Recap / ER S1E10 "Blizzard"

Season 1, Episode 10:

Blizzard

Chestnuts roasting on an open fire...

Winter is in full swing, and the pace at County General has slowed down significantly.

Jerry walks to work singing "Jingle Bells" and arrives at the front door... just as Nurse Wendy rollerblades into him, having skated through the rest of the ER wing. She tells them that the hospital hasn't had any patients all day. Elsewhere in the wing, Mark and Susan play a practical joke on Carter (who is asleep in an exam room) by wrapping his leg up in a cast, laughing all the while.

A newscast explains that a massive snowstorm has moved into the area while the nurses lay out Christmas decorations. Temp clerk Roxanne is criticized by Haleh for not answering the phones quickly enough, while Bob is busy mopping the floors. After finishing their job creating the leg cast, the staff pool together and call Carter over the intercom, causing him to stumble out and fall, to much knowing laughter. With the hospital so empty, staff members resort to snowfights outside, and Carol arrives at the ER to find Malik rapping over the intercom and staff members playing soccer while sitting in office chairs.

Soon after, the staff asks Carol to show off her "special surprise" — an engagement ring from Dr. Taglieri. Haleh and the other nurses fawn over the ring, which has an expensive diamond in it just before Doug arrives at the ER, with Linda in tow. Seeing the engagement ring, he congratulates her on the engagement and goes to get some sleep, while Linda dismisses Carol before walking off. Meanwhile, characters try to give Bob advice regarding how to hang up the decorations.

The staff passes the time with more activities. As they play soccer by the front desk, Carol is called by a dispatcher looking for information:

Dispatch: General, implement disaster protocol. Mass casualty alert. 32-vehicle pile-up on the Kennedy Expressway. Over.
Carol Hathaway: Is this a drill? Over.
Dispatch: Negative, General. This is not a drill. 18 majors, 29 minors, fire at scene. Rescue vehicle access and communication limited by weather. We're calling out a Plan 1. Over.
Carol Hathaway: Roger, Dispatch. Do you have an extimate on the number of casualties? Over.
Dispatch: 50 to 100. Over.
Carol Hathaway: How many are coming to us? Over.
Dispatch: Mercy's power is down. You may get them all. Over.

Realizing how dire the situation is, the staff immediately enact a disaster protocol. Supplies and trauma kits are readied near the front of the ER wing, Doug rouses himself from sleep and readies for the coming wave of patients, and the staff put on their gowns as the sirens get closer.

Soon after, patients begin flooding into the ER wing. Doug delegates patients to different trauma rooms, including a patient with 25 per cent of his body covered in burns, while Malik attempts to stabilize a patient involved in a rollover, Mark asks Carter to supervise and help where he can, and Susan and Lydia attempt to stabilize a patient with a spinal cord injury. The situation begins to get more and more frantic, with multiple burn victims being wheeled in at once, Malik attempting to shove out intruding reporters and Carol trying to delegate and send off patients with minor wounds. With Roxanne quickly growing overburdened with the phone lines, Linda steps in to help after Carol tells her what to do, having been unable to leave the hospital due to the snow.

More patients continue to arrive, including a man who lost his thumb, a crying child with no parents, and an older man missing his left leg. Mookie is conscripted to aid Benton and Lydia as they treat the man with the missing leg, while Haleh calms the child by singing to her in the middle of the chaos. Soon after, Team Mascot Patrick arrives at the ER, and Carol greets him before being called away quickly. At the same time, Morgenstern arrives and Mark gives him a status update. Morgenstern thanks him and tells him to "go be a doc" before taking over the coordination of the different departments. Another individual named "Hicks" arrives soon after, and Doug initially tries to put her on "bedpan detail" before she explains that she's Dr. Angela Hicks, the new Attending Physician. Realizing his mistake, Doug apologizes.

Doug's attention is distracted when one of the patients, Mr. Ramos, who was tagged as non-critical ten minutes earlier, suddenly flatlines in the waiting room. Despite Mark and Doug's best efforts to resuscitate him, Mr. Ramos dies from an apparent heart attack. While a nun performs last rites on his body, Doug walks out in a daze. Nearby, Benton stabilize the man with a missing leg... who is revealed to be his neighbour, Dex. Dr. Hicks introduces herself to him, and together, they work on Dex after his vitals spike again.

In a nearby room, Susan and Lydia are treating a "Mr. Bozinsky", who is suffering from chest pains. His pressure begins to fall fast as both doctors wotk on him, with Bob watching nearby in concern. Revealing that he has an aortic aneurysm, he shakes his head in the negative. Despite their attempt to move him to an operating room, Susan is informed that there are none available, as all doctors are currently indisposed with other surgeries. When Susan asks Hicks for help, the latter asks her if she's ever done a cross-clamp before to which Susan replies in the negative. Outside, Mr. Bozinsky begins to flatline while his wife cries for help and Lydia tries to administer CPR.

Seeing what's happening, Bob drops the trash bag she was carrying, dons a pair of surgical gloves and cuts Mr. Bozinsky's chest open before applying the cross-clamp herself, revealing that she has medical training. She successfully saves his life, while Susan walks into the treatment area and reacts in shock to the reveal. In a panic, Bob runs out of the hospital and stands outside crying in the snow...

As the last of the patients are brought in, a husband and wife rushes in, revealing they are the parents of the missing child. Dex's missing leg is brought in, and Carter is able to get the leg cast sawed off by a patient who was riding a motorcycle during the accident. Outside, Carter helps load some supplies into a car, but discovers Bob and asks her if she's alright. She admits to him that she was a vascular surgeon in Poland, and was trying to re-certify in the U.S., but is afraid that her actions may have ruined her chances. Carter offers to help her train for the board exam after learning she saved Mr. Bobinsky's life.

Doug tells Linda that he's ready to leave for the night, and brushes off Carol's attempts to console him regarding Mr. Ramos' death. As he goes to collect his coat, Linda admits to Carol that while she has a lot of fun with Doug, his "perfect love" is her. She stands speechless as the pizzas Linda ordered finally arrive at the ER, while the staff congratulate "Dr. Bob" and Hicks congratulates the staff. Finally, as the evening draws to a close, the staff celebrates with a pizza party while Mark departs for home...

Tropes:

• Aborted Arc: Though Bob appears in several episodes after this, her apparent intended storyarc (Carter helping her pass an exam to help her re-certify as an American physician) is dropped after this episode.
• An Arm and a Leg: At least two traumatic amputations have to be dealt with.
  Lydia: (while working on Dexter) We've got a pumper!
• As You Know: The second segment of the episode begins with an overview of County General's triage tag system, given to Wendy by Carol: green is "walking wounded", yellow is urgent, red is critical (trauma rooms, or straight to OR in some cases), black is dead on arrival.
• Audience Surrogate: Mookie James, who sees the confusion of the ER wing up close during a disaster event, and gets conscripted by Benton to aid during the surgery on Dex.
• Awesomeness by Analysis: Linda is able to tell exactly what cut, layout and configuration Carol's ring from Tag is — and is able to tell her exactly how much it costs ($12,000).
• Big Damn Heroes: Bob counts when she saves the elderly gentleman whose previously-undiagnosed aortic aneurysm ruptures. It turns out she had been a surgeon in her native Poland, and was doing lesser work at County General while learning English and waiting to re-certify in the United States.
• Blooper: During the opening scene, when Lydia sits in the wheelchair and Jerry calls for Carter (who's been placed in a leg cast) to come to the front desk, the director's chair can be seen on the left-side of the shot.
• Born During a Storm: Throughout the episode. Mark fields calls from a man whose wife is in labor, and is determined to give birth at home. He ultimately assists with the birth over the phone while also helping the surgery to save Dexter's leg. The episode ends with the family and baby arriving at County General, being greeted by Mark.
• Brick Joke: The hospital intercomm system is initially used by Malik to bolster the staff's spirits as the snowstorm hits. Once patients start flooding into the ER, Patrick uses the intercomm to play Christmas tunes.
• The Bus Came Back: Every main and supporting character of importance from the past nine episodes (and others, including Team Mascot Patrick, Mookie and others) rally together to get County through the disaster protocol.
• The Cavalry: Several doctors arrive to bolster the hospital's ranks; Dr. Hicks being one of them. Half-way through, Dr. Morganstern arrives and relieves Mark, who was initially in charge, allowing him to focus on helping patients. Even Linda steps up and takes up the receptionist slack for the flaky Roxanne.
  Morganstern: Go be a doc!
• Chekhov's Gunman:
  • Early in the episode, a dispatcher calls County to find out their status, with Carol explaining that they are completely open for patients. Several minutes later, the dispatcher calls her back to relay the information that injured patients will soon be flooding into the hospital.
  • Linda is also conscripted to help the staff manage the overflowing phone lines after she is unable to get away from the hospital due to her car being snowplowed in.
• Chekhov's Skill: Doug's experience managing operations two episodes earlier comes in handy when he begins to take a leadership role, delegating and triaging patients arriving after the pileup.
• Christmas Episode: The episode takes place in the lead-up to Christmas, with various Yuletide tunes being played throughout the episode.
• Coincidental Broadcast: The day starts out slow, until Carol receives a call about the pile-up on the Kennedy Expressway. Right at that moment, it appears on the news.
  Mark: Oh boy. Here we go.
• Continuity Nod: At the peak of the situation, several doctors try to reach Dr. Cvetic (who was previously shown in full-blown Sanity Slippage in the previous episode) — to no avail.
• Dare to Be Badass: Dr. Hicks suggests that Benton and her reattach Dex's severed leg, despite not having access to the full facilities of an operating room. Together, they manage to reattach the main veins on the limb, with Morgenstern congratulating both of them afterwards.
• Deadpan Snarker: Jerry takes this mantle when he overhears Roxanne complaining.
  Roxanne: Shoot me if I take this job again.
  Jerry: Find me a gun, I'll shoot you now.
• Dissonant Serenity: When Haleh sings to the child during the chaos of the disaster protocol, the music and sound drops out completely, with the child calming down soon after.
• Downer Ending: At least half a dozen patients die during the disaster, with at least one ruled DOA on-camera. Most acute is Ramos, who suffered a heart attack after initially being green-tagged by Doug to the waiting area, and later dies.
• Enormous Engagement Ring: Carol initially is okay with the other nurses being wowed by the engagement ring given to her by Dr. Taglieri. It wasn't until Linda analyzes it (pricing it at about $12,000) that she started getting self-conscious about it. It adds up when another patient is wowed by it while being examined by Doug, potentially annoying him.
• First-Person Perspective: We get a brief scene where we see the chaos from Mookie's perspective before he brings needed materials to the trauma room where a patient was taken for his leg amputation.
• Foreshadowing:
  • In the segment before the pile-up, Carol does a radio check with 9-1-1 dispatch. Immediately after, Doug's latest girlfriend, Linda comes back in because her car was snow-plowed in with the increasing snowfall.
  • Throughout the episode. Mark helps with a childbirth over the phone. His experiences with emergency childbirth will take a more tragic turn later in the season.
  • When Doug asks where Jen is, Mark mentions that she left to go to Milwaukee four days earlier than expected...
• Funny Background Event: While Mark is getting exasperated with Roxanne's antics, Nurse Wendy can be seen skating by in the background before crashing through a door.
• The Glomp: Patrick hugs a husband and wife after they reveal they are the parents of the missing child and hug her warmly.
• Hidden Depths: Bob, as revealed when she saves the life of a patient by jumping into action, donning a pair of surgical gloves and opening up a patient's chest in order to stabilize them, as Lydia and the rest of the nurses look on in amazement.
• Honest Advisor: Carter confirms a fracture diagnosis from an X-ray with Dr. Flint, an orthopedist helping in the ER. Carter follows it up by giving Dr. Flint some pointers on some sutures he is doing.
• Idiot Ball: Roxanne walks into the middle of a high-stakes situation (the staff trying to stabilize the patient missing a leg)... to ask if Benton can stamp her time card.
  Roxanne: It's been eight hours.
  Benton: (Death Glare) Get her the hell out of here!
• Initiation Ceremony: The hazing of Carter continues as Mark and Susan put a cast on one of his legs in the cold open. He would be encumbered for most of the episode as a result.
• Innocently Insensitive: A few in regard to Dr. Hicks. A few think she's a nurse, and she ultimately clears up that she's the new attending ER surgeon to Dr. Ross.
  Doug: Oops!
• Ironic Nickname: Carol tells a motorcyclist who received minor injuries in the pile-up that the nurses refer to motorcycles as "donorcycles". He got a chuckle out of it himself.
• It's All My Fault: Doug blames himself for the death of Mr. Ramos, who he "green-tagged" when the latter had no apparent injuries.
  Doug: I missed it.
  Mark: (to Doug) You triaged 70-odd patients. You're human.
• Just a Flesh Wound: A patient speaking Spanish is brought in by a cop and begins crying about his wound... only for Carol to diagnose it as "just a small puncture wound", before sending him back out.
• Let's Get Dangerous!: When Bob decides to help the flatlining patient Lydia is working on, complete with determined look and musical cue.
• Lock-and-Load Montage: As the staff prepare supplies and layouts for the arrival of the injured civilians in the pileup.
• Major Injury Underreaction: The young black man who walks up to Doug with one of his thumbs severed. He was keeping his severed thumb in a plastic bag. Doug has Malik wheelchair him straight to the OR.
• Mass "Oh, Crap!": Once the staff learn just how many patients are headed their way after the pileup.
• Maybe Magic, Maybe Mundane: The disaster protocol has a number of odd coincidences that are left unexplained, such as the random nun who has somehow been allowed into the ER and gives last rites to Mr. Ramos (and disappears just as quickly afterwards), along with Team Mascot Patrick, who wanders over to the hospital and arrives just as the situation is at its worst to provide levity to the situation.
• Mistaken Identity: A few of the regulars at County General don't know at first that Dr. Hicks is indeed a doctor, thinking she's a backup nurse instead of their new attending physician. Doug is the first to find out otherwise.
• Mood Whiplash:
  • The first ten minutes of the episode are an otherwise-lighthearted affair, with the characters playing pranks on each other, Doug congratulating Carol on her engagement to Tag and the overall mood being one of boredom due to nothing happening outside. Then Carol gets the call...
  • Patrick also puts on "Deck the Halls" over the intercom... which plays as Doug and Mark attempt to stabilize a flatlining patient.
• More than Meets the Eye: A couple cases:
  • "Bob", the foreign nurse's assistant, is really a cutting-edge cardiothoracic surgeon from Eastern Europe who is trying to learn English for her American board exams.
  • Angela Hicks, County General's new attending ER physician, is initially mistaken by more than one staff member as a backup nurse.
• My God, What Have I Done?:
  • Doug gets it after he mistakenly "green-tags" Mr. Ramos, a patient with no outward symptoms. A few minutes later, Ramos goes into cardiac arrest due to a heart attack, and Doug and Mark are unable to save him. Doug ends up blaming himself until Mark points out that a mistake was inevitable, given the dozens of patients he triaged.
  • Bob, after saving the aneurysm patient. She was scared she would be in trouble for performing medicine without a valid license.
• Obfuscating Stupidity: Bob initially appears to be a meek, unassuming nurse's aide/janitor who has trouble hanging up decorations and unintentionally doesn't understand much of what the doctors are saying... then it's revealed that she's a cutting-edge thoracic surgeon who can perform a procedure even Susan wasn't aware of.
• Oh, Crap!: TONS! Wouldn't be a mass casualty incident without them:
  • Doug's reaction when one patient nonchalantly walks up to him, then reveals one of his hands is missing a thumb.
  • Doug again, when he finds out Ramos, a patient who was brought in with apparently minor injuries, was found unresponsive after a heart attack.
  • Peter, when the leg amputation patient, Dexter, says his name, and he realizes he knows the guy from his neighborhood.
  • Again with Peter and Dr. Hicks when Dexter goes into v-fib.
• Old Media Are Evil: Reporters are occasionally seen barging in trying to get a quick story. At one point, Doug has to force a reporter out of the entrance from the ambulance bay.
• The Oner: Multiple instances occur throughout the episode, including Wendy's skate through the ER in the opening sequence, and several long shots following different characters amid the chaos of the disaster protocol.
• One True Love: Linda describes Carol how amazing things were with Doug on their weekend together. She then says something utterly stunning:
  Linda: Do you think there's one perfect love? Ya know, like Sleepless in Seattle: somewhere under the stars, one perfect person for everybody.
  Carol: I don't know. Why?
  Linda: Because for Doug, it's you.
• P.O.V. Cam:
  • As Nurse Wendy skates through the ER (seen from a first-person view) during the opening sequence (also counts as The Oner).
  • Mookie gets one as he tries to process everything going on around him when tasked to bring items to one of the trauma rooms early on in the disaster.
• The Reveal: That "Bob" actually has full certification as a vascular surgeon in Poland. After moving to Chicago, she started working as a nurse's aide in order to learn English and prepare for the exams to earn an American medical license.
• Rich Bitch: Subverted; Linda initially presents herself as such to the hospital staff, but once the situation becomes dire, she rolls up her sleeves, mans the hospital switchboard after the flaky Roxanne flees from the front desk, and has a local pizza place deliver 30 pizzas to the ER by the time the situation calms down.
• Running Gag: Several.
  • Patrick continues to play Christmas tunes over the course of the episode, with the doctors repeatedly trying to get him to stop.
  • Wendy skating around the ER in boredom.
  • Mr. Decker, the husband who calls Mark repeatedly to help aid his wife as she gives birth at home.
• Spoiled Sweet: Linda is depicted initially with rich girl tropes, but is willing to get her hands dirty to help where she can at the receptionist desk. She also pulls some strings to get pizzas for the ER staff.
• Team Mascot: Patrick reappears out of nowhere after appearing in "One Perfect Day", and helps lift the staff's spirits by redecorating the wing and playing Christmas music.
• This Is Gonna Suck: The entire ER staff get this when they realize (a) the mass casualty report is not a drill, and (b) due to delays and power failures at other hospitals, most (if not all) of the patients involved in the pile-up will be arriving at County General.
• This Is Not a Drill: Carol has to confirm with Dispatch that the alert about the pile-up is not a drill. It is seconds later that it appears on the news.
• Too Much Information: When a burn victim named Eddie is wheeled into the ER, he has this conversation with Susan:
  Eddie: I haven't been tied up this tight since last Saturday night!
  Susan: Thank you for sharing that.
• Unfortunate Implications: Invoked. Caucasian Doug mistakes African-American Angela Hicks for a nurse -— to the point where he's giving her orders, etc. —- before she coldly informs him that she's a doctor. He winces at the mistake, realizing how badly he's come across.
• Wham Episode: After nine episodes of a fairly standard A-B-C plot format, the show changes gears dramatically and presents the first mass-casualty incident, which pushes the staff to their breaking point and prompts the participation of every main and supporting character, including Bob and Morgenstern.
• Wham Line:
  • Carol revealing her engagement to Dr. Taglieri. Though Doug sincerely congratulates her, it becomes a source of stress for her in this episode, and for the rest of Season 1.
  • Then the one where Linda reveals to Carol that Doug is still in love with her. See One True Love.
• You Did the Right Thing: Carter re-assures Bob that she won't be in trouble for saving the aneurysm patient. He also offers to help her with her English for her board exams.
  • Mark re-assures Doug after Ramos's death. Doug was certain he missed something, and could've tagged him properly to save him. Mark reminds him that they still saved a lot of people from the pile-up.

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