As the doctors continue to work on Rick, Manning is informed the wife has arrived. Marcel takes Rick to the OR. With Marcel taking charge of Rick’s treatment, tends to Kim’s needs. Examining Kim, Manning discovers significant bruising on her lower back that couldn’t have come from the accident.

Not wanting to draw attention to what is really happening, Kim offers the doctor some feeble excuse. She states that she fell down a flight of stairs the previous week. Does Kim seriously think we were born yesterday? The pattern of bruising is inconsistent with what would occur if she had fallen down a staircase. None of Kim’s excuses is plausible.

Later, we find Marcel operating on Rick. One of the surgeons finds it strange that there is only 10cc’s of urine in his foley. Because it is dark and brown, a sample was sent to the lab for analysis. Marcel suggests that the urine’s colour could be a result of Rick being in rhabdo.

Rhabdo is an abbreviation of the word Rhabdomyolysis. It pertains to a breakdown of damaged skeletal muscle. Muscle breakdown can cause a build-up of the protein myoglobin in the bloodstream. Myoglobin, depending on the concentration, can cause kidney damage.

Marcel, on examining Rick’s right leg, notes that one of the muscles is dying and it’s dumping off into his bloodstream. CPK, an enzyme in the body, levels are at 25,000. Marcel recognises that this level clearly indicates rhabdomyolysis is extremely likely. Amputating the leg is the only option. Marcel can’t amputate the leg without first speaking with Kim.

Elsewhere, Manning is with Kim. Based on scans, a traumatic brain injury has been ruled out. Manning pushes the issue of bruising because she hasn’t bought into Kim’s story. Before either Manning or Kim can further their conversation, Marcel arrives.

Marcel informs Kim that her husband suffered a bad liver injury. Even though Marcel was able to get Rick’s bleeding under control, the doctor’s main concern is his right leg. Because one of the leg muscles is dying, it is poisoning his blood. Blood poisoning is putting Rick into renal failure. Rick’s right leg must be amputated.

When Marcel suggests that they move Rick to the ICU, even though Kim goes for that option, the doctor tells her that every second increases the Rick of him dying of multiple organ failure. Whilst Kim understands the situation, she’s adamant her husband should be the one to decide whether ort not to amputate his right leg.

Manning privately speaks with Marcel about her concerns. She isn’t comfortable with the entire situation. Manning tells Marcel that she believes Kim has been abused by her husband. Consequently, because of the abuse, Manning doesn’t believe Kim should be making any decisions pertaining to her husband’s care. This conversation leads them to take the issue to Chief of Services Sharon Goodwin (S. Epatha Merkerson).

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Manning doesn’t believe Kim is in the right state of mind to make the call. It’s a life or death situation. With Kim being too vulnerable, noting that it’s a decision she would have to live with for the rest of her life, it’s something the hospital should determine. Goodwin calls for an ethics panel decision.

The ethics panel sides with Manning. Whilst Marcel doesn’t agree with the ethics panel decision, the green light to go ahead with amputating Rick’s leg is given. As Marcel heads to the OR, Goodwin goes with Manning to give Kim the news.

Goodwin informs Kim that the hospital is moving forward with her husband’s amputation. This causes Kim to completely freak out. It’s an awkward moment. Kim believes Rick will blame her for him losing his leg.

Later, after Rick’s surgery, Manning leaves Kim alone with Rick. Kim, as Manning speaks with the social worker, looks anxious. Hearing a familiar sound coming from the treatment room, Manning rushes back in to find K switched her husband’s ventilator off. Kim admits to killing Rick. Time of death: 18:08. Police officers escort Kim from the hospital. Goodwin suggests to Manning that there might not have been “anyway to reach her.”