Hello Fellow Fangirls and welcome to Ryan’s First Day. “But wait!” you may be saying, “Ryan is the young, slightly nerdy blonde, right? The one that looked a little like Spongebob Squarepants? He was in the previous episode! How can this episode be his first day?” Such a good observation. In fact, the first episode aired (where we got a dose of newbie Ryan) was actually filmed to be the third episode. So this episode – the proper second episode and aired as such – introduces us to Ryan…
Donor: Daniel Noonan, Bostonian, mommas boy, murder suspect
Recipient #1: Ben Parnell, long-term dialysis patient, family man
Transplant type – Kidney
Recipient #2: Christy Martinez, 18 year old cancer survivor, college Freshman
Transplant type – Double Lung
Medical dilemma – Christy is a cancer survivor of 3+ years, but policy states that a patient must be in remission 5+ years to qualify for transplant. When a pair of lungs, slightly damaged in a car accident become available, no other lung transplant patient wants them. Is it right to give an organ to a patient who may die of cancer post-transplant? Is it right to give a damaged organ to someone in a desperate situation, or should organs considered for transplant always be in optimal condition?
We begin in Boston where a carjacker takes a young woman’s sedan and drives off at a high rate of speed. I got a small chuckle out of the victim’s call for help, “does anybody have a cell phone?” I guess in 2009, it was possible not everyone did. Seems unheard of in 2013! The carjacker, fiddling with his new ride’s radio, runs a red light and is hit by Daniel, a young man who had just left his mother’s house. Daniel and Mom appear to have a good relationship, after he teases her about her cooking, he sincerely wishes her a nice day at work. She blows him a sarcastic kiss as the camera lingers on Daniel’s keychain, which is brightly colored and lettered with beads that spell out the word “Faith.” After the collision, the carjacker runs away on foot, and the camera zooms in on Daniel’s bloody and unmoving face, focusing yet again on his “Faith” keychain.
At the hospital, Nurse Pam Acosta and Dr. Andy Yablonski are chatting. We learn that Andy isn’t living at home, but in a hotel attached to the hospital complex. When Pam invites Andy to a Steelers game in Cleveland (a nice show of Pittsburgh realism), he says he’ll “check with Rena,” and Pam rolls her eyes. Pam calls on doctors Miranda Foster and David Lee to encourage Andy to find an apartment and get his life together. Andy insists he and Rena will work it out and that everything is fine.
A young, slightly nerdy blonde approaches the group and they pass him like they don’t know him, which of course they do not. “Ryan” is looking for Dr. Jordan, and we see the busy transplant center through Ryan’s new eyes. Dr. Jordan explains Ryan’s job to him, the basic duties of the Assistant to the Transplant Coordinator — and then informs him that the Transplant Coordinator has quit, leaving a vacancy that needs to be filled, so in the meantime, Ryan gets to pick up extra slack. I assume of course for no extra pay.
ER Dr. Lisa Reed is walking through the transplant wing to check on a patient… but she obviously came to make eyes at Andy as well. They share a cute, flirtatious moment (she apparently hasn’t heard Andy plans to work things out with Rena). The camera tracks Miranda and Andy into an exam room where they’re visiting with a long-time patient. Coach Carson Hayes is a man in his fifties who hasn’t taken the best care of his health in terms of stress, diet, exercise and smoking. He has diabetes and his heart is skipping beats (I blame Andy). Miranda and Andy have obviously been caring for this man for many years but he continues to go against their advice. Andy says “I told you so” approximately a million times, but Carson maintains his cheerful, buddy-buddy attitude with his doctors, not taking their concerns very seriously.
At Carnegie Mellon University in Pittsburgh, Freshman Christy Martinez is finishing up a phone call when she’s approached by her friend, a bubbly blonde with huge peace-sign earrings (really?!? in 2009???). They’re planning their afternoon when Christy starts wheezing and reaches into her bag for her asthma inhaler. Unable to find it in time, she collapses.
Christy is brought to Three Rivers where Dr. Reed meets her in the Emergency Room. She orders an intubation for Christy, but the young woman refuses the treatment, instead asking for the less invasive BPAP. Christy is knowledgeable about her condition and prepared to make her own treatment decisions.
Back in Boston, Daniel’s mom, Ruth Noonan, is mourning at his bedside. She expresses anger at the man who caused the car accident and then ran away. “People like that don’t deserve to live,” she says. Daniel is in fact brain dead. The hospital representative informs her that Daniel was a registered organ donor and Ruth is not surprised. “He was a good boy,” she says for the first but not the last time in this episode. Ruth collapses in tears at the knowledge that her son has been taken from her.
Back at 3R, Dr. Jordan is continuing Ryan’s tour, introducing him to the gang. She pulls Miranda aside to clarica about Miranda’s personalty faults (rude, short-tempered) to her face as Andy smirks and grimaces and eye-sexes the crap out of Dr. Jordan in the background (see above .gif). Some further clarica about Miranda is given by David and Ryan – Miranda’s father was a pioneer in the field of transplant medicine, he died last year, and he and Miranda were not close. For the second episode in a row (whichever way you look at it) David tells Ryan to get him some food from a local restaurant. How Dr. Lee maintains his figure with all those cheesesteaks, french fries and cinnamon rolls — well, I’m not judging but I am jealous!
In an exam room, Dr. Jordan visits with her patient, Ben Parnell, who is undergoing kidney dialysis. His family has wished him well and left for the day, as he has been admitted for his treatment. Across the hall, it is revealed that Carson needs double-bypass surgery, and according to Andy, Carson should call his family for help recovering from this major surgery. However, unlike Ben, Carson isn’t much of a family man.
Meanwhile, Christy has crashed so Lisa has no choice but to intubate her and send her up to the surgical floor. Andy and Lisa examine Christy, determining she needs a double-lung transplant. Christy’s father Manuel arrives, and demonstrates his knowledge of Christy’s condition by asking for some very specific test results. He discloses that Christy had a rare type of lung cancer, which was treated with radiation and chemotherapy. She also had pneumonia, all of which explain why her lungs are in such poor shape though she is only 18 years old. Out of the exam room, Andy expresses dismay that Christy has only been in remission from her cancer for three years – patients need to be cancer free for at least five years before they can be considered for a transplant.
In the transplant committee meeting, Andy presents Christy’s case. He wants to make an exception to the five year rule, but Dr. Jordan can easily explain why the policy is a good one — the immuno-suppressant drugs transplant patients must take in order for their bodies to accept new organs makes it likely the cancer will come back. Christy will die anyway, and the lungs could have been given to a patient with a greater chance of success. Andy breaks the bad news to Manuel and Christy who are obviously distraught. Andy works the eyebrows, begging Christy to fight for her life while he tries to find a way to help her.
Back on the floor, Ryan has accepted an offer on Daniel’s kidneys for Ben. He, Miranda and David plan their trip to Boston while Andy asks about Daniel’s lungs. Apparently they were damaged in the crash, so were not preferred for transplant, with other patient and hospitals turning them down. Andy makes the case for Christy – she can’t be given lungs good enough for another patient, but could she be given lungs no one else wants?
Dr. Jordan tells Ben the good news about the kidney – he is overcome with emotion at the idea of never having to undergo dialysis again and being free to spend more time with his wife and daughters.
Miranda checks in with Carson before she leaves for Boston and meets Carson’s son Jeremy, who is obviously uncomfortable in his father’s presence. It’s been a long time since they’ve seen each other as Jeremy appears to be in his early twenties, Carson observes “you’ve gotten tall!” Jeremy calls Carson a pathetic excuse for a father as Miranda intervenes, asking Jeremy to understand that Carson’s heart problems could be further aggravated by a confrontation, so Jeremy leaves. Andy then visits with Carson, and encourages the older man to try again and make the most of the years he has left. Carson takes Andy’s advice, but the relationship with Jeremy is strained and difficult.
In Boston, the unfortunate reveal: Miranda expects Ryan to have some medical training, preparing the organs for travel back to Pittsburgh. However, Ryan was hired to be an administrative assistant, and has no medical training. Miranda is shocked nearly speechless.
As the operation to retrieve Daniel’s organs is about to begin, the doctors are called out of the OR to speak with a police detective. The detective pulls out Daniel’s “Faith” keychain, stating that it belonged to a murder victim and since it was FAHNED in Daniel’s CAH (cause we’re in Boston now, remember?) it makes him the primary suspect in the MURDAH. Ruth hears this and is distraught. Christy and Ben’s lives hang in the balance.
The detectives determine that Daniel is indeed their murderer and the doctors are allowed to proceed. Miranda and Andy conclude the lungs could work for Christy. Miranda will bring them in just in case Andy gets permission to do the surgery, which he does. Andy explains the situation to Manuel and Christy. Manuel is unhappy but Christy, now 18 and in charge of her own medical decisions, wants to go ahead with the transplant, even though the lungs are damaged and not necessarily a permanent solution.
Ben and Christy are prepped for surgery as Ryan, Miranda and David return to Pittsburgh. Their progress is stopped as a bomb threat has closed all the bridges into downtown. Ryan saves the day by arranging for the police to escort the ambulance, and the organs are rushed into the hospital.
Miranda returns to the surgical floor to find Carson’s heart has stopped due to a stroke. She does her best to revive him, but is unsuccessful. She comforts a confused and mourning Jeremy.
Andy and Pam perform Christy’s lung transplant as Lisa watches from the observation room. Scenes from Daniel and Christy’s lives intermingle as his lung becomes part of her body and she breathes with it for the first time.
David comes to tell Ben’s family that his surgery was also a success. They all hug with happiness.
Miranda is feeling melancholy over Carson’s death when Andy joins her on what in real life would be the smoker’s deck. They talk about this and that, and Miranda admits how Carson and Jeremy’s situation mirrors her own. She needles Andy about his home life, and they are joined by David, who declares today “a good day,” thinking of Ben and Christy, and Andy agrees.
Some time later, Ruth visits 3R to meet Christy. She runs into Andy by the memorial wall of donors and is comforted by the fact that Daniel will be remembered here as someone who saved lives, not as a murderer.
There are a number of moving scenes in this episode: Watching Ruth Noonan struggle with the loss of her son and having to face the unfortunate facts about his life; the efforts of Carson and Jeremy to find a new relationship, but running out of time; Ben Parnell wore his heart on his sleeve for his wife and daughters and lived for them. But for me, the most moving part of this episode is seeing the success of Christy breathing with Daniel’s lung for the first time. If that moment doesn’t inspire people to strongly consider organ donation, I’m not sure what will.
Now how about some pictures of this beautiful, complicated episode?
Thanks for joining us! We look forward to hearing your thoughts on “Ryan’s First Day.”