1 00:00:17,388 --> 00:00:18,598 I'm in. 2 00:00:18,681 --> 00:00:19,932 Bag him. 3 00:00:23,227 --> 00:00:25,897 Defib pads are in place. 4 00:00:25,980 --> 00:00:27,857 OK, holding compressions. 5 00:00:27,940 --> 00:00:29,901 Good square line on the End-Tidal CO2. 6 00:00:29,984 --> 00:00:32,570 V-fib, charge to 200. 7 00:00:33,946 --> 00:00:35,198 Charged. 8 00:00:35,281 --> 00:00:36,824 Clear. 9 00:00:38,618 --> 00:00:40,870 Stand by with epi. 10 00:00:44,457 --> 00:00:46,292 Suction that tube. 11 00:00:48,294 --> 00:00:49,504 You're not in the esophagus, are you? 12 00:00:49,587 --> 00:00:50,755 Definitely not. 13 00:00:50,838 --> 00:00:52,215 I passed right through the cords. 14 00:00:52,298 --> 00:00:54,926 Good breath sounds. End-Tidal CO2 confirmed. 15 00:00:55,009 --> 00:00:56,302 His lungs are filling up with blood. 16 00:00:56,385 --> 00:00:57,512 I know. 17 00:01:03,142 --> 00:01:04,435 OK, rhythm check. 18 00:01:06,187 --> 00:01:07,647 Asystole. Push the epi. 19 00:01:07,730 --> 00:01:09,357 Fuck. 20 00:01:12,902 --> 00:01:14,654 Patients with lunch trays have been admitted. 21 00:01:14,737 --> 00:01:16,030 They're boarders. 22 00:01:16,113 --> 00:01:17,865 They're waiting for a bed to open upstairs. 23 00:01:17,949 --> 00:01:20,034 - And what about the others? - Non-admitted patients. 24 00:01:20,117 --> 00:01:21,786 They can have sandwiches or juice boxes. 25 00:01:21,869 --> 00:01:24,205 Just make sure they're not NPO. 26 00:01:24,288 --> 00:01:25,498 That's "nil per os." 27 00:01:25,581 --> 00:01:26,707 It's Latin for "nothing by mouth." 28 00:01:26,791 --> 00:01:28,501 NPOs are waiting for surgery. 29 00:01:28,584 --> 00:01:30,336 They'll beg, spit, and curse for food, 30 00:01:30,419 --> 00:01:31,671 but you got to stay strong. 31 00:01:31,754 --> 00:01:33,130 Hey, I've been waiting for an hour. 32 00:01:33,214 --> 00:01:34,966 When am I gonna see a fucking doctor? 33 00:01:35,049 --> 00:01:37,176 Excuse me! 34 00:01:37,260 --> 00:01:39,220 Perhaps you didn't see this, which is strange, 35 00:01:39,303 --> 00:01:41,264 because they're all over the place. 36 00:01:41,347 --> 00:01:43,474 Aggressive behavior toward healthcare workers is a felony. 37 00:01:43,558 --> 00:01:45,351 $2,000 fine, possible jail time. 38 00:01:45,434 --> 00:01:46,686 Got it? 39 00:01:46,769 --> 00:01:49,272 OK. I was just asking. 40 00:01:49,355 --> 00:01:50,940 We're busy today. 41 00:01:51,023 --> 00:01:52,233 It's a holiday weekend. 42 00:01:52,316 --> 00:01:53,526 We see the sickest patients first, 43 00:01:53,609 --> 00:01:55,278 so be happy you're still waiting. 44 00:01:56,863 --> 00:01:58,072 Jag-off. 45 00:02:00,241 --> 00:02:01,784 PTMC charge nurse. 46 00:02:01,868 --> 00:02:04,579 Go ahead, Medic Command. 47 00:02:04,662 --> 00:02:07,290 OK. Got it. 48 00:02:07,373 --> 00:02:08,499 Incoming trauma. 49 00:02:08,583 --> 00:02:11,002 Come on. 50 00:02:11,085 --> 00:02:12,420 Three minutes since the last epi. 51 00:02:12,503 --> 00:02:13,796 Hold compressions. 52 00:02:15,006 --> 00:02:16,257 Asystole. 53 00:02:16,340 --> 00:02:18,509 Resume CPR. Another amp of epi. 54 00:02:18,593 --> 00:02:20,887 Needs more suction. 55 00:02:26,684 --> 00:02:28,728 Pulmonary hemorrhage from liver failure. 56 00:02:28,811 --> 00:02:30,605 Is he going to make it? 57 00:02:35,902 --> 00:02:37,945 Should we give PCC? 58 00:02:38,029 --> 00:02:40,197 Too late for that. 59 00:02:40,281 --> 00:02:42,116 And he's not an ECMO candidate. 60 00:02:42,199 --> 00:02:44,201 Nothing else we can do? 61 00:02:49,165 --> 00:02:51,459 No, I think we're done. 62 00:02:56,464 --> 00:02:58,591 Louie. 63 00:03:02,637 --> 00:03:04,847 12:07. 64 00:03:11,687 --> 00:03:14,065 Should we do a debrief? 65 00:03:14,148 --> 00:03:16,025 We've got another motorcycle injury coming in, 66 00:03:16,108 --> 00:03:17,318 ETA 10 minutes. 67 00:03:17,401 --> 00:03:18,819 Why don't we get Louie cleaned up, 68 00:03:18,903 --> 00:03:20,863 - move him to the viewing room? - Yeah. 69 00:03:20,947 --> 00:03:23,783 Anybody that wants to pay their respects can join us in there. 70 00:03:26,118 --> 00:03:27,828 Thank you, everyone. 71 00:03:35,127 --> 00:03:36,504 I'll clean him up. 72 00:03:36,587 --> 00:03:38,673 Why don't you take five first? 73 00:03:38,756 --> 00:03:41,258 Or ten. Yeah? 74 00:03:41,342 --> 00:03:42,718 Yep. 75 00:03:52,520 --> 00:03:54,689 This is Dr. Jefferson from psychiatry. 76 00:03:54,772 --> 00:03:57,441 Why do I need to see a psychiatrist? 77 00:03:57,525 --> 00:03:59,777 Jada, why do I need to see a psychiatrist? 78 00:03:59,860 --> 00:04:01,445 It's gonna be OK, Jackson. 79 00:04:01,529 --> 00:04:03,990 Dr. Jefferson says he can help. 80 00:04:04,073 --> 00:04:06,742 Do you know how you got here? 81 00:04:06,826 --> 00:04:09,161 The medics brought me. 82 00:04:09,245 --> 00:04:11,998 I don't really remember. I…I was in the library. 83 00:04:12,081 --> 00:04:14,917 What were you doing there? 84 00:04:15,001 --> 00:04:17,795 I was…I was studying. 85 00:04:17,878 --> 00:04:20,464 I was trying to study. 86 00:04:20,548 --> 00:04:22,216 But then they wouldn't stop talking. 87 00:04:22,299 --> 00:04:24,427 Who wouldn't stop talking? 88 00:04:24,510 --> 00:04:26,095 They don't want me to pass the bar. 89 00:04:26,178 --> 00:04:27,680 Who doesn't want you to pass the bar? 90 00:04:27,763 --> 00:04:29,765 - That's what they told me. - Hey, hey. 91 00:04:29,849 --> 00:04:31,017 Hey, look at me. Look at me. 92 00:04:31,100 --> 00:04:32,309 Who doesn't want you to pass the bar? 93 00:04:32,393 --> 00:04:34,145 Let's give them some privacy. 94 00:04:34,228 --> 00:04:37,440 Dr. Jefferson will let us know when he's done. 95 00:04:37,523 --> 00:04:38,816 They don't want me to pass the bar. 96 00:04:38,899 --> 00:04:40,651 I'll be right outside, OK? 97 00:04:40,735 --> 00:04:44,196 I'll be right outside, Jackson. 98 00:04:44,280 --> 00:04:47,158 Why don't they want you to pass the bar, Jackson? 99 00:04:47,241 --> 00:04:49,118 They're afraid of me becoming a lawyer. 100 00:04:49,201 --> 00:04:52,121 They're afraid of you becoming a lawyer? 101 00:04:52,204 --> 00:04:56,375 He must have been studying with his law school friends. 102 00:04:56,459 --> 00:04:58,044 They…they should know what happened. 103 00:04:58,127 --> 00:05:00,713 I'm gonna call them. 104 00:05:00,796 --> 00:05:02,590 If you need anything, let me know. 105 00:05:02,673 --> 00:05:05,051 - OK, thank you. - Mm-hmm. 106 00:05:14,518 --> 00:05:15,686 Louie. 107 00:05:17,229 --> 00:05:20,357 Pulmonary hemorrhage. 108 00:05:20,441 --> 00:05:22,777 That was quick. 109 00:05:22,860 --> 00:05:25,279 I'm gonna go clean him up. 110 00:05:25,362 --> 00:05:26,655 I'll help. 111 00:05:29,950 --> 00:05:31,160 Go, go. 112 00:05:34,914 --> 00:05:38,125 Everything OK, Roxie? 113 00:05:38,209 --> 00:05:39,960 I can't get off the bedpan. 114 00:05:40,044 --> 00:05:42,129 Oh, that's what I'm here for. 115 00:05:48,177 --> 00:05:50,554 Your husband seems like a saint. 116 00:05:50,638 --> 00:05:53,849 How long you been married? 117 00:05:53,933 --> 00:05:55,476 Too long. 118 00:05:57,895 --> 00:06:00,773 Almost 20 years. 119 00:06:00,856 --> 00:06:02,566 - OK, put your arm around me. - Mm-hmm. 120 00:06:02,650 --> 00:06:04,401 And I'll pull the bedpan on three. 121 00:06:04,485 --> 00:06:05,611 OK. 122 00:06:05,694 --> 00:06:09,115 One, two, three. 123 00:06:09,198 --> 00:06:10,783 One more. 124 00:06:10,866 --> 00:06:12,993 - Great. - Mm. 125 00:06:13,077 --> 00:06:16,705 20? Wow. 126 00:06:16,789 --> 00:06:18,749 Yeah. 127 00:06:18,833 --> 00:06:22,837 He's been by my side through all of this. 128 00:06:24,755 --> 00:06:28,676 I've watched the light go out of him. 129 00:06:28,759 --> 00:06:31,137 So have the kids. 130 00:06:31,220 --> 00:06:32,555 That's what happened to my auntie 131 00:06:32,638 --> 00:06:35,891 when my Uncle Gerald got sick. 132 00:06:35,975 --> 00:06:38,477 But your husband does it because he loves you. 133 00:06:38,561 --> 00:06:39,937 Mm. 134 00:06:40,020 --> 00:06:42,189 I don't know how you do it, 135 00:06:42,273 --> 00:06:44,775 care for people day after day. 136 00:06:44,859 --> 00:06:47,236 I'll tell you my secret. 137 00:06:47,319 --> 00:06:50,156 I go home at the end of every shift, 138 00:06:50,239 --> 00:06:52,741 leave this all behind, 139 00:06:52,825 --> 00:06:54,743 and escape to "Love Island." 140 00:06:56,537 --> 00:06:58,038 How's it going in here? 141 00:06:58,122 --> 00:06:59,915 The higher-demand dose of morphine helped a little, 142 00:06:59,999 --> 00:07:01,959 - but she's still in pain. - OK. 143 00:07:02,042 --> 00:07:04,795 I got your order. 0.1 per kilo. 144 00:07:04,879 --> 00:07:06,463 - Thanks. - Mm-hmm. 145 00:07:06,547 --> 00:07:09,049 This is a very low sub-dissociative dose 146 00:07:09,133 --> 00:07:10,259 of ketamine. 147 00:07:10,342 --> 00:07:11,760 You might feel a little weird, 148 00:07:11,844 --> 00:07:14,305 but I think it's gonna help with the pain. 149 00:07:16,932 --> 00:07:18,893 Is my husband still in the cafeteria? 150 00:07:18,976 --> 00:07:20,936 I think so. Want me to get him? 151 00:07:21,020 --> 00:07:23,606 No, no. 152 00:07:23,689 --> 00:07:27,026 It's good for us to have a little time apart. 153 00:07:29,361 --> 00:07:31,655 I'll get you another blanket. 154 00:07:35,784 --> 00:07:37,328 Here. I'm headed that way. 155 00:07:37,411 --> 00:07:39,246 Thank you. 156 00:07:39,330 --> 00:07:40,915 Back here for good? 157 00:07:40,998 --> 00:07:42,666 Officially out of triage. 158 00:07:42,750 --> 00:07:45,878 They need extra hands with all the Westbridge hullabaloo. 159 00:07:45,961 --> 00:07:47,838 How many cups have you had today? 160 00:07:47,922 --> 00:07:49,340 - Don't judge me. - Just asking. 161 00:07:49,423 --> 00:07:50,716 You're judging. 162 00:07:52,676 --> 00:07:53,928 Did you hear about Louie? 163 00:07:54,011 --> 00:07:55,346 No. 164 00:07:55,429 --> 00:07:57,306 Pulmonary hemorrhage. Didn't make it. 165 00:07:57,389 --> 00:07:59,892 - Shit. - Mm. 166 00:07:59,975 --> 00:08:01,560 He's been here a hundred times. 167 00:08:01,644 --> 00:08:03,145 I know. 168 00:08:03,229 --> 00:08:06,398 Debrief in the viewing room later. 169 00:08:06,482 --> 00:08:08,025 On a happier note, Perlah and I are planning 170 00:08:08,108 --> 00:08:09,652 a birthday party for Javadi. 171 00:08:09,735 --> 00:08:11,403 She's turning 21. 172 00:08:11,487 --> 00:08:14,198 You two are thick as thieves. 173 00:08:14,281 --> 00:08:16,700 I don't have much of a social life these days, 174 00:08:16,784 --> 00:08:19,578 but I'll be sure to keep an eye out for the Partiful. 175 00:08:19,662 --> 00:08:22,539 Let's discuss our incarcerated patient Gus. 176 00:08:22,623 --> 00:08:24,333 Prison infirmaries tend to be short-staffed, 177 00:08:24,416 --> 00:08:26,710 so we need to be thorough. 178 00:08:26,794 --> 00:08:29,922 What's in the differential diagnosis for malnutrition? 179 00:08:30,005 --> 00:08:33,092 Inadequate intake, methamphetamine use, 180 00:08:33,175 --> 00:08:36,136 severe alcoholism, ADHD medication. 181 00:08:36,220 --> 00:08:37,763 What else? 182 00:08:37,846 --> 00:08:40,099 Cancer of the oropharynx, esophageal strictures, 183 00:08:40,182 --> 00:08:43,143 prior strokes, malabsorption, inflammatory bowel disease, 184 00:08:43,227 --> 00:08:45,104 none of which were in his medical record. 185 00:08:45,187 --> 00:08:47,523 What about psychosocial causes? 186 00:08:47,606 --> 00:08:49,858 Could be an intentional hunger strike. 187 00:08:49,942 --> 00:08:51,986 Or refusing food to get to the infirmary. 188 00:08:52,069 --> 00:08:53,821 Could also be abuse or neglect. 189 00:08:53,904 --> 00:08:56,115 Let's start with a nutrition history once he's back from CT. 190 00:08:56,198 --> 00:08:57,408 Do you have a second to talk about Westbridge? 191 00:08:57,491 --> 00:08:58,492 Mm-hmm. 192 00:08:58,575 --> 00:09:00,244 Hey, we need to start moving some patients out of here. 193 00:09:00,327 --> 00:09:01,996 These walls are starting to fill up with gurneys. 194 00:09:02,079 --> 00:09:03,455 Santos, Ogilvie, and King 195 00:09:03,539 --> 00:09:04,957 all have patients on the launching pad. 196 00:09:05,040 --> 00:09:06,041 I'll check in with them. 197 00:09:06,125 --> 00:09:07,793 How many patients have we had rerouted from Westbridge? 198 00:09:07,876 --> 00:09:09,753 Ten, and God knows how many more in the waiting room. 199 00:09:09,837 --> 00:09:11,005 Ambulance will be here in a few minutes 200 00:09:11,088 --> 00:09:13,257 with the accident victim; I'll stick him in Trauma Two. 201 00:09:13,340 --> 00:09:15,676 What is the story with your incarcerated patient? 202 00:09:15,759 --> 00:09:17,594 Gus Varney, three rib fractures 203 00:09:17,678 --> 00:09:20,264 with normal O2 sats currently, waiting on CT results. 204 00:09:20,347 --> 00:09:21,347 OK, if he's stable at the two-hour mark, 205 00:09:21,390 --> 00:09:22,725 I'd say he's good to go. 206 00:09:22,808 --> 00:09:23,892 Let's get the ball rolling on discharge. 207 00:09:23,976 --> 00:09:25,352 Let's wait on the CT results. 208 00:09:25,436 --> 00:09:26,812 We can move him out of Trauma One, at least. 209 00:09:26,895 --> 00:09:28,105 Yes, we can. What's open? 210 00:09:28,188 --> 00:09:29,815 13 and 14 will be discharged soon, 211 00:09:29,898 --> 00:09:31,567 15 once we move Louie to the viewing room 212 00:09:31,650 --> 00:09:33,027 and get it cleaned up. 213 00:09:33,110 --> 00:09:34,903 Our paracentesis patient, Mr. Cloverfield? 214 00:09:34,987 --> 00:09:36,447 V-fib arrest. 215 00:09:36,530 --> 00:09:37,698 We'll do a debrief when we know how many patients 216 00:09:37,781 --> 00:09:39,116 we're getting from Westbridge. 217 00:09:39,199 --> 00:09:42,202 So Gus goes to 13, 14, or 15? 218 00:09:42,286 --> 00:09:43,829 I kind of want to keep him in plain sight. 219 00:09:43,912 --> 00:09:45,831 - What about BH-2? - Sold. 220 00:09:45,914 --> 00:09:47,624 Why not give him some privacy? 221 00:09:47,708 --> 00:09:50,836 Everyone can see him in BH-2 like he's a monkey at the zoo. 222 00:09:50,919 --> 00:09:52,755 Because he came in with an orange jumpsuit, 223 00:09:52,838 --> 00:09:54,631 and we need to think about patient and staff safety. 224 00:09:54,715 --> 00:09:56,717 Safety first. BH-2 beats a prison cell. 225 00:09:56,800 --> 00:09:58,135 Not by much. 226 00:09:58,218 --> 00:09:59,803 Did you guys hear about Louie? 227 00:09:59,887 --> 00:10:02,473 - Yeah. - Yeah, chronic alcoholic. 228 00:10:02,556 --> 00:10:04,099 Go figure. 229 00:10:04,183 --> 00:10:06,643 Hey, fent OD in South 20 is ready for discharge, 230 00:10:06,727 --> 00:10:08,645 but could you get Lupe to call him a ride? 231 00:10:08,729 --> 00:10:10,064 I need to check on Louie. 232 00:10:10,147 --> 00:10:13,108 - Uh, actually, Whitaker… - He croaked. 233 00:10:13,192 --> 00:10:14,943 - What? - Five minutes ago. 234 00:10:15,027 --> 00:10:16,487 Robby called it. 235 00:10:26,622 --> 00:10:27,790 I'm sorry, man. 236 00:10:27,873 --> 00:10:30,626 We didn't have time to find you. 237 00:10:30,709 --> 00:10:32,920 What happened? 238 00:10:33,003 --> 00:10:35,506 He was apneic and pulseless. 239 00:10:35,589 --> 00:10:38,175 We started CPR and intubated him. 240 00:10:38,258 --> 00:10:39,885 He had a massive pulmonary hemorrhage. 241 00:10:39,968 --> 00:10:41,220 Robby called it. 242 00:10:43,972 --> 00:10:45,891 Found this with his stuff. 243 00:10:45,974 --> 00:10:48,185 Guess he was married at some point. 244 00:10:48,268 --> 00:10:49,978 Never knew that. 245 00:10:53,273 --> 00:10:55,943 Oh, didn't miss this part of the job. 246 00:10:56,026 --> 00:10:57,945 Yeah. 247 00:10:58,028 --> 00:11:03,409 Perlah, did Louie ever mention anything about a wife and kids? 248 00:11:03,492 --> 00:11:05,035 Not as far as I know. 249 00:11:05,119 --> 00:11:07,121 He only had eyes for Rita Moreno. 250 00:11:07,204 --> 00:11:10,833 Well, this is not Rita Moreno. 251 00:11:10,916 --> 00:11:12,668 No, it's not. 252 00:11:12,751 --> 00:11:14,711 Can we check to see if there's an emergency contact? 253 00:11:16,880 --> 00:11:19,716 Yeah, there's a number listed. 254 00:11:26,223 --> 00:11:27,808 You were his primary. Do you want to… 255 00:11:30,310 --> 00:11:31,937 No. 256 00:11:41,488 --> 00:11:43,907 PTMC charge nurse. 257 00:11:43,991 --> 00:11:48,120 Langdon? Where are you? 258 00:11:48,203 --> 00:11:50,205 Makes sense that we'd be his emergency contact. 259 00:11:50,289 --> 00:11:53,792 Sorry to get your hopes up. 260 00:11:53,876 --> 00:11:55,711 Our social worker's gonna do their thing. 261 00:11:55,794 --> 00:11:59,506 If Louie had any family left, they'll find them. 262 00:11:59,590 --> 00:12:01,216 You OK? 263 00:12:02,551 --> 00:12:06,054 Guess it's good it happened here, not out on the street. 264 00:12:06,138 --> 00:12:07,514 You're off the hook with Louie. 265 00:12:07,598 --> 00:12:10,225 I'ma teach Emma here how to clean a dead body. 266 00:12:12,352 --> 00:12:14,104 I'm sorry, but they need me in L&D. 267 00:12:14,188 --> 00:12:15,772 You might want to call for another interpreter. 268 00:12:15,856 --> 00:12:17,191 Busy day. 269 00:12:17,274 --> 00:12:18,650 Shit, that's the girl in 12? 270 00:12:18,734 --> 00:12:20,360 Yeah, she's been waiting for five hours. 271 00:12:20,444 --> 00:12:22,070 Didn't hear her name called the first time. 272 00:12:22,154 --> 00:12:23,614 You check on her? 273 00:12:23,697 --> 00:12:24,990 Need to brush up on my ASL. 274 00:12:25,073 --> 00:12:26,450 You know sign language too? 275 00:12:26,533 --> 00:12:28,202 Princess here knows six languages. 276 00:12:28,285 --> 00:12:30,787 - I know French. - OK, it's not a contest. 277 00:12:32,789 --> 00:12:34,291 No shit talking in front of me. 278 00:12:34,374 --> 00:12:36,668 I get enough of that from her and Perlah. 279 00:12:36,752 --> 00:12:39,421 Guess I'll call for backup. 280 00:12:39,505 --> 00:12:41,465 Yo, Donnie, did you discharge your butt abscess? 281 00:12:41,548 --> 00:12:43,884 Not yet! 282 00:12:43,967 --> 00:12:45,511 What the hell? 283 00:12:45,594 --> 00:12:46,678 Your good friends upstairs sent doughnuts. 284 00:12:46,762 --> 00:12:48,096 Special thank-you for working the holiday. 285 00:12:48,180 --> 00:12:49,890 You got to be kidding me. 286 00:12:49,973 --> 00:12:51,725 What were you expecting, tacos and tequila? 287 00:12:51,808 --> 00:12:53,602 Every single one of them can forget about extra shifts. 288 00:12:53,685 --> 00:12:55,771 - Won't hire more nurses. - Won't pay us a decent wage. 289 00:12:55,854 --> 00:12:57,272 Won't hire security that can actually 290 00:12:57,356 --> 00:12:58,357 protect us from patients. 291 00:12:58,440 --> 00:12:59,983 But absolutely, send doughnuts. 292 00:13:00,067 --> 00:13:01,485 Sure you want to go into this line of work? 293 00:13:01,568 --> 00:13:02,569 Want me get you one? 294 00:13:02,653 --> 00:13:04,863 Of course I do, but I'm not taking admin's blood pastries. 295 00:13:05,572 --> 00:13:07,699 Et tu, Donnie? 296 00:13:07,783 --> 00:13:09,660 OK, move it or lose it. 297 00:13:09,743 --> 00:13:12,120 Meet me in South 15 with gowns and gloves. 298 00:13:12,204 --> 00:13:13,830 Looks like happy hour in here. 299 00:13:13,914 --> 00:13:15,582 Don't ask. What's up with Evel Knievel? 300 00:13:15,666 --> 00:13:18,001 Brandon Li, 52, fell off a motorcycle pyramid 301 00:13:18,085 --> 00:13:19,628 at 25 miles per hour. 302 00:13:19,711 --> 00:13:21,588 Motorcycle pyramid? You recruiting? 303 00:13:21,672 --> 00:13:22,965 Got a fellow rider in your midst. 304 00:13:23,048 --> 00:13:24,258 - No kidding. - How high up were you? 305 00:13:24,341 --> 00:13:26,051 On top of a three, two, one. 306 00:13:26,134 --> 00:13:27,970 But the bottom guys are sitting down driving the choppers. 307 00:13:28,053 --> 00:13:29,680 I'm fine. I don't need all this. 308 00:13:29,763 --> 00:13:31,390 - Were you wearing a helmet? - Of course. 309 00:13:31,473 --> 00:13:33,684 Oh, what do you know? They're still in style. 310 00:13:33,767 --> 00:13:36,270 Good vitals, tender right wrist, and big left knee lac. 311 00:13:36,353 --> 00:13:38,605 Hey, Joy, Perlah, Trauma Two. 312 00:13:38,689 --> 00:13:40,023 Who else can I have? 313 00:13:40,107 --> 00:13:41,650 Santos and Whitaker are in with Louie. 314 00:13:41,733 --> 00:13:43,485 Yeah, give me Whitaker. He could use a distraction. 315 00:13:43,569 --> 00:13:45,195 And Santos has been ducking traumas all day. 316 00:13:45,279 --> 00:13:46,655 Well, she's behind in her charting. 317 00:13:46,738 --> 00:13:47,990 Who isn't? 318 00:13:51,118 --> 00:13:54,621 OK, even when it's not your fault, 319 00:13:54,705 --> 00:13:56,206 sometimes it's worse knowing 320 00:13:56,290 --> 00:13:58,375 that there was nothing you could do. 321 00:13:58,458 --> 00:14:00,752 Uh-huh. 322 00:14:00,836 --> 00:14:02,546 Are you… 323 00:14:02,629 --> 00:14:04,006 Robby needs you both in Trauma Two, 324 00:14:04,089 --> 00:14:05,799 and I need you to discharge sweet Patty in 13 325 00:14:05,882 --> 00:14:07,175 as soon as you're done. 326 00:14:07,259 --> 00:14:08,677 Can't catch a break. 327 00:14:08,760 --> 00:14:10,596 I push you 'cause I know you can take it. 328 00:14:22,983 --> 00:14:26,028 You ever clean a dead body? 329 00:14:26,111 --> 00:14:29,781 Probably never seen one either. 330 00:14:29,865 --> 00:14:32,743 No one tells you what it looks, feels, or smells like, 331 00:14:32,826 --> 00:14:35,412 but you get used to it over time. 332 00:14:37,039 --> 00:14:40,083 You pull off the gown. You wipe him down with towels. 333 00:14:40,167 --> 00:14:42,336 Then we'll roll him on his side, 334 00:14:42,419 --> 00:14:45,631 clean his back, stuff the sheet under him, 335 00:14:45,714 --> 00:14:48,216 wipe down the bed, roll him the other way, 336 00:14:48,300 --> 00:14:49,926 pull out the sheet, and repeat. 337 00:14:50,010 --> 00:14:52,596 Just follow my lead. 338 00:14:52,679 --> 00:14:56,600 Usually, you leave the ET tube in for the coroner, 339 00:14:56,683 --> 00:15:00,479 but Louie's a chronic alcoholic with end-stage liver disease. 340 00:15:00,562 --> 00:15:02,314 Not a coroner's case. 341 00:15:04,441 --> 00:15:07,653 - Did he have family? - Everyone has family. 342 00:15:07,736 --> 00:15:10,781 The social worker always tries to find them. 343 00:15:10,864 --> 00:15:13,158 Sometimes the family loved them, 344 00:15:13,241 --> 00:15:14,368 tried to get them to come home. 345 00:15:14,451 --> 00:15:17,454 Other times, the family wants nothing to do with them. 346 00:15:17,537 --> 00:15:19,539 - That's sad. - That's life. 347 00:15:21,375 --> 00:15:23,043 What happens if no one claims his body? 348 00:15:23,126 --> 00:15:24,670 He'll be cremated. 349 00:15:24,753 --> 00:15:26,213 Where would his ashes go? 350 00:15:26,296 --> 00:15:27,631 They'll keep him for a few months. 351 00:15:27,714 --> 00:15:29,049 Then he gets buried in a mass grave 352 00:15:29,132 --> 00:15:31,176 with all the other unclaimed bodies. 353 00:15:33,095 --> 00:15:35,972 OK, now we roll him. 354 00:15:39,017 --> 00:15:40,769 Ready. 355 00:15:40,852 --> 00:15:42,396 Go. 356 00:15:42,479 --> 00:15:43,772 Oh, my God, is he still alive? 357 00:15:43,855 --> 00:15:45,565 No, that happens. 358 00:15:46,525 --> 00:15:48,360 These frequent fliers. 359 00:15:48,443 --> 00:15:52,155 They can be a real pain in the ass, but… 360 00:15:52,239 --> 00:15:55,283 you miss them when they're gone. 361 00:16:02,040 --> 00:16:04,126 I've been at every Millvale Fourth of July parade 362 00:16:04,209 --> 00:16:05,627 since '08. 363 00:16:05,711 --> 00:16:08,046 World record is 40 men on seven motorcycles. 364 00:16:08,130 --> 00:16:09,631 I plan to beat that someday. 365 00:16:09,715 --> 00:16:11,633 Good lung sliding bilaterally. 366 00:16:11,717 --> 00:16:13,218 Pupils equal and reactive. 367 00:16:13,301 --> 00:16:15,053 - What do you ride? - The Bullet. 368 00:16:15,137 --> 00:16:16,930 Oh, Royal Enfield. Ankle breaker. 369 00:16:17,013 --> 00:16:19,266 - Thumper. - BP 138 over 80. 370 00:16:19,349 --> 00:16:21,435 Pulse 94. Pulse ox 98. 371 00:16:21,518 --> 00:16:23,687 All your vitals sound really good, Brandon. 372 00:16:23,770 --> 00:16:25,313 They call it an ankle breaker 'cause 373 00:16:25,397 --> 00:16:26,982 you got to kick over a big, fat single cylinder 374 00:16:27,065 --> 00:16:29,234 to get it started, sometimes five or six kicks. 375 00:16:29,317 --> 00:16:31,445 Yeah, especially on a cold day. 376 00:16:31,528 --> 00:16:33,739 Um, does anyone have any trauma scissors? 377 00:16:33,822 --> 00:16:35,615 - I'll check the knee. - Uh, not yet. 378 00:16:35,699 --> 00:16:37,451 - Why not? - Dr. Santos. 379 00:16:37,534 --> 00:16:39,911 Primary survey means rule out the life threats. 380 00:16:39,995 --> 00:16:41,997 Don't get distracted by lacerations or fractures. 381 00:16:42,080 --> 00:16:43,749 No free fluid in the belly. 382 00:16:43,832 --> 00:16:46,209 Airway, breathing, circulation are fine. 383 00:16:46,293 --> 00:16:48,462 OK, that's ABC. That just leaves two letters. 384 00:16:48,545 --> 00:16:50,672 Tell her about D, Dr. Santos. 385 00:16:50,756 --> 00:16:52,674 Disability. Wiggle your toes, sir. 386 00:16:52,758 --> 00:16:54,885 Any pain in your arms or legs? 387 00:16:54,968 --> 00:16:56,470 Not really. 388 00:16:56,553 --> 00:16:57,763 Does it hurt when I push here? 389 00:16:57,846 --> 00:16:59,681 - No. - OK, no midline tenderness. 390 00:16:59,765 --> 00:17:01,349 Nexus negative. 391 00:17:01,433 --> 00:17:03,518 With no obvious brain injury or spinal cord injury. 392 00:17:03,602 --> 00:17:06,688 That just leaves E. Joy. 393 00:17:06,772 --> 00:17:08,440 Can I buy another vowel? 394 00:17:08,523 --> 00:17:10,650 - Dr. Whitaker. - Exposure. 395 00:17:10,734 --> 00:17:12,152 AKA strip and flip. 396 00:17:12,235 --> 00:17:14,279 Cut off his clothes, and we'll log roll him. 397 00:17:14,362 --> 00:17:16,323 What do we have? 398 00:17:16,406 --> 00:17:18,241 Helmeted motorcycle acrobat. 399 00:17:18,325 --> 00:17:20,827 8-foot fall standing on top of five riders. 400 00:17:20,911 --> 00:17:22,496 Primary survey normal, E-FAST negative. 401 00:17:22,579 --> 00:17:24,414 Another motorcycle accident. 402 00:17:24,498 --> 00:17:26,625 Hello, sir. I'm Dr. Garcia from surgery. 403 00:17:26,708 --> 00:17:28,084 Hello. 404 00:17:28,168 --> 00:17:33,298 OK, we will roll him in three, two, one. 405 00:17:37,344 --> 00:17:39,721 Well, I grew up a block from Carrick, 406 00:17:39,805 --> 00:17:42,641 but my mom was a teacher at Brashear, so I had to go there. 407 00:17:42,724 --> 00:17:45,143 - The Bullets? - That's right. 408 00:17:45,227 --> 00:17:46,520 They were the Bullets when I was there. 409 00:17:46,603 --> 00:17:48,313 They changed to the Bulls when I left. 410 00:17:48,396 --> 00:17:49,815 Oh. 411 00:17:49,898 --> 00:17:52,859 Hey, you think I could get something to eat? 412 00:17:54,361 --> 00:17:56,905 Gus here is wondering if he's clear to eat. 413 00:17:56,988 --> 00:17:58,865 As long as it's a liquid diet. 414 00:17:58,949 --> 00:18:01,743 We have the results of your CT scan. 415 00:18:01,827 --> 00:18:04,663 Your jaw should heal without surgery, which is good news, 416 00:18:04,746 --> 00:18:07,249 but it will be a few weeks. 417 00:18:07,332 --> 00:18:08,750 Before I can eat? 418 00:18:08,834 --> 00:18:10,544 Solid foods, yes. 419 00:18:10,627 --> 00:18:14,339 Or you can have food pureed with liquid in a blender. 420 00:18:14,422 --> 00:18:17,008 I don't have a blender. 421 00:18:17,092 --> 00:18:18,426 Right. 422 00:18:18,510 --> 00:18:20,345 Sorry. 423 00:18:20,428 --> 00:18:23,723 We have a calorie-rich supplement drink called Ensure. 424 00:18:23,807 --> 00:18:27,143 Comes in chocolate, vanilla, or strawberry. 425 00:18:27,227 --> 00:18:29,020 Chocolate, please. 426 00:18:29,104 --> 00:18:30,689 - Good choice. - How many can I have? 427 00:18:30,772 --> 00:18:32,190 Two a day is recommended. 428 00:18:32,274 --> 00:18:34,276 I'll get it for you. 429 00:18:34,359 --> 00:18:37,696 You have an appetite. That's good. 430 00:18:37,779 --> 00:18:39,823 Mr. Varney, your blood tests indicate 431 00:18:39,906 --> 00:18:42,409 low levels of protein and vitamins. 432 00:18:42,492 --> 00:18:44,661 Can we ask you a few questions about your diet? 433 00:18:46,454 --> 00:18:49,666 How many meals or snacks do you have in a 24-hour period? 434 00:18:49,749 --> 00:18:51,042 I don't know. 435 00:18:51,126 --> 00:18:53,003 Don't count. 436 00:18:53,086 --> 00:18:55,630 Pretty sure it's three trays a day. 437 00:18:55,714 --> 00:18:57,299 OK. 438 00:18:57,382 --> 00:19:00,510 How often do you eat cereals, fruits, or vegetables? 439 00:19:00,594 --> 00:19:03,763 Not many fruits and vegetables in prison. 440 00:19:03,847 --> 00:19:05,473 Slow and steady. 441 00:19:07,517 --> 00:19:09,561 What year is your Bonneville? 442 00:19:09,644 --> 00:19:10,854 '69. 443 00:19:10,937 --> 00:19:13,231 Rescued it from a motor graveyard. 444 00:19:13,315 --> 00:19:14,774 Brought it back to life with a buddy of mine, 445 00:19:14,858 --> 00:19:16,526 who's supposed to be coming in today. 446 00:19:16,610 --> 00:19:17,986 How often do you ride? 447 00:19:18,069 --> 00:19:19,821 I ride it in to work every day. 448 00:19:19,905 --> 00:19:21,031 Good for you. 449 00:19:21,114 --> 00:19:22,699 Don't encourage him. 450 00:19:22,782 --> 00:19:24,451 CT's ready for Brandon. 451 00:19:24,534 --> 00:19:27,120 As soon as we take a look at this knee. 452 00:19:28,538 --> 00:19:30,790 - Whoa. - Through the deep fascia. 453 00:19:30,874 --> 00:19:31,917 How's it look? 454 00:19:32,000 --> 00:19:33,084 Definitely gonna need stitches. 455 00:19:33,168 --> 00:19:34,419 - How many? - A lot. 456 00:19:34,502 --> 00:19:35,962 It could be an open joint. 457 00:19:36,046 --> 00:19:37,839 We'll do a saline load after CT. 458 00:19:37,923 --> 00:19:39,382 OK. 459 00:19:39,466 --> 00:19:41,301 Lever sign negative. ACL intact. 460 00:19:41,384 --> 00:19:42,719 OK, ready to roll. 461 00:19:47,766 --> 00:19:49,517 Are you still coming over tonight? 462 00:19:49,601 --> 00:19:51,311 I think Whitaker is gonna be playing 463 00:19:51,394 --> 00:19:53,355 farm boy again this weekend, so he's not gonna be around. 464 00:19:53,438 --> 00:19:55,065 I may need a rain check. 465 00:19:55,148 --> 00:19:56,733 Hey, do you have an update on that nec fasc patient? 466 00:19:56,816 --> 00:19:58,193 Last I heard, Miller was doing 467 00:19:58,276 --> 00:20:00,362 an above-the-knee amputation with ortho. 468 00:20:02,405 --> 00:20:04,741 Langdon's waitress with the cellulitis? 469 00:20:04,824 --> 00:20:06,076 Yeah. 470 00:20:06,159 --> 00:20:08,703 - Man, that took a turn. - Sure did. 471 00:20:08,787 --> 00:20:11,414 Hey, did you hear about Louie? 472 00:20:12,707 --> 00:20:15,126 - Yeah. - You OK? 473 00:20:15,210 --> 00:20:16,628 Um, 474 00:20:16,711 --> 00:20:20,173 one of my uncles drank himself to death. 475 00:20:20,256 --> 00:20:23,051 I barely recognized him at the end. 476 00:20:23,134 --> 00:20:26,346 At least Louie always seemed happy. 477 00:20:26,429 --> 00:20:28,014 I'm here if you want to talk. 478 00:20:33,645 --> 00:20:36,481 Should've known I'd find you in here. 479 00:20:36,564 --> 00:20:40,318 You steal anyone's lunch, it's a $20 fine. 480 00:20:40,402 --> 00:20:41,987 Made a lot of changes while you were gone. 481 00:20:42,070 --> 00:20:43,613 I can see that. 482 00:20:43,697 --> 00:20:45,073 Look, I'll let you hide out a little bit longer, 483 00:20:45,156 --> 00:20:46,741 but then I need you to pick up more patients. 484 00:20:46,825 --> 00:20:48,326 You're not as fast as you used to be. 485 00:20:48,410 --> 00:20:50,453 Damn doughnuts! 486 00:20:50,537 --> 00:20:52,789 Ouch. 487 00:20:52,872 --> 00:20:55,750 First day back, I get kicked in the nuts. 488 00:20:55,834 --> 00:20:57,919 One dead, one septic bounce-back. 489 00:20:58,003 --> 00:21:00,255 Both of those not your fault. 490 00:21:02,882 --> 00:21:04,551 You expecting a party? 491 00:21:04,634 --> 00:21:06,261 No, not really. 492 00:21:06,344 --> 00:21:08,722 Didn't hear from anyone while I was gone. 493 00:21:11,224 --> 00:21:12,976 Sorry. 494 00:21:13,059 --> 00:21:16,646 They ever, uh, arrest that guy who punched you? 495 00:21:16,730 --> 00:21:18,481 Yeah. 496 00:21:18,565 --> 00:21:20,400 Wanted to know if I wanted to press charges, 497 00:21:20,483 --> 00:21:23,737 but didn't want to go through all that. 498 00:21:23,820 --> 00:21:26,322 Thought I was done, really did, but… 499 00:21:26,406 --> 00:21:29,993 I got bored at home, so only lasted a few weeks. 500 00:21:30,076 --> 00:21:31,786 You? 501 00:21:31,870 --> 00:21:34,497 10 months is a long time to be alone with your thoughts. 502 00:21:34,581 --> 00:21:37,083 I almost lost everything. 503 00:21:37,167 --> 00:21:39,252 I know a lot of women who would have taken the kids and left, 504 00:21:39,335 --> 00:21:42,505 - but Abby stayed. - 'Cause she's a good woman. 505 00:21:42,589 --> 00:21:44,340 'Cause you deserve a second chance. 506 00:21:44,424 --> 00:21:46,134 I'm not sure everyone agrees with you. 507 00:21:46,217 --> 00:21:47,427 Give it time. 508 00:21:47,510 --> 00:21:49,554 Look, I… 509 00:21:53,767 --> 00:21:56,227 I, um… 510 00:21:56,311 --> 00:22:00,106 I've been working the 12 steps, trying to make amends. 511 00:22:00,190 --> 00:22:01,858 I was really selfish. 512 00:22:01,941 --> 00:22:03,735 I lied to myself, and I lied to you. 513 00:22:03,818 --> 00:22:05,111 I'm really sorry. 514 00:22:05,195 --> 00:22:06,529 You can check me off your list, kid. 515 00:22:06,613 --> 00:22:08,448 We're good. 516 00:22:08,531 --> 00:22:10,617 - OK. - Yeah. 517 00:22:10,700 --> 00:22:12,285 Got a lovely patient for you in Two. 518 00:22:12,368 --> 00:22:14,287 Let's get you back on the horse. 519 00:22:17,332 --> 00:22:18,750 Really need to talk with Robby. 520 00:22:18,833 --> 00:22:20,168 I don't know if today's the best day for that. 521 00:22:20,251 --> 00:22:21,461 He leaves on vacation tomorrow. 522 00:22:21,544 --> 00:22:22,962 Let him get through the day in peace. 523 00:22:23,046 --> 00:22:24,464 He's supposed to be gone for three months? 524 00:22:24,547 --> 00:22:26,466 So he says. I give him one. 525 00:22:26,549 --> 00:22:27,926 Go get 'em, kid. 526 00:22:30,720 --> 00:22:33,431 Dr. Langdon, this is Rocky. 527 00:22:33,515 --> 00:22:34,808 Great name. 528 00:22:34,891 --> 00:22:38,436 What brings you in, Rocky? 529 00:22:38,520 --> 00:22:40,146 Very sick. 530 00:22:40,230 --> 00:22:42,398 When did it start? 531 00:22:42,482 --> 00:22:43,983 An hour ago. 532 00:22:44,067 --> 00:22:46,611 After he won a hot dog eating contest. 533 00:22:46,694 --> 00:22:49,114 A hot dog eating contest? How many you eat? 534 00:22:52,033 --> 00:22:54,077 351 hot dogs? 535 00:22:58,248 --> 00:22:59,666 36. 536 00:22:59,749 --> 00:23:02,168 Still a lot. 537 00:23:02,252 --> 00:23:04,170 - I pulled eight of Zofran. - Go for it. 538 00:23:04,254 --> 00:23:05,588 All right, this should help. 539 00:23:05,672 --> 00:23:07,257 Stick it under your tongue. Let it dissolve. 540 00:23:07,340 --> 00:23:08,508 OK, are you taking any prescription… 541 00:23:13,930 --> 00:23:16,224 Oh, thank you. 542 00:23:16,307 --> 00:23:18,768 Thanks. 543 00:23:18,852 --> 00:23:21,062 Santos, what's up with your ileus patient? 544 00:23:21,146 --> 00:23:23,064 Admitted to medicine, and before you ask, 545 00:23:23,148 --> 00:23:24,816 13 has been discharged. 546 00:23:24,899 --> 00:23:27,110 Great. 12 needs a doctor. 547 00:23:27,193 --> 00:23:28,987 No, don't make me go back there. 548 00:23:29,070 --> 00:23:32,157 That disimpaction left a smell and stunk up the whole hallway. 549 00:23:32,240 --> 00:23:34,200 So grab some coffee grounds from the lounge. 550 00:23:34,284 --> 00:23:36,828 We need to admit our incarcerated patient, Gus. 551 00:23:36,911 --> 00:23:38,705 What did the CT show? 552 00:23:38,788 --> 00:23:41,166 Moderate pulmonary contusion, three rib fractures, 553 00:23:41,249 --> 00:23:43,960 no intra-abdominal bleeding, and oblique fracture 554 00:23:44,043 --> 00:23:46,588 in the body of the mandible anterior to the angle. 555 00:23:46,671 --> 00:23:48,798 All favorable for healing. What's the treatment plan? 556 00:23:48,882 --> 00:23:50,633 - A pain med… - Security. 557 00:23:50,717 --> 00:23:52,051 People are trying to sleep. 558 00:23:52,135 --> 00:23:55,555 Pain medication, antibiotics, liquid diet, 559 00:23:55,638 --> 00:23:57,515 um, a pulse ox a few times a day, 560 00:23:57,599 --> 00:24:00,351 and then also dressing changes for the laceration. 561 00:24:00,435 --> 00:24:02,854 Which he can get at his correctional facility. 562 00:24:02,937 --> 00:24:05,106 Or he stays here for a few days, 563 00:24:05,190 --> 00:24:08,026 and we get him on the right track to healing. 564 00:24:08,109 --> 00:24:10,111 Why don't you two go check on your patients? 565 00:24:10,195 --> 00:24:12,822 - Got it. - Sure thing. 566 00:24:12,906 --> 00:24:14,657 What am I missing? 567 00:24:14,741 --> 00:24:16,075 He's not getting enough to eat 568 00:24:16,159 --> 00:24:17,577 at his correctional facility. 569 00:24:17,660 --> 00:24:19,162 The portions are tiny. 570 00:24:19,245 --> 00:24:21,122 Too many carbs, not enough fruits or vegetables. 571 00:24:21,206 --> 00:24:24,584 He's lucky he hasn't developed a chronic illness. 572 00:24:24,667 --> 00:24:26,377 We don't have any inpatient beds. 573 00:24:26,461 --> 00:24:27,921 He would board down here for three days. 574 00:24:28,004 --> 00:24:29,464 We're still getting runs from Westbridge, 575 00:24:29,547 --> 00:24:31,799 and we cannot tie up Behavioral for that long. 576 00:24:31,883 --> 00:24:33,635 Dr. Al-Hashimi, Dr. Jefferson wants to talk 577 00:24:33,718 --> 00:24:35,386 to you about our tasered kid. 578 00:24:39,307 --> 00:24:40,683 Why don't I call the prison doctor 579 00:24:40,767 --> 00:24:42,393 and find out what they're working with over there? 580 00:24:42,477 --> 00:24:44,229 - Thank you. - My pleasure. 581 00:24:46,356 --> 00:24:48,650 Dr. Jefferson seems to have a good rapport with Jackson. 582 00:24:48,733 --> 00:24:50,026 That's excellent. 583 00:24:50,109 --> 00:24:51,361 How's the sister doing? 584 00:24:51,444 --> 00:24:52,737 Still pretty upset. 585 00:24:52,820 --> 00:24:54,239 She's never seen him like this. 586 00:24:54,322 --> 00:24:55,865 It's a lot to process. 587 00:24:55,949 --> 00:24:58,117 - How's he doing? - He's scared. 588 00:24:58,201 --> 00:24:59,661 Droperidol had a positive effect, 589 00:24:59,744 --> 00:25:02,038 but he doesn't understand what's going on. 590 00:25:02,121 --> 00:25:04,082 He's been experiencing auditory hallucinations 591 00:25:04,165 --> 00:25:05,667 and paranoid delusions. 592 00:25:05,750 --> 00:25:08,878 Voices are telling him he isn't safe. 593 00:25:08,962 --> 00:25:10,171 This has been going on for months. 594 00:25:10,255 --> 00:25:11,798 - Months? - Yeah. 595 00:25:11,881 --> 00:25:13,383 Turns out, his sister hasn't seen him in a while. 596 00:25:13,466 --> 00:25:15,426 Family history of mental illness? 597 00:25:15,510 --> 00:25:17,637 Not that we know of. 598 00:25:17,720 --> 00:25:21,474 I'm gonna give him a break and then continue the conversation. 599 00:25:21,557 --> 00:25:22,850 Parents are on their way. 600 00:25:22,934 --> 00:25:23,920 We'll let you know when they get here. 601 00:25:23,935 --> 00:25:25,311 Yes. Do. 602 00:25:25,395 --> 00:25:27,146 OK, hospital bed, wheelchair, 603 00:25:27,230 --> 00:25:30,149 and shower chair have all been ordered. 604 00:25:30,233 --> 00:25:31,859 What do you say, kid? 605 00:25:31,943 --> 00:25:33,820 Ready to go home? 606 00:25:36,197 --> 00:25:38,992 How's your pain, Mrs. Hamler? 607 00:25:39,075 --> 00:25:40,493 The same. 608 00:25:40,576 --> 00:25:42,829 We're gonna write you a script for Keppra. 609 00:25:42,912 --> 00:25:44,163 You'll take that to prevent seizures 610 00:25:44,247 --> 00:25:45,999 once a day, starting tomorrow. 611 00:25:46,082 --> 00:25:47,959 Between your broken leg and the bruises from your seizure, 612 00:25:48,042 --> 00:25:50,003 the pain will probably get a little worse. 613 00:25:50,086 --> 00:25:51,254 Yeah, the most important thing is 614 00:25:51,337 --> 00:25:52,463 to let others help you. 615 00:25:52,547 --> 00:25:54,048 You'll need assistance showering 616 00:25:54,132 --> 00:25:55,550 and getting to the bathroom. 617 00:25:55,633 --> 00:25:57,468 Yeah, no problem. I won't leave her side. 618 00:25:57,552 --> 00:25:59,846 Paul, you need a break. 619 00:25:59,929 --> 00:26:04,309 You're…you're taking care of me, the kids, the house. 620 00:26:04,392 --> 00:26:07,562 It's too much for one person. 621 00:26:07,645 --> 00:26:09,856 I'm not the one battling cancer. 622 00:26:09,939 --> 00:26:11,149 Paul. 623 00:26:11,232 --> 00:26:14,610 Hey, you're in pain every day, 624 00:26:14,694 --> 00:26:16,321 fighting for your life. 625 00:26:16,404 --> 00:26:18,990 I'm happy to do this for you. 626 00:26:19,073 --> 00:26:21,534 You're my wife. 627 00:26:21,617 --> 00:26:24,662 Now, let's go home and forget this day ever happened. 628 00:26:24,746 --> 00:26:26,122 I'll call the transpo ambulance. 629 00:26:26,205 --> 00:26:27,457 Thanks, Princess. 630 00:26:34,047 --> 00:26:35,548 Hey. 631 00:26:37,091 --> 00:26:39,177 Why don't you go ahead? 632 00:26:39,260 --> 00:26:40,261 - What? - Yeah. 633 00:26:40,345 --> 00:26:41,554 You can get the house ready. 634 00:26:41,637 --> 00:26:43,723 I'll be right behind you. 635 00:26:43,806 --> 00:26:45,391 - No. - Mm-hmm. 636 00:26:45,475 --> 00:26:49,520 No, I'm…I'm riding in the back with you. 637 00:26:49,604 --> 00:26:52,440 You know what? I'll stay with her. 638 00:26:54,025 --> 00:26:55,735 Are you sure? 639 00:26:55,818 --> 00:26:57,987 - Mm-hmm. - Yeah. 640 00:26:58,071 --> 00:27:01,199 OK. 641 00:27:01,282 --> 00:27:04,160 Um, call me if you need me to come back. 642 00:27:04,243 --> 00:27:05,995 Mm-hmm. 643 00:27:11,292 --> 00:27:12,627 When will the ambulance get here? 644 00:27:12,710 --> 00:27:13,711 It shouldn't be long. 645 00:27:13,795 --> 00:27:15,797 Mr. Francis, short of breath? 646 00:27:15,880 --> 00:27:17,256 Yeah, I was worried the clot in my leg 647 00:27:17,340 --> 00:27:19,300 could have gone up to my lungs, so… 648 00:27:19,384 --> 00:27:21,135 You're on Eliquis. That shouldn't happen. 649 00:27:21,219 --> 00:27:22,970 - Yeah, I know, but… - Hey, Donnie, I got this. 650 00:27:23,054 --> 00:27:24,472 Don't worry, Mr. Francis. 651 00:27:24,555 --> 00:27:26,140 I'll order the D-dimer. I'll be back to see you. 652 00:27:26,224 --> 00:27:28,726 Thank you, Dr. Mohan. 653 00:27:28,810 --> 00:27:30,728 You know I'm an NP now. 654 00:27:30,812 --> 00:27:32,230 I can pick up a patient with dyspnea. 655 00:27:32,313 --> 00:27:33,731 I'm sorry. 656 00:27:33,815 --> 00:27:36,150 I've seen him before, and he's asked for me. 657 00:27:36,234 --> 00:27:38,277 Why even order the test? He's on Eliquis. 658 00:27:38,361 --> 00:27:39,612 Mr. Francis comes in every month 659 00:27:39,695 --> 00:27:41,614 and always asks for a D-dimer. 660 00:27:41,697 --> 00:27:44,075 Just…he's worried, and it puts his mind at ease. 661 00:27:44,158 --> 00:27:46,702 - Why not? - Yeah, OK. 662 00:27:46,786 --> 00:27:49,539 Donnie's the best. You'll learn a lot from him. 663 00:27:49,622 --> 00:27:51,582 That's right. 664 00:28:18,276 --> 00:28:20,319 All right, fill me in. 665 00:28:20,403 --> 00:28:23,030 This is Harlow Graham. She was seen in triage. 666 00:28:23,114 --> 00:28:25,408 CBC and CMP came back normal. 667 00:28:25,491 --> 00:28:27,910 IT was supposed to bring the VRI down, but they're slammed. 668 00:28:27,994 --> 00:28:29,620 I know a bit of sign language. 669 00:28:29,704 --> 00:28:35,126 Harlow, this is Dr. Santos. 670 00:28:35,209 --> 00:28:36,878 Hi, Harlow. How are you feeling? 671 00:28:39,755 --> 00:28:41,007 She has a headache. 672 00:28:41,090 --> 00:28:42,884 OK. What else? 673 00:28:48,389 --> 00:28:49,932 What is she saying? 674 00:28:50,016 --> 00:28:52,059 I think she had a stomachache, 675 00:28:52,143 --> 00:28:54,937 and she might have passed out. 676 00:28:58,065 --> 00:28:59,734 I'm not 100% sure. 677 00:28:59,817 --> 00:29:02,320 OK, we're just gonna need to wait for an interpreter, 678 00:29:02,403 --> 00:29:03,988 'cause I need to ask a million questions, 679 00:29:04,071 --> 00:29:05,615 and I can't do it this way. 680 00:29:05,698 --> 00:29:07,742 So just call me when IT comes down. 681 00:29:19,128 --> 00:29:21,964 CT head, neck, chest, abdomen, pelvis all negative. 682 00:29:22,048 --> 00:29:25,051 It means we can get this collar off. 683 00:29:25,134 --> 00:29:27,178 Thank you. 684 00:29:27,261 --> 00:29:28,596 Roll to your side. 685 00:29:28,679 --> 00:29:30,848 We'll get you off this board. 686 00:29:30,932 --> 00:29:32,433 How long is your trip? 687 00:29:32,517 --> 00:29:35,311 2,000 miles, all the way from here to Alberta. 688 00:29:35,394 --> 00:29:36,979 Couple stops along the way. 689 00:29:37,063 --> 00:29:38,523 Got the whole thing mapped out. 690 00:29:38,606 --> 00:29:40,733 - Sounds like heaven. - Let's sit you up. 691 00:29:40,816 --> 00:29:42,443 Sorry, I got stuck with a patient. 692 00:29:42,527 --> 00:29:44,529 You know the old saying, four wheels move the body, 693 00:29:44,612 --> 00:29:46,113 two wheels move the soul. 694 00:29:46,197 --> 00:29:47,615 You're gonna be living the dream. 695 00:29:47,698 --> 00:29:49,033 Thank you, Brandon. 696 00:29:49,116 --> 00:29:50,576 Not everybody down here feels that way. 697 00:29:50,660 --> 00:29:52,870 - OK, Whitaker, what's next? - Ortho assessment. 698 00:29:52,954 --> 00:29:56,082 Palpate all long bones, starting with the clavicle. 699 00:29:56,165 --> 00:29:57,375 Got it. 700 00:29:57,458 --> 00:29:59,919 I'll take the lower extremities. 701 00:30:04,549 --> 00:30:05,716 Distal radius tender. No deformities. 702 00:30:05,800 --> 00:30:06,926 Needs an X-ray. 703 00:30:07,009 --> 00:30:08,302 No bony tenderness down here. 704 00:30:08,386 --> 00:30:09,720 No laxity of the knee. 705 00:30:09,804 --> 00:30:12,431 Are you concerned about that knee lac? 706 00:30:12,515 --> 00:30:14,600 If it's an open joint, he'll need a washout in the OR. 707 00:30:14,684 --> 00:30:16,561 We could try a fluorescein injection. 708 00:30:16,644 --> 00:30:18,062 OK, we'll need a… 709 00:30:18,145 --> 00:30:19,730 Wood's lamp, 1% lido with epi, 710 00:30:19,814 --> 00:30:22,149 sterile saline, sterile basin, sterile fluoro-strip, 711 00:30:22,233 --> 00:30:26,279 18- and 27-gauge needles, 5- and 60-cc syringes. 712 00:30:26,362 --> 00:30:28,739 How does she know all that? 713 00:30:28,823 --> 00:30:30,116 She just does. 714 00:30:31,576 --> 00:30:32,868 How are you feeling, Rocky? 715 00:30:32,952 --> 00:30:34,662 Oh, much better. 716 00:30:34,745 --> 00:30:36,414 He's had eight migs of ondansetron. 717 00:30:36,497 --> 00:30:37,873 Any pain in the belly? 718 00:30:37,957 --> 00:30:40,167 No, but my mouth is really dry. 719 00:30:40,251 --> 00:30:43,629 No doubt from consuming mass quantities of salty hot dogs. 720 00:30:43,713 --> 00:30:45,172 Could I have another sip of water? 721 00:30:45,256 --> 00:30:46,757 Sure. A little sip. 722 00:30:46,841 --> 00:30:48,801 Take it slow. 723 00:30:48,884 --> 00:30:50,303 - Here you go. - Thank you. 724 00:30:50,386 --> 00:30:54,015 Just enough to wet your whistle. 725 00:30:54,098 --> 00:30:56,851 So how'd you get your start as a competitive eater? 726 00:31:05,651 --> 00:31:08,029 Any pain here, Mr. Li? 727 00:31:08,112 --> 00:31:09,697 - Can't feel a thing. - Great. 728 00:31:09,780 --> 00:31:11,032 Where is Santos? 729 00:31:11,115 --> 00:31:13,701 Probably catching up on her charting. 730 00:31:13,784 --> 00:31:15,119 - Right. - Lights out. 731 00:31:15,202 --> 00:31:16,996 Wood's lamp on. 732 00:31:18,914 --> 00:31:20,708 OK. 733 00:31:22,335 --> 00:31:24,170 I might want to use some of that on Halloween. 734 00:31:24,253 --> 00:31:27,006 That is 250 ccs of sterile saline 735 00:31:27,089 --> 00:31:29,800 with one small touch of a sterile fluoro-strip. 736 00:31:29,884 --> 00:31:31,552 OK. 737 00:31:31,636 --> 00:31:34,347 We're going to inject this fluid into your knee, Brandon, 738 00:31:34,430 --> 00:31:37,975 and if there's anything glowing in your wound, 739 00:31:38,059 --> 00:31:39,935 we know we have a leak. 740 00:31:40,019 --> 00:31:42,438 - Feeling some pressure. - Yeah, it's normal. 741 00:31:42,521 --> 00:31:45,399 As soon as I finish the test, I'll pull off the fluid. 742 00:31:47,693 --> 00:31:49,236 That looks good. 743 00:31:49,320 --> 00:31:51,280 Laceration did not enter into the joint space. 744 00:31:51,364 --> 00:31:52,823 Surgery not needed. 745 00:31:52,907 --> 00:31:54,492 Excellent. I can get back to the parade. 746 00:31:54,575 --> 00:31:55,910 No, we'll still need to 747 00:31:55,993 --> 00:31:57,328 stitch you up and splint your wrist. 748 00:31:57,411 --> 00:31:58,663 Hanging a gram of Ancef. 749 00:31:58,746 --> 00:32:00,456 Wait, he has a penicillin allergy. 750 00:32:00,539 --> 00:32:03,084 No, PEN-FAST was negative. We're OK. 751 00:32:03,167 --> 00:32:05,878 My mom said I got a rash with amoxicillin when I was two. 752 00:32:05,961 --> 00:32:07,797 Yeah, probably not a true allergy. 753 00:32:07,880 --> 00:32:09,382 Go ahead and give it, Kim. 754 00:32:09,465 --> 00:32:11,384 But have epi and Benadryl standing by, right? 755 00:32:11,467 --> 00:32:13,386 Yes, to be on the safe side. 756 00:32:13,469 --> 00:32:15,638 Most people who think they have a penicillin allergy 757 00:32:15,721 --> 00:32:17,598 actually don't. 758 00:32:17,682 --> 00:32:20,184 Always listen to the nurses. They run the ER. 759 00:32:20,267 --> 00:32:22,228 We just try and stay out of their way. 760 00:32:29,193 --> 00:32:31,153 Now we can really clean him up. 761 00:32:31,237 --> 00:32:32,822 Didn't we already do that? 762 00:32:32,905 --> 00:32:35,032 Dried blood on the face, neck, hands. 763 00:32:35,116 --> 00:32:37,952 If anyone comes, they shouldn't have to see that. 764 00:32:38,035 --> 00:32:40,079 Sometimes the local unhoused folks will pay a visit, 765 00:32:40,162 --> 00:32:41,706 but we always make them presentable 766 00:32:41,789 --> 00:32:44,208 in case anyone comes. 767 00:32:44,291 --> 00:32:47,336 That's the last thing we can do for them. 768 00:32:47,420 --> 00:32:51,006 Didn't get to do that during COVID. 769 00:32:51,090 --> 00:32:53,384 Once he's spotless, we'll tuck him in nice and tight, 770 00:32:53,467 --> 00:32:55,678 but we always leave one arm outside the sheet. 771 00:32:55,761 --> 00:32:57,972 Because? 772 00:32:58,055 --> 00:33:00,599 So loved ones can hold their hand. 773 00:33:00,683 --> 00:33:02,643 - Here you go. - Thanks. 774 00:33:02,727 --> 00:33:04,228 Yeah. 775 00:33:06,355 --> 00:33:08,524 We're ready to discharge our cancer mom, Roxie. 776 00:33:08,607 --> 00:33:10,025 Ambulance is on the way; we just need 777 00:33:10,109 --> 00:33:11,902 - to reconcile her home meds. - Sounds good. 778 00:33:11,986 --> 00:33:13,821 Hey, I thought I saw another charge nurse around here. 779 00:33:13,904 --> 00:33:15,614 Oh, yeah. We travel in packs. 780 00:33:15,698 --> 00:33:16,991 Aren't you sick of this place yet? 781 00:33:17,074 --> 00:33:19,160 Oh, someone is ready for his sabbatical. 782 00:33:19,243 --> 00:33:20,828 Guilty as charged. 783 00:33:20,911 --> 00:33:22,788 Hey, I just got word that the at-home morphine pump 784 00:33:22,872 --> 00:33:23,956 is gonna be delayed. 785 00:33:24,039 --> 00:33:25,624 Hospital pharmacy has to mix it 786 00:33:25,708 --> 00:33:27,168 and then deliver it later today. 787 00:33:27,251 --> 00:33:28,919 Well, should we keep her here until it's ready? 788 00:33:29,003 --> 00:33:30,254 No, you can give her 789 00:33:30,337 --> 00:33:31,922 a 200-milligram tablet of MS Contin. 790 00:33:32,006 --> 00:33:34,091 - 200 milligrams? - Biggest pill they make. 791 00:33:34,175 --> 00:33:37,511 Releases over 12 hours for patients with opiate tolerance. 792 00:33:37,595 --> 00:33:39,096 Got it. 793 00:33:39,180 --> 00:33:40,556 Hey, do you want to stick around a little bit? 794 00:33:40,639 --> 00:33:42,016 Westbridge is closed to internal disaster. 795 00:33:42,099 --> 00:33:43,309 - We're getting all their runs. - Yeah, I heard. 796 00:33:43,392 --> 00:33:44,852 I put 20 bucks on a plumbing issue. 797 00:33:44,935 --> 00:33:46,729 I just watched that poop cruise documentary. 798 00:33:46,812 --> 00:33:48,522 Oh, I cannot stop thinking about it. 799 00:33:48,606 --> 00:33:50,649 That sounds like something I will absolutely never watch. 800 00:33:50,733 --> 00:33:52,234 Dr. Robby, 801 00:33:52,318 --> 00:33:54,820 you gave us a clozapine ileus about an hour ago. 802 00:33:54,904 --> 00:33:56,447 Your resident reported no surgical history, 803 00:33:56,530 --> 00:33:58,699 but the chart says they've had an appendectomy. 804 00:33:58,783 --> 00:34:00,785 We're not admitting the patient without a surgery consult. 805 00:34:00,868 --> 00:34:03,120 - Who called it in? - A Dr. Trinity Santos. 806 00:34:03,204 --> 00:34:06,457 Dr. Santos, you had an ileus patient. 807 00:34:06,540 --> 00:34:08,876 You neglected to mention a history of appendectomy. 808 00:34:08,959 --> 00:34:10,961 There was no history of appendectomy. 809 00:34:11,045 --> 00:34:12,379 It was in your note. 810 00:34:12,463 --> 00:34:15,174 I may have forgotten to proof check it. 811 00:34:15,257 --> 00:34:17,301 I was using the app that Dr. Al-Hashimi suggested 812 00:34:17,384 --> 00:34:18,427 to catch up on my charting. 813 00:34:18,511 --> 00:34:19,929 Wonderful. 814 00:34:20,012 --> 00:34:21,931 - Ah, Dr. Al-Hashimi. - Yes? 815 00:34:22,014 --> 00:34:25,518 Dr. Santos was just using your AI tool for her charting, 816 00:34:25,601 --> 00:34:28,813 and it hallucinated a history of appendicitis. 817 00:34:28,896 --> 00:34:32,107 As I mentioned to Dr. Santos, generative AI is not perfect. 818 00:34:32,191 --> 00:34:34,527 We still need to proofread every chart it creates. 819 00:34:34,610 --> 00:34:37,154 Mm-hmm, the patient also has a history of headache, 820 00:34:37,238 --> 00:34:39,281 followed by Dr. Park from Urology. 821 00:34:39,365 --> 00:34:41,992 That should probably be Neurology. 822 00:34:42,076 --> 00:34:44,245 Unless urologists are now treating migraines. 823 00:34:44,328 --> 00:34:45,663 Another example that should have been caught 824 00:34:45,746 --> 00:34:47,289 by proofreading. 825 00:34:47,373 --> 00:34:49,625 AI's 2% error rate is still better than dictation. 826 00:34:49,708 --> 00:34:51,126 Yeah, I don't really give a shit whether or not 827 00:34:51,210 --> 00:34:53,170 you want to use robots down here. 828 00:34:53,254 --> 00:34:55,631 I need accurate information in the medical record. 829 00:34:55,714 --> 00:34:57,091 - Understood. - OK. 830 00:34:57,174 --> 00:34:59,760 Dr. Santos. 831 00:34:59,844 --> 00:35:01,804 Dr. Santos! 832 00:35:01,887 --> 00:35:03,681 Yup. Won't happen again. 833 00:35:06,433 --> 00:35:07,434 Hoy. 834 00:35:09,144 --> 00:35:10,521 Thanks, Perlah. 835 00:35:10,604 --> 00:35:12,898 Six hours to go. You got this. 836 00:35:14,733 --> 00:35:17,736 When a wound is gaping like this, 837 00:35:17,820 --> 00:35:20,155 you want to use sub-Q to bring the edges together. 838 00:35:20,239 --> 00:35:21,949 A lot of meat to close. 839 00:35:22,032 --> 00:35:25,411 What would happen if we just did a simple wound closure? 840 00:35:25,494 --> 00:35:27,162 You take the stitches out in ten days, 841 00:35:27,246 --> 00:35:29,081 the wound opens, dehisces. 842 00:35:29,164 --> 00:35:30,416 Exactly. 843 00:35:30,499 --> 00:35:32,459 So what suture do we use under the skin? 844 00:35:32,543 --> 00:35:34,003 Vicryl provides support for a month. 845 00:35:34,086 --> 00:35:35,546 It takes two months to dissolve. 846 00:35:35,629 --> 00:35:38,883 Mm-hmm. So 5-0 nylon on the skin. 847 00:35:38,966 --> 00:35:40,968 4-0 vicryl under the skin. 848 00:35:41,051 --> 00:35:43,095 I'd go with a 3-0 vicryl. 849 00:35:43,178 --> 00:35:45,723 - You think? - Most definitely. 850 00:35:45,806 --> 00:35:48,100 Donnie is the master of wound closure. 851 00:35:48,183 --> 00:35:51,478 I do at least ten lacs a day out at triage, so… 852 00:35:51,562 --> 00:35:55,441 Can we see your sub-Q? 853 00:35:55,524 --> 00:35:57,067 Be my guest. 854 00:35:57,151 --> 00:35:59,153 If you insist. 855 00:36:03,657 --> 00:36:05,868 So… 856 00:36:05,951 --> 00:36:09,330 the secret is to be sure your entry point 857 00:36:09,413 --> 00:36:12,124 and exit point on both sides of the wound 858 00:36:12,207 --> 00:36:15,044 matches the depth on the other side. 859 00:36:15,127 --> 00:36:16,378 S… 860 00:36:19,882 --> 00:36:21,550 Start deep. 861 00:36:21,634 --> 00:36:25,512 Come up at the dermis. 862 00:36:25,596 --> 00:36:28,349 Big bites help the tissue close. 863 00:36:31,101 --> 00:36:34,271 It's a mirror image on the other side. 864 00:36:34,355 --> 00:36:36,941 Superficial to deep. 865 00:36:38,817 --> 00:36:41,487 - So you bury the knot. - Bingo. 866 00:36:41,570 --> 00:36:44,323 Avoids bumps on the scar line. 867 00:36:44,406 --> 00:36:48,077 Three ties, not four. 868 00:36:48,160 --> 00:36:50,496 Yeah, that's beautiful. 869 00:36:50,579 --> 00:36:53,666 And then you cut it short. 870 00:36:53,749 --> 00:36:55,292 Not too short. 871 00:36:55,376 --> 00:36:58,963 I like to slide my scissors 872 00:36:59,046 --> 00:37:02,091 down on the knot, 873 00:37:02,174 --> 00:37:07,346 then rotate up 45 degrees before I cut. 874 00:37:07,429 --> 00:37:09,515 Could use two more sub-Qs, 875 00:37:09,598 --> 00:37:12,726 one above, one below. 876 00:37:12,810 --> 00:37:13,894 Have at it. 877 00:37:16,313 --> 00:37:19,316 Interesting ink. Do they mean anything? 878 00:37:21,318 --> 00:37:24,905 This, this is "death and chaos," 879 00:37:24,989 --> 00:37:27,366 and this is "miracles and blessings." 880 00:37:27,449 --> 00:37:31,120 Got this one after the PittFest shooting, 881 00:37:31,203 --> 00:37:35,457 and I got this after my daughter was born. 882 00:37:38,043 --> 00:37:39,336 Put the head of the gurney up 883 00:37:39,420 --> 00:37:41,296 so people can see him, but not so high 884 00:37:41,380 --> 00:37:43,424 that his head flops to the side. 885 00:37:47,678 --> 00:37:48,929 What do you think? 886 00:37:49,013 --> 00:37:51,515 He looks peaceful. 887 00:37:51,598 --> 00:37:54,101 What's the hardest part of this job? 888 00:37:54,184 --> 00:37:55,936 It's pretty thankless, and that can be tough. 889 00:37:56,020 --> 00:37:57,354 You've seen burnout rates. 890 00:37:57,438 --> 00:37:59,148 I'm sure they teach you that in school. 891 00:37:59,231 --> 00:38:02,234 All my closest friends left after COVID. 892 00:38:02,317 --> 00:38:04,278 Some during. 893 00:38:04,361 --> 00:38:06,071 But I don't blame them. 894 00:38:06,155 --> 00:38:09,074 They needed to do what was best for their mental health. 895 00:38:09,158 --> 00:38:11,493 A lot of people broke. 896 00:38:11,577 --> 00:38:13,454 Why do you keep coming back? 897 00:38:15,998 --> 00:38:18,208 Why don't you, um, 898 00:38:18,292 --> 00:38:21,587 just finish up here and then go help Perlah for a bit? 899 00:38:25,799 --> 00:38:27,134 Great. Thank you. 900 00:38:27,217 --> 00:38:28,510 No, that is exactly what I needed to know. 901 00:38:28,594 --> 00:38:30,095 OK. 902 00:38:30,179 --> 00:38:32,723 I just got off the phone with the physician assistant 903 00:38:32,806 --> 00:38:35,225 at the prison; they've got a 16-hour-a-day infirmary 904 00:38:35,309 --> 00:38:37,478 with NP and PA coverage giving everything that we need, 905 00:38:37,561 --> 00:38:39,313 and they've got an RN for overnights. 906 00:38:39,396 --> 00:38:40,939 Even so, he's here because 907 00:38:41,023 --> 00:38:43,567 they're ignoring his basic needs. 908 00:38:43,650 --> 00:38:45,736 He's here because somebody kicked the shit out of him. 909 00:38:45,819 --> 00:38:47,237 I think you're missing the point. 910 00:38:47,321 --> 00:38:48,822 We have more to offer. 911 00:38:48,906 --> 00:38:50,949 Robby, we've got four more coming our way. 912 00:38:51,033 --> 00:38:52,576 OK, got it. 913 00:38:52,659 --> 00:38:54,036 What you're trying to do is very noble. 914 00:38:54,119 --> 00:38:55,454 We don't have the resources to spare. 915 00:38:55,537 --> 00:38:57,748 OK, then why admit the unhoused man, Digby? 916 00:38:57,831 --> 00:38:59,333 Why not send him back to the street 917 00:38:59,416 --> 00:39:01,001 with antibiotics and a roll of gauze? 918 00:39:01,085 --> 00:39:02,628 Because Digby lives on the street, 919 00:39:02,711 --> 00:39:05,255 and your incarcerated patient has a mid-level provider 920 00:39:05,339 --> 00:39:06,799 and a nurse looking after him. 921 00:39:06,882 --> 00:39:09,051 We both know the quality of care is not the same. 922 00:39:09,134 --> 00:39:10,120 Sorry, are you waiting for me? 923 00:39:10,135 --> 00:39:11,428 No. 924 00:39:11,512 --> 00:39:13,055 Dr. Al-Hashimi, for the patient in Seven. 925 00:39:13,138 --> 00:39:14,348 A few days here could make a world of difference 926 00:39:14,431 --> 00:39:15,808 for Gus' health. 927 00:39:15,891 --> 00:39:18,018 We are a safety net, but nets have holes. 928 00:39:18,102 --> 00:39:19,478 We are not admitting him 929 00:39:19,561 --> 00:39:21,313 'cause this is not about social justice. 930 00:39:23,524 --> 00:39:24,983 Everything I've done in my career 931 00:39:25,067 --> 00:39:27,444 is an effort to improve the system. 932 00:39:27,528 --> 00:39:29,154 Just because you know it's broken 933 00:39:29,238 --> 00:39:31,698 doesn't mean you stop trying. 934 00:39:31,782 --> 00:39:33,200 Excuse me. 935 00:39:37,663 --> 00:39:39,706 I talked to Jackson's girlfriend. 936 00:39:39,790 --> 00:39:40,874 OK. 937 00:39:40,958 --> 00:39:42,876 She told me a lot of stuff. 938 00:39:42,960 --> 00:39:45,295 Um, she wants to come see him, 939 00:39:45,379 --> 00:39:48,090 but I just don't think that's a good idea. 940 00:39:48,173 --> 00:39:50,551 And my…my parents are asking a lot of questions. 941 00:39:50,634 --> 00:39:52,469 Can I just take him home? 942 00:39:52,553 --> 00:39:54,012 I'm so sorry. 943 00:39:54,096 --> 00:39:56,181 Your…your brother is on an involuntary psych hold. 944 00:39:56,265 --> 00:39:57,516 He can't leave. 945 00:39:57,599 --> 00:39:58,642 It could take us weeks to figure out 946 00:39:58,725 --> 00:39:59,977 what's wrong with him. 947 00:40:00,060 --> 00:40:01,895 What's wrong with him? 948 00:40:01,979 --> 00:40:03,730 I'm so sorry. I did not mean it like that. 949 00:40:03,814 --> 00:40:05,065 What's… 950 00:40:05,149 --> 00:40:06,400 Why don't we go somewhere quiet, yeah? 951 00:40:06,483 --> 00:40:08,569 What's wrong with him? 952 00:40:08,652 --> 00:40:11,905 - Let's go over here. - What's wrong with him? 953 00:40:11,989 --> 00:40:13,866 What's wrong with him? 954 00:40:15,576 --> 00:40:17,536 What's wrong with him? 955 00:40:27,713 --> 00:40:29,339 How's she doing? 956 00:40:29,423 --> 00:40:31,550 She took three ounces of formula 957 00:40:31,633 --> 00:40:32,968 without vomiting or distress. 958 00:40:33,051 --> 00:40:34,469 Excellent. 959 00:40:34,553 --> 00:40:37,389 Dr. Wolke from Pedes should be down shortly. 960 00:40:37,472 --> 00:40:40,309 Yeah. I think I saw her smile. 961 00:40:40,392 --> 00:40:43,520 A true social smile where the baby is awake, alert, 962 00:40:43,604 --> 00:40:45,314 and responding to facial expressions 963 00:40:45,397 --> 00:40:47,858 usually doesn't happen until six weeks or older. 964 00:40:47,941 --> 00:40:49,568 It was likely a reflex smile that happens 965 00:40:49,651 --> 00:40:52,654 while they're sleeping. 966 00:40:52,738 --> 00:40:56,283 But some parents have reported their babies 967 00:40:56,366 --> 00:40:58,785 smiled socially as early as four weeks, 968 00:40:58,869 --> 00:41:01,747 so who knows? 969 00:41:01,830 --> 00:41:03,332 - Jesse. - Hmm? 970 00:41:03,415 --> 00:41:05,000 North 4 needs a blood draw when you have a sec. 971 00:41:05,083 --> 00:41:06,126 Got it. 972 00:41:06,210 --> 00:41:07,336 How we doing in here? 973 00:41:07,419 --> 00:41:08,545 Almost ready to head out. 974 00:41:08,629 --> 00:41:09,713 Looking good. 975 00:41:09,796 --> 00:41:10,796 Heart rate 91. 976 00:41:10,839 --> 00:41:12,424 BP is 115 over 82. 977 00:41:12,507 --> 00:41:14,343 Oxygen sat's 95%. 978 00:41:14,426 --> 00:41:15,969 Great. 979 00:41:16,053 --> 00:41:17,471 I'm sending him home with some nonstick dressing 980 00:41:17,554 --> 00:41:18,931 in case they don't stock them. 981 00:41:19,014 --> 00:41:20,682 Grab some burn net too. 982 00:41:20,766 --> 00:41:23,310 He's a good guy. He's a local. 983 00:41:23,393 --> 00:41:25,687 Yeah? You're from Pittsburgh? 984 00:41:25,771 --> 00:41:27,314 Yes, ma'am. Born and raised. 985 00:41:27,397 --> 00:41:28,482 Whereabouts? 986 00:41:28,565 --> 00:41:30,776 Bloomfield, Liberty Ave. 987 00:41:30,859 --> 00:41:33,362 Bloomfield? 988 00:41:33,445 --> 00:41:35,030 You know Sonny's Tavern? 989 00:41:35,113 --> 00:41:36,657 Worked there through high school. 990 00:41:36,740 --> 00:41:38,575 - No kidding. - You know Sonny's? 991 00:41:40,160 --> 00:41:43,330 Had my first kiss there. 992 00:41:43,413 --> 00:41:45,791 Hey, Donnie, my buddy Duke hasn't checked in yet? 993 00:41:45,874 --> 00:41:47,501 Nah, I told Lupe to keep an eye out. 994 00:41:47,584 --> 00:41:49,002 - Thank you. - Yep. 995 00:41:49,086 --> 00:41:51,380 Right, left. Right, left. Yeah. That's it. 996 00:41:55,050 --> 00:41:56,426 You back to check our work? 997 00:41:56,510 --> 00:41:58,595 Nope. I need a silastic loop drain. 998 00:41:58,679 --> 00:42:00,681 That looks great. 999 00:42:00,764 --> 00:42:02,474 It's thanks to your fine instruction. 1000 00:42:02,557 --> 00:42:06,478 OK, he's going to need Kerlix and Xeroform. 1001 00:42:06,561 --> 00:42:08,355 You should throw a neoprene sleeve on him. 1002 00:42:08,438 --> 00:42:10,107 Limits the range of motion at the knee 1003 00:42:10,190 --> 00:42:11,900 - so the sutures don't pull out. - That's a good idea. 1004 00:42:11,984 --> 00:42:13,193 Must be fun to work here. 1005 00:42:13,277 --> 00:42:16,029 Oh, sure is. First week for these two. 1006 00:42:16,113 --> 00:42:17,489 How are you guys liking the Pitt? 1007 00:42:17,572 --> 00:42:18,991 I feel like I was born to do this. 1008 00:42:20,242 --> 00:42:21,451 Hard pass. 1009 00:42:21,535 --> 00:42:23,412 I'm shooting for pathology. 1010 00:42:23,495 --> 00:42:24,830 I like medical mysteries, 1011 00:42:24,913 --> 00:42:26,999 but I don't really deal well with people. 1012 00:42:27,082 --> 00:42:28,875 You have an interesting energy. 1013 00:42:28,959 --> 00:42:30,711 What's that for? 1014 00:42:30,794 --> 00:42:32,879 Splint starts at the knuckles, 1015 00:42:32,963 --> 00:42:36,425 comes up and around the elbow, 1016 00:42:36,508 --> 00:42:38,802 and back down to the palm. 1017 00:42:38,885 --> 00:42:41,638 It needs to be smaller. I can't ride with a splint. 1018 00:42:41,722 --> 00:42:43,098 Well, no, you shouldn't be riding at all. 1019 00:42:43,181 --> 00:42:45,058 Right now, that's a non-displaced fracture. 1020 00:42:45,142 --> 00:42:48,103 If you fall on it again, you're gonna need to go to the OR. 1021 00:42:48,186 --> 00:42:51,315 No worries, Doc. I won't fall again. 1022 00:42:51,398 --> 00:42:52,607 Uh-huh. 1023 00:42:54,568 --> 00:42:56,445 Robby, pulse ox just dropped. 1024 00:42:56,528 --> 00:42:57,946 What happened? 1025 00:42:58,030 --> 00:42:59,406 I don't know. I stepped out for a minute. 1026 00:42:59,489 --> 00:43:01,241 It's down to 85%. 1027 00:43:01,325 --> 00:43:02,659 Are you having some trouble breathing? 1028 00:43:02,743 --> 00:43:04,202 A little. 1029 00:43:04,286 --> 00:43:05,871 Start him on 2 liters oxygen, nasal cannula. 1030 00:43:05,954 --> 00:43:07,456 Titrate to 5. 1031 00:43:07,539 --> 00:43:09,082 Keep the pulse ox at 92 or higher 1032 00:43:09,166 --> 00:43:12,502 and have a rebreather standing by just in case. 1033 00:43:12,586 --> 00:43:14,338 He's gonna have to stay. 1034 00:43:14,421 --> 00:43:16,089 For how long? 1035 00:43:16,173 --> 00:43:18,884 Not sure. 1036 00:43:18,967 --> 00:43:20,761 Sorry, boss, I only stepped out for a second. 1037 00:43:20,844 --> 00:43:22,304 Let me know if anything changes. 1038 00:43:22,387 --> 00:43:23,889 You were in the room when his pulse ox dropped? 1039 00:43:23,972 --> 00:43:25,140 - I was. - What were you doing? 1040 00:43:25,223 --> 00:43:26,892 D, still can't get a hold of Ortho. 1041 00:43:26,975 --> 00:43:30,187 Leave them to me. 1042 00:43:30,270 --> 00:43:32,481 - Feeling better? - Oh, so much better. 1043 00:43:32,564 --> 00:43:35,650 Well, I wrote you a script for Zofran, just in case. 1044 00:43:35,734 --> 00:43:38,111 Thanks. I think I cleared it all out. 1045 00:43:38,195 --> 00:43:40,781 - So no more hot dogs, right? - Oh, not today. 1046 00:43:40,864 --> 00:43:42,282 But I'll be back next year. 1047 00:43:42,366 --> 00:43:43,617 - Got to defend my title! - Yo. 1048 00:43:43,700 --> 00:43:45,035 OK, well, best of luck to you. 1049 00:43:45,118 --> 00:43:46,578 They got a Wiener World truck outside. 1050 00:43:46,661 --> 00:43:48,205 You want one? 1051 00:43:48,288 --> 00:43:49,915 I think I'm good on hot dogs for the rest of my life. 1052 00:43:49,998 --> 00:43:51,792 Wait, didn't I just see you eating a doughnut? 1053 00:43:51,875 --> 00:43:53,460 Don't judge. 1054 00:43:53,543 --> 00:43:55,045 Stay here for a sec. 1055 00:44:01,093 --> 00:44:03,428 - Transport ambulance is here. - Thanks, Princess. 1056 00:44:03,512 --> 00:44:05,889 This is a 200-milligram MS Contin. 1057 00:44:05,972 --> 00:44:09,226 This will give you 12 hours of relief. 1058 00:44:09,309 --> 00:44:11,103 - OK. - Mm. 1059 00:44:11,186 --> 00:44:12,562 Yes. 1060 00:44:14,481 --> 00:44:16,191 Whenever you're ready, Rox. 1061 00:44:16,274 --> 00:44:18,110 Hey, guys, this is Roxie Hamler. 1062 00:44:18,193 --> 00:44:19,903 Hello, ma'am. 1063 00:44:19,986 --> 00:44:21,988 - Easy on the transfer, guys. - Yeah. 1064 00:44:28,662 --> 00:44:30,789 OK, on my count. 1065 00:44:30,872 --> 00:44:33,667 No, no, no. This isn't gonna work out. 1066 00:44:35,252 --> 00:44:36,837 I'm sorry. 1067 00:44:36,920 --> 00:44:38,505 I can't…I can't… 1068 00:44:38,588 --> 00:44:42,134 I can't…I can't do this. 1069 00:44:42,217 --> 00:44:45,178 - It's OK. - I want to stay. 1070 00:44:45,262 --> 00:44:48,932 Please. 1071 00:44:49,015 --> 00:44:52,060 It's OK. 1072 00:44:52,144 --> 00:44:53,979 Can I assume that you've already called upstairs 1073 00:44:54,062 --> 00:44:55,856 to get Gus Varney a bed? 1074 00:44:55,939 --> 00:44:58,150 Do you want to tell me what you did? 1075 00:44:58,233 --> 00:45:00,652 I don't know what you're talking about. 1076 00:45:00,735 --> 00:45:03,572 His pulse ox was steady. We were about to discharge him. 1077 00:45:03,655 --> 00:45:05,365 Did Dr. Al-Hashimi put you up to that? 1078 00:45:05,449 --> 00:45:07,701 Al-Hashimi? No. 1079 00:45:07,784 --> 00:45:09,202 You know he's gonna go back to prison 1080 00:45:09,286 --> 00:45:12,998 after they discharge him upstairs. 1081 00:45:13,081 --> 00:45:14,749 I thought you didn't go the extra distance 1082 00:45:14,833 --> 00:45:16,168 for your patients anymore. 1083 00:45:22,841 --> 00:45:25,343 - It's Emma, right? - Yeah. 1084 00:45:25,427 --> 00:45:26,970 How's your first day going? 1085 00:45:27,053 --> 00:45:28,722 Good, I think. 1086 00:45:28,805 --> 00:45:32,100 Haven't killed anyone yet. 1087 00:45:32,184 --> 00:45:35,479 - I'm sorry. I… - It's OK. 1088 00:45:35,562 --> 00:45:39,024 I guess time will tell if I'm cut out for this. 1089 00:45:39,107 --> 00:45:42,736 Well, when in doubt, stick with her, kid. 1090 00:45:42,819 --> 00:45:44,237 She scares me. 1091 00:45:44,321 --> 00:45:46,907 No, that's just a… it's a tough exterior. 1092 00:45:46,990 --> 00:45:50,702 She's warm and gooey on the inside. 1093 00:45:50,785 --> 00:45:53,580 Looks like they're doing the debrief for Louie. 1094 00:45:53,663 --> 00:45:55,624 - You coming? - I paid my respects. 1095 00:45:55,707 --> 00:45:57,834 Besides, who's gonna hold down the fort? 1096 00:46:09,971 --> 00:46:12,390 Remember the day you found him passed out in the park? 1097 00:46:12,474 --> 00:46:13,642 Sure do. 1098 00:46:13,725 --> 00:46:15,143 I had to drag his ass over here. 1099 00:46:15,227 --> 00:46:16,561 Came in soaked to the bone. 1100 00:46:16,645 --> 00:46:18,355 You saved his life. 1101 00:46:18,438 --> 00:46:20,398 How about last summer when we didn't see him for months? 1102 00:46:20,482 --> 00:46:21,858 He said he finally quit drinking, 1103 00:46:21,942 --> 00:46:23,652 - so he didn't need to come in. - Mm-hmm. 1104 00:46:23,735 --> 00:46:26,071 How many times did he say he was gonna quit drinking? 1105 00:46:26,154 --> 00:46:28,156 Mm-hmm. 1106 00:46:28,240 --> 00:46:30,784 He always asked about Harrison. 1107 00:46:30,867 --> 00:46:33,203 - Always said thank you. - Mm-hmm. 1108 00:46:33,286 --> 00:46:36,623 Found this with his stuff. 1109 00:46:36,706 --> 00:46:38,208 Who knew he was married? 1110 00:46:40,961 --> 00:46:43,421 That's Rhonda, Louie's wife. 1111 00:46:43,505 --> 00:46:45,340 High school sweetheart. 1112 00:46:45,423 --> 00:46:48,468 About five years ago, I was covering a night shift. 1113 00:46:48,552 --> 00:46:51,721 He came in feeling talkative. 1114 00:46:51,805 --> 00:46:53,348 Born and raised in Pittsburgh. 1115 00:46:53,431 --> 00:46:55,725 Lifelong Steelers fan. 1116 00:46:55,809 --> 00:46:57,477 Groundskeeper at Three Rivers Stadium 1117 00:46:57,561 --> 00:46:58,895 until 1998. 1118 00:47:01,731 --> 00:47:04,526 He never really wanted kids, 1119 00:47:04,609 --> 00:47:06,945 but Rhonda wore him down, 1120 00:47:07,028 --> 00:47:08,572 and when she finally got pregnant, 1121 00:47:08,655 --> 00:47:11,324 he changed his tune, he got excited. 1122 00:47:14,744 --> 00:47:16,997 And then about a month before the baby was due, 1123 00:47:17,080 --> 00:47:20,083 Rhonda and the baby were killed in a car crash. 1124 00:47:23,378 --> 00:47:25,839 Louie never really came back from that. 1125 00:47:29,884 --> 00:47:32,262 May his memory be a blessing. 1126 00:47:32,345 --> 00:47:34,598 - Amen. - May his memory be a blessing. 1127 00:47:36,683 --> 00:47:37,934 Yep.