A man comes in on a gurney with an open tibia fracture. Pratt talks Abby, who's off the clock, into staying to help get the man into a trauma room. This patient is in a wretched mood, snapping and screaming at everyone, probably in part because his leg bone is protruding from his shin. His name is Mathers, but in the seven-dwarves spirit of this show, I'm going to call him Gimpy. He rants that St. Thomas's shipped him there because he has no insurance -- apparently he just doesn't want to be at County. Abby tries to calm him down, but he's well into his tantrum and will not be denied.

As he and Abby wheel Gimpy down the hall, Pratt spies a group of med students staring vacantly at the action. "Hey, this look like TV to you?" he snaps. How meta. Shut up, ER. ["It would have been better if one of the students had responded to the question with an elaborate yawn.' -- Wing Chun] Pratt orders them back to work, and then turns on the charm and announces to Gimpy that he's lucky to be at County because they give the best care in the city. In a moment of mixed fairy tales, Pratt's nose immediately grows to the size of Dr. Diego's big red dog and skewers Gimpy right in his good leg. Pratt decides that, to divert attention from his Pinocchio moment, he ought to deliver a rousing motivational speech. "Listen up!" he stops and shouts. A crowd of extras promptly assembles nearby. Gimpy's face is like, "Holy shit, people, can you shut up and start paying attention to my protruding shin bone?" "We're the A Team, people, you know what that means?" Pratt booms. Oh, God, please can it mean Mr. T. Please! It's been three seasons! Don't I deserve this? Don't you, TPTB, pity the fool who recaps your show? "We've got twelve hours to clear this place out and show those quacks in the day shift how it's done," Pratt shouts. Then he heaves a satisfied, yet slightly put-upon sigh. We smash into the credits hoping that Gimpy stood up and stabbed Pratt with his bone shard.

After some people try to sell us a combination of things we don't need (the Halloween episode of Fear Factor) and things we do need (enough beer to erase completely the memory of accidentally seeing the horrifying toe-related agonies in the commercial for the Halloween episode of Fear Factor), we return to ER and its prosthetics lab. There sits Dr. Robert "Stumpy" Romano, the dwarf with the bad temper and the asymmetrical body. He is, for possibly the first time on the show, shirtless. Which is rather unfair, for as wonderful a person as I hear Paul McCrane is, he doesn't really compare favorably with Dr. Diego's torso or Pratt's shoulders. It's so unfair to him. It's kind of like asking Noah Wyle to quote Hamlet right before telling Goran Visnjic to do it in Croatian. Anyway, the prosthetics lady is showing Romano a big old rubber arm that's the tops in myoelectric devices. It's called a Utah Arm, and after last episode's big deal about Romano's not getting one, I'm glad to see that the show has remained careless and subsequently given him one without addressing how and why. It's a weird-looking thing, too: although it is arm-esque, it looks more like the oversized beige hand of one of those creepy CPR dummies. The lady demonstrates to a crabby, wisecracking Romano how the arm is moved up and down through bicep contractions. "Bicep up, tricep down," she repeats as the arm makes mechanical noises. Romano shoots her a withering look. "They actually pay you to state the obvious?" he sneers. She politely explains that the arm can lock if he pauses abruptly with it, and it unlocks through a code contraction that he'll have to learn. This all sounds incredibly complicated and like he'll have to retrain his muscles, but Romano doesn't care -- he wants to wear it now. "Donning and doffing are complex..." the prosthetist attempts. "I WANT MY DAMN ARM, ALL RIGHT?" Romano screams. "I've waited long enough."