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These are the user uploaded subtitles that are being translated: 1 00:00:00,492 --> 00:00:02,292 Ben and I are getting a divorce. 2 00:00:15,006 --> 00:00:16,784 Something's wrong with Dad. 3 00:00:16,995 --> 00:00:18,956 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 00:00:31,844 --> 00:00:33,720 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 Repair and Synchronization by Easy Subtitles Synchronizer 1.0.0.0 61531

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