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INT--EMERGENCY DEPARTMENT, BROOKINGS HOSPITAL, BALTIMORE, MD--NIGHT
Moving through a large waiting area during change of shift at the Brookings ED, a Level One trauma center. Many PATIENTS are waiting, including an obese MAN who limps with a cane. ED STAFF walk in all directions.
At the doorway of Trauma Room One, half a dozen ED NURSES, including JACK MENDEZ, are doing rounds. Inside Trauma One, a RESIDENT, an INTERN, a MEDICAL STUDENT and a NURSE work on the unconscious MEL WYATT, a young man who has been struck by a vehicle and whose older sister DONNA WYATT watches. At the doorway, nurse MARTHA SUGGS speaks to the other NURSES on rounds, as they look into Trauma One.
SUGGS
This is Mel Wyatt, a 19-year-old black male, ped. vs. auto, liver lac., GCS 9--
DONNA WYATT
"Ped. vs. auto?" It wasn't a baseball game. Maybe Mel looked like a baseball when that bastard hit him with his SUV. And didn't even stop.
The NURSES on rounds look at WYATT for a moment.
RESIDENT
(Low, not looking up from her work.)
Ah, the SUV...the street-legal monster truck.
SUGGS
(To the NURSES on rounds.)
This is Mr. Wyatt's sister.
(To DONNA WYATT.)
I'm sorry, Ma'am, that's just a phrase we use to explain injuries to the
nurses coming on for the next shift. We know this must be awful for you.
WYATT
(Pausing, then nodding slightly.)
All right.
SUGGS
(To the NURSES, a little lower.)
Contusion over left occiput, IV's 3 and 4 hanging, lactating ringers--
WYATT
And you know what I think? That sonofabitch works here!
INTERN
Ma'am, we're trying to focus on--
WYATT
'Cause it was just a few blocks from here, and the frame on the license plate says "Brookings Hospital." What do you all think of that?
As WYATT finishes, WENDY WOLF, another ED nurse, and BILL MONROE, a security guard, stumble around the corner supporting a YOUNG MAN with thigh and head wounds.
WOLF
(To SUGGS and the other NURSES.)
Martha, this guy's shot in the thigh, I see an entrance and exit, also
has a head wound, and there's 3 more shot in a car crashed outside. Kim's
out there, she needs stretchers, collars, backboards, gloves and ambu
bags.
SUGGS
OK, everyone with me except Wendy, why don't you stay with your friend here.
WOLF
Call two trauma yellows!
As WOLF and MONROE put the wounded YOUNG MAN on a stretcher, SUGGS, MENDEZ, and the other NURSES run back the way WOLF came.
MENDEZ
(To SUGGS, as they start to RUN.)
Bangers?
EXT--EMERGENCY DEPARTMENT, BROOKINGS HOSPITAL, BALTIMORE, MD--NIGHT
The NURSES and BILL MONROE burst out of the doors to the ED with 3 rolling stretchers and head down the ramp outside, toward the vehicle street entrance. An older SEDAN has crashed hard into the cement wall next to this entrance, apparently trying to drive in the entrance. A police SIREN begins to wail from far away.
As the NURSES approach the car, they see triage nurse KIM SPINELLI doing CPR on the DRIVER using her pocket mask for the respirations. There is BROKEN GLASS and BLOOD. Three figures are in the car, the DRIVER and a PASSENGER in the front, one PASSENGER in the back.
The DRIVER and one PASSENGER are young WOMEN.
SPINELLI
I need an ambu bag, collar and backboard here.
Some NURSES rush to each patient. MENDEZ and other NURSES struggle to help SPINELLI put a collar on the DRIVER, while continuing CPR and trying to get her out of the car and onto a backboard on the ground. MENDEZ looks OVERWHELMED.
INT--EMERGENCY DEPARTMENT, BROOKINGS HOSPITAL, BALTIMORE, MD--NIGHT
MENDEZ and SPINELLI push a stretcher with the DRIVER down a hallway, while SUGGS kneels over the DRIVER doing CPR and a FOURTH NURSE runs alongside trying to use the ambu bag.
At Trauma Room Two they meet ED ATTENDING ELLEN CASEY*, a RESIDENT, and an INTERN who have evidently been waiting.
SPINELLI
(To the PHYSICIANS.)
Thanks for all your help out there. You are allowed that far out of the
cage, you know.
CASEY
We do have a few other things to do, Kim.
As the NURSES wheel the stretcher into place, ED and Trauma teams quickly assemble in Trauma Two, including MENDEZ, SUGGS, SPINELLI, the FOURTH NURSE, CASEY, ED Clinical Nurse Specialist JON CALVERT*, an ED RESIDENT, two ED INTERNS, Chief of Trauma Surgery LUTHER BENCHLEY, two TRAUMA RESIDENTS, one TRAUMA INTERN, and five MEDICAL STUDENTS.
SUGGS
I need medical students to take over compressions and bagging.
SENIOR TRAUMA RESIDENT
(Motioning to the MEDICAL STUDENTS.)
Greg. Tim.
Two MEDICAL STUDENTS take over CPR. SPINELLI goes back to triage. The FOURTH NURSE begins attaching heart and O2 sat. monitors.
SUGGS
This is the driver of a car that crashed into the wall out front.
FOURTH NURSE
(To MENDEZ.)
You want to start an IV?
CALVERT
I'll get the fluid warmer set up.
MENDEZ prepares to start an IV as the report continues.
SUGGS
Bystanders think maybe 40 miles an hour. Four passengers, all with gunshot wounds, no belts, no airbags. I see a gunshot wound in the forearm.
SENIOR TRAUMA RESIDENT
All right, let's tube her, check for a pulse, get her clothes off and look for more gunshot wounds.
RESIDENTS and INTERNS begin cutting the DRIVER's clothes off while the ED RESIDENT intubates her. The FOURTH NURSE has finished attaching monitors and begins writing.
SUGGS
(Looking at the monitor.)
She's got a junctional rhythm. Let's check a pulse. I'll get an IV and
draw blood over here.
SUGGS moves to start another IV. The MEDICAL STUDENT stops CPR. The SENIOR
TRAUMA RESIDENT checks the pulse. MENDEZ is trying to start an IV on the
DRIVER's hand.
SENIOR TRAUMA RESIDENT
There's no pulse. It's P.E.A. Continue CPR.
The MEDICAL STUDENT continues CPR.
MENDEZ
The vein blew.
SENIOR TRAUMA RESIDENT
Can we get someone who knows what he's doing?
CALVERT
(To MENDEZ.)
It's OK. I'll start the line, Jack.
CALVERT, who has been getting tubing from the supply cart, struggles around observing MEDICAL STUDENTS and INTERNS.
CALVERT
(To CASEY and BENCHLEY.)
We need room to work, can all non-essential personnel stand back?
The ATTENDINGS nod, and MEDICAL STUDENTS move back towards the walls. As CALVERT prepares to start the IV, a NURSE bursts through the two-way doors leading to the adjoining Trauma Room Three and heads for the supply cart.
NURSE
I need a chest tube tray.
(Finding one and heading back out.)
Hey, one of the guys said the two women are sisters. Mom's gonna be thrilled.
CASEY
(Not smiling.)
They're the Second Amendment sisters.
CALVERT
(To MENDEZ, while hanging the DRIVER's arm off the stretcher, tying a
tourniquet, and wiping with a swab.)
Try the antecubital first in a code. The veins are bigger. I need a 14-gauge.
MENDEZ fumbles for the needle and hands it to CALVERT. At close range we see CALVERT pull the skin tight against the vein, flick it and POP the big needle in. All in a few seconds, we see the BLOOD flashback, the needle is retracted slightly, the needle and catheter are advanced, the needle is retracted into the protector, gauze goes under the IV, the needle is removed, and the IV tubing connected to the fluid warmer is opened up. At that moment the camera is INSIDE the tubing, and the fluid CRASHES into the camera and pushes us through like a surfer on a wave of IV fluid in a huge clear twisting tube, shooting us through the catheter and into the DRIVER's VEIN.
SUGGS
(Seeing a change in the monitor.)
Hold CPR, she's in V-tach! I'll charge to 200...
SUGGS gets the paddles and gel as the defibrillator charges. The MEDICAL STUDENT stops CPR. Meanwhile Director of Nursing LINDA HALL* has entered the room.
BENCHLEY
(Nodding at HALL, but addressing the TRAUMA PHYSICIANS and MEDICAL STUDENTS.)
Trauma kids, that's Director of Nursing Linda Hall. Fighter for truth,
justice, and adequate nursing staff. Bow in her presence.
HALL
Thanks, Luther, but I'd settle for basic social skills.
The defibrillator BEEPS.
SUGGS
Clear!
Everyone backs off the stretcher and SUGGS SHOCKS the DRIVER. The RESIDENT resumes bagging, while everyone else waits to see whether the heart will restart. It doesn't.
SUGGS
Now it's asystole.
SENIOR TRAUMA RESIDENT
Let's check her back.
The NURSES and RESIDENTS turn the DRIVER over each way.
SENIOR TRAUMA RESIDENT
The back's clear. We're cracking the chest.
CALVERT
That's pointless. And a waste of resources with other critical patients on deck. This is blunt trauma from the crash. The gunshot wound was below the elbow. Practice on someone else.
BENCHLEY
(To CALVERT, but motioning at HALL.)
You after her job?
SENIOR TRAUMA RESIDENT
I need the chest tray.
CALVERT
Why?
BENCHLEY
The wound's right up on the elbow. Could be penetrating trauma.
CASEY
No, it's below the elbow, nothing could get through there. We're not tearing this kid up any more than we have to. She's gone. Unless you've got anything else to suggest, we're calling it.
BENCHLEY
You guys are no fun at all, Ellen. How're my kids gonna learn anything?
INT--EMERGENCY DEPARTMENT, BROOKINGS HOSPITAL, BALTIMORE, MD--NIGHT
MENDEZ walks out of Trauma Two and down the hall toward where the first wounded YOUNG MAN sits on one of the stretchers lined up in front of the trauma rooms, arguing with Baltimore P.D. Detective MEL JORDAN. The WOUNDED YOUNG MAN's leg and head are bandaged. MENDEZ stops within earshot, watching.
YOUNG MAN
--told you it was a date, they our girlfriends.
JORDAN
Yeah? Girlfriends for the night?
YOUNG MAN
They ain't no 'hos. She my girl, for real.
JORDAN
Aw...sensitive thug, ya just need a hug. 7
WOUNDED YOUNG MAN
Man, you think I'm afraida--
JORDAN
Yeah, I do. But let's say it's true. What'd you do to bring this down on 'em?
YOUNG MAN
Nothin'.
JORDAN
Oh, it was just an accident, right? Big mistake.
Silence.
JORDAN
C'mon, Damon, I know where you're from, I know y'all sellin' over there, you think we're blind?
DAMON
I'm tellin' you, we don't sell, yo. Find anything in the car? Find a piece?
JORDAN
So you just happened to cruise into a shooting range on your big date--that before or after you hit Mickey D's?
DAMON
You a fool.
JORDAN
Least I'm a man. You ain't--got your girls shot up and won't even admit it's your fault.
DAMON
Wasn't nobody's fault! You know who their--
JORDAN
Who their what?
DAMON
Nothin'.
JORDAN
No, no. Best just tell me now.
DAMON
Who their brother is.
JORDAN
Who?
DAMON
D-Block Smith.
JORDAN
D-Block? D-Block who just popped them boys in the Western? No kiddin'.
DAMON
Yeah, no kiddin'. So what you think happened out there? Nobody in that
car did nothin'. Wasn't about us.
(Turning to MENDEZ.)
How she doin'? I know she took one in the arm, but she...
(Processing MENDEZ's expression.)
...she saved our...
INT--EMERGENCY DEPARTMENT, BROOKINGS HOSPITAL, BALTIMORE, MD--EARLY MORNING
MENDEZ walks slowly down the hall. He looks exhausted and it is apparently not long till the end of his shift. He turns and enters the triage area, where triage nurse KIM SPINELLI sits talking to an older male PATIENT whose appearance suggests he is not well off.
SPINELLI
And how long have you had these chest pains, sir?
PATIENT
Two years. No, three years.
SPINELLI
Have you been to see anyone about the pains before now?
PATIENT
No.
MENDEZ
Excuse me, Kim? Mary asked me to come get a feel for what it's like here. It's slower back there. Finally.
SPINELLI
Fine with me. Sure you're ready for triage? You're a new grad, right?
MENDEZ
Yeah, but we're so short staffed, Mary thought I should start getting trained.
SPINELLI
Got it. Work hard, next week you could be nurse manager.
SPINELLI turns back to the PATIENT.
SPINELLI
Sir, if you've had serious chest pain for three years, why haven't you gotten any treatment till now?
PATIENT
Don't like hospitals.
SPINELLI
And why's that, sir?
PATIENT
They're full of people on drugs.
SPINELLI
But that's part of the treatment for--
PATIENT
Not to mention the shape-shifters.
INT--THE BURNING EMBER, BALTIMORE, MD--DAY
The five NURSES are about finished their drinks. Bar NOISE continues in the background.
SMITH
He was probably just confused by the array of minimally trained unlicensed
caregivers doing nursing tasks in the managed care era.
(Looking at her watch.)
I'm outta here.
MENDEZ
Anybody need a ride back to the house?
NGUYEN
I do.
DAY
Me too. But I'll drive, brew boy.
MENDEZ
All right.
(Raising his glass in a final toast.)
Anybody got anything to drink to today?
DAY
(Holding up her hospital I.D.)
The Health Security Card.
As the other NURSES raise their glasses, one of the RETIREES from the main bar area appears at their table.
RETIREE
Hey. You all work at the Hospital?
MENDEZ
Brookings? Yeah.
RETIREE
Know any good doctors there?
DUPREE
Depends what you mean by "good."
SMITH
We do, sir, though physicians aren't the only ones who solve health problems, if that's what you're--
RETIREE
Well, let's see how they solve this.
The RETIREE pulls out a HANDGUN and aims it at the NURSES.The screen goes BLACK.
One GUNSHOT.
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