Code Black Season 1 Episode 4 Review: “Sometimes It’s a Zebra”

Code Black Season 1 Episode 4 is another solid hour of the CBS freshman series. One of the reveals in “Sometimes It’s a Zebra” lets viewers know that this is a show that’s not going to reveal all of it’s secrets all at once! Really, how could it?  These doctors have a heavy case load all the time so they’re not a lot of time for telling a character’s life story.  Even though not every case is a perfect 10 in this, every episode gives us enough pieces to make each one of these people interesting and pique more curiosity about who they are and where things are headed.

The episode’s title comes from the phrase: “When you hear hoofbeats, think horses, not zebras.” In medicine it means when looking at the symptoms you should rule out the obvious before jumping to the exotic.  Like, every headache is not a brain tumor – unless of course, it is.  In Code Black Season 1 Episode 4 there are a few zebras prancing about – but the horses are as beautiful and they are worthy of attention as well – maybe even more so.

The Setup

There’s a new surgical attending physician at Angel’s Memorial. It’s Cole Guthrie (Cress Williams) son of Dr. Rollie Guthrie  (William Allen Young). As he’s being led around the E.R. by hospital administrator Dr. Taylor (Kevin Dunn) we immediately get that Cole’s got a chip on his shoulder. Dr. Taylor mentions having worked at the hospital almost as long as Cole’s father and Cole, see suggests that, like his father, Dr.  Taylor is “nostalgic” about Angels Memorial – and it’s not a good thing.  In reply Dr. Taylor says the only thing he’s nostalgic about is some move he remembers a “german prostitute doing.” Okay…that funny but weird, but let’s move on.

Taylor introduces Cole to our favorite residency director Dr. Leanne “Daddy” Rorish (Marcia Gay Harden).  She seems pleased to meet him, but the first thing she asks is if he’s seen his father yet. Her’s is the pleasure of meeting a friend’s kid – not necessarily about who this guy is.  She notices Cole’s hesitancy around the mention of his Dad, but there’s no time to analyse.   Head nurse Jesse “Mama” Sallander (Luis Guzmán) comes in announcing the ER has 3 incoming from house fire.  Instantly everyone goes into work mode.  Leanne sends Cole with Dr. Taylor to the observation section and then calls in the medical residents she wants with her: doctors Malaya Pineda (Melanie Chandra), Angus Leighton (Harry Ford) and Christa Lorenson (Bonnie Somerville).  There’s no time to really think about this as it’s happening, but in retrospect, the fact that she doesn’t ask for the other resident doctor – Mario Savetti (Benjamin Hollingsworth) – is a holdover from what went down last week.

The Cases

Center Stage

Right away we’ve got these three house fire victims, who are explained to us via the EMT’s as the are taken to trauma 1 – aka center stage.

• The most critical is a woman in her 20’s  named Tina (Sigrid Owen) who’s got severe burns on legs and torso and “very limited air.”  She goes with Angus and Leanne.

• Next is a man 55, Dennis (Glenn Morshower) with some breathing issues and 2nd and 3rd degree burns on his arms and legs. Rollie and Malaya take him.
• The least injured is a 5-month-old baby boy named Tommy.  He has smoke inhalation, but is barely breathing – Dr. Neal Hudson (Raza Jaffrey) takes that case – and Christa.

At center stage, Dr. Taylor, Cole, medical interns – and Mario – are all packed in the observation area.  As usual, it’s super intense.   Angus is at times so devastated by the state of the woman’s body.  I don’t blame him: she’s got 60 percent third degree burns to the point that her bra is fused to her skin and the rest of her looks like thick dried and cracked mud or paste.  The art department a good job at depicting the horror it is to see a severe burn victim – never mind the thought of being one.

Meanwhile Christa is having a tough time with the baby.  Something’s wrong, she can’t get a line in to give it fluids.

Christa:     “Every time I try to get a line it creates a bleed that won’t stop.”

Neal:           “That shouldn’t be happening – not with a burn”

Christa:       “But it is happening!”

Christa’s response isn’t fearful – rather she’s annoyed with Neal telling her what should be when she’s dealing with what is.  Neal tells her to take a deep breath and try again….  We don’t know it yet, but this baby’s a zebra.  For now though, Christa is having a difficult time dealing with this sick baby.  When she and Neal realize she’s going to have to drill into the baby’s leg in order to get a line in,  she starts remembering her own lost child and the endless medical procedures.  Leanne spares a glance over and notes what’s happening as Christa leaves the center stage area telling a surprised Neal that she “just can’t” do it.

The last house fire patient is worried about his daughter and grandson.   As Cole’s father is dealing with him, Cole is busy criticizing the observation area, noting that it’s “not particularly sterile.”  Dr. Taylor dryly notes that neither are taxi cabs – but many a baby has born in one.  Cole is on a tear though, so when his father tells Malaya do a procedure without using an ultrasound, he corrects his father.  You read that right, he corrects his father – from observation.  Leanne shuts Cole down immediately by telling Malaya to do it the way Rollie said.

 The Other Cases

1. A man comes in that wants to get sobered up so that he can go to his daughter’s wedding.
2. Angus and Mario have to deal with a woman stuck in… some kind sexual arousal state.
3. A mother brings her college-bound daughter in because she’s been throwing up the last three days.
4. Mario has to deal with a patient who has over-dosed.

Daddy’s in the House

In a fast-paced story world with an ensemble cast a single character doesn’t always pop out in a episode.  This week however, Harden’s Dr. Leanne Rorish (I love her last name Roar-ish, it’s so….Skywalker) is really the one to watch.  She’s involved in four of the six cases and has such emotionally charged scenes that it’s fair to say she owns “Sometimes It’s a Zebra.”

Let’s start with her role in Christa’s baby drama story.  This scene is my favorite of the episode.

It is rare to have a scene like this on television.  We’ve got two women over forty, each has strong, convictions, each have been through tragedy and loss, but one’s the boss.  The fact that Leanna isn’t trying to cut Christa down for this, or act like she’s got it all together while Christa doesn’t is great.  We get a moment of a real mentorship and budding friendship in this scene.  The emotions from both actresses are nuanced and honest as each sees and understands something about the other.  I love watching this relationship develop.  Yes, I know there’s another relationship developing for Christa, but romances are a dime a dozen for shows like this.  What’s going on with Christa and Leanne, equals yet mentor/mentee, is unusual and the performances are nuanced and a joy to watch.

The other short but pivotal moment Daddy has in regard to Rollie’s son Cole.  After that little stunt in the E.R. she lets Cole have it!  First she nails him about countermanding orders to her residents given by doctors on the floor and tells him he’s not to ever do it again.  Cole’s response is to smugly point out that what he said was right, so Daddy has to smack him down again by pointing out that it’s a teaching hospital.  They teach the residents the old-fashion way because technology can fail or be unavailable – knowing how to do things  without the fancy equipment in the long run gives those doctors options and increase the hospital’s overall success rate in terms of that procedure. (She says it in a way much sharper than I’m writing.)

I can’t help but wonder if some of the reasons Leanne has this insight has to do with what she told Christa about watching a intern “try and fail” to save her daughter.  Did they not know how to do something without an ultrasound?  Neal has talked about Leanne’s approach to training being different since the car accident, and Taylor has noted they are turning out better doctors under Leanne’s training.

Cole’s arrogance and pride won’t let him admit defeat though.  He still tries come out the winner in the conversation – but he epically fails!

Cole:      “With all due respect, I don’t take orders from you….and I don’t take them from my father.”

Leanne: “You have no idea how you got this job, do you?  You think you just apply to Angel’s Memorial and you get hired?  700 people applied for that opening.  You got the job for one reason, and one reason only:  Your father recommended you.  So the next time you feel like embarrassing him, try saying, “thank you” instead

As the saying goes…”Bam, said the lady!”

Cole is not happy to learn this and confronts his father about it – twice.  The first we hear about because Rollie talks to Leanne about it.  He asks her to “go easy” on Cole because he wasn’t a great father to Cole as a kid.  He’s tried to build a relationship with Cole when Cole was older, but it’s been difficult.  Leanne says she won’t treat him differently than anyone else.  Rollie’s response is that’s fair that she not go easier on him just because Cole’s his son, but hopes it means she won’t be harder on Cole either.   Leanne agrees. I’m not sure if this is a promise she’s gonna be able to keep, because if Leanne is just being Leanne, Cole’s attitude towards his father will continue to annoy her!

We actually get to see Cole and his father discuss the past and the giant chip Cole has on his shoulder.  Rollie gets the last word:

Leanne, Mario, and Zebras

Leanne’s day of dealing with prideful men isn’t over.  She has quite the day with Mario – who, as we’ll see, is not having a good day.  For now I’ll just deal with the two cases that involve his relationship with Leanne – both of them are zebras.

In the case of the young man who overdosed, Daryl Bridges (Doug Haley)isn’t open to Mario’s Mr. Nice routine when Mario tries to find out what drugs Daryl had taken.  Instead,  Daryl goes on about knowing his rights and spits in Mario’s face.  Mario is furious, but walks away.  Mr. O.D. wants to leave, but Mario coolly informs Daryl that he has to stay until his mental state is evaluated.

Mario: I hope your restraints won’t be too uncomfortable”

Mario’s not just talking about the ones that have the patient tied down to the bed.  Nope, he orders a spit mask put on him – a mesh bag that goes over the person’s head – and walks away!  I don’t blame him, but it still comes off as an act out of anger than for self-protection.  It’s act that comes back to bite him the butt.

In the middle of a code black crisis, Mario’s patient manages to escape his restraints and leave the hospital!  Leanna asks Mario if he’d had someone watching him – or at least asked a fellow resident to watch him.  When he stammers no Daddy lets Mario have it!

No, of course you didn’t – because you’re a first year resident!  This job requires you to be in several places at the same time – I have told you, you can’t do it alone.  I see he had an IV in place.  So he could be on the street mainlining his drug of choice.  We are going to be liable for both the 50-150 failure and the IV elopement unless we find this guy, quick.  Let’s get security on it – now!

Angus witnesses the entire dressing down that Mario gets.  Being that last week Mario tossed Angus under the bus and let Angus take the full blame on an error, Mario is well aware that Angus had to have enjoyed watching that little scene.  You’d think he’d have known better than to ask…

Mario:  “You’re enjoying this aren’t you?”

Angus:  “Like a tornado loves a trailer park.”

Later that night Daryl is brought back in by paramedics.  He’d gotten a mere two blocks away before going into uncontrollable seizures.  It looks bad – until Mario remembers something from Daryl’s earlier blood work and vital signs.  He rushes it to Leanne and together they figure out that only certain drugs create the abnormal blood patterns and heart rhythms – it’s a group of antidepressants!  Daryl’s another zebra!  He wasn’t a drug addict – he’d been attempting suicide! Leanne quickly figures out the antidote – a lot of sodium bicarbonate!  It’s quickly injected and Daryl stops seizing!  Mario’s thrilled, but Leanne throws cold water on the victory.

Leanne:  “You got lucky, Dr. Savetti.  I wonder how long that’s gonna last?”

Ouch!  It could be that Leanne, who knew about Mario’s behavior with Angus last week, was even less thrilled with Mario because of the others dealings she’d had with him that day.  Mario had a patient prior to Daryl: Chef Holder (José Zúniga) a happy drunk guy who’d cut his arm.  Head nurse Jesse “Mama” Sallander (Luis Guzmán) warned Mario that he needs to get the man out of the E.R. before he starts going into withdrawal because once he does they can’t let him leave – because alcohol withdrawal “can be fatal for alcoholics.”

It’s was a little surprising to me that Mama’s the one suggesting to kick out Chef.  Even Mario notes that doing so means the man will just go and start drinking again.  (Yes, Mario does show some concern!)  Nevertheless, Mario tried to do what Mama said.  It’s hard because Chef really wants to sober up.  His daughter is getting married the next day and he doesn’t want to show up drunk.   That’s when Chef saw Dr. Rorish – who had just finished talking with Christa about the baby.   He obviously knew the doctor because he called her “Leanne.”  This guy is a regular customer.

Leanne started checking Chef’s eyes.  Mario then parroted what Jesse told him about not having the space to keep him and added that Chef would just go out and get drunk again anyway.  Leanne wasn’t pleased.

Leanne:  “Thanks for your opinion Dr. Savetti, but we have no choice once alcohol withdrawal has begun.”

Mario:      “It hasn’t”

Oh really?  Leanne had Christa come over and look at Chef’s tongue.

Leanne:    “Tell me what you see.”

Christa:     “tongue fasciculations most likely from alcohol withdrawal.”

Leanne gave Mario the “Daddy glare” and walked away.  Mario whined at Christa as if she somehow made him look bad on purpose – which she didn’t.  All she did was answer the question.   His thought that she’d done it deliberately is more in line with how he thinks about things.  It’s the first lesson of the night that Mario got about going it alone.  It showed him just how not great it feels to be not supported by your colleagues – even though in truth that’s not what actually happened.

Watching this all play out I wonder if we’re supposed to think Jesse set Mario up for that scene.  If Chef knew Leanne he likely knew Jesse as well, which means Jesse likely knew exactly how Leanne would respond to this situation.  Jesse’s bad advice to Mario makes me think Mama set this entire situation up to teach Mario a lesson or two.

Jesse: “Life lesson:  when your daddy tells you to do something – just do it.”

Mario is pulled off that case.  Instead at various times we see Jesse, Christa and Leanne dealing with Chef as he goes through withdrawal.  There are times where it’s really bad, but Leanne and Christa handle it.  At the end of it all – the treating him in a broom closet, the sweats and the shakes – we learn that next day he’s gone back to drinking.  Why is this patient a zebra?  Because Leanne knew that the man’s daughter had died ten years prior – on her wedding day.

Leanne: ” This is what is known as a ‘grief ritual.’  Trauma one was the last place he saw her alive.  He’s stuck in that moment and he tries to escape it – but he can’t.”

There’s more to this story…Mama eluded to as much earlier.  Maybe this man’s daughter was in the car being driven by the drunk driver?  Perhaps it’s more that Leanne relates to the idea of a “grief ritual.”  Maybe alcohol was her friend for a time after the accident.  I’m looking forward to learning more about the things that have Dr. Rorish the doctor we see now.

This story affects Mario.  It’s another opportunity to see that the guy does in fact have a heart. Just prior to the closing scene with Leanne he’d seen Angus and Malaya all going out together to grab breakfast after their shift.  He looked sad, contrite and lonely.  There may be hope for him yet!

Malaya’s Zebra

Malaya’s zebra is a twist on the “Immaculate Conception” plot.  A college-bound African-American teen girl Keesha (Ajiona Alexus) and her mother Shanni (Angela Lewis) come to the hospital because the Keesha’s been vomiting all morning.  She’s had symptoms for the last three days.  Keesha is a sweet, soft-spoken young lady with a strong outspoken mom. The crossed wires start with the obvious question: could she be pregnant.  Both Keesha and her mom say that’s an impossibility.  Mom says she’s been determined Keesha won’t be a unwed teen mother like she was, and Keesha says she’s been down with the program – and her grades reflect it. Mom proudly reports that they’re aiming for Stanford.  Malaya lights up and offers…encouragement.

Malaya: “I went there.  It’s so hard to get in now, but they’ve got an excellent diversity outreach program.”

Shanni:  “Diversity outreach?  Is that how you got in?”

Shanni is outraged at Malaya’s assumption, but I’m taken aback that we’re not supposed to see that Malaya’s ethnic background would in fact have qualified her for “diversity outreach.”  A name like “Malaya Pineda” does not read as white American, but the setup here is that Malaya is completely removed from the possibility.  That’s what makes it offensive to Shanni.  Had for instance, Rollie been the doctor that mentioned it, Shanni would more likely have said Keesha didn’t need it, but not taken it offensively.  I see what the writer of the episode was going for here, but color-blind casting doesn’t hold up when you’re trying to directly address issues of racial prejudice.

However, I do understand the point they were trying to make, and it’s a good one.  Programs to help people of color, or from poor economic backgrounds get into college are great and helpful – but it doesn’t follow that because you are a person of color or from a poor background that you in particular need those programs to get in.  It’s a good reality check, reminding us that the social stereotype of the unambitious black urban teenager and the uninvolved single mother raising her is just that – a stereotype.

Of course the standard tests come back and say that Keesha is pregnant.  Shanni is angry with Keesha but Keesha swears it’s impossible because she’s a virgin.  When the time comes to discharge Keesha, Shanni is clearly devastated.  She sees it as all the dreams she had for her daughter to have a better life are gone – because she believes Keesha’s been lying and is pregnant. On the other hand Keesha is pleading with Malaya, saying “there’s no such thing as a statistical certainty” –  and with all the studying she does when would she even have the time to get pregnant?  (That alone should have tipped the mom off that Keesha’s telling the truth.  If you’re sexually active at that age you know finding the time isn’t difficult!).

Keesha’s sincerity makes Malaya take a step back.  This looks like a straightforward case of a daughter trying to hide her sex life, but what if it’s not?  She tells Angus she had a tough mom, at at that age she was always studying and was a virgin.  She reexamines the symptoms she noted on intake and one of them – bruises on Keesha’s legs that Keesha said were because she’s clumsy, makes her think.  She runs one last test and discovers that Keesha has a rare kind of brain tumor that “leaks the same protein that indicates pregnancy.

Keesha:  “I liked it better when I was pregnant.  Can we go back to that?”

This was a classic “zebra” story, although I think everyone watching knew she wasn’t going to end up being pregnant.  There’s also the line where Keesha says, “So, I’m not pregnant?” – which undermines the entire premise that Keesha knew she couldn’t be pregnant.  It’s things like that, and the color-blind casting issue that – despite its good intentions – make this story one of the weaker ones I’ve seen on Code Black.

Christa, Neal, and the Big Zebra

The driving story of the episode is the one involving the house fire victims, and it’s masterfully done.  Early on Dennis is panicked about the welfare of his daughter and grandson.   Meanwhile,  Christa is having her crisis about treating the baby and after talking with Leanne decides she needs to let Neal know why she freaked out about having to “drill into the baby’s leg.”

So, yes, that relationship thing is happening….  I wonder how Leanne will feel about her former student and current student getting together?  Hopefully that won’t be for a while.  I’m in no hurry for an E.R. active romance.

As it turns out, the reason Christa was having such a difficult time getting a line on the baby is that it has some kind of illness that pre-dates the fire injuries.  Christa is starting to wonder about the mother.  How could Tina not have known her child was ill.  Making things worse, the fire marshall wants to talk to Tina.  They think she may have set the fire on purpose!  So now, not only did this mother possibly neglect and abuse Tommy, but she may have tried to kill the boy, grandfather and herself in some kind of postpartum depression.  Christa is really upset.   However, Dennis assures Neal and Christa that his daughter is a “good girl” who would never try and hurt Tommy.  He wants to go see them, but Neal insists Dennis say in bed and rest.

Tina at one point wakes up and in a panic looks around.  She painfully reaches for a pen and pad on the table next to her and writes something.  However, the pad falls to the ground and her movements set off the respiratory alarm.  Neal comes over and injects more sedative into her IV.

The baby needs a spinal tap – (checking for meningitis?)  Neal encourages Christa to do the procedure, but she can’t – she’s afraid she’ll hurt the baby.  The spinal tap shows that the baby does have some kind of infection.  Neal has it sent to the lab so they can figure out what kind of antibiotic Tommy needs.

Unlike the twist with Keesha, I didn’t see this one coming.  Tina wakes up again and looks around.  Upon seeing Dennis in the bed across the room her eyes well up with tears and she tries to remove her breathing tube.  I’m thinking she’s feeling guilty…all she says is “Tommy.”

Yanking the breathing tube sets of alarms that send Neal, Christa, Mama and Daddy running over to her.  It’s Daddy that saves Tina from having her throat cut open for air.  She rethreads the breathing stuff in record time.  That’s when Mama notices the piece of paper on the floor.  It says:

Tina Collins
Kidnapped

What!?   Talk about a zebra.  Dennis must have realized Tina was going to tell, because when they look over to his bed he’s gone.   Neal finds Dennis and stops him from leaving.  He’s disgusted.

Neal:     “You’re either lying or you’re delusional! Either way it’s over!  We know you took her!”

Dennis:  “You don’t know anything! We’re a family! She is mine!  She needed me and I gave her a reason to live!  She loves me!  What about the baby she gave me?!  Doesn’t that proof anything?!

The entire case is a zebra!  Nothing about it is as it seemed. That man isn’t her father, he’s a sicko rapist who kidnapped Tina two years prior!  He’s Tommy’s father!  Tina did set the fire, but she did it because it was the only way she could think of to get her sick child to the hospital!  Holy crap! I did not expect any of that!  What a surprising twist! Bravo!

With Tina’s courage as a shinning example and incentive, Mama standing at her side, plus Christa using Leanne’s words about imagining the child leaving the hospital happy and healthy to assure Tina,  Christa is able to suck it up and insert a chest tube into Tommy in order to suck pus out of his lungs (eww!).  Leanne and Neal arrive just in time to see her do it – thus proving to both that she’s moved past her problem.

At the end of the episode Christa delivers a sleeping, going to be fine, Tommy into Tina’s arms.  In the locker room, Christa picks up a small toy truck from her locker shelf and whispers, “Mom did good today.”   Walking out to leave she runs into Neal – who asks if she’s like to grab breakfast.  She can’t because she’d made plans to meet Angus and Malaya after, but does ask for a raincheck.  …Like I said, I like that romance is in the air – but I don’t want it to take over the show.

The Wrap Up

Yes, I’m wrapping up – even though I’ve skipped a case.  That’s because it’s the first time a case was a real fail for me.  The whole idea of a woman in the emergency moaning like she’s doing the Meg Ryan routine from When Harry Met Sally because she can’t get relief was beyond juvenile.  It may have been okay as a Saturday Night Live skit with mama delivering the “punch line” about fixing “the condition” by making her sneeze, but even then it’s silly frat-boy humor.  In a drama though, it’s just stupid.

It’s because of that case and the issues with Malaya’s that Code Black Season 1 Episode 4 is my lowest-rated episode to date.  Overall, I really enjoyed “Sometimes it’s a Zebra” and thought we got some great moments and information about Leanne, Christa, and Mario.  Also Harden and Somerville continue to be standouts in their performances.  However, I can’t ignore that the case-writing was uneven either.  Hopefully, next week will be back up to par, because I have already become invested in these characters!

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[Photos via CBS]