August 27, 2019

ER 4.15, Exodus: Carter, Take the Wheel

Posted in TV tagged , at 5:04 pm by Jenn

The face of a (decontaminated) hero

Summary: Doug goes to see Carol before work, but she doesn’t come to the door. Elizabeth is preparing for a ride-along with Zadro, who doesn’t think she’s ready for what they could face. She’s there to observe and see what the paramedics experience every day. She promises to follow protocol and not go off on her own. They head to the scene of a building fire and learn that someone’s trapped in some rubble. Elizabeth offers to crawl under the building to tend to him. The building is just barely still standing, so Elizabeth is risking her life for the trapped man.

At County, Anna and Weaver chat in the cafeteria before running into Carter. He’s working in ophthalmology right now and offers to examine Weaver, who thinks she might need new reading glasses. Paramedics bring in a man named Chuck who fainted during a breakfast meeting. He thinks his assistant overreacted and his condition isn’t serious. He hopes Jeanie isn’t the only medical professional who will be treating him; he’d prefer a doctor. Jerry tells Weaver that a fire and explosion have led to a number of injuries, so they’re about to get an influx of patients.

Elizabeth and a firefighter do what they can for their patient, Leo, but Elizabeth can’t assess his arm, which is pinned under concrete. She’s worried that she won’t be able to save it and will have to amputate. She promises Leo that that will be the last resort. Elizabeth requests something she can use to oil Leo up so they can slide his arm out. The firefighter suggests motor oil.

Carter’s supervisor for the week kicks him out of the exam he’s performing and sends him to the ER for a glaucoma patient. The people from the fire and explosion start coming in, including a guy named Glenn. Jerry is pleased that Chuck has excellent insurance, which could help with the ER’s budget deficit. Weaver tells Chuck that he may have had a small heart attack, so he’ll need to stay there for a little while. He asks her to call his regular doctor, though Weaver promises that his standard of care at County will be terrific.

Elizabeth and the firefighter, Dewey, oil Leo up and try to yank him out of the spot where he’s stuck. It doesn’t work. The building shifts and debris falls on them, thanks to an explosion in the chemical area of the building. One of Dewey’s fellow firefighters radios that they need to evacuate immediately. Elizabeth refuses to leave Leo behind, ordering Dewey to go get whatever he needs to get Leo out. She knows no one will let the firefighters or paramedics leave her behind if she’s still down there. Leo isn’t as optimistic as Elizabeth that this one piece of equipment they need will solve all their problems.

Carol brings Doug a patient, an eight-year-old girl named Sophie who’s altered. She tells him she wasn’t at home when he came by because she had an early meeting. Doug is skeptical, so Carol asks if he’s monitoring her. He says he only stopped by the house to offer her a ride to work. Sophie’s babysitter, Donna, tells Doug and Carol that she’s been sick for a couple days, but not this sick. They send her to try to contact Sophie’s mother again.

Carter examines the glaucoma patient, Bikel, who mentions that he used to do a scientific TV program. Then “that son of a b&^$% Mr. Wizard” came along and Bikel’s 15 minutes of fame were over. Thanks to his science background, Bikel understands the cause of his problems and the mechanism of the equipment used to treat it. He offers to build Carter one out of household materials.

Sophie’s in kidney failure, possible from E. coli. They have to put her to sleep to intubate her and help her breathe. Sophie’s mother arrives, shocked that her condition has gotten so bad. She asks for a second opinion before allowing Doug to give her dialysis. Doug bluntly says that she’ll die without dialysis. Back at the building, Elizabeth ignores Dewey’s warnings and uses a jig to raise the building slightly and make it easier to get Leo out. It work, but more debris falls, and the group is barely able to make it out before the building collapses on them.

At County, some people from the chemical wing of the building bring in a co-worker. They’re all covered in solvent, which has made some of their other co-workers sick. Weaver tells Jeanie to bag up their clothes. As Carter is escorting Bikel out, they smell the solvent, which Bikel recognizes as benzene. Carter figures it’s just something being used to clean the floors. Bikel tells him to find out where the smell is coming from ASAP.

Carter heads to the ER, where the benzene smell is slowly affecting everyone. Weaver collapses, and Anna and Jeanie help her as she starts seizing. Carter announces that it might be benzene, so everyone needs to be sure not to touch it. At the building, the fire captain yells at Elizabeth for taking too many chances. She and Zadro are told that there’s an unknown solvent leaking from a holding tank, so everyone at the scene will need to be decontaminated.

With Weaver out of commission, Anspaugh away, and Mark still in California, no one is in charge of the ER. Carter starts handing out assignments so they can keep the contaminated patients away from the others. Glenn, being wheeled through by Benton on his way somewhere else, tells the staff to call a Hazmat unit. Jerry has the idea to start up a fan to get rid of the fumes, but Carter stops him, worried that a spark could ignite.

Carol makes the decision to close the ER to new traumas. Jerry runs around looking for something. Elizabeth and Zadro bring in Leo, but Carter won’t let them enter the ER. He sends them to a back hallway and assigns Malik to assist with prep for surgery Leo needs on his arm. Chuck gets moved out of the ER as Benton brings Glenn back through. Randi has passed out from the fumes, so the staff is down one more helper.

There’s a traffic jam in the hallway, as the surgeons don’t know where to take their patients. Another victim from the explosion is brought in, even though Carol put a stop to paramedics coming in. The paramedics are mad, but Jerry blames them, since they didn’t control the scene, allowing the first benzene-covered patient to be brought in by a co-worker. Everyone yells at each other to move until Carter decides it’s time to put on his superhero cape and take control.

Carter announces that they need to evacuate the ER. Anyone contaminated by benzene will be sent to the ambulance bay. Randi, now conscious again, objects to going outside without her coat. Carter tells Anna that they need to send non-urgent patients home. People who need x-rays or stitches can wait in the lobby. Carter starts taking record of all critical patients, then sends them to the cafeteria, since it’s big enough to hold them all.

Doug needs to move Sophie during her treatment, which the dialysis nurse, Dori, says is a horrible idea. They have to unplug the machine and use a hand crank to continue keeping Sophie breathing. Jerry searches the lounge for the hospital’s disaster manual, but Carter doesn’t see the point. Right now, they need to move. Anna finds information on benzene, and she and Carter determine that they just need to keep treating those affected with oxygen.

Benton takes the lead in the cafeteria, ignoring the complaints of a cafeteria worker who doesn’t want her tables moved. Outside, Jeanie tells the fire captain that they need to set up shelters for the patients in the ambulance bay. Carter sends a bunch of supplies to the cafeteria, then prepares to stock the other triage areas. The captain tells him he needs to evacuate along with everyone else. Carter asks for five more minutes to make sure the supplies are taken care of. The captain gives him two.

Doug, Carol, and Dori are about to move Sophie up to the pediatric ward. Lily calls Carter in to help her transport an elderly woman, Inga, who needs manual oxygen bagging. Carter sends Lily off with supplies, thinking he can move and bag Inga at the same time. There isn’t enough room for Sophie’s bed, her dialysis machine, Doug, Carol, and Dori in the elevator, but Doug doesn’t want to take Sophie to the cafeteria with the other critical patients. He tells Dori to take the elevator with the machine and meet the rest of them upstairs.

Poor Inga has to bag herself as Carter wheels her through the hall. The fire alarm starts going off, and moments later, the elevator Doug, Carol, and Sophie are in stops. Sophie, who’s awake and aware of what’s going on, only has 20 minutes of oxygen left. Doug presses the alarm and hopes someone hears it.

The Hazmat team has arrived and is decontaminating peoplein the ambulance bay. Sophie’s mother is outside, and not happy that she won’t be let in to find her daughter. The fire captain assures Carter that there’s no fire; someone must have panicked and pull the alarm. Weaver’s conscious but confused, which Carter tells Jeanie is probably from her seizures, not the benzene.

The captain tells Carter that they’ve divided the ambulance into cold and warm zones. No one goes in the warm zone without a Hazmat suit. The ER is a hot zone. The hospital’s VP of operations, Harriet Spooner, arrives to take on the role of incident commander. She chastises Carter for evacuating the ER to the cafeteria; he should have sent the patients to the physical therapy wing. Carter’s like, “We were a little too busy trying to save people’s lives to look up things like that.”

The firefighters are alerted to the alarm from the elevator, but the phone is dead, so they can’t contact Doug and Carol. They’re currently trying to keep Sophie calm and alive. Doug’s annoyed that they don’t have a medication they need, and Carol reminds him that it wasn’t her idea to move Sophie like this. They pick something else, though if they don’t get out in the next ten minutes, before Sophie’s oxygen runs out, it won’t matter.

Leo’s ready for surgery, so Elizabeth takes him out of the cafeteria. A decontaminated Weaver is brought in and placed next to Chuck, whom she doesn’t remember treating. Chuck is probably mentally making a list of reasons this hospital sucks. Chuny gets another ventilation machine for the critical patients, and Inga declines to be the first one to use it. She insists she’s fine continuing to manually bag herself.

Carter takes Harriet to Weaver, who probably doesn’t appreciate her superior seeing her in this position. Weaver doesn’t even remember what happened to her. Harriet has an action packet and walkie-talkie for the chief medical officer, which she guesses is Carter. She heads to the elevator to oversee Doug, Carol, and Sophie’s rescue.

Doug is done waiting and manages to pry open the doors a few feet short of the next floor. Carol’s worried that he’ll hurt himself climbing around; he jokes that, in that case, she won’t have to worry about commitment. As Sophie’s oxygen levels fall to dangerous lows, the rescue team makes contact with Doug. Carol doesn’t think Doug can get the doors all the way open, but with help from the rescue team, he proves her wrong. Scrub nurse Kit is waiting with oxygen for Sophie.

Romano meets Elizabeth in the OR for Leo’s surgery, though he doesn’t think they’ll be able to save his arm. (Ooh, foreshadowing.) Benton tries to take care of Glenn in the cafeteria, with limited resources. Weaver asks Chuck to tell her what happened while she was unconscious. She’s not happy to hear that he was present when her clothes were removed.

One of the contaminated people is having trouble breathing, but the fire captain doesn’t want Carter to go into the warm zone to help him. It’ll take Carter a long time to suit up, and by the time he’s done, the patient will be out of the warm zone. Carter’s not willing to wait, so he grabs some equipment and tries to make a break for the warm zone. The fire captain stops him, but Carter breaks away and makes it in. As soon as he’s intubated the patient, Carter’s forced into a decontamination shower.

Glenn needs surgery on his leg, but it’s Inga who’s in serious need of help. In the ambulance bay, Carter hears that she’s coding and runs back to the cafeteria to help. Benton, Anna, and Chuny are trying their best to save her, but they have to declare her death after 18 minutes. Benton takes Glenn off to surgery, leaving Inga’s body behind. Carter’s mad that he didn’t take her to the ICU. Anna points out that he turned the cafeteria into an ICU. Carter corrects that it’s just someplace they threw together. Anna knows from reading Inga’s chart that she wasn’t going to live much longer anyway.

Chuck feels dizzy again, thanks to another heart episode. Carter sends Jerry to the pharmacy to get some medication. He and Anna need to shock Chuck’s heart, but the battery on the remaining crash cart is dead. Chuny and Lily move it to a wall to plug it in. Carter looks around the room, weighing his options, then fills a bin with ice water. He dunks Chuck’s head in, triggering a reflex that slows his heart and revives him. Jerry returns with the medication, thinking he’s just saved the day.

Leo’s out of surgery (minus one arm), and when Elizabeth gets a minute to breathe, Benton examines a bruise she sustained under the building. She asks for a “debriefing” once he’s done with surgery for the day. So…that’s where their relationship has progressed. Up in pediatrics, Sophie is doing much better, and she gets Doug and Carol to admit that they were scared on the elevator. Since she was on a ventilator, she wasn’t in any danger from the benzene, so her mom’s upset that Doug and Carol reacted the way they did. Sophie says they took good care of her.

On their way to the ER, Doug asks Carol if she’s still mad about that morning, and what she perceived as him spying on her. She says she was just annoyed, and he doesn’t need to check up on her. He says he wanted to see her last night, and they shouldn’t spend so much time apart anymore. She agrees. They get in another elevator together, hoping this one will do what it’s supposed to.

The ER is quiet and empty when Carter leads the critical patients back in. Weaver thinks she’s well enough to take charge. She appreciates Carter’s help during the emergency and asks him to speak to the press. Carter’s barely listening as she tells him how important the PR response is. He’s still overseeing the operations in the ER.

Jerry tells Weaver that the admins who work the day shift are to blame for the poor emergency response – they haven’t been keeping their work area organized. Things would have gone more smoothly if Jerry had been able to find the manual he needed. Now that he’s back working days, he promises more efficiency.

Carter runs into the fire captain as he leaves for the night. Carter things the staff handled things pretty well, but the fire captain disagrees. The staff was unprepared, though Carter himself did all right. In fact, the captain wants to work with him to schedule disaster drills. Carter says he doesn’t have the authority to head up something like that; he’s just an intern. The fire captain is surprised to hear that. Mark arrives, fresh off the plane from California, and Carter goes back inside the hospital to tell him everything he missed.

Thoughts: Four recognizable guest stars here:

This is one of my favorite episodes. This is how to do an episode about a big disaster. The show, unfortunately, won’t always remember this later.

Look how mature Benton is, letting Carter take charge. He could have postured and tried to take over, just because he felt like it, but instead, he let Carter keep running things. I think he knew Carter could handle it.

1 Comment »

  1. Nick Rivers said,

    Really loved this episode, both the first time I saw it and on this rewatch. It’s right up there with the huge snowstorm-car-crash episode from season 1. I always like the disaster episodes because it forces all the docs out of their comfort zone. Who knew that Carter had a knack for creative problem solving, both from managing and handling the disaster with aplomb to his treatment of Chuck with the ice dunk? You don’t get to deal with that sort of stuff in surgery, so this should cement in Carter’s mind why he is best where he is, in emergency medicine. Some people crumble under pressure and stress and crisis situations, and some people rise to the occasion. I think Anna would have handled it well too, and we know Mark and Weaver would have done fine with it, probably Doyle as well though she’s essentially written off the show at this point. And we saw Susan Lewis handle things excellently as well. However, I think Corday would not have handled it well, thinking back to how she froze when her vocal cord patient was coding in the OR, and how impulsively she acted in this episode, which put several lives at risk. Benton might have done fine with it but he didn’t rise to the occasion as quickly as Carter did; both recognized that there was no clear chain of command but only Carter took the reins quickly to lead. I gotta watch this one again!

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