1 00:00:05,384 --> 00:00:10,009 Sync and corrections by btsix www.addic7ed.com 2 00:00:10,010 --> 00:00:12,053 [SIGHS] 3 00:00:14,431 --> 00:00:16,098 [INHALES SHARPLY] 4 00:00:16,099 --> 00:00:17,600 [GRUNTS] 5 00:00:18,768 --> 00:00:21,103 [SOBS] 6 00:00:21,104 --> 00:00:24,232 [SIGHING] 7 00:00:28,778 --> 00:00:30,738 [DOOR OPENING] 8 00:00:30,739 --> 00:00:33,825 [INDISTINCT CHATTER] 9 00:00:46,796 --> 00:00:49,841 [BREATHING SHAKILY] 10 00:01:02,312 --> 00:01:03,437 16 is open. 11 00:01:03,438 --> 00:01:05,314 How come nobody's been... 12 00:01:05,315 --> 00:01:07,066 my bad, it's taken. 13 00:01:07,067 --> 00:01:08,650 Sorry. 14 00:01:08,651 --> 00:01:10,652 Mr. Louie was found unresponsive 15 00:01:10,653 --> 00:01:13,197 and on the sidewalk next to Fine Wine and Good Spirits. 16 00:01:13,198 --> 00:01:14,948 Decent vitals, no head trauma. 17 00:01:14,949 --> 00:01:16,825 Didn't we just discharge him a couple hours ago? 18 00:01:16,826 --> 00:01:19,119 Yeah. Stone-cold sober at 7:00 a.m. 19 00:01:19,120 --> 00:01:20,537 [SNIFFS] Oh, God. 20 00:01:20,538 --> 00:01:21,663 Don't light any matches. 21 00:01:21,664 --> 00:01:22,998 Hey, Doc, how you doing? 22 00:01:22,999 --> 00:01:24,291 Not as good as you, Louie. 23 00:01:24,292 --> 00:01:25,834 Hey, you know it, Doc. 24 00:01:25,835 --> 00:01:27,336 How much did you have to drink, Louie? 25 00:01:27,337 --> 00:01:29,922 Uh, just a couple of shots of vodka. 26 00:01:29,923 --> 00:01:31,006 So like a half-gallon? 27 00:01:31,007 --> 00:01:32,091 Oh, hell no. 28 00:01:32,092 --> 00:01:33,675 Just... just a quart. 29 00:01:33,676 --> 00:01:35,010 If you overexaggerate with your question, 30 00:01:35,011 --> 00:01:36,136 you usually get a truthful answer. 31 00:01:36,137 --> 00:01:37,846 Learned from the best. 32 00:01:37,847 --> 00:01:39,807 Uh, he's got Librium from this morning. 33 00:01:39,808 --> 00:01:41,266 That's what I prescribed him. 34 00:01:41,267 --> 00:01:44,186 All right, Louie, let's scoot it on over. 35 00:01:44,187 --> 00:01:46,897 You want to guess the blood alcohol level? 36 00:01:46,898 --> 00:01:48,482 Why would I want to do that? 37 00:01:48,483 --> 00:01:49,691 I don't know, because it's fun? 38 00:01:49,692 --> 00:01:51,485 You prescribed 20 Librium. 39 00:01:51,486 --> 00:01:52,903 There's only 10 left. 40 00:01:52,904 --> 00:01:54,655 See you next time. 41 00:01:54,656 --> 00:01:56,240 Uh, shouldn't we be concerned about an overdose? 42 00:01:56,241 --> 00:01:57,533 Oh, no. 43 00:01:57,534 --> 00:01:59,368 Vodka is Louie's drug of choice. 44 00:01:59,369 --> 00:02:00,536 Quickest way to kill the shakes. 45 00:02:00,537 --> 00:02:01,954 Oh, true that. 46 00:02:01,955 --> 00:02:02,955 Where did the other 10 pills go? 47 00:02:02,956 --> 00:02:03,956 I don't know. 48 00:02:03,957 --> 00:02:05,374 Maybe, uh, lost, stolen. 49 00:02:05,375 --> 00:02:07,376 Maybe he sold them to buy the vodka. 50 00:02:07,377 --> 00:02:09,169 What'd you do with the other pills, Louie? 51 00:02:09,170 --> 00:02:10,170 In my pocket. 52 00:02:10,171 --> 00:02:11,463 I didn't need them. 53 00:02:11,464 --> 00:02:15,176 [GROANS] Come on, give it a rest. 54 00:02:21,975 --> 00:02:23,559 Is everything OK with Collins? 55 00:02:23,560 --> 00:02:26,562 She seems fine to me, unlike our patient board. 56 00:02:26,563 --> 00:02:27,604 How's the Kraken? 57 00:02:27,605 --> 00:02:29,064 Sleeping like a baby. 58 00:02:29,065 --> 00:02:30,482 What's the story with beds upstairs? 59 00:02:30,483 --> 00:02:32,192 A ladder fall took the last ICU bed. 60 00:02:32,193 --> 00:02:34,570 One tele bed's open, no med-surge, no pedes. 61 00:02:34,571 --> 00:02:35,654 So which one of our 21 boarders 62 00:02:35,655 --> 00:02:37,239 is going to win the lottery? 63 00:02:37,240 --> 00:02:39,491 CHF exacerbation's been with us for two days. 64 00:02:39,492 --> 00:02:40,909 Sounds like a winner. 65 00:02:40,910 --> 00:02:42,161 The rest will receive our lovely 66 00:02:42,162 --> 00:02:43,579 consolation prize package. 67 00:02:43,580 --> 00:02:45,080 - Tell them what they won, Dana. - Stop. 68 00:02:45,081 --> 00:02:46,957 It's another 24 hours of bright lights, 69 00:02:46,958 --> 00:02:48,208 screaming trauma patients, hard gurneys, 70 00:02:48,209 --> 00:02:49,626 and sleep deprivation, 71 00:02:49,627 --> 00:02:51,128 all while you wait for a bed upstairs. 72 00:02:51,129 --> 00:02:52,421 Hey, uh, Nandi, 73 00:02:52,422 --> 00:02:53,755 the influencer in Central Eight, 74 00:02:53,756 --> 00:02:54,756 still waiting for psych? 75 00:02:54,757 --> 00:02:55,924 Nope. She's a keeper. 76 00:02:55,925 --> 00:02:56,967 Her mercury levels are sky high 77 00:02:56,968 --> 00:02:58,135 from that face cream. 78 00:02:58,136 --> 00:03:00,179 I ordered chelation TID, 79 00:03:00,180 --> 00:03:01,889 10 per kilo of DMSO. 80 00:03:01,890 --> 00:03:03,724 I'll make sure it comes up from pharmacy. 81 00:03:03,725 --> 00:03:04,766 Great pickup. 82 00:03:04,767 --> 00:03:06,560 Hey. You OK? 83 00:03:06,561 --> 00:03:08,437 Excuse me. 84 00:03:08,438 --> 00:03:09,855 I'm sorry, Dr. Robinavitch? 85 00:03:09,856 --> 00:03:11,607 - Yes, that is me. - Father McGill. 86 00:03:11,608 --> 00:03:12,941 Here to see John and Lily Bradley. 87 00:03:12,942 --> 00:03:14,359 Oh, yes. Thank you for coming. 88 00:03:14,360 --> 00:03:15,736 No problem. 89 00:03:15,737 --> 00:03:17,738 I will take you to the family room. 90 00:03:17,739 --> 00:03:18,906 Dana, I need some help. 91 00:03:18,907 --> 00:03:20,657 What's up? 92 00:03:20,658 --> 00:03:21,992 I've been trying to check the nursing notes on Louie 93 00:03:21,993 --> 00:03:23,952 from 7:00 a.m. this morning. 94 00:03:23,953 --> 00:03:26,788 Uh, Langdon ordered lorazepam, but I don't think it was given. 95 00:03:26,789 --> 00:03:28,624 Yeah, lorazepam ordered, dispensed, 96 00:03:28,625 --> 00:03:31,210 and then returned unused to the PDS per Dr. Langdon, 97 00:03:31,211 --> 00:03:33,128 as patient's tremor had resolved. 98 00:03:33,129 --> 00:03:34,254 Is that unusual? 99 00:03:34,255 --> 00:03:35,797 No, it happens all the time. 100 00:03:35,798 --> 00:03:37,466 You think that could be the vial I couldn't open 101 00:03:37,467 --> 00:03:38,759 on our seizure patient? 102 00:03:38,760 --> 00:03:40,469 Possibly. 103 00:03:40,470 --> 00:03:41,970 Can we check the other vials in the PDS? 104 00:03:41,971 --> 00:03:43,222 Make sure they're OK? 105 00:03:43,223 --> 00:03:44,765 - If you really want to. - I do. 106 00:03:44,766 --> 00:03:46,308 All right, come on. 107 00:03:46,309 --> 00:03:48,268 Dysuria in North Two's been waiting a long time. 108 00:03:48,269 --> 00:03:49,353 I'll take it. 109 00:03:49,354 --> 00:03:51,021 Oh, Dr. King. 110 00:03:51,022 --> 00:03:52,022 Rita! 111 00:03:52,023 --> 00:03:53,023 We were so worried. 112 00:03:53,024 --> 00:03:54,107 Oh, I'm so sorry. 113 00:03:54,108 --> 00:03:55,817 My phone was on silent. 114 00:03:55,818 --> 00:03:57,486 I missed 10 calls from the hospital. 115 00:03:57,487 --> 00:03:58,654 Is my mom OK? 116 00:03:58,655 --> 00:04:00,197 Oh, yeah, she's fine. 117 00:04:00,198 --> 00:04:03,325 [SIGHS] Uh, I went to move my car, 118 00:04:03,326 --> 00:04:05,661 and it was so peaceful and quiet when I parked 119 00:04:05,662 --> 00:04:10,082 in the garage, I dozed off. 120 00:04:10,083 --> 00:04:11,959 I'm just really glad you're back. 121 00:04:11,960 --> 00:04:13,460 Oh, your mom is going to be so happy. 122 00:04:13,461 --> 00:04:14,795 She's... she's waiting in the hall. 123 00:04:14,796 --> 00:04:16,171 OK. 124 00:04:16,172 --> 00:04:19,049 So if I order lorazepam for Louie, 125 00:04:19,050 --> 00:04:21,635 the log shows me we have five vials left. 126 00:04:21,636 --> 00:04:24,304 [CLANGING, WHIRRING] 127 00:04:24,305 --> 00:04:27,307 Take one out, and now we have four left. 128 00:04:27,308 --> 00:04:31,353 But if I click that I want to return one unused, 129 00:04:31,354 --> 00:04:34,481 you put it back, and the computer count 130 00:04:34,482 --> 00:04:36,316 goes back up to five. 131 00:04:36,317 --> 00:04:37,317 Yeah. 132 00:04:37,318 --> 00:04:38,318 Same lot numbers. 133 00:04:38,319 --> 00:04:39,611 Everything looks good. 134 00:04:39,612 --> 00:04:40,696 No way of knowing which vial 135 00:04:40,697 --> 00:04:42,281 was returned by Dr. Langdon. 136 00:04:42,282 --> 00:04:43,824 Yeah, I guess. 137 00:04:43,825 --> 00:04:45,617 - Thanks. - Yeah. 138 00:04:45,618 --> 00:04:47,828 Old man coming in with a heart rate of 30. 139 00:04:47,829 --> 00:04:49,329 Sounds like pacemaker failure. 140 00:04:49,330 --> 00:04:50,914 Could be a good case. 141 00:04:50,915 --> 00:04:52,916 Putting an amputation in 15. 142 00:04:52,917 --> 00:04:54,543 Ooh, that one sounds even better. 143 00:04:54,544 --> 00:04:56,045 Yeah. 144 00:04:58,339 --> 00:04:59,673 Rocco DeJulio. 145 00:04:59,674 --> 00:05:01,049 Amputation of the fourth fingertip 146 00:05:01,050 --> 00:05:03,510 at the base of the nail, bone exposed. 147 00:05:03,511 --> 00:05:05,220 Uh, how'd this happen? 148 00:05:05,221 --> 00:05:08,515 I, uh... I crushed it under an air conditioning unit 149 00:05:08,516 --> 00:05:09,683 we were installing. 150 00:05:09,684 --> 00:05:11,143 We'll numb up your finger. 151 00:05:11,144 --> 00:05:13,312 One shot will help with the pain. 152 00:05:13,313 --> 00:05:14,521 Amazing. 153 00:05:14,522 --> 00:05:15,647 Digital block, 154 00:05:15,648 --> 00:05:17,566 three ccs of marcaine. 155 00:05:17,567 --> 00:05:20,736 Pulse 110, BP 135 over 88 in triage. 156 00:05:20,737 --> 00:05:22,112 Any drug allergies, sir? 157 00:05:22,113 --> 00:05:23,238 Uh-uh. 158 00:05:23,239 --> 00:05:24,364 Two grams of Cefazolin? 159 00:05:24,365 --> 00:05:26,199 Uh-huh. 160 00:05:26,200 --> 00:05:28,870 [INHALES SHARPLY] Oh, wow. 161 00:05:31,289 --> 00:05:33,081 Go with the block. 162 00:05:33,082 --> 00:05:34,082 Are you ready? 163 00:05:34,083 --> 00:05:35,709 Mm-hmm. 164 00:05:35,710 --> 00:05:38,211 Pinprick and some burning. 165 00:05:38,212 --> 00:05:40,589 Uh, where's the missing piece of skin? 166 00:05:40,590 --> 00:05:44,426 It's, um, under a thousand-pound unit. 167 00:05:44,427 --> 00:05:46,428 It's flat as a pancake. 168 00:05:46,429 --> 00:05:48,221 Well, then we have nothing to reattach. 169 00:05:48,222 --> 00:05:49,890 Plan, Dr. McKay? 170 00:05:49,891 --> 00:05:52,100 Bone rongeur, V-Y flap. 171 00:05:52,101 --> 00:05:53,894 - Exactly. - Awesome. 172 00:05:53,895 --> 00:05:55,480 I picked the right case. 173 00:05:57,357 --> 00:05:58,815 Can somebody translate? 174 00:05:58,816 --> 00:06:00,108 To close the wound, 175 00:06:00,109 --> 00:06:01,651 we're going to trim down the bone, 176 00:06:01,652 --> 00:06:03,278 then use a plastic surgery trick so the skin 177 00:06:03,279 --> 00:06:04,404 will cover everything. 178 00:06:04,405 --> 00:06:05,947 OK. 179 00:06:05,948 --> 00:06:07,783 Your finger is going to be a little shorter. 180 00:06:07,784 --> 00:06:09,076 No nail. 181 00:06:09,077 --> 00:06:10,619 Great. 182 00:06:10,620 --> 00:06:12,287 10% off manicures. 183 00:06:12,288 --> 00:06:13,498 [LAUGHS] 184 00:06:15,124 --> 00:06:16,958 Looks like they found you guys a new rig. 185 00:06:16,959 --> 00:06:18,293 Nah, we Ubered. 186 00:06:18,294 --> 00:06:20,045 Willie Alexander, 81, near syncope 187 00:06:20,046 --> 00:06:21,546 from the Memory Day Center. 188 00:06:21,547 --> 00:06:22,672 They said he's more altered than usual. 189 00:06:22,673 --> 00:06:24,633 Pulse is 30, BP's 80 over 40. 190 00:06:24,634 --> 00:06:26,676 No change with a mig of atropine. 191 00:06:26,677 --> 00:06:28,929 He's got a pacer in his chest, but there's no capture. 192 00:06:28,930 --> 00:06:30,639 How are you feeling, Mr. Alexander? 193 00:06:30,640 --> 00:06:32,140 Call me Willie. 194 00:06:32,141 --> 00:06:33,350 I'm fine, I'm fine. 195 00:06:33,351 --> 00:06:34,476 Any chest pain? 196 00:06:34,477 --> 00:06:35,602 No, ma'am. 197 00:06:35,603 --> 00:06:37,145 Do you take beta blockers? 198 00:06:37,146 --> 00:06:39,731 I take walks every day. 199 00:06:39,732 --> 00:06:40,982 Only med is Namenda. 200 00:06:40,983 --> 00:06:41,983 On my count. 201 00:06:41,984 --> 00:06:43,151 One, two, three. 202 00:06:43,152 --> 00:06:45,112 [GRUNTS] 203 00:06:45,113 --> 00:06:47,489 Pacemaker patient with dementia. 204 00:06:47,490 --> 00:06:48,949 Heart rate of 30. 205 00:06:48,950 --> 00:06:50,659 A little altered with a systolic of 80. 206 00:06:50,660 --> 00:06:52,244 What's your plan, Dr. Langdon? 207 00:06:52,245 --> 00:06:54,329 Second mig of atropine now. 208 00:06:54,330 --> 00:06:57,290 Push dose epi, 0.1 milligram. 209 00:06:57,291 --> 00:06:58,333 Portable chest. 210 00:06:58,334 --> 00:07:00,043 31 on the monitor. 211 00:07:00,044 --> 00:07:01,962 Dr. Javadi, what do you think of that heart rate? 212 00:07:01,963 --> 00:07:03,463 Uh, it's not beta blockers, so junctional escape rhythm? 213 00:07:03,464 --> 00:07:04,548 Exactly... common with 214 00:07:04,549 --> 00:07:06,007 a non-functioning pacemaker. 215 00:07:06,008 --> 00:07:07,217 Etiology, Dr. Mohan? 216 00:07:07,218 --> 00:07:09,177 Dead battery or lead failure? 217 00:07:09,178 --> 00:07:10,595 Indeed. 218 00:07:10,596 --> 00:07:12,681 Good squeeze, even if it is slow. 219 00:07:12,682 --> 00:07:14,182 Atropine and epi on board. 220 00:07:14,183 --> 00:07:15,600 What's next, Dr. Langdon? 221 00:07:15,601 --> 00:07:17,185 We can try percutaneous pacing, 222 00:07:17,186 --> 00:07:18,937 but eventually, he'll need transvenous. 223 00:07:18,938 --> 00:07:20,105 Agreed. 224 00:07:20,106 --> 00:07:21,273 Systolic's up to 95 with epi. 225 00:07:21,274 --> 00:07:23,024 [WHEEZES] It's too low. 226 00:07:23,025 --> 00:07:24,651 Let's start a drip. 227 00:07:24,652 --> 00:07:26,403 Two mikes per minute. Check the mental status. 228 00:07:26,404 --> 00:07:27,737 Um, he knows his name. 229 00:07:27,738 --> 00:07:29,489 Sir, do you know what year it is? 230 00:07:29,490 --> 00:07:31,867 Um, it's 20-something. 231 00:07:31,868 --> 00:07:32,909 Uh... 232 00:07:32,910 --> 00:07:34,202 Do you know where you are? 233 00:07:34,203 --> 00:07:36,371 It looks like a hospital to me. 234 00:07:36,372 --> 00:07:37,581 Pittsburgh Trauma Medical Center. 235 00:07:37,582 --> 00:07:38,582 Yep. 236 00:07:38,583 --> 00:07:40,459 Yep, I know this place. 237 00:07:40,460 --> 00:07:43,211 It's Dr. Adamson's place. 238 00:07:43,212 --> 00:07:44,212 Where's he at? 239 00:07:44,213 --> 00:07:45,715 He working today? 240 00:07:48,050 --> 00:07:49,134 Are you feeling any pain? 241 00:07:49,135 --> 00:07:50,469 No, that shot worked great. 242 00:07:50,470 --> 00:07:51,470 OK. 243 00:07:51,471 --> 00:07:53,346 Just like this. 244 00:07:53,347 --> 00:07:54,849 [SNIPS] 245 00:07:56,142 --> 00:07:57,517 Uh, how far down? 246 00:07:57,518 --> 00:07:59,394 Just so the sub-Q will cover. 247 00:07:59,395 --> 00:08:01,104 You'll need to take a few days off work, sir. 248 00:08:01,105 --> 00:08:02,564 Good. More time to study. 249 00:08:02,565 --> 00:08:03,565 Oh, yeah? 250 00:08:03,566 --> 00:08:04,566 For what? 251 00:08:04,567 --> 00:08:05,775 Uh, master's degree. 252 00:08:05,776 --> 00:08:07,903 - Psychology. - Oh, no kidding. 253 00:08:07,904 --> 00:08:10,071 Yeah. HVAC's just my day job. 254 00:08:10,072 --> 00:08:12,908 I went to trade school because I couldn't afford college. 255 00:08:12,909 --> 00:08:14,743 Now I can. 256 00:08:14,744 --> 00:08:17,746 Good on the rongeur. 257 00:08:17,747 --> 00:08:19,915 Marking the surgical borders. 258 00:08:19,916 --> 00:08:21,459 Two incisions. 259 00:08:23,169 --> 00:08:26,254 Advance the triangle to cover the tip. 260 00:08:26,255 --> 00:08:27,964 Until the V becomes a Y? 261 00:08:27,965 --> 00:08:29,842 Exactly. 262 00:08:31,302 --> 00:08:33,428 I guess you're the boss here? 263 00:08:33,429 --> 00:08:35,096 Something like that. 264 00:08:35,097 --> 00:08:37,599 You're very good at teaching. 265 00:08:37,600 --> 00:08:38,975 Seriously. 266 00:08:38,976 --> 00:08:40,602 You step back, and with a few words, 267 00:08:40,603 --> 00:08:43,271 you impart wisdom. 268 00:08:43,272 --> 00:08:45,106 If you say so. 269 00:08:45,107 --> 00:08:48,652 Do you mind if I ask what you do when you don't work? 270 00:08:48,653 --> 00:08:50,237 Sleep. 271 00:08:50,238 --> 00:08:53,866 Now a blunt dissect to undermine the tissue. 272 00:08:56,661 --> 00:08:58,203 What do you think, Dr. Javadi? 273 00:08:58,204 --> 00:08:59,538 Third degree. 274 00:08:59,539 --> 00:09:00,580 - Complete heart block. - Because? 275 00:09:00,581 --> 00:09:01,957 AV dissociation. 276 00:09:01,958 --> 00:09:03,542 No relationship between the P waves 277 00:09:03,543 --> 00:09:04,793 and the QRS complexes. 278 00:09:04,794 --> 00:09:05,794 Clear. 279 00:09:05,795 --> 00:09:07,462 Heart rate is 30. 280 00:09:07,463 --> 00:09:09,381 His low BP is going to make him a lot more confused. 281 00:09:09,382 --> 00:09:11,967 Could cause a heart attack or a stroke if we don't fix it. 282 00:09:11,968 --> 00:09:12,968 Oh. 283 00:09:12,969 --> 00:09:14,427 Well, mystery solved. 284 00:09:14,428 --> 00:09:15,595 The wires aren't even touching. 285 00:09:15,596 --> 00:09:16,972 They're totally disconnected. 286 00:09:16,973 --> 00:09:18,098 Shit happens. 287 00:09:18,099 --> 00:09:19,307 Heart rate still in low 30s. 288 00:09:19,308 --> 00:09:20,600 No change with atropine. 289 00:09:20,601 --> 00:09:21,643 Pacing pads are on. 290 00:09:21,644 --> 00:09:23,061 We can try. 291 00:09:23,062 --> 00:09:25,647 Willie, your pacemaker isn't working. 292 00:09:25,648 --> 00:09:27,482 Well, you better fix it. 293 00:09:27,483 --> 00:09:29,276 We're going to try to pace your heart from the outside. 294 00:09:29,277 --> 00:09:30,777 You might feel it in your chest. 295 00:09:30,778 --> 00:09:32,612 Let's start at 10 milliamps, rate of 60. 296 00:09:32,613 --> 00:09:34,240 Pacer on. 297 00:09:36,617 --> 00:09:37,951 I'm twitching. 298 00:09:37,952 --> 00:09:39,536 No capture. 299 00:09:39,537 --> 00:09:41,037 Increase to 20 milliamps. 300 00:09:41,038 --> 00:09:42,622 Now it's more like a shock. 301 00:09:42,623 --> 00:09:43,623 Still no capture. 302 00:09:43,624 --> 00:09:44,624 Up to 30. 303 00:09:44,625 --> 00:09:45,625 [BEEPS] 304 00:09:45,626 --> 00:09:47,168 Whoa! 305 00:09:47,169 --> 00:09:48,712 - Y'all trying to electrocute me? - Pacer off. 306 00:09:48,713 --> 00:09:49,796 - Can't tolerate it. - Get rid of this shit! 307 00:09:49,797 --> 00:09:50,797 Dr. Langdon? 308 00:09:50,798 --> 00:09:51,881 One of versed. 309 00:09:51,882 --> 00:09:53,300 Can we set up for transvenous? 310 00:09:53,301 --> 00:09:55,052 I was set up before you got here. 311 00:09:57,847 --> 00:09:59,472 Versed's on board. 312 00:09:59,473 --> 00:10:01,850 Willie, we need to float a temporary pacemaker 313 00:10:01,851 --> 00:10:04,185 from your neck into your heart. 314 00:10:04,186 --> 00:10:05,520 Why is that? 315 00:10:05,521 --> 00:10:07,355 Because your heart rate is only 30. 316 00:10:07,356 --> 00:10:11,276 Then, uh, hit me with, uh, a shot of atropine. 317 00:10:11,277 --> 00:10:13,361 You've already had three. 318 00:10:13,362 --> 00:10:14,988 Wait, are you a doctor? 319 00:10:14,989 --> 00:10:18,491 [WHEEZING, SNORING] 320 00:10:18,492 --> 00:10:20,328 He's out. 321 00:10:22,747 --> 00:10:27,709 Ginger, what do you think about having some help at home? 322 00:10:27,710 --> 00:10:31,755 I think Rita could use a little break 323 00:10:31,756 --> 00:10:35,091 every now and then. 324 00:10:35,092 --> 00:10:36,885 We can't afford it. 325 00:10:36,886 --> 00:10:40,555 Oh, um, Kiara told me about DHS senior phone line. 326 00:10:40,556 --> 00:10:45,393 It's part of AAA, the Area Agency on Aging. 327 00:10:45,394 --> 00:10:48,229 They make referrals for in-home services. 328 00:10:48,230 --> 00:10:50,065 Uh, what's that going to cost? 329 00:10:50,066 --> 00:10:51,900 Medicare will cover short-term home care, 330 00:10:51,901 --> 00:10:55,403 at least 10 hours a week. 331 00:10:55,404 --> 00:10:57,614 Ginger, have you ever been to a senior center? 332 00:10:57,615 --> 00:10:58,740 I went once. 333 00:10:58,741 --> 00:11:00,784 Nothing but old people. 334 00:11:00,785 --> 00:11:02,744 AAA also has senior companions 335 00:11:02,745 --> 00:11:04,245 for a few hours a day. 336 00:11:04,246 --> 00:11:05,914 And if Rita needs to be away at lunchtime, 337 00:11:05,915 --> 00:11:08,209 the OPTIONS program can deliver a meal. 338 00:11:13,297 --> 00:11:16,341 Uh, is everything all right? 339 00:11:16,342 --> 00:11:18,593 Yeah. 340 00:11:18,594 --> 00:11:20,595 Did I say something that upset you? 341 00:11:20,596 --> 00:11:23,098 [SNIFFLES] No, it's all good. 342 00:11:23,099 --> 00:11:27,435 This is... [SNIFFLES] 343 00:11:27,436 --> 00:11:30,314 This is way more than I expected, so... 344 00:11:37,488 --> 00:11:38,488 Bam. 345 00:11:38,489 --> 00:11:40,657 Internal jugular accessed. 346 00:11:40,658 --> 00:11:42,784 Pulse ox 99 on five liters. 347 00:11:42,785 --> 00:11:44,327 Systolic's 95 on epi. 348 00:11:44,328 --> 00:11:45,745 That's good enough to perfuse the brain. 349 00:11:45,746 --> 00:11:47,747 Guidewire. 350 00:11:47,748 --> 00:11:49,833 You doing OK under there, Willie? 351 00:11:49,834 --> 00:11:51,251 I guess. 352 00:11:51,252 --> 00:11:52,919 So this is just like a triple lumen? 353 00:11:52,920 --> 00:11:55,588 Except you need a big seven French introducer 354 00:11:55,589 --> 00:11:56,631 to fit the pacing wire. 355 00:11:56,632 --> 00:11:59,926 [MACHINERY BEEPING] 356 00:11:59,927 --> 00:12:02,929 I could use some air. 357 00:12:02,930 --> 00:12:04,681 Is that any better? 358 00:12:04,682 --> 00:12:07,475 [SIGHS] What y'all doing? 359 00:12:07,476 --> 00:12:10,770 We're putting a temporary wire into an external pacemaker 360 00:12:10,771 --> 00:12:14,315 until you can have surgery to repair the one in your chest. 361 00:12:14,316 --> 00:12:16,109 Heart rate's still 31. 362 00:12:16,110 --> 00:12:19,487 Bradycardia. 363 00:12:19,488 --> 00:12:21,489 Are you a doctor, Willie? 364 00:12:21,490 --> 00:12:24,617 [CHUCKLING] 365 00:12:24,618 --> 00:12:26,578 Yeah, right. 366 00:12:26,579 --> 00:12:30,081 No mention of any medical career in his past records. 367 00:12:30,082 --> 00:12:31,458 Just mild dementia. 368 00:12:31,459 --> 00:12:33,668 "Are you a doctor?" 369 00:12:33,669 --> 00:12:34,753 That's a good one. 370 00:12:34,754 --> 00:12:35,837 [LAUGHS] 371 00:12:35,838 --> 00:12:37,547 OK, last one. 372 00:12:37,548 --> 00:12:40,675 How's it look? 373 00:12:40,676 --> 00:12:41,843 Perfect. 374 00:12:41,844 --> 00:12:43,052 Uh, Xeroform and tube gauze? 375 00:12:43,053 --> 00:12:44,179 Mm-hmm. 376 00:12:44,180 --> 00:12:45,847 What's up, party people? 377 00:12:45,848 --> 00:12:47,724 Uh, V-Y flap. 378 00:12:47,725 --> 00:12:49,893 Nicely done. Can I borrow Dr. Santos? 379 00:12:49,894 --> 00:12:52,353 As long as Dr. McKay can finish the dressing. 380 00:12:52,354 --> 00:12:53,814 Sure. 381 00:12:58,152 --> 00:12:59,694 [SIGHS] 382 00:12:59,695 --> 00:13:03,698 I can't stop thinking about your foot. 383 00:13:03,699 --> 00:13:05,200 Uh, you know what I mean. 384 00:13:05,201 --> 00:13:07,994 - I'm... I'm sorry, but... - I know. Move on. 385 00:13:07,995 --> 00:13:10,455 - I already did. - OK. 386 00:13:10,456 --> 00:13:12,373 There's a high-maintenance surgery clinic patient 387 00:13:12,374 --> 00:13:15,335 down here... as in total pain in the ass. 388 00:13:15,336 --> 00:13:17,670 I could use your help distracting her. 389 00:13:17,671 --> 00:13:20,381 So we're... we're good? 390 00:13:20,382 --> 00:13:23,009 Every hero needs a sidekick. 391 00:13:23,010 --> 00:13:24,844 I need to find a tube gauze cage. 392 00:13:24,845 --> 00:13:26,554 I'll be right back. 393 00:13:26,555 --> 00:13:29,682 You'll need to elevate, antibiotics three times a day 394 00:13:29,683 --> 00:13:33,061 for a week, a couple of painkiller tablets, 395 00:13:33,062 --> 00:13:36,064 but try to get by on Tylenol and ibuprofen. 396 00:13:36,065 --> 00:13:38,149 Are you OK? 397 00:13:38,150 --> 00:13:39,359 Is today a bad day? 398 00:13:39,360 --> 00:13:40,360 Drowning victim. 399 00:13:40,361 --> 00:13:43,112 ETA three minutes. 400 00:13:43,113 --> 00:13:44,949 Sorry, I got to go. 401 00:13:47,034 --> 00:13:50,036 20 centimeters clears the cordis. 402 00:13:50,037 --> 00:13:53,248 Pacing box rate of 80, five milliamps. 403 00:13:53,249 --> 00:13:54,249 Confirmed. 404 00:13:54,250 --> 00:13:55,750 On ventricular setting. 405 00:13:55,751 --> 00:13:58,628 Passing to 30, just outside the heart. 406 00:13:58,629 --> 00:14:00,213 Why do we inflate the balloon now? 407 00:14:00,214 --> 00:14:01,589 So it'll float into the right ventricle. 408 00:14:01,590 --> 00:14:03,716 Exactly. And we're looking for? 409 00:14:03,717 --> 00:14:05,969 An injury pattern, since it's below the AV node. 410 00:14:05,970 --> 00:14:07,136 Looking good. 411 00:14:07,137 --> 00:14:09,931 Check the pulse. 412 00:14:09,932 --> 00:14:11,516 Strong radial. Really strong. 413 00:14:11,517 --> 00:14:13,685 Man, I feel like I just woke up. 414 00:14:13,686 --> 00:14:15,270 Nice work, Dr. Langdon. 415 00:14:15,271 --> 00:14:16,771 Systolic's up to 130. 416 00:14:16,772 --> 00:14:18,606 How do you feel? 417 00:14:18,607 --> 00:14:20,733 Feel like a million bucks. 418 00:14:20,734 --> 00:14:23,278 Widened QRS on the scope. 419 00:14:23,279 --> 00:14:25,572 Willie, did you used to work at this hospital? 420 00:14:25,573 --> 00:14:26,573 Hell, no. 421 00:14:26,574 --> 00:14:28,199 I just brought the mail. 422 00:14:28,200 --> 00:14:29,534 Can we steal Javadi? 423 00:14:29,535 --> 00:14:31,119 Absolutely. 424 00:14:31,120 --> 00:14:33,413 Time to shine, Crash. 425 00:14:33,414 --> 00:14:35,623 Do you have time to write the procedure note? 426 00:14:35,624 --> 00:14:37,041 No problem. 427 00:14:37,042 --> 00:14:38,251 I'll be at Central if you need me. 428 00:14:38,252 --> 00:14:39,878 Oh, jeez. 429 00:14:39,879 --> 00:14:41,796 I still need to tell Nandi about her mercury level. 430 00:14:41,797 --> 00:14:44,674 The average emergency doctor gets pulled from task A 431 00:14:44,675 --> 00:14:46,634 to task B every three to five minutes. 432 00:14:46,635 --> 00:14:48,636 Remind me again why we picked this specialty? 433 00:14:48,637 --> 00:14:50,138 Because we all have ADHD, 434 00:14:50,139 --> 00:14:52,433 and anything else would be boring as hell. 435 00:14:54,935 --> 00:14:57,813 [INDISTINCT CHATTER] 436 00:15:01,150 --> 00:15:02,525 Another ICU admission. 437 00:15:02,526 --> 00:15:04,319 I'll call to confirm. 438 00:15:04,320 --> 00:15:06,154 Dr. Collins, do you think that we might be able to... 439 00:15:06,155 --> 00:15:07,196 Drowning victim here. 440 00:15:07,197 --> 00:15:08,490 Not right now. 441 00:15:10,326 --> 00:15:12,327 Amber Phillips, six years old. 442 00:15:12,328 --> 00:15:14,287 Found at the bottom of a home pool with an unknown downtime. 443 00:15:14,288 --> 00:15:15,997 Asystole on the monitor. 444 00:15:15,998 --> 00:15:19,500 Intubated with a cuffed 4.5, 22-gauge left AC, 445 00:15:19,501 --> 00:15:21,169 0.25 epi three minutes ago. 446 00:15:21,170 --> 00:15:23,796 One, two, three. 447 00:15:23,797 --> 00:15:25,215 OK. 448 00:15:27,509 --> 00:15:29,302 Whitaker, take over compressions. 449 00:15:29,303 --> 00:15:31,012 - Any family coming in? - Grandma and little sister. 450 00:15:31,013 --> 00:15:32,723 Fast and deep. 451 00:15:34,183 --> 00:15:35,099 Ready? 452 00:15:35,100 --> 00:15:36,100 Yeah. 453 00:15:36,101 --> 00:15:38,186 Go. 454 00:15:38,187 --> 00:15:39,187 She's really cold. 455 00:15:39,188 --> 00:15:40,188 OK. 456 00:15:40,189 --> 00:15:41,732 Get a core temp. 457 00:15:44,276 --> 00:15:45,485 Good breath sounds bilaterally. 458 00:15:45,486 --> 00:15:46,861 Should we use the Lucas? 459 00:15:46,862 --> 00:15:48,404 No, she's way too small for that. 460 00:15:48,405 --> 00:15:50,907 - Rectal temp only 85. - What do you think, Mel? 461 00:15:50,908 --> 00:15:53,201 Uh, she's cold. Moderate hypothermia. 462 00:15:53,202 --> 00:15:54,702 We need to get her up to 90 if we have any chance 463 00:15:54,703 --> 00:15:55,703 of restarting her heart. 464 00:15:55,704 --> 00:15:57,747 250 ccs heated saline. 465 00:15:57,748 --> 00:15:59,082 Set up the Arctic Sun. 466 00:15:59,083 --> 00:16:00,375 Continuous core temp monitoring, 467 00:16:00,376 --> 00:16:01,709 and prep another epi 0.25. 468 00:16:01,710 --> 00:16:03,253 Yep. 469 00:16:05,839 --> 00:16:07,757 Preemptive orders done. Let's go. 470 00:16:07,758 --> 00:16:09,676 I just... I don't understand why you need me. 471 00:16:09,677 --> 00:16:11,928 Crohn's disease status post colectomy 10 years ago, 472 00:16:11,929 --> 00:16:13,846 now with severe abdominal pain. 473 00:16:13,847 --> 00:16:16,391 Could be perforation, fistula, obstruction. 474 00:16:16,392 --> 00:16:18,184 Great teaching case. 475 00:16:18,185 --> 00:16:21,354 [GROANING] Someone give me something for the pain! 476 00:16:21,355 --> 00:16:22,480 [MOANS] 477 00:16:22,481 --> 00:16:23,564 Good afternoon, Ms. Walker. 478 00:16:23,565 --> 00:16:25,066 I'm Dr. Garcia from surgery. 479 00:16:25,067 --> 00:16:26,693 This is Dr. Santos and Javadi. 480 00:16:26,694 --> 00:16:28,069 It looks like you're in a lot of pain. 481 00:16:28,070 --> 00:16:29,362 No shit! 482 00:16:29,363 --> 00:16:30,488 We ordered you some morphine. 483 00:16:30,489 --> 00:16:31,489 Did you read my chart? 484 00:16:31,490 --> 00:16:32,907 I'm allergic to morphine! 485 00:16:32,908 --> 00:16:34,701 I'll puke my guts out. 486 00:16:34,702 --> 00:16:36,869 That's a side effect, not an allergy. 487 00:16:36,870 --> 00:16:38,204 Oh, give me some Dilaudid. 488 00:16:38,205 --> 00:16:39,205 OK. 489 00:16:39,206 --> 00:16:40,581 One milligram Dilaudid. 490 00:16:40,582 --> 00:16:41,582 I'll grab it from the PDS. 491 00:16:41,583 --> 00:16:42,709 One is never enough. 492 00:16:42,710 --> 00:16:43,710 I need two, sometimes four. 493 00:16:43,711 --> 00:16:44,752 Got it. 494 00:16:44,753 --> 00:16:46,462 Pertinent history, Javadi? 495 00:16:46,463 --> 00:16:48,297 Um, have you had any fever or vomiting? 496 00:16:48,298 --> 00:16:51,217 [GROANS] Shut up with your questions! 497 00:16:51,218 --> 00:16:52,885 Ma'am, we can't help you if we don't know your... 498 00:16:52,886 --> 00:16:54,303 If you want to help me, get me my doctor. 499 00:16:54,304 --> 00:16:55,596 Dr. Shamsi. 500 00:16:55,597 --> 00:16:57,390 10 years, no one knows me better. 501 00:16:57,391 --> 00:16:59,100 I don't want to talk to anybody else. 502 00:16:59,101 --> 00:17:01,269 I'm very sorry, but she's in surgery right now. 503 00:17:01,270 --> 00:17:02,937 - How long? - Unknown. 504 00:17:02,938 --> 00:17:04,272 [MOANS] 505 00:17:04,273 --> 00:17:07,066 But ma'am, right here we have 506 00:17:07,067 --> 00:17:09,318 Dr. Shamsi's daughter, Victoria. 507 00:17:09,319 --> 00:17:12,613 She's the next best thing. 508 00:17:12,614 --> 00:17:15,616 [GROANING] 509 00:17:15,617 --> 00:17:18,911 Time for another epi. 510 00:17:18,912 --> 00:17:20,621 Dr. Robby? 511 00:17:20,622 --> 00:17:22,499 I'll be right back. 512 00:17:26,545 --> 00:17:29,130 Uh, my wife and I decided. 513 00:17:29,131 --> 00:17:30,798 We're on board with organ donation. 514 00:17:30,799 --> 00:17:33,092 Oh, I'm really glad to hear it. 515 00:17:33,093 --> 00:17:35,595 Uh, the church supports their decision. 516 00:17:35,596 --> 00:17:37,722 The OPO is sending an ambulance. 517 00:17:37,723 --> 00:17:39,600 I'll be staying with the family. 518 00:17:42,227 --> 00:17:43,269 [SIGHS] 519 00:17:43,270 --> 00:17:44,312 How's it going in there? 520 00:17:44,313 --> 00:17:46,647 Oh, not good. Not good. 521 00:17:46,648 --> 00:17:48,024 - Robby. - Yeah? 522 00:17:48,025 --> 00:17:49,609 For the little girl in Trauma One, 523 00:17:49,610 --> 00:17:52,487 this is grandmother Frances and sister Bella. 524 00:17:52,488 --> 00:17:53,988 Hi, I'm Dr. Robinavitch. 525 00:17:53,989 --> 00:17:55,490 How is she? 526 00:17:55,491 --> 00:17:56,866 Um... 527 00:17:56,867 --> 00:17:58,659 Bella, would you like to color? 528 00:17:58,660 --> 00:17:59,786 Maybe get a snack? 529 00:17:59,787 --> 00:18:01,329 Yes, please. 530 00:18:01,330 --> 00:18:02,830 My name is Kiara. 531 00:18:02,831 --> 00:18:04,499 Let's find you some crayons. 532 00:18:04,500 --> 00:18:05,833 I like to draw. 533 00:18:05,834 --> 00:18:06,834 Let's do it. 534 00:18:06,835 --> 00:18:08,504 Come on. 535 00:18:10,506 --> 00:18:12,715 They are still doing CPR. 536 00:18:12,716 --> 00:18:13,841 Can I please see her? 537 00:18:13,842 --> 00:18:15,885 Yes, of course. 538 00:18:15,886 --> 00:18:17,220 Got Grandma coming in. 539 00:18:17,221 --> 00:18:19,097 You can sit right by the bedside. 540 00:18:19,098 --> 00:18:20,306 Ready to switch? 541 00:18:20,307 --> 00:18:22,642 Go. 542 00:18:22,643 --> 00:18:25,978 Here you go, ma'am. 543 00:18:25,979 --> 00:18:27,188 You can hold her hand. 544 00:18:27,189 --> 00:18:28,523 She wasn't breathing, 545 00:18:28,524 --> 00:18:29,982 so the medics put a tube in her throat. 546 00:18:29,983 --> 00:18:31,192 She's so cold. 547 00:18:31,193 --> 00:18:32,610 We're warming her up. 548 00:18:32,611 --> 00:18:33,986 That way, she'll have a better chance 549 00:18:33,987 --> 00:18:36,364 to respond to the medicines. 550 00:18:36,365 --> 00:18:39,617 They moved a bench next to the pool fence 551 00:18:39,618 --> 00:18:42,286 so they could go over, 552 00:18:42,287 --> 00:18:44,789 because their soccer ball went in the water. 553 00:18:44,790 --> 00:18:47,208 Amber couldn't make it out of the deep end. 554 00:18:47,209 --> 00:18:48,709 The gate was locked. 555 00:18:48,710 --> 00:18:49,836 I was vacuuming. 556 00:18:49,837 --> 00:18:51,671 I didn't hear them. 557 00:18:51,672 --> 00:18:54,758 [SNIFFLES, SIGHS] 558 00:18:55,968 --> 00:18:57,760 My mercury level is 94? 559 00:18:57,761 --> 00:19:00,096 That's high enough to cause all your symptoms... 560 00:19:00,097 --> 00:19:03,724 insomnia, tremors, imbalance, psychosis. 561 00:19:03,725 --> 00:19:05,893 From a stupid face cream? 562 00:19:05,894 --> 00:19:07,728 We're going to start chelation therapy. 563 00:19:07,729 --> 00:19:10,106 It's a medication that binds with the mercury 564 00:19:10,107 --> 00:19:11,941 and helps your body excrete it. 565 00:19:11,942 --> 00:19:13,860 And then I'll be back to normal? 566 00:19:13,861 --> 00:19:15,403 I don't know. 567 00:19:15,404 --> 00:19:17,405 Are any of us normal? 568 00:19:17,406 --> 00:19:19,240 Where's my phone? 569 00:19:19,241 --> 00:19:20,867 They locked it away with all your valuables. 570 00:19:20,868 --> 00:19:22,076 I... I need my phone. 571 00:19:22,077 --> 00:19:23,578 OK. 572 00:19:23,579 --> 00:19:25,037 But when you post, you have to tell everyone 573 00:19:25,038 --> 00:19:26,873 - not to use the cream. - Definitely. 574 00:19:26,874 --> 00:19:27,915 Can I borrow your phone? 575 00:19:27,916 --> 00:19:29,417 Just the camera. 576 00:19:29,418 --> 00:19:31,002 I was wearing a wig when I left my apartment 577 00:19:31,003 --> 00:19:32,753 and I had a wig when I came in, right? 578 00:19:32,754 --> 00:19:34,673 Not when you came in. 579 00:19:36,300 --> 00:19:38,468 Oh my God. 580 00:19:40,012 --> 00:19:42,181 I look like shit. 581 00:19:48,270 --> 00:19:50,062 - How is he doing? - Stable. 582 00:19:50,063 --> 00:19:52,106 Scheduled for a new pacer tomorrow with cardiology. 583 00:19:52,107 --> 00:19:53,816 - Great. - Robby. 584 00:19:53,817 --> 00:19:55,818 Parents of T1. 585 00:19:55,819 --> 00:19:56,944 This is Dr. Robby. 586 00:19:56,945 --> 00:19:58,404 Where's Amber? Is she OK? 587 00:19:58,405 --> 00:19:59,780 What have you heard? 588 00:19:59,781 --> 00:20:01,616 That she got pulled from the pool. 589 00:20:01,617 --> 00:20:02,950 She wasn't breathing, 590 00:20:02,951 --> 00:20:04,619 so we're doing that for her now. 591 00:20:04,620 --> 00:20:06,329 And we're trying to get her heart started again. 592 00:20:06,330 --> 00:20:08,581 Wait, her heart stopped? 593 00:20:08,582 --> 00:20:09,832 I have to be with her. 594 00:20:09,833 --> 00:20:11,125 Of course. 595 00:20:11,126 --> 00:20:12,418 There are a lot of people in here 596 00:20:12,419 --> 00:20:13,794 right now trying to help her. 597 00:20:13,795 --> 00:20:15,922 We understand. 598 00:20:15,923 --> 00:20:16,923 Amber. 599 00:20:16,924 --> 00:20:18,966 Oh my God, Amber! 600 00:20:18,967 --> 00:20:20,635 I'm here. I love you. 601 00:20:20,636 --> 00:20:21,677 I love you so much. 602 00:20:21,678 --> 00:20:23,262 Gina, I am so sorry. 603 00:20:23,263 --> 00:20:24,430 Where's Bella? 604 00:20:24,431 --> 00:20:26,057 She's with our social worker. 605 00:20:26,058 --> 00:20:27,767 Oh, I should be with her. 606 00:20:27,768 --> 00:20:28,768 I'll go with you, Mom. 607 00:20:28,769 --> 00:20:30,228 I'll be right back. 608 00:20:30,229 --> 00:20:33,064 OK. Come on. She's just down the hall. 609 00:20:33,065 --> 00:20:36,817 - Hang on. We got it. - Oh. 610 00:20:36,818 --> 00:20:38,362 [SOBS] 611 00:20:40,364 --> 00:20:41,322 Rhythm check. 612 00:20:41,323 --> 00:20:42,990 Hold compressions. 613 00:20:42,991 --> 00:20:45,284 [MACHINERY FLATLINES] 614 00:20:45,285 --> 00:20:46,285 Asystole. 615 00:20:46,286 --> 00:20:49,121 Resume compressions. 616 00:20:49,122 --> 00:20:50,498 Three minutes since the last epi. 617 00:20:50,499 --> 00:20:51,582 Push another. 618 00:20:51,583 --> 00:20:53,167 Did you shock the heart? 619 00:20:53,168 --> 00:20:54,627 Uh, no. 620 00:20:54,628 --> 00:20:56,337 Why didn't you shock the heart? 621 00:20:56,338 --> 00:20:58,130 We've got to save her. You've got to shock the heart. 622 00:20:58,131 --> 00:20:59,507 Heart rhythm right now is flatlining. 623 00:20:59,508 --> 00:21:01,300 That's not treatable with a shock. 624 00:21:01,301 --> 00:21:02,635 We're trying to get the rhythm to change to something 625 00:21:02,636 --> 00:21:04,178 we can shock by warming her up. 626 00:21:04,179 --> 00:21:06,055 OK. So we've got to warm up. 627 00:21:06,056 --> 00:21:07,515 You've got to get some more blankets in here or something. 628 00:21:07,516 --> 00:21:08,683 We are giving her warm IV fluids, 629 00:21:08,684 --> 00:21:10,184 and you can feel these blue pads. 630 00:21:10,185 --> 00:21:11,477 They have warm water running through them 631 00:21:11,478 --> 00:21:12,980 like a hot tub. 632 00:21:17,609 --> 00:21:20,194 Are you sure you're doing everything? 633 00:21:20,195 --> 00:21:22,738 Yes, we are. 634 00:21:22,739 --> 00:21:25,491 [SNIFFLES] 635 00:21:25,492 --> 00:21:28,869 Amber, honey, I'm here. 636 00:21:28,870 --> 00:21:30,496 It's going to be OK. 637 00:21:30,497 --> 00:21:34,709 I promise you, everything's going to be OK. 638 00:21:34,710 --> 00:21:36,377 I can't take much longer! 639 00:21:36,378 --> 00:21:38,838 I've got Dr. Shamsi on speakerphone from the OR. 640 00:21:38,839 --> 00:21:40,881 Eileen, how soon can you get here? 641 00:21:40,882 --> 00:21:42,383 I'm finishing a lap chole. 642 00:21:42,384 --> 00:21:43,384 Shouldn't be long. 643 00:21:43,385 --> 00:21:45,052 Your daughter is here. 644 00:21:45,053 --> 00:21:47,013 Hi, honey. 645 00:21:47,014 --> 00:21:48,889 Minimal relief with two of Dilaudid. 646 00:21:48,890 --> 00:21:50,349 She needs four. 647 00:21:50,350 --> 00:21:51,726 That's what I've been telling them! 648 00:21:51,727 --> 00:21:53,185 We're titrating. 649 00:21:53,186 --> 00:21:54,729 We didn't want her to stop breathing. 650 00:21:54,730 --> 00:21:56,689 - Is Dr. Garcia with you? - Right here. 651 00:21:56,690 --> 00:21:57,690 How's the exam? 652 00:21:57,691 --> 00:21:59,066 Rigidity with guarding. 653 00:21:59,067 --> 00:22:00,901 Sounds like peritonitis. 654 00:22:00,902 --> 00:22:03,362 Two sets of blood cultures and 3.375 of Zosyn. 655 00:22:03,363 --> 00:22:05,573 Make sure she's next in line for a CT scan. 656 00:22:05,574 --> 00:22:06,866 Bump everyone else. 657 00:22:06,867 --> 00:22:08,242 Do you understand? Victoria? 658 00:22:08,243 --> 00:22:09,910 - Got it. - See you soon. 659 00:22:09,911 --> 00:22:10,911 Thank you, Eileen. 660 00:22:10,912 --> 00:22:12,079 [DIAL TONE] 661 00:22:12,080 --> 00:22:13,748 Ready for some more Dilaudid? 662 00:22:13,749 --> 00:22:15,416 God, yes. 663 00:22:15,417 --> 00:22:16,542 Victoria will make sure all of Dr. Shamsi's 664 00:22:16,543 --> 00:22:17,752 orders are followed. 665 00:22:17,753 --> 00:22:18,794 Call if you need us. 666 00:22:18,795 --> 00:22:21,047 Yeah. 667 00:22:21,048 --> 00:22:23,966 Great move bringing in Javadi. 668 00:22:23,967 --> 00:22:27,428 Is this patient payback for dropping the scalpel? 669 00:22:27,429 --> 00:22:29,597 Look at the bright side... if she goes to the OR for perf, 670 00:22:29,598 --> 00:22:30,681 you can scrub in. 671 00:22:30,682 --> 00:22:32,433 I'll coach you. 672 00:22:32,434 --> 00:22:33,851 You'll make a brilliant first impression on Dr. Shamsi. 673 00:22:33,852 --> 00:22:36,562 - Really? You'd do that? - Mm-hmm. 674 00:22:36,563 --> 00:22:38,356 Thanks. 675 00:22:38,357 --> 00:22:43,611 I, um... I have something unusual to ask. 676 00:22:43,612 --> 00:22:45,696 OK. 677 00:22:45,697 --> 00:22:48,115 I've been on two cases with Langdon, 678 00:22:48,116 --> 00:22:50,534 and there have been irregularities 679 00:22:50,535 --> 00:22:53,120 with benzos... Lorazepam with a seizure, 680 00:22:53,121 --> 00:22:54,747 Librium with an alcoholic. 681 00:22:54,748 --> 00:22:55,790 And? 682 00:22:55,791 --> 00:22:58,250 And I'm concerned. 683 00:22:58,251 --> 00:23:00,252 Concerned about what? 684 00:23:00,253 --> 00:23:04,340 [SIGHS] That he could be stealing. 685 00:23:04,341 --> 00:23:05,633 Whoa, whoa, whoa. 686 00:23:05,634 --> 00:23:07,301 I insult the shit out of Langdon, 687 00:23:07,302 --> 00:23:08,969 but he's a great doctor. 688 00:23:08,970 --> 00:23:10,846 I've never seen him impaired. 689 00:23:10,847 --> 00:23:12,681 What do I do? 690 00:23:12,682 --> 00:23:14,809 You've been here for, what, seven hours? 691 00:23:14,810 --> 00:23:16,686 Just do your job. 692 00:23:19,022 --> 00:23:20,732 [SCOFFS] 693 00:23:24,444 --> 00:23:27,072 [SIGHS] 694 00:23:30,367 --> 00:23:32,284 Kind of a weird vibe out here. 695 00:23:32,285 --> 00:23:36,330 Yeah, pediatric drowning will do that. 696 00:23:36,331 --> 00:23:37,790 Glad I didn't end up in there. 697 00:23:37,791 --> 00:23:40,668 Yeah, you and me both. 698 00:23:40,669 --> 00:23:43,421 Uh, what's with the scarf? 699 00:23:43,422 --> 00:23:44,964 Oh, it's from the lost and found, 700 00:23:44,965 --> 00:23:46,340 for my patient in Central Eight. 701 00:23:46,341 --> 00:23:47,341 Cool. 702 00:23:47,342 --> 00:23:49,343 I'm off to North Two. 703 00:23:49,344 --> 00:23:51,262 Dysuria. 704 00:23:51,263 --> 00:23:54,682 What happened to two visitors a patient? 705 00:23:54,683 --> 00:23:56,934 It's the fentanyl overdose. 706 00:23:56,935 --> 00:23:58,769 There's going to be an honor walk. 707 00:23:58,770 --> 00:24:01,522 He's an organ donor. 708 00:24:01,523 --> 00:24:02,815 Well, see you later. 709 00:24:02,816 --> 00:24:03,984 See you. 710 00:24:12,075 --> 00:24:13,243 Myrna? 711 00:24:15,620 --> 00:24:17,164 Myrna! 712 00:24:19,082 --> 00:24:20,416 Oh, no. No, not today. 713 00:24:20,417 --> 00:24:22,543 - Myrna! - [GASPS] 714 00:24:22,544 --> 00:24:24,378 What the fuck? 715 00:24:24,379 --> 00:24:26,380 What do you think you're doing? 716 00:24:26,381 --> 00:24:29,550 I... I was just checking on you, ma'am. 717 00:24:29,551 --> 00:24:32,761 You can't even take a nap in this hellhole. 718 00:24:32,762 --> 00:24:34,180 Fuck off! 719 00:24:34,181 --> 00:24:35,307 Sorry. 720 00:24:37,058 --> 00:24:39,518 Hi, I'm Dr. McKay. 721 00:24:39,519 --> 00:24:40,728 Uh, Piper. 722 00:24:40,729 --> 00:24:41,729 Laura. 723 00:24:41,730 --> 00:24:43,314 And you guys are? 724 00:24:43,315 --> 00:24:44,356 She's my boss. 725 00:24:44,357 --> 00:24:46,025 Oh, what kind of work? 726 00:24:46,026 --> 00:24:48,027 I'm an accountant, and she's my assistant. 727 00:24:48,028 --> 00:24:50,029 Oh, cool. 728 00:24:50,030 --> 00:24:53,866 Um, Piper, are you OK with your boss being here while we talk? 729 00:24:53,867 --> 00:24:55,075 Yeah, I'm... I'm good. 730 00:24:55,076 --> 00:24:56,994 Are you sure? 731 00:24:56,995 --> 00:24:58,496 I'm going to be asking you some pretty personal questions. 732 00:24:58,497 --> 00:24:59,538 She doesn't mind. 733 00:24:59,539 --> 00:25:01,708 We... we have no secrets. 734 00:25:04,294 --> 00:25:05,794 OK. 735 00:25:05,795 --> 00:25:06,921 So burning with urination. 736 00:25:06,922 --> 00:25:07,922 Mm-hmm. 737 00:25:07,923 --> 00:25:09,048 When did that start? 738 00:25:09,049 --> 00:25:11,133 About two days ago. 739 00:25:11,134 --> 00:25:13,260 Why don't we let Piper answer the questions? 740 00:25:13,261 --> 00:25:16,014 I'm sorry, it's just, we've been waiting so long. 741 00:25:18,475 --> 00:25:19,475 About two days ago. 742 00:25:19,476 --> 00:25:21,769 Any blood in the urine? 743 00:25:21,770 --> 00:25:23,270 I don't think so. 744 00:25:23,271 --> 00:25:25,607 No, she would have definitely noticed that. 745 00:25:27,234 --> 00:25:28,984 OK. 746 00:25:28,985 --> 00:25:30,736 I'm going to get you a gown and I'll be right back, OK? 747 00:25:30,737 --> 00:25:31,863 OK. 748 00:25:35,784 --> 00:25:37,117 [GROANS] 749 00:25:37,118 --> 00:25:39,119 Any change with the extra Dilaudid? 750 00:25:39,120 --> 00:25:40,579 Not really. 751 00:25:40,580 --> 00:25:42,249 The pain is still there. 752 00:25:44,459 --> 00:25:45,459 [GROANING] 753 00:25:45,460 --> 00:25:49,129 Sorry. Sorry. 754 00:25:49,130 --> 00:25:52,633 Just to review, no fever, no vomiting, 755 00:25:52,634 --> 00:25:55,052 no diarrhea, no constipation. 756 00:25:55,053 --> 00:25:56,637 Correct. 757 00:25:56,638 --> 00:25:59,306 When exactly did the pain start? 758 00:25:59,307 --> 00:26:03,477 10:15 this morning, all of a sudden. 759 00:26:03,478 --> 00:26:04,812 That's very strange. 760 00:26:04,813 --> 00:26:06,231 I agree. 761 00:26:08,358 --> 00:26:10,651 Will you tell me everything you did this morning? 762 00:26:10,652 --> 00:26:12,152 Took a shower. 763 00:26:12,153 --> 00:26:17,324 I had breakfast, some coffee, toast with jam. 764 00:26:17,325 --> 00:26:18,867 Yard work. 765 00:26:18,868 --> 00:26:20,661 Moved some firewood. 766 00:26:20,662 --> 00:26:23,831 Did the pain start before or after the firewood? 767 00:26:23,832 --> 00:26:25,874 A little bit after. 768 00:26:25,875 --> 00:26:27,459 I might have got a splinter in my foot. 769 00:26:27,460 --> 00:26:28,711 I wasn't wearing socks. 770 00:26:28,712 --> 00:26:34,341 [GROANING] Other one. 771 00:26:34,342 --> 00:26:38,013 [MACHINERY BEEPING] 772 00:26:40,265 --> 00:26:43,267 Two small puncture wounds, one millimeter apart. 773 00:26:43,268 --> 00:26:48,022 [GROANS] Two splinters? 774 00:26:48,023 --> 00:26:49,815 Whoa. 775 00:26:49,816 --> 00:26:51,985 What? 776 00:26:53,194 --> 00:26:55,195 There's a dead black widow spider in your shoe. 777 00:26:55,196 --> 00:26:57,031 [GASPS] You're shitting me. 778 00:26:57,032 --> 00:26:58,532 Red hourglass marking. 779 00:26:58,533 --> 00:27:00,367 We need IV diazepam. Start with five. 780 00:27:00,368 --> 00:27:01,702 Might need 10. 781 00:27:01,703 --> 00:27:04,831 [GROANING] 782 00:27:06,416 --> 00:27:09,209 What does a spider bite have to do with my Crohn's disease? 783 00:27:09,210 --> 00:27:11,086 Oh, nothing. 784 00:27:11,087 --> 00:27:13,422 Um, black widow venom can cause muscle spasms in the belly. 785 00:27:13,423 --> 00:27:16,383 People have had surgery thinking it was appendicitis. 786 00:27:16,384 --> 00:27:18,093 Hi, Dolores. 787 00:27:18,094 --> 00:27:19,845 Why didn't you get her to CT yet? 788 00:27:19,846 --> 00:27:21,388 I... I don't think she needs it. 789 00:27:21,389 --> 00:27:23,223 The abdomen is rigid. She's perfed. 790 00:27:23,224 --> 00:27:24,224 Maybe not. 791 00:27:24,225 --> 00:27:25,559 What are you giving? 792 00:27:25,560 --> 00:27:27,061 - Diazepam. - I didn't order that. 793 00:27:27,062 --> 00:27:28,354 I did. 794 00:27:28,355 --> 00:27:29,730 She has a rigid abdomen 795 00:27:29,731 --> 00:27:30,939 but no other GI signs or symptoms. 796 00:27:30,940 --> 00:27:32,775 It didn't make any sense. 797 00:27:32,776 --> 00:27:34,860 There's a black widow spider and a bite mark on the foot. 798 00:27:34,861 --> 00:27:38,072 The venom is causing spasm of the abdominal wall musculature. 799 00:27:38,073 --> 00:27:41,075 Whatever you guys gave me, it's working. 800 00:27:41,076 --> 00:27:42,076 Possibly. 801 00:27:42,077 --> 00:27:46,538 No, definitely. 802 00:27:46,539 --> 00:27:48,708 I'm much better. 803 00:27:54,089 --> 00:27:55,005 Take a deep breath. 804 00:27:55,006 --> 00:27:58,093 [BREATHING DEEPLY] 805 00:27:59,636 --> 00:28:01,178 Good, good. 806 00:28:01,179 --> 00:28:02,680 Are you from Pittsburgh? 807 00:28:02,681 --> 00:28:04,848 Uh, two hours north. 808 00:28:04,849 --> 00:28:06,266 Like, Mill Village. 809 00:28:06,267 --> 00:28:07,685 OK. 810 00:28:07,686 --> 00:28:09,228 You have any family you want to call? 811 00:28:09,229 --> 00:28:10,604 I don't have a phone. 812 00:28:10,605 --> 00:28:12,774 She can use mine if she needs to. 813 00:28:15,151 --> 00:28:17,111 OK. 814 00:28:17,112 --> 00:28:19,279 Lay down. 815 00:28:19,280 --> 00:28:22,116 [CLEARS THROAT] 816 00:28:22,117 --> 00:28:24,993 I've, uh, never heard of Mill Village. 817 00:28:24,994 --> 00:28:26,787 Yeah, nobody has. 818 00:28:26,788 --> 00:28:28,080 Population 400. 819 00:28:28,081 --> 00:28:29,248 Wow, that's small. 820 00:28:29,249 --> 00:28:30,791 Tell me about it. 821 00:28:30,792 --> 00:28:32,584 After high school, I had to get out of there. 822 00:28:32,585 --> 00:28:33,919 Mm. 823 00:28:33,920 --> 00:28:35,796 Well, you're lucky you found a job. 824 00:28:35,797 --> 00:28:37,464 Any pain around here? 825 00:28:37,465 --> 00:28:39,967 Mm-hmm, a little. 826 00:28:39,968 --> 00:28:40,968 OK. 827 00:28:40,969 --> 00:28:42,470 Sit up for me. 828 00:28:43,847 --> 00:28:44,930 All right. 829 00:28:44,931 --> 00:28:46,265 You gave us a urine specimen? 830 00:28:46,266 --> 00:28:48,308 Hours ago, in the waiting room. 831 00:28:48,309 --> 00:28:49,435 OK. 832 00:28:49,436 --> 00:28:50,894 Well, I'll find the results, 833 00:28:50,895 --> 00:28:52,563 and then you might need a pelvic exam. 834 00:28:52,564 --> 00:28:55,399 Is that really necessary? 835 00:28:55,400 --> 00:28:56,734 It could be. 836 00:28:56,735 --> 00:28:57,901 If there's no bladder infection, 837 00:28:57,902 --> 00:28:59,445 it's important to check. 838 00:28:59,446 --> 00:29:00,821 OK. 839 00:29:00,822 --> 00:29:02,406 And if we do a pelvic, Laura, 840 00:29:02,407 --> 00:29:03,949 we'll have you step outside for a minute. 841 00:29:03,950 --> 00:29:07,245 I'd prefer to stay with her, for support. 842 00:29:09,998 --> 00:29:12,167 Piper, do you want some privacy? 843 00:29:14,169 --> 00:29:15,461 No, it's cool. 844 00:29:15,462 --> 00:29:18,213 She... she can stay. 845 00:29:18,214 --> 00:29:19,924 OK. 846 00:29:21,301 --> 00:29:22,301 All right. 847 00:29:22,302 --> 00:29:23,803 I'll be back. 848 00:29:26,890 --> 00:29:29,516 Core temp is 88. 849 00:29:29,517 --> 00:29:31,310 Is... is that good? 850 00:29:31,311 --> 00:29:33,979 It's up from 85 on her arrival, 851 00:29:33,980 --> 00:29:36,523 so we're headed in the right direction. 852 00:29:36,524 --> 00:29:37,858 [BREATHES DEEPLY] 853 00:29:37,859 --> 00:29:40,027 You hear that, Amber? 854 00:29:40,028 --> 00:29:41,195 It's better. 855 00:29:41,196 --> 00:29:43,531 You're getting better. 856 00:29:45,950 --> 00:29:47,367 I need to step out for a second. 857 00:29:47,368 --> 00:29:49,703 You're in good hands. 858 00:29:49,704 --> 00:29:52,290 Come find me when it's over 90. 859 00:29:54,584 --> 00:29:57,629 [SIGHS] 860 00:29:59,881 --> 00:30:01,715 Parents are going to need the family room. 861 00:30:01,716 --> 00:30:02,967 It's available now. 862 00:30:05,720 --> 00:30:07,721 Last rites for Nick. 863 00:30:07,722 --> 00:30:09,223 Just one of those days. 864 00:30:09,224 --> 00:30:10,224 Yeah. 865 00:30:10,225 --> 00:30:11,642 Anyone else dying? 866 00:30:11,643 --> 00:30:12,977 Not at the moment. 867 00:30:15,647 --> 00:30:17,607 What the hell is that? 868 00:30:19,859 --> 00:30:22,194 You asked for better patient satisfaction scores. 869 00:30:22,195 --> 00:30:23,195 [SCOFFS] 870 00:30:23,196 --> 00:30:24,446 What do you want, man? 871 00:30:24,447 --> 00:30:25,697 [LAUGHS] Oh, jeez. 872 00:30:25,698 --> 00:30:27,032 Excuse me, Dr. Robby. 873 00:30:27,033 --> 00:30:28,700 This is Eli, son of Willie Alexander. 874 00:30:28,701 --> 00:30:30,077 - Hey, nice to meet you. - Likewise. 875 00:30:30,078 --> 00:30:31,745 - How's he doing? - He's doing better. 876 00:30:31,746 --> 00:30:32,913 He's going to need to stay with us, 877 00:30:32,914 --> 00:30:34,289 though, for a new pacemaker. 878 00:30:34,290 --> 00:30:35,749 He got a new one at Presby 879 00:30:35,750 --> 00:30:37,417 about, uh, a year ago. 880 00:30:37,418 --> 00:30:38,961 They said it'd be good for 10 years. 881 00:30:38,962 --> 00:30:41,296 Yes, but the wires separated from the box. 882 00:30:41,297 --> 00:30:43,298 It happens sometimes. 883 00:30:43,299 --> 00:30:44,466 Can he have a visitor? 884 00:30:44,467 --> 00:30:46,927 Of course. Right this way. 885 00:30:46,928 --> 00:30:49,096 Hey, Eli, what did your dad do for a living? 886 00:30:49,097 --> 00:30:52,349 Uh, postal worker, 40 years. 887 00:30:52,350 --> 00:30:54,601 Did he ever do any volunteer work at the hospital? 888 00:30:54,602 --> 00:30:56,061 No. 889 00:30:56,062 --> 00:30:57,896 But when he was a kid, he was a medic 890 00:30:57,897 --> 00:30:59,899 for the Freedom House Ambulance Service. 891 00:31:01,985 --> 00:31:03,193 That's incredible. 892 00:31:03,194 --> 00:31:05,028 Uh, I will be in as soon as I can. 893 00:31:05,029 --> 00:31:06,530 Thank you. 894 00:31:06,531 --> 00:31:08,574 That guy's a legend. 895 00:31:08,575 --> 00:31:10,117 I know. 896 00:31:10,118 --> 00:31:11,243 Sorry, can I get your help with something? 897 00:31:11,244 --> 00:31:12,703 Yeah. 898 00:31:12,704 --> 00:31:15,080 Um, 18-year-old woman with dysuria, 899 00:31:15,081 --> 00:31:17,374 moved here two months ago from rural Pennsylvania. 900 00:31:17,375 --> 00:31:19,167 She's with her female boss, 901 00:31:19,168 --> 00:31:22,671 who's very controlling and answers questions for her 902 00:31:22,672 --> 00:31:25,799 and won't leave her side for anything, even a pelvic exam. 903 00:31:25,800 --> 00:31:28,260 And you're thinking? 904 00:31:28,261 --> 00:31:30,679 - Red flags for trafficking. - Sounds like it. 905 00:31:30,680 --> 00:31:32,306 I need to take a sexual history 906 00:31:32,307 --> 00:31:33,974 and do a pelvic in private. 907 00:31:33,975 --> 00:31:36,101 She's not going to talk unless we separate them. 908 00:31:36,102 --> 00:31:37,854 That we can do. Come on. 909 00:31:41,274 --> 00:31:44,192 That looks like ST elevation. 910 00:31:44,193 --> 00:31:45,944 That could be bad. 911 00:31:45,945 --> 00:31:47,654 Oh, no. 912 00:31:47,655 --> 00:31:50,073 That's just because we're pacing your right ventricle. 913 00:31:50,074 --> 00:31:51,575 Willie, I'm impressed. 914 00:31:51,576 --> 00:31:52,951 After all these years, you still remember 915 00:31:52,952 --> 00:31:54,620 your medical training. 916 00:31:54,621 --> 00:31:56,079 He couldn't tell you what he had for breakfast. 917 00:31:56,080 --> 00:31:58,415 - [SCOFFS] - It's all right. 918 00:31:58,416 --> 00:32:00,500 I remember what's important. 919 00:32:00,501 --> 00:32:02,169 Like the Freedom House. 920 00:32:02,170 --> 00:32:03,670 What's that? 921 00:32:03,671 --> 00:32:04,755 A damn shame. 922 00:32:04,756 --> 00:32:06,256 That's your history. 923 00:32:06,257 --> 00:32:07,674 Dad, they're busy. 924 00:32:07,675 --> 00:32:09,968 Back in the '60s, no 911, 925 00:32:09,969 --> 00:32:11,678 no ambulances. 926 00:32:11,679 --> 00:32:13,472 All we had was police paddy wagons 927 00:32:13,473 --> 00:32:17,184 that took you to the hospital, if you were lucky. 928 00:32:17,185 --> 00:32:20,520 Then this doc from Pitt, Dr. Safar, 929 00:32:20,521 --> 00:32:22,898 he got some money and trained us up. 930 00:32:22,899 --> 00:32:25,025 Well, you must have been a good student. 931 00:32:25,026 --> 00:32:26,526 Hell, no. 932 00:32:26,527 --> 00:32:28,403 I was a knucklehead. 933 00:32:28,404 --> 00:32:32,032 Smoked a lot of weed, dropped out of high school. 934 00:32:32,033 --> 00:32:34,701 But Freedom House trained me up. 935 00:32:34,702 --> 00:32:36,370 Saved my life. 936 00:32:36,371 --> 00:32:38,538 What are you doing there, Willie? 937 00:32:38,539 --> 00:32:39,998 Nothing. 938 00:32:39,999 --> 00:32:41,917 You're moving your old pacemaker. 939 00:32:41,918 --> 00:32:43,043 Diagnosis made. 940 00:32:43,044 --> 00:32:44,044 What? 941 00:32:44,045 --> 00:32:45,921 Twiddler's syndrome. 942 00:32:45,922 --> 00:32:48,256 Spinning that thing around caused the wires to break off. 943 00:32:48,257 --> 00:32:49,925 Oh, Dad. 944 00:32:49,926 --> 00:32:51,510 - I didn't mean to. - It's OK. 945 00:32:51,511 --> 00:32:52,886 We'll put the new one in a little deeper. 946 00:32:52,887 --> 00:32:54,054 Won't happen again. 947 00:32:54,055 --> 00:32:56,223 [SIGHS] 948 00:32:56,224 --> 00:32:59,226 Some of your tests are concerning for a kidney stone. 949 00:32:59,227 --> 00:33:00,894 Wouldn't that give more pain? 950 00:33:00,895 --> 00:33:02,479 Not always. 951 00:33:02,480 --> 00:33:03,897 If it's a urine infection with a stone, 952 00:33:03,898 --> 00:33:04,898 you'll need to stay in the hospital 953 00:33:04,899 --> 00:33:07,401 for some IV antibiotics. 954 00:33:07,402 --> 00:33:08,652 What do we have to do? 955 00:33:08,653 --> 00:33:10,570 A CT scan of your kidneys. 956 00:33:10,571 --> 00:33:12,197 How long is that going to take? 957 00:33:12,198 --> 00:33:13,824 - They can do it right now. - Great. 958 00:33:13,825 --> 00:33:15,575 - Let's go. - I'm... I'm sorry. 959 00:33:15,576 --> 00:33:16,994 There's radiation. 960 00:33:16,995 --> 00:33:18,578 You won't be able to stay with her. 961 00:33:18,579 --> 00:33:20,998 But we'll be back as soon as the scan is done. 962 00:33:20,999 --> 00:33:22,416 You're good with this, right? 963 00:33:22,417 --> 00:33:25,377 Yeah, I'll be fine. 964 00:33:25,378 --> 00:33:27,879 We'll see you in a minute. 965 00:33:27,880 --> 00:33:29,589 So Laura's an accountant? 966 00:33:29,590 --> 00:33:31,049 - Uh-huh. - Oh. 967 00:33:31,050 --> 00:33:33,260 How'd you get the job? 968 00:33:33,261 --> 00:33:34,386 - Online ad. - Yeah. 969 00:33:34,387 --> 00:33:36,221 Zoom interview. 970 00:33:36,222 --> 00:33:37,889 You must be good at math. 971 00:33:37,890 --> 00:33:39,975 Not really. 972 00:33:39,976 --> 00:33:42,227 So what do you do for work? 973 00:33:42,228 --> 00:33:46,106 I answer the phones, I make appointments, I... 974 00:33:46,107 --> 00:33:48,233 I bring deposits to the bank. 975 00:33:48,234 --> 00:33:50,986 You work with spreadsheets? 976 00:33:50,987 --> 00:33:53,905 She hasn't taught me that yet. 977 00:33:53,906 --> 00:33:56,033 This is where you do the CT? 978 00:33:56,034 --> 00:33:58,285 Uh, no. 979 00:33:58,286 --> 00:34:02,539 We wanted to give you some privacy for your pelvic exam. 980 00:34:02,540 --> 00:34:04,207 Laura's going to be so pissed. 981 00:34:04,208 --> 00:34:05,792 Why would she be mad? 982 00:34:05,793 --> 00:34:07,544 Piper, do you have any concerns 983 00:34:07,545 --> 00:34:09,796 you want to talk about? 984 00:34:09,797 --> 00:34:13,425 No, just the pain when I pee. 985 00:34:13,426 --> 00:34:17,095 Anything you need to tell us about your job or your boss? 986 00:34:17,096 --> 00:34:18,138 No. 987 00:34:18,139 --> 00:34:20,975 No, it's all really great. 988 00:34:25,271 --> 00:34:27,147 OK. 989 00:34:27,148 --> 00:34:29,149 Temp is up to 91. 990 00:34:29,150 --> 00:34:30,817 She's so much warmer. 991 00:34:30,818 --> 00:34:32,819 Is it working? 992 00:34:32,820 --> 00:34:35,155 Can you shock the heart now? 993 00:34:35,156 --> 00:34:37,991 91 is warm enough for her heart to respond. 994 00:34:37,992 --> 00:34:39,034 Hold compressions. 995 00:34:39,035 --> 00:34:41,203 [MACHINERY FLATLINES] 996 00:34:41,204 --> 00:34:42,788 Asystole. 997 00:34:42,789 --> 00:34:45,332 Resuming compressions. 998 00:34:45,333 --> 00:34:46,792 Got the potassium level back. 999 00:34:46,793 --> 00:34:48,794 12.2. 1000 00:34:48,795 --> 00:34:51,631 [MACHINERY BEEPING] 1001 00:35:03,684 --> 00:35:06,269 No one has ever survived a cardiac arrest 1002 00:35:06,270 --> 00:35:08,606 with a potassium over 11. 1003 00:35:10,274 --> 00:35:14,820 There is absolutely no chance of recovery. 1004 00:35:14,821 --> 00:35:17,697 I am so sorry. 1005 00:35:17,698 --> 00:35:19,199 Amber has died. 1006 00:35:19,200 --> 00:35:21,701 [SOBBING] No. 1007 00:35:21,702 --> 00:35:23,537 No, no, no, no, no, no, no. 1008 00:35:23,538 --> 00:35:24,538 It's not happening. 1009 00:35:24,539 --> 00:35:25,622 No, no, no! 1010 00:35:25,623 --> 00:35:29,167 No! No! 1011 00:35:29,168 --> 00:35:30,377 I'm sorry. 1012 00:35:30,378 --> 00:35:32,712 I am so... 1013 00:35:32,713 --> 00:35:36,258 Before we stop, do you think her sister 1014 00:35:36,259 --> 00:35:38,760 would like a chance to say goodbye? 1015 00:35:38,761 --> 00:35:40,220 No. 1016 00:35:40,221 --> 00:35:43,056 Uh, Bella shouldn't see her like this. 1017 00:35:43,057 --> 00:35:44,057 OK. 1018 00:35:44,058 --> 00:35:45,559 [SOBBING] 1019 00:35:45,560 --> 00:35:47,227 You can stay in here for as long as you like. 1020 00:35:47,228 --> 00:35:48,228 Shh. 1021 00:35:48,229 --> 00:35:50,897 It's OK. It's OK. 1022 00:35:50,898 --> 00:35:54,109 We are going to stop now. 1023 00:35:54,110 --> 00:35:57,904 [BOTH SOBBING] 1024 00:35:57,905 --> 00:36:01,741 Resuscitation efforts discontinued at 14:51. 1025 00:36:01,742 --> 00:36:04,369 [MACHINERY FLATLINING] 1026 00:36:04,370 --> 00:36:07,497 Oh, sweetheart, I'm sorry. 1027 00:36:07,498 --> 00:36:10,585 [BOTH SOBBING] 1028 00:36:13,421 --> 00:36:14,754 OK, that's it. 1029 00:36:14,755 --> 00:36:16,756 We're done. 1030 00:36:16,757 --> 00:36:18,050 Let me get the gurney up. 1031 00:36:23,598 --> 00:36:24,931 Is everything OK? 1032 00:36:24,932 --> 00:36:26,099 Yeah. 1033 00:36:26,100 --> 00:36:27,184 There's no infection 1034 00:36:27,185 --> 00:36:28,685 in your uterus or ovaries. 1035 00:36:28,686 --> 00:36:30,937 OK, that's... that's good. 1036 00:36:30,938 --> 00:36:34,608 But your urine test was positive for chlamydia. 1037 00:36:34,609 --> 00:36:36,067 Shit. 1038 00:36:36,068 --> 00:36:38,778 It's a sexually transmitted infection. 1039 00:36:38,779 --> 00:36:41,781 Any idea how that happened? 1040 00:36:41,782 --> 00:36:43,909 Yeah, my cheating 1041 00:36:43,910 --> 00:36:46,411 piece of shit ex-boyfriend back home. 1042 00:36:46,412 --> 00:36:48,788 But we broke up before I moved. 1043 00:36:48,789 --> 00:36:51,458 You need antibiotics twice a day for 10 days. 1044 00:36:51,459 --> 00:36:52,584 That'll clear it up. 1045 00:36:52,585 --> 00:36:54,127 And he'll need treatment too. 1046 00:36:54,128 --> 00:36:55,837 If I don't tell him, is there a chance 1047 00:36:55,838 --> 00:36:57,797 his dick will fall off? 1048 00:36:57,798 --> 00:37:00,467 If you don't tell him, a public health nurse will. 1049 00:37:00,468 --> 00:37:02,302 You should also test for HIV, syphilis, 1050 00:37:02,303 --> 00:37:03,970 gonorrhea, and hepatitis. 1051 00:37:03,971 --> 00:37:05,305 OK. 1052 00:37:05,306 --> 00:37:06,556 Any other sexual partners 1053 00:37:06,557 --> 00:37:09,100 in the last few months? 1054 00:37:09,101 --> 00:37:10,560 Not really. 1055 00:37:10,561 --> 00:37:11,645 Use condoms? 1056 00:37:11,646 --> 00:37:13,146 Most of the time. 1057 00:37:13,147 --> 00:37:14,481 It's important to use them all the time. 1058 00:37:14,482 --> 00:37:15,899 Yeah, but if I forget, 1059 00:37:15,900 --> 00:37:17,067 you can just give me a shot, right? 1060 00:37:17,068 --> 00:37:18,235 Not for some infections. 1061 00:37:18,236 --> 00:37:20,070 This is serious. 1062 00:37:20,071 --> 00:37:21,112 Birth control? 1063 00:37:21,113 --> 00:37:22,155 Norplant. 1064 00:37:22,156 --> 00:37:25,492 It's good for five years. 1065 00:37:25,493 --> 00:37:29,412 Piper, we have a question that we ask everyone. 1066 00:37:29,413 --> 00:37:31,748 Sometimes people are pressured 1067 00:37:31,749 --> 00:37:33,833 to have sex when they don't want to. 1068 00:37:33,834 --> 00:37:35,795 Does that ever happen to you? 1069 00:37:38,422 --> 00:37:40,340 No, never. 1070 00:37:40,341 --> 00:37:42,676 And when you signed in, you put down Laura 1071 00:37:42,677 --> 00:37:44,344 as your emergency contact. 1072 00:37:44,345 --> 00:37:46,388 Yeah. 1073 00:37:46,389 --> 00:37:48,807 You have the same address as Laura? 1074 00:37:48,808 --> 00:37:50,183 Yeah. 1075 00:37:50,184 --> 00:37:51,685 She's letting me use her guest room 1076 00:37:51,686 --> 00:37:53,729 until I can save up for a place of my own. 1077 00:37:55,356 --> 00:37:57,524 OK. 1078 00:37:57,525 --> 00:37:59,067 Why don't we have you lie down again? 1079 00:37:59,068 --> 00:38:00,193 What for? 1080 00:38:00,194 --> 00:38:01,569 Uh, ultrasound. 1081 00:38:01,570 --> 00:38:03,446 We're going to check your kidneys. 1082 00:38:03,447 --> 00:38:07,368 You got bumped from CT by a couple of emergency cases. 1083 00:38:22,591 --> 00:38:26,720 Bella, Dr. King and Dr. Collins are here. 1084 00:38:26,721 --> 00:38:27,887 Hi. 1085 00:38:27,888 --> 00:38:30,473 I'm coloring. 1086 00:38:30,474 --> 00:38:32,392 You're a very good artist. 1087 00:38:32,393 --> 00:38:34,186 Thanks. 1088 00:38:37,106 --> 00:38:39,899 Um, Bella? 1089 00:38:39,900 --> 00:38:41,276 Yeah? 1090 00:38:41,277 --> 00:38:43,611 What have you heard about Amber? 1091 00:38:43,612 --> 00:38:47,073 She's really sick, but the doctor and the nurse 1092 00:38:47,074 --> 00:38:50,285 is trying to make her better. 1093 00:38:50,286 --> 00:38:52,663 That must make you sad. 1094 00:38:54,582 --> 00:38:56,082 You know, I have a sister too, 1095 00:38:56,083 --> 00:38:59,210 and I don't like it when she's sick. 1096 00:38:59,211 --> 00:39:01,255 She saved me. 1097 00:39:03,424 --> 00:39:05,258 She did? 1098 00:39:05,259 --> 00:39:07,427 I fell in the pool. 1099 00:39:07,428 --> 00:39:11,182 She helped me get out, but then she couldn't get out. 1100 00:39:13,601 --> 00:39:16,228 I'm making her a card. 1101 00:39:22,026 --> 00:39:23,444 [DOOR CLOSES] 1102 00:39:27,782 --> 00:39:31,951 Freedom House took us in and trained us for 300 hours. 1103 00:39:31,952 --> 00:39:34,120 They turned out the very first medics 1104 00:39:34,121 --> 00:39:35,872 in the United States. 1105 00:39:35,873 --> 00:39:39,751 We started IVs, defibrillated, 1106 00:39:39,752 --> 00:39:42,504 intubated in the field. 1107 00:39:42,505 --> 00:39:44,506 They were the heroes of Hill District, 1108 00:39:44,507 --> 00:39:47,801 a bunch of young Black dudes saving lives every day. 1109 00:39:47,802 --> 00:39:49,010 Why'd you quit? 1110 00:39:49,011 --> 00:39:50,470 I didn't. 1111 00:39:50,471 --> 00:39:51,638 The city saw how successful it was 1112 00:39:51,639 --> 00:39:53,473 and took over the program. 1113 00:39:53,474 --> 00:39:55,308 Trained new medics. 1114 00:39:55,309 --> 00:39:56,810 All white. 1115 00:39:56,811 --> 00:39:58,436 Everything that Willie and his friends did 1116 00:39:58,437 --> 00:40:01,314 set the EMS standard for the entire country. 1117 00:40:01,315 --> 00:40:04,317 Their program created the 911 system. 1118 00:40:04,318 --> 00:40:06,152 It wasn't just us. 1119 00:40:06,153 --> 00:40:09,072 We had the best teachers. 1120 00:40:09,073 --> 00:40:12,951 Dr. Safar invented CPR. 1121 00:40:12,952 --> 00:40:16,496 Dr. Adamson, med student when I arrived. 1122 00:40:16,497 --> 00:40:20,458 But I'm telling you, boy, that guy could teach 1123 00:40:20,459 --> 00:40:23,294 like there was no tomorrow. 1124 00:40:23,295 --> 00:40:25,171 You ever hear him give a lecture? 1125 00:40:25,172 --> 00:40:26,673 Many times. 1126 00:40:26,674 --> 00:40:29,175 Every time I saved a patient, 1127 00:40:29,176 --> 00:40:30,844 it was like he was standing right here, 1128 00:40:30,845 --> 00:40:32,011 whispering in my ear, 1129 00:40:32,012 --> 00:40:34,013 telling me what to do. 1130 00:40:34,014 --> 00:40:35,306 Me too. 1131 00:40:35,307 --> 00:40:37,016 Yeah. 1132 00:40:37,017 --> 00:40:39,018 Where is he working now? 1133 00:40:39,019 --> 00:40:42,814 Dr. Adamson died a few years ago, during COVID. 1134 00:40:42,815 --> 00:40:44,566 Oh. 1135 00:40:44,567 --> 00:40:46,860 Hard to believe. 1136 00:40:46,861 --> 00:40:48,903 He was so young, so full of life. 1137 00:40:48,904 --> 00:40:50,738 A force of nature. 1138 00:40:50,739 --> 00:40:53,409 Yes, he was. 1139 00:40:57,246 --> 00:40:58,746 We're back. 1140 00:40:58,747 --> 00:41:01,749 I should be out there for the honor walk. 1141 00:41:01,750 --> 00:41:03,501 Right. 1142 00:41:03,502 --> 00:41:04,919 Hey, Mrs. Phillips. 1143 00:41:04,920 --> 00:41:06,337 Your son would like to speak with you. 1144 00:41:06,338 --> 00:41:07,338 Oh. 1145 00:41:07,339 --> 00:41:09,340 Dr. King can stay here. 1146 00:41:09,341 --> 00:41:12,178 Bella, I'll be right back. 1147 00:41:25,941 --> 00:41:28,486 I finished my card. 1148 00:41:30,070 --> 00:41:31,947 Oh. 1149 00:41:34,325 --> 00:41:35,325 It's beautiful. 1150 00:41:35,326 --> 00:41:37,077 - I love it. - Thanks. 1151 00:41:38,454 --> 00:41:41,915 Can I see Amber now? 1152 00:41:41,916 --> 00:41:45,251 Um, not quite yet. 1153 00:41:45,252 --> 00:41:46,753 What is that? 1154 00:41:46,754 --> 00:41:49,255 Oh, uh, it's from the gift shop. 1155 00:41:49,256 --> 00:41:50,924 For Amber? 1156 00:41:50,925 --> 00:41:53,927 For you and for Amber. 1157 00:41:53,928 --> 00:41:56,763 Um, but you get to name it. 1158 00:41:56,764 --> 00:41:59,474 I think her name will be Bear. 1159 00:41:59,475 --> 00:42:00,475 Bear. 1160 00:42:00,476 --> 00:42:01,976 All right. 1161 00:42:01,977 --> 00:42:05,396 Um, since you can't see Amber right now, 1162 00:42:05,397 --> 00:42:08,233 but I bet you got a lot of things to tell her, 1163 00:42:08,234 --> 00:42:09,901 Bear is going to help. 1164 00:42:09,902 --> 00:42:11,319 How? 1165 00:42:11,320 --> 00:42:14,781 Well, um, if you tell Bear 1166 00:42:14,782 --> 00:42:16,783 everything you want to tell Amber, 1167 00:42:16,784 --> 00:42:19,118 then I'll take Bear and sit her on Amber's pillow, 1168 00:42:19,119 --> 00:42:21,287 and then she'll tell her everything you said. 1169 00:42:21,288 --> 00:42:22,539 What do you think of that plan? 1170 00:42:22,540 --> 00:42:23,915 - I like it. - Yeah? 1171 00:42:23,916 --> 00:42:25,041 OK. 1172 00:42:25,042 --> 00:42:26,626 Do you want to give it a try? 1173 00:42:26,627 --> 00:42:27,753 There you go. 1174 00:42:30,381 --> 00:42:31,965 Hi, Amber. 1175 00:42:31,966 --> 00:42:33,883 It's me, Bella. 1176 00:42:33,884 --> 00:42:36,719 Thank you for saving me. 1177 00:42:36,720 --> 00:42:40,223 When you come home, I promise 1178 00:42:40,224 --> 00:42:44,310 I won't touch your toys without asking. 1179 00:42:44,311 --> 00:42:48,273 And I'll try not to fight, because you're my best friend 1180 00:42:48,274 --> 00:42:50,024 in the whole entire world. 1181 00:42:50,025 --> 00:42:51,819 I love you. 1182 00:42:56,448 --> 00:42:59,492 Amber is going to be so happy with that. 1183 00:42:59,493 --> 00:43:01,453 [BREATHES DEEPLY] 1184 00:43:03,789 --> 00:43:05,039 Hey. 1185 00:43:05,040 --> 00:43:07,500 Hey. 1186 00:43:07,501 --> 00:43:11,212 Uh, how long have you been working here? 1187 00:43:11,213 --> 00:43:12,797 32 years. 1188 00:43:12,798 --> 00:43:14,173 All in the ER? 1189 00:43:14,174 --> 00:43:15,174 Yeah. 1190 00:43:15,175 --> 00:43:16,926 Oh, man. 1191 00:43:16,927 --> 00:43:18,845 How do you do it? 1192 00:43:18,846 --> 00:43:20,805 I like taking care of everyone, 1193 00:43:20,806 --> 00:43:22,682 especially the ones who fall through the cracks. 1194 00:43:22,683 --> 00:43:24,684 They got nowhere else to go. 1195 00:43:24,685 --> 00:43:26,352 Well, you deserve a medal. 1196 00:43:26,353 --> 00:43:31,025 [CHUCKLES] Yeah, I'd settle for a raise. 1197 00:43:42,870 --> 00:43:45,538 Thank you for everything. 1198 00:43:45,539 --> 00:43:51,210 Uh...[SNIFFLES] 1199 00:43:51,211 --> 00:43:53,379 I wish they could do the surgery here. 1200 00:43:53,380 --> 00:43:55,715 Surgical teams are flying in from all over the country 1201 00:43:55,716 --> 00:43:59,052 to meet Nick at the Center for Organ Recovery. 1202 00:43:59,053 --> 00:44:00,887 We have a car and driver waiting 1203 00:44:00,888 --> 00:44:03,389 so John and Lily can follow right behind the ambulance. 1204 00:44:03,390 --> 00:44:05,391 Thank you. 1205 00:44:05,392 --> 00:44:07,978 So we won't be seeing you again? 1206 00:44:10,064 --> 00:44:12,023 If it's all right, I think a lot of us here 1207 00:44:12,024 --> 00:44:13,984 would like to attend Nick's funeral. 1208 00:44:16,278 --> 00:44:19,323 [BREATHING SHAKILY] 1209 00:44:22,451 --> 00:44:23,910 Yeah, of course. 1210 00:44:23,911 --> 00:44:25,287 [SOBS] 1211 00:44:48,435 --> 00:44:50,604 Thank you. 1212 00:44:55,109 --> 00:44:58,153 [SOBBING SOFTLY] 1213 00:45:31,854 --> 00:45:33,229 [SIREN CHIRPS] 1214 00:45:33,230 --> 00:45:36,316 [SIREN WAILING] 1215 00:45:41,697 --> 00:45:44,490 [SOLEMN MUSIC] 1216 00:45:44,491 --> 00:45:51,582 Sync and corrections by btsix www.addic7ed.com