1 00:00:11,637 --> 00:00:14,765 Structural collapse at the water park… two victims coming in via helicopter. 2 00:00:14,848 --> 00:00:17,351 - ETA, five minutes. - Time to rally the troops. 3 00:00:17,434 --> 00:00:19,645 I'll get environmental to clear and prep the trauma rooms. 4 00:00:19,728 --> 00:00:20,729 Emma, restock the crash carts. 5 00:00:20,812 --> 00:00:22,773 Makedah, take the latest scripts to the drug cage. 6 00:00:22,856 --> 00:00:25,150 - Should be a fun one. - "Fun one"? What's up? 7 00:00:25,234 --> 00:00:27,778 Slide broke at the water park… two victims, five minutes to touchdown. 8 00:00:27,861 --> 00:00:30,364 - No information on extent of injuries. - I can jump in with… 9 00:00:30,447 --> 00:00:34,576 Ogilvie, grab some goggles, gloves, gown. Go up to the roof. 10 00:00:34,660 --> 00:00:36,745 First patient that lands, bring 'em down. 11 00:00:36,828 --> 00:00:39,373 We got two choppers. You want to grab some bodies and meet me? 12 00:00:39,456 --> 00:00:42,793 - What injuries are we expecting? - Structural collapse. Could be anything. 13 00:00:42,876 --> 00:00:46,380 I can increase the morphine drip to manage the pain, 14 00:00:46,463 --> 00:00:49,049 but that could also slow down your breathing. 15 00:00:49,132 --> 00:00:52,886 You will likely feel very drowsy. You may lose consciousness. 16 00:00:54,012 --> 00:00:56,139 And it could cause you to stop breathing altogether. 17 00:01:06,275 --> 00:01:07,901 I'll be right back. 18 00:01:15,284 --> 00:01:18,412 - Hey, you okay? - Yeah. 19 00:01:18,495 --> 00:01:19,788 Yeah. Sorry. 20 00:01:19,871 --> 00:01:23,417 Look, it's hard seeing your patients die. 21 00:01:23,500 --> 00:01:27,421 But as professionals, we have to create emotional boundaries for ourselves. 22 00:01:27,504 --> 00:01:29,923 It's not about us. It's about them. 23 00:01:32,009 --> 00:01:34,011 She's so calm. I just… 24 00:01:34,928 --> 00:01:36,430 Yeah. 25 00:01:36,513 --> 00:01:38,682 She's had a long time to prepare for this moment. 26 00:01:39,975 --> 00:01:44,938 What she's doing for her sons… managing this with so much grace… 27 00:01:45,022 --> 00:01:46,648 it's a real gift of love. 28 00:01:46,732 --> 00:01:48,525 I feel like an asshole. 29 00:01:49,568 --> 00:01:51,612 All they want is more time with their mother. 30 00:01:51,695 --> 00:01:53,447 All I want is less time with mine. 31 00:01:53,530 --> 00:01:55,407 Don't feel guilty. 32 00:01:55,490 --> 00:01:59,661 I mean, you can be grateful and gracious from a distance. 33 00:01:59,745 --> 00:02:02,456 Just talk to her. Tell her what you want. She'll understand. 34 00:02:05,125 --> 00:02:06,335 I doubt that. 35 00:02:07,711 --> 00:02:10,839 Give her a chance, you know? She may surprise you. 36 00:02:13,300 --> 00:02:14,718 Hey. 37 00:02:14,801 --> 00:02:16,678 Two birds headed our way. Need a hand? 38 00:02:16,762 --> 00:02:18,472 That's the rumor. 39 00:02:18,555 --> 00:02:20,390 Santos, trauma incoming. 40 00:02:20,474 --> 00:02:22,976 Grab a gown. You can assist Dr. Langdon. 41 00:02:25,979 --> 00:02:27,272 Fuck me. 42 00:02:27,356 --> 00:02:29,900 Jesus, I got blood tubes growing moss over here. 43 00:02:29,983 --> 00:02:31,985 Ticktock, people. 44 00:02:32,069 --> 00:02:34,279 Hey, Olive, do me a solid… run these to the lab. 45 00:02:34,363 --> 00:02:35,489 No problem. 46 00:02:35,572 --> 00:02:37,366 I got more lab results. 47 00:02:37,449 --> 00:02:39,493 Start putting them on the patient clipboards, 48 00:02:39,576 --> 00:02:41,703 PTMC Emergency. Go ahead, Medic Command. 49 00:02:41,787 --> 00:02:43,372 Do cyberattacks happen often? 50 00:02:43,455 --> 00:02:45,582 - More than you realize. - I blame the Russkies. 51 00:02:45,666 --> 00:02:48,669 Dr. Mohan, it's your mother? 52 00:02:48,752 --> 00:02:50,379 She sounds pretty upset. 53 00:02:50,462 --> 00:02:52,798 Says she really needs to talk to you. 54 00:02:53,799 --> 00:02:55,801 You're shitting me. Tell her I'm not available. 55 00:03:06,186 --> 00:03:07,479 How's your shift going? 56 00:03:08,397 --> 00:03:10,524 It's been a lot already. 57 00:03:11,608 --> 00:03:14,194 You know, I worked in an ER before, up in Vermont, 58 00:03:14,277 --> 00:03:17,948 and we had MVAs and ODs, MIs. 59 00:03:18,031 --> 00:03:19,199 But this place… 60 00:03:20,033 --> 00:03:21,493 …this place is relentless. 61 00:03:22,202 --> 00:03:25,038 Holiday weekend. We're not normally offline. 62 00:03:26,039 --> 00:03:28,709 I think we have a very different idea of normal. 63 00:03:28,792 --> 00:03:30,168 It's not for everyone. 64 00:03:30,252 --> 00:03:33,338 - I'm not sure it's healthy for anybody. - Here's her leg. 65 00:03:34,423 --> 00:03:36,049 Jesus. 66 00:03:43,432 --> 00:03:45,976 - I need more runners. - Oh, you could shut down the gift shop. 67 00:03:46,059 --> 00:03:48,145 They always have a couple of volunteers there. 68 00:03:48,228 --> 00:03:50,147 Most of those volunteers use walkers. 69 00:03:50,230 --> 00:03:51,773 Beggars can't be choosers. 70 00:03:51,857 --> 00:03:53,191 Go get 'em. 71 00:03:53,275 --> 00:03:55,569 - Okay, I'm gonna grab a smoke first. - No time. 72 00:03:55,652 --> 00:03:57,154 Nicotine gum…take the edge off. 73 00:03:57,237 --> 00:03:59,781 You two, head to triage to help out the front of the house. 74 00:03:59,865 --> 00:04:02,576 They're running out of space, and there's a line out the door. 75 00:04:02,659 --> 00:04:05,245 - Okay, let's go. - Hang on, Mohan. 76 00:04:06,872 --> 00:04:08,123 Sign this. 77 00:04:10,459 --> 00:04:12,377 Nicotine patch, 21 milligrams. 78 00:04:12,461 --> 00:04:15,005 - Who's it for? - Monica. This nicotine gum's shit. 79 00:04:15,088 --> 00:04:18,133 She'll never survive the shift, and I need her so I don't lose my goddamn mind. 80 00:04:20,886 --> 00:04:22,095 Thanks. 81 00:04:22,179 --> 00:04:23,847 Is Dr. Abbot still around? 82 00:04:23,930 --> 00:04:26,600 He went to get some sleep before his night shift starts in a couple hours. 83 00:04:26,683 --> 00:04:29,394 Shit. Okay, I should have planned this better. 84 00:04:29,478 --> 00:04:32,189 I was hoping he'd write me a letter of rec for an elective 85 00:04:32,272 --> 00:04:34,566 so I could have a shot at a fellowship next year. 86 00:04:34,649 --> 00:04:35,692 Which one? 87 00:04:36,902 --> 00:04:38,195 Whichever will take me. 88 00:04:38,278 --> 00:04:40,405 Didn't the electives fill up a while ago? 89 00:04:40,489 --> 00:04:42,824 Don't remind me. I'm gonna throw myself at the mercy of the court, 90 00:04:42,908 --> 00:04:44,826 beg for them to take me anyway. 91 00:04:44,910 --> 00:04:47,621 Just kill me now. It'll be less painful. 92 00:04:47,704 --> 00:04:49,748 Dana, I can't read this handwriting. 93 00:04:49,831 --> 00:04:50,916 It says… 94 00:04:51,917 --> 00:04:56,421 …1,000 milligrams acetaminophen orally, 4 milligrams ondansetron under the tongue, 95 00:04:56,505 --> 00:04:58,632 and trial of clear fluids. 96 00:04:58,715 --> 00:05:00,425 Seriously? It says all that? 97 00:05:00,509 --> 00:05:03,220 If it's not in a text with emojis, you kids can't read for shit. 98 00:05:06,515 --> 00:05:07,557 What do we have? 99 00:05:07,641 --> 00:05:09,559 A fall from 10 feet onto a metal fence. 100 00:05:09,643 --> 00:05:11,937 Right below the knee. Good vitals. 101 00:05:12,020 --> 00:05:13,688 Oh, it hurts. Oh, my God. 102 00:05:13,772 --> 00:05:16,066 - What's she had so far? - 50 of fent, repeated 25. 103 00:05:16,149 --> 00:05:17,442 No meds, no allergies. 104 00:05:17,526 --> 00:05:19,778 - Where should I put this? - Just hang on to it for now. 105 00:05:19,861 --> 00:05:23,657 On my count. One, two, three. 106 00:05:25,450 --> 00:05:28,578 Okay, Whitaker, E-FAST. Donnie, primary survey, please. 107 00:05:28,662 --> 00:05:30,747 Pupils equal and reactive. 108 00:05:31,456 --> 00:05:33,875 - What's your name? - My leg hurts really bad. 109 00:05:33,959 --> 00:05:35,669 Did I break it? 110 00:05:35,752 --> 00:05:37,212 I wouldn't say that it's broken exactly. 111 00:05:37,295 --> 00:05:39,464 We're gonna get an X-ray to determine that. 112 00:05:39,548 --> 00:05:41,466 Put that on the gurney, line it up for X-ray, 113 00:05:41,550 --> 00:05:42,884 keep your fucking mouth shut. 114 00:05:42,968 --> 00:05:44,761 Good lung sliding right and left. 115 00:05:44,845 --> 00:05:46,847 Airway patent, breath sounds bilaterally. 116 00:05:47,556 --> 00:05:49,933 - Please, it hurts. - BP 100 over 60. 117 00:05:50,016 --> 00:05:52,978 Pulse 118, pulse ox 98%. 118 00:05:53,061 --> 00:05:56,273 - Does your belly hurt? - No, asshole! It's my leg! 119 00:05:56,356 --> 00:05:59,401 - Okay, she's really moving here. - 100 of ketamine? 120 00:05:59,484 --> 00:06:01,319 Yeah, we can't evaluate like this. 121 00:06:02,362 --> 00:06:03,989 Hey, Ogilvie? 122 00:06:04,072 --> 00:06:06,157 - Deep breaths, yeah? - Yeah, okay. 123 00:06:06,241 --> 00:06:07,701 Whitaker, what's next? 124 00:06:07,784 --> 00:06:10,245 Once she's sedated, finish the E-FAST, 125 00:06:10,328 --> 00:06:12,163 plain X-ray, check her back, straight to CT. 126 00:06:12,247 --> 00:06:14,499 - What if the ketamine wears off? - Right. 127 00:06:14,583 --> 00:06:18,128 We should do a popliteal nerve block before the CT, 128 00:06:18,211 --> 00:06:20,046 anesthetize from the knee down. 129 00:06:20,130 --> 00:06:22,132 - Two view tib-fib. - Pushing ketamine now. 130 00:06:22,215 --> 00:06:24,926 - What's the bullet? - 42-year-old male with 20-foot fall. 131 00:06:25,010 --> 00:06:27,012 Blunt chest trauma with hand injury. 132 00:06:27,554 --> 00:06:29,472 Where's my son? Where's my son? 133 00:06:29,556 --> 00:06:31,850 He's tachy to 108, sats 98 on 2 liters, 134 00:06:31,933 --> 00:06:34,561 - BP 122 over 84. - We'll pan scan due to mechanism. 135 00:06:34,644 --> 00:06:36,521 - You? - Tib-fib amputation. 136 00:06:36,605 --> 00:06:39,482 Hoping ortho can give us a little hope for replantation. 137 00:06:39,566 --> 00:06:42,319 - Derek, where are you hurting? - Chest and my finger. 138 00:06:42,402 --> 00:06:43,445 Did they find my son? 139 00:06:43,528 --> 00:06:45,530 - Did you hit your head? - Don't think so. 140 00:06:45,614 --> 00:06:46,948 I need to find my son! 141 00:06:47,032 --> 00:06:49,326 We'll find him for you, but we need to take care of you first. 142 00:06:49,409 --> 00:06:52,329 Pericardium's clear. No fluid in Morrison's. 143 00:06:52,412 --> 00:06:53,997 Move both arms, wiggle your feet. 144 00:06:54,623 --> 00:06:56,958 - Good. Any pain in your neck? - No. 145 00:06:57,042 --> 00:06:58,752 - Spleen looks good. - Start with his chest. 146 00:06:58,835 --> 00:07:00,170 That's where he hurts. 147 00:07:00,253 --> 00:07:02,464 - No hemotympanum. - Normal sliding. 148 00:07:03,048 --> 00:07:05,008 Best to start with the side he's complaining about first. 149 00:07:06,635 --> 00:07:08,511 I don't see much sliding there. 150 00:07:08,595 --> 00:07:10,764 His name is Zack. He's seven. 151 00:07:10,847 --> 00:07:12,557 - Pneumothorax? - Set up for a chest tube. 152 00:07:12,641 --> 00:07:16,770 Not yet. Let's go posterolateral. Look for fluid first. 153 00:07:16,853 --> 00:07:18,813 Traumatic pneumothorax. We should prep the chest. 154 00:07:19,522 --> 00:07:21,441 Not necessarily. He's hemodynamically stable. 155 00:07:22,275 --> 00:07:23,568 Okay. 156 00:07:23,652 --> 00:07:25,320 Does that look like some fluid there? 157 00:07:25,403 --> 00:07:26,780 Hard to say for sure. 158 00:07:26,863 --> 00:07:29,574 Okay, he's tachycardic hemopneumothorax. He needs a chest tube. 159 00:07:29,658 --> 00:07:33,578 BP and sats are fine. We can wait for CT. If it's small, it'll resolve on its own. 160 00:07:33,662 --> 00:07:35,997 - We observe and reimage. - I agree. He's stable for now. 161 00:07:36,081 --> 00:07:37,457 Let's wait for the scan, Dr. Santos. 162 00:07:37,540 --> 00:07:39,793 - Okay, let's order… - Okay. 163 00:07:39,876 --> 00:07:42,295 …a CT chest, abdomen, pelvis, and X-ray left hand. 164 00:07:44,089 --> 00:07:46,216 - Major degloving. - Focus on the primary. 165 00:07:46,299 --> 00:07:48,426 Dr. Langdon's correct. We need to logroll him. 166 00:07:50,220 --> 00:07:52,347 Oh, okay. How about another 4 of morphine? 167 00:07:52,430 --> 00:07:53,430 Put it in. 168 00:07:53,473 --> 00:07:55,475 Hang in there, Derek. We got you. 169 00:07:57,727 --> 00:07:59,604 Fuck off already. 170 00:07:59,688 --> 00:08:02,232 - Boyfriend? - Wish. My mom. 171 00:08:02,315 --> 00:08:04,192 Every time I get a second of service, 172 00:08:04,275 --> 00:08:07,028 - another dozen texts come in. - Hey! How much longer do I have to wait? 173 00:08:07,112 --> 00:08:08,738 I got a broken leg here. 174 00:08:08,822 --> 00:08:10,407 Someone will be with you shortly, sir. 175 00:08:10,490 --> 00:08:13,243 Am I allowed to use the bathroom? I really have to go. 176 00:08:13,326 --> 00:08:15,203 I don't know, ma'am. I am not your doctor. 177 00:08:15,286 --> 00:08:18,373 - It says right there "doctor." - Yes, but I'm not your doctor. 178 00:08:18,456 --> 00:08:20,709 But if you go back to your room, a nurse will come find you. 179 00:08:20,792 --> 00:08:22,460 I wasn't in a room. 180 00:08:22,544 --> 00:08:25,422 I'm sorry. Are either of you treating my mother? 181 00:08:25,505 --> 00:08:26,506 Nope! 182 00:08:33,638 --> 00:08:35,724 Take a seat. It's gonna be a while. 183 00:08:39,144 --> 00:08:41,187 Helen Torres, come on down. 184 00:08:42,856 --> 00:08:44,858 Helen Torres? 185 00:08:44,941 --> 00:08:46,359 Yes, I'm coming. 186 00:08:48,945 --> 00:08:52,157 - Go through the door on this side. - Thank you. 187 00:09:00,165 --> 00:09:01,166 Thank you. 188 00:09:06,337 --> 00:09:08,173 I'm Dr. Mohan. This is Student Doctor Kwon. 189 00:09:08,256 --> 00:09:09,257 Helen. 190 00:09:09,340 --> 00:09:11,509 How long has your leg been swollen, Helen? 191 00:09:11,593 --> 00:09:14,220 It's been getting worse over the past week. 192 00:09:14,929 --> 00:09:16,681 Dr. Mohan, your mom called again. 193 00:09:16,765 --> 00:09:18,391 - She said you need to call her back. - Not now! 194 00:09:19,350 --> 00:09:20,560 I'm with a patient. 195 00:09:23,271 --> 00:09:24,397 Sorry about that. 196 00:09:25,774 --> 00:09:27,692 Did you fall or hit your leg? 197 00:09:27,776 --> 00:09:28,902 No. 198 00:09:29,778 --> 00:09:32,697 Have you ever had a blood clot before? 199 00:09:32,781 --> 00:09:33,782 No. 200 00:09:37,410 --> 00:09:39,662 - Are you all right? - Excuse me? 201 00:09:39,746 --> 00:09:42,916 - Do you need to sit down? - Oh, no. I'm fine. 202 00:09:42,999 --> 00:09:44,167 You don't look too good. 203 00:09:44,793 --> 00:09:46,211 What? 204 00:09:46,294 --> 00:09:47,962 No, it's just… 205 00:09:48,046 --> 00:09:49,631 it's really hot in here. 206 00:09:49,714 --> 00:09:50,840 And… 207 00:09:52,175 --> 00:09:54,219 - You need to sit down. - I'm good. 208 00:09:56,012 --> 00:09:57,931 I just need some air. 209 00:09:58,014 --> 00:09:59,599 Excuse me one second. 210 00:10:17,242 --> 00:10:20,078 - You a doctor? - Sorry, Doctor, does this look infected? 211 00:10:20,161 --> 00:10:22,747 I've been waiting six hours, and people keep cutting in front of me. 212 00:10:22,831 --> 00:10:25,959 Doctor, can you just look at my throat just to see if it's strep? 213 00:10:26,042 --> 00:10:27,627 Look out! Make way! 214 00:10:28,837 --> 00:10:30,338 Get in. 215 00:10:30,421 --> 00:10:32,006 No, I'm okay. 216 00:10:32,090 --> 00:10:34,843 - I'm okay. - Get in the fucking chair. 217 00:10:38,054 --> 00:10:39,180 Excuse me, ma'am. 218 00:10:39,264 --> 00:10:41,391 Excuse me, coming through! 219 00:10:41,474 --> 00:10:42,976 Out of my way! 220 00:10:43,059 --> 00:10:46,354 We were going down the water slide, and the bottom just fell off. 221 00:10:46,437 --> 00:10:48,982 I grabbed Zack's arm, and I tried to hold on to the sides, 222 00:10:49,065 --> 00:10:51,192 but my hand slipped, and my ring got stuck. 223 00:10:51,276 --> 00:10:53,069 My finger was ripping off, and I just… 224 00:10:53,862 --> 00:10:55,446 …and I lost him. 225 00:10:56,072 --> 00:10:59,492 We can numb up your finger as soon as we gauge the extent of the injury. 226 00:10:59,576 --> 00:11:01,411 You can cut the damn thing off for all I care. 227 00:11:01,494 --> 00:11:03,037 I just need to find Zack. 228 00:11:03,872 --> 00:11:06,499 - Okay, do you feel anything here? - Yeah, sharp. 229 00:11:06,583 --> 00:11:08,376 - How about here? - Sharp again. 230 00:11:08,459 --> 00:11:09,794 A little late for the show, Yoyo. 231 00:11:09,878 --> 00:11:12,005 I am the show, Dr. Langdon. You're the warm-up act. 232 00:11:12,088 --> 00:11:13,423 I knew somebody missed me. 233 00:11:14,132 --> 00:11:16,801 Mr. Foster suffered a degloving injury of the ring finger. 234 00:11:16,885 --> 00:11:19,012 Stable pneumothorax awaiting imaging. 235 00:11:19,095 --> 00:11:21,681 Hello, sir. I'm Dr. Garcia from the trauma service. 236 00:11:22,307 --> 00:11:23,433 I need the ring cutter. 237 00:11:23,516 --> 00:11:25,310 That's why they pay the surgeons the big bucks. 238 00:11:25,894 --> 00:11:27,896 Possible flexor tendon injury. 239 00:11:29,522 --> 00:11:32,108 Try to bend up your ring finger. 240 00:11:34,652 --> 00:11:36,154 Let's go with the block. 241 00:11:36,237 --> 00:11:39,240 You're gonna feel a pinprick and some burning. 242 00:11:39,324 --> 00:11:41,826 Which tendon did we test, Dr. Santos? 243 00:11:41,910 --> 00:11:43,745 Seriously? That's a med-student question. 244 00:11:44,537 --> 00:11:47,332 We're a teaching hospital. It's always good to review. 245 00:11:48,708 --> 00:11:51,628 Flexor digitorum superficialis is intact 246 00:11:51,711 --> 00:11:54,047 as it inserts on the middle phalanx. 247 00:11:54,130 --> 00:11:56,424 - Correct. - Gee, thanks. 248 00:11:57,133 --> 00:11:58,551 No sign of tension. 249 00:11:59,177 --> 00:12:00,887 At least no tension pneumo. 250 00:12:01,721 --> 00:12:03,640 Let's wait for the CT. I'll be next door. 251 00:12:03,723 --> 00:12:06,434 Langdon, Mel's sister's been asking for you. 252 00:12:06,517 --> 00:12:08,645 She's getting antsy, and we could really use the room. 253 00:12:08,728 --> 00:12:10,897 - CT's ready. - Okay. Let Becca know I'll be there soon. 254 00:12:10,980 --> 00:12:14,275 And Mr. Foster got separated from his son Zack 255 00:12:14,359 --> 00:12:15,652 at the water park. 256 00:12:15,735 --> 00:12:18,279 - Is there anyone we can call for you? - My wife, Angela. 257 00:12:18,363 --> 00:12:21,366 Dr. Santos, will you escort Mr. Foster to CT? 258 00:12:25,745 --> 00:12:26,829 Help! 259 00:12:26,913 --> 00:12:28,581 Need a hand here. 260 00:12:29,374 --> 00:12:32,210 - What the hell happened? - I think I'm having an MI. 261 00:12:32,293 --> 00:12:34,420 My chest is so tight, I can barely breathe. 262 00:12:34,504 --> 00:12:37,507 Okay, I got to get a 12 lead. Perlah, can I get an assist here? 263 00:12:37,590 --> 00:12:38,758 Yeah, I'm on it. 264 00:12:40,218 --> 00:12:41,219 CT's normal. 265 00:12:41,302 --> 00:12:43,096 Why do we take down the tourniquet, Whitaker? 266 00:12:43,179 --> 00:12:45,974 To give the residual limb blood flow. 267 00:12:46,057 --> 00:12:47,475 Just two little pumpers. 268 00:12:47,558 --> 00:12:49,602 A couple of figure eights ought to take care of those. 269 00:12:50,395 --> 00:12:51,854 Park. 270 00:12:51,938 --> 00:12:54,399 Park the Shark, orthopedic surgeon. 271 00:12:54,983 --> 00:12:57,110 - Is this a favorable amputation? - Pretty clean cut. 272 00:12:57,193 --> 00:12:58,903 Fence sliced through like a guillotine. 273 00:12:58,987 --> 00:13:00,154 X-ray? 274 00:13:02,699 --> 00:13:03,992 Not too bad. 275 00:13:06,202 --> 00:13:09,622 Just tying off a couple arterioles. 276 00:13:09,706 --> 00:13:11,207 I'm not blind. 277 00:13:11,916 --> 00:13:14,627 - Where's the amputated leg? - Double bagged on ice. 278 00:13:15,420 --> 00:13:17,588 Sterile saline on the inner bag. 279 00:13:17,672 --> 00:13:21,551 Ice water in the outer bag. No direct ice-on-skin contact. 280 00:13:21,634 --> 00:13:25,013 - We spent a lot of time prepping… - He still needs to look. 281 00:13:29,434 --> 00:13:30,643 Get Robby. 282 00:13:39,861 --> 00:13:42,530 - Antibiotics? - Cefazolin and gent. 283 00:13:42,613 --> 00:13:44,991 We've cleared her chest, abdomen, and pelvis. 284 00:13:45,074 --> 00:13:49,245 Clean wound, no crush injury, rapid transport time. 285 00:13:49,787 --> 00:13:51,372 Replantation is a go. 286 00:13:51,456 --> 00:13:52,582 I'll book an OR. 287 00:13:52,665 --> 00:13:54,167 Irrigate the hell out of this with 3 liters. 288 00:13:54,250 --> 00:13:56,753 - 3 liters? - Of saline, genius. 289 00:13:58,629 --> 00:13:59,839 Thanks, Shark. 290 00:14:03,676 --> 00:14:05,345 I knew he meant saline. 291 00:14:06,471 --> 00:14:10,558 Dr. Robby, we need you in Central 6. Dr. Mohan may be having a heart attack. 292 00:14:10,641 --> 00:14:11,684 What? 293 00:14:13,644 --> 00:14:16,189 - EKG is normal. - You sure? 294 00:14:16,272 --> 00:14:18,399 Check it out. You can be your own second opinion. 295 00:14:18,483 --> 00:14:20,568 - What's going on? - It's okay. I'm okay. 296 00:14:20,651 --> 00:14:22,070 You don't look okay. 297 00:14:22,153 --> 00:14:24,197 - You look like shit. - I feel like shit. 298 00:14:24,280 --> 00:14:26,783 - What happened? - I don't know. 299 00:14:26,866 --> 00:14:30,661 I just got really hot, and I started having trouble breathing. 300 00:14:31,496 --> 00:14:33,706 We should send up some labs just to be safe. 301 00:14:34,707 --> 00:14:35,917 Any chance you're pregnant? 302 00:14:36,000 --> 00:14:38,711 I'm not sure I feel comfortable answering that. 303 00:14:40,463 --> 00:14:42,799 - No. - She was tachy, but it's resolved now. 304 00:14:42,882 --> 00:14:44,717 - Have you eaten anything? - Yeah. 305 00:14:45,301 --> 00:14:47,095 - You staying hydrated? - 100%. 306 00:14:47,720 --> 00:14:48,846 I'm doing everything right. 307 00:14:48,930 --> 00:14:51,140 It's everything around me that's all fucked up. 308 00:14:51,224 --> 00:14:54,102 It's just my mom moving and calling me over and over again 309 00:14:54,185 --> 00:14:56,020 and now me scrambling to find a job next year. 310 00:14:56,104 --> 00:14:58,815 I had it all planned out, and now everything's just out the window. 311 00:14:58,898 --> 00:15:01,776 Wait a minute. Is this a panic attack because of your mommy issues? 312 00:15:02,443 --> 00:15:03,945 - What? No. - Jesus. 313 00:15:04,028 --> 00:15:05,238 Do you need to go home? 314 00:15:05,321 --> 00:15:06,948 - You should go home. - No, I'm fine. 315 00:15:07,031 --> 00:15:08,574 I don't need the fucking liability. Go home. 316 00:15:09,117 --> 00:15:11,828 And the rest of you, the last time I checked, the ED is a shit show. 317 00:15:11,911 --> 00:15:13,913 So let's all get back to work, huh? 318 00:15:21,254 --> 00:15:23,714 Sorry for taking so long, Becca. 319 00:15:23,798 --> 00:15:25,800 Nurse Dana said you'd be back in a few minutes, 320 00:15:25,883 --> 00:15:28,052 but it's definitely been more than a few minutes. 321 00:15:28,136 --> 00:15:29,929 You're right. My apologies. 322 00:15:30,555 --> 00:15:32,682 - I brought some drink options. - Okay. 323 00:15:32,765 --> 00:15:36,519 We've got apple juice, cranberry juice, 324 00:15:36,602 --> 00:15:39,647 OJ, and Pittsburgh's finest. 325 00:15:39,730 --> 00:15:41,941 - What's that? - Water. 326 00:15:42,775 --> 00:15:44,569 - OJ, please. - Okay. 327 00:15:45,945 --> 00:15:47,363 Let's see. 328 00:15:50,533 --> 00:15:51,576 All right. 329 00:15:52,577 --> 00:15:55,371 Now, I am going to give you two pills. 330 00:15:55,955 --> 00:15:57,999 The first is an antibiotic. 331 00:15:58,082 --> 00:16:00,293 That will get rid of the infection. 332 00:16:00,376 --> 00:16:02,295 The second should take care of the burning. 333 00:16:02,378 --> 00:16:05,798 You want to take both pills for three days and drink lots of water. 334 00:16:05,882 --> 00:16:07,300 I'll write it all down. 335 00:16:07,383 --> 00:16:08,593 I hate pills. 336 00:16:09,260 --> 00:16:12,138 Could you mash those up and put them in the OJ for me? 337 00:16:12,221 --> 00:16:13,598 Coming right up. 338 00:16:15,516 --> 00:16:16,601 Okay. 339 00:16:17,810 --> 00:16:20,480 Mel's gonna be super worried when you tell her. 340 00:16:21,105 --> 00:16:22,648 You are gonna be just fine. 341 00:16:22,732 --> 00:16:26,110 But as far as telling your sister what's going on with you, 342 00:16:26,194 --> 00:16:28,362 that is your decision, not mine. 343 00:16:30,615 --> 00:16:33,618 So you're not going to tell Mel? 344 00:16:34,410 --> 00:16:38,372 I can't, not unless you, my patient, tell me to. 345 00:16:41,626 --> 00:16:45,213 Do you know when Mel's gonna be done with her important meeting? 346 00:16:46,005 --> 00:16:47,215 Hopefully soon. 347 00:16:48,633 --> 00:16:52,136 Dr. Langdon, they need you back in Trauma Two. 348 00:16:52,220 --> 00:16:53,221 Hi. 349 00:16:55,556 --> 00:16:57,099 Becca, I got to go. I'll be… 350 00:16:57,183 --> 00:17:00,311 Don't say "in a few minutes" unless you actually mean in a few minutes. 351 00:17:01,020 --> 00:17:02,230 I would never. 352 00:17:07,151 --> 00:17:10,363 And I need you to be kind to each other. 353 00:17:10,446 --> 00:17:13,866 I am kind. Shane's just a butthead sometimes. 354 00:17:15,451 --> 00:17:19,038 He's your brother, and he loves you. 355 00:17:21,332 --> 00:17:22,458 Don't go. 356 00:17:23,251 --> 00:17:24,669 I don't want to go. 357 00:17:26,003 --> 00:17:28,756 But it's not up to me. 358 00:17:29,882 --> 00:17:30,967 Hey. 359 00:17:31,050 --> 00:17:33,052 We'll always be connected… 360 00:17:33,886 --> 00:17:35,263 …no matter what. 361 00:17:38,266 --> 00:17:39,892 Invisible string. 362 00:17:43,479 --> 00:17:45,064 Invisible string. 363 00:17:57,285 --> 00:17:58,286 Hey. 364 00:18:00,705 --> 00:18:02,415 You gonna go in and see your mom? 365 00:18:03,916 --> 00:18:05,501 Cancer sucks. 366 00:18:06,502 --> 00:18:07,753 Yeah. 367 00:18:07,837 --> 00:18:09,297 Yeah, it does. 368 00:18:12,300 --> 00:18:15,511 - It's not fair. - No, it's not. 369 00:18:20,099 --> 00:18:21,684 I don't want to go in there. 370 00:18:23,728 --> 00:18:25,730 Nobody's gonna make you. 371 00:18:32,737 --> 00:18:34,739 She didn't used to look like that. 372 00:18:37,742 --> 00:18:39,327 Yeah, I get that. 373 00:18:42,997 --> 00:18:46,042 But if you don't go in there and say goodbye 374 00:18:46,125 --> 00:18:48,127 and tell your mom you love her… 375 00:18:49,754 --> 00:18:52,965 …I think you might wish you had for a very long time. 376 00:18:57,136 --> 00:18:58,554 It's your call. 377 00:19:02,350 --> 00:19:06,562 D-5 half normal saline, 20 of K running at 125 an hour. 378 00:19:07,355 --> 00:19:08,689 One of the most common reasons 379 00:19:08,773 --> 00:19:11,108 for traumatic-replantation failure is infections. 380 00:19:11,192 --> 00:19:12,568 So we do what, Whitaker? 381 00:19:12,652 --> 00:19:14,737 Rinse and repeat until surgery calls for us. 382 00:19:16,989 --> 00:19:19,075 Is everything okay with Dr. Mohan? 383 00:19:19,158 --> 00:19:20,660 She's fine. Focus. 384 00:19:25,998 --> 00:19:27,166 Where am I? 385 00:19:28,376 --> 00:19:29,835 Ketamine's wearing off. 386 00:19:33,005 --> 00:19:35,007 I can't feel my leg. 387 00:19:35,091 --> 00:19:37,885 I'm Dr. Michael Robinavitch. You're at a hospital. 388 00:19:37,968 --> 00:19:40,554 And we gave you a nerve block so that you can't feel any pain. 389 00:19:40,638 --> 00:19:41,639 Why? 390 00:19:41,722 --> 00:19:45,685 You were on a water slide that collapsed and did serious injury to your leg. 391 00:19:49,814 --> 00:19:51,065 What the fuck? 392 00:19:51,148 --> 00:19:52,441 Is that my leg? 393 00:19:52,525 --> 00:19:53,526 Is that my… 394 00:19:53,609 --> 00:19:56,362 - Did you cut my fucking leg off? - Your leg was cut off in the accident. 395 00:19:56,445 --> 00:19:58,572 Our surgeons are going to try for replantation. 396 00:19:58,656 --> 00:20:00,116 No. 397 00:20:00,199 --> 00:20:01,534 - She needs more ketamine. - Just wrap up the leg. 398 00:20:01,617 --> 00:20:02,743 Emily, I know that this is really hard. 399 00:20:02,827 --> 00:20:04,245 I need you to focus on me right now, 400 00:20:04,328 --> 00:20:05,746 because we need to get your consent 401 00:20:05,830 --> 00:20:07,540 - to proceed with the surgery. - Why? 402 00:20:07,623 --> 00:20:08,958 There are risks with the surgery. 403 00:20:09,041 --> 00:20:11,335 There's anesthesia, and there's no guarantee… 404 00:20:11,419 --> 00:20:12,962 Emily? 405 00:20:13,045 --> 00:20:15,756 Can you just put it back on? 406 00:20:15,840 --> 00:20:18,259 - Can you just put it back on? - Sounds like consent to me. 407 00:20:18,342 --> 00:20:20,761 - Now can she have sedation? - Okay, load her up. Ketamine and rock. 408 00:20:20,845 --> 00:20:22,138 It's gonna be okay. It's gonna be okay. 409 00:20:22,221 --> 00:20:24,014 We're gonna intubate before the OR. 410 00:20:24,098 --> 00:20:25,641 It's gonna be okay. 411 00:20:26,267 --> 00:20:29,353 - Finishing second cut. - Success. 412 00:20:29,437 --> 00:20:32,606 - Can that be saved? - The finger or the ring? 413 00:20:32,690 --> 00:20:34,275 - The wedding ring. - Yes, sir. 414 00:20:34,358 --> 00:20:36,652 A jeweler can weld it back together good as new. 415 00:20:37,403 --> 00:20:40,156 Stop. Irrigate the ring shavings off first. 416 00:20:42,074 --> 00:20:44,660 - What did I miss? - Finishing irrigation. 417 00:20:45,453 --> 00:20:46,579 Okay. 418 00:20:46,662 --> 00:20:48,372 Doesn't look like you lost any skin. 419 00:20:48,456 --> 00:20:50,541 It's a little dusky. Might not be viable. 420 00:20:50,624 --> 00:20:52,376 There's intact skin on the dorsum. 421 00:20:52,460 --> 00:20:54,754 More irrigation, then tack it down with one suture. 422 00:20:54,837 --> 00:20:56,255 Okay, thanks. 423 00:20:56,338 --> 00:21:00,176 - Radiologist reports a 25% pneumothorax. - Is that bad? 424 00:21:00,259 --> 00:21:03,012 That is a partially collapsed lung that needs treatment. 425 00:21:03,095 --> 00:21:05,681 - I can put in a chest tube. - He doesn't need a chest tube. 426 00:21:05,765 --> 00:21:07,850 Okay, what do you want, a pigtail catheter? 427 00:21:08,684 --> 00:21:10,311 I was thinking a ThoraVent. 428 00:21:10,394 --> 00:21:11,687 What? Why? 429 00:21:11,771 --> 00:21:13,981 It's not a bad idea. No need for wall suction. 430 00:21:14,064 --> 00:21:17,026 If Hand can operate today, he can go home tomorrow with the ThoraVent. 431 00:21:17,109 --> 00:21:19,403 You can learn a lot from your senior residents. 432 00:21:19,487 --> 00:21:21,697 I'm happy to teach Dr. Santos. 433 00:21:21,781 --> 00:21:23,699 Thank you, Dr. Langdon. 434 00:21:27,912 --> 00:21:31,040 Janelle, I need you to take the samples to the lab 435 00:21:31,123 --> 00:21:32,917 and come back with any results that are ready. 436 00:21:33,000 --> 00:21:36,837 Geoffrey, head to CT to see if any new results are printed and bring those back. 437 00:21:36,921 --> 00:21:39,757 Pam, check in with whoever's running the PDS 438 00:21:39,840 --> 00:21:42,051 to see if any orders need to go to the pharmacy 439 00:21:42,134 --> 00:21:44,136 and bring back any meds that are ready for pickup. 440 00:21:44,220 --> 00:21:46,597 Rinse and repeat every 15 minutes. 441 00:21:46,680 --> 00:21:48,599 Double-tie those shoelaces and hydrate. 442 00:21:48,682 --> 00:21:50,726 It's not a sprint. It's a marathon. 443 00:21:51,519 --> 00:21:53,145 Fly, my pretties. 444 00:21:53,938 --> 00:21:56,649 Okay, any word on finding our water slide dad's kid? 445 00:21:56,732 --> 00:22:00,319 Not yet. Called the wife, went straight to voicemail. 446 00:22:00,402 --> 00:22:03,072 Police dispatch said that there were a couple of fatalities on site… 447 00:22:03,155 --> 00:22:05,658 - one adult, one kid. - Sweet Jesus. 448 00:22:05,741 --> 00:22:06,909 Who the fuck did this? 449 00:22:06,992 --> 00:22:11,247 No sign-off on orders for labs or X-rays, and it's in the wrong freaking rack? 450 00:22:11,330 --> 00:22:13,749 You guys trying to kill me and the patient? 451 00:22:13,833 --> 00:22:15,459 - I'll take care of it. - Thanks. 452 00:22:15,543 --> 00:22:18,879 - Dana, this gum is abso… - Shit. I know. 453 00:22:18,963 --> 00:22:20,881 Pharmacy said you needed this right away. 454 00:22:20,965 --> 00:22:23,425 Just in time. Slap one on and give it an hour to kick in. 455 00:22:23,509 --> 00:22:24,510 You're welcome. 456 00:22:25,719 --> 00:22:28,514 - What? - The prescription is for you. 457 00:22:28,597 --> 00:22:30,432 My insurance will cover it. Hers won't. 458 00:22:31,183 --> 00:22:32,601 Isn't that insurance fraud? 459 00:22:33,561 --> 00:22:35,688 Throw me in jail. I could use a vacation. 460 00:22:39,149 --> 00:22:40,192 Mom. 461 00:22:45,781 --> 00:22:47,283 I'm really glad to see you, Mom. I… 462 00:22:47,366 --> 00:22:49,785 Garcia told me about the sigmoid volvulus you missed. 463 00:22:49,869 --> 00:22:52,204 - It was an oversight. - That could have killed her. 464 00:22:52,788 --> 00:22:55,291 Without electronic records, it's been kind of a challenge to figure out… 465 00:22:55,374 --> 00:22:58,294 Chaos is the status quo in the ED, even when the computers are working properly. 466 00:22:58,377 --> 00:23:00,546 You have to be hypervigilant and double-check everything. 467 00:23:00,629 --> 00:23:03,007 - I can handle it. - Why would you want to? 468 00:23:03,883 --> 00:23:07,136 Down here your learning street-level medicine, all seat of your pants. 469 00:23:07,219 --> 00:23:08,512 Oh, well, I made a mistake, 470 00:23:08,596 --> 00:23:11,599 but the more talented practitioners upstairs will fix it. 471 00:23:13,809 --> 00:23:15,269 You are better than this. 472 00:23:16,812 --> 00:23:19,815 I love you, too. 473 00:23:24,194 --> 00:23:28,157 - Well, that is one way to do a debrief. - You should talk to her. 474 00:23:28,240 --> 00:23:30,868 - Which one? - Honestly, both of them. 475 00:23:30,951 --> 00:23:33,579 - Can you call in some extra doctors? - Sure. 476 00:23:33,662 --> 00:23:35,289 Everyone's dying to work on the Fourth of July. 477 00:23:35,372 --> 00:23:37,458 - Why? - Dr. Mohan went down. 478 00:23:37,541 --> 00:23:39,710 Yeah. I saw your pep talk. 479 00:23:40,628 --> 00:23:43,339 She's taking a little break until her labs are back. 480 00:23:43,422 --> 00:23:46,759 She's going to be fine, but I'm not sure her head is in the game. 481 00:23:47,635 --> 00:23:49,053 I'm on it, Cap. 482 00:23:49,136 --> 00:23:50,971 Small stab incision with the 11 blade, 483 00:23:51,055 --> 00:23:54,350 midclavicular line, second intercostal space. 484 00:23:54,433 --> 00:23:57,227 - She's gonna stab me? - It's just a medical term. 485 00:23:57,311 --> 00:23:58,562 Stay superior to the rib. 486 00:24:03,651 --> 00:24:06,612 - Is there a problem? - Nope, everything's going well. 487 00:24:07,780 --> 00:24:09,073 Place the trocar. 488 00:24:09,865 --> 00:24:12,493 Hold back the adhesive wings 489 00:24:12,576 --> 00:24:15,996 and advance until you see the red diaphragm move. 490 00:24:16,080 --> 00:24:18,082 That means you're in the pleural space. 491 00:24:18,791 --> 00:24:21,126 Now remove the trocar. 492 00:24:24,630 --> 00:24:25,798 Perfect. 493 00:24:25,881 --> 00:24:29,551 Okay, now we can either hook up to wall suction, 494 00:24:29,635 --> 00:24:33,013 or we can use this one-way valve to repeatedly aspirate with a syringe. 495 00:24:33,097 --> 00:24:35,391 Well, with all your vast experience, Dr. Langdon, 496 00:24:35,474 --> 00:24:37,142 you should probably decide. 497 00:24:39,853 --> 00:24:42,606 We can avoid wall suction if I pump manually. 498 00:24:42,690 --> 00:24:44,400 - Have at it, Doc. - Enough. 499 00:24:44,483 --> 00:24:48,028 Apparently, decency and decorum need to be reintroduced to our R2 curriculum. 500 00:24:48,737 --> 00:24:50,447 Nice work, Dr. Langdon. 501 00:24:50,531 --> 00:24:52,700 I'll go check on an OR for Mr. Foster. 502 00:24:58,122 --> 00:25:00,499 Hey. I'm gonna need you to pick up the pace. 503 00:25:01,291 --> 00:25:04,420 Can I get a sec? Dr. Mohan just almost died on me. 504 00:25:04,503 --> 00:25:06,839 Not even close. She's tougher than she looks. 505 00:25:06,922 --> 00:25:08,716 Propane hero in North 4. 506 00:25:08,799 --> 00:25:10,300 Hey, any word from surgery 507 00:25:10,384 --> 00:25:13,429 on how our big patient Howard's perforated diverticulitis is doing? 508 00:25:13,512 --> 00:25:16,056 - Still in the OR. - What about our drunk firework kid? 509 00:25:16,140 --> 00:25:18,100 Waiting his turn in the surgical conga line. 510 00:25:18,726 --> 00:25:20,352 What about Social Services? 511 00:25:20,436 --> 00:25:22,438 Have they found a temporary foster home 512 00:25:22,521 --> 00:25:24,857 - for our baby Jane Doe? - Still working on it. 513 00:25:24,940 --> 00:25:27,818 Kid's gonna be old enough to drive by the time she gets out of here. 514 00:25:27,901 --> 00:25:29,361 You joke… 515 00:25:30,446 --> 00:25:32,072 Oh, for fuck's sake! 516 00:25:32,156 --> 00:25:35,284 Go, quickly, before I change my mind. 517 00:25:35,367 --> 00:25:38,078 Hey, did the county pick up Louie's body yet? 518 00:25:38,162 --> 00:25:41,081 - No. He's still in the viewing room. - Jesus. He's just laying in there? 519 00:25:41,165 --> 00:25:44,168 Yeah. Another couple minutes, I'm gonna wheel him down to the morgue myself. 520 00:25:45,878 --> 00:25:46,879 What's the bullet? 521 00:25:46,962 --> 00:25:48,881 Eight-year-old boy, part of the water park accident. 522 00:25:48,964 --> 00:25:50,883 - Thrown off the water slide. - How far did he fall? 523 00:25:50,966 --> 00:25:53,260 Maybe 6 or 7 feet, landed in a tree. 524 00:25:53,343 --> 00:25:55,054 Had to wait for a ladder truck to get him down. 525 00:25:55,137 --> 00:25:57,264 Major neck trauma. Must've taken all the impact there. 526 00:25:57,347 --> 00:25:58,682 Couldn't tube him, hard to bag. 527 00:25:58,766 --> 00:26:02,394 Sats in the 80s. BP 85 over 60. Pulse 50. 528 00:26:04,563 --> 00:26:06,982 Okay, one, two, and three. 529 00:26:08,233 --> 00:26:10,903 - Possible laryngeal fracture. - Hypoxic bradycardic. 530 00:26:10,986 --> 00:26:12,946 Kid needs an airway before he arrests. 531 00:26:13,030 --> 00:26:15,365 Broselow tape, pedes cart, set up suction. 532 00:26:15,449 --> 00:26:17,618 Oh, my God. Is that Zack? 533 00:26:18,327 --> 00:26:20,412 Hey. Hey, kid, can you look at me? 534 00:26:21,121 --> 00:26:23,791 No response, no purposeful movement to pain. 535 00:26:25,125 --> 00:26:26,168 Oh, my God. 536 00:26:26,251 --> 00:26:27,294 Is this your kid? 537 00:26:28,003 --> 00:26:29,505 - No. - Sir, go back to your room now. 538 00:26:29,588 --> 00:26:31,465 - Broselow says 25 kilograms. - Jesse? 539 00:26:31,548 --> 00:26:32,883 5 1/2 ET tube. 540 00:26:32,966 --> 00:26:36,595 - Okay, 30 of rock, 50 ketamine. - You're gonna paralyze? 541 00:26:36,678 --> 00:26:39,139 - Yep. - If we can't intubate, we crike? 542 00:26:39,223 --> 00:26:40,516 He's too young for a crike. 543 00:26:40,599 --> 00:26:42,601 - Needle crike? - Can't ventilate through that. 544 00:26:42,684 --> 00:26:45,646 - Sats down to 78. - 11 blade, Kelly, and a pedes bougie. 545 00:26:45,729 --> 00:26:46,980 One quick look, and then we cut. 546 00:26:47,689 --> 00:26:50,275 I can't tell if there's lung sliding. No movement, no air entry. 547 00:26:50,359 --> 00:26:52,361 Way too edematous. I can't see the cords. 548 00:26:52,444 --> 00:26:54,071 Better with cricoid pressure? 549 00:26:55,239 --> 00:26:56,323 Nothing. Fuck. 550 00:26:56,406 --> 00:26:58,158 Okay. Towel roll between the shoulder blades, please. 551 00:26:58,242 --> 00:27:00,369 Heart rate down to 49. Headed to cardiac arrest. 552 00:27:00,452 --> 00:27:02,538 Trake's going to take 20 minutes. This kid's not gonna last 60 seconds. 553 00:27:02,621 --> 00:27:03,956 That's why we're doing a slash trake. 554 00:27:04,039 --> 00:27:05,541 - Don't know it. - Me neither. 555 00:27:05,624 --> 00:27:07,543 - Boss? - Show me what you got. 556 00:27:16,844 --> 00:27:20,055 Pull up the trachea between your thumb and middle finger. 557 00:27:20,722 --> 00:27:23,642 Vertical incision right over the trachea. 558 00:27:24,476 --> 00:27:28,105 Vertical, not horizontal, or you transect the trachea and cut the jugular veins. 559 00:27:29,565 --> 00:27:30,899 That's a lot of blood. 560 00:27:31,483 --> 00:27:33,318 Now it's a tactile procedure. 561 00:27:33,402 --> 00:27:36,029 2-centimeter incision through the tracheal rings. 562 00:27:36,655 --> 00:27:38,282 Finger in the trachea. 563 00:27:39,867 --> 00:27:41,618 Bougie into the airway. 564 00:27:43,495 --> 00:27:47,040 - Thoughts on what's next, Dr. Whitaker? - Insert the ET tube into the trachea. 565 00:27:48,333 --> 00:27:50,335 Suction. Lots of blood in the airway. 566 00:27:57,134 --> 00:27:58,302 Okay, bag him. 567 00:27:59,386 --> 00:28:00,679 Check the CO2. 568 00:28:01,889 --> 00:28:03,807 Sats coming up, in the 80s. 569 00:28:03,891 --> 00:28:06,810 Bilateral breath sounds. End tidal CO2 is 70. 570 00:28:06,894 --> 00:28:08,604 - That's crazy high. - It'll come down. 571 00:28:08,687 --> 00:28:10,606 Tie down the tube, control all the bleeders. 572 00:28:10,689 --> 00:28:13,233 Spray an amp of epi on a stack of 4-by-4s. 573 00:28:13,317 --> 00:28:15,986 Okay. Sats are up to the 90s. 574 00:28:16,069 --> 00:28:18,238 Good. CO2's in the 50s. Good heart rate. 575 00:28:18,322 --> 00:28:19,948 You forgot the last step. 576 00:28:20,032 --> 00:28:21,825 Change your underwear. 577 00:28:21,909 --> 00:28:24,536 - How many of these you done? - First one. 578 00:28:24,620 --> 00:28:25,746 You serious? 579 00:28:25,829 --> 00:28:27,623 - How about you? - None. 580 00:28:27,706 --> 00:28:30,250 I practiced in the Sim Lab when I was at Stanford. 581 00:28:30,334 --> 00:28:31,627 - What'd I miss? - All the fun. 582 00:28:31,710 --> 00:28:32,961 - Slash trake. - Seriously? 583 00:28:33,921 --> 00:28:36,798 Fractured larynx. Couldn't oxygenate, couldn't ventilate. 584 00:28:36,882 --> 00:28:40,594 - You use a meat cleaver on this kid? - ENT can revise the trake in the OR. 585 00:28:41,303 --> 00:28:42,971 They'll be thrilled to clean up your mess. 586 00:28:43,931 --> 00:28:46,350 Or maybe they'll thank us for not letting him die. 587 00:28:52,022 --> 00:28:53,982 So we're still waiting on your prescription, 588 00:28:54,066 --> 00:28:55,859 and the pharmacy is a little backed up. 589 00:28:55,943 --> 00:28:58,403 But I'm glad to see you're doing good. 590 00:28:58,487 --> 00:28:59,487 Well. 591 00:29:00,072 --> 00:29:01,156 I'm well. 592 00:29:02,741 --> 00:29:04,076 Glad to see you're well. 593 00:29:04,159 --> 00:29:06,370 Can't you expedite my medication? 594 00:29:07,079 --> 00:29:09,289 Sure, but it may still be a little while 595 00:29:09,373 --> 00:29:13,460 before Dr. Mohan can sign off on the discharge, so sit tight. 596 00:29:15,379 --> 00:29:16,588 And do what? 597 00:29:20,759 --> 00:29:23,387 You just keep this handy for occasions like this? 598 00:29:24,388 --> 00:29:27,015 I thought that I might not have that much to do today. 599 00:29:27,099 --> 00:29:28,183 But… 600 00:29:28,976 --> 00:29:30,602 …man, I was wrong. 601 00:29:37,317 --> 00:29:38,610 Thank you. 602 00:29:43,407 --> 00:29:46,702 - What brings you in today? - A friend made me come in. 603 00:29:46,785 --> 00:29:49,913 - Name's Robby. He said I should… - You're Duke. 604 00:29:50,622 --> 00:29:52,124 - Donnie? - Yep? 605 00:29:52,207 --> 00:29:54,001 Robby's VIP is here. 606 00:29:57,629 --> 00:30:00,549 Hi. I'm Donnie, nurse practitioner. 607 00:30:00,632 --> 00:30:04,720 Robby's already put in orders for a numbing spray for your nostril. 608 00:30:04,803 --> 00:30:06,805 "Nostril"? It's my throat. 609 00:30:06,888 --> 00:30:08,724 - It's not my nose. - Okay. 610 00:30:08,807 --> 00:30:11,226 Let's get you set up in a room. 611 00:30:14,563 --> 00:30:18,233 That was the most unprofessional deposition I've ever witnessed. 612 00:30:18,317 --> 00:30:20,652 They were nowhere near that aggressive with Dr. Ellis. 613 00:30:21,820 --> 00:30:23,238 Oh, okay. 614 00:30:25,449 --> 00:30:27,451 It didn't go as badly as you think. 615 00:30:27,993 --> 00:30:29,828 They suggested I was incompetent. 616 00:30:29,911 --> 00:30:33,915 They're posturing to set the stage for a ridiculous settlement request. 617 00:30:33,999 --> 00:30:35,751 This isn't about those parents or that kid. 618 00:30:35,834 --> 00:30:38,003 It's only about trying to make a lot of money. 619 00:30:38,086 --> 00:30:41,256 Well, I don't have a lot of money. 620 00:30:41,340 --> 00:30:43,967 Not your money, Dr. King. It's an insurance game. 621 00:30:44,051 --> 00:30:47,262 You're protected by the hospital. This won't affect your career. 622 00:30:53,060 --> 00:30:55,395 Hey. How was your deposition? 623 00:30:55,479 --> 00:30:56,813 Have you seen Dr. Langdon? 624 00:30:57,397 --> 00:30:58,482 No. Why? 625 00:31:00,233 --> 00:31:02,069 Okay, okay. How's Becca? 626 00:31:02,152 --> 00:31:03,612 - Oh, she's fine. - Yeah? 627 00:31:03,695 --> 00:31:04,988 Okay, I should go see her, then. 628 00:31:05,072 --> 00:31:07,407 How was your deposition? I'm sure it was stressful. 629 00:31:11,078 --> 00:31:13,288 What's going on with Becca? What's her diagnosis? 630 00:31:13,372 --> 00:31:14,498 I can't tell you. 631 00:31:15,207 --> 00:31:16,458 Why? 632 00:31:16,541 --> 00:31:18,001 - HIPAA. - Seriously? 633 00:31:18,085 --> 00:31:19,628 If you want to know what's going on with Becca, 634 00:31:19,711 --> 00:31:21,213 you're gonna have to ask her yourself. 635 00:31:21,296 --> 00:31:23,048 Hey, you survived your deposition. 636 00:31:23,131 --> 00:31:25,217 Welcome back to the seventh circle of hell. 637 00:31:25,300 --> 00:31:26,301 What's this? 638 00:31:26,385 --> 00:31:28,804 You're welcome for covering your patients. They're yours again. 639 00:31:28,887 --> 00:31:31,431 Might want to check on the pancreatitis in North 3 first. 640 00:31:32,307 --> 00:31:33,350 Okay. 641 00:31:33,433 --> 00:31:36,019 Langdon, I got some intel on Louie. 642 00:31:36,103 --> 00:31:37,604 They move him out of the viewing room? 643 00:31:37,687 --> 00:31:40,232 No, but county's promised they're on the way to come get him. 644 00:31:40,315 --> 00:31:43,235 - Can I get the county coroner's number? - What for? 645 00:31:43,318 --> 00:31:45,195 I just want to make sure if no family shows up, 646 00:31:45,278 --> 00:31:47,447 - Louie gets a proper burial. - That's expensive. 647 00:31:47,531 --> 00:31:49,741 You may want to run it by the missus first. 648 00:31:50,325 --> 00:31:53,036 Maybe I'll start a GoFundMe. I bet people around here would pitch in. 649 00:31:53,120 --> 00:31:56,123 Hey, kid, you can't do this for every unhoused guy 650 00:31:56,206 --> 00:31:57,999 that dies around here. 651 00:31:58,083 --> 00:31:59,626 There but for the grace of God. 652 00:31:59,709 --> 00:32:03,839 No, the success of your sobriety is a testament to your support system. 653 00:32:03,922 --> 00:32:05,674 Louie didn't have that. 654 00:32:05,757 --> 00:32:07,801 Still, Louie was a good man. 655 00:32:07,884 --> 00:32:10,053 He deserves to be put to rest with dignity. 656 00:32:10,137 --> 00:32:12,472 Okay. I'll dig it up. 657 00:32:15,225 --> 00:32:16,560 You heard all that? 658 00:32:18,103 --> 00:32:21,356 Robby, your VIP's here. Got him in Central 11. 659 00:32:21,440 --> 00:32:22,774 Finally. 660 00:32:26,153 --> 00:32:27,404 About fucking time. 661 00:32:27,487 --> 00:32:30,866 If I knew you were gonna make me wear a dress, I wouldn't have come at all. 662 00:32:30,949 --> 00:32:34,202 - Dennis Whitaker, meet my buddy Duke. - Nice to meet you. 663 00:32:34,286 --> 00:32:36,413 Any friend of Dr. Robby's is a friend of mine. 664 00:32:36,496 --> 00:32:40,083 "Friend" is a vast overstatement. He's more just a pain in my ass. 665 00:32:40,167 --> 00:32:42,210 Don't let his surly exterior fool you. 666 00:32:42,294 --> 00:32:44,796 Deep down inside, he's just as grumpy. 667 00:32:44,880 --> 00:32:47,382 - How did you two meet? - Tinder. 668 00:32:48,592 --> 00:32:50,886 Duke is a motorcycle engineer. 669 00:32:50,969 --> 00:32:54,306 You should've seen his Bonneville when he first brought it in six months ago. 670 00:32:54,389 --> 00:32:56,099 Someone left it for dead. 671 00:32:56,183 --> 00:32:59,102 He helped me bring it back to life. Today we're going to return the favor. 672 00:32:59,186 --> 00:33:01,313 Dr. Whitaker's one of our most trusted physicians, 673 00:33:01,396 --> 00:33:03,523 and today he's going to help me oversee your care. 674 00:33:04,191 --> 00:33:05,984 what seems to be troubling you? 675 00:33:06,067 --> 00:33:08,111 Ask him. He's the one who made me come in. 676 00:33:08,195 --> 00:33:10,864 He's had some hoarseness on and off for a couple months. 677 00:33:10,947 --> 00:33:13,617 Okay, any history of tobacco or alcohol use? 678 00:33:14,826 --> 00:33:16,495 Two of my oldest and closest friends. 679 00:33:16,578 --> 00:33:19,539 Former two-pack-a-day smoker and lover of the drink. 680 00:33:19,623 --> 00:33:21,541 Okay. He on any medication? 681 00:33:21,625 --> 00:33:23,335 Blood-pressure meds. 682 00:33:23,418 --> 00:33:25,045 Which he forgets to take. 683 00:33:25,128 --> 00:33:26,755 He's all numbed up and ready to go. 684 00:33:26,838 --> 00:33:28,673 Okay. Thank you, Donnie. 685 00:33:29,633 --> 00:33:34,554 My man, I am gonna take this scope, and I'm gonna stick it in your nose, 686 00:33:34,638 --> 00:33:37,349 and we're going to check out your upper airway. 687 00:33:37,432 --> 00:33:39,768 That seems like a lot of fuss for a sore throat. 688 00:33:39,851 --> 00:33:41,144 Dr. Whitaker, you want to explain to Duke 689 00:33:41,228 --> 00:33:43,980 why this procedure is absolutely necessary? 690 00:33:44,064 --> 00:33:46,733 The scope is gonna give us a better view of your voice box 691 00:33:46,816 --> 00:33:48,443 and your vocal cords. 692 00:33:49,027 --> 00:33:50,320 Here we go. 693 00:33:55,242 --> 00:33:57,536 Gonna feel a little pressure between your eyes. 694 00:33:57,619 --> 00:33:59,037 I am sorry about that. 695 00:33:59,120 --> 00:34:01,289 Okay, just breathe through your nose. 696 00:34:01,373 --> 00:34:03,959 This is gonna help us see if there are any abnormalities 697 00:34:04,042 --> 00:34:07,045 like inflammation, tumors, nodules. 698 00:34:07,671 --> 00:34:09,381 That all looks pretty normal. 699 00:34:09,464 --> 00:34:11,925 I don't see too much drainage. Stick your tongue out for me, all the way. 700 00:34:12,842 --> 00:34:14,678 All the way out. Good. Now say… 701 00:34:16,471 --> 00:34:18,056 Good. Now again, say… 702 00:34:19,558 --> 00:34:21,268 Good. Removing the scope. 703 00:34:22,811 --> 00:34:24,854 Dr. Whitaker, what do you think? 704 00:34:24,938 --> 00:34:27,816 - Looks normal, no abnormalities. - Told you it was nothing. 705 00:34:27,899 --> 00:34:31,403 With your history of smoking, I'd like to do a chest X-ray. 706 00:34:31,486 --> 00:34:33,196 If there are growths, 707 00:34:33,280 --> 00:34:36,866 they can push against the recurrent laryngeal nerve intermittently. 708 00:34:36,950 --> 00:34:41,621 That can paralyze one of the vocal cords and cause the hoarseness. 709 00:34:41,705 --> 00:34:45,208 That sounds like a lot of bullshit doctor speak to charge me more. 710 00:34:45,292 --> 00:34:46,418 You've got Medicare. 711 00:34:46,501 --> 00:34:48,003 And, besides, I finally got you into my ED. 712 00:34:48,086 --> 00:34:51,631 You're gonna get the golden workup before I leave town tonight. 713 00:34:51,715 --> 00:34:55,302 Only an idiot would ride all night after working a 12-hour day. 714 00:34:55,385 --> 00:34:57,345 That does sound pretty dangerous. 715 00:34:57,429 --> 00:34:59,222 You gonna stay put, or do I have to tie you down? 716 00:34:59,306 --> 00:35:01,683 Fine, so long as you keep your hands where I can see 'em. 717 00:35:01,766 --> 00:35:03,226 No promises. 718 00:35:03,310 --> 00:35:04,853 Let me know when his chest X-ray is back. 719 00:35:04,936 --> 00:35:06,104 Yeah. 720 00:35:09,524 --> 00:35:10,734 - Hey. - Hey. 721 00:35:11,735 --> 00:35:12,944 Are we okay? 722 00:35:14,529 --> 00:35:17,657 - Yeah. Why? - I don't know. 723 00:35:17,741 --> 00:35:20,952 You kind of ripped me a new one in front of Langdon. 724 00:35:21,745 --> 00:35:24,247 - Whose side are you on? - This isn't middle school. 725 00:35:24,331 --> 00:35:26,249 Langdon made a mistake and owned up to it. 726 00:35:26,333 --> 00:35:28,126 - Let it go. - He should… 727 00:35:30,754 --> 00:35:32,714 He should have been fired. 728 00:35:32,797 --> 00:35:35,508 But instead, he waltzes back in here, no big deal. 729 00:35:35,592 --> 00:35:37,802 Meanwhile, I've been a goddamn pariah for the last 10 months 730 00:35:37,886 --> 00:35:39,512 for doing the right thing. 731 00:35:39,596 --> 00:35:42,641 Or maybe you're a pariah because you don't play well with others. 732 00:35:44,142 --> 00:35:46,770 If you've still got beef with Langdon, go tell him. 733 00:35:46,853 --> 00:35:50,231 He's here to stay, so put on your big-girl panties and work it out. 734 00:35:50,315 --> 00:35:52,192 - He is no… - Nope. 735 00:35:52,275 --> 00:35:54,903 You want to have sex and eat ramen in bed, I'm your girl. 736 00:35:54,986 --> 00:35:58,490 But if you want to talk about this Langdon shit, again, 737 00:35:58,573 --> 00:35:59,949 call a therapist. 738 00:36:09,417 --> 00:36:11,294 How's it hanging, Dr. J? 739 00:36:11,378 --> 00:36:14,881 - Never call me that again. - It was a joke. 740 00:36:14,964 --> 00:36:18,510 Relax. He's clueless about your TikToks. 741 00:36:18,593 --> 00:36:20,095 But you're not. 742 00:36:20,178 --> 00:36:22,514 - Props on the side hustle. - There is no hustle. 743 00:36:22,597 --> 00:36:23,723 They're just some stupid videos. 744 00:36:23,807 --> 00:36:25,725 - Wait, are you an influencer? - No! 745 00:36:25,809 --> 00:36:26,976 Yep. 746 00:36:28,228 --> 00:36:30,271 Yo, pre-docs, it's not happy hour yet. 747 00:36:30,355 --> 00:36:32,607 There's still a shit ton of patients to be seen. 748 00:36:37,195 --> 00:36:39,906 Ben, our slash-trake kid from the water park 749 00:36:39,989 --> 00:36:41,950 had some purposeful movement in pre-op. 750 00:36:42,033 --> 00:36:43,326 That's a good sign. 751 00:36:43,410 --> 00:36:44,619 Take the win. 752 00:36:47,205 --> 00:36:48,373 We need to talk. 753 00:36:50,417 --> 00:36:52,419 - We are talking. - In private. 754 00:37:01,428 --> 00:37:03,930 What the hell was that with Samira earlier? 755 00:37:04,639 --> 00:37:07,142 - That was tough love. - You are her superior. 756 00:37:07,225 --> 00:37:10,603 She was obviously struggling, and your advice was "go home"? 757 00:37:10,687 --> 00:37:12,105 Essentially, yeah. 758 00:37:12,188 --> 00:37:14,691 This is the ED. It's not for the faint of heart. 759 00:37:14,774 --> 00:37:16,651 It's not for the unempathetic either. 760 00:37:17,444 --> 00:37:19,779 Samira's not having a panic attack because of her patient. 761 00:37:19,863 --> 00:37:21,573 She's having one because of personal baggage. 762 00:37:21,656 --> 00:37:24,159 What she needs to do is pull her head out of her ass and focus on the work. 763 00:37:24,242 --> 00:37:25,285 What about you? 764 00:37:25,368 --> 00:37:28,121 What do you need to get some basic human empathy back? 765 00:37:30,665 --> 00:37:31,791 I don't know. 766 00:37:31,875 --> 00:37:34,878 Something that gives me a little hope this place won't fall to shit when I'm gone. 767 00:37:36,463 --> 00:37:38,715 - Found him! - Found who? 768 00:37:39,424 --> 00:37:41,801 - The water slide dad's kid. - How'd you manage that? 769 00:37:41,885 --> 00:37:43,803 I went outside, stalked the dad's IG, 770 00:37:43,887 --> 00:37:45,805 found a pic of his son, sent it to Pittsburgh PD. 771 00:37:45,889 --> 00:37:46,931 Now they're on their way over. 772 00:37:47,682 --> 00:37:49,893 Well, maybe Gen Z should be working for the FBI. 773 00:37:54,105 --> 00:37:55,690 - Hi, Becca. Hi. - Mel! 774 00:37:57,901 --> 00:38:00,612 - You doing all right? - I'm a little bored. 775 00:38:00,695 --> 00:38:01,696 Yeah? 776 00:38:02,906 --> 00:38:04,824 - How are you feeling? - A lot better. 777 00:38:04,908 --> 00:38:07,243 Dr. Langdon gave me some medicine and OJ. 778 00:38:07,327 --> 00:38:08,828 He's super nice. 779 00:38:08,912 --> 00:38:10,246 I see why you like him. 780 00:38:11,289 --> 00:38:13,958 Did he tell you what the medicine was for? 781 00:38:14,042 --> 00:38:15,210 Yes. 782 00:38:15,293 --> 00:38:16,836 Did you tell her? 783 00:38:16,920 --> 00:38:17,921 I did not. 784 00:38:18,713 --> 00:38:22,425 I explained to Becca that due to doctor-patient confidentiality, 785 00:38:22,509 --> 00:38:24,427 everything she told me was private 786 00:38:24,511 --> 00:38:26,221 and that it was her decision 787 00:38:26,304 --> 00:38:29,307 if she wanted to share anything with you or not. 788 00:38:31,142 --> 00:38:33,353 - Do you want to share? - Yes. 789 00:38:44,531 --> 00:38:47,033 I have a urinary-tract infection. 790 00:38:49,953 --> 00:38:51,079 Okay. 791 00:38:51,162 --> 00:38:55,875 Yeah, those can happen if you, you know, hold your pee in for too long 792 00:38:55,959 --> 00:38:57,877 or you accidentally wipe from back to front… 793 00:38:57,961 --> 00:39:00,088 Mel, I know. I know, Mel. He told me. 794 00:39:00,171 --> 00:39:01,881 Oh, good. 795 00:39:01,965 --> 00:39:04,926 You know, he also told me it can happen from having sex. 796 00:39:06,553 --> 00:39:07,971 Yeah, it can. 797 00:39:08,763 --> 00:39:11,182 - It's not like you're having sex. - Yes, I am. 798 00:39:15,270 --> 00:39:16,521 I'm sorr…What? 799 00:39:16,604 --> 00:39:18,690 I'm having sex. 800 00:39:20,567 --> 00:39:22,777 - With who? - My boyfriend. 801 00:39:22,861 --> 00:39:24,946 - You have a boyfriend? - Yes. 802 00:39:25,029 --> 00:39:29,784 His name is Adam, and we're having sex, 803 00:39:29,868 --> 00:39:31,202 lots of sex. 804 00:39:33,371 --> 00:39:34,581 Okay. 805 00:39:38,376 --> 00:39:41,004 Mel, are you okay? 806 00:39:45,800 --> 00:39:47,760 - Got a sec? - Sure. 807 00:39:47,844 --> 00:39:50,305 - How you feeling? - I'm fine. 808 00:39:51,139 --> 00:39:52,640 - Are you sure? - Yeah. 809 00:39:52,724 --> 00:39:55,018 Troponin, D-dimer, and TSH all normal. 810 00:39:55,810 --> 00:39:57,145 Listen, I'm sorry about earlier. 811 00:39:57,228 --> 00:39:59,022 - I think I was being… - A dick? 812 00:40:00,607 --> 00:40:03,610 I was gonna say "unprofessional," but probably that, too. 813 00:40:04,527 --> 00:40:05,528 I'm sorry. 814 00:40:06,821 --> 00:40:07,822 Thanks. 815 00:40:08,865 --> 00:40:10,867 But now I kind of need you to stop feeling sorry for yourself 816 00:40:10,950 --> 00:40:12,535 and focus back on your patients. 817 00:40:12,619 --> 00:40:13,703 Think you can do that? 818 00:40:14,829 --> 00:40:16,414 - Sure. - Great. 819 00:40:20,001 --> 00:40:24,339 With this extra dose and increased morphine from the pump, 820 00:40:24,422 --> 00:40:25,965 your pain should subside. 821 00:40:26,049 --> 00:40:27,842 Your breathing will slow down. 822 00:40:28,885 --> 00:40:30,553 You may get very sleepy. 823 00:40:31,846 --> 00:40:34,265 Paul, go be with the boys. 824 00:40:35,642 --> 00:40:38,269 They need you more than I do now. 825 00:40:39,228 --> 00:40:40,438 Later. 826 00:40:41,147 --> 00:40:43,650 Right now I'm exactly where I'm supposed to be. 827 00:40:52,075 --> 00:40:53,076 Yeah. 828 00:40:54,035 --> 00:40:55,370 Okay. 829 00:40:55,453 --> 00:40:56,663 Here we go.