The scene opens with Dr. Kevin Moretti  meticulously pouring himself a cup of coffee. Heh.  On his mug is that famous painting that speaks to frustration and inward turmoil, Munsch’s ‘The Scream’.   He is in the staff break room and peers through the blinds into the quietly full waiting room and then out the window at the quiet ambulance bay area.  He is anti-smiling in a sort of satisfaction.  Morris, Abby and Pratt push through the doors to the ambulance bay as they leave after their shift.  They are complaining about Moretti and decide that someone needs to talk to Dr. Anspaugh about him.  Morris and Pratt look at Abby and she asks why her.  Pratt tells her to turn on that ‘old Abby charm’.  ‘Old?” she asks.  Morris says they need to go have a drink and plan the ‘revolution’…and Pratt is buying.  He says that he isn’t and Abby slyly asks where the ‘old Pratt charm’ is as she takes his arm.  Okay, maybe one, he agrees. 

Back at the admit desk Sam is wiping a patient’s name off the board and is approached by a new intern.  She tells him that he is a month early (establishing this ER time as June because new interns start in July) and he tells her that he is actually 11 months late.  He had some trouble with the law but it’s all good now.  She is trying to ignore him and Frank tells him to leave her alone and points him in the direction of an approaching Moretti.  Moretti asks if he is Grady…his clod of unmolded clay…his tabula rasa.  Grady comments that Moretti is new too.  Moretti tells him that lesson number1 is to take no lessons from County.  Grady responds that that means he can’t take lessons from him then.  Moretti looks at him and tells him ‘only from me, Grady.  Only from me.”  We are interrupted as Sam takes a call from the paramedic station.  She tells Moretti that there re incoming from an accident in the park.  Moretti asks who is on and frank tells him he is, an R3, a junior and his ‘lump of play doh over there’.  Hee.  Moretti tells Sam to tell them they will take two.  She says she already told them they will take 4 majors ad 10 minors.  Standard protocol.  Grady says it’s a good thing he showed up then and Moretti glances at him as the new intern struggles to put gloves on his hands. 

Cut to a shot of a screaming kid in an ambulance as Gates is working on him.  He has a piece of wood, apparently from a protest sign, protruding from his chest.  As he works Gates is questioning the paramedic about who might have picked up Neela.  The paramedic doesn’t know but says they will be dropping him off and going right back out.  As Gates works to stabilize the odd and administer pain meds to the boy, he is watching the paramedic on the phone and answers questions about Neela’s age, etc. 

Cut to Ike’s bar where Morris and Pratt are having a beer and Abby is nursing a club soda with lime,  They are trying to decide what to do about Moretti.  Morris suggests a secret signal so they can unify if they don’t agree with Moretti.  Abby chuckles says it’s a good idea.  She sets up a scenario that is a patient needs an intubation and Moretti disagrees then they can…and she taps a finger to her nose.  Pratt tells him not to encourage him.  They look back as an ambulance speeds by the window with sirens blaring.  Abby says they should probably get out of there before Moretti decides to…she stops as her pager goes off.  And then Morris’ and then Pratt’s.  Pratt says he should have gone home and asks for the check. 

Cut to the ambulance bay as a door to the back of a ‘bus’ opens.  Moretti and Sam are ready as the paramedic reels off information about Daniel Harris…58…a heart attack victim who was running away from the crowd.  Moretti directs Sam to ….but she butts in with ‘aspirin, beta blockers and cath lab’, their standard protocol.  Moretti asks Grady if he has ever handled a STEMI and tells him to stick with the nurse.  He turns to another arriving ambulance.  It holds Candance Morgan, 16, a bad crush injury to the chest.  The 200 pound podium at the rally fell on her. Moretti tells Chuny to take her to room 2 and get her labs cooking as he turns to a third ambulance.  Pratt, Abby and Morris hurry through the ambulance entrance and Moretti tells them they are back on.  The doors open and Gates spills information about Aaron Gonzalez, 12, with a penetrating injury to the chest and a crush injury to the pelvis.  He says he was there and saw it happen.  Adam is crying and telling them to take it out.  Gates as Doris if she has seen Neela.  Pratt stops him and asks what about Neela.  Gates says that she was hurt but the boy was critical and he had to stay with him.  Pratt says maybe she didn’t need transporting and Abby says she is probably helping out in the field.  Moretti yells at them to get inside because they are getting 10 more patients.  They move toward the door but Gates is clearly torn between going inside and returning to the park for Neela.  He finally makes his way toward the ER doors. 

Moretti pushes his way into the exam room where Chuny, Morris and Pratt are dealing with Candace.   They are putting her on a rebreather and she is complaining about pain.  She has 10 broken ribs.  Pratt wants more morphine but Moretti says no because it will compromise her tidal volume.  He directs them to use an epidural.  Pratt says they can’t and Moretti says he is credentialed for the procedure.   Pratt is upset as Moretti pushes into the room where Abby and Gates are working on Aaron’s chest injury.  Aaron wants his mom.  Gates is talking over the speaker phone with the paramedic line asking about Neela.  Abby is talking to them as well.  Gates tells Moretti that he resuscitated Aaron in the field and promised his mother he would stay with him  Moretti asks Gates for his secondary report and Abby talks to the paramedic line about other places they might have transported Neela too.  Moretti hangs up the phone and tells them the kid needs their undivided attention and to give it to him.  He leaves the trauma room and moves to the heart attack victim Sam and Grady are treating.  Moretti asks for a drug that is usually given up in the cath lab.  He and Grady muse over a chart that according to some medical journal it would reduce hospital mortality by 50%.  Sam tells them to take it up with Dr. Kayson and Moretti says he will.  Lily enters with a stack of charts for the less injured patients for Moretti to sign off on.  He tells her to give them to a resident but she says they are all busy.  He is clearly overwhelmed.  He tells Sam to start another IV.  She tells him she’s doing it now and mutters ‘a little prick here’ and glances over her shoulder as Moretti leaves. 

 He enters the main ER treatment area and is immediately approached by a nurse who has been floated down from surgery.  He directs her to use some meds with a nose bleed and she asks where they keep that.  Frank is at the desk with two phones in hand and tells the ‘new guy’ that a news camera is outside waiting for someone to talk to them.  The visiting nurse asks about the nosebleed and Moretti tells her to keep pressure on it for now.  The camera swings past Frank and we see that he is asking about Neela.  Abby hears him and moves toward him to suggest that he call one of the other hospitals and Moretti stops him.  He scolds Frank and tells Abby they need to focus on the patients they actually have there and can help.  Abby scowls and turns away as we see Moretti through the patient board.  Chuny approaches from behind and asks if he is ready to do the epidural.  He tells her yeah and then reaches for his coffee.  It spills all over the counter and he mops it up with a surgical towel.  He takes a deep breath as we hear sirens wailing in the background signaling approaching patients. 

 Dawn pushes into the trauma room with chest films for Abby and Gates.  As Aaron’s mom asks if he is hurting. Abby says morphine is on board and she exams the x-rays with Gates.  One of Aaron’s lungs is partially collapsed and Gates says he will put in a tube to help it inflate.  Abby tells Aaron’s mom she can step out if she wants to but she says no.  She and Aaron tell Gates they were at the rally to show support for the troops.  Aaron’s brother is in Iraq.  Moretti walks in and Gates says that Mom has consented to the chest tube.  Moretti tells him to let Dr. Lockhart do the procedure.  As senior doctor it will be better for her son.  As Moretti leaves Aaron tells gates that he doesn’t think that doctor likes him.  Hee.

Moretti enters Candace’s room where her Grandfather is waiting.  He sits down next to the gurney and proceeds with the epidural.  Candace asks her Grandpa if he got a hold pf her parents.  He says he couldn’t.  They are on an Alaskan cruise.  He took Candace to the rally to show her the ‘power of the people’ and how a democracy works.  He was tear gassed at the convention in 1968 and went on to defend one of the plaintiffs.  An old peacenik, Pratt calls him.  Moretti completes the epidural and pulls Pratt and Morris aside to review the chest films.  Under his breath he asks why he smells ETOH on their breaths.  Morris tells him they were off duty.  Pratt says they only had half a beer each.  Moretti tells them they are done for the day.  It’s too much of a liability to have them there.  Abby opens the door to say that an ambulance is on the way in with a young woman in her late 20’s in full arrest.  They are about ready to call it.  She leaves. 

Cut to the ambulance bay with a bus squealing in.  Abby and Moretti push through he doors and Moretti tells her Pratt and Morris are done for the day.  Abby is stunned and asks why.  The doors of the ambulance open and a gurney is pushed out.  The paramedic says she has been asystole for 15 minutes and they are done.  The camera swings and we see that it’s not Neela.  Another ambulance pulls up and the doors swing open.  The paramedic says that it’s Neela.  She has crush injuries to the abdomen and chest and all four extremities.  Abby asks how she is doing and Neela says she has been better.  Moretti checks her pupil reaction and asks what year it is.  He says to take her to Trauma one and Neela says ‘God, not the yellow room’.  Abby tells her it’s going to be fine.  She says they will start with a lateral c-spine and Moretti says it will be a waste of time.  Abby tells him firmly they are starting with the arterial okay?  Moretti backs off. 

Cut to the surgical floor and Dubenko is hurrying through the hall with Crenshaw and a slew of residents checking off orders and preparations for various surgeries.  He is irritated that his pager is going off and that it’s the Er again.  Shirley is following them trying to get his attention.  Finally she is able to tell him the major trauma patient downstairs is Neela.  Dubenko stops and stares at her and then moves quickly off screen.

 Cut to Aaron’s bed downstairs.  Gates is monitoring him and Aaron asks his mom for her cell phone.  He tells gates he needs a picture because the kids at school won’t believe it.  Gates takes the picture and then sees Abby with a gurney going down the corridor.  He is distracted as Aaron’s mother asks when he will be getting surgery.  Gates tells her he is going to talk to the surgeons and hurries after Neela’s gurney.

In Trauma one Neela is shifted to the gurney and Abby calls for some tests – including a cauterized urine.  Neela says ‘bullocks’.  Gates approaches and tells her they have been looking for her.  Moretti asks why he is there and gates says he is waiting for Dubenko on his impalement kid.  He says as long as he is there he can help out.  Moretti tells him no.  Neela asks if she is bleeding internally and Abby tells her it’s okay. Dubenko comes in and asks ‘quick and concise how she is?” Hypotensive and anemic with abdominal pain, Abby tells him.  Neela says she is thirsty and begins to fade.  Gates wants to do a femoral and Moretti tells him no.  Dawn comes in with an update on Aaron and Gates brushes her off.  Moretti tells him to leave.  Abby tells Neela she is going to go to sleep and she will be there when she wakes up.  Neela’s eyes close.

 Gates returns to Aaron who is vomiting and has low blood pressure.  Pratt is at the desk and tells Gates the OR can take him on 30 minutes.  Dawn says he will need it sooner than that. Pratt asks about Neela and Gates tells him a little.  He asks for help with Aaron but Pratt says ‘the idiot has benched him.’  Chuny rushes by with a monitor of some kind and Pratt asks if it is for Candace.  She tells him that she isn’t doing so good.  He follows her into Candace’s room and they put a bipap mask on her for pressurized oxygen because her lungs are collapsing.  Morris hurries in and asks what he is doing.  Pratt tells him and Morris asks if he knows that Moretti is right next door.  Pratt says he doesn’t care.  Morris looks around in a panic and then drags Pratt into the trauma room on the other side.  He hurriedly tells him they are going to do blood alcohol tests on each other to show Moretti that they are not drunk.  Pratt isn’t game but agrees.  

 Back in Trauma one with Neela, Dubenko and Moretti are arguing about moving her.  Moretti says she is unstable and Dubenko wants her in surgery immediately.  Gates burst in with his info on Aaron and then tries to inject on Neela and Moretti gets ballistic.  Gates glares at him leaves and Moretti asks what it is with him.  Abby says they used to date.  Moretti refuses to let Dubenko leave and says Neela will crash in the elevator.  Lily enters with her stack of charts and says the dislocation is losing a foot pulse and the burn victim is…..Moretti tells her he’s got it.  He tells Abby that he needs her out there.  She leaves reluctantly.

 Pratt and Morris are drawing blood on one another and Morris hands the vials to a waiting nurse.  He tells her to get them to the lab and back fast.  Chuny tells Morris that she needs him with Candace.  The bipap isn’t working so they need to intubate her.  She starts to cry and Pratt explains about the tube.  Morris is watching through the window for Moretti.  Cut to Abby as she cracks the dislocated hip into place and reels off some treatment orders.  She asks Lily who is next.  A nosebleed in the hall.  Abby approaches an older man and says she is going to try to help him.  He tells her he was just walking in the park.  Grady approaches and asks if she is an intern and says he needs some aguze for an avulsed toenail.  Without a glance Abby steps away and toward another patient telling him she is not an intern but an R-3 and directs him to the exam room where he can find his things.  He heads off in the wrong direction and she points the way.  She draws open the curtains for a burn patient who was trying to put out a burning American flag.  A quick assessment and directive and she is off to another patient.  Gates is inserting a suprapubic catheter in Aaron.  Surmising that he must have torn his urethra, his bladder is the size of a basketball.  Abby says she will tell Dubenko.  Gates asks about Neela and Abby says she doesn’t know because she has been out of there a while.  Gates lifts a plug and urine pours form the tube.  Aaron’s eyes widen and he asks if he is peeing.  Dawn tells him sort of and he asks his mother to take another picture.  Hee.  Gates looks up to see Moretti and Dubenko arguing.  Cut to Trauma one and Neela is in V-TACH.  Abby prepares to shock her as Dubenko bags her.  Nothing happens.  Abby calls for 10 of lido and shocks her again.  They have sinus.  Sam picks up the phone and tells them her potassium. It is rhabdo..whatever. Moretti calls for meds and Dubenko hurries to dispense them.  Moretti tells Abby to leave and she tells him no.  He says they need…and she butts in to tell him no…that he can go.  She is not leaving Neela.  Cut to commercial.

 When we return Abby, Dubenko, Sam and Moretti are pushing Neela’s gurney to the elevator.  Dubenko is asking that test results be sent upstairs.  Abby tells Neela that she is intubated and going upstairs for an exlap.  She says she is going to stay with her.  Abby , Dubenko and Sam are in the elevator with Neela’s gurney.

Moretti watches the doors close and then Grady approaches him.  They head toward a man on the gurney with an eye injury.  Moretti checks him over and diagnoses a ruptured globe.  As he is giving Grady orders he sees Morris s helping Gates with another patient.  They are working with a man (Elden from all of the Mighty Ducks movies…and he is blonde!)  who has a severe hand injury.  Moretti starts to say something but Morris tells him to check his pocket for the lab report on his two favorite attendings.  Blood alcohol was less than .01 and they let airline pilots fly with that level.  Moretti crumbles the ;ab reports and asks the patient how his injury happened.  He says he was cutting the lawn and having trouble with the mower.  He knew he was low on gas and tried to fill it without shutting it off.  He guesses that he blacked out after that. He wants to know if they can sew his fingers back on and Moretti asks if they have them.  Gates shakes his head.  Moretti says good luck and leaves.

Back in the trauma room with Candace, Moretti asks Pratt what is going on and Pratt is instantly defensive.  Moretti tells him to relax because he has talked to Morris.  Moretti looks at the x-ray and tells Pratt to leave, he can be better utilized with other patients.  Pratt protests and Moretti tells him it’s better to spend his time on patients that actually have a chance.  Moretti does not know that Grandpa is standing right behind him.  Grandpa goes haywire on Moretti.  Moretti explains that with the extent of her hemorrhaging there is very little chance that she will survive.  Grandpa insists that she was doing fine with Pratt’s care and wants Moretti out of the room.  Candace starts to flat line and Moretti pulls the crash cart close as grandpa tells him that it’s all his fault.

Cut to Neela’s surgical team.  She is on the gurney and Dubenko and Crenshaw are operating.  We can see the operating field on a computer screen.  Abby is in scrubs and standing in the background.  They open Neela’s chest and blood begins pooling and then pouring from her chest.  Crenshaw insists that they start packing the spleen and Dubenko says the liver needs to be taken care of first.  They are arguing and Abby draws their attention and tells them to stop.

Back at the ER Sam is in the phone at the desk asking for information about Neela.  The police officer from last season approaches and tells her he has a live one for her.  It’s Howard Hessman as a stoner oldie from the rally.  They suspect an acid trip but he says no…LSD is a man made chemical but psilocybin is a gift from God.  TOO funny and Hessman has not lost his ‘magic’. No medical problems, he says.  His skin becomes transparent and he can see his organs.  Hee.  Wants Sam to hold his hand so he doesn’t float away.  Hee.  Love him to death. 

Gates and Morris are looking over the board and commenting on the fact that there were no shrapnel injuries.  Sam’s police officer buddy said it wasn’t a bomb.  Gates is confused because he was there and said by the sound it had to have been at least an M-80.  The officer said there was no trace of anything.

Cut back to Neela’s surgery.  It’s getting out of hand and Dubenko is losing his cool.  She is bleeding out and Crenshaw wants to close her and come back in two days to do a more definitive liver repair.  Dubenko wants to use the argon coalagelator  and Abby jumps into the tray.  Crenshaw tells her she isn’t helping so she tells them both to shut up.  She asks if the repair can be done and they both say yes.  Abby tells Dubenko that Dr.Crenshaw is going to do the surgery and he is going to assist.  She tells him that he is too close to the situation and he knows it.  Dubenko stares across at Crenshaw and then hands him the surgical tool.

Gates passes through the corridor and watches as a sheet is drawn up over Candace’s face and her grandfather begins to cry.  We can see his anger building as he approaches his hand injury guy and asks how it is going.  Chuny tells him that  hand service can take him in an hour.  He is hungry so Gates asks Chuny to get him some ice chips.  Gates begins questioning him about the lawn he was supposedly cutting.  It’s becoming obvious that he is lying about his injury.  He gets out of bed when Gates begins to berate him and they work their way through the ER.  Gates grabs him and drags him around to every person that was hurt at the rally.  Frank and Dawn try to reel him in and calm him down but are unsuccessful.  He points to the gurney passing with Candace’s body and gates tells him that he killed people.  He throws big Elden to the ground.

 We next see Gates brooding in profile as he sits on a bench and Moretti approaches in the distance.  Calls him a tough guy.  Says he has a history of violence whenever his vocabulary is overtaxed and that it is happening with alarming frequency.  Gates says every bed in the place had a patient because of that guy.  Moretti calls him on the relationship he had with Neela and said it doesn’t make it more acceptable.  Gates tries to justify his action and Moretti tells him it doesn’t matter if the guy attacked his crippled, blind mother.  He is not getting away with it any more.  Gates says he understands and he will check himself the next time it happens.  Moretti tells him he is going to check himself into the ICU.  Gates is dumbfounded.  Moretti says that the ICU forces one – especially an ex-paramedic - to slow down and think.  He says that people are dying there in excruciatingly slow ways so he really won’t have much choice.  He hands a paper to Gates who takes it from him angrily. 

Cut to Neela’s surgery and we see Abby standing at her head.  There is blood everywhere and the computer screen is all blood and gore.  The pringle is holding and there is minimal oozing from the liver.  Crenshaw tells Dubenko it was a sound choice and Dubenko tells Crenshaw it was wonderfully executed.  Abby is relieved.  Crenshaw leaves for another surgery.  Abby leaves to go back to the ER and Dubenko is left to close the surgical field.

Morris is sitting at a desk and Dawn asks if there is any word on Neela.  She heard that they used 10 units of blood.  Morris said that they are still working on her.  He looks up as Dawn walks away and he hears a humming and crooning coming from a curtained bed.  He pulls back the curtain and Mr. Magic Mushrooms is standing next to a sleeping, smiling patient and finishing a cast on the patient’s hand.  Mr. Magic Mushrooms tells him that it was a colles fraction and reduced at a 45 degree angle.  He has cast it.  He apologizes for not introducing himself properly.  He is James Broderick, chair of orthopedics at Saint Rafes and hands Morris a card.  One of the top orthopedist in the nation.  Heh.  Morris tells him he isn’t licensed to practice there and tells Dawn to help him back to bed.  He studies he perfect cast as Gates approaches.  Morris tells him that he heard Moretti reassigned him and Gates says it’s only temporary.  Gates approaches the desk and asks what is happening in surgery.  Dawn says she had trouble maintain her blood pressure and Sam said she is in renal failure.  Gates tries to cal but Pratt stops him.  He tells him to let them do their thing.  Dubenko and Crenshaw are with her.  Chuny says Abby is too and then Abby approaches them.  Abby tells them they repaired the liver and that Dubenko was closing up when she left.  Gates asked if she is awake and Pratt said with the hypotension  and arrest it might be a while.  Abby agreed.  She asked where Mussolini is because he said he needed her down there.  Sam hands her a stack of charts and said she wasn’t to leave until they were all dispoed.  Abby shook her head and looked around.  She is looking through the corridor when she finds Moretti sitting on a step in the staircase.  He rubs his head and is looking around in exhausted stoic despair.  She starts to walk away and then rolls her eyes upward and heads toward him.

“You’re not lost, are you?”  she asks him.  “Because if you need directions….”  Moretti looks up and chuckles.  He goes into a long monologue about the reason they are there is because of war.  If there wasn’t war she would probably be a pediatrician or oncologist and he would still be losing his mind in the ICU.  Abby is being polite and bored as he goes into the history of ERs being defined by doctors and nurses in bombed out buildings…tent hospitals,,,,the collaborative art form that they practice today..etc.  Abby nods appreciatively at his knowledge and then says ‘You don’t get out much, do you?”  He grins shyly and looks up at her.  He says, ‘If you can’t take the bunker then get out of the trauma room.”  She laughs and says that she hopes he isn’t talking about her.

He admits to wondering if he can’t manage things during a mass cas….and she tells him that every day is not the bunker.  Most days aren’t in fact. There is a crash from a nearby room and Abby calls for security.  She opens the door and Chuny is trying to pull Candace’s grandpa off blonde Elden with the hand injury.  He is strangling him and hollering that he killed her.  Moretti pulls him off and Abby and Chuny try to deal with an unresponsive Elden.

 Cut to Gates walking into the post surgical unit.  He looks in the window and then sees Dubenko and Shirley pushing Neela’s gurney to the recovery room.  Dubenko says that she will be sleeping for a while and tells Gates to wait there because he has several pages of post op notes to write.  Gates nods and Dubenko pushes Neela’s bed into the room.  Shirley says she’ll wait for his notes and Dubenko tells her that he has them already.  He hands her Neela’s chart and then settles in a stool to hold her hand while she sleeps.

 Frank is still working the desk and Pratt and Morris approach.  They ask if there is any word on Neela and frank tells them negative.  They talk about it being weird if she were to be awake now anyway.  Frank says that Sam was on her way up and wondered if anyone else wanted to go with her.  Cut to Gates leaning against the window in the waiting room and brooding.  Sam, Pratt and Morris enter.  Gates looks up and gives them a rundown about Neela’s stable vitals and okay crits.  Says she hasn’t woken up yet.  Abby, Chuny and Frank enter.  Abby asks if anyone has seen her and Gates says he saw her on the way to recovery and she looked great.  Said Dubenko would let them know when they could go in.  So they wait, Frank says.  They all stand still for a brief second and then move about the waiting room to settle in and wait.  Morris, Pratt, Chuny, Sam and Frank sit on the couches and Abby sits on the coffee table in front of them.  Morris says he is calling for pizza and wants to know who is in.  They all raise their hands and he says ‘Cool…Pratt’s buying.”  The camera pans back and we see our ER ‘family’ as they wait to see Neela.

Reviewed by Lynda Foote on October 04, 2007