1
00:00:11,512 --> 00:00:13,138
Next time, maybe inform
the department chair

2
00:00:13,222 --> 00:00:14,222
before the shit hits the fan.

3
00:00:14,264 --> 00:00:15,849
I was on my way to tell you.

4
00:00:15,933 --> 00:00:17,184
Make sure you get
everything you need.

5
00:00:17,267 --> 00:00:18,268
OK, let's do this.

6
00:00:18,352 --> 00:00:19,853
IT called me up because

7
00:00:19,937 --> 00:00:22,189
I've trained in cyberattack
prevention and response.

8
00:00:22,272 --> 00:00:23,482
Then you can tell everybody
what to do.

9
00:00:23,565 --> 00:00:24,858
No, thank you.

10
00:00:24,942 --> 00:00:26,109
Best if it comes
from the department chair.

11
00:00:26,193 --> 00:00:27,194
Oh, you think?

12
00:00:29,696 --> 00:00:31,865
All right, everybody,
circle up.

13
00:00:31,949 --> 00:00:33,116
What the fuck?

14
00:00:33,200 --> 00:00:35,077
We may have had
a cyberattack.

15
00:00:35,160 --> 00:00:37,412
No, we shut down
to prevent a cyberattack.

16
00:00:39,164 --> 00:00:41,166
OK, everybody, settle down.
Listen up.

17
00:00:41,250 --> 00:00:42,543
As you can see,
we're doing a little

18
00:00:42,626 --> 00:00:45,045
redecorating
in the central work area.

19
00:00:45,128 --> 00:00:47,923
Our hospital computers are
at risk for a cyberattack,

20
00:00:48,006 --> 00:00:49,925
so we are going old school,
analog.

21
00:00:50,008 --> 00:00:51,343
- For how long?
- Great question.

22
00:00:51,426 --> 00:00:53,387
Our IT department
has shut everything down

23
00:00:53,470 --> 00:00:55,722
to give them time to bolster
our cyber defenses.

24
00:00:55,806 --> 00:00:57,641
I believe the question was,
for how long?

25
00:00:57,724 --> 00:00:58,934
Uh, hard to say.

26
00:00:59,017 --> 00:01:00,227
Could be up to 24 hours.

27
00:01:00,310 --> 00:01:01,853
Jesus Christ.

28
00:01:01,937 --> 00:01:03,480
So first order of business,

29
00:01:03,564 --> 00:01:05,440
we need to replicate
the electronic patient boards

30
00:01:05,524 --> 00:01:06,775
on these dry-erase boards.

31
00:01:06,858 --> 00:01:07,859
So please, somebody tell me

32
00:01:07,943 --> 00:01:08,986
they got a photo of the boards.

33
00:01:09,069 --> 00:01:10,055
Uh, yeah, yeah, yeah.

34
00:01:10,070 --> 00:01:11,488
Right here. OK.

35
00:01:11,572 --> 00:01:12,614
Oh, uh…

36
00:01:14,783 --> 00:01:16,910
It's a little blurry.

37
00:01:16,994 --> 00:01:19,538
No, more than
a little blurry.

38
00:01:19,621 --> 00:01:22,332
- Sorry.
- Oh, my God.

39
00:01:22,416 --> 00:01:24,084
- I remember.
- Great.

40
00:01:24,167 --> 00:01:26,044
If everybody else can remember
their patient names

41
00:01:26,128 --> 00:01:27,421
and their room numbers,
that would be awesome.

42
00:01:27,504 --> 00:01:29,423
No, I mean
I can remember all of it.

43
00:01:29,506 --> 00:01:30,549
All of what?

44
00:01:30,632 --> 00:01:32,759
Names, doctors, room numbers.

45
00:01:32,843 --> 00:01:35,178
I kind of have
a photographic memory.

46
00:01:35,262 --> 00:01:37,306
Seriously? The whole board?

47
00:01:37,389 --> 00:01:39,683
Central 12,
Harlow Graham, headache,

48
00:01:39,766 --> 00:01:42,436
- abdominal pain, ASL only.
- Oh, shit.

49
00:01:42,519 --> 00:01:44,354
I have an interpreter
waiting for me.

50
00:01:44,438 --> 00:01:46,481
- Go.
- OK, for patient privacy,

51
00:01:46,565 --> 00:01:48,191
all chief complaints
will be abbreviated.

52
00:01:48,275 --> 00:01:49,526
So HA for headache,

53
00:01:49,610 --> 00:01:51,486
AP for abdominal pain,
and so forth.

54
00:01:51,570 --> 00:01:54,740
Central 10, Jackson Davis,
new-onset psychosis.

55
00:01:54,823 --> 00:01:56,199
Javadi, psych admission.

56
00:01:56,283 --> 00:01:58,201
Greek letter psi for psych.

57
00:01:58,285 --> 00:02:00,454
Pedes is Baby Jane Doe,
fever, Dr. Mohan,

58
00:02:00,537 --> 00:02:01,997
awaiting admission orders.

59
00:02:02,080 --> 00:02:03,707
Nurses need to convert
to a zone defense…

60
00:02:03,790 --> 00:02:04,790
north, central, south, trauma.

61
00:02:04,833 --> 00:02:05,917
Where's Dana?

62
00:02:06,001 --> 00:02:07,586
In with
a sexual assault case.

63
00:02:07,669 --> 00:02:09,171
She can't leave
until the exam is finished.

64
00:02:09,254 --> 00:02:10,464
Yeah, it could be a while.

65
00:02:10,547 --> 00:02:11,882
Princess has
charge nurse experience.

66
00:02:11,965 --> 00:02:13,342
- Not really.
- That's a great idea.

67
00:02:13,425 --> 00:02:14,593
Princess it is.

68
00:02:14,676 --> 00:02:15,662
You can make
the nursing assignments.

69
00:02:15,677 --> 00:02:16,928
- Next.
- Central 9,

70
00:02:17,012 --> 00:02:18,889
Roxie Hamler,
end-stage lung cancer.

71
00:02:18,972 --> 00:02:20,265
Sorry, do we have
to stand here while

72
00:02:20,349 --> 00:02:21,475
- she recites the whole board?
- No.

73
00:02:21,558 --> 00:02:22,726
In fact, go check
on your patients

74
00:02:22,809 --> 00:02:24,227
and then please come back here.

75
00:02:24,311 --> 00:02:25,771
Thank you.

76
00:02:25,854 --> 00:02:27,606
How many hours a day
are you on your laptop?

77
00:02:30,651 --> 00:02:31,902
At least eight hours.

78
00:02:31,985 --> 00:02:33,320
I work from home.

79
00:02:33,403 --> 00:02:35,280
And are you at a desk
all day?

80
00:02:37,157 --> 00:02:38,408
No, no.

81
00:02:38,492 --> 00:02:39,868
I will either sit on the sofa,

82
00:02:39,951 --> 00:02:42,120
or sometimes I'll be in bed,

83
00:02:42,204 --> 00:02:44,289
kind of sitting up
with the computer on my lap,

84
00:02:44,373 --> 00:02:45,832
that kind of thing.

85
00:02:45,916 --> 00:02:48,460
So you're always looking down
at the screen?

86
00:02:48,543 --> 00:02:50,087
- Yeah.
- OK.

87
00:02:50,170 --> 00:02:52,589
I'm going to check
the muscles in your neck.

88
00:02:59,304 --> 00:03:00,305
- Ooh!
- Ooh!

89
00:03:00,389 --> 00:03:02,516
Ow, that hurts.

90
00:03:02,599 --> 00:03:05,227
All right.
Well, I think we can help.

91
00:03:05,310 --> 00:03:07,396
Come on over.

92
00:03:07,479 --> 00:03:08,939
OK, gather up.

93
00:03:09,022 --> 00:03:11,149
Listen up, everybody.
This is our chart rack.

94
00:03:11,233 --> 00:03:13,110
So as you can see,
each slot and clipboard

95
00:03:13,193 --> 00:03:14,236
has a room number on it.

96
00:03:14,319 --> 00:03:15,654
When you pick up a new patient,

97
00:03:15,737 --> 00:03:18,031
you grab a fresh chart
from the T-system.

98
00:03:18,115 --> 00:03:21,034
Pick your chart
by chief complaint.

99
00:03:21,118 --> 00:03:23,245
Use the cartoon to find it.

100
00:03:23,328 --> 00:03:24,996
Why are there two bodies?

101
00:03:25,080 --> 00:03:26,998
Trauma on the left,
medical on the right.

102
00:03:27,082 --> 00:03:28,375
So head injury, you go left.

103
00:03:28,458 --> 00:03:29,918
Headache, go right.

104
00:03:30,001 --> 00:03:31,461
Are those fish
swimming in seaweed?

105
00:03:31,545 --> 00:03:32,546
No.

106
00:03:32,629 --> 00:03:33,880
That is bees and grass.

107
00:03:33,964 --> 00:03:35,132
That's the section
for insect bites,

108
00:03:35,215 --> 00:03:36,675
skin rash, allergies.

109
00:03:36,758 --> 00:03:38,260
OK, let's say, for example,

110
00:03:38,343 --> 00:03:40,387
Dr. Al-Hashimi has
a new patient with belly pain.

111
00:03:40,470 --> 00:03:43,014
For the history,
circle the positives,

112
00:03:43,098 --> 00:03:44,975
like vomiting and diarrhea.

113
00:03:45,058 --> 00:03:47,602
Backslash the negative,
such as recent travel,

114
00:03:47,686 --> 00:03:49,187
sick contacts, fever.

115
00:03:49,271 --> 00:03:53,108
For physical exam,
checkmark normals on the left,

116
00:03:53,191 --> 00:03:55,360
and circle any
abnormal findings on the right.

117
00:03:55,444 --> 00:03:56,445
Questions?

118
00:03:56,528 --> 00:03:57,654
Is your generative AI program

119
00:03:57,738 --> 00:03:58,738
still gonna be working?

120
00:04:00,115 --> 00:04:01,324
Not for a while.

121
00:04:01,408 --> 00:04:03,034
And ditch
your SpectraLink phones.

122
00:04:03,118 --> 00:04:04,661
Those are voice over internet.

123
00:04:07,748 --> 00:04:08,874
PTMC Emergency.

124
00:04:08,957 --> 00:04:10,417
Go ahead, Medic Command.

125
00:04:10,500 --> 00:04:11,585
That is how we will hear
about incoming runs.

126
00:04:11,668 --> 00:04:13,044
Thanks.

127
00:04:13,128 --> 00:04:14,755
Two minutes out with
abdominal pain and fever.

128
00:04:14,838 --> 00:04:16,214
OK, has everybody
got that so far?

129
00:04:16,298 --> 00:04:17,799
How do we write orders?

130
00:04:17,883 --> 00:04:19,426
Physician order form
in triplicate.

131
00:04:19,509 --> 00:04:22,220
Labs, X-rays, IV fluid,
medication.

132
00:04:22,304 --> 00:04:23,638
Will the labs still be able
to run blood tests?

133
00:04:23,722 --> 00:04:25,015
Yes.

134
00:04:25,098 --> 00:04:26,433
Are the CT scanners
still working?

135
00:04:26,516 --> 00:04:27,768
Yes, but the results
will come back

136
00:04:27,851 --> 00:04:30,061
on paper from the radiologist.

137
00:04:30,145 --> 00:04:31,563
This is the dark ages.

138
00:04:31,646 --> 00:04:33,774
So if you have orders
with labs or X-rays,

139
00:04:33,857 --> 00:04:35,317
they go into
the clerk file here.

140
00:04:35,400 --> 00:04:36,610
They will sign them off.

141
00:04:36,693 --> 00:04:38,069
They will add
a downtime slip on them,

142
00:04:38,153 --> 00:04:39,362
make sure they go
to the correct department.

143
00:04:39,446 --> 00:04:40,906
I'm sorry,
who are the clerks?

144
00:04:40,989 --> 00:04:42,199
- You're looking at them.
- At your service.

145
00:04:42,282 --> 00:04:43,492
Larry and Antoine are
filling in

146
00:04:43,575 --> 00:04:45,035
- until more help arrives.
- We got this.

147
00:04:45,118 --> 00:04:47,120
After the clerk orders,
chart gets moved

148
00:04:47,204 --> 00:04:48,872
to the nursing order rack
here for IVs,

149
00:04:48,955 --> 00:04:50,624
medications, procedures.

150
00:04:50,707 --> 00:04:52,834
Medications are locked up
in the PDS.

151
00:04:52,918 --> 00:04:55,629
The PDS is getting unlocked
by a clinical pharmacist,

152
00:04:55,712 --> 00:04:57,214
- Dr. Megan Nordt.
- We've got your back.

153
00:04:57,297 --> 00:04:58,283
This is a lot.

154
00:04:58,298 --> 00:05:00,175
Any questions? Yes.

155
00:05:00,258 --> 00:05:01,468
Uh, no.

156
00:05:01,551 --> 00:05:03,011
What's up
with the third rack?

157
00:05:03,094 --> 00:05:04,554
When your patient is
ready to be discharged,

158
00:05:04,638 --> 00:05:05,806
chart goes here.

159
00:05:05,889 --> 00:05:07,057
This lets everybody know

160
00:05:07,140 --> 00:05:08,308
we're about to have
an open bed.

161
00:05:08,391 --> 00:05:10,101
Or that your tuna melt is up.

162
00:05:10,185 --> 00:05:11,436
Jesse?

163
00:05:12,729 --> 00:05:14,689
- What is that?
- What is that?

164
00:05:14,773 --> 00:05:16,483
That is a fax machine.

165
00:05:16,566 --> 00:05:17,943
They still make those?

166
00:05:18,026 --> 00:05:19,778
This is our lifeline
to labs and X-rays.

167
00:05:19,861 --> 00:05:21,655
When the results come back,
they will fax to us,

168
00:05:21,738 --> 00:05:23,365
and the clerks will
put them on the charts.

169
00:05:23,448 --> 00:05:24,699
- Yes?
- If you say so.

170
00:05:24,783 --> 00:05:26,451
Incoming.

171
00:05:26,535 --> 00:05:29,704
OK, Dr. McKay, Dr. Whitaker,
Ogilvie, you're with me.

172
00:05:29,788 --> 00:05:32,541
The rest of you,
build your clipboards.

173
00:05:34,918 --> 00:05:37,546
Howard Knox, 52,
abdominal pain and fever.

174
00:05:37,629 --> 00:05:40,215
152 over 90, tachy at 120.

175
00:05:40,298 --> 00:05:41,967
- Couldn't get an IV.
- I wonder why.

176
00:05:42,050 --> 00:05:43,552
Hello, sir.
My name is Dr. Robby.

177
00:05:43,635 --> 00:05:45,971
- Howard.
- This is a teaching hospital.

178
00:05:46,054 --> 00:05:48,098
I'll be supervising
Doctors McKay and Dr. Whitaker

179
00:05:48,181 --> 00:05:49,349
- and student Dr. Ogilvie.
- Hey.

180
00:05:49,432 --> 00:05:50,517
- Hello.
- How are you feeling?

181
00:05:50,600 --> 00:05:51,935
- Not so great.
- OK.

182
00:05:52,018 --> 00:05:53,436
- Princess, what's free?
- Trauma 1.

183
00:05:53,520 --> 00:05:54,855
Perlah?

184
00:05:57,315 --> 00:06:00,861
All right, orders for Mylanta
and bupivacaine, Central 12.

185
00:06:00,944 --> 00:06:02,237
Wrong spot, Dr. Santos.

186
00:06:02,320 --> 00:06:04,239
And you need a sticker.

187
00:06:05,991 --> 00:06:07,242
Put it
in the nursing orders rack.

188
00:06:07,325 --> 00:06:08,743
And meet me over at PDS.

189
00:06:08,827 --> 00:06:10,328
How much does this suck?

190
00:06:10,412 --> 00:06:12,038
I didn't think
today could get any worse.

191
00:06:12,122 --> 00:06:14,165
This is how we rolled
when I was a resident.

192
00:06:14,249 --> 00:06:15,750
Was that in the 1900s?

193
00:06:15,834 --> 00:06:18,044
Yeah, when charts were
written by candlelight.

194
00:06:18,128 --> 00:06:19,880
Hey, today will be
an adventure.

195
00:06:19,963 --> 00:06:22,173
Think of it like
"Back to the Future."

196
00:06:24,801 --> 00:06:26,761
Or possibly "Titanic."

197
00:06:26,845 --> 00:06:28,638
Here is your antacid.

198
00:06:28,722 --> 00:06:30,015
Cheers.

199
00:06:30,098 --> 00:06:31,766
And I marked the trigger point

200
00:06:31,850 --> 00:06:33,310
that is bringing out
your headache,

201
00:06:33,393 --> 00:06:35,061
and a shot of local anesthetic
in that area

202
00:06:35,145 --> 00:06:37,105
could really help.

203
00:06:38,356 --> 00:06:39,357
Yeah, let's do it.

204
00:06:39,441 --> 00:06:40,650
All right.

205
00:06:41,860 --> 00:06:44,571
You are going to feel
a little pinprick

206
00:06:44,654 --> 00:06:46,239
and some burning.

207
00:06:51,912 --> 00:06:53,788
OK.

208
00:06:53,872 --> 00:06:55,790
Oh, ow, ow,
that really hurts.

209
00:06:55,874 --> 00:07:00,295
Temp 101.4, tachy at 128,
pulse ox 92 on 2 liters.

210
00:07:00,378 --> 00:07:01,671
When did the pain start?

211
00:07:01,755 --> 00:07:03,214
It's been on and off
for about a week.

212
00:07:03,298 --> 00:07:05,008
- And where do you feel it?
- All over.

213
00:07:05,091 --> 00:07:07,552
It started on the left, and now
there's some on the right.

214
00:07:07,636 --> 00:07:08,762
How about that fever?

215
00:07:08,845 --> 00:07:10,096
Since last night.

216
00:07:10,180 --> 00:07:11,473
I was burning up.

217
00:07:11,556 --> 00:07:13,308
Then I had chills pretty bad.

218
00:07:13,391 --> 00:07:14,377
I can't find a vein here.

219
00:07:14,392 --> 00:07:15,392
We'll try for a midline.

220
00:07:15,435 --> 00:07:17,103
Let us know if this hurts.

221
00:07:17,187 --> 00:07:18,480
- Ah, ah.
- Sorry.

222
00:07:18,563 --> 00:07:20,357
- And on this side?
- Yeah, yeah!

223
00:07:20,440 --> 00:07:21,483
Sorry, sir.

224
00:07:21,566 --> 00:07:22,567
Guarding with no rigidity.

225
00:07:22,651 --> 00:07:24,736
For pain, 100 of fent IM?

226
00:07:24,819 --> 00:07:26,071
Plan, Dr. Whitaker?

227
00:07:26,154 --> 00:07:28,782
Blood cultures,
lactate, Zosyn.

228
00:07:28,865 --> 00:07:31,284
We're gonna need a CT
to figure out what's going on.

229
00:07:31,368 --> 00:07:32,702
Ah-ah.

230
00:07:32,786 --> 00:07:34,746
- Yeah, it's not gonna work.
- Yep.

231
00:07:34,829 --> 00:07:36,081
Write neatly.
Penmanship counts.

232
00:07:36,164 --> 00:07:37,415
Howard, for the scan,
we're gonna have

233
00:07:37,499 --> 00:07:38,500
to lay you flat on your back.

234
00:07:38,583 --> 00:07:39,751
Can you do that?

235
00:07:39,834 --> 00:07:41,002
I could ten years ago,

236
00:07:41,086 --> 00:07:42,587
but now
it's too hard to breathe.

237
00:07:42,671 --> 00:07:44,297
If we can't lay you flat,

238
00:07:44,381 --> 00:07:45,799
then we're gonna have to put
a tube in your windpipe

239
00:07:45,882 --> 00:07:47,300
to help you breathe…
are you OK with that?

240
00:07:47,384 --> 00:07:48,802
Intubation with rapid
sequence induction?

241
00:07:48,885 --> 00:07:50,136
No, we can't lay him down.

242
00:07:50,220 --> 00:07:51,304
The tube will go in your nose

243
00:07:51,388 --> 00:07:52,430
while you're awake, sir.

244
00:07:52,514 --> 00:07:53,514
- Well…
- Right.

245
00:07:53,556 --> 00:07:54,766
Does it hurt?

246
00:07:54,849 --> 00:07:55,934
You'll be numbed up
completely.

247
00:07:56,017 --> 00:07:57,352
You won't feel any discomfort.

248
00:07:57,435 --> 00:08:00,230
Do you happen
to know your weight?

249
00:08:00,313 --> 00:08:01,898
A little over 400.

250
00:08:01,982 --> 00:08:03,233
When was the last time
you checked?

251
00:08:03,316 --> 00:08:04,734
It's been a while.

252
00:08:04,818 --> 00:08:07,195
Is it possible
that you might be over 450?

253
00:08:07,278 --> 00:08:09,155
Possibly.

254
00:08:09,239 --> 00:08:11,449
Perlah,
let's call for the Hoyer.

255
00:08:11,533 --> 00:08:14,452
So we're gonna place the tube
and get you ready for the scan.

256
00:08:14,536 --> 00:08:16,121
Is this something serious?

257
00:08:16,204 --> 00:08:17,914
Well, it's hard to tell
without a CT.

258
00:08:17,998 --> 00:08:19,624
You could just need
antibiotics,

259
00:08:19,708 --> 00:08:21,418
or you could require
an operation.

260
00:08:21,501 --> 00:08:22,711
If surgery is necessary,

261
00:08:22,794 --> 00:08:24,045
then your weight could
make things

262
00:08:24,129 --> 00:08:25,463
- a little bit more complicated.
- I know.

263
00:08:25,547 --> 00:08:27,048
- I'm sorry.
- Not to worry.

264
00:08:27,132 --> 00:08:28,466
We're gonna take
very good care of you.

265
00:08:28,550 --> 00:08:29,759
Team.

266
00:08:29,843 --> 00:08:30,885
OK.

267
00:08:30,969 --> 00:08:32,387
Pain medication for you, OK?

268
00:08:32,470 --> 00:08:34,264
Let's try for a midline,

269
00:08:34,347 --> 00:08:36,141
basilic vein
with ultrasound guidance.

270
00:08:36,224 --> 00:08:37,600
Can ultrasound check
for an appy?

271
00:08:37,684 --> 00:08:39,477
He's a little too large
for an ultrasound.

272
00:08:39,561 --> 00:08:41,896
Plus, our CT can only handle
450 pounds.

273
00:08:41,980 --> 00:08:44,441
And so if he's over that,
we send him to the zoo?

274
00:08:45,483 --> 00:08:46,818
He's right there.

275
00:08:49,154 --> 00:08:52,115
I…I heard that there's
a large animal CT at the zoo.

276
00:08:52,198 --> 00:08:54,117
Presby's CT can handle 650.

277
00:08:54,200 --> 00:08:56,327
Yeah, if Presby's still
up and running.

278
00:08:56,411 --> 00:08:57,829
Wh…

279
00:08:57,912 --> 00:08:59,831
That…that's not a jinx.
It's…

280
00:08:59,914 --> 00:09:02,459
Have any of you ever done
an awake naso-tracheal?

281
00:09:02,542 --> 00:09:03,752
OK.

282
00:09:03,835 --> 00:09:04,836
Perlah, can you also ask

283
00:09:04,919 --> 00:09:06,004
Dr. Al-Hashimi to come in?

284
00:09:06,087 --> 00:09:07,088
I'm gonna need an assist.

285
00:09:07,172 --> 00:09:08,465
Yep. You got it.

286
00:09:08,548 --> 00:09:10,508
Ah, sorry. Signed.

287
00:09:11,676 --> 00:09:14,846
Hall bed F, George Francis,
shortness of breath,

288
00:09:14,929 --> 00:09:17,307
Dr. Mohan, awaiting D-dimer.

289
00:09:17,390 --> 00:09:18,933
Wow. She's still going?

290
00:09:19,017 --> 00:09:21,061
Yeah. Remarkable, really.

291
00:09:21,144 --> 00:09:22,645
Dr. Al,
Robby's asking for you.

292
00:09:22,729 --> 00:09:23,855
Uh, OK.

293
00:09:23,938 --> 00:09:25,607
In Trauma if you need me,
Princess.

294
00:09:25,690 --> 00:09:26,816
Got it.

295
00:09:28,443 --> 00:09:29,944
Who's supposed to run
the downtime slips

296
00:09:30,028 --> 00:09:31,154
to X-ray and lab?

297
00:09:31,237 --> 00:09:33,656
Uh, the charge nurse?

298
00:09:33,740 --> 00:09:35,450
Don't look at me.

299
00:09:35,533 --> 00:09:36,910
My plate's full!

300
00:09:38,953 --> 00:09:41,539
Uh, parents of Roxie Hamler?

301
00:09:41,623 --> 00:09:42,791
Central 9.

302
00:09:42,874 --> 00:09:44,084
Oh, I got it, Donnie.

303
00:09:44,167 --> 00:09:45,376
Hi, I'm Victoria Javadi,

304
00:09:45,460 --> 00:09:46,836
one of the student
doctors here.

305
00:09:46,920 --> 00:09:48,379
I've been assisting
with Roxie's care.

306
00:09:48,463 --> 00:09:49,756
Oh, thank you so much.

307
00:09:49,839 --> 00:09:51,966
- I'm Lloyd.
- Cora.

308
00:09:52,050 --> 00:09:53,093
It's nice to meet you.

309
00:09:53,176 --> 00:09:54,260
She broke her leg?

310
00:09:54,344 --> 00:09:55,595
Um, yeah.

311
00:09:55,678 --> 00:09:57,347
There's a fracture
down by the ankle.

312
00:09:57,430 --> 00:09:59,891
She's in a boot now, so there's
not quite so much pain.

313
00:09:59,974 --> 00:10:02,268
But I'll take you.
She's just in 9.

314
00:10:07,732 --> 00:10:09,067
The hospital Wi-Fi
isn't working.

315
00:10:09,150 --> 00:10:10,443
Oh, it'll be down
for a while.

316
00:10:10,527 --> 00:10:12,278
Sorry.

317
00:10:12,362 --> 00:10:14,781
Mom broke her leg, Grandpa.

318
00:10:14,864 --> 00:10:16,908
We heard.

319
00:10:16,991 --> 00:10:18,618
How are you, honey?

320
00:10:20,870 --> 00:10:23,206
You've got this, kiddo.

321
00:10:23,289 --> 00:10:25,500
Yeah.

322
00:10:25,583 --> 00:10:27,585
How long will she stay
in the ER?

323
00:10:27,669 --> 00:10:31,214
Oh, until a bed
opens up upstairs.

324
00:10:31,297 --> 00:10:32,841
Could be a while.

325
00:10:38,138 --> 00:10:39,806
You know, it's getting
pretty crowded in here.

326
00:10:39,889 --> 00:10:41,558
Maybe we should take Tucker
and Shane out for ice cream.

327
00:10:41,641 --> 00:10:45,019
- Yes, please.
- No, no. I'm OK.

328
00:10:45,103 --> 00:10:48,189
Maybe your mom would like
some time to rest.

329
00:10:48,273 --> 00:10:50,400
Yeah. Go.

330
00:10:52,110 --> 00:10:54,445
Can she have ice cream?

331
00:10:54,529 --> 00:10:57,657
She can have
anything she wants.

332
00:10:57,740 --> 00:11:00,618
Come on, let's go.

333
00:11:00,702 --> 00:11:02,537
Bye, Mom.

334
00:11:04,247 --> 00:11:06,457
Ice cream, ice cream.

335
00:11:09,752 --> 00:11:11,045
Yep.

336
00:11:11,129 --> 00:11:13,047
Listen up.

337
00:11:13,131 --> 00:11:14,549
This is Oxymetazoline.

338
00:11:14,632 --> 00:11:15,632
This will open up the passage.

339
00:11:16,801 --> 00:11:18,178
What medication do you take?

340
00:11:18,261 --> 00:11:20,972
Uh, Lisinopril and Metformin.

341
00:11:21,055 --> 00:11:22,891
Ozempic? Wegovy?

342
00:11:22,974 --> 00:11:24,809
No. Kind of expensive.

343
00:11:24,893 --> 00:11:26,769
I'm going to squirt
some numbing gel in your nose.

344
00:11:26,853 --> 00:11:30,273
If it drips back
in your throat, that's OK.

345
00:11:30,356 --> 00:11:32,567
Here, in case you need it.

346
00:11:32,650 --> 00:11:34,402
Do you smoke?

347
00:11:34,485 --> 00:11:35,695
Alcohol?

348
00:11:35,778 --> 00:11:37,780
- Never.
- Do you exercise?

349
00:11:37,864 --> 00:11:40,241
Moving from the bedroom
to the kitchen.

350
00:11:40,325 --> 00:11:41,743
No, I'd walk more,

351
00:11:41,826 --> 00:11:44,370
but I need a bench
to rest on every block.

352
00:11:44,454 --> 00:11:45,872
What about water aerobics?

353
00:11:45,955 --> 00:11:48,166
Let's focus
on helping Mr. Knox.

354
00:11:48,249 --> 00:11:49,584
Agreed.

355
00:11:49,667 --> 00:11:51,586
It took me 25 years
to get this way.

356
00:11:51,669 --> 00:11:54,214
Car crash, burn unit,

357
00:11:54,297 --> 00:11:57,008
four leg surgeries
over ten years.

358
00:11:57,091 --> 00:11:59,219
Laid me up so much,
I lost my job.

359
00:11:59,302 --> 00:12:00,887
I need to numb
the back of your tongue.

360
00:12:00,970 --> 00:12:02,722
This is gonna taste pretty bad.

361
00:12:02,805 --> 00:12:04,140
Is there anyone
you'd like us to call?

362
00:12:04,224 --> 00:12:05,308
No.

363
00:12:05,391 --> 00:12:06,851
Any family?

364
00:12:06,935 --> 00:12:09,437
Mm. My parents passed.

365
00:12:09,520 --> 00:12:10,647
I'm single.

366
00:12:10,730 --> 00:12:11,716
Go figure.

367
00:12:11,731 --> 00:12:12,857
Siblings?

368
00:12:12,941 --> 00:12:14,859
Sister in Arizona.

369
00:12:14,943 --> 00:12:17,278
We don't talk much.

370
00:12:17,362 --> 00:12:19,155
Now that we've numbed up
the back of your tongue,

371
00:12:19,239 --> 00:12:22,700
we can anesthetize
a bit deeper.

372
00:12:22,784 --> 00:12:23,770
Um, sorry to interrupt.

373
00:12:23,785 --> 00:12:24,771
I have a middle-aged woman

374
00:12:24,786 --> 00:12:26,371
with sudden onset blindness.

375
00:12:26,454 --> 00:12:27,747
- I can go.
- OK.

376
00:12:27,830 --> 00:12:28,998
Will you see if Abbot's
still around?

377
00:12:29,082 --> 00:12:30,068
- Yeah.
- Thank you.

378
00:12:30,083 --> 00:12:31,626
What's your sister's name?

379
00:12:31,709 --> 00:12:33,336
Lauren Milford.

380
00:12:33,419 --> 00:12:34,837
Where in Arizona?

381
00:12:34,921 --> 00:12:36,464
Flagstaff, I think.

382
00:12:36,547 --> 00:12:37,674
Just gonna go
over your tongue

383
00:12:37,757 --> 00:12:38,883
and numb your vocal cords.

384
00:12:38,967 --> 00:12:39,953
Ah.

385
00:12:39,968 --> 00:12:42,262
Ah…

386
00:12:42,345 --> 00:12:43,429
How many fingers?

387
00:12:43,513 --> 00:12:45,640
I don't see any fingers.

388
00:12:45,723 --> 00:12:47,600
And now?

389
00:12:47,684 --> 00:12:50,144
I can see a little bit
of light.

390
00:12:50,228 --> 00:12:51,896
Um, Brooke,
you've met Dr. King.

391
00:12:51,980 --> 00:12:53,398
This is Dr. Al-Hashimi.

392
00:12:53,481 --> 00:12:54,732
- Nice to meet you.
- And her wife, Wendy.

393
00:12:54,816 --> 00:12:56,025
- Hello.
- Hello.

394
00:12:56,109 --> 00:12:57,777
OK if we discuss
your symptoms?

395
00:12:57,860 --> 00:12:59,988
As long as I can correct you
if you get anything wrong.

396
00:13:00,071 --> 00:13:01,781
Trust me, she will.

397
00:13:01,864 --> 00:13:04,867
One hour of sudden, painless
vision loss in the left eye.

398
00:13:04,951 --> 00:13:06,703
No history
of hypercoagulable state

399
00:13:06,786 --> 00:13:08,079
or vascular disease.

400
00:13:08,162 --> 00:13:09,622
Could you look straight ahead,
please?

401
00:13:09,706 --> 00:13:12,083
Could be a central
retinal artery occlusion.

402
00:13:12,166 --> 00:13:13,543
In English, please?

403
00:13:13,626 --> 00:13:15,712
A little blood clot
can block the artery

404
00:13:15,795 --> 00:13:18,298
at the back of the eye
and decrease your vision.

405
00:13:18,381 --> 00:13:19,924
Sometimes it's called
an eye stroke.

406
00:13:20,008 --> 00:13:20,994
Stroke?

407
00:13:21,009 --> 00:13:22,343
Like she could be paralyzed?

408
00:13:22,427 --> 00:13:23,886
No, this would be
limited to the eye.

409
00:13:23,970 --> 00:13:25,305
Is it permanent?

410
00:13:25,388 --> 00:13:27,682
First, we have
to make the diagnosis.

411
00:13:27,765 --> 00:13:28,891
Retinal exam?

412
00:13:28,975 --> 00:13:29,975
Hard to get a good look.

413
00:13:30,018 --> 00:13:31,519
We need the FOP.

414
00:13:31,602 --> 00:13:33,271
The what?

415
00:13:35,648 --> 00:13:37,317
Oh, Princess.

416
00:13:37,400 --> 00:13:39,277
We need patient stickers
on each of these order sheets,

417
00:13:39,360 --> 00:13:41,404
or the pharmacy won't know
who to give meds to.

418
00:13:41,487 --> 00:13:42,822
We're on it.

419
00:13:42,905 --> 00:13:44,991
Princess,
smartphone fundoscope?

420
00:13:45,074 --> 00:13:46,367
Equipment corridor, eye cart.

421
00:13:46,451 --> 00:13:49,495
- Thanks.
- You seem a little confused.

422
00:13:49,579 --> 00:13:51,289
How do I figure out
which new patient to pick up?

423
00:13:51,372 --> 00:13:52,623
Top of the board.

424
00:13:52,707 --> 00:13:53,833
They're listed
in the order they arrive.

425
00:13:53,916 --> 00:13:55,084
You erase the first one,
then put

426
00:13:55,168 --> 00:13:56,544
your initials in the MD box.

427
00:13:56,627 --> 00:13:58,171
OK. Thanks.

428
00:13:58,254 --> 00:13:59,547
- Caleb.
- Michael.

429
00:13:59,630 --> 00:14:01,382
Are you managing this chaos OK?

430
00:14:01,466 --> 00:14:04,010
Well, it's all pretty easy
when you're a short-timer.

431
00:14:04,093 --> 00:14:06,637
Any more comatose patients
for me to have a chat with?

432
00:14:08,431 --> 00:14:09,682
I'm kidding.

433
00:14:09,766 --> 00:14:11,267
OK.

434
00:14:11,351 --> 00:14:12,935
Victoria,
this is Nicole Steadman.

435
00:14:13,019 --> 00:14:14,145
I run
the parent support group

436
00:14:14,228 --> 00:14:15,605
for the psychiatric service.

437
00:14:15,688 --> 00:14:17,398
Yeah.
Nicole's daughter was diagnosed

438
00:14:17,482 --> 00:14:19,150
sophomore year in college.

439
00:14:19,233 --> 00:14:22,278
You think Jackson's parents
might have a chat with her?

440
00:14:22,362 --> 00:14:24,197
We can certainly ask.

441
00:14:24,280 --> 00:14:25,865
Now we can see
the whole retina

442
00:14:25,948 --> 00:14:27,367
without dilating the pupil.

443
00:14:28,576 --> 00:14:30,119
You're looking
in the wrong eye.

444
00:14:30,203 --> 00:14:32,372
Oh, we start with
the good eye for comparison.

445
00:14:32,455 --> 00:14:34,457
Oh.

446
00:14:34,540 --> 00:14:35,541
Retina looks great.

447
00:14:35,625 --> 00:14:36,709
Now for the bad eye?

448
00:14:36,793 --> 00:14:38,044
Eyes wide open.

449
00:14:40,505 --> 00:14:41,798
How's it look?

450
00:14:41,881 --> 00:14:43,383
Extremely pale,
no blood flow.

451
00:14:43,466 --> 00:14:45,510
Digital massage,
10 seconds on, 5 seconds off.

452
00:14:45,593 --> 00:14:48,971
Order non-contrast head CT.

453
00:14:50,598 --> 00:14:52,642
Come in.

454
00:14:52,725 --> 00:14:53,810
Hi.

455
00:14:53,893 --> 00:14:55,228
Heard your patient took off.

456
00:14:55,311 --> 00:14:56,771
She's taking a little break.

457
00:14:56,854 --> 00:14:59,148
How long are you gonna wait?

458
00:14:59,232 --> 00:15:01,025
You know about
the cyber shutdown thing?

459
00:15:01,109 --> 00:15:02,568
Yeah.

460
00:15:02,652 --> 00:15:04,028
Wish I could help,
but I gotta stay here

461
00:15:04,112 --> 00:15:05,446
till all the evidence
is collected, so…

462
00:15:05,530 --> 00:15:07,073
It's a hot mess out there.

463
00:15:07,156 --> 00:15:08,449
This whole day is.

464
00:15:09,617 --> 00:15:12,078
Sorry.
I was just leaving.

465
00:15:12,161 --> 00:15:14,247
You OK?

466
00:15:14,330 --> 00:15:15,706
I'm good.

467
00:15:15,790 --> 00:15:17,458
I'm glad to hear it.

468
00:15:17,542 --> 00:15:18,542
You get something to eat?

469
00:15:18,584 --> 00:15:21,379
No.

470
00:15:21,462 --> 00:15:23,506
Let's keep going.

471
00:15:23,589 --> 00:15:24,841
OK.

472
00:15:24,924 --> 00:15:25,967
Yeah.

473
00:15:36,436 --> 00:15:38,855
Why don't we keep one
in the ER?

474
00:15:38,938 --> 00:15:42,525
Because our intubated
patients are usually sedated.

475
00:15:42,608 --> 00:15:44,026
Right.

476
00:15:44,110 --> 00:15:45,653
Maybe you could ease up

477
00:15:45,736 --> 00:15:47,321
with your comments
about his weight.

478
00:15:48,781 --> 00:15:50,658
I was just wondering
how he got so big

479
00:15:50,741 --> 00:15:52,326
and how we could help.

480
00:15:52,410 --> 00:15:54,036
We can help by finding out
what's wrong with him

481
00:15:54,120 --> 00:15:55,120
and treating him with respect.

482
00:15:55,163 --> 00:15:56,149
How's your belly now?

483
00:15:56,164 --> 00:15:57,415
Second pain shot helped.

484
00:15:57,498 --> 00:15:59,292
OK.
There's more if you need it.

485
00:15:59,375 --> 00:16:00,543
Diminished bowel sounds.

486
00:16:00,626 --> 00:16:01,878
VidaTalk from the ICU.

487
00:16:01,961 --> 00:16:03,463
Great.

488
00:16:03,546 --> 00:16:04,755
Howard, we need to open up
that passageway now

489
00:16:04,839 --> 00:16:06,007
so we can pass the tube.

490
00:16:06,090 --> 00:16:07,592
I'm gonna start
with my pinky.

491
00:16:07,675 --> 00:16:09,010
Slowly, over a few minutes,
I'm gonna go deeper,

492
00:16:09,093 --> 00:16:10,470
all the way to the back
of my knuckle.

493
00:16:10,553 --> 00:16:12,180
Once the tube's
through your vocal cords,

494
00:16:12,263 --> 00:16:13,681
you won't be able to talk.

495
00:16:13,764 --> 00:16:15,433
But this is
a communication device.

496
00:16:15,516 --> 00:16:18,102
Swipe through the screen
for anything you want to say.

497
00:16:18,186 --> 00:16:20,605
Hit the icon,
and it talks to us.

498
00:16:20,688 --> 00:16:22,857
<i>I would like
some pain medicine.</i>

499
00:16:22,940 --> 00:16:24,692
<i>My pain is a nine.</i>

500
00:16:24,775 --> 00:16:26,360
Can I get it
to order a pizza?

501
00:16:28,821 --> 00:16:30,573
There's cell service
in the ambulance bay.

502
00:16:30,656 --> 00:16:33,117
I found his sister's
new number, left a voicemail.

503
00:16:33,201 --> 00:16:34,368
OK, I'm gonna start.

504
00:16:34,452 --> 00:16:35,578
You ready?

505
00:16:35,661 --> 00:16:37,038
Not really.

506
00:16:37,121 --> 00:16:38,107
Go ahead.

507
00:16:38,122 --> 00:16:39,415
Robby, over here.

508
00:16:39,499 --> 00:16:41,709
Here we go. Head back.

509
00:16:43,169 --> 00:16:44,378
You thinking it's surgical?

510
00:16:44,462 --> 00:16:45,838
I'm hoping
for a non-perfed appy.

511
00:16:45,922 --> 00:16:47,423
- Can you do it with a scope?
- Possibly,

512
00:16:47,507 --> 00:16:49,091
but he could be treated
with antibiotics alone.

513
00:16:49,175 --> 00:16:51,093
And if he needs surgery?

514
00:16:51,177 --> 00:16:54,096
With his size,
an emergency open laparotomy,

515
00:16:54,180 --> 00:16:56,224
death rate's close to 50%.

516
00:16:56,307 --> 00:16:57,808
OK, one step at a time.

517
00:16:57,892 --> 00:17:00,394
Let's keep trying his sister
every 15 minutes.

518
00:17:00,478 --> 00:17:01,812
She'll get it.

519
00:17:05,733 --> 00:17:08,819
Half the downtime slips
are blank.

520
00:17:08,903 --> 00:17:10,905
What are you talking about?

521
00:17:10,988 --> 00:17:13,074
Here and here.

522
00:17:13,157 --> 00:17:15,159
Larry, are you using
a felt tip pen?

523
00:17:15,243 --> 00:17:17,453
Maybe.

524
00:17:17,537 --> 00:17:20,748
It's not going through
for the copies.

525
00:17:20,831 --> 00:17:22,542
Ballpoint pen only.

526
00:17:22,625 --> 00:17:23,960
OK.

527
00:17:26,420 --> 00:17:27,713
Digby still MIA?

528
00:17:27,797 --> 00:17:28,923
Is that the homeless guy?

529
00:17:29,006 --> 00:17:30,758
We need the bed if he eloped.

530
00:17:32,176 --> 00:17:34,011
- What do you need?
- An attending.

531
00:17:34,095 --> 00:17:35,846
- Or a senior resident?
- Nope, I'm good.

532
00:17:35,930 --> 00:17:38,057
- Dr. Al-Hashimi, can I present?
- Yes.

533
00:17:38,140 --> 00:17:40,643
32-year-old deaf woman
with myofascial headache.

534
00:17:40,726 --> 00:17:42,937
Ibuprofen caused gastritis
and epigastric pain,

535
00:17:43,020 --> 00:17:45,147
and she vasovagalled,
but now pain-free

536
00:17:45,231 --> 00:17:47,191
after Mylanta
and a trigger point injection.

537
00:17:47,275 --> 00:17:48,401
Excellent.
That can take care of the pain

538
00:17:48,484 --> 00:17:50,069
- for several months.
- Yeah.

539
00:17:50,152 --> 00:17:52,405
It shouldn't recur if she keeps
her screen at eye level.

540
00:17:52,488 --> 00:17:53,781
There was a delay

541
00:17:53,864 --> 00:17:55,366
in getting an ASL interpreter.

542
00:17:55,449 --> 00:17:57,034
And I almost gave up
and ordered

543
00:17:57,118 --> 00:17:59,203
an unnecessary brain
and abdominal CT.

544
00:17:59,287 --> 00:18:00,454
Good thing you didn't.

545
00:18:00,538 --> 00:18:03,124
Dr. Al-Hashimi, for you.

546
00:18:03,207 --> 00:18:04,500
Nice job
on the trigger point.

547
00:18:04,584 --> 00:18:05,710
Yeah, I know.

548
00:18:05,793 --> 00:18:07,461
How's the T-system going?

549
00:18:07,545 --> 00:18:09,547
- Quick and easy.
- Yeah.

550
00:18:09,630 --> 00:18:11,799
On these MDMs, don't just
circle your diagnosis.

551
00:18:11,882 --> 00:18:13,593
Also put a backslash
through all the ones

552
00:18:13,676 --> 00:18:14,676
that you've ruled out.

553
00:18:14,719 --> 00:18:15,719
No problem.

554
00:18:15,761 --> 00:18:17,346
Thank you very much.

555
00:18:17,430 --> 00:18:19,348
Princess, bump Central 13
to the front of the CT line.

556
00:18:19,432 --> 00:18:20,516
What do you got?

557
00:18:20,600 --> 00:18:21,892
Sudden onset
blindness patient

558
00:18:21,976 --> 00:18:23,436
has central retinal
artery occlusion.

559
00:18:23,519 --> 00:18:25,104
I just spoke
to an ophthalmologist

560
00:18:25,187 --> 00:18:26,689
at the VA,
principal investigator

561
00:18:26,772 --> 00:18:28,357
for thrombolytics
in cases like this.

562
00:18:28,441 --> 00:18:29,817
Not exactly standard of care.

563
00:18:29,900 --> 00:18:30,900
Kind of risky.

564
00:18:30,943 --> 00:18:32,486
We'll do informed consent.

565
00:18:32,570 --> 00:18:34,030
It's our best shot at saving
some of her vision.

566
00:18:34,113 --> 00:18:35,823
Your patient, your call.

567
00:18:35,906 --> 00:18:37,825
I'm not gonna be around long
enough for any complications.

568
00:18:40,828 --> 00:18:44,415
I'll be taking
two swabs from the vagina,

569
00:18:44,498 --> 00:18:46,459
two swabs from the cervix.

570
00:18:49,879 --> 00:18:52,673
Let me know if you feel
any discomfort.

571
00:18:52,757 --> 00:18:54,717
OK.

572
00:18:54,800 --> 00:18:58,888
Each swab gets labeled…
first vaginal, second vaginal.

573
00:18:58,971 --> 00:19:01,182
Smear a slide with both,
and let it air dry.

574
00:19:01,265 --> 00:19:02,391
Same for the cervix?

575
00:19:02,475 --> 00:19:03,461
Yeah.

576
00:19:03,476 --> 00:19:04,769
No slide needed.

577
00:19:06,437 --> 00:19:08,564
How you doing, Ilana?

578
00:19:08,648 --> 00:19:10,608
Hanging in there.

579
00:19:10,691 --> 00:19:12,109
OK.

580
00:19:12,193 --> 00:19:13,611
Almost done.

581
00:19:16,405 --> 00:19:19,116
All these samples go in
the vaginal contact envelope.

582
00:19:19,200 --> 00:19:20,534
- I can help with that.
- No.

583
00:19:20,618 --> 00:19:22,244
It's gotta be me.

584
00:19:22,328 --> 00:19:25,623
I'm gonna pull this out.

585
00:19:25,706 --> 00:19:27,416
OK.

586
00:19:27,500 --> 00:19:28,501
All good here.

587
00:19:28,584 --> 00:19:29,960
Legs can come down.

588
00:19:33,798 --> 00:19:35,675
Are we done?

589
00:19:35,758 --> 00:19:37,009
One last thing.

590
00:19:37,093 --> 00:19:39,428
Four more swabs
inside your mouth.

591
00:19:39,512 --> 00:19:41,138
Didn't you do that already?

592
00:19:41,222 --> 00:19:44,141
This one's different…
inside your cheek for your DNA,

593
00:19:44,225 --> 00:19:45,810
not for his.

594
00:19:48,521 --> 00:19:53,901
So it could be bipolar
or schizophrenia?

595
00:19:53,984 --> 00:19:56,195
Those are the two
most likely possibilities.

596
00:19:56,278 --> 00:19:57,738
How do they know which it is?

597
00:19:57,822 --> 00:19:59,907
Based on response
to medicine,

598
00:19:59,990 --> 00:20:02,493
but also with therapy
and observation on the ward.

599
00:20:02,576 --> 00:20:05,955
They'll monitor his mood
and interactions with others.

600
00:20:07,915 --> 00:20:10,668
Is there a blood test
or a brain scan

601
00:20:10,751 --> 00:20:11,751
that will tell us for sure?

602
00:20:11,794 --> 00:20:13,671
Unfortunately not.

603
00:20:13,754 --> 00:20:16,632
When properly medicated,
people with bipolar disorder

604
00:20:16,716 --> 00:20:19,343
can have successful careers.

605
00:20:19,427 --> 00:20:21,262
So we hope for bipolar?

606
00:20:21,345 --> 00:20:23,264
You can hope
for your son's happiness.

607
00:20:23,347 --> 00:20:25,891
With early treatment,
20% of people

608
00:20:25,975 --> 00:20:28,644
with schizophrenia have
a complete recovery.

609
00:20:28,728 --> 00:20:30,563
So 80% don't?

610
00:20:30,646 --> 00:20:32,857
This is a new version
of Jackson.

611
00:20:35,651 --> 00:20:36,736
How old was your daughter?

612
00:20:36,819 --> 00:20:38,654
20.

613
00:20:38,738 --> 00:20:42,074
Studying architecture
at Georgetown.

614
00:20:42,158 --> 00:20:43,784
Schizophrenia.

615
00:20:43,868 --> 00:20:45,995
I'm sorry.

616
00:20:46,078 --> 00:20:47,663
Oh, she's good.

617
00:20:47,747 --> 00:20:52,543
Living at home, working
as a cashier at Giant Eagle.

618
00:20:52,626 --> 00:20:55,004
Employee of the Month.

619
00:20:55,087 --> 00:20:57,214
We still have struggles,

620
00:20:57,298 --> 00:21:00,259
but there's also laughter
and love.

621
00:21:07,516 --> 00:21:08,934
Good to go.

622
00:21:09,018 --> 00:21:10,004
How'd that feel?

623
00:21:10,019 --> 00:21:11,479
Very weird.

624
00:21:11,562 --> 00:21:13,564
There's no pain. Just weird.

625
00:21:13,647 --> 00:21:15,858
OK, the next step is,
we're gonna take this tube

626
00:21:15,941 --> 00:21:17,860
and pass it through your nose,

627
00:21:17,943 --> 00:21:20,362
stopping at the back
of your tongue.

628
00:21:20,446 --> 00:21:22,239
Best not to talk for that.

629
00:21:22,323 --> 00:21:25,868
Tube's soaking in warm water
to make it more flexible.

630
00:21:25,951 --> 00:21:28,579
Do you wanna try it?

631
00:21:28,662 --> 00:21:30,456
<i>What day and time is it?</i>

632
00:21:30,539 --> 00:21:32,833
4th of July, 2:31 p.m.

633
00:21:32,917 --> 00:21:34,752
<i>When is my tube coming out?</i>

634
00:21:34,835 --> 00:21:37,630
We have to put it in first.

635
00:21:37,713 --> 00:21:38,699
<i>I know.</i>

636
00:21:38,714 --> 00:21:40,257
<i>Just practicing.</i>

637
00:21:40,341 --> 00:21:43,636
Sounds like
you're an expert already.

638
00:21:43,719 --> 00:21:46,680
Before I can't talk,

639
00:21:46,764 --> 00:21:49,433
I just wanna say

640
00:21:49,517 --> 00:21:52,895
thank you for everything.

641
00:21:52,978 --> 00:21:55,022
You're very welcome.

642
00:22:00,820 --> 00:22:02,196
Here we go.

643
00:22:06,867 --> 00:22:08,244
STI prevention.

644
00:22:08,327 --> 00:22:09,870
One shot treats gonorrhea,

645
00:22:09,954 --> 00:22:12,248
then pills for chlamydia
and trichomonas.

646
00:22:12,331 --> 00:22:13,791
Thank you.

647
00:22:13,874 --> 00:22:15,584
We also have
morning-after contraception.

648
00:22:15,668 --> 00:22:16,669
She has an IUD.

649
00:22:16,752 --> 00:22:19,213
Over 99% effective, not 100%.

650
00:22:19,296 --> 00:22:20,756
We still offer.

651
00:22:20,840 --> 00:22:22,341
I'll pass.

652
00:22:22,424 --> 00:22:25,803
For HIV, we got PEP,
Post-Exposure Prophylaxis.

653
00:22:25,886 --> 00:22:27,304
28 days.

654
00:22:27,388 --> 00:22:30,558
The sooner you start,
the more effective.

655
00:22:30,641 --> 00:22:32,309
Emma, I'm pretty sure
they could use

656
00:22:32,393 --> 00:22:35,479
an extra set of hands
out there.

657
00:22:35,563 --> 00:22:37,940
It's nice to meet you, Ilana.

658
00:22:38,023 --> 00:22:39,358
You're a very brave woman.

659
00:22:39,441 --> 00:22:40,484
Yeah.

660
00:22:47,616 --> 00:22:49,034
She's a good nurse.

661
00:22:49,118 --> 00:22:53,539
She's still learning,
but she will be.

662
00:22:53,622 --> 00:22:55,499
After this, we're done?

663
00:22:55,583 --> 00:22:57,167
Yeah.

664
00:23:00,421 --> 00:23:02,631
I'm glad you were here today.

665
00:23:07,094 --> 00:23:09,680
Me too.

666
00:23:09,763 --> 00:23:12,766
We have a decision to make.

667
00:23:12,850 --> 00:23:14,768
Studies have shown
that some vision

668
00:23:14,852 --> 00:23:17,563
can be restored
with a clot-busting medication.

669
00:23:17,646 --> 00:23:18,981
So give it.

670
00:23:19,064 --> 00:23:21,150
But there are possible risks.

671
00:23:21,233 --> 00:23:25,738
For eye stroke, only 17% get
better without any treatment.

672
00:23:25,821 --> 00:23:27,740
- Only 17%?
- Yes.

673
00:23:27,823 --> 00:23:32,077
But with the medicine,
another 20% can improve.

674
00:23:32,161 --> 00:23:34,580
But there can be complications.

675
00:23:34,663 --> 00:23:38,208
2% of patients who receive
the medication get worse,

676
00:23:38,292 --> 00:23:43,088
and 1% have
severe disability or death.

677
00:23:48,677 --> 00:23:52,222
Honey, this one
has to be your call.

678
00:23:53,474 --> 00:23:56,685
No, it's our call.

679
00:23:56,769 --> 00:23:58,562
What would you do without me?

680
00:23:58,646 --> 00:24:00,773
I'd figure out how to get by.

681
00:24:02,733 --> 00:24:05,653
And I'd probably cry
for two years solid.

682
00:24:05,736 --> 00:24:08,155
Two years? That's all?

683
00:24:09,406 --> 00:24:10,783
I want the medication.

684
00:24:10,866 --> 00:24:12,743
OK.

685
00:24:16,288 --> 00:24:18,207
<i>OK, we need your full name
to make a chart.</i>

686
00:24:18,290 --> 00:24:20,292
Jackie Liddell.

687
00:24:20,376 --> 00:24:21,961
Jackie Liddell.

688
00:24:22,044 --> 00:24:23,044
And you are?

689
00:24:23,087 --> 00:24:24,421
Her friend Jaquie.

690
00:24:24,505 --> 00:24:26,340
- You have the same name?
- No, no.

691
00:24:26,423 --> 00:24:28,550
She's Jackie with a C-K.
I'm Jaquie with a Q.

692
00:24:28,634 --> 00:24:30,344
You can call me CK.

693
00:24:30,427 --> 00:24:31,428
Oh.

694
00:24:31,512 --> 00:24:32,763
Best not to talk, CK, OK?

695
00:24:32,846 --> 00:24:34,264
- Just chill.
- Chill?

696
00:24:34,348 --> 00:24:37,601
- Q, I bit off half my tongue!
- What?

697
00:24:37,685 --> 00:24:39,436
She said,
I bit off half my tongue.

698
00:24:39,520 --> 00:24:40,813
You can understand that?

699
00:24:40,896 --> 00:24:42,481
Oh, you should hear her
when she's had

700
00:24:42,564 --> 00:24:44,400
two pitchers of margaritas,
fucked up and slurring.

701
00:24:44,483 --> 00:24:46,944
Ooh, you are such an idiot!

702
00:24:47,027 --> 00:24:48,570
Princess, what's open?

703
00:24:48,654 --> 00:24:50,322
South 15's clean.

704
00:24:50,406 --> 00:24:51,865
Deep tongue laceration.

705
00:24:51,949 --> 00:24:54,576
I can jump on this.

706
00:24:54,660 --> 00:24:57,538
Robby and Al-Hashimi are
both with critical patients.

707
00:24:57,621 --> 00:24:58,872
Hello.

708
00:24:58,956 --> 00:25:00,124
I'm Dr. Langdon.

709
00:25:00,207 --> 00:25:01,959
I'll be supervising your care.

710
00:25:04,003 --> 00:25:06,588
Jesus, CK,
your doctor's fucking hot.

711
00:25:09,508 --> 00:25:11,844
Tube's at 14 centimeters,
just above the airway.

712
00:25:11,927 --> 00:25:14,221
OK, Howard,
I'm going to start.

713
00:25:14,304 --> 00:25:18,392
If you want me to stop,
you just put your hand up, OK?

714
00:25:18,475 --> 00:25:21,061
Blue mark tells me
I'm in the tube.

715
00:25:24,481 --> 00:25:26,567
Looks like he cleared it.

716
00:25:26,650 --> 00:25:29,153
If he inhales,
we should see chords.

717
00:25:29,236 --> 00:25:31,530
OK, deep breath for me,
Howard.

718
00:25:34,324 --> 00:25:36,702
- OK.
- Beautiful.

719
00:25:36,785 --> 00:25:38,328
Chords are sensitive,
so we spray lidocaine

720
00:25:38,412 --> 00:25:40,789
- in the scope.
- OK.

721
00:25:40,873 --> 00:25:44,334
1 cc going in now.

722
00:25:44,418 --> 00:25:47,046
And we'll just give that
a second to work.

723
00:25:47,129 --> 00:25:48,547
How you doing, Howard?

724
00:25:49,923 --> 00:25:51,675
Once the tube's in,
you'll have to breathe

725
00:25:51,759 --> 00:25:53,010
through your nose.

726
00:25:53,093 --> 00:25:54,428
OK, Howard, hold still.

727
00:25:54,511 --> 00:25:57,931
I am now going in
past your vocal cords

728
00:25:58,015 --> 00:26:00,517
until we see the carina.

729
00:26:02,144 --> 00:26:03,687
Ogilvie.

730
00:26:03,771 --> 00:26:04,938
Uh, there.

731
00:26:05,022 --> 00:26:06,065
Right and left mainstem.

732
00:26:06,148 --> 00:26:08,901
And the tube slides in.

733
00:26:12,780 --> 00:26:16,033
And then the scope comes out.

734
00:26:17,868 --> 00:26:19,369
Great.

735
00:26:19,453 --> 00:26:20,704
OK, inflate the balloon.

736
00:26:20,788 --> 00:26:22,122
Deep breath through your nose.

737
00:26:22,206 --> 00:26:23,332
Amazing.

738
00:26:23,415 --> 00:26:25,459
You good?

739
00:26:25,542 --> 00:26:27,086
Great end-tidal waveform.

740
00:26:27,169 --> 00:26:28,337
Does he need a vent?

741
00:26:28,420 --> 00:26:29,546
He's breathing on his own,

742
00:26:29,630 --> 00:26:30,964
but a little CPAP
wouldn't hurt.

743
00:26:31,048 --> 00:26:33,175
Starting at 5, titrate to 10.

744
00:26:33,258 --> 00:26:35,177
OK, that went
really well, Howard.

745
00:26:35,260 --> 00:26:36,970
Now we're going
to check your weight.

746
00:26:38,931 --> 00:26:40,474
So the nurse examiner
is supposed

747
00:26:40,557 --> 00:26:42,351
to lock up the rape kit
in this fridge,

748
00:26:42,434 --> 00:26:45,521
where it stays until it gets
turned over to law enforcement.

749
00:26:45,604 --> 00:26:48,232
It's called preserving
the chain of evidence.

750
00:26:48,315 --> 00:26:50,526
Are you fucking kidding me?

751
00:26:50,609 --> 00:26:52,402
Is there a problem?

752
00:26:52,486 --> 00:26:54,696
Jesus Christ.

753
00:26:54,780 --> 00:26:57,783
Police are supposed to pick up
the rape kits within 72 hours.

754
00:26:57,866 --> 00:27:00,786
This one I did two weeks ago.

755
00:27:00,869 --> 00:27:02,287
God damn it.

756
00:27:04,540 --> 00:27:06,708
So how exactly
did this happen?

757
00:27:06,792 --> 00:27:09,586
We were in between pubs
taking a selfie.

758
00:27:09,670 --> 00:27:10,671
Very nice.

759
00:27:10,754 --> 00:27:13,132
Until she jerked her head up.

760
00:27:13,215 --> 00:27:14,591
Ooh.

761
00:27:14,675 --> 00:27:15,926
Ouch.

762
00:27:16,009 --> 00:27:17,594
OK, topical epi
did the trick.

763
00:27:17,678 --> 00:27:19,012
- No more bleeding.
- Sweet.

764
00:27:19,096 --> 00:27:20,389
I can go home now?

765
00:27:20,472 --> 00:27:22,266
I don't think so.

766
00:27:22,349 --> 00:27:23,851
It looks like the Grand Canyon
across the back of your tongue.

767
00:27:23,934 --> 00:27:25,853
We need to put in
some stitches.

768
00:27:25,936 --> 00:27:26,922
I don't want stitches.

769
00:27:26,937 --> 00:27:28,939
Oh. Listen to the doctor.

770
00:27:29,022 --> 00:27:30,691
Don't tell me what to do.

771
00:27:30,774 --> 00:27:32,192
This is all your fault.

772
00:27:32,276 --> 00:27:34,236
- No, it's not.
- Uh, yes, it is.

773
00:27:34,319 --> 00:27:35,904
- Uh, Princess.
- No, it's not.

774
00:27:35,988 --> 00:27:37,489
Princess, hey,
why don't you show Q

775
00:27:37,573 --> 00:27:39,283
where she can wait
while we patch up her friend?

776
00:27:39,366 --> 00:27:40,784
Of course.

777
00:27:40,868 --> 00:27:42,995
OK, this is
a numbing shot for the tip.

778
00:27:43,078 --> 00:27:44,064
The tip?

779
00:27:44,079 --> 00:27:45,914
That's not where I bit it.

780
00:27:45,998 --> 00:27:47,416
One step at a time.

781
00:27:54,631 --> 00:27:56,925
That's 20 migs of TNK.

782
00:27:57,009 --> 00:27:59,970
In at 14:39.

783
00:28:00,053 --> 00:28:02,264
Feeling anything?

784
00:28:02,347 --> 00:28:03,390
Not yet.

785
00:28:03,473 --> 00:28:06,310
Could take an hour or two.

786
00:28:06,393 --> 00:28:07,769
We're going to move you
to another room

787
00:28:07,853 --> 00:28:09,646
for better monitoring.

788
00:28:09,730 --> 00:28:11,273
Dr. King.

789
00:28:14,109 --> 00:28:17,446
I'd like you to stay with her.

790
00:28:17,529 --> 00:28:18,780
Why?

791
00:28:18,864 --> 00:28:20,407
In case
there are complications.

792
00:28:20,490 --> 00:28:22,159
You'll be there
to respond quickly

793
00:28:22,242 --> 00:28:25,078
to a blown pupil, a seizure,
altered mental status.

794
00:28:25,162 --> 00:28:27,122
Or I could catch up
on my charts.

795
00:28:27,206 --> 00:28:29,041
And my deposition's coming up.

796
00:28:29,124 --> 00:28:31,543
Think of this as a great way
to steal some quiet time

797
00:28:31,627 --> 00:28:32,836
and get mentally prepared.

798
00:28:32,920 --> 00:28:35,130
Jesse, Mel's with you.

799
00:28:36,924 --> 00:28:38,842
Oh, excuse me, Dr. Mohan.

800
00:28:38,926 --> 00:28:39,968
Excuse me.

801
00:28:40,052 --> 00:28:41,038
Dr. Mohan.

802
00:28:41,053 --> 00:28:42,387
Uh, in a minute, George.

803
00:28:42,471 --> 00:28:43,472
I've got this.

804
00:28:43,555 --> 00:28:44,681
Thank you.

805
00:28:44,765 --> 00:28:47,017
Oh, uh, I, um…

806
00:28:47,100 --> 00:28:49,186
D-dimer is back normal.

807
00:28:49,269 --> 00:28:50,255
Oh.

808
00:28:50,270 --> 00:28:51,521
I'm ready to go.

809
00:28:51,605 --> 00:28:53,398
Are you feeling better?

810
00:28:53,482 --> 00:28:57,152
I…I really wasn't
short of breath this time.

811
00:28:58,320 --> 00:28:59,947
Then why'd you come in?

812
00:29:01,531 --> 00:29:03,492
When I found out about
the blood clot in my leg,

813
00:29:03,575 --> 00:29:06,411
I just kept thinking it's gonna
go to my lung and kill me.

814
00:29:06,495 --> 00:29:09,581
We've talked before about how
the Eliquis would prevent that.

815
00:29:09,665 --> 00:29:12,292
I know.

816
00:29:12,376 --> 00:29:14,670
Well, I finally took
your advice.

817
00:29:14,753 --> 00:29:17,130
I got out of the house,
and I joined

818
00:29:17,214 --> 00:29:19,049
the Frick Park
Lawn Bowling Club.

819
00:29:19,132 --> 00:29:20,342
Wonderful.

820
00:29:20,425 --> 00:29:21,468
Yeah.

821
00:29:21,551 --> 00:29:23,303
I mean, you're right, you know?

822
00:29:23,387 --> 00:29:25,347
We all need a community.

823
00:29:29,393 --> 00:29:30,769
You're gonna do what?

824
00:29:30,852 --> 00:29:32,437
In order to fix your tongue,

825
00:29:32,521 --> 00:29:34,982
we need to move it forward
to access the laceration.

826
00:29:35,065 --> 00:29:36,608
You're just gonna feel
some pulling, OK?

827
00:29:36,692 --> 00:29:39,987
I guess so.

828
00:29:40,070 --> 00:29:42,698
Go for it.

829
00:29:42,781 --> 00:29:44,074
What size suture is that?

830
00:29:44,157 --> 00:29:47,869
O-silk, the biggest one
we got.

831
00:29:47,953 --> 00:29:50,831
As soon as I cut the needle,
you're on traction, Joy.

832
00:29:59,631 --> 00:30:01,091
Oh.

833
00:30:01,174 --> 00:30:03,302
That is pretty deep.

834
00:30:03,385 --> 00:30:04,886
And now we can
numb up the cut.

835
00:30:04,970 --> 00:30:06,221
It's best to start with…

836
00:30:06,305 --> 00:30:07,639
Proximal side first
so she doesn't

837
00:30:07,723 --> 00:30:10,851
feel the distal injection.

838
00:30:10,934 --> 00:30:11,920
Give it ten minutes.

839
00:30:11,935 --> 00:30:13,437
I'll be back for the repair.

840
00:30:17,649 --> 00:30:19,484
I got a rape kit
sitting here for two weeks

841
00:30:19,568 --> 00:30:21,987
that was supposed to be
picked up within 72 hours.

842
00:30:22,070 --> 00:30:23,070
I don't care!

843
00:30:23,113 --> 00:30:25,073
Get someone over here now! No.

844
00:30:25,157 --> 00:30:26,575
You expect us
to treat your officers

845
00:30:26,658 --> 00:30:28,201
as soon as they come in,

846
00:30:28,285 --> 00:30:30,037
you get a detective
to pick these kits up ASAP.

847
00:30:30,120 --> 00:30:31,106
I gotta go.

848
00:30:31,121 --> 00:30:32,622
- Dana…
- Hey, Dana.

849
00:30:32,706 --> 00:30:33,790
South 19 got their head CT
before we went down.

850
00:30:33,874 --> 00:30:35,125
No results yet.

851
00:30:35,208 --> 00:30:36,293
All right,
I'll send a reminder.

852
00:30:36,376 --> 00:30:37,362
- Hey, Dana.
- Dana.

853
00:30:37,377 --> 00:30:38,754
Hang on.

854
00:30:39,796 --> 00:30:41,465
What's up?

855
00:30:41,548 --> 00:30:43,425
We put in an order
for more pain meds for Roxie.

856
00:30:43,508 --> 00:30:45,510
All right, so put it
in the nursing racks.

857
00:30:45,594 --> 00:30:48,138
Oh, I did, a long time ago.

858
00:30:48,221 --> 00:30:50,015
All right.
I'll bump it to the front.

859
00:30:50,098 --> 00:30:51,558
Thank you.

860
00:30:51,641 --> 00:30:53,268
Uh, what's that noise?

861
00:30:53,352 --> 00:30:54,353
UFO landed.

862
00:30:54,436 --> 00:30:55,422
Aliens are invading.

863
00:30:55,437 --> 00:30:56,855
Hey, Dana.

864
00:30:56,938 --> 00:30:58,732
Chem 7's not back
on Trauma 2 yet.

865
00:30:58,815 --> 00:31:01,026
Let me see the chart.

866
00:31:01,109 --> 00:31:02,569
Oh, Jesus.

867
00:31:02,652 --> 00:31:04,112
I bet your Chem 7 rec
went to Radiology.

868
00:31:04,196 --> 00:31:05,947
Larry, Antoine.

869
00:31:06,031 --> 00:31:08,450
You put labs and chest X-ray
on the same downtime form.

870
00:31:08,533 --> 00:31:10,744
You need two slips…one
for labs, one for radiology.

871
00:31:10,827 --> 00:31:12,412
- Got it.
- Won't happen again.

872
00:31:12,496 --> 00:31:13,538
I'll run it down myself.

873
00:31:13,622 --> 00:31:15,248
Use the iStat at bedside.

874
00:31:15,332 --> 00:31:16,666
They won't take him to CT
without a creatinine.

875
00:31:16,750 --> 00:31:17,876
Oh, perfect.

876
00:31:17,959 --> 00:31:19,002
Nice to have you back.

877
00:31:19,086 --> 00:31:20,295
Thrilled to be here.

878
00:31:20,379 --> 00:31:21,421
You trying to text?

879
00:31:21,505 --> 00:31:22,964
I am just composing.

880
00:31:23,048 --> 00:31:24,508
I'm gonna send it from the bay.

881
00:31:24,591 --> 00:31:26,760
My mechanic friend, Duke,
never showed up.

882
00:31:26,843 --> 00:31:28,303
I thought he was
coming in this morning.

883
00:31:28,387 --> 00:31:29,513
That was the plan.

884
00:31:29,596 --> 00:31:31,807
I guess he got busy.

885
00:31:31,890 --> 00:31:33,016
What if he's a no-show?

886
00:31:33,100 --> 00:31:34,643
Tell me what he needs.

887
00:31:34,726 --> 00:31:35,727
I'll pass it on
to the night shift.

888
00:31:35,811 --> 00:31:36,811
That won't be necessary.

889
00:31:39,564 --> 00:31:41,316
Oh, Princess.

890
00:31:41,400 --> 00:31:42,401
Ask and you shall receive.

891
00:31:42,484 --> 00:31:43,527
Normal head CT.

892
00:31:43,610 --> 00:31:45,904
Thanks.
I'll get him discharged.

893
00:31:45,987 --> 00:31:47,739
How's your day going?

894
00:31:47,823 --> 00:31:50,242
I think I'm getting
writer's cramp.

895
00:31:50,325 --> 00:31:51,576
You with the big guy?

896
00:31:51,660 --> 00:31:53,829
Yeah. It's sad.

897
00:31:53,912 --> 00:31:57,749
Bad car accident, multiple
operations, tons of stress.

898
00:31:59,835 --> 00:32:01,628
Lidocaine shot
to a sensitive area.

899
00:32:01,711 --> 00:32:03,380
I got a binge-drinking
party girl with a tongue lac.

900
00:32:03,463 --> 00:32:04,714
Mm.

901
00:32:04,798 --> 00:32:05,966
Sounds like
she needs some help.

902
00:32:06,049 --> 00:32:08,677
In more ways than one.

903
00:32:08,760 --> 00:32:12,389
How's, uh…how's
your first shift back going?

904
00:32:12,472 --> 00:32:14,599
One day at a time.

905
00:32:14,683 --> 00:32:16,184
First year sober
is the hardest.

906
00:32:16,268 --> 00:32:17,436
That's what
they keep telling me.

907
00:32:17,519 --> 00:32:20,105
I'm nine years and counting.

908
00:32:22,566 --> 00:32:24,067
Oh.

909
00:32:24,151 --> 00:32:27,612
Special delivery for my guy.

910
00:32:27,696 --> 00:32:29,573
If you, um…if you
need anything, call me.

911
00:32:29,656 --> 00:32:31,241
Thanks.

912
00:32:37,247 --> 00:32:38,790
Where are you going?

913
00:32:38,874 --> 00:32:40,167
Blisters in North 3.

914
00:32:40,250 --> 00:32:41,668
That's where I'm going.

915
00:32:41,751 --> 00:32:43,545
Did you sign up
for the patient?

916
00:32:43,628 --> 00:32:45,338
I pulled the chart
from the rack.

917
00:32:45,422 --> 00:32:47,090
You're supposed to sign up
on the dry-erase board.

918
00:32:47,174 --> 00:32:48,967
You're supposed to have
a clipboard for the patient.

919
00:32:49,050 --> 00:32:50,760
I thought
the nurses had that.

920
00:32:50,844 --> 00:32:52,387
Whatever.

921
00:32:52,471 --> 00:32:53,513
Hi.

922
00:32:53,597 --> 00:32:54,931
I'm Student Doctor Ogilvie.

923
00:32:55,015 --> 00:32:57,142
And this is…wow.

924
00:32:57,225 --> 00:32:58,602
That is some rash.

925
00:32:58,685 --> 00:33:01,480
- Yeah. Tell me about it.
- Student Doctor Javadi.

926
00:33:01,563 --> 00:33:03,690
- When did this start?
- Last night.

927
00:33:03,773 --> 00:33:05,233
And have you been
on any hikes recently

928
00:33:05,317 --> 00:33:06,359
around poison ivy?

929
00:33:06,443 --> 00:33:08,278
Nope. Haven't left the house.

930
00:33:08,361 --> 00:33:11,281
What about new medications,
lotions, soaps,

931
00:33:11,364 --> 00:33:12,350
detergents, even?

932
00:33:12,365 --> 00:33:13,575
I don't take medicine.

933
00:33:13,658 --> 00:33:15,243
Nothing new with all
that other stuff.

934
00:33:15,327 --> 00:33:16,328
Uh-huh.
And where did this start?

935
00:33:16,411 --> 00:33:17,746
Everywhere, all at once.

936
00:33:17,829 --> 00:33:21,082
Just a lot of pain,
really itchy.

937
00:33:21,166 --> 00:33:22,792
What is it?

938
00:33:22,876 --> 00:33:24,294
I'm not sure yet.

939
00:33:24,377 --> 00:33:27,047
Um, be back in a second.

940
00:33:27,130 --> 00:33:28,673
Can't…will you…

941
00:33:32,928 --> 00:33:34,888
What are you thinking?

942
00:33:34,971 --> 00:33:35,972
I have no idea.

943
00:33:36,056 --> 00:33:37,224
Agreed.

944
00:33:39,100 --> 00:33:40,602
Bullous pemphigoid?

945
00:33:40,685 --> 00:33:42,312
Autoimmune severe pruritis?

946
00:33:42,395 --> 00:33:43,939
Yeah, but not as deadly
as pemphigus vulgaris.

947
00:33:44,022 --> 00:33:45,941
Untreated, the death rate
is over 90%.

948
00:33:46,024 --> 00:33:47,359
We need to check
for pustules,

949
00:33:47,442 --> 00:33:48,485
mucous membrane involvement…

950
00:33:48,568 --> 00:33:49,945
And the Nikolsky sign.

951
00:33:52,447 --> 00:33:53,823
Here you go.

952
00:33:55,325 --> 00:33:56,326
What?

953
00:33:56,409 --> 00:33:57,953
For your progress note.

954
00:33:59,329 --> 00:34:02,249
Did I hear
we're making progress?

955
00:34:02,332 --> 00:34:04,543
Oh, um,
it's just what we call it

956
00:34:04,626 --> 00:34:07,712
when we write down things
to describe a clinical course.

957
00:34:09,256 --> 00:34:10,256
Any changes?

958
00:34:11,299 --> 00:34:12,509
Not so far.

959
00:34:12,592 --> 00:34:14,886
It's time for the next
neuro check.

960
00:34:14,970 --> 00:34:17,180
Excuse me, Dr. King,
do you have a minute?

961
00:34:17,264 --> 00:34:18,765
Um, no.

962
00:34:18,848 --> 00:34:20,559
I'm observing
a patient right now.

963
00:34:20,642 --> 00:34:22,978
60 seconds tops.

964
00:34:24,396 --> 00:34:25,689
I'll check pupils.

965
00:34:25,772 --> 00:34:27,315
We're good here.

966
00:34:32,946 --> 00:34:34,823
Hey.

967
00:34:34,906 --> 00:34:37,158
I just finished
my deposition.

968
00:34:37,242 --> 00:34:39,619
Oh, should I go up now?

969
00:34:39,703 --> 00:34:41,329
Yeah.
Just wait until you get a call.

970
00:34:41,413 --> 00:34:42,706
OK.

971
00:34:42,789 --> 00:34:44,165
Well, I'd ask how it went,

972
00:34:44,249 --> 00:34:46,209
but we're not supposed
to discuss the case.

973
00:34:46,293 --> 00:34:47,711
This isn't a discussion.

974
00:34:47,794 --> 00:34:50,964
It's a monologue,
so shut up and listen.

975
00:34:51,047 --> 00:34:53,174
The malpractice case
is frivolous.

976
00:34:53,258 --> 00:34:54,718
The mother
of the measles kid claims

977
00:34:54,801 --> 00:34:56,136
we caused intellectual decline

978
00:34:56,219 --> 00:34:58,221
by performing a spinal tap.

979
00:34:58,305 --> 00:35:01,433
But the tap was perfect
with no complications.

980
00:35:01,516 --> 00:35:03,184
Her son presented
with altered mental status

981
00:35:03,268 --> 00:35:06,646
due to low oxygen
from measles pneumonia.

982
00:35:06,730 --> 00:35:09,107
Any change in intellect was
due to hypoxic brain injury.

983
00:35:09,190 --> 00:35:12,777
It had nothing to do
with your spinal tap.

984
00:35:12,861 --> 00:35:14,487
End of monologue.

985
00:35:14,571 --> 00:35:17,240
We never discussed the case.

986
00:35:17,324 --> 00:35:19,576
I gotta get some sleep.

987
00:35:19,659 --> 00:35:22,912
Thanks, I guess.

988
00:35:24,581 --> 00:35:26,791
OK, are you ready
to lay down?

989
00:35:26,875 --> 00:35:27,861
I got your head.

990
00:35:27,876 --> 00:35:29,002
Nice and slow.

991
00:35:29,085 --> 00:35:31,212
One, two, three.

992
00:35:32,631 --> 00:35:33,617
OK.

993
00:35:33,632 --> 00:35:34,716
How's that feel?

994
00:35:37,636 --> 00:35:38,762
Lifting up now.

995
00:35:48,772 --> 00:35:50,398
Keep going.

996
00:35:53,026 --> 00:35:56,279
And…that ought to do it
right about there.

997
00:35:58,031 --> 00:35:59,783
215?

998
00:35:59,866 --> 00:36:01,785
Oh, that's in kilos.

999
00:36:04,120 --> 00:36:05,705
OK, team.

1000
00:36:11,336 --> 00:36:13,004
It's not that much over 450.

1001
00:36:13,088 --> 00:36:15,799
No, we can't risk breaking
our CT on a holiday weekend.

1002
00:36:15,882 --> 00:36:17,926
Would the medics take him
while he's intubated?

1003
00:36:18,009 --> 00:36:20,303
If I go along for the ride,
I could still get a nap in

1004
00:36:20,387 --> 00:36:21,930
before my night shift.

1005
00:36:25,934 --> 00:36:28,812
474.

1006
00:36:28,895 --> 00:36:30,689
Our CT can't handle
your weight,

1007
00:36:30,772 --> 00:36:34,067
but we're gonna take you over
to Presbyterian Hospital.

1008
00:36:34,150 --> 00:36:35,985
<i>Road trip.</i>

1009
00:36:36,069 --> 00:36:38,363
I'll keep you company
the whole time.

1010
00:36:40,907 --> 00:36:42,909
<i>Sorry for all this trouble.</i>

1011
00:36:42,992 --> 00:36:44,119
It's OK.

1012
00:36:44,202 --> 00:36:45,620
This is what we do.

1013
00:36:51,126 --> 00:36:52,627
So sub Q starts deep.

1014
00:36:52,711 --> 00:36:53,753
You want to bury the knot.

1015
00:36:53,837 --> 00:36:55,296
Yeah, I've done these before.

1016
00:36:55,380 --> 00:36:57,590
Joy, how do we cut the ends?

1017
00:36:57,674 --> 00:36:59,134
Short.
Slide to the knot.

1018
00:36:59,217 --> 00:37:00,203
Turn 45 degrees.

1019
00:37:00,218 --> 00:37:02,262
Excellent.

1020
00:37:02,345 --> 00:37:04,097
Um, Dr. Langdon,
we have a case.

1021
00:37:04,180 --> 00:37:05,166
It'll have to wait.

1022
00:37:05,181 --> 00:37:06,224
It could be urgent.

1023
00:37:06,307 --> 00:37:10,061
Find Robby or Al-Hashimi.

1024
00:37:10,145 --> 00:37:12,397
This girl is wasted.

1025
00:37:12,480 --> 00:37:14,441
Drunk as a skunk.

1026
00:37:14,524 --> 00:37:16,192
Should we check
her blood alcohol level?

1027
00:37:16,276 --> 00:37:17,819
No, it won't change
what we do.

1028
00:37:17,902 --> 00:37:19,404
She can go home
when she has a steady gait.

1029
00:37:19,487 --> 00:37:21,573
I already sent one off.

1030
00:37:21,656 --> 00:37:24,242
Joy, do you want to guess
her blood alcohol?

1031
00:37:24,325 --> 00:37:25,744
Why would I want to do that?

1032
00:37:25,827 --> 00:37:27,871
I don't know.
'Cause it's fun.

1033
00:37:33,877 --> 00:37:35,462
When will you have a bed?

1034
00:37:35,545 --> 00:37:37,297
I'm not sure she needs a bed.

1035
00:37:37,380 --> 00:37:39,090
She's a febrile infant.

1036
00:37:39,174 --> 00:37:41,050
Who is clearly over a month
old and looks amazing.

1037
00:37:41,134 --> 00:37:43,011
Every marker is normal.
She has a cold virus.

1038
00:37:43,094 --> 00:37:44,763
Infants with rhinovirus
can still have

1039
00:37:44,846 --> 00:37:46,181
a serious bacterial infection.

1040
00:37:46,264 --> 00:37:47,682
Not this one.

1041
00:37:47,766 --> 00:37:49,309
We send kids like this home
all the time.

1042
00:37:49,392 --> 00:37:52,353
Except this one doesn't have
a home or a parent.

1043
00:37:53,730 --> 00:37:55,190
All right.

1044
00:37:55,273 --> 00:37:56,941
I can't put a kid
with a virus in the nursery,

1045
00:37:57,025 --> 00:37:59,194
and I can't waste a private
room on a healthy baby.

1046
00:37:59,277 --> 00:38:00,612
Then what do you propose?

1047
00:38:00,695 --> 00:38:02,572
CYF can place her
in emergency foster care

1048
00:38:02,655 --> 00:38:04,115
by tomorrow morning.

1049
00:38:04,199 --> 00:38:06,326
You want to leave her
down here overnight?

1050
00:38:06,409 --> 00:38:08,703
Seems to be the standard
of care these days.

1051
00:38:08,787 --> 00:38:10,038
Have your attending
give me a call.

1052
00:38:10,121 --> 00:38:11,121
Will do.

1053
00:38:11,164 --> 00:38:12,415
I can't believe this.

1054
00:38:12,499 --> 00:38:14,209
Let CYF know
it's very urgent.

1055
00:38:14,292 --> 00:38:15,710
Got it.

1056
00:38:15,794 --> 00:38:18,254
This is turning
into quite the day.

1057
00:38:18,338 --> 00:38:20,173
You know, I've been thinking

1058
00:38:20,256 --> 00:38:21,716
about applying
for a fellowship.

1059
00:38:21,800 --> 00:38:23,676
I thought you had a job
lined up in New Jersey.

1060
00:38:23,760 --> 00:38:25,804
I did, to be close to my mom.

1061
00:38:25,887 --> 00:38:29,349
But she sold her house
to travel the world

1062
00:38:29,432 --> 00:38:31,351
with her new boyfriend.

1063
00:38:31,434 --> 00:38:33,186
So what's the point
of New Jersey?

1064
00:38:33,269 --> 00:38:34,604
Yeah, good question.

1065
00:38:34,687 --> 00:38:36,231
Which fellowship?

1066
00:38:36,314 --> 00:38:39,943
I've narrowed it down
to ultrasound, toxicology,

1067
00:38:40,026 --> 00:38:43,196
and sports medicine.

1068
00:38:43,279 --> 00:38:44,572
Those are
very disparate fields

1069
00:38:44,656 --> 00:38:46,074
leading to very
different careers.

1070
00:38:46,157 --> 00:38:47,242
I know.

1071
00:38:47,325 --> 00:38:49,327
I'm a little undecided.

1072
00:38:49,410 --> 00:38:50,954
Do you have
research experience?

1073
00:38:51,037 --> 00:38:53,540
I was a part of a study
on racial disparities

1074
00:38:53,623 --> 00:38:55,416
in health care
until the White House

1075
00:38:55,500 --> 00:38:56,960
cut the funding last year.

1076
00:38:57,043 --> 00:38:59,379
Yeah. You are not alone.

1077
00:38:59,462 --> 00:39:02,298
Have you considered
a geriatrics fellowship?

1078
00:39:02,382 --> 00:39:04,217
I have not.

1079
00:39:04,300 --> 00:39:06,344
I've seen your skills
with the elderly,

1080
00:39:06,427 --> 00:39:08,471
and there are
a lot of openings.

1081
00:39:08,555 --> 00:39:10,306
It might be your best shot.

1082
00:39:10,390 --> 00:39:13,142
Think about it.

1083
00:39:13,226 --> 00:39:14,212
Last stitch.

1084
00:39:14,227 --> 00:39:15,228
You want me to cut?

1085
00:39:15,311 --> 00:39:16,771
I got it.

1086
00:39:18,481 --> 00:39:19,732
It looks good.

1087
00:39:19,816 --> 00:39:21,818
OK.
Let's pull the traction suture.

1088
00:39:21,901 --> 00:39:23,278
With pleasure.

1089
00:39:25,238 --> 00:39:27,282
OK, Jackie.

1090
00:39:27,365 --> 00:39:28,700
- Jackie.
- Stop it.

1091
00:39:28,783 --> 00:39:29,769
Stop.

1092
00:39:29,784 --> 00:39:30,994
All done.

1093
00:39:31,077 --> 00:39:32,579
All done with what?

1094
00:39:32,662 --> 00:39:34,247
Sewing up your tongue.

1095
00:39:34,330 --> 00:39:35,957
What happened to my tongue?

1096
00:39:36,040 --> 00:39:37,166
You bit it.

1097
00:39:37,250 --> 00:39:38,236
Ha.

1098
00:39:38,251 --> 00:39:39,836
No, I didn't.

1099
00:39:39,919 --> 00:39:41,671
That is called a blackout.

1100
00:39:41,754 --> 00:39:43,506
How much did you drink?

1101
00:39:43,590 --> 00:39:45,758
A couple Bloody Marys.

1102
00:39:45,842 --> 00:39:46,968
Only a couple?

1103
00:39:47,051 --> 00:39:49,137
I don't know. Maybe more.

1104
00:39:49,220 --> 00:39:51,848
It's a holiday, a pub crawl.

1105
00:39:51,931 --> 00:39:54,559
Do you usually have
a couple cocktails every day?

1106
00:39:54,642 --> 00:39:55,810
Only on weekends.

1107
00:39:55,894 --> 00:39:57,145
How about during the week?

1108
00:39:57,228 --> 00:39:58,563
Nothing much.

1109
00:39:58,646 --> 00:40:03,568
Just wine with dinner
or a few beers.

1110
00:40:03,651 --> 00:40:06,738
Maybe we should
recommend rehab?

1111
00:40:06,821 --> 00:40:07,822
Yeah.

1112
00:40:07,906 --> 00:40:09,324
We could try.

1113
00:40:13,912 --> 00:40:16,289
Ready to roll.

1114
00:40:16,372 --> 00:40:17,916
How are you feeling?

1115
00:40:17,999 --> 00:40:19,292
<i>My pain is a two.</i>

1116
00:40:19,375 --> 00:40:20,877
We got meds if you need them.

1117
00:40:20,960 --> 00:40:22,420
Scan will be quicker
than the ride to Presby.

1118
00:40:22,503 --> 00:40:23,796
We'll keep trying
to reach your sister.

1119
00:40:23,880 --> 00:40:25,423
<i>- You guys are the best.</i>
- See you later.

1120
00:40:25,506 --> 00:40:27,216
Can I put a new patient
in T1?

1121
00:40:27,300 --> 00:40:29,594
Uh, no, I kind of want
to leave one trauma room open.

1122
00:40:29,677 --> 00:40:33,222
Why don't you double up
the north if you have to?

1123
00:40:33,306 --> 00:40:36,142
Mr. Digby?

1124
00:40:36,225 --> 00:40:38,019
- It's just Digby.
- Right.

1125
00:40:38,102 --> 00:40:40,563
We've been looking all over.
Where you been?

1126
00:40:40,647 --> 00:40:42,106
With Louie.

1127
00:40:42,190 --> 00:40:43,608
You've been in there
for an hour?

1128
00:40:43,691 --> 00:40:45,652
He was my friend.

1129
00:40:45,735 --> 00:40:47,570
- I had a lot to say.
- Hmm.

1130
00:40:47,654 --> 00:40:49,948
Well, let's get you
back to your bed.

1131
00:40:52,033 --> 00:40:53,826
Louie got his wings.

1132
00:40:53,910 --> 00:40:55,745
- Dr. Robby.
- Dr. Robby.

1133
00:40:55,828 --> 00:40:57,330
We picked up
a patient together.

1134
00:40:57,413 --> 00:40:58,748
Teamwork!

1135
00:40:58,831 --> 00:41:00,291
It's a concerning
bullous rash.

1136
00:41:00,375 --> 00:41:01,876
We might need a biopsy
for pemphigus vulgaris.

1137
00:41:01,960 --> 00:41:03,336
It's phytophotodermatitis.

1138
00:41:03,419 --> 00:41:05,088
- What?
- I asked.

1139
00:41:05,171 --> 00:41:07,215
He was making three gallons
of margaritas for a party,

1140
00:41:07,298 --> 00:41:09,467
squeezing fresh limes
out in the sun.

1141
00:41:09,550 --> 00:41:10,885
Let's go take a peek.

1142
00:41:10,969 --> 00:41:12,804
I don't need to see it again.

1143
00:41:15,348 --> 00:41:16,724
How's it going out there?

1144
00:41:16,808 --> 00:41:18,309
Standing room only.

1145
00:41:18,393 --> 00:41:19,727
If I call the fire department,
will they clear

1146
00:41:19,811 --> 00:41:21,020
- that waiting room?
- I wish.

1147
00:41:21,104 --> 00:41:22,146
What's up?

1148
00:41:22,230 --> 00:41:24,190
12 patients need med refills.

1149
00:41:24,273 --> 00:41:25,775
Shouldn't they see
their doctors?

1150
00:41:25,858 --> 00:41:27,527
With the Medicaid cuts,
we are their doctor.

1151
00:41:27,610 --> 00:41:29,237
No, I can't e-prescribe
to their pharmacies.

1152
00:41:29,320 --> 00:41:30,947
So get out your pen.
Go old school.

1153
00:41:31,030 --> 00:41:33,282
Dana, on what?

1154
00:41:33,366 --> 00:41:35,743
Nordt, you got
the security pads?

1155
00:41:35,827 --> 00:41:37,036
Sure do.

1156
00:41:37,120 --> 00:41:38,830
Just need a patient sticker.

1157
00:41:38,913 --> 00:41:41,207
- Any other questions?
- Yeah.

1158
00:41:41,290 --> 00:41:43,668
What would have happened
if you weren't here today?

1159
00:41:44,877 --> 00:41:46,629
You'd all be curled up
in the fetal position,

1160
00:41:46,713 --> 00:41:48,965
crying like babies.

1161
00:41:49,048 --> 00:41:50,591
Were you wearing flip-flops?

1162
00:41:50,675 --> 00:41:51,926
I was.

1163
00:41:52,010 --> 00:41:53,845
- What is it?
- Phytophotodermatitis.

1164
00:41:53,928 --> 00:41:56,055
Otherwise known
as margarita burn.

1165
00:41:56,139 --> 00:41:57,598
For some people,
limes plus sunshine

1166
00:41:57,682 --> 00:41:58,933
can cause a horrible rash.

1167
00:41:59,017 --> 00:42:01,060
This is all because of limes?

1168
00:42:01,144 --> 00:42:03,896
Have you ever squeezed limes
outside in the sun before?

1169
00:42:03,980 --> 00:42:05,565
I don't think so.

1170
00:42:05,648 --> 00:42:08,026
You will feel better
after a day of steroid pills.

1171
00:42:08,109 --> 00:42:09,944
But once these heal,
you gotta wear sunscreen.

1172
00:42:10,028 --> 00:42:12,071
Because these blisters
can turn into dark scars

1173
00:42:12,155 --> 00:42:13,322
and stay a while if you don't.

1174
00:42:15,033 --> 00:42:18,286
I'll be right back with
your aftercare instructions.

1175
00:42:18,369 --> 00:42:20,246
- Hey, Robby.
- Yep.

1176
00:42:20,329 --> 00:42:22,415
My, uh…
my hospice patient Roxie

1177
00:42:22,498 --> 00:42:24,333
is still in a ton of pain.

1178
00:42:24,417 --> 00:42:25,626
Where are we
with the morphine?

1179
00:42:25,710 --> 00:42:27,587
10 milligrams an hour.

1180
00:42:27,670 --> 00:42:30,131
OK, you can bolus another 2
and go up to 12.

1181
00:42:30,214 --> 00:42:31,507
I will let Princess know.

1182
00:42:31,591 --> 00:42:32,884
12 an hour is a lot.

1183
00:42:32,967 --> 00:42:34,343
Yeah, on top
of the MS Contin,

1184
00:42:34,427 --> 00:42:37,305
she could stop breathing.

1185
00:42:37,388 --> 00:42:40,641
Are you familiar with
the doctrine of double effect?

1186
00:42:40,725 --> 00:42:42,727
- Not really.
- No.

1187
00:42:42,810 --> 00:42:45,229
It is an ethical principle
in palliative care.

1188
00:42:45,313 --> 00:42:46,939
We treat pain.

1189
00:42:47,023 --> 00:42:48,900
And if, in doing so,
there's a negative side effect,

1190
00:42:48,983 --> 00:42:50,526
we accept it.

1191
00:42:50,610 --> 00:42:53,362
Even if the negative
side effect is death?

1192
00:42:53,446 --> 00:42:56,074
In some cases,
that could be the best outcome.

1193
00:43:01,913 --> 00:43:03,289
Maybe the nurse has it.

1194
00:43:03,372 --> 00:43:06,000
Emma. Emma, where does…

1195
00:43:06,084 --> 00:43:07,752
Maybe the fax
ran out of paper?

1196
00:43:07,835 --> 00:43:10,463
No, there is enough paper.
I don't know what's wrong.

1197
00:43:10,546 --> 00:43:11,964
- Could be in another room.
- We should call IT.

1198
00:43:12,048 --> 00:43:13,966
You want me to check
every room?

1199
00:43:14,050 --> 00:43:15,551
How are we gonna
get through this mess?

1200
00:43:15,635 --> 00:43:18,513
I was about to ask you.

1201
00:43:18,596 --> 00:43:20,056
Ask the pharmacist.

1202
00:43:20,139 --> 00:43:21,641
She can't leave the PDS.

1203
00:43:21,724 --> 00:43:23,434
Nothing's getting done here.