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Sync and corrections by btsix
www.addic7ed.com
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Dr. Al?
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Dr. Al.
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Trauma's at the back door.
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Let me know when the rest
of her labs are back.
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The girlfriend hasn't been much help.
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- Is she being uncooperative?
- No, not really.
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Apparently, she's only been going out
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with the little girl Kylie's
father for a few months.
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- Where is he now?
- He's in New Castle for work.
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I left him a message to come in.
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Okay, come find me when he gets here.
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You talk to
the trauma counselor this week?
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I'm going to.
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- Promise.
- Okay, good.
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- Medics are rolling in.
- I'll be right there.
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How's our little girl
who took a stair tumble?
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I'm going to check
for internal hemorrhage
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with an ultrasound.
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- What is your gut telling you?
- Her gut?
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Yeah, it's this thing
that AI will never have.
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I don't want to think
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about what my gut is saying right now.
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Come find me when you know more.
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- Us, if you don't mind.
- I don't mind.
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Us... come find us when you know more.
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Do you want to jump on this trauma?
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I've got my hands full.
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I don't want this one
getting away from me.
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We don't know what this is yet.
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Don't go jumping to conclusions.
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I'm not jumping to anything.
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I'm just looking out for my patient.
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Uh, something I should know
about Santos?
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Very confident, not afraid
to get her hands dirty,
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strong patient advocate, fearless.
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Seems like you were suggesting
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- she jumps to conclusions.
- No, no, no, no.
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I was merely suggesting
or reminding her not to.
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- Yeah.
- Uh, 58-year-old guy.
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Tripped with a scaphoid fracture.
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Epistaxis, non-focal neuro,
but denies head trauma.
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But every time I check on him,
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his affect has drastically changed.
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My gut is telling me
something's not right.
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- What?
- Nothing.
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Your play.
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Start with a head CT.
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If normal, LP, rule out encephalitis.
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Put in your orders.
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- Has he been here before?
- No.
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Have you called the family to rule out
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- any psychiatric history?
- No, but I will.
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Do you want to jump
on this trauma in the meantime?
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- What is it?
- It's a surprise.
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Wonderful.
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Mel, you want to jump on this?
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- What is it?
- It's a surprise.
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What do you got for us, Amboy?
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Allen Billings...
Pallet of roofing tiles
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fell eight feet, hit his upper
arm with an open dislocation.
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Ouch.
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Two rounds of fent, 1 then 0.5 per kilo.
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A and O, with good vitals.
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- Mel, hold the arm steady.
- Sure.
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Uno, dos, tres.
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Mr. Billings, I'm Dr. McKay.
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And I'm Dr. Garcia from surgery.
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- And this is Dr. King.
- Hi.
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- Oh, it really hurts.
- Give us a minute.
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And we're gonna take care of that, okay?
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Any headache, chest or belly pain?
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- No, just the arm.
- Sats 99. Pulse 104.
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BP 116/78.
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What do you think, Dr. King?
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Oh, um, it is an open dislocation.
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Can you be more specific?
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I think it's inferior, yeah?
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Do you remember the name for that?
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Sounds like a Harry Potter spell.
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- I...
- Luxatio erecta.
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Correct. Check the neuro-circ.
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Sir, can you feel me touching you?
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Okay.
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- Can you wiggle your fingers?
- Yeah.
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- Good radial pulse.
- E-FAST is negative.
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- Okay, what's next, Dr. McKay?
- Ancef and gentamicin.
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Sedate for traction, countertraction.
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And he needs a CT angiogram
to rule out vascular injury.
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That sounds like a plan.
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But with an open joint,
he needs a washout
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- in the OR with ortho.
- Agreed.
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Instead of wasting time down here,
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it should be easier to reduce
under general anesthesia
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- with fewer risks.
- Possibly.
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Let's get an opinion from ortho.
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You're definitely new,
Doctor... wishful thinking.
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Ortho like to take their sweet time.
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Okay, sedation orders, Dr. McKay.
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100 of propofol. Titrate to effect.
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Be back with that.
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Excuse me.
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- How's your day going, Doc?
- Yeah, pretty good.
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Looks like your albumin's infusing.
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Oh, uh, medical students
Ogilvie and Kwon
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are gonna be working with me.
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- Hello.
- Student doctors.
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You want them to try it?
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They got to learn sometime.
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Uh, it's best if they watch
the first one.
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- I can prep and drape.
- Yeah.
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- After your albumin's in.
- That's correct.
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Uh, to prevent hypotension,
we introduce albumin
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if we anticipate more than five liters.
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Last time it was six.
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That's, like, a gallon and a half.
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Of high-octane premium.
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Okay, you need anything else, Mr. Louie?
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- No, ma'am.
- Okay.
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- Grab me when you're ready?
- Yeah.
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Whitaker, wife of your DNR
this morning is in Central 8.
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Does she know her husband died?
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Not till you tell her.
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I'll be right there.
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Uh, yeah, uh, always make sure
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your entry point is safe
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by identifying the pocket of fluid.
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That's not a pocket. That's a lake.
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Yeah, but you do not want
to hit a vein or artery
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on the way in, so make sure
you check with color Doppler.
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Huh.
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Joy?
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I can't see. I can't see anything.
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That's 'cause your eye is shut.
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I can't open it. It's glued shut.
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I was trying to put on lashes.
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Oh, my God. Am I gonna go blind?
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No, no, I'm pretty sure
this is something we can fix.
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Just take a deep breath.
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Okay, so you, uh, glued your
eye shut with what exactly?
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- Super glue.
- Okay.
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Well, is it something you typically use
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to apply your lashes?
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No, it's typically something you use
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to glue shit you break,
like coffee mugs and stuff.
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You know what I'm talking about.
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- It's... it's... it's super glue.
- Okay, okay. Yeah, got it.
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Can I just talk to Dr. J?
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She'll know what to do.
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Is that an ophthalmologist?
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No, she works here in the ER.
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Yeah, I don't think so.
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But I know what I'm doing...
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most of the time.
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For a Z-track, we pull up the skin
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before advancing
into the peritoneal space.
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- Looks good.
- Fluid's clear.
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Does that hurt as much as it looks?
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Oh, it's not too bad.
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Ogilvie, spike the bottle for me.
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What tests do we want on these fluids?
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Uh, Cell count to rule out spontaneous
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- bacterial peritonitis.
- Ding.
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What would make that diagnosis, Joy?
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Um...
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Absolute neutrophil count over 250.
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- How are we doing in here?
- They are doing great.
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I think they got this.
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Hey, Dana, can you get
Kiara down here for me?
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She isn't answering her Spectralink.
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She's not working today. It's, uh...
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I forget. I'll find out
and get 'em down here.
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What else you need?
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How about a double espresso martini?
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I like the way you think.
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Hey, Trudy, it's Dana.
What's going on up there?
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What's up, Crash?
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You mean besides
my mother driving me insane?
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Just tell her that her
efforts would be better suited
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endorsing someone like myself.
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If you're seriously thinking
of a double residency,
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let me save you the trouble...
you can't do it.
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Why? Just because you couldn't do it?
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Honestly, yes.
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Because you're a genius.
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Yes.
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What's the square root of 841?
188
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I'm not a human calculator.
189
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Social worker Dylan Easton is covering
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for Kiara this weekend.
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- They're on their way down.
- Thank you.
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Yep.
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Oh, shit.
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00:07:28,656 --> 00:07:30,740
I have a nun with conjunctivitis.
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Her swab is showing
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gram-negative intracellular diplococci.
197
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Gonorrhea?
198
00:07:35,246 --> 00:07:37,581
Come to Jesus.
199
00:07:37,582 --> 00:07:39,749
Well, the lab... the lab
must have made a mistake.
200
00:07:39,750 --> 00:07:42,127
Maybe it's an immaculate infection.
201
00:07:42,128 --> 00:07:44,045
I'll call the lab supe, clear this up.
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Tread carefully, missy.
203
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There's a nun with gonorrhea in her eye.
204
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Seriously, you guys are gonna
take this away from me?
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00:07:53,806 --> 00:07:55,724
I'm disappointed in you two.
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29.
207
00:07:57,268 --> 00:07:58,602
What?
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00:07:58,603 --> 00:08:00,937
The square root of 841.
209
00:08:00,938 --> 00:08:02,772
How we doing with Mr. Digby?
210
00:08:02,773 --> 00:08:04,608
He's in a gown in South 21.
211
00:08:04,609 --> 00:08:06,610
Is there someplace
we can get this laundered?
212
00:08:06,611 --> 00:08:08,612
Those are going
right in the incinerator.
213
00:08:08,613 --> 00:08:10,405
We'll get him a whole new wardrobe.
214
00:08:10,406 --> 00:08:12,240
- You ever use a cast saw before?
- Uh...
215
00:08:12,241 --> 00:08:14,409
Of course you haven't.
Well, today's your lucky day.
216
00:08:14,410 --> 00:08:15,911
Follow me.
217
00:08:15,912 --> 00:08:18,413
- Dr. Mohan, you got a minute?
- Yeah.
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00:08:18,414 --> 00:08:21,666
Have you met Emma?
First day. New grad RN.
219
00:08:21,667 --> 00:08:23,251
- Hi.
- Nice to meet you.
220
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Emma needs to learn cast removal.
221
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How long has the cast been on?
222
00:08:26,839 --> 00:08:28,632
Months, maybe years.
223
00:08:28,633 --> 00:08:30,593
Probably gonna want to breathe
through your mouth.
224
00:08:33,304 --> 00:08:35,430
All right, Mr. Digby.
225
00:08:35,431 --> 00:08:38,183
Dr. Mohan can cut your cast off now.
226
00:08:38,184 --> 00:08:39,851
How long's the cast been on?
227
00:08:39,852 --> 00:08:42,729
I don't know,
but it's really getting itchy.
228
00:08:42,730 --> 00:08:45,440
Okay, this cuts the cast...
229
00:08:45,441 --> 00:08:47,108
Not the skin.
230
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This should relieve the itching.
231
00:09:02,291 --> 00:09:05,127
- Get the cast spreader.
- Oh, uh...
232
00:09:10,216 --> 00:09:13,301
Thank you.
233
00:09:13,302 --> 00:09:15,053
Okay.
234
00:09:18,891 --> 00:09:20,601
Okay.
235
00:09:25,481 --> 00:09:27,649
Oh, I see you brought some friends.
236
00:09:27,650 --> 00:09:29,860
- Oh, my God, are those...
- Maggots.
237
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I'll need ethyl chloride spray
to freeze them off.
238
00:09:38,536 --> 00:09:41,330
Never saw that
in nursing school, am I right?
239
00:09:46,544 --> 00:09:49,087
Now irrigate like hell, Mel.
240
00:09:49,088 --> 00:09:50,131
Okay.
241
00:09:54,677 --> 00:09:56,803
Okay, on my count.
242
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One, two, three.
243
00:10:00,766 --> 00:10:02,767
Come on, motherfucker.
244
00:10:02,768 --> 00:10:04,686
Humeral head is not reducing.
245
00:10:04,687 --> 00:10:06,938
- Should be done in the OR.
- I am the OR.
246
00:10:06,939 --> 00:10:08,440
Okay, we're gonna get this back in
247
00:10:08,441 --> 00:10:10,358
before ortho even answers the page.
248
00:10:10,359 --> 00:10:12,944
Mel, stick four fingers
under that humeral head.
249
00:10:12,945 --> 00:10:14,279
Really?
250
00:10:14,280 --> 00:10:16,197
Yeah, get in there really, really deep.
251
00:10:16,198 --> 00:10:19,034
And when you feel the traction
and lift it above the glenoid,
252
00:10:19,035 --> 00:10:21,036
that will convert this
to an anterior dislocation,
253
00:10:21,037 --> 00:10:23,371
and it should pop right back in.
254
00:10:23,372 --> 00:10:25,206
Okay.
255
00:10:25,207 --> 00:10:26,541
Ready to go.
256
00:10:26,542 --> 00:10:29,878
One, two, three.
257
00:10:29,879 --> 00:10:31,713
Okay.
258
00:10:31,714 --> 00:10:33,965
- Ooh.
- Oh, very cool.
259
00:10:33,966 --> 00:10:36,176
Sterile saline dressing.
260
00:10:36,177 --> 00:10:38,637
- Shoulder immobilizer and CT.
- Okay.
261
00:10:38,638 --> 00:10:40,931
Guess you guys don't need me anymore.
262
00:10:43,184 --> 00:10:45,852
- You all right, Dr. King?
- Yeah.
263
00:10:45,853 --> 00:10:48,355
You don't seem all right.
264
00:10:48,356 --> 00:10:50,774
Well, my deposition is today.
265
00:10:50,775 --> 00:10:53,151
Ah, do you want to talk about it?
266
00:10:53,152 --> 00:10:54,819
I'm not allowed to.
267
00:10:54,820 --> 00:10:56,780
No, we don't have to talk
about the deposition,
268
00:10:56,781 --> 00:10:59,449
but we can talk
about how it is affecting you.
269
00:10:59,450 --> 00:11:00,867
Average emergency physician
270
00:11:00,868 --> 00:11:02,744
catches a med-mal case
every seven years.
271
00:11:02,745 --> 00:11:04,579
Nine times out of ten, the doctor wins.
272
00:11:04,580 --> 00:11:06,247
I've been sued four times myself.
273
00:11:06,248 --> 00:11:08,583
Dr. Al?
274
00:11:08,584 --> 00:11:11,253
I've never been named in a lawsuit.
275
00:11:12,838 --> 00:11:15,423
Mm, mm, mm...
276
00:11:15,424 --> 00:11:19,427
Um, but sometime...
277
00:11:21,764 --> 00:11:23,473
Sister Grace...
278
00:11:23,474 --> 00:11:25,767
this is one of my residents, Dr. Mohan.
279
00:11:25,768 --> 00:11:27,519
- Nice to meet you.
- You as well.
280
00:11:27,520 --> 00:11:29,813
I wish we could recruit as dedicated
281
00:11:29,814 --> 00:11:31,940
and talented young women as you two.
282
00:11:31,941 --> 00:11:34,651
I imagine it's a calling,
much like medicine.
283
00:11:34,652 --> 00:11:37,237
Yes, very much so.
284
00:11:37,238 --> 00:11:40,365
Sister Grace, under the microscope,
285
00:11:40,366 --> 00:11:43,910
we're seeing something called
a gram-negative bacteria.
286
00:11:43,911 --> 00:11:45,620
Is that serious?
287
00:11:45,621 --> 00:11:47,789
It can be if left untreated.
288
00:11:47,790 --> 00:11:50,291
But, fortunately, we can give
you a shot of antibiotics,
289
00:11:50,292 --> 00:11:51,960
irrigate your eye
with a liter of saline,
290
00:11:51,961 --> 00:11:54,504
and give you drops to use
at home every few hours.
291
00:11:54,505 --> 00:11:56,298
How did I get it?
292
00:11:58,050 --> 00:12:01,302
So the... the appearance
of the bacteria in your eye
293
00:12:01,303 --> 00:12:03,263
suggests that it's...
294
00:12:03,264 --> 00:12:04,973
it's gonorrhea.
295
00:12:04,974 --> 00:12:06,850
Um, traditionally, that's a sexually...
296
00:12:06,851 --> 00:12:08,977
I know what gonorrhea is, Dr. Javadi.
297
00:12:08,978 --> 00:12:11,354
I'm a nun, not a numbskull.
298
00:12:11,355 --> 00:12:14,691
I do a lot of work
at an unhoused shelter.
299
00:12:14,692 --> 00:12:17,402
Are... are you handling dirty sheets,
300
00:12:17,403 --> 00:12:20,864
- pillowcases, soiled clothes?
- Yes.
301
00:12:20,865 --> 00:12:25,076
Uh, part of my day is spent
doing laundry, making beds,
302
00:12:25,077 --> 00:12:27,203
disposing of old clothes.
303
00:12:27,204 --> 00:12:29,080
Do you wear gloves?
304
00:12:29,081 --> 00:12:31,374
- When they're available.
- Okay.
305
00:12:31,375 --> 00:12:33,835
Uh, well, let's...
let's get you your shot
306
00:12:33,836 --> 00:12:35,920
and set up for irrigating your eye.
307
00:12:35,921 --> 00:12:38,089
I bet we can scrounge up
a couple boxes of gloves
308
00:12:38,090 --> 00:12:39,507
while you're here.
309
00:12:39,508 --> 00:12:42,051
It's important to protect yourself.
310
00:12:42,052 --> 00:12:43,721
We'll be back.
311
00:12:45,681 --> 00:12:47,807
Why am I here?
312
00:12:47,808 --> 00:12:49,768
I'm not sick.
313
00:12:49,769 --> 00:12:53,521
Oh, we took care of your
husband, Ethan, earlier today.
314
00:12:53,522 --> 00:12:56,524
Is Ethan sick?
315
00:12:56,525 --> 00:12:59,194
Well, he was very ill.
316
00:12:59,195 --> 00:13:02,530
And, um, we did everything
we could to treat him,
317
00:13:02,531 --> 00:13:05,408
but his heart stopped beating.
318
00:13:05,409 --> 00:13:06,701
And...
319
00:13:06,702 --> 00:13:09,079
I'm so sorry to say that he died.
320
00:13:11,123 --> 00:13:13,583
He died?
321
00:13:13,584 --> 00:13:15,210
Ethan?
322
00:13:15,211 --> 00:13:18,463
No, no.
323
00:13:18,464 --> 00:13:20,382
Are you sure?
324
00:13:22,468 --> 00:13:24,427
Yes.
325
00:13:24,428 --> 00:13:27,222
No, no, no, no, no.
326
00:13:27,223 --> 00:13:29,557
Ethan isn't sick.
327
00:13:29,558 --> 00:13:31,059
No!
328
00:13:31,060 --> 00:13:33,895
I-I know how difficult
this must be for you.
329
00:13:40,319 --> 00:13:42,445
Uh, kidneys look good on ultrasound.
330
00:13:42,446 --> 00:13:44,197
No intra-abdominal injury.
331
00:13:44,198 --> 00:13:46,157
- Hey, Dylan.
- Robby.
332
00:13:46,158 --> 00:13:48,117
Is this the "tumble down
the stairs" kid... Kylie?
333
00:13:48,118 --> 00:13:49,661
- Yeah.
- And?
334
00:13:49,662 --> 00:13:51,538
I'd like to talk
to the girlfriend first,
335
00:13:51,539 --> 00:13:53,456
- away from the little girl.
- We can arrange that.
336
00:13:53,457 --> 00:13:55,166
- Okay.
- Keep us informed.
337
00:13:55,167 --> 00:13:57,752
Yes, keep us informed.
338
00:13:57,753 --> 00:14:01,548
More labs are back
on our abandoned baby Jane Doe.
339
00:14:01,549 --> 00:14:03,758
Everything looks normal so far,
340
00:14:03,759 --> 00:14:06,928
but you seemed really concerned earlier.
341
00:14:06,929 --> 00:14:08,763
She still needs a cathed urine.
342
00:14:08,764 --> 00:14:10,224
Or not.
343
00:14:11,642 --> 00:14:13,852
You can't trust a bagged urine.
344
00:14:13,853 --> 00:14:16,187
Agreed, but we can avoid
the trauma of a catheter.
345
00:14:16,188 --> 00:14:18,147
With a suprapubic tap?
346
00:14:18,148 --> 00:14:21,026
Oh, I may have a trick or two
up my sleeve, Dr. Al-Hashimi.
347
00:14:24,113 --> 00:14:26,614
Hey, Princess, hold up.
348
00:14:26,615 --> 00:14:27,991
Hi.
349
00:14:27,992 --> 00:14:30,201
- How you feeling, Mr. Williams?
- Okay.
350
00:14:30,202 --> 00:14:32,453
A little nervous
about going in the machine.
351
00:14:32,454 --> 00:14:34,622
I can get a tad claustrophobic.
352
00:14:34,623 --> 00:14:36,207
Yeah, well, um...
353
00:14:36,208 --> 00:14:38,543
we're sending you for a CT, not an MRI.
354
00:14:38,544 --> 00:14:41,004
So it's like a open doughnut.
355
00:14:41,005 --> 00:14:42,714
Oh, good. I like doughnuts.
356
00:14:44,466 --> 00:14:47,093
There you are.
Thought you forgot about me.
357
00:14:47,094 --> 00:14:50,680
Oh, no. I was just with other patients.
358
00:14:50,681 --> 00:14:53,683
So what do you do for fun?
359
00:14:53,684 --> 00:14:55,560
I mainly do what my sister likes.
360
00:14:55,561 --> 00:14:57,729
Um, she loves Kennywood and the zoo.
361
00:14:57,730 --> 00:15:00,356
No, what about you?
362
00:15:00,357 --> 00:15:02,401
What do you like to do?
363
00:15:05,571 --> 00:15:09,741
Um, I used to like, um,
the Renaissance fair.
364
00:15:09,742 --> 00:15:11,743
- Really?
- Yeah.
365
00:15:11,744 --> 00:15:13,745
Isn't that kind of dorky,
though, where everybody
366
00:15:13,746 --> 00:15:15,204
dresses up like somebody they're not?
367
00:15:15,205 --> 00:15:16,664
Yeah, but that's the fun, you know?
368
00:15:16,665 --> 00:15:18,499
You can be anyone or anything you want.
369
00:15:18,500 --> 00:15:20,877
I, um, actually had this alter ego
370
00:15:20,878 --> 00:15:22,503
that was a 17th-century French woman...
371
00:15:22,504 --> 00:15:24,714
Stop!
372
00:15:27,843 --> 00:15:29,761
You okay, kid?
373
00:15:29,762 --> 00:15:32,680
That was a doozy.
374
00:15:32,681 --> 00:15:34,766
Okay, are we ready?
375
00:15:34,767 --> 00:15:36,392
Cleaned and dried with sterile gauze.
376
00:15:36,393 --> 00:15:38,353
- Is that water cold?
- Right out the fridge.
377
00:15:38,354 --> 00:15:40,063
Okay, Jesse, you can take the armpits.
378
00:15:40,064 --> 00:15:42,065
I'm gonna take the legs.
379
00:15:42,066 --> 00:15:43,650
One, two, three, up.
380
00:15:43,651 --> 00:15:45,860
Dr. Al-Hashimi,
you're gonna be our catcher.
381
00:15:45,861 --> 00:15:48,529
And, Samira, you're gonna do
suprapubic circles
382
00:15:48,530 --> 00:15:50,031
with that gauze.
383
00:15:50,032 --> 00:15:52,659
And the cold should stimulate voiding.
384
00:15:52,660 --> 00:15:54,911
Even if she pees, it's likely
to be contaminated.
385
00:15:54,912 --> 00:15:56,829
Not according to
the "British Medical Journal."
386
00:15:56,830 --> 00:15:58,414
They did the wee-search.
387
00:15:58,415 --> 00:16:01,334
Any leuks or nitrates, and we cath.
388
00:16:01,335 --> 00:16:04,504
Oh. Oh. Dr. Al-Hashimi, get it.
389
00:16:04,505 --> 00:16:06,673
I was gonna invite you
to join the softball team,
390
00:16:06,674 --> 00:16:08,883
but now I'm not so sure.
391
00:16:08,884 --> 00:16:10,343
There we go.
392
00:16:10,344 --> 00:16:12,345
Looks like you got
a good midstream sample.
393
00:16:12,346 --> 00:16:13,888
Here's a fresh blanket.
394
00:16:13,889 --> 00:16:16,140
Okay. Plan.
395
00:16:16,141 --> 00:16:19,560
Ceftriaxone, two-day admit
till blood culture is negative.
396
00:16:19,561 --> 00:16:20,770
Next steps?
397
00:16:20,771 --> 00:16:22,146
Foster care.
398
00:16:22,147 --> 00:16:23,731
Oh, yeah.
399
00:16:23,732 --> 00:16:25,316
Ha.
400
00:16:25,317 --> 00:16:28,111
Someone must have been in a bad way
401
00:16:28,112 --> 00:16:30,738
to walk away from you, little one.
402
00:16:30,739 --> 00:16:33,324
We need to call the police?
403
00:16:33,325 --> 00:16:35,744
Let me know what the urine dip shows.
404
00:16:38,330 --> 00:16:42,500
We will let you know
what the urine dip shows.
405
00:16:42,501 --> 00:16:45,253
You must be Dr. Al-Hashimi.
406
00:16:45,254 --> 00:16:47,088
And you must be Dr. Langdon.
407
00:16:47,089 --> 00:16:49,048
I've heard all about you.
408
00:16:49,049 --> 00:16:50,550
Welcome back.
409
00:16:50,551 --> 00:16:53,261
- And this is?
- Uh, Linda Stevens.
410
00:16:53,262 --> 00:16:56,097
One episode of substernal chest
pressure resolved with rest.
411
00:16:56,098 --> 00:16:57,932
12-lead negative for STEMI.
412
00:16:57,933 --> 00:17:00,393
Heading for North 4.
413
00:17:00,394 --> 00:17:03,271
Hello, I'm Dr. Al-Hashimi.
414
00:17:03,272 --> 00:17:05,940
- Nice to meet you.
- Nice to meet you.
415
00:17:05,941 --> 00:17:08,026
Ma'am, this is a teaching hospital.
416
00:17:08,027 --> 00:17:10,361
Is it okay if some
of our trainees join me?
417
00:17:10,362 --> 00:17:12,405
Not... not a problem.
418
00:17:12,406 --> 00:17:16,367
Dr. Whitaker, Javadi, Ogilvie, Joy...
419
00:17:16,368 --> 00:17:18,619
gather round.
420
00:17:18,620 --> 00:17:21,164
Dr. Langdon, you are more
than welcome to stay, too.
421
00:17:21,165 --> 00:17:24,000
Uh, maybe for a minute.
We're pretty busy in triage.
422
00:17:24,001 --> 00:17:25,626
Okay.
423
00:17:25,627 --> 00:17:27,962
Ms. Stevens...
424
00:17:27,963 --> 00:17:29,630
I have an app on my phone
425
00:17:29,631 --> 00:17:31,632
that can listen to our conversation
426
00:17:31,633 --> 00:17:33,676
and the details of my physical exam
427
00:17:33,677 --> 00:17:35,887
and write it all up
in your medical record.
428
00:17:35,888 --> 00:17:37,805
Wow.
429
00:17:37,806 --> 00:17:41,517
It's protected, confidential,
doesn't even stay on my phone.
430
00:17:41,518 --> 00:17:43,478
- And it means I can...
- What's going on?
431
00:17:43,479 --> 00:17:45,646
Some A-hole perp took off
when he saw the cops,
432
00:17:45,647 --> 00:17:47,398
knocked her backwards off a stool.
433
00:17:47,399 --> 00:17:49,609
- Oh, Jesus.
- Head trauma, no LOC.
434
00:17:49,610 --> 00:17:51,611
Okay, you need to get checked out.
435
00:17:51,612 --> 00:17:53,780
- I'm fine.
- No choice. It's work-related.
436
00:17:53,781 --> 00:17:55,615
Let's, uh... let's find her a room
437
00:17:55,616 --> 00:17:58,409
- and prep for a burr hole.
- What?
438
00:17:58,410 --> 00:18:00,411
Oh...
439
00:18:00,412 --> 00:18:04,082
I forgot how much you
like to joke, Captain Scurvy.
440
00:18:04,083 --> 00:18:06,501
Who the hell's Captain Scurvy?
441
00:18:06,502 --> 00:18:08,544
It's an inside thing.
442
00:18:08,545 --> 00:18:11,798
- How's our shoulder guy?
- Oh, he slept like a baby.
443
00:18:11,799 --> 00:18:14,634
CT angio shows no vascular injury.
444
00:18:14,635 --> 00:18:18,221
What about your slip-and-fall
guy with a labile affect?
445
00:18:18,222 --> 00:18:20,223
Mm, Michael Williams.
446
00:18:20,224 --> 00:18:22,100
He's still in the scanner.
447
00:18:22,101 --> 00:18:24,352
He seems to have settled down,
so he doesn't need babysitting.
448
00:18:24,353 --> 00:18:25,937
Good. Maybe he's coming around.
449
00:18:25,938 --> 00:18:28,022
Ortho can take Mr. Billings
here up for surgery.
450
00:18:28,023 --> 00:18:29,440
Belay that order, sailor.
451
00:18:29,441 --> 00:18:32,026
- Dr. Robinavitch.
- Nurse Hastings.
452
00:18:32,027 --> 00:18:33,694
You can call me Robby.
453
00:18:33,695 --> 00:18:35,447
You can call me Noelle.
454
00:18:37,866 --> 00:18:41,035
Uh, you could just tell me
what the hell's going on here.
455
00:18:41,036 --> 00:18:43,037
This is Noelle. She's our, um...
456
00:18:43,038 --> 00:18:44,747
Bed control manager. No, we met.
457
00:18:44,748 --> 00:18:46,040
Both: Case manager.
458
00:18:46,041 --> 00:18:47,625
And this guy won't be staying.
459
00:18:47,626 --> 00:18:49,544
Oh, he needs surgery.
460
00:18:49,545 --> 00:18:52,338
Which his insurance will pay
for at Westbridge Memorial,
461
00:18:52,339 --> 00:18:54,090
not here.
462
00:18:54,091 --> 00:18:57,718
- Wait, so we have to transfer?
- If... if he's stable.
463
00:18:57,719 --> 00:18:59,428
I believe that he is.
464
00:18:59,429 --> 00:19:00,972
Look on the bright side.
465
00:19:00,973 --> 00:19:03,141
We're gonna free up a bed,
discharge a patient.
466
00:19:03,142 --> 00:19:05,685
I mean, that's great for us,
not so good for him.
467
00:19:05,686 --> 00:19:07,937
He will get great care at Westbridge.
468
00:19:07,938 --> 00:19:10,523
Don't you agree, Robby?
469
00:19:10,524 --> 00:19:13,359
- I'm sure that he will.
- Yeah.
470
00:19:13,360 --> 00:19:15,278
What am I missing?
471
00:19:15,279 --> 00:19:17,488
Is there something else
happening with Allen Billings
472
00:19:17,489 --> 00:19:19,198
that I don't know about?
473
00:19:19,199 --> 00:19:20,658
Not medically.
474
00:19:20,659 --> 00:19:24,078
This is just
a simple insurance transfer.
475
00:19:24,079 --> 00:19:26,206
Mm, yeah, okay.
476
00:19:30,419 --> 00:19:32,753
What's that about?
477
00:19:32,754 --> 00:19:35,756
- Nothing.
- Didn't feel like nothing.
478
00:19:35,757 --> 00:19:38,092
Dr. McKay has a very
heightened sense of empathy.
479
00:19:38,093 --> 00:19:39,594
Meaning?
480
00:19:39,595 --> 00:19:41,929
Meaning she's good
at picking up on stuff.
481
00:19:41,930 --> 00:19:43,931
You didn't say anything, did you?
482
00:19:43,932 --> 00:19:45,266
Nope.
483
00:19:45,267 --> 00:19:47,310
I subscribe to the Falstaff advice.
484
00:19:47,311 --> 00:19:49,103
Discretion is the better part of valor.
485
00:19:49,104 --> 00:19:50,479
Oh.
486
00:19:50,480 --> 00:19:52,315
You still planning on leaving tonight?
487
00:19:52,316 --> 00:19:54,233
Yep.
488
00:19:54,234 --> 00:19:58,112
I don't understand why
you can't leave in the morning.
489
00:19:58,113 --> 00:19:59,822
Will you excuse me for a second?
490
00:19:59,823 --> 00:20:01,657
I got to go talk to a patient
while she's separated
491
00:20:01,658 --> 00:20:02,992
- from her caregiver.
- Oh, yeah.
492
00:20:02,993 --> 00:20:04,744
- That doesn't sound ideal.
- It's not ideal.
493
00:20:04,745 --> 00:20:06,746
I got to figure out what's going on.
494
00:20:06,747 --> 00:20:08,915
And I'll find you before I leave.
495
00:20:08,916 --> 00:20:10,375
Okay.
496
00:20:13,045 --> 00:20:16,589
Okay, you got to stop this.
497
00:20:16,590 --> 00:20:18,674
Hastings.
498
00:20:18,675 --> 00:20:20,051
Evans.
499
00:20:20,052 --> 00:20:21,969
Hope you know what you're doing.
500
00:20:21,970 --> 00:20:24,972
What is that supposed to mean?
501
00:20:24,973 --> 00:20:27,475
I'm a big girl.
502
00:20:27,476 --> 00:20:30,645
Okay, big girl.
503
00:20:30,646 --> 00:20:31,979
I'm fine.
504
00:20:31,980 --> 00:20:33,941
That's good. Follow my finger.
505
00:20:35,567 --> 00:20:37,068
How's the head?
506
00:20:37,069 --> 00:20:38,986
It's a little sore.
507
00:20:38,987 --> 00:20:41,864
Lean forward. Let me take a look.
508
00:20:41,865 --> 00:20:44,909
Yeah, you're gonna have
a pretty good goose egg.
509
00:20:44,910 --> 00:20:47,370
- Headache?
- A little.
510
00:20:47,371 --> 00:20:48,996
I can get you some Tylenol,
511
00:20:48,997 --> 00:20:50,665
unless you need something stronger.
512
00:20:50,666 --> 00:20:53,376
Oh, no, that's okay.
I'm not very drug tolerant.
513
00:20:53,377 --> 00:20:55,295
Lucky you.
514
00:20:57,798 --> 00:20:59,799
You know, I'm glad you're back.
515
00:20:59,800 --> 00:21:04,095
Thanks. Yeah, I'm glad to be back.
516
00:21:04,096 --> 00:21:06,389
- You know why I was away?
- I should see my patient...
517
00:21:06,390 --> 00:21:09,016
Um, no, not really.
518
00:21:09,017 --> 00:21:10,685
I mean, I heard rumors, but I learned
519
00:21:10,686 --> 00:21:12,144
a long time ago not to listen.
520
00:21:12,145 --> 00:21:13,521
- I was in rehab...
- Oh.
521
00:21:13,522 --> 00:21:15,564
For an addiction to benzos.
522
00:21:15,565 --> 00:21:17,525
Oh.
523
00:21:17,526 --> 00:21:20,194
Yeah, but I'm... I'm clean now.
524
00:21:20,195 --> 00:21:21,988
A-and it never affected my work.
525
00:21:21,989 --> 00:21:23,614
I just...
526
00:21:23,615 --> 00:21:26,326
needed to get it all out
of my system once and for all.
527
00:21:28,578 --> 00:21:31,872
Yeah, I-I didn't handle things
the way I should have.
528
00:21:31,873 --> 00:21:36,711
I thought I could treat myself,
and I let a lot of people down.
529
00:21:36,712 --> 00:21:39,422
I'm sorry, Mel.
530
00:21:39,423 --> 00:21:42,425
You never let me down.
531
00:21:42,426 --> 00:21:43,634
Yeah.
532
00:21:43,635 --> 00:21:45,428
Yeah, I did.
533
00:21:45,429 --> 00:21:48,431
I should be setting an example,
not a cautionary tale.
534
00:21:50,225 --> 00:21:51,976
Hey.
535
00:21:51,977 --> 00:21:54,228
- How you doing?
- I'm okay.
536
00:21:54,229 --> 00:21:56,981
Listen, I'm really sorry about all that.
537
00:21:56,982 --> 00:21:58,941
The guy robbed
a liquor store last night.
538
00:21:58,942 --> 00:22:01,027
He tried to get away on a bicycle
539
00:22:01,028 --> 00:22:02,737
but wiped out and took off on foot.
540
00:22:02,738 --> 00:22:04,322
He must've hobbled in here...
541
00:22:04,323 --> 00:22:06,657
more so to hide out than
to get stitched up, I think.
542
00:22:06,658 --> 00:22:08,367
- You catch him?
- We will.
543
00:22:08,368 --> 00:22:10,244
Anything you could tell us
about him will help.
544
00:22:10,245 --> 00:22:12,204
You think he gave legit information?
545
00:22:12,205 --> 00:22:15,708
Probably not, but it's
all we have at the moment.
546
00:22:15,709 --> 00:22:17,376
If we do find him,
547
00:22:17,377 --> 00:22:20,421
you may have to testify
in court, Dr. King.
548
00:22:20,422 --> 00:22:22,757
- "In court"?
- As a material witness.
549
00:22:22,758 --> 00:22:25,676
Attest to his injuries,
his treatments...
550
00:22:25,677 --> 00:22:27,178
simple stuff.
551
00:22:27,179 --> 00:22:28,929
Yeah, but we'll cross that bridge
552
00:22:28,930 --> 00:22:30,765
when we come to it, right?
553
00:22:30,766 --> 00:22:32,850
Mel?
554
00:22:32,851 --> 00:22:34,935
Rest here a minute. I'll be right back.
555
00:22:34,936 --> 00:22:36,104
Mm.
556
00:22:38,440 --> 00:22:40,691
You know, I'm...
I'm fine, really. I should...
557
00:22:40,692 --> 00:22:43,111
Ten minutes, please. Doctor's orders.
558
00:22:45,614 --> 00:22:48,325
ER can be a little bright and noisy.
559
00:22:52,996 --> 00:22:55,122
Dorsalis pedis
560
00:22:55,123 --> 00:22:58,667
and posterior tibial pulses
2 plus and equal.
561
00:22:58,668 --> 00:23:00,336
Your exam is perfect, ma'am.
562
00:23:00,337 --> 00:23:02,421
Oh, that is good to hear.
563
00:23:02,422 --> 00:23:04,965
I will be back when
your blood tests are ready.
564
00:23:04,966 --> 00:23:07,051
Let us know if the chest pain returns.
565
00:23:07,052 --> 00:23:09,512
- Thank you.
- You are so welcome.
566
00:23:11,348 --> 00:23:12,765
What do you think?
567
00:23:12,766 --> 00:23:14,350
Well, I don't think it's cardiac.
568
00:23:14,351 --> 00:23:16,143
I mean, what do you think of the app?
569
00:23:16,144 --> 00:23:18,729
I mean, it's hard to say
without seeing the full thing.
570
00:23:18,730 --> 00:23:21,273
Take a look.
571
00:23:21,274 --> 00:23:22,733
Oh, my God.
572
00:23:22,734 --> 00:23:24,693
Do you know how much time
this will save?
573
00:23:24,694 --> 00:23:27,988
Studies show you can spend
80% less time charting.
574
00:23:27,989 --> 00:23:29,740
You'll get out of here sooner,
575
00:23:29,741 --> 00:23:31,992
improving both patient
and physician satisfaction.
576
00:23:31,993 --> 00:23:33,577
Oh, excuse me.
577
00:23:33,578 --> 00:23:35,996
It says here she takes
Risperdal, an antipsychotic.
578
00:23:35,997 --> 00:23:38,374
She takes Restoril
when needed for sleep.
579
00:23:38,375 --> 00:23:39,750
So is that, um...
580
00:23:39,751 --> 00:23:42,211
AI, "almost intelligent."
581
00:23:42,212 --> 00:23:45,923
Generative AI is
98% accurate at present.
582
00:23:45,924 --> 00:23:47,758
You must always carefully proofread
583
00:23:47,759 --> 00:23:49,343
and correct the minor errors.
584
00:23:49,344 --> 00:23:50,928
It's excellent but not perfect.
585
00:23:50,929 --> 00:23:53,347
This is amazing.
586
00:23:53,348 --> 00:23:55,015
Moteshakeram.
587
00:23:55,016 --> 00:23:57,768
Khahesh mikonam.
588
00:23:57,769 --> 00:24:00,729
- You speak Farsi?
- I did my undergrad at UCLA.
589
00:24:00,730 --> 00:24:02,565
A lot of my friends were Persian.
590
00:24:02,566 --> 00:24:04,275
So you learned the language?
591
00:24:04,276 --> 00:24:06,235
Enough to break the ice.
592
00:24:06,236 --> 00:24:08,405
I am impressed.
593
00:24:09,614 --> 00:24:11,157
Me too...
594
00:24:11,158 --> 00:24:12,741
that you had friends.
595
00:24:12,742 --> 00:24:15,035
Dr. Whitaker, I said hello to your widow
596
00:24:15,036 --> 00:24:17,121
with Alzheimer's, but she only
wants to talk to a doctor.
597
00:24:17,122 --> 00:24:19,373
She's also very overdue
for a diaper change.
598
00:24:19,374 --> 00:24:21,375
Okay. Yeah, thank you.
599
00:24:21,376 --> 00:24:23,420
Uh, Ogilvie, you're with me.
600
00:24:24,796 --> 00:24:26,005
Come on.
601
00:24:26,006 --> 00:24:28,717
Ah, Mrs. Bostick?
602
00:24:30,844 --> 00:24:32,136
Takotsubo?
603
00:24:32,137 --> 00:24:33,387
- Broken heart syndrome?
- Uh, no.
604
00:24:33,388 --> 00:24:34,430
Aah!
605
00:24:34,431 --> 00:24:35,890
Hello?
606
00:24:35,891 --> 00:24:37,391
Hey.
607
00:24:37,392 --> 00:24:39,226
Um, you wanted to see me?
608
00:24:39,227 --> 00:24:40,978
No.
609
00:24:40,979 --> 00:24:43,147
Who are you?
610
00:24:43,148 --> 00:24:44,940
I'm Dr. Whitaker.
611
00:24:44,941 --> 00:24:47,067
We talked about your husband?
612
00:24:47,068 --> 00:24:49,904
Oh, Ethan.
613
00:24:49,905 --> 00:24:52,781
Oh, can he please come see me?
614
00:24:52,782 --> 00:24:55,117
Um...
615
00:24:55,118 --> 00:24:57,578
um...
616
00:24:57,579 --> 00:24:59,497
no.
617
00:24:59,498 --> 00:25:03,083
Unfortunately, he was very sick...
618
00:25:03,084 --> 00:25:05,462
and he died.
619
00:25:07,672 --> 00:25:09,632
Ethan?
620
00:25:09,633 --> 00:25:11,842
Died?
621
00:25:11,843 --> 00:25:13,260
No.
622
00:25:13,261 --> 00:25:14,595
Oh, no.
623
00:25:14,596 --> 00:25:17,223
No, that's impossible.
624
00:25:17,224 --> 00:25:20,226
No.
625
00:25:20,227 --> 00:25:23,270
No, no, no, no, no.
626
00:25:23,271 --> 00:25:25,439
What do you like to do for fun?
627
00:25:25,440 --> 00:25:26,857
I love horseback riding.
628
00:25:26,858 --> 00:25:28,901
- Does your dad take you?
- Yep.
629
00:25:28,902 --> 00:25:30,486
Sometimes he even rides,
630
00:25:30,487 --> 00:25:32,738
but most of the time,
he just watches me.
631
00:25:32,739 --> 00:25:35,449
Have you ever fallen off?
Have you ever been thrown?
632
00:25:35,450 --> 00:25:38,452
Nope. I'm a very good rider.
633
00:25:38,453 --> 00:25:40,788
- Do you have your own horse?
- I wish.
634
00:25:40,789 --> 00:25:42,998
We live in an apartment.
635
00:25:42,999 --> 00:25:45,668
Okay, Kylie, we need
to take some blood now.
636
00:25:45,669 --> 00:25:47,378
Do you have to do that?
637
00:25:47,379 --> 00:25:50,297
Yeah, but I promise it'll go super fast
638
00:25:50,298 --> 00:25:52,841
and only hurt for, like, a moment, okay?
639
00:25:52,842 --> 00:25:56,470
So I'm just gonna put this rubber band
640
00:25:56,471 --> 00:25:59,473
around your arm to help me
find your vein better.
641
00:25:59,474 --> 00:26:03,644
And then this makes sure
no germs get in your body
642
00:26:03,645 --> 00:26:05,521
when we do it.
643
00:26:05,522 --> 00:26:08,482
Okay, now you're just gonna
feel this teeny little prick.
644
00:26:08,483 --> 00:26:10,527
But you can look away, okay?
645
00:26:12,612 --> 00:26:14,739
Worst part's over.
646
00:26:16,866 --> 00:26:18,784
Tough little girl.
647
00:26:18,785 --> 00:26:20,369
Yeah, well, little girls can be
648
00:26:20,370 --> 00:26:22,705
just as tough as little boys,
even tougher.
649
00:26:22,706 --> 00:26:25,291
Yes. I just hope it's not
because she's become
650
00:26:25,292 --> 00:26:26,959
accustomed to pain.
651
00:26:26,960 --> 00:26:29,295
At the very least,
she's gonna need a visual exam
652
00:26:29,296 --> 00:26:31,422
of external genitalia
to look for signs of trauma.
653
00:26:31,423 --> 00:26:33,299
I can have Dr. Al-Hashimi...
654
00:26:33,300 --> 00:26:35,343
No, she's my patient. I can do it.
655
00:26:43,768 --> 00:26:45,853
Nice and clear.
656
00:26:45,854 --> 00:26:50,524
Uh, with an infection,
it'd be kind of cloudy.
657
00:26:50,525 --> 00:26:52,526
Joy, get ready to spike
the third bottle here
658
00:26:52,527 --> 00:26:53,902
after I clamp.
659
00:26:53,903 --> 00:26:55,738
- All good in here?
- Yes.
660
00:26:55,739 --> 00:26:58,532
Uh, Dr. Whitaker was just
explaining that with SBP,
661
00:26:58,533 --> 00:27:00,743
we would see a turbid appearance.
662
00:27:00,744 --> 00:27:03,579
However, he failed to mention
that bloody fluid indicates
663
00:27:03,580 --> 00:27:05,623
either a traumatic tap or the likelihood
664
00:27:05,624 --> 00:27:07,207
of hepatocellular carcinoma,
665
00:27:07,208 --> 00:27:09,752
in which case,
we would send for cytology.
666
00:27:09,753 --> 00:27:11,003
That is correct.
667
00:27:11,004 --> 00:27:12,838
Kid knows his shit.
668
00:27:12,839 --> 00:27:15,467
He's so smart.
669
00:27:18,553 --> 00:27:20,846
- Oh, hey.
- Hey.
670
00:27:20,847 --> 00:27:22,890
How's it feel to officially be a doctor?
671
00:27:22,891 --> 00:27:25,017
It's pretty cool, actually.
672
00:27:25,018 --> 00:27:26,810
Uh, I get my first paycheck today.
673
00:27:26,811 --> 00:27:29,772
It's only for the first week,
but I will take it.
674
00:27:29,773 --> 00:27:33,609
- How are the med students?
- Um, Joy is pretty peculiar.
675
00:27:33,610 --> 00:27:36,570
And the other guy, Ogilvie,
is really smart
676
00:27:36,571 --> 00:27:38,781
and likes to show people.
677
00:27:38,782 --> 00:27:41,283
- He's obnoxious.
- Well...
678
00:27:41,284 --> 00:27:43,786
What he is, is your competition.
679
00:27:43,787 --> 00:27:46,831
- He's a gunner.
- Yeah, right.
680
00:27:49,584 --> 00:27:51,835
He's not my competition.
681
00:27:51,836 --> 00:27:54,922
He's from out of state
for a four-week sub-internship.
682
00:27:54,923 --> 00:27:57,591
You don't think he's angling
for an emergency residency spot
683
00:27:57,592 --> 00:27:59,426
here next year?
684
00:27:59,427 --> 00:28:02,596
- I mean, even if he was...
- What?
685
00:28:02,597 --> 00:28:06,518
He couldn't possibly compete
with your gigantic brain?
686
00:28:10,105 --> 00:28:13,066
I'd step it up if I were you, Crash.
687
00:28:15,402 --> 00:28:18,320
Oh, she's still calling you that, huh?
688
00:28:18,321 --> 00:28:20,114
I don't really even care anymore.
689
00:28:20,115 --> 00:28:22,032
I mean, she still calls you Huckleberry.
690
00:28:22,033 --> 00:28:25,035
Yeah, but, you know, friends now, so...
691
00:28:25,036 --> 00:28:28,038
Friends don't give each other
shitty nicknames.
692
00:28:28,039 --> 00:28:31,126
You think Huckleberry
is a shitty nickname?
693
00:28:32,585 --> 00:28:33,836
No.
694
00:28:33,837 --> 00:28:35,838
No, H-Huckleberry is cute.
695
00:28:35,839 --> 00:28:37,172
Oh.
696
00:28:37,173 --> 00:28:39,842
It's cool. It's not like Crash.
697
00:28:39,843 --> 00:28:42,052
Oh, come on, man. Crash is pretty cool.
698
00:28:42,053 --> 00:28:44,304
It's, like, you know... Crash.
699
00:28:44,305 --> 00:28:46,974
It's got momentum.
700
00:28:46,975 --> 00:28:49,560
Dr. Javadi, Dr. Whitaker.
701
00:28:49,561 --> 00:28:51,478
Oh, I'm... I'm still a student doctor.
702
00:28:51,479 --> 00:28:53,313
Whitaker's the real deal now.
703
00:28:53,314 --> 00:28:55,315
Right.
704
00:28:55,316 --> 00:28:56,984
Welcome back.
705
00:28:56,985 --> 00:28:59,069
Thanks. Yeah, thank you.
706
00:28:59,070 --> 00:29:01,072
It's good to be back.
707
00:29:02,866 --> 00:29:06,994
Okay, I will be in exile
on Triage Island
708
00:29:06,995 --> 00:29:08,871
with the rest of the drug addicts,
709
00:29:08,872 --> 00:29:11,206
if anyone needs me.
710
00:29:11,207 --> 00:29:13,667
- That was weird.
- Very.
711
00:29:16,504 --> 00:29:17,547
What?
712
00:29:36,107 --> 00:29:37,817
Mm-hmm.
713
00:29:39,611 --> 00:29:41,987
Ooh! That's got to hurt.
714
00:29:41,988 --> 00:29:44,531
Dr. Langdon, Clint Hansen,
his cousin Mona.
715
00:29:44,532 --> 00:29:45,741
How'd this happen?
716
00:29:47,118 --> 00:29:49,244
Bacon grease from a big griddle.
717
00:29:49,245 --> 00:29:50,913
Oh, looks like more than a splatter.
718
00:29:50,914 --> 00:29:52,706
Yeah, some fool poured it in the sink
719
00:29:52,707 --> 00:29:54,374
- while I was washing dishes.
- I was so far away.
720
00:29:54,375 --> 00:29:55,959
You reached for the soap
without even looking.
721
00:29:55,960 --> 00:29:57,294
You couldn't hear me?
722
00:29:57,295 --> 00:29:58,879
No, not with the water running.
723
00:29:58,880 --> 00:30:00,714
Who the hell pours
bacon grease down the drain?
724
00:30:00,715 --> 00:30:02,549
- There's a jar under the sink.
- You could have told me that.
725
00:30:02,550 --> 00:30:04,218
You're a guest in my house,
726
00:30:04,219 --> 00:30:05,803
and now you've totally
fucked up my plumbing.
727
00:30:05,804 --> 00:30:07,596
Okay, how about we focus
on treating this burn?
728
00:30:07,597 --> 00:30:09,223
I'll grab the LET.
729
00:30:09,224 --> 00:30:10,557
We're gonna need to trim
off some of the dead skin
730
00:30:10,558 --> 00:30:11,892
so it doesn't get infected.
731
00:30:11,893 --> 00:30:13,477
I'm in charge of the brunch buffet.
732
00:30:13,478 --> 00:30:15,395
- Can you make it fast?
- Sure. Yeah, we...
733
00:30:15,396 --> 00:30:17,356
This one came in by car.
All I got is a name.
734
00:30:17,357 --> 00:30:18,941
- Orlando Diaz.
- What's the story?
735
00:30:18,942 --> 00:30:20,400
He tripped over some rebar.
736
00:30:20,401 --> 00:30:21,902
- Tripped or fainted?
- I don't know.
737
00:30:21,903 --> 00:30:24,238
Orlando, open your eyes.
738
00:30:24,239 --> 00:30:25,906
- Hit his head?
- I guess.
739
00:30:25,907 --> 00:30:27,741
- Why didn't you call 911?
- He wouldn't let me.
740
00:30:27,742 --> 00:30:29,368
He was talking... not so much now.
741
00:30:29,369 --> 00:30:31,745
Orlando. Mr. Diaz.
742
00:30:31,746 --> 00:30:33,455
- Jesus.
- He drunk?
743
00:30:33,456 --> 00:30:34,706
No. Ketones on his breath.
744
00:30:34,707 --> 00:30:36,291
- He diabetic?
- I don't know.
745
00:30:36,292 --> 00:30:38,377
Altered head trauma, possible DKA.
746
00:30:38,378 --> 00:30:39,796
Call it overhead.
747
00:30:41,548 --> 00:30:44,591
Code trauma tier one now.
Code trauma tier one now.
748
00:30:44,592 --> 00:30:47,594
Dr. Whitaker,
your assessment was spot-on.
749
00:30:47,595 --> 00:30:50,097
Your Alzheimer's widow
definitely needs placement.
750
00:30:50,098 --> 00:30:51,974
Do you have a nursing home
that can take her today?
751
00:30:51,975 --> 00:30:53,517
I wish.
752
00:30:53,518 --> 00:30:55,519
Medicare requires
a three-day hospitalization
753
00:30:55,520 --> 00:30:57,020
before they'll approve that.
754
00:30:57,021 --> 00:30:58,981
I don't really have
a reason to admit her.
755
00:30:58,982 --> 00:31:01,775
But I do. She's gravely disabled.
756
00:31:01,776 --> 00:31:04,111
I'll put her on a cycle.
We'll make it work.
757
00:31:04,112 --> 00:31:06,780
Thank you, Caleb.
758
00:31:06,781 --> 00:31:09,116
Yeah, you have a few moments, Michael?
759
00:31:09,117 --> 00:31:11,118
Actually, I do not.
760
00:31:11,119 --> 00:31:14,288
But once I get things settled
here, I will come and find you.
761
00:31:14,289 --> 00:31:15,290
Okay.
762
00:31:17,458 --> 00:31:19,334
Dr. Robby, Dylan just
talked to the girlfriend.
763
00:31:19,335 --> 00:31:20,752
Robby!
764
00:31:20,753 --> 00:31:22,671
You'll have to fill me in in a minute.
765
00:31:22,672 --> 00:31:24,214
- What do you got?
- AMS.
766
00:31:24,215 --> 00:31:26,008
I can't tell if he fell
'cause he was altered
767
00:31:26,009 --> 00:31:27,968
or he's altered because he fell.
768
00:31:27,969 --> 00:31:31,430
- There's ketones on his breath.
- Okay, I got this. Thank you.
769
00:31:31,431 --> 00:31:33,223
All right, I guess it's just us.
770
00:31:33,224 --> 00:31:35,142
Um, what did the girlfriend have to say?
771
00:31:35,143 --> 00:31:37,436
Well, Gina seems a little
confused and on edge by this,
772
00:31:37,437 --> 00:31:39,271
but I'm not suspicious
about abuse on her part.
773
00:31:39,272 --> 00:31:40,814
What about Kylie's father?
774
00:31:40,815 --> 00:31:42,357
Well, I'm a social worker,
not a mind reader.
775
00:31:42,358 --> 00:31:43,567
I need to speak with him.
776
00:31:43,568 --> 00:31:45,235
Yeah, he's supposed to come in.
777
00:31:45,236 --> 00:31:47,279
If he doesn't, looks pretty guilty.
778
00:31:47,280 --> 00:31:49,489
Let's not jump
to any conclusions just yet.
779
00:31:49,490 --> 00:31:50,908
I'm not jumping.
780
00:31:50,909 --> 00:31:54,036
I'm just saying,
if this dude doesn't show up,
781
00:31:54,037 --> 00:31:56,163
hell, I'll go find him myself.
782
00:31:56,164 --> 00:31:58,665
Kidding.
783
00:31:58,666 --> 00:32:01,251
I will speak to Kylie
before her dad gets here.
784
00:32:01,252 --> 00:32:03,170
If he shows up.
785
00:32:03,171 --> 00:32:04,922
Yes.
786
00:32:04,923 --> 00:32:07,507
That's definitely ketones.
We need to do an Accu-Check.
787
00:32:07,508 --> 00:32:09,217
I'm on it. He's tachy at 124.
788
00:32:09,218 --> 00:32:12,179
Pulse ox 97. BP's 106/72.
789
00:32:12,180 --> 00:32:14,890
- Lung sliding bilaterally.
- Good bowel sounds.
790
00:32:14,891 --> 00:32:16,558
Abdomen is soft, non-tender.
791
00:32:16,559 --> 00:32:19,019
How do you know it's non-tender?
792
00:32:19,020 --> 00:32:21,063
Because I didn't see any grimacing.
793
00:32:21,064 --> 00:32:23,774
He's altered. He didn't even
flinch for the IV start.
794
00:32:23,775 --> 00:32:26,652
- I meant to say non-rigid.
- Huh.
795
00:32:26,653 --> 00:32:28,236
Toes down... going bilaterally.
796
00:32:28,237 --> 00:32:29,738
No evidence of upper
motor neuron deficit.
797
00:32:29,739 --> 00:32:31,114
Good.
798
00:32:31,115 --> 00:32:33,075
- E-FAST negative.
- How can I assist?
799
00:32:33,076 --> 00:32:35,911
You can check in
with Dr. McKay or Dr. Santos.
800
00:32:35,912 --> 00:32:37,579
If you don't mind, I'd like to observe,
801
00:32:37,580 --> 00:32:39,247
learn how you handle things.
802
00:32:39,248 --> 00:32:41,083
Whoa, blood sugar's
critical high... it's over 500.
803
00:32:41,084 --> 00:32:42,501
Ding, ding, ding, ding.
804
00:32:42,502 --> 00:32:44,294
Sounds like diabetic ketoacidosis.
805
00:32:44,295 --> 00:32:46,088
We need to start treating that,
then right to CT
806
00:32:46,089 --> 00:32:47,923
to rule out an intracranial bleed.
807
00:32:47,924 --> 00:32:49,841
Severe respiratory distress
coming in... ETA three minutes.
808
00:32:49,842 --> 00:32:51,301
- I'll stick them in Trauma 1.
- Yep.
809
00:32:51,302 --> 00:32:53,095
Would you like me to take that?
810
00:32:53,096 --> 00:32:54,471
Yes, please. Thank you.
811
00:32:54,472 --> 00:32:56,306
This guy needs an insulin drip, right?
812
00:32:56,307 --> 00:32:57,724
0.1 units per kilo?
813
00:32:57,725 --> 00:32:59,559
No, not without knowing his potassium.
814
00:32:59,560 --> 00:33:01,561
Insulin causes an intracellular shift.
815
00:33:01,562 --> 00:33:03,563
And if the potassium is under
3.5, the drip would kill him.
816
00:33:03,564 --> 00:33:04,940
That is very true.
817
00:33:04,941 --> 00:33:06,733
We can start with lactated ringers.
818
00:33:06,734 --> 00:33:08,485
1 liter per hour
until we get the results
819
00:33:08,486 --> 00:33:10,237
from the chem-7 and the VBG.
820
00:33:10,238 --> 00:33:11,738
Why is he in DKA?
821
00:33:11,739 --> 00:33:13,115
Maybe he's not taking enough insulin.
822
00:33:13,116 --> 00:33:14,574
More frequently, a precipitating event
823
00:33:14,575 --> 00:33:16,076
can be identified, such as pneumonia,
824
00:33:16,077 --> 00:33:17,619
urinary tract infection, stroke,
825
00:33:17,620 --> 00:33:19,121
myocardial infarction, pancreatitis.
826
00:33:19,122 --> 00:33:20,956
Yeah, we always check for those.
827
00:33:20,957 --> 00:33:24,376
They're part of the standard
order set, right, Dr. Mohan?
828
00:33:32,176 --> 00:33:34,136
He's from crazy Grandpa Jimmy's side.
829
00:33:34,137 --> 00:33:35,929
She's from my grandfather's
brother's side.
830
00:33:35,930 --> 00:33:37,848
Grandpa Ricky is still a psycho.
831
00:33:37,849 --> 00:33:40,434
- Clearly runs in the family.
- Well, hold on.
832
00:33:40,435 --> 00:33:43,562
Your grandparents
are Ricky and Jimmy Hansen...
833
00:33:43,563 --> 00:33:45,230
from the racing family?
834
00:33:45,231 --> 00:33:46,773
Unfortunately.
835
00:33:46,774 --> 00:33:48,900
I got something that needs attention.
836
00:33:48,901 --> 00:33:50,611
Not another baby.
837
00:33:52,572 --> 00:33:54,407
Sorry. Excuse me.
838
00:33:56,784 --> 00:33:58,660
This is Mr. Randall.
839
00:33:58,661 --> 00:34:01,371
He's been erect
for the last eight hours.
840
00:34:01,372 --> 00:34:03,123
Should have gone down by now, right?
841
00:34:03,124 --> 00:34:04,541
It happens.
842
00:34:04,542 --> 00:34:06,043
It's a good thing
you came in, Mr. Randall.
843
00:34:06,044 --> 00:34:07,544
I'll take him right back.
844
00:34:07,545 --> 00:34:09,379
Do you mind finishing up
with the Bickersons?
845
00:34:09,380 --> 00:34:10,630
I'd rather not.
846
00:34:10,631 --> 00:34:13,133
- So, Mr. Randall...
- Ian.
847
00:34:13,134 --> 00:34:15,385
Ian, did you take anything
848
00:34:15,386 --> 00:34:17,637
that might have led to this condition?
849
00:34:17,638 --> 00:34:20,640
I used an ED injection... two, actually.
850
00:34:20,641 --> 00:34:24,394
I gave myself a second shot,
one on each side.
851
00:34:24,395 --> 00:34:27,606
So double the recommended dosage?
852
00:34:27,607 --> 00:34:29,399
Uh...
853
00:34:29,400 --> 00:34:31,693
It's our wedding anniversary.
854
00:34:31,694 --> 00:34:33,612
Ah. Is this a big one?
855
00:34:33,613 --> 00:34:36,281
The anniversary, is it important?
856
00:34:36,282 --> 00:34:38,867
Like, uh, significant?
Like, a milestone or...
857
00:34:38,868 --> 00:34:40,660
- It's our 20th.
- Oh, nice.
858
00:34:40,661 --> 00:34:43,955
Well done. Congratulations.
859
00:34:43,956 --> 00:34:45,332
Glucose 521.
860
00:34:45,333 --> 00:34:46,708
Sodium 129.
861
00:34:46,709 --> 00:34:48,668
Potassium's 3.7.
862
00:34:48,669 --> 00:34:50,337
Chloride's 97.
863
00:34:50,338 --> 00:34:52,297
- Bicarb's 8.
- Meaning?
864
00:34:52,298 --> 00:34:55,509
We can start the insulin drip
and add 20 of K to each liter.
865
00:34:55,510 --> 00:34:57,719
Big anion gap of 24.
866
00:34:57,720 --> 00:34:59,096
It should be under 10.
867
00:34:59,097 --> 00:35:00,847
We follow it to assess progress.
868
00:35:00,848 --> 00:35:03,517
Actually, the 2024
international guidelines
869
00:35:03,518 --> 00:35:05,435
state that anion gap should not be used,
870
00:35:05,436 --> 00:35:07,687
as they can be misleading
in the presence
871
00:35:07,688 --> 00:35:10,524
of hyperchloremic metabolic acidosis.
872
00:35:10,525 --> 00:35:13,026
I-I recently had a case in the ICU.
873
00:35:13,027 --> 00:35:15,570
VBG is back... pH of 6.97.
874
00:35:15,571 --> 00:35:16,696
Normal's 7.4.
875
00:35:16,697 --> 00:35:18,281
What causes the acidemia?
876
00:35:18,282 --> 00:35:20,242
Without insulin,
the body can't use glucose,
877
00:35:20,243 --> 00:35:22,244
so it breaks down fat-producing ketones,
878
00:35:22,245 --> 00:35:24,538
leading to severe acidosis,
which can cause cardiac arrest.
879
00:35:24,539 --> 00:35:26,873
But the hyperglycemia causes
the body to excrete more water
880
00:35:26,874 --> 00:35:29,042
and electrolytes,
leading to severe dehydration,
881
00:35:29,043 --> 00:35:30,919
cardiac and renal dysfunction.
882
00:35:30,920 --> 00:35:32,671
Insulin drip, fluids with KCL,
883
00:35:32,672 --> 00:35:35,549
capillary glucose every hour,
chem-7 every four hours.
884
00:35:35,550 --> 00:35:37,175
ICU is gonna want
a double lumen midline, too.
885
00:35:37,176 --> 00:35:38,426
Both: I can do it.
886
00:35:38,427 --> 00:35:39,886
- 6 1/2 gloves.
- 7 1/2 gloves.
887
00:35:39,887 --> 00:35:41,263
Can I just say, we evaluate our students
888
00:35:41,264 --> 00:35:42,889
not only on their fund of knowledge
889
00:35:42,890 --> 00:35:44,724
and on their procedural mastery,
890
00:35:44,725 --> 00:35:46,268
but, also, maybe more importantly,
891
00:35:46,269 --> 00:35:48,186
on their skills as team players?
892
00:35:48,187 --> 00:35:50,856
- He can do it.
- She... she can do it.
893
00:35:50,857 --> 00:35:52,649
Otero, will you update everyone?
894
00:35:52,650 --> 00:35:54,985
Barry Mitchell.
Eating breakfast at Pamela's.
895
00:35:54,986 --> 00:35:56,653
Sudden onset respiratory distress.
896
00:35:56,654 --> 00:35:58,113
Some stridor.
897
00:35:58,114 --> 00:36:00,073
Decent pulse ox but trouble speaking.
898
00:36:00,074 --> 00:36:02,075
- And they tried the Heimlich?
- Three times.
899
00:36:02,076 --> 00:36:04,745
Any history of asthma?
900
00:36:06,497 --> 00:36:08,456
- Set up for intubation.
- Agreed.
901
00:36:08,457 --> 00:36:11,084
Okay, sir, scoot across.
902
00:36:11,085 --> 00:36:13,837
Always a good sign when
they slide over on their own.
903
00:36:13,838 --> 00:36:16,423
Came from a diner with
an upper-airway obstruction.
904
00:36:16,424 --> 00:36:18,133
Didn't clear with abdominal thrusts.
905
00:36:18,134 --> 00:36:19,426
We got to take a look.
906
00:36:19,427 --> 00:36:21,761
Heart rate's 118. Pulse ox 96.
907
00:36:21,762 --> 00:36:23,597
Mr. Mitchell, we're gonna sedate you
908
00:36:23,598 --> 00:36:25,140
to look down your throat, okay?
909
00:36:25,141 --> 00:36:27,017
Draw up ketamine and rocuronium.
910
00:36:27,018 --> 00:36:29,436
What about ketamine only?
911
00:36:29,437 --> 00:36:31,313
No, we need full paralysis
912
00:36:31,314 --> 00:36:33,231
for a successful first-pass intubation.
913
00:36:33,232 --> 00:36:35,817
Might not need an intubation
if it's just a foreign body.
914
00:36:35,818 --> 00:36:37,444
We can't assume that.
915
00:36:37,445 --> 00:36:39,487
It could be subglottic
stenosis, epiglottitis.
916
00:36:39,488 --> 00:36:41,324
I got ketamine and roc.
917
00:36:43,159 --> 00:36:46,119
Ketamine only, 80 milligrams.
918
00:36:46,120 --> 00:36:50,165
In that case, I'll leave this
in your capable hands.
919
00:36:50,166 --> 00:36:54,461
Cetacaine spray and a Yankauer, please.
920
00:36:54,462 --> 00:36:57,130
30 minutes ago, I told you
I'd never been sued.
921
00:36:57,131 --> 00:36:59,341
- I'd like to keep it that way.
- Mm.
922
00:37:01,135 --> 00:37:03,678
Instead of showing up here, you'd think
923
00:37:03,679 --> 00:37:06,348
he'd put an eight-hour hard-on
to good use.
924
00:37:06,349 --> 00:37:08,475
Well, it is a medical emergency.
925
00:37:08,476 --> 00:37:10,393
If left untreated, priapism can cause
926
00:37:10,394 --> 00:37:12,020
permanent damage to the penis
927
00:37:12,021 --> 00:37:13,688
and erectile dysfunction forever.
928
00:37:13,689 --> 00:37:15,357
Thanks for the PSA.
929
00:37:15,358 --> 00:37:17,150
Pharmacist mixed up phenylephrine.
930
00:37:17,151 --> 00:37:19,736
10 cc's of 100 mikes per cc.
931
00:37:19,737 --> 00:37:21,154
Great. That's the maximum dose.
932
00:37:21,155 --> 00:37:22,530
Sterile bolus saline.
933
00:37:22,531 --> 00:37:23,990
You might need to refill
934
00:37:23,991 --> 00:37:25,909
since they'll be
flushing over and over again.
935
00:37:25,910 --> 00:37:28,370
Hold out the empty basin to
catch whatever they pull out.
936
00:37:28,371 --> 00:37:30,330
- Got it?
- I think so.
937
00:37:30,331 --> 00:37:31,998
Holler if you need me.
938
00:37:31,999 --> 00:37:34,334
- How we doing?
- Oh, he's out from Versed.
939
00:37:34,335 --> 00:37:36,962
Did a lidocaine block
to the dorsal penile nerves
940
00:37:36,963 --> 00:37:39,089
- at 10 and 2.
- Yeah, he's ready.
941
00:37:39,090 --> 00:37:40,799
Excellent.
942
00:37:40,800 --> 00:37:43,802
Enter the dorsal side
to hit the corpus cavernosum.
943
00:37:43,803 --> 00:37:45,011
I'll hold the glans.
944
00:37:45,012 --> 00:37:47,973
- How deep?
- 2 centimeters.
945
00:37:47,974 --> 00:37:49,892
Ah, now aspirate.
946
00:37:52,395 --> 00:37:56,356
You guys do this, like, every day?
947
00:37:56,357 --> 00:37:58,400
If we're lucky.
948
00:37:58,401 --> 00:37:59,609
Come here.
949
00:38:02,697 --> 00:38:06,032
Okay, let's lay him down
and take a look.
950
00:38:06,033 --> 00:38:07,867
Okay.
951
00:38:14,208 --> 00:38:17,043
Good view of the epiglottis.
952
00:38:17,044 --> 00:38:20,213
And mystery solved.
953
00:38:20,214 --> 00:38:23,425
This is what you get for
eating broccoli for breakfast.
954
00:38:23,426 --> 00:38:25,427
Get a good grip on it.
955
00:38:25,428 --> 00:38:26,470
Okay.
956
00:38:28,431 --> 00:38:30,349
Okay.
957
00:38:35,730 --> 00:38:38,648
I can see why the Heimlich didn't work.
958
00:38:38,649 --> 00:38:40,526
Rotate a little bit.
959
00:38:43,904 --> 00:38:46,072
Voilà!
960
00:38:46,073 --> 00:38:48,825
That is why you give ketamine alone,
961
00:38:48,826 --> 00:38:50,452
because if we gave a paralytic,
962
00:38:50,453 --> 00:38:53,705
we would have to intubate
and ventilate for an hour.
963
00:38:55,458 --> 00:38:58,043
All right, this guy is going
to Westbridge for surgery.
964
00:38:58,044 --> 00:39:00,211
Trauma 1 will move out shortly.
965
00:39:00,212 --> 00:39:02,672
And our Alzheimer's widow,
Evelyn Bostick,
966
00:39:02,673 --> 00:39:04,799
can see her husband in the viewing room.
967
00:39:04,800 --> 00:39:06,343
God bless her.
968
00:39:06,344 --> 00:39:08,470
My CT results back on Michael Williams?
969
00:39:08,471 --> 00:39:10,472
Not yet... neither are the labs
on our little girl, Kylie.
970
00:39:10,473 --> 00:39:12,015
That's not me.
971
00:39:12,016 --> 00:39:13,933
I did, however, get a few things back
972
00:39:13,934 --> 00:39:15,268
on our abandoned baby Jane Doe.
973
00:39:15,269 --> 00:39:16,519
Still not me.
974
00:39:16,520 --> 00:39:18,104
I'll take those.
975
00:39:18,105 --> 00:39:20,482
Just keeping you informed.
976
00:39:20,483 --> 00:39:22,359
Yep.
977
00:39:22,360 --> 00:39:24,611
Okay.
978
00:39:24,612 --> 00:39:27,864
We're just trying to get her upstairs.
979
00:39:27,865 --> 00:39:30,450
Okay. All right, got it.
980
00:39:30,451 --> 00:39:33,620
Superbaby's urine
dipped negative 0 WBCs.
981
00:39:33,621 --> 00:39:35,622
Respiratory panel is positive
for rhinovirus,
982
00:39:35,623 --> 00:39:36,998
giving us a benign source.
983
00:39:36,999 --> 00:39:38,666
Procalcitonin and CRP are pending.
984
00:39:38,667 --> 00:39:40,752
Now peds is saying
they want a urine tox screen
985
00:39:40,753 --> 00:39:42,837
and an HIV antigen
before they'll take her.
986
00:39:42,838 --> 00:39:44,714
That sounds excessive.
987
00:39:44,715 --> 00:39:46,758
I feel like they're just
trying to keep her down here.
988
00:39:46,759 --> 00:39:48,468
Can you blame them?
989
00:39:48,469 --> 00:39:50,595
Never met a peds nurse yet
that wasn't a little wacky.
990
00:39:50,596 --> 00:39:52,514
You know what 12 hours
of crying babies does
991
00:39:52,515 --> 00:39:53,848
to a person's psyche?
992
00:39:53,849 --> 00:39:55,308
I almost went into peds.
993
00:39:55,309 --> 00:39:56,976
Good thing you didn't, trust me.
994
00:39:56,977 --> 00:39:59,104
Too long up there,
you're cuckoo for Cocoa Puffs.
995
00:39:59,105 --> 00:40:01,773
- You are very punchy today.
- Punchy's my new baseline.
996
00:40:01,774 --> 00:40:03,942
Anyone even looks at me funny,
I'm taking them out,
997
00:40:03,943 --> 00:40:05,443
going right for the eyes.
998
00:40:05,444 --> 00:40:06,945
I'll eye-gouge you.
999
00:40:06,946 --> 00:40:08,738
Bet you never knew that about me.
1000
00:40:08,739 --> 00:40:10,407
I did not.
1001
00:40:10,408 --> 00:40:12,325
- Where is Dr. Al-Hashimi?
- In North 5 with the priapism.
1002
00:40:12,326 --> 00:40:14,160
Ha! Better her than me.
1003
00:40:14,161 --> 00:40:16,162
I did not intend for that
1004
00:40:16,163 --> 00:40:18,164
to come off as sexual in any way.
1005
00:40:18,165 --> 00:40:19,999
And on that note,
I'm gonna go check on Louie,
1006
00:40:20,000 --> 00:40:21,876
and then I'm gonna get
some air in the ambulance bay.
1007
00:40:21,877 --> 00:40:23,753
So if anybody needs me,
that's where I'll be.
1008
00:40:23,754 --> 00:40:25,213
Got it, Cap.
1009
00:40:25,214 --> 00:40:27,924
Ah, ah, ah!
1010
00:40:27,925 --> 00:40:30,718
It looks like some pus at the
base of the lateral incisor.
1011
00:40:30,719 --> 00:40:33,012
We can drain that for you.
1012
00:40:33,013 --> 00:40:36,182
- Sounds like it's gonna hurt.
- No, we'll numb you up.
1013
00:40:36,183 --> 00:40:38,768
Make sure you... you use the good stuff.
1014
00:40:38,769 --> 00:40:41,229
It'll be top shelf, Louie, I promise.
1015
00:40:41,230 --> 00:40:43,940
- How we doing in here?
- Good.
1016
00:40:43,941 --> 00:40:46,025
Almost 4 liters out.
1017
00:40:46,026 --> 00:40:48,820
I already feel like a million bucks.
1018
00:40:48,821 --> 00:40:51,114
I just needed an oil change.
1019
00:40:51,115 --> 00:40:53,408
And I'm just about
to drain an apical abscess.
1020
00:40:53,409 --> 00:40:55,368
That's what I'm talking about.
1021
00:40:55,369 --> 00:40:57,745
I feel like I'm having a spa day.
1022
00:40:59,540 --> 00:41:02,460
Keep it up, Whitaker.
1023
00:41:04,336 --> 00:41:06,212
How long does this take?
1024
00:41:06,213 --> 00:41:09,007
Up to an hour, sometimes two.
1025
00:41:09,008 --> 00:41:10,676
Mel, any suggestions?
1026
00:41:13,053 --> 00:41:15,597
Mel, you did these at the VA.
1027
00:41:15,598 --> 00:41:18,057
How can we facilitate detumescence?
1028
00:41:18,058 --> 00:41:21,978
Oh, um, sometimes massaging
the shaft can help.
1029
00:41:21,979 --> 00:41:23,771
Oh, that's what she said.
1030
00:41:23,772 --> 00:41:27,734
You can break up the clots
with massage or compression.
1031
00:41:27,735 --> 00:41:29,402
Got it.
1032
00:41:29,403 --> 00:41:30,737
You okay, Mel?
1033
00:41:30,738 --> 00:41:34,073
She's thinking about her deposition.
1034
00:41:34,074 --> 00:41:36,075
Just stick with the facts of the case,
1035
00:41:36,076 --> 00:41:37,619
and it always goes well.
1036
00:41:37,620 --> 00:41:39,746
I thought you said you hadn't been sued.
1037
00:41:39,747 --> 00:41:42,332
I haven't, but I know
many colleagues who have.
1038
00:41:42,333 --> 00:41:45,043
I also know your work, Dr. King.
1039
00:41:45,044 --> 00:41:47,045
Your medical decision-making
in the chart
1040
00:41:47,046 --> 00:41:48,796
is always extremely thorough.
1041
00:41:48,797 --> 00:41:50,590
Now we're getting somewhere.
1042
00:41:50,591 --> 00:41:53,010
First signs of flaccidity.
1043
00:41:56,222 --> 00:41:58,389
I don't know how I could ever thank you.
1044
00:41:58,390 --> 00:42:00,600
Mm, well, I think you just did.
1045
00:42:00,601 --> 00:42:02,644
You saved my life.
1046
00:42:02,645 --> 00:42:04,229
I didn't do anything.
1047
00:42:04,230 --> 00:42:05,897
This is what happens
1048
00:42:05,898 --> 00:42:08,274
when your wife starts
being a Nazi about your diet.
1049
00:42:08,275 --> 00:42:10,568
She's got me keeping a food journal.
1050
00:42:10,569 --> 00:42:12,570
It's a good way to count calories.
1051
00:42:12,571 --> 00:42:14,322
What calories?
1052
00:42:14,323 --> 00:42:17,283
She insists I eat five servings
of vegetables a day.
1053
00:42:17,284 --> 00:42:19,786
A rabbit don't even eat
that many vegetables.
1054
00:42:19,787 --> 00:42:23,039
I ain't never choked
on a Sausage Egg McMuffin.
1055
00:42:23,040 --> 00:42:25,625
I feel like I've been here all day.
1056
00:42:25,626 --> 00:42:27,293
It's actually only been
1057
00:42:27,294 --> 00:42:29,379
a couple of hours, Mrs. Bostick.
1058
00:42:29,380 --> 00:42:31,881
Well, where are we going now?
1059
00:42:31,882 --> 00:42:33,299
Um...
1060
00:42:33,300 --> 00:42:35,677
I thought you...
1061
00:42:35,678 --> 00:42:38,638
might like to see your husband.
1062
00:42:38,639 --> 00:42:41,891
Is Ethan still here?
1063
00:42:41,892 --> 00:42:43,309
- Yeah.
- Oh.
1064
00:42:43,310 --> 00:42:45,896
Yes, yes, please.
1065
00:42:47,481 --> 00:42:48,941
Oh.
1066
00:42:51,819 --> 00:42:53,695
Oh...
1067
00:42:53,696 --> 00:42:57,282
this has been such a long day.
1068
00:42:57,283 --> 00:43:00,118
I'm so glad to see you resting,
1069
00:43:00,119 --> 00:43:03,079
but I think it's time.
1070
00:43:03,080 --> 00:43:05,164
We should be going home.
1071
00:43:05,165 --> 00:43:07,292
Uh, if... if we stop at the store
on the way,
1072
00:43:07,293 --> 00:43:10,211
I can pick up what I need
to make your shepherd's pie.
1073
00:43:10,212 --> 00:43:12,714
But not if it's hot out.
1074
00:43:12,715 --> 00:43:15,091
You know how I hate
using the oven in the heat.
1075
00:43:17,177 --> 00:43:19,305
We're ready to leave now.
1076
00:43:26,937 --> 00:43:29,230
Dr. Robby, is this a good time?
1077
00:43:29,231 --> 00:43:32,734
That depends on what you
have in mind, Dr. Al-Hashimi.
1078
00:43:32,735 --> 00:43:34,944
I'd hoped you would have viewed my ideas
1079
00:43:34,945 --> 00:43:37,238
for improving the department.
1080
00:43:37,239 --> 00:43:39,365
I was looking forward to
getting some feedback from you.
1081
00:43:39,366 --> 00:43:41,367
Okay, well, I think
the department functions
1082
00:43:41,368 --> 00:43:42,744
pretty well, all things considered.
1083
00:43:42,745 --> 00:43:44,370
I mean, we face the same challenges
1084
00:43:44,371 --> 00:43:45,872
that most emergency departments face.
1085
00:43:45,873 --> 00:43:47,832
Let's take generative AI, for instance.
1086
00:43:47,833 --> 00:43:50,293
ER doctors spend 40%
of their time charting,
1087
00:43:50,294 --> 00:43:53,171
only 28% of their time at the bedside.
1088
00:43:53,172 --> 00:43:56,341
That doesn't sound accurate.
1089
00:43:56,342 --> 00:43:58,259
I've included the study in my packet.
1090
00:43:58,260 --> 00:43:59,677
Right.
1091
00:43:59,678 --> 00:44:01,346
And patient passports have been shown
1092
00:44:01,347 --> 00:44:02,722
to increase satisfaction
1093
00:44:02,723 --> 00:44:04,474
because they show the time required
1094
00:44:04,475 --> 00:44:06,309
- for each phase of the visit.
- Yeah, I got it right here.
1095
00:44:06,310 --> 00:44:07,935
- What do you got?
- Combative college kid.
1096
00:44:07,936 --> 00:44:09,228
Flipped out in the library,
1097
00:44:09,229 --> 00:44:11,189
Tased in the neck by campus security.
1098
00:44:11,190 --> 00:44:13,316
- 5 midazolam didn't touch him.
- Will you get the fuck off me?
1099
00:44:13,317 --> 00:44:15,693
2901! 2901, motherfucker!
1100
00:44:15,694 --> 00:44:17,987
Get off! Fuck you, man!
1101
00:44:17,988 --> 00:44:20,573
Want to tell me some more
about your ideas?
1102
00:44:20,574 --> 00:44:22,116
- Maybe later.
- Let me out.
1103
00:44:22,117 --> 00:44:25,829
Let me the fuck out!
Let me out! Let me out!
1104
00:44:25,830 --> 00:44:27,830
Sync and corrections by btsix
www.addic7ed.com