1 00:00:13,138 --> 00:00:14,348 I'm in. 2 00:00:14,431 --> 00:00:15,682 Bag him. 3 00:00:18,977 --> 00:00:21,647 Defib pads are in place. 4 00:00:21,730 --> 00:00:23,607 OK, holding compressions. 5 00:00:23,690 --> 00:00:25,651 Good square line on the End-Tidal CO2. 6 00:00:25,734 --> 00:00:28,320 V-fib, charge to 200. 7 00:00:29,696 --> 00:00:30,948 Charged. 8 00:00:31,031 --> 00:00:32,574 Clear. 9 00:00:34,368 --> 00:00:36,620 Stand by with epi. 10 00:00:40,207 --> 00:00:42,042 Suction that tube. 11 00:00:44,044 --> 00:00:45,254 You're not in the esophagus, are you? 12 00:00:45,337 --> 00:00:46,505 Definitely not. 13 00:00:46,588 --> 00:00:47,965 I passed right through the cords. 14 00:00:48,048 --> 00:00:50,676 Good breath sounds. End-Tidal CO2 confirmed. 15 00:00:50,759 --> 00:00:52,052 His lungs are filling up with blood. 16 00:00:52,135 --> 00:00:53,262 I know. 17 00:00:58,892 --> 00:01:00,185 OK, rhythm check. 18 00:01:01,937 --> 00:01:03,397 Asystole. Push the epi. 19 00:01:03,480 --> 00:01:05,107 Fuck. 20 00:01:08,652 --> 00:01:10,404 Patients with lunch trays have been admitted. 21 00:01:10,487 --> 00:01:11,780 They're boarders. 22 00:01:11,863 --> 00:01:13,615 They're waiting for a bed to open upstairs. 23 00:01:13,699 --> 00:01:15,784 - And what about the others? - Non-admitted patients. 24 00:01:15,867 --> 00:01:17,536 They can have sandwiches or juice boxes. 25 00:01:17,619 --> 00:01:19,955 Just make sure they're not NPO. 26 00:01:20,038 --> 00:01:21,248 That's "nil per os." 27 00:01:21,331 --> 00:01:22,457 It's Latin for "nothing by mouth." 28 00:01:22,541 --> 00:01:24,251 NPOs are waiting for surgery. 29 00:01:24,334 --> 00:01:26,086 They'll beg, spit, and curse for food, 30 00:01:26,169 --> 00:01:27,421 but you got to stay strong. 31 00:01:27,504 --> 00:01:28,880 Hey, I've been waiting for an hour. 32 00:01:28,964 --> 00:01:30,716 When am I gonna see a fucking doctor? 33 00:01:30,799 --> 00:01:32,926 Excuse me! 34 00:01:33,010 --> 00:01:34,970 Perhaps you didn't see this, which is strange, 35 00:01:35,053 --> 00:01:37,014 because they're all over the place. 36 00:01:37,097 --> 00:01:39,224 Aggressive behavior toward healthcare workers is a felony. 37 00:01:39,308 --> 00:01:41,101 $2,000 fine, possible jail time. 38 00:01:41,184 --> 00:01:42,436 Got it? 39 00:01:42,519 --> 00:01:45,022 OK. I was just asking. 40 00:01:45,105 --> 00:01:46,690 We're busy today. 41 00:01:46,773 --> 00:01:47,983 It's a holiday weekend. 42 00:01:48,066 --> 00:01:49,276 We see the sickest patients first, 43 00:01:49,359 --> 00:01:51,028 so be happy you're still waiting. 44 00:01:52,613 --> 00:01:53,822 Jag-off. 45 00:01:55,991 --> 00:01:57,534 PTMC charge nurse. 46 00:01:57,618 --> 00:02:00,329 Go ahead, Medic Command. 47 00:02:00,412 --> 00:02:03,040 OK. Got it. 48 00:02:03,123 --> 00:02:04,249 Incoming trauma. 49 00:02:04,333 --> 00:02:06,752 Come on. 50 00:02:06,835 --> 00:02:08,170 Three minutes since the last epi. 51 00:02:08,253 --> 00:02:09,546 Hold compressions. 52 00:02:10,756 --> 00:02:12,007 Asystole. 53 00:02:12,090 --> 00:02:14,259 Resume CPR. Another amp of epi. 54 00:02:14,343 --> 00:02:16,637 Needs more suction. 55 00:02:22,434 --> 00:02:24,478 Pulmonary hemorrhage from liver failure. 56 00:02:24,561 --> 00:02:26,355 Is he going to make it? 57 00:02:31,652 --> 00:02:33,695 Should we give PCC? 58 00:02:33,779 --> 00:02:35,947 Too late for that. 59 00:02:36,031 --> 00:02:37,866 And he's not an ECMO candidate. 60 00:02:37,949 --> 00:02:39,951 Nothing else we can do? 61 00:02:44,915 --> 00:02:47,209 No, I think we're done. 62 00:02:52,214 --> 00:02:54,341 Louie. 63 00:02:58,387 --> 00:03:00,597 12:07. 64 00:03:07,437 --> 00:03:09,815 Should we do a debrief? 65 00:03:09,898 --> 00:03:11,775 We've got another motorcycle injury coming in, 66 00:03:11,858 --> 00:03:13,068 ETA 10 minutes. 67 00:03:13,151 --> 00:03:14,569 Why don't we get Louie cleaned up, 68 00:03:14,653 --> 00:03:16,613 - move him to the viewing room? - Yeah. 69 00:03:16,697 --> 00:03:19,533 Anybody that wants to pay their respects can join us in there. 70 00:03:21,868 --> 00:03:23,578 Thank you, everyone. 71 00:03:30,877 --> 00:03:32,254 I'll clean him up. 72 00:03:32,337 --> 00:03:34,423 Why don't you take five first? 73 00:03:34,506 --> 00:03:37,008 Or ten. Yeah? 74 00:03:37,092 --> 00:03:38,468 Yep. 75 00:03:48,270 --> 00:03:50,439 This is Dr. Jefferson from psychiatry. 76 00:03:50,522 --> 00:03:53,191 Why do I need to see a psychiatrist? 77 00:03:53,275 --> 00:03:55,527 Jada, why do I need to see a psychiatrist? 78 00:03:55,610 --> 00:03:57,195 It's gonna be OK, Jackson. 79 00:03:57,279 --> 00:03:59,740 Dr. Jefferson says he can help. 80 00:03:59,823 --> 00:04:02,492 Do you know how you got here? 81 00:04:02,576 --> 00:04:04,911 The medics brought me. 82 00:04:04,995 --> 00:04:07,748 I don't really remember. I…I was in the library. 83 00:04:07,831 --> 00:04:10,667 What were you doing there? 84 00:04:10,751 --> 00:04:13,545 I was…I was studying. 85 00:04:13,628 --> 00:04:16,214 I was trying to study. 86 00:04:16,298 --> 00:04:17,966 But then they wouldn't stop talking. 87 00:04:18,049 --> 00:04:20,177 Who wouldn't stop talking? 88 00:04:20,260 --> 00:04:21,845 They don't want me to pass the bar. 89 00:04:21,928 --> 00:04:23,430 Who doesn't want you to pass the bar? 90 00:04:23,513 --> 00:04:25,515 - That's what they told me. - Hey, hey. 91 00:04:25,599 --> 00:04:26,767 Hey, look at me. Look at me. 92 00:04:26,850 --> 00:04:28,059 Who doesn't want you to pass the bar? 93 00:04:28,143 --> 00:04:29,895 Let's give them some privacy. 94 00:04:29,978 --> 00:04:33,190 Dr. Jefferson will let us know when he's done. 95 00:04:33,273 --> 00:04:34,566 They don't want me to pass the bar. 96 00:04:34,649 --> 00:04:36,401 I'll be right outside, OK? 97 00:04:36,485 --> 00:04:39,946 I'll be right outside, Jackson. 98 00:04:40,030 --> 00:04:42,908 Why don't they want you to pass the bar, Jackson? 99 00:04:42,991 --> 00:04:44,868 They're afraid of me becoming a lawyer. 100 00:04:44,951 --> 00:04:47,871 They're afraid of you becoming a lawyer? 101 00:04:47,954 --> 00:04:52,125 He must have been studying with his law school friends. 102 00:04:52,209 --> 00:04:53,794 They…they should know what happened. 103 00:04:53,877 --> 00:04:56,463 I'm gonna call them. 104 00:04:56,546 --> 00:04:58,340 If you need anything, let me know. 105 00:04:58,423 --> 00:05:00,801 - OK, thank you. - Mm-hmm. 106 00:05:10,268 --> 00:05:11,436 Louie. 107 00:05:12,979 --> 00:05:16,107 Pulmonary hemorrhage. 108 00:05:16,191 --> 00:05:18,527 That was quick. 109 00:05:18,610 --> 00:05:21,029 I'm gonna go clean him up. 110 00:05:21,112 --> 00:05:22,405 I'll help. 111 00:05:25,700 --> 00:05:26,910 Go, go. 112 00:05:30,664 --> 00:05:33,875 Everything OK, Roxie? 113 00:05:33,959 --> 00:05:35,710 I can't get off the bedpan. 114 00:05:35,794 --> 00:05:37,879 Oh, that's what I'm here for. 115 00:05:43,927 --> 00:05:46,304 Your husband seems like a saint. 116 00:05:46,388 --> 00:05:49,599 How long you been married? 117 00:05:49,683 --> 00:05:51,226 Too long. 118 00:05:53,645 --> 00:05:56,523 Almost 20 years. 119 00:05:56,606 --> 00:05:58,316 - OK, put your arm around me. - Mm-hmm. 120 00:05:58,400 --> 00:06:00,151 And I'll pull the bedpan on three. 121 00:06:00,235 --> 00:06:01,361 OK. 122 00:06:01,444 --> 00:06:04,865 One, two, three. 123 00:06:04,948 --> 00:06:06,533 One more. 124 00:06:06,616 --> 00:06:08,743 - Great. - Mm. 125 00:06:08,827 --> 00:06:12,455 20? Wow. 126 00:06:12,539 --> 00:06:14,499 Yeah. 127 00:06:14,583 --> 00:06:18,587 He's been by my side through all of this. 128 00:06:20,505 --> 00:06:24,426 I've watched the light go out of him. 129 00:06:24,509 --> 00:06:26,887 So have the kids. 130 00:06:26,970 --> 00:06:28,305 That's what happened to my auntie 131 00:06:28,388 --> 00:06:31,641 when my Uncle Gerald got sick. 132 00:06:31,725 --> 00:06:34,227 But your husband does it because he loves you. 133 00:06:34,311 --> 00:06:35,687 Mm. 134 00:06:35,770 --> 00:06:37,939 I don't know how you do it, 135 00:06:38,023 --> 00:06:40,525 care for people day after day. 136 00:06:40,609 --> 00:06:42,986 I'll tell you my secret. 137 00:06:43,069 --> 00:06:45,906 I go home at the end of every shift, 138 00:06:45,989 --> 00:06:48,491 leave this all behind, 139 00:06:48,575 --> 00:06:50,493 and escape to "Love Island." 140 00:06:52,287 --> 00:06:53,788 How's it going in here? 141 00:06:53,872 --> 00:06:55,665 The higher-demand dose of morphine helped a little, 142 00:06:55,749 --> 00:06:57,709 - but she's still in pain. - OK. 143 00:06:57,792 --> 00:07:00,545 I got your order. 0.1 per kilo. 144 00:07:00,629 --> 00:07:02,213 - Thanks. - Mm-hmm. 145 00:07:02,297 --> 00:07:04,799 This is a very low sub-dissociative dose 146 00:07:04,883 --> 00:07:06,009 of ketamine. 147 00:07:06,092 --> 00:07:07,510 You might feel a little weird, 148 00:07:07,594 --> 00:07:10,055 but I think it's gonna help with the pain. 149 00:07:12,682 --> 00:07:14,643 Is my husband still in the cafeteria? 150 00:07:14,726 --> 00:07:16,686 I think so. Want me to get him? 151 00:07:16,770 --> 00:07:19,356 No, no. 152 00:07:19,439 --> 00:07:22,776 It's good for us to have a little time apart. 153 00:07:25,111 --> 00:07:27,405 I'll get you another blanket. 154 00:07:31,534 --> 00:07:33,078 Here. I'm headed that way. 155 00:07:33,161 --> 00:07:34,996 Thank you. 156 00:07:35,080 --> 00:07:36,665 Back here for good? 157 00:07:36,748 --> 00:07:38,416 Officially out of triage. 158 00:07:38,500 --> 00:07:41,628 They need extra hands with all the Westbridge hullabaloo. 159 00:07:41,711 --> 00:07:43,588 How many cups have you had today? 160 00:07:43,672 --> 00:07:45,090 - Don't judge me. - Just asking. 161 00:07:45,173 --> 00:07:46,466 You're judging. 162 00:07:48,426 --> 00:07:49,678 Did you hear about Louie? 163 00:07:49,761 --> 00:07:51,096 No. 164 00:07:51,179 --> 00:07:53,056 Pulmonary hemorrhage. Didn't make it. 165 00:07:53,139 --> 00:07:55,642 - Shit. - Mm. 166 00:07:55,725 --> 00:07:57,310 He's been here a hundred times. 167 00:07:57,394 --> 00:07:58,895 I know. 168 00:07:58,979 --> 00:08:02,148 Debrief in the viewing room later. 169 00:08:02,232 --> 00:08:03,775 On a happier note, Perlah and I are planning 170 00:08:03,858 --> 00:08:05,402 a birthday party for Javadi. 171 00:08:05,485 --> 00:08:07,153 She's turning 21. 172 00:08:07,237 --> 00:08:09,948 You two are thick as thieves. 173 00:08:10,031 --> 00:08:12,450 I don't have much of a social life these days, 174 00:08:12,534 --> 00:08:15,328 but I'll be sure to keep an eye out for the Partiful. 175 00:08:15,412 --> 00:08:18,289 Let's discuss our incarcerated patient Gus. 176 00:08:18,373 --> 00:08:20,083 Prison infirmaries tend to be short-staffed, 177 00:08:20,166 --> 00:08:22,460 so we need to be thorough. 178 00:08:22,544 --> 00:08:25,672 What's in the differential diagnosis for malnutrition? 179 00:08:25,755 --> 00:08:28,842 Inadequate intake, methamphetamine use, 180 00:08:28,925 --> 00:08:31,886 severe alcoholism, ADHD medication. 181 00:08:31,970 --> 00:08:33,513 What else? 182 00:08:33,596 --> 00:08:35,849 Cancer of the oropharynx, esophageal strictures, 183 00:08:35,932 --> 00:08:38,893 prior strokes, malabsorption, inflammatory bowel disease, 184 00:08:38,977 --> 00:08:40,854 none of which were in his medical record. 185 00:08:40,937 --> 00:08:43,273 What about psychosocial causes? 186 00:08:43,356 --> 00:08:45,608 Could be an intentional hunger strike. 187 00:08:45,692 --> 00:08:47,736 Or refusing food to get to the infirmary. 188 00:08:47,819 --> 00:08:49,571 Could also be abuse or neglect. 189 00:08:49,654 --> 00:08:51,865 Let's start with a nutrition history once he's back from CT. 190 00:08:51,948 --> 00:08:53,158 Do you have a second to talk about Westbridge? 191 00:08:53,241 --> 00:08:54,242 Mm-hmm. 192 00:08:54,325 --> 00:08:55,994 Hey, we need to start moving some patients out of here. 193 00:08:56,077 --> 00:08:57,746 These walls are starting to fill up with gurneys. 194 00:08:57,829 --> 00:08:59,205 Santos, Ogilvie, and King 195 00:08:59,289 --> 00:09:00,707 all have patients on the launching pad. 196 00:09:00,790 --> 00:09:01,791 I'll check in with them. 197 00:09:01,875 --> 00:09:03,543 How many patients have we had rerouted from Westbridge? 198 00:09:03,626 --> 00:09:05,503 Ten, and God knows how many more in the waiting room. 199 00:09:05,587 --> 00:09:06,755 Ambulance will be here in a few minutes 200 00:09:06,838 --> 00:09:09,007 with the accident victim; I'll stick him in Trauma Two. 201 00:09:09,090 --> 00:09:11,426 What is the story with your incarcerated patient? 202 00:09:11,509 --> 00:09:13,344 Gus Varney, three rib fractures 203 00:09:13,428 --> 00:09:16,014 with normal O2 sats currently, waiting on CT results. 204 00:09:16,097 --> 00:09:17,097 OK, if he's stable at the two-hour mark, 205 00:09:17,140 --> 00:09:18,475 I'd say he's good to go. 206 00:09:18,558 --> 00:09:19,642 Let's get the ball rolling on discharge. 207 00:09:19,726 --> 00:09:21,102 Let's wait on the CT results. 208 00:09:21,186 --> 00:09:22,562 We can move him out of Trauma One, at least. 209 00:09:22,645 --> 00:09:23,855 Yes, we can. What's open? 210 00:09:23,938 --> 00:09:25,565 13 and 14 will be discharged soon, 211 00:09:25,648 --> 00:09:27,317 15 once we move Louie to the viewing room 212 00:09:27,400 --> 00:09:28,777 and get it cleaned up. 213 00:09:28,860 --> 00:09:30,653 Our paracentesis patient, Mr. Cloverfield? 214 00:09:30,737 --> 00:09:32,197 V-fib arrest. 215 00:09:32,280 --> 00:09:33,448 We'll do a debrief when we know how many patients 216 00:09:33,531 --> 00:09:34,866 we're getting from Westbridge. 217 00:09:34,949 --> 00:09:37,952 So Gus goes to 13, 14, or 15? 218 00:09:38,036 --> 00:09:39,579 I kind of want to keep him in plain sight. 219 00:09:39,662 --> 00:09:41,581 - What about BH-2? - Sold. 220 00:09:41,664 --> 00:09:43,374 Why not give him some privacy? 221 00:09:43,458 --> 00:09:46,586 Everyone can see him in BH-2 like he's a monkey at the zoo. 222 00:09:46,669 --> 00:09:48,505 Because he came in with an orange jumpsuit, 223 00:09:48,588 --> 00:09:50,381 and we need to think about patient and staff safety. 224 00:09:50,465 --> 00:09:52,467 Safety first. BH-2 beats a prison cell. 225 00:09:52,550 --> 00:09:53,885 Not by much. 226 00:09:53,968 --> 00:09:55,553 Did you guys hear about Louie? 227 00:09:55,637 --> 00:09:58,223 - Yeah. - Yeah, chronic alcoholic. 228 00:09:58,306 --> 00:09:59,849 Go figure. 229 00:09:59,933 --> 00:10:02,393 Hey, fent OD in South 20 is ready for discharge, 230 00:10:02,477 --> 00:10:04,395 but could you get Lupe to call him a ride? 231 00:10:04,479 --> 00:10:05,814 I need to check on Louie. 232 00:10:05,897 --> 00:10:08,858 - Uh, actually, Whitaker… - He croaked. 233 00:10:08,942 --> 00:10:10,693 - What? - Five minutes ago. 234 00:10:10,777 --> 00:10:12,237 Robby called it. 235 00:10:22,372 --> 00:10:23,540 I'm sorry, man. 236 00:10:23,623 --> 00:10:26,376 We didn't have time to find you. 237 00:10:26,459 --> 00:10:28,670 What happened? 238 00:10:28,753 --> 00:10:31,256 He was apneic and pulseless. 239 00:10:31,339 --> 00:10:33,925 We started CPR and intubated him. 240 00:10:34,008 --> 00:10:35,635 He had a massive pulmonary hemorrhage. 241 00:10:35,718 --> 00:10:36,970 Robby called it. 242 00:10:39,722 --> 00:10:41,641 Found this with his stuff. 243 00:10:41,724 --> 00:10:43,935 Guess he was married at some point. 244 00:10:44,018 --> 00:10:45,728 Never knew that. 245 00:10:49,023 --> 00:10:51,693 Oh, didn't miss this part of the job. 246 00:10:51,776 --> 00:10:53,695 Yeah. 247 00:10:53,778 --> 00:10:59,159 Perlah, did Louie ever mention anything about a wife and kids? 248 00:10:59,242 --> 00:11:00,785 Not as far as I know. 249 00:11:00,869 --> 00:11:02,871 He only had eyes for Rita Moreno. 250 00:11:02,954 --> 00:11:06,583 Well, this is not Rita Moreno. 251 00:11:06,666 --> 00:11:08,418 No, it's not. 252 00:11:08,501 --> 00:11:10,461 Can we check to see if there's an emergency contact? 253 00:11:12,630 --> 00:11:15,466 Yeah, there's a number listed. 254 00:11:21,973 --> 00:11:23,558 You were his primary. Do you want to… 255 00:11:26,060 --> 00:11:27,687 No. 256 00:11:37,238 --> 00:11:39,657 PTMC charge nurse. 257 00:11:39,741 --> 00:11:43,870 Langdon? Where are you? 258 00:11:43,953 --> 00:11:45,955 Makes sense that we'd be his emergency contact. 259 00:11:46,039 --> 00:11:49,542 Sorry to get your hopes up. 260 00:11:49,626 --> 00:11:51,461 Our social worker's gonna do their thing. 261 00:11:51,544 --> 00:11:55,256 If Louie had any family left, they'll find them. 262 00:11:55,340 --> 00:11:56,966 You OK? 263 00:11:58,301 --> 00:12:01,804 Guess it's good it happened here, not out on the street. 264 00:12:01,888 --> 00:12:03,264 You're off the hook with Louie. 265 00:12:03,348 --> 00:12:05,975 I'ma teach Emma here how to clean a dead body. 266 00:12:08,102 --> 00:12:09,854 I'm sorry, but they need me in L&D. 267 00:12:09,938 --> 00:12:11,522 You might want to call for another interpreter. 268 00:12:11,606 --> 00:12:12,941 Busy day. 269 00:12:13,024 --> 00:12:14,400 Shit, that's the girl in 12? 270 00:12:14,484 --> 00:12:16,110 Yeah, she's been waiting for five hours. 271 00:12:16,194 --> 00:12:17,820 Didn't hear her name called the first time. 272 00:12:17,904 --> 00:12:19,364 You check on her? 273 00:12:19,447 --> 00:12:20,740 Need to brush up on my ASL. 274 00:12:20,823 --> 00:12:22,200 You know sign language too? 275 00:12:22,283 --> 00:12:23,952 Princess here knows six languages. 276 00:12:24,035 --> 00:12:26,537 - I know French. - OK, it's not a contest. 277 00:12:28,539 --> 00:12:30,041 No shit talking in front of me. 278 00:12:30,124 --> 00:12:32,418 I get enough of that from her and Perlah. 279 00:12:32,502 --> 00:12:35,171 Guess I'll call for backup. 280 00:12:35,255 --> 00:12:37,215 Yo, Donnie, did you discharge your butt abscess? 281 00:12:37,298 --> 00:12:39,634 Not yet! 282 00:12:39,717 --> 00:12:41,261 What the hell? 283 00:12:41,344 --> 00:12:42,428 Your good friends upstairs sent doughnuts. 284 00:12:42,512 --> 00:12:43,846 Special thank-you for working the holiday. 285 00:12:43,930 --> 00:12:45,640 You got to be kidding me. 286 00:12:45,723 --> 00:12:47,475 What were you expecting, tacos and tequila? 287 00:12:47,558 --> 00:12:49,352 Every single one of them can forget about extra shifts. 288 00:12:49,435 --> 00:12:51,521 - Won't hire more nurses. - Won't pay us a decent wage. 289 00:12:51,604 --> 00:12:53,022 Won't hire security that can actually 290 00:12:53,106 --> 00:12:54,107 protect us from patients. 291 00:12:54,190 --> 00:12:55,733 But absolutely, send doughnuts. 292 00:12:55,817 --> 00:12:57,235 Sure you want to go into this line of work? 293 00:12:57,318 --> 00:12:58,319 Want me get you one? 294 00:12:58,403 --> 00:13:00,613 Of course I do, but I'm not taking admin's blood pastries. 295 00:13:01,322 --> 00:13:03,449 Et tu, Donnie? 296 00:13:03,533 --> 00:13:05,410 OK, move it or lose it. 297 00:13:05,493 --> 00:13:07,870 Meet me in South 15 with gowns and gloves. 298 00:13:07,954 --> 00:13:09,580 Looks like happy hour in here. 299 00:13:09,664 --> 00:13:11,332 Don't ask. What's up with Evel Knievel? 300 00:13:11,416 --> 00:13:13,751 Brandon Li, 52, fell off a motorcycle pyramid 301 00:13:13,835 --> 00:13:15,378 at 25 miles per hour. 302 00:13:15,461 --> 00:13:17,338 Motorcycle pyramid? You recruiting? 303 00:13:17,422 --> 00:13:18,715 Got a fellow rider in your midst. 304 00:13:18,798 --> 00:13:20,008 - No kidding. - How high up were you? 305 00:13:20,091 --> 00:13:21,801 On top of a three, two, one. 306 00:13:21,884 --> 00:13:23,720 But the bottom guys are sitting down driving the choppers. 307 00:13:23,803 --> 00:13:25,430 I'm fine. I don't need all this. 308 00:13:25,513 --> 00:13:27,140 - Were you wearing a helmet? - Of course. 309 00:13:27,223 --> 00:13:29,434 Oh, what do you know? They're still in style. 310 00:13:29,517 --> 00:13:32,020 Good vitals, tender right wrist, and big left knee lac. 311 00:13:32,103 --> 00:13:34,355 Hey, Joy, Perlah, Trauma Two. 312 00:13:34,439 --> 00:13:35,773 Who else can I have? 313 00:13:35,857 --> 00:13:37,400 Santos and Whitaker are in with Louie. 314 00:13:37,483 --> 00:13:39,235 Yeah, give me Whitaker. He could use a distraction. 315 00:13:39,319 --> 00:13:40,945 And Santos has been ducking traumas all day. 316 00:13:41,029 --> 00:13:42,405 Well, she's behind in her charting. 317 00:13:42,488 --> 00:13:43,740 Who isn't? 318 00:13:46,868 --> 00:13:50,371 OK, even when it's not your fault, 319 00:13:50,455 --> 00:13:51,956 sometimes it's worse knowing 320 00:13:52,040 --> 00:13:54,125 that there was nothing you could do. 321 00:13:54,208 --> 00:13:56,502 Uh-huh. 322 00:13:56,586 --> 00:13:58,296 Are you… 323 00:13:58,379 --> 00:13:59,756 Robby needs you both in Trauma Two, 324 00:13:59,839 --> 00:14:01,549 and I need you to discharge sweet Patty in 13 325 00:14:01,632 --> 00:14:02,925 as soon as you're done. 326 00:14:03,009 --> 00:14:04,427 Can't catch a break. 327 00:14:04,510 --> 00:14:06,346 I push you 'cause I know you can take it. 328 00:14:18,733 --> 00:14:21,778 You ever clean a dead body? 329 00:14:21,861 --> 00:14:25,531 Probably never seen one either. 330 00:14:25,615 --> 00:14:28,493 No one tells you what it looks, feels, or smells like, 331 00:14:28,576 --> 00:14:31,162 but you get used to it over time. 332 00:14:32,789 --> 00:14:35,833 You pull off the gown. You wipe him down with towels. 333 00:14:35,917 --> 00:14:38,086 Then we'll roll him on his side, 334 00:14:38,169 --> 00:14:41,381 clean his back, stuff the sheet under him, 335 00:14:41,464 --> 00:14:43,966 wipe down the bed, roll him the other way, 336 00:14:44,050 --> 00:14:45,676 pull out the sheet, and repeat. 337 00:14:45,760 --> 00:14:48,346 Just follow my lead. 338 00:14:48,429 --> 00:14:52,350 Usually, you leave the ET tube in for the coroner, 339 00:14:52,433 --> 00:14:56,229 but Louie's a chronic alcoholic with end-stage liver disease. 340 00:14:56,312 --> 00:14:58,064 Not a coroner's case. 341 00:15:00,191 --> 00:15:03,403 - Did he have family? - Everyone has family. 342 00:15:03,486 --> 00:15:06,531 The social worker always tries to find them. 343 00:15:06,614 --> 00:15:08,908 Sometimes the family loved them, 344 00:15:08,991 --> 00:15:10,118 tried to get them to come home. 345 00:15:10,201 --> 00:15:13,204 Other times, the family wants nothing to do with them. 346 00:15:13,287 --> 00:15:15,289 - That's sad. - That's life. 347 00:15:17,125 --> 00:15:18,793 What happens if no one claims his body? 348 00:15:18,876 --> 00:15:20,420 He'll be cremated. 349 00:15:20,503 --> 00:15:21,963 Where would his ashes go? 350 00:15:22,046 --> 00:15:23,381 They'll keep him for a few months. 351 00:15:23,464 --> 00:15:24,799 Then he gets buried in a mass grave 352 00:15:24,882 --> 00:15:26,926 with all the other unclaimed bodies. 353 00:15:28,845 --> 00:15:31,722 OK, now we roll him. 354 00:15:34,767 --> 00:15:36,519 Ready. 355 00:15:36,602 --> 00:15:38,146 Go. 356 00:15:38,229 --> 00:15:39,522 Oh, my God, is he still alive? 357 00:15:39,605 --> 00:15:41,315 No, that happens. 358 00:15:42,275 --> 00:15:44,110 These frequent fliers. 359 00:15:44,193 --> 00:15:47,905 They can be a real pain in the ass, but… 360 00:15:47,989 --> 00:15:51,033 you miss them when they're gone. 361 00:15:57,790 --> 00:15:59,876 I've been at every Millvale Fourth of July parade 362 00:15:59,959 --> 00:16:01,377 since '08. 363 00:16:01,461 --> 00:16:03,796 World record is 40 men on seven motorcycles. 364 00:16:03,880 --> 00:16:05,381 I plan to beat that someday. 365 00:16:05,465 --> 00:16:07,383 Good lung sliding bilaterally. 366 00:16:07,467 --> 00:16:08,968 Pupils equal and reactive. 367 00:16:09,051 --> 00:16:10,803 - What do you ride? - The Bullet. 368 00:16:10,887 --> 00:16:12,680 Oh, Royal Enfield. Ankle breaker. 369 00:16:12,763 --> 00:16:15,016 - Thumper. - BP 138 over 80. 370 00:16:15,099 --> 00:16:17,185 Pulse 94. Pulse ox 98. 371 00:16:17,268 --> 00:16:19,437 All your vitals sound really good, Brandon. 372 00:16:19,520 --> 00:16:21,063 They call it an ankle breaker 'cause 373 00:16:21,147 --> 00:16:22,732 you got to kick over a big, fat single cylinder 374 00:16:22,815 --> 00:16:24,984 to get it started, sometimes five or six kicks. 375 00:16:25,067 --> 00:16:27,195 Yeah, especially on a cold day. 376 00:16:27,278 --> 00:16:29,489 Um, does anyone have any trauma scissors? 377 00:16:29,572 --> 00:16:31,365 - I'll check the knee. - Uh, not yet. 378 00:16:31,449 --> 00:16:33,201 - Why not? - Dr. Santos. 379 00:16:33,284 --> 00:16:35,661 Primary survey means rule out the life threats. 380 00:16:35,745 --> 00:16:37,747 Don't get distracted by lacerations or fractures. 381 00:16:37,830 --> 00:16:39,499 No free fluid in the belly. 382 00:16:39,582 --> 00:16:41,959 Airway, breathing, circulation are fine. 383 00:16:42,043 --> 00:16:44,212 OK, that's ABC. That just leaves two letters. 384 00:16:44,295 --> 00:16:46,422 Tell her about D, Dr. Santos. 385 00:16:46,506 --> 00:16:48,424 Disability. Wiggle your toes, sir. 386 00:16:48,508 --> 00:16:50,635 Any pain in your arms or legs? 387 00:16:50,718 --> 00:16:52,220 Not really. 388 00:16:52,303 --> 00:16:53,513 Does it hurt when I push here? 389 00:16:53,596 --> 00:16:55,431 - No. - OK, no midline tenderness. 390 00:16:55,515 --> 00:16:57,099 Nexus negative. 391 00:16:57,183 --> 00:16:59,268 With no obvious brain injury or spinal cord injury. 392 00:16:59,352 --> 00:17:02,438 That just leaves E. Joy. 393 00:17:02,522 --> 00:17:04,190 Can I buy another vowel? 394 00:17:04,273 --> 00:17:06,400 - Dr. Whitaker. - Exposure. 395 00:17:06,484 --> 00:17:07,902 AKA strip and flip. 396 00:17:07,985 --> 00:17:10,029 Cut off his clothes, and we'll log roll him. 397 00:17:10,112 --> 00:17:12,073 What do we have? 398 00:17:12,156 --> 00:17:13,991 Helmeted motorcycle acrobat. 399 00:17:14,075 --> 00:17:16,577 8-foot fall standing on top of five riders. 400 00:17:16,661 --> 00:17:18,246 Primary survey normal, E-FAST negative. 401 00:17:18,329 --> 00:17:20,164 Another motorcycle accident. 402 00:17:20,248 --> 00:17:22,375 Hello, sir. I'm Dr. Garcia from surgery. 403 00:17:22,458 --> 00:17:23,834 Hello. 404 00:17:23,918 --> 00:17:29,048 OK, we will roll him in three, two, one. 405 00:17:33,094 --> 00:17:35,471 Well, I grew up a block from Carrick, 406 00:17:35,555 --> 00:17:38,391 but my mom was a teacher at Brashear, so I had to go there. 407 00:17:38,474 --> 00:17:40,893 - The Bullets? - That's right. 408 00:17:40,977 --> 00:17:42,270 They were the Bullets when I was there. 409 00:17:42,353 --> 00:17:44,063 They changed to the Bulls when I left. 410 00:17:44,146 --> 00:17:45,565 Oh. 411 00:17:45,648 --> 00:17:48,609 Hey, you think I could get something to eat? 412 00:17:50,111 --> 00:17:52,655 Gus here is wondering if he's clear to eat. 413 00:17:52,738 --> 00:17:54,615 As long as it's a liquid diet. 414 00:17:54,699 --> 00:17:57,493 We have the results of your CT scan. 415 00:17:57,577 --> 00:18:00,413 Your jaw should heal without surgery, which is good news, 416 00:18:00,496 --> 00:18:02,999 but it will be a few weeks. 417 00:18:03,082 --> 00:18:04,500 Before I can eat? 418 00:18:04,584 --> 00:18:06,294 Solid foods, yes. 419 00:18:06,377 --> 00:18:10,089 Or you can have food pureed with liquid in a blender. 420 00:18:10,172 --> 00:18:12,758 I don't have a blender. 421 00:18:12,842 --> 00:18:14,176 Right. 422 00:18:14,260 --> 00:18:16,095 Sorry. 423 00:18:16,178 --> 00:18:19,473 We have a calorie-rich supplement drink called Ensure. 424 00:18:19,557 --> 00:18:22,893 Comes in chocolate, vanilla, or strawberry. 425 00:18:22,977 --> 00:18:24,770 Chocolate, please. 426 00:18:24,854 --> 00:18:26,439 - Good choice. - How many can I have? 427 00:18:26,522 --> 00:18:27,940 Two a day is recommended. 428 00:18:28,024 --> 00:18:30,026 I'll get it for you. 429 00:18:30,109 --> 00:18:33,446 You have an appetite. That's good. 430 00:18:33,529 --> 00:18:35,573 Mr. Varney, your blood tests indicate 431 00:18:35,656 --> 00:18:38,159 low levels of protein and vitamins. 432 00:18:38,242 --> 00:18:40,411 Can we ask you a few questions about your diet? 433 00:18:42,204 --> 00:18:45,416 How many meals or snacks do you have in a 24-hour period? 434 00:18:45,499 --> 00:18:46,792 I don't know. 435 00:18:46,876 --> 00:18:48,753 Don't count. 436 00:18:48,836 --> 00:18:51,380 Pretty sure it's three trays a day. 437 00:18:51,464 --> 00:18:53,049 OK. 438 00:18:53,132 --> 00:18:56,260 How often do you eat cereals, fruits, or vegetables? 439 00:18:56,344 --> 00:18:59,513 Not many fruits and vegetables in prison. 440 00:18:59,597 --> 00:19:01,223 Slow and steady. 441 00:19:03,267 --> 00:19:05,311 What year is your Bonneville? 442 00:19:05,394 --> 00:19:06,604 '69. 443 00:19:06,687 --> 00:19:08,981 Rescued it from a motor graveyard. 444 00:19:09,065 --> 00:19:10,524 Brought it back to life with a buddy of mine, 445 00:19:10,608 --> 00:19:12,276 who's supposed to be coming in today. 446 00:19:12,360 --> 00:19:13,736 How often do you ride? 447 00:19:13,819 --> 00:19:15,571 I ride it in to work every day. 448 00:19:15,655 --> 00:19:16,781 Good for you. 449 00:19:16,864 --> 00:19:18,449 Don't encourage him. 450 00:19:18,532 --> 00:19:20,201 CT's ready for Brandon. 451 00:19:20,284 --> 00:19:22,870 As soon as we take a look at this knee. 452 00:19:24,288 --> 00:19:26,540 - Whoa. - Through the deep fascia. 453 00:19:26,624 --> 00:19:27,667 How's it look? 454 00:19:27,750 --> 00:19:28,834 Definitely gonna need stitches. 455 00:19:28,918 --> 00:19:30,169 - How many? - A lot. 456 00:19:30,252 --> 00:19:31,712 It could be an open joint. 457 00:19:31,796 --> 00:19:33,589 We'll do a saline load after CT. 458 00:19:33,673 --> 00:19:35,132 OK. 459 00:19:35,216 --> 00:19:37,051 Lever sign negative. ACL intact. 460 00:19:37,134 --> 00:19:38,469 OK, ready to roll. 461 00:19:43,516 --> 00:19:45,267 Are you still coming over tonight? 462 00:19:45,351 --> 00:19:47,061 I think Whitaker is gonna be playing 463 00:19:47,144 --> 00:19:49,105 farm boy again this weekend, so he's not gonna be around. 464 00:19:49,188 --> 00:19:50,815 I may need a rain check. 465 00:19:50,898 --> 00:19:52,483 Hey, do you have an update on that nec fasc patient? 466 00:19:52,566 --> 00:19:53,943 Last I heard, Miller was doing 467 00:19:54,026 --> 00:19:56,112 an above-the-knee amputation with ortho. 468 00:19:58,155 --> 00:20:00,491 Langdon's waitress with the cellulitis? 469 00:20:00,574 --> 00:20:01,826 Yeah. 470 00:20:01,909 --> 00:20:04,453 - Man, that took a turn. - Sure did. 471 00:20:04,537 --> 00:20:07,164 Hey, did you hear about Louie? 472 00:20:08,457 --> 00:20:10,876 - Yeah. - You OK? 473 00:20:10,960 --> 00:20:12,378 Um, 474 00:20:12,461 --> 00:20:15,923 one of my uncles drank himself to death. 475 00:20:16,006 --> 00:20:18,801 I barely recognized him at the end. 476 00:20:18,884 --> 00:20:22,096 At least Louie always seemed happy. 477 00:20:22,179 --> 00:20:23,764 I'm here if you want to talk. 478 00:20:29,395 --> 00:20:32,231 Should've known I'd find you in here. 479 00:20:32,314 --> 00:20:36,068 You steal anyone's lunch, it's a $20 fine. 480 00:20:36,152 --> 00:20:37,737 Made a lot of changes while you were gone. 481 00:20:37,820 --> 00:20:39,363 I can see that. 482 00:20:39,447 --> 00:20:40,823 Look, I'll let you hide out a little bit longer, 483 00:20:40,906 --> 00:20:42,491 but then I need you to pick up more patients. 484 00:20:42,575 --> 00:20:44,076 You're not as fast as you used to be. 485 00:20:44,160 --> 00:20:46,203 Damn doughnuts! 486 00:20:46,287 --> 00:20:48,539 Ouch. 487 00:20:48,622 --> 00:20:51,500 First day back, I get kicked in the nuts. 488 00:20:51,584 --> 00:20:53,669 One dead, one septic bounce-back. 489 00:20:53,753 --> 00:20:56,005 Both of those not your fault. 490 00:20:58,632 --> 00:21:00,301 You expecting a party? 491 00:21:00,384 --> 00:21:02,011 No, not really. 492 00:21:02,094 --> 00:21:04,472 Didn't hear from anyone while I was gone. 493 00:21:06,974 --> 00:21:08,726 Sorry. 494 00:21:08,809 --> 00:21:12,396 They ever, uh, arrest that guy who punched you? 495 00:21:12,480 --> 00:21:14,231 Yeah. 496 00:21:14,315 --> 00:21:16,150 Wanted to know if I wanted to press charges, 497 00:21:16,233 --> 00:21:19,487 but didn't want to go through all that. 498 00:21:19,570 --> 00:21:22,072 Thought I was done, really did, but… 499 00:21:22,156 --> 00:21:25,743 I got bored at home, so only lasted a few weeks. 500 00:21:25,826 --> 00:21:27,536 You? 501 00:21:27,620 --> 00:21:30,247 10 months is a long time to be alone with your thoughts. 502 00:21:30,331 --> 00:21:32,833 I almost lost everything. 503 00:21:32,917 --> 00:21:35,002 I know a lot of women who would have taken the kids and left, 504 00:21:35,085 --> 00:21:38,255 - but Abby stayed. - 'Cause she's a good woman. 505 00:21:38,339 --> 00:21:40,090 'Cause you deserve a second chance. 506 00:21:40,174 --> 00:21:41,884 I'm not sure everyone agrees with you. 507 00:21:41,967 --> 00:21:43,177 Give it time. 508 00:21:43,260 --> 00:21:45,304 Look, I… 509 00:21:49,517 --> 00:21:51,977 I, um… 510 00:21:52,061 --> 00:21:55,856 I've been working the 12 steps, trying to make amends. 511 00:21:55,940 --> 00:21:57,608 I was really selfish. 512 00:21:57,691 --> 00:21:59,485 I lied to myself, and I lied to you. 513 00:21:59,568 --> 00:22:00,861 I'm really sorry. 514 00:22:00,945 --> 00:22:02,279 You can check me off your list, kid. 515 00:22:02,363 --> 00:22:04,198 We're good. 516 00:22:04,281 --> 00:22:06,367 - OK. - Yeah. 517 00:22:06,450 --> 00:22:08,035 Got a lovely patient for you in Two. 518 00:22:08,118 --> 00:22:10,037 Let's get you back on the horse. 519 00:22:13,082 --> 00:22:14,500 Really need to talk with Robby. 520 00:22:14,583 --> 00:22:15,918 I don't know if today's the best day for that. 521 00:22:16,001 --> 00:22:17,211 He leaves on vacation tomorrow. 522 00:22:17,294 --> 00:22:18,712 Let him get through the day in peace. 523 00:22:18,796 --> 00:22:20,214 He's supposed to be gone for three months? 524 00:22:20,297 --> 00:22:22,216 So he says. I give him one. 525 00:22:22,299 --> 00:22:23,676 Go get 'em, kid. 526 00:22:26,470 --> 00:22:29,181 Dr. Langdon, this is Rocky. 527 00:22:29,265 --> 00:22:30,558 Great name. 528 00:22:30,641 --> 00:22:34,186 What brings you in, Rocky? 529 00:22:34,270 --> 00:22:35,896 Very sick. 530 00:22:35,980 --> 00:22:38,148 When did it start? 531 00:22:38,232 --> 00:22:39,733 An hour ago. 532 00:22:39,817 --> 00:22:42,361 After he won a hot dog eating contest. 533 00:22:42,444 --> 00:22:44,864 A hot dog eating contest? How many you eat? 534 00:22:47,783 --> 00:22:49,827 351 hot dogs? 535 00:22:53,998 --> 00:22:55,416 36. 536 00:22:55,499 --> 00:22:57,918 Still a lot. 537 00:22:58,002 --> 00:22:59,920 - I pulled eight of Zofran. - Go for it. 538 00:23:00,004 --> 00:23:01,338 All right, this should help. 539 00:23:01,422 --> 00:23:03,007 Stick it under your tongue. Let it dissolve. 540 00:23:03,090 --> 00:23:04,258 OK, are you taking any prescription… 541 00:23:09,680 --> 00:23:11,974 Oh, thank you. 542 00:23:12,057 --> 00:23:14,518 Thanks. 543 00:23:14,602 --> 00:23:16,812 Santos, what's up with your ileus patient? 544 00:23:16,896 --> 00:23:18,814 Admitted to medicine, and before you ask, 545 00:23:18,898 --> 00:23:20,566 13 has been discharged. 546 00:23:20,649 --> 00:23:22,860 Great. 12 needs a doctor. 547 00:23:22,943 --> 00:23:24,737 No, don't make me go back there. 548 00:23:24,820 --> 00:23:27,907 That disimpaction left a smell and stunk up the whole hallway. 549 00:23:27,990 --> 00:23:29,950 So grab some coffee grounds from the lounge. 550 00:23:30,034 --> 00:23:32,578 We need to admit our incarcerated patient, Gus. 551 00:23:32,661 --> 00:23:34,455 What did the CT show? 552 00:23:34,538 --> 00:23:36,916 Moderate pulmonary contusion, three rib fractures, 553 00:23:36,999 --> 00:23:39,710 no intra-abdominal bleeding, and oblique fracture 554 00:23:39,793 --> 00:23:42,338 in the body of the mandible anterior to the angle. 555 00:23:42,421 --> 00:23:44,548 All favorable for healing. What's the treatment plan? 556 00:23:44,632 --> 00:23:46,383 - A pain med… - Security. 557 00:23:46,467 --> 00:23:47,801 People are trying to sleep. 558 00:23:47,885 --> 00:23:51,305 Pain medication, antibiotics, liquid diet, 559 00:23:51,388 --> 00:23:53,265 um, a pulse ox a few times a day, 560 00:23:53,349 --> 00:23:56,101 and then also dressing changes for the laceration. 561 00:23:56,185 --> 00:23:58,604 Which he can get at his correctional facility. 562 00:23:58,687 --> 00:24:00,856 Or he stays here for a few days, 563 00:24:00,940 --> 00:24:03,776 and we get him on the right track to healing. 564 00:24:03,859 --> 00:24:05,861 Why don't you two go check on your patients? 565 00:24:05,945 --> 00:24:08,572 - Got it. - Sure thing. 566 00:24:08,656 --> 00:24:10,407 What am I missing? 567 00:24:10,491 --> 00:24:11,825 He's not getting enough to eat 568 00:24:11,909 --> 00:24:13,327 at his correctional facility. 569 00:24:13,410 --> 00:24:14,912 The portions are tiny. 570 00:24:14,995 --> 00:24:16,872 Too many carbs, not enough fruits or vegetables. 571 00:24:16,956 --> 00:24:20,334 He's lucky he hasn't developed a chronic illness. 572 00:24:20,417 --> 00:24:22,127 We don't have any inpatient beds. 573 00:24:22,211 --> 00:24:23,671 He would board down here for three days. 574 00:24:23,754 --> 00:24:25,214 We're still getting runs from Westbridge, 575 00:24:25,297 --> 00:24:27,549 and we cannot tie up Behavioral for that long. 576 00:24:27,633 --> 00:24:29,385 Dr. Al-Hashimi, Dr. Jefferson wants to talk 577 00:24:29,468 --> 00:24:31,136 to you about our tasered kid. 578 00:24:35,057 --> 00:24:36,433 Why don't I call the prison doctor 579 00:24:36,517 --> 00:24:38,143 and find out what they're working with over there? 580 00:24:38,227 --> 00:24:39,979 - Thank you. - My pleasure. 581 00:24:42,106 --> 00:24:44,400 Dr. Jefferson seems to have a good rapport with Jackson. 582 00:24:44,483 --> 00:24:45,776 That's excellent. 583 00:24:45,859 --> 00:24:47,111 How's the sister doing? 584 00:24:47,194 --> 00:24:48,487 Still pretty upset. 585 00:24:48,570 --> 00:24:49,989 She's never seen him like this. 586 00:24:50,072 --> 00:24:51,615 It's a lot to process. 587 00:24:51,699 --> 00:24:53,867 - How's he doing? - He's scared. 588 00:24:53,951 --> 00:24:55,411 Droperidol had a positive effect, 589 00:24:55,494 --> 00:24:57,788 but he doesn't understand what's going on. 590 00:24:57,871 --> 00:24:59,832 He's been experiencing auditory hallucinations 591 00:24:59,915 --> 00:25:01,417 and paranoid delusions. 592 00:25:01,500 --> 00:25:04,628 Voices are telling him he isn't safe. 593 00:25:04,712 --> 00:25:05,921 This has been going on for months. 594 00:25:06,005 --> 00:25:07,548 - Months? - Yeah. 595 00:25:07,631 --> 00:25:09,133 Turns out, his sister hasn't seen him in a while. 596 00:25:09,216 --> 00:25:11,176 Family history of mental illness? 597 00:25:11,260 --> 00:25:13,387 Not that we know of. 598 00:25:13,470 --> 00:25:17,224 I'm gonna give him a break and then continue the conversation. 599 00:25:17,307 --> 00:25:18,600 Parents are on their way. 600 00:25:18,684 --> 00:25:19,670 We'll let you know when they get here. 601 00:25:19,685 --> 00:25:21,061 Yes. Do. 602 00:25:21,145 --> 00:25:22,896 OK, hospital bed, wheelchair, 603 00:25:22,980 --> 00:25:25,899 and shower chair have all been ordered. 604 00:25:25,983 --> 00:25:27,609 What do you say, kid? 605 00:25:27,693 --> 00:25:29,570 Ready to go home? 606 00:25:31,947 --> 00:25:34,742 How's your pain, Mrs. Hamler? 607 00:25:34,825 --> 00:25:36,243 The same. 608 00:25:36,326 --> 00:25:38,579 We're gonna write you a script for Keppra. 609 00:25:38,662 --> 00:25:39,913 You'll take that to prevent seizures 610 00:25:39,997 --> 00:25:41,749 once a day, starting tomorrow. 611 00:25:41,832 --> 00:25:43,709 Between your broken leg and the bruises from your seizure, 612 00:25:43,792 --> 00:25:45,753 the pain will probably get a little worse. 613 00:25:45,836 --> 00:25:47,004 Yeah, the most important thing is 614 00:25:47,087 --> 00:25:48,213 to let others help you. 615 00:25:48,297 --> 00:25:49,798 You'll need assistance showering 616 00:25:49,882 --> 00:25:51,300 and getting to the bathroom. 617 00:25:51,383 --> 00:25:53,218 Yeah, no problem. I won't leave her side. 618 00:25:53,302 --> 00:25:55,596 Paul, you need a break. 619 00:25:55,679 --> 00:26:00,059 You're…you're taking care of me, the kids, the house. 620 00:26:00,142 --> 00:26:03,312 It's too much for one person. 621 00:26:03,395 --> 00:26:05,606 I'm not the one battling cancer. 622 00:26:05,689 --> 00:26:06,899 Paul. 623 00:26:06,982 --> 00:26:10,360 Hey, you're in pain every day, 624 00:26:10,444 --> 00:26:12,071 fighting for your life. 625 00:26:12,154 --> 00:26:14,740 I'm happy to do this for you. 626 00:26:14,823 --> 00:26:17,284 You're my wife. 627 00:26:17,367 --> 00:26:20,412 Now, let's go home and forget this day ever happened. 628 00:26:20,496 --> 00:26:21,872 I'll call the transpo ambulance. 629 00:26:21,955 --> 00:26:23,207 Thanks, Princess. 630 00:26:29,797 --> 00:26:31,298 Hey. 631 00:26:32,841 --> 00:26:34,927 Why don't you go ahead? 632 00:26:35,010 --> 00:26:36,011 - What? - Yeah. 633 00:26:36,095 --> 00:26:37,304 You can get the house ready. 634 00:26:37,387 --> 00:26:39,473 I'll be right behind you. 635 00:26:39,556 --> 00:26:41,141 - No. - Mm-hmm. 636 00:26:41,225 --> 00:26:45,270 No, I'm…I'm riding in the back with you. 637 00:26:45,354 --> 00:26:48,190 You know what? I'll stay with her. 638 00:26:49,775 --> 00:26:51,485 Are you sure? 639 00:26:51,568 --> 00:26:53,737 - Mm-hmm. - Yeah. 640 00:26:53,821 --> 00:26:56,949 OK. 641 00:26:57,032 --> 00:26:59,910 Um, call me if you need me to come back. 642 00:26:59,993 --> 00:27:01,745 Mm-hmm. 643 00:27:07,042 --> 00:27:08,377 When will the ambulance get here? 644 00:27:08,460 --> 00:27:09,461 It shouldn't be long. 645 00:27:09,545 --> 00:27:11,547 Mr. Francis, short of breath? 646 00:27:11,630 --> 00:27:13,006 Yeah, I was worried the clot in my leg 647 00:27:13,090 --> 00:27:15,050 could have gone up to my lungs, so… 648 00:27:15,134 --> 00:27:16,885 You're on Eliquis. That shouldn't happen. 649 00:27:16,969 --> 00:27:18,720 - Yeah, I know, but… - Hey, Donnie, I got this. 650 00:27:18,804 --> 00:27:20,222 Don't worry, Mr. Francis. 651 00:27:20,305 --> 00:27:21,890 I'll order the D-dimer. I'll be back to see you. 652 00:27:21,974 --> 00:27:24,476 Thank you, Dr. Mohan. 653 00:27:24,560 --> 00:27:26,478 You know I'm an NP now. 654 00:27:26,562 --> 00:27:27,980 I can pick up a patient with dyspnea. 655 00:27:28,063 --> 00:27:29,481 I'm sorry. 656 00:27:29,565 --> 00:27:31,900 I've seen him before, and he's asked for me. 657 00:27:31,984 --> 00:27:34,027 Why even order the test? He's on Eliquis. 658 00:27:34,111 --> 00:27:35,362 Mr. Francis comes in every month 659 00:27:35,445 --> 00:27:37,364 and always asks for a D-dimer. 660 00:27:37,447 --> 00:27:39,825 Just…he's worried, and it puts his mind at ease. 661 00:27:39,908 --> 00:27:42,452 - Why not? - Yeah, OK. 662 00:27:42,536 --> 00:27:45,289 Donnie's the best. You'll learn a lot from him. 663 00:27:45,372 --> 00:27:47,332 That's right. 664 00:28:14,026 --> 00:28:16,069 All right, fill me in. 665 00:28:16,153 --> 00:28:18,780 This is Harlow Graham. She was seen in triage. 666 00:28:18,864 --> 00:28:21,158 CBC and CMP came back normal. 667 00:28:21,241 --> 00:28:23,660 IT was supposed to bring the VRI down, but they're slammed. 668 00:28:23,744 --> 00:28:25,370 I know a bit of sign language. 669 00:28:25,454 --> 00:28:30,876 Harlow, this is Dr. Santos. 670 00:28:30,959 --> 00:28:32,628 Hi, Harlow. How are you feeling? 671 00:28:35,505 --> 00:28:36,757 She has a headache. 672 00:28:36,840 --> 00:28:38,634 OK. What else? 673 00:28:44,139 --> 00:28:45,682 What is she saying? 674 00:28:45,766 --> 00:28:47,809 I think she had a stomachache, 675 00:28:47,893 --> 00:28:50,687 and she might have passed out. 676 00:28:53,815 --> 00:28:55,484 I'm not 100% sure. 677 00:28:55,567 --> 00:28:58,070 OK, we're just gonna need to wait for an interpreter, 678 00:28:58,153 --> 00:28:59,738 'cause I need to ask a million questions, 679 00:28:59,821 --> 00:29:01,365 and I can't do it this way. 680 00:29:01,448 --> 00:29:03,492 So just call me when IT comes down. 681 00:29:14,878 --> 00:29:17,714 CT head, neck, chest, abdomen, pelvis all negative. 682 00:29:17,798 --> 00:29:20,801 It means we can get this collar off. 683 00:29:20,884 --> 00:29:22,928 Thank you. 684 00:29:23,011 --> 00:29:24,346 Roll to your side. 685 00:29:24,429 --> 00:29:26,598 We'll get you off this board. 686 00:29:26,682 --> 00:29:28,183 How long is your trip? 687 00:29:28,267 --> 00:29:31,061 2,000 miles, all the way from here to Alberta. 688 00:29:31,144 --> 00:29:32,729 Couple stops along the way. 689 00:29:32,813 --> 00:29:34,273 Got the whole thing mapped out. 690 00:29:34,356 --> 00:29:36,483 - Sounds like heaven. - Let's sit you up. 691 00:29:36,566 --> 00:29:38,193 Sorry, I got stuck with a patient. 692 00:29:38,277 --> 00:29:40,279 You know the old saying, four wheels move the body, 693 00:29:40,362 --> 00:29:41,863 two wheels move the soul. 694 00:29:41,947 --> 00:29:43,365 You're gonna be living the dream. 695 00:29:43,448 --> 00:29:44,783 Thank you, Brandon. 696 00:29:44,866 --> 00:29:46,326 Not everybody down here feels that way. 697 00:29:46,410 --> 00:29:48,620 - OK, Whitaker, what's next? - Ortho assessment. 698 00:29:48,704 --> 00:29:51,832 Palpate all long bones, starting with the clavicle. 699 00:29:51,915 --> 00:29:53,125 Got it. 700 00:29:53,208 --> 00:29:55,669 I'll take the lower extremities. 701 00:30:00,299 --> 00:30:01,466 Distal radius tender. No deformities. 702 00:30:01,550 --> 00:30:02,676 Needs an X-ray. 703 00:30:02,759 --> 00:30:04,052 No bony tenderness down here. 704 00:30:04,136 --> 00:30:05,470 No laxity of the knee. 705 00:30:05,554 --> 00:30:08,181 Are you concerned about that knee lac? 706 00:30:08,265 --> 00:30:10,350 If it's an open joint, he'll need a washout in the OR. 707 00:30:10,434 --> 00:30:12,311 We could try a fluorescein injection. 708 00:30:12,394 --> 00:30:13,812 OK, we'll need a… 709 00:30:13,895 --> 00:30:15,480 Wood's lamp, 1% lido with epi, 710 00:30:15,564 --> 00:30:17,899 sterile saline, sterile basin, sterile fluoro-strip, 711 00:30:17,983 --> 00:30:22,029 18- and 27-gauge needles, 5- and 60-cc syringes. 712 00:30:22,112 --> 00:30:24,489 How does she know all that? 713 00:30:24,573 --> 00:30:25,866 She just does. 714 00:30:27,326 --> 00:30:28,618 How are you feeling, Rocky? 715 00:30:28,702 --> 00:30:30,412 Oh, much better. 716 00:30:30,495 --> 00:30:32,164 He's had eight migs of ondansetron. 717 00:30:32,247 --> 00:30:33,623 Any pain in the belly? 718 00:30:33,707 --> 00:30:35,917 No, but my mouth is really dry. 719 00:30:36,001 --> 00:30:39,379 No doubt from consuming mass quantities of salty hot dogs. 720 00:30:39,463 --> 00:30:40,922 Could I have another sip of water? 721 00:30:41,006 --> 00:30:42,507 Sure. A little sip. 722 00:30:42,591 --> 00:30:44,551 Take it slow. 723 00:30:44,634 --> 00:30:46,053 - Here you go. - Thank you. 724 00:30:46,136 --> 00:30:49,765 Just enough to wet your whistle. 725 00:30:49,848 --> 00:30:52,601 So how'd you get your start as a competitive eater? 726 00:31:01,401 --> 00:31:03,779 Any pain here, Mr. Li? 727 00:31:03,862 --> 00:31:05,447 - Can't feel a thing. - Great. 728 00:31:05,530 --> 00:31:06,782 Where is Santos? 729 00:31:06,865 --> 00:31:09,451 Probably catching up on her charting. 730 00:31:09,534 --> 00:31:10,869 - Right. - Lights out. 731 00:31:10,952 --> 00:31:12,746 Wood's lamp on. 732 00:31:14,664 --> 00:31:16,458 OK. 733 00:31:18,085 --> 00:31:19,920 I might want to use some of that on Halloween. 734 00:31:20,003 --> 00:31:22,756 That is 250 ccs of sterile saline 735 00:31:22,839 --> 00:31:25,550 with one small touch of a sterile fluoro-strip. 736 00:31:25,634 --> 00:31:27,302 OK. 737 00:31:27,386 --> 00:31:30,097 We're going to inject this fluid into your knee, Brandon, 738 00:31:30,180 --> 00:31:33,725 and if there's anything glowing in your wound, 739 00:31:33,809 --> 00:31:35,685 we know we have a leak. 740 00:31:35,769 --> 00:31:38,188 - Feeling some pressure. - Yeah, it's normal. 741 00:31:38,271 --> 00:31:41,149 As soon as I finish the test, I'll pull off the fluid. 742 00:31:43,443 --> 00:31:44,986 That looks good. 743 00:31:45,070 --> 00:31:47,030 Laceration did not enter into the joint space. 744 00:31:47,114 --> 00:31:48,573 Surgery not needed. 745 00:31:48,657 --> 00:31:50,242 Excellent. I can get back to the parade. 746 00:31:50,325 --> 00:31:51,660 No, we'll still need to 747 00:31:51,743 --> 00:31:53,078 stitch you up and splint your wrist. 748 00:31:53,161 --> 00:31:54,413 Hanging a gram of Ancef. 749 00:31:54,496 --> 00:31:56,206 Wait, he has a penicillin allergy. 750 00:31:56,289 --> 00:31:58,834 No, PEN-FAST was negative. We're OK. 751 00:31:58,917 --> 00:32:01,628 My mom said I got a rash with amoxicillin when I was two. 752 00:32:01,711 --> 00:32:03,547 Yeah, probably not a true allergy. 753 00:32:03,630 --> 00:32:05,132 Go ahead and give it, Kim. 754 00:32:05,215 --> 00:32:07,134 But have epi and Benadryl standing by, right? 755 00:32:07,217 --> 00:32:09,136 Yes, to be on the safe side. 756 00:32:09,219 --> 00:32:11,388 Most people who think they have a penicillin allergy 757 00:32:11,471 --> 00:32:13,348 actually don't. 758 00:32:13,432 --> 00:32:15,934 Always listen to the nurses. They run the ER. 759 00:32:16,017 --> 00:32:17,978 We just try and stay out of their way. 760 00:32:24,943 --> 00:32:26,903 Now we can really clean him up. 761 00:32:26,987 --> 00:32:28,572 Didn't we already do that? 762 00:32:28,655 --> 00:32:30,782 Dried blood on the face, neck, hands. 763 00:32:30,866 --> 00:32:33,702 If anyone comes, they shouldn't have to see that. 764 00:32:33,785 --> 00:32:35,829 Sometimes the local unhoused folks will pay a visit, 765 00:32:35,912 --> 00:32:37,456 but we always make them presentable 766 00:32:37,539 --> 00:32:39,958 in case anyone comes. 767 00:32:40,041 --> 00:32:43,086 That's the last thing we can do for them. 768 00:32:43,170 --> 00:32:46,756 Didn't get to do that during COVID. 769 00:32:46,840 --> 00:32:49,134 Once he's spotless, we'll tuck him in nice and tight, 770 00:32:49,217 --> 00:32:51,428 but we always leave one arm outside the sheet. 771 00:32:51,511 --> 00:32:53,722 Because? 772 00:32:53,805 --> 00:32:56,349 So loved ones can hold their hand. 773 00:32:56,433 --> 00:32:58,393 - Here you go. - Thanks. 774 00:32:58,477 --> 00:32:59,978 Yeah. 775 00:33:02,105 --> 00:33:04,274 We're ready to discharge our cancer mom, Roxie. 776 00:33:04,357 --> 00:33:05,775 Ambulance is on the way; we just need 777 00:33:05,859 --> 00:33:07,652 - to reconcile her home meds. - Sounds good. 778 00:33:07,736 --> 00:33:09,571 Hey, I thought I saw another charge nurse around here. 779 00:33:09,654 --> 00:33:11,364 Oh, yeah. We travel in packs. 780 00:33:11,448 --> 00:33:12,741 Aren't you sick of this place yet? 781 00:33:12,824 --> 00:33:14,910 Oh, someone is ready for his sabbatical. 782 00:33:14,993 --> 00:33:16,578 Guilty as charged. 783 00:33:16,661 --> 00:33:18,538 Hey, I just got word that the at-home morphine pump 784 00:33:18,622 --> 00:33:19,706 is gonna be delayed. 785 00:33:19,789 --> 00:33:21,374 Hospital pharmacy has to mix it 786 00:33:21,458 --> 00:33:22,918 and then deliver it later today. 787 00:33:23,001 --> 00:33:24,669 Well, should we keep her here until it's ready? 788 00:33:24,753 --> 00:33:26,004 No, you can give her 789 00:33:26,087 --> 00:33:27,672 a 200-milligram tablet of MS Contin. 790 00:33:27,756 --> 00:33:29,841 - 200 milligrams? - Biggest pill they make. 791 00:33:29,925 --> 00:33:33,261 Releases over 12 hours for patients with opiate tolerance. 792 00:33:33,345 --> 00:33:34,846 Got it. 793 00:33:34,930 --> 00:33:36,306 Hey, do you want to stick around a little bit? 794 00:33:36,389 --> 00:33:37,766 Westbridge is closed to internal disaster. 795 00:33:37,849 --> 00:33:39,059 - We're getting all their runs. - Yeah, I heard. 796 00:33:39,142 --> 00:33:40,602 I put 20 bucks on a plumbing issue. 797 00:33:40,685 --> 00:33:42,479 I just watched that poop cruise documentary. 798 00:33:42,562 --> 00:33:44,272 Oh, I cannot stop thinking about it. 799 00:33:44,356 --> 00:33:46,399 That sounds like something I will absolutely never watch. 800 00:33:46,483 --> 00:33:47,984 Dr. Robby, 801 00:33:48,068 --> 00:33:50,570 you gave us a clozapine ileus about an hour ago. 802 00:33:50,654 --> 00:33:52,197 Your resident reported no surgical history, 803 00:33:52,280 --> 00:33:54,449 but the chart says they've had an appendectomy. 804 00:33:54,533 --> 00:33:56,535 We're not admitting the patient without a surgery consult. 805 00:33:56,618 --> 00:33:58,870 - Who called it in? - A Dr. Trinity Santos. 806 00:33:58,954 --> 00:34:02,207 Dr. Santos, you had an ileus patient. 807 00:34:02,290 --> 00:34:04,626 You neglected to mention a history of appendectomy. 808 00:34:04,709 --> 00:34:06,711 There was no history of appendectomy. 809 00:34:06,795 --> 00:34:08,129 It was in your note. 810 00:34:08,213 --> 00:34:10,924 I may have forgotten to proof check it. 811 00:34:11,007 --> 00:34:13,051 I was using the app that Dr. Al-Hashimi suggested 812 00:34:13,134 --> 00:34:14,177 to catch up on my charting. 813 00:34:14,261 --> 00:34:15,679 Wonderful. 814 00:34:15,762 --> 00:34:17,681 - Ah, Dr. Al-Hashimi. - Yes? 815 00:34:17,764 --> 00:34:21,268 Dr. Santos was just using your AI tool for her charting, 816 00:34:21,351 --> 00:34:24,563 and it hallucinated a history of appendicitis. 817 00:34:24,646 --> 00:34:27,857 As I mentioned to Dr. Santos, generative AI is not perfect. 818 00:34:27,941 --> 00:34:30,277 We still need to proofread every chart it creates. 819 00:34:30,360 --> 00:34:32,904 Mm-hmm, the patient also has a history of headache, 820 00:34:32,988 --> 00:34:35,031 followed by Dr. Park from Urology. 821 00:34:35,115 --> 00:34:37,742 That should probably be Neurology. 822 00:34:37,826 --> 00:34:39,995 Unless urologists are now treating migraines. 823 00:34:40,078 --> 00:34:41,413 Another example that should have been caught 824 00:34:41,496 --> 00:34:43,039 by proofreading. 825 00:34:43,123 --> 00:34:45,375 AI's 2% error rate is still better than dictation. 826 00:34:45,458 --> 00:34:46,876 Yeah, I don't really give a shit whether or not 827 00:34:46,960 --> 00:34:48,920 you want to use robots down here. 828 00:34:49,004 --> 00:34:51,381 I need accurate information in the medical record. 829 00:34:51,464 --> 00:34:52,841 - Understood. - OK. 830 00:34:52,924 --> 00:34:55,510 Dr. Santos. 831 00:34:55,594 --> 00:34:57,554 Dr. Santos! 832 00:34:57,637 --> 00:34:59,431 Yup. Won't happen again. 833 00:35:02,183 --> 00:35:03,184 Hoy. 834 00:35:04,894 --> 00:35:06,271 Thanks, Perlah. 835 00:35:06,354 --> 00:35:08,648 Six hours to go. You got this. 836 00:35:10,483 --> 00:35:13,486 When a wound is gaping like this, 837 00:35:13,570 --> 00:35:15,905 you want to use sub-Q to bring the edges together. 838 00:35:15,989 --> 00:35:17,699 A lot of meat to close. 839 00:35:17,782 --> 00:35:21,161 What would happen if we just did a simple wound closure? 840 00:35:21,244 --> 00:35:22,912 You take the stitches out in ten days, 841 00:35:22,996 --> 00:35:24,831 the wound opens, dehisces. 842 00:35:24,914 --> 00:35:26,166 Exactly. 843 00:35:26,249 --> 00:35:28,209 So what suture do we use under the skin? 844 00:35:28,293 --> 00:35:29,753 Vicryl provides support for a month. 845 00:35:29,836 --> 00:35:31,296 It takes two months to dissolve. 846 00:35:31,379 --> 00:35:34,633 Mm-hmm. So 5-0 nylon on the skin. 847 00:35:34,716 --> 00:35:36,718 4-0 vicryl under the skin. 848 00:35:36,801 --> 00:35:38,845 I'd go with a 3-0 vicryl. 849 00:35:38,928 --> 00:35:41,473 - You think? - Most definitely. 850 00:35:41,556 --> 00:35:43,850 Donnie is the master of wound closure. 851 00:35:43,933 --> 00:35:47,228 I do at least ten lacs a day out at triage, so… 852 00:35:47,312 --> 00:35:51,191 Can we see your sub-Q? 853 00:35:51,274 --> 00:35:52,817 Be my guest. 854 00:35:52,901 --> 00:35:54,903 If you insist. 855 00:35:59,407 --> 00:36:01,618 So… 856 00:36:01,701 --> 00:36:05,080 the secret is to be sure your entry point 857 00:36:05,163 --> 00:36:07,874 and exit point on both sides of the wound 858 00:36:07,957 --> 00:36:10,794 matches the depth on the other side. 859 00:36:10,877 --> 00:36:12,128 S… 860 00:36:15,632 --> 00:36:17,300 Start deep. 861 00:36:17,384 --> 00:36:21,262 Come up at the dermis. 862 00:36:21,346 --> 00:36:24,099 Big bites help the tissue close. 863 00:36:26,851 --> 00:36:30,021 It's a mirror image on the other side. 864 00:36:30,105 --> 00:36:32,691 Superficial to deep. 865 00:36:34,567 --> 00:36:37,237 - So you bury the knot. - Bingo. 866 00:36:37,320 --> 00:36:40,073 Avoids bumps on the scar line. 867 00:36:40,156 --> 00:36:43,827 Three ties, not four. 868 00:36:43,910 --> 00:36:46,246 Yeah, that's beautiful. 869 00:36:46,329 --> 00:36:49,416 And then you cut it short. 870 00:36:49,499 --> 00:36:51,042 Not too short. 871 00:36:51,126 --> 00:36:54,713 I like to slide my scissors 872 00:36:54,796 --> 00:36:57,841 down on the knot, 873 00:36:57,924 --> 00:37:03,096 then rotate up 45 degrees before I cut. 874 00:37:03,179 --> 00:37:05,265 Could use two more sub-Qs, 875 00:37:05,348 --> 00:37:08,476 one above, one below. 876 00:37:08,560 --> 00:37:09,644 Have at it. 877 00:37:12,063 --> 00:37:15,066 Interesting ink. Do they mean anything? 878 00:37:17,068 --> 00:37:20,655 This, this is "death and chaos," 879 00:37:20,739 --> 00:37:23,116 and this is "miracles and blessings." 880 00:37:23,199 --> 00:37:26,870 Got this one after the PittFest shooting, 881 00:37:26,953 --> 00:37:31,207 and I got this after my daughter was born. 882 00:37:33,793 --> 00:37:35,086 Put the head of the gurney up 883 00:37:35,170 --> 00:37:37,046 so people can see him, but not so high 884 00:37:37,130 --> 00:37:39,174 that his head flops to the side. 885 00:37:43,428 --> 00:37:44,679 What do you think? 886 00:37:44,763 --> 00:37:47,265 He looks peaceful. 887 00:37:47,348 --> 00:37:49,851 What's the hardest part of this job? 888 00:37:49,934 --> 00:37:51,686 It's pretty thankless, and that can be tough. 889 00:37:51,770 --> 00:37:53,104 You've seen burnout rates. 890 00:37:53,188 --> 00:37:54,898 I'm sure they teach you that in school. 891 00:37:54,981 --> 00:37:57,984 All my closest friends left after COVID. 892 00:37:58,067 --> 00:38:00,028 Some during. 893 00:38:00,111 --> 00:38:01,821 But I don't blame them. 894 00:38:01,905 --> 00:38:04,824 They needed to do what was best for their mental health. 895 00:38:04,908 --> 00:38:07,243 A lot of people broke. 896 00:38:07,327 --> 00:38:09,204 Why do you keep coming back? 897 00:38:11,748 --> 00:38:13,958 Why don't you, um, 898 00:38:14,042 --> 00:38:17,337 just finish up here and then go help Perlah for a bit? 899 00:38:21,549 --> 00:38:22,884 Great. Thank you. 900 00:38:22,967 --> 00:38:24,260 No, that is exactly what I needed to know. 901 00:38:24,344 --> 00:38:25,845 OK. 902 00:38:25,929 --> 00:38:28,473 I just got off the phone with the physician assistant 903 00:38:28,556 --> 00:38:30,975 at the prison; they've got a 16-hour-a-day infirmary 904 00:38:31,059 --> 00:38:33,228 with NP and PA coverage giving everything that we need, 905 00:38:33,311 --> 00:38:35,063 and they've got an RN for overnights. 906 00:38:35,146 --> 00:38:36,689 Even so, he's here because 907 00:38:36,773 --> 00:38:39,317 they're ignoring his basic needs. 908 00:38:39,400 --> 00:38:41,486 He's here because somebody kicked the shit out of him. 909 00:38:41,569 --> 00:38:42,987 I think you're missing the point. 910 00:38:43,071 --> 00:38:44,572 We have more to offer. 911 00:38:44,656 --> 00:38:46,699 Robby, we've got four more coming our way. 912 00:38:46,783 --> 00:38:48,326 OK, got it. 913 00:38:48,409 --> 00:38:49,786 What you're trying to do is very noble. 914 00:38:49,869 --> 00:38:51,204 We don't have the resources to spare. 915 00:38:51,287 --> 00:38:53,498 OK, then why admit the unhoused man, Digby? 916 00:38:53,581 --> 00:38:55,083 Why not send him back to the street 917 00:38:55,166 --> 00:38:56,751 with antibiotics and a roll of gauze? 918 00:38:56,835 --> 00:38:58,378 Because Digby lives on the street, 919 00:38:58,461 --> 00:39:01,005 and your incarcerated patient has a mid-level provider 920 00:39:01,089 --> 00:39:02,549 and a nurse looking after him. 921 00:39:02,632 --> 00:39:04,801 We both know the quality of care is not the same. 922 00:39:04,884 --> 00:39:05,870 Sorry, are you waiting for me? 923 00:39:05,885 --> 00:39:07,178 No. 924 00:39:07,262 --> 00:39:08,805 Dr. Al-Hashimi, for the patient in Seven. 925 00:39:08,888 --> 00:39:10,098 A few days here could make a world of difference 926 00:39:10,181 --> 00:39:11,558 for Gus' health. 927 00:39:11,641 --> 00:39:13,768 We are a safety net, but nets have holes. 928 00:39:13,852 --> 00:39:15,228 We are not admitting him 929 00:39:15,311 --> 00:39:17,063 'cause this is not about social justice. 930 00:39:19,274 --> 00:39:20,733 Everything I've done in my career 931 00:39:20,817 --> 00:39:23,194 is an effort to improve the system. 932 00:39:23,278 --> 00:39:24,904 Just because you know it's broken 933 00:39:24,988 --> 00:39:27,448 doesn't mean you stop trying. 934 00:39:27,532 --> 00:39:28,950 Excuse me. 935 00:39:33,413 --> 00:39:35,456 I talked to Jackson's girlfriend. 936 00:39:35,540 --> 00:39:36,624 OK. 937 00:39:36,708 --> 00:39:38,626 She told me a lot of stuff. 938 00:39:38,710 --> 00:39:41,045 Um, she wants to come see him, 939 00:39:41,129 --> 00:39:43,840 but I just don't think that's a good idea. 940 00:39:43,923 --> 00:39:46,301 And my…my parents are asking a lot of questions. 941 00:39:46,384 --> 00:39:48,219 Can I just take him home? 942 00:39:48,303 --> 00:39:49,762 I'm so sorry. 943 00:39:49,846 --> 00:39:51,931 Your…your brother is on an involuntary psych hold. 944 00:39:52,015 --> 00:39:53,266 He can't leave. 945 00:39:53,349 --> 00:39:54,392 It could take us weeks to figure out 946 00:39:54,475 --> 00:39:55,727 what's wrong with him. 947 00:39:55,810 --> 00:39:57,645 What's wrong with him? 948 00:39:57,729 --> 00:39:59,480 I'm so sorry. I did not mean it like that. 949 00:39:59,564 --> 00:40:00,815 What's… 950 00:40:00,899 --> 00:40:02,150 Why don't we go somewhere quiet, yeah? 951 00:40:02,233 --> 00:40:04,319 What's wrong with him? 952 00:40:04,402 --> 00:40:07,655 - Let's go over here. - What's wrong with him? 953 00:40:07,739 --> 00:40:09,616 What's wrong with him? 954 00:40:11,326 --> 00:40:13,286 What's wrong with him? 955 00:40:23,463 --> 00:40:25,089 How's she doing? 956 00:40:25,173 --> 00:40:27,300 She took three ounces of formula 957 00:40:27,383 --> 00:40:28,718 without vomiting or distress. 958 00:40:28,801 --> 00:40:30,219 Excellent. 959 00:40:30,303 --> 00:40:33,139 Dr. Wolke from Pedes should be down shortly. 960 00:40:33,222 --> 00:40:36,059 Yeah. I think I saw her smile. 961 00:40:36,142 --> 00:40:39,270 A true social smile where the baby is awake, alert, 962 00:40:39,354 --> 00:40:41,064 and responding to facial expressions 963 00:40:41,147 --> 00:40:43,608 usually doesn't happen until six weeks or older. 964 00:40:43,691 --> 00:40:45,318 It was likely a reflex smile that happens 965 00:40:45,401 --> 00:40:48,404 while they're sleeping. 966 00:40:48,488 --> 00:40:52,033 But some parents have reported their babies 967 00:40:52,116 --> 00:40:54,535 smiled socially as early as four weeks, 968 00:40:54,619 --> 00:40:57,497 so who knows? 969 00:40:57,580 --> 00:40:59,082 - Jesse. - Hmm? 970 00:40:59,165 --> 00:41:00,750 North 4 needs a blood draw when you have a sec. 971 00:41:00,833 --> 00:41:01,876 Got it. 972 00:41:01,960 --> 00:41:03,086 How we doing in here? 973 00:41:03,169 --> 00:41:04,295 Almost ready to head out. 974 00:41:04,379 --> 00:41:05,463 Looking good. 975 00:41:05,546 --> 00:41:06,546 Heart rate 91. 976 00:41:06,589 --> 00:41:08,174 BP is 115 over 82. 977 00:41:08,257 --> 00:41:10,093 Oxygen sat's 95%. 978 00:41:10,176 --> 00:41:11,719 Great. 979 00:41:11,803 --> 00:41:13,221 I'm sending him home with some nonstick dressing 980 00:41:13,304 --> 00:41:14,681 in case they don't stock them. 981 00:41:14,764 --> 00:41:16,432 Grab some burn net too. 982 00:41:16,516 --> 00:41:19,060 He's a good guy. He's a local. 983 00:41:19,143 --> 00:41:21,437 Yeah? You're from Pittsburgh? 984 00:41:21,521 --> 00:41:23,064 Yes, ma'am. Born and raised. 985 00:41:23,147 --> 00:41:24,232 Whereabouts? 986 00:41:24,315 --> 00:41:26,526 Bloomfield, Liberty Ave. 987 00:41:26,609 --> 00:41:29,112 Bloomfield? 988 00:41:29,195 --> 00:41:30,780 You know Sonny's Tavern? 989 00:41:30,863 --> 00:41:32,407 Worked there through high school. 990 00:41:32,490 --> 00:41:34,325 - No kidding. - You know Sonny's? 991 00:41:35,910 --> 00:41:39,080 Had my first kiss there. 992 00:41:39,163 --> 00:41:41,541 Hey, Donnie, my buddy Duke hasn't checked in yet? 993 00:41:41,624 --> 00:41:43,251 Nah, I told Lupe to keep an eye out. 994 00:41:43,334 --> 00:41:44,752 - Thank you. - Yep. 995 00:41:44,836 --> 00:41:47,130 Right, left. Right, left. Yeah. That's it. 996 00:41:50,800 --> 00:41:52,176 You back to check our work? 997 00:41:52,260 --> 00:41:54,345 Nope. I need a silastic loop drain. 998 00:41:54,429 --> 00:41:56,431 That looks great. 999 00:41:56,514 --> 00:41:58,224 It's thanks to your fine instruction. 1000 00:41:58,307 --> 00:42:02,228 OK, he's going to need Kerlix and Xeroform. 1001 00:42:02,311 --> 00:42:04,105 You should throw a neoprene sleeve on him. 1002 00:42:04,188 --> 00:42:05,857 Limits the range of motion at the knee 1003 00:42:05,940 --> 00:42:07,650 - so the sutures don't pull out. - That's a good idea. 1004 00:42:07,734 --> 00:42:08,943 Must be fun to work here. 1005 00:42:09,027 --> 00:42:11,779 Oh, sure is. First week for these two. 1006 00:42:11,863 --> 00:42:13,239 How are you guys liking the Pitt? 1007 00:42:13,322 --> 00:42:14,741 I feel like I was born to do this. 1008 00:42:15,992 --> 00:42:17,201 Hard pass. 1009 00:42:17,285 --> 00:42:19,162 I'm shooting for pathology. 1010 00:42:19,245 --> 00:42:20,580 I like medical mysteries, 1011 00:42:20,663 --> 00:42:22,749 but I don't really deal well with people. 1012 00:42:22,832 --> 00:42:24,625 You have an interesting energy. 1013 00:42:24,709 --> 00:42:26,461 What's that for? 1014 00:42:26,544 --> 00:42:28,629 Splint starts at the knuckles, 1015 00:42:28,713 --> 00:42:32,175 comes up and around the elbow, 1016 00:42:32,258 --> 00:42:34,552 and back down to the palm. 1017 00:42:34,635 --> 00:42:37,388 It needs to be smaller. I can't ride with a splint. 1018 00:42:37,472 --> 00:42:38,848 Well, no, you shouldn't be riding at all. 1019 00:42:38,931 --> 00:42:40,808 Right now, that's a non-displaced fracture. 1020 00:42:40,892 --> 00:42:43,853 If you fall on it again, you're gonna need to go to the OR. 1021 00:42:43,936 --> 00:42:47,065 No worries, Doc. I won't fall again. 1022 00:42:47,148 --> 00:42:48,357 Uh-huh. 1023 00:42:50,318 --> 00:42:52,195 Robby, pulse ox just dropped. 1024 00:42:52,278 --> 00:42:53,696 What happened? 1025 00:42:53,780 --> 00:42:55,156 I don't know. I stepped out for a minute. 1026 00:42:55,239 --> 00:42:56,991 It's down to 85%. 1027 00:42:57,075 --> 00:42:58,409 Are you having some trouble breathing? 1028 00:42:58,493 --> 00:42:59,952 A little. 1029 00:43:00,036 --> 00:43:01,621 Start him on 2 liters oxygen, nasal cannula. 1030 00:43:01,704 --> 00:43:03,206 Titrate to 5. 1031 00:43:03,289 --> 00:43:04,832 Keep the pulse ox at 92 or higher 1032 00:43:04,916 --> 00:43:08,252 and have a rebreather standing by just in case. 1033 00:43:08,336 --> 00:43:10,088 He's gonna have to stay. 1034 00:43:10,171 --> 00:43:11,839 For how long? 1035 00:43:11,923 --> 00:43:14,634 Not sure. 1036 00:43:14,717 --> 00:43:16,511 Sorry, boss, I only stepped out for a second. 1037 00:43:16,594 --> 00:43:18,054 Let me know if anything changes. 1038 00:43:18,137 --> 00:43:19,639 You were in the room when his pulse ox dropped? 1039 00:43:19,722 --> 00:43:20,890 - I was. - What were you doing? 1040 00:43:20,973 --> 00:43:22,642 D, still can't get a hold of Ortho. 1041 00:43:22,725 --> 00:43:25,937 Leave them to me. 1042 00:43:26,020 --> 00:43:28,231 - Feeling better? - Oh, so much better. 1043 00:43:28,314 --> 00:43:31,400 Well, I wrote you a script for Zofran, just in case. 1044 00:43:31,484 --> 00:43:33,861 Thanks. I think I cleared it all out. 1045 00:43:33,945 --> 00:43:36,531 - So no more hot dogs, right? - Oh, not today. 1046 00:43:36,614 --> 00:43:38,032 But I'll be back next year. 1047 00:43:38,116 --> 00:43:39,367 - Got to defend my title! - Yo. 1048 00:43:39,450 --> 00:43:40,785 OK, well, best of luck to you. 1049 00:43:40,868 --> 00:43:42,328 They got a Wiener World truck outside. 1050 00:43:42,411 --> 00:43:43,955 You want one? 1051 00:43:44,038 --> 00:43:45,665 I think I'm good on hot dogs for the rest of my life. 1052 00:43:45,748 --> 00:43:47,542 Wait, didn't I just see you eating a doughnut? 1053 00:43:47,625 --> 00:43:49,210 Don't judge. 1054 00:43:49,293 --> 00:43:50,795 Stay here for a sec. 1055 00:43:56,843 --> 00:43:59,178 - Transport ambulance is here. - Thanks, Princess. 1056 00:43:59,262 --> 00:44:01,639 This is a 200-milligram MS Contin. 1057 00:44:01,722 --> 00:44:04,976 This will give you 12 hours of relief. 1058 00:44:05,059 --> 00:44:06,853 - OK. - Mm. 1059 00:44:06,936 --> 00:44:08,312 Yes. 1060 00:44:10,231 --> 00:44:11,941 Whenever you're ready, Rox. 1061 00:44:12,024 --> 00:44:13,860 Hey, guys, this is Roxie Hamler. 1062 00:44:13,943 --> 00:44:15,653 Hello, ma'am. 1063 00:44:15,736 --> 00:44:17,738 - Easy on the transfer, guys. - Yeah. 1064 00:44:24,412 --> 00:44:26,539 OK, on my count. 1065 00:44:26,622 --> 00:44:29,417 No, no, no. This isn't gonna work out. 1066 00:44:31,002 --> 00:44:32,587 I'm sorry. 1067 00:44:32,670 --> 00:44:34,255 I can't…I can't… 1068 00:44:34,338 --> 00:44:37,884 I can't…I can't do this. 1069 00:44:37,967 --> 00:44:40,928 - It's OK. - I want to stay. 1070 00:44:41,012 --> 00:44:44,682 Please. 1071 00:44:44,765 --> 00:44:47,810 It's OK. 1072 00:44:47,894 --> 00:44:49,729 Can I assume that you've already called upstairs 1073 00:44:49,812 --> 00:44:51,606 to get Gus Varney a bed? 1074 00:44:51,689 --> 00:44:53,900 Do you want to tell me what you did? 1075 00:44:53,983 --> 00:44:56,402 I don't know what you're talking about. 1076 00:44:56,485 --> 00:44:59,322 His pulse ox was steady. We were about to discharge him. 1077 00:44:59,405 --> 00:45:01,115 Did Dr. Al-Hashimi put you up to that? 1078 00:45:01,199 --> 00:45:03,451 Al-Hashimi? No. 1079 00:45:03,534 --> 00:45:04,952 You know he's gonna go back to prison 1080 00:45:05,036 --> 00:45:08,748 after they discharge him upstairs. 1081 00:45:08,831 --> 00:45:10,499 I thought you didn't go the extra distance 1082 00:45:10,583 --> 00:45:11,918 for your patients anymore. 1083 00:45:18,591 --> 00:45:21,093 - It's Emma, right? - Yeah. 1084 00:45:21,177 --> 00:45:22,720 How's your first day going? 1085 00:45:22,803 --> 00:45:24,472 Good, I think. 1086 00:45:24,555 --> 00:45:27,850 Haven't killed anyone yet. 1087 00:45:27,934 --> 00:45:31,229 - I'm sorry. I… - It's OK. 1088 00:45:31,312 --> 00:45:34,774 I guess time will tell if I'm cut out for this. 1089 00:45:34,857 --> 00:45:38,486 Well, when in doubt, stick with her, kid. 1090 00:45:38,569 --> 00:45:39,987 She scares me. 1091 00:45:40,071 --> 00:45:42,657 No, that's just a… it's a tough exterior. 1092 00:45:42,740 --> 00:45:46,452 She's warm and gooey on the inside. 1093 00:45:46,535 --> 00:45:49,330 Looks like they're doing the debrief for Louie. 1094 00:45:49,413 --> 00:45:51,374 - You coming? - I paid my respects. 1095 00:45:51,457 --> 00:45:53,584 Besides, who's gonna hold down the fort? 1096 00:46:05,721 --> 00:46:08,140 Remember the day you found him passed out in the park? 1097 00:46:08,224 --> 00:46:09,392 Sure do. 1098 00:46:09,475 --> 00:46:10,893 I had to drag his ass over here. 1099 00:46:10,977 --> 00:46:12,311 Came in soaked to the bone. 1100 00:46:12,395 --> 00:46:14,105 You saved his life. 1101 00:46:14,188 --> 00:46:16,148 How about last summer when we didn't see him for months? 1102 00:46:16,232 --> 00:46:17,608 He said he finally quit drinking, 1103 00:46:17,692 --> 00:46:19,402 - so he didn't need to come in. - Mm-hmm. 1104 00:46:19,485 --> 00:46:21,821 How many times did he say he was gonna quit drinking? 1105 00:46:21,904 --> 00:46:23,906 Mm-hmm. 1106 00:46:23,990 --> 00:46:26,534 He always asked about Harrison. 1107 00:46:26,617 --> 00:46:28,953 - Always said thank you. - Mm-hmm. 1108 00:46:29,036 --> 00:46:32,373 Found this with his stuff. 1109 00:46:32,456 --> 00:46:33,958 Who knew he was married? 1110 00:46:36,711 --> 00:46:39,171 That's Rhonda, Louie's wife. 1111 00:46:39,255 --> 00:46:41,090 High school sweetheart. 1112 00:46:41,173 --> 00:46:44,218 About five years ago, I was covering a night shift. 1113 00:46:44,302 --> 00:46:47,471 He came in feeling talkative. 1114 00:46:47,555 --> 00:46:49,098 Born and raised in Pittsburgh. 1115 00:46:49,181 --> 00:46:51,475 Lifelong Steelers fan. 1116 00:46:51,559 --> 00:46:53,227 Groundskeeper at Three Rivers Stadium 1117 00:46:53,311 --> 00:46:54,645 until 1998. 1118 00:46:57,481 --> 00:47:00,276 He never really wanted kids, 1119 00:47:00,359 --> 00:47:02,695 but Rhonda wore him down, 1120 00:47:02,778 --> 00:47:04,322 and when she finally got pregnant, 1121 00:47:04,405 --> 00:47:07,074 he changed his tune, he got excited. 1122 00:47:10,494 --> 00:47:12,747 And then about a month before the baby was due, 1123 00:47:12,830 --> 00:47:15,833 Rhonda and the baby were killed in a car crash. 1124 00:47:19,128 --> 00:47:21,589 Louie never really came back from that. 1125 00:47:25,634 --> 00:47:28,012 May his memory be a blessing. 1126 00:47:28,095 --> 00:47:30,348 - Amen. - May his memory be a blessing. 1127 00:47:32,433 --> 00:47:33,684 Yep.