1 00:00:08,590 --> 00:00:12,591 Sync and corrections by btsix www.addic7ed.com 2 00:00:12,592 --> 00:00:14,928 Baran, is this you? 3 00:00:20,433 --> 00:00:23,227 It began after a bad case of viral meningitis 4 00:00:23,228 --> 00:00:24,978 when I was five. 5 00:00:24,979 --> 00:00:27,314 They tried every anti-seizure medication, 6 00:00:27,315 --> 00:00:31,276 but I still had episodes every few months or so. 7 00:00:31,277 --> 00:00:32,528 No one's ever noticed before. 8 00:00:32,529 --> 00:00:33,988 They just think I'm thoughtful. 9 00:00:36,032 --> 00:00:37,449 Are you driving? 10 00:00:37,450 --> 00:00:40,577 I couldn't until laser ablation 11 00:00:40,578 --> 00:00:43,914 to my left temporal lobe 12 years ago. 12 00:00:43,915 --> 00:00:46,708 Between that and the Keppra, I've been seizure-free, 13 00:00:46,709 --> 00:00:50,380 cleared by Neurology to drive and to work as an attending. 14 00:00:52,173 --> 00:00:54,466 How long, uh, between the seizure 15 00:00:54,467 --> 00:00:56,343 you had today and the last one? 16 00:00:56,344 --> 00:00:59,597 It's been well over a year. 17 00:01:01,766 --> 00:01:03,268 But I had two today. 18 00:01:07,897 --> 00:01:09,439 I don't know why. 19 00:01:09,440 --> 00:01:12,651 It could be sleep deprivation, new job stress. 20 00:01:12,652 --> 00:01:15,946 I... I haven't had to deal with Peds cases 21 00:01:15,947 --> 00:01:17,447 since Afghanistan. 22 00:01:17,448 --> 00:01:19,199 What are your options now? 23 00:01:19,200 --> 00:01:21,326 Um... 24 00:01:21,327 --> 00:01:24,871 up my Keppra or maybe try 25 00:01:24,872 --> 00:01:26,498 one of the newer anti-seizure meds. 26 00:01:26,499 --> 00:01:29,334 But if that doesn't work, I'm left with two choices... 27 00:01:29,335 --> 00:01:33,797 um, a temporal lobectomy, which could impair my speech, 28 00:01:33,798 --> 00:01:36,258 or get a neuromodulation device, 29 00:01:36,259 --> 00:01:37,968 which can sense and stop the seizures 30 00:01:37,969 --> 00:01:39,803 almost immediately. 31 00:01:39,804 --> 00:01:41,638 You need to disclose this. 32 00:01:41,639 --> 00:01:43,682 I know. I have a plan. 33 00:01:43,683 --> 00:01:44,808 Hey, Robby, Dana's looking for you. 34 00:01:44,809 --> 00:01:46,018 She's in Peds. 35 00:01:46,019 --> 00:01:47,352 Yeah, OK, I'll be right there. 36 00:01:47,353 --> 00:01:48,729 [DOOR CLOSES] 37 00:01:48,730 --> 00:01:49,980 Sounds like you're needed in Peds, 38 00:01:49,981 --> 00:01:52,065 and I have patients to see. 39 00:01:52,066 --> 00:01:53,984 Robby, pregnant woman with severe headache 40 00:01:53,985 --> 00:01:55,694 on her way in by ambulance. 41 00:01:55,695 --> 00:01:58,197 Find Abbot or a night shift resident. 42 00:02:04,787 --> 00:02:07,832 [INDISTINCT CHATTER] 43 00:02:13,212 --> 00:02:15,089 Need you to turn out your pockets. 44 00:02:21,346 --> 00:02:23,222 OK. Show me your hands. 45 00:02:43,368 --> 00:02:44,869 [SIGHS] 46 00:02:47,747 --> 00:02:51,208 [URINE TRICKLING] 47 00:02:51,209 --> 00:02:52,543 Come here often? 48 00:02:56,255 --> 00:02:58,048 [BABY CRYING] 49 00:02:58,049 --> 00:02:59,550 [CLEARS THROAT] 50 00:03:01,302 --> 00:03:02,803 What's going on? 51 00:03:02,804 --> 00:03:04,554 Oh, sorry... false alarm. 52 00:03:04,555 --> 00:03:06,996 We thought she spiked a fever, but it was the wrong chart 53 00:03:06,997 --> 00:03:09,226 from our analog hell. 54 00:03:09,227 --> 00:03:11,770 You know anybody who might consider kinship adoption? 55 00:03:11,771 --> 00:03:13,563 Doctors and nurses qualify. 56 00:03:13,564 --> 00:03:15,190 Don't look at me. 57 00:03:15,191 --> 00:03:17,275 Hey, can your staff keep an eye on Dr. Al-Hashimi 58 00:03:17,276 --> 00:03:18,360 until she leaves? 59 00:03:18,361 --> 00:03:20,779 Why? 60 00:03:20,780 --> 00:03:22,948 Uh, because I think she's tired, 61 00:03:22,949 --> 00:03:24,533 and I don't want her to make any mistakes. 62 00:03:24,534 --> 00:03:26,996 Oh, great advice. Maybe you should take it. 63 00:03:26,997 --> 00:03:28,916 Yeah. I'm gonna go get some fresh air. 64 00:03:28,917 --> 00:03:30,551 Grab some for me while you're out there. 65 00:03:30,552 --> 00:03:31,998 Your lungs wouldn't know what to do with it. 66 00:03:31,999 --> 00:03:33,083 Screw you! 67 00:03:33,084 --> 00:03:34,710 In front of the baby? Nice. 68 00:03:34,711 --> 00:03:37,587 [BABY CRYING] 69 00:03:37,588 --> 00:03:39,214 Yeah. 70 00:03:39,215 --> 00:03:41,049 We are the night crawlers. 71 00:03:41,050 --> 00:03:44,052 We deal with the weirdest and the wildest because... 72 00:03:44,053 --> 00:03:46,596 ALL: We are the weirdest and the wildest of them all. 73 00:03:46,597 --> 00:03:47,723 That is right, and tonight, 74 00:03:47,724 --> 00:03:49,057 they are really gonna be crawling. 75 00:03:49,058 --> 00:03:50,434 Now go get some! 76 00:03:50,435 --> 00:03:51,435 ALL: Hooah! 77 00:03:51,436 --> 00:03:52,520 [CLAPS] 78 00:03:54,313 --> 00:03:55,856 [CLEARS THROAT] 79 00:03:55,857 --> 00:03:57,441 Sorry to wake you. 80 00:03:57,442 --> 00:03:58,943 I... I was thinking. 81 00:04:02,321 --> 00:04:04,114 [YAWNS] Doubt PTX. 82 00:04:04,115 --> 00:04:06,324 You're supposed to be leaving. 83 00:04:06,325 --> 00:04:07,452 I am. 84 00:04:09,746 --> 00:04:11,288 You know, this spirit quest of yours 85 00:04:11,289 --> 00:04:13,165 has a lot of people up in arms around here. 86 00:04:13,166 --> 00:04:14,624 Everyone's gonna be fine without me, 87 00:04:14,625 --> 00:04:16,293 and it's hardly a spirit quest. 88 00:04:16,294 --> 00:04:18,123 Whatever it is, it seems you've given people 89 00:04:18,124 --> 00:04:19,610 the impression you might not be coming back. 90 00:04:19,611 --> 00:04:22,132 Well, who knows what the future has in store for any of us? 91 00:04:22,133 --> 00:04:24,551 Yeah, saying shit like that right there isn't helping. 92 00:04:24,552 --> 00:04:25,969 People are worried about you. 93 00:04:25,970 --> 00:04:27,888 Dr. Abbot, the patient in South 21, 94 00:04:27,889 --> 00:04:29,347 Digby, he's missing again. 95 00:04:29,348 --> 00:04:30,724 Sounds like a day shift problem. 96 00:04:30,725 --> 00:04:32,977 Not if he was handed off already. 97 00:04:37,148 --> 00:04:38,815 Best I can do under the circumstances. 98 00:04:38,816 --> 00:04:40,108 Thank you. 99 00:04:40,109 --> 00:04:41,610 Hey, don't leave before I get back, yeah? 100 00:04:41,611 --> 00:04:43,362 Hell, I feel like I live here now. 101 00:04:46,783 --> 00:04:48,116 Your friend fixing your bike? 102 00:04:48,117 --> 00:04:49,326 Ambulance clipped it 103 00:04:49,327 --> 00:04:51,203 while it was just parked here today. 104 00:04:51,204 --> 00:04:53,413 Jesus Christ. 105 00:04:53,414 --> 00:04:54,998 That's a sign if I've ever seen one. 106 00:04:54,999 --> 00:04:56,583 [SIREN CHIRPS] 107 00:04:56,584 --> 00:04:58,418 Yeah, here's the thing... when people worry about you, 108 00:04:58,419 --> 00:05:00,170 it makes me think that I should be worried about you, 109 00:05:00,171 --> 00:05:01,838 and I don't like worrying about things. 110 00:05:01,839 --> 00:05:03,048 Ooh. Now you're a shrink? 111 00:05:03,049 --> 00:05:04,174 No, I'm trying to be your friend. 112 00:05:04,175 --> 00:05:05,342 You got... you got Dana convinced 113 00:05:05,343 --> 00:05:06,669 that you're gonna hurt yourself. 114 00:05:06,670 --> 00:05:08,276 - Dana's got her own issues. - That sounds like projection. 115 00:05:08,277 --> 00:05:10,013 Are you seriously trying to have this fucking 116 00:05:10,014 --> 00:05:11,556 conversation with me right now, man? 117 00:05:11,557 --> 00:05:13,183 I... I'm not the one 118 00:05:13,184 --> 00:05:15,519 who spends his free time getting shot at. 119 00:05:15,520 --> 00:05:17,145 Hooah! 120 00:05:17,146 --> 00:05:19,481 Hey, Dr. Robby, this is Judith Lastrade... 121 00:05:19,482 --> 00:05:21,691 36 weeks pregnant with two days of headache, 122 00:05:21,692 --> 00:05:24,194 now a 10 out of 10 with blurred vision. 123 00:05:24,195 --> 00:05:27,405 BP 174/120, heart rate 92. 124 00:05:27,406 --> 00:05:29,533 - No relief with fentanyl. - Judith, I'm Dr. Abbot. 125 00:05:29,534 --> 00:05:30,909 Any weakness in your arms or legs? 126 00:05:30,910 --> 00:05:32,452 No, no. Is this a stroke? 127 00:05:32,453 --> 00:05:33,870 We need to check for everything. 128 00:05:33,871 --> 00:05:36,581 Pitting edema with severe preeclampsia. 129 00:05:36,582 --> 00:05:38,542 Where are you doing your prenatal care? 130 00:05:38,543 --> 00:05:39,751 Nowhere. 131 00:05:39,752 --> 00:05:41,253 It's a wild pregnancy. 132 00:05:41,254 --> 00:05:43,214 I want a free birth. 133 00:05:45,341 --> 00:05:48,718 This 81-year-old nun presents with red, itchy eyes 134 00:05:48,719 --> 00:05:51,888 with secretions for the past two days. 135 00:05:51,889 --> 00:05:54,391 Patient complains of no URI symptoms, 136 00:05:54,392 --> 00:05:55,976 - no contact with any chemical... - Hey. 137 00:05:55,977 --> 00:05:57,394 Agents, no known exposures... 138 00:05:57,395 --> 00:05:58,895 Want half a Monster? 139 00:05:58,896 --> 00:06:00,564 Oh, no, thanks. 140 00:06:00,565 --> 00:06:02,065 I... I don't really want to stay awake 141 00:06:02,066 --> 00:06:04,234 any longer than I have to. 142 00:06:04,235 --> 00:06:05,695 Yeah, I hear you. 143 00:06:07,238 --> 00:06:09,281 Did you find your ID badge? 144 00:06:09,282 --> 00:06:10,866 Uh, no. 145 00:06:10,867 --> 00:06:13,118 You any closer to deciding what's next for you? 146 00:06:13,119 --> 00:06:15,078 Uh, yeah, I'm seriously considering law school. 147 00:06:15,079 --> 00:06:16,580 What? What are you talking about? 148 00:06:16,581 --> 00:06:18,457 You're gonna be a great doctor. 149 00:06:19,917 --> 00:06:23,211 I mean, no offense, but look what this place does to you. 150 00:06:23,212 --> 00:06:24,880 Langdon's an addict. 151 00:06:24,881 --> 00:06:27,591 Is a person with a substance use disorder. 152 00:06:27,592 --> 00:06:29,509 McKay was on house arrest. 153 00:06:29,510 --> 00:06:31,011 Dana's a time bomb. 154 00:06:31,012 --> 00:06:32,762 Santos is one of the angriest people 155 00:06:32,763 --> 00:06:34,264 you are ever going to meet. 156 00:06:34,265 --> 00:06:35,765 Sarcastic, yes. Cynical, definitely. 157 00:06:35,766 --> 00:06:37,267 I don't know if she's, you know... 158 00:06:37,268 --> 00:06:38,644 Mel? 159 00:06:39,687 --> 00:06:42,731 Samira has no life. 160 00:06:42,732 --> 00:06:45,942 Abbot's an adrenaline junkie who gets shot at for fun. 161 00:06:45,943 --> 00:06:48,778 Robby's got, like, PTSD or something way fucking worse. 162 00:06:48,779 --> 00:06:50,071 OK, well, I... I mean, 163 00:06:50,072 --> 00:06:52,116 I'd hate to know what you think about me. 164 00:06:53,659 --> 00:06:55,327 I don't know, I just... 165 00:06:55,328 --> 00:06:57,954 the more time I spend here, 166 00:06:57,955 --> 00:06:59,205 the more I realize the importance 167 00:06:59,206 --> 00:07:01,876 of my mental health. 168 00:07:02,960 --> 00:07:04,044 Mm. 169 00:07:04,045 --> 00:07:05,337 For patients and for us. 170 00:07:05,338 --> 00:07:07,964 And this is... 171 00:07:07,965 --> 00:07:09,132 Yeah. 172 00:07:09,133 --> 00:07:10,383 Well, you know, 173 00:07:10,384 --> 00:07:13,220 maybe that's what you should focus on. 174 00:07:14,305 --> 00:07:16,598 - What? - Mental health. 175 00:07:16,599 --> 00:07:18,850 Clearly, you have a passion for it, right? 176 00:07:18,851 --> 00:07:20,435 I mean, that's... that's great. 177 00:07:20,436 --> 00:07:21,478 I don't know if I'd call it a passion. 178 00:07:21,479 --> 00:07:23,648 I would call it, like, a... 179 00:07:26,525 --> 00:07:28,152 Oh, my God. 180 00:07:30,029 --> 00:07:32,198 You might be right. 181 00:07:33,741 --> 00:07:35,367 Oh, you're a genius, Whitaker. 182 00:07:35,368 --> 00:07:36,576 Oh, OK. 183 00:07:36,577 --> 00:07:38,203 [LAUGHS] 184 00:07:38,204 --> 00:07:40,205 CTG is on. 185 00:07:40,206 --> 00:07:42,499 - CTG? - Cardiotocography. 186 00:07:42,500 --> 00:07:45,961 Measures the baby's heart rate and checks for contractions. 187 00:07:45,962 --> 00:07:47,504 Fetal heart rate 128. 188 00:07:47,505 --> 00:07:49,047 Normal range, Nazely? 189 00:07:49,048 --> 00:07:50,966 110 to 160. 190 00:07:50,967 --> 00:07:52,842 So the baby's OK? 191 00:07:52,843 --> 00:07:54,010 Right now, yes. 192 00:07:54,011 --> 00:07:55,470 128 is reassuring. 193 00:07:55,471 --> 00:07:57,681 BP's 170/119. 194 00:07:57,682 --> 00:07:59,432 6 grams of magnesium running in. 195 00:07:59,433 --> 00:08:01,017 Your next move, Crus? 196 00:08:01,018 --> 00:08:03,687 20 of labetalol, IV push over two minutes. 197 00:08:03,688 --> 00:08:05,188 Uh, what's happening? 198 00:08:05,189 --> 00:08:07,232 Uh, you have a condition called preeclampsia. 199 00:08:07,233 --> 00:08:08,525 And how did it happen? 200 00:08:08,526 --> 00:08:10,735 Uh, nobody really knows, actually. 201 00:08:10,736 --> 00:08:13,071 It affects about 10% of the pregnancies. 202 00:08:13,072 --> 00:08:14,531 High blood pressure, headaches, 203 00:08:14,532 --> 00:08:17,033 protein in the urine, and swollen ankles. 204 00:08:17,034 --> 00:08:19,327 OK, well, it's a wild pregnancy, 205 00:08:19,328 --> 00:08:21,538 so that means no medical care. 206 00:08:21,539 --> 00:08:23,540 Then why are you here? 207 00:08:23,541 --> 00:08:25,041 [CRYING] 208 00:08:25,042 --> 00:08:27,294 I just need to get rid of this headache. 209 00:08:29,422 --> 00:08:32,465 Well, if we don't lower your blood pressure 210 00:08:32,466 --> 00:08:35,385 and treat with magnesium, there can be problems. 211 00:08:35,386 --> 00:08:36,636 Like what? 212 00:08:36,637 --> 00:08:38,263 Seizures, bleeding, 213 00:08:38,264 --> 00:08:40,390 even death, for you and the baby. 214 00:08:40,391 --> 00:08:42,225 [CRYING] Oh, my God. 215 00:08:42,226 --> 00:08:43,893 Robby, your VIP's ready to go. 216 00:08:43,894 --> 00:08:45,979 OK, I'll be right there. 217 00:08:45,980 --> 00:08:47,605 - You good? - Yeah, I'm good. 218 00:08:47,606 --> 00:08:50,316 I got it. With my eyes closed. 219 00:08:50,317 --> 00:08:51,651 But I won't. Maybe one eye. 220 00:08:51,652 --> 00:08:52,986 [CLICKS TONGUE] 221 00:08:52,987 --> 00:08:54,070 Hey... [DOOR CLOSES] 222 00:08:54,071 --> 00:08:56,073 [MACHINES BEEPING] 223 00:08:57,450 --> 00:08:58,908 Hey, Becca. How you feeling? 224 00:08:58,909 --> 00:09:01,120 I'm better. Thanks. 225 00:09:02,621 --> 00:09:04,039 Where are you? 226 00:09:04,040 --> 00:09:05,915 I'm at Adam's house. 227 00:09:05,916 --> 00:09:07,709 Can I call you later? We're watching a movie. 228 00:09:07,710 --> 00:09:08,918 Oh, sure. I just... I thought 229 00:09:08,919 --> 00:09:10,462 you were gonna see the fireworks. 230 00:09:10,463 --> 00:09:13,089 Nope, we decided to watch "Elf" instead. 231 00:09:13,090 --> 00:09:14,424 Ah. 232 00:09:14,425 --> 00:09:16,426 - Of course you did. - OK. 233 00:09:16,427 --> 00:09:18,094 - I'll call you tomorrow! - Tomorrow? Wait. 234 00:09:18,095 --> 00:09:20,430 Uh, are... are you spending the night? 235 00:09:20,431 --> 00:09:22,265 Um, uh, yes. 236 00:09:22,266 --> 00:09:24,059 His parents invited me. 237 00:09:24,060 --> 00:09:25,560 They... they need to ask me that. 238 00:09:25,561 --> 00:09:27,979 Are... are you staying here too? 239 00:09:27,980 --> 00:09:32,067 No, they... they needed to ask if it was OK if you stayed. 240 00:09:32,068 --> 00:09:33,443 Why? 241 00:09:33,444 --> 00:09:38,073 Be... because, uh, it's polite. 242 00:09:38,074 --> 00:09:40,366 It's the right... it's the right thing to do. 243 00:09:40,367 --> 00:09:43,453 Um, I need to talk to them. 244 00:09:43,454 --> 00:09:46,164 Um, they're not here. They're at a barbecue. 245 00:09:46,165 --> 00:09:48,291 OK, um, can you have them call me 246 00:09:48,292 --> 00:09:49,626 as soon as they get home? 247 00:09:49,627 --> 00:09:51,503 - Yes. - Can you promise? 248 00:09:51,504 --> 00:09:53,379 I promise. OK, bye, Mel! 249 00:09:53,380 --> 00:09:54,799 - [PHONE CHIMES] - Bye. Have fun... 250 00:09:56,175 --> 00:09:57,801 Thanks for fixing my bike. 251 00:09:57,802 --> 00:09:59,970 Well, you keep me running, I'll keep her going. 252 00:10:01,847 --> 00:10:05,433 You know, the Cree don't have a word for goodbye. 253 00:10:05,434 --> 00:10:06,601 You know a lot of Cree? 254 00:10:06,602 --> 00:10:08,353 [CHUCKLES] A bit. 255 00:10:08,354 --> 00:10:09,479 I got around, man. 256 00:10:09,480 --> 00:10:10,815 I don't doubt it. 257 00:10:13,317 --> 00:10:15,819 Look, I'll come back for all this other shit... 258 00:10:15,820 --> 00:10:17,153 Great. 259 00:10:17,154 --> 00:10:18,655 If you promise to come back 260 00:10:18,656 --> 00:10:20,490 and let me take the Bonnie for a ride. 261 00:10:20,491 --> 00:10:21,699 Uh, I don't know. 262 00:10:21,700 --> 00:10:23,118 I've seen you ride, old man. 263 00:10:23,119 --> 00:10:24,536 Fuck you. 264 00:10:24,537 --> 00:10:26,496 I mean it. 265 00:10:26,497 --> 00:10:27,706 We got a deal? 266 00:10:30,793 --> 00:10:32,670 I'll think about it. 267 00:10:45,766 --> 00:10:47,851 This looks like an ambush. 268 00:10:47,852 --> 00:10:49,519 We got a slight hiccup in chairs. 269 00:10:49,520 --> 00:10:50,562 ICE is back? 270 00:10:50,563 --> 00:10:52,564 No, we got a dead body. 271 00:10:52,565 --> 00:10:54,190 - Somebody died out there? - Yeah. 272 00:10:54,191 --> 00:10:56,025 Poor devil checked in at 5:00 this morning. 273 00:10:56,026 --> 00:10:57,485 - He was a DNR. - [GROANS] 274 00:10:57,486 --> 00:10:58,695 - What was his chief complaint? - Hemorrhoids 275 00:10:58,696 --> 00:11:00,196 - and constipation. - No shit. 276 00:11:00,197 --> 00:11:02,532 - Hence the constipation. - [LAUGHS] 277 00:11:02,533 --> 00:11:04,284 Throw me a slow one, I'm gonna hit it. 278 00:11:04,285 --> 00:11:05,952 Tell the night shift. I'm saying that's when he died. 279 00:11:05,953 --> 00:11:07,203 We all in agreement on that? 280 00:11:07,204 --> 00:11:08,580 To the grave. 281 00:11:08,581 --> 00:11:10,373 Just like poor Jasper. 282 00:11:10,374 --> 00:11:11,875 You're on fire. 283 00:11:11,876 --> 00:11:13,294 Just getting my second wind. 284 00:11:14,587 --> 00:11:15,879 How's the headache? 285 00:11:15,880 --> 00:11:17,213 Still a 10. 286 00:11:17,214 --> 00:11:18,715 More fentanyl? 287 00:11:18,716 --> 00:11:21,092 - Yep. - BP's good. Another 50. 288 00:11:21,093 --> 00:11:22,552 Hey, Abbot. 289 00:11:22,553 --> 00:11:24,554 Attending and resident are stuck in the OR. 290 00:11:24,555 --> 00:11:26,389 Oh, you're the next best thing. 291 00:11:26,390 --> 00:11:27,724 Better, some would say. 292 00:11:27,725 --> 00:11:29,058 Mm. 293 00:11:29,059 --> 00:11:30,602 - What do you got? - This is Judith. 294 00:11:30,603 --> 00:11:33,062 G1, P0 with no prenatal care. 295 00:11:33,063 --> 00:11:35,190 Preeclampsia with severe hypertension. 296 00:11:35,191 --> 00:11:37,609 Hi, Judith. Nurse Garvin from OB. 297 00:11:37,610 --> 00:11:39,068 Some jelly on the belly. 298 00:11:39,069 --> 00:11:40,612 Gonna take a quick look with ultrasound. 299 00:11:40,613 --> 00:11:42,572 No, no, no. Ultrasound can harm the baby. 300 00:11:42,573 --> 00:11:44,574 - Not true. - Not doing the ultrasound 301 00:11:44,575 --> 00:11:46,660 could end up harming you and the baby. 302 00:11:47,912 --> 00:11:49,078 [SIGHS] OK. 303 00:11:49,079 --> 00:11:51,623 Just do it as fast as you can. 304 00:11:51,624 --> 00:11:54,084 Why no prenatal care, Judith? 305 00:11:55,127 --> 00:11:57,587 I wanted a free birth... 306 00:11:57,588 --> 00:11:59,756 no doctors, no hospital, no medicine. 307 00:11:59,757 --> 00:12:02,592 Mm. You have a midwife? 308 00:12:02,593 --> 00:12:03,635 A birth doula? 309 00:12:03,636 --> 00:12:06,054 No, I don't need one. 310 00:12:06,055 --> 00:12:07,347 Women have been having children on their own 311 00:12:07,348 --> 00:12:08,598 for thousands of years. 312 00:12:08,599 --> 00:12:10,141 Yeah, with an infant mortality rate 313 00:12:10,142 --> 00:12:13,061 of 30% for most of those thousands of years. 314 00:12:13,062 --> 00:12:15,313 - Femur length 7 centimeters. - 37 weeks. 315 00:12:15,314 --> 00:12:17,273 They'll probably induce. 316 00:12:17,274 --> 00:12:19,234 What? No. 317 00:12:19,235 --> 00:12:20,610 No, no, no, no. Absolutely not. 318 00:12:20,611 --> 00:12:22,111 At 37 weeks, 319 00:12:22,112 --> 00:12:24,322 the cure for preeclampsia is to deliver the baby. 320 00:12:24,323 --> 00:12:26,115 We need to get you upstairs so the OB doctors 321 00:12:26,116 --> 00:12:28,910 can induce labor to save you and your baby. 322 00:12:28,911 --> 00:12:31,330 No. No, no, no, no. Mm-mm. 323 00:12:33,666 --> 00:12:35,416 Yep, that's definitely Jasper. 324 00:12:35,417 --> 00:12:36,668 He was alive and kicking 325 00:12:36,669 --> 00:12:38,086 when my shift ended this morning. 326 00:12:38,087 --> 00:12:39,462 This is definitely a day shift patient. 327 00:12:39,463 --> 00:12:40,797 Now he's not a patient. 328 00:12:40,798 --> 00:12:42,298 He's a DB that we gotta deal with. 329 00:12:42,299 --> 00:12:43,467 [SIGHS] 330 00:12:44,802 --> 00:12:46,052 Is this dude dead? 331 00:12:46,053 --> 00:12:47,553 BOTH: Nope. 332 00:12:47,554 --> 00:12:49,389 All right, Mr. Reed, time to take you back 333 00:12:49,390 --> 00:12:50,848 and get you checked out, OK? 334 00:12:50,849 --> 00:12:52,308 - He sure looks dead. - Are you a doctor? 335 00:12:52,309 --> 00:12:54,644 - No, but he... - Has hypernarcolepsy. 336 00:12:54,645 --> 00:12:56,354 - It's no joke. - Mm-hmm. 337 00:12:56,355 --> 00:12:58,648 - Excuse me. - [CLEARS THROAT] 338 00:12:58,649 --> 00:13:00,566 Oh, sometimes I hate nights. 339 00:13:00,567 --> 00:13:01,818 - Yep. - Oof. 340 00:13:01,819 --> 00:13:02,861 [GRUNTS] 341 00:13:08,158 --> 00:13:11,203 [FIREWORKS WHISTLING, POPPING] 342 00:13:12,705 --> 00:13:14,122 Wow. 343 00:13:14,123 --> 00:13:17,333 Crazy how muggy it still is out here. 344 00:13:17,334 --> 00:13:20,003 You, uh... you seen Robby? 345 00:13:20,004 --> 00:13:22,171 Uh, not for a bit. 346 00:13:22,172 --> 00:13:23,506 You catch up on your charts 347 00:13:23,507 --> 00:13:25,008 from the beginning of the shift? 348 00:13:25,009 --> 00:13:26,301 Yeah. 349 00:13:26,302 --> 00:13:27,343 What are you still doing here? 350 00:13:27,344 --> 00:13:29,178 Uh, just gonna... 351 00:13:29,179 --> 00:13:31,556 You staying for the fireworks? 352 00:13:31,557 --> 00:13:32,974 Yeah. 353 00:13:32,975 --> 00:13:34,350 I was supposed to see them with Becca, 354 00:13:34,351 --> 00:13:38,354 but she is at her boyfriend Adam's 355 00:13:38,355 --> 00:13:40,232 family's house instead. 356 00:13:44,528 --> 00:13:50,742 Your sister seems like she's, uh, pretty put-together. 357 00:13:50,743 --> 00:13:52,035 Yeah. 358 00:13:52,036 --> 00:13:54,788 Uh, a lot more than I realized. 359 00:13:56,707 --> 00:13:58,125 How was your day? 360 00:13:59,960 --> 00:14:02,462 I've had better. 361 00:14:02,463 --> 00:14:03,589 You? 362 00:14:06,467 --> 00:14:08,885 Yeah. 363 00:14:08,886 --> 00:14:12,221 But then again, I've had a lot worse. 364 00:14:12,222 --> 00:14:14,724 Hell, I did a closed cervical reduction, like, an hour ago. 365 00:14:14,725 --> 00:14:16,977 Oh, I heard. That must have been so intense. 366 00:14:18,687 --> 00:14:20,855 My hands are still shaking. 367 00:14:20,856 --> 00:14:22,899 Hey, um, do you think you could teach me 368 00:14:22,900 --> 00:14:25,068 how to do that sometime? 369 00:14:25,069 --> 00:14:26,527 Uh, yeah. 370 00:14:26,528 --> 00:14:27,737 - Yeah? - Yeah, sure. I mean, 371 00:14:27,738 --> 00:14:29,280 I hope you never have to use it. 372 00:14:29,281 --> 00:14:31,240 I could have paralyzed that guy. 373 00:14:31,241 --> 00:14:33,951 Yeah, but you didn't. 374 00:14:33,952 --> 00:14:37,246 No, I didn't. 375 00:14:37,247 --> 00:14:39,707 Thank you... 376 00:14:39,708 --> 00:14:41,793 by the way, for... 377 00:14:41,794 --> 00:14:44,545 talking me down earlier. 378 00:14:44,546 --> 00:14:46,423 I'm sorry I snapped. 379 00:14:47,925 --> 00:14:49,259 It's OK. 380 00:14:57,434 --> 00:15:00,103 Dr. Mohan, you ever heard of kinship fostering? 381 00:15:00,104 --> 00:15:01,813 It's where a nurse or doctor can 382 00:15:01,814 --> 00:15:03,314 - become an emergency foster... - Oh, no. 383 00:15:03,315 --> 00:15:04,816 I don't need any kids. 384 00:15:04,817 --> 00:15:06,984 I need to find a job first. 385 00:15:06,985 --> 00:15:09,445 Candice O'Grady is an 82-year-old female 386 00:15:09,446 --> 00:15:11,948 brought in by her son for intractable vomiting. 387 00:15:11,949 --> 00:15:14,910 No fever, no chills, no abdominal pain, no rash. 388 00:15:15,994 --> 00:15:17,995 Beep. 389 00:15:17,996 --> 00:15:21,416 Oh, I've already got one I can barely keep up with. 390 00:15:21,417 --> 00:15:23,292 What about Sleeping Beauty over here? 391 00:15:23,293 --> 00:15:25,336 She's already babysitting Whitaker. 392 00:15:25,337 --> 00:15:27,422 Well, if you know anyone who'd like to help us out 393 00:15:27,423 --> 00:15:29,340 with Baby Jane Doe, have them call the main desk. 394 00:15:29,341 --> 00:15:30,967 Sure thing. 395 00:15:30,968 --> 00:15:34,138 I'd take her myself, but Benji'd kill me. 396 00:15:35,514 --> 00:15:37,306 BP's 164/114. 397 00:15:37,307 --> 00:15:38,683 Another 40 of labetalol. 398 00:15:38,684 --> 00:15:39,809 Mag bolus is in. 399 00:15:39,810 --> 00:15:41,477 Now infusing 2 grams an hour. 400 00:15:41,478 --> 00:15:42,770 Labs are coming back. 401 00:15:42,771 --> 00:15:45,022 Hemoglobin 7.5, platelets 40. 402 00:15:45,023 --> 00:15:47,024 LFTs are sky high. 403 00:15:47,025 --> 00:15:48,818 - HELLP syndrome. - Hemolytic anemia, 404 00:15:48,819 --> 00:15:51,154 elevated liver enzymes, and low platelets. 405 00:15:51,155 --> 00:15:52,530 They're cleaning a room. 406 00:15:52,531 --> 00:15:54,490 We can bring her up in ten minutes. 407 00:15:54,491 --> 00:15:55,701 How you doing, Judith? 408 00:15:57,703 --> 00:16:00,246 I... I... 409 00:16:00,247 --> 00:16:01,914 - [MACHINE BEEPING] - Oh, she's seizing. 410 00:16:01,915 --> 00:16:03,583 Oh, shit. 411 00:16:03,584 --> 00:16:06,169 10 of IV diazepam. Have another 10 ready. 412 00:16:06,170 --> 00:16:08,129 With all the movement, we can't get a fetal heartbeat. 413 00:16:08,130 --> 00:16:10,423 Putting on 15 liters by mask. Should we intubate? 414 00:16:10,424 --> 00:16:12,425 Hold intubation. Let's try to break this. 415 00:16:12,426 --> 00:16:14,343 We don't want to mask seizures with paralysis 416 00:16:14,344 --> 00:16:15,928 unless we have to. 417 00:16:15,929 --> 00:16:17,513 OK, um... 418 00:16:17,514 --> 00:16:19,974 [RAPID BEEPING] 419 00:16:19,975 --> 00:16:21,726 Crus, CTG isn't reading. 420 00:16:21,727 --> 00:16:23,186 - Check with ultrasound. - On it. 421 00:16:23,187 --> 00:16:24,812 Nazely, what's the diagnosis? 422 00:16:24,813 --> 00:16:27,858 Um, with the seizure, now it's eclampsia. 423 00:16:29,026 --> 00:16:31,068 - Fetal heart rate is about 90. - Way too low. 424 00:16:31,069 --> 00:16:32,361 Mom's sats are going down. 425 00:16:32,362 --> 00:16:33,821 Time to tube her? 426 00:16:33,822 --> 00:16:35,490 Set up for it, but wait. 427 00:16:35,491 --> 00:16:36,824 Another 10 of diazepam. 428 00:16:36,825 --> 00:16:39,286 Push 4 grams of Keppra. 429 00:16:40,496 --> 00:16:42,038 [BABY FUSSING] 430 00:16:42,039 --> 00:16:43,539 History of hypertension 431 00:16:43,540 --> 00:16:44,874 presents to the emergency department 432 00:16:44,875 --> 00:16:47,210 with a chief complaint of dizziness 433 00:16:47,211 --> 00:16:49,420 after inadvertently ingesting 80 milligrams... 434 00:16:49,421 --> 00:16:50,713 Hey, how are you guys making out? 435 00:16:50,714 --> 00:16:51,797 Yeah, we're getting there. 436 00:16:51,798 --> 00:16:53,549 Have you seen Dr. Al-Hashimi? 437 00:16:53,550 --> 00:16:55,385 - No. - Can I talk to you for a sec? 438 00:17:00,933 --> 00:17:02,266 So I just wanted to let you know that I've been 439 00:17:02,267 --> 00:17:03,559 checking out some of your online posts... 440 00:17:03,560 --> 00:17:04,727 Look, I was just trying to help 441 00:17:04,728 --> 00:17:06,312 get some health messages out there, 442 00:17:06,313 --> 00:17:07,897 - especially for young people. - I think they're great. 443 00:17:07,898 --> 00:17:09,899 Really good. 444 00:17:09,900 --> 00:17:11,901 - You do? - Yeah. 445 00:17:11,902 --> 00:17:14,111 Yeah, um, keep it up. 446 00:17:14,112 --> 00:17:15,571 OK. 447 00:17:15,572 --> 00:17:17,907 As long as you follow the HIPAA laws. 448 00:17:17,908 --> 00:17:19,283 I do. 449 00:17:19,284 --> 00:17:20,868 And wait until you're done charting. 450 00:17:20,869 --> 00:17:22,496 [SCOFFS] Sure. 451 00:17:24,706 --> 00:17:29,043 Actually, Dr. Robby... sorry, um, can I ask you a question? 452 00:17:29,044 --> 00:17:30,253 Shoot. 453 00:17:30,254 --> 00:17:31,712 Um, I... I may be 454 00:17:31,713 --> 00:17:34,508 considering emergency psychiatry. 455 00:17:35,759 --> 00:17:37,969 Very cool. 456 00:17:37,970 --> 00:17:39,763 Think I could do it? 457 00:17:41,932 --> 00:17:43,432 I think that you could do 458 00:17:43,433 --> 00:17:46,019 anything that you put your mind to, Victoria. 459 00:17:50,107 --> 00:17:51,566 OK. 460 00:17:51,567 --> 00:17:53,276 Pulse ox is 88. 461 00:17:53,277 --> 00:17:54,443 [RAPID BEEPING] 462 00:17:54,444 --> 00:17:56,487 Dr. Abbot? 463 00:17:56,488 --> 00:17:58,656 - Intubate? - Let's do it. 464 00:17:58,657 --> 00:18:01,993 Nazely, what do you suggest for rapid sequence induction? 465 00:18:01,994 --> 00:18:03,202 Etomidate and roc. 466 00:18:03,203 --> 00:18:04,370 Mm, not quite. 467 00:18:04,371 --> 00:18:05,496 120 of propofol, 468 00:18:05,497 --> 00:18:06,497 60 of succinylcholine. 469 00:18:06,498 --> 00:18:07,957 Why is that, Crus? 470 00:18:07,958 --> 00:18:09,667 Propofol for the anti-seizure effect, 471 00:18:09,668 --> 00:18:11,294 sux to avoid prolonged paralysis 472 00:18:11,295 --> 00:18:13,379 - so we can check her neuro exam. - Exactly. 473 00:18:13,380 --> 00:18:14,714 Pushing the propofol. 474 00:18:14,715 --> 00:18:16,215 Once she's flat for intubation, 475 00:18:16,216 --> 00:18:17,800 we need to displace the uterus to the left. 476 00:18:17,801 --> 00:18:19,427 Nazely, that's you. Big hug, both arms. 477 00:18:19,428 --> 00:18:21,762 - Get the baby off the vena cava. - Sux is on board. 478 00:18:21,763 --> 00:18:24,515 But after she's paralyzed, the seizing stops, right? 479 00:18:24,516 --> 00:18:26,017 It might look like that, 480 00:18:26,018 --> 00:18:28,102 but an ongoing seizure will still fry the brain. 481 00:18:28,103 --> 00:18:29,937 We monitor with EEG. 482 00:18:29,938 --> 00:18:31,815 - Is there time for that? - Wait and see. 483 00:18:32,941 --> 00:18:34,191 Paralytics kicked in. 484 00:18:34,192 --> 00:18:35,736 Let's go. Roll her to her back. 485 00:18:36,778 --> 00:18:38,487 Intubate, then EEG 486 00:18:38,488 --> 00:18:40,990 to see if her brain is still seizing. 487 00:18:40,991 --> 00:18:42,533 I need first pass success. 488 00:18:42,534 --> 00:18:43,784 You and me both. 489 00:18:43,785 --> 00:18:46,830 [MACHINERY BEEPING] 490 00:18:50,000 --> 00:18:51,500 [INDISTINCT CHATTER] 491 00:18:51,501 --> 00:18:54,045 [SIGHS] Have you seen Dr. Al-Hashimi? 492 00:18:54,046 --> 00:18:55,254 No. 493 00:18:55,255 --> 00:18:57,673 Have you seen Dr. Al-Hashimi? 494 00:18:57,674 --> 00:18:59,425 Al-Hashimi? 495 00:18:59,426 --> 00:19:02,011 With how this day's going, she probably quit. 496 00:19:02,012 --> 00:19:05,264 Last I saw her, she was in Peds with Baby Jane Doe. 497 00:19:05,265 --> 00:19:07,683 Nope, I was just in there. 498 00:19:07,684 --> 00:19:08,684 Want me to page her? 499 00:19:08,685 --> 00:19:10,519 Uh, no, that's OK. 500 00:19:10,520 --> 00:19:11,813 I will find her. 501 00:19:16,401 --> 00:19:17,653 Hello. 502 00:19:20,447 --> 00:19:22,865 Hey, how did our people do at the deposition? 503 00:19:22,866 --> 00:19:25,409 Oh, well, Dr. Ellis is a pit bull. 504 00:19:25,410 --> 00:19:27,536 Dr. King is a petunia. 505 00:19:27,537 --> 00:19:28,871 They were pretty brutal with her. 506 00:19:28,872 --> 00:19:30,706 - She's sensitive. - Very. 507 00:19:30,707 --> 00:19:32,333 And I'm afraid it isn't over. 508 00:19:32,334 --> 00:19:33,501 They want to call her back. 509 00:19:33,502 --> 00:19:35,336 Oh, that's unfortunate. 510 00:19:35,337 --> 00:19:36,545 Maybe I should go with you 511 00:19:36,546 --> 00:19:38,214 to break that news to her, actually. 512 00:19:38,215 --> 00:19:40,049 - Misery loves company. - Um, hey, while I have you, 513 00:19:40,050 --> 00:19:42,843 can I pose a hypothetical to you? 514 00:19:42,844 --> 00:19:44,845 If a doctor suspects another physician 515 00:19:44,846 --> 00:19:47,098 of having a medical condition that could negatively 516 00:19:47,099 --> 00:19:49,225 affect the way they would treat a patient, 517 00:19:49,226 --> 00:19:50,935 where would disclosing that fall 518 00:19:50,936 --> 00:19:52,938 on the HIPAA violation scale? 519 00:19:53,939 --> 00:19:55,941 First, do no harm. 520 00:19:58,402 --> 00:20:00,821 Dr. King, do you have a second? 521 00:20:03,407 --> 00:20:06,201 Mm... 522 00:20:07,994 --> 00:20:10,079 Good lung sliding bilaterally. 523 00:20:10,080 --> 00:20:12,082 Fetal heart rate borderline at 98. 524 00:20:13,583 --> 00:20:15,751 Roll her to the left again. That can help. 525 00:20:15,752 --> 00:20:18,921 - One, two, three. - [GRUNTS] 526 00:20:18,922 --> 00:20:22,425 OK, all set here. 527 00:20:22,426 --> 00:20:23,926 EEG monitor's good to go. 528 00:20:23,927 --> 00:20:25,678 That was fast. 529 00:20:25,679 --> 00:20:27,138 Still seizing while paralyzed. 530 00:20:27,139 --> 00:20:29,724 It's nonconvulsive status. 531 00:20:29,725 --> 00:20:31,100 What's she had so far? 532 00:20:31,101 --> 00:20:32,768 30 of diazepam, a full load of mag, 533 00:20:32,769 --> 00:20:33,936 Keppra, and propofol. 534 00:20:33,937 --> 00:20:35,312 Damn. What's your next step? 535 00:20:35,313 --> 00:20:36,564 Any ideas? 536 00:20:36,565 --> 00:20:38,774 Hmm? Nazely? 537 00:20:38,775 --> 00:20:40,735 Dilantin? Valproate? 538 00:20:40,736 --> 00:20:42,069 Mm, infusion is too long. 539 00:20:42,070 --> 00:20:43,612 So is onset of action. 540 00:20:43,613 --> 00:20:45,072 Push 100 of ketamine. 541 00:20:45,073 --> 00:20:47,283 That's had results with refractory status. 542 00:20:47,284 --> 00:20:49,577 She also has HELLP syndrome... hemoglobin only 7, 543 00:20:49,578 --> 00:20:52,496 - platelets down to 30. - Two units whole blood? 544 00:20:52,497 --> 00:20:54,957 O-neg is going up on the rapid infuser as we speak. 545 00:20:54,958 --> 00:20:57,001 Uh, put the AP pads on, just in case. 546 00:20:57,002 --> 00:20:59,795 And 10 of Decadron IV push for the inflammatory storm. 547 00:20:59,796 --> 00:21:01,964 - Fetal heart rate up to 104. - Hmm. 548 00:21:01,965 --> 00:21:03,299 - Little better. - Yeah. 549 00:21:03,300 --> 00:21:05,634 She should be upstairs with OB. 550 00:21:05,635 --> 00:21:09,388 She will be after we break this seizure. 551 00:21:09,389 --> 00:21:12,600 There was a delay in history-taking 552 00:21:12,601 --> 00:21:15,728 due to a malfunctioning VRI interpretation device. 553 00:21:15,729 --> 00:21:18,314 During this time, there was a normal CBC 554 00:21:18,315 --> 00:21:19,982 and comprehensive metabolic panel 555 00:21:19,983 --> 00:21:21,693 that came back from the lab. 556 00:21:23,153 --> 00:21:25,070 What's wrong with you, Malfeasance? 557 00:21:25,071 --> 00:21:28,073 I have to do another deposition. 558 00:21:28,074 --> 00:21:30,034 Oh, that sucks. 559 00:21:30,035 --> 00:21:31,995 You must have really messed up. [CHUCKLES] 560 00:21:33,038 --> 00:21:34,789 Dude, I'm joking. 561 00:21:34,790 --> 00:21:35,831 You gotta lighten up. 562 00:21:35,832 --> 00:21:37,501 It's all just bullshit. 563 00:21:39,002 --> 00:21:41,462 [SIGHS] God, you know what? Fuck all this. 564 00:21:41,463 --> 00:21:42,839 Do you want to go get a drink? 565 00:21:43,965 --> 00:21:45,007 Me? 566 00:21:45,008 --> 00:21:46,675 Yes, you. 567 00:21:46,676 --> 00:21:49,011 You... you do go out, don't you? 568 00:21:49,012 --> 00:21:51,180 Well, I'm usually with Becca. 569 00:21:51,181 --> 00:21:52,515 Well, bring her along. 570 00:21:52,516 --> 00:21:53,849 Can she drive? 571 00:21:53,850 --> 00:21:56,102 No, and she's with her boyfriend. 572 00:21:57,062 --> 00:21:58,522 OK, Becca. 573 00:22:00,190 --> 00:22:02,150 So it's just you and me. 574 00:22:04,277 --> 00:22:06,695 Do you like karaoke? 575 00:22:06,696 --> 00:22:08,572 You do karaoke? 576 00:22:08,573 --> 00:22:12,952 Well, what I do is more like primal scream therapy. 577 00:22:12,953 --> 00:22:14,703 There's nothing like getting wasted 578 00:22:14,704 --> 00:22:16,205 and just absolutely wailing 579 00:22:16,206 --> 00:22:18,958 to shake off a shit show like today. 580 00:22:18,959 --> 00:22:20,836 I could use a fun night. 581 00:22:22,212 --> 00:22:24,088 You and me both, sister. 582 00:22:24,089 --> 00:22:25,881 There's been no improvement. 583 00:22:25,882 --> 00:22:27,424 Still seizing on the EEG. 584 00:22:27,425 --> 00:22:29,134 - Neurology has been called. - OK. Got it. 585 00:22:29,135 --> 00:22:31,095 OB says send her up. They have an OR ready. 586 00:22:31,096 --> 00:22:32,555 About time. 587 00:22:32,556 --> 00:22:34,265 Baby's been bradying down a bit more. 588 00:22:34,266 --> 00:22:35,850 This one looks like it took a turn for the worse. 589 00:22:35,851 --> 00:22:37,685 Eclampsia, refractory seizures, 590 00:22:37,686 --> 00:22:39,937 HELLP syndrome with anemia and thrombocytopenia. 591 00:22:39,938 --> 00:22:41,397 Yeah, about as bad as it gets. 592 00:22:41,398 --> 00:22:43,899 - [ALARM BLARING] - V-fib! 593 00:22:43,900 --> 00:22:45,901 Chest compressions, Nazely. 594 00:22:45,902 --> 00:22:48,696 Charge to 200. 595 00:22:48,697 --> 00:22:50,114 Prep the belly. 596 00:22:50,115 --> 00:22:51,448 Get a baby warmer. 597 00:22:51,449 --> 00:22:53,117 Call the NICU. Start a timer. 598 00:22:53,118 --> 00:22:54,952 Charged. 599 00:22:54,953 --> 00:22:56,245 Clear. 600 00:22:56,246 --> 00:22:58,080 [TENSE MUSIC] 601 00:22:58,081 --> 00:22:59,415 Continue compressions. 602 00:22:59,416 --> 00:23:01,792 We'll check a rhythm in a minute. 603 00:23:01,793 --> 00:23:03,085 Gown up. 604 00:23:03,086 --> 00:23:04,420 Robby, it's you and me. 605 00:23:04,421 --> 00:23:06,422 Nazely, what's the four-minute rule? 606 00:23:06,423 --> 00:23:08,674 Uh, not sure. 607 00:23:08,675 --> 00:23:10,467 Pregnant patient with a viable fetus, 608 00:23:10,468 --> 00:23:12,094 you have four minutes after cardiac arrest 609 00:23:12,095 --> 00:23:14,388 - to save the baby. - And the mom. 610 00:23:14,389 --> 00:23:16,682 We don't call it a postmortem C-section anymore. 611 00:23:16,683 --> 00:23:17,933 It's a resuscitative hysterotomy 612 00:23:17,934 --> 00:23:19,435 to try to save them both. 613 00:23:19,436 --> 00:23:20,769 But she doesn't want any medical intervention. 614 00:23:20,770 --> 00:23:22,146 That doesn't matter. 615 00:23:22,147 --> 00:23:23,647 Mom and baby are both dead if we do nothing. 616 00:23:23,648 --> 00:23:25,441 OK, charge to 200. 617 00:23:25,442 --> 00:23:27,485 One more rhythm check and then Abbot and I are gonna cut. 618 00:23:28,778 --> 00:23:31,363 Ellis, you and Crus on Mom resuscitation. 619 00:23:31,364 --> 00:23:32,823 Shen, you and Nazely take the baby. 620 00:23:32,824 --> 00:23:34,325 OK, hold compressions. 621 00:23:34,326 --> 00:23:35,993 ♪ ♪ 622 00:23:35,994 --> 00:23:37,620 Still V-fib. 623 00:23:37,621 --> 00:23:38,787 Clear. 624 00:23:38,788 --> 00:23:40,623 - [THUD] - No change. 625 00:23:40,624 --> 00:23:42,666 - Resume compression, amp of epi. - OK, showtime. 626 00:23:42,667 --> 00:23:44,335 We need to get this baby out right now. 627 00:23:44,336 --> 00:23:45,462 OK, take a break. 628 00:23:48,006 --> 00:23:51,508 OK, 10 blade. Good. 629 00:23:51,509 --> 00:23:53,761 First incision is from the xiphoid 630 00:23:53,762 --> 00:23:55,471 to the pubic symphysis 631 00:23:55,472 --> 00:23:58,474 through the skin to the linea alba. 632 00:23:58,475 --> 00:24:00,601 Units three and four on the infuser. 633 00:24:00,602 --> 00:24:03,479 Second incision goes through the peritoneum, 634 00:24:03,480 --> 00:24:05,272 exposing the uterus. 635 00:24:05,273 --> 00:24:06,982 Where do you need me? 636 00:24:06,983 --> 00:24:09,193 You're with the baby. Nazely's got the bag mask. 637 00:24:09,194 --> 00:24:11,403 You're on suction. Stand by for intubation. 638 00:24:11,404 --> 00:24:12,905 Bladder retractors. 639 00:24:12,906 --> 00:24:14,573 Neonatal monitor and pulse ox ready to go. 640 00:24:14,574 --> 00:24:16,992 Ellis, gentle traction. 641 00:24:16,993 --> 00:24:19,078 OK, making a small vertical incision 642 00:24:19,079 --> 00:24:22,706 through the lower uterus so as not to cut the baby. 643 00:24:22,707 --> 00:24:24,500 Mm-hmm. 644 00:24:24,501 --> 00:24:26,043 - Got it? - Yep, I got it. 645 00:24:26,044 --> 00:24:27,503 - OK. - OK. 646 00:24:27,504 --> 00:24:30,631 Using scissors to extend superiorly. 647 00:24:30,632 --> 00:24:32,091 ♪ ♪ 648 00:24:32,092 --> 00:24:34,176 Ellis, hand retract the uterus with me. 649 00:24:34,177 --> 00:24:36,095 Amniotic fluid looks good. 650 00:24:36,096 --> 00:24:37,721 ♪ ♪ 651 00:24:37,722 --> 00:24:39,473 Give me some fundal pressure. 652 00:24:39,474 --> 00:24:40,891 Breech position. 653 00:24:40,892 --> 00:24:43,310 ♪ ♪ 654 00:24:43,311 --> 00:24:46,480 OK, baby's out. 655 00:24:46,481 --> 00:24:48,315 - It's a girl. - All right. 656 00:24:48,316 --> 00:24:49,984 ♪ ♪ 657 00:24:49,985 --> 00:24:52,987 Milking the cord. 658 00:24:52,988 --> 00:24:55,489 Clamping. 659 00:24:55,490 --> 00:24:57,491 Cutting. 660 00:24:57,492 --> 00:24:59,076 OK, blue and flaccid. Coming to you, Shen. 661 00:24:59,077 --> 00:25:00,202 - You ready? - Yeah, you got her. 662 00:25:00,203 --> 00:25:02,246 I got it, yep. 663 00:25:02,247 --> 00:25:03,664 OK. 664 00:25:03,665 --> 00:25:07,251 [RAPID BEEPING] 665 00:25:07,252 --> 00:25:09,712 Poor tone, no movement. 666 00:25:09,713 --> 00:25:12,381 Keep the blow-by closer. 667 00:25:12,382 --> 00:25:13,757 She's really blue. 668 00:25:13,758 --> 00:25:16,593 Some blue is normal, but not this much. 669 00:25:16,594 --> 00:25:18,554 - Do we need to intubate? - Not yet, no. 670 00:25:18,555 --> 00:25:21,265 They usually pink up with stimulation and blow-by. 671 00:25:21,266 --> 00:25:23,058 OK, removing the placenta. 672 00:25:23,059 --> 00:25:25,436 Sweeping to the left, trying to get it in one piece. 673 00:25:25,437 --> 00:25:27,271 ♪ ♪ 674 00:25:27,272 --> 00:25:28,564 - Looks intact. - Yeah. 675 00:25:28,565 --> 00:25:30,733 Nicely done. 676 00:25:30,734 --> 00:25:32,735 10 of IV Pitocin to contract the uterus. 677 00:25:32,736 --> 00:25:34,903 And lots of massage. 678 00:25:34,904 --> 00:25:36,572 Heart rate 76. 679 00:25:36,573 --> 00:25:38,157 Less than 100 means we need to bag. 680 00:25:38,158 --> 00:25:39,366 Suction first. 681 00:25:39,367 --> 00:25:40,534 OK. 682 00:25:40,535 --> 00:25:42,453 ♪ ♪ 683 00:25:42,454 --> 00:25:43,912 Hey, Jord, charge to 200. 684 00:25:43,913 --> 00:25:46,749 Stand by for the next rhythm check. 685 00:25:46,750 --> 00:25:48,459 She grimaced. Good sign. 686 00:25:48,460 --> 00:25:49,543 Bagging. 687 00:25:49,544 --> 00:25:51,545 Pulse ox 45%. 688 00:25:51,546 --> 00:25:53,130 Oh, I've never seen it that low. 689 00:25:53,131 --> 00:25:54,923 It's not as bad as it sounds. 690 00:25:54,924 --> 00:25:56,967 I'm more worried about the heart rate. 691 00:25:56,968 --> 00:25:59,136 McKay, get ready with an IO in case we need epi. 692 00:25:59,137 --> 00:26:00,596 OK. 693 00:26:00,597 --> 00:26:02,431 [WHIRRING] 694 00:26:02,432 --> 00:26:04,933 Rhythm check. Hold compressions. 695 00:26:04,934 --> 00:26:05,976 Still V-fib. 696 00:26:05,977 --> 00:26:07,478 - OK, shock it. - Clear. 697 00:26:07,479 --> 00:26:08,479 [THUD] 698 00:26:08,480 --> 00:26:09,980 Resume compressions. 699 00:26:09,981 --> 00:26:11,482 Shen, how's she doing over there? 700 00:26:11,483 --> 00:26:12,775 Heart rate's up to 104. 701 00:26:12,776 --> 00:26:14,026 Uh, at one minute, 702 00:26:14,027 --> 00:26:16,361 she's 0 for color, 2 for heart rate, 703 00:26:16,362 --> 00:26:17,696 1 for reflex, tone, breathing. 704 00:26:17,697 --> 00:26:19,323 APGAR of 5. 705 00:26:19,324 --> 00:26:21,283 5 out of 10. Not great. 706 00:26:21,284 --> 00:26:22,951 Pulse ox 58%. 707 00:26:22,952 --> 00:26:24,870 - Intubation? - Uh, not yet. 708 00:26:24,871 --> 00:26:26,955 O2 sat in the 60s is normal at one minute. 709 00:26:26,956 --> 00:26:29,833 Her heart rate and pulse ox are trending higher. 710 00:26:29,834 --> 00:26:31,293 Let's keep doing what we're doing. 711 00:26:31,294 --> 00:26:32,795 A little tincture of time. 712 00:26:32,796 --> 00:26:34,463 Hold compressions. 713 00:26:34,464 --> 00:26:36,548 Looks like sinus. 714 00:26:36,549 --> 00:26:38,217 Can't feel a carotid. 715 00:26:38,218 --> 00:26:39,635 No. 716 00:26:39,636 --> 00:26:41,637 Heart's barely pumping. It's PEA. 717 00:26:41,638 --> 00:26:42,930 Back on compressions. 718 00:26:42,931 --> 00:26:44,431 Transfuse two more units. 719 00:26:44,432 --> 00:26:45,808 She needs more red cells and platelets. 720 00:26:45,809 --> 00:26:47,518 Ongoing blood loss from the uterus. 721 00:26:47,519 --> 00:26:49,103 Give me all the lap pads we got, please. 722 00:26:49,104 --> 00:26:52,106 [RAPID BEEPING] 723 00:26:52,107 --> 00:26:56,527 ♪ ♪ 724 00:26:56,528 --> 00:26:57,861 Yeah. 725 00:26:57,862 --> 00:26:58,987 OK, yeah, thanks. 726 00:26:58,988 --> 00:27:00,447 I appreciate it, honey. 727 00:27:00,448 --> 00:27:02,324 Oh, gotta go. 728 00:27:02,325 --> 00:27:03,659 Whoa, whoa, whoa! 729 00:27:03,660 --> 00:27:04,660 Hold up. 730 00:27:04,661 --> 00:27:06,161 Is there a problem here? 731 00:27:06,162 --> 00:27:08,288 Yeah, you two aren't leaving empty-handed. 732 00:27:08,289 --> 00:27:09,332 What? 733 00:27:10,500 --> 00:27:12,043 One of you follow me. 734 00:27:13,711 --> 00:27:15,546 Rape kits are supposed to be picked up 735 00:27:15,547 --> 00:27:18,507 within 72 hours of collecting 'em. 736 00:27:18,508 --> 00:27:21,218 This one's been here for over two weeks. 737 00:27:21,219 --> 00:27:22,928 That's not on us. 738 00:27:22,929 --> 00:27:24,513 Well, it's on somebody. 739 00:27:24,514 --> 00:27:26,014 It's not bad enough these poor women 740 00:27:26,015 --> 00:27:27,599 go through an assault, plus the indignity 741 00:27:27,600 --> 00:27:29,268 of the whole collection process, 742 00:27:29,269 --> 00:27:31,019 but nobody from the police department 743 00:27:31,020 --> 00:27:33,605 even has the human decency to come get these things? 744 00:27:33,606 --> 00:27:34,731 Like nobody there gives a flying fuck? 745 00:27:34,732 --> 00:27:36,358 OK, we got it. 746 00:27:36,359 --> 00:27:38,277 We'll see that these get put into evidence properly. 747 00:27:38,278 --> 00:27:39,487 Thank you. 748 00:27:41,614 --> 00:27:42,866 How hard was that? 749 00:27:45,410 --> 00:27:46,702 [RAPID BEEPING] 750 00:27:46,703 --> 00:27:47,870 Units five and six are in. 751 00:27:47,871 --> 00:27:49,329 Down to a slow ooze here. 752 00:27:49,330 --> 00:27:50,706 Hold compressions. 753 00:27:50,707 --> 00:27:54,251 [MACHINERY BEEPING] 754 00:27:54,252 --> 00:27:56,336 Looks like sinus. 755 00:27:56,337 --> 00:27:57,713 - And I got a weak carotid. - OK. 756 00:27:57,714 --> 00:27:59,214 Cycle the BP. 757 00:27:59,215 --> 00:28:01,341 Better filling, better squeeze. 758 00:28:01,342 --> 00:28:02,926 No seizure activity on the EEG. 759 00:28:02,927 --> 00:28:04,428 That's progress. That's progress. 760 00:28:04,429 --> 00:28:05,512 We're at five minutes. 761 00:28:05,513 --> 00:28:07,431 Uh, heart rate is 132. 762 00:28:07,432 --> 00:28:09,099 Uh, pulse ox 79%. 763 00:28:09,100 --> 00:28:11,018 Nazely, the APGAR? 764 00:28:11,019 --> 00:28:12,561 Um... 765 00:28:12,562 --> 00:28:14,730 1 off for color, 1 off for tone, 766 00:28:14,731 --> 00:28:17,274 1 off for respiration with hypoxia, total of 7. 767 00:28:17,275 --> 00:28:18,650 Respiration score is for observed breathing, 768 00:28:18,651 --> 00:28:20,068 not pulse ox. 769 00:28:20,069 --> 00:28:21,612 Sat of 80 is normal at five minutes. 770 00:28:21,613 --> 00:28:23,071 With no crying, she still gets 1 off. 771 00:28:23,072 --> 00:28:24,115 Yeah. 772 00:28:26,492 --> 00:28:27,993 - [BABY CRYING] - Ah! 773 00:28:27,994 --> 00:28:29,953 She just scored the winning point! 774 00:28:29,954 --> 00:28:32,290 APGAR of 8 is pretty normal. 775 00:28:35,585 --> 00:28:37,920 Holy shit. What did I miss? 776 00:28:37,921 --> 00:28:40,631 Eclampsia with status, HELLP syndrome, 777 00:28:40,632 --> 00:28:43,800 cardiac arrest, resuscitative hysterotomy. 778 00:28:43,801 --> 00:28:46,136 I was in the OR with a septic twin C-section. 779 00:28:46,137 --> 00:28:47,429 Got your text 12 minutes ago. 780 00:28:47,430 --> 00:28:48,931 Shit happens fast down here. 781 00:28:48,932 --> 00:28:51,475 Resuscitative hysterotomy in 36 seconds. 782 00:28:51,476 --> 00:28:53,769 - Impressive. - BP's 102/64. 783 00:28:53,770 --> 00:28:54,978 Hemoglobin is up to 9. 784 00:28:54,979 --> 00:28:57,064 That'll do. 785 00:28:57,065 --> 00:28:58,440 NICU's sending a team down. 786 00:28:58,441 --> 00:29:00,776 We can take Mom. You guys are rock stars. 787 00:29:00,777 --> 00:29:03,279 We like to be referred to as crawlers of the night. 788 00:29:04,906 --> 00:29:06,448 [SIGHS] 789 00:29:06,449 --> 00:29:07,824 If you're not careful, 790 00:29:07,825 --> 00:29:09,409 you're gonna get stuck here all night. 791 00:29:09,410 --> 00:29:11,912 Nah, Henny said she'd be here in 30 minutes. 792 00:29:11,913 --> 00:29:14,456 - How's Mom and baby? - Whew. 793 00:29:14,457 --> 00:29:16,458 They're both gonna go upstairs. 794 00:29:16,459 --> 00:29:18,627 Good. You leaving now? 795 00:29:18,628 --> 00:29:20,295 Yeah, pretty soon. 796 00:29:20,296 --> 00:29:23,382 I gotta find Whitaker, I gotta find Al-Hashimi, 797 00:29:23,383 --> 00:29:25,634 and I gotta find Langdon before I leave. 798 00:29:25,635 --> 00:29:28,137 You missed Langdon. He just checked out. 799 00:29:30,556 --> 00:29:32,600 [SIGHS] Shit. 800 00:29:56,040 --> 00:29:57,457 Can I help you? 801 00:29:57,458 --> 00:30:01,003 Uh, yeah, I'm Dr. Langdon from the ED. 802 00:30:01,004 --> 00:30:03,964 I was just, uh, checking in on the status 803 00:30:03,965 --> 00:30:06,633 of someone we sent up here earlier. 804 00:30:06,634 --> 00:30:09,219 Patient's name is, uh, Cohen. 805 00:30:09,220 --> 00:30:10,512 Let me check. 806 00:30:10,513 --> 00:30:11,805 What was she up here for? 807 00:30:11,806 --> 00:30:13,640 Uh, clean out a nasty neck fash. 808 00:30:13,641 --> 00:30:16,310 [KEYS CLACKING] 809 00:30:16,311 --> 00:30:17,978 Oh, yeah, she's good. 810 00:30:17,979 --> 00:30:21,064 She's in 4202, recovering nicely. 811 00:30:21,065 --> 00:30:23,650 Great, great. 812 00:30:23,651 --> 00:30:26,570 I mean, she was... she was in not-great shape earlier. 813 00:30:26,571 --> 00:30:28,697 It was a good catch. 814 00:30:28,698 --> 00:30:32,701 Saved her life, even if we couldn't save her leg. 815 00:30:32,702 --> 00:30:35,704 Uh, was it below the knee? 816 00:30:35,705 --> 00:30:37,540 Unfortunately, it was above. 817 00:30:54,432 --> 00:30:57,559 My cell phone and the building manager's. 818 00:30:57,560 --> 00:30:59,519 He can help if there's any emergencies. 819 00:30:59,520 --> 00:31:01,605 Yeah, what kind of emergencies? 820 00:31:01,606 --> 00:31:03,023 Whatever. 821 00:31:03,024 --> 00:31:04,024 And follow up with Duke 822 00:31:04,025 --> 00:31:05,025 in a couple days, yeah? 823 00:31:05,026 --> 00:31:06,068 Yeah. 824 00:31:06,069 --> 00:31:08,445 You, um... you sure about this? 825 00:31:08,446 --> 00:31:10,280 I trust you, Whitaker. 826 00:31:10,281 --> 00:31:12,074 Great. 827 00:31:12,075 --> 00:31:13,533 Any questions? 828 00:31:13,534 --> 00:31:16,578 Uh, when are you back, exactly? 829 00:31:16,579 --> 00:31:18,080 You know, I'll text you. 830 00:31:18,081 --> 00:31:19,916 I'm trying to keep my dates kind of fluid. 831 00:31:21,292 --> 00:31:23,418 I think this is your ride. 832 00:31:23,419 --> 00:31:25,462 Yeah, uh, yes. 833 00:31:25,463 --> 00:31:28,006 I... I promise I'll check in on your house tomorrow. 834 00:31:28,007 --> 00:31:29,509 Sounds good. 835 00:31:30,635 --> 00:31:32,344 - Hey. - Hey. 836 00:31:32,345 --> 00:31:35,430 OK. Hey, Theo. 837 00:31:35,431 --> 00:31:37,265 You're up late, huh? 838 00:31:37,266 --> 00:31:39,936 What you got there? [CHUCKLES] 839 00:31:41,479 --> 00:31:43,939 OK. 840 00:31:43,940 --> 00:31:45,607 He's been fussy all day. 841 00:31:45,608 --> 00:31:47,776 I think he's got another tooth coming in. 842 00:31:47,777 --> 00:31:49,444 Aw, right on, big guy. 843 00:31:49,445 --> 00:31:52,864 Are you ready to get funky? 844 00:31:52,865 --> 00:31:54,658 - Yeah? - [CHUCKLES] 845 00:31:54,659 --> 00:31:56,910 ♪ Ain't we funkin' now ♪ 846 00:31:56,911 --> 00:31:58,787 [THE BROTHERS JOHNSON'S "AIN'T WE FUNKIN' NOW"] 847 00:31:58,788 --> 00:32:00,789 ♪ Ain't we funkin' now ♪ 848 00:32:00,790 --> 00:32:06,796 ♪ ♪ 849 00:32:13,761 --> 00:32:15,137 Hey. 850 00:32:15,138 --> 00:32:17,140 Any luck picking an elective? 851 00:32:18,599 --> 00:32:21,435 Don't know. [SIGHS] 852 00:32:21,436 --> 00:32:23,646 Maybe I will go into geriatrics. 853 00:32:25,148 --> 00:32:27,108 It's a smart choice. 854 00:32:30,820 --> 00:32:32,487 I know that life can be challenging, 855 00:32:32,488 --> 00:32:33,822 especially when it doesn't work out 856 00:32:33,823 --> 00:32:35,157 the way you expected. 857 00:32:35,158 --> 00:32:36,367 OK. 858 00:32:41,205 --> 00:32:42,664 I thought I would be married 859 00:32:42,665 --> 00:32:44,750 with two kids in college by now. 860 00:32:46,043 --> 00:32:48,837 Maybe have some property with a pond, 861 00:32:48,838 --> 00:32:51,047 and we could play hockey on it in the wintertime. 862 00:32:51,048 --> 00:32:53,175 [SIREN WAILING] 863 00:32:53,176 --> 00:32:54,384 And yet look at me now. 864 00:32:54,385 --> 00:32:58,514 No wife, no kids, no pond. 865 00:33:01,976 --> 00:33:04,186 It's never too late. 866 00:33:04,187 --> 00:33:06,688 Do you really believe that? 867 00:33:06,689 --> 00:33:08,023 Yeah. 868 00:33:08,024 --> 00:33:09,733 Only for me, or for you too? 869 00:33:09,734 --> 00:33:11,359 OK. [SIREN CHIRPS] 870 00:33:11,360 --> 00:33:12,945 I see what you did there. 871 00:33:14,155 --> 00:33:16,865 Was that true, or something you just said to make a point? 872 00:33:16,866 --> 00:33:18,242 [VEHICLE DOOR OPENS] 873 00:33:22,997 --> 00:33:25,750 Have you worked things out with your mom? 874 00:33:27,960 --> 00:33:29,545 We're not talking. 875 00:33:32,798 --> 00:33:37,136 I am sorry that, um, I let it distract me. 876 00:33:38,638 --> 00:33:40,305 She was treating me like a child, 877 00:33:40,306 --> 00:33:41,724 and I was letting her. 878 00:33:46,896 --> 00:33:48,397 Have a good trip. 879 00:33:49,565 --> 00:33:50,733 Please be safe. 880 00:33:52,652 --> 00:33:55,070 We need you here. 881 00:33:55,071 --> 00:33:57,240 Even if you can be a dick sometimes. 882 00:34:00,076 --> 00:34:01,285 Good luck. 883 00:34:02,620 --> 00:34:03,996 You too. 884 00:34:09,752 --> 00:34:10,752 [LOUD BANG] 885 00:34:10,753 --> 00:34:12,338 [CAR ALARM BLARING] 886 00:34:13,089 --> 00:34:15,257 Hey, I didn't think you were still here. 887 00:34:15,258 --> 00:34:17,677 I was just talking to the neurologist on call. 888 00:34:19,095 --> 00:34:20,887 And? 889 00:34:20,888 --> 00:34:24,224 We had a nice chat. 890 00:34:24,225 --> 00:34:26,893 She agrees I can work with double coverage. 891 00:34:26,894 --> 00:34:29,271 That's not her call to make. 892 00:34:29,272 --> 00:34:30,647 You can't do anything critical 893 00:34:30,648 --> 00:34:32,148 where a five-second lapse in consciousness 894 00:34:32,149 --> 00:34:33,943 could potentially kill a patient. 895 00:34:35,778 --> 00:34:36,988 I agree. 896 00:34:39,115 --> 00:34:40,448 [SIGHS] 897 00:34:40,449 --> 00:34:41,741 But 90% of our patients 898 00:34:41,742 --> 00:34:43,034 don't require critical procedures. 899 00:34:43,035 --> 00:34:45,203 And the ones that do? 900 00:34:45,204 --> 00:34:47,622 Will be handled by whomever is working with me. 901 00:34:47,623 --> 00:34:49,499 Unless they're also tied up with a critical patient. 902 00:34:49,500 --> 00:34:50,875 What if it's a double or triple trauma? 903 00:34:50,876 --> 00:34:52,877 - Robby, I can handle it. - No, you can't. 904 00:34:52,878 --> 00:34:54,296 And I can't let you. 905 00:34:54,297 --> 00:34:55,714 I am fully capable of handling... 906 00:34:55,715 --> 00:34:57,299 No, you are not fully capable, 907 00:34:57,300 --> 00:34:58,759 and you know it. 908 00:35:02,471 --> 00:35:03,972 What do you want from me? 909 00:35:03,973 --> 00:35:05,098 I want what's best for this department... 910 00:35:05,099 --> 00:35:06,516 patients and staff. 911 00:35:06,517 --> 00:35:08,810 Best-case scenario, you get a handle on this, 912 00:35:08,811 --> 00:35:10,353 you're seizure-free for six months, 913 00:35:10,354 --> 00:35:11,605 you get your driver's license back, 914 00:35:11,606 --> 00:35:12,856 you are cleared to work. 915 00:35:12,857 --> 00:35:15,191 I am cleared for my driver's license. 916 00:35:15,192 --> 00:35:17,360 You shouldn't be driving at all like this. 917 00:35:17,361 --> 00:35:19,821 If you were a patient, we would have to report you. 918 00:35:19,822 --> 00:35:21,448 I am not your fucking patient. 919 00:35:21,449 --> 00:35:22,532 No, but I cannot let you work 920 00:35:22,533 --> 00:35:23,950 in my emergency department 921 00:35:23,951 --> 00:35:25,785 until you're fully capable of doing so. 922 00:35:25,786 --> 00:35:27,495 That is not your fucking call! 923 00:35:27,496 --> 00:35:28,997 You're fucking-A right, that's my call! 924 00:35:28,998 --> 00:35:30,999 I'm trying to protect you and my patients, 925 00:35:31,000 --> 00:35:32,334 and you know I'm right about this. 926 00:35:32,335 --> 00:35:34,044 Oh, "my department," "my patients." 927 00:35:34,045 --> 00:35:35,545 All you fucking think about is yourself! 928 00:35:35,546 --> 00:35:36,838 Do you hear yourself? 929 00:35:36,839 --> 00:35:37,881 You didn't rat out Langdon 930 00:35:37,882 --> 00:35:39,424 for stealing fucking drugs. 931 00:35:39,425 --> 00:35:41,009 No, but I kicked him out of this department 932 00:35:41,010 --> 00:35:42,927 until he got the appropriate help that he needs, 933 00:35:42,928 --> 00:35:44,846 and the same goes for you. 934 00:35:44,847 --> 00:35:46,431 You've got until Monday to let the administration know, 935 00:35:46,432 --> 00:35:47,600 or I will. 936 00:35:53,439 --> 00:35:54,689 [BELL DINGING] 937 00:35:54,690 --> 00:35:56,524 I am finished. 938 00:35:56,525 --> 00:35:58,360 Last chart. 939 00:35:58,361 --> 00:35:59,444 [BELL DINGS] 940 00:35:59,445 --> 00:36:00,945 - You and me both. - Really? 941 00:36:00,946 --> 00:36:02,530 Is this a thing? I finished a while ago. 942 00:36:02,531 --> 00:36:03,990 [BELL DINGS] 943 00:36:03,991 --> 00:36:05,785 I never want to hear that fucking bell again. 944 00:36:10,373 --> 00:36:11,873 - Where's Dana? - Not sure. 945 00:36:11,874 --> 00:36:13,375 A bunch of day shift just headed to the roof 946 00:36:13,376 --> 00:36:14,584 to watch the fireworks. 947 00:36:14,585 --> 00:36:15,877 You want me to call her? 948 00:36:15,878 --> 00:36:17,380 No, that's OK. 949 00:36:19,256 --> 00:36:20,757 Yo. 950 00:36:20,758 --> 00:36:22,468 Thanks for your help in there. 951 00:36:24,387 --> 00:36:26,597 - Almost out? - Yep, just about. 952 00:36:28,891 --> 00:36:30,600 Is this where you try to talk me out of going? 953 00:36:30,601 --> 00:36:31,601 Me? 954 00:36:31,602 --> 00:36:33,395 No, not a chance. 955 00:36:33,396 --> 00:36:34,604 Why, are you having second thoughts? 956 00:36:34,605 --> 00:36:35,605 - Nope. - No? 957 00:36:35,606 --> 00:36:37,232 Nope. 958 00:36:37,233 --> 00:36:39,234 Don't have to convince me. 959 00:36:39,235 --> 00:36:40,568 I mean, it is a little strange the only place 960 00:36:40,569 --> 00:36:42,112 you talked about going is somewhere 961 00:36:42,113 --> 00:36:43,405 they used to drive buffalo off a cliff to die. 962 00:36:43,406 --> 00:36:44,739 - Here it comes. - I looked it up, 963 00:36:44,740 --> 00:36:46,408 and as far as summer vacations go, 964 00:36:46,409 --> 00:36:48,159 it's not exactly a holiday hotspot. 965 00:36:48,160 --> 00:36:51,287 I mean, what's in the fucking gift shop, man? 966 00:36:51,288 --> 00:36:52,497 It's just one place I'm going. 967 00:36:52,498 --> 00:36:54,082 As long as it's not the last. 968 00:36:54,083 --> 00:36:56,251 Don't be pulling a "Thelma and Louise" out there. 969 00:36:56,252 --> 00:36:58,461 I am minutes from taking a three-month vacation. 970 00:36:58,462 --> 00:37:00,004 When's the last time you took any time off, Jack? 971 00:37:00,005 --> 00:37:01,882 Yeah, but I've dealt with my demons. 972 00:37:03,175 --> 00:37:05,802 It's a process. 973 00:37:05,803 --> 00:37:08,555 You want to know why I never killed myself? 974 00:37:08,556 --> 00:37:11,933 After what I saw, lived through? 975 00:37:11,934 --> 00:37:15,521 Losing my leg, losing my wife? 976 00:37:16,772 --> 00:37:18,940 Because it comes for all of us, man. 977 00:37:18,941 --> 00:37:20,150 You and I know it more than most. 978 00:37:20,151 --> 00:37:21,901 We see it every shift, 979 00:37:21,902 --> 00:37:24,029 but we can't let ourselves succumb to it. 980 00:37:25,114 --> 00:37:26,949 Yes, life can suck. 981 00:37:28,284 --> 00:37:30,285 It can be unbearable 982 00:37:30,286 --> 00:37:32,120 and... and brutal 983 00:37:32,121 --> 00:37:34,831 and ugly and heartbreaking. 984 00:37:34,832 --> 00:37:39,002 But it's also beautiful... and hilarious. 985 00:37:39,003 --> 00:37:41,255 And that woman today... 986 00:37:44,300 --> 00:37:45,884 Her baby, they'd both be in the morgue 987 00:37:45,885 --> 00:37:47,802 if you hadn't been here. 988 00:37:47,803 --> 00:37:49,637 That's us. That's you and me. 989 00:37:49,638 --> 00:37:52,640 That's what we're here for. 990 00:37:52,641 --> 00:37:55,226 The most important things I've ever done in my life 991 00:37:55,227 --> 00:37:57,896 have been in this hospital. 992 00:37:57,897 --> 00:38:00,356 Nothing will ever matter more than what I've done 993 00:38:00,357 --> 00:38:03,319 in this hospital, but it is killing me. 994 00:38:04,945 --> 00:38:07,071 You know how they say that a part of you dies 995 00:38:07,072 --> 00:38:08,698 when you lose someone you love? 996 00:38:08,699 --> 00:38:11,117 I'm not convinced that a part of you doesn't die 997 00:38:11,118 --> 00:38:13,286 every time you see a fellow human pass. 998 00:38:13,287 --> 00:38:17,791 And I've seen so many people die 999 00:38:17,792 --> 00:38:20,836 that I feel like it's leaching something from my soul. 1000 00:38:22,505 --> 00:38:24,507 Go on a cruise, man. 1001 00:38:26,884 --> 00:38:29,719 Knock off this helmetless motorcycle shit. 1002 00:38:29,720 --> 00:38:31,805 Yeah, people talk. 1003 00:38:31,806 --> 00:38:33,181 That's death-wish behavior. 1004 00:38:33,182 --> 00:38:34,641 I'm tired of being a role model. 1005 00:38:34,642 --> 00:38:36,559 I'm tired of feeling like you can't get ahead. 1006 00:38:36,560 --> 00:38:38,353 I'm tired of feeling like I'm drowning every day. 1007 00:38:38,354 --> 00:38:39,604 I'm tired of all of it. 1008 00:38:39,605 --> 00:38:40,855 You need to get away for a while, 1009 00:38:40,856 --> 00:38:42,232 and you need to get some help. 1010 00:38:42,233 --> 00:38:45,694 You need this place as much as it needs you. 1011 00:38:46,862 --> 00:38:50,073 [BREATHES DEEPLY] 1012 00:38:50,074 --> 00:38:52,200 Am I fucked up? 1013 00:38:52,201 --> 00:38:53,786 100%. 1014 00:38:57,289 --> 00:38:59,541 But nobody works here as long as you and me 1015 00:38:59,542 --> 00:39:00,708 and doesn't get screwed up. 1016 00:39:00,709 --> 00:39:03,878 You... you gotta find somebody 1017 00:39:03,879 --> 00:39:06,589 to help you dance through the darkness. 1018 00:39:06,590 --> 00:39:10,593 [BREATHES DEEPLY] 1019 00:39:10,594 --> 00:39:12,304 Did you just make that up? 1020 00:39:14,515 --> 00:39:15,890 - Maybe it's a song lyric. - [LAUGHS] 1021 00:39:15,891 --> 00:39:17,684 I don't... maybe my therapist said it. 1022 00:39:17,685 --> 00:39:19,686 I don't know. 1023 00:39:19,687 --> 00:39:22,397 [SIGHS] 1024 00:39:22,398 --> 00:39:23,857 Some dude just pulled up. 1025 00:39:23,858 --> 00:39:25,901 Looks like he blew half his face off. 1026 00:39:28,737 --> 00:39:30,573 How can you not love this place? 1027 00:39:32,950 --> 00:39:36,411 Look, don't make me look stupid. 1028 00:39:36,412 --> 00:39:38,831 You come back to us in one piece. 1029 00:39:42,167 --> 00:39:43,626 I'm still your emergency contact, 1030 00:39:43,627 --> 00:39:46,005 and I do not want to be contacted. 1031 00:39:48,340 --> 00:39:49,591 All right, night crawlers, 1032 00:39:49,592 --> 00:39:50,800 what the hell's going on out here? 1033 00:39:50,801 --> 00:39:53,846 [INDISTINCT CHATTER] 1034 00:39:56,348 --> 00:39:57,682 25-year-old man... 1035 00:39:57,683 --> 00:39:58,975 [INDISTINCT] history, 1036 00:39:58,976 --> 00:40:00,310 no meds, no allergies. 1037 00:40:00,311 --> 00:40:03,355 [CONTINUES SPEAKING INDISTINCTLY] 1038 00:40:28,297 --> 00:40:29,298 [LOCK CHIRPS] 1039 00:40:54,198 --> 00:40:56,991 [ENGINE STARTS] 1040 00:40:56,992 --> 00:40:58,661 [CHIMING] 1041 00:41:15,511 --> 00:41:18,514 [SOBBING] 1042 00:41:26,689 --> 00:41:28,648 More than 2,000 years ago, 1043 00:41:28,649 --> 00:41:30,817 the Chinese were throwing bamboo into fire 1044 00:41:30,818 --> 00:41:32,819 to make explosions. 1045 00:41:32,820 --> 00:41:34,362 They went on to invent gunpowder. 1046 00:41:34,363 --> 00:41:36,532 And boom! The rest is history. 1047 00:41:38,158 --> 00:41:41,244 They had chemicals to get the different colors, you know? 1048 00:41:41,245 --> 00:41:44,038 Sodium gives you yellow, strontium gives you red, 1049 00:41:44,039 --> 00:41:47,083 and barium is green. 1050 00:41:47,084 --> 00:41:50,670 Who knew chemistry could be so damn pretty? 1051 00:41:50,671 --> 00:41:52,213 [BOOMING] 1052 00:41:52,214 --> 00:41:54,048 [CHATTER, LAUGHTER] 1053 00:41:54,049 --> 00:41:57,051 [FIREWORKS POPPING] 1054 00:41:57,052 --> 00:42:00,054 ["AMERICA THE BEAUTIFUL" PLAYING] 1055 00:42:00,055 --> 00:42:06,937 ♪ ♪ 1056 00:42:59,615 --> 00:43:01,365 - Hey. - Hey. 1057 00:43:01,366 --> 00:43:03,785 - I thought you'd left already. - On my way out. 1058 00:43:03,786 --> 00:43:07,789 Hey, I'm sorry that I didn't find the time today 1059 00:43:07,790 --> 00:43:08,956 to have that conversation. 1060 00:43:08,957 --> 00:43:10,291 Yeah, that's all right. 1061 00:43:10,292 --> 00:43:12,168 Seems like you didn't really want to. 1062 00:43:12,169 --> 00:43:14,296 I didn't. [SIGHS] 1063 00:43:16,465 --> 00:43:17,882 Did you? 1064 00:43:17,883 --> 00:43:20,259 Uh... 1065 00:43:20,260 --> 00:43:23,012 yeah, actually. 1066 00:43:23,013 --> 00:43:26,140 Look, I'm doing the work. 1067 00:43:26,141 --> 00:43:28,601 I'm... I've been sober 186 days. 1068 00:43:28,602 --> 00:43:30,812 I'm going to meetings. I'm taking the drug tests. 1069 00:43:30,813 --> 00:43:33,065 - That's good. - And you're still riding me. 1070 00:43:36,110 --> 00:43:39,487 What would have happened if I'd paralyzed that guy? 1071 00:43:39,488 --> 00:43:41,155 I don't know. 1072 00:43:41,156 --> 00:43:42,782 What would have happened if I hadn't been here today? 1073 00:43:42,783 --> 00:43:44,450 You'd still be questioning yourself. 1074 00:43:44,451 --> 00:43:46,202 Now you know you can do it. You're welcome. 1075 00:43:46,203 --> 00:43:47,829 Oh, so that's... that's how you teach now? 1076 00:43:47,830 --> 00:43:49,789 Sometimes. 1077 00:43:49,790 --> 00:43:52,083 You know who I saw in rehab? 1078 00:43:52,084 --> 00:43:54,752 I saw a bunch of guys just like you. 1079 00:43:54,753 --> 00:43:56,045 The only difference is, 1080 00:43:56,046 --> 00:43:59,173 they've accepted that they need help. 1081 00:43:59,174 --> 00:44:01,217 I think you're afraid to admit that 1082 00:44:01,218 --> 00:44:03,886 the mighty Dr. Robinavitch isn't perfect. 1083 00:44:03,887 --> 00:44:05,930 Oh, I never claimed to be perfect. 1084 00:44:05,931 --> 00:44:09,183 No, but you expect it of yourself, 1085 00:44:09,184 --> 00:44:11,686 and it's not realistic, man. 1086 00:44:11,687 --> 00:44:14,021 How can any of us live up to your standards 1087 00:44:14,022 --> 00:44:15,732 if you can't even do it? 1088 00:44:17,109 --> 00:44:20,069 You need help, Robby. 1089 00:44:20,070 --> 00:44:21,863 You need help. 1090 00:44:21,864 --> 00:44:24,699 [BABY CRYING] 1091 00:44:24,700 --> 00:44:25,868 Finished? 1092 00:44:27,035 --> 00:44:29,412 You don't gotta be honest with me, man. 1093 00:44:29,413 --> 00:44:31,497 At least be honest with yourself. 1094 00:44:31,498 --> 00:44:34,543 [BABY CRYING] 1095 00:44:46,930 --> 00:44:49,348 She is due for a new bottle. 1096 00:44:49,349 --> 00:44:52,102 I was hoping to get her some formula before I clocked out. 1097 00:44:53,770 --> 00:44:56,147 I'll stay with her. 1098 00:44:56,148 --> 00:44:57,399 Thanks. 1099 00:44:59,651 --> 00:45:01,903 Why are you... will you hit those lights on your way out? 1100 00:45:01,904 --> 00:45:04,906 - Yep. - Why are you crying? 1101 00:45:04,907 --> 00:45:07,491 Why are you crying, little one? 1102 00:45:07,492 --> 00:45:10,077 You're OK. You're safe. 1103 00:45:10,078 --> 00:45:12,413 Yeah, you're not alone. 1104 00:45:12,414 --> 00:45:15,417 [BABY CRYING] 1105 00:45:19,254 --> 00:45:21,797 Yeah, you're OK. 1106 00:45:21,798 --> 00:45:25,092 Do you need to be swaddled again? 1107 00:45:25,093 --> 00:45:26,886 Is that it? 1108 00:45:26,887 --> 00:45:28,804 I can do that. Look. 1109 00:45:28,805 --> 00:45:31,432 Aww. 1110 00:45:31,433 --> 00:45:35,144 I wish somebody would swaddle me. 1111 00:45:35,145 --> 00:45:37,605 Yes, I do. 1112 00:45:37,606 --> 00:45:39,649 Oh. 1113 00:45:39,650 --> 00:45:42,068 [ROSIE CARNEY'S "THOUSAND"] 1114 00:45:42,069 --> 00:45:45,112 You got off to kind of a rough start, 1115 00:45:45,113 --> 00:45:48,241 didn't you, little one? 1116 00:45:48,242 --> 00:45:50,326 Yeah, you did. 1117 00:45:50,327 --> 00:45:52,620 ♪ She is left stuck on her own ♪ 1118 00:45:52,621 --> 00:45:55,289 Well, that makes two of us. 1119 00:45:55,290 --> 00:45:57,667 ♪ Dust grows ♪ 1120 00:45:57,668 --> 00:45:58,876 [SIGHS] 1121 00:45:58,877 --> 00:46:00,962 I got abandoned too. 1122 00:46:00,963 --> 00:46:04,298 ♪ Can't move, can't grow ♪ 1123 00:46:04,299 --> 00:46:06,634 When I was eight. 1124 00:46:06,635 --> 00:46:10,179 ♪ When you've fallen on your knees ♪ 1125 00:46:10,180 --> 00:46:15,643 But I got through all of that, and so will you. 1126 00:46:15,644 --> 00:46:19,647 I got a good feeling that you're gonna be just fine. 1127 00:46:19,648 --> 00:46:23,150 Everything's gonna be just fine. 1128 00:46:23,151 --> 00:46:26,112 You got so many wonderful things to see 1129 00:46:26,113 --> 00:46:29,323 and so many people to love ahead of you. 1130 00:46:29,324 --> 00:46:31,492 ♪ ♪ 1131 00:46:31,493 --> 00:46:36,497 So many wonderful things to see, 1132 00:46:36,498 --> 00:46:38,666 people to love ahead of you. 1133 00:46:38,667 --> 00:46:41,877 ♪ To show they really care ♪ 1134 00:46:41,878 --> 00:46:44,171 ♪ Love, please surround me ♪ 1135 00:46:44,172 --> 00:46:47,133 - [BABY FUSSING] - Shh. 1136 00:46:47,134 --> 00:46:51,887 It's OK. It's gonna be OK. 1137 00:46:51,888 --> 00:46:54,473 It's OK. 1138 00:46:54,474 --> 00:46:59,186 ♪ But a thousand more to live ♪ 1139 00:46:59,187 --> 00:47:03,024 ♪ Will it be this way tomorrow ♪ 1140 00:47:03,025 --> 00:47:04,525 ♪ I don't know ♪ 1141 00:47:04,526 --> 00:47:10,699 ♪ But I won't fade ♪ 1142 00:47:19,875 --> 00:47:24,045 BOTH: ♪ I want you to know ♪ 1143 00:47:24,046 --> 00:47:28,841 ♪ That I'm happy for you ♪ 1144 00:47:28,842 --> 00:47:32,887 ♪ I wish nothing but ♪ 1145 00:47:32,888 --> 00:47:37,350 ♪ The best for you both ♪ 1146 00:47:37,351 --> 00:47:39,560 ♪ An older version of me ♪ 1147 00:47:39,561 --> 00:47:41,771 ♪ Is she perverted like me ♪ 1148 00:47:41,772 --> 00:47:46,359 ♪ Would she go down on you in a theater ♪ 1149 00:47:46,360 --> 00:47:48,694 ♪ Does she speak eloquently ♪ 1150 00:47:48,695 --> 00:47:50,905 ♪ And would she have your baby ♪ 1151 00:47:50,906 --> 00:47:56,077 ♪ I'm sure she'd make a really excellent mother ♪ 1152 00:47:56,078 --> 00:47:57,953 ♪ 'Cause the love that you gave that we made ♪ 1153 00:47:57,954 --> 00:47:59,747 ♪ Wasn't able to make it enough ♪ 1154 00:47:59,748 --> 00:48:02,958 ♪ For you to be open wide ♪ 1155 00:48:02,959 --> 00:48:05,252 ♪ No ♪ 1156 00:48:05,253 --> 00:48:07,630 ♪ And every time you speak her name ♪ 1157 00:48:07,631 --> 00:48:08,923 ♪ Does she know how you told me ♪ 1158 00:48:08,924 --> 00:48:10,800 ♪ You'd hold me until you died ♪ 1159 00:48:10,801 --> 00:48:13,928 ♪ Till you died, but you're still alive ♪ 1160 00:48:13,929 --> 00:48:18,432 ♪ And I'm here to remind you ♪ 1161 00:48:18,433 --> 00:48:20,768 ♪ Of the mess that you left ♪ 1162 00:48:20,769 --> 00:48:22,937 ♪ When you went away ♪ 1163 00:48:22,938 --> 00:48:27,608 ♪ It's not fair to deny me ♪ 1164 00:48:27,609 --> 00:48:31,612 ♪ Of the cross I bear that you gave to me ♪ 1165 00:48:31,613 --> 00:48:35,149 ♪ You, you, you oughta know ♪ 1166 00:48:35,150 --> 00:48:38,696 Sync and corrections by btsix www.addic7ed.com 1167 00:48:39,081 --> 00:48:42,157 [ALANIS MORISSETTE'S "YOU OUGHTA KNOW" PLAYING] 1168 00:48:42,158 --> 00:48:49,207 ♪ ♪