As the night shift begins, Mohan's AMA patient is brought back to the ER, Langdon doubts his place in the Pitt, and Robby gets Duke's results.
What will happen if Robby doesn't come back? He's joked about that possibility as it pertains to his sabbatical. It's been delivered with a hint of truth to it. It's something he has thought about. He committed to this time away from the hospital. And yet, he seemingly can't pull himself away from this place. He's personally invested in the lives of his staff. He fears they will crumble without his leadership. He can't allow any of them to make mistakes. He carries that responsibility. Anything that goes wrong with them is a personal blow to him. He can't take it. That pushes him away. That makes him volatile. He can't be trusted right now. Dana calls him out repeatedly. She's the only person he can truly confide in about his frustrations. He has taken too much personal ownership over the emergency department. The place doesn't fall apart when the night shift takes over. That's due to Robby trusting Abbot completely. He's not trying to change this place. That's what Al-Hashimi represents. She wants to change procedures. She serves as the threat to Robby's authority. He only now notices her zoning out for a few moments. He immediately sees that as a reason why she can't replace him. He can't trust her if she's dealing with an undisclosed health issue. He also can't abandon Duke. His friend needs surgery. The team upstairs doesn't want to act immediately. Duke could die but must meet certain criteria first. Robby has to be the one who guides everyone through the process. That's too much for any person to bear. That's why Al-Hashimi's recommended having two attendings on shift. It's a solution to the obvious problem. Robby can't get out of his own way. It's too personal.
Robby needs to know that the legacy of this hospital is being passed on to the next generation. He's proud of how much wisdom Whitaker has soaked up during his time here. Whitaker has only recently become a doctor. He chose to be proactive in teaching. He oversaw Joy and Ogilvie throughout the shift. Joy is firm in her boundaries. She's not looking to make a career out of emergency medicine. This rotation is required for her to graduate medical school. She's focused elsewhere. Meanwhile, Ogilvie saw this position as the top prize. He was eager to impress. He's made mistakes. Those impact him deeply. Death is a part of this job. The staff get invested only for their patients to die. Whitaker knows how damaging that can be. He was traumatized during his first shift. He aims to pass that lesson on to the medical student under his wing. Ogilvie was pushed to his breaking point. The digital system being down compromised care. His patient could have lived had those past medical records been available. They weren't. The teacher didn't share those details either. Ogilvie operated with the best information he had at the time. He was given the opportunity to learn and grow. He doesn't know if he's cut out for this job. That can't be a decision he makes in the heat of the moment. Whitaker is precisely where he belongs. He was meant to be here. Ogilvie deserves the freedom to make his own decision. It can't be forced on him by others.
That's the underlying lesson Robby must learn as well. He expects everyone to respond to the world the same way he does. He connects with Mohan but condemns her because she behaves differently. She accepted help during her panic attack. Robby felt shame during his breakdown. He needed Whitaker to keep quiet. That formed a special attachment between them. Robby has to be fair in teaching. He needs everyone to be able to do this job. That's the only way any of them have the potential to save lives. They have to work as a cohesive team. That means stepping up even when their shifts have ended. They didn't get to go home once all of their cases are handed off. They must stay and deal with the aftermath. For Whitaker and Santos, that means digitizing the files. For others, it means continuing to see patients. Robby needs his staff to be unafraid of what is demanded of them. He sees potential. That must be nurtured. He won't accept anything else. Javadi must be willing to volunteer to assist during brain surgery. She can't allow her voice to be silenced because of outside pressure from her parents or simply being tired after a long day. This job demands so much. Robby knows that all too well. He believes it will be easier if he makes all the decisions. He's collaborative when it comes to treatment. He wants the staff to come to their own conclusions so they are involved in the process. However, he needs everyone to be dependent on his guidance so he can continue to feel good. That isn't healthy in the slightest.
Nevertheless, people expect Robby to return. Noelle believes it will be within a week. She fears he's leaving because of their relationship. It isn't about her at all. She wants her presence to be reassuring. That's not how she comes across. She's treated as an outsider who makes things needlessly more complicated. She serves a vital role in the hospital. Her job is important. It doesn't extend much grace. Mohan is falling apart. She tried her best to get Orlando Diaz to stay. She wanted to provide him with the supplies to keep his health improving. Instead, he walked away because the demands of work were more important. He felt that pressure. He couldn't walk away. And now, he's suffering from extensive injuries. The doctors will only know his prognosis after several weeks. Robby theorizes it was a suicide attempt based solely on the numbers he sees. Orlando's family didn't even know he left the hospital. They thought a deal had already been worked out for him to stay. He didn't communicate. Mohan punishes herself for not doing more. She's apologetic towards Robby before he has a chance to say anything. She wants to get ahead of his judgment. She's harsher on herself than others are on her. She can't even focus when the team wants to teach during the trauma. She breaks when Whitaker shares Ogilvie's patient died. That mistake was on her too. Whitaker could reach out to Ogilvie. With Mohan, he only made things worse.
Many are doubting themselves. Those insecurities are only amplified when standing next to people obviously succeeding. Both Mohan and Langdon feel inadequate in comparison to night shift resident Crus Henderson. He discharges two patients waiting for x-rays by diagnosing with ultrasound instead. He's been involved in a published research article. He thought to check for a collapsed lung before intubating his patient. Langdon didn't know what to expect upon returning to the job. He wanted to have a meaningful conversation with Robby. His former mentor shut him down every single time. His instincts haven't kicked back in. He's proven himself more than capable of handling the job. The pressure makes him feel as if he can't do it. Mohan understands that impulse. She faces it as well. That's how this job is designed. It puts a crushing amount of responsibility on the staff. They are required to help during people's worst moments. Any mistake will be scrutinized. They can only do so much. They are on the frontlines of seeing the system fail elsewhere. Another family comes in after being unable to afford a prescription. This is the worst possible outcome. It's scary and perilous. Because of those shortcomings elsewhere, it creates even more dangerous scenarios for the emergency staff to face. No one is trying to ease that burden. It takes so much until everyone inevitable falls apart. The egos along the way don't help the matter either.
Some more thoughts:
- It's frustrating how Al-Hashimi has been presented as a mystery rather than a character. Her arc throughout the season was wondering what's happening with her. It was previously revealed she has a neurologist. She wanted an appointment right away. That was her only private moment. The rest of the time she has been an obstacle meant to be overcome by the characters who are more developed and beloved.
- The woman with the severe sunburn is basically just a recurring visual meant to produce a laugh. She's not exactly a patient with a story given. She's an extreme meant to remind everyone of the holiday weekend. It's more amusing when it's just the practice dummy dressed up and moved around the department. At least that seems purposeful.
- Monica's biases were previously on display in her chatting with the ICE agent and her disparaging comments towards Javadi. As such, it wasn't all that necessary for the camera to focus on her when Al-Hashimi speaks to the new night shift intern in Armenian. It makes the moment about her and her judgment.
- It could be terrifying to know this is the first shift for your doctor or nurse. Yet Digby is comforted by that from Emma. In fact, his backstory is provided after spending the entire shift in the department. Dana and Emma offer a shave and haircut. He's no longer recognizable. However, they reassure him that his family will fondly recall all the happy memories they shared together.
- Whitaker causes potential panic by mentioning a young woman's septum could be damaged if the magnetic piercings continue to cut off blood supply. It's a relatively easy fix for him to handle. Someone with more experience was needed. He stepped up. He's still learning but he offers the necessary treatment without anything else being required.
- Santos appreciates people during stupid things. She views that as job security. She lurks online to remain up-to-date on stupid trends. Having that awareness makes her know how to spot what's causing liver damage with McKay's patient. It's not particularly the most empathetic response. McKay sees that. It's effective nevertheless.
- The chief of neurosurgery is working on the holiday weekend. Robby sees that as a golden opportunity for Javadi to make a solid first impression. He doesn't want her to blow it. She doesn't. However, brain surgery is perhaps one of the most graphic things the show has depicted so far.
