"The symptoms of the upper girl are all the same." "Fever, chill, severe headaches and rash." "And some of the patients are even presenting with seizure and swelling of the brain." "One more died last night." "And two more fresh cases came in this morning." "Whatever we're dealing with is spreading faster than we thought and I still want a working theory before Powell and Connor get here." "Four more on the way." "Four?" "A family, I send them by bus an hour ago." "The doctor ... told me" "You're breaking up." "Say that again." "The doctor in their village told me that there is another cluster of sick in a church, not far from here." "They've been presenting much longer, based on the timeline, the source of the outbreak will be up there." "What do you mean up ?" "North." "Miles, you know what's going on up there." "It's not safe." "If the answers to stop this thing are up there, it is not safe of being down here." "Be careful." "Don't worry, mom." "I'd be home by dark." "Any idea, what's causing this ?" "Swelling of the brain would indicate that's dengue fever, but I've still been unable to id a specific pathogen." "And there are four more incoming." "Actually, I think they've just got here." "Mi esposa, ayuda le, por favor." "Habla ingles." "Un poquito." "We're going to take care of you, and your baby. ok ?" "If this continues, we're not gonna have much room." "There is a larger hospital a couple of miles from here." "Maybe they can accept our overflow." "Yeah, I'll go there." "Hola." "Gracias." "Buenas dias." "Donde esta el Padre ?" "You'll have to excuse the welcome wagon." "They don't trust you." "Why is that ?" "You came from the south." "You's the doctor ?" "Miles McCabe, I was told there are some very sick people here." "Down in the basement." "I'll get my bag." "Watch your step." "Father" "Thanks for coming." "Sure." "I can treat their minor ailments, coughs and chills but ... what's infected these people is beyond me or Kris." "Von Goetz." "I'm a nurse." "I will take a look." "Hola." "Esta bien, esta bien." "Their lungs are full of fluid." "Fever is very high." "They all this bad ?" "The other ones are worse." "Padre, padre." "Nos podemos ay ..." "Hola, como estan ?" "They know, I'm from the south too ?" "They know you're american." "They wonder why it takes a crisis for your people to come and help." "Frankly, so do I." "Try to relax, ok ?" "Get some rest." "Look out." "Look out !" "I'll be right there." "" " Medical Investigation 119 -- " " Mission La Roca part 1 " "The quake registered 7.4 on the Richter scale." "The jolt rocked Central America early morning local time." "The tremblor was felt from hundreds of kilometers in every direction of the epicenter." "And this can be seen from this early footage, the results have been devastating." "Thanks man." "You're welcome." "You know, I've seen some pathetic things in my life but ... this takes it." "Well, what's wrong with you ?" "What's wrong with me ?" "I've been trying to call you for the last 12 hours." "I didn't hear it ring." "You haven't showed up at the NIH fund raising last night either." "Hey, try this." "Come on." "No." "How did you find me ?" "Hello Jack, on that piece of crap El Camino you call a ride." "I was a cop before, I worked for you, remember ?" "You don't work for me anymore, Frank." "All right, what's going on ?" "This job." "It's destroying my life." "What are you talking about ?" "This job is your life." "This is a letter from my son." "He wants to know, how come I spent so much of my life with strangers." "And so little of it with him." "The truth is I haven't been around him at all." "But that's gonna change." "It's time to save my own life." "So Frank, if you don't mind." "Stephen." "Just tell Eva and ..." "Natalie and Miles, that I'm sorry and ..." "Stephen, I can't tell them anything, that's why I've been trying to reach you." "What's wrong ?" "Reports of buildings collapsing, bridges falling, and trains derailing are flooding in." "It is very much like an unending war zone." "Early estimates fear hunders dead, thousands missing and upwards of 100 000 left homeless." "Oh my god, she called in all the teams." "Let's put it together, right now there is no cell, no satellite, no land line." "I've been trying to reach them over the net, but as of right now there is no communication." "I should have been there." "Whao, whao." "Wait a minute, Stephen." "You can't blame yourself for everything, especially for natural disaster." "They're down there alone cause I've sent them." "I'm going down there to bring them back." "Wait a minute, whao." "We're going down here." "The local governments request help from almost every health agency on the planet." "NIH teams were already on the ground, investigating an undiagnosed outbreak prior to the earthquake." "Since we were first on site, we'll be in charge." "Any questions ?" "We hear rumors, there's a terrorist problem down there." "It's mainly in the northen provinces." "All NIH staff are stricly prohibitted from entering those territories." "What if the illness leads us there ?" "Well, let's cross that bridge when we come to it." "OK." "Team 1, stabilise traumatic injuries." "Team 2, you're handlying surveillance." "Team 3, water and sanitation." "4, immunization, you know the drill." "All right, planes are in the air in 30 minutes." "Stephen, any word on Nathalie, Eva or Miles ?" "Hum..., not yet." "Aywall for 36 hours ?" "What's up with you ?" "I've got a plane to catch, and" "You gonna be able to handle this ?" "I've got to find my team." "Juanito, esta bien ?" "There's no way out." "The support walls collapsed, it completely blocks the only way in or out." "God, the priest is stuck." "I can't move my leg." "Ok, hold on for a while." "Your femur is broken father, I'll have to stabilize you." "Dr McCabe." "Ok, just a minute" "Help me get this stuff off him" "Go, go." "All right." "Come on, give us a hand." "We can use some help over here." "Pedro." "He's not breathing." "His neck's broken." "Esos dos, estan vivos." "Pulse is strong, respiration steady." "The pulse is slow, but it was before the quake." "Ok, great." "Padre, Juanito." "We're gonna need this thing off you father." "I'm having trouble getting my breath." "Come on, this is going to take all of us." "We're gonna hold this thing up, see if you can pull him off from underneath." "Ready, one, two, three." "There." "No te preocupes, niña." "Oh man !" "They're afraid to go back inside." "There're gonna be tent cities popping up everywhere soon." "We're going to have to coordinate with the other teams." "Set up solar powered water purifiezer immediately." "Look at this place." "The proximity of all these refugies all together, malaria, dysentria, encephylatis they all run rampant." "This is like a war zone." "No, it's worse." "Nathalie, Eva and Miles, they were working in there." "Let's go." "Hey." "Anything ?" "It's damn unstable in there, but there are some pockets." "Any life ?" "Give me some more cable." "Yeah, I've got something." "Is he one of our team ?" "There's only one way to find out." "Yeah." "Breathe." "Just try and relax, Father." "How is he ?" "He has bilatteral hymothorax and hemothorax on the left, multiple ribs fracture on both side." "I'm afraid his right lung is about to collapse too." "I need to put in a philocostomy too, what kind of supplies do you have down here." "Not much, some seringes, ceiling, gazes." "I need a scalpel." "The rest of my supplies are upstairs." "What's your name ?" "Como te llamas ?" "His name is Nestor." "The younger one is Juan, they're brothers." "They're both with the insurgents north of here." "Nestor, I need to use your knife." "Necesito ..." "No !" "He is dying." "I need to do an emergency procedure now." "Do they understand what's going on here ?" "And what the hell are two teenagers doing with automatic weapons ?" "He is going into a respitorial arrest." "I need to drain his lungs." "Give me one of your seringes and the largest gage you have." "Hurry." "I'm sorry father." "I need another one." "Now, we're losing him." "I need to check valves and cathoric." "That's it, that's all we have." "Damn it !" "Come on, father." "Hang on." "Come on, father." "Doctor." "Hey." "Are you ok ?" "It's ok." "I'm here to help." "Can you tell me where you live ?" "Como te llamas ?" "Me llamo Eva." "Oh." "That's about the extent of my spanish." "Crying can be heard coming from some of the collapsed structures, as the rescue effort continues." "In a race against time, teams, both professional and local dig frantically, in many cases with their bare hands to find survivors trapped beneath the rubble." "Ok." "I'm in." "Just got me to me where you saw the movement." "Ok." "Listen, below you onto your right, there should be an opening." "Hell of a place to be if you're claustrophobic." "It opens up after a few meters to a space where you should be able to stand." "Ok." "Are you alright ?" "Stephen." "Stephen." "Yeah." "Just tell me where to go." "Up ahead to your left." "Hurry up man." "You don't want to be down there if the place start shaking again." "The fever is back up. 104.3°F (=40.2°C)" "She first started to complain of flu like symptoms." "Is that how the disease started with most of your patients ?" "All of them." "What about neurologic symptoms, irritability, confusion, seizure ?" "Some." "Mostly the children and the older patients." "Juanito." "Juan." "Oh." "He's burning up." "He must have been exposed to the disease too." "Looks like he's been exposed to combat." "That's a gunshot wound." "No lo toces." "I need to take a look at him." "Can I ?" "Fine." "Oh god." "It's infected." "See if there is a corresponding exit wound ?" "Bullet still in there." "Nestor ?" "I need to remove that bullet from your brother." "It's making him sick, if I don't, he could die." "Dejalo." "Dejalo." "You're in the lab area where Natalie was working." "Anything ?" "Not yet." "Alright, the mouvement we spotted was six feet south of you." "The legs under the gurney." "Right up ahead." "It's a woman." "Stephen, is that her ?" "Is she alive ?" "No." "Stephen ?" "Natalie ?" "Over here." "Hmm." "Come on." "Come on." "Hey, we've got somebody up here who's about to have a heart attack." "What's going on down there ?" "I found Natalie." "She's ok." "Miles and Eva are down here ?" "No." "No." "Miles went up north, and Eva she drove to the ... the hospital, south of ... ouch !" "south of town." "We haven't heard from them." "Look up Nat, it's been a big shaker, 7.4." "Buildings are down everywhere, entire villages are flattened." "Oh..." "Stephen." "Come on." "We're going to find them." "I can't leave my patients, they're in there." "Let's go." "Help me, Connor." "Help me out." "You guys need to get out of there." "Oh no." "He's dead too." "She's alive." "Well, she's burning up but she's alive." "We've got to get her to the other hospital." "Pulse and respiration are up too." "She is not getting enough oxygen." "Ok." "Start her on 100% O² at 2 litres." "Yes, doctor." "I'll set her on the ceiling drip, and get some fluids in her and add some aphedemines for the fever." "She is from the village where Miles went to." "She might know where he was headed." "Do you know her name ?" "Marilu" "Marilu" "Marilu, can you hear me ?" "We need to know the name of your village." "The doctor that sent you here, he might be in trouble." "Do you know where he was headed ?" "En el norte, cerca del Rio Jalisco." "He told us, that there were other people in your village who were sick up north in a church somewhere." "Do you know where that might be ?" "Mission La Roca." "La Roca" "Hey, Powell is on his way with a map." "Marilu is struggling." "I'm thinking it's some type of meningitis." "Bactorial or viral ?" "The symptoms seem too severe to be viral, but I lost all my lab in the earthquake." "I'm going to start all over again now." "Mission La Roca is 30 kilometers north of Jalisco." "It's in the insurgent territory." "Ok." "First thing we're going to find them." "I thought I'd find you here." "Eva !" "You're alright ?" "Yeah, I was lucky." "Who is he ?" "I wish I knew." "I can't get him to tell me his name, or where he lives." "I can't get him to say anything." "Where did you find him ?" "Outside what was left of a school bus." "Everyone else was dead." "He must have been there for hours all alone." "No wonder he is not talking." "He is in a bad state of shock." "Post traumatic stress." "Everyone around here is facing that to some degree." "So what do we do with him ?" "Well he seems to have formed a pretty nice bond with you, maybe you can help him find his family." "He's dehydrated." "We really need to push the fluids." "I only have a couple more bags of ceiling down here, the rest is upstairs." "Perfect." "Just getting more and more agitated and confused, he is not far behind." "His optic disk is swollen." "His brain is beginning to swell, there's nothing I can do for him now." "Kris, Kris, ven pa'ca." "His infection is spreading." "If we can't do something for him, he'll get sceptic and die." "If somebody doesn't get us out of here soon, we're all gonna die." "Connor, talk to me." "All NIH personnel accounted for, all except Miles." "Any idea where he is." "Based on what I found, somewhere north." "North ?" "Did you authorized this ?" "When I sent him down here, I authorized him to save lives." "It's out ... of our region Stephen, and you know it." "Kate, we don't have time for this." "Natalie said that on top of everything else, we're dealing with an outbreak of bacterial meningitis." "Coordinate with her when you land." "She'll tell you what she needs." "And where are you gonna be ?" "North." "To find Miles." "Stephen, I just got off the phone with the secretary, she explicitely reminded me that all disaster relief personnel are forbidden to travel in insurgent territory." "Sorry Kate, you're breaking up." "Stephen, I mean it, you are not to travel north." "I don't know their names." "No ses su nombres." "Hello." "Hello !" "Ohh Damnit !" "No luck finding the boy's family ?" "I track the village from the name on the side of his bus, but the village and his school were destroyed." "Government infrastructure non-existent." "The reality of disaster relief." "What about communicating directly with him ?" "When I tried using a translator, to try to get through to him, still nothing." "Keep trying." "Just park it anywhere you can find." "Hola." "You're hungry ?" "Where I come from, they call these MRE." "I've got fruit salad, and mac and cheese." "Ayuda lo, para que no sente dolor." "Unless we take that bullet out of him, there's nothing I can do." "The medecine is in ... truck." "It's better than nothing." "Here, this will help." "Tequila ?" "Yeah, world's most underated analgesic, may I ?" "Well, take it easy, just a little." "When I was a kid, the closer I ever came to trouble was joyridding my father's sedan." "As young boys, Nestor and Juan ... watched his family were hunted down in Mexico right outside these walls." "They were trained to fight and kill from that day on." "Causes, I get." "Killing people to win, I may never will." "He's gone, isn't he ?" "Connor ?" "He went to go find Miles." "Oh." "We were all worried, I'm glad you and Eva are ok." "Thanks." "Why don't you grab some gloves, we need your help." "Where ?" "Round the corner, right here." "So Connor said we may potentially may be dealing with some unexplained cause of meningitis." "I was thinking it was a cluster before, now I'm afraid it's a full blown outbreak." "Why don't you take her." "Are you sure it's meningitis ?" "I'm retesting now, but we need to start treatment immediately." "My onboard supply is sepataxin will only treat a dozen or so patients as it is." "Alright." "We'll use that to treat the ones that are already presenting." "But I'm gonna need a hell of a lot more preventive doses of rophapin to treat the ones that have been exposed, but aren't symptomatic yet." "Meningitis kills in 48 hours." "If it's meningitis." "This patient needs a sling." "I'll get it." "Reality check, there is a finite number of resources available and a finite number ways of transporting them." "I can't exclude one medicine I know we'll need for when we may or may not." "I need you to be positive." "Carlos." "Rosa." "Marilu." "Excuse me." "You ok ?" "Donde esta my esposo ?" "How do you feel ?" "Mi familia ?" "Her family came in, presenting before the quake." "Marilu, your family, tu familia, when the building ... collapsed ..." "I'm so sorry." "Lo siento y mi niño ?" "The baby is ok." "I need one of those doses for her." "I don't have time to be positive." "And neither does her baby." "Hampering relief efforts is the ongoing conflict between the local government and the northen insurgency." "As always, the innocent are caught in the middle." "Vito esto hombre ?" "No." "Vito esto hombre ?" "No, no, no." "No" "Hey." "Hey." "None of these people seem to have seen Miles, but most of them are in shock anyway." "Frank, we're gonna find him." "Se necesito ayud aqui." "Hablas ingles ?" "Si." "Were they ill or were they quake victims ?" "Neither, they were relief workers." "They were ambushed and shot by the insurgents from el norte." "They don't trust ousiders." "Give me the picture." "Have you seen this man ?" "He was the doctor." "He was here the morning of the quake." "He said he was searching for more sick." "Alright, look, he was headed to a church." "Mission La Roca, do you know how to get there ?" "Straight up that road, but I wouldn't go there." "Why ?" "Up there is where I found them." "Look, we haven't any choice." "We have to go." "Then, you might wanna take this." "It didn't do them any good, but maybe it will bring you more luck." "Muchas gracias." "Let's go." "Come on." "Mama." "Mama." "Donde estas ?" "Donde estas, mama ?" "You should be fine now." "We just got several more patients coming in, all presenting with the same symptoms." "From the north ?" "Yes, and no." "They were originally from the north but they've been living in a refugee camp since the earthquake." "So this thing is spreading ?" "You have to act now." "And you need to finish those tests." "This is Kate Ewing." "Natalie, can I talk to you ?" "It's something with the boy ?" "Yeah." "You know I haven't been able to get him to talk, right ?" "Well I left him a minute ago and he was talking to somebody who wasn't there." "Maybe his mother." "He is just reconstructing a mental picture of her." "It's very common." "I just feel so helpless." "Look, the best thing you could do is just try to find concrete answers for him." "I know, find his family." "Until he knows what truly happened to them, his mind is just gonna fill in the blanks for him." "He's not getting to be able to get over this trauma." "I know." "He's gone." "He must have gone back to his village." "Can you deal without me for a little while ?" "Of course, go." "Oh man, this isn't good." "Check the map, there's gonna be another around here." "Stephen, get the hell out of here." "Doesn't look like we're going anywhere." "No le toces." "That Tequila makes him feel better but if I don't take that bullet out of him, he's going to die." "Se va morir." "Tu hermano se necesita este operation." "Nestor, no." "Don't let your brother die, when he doesn't have to." "Por favor, Nestor, no le tejes morir a tu hermano." "I need your knife." "Frank." "Frank." "Hum." "How in hell do we get in here ?" "Hm." "How in hell do we get out ?" "Can you move your hands at all ?" "No." "Come on." "Come on." "I've seen this in a movie." "It doesn't end well." "Who are you ?" "I'm Stephen Connor, we're doctors." "This is Frank Powell." "We're here to provide your country with disaster relief." "And you're here just to help ?" "Look, we're here looking for a friend, alright." "He is a doctor too, his picture is right in there." "Right there." "That's it." "Have you seen him ?" "He has." "Is he alive ?" "Look, most of the people who are sick in our hospital are from up here in the north." "Are any of your people sick ?" "Many." "You have a son ?" "Yeah." "Two of my men are missing." "One of them was wounded." "They're my sons." "They were last seen going north to where an american doctor was supposed to be." "That's probably Dr McCabe, our friend." "They might all need our help." "I don't know where they went to." "I think I do." "Cargen el vehiculo, nos iremos inmediatamente" "How is she doing ?" "Still touch and go." "So she's not responding to the cefotaxime ?" "Not yet, she is complaining of stomach pain." "May I ?" "Sure." "Is this sore ?" "Dolor ?" "Si." "Something's not right with the baby." "She's bleeding, this just started." "Por favor." "Si" "The trauma from the quake may have caused her placenta to separate from her uterus." "If she doesn't stop bleeding in the next couple of hours, she is gonna need an emergency c-section to survive, for both her and the baby." "I haven't done a c-section in years." "Me neither." "I'm almost set here." "I'm not sure which one needs this the most." "I know the doctor could use one." "You're okay ?" "No." "You have it, don't you ?" "It's not important right now, he is." "He dies, you die." "Me entiendes ?" "Hola." "I have been driving around looking for you for hours." "Tu casa ?" "This is where you lived ?" "That happened when the earth shook." "En el temblor." "Hola, Berto." "We'll find your family." "I promise." "He is in pain." "I can't do this without hurting him." "Nestor, Juan." "Nestor, Juan." "Nestor, Juan." "Papa, aqui." "Estamos aqui." "Papa, aqui." "Escarven !" "Juan, papa esta aqui." "Juan, juan." "It's an aftershock, everybody out now." "Now !" "Move !"