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1
00:00:00,492 --> 00:00:02,292
Ben and I are getting a divorce.
2
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Something's wrong with Dad.
3
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He's forgetting things.
4
00:00:18,997 --> 00:00:20,165
It's getting worse.
5
00:00:20,207 --> 00:00:22,501
He doesn't know where he is.
6
00:00:22,543 --> 00:00:24,837
Damn.
7
00:00:24,878 --> 00:00:26,755
You've already flamed
out of two hospitals,
8
00:00:26,797 --> 00:00:28,924
and you're doing your best
to flame out of a third?
9
00:00:28,966 --> 00:00:30,425
So I'm not fired?
10
00:00:30,467 --> 00:00:31,802
Medical ethics course.
11
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If I were you, I'd take notes.
12
00:00:36,306 --> 00:00:37,766
Wow.
13
00:00:37,808 --> 00:00:40,435
How does that make you feel?
14
00:00:40,477 --> 00:00:41,854
I'm not sure.
15
00:00:41,895 --> 00:00:43,522
It is what it is.
16
00:00:43,564 --> 00:00:46,692
- Good morning, Peter.
- Morning, Maggie. Dr. Ahmad.
17
00:00:46,733 --> 00:00:48,652
Do we have a notary in house?
18
00:00:48,694 --> 00:00:49,862
I have some papers to sign.
19
00:00:49,903 --> 00:00:51,196
Yeah, Edward.
20
00:00:51,238 --> 00:00:52,865
I'll send him down
at the end of the day.
21
00:00:52,906 --> 00:00:54,491
You need some help?
22
00:00:54,533 --> 00:00:56,368
- Are you a doctor?
- I am. What happened?
23
00:00:56,410 --> 00:00:58,370
I don't know. I've never
seen this man before.
24
00:00:58,412 --> 00:01:00,164
He was wandering a
couple blocks from here.
25
00:01:00,205 --> 00:01:01,957
He kept saying, "Help Betty."
26
00:01:01,999 --> 00:01:03,125
He's really cold.
27
00:01:03,167 --> 00:01:04,668
Okay, let's get him inside.
28
00:01:04,710 --> 00:01:06,253
Betty.
29
00:01:09,006 --> 00:01:10,215
Dr. Sorensen.
30
00:01:10,257 --> 00:01:11,884
No, I'm Dr. Ripley.
31
00:01:11,925 --> 00:01:13,218
Nancy, he's hypothermic.
32
00:01:13,260 --> 00:01:14,303
I need blankets and warm IV bags.
33
00:01:14,344 --> 00:01:15,679
On it. You're going to five.
34
00:01:15,721 --> 00:01:18,140
Okay.
35
00:01:18,182 --> 00:01:20,684
Help Betty.
36
00:01:20,726 --> 00:01:21,726
Betty?
37
00:01:23,770 --> 00:01:25,063
Hey, Daniel.
38
00:01:25,105 --> 00:01:27,232
- Morning.
- Good morning.
39
00:01:27,274 --> 00:01:28,984
When was the last time you saw Bert?
40
00:01:29,026 --> 00:01:30,944
Not for a while.
41
00:01:30,986 --> 00:01:32,070
I mean, come to think of it,
42
00:01:32,112 --> 00:01:34,072
I did call him a couple weeks ago,
43
00:01:34,114 --> 00:01:36,283
and he was in a hurry.
44
00:01:36,325 --> 00:01:38,452
Said he'd call me back, and
I'm now realizing he never did.
45
00:01:38,494 --> 00:01:40,787
Yeah, and is that
something you've noticed...
46
00:01:40,829 --> 00:01:42,372
- his memory?
- Not really.
47
00:01:42,414 --> 00:01:44,583
I mean, that could happen to any of us.
48
00:01:44,625 --> 00:01:46,251
I mean, I do that stuff all the time.
49
00:01:46,293 --> 00:01:47,336
Why? Are you worried about him?
50
00:01:47,377 --> 00:01:49,546
I don't know, but Tara is.
51
00:01:49,588 --> 00:01:50,923
And he was here.
52
00:01:50,964 --> 00:01:53,800
He fell when he was watching Isaiah.
53
00:01:53,842 --> 00:01:55,177
He fell?
54
00:01:55,219 --> 00:01:58,305
Yeah, nothing serious,
but he did twist his knee.
55
00:01:58,347 --> 00:02:00,182
He just seemed a little confused,
56
00:02:00,224 --> 00:02:01,767
and I wouldn't be concerned,
57
00:02:01,809 --> 00:02:05,270
but Bert does have a
family history of dementia.
58
00:02:05,312 --> 00:02:07,523
We should probably have him checked out.
59
00:02:07,564 --> 00:02:11,735
To get Bert to see a doctor
for anything is an ordeal.
60
00:02:11,777 --> 00:02:13,737
- You know that.
- Right, tell me about it.
61
00:02:13,779 --> 00:02:17,282
But he's coming here today
for a follow-up on his knee.
62
00:02:17,324 --> 00:02:19,368
Oh, well, why don't I just, you know,
63
00:02:19,409 --> 00:02:22,287
spontaneously stop
by, have a little chat?
64
00:02:22,329 --> 00:02:23,872
That would be great.
65
00:02:23,914 --> 00:02:25,791
Thank you.
66
00:02:27,668 --> 00:02:28,836
Hi, Alex.
67
00:02:28,877 --> 00:02:30,963
- Hi.
- I'm Dr. Ahmad.
68
00:02:31,004 --> 00:02:33,131
Emily. My husband, Mark.
69
00:02:33,173 --> 00:02:36,176
So I see that your heart rate is fast.
70
00:02:36,218 --> 00:02:37,928
I don't feel it.
71
00:02:37,970 --> 00:02:39,763
But his watch says it's at 140.
72
00:02:39,805 --> 00:02:42,099
It's probably nothing, but
that's why we brought him in.
73
00:02:42,141 --> 00:02:45,018
Well, your watch isn't lying, 140.
74
00:02:45,060 --> 00:02:47,020
Rest of your vitals are good.
75
00:02:47,062 --> 00:02:48,147
Is there anything bothering you?
76
00:02:48,188 --> 00:02:49,314
No, I feel fine.
77
00:02:49,356 --> 00:02:50,899
Normally, he eats like a horse,
78
00:02:50,941 --> 00:02:53,318
but the last couple of days,
he's hardly had anything.
79
00:02:53,360 --> 00:02:55,154
I just wasn't hungry.
80
00:02:58,031 --> 00:03:00,284
Lungs sound good.
81
00:03:02,369 --> 00:03:04,538
Lymph nodes aren't swollen.
82
00:03:04,580 --> 00:03:05,998
Any tenderness?
83
00:03:06,039 --> 00:03:07,666
Mm-mm.
84
00:03:07,708 --> 00:03:08,708
What about here?
85
00:03:09,710 --> 00:03:11,879
Yeah, a little bit.
86
00:03:11,920 --> 00:03:13,380
What does that mean?
87
00:03:13,422 --> 00:03:16,216
I'm not sure, but I'd like
to order a CT to find out.
88
00:03:18,552 --> 00:03:20,262
- Okay.
- I'll put the order in.
89
00:03:20,304 --> 00:03:21,763
I'll be back to check on you soon.
90
00:03:21,805 --> 00:03:22,806
- Thank you.
- Yeah.
91
00:03:22,848 --> 00:03:24,975
Thank you.
92
00:03:25,017 --> 00:03:26,518
- Loren?
- Maggie.
93
00:03:26,560 --> 00:03:29,104
Kaitlin Neeley, 28, septic shock.
94
00:03:29,146 --> 00:03:31,690
Leukocytosis and hypotensive.
95
00:03:31,732 --> 00:03:35,027
BP 80/43, temp 103.5.
96
00:03:35,068 --> 00:03:36,236
She was pregnant.
97
00:03:36,278 --> 00:03:37,946
Water broke at 15 weeks pre-viability.
98
00:03:37,988 --> 00:03:39,364
That was two weeks ago.
99
00:03:39,406 --> 00:03:41,033
It's not there. It's not there.
100
00:03:41,074 --> 00:03:42,242
No, don't say it.
101
00:03:42,284 --> 00:03:44,411
- No, no.
- Honey, everything's okay.
102
00:03:44,453 --> 00:03:46,413
We're at the hospital.
They're gonna take care of you.
103
00:03:46,455 --> 00:03:49,249
They were driving here, but she
got so sick, they had to pull over.
104
00:03:49,291 --> 00:03:50,626
Rural clinic didn't have the
capabilities to care for her,
105
00:03:50,667 --> 00:03:52,586
- so they called me.
- Okay.
106
00:03:52,628 --> 00:03:54,046
Can I help?
107
00:03:54,087 --> 00:03:55,087
No, unfortunately, this is OB.
108
00:03:55,088 --> 00:03:56,423
- Hannah.
- Yeah.
109
00:03:56,465 --> 00:03:58,467
Kaitlin Neeley, 15 weeks, water broke.
110
00:03:58,509 --> 00:03:59,885
White blood count is high.
111
00:03:59,927 --> 00:04:01,261
This is her husband, Eric.
112
00:04:01,303 --> 00:04:03,096
All right, Maggie, start a second IV.
113
00:04:03,138 --> 00:04:04,765
- You got it, Doc.
- Did they perform a D&E?
114
00:04:04,807 --> 00:04:06,308
No, the doctor said they had to wait
115
00:04:06,350 --> 00:04:07,726
for her to pass the remains on her own.
116
00:04:07,768 --> 00:04:10,938
Okay, CBC, CMP, lactate,
and blood cultures.
117
00:04:10,979 --> 00:04:12,731
Oh, honey!
118
00:04:12,773 --> 00:04:14,233
Honey!
119
00:04:14,274 --> 00:04:15,609
I need to start your wife
on antibiotics immediately.
120
00:04:15,651 --> 00:04:16,944
Do you know if she's allergic to any?
121
00:04:16,985 --> 00:04:18,320
- She isn't.
- Okay.
122
00:04:18,362 --> 00:04:20,823
Triple up... ampicillin,
clindamycin, gentamicin.
123
00:04:20,864 --> 00:04:21,865
Copy that.
124
00:04:21,907 --> 00:04:22,950
Your wife is very sick,
125
00:04:22,991 --> 00:04:24,284
but we're gonna take good care of her.
126
00:04:36,632 --> 00:04:38,634
She's been carrying fetal
remains for two weeks.
127
00:04:38,985 --> 00:04:40,885
Oh, my God. And she couldn't get a D&E?
128
00:04:40,886 --> 00:04:42,471
No, her doctor wouldn't do it.
129
00:04:42,513 --> 00:04:44,139
Why?
130
00:04:47,392 --> 00:04:48,519
How's our patient?
131
00:04:48,560 --> 00:04:49,561
Better.
132
00:04:49,603 --> 00:04:51,814
Temp's come up to 95.
133
00:04:51,855 --> 00:04:53,148
How is his cognition?
134
00:04:56,777 --> 00:04:58,237
Sir.
135
00:05:00,906 --> 00:05:02,241
Can you tell us your name?
136
00:05:02,282 --> 00:05:04,368
Jimmy.
137
00:05:04,409 --> 00:05:05,786
Did you hurt yourself?
138
00:05:05,828 --> 00:05:08,163
- Maybe hit your head?
- No.
139
00:05:08,205 --> 00:05:09,289
Betty.
140
00:05:09,331 --> 00:05:10,874
Who's Betty?
141
00:05:10,916 --> 00:05:12,459
My sister.
142
00:05:12,501 --> 00:05:15,379
No ID, but he had this
Post-it in his pocket.
143
00:05:15,420 --> 00:05:16,713
It's a telephone number.
144
00:05:16,755 --> 00:05:18,590
What happened to Betty? Where is she?
145
00:05:18,632 --> 00:05:21,260
Home. She got sick.
146
00:05:21,301 --> 00:05:24,179
Get Dr. Sorensen.
147
00:05:24,221 --> 00:05:25,973
Is... is that her doctor or your doctor?
148
00:05:26,014 --> 00:05:28,684
Dr. Sorensen.
149
00:05:28,725 --> 00:05:30,102
Does he work at this hospital?
150
00:05:30,144 --> 00:05:32,437
- Yes, here.
- Okay.
151
00:05:32,479 --> 00:05:34,690
Okay, see if you can
find this Dr. Sorensen
152
00:05:34,731 --> 00:05:35,983
and try that number.
153
00:05:39,611 --> 00:05:41,155
We're gonna take good
care of you, Jimmy.
154
00:05:41,196 --> 00:05:41,988
Okay?
155
00:05:41,989 --> 00:05:43,949
Oh, thank you.
156
00:05:50,038 --> 00:05:52,541
Dr. Charles?
157
00:05:52,583 --> 00:05:54,751
I've got an elderly patient,
158
00:05:54,793 --> 00:05:56,545
severely hypothermic.
159
00:05:56,587 --> 00:05:59,506
No visible injuries, um,
160
00:05:59,548 --> 00:06:01,258
but he's pretty out of it.
161
00:06:01,300 --> 00:06:03,302
No ID other than a phone number.
162
00:06:03,343 --> 00:06:06,180
I'm thinking he's got
dementia or maybe wandered away
163
00:06:06,221 --> 00:06:08,348
- from a care facility.
- Oh.
164
00:06:08,390 --> 00:06:09,725
You wanna give me your take?
165
00:06:09,766 --> 00:06:11,560
Sure.
166
00:06:11,602 --> 00:06:13,479
His name's Jimmy.
167
00:06:13,520 --> 00:06:15,606
Shoot me his chart.
Give me a couple minutes.
168
00:06:15,647 --> 00:06:17,441
Yeah.
169
00:06:17,483 --> 00:06:20,486
Hi, Alex. Mr. and Mrs. Foster.
170
00:06:20,527 --> 00:06:22,070
This is Dr. Marcel.
He's one of our surgeons.
171
00:06:22,112 --> 00:06:23,655
I've asked him to consult.
172
00:06:23,697 --> 00:06:25,449
Surgeon? Why?
173
00:06:25,491 --> 00:06:28,619
Well, Radiology said that
Alex's CT was equivocal,
174
00:06:28,660 --> 00:06:31,038
meaning it was inconclusive.
175
00:06:31,079 --> 00:06:34,583
But what it did show is
a possible appendicitis.
176
00:06:34,625 --> 00:06:38,462
And from my experience, with
Alex's elevated heart rate
177
00:06:38,504 --> 00:06:39,505
and loss of appetite,
178
00:06:39,546 --> 00:06:41,173
I believe that is, indeed, the case.
179
00:06:41,215 --> 00:06:43,091
So I'd like to operate.
180
00:06:43,133 --> 00:06:44,927
Wait, so you're not
sure it's appendicitis?
181
00:06:44,968 --> 00:06:46,136
No.
182
00:06:46,178 --> 00:06:47,638
Why do I have to have an operation?
183
00:06:47,679 --> 00:06:50,390
Because if it is appendicitis
and your appendix bursts,
184
00:06:50,432 --> 00:06:52,893
that would put you at risk
of an infection in the belly,
185
00:06:52,935 --> 00:06:55,479
and that could be life-threatening.
186
00:06:55,521 --> 00:06:57,231
Oh.
187
00:06:57,272 --> 00:06:59,525
But we can avoid that
with a minimally invasive
188
00:06:59,566 --> 00:07:02,277
laparoscopic surgery done with a camera
189
00:07:02,319 --> 00:07:04,279
through several small incisions...
190
00:07:04,321 --> 00:07:06,281
what we call a Band-Aid surgery.
191
00:07:06,323 --> 00:07:07,825
I agree with Dr. Marcel.
192
00:07:07,866 --> 00:07:11,829
A laparoscopic appendectomy
is the best course of action.
193
00:07:11,870 --> 00:07:13,372
Most likely, he'd be
done in half an hour.
194
00:07:14,748 --> 00:07:16,208
Mom? Dad?
195
00:07:19,753 --> 00:07:21,421
Yeah, okay.
196
00:07:21,463 --> 00:07:23,006
Okay.
197
00:07:23,048 --> 00:07:24,216
- All right.
- Thank you.
198
00:07:24,258 --> 00:07:25,717
I'll see you after.
199
00:07:25,759 --> 00:07:26,844
- All right.
- Thank you.
200
00:07:26,885 --> 00:07:29,388
Thank you.
201
00:07:29,429 --> 00:07:31,890
- You okay?
- It'll be fine. Mm-hmm.
202
00:07:36,687 --> 00:07:38,856
Is she doing any better?
203
00:07:38,897 --> 00:07:41,024
About the same.
204
00:07:41,066 --> 00:07:42,359
You know, I don't have
any more flights today,
205
00:07:42,401 --> 00:07:43,944
so I think I'll stick
around, if you don't mind.
206
00:07:43,986 --> 00:07:45,445
Mm.
207
00:07:45,487 --> 00:07:48,907
Maybe I can give Eric
some moral support.
208
00:07:48,949 --> 00:07:50,159
That's a good idea.
209
00:07:51,577 --> 00:07:54,371
Are you gonna do that operation?
210
00:07:54,413 --> 00:07:57,541
I recommend we try to
induce instead of a D&E.
211
00:07:57,583 --> 00:08:01,044
Surgery can be much
riskier if she's septic.
212
00:08:03,547 --> 00:08:06,133
Tell me what happened.
213
00:08:06,175 --> 00:08:07,676
Kaitlin's water broke.
214
00:08:07,718 --> 00:08:10,596
Everybody said the fetus
couldn't survive at 15 weeks,
215
00:08:10,637 --> 00:08:12,389
but it was still alive,
216
00:08:12,431 --> 00:08:16,894
so doctors were afraid to do the D&E.
217
00:08:16,935 --> 00:08:18,228
She didn't wanna get arrested.
218
00:08:20,397 --> 00:08:22,858
Where we live, that could happen.
219
00:08:22,900 --> 00:08:24,985
They sent us home.
220
00:08:25,027 --> 00:08:27,070
Kaitlin got sicker and sicker.
221
00:08:27,112 --> 00:08:29,031
And I kept calling,
and they kept telling me
222
00:08:29,072 --> 00:08:32,242
it wasn't a life-threatening emergency.
223
00:08:32,284 --> 00:08:35,787
Finally, I just gave up
and started driving here.
224
00:08:35,829 --> 00:08:37,831
Kaitlin's from Chicago.
225
00:08:37,873 --> 00:08:41,343
When we got married, we
moved to my family's farm,
226
00:08:41,384 --> 00:08:43,795
where I grew up.
227
00:08:43,837 --> 00:08:47,216
We were so excited when
Kaitlin finally got pregnant.
228
00:08:49,635 --> 00:08:53,222
She's been so worried she's
not gonna be able to again.
229
00:08:55,140 --> 00:08:58,769
Eric, I'm gonna do the best that I can.
230
00:08:58,811 --> 00:09:02,022
But I don't know.
231
00:09:02,064 --> 00:09:03,064
I don't know.
232
00:09:11,740 --> 00:09:13,700
Okay, staple line looks good.
233
00:09:13,742 --> 00:09:15,077
No bleeding.
234
00:09:17,704 --> 00:09:19,581
Nice and easy.
235
00:09:24,920 --> 00:09:26,421
Appendix is in the bag.
236
00:09:26,463 --> 00:09:28,757
Gently wiggle the bag circularly,
237
00:09:28,799 --> 00:09:31,009
and then pull it up and out.
238
00:09:34,930 --> 00:09:36,056
Hold on.
239
00:09:39,226 --> 00:09:41,645
This feels unusual.
240
00:09:41,687 --> 00:09:44,231
Go ahead and send that for a
stat frozen section, please.
241
00:09:53,699 --> 00:09:56,160
Definitely some cognitive impairment,
242
00:09:56,201 --> 00:09:57,870
though I'm not quite sure why.
243
00:09:57,911 --> 00:10:01,331
Tox screen's negative,
no sign of head trauma.
244
00:10:01,373 --> 00:10:03,542
The childlike affect, it's
not what you normally see
245
00:10:03,584 --> 00:10:05,836
with Alzheimer's or vascular dementia,
246
00:10:05,878 --> 00:10:07,462
though you can't rule it out.
247
00:10:07,504 --> 00:10:11,341
I'm thinking some kind
of intellectual deficit.
248
00:10:11,383 --> 00:10:13,177
So I'm thinking we should get a head CT.
249
00:10:13,218 --> 00:10:14,469
Definitely.
250
00:10:14,511 --> 00:10:16,138
We have no more information on the guy?
251
00:10:16,180 --> 00:10:17,347
You reach out to CPD?
252
00:10:17,389 --> 00:10:18,932
Yeah, there's no missing persons
253
00:10:18,974 --> 00:10:21,477
matching his description, and
no one's come looking for him.
254
00:10:21,518 --> 00:10:24,271
He can't stop talking about
his sister, Betty, right,
255
00:10:24,313 --> 00:10:26,815
how he is just very concerned about her.
256
00:10:26,857 --> 00:10:28,442
She's sick. She needs our help.
257
00:10:28,484 --> 00:10:29,943
Yeah, but given his mental state,
258
00:10:29,985 --> 00:10:31,653
is that even a real person?
259
00:10:31,695 --> 00:10:33,322
You know, maybe it's
someone from his childhood
260
00:10:33,363 --> 00:10:35,532
- or a show he saw on TV.
- Yeah.
261
00:10:35,574 --> 00:10:37,242
I tried the number he had again...
262
00:10:37,284 --> 00:10:38,410
still no answer.
263
00:10:38,452 --> 00:10:40,871
- I left another message.
- Okay.
264
00:10:40,913 --> 00:10:43,373
Let's say that is actually
Betty's number, right?
265
00:10:43,415 --> 00:10:45,209
Maybe she's not answering
because she can't
266
00:10:45,250 --> 00:10:48,212
because she is, in fact, incapacitated.
267
00:10:48,253 --> 00:10:51,340
How about we ask CPD
to run a reverse trace?
268
00:10:51,381 --> 00:10:53,133
That way, at least,
we'll get an address.
269
00:10:53,175 --> 00:10:54,301
Okay.
270
00:11:03,769 --> 00:11:05,854
Dr. Archer, incoming.
271
00:11:05,896 --> 00:11:06,939
You're going to trauma four.
272
00:11:06,980 --> 00:11:08,232
Damon Adams, 28,
273
00:11:08,273 --> 00:11:10,984
shortness of breath, diaphoretic.
274
00:11:11,026 --> 00:11:13,695
BP 130/90, heart rate 125. Sats 89.
275
00:11:13,737 --> 00:11:15,906
- Need help.
- It's right there.
276
00:11:15,948 --> 00:11:17,282
Sean.
277
00:11:17,324 --> 00:11:18,367
He lives at the center where I work.
278
00:11:18,408 --> 00:11:21,078
I've been counseling him.
279
00:11:21,119 --> 00:11:22,913
All right, wait here.
280
00:11:22,955 --> 00:11:25,040
All right, on my count. Ready?
281
00:11:25,082 --> 00:11:27,501
We good? One, two, three.
282
00:11:29,211 --> 00:11:30,712
All right, Damon, I'm Dr. Archer.
283
00:11:30,754 --> 00:11:31,587
What's going on?
284
00:11:31,588 --> 00:11:33,715
- Real sick.
- Yeah?
285
00:11:33,757 --> 00:11:34,715
When did this start?
286
00:11:34,716 --> 00:11:37,302
A couple days ago.
287
00:11:37,344 --> 00:11:38,637
- I can't catch my breath.
- Well, we can help you.
288
00:11:38,679 --> 00:11:40,264
Come on, let's get him up here.
289
00:11:40,305 --> 00:11:42,933
Lift him up. Start him on 100% O2.
290
00:11:42,975 --> 00:11:44,184
AP chest stat.
291
00:11:44,226 --> 00:11:47,646
I need a CBC, BNP, and an ABG.
292
00:11:49,982 --> 00:11:52,943
- X-ray.
- Clear.
293
00:11:52,985 --> 00:11:54,403
Pulmonary edema.
294
00:11:54,444 --> 00:11:56,572
Fluid in the lungs.
295
00:11:56,613 --> 00:11:58,365
Call Cardiology for a stat echo.
296
00:11:58,407 --> 00:12:01,118
Yeah, got it.
297
00:12:01,160 --> 00:12:03,078
Okay.
298
00:12:03,120 --> 00:12:04,329
Better?
299
00:12:05,831 --> 00:12:07,916
You okay if I share
some things with Sean?
300
00:12:09,459 --> 00:12:10,919
All right, I'll check back soon.
301
00:12:13,255 --> 00:12:16,133
So...
302
00:12:16,175 --> 00:12:17,634
Your friend's in pretty bad shape.
303
00:12:17,676 --> 00:12:20,888
Pulmonary edema suggests
that he's in heart failure.
304
00:12:20,929 --> 00:12:22,681
We shouldn't be seeing
that in somebody so young.
305
00:12:22,723 --> 00:12:24,683
Oh, man.
306
00:12:24,725 --> 00:12:27,311
You say that he's living
at the rehab center.
307
00:12:27,352 --> 00:12:28,770
- Is he an addict?
- Recovering,
308
00:12:28,812 --> 00:12:30,689
but I'm pretty sure he's
clean. We talk a lot.
309
00:12:30,731 --> 00:12:32,316
He's really been working the program.
310
00:12:32,357 --> 00:12:34,651
It's possible whatever's going on
311
00:12:34,693 --> 00:12:35,777
with his heart might
have something to do
312
00:12:35,819 --> 00:12:37,446
with IV drug use.
313
00:12:37,488 --> 00:12:38,822
Well, you'll be able to help him, right?
314
00:12:38,864 --> 00:12:40,491
I'll do what I can, but
you need to understand,
315
00:12:40,532 --> 00:12:44,036
Sean, his condition is serious.
316
00:12:44,077 --> 00:12:47,372
Well, if anybody can
help him, you can, Dad.
317
00:12:47,414 --> 00:12:49,166
I know you can.
318
00:12:58,289 --> 00:12:59,539
Is Alex all right?
319
00:12:59,707 --> 00:13:02,042
- Yes.
- He handled the surgery like a champ.
320
00:13:02,084 --> 00:13:03,419
And it's a good thing
you brought him in.
321
00:13:03,461 --> 00:13:05,004
His appendix really needed to come out.
322
00:13:05,045 --> 00:13:08,507
Yeah, the pathology report showed
a contained appendiceal cancer.
323
00:13:08,549 --> 00:13:09,800
- Cancer?
- Cancer?
324
00:13:09,842 --> 00:13:11,218
Wait, he's only 15.
325
00:13:11,260 --> 00:13:12,511
No need to worry.
326
00:13:12,553 --> 00:13:14,889
It was small, just one
centimeter, and we got it all.
327
00:13:14,930 --> 00:13:16,599
Good thing he was wearing that watch.
328
00:13:16,640 --> 00:13:17,850
Oh.
329
00:13:17,892 --> 00:13:19,351
Wow.
330
00:13:19,393 --> 00:13:21,270
And we don't need to
talk to an oncologist?
331
00:13:21,312 --> 00:13:22,938
Well, when you come
back for a follow-up,
332
00:13:22,980 --> 00:13:24,523
we could talk about that.
333
00:13:24,565 --> 00:13:26,942
But the treatment is to remove
the appendix, and we did that.
334
00:13:26,984 --> 00:13:29,236
Mm, okay.
335
00:13:29,278 --> 00:13:31,363
- When can we see Alex?
- Now.
336
00:13:31,405 --> 00:13:33,199
Dr. Ahmad will take you to recovery.
337
00:13:33,240 --> 00:13:34,325
- Thank you.
- Thank you.
338
00:13:34,366 --> 00:13:36,035
You got it.
339
00:13:36,076 --> 00:13:39,455
No, no, no, no, I'm just here
to have my knee looked at.
340
00:13:39,497 --> 00:13:41,415
When was the last time
you had a physical, Bert?
341
00:13:41,457 --> 00:13:42,541
I don't know.
342
00:13:42,583 --> 00:13:44,043
They did some scans when I was here.
343
00:13:44,084 --> 00:13:45,878
That is not a physical.
344
00:13:45,920 --> 00:13:46,962
You're already here.
345
00:13:47,004 --> 00:13:48,422
The doctor will make it quick.
346
00:13:48,464 --> 00:13:51,008
Daniel will come in and say hello.
347
00:13:51,050 --> 00:13:53,636
You owe it to your
children and your grandson
348
00:13:53,677 --> 00:13:56,889
to look after your health.
349
00:13:56,931 --> 00:13:59,225
All right. All right.
350
00:13:59,266 --> 00:14:01,811
Thank you.
351
00:14:01,852 --> 00:14:03,979
I'm seeing pericardial effusion.
352
00:14:04,021 --> 00:14:05,898
That means that there's
a buildup of fluid
353
00:14:05,940 --> 00:14:07,733
in the sac around the
heart, and that puts pressure
354
00:14:07,775 --> 00:14:10,903
on the heart so that it
doesn't pump effectively.
355
00:14:10,945 --> 00:14:12,571
Would you please let me
know when the attending
356
00:14:12,613 --> 00:14:13,948
- has looked at this?
- You got it.
357
00:14:13,989 --> 00:14:14,948
Okay.
358
00:14:14,949 --> 00:14:17,451
So I'm not sure what's going on.
359
00:14:17,493 --> 00:14:19,370
So I'm gonna start you on antibiotics,
360
00:14:19,411 --> 00:14:21,372
in case it's a bacterial infection.
361
00:14:21,413 --> 00:14:23,457
We're gonna treat the
pericardial effusion
362
00:14:23,499 --> 00:14:25,793
with steroids and anti-inflammatories.
363
00:14:25,835 --> 00:14:27,294
Sats are at 83,
364
00:14:27,336 --> 00:14:28,838
and blood pressure's dropping.
365
00:14:31,132 --> 00:14:32,216
Dad?
366
00:14:34,260 --> 00:14:37,054
Okay, I think we need to put you
on a machine that breathes for you.
367
00:14:37,096 --> 00:14:38,389
- Okay.
- All right?
368
00:14:38,431 --> 00:14:39,557
In order to do that, we
need to put you to sleep.
369
00:14:39,598 --> 00:14:41,767
Is that all right?
370
00:14:41,809 --> 00:14:42,809
All right.
371
00:14:42,810 --> 00:14:44,562
Call respiratory.
372
00:14:44,603 --> 00:14:46,939
All right, 20 of
etomidate and 100 of sux.
373
00:14:46,981 --> 00:14:48,858
On its way.
374
00:15:00,578 --> 00:15:02,955
Okay, I'm in.
375
00:15:02,997 --> 00:15:04,457
Bag him.
376
00:15:07,835 --> 00:15:09,712
All right, this will let his body rest,
377
00:15:09,754 --> 00:15:12,506
and hopefully, it'll help push
the fluid out of his lungs.
378
00:15:12,548 --> 00:15:13,758
Thanks, Dad.
379
00:15:13,799 --> 00:15:15,342
Put a foley in, and let's start him
380
00:15:15,384 --> 00:15:19,680
on 125 milligrams of Solumedrol
and 10 milligrams of Lasix.
381
00:15:19,722 --> 00:15:22,850
We won't see any changes for
a while, so I'll check back.
382
00:15:24,560 --> 00:15:26,645
- Dr. Archer.
- Yeah?
383
00:15:26,687 --> 00:15:28,481
- Have you got a minute?
- Yeah.
384
00:15:28,522 --> 00:15:33,235
My ex-husband, Bert, is here
for a follow-up on a knee injury.
385
00:15:33,277 --> 00:15:35,029
He hasn't had a physical in ages,
386
00:15:35,070 --> 00:15:37,782
and he has finally agreed to get one.
387
00:15:37,823 --> 00:15:40,618
Would you mind giving
him a quick look-see?
388
00:15:40,659 --> 00:15:42,036
- Just the basics.
- No problem.
389
00:15:42,077 --> 00:15:43,162
He's in two.
390
00:15:43,204 --> 00:15:45,998
Oh, and um, Dr. Charles,
391
00:15:46,040 --> 00:15:47,333
he might stop by.
392
00:15:47,374 --> 00:15:48,667
He and Bert are old friends.
393
00:15:48,709 --> 00:15:49,877
- Okay.
- Thank you.
394
00:15:49,919 --> 00:15:51,837
Sure.
395
00:15:51,879 --> 00:15:53,547
Hey, Nancy?
396
00:15:53,589 --> 00:15:55,883
- Is Jimmy's CT back?
- Not yet.
397
00:15:55,925 --> 00:15:58,761
Uh, how's CPD doing
on that reverse trace?
398
00:15:58,803 --> 00:16:00,179
They have an address.
399
00:16:00,221 --> 00:16:01,430
They're sending a car over now.
400
00:16:01,472 --> 00:16:03,390
I hope they find a contact.
401
00:16:03,432 --> 00:16:06,102
Jimmy started running a fever
and his chest is congested.
402
00:16:06,143 --> 00:16:09,021
I put him on antibiotics
in case of pneumonia.
403
00:16:09,063 --> 00:16:10,731
Listen, I don't know
if this means anything,
404
00:16:10,773 --> 00:16:15,611
but I did, in the archives, find
a Dr. Sorensen who worked here.
405
00:16:15,653 --> 00:16:17,363
Great, can we... can we get in touch?
406
00:16:17,404 --> 00:16:19,073
Unfortunately, no.
407
00:16:19,115 --> 00:16:20,533
He died 50 years ago.
408
00:16:25,538 --> 00:16:27,998
Well, he's not gonna be any help.
409
00:16:31,627 --> 00:16:33,045
How long is this gonna take?
410
00:16:33,087 --> 00:16:34,922
Longer if you don't keep still.
411
00:16:36,298 --> 00:16:39,593
I heard I had an old pal
in here, making trouble.
412
00:16:39,635 --> 00:16:41,846
Sharon twisted my arm.
413
00:16:41,887 --> 00:16:43,472
How we doing? Where are you guys at?
414
00:16:43,514 --> 00:16:45,391
I took his vitals, got blood.
415
00:16:45,433 --> 00:16:47,226
Treated me like a pincushion.
416
00:16:47,268 --> 00:16:48,686
I have a proposal for you.
417
00:16:48,727 --> 00:16:51,063
What do you say I take
over before this old crank
418
00:16:51,105 --> 00:16:52,356
bites your head off?
419
00:16:52,398 --> 00:16:54,525
I will absolutely take
you up on your offer.
420
00:16:57,987 --> 00:16:59,238
Okay.
421
00:16:59,280 --> 00:17:02,199
Let us see what we have here.
422
00:17:02,241 --> 00:17:04,535
Uh, look up for me, buddy.
423
00:17:06,704 --> 00:17:08,981
So you know we've got
Celtics-Bulls tomorrow night, right?
424
00:17:08,982 --> 00:17:10,020
Right.
425
00:17:10,021 --> 00:17:12,751
I was actually thinking about
putting down a little action.
426
00:17:12,793 --> 00:17:14,962
- You? Action?
- Why not?
427
00:17:15,004 --> 00:17:16,714
Celtics heavily favored,
all right, but I'm just...
428
00:17:16,756 --> 00:17:18,924
I'm really feeling the upset.
429
00:17:18,966 --> 00:17:22,261
If I take the Bulls, I get 6-to-1 odds.
430
00:17:22,303 --> 00:17:23,554
Hmm.
431
00:17:23,596 --> 00:17:25,765
Yeah?
432
00:17:25,806 --> 00:17:29,477
Okay, now follow with
your eyes, not your head.
433
00:17:29,518 --> 00:17:31,479
Here you go.
434
00:17:32,897 --> 00:17:38,027
So if I put down 20 bucks,
435
00:17:38,068 --> 00:17:39,236
that would get me,
436
00:17:39,278 --> 00:17:41,155
when it's 6 to 1 odds,
that would get me...
437
00:17:41,197 --> 00:17:43,657
Uh, 110?
438
00:17:45,326 --> 00:17:46,326
120, isn't it?
439
00:17:46,327 --> 00:17:47,328
I think it's 120, yeah.
440
00:17:47,369 --> 00:17:49,622
Oh, yeah, yeah, yeah, yeah, 120.
441
00:17:50,748 --> 00:17:52,208
Not bad, huh?
442
00:17:52,249 --> 00:17:54,293
No. No, not bad.
443
00:17:54,335 --> 00:17:55,961
Mm.
444
00:17:56,003 --> 00:17:58,798
You know, we haven't
been to Al's for a while.
445
00:17:58,839 --> 00:18:00,216
You wanna grab some lunch on Friday?
446
00:18:00,257 --> 00:18:01,926
You got it.
447
00:18:01,967 --> 00:18:03,135
Okay.
448
00:18:08,390 --> 00:18:10,643
Hey, Alex. Can you hear me?
449
00:18:12,812 --> 00:18:13,854
Can you open your eyes for me?
450
00:18:16,357 --> 00:18:18,484
Can you squeeze my hand for me?
451
00:18:18,526 --> 00:18:20,820
Can you do that?
452
00:18:20,861 --> 00:18:22,321
Is something wrong?
453
00:18:22,363 --> 00:18:25,032
No, his body is just
taking longer than expected
454
00:18:25,074 --> 00:18:26,992
to clear the muscle
relaxant that we gave him,
455
00:18:27,034 --> 00:18:28,160
which was part of the anesthetic.
456
00:18:28,202 --> 00:18:29,537
Is that a problem?
457
00:18:29,578 --> 00:18:31,455
No, we can give Alex a
medication that will help
458
00:18:31,497 --> 00:18:34,090
reverse the muscle relaxant
and help him come back to us
459
00:18:34,091 --> 00:18:35,115
a little bit faster.
460
00:18:35,116 --> 00:18:37,670
- We do this all the time.
- Okay.
461
00:18:37,711 --> 00:18:40,214
Let's give him 0.2 of Exsomadex.
462
00:18:40,256 --> 00:18:41,257
On its way.
463
00:18:41,298 --> 00:18:43,843
This should act fast.
464
00:18:47,471 --> 00:18:49,181
Sinus tachycardia.
465
00:18:49,223 --> 00:18:50,683
BP 80/50.
466
00:18:50,724 --> 00:18:52,101
Oh, what's happening to him?
467
00:18:52,143 --> 00:18:53,227
Let's get him upright.
468
00:18:53,269 --> 00:18:54,895
He's having an anaphylactoid reaction,
469
00:18:54,937 --> 00:18:56,188
which is like an allergic reaction.
470
00:18:56,230 --> 00:18:58,190
Oh, God!
471
00:18:58,232 --> 00:18:59,525
Epi 0.3 milligrams IM.
472
00:18:59,567 --> 00:19:00,734
On its way.
473
00:19:00,776 --> 00:19:02,027
You said you do this all the time.
474
00:19:02,069 --> 00:19:03,362
We do.
475
00:19:03,404 --> 00:19:05,698
BP now 72/45.
476
00:19:05,739 --> 00:19:09,160
Solumedrol 125, diphenhydramine 50,
477
00:19:09,201 --> 00:19:10,744
Famotidine 20.
478
00:19:10,786 --> 00:19:12,538
Oh, my God. My baby.
479
00:19:12,580 --> 00:19:14,248
Oh, my baby.
480
00:19:17,585 --> 00:19:19,044
Okay, BP's coming up.
481
00:19:19,086 --> 00:19:22,047
87/55.
482
00:19:22,089 --> 00:19:24,216
93/60.
483
00:19:24,258 --> 00:19:25,760
Oh.
484
00:19:28,429 --> 00:19:29,722
He's gonna be okay.
485
00:19:29,764 --> 00:19:30,722
Really, he's gonna be fine.
486
00:19:30,723 --> 00:19:32,391
But why?
487
00:19:32,433 --> 00:19:34,143
Why did this happen?
488
00:19:39,648 --> 00:19:41,859
Dr. Asher, we need you in here.
489
00:19:41,901 --> 00:19:44,737
Her BP keeps dropping.
490
00:19:44,779 --> 00:19:47,406
Okay, up her Levophed to 20.
491
00:19:48,616 --> 00:19:50,659
Oh, God! Oh, God!
492
00:19:50,701 --> 00:19:52,703
Brisk VB.
493
00:19:55,372 --> 00:19:56,957
- She's not dilating.
- What does that mean?
494
00:19:56,999 --> 00:19:59,460
It means that the medication
we used to induce labor
495
00:19:59,502 --> 00:20:00,544
isn't working fast enough.
496
00:20:00,586 --> 00:20:01,879
BP's still low.
497
00:20:01,921 --> 00:20:03,589
Transfuse 2 of red and 2 of plasma.
498
00:20:03,631 --> 00:20:04,840
Call for 6 and 6.
499
00:20:04,882 --> 00:20:06,217
We need to operate now.
500
00:20:06,258 --> 00:20:07,760
You said it was risky
while she was septic.
501
00:20:07,802 --> 00:20:09,261
We can't wait. Call the OR.
502
00:20:09,303 --> 00:20:11,680
Let them know we're coming
up for an emergent D&E.
503
00:20:18,437 --> 00:20:19,563
Don't let her die.
504
00:20:19,605 --> 00:20:21,232
Please don't let her die.
505
00:20:25,765 --> 00:20:28,234
Can I ask you for a
little favor? All right?
506
00:20:28,286 --> 00:20:29,496
Just because your blood
pressure is a little high,
507
00:20:29,538 --> 00:20:31,248
do you mind hanging around
508
00:20:31,289 --> 00:20:32,290
till I get your blood work back?
509
00:20:32,332 --> 00:20:33,750
Just for my own peace of mind.
510
00:20:33,792 --> 00:20:35,961
Go to the caf�. Have
a nice cup of coffee.
511
00:20:36,002 --> 00:20:37,379
It won't be long.
512
00:20:37,420 --> 00:20:38,420
I'll text you one way or the other.
513
00:20:38,421 --> 00:20:40,090
Okay.
514
00:20:40,132 --> 00:20:42,342
Looking forward to Friday.
515
00:20:42,384 --> 00:20:44,261
Friday?
516
00:20:44,302 --> 00:20:45,929
Lunch. Lunch at Al's.
517
00:20:45,971 --> 00:20:48,098
- 1:00.
- Right.
518
00:20:48,140 --> 00:20:50,267
Right. Lunch at Al's.
519
00:20:50,308 --> 00:20:52,310
1:00. See you, Dan.
520
00:20:52,352 --> 00:20:54,271
See you, pal.
521
00:21:00,152 --> 00:21:01,152
Give me suction.
522
00:21:04,614 --> 00:21:06,908
Marty, how's she looking?
523
00:21:06,950 --> 00:21:09,536
BP's better than pre-op, 100/60.
524
00:21:09,578 --> 00:21:10,787
Good.
525
00:21:10,829 --> 00:21:12,539
Good, good, good, good.
526
00:21:13,707 --> 00:21:15,876
Uterus feels clear.
527
00:21:15,917 --> 00:21:17,752
Marty, how much IVF did she get?
528
00:21:17,794 --> 00:21:22,340
2 liters of NS, 2 PRBC, 2 of plasma.
529
00:21:22,382 --> 00:21:23,884
Urine output is at 300 CC...
530
00:21:23,925 --> 00:21:25,760
Dr. Asher.
531
00:21:25,802 --> 00:21:28,138
She's hemorrhaging!
532
00:21:28,180 --> 00:21:30,807
BP 70/30, heart rate 150.
533
00:21:30,849 --> 00:21:32,767
Start the MTP and give her 1 gram TXA,
534
00:21:32,809 --> 00:21:35,937
0.2 milligrams methergine
IM now and 1,000 misoprostol.
535
00:21:35,979 --> 00:21:38,106
- Should we open?
- No, get me a Bakri balloon.
536
00:21:38,148 --> 00:21:39,274
Retractor.
537
00:21:43,528 --> 00:21:45,655
Inflating.
538
00:21:46,781 --> 00:21:47,991
The bleeding's slowing.
539
00:21:48,033 --> 00:21:49,451
BP coming up.
540
00:22:01,463 --> 00:22:03,048
How's he doing?
541
00:22:03,089 --> 00:22:04,299
Not great.
542
00:22:04,341 --> 00:22:06,092
He feels helpless.
543
00:22:06,134 --> 00:22:07,719
Is she gonna be able to keep her uterus?
544
00:22:07,761 --> 00:22:09,513
I don't know.
545
00:22:09,554 --> 00:22:11,890
Right now, it's all
about saving her life.
546
00:22:11,932 --> 00:22:13,517
Yeah.
547
00:22:16,353 --> 00:22:17,521
So you have kids?
548
00:22:17,562 --> 00:22:18,605
One.
549
00:22:18,647 --> 00:22:20,565
She's grown.
550
00:22:20,607 --> 00:22:22,818
My ex and I, we tried to adopt,
551
00:22:22,859 --> 00:22:26,488
but it didn't work out.
552
00:22:26,530 --> 00:22:28,031
What about you?
553
00:22:28,073 --> 00:22:29,282
No.
554
00:22:29,324 --> 00:22:30,826
No, I, um...
555
00:22:30,867 --> 00:22:32,744
I was married young
556
00:22:32,786 --> 00:22:34,120
before I went into the service.
557
00:22:34,162 --> 00:22:36,873
And after I got back from deployment,
558
00:22:36,915 --> 00:22:41,127
we both agreed that
there was nothing there.
559
00:22:41,169 --> 00:22:43,505
It's all so hard.
560
00:22:43,547 --> 00:22:45,674
And to have this?
561
00:22:52,222 --> 00:22:53,348
Dr. Ripley.
562
00:22:53,390 --> 00:22:54,516
Yeah.
563
00:22:54,558 --> 00:22:56,685
Jimmy's CT.
564
00:22:56,726 --> 00:22:59,104
It doesn't look like
Alzheimer's, does it?
565
00:22:59,146 --> 00:23:00,230
No.
566
00:23:00,272 --> 00:23:02,816
No, brain's not globally atrophied.
567
00:23:02,858 --> 00:23:06,486
It looks like a lot of
scarring in the frontal area.
568
00:23:06,528 --> 00:23:07,863
Yeah.
569
00:23:07,904 --> 00:23:10,198
So traumatic brain injury?
570
00:23:16,580 --> 00:23:19,124
In a manner of speaking.
571
00:23:19,166 --> 00:23:21,835
I read about this in medical school.
572
00:23:25,130 --> 00:23:27,215
Dr. Charles.
573
00:23:27,257 --> 00:23:28,341
Hey.
574
00:23:28,383 --> 00:23:30,510
So what do you think?
575
00:23:30,552 --> 00:23:34,890
I think that we could be
looking at some issues.
576
00:23:34,931 --> 00:23:38,351
So he's gonna need a thorough workup.
577
00:23:38,393 --> 00:23:39,644
It's a good idea.
578
00:23:39,686 --> 00:23:43,815
Convincing him is not gonna be easy.
579
00:23:43,857 --> 00:23:45,400
Help me out with that?
580
00:23:45,442 --> 00:23:47,861
Actually, I made up a
little excuse about his labs
581
00:23:47,903 --> 00:23:50,572
in order to keep him here.
582
00:23:50,614 --> 00:23:52,657
Tell him together after I get him back?
583
00:23:52,699 --> 00:23:54,159
Text me.
584
00:23:54,201 --> 00:23:55,201
Thanks.
585
00:24:05,471 --> 00:24:07,185
- How's the kid?
- He's fine.
586
00:24:07,601 --> 00:24:08,808
It was scary.
587
00:24:08,850 --> 00:24:10,268
Yeah.
588
00:24:10,310 --> 00:24:12,270
I think the hospital
should pull Exsomadex.
589
00:24:12,312 --> 00:24:14,480
Whoa. Why?
590
00:24:14,522 --> 00:24:16,024
The anaphylactic reaction happened
591
00:24:16,065 --> 00:24:17,275
after we administered it.
592
00:24:17,317 --> 00:24:19,277
Temporal connection
doesn't mean anything.
593
00:24:19,319 --> 00:24:20,903
That kid's on 15 other medications.
594
00:24:20,945 --> 00:24:22,780
They could have a delayed effect.
595
00:24:22,822 --> 00:24:25,241
More likely, it was the
antibiotic or the anesthetic.
596
00:24:25,283 --> 00:24:28,077
I considered that, so I pulled ADR data.
597
00:24:28,119 --> 00:24:30,747
There have been several similar
reactions to Exsomadex here.
598
00:24:30,788 --> 00:24:35,585
Get this... the manufacturer
report claims 1 out of 2,500.
599
00:24:35,627 --> 00:24:38,630
Med data shows 1 out of 200.
600
00:24:38,671 --> 00:24:40,840
That's 10 times what
the manufacturer claims.
601
00:24:42,884 --> 00:24:44,385
Well, you might have a case,
602
00:24:44,427 --> 00:24:46,429
but this data is retrospective.
603
00:24:46,471 --> 00:24:48,473
It's not any kind of clinical study.
604
00:24:48,514 --> 00:24:51,434
So pull Exsomadex until we have one.
605
00:24:51,476 --> 00:24:53,811
Hold on. It's a popular medication.
606
00:24:53,853 --> 00:24:55,438
I've used it and never had a problem.
607
00:24:55,480 --> 00:24:57,774
It doesn't mean that you won't.
608
00:24:57,815 --> 00:25:03,988
Crockett, that boy almost died today.
609
00:25:04,030 --> 00:25:05,281
All right.
610
00:25:05,323 --> 00:25:06,783
I'll, uh...
611
00:25:06,824 --> 00:25:09,077
I'll bring this up at the
drug and formulary meeting.
612
00:25:09,118 --> 00:25:10,203
Best I can do for now.
613
00:25:10,244 --> 00:25:11,704
In the meantime, make
sure that the nurses
614
00:25:11,746 --> 00:25:14,540
submit an adverse drug
reaction report, okay?
615
00:25:14,582 --> 00:25:16,125
Thank you.
616
00:25:18,670 --> 00:25:21,005
To begin the transorbital lobotomy,
617
00:25:21,047 --> 00:25:24,133
the orbitoclast is inserted
under the left eyelid
618
00:25:24,175 --> 00:25:26,928
and up against the
top of the eye socket.
619
00:25:26,970 --> 00:25:28,930
The neurosurgeon drives the point
620
00:25:28,972 --> 00:25:31,474
through the orbital plate
into the frontal lobe
621
00:25:31,516 --> 00:25:34,143
to a depth of 5 centimeters.
622
00:25:34,185 --> 00:25:37,146
He then swings the handle far laterally.
623
00:25:37,188 --> 00:25:40,483
He now drives the instrument
another 2 centimeters...
624
00:25:55,123 --> 00:25:57,041
Here's Jimmy's CT.
625
00:25:57,083 --> 00:26:00,545
I think we can rule out Alzheimer's.
626
00:26:00,586 --> 00:26:03,548
Identical scarring on...
627
00:26:03,589 --> 00:26:06,509
oh, my God.
628
00:26:06,551 --> 00:26:07,927
He had a lobotomy?
629
00:26:07,969 --> 00:26:10,138
Yeah.
630
00:26:10,179 --> 00:26:12,682
They haven't done those
for, like, 60 years.
631
00:26:12,724 --> 00:26:15,018
I mean, he must have been a kid.
632
00:26:15,059 --> 00:26:18,146
They did the procedure
on difficult patients.
633
00:26:18,187 --> 00:26:20,690
Jimmy was probably a discipline problem,
634
00:26:20,732 --> 00:26:22,150
hard to control.
635
00:26:22,191 --> 00:26:26,154
So Dr. Sorensen stuck
a skewer into his brain
636
00:26:26,195 --> 00:26:29,782
and... took care of that.
637
00:26:33,620 --> 00:26:35,371
Awful.
638
00:26:42,458 --> 00:26:45,776
Dad said he's getting more
oxygen now, so that's good.
639
00:26:46,395 --> 00:26:47,980
Hey. This is Dr. Collins.
640
00:26:48,022 --> 00:26:50,316
- She started our center.
- Oh, Margo. Please.
641
00:26:50,358 --> 00:26:51,901
I think I've seen you
around the hospital.
642
00:26:51,943 --> 00:26:53,194
Yeah, I recently got privileges.
643
00:26:53,236 --> 00:26:54,946
I'm sorry I couldn't get here earlier.
644
00:26:54,987 --> 00:26:56,697
Several new residents were checking in.
645
00:26:56,739 --> 00:26:58,241
So how is Damon doing?
646
00:26:58,282 --> 00:27:00,368
Well, he's sedated.
He's on a ventilator.
647
00:27:00,409 --> 00:27:01,911
Dad's been taking
really good care of him.
648
00:27:01,953 --> 00:27:03,162
I'm sure he has.
649
00:27:03,204 --> 00:27:04,747
Well, we're by no
means out of the woods.
650
00:27:04,789 --> 00:27:06,165
Can I see his chart?
651
00:27:06,207 --> 00:27:08,334
Sure.
652
00:27:08,376 --> 00:27:10,169
Endocarditis.
653
00:27:10,211 --> 00:27:12,171
We're hoping the
antibiotics knock it out.
654
00:27:12,213 --> 00:27:13,673
Listen, if you need to get back,
655
00:27:13,714 --> 00:27:15,216
I can call you if there's a change.
656
00:27:15,258 --> 00:27:20,096
Uh, no, I'd like to
stay, see how he does.
657
00:27:20,138 --> 00:27:21,931
Is it all right if I sit with him?
658
00:27:21,973 --> 00:27:24,350
- Of course.
- Thank you.
659
00:27:24,392 --> 00:27:26,227
Hey, just so you know,
660
00:27:26,269 --> 00:27:28,354
your son, he's been a real godsend.
661
00:27:28,396 --> 00:27:29,772
That's nice to hear.
662
00:27:29,814 --> 00:27:31,816
It's so helpful to have
people around our residents
663
00:27:31,858 --> 00:27:33,818
who understand their challenges.
664
00:27:41,617 --> 00:27:43,744
Kaitlin?
665
00:27:43,786 --> 00:27:46,080
Kaitlin, can you hear me?
666
00:27:46,122 --> 00:27:47,915
Hi.
667
00:27:47,957 --> 00:27:49,709
I got good news.
668
00:27:49,750 --> 00:27:52,378
We were able to save your uterus.
669
00:27:52,420 --> 00:27:55,548
So if you decide to conceive again,
670
00:27:55,590 --> 00:27:56,590
you should be able to.
671
00:27:58,551 --> 00:28:00,595
Honey, did you hear?
672
00:28:00,636 --> 00:28:01,846
No.
673
00:28:01,888 --> 00:28:03,389
No, I can't.
674
00:28:03,431 --> 00:28:05,516
I can't do it again.
675
00:28:05,558 --> 00:28:07,560
Please. I'm sorry.
676
00:28:07,602 --> 00:28:09,854
It's okay. It's okay.
677
00:28:09,896 --> 00:28:11,147
Nobody would help.
678
00:28:11,189 --> 00:28:12,356
I know.
679
00:28:12,398 --> 00:28:15,902
They made me feel like I didn't matter.
680
00:28:17,653 --> 00:28:19,530
I was thinking,
681
00:28:19,572 --> 00:28:21,449
if you agree,
682
00:28:21,491 --> 00:28:22,950
maybe we should move.
683
00:28:22,992 --> 00:28:24,827
But your home, the farm.
684
00:28:24,869 --> 00:28:26,662
I can't go back there.
685
00:28:26,704 --> 00:28:28,456
How could I?
686
00:28:28,498 --> 00:28:31,459
Oh, God, Kaitlin,
687
00:28:31,501 --> 00:28:35,213
I don't think I could stand to
see you suffer like that again.
688
00:28:36,005 --> 00:28:39,884
I know how much you
wanted a family, so...
689
00:28:39,926 --> 00:28:44,138
if you decide you want us to try again,
690
00:28:44,180 --> 00:28:46,265
you don't have to be afraid.
691
00:28:46,307 --> 00:28:48,518
We'll leave you two alone.
692
00:28:53,356 --> 00:28:55,399
Well, it's good to know
693
00:28:55,441 --> 00:28:58,361
there's some good guys in the world.
694
00:28:58,402 --> 00:28:59,445
Yeah.
695
00:29:03,074 --> 00:29:04,951
How is she?
696
00:29:14,001 --> 00:29:16,546
They're not gonna pull Exsomadex.
697
00:29:16,587 --> 00:29:18,339
They're submitting the data to the FDA,
698
00:29:18,381 --> 00:29:20,842
and they'll, uh, follow
their recommendations.
699
00:29:20,883 --> 00:29:23,344
That could take forever.
700
00:29:23,386 --> 00:29:25,179
We need to pull it
now. I'll talk to them.
701
00:29:25,221 --> 00:29:27,056
Hold on. I made the case.
702
00:29:27,098 --> 00:29:29,559
- It's been decided.
- I can still try.
703
00:29:29,600 --> 00:29:32,186
Drop it, Zola.
704
00:29:32,228 --> 00:29:35,356
It's not how things work here.
705
00:29:35,398 --> 00:29:36,732
Of course.
706
00:29:45,908 --> 00:29:47,869
You feeling better, Jimmy?
707
00:29:47,910 --> 00:29:49,078
Uh-huh.
708
00:29:49,120 --> 00:29:50,580
What about Betty?
709
00:29:50,621 --> 00:29:53,249
Dr. Ripley, CPD is here.
710
00:29:53,291 --> 00:29:55,251
I'll be back in a minute.
711
00:29:55,293 --> 00:29:57,962
- Dr. Ripley?
- Hi.
712
00:29:58,004 --> 00:29:59,297
We did a well-being check on the address
713
00:29:59,338 --> 00:30:00,965
associated with that number.
714
00:30:01,007 --> 00:30:04,760
We found an elderly woman... deceased.
715
00:30:04,802 --> 00:30:06,387
Medical examiner is investigating,
716
00:30:06,429 --> 00:30:08,306
but it looks like natural causes.
717
00:30:08,347 --> 00:30:10,600
I took this off the credenza.
718
00:30:13,936 --> 00:30:15,229
That's my patient.
719
00:30:15,271 --> 00:30:16,898
And that's the woman we found.
720
00:30:16,939 --> 00:30:19,233
I talked to a neighbor who said
they were brother and sister.
721
00:30:19,275 --> 00:30:21,903
And she was her brother's caregiver.
722
00:30:21,944 --> 00:30:25,072
Sorry I don't have better news.
723
00:30:25,114 --> 00:30:26,240
She must have collapsed,
724
00:30:26,282 --> 00:30:28,451
and Jimmy went looking for help.
725
00:30:32,747 --> 00:30:34,582
Better call social work.
726
00:30:34,624 --> 00:30:35,666
He's not going home.
727
00:30:45,384 --> 00:30:48,596
I thought you'd be more
comfortable waiting in here.
728
00:30:48,638 --> 00:30:51,349
I haven't been in your
office for a long time.
729
00:30:51,390 --> 00:30:52,517
Very nice.
730
00:30:52,558 --> 00:30:54,769
Please. Can I get you anything?
731
00:30:54,811 --> 00:30:56,729
Nah.
732
00:30:56,771 --> 00:30:59,440
- Come on in.
- Daniel.
733
00:30:59,482 --> 00:31:00,775
Go ahead.
734
00:31:00,817 --> 00:31:03,027
Tell her what great shape I'm in.
735
00:31:03,069 --> 00:31:04,779
Well, I mean, by and large, you are.
736
00:31:04,821 --> 00:31:07,198
There you go.
737
00:31:07,240 --> 00:31:09,951
Yeah, I noticed a...
738
00:31:09,992 --> 00:31:11,369
a minor balance issue.
739
00:31:11,410 --> 00:31:13,329
I hurt my knee. What do you expect?
740
00:31:13,371 --> 00:31:15,915
And some short-term memory issues.
741
00:31:15,957 --> 00:31:18,626
Memory?
742
00:31:18,668 --> 00:31:19,794
What do you mean?
743
00:31:19,836 --> 00:31:21,087
Well, you're forgetting things, Bert.
744
00:31:21,129 --> 00:31:23,548
Well, who doesn't forget things?
745
00:31:23,589 --> 00:31:25,133
What's this about?
746
00:31:27,009 --> 00:31:28,636
Really just about your...
747
00:31:28,678 --> 00:31:31,055
your friends and your family
being a little bit concerned.
748
00:31:31,097 --> 00:31:32,765
That's all.
749
00:31:32,807 --> 00:31:34,267
Concerned.
750
00:31:34,308 --> 00:31:37,687
We'd like you to take
some more tests, Bert.
751
00:31:37,728 --> 00:31:40,189
What tests?
752
00:31:40,231 --> 00:31:42,692
Oh, to see if I'm all
there, compos mentis.
753
00:31:42,733 --> 00:31:44,485
Is that what you're talking about?
754
00:31:44,527 --> 00:31:46,195
Well, I mean, if there is an issue...
755
00:31:46,237 --> 00:31:48,739
and trust me, big if...
756
00:31:48,781 --> 00:31:49,824
don't you wanna know?
757
00:31:49,866 --> 00:31:50,866
I mean, I certainly would.
758
00:31:50,867 --> 00:31:52,368
There isn't.
759
00:31:52,410 --> 00:31:55,913
Well, just in case, let's make an
appointment with the neurologist.
760
00:31:55,955 --> 00:31:56,956
Oh, yeah.
761
00:31:56,998 --> 00:31:58,166
I get it.
762
00:31:58,207 --> 00:31:59,500
This is a setup.
763
00:31:59,542 --> 00:32:01,002
It was a setup from the beginning.
764
00:32:01,043 --> 00:32:02,378
Look, I apologize, Bert,
765
00:32:02,420 --> 00:32:04,881
but I knew you wouldn't
come here on your own.
766
00:32:04,922 --> 00:32:07,308
And Tara has been so worried.
767
00:32:07,349 --> 00:32:08,843
Uh-uh. Don't put this on Tara.
768
00:32:08,885 --> 00:32:10,761
This is... this is you.
769
00:32:10,803 --> 00:32:12,680
Yeah, y-you're trying to put me away.
770
00:32:12,722 --> 00:32:15,433
You wanna put me away so
you can get your hands on...
771
00:32:15,475 --> 00:32:17,477
- on my... on my pension!
- Oh, Bert!
772
00:32:17,518 --> 00:32:19,479
And... and you're in it with her.
773
00:32:19,520 --> 00:32:21,189
The two of you are
cooking up this nonsense
774
00:32:21,230 --> 00:32:22,982
so you can get my money!
775
00:32:23,024 --> 00:32:24,484
Couple of crooks!
776
00:32:24,525 --> 00:32:25,526
Bert.
777
00:32:25,568 --> 00:32:26,652
Bert.
778
00:32:26,694 --> 00:32:28,321
How long have we been friends for, huh?
779
00:32:28,362 --> 00:32:30,531
- 40 years?
- 40 years, but not anymore.
780
00:32:30,573 --> 00:32:32,033
A-and what was that power I gave you?
781
00:32:32,074 --> 00:32:33,201
That law power?
782
00:32:33,242 --> 00:32:34,243
Power of attorney.
783
00:32:34,285 --> 00:32:35,285
Well, you don't have it anymore.
784
00:32:35,286 --> 00:32:36,496
You ought to be ashamed!
785
00:32:36,537 --> 00:32:37,997
Bert!
786
00:32:46,858 --> 00:32:49,526
Dr. Ahmad, they discharged Alex.
787
00:32:49,802 --> 00:32:51,011
Great.
788
00:32:51,053 --> 00:32:54,014
Yeah, like you said, no big deal.
789
00:32:54,056 --> 00:32:55,099
I'm sorry for what happened.
790
00:32:55,140 --> 00:32:57,518
No. Please, it wasn't your fault.
791
00:32:57,560 --> 00:32:59,186
And Alex is doing fine.
792
00:32:59,228 --> 00:33:00,854
You caught his cancer.
793
00:33:00,896 --> 00:33:02,314
My God.
794
00:33:02,356 --> 00:33:04,525
We are so grateful
to you and Dr. Marcel.
795
00:33:06,277 --> 00:33:08,279
We can't even begin to thank you enough.
796
00:33:08,320 --> 00:33:10,155
Thank you, guys. Good luck.
797
00:33:10,197 --> 00:33:11,991
- Thank you.
- Thanks.
798
00:33:12,032 --> 00:33:13,409
Thank you.
799
00:33:17,872 --> 00:33:19,415
No pulse.
800
00:33:20,875 --> 00:33:22,042
He's fibrillating.
801
00:33:22,084 --> 00:33:23,586
I'll get on his chest.
802
00:33:23,627 --> 00:33:25,421
Milligram of epi.
803
00:33:25,462 --> 00:33:26,421
Charge to 200.
804
00:33:26,422 --> 00:33:27,548
Charging.
805
00:33:27,590 --> 00:33:28,883
Clear.
806
00:33:30,759 --> 00:33:31,969
Still no pulse.
807
00:33:32,011 --> 00:33:33,012
Epi's in.
808
00:33:33,053 --> 00:33:34,054
Again, charge to 200.
809
00:33:34,096 --> 00:33:35,472
Charging.
810
00:33:35,514 --> 00:33:37,975
Clear.
811
00:33:40,769 --> 00:33:42,855
Huh, nothing.
812
00:33:42,897 --> 00:33:44,523
He's asystole.
813
00:33:50,362 --> 00:33:51,822
No.
814
00:33:51,864 --> 00:33:53,115
No.
815
00:33:56,076 --> 00:33:58,704
Damn it.
816
00:34:01,624 --> 00:34:04,001
Time of death, 1703.
817
00:34:16,513 --> 00:34:19,558
All right, Jimmy, let's get
you into this wheelchair.
818
00:34:23,437 --> 00:34:25,064
That's it.
819
00:34:27,107 --> 00:34:28,484
Now, you see that nice woman?
820
00:34:30,611 --> 00:34:33,030
She's gonna take you to a new home.
821
00:34:34,740 --> 00:34:37,201
Did you help Betty?
822
00:34:37,243 --> 00:34:39,453
Some very good people went to help her.
823
00:34:41,372 --> 00:34:44,542
Where I'm going, is Betty there?
824
00:34:46,835 --> 00:34:49,171
No, she isn't.
825
00:34:51,507 --> 00:34:53,342
I-I want Betty.
826
00:34:57,680 --> 00:34:59,140
I'm sorry, Jimmy.
827
00:34:59,682 --> 00:35:01,141
She can't be there.
828
00:35:01,183 --> 00:35:03,310
But she'd want you to go,
829
00:35:03,352 --> 00:35:06,730
and she'd want you to be happy.
830
00:35:06,772 --> 00:35:11,485
I... I want Betty.
831
00:35:11,527 --> 00:35:12,862
Yeah.
832
00:35:12,903 --> 00:35:16,115
Yeah, I know.
833
00:35:16,156 --> 00:35:17,950
I'm sorry, Jimmy.
834
00:35:23,706 --> 00:35:25,082
Here.
835
00:35:28,168 --> 00:35:31,380
That's Betty
836
00:35:31,422 --> 00:35:33,007
and me.
837
00:35:33,048 --> 00:35:34,216
Yeah.
838
00:35:36,886 --> 00:35:38,846
I love Betty.
839
00:35:45,311 --> 00:35:47,354
It's gonna be all right, Jimmy.
840
00:35:47,396 --> 00:35:49,023
I'll come see you, okay?
841
00:35:49,064 --> 00:35:50,774
And we'll talk about Betty then.
842
00:35:53,611 --> 00:35:56,280
I was cold.
843
00:35:56,322 --> 00:35:58,157
Now I'm warm.
844
00:36:00,075 --> 00:36:01,410
Thank you.
845
00:36:03,704 --> 00:36:04,788
You're welcome.
846
00:36:09,084 --> 00:36:10,544
Hi, Jimmy.
847
00:36:10,586 --> 00:36:12,087
I'm Madeline.
848
00:36:18,093 --> 00:36:20,888
Hi, Madeline.
849
00:36:33,275 --> 00:36:36,445
That's a... a tough one, huh?
850
00:36:38,489 --> 00:36:40,333
I just keep wondering
851
00:36:41,075 --> 00:36:44,912
what his life might have been if,
852
00:36:44,954 --> 00:36:47,164
you know...
853
00:36:47,206 --> 00:36:51,752
If they hadn't given up on him?
854
00:36:51,794 --> 00:36:53,212
Yeah.
855
00:36:55,047 --> 00:36:58,467
You know, I've been meaning to ask you,
856
00:36:58,509 --> 00:37:00,761
were you ever able to
reconnect with your mom?
857
00:37:02,221 --> 00:37:03,681
No.
858
00:37:03,722 --> 00:37:06,058
I heard she's been in and out of rehab,
859
00:37:06,100 --> 00:37:07,768
in and out of custody.
860
00:37:07,810 --> 00:37:10,145
Well,
861
00:37:10,187 --> 00:37:11,897
I'm sorry to hear that.
862
00:37:14,817 --> 00:37:18,070
And I'm also...
863
00:37:18,112 --> 00:37:21,991
I'm just so sorry if I...
864
00:37:22,032 --> 00:37:24,577
turned out to be yet another person
865
00:37:24,618 --> 00:37:27,788
that made you feel
abandoned in this life.
866
00:37:27,830 --> 00:37:31,333
You know, I just... I
genuinely regret that.
867
00:37:31,375 --> 00:37:35,379
And I... I hope you'll
accept my apology.
868
00:37:58,027 --> 00:38:00,196
It's real.
869
00:38:00,237 --> 00:38:02,281
I'm sorry.
870
00:38:02,323 --> 00:38:04,825
Yeah.
871
00:38:04,867 --> 00:38:07,119
Thank you for not saying,
"Now you can move on,"
872
00:38:07,161 --> 00:38:09,246
or something ridiculous like that.
873
00:38:09,288 --> 00:38:10,831
I mean, I was tempted.
874
00:38:10,873 --> 00:38:12,124
Me too.
875
00:38:23,886 --> 00:38:25,137
I'm not ready.
876
00:38:25,179 --> 00:38:26,639
Hmm?
877
00:38:34,188 --> 00:38:35,856
Why?
878
00:38:37,816 --> 00:38:39,068
Why?
879
00:38:39,109 --> 00:38:40,611
Until there's an autopsy,
880
00:38:40,653 --> 00:38:41,862
there's no way to know for sure.
881
00:38:41,904 --> 00:38:43,864
But whatever that infection was,
882
00:38:43,906 --> 00:38:48,536
it just weakened his heart
until we couldn't save him.
883
00:38:48,577 --> 00:38:50,246
Because he used drugs?
884
00:38:50,287 --> 00:38:53,207
Well, we might have a better
idea after the autopsy.
885
00:38:53,249 --> 00:38:54,917
But it's possible.
886
00:38:54,959 --> 00:38:56,919
Street drugs, dirty needles.
887
00:39:00,798 --> 00:39:02,216
Oh, man.
888
00:39:02,258 --> 00:39:04,134
Sean,
889
00:39:04,176 --> 00:39:07,012
I'm sorry I couldn't save him.
890
00:39:13,310 --> 00:39:16,313
You did everything you could.
891
00:39:16,355 --> 00:39:18,691
In my world, you see a lot of loss.
892
00:39:18,732 --> 00:39:20,526
And no matter how hard you try,
893
00:39:20,568 --> 00:39:23,112
sometimes it's just never enough.
894
00:39:23,153 --> 00:39:25,698
I can guess how Sean is feeling.
895
00:39:25,739 --> 00:39:28,075
He came to the center full of hope,
896
00:39:28,117 --> 00:39:29,410
wanting to make a difference.
897
00:39:31,495 --> 00:39:33,873
I'll talk to him.
898
00:39:42,756 --> 00:39:45,217
Bert?
899
00:39:45,259 --> 00:39:48,596
I'll, uh, get tested, just to...
900
00:39:48,637 --> 00:39:50,306
just to get you off my back.
901
00:39:52,433 --> 00:39:53,434
Okay.
902
00:39:53,475 --> 00:39:55,519
Satisfied?
903
00:40:08,407 --> 00:40:10,618
Oh.
904
00:40:10,659 --> 00:40:12,703
- Hey.
- Hey.
905
00:40:14,496 --> 00:40:17,124
You, uh, pulling another shift?
906
00:40:17,166 --> 00:40:19,293
Yeah.
907
00:40:19,335 --> 00:40:22,713
I thought I was the only
one into self-flagellation.
908
00:40:24,548 --> 00:40:26,133
No, I'm pretty good at it too.
909
00:40:31,305 --> 00:40:32,431
Rough day?
910
00:40:32,473 --> 00:40:34,141
Yeah.
911
00:40:34,183 --> 00:40:36,310
You?
912
00:40:36,352 --> 00:40:37,978
Yeah.
913
00:40:46,570 --> 00:40:48,113
Get some rest.
914
00:40:53,327 --> 00:40:55,162
You too.
915
00:40:55,212 --> 00:40:59,762
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