Survivor: David vs. Goliath lost a "David" tribe member in Pat Cusack due to a medical evacuation during Wednesday night's special 90-minute premiere episode of Season 37 on CBS.

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Pat, a 40-year-old maintenance manager from Cohoes, NY, who currently resides in Watervliet, NY, was medically evacuated from the game on Day 3 after injuring his back on the boat ride returning from the season's first Immunity Challenge.

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Pat begged Survivor host Jeff Probst to stay in the game and continue competing, but his pain was so severe the medics worried his injury might be very serious.

"To be out of the game not by vote but by pure accident, it's gut-wrenching, but my life and my health is bigger than this game. And ultimately, I will pick myself up off the beach, dust the sand off, and get back on my horse. As a David, it's what I've done for 41 years; it's the story of my life," Pat said following his ouster.

The Survivor broadcast began with the two tribes -- the Davids and the Goliaths -- meeting Jeff Probst on a boat. The Goliaths quickly noticed their tribe was stacked with brains, beauty and brawn, while the other tribe appeared to be lacking in those areas.

The Davids, however, were proud of their name given David had a lot to prove but ended up being king in the classic story.

The "David" Tribe was comprised of Pat; Christian Hubicki, a 32-year-old robotics scientist from Baltimore, MD, who currently resides in Tallahassee, FL; Nick Wilson, a 27-year-old public defender from Williamsburg, KY, who currently resides in London, KY; Davie Rickenbacker, a 30-year-old social media manager from Orangeburg, SC, who currently resides in Atlanta, GA; Carl Boudreaux, a 41-year-old truck driver from Beaumont, TX, who currently resides in Houston, TX; Jessica Peet, a 19-year-old waitress from Lakeland, FL; Elizabeth Olson, a 31-year-old kitchen staffer from Dallas, Fort Worth, TX, who currently resides in Longview, TX; Gabby Pascuzzi, a 25-year-old technical writer from St. Augustine, FL, who currently resides in Denver, CO; Lyrsa Torres, a 36-year-old airline agent from Puerto Rico, who currently resides in Boston, MA; and Bi Nguyen, a 28-year-old MMA fighter from Houston, TX.

The "Goliath" Tribe was made up of John Hennigan, a 38-year-old professional wrestler from Los Angeles, CA; Alec Merlino, a 24-year-old bartender from San Clemente, CA; Jeremy Crawford, a 40-year-old attorney from Clover, SC, who currently resides in New York, NY; Dan Rengering, a 27-year-old S.W.A.T. officer from Lake Butler, FL, who currently resides in Gainesville, FL; Mike White, a 47-year-old filmmaker from San Diego, CA, who currently resides in Los Angeles, CA and has previously competed on The Amazing Race; Natalia Azoqa, a 25-year-old industrial engineer from Irvine, CA; Angelina Keeley, a 28-year-old financial consultant from Sparks, NV, who currently resides in San Clemente, CA; Kara Kay, a 30-year-old realtor from San Diego, CA; Alison Raybould, a 28-year-old physician from Leawood, KS, who currently resides in Chapel Hill, NC; and Natalie Cole, a 56-year-old publishing CEO from Los Angeles, CA.

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John, the pro wrestler, seemingly rubbed everyone the wrong way almost immediately with his confidence, while Pat tugged at heartstrings by revealing his mother was paralyzed when he was a young boy and his family lived paycheck to paycheck -- without college even being an option.

Jeff then had the two tribes participate in an experiment about capitalizing on every possible advantage. 
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Jeff asked the Goliaths to choose the apparent weakest male and female members of the David tribe, and they selected Lyrsa, who had purple hair and admitted she was a tad overweight, and Christian, whom the Goliaths dubbed "Big Bang Theory."

The Goliaths then had to choose the strongest male and female on their own tribe, who just so happened to be Alison and John. They were tall, fit and outspoken. Alison had also revealed she's a doctor, so everyone probably assumed she's intelligent.

The two pairs then had to compete in a Reward Challenge, but the Davids had an advantage as well -- they could choose the three paths the Goliaths would take to get to the end of the obstacle-course type of competition.

The competition had three parts: Balance, agility and one final task.

For Balance, the Davids could make the Goliaths walk across a balance beam over the water, walk across a plank bridge, or walk across a two-person track.

For Agility, the Davids could force Alison and John to climb up a net tube, pass through a rope tunnel, or crawl under a net.

And for the final task, the three options were a 15-piece cube puzzle, an eight-piece slide puzzle, or transferring 30 sandbags to one platform to another.

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The Davids could choose their own paths as well, and the winning pair would ultimately release a massive shelter-building kit into the water for their tribe.

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The Goliaths got stuck with the plank bridge, the net tube, and the 15-block puzzle. Meanwhile, Christian and Lyrsa opted to take on the balance beam, crawling under a net, and doing the eight-piece slide puzzle.

The challenge was "a blowout," according to Jeff, with the Davids surprisingly claiming victory. It all came down to the puzzle, and Christian disclosed to the group he ironically and coincidentally used to write algorithms for slide puzzles.

Each tribe was then given a map to their new home, and their Survivor adventure began.

A couple of Goliath's tribe members recognized Mike, who admitted he's more successful than he ever thought he'd be as a writer, director and The Amazing Race contestant. Mike gushed about how he's an obsessive Survivor fan and playing the game is a dream come true.

And Dan informed his tribemates he gained a lot of weight when he became a police officer but recently lost 100 pounds in a year.

Dan found himself very attracted to Kara. He said she's blonde and beautiful and would probably be his "Kryptonite" in the game.

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Kara, in turn, found Dan to be genuine, kind and hilarious. The former NFL cheerleader admitted Dan was drawn to her, which made it impossible for her not to be drawn to him in return.

"I'm so screwed. I'm like, 'Don't do it, Dan. Don't do it. You know better. You know this will mess you up. Showmances screw you so hard. Don't do it,' I kept telling myself. But some people have found love on Survivor, so why not me?" Dan said in a confessional.

Meanwhile, the Davids began building their shelter, and Gabby noted it was "game on" and time to work.

It didn't take long for Christian to realize Pat had "a strong personality," as he was dishing out instruction and direction for everyone.

Christian admitted Pat was coming across a little bossy and it might put a target on his back. Christian also said people didn't find Pat's jokes to be funny; however, everyone was satisfied with what he was accomplishing at camp.

Later that day, at the Goliath camp, Natalie vented about how she's much older than her castmates. 

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Natalie said she's 57 years old and they are about 25. Natalie was accustomed to being in charge and having young people work under her, but Natalia -- an industrial engineer -- didn't approve of her elder barking orders and making demands.

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At the David camp, Jessica said in a confessional she had told her castmates she's 22 even though she's only 19 years old. She figured her age would be her greatest challenge because she didn't want people to think she's not strong or mature enough to play this game.

Jessica's goal was to make as many alliances as possible early on, and she bonded with Carl, who acknowledged he was annoyed by Pat.

As for Lyrsa, she made a connection with Elizabeth. The girls, who look and act so differently, bonded over their mutual respect of the game as well as a need for trust and loyalty. Lyrsa also pointed out no one would ever suspect they'd be working together, which could ultimately serve as a big advantage for them.

Meanwhile, Gabby called Christian her "kindred spirit." She considered them both "nerds" and noted they needed to stick together, and Christian loved Gabby in return. Christian predicted they'd be "a platonic couple threat" on Survivor this season.

Over at the Goliath tribe's camp, it was raining nonstop and all of the castaways were having a tough time, as their bodies were cold and tired.

As everyone was caught up working their social game and making connections, Mike decided to take off looking for a hidden Immunity Idol, and everyone noticed his sudden absence. Mike's exploration put a target on his back, but Natalia wanted Natalie gone because she allegedly helped out very little around camp.

When Natalie found Mike, she disclosed how he had put a big target on his back, and Mike owned up to making a big, "rookie mistake."

On Day 2, at the David camp, Nick made an alliance with Elizabeth and called themselves "Thoroughbreds" to solidify trust. But Carl said Nick hadn't done much of anything since they had arrived on the beach, and so in Carl's mind, Nick had to go and was No. 1 on his list. Pat also agreed.

Most of the Goliath tribe members, including Angelina, were then shown looking for hidden Immunity Idols.

It was a race to find an idol, as John said it's in Goliaths' "DNA" to be in power and get one step ahead. And Dan eventually found an idol with Natalia and Kara by his side. The trio were ecstatic to get off to such a good start on Survivor.

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Meanwhile, Davie caught an octopus, and the David tribe was incredibly impressed with his find. He called himself a "blerd," which is a "black nerd."

Jessica was then shown crying about how her mother had been in a toxic, abusive relationship, and Bi shared how she had also been abused by an ex. All of the castaways got very emotional, opening up to each other about their life's stories and hardships, and then Nick disclosed his mother had passed away from an overdose.

On Day 3, the two tribes gathered together and met Jeff for the first Immunity Challenge of the season.

The challenge required each tribe to sprint through an obstacle to a sandpit, where one member from each tribe must race to dig under a log.

The first person to make it under the log would find a machete, where he or she must then chop a rope to ultimately release a ladder. The other tribe, however, would be penalized at this point in the course by having to untie knots in order to release their ladder.

After pole vaulting from one high platform to another, a giant number puzzle awaited each tribe at the finish line.

The first tribe to complete the challenge would win immunity and be safe from the first vote, while Reward would also be offered in the form of flint to make fire.

In the end, Goliaths won the first Immunity Challenge, sending the David tribe to Tribal Council. Lyrsa noted she didn't trust Nick and she never saw him performing or contributing anything at camp, which was apparently the consensus of the whole tribe.

Suddenly, after a commercial break, Pat was shown sprawled out on a stretcher surrounded by medics, and his limbs were visibly shaking.

Pat's back was apparently in severe pain and he had trouble breathing. Gabby explained the boat was sailing on high seas and a crack could be heard, which stemmed from Pat's movement on the boat.

Gabby cried about the idea of potentially losing a tribemate so soon, and Jeff admitted no one has ever been injured during transportation before on the show.

"Because of the impact to his back and the amount of pain he's in, we are worried that he could have done some damage, maybe some fractures to his back," the medic explained to Jeff.

Pat begged the medics not to make him leave the game; he didn't want his time on the show to end this way. However, the medics said they had "no choice" but to pull him from the game because his health and safety mattered more than anything. The medics also feared his injury was quite serious.

"I feel so bad for him," Gabby cried.

"You just said at the end of the challenge the David tribe was going to lose an artery but the heart was going to go on," Jeff told Pat, as tears could be seen streaming down Pat's face.

"You clearly didn't know you were going to be the artery... You are not quitting. Dr. Joe is pulling you from the game for your own safety. There is nobody that is going to question your heart."

The David tribe expressed to Pat how much they loved and appreciated his presence on the tribe, and they were very grateful for all of the work he had done. They wished him nothing but the best.

Gabby then acknowledged she had "misjudged" Pat because he had been her tribe's leader since Day 1.

After Pat was taken away in a helicopter, Jeff announced to the David tribe they would not have to attend Tribal Council that night and a flint would be waiting for them back at camp.

One disaster after the next is typical for what a David must go through in life in order to succeed, according to Elizabeth, who pointed out her tribemates would keep fighting.

Based on the episode's closing credits, Pat was treated for his injuries and has since made a full recovery.