A woman walks through the waiting room with Ellie's three kids in tow. She's Ellie's neighbor. Meanwhile, Ellie is trying to think through her condition. She decides that the stroke has to be minor, because she can think, feel, and hear. Then she realizes that she's drooling. Sam gives Ellie a blanket and says it'll make her more comfortable. Ellie notes that Sam is smiling, so it must not be that bad, or it could mean that she doesn't know what's going on, since she's a nurse. Abby walks in and looks in Ellie's mouth. Ellie notes that Abby, the doctor, isn't smiling, but speculates that she might just be more serious. Abby reports that Ellie has no gag reflex. Luka says that her swallowing muscles are weak on the right side. Ellie looks at Luka and says, "Now, this one. He is gorgeous! What is he, 6'4", 6'5"?" Luka tells Ellie that they have to put a tube in her throat to protect her airway.
The neighbor shows up and asks if Ellie's kids can come in. Abby says that they can, but only for a minute. Sam tells Ellie that her kids are there. The kids walk in slowly, clearly terrified. Luka tells them to stand on Ellie's left side, so that she can hear them better. Abby explains that their mom is having a little trouble moving her right side. In her head, Ellie is cheery and encouraging, but her face doesn't move. One of the boys asks why Ellie's face looks funny. The other asks if she's dying. Ellie tries to reassure them, as Luka says that she's not dying, and asks when they saw her last. Ellie's daughter says that they saw their mom right after school, and she was fine. Ellie starts coughing. The kids look even more scared. Sam asks the neighbor to take the kids outside. The daughter asks what's going on, and Abby says that they need to help Ellie breathe. The neighbor herds the kids out. Ellie continues coughing, and monitors start beeping. Abby calls for etomidate and sux. Luka tells her that she's going to sleep now, and when she wakes up, she'll be breathing with a tube.
Ellie is getting a head CT when she wakes up. She wonders if she's dead, but then realizes that something's wrong because she can't open her eyes or move at all. The examining neurosurgeon tells Sam and Abby that there's no sign of a tumor, so it must be a clot. Abby asks if it's too late for TPA, and the neurosurgeon says that it can cause brain bleed if it's done after three hours. Given the timeline they have, it's too risky. Would they really let Sam observe this whole thing? Don't they need her down in the ER? Abby asks what the other options are. The neurosurgeon says that they can hope that collateral flow develops, and get her into physical therapy. He adds that the chances of a meaningful recovery aren't good. Almost as an afterthought, he says that they could also try "the MERCI." Sam doesn't know what that is, so the neurosurgeon explains that they would use a catheter inserted in the groin to retrieve the clot. Abby asks if it reverses the stroke completely, and the neurosurgeon says it has risks, and that they would need the family's consent.