Crash scene. Carter stops a couple of paramedics wheeling a victim of an abdominal wound toward an ambulance bound for "Lakeshore." Carter takes a quick look and tells them that she needs to go to a trauma centre, and that they should reroute her to County. Morales calls Carter over and, holding a needle aloft, tells Carter he needs to stick the victim. I think he's supposed to release the pressure in the patient's lung, but I'm not a doctor, besides which, the scene is dark and loud. Morales asks whether Carter was successful in whatever he was attempting, and Carter, with his ear poised over the needle, says he can't hear with all the noise. We get a shot of the night sky, illuminated by at least four helicopters. Carter asks, of the helicopters, "Are these all ours?" Morales replies, "No, it's the damn news!" Vultures! Bringing information about the crash to the friends and family members of its victims! Carter is satisfied with the results of his work, and tells Morales to send this victim, also, to County, for a chest tube, among other things.

Over by Crushed Firefighter, the jackhammering continues apace...until it causes the train car to give way and crush Crushed Firefighter even more, whereupon he screams in pain. Elizabeth leans over to help him, and ends up cradling her back in her hands instead. Carter scurries over and, ignoring Crushed Firefighter, asks Elizabeth whether she's all right. She tells him she may have strained her back. Oh, yeah? So badly it might have to be amputated in the middle of a dusty winter field, with hardly any anaesthetic? No? Then stow it. Crushed Firefighter begs them not to stop digging him out, but Capt. Davis explains that, if they do, the weight of the train will shift onto him. Carter urgently asks whether a crane is coming, and Capt. Davis replies, "From Indiana." "What?!" Carter screams. Capt. Davis promises that it's coming. Elizabeth is still clutching the small of her back as she asks for Crushed Firefighter's blood pressure. Hearing the answer, she looks at Carter, who silently but seriously shakes his head. "Can you assist?" she asks. Carter says he can. Elizabeth leans over and explains, as gently as one can when one is literally screaming into another person's face, that she'll have to proceed with amputating both his legs. Crushed Firefighter starts sobbing in protest, insisting that he's worked on people who've been trapped for hours before they got them out. Elizabeth tells him that he's lost too much blood: "If I don't amputate and control the bleeding, you're going to die." Crushed Firefighter stares into the heavens and curses his fate. Or cries and drools, silently. Elizabeth, taking this as her answer, says, "Okay, then. I'm going to start. Do you understand? I have to start now." Crushed Firefighter nods feebly. Elizabeth tells Carter to prep the area, and calls for a scalpel. Crushed Firefighter makes a face like it really, really, really hurts.