Original subtitles

This is Andrews' fault.

Agreed.

The bourbon may also bear some responsibility.

Agreed.

You said "fault."

You don't regret that we... No, not at all.

Seriously.

It was...

Pretty great.

Yeah.

And definitely shouldn't happen again.

No, it shouldn't.

It'd make things too complicated at work.

Let's chalk it up to, uh,

"Andrews screwed us, so we screwed each other" impulse.

I gotta get going.

I'm covering the E.R. today.

Ooh, right before Christmas?

Gonna be a madhouse.

Yeah.

I love those J-I-N-G-L-E bells

Oh, those holiday J-I-N-G-L-E bells

Those happy

J-I-N-G-L-E B-E- double L-S

I love those J-I-N-G-L-E bells

Oh

Jingle bells, jingle bells

Jingle all the way

Oh, what fun it is to ride...

What is that noise?

"Jingle Bells"?

Two ambulances coming in, back-to-back.

Hey. I need you on your game today, Murphy.

Okay.

Uh, male, mid-30s,

found unresponsive in Arrivals.

Restarted his heart on site. Low O2,

wheezing, significant airway resistance to the bag mask...

We need more hands on deck. STAT. I've been calling,

everyone's left town for the holidays.

Reznick's around.

Weird you know that, but glad you do.

Get Reznick in here. On it.

Take him to Bay 4. Murphy, I need you with me.

What do we got?

This is Marianne Southam, she collapsed in Baggage Claim.

Both patients came from the airport?

It's that time of year. Everyone's traveling.

Right leg is red and swollen.

She's complaining of chest pains, shortness of breath,

and she has a low-grade fever.

Did you just get off a long flight?

20 hours, from Malaysia.

Deep vein thrombosis formed while she was seated,

that explains the red leg and the fever.

Part of the clot broke off, traveled to her lung,

that explains the chest pain. Pulmonary embolism.

We lost his pulse again!

Take Marianne to Bay 5.

I'll talk you through managing a pulmonary embolism.

I'm gonna light him up.

Clear.

Got a rhythm. Barely.

He can't live on 30 beats a minute.

His lungs are too stiff to pre-oxygenate.

Fiberoptic blade and a 7.5 ET tube.

Murphy, anti-coagulate her with a 5,000-unit heparin bolus.

Set the ventilator to assist control.

Heparin bolus infused. Fever's spiking at 103.5.

Could be ARDS from a viral pneumonia.

Get a chest X-ray.

Lost him again.

O2 SAT is 92.

Your chest pain should be getting better.

It is. Thank you.

Peak airway pressure's 50.

Switch the ventilator to PRVC.

Pushing I.V. epinephrine.

Now you need to insert a central line in case we go to thrombolysis.

I need you, Murphy.

Still V. Fib.

Push 300 of amiodarone.

Asystole. He's still not responding.

That's over 30 minutes of brain and cardiac hypoxia.

Stop compressions.

Time of death, 10:07.

Have you had contact with this man?

He was on my flight from Malaysia.

They both have vesicular rashes on their necks.

Whatever infection killed him, she may have it, too.

This is a negative pressure room,

designed so no air flows out.

Keeps germs from spreading.

Because whatever I have is gonna kill me,

just like the man from the plane?

Your symptoms are not as severe as his.

Although, yours will probably get worse

as the virus progresses.

We don't know for sure whether you have the same thing.

We know nothing about him, his condition, or his history.

When did you start feeling sick?

On the plane.

I've never even been outside the U.S. before.

My ex-husband hated to travel and...

Was the man who died sitting near you?

No, he was six or seven rows in front of me.

Were you ever physically close to him?

Say, waiting for the restroom or in line to board?

No, I think he slept almost the entire flight.

That suggests the virus can be transmitted in the air.

Which means everyone in the plane

and this emergency room has been exposed.

We'll start conditioning tomorrow,

so we use chemo and total body irradiation to...

To wipe out my crappy leukemia-producing bone marrow

so you can replace it with some good stuff. Well said.

Looks like your dad's good to go on his marrow donation.

Please don't call him that.

Bob Cravens walked out on me and my mom when I was four.

His biological material gave me life,

and apparently he's gonna save me,

but he's not my dad.

Any unusual complaints or pain we should know about?

I've been tired.

And the last day, achy,

kind of stiff... Standard leukemia woes.

Anywhere in particular?

My neck, left arm.

Right, Chris, you're having a heart attack.

N-No. My chest feels fine.

We need to get you up to radiation right away.

Call and let them know we're coming.

Get his donor in here.

How is radiation gonna help a heart attack?

Your blockage is most likely excess blast white cells.

The best way to clear out your heart

is to treat your leukemia.

It's what we planned. Just a day early.

It might not be airborne.

Maybe both passengers were already infected

when they got on the plane.

Marianne said she felt fine before the flight.

But even if she did contract it on the plane,

it could've been through a shared water cup

or napkin...

Which would make a quarantine unnecessary.

I'll call the Public Health Department, the CDC,

they may want to track the passengers

and anyone they came into contact with.

Keep me up to date. Okay.

Hey. I'm done.

Jill, are you still on?

Get me the CDC and a change of clothes.

I'm coming in.

Thanks for getting me called in, Tyler.

You're welcome. That was sarcasm.

Oh, was it? If this turns into a crisis,

where else would you want to be?

I hear you're having some stomach pain?

It hurts a lot.

I figured it was probably the candy canes, but I took some Pepto.

Didn't help at all.

How many candy canes we talking?

Three or four... Dozen.

Of the little ones.

They pass them out at the mall where I work.

I like to munch on them. Keeps me in character.

Sounds like you might be overdoing it.

Take off your shirt.

How did you know I was still in town?

Because the holidays are "an obligatory performance

"where families buy each other gifts

and pretend everything is perfect."

Which is why you tell yours you have to work every year

even when you don't.

He's a good listener.

What's that scar from?

Rudolph is an ass.

It's a minor bowel resection

for diverticulitis eight months ago.

Oh, we need to do a contrast CT.

You need to come with me.

Dr. Lim, he has it, too.

There, on his neck. A rash.

It wasn't there earlier.

It hasn't fully developed, but it could be the same thing.

It can't be. I had on a mask, gloves...

Did you keep on the mask the whole time?

Not... With airborne diseases, that's important...

It's Marianne. Her O2 SATs are crashing.

Get another dose of I.V. methylprednisolone.

We need to move up the transplant.

No, it doesn't change anything.

You'll be anesthetized, you won't feel a thing

and when you wake up,

your son will be on his way to being healthy.

We'll see you soon.

Sorry I couldn't meet you at the airport.

That's a cool t-shirt.

It probably freaks you out, right?

Like, "is he gonna gender-transition or something?"

No, if that's your thing, I'm cool.

How long am I stuck here?

Just for the rest of this shift.

And then I'm out of here for three days.

There's a new rock-climbing gym we can check out,

and the batting cages.

I'm good.

I got a season of "Rick and Morty" on my phone.

DR. LIM: Clear.

That's six rounds of defib. And 30 minutes of CPR.

Okay, Dr. Murphy, you can stop.

I just spoke with Dr. Andrews.

We're on soft quarantine while he consults the Board.

Call dispatch, put all ambulances on diversion.

Do your best to stop all walk-ins.

Say we're at capacity and send them to County.

Stall all discharges.

Tyler stays in isolation and on antivirals.

Fever is likely the next stage, so keep a close eye.

What else are we dealing with?

I always have lunch by 2:00.

It's 2:15. I need to eat.

I've got a banana in my bag if you want it.

A banana isn't lunch.

A turkey sandwich and milk is lunch.

Dr. Murphy, patients first,

then we'll work on that sandwich.

What else? 60-year-old woman with angina,

visiting her family for the holidays.

Forgot her blood pressure meds. Came in for a prescription.

Her refill just got delayed. What else?

The crib was almost finished when the screwdriver slipped.

My family doctor's closed for the holidays.

They would've sent you here anyway.

This type of injury can cause permanent damage.

Makes me feel less guilty for bringing my baby into a germ pit.

No offense.

Guessing this is your first?

My husband and I waited a long time.

I want everything to be perfect.

Which, as my husband reminds me, is impossible.

Yet, my birth plan is five pages long.

All closed up.

So I can go home?

Not before we do a nerve study.

I would hate for you to lose feeling in your fingers.

You can't leave.

'm sorry. What? Hospital policy.

Look, I'm... I'm not a patient.

All right, I just came down here to get some chips. My dad's a doctor.

Who's your dad? Dr. Alex Park.

Can you call him?

My phone's charging upstairs.

I'll call him, so he knows where to come find you when he's free.

But for now, you've got to stay put.

Why? Because I'm older than you.

Find the employee contact list, call Park.

He should know where his son is. Sure.

I feel so much worse than when I was having a heart attack.

I don't doubt it.

Because of the urgency of your situation,

we used combined leukapheresis, chemo, and radiation.

You're no longer at risk for another heart attack or stroke.

And I also no longer have an immune system.

My donor's on his way, right?

I spoke with him. He said he was getting in his car.

When was that?

I'll follow up.

He's still finding new ways to let me down.

I thought you guys were gonna do a C.T.

We're doing a KUB X-ray instead.

It's almost as good.

Why would you go with "almost"?

Can you hear that?

Hear what? Excuse me.

I'm looking for a patient.

You'll need to speak with a nurse.

I've been waiting to speak to a nurse.

You must hear that. The light is buzzing.

I don't hear anything. It's loud

and very distracting.

It needs to be fixed.

You like Italian?

La Nostra?

It's great.

Barbecue? Ethiopian?

What are you talking about?

Where we're going on our date.

You haven't asked me on one, and I haven't said yes.

Who turns down the request of a man trapped in isolation?

What about sushi? Everybody likes it.

Also, I'm pretty good with chopsticks.

Never hurts to display a little manual dexterity.

You know, tends to impress.

I will want a cocktail to soothe my nerves, but...

Why would you be nervous?

Have you seen you?

You are smart as well as beautiful,

and I will need all the tools in my toolkit to dazzle you, so...

No drink for me.

Have one after the appetizers.

I'll be impressed by then.

You have a fever.

He has a fever, and the rash is fully materialized.

Okay.

Here we go.

Quarantine has been approved.

Yeah.

Can I have everyone's attention?

This emergency room and everyone in it is now under quarantine.

We're hoping none of you have been exposed,

but a serious respiratory virus

has infected three patients.

What? This can't happen.

We're starting everyone on antivirals just as a precaution.

We'll also be bringing in food and water,

so if any of you have any dietary restrictions, please let us know now.

You can't make us stay here. That's right.

I-I can't... Especially not if someone's seriously ill.

We are legally entitled to keep you for...

They locked us in.

Are we locked in? Oh, no way.

I gotta get out. Sir.

Sorry.

Like it or not, no one's leaving.

The decision to implement the quarantine

was made after consultation with the Board.

The CDC has been kept fully informed,

and we will be proceeding in accordance with all protocol...

Shaun, Morgan, and Lim are in there.

And our patient is out here.

There's still no sign of the donor. He's not answering my calls.

I asked my contact at San Jose PD to do a home check-in.

Park.

He's down there?

How... Yeah, put him on.

It's Security... Kellan's stuck in the quarantine.

I'll pass along anything I hear from San Jose PD.

Tyler started coughing.

Let's up his antivirals. Start high flow oxygen and zosyn

to counter any underlying infection.

Santa Pete has a sigmoid volvulus,

he needs surgery very soon.

My call ended 37 minutes ago.

I'm supposed to be somewhere else, It's important.

No, it's not.

We need a non-surgical fix to a bowel obstruction.

Anyone?

Murphy.

Mmm. You got something?

Not really.

Anything at all. Please.

We...

We usually...

We...

We usually make a hole and...

And come at an obstruction from the side,

but we can't.

We need to use the existing holes.

An endoscope risks tearing right through the bowel.

A saline enema doesn't.

And it might untwist the bowel.

Simple, but it could work.

Nice.

I'm fine.

Do you have your inhaler? Of course I do.

What were you doing down here?

This isn't my fault.

If you hadn't been working... Kellan.

I know you must be scared.

I'm fine.

I'm keeping this hat on for luck.

Here we go.

I'm threading the tube into the rectum.

Now, slowly push the saline.

That's...

It's not a pleasant experience.

I'm getting some resistance to flow.

I must've reached the obstruction.

Push harder. Hang in there, Pete.

Call me Santa...

Ahhh!

Keep pushing the saline.

I'm sorry, Santa.

I feel so much better.

We've got you on a pretty high dose of antivirals.

TYLER: So, what's next?

We're debating nitric oxide...

No, I mean if this doesn't turn around.

What happens to me next?

ARDS.

Then full respiratory failure.

Hey, I've got a new idea for our first date.

Archery.

I used to compete when I was young.

Basically, you'd be showing off.

I can show you some tricks.

Teach you a spit-finger hook, how to anchor...

And then proceed to demolish you.

Well, that sounds like a reason to live.

I'm here to take you to your imaging appointment.

Where's Shaun?

Shaun is quarantined in the E.R.

Quarantined? What, what... What quarantine?

Apparently for some highly contagious, deadly virus.

But Shaun sounds fine.

Except for some buzzing light

and his concern about lunch

and you missing your appointment at the imaging clinic, so...

Let's go. Take me to the hospital.

We are going to your appointment and making sure

your think-melon remains tumor-free.

Take me to the hospital please.

I'd like to help. How?

By taking your old job back and saving the day?

Putting on an "Outbreak" suit and rescuing Shaun?

Some people may find your sassy attitude appealing.

I'm not one of them.

And I am crushed.

Sir, I'm sorry. You can't...

My wife's in there.

Viola! Look, that's her. I need to get in there.

They're setting up a room inside for friends and family.

Clifton, what are you doing?

Look, I'm coming in. Stop... Let go of me!

Calm down or you're gonna get hurt.

Stop. This is all my fault.

No. If I'd put the crib together like you asked...

Forget about the crib.

I need you to take care of yourself.

Because if something happens to me...

...our son needs someone to take care of him.

It's... It's a boy?

I'm sorry I'm ruining your surprise.

No.

Baby, I love you so much.

I love you, too.

I love you.

Dr. Shaun Murphy.

Shaun?

Why are you answering our donor's phone?

Because he's here in quarantine.

What happened to the CDC getting a team here today?

They confirmed that it started in Malaysia last week.

Between the virologists already there

and the ones grounded on the East Coast because of the snowstorm...

Stay on them.

What do we know about the virus?

Similar symptoms to SARS, but much faster moving.

Is Bob Cravens infected?

Not so far.

Currently Tyler Durnes, the EMT,

is the only person displaying symptoms.

I need his bone marrow. I'd like to go in and get it.

I'll comply with all protocol.

You're not hot zone certified. None of us are.

My leukemia patient has no immune system.

He'll die soon without a marrow transplant.

Well, then you best find him another donor

because no one, or their bone marrow, is leaving that quarantine.

Have you heard from County about taking our PICU transfers?

H-How are my O2 SATs?

Holding steady.

Do you want to call anyone?

Uh, I, uh...

I... I thought about letting my mom know...

what was going on, but...

She'd just worry about me and feel bad she's not here.

So...

She... She knows I love her.

How's it going in here?

Dr. Reznick was just telling me

about some college lesbian experiences...

Was that just my imagination?

Actually, we were talking about your mother.

Interesting.

I don't like the drop in his O2 SATs.

Let's start him on nitric oxide.

I knew you liked me.

He's in this hospital?

Bob actually came through for once.

Unfortunately, we can't wait for him to get out of quarantine.

But we found an alternative donor in the Bay Area.

How compatible are they?

They share five out of eight of your markers.

Bob is a much better match.

I can't handle marrow rejection,

or having to repeat this nightmare.

That's a symptom of the MAC pneumonia.

The antibiotics aren't working.

You need bone marrow, or this infection is going to kill you. Soon.

Days, not weeks.

Seven years I've been battling leukemia.

Been through four full courses of chemo,

so many trips to the hospital I've lost count.

Just knowing my father showed up,

I'm grateful, relieved.

I'm okay if this is the end.

I'd like to sign a DNR.

Chris, the CDC will be here tomorrow.

If they can identify the virus, we can test Bob.

If he's negative... Whatever you can manage before my heart stops,

go for it.

Please get me the form.

His fever's climbing.

Give the nebulizer time to work.

Cooling blankets, that could help.

I'll go get some from the supply closet.

Put your mask back on.

Why?

Because I'm infected.

You got it, too?

You guys any closer to figuring this thing out?

Afraid not.

On the bright side, I...

I think I'm growing on Morgan.

There's got to be a way.

You can't go in.

Bob can't come out. The marrow can't come out.

What if it doesn't?

What if the marrow never leaves?

Are we suggesting we put a man with no immune system into the quarantine?

We expand the quarantine, create a section just for him.

One of the doctors inside could do the extraction and the transplant.

And then one of two things happens.

He stays in isolation till we know he hasn't been infected.

Or it kills him.

There's no way Andrews will let us expand the quarantine.

Wish me luck.

Going to 360 Joules. Clear.

We can crack his chest and do cardiac massage.

Dr. Reznick. Have Petringa bring in

the internal paddles from the trauma bay...

Morgan.

Hey, Doogie.

You didn't hear me talking to you?

My sugar's crazy high. 650.

That doesn't make sense.

I gave you the proper dosage of insulin.

10 units.

10 units?

10 units doesn't even make a dent with me.

You got a doctor around here who knows what he's doing?

I'm Dr. Shaun Murphy.

I'll give you another 10 units.

Waste of time. Make it 20.

I'll give you 10.

What's wrong with you? You sound like an idiot.

Don't be a jerk. Mind your own business.

Doc. Doc, I don't feel so...

Ahhh! What the hell?

Did he just infect me?

Possibly.

I need to examine your abdomen.

Your obstruction has returned.

You need surgery, now.

But we're stuck in here.

And there's no operating room.

We will have to improvise.

There's no Neptune machine.

Without suction, the surgical field will be filled with blood.

We can use the wall suction, set to continuous.

That'll do.

No electrocautery to control the bleeding.

You'll have to do this combat style.

Tie off each artery before you cut.

Dr. Reznick.

Are you ready? Because I think we are.

I'll go get the patient.

You should lie down.

He's out.

Scalpel.

If we expand the quarantine, I can do the transplant.

The only technical breach will be...

She's infected.

Melendez.

Yeah.

Take down the adhesions on the sigmoid.

How are his vitals?

Holding steady, Doctor.

That's dead bowel.

It's perforated.

Damn it.

I need a doctor!

Petringa needs help.

If I don't secure these clamps,

there'll be stool everywhere.

Murphy, go.

He signed a DNR.

He shouldn't have.

This is battery.

He doesn't need to die.

We're gonna get his donor's marrow.

Andrews agreed to the plan?

Not yet.

If he doesn't, we'll think of something else.

He said he was feeling lightheaded.

I hear you, but please stay back.

He's... Is he infected?

From when Santa vomited on him?

He should go to isolation.

He's in...

...hypoglycemic shock.

Give him D50.

It's spreading.

Kellan!

Kellan!

Kellan!

Kellan! Kellan!

Kellan!

Dr. Glassman?

Hi.

We got what we needed for images.

You are okay to go.

We'll send them to Dr. Blaize.

Anything I should be worried about?

You're seeing Dr. Blaize before the holiday?

As a matter of fact, I'm seeing her now.

So, I could just show her the hard copy.

I'm not supposed to do that. Oh, no. I know.

I've been a neurosurgeon for, like, 100 years.

I understand protocol. I'm not gonna look at it.

I just want to move things along.

Thank you.

It's back.

Suction.

I must've nicked a branch of the inferior mesenteric artery.

I can't see where.

Can you feel it?

I think so. Use your finger to plug the hole.

Now what?

Dr. Lim?

Everyone, calm down.

Hey, Kellan! Kellan! Look at me!

Look at me! Breathe!

Can... Can you hear me? Can you hear me?

Help my son!

Silent night

Holy night

All is calm

All is bright

Round yon Virgin

Mother and Child

Holy Infant

So tender and mild

Peace

Sleep in heavenly

Peace