"Out of Time" by the Rolling Stones plays as Ray Liotta (why bother with his character's name when that's what you think every time you see him anyway?) looks around at the other people in the ER waiting room with him. One woman has some nasty-looking boils on her face, although I suppose there aren't a lot of good-looking boils. He checks the wall clock and sees that it's 11:22. As if they would have a wall clock in the waiting room. That's just asking for trouble. Ray watches some workmen put up a sign that explains that patients will be seen in order of arrival, which they won't, so I don't know what's up with that sign. Don't all ERs perform triage and take the direst cases first? Ray blinks his incredibly bloodshot eyes and glares at the workmen, who are being loud, then sighs and ducks his head as Mick Jagger sings, "Baby, baby, baby, you're out of time." Oh, good Lord. I've only been recapping this show for two minutes, and already with the anvils? Elsewhere in the waiting room, an old guy listens to a radio and a baby starts crying. A woman with an Eastern European or Russian accent asks whom she has to screw to get help, and walks up to Sam, who tells her to try an intern because they're always hard up.
Sam walks a boy named Jeremy, who is eleven years old, into the back. Jeremy asks if his father is there yet, and clutches a bloody towel to his head. He's accompanied by his younger sister. Sam says his dad isn't there yet, but that he's on his way. As Sam walks by, Ray grabs her arm and asks, "Do I give my ticket to you?" Sam gently removes his hand and says it'll just be a little longer. Ray mumbles something about how his baggage already went through, and Sam's like, "Uh huh" as she walks away.
Sam hands Jeremy off to Pratt and Darlene, explaining that Jeremy has "multiple lacs" because the television fell on him while the kids were home alone. Pratt promises to get to him soon, while Darlene helps Jeremy into a wheelchair and starts babbling about the standard of care which Pratt dismisses as "for rookies." Luka walks by and tells Darlene to get started; Pratt will join her shortly.
Sam tells Pratt she has a real winner for him: "Belly pain with combustible breath." Pratt asks if she's talking about "the creepy homeless guy" and gestures toward Ray, who is still looking mighty confused out in the waiting room. Sam admits that he's creepy, but says she doesn't think he's homeless. Pratt thinks they should let Ray sober up first, since Pratt will be done with his shift by then. Sam firmly says that Ray needs to be examined; Luka walks by and says he'll take care of it, and grabs the chart. Sam says that Ray has been there about two hours, and thinks he's in an airport. Luka translates, "He's altered?" Pratt thinks they should have one line for legitimate patients and one line for the rest. Man, that head trauma didn't help Pratt's personality at all, did it? (Is that ever going to come up again, or are we supposed to forget it happened?) Abby walks in with charts for Luka to sign out.
Shane West (see, I can't call him "Ray" because of Ray Liotta) struts in and says he hasn't been this starved since "the last Burning Man festival." First of all, shut up, Shane West. And second, nice try, writers, but 1998 called and it wants its hip edgy reference back. And third, shut up, Burning Man people. Anyway, all this to say that Shane West is going to get "some 'za." Are the writers trying to make us hate him? Nobody says "'za" except assholes and Steve Sanders. Okay, so just assholes, then. Abby looks for a volunteer to take her blood, and Chuny accepts. Shane West asks pointedly if this is about Abby's "needle stick," and Abby confirms it. Shane West gets on the phone and orders seven pizzas. He confirms that it's currently 11:23, which means if they don't get their pizzas by 12:03, they are free. I thought pizza places did away with those types of delivery policies when their drivers were causing all kinds of accidents and stuff. Anyway, this whole thing is just a ploy to make you notice that the episode is in real time, but since few of the Eagle-Eyed Forum Posters realized it, I guess it wasn't that successful. Shane hangs up the phone and explains to Pratt that, due to construction, the pizzas will never make it in time, and thus there will be no charge. While Shane babbles on, Sam watches Ray Liotta start to slump over in the waiting room. She yells to Luka to help her, and they run into the waiting room, where Ray Liotta is unconscious on the floor.
Sam and Luka start treatment. Indeterminate Accent Lady complains that she was there first. Um, lady? The dude might be dead. I think he gets priority. Sam says that Ray's vitals were normal when she triaged him a few hours ago, and Luka says that now his pulse is weak and thready and his blood pressure is crazy low. Indeterminate Accent Lady continues to yell and complain, and even goes so far as to lie down on the floor (ew!) and flop around to get attention. Yeah, she must be really sick if she can yell and run around like that. Some orderlies help Luka and Sam to bring Ray in on a portable gurney. Ray regains consciousness and asks Sam to grab his suitcase, which she does. Luka orders an EKG in case of "an M.I.," and Indeterminate Accent Lady shrikes that she's having an M.I. too. Shut up, Indeterminate Accent Lady.
Luka and Sam wheel Ray into one of the curtain rooms, and Luka asks Abby to skip her blood draw and give them a hand. They remove Ray's coat, and Ray struggles and seems disoriented. Luka asks Pratt if they can borrow Darlene, and Luka hands Darlene a clipboard and tells her to document everything they do and the time they do it. Darlene protests that it's a nurse's job, and Sam points out that there is a nurse shortage. There is? This is another effort to make the viewers realize that the whole thing is happening in real time, as Sam says that they are giving Ray oxygen at 11:25. Ray fights with the doctors, but finally relents and lets Luka listen to his chest. Yes, submit to Luka. It's the best way. Abby puts Ray's suitcase on the floor, and he yells that he wants it back. Ray has a freakout and Sam subdues him by holding a forearm against his throat, explaining that they're trying to help. The director is really fond of handheld camera shots between two people's shoulders, I'm noticing. Abby reads the EKG and lists off some orders. Luka checks it out and notes no ischemic changes. They continue to confer, and Ray interrupts them to tell them his name. Because he's a person! And there's never been an episode of this show that drives home the point that doctors treat their patients like objects. Except about once per season. Abby, Sam, and Luke exchange guilty looks.
In the curtain area over, Jeremy yells at Pratt for doing something, and Pratt promises not to hurt him. Luka says that Ray needs to be gowned, and asks Ray to work with them. Luka walks over to see what's going on with Pratt, who explains that Jeremy has a possible tendon laceration in his ankle. Jeremy wiggles his toes on command and explains that his sister pulled the television down on him. The sister says it was an accident. Pratt wisecracks that TV really is bad for kids. Shut up, Pratt. Luka asks about their parents, and Jeremy says that his dad was at work, and they can't afford a babysitter. Pratt comments that they can't afford a babysitter, but they have a big TV. How does he know how big the TV was? And how does he know that it wasn't a gift or really old or something? Shut up again, Pratt. Luka asks about the dad, and Pratt says that the neighbor called and he's on his way. Luka tells Pratt to clean Jeremy up and send him for X-rays. The sister tells Pratt that they have three TVs. Don't encourage him, little girl.
Luka walks back over to Ray, who now has an IV of some sort going, in addition to the oxygen tubes in his nose. Ray tries to apologize for his behavior. Sam gives Darlene another time stamp: 11:27. Luka reports on the heart sounds, which are normal, and Ray expresses pain when someone touches his stomach. Luka asks if Ray has seen a doctor lately, or has a primary care physician. Negative to both. In the bed, Jeremy and his sister watch the proceedings with wide eyes. Hey, there's a curtain right there. Why not pull it? Abby asks the last doctor Ray saw, and Ray doesn't remember the name, but says he was in Taylorville. Pratt hears that, and asks if Ray was in prison there. Ray was, and Pratt says he knows someone else who was there, too.
Luka notes a "positive fluid wave," small liver, and enlarged spleen. Abby explains that Ray has fluid in his belly. Pratt won't drop the prison thing, asking what Ray was in for. Ray says that it was a mistake, and Pratt scoffs and gives Ray the stink-eye. He asks what kind of mistake it was, and Ray says that he killed a guy for asking too many questions. Jeremy speaks, which reminds Pratt that he is supposed to be working. Ray hollers to Jeremy, but Pratt tells Jeremy not to pay attention. Luka gets Ray's attention and says that Ray is anemic and could be losing blood from an ulcer. Abby asks Ray if he's a drinker, and Ray chuckles sardonically. Abby asks if he drank in prison too. Ray says he drank something called Pruno in prison, and now he drinks wine, beer, or whatever he can get his hands on. But does he drink vanilla extract like Tom Hanks when he guest-starred on Family Ties? Luka asks what Pruno is. Ray explains that you get fruit and bread from the cafeteria, put it in a garbage bag with toilet water, let it ferment, strain it through your socks, and drink it. Wow. There's a taste sensation that will soon be sweeping the nation. ["Read all about it in The New Yorker, Luka! I did, in an article about the Aryan Brotherhood that scared the shit out of me." -- Wing Chun] Ray tells Abby that she doesn't know what it's like to need a drink, and Abby snarks, "I can imagine."
Luka announces that, to check for blood loss, they're going to have to do a rectal exam. Ray isn't having it. Luka explains why it's necessary, but Ray isn't convinced. Luka thinks his finger is smaller than Ray's bowel movements. Ew. Ray says that area is "exit only," and Luka says internal bleeding is life-threatening. Ray relents and asks if they can cover him up. Meanwhile, Jeremy is yelling at Pratt because he doesn't want a shot. Ray stares over, and suddenly Jeremy changes into another boy entirely, still yelling that he doesn't want a shot. Then he changes back into Jeremy, and Ray explains that doctors are mean and want to make them cry, but if Jeremy won't cry, then Ray won't either. Jeremy's silence is taken as assent. Pratt gives the shot as Luka sticks a digit up Ray's ass. Um, curtain? Should two little kids really be watching an old drunk getting a rectal exam? Or anyone getting a rectal exam, really?
Luka wipes his finger (ew) and explains that they need to put a tube down Ray's nose to figure out what's causing the bleeding. Ray says that the jail doctors did that for his pancreatitis. Sam promises that they'll numb it up, and Luka adds that they won't keep the tube in any longer than necessary. As they prep Ray for the tube, he talks about how he used to be an artist -- a painter -- but that he also worked as a contractor. Sam tells Ray to swallow as they insert the tube to make it go down easier. Ray gags a bit as they insert the tube, but it goes in just fine. Luka tells Sam to hook up the suction. Ray says that he gets confused sometimes, but that he's better know. Sam asks if he thinks he's going on a trip, and explains what happened in the waiting room. Lots of blood starts coming through the tube, but no one seems very alarmed. Ray says that sometimes he thinks he's going on a train, or a boat, or a plane. Abby asks if the suitcase is part of his delusions, but Ray says he has to carry his belongings around so that they aren't stolen from the flophouse.
Sam says that they've suctioned out one liter of blood as of 11:32. Can you imagine having a liter of blood in your stomach? Luka notes that the blood is too dark for an ulcer. Abby suggests varices and explains to Ray that it happens when your liver pressure backs up. Luka adds that the veins in the esophagus become fragile and can bleed uncontrollably. Ray takes this moment to vomit up some dark, dark blood. Lovely. Ray asks them to get the tube out of him, because it's making things worse. Luke tries to explain why they shouldn't remove the tube, and then orders Ray put into soft restraints. Sam notes that Ray's blood pressure is dropping, and Luka orders blood and a GI consult. Abby thinks Ray needs a room. Now, he needs a room? I think the rectal exam could've been the first clue. Ray begs them not to put him in restraints, as Abby tries to find out if he has any family they can call. Ray says there's no one. Pratt sends Jeremy and his sister up to X-ray. Luke tells Pratt to join them, and he rolls his eyes. They roll Ray into Trauma Yellow, barking out medical orders all the while, including prepping for a central line.
Darlene runs in with the blood and Luka continues to give everyone orders. Are all of the doctors on duty with this one patient? I guess Shane West and Neela aren't, but it seems like everyone else is. And God knows where in the hell Susan and Carter are. Pratt complains about the measures they are taking, since there is a slim chance Ray will live. Darlene can't believe that Ray is so close to death, since he was just "lucid and talking." Pratt says that Ray is "right on the edge -- all he needs is a little push." Whoa, why the hostility? Besides general prickishness. Sam tells Pratt that if he doesn't want to help, and trails off as Pratt asks why no one wants to be a nurse anymore. Abby tells Pratt to "come on" and Sam spits out, "Prick." Luka yells at them both.
Oh yeah, the patient, who is unconscious. Luka asks whether Ray is taking any meds, and Abby suggests that they check his bag. Sam notes that the first unit of blood went up at 11:35, and Darlene dutifully writes it down. Sam pulls out Ray's suitcase and finds a bottle of liquor, causing Pratt to call Ray "a class act." What, he's supposed to drink Grey Goose? Lighten up, dude. Sam asks Pratt what his problem is, and Pratt says that they are killing themselves for "a non-compliant, alcoholic, ex-con drifter with end-stage liver failure." Well, when you put it like that. Luka yells at Pratt to get out if he wants, and Pratt removes his gloves and stomps away, saying he doesn't do lost causes on Fridays. Awkward.
Luka asks if there's anything else important in the suitcase. Sam finds a photo of Ray, his wife, and a kid, along with some letters, a journal, and a painting. Ray wakes up and starts mumbling that he can't go anywhere without his passport. He tries to get up and look for it. Luka orders Ray's upper body to be tilted up, and Abby and Darlene start to remove Ray's restraints.
Luka walks out of the room and finds Pratt, asking, "Do you have a problem with me?" Pratt admits that he was out of line (!), and Luka tells him to come back into the room. Pratt says that Ray is a waste, dying from something he did to himself. Luka says that alcoholism is still a disease. Pratt says that suicide is too, and maybe Ray should catch some of that. That doesn't even make sense. Suicide isn't a disease. And isn't Ray's brand of alcoholism a particularly painful and slow form of suicide? In conclusion, shut up, Pratt. Luka says that they get cases like Ray's every day, and Pratt spits that he might need a day off. Luka asks if it's personal, and says they'll have to talk about it. Pratt ups the HoYay by asking Luka, "You like riding me, don't you?" Luka denies that he does, but Pratt says that, ever since he was an intern, Luka has been on his back. Luka admits it, and says that Pratt is good, but could be better. Luka walks away, and Pratt is all, "Daddy?" and then "Father Figure" starts playing on the soundtrack.
Sam tells Ray that they found the name "Bobby" and a phone number in his journal, and asks if they should call this Bobby character. Ray begs them not to call, and makes it very clear that he doesn't want to see Bobby. Luka comes in and says that the veins in Ray's esophagus are bleeding a lot, due to his cirrhosis, which means Ray has a less than 50% chance of surviving. Ray looks taken aback. Darlene blinks, which is about all she gets to do in this episode. Well, that and write shit down on her clipboard. Ray asks if they're talking about a few months, a month or what. Luka says simply, "Not that long." Pratt asks if Ray wants heroic measures taken to save his life. Ray doesn't understand. Pratt asks if Ray wants CPR, defibrillation, or a breathing machine. Ray realizes that they are telling him he's going to die really soon, like today. Ray says he has a lot of things to do, and that he's not ready. Pratt says that Ray clearly wants all measures taken. Ray looks around at the disappointed faces.
Adler from GI walks in for the consult, and asks how bad it is. Way to go, Mr. Positive. Pratt says they have two-and-a-half liters of output. Damn. GI Adler asks for "a six-shooter," and Ray asks for an explanation. Abby says they're going to look down his esophagus and try to "band the veins to stop the bleeding." A tech asks what's up with the suction, and Abby tells him to turn it up. The tech duhs, "I did." Sam says that nothing is coming out, which is bad news, since it means the suction isn't working. Abby runs into Trauma Green and asks Neela and Shane West, who are working on some old dude, if they have suction. Shane timestamps it at 11:40, claiming that he's still thinking about his pizza arrival. Abby checks the suction, and then asks if their patient is stable, because they need the room. Shane West asks Abby if she likes pepperoni, and Abby accuses him of having ADD and orders him to switch rooms. Shane protests that his patient may just need to be tubed, and Abby trumps him, saying that her guy might need to be pronounced.
Shane rolls his guy out, and Luka and Sam roll Ray in. They prep Ray for the procedure. Abby explains that he'll have to use a bite guard to keep from biting down on the fiber-optic scope. Sam asks Ray whether the photo from his suitcase is Bobby, his son. Ray says it is. Sam offers to call his wife, and Ray says it's been a long time. Sam asks about Bobby, and Ray says he's almost twenty and in college. Sam thinks they should call him. Ray says he hasn't talked to his son in years, and that he just got the phone number when he was released from jail. Sam urges him to okay the call and walks away. Luka pulls out the suction tube so that the fiber-optic scope can be inserted. Ray grunts painfully as the tube is removed.
After a blood-pressure check, Ray is ready to go. Abby puts the bite guard in his mouth while Sam calls Bobby. It seems that Bobby is sleeping, so Sam asks his roommates to wake Bobby up. The scope is inserted, and everyone watches the monitor. Sam explains to Bobby who she is. Adler notes that the varices are grade three, whatever that means. Sam tells Bobby that his father is out of jail, and has been for a while. Abby notes that Ray's blood pressure is down, and Luka orders a saline bolus. Ray listens carefully to Sam's end of the conversation. Sam says that Ray can't talk right now because he's in a procedure. Sam says that Bobby wants to talk to Ray, who tries to remove the bite guard and gets yelled at by Adler. Ray agrees to talk, anyway. Sam puts Bobby on speakerphone, which seems like a really bad idea. Ray talks the best he can. Bobby asks if Ray if dying. Ray says he's not. Bobby asks Sam, who says that Ray is very sick. Bobby asks what he's supposed to say, because it's been a long time. Bobby starts to say a few things, but stops himself, and then tells Ray, "Nice knowing you" and hangs up. Ray starts to sob, which can't be good when doctors are trying to repair your esophagus. Everyone stares at each other, and Ray says he told them not to call. Adler asks for more suction, since he can't fix what he can't see. All kinds of alarms start beeping, as Ray's blood pressure drops and they lose his pulse. Maybe the pulse ran out to go see Bobby and beg for forgiveness.
Ray has a hallucination that he's walking through the desert, calling out to his son. Bobby, a little kid, walks ahead of him, carrying a fishing pole. Ray whistles, but Bobby keeps running ahead.
Trauma. Pratt notes that Ray is bleeding out, and Luka calls for more blood on the rapid infuser.
Raylucination. Ray's wife is sitting on a dock near the water, and she tells him to come on in, since the water is warm.
Trauma. They bag Ray and give him more blood.
Raylucination. Ray is walking behind his younger self, as Young Ray is led into jail. Old Ray calls himself a "dumb son of a bitch." Young Ray turns and looks, and I have to wonder if they CGId that shot from GoodFellas, because Ray Liotta looks about twenty pounds lighter in the face alone, which would be hard to fake, and makeup can only do so much.
Trama. Pratt starts compressions as Sam feels for a pulse that isn't there and the monitor continues beeping as we go to commercial.
Ray is conscious again. Abby comments that she thought they lost him, and Sam tenderly wipes the dried blood from Ray's chin. Ray asks about Bobby, and Sam glances around before admitting that they had him on the phone. Ray asks if Bobby is coming, and Pratt says softly that Bobby isn't coming. Darlene calls out the blood pressure, and timestamps it 11:44. Adler calls Luka over for a whispered conference. Sam asks Ray how long he's been out of touch with Bobby. Ray says it's been a long time, since he went to prison. Behind them, Luka claps Adler on the shoulder as Adler leaves, so I guess they won't be retrying the procedure. Pratt points out that Bobby was still Ray's kid, prison or no. Abby announces that the blood has arrived. Ray says that Pratt doesn't know what it's like, and Pratt says that if he had a kid, he'd do everything he could to stay with him. What if he had a daughter? That's a scary thought. Ray say that Pratt doesn't know how life could turn on a dime, and how it breaks and you can't think how to fix it.
Luka says that they're going to try to control Ray's breathing with a scope. Ray's all, "Huh?" Luka explains that they'll pass a balloon into Ray's stomach to keep pressure on the bleeding veins. Ray says he has nothing to lose at this point. Sam offers to test the balloon. How? Is she going to make it into a little hat? Or an elephant? It would've been awesome if, the whole time this serious scene was going on, Sam was in the background making balloon animals. Ray says it was April 10, 1992, which was Bobby's eighth birthday. Ray's wife wanted him to go pick something up for the birthday party, but Ray wanted to stay and finish putting together Bobby's gift, so his wife went. And then Ray's wife got hit by a car, and Ray had to try to raise Bobby alone. So Ray started drinking. Ray cries that he couldn't keep it together, and that he stabbed some guy in a bar for some stupid reason. The medical team continues working while Ray spins this fascinating yarn. They prep the balloon and stick it down Ray's nose as he gags. Luka asks what happened to Bobby, and Ray says he lived with Ray's in-laws. They used to bring Bobby by on visiting days, but then they stopped, and his letters were returned unopened.
Ray suddenly says in a panicked tone that he doesn't feel well, and that something is wrong. No one seems very concerned. Sam reports an elevated creatinine level, suggesting kidney failure (I'm a cat owner; I know from kidney failure), and Luka snaps off his gloves and tells them to call Renal and put in a catheter. Pratt suggests TIPS, which Luka explains stands for Transjugular Interhepatic Portasystemic Shunt. Oh, that. Abby inserts the catheter, with Sam's assistance. Luka further explains that they can put a catheter from Ray's neck to his belly, connect the two main blood vessels in the body, bypass the liver, and slow down the bleeding. That seems like a lot of work for a dude who's in basically total system failure. Ray asks how much time that would give him, and Pratt equivocates that it's hard to say. Sam reports no urine output, which Abby says means hepatorenal syndrome. Luka tells Ray that his kidneys aren't working, and Abby says he needs dialysis. Pratt offers to call.
Shane West and Chuny roll in a guy with a gunshot wound to the belly. Luka tells them to buzz off, but Chuny says there's nowhere else to go. They slide Ray over to the side and start working on Mr. GSW. Ray gives the bullet as the patient complains that he got shot for stealing his own spliff. Drugs kill. Neela brings Ray's suitcase over from Trauma Yellow and asks for another nurse. Abby tells Ray that they just need to stabilize Mr. GSW, who is yelling that he wants his own room. Abby picks up Ray's suitcase, dumping half the contents in the process. She picks up the painting of a house, and Ray explains that it's a lake house they rented one summer. Luka notes that Mr. GSW has periumbilical something with intestinal prolapse. I take that to mean his guts are falling out of his belly button, and that's about as much as I can take, because you know that problem Heathen has with eyes? I have that problem with belly buttons. I can barely look at my own. My best friend's daughter rubs her belly button to soothe herself and I have to leave the room every time. Dubenko shows up and asks what's up with Ray and, after getting the bullet from Luka, says it sounds bad. They pack up Mr. GSW for transport upstairs for X-rays and surgery. Ray holds his painting with trembling hands. Shane West is compelled to report that he only has eleven minutes left until his pizzas are free.
Pratt returns and reports that the consults are on the way. Abby says that Ray is getting tremulous. Ray says he hasn't had a drink since last night. Luka says it's alcohol withdrawal. Ramirez from Nephrology walks in, and the doctors start talking in medical speak. Ray wants to know what's going on, and Abby says that Ramirez is here to perform the dialysis they discussed. Ray says he never discussed it. The doctor who will perform the TIPS procedure walks in and says that he should go first, before dialysis. Ray asks what they're talking about. The two new doctors argue over which procedure needs to happen first, and Ray keeps asking what they are talking about. Everyone ignores him. The doctors says that Ray will need dialysis three times a week for the rest of his life, and that TIPS is just a bridge to a liver transplant. Ray gets their attention and reminds them that he's right there, so they can talk to him. Everyone is silent. Ray asks if they can fix his kidneys. Abby says he'll need dialysis three times a week. Ray asks about his liver problem and the bleeding. Pratt says that TIPS is temporary, and Abby adds that what Ray really needs is a liver transplant. Ray asks what the odds are of his getting a new liver, and Luka admits that, based on Ray's alcoholism, the odds aren't good. Ray asks if there's any chance he'll walk out of there. Luka starts to answer, but Ray clarifies that he means today. Luka says honestly that there's no chance of that.
Ray takes this in, and then says that he doesn't want anything, then. Luka explains that it means that Ray will die. Ray says he gets it, and asks them to stop everything. The group runs down the various support procedures: blood transfusions, breathing machine, CPR. Ray says no to all of them. Luke wants to be clear and make sure Ray understands what he's saying. Ray says that he understands. Everyone pauses, and Luka says that Ray is a DNR as of 11:57. Luka starts to walk out, but Pratt chases after him and says that Ray isn't competent to make a decision. Luka says it's what Ray wants. Ray asks them to do something for the shaking. Abby asks if they can give him an alcohol drip. Ray chuckles that they're going to get him drunk, and Luka says it's just to stop the tremors. Pratt asks Ray to let them do the procedure. Ray asks Sam to call Bobby again, because if he knows it's really over, he'll show up. Ray clutches his painting in his hands and stares at the ceiling.
Sam tries to call Bobby again. She reports to to Ray that Bobby went to class, and that his roommate is going to try to find him. Ray asks them to take out the tube with the inflated balloon, adding that he knows what that means. Pratt reluctantly agrees. Ray asks them to open a window and get some fresh air in there. There are windows in the trauma rooms that can be opened? That seems like a safety hazard. Pratt pulls out the tube as Sam opens the window. The street noise filters in. Sam and Abby discuss what street it is, and how they never considered what was outside the window. Ray notices that his nose is bleeding, and Abby says it's from the tube. Ray comments that the booze works fast. Ray says that "all this stuff" is just a screen, and that he doesn't want anything separating him from what's happening, because he won't hide from this. Luka softly issues some more orders. Ray talks about his brother Lou, who died when they were kids. Ray's mom told him that Lou went away on a long trip, but he can't finish the sentence without being overcome by emotion.
door, Indeterminate Accent Lady yells at someone for leaving her alone in the room, and demands to see a doctor immediately. Ray stares at her as a tear runs down his face.
Raylucination. He's in a train station that's also the ER waiting room. Indeterminate Accent Lady screams, asking when it's going to be her turn. Ray catches sight of himself in a reflective surface, and he's clean-shaven and well-groomed, if still a bit puffy. He touches his face, but the beard is still there. The announcer is giving vitals instead of arrivals and departures. Ray walks up to a counter, where Abby stands, punching tickets. He asks what's going on. Abby says she's reading his vital signs. He asks if it's starting, and Abby nods that it is. Abby leans Ray's bed back so that he's lying down. She tells him that he won't be alone, and that someone will stay with him. Ray keeps switching back and forth between Reality Abby and Train Station Abby. Train Station Abby is very curt and customer-service-type friendly, whereas Reality Abby either actually cares or does a better job of faking it.
Abby asks Sam if she's got it under control, and walks out. Ray turns to Sam and asks if she will touch him. Sam's like, "Sorry?" Ray clarifies that he wants her to touch his face. Sam obliges, taking off her gloves.
Raylucination. He's in a boat with Bobby, fishing. He says that maybe they should anchor. Sam, sitting to him in the boat, asks what he means. As with Abby, he keeps cutting back and forth between Reality Sam and Fishing Sam. Sam says she doesn't know. Ray asks what she thinks Bobby wants. Sam says she doesn't think he knows. Bobby reaches over the side of the boat and plays in the water. Ray asks if it's too late, and Sam says it's not if he doesn't want it to be. A nurse drops some papers, and in Ray's mind, Bobby and Sam both disappear into the water.
Ray grabs his head and moans. He hears tapping, and it's Sam fixing his IV drip. Ray comments that he feels drunk again, and he thanks her. Sam nods. Luka returns and says that they're going to keep a heart monitor on, and the alcohol drip for comfort. Luka says that they're going to remove the other support measures, and that it shouldn't be long now. Ray says shortly, "Okay." Sam takes his journal and places it nearby. Ray tells Luka that he never believed in God, and that he wonders if it'll bite him in the ass now. Luka says that God will get over it. The monitor beeps, indicating that Ray's heart has stopped.
Raylucination. Or is it? Ray is walking through the desert. He gets onto a bus. The driver is trying to adjust a radio. Ray sees some of the people from the waiting room on the bus, too.
Trauma. Luka wipes Ray's forehead, possibly about to shut Ray's eyes. Neela comes in and asks if she can take the monitor. Luka tells her to take it.
Raylucination. Luka appears on the bus, wearing a John Deere cap. Ray sits down and asks what he can take.
Trauma. Ray has spoken aloud, and Luka realizes he's not gone yet. He tells Neela to leave the monitor.
Raylucination. Ray asks Luka what it's going to be like there. Trauma Luka says it'll be peaceful. Ray rides the bus and sees his wife walking through the desert in the opposite way. He calls to her to come back.
Trauma. Pratt tries to calm Ray down. Ray asks if they got all his stuff, and asks Pratt to make sure that Bobby gets it. He also wants Bobby to have the painting. Ray looks at Pratt and says, "You never knew your dad." Pratt confirms it. Ray says it's too bad. Pratt says he doesn't let it bother him. Ray says, "I bet it bothers him." Pratt nods and stares at the painting.
Raylucination. Ray has arrived at the house from the painting. He runs toward it. The door is locked, so he runs around, trying to see in the windows. Bobby is inside, blowing out candles on his birthday cake. Ray tries frantically to get inside, and whispers, "Let me in." He gets to another window, this one without curtains, and sees that the inside of the house is now bare.
Trauma. Ray whispers, "Bobby. Open up. Let me in."
Raylucination. Ray lies on his back in the desert. Bobby sits over him and whispers, "Can you hear me?" Ray is happy to see that Bobby made it. Ray asks how he looks, and Bobby says he looks okay. Ray says, "I'm so sorry."
Trauma. Pratt stands over Bobby, a single tear streaking down his face. Ray starts crying and says again that he's sorry. Pratt tells him not to think about that, and to take it easy. Ray says, "It's okay, son. It's..." The heart monitor flatlines. Pratt looks away and sniffs. He calls the time of death at 12:04. He and Darlene are the only ones left in the room. Pratt takes the painting from Ray's hands. Darlene is just standing there, stone-faced, probably wondering if this gig was such a good idea. Pratt takes the chart from her and walks out, carrying the suitcase.
Indeterminate Accent Woman is still trying to find out how much longer she has to wait. Shane West shows up and gives Pratt a hard time for staying with one patient for so long. Pratt shoves down all his emotion and tells Shane to do as he says, not as he does. Shane says that Jeremy, the TV kid, is waiting with his dad and sister. Shane asks if things went south, and Pratt nods. Shane West says that Ray was a nice guy, and Pratt gruffs, "Just a drunk." Shane West babbles that the pizza guy was late, so the pizzas were free.
Pratt looks over to where Jeremy is getting his head bandaged, and walks over to talk to him. The camera focuses in on Ray's suitcase, lying under a stethoscope and a piece of pizza. The Rolling Stones song starts up again, but the beginning sounds like circus music, which is kind of jarring given the subject of this episode. They should have faded back up on the chorus or something.