She and her husband, Brian (Tate Donovan), have decided the only way out of the situation with Duncan Carlisle (Dylan McDermott) holding their family hostage is to kill him.
Given that Carlisle’s a trained marksman, with an arsenal at his disposal, Ellen a surgeon and Brian a businessman, the odds of successfully killing Carlisle are lousy.
The episode brings the action back to the series’ premise: assassinating the president (James Naughton), who appears on screen for the first time in a while.
For those watching closely: A hint was dropped in the third episode that the first lady of the United States (Mary Elizabeth Mastroantonio) could be the power who wants her husband dead.
In this episode, her sister (Joanna Kelly) shows up as an ambassador, who had a fling with the president. The first lady is not the forgiving sort.
In a tense conversation toward the end of the hour, the president compliments his wife on her political acumen. “That’s why I married you, sweetheart,” he says. “You see the big picture, the truth behind the lie.”
She corrects him, saying that’s not why.
“You needed money, connections, and someone to save your failing political career,” the FLOTUS says. “That is the truth behind the lie.”
Ellen looks whipped when the first lady again tells her she does not want her operating on her husband. Still, Ellen remains a woman on a mission, even if it is not the mission that has her family under siege.
Ellen knows that neither she nor her husband is capable of the deadly deed that must be done, so she decides to visit Burton Delaney (Larry Pine). He was a friend of her father’s and has known her since she was a young ER resident, when she let a man die because he was a rapist.
Ellen thinks Burton is the only person she knows who could connect her with a hitman to take out Carlisle. She goes to his house and you can see the blood drain from her face when Carlisle’s daughter comes downstairs and recognizes Ellen from when she went to the girl’s school. As Burton steps outside of the room, Ellen takes in the family photos — and comes to the sickening realization that Burton is Carlisle’s father-in-law.
He explains that there is no way out. None. They are all stuck and if they don’t kill the president, they will be killed.
Ellen returns home, where Carlisle has been trying to cozy up to Brian, so he can be enlisted to persuade Ellen to kill the president in surgery. Trying to make up for being a lousy father and husband, Brian has sacrificed himself the last few episodes.
He makes a wild bid to kill Carlisle in the last moments of the episode and stabs him with the hypodermic needle containing the poison Ellen was supposed to use on the president.
A scuffle ensues, and Carlisle is stabbed in the chest with the needle. Will it kill him? It could have been something lethal for the president, especially combined with anesthesia, but it may not have the desired effect on Carlisle.
Plus it’s likely Ellen’s instinct as a doctor will kick in. That seems likely because if this episode proves anything, it is that this woman cannot catch a break.