As the night shift begins, Robby refuses to give up on a mass casualty victim. Samira and Santos each attempt risky moves.
Robby has been holding in a breakdown all day. He kept it inside to handle his professional responsibilities. He strived to confront his trauma head on for the first time in years. The agony of losing someone he cared about on this day still stings. And now, he is faced with the prospect of losing another loved one. He's been unable to reach Jake ever since reports of an active shooter at PittFest started. He lived in the ambiguity of not knowing for over an hour. He feared for the worst. He had to keep it together in order to lead the staff through this tragedy. They still don't know how many patients to expect. They have easily surpassed a hundred at this point. That's how many lives have been touched by this event. People went to PittFest hoping to have a good time as a community. They will forever be bonded by this tragedy. It's also claimed many lives. One of which was Jake's girlfriend, Leah. He tried his best to keep her alive long enough to get to the hospital. He knew Robby and Dana could save her. And yet, her injuries were too extensive. Robby breaks protocol in his attempt to save her. It's all futile. He's the last person to accept this brutal reality. He still struggles. He wants to justify it somehow. It doesn't make any sense. That unravels all that he has kept inside for a long time. He doesn't want to break down in front of Jake. Yet he still leaves his stepson with confusion over the situation.
The shooting has required the Pitt to completely alter its system. The staff has to ration resources in order to better prepare for all the victims they will possibly be treating. Initial assessments have to be made. They need to be brutal. Robby relies on the senior residents from the night shift for that responsibility. None of the characters seen this season have to handle those life-or-death decisions within seconds. They are inside trying to save the people who require treatment. Even that has proven to be a herculean task. It's overwhelming. The pace refuses to let up. The staff still haven't heard anything about the shooter. David casually tries to walk back into the hospital to pick up his mother. He has avoided her throughout the entire day. Now, he returns with no explanation. Everyone is quick to view him as responsible. The season has certainty set up that expectation. The threats were real. He fits the profile. Yet it wouldn't be surprising if a twist was on the horizon. S.W.A.T. has descended on the hospital under the guise of keeping it safe if the shooter heads in this direction. That's just a rumor. It's irresponsible for Langdon to speculate. In reality, law enforcement rally behind one of their own injured in the field. They question the staff. They want to know everything is being done to save him. His treatment is working for now. Everything still remains very tenuous. Anyone could reach their breaking point at any time in this chaotic environment. They all hit the floor when Langdon sees a gun on a patient. It isn't the shooter but the fear remains high.
Robby has offered stability. He has been a tough but fair attending to all of the doctors under his purview. He knows what they are each capable of handling. The new interns have been thrown into the deep end during this shift. He has asked everyone to rise above it all in the hopes of responding to this tragedy. He knows they can handle it. He has complete trust in them. He doesn't have a second to question Langdon's presence. He's simply grateful Abbott came prepared with a bag of medical devices to help in a situation just like this. Treatments have required the physicians to go old school. They can't rely on technology to make the procedures easy. They have to let the human body guide them. It's difficult. It allows for many opportunities for Robby and Abbott to show off their skills. They are only two people amongst this mess though. They can't be everywhere all the time. Robby wants a private moment with Jake to detail what happened to Leah. He also wants to be in the evaluation on David to determine what happened. He feels the pressure and responsibility to so many patients and his staff. It all boils up until he explores. Even then, he suggests he could have saved Leah under normal circumstances. Abbott and Dana know that isn't true. They allowed Robby to reach that conclusion on his own. He wasted resources in the hopes of reviving her. That was never going to happen. That leaves Jake feeling like he has to blame his family at the Pitt he trusted completely. It's not their fault.
Without an attending or resident, Santos performs a risky procedure in the hopes of stabilizing a patient. In doing so, she cuts off mobility to the lower half of the body. It's dangerous. A clock starts counting down to restore function. Santos never should have done it. She took ahold of the situation and did what had to be done. In a controlled setting, she previously made a mistake that compromised a patient's care. She was warned by her superiors including Langdon. She has been envious of the cool procedures others have done. She's amassed when Mohan uses the IO drill to relieve pressure in a patient's brain. It's all very risky. No one knows if the actions taken will ultimately be life-saving. Plenty of people are receiving news about their loved ones being killed. Kiana and Lupe are having those conversations. Jake receives special privileges. He's able to see Leah's body. That doesn't provide closure. It further hinders Robby because he's distracted by the loss of Dr. Adamson all over again. The pediatric room has once again become a morgue. It's brutal. Everyone wants to stay out of there for as long as possible. It's unavoidable sometimes. The emergency physicians provide enough stabilizing care to get people up to surgery. The entire system is backing up. No one has time to catch their breath. It's miraculous when McKay gets to see her son. She also cuts off her ankle monitor without worrying about the consequences. That's the headspace everyone is in.
Whitaker is still learning the proper balance between connecting with the patient and performing the medical procedures. He worries when Grayson is asleep and doesn't respond right away. He still requires more treatment. Meanwhile, Whitaker aims to keep Carmen distracted as she continues to bleed out from the wound on her upper leg. The newcomers have to be inventive with how they treat this particular injury. They rise to the occasion. They still require oversight. It's an overwhelming experience for Mel as she tries her best to follow Robby's orders. She knows not everyone needs an IO in order to receive fluids. Whitaker makes that mistake. It's clarified to him what is needed in this moment. He is afforded the ability to make that mistake. Mel and Santos run to get people when an emergency suddenly develops. Sometimes help arrives. Sometimes it doesn't. Mel would rather wait while Santos takes action. Mohan does as well. She is no longer deserving of the moniker "SloMo." She has proven herself. In fact, Robby is now the person wasting his time and resources on one patient at the expense of others. He has the authority to break the rules. He's personally invested. He crumbles on the floor by himself. He requires that privacy. It's heartbreaking. He carries the burden of all the people who died during this shift. He remembers each of them. The numbers have started to add up given the shooting. Leah serves as that tipping point. The system doesn't break without him. It would sure be better if he was focused and operating at the top of his game too. He's beat emotionally and physically. These characters can only endure so much. That's true of the attending just as much as the interns.
