1
00:00:09,344 --> 00:00:14,388
<b><font color="#ff0000">Sync and corrections by btsix
www.addic7ed.com</font></b>

2
00:01:38,014 --> 00:01:39,390
Is it true?

3
00:01:39,391 --> 00:01:41,392
Simi told Hector that Dr. Deranjian said

4
00:01:41,393 --> 00:01:43,102
the hospital was up for sale.

5
00:01:43,103 --> 00:01:45,604
They might turn it into
an ortho center with no ER.

6
00:01:45,605 --> 00:01:47,481
Oh, they're always
threatening to shut us down,

7
00:01:47,482 --> 00:01:49,441
but they never do.

8
00:01:55,990 --> 00:01:57,783
Gloria is looking for you.

9
00:01:57,784 --> 00:01:59,284
No guts, no Gloria.

10
00:01:59,285 --> 00:02:00,953
Must be time for my weekly spanking.

11
00:02:00,954 --> 00:02:03,247
Try to be nice, for all our sakes.

12
00:02:03,248 --> 00:02:05,958
You sure you're cool being here today?

13
00:02:05,959 --> 00:02:09,128
Yeah. Why wouldn't I be?

14
00:02:09,129 --> 00:02:10,546
Well, if you need to talk...

15
00:02:10,547 --> 00:02:13,757
Yeah, I won't, but thanks.

16
00:02:13,758 --> 00:02:16,844
Where's Abbot?

17
00:02:16,845 --> 00:02:18,596
Getting some air.

18
00:02:21,391 --> 00:02:23,017
Really?

19
00:02:30,400 --> 00:02:32,484
Hey.

20
00:02:32,485 --> 00:02:34,196
You OK in there?

21
00:02:35,113 --> 00:02:37,656
Uh, awesome.

22
00:02:39,784 --> 00:02:42,286
I'd like to say it goes away,
but I had morning sickness

23
00:02:42,287 --> 00:02:43,996
for six months with my second daughter.

24
00:02:43,997 --> 00:02:46,165
Hell, who am I kidding?

25
00:02:46,166 --> 00:02:48,167
That one still worries me sick.

26
00:02:49,794 --> 00:02:52,963
- Thanks.
- But it's worth it.

27
00:02:52,964 --> 00:02:54,673
You tell anybody yet?

28
00:02:54,674 --> 00:02:57,468
Oh, no.

29
00:02:57,469 --> 00:03:00,304
Not until I pass 12 weeks.
Not this time.

30
00:03:00,305 --> 00:03:02,514
Nothing but good vibes.

31
00:03:02,515 --> 00:03:05,351
But just so you know,
Robby's working today.

32
00:03:05,352 --> 00:03:07,019
Today's the day Doc Adamson died.

33
00:03:07,020 --> 00:03:08,938
He hasn't worked it in four years.

34
00:03:11,524 --> 00:03:13,150
So why is he here?

35
00:03:13,151 --> 00:03:15,402
All I know is, he still blames himself

36
00:03:15,403 --> 00:03:18,322
for Adamson's death, so if
he's a little prickly today,

37
00:03:18,323 --> 00:03:20,200
give him a pass, OK?

38
00:03:21,451 --> 00:03:23,577
- Right.
- Thank you.

39
00:03:23,578 --> 00:03:25,496
Hang in there, kid.

40
00:03:36,049 --> 00:03:39,385
Good morning, Jack.

41
00:03:39,386 --> 00:03:42,680
What are you doing here?

42
00:03:42,681 --> 00:03:44,306
I'm working.

43
00:03:44,307 --> 00:03:47,559
And you?

44
00:03:47,560 --> 00:03:49,770
Oh, I don't know.

45
00:03:49,771 --> 00:03:52,106
Had a guy come in.

46
00:03:52,107 --> 00:03:54,733
Hit by a drunk driver in a crosswalk.

47
00:03:54,734 --> 00:03:57,277
39-year-old vet.

48
00:03:57,278 --> 00:04:00,030
Survived three tours without a scratch.

49
00:04:02,492 --> 00:04:05,620
I spent the last two hours coding him.

50
00:04:07,122 --> 00:04:09,498
That's always a rough way
to end the night.

51
00:04:09,499 --> 00:04:10,874
I must have had a reason

52
00:04:10,875 --> 00:04:12,584
at one time to keep coming back,

53
00:04:12,585 --> 00:04:17,923
but I can't think of it right now.

54
00:04:17,924 --> 00:04:21,218
Because this is the job
that keeps on giving.

55
00:04:21,219 --> 00:04:22,761
Nightmares.

56
00:04:22,762 --> 00:04:24,763
Ulcers.

57
00:04:24,764 --> 00:04:26,808
Suicidal tendencies.

58
00:04:29,686 --> 00:04:32,271
Besides, if you jump on my shift,

59
00:04:32,272 --> 00:04:36,108
that's just rude, man.

60
00:04:42,615 --> 00:04:45,617
I hope I'm never one of your patients.

61
00:04:45,618 --> 00:04:49,413
That makes two of us, my friend.

62
00:04:49,414 --> 00:04:52,916
I got a pregnant teen coming
back today for mifepristone

63
00:04:52,917 --> 00:04:55,419
and a small bowel obstruction
waiting on surgery

64
00:04:55,420 --> 00:04:57,504
for the last three hours.

65
00:04:57,505 --> 00:05:00,132
Oh, and unfortunately,

66
00:05:00,133 --> 00:05:02,509
the Kraken is still boarding in BH.

67
00:05:02,510 --> 00:05:03,764
Still?

68
00:05:03,765 --> 00:05:06,096
Guy's been here for a week
waiting on the psych ward.

69
00:05:06,097 --> 00:05:08,599
Yep. He's only getting worse.

70
00:05:08,600 --> 00:05:10,976
He's catching some Zyprexa Z's
at the moment.

71
00:05:10,977 --> 00:05:14,980
But when he wakes up, God help you all.

72
00:05:16,608 --> 00:05:18,609
I wrote a note
for the family of my dead vet,

73
00:05:18,610 --> 00:05:21,195
if anyone shows.

74
00:05:21,196 --> 00:05:23,197
Oh, and you got the med students

75
00:05:23,198 --> 00:05:26,325
and new interns starting today,
so good luck with that.

76
00:05:26,326 --> 00:05:28,160
Lucky, lucky me.

77
00:05:28,161 --> 00:05:30,704
- Sir, get back here!
- No needles! No needles!

78
00:05:30,705 --> 00:05:32,862
- Oh!
- Sir! Stop!

79
00:05:32,863 --> 00:05:34,124
- Somebody help me!
- They're gonna hurt me!

80
00:05:34,125 --> 00:05:36,669
Sure you want to work today, huh?

81
00:05:36,670 --> 00:05:39,371
Sir, I promise
nobody is going to hurt you.

82
00:05:40,965 --> 00:05:42,967
Sir!

83
00:05:44,844 --> 00:05:47,221
Who left this mess?

84
00:05:47,222 --> 00:05:50,265
They had a rough night.

85
00:05:50,266 --> 00:05:52,309
Good morning, sunshine.

86
00:05:52,310 --> 00:05:54,186
You obviously haven't seen this board.

87
00:05:54,187 --> 00:05:55,854
Oh, we've seen worse.

88
00:05:55,855 --> 00:05:57,856
Nothing like a little challenge
every now and then

89
00:05:57,857 --> 00:05:59,525
to keep everybody on their toes.

90
00:05:59,526 --> 00:06:01,151
- Dr. Robinavitch?
- Yep.

91
00:06:01,152 --> 00:06:03,654
Melissa King.
I will be joining you today.

92
00:06:03,655 --> 00:06:05,030
I just came from two months at the VA.

93
00:06:05,031 --> 00:06:06,448
Hey, welcome to the Pitt.

94
00:06:06,449 --> 00:06:08,033
This is Dr. Jack Abbot.

95
00:06:08,034 --> 00:06:09,868
Nice to meet you.

96
00:06:09,869 --> 00:06:12,705
I can't tell you how excited
I am to be here today, so...

97
00:06:12,706 --> 00:06:15,290
Talk to me at the end of the day.

98
00:06:15,291 --> 00:06:17,710
Ignore him. He had a rough night

99
00:06:17,711 --> 00:06:20,629
and is having
an ongoing existential crisis.

100
00:06:20,630 --> 00:06:23,382
Don't worry,
you'll get there soon enough.

101
00:06:23,383 --> 00:06:27,553
I married my second husband,
Everett, in 1964.

102
00:06:27,554 --> 00:06:31,849
He unfortunately passed in 1976
from a heart attack

103
00:06:31,850 --> 00:06:34,727
while we were vacationing
in Kissimmee, Florida.

104
00:06:34,728 --> 00:06:36,562
- It was awful.
- Good morning.

105
00:06:36,563 --> 00:06:39,815
We're gonna round, Dr. Mohan.

106
00:06:39,816 --> 00:06:42,360
Excuse me, Estelle. I'll be right back.

107
00:06:44,070 --> 00:06:45,904
So you know we track every resident's

108
00:06:45,905 --> 00:06:47,322
patients seen per hour.

109
00:06:47,323 --> 00:06:48,514
I was just taking her history.

110
00:06:48,515 --> 00:06:50,124
It's a brief backstory
about what brought them in,

111
00:06:50,125 --> 00:06:51,994
- not an autobiography.
- I was almost done.

112
00:06:51,995 --> 00:06:54,093
You hadn't even made it to this century.

113
00:06:55,373 --> 00:06:58,375
Patients, they check in
for registration here.

114
00:06:58,376 --> 00:07:01,587
A nurse eyeballs them,
makes sure they're not dying.

115
00:07:01,588 --> 00:07:04,048
If not, they're moved to one
of two triage rooms for vitals

116
00:07:04,049 --> 00:07:05,591
and a quick chair exam
where you can order

117
00:07:05,592 --> 00:07:07,384
your labs and your X-rays.

118
00:07:07,385 --> 00:07:08,927
And then they come back to...

119
00:07:08,928 --> 00:07:11,096
Waiting room, until a bed opens up.

120
00:07:11,097 --> 00:07:12,598
For how long?

121
00:07:12,599 --> 00:07:14,433
Eight hours, if they're lucky.

122
00:07:14,434 --> 00:07:15,934
A lot of times, 12.

123
00:07:15,935 --> 00:07:18,520
Uh, is it always this busy?

124
00:07:18,521 --> 00:07:19,938
Uh, no.

125
00:07:19,939 --> 00:07:22,191
It gets a lot busier.

126
00:07:24,944 --> 00:07:26,278
Take this.

127
00:07:26,279 --> 00:07:27,321
Hey, Mateo.

128
00:07:27,322 --> 00:07:28,489
Good morning, Cass.

129
00:07:28,490 --> 00:07:30,449
This is Sherry.

130
00:07:30,450 --> 00:07:31,784
Hi.

131
00:07:31,785 --> 00:07:33,660
Sherry, I'm Dr. McKay.

132
00:07:33,661 --> 00:07:35,454
I have some student doctors
with me today.

133
00:07:35,455 --> 00:07:36,830
Do you mind if they observe?

134
00:07:36,831 --> 00:07:39,291
Sure.

135
00:07:39,292 --> 00:07:40,918
What's going on, Sherry?

136
00:07:40,919 --> 00:07:43,462
I...

137
00:07:43,463 --> 00:07:46,048
I burned my hand on a Sterno.

138
00:07:46,049 --> 00:07:47,800
What were you doing with a Sterno?

139
00:07:47,801 --> 00:07:49,134
Uh, cooking.

140
00:07:49,135 --> 00:07:50,969
You were cooking with a Sterno?

141
00:07:50,970 --> 00:07:54,473
Yeah, we were making s'mores.

142
00:07:54,474 --> 00:07:55,474
That's sweet.

143
00:07:55,475 --> 00:07:58,352
My son loves s'mores.

144
00:07:58,353 --> 00:08:01,146
Uh, we've... we've been here for hours,

145
00:08:01,147 --> 00:08:02,773
and I have to get them to school.

146
00:08:02,774 --> 00:08:04,817
Do you know how much longer
this will take?

147
00:08:04,818 --> 00:08:07,986
Uh, yeah, let's see.

148
00:08:07,987 --> 00:08:10,406
- You take anything for the pain?
- Uh, not yet.

149
00:08:10,407 --> 00:08:12,658
1,000 Tylenol, 400 ibuprofen,
and saline dressing?

150
00:08:12,659 --> 00:08:14,993
Yes, please.

151
00:08:14,994 --> 00:08:16,662
McKay, we're going to round.

152
00:08:16,663 --> 00:08:18,831
And the fun begins.

153
00:08:18,832 --> 00:08:20,499
All right, Sherry,
we're gonna patch you up

154
00:08:20,500 --> 00:08:23,127
and get you out of here
as soon as possible, OK?

155
00:08:23,128 --> 00:08:24,421
I'll be back.

156
00:08:28,008 --> 00:08:31,343
As you can see, we have some
new faces with us this morning.

157
00:08:31,344 --> 00:08:33,178
Good morning, good morning.
Come on over.

158
00:08:33,179 --> 00:08:36,056
Starting with second-year
resident Dr. Melissa King,

159
00:08:36,057 --> 00:08:37,516
fresh from the VA.

160
00:08:37,517 --> 00:08:39,143
Everyone calls me Mel.

161
00:08:39,144 --> 00:08:41,061
I'm so happy to be here.

162
00:08:41,062 --> 00:08:43,063
Trinity Santos, intern.

163
00:08:43,064 --> 00:08:45,399
Victoria Javadi, MS3.

164
00:08:45,400 --> 00:08:47,901
Uh, Dennis Whitaker, MS4.

165
00:08:47,902 --> 00:08:49,361
Welcome to the Pitt. I'm...

166
00:08:49,362 --> 00:08:50,738
We've got two traumas from the T.

167
00:08:50,739 --> 00:08:52,252
- Five minutes out.
- OK, copy that.

168
00:08:52,253 --> 00:08:54,033
Actually, this is
the most important person

169
00:08:54,034 --> 00:08:55,534
that you're gonna meet today.
This is Dana.

170
00:08:55,535 --> 00:08:56,910
She's our charge nurse.

171
00:08:56,911 --> 00:08:59,329
She is the ringleader of our circus.

172
00:08:59,330 --> 00:09:01,373
Do what she says when she says it.

173
00:09:01,374 --> 00:09:04,793
As you can see,
our house is always packed,

174
00:09:04,794 --> 00:09:07,129
and our department is mostly
clogged up with boarders.

175
00:09:07,130 --> 00:09:09,381
Those are admitted patients
waiting for a room upstairs,

176
00:09:09,382 --> 00:09:11,300
sometimes for days.

177
00:09:11,301 --> 00:09:13,510
Beds are a very precious
commodity around here,

178
00:09:13,511 --> 00:09:14,803
so please be quick and efficient

179
00:09:14,804 --> 00:09:15,804
with your workups.

180
00:09:15,805 --> 00:09:17,222
What else?

181
00:09:17,223 --> 00:09:18,807
We treat the sicker patients back here,

182
00:09:18,808 --> 00:09:20,476
but please keep your eye
on that waiting room.

183
00:09:20,477 --> 00:09:23,020
Make sure nobody's gonna die out there.

184
00:09:23,021 --> 00:09:25,808
Your senior residents are Dr. Collins

185
00:09:25,809 --> 00:09:27,512
and Dr. Langdon.

186
00:09:27,513 --> 00:09:31,176
You report to them,
and they report to me.

187
00:09:31,177 --> 00:09:33,112
Senior residents,
you got your sign-outs?

188
00:09:33,113 --> 00:09:37,284
- Yep.
- OK. Let's do this.

189
00:09:37,285 --> 00:09:39,787
Virgil Straker.

190
00:09:39,788 --> 00:09:42,706
9mm GSW to the left shoulder.

191
00:09:42,707 --> 00:09:44,917
CT angiogram negative,
surgery wants to admit

192
00:09:44,918 --> 00:09:46,585
for overnight observation.

193
00:09:46,586 --> 00:09:48,962
Good vitals. They repeat a crit?

194
00:09:48,963 --> 00:09:50,547
Stable crits
every two hours times three.

195
00:09:50,548 --> 00:09:52,424
Discharge on Ceftin, recheck tomorrow.

196
00:09:52,425 --> 00:09:54,426
He'll get way more rest at home.

197
00:09:54,427 --> 00:09:56,428
Good morning, Mr. Straker.
You want to go home?

198
00:09:56,429 --> 00:09:58,764
- Hell yeah.
- OK.

199
00:09:58,765 --> 00:10:00,265
Hey. Hey, Ro.

200
00:10:00,266 --> 00:10:02,143
Hey, Ro, I'm finally
getting out of here!

201
00:10:03,645 --> 00:10:05,562
All right, Murphy Rottenstein.

202
00:10:05,563 --> 00:10:07,398
48-year-old woman with cirrhosis

203
00:10:07,399 --> 00:10:08,774
and upper GI bleed.

204
00:10:08,775 --> 00:10:11,568
Intubated and stable after one unit.

205
00:10:11,569 --> 00:10:13,195
Awaiting ICU bed.

206
00:10:13,196 --> 00:10:15,072
Hey, Doc.

207
00:10:15,073 --> 00:10:17,783
And we all know Louie Cloverfield.

208
00:10:17,784 --> 00:10:21,620
Blood alcohol of .420 at 11:00 PM.

209
00:10:21,621 --> 00:10:23,580
- I've been cutting back.
- How is he still breathing?

210
00:10:23,581 --> 00:10:25,124
That's a lethal dose for you and me.

211
00:10:25,125 --> 00:10:26,709
That's happy hour for Louie.

212
00:10:26,710 --> 00:10:28,460
Sobered up. Had two rounds of lorazepam.

213
00:10:28,461 --> 00:10:31,630
Hold out your hands for me, Louie.

214
00:10:31,631 --> 00:10:33,298
- Another two of lorazepam.
- On it.

215
00:10:33,299 --> 00:10:34,425
And a script for Librium.

216
00:10:34,426 --> 00:10:35,509
It's good to see you, Louie.

217
00:10:35,510 --> 00:10:37,636
It's always a pleasure, Doc.

218
00:10:37,637 --> 00:10:39,763
Bar fight with complete avulsion

219
00:10:39,764 --> 00:10:41,765
of tooth number eight.

220
00:10:41,766 --> 00:10:43,434
Smile, Charlie.

221
00:10:43,435 --> 00:10:46,478
Oh! Where's your tooth, Charlie?

222
00:10:46,479 --> 00:10:48,439
Fuck if I know.

223
00:10:48,440 --> 00:10:50,983
Cancel the discharge.
Order a chest X-ray.

224
00:10:50,984 --> 00:10:52,484
Got to rule out aspiration.

225
00:10:52,485 --> 00:10:55,154
Incoming!

226
00:10:55,155 --> 00:10:56,947
42-year-old male, Sam Wallace.

227
00:10:56,948 --> 00:10:58,782
Blunt head with agonal respirations.

228
00:10:58,783 --> 00:11:00,492
Dropped down on the T tracks.
Couldn't tube him.

229
00:11:00,493 --> 00:11:01,994
- LMA in place.
- Suicide attempt?

230
00:11:01,995 --> 00:11:03,996
Rescue. He's a good Samaritan.

231
00:11:03,997 --> 00:11:06,331
Took a spill helping an elderly
woman who fell off the tracks.

232
00:11:06,332 --> 00:11:08,000
- She's right behind us.
- OK. Trauma one. Go ahead.

233
00:11:08,001 --> 00:11:09,251
Copy.

234
00:11:09,252 --> 00:11:11,003
Come on.

235
00:11:11,004 --> 00:11:12,838
Elderly woman, fell from T platform.

236
00:11:12,839 --> 00:11:14,673
Good vitals and no head injuries.

237
00:11:14,674 --> 00:11:16,300
Degloving injury, right lower leg

238
00:11:16,301 --> 00:11:18,635
with open fracture dislocation
to the ankle.

239
00:11:18,636 --> 00:11:20,137
Whoa. OK.

240
00:11:20,138 --> 00:11:22,014
Trauma two. Trauma two. Let's go!

241
00:11:28,938 --> 00:11:30,981
How are we doing? We ready?

242
00:11:30,982 --> 00:11:32,524
OK, here we go. Ready?

243
00:11:32,525 --> 00:11:35,486
One, two, three.

244
00:11:35,487 --> 00:11:36,820
Good breath sounds bilaterally,

245
00:11:36,821 --> 00:11:38,364
but we need to protect...

246
00:11:38,365 --> 00:11:39,823
Apparently he jumped down
to save the lady.

247
00:11:39,824 --> 00:11:41,367
When he climbed back up, he slipped,

248
00:11:41,368 --> 00:11:43,160
- fell back, and hit his head.
- OK, thanks.

249
00:11:43,161 --> 00:11:44,661
Uh, Mel, right?

250
00:11:44,662 --> 00:11:46,372
I need you on the E-FAST.

251
00:11:46,373 --> 00:11:48,207
Pupils four millimeters and reactive.

252
00:11:48,208 --> 00:11:50,042
OK, that's encouraging.

253
00:11:50,043 --> 00:11:52,044
- What do you want for meds?
- 120 ketamine, 80 of rock.

254
00:11:52,045 --> 00:11:54,505
- A-fib on the monitor.
- Courses clear.

255
00:11:54,506 --> 00:11:56,507
That's a lot more blood than expected.

256
00:11:56,508 --> 00:11:59,760
Um, he's probably
anticoagulated for A-fib.

257
00:11:59,761 --> 00:12:01,845
Check his medical records,
see if he's on a DOAC.

258
00:12:01,846 --> 00:12:04,390
Stand by with four-factor PCC
if there's a brain bleed.

259
00:12:04,391 --> 00:12:06,475
What's in the PCC, Mel?

260
00:12:06,476 --> 00:12:09,520
Uh, clotting factors
two, seven, nine, and ten.

261
00:12:09,521 --> 00:12:11,355
OK. Be right back.

262
00:12:11,356 --> 00:12:12,981
50 of fent didn't touch her.

263
00:12:12,982 --> 00:12:14,566
Did she faint or did she trip
off the platform?

264
00:12:14,567 --> 00:12:16,235
Nobody knows.

265
00:12:16,236 --> 00:12:17,569
The other guy jumped down,
pulled her off the tracks

266
00:12:17,570 --> 00:12:18,654
just as the train was rolling in.

267
00:12:18,655 --> 00:12:19,905
Isolated injury to the foot.

268
00:12:19,906 --> 00:12:21,240
The train ran over her foot?

269
00:12:21,241 --> 00:12:22,241
Got caught between the platform

270
00:12:22,242 --> 00:12:23,409
and the incoming train.

271
00:12:23,410 --> 00:12:24,827
Ma'am? Ma'am, what's your name?

272
00:12:24,828 --> 00:12:26,161
All right, type 3 open fracture.

273
00:12:26,162 --> 00:12:27,913
Two grams Cefazolin, 400 of gent.

274
00:12:27,914 --> 00:12:29,748
Do you speak any English?

275
00:12:29,749 --> 00:12:31,709
Airway and breathing are perfect.

276
00:12:31,710 --> 00:12:33,252
As is circulation.

277
00:12:33,253 --> 00:12:35,587
BP 140 over 85.

278
00:12:35,588 --> 00:12:38,132
Students, what might have
made her faint on the platform?

279
00:12:38,133 --> 00:12:39,591
- Uh, TIA, CVA.
- Could be an arrhythmia,

280
00:12:39,592 --> 00:12:41,301
- cardiac event.
- So she needs...

281
00:12:41,302 --> 00:12:42,928
- Hed CT.
- EKG and troponin.

282
00:12:42,929 --> 00:12:44,430
- OK, good.
- What do we got, party people?

283
00:12:44,431 --> 00:12:45,931
Subway train degloved her foot

284
00:12:45,932 --> 00:12:47,433
with an open fracture dislocation.

285
00:12:47,434 --> 00:12:48,934
Ooh, and I thought
my heels were painful.

286
00:12:48,935 --> 00:12:50,728
- Hemodynamically stable.
- E-FAST negative.

287
00:12:50,729 --> 00:12:52,271
Ma'am, I'm Dr. Yolanda Garcia.

288
00:12:52,272 --> 00:12:54,064
Any pain in your chest or belly?

289
00:12:56,776 --> 00:12:58,277
Can we please push the morphine?

290
00:12:58,278 --> 00:13:00,279
No, it could cloud her mental status.

291
00:13:00,280 --> 00:13:03,282
I can't do an exam like this.
Push the damn morphine.

292
00:13:03,283 --> 00:13:04,908
We're doing a popliteal block.

293
00:13:04,909 --> 00:13:06,618
Numbs the lower leg, no side effects.

294
00:13:06,619 --> 00:13:07,953
Wonderful. Where's the other guy?

295
00:13:07,954 --> 00:13:09,455
Next door. He's a bit worse.

296
00:13:09,456 --> 00:13:10,789
Pan scan her.

297
00:13:10,790 --> 00:13:12,791
Let me know when she stops screaming.

298
00:13:15,920 --> 00:13:17,546
The cords are very anterior.

299
00:13:17,547 --> 00:13:19,298
Yeah, that's because
we can't flex the neck.

300
00:13:19,299 --> 00:13:22,259
Keep the hockey stick straight up.

301
00:13:22,260 --> 00:13:24,136
- I'm in.
- Good. Well done.

302
00:13:24,137 --> 00:13:25,471
Bring me up to speed.

303
00:13:25,472 --> 00:13:27,222
Intubated for agonal respirations.

304
00:13:27,223 --> 00:13:29,892
GCS 5. Probably anticoagulated.

305
00:13:29,893 --> 00:13:30,976
With what?

306
00:13:30,977 --> 00:13:32,144
First time here.

307
00:13:32,145 --> 00:13:33,771
There's no medical records.

308
00:13:33,772 --> 00:13:36,398
- Call for FFP?
- No, we got four-factor PCC.

309
00:13:36,399 --> 00:13:38,150
80 of mannitol to reduce brain swelling,

310
00:13:38,151 --> 00:13:39,318
then right up to CT.

311
00:13:40,779 --> 00:13:42,196
Do me a favor.

312
00:13:42,197 --> 00:13:43,489
Swap out with Jesse for me, would you?

313
00:13:43,490 --> 00:13:44,990
- Of course.
- My attending.

314
00:13:44,991 --> 00:13:46,450
Dr. Robinavitch, do you have a moment?

315
00:13:46,451 --> 00:13:48,035
I'm just a little busy
right now, Gloria.

316
00:13:48,036 --> 00:13:49,537
One sec.

317
00:13:50,622 --> 00:13:52,373
Nerve block complete.

318
00:13:52,374 --> 00:13:53,957
Seems like it's starting to work.

319
00:13:53,958 --> 00:13:55,459
Swapping out, Jesse.

320
00:13:55,460 --> 00:13:56,960
Takes ten minutes for the full effect,

321
00:13:56,961 --> 00:13:58,671
and the Marcaine lasts
a good four hours.

322
00:13:58,672 --> 00:14:00,381
She's next for CT.

323
00:14:00,382 --> 00:14:01,674
You have any idea what language that is?

324
00:14:01,675 --> 00:14:02,966
Definitely not Tagalog.

325
00:14:02,967 --> 00:14:04,718
Maybe Hindi or Urdu.

326
00:14:04,719 --> 00:14:06,303
I'm gonna go get language services.

327
00:14:06,304 --> 00:14:07,680
Don't you speak, like, five languages?

328
00:14:07,681 --> 00:14:09,306
Six, but that's not one of them.

329
00:14:09,307 --> 00:14:10,641
Six?

330
00:14:10,642 --> 00:14:11,642
And I thought Collins was smart.

331
00:14:11,643 --> 00:14:13,018
Oh, it's way too early

332
00:14:13,019 --> 00:14:14,520
for you to start being an ass, Langdon.

333
00:14:14,521 --> 00:14:16,105
Open hostility in front of the patient?

334
00:14:16,106 --> 00:14:17,648
She doesn't speak English.

335
00:14:17,649 --> 00:14:19,316
Judgmental and dismissive.

336
00:14:19,317 --> 00:14:20,776
How are we doing?

337
00:14:20,777 --> 00:14:22,945
- Vitals stable.
- Unlike these two.

338
00:14:22,946 --> 00:14:25,407
Ooh, good for you. Princess made a joke.

339
00:14:26,866 --> 00:14:28,283
And I thank you
for that beautiful blessing.

340
00:14:28,284 --> 00:14:30,536
- Namaste.
- OK, do we have a phone

341
00:14:30,537 --> 00:14:31,870
or anything
with a relative's name on it?

342
00:14:31,871 --> 00:14:33,956
EMT said the purse got obliterated

343
00:14:33,957 --> 00:14:36,625
when the subway ran over it.

344
00:14:36,626 --> 00:14:39,003
- Any way I can speak with her?
- Highly doubt it.

345
00:14:39,004 --> 00:14:40,546
We don't know what language she speaks.

346
00:14:40,547 --> 00:14:44,550
Hey, um, any chance she jumped?

347
00:14:44,551 --> 00:14:46,218
She may have been pushed.

348
00:14:46,219 --> 00:14:47,678
- Jesus.
- Yeah.

349
00:14:47,679 --> 00:14:49,346
Could be looking
at a possible hate crime.

350
00:14:49,347 --> 00:14:50,682
I take it you're free now?

351
00:14:55,645 --> 00:14:57,187
We need to talk about your numbers.

352
00:14:57,188 --> 00:14:59,565
- Of people we've saved?
- Metrics.

353
00:14:59,566 --> 00:15:01,900
Our door-to-balloon times
beat federal standards.

354
00:15:01,901 --> 00:15:04,778
I'm talking about Press Ganey scores.

355
00:15:04,779 --> 00:15:06,572
Patient satisfaction.

356
00:15:06,573 --> 00:15:08,615
If they're still alive,
they should be satisfied.

357
00:15:08,616 --> 00:15:11,910
Our goal is 36%
very satisfied with their care.

358
00:15:11,911 --> 00:15:14,371
Your department is at 8%.

359
00:15:14,372 --> 00:15:16,749
Do you know how likely patients
are to recommend this hospital?

360
00:15:16,750 --> 00:15:18,208
This is an emergency department,

361
00:15:18,209 --> 00:15:19,918
not a Taco Bell.

362
00:15:19,919 --> 00:15:21,420
11%.

363
00:15:21,421 --> 00:15:22,755
Well, if you want people to be happier,

364
00:15:22,756 --> 00:15:24,423
don't make 'em wait for 12 hours.

365
00:15:24,424 --> 00:15:26,258
There's a nursing shortage
across the country.

366
00:15:26,259 --> 00:15:28,344
Most of our patients are boarders

367
00:15:28,345 --> 00:15:31,096
who are waiting for a bed upstairs.

368
00:15:31,097 --> 00:15:32,723
We don't have the beds.

369
00:15:32,724 --> 00:15:34,350
That's bullshit. The beds are up there.

370
00:15:34,351 --> 00:15:35,601
You just don't want to hire
the staff you need

371
00:15:35,602 --> 00:15:37,686
to care for them.

372
00:15:37,687 --> 00:15:40,272
Oh, Doc. Doc, it ain't working.

373
00:15:40,273 --> 00:15:42,441
Man, whatever they're
giving me, it's not working.

374
00:15:42,442 --> 00:15:44,109
No response to mag citrate.

375
00:15:44,110 --> 00:15:46,487
Should I send in the Fleet?

376
00:15:46,488 --> 00:15:49,156
OK, sir, we're gonna try an enema.

377
00:15:49,157 --> 00:15:51,450
Like I said, there's a nursing shortage.

378
00:15:51,451 --> 00:15:52,826
Well, if you paid them a living wage,

379
00:15:52,827 --> 00:15:54,286
they'd be lining up to work here.

380
00:15:54,287 --> 00:15:55,788
Our budget can't support that.

381
00:15:55,789 --> 00:15:57,414
Here's a dirty little secret.

382
00:15:57,415 --> 00:15:58,832
The hospital saves money

383
00:15:58,833 --> 00:16:00,459
keeping patients down here in the Pitt.

384
00:16:00,460 --> 00:16:02,294
It's way cheaper than staffing upstairs.

385
00:16:02,295 --> 00:16:04,088
I have asked you repeatedly

386
00:16:04,089 --> 00:16:06,298
to stop referring
to the emergency department

387
00:16:06,299 --> 00:16:08,592
as the Pitt... it is derogatory

388
00:16:08,593 --> 00:16:10,678
and incompatible
to the institution's image.

389
00:16:10,679 --> 00:16:12,346
You know what's incompatible
with the institution's image?

390
00:16:12,347 --> 00:16:14,014
Me speaking to the media

391
00:16:14,015 --> 00:16:15,808
about people who code
in our waiting rooms

392
00:16:15,809 --> 00:16:17,601
and people who get
shitty care in our hallways

393
00:16:17,602 --> 00:16:19,395
waiting for an ICU bed for days.

394
00:16:19,396 --> 00:16:21,397
I've heard about doctors
who have tried that

395
00:16:21,398 --> 00:16:23,065
and find themselves out of work.

396
00:16:23,066 --> 00:16:24,441
Uh-huh.

397
00:16:24,442 --> 00:16:25,818
I know today is difficult for you.

398
00:16:25,819 --> 00:16:27,444
Every day is difficult down here.

399
00:16:27,445 --> 00:16:29,613
Boarding is a nationwide problem.

400
00:16:29,614 --> 00:16:32,074
Your predecessor, Adamson,
sure as hell knew that.

401
00:16:32,075 --> 00:16:33,742
Or wasn't that something he taught you?

402
00:16:33,743 --> 00:16:36,161
Fuck. Wow. Really?

403
00:16:36,162 --> 00:16:37,955
Yes, really.

404
00:16:37,956 --> 00:16:39,832
Other hospitals are managing this crisis

405
00:16:39,833 --> 00:16:41,166
much more effectively.

406
00:16:41,167 --> 00:16:42,960
So you can either step up your game,

407
00:16:42,961 --> 00:16:44,629
or you can step aside.

408
00:16:55,807 --> 00:16:57,891
Good Samaritan dude has
a small left temporal

409
00:16:57,892 --> 00:16:59,810
intraparenchymal bleed.

410
00:16:59,811 --> 00:17:01,895
No epidural, no subdural,
no midline shift in the brain.

411
00:17:01,896 --> 00:17:03,480
Oh, that's good news. He could recover.

412
00:17:03,481 --> 00:17:04,857
CT can take her in five.

413
00:17:04,858 --> 00:17:06,650
Let's have a look. Bandage scissors?

414
00:17:06,651 --> 00:17:08,027
All right.

415
00:17:08,028 --> 00:17:10,029
If an artery is totally transected,

416
00:17:10,030 --> 00:17:12,031
the smooth muscle and the tunica media

417
00:17:12,032 --> 00:17:13,699
contracts with hemostasis.

418
00:17:13,700 --> 00:17:16,535
But if it's a partial cut,
get out your umbrella.

419
00:17:16,536 --> 00:17:19,371
Grab a culture from the open
fibula before you reduce.

420
00:17:19,372 --> 00:17:22,124
You're up.

421
00:17:22,125 --> 00:17:24,043
I'll stabilize the knee
for the reduction.

422
00:17:24,044 --> 00:17:26,670
Dr. Langdon will be distracting distally

423
00:17:26,671 --> 00:17:29,548
before moving medially
to clear the tibia.

424
00:17:29,549 --> 00:17:32,051
Good.

425
00:17:32,052 --> 00:17:33,344
Ready?

426
00:17:45,440 --> 00:17:47,776
Med student down.

427
00:17:48,818 --> 00:17:50,611
Good catch on Bar Fight Billy.

428
00:17:50,612 --> 00:17:52,613
There was an aspirated tooth
on chest X-ray.

429
00:17:52,614 --> 00:17:54,365
Would have been dead in a week
from a lung abscess

430
00:17:54,366 --> 00:17:55,532
had you let him be discharged.

431
00:17:55,533 --> 00:17:56,784
Good call on the pulmonary.

432
00:17:56,785 --> 00:17:58,619
Cardiac arrest, ETA 10 minutes.

433
00:17:58,620 --> 00:18:00,579
- Where should we put it?
- Anywhere.

434
00:18:00,580 --> 00:18:02,748
We might have to put
somebody in the hall.

435
00:18:02,749 --> 00:18:05,042
Dr. Robby? She, uh, took a fall.

436
00:18:05,043 --> 00:18:06,752
No, I... I tripped on the gurney.

437
00:18:06,753 --> 00:18:08,088
I'm fine.

438
00:18:10,382 --> 00:18:12,299
Why don't you go get a cold drink

439
00:18:12,300 --> 00:18:14,885
in the staff lounge?

440
00:18:14,886 --> 00:18:16,261
I'm fine, really. I swear.

441
00:18:16,262 --> 00:18:18,138
Oh, I know, but it's hospital policy.

442
00:18:18,139 --> 00:18:19,932
Anytime someone gets
a paper cut around here,

443
00:18:19,933 --> 00:18:21,726
we have to fill out
a workers' comp report.

444
00:18:27,107 --> 00:18:28,817
Other way.

445
00:18:31,027 --> 00:18:33,112
I was fine until about two weeks ago,

446
00:18:33,113 --> 00:18:34,446
after the Rochester Marathon.

447
00:18:34,447 --> 00:18:36,782
OK. Any falls or injuries?

448
00:18:36,783 --> 00:18:38,784
Just tired. Sore muscles.

449
00:18:38,785 --> 00:18:40,911
Yeah, I'd be in bed for a month.

450
00:18:40,912 --> 00:18:42,454
Was this your first triathlon?

451
00:18:42,455 --> 00:18:43,622
God no.

452
00:18:43,623 --> 00:18:45,874
No, I do one every few months.

453
00:18:45,875 --> 00:18:47,793
Have you seen a doctor yet?

454
00:18:47,794 --> 00:18:49,878
Uh, no.

455
00:18:49,879 --> 00:18:51,630
I went for a run this morning.

456
00:18:51,631 --> 00:18:53,090
Had to quit after a minute.

457
00:18:53,091 --> 00:18:54,258
Pretty short of breath.

458
00:18:54,259 --> 00:18:56,802
This goes under your tongue.

459
00:18:56,803 --> 00:18:58,637
- No current meds, no allergies?
- Mm-mm.

460
00:18:58,638 --> 00:19:00,806
We're gonna check a few labs and an EKG.

461
00:19:00,807 --> 00:19:03,018
- Draw a red and purple top.
- Yep.

462
00:19:05,270 --> 00:19:08,522
Temp 98.2.

463
00:19:08,523 --> 00:19:10,274
Take a deep breath for me, Otis.

464
00:19:11,651 --> 00:19:13,570
Little pinprick now, OK?

465
00:19:17,157 --> 00:19:19,324
Otis?

466
00:19:19,325 --> 00:19:21,035
Otis.

467
00:19:21,036 --> 00:19:23,038
I didn't take him
for a lightweight, huh?

468
00:19:25,707 --> 00:19:27,082
Oh, shit. No pulse.

469
00:19:27,083 --> 00:19:29,252
Crash cart! Lay him flat!

470
00:19:31,379 --> 00:19:33,214
- Let's check a rhythm.
- Saline pads.

471
00:19:35,842 --> 00:19:37,635
Quick look paddles.

472
00:19:40,722 --> 00:19:42,181
V-tach.

473
00:19:42,182 --> 00:19:43,807
Charging at 200.

474
00:19:43,808 --> 00:19:45,017
Charged.

475
00:19:45,018 --> 00:19:46,352
Clear!

476
00:19:47,854 --> 00:19:49,772
All right, he's back to normal sinus.

477
00:19:49,773 --> 00:19:51,149
Need a gurney in here!

478
00:19:53,318 --> 00:19:55,152
So what's the plan?

479
00:19:55,153 --> 00:19:59,031
ICU when we can get a bed
and admit for supportive care.

480
00:19:59,032 --> 00:20:02,242
Repeat head CT in three hours.

481
00:20:02,243 --> 00:20:04,411
Or sooner, if he blows a pupil.

482
00:20:04,412 --> 00:20:06,706
- Want a Keppra load?
- Order's already in.

483
00:20:08,333 --> 00:20:09,584
Nice job.

484
00:20:11,836 --> 00:20:13,712
Do you think he'll wake up?

485
00:20:13,713 --> 00:20:15,839
Maybe.

486
00:20:15,840 --> 00:20:18,717
Maybe not.

487
00:20:18,718 --> 00:20:22,846
No good deed goes unpunished.

488
00:20:22,847 --> 00:20:25,850
Oh, has anyone, um, notified the family?

489
00:20:29,771 --> 00:20:31,397
I could try.

490
00:20:31,398 --> 00:20:33,899
Otis Williams. Healthy 31-year-old.

491
00:20:33,900 --> 00:20:36,485
V-tach arrest two weeks after triathlon.

492
00:20:36,486 --> 00:20:38,195
NSR with one shock.

493
00:20:38,196 --> 00:20:40,197
Pulse 98, BP 110 over 60.

494
00:20:40,198 --> 00:20:41,240
He's a little young for an MI.

495
00:20:41,241 --> 00:20:42,741
Exactly right,

496
00:20:42,742 --> 00:20:44,201
What's in the differential, Dr. Collins?

497
00:20:44,202 --> 00:20:46,912
Drug overdose, electrolytes, long QT...

498
00:20:46,913 --> 00:20:48,872
ooh, Brugada syndrome, WPW...

499
00:20:48,873 --> 00:20:50,582
How you doing there, Otis?

500
00:20:50,583 --> 00:20:52,418
OK. What ha...

501
00:20:52,419 --> 00:20:54,169
V-tach again.

502
00:20:54,170 --> 00:20:55,546
200 joules.

503
00:20:55,547 --> 00:20:58,757
Charged, and clear!

504
00:20:58,758 --> 00:21:00,718
Back in sinus.

505
00:21:00,719 --> 00:21:01,927
Otis?

506
00:21:04,431 --> 00:21:06,432
Otis?

507
00:21:06,433 --> 00:21:09,560
Oh, groaning's good. 5 of nasal O2, CBC,

508
00:21:09,561 --> 00:21:12,229
CMP, troponin, and D-dimer.

509
00:21:12,230 --> 00:21:13,605
What are you doing?

510
00:21:13,606 --> 00:21:15,315
One gram calcium gluconate, IV push.

511
00:21:15,316 --> 00:21:17,109
- We don't have the labs back.
- Look at the monitor.

512
00:21:17,110 --> 00:21:18,444
Widened QRS and PT waves.

513
00:21:18,445 --> 00:21:19,987
- Hyperkalemia.
- How'd he get that?

514
00:21:19,988 --> 00:21:21,739
Intense exercise
caused muscle breakdown.

515
00:21:21,740 --> 00:21:23,073
Rhabdomyolysis knocked out his kidneys.

516
00:21:23,074 --> 00:21:24,158
Now he's not clearing potassium.

517
00:21:24,159 --> 00:21:25,576
I bet it's over 7.5.

518
00:21:25,577 --> 00:21:27,244
Wait two minutes for the i-STAT.

519
00:21:27,245 --> 00:21:28,746
If he arrests again,
we might not get him back.

520
00:21:28,747 --> 00:21:30,205
If it's hypercalcemia,
you could kill him.

521
00:21:30,206 --> 00:21:32,751
- Wait.
- Oh, it's my ass, not yours.

522
00:21:43,345 --> 00:21:44,720
Pan scan is negative.

523
00:21:44,721 --> 00:21:46,388
That means you can admit to orthopedics.

524
00:21:46,389 --> 00:21:48,265
But there may have been
a medical etiology

525
00:21:48,266 --> 00:21:50,100
- if she fainted.
- That's not surgical.

526
00:21:50,101 --> 00:21:51,727
Get an internal medicine consult,

527
00:21:51,728 --> 00:21:53,979
or admit to medicine
with ortho consulting.

528
00:21:53,980 --> 00:21:55,272
Either way, I'm off the case.

529
00:21:55,273 --> 00:21:57,483
OK. Thanks for nothing.

530
00:21:57,484 --> 00:22:00,444
Ancef's in. I'll grab the gent.

531
00:22:00,445 --> 00:22:02,196
Did we figure out what she's speaking?

532
00:22:02,197 --> 00:22:04,823
Last interpreter thought
she might be from Pakistan.

533
00:22:04,824 --> 00:22:07,451
There are 77 languages in Pakistan.

534
00:22:07,452 --> 00:22:10,537
OK, well, I will buy lunch
for whoever figures it out.

535
00:22:10,538 --> 00:22:11,997
Good luck.

536
00:22:11,998 --> 00:22:14,875
If you need me, I'll be saving lives.

537
00:22:14,876 --> 00:22:16,835
That was wicked.

538
00:22:16,836 --> 00:22:19,171
- That was gross.
- Yeah.

539
00:22:19,172 --> 00:22:21,799
Too much for Little Miss Crash and Burn.

540
00:22:21,800 --> 00:22:23,342
- What'd you do with her?
- Nothing.

541
00:22:23,343 --> 00:22:25,844
- I think she'll be fine.
- Are you kidding?

542
00:22:25,845 --> 00:22:27,221
If that took her out,
she'll be lucky to make it

543
00:22:27,222 --> 00:22:29,014
through this rotation.

544
00:22:29,015 --> 00:22:30,766
I got 50 bucks says she doesn't
last through this shift.

545
00:22:32,519 --> 00:22:33,852
Come on.

546
00:22:33,853 --> 00:22:35,187
Put your money where your mouth is.

547
00:22:35,188 --> 00:22:37,815
Uh, no. I didn't say anything, OK?

548
00:22:37,816 --> 00:22:40,442
And I sure as hell don't have 50 bucks.

549
00:22:40,443 --> 00:22:41,860
I'll be this lady's age by the time

550
00:22:41,861 --> 00:22:43,112
I pay off my student loans.

551
00:22:43,113 --> 00:22:44,406
Not that you're...

552
00:22:45,907 --> 00:22:50,202
Hey, you want to sell a kidney?

553
00:22:50,203 --> 00:22:53,497
I could get you 30K
as soon as this weekend.

554
00:22:53,498 --> 00:22:56,542
That's just between you and me.

555
00:22:56,543 --> 00:22:57,919
Think about it.

556
00:23:02,590 --> 00:23:04,717
How you doing?

557
00:23:04,718 --> 00:23:06,427
Yeah.

558
00:23:06,428 --> 00:23:08,345
QRS has narrowed.

559
00:23:08,346 --> 00:23:09,388
Much better.

560
00:23:09,389 --> 00:23:11,223
Potassium is 7.7.

561
00:23:11,224 --> 00:23:13,517
Creatinine, 5.6.

562
00:23:13,518 --> 00:23:15,227
High potassium and renal failure.

563
00:23:15,228 --> 00:23:16,520
Just what you thought.

564
00:23:16,521 --> 00:23:18,230
It must be my lucky day.

565
00:23:18,231 --> 00:23:20,399
Ordering 10 units of regular insulin

566
00:23:20,400 --> 00:23:23,736
and 25 grams of glucose.

567
00:23:23,737 --> 00:23:25,571
Why insulin and glucose?

568
00:23:25,572 --> 00:23:27,364
Shift the potassium intracellularly.

569
00:23:27,365 --> 00:23:29,074
Exactly, but the definitive
treatment is...

570
00:23:29,075 --> 00:23:30,576
Hemodialysis. I'll call renal

571
00:23:30,577 --> 00:23:32,536
and get a tech down with the machine.

572
00:23:32,537 --> 00:23:35,581
Have you ever seen
a dialysis catheter inserted?

573
00:23:35,582 --> 00:23:37,416
Dr. Collins is gonna place
a femoral Quinton

574
00:23:37,417 --> 00:23:38,584
under ultrasound guidance.

575
00:23:38,585 --> 00:23:39,752
It's an excellent way to learn.

576
00:23:39,753 --> 00:23:41,920
Oh, my chest.

577
00:23:41,921 --> 00:23:43,422
Yeah, we had to shock you.

578
00:23:43,423 --> 00:23:45,257
You're gonna be sore for a while.

579
00:23:45,258 --> 00:23:46,842
You shocked my heart?

580
00:23:46,843 --> 00:23:49,471
Long story.
Dr. Collins will fill you in.

581
00:23:57,103 --> 00:23:59,356
You got a sec?

582
00:24:02,025 --> 00:24:03,609
You OK?

583
00:24:03,610 --> 00:24:05,569
Why wouldn't I be? Are you OK?

584
00:24:05,570 --> 00:24:07,405
Why wouldn't I be?

585
00:24:08,823 --> 00:24:10,407
You seem annoyed with me already,

586
00:24:10,408 --> 00:24:13,118
and I just got here.

587
00:24:13,119 --> 00:24:15,622
It's not always about you, Robby.

588
00:24:17,499 --> 00:24:19,333
Am I gonna be OK?

589
00:24:19,334 --> 00:24:20,918
Yeah.

590
00:24:20,919 --> 00:24:23,087
You just need to take it easy
on yourself.

591
00:24:23,088 --> 00:24:26,590
Muscle breakdown and myoglobin
damaged your kidneys.

592
00:24:26,591 --> 00:24:28,342
Why'd you shock my heart?

593
00:24:28,343 --> 00:24:30,969
When your kidneys don't work,
potassium builds up

594
00:24:30,970 --> 00:24:35,474
and messes with the electrical
activity in your heart.

595
00:24:35,475 --> 00:24:37,768
Can it happen again?

596
00:24:37,769 --> 00:24:39,728
We gave you medicine
to lower your potassium,

597
00:24:39,729 --> 00:24:42,272
and you'll need dialysis
to clear it all out.

598
00:24:42,273 --> 00:24:44,149
Then I'll be OK?

599
00:24:44,150 --> 00:24:45,401
Yeah.

600
00:24:45,402 --> 00:24:46,819
You might need a week or two

601
00:24:46,820 --> 00:24:49,446
for your kidneys to recover, but yeah.

602
00:24:49,447 --> 00:24:51,782
You really need to hydrate like crazy

603
00:24:51,783 --> 00:24:54,660
before and after a triathlon.

604
00:24:54,661 --> 00:24:58,330
Trust me, I won't let this happen again.

605
00:24:58,331 --> 00:25:01,000
Good.

606
00:25:01,001 --> 00:25:03,545
Be kind to yourself.

607
00:25:11,803 --> 00:25:14,680
Oh, hey.

608
00:25:14,681 --> 00:25:16,515
Abbot's told me that he's got
a pregnant teen

609
00:25:16,516 --> 00:25:17,975
coming back today for mifepristone.

610
00:25:17,976 --> 00:25:19,852
- Let me know when she gets here.
- Yep.

611
00:25:19,853 --> 00:25:21,353
Bowel obstruction, still waiting

612
00:25:21,354 --> 00:25:23,063
on a surgery consult. What about Garcia?

613
00:25:23,064 --> 00:25:25,065
She was just here for the traumas.

614
00:25:25,066 --> 00:25:29,486
I think she was waiting
for her attending to sign off.

615
00:25:29,487 --> 00:25:31,989
OK.

616
00:25:31,990 --> 00:25:34,658
Oh, one of the med students
took a header.

617
00:25:34,659 --> 00:25:36,118
I parked her in the lounge
under the guise

618
00:25:36,119 --> 00:25:37,536
of a work comp report.

619
00:25:37,537 --> 00:25:38,704
Will you just go in there, eyeball her,

620
00:25:38,705 --> 00:25:40,164
and make sure she's all right?

621
00:25:40,165 --> 00:25:41,206
She's gonna miss the morning arrival

622
00:25:41,207 --> 00:25:42,541
of the living dead.

623
00:25:42,542 --> 00:25:44,126
How many are we expecting?

624
00:25:44,127 --> 00:25:45,878
We were getting three,
but one died en route.

625
00:25:45,879 --> 00:25:47,713
Don't know who's luckier, us or them.

626
00:25:47,714 --> 00:25:49,381
- What's open?
- 14.

627
00:25:49,382 --> 00:25:51,050
89-year-old woman from a SNF.

628
00:25:51,051 --> 00:25:53,385
History of emphysema, CHF, MS.

629
00:25:53,386 --> 00:25:55,220
V-fib, unresponsive to three shocks.

630
00:25:55,221 --> 00:25:57,514
- Two rounds of epi.
- What is that?

631
00:25:57,515 --> 00:25:59,058
LUCAS chest compression system.

632
00:25:59,059 --> 00:26:00,559
Robotic CPR.

633
00:26:03,063 --> 00:26:05,815
Everybody get a hold. One, two, three.

634
00:26:10,904 --> 00:26:12,780
Students are dropping like flies.

635
00:26:12,781 --> 00:26:14,531
Take a break. Ice the finger.

636
00:26:14,532 --> 00:26:16,909
You can count on getting
a couple elderly patients

637
00:26:16,910 --> 00:26:19,536
every day around 7:30,
after the nursing homes

638
00:26:19,537 --> 00:26:21,914
and assisted living facilities
do their morning bed checks.

639
00:26:21,915 --> 00:26:24,083
You can practically set your watch.

640
00:26:24,084 --> 00:26:25,417
Was there an advanced directive?

641
00:26:25,418 --> 00:26:27,419
No, full code, per the nursing home.

642
00:26:27,420 --> 00:26:29,713
Seriously?

643
00:26:29,714 --> 00:26:32,257
LUCAS off.

644
00:26:32,258 --> 00:26:33,717
Still V-fib.

645
00:26:33,718 --> 00:26:35,260
LUCAS on.

646
00:26:35,261 --> 00:26:37,680
One more round of epi, one more shock,

647
00:26:37,681 --> 00:26:38,847
and then we call it?

648
00:26:43,311 --> 00:26:44,895
Joseph Spencer, 79.

649
00:26:44,896 --> 00:26:46,855
Fever and cough. From assisted living.

650
00:26:46,856 --> 00:26:49,608
He has a history of mild Alzheimer's.

651
00:26:49,609 --> 00:26:52,403
One, two, three.

652
00:26:52,404 --> 00:26:54,279
Pulse 130. BP 90 over 60.

653
00:26:54,280 --> 00:26:56,448
Gave him 500 cc's normal saline.

654
00:26:56,449 --> 00:26:58,242
Hi, Mr. Spencer. I'm Dr. King.

655
00:26:58,243 --> 00:26:59,743
This is Dr. Collins.

656
00:26:59,744 --> 00:27:01,286
How are you feeling today?

657
00:27:01,287 --> 00:27:04,540
Is it dinnertime?
I... I'm not really hungry.

658
00:27:04,541 --> 00:27:06,375
Do we have any paperwork
from the facility?

659
00:27:06,376 --> 00:27:07,626
He has a POLST.

660
00:27:07,627 --> 00:27:09,128
IV fluids and medications are fine,

661
00:27:09,129 --> 00:27:11,130
but no intubation
and no chest compressions.

662
00:27:11,131 --> 00:27:12,589
That's helpful.

663
00:27:12,590 --> 00:27:14,299
Coarse rhonchi here.

664
00:27:14,300 --> 00:27:16,635
Right middle lobe infiltrate.

665
00:27:16,636 --> 00:27:19,471
Temp 102. Call a code sepsis.

666
00:27:19,472 --> 00:27:20,973
- Mm-hmm.
- Code?

667
00:27:20,974 --> 00:27:22,933
To make sure we check all of our boxes.

668
00:27:22,934 --> 00:27:25,102
The federal government audits
our sepsis bundle performance

669
00:27:25,103 --> 00:27:26,812
and publishes the data online.

670
00:27:26,813 --> 00:27:28,647
Today, it better be perfect.

671
00:27:28,648 --> 00:27:31,650
Two sets of blood cultures, lactic acid,

672
00:27:31,651 --> 00:27:35,029
30 cc's per kilo NS,
a gram of ceftriaxone,

673
00:27:35,030 --> 00:27:38,991
500 of azithromycin,
repeat lactic in three hours.

674
00:27:38,992 --> 00:27:40,576
Nice.

675
00:27:40,577 --> 00:27:44,997
Charging, and...

676
00:27:44,998 --> 00:27:46,248
Stop.

677
00:27:46,249 --> 00:27:47,583
Call it.

678
00:27:47,584 --> 00:27:49,335
Nursing home just faxed us a DNR.

679
00:27:49,336 --> 00:27:51,128
Are you kidding me?

680
00:27:51,129 --> 00:27:52,921
Power off the defibrillator
and the LUCAS.

681
00:27:52,922 --> 00:27:54,256
Complete waste of time and money.

682
00:27:54,257 --> 00:27:55,674
Who the hell works at that place?

683
00:27:55,675 --> 00:27:56,842
A nurse taking care of 60 patients

684
00:27:56,843 --> 00:27:58,510
who couldn't find the form.

685
00:27:58,511 --> 00:28:00,346
She called 911 so she could
take care of the others.

686
00:28:00,347 --> 00:28:01,930
OK, let's move her to the viewing room

687
00:28:01,931 --> 00:28:04,433
- and notify the family.
- Yep.

688
00:28:04,434 --> 00:28:07,853
One of the things we do here
is to take a moment of silence

689
00:28:07,854 --> 00:28:11,482
when we lose a patient,
to respect their humanity

690
00:28:11,483 --> 00:28:14,026
And also to remember
that this was somebody's child

691
00:28:14,027 --> 00:28:18,239
or sibling or parent, friend.

692
00:28:25,580 --> 00:28:28,499
<i>♪ I like the sound of funky music ♪</i>

693
00:28:28,500 --> 00:28:31,377
Oh. Ow, ow!

694
00:28:32,379 --> 00:28:34,088
I am so sorry.

695
00:28:34,089 --> 00:28:36,341
Maybe leave it on vibrate
while you're working.

696
00:28:39,594 --> 00:28:41,887
- Later, Doc.
- You behave yourself now.

697
00:28:41,888 --> 00:28:43,431
Always.

698
00:28:45,558 --> 00:28:48,143
Your med student's back on her feet.

699
00:28:48,144 --> 00:28:50,521
- How old's that kid?
- I don't know. I didn't ask.

700
00:28:50,522 --> 00:28:51,897
What is she, some sort of savant?

701
00:28:51,898 --> 00:28:53,148
I don't know. Maybe.

702
00:28:53,149 --> 00:28:54,692
Dr. Robinavitch, hi.

703
00:28:54,693 --> 00:28:56,026
I just wanted to apologize
for any trouble

704
00:28:56,027 --> 00:28:57,403
my clumsiness might have caused.

705
00:28:57,404 --> 00:28:58,737
I feel ridiculous.

706
00:28:58,738 --> 00:29:00,072
Oh, I can't tell how many times

707
00:29:00,073 --> 00:29:01,365
I've hit my head on an overhead lamp.

708
00:29:01,366 --> 00:29:03,242
Twice I needed to get staples.

709
00:29:03,243 --> 00:29:05,744
Why don't you go work
with Dr. McKay in triage?

710
00:29:05,745 --> 00:29:07,538
That would help both of us.

711
00:29:07,539 --> 00:29:10,040
Oh, I... I don't need special treatment.

712
00:29:10,041 --> 00:29:11,333
Good, because I don't give it.

713
00:29:14,170 --> 00:29:15,587
Look, I know I might look too young,

714
00:29:15,588 --> 00:29:17,756
but I studied my ass off to get here.

715
00:29:17,757 --> 00:29:19,883
Probably harder than the others.

716
00:29:19,884 --> 00:29:21,301
I earned this.

717
00:29:21,302 --> 00:29:23,470
OK, look, I respect your dedication

718
00:29:23,471 --> 00:29:25,389
and your determination,
but while you're here,

719
00:29:25,390 --> 00:29:26,765
you're my responsibility.

720
00:29:26,766 --> 00:29:27,975
And when one of my responsibilities

721
00:29:27,976 --> 00:29:29,643
takes a header... wow!

722
00:29:29,644 --> 00:29:31,145
Abbot called for a surgical consult

723
00:29:31,146 --> 00:29:32,438
on the SBO three hours ago.

724
00:29:32,439 --> 00:29:33,731
You're very lucky they didn't perf.

725
00:29:33,732 --> 00:29:35,607
I'm here to see my daughter.

726
00:29:35,608 --> 00:29:37,109
I'm sorry, is that a patient?

727
00:29:37,110 --> 00:29:38,737
You're talking to her.

728
00:29:41,156 --> 00:29:42,573
Am I interrupting?

729
00:29:42,574 --> 00:29:44,116
No.

730
00:29:44,117 --> 00:29:46,285
No, we're done. We're good.

731
00:29:46,286 --> 00:29:48,120
Come find me when you're ready
to present your next case.

732
00:29:48,121 --> 00:29:49,330
Thank you.

733
00:29:51,041 --> 00:29:53,083
So how's your first day going?

734
00:29:53,084 --> 00:29:54,376
- It's great.
- Yeah?

735
00:29:54,377 --> 00:29:55,753
Yeah, really great.

736
00:29:55,754 --> 00:29:57,796
Hey, Crash, they're doing a dialysis

737
00:29:57,797 --> 00:29:59,590
catheter insertion in North One
if you want to check it out.

738
00:29:59,591 --> 00:30:00,966
Mm-hmm.

739
00:30:00,967 --> 00:30:02,885
- The thing...
- Did she say Crash?

740
00:30:02,886 --> 00:30:04,136
No.

741
00:30:04,137 --> 00:30:05,804
No, no, it's not crash.

742
00:30:05,805 --> 00:30:08,432
Um, she said crush,
'cause I'm always crushing it.

743
00:30:10,977 --> 00:30:12,811
Um, thanks for coming down,
Mom, but I've...

744
00:30:12,812 --> 00:30:14,563
I've got a patient.

745
00:30:14,564 --> 00:30:15,690
Bye.

746
00:30:25,158 --> 00:30:26,825
What do you want?

747
00:30:26,826 --> 00:30:29,661
Um, I... I just wanted to make
sure you're comfortable.

748
00:30:29,662 --> 00:30:34,208
I am taking a dump in a dustpan,

749
00:30:34,209 --> 00:30:36,168
so what's that fucking tell you?

750
00:30:36,169 --> 00:30:37,795
Um, I'm...

751
00:30:37,796 --> 00:30:39,463
I'm clearly...
I'm clearly in the wrong room.

752
00:30:39,464 --> 00:30:40,464
- Yeah.
- I'm sorry.

753
00:30:40,465 --> 00:30:42,174
Mm-hmm.

754
00:30:46,721 --> 00:30:49,515
So it would have been nice
if someone had told me

755
00:30:49,516 --> 00:30:52,101
that Eileen Shamsi's daughter
was one of our med students.

756
00:30:52,102 --> 00:30:54,436
What, and ruin the surprise?

757
00:30:54,437 --> 00:30:56,188
Was it as awkward
as I hoped it would be?

758
00:30:56,189 --> 00:30:59,024
You... you have a mean streak
in you, you know that?

759
00:30:59,025 --> 00:31:01,026
And what's the deal with the body in 19?

760
00:31:01,027 --> 00:31:03,195
That's Abbot's MVC vet from last night.

761
00:31:03,196 --> 00:31:04,446
Still waiting on next of kin.

762
00:31:04,447 --> 00:31:06,031
- Supposedly on their way.
- OK.

763
00:31:06,032 --> 00:31:07,533
Can we move him
to the viewing room, at least?

764
00:31:07,534 --> 00:31:08,701
Nursing home DNR is heading there,

765
00:31:08,702 --> 00:31:09,993
joining last night's Jane Doe.

766
00:31:09,994 --> 00:31:11,537
Coroner's office is backed up.

767
00:31:11,538 --> 00:31:15,207
Well, then our morgue
needs to take her, then.

768
00:31:15,208 --> 00:31:17,543
Perlah.

769
00:31:17,544 --> 00:31:19,086
Triathlete, Otis?

770
00:31:19,087 --> 00:31:20,212
Oh, he's stable.

771
00:31:20,213 --> 00:31:22,006
Repeat potassium is 6.1.

772
00:31:22,007 --> 00:31:24,008
Renal wrote the dialysis order.

773
00:31:24,009 --> 00:31:25,884
Tech should be down in 15 minutes.

774
00:31:25,885 --> 00:31:28,595
Good. Thank you.

775
00:31:28,596 --> 00:31:30,055
Language mystery solved yet?

776
00:31:30,056 --> 00:31:31,223
No.

777
00:31:31,224 --> 00:31:35,019
Hey, what's your take on dogs?

778
00:31:35,020 --> 00:31:36,437
In what context?

779
00:31:36,438 --> 00:31:38,188
For kids.

780
00:31:38,189 --> 00:31:40,774
Kids and puppies go together
like fish and chips.

781
00:31:40,775 --> 00:31:42,192
Man's best friend, you know?

782
00:31:42,193 --> 00:31:43,444
Well, you don't have a dog.

783
00:31:43,445 --> 00:31:44,903
I don't have a best friend.

784
00:31:44,904 --> 00:31:46,572
- What am I?
- You're my best resident.

785
00:31:46,573 --> 00:31:47,865
Big difference.

786
00:31:47,866 --> 00:31:49,658
Yeah, but we're still friends.

787
00:31:49,659 --> 00:31:52,494
Not if this conversation
goes on much longer.

788
00:31:52,495 --> 00:31:54,538
I have a lethargic four-year-old,

789
00:31:54,539 --> 00:31:58,375
no PMH, no antecedent illness,
no fever or vomiting.

790
00:31:58,376 --> 00:32:00,085
Parents just couldn't
wake him up this morning.

791
00:32:00,086 --> 00:32:03,047
- What room?
- Oh, south 15.

792
00:32:03,048 --> 00:32:05,090
There's no nuchal rigidity,

793
00:32:05,091 --> 00:32:09,678
no skin lesions, no focal neuro.

794
00:32:09,679 --> 00:32:12,681
He looks well fed and cared for.

795
00:32:12,682 --> 00:32:14,850
DKA from new-onset diabetes?

796
00:32:14,851 --> 00:32:16,435
No, BG 85.

797
00:32:16,436 --> 00:32:20,939
CBC, BMP, UA, and UDS ordered.

798
00:32:28,740 --> 00:32:31,784
Can you wake up for me, Tyler?

799
00:32:31,785 --> 00:32:33,452
He's not usually this sleepy?

800
00:32:33,453 --> 00:32:35,621
No, and he barely flinched
for the blood test.

801
00:32:35,622 --> 00:32:37,122
He wakes up at 90 miles an hour

802
00:32:37,123 --> 00:32:38,791
and doesn't stop
till he passes out at night.

803
00:32:38,792 --> 00:32:40,125
He passes out?

804
00:32:40,126 --> 00:32:42,127
No, he just means he goes all day.

805
00:32:42,128 --> 00:32:44,338
Any chance he could have
ingested something?

806
00:32:44,339 --> 00:32:46,632
Any pills, vitamins,

807
00:32:46,633 --> 00:32:48,801
any prescriptions
that may have been left around?

808
00:32:48,802 --> 00:32:51,178
No, that's all kept locked
in the medicine cabinet.

809
00:32:51,179 --> 00:32:53,138
The whole house is childproof.

810
00:32:53,139 --> 00:32:55,933
Uh, what about alcohol?
Anything left out?

811
00:32:55,934 --> 00:32:58,143
- No.
- What about pets?

812
00:32:58,144 --> 00:32:59,645
No.

813
00:32:59,646 --> 00:33:01,605
So he's usually, like, quite active?

814
00:33:01,606 --> 00:33:04,441
- Very.
- Um, any injuries lately?

815
00:33:04,442 --> 00:33:05,818
No.

816
00:33:05,819 --> 00:33:07,444
Hasn't bumped his head recently?

817
00:33:07,445 --> 00:33:09,113
Not that I'm aware of, but he does love

818
00:33:09,114 --> 00:33:10,322
roughhousing with Drew.

819
00:33:10,323 --> 00:33:11,657
But he never gets hurt.

820
00:33:11,658 --> 00:33:13,575
Oxygen level is normal.

821
00:33:13,576 --> 00:33:16,662
Good pulse and blood pressure.
No signs of infection.

822
00:33:16,663 --> 00:33:18,664
We're gonna start
with blood and urine tests,

823
00:33:18,665 --> 00:33:21,584
check for any metabolic abnormalities.

824
00:33:24,295 --> 00:33:26,880
It's really throbbing.

825
00:33:26,881 --> 00:33:28,173
Yeah, the blood's under pressure.

826
00:33:28,174 --> 00:33:30,676
Gotta drain it.

827
00:33:30,677 --> 00:33:32,219
No anesthesia, or...

828
00:33:32,220 --> 00:33:35,180
I'll stop before I hit the nail bed.

829
00:33:35,181 --> 00:33:36,558
I hope.

830
00:33:39,811 --> 00:33:41,145
Hey, eyes down here.

831
00:33:41,146 --> 00:33:42,521
Watch and learn.

832
00:33:42,522 --> 00:33:44,356
I'm just looking who to see next.

833
00:33:44,357 --> 00:33:46,859
You're supposed to take them
in the order they arrive.

834
00:33:46,860 --> 00:33:48,318
Yeah, I know how it works.

835
00:33:48,319 --> 00:33:50,362
OK. No need to cry about it.

836
00:33:50,363 --> 00:33:51,905
Do you want me to choose for you?

837
00:33:51,906 --> 00:33:53,283
No.

838
00:33:55,577 --> 00:33:57,619
Wow, pain's gone.

839
00:33:57,620 --> 00:33:58,871
Thank you.

840
00:33:58,872 --> 00:34:00,289
All right.

841
00:34:00,290 --> 00:34:02,958
How about a 20-year-old cough in eight?

842
00:34:02,959 --> 00:34:05,044
Should be easy. Probably viral.

843
00:34:05,045 --> 00:34:06,879
I don't need an easy one.

844
00:34:06,880 --> 00:34:08,839
Suit yourself, Huckleberry.

845
00:34:08,840 --> 00:34:10,799
I'm gonna take the splitting headache.

846
00:34:10,800 --> 00:34:13,218
Maybe I'll catch a subarachnoid
hemorrhage or something cool.

847
00:34:13,219 --> 00:34:15,054
Hey, why do you keep calling me that?

848
00:34:15,055 --> 00:34:16,221
Huckleberry?

849
00:34:16,222 --> 00:34:18,057
It's a term of endearment.

850
00:34:18,058 --> 00:34:19,391
It sounds like sarcasm.

851
00:34:19,392 --> 00:34:20,517
You think?

852
00:34:20,518 --> 00:34:23,354
Bordering on harassment.

853
00:34:23,355 --> 00:34:24,897
Where are you from?

854
00:34:24,898 --> 00:34:26,857
Broken Bow, Nebraska.

855
00:34:26,858 --> 00:34:28,734
Jesus, where the hell is that?

856
00:34:28,735 --> 00:34:31,236
It's about three and a half
hours west of Omaha.

857
00:34:31,237 --> 00:34:33,739
Oh, yeah, just a little
south of nowhere.

858
00:34:33,740 --> 00:34:35,074
What the hell do you do there?

859
00:34:35,075 --> 00:34:37,576
My parents have a farm, so...

860
00:34:37,577 --> 00:34:40,037
You're a farm boy?

861
00:34:40,038 --> 00:34:42,039
Yeah, I guess.

862
00:34:42,040 --> 00:34:44,876
I rest my case, Huckleberry.

863
00:34:50,799 --> 00:34:52,216
I'm so sorry, ma'am.

864
00:34:52,217 --> 00:34:54,385
We don't understand you.

865
00:34:58,807 --> 00:35:01,433
Oh.

866
00:35:01,434 --> 00:35:04,937
Me, I'm Dr. Heather Collins.

867
00:35:04,938 --> 00:35:07,856
I'm from here.

868
00:35:07,857 --> 00:35:09,441
Portland, Oregon.

869
00:35:09,442 --> 00:35:11,026
You.

870
00:35:11,027 --> 00:35:13,779
Where are you from?

871
00:35:13,780 --> 00:35:15,323
Uh-huh.

872
00:35:16,950 --> 00:35:19,118
Uh, China? India?

873
00:35:19,119 --> 00:35:20,285
I can't tell where you're pointing.

874
00:35:20,286 --> 00:35:21,579
Tajikistan?

875
00:35:23,707 --> 00:35:25,082
Nepal.

876
00:35:25,083 --> 00:35:26,458
Mm.

877
00:35:26,459 --> 00:35:28,920
- You're from Nepal.
- Nepali.

878
00:35:34,217 --> 00:35:35,467
Mom's got a bad burn.

879
00:35:35,468 --> 00:35:37,177
Needs wound checks and hand therapy.

880
00:35:37,178 --> 00:35:40,139
And I got a sneaking suspicion
she may be unhoused.

881
00:35:40,140 --> 00:35:42,141
I'll talk to her.
We can offer some help.

882
00:35:42,142 --> 00:35:45,310
Thank you, I appreciate it.
Ah, you're back.

883
00:35:45,311 --> 00:35:47,646
Dr. Robby suggested
I might be of assistance.

884
00:35:47,647 --> 00:35:49,481
Yeah, I could use the company.

885
00:35:49,482 --> 00:35:51,984
Victoria Javadi, this is Kiara Alfaro.

886
00:35:51,985 --> 00:35:53,444
She's the department social worker,

887
00:35:53,445 --> 00:35:55,446
which pretty much makes her an angel.

888
00:35:55,447 --> 00:35:56,989
- Welcome.
- Thanks.

889
00:35:56,990 --> 00:35:58,198
Thank you.

890
00:35:58,199 --> 00:36:00,117
So what rotation is this for you?

891
00:36:00,118 --> 00:36:01,160
Um, third.

892
00:36:01,161 --> 00:36:02,661
I've done OB-GYN and pedes.

893
00:36:02,662 --> 00:36:04,163
You have any favorites?

894
00:36:04,164 --> 00:36:05,581
Not really.

895
00:36:05,582 --> 00:36:07,333
Well, what are you leaning towards?

896
00:36:07,334 --> 00:36:09,251
I'm not really sure yet.

897
00:36:09,252 --> 00:36:11,003
OK, well, you have time.

898
00:36:11,004 --> 00:36:14,631
Uh, can I actually ask you
a personal question?

899
00:36:14,632 --> 00:36:17,801
I'm 20, and I've earned
the right to be here.

900
00:36:17,802 --> 00:36:19,428
Oh.

901
00:36:19,429 --> 00:36:21,430
Yeah, I don't... I don't
doubt that for a minute.

902
00:36:21,431 --> 00:36:25,517
I... I was actually wondering if
Dr. Eileen Shamsi from surgery

903
00:36:25,518 --> 00:36:27,686
is a friend or relative of yours.

904
00:36:27,687 --> 00:36:29,480
I saw you talking to her
in the hall and I thought...

905
00:36:29,481 --> 00:36:30,899
Yeah, she's my mother.

906
00:36:32,562 --> 00:36:33,692
Oh.

907
00:36:33,693 --> 00:36:35,402
Oh, wow.

908
00:36:35,403 --> 00:36:38,197
Oh, that's cool.

909
00:36:38,198 --> 00:36:40,824
- You're really only 20?
- Yeah.

910
00:36:40,825 --> 00:36:43,202
And for the record, my...
my father also works here.

911
00:36:43,203 --> 00:36:44,661
He's an endocrinologist.

912
00:36:44,662 --> 00:36:46,038
Oh, so it's like a family business.

913
00:36:47,999 --> 00:36:50,084
I'm sorry. That was a joke.
That was a joke.

914
00:36:50,085 --> 00:36:52,002
And I'm sure that comes
with a lot of pressure.

915
00:36:52,003 --> 00:36:54,838
And as for the age thing,
I'm a 42-year-old R2,

916
00:36:54,839 --> 00:36:57,716
so I have my own haters, trust me.

917
00:36:57,717 --> 00:36:59,718
OK.

918
00:36:59,719 --> 00:37:01,220
Um, sometimes when it gets busy,

919
00:37:01,221 --> 00:37:02,888
we'll help the nurses
bring back patients.

920
00:37:02,889 --> 00:37:04,723
- OK.
- Um, OK.

921
00:37:04,724 --> 00:37:06,475
Next to come back is Fred Saeta.

922
00:37:06,476 --> 00:37:08,227
Knee pain after a fall.

923
00:37:08,228 --> 00:37:09,395
- Fred Sa...
- Hey, Doc. Hi.

924
00:37:09,396 --> 00:37:10,729
Hi. Doug Driscoll.

925
00:37:10,730 --> 00:37:12,147
Any chance someone could see me now?

926
00:37:12,148 --> 00:37:13,899
I've been here for, like, two hours.

927
00:37:13,900 --> 00:37:15,567
Unfortunately, Mr. Driscoll,
there's a lot of patients

928
00:37:15,568 --> 00:37:17,236
still ahead of you,
some of whom are severely ill.

929
00:37:17,237 --> 00:37:18,737
Yeah, and I got chest pains
that woke me up

930
00:37:18,738 --> 00:37:20,072
- in the middle of the night.
- Chest pain.

931
00:37:20,073 --> 00:37:21,699
- Yeah.
- No, it's not plural.

932
00:37:21,700 --> 00:37:23,909
It's just chest pain, not chest pains.

933
00:37:23,910 --> 00:37:26,995
Yeah, and if I have more
than one, it's chest pains.

934
00:37:26,996 --> 00:37:29,164
- Are you even a real doctor?
- She's a student doctor.

935
00:37:29,165 --> 00:37:30,749
Yeah, well, keep her
the hell away from me.

936
00:37:30,750 --> 00:37:33,127
I just need to see someone, OK? Not her.

937
00:37:33,128 --> 00:37:34,920
Isn't chest pain an emergency?
I don't...

938
00:37:34,921 --> 00:37:36,964
It looks here like you got an EKG

939
00:37:36,965 --> 00:37:39,216
five minutes after arrival,
so it's not a heart attack.

940
00:37:39,217 --> 00:37:42,469
Yeah, but I'm supposed to get
a chest X-ray and blood tests.

941
00:37:42,470 --> 00:37:45,055
Ah, and you are next
in line for the lab tech, OK?

942
00:37:45,056 --> 00:37:47,099
So listen for your name. Excuse me.

943
00:37:47,100 --> 00:37:49,101
Fred...

944
00:37:49,102 --> 00:37:52,146
Actually, can you get me
a wheelchair, please?

945
00:37:52,147 --> 00:37:53,939
Uh, hi. I'm... I'm Dr. McKay.

946
00:37:53,940 --> 00:37:55,607
What's going on?

947
00:37:55,608 --> 00:37:57,443
I, uh, found her
on the floor in the bathroom.

948
00:37:57,444 --> 00:37:59,445
- She can't stop puking.
- What's her name?

949
00:37:59,446 --> 00:38:01,447
Theresa. She's my mom.

950
00:38:01,448 --> 00:38:02,948
Theresa?

951
00:38:02,949 --> 00:38:03,949
Theresa, are you taking any medication?

952
00:38:03,950 --> 00:38:05,242
No.

953
00:38:05,243 --> 00:38:06,243
Any previous stomach problems?

954
00:38:06,244 --> 00:38:07,411
Oh, no.

955
00:38:07,412 --> 00:38:08,787
When did the vomiting begin?

956
00:38:08,788 --> 00:38:10,414
Um, last night.

957
00:38:10,415 --> 00:38:12,291
Last night.

958
00:38:12,292 --> 00:38:15,085
Do you have any dizziness or fatigue?

959
00:38:15,086 --> 00:38:17,046
Mystery solved.

960
00:38:17,047 --> 00:38:19,757
Our lady with the degloved foot
is Nepali.

961
00:38:19,758 --> 00:38:22,551
Oh, hey, congratulations.

962
00:38:22,552 --> 00:38:24,470
Otis's BP is crashing. 70 over 50.

963
00:38:24,471 --> 00:38:27,139
Still waiting for dialysis.

964
00:38:29,476 --> 00:38:31,643
How you doing there, Otis?

965
00:38:31,644 --> 00:38:32,978
- Not so good.
- 50 liters.

966
00:38:32,979 --> 00:38:34,397
Non-rebreather, please.

967
00:38:39,778 --> 00:38:41,653
Oh, crap.

968
00:38:41,654 --> 00:38:43,781
Diastolic collapse of the right
atrium and right ventricle.

969
00:38:43,782 --> 00:38:45,282
Tamponade from uremic effusion.

970
00:38:45,283 --> 00:38:46,658
- That's why his BP is low?
- Yep.

971
00:38:46,659 --> 00:38:47,993
Too much fluid and pressure

972
00:38:47,994 --> 00:38:49,661
around the heart, chambers can't fill.

973
00:38:49,662 --> 00:38:51,121
Otis, you've got
some fluid around your heart.

974
00:38:51,122 --> 00:38:52,289
We need to get it off.

975
00:38:52,290 --> 00:38:53,832
What's happening?

976
00:38:53,833 --> 00:38:55,959
25 of Propofol,
10 cc's of lidocaine with epi,

977
00:38:55,960 --> 00:38:57,336
pericardiocentesis tray.

978
00:38:57,337 --> 00:38:58,712
I have to get that from central.

979
00:38:58,713 --> 00:39:00,047
No, no. Just open a central line kit.

980
00:39:00,048 --> 00:39:01,674
Dr. Santos, take the head of the bed

981
00:39:01,675 --> 00:39:03,050
and bag him if he stops breathing,

982
00:39:03,051 --> 00:39:04,885
compressions if we lose the carotid.

983
00:39:04,886 --> 00:39:06,470
Prep and drape the subxiphoid, please.

984
00:39:06,471 --> 00:39:08,639
- 10 cc's of 1% with.
- Chlorhexidine here.

985
00:39:08,640 --> 00:39:10,933
- 25 or 27-gauge?
- Long 25, 25.

986
00:39:10,934 --> 00:39:13,852
Thank you.

987
00:39:13,853 --> 00:39:16,438
Injecting lidocaine.

988
00:39:16,439 --> 00:39:18,816
Pressure down. 60 over 40.

989
00:39:18,817 --> 00:39:20,985
Right.

990
00:39:22,737 --> 00:39:24,446
Wait, you can't ultrasound and place.

991
00:39:24,447 --> 00:39:26,031
I know, that's why I'm taking the probe.

992
00:39:26,032 --> 00:39:27,533
18-gauge thin wall

993
00:39:27,534 --> 00:39:29,368
on a 60 cc syringe, please, Dr. Collins.

994
00:39:29,369 --> 00:39:31,453
Let's go.

995
00:39:31,454 --> 00:39:34,665
You're going in right over
the center of my probe,

996
00:39:34,666 --> 00:39:36,875
advancing very slowly.

997
00:39:36,876 --> 00:39:39,712
We're looking for the hyperechoic tip.

998
00:39:39,713 --> 00:39:42,214
Very, very slowly.
Do not hit that heart.

999
00:39:42,215 --> 00:39:43,674
Dr. Santos, do you see
that sea of black?

1000
00:39:43,675 --> 00:39:45,175
That's the effusion.

1001
00:39:45,176 --> 00:39:46,760
We're looking for a little white dot.

1002
00:39:46,761 --> 00:39:48,554
There it is.

1003
00:39:48,555 --> 00:39:50,180
Got it.

1004
00:39:50,181 --> 00:39:51,515
Aspirating.

1005
00:39:51,516 --> 00:39:53,434
3 cc's should be enough.

1006
00:39:56,563 --> 00:39:57,855
Good.

1007
00:39:57,856 --> 00:39:59,106
Next, we'll place the guide wire,

1008
00:39:59,107 --> 00:40:01,066
and then the triple lumen catheter.

1009
00:40:01,067 --> 00:40:02,234
Pulse ox is 99.

1010
00:40:02,235 --> 00:40:05,571
Pressure is up. 124 over 78.

1011
00:40:05,572 --> 00:40:09,033
Looks like things are back to normal.

1012
00:40:09,034 --> 00:40:10,409
That was cool.

1013
00:40:10,410 --> 00:40:12,578
Four Zofrans on board.

1014
00:40:12,579 --> 00:40:15,414
That should stop the nausea.

1015
00:40:15,415 --> 00:40:17,416
David, have you had any vomiting?

1016
00:40:17,417 --> 00:40:21,420
- No.
- Anyone else sick at home?

1017
00:40:21,421 --> 00:40:23,714
No, it's just us.

1018
00:40:23,715 --> 00:40:27,092
My husband passed away
a few years ago, from COVID.

1019
00:40:27,093 --> 00:40:29,678
Oh, I'm so sorry.

1020
00:40:29,679 --> 00:40:31,181
Potassium, 3.1.

1021
00:40:32,974 --> 00:40:34,767
Is that bad?

1022
00:40:34,768 --> 00:40:36,101
It can cause heart problems.

1023
00:40:36,102 --> 00:40:37,436
But we're gonna correct it, OK?

1024
00:40:37,437 --> 00:40:40,064
10 in the bag, 20 PO.

1025
00:40:40,065 --> 00:40:42,775
Javadi, any questions?

1026
00:40:42,776 --> 00:40:44,401
Um...

1027
00:40:44,402 --> 00:40:46,236
uh, David, have you two traveled

1028
00:40:46,237 --> 00:40:47,780
out of the country recently?

1029
00:40:47,781 --> 00:40:50,115
We never go anywhere.

1030
00:40:50,116 --> 00:40:52,410
Is she gonna have to stay here?

1031
00:40:54,579 --> 00:40:56,121
If the rest of the tests are good,

1032
00:40:56,122 --> 00:40:59,501
and she responds to treatment,
she can go home.

1033
00:41:06,466 --> 00:41:08,967
Mr. Milton, my name is Dennis Whitaker.

1034
00:41:08,968 --> 00:41:10,886
I'm one of the student doctors here.

1035
00:41:10,887 --> 00:41:12,221
I'll be seeing you first.

1036
00:41:12,222 --> 00:41:13,222
Nice to meet you.

1037
00:41:13,223 --> 00:41:15,057
BP's 150 over 90.

1038
00:41:15,058 --> 00:41:17,559
OK, that's just a touch high.

1039
00:41:17,560 --> 00:41:19,478
I forgot to take my damn
enalapril this morning.

1040
00:41:19,479 --> 00:41:20,979
Oh, we'll get that for you.

1041
00:41:20,980 --> 00:41:22,898
Tell me about this belly pain.

1042
00:41:22,899 --> 00:41:26,485
Uh, it started about here.

1043
00:41:26,486 --> 00:41:29,988
Um, woke me up at, like, 2:00 AM.

1044
00:41:29,989 --> 00:41:31,782
Pretty intense.

1045
00:41:31,783 --> 00:41:33,909
- Lasted about an hour.
- Mm-hmm.

1046
00:41:33,910 --> 00:41:35,285
Now it's gone.

1047
00:41:35,286 --> 00:41:36,787
Any fever or vomiting?

1048
00:41:36,788 --> 00:41:38,789
Nah, I never get sick.

1049
00:41:38,790 --> 00:41:40,124
OK.

1050
00:41:40,125 --> 00:41:42,167
Uh, what did you eat last night?

1051
00:41:42,168 --> 00:41:43,961
Oh, it was my wife's birthday.

1052
00:41:43,962 --> 00:41:45,796
I took her out to Sullivan's
for a steak.

1053
00:41:45,797 --> 00:41:47,172
OK.

1054
00:41:47,173 --> 00:41:49,008
Well, the exam is pretty benign.

1055
00:41:49,009 --> 00:41:50,801
I'm gonna test for gallstones.

1056
00:41:50,802 --> 00:41:55,889
If there is a stone
and you eat fatty food,

1057
00:41:55,890 --> 00:41:59,852
there can be pain when
the gallbladder contracts.

1058
00:41:59,853 --> 00:42:01,061
Oh.

1059
00:42:01,062 --> 00:42:02,730
Uh, bingo.

1060
00:42:02,731 --> 00:42:05,649
One stone. There it is.

1061
00:42:05,650 --> 00:42:07,693
Do I need surgery?

1062
00:42:07,694 --> 00:42:10,320
Uh, you should be able
to manage with a low-fat diet.

1063
00:42:10,321 --> 00:42:13,282
But we'll send off labs
for liver and pancreas.

1064
00:42:13,283 --> 00:42:16,285
Just let us know
if you have any more pain.

1065
00:42:16,286 --> 00:42:17,703
OK.

1066
00:42:17,704 --> 00:42:19,621
Thanks.

1067
00:42:19,622 --> 00:42:21,707
Yeah, you bet.

1068
00:42:21,708 --> 00:42:23,834
Great.

1069
00:42:23,835 --> 00:42:25,669
You want an EKG?

1070
00:42:25,670 --> 00:42:27,379
For?

1071
00:42:27,380 --> 00:42:30,132
Heart attacks can present
as upper abdominal pain.

1072
00:42:30,133 --> 00:42:31,884
Um, yeah.

1073
00:42:31,885 --> 00:42:33,385
No, yeah, that's a great idea.

1074
00:42:33,386 --> 00:42:35,847
Thank you.

1075
00:42:48,610 --> 00:42:50,069
I'm going as fast as I can.

1076
00:42:50,070 --> 00:42:51,403
I'm picking up two more patients.

1077
00:42:51,404 --> 00:42:54,365
I didn't say anything.

1078
00:42:54,366 --> 00:42:56,408
I, uh... I need a fresh set of eyes.

1079
00:42:56,409 --> 00:42:58,285
On what?

1080
00:42:58,286 --> 00:43:00,245
54-year-old woman brought in
with intractable vomiting

1081
00:43:00,246 --> 00:43:01,705
by her 18-year-old son.

1082
00:43:01,706 --> 00:43:04,292
I'm, um... I'm getting a weird vibe.

1083
00:43:06,211 --> 00:43:07,920
How so?

1084
00:43:07,921 --> 00:43:09,880
Like, I don't know,
maybe she was given something.

1085
00:43:09,881 --> 00:43:12,424
Some sort of elder abuse.

1086
00:43:12,425 --> 00:43:14,593
There's just a strange dynamic
I can't quite figure out.

1087
00:43:14,594 --> 00:43:16,595
You're really good at
sussing out that sort of thing.

1088
00:43:16,596 --> 00:43:19,349
I don't know about that.

1089
00:43:21,976 --> 00:43:25,104
Uh, excuse me, Dr. Langdon.

1090
00:43:25,105 --> 00:43:27,856
Almost all of our labs are back
on sleeping boy Tyler.

1091
00:43:27,857 --> 00:43:30,567
All 100% normal.

1092
00:43:30,568 --> 00:43:32,070
What are we missing?

1093
00:43:35,865 --> 00:43:37,282
Is he waking up?

1094
00:43:37,283 --> 00:43:39,576
No, he's... he's still fast asleep.

1095
00:43:39,577 --> 00:43:42,121
Most of the lab results
are in, and they look great.

1096
00:43:42,122 --> 00:43:44,206
No abnormal blood count, no, uh,

1097
00:43:44,207 --> 00:43:46,917
electrolyte abnormalities, no diabetes,

1098
00:43:46,918 --> 00:43:49,753
no, um, kidney disease, so...

1099
00:43:49,754 --> 00:43:52,339
Good. So... so what's wrong with him?

1100
00:43:52,340 --> 00:43:54,633
We're still trying to figure that out.

1101
00:43:54,634 --> 00:43:57,344
Did he, uh, have a playdate
yesterday, by chance?

1102
00:43:57,345 --> 00:43:58,804
No, he had preschool,

1103
00:43:58,805 --> 00:44:00,305
but he was fine when I picked him up.

1104
00:44:00,306 --> 00:44:02,141
Any kids in his class ill?

1105
00:44:02,142 --> 00:44:03,642
No, my phone tree would have lit up

1106
00:44:03,643 --> 00:44:05,144
if someone else was sick.

1107
00:44:05,145 --> 00:44:06,937
He eat anything this morning?

1108
00:44:06,938 --> 00:44:08,605
No.

1109
00:44:08,606 --> 00:44:10,441
Why?

1110
00:44:10,442 --> 00:44:13,360
It looks like some sort of gelatin.

1111
00:44:13,361 --> 00:44:14,820
Any chance he could have gotten

1112
00:44:14,821 --> 00:44:17,322
into some bath beads or laundry pods?

1113
00:44:17,323 --> 00:44:19,158
No, there's no such thing in our house.

1114
00:44:19,159 --> 00:44:20,617
What about gummies?

1115
00:44:20,618 --> 00:44:22,828
No, we're very strict about candy.

1116
00:44:22,829 --> 00:44:24,122
Right?

1117
00:44:26,708 --> 00:44:29,668
Oh, shit.

1118
00:44:29,669 --> 00:44:30,961
Danny.

1119
00:44:30,962 --> 00:44:32,171
What about Danny?

1120
00:44:32,172 --> 00:44:34,631
Your brother, he...

1121
00:44:34,632 --> 00:44:36,675
he gave me some gummies
he got in Cleveland.

1122
00:44:36,676 --> 00:44:39,511
They were in my coat pocket.

1123
00:44:39,512 --> 00:44:41,180
Are you fucking serious?

1124
00:44:41,181 --> 00:44:42,348
Pot gummies?

1125
00:44:42,349 --> 00:44:44,683
Yes. I'm so sorry.

1126
00:44:44,684 --> 00:44:46,852
Let me call the lab.
Maybe the tox screen is back.

1127
00:44:46,853 --> 00:44:49,063
Hey, this is Dr. Langdon from the ED.

1128
00:44:49,064 --> 00:44:51,023
Can I fast-track a lab on a little boy,

1129
00:44:51,024 --> 00:44:52,983
last name Jones,
first name Tyler, tox screen?

1130
00:44:52,984 --> 00:44:54,693
Get the fuck out! I mean it.

1131
00:44:54,694 --> 00:44:56,528
Why don't we step outside,
and maybe you can help me

1132
00:44:56,529 --> 00:44:59,073
figure out how much he may have taken.

1133
00:44:59,074 --> 00:45:00,532
Thanks.

1134
00:45:00,533 --> 00:45:03,911
I appreciate that quick turnaround.

1135
00:45:03,912 --> 00:45:05,371
The labs confirm it.

1136
00:45:05,372 --> 00:45:07,915
Your son tested positive for cannabis.

1137
00:45:07,916 --> 00:45:09,334
This is a fucking nightmare.

1138
00:45:13,922 --> 00:45:17,841
Theresa, David, this is
my attending, Dr. Robinavitch.

1139
00:45:17,842 --> 00:45:19,385
Hi, I'm Dr. Robby.

1140
00:45:19,386 --> 00:45:21,679
We need to do a pelvic exam.

1141
00:45:21,680 --> 00:45:24,306
And David, I don't think you
want to be in here for that.

1142
00:45:24,307 --> 00:45:26,058
Definitely not.

1143
00:45:26,059 --> 00:45:28,977
Can you have Nurse Perlah
come join me, please?

1144
00:45:28,978 --> 00:45:32,064
Do you want a coffee
or a soda or something?

1145
00:45:32,065 --> 00:45:33,482
Why do I need a pelvic exam?

1146
00:45:33,483 --> 00:45:36,402
Uh, you don't.

1147
00:45:36,403 --> 00:45:38,028
Your son seems like a nice kid.

1148
00:45:38,029 --> 00:45:40,239
He's clearly worried about you.

1149
00:45:40,240 --> 00:45:42,741
But your exam and your labs
are not matching

1150
00:45:42,742 --> 00:45:44,159
any of the usual diagnoses,

1151
00:45:44,160 --> 00:45:45,704
so I'm not really sure what's going on.

1152
00:45:47,580 --> 00:45:49,331
I'm not here for me.

1153
00:45:49,332 --> 00:45:51,625
- I'm here for David.
- I don't understand.

1154
00:45:51,626 --> 00:45:53,127
He said that you've had
persistent vomiting,

1155
00:45:53,128 --> 00:45:54,461
some... some dehydration.

1156
00:45:54,462 --> 00:45:57,297
I made myself sick with ipecac.

1157
00:45:57,298 --> 00:45:59,758
To induce vomiting?
Why would you do that?

1158
00:45:59,759 --> 00:46:02,928
So David would bring me here.

1159
00:46:02,929 --> 00:46:05,097
My son has some problems.

1160
00:46:05,098 --> 00:46:07,224
He needs professional help.

1161
00:46:07,225 --> 00:46:08,642
OK. What kind of problems?

1162
00:46:08,643 --> 00:46:11,937
Drugs, alcohol?

1163
00:46:11,938 --> 00:46:15,482
I found some of his writing.

1164
00:46:15,483 --> 00:46:20,612
I thought it was schoolwork,
but it wasn't.

1165
00:46:20,613 --> 00:46:23,992
It was lists of girls he wanted to hurt.

1166
00:46:37,172 --> 00:46:38,714
Hurt them how?

1167
00:46:38,715 --> 00:46:42,260
He said, "They should all
be eliminated."

1168
00:46:44,804 --> 00:46:46,555
Has David seen a therapist?

1169
00:46:46,556 --> 00:46:48,891
No.

1170
00:46:48,892 --> 00:46:52,478
He's not a bad kid,
but I'm afraid he's troubled,

1171
00:46:52,479 --> 00:46:53,854
and I didn't want to call the police

1172
00:46:53,855 --> 00:46:55,439
because I was afraid they'd overreact.

1173
00:46:55,440 --> 00:46:57,816
- He's just a kid.
- How old is David?

1174
00:46:57,817 --> 00:47:01,320
He just turned 18 last month.

1175
00:47:01,321 --> 00:47:02,863
Then he's considered an adult

1176
00:47:02,864 --> 00:47:06,825
and he would have to consent
to treatment.

1177
00:47:06,826 --> 00:47:08,369
Do you have any guns in the house?

1178
00:47:08,370 --> 00:47:09,661
No.

1179
00:47:09,662 --> 00:47:11,205
My husband did,

1180
00:47:11,206 --> 00:47:13,707
but I got rid of all of them
after he passed.

1181
00:47:13,708 --> 00:47:15,668
He's a good soul.

1182
00:47:15,669 --> 00:47:18,797
I just don't want to see him
hurt anyone or himself.

1183
00:47:21,508 --> 00:47:23,342
How are you feeling, Crash?

1184
00:47:23,343 --> 00:47:25,844
I'd really appreciate
if you didn't call me that.

1185
00:47:25,845 --> 00:47:27,846
Why not? It's a cool nickname.

1186
00:47:27,847 --> 00:47:31,141
You earned it. You should own it.

1187
00:47:31,142 --> 00:47:33,519
I don't like it.

1188
00:47:33,520 --> 00:47:36,898
All right. It's just a joke.

1189
00:47:39,526 --> 00:47:43,028
You know, if it makes you
feel any better,

1190
00:47:43,029 --> 00:47:46,950
I sharted the first time
I saw an emergency C-section.

1191
00:47:48,410 --> 00:47:50,786
Really?

1192
00:47:50,787 --> 00:47:52,580
Of course not.

1193
00:48:01,965 --> 00:48:05,384
Excuse me. I'll be right back.

1194
00:48:05,385 --> 00:48:07,052
I got a situation.

1195
00:48:07,053 --> 00:48:09,555
18-year-old kid brings in
his dehydrated mom.

1196
00:48:09,556 --> 00:48:11,265
Dad died during the pandemic.

1197
00:48:11,266 --> 00:48:13,559
Mom's vomiting is self-induced
for the sole purpose

1198
00:48:13,560 --> 00:48:15,185
of getting him here after she finds

1199
00:48:15,186 --> 00:48:17,271
his death list for classmates.

1200
00:48:17,272 --> 00:48:20,691
I... OK.

1201
00:48:20,692 --> 00:48:22,568
What does she want us to do?

1202
00:48:22,569 --> 00:48:24,403
Help him, protect him, save him.

1203
00:48:24,404 --> 00:48:27,906
- Where is he now?
- Talking to McKay.

1204
00:48:27,907 --> 00:48:29,366
How are you doing?

1205
00:48:29,367 --> 00:48:30,826
Me? I'm good.

1206
00:48:30,827 --> 00:48:32,411
I'm always good. You know that.

1207
00:48:32,412 --> 00:48:34,329
Do I? Does anybody?

1208
00:48:34,330 --> 00:48:37,249
- I'm an open book.
- Not even close.

1209
00:48:37,250 --> 00:48:39,001
You do know you can always
come talk to me, right?

1210
00:48:39,002 --> 00:48:40,753
Yep.

1211
00:48:40,754 --> 00:48:43,088
Zofran. It's what...

1212
00:48:43,089 --> 00:48:45,841
- How's it going over here?
- Good, good.

1213
00:48:45,842 --> 00:48:48,093
We're just going over
aftercare instructions,

1214
00:48:48,094 --> 00:48:49,720
prescription medications, special diet

1215
00:48:49,721 --> 00:48:51,347
for the next few days.

1216
00:48:51,348 --> 00:48:53,223
Dr. McKay, can you check
orthostatics on Mom?

1217
00:48:53,224 --> 00:48:54,600
I can.

1218
00:48:54,601 --> 00:48:55,934
David, I wanted you to meet Kiara.

1219
00:48:55,935 --> 00:48:57,269
She's a social worker here who helps

1220
00:48:57,270 --> 00:48:59,104
in situations like this.

1221
00:48:59,105 --> 00:49:01,398
We heard about your father's passing.

1222
00:49:01,399 --> 00:49:02,941
We're really sorry.

1223
00:49:02,942 --> 00:49:05,069
And we know that it can put
a lot of pressure

1224
00:49:05,070 --> 00:49:08,155
on somebody your age,
which combined with school

1225
00:49:08,156 --> 00:49:11,241
and now having to take care
of your mom, that's a lot.

1226
00:49:11,242 --> 00:49:13,118
It's fine.

1227
00:49:13,119 --> 00:49:14,828
We just want to make sure
that when your mom goes home,

1228
00:49:14,829 --> 00:49:16,163
you can handle it.

1229
00:49:16,164 --> 00:49:17,456
We want to make sure you have someone

1230
00:49:17,457 --> 00:49:18,999
you can talk to if you need to.

1231
00:49:19,000 --> 00:49:20,334
I'm OK.

1232
00:49:20,335 --> 00:49:23,253
I don't need to talk to anybody.

1233
00:49:23,254 --> 00:49:24,672
After a parent dies,

1234
00:49:24,673 --> 00:49:27,091
the sadness can last a long time.

1235
00:49:27,092 --> 00:49:29,093
How's that going for you?

1236
00:49:29,094 --> 00:49:31,053
It's not a problem.

1237
00:49:31,054 --> 00:49:32,471
What about school?

1238
00:49:32,472 --> 00:49:33,889
What about it?

1239
00:49:33,890 --> 00:49:36,141
Anything you enjoy there?

1240
00:49:36,142 --> 00:49:39,478
Not really.

1241
00:49:39,479 --> 00:49:42,606
A lot of people have thoughts
that can disturb them.

1242
00:49:42,607 --> 00:49:44,817
If you've had any,
it's OK to talk about it.

1243
00:49:44,818 --> 00:49:47,486
What's that have to do with my mom?

1244
00:49:47,487 --> 00:49:49,988
- Is she gonna be OK?
- Yeah, she's gonna be fine.

1245
00:49:49,989 --> 00:49:51,323
She's probably got a stomach virus,

1246
00:49:51,324 --> 00:49:52,825
maybe food poisoning.

1247
00:49:52,826 --> 00:49:55,160
I think she's more worried about you.

1248
00:49:55,161 --> 00:49:57,079
She always worries about me.

1249
00:49:57,080 --> 00:50:00,666
- Does she have a reason to?
- No.

1250
00:50:00,667 --> 00:50:03,836
It's almost 8:00. I gotta go.

1251
00:50:03,837 --> 00:50:05,963
Are you sure you wouldn't
prefer to wait with your mom?

1252
00:50:05,964 --> 00:50:07,339
I'm late for school.

1253
00:50:07,340 --> 00:50:10,134
She can just call me when she's ready.

1254
00:50:10,135 --> 00:50:11,552
It would actually be kind of helpful

1255
00:50:11,553 --> 00:50:12,845
to talk to you some more.

1256
00:50:12,846 --> 00:50:15,514
Hey, David.

1257
00:50:15,515 --> 00:50:17,391
David.

1258
00:50:17,392 --> 00:50:18,517
Just give me five minutes.

1259
00:50:18,518 --> 00:50:19,685
Leave me alone!

1260
00:50:28,570 --> 00:50:30,988
Hey, David!

1261
00:50:30,989 --> 00:50:32,449
Shit.

1262
00:50:34,534 --> 00:50:36,368
Robby!

1263
00:50:36,369 --> 00:50:38,537
Robby.

1264
00:50:38,538 --> 00:50:40,289
Got a college kid, respiratory arrest,

1265
00:50:40,290 --> 00:50:41,458
coming in hot.

1266
00:51:12,364 --> 00:51:15,532
Robby, we need to intubate here.

1267
00:51:15,533 --> 00:51:16,909
Dr. Adamson just went down

1268
00:51:16,910 --> 00:51:18,577
with a pulse ox of 65.

1269
00:51:26,836 --> 00:51:28,129
Robby!

1270
00:51:28,130 --> 00:51:33,718
<b><font color="#ff0000">Sync and corrections by btsix
www.addic7ed.com</font></b>