1 00:00:10,707 --> 00:00:14,051 Sync and corrections by btsix www.addic7ed.com 2 00:00:16,262 --> 00:00:18,388 I'm in. 3 00:00:18,389 --> 00:00:19,682 Bag him. 4 00:00:22,936 --> 00:00:25,729 Defib pads are in place. 5 00:00:25,730 --> 00:00:27,689 OK, holding compressions. 6 00:00:27,690 --> 00:00:29,733 Good square line on the End-Tidal CO2. 7 00:00:29,734 --> 00:00:32,361 V-fib, charge to 200. 8 00:00:33,696 --> 00:00:35,030 Charged. 9 00:00:35,031 --> 00:00:38,367 Clear. 10 00:00:38,368 --> 00:00:40,662 Stand by with epi. 11 00:00:44,165 --> 00:00:46,084 Suction that tube. 12 00:00:48,002 --> 00:00:49,294 You're not in the esophagus, are you? 13 00:00:49,295 --> 00:00:50,587 Definitely not. 14 00:00:50,588 --> 00:00:52,005 I passed right through the cords. 15 00:00:52,006 --> 00:00:54,758 Good breath sounds. End-Tidal CO2 confirmed. 16 00:00:54,759 --> 00:00:56,093 His lungs are filling up with blood. 17 00:00:56,094 --> 00:00:57,261 I know. 18 00:01:02,892 --> 00:01:04,268 OK, rhythm check. 19 00:01:05,937 --> 00:01:07,437 Asystole. Push the epi. 20 00:01:07,438 --> 00:01:09,148 Fuck. 21 00:01:12,610 --> 00:01:14,444 Patients with lunch trays have been admitted. 22 00:01:14,445 --> 00:01:15,821 They're boarders. 23 00:01:15,822 --> 00:01:17,656 They're waiting for a bed to open upstairs. 24 00:01:17,657 --> 00:01:19,825 - And what about the others? - Non-admitted patients. 25 00:01:19,826 --> 00:01:21,618 They can have sandwiches or juice boxes. 26 00:01:21,619 --> 00:01:23,996 Just make sure they're not NPO. 27 00:01:23,997 --> 00:01:25,289 That's "nil per os." 28 00:01:25,290 --> 00:01:26,498 It's Latin for "nothing by mouth." 29 00:01:26,499 --> 00:01:28,292 NPOs are waiting for surgery. 30 00:01:28,293 --> 00:01:30,127 They'll beg, spit, and curse for food, 31 00:01:30,128 --> 00:01:31,461 but you got to stay strong. 32 00:01:31,462 --> 00:01:32,963 Hey, I've been waiting for an hour. 33 00:01:32,964 --> 00:01:34,798 When am I gonna see a fucking doctor? 34 00:01:34,799 --> 00:01:36,967 Excuse me! 35 00:01:36,968 --> 00:01:39,011 Perhaps you didn't see this, which is strange, 36 00:01:39,012 --> 00:01:40,804 because they're all over the place. 37 00:01:40,805 --> 00:01:43,307 Aggressive behavior toward healthcare workers is a felony. 38 00:01:43,308 --> 00:01:45,142 $2,000 fine, possible jail time. 39 00:01:45,143 --> 00:01:46,476 Got it? 40 00:01:46,477 --> 00:01:49,062 OK. I was just asking. 41 00:01:49,063 --> 00:01:50,731 We're busy today. 42 00:01:50,732 --> 00:01:52,024 It's a holiday weekend. 43 00:01:52,025 --> 00:01:53,317 We see the sickest patients first, 44 00:01:53,318 --> 00:01:55,861 so be happy you're still waiting. 45 00:01:55,862 --> 00:01:59,990 Jag-off. 46 00:01:59,991 --> 00:02:01,617 PTMC charge nurse. 47 00:02:01,618 --> 00:02:04,369 Go ahead, Medic Command. 48 00:02:04,370 --> 00:02:07,122 OK. Got it. 49 00:02:07,123 --> 00:02:08,332 Incoming trauma. 50 00:02:08,333 --> 00:02:10,834 Come on. 51 00:02:10,835 --> 00:02:12,210 Three minutes since the last epi. 52 00:02:12,211 --> 00:02:14,713 Hold compressions. 53 00:02:14,714 --> 00:02:16,048 Asystole. 54 00:02:16,049 --> 00:02:18,342 Resume CPR. Another amp of epi. 55 00:02:18,343 --> 00:02:20,677 Needs more suction. 56 00:02:26,392 --> 00:02:28,518 Pulmonary hemorrhage from liver failure. 57 00:02:28,519 --> 00:02:30,396 Is he going to make it? 58 00:02:35,652 --> 00:02:37,736 Should we give PCC? 59 00:02:37,737 --> 00:02:40,030 Too late for that. 60 00:02:40,031 --> 00:02:41,907 And he's not an ECMO candidate. 61 00:02:41,908 --> 00:02:43,992 Nothing else we can do? 62 00:02:48,873 --> 00:02:51,208 No, I think we're done. 63 00:02:55,755 --> 00:02:58,383 Louie. 64 00:03:02,387 --> 00:03:04,597 12:07. 65 00:03:11,396 --> 00:03:13,897 Should we do a debrief? 66 00:03:13,898 --> 00:03:15,857 We've got another motorcycle injury coming in, 67 00:03:15,858 --> 00:03:17,109 ETA 10 minutes. 68 00:03:17,110 --> 00:03:18,610 Why don't we get Louie cleaned up, 69 00:03:18,611 --> 00:03:20,654 - move him to the viewing room? - Yeah. 70 00:03:20,655 --> 00:03:23,574 Anybody that wants to pay their respects can join us in there. 71 00:03:25,827 --> 00:03:27,578 Thank you, everyone. 72 00:03:34,877 --> 00:03:36,294 I'll clean him up. 73 00:03:36,295 --> 00:03:38,463 Why don't you take five first? 74 00:03:38,464 --> 00:03:41,091 Or ten. Yeah? 75 00:03:41,092 --> 00:03:42,510 Yep. 76 00:03:52,270 --> 00:03:54,479 This is Dr. Jefferson from psychiatry. 77 00:03:54,480 --> 00:03:57,232 Why do I need to see a psychiatrist? 78 00:03:57,233 --> 00:03:59,609 Jada, why do I need to see a psychiatrist? 79 00:03:59,610 --> 00:04:01,278 It's gonna be OK, Jackson. 80 00:04:01,279 --> 00:04:03,780 Dr. Jefferson says he can help. 81 00:04:03,781 --> 00:04:06,575 Do you know how you got here? 82 00:04:06,576 --> 00:04:08,952 The medics brought me. 83 00:04:08,953 --> 00:04:11,788 I don't really remember. I... I was in the library. 84 00:04:11,789 --> 00:04:14,750 What were you doing there? 85 00:04:14,751 --> 00:04:17,627 I was... I was studying. 86 00:04:17,628 --> 00:04:20,297 I was trying to study. 87 00:04:20,298 --> 00:04:22,007 But then they wouldn't stop talking. 88 00:04:22,008 --> 00:04:24,217 Who wouldn't stop talking? 89 00:04:24,218 --> 00:04:25,886 They don't want me to pass the bar. 90 00:04:25,887 --> 00:04:27,471 Who doesn't want you to pass the bar? 91 00:04:27,472 --> 00:04:29,556 - That's what they told me. - Hey, hey. 92 00:04:29,557 --> 00:04:30,807 Hey, look at me. Look at me. 93 00:04:30,808 --> 00:04:32,142 Who doesn't want you to pass the bar? 94 00:04:32,143 --> 00:04:33,935 Let's give them some privacy. 95 00:04:33,936 --> 00:04:37,272 Dr. Jefferson will let us know when he's done. 96 00:04:37,273 --> 00:04:38,648 They don't want me to pass the bar. 97 00:04:38,649 --> 00:04:40,484 I'll be right outside, OK? 98 00:04:40,485 --> 00:04:43,987 I'll be right outside, Jackson. 99 00:04:43,988 --> 00:04:46,948 Why don't they want you to pass the bar, Jackson? 100 00:04:46,949 --> 00:04:48,950 They're afraid of me becoming a lawyer. 101 00:04:48,951 --> 00:04:51,953 They're afraid of you becoming a lawyer? 102 00:04:51,954 --> 00:04:56,166 He must have been studying with his law school friends. 103 00:04:56,167 --> 00:04:57,834 They... they should know what happened. 104 00:04:57,835 --> 00:05:00,504 I'm gonna call them. 105 00:05:00,505 --> 00:05:02,380 If you need anything, let me know. 106 00:05:02,381 --> 00:05:04,842 - OK, thank you. - Mm-hmm. 107 00:05:14,227 --> 00:05:15,520 Louie. 108 00:05:16,979 --> 00:05:20,190 Pulmonary hemorrhage. 109 00:05:20,191 --> 00:05:22,567 That was quick. 110 00:05:22,568 --> 00:05:25,070 I'm gonna go clean him up. 111 00:05:25,071 --> 00:05:26,446 I'll help. 112 00:05:29,700 --> 00:05:30,951 Go, go. 113 00:05:34,622 --> 00:05:37,916 Everything OK, Roxie? 114 00:05:37,917 --> 00:05:39,751 I can't get off the bedpan. 115 00:05:39,752 --> 00:05:41,879 Oh, that's what I'm here for. 116 00:05:47,885 --> 00:05:50,387 Your husband seems like a saint. 117 00:05:50,388 --> 00:05:53,682 How long you been married? 118 00:05:53,683 --> 00:05:56,143 Too long. 119 00:05:57,603 --> 00:06:00,564 Almost 20 years. 120 00:06:00,565 --> 00:06:02,399 - OK, put your arm around me. - Mm-hmm. 121 00:06:02,400 --> 00:06:04,234 And I'll pull the bedpan on three. 122 00:06:04,235 --> 00:06:05,402 OK. 123 00:06:05,403 --> 00:06:08,905 One, two, three. 124 00:06:08,906 --> 00:06:10,574 One more. 125 00:06:10,575 --> 00:06:12,784 - Great. - Mm. 126 00:06:12,785 --> 00:06:16,538 20? Wow. 127 00:06:16,539 --> 00:06:18,540 Yeah. 128 00:06:18,541 --> 00:06:22,587 He's been by my side through all of this. 129 00:06:24,463 --> 00:06:28,466 I've watched the light go out of him. 130 00:06:28,467 --> 00:06:30,927 So have the kids. 131 00:06:30,928 --> 00:06:32,345 That's what happened to my auntie 132 00:06:32,346 --> 00:06:35,682 when my Uncle Gerald got sick. 133 00:06:35,683 --> 00:06:38,268 But your husband does it because he loves you. 134 00:06:38,269 --> 00:06:39,769 Mm. 135 00:06:39,770 --> 00:06:41,980 I don't know how you do it, 136 00:06:41,981 --> 00:06:44,608 care for people day after day. 137 00:06:44,609 --> 00:06:47,068 I'll tell you my secret. 138 00:06:47,069 --> 00:06:49,946 I go home at the end of every shift, 139 00:06:49,947 --> 00:06:52,574 leave this all behind, 140 00:06:52,575 --> 00:06:54,492 and escape to "Love Island." 141 00:06:56,287 --> 00:06:57,829 How's it going in here? 142 00:06:57,830 --> 00:06:59,706 The higher-demand dose of morphine helped a little, 143 00:06:59,707 --> 00:07:01,791 - but she's still in pain. - OK. 144 00:07:01,792 --> 00:07:04,628 I got your order. 0.1 per kilo. 145 00:07:04,629 --> 00:07:06,296 - Thanks. - Mm-hmm. 146 00:07:06,297 --> 00:07:08,840 This is a very low sub-dissociative dose 147 00:07:08,841 --> 00:07:10,050 of ketamine. 148 00:07:10,051 --> 00:07:11,551 You might feel a little weird, 149 00:07:11,552 --> 00:07:14,138 but I think it's gonna help with the pain. 150 00:07:16,641 --> 00:07:18,683 Is my husband still in the cafeteria? 151 00:07:18,684 --> 00:07:20,769 I think so. Want me to get him? 152 00:07:20,770 --> 00:07:23,438 No, no. 153 00:07:23,439 --> 00:07:26,817 It's good for us to have a little time apart. 154 00:07:29,070 --> 00:07:31,405 I'll get you another blanket. 155 00:07:35,493 --> 00:07:37,160 Here. I'm headed that way. 156 00:07:37,161 --> 00:07:39,037 Thank you. 157 00:07:39,038 --> 00:07:40,705 Back here for good? 158 00:07:40,706 --> 00:07:42,499 Officially out of triage. 159 00:07:42,500 --> 00:07:45,669 They need extra hands with all the Westbridge hullabaloo. 160 00:07:45,670 --> 00:07:47,671 How many cups have you had today? 161 00:07:47,672 --> 00:07:49,172 - Don't judge me. - Just asking. 162 00:07:49,173 --> 00:07:50,508 You're judging. 163 00:07:52,385 --> 00:07:53,718 Did you hear about Louie? 164 00:07:53,719 --> 00:07:55,136 No. 165 00:07:55,137 --> 00:07:57,138 Pulmonary hemorrhage. Didn't make it. 166 00:07:57,139 --> 00:07:59,683 - Shit. - Mm. 167 00:07:59,684 --> 00:08:01,351 He's been here a hundred times. 168 00:08:01,352 --> 00:08:02,936 I know. 169 00:08:02,937 --> 00:08:06,189 Debrief in the viewing room later. 170 00:08:06,190 --> 00:08:07,857 On a happier note, Perlah and I are planning 171 00:08:07,858 --> 00:08:09,442 a birthday party for Javadi. 172 00:08:09,443 --> 00:08:11,194 She's turning 21. 173 00:08:11,195 --> 00:08:14,030 You two are thick as thieves. 174 00:08:14,031 --> 00:08:16,533 I don't have much of a social life these days, 175 00:08:16,534 --> 00:08:19,369 but I'll be sure to keep an eye out for the Partiful. 176 00:08:19,370 --> 00:08:22,372 Let's discuss our incarcerated patient Gus. 177 00:08:22,373 --> 00:08:24,165 Prison infirmaries tend to be short-staffed, 178 00:08:24,166 --> 00:08:26,501 so we need to be thorough. 179 00:08:26,502 --> 00:08:29,713 What's in the differential diagnosis for malnutrition? 180 00:08:29,714 --> 00:08:32,882 Inadequate intake, methamphetamine use, 181 00:08:32,883 --> 00:08:35,927 severe alcoholism, ADHD medication. 182 00:08:35,928 --> 00:08:37,554 What else? 183 00:08:37,555 --> 00:08:39,889 Cancer of the oropharynx, esophageal strictures, 184 00:08:39,890 --> 00:08:42,934 prior strokes, malabsorption, inflammatory bowel disease, 185 00:08:42,935 --> 00:08:44,894 none of which were in his medical record. 186 00:08:44,895 --> 00:08:47,313 What about psychosocial causes? 187 00:08:47,314 --> 00:08:49,649 Could be an intentional hunger strike. 188 00:08:49,650 --> 00:08:51,776 Or refusing food to get to the infirmary. 189 00:08:51,777 --> 00:08:53,611 Could also be abuse or neglect. 190 00:08:53,612 --> 00:08:55,905 Let's start with a nutrition history once he's back from CT. 191 00:08:55,906 --> 00:08:57,323 Do you have a second to talk about Westbridge? 192 00:08:57,324 --> 00:08:59,075 Mm-hmm. 193 00:08:59,076 --> 00:09:00,493 Hey, we need to start moving some patients out of here. 194 00:09:00,494 --> 00:09:01,786 These walls are starting to fill up with gurneys. 195 00:09:01,787 --> 00:09:03,246 Santos, Ogilvie, and King 196 00:09:03,247 --> 00:09:04,748 all have patients on the launching pad. 197 00:09:04,749 --> 00:09:06,583 I'll check in with them. 198 00:09:06,584 --> 00:09:08,251 How many patients have we had rerouted from Westbridge? 199 00:09:08,252 --> 00:09:09,586 Ten, and God knows how many more in the waiting room. 200 00:09:09,587 --> 00:09:11,254 Ambulance will be here in a few minutes 201 00:09:11,255 --> 00:09:13,048 with the accident victim; I'll stick him in Trauma Two. 202 00:09:13,049 --> 00:09:15,467 What is the story with your incarcerated patient? 203 00:09:15,468 --> 00:09:17,427 Gus Varney, three rib fractures 204 00:09:17,428 --> 00:09:20,055 with normal O2 sats currently, waiting on CT results. 205 00:09:20,056 --> 00:09:21,097 OK, if he's stable at the two-hour mark, 206 00:09:21,098 --> 00:09:22,557 I'd say he's good to go. 207 00:09:22,558 --> 00:09:23,725 Let's get the ball rolling on discharge. 208 00:09:23,726 --> 00:09:25,143 Let's wait on the CT results. 209 00:09:25,144 --> 00:09:26,603 We can move him out of Trauma One, at least. 210 00:09:26,604 --> 00:09:27,937 Yes, we can. What's open? 211 00:09:27,938 --> 00:09:29,606 13 and 14 will be discharged soon, 212 00:09:29,607 --> 00:09:31,399 15 once we move Louie to the viewing room 213 00:09:31,400 --> 00:09:32,817 and get it cleaned up. 214 00:09:32,818 --> 00:09:34,694 Our paracentesis patient, Mr. Cloverfield? 215 00:09:34,695 --> 00:09:36,279 V-fib arrest. 216 00:09:36,280 --> 00:09:37,489 We'll do a debrief when we know how many patients 217 00:09:37,490 --> 00:09:38,948 we're getting from Westbridge. 218 00:09:38,949 --> 00:09:41,993 So Gus goes to 13, 14, or 15? 219 00:09:41,994 --> 00:09:43,620 I kind of want to keep him in plain sight. 220 00:09:43,621 --> 00:09:45,622 - What about BH-2? - Sold. 221 00:09:45,623 --> 00:09:47,457 Why not give him some privacy? 222 00:09:47,458 --> 00:09:50,627 Everyone can see him in BH-2 like he's a monkey at the zoo. 223 00:09:50,628 --> 00:09:52,545 Because he came in with an orange jumpsuit, 224 00:09:52,546 --> 00:09:54,464 and we need to think about patient and staff safety. 225 00:09:54,465 --> 00:09:56,508 Safety first. BH-2 beats a prison cell. 226 00:09:56,509 --> 00:09:57,967 Not by much. 227 00:09:57,968 --> 00:09:59,636 Did you guys hear about Louie? 228 00:09:59,637 --> 00:10:02,305 - Yeah. - Yeah, chronic alcoholic. 229 00:10:02,306 --> 00:10:03,890 Go figure. 230 00:10:03,891 --> 00:10:06,476 Hey, fent OD in South 20 is ready for discharge, 231 00:10:06,477 --> 00:10:08,478 but could you get Lupe to call him a ride? 232 00:10:08,479 --> 00:10:09,854 I need to check on Louie. 233 00:10:09,855 --> 00:10:12,941 - Uh, actually, Whitaker... - He croaked. 234 00:10:12,942 --> 00:10:14,776 - What? - Five minutes ago. 235 00:10:14,777 --> 00:10:16,237 Robby called it. 236 00:10:26,330 --> 00:10:27,622 I'm sorry, man. 237 00:10:27,623 --> 00:10:30,458 We didn't have time to find you. 238 00:10:30,459 --> 00:10:32,710 What happened? 239 00:10:32,711 --> 00:10:35,338 He was apneic and pulseless. 240 00:10:35,339 --> 00:10:38,007 We started CPR and intubated him. 241 00:10:38,008 --> 00:10:39,676 He had a massive pulmonary hemorrhage. 242 00:10:39,677 --> 00:10:42,512 Robby called it. 243 00:10:43,681 --> 00:10:45,682 Found this with his stuff. 244 00:10:45,683 --> 00:10:48,017 Guess he was married at some point. 245 00:10:48,018 --> 00:10:49,770 Never knew that. 246 00:10:53,023 --> 00:10:55,733 Oh, didn't miss this part of the job. 247 00:10:55,734 --> 00:10:57,735 Yeah. 248 00:10:57,736 --> 00:11:03,199 Perlah, did Louie ever mention anything about a wife and kids? 249 00:11:03,200 --> 00:11:04,868 Not as far as I know. 250 00:11:04,869 --> 00:11:06,911 He only had eyes for Rita Moreno. 251 00:11:06,912 --> 00:11:10,665 Well, this is not Rita Moreno. 252 00:11:10,666 --> 00:11:12,500 No, it's not. 253 00:11:12,501 --> 00:11:16,588 Can we check to see if there's an emergency contact? 254 00:11:16,589 --> 00:11:19,466 Yeah, there's a number listed. 255 00:11:25,931 --> 00:11:30,059 You were his primary. Do you want to... 256 00:11:30,060 --> 00:11:31,729 No. 257 00:11:41,238 --> 00:11:43,740 PTMC charge nurse. 258 00:11:43,741 --> 00:11:47,911 Langdon? Where are you? 259 00:11:47,912 --> 00:11:49,996 Makes sense that we'd be his emergency contact. 260 00:11:49,997 --> 00:11:53,583 Sorry to get your hopes up. 261 00:11:53,584 --> 00:11:55,501 Our social worker's gonna do their thing. 262 00:11:55,502 --> 00:11:59,297 If Louie had any family left, they'll find them. 263 00:11:59,298 --> 00:12:01,257 OK? 264 00:12:02,968 --> 00:12:05,845 Guess it's good it happened here, not out on the street. 265 00:12:05,846 --> 00:12:07,305 You're off the hook with Louie. 266 00:12:07,306 --> 00:12:10,017 I'ma teach Emma here how to clean a dead body. 267 00:12:12,102 --> 00:12:13,937 I'm sorry, but they need me in L&D. 268 00:12:13,938 --> 00:12:15,605 You might want to call for another interpreter. 269 00:12:15,606 --> 00:12:16,981 Busy day. 270 00:12:16,982 --> 00:12:18,441 Shit, that's the girl in 12? 271 00:12:18,442 --> 00:12:20,151 Yeah, she's been waiting for five hours. 272 00:12:20,152 --> 00:12:21,903 Didn't hear her name called the first time. 273 00:12:21,904 --> 00:12:23,446 You check on her? 274 00:12:23,447 --> 00:12:24,781 Need to brush up on my ASL. 275 00:12:24,782 --> 00:12:26,282 You know sign language too? 276 00:12:26,283 --> 00:12:27,992 Princess here knows six languages. 277 00:12:27,993 --> 00:12:30,578 - I know French. - OK, it's not a contest. 278 00:12:30,579 --> 00:12:32,497 Ah! 279 00:12:32,498 --> 00:12:34,123 No shit talking in front of me. 280 00:12:34,124 --> 00:12:36,459 I get enough of that from her and Perlah. 281 00:12:36,460 --> 00:12:39,254 Guess I'll call for backup. 282 00:12:39,255 --> 00:12:41,297 Yo, Donnie, did you discharge your butt abscess? 283 00:12:41,298 --> 00:12:43,675 Not yet! 284 00:12:43,676 --> 00:12:45,176 What the hell? 285 00:12:45,177 --> 00:12:46,469 Your good friends upstairs sent doughnuts. 286 00:12:46,470 --> 00:12:47,887 Special thank-you for working the holiday. 287 00:12:47,888 --> 00:12:49,681 You got to be kidding me. 288 00:12:49,682 --> 00:12:51,516 What were you expecting, tacos and tequila? 289 00:12:51,517 --> 00:12:53,393 Every single one of them can forget about extra shifts. 290 00:12:53,394 --> 00:12:55,561 - Won't hire more nurses. - Won't pay us a decent wage. 291 00:12:55,562 --> 00:12:57,063 Won't hire security that can actually 292 00:12:57,064 --> 00:12:58,147 protect us from patients. 293 00:12:58,148 --> 00:12:59,816 But absolutely, send doughnuts. 294 00:12:59,817 --> 00:13:01,317 Sure you want to go into this line of work? 295 00:13:01,318 --> 00:13:03,152 Want me get you one? 296 00:13:03,153 --> 00:13:04,654 Of course I do, but I'm not taking admin's blood pastries. 297 00:13:04,655 --> 00:13:07,490 Et tu, Donnie? 298 00:13:07,491 --> 00:13:09,492 OK, move it or lose it. 299 00:13:09,493 --> 00:13:11,953 Meet me in South 15 with gowns and gloves. 300 00:13:11,954 --> 00:13:13,663 Looks like happy hour in here. 301 00:13:13,664 --> 00:13:15,373 Don't ask. What's up with Evel Knievel? 302 00:13:15,374 --> 00:13:17,834 Brandon Li, 52, fell off a motorcycle pyramid 303 00:13:17,835 --> 00:13:19,460 at 25 miles per hour. 304 00:13:19,461 --> 00:13:21,379 Motorcycle pyramid? You recruiting? 305 00:13:21,380 --> 00:13:22,797 Got a fellow rider in your midst. 306 00:13:22,798 --> 00:13:24,048 - No kidding. - How high up were you? 307 00:13:24,049 --> 00:13:25,842 On top of a three, two, one. 308 00:13:25,843 --> 00:13:27,802 But the bottom guys are sitting down driving the choppers. 309 00:13:27,803 --> 00:13:29,470 I'm fine. I don't need all this. 310 00:13:29,471 --> 00:13:31,180 - Were you wearing a helmet? - Of course. 311 00:13:31,181 --> 00:13:33,474 Oh, what do you know? They're still in style. 312 00:13:33,475 --> 00:13:36,060 Good vitals, tender right wrist, and big left knee lac. 313 00:13:36,061 --> 00:13:38,396 Hey, Joy, Perlah, Trauma Two. 314 00:13:38,397 --> 00:13:39,856 Who else can I have? 315 00:13:39,857 --> 00:13:41,482 Santos and Whitaker are in with Louie. 316 00:13:41,483 --> 00:13:43,276 Yeah, give me Whitaker. He could use a distraction. 317 00:13:43,277 --> 00:13:45,028 And Santos has been ducking traumas all day. 318 00:13:45,029 --> 00:13:46,446 Well, she's behind in her charting. 319 00:13:46,447 --> 00:13:47,740 Who isn't? 320 00:13:50,868 --> 00:13:54,412 OK, even when it's not your fault, 321 00:13:54,413 --> 00:13:56,039 sometimes it's worse knowing 322 00:13:56,040 --> 00:13:58,207 that there was nothing you could do. 323 00:13:58,208 --> 00:14:00,543 Uh-huh. 324 00:14:00,544 --> 00:14:02,378 Are you... 325 00:14:02,379 --> 00:14:03,796 Robby needs you both in Trauma Two, 326 00:14:03,797 --> 00:14:05,590 and I need you to discharge sweet Patty in 13 327 00:14:05,591 --> 00:14:06,966 as soon as you're done. 328 00:14:06,967 --> 00:14:08,468 Can't catch a break. 329 00:14:08,469 --> 00:14:10,387 I push you 'cause I know you can take it. 330 00:14:22,733 --> 00:14:25,860 You ever clean a dead body? 331 00:14:25,861 --> 00:14:29,572 Probably never seen one either. 332 00:14:29,573 --> 00:14:32,575 No one tells you what it looks, feels, or smells like, 333 00:14:32,576 --> 00:14:36,746 but you get used to it over time. 334 00:14:36,747 --> 00:14:39,916 You pull off the gown. You wipe him down with towels. 335 00:14:39,917 --> 00:14:42,126 Then we'll roll him on his side, 336 00:14:42,127 --> 00:14:45,421 clean his back, stuff the sheet under him, 337 00:14:45,422 --> 00:14:48,007 wipe down the bed, roll him the other way, 338 00:14:48,008 --> 00:14:49,759 pull out the sheet, and repeat. 339 00:14:49,760 --> 00:14:52,428 Just follow my lead. 340 00:14:52,429 --> 00:14:56,391 Usually, you leave the ET tube in for the coroner, 341 00:14:56,392 --> 00:15:00,269 but Louie's a chronic alcoholic with end-stage liver disease. 342 00:15:00,270 --> 00:15:04,148 Not a coroner's case. 343 00:15:04,149 --> 00:15:07,443 - Did he have family? - Everyone has family. 344 00:15:07,444 --> 00:15:10,613 The social worker always tries to find them. 345 00:15:10,614 --> 00:15:12,949 Sometimes the family loved them, 346 00:15:12,950 --> 00:15:14,575 tried to get them to come home. 347 00:15:14,576 --> 00:15:17,286 Other times, the family wants nothing to do with them. 348 00:15:17,287 --> 00:15:21,124 - That's sad. - That's life. 349 00:15:21,125 --> 00:15:22,834 What happens if no one claims his body? 350 00:15:22,835 --> 00:15:24,460 He'll be cremated. 351 00:15:24,461 --> 00:15:26,003 Where would his ashes go? 352 00:15:26,004 --> 00:15:27,463 They'll keep him for a few months. 353 00:15:27,464 --> 00:15:28,840 Then he gets buried in a mass grave 354 00:15:28,841 --> 00:15:32,802 with all the other unclaimed bodies. 355 00:15:32,803 --> 00:15:35,722 OK, now we roll him. 356 00:15:38,767 --> 00:15:40,601 Ready. 357 00:15:40,602 --> 00:15:42,186 Go. 358 00:15:42,187 --> 00:15:43,604 Oh, my God, is he still alive? 359 00:15:43,605 --> 00:15:45,314 No, that happens. 360 00:15:45,315 --> 00:15:48,151 These frequent fliers. 361 00:15:48,152 --> 00:15:51,988 They can be a real pain in the ass, but... 362 00:15:51,989 --> 00:15:55,075 you miss them when they're gone. 363 00:16:01,748 --> 00:16:03,916 I've been at every Millvale Fourth of July parade 364 00:16:03,917 --> 00:16:05,418 since '08. 365 00:16:05,419 --> 00:16:07,837 World record is 40 men on seven motorcycles. 366 00:16:07,838 --> 00:16:09,422 I plan to beat that someday. 367 00:16:09,423 --> 00:16:11,424 Good lung sliding bilaterally. 368 00:16:11,425 --> 00:16:13,009 Pupils equal and reactive. 369 00:16:13,010 --> 00:16:14,844 - What do you ride? - The Bullet. 370 00:16:14,845 --> 00:16:16,721 Oh, Royal Enfield. Ankle breaker. 371 00:16:16,722 --> 00:16:19,056 - Thumper. - BP 138 over 80. 372 00:16:19,057 --> 00:16:21,225 Pulse 94. Pulse ox 98. 373 00:16:21,226 --> 00:16:23,519 All your vitals sound really good, Brandon. 374 00:16:23,520 --> 00:16:25,146 They call it an ankle breaker 'cause 375 00:16:25,147 --> 00:16:26,814 you got to kick over a big, fat single cylinder 376 00:16:26,815 --> 00:16:29,025 to get it started, sometimes five or six kicks. 377 00:16:29,026 --> 00:16:31,235 Yeah, especially on a cold day. 378 00:16:31,236 --> 00:16:33,529 Um, does anyone have any trauma scissors? 379 00:16:33,530 --> 00:16:35,406 - I'll check the knee. - Uh, not yet. 380 00:16:35,407 --> 00:16:37,241 - Why not? - Dr. Santos. 381 00:16:37,242 --> 00:16:39,702 Primary survey means rule out the life threats. 382 00:16:39,703 --> 00:16:41,829 Don't get distracted by lacerations or fractures. 383 00:16:41,830 --> 00:16:43,539 No free fluid in the belly. 384 00:16:43,540 --> 00:16:46,042 Airway, breathing, circulation are fine. 385 00:16:46,043 --> 00:16:48,252 OK, that's ABC. That just leaves two letters. 386 00:16:48,253 --> 00:16:50,463 Tell her about D, Dr. Santos. 387 00:16:50,464 --> 00:16:52,465 Disability. Wiggle your toes, sir. 388 00:16:52,466 --> 00:16:54,717 Any pain in your arms or legs? 389 00:16:54,718 --> 00:16:56,260 Not really. 390 00:16:56,261 --> 00:16:57,553 Does it hurt when I push here? 391 00:16:57,554 --> 00:16:59,472 - No. - OK, no midline tenderness. 392 00:16:59,473 --> 00:17:01,140 Nexus negative. 393 00:17:01,141 --> 00:17:03,309 With no obvious brain injury or spinal cord injury. 394 00:17:03,310 --> 00:17:06,479 That just leaves E. Joy. 395 00:17:06,480 --> 00:17:08,231 Can I buy another vowel? 396 00:17:08,232 --> 00:17:10,441 - Dr. Whitaker. - Exposure. 397 00:17:10,442 --> 00:17:11,943 AKA strip and flip. 398 00:17:11,944 --> 00:17:14,070 Cut off his clothes, and we'll log roll him. 399 00:17:14,071 --> 00:17:16,113 What do we have? 400 00:17:16,114 --> 00:17:18,032 Helmeted motorcycle acrobat. 401 00:17:18,033 --> 00:17:20,618 8-foot fall standing on top of five riders. 402 00:17:20,619 --> 00:17:22,286 Primary survey normal, E-FAST negative. 403 00:17:22,287 --> 00:17:24,205 Another motorcycle accident. 404 00:17:24,206 --> 00:17:26,415 Hello, sir. I'm Dr. Garcia from surgery. 405 00:17:26,416 --> 00:17:27,917 Hello. 406 00:17:27,918 --> 00:17:33,090 OK, we will roll him in three, two, one. 407 00:17:37,094 --> 00:17:39,554 Well, I grew up a block from Carrick, 408 00:17:39,555 --> 00:17:42,431 but my mom was a teacher at Brashear, so I had to go there. 409 00:17:42,432 --> 00:17:44,934 - The Bullets? - That's right. 410 00:17:44,935 --> 00:17:46,310 They were the Bullets when I was there. 411 00:17:46,311 --> 00:17:48,104 They changed to the Bulls when I left. 412 00:17:48,105 --> 00:17:49,605 Oh. 413 00:17:49,606 --> 00:17:54,110 Hey, you think I could get something to eat? 414 00:17:54,111 --> 00:17:56,696 Gus here is wondering if he's clear to eat. 415 00:17:56,697 --> 00:17:58,656 As long as it's a liquid diet. 416 00:17:58,657 --> 00:18:01,534 We have the results of your CT scan. 417 00:18:01,535 --> 00:18:04,453 Your jaw should heal without surgery, which is good news, 418 00:18:04,454 --> 00:18:07,039 but it will be a few weeks. 419 00:18:07,040 --> 00:18:08,541 Before I can eat? 420 00:18:08,542 --> 00:18:10,334 Solid foods, yes. 421 00:18:10,335 --> 00:18:14,130 Or you can have food pureed with liquid in a blender. 422 00:18:14,131 --> 00:18:16,799 I don't have a blender. 423 00:18:16,800 --> 00:18:18,217 Right. 424 00:18:18,218 --> 00:18:20,136 Sorry. 425 00:18:20,137 --> 00:18:23,514 We have a calorie-rich supplement drink called Ensure. 426 00:18:23,515 --> 00:18:26,976 Comes in chocolate, vanilla, or strawberry. 427 00:18:26,977 --> 00:18:28,811 Chocolate, please. 428 00:18:28,812 --> 00:18:30,479 - Good choice. - How many can I have? 429 00:18:30,480 --> 00:18:31,981 Two a day is recommended. 430 00:18:31,982 --> 00:18:34,108 I'll get it for you. 431 00:18:34,109 --> 00:18:37,486 You have an appetite. That's good. 432 00:18:37,487 --> 00:18:39,655 Mr. Varney, your blood tests indicate 433 00:18:39,656 --> 00:18:42,199 low levels of protein and vitamins. 434 00:18:42,200 --> 00:18:46,162 Can we ask you a few questions about your diet? 435 00:18:46,163 --> 00:18:49,498 How many meals or snacks do you have in a 24-hour period? 436 00:18:49,499 --> 00:18:50,833 I don't know. 437 00:18:50,834 --> 00:18:52,835 Don't count. 438 00:18:52,836 --> 00:18:55,421 Pretty sure it's three trays a day. 439 00:18:55,422 --> 00:18:57,089 OK. 440 00:18:57,090 --> 00:19:00,301 How often do you eat cereals, fruits, or vegetables? 441 00:19:00,302 --> 00:19:03,554 Not many fruits and vegetables in prison. 442 00:19:03,555 --> 00:19:05,223 Slow and steady. 443 00:19:07,225 --> 00:19:09,352 What year is your Bonneville? 444 00:19:09,353 --> 00:19:10,686 '69. 445 00:19:10,687 --> 00:19:13,022 Rescued it from a motor graveyard. 446 00:19:13,023 --> 00:19:14,565 Brought it back to life with a buddy of mine, 447 00:19:14,566 --> 00:19:16,359 who's supposed to be coming in today. 448 00:19:16,360 --> 00:19:17,777 How often do you ride? 449 00:19:17,778 --> 00:19:19,612 I ride it in to work every day. 450 00:19:19,613 --> 00:19:20,863 Good for you. 451 00:19:20,864 --> 00:19:22,531 Don't encourage him. 452 00:19:22,532 --> 00:19:24,241 CT's ready for Brandon. 453 00:19:24,242 --> 00:19:28,245 As soon as we take a look at this knee. 454 00:19:28,246 --> 00:19:30,581 - Whoa. - Through the deep fascia. 455 00:19:30,582 --> 00:19:31,874 How's it look? 456 00:19:31,875 --> 00:19:32,875 Definitely gonna need stitches. 457 00:19:32,876 --> 00:19:34,210 - How many? - A lot. 458 00:19:34,211 --> 00:19:35,753 It could be an open joint. 459 00:19:35,754 --> 00:19:37,672 We'll do a saline load after CT. 460 00:19:37,673 --> 00:19:39,215 OK. 461 00:19:39,216 --> 00:19:41,092 Lever sign negative. ACL intact. 462 00:19:41,093 --> 00:19:42,469 OK, ready to roll. 463 00:19:47,516 --> 00:19:49,350 Are you still coming over tonight? 464 00:19:49,351 --> 00:19:51,102 I think Whitaker is gonna be playing 465 00:19:51,103 --> 00:19:53,187 farm boy again this weekend, so he's not gonna be around. 466 00:19:53,188 --> 00:19:54,855 I may need a rain check. 467 00:19:54,856 --> 00:19:56,565 Hey, do you have an update on that nec fasc patient? 468 00:19:56,566 --> 00:19:57,983 Last I heard, Miller was doing 469 00:19:57,984 --> 00:20:00,153 an above-the-knee amputation with ortho. 470 00:20:02,114 --> 00:20:04,573 Langdon's waitress with the cellulitis? 471 00:20:04,574 --> 00:20:05,866 Yeah. 472 00:20:05,867 --> 00:20:08,494 - Man, that took a turn. - Sure did. 473 00:20:08,495 --> 00:20:12,415 Hey, did you hear about Louie? 474 00:20:12,416 --> 00:20:14,917 - Yeah. - You OK? 475 00:20:14,918 --> 00:20:16,419 Um, 476 00:20:16,420 --> 00:20:19,964 one of my uncles drank himself to death. 477 00:20:19,965 --> 00:20:22,842 I barely recognized him at the end. 478 00:20:22,843 --> 00:20:26,137 At least Louie always seemed happy. 479 00:20:26,138 --> 00:20:27,806 I'm here if you want to talk. 480 00:20:33,395 --> 00:20:36,272 Should've known I'd find you in here. 481 00:20:36,273 --> 00:20:40,109 You steal anyone's lunch, it's a $20 fine. 482 00:20:40,110 --> 00:20:41,777 Made a lot of changes while you were gone. 483 00:20:41,778 --> 00:20:43,446 I can see that. 484 00:20:43,447 --> 00:20:44,905 Look, I'll let you hide out a little bit longer, 485 00:20:44,906 --> 00:20:46,574 but then I need you to pick up more patients. 486 00:20:46,575 --> 00:20:48,117 You're not as fast as you used to be. 487 00:20:48,118 --> 00:20:50,286 Damn doughnuts! 488 00:20:50,287 --> 00:20:52,621 Ouch. 489 00:20:52,622 --> 00:20:55,583 First day back, I get kicked in the nuts. 490 00:20:55,584 --> 00:20:57,752 One dead, one septic bounce-back. 491 00:20:57,753 --> 00:21:00,046 Both of those not your fault. 492 00:21:02,632 --> 00:21:04,341 You expecting a party? 493 00:21:04,342 --> 00:21:06,051 No, not really. 494 00:21:06,052 --> 00:21:08,513 Didn't hear from anyone while I was gone. 495 00:21:10,974 --> 00:21:12,767 Sorry. 496 00:21:12,768 --> 00:21:16,437 They ever, uh, arrest that guy who punched you? 497 00:21:16,438 --> 00:21:18,272 Yeah. 498 00:21:18,273 --> 00:21:20,191 Wanted to know if I wanted to press charges, 499 00:21:20,192 --> 00:21:23,527 but didn't want to go through all that. 500 00:21:23,528 --> 00:21:26,155 Thought I was done, really did, but... 501 00:21:26,156 --> 00:21:29,825 I got bored at home, so only lasted a few weeks. 502 00:21:29,826 --> 00:21:31,619 You? 503 00:21:31,620 --> 00:21:34,330 10 months is a long time to be alone with your thoughts. 504 00:21:34,331 --> 00:21:36,874 I almost lost everything. 505 00:21:36,875 --> 00:21:39,043 I know a lot of women who would have taken the kids and left, 506 00:21:39,044 --> 00:21:42,338 - but Abby stayed. - 'Cause she's a good woman. 507 00:21:42,339 --> 00:21:44,173 'Cause you deserve a second chance. 508 00:21:44,174 --> 00:21:45,800 I'm not sure everyone agrees with you. 509 00:21:45,801 --> 00:21:47,218 Give it time. 510 00:21:47,219 --> 00:21:49,346 Look, I... 511 00:21:53,475 --> 00:21:56,018 I, um... 512 00:21:56,019 --> 00:21:59,897 I've been working the 12 steps, trying to make amends. 513 00:21:59,898 --> 00:22:01,690 I was really selfish. 514 00:22:01,691 --> 00:22:03,526 I lied to myself, and I lied to you. 515 00:22:03,527 --> 00:22:04,902 I'm really sorry. 516 00:22:04,903 --> 00:22:06,362 You can check me off your list, kid. 517 00:22:06,363 --> 00:22:08,239 We're good. 518 00:22:08,240 --> 00:22:10,407 - OK. - Yeah. 519 00:22:10,408 --> 00:22:12,076 Got a lovely patient for you in Two. 520 00:22:12,077 --> 00:22:14,037 Let's get you back on the horse. 521 00:22:17,040 --> 00:22:18,541 Really need to talk with Robby. 522 00:22:18,542 --> 00:22:19,959 I don't know if today's the best day for that. 523 00:22:19,960 --> 00:22:21,252 He leaves on vacation tomorrow. 524 00:22:21,253 --> 00:22:22,753 Let him get through the day in peace. 525 00:22:22,754 --> 00:22:24,255 He's supposed to be gone for three months? 526 00:22:24,256 --> 00:22:26,257 So he says. I give him one. 527 00:22:26,258 --> 00:22:27,676 Go get 'em, kid. 528 00:22:29,886 --> 00:22:33,222 Dr. Langdon, this is Rocky. 529 00:22:33,223 --> 00:22:34,598 Great name. 530 00:22:34,599 --> 00:22:38,227 What brings you in, Rocky? 531 00:22:38,228 --> 00:22:39,937 Very sick. 532 00:22:39,938 --> 00:22:42,231 When did it start? 533 00:22:42,232 --> 00:22:43,774 An hour ago. 534 00:22:43,775 --> 00:22:46,402 After he won a hot dog eating contest. 535 00:22:46,403 --> 00:22:48,905 A hot dog eating contest? How many you eat? 536 00:22:51,741 --> 00:22:53,827 351 hot dogs? 537 00:22:57,956 --> 00:22:59,456 36. 538 00:22:59,457 --> 00:23:01,959 Still a lot. 539 00:23:01,960 --> 00:23:03,961 - I pulled eight of Zofran. - Go for it. 540 00:23:03,962 --> 00:23:05,379 All right, this should help. 541 00:23:05,380 --> 00:23:07,089 Stick it under your tongue. Let it dissolve. 542 00:23:07,090 --> 00:23:08,610 OK, are you taking any prescription... 543 00:23:13,638 --> 00:23:16,015 Oh, thank you. 544 00:23:16,016 --> 00:23:18,601 Thanks. 545 00:23:18,602 --> 00:23:20,853 Santos, what's up with your ileus patient? 546 00:23:20,854 --> 00:23:22,855 Admitted to medicine, and before you ask, 547 00:23:22,856 --> 00:23:24,607 13 has been discharged. 548 00:23:24,608 --> 00:23:26,942 Great. 12 needs a doctor. 549 00:23:26,943 --> 00:23:28,777 No, don't make me go back there. 550 00:23:28,778 --> 00:23:31,947 That disimpaction left a smell and stunk up the whole hallway. 551 00:23:31,948 --> 00:23:33,991 So grab some coffee grounds from the lounge. 552 00:23:33,992 --> 00:23:36,619 We need to admit our incarcerated patient, Gus. 553 00:23:36,620 --> 00:23:38,495 What did the CT show? 554 00:23:38,496 --> 00:23:40,956 Moderate pulmonary contusion, three rib fractures, 555 00:23:40,957 --> 00:23:43,751 no intra-abdominal bleeding, and oblique fracture 556 00:23:43,752 --> 00:23:46,420 in the body of the mandible anterior to the angle. 557 00:23:46,421 --> 00:23:48,631 All favorable for healing. What's the treatment plan? 558 00:23:48,632 --> 00:23:50,466 - A pain med... - Security. 559 00:23:50,467 --> 00:23:51,842 People are trying to sleep. 560 00:23:51,843 --> 00:23:55,346 Pain medication, antibiotics, liquid diet, 561 00:23:55,347 --> 00:23:57,306 um, a pulse ox a few times a day, 562 00:23:57,307 --> 00:24:00,142 and then also dressing changes for the laceration. 563 00:24:00,143 --> 00:24:02,645 Which he can get at his correctional facility. 564 00:24:02,646 --> 00:24:04,939 Or he stays here for a few days, 565 00:24:04,940 --> 00:24:07,816 and we get him on the right track to healing. 566 00:24:07,817 --> 00:24:09,902 Why don't you two go check on your patients? 567 00:24:09,903 --> 00:24:12,655 - Got it. - Sure thing. 568 00:24:12,656 --> 00:24:14,490 What am I missing? 569 00:24:14,491 --> 00:24:15,866 He's not getting enough to eat 570 00:24:15,867 --> 00:24:17,368 at his correctional facility. 571 00:24:17,369 --> 00:24:18,953 The portions are tiny. 572 00:24:18,954 --> 00:24:20,913 Too many carbs, not enough fruits or vegetables. 573 00:24:20,914 --> 00:24:24,375 He's lucky he hasn't developed a chronic illness. 574 00:24:24,376 --> 00:24:26,168 We don't have any inpatient beds. 575 00:24:26,169 --> 00:24:27,711 He would board down here for three days. 576 00:24:27,712 --> 00:24:29,254 We're still getting runs from Westbridge, 577 00:24:29,255 --> 00:24:31,590 and we cannot tie up Behavioral for that long. 578 00:24:31,591 --> 00:24:33,425 Dr. Al-Hashimi, Dr. Jefferson wants to talk 579 00:24:33,426 --> 00:24:35,136 to you about our tasered kid. 580 00:24:39,015 --> 00:24:40,516 Why don't I call the prison doctor 581 00:24:40,517 --> 00:24:42,184 and find out what they're working with over there? 582 00:24:42,185 --> 00:24:44,020 - Thank you. - My pleasure. 583 00:24:46,064 --> 00:24:48,482 Dr. Jefferson seems to have a good rapport with Jackson. 584 00:24:48,483 --> 00:24:49,858 That's excellent. 585 00:24:49,859 --> 00:24:51,193 How's the sister doing? 586 00:24:51,194 --> 00:24:52,528 Still pretty upset. 587 00:24:52,529 --> 00:24:54,029 She's never seen him like this. 588 00:24:54,030 --> 00:24:55,698 It's a lot to process. 589 00:24:55,699 --> 00:24:57,908 - How's he doing? - He's scared. 590 00:24:57,909 --> 00:24:59,493 Droperidol had a positive effect, 591 00:24:59,494 --> 00:25:01,870 but he doesn't understand what's going on. 592 00:25:01,871 --> 00:25:03,872 He's been experiencing auditory hallucinations 593 00:25:03,873 --> 00:25:05,499 and paranoid delusions. 594 00:25:05,500 --> 00:25:08,711 Voices are telling him he isn't safe. 595 00:25:08,712 --> 00:25:09,962 This has been going on for months. 596 00:25:09,963 --> 00:25:11,588 - Months? - Yeah. 597 00:25:11,589 --> 00:25:13,215 Turns out, his sister hasn't seen him in a while. 598 00:25:13,216 --> 00:25:15,217 Family history of mental illness? 599 00:25:15,218 --> 00:25:17,428 Not that we know of. 600 00:25:17,429 --> 00:25:21,265 I'm gonna give him a break and then continue the conversation. 601 00:25:21,266 --> 00:25:22,641 Parents are on their way. 602 00:25:22,642 --> 00:25:23,642 We'll let you know when they get here. 603 00:25:23,643 --> 00:25:25,102 Yes. Do. 604 00:25:25,103 --> 00:25:26,937 OK, hospital bed, wheelchair, 605 00:25:26,938 --> 00:25:29,940 and shower chair have all been ordered. 606 00:25:29,941 --> 00:25:31,650 What do you say, kid? 607 00:25:31,651 --> 00:25:33,611 Ready to go home? 608 00:25:35,905 --> 00:25:38,782 How's your pain, Mrs. Hamler? 609 00:25:38,783 --> 00:25:40,284 The same. 610 00:25:40,285 --> 00:25:42,619 We're gonna write you a script for Keppra. 611 00:25:42,620 --> 00:25:43,954 You'll take that to prevent seizures 612 00:25:43,955 --> 00:25:45,789 once a day, starting tomorrow. 613 00:25:45,790 --> 00:25:47,750 Between your broken leg and the bruises from your seizure, 614 00:25:47,751 --> 00:25:49,793 the pain will probably get a little worse. 615 00:25:49,794 --> 00:25:51,086 Yeah, the most important thing is 616 00:25:51,087 --> 00:25:52,254 to let others help you. 617 00:25:52,255 --> 00:25:53,881 You'll need assistance showering 618 00:25:53,882 --> 00:25:55,382 and getting to the bathroom. 619 00:25:55,383 --> 00:25:57,259 Yeah, no problem. I won't leave her side. 620 00:25:57,260 --> 00:25:59,636 Paul, you need a break. 621 00:25:59,637 --> 00:26:04,099 You're... you're taking care of me, the kids, the house. 622 00:26:04,100 --> 00:26:07,394 It's too much for one person. 623 00:26:07,395 --> 00:26:09,646 I'm not the one battling cancer. 624 00:26:09,647 --> 00:26:10,939 Paul. 625 00:26:10,940 --> 00:26:14,443 Hey, you're in pain every day, 626 00:26:14,444 --> 00:26:16,111 fighting for your life. 627 00:26:16,112 --> 00:26:18,781 I'm happy to do this for you. 628 00:26:18,782 --> 00:26:21,325 You're my wife. 629 00:26:21,326 --> 00:26:24,453 Now, let's go home and forget this day ever happened. 630 00:26:24,454 --> 00:26:25,954 I'll call the transpo ambulance. 631 00:26:25,955 --> 00:26:27,248 Thanks, Princess. 632 00:26:33,797 --> 00:26:35,339 Hey. 633 00:26:35,340 --> 00:26:36,799 Hmm? 634 00:26:36,800 --> 00:26:38,967 Why don't you go ahead? 635 00:26:38,968 --> 00:26:40,052 - What? - Yeah. 636 00:26:40,053 --> 00:26:41,345 You can get the house ready. 637 00:26:41,346 --> 00:26:43,514 I'll be right behind you. 638 00:26:43,515 --> 00:26:45,182 - No. - Mm-hmm. 639 00:26:45,183 --> 00:26:49,311 No, I'm... I'm riding in the back with you. 640 00:26:49,312 --> 00:26:52,232 You know what? I'll stay with her. 641 00:26:53,775 --> 00:26:55,526 Are you sure? 642 00:26:55,527 --> 00:26:57,820 - Mm-hmm. - Yeah. 643 00:26:57,821 --> 00:27:00,989 OK. 644 00:27:00,990 --> 00:27:03,992 Um, call me if you need me to come back. 645 00:27:03,993 --> 00:27:05,828 Mm-hmm. 646 00:27:11,000 --> 00:27:12,459 When will the ambulance get here? 647 00:27:12,460 --> 00:27:13,502 It shouldn't be long. 648 00:27:13,503 --> 00:27:15,587 Mr. Francis, short of breath? 649 00:27:15,588 --> 00:27:17,047 Yeah, I was worried the clot in my leg 650 00:27:17,048 --> 00:27:19,091 could have gone up to my lungs, so... 651 00:27:19,092 --> 00:27:20,926 You're on Eliquis. That shouldn't happen. 652 00:27:20,927 --> 00:27:22,761 - Yeah, I know, but... - Hey, Donnie, I got this. 653 00:27:22,762 --> 00:27:24,263 Don't worry, Mr. Francis. 654 00:27:24,264 --> 00:27:25,931 I'll order the D-dimer. I'll be back to see you. 655 00:27:25,932 --> 00:27:28,517 Thank you, Dr. Mohan. 656 00:27:28,518 --> 00:27:30,519 You know I'm an NP now. 657 00:27:30,520 --> 00:27:32,020 I can pick up a patient with dyspnea. 658 00:27:32,021 --> 00:27:33,522 I'm sorry. 659 00:27:33,523 --> 00:27:35,941 I've seen him before, and he's asked for me. 660 00:27:35,942 --> 00:27:38,068 Why even order the test? He's on Eliquis. 661 00:27:38,069 --> 00:27:39,403 Mr. Francis comes in every month 662 00:27:39,404 --> 00:27:41,405 and always asks for a D-dimer. 663 00:27:41,406 --> 00:27:43,866 Just... he's worried, and it puts his mind at ease. 664 00:27:43,867 --> 00:27:46,535 - Why not? - Yeah, OK. 665 00:27:46,536 --> 00:27:49,371 Donnie's the best. You'll learn a lot from him. 666 00:27:49,372 --> 00:27:51,374 That's right. 667 00:28:17,984 --> 00:28:20,110 All right, fill me in. 668 00:28:20,111 --> 00:28:22,821 This is Harlow Graham. She was seen in triage. 669 00:28:22,822 --> 00:28:25,240 CBC and CMP came back normal. 670 00:28:25,241 --> 00:28:27,743 IT was supposed to bring the VRI down, but they're slammed. 671 00:28:27,744 --> 00:28:29,411 I know a bit of sign language. 672 00:28:29,412 --> 00:28:34,917 Harlow, this is Dr. Santos. 673 00:28:34,918 --> 00:28:36,628 Hi, Harlow. How are you feeling? 674 00:28:39,464 --> 00:28:40,797 She has a headache. 675 00:28:40,798 --> 00:28:42,634 OK. What else? 676 00:28:48,097 --> 00:28:49,765 What is she saying? 677 00:28:49,766 --> 00:28:51,892 I think she had a stomachache, 678 00:28:51,893 --> 00:28:54,687 and she might have passed out. 679 00:28:57,774 --> 00:28:59,566 I'm not 100% sure. 680 00:28:59,567 --> 00:29:02,110 OK, we're just gonna need to wait for an interpreter, 681 00:29:02,111 --> 00:29:03,779 'cause I need to ask a million questions, 682 00:29:03,780 --> 00:29:05,447 and I can't do it this way. 683 00:29:05,448 --> 00:29:07,533 So just call me when IT comes down. 684 00:29:18,836 --> 00:29:21,797 CT head, neck, chest, abdomen, pelvis all negative. 685 00:29:21,798 --> 00:29:24,841 It means we can get this collar off. 686 00:29:24,842 --> 00:29:26,969 Thank you. 687 00:29:26,970 --> 00:29:28,387 Roll to your side. 688 00:29:28,388 --> 00:29:30,639 We'll get you off this board. 689 00:29:30,640 --> 00:29:32,224 How long is your trip? 690 00:29:32,225 --> 00:29:35,143 2,000 miles, all the way from here to Alberta. 691 00:29:35,144 --> 00:29:36,812 Couple stops along the way. 692 00:29:36,813 --> 00:29:38,313 Got the whole thing mapped out. 693 00:29:38,314 --> 00:29:40,524 - Sounds like heaven. - Let's sit you up. 694 00:29:40,525 --> 00:29:42,234 Sorry, I got stuck with a patient. 695 00:29:42,235 --> 00:29:44,319 You know the old saying, four wheels move the body, 696 00:29:44,320 --> 00:29:45,904 two wheels move the soul. 697 00:29:45,905 --> 00:29:47,406 You're gonna be living the dream. 698 00:29:47,407 --> 00:29:48,824 Thank you, Brandon. 699 00:29:48,825 --> 00:29:50,367 Not everybody down here feels that way. 700 00:29:50,368 --> 00:29:52,661 - OK, Whitaker, what's next? - Ortho assessment. 701 00:29:52,662 --> 00:29:55,872 Palpate all long bones, starting with the clavicle. 702 00:29:55,873 --> 00:29:57,165 Got it. 703 00:29:57,166 --> 00:29:59,711 I'll take the lower extremities. 704 00:30:04,299 --> 00:30:05,507 Distal radius tender. No deformities. 705 00:30:05,508 --> 00:30:06,717 Needs an X-ray. 706 00:30:06,718 --> 00:30:08,135 No bony tenderness down here. 707 00:30:08,136 --> 00:30:09,511 No laxity of the knee. 708 00:30:09,512 --> 00:30:12,222 Are you concerned about that knee lac? 709 00:30:12,223 --> 00:30:14,391 If it's an open joint, he'll need a washout in the OR. 710 00:30:14,392 --> 00:30:16,351 We could try a fluorescein injection. 711 00:30:16,352 --> 00:30:17,853 OK, we'll need a... 712 00:30:17,854 --> 00:30:19,521 Wood's lamp, 1% lido with epi, 713 00:30:19,522 --> 00:30:21,940 sterile saline, sterile basin, sterile fluoro-strip, 714 00:30:21,941 --> 00:30:26,069 18- and 27-gauge needles, 5- and 60-cc syringes. 715 00:30:26,070 --> 00:30:28,530 How does she know all that? 716 00:30:28,531 --> 00:30:31,283 She just does. 717 00:30:31,284 --> 00:30:32,701 How are you feeling, Rocky? 718 00:30:32,702 --> 00:30:34,453 Oh, much better. 719 00:30:34,454 --> 00:30:36,204 He's had eight migs of ondansetron. 720 00:30:36,205 --> 00:30:37,706 Any pain in the belly? 721 00:30:37,707 --> 00:30:39,958 No, but my mouth is really dry. 722 00:30:39,959 --> 00:30:43,086 No doubt from consuming mass quantities of salty hot dogs. 723 00:30:43,087 --> 00:30:44,963 Could I have another sip of water? 724 00:30:44,964 --> 00:30:46,548 Sure. A little sip. 725 00:30:46,549 --> 00:30:48,592 Take it slow. 726 00:30:48,593 --> 00:30:50,093 - Here you go. - Thank you. 727 00:30:50,094 --> 00:30:53,847 Just enough to wet your whistle. 728 00:30:53,848 --> 00:30:56,600 So how'd you get your start as a competitive eater? 729 00:31:05,401 --> 00:31:07,861 Any pain here, Mr. Li? 730 00:31:07,862 --> 00:31:09,529 - Can't feel a thing. - Great. 731 00:31:09,530 --> 00:31:10,864 Where is Santos? 732 00:31:10,865 --> 00:31:13,533 Probably catching up on her charting. 733 00:31:13,534 --> 00:31:14,910 - Right. - Lights out. 734 00:31:14,911 --> 00:31:16,788 Wood's lamp on. 735 00:31:18,623 --> 00:31:20,458 OK. 736 00:31:22,085 --> 00:31:23,960 I might want to use some of that on Halloween. 737 00:31:23,961 --> 00:31:26,797 That is 250 ccs of sterile saline 738 00:31:26,798 --> 00:31:29,591 with one small touch of a sterile fluoro-strip. 739 00:31:29,592 --> 00:31:31,343 OK. 740 00:31:31,344 --> 00:31:34,137 We're going to inject this fluid into your knee, Brandon, 741 00:31:34,138 --> 00:31:37,766 and if there's anything glowing in your wound, 742 00:31:37,767 --> 00:31:39,768 we know we have a leak. 743 00:31:39,769 --> 00:31:42,270 - Feeling some pressure. - Yeah, it's normal. 744 00:31:42,271 --> 00:31:45,148 As soon as I finish the test, I'll pull off the fluid. 745 00:31:47,443 --> 00:31:49,027 That looks good. 746 00:31:49,028 --> 00:31:51,113 Laceration did not enter into the joint space. 747 00:31:51,114 --> 00:31:52,614 Surgery not needed. 748 00:31:52,615 --> 00:31:54,282 Excellent. I can get back to the parade. 749 00:31:54,283 --> 00:31:55,742 No, we'll still need to 750 00:31:55,743 --> 00:31:57,119 stitch you up and splint your wrist. 751 00:31:57,120 --> 00:31:58,453 Hanging a gram of Ancef. 752 00:31:58,454 --> 00:32:00,288 Wait, he has a penicillin allergy. 753 00:32:00,289 --> 00:32:02,916 No, PEN-FAST was negative. We're OK. 754 00:32:02,917 --> 00:32:05,669 My mom said I got a rash with amoxicillin when I was two. 755 00:32:05,670 --> 00:32:07,629 Yeah, probably not a true allergy. 756 00:32:07,630 --> 00:32:09,172 Go ahead and give it, Kim. 757 00:32:09,173 --> 00:32:11,174 But have epi and Benadryl standing by, right? 758 00:32:11,175 --> 00:32:13,176 Yes, to be on the safe side. 759 00:32:13,177 --> 00:32:15,470 Most people who think they have a penicillin allergy 760 00:32:15,471 --> 00:32:17,431 actually don't. 761 00:32:17,432 --> 00:32:19,975 Always listen to the nurses. They run the ER. 762 00:32:19,976 --> 00:32:22,019 We just try and stay out of their way. 763 00:32:28,901 --> 00:32:30,986 Now we can really clean him up. 764 00:32:30,987 --> 00:32:32,654 Didn't we already do that? 765 00:32:32,655 --> 00:32:34,823 Dried blood on the face, neck, hands. 766 00:32:34,824 --> 00:32:37,742 If anyone comes, they shouldn't have to see that. 767 00:32:37,743 --> 00:32:39,870 Sometimes the local unhoused folks will pay a visit, 768 00:32:39,871 --> 00:32:41,496 but we always make them presentable 769 00:32:41,497 --> 00:32:43,999 in case anyone comes. 770 00:32:44,000 --> 00:32:47,169 That's the last thing we can do for them. 771 00:32:47,170 --> 00:32:50,839 Didn't get to do that during COVID. 772 00:32:50,840 --> 00:32:53,175 Once he's spotless, we'll tuck him in nice and tight, 773 00:32:53,176 --> 00:32:55,510 but we always leave one arm outside the sheet. 774 00:32:55,511 --> 00:32:57,804 Because? 775 00:32:57,805 --> 00:33:00,390 So loved ones can hold their hand. 776 00:33:00,391 --> 00:33:02,476 - Here you go. - Thanks. 777 00:33:02,477 --> 00:33:04,020 Yeah. 778 00:33:06,063 --> 00:33:08,356 We're ready to discharge our cancer mom, Roxie. 779 00:33:08,357 --> 00:33:09,858 Ambulance is on the way; we just need 780 00:33:09,859 --> 00:33:11,693 - to reconcile her home meds. - Sounds good. 781 00:33:11,694 --> 00:33:13,653 Hey, I thought I saw another charge nurse around here. 782 00:33:13,654 --> 00:33:15,405 Oh, yeah. We travel in packs. 783 00:33:15,406 --> 00:33:16,865 Aren't you sick of this place yet? 784 00:33:16,866 --> 00:33:18,992 Oh, someone is ready for his sabbatical. 785 00:33:18,993 --> 00:33:20,660 Guilty as charged. 786 00:33:20,661 --> 00:33:22,579 Hey, I just got word that the at-home morphine pump 787 00:33:22,580 --> 00:33:23,747 is gonna be delayed. 788 00:33:23,748 --> 00:33:25,415 Hospital pharmacy has to mix it 789 00:33:25,416 --> 00:33:26,958 and then deliver it later today. 790 00:33:26,959 --> 00:33:28,710 Well, should we keep her here until it's ready? 791 00:33:28,711 --> 00:33:30,045 No, you can give her 792 00:33:30,046 --> 00:33:31,713 a 200-milligram tablet of MS Contin. 793 00:33:31,714 --> 00:33:33,882 - 200 milligrams? - Biggest pill they make. 794 00:33:33,883 --> 00:33:37,302 Releases over 12 hours for patients with opiate tolerance. 795 00:33:37,303 --> 00:33:38,887 Got it. 796 00:33:38,888 --> 00:33:40,388 Hey, do you want to stick around a little bit? 797 00:33:40,389 --> 00:33:41,806 Westbridge is closed to internal disaster. 798 00:33:41,807 --> 00:33:43,099 - We're getting all their runs. - Yeah, I heard. 799 00:33:43,100 --> 00:33:44,643 I put 20 bucks on a plumbing issue. 800 00:33:44,644 --> 00:33:46,561 I just watched that poop cruise documentary. 801 00:33:46,562 --> 00:33:48,313 Oh, I cannot stop thinking about it. 802 00:33:48,314 --> 00:33:50,440 That sounds like something I will absolutely never watch. 803 00:33:50,441 --> 00:33:52,025 Dr. Robby, 804 00:33:52,026 --> 00:33:54,611 you gave us a clozapine ileus about an hour ago. 805 00:33:54,612 --> 00:33:56,238 Your resident reported no surgical history, 806 00:33:56,239 --> 00:33:58,532 but the chart says they've had an appendectomy. 807 00:33:58,533 --> 00:34:00,575 We're not admitting the patient without a surgery consult. 808 00:34:00,576 --> 00:34:02,911 - Who called it in? - A Dr. Trinity Santos. 809 00:34:02,912 --> 00:34:06,248 Dr. Santos, you had an ileus patient. 810 00:34:06,249 --> 00:34:08,708 You neglected to mention a history of appendectomy. 811 00:34:08,709 --> 00:34:10,752 There was no history of appendectomy. 812 00:34:10,753 --> 00:34:12,212 It was in your note. 813 00:34:12,213 --> 00:34:14,965 I may have forgotten to proof check it. 814 00:34:14,966 --> 00:34:17,092 I was using the app that Dr. Al-Hashimi suggested 815 00:34:17,093 --> 00:34:18,562 to catch up on my charting. 816 00:34:18,563 --> 00:34:19,761 Wonderful. 817 00:34:19,762 --> 00:34:21,721 - Ah, Dr. Al-Hashimi. - Yes? 818 00:34:21,722 --> 00:34:25,308 Dr. Santos was just using your AI tool for her charting, 819 00:34:25,309 --> 00:34:28,603 and it hallucinated a history of appendicitis. 820 00:34:28,604 --> 00:34:31,898 As I mentioned to Dr. Santos, generative AI is not perfect. 821 00:34:31,899 --> 00:34:34,317 We still need to proofread every chart it creates. 822 00:34:34,318 --> 00:34:36,945 Mm-hmm, the patient also has a history of headache, 823 00:34:36,946 --> 00:34:39,114 followed by Dr. Park from Urology. 824 00:34:39,115 --> 00:34:41,783 That should probably be Neurology. 825 00:34:41,784 --> 00:34:44,035 Unless urologists are now treating migraines. 826 00:34:44,036 --> 00:34:45,453 Another example that should have been caught 827 00:34:45,454 --> 00:34:47,122 by proofreading. 828 00:34:47,123 --> 00:34:49,457 AI's 2% error rate is still better than dictation. 829 00:34:49,458 --> 00:34:50,959 Yeah, I don't really give a shit whether or not 830 00:34:50,960 --> 00:34:52,961 you want to use robots down here. 831 00:34:52,962 --> 00:34:55,463 I need accurate information in the medical record. 832 00:34:55,464 --> 00:34:56,881 - Understood. - OK. 833 00:34:56,882 --> 00:34:59,551 Dr. Santos. 834 00:34:59,552 --> 00:35:01,636 Dr. Santos! 835 00:35:01,637 --> 00:35:03,472 Yup. Won't happen again. 836 00:35:06,142 --> 00:35:07,184 Hoy. 837 00:35:08,853 --> 00:35:10,312 Thanks, Perlah. 838 00:35:10,313 --> 00:35:12,648 Six hours to go. You got this. 839 00:35:14,483 --> 00:35:17,527 When a wound is gaping like this, 840 00:35:17,528 --> 00:35:19,988 you want to use sub-Q to bring the edges together. 841 00:35:19,989 --> 00:35:21,781 A lot of meat to close. 842 00:35:21,782 --> 00:35:25,201 What would happen if we just did a simple wound closure? 843 00:35:25,202 --> 00:35:26,995 You take the stitches out in ten days, 844 00:35:26,996 --> 00:35:28,872 the wound opens, dehisces. 845 00:35:28,873 --> 00:35:30,206 Exactly. 846 00:35:30,207 --> 00:35:32,250 So what suture do we use under the skin? 847 00:35:32,251 --> 00:35:33,835 Vicryl provides support for a month. 848 00:35:33,836 --> 00:35:35,337 It takes two months to dissolve. 849 00:35:35,338 --> 00:35:38,673 Mm-hmm. So 5-0 nylon on the skin. 850 00:35:38,674 --> 00:35:40,759 4-0 vicryl under the skin. 851 00:35:40,760 --> 00:35:42,886 I'd go with a 3-0 vicryl. 852 00:35:42,887 --> 00:35:45,513 - You think? - Most definitely. 853 00:35:45,514 --> 00:35:47,891 Donnie is the master of wound closure. 854 00:35:47,892 --> 00:35:51,269 I do at least ten lacs a day out at triage, so... 855 00:35:51,270 --> 00:35:55,231 Can we see your sub-Q? 856 00:35:55,232 --> 00:35:56,858 Be my guest. 857 00:35:56,859 --> 00:35:58,903 If you insist. 858 00:36:03,366 --> 00:36:05,700 So... 859 00:36:05,701 --> 00:36:09,162 The secret is to be sure your entry point 860 00:36:09,163 --> 00:36:11,915 and exit point on both sides of the wound 861 00:36:11,916 --> 00:36:14,876 matches the depth on the other side. 862 00:36:14,877 --> 00:36:16,128 S... 863 00:36:19,590 --> 00:36:21,383 Start deep. 864 00:36:21,384 --> 00:36:25,345 Come up at the dermis. 865 00:36:25,346 --> 00:36:28,140 Big bites help the tissue close. 866 00:36:30,851 --> 00:36:34,062 It's a mirror image on the other side. 867 00:36:34,063 --> 00:36:36,732 Superficial to deep. 868 00:36:38,567 --> 00:36:41,277 - So you bury the knot. - Bingo. 869 00:36:41,278 --> 00:36:44,114 Avoids bumps on the scar line. 870 00:36:44,115 --> 00:36:47,909 Three ties, not four. 871 00:36:47,910 --> 00:36:50,286 Yeah, that's beautiful. 872 00:36:50,287 --> 00:36:53,456 And then you cut it short. 873 00:36:53,457 --> 00:36:55,083 Not too short. 874 00:36:55,084 --> 00:36:58,753 I like to slide my scissors 875 00:36:58,754 --> 00:37:01,923 down on the knot, 876 00:37:01,924 --> 00:37:07,137 then rotate up 45 degrees before I cut. 877 00:37:07,138 --> 00:37:09,305 Could use two more sub-Qs, 878 00:37:09,306 --> 00:37:12,559 one above, one below. 879 00:37:12,560 --> 00:37:13,686 Have at it. 880 00:37:16,063 --> 00:37:19,108 Interesting ink. Do they mean anything? 881 00:37:21,068 --> 00:37:24,738 This, this is "death and chaos," 882 00:37:24,739 --> 00:37:27,157 and this is "miracles and blessings." 883 00:37:27,158 --> 00:37:30,952 Got this one after the PittFest shooting, 884 00:37:30,953 --> 00:37:35,291 and I got this after my daughter was born. 885 00:37:37,793 --> 00:37:39,127 Put the head of the gurney up 886 00:37:39,128 --> 00:37:41,129 so people can see him, but not so high 887 00:37:41,130 --> 00:37:43,174 that his head flops to the side. 888 00:37:47,386 --> 00:37:48,720 What do you think? 889 00:37:48,721 --> 00:37:51,306 He looks peaceful. 890 00:37:51,307 --> 00:37:53,892 What's the hardest part of this job? 891 00:37:53,893 --> 00:37:55,727 It's pretty thankless, and that can be tough. 892 00:37:55,728 --> 00:37:57,145 You've seen burnout rates. 893 00:37:57,146 --> 00:37:58,980 I'm sure they teach you that in school. 894 00:37:58,981 --> 00:38:02,025 All my closest friends left after COVID. 895 00:38:02,026 --> 00:38:04,068 Some during. 896 00:38:04,069 --> 00:38:05,862 But I don't blame them. 897 00:38:05,863 --> 00:38:08,865 They needed to do what was best for their mental health. 898 00:38:08,866 --> 00:38:11,326 A lot of people broke. 899 00:38:11,327 --> 00:38:13,245 Why do you keep coming back? 900 00:38:15,706 --> 00:38:17,999 Why don't you, um, 901 00:38:18,000 --> 00:38:21,337 just finish up here and then go help Perlah for a bit? 902 00:38:25,508 --> 00:38:27,008 Great. Thank you. 903 00:38:27,009 --> 00:38:28,343 No, that is exactly what I needed to know. 904 00:38:28,344 --> 00:38:29,886 OK. 905 00:38:29,887 --> 00:38:32,514 I just got off the phone with the physician assistant 906 00:38:32,515 --> 00:38:35,016 at the prison; they've got a 16-hour-a-day infirmary 907 00:38:35,017 --> 00:38:37,310 with NP and PA coverage giving everything that we need, 908 00:38:37,311 --> 00:38:39,103 and they've got an RN for overnights. 909 00:38:39,104 --> 00:38:40,730 Even so, he's here because 910 00:38:40,731 --> 00:38:43,358 they're ignoring his basic needs. 911 00:38:43,359 --> 00:38:45,527 He's here because somebody kicked the shit out of him. 912 00:38:45,528 --> 00:38:47,028 I think you're missing the point. 913 00:38:47,029 --> 00:38:48,613 We have more to offer. 914 00:38:48,614 --> 00:38:50,740 Robby, we've got four more coming our way. 915 00:38:50,741 --> 00:38:52,367 OK, got it. 916 00:38:52,368 --> 00:38:53,868 What you're trying to do is very noble. 917 00:38:53,869 --> 00:38:55,245 We don't have the resources to spare. 918 00:38:55,246 --> 00:38:57,539 OK, then why admit the unhoused man, Digby? 919 00:38:57,540 --> 00:38:59,123 Why not send him back to the street 920 00:38:59,124 --> 00:39:00,792 with antibiotics and a roll of gauze? 921 00:39:00,793 --> 00:39:02,418 Because Digby lives on the street, 922 00:39:02,419 --> 00:39:05,046 and your incarcerated patient has a mid-level provider 923 00:39:05,047 --> 00:39:06,589 and a nurse looking after him. 924 00:39:06,590 --> 00:39:08,883 We both know the quality of care is not the same. 925 00:39:08,884 --> 00:39:09,884 Sorry, are you waiting for me? 926 00:39:09,885 --> 00:39:11,219 No. 927 00:39:11,220 --> 00:39:12,887 Dr. Al-Hashimi, for the patient in Seven. 928 00:39:12,888 --> 00:39:14,180 A few days here could make a world of difference 929 00:39:14,181 --> 00:39:15,598 for Gus' health. 930 00:39:15,599 --> 00:39:17,851 We are a safety net, but nets have holes. 931 00:39:17,852 --> 00:39:19,269 We are not admitting him 932 00:39:19,270 --> 00:39:21,104 'cause this is not about social justice. 933 00:39:23,232 --> 00:39:24,774 Everything I've done in my career 934 00:39:24,775 --> 00:39:27,235 is an effort to improve the system. 935 00:39:27,236 --> 00:39:28,945 Just because you know it's broken 936 00:39:28,946 --> 00:39:31,531 doesn't mean you stop trying. 937 00:39:31,532 --> 00:39:32,950 Excuse me. 938 00:39:37,413 --> 00:39:39,539 I talked to Jackson's girlfriend. 939 00:39:39,540 --> 00:39:40,665 OK. 940 00:39:40,666 --> 00:39:42,667 She told me a lot of stuff. 941 00:39:42,668 --> 00:39:45,086 Um, she wants to come see him, 942 00:39:45,087 --> 00:39:47,922 but I just don't think that's a good idea. 943 00:39:47,923 --> 00:39:50,341 And my... my parents are asking a lot of questions. 944 00:39:50,342 --> 00:39:52,260 Can I just take him home? 945 00:39:52,261 --> 00:39:53,803 I'm so sorry. 946 00:39:53,804 --> 00:39:55,972 Your... your brother is on an involuntary psych hold. 947 00:39:55,973 --> 00:39:57,307 He can't leave. 948 00:39:57,308 --> 00:39:58,433 It could take us weeks to figure out 949 00:39:58,434 --> 00:39:59,767 what's wrong with him. 950 00:39:59,768 --> 00:40:01,686 What's wrong with him? 951 00:40:01,687 --> 00:40:03,521 I'm so sorry. I did not mean it like that. 952 00:40:03,522 --> 00:40:04,856 What's... 953 00:40:04,857 --> 00:40:06,190 Why don't we go somewhere quiet, yeah? 954 00:40:06,191 --> 00:40:08,359 What's wrong with him? 955 00:40:08,360 --> 00:40:11,696 - Let's go over here. - What's wrong with him? 956 00:40:11,697 --> 00:40:13,615 What's wrong with him? 957 00:40:15,284 --> 00:40:17,328 What's wrong with him? 958 00:40:27,463 --> 00:40:29,130 How's she doing? 959 00:40:29,131 --> 00:40:31,341 She took three ounces of formula 960 00:40:31,342 --> 00:40:32,800 without vomiting or distress. 961 00:40:32,801 --> 00:40:34,260 Excellent. 962 00:40:34,261 --> 00:40:37,180 Dr. Wolke from Pedes should be down shortly. 963 00:40:37,181 --> 00:40:40,141 Yeah. I think I saw her smile. 964 00:40:40,142 --> 00:40:43,311 A true social smile where the baby is awake, alert, 965 00:40:43,312 --> 00:40:45,104 and responding to facial expressions 966 00:40:45,105 --> 00:40:47,649 usually doesn't happen until six weeks or older. 967 00:40:47,650 --> 00:40:49,359 It was likely a reflex smile that happens 968 00:40:49,360 --> 00:40:52,487 while they're sleeping. 969 00:40:52,488 --> 00:40:56,074 But some parents have reported their babies 970 00:40:56,075 --> 00:40:58,576 smiled socially as early as four weeks, 971 00:40:58,577 --> 00:41:01,537 so who knows? 972 00:41:01,538 --> 00:41:03,164 - Jesse. - Hmm? 973 00:41:03,165 --> 00:41:04,832 North 4 needs a blood draw when you have a sec. 974 00:41:04,833 --> 00:41:05,917 Got it. 975 00:41:05,918 --> 00:41:07,168 How we doing in here? 976 00:41:07,169 --> 00:41:08,336 Almost ready to head out. 977 00:41:08,337 --> 00:41:09,504 Looking good. 978 00:41:09,505 --> 00:41:10,546 Heart rate 91. 979 00:41:10,547 --> 00:41:12,215 BP is 115 over 82. 980 00:41:12,216 --> 00:41:14,175 Oxygen sat's 95%. 981 00:41:14,176 --> 00:41:15,802 Great. 982 00:41:15,803 --> 00:41:17,303 I'm sending him home with some nonstick dressing 983 00:41:17,304 --> 00:41:18,721 in case they don't stock them. 984 00:41:18,722 --> 00:41:20,515 Grab some burn net too. 985 00:41:20,516 --> 00:41:23,142 He's a good guy. He's a local. 986 00:41:23,143 --> 00:41:25,520 Yeah? You're from Pittsburgh? 987 00:41:25,521 --> 00:41:27,146 Yes, ma'am. Born and raised. 988 00:41:27,147 --> 00:41:28,314 Whereabouts? 989 00:41:28,315 --> 00:41:30,566 Bloomfield, Liberty Ave. 990 00:41:30,567 --> 00:41:33,194 Bloomfield? 991 00:41:33,195 --> 00:41:34,862 You know Sonny's Tavern? 992 00:41:34,863 --> 00:41:36,489 Worked there through high school. 993 00:41:36,490 --> 00:41:38,367 - No kidding. - You know Sonny's? 994 00:41:39,868 --> 00:41:43,162 Had my first kiss there. 995 00:41:43,163 --> 00:41:45,581 Hey, Donnie, my buddy Duke hasn't checked in yet? 996 00:41:45,582 --> 00:41:47,291 Nah, I told Lupe to keep an eye out. 997 00:41:47,292 --> 00:41:48,793 - Thank you. - Yep. 998 00:41:48,794 --> 00:41:51,130 Right, left. Right, left. Yeah. That's it. 999 00:41:54,758 --> 00:41:56,217 You back to check our work? 1000 00:41:56,218 --> 00:41:58,386 Nope. I need a silastic loop drain. 1001 00:41:58,387 --> 00:42:00,471 That looks great. 1002 00:42:00,472 --> 00:42:02,265 It's thanks to your fine instruction. 1003 00:42:02,266 --> 00:42:06,269 OK, he's going to need Kerlix and Xeroform. 1004 00:42:06,270 --> 00:42:08,146 You should throw a neoprene sleeve on him. 1005 00:42:08,147 --> 00:42:09,897 Limits the range of motion at the knee 1006 00:42:09,898 --> 00:42:11,733 - so the sutures don't pull out. - That's a good idea. 1007 00:42:11,734 --> 00:42:13,067 Must be fun to work here. 1008 00:42:13,068 --> 00:42:15,820 Oh, sure is. First week for these two. 1009 00:42:15,821 --> 00:42:17,280 How are you guys liking the Pitt? 1010 00:42:17,281 --> 00:42:18,740 I feel like I was born to do this. 1011 00:42:18,741 --> 00:42:21,242 Hard pass. 1012 00:42:21,243 --> 00:42:23,244 I'm shooting for pathology. 1013 00:42:23,245 --> 00:42:24,620 I like medical mysteries, 1014 00:42:24,621 --> 00:42:26,789 but I don't really deal well with people. 1015 00:42:26,790 --> 00:42:28,708 You have an interesting energy. 1016 00:42:28,709 --> 00:42:30,543 What's that for? 1017 00:42:30,544 --> 00:42:32,712 Splint starts at the knuckles, 1018 00:42:32,713 --> 00:42:36,257 comes up and around the elbow, 1019 00:42:36,258 --> 00:42:38,593 and back down to the palm. 1020 00:42:38,594 --> 00:42:41,429 It needs to be smaller. I can't ride with a splint. 1021 00:42:41,430 --> 00:42:42,930 Well, no, you shouldn't be riding at all. 1022 00:42:42,931 --> 00:42:44,891 Right now, that's a non-displaced fracture. 1023 00:42:44,892 --> 00:42:47,935 If you fall on it again, you're gonna need to go to the OR. 1024 00:42:47,936 --> 00:42:51,105 No worries, Doc. I won't fall again. 1025 00:42:51,106 --> 00:42:52,356 Uh-huh. 1026 00:42:54,276 --> 00:42:56,277 Robby, pulse ox just dropped. 1027 00:42:56,278 --> 00:42:57,779 What happened? 1028 00:42:57,780 --> 00:42:59,197 I don't know. I stepped out for a minute. 1029 00:42:59,198 --> 00:43:01,032 It's down to 85%. 1030 00:43:01,033 --> 00:43:02,450 Are you having some trouble breathing? 1031 00:43:02,451 --> 00:43:03,993 A little. 1032 00:43:03,994 --> 00:43:05,661 Start him on 2 liters oxygen, nasal cannula. 1033 00:43:05,662 --> 00:43:07,288 Titrate to 5. 1034 00:43:07,289 --> 00:43:08,873 Keep the pulse ox at 92 or higher 1035 00:43:08,874 --> 00:43:12,293 and have a rebreather standing by just in case. 1036 00:43:12,294 --> 00:43:14,128 He's gonna have to stay. 1037 00:43:14,129 --> 00:43:15,880 For how long? 1038 00:43:15,881 --> 00:43:18,674 Not sure. 1039 00:43:18,675 --> 00:43:20,593 Sorry, boss, I only stepped out for a second. 1040 00:43:20,594 --> 00:43:22,136 Let me know if anything changes. 1041 00:43:22,137 --> 00:43:23,679 You were in the room when his pulse ox dropped? 1042 00:43:23,680 --> 00:43:24,972 - I was. - What were you doing? 1043 00:43:24,973 --> 00:43:26,682 D, still can't get a hold of Ortho. 1044 00:43:26,683 --> 00:43:29,977 Leave them to me. 1045 00:43:29,978 --> 00:43:32,271 - Feeling better? - Oh, so much better. 1046 00:43:32,272 --> 00:43:35,483 Well, I wrote you a script for Zofran, just in case. 1047 00:43:35,484 --> 00:43:37,944 Thanks. I think I cleared it all out. 1048 00:43:37,945 --> 00:43:40,613 - So no more hot dogs, right? - Oh, not today. 1049 00:43:40,614 --> 00:43:42,115 But I'll be back next year. 1050 00:43:42,116 --> 00:43:43,449 - Got to defend my title! - Yo. 1051 00:43:43,450 --> 00:43:44,826 OK, well, best of luck to you. 1052 00:43:44,827 --> 00:43:46,369 They got a Wiener World truck outside. 1053 00:43:46,370 --> 00:43:47,995 You want one? 1054 00:43:47,996 --> 00:43:49,705 I think I'm good on hot dogs for the rest of my life. 1055 00:43:49,706 --> 00:43:51,582 Wait, didn't I just see you eating a doughnut? 1056 00:43:51,583 --> 00:43:53,251 Don't judge. 1057 00:43:53,252 --> 00:43:54,795 Stay here for a sec. 1058 00:44:00,843 --> 00:44:03,219 - Transport ambulance is here. - Thanks, Princess. 1059 00:44:03,220 --> 00:44:05,680 This is a 200-milligram MS Contin. 1060 00:44:05,681 --> 00:44:09,016 This will give you 12 hours of relief. 1061 00:44:09,017 --> 00:44:10,893 - OK. - Mm. 1062 00:44:10,894 --> 00:44:12,312 Yes. 1063 00:44:14,189 --> 00:44:16,023 Whenever you're ready, Rox. 1064 00:44:16,024 --> 00:44:17,900 Hey, guys, this is Roxie Hamler. 1065 00:44:17,901 --> 00:44:19,694 Hello, ma'am. 1066 00:44:19,695 --> 00:44:21,738 - Easy on the transfer, guys. - Yeah. 1067 00:44:28,370 --> 00:44:30,580 OK, on my count. 1068 00:44:30,581 --> 00:44:33,499 No, no, no. This isn't gonna work out. 1069 00:44:33,500 --> 00:44:36,669 I'm sorry. 1070 00:44:36,670 --> 00:44:38,337 I can't... I can't... 1071 00:44:38,338 --> 00:44:41,924 I can't... I can't do this. 1072 00:44:41,925 --> 00:44:45,011 - It's OK. - I want to stay. 1073 00:44:45,012 --> 00:44:48,723 Please. 1074 00:44:48,724 --> 00:44:51,893 It's OK. 1075 00:44:51,894 --> 00:44:53,769 Can I assume that you've already called upstairs 1076 00:44:53,770 --> 00:44:55,646 to get Gus Varney a bed? 1077 00:44:55,647 --> 00:44:57,940 Do you want to tell me what you did? 1078 00:44:57,941 --> 00:45:00,443 I don't know what you're talking about. 1079 00:45:00,444 --> 00:45:03,404 His pulse ox was steady. We were about to discharge him. 1080 00:45:03,405 --> 00:45:05,156 Did Dr. Al-Hashimi put you up to that? 1081 00:45:05,157 --> 00:45:07,491 Al-Hashimi? No. 1082 00:45:07,492 --> 00:45:08,993 You know he's gonna go back to prison 1083 00:45:08,994 --> 00:45:12,788 after they discharge him upstairs. 1084 00:45:12,789 --> 00:45:14,582 I thought you didn't go the extra distance 1085 00:45:14,583 --> 00:45:15,959 for your patients anymore. 1086 00:45:22,591 --> 00:45:25,134 - It's Emma, right? - Yeah. 1087 00:45:25,135 --> 00:45:26,761 How's your first day going? 1088 00:45:26,762 --> 00:45:28,554 Good, I think. 1089 00:45:28,555 --> 00:45:31,933 Haven't killed anyone yet. 1090 00:45:31,934 --> 00:45:35,269 - I'm sorry. I... - It's OK. 1091 00:45:35,270 --> 00:45:38,814 I guess time will tell if I'm cut out for this. 1092 00:45:38,815 --> 00:45:42,568 Well, when in doubt, stick with her, kid. 1093 00:45:42,569 --> 00:45:44,070 She scares me. 1094 00:45:44,071 --> 00:45:46,739 No, that's just a... it's a tough exterior. 1095 00:45:46,740 --> 00:45:50,493 She's warm and gooey on the inside. 1096 00:45:50,494 --> 00:45:53,412 Looks like they're doing the debrief for Louie. 1097 00:45:53,413 --> 00:45:55,414 - You coming? - I paid my respects. 1098 00:45:55,415 --> 00:45:57,626 Besides, who's gonna hold down the fort? 1099 00:46:09,680 --> 00:46:12,181 Remember the day you found him passed out in the park? 1100 00:46:12,182 --> 00:46:13,474 Sure do. 1101 00:46:13,475 --> 00:46:14,976 I had to drag his ass over here. 1102 00:46:14,977 --> 00:46:16,352 Came in soaked to the bone. 1103 00:46:16,353 --> 00:46:18,145 You saved his life. 1104 00:46:18,146 --> 00:46:20,189 How about last summer when we didn't see him for months? 1105 00:46:20,190 --> 00:46:21,649 He said he finally quit drinking, 1106 00:46:21,650 --> 00:46:23,484 - so he didn't need to come in. - Mm-hmm. 1107 00:46:23,485 --> 00:46:25,861 How many times did he say he was gonna quit drinking? 1108 00:46:25,862 --> 00:46:27,989 Mm-hmm. 1109 00:46:27,990 --> 00:46:30,616 He always asked about Harrison. 1110 00:46:30,617 --> 00:46:32,994 - Always said thank you. - Mm-hmm. 1111 00:46:32,995 --> 00:46:36,455 Found this with his stuff. 1112 00:46:36,456 --> 00:46:37,999 Who knew he was married? 1113 00:46:38,000 --> 00:46:40,668 Hmm. 1114 00:46:40,669 --> 00:46:43,212 That's Rhonda, Louie's wife. 1115 00:46:43,213 --> 00:46:45,172 High school sweetheart. 1116 00:46:45,173 --> 00:46:48,301 About five years ago, I was covering a night shift. 1117 00:46:48,302 --> 00:46:51,512 He came in feeling talkative. 1118 00:46:51,513 --> 00:46:53,180 Born and raised in Pittsburgh. 1119 00:46:53,181 --> 00:46:55,516 Lifelong Steelers fan. 1120 00:46:55,517 --> 00:46:57,268 Groundskeeper at Three Rivers Stadium 1121 00:46:57,269 --> 00:46:58,687 until 1998. 1122 00:47:01,440 --> 00:47:04,358 He never really wanted kids, 1123 00:47:04,359 --> 00:47:06,736 but Rhonda wore him down, 1124 00:47:06,737 --> 00:47:08,362 and when she finally got pregnant, 1125 00:47:08,363 --> 00:47:11,115 he changed his tune, he got excited. 1126 00:47:14,453 --> 00:47:16,787 And then about a month before the baby was due, 1127 00:47:16,788 --> 00:47:19,875 Rhonda and the baby were killed in a car crash. 1128 00:47:23,086 --> 00:47:25,589 Louie never really came back from that. 1129 00:47:29,593 --> 00:47:32,053 May his memory be a blessing. 1130 00:47:32,054 --> 00:47:34,389 - Amen. - May his memory be a blessing. 1131 00:47:36,391 --> 00:47:37,725 Yep. 1132 00:47:37,726 --> 00:47:40,728 Sync and corrections by btsix www.addic7ed.com