1 00:00:15,787 --> 00:00:18,915 Structural collapse at the water park… two victims coming in via helicopter. 2 00:00:18,998 --> 00:00:21,501 - ETA, five minutes. - Time to rally the troops. 3 00:00:21,584 --> 00:00:23,795 I'll get environmental to clear and prep the trauma rooms. 4 00:00:23,878 --> 00:00:24,879 Emma, restock the crash carts. 5 00:00:24,962 --> 00:00:26,923 Makedah, take the latest scripts to the drug cage. 6 00:00:27,006 --> 00:00:29,300 - Should be a fun one. - "Fun one"? What's up? 7 00:00:29,384 --> 00:00:31,928 Slide broke at the water park… two victims, five minutes to touchdown. 8 00:00:32,011 --> 00:00:34,514 - No information on extent of injuries. - I can jump in with… 9 00:00:34,597 --> 00:00:38,726 Ogilvie, grab some goggles, gloves, gown. Go up to the roof. 10 00:00:38,810 --> 00:00:40,895 First patient that lands, bring 'em down. 11 00:00:40,978 --> 00:00:43,523 We got two choppers. You want to grab some bodies and meet me? 12 00:00:43,606 --> 00:00:46,943 - What injuries are we expecting? - Structural collapse. Could be anything. 13 00:00:47,026 --> 00:00:50,530 I can increase the morphine drip to manage the pain, 14 00:00:50,613 --> 00:00:53,199 but that could also slow down your breathing. 15 00:00:53,282 --> 00:00:57,036 You will likely feel very drowsy. You may lose consciousness. 16 00:00:58,162 --> 00:01:00,289 And it could cause you to stop breathing altogether. 17 00:01:10,425 --> 00:01:12,051 I'll be right back. 18 00:01:19,434 --> 00:01:22,562 - Hey, you okay? - Yeah. 19 00:01:22,645 --> 00:01:23,938 Yeah. Sorry. 20 00:01:24,021 --> 00:01:27,567 Look, it's hard seeing your patients die. 21 00:01:27,650 --> 00:01:31,571 But as professionals, we have to create emotional boundaries for ourselves. 22 00:01:31,654 --> 00:01:34,073 It's not about us. It's about them. 23 00:01:36,159 --> 00:01:38,161 She's so calm. I just… 24 00:01:39,078 --> 00:01:40,580 Yeah. 25 00:01:40,663 --> 00:01:42,832 She's had a long time to prepare for this moment. 26 00:01:44,125 --> 00:01:49,088 What she's doing for her sons… managing this with so much grace… 27 00:01:49,172 --> 00:01:50,798 it's a real gift of love. 28 00:01:50,882 --> 00:01:52,675 I feel like an asshole. 29 00:01:53,718 --> 00:01:55,762 All they want is more time with their mother. 30 00:01:55,845 --> 00:01:57,597 All I want is less time with mine. 31 00:01:57,680 --> 00:01:59,557 Don't feel guilty. 32 00:01:59,640 --> 00:02:03,811 I mean, you can be grateful and gracious from a distance. 33 00:02:03,895 --> 00:02:06,606 Just talk to her. Tell her what you want. She'll understand. 34 00:02:09,275 --> 00:02:10,485 I doubt that. 35 00:02:11,861 --> 00:02:14,989 Give her a chance, you know? She may surprise you. 36 00:02:17,450 --> 00:02:18,868 Hey. 37 00:02:18,951 --> 00:02:20,828 Two birds headed our way. Need a hand? 38 00:02:20,912 --> 00:02:22,622 That's the rumor. 39 00:02:22,705 --> 00:02:24,540 Santos, trauma incoming. 40 00:02:24,624 --> 00:02:27,126 Grab a gown. You can assist Dr. Langdon. 41 00:02:30,129 --> 00:02:31,422 Fuck me. 42 00:02:31,506 --> 00:02:34,050 Jesus, I got blood tubes growing moss over here. 43 00:02:34,133 --> 00:02:36,135 Ticktock, people. 44 00:02:36,219 --> 00:02:38,429 Hey, Olive, do me a solid… run these to the lab. 45 00:02:38,513 --> 00:02:39,639 No problem. 46 00:02:39,722 --> 00:02:41,516 I got more lab results. 47 00:02:41,599 --> 00:02:43,643 Start putting them on the patient clipboards, 48 00:02:43,726 --> 00:02:45,853 PTMC Emergency. Go ahead, Medic Command. 49 00:02:45,937 --> 00:02:47,522 Do cyberattacks happen often? 50 00:02:47,605 --> 00:02:49,732 - More than you realize. - I blame the Russkies. 51 00:02:49,816 --> 00:02:52,819 Dr. Mohan, it's your mother? 52 00:02:52,902 --> 00:02:54,529 She sounds pretty upset. 53 00:02:54,612 --> 00:02:56,948 Says she really needs to talk to you. 54 00:02:57,949 --> 00:02:59,951 You're shitting me. Tell her I'm not available. 55 00:03:10,336 --> 00:03:11,629 How's your shift going? 56 00:03:12,547 --> 00:03:14,674 It's been a lot already. 57 00:03:15,758 --> 00:03:18,344 You know, I worked in an ER before, up in Vermont, 58 00:03:18,427 --> 00:03:22,098 and we had MVAs and ODs, MIs. 59 00:03:22,181 --> 00:03:23,349 But this place… 60 00:03:24,183 --> 00:03:25,643 …this place is relentless. 61 00:03:26,352 --> 00:03:29,188 Holiday weekend. We're not normally offline. 62 00:03:30,189 --> 00:03:32,859 I think we have a very different idea of normal. 63 00:03:32,942 --> 00:03:34,318 It's not for everyone. 64 00:03:34,402 --> 00:03:37,488 - I'm not sure it's healthy for anybody. - Here's her leg. 65 00:03:38,573 --> 00:03:40,199 Jesus. 66 00:03:47,582 --> 00:03:50,126 - I need more runners. - Oh, you could shut down the gift shop. 67 00:03:50,209 --> 00:03:52,295 They always have a couple of volunteers there. 68 00:03:52,378 --> 00:03:54,297 Most of those volunteers use walkers. 69 00:03:54,380 --> 00:03:55,923 Beggars can't be choosers. 70 00:03:56,007 --> 00:03:57,341 Go get 'em. 71 00:03:57,425 --> 00:03:59,719 - Okay, I'm gonna grab a smoke first. - No time. 72 00:03:59,802 --> 00:04:01,304 Nicotine gum…take the edge off. 73 00:04:01,387 --> 00:04:03,931 You two, head to triage to help out the front of the house. 74 00:04:04,015 --> 00:04:06,726 They're running out of space, and there's a line out the door. 75 00:04:06,809 --> 00:04:09,395 - Okay, let's go. - Hang on, Mohan. 76 00:04:11,022 --> 00:04:12,273 Sign this. 77 00:04:14,609 --> 00:04:16,527 Nicotine patch, 21 milligrams. 78 00:04:16,611 --> 00:04:19,155 - Who's it for? - Monica. This nicotine gum's shit. 79 00:04:19,238 --> 00:04:22,283 She'll never survive the shift, and I need her so I don't lose my goddamn mind. 80 00:04:25,036 --> 00:04:26,245 Thanks. 81 00:04:26,329 --> 00:04:27,997 Is Dr. Abbot still around? 82 00:04:28,080 --> 00:04:30,750 He went to get some sleep before his night shift starts in a couple hours. 83 00:04:30,833 --> 00:04:33,544 Shit. Okay, I should have planned this better. 84 00:04:33,628 --> 00:04:36,339 I was hoping he'd write me a letter of rec for an elective 85 00:04:36,422 --> 00:04:38,716 so I could have a shot at a fellowship next year. 86 00:04:38,799 --> 00:04:39,842 Which one? 87 00:04:41,052 --> 00:04:42,345 Whichever will take me. 88 00:04:42,428 --> 00:04:44,555 Didn't the electives fill up a while ago? 89 00:04:44,639 --> 00:04:46,974 Don't remind me. I'm gonna throw myself at the mercy of the court, 90 00:04:47,058 --> 00:04:48,976 beg for them to take me anyway. 91 00:04:49,060 --> 00:04:51,771 Just kill me now. It'll be less painful. 92 00:04:51,854 --> 00:04:53,898 Dana, I can't read this handwriting. 93 00:04:53,981 --> 00:04:55,066 It says… 94 00:04:56,067 --> 00:05:00,571 …1,000 milligrams acetaminophen orally, 4 milligrams ondansetron under the tongue, 95 00:05:00,655 --> 00:05:02,782 and trial of clear fluids. 96 00:05:02,865 --> 00:05:04,575 Seriously? It says all that? 97 00:05:04,659 --> 00:05:07,370 If it's not in a text with emojis, you kids can't read for shit. 98 00:05:10,665 --> 00:05:11,707 What do we have? 99 00:05:11,791 --> 00:05:13,709 A fall from 10 feet onto a metal fence. 100 00:05:13,793 --> 00:05:16,087 Right below the knee. Good vitals. 101 00:05:16,170 --> 00:05:17,838 Oh, it hurts. Oh, my God. 102 00:05:17,922 --> 00:05:20,216 - What's she had so far? - 50 of fent, repeated 25. 103 00:05:20,299 --> 00:05:21,592 No meds, no allergies. 104 00:05:21,676 --> 00:05:23,928 - Where should I put this? - Just hang on to it for now. 105 00:05:24,011 --> 00:05:27,807 On my count. One, two, three. 106 00:05:29,600 --> 00:05:32,728 Okay, Whitaker, E-FAST. Donnie, primary survey, please. 107 00:05:32,812 --> 00:05:34,897 Pupils equal and reactive. 108 00:05:35,606 --> 00:05:38,025 - What's your name? - My leg hurts really bad. 109 00:05:38,109 --> 00:05:39,819 Did I break it? 110 00:05:39,902 --> 00:05:41,362 I wouldn't say that it's broken exactly. 111 00:05:41,445 --> 00:05:43,614 We're gonna get an X-ray to determine that. 112 00:05:43,698 --> 00:05:45,616 Put that on the gurney, line it up for X-ray, 113 00:05:45,700 --> 00:05:47,034 keep your fucking mouth shut. 114 00:05:47,118 --> 00:05:48,911 Good lung sliding right and left. 115 00:05:48,995 --> 00:05:50,997 Airway patent, breath sounds bilaterally. 116 00:05:51,706 --> 00:05:54,083 - Please, it hurts. - BP 100 over 60. 117 00:05:54,166 --> 00:05:57,128 Pulse 118, pulse ox 98%. 118 00:05:57,211 --> 00:06:00,423 - Does your belly hurt? - No, asshole! It's my leg! 119 00:06:00,506 --> 00:06:03,551 - Okay, she's really moving here. - 100 of ketamine? 120 00:06:03,634 --> 00:06:05,469 Yeah, we can't evaluate like this. 121 00:06:06,512 --> 00:06:08,139 Hey, Ogilvie? 122 00:06:08,222 --> 00:06:10,307 - Deep breaths, yeah? - Yeah, okay. 123 00:06:10,391 --> 00:06:11,851 Whitaker, what's next? 124 00:06:11,934 --> 00:06:14,395 Once she's sedated, finish the E-FAST, 125 00:06:14,478 --> 00:06:16,313 plain X-ray, check her back, straight to CT. 126 00:06:16,397 --> 00:06:18,649 - What if the ketamine wears off? - Right. 127 00:06:18,733 --> 00:06:22,278 We should do a popliteal nerve block before the CT, 128 00:06:22,361 --> 00:06:24,196 anesthetize from the knee down. 129 00:06:24,280 --> 00:06:26,282 - Two view tib-fib. - Pushing ketamine now. 130 00:06:26,365 --> 00:06:29,076 - What's the bullet? - 42-year-old male with 20-foot fall. 131 00:06:29,160 --> 00:06:31,162 Blunt chest trauma with hand injury. 132 00:06:31,704 --> 00:06:33,622 Where's my son? Where's my son? 133 00:06:33,706 --> 00:06:36,000 He's tachy to 108, sats 98 on 2 liters, 134 00:06:36,083 --> 00:06:38,711 - BP 122 over 84. - We'll pan scan due to mechanism. 135 00:06:38,794 --> 00:06:40,671 - You? - Tib-fib amputation. 136 00:06:40,755 --> 00:06:43,632 Hoping ortho can give us a little hope for replantation. 137 00:06:43,716 --> 00:06:46,469 - Derek, where are you hurting? - Chest and my finger. 138 00:06:46,552 --> 00:06:47,595 Did they find my son? 139 00:06:47,678 --> 00:06:49,680 - Did you hit your head? - Don't think so. 140 00:06:49,764 --> 00:06:51,098 I need to find my son! 141 00:06:51,182 --> 00:06:53,476 We'll find him for you, but we need to take care of you first. 142 00:06:53,559 --> 00:06:56,479 Pericardium's clear. No fluid in Morrison's. 143 00:06:56,562 --> 00:06:58,147 Move both arms, wiggle your feet. 144 00:06:58,773 --> 00:07:01,108 - Good. Any pain in your neck? - No. 145 00:07:01,192 --> 00:07:02,902 - Spleen looks good. - Start with his chest. 146 00:07:02,985 --> 00:07:04,320 That's where he hurts. 147 00:07:04,403 --> 00:07:06,614 - No hemotympanum. - Normal sliding. 148 00:07:07,198 --> 00:07:09,158 Best to start with the side he's complaining about first. 149 00:07:10,785 --> 00:07:12,661 I don't see much sliding there. 150 00:07:12,745 --> 00:07:14,914 His name is Zack. He's seven. 151 00:07:14,997 --> 00:07:16,707 - Pneumothorax? - Set up for a chest tube. 152 00:07:16,791 --> 00:07:20,920 Not yet. Let's go posterolateral. Look for fluid first. 153 00:07:21,003 --> 00:07:22,963 Traumatic pneumothorax. We should prep the chest. 154 00:07:23,672 --> 00:07:25,591 Not necessarily. He's hemodynamically stable. 155 00:07:26,425 --> 00:07:27,718 Okay. 156 00:07:27,802 --> 00:07:29,470 Does that look like some fluid there? 157 00:07:29,553 --> 00:07:30,930 Hard to say for sure. 158 00:07:31,013 --> 00:07:33,724 Okay, he's tachycardic hemopneumothorax. He needs a chest tube. 159 00:07:33,808 --> 00:07:37,728 BP and sats are fine. We can wait for CT. If it's small, it'll resolve on its own. 160 00:07:37,812 --> 00:07:40,147 - We observe and reimage. - I agree. He's stable for now. 161 00:07:40,231 --> 00:07:41,607 Let's wait for the scan, Dr. Santos. 162 00:07:41,690 --> 00:07:43,943 - Okay, let's order… - Okay. 163 00:07:44,026 --> 00:07:46,445 …a CT chest, abdomen, pelvis, and X-ray left hand. 164 00:07:48,239 --> 00:07:50,366 - Major degloving. - Focus on the primary. 165 00:07:50,449 --> 00:07:52,576 Dr. Langdon's correct. We need to logroll him. 166 00:07:54,370 --> 00:07:56,497 Oh, okay. How about another 4 of morphine? 167 00:07:56,580 --> 00:07:57,580 Put it in. 168 00:07:57,623 --> 00:07:59,625 Hang in there, Derek. We got you. 169 00:08:01,877 --> 00:08:03,754 Fuck off already. 170 00:08:03,838 --> 00:08:06,382 - Boyfriend? - Wish. My mom. 171 00:08:06,465 --> 00:08:08,342 Every time I get a second of service, 172 00:08:08,425 --> 00:08:11,178 - another dozen texts come in. - Hey! How much longer do I have to wait? 173 00:08:11,262 --> 00:08:12,888 I got a broken leg here. 174 00:08:12,972 --> 00:08:14,557 Someone will be with you shortly, sir. 175 00:08:14,640 --> 00:08:17,393 Am I allowed to use the bathroom? I really have to go. 176 00:08:17,476 --> 00:08:19,353 I don't know, ma'am. I am not your doctor. 177 00:08:19,436 --> 00:08:22,523 - It says right there "doctor." - Yes, but I'm not your doctor. 178 00:08:22,606 --> 00:08:24,859 But if you go back to your room, a nurse will come find you. 179 00:08:24,942 --> 00:08:26,610 I wasn't in a room. 180 00:08:26,694 --> 00:08:29,572 I'm sorry. Are either of you treating my mother? 181 00:08:29,655 --> 00:08:30,656 Nope! 182 00:08:37,788 --> 00:08:39,874 Take a seat. It's gonna be a while. 183 00:08:43,294 --> 00:08:45,337 Helen Torres, come on down. 184 00:08:47,006 --> 00:08:49,008 Helen Torres? 185 00:08:49,091 --> 00:08:50,509 Yes, I'm coming. 186 00:08:53,095 --> 00:08:56,307 - Go through the door on this side. - Thank you. 187 00:09:04,315 --> 00:09:05,316 Thank you. 188 00:09:10,487 --> 00:09:12,323 I'm Dr. Mohan. This is Student Doctor Kwon. 189 00:09:12,406 --> 00:09:13,407 Helen. 190 00:09:13,490 --> 00:09:15,659 How long has your leg been swollen, Helen? 191 00:09:15,743 --> 00:09:18,370 It's been getting worse over the past week. 192 00:09:19,079 --> 00:09:20,831 Dr. Mohan, your mom called again. 193 00:09:20,915 --> 00:09:22,541 - She said you need to call her back. - Not now! 194 00:09:23,500 --> 00:09:24,710 I'm with a patient. 195 00:09:27,421 --> 00:09:28,547 Sorry about that. 196 00:09:29,924 --> 00:09:31,842 Did you fall or hit your leg? 197 00:09:31,926 --> 00:09:33,052 No. 198 00:09:33,928 --> 00:09:36,847 Have you ever had a blood clot before? 199 00:09:36,931 --> 00:09:37,932 No. 200 00:09:41,560 --> 00:09:43,812 - Are you all right? - Excuse me? 201 00:09:43,896 --> 00:09:47,066 - Do you need to sit down? - Oh, no. I'm fine. 202 00:09:47,149 --> 00:09:48,317 You don't look too good. 203 00:09:48,943 --> 00:09:50,361 What? 204 00:09:50,444 --> 00:09:52,112 No, it's just… 205 00:09:52,196 --> 00:09:53,781 it's really hot in here. 206 00:09:53,864 --> 00:09:54,990 And… 207 00:09:56,325 --> 00:09:58,369 - You need to sit down. - I'm good. 208 00:10:00,162 --> 00:10:02,081 I just need some air. 209 00:10:02,164 --> 00:10:03,749 Excuse me one second. 210 00:10:21,392 --> 00:10:24,228 - You a doctor? - Sorry, Doctor, does this look infected? 211 00:10:24,311 --> 00:10:26,897 I've been waiting six hours, and people keep cutting in front of me. 212 00:10:26,981 --> 00:10:30,109 Doctor, can you just look at my throat just to see if it's strep? 213 00:10:30,192 --> 00:10:31,777 Look out! Make way! 214 00:10:32,987 --> 00:10:34,488 Get in. 215 00:10:34,571 --> 00:10:36,156 No, I'm okay. 216 00:10:36,240 --> 00:10:38,993 - I'm okay. - Get in the fucking chair. 217 00:10:42,204 --> 00:10:43,330 Excuse me, ma'am. 218 00:10:43,414 --> 00:10:45,541 Excuse me, coming through! 219 00:10:45,624 --> 00:10:47,126 Out of my way! 220 00:10:47,209 --> 00:10:50,504 We were going down the water slide, and the bottom just fell off. 221 00:10:50,587 --> 00:10:53,132 I grabbed Zack's arm, and I tried to hold on to the sides, 222 00:10:53,215 --> 00:10:55,342 but my hand slipped, and my ring got stuck. 223 00:10:55,426 --> 00:10:57,219 My finger was ripping off, and I just… 224 00:10:58,012 --> 00:10:59,596 …and I lost him. 225 00:11:00,222 --> 00:11:03,642 We can numb up your finger as soon as we gauge the extent of the injury. 226 00:11:03,726 --> 00:11:05,561 You can cut the damn thing off for all I care. 227 00:11:05,644 --> 00:11:07,187 I just need to find Zack. 228 00:11:08,022 --> 00:11:10,649 - Okay, do you feel anything here? - Yeah, sharp. 229 00:11:10,733 --> 00:11:12,526 - How about here? - Sharp again. 230 00:11:12,609 --> 00:11:13,944 A little late for the show, Yoyo. 231 00:11:14,028 --> 00:11:16,155 I am the show, Dr. Langdon. You're the warm-up act. 232 00:11:16,238 --> 00:11:17,573 I knew somebody missed me. 233 00:11:18,282 --> 00:11:20,951 Mr. Foster suffered a degloving injury of the ring finger. 234 00:11:21,035 --> 00:11:23,162 Stable pneumothorax awaiting imaging. 235 00:11:23,245 --> 00:11:25,831 Hello, sir. I'm Dr. Garcia from the trauma service. 236 00:11:26,457 --> 00:11:27,583 I need the ring cutter. 237 00:11:27,666 --> 00:11:29,460 That's why they pay the surgeons the big bucks. 238 00:11:30,044 --> 00:11:32,046 Possible flexor tendon injury. 239 00:11:33,672 --> 00:11:36,258 Try to bend up your ring finger. 240 00:11:38,802 --> 00:11:40,304 Let's go with the block. 241 00:11:40,387 --> 00:11:43,390 You're gonna feel a pinprick and some burning. 242 00:11:43,474 --> 00:11:45,976 Which tendon did we test, Dr. Santos? 243 00:11:46,060 --> 00:11:47,895 Seriously? That's a med-student question. 244 00:11:48,687 --> 00:11:51,482 We're a teaching hospital. It's always good to review. 245 00:11:52,858 --> 00:11:55,778 Flexor digitorum superficialis is intact 246 00:11:55,861 --> 00:11:58,197 as it inserts on the middle phalanx. 247 00:11:58,280 --> 00:12:00,574 - Correct. - Gee, thanks. 248 00:12:01,283 --> 00:12:02,701 No sign of tension. 249 00:12:03,327 --> 00:12:05,037 At least no tension pneumo. 250 00:12:05,871 --> 00:12:07,790 Let's wait for the CT. I'll be next door. 251 00:12:07,873 --> 00:12:10,584 Langdon, Mel's sister's been asking for you. 252 00:12:10,667 --> 00:12:12,795 She's getting antsy, and we could really use the room. 253 00:12:12,878 --> 00:12:15,047 - CT's ready. - Okay. Let Becca know I'll be there soon. 254 00:12:15,130 --> 00:12:18,425 And Mr. Foster got separated from his son Zack 255 00:12:18,509 --> 00:12:19,802 at the water park. 256 00:12:19,885 --> 00:12:22,429 - Is there anyone we can call for you? - My wife, Angela. 257 00:12:22,513 --> 00:12:25,516 Dr. Santos, will you escort Mr. Foster to CT? 258 00:12:29,895 --> 00:12:30,979 Help! 259 00:12:31,063 --> 00:12:32,731 Need a hand here. 260 00:12:33,524 --> 00:12:36,360 - What the hell happened? - I think I'm having an MI. 261 00:12:36,443 --> 00:12:38,570 My chest is so tight, I can barely breathe. 262 00:12:38,654 --> 00:12:41,657 Okay, I got to get a 12 lead. Perlah, can I get an assist here? 263 00:12:41,740 --> 00:12:42,908 Yeah, I'm on it. 264 00:12:44,368 --> 00:12:45,369 CT's normal. 265 00:12:45,452 --> 00:12:47,246 Why do we take down the tourniquet, Whitaker? 266 00:12:47,329 --> 00:12:50,124 To give the residual limb blood flow. 267 00:12:50,207 --> 00:12:51,625 Just two little pumpers. 268 00:12:51,708 --> 00:12:53,752 A couple of figure eights ought to take care of those. 269 00:12:54,545 --> 00:12:56,004 Park. 270 00:12:56,088 --> 00:12:58,549 Park the Shark, orthopedic surgeon. 271 00:12:59,133 --> 00:13:01,260 - Is this a favorable amputation? - Pretty clean cut. 272 00:13:01,343 --> 00:13:03,053 Fence sliced through like a guillotine. 273 00:13:03,137 --> 00:13:04,304 X-ray? 274 00:13:06,849 --> 00:13:08,142 Not too bad. 275 00:13:10,352 --> 00:13:13,772 Just tying off a couple arterioles. 276 00:13:13,856 --> 00:13:15,357 I'm not blind. 277 00:13:16,066 --> 00:13:18,777 - Where's the amputated leg? - Double bagged on ice. 278 00:13:19,570 --> 00:13:21,738 Sterile saline on the inner bag. 279 00:13:21,822 --> 00:13:25,701 Ice water in the outer bag. No direct ice-on-skin contact. 280 00:13:25,784 --> 00:13:29,163 - We spent a lot of time prepping… - He still needs to look. 281 00:13:33,584 --> 00:13:34,793 Get Robby. 282 00:13:44,011 --> 00:13:46,680 - Antibiotics? - Cefazolin and gent. 283 00:13:46,763 --> 00:13:49,141 We've cleared her chest, abdomen, and pelvis. 284 00:13:49,224 --> 00:13:53,395 Clean wound, no crush injury, rapid transport time. 285 00:13:53,937 --> 00:13:55,522 Replantation is a go. 286 00:13:55,606 --> 00:13:56,732 I'll book an OR. 287 00:13:56,815 --> 00:13:58,317 Irrigate the hell out of this with 3 liters. 288 00:13:58,400 --> 00:14:00,903 - 3 liters? - Of saline, genius. 289 00:14:02,779 --> 00:14:03,989 Thanks, Shark. 290 00:14:07,826 --> 00:14:09,495 I knew he meant saline. 291 00:14:10,621 --> 00:14:14,708 Dr. Robby, we need you in Central 6. Dr. Mohan may be having a heart attack. 292 00:14:14,791 --> 00:14:15,834 What? 293 00:14:17,794 --> 00:14:20,339 - EKG is normal. - You sure? 294 00:14:20,422 --> 00:14:22,549 Check it out. You can be your own second opinion. 295 00:14:22,633 --> 00:14:24,718 - What's going on? - It's okay. I'm okay. 296 00:14:24,801 --> 00:14:26,220 You don't look okay. 297 00:14:26,303 --> 00:14:28,347 - You look like shit. - I feel like shit. 298 00:14:28,430 --> 00:14:30,933 - What happened? - I don't know. 299 00:14:31,016 --> 00:14:34,811 I just got really hot, and I started having trouble breathing. 300 00:14:35,646 --> 00:14:37,856 We should send up some labs just to be safe. 301 00:14:38,857 --> 00:14:40,067 Any chance you're pregnant? 302 00:14:40,150 --> 00:14:42,861 I'm not sure I feel comfortable answering that. 303 00:14:44,613 --> 00:14:46,949 - No. - She was tachy, but it's resolved now. 304 00:14:47,032 --> 00:14:48,867 - Have you eaten anything? - Yeah. 305 00:14:49,451 --> 00:14:51,245 - You staying hydrated? - 100%. 306 00:14:51,870 --> 00:14:52,996 I'm doing everything right. 307 00:14:53,080 --> 00:14:55,290 It's everything around me that's all fucked up. 308 00:14:55,374 --> 00:14:58,252 It's just my mom moving and calling me over and over again 309 00:14:58,335 --> 00:15:00,170 and now me scrambling to find a job next year. 310 00:15:00,254 --> 00:15:02,965 I had it all planned out, and now everything's just out the window. 311 00:15:03,048 --> 00:15:05,926 Wait a minute. Is this a panic attack because of your mommy issues? 312 00:15:06,593 --> 00:15:08,095 - What? No. - Jesus. 313 00:15:08,178 --> 00:15:09,388 Do you need to go home? 314 00:15:09,471 --> 00:15:11,098 - You should go home. - No, I'm fine. 315 00:15:11,181 --> 00:15:12,724 I don't need the fucking liability. Go home. 316 00:15:13,267 --> 00:15:15,978 And the rest of you, the last time I checked, the ED is a shit show. 317 00:15:16,061 --> 00:15:18,063 So let's all get back to work, huh? 318 00:15:25,404 --> 00:15:27,864 Sorry for taking so long, Becca. 319 00:15:27,948 --> 00:15:29,950 Nurse Dana said you'd be back in a few minutes, 320 00:15:30,033 --> 00:15:32,202 but it's definitely been more than a few minutes. 321 00:15:32,286 --> 00:15:34,079 You're right. My apologies. 322 00:15:34,705 --> 00:15:36,832 - I brought some drink options. - Okay. 323 00:15:36,915 --> 00:15:40,669 We've got apple juice, cranberry juice, 324 00:15:40,752 --> 00:15:43,797 OJ, and Pittsburgh's finest. 325 00:15:43,880 --> 00:15:46,091 - What's that? - Water. 326 00:15:46,925 --> 00:15:48,719 - OJ, please. - Okay. 327 00:15:50,095 --> 00:15:51,513 Let's see. 328 00:15:54,683 --> 00:15:55,726 All right. 329 00:15:56,727 --> 00:15:59,521 Now, I am going to give you two pills. 330 00:16:00,105 --> 00:16:02,149 The first is an antibiotic. 331 00:16:02,232 --> 00:16:04,443 That will get rid of the infection. 332 00:16:04,526 --> 00:16:06,445 The second should take care of the burning. 333 00:16:06,528 --> 00:16:09,948 You want to take both pills for three days and drink lots of water. 334 00:16:10,032 --> 00:16:11,450 I'll write it all down. 335 00:16:11,533 --> 00:16:12,743 I hate pills. 336 00:16:13,410 --> 00:16:16,288 Could you mash those up and put them in the OJ for me? 337 00:16:16,371 --> 00:16:17,748 Coming right up. 338 00:16:19,666 --> 00:16:20,751 Okay. 339 00:16:21,960 --> 00:16:24,630 Mel's gonna be super worried when you tell her. 340 00:16:25,255 --> 00:16:26,798 You are gonna be just fine. 341 00:16:26,882 --> 00:16:30,260 But as far as telling your sister what's going on with you, 342 00:16:30,344 --> 00:16:32,512 that is your decision, not mine. 343 00:16:34,765 --> 00:16:37,768 So you're not going to tell Mel? 344 00:16:38,560 --> 00:16:42,522 I can't, not unless you, my patient, tell me to. 345 00:16:45,776 --> 00:16:49,363 Do you know when Mel's gonna be done with her important meeting? 346 00:16:50,155 --> 00:16:51,365 Hopefully soon. 347 00:16:52,783 --> 00:16:56,286 Dr. Langdon, they need you back in Trauma Two. 348 00:16:56,370 --> 00:16:57,371 Hi. 349 00:16:59,706 --> 00:17:01,249 Becca, I got to go. I'll be… 350 00:17:01,333 --> 00:17:04,461 Don't say "in a few minutes" unless you actually mean in a few minutes. 351 00:17:05,170 --> 00:17:06,380 I would never. 352 00:17:11,301 --> 00:17:14,513 And I need you to be kind to each other. 353 00:17:14,596 --> 00:17:18,016 I am kind. Shane's just a butthead sometimes. 354 00:17:19,601 --> 00:17:23,188 He's your brother, and he loves you. 355 00:17:25,482 --> 00:17:26,608 Don't go. 356 00:17:27,401 --> 00:17:28,819 I don't want to go. 357 00:17:30,153 --> 00:17:32,906 But it's not up to me. 358 00:17:34,032 --> 00:17:35,117 Hey. 359 00:17:35,200 --> 00:17:37,202 We'll always be connected… 360 00:17:38,036 --> 00:17:39,413 …no matter what. 361 00:17:42,416 --> 00:17:44,042 Invisible string. 362 00:17:47,629 --> 00:17:49,214 Invisible string. 363 00:18:01,435 --> 00:18:02,436 Hey. 364 00:18:04,855 --> 00:18:06,565 You gonna go in and see your mom? 365 00:18:08,066 --> 00:18:09,651 Cancer sucks. 366 00:18:10,652 --> 00:18:11,903 Yeah. 367 00:18:11,987 --> 00:18:13,447 Yeah, it does. 368 00:18:16,450 --> 00:18:19,661 - It's not fair. - No, it's not. 369 00:18:24,249 --> 00:18:25,834 I don't want to go in there. 370 00:18:27,878 --> 00:18:29,880 Nobody's gonna make you. 371 00:18:36,887 --> 00:18:38,889 She didn't used to look like that. 372 00:18:41,892 --> 00:18:43,477 Yeah, I get that. 373 00:18:47,147 --> 00:18:50,192 But if you don't go in there and say goodbye 374 00:18:50,275 --> 00:18:52,277 and tell your mom you love her… 375 00:18:53,904 --> 00:18:57,115 …I think you might wish you had for a very long time. 376 00:19:01,286 --> 00:19:02,704 It's your call. 377 00:19:06,500 --> 00:19:10,712 D-5 half normal saline, 20 of K running at 125 an hour. 378 00:19:11,505 --> 00:19:12,839 One of the most common reasons 379 00:19:12,923 --> 00:19:15,258 for traumatic-replantation failure is infections. 380 00:19:15,342 --> 00:19:16,718 So we do what, Whitaker? 381 00:19:16,802 --> 00:19:18,887 Rinse and repeat until surgery calls for us. 382 00:19:21,139 --> 00:19:23,225 Is everything okay with Dr. Mohan? 383 00:19:23,308 --> 00:19:24,810 She's fine. Focus. 384 00:19:30,148 --> 00:19:31,316 Where am I? 385 00:19:32,526 --> 00:19:33,985 Ketamine's wearing off. 386 00:19:37,155 --> 00:19:39,157 I can't feel my leg. 387 00:19:39,241 --> 00:19:42,035 I'm Dr. Michael Robinavitch. You're at a hospital. 388 00:19:42,118 --> 00:19:44,704 And we gave you a nerve block so that you can't feel any pain. 389 00:19:44,788 --> 00:19:45,789 Why? 390 00:19:45,872 --> 00:19:49,835 You were on a water slide that collapsed and did serious injury to your leg. 391 00:19:53,964 --> 00:19:55,215 What the fuck? 392 00:19:55,298 --> 00:19:56,591 Is that my leg? 393 00:19:56,675 --> 00:19:57,676 Is that my… 394 00:19:57,759 --> 00:20:00,512 - Did you cut my fucking leg off? - Your leg was cut off in the accident. 395 00:20:00,595 --> 00:20:02,722 Our surgeons are going to try for replantation. 396 00:20:02,806 --> 00:20:04,266 No. 397 00:20:04,349 --> 00:20:05,684 - She needs more ketamine. - Just wrap up the leg. 398 00:20:05,767 --> 00:20:06,893 Emily, I know that this is really hard. 399 00:20:06,977 --> 00:20:08,395 I need you to focus on me right now, 400 00:20:08,478 --> 00:20:09,896 because we need to get your consent 401 00:20:09,980 --> 00:20:11,690 - to proceed with the surgery. - Why? 402 00:20:11,773 --> 00:20:13,108 There are risks with the surgery. 403 00:20:13,191 --> 00:20:15,485 There's anesthesia, and there's no guarantee… 404 00:20:15,569 --> 00:20:17,112 Emily? 405 00:20:17,195 --> 00:20:19,906 Can you just put it back on? 406 00:20:19,990 --> 00:20:22,409 - Can you just put it back on? - Sounds like consent to me. 407 00:20:22,492 --> 00:20:24,911 - Now can she have sedation? - Okay, load her up. Ketamine and rock. 408 00:20:24,995 --> 00:20:26,288 It's gonna be okay. It's gonna be okay. 409 00:20:26,371 --> 00:20:28,164 We're gonna intubate before the OR. 410 00:20:28,248 --> 00:20:29,791 It's gonna be okay. 411 00:20:30,417 --> 00:20:33,503 - Finishing second cut. - Success. 412 00:20:33,587 --> 00:20:36,756 - Can that be saved? - The finger or the ring? 413 00:20:36,840 --> 00:20:38,425 - The wedding ring. - Yes, sir. 414 00:20:38,508 --> 00:20:40,802 A jeweler can weld it back together good as new. 415 00:20:41,553 --> 00:20:44,306 Stop. Irrigate the ring shavings off first. 416 00:20:46,224 --> 00:20:48,810 - What did I miss? - Finishing irrigation. 417 00:20:49,603 --> 00:20:50,729 Okay. 418 00:20:50,812 --> 00:20:52,522 Doesn't look like you lost any skin. 419 00:20:52,606 --> 00:20:54,691 It's a little dusky. Might not be viable. 420 00:20:54,774 --> 00:20:56,526 There's intact skin on the dorsum. 421 00:20:56,610 --> 00:20:58,904 More irrigation, then tack it down with one suture. 422 00:20:58,987 --> 00:21:00,405 Okay, thanks. 423 00:21:00,488 --> 00:21:04,326 - Radiologist reports a 25% pneumothorax. - Is that bad? 424 00:21:04,409 --> 00:21:07,162 That is a partially collapsed lung that needs treatment. 425 00:21:07,245 --> 00:21:09,831 - I can put in a chest tube. - He doesn't need a chest tube. 426 00:21:09,915 --> 00:21:12,000 Okay, what do you want, a pigtail catheter? 427 00:21:12,834 --> 00:21:14,461 I was thinking a ThoraVent. 428 00:21:14,544 --> 00:21:15,837 What? Why? 429 00:21:15,921 --> 00:21:18,131 It's not a bad idea. No need for wall suction. 430 00:21:18,214 --> 00:21:21,176 If Hand can operate today, he can go home tomorrow with the ThoraVent. 431 00:21:21,259 --> 00:21:23,553 You can learn a lot from your senior residents. 432 00:21:23,637 --> 00:21:25,847 I'm happy to teach Dr. Santos. 433 00:21:25,931 --> 00:21:27,849 Thank you, Dr. Langdon. 434 00:21:32,062 --> 00:21:35,190 Janelle, I need you to take the samples to the lab 435 00:21:35,273 --> 00:21:37,067 and come back with any results that are ready. 436 00:21:37,150 --> 00:21:40,987 Geoffrey, head to CT to see if any new results are printed and bring those back. 437 00:21:41,071 --> 00:21:43,907 Pam, check in with whoever's running the PDS 438 00:21:43,990 --> 00:21:46,201 to see if any orders need to go to the pharmacy 439 00:21:46,284 --> 00:21:48,286 and bring back any meds that are ready for pickup. 440 00:21:48,370 --> 00:21:50,747 Rinse and repeat every 15 minutes. 441 00:21:50,830 --> 00:21:52,749 Double-tie those shoelaces and hydrate. 442 00:21:52,832 --> 00:21:54,876 It's not a sprint. It's a marathon. 443 00:21:55,669 --> 00:21:57,295 Fly, my pretties. 444 00:21:58,088 --> 00:22:00,799 Okay, any word on finding our water slide dad's kid? 445 00:22:00,882 --> 00:22:04,469 Not yet. Called the wife, went straight to voicemail. 446 00:22:04,552 --> 00:22:07,222 Police dispatch said that there were a couple of fatalities on site… 447 00:22:07,305 --> 00:22:09,808 - one adult, one kid. - Sweet Jesus. 448 00:22:09,891 --> 00:22:11,059 Who the fuck did this? 449 00:22:11,142 --> 00:22:15,397 No sign-off on orders for labs or X-rays, and it's in the wrong freaking rack? 450 00:22:15,480 --> 00:22:17,899 You guys trying to kill me and the patient? 451 00:22:17,983 --> 00:22:19,609 - I'll take care of it. - Thanks. 452 00:22:19,693 --> 00:22:23,029 - Dana, this gum is abso… - Shit. I know. 453 00:22:23,113 --> 00:22:25,031 Pharmacy said you needed this right away. 454 00:22:25,115 --> 00:22:27,575 Just in time. Slap one on and give it an hour to kick in. 455 00:22:27,659 --> 00:22:28,660 You're welcome. 456 00:22:29,869 --> 00:22:32,664 - What? - The prescription is for you. 457 00:22:32,747 --> 00:22:34,582 My insurance will cover it. Hers won't. 458 00:22:35,333 --> 00:22:36,751 Isn't that insurance fraud? 459 00:22:37,711 --> 00:22:39,838 Throw me in jail. I could use a vacation. 460 00:22:43,299 --> 00:22:44,342 Mom. 461 00:22:49,931 --> 00:22:51,433 I'm really glad to see you, Mom. I… 462 00:22:51,516 --> 00:22:53,935 Garcia told me about the sigmoid volvulus you missed. 463 00:22:54,019 --> 00:22:56,354 - It was an oversight. - That could have killed her. 464 00:22:56,938 --> 00:22:59,441 Without electronic records, it's been kind of a challenge to figure out… 465 00:22:59,524 --> 00:23:02,444 Chaos is the status quo in the ED, even when the computers are working properly. 466 00:23:02,527 --> 00:23:04,696 You have to be hypervigilant and double-check everything. 467 00:23:04,779 --> 00:23:07,157 - I can handle it. - Why would you want to? 468 00:23:08,033 --> 00:23:11,286 Down here your learning street-level medicine, all seat of your pants. 469 00:23:11,369 --> 00:23:12,662 Oh, well, I made a mistake, 470 00:23:12,746 --> 00:23:15,749 but the more talented practitioners upstairs will fix it. 471 00:23:17,959 --> 00:23:19,419 You are better than this. 472 00:23:20,962 --> 00:23:23,965 I love you, too. 473 00:23:28,344 --> 00:23:32,307 - Well, that is one way to do a debrief. - You should talk to her. 474 00:23:32,390 --> 00:23:35,018 - Which one? - Honestly, both of them. 475 00:23:35,101 --> 00:23:37,729 - Can you call in some extra doctors? - Sure. 476 00:23:37,812 --> 00:23:39,439 Everyone's dying to work on the Fourth of July. 477 00:23:39,522 --> 00:23:41,608 - Why? - Dr. Mohan went down. 478 00:23:41,691 --> 00:23:43,860 Yeah. I saw your pep talk. 479 00:23:44,778 --> 00:23:47,489 She's taking a little break until her labs are back. 480 00:23:47,572 --> 00:23:50,909 She's going to be fine, but I'm not sure her head is in the game. 481 00:23:51,785 --> 00:23:53,203 I'm on it, Cap. 482 00:23:53,286 --> 00:23:55,121 Small stab incision with the 11 blade, 483 00:23:55,205 --> 00:23:58,500 midclavicular line, second intercostal space. 484 00:23:58,583 --> 00:24:01,377 - She's gonna stab me? - It's just a medical term. 485 00:24:01,461 --> 00:24:02,712 Stay superior to the rib. 486 00:24:07,801 --> 00:24:10,762 - Is there a problem? - Nope, everything's going well. 487 00:24:11,930 --> 00:24:13,223 Place the trocar. 488 00:24:14,015 --> 00:24:16,643 Hold back the adhesive wings 489 00:24:16,726 --> 00:24:20,146 and advance until you see the red diaphragm move. 490 00:24:20,230 --> 00:24:22,232 That means you're in the pleural space. 491 00:24:22,941 --> 00:24:25,276 Now remove the trocar. 492 00:24:28,780 --> 00:24:29,948 Perfect. 493 00:24:30,031 --> 00:24:33,701 Okay, now we can either hook up to wall suction, 494 00:24:33,785 --> 00:24:37,163 or we can use this one-way valve to repeatedly aspirate with a syringe. 495 00:24:37,247 --> 00:24:39,541 Well, with all your vast experience, Dr. Langdon, 496 00:24:39,624 --> 00:24:41,292 you should probably decide. 497 00:24:44,003 --> 00:24:46,756 We can avoid wall suction if I pump manually. 498 00:24:46,840 --> 00:24:48,550 - Have at it, Doc. - Enough. 499 00:24:48,633 --> 00:24:52,178 Apparently, decency and decorum need to be reintroduced to our R2 curriculum. 500 00:24:52,887 --> 00:24:54,597 Nice work, Dr. Langdon. 501 00:24:54,681 --> 00:24:56,850 I'll go check on an OR for Mr. Foster. 502 00:25:02,272 --> 00:25:04,649 Hey. I'm gonna need you to pick up the pace. 503 00:25:05,441 --> 00:25:08,570 Can I get a sec? Dr. Mohan just almost died on me. 504 00:25:08,653 --> 00:25:10,989 Not even close. She's tougher than she looks. 505 00:25:11,072 --> 00:25:12,866 Propane hero in North 4. 506 00:25:12,949 --> 00:25:14,450 Hey, any word from surgery 507 00:25:14,534 --> 00:25:17,579 on how our big patient Howard's perforated diverticulitis is doing? 508 00:25:17,662 --> 00:25:20,206 - Still in the OR. - What about our drunk firework kid? 509 00:25:20,290 --> 00:25:22,250 Waiting his turn in the surgical conga line. 510 00:25:22,876 --> 00:25:24,502 What about Social Services? 511 00:25:24,586 --> 00:25:26,588 Have they found a temporary foster home 512 00:25:26,671 --> 00:25:29,007 - for our baby Jane Doe? - Still working on it. 513 00:25:29,090 --> 00:25:31,968 Kid's gonna be old enough to drive by the time she gets out of here. 514 00:25:32,051 --> 00:25:33,511 You joke… 515 00:25:34,596 --> 00:25:36,222 Oh, for fuck's sake! 516 00:25:36,306 --> 00:25:39,434 Go, quickly, before I change my mind. 517 00:25:39,517 --> 00:25:42,228 Hey, did the county pick up Louie's body yet? 518 00:25:42,312 --> 00:25:45,231 - No. He's still in the viewing room. - Jesus. He's just laying in there? 519 00:25:45,315 --> 00:25:48,318 Yeah. Another couple minutes, I'm gonna wheel him down to the morgue myself. 520 00:25:50,028 --> 00:25:51,029 What's the bullet? 521 00:25:51,112 --> 00:25:53,031 Eight-year-old boy, part of the water park accident. 522 00:25:53,114 --> 00:25:55,033 - Thrown off the water slide. - How far did he fall? 523 00:25:55,116 --> 00:25:57,410 Maybe 6 or 7 feet, landed in a tree. 524 00:25:57,493 --> 00:25:59,204 Had to wait for a ladder truck to get him down. 525 00:25:59,287 --> 00:26:01,414 Major neck trauma. Must've taken all the impact there. 526 00:26:01,497 --> 00:26:02,832 Couldn't tube him, hard to bag. 527 00:26:02,916 --> 00:26:06,544 Sats in the 80s. BP 85 over 60. Pulse 50. 528 00:26:08,713 --> 00:26:11,132 Okay, one, two, and three. 529 00:26:12,383 --> 00:26:15,053 - Possible laryngeal fracture. - Hypoxic bradycardic. 530 00:26:15,136 --> 00:26:17,096 Kid needs an airway before he arrests. 531 00:26:17,180 --> 00:26:19,515 Broselow tape, pedes cart, set up suction. 532 00:26:19,599 --> 00:26:21,768 Oh, my God. Is that Zack? 533 00:26:22,477 --> 00:26:24,562 Hey. Hey, kid, can you look at me? 534 00:26:25,271 --> 00:26:27,941 No response, no purposeful movement to pain. 535 00:26:29,275 --> 00:26:30,318 Oh, my God. 536 00:26:30,401 --> 00:26:31,444 Is this your kid? 537 00:26:32,153 --> 00:26:33,655 - No. - Sir, go back to your room now. 538 00:26:33,738 --> 00:26:35,615 - Broselow says 25 kilograms. - Jesse? 539 00:26:35,698 --> 00:26:37,033 5 1/2 ET tube. 540 00:26:37,116 --> 00:26:40,745 - Okay, 30 of rock, 50 ketamine. - You're gonna paralyze? 541 00:26:40,828 --> 00:26:43,289 - Yep. - If we can't intubate, we crike? 542 00:26:43,373 --> 00:26:44,666 He's too young for a crike. 543 00:26:44,749 --> 00:26:46,751 - Needle crike? - Can't ventilate through that. 544 00:26:46,834 --> 00:26:49,796 - Sats down to 78. - 11 blade, Kelly, and a pedes bougie. 545 00:26:49,879 --> 00:26:51,130 One quick look, and then we cut. 546 00:26:51,839 --> 00:26:54,425 I can't tell if there's lung sliding. No movement, no air entry. 547 00:26:54,509 --> 00:26:56,511 Way too edematous. I can't see the cords. 548 00:26:56,594 --> 00:26:58,221 Better with cricoid pressure? 549 00:26:59,389 --> 00:27:00,473 Nothing. Fuck. 550 00:27:00,556 --> 00:27:02,308 Okay. Towel roll between the shoulder blades, please. 551 00:27:02,392 --> 00:27:04,519 Heart rate down to 49. Headed to cardiac arrest. 552 00:27:04,602 --> 00:27:06,688 Trake's going to take 20 minutes. This kid's not gonna last 60 seconds. 553 00:27:06,771 --> 00:27:08,106 That's why we're doing a slash trake. 554 00:27:08,189 --> 00:27:09,691 - Don't know it. - Me neither. 555 00:27:09,774 --> 00:27:11,693 - Boss? - Show me what you got. 556 00:27:20,994 --> 00:27:24,205 Pull up the trachea between your thumb and middle finger. 557 00:27:24,872 --> 00:27:27,792 Vertical incision right over the trachea. 558 00:27:28,626 --> 00:27:32,255 Vertical, not horizontal, or you transect the trachea and cut the jugular veins. 559 00:27:33,715 --> 00:27:35,049 That's a lot of blood. 560 00:27:35,633 --> 00:27:37,468 Now it's a tactile procedure. 561 00:27:37,552 --> 00:27:40,179 2-centimeter incision through the tracheal rings. 562 00:27:40,805 --> 00:27:42,432 Finger in the trachea. 563 00:27:44,017 --> 00:27:45,768 Bougie into the airway. 564 00:27:47,645 --> 00:27:51,190 - Thoughts on what's next, Dr. Whitaker? - Insert the ET tube into the trachea. 565 00:27:52,483 --> 00:27:54,485 Suction. Lots of blood in the airway. 566 00:28:01,284 --> 00:28:02,452 Okay, bag him. 567 00:28:03,536 --> 00:28:04,829 Check the CO2. 568 00:28:06,039 --> 00:28:07,957 Sats coming up, in the 80s. 569 00:28:08,041 --> 00:28:10,960 Bilateral breath sounds. End tidal CO2 is 70. 570 00:28:11,044 --> 00:28:12,754 - That's crazy high. - It'll come down. 571 00:28:12,837 --> 00:28:14,756 Tie down the tube, control all the bleeders. 572 00:28:14,839 --> 00:28:17,383 Spray an amp of epi on a stack of 4-by-4s. 573 00:28:17,467 --> 00:28:20,136 Okay. Sats are up to the 90s. 574 00:28:20,219 --> 00:28:22,388 Good. CO2's in the 50s. Good heart rate. 575 00:28:22,472 --> 00:28:24,098 You forgot the last step. 576 00:28:24,182 --> 00:28:25,975 Change your underwear. 577 00:28:26,059 --> 00:28:28,686 - How many of these you done? - First one. 578 00:28:28,770 --> 00:28:29,896 You serious? 579 00:28:29,979 --> 00:28:31,773 - How about you? - None. 580 00:28:31,856 --> 00:28:34,400 I practiced in the Sim Lab when I was at Stanford. 581 00:28:34,484 --> 00:28:35,777 - What'd I miss? - All the fun. 582 00:28:35,860 --> 00:28:37,111 - Slash trake. - Seriously? 583 00:28:38,071 --> 00:28:40,948 Fractured larynx. Couldn't oxygenate, couldn't ventilate. 584 00:28:41,032 --> 00:28:44,744 - You use a meat cleaver on this kid? - ENT can revise the trake in the OR. 585 00:28:45,453 --> 00:28:47,121 They'll be thrilled to clean up your mess. 586 00:28:48,081 --> 00:28:50,500 Or maybe they'll thank us for not letting him die. 587 00:28:56,172 --> 00:28:58,132 So we're still waiting on your prescription, 588 00:28:58,216 --> 00:29:00,009 and the pharmacy is a little backed up. 589 00:29:00,093 --> 00:29:02,553 But I'm glad to see you're doing good. 590 00:29:02,637 --> 00:29:03,637 Well. 591 00:29:04,222 --> 00:29:05,306 I'm well. 592 00:29:06,891 --> 00:29:08,226 Glad to see you're well. 593 00:29:08,309 --> 00:29:10,520 Can't you expedite my medication? 594 00:29:11,229 --> 00:29:13,439 Sure, but it may still be a little while 595 00:29:13,523 --> 00:29:17,610 before Dr. Mohan can sign off on the discharge, so sit tight. 596 00:29:19,529 --> 00:29:20,738 And do what? 597 00:29:24,909 --> 00:29:27,537 You just keep this handy for occasions like this? 598 00:29:28,538 --> 00:29:31,165 I thought that I might not have that much to do today. 599 00:29:31,249 --> 00:29:32,333 But… 600 00:29:33,126 --> 00:29:34,752 …man, I was wrong. 601 00:29:41,467 --> 00:29:42,760 Thank you. 602 00:29:47,557 --> 00:29:50,852 - What brings you in today? - A friend made me come in. 603 00:29:50,935 --> 00:29:54,063 - Name's Robby. He said I should… - You're Duke. 604 00:29:54,772 --> 00:29:56,274 - Donnie? - Yep? 605 00:29:56,357 --> 00:29:58,151 Robby's VIP is here. 606 00:30:01,779 --> 00:30:04,699 Hi. I'm Donnie, nurse practitioner. 607 00:30:04,782 --> 00:30:08,870 Robby's already put in orders for a numbing spray for your nostril. 608 00:30:08,953 --> 00:30:10,955 "Nostril"? It's my throat. 609 00:30:11,038 --> 00:30:12,874 - It's not my nose. - Okay. 610 00:30:12,957 --> 00:30:15,376 Let's get you set up in a room. 611 00:30:18,713 --> 00:30:22,383 That was the most unprofessional deposition I've ever witnessed. 612 00:30:22,467 --> 00:30:24,802 They were nowhere near that aggressive with Dr. Ellis. 613 00:30:25,970 --> 00:30:27,388 Oh, okay. 614 00:30:29,599 --> 00:30:31,601 It didn't go as badly as you think. 615 00:30:32,143 --> 00:30:33,978 They suggested I was incompetent. 616 00:30:34,061 --> 00:30:38,065 They're posturing to set the stage for a ridiculous settlement request. 617 00:30:38,149 --> 00:30:39,901 This isn't about those parents or that kid. 618 00:30:39,984 --> 00:30:42,153 It's only about trying to make a lot of money. 619 00:30:42,236 --> 00:30:45,406 Well, I don't have a lot of money. 620 00:30:45,490 --> 00:30:48,117 Not your money, Dr. King. It's an insurance game. 621 00:30:48,201 --> 00:30:51,412 You're protected by the hospital. This won't affect your career. 622 00:30:57,210 --> 00:30:59,545 Hey. How was your deposition? 623 00:30:59,629 --> 00:31:00,963 Have you seen Dr. Langdon? 624 00:31:01,547 --> 00:31:02,632 No. Why? 625 00:31:04,383 --> 00:31:06,219 Okay, okay. How's Becca? 626 00:31:06,302 --> 00:31:07,762 - Oh, she's fine. - Yeah? 627 00:31:07,845 --> 00:31:09,138 Okay, I should go see her, then. 628 00:31:09,222 --> 00:31:11,557 How was your deposition? I'm sure it was stressful. 629 00:31:15,228 --> 00:31:17,438 What's going on with Becca? What's her diagnosis? 630 00:31:17,522 --> 00:31:18,648 I can't tell you. 631 00:31:19,357 --> 00:31:20,608 Why? 632 00:31:20,691 --> 00:31:22,151 - HIPAA. - Seriously? 633 00:31:22,235 --> 00:31:23,778 If you want to know what's going on with Becca, 634 00:31:23,861 --> 00:31:25,363 you're gonna have to ask her yourself. 635 00:31:25,446 --> 00:31:27,198 Hey, you survived your deposition. 636 00:31:27,281 --> 00:31:29,367 Welcome back to the seventh circle of hell. 637 00:31:29,450 --> 00:31:30,451 What's this? 638 00:31:30,535 --> 00:31:32,954 You're welcome for covering your patients. They're yours again. 639 00:31:33,037 --> 00:31:35,581 Might want to check on the pancreatitis in North 3 first. 640 00:31:36,457 --> 00:31:37,500 Okay. 641 00:31:37,583 --> 00:31:40,169 Langdon, I got some intel on Louie. 642 00:31:40,253 --> 00:31:41,754 They move him out of the viewing room? 643 00:31:41,837 --> 00:31:44,382 No, but county's promised they're on the way to come get him. 644 00:31:44,465 --> 00:31:47,385 - Can I get the county coroner's number? - What for? 645 00:31:47,468 --> 00:31:49,345 I just want to make sure if no family shows up, 646 00:31:49,428 --> 00:31:51,597 - Louie gets a proper burial. - That's expensive. 647 00:31:51,681 --> 00:31:53,891 You may want to run it by the missus first. 648 00:31:54,475 --> 00:31:57,186 Maybe I'll start a GoFundMe. I bet people around here would pitch in. 649 00:31:57,270 --> 00:32:00,273 Hey, kid, you can't do this for every unhoused guy 650 00:32:00,356 --> 00:32:02,149 that dies around here. 651 00:32:02,233 --> 00:32:03,776 There but for the grace of God. 652 00:32:03,859 --> 00:32:07,989 No, the success of your sobriety is a testament to your support system. 653 00:32:08,072 --> 00:32:09,824 Louie didn't have that. 654 00:32:09,907 --> 00:32:11,951 Still, Louie was a good man. 655 00:32:12,034 --> 00:32:14,203 He deserves to be put to rest with dignity. 656 00:32:14,287 --> 00:32:16,622 Okay. I'll dig it up. 657 00:32:19,375 --> 00:32:20,710 You heard all that? 658 00:32:22,253 --> 00:32:25,506 Robby, your VIP's here. Got him in Central 11. 659 00:32:25,590 --> 00:32:26,924 Finally. 660 00:32:30,303 --> 00:32:31,554 About fucking time. 661 00:32:31,637 --> 00:32:35,016 If I knew you were gonna make me wear a dress, I wouldn't have come at all. 662 00:32:35,099 --> 00:32:38,352 - Dennis Whitaker, meet my buddy Duke. - Nice to meet you. 663 00:32:38,436 --> 00:32:40,563 Any friend of Dr. Robby's is a friend of mine. 664 00:32:40,646 --> 00:32:44,233 "Friend" is a vast overstatement. He's more just a pain in my ass. 665 00:32:44,317 --> 00:32:46,360 Don't let his surly exterior fool you. 666 00:32:46,444 --> 00:32:48,946 Deep down inside, he's just as grumpy. 667 00:32:49,030 --> 00:32:51,532 - How did you two meet? - Tinder. 668 00:32:52,742 --> 00:32:55,036 Duke is a motorcycle engineer. 669 00:32:55,119 --> 00:32:58,456 You should've seen his Bonneville when he first brought it in six months ago. 670 00:32:58,539 --> 00:33:00,249 Someone left it for dead. 671 00:33:00,333 --> 00:33:03,252 He helped me bring it back to life. Today we're going to return the favor. 672 00:33:03,336 --> 00:33:05,463 Dr. Whitaker's one of our most trusted physicians, 673 00:33:05,546 --> 00:33:07,673 and today he's going to help me oversee your care. 674 00:33:08,341 --> 00:33:10,134 what seems to be troubling you? 675 00:33:10,217 --> 00:33:12,261 Ask him. He's the one who made me come in. 676 00:33:12,345 --> 00:33:15,014 He's had some hoarseness on and off for a couple months. 677 00:33:15,097 --> 00:33:17,767 Okay, any history of tobacco or alcohol use? 678 00:33:18,976 --> 00:33:20,645 Two of my oldest and closest friends. 679 00:33:20,728 --> 00:33:23,689 Former two-pack-a-day smoker and lover of the drink. 680 00:33:23,773 --> 00:33:25,691 Okay. He on any medication? 681 00:33:25,775 --> 00:33:27,485 Blood-pressure meds. 682 00:33:27,568 --> 00:33:29,195 Which he forgets to take. 683 00:33:29,278 --> 00:33:30,905 He's all numbed up and ready to go. 684 00:33:30,988 --> 00:33:32,823 Okay. Thank you, Donnie. 685 00:33:33,783 --> 00:33:38,704 My man, I am gonna take this scope, and I'm gonna stick it in your nose, 686 00:33:38,788 --> 00:33:41,499 and we're going to check out your upper airway. 687 00:33:41,582 --> 00:33:43,918 That seems like a lot of fuss for a sore throat. 688 00:33:44,001 --> 00:33:45,294 Dr. Whitaker, you want to explain to Duke 689 00:33:45,378 --> 00:33:48,130 why this procedure is absolutely necessary? 690 00:33:48,214 --> 00:33:50,883 The scope is gonna give us a better view of your voice box 691 00:33:50,966 --> 00:33:52,593 and your vocal cords. 692 00:33:53,177 --> 00:33:54,470 Here we go. 693 00:33:59,392 --> 00:34:01,686 Gonna feel a little pressure between your eyes. 694 00:34:01,769 --> 00:34:03,187 I am sorry about that. 695 00:34:03,270 --> 00:34:05,439 Okay, just breathe through your nose. 696 00:34:05,523 --> 00:34:08,109 This is gonna help us see if there are any abnormalities 697 00:34:08,192 --> 00:34:11,195 like inflammation, tumors, nodules. 698 00:34:11,821 --> 00:34:13,531 That all looks pretty normal. 699 00:34:13,614 --> 00:34:16,075 I don't see too much drainage. Stick your tongue out for me, all the way. 700 00:34:16,992 --> 00:34:18,828 All the way out. Good. Now say… 701 00:34:20,621 --> 00:34:22,206 Good. Now again, say… 702 00:34:23,708 --> 00:34:25,418 Good. Removing the scope. 703 00:34:26,961 --> 00:34:29,004 Dr. Whitaker, what do you think? 704 00:34:29,088 --> 00:34:31,966 - Looks normal, no abnormalities. - Told you it was nothing. 705 00:34:32,049 --> 00:34:35,553 With your history of smoking, I'd like to do a chest X-ray. 706 00:34:35,636 --> 00:34:37,346 If there are growths, 707 00:34:37,430 --> 00:34:41,016 they can push against the recurrent laryngeal nerve intermittently. 708 00:34:41,100 --> 00:34:45,771 That can paralyze one of the vocal cords and cause the hoarseness. 709 00:34:45,855 --> 00:34:49,358 That sounds like a lot of bullshit doctor speak to charge me more. 710 00:34:49,442 --> 00:34:50,568 You've got Medicare. 711 00:34:50,651 --> 00:34:52,153 And, besides, I finally got you into my ED. 712 00:34:52,236 --> 00:34:55,781 You're gonna get the golden workup before I leave town tonight. 713 00:34:55,865 --> 00:34:59,452 Only an idiot would ride all night after working a 12-hour day. 714 00:34:59,535 --> 00:35:01,495 That does sound pretty dangerous. 715 00:35:01,579 --> 00:35:03,372 You gonna stay put, or do I have to tie you down? 716 00:35:03,456 --> 00:35:05,833 Fine, so long as you keep your hands where I can see 'em. 717 00:35:05,916 --> 00:35:07,376 No promises. 718 00:35:07,460 --> 00:35:09,003 Let me know when his chest X-ray is back. 719 00:35:09,086 --> 00:35:10,254 Yeah. 720 00:35:13,674 --> 00:35:14,884 - Hey. - Hey. 721 00:35:15,885 --> 00:35:17,094 Are we okay? 722 00:35:18,679 --> 00:35:21,807 - Yeah. Why? - I don't know. 723 00:35:21,891 --> 00:35:25,102 You kind of ripped me a new one in front of Langdon. 724 00:35:25,895 --> 00:35:28,397 - Whose side are you on? - This isn't middle school. 725 00:35:28,481 --> 00:35:30,399 Langdon made a mistake and owned up to it. 726 00:35:30,483 --> 00:35:32,276 - Let it go. - He should… 727 00:35:34,904 --> 00:35:36,864 He should have been fired. 728 00:35:36,947 --> 00:35:39,658 But instead, he waltzes back in here, no big deal. 729 00:35:39,742 --> 00:35:41,952 Meanwhile, I've been a goddamn pariah for the last 10 months 730 00:35:42,036 --> 00:35:43,662 for doing the right thing. 731 00:35:43,746 --> 00:35:46,791 Or maybe you're a pariah because you don't play well with others. 732 00:35:48,292 --> 00:35:50,920 If you've still got beef with Langdon, go tell him. 733 00:35:51,003 --> 00:35:54,381 He's here to stay, so put on your big-girl panties and work it out. 734 00:35:54,465 --> 00:35:56,342 - He is no… - Nope. 735 00:35:56,425 --> 00:35:59,053 You want to have sex and eat ramen in bed, I'm your girl. 736 00:35:59,136 --> 00:36:02,640 But if you want to talk about this Langdon shit, again, 737 00:36:02,723 --> 00:36:04,099 call a therapist. 738 00:36:13,567 --> 00:36:15,444 How's it hanging, Dr. J? 739 00:36:15,528 --> 00:36:19,031 - Never call me that again. - It was a joke. 740 00:36:19,114 --> 00:36:22,660 Relax. He's clueless about your TikToks. 741 00:36:22,743 --> 00:36:24,245 But you're not. 742 00:36:24,328 --> 00:36:26,664 - Props on the side hustle. - There is no hustle. 743 00:36:26,747 --> 00:36:27,873 They're just some stupid videos. 744 00:36:27,957 --> 00:36:29,875 - Wait, are you an influencer? - No! 745 00:36:29,959 --> 00:36:31,126 Yep. 746 00:36:32,378 --> 00:36:34,421 Yo, pre-docs, it's not happy hour yet. 747 00:36:34,505 --> 00:36:36,757 There's still a shit ton of patients to be seen. 748 00:36:41,345 --> 00:36:44,056 Ben, our slash-trake kid from the water park 749 00:36:44,139 --> 00:36:46,100 had some purposeful movement in pre-op. 750 00:36:46,183 --> 00:36:47,476 That's a good sign. 751 00:36:47,560 --> 00:36:48,769 Take the win. 752 00:36:51,355 --> 00:36:52,523 We need to talk. 753 00:36:54,567 --> 00:36:56,569 - We are talking. - In private. 754 00:37:05,578 --> 00:37:08,080 What the hell was that with Samira earlier? 755 00:37:08,789 --> 00:37:11,292 - That was tough love. - You are her superior. 756 00:37:11,375 --> 00:37:14,753 She was obviously struggling, and your advice was "go home"? 757 00:37:14,837 --> 00:37:16,255 Essentially, yeah. 758 00:37:16,338 --> 00:37:18,841 This is the ED. It's not for the faint of heart. 759 00:37:18,924 --> 00:37:20,801 It's not for the unempathetic either. 760 00:37:21,594 --> 00:37:23,929 Samira's not having a panic attack because of her patient. 761 00:37:24,013 --> 00:37:25,723 She's having one because of personal baggage. 762 00:37:25,806 --> 00:37:28,309 What she needs to do is pull her head out of her ass and focus on the work. 763 00:37:28,392 --> 00:37:29,435 What about you? 764 00:37:29,518 --> 00:37:32,271 What do you need to get some basic human empathy back? 765 00:37:34,815 --> 00:37:35,941 I don't know. 766 00:37:36,025 --> 00:37:39,028 Something that gives me a little hope this place won't fall to shit when I'm gone. 767 00:37:40,613 --> 00:37:42,865 - Found him! - Found who? 768 00:37:43,574 --> 00:37:45,951 - The water slide dad's kid. - How'd you manage that? 769 00:37:46,035 --> 00:37:47,953 I went outside, stalked the dad's IG, 770 00:37:48,037 --> 00:37:49,955 found a pic of his son, sent it to Pittsburgh PD. 771 00:37:50,039 --> 00:37:51,081 Now they're on their way over. 772 00:37:51,832 --> 00:37:54,043 Well, maybe Gen Z should be working for the FBI. 773 00:37:58,255 --> 00:37:59,840 - Hi, Becca. Hi. - Mel! 774 00:38:02,051 --> 00:38:04,762 - You doing all right? - I'm a little bored. 775 00:38:04,845 --> 00:38:05,846 Yeah? 776 00:38:07,056 --> 00:38:08,974 - How are you feeling? - A lot better. 777 00:38:09,058 --> 00:38:11,393 Dr. Langdon gave me some medicine and OJ. 778 00:38:11,477 --> 00:38:12,978 He's super nice. 779 00:38:13,062 --> 00:38:14,396 I see why you like him. 780 00:38:15,439 --> 00:38:18,108 Did he tell you what the medicine was for? 781 00:38:18,192 --> 00:38:19,360 Yes. 782 00:38:19,443 --> 00:38:20,986 Did you tell her? 783 00:38:21,070 --> 00:38:22,071 I did not. 784 00:38:22,863 --> 00:38:26,575 I explained to Becca that due to doctor-patient confidentiality, 785 00:38:26,659 --> 00:38:28,577 everything she told me was private 786 00:38:28,661 --> 00:38:30,371 and that it was her decision 787 00:38:30,454 --> 00:38:33,457 if she wanted to share anything with you or not. 788 00:38:35,292 --> 00:38:37,503 - Do you want to share? - Yes. 789 00:38:48,681 --> 00:38:51,183 I have a urinary-tract infection. 790 00:38:54,103 --> 00:38:55,229 Okay. 791 00:38:55,312 --> 00:39:00,025 Yeah, those can happen if you, you know, hold your pee in for too long 792 00:39:00,109 --> 00:39:02,027 or you accidentally wipe from back to front… 793 00:39:02,111 --> 00:39:04,238 Mel, I know. I know, Mel. He told me. 794 00:39:04,321 --> 00:39:06,031 Oh, good. 795 00:39:06,115 --> 00:39:09,076 You know, he also told me it can happen from having sex. 796 00:39:10,703 --> 00:39:12,121 Yeah, it can. 797 00:39:12,913 --> 00:39:15,332 - It's not like you're having sex. - Yes, I am. 798 00:39:19,420 --> 00:39:20,671 I'm sorr…What? 799 00:39:20,754 --> 00:39:22,840 I'm having sex. 800 00:39:24,717 --> 00:39:26,927 - With who? - My boyfriend. 801 00:39:27,011 --> 00:39:29,096 - You have a boyfriend? - Yes. 802 00:39:29,179 --> 00:39:33,934 His name is Adam, and we're having sex, 803 00:39:34,018 --> 00:39:35,352 lots of sex. 804 00:39:37,521 --> 00:39:38,731 Okay. 805 00:39:42,526 --> 00:39:45,154 Mel, are you okay? 806 00:39:49,950 --> 00:39:51,910 - Got a sec? - Sure. 807 00:39:51,994 --> 00:39:54,455 - How you feeling? - I'm fine. 808 00:39:55,289 --> 00:39:56,790 - Are you sure? - Yeah. 809 00:39:56,874 --> 00:39:59,168 Troponin, D-dimer, and TSH all normal. 810 00:39:59,960 --> 00:40:01,295 Listen, I'm sorry about earlier. 811 00:40:01,378 --> 00:40:03,172 - I think I was being… - A dick? 812 00:40:04,757 --> 00:40:07,760 I was gonna say "unprofessional," but probably that, too. 813 00:40:08,677 --> 00:40:09,678 I'm sorry. 814 00:40:10,971 --> 00:40:11,972 Thanks. 815 00:40:13,015 --> 00:40:15,017 But now I kind of need you to stop feeling sorry for yourself 816 00:40:15,100 --> 00:40:16,685 and focus back on your patients. 817 00:40:16,769 --> 00:40:17,853 Think you can do that? 818 00:40:18,979 --> 00:40:20,564 - Sure. - Great. 819 00:40:24,151 --> 00:40:28,489 With this extra dose and increased morphine from the pump, 820 00:40:28,572 --> 00:40:30,115 your pain should subside. 821 00:40:30,199 --> 00:40:31,992 Your breathing will slow down. 822 00:40:33,035 --> 00:40:34,703 You may get very sleepy. 823 00:40:35,996 --> 00:40:38,415 Paul, go be with the boys. 824 00:40:39,792 --> 00:40:42,419 They need you more than I do now. 825 00:40:43,378 --> 00:40:44,588 Later. 826 00:40:45,297 --> 00:40:47,800 Right now I'm exactly where I'm supposed to be. 827 00:40:56,225 --> 00:40:57,226 Yeah. 828 00:40:58,185 --> 00:40:59,520 Okay. 829 00:40:59,603 --> 00:41:00,813 Here we go.