eyes narrowed. "You know, it's Artie's first night in surgery, so I don't think it's…" Brody trailed off when he saw Artie shaking his head. "Scrubs are right in there," he said, pointing to the scrubs room.
"Fantastic," Julian said as he took off towards the scrubs room.
"You didn't have to say yes," Brody said as they started to wheel the patient to the OR floor.
"Yeah I did. He's relentless. He would have found his way to the OR eventually."
At the nurses' station, Sam was waiting for the CT results from Alex's tests. "Hey, you. Crazy night, right?" Mercedes said, passing him.
"Yeah, one for the books," he said, not taking his eyes off the tablet screen.
"Is Alex done with her scan?" Mercedes asked, trying to make conversation.
"She'll be back in five."
The two of them looked at each other in awkward silence for a few minutes. "Is this how it's gonna be between us now?"
Sam took a deep breath. "I've got work to do and I'm sure you do too."
"Hey, Jesse. Walk with me," Puck said. "How are we doing on blood?"
"Good. We just got a new shipment in from the blood drive and it should take us through the night," Jesse said as Puck's phone started going off.
"Great. Brody and Artie just freed up some beds so let's get them up there ASAP," Puck said, taking out his phone.
"You a fan of Grumpy Cat?" Jesse asked, seeing a video pop up on his screen. "Makes me laugh every time."
"No, it's…when my daughter and I got our new phones, we somehow got stuck sharing the same Cloud, so now I'm getting her texts every five seconds. I need to ask them to disconnect—"
"Whoa, whoa, whoa," Jesse said, cutting him off. "Hold on a second. Sharing that Cloud gives you complete insight into her world. It's like a gift from the gods. You can make sure she's not doing anything…you know…unsavory." Puck and Jesse shared an awkward silence. "Anyway. I'm heading to the ICU."
Rachel walked into Alex's recovery room once her test results came back. "Doc, thank god. Her vision came back," Boone said.
"I thought it would be good if he hung out with Alex and keep her calm," Mercedes said.
"That's a great idea. I just need to get in there and take a look," Rachel said, holding a little flashlight up to her eyes. "Do you have any blurriness?"
"Just a little. I thought my painting career was over before it started."
"I can imagine. Luckily, your CT came back and there's no acute bleeding but we're still going to have ophthalmology and neurology take a look. How are you feeling?"
"Aside from the bumps and bruises, I feel okay. Have they figured out why the building blew up?"
"Alex, you need to rest," Boone said. "Let the doctor go do her job."
"That's okay," Mercedes said. "Early reports are saying it's a gas line leak."
"Oh god," Alex said, leaning back against the pillow.
"What's wrong?" Rachel asked.
"I was working late at the diner and I can't remember if I turned off the pilot light."
"Alex, it's not your fault, honey," Boone said, trying to keep her calm. "It couldn't be."
"Does someone want to catch me up here?" Rachel asked, looking between Boone and Alex.
"My diner is on the ground level of the same building that was damaged," Boone explained. "When we close up in the evening, it's Alex's job to turn off the pilot light on the stove and the water heater."
"And I couldn't remember if I did so I got dressed and headed back to the diner to check. But just as I went inside—"
"Alex, I'm sure your uncle is right. I mean, have you ever forgotten before?" Rachel asked.
"No, it's just that…I can't remember." She started shaking slightly and her machines started beeping faster.
"BP is 220 systolic," Rachel said.
"What does that mean?" Boone asked as Mercedes pushed past him.
"Right hand has paralysis. Start a nitro-drip, she's having a stroke!" Rachel said.
"Boone, I need you to try and breathe like me," Mercedes said as Boone started hyperventilating. He collapsed to the ground. "There's no pulse!"
"His heart is failing. Grab a crash cart," Rachel said.
Back at the building fire, things were starting to slow down. "The last of the red and yellow tags have been moved to the ER," one of the paramedics said. "We have a few green tags but I think everyone's been treated."
"Okay, great. Let's pack it up," Finn said. "Where's Santana and Kurt?"
"They were doing last looks with Bennett," he responded as they heard a huge explosion from behind them. They ducked down to the ground and saw the building go up in flames.
Once the building was cleared for entry and Santana and Kurt were out safely, Finn and the two of them went back into the building to find Bennett. "Okay, we need to find the big Army medic. Kurt, are you sure you saw him come in here?"
"A guy that size is kind of hard to miss," Kurt responded. "I saw him run into the building after the second explosion."
The three of them heard a loud crash. "That's not good," Santana said from where she's standing.
"I'm not leaving until I find him," Finn said. "Bennett!" Finn said, calling for him.
"Over here!" Santana called, seeing him laying down under a pile of rubble. "Bennett, we're here."
"We need to get this stuff off him," Kurt said.
"Watch out," Finn said. "We need to be careful. Kurt, support his torso and I'll pull him out on three. One—"
"Finn, wait. His arm's been severed," Kurt said.
"Son of a bitch," Finn muttered under his breath. "We have to move him now."
In the OR, Brody and Artie were working on their patient as Julian was watching. "I'm now going to reduce the compartment pressure. 10-blade to our intern," Brody said.
"Seriously?" Artie said.
"If you never do it, you'll never learn," Brody said. "You're up."
"You mean the 11-blade, right, Doctor Weston?" Julian asked.
"Well, I said 10 and I meant 10. We all have our preferences."
"This isn't a preference. There's a right way and a wrong way. 11 gives you a more precise cut and less tissue loss."
"That's what an 11-blade does but we don't have time to be cute or fancy. This is a fasciotomy to reduce the compartment pressure. This isn't neurosurgery."
"That's for sure," Julian muttered under his breath.
"10-blade to our intern, please," Brody repeated.
"Artie," Julian started. "Use the 11-blade."
"Doctor Abrams, I understand that you are used to running the show, but you are in my OR and I cannot have you compromising my team," Brody said. "You will either have to let us do our work or step out."
"Fine, I'll step out. It just drives me crazy to see things done the wrong way."
Brody sighed. "You've had to put up with that your whole life?"
"I came out here to get out from under his shadow. I guess Texas wasn't far enough."
"James Bennett, 23, building collapse caused transial amputation to the left arm. Hypotensive and tachycardic," Finn said when they arrived at the hospital. "Molly, prep this arm for reattachment."
"My hand's burning, just give me something for it and I'll be okay," Bennett said.
"Take it easy, Bennett," Finn said before he started calling off the medications he wanted for Bennett. "I also need two units of O-neg and set up for a central line."
Bennett started moving around and smacked Santana's jaw by mistake. "I'm going back out there. You can shoot me if you have to."
"No one's going to shoot you," Kurt said as he injected Bennett with morphine. "We're going to take care of you and you're going to be okay."
"Jocelyn, can you call up to surgery and make sure there's an OR ready for an arm reattachment? And can you do it now, please?" Finn asked.
"You okay?" Kurt asked Santana. "You took quite a shot."
"I'm good. I've been hit harder than that before. On three. One, two, three," Santana said as they moved him from the gurney to the hospital bed.
Outside of Boone's room, Rachel was filling in Puck and Mercedes about what was going on. "He's in heart failure. There's fluids in his lungs."
"Did we miss a heart attack?" Mercedes asked.
"No, we didn't miss it. It's more complicated than that."
"Maybe it's an echo cardiogram," Puck suggested.
Molly came up to them with a tablet to show them Alex's brain scans and to tell them what medicine she was on. "Look at this," Puck said, zooming in on a part of the scan. "Things just got more complicated for Alex."
"That's definitely not good," Rachel said. "Mercedes, stay here and watch Boone. I'll be upstairs getting a surgical consult."
Rachel got up to the OR floor and started listing off what was wrong with Alex to Brody. "She has a carotid dissection that is sending blood clots to her brain."
"Well, that would explain the loss of vision and then the stroke," Brody said as he started to wash his hands.
"Exactly. And in a few hours, the damage from the stroke will be permanent and a large section of her brain will die," Rachel said. "But, there is a Hail Mary."
"Yeah, mechanically. We can remove clots from the brain using a catheter. But we'll be hard-pressed getting an interventionalist to the hospital this late at night."
"Yeah, well, the thing is we already have one."
"Artie's dad," Brody said, feeling his shoulders slump.
"I've already called the hospital for privileges and they're sending over authorization paperwork now. I want you to ask him. I figured he'd respect you more. You know, surgeon to surgeon."
Brody grabbed paper towels from the dispenser and ripped them off. "Yeah."
"Awesome. Thank you. I appreciate it," Rachel said, turning on her heel to leave the scrub room.
Puck, Finn and Kurt were walking the ER halls to get Puck's permission on working on Bennett themselves. "Limb reattachment in the ER? I don't know. What's the wait on surgery and vascular?"
"Backed up for hours," Kurt said.
"And Bennett doesn't have hours," Finn said. "He'll lose the arm. I don't know his full story but he hasn't had it easy since post-deployment."
"Puck, you gotta let us try," Kurt said, "He's a soldier, he's one of us. He's out there saving people."
"I get what you're saying and what's at stake. I want you guys to do it, but if we get swamped again, I can't have you two siphoned off for the rest of the night while people die," Puck said. "Molly, how are we looking on mass casualty admittances?"
"Haven't had one in awhile. They say the area is all clear."
"See, there you go," Finn said.
"Fine go ahead. But if we get busy again, I'm pulling you off," Puck said. "We can't trade a life for an arm."
Back in Boone's trauma room, Rachel and Mercedes were trying to figure out what was going on with him. "Was it a heart attack?"
"No," Rachel sighed.
"Then how did his heart get so dilated?"
"He mentioned that he was under a lot of pressure earlier this evening. It could be the severe stressor that weakened his heart that's causing dilation. Check and see if it's cardio-myopathy."
"Broken heart syndrome?"
"It's what it looks like," Rachel said, wiping the ultrasound gel off his chest. "He's going to need a heart transplant or at the very least, an LVAD. I'll let him know what his options are when he wakes up, but for now, we should keep an eye on Alex's surgery. He'll want to know how she's doing."
In a corridor, Brody and Artie were talking to Julian about performing Alex's surgery. "And we've just received hospital privileges for you to perform the surgery," Brody finished explaining.
"Of course you did," Julian said. "So, Doctor Weston, you'll allow me to use your OR? And perhaps an 11-blade?"
Brody tried to suppress the grimace that was bound to be forming on his face. "Look, I'm sorry if you felt that I was—"
"Tactless, disrespectful, rude—"
"Dad!" Artie said. "You're the only one capable of the procedure that will save her life. So please just do it."
"Fine. I'll perform the procedure. Under two conditions. One, Doctor Weston, you stay out of my OR. And two, I need Artie to assist me."
"It's his first night on surgery."
"Artie, scrub in," Julian said. "Then we can finally have that talk you've been avoiding."
In the OR, Julian was showing Artie how to do the surgery. "Now we are steering the catheter up to the blood clot in her brain, opening the basket, and grabbing the clot," Julian said, keeping his eyes on the screen to make sure nothing would go wrong. "Watch this, Artie." Julian picked up a larger needle and pushed it. "And just like that…no more clot."
"That's really cool," Artie said from where he was watching.
"Really? You think your old man's cool?"
"I've always thought that."
"I find that hard to believe," Julian said, turning around to look at Artie. "You could have gone to my alma mater, or my med school or joined our practice after your residency."
"I said I admired you. I didn't say I wanted to be you. Can we do this later? Please?"
"Well, this is the only time I get to see you. Every time I call you, you're either too tired or too busy or whatever else you make up to get me off the phone. So, let's talk about what it's going to take for you to accept the surgical residency at Johns Hopkins. It's time for you to go big or go home."
In Bennett's trauma room, Kurt and Finn were trading stories to try and help pass the time. "So, what was your lucky break?" Kurt asked.
"That's a long story," Finn said.
"We're reattaching an arm. We've got time."
"Touché. You ever drive a '64 GTO?"
"No. Is that the car you had growing up?"
"Oh hell no. I was broke. But Thad and I, we drove one this one time. Man, driving that car was a real come to Jesus moment."
"Wait, you and your brother…stole the car?"
"No. Well…we were going to return it. We used to go down to Camden Yards and borrow cars during games. We got about five blocks before we got busted. On the morning of the hearing, we were on our way to the courthouse and the energy felt wrong. So we look around and everyone's eyes are on the TVs."
"What was going on? What was on it?"
"Well, we got there just in time to see the second plane crash into the World Trade Center. So we just sat there and we watched and made all the crap we were doing seem so childish. So we went up to the judge and we said 'Hey. If you let us off, we will go straight down to the recruiting office and sign up for the Army and go kick some serious ass for the USA.'"
"That's some break."
"Yeah, I told you," Finn said. "I was sitting there with a serious come to Jesus moment. And the Army put me through med school. Without that, who knows where I'd be."
"Probably in prison. Being traded for a pack of cigarettes."
"Hey, I'm at least worth a carton," Finn said.
"Whatever you say, Doc," Kurt said as they kept working on Bennett's arm.
In the scrub room, Artie was washing up after the surgery with his dad. "I can't give you a decision."
"Well, you're going to have to. They're not going to hold that residency for you forever."
"I didn't ask you to get me one," Artie said angrily. "And if I wanted one, I would have gotten it for myself."
"Maybe. It's very competitive. People would have killed for this opportunity. But you didn't even try. And that tells me that you're afraid."
"I wasn't afraid, okay? I didn't want to go there."
"Well, son, sometimes a father can see what's best for his child even if they can't," Julian said as the door opened and Brody stepped in.
"Just checking in to see how Alex's procedure went," Brody said, noticing he walked in at a tense time.
"How do you think it went, Artie. We'll talk about this later. I need to make sure your staff can properly take care of my patient." Julian left the scrub room and Brody turned to face Artie.
"Come on. Let's talk a walk," Brody said.
In the corridor, Puck saw Santana walking towards him. "Please tell me we're done, Santana."
"We've been given the all clear. No more casualties heading this way," Santana said as she kept walking.
"Finally," Jesse said, overhearing the conversation.
"It's been one hell of a night," Puck said. "Oh, Jesse. You were right about your advice with my daughter's phone. Check this out," he said, extending the phone so Jesse could see the screen. "I mean, don't check it out. But look."
"Whoa. That is a very skimpy bathing suit."
"I didn't even know she had that. I did not get her that phone to be sexting. I thought she was a nerd. I mean, I want her to be a nerd," Puck said as the phone beeped again.
"Kids are what they are, you know?" Jesse said, getting a cup of coffee.
"Holy…she just said that I'm working all night and he won't know if we hook up. She…she is grounded forever. That text is going to be her last on that phone."
"Wait," Jesse said as Puck started walking away. "Hold on. Keep your cool. Don't blow your cover."
"Blow my cover? This isn't The Departed. This is my daughter we're talking about."
"Look, when the Brits cracked the Nazi code in World War II, they waited to get more information."
"I don't care about that. Some punk named SexyMan916 is sexting with my daughter."
"Okay. Blow your cover. Then you'll never know what she's up to again. Listen to me. You have Quinn. Make sure she's in on this and you track this. You don't know what else she's up to."
"I think I'm going to be sick," Puck said.
"Yeah, well. You'll get used to it. I wish I had something like that to know what Naomi's doing. Trust me, they grow up really fast." Jesse left the break room.
"I hate technology," Puck muttered before pouring himself a cup of coffee.
Rachel walked out from behind the nurses' station with a lot on her mind. She hadn't been sleeping well the last few nights – given she'd found out about her stalker then found out about the baby. She was hoping to break away for a little peace and quiet before things started to pick up pace again. She looked at her watch and smiled to herself.
Finn saw her and ran after her. "Hey," he said, reaching out to take one of her hands.
"Hey babe. Haven't seen you all night." She stopped walking and leaned against the wall. "So, limb attachment in the ER. Pretty exciting stuff."
"Yeah. Just waiting for it to pink up and see if it worked. So, how you feeling, Momma?" Finn asked, eyes moving down to Rachel's stomach. "You didn't get any sleep this afternoon."
"I know. That's because every time I closed my eyes, there were a million questions just running through my head."
Finn reached out and took Rachel's head in his hands. "You need to relax."
"I know. I'm trying. But…okay. Which OB are we going with? Where are we going to live once the baby gets here? And who's going to take care of the baby when we're both working a shift here?" Rachel asked.
"Got it. Doctor Newton, my apartment, Puck will schedule us on different shifts. I'm a genius. Problem solved. Thank you," Finn said.
Rachel raised her eyebrow. "Well, okay. But I'd prefer Doctor Zully over Doctor Newton, your apartment is way too small and we will never see each other if we work separate shifts."
"Well, when you put it like that…" Finn said, leaning in to kiss her.
"Rachel," Mercedes said, coming up. "I need you to talk to Boone. He's freaking out."
"Okay. I'll be right there." She turned back to Finn and ran her hands over his cheeks. "Thank god you're cute."
In another part of the hospital, Brody and Artie were having a talk. "I have seen hundreds of surgical residents and ER interns do their rotations and I can tell you after one day, you're in the top five," Brody said.
"Really?"
"Yeah. So I get why you're father pushes you as hard as he does. I'm sure you are a really good ER doc. But you could be an amazing surgeon. It's like when Jordan left the Bulls to go play baseball. It just felt like such a waste."
"It was his first love. He was following his heart."
"Okay. So what's in your heart? ER medicine?"
Artie thought for a minute. "No."
"Then what is? Because if you are just rebelling against your father, then you're cutting your nose off despite your face. If you want to be a surgeon, be one."
Rachel got to Boone's room and was sitting and talking to him. "Boone, you do understand that if you refuse the medical advice I'm giving you, your chance of survival is close to zero."
"Yes, I understand. Yes I want to die."
"Where is this coming from?" Rachel asked, trying to understand. "What about Alex? She's going to need you more now than ever. I realize that a heart transplant is a scary proposal—"
"It's not that. The heart should go to someone else."
"Why would you—"
"Because I caused that explosion that made the building collapse," Boone said as Rachel's eyes widened.
"I can't believe it," Puck said when Rachel told him what happened.
"What's going on?" Finn asked, coming behind the nurses' station to talk with Puck and Rachel.
"Our first patient of the shift, Boone. The whole mass casualty was his fault," Puck said.
"He just confessed to me that he was going bankrupt so he intentionally set fire to his diner to collect the insurance money," Rachel said. "He thought it was contained. And now he may have injured or killed all those people, not to mention his goddaughter."
"Has he been read his rights?" Finn asked.
"Police are on their way but for now he's our patient and we just have to keep him alive."
"Except he's refusing medical treatment," Puck said. "He just wants to die."
"I don't think he's going to get off that lucky."
"He's devastated about what he did," Rachel said. "Especially how it's going to affect Alex. He can't even face her. I'm going to have to tell her before the police get here."
"Good luck," Puck said as Finn laid a reassuring hand on her shoulder.
"Oh yeah. Good times," Rachel said sarcastically as she walked off.
In Bennett's room, his arm pinked up and he was awake and talking. "So they're taking this thing off? I was just starting to like it. It's kind of a cool look," Bennett said, making Finn and Kurt start laughing.
"Well, with some time to heal and a good amount of physical therapy, you're going to be ready to work," Kurt said.
"Work? That's really funny, Doc."
"Well, actually, we did some digging at the VA. They have a program that credits Army medics for their service and gets guys like you jobs in VA emergency centers," Finn said.
"It's called an intermediate care technician," Kurt said. "You train as you get paid and thirteen months you'll be fully certified for any hospital in the country."
"I had no idea about the VA stuff," Bennett said with a smile.
"Well, they do some good things there. Don't paint them all bad," Finn said. "So, there's a slot waiting for you. You start class in a couple of weeks and you earn while you learn."
"I can't believe I'm gonna be a big baby about this," Bennett said, tears coming to his eyes. "Um, nobody's ever – uh – why are you guys doing this for me? I'm a nobody."
"You're not a nobody," Kurt said. "Everybody needs a break and this one's yours."
"Yeah, so don't screw it up," Finn said with a slight wink. "Let's get the surgery team to finish you up." The two of them started wheeling Bennett out when they stopped when they almost hit another bed.
"That's him!" a patient said. "That's my guardian angel."
"That's one nice sized angel," Molly said. "Glad you got your wing fixed."
In Alex's room, Rachel had just finished telling her what was happening. "He was my only family," Alex said. "I can't believe he did this. Was it to help pay for my school?"
"No. This had nothing to do with you. He got into money trouble for a lot of reasons and a good man made a bad decision. I think it's best you try and remember all the good that he did for you," Rachel said.
"I don't know if I'll be able to. Could you if you were me?"
Rachel thought to herself for a second. "I don't know. My father did some pretty stupid things. But lately I find myself remembering all the fun we had. You know, hiking in the woods, homemade ice cream. I think it's important to remember those things."
"I already miss him so much," Alex said as she started to cry.
"I know you do, sweetie," Rachel said, reaching out to take her head. "I know."
In one of the hallways, Artie was talking with his dad. "You were right. Surgery is in my blood and I'm good at it."
"You're very good at it."
"And I think I might want to pursue it," Artie said.
"Finally. You have no idea how happy that makes me. I'll call Doctor Nelson at Hopkins and secure your spot."
"I didn't say Hopkins."
"I don't understand," Julian said. "You said you wanted to go into surgical."
"And I do. But on my own terms. And not just surgery. Pediatric surgery."
"Pediatrics?" Julian said incredulously.
"Yeah. The drunks, the GSWs, I can do that. But I like working with kids. And I'm good at it."
"That's a very tough discipline. And Johns Hopkins only has one slot. I don't know if I can swing—"
"You don't have to," Artie cut him off. "I've got a secure slot."
"We're going to start a pediatric surgical fellowship here next year," Brody said from where he was standing behind Julian. "Artie will finish up his internship and then move into a dual pediatric and surgical residency."
"That's an awfully big bite you risk for being mediocre at both."
"Or being the best. Go big or go home, right?"
"It's a pleasure to meet you, Doctor Abrams," Brody said as he walked off.
"Look, I only want the best for you," Julian said.
"I know you do, Dad. Believe me, I know. You know, a patient of mine, Oren, same age as me. He just died last night. And the last thing he wanted to do before he died was take a fishing trip with his father. But he never got to make it."
"That…that must have been very tough on his father. There's nothing worse than the loss of a child."
"Well, I'm taking that fishing trip with his father this summer. And I know it's not your thing and it's probably not my thing either but I would very much like it if you came with us."
"Sure. Sure. I'll see if I can make it. Busy schedule and all."
"Yeah of course," Artie said, feeling dejected.
"Artie. I'd love to come but my surgeries are booked so far in advanced there's nothing I can do. But maybe, maybe one day we can make that trip."
"Absolutely," Artie said.
Julian pat him on the shoulder and started walking off. "Don't forget to call your mother."
"I won't forget."
Puck walked up to the nurses' station at the end of the shift. "Great work, everyone. I just want to thank you all for stepping up tonight," he said as Santana started clapping. "Even Jesse. That was solid work you did tonight."
"Thank you," Jesse responded as Puck's phone started beeping again. "So, what's the latest in teenage daughter world? Anything juicy?"
"Uh, yeah. I gotta say, your advice was spot on. Look at this," Puck said, laying the phone down in front of Jesse. "She organized a party for tonight while I'm working and Quinn is at her mom's with the twins."
"I think it's time to bring that hammer down."
"It's definitely time, right?" Puck asked, dialing Beth's phone number. "This is gonna be a little fun. Sometimes, you have to fire a shot across the bow and show them Dad is not a pushover."
"Exactly. You have to scare them sometimes."
"Yeah, Beth, it's Dad. Do not even speak. You're grounded until you're 30. Oh yes I can. Why? Because I know about the party," he said, smirking in Jesse's direction. Jesse responded with a thumbs up. "Put your mother on the phone. Quinn? Yeah, did you know that our—" Puck stopped talking when Quinn started talking. "What? What? I-I was just trying to…okay, okay."
"What was that?" Jesse asked when Puck hung up the phone.
"Well, apparently, my daughter knew I was spying. The whole time."
"What? How?"
"She's a nerd. Like I said. She could tell when I opened her texts and she told Quinn. So they taught me a lesson in trust. SexyMan916 is a fake account. Now my daughter – and my wife – are unhappy with me."
"It was a good plan."
"It was a terrible plan."
"Well, in hindsight—"
"In any sight! Thanks a lot, Jesse. Super advice. I can't wait to go home to my own mass casualty."
"Can you put these over there for me?" Sam asked one of the other nurses at the nurses' station. He looked to his right and saw Santana filing out some paperwork. "So…any plans for after the shift?"
Santana looked up from her paperwork. "You asking?"
"I think I just did."
Santana's smile faded. "Look, you don't have to just because we…"
"Yes. Yes we did. And I don't know about you, but I'd like to do it again. But first, I'd like to take you to dinner. Maybe a movie or a Spurs game."
"Like a real date," Santana said, feeling her smile grow again.
"Date or dates. Doesn't have to be just one."
"Sam Evans," she said, stepping closer to him. "You are interesting mix of ego and sensitivity. Do you know that?"
"Yeah, well, I do what I can. But for now, let's go grab some pancakes."
"Yes. Double stacks because I'm starving," Santana said.
"Sounds good. Just give me one minute. I have one piece of business I have to finish."
All of the doctors crowded into the locker rooms at the end of the shift. Unlike at the beginning of the shift, there was no energy to be found in the room. Instead, they were all about to fall asleep against the lockers.
"So, I was thinking, with a kid and all, we should get a bigger place," Finn whispered to Rachel as she got comfortable in his arms.
She smiled to herself. "That's a great idea. Why didn't I think of that?"
"It's because I have all the good ideas,"
"Shhh. Don't speak," she said.
Kurt sat down on one of the benches next to Puck and laid out. "Hell of a night. So, are we all still going out for breakfast? Or just get…"
"Just another five minutes," Puck said, shutting his eyes.
"Or ten minutes," Rachel said.
"Maybe just call it an even half-hour," Mercedes said, sliding down the lockers to sit on the floor.
"That's good. Half an hour," Finn said.
The room was quiet for a few seconds until an air horn sounded, causing them all to wake up.
"Ahhh, retribution," Sam said as he started laughing at them. "It can be swift." He shut the door and they are got back into their sleeping position.
Once they'd all finished breakfast, Finn and Rachel went back to her place. As soon as she opened the door, Max ran over from where he was on the couch and started jumping up. "Can you take care of him?" Rachel asked, setting her bag down on the front table. "I've got so much I need to do and—"
"The only thing you need to do right now is get sleep," Finn said. "I will take Max out for a quick walk and by the time I get back, you should be in bed, at least trying to fall asleep." He kissed her forehead and grabbed Max's leash off the table. "Come on, boy. Let's go for a walk."
Rachel smiled at him and watched the two of them go for a walk. She looked at the couch, deciding she was too tired to go all the way back to the room. She took a deep breath and kicked her shoes off before collapsing into the couch.
When Finn and Max got back from their walk, he saw Rachel curled up on the couch. Not wanting to wake her up, he crossed the room and gently picked her up. Her arms immediately went around his neck as she pulled herself closer to him and he felt her sigh against his chest.
"I can certainly get used to this," Finn whispered as he carried Rachel back to their room.