Summary: Romano is overseeing a trauma case Abby, Sam, and Neela are working on together. It’s not going well. Abby made the wrong call with medications, and Romano gets Neela to tell him what she should have used instead. (He is, unsurprisingly, racist in the process.) The patient doesn’t make it, but it’s okay because it’s just a practice dummy.
It’s Thanksgiving, but Abby doesn’t have any family in town, so she doesn’t seem too disappointed to have to spend the holiday at work. The ER is busy, and Luka can’t find a room for his patient, Mr. Garland, who has pneumonia. He needs IV antibiotics and isn’t thrilled to be away from his family on Thanksgiving. Luka asks Abby about her training, and she laments that she looked dumb. He thinks she’ll catch on in time.
Frank is annoyed that no one on the night shift decorated the admit area for the holiday. He thought his only responsibility was organizing the staff potluck. Sam has left Alex home alone, which sounds like a disaster in the making. She’s happy to only be working until 3:00, when she’ll get to spend Thanksgiving with her son for the first time in years.
Neela goes to grab a coffee from the desk and learns that the nurses have a coffee club with monthly dues. Looks like Abby’s still in the club. Susan’s overseeing med-student assignments, so maybe she’s more involved with them than I previously thought. Pratt catches Morris picking through charts for a patient who doesn’t have something gross wrong with them. Frank snaps a picture of the two of them with an old camera he found. He wonders what else is on the film roll.
Abby tends to a woman named Loren who worries that she’s having a miscarriage. She’s also HIV-positive. Lily asks Abby to work a nursing shift that night, even though she usually only does them on weekends. Susan offers to let her off her med-student rotation at 5:00 so she can take a nap before clocking back in. Abby resists taking one for the team, but agrees to work if no one else can come in.
Morris examines a man who’s been treating his glaucoma with some special medication his nephew gave him. That “special medication” should stay in his pocket so any cops who happen to be in the ER don’t see it. (That’s my way of saying it’s pot.) Coop is taking care of a man named Fritz who accidentally cut himself with an electric carving knife.
Paramedics bring in a man named Mr. Westbrook who was in a car accident. Pratt and Elizabeth quiz Morris as they start to work, but Morris wants to go back to his glaucoma patient. Pratt chastises him for giving up a great learning opportunity. Abby asks for a second person to be in the room while she performs a pelvic exam, but when Neela offers, Abby turns her down. Luka’s having trouble getting Mr. Garland admitted, but Mr. Garland is very patient and is willing to wait. That makes a total of one patient in the hospital who understands that you can’t always get treated right away.
As Neela learns what a turducken is, Abby does Loren’s pelvic exam and confirms that she’s miscarrying. Loren suddenly passes out, so Abby calls the admit desk to get Frank to find someone who can help her save her patient. Westbrook doesn’t want to be treated at County, so he starts to call his lawyer. (No, I don’t know why he thinks he needs a lawyer.) Pratt tells him he can’t use his cell phone in the ER, but Westbrook ignores him.
Pratt takes the phone from him just as Romano arrives. Westbrook went to Wharton with County’s CEO, which makes him a VIP, so Romano’s there to suck up and berate Pratt for not giving him special treatment. Pratt says he treats all his patients the same. Romano regrets letting Pratt continue working at County after his previous missteps. Pratt refuses to sign any papers allowing Westbrook to be transferred to another hospital, even if tests show he’s stable enough to go. Romano says it doesn’t matter, because Pratt’s fired.
Loren’s stable, despite some blood loss, but she’ll need to have a procedure to complete her miscarriage. Abby acts like it’s not a big deal, but Luka pulls her out of the room to say that because of some fibroids, it won’t be that simple. Abby needs to be more careful about what she tells patients. Pratt has ignored Romano and is still seeing patients. He even tries to get back on Westbrook’s case. Romano tells him that they’ll be meeting with Weaver and Anspaugh at the end of Pratt’s shift. Pratt comments to himself that this is the only way Romano can avoid spending Thanksgiving alone.
Frank snaps another candid picture as various staff members do various medical things. Morris gives his patient a prescription and tells him to stop using pot. Gallant arrives as Luka and Sam tend to patients who have had to hang out in the hallway because the ER is too full for them. Mr. Garland is still being patient; it helps that he likes to people-watch. Luka tells Sam to get restraints for him, which confuses her, since Mr. Garland is totally calm.
Coburn comes to see Loren, who needs exploratory surgery and could need a hysterectomy if Coburn can’t control her bleeding. Loren refuses to consent to that. Abby pulls Coburn out of the room to ask her to consider other options. She thinks Coburn is jumping to the most damaging solution because Loren has HIV.
Romano intervenes and sides with Coburn. He doesn’t think a woman who has HIV should be having children. Abby notes that Loren’s viral load is low and her chances of transmitting HIV to a baby are less than 3%. Romano says Loren will die before her kid turns ten. Coburn agrees to try something less invasive, but she can’t promise not to have to perform a hysterectomy.
Chuck brings Susan some flowers that he says he took from a dead patient at another hospital (I can’t tell if he’s joking or not). He wants to get together that night, but Susan isn’t interested. Westbrook’s transfer has been approved, and Chuck will be one of his flight nurses. Romano declines to accompany his patient to the roof as he’s loaded in the helicopter. Fair.
Abby sends Loren to surgery, promising to scrub in on her procedure later. Coop discharges Fritz, who says he doesn’t need painkillers – he’s immune to pain after ten years of marriage to his wife, Berta. Neela gives a girl helium (apparently it’s used for asthma patients sometimes) and demonstrates some good bedside manner.
Frank tells Romano that Westbrook left his watch in his trauma room, so Romano tells Neela (“Indira”) to take it to the roof. Frank thinks Romano won’t take it himself because he’s scared. Romano takes the bait and says he’ll go with Neela. As they’re leaving, Morris’ patient returns and complains that Morris stole his medication. Morris is currently in an alley, about to smoke that medication.
Luka and Sam take Mr. Garland to the ICU, and Luka uses restraints to attach him to a pillar so the ICU staff can’t get rid of him. Luka lies that Mr. Garland is a troublemaker and might leave against medical advice. He doesn’t buy Kit’s excuse that they can’t take more patients, since the ER accepts more than they can accommodate all the time.
Romano and Neela are quiet as he tries to hide his anxiety in the elevator on the way to the roof. The muzak is Tom Petty’s “Free Fallin’.” When they reach the roof, Romano has a bit of a staredown with the helicopter. He stays in the elevator while Neela takes the watch to Westbrook. As Chuck is loading Westbrook on the helicopter, a flight nurse from the hospital where they’re taking Westbrook says that they’re at capacity and Chuck can’t come. Chuck says he has to, for insurance purposes, so the other nurse will have to leave.
Romano rushes back downstairs and outside to the ambulance bay, needing fresh air. He spots Morris smoking and sends him to the admit desk for a timeout. He’s not allowed to move until Romano comes to get him. On the roof, Neela and a nurse head back to the elevator after putting Westbrook on the helicopter. A strap on their gurney gets caught and they pause to free it. The helicopter suddenly comes back down, spinning on its side. Debris flies at Neela and the nurse, and a big chunk of metal hits the nurse in the back. The helicopter tips over and falls off the roof.
In the ICU, Luka and Sam are bickering over whether it’s okay to force the staff to admit Mr. Garland. Outside, the helicopter explodes, rocking the hospital. It falls out of the sky into the ambulance bay, landing right on top of Romano. No, really. No, REALLY. Romano is dead, and it’s because a helicopter fell on him. I AM NOT MAKING THIS UP.
The ER staff starts preparing for mass traumas. Abby tells Susan that there was a helicopter crash, and Susan immediately worries that Chuck was involved. At this moment, she realizes she cares about him more than she thought. Abby gives Neela and Lester a crash course on triage and sends them to the ambulance bay to assess patients. Morris stays put at the admit desk, since Romano told him not to move.
Susan goes outside to see how bad the situation is. Uh, it’s bad. A bunch of people are hurt and a bunch of stuff is on fire. Susan is still worried about Chuck, but she has to set that aside to take care of a patient. Fritz is hurt but wants the staff to work on Berta first. Abby tells Susan she can go wait inside and let everyone else take care of the patients, but Susan isn’t going to sit out a mass trauma, even though she’s having trouble keeping her emotions under control.
The ICU is on fire and the phone lines are dead, so the staff can’t call for help from other departments. Luka has to undo Mr. Garland’s restraints to move him to safety, but he can’t find the key. Freaking A, Luka. Back outside, the staff is moving quickly to get patients into the ER. A firefighter tells Susan that so far, four people have been declared dead. Abby again gives Susan the chance to sit this out, but Susan won’t take it.
Luka tries to help a woman whose intubation melted because of the fire. ICK. He and Sam are both keeping their cool as they deal with critical patients in the middle of a smoky room. Weaver arrives outside, relieving Susan of her position as the current highest-ranking staff member. She’s not happy that Susan doesn’t know where Luka and Romano are, since she’s supposed to be the incident commander, but when Susan tells her that Chuck was on the helicopter, Weaver backs off.
Weaver joins Gallant to treat Fritz as Berta is taking up to surgery. Anspaugh has also arrived, having selflessly skipped out on Thanksgiving dinner to come lend a hand. Staff members transport patients around, including Dwight, who may have a concussion. Pratt praises Severa for continuing to work with an injured hand.
And then, like an angel from Heaven, Chuck steps off an elevator. He got taken off the flight at the last minute and has brought down another patient instead. Coop, who’s working with Susan, spots Chuck across the ER and comments that he thought Chuck was dead. Chuck gives Susan a wave through the window, having no clue that she thought the worst had happened. She runs to him and grabs him in a tight hug. He complains that the flight nurse who came with the helicopter wouldn’t let him fly with her. Susan points out that that woman saved his life. She has to go back to work, but she takes a moment to be relieved that he’s okay, with just a scrape on his back.
Luka’s having trouble with his patient in the ICU, and the department is short-staffed, so it’s basically just him, Sam, and Kit taking care of everyone. Luka finally stabilizes his patient, then goes to help Kit as Sam heads to the OR to get some more supplies. In the ER, Pratt is tending to a patient with a carotid injury that’s left him paralyzed. From the next trauma room, Weaver tells him to send the patient to surgery. Pratt doesn’t think he’ll live that long, so he preps for a procedure in the trauma room.
Coop’s asthma is acting up, so he takes some helium, which of course makes him sound funny. Suddenly Chuck collapses in an exam room. Abby realizes his back is bleeding. Neela goes looking for a doctor, but everyone’s busy. She goes back to Abby, who’s working with Lester to revive Chuck. He needs to be intubated, but none of the med students wants to take the lead. Abby steps up and gets it done, but Chuck has an injury to his spleen and needs a central line, something an attending usually handles.
Luka, Sam, and Kit are working on the last critical patient in the ICU. Trivia: Sam used to be a surgical tech. Somehow, there’s an OR available, and Anspaugh takes the patient right up, complaining that he has to miss Thanksgiving. Oh, wah. At least you don’t have metal in your spleen like poor Chuck does. Sam realizes she’s two hours past the time she was supposed to go home. Luka tells Mr. Garland that his burns aren’t too bad. “I liked it better downstairs,” Mr. Garland replies. “I only had pneumonia downstairs.”
Fritz doesn’t make it, and once Weaver declares him dead, she goes next door to check in with Pratt. He couldn’t get a surgeon to take his patient up, so he’s doing the procedure Weaver told him not to do. She’s surprised to see that the procedure worked and the patient is no longer paralyzed. I’m sure Pratt will get yelled at later, but for now, it’s hard to argue with his results.
Neela goes looking for an attending again, which is how Susan learns that Chuck is now a patient. Abby admits to doing procedures she wasn’t supposed to as a med student, but she gets Susan to sign the paperwork saying she did them. Elizabeth comes to get Chuck so he can go to surgery. Susan heads up with them, tearfully thanking Abby for saving his life. Abby and Neela have their first quiet moment in hours, wondering if the chaos is over.
Later, Coburn tells Abby that she tried to be conservative while treating Loren but she ultimately had to do a hysterectomy. I think Abby’s just grateful that she considered all her options before making the decision. Alex arrives, excited because there was a big disaster. He invites Luka to join him and Sam for dinner at a diner, since Sam didn’t have time to cook. Sam resists, but Alex talks her into letting him come.
Anspaugh goes to get Pratt so they can have their meeting with Romano, who’s MIA (of course). Weaver is still tending to a patient and tells them to fill her in later. Romano has sent Anspaugh a bunch of Pratt’s disciplinary letters, and it’s enough to merit a suspension, but Anspaugh doesn’t buy any of it. Since Romano’s the only one who’s complained, and he didn’t bother to show up to this meeting, Anspaugh won’t take him seriously. Plus, he saw Pratt in action today and knows he’s a great doctor.
Alex wants French toast for dinner. No one cares. He’s annoyed with Sam for ruining their Thanksgiving, and he starts to burn a little figurine in the candle on the table. Luka wisely excuses himself. Sam asks Alex why he invited Luka, and why he considers a man over the age of 30 his friend. She knows Alex is trying to fix them up. Alex says Luka’s his friend, not Sam’s.
Abby gave some orders for a patient hours ago, but because of all the chaos, none of the nurses completed them. Abby confuses the patient by saying she’ll do it, since she’s a nurse now. Lester and Neela ask Abby a couple of questions about treatments, and she demonstrates her medical knowledge. Someone took the time to develop the pictures Frank took earlier, and Lily and Chuny laugh over one of Pratt. Morris is still at the desk, since Romano hasn’t let him out of timeout. Pratt can’t believe he sat out the entire mass casualty.
The other pictures on the film roll are from a couple Christmases ago, and Chuny points out Mark to Neela. Lily gives Abby one of her with Romano in the background. There’s a staff photo that includes Mark and Carter, and Lily asks if anyone has heard from Carter recently. Frank says he sent a postcard a month ago. Chuny asks how he is, and Abby says she doesn’t know. Cut to Carter in the Congo, with a beard and a woman named Kem who wants him to come back to bed. So I’d say he’s doing pretty well.
Chuck is out of surgery, and Susan visits him with the flowers he gave her earlier. He jokes that he should fake his death more often. He knew the two of them would end up spending the evening together. Awww, you guys, she loves him! Outside, Abby returns from a coffee run and meets up with Neela, who’s impressed with how well they handled the day’s crisis. It was a roller-coaster. She usually hates them, but she liked this one. Abby offers her coffee, and Neela says she’s not in the club, but Abby bought an extra one. Meanwhile, a crew lifts up the helicopter and finds Romano’s body underneath.
Thoughts: Kem is played by the fantastic Thandie Newton, who is ten times more talented than she ever gets to show in this series.
I have to wonder what went through Paul McCrane’s (Romano) head when he found out how his character was going to die. “A helicopter? Again? …Seriously?”
Ugh, naming a German character Fritz is so lazy.
The scene where Susan and Chuck reunite gets me every time. Even if you don’t like or care about them together, you have to enjoy that moment.
'90s Flashback 
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