Marcel is late because of traffic. Archer tells him a new high speed subway has caused problems. Also Blake is taking a job in Boston and is not coming back to Med. Marcel wants to talk to her but she won't answer her phone. He says he'll be back in an hour as he has to go talk to her.

Asher sees a pregnant woman who has sharp pains in her back and her OBGYN told her to come to the ED. The woman feels the baby kicking. She says she has had three miscarriages and is on edge.

Archer tells Asher to take her drug test which annoys her.

Marcel discovers a road is closed he needs to walk down. There is a big crash. The hypertrain has derailed! Marcel jumps the barrier and goes down to help. It is very dark and hard to see. He finds someone trapped in the rubble.

A guy's leg is stuck. He tried to call 911 but there's no service. Marcel helps free him but the man says other people need help more. There's a guy who has something lodged in his chest. Marcel gets him off the tracks  and tries to examine him. He says he has broken ribs and likely has a collapsed lung. More rubble falls, trapping them. Marcel says the safest option is to wait for the fire department to get them out. He makes a makeshift tourniquet.

Will sees a woman who has Type 1 Diabetes and hypertension but is here for a UTI. She has a fungal infection but the medicine is out of stock and the only med available is an old med that is contraindicated.

Asher wants a CT scan but there is still a shortage of dye. Asher wants her to do an ultrasound first even though Asher thinks it's a waste of time.

Charles talks to yet another therapist and complains about Anna not wanting anything to do with him. He feels weird about this issue when he is a psychiatrist. Charles also shares that lately when he has to give someone a tough diagnosis it bothers him.  His therapist thinks he's having a heart attack and collapses (really???)

The therapist is taken to the hospital. Charles tells Zach to take good care of his therapist.

The fire department shows up but can't get through yet and Marcel says the seriously injured conductor can't wait; he must operate right here.

Maggie makes the announcement that Marcel is stuck in the tunnel but as far as she knows he is okay. Will and Vanessa seem upset. They decide to talk to Sharon about their patient. Sharon says she will reach out to suppliers out of state and possibly the Army. She also tells Will she heard about Jay leaving Chicago. Will thinks it will be good for Jay.

A man has had an accident on a ladder. He hates hospitals. Tanaka-Reid works with Choi to try to help the guy who doesn't want to be here despite very serious injuries. Maggie says there is a problem. No chest tube because Marcel has been given it down in the tunnel. Tanaka-Reid feels a need to whine about how that isn't a good idea and gets told by Archer to shut up. Archer and Choi have an idea that might work.

Meanwhile, Candice may have a kidney infection. Asher is annoyed that Archer assumed an infection. Archer thinks she's overthinking. She takes it personally. Archer says there are a lot of shortages and she cannot send patients for CTs until it's proven it's needed.

Zach says there is no sign of cardiac problems in the psychiatrist. His only issue is lack of sleep. Charles goes to see him. He is embarrassed that his patient has to take care of him instead of the other way around. Charles thinks it might have been a panic attack. Otis wants to go home but his heart rate goes back up; he's having another panic attack.

The Fire Department tries to get Marcel supplies but the tube os stuck and pulling it causes an avalanche, pinning Marcel's hand.

CFD calls Maggie with an update. No one knows if Marcel is okay.

Asher gets called in because Candice is vomiting. She has a fever. Asher finally relents about the CT.

Marcel is continuing to try to get the supplies. Nathaniel is unconscious. Marcel wants the other guy to dislocate his shoulder so he can free his arm. His plan works.  He needss the guy to help him relocate his shoulder. He does.  The other guy is worried about getting out but Marcel says Nathaniel is the priority. He needs the light fro the other gy's phone. He instrcts him what to do to help him. They need to get Nathaniel's BP back up. They are going to sedate and intubate right here in the tunnel. Marcel needs more ilght.

Choi explains his homemade drainage system for his makeshift chest tube. Kai gets it.  Choi wants Kai to intubate. Kai is smirking as he begins. They do it.

The med is not available because of a manufacturer error. Sharon asks what can be done right now? Will says they MUST treat the infection or Rose will get worse. Sharon leaves. Vanessa knows someone who can get drugs illegally. Maybe they can get the meds from him. Will says this is a bad idea. They could lose their licenses or go to ail if they did that.

Marcel has gotten the light he needs. He starts his procedure. (At least it's not totally Macgyvered) He intubates and connects to a portable ventilator. He needs to drain blood from the lungs.

Asher has discovered Candice has appendicitis. She wants to be in on the surgery in case anything goes wrong with the pregnancy.

Rose is delirious and is crashing. She says her feet are cold. Her husband begs them to do something. Vanessa says she will be right back. She goes outside and calls her friend.

Charles goes to see Otis, who admits Charles might be right about it being a panic attack. Charles says Otis was triggered by what he said. Otis says he reads journals all the time and recently learned about Sporadic Familial Insomnia. It starts with an inability to sleep that worsens until it kills you. Charles says Otis is worried he might  have it? Otis knows it's irrational but he can't help it. He doesn't want to get tested -- what if he tests positive? He'll be consumed with it. Charles points out he is consumed by it already. Even if he tests positive, he'd be able to make choices about what to do with the time he has left.  Otis agrees to get the scan.

Will is checking for the drug and no one has it. Vanessa has got it from her friend but won't tell Will where she got it. Will says it's a crime. Vanessa says but Rose will die. Will asks how she will explain it in her chart? Vanessa doesn't know. Will tells Nancy to give them a moment and goes in himself. He talks to the husband. He says he can't legally give Rose the pills but her husband can. He leaves.

Marcel realizes the battery on the ventilator is dying. The other guy says he created this train to change the world -- why did Marcel jump in here? Jack admits he just wanted to make money, but Marcel was altruistic. Marcel says he is far from selfless. CFD finally gets them out.

Otis is negative for SFI. He is so relieved but feels this is a massive breach of therapeutic boundaries. Charles wants to keep working with Otis if that's okay. It's so difficult to find a practitioner who will actually listen, and this experience just made Charles want to work with Otis more.

Maggie and Sharon announce that Marcel is safe.

Choi tells Kai that Archer taught him this trick in Afghanistan. He says Archer is a good teacher and so is Marcel.

Archer tells Asher the patient was lucky to have a good doctor. She doesn't need to take drug tests anymore.

Rose feels much better. In fact she's sanguine. She may be discharged soon.

Will told Vanessa that no one can ever know about this ever.

Marcel's patients are here but Marcel does not show up. He's gone to see Blake. Avery says that her mom left and didn't want to talk to Marcel. Marcel asks her to tell Blake he hasn't been honest with her or himself.  He made the decision he wanted about her care and it was selfish. He didn't want to lose her but he did anyway.