Big ups to Stedman's Medical Dictionary and Wing Chun.
Previously on ER: Holling didn't want to get hooked up to a bunch of tubes and spend the end of his life puking; Elizabeth urged Mark to respect Holling's wishes, but Mark wanted to "help" Holling, which Elizabeth suggested Mark do by listening to Holling; Cleo and Carter discovered that Husky Lad had Type II diabetes, but Husky Dad didn't have the insurance to cover the treatment, so Carter ignored Cleo's warnings about serious complications and falsified Husky Lad's chart to indicate that he had gastroenteritis; Sars and Wing Chun whipped out their banjos and played "Dueling Health-Care-System Soapboxes," then went back to drooling over Goran Visnjic when they realized the writers would probably forget Husky Lad's entire existence. For the record: Oops.
As we fade up, Jing-Mei "Flower" Chen updates "Critical" Kerry Weaver on the status of various patients. Robert "When In" Romano appears behind them and wishes them good morning, and says that he heard they had a double trauma coming in and thought they could use some help. Kerry tells him that it's two minor traumas and they can handle it, but Romano says something about how he might as well flip these two burgers. In answer to the "whaaaaaat?" looks he gets from Chen and Kerry, Romano explains that Ray Kroc, owner of McDonald's, used to get behind the counter once a year and make burgers and milkshakes, so Romano thought he'd do the same and "get back in the trenches, where the little people work." And Romano would know from little people, I guess. Chen and Kerry both comment rather acidly on Romano's disparaging phraseology, and he tells them he wants to make sure "the ship is ship-shape." Enter two guys yelling and flailing at each other; one guy tackles the other to the ground, and Romano jumps in to break it up, and eventually the ER staff gets the two guys separated, and one of them -- Mitch Pileggi, a.k.a. Skinner from The X-Files -- snarls, "Get away from me, ya dumb-ass punk!" The Shaky Camera Of Chaos cuts back and forth between them as they continue to argue, and "I'm Sorry" Dave "I'm Afraid I Can't Do That" Malucci bolts out of the lounge and into the fray, and Skinner shouts, "You ran into me!" and the other guy, a tall black man, bawls, "You cut me off!" and Dave makes the mistake of calling the black man "bud," so the black man wants to know who Dave is calling "bud," and he hurls himself at Dave, and Dave pins him against the front desk and sneers, "You, that's who, bud," like, Dave couldn't wait until AFTER the credits to whip it out? But we don't see him again after the opening sequence, so I guess he couldn't. Finally, the road-ragers get wrangled into curtain two as the paramedics give the ER team the bullet: MVA collision, both Skinner and Bud have multiple abrasions and a couple of cuts. Kerry orders Skinner put in restraints. Skinner and Bud continue the "I didn't start it / shut up / no you shut up" rondelet, and Romano orders both of them to settle down, and Bud plays nice for five seconds and then starts up out of bed and shakes Chen and a paramedic off of him and throws an equipment tray in Skinner's direction, and Skinner in turn gets free of Kerry and Romano and grabs a fountain pen from Romano's pocket and buries it in the left side of Bud's face, and Chen goes, "Auuuuugh!" and the rest of the team goes, "Ohhhhh," and Romano muscles Skinner back into bed as Dave looks at the impacted pen in Bud's cheek and says, "Oh, man, this is nasty," like, shut up and go drink some breast milk, Dave. Kerry ties on Skinner's wrist restraints and sarcastically asks Romano if this is what he meant by flipping burgers, then says she has other things to do if Romano doesn't "need any of the little people," and he says he has it under control. Kerry leaves. Dave asks Romano if he should just "yank" the pen out, and Romano says no, they have to check for damage to the facial nerve, "not to mention damage to my pen." Bud garbles through a mouthful of blood, "I've been stabbed, and you're worried about a pen?" "Oh, shut up," Romano tells him -- snerk -- and we go to credits.