All language subtitles for Chicago Med 8x03 - Winning the Battle, but Still Losing the War (English)

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Would you like to inspect the original subtitles? These are the user uploaded subtitles that are being translated: 1 00:00:03,742 --> 00:00:05,483 Move the CR! 2 00:00:05,527 --> 00:00:06,528 Stay with me. 3 00:00:06,571 --> 00:00:07,833 So this is how it's gonna be? 4 00:00:07,877 --> 00:00:09,618 All day long, you've been talking down to me. 5 00:00:09,661 --> 00:00:11,098 I should have given you credit. 6 00:00:11,141 --> 00:00:13,796 I was very impressed with the way you nearly killed our patient. 7 00:00:15,928 --> 00:00:20,411 We are running low on a number of key supplies. 8 00:00:20,455 --> 00:00:22,674 No, no, no, no, no! Stop! Stop! I need that dye. 9 00:00:22,718 --> 00:00:25,938 We can't have one patient depleting our supplies. 10 00:00:25,982 --> 00:00:27,027 So call into the hospital. 11 00:00:27,070 --> 00:00:28,767 We're all in the same boat. 12 00:00:28,811 --> 00:00:30,726 Dr. Cuevas and I have a strong hunch 13 00:00:30,769 --> 00:00:33,207 that David is developing schizoaffective disorder. 14 00:00:33,250 --> 00:00:35,035 No! My boy isn't crazy. 15 00:00:35,078 --> 00:00:36,514 Stay away from us. 16 00:00:36,558 --> 00:00:39,213 How is that boy supposed to get any help? 17 00:00:40,779 --> 00:00:44,174 It is a real pleasure to finally meet you, Dr. Hawthorne. 18 00:00:44,218 --> 00:00:47,177 My colleague at Med, David Kwan, 19 00:00:47,221 --> 00:00:49,701 he sings your praises highly. 20 00:00:49,745 --> 00:00:51,529 Oh, I'm not the doctor. 21 00:00:51,573 --> 00:00:53,749 I'm her assistant, Katherine. 22 00:00:53,792 --> 00:00:55,055 Okay. 23 00:00:55,098 --> 00:00:57,753 Sign and date these forms, please. 24 00:01:01,844 --> 00:01:04,238 Just wherever you see a highlight. 25 00:01:07,154 --> 00:01:08,459 While you're finishing up with that, 26 00:01:08,503 --> 00:01:11,245 I'll go over our policies and procedures. 27 00:01:13,856 --> 00:01:15,553 Everything you discuss with Dr. Hawthorne 28 00:01:15,597 --> 00:01:17,729 is confidential, except in the event she feels 29 00:01:17,773 --> 00:01:19,340 - you're a danger to yourself. - You know what, Katherine? 30 00:01:19,383 --> 00:01:21,385 I'm... I'm actually a practicing psychiatrist myself, 31 00:01:21,429 --> 00:01:24,693 so, I mean, if you'd like, you can skip that part. 32 00:01:24,736 --> 00:01:25,998 I totally get it, 33 00:01:26,042 --> 00:01:28,479 but Dr. Hawthorne, who you'll meet next week, 34 00:01:28,523 --> 00:01:31,265 requires we go through the policies together. 35 00:01:31,308 --> 00:01:33,745 If the doctor feels that you're a danger to yourself or others, 36 00:01:33,789 --> 00:01:35,573 - she's required to report... - You know what, Katherine? 37 00:01:35,617 --> 00:01:38,185 I appreciate you're just trying to do your job. 38 00:01:38,228 --> 00:01:42,102 But, um, maybe you could tell Dr. Hawthorne 39 00:01:42,145 --> 00:01:45,496 to give me a call when she has a chance 40 00:01:45,540 --> 00:01:48,108 to meet me herself in person, okay? 41 00:01:49,152 --> 00:01:51,502 Um, you know what? 42 00:01:51,546 --> 00:01:56,116 On second thought, maybe tell her not to bother. 43 00:01:57,943 --> 00:01:59,671 Yeah. 44 00:02:02,339 --> 00:02:05,168 It's been a long time since you had to hunt for a therapist. 45 00:02:05,212 --> 00:02:06,818 Want me to shoot you some names? 46 00:02:06,843 --> 00:02:08,867 I got a small stockpile of referrals. 47 00:02:08,911 --> 00:02:11,435 I gotta be honest, Sharon, after these last two experiences, 48 00:02:11,479 --> 00:02:13,785 my interest in the process might be waning. 49 00:02:13,829 --> 00:02:16,614 I mean, this morning in particular 50 00:02:16,658 --> 00:02:18,877 actually had me questioning the state of psychiatry. 51 00:02:18,921 --> 00:02:21,533 Well, that assembly-line mentality 52 00:02:21,558 --> 00:02:23,560 is plaguing much of medicine these days, 53 00:02:23,603 --> 00:02:25,039 not just psychiatry. 54 00:02:25,083 --> 00:02:27,607 But don't worry, you'll find your person. 55 00:02:27,651 --> 00:02:29,696 - See you later. - No coffee? 56 00:02:29,740 --> 00:02:31,306 Ugh, no. I don't have any time. 57 00:02:31,350 --> 00:02:34,005 We're implementing a new drug shortage protocol, 58 00:02:34,048 --> 00:02:36,703 so I'll be in the ED all morning walking the staff 59 00:02:36,747 --> 00:02:38,139 through the new guidelines. 60 00:02:38,183 --> 00:02:39,924 You couldn't get the enforcer, 61 00:02:39,967 --> 00:02:41,752 otherwise known as Maggie Lockwood on that? 62 00:02:41,795 --> 00:02:43,536 She's in Paris. 63 00:02:43,580 --> 00:02:45,233 She and Ben never took their honeymoon, 64 00:02:45,277 --> 00:02:47,627 and she was gonna lose her vacation days. 65 00:02:47,671 --> 00:02:49,324 - Wow. - Yeah. 66 00:02:49,368 --> 00:02:50,500 Well, still, not a great time 67 00:02:50,543 --> 00:02:51,544 to be short-staffed, though, right? 68 00:02:51,588 --> 00:02:53,241 There's never a good time. 69 00:02:53,285 --> 00:02:55,461 - Yep, you got that right. - See you later. 70 00:02:56,854 --> 00:02:58,420 Get these off me! 71 00:02:58,464 --> 00:02:59,683 David Sullivan, 17-year-old male. 72 00:02:59,726 --> 00:03:01,728 Oh, we've met. David, it's me, Dr. Archer. 73 00:03:01,772 --> 00:03:03,034 - Do you remember me? - I can't stay here. 74 00:03:03,077 --> 00:03:04,818 They're gonna find me. I have to keep moving. 75 00:03:04,862 --> 00:03:06,385 - I can't stay in one place! - It's okay, honey. 76 00:03:06,428 --> 00:03:07,821 - You're safe. You're safe. - He ran naked into the street. 77 00:03:07,865 --> 00:03:09,997 Dad managed to grab him before he got hit by a car. 78 00:03:10,041 --> 00:03:11,912 No visible injuries that I can see. 79 00:03:11,956 --> 00:03:14,175 Gave him 0.5 of lorazepam en route. 80 00:03:14,219 --> 00:03:16,569 Hello, again, Mrs. Sullivan. Is your husband all right? 81 00:03:16,613 --> 00:03:19,485 He's fine, yeah. He's just a bit shaken up. 82 00:03:19,529 --> 00:03:21,226 He drove behind us, should be here any minute. 83 00:03:21,269 --> 00:03:23,358 - Doris, would you... - Page psych. I'm on it. 84 00:03:23,402 --> 00:03:25,012 Okay, finish my sentences for me, why don't you? 85 00:03:25,056 --> 00:03:27,493 Okay, David, we're gonna loosen your restraints now 86 00:03:27,537 --> 00:03:29,190 and move you to the bed. 87 00:03:29,234 --> 00:03:31,149 I need you to stay still. 88 00:03:31,192 --> 00:03:33,760 Keep your hands by your side, all right? 89 00:03:33,804 --> 00:03:35,022 Okay, ready, everybody? 90 00:03:35,066 --> 00:03:38,548 On my count, one, two, three. 91 00:03:38,591 --> 00:03:41,202 Good. Okay. 92 00:03:41,246 --> 00:03:42,856 Very good, okay. 93 00:03:42,900 --> 00:03:44,423 - Oh, no, no, no, no, no! - It's all right. 94 00:03:44,466 --> 00:03:45,729 - It's all right. - David, please. 95 00:03:45,772 --> 00:03:47,557 Just let the doctor look at you, okay, honey? 96 00:03:47,600 --> 00:03:48,993 They came inside the light. 97 00:03:49,036 --> 00:03:52,213 They're trying to steal my DNA so they can clone me. 98 00:03:52,257 --> 00:03:53,867 Okay, so what do you think could have triggered this? 99 00:03:53,911 --> 00:03:55,652 We were at a stoplight, 100 00:03:55,695 --> 00:03:57,479 and David became fixated on this billboard. 101 00:03:57,523 --> 00:03:59,699 It was just some random man selling car insurance. 102 00:03:59,743 --> 00:04:01,919 He's not random. He works for them. 103 00:04:01,962 --> 00:04:03,398 - There's a whole network. - I don't know. 104 00:04:03,442 --> 00:04:05,226 He started taking his clothes off and telling us 105 00:04:05,270 --> 00:04:08,316 that they were... they were bugged with recording devices. 106 00:04:08,360 --> 00:04:09,753 And then right when the light turned green, he bolted. 107 00:04:09,796 --> 00:04:12,016 He ran across four lanes of oncoming traffic. 108 00:04:12,059 --> 00:04:13,260 There was... 109 00:04:14,888 --> 00:04:16,890 There was a pickup truck that was coming right at him. 110 00:04:16,942 --> 00:04:18,813 - And he... - Eric. 111 00:04:18,849 --> 00:04:20,067 - Sir, are you all right? - Oh, my God, Eric! 112 00:04:20,111 --> 00:04:21,591 All right, let's get him to the ground. 113 00:04:21,634 --> 00:04:23,027 - Eric! Eric! - Come on. 114 00:04:23,070 --> 00:04:24,332 - What's going on with him? - It was meant for me. 115 00:04:24,376 --> 00:04:25,638 - They're gonna kill us all! - It's okay, honey. 116 00:04:25,682 --> 00:04:26,944 Mom, we gotta get out of here now. 117 00:04:26,987 --> 00:04:27,988 - Let's get a gurney over here! - It's okay. 118 00:04:28,013 --> 00:04:29,069 - Come on! - Oh, my God. 119 00:04:29,094 --> 00:04:30,879 No, no, no! No, no! 120 00:04:39,968 --> 00:04:43,675 Your husband's CT angiogram showed an aortic dissection. 121 00:04:43,700 --> 00:04:46,703 That's essentially a tear in the wall of his aorta. 122 00:04:46,746 --> 00:04:48,665 So Eric didn't have a heart attack? 123 00:04:48,690 --> 00:04:50,909 Well, a dissection can often mimic 124 00:04:50,953 --> 00:04:52,694 heart attacks in presentation. 125 00:04:52,737 --> 00:04:55,871 This particular tear is very close to his heart, 126 00:04:55,914 --> 00:04:59,004 which is why we need to get him to surgery as soon as possible 127 00:04:59,048 --> 00:05:00,397 in order to repair it. 128 00:05:00,440 --> 00:05:02,704 - Open heart surgery? - Mm-hmm, yes. 129 00:05:02,747 --> 00:05:05,402 Dr. Morris, one of our cardiothoracic surgeons, 130 00:05:05,445 --> 00:05:06,838 will be performing the operation. 131 00:05:06,882 --> 00:05:08,884 He's on his way here now. 132 00:05:08,927 --> 00:05:10,363 Oh. 133 00:05:10,407 --> 00:05:13,192 Okay, can I see Eric before he goes under? 134 00:05:13,236 --> 00:05:14,890 Yes, of course. 135 00:05:14,933 --> 00:05:17,283 Once we get him to pre-op, I'll have a nurse come get you. 136 00:05:19,634 --> 00:05:21,418 How about we go somewhere and chat for a bit? 137 00:05:21,461 --> 00:05:23,028 Thank you. 138 00:05:23,072 --> 00:05:24,334 Okay. 139 00:05:24,377 --> 00:05:25,857 I don't understand. 140 00:05:25,901 --> 00:05:29,034 Why would David think that this man on a billboard 141 00:05:29,078 --> 00:05:30,732 was after him? 142 00:05:30,775 --> 00:05:32,777 It's what we call a delusion of persecution. 143 00:05:32,821 --> 00:05:36,607 Yeah, one becomes convinced that some individual, 144 00:05:36,651 --> 00:05:39,262 you know, or group is conspiring to harm them 145 00:05:39,305 --> 00:05:40,655 or the people that they love. 146 00:05:40,698 --> 00:05:44,267 And these delusions, that's something that 147 00:05:44,310 --> 00:05:45,703 you see with schizophrenia? 148 00:05:45,747 --> 00:05:46,835 It is, yeah. 149 00:05:49,489 --> 00:05:53,885 I know Eric and I weren't exactly receptive 150 00:05:53,929 --> 00:05:55,147 the last time we all spoke. 151 00:05:55,191 --> 00:05:56,279 We completely understand. 152 00:05:56,322 --> 00:05:58,194 It's... it's a lot to take in. 153 00:05:58,237 --> 00:05:59,761 I Just thought that David was going 154 00:05:59,804 --> 00:06:04,530 through some kind of phase, growing pains, you know? 155 00:06:05,418 --> 00:06:10,402 But in these last couple of days, it's like he's... 156 00:06:10,641 --> 00:06:14,471 He's lost all touch with reality. 157 00:06:14,514 --> 00:06:18,518 It's just like, I feel him slipping away. 158 00:06:18,562 --> 00:06:21,739 Mrs. Sullivan, I promise you, David is still there. 159 00:06:21,783 --> 00:06:24,437 Yeah, and with treatment, these episodes will become 160 00:06:24,481 --> 00:06:26,483 less severe and less frequent. 161 00:06:26,526 --> 00:06:29,225 And with proper management, they can even go away. 162 00:06:29,268 --> 00:06:30,661 What do you mean, medication? 163 00:06:30,705 --> 00:06:33,751 That's a crucial component, yeah. 164 00:06:33,795 --> 00:06:36,754 David thinks people are trying to poison him. 165 00:06:36,798 --> 00:06:39,670 How am I going to convince him to take pills? 166 00:06:39,714 --> 00:06:41,977 There are actually injectable versions 167 00:06:42,020 --> 00:06:44,501 of many antipsychotics. 168 00:06:44,544 --> 00:06:46,155 Though we don't generally start there. 169 00:06:46,198 --> 00:06:47,547 Those are usually held in reserve 170 00:06:47,591 --> 00:06:49,332 for non-compliant patients. 171 00:06:49,375 --> 00:06:50,942 Of course. 172 00:06:50,986 --> 00:06:54,380 I'm just saying, if he refuses or becomes non-cooperative, 173 00:06:54,424 --> 00:06:56,556 - they're an option. - Right. 174 00:06:56,600 --> 00:06:59,342 But we'll cross that bridge if and when we get there. 175 00:06:59,385 --> 00:07:00,822 In the long run, it's just much better 176 00:07:00,865 --> 00:07:03,650 if we can get David on board with taking medication. 177 00:07:03,694 --> 00:07:05,783 Okay. 178 00:07:08,655 --> 00:07:10,919 Ms. Martin, I'm Doctor... 179 00:07:10,962 --> 00:07:15,010 Liza. 180 00:07:15,053 --> 00:07:17,795 Sorry, you were saying? 181 00:07:17,839 --> 00:07:19,318 Uh, I'm Dr. Choi. 182 00:07:19,362 --> 00:07:21,190 I understand you haven't been feeling well. 183 00:07:21,233 --> 00:07:23,192 Yeah I can't keep anything down. 184 00:07:23,235 --> 00:07:25,585 And you're 12 weeks along. 185 00:07:25,629 --> 00:07:29,633 Uh, that's just an estimate. 186 00:07:29,676 --> 00:07:33,637 I only just recently found out I was pregnant. 187 00:07:33,680 --> 00:07:36,640 I haven't gotten around to see a doctor just yet. 188 00:07:36,683 --> 00:07:39,599 Well, in that case, we'll go ahead and run an ultrasound. 189 00:07:39,643 --> 00:07:41,340 Doris, will you mind grabbing Dr. Asher? 190 00:07:41,384 --> 00:07:43,821 - Sure thing. - Thanks. 191 00:07:43,865 --> 00:07:46,215 So when did the vomiting and diarrhea start? 192 00:07:46,258 --> 00:07:47,433 Just last night. 193 00:07:47,477 --> 00:07:49,044 And you haven't taken any medication? 194 00:07:49,087 --> 00:07:51,786 No, nothing. 195 00:07:51,829 --> 00:07:54,049 I don't want to take anything while I'm pregnant. 196 00:07:54,092 --> 00:07:56,399 Well, you know there are some nausea medications 197 00:07:56,442 --> 00:07:57,792 that are safe for pregnancy. 198 00:07:57,835 --> 00:07:59,968 Still, I just... 199 00:08:00,011 --> 00:08:01,665 I would rather not. 200 00:08:03,362 --> 00:08:04,886 I'll be fine. 201 00:08:04,929 --> 00:08:07,845 I just really came in here to make sure the baby's okay. 202 00:08:07,889 --> 00:08:10,369 Understood. Mind if I press on your belly? 203 00:08:10,413 --> 00:08:12,067 I just want to see if anything feels tender. 204 00:08:12,110 --> 00:08:13,938 Mm-hmm. 205 00:08:16,288 --> 00:08:18,073 No, no, no. No, no, no. 206 00:08:18,116 --> 00:08:19,901 I don't want her. 207 00:08:19,944 --> 00:08:21,903 You'll have to get me another doctor. 208 00:08:21,946 --> 00:08:23,469 Dr. Asher? 209 00:08:23,513 --> 00:08:25,776 Hannah Asher, right? 210 00:08:25,820 --> 00:08:27,430 Yeah. She's an excellent physician. 211 00:08:27,473 --> 00:08:30,041 She's an addict. 212 00:08:30,085 --> 00:08:31,738 You get me another doctor, or I'm leaving. 213 00:08:31,782 --> 00:08:33,262 Whoa, whoa, whoa. Okay, okay, okay. 214 00:08:33,287 --> 00:08:34,436 Just hold on a moment. 215 00:08:38,920 --> 00:08:42,488 Hey, Hannah, sorry, I jumped the gun, actually. 216 00:08:42,532 --> 00:08:44,186 We're all good. 217 00:08:44,229 --> 00:08:45,883 Oh, okay. 218 00:08:45,927 --> 00:08:47,319 Well, in that case, I'm grabbing breakfast 219 00:08:47,363 --> 00:08:50,540 if anybody's looking for me. 220 00:08:57,460 --> 00:08:59,592 Dr. Tanaka-Reed, hold up a minute. 221 00:08:59,636 --> 00:09:01,464 Can you have them update that for me? 222 00:09:01,507 --> 00:09:02,900 Thank you. 223 00:09:02,944 --> 00:09:05,729 Look, I... I wanted to clear the air. 224 00:09:05,772 --> 00:09:09,515 The other day, I may have come off a little condescending. 225 00:09:09,559 --> 00:09:11,822 I appreciate the acknowledgment, Dr. Marcel. 226 00:09:11,866 --> 00:09:15,957 Of course, and if there's anything you'd like to say... 227 00:09:16,000 --> 00:09:18,307 No, don't think so. 228 00:09:18,350 --> 00:09:20,918 We're all good. 229 00:09:20,962 --> 00:09:22,354 What, you didn't have time to grab him 230 00:09:22,398 --> 00:09:24,748 flowers from the gift shop? 231 00:09:24,791 --> 00:09:26,532 Huh? 232 00:09:26,576 --> 00:09:27,794 I mean, I expect the other docs 233 00:09:27,838 --> 00:09:30,667 to go soft on the residents. 234 00:09:30,710 --> 00:09:32,495 I thought you had grit. 235 00:09:32,538 --> 00:09:34,105 Well, no man's an island, right? 236 00:09:34,149 --> 00:09:35,498 Aha. 237 00:09:35,541 --> 00:09:36,847 You know, island life's really not so bad. 238 00:09:36,891 --> 00:09:38,675 Maybe you just don't have the stomach for it. 239 00:09:38,718 --> 00:09:41,069 Dr. Marcel, you've got a trauma incoming. 240 00:09:41,112 --> 00:09:43,332 Well, thanks for that pep talk, coach. 241 00:09:43,375 --> 00:09:44,899 Any time. 242 00:09:47,205 --> 00:09:48,641 What do we got? 243 00:09:48,685 --> 00:09:51,079 Marcus Walker, 50-year-old male, fall from standing. 244 00:09:51,122 --> 00:09:53,603 Gave him a 500 liter bolus en route. 245 00:09:53,646 --> 00:09:55,300 Pressure's hanging around 100, systolic. 246 00:09:55,344 --> 00:09:56,736 Heart rate's 120. 247 00:09:56,780 --> 00:09:58,738 Yeah, I've never seen him in this much pain. 248 00:09:58,782 --> 00:10:01,132 It hasn't let up since he hit the pavement. 249 00:10:01,176 --> 00:10:02,177 This is his sister, Janet. 250 00:10:02,220 --> 00:10:03,743 Did you witness the fall, Janet? 251 00:10:03,787 --> 00:10:05,180 He lost his balance stepping off the sidewalk. 252 00:10:05,223 --> 00:10:07,138 It didn't look that bad, but then he couldn't get up. 253 00:10:07,182 --> 00:10:08,618 Okay, we'll give him something for the pain. 254 00:10:08,661 --> 00:10:09,793 We just got to find the source of it first. 255 00:10:09,836 --> 00:10:10,837 Any medications we should know about? 256 00:10:10,881 --> 00:10:12,230 Dialysis. 257 00:10:12,274 --> 00:10:13,666 Oh, and he takes ramipril for his blood pressure. 258 00:10:13,710 --> 00:10:14,841 Okay, here we go, guys. 259 00:10:14,885 --> 00:10:16,191 Nice and easy on my count, okay? 260 00:10:16,234 --> 00:10:17,932 One, two, three. 261 00:10:17,975 --> 00:10:20,499 I'm sorry, Marcus. 262 00:10:20,543 --> 00:10:22,937 I'm right here, Marcus. I'm right here. 263 00:10:22,980 --> 00:10:24,982 Janet, let's give the doctor some room to work, okay? 264 00:10:25,026 --> 00:10:26,897 We're gonna take care of him, Janet, we got this. 265 00:10:26,941 --> 00:10:28,290 Let's hang a unit of whole blood. 266 00:10:28,333 --> 00:10:29,726 Pressure it in, Ron. 267 00:10:29,769 --> 00:10:32,729 Hey, Marcus, put your arms by your side for me. 268 00:10:32,772 --> 00:10:34,600 There you go, bud. Deep breaths. 269 00:10:34,644 --> 00:10:35,993 Okay, lungs are clear. 270 00:10:36,037 --> 00:10:37,734 - He's still shocking. - Yeah. 271 00:10:37,777 --> 00:10:39,301 He's bleeding from somewhere. 272 00:10:39,344 --> 00:10:41,085 Let's fast him, Dr. Taylor. 273 00:10:48,397 --> 00:10:49,789 Belly's negative. 274 00:10:49,833 --> 00:10:51,356 Really? 275 00:10:51,400 --> 00:10:53,097 Yeah. 276 00:10:53,141 --> 00:10:55,143 All right, let's get him on his side. 277 00:10:55,186 --> 00:10:57,972 Herbert, come over, please. 278 00:10:58,015 --> 00:11:00,017 All right, here we go. Nice and easy, all right? 279 00:11:00,061 --> 00:11:01,497 One, two, three. 280 00:11:03,194 --> 00:11:04,456 There you go. You're doing great. 281 00:11:04,500 --> 00:11:06,241 You're doing great, Marcus. 282 00:11:10,288 --> 00:11:12,203 What is it? 283 00:11:12,247 --> 00:11:13,248 Oh. 284 00:11:13,291 --> 00:11:14,423 An abscess. 285 00:11:14,448 --> 00:11:16,773 Looks like it. Pus under pressure. 286 00:11:16,816 --> 00:11:18,340 It's gotta be the source of the pain. 287 00:11:18,383 --> 00:11:20,951 All right, let's drain it. 288 00:11:20,995 --> 00:11:22,083 Scalpel. 289 00:11:28,089 --> 00:11:29,873 Hematoma. 290 00:11:36,401 --> 00:11:37,533 Yep. 291 00:11:37,576 --> 00:11:40,231 Hold pressure and pack it in. 292 00:11:40,275 --> 00:11:41,450 - You got it? - Yeah. 293 00:11:41,493 --> 00:11:42,842 - Okay. - Got it. 294 00:11:42,886 --> 00:11:44,801 All right, give me another unit of whole blood. 295 00:11:44,844 --> 00:11:49,153 Start DDAVP and a unit of platelets, stat. 296 00:11:49,197 --> 00:11:50,763 Come on, let's move, folks. 297 00:11:57,935 --> 00:11:59,903 Ms. Arya, hello again. 298 00:11:59,946 --> 00:12:01,557 Indrani, please. 299 00:12:01,600 --> 00:12:04,299 Indrani, I got the results back on your culture. 300 00:12:04,342 --> 00:12:07,650 Unfortunately, you tested positive for an infection called MRSA. 301 00:12:07,693 --> 00:12:11,132 From an ingrown toenail? 302 00:12:11,175 --> 00:12:14,222 MRSA is really hard to treat, isn't it? 303 00:12:14,265 --> 00:12:16,354 While it is resistant to many antibiotics, 304 00:12:16,398 --> 00:12:18,226 luckily, there are a couple that still work for it. 305 00:12:18,269 --> 00:12:20,358 How long do I have to be on antibiotics? 306 00:12:20,402 --> 00:12:22,143 - About seven to ten days. - Oh. 307 00:12:22,186 --> 00:12:25,363 See, I told you you wouldn't have to cancel your trip. 308 00:12:25,407 --> 00:12:27,104 Oh, yeah? Where are you headed? 309 00:12:27,148 --> 00:12:29,106 Well, I'm going to Scotland in a few weeks 310 00:12:29,150 --> 00:12:30,716 to hike the West Highland Way. 311 00:12:30,760 --> 00:12:34,111 It's a 96-mile trail through the Scottish Highlands. 312 00:12:34,155 --> 00:12:35,417 96 miles? 313 00:12:35,460 --> 00:12:37,636 I've been training for the last year. 314 00:12:37,680 --> 00:12:40,422 I may be pushing 60, but I don't feel it. 315 00:12:40,465 --> 00:12:42,424 Let's start with vancomycin. 316 00:12:42,467 --> 00:12:45,079 No, I can't take vancomycin. I'm allergic. 317 00:12:45,122 --> 00:12:46,645 Aha, I see that. 318 00:12:46,689 --> 00:12:48,952 I had a terrible reaction when I was a kid. 319 00:12:48,995 --> 00:12:50,214 My throat closed up. 320 00:12:50,258 --> 00:12:52,042 Then we will steer clear. Nancy? 321 00:12:52,086 --> 00:12:54,436 - Linezolid? On it. - Mm-hmm. 322 00:12:54,479 --> 00:12:56,220 We'll get you in tip top shape for Scotland, Indrani. 323 00:12:56,264 --> 00:12:58,266 I've been wanting to do this a long time. 324 00:12:58,309 --> 00:13:01,269 Um, Dr. Halstead, the pharmacy 325 00:13:01,312 --> 00:13:03,793 won't release the medication. 326 00:13:03,836 --> 00:13:05,621 What? 327 00:13:05,664 --> 00:13:06,665 Is there a problem? 328 00:13:09,494 --> 00:13:12,323 No, just probably a system glitch. 329 00:13:12,367 --> 00:13:14,456 Sit tight, and I'll be right back. 330 00:13:14,499 --> 00:13:16,806 Look, per the new protocol, 331 00:13:16,849 --> 00:13:19,287 you're gonna have to go through Infectious Disease first. 332 00:13:19,330 --> 00:13:21,985 And they're going to want to try incising 333 00:13:22,028 --> 00:13:23,639 and draining the infected tissue 334 00:13:23,682 --> 00:13:26,076 before they approve giving linezolid. 335 00:13:26,120 --> 00:13:27,164 Incising and draining? 336 00:13:27,208 --> 00:13:28,644 So source control. 337 00:13:28,687 --> 00:13:30,211 That is not gonna cut it, Ms. Goodwin. 338 00:13:30,254 --> 00:13:32,082 She needs linezolid. 339 00:13:34,476 --> 00:13:36,478 I mean, can't we just say that, um, 340 00:13:36,521 --> 00:13:39,307 you know, Infectious Disease already signed off? 341 00:13:39,350 --> 00:13:41,309 No, we cannot, Dr. Halstead. 342 00:13:41,352 --> 00:13:43,398 Linezolid is on the restricted list 343 00:13:43,441 --> 00:13:45,878 due to extremely low inventory. 344 00:13:45,922 --> 00:13:48,577 There's a region-wide shortage. 345 00:13:48,620 --> 00:13:51,145 And we are dealing with a systemic MRSA infection. 346 00:13:51,188 --> 00:13:53,973 You're looking at the patient in front of you. 347 00:13:54,017 --> 00:13:57,194 But the Oversight Committee designed the guidelines 348 00:13:57,238 --> 00:14:01,198 to ration these drugs to the most severe cases. 349 00:14:01,242 --> 00:14:06,160 I have seen early source control work wonders. 350 00:14:06,203 --> 00:14:07,813 Give it a shot. 351 00:14:13,079 --> 00:14:14,690 Dr. Marcel. 352 00:14:14,733 --> 00:14:16,866 - Yeah? - I got Marcus' CAT scans. 353 00:14:16,909 --> 00:14:18,215 Uh-huh. 354 00:14:18,259 --> 00:14:20,086 Two very severe lumbar burst fractures. 355 00:14:20,130 --> 00:14:21,523 All from a spill on the sidewalk? 356 00:14:21,566 --> 00:14:22,567 Take a look. 357 00:14:24,090 --> 00:14:25,353 Oof. 358 00:14:25,396 --> 00:14:27,442 Renal disease definitely sped up his bone loss. 359 00:14:27,485 --> 00:14:29,705 He's gonna need spinal stabilization surgery. 360 00:14:29,748 --> 00:14:33,535 Yeah, agreed, only option to get him walking again. 361 00:14:33,578 --> 00:14:35,232 Given his co-morbidities, without it, 362 00:14:35,276 --> 00:14:37,408 he's just gonna circle the drain. 363 00:14:37,452 --> 00:14:41,369 All right, let's... Let's go talk to neurosurgery. 364 00:14:42,761 --> 00:14:45,677 And David, this voice that you're hearing, 365 00:14:45,721 --> 00:14:48,158 is it male or female? 366 00:14:48,202 --> 00:14:49,681 I don't know. 367 00:14:49,725 --> 00:14:52,554 It's more like it has its own language, 368 00:14:52,597 --> 00:14:54,512 its own way of communicating. 369 00:14:54,556 --> 00:14:57,385 And then my brain translates messages 370 00:14:57,428 --> 00:14:59,387 - so I can understand them. - Mm. 371 00:14:59,430 --> 00:15:01,606 Are you getting any messages right now? 372 00:15:01,650 --> 00:15:03,739 That you're writing down everything 373 00:15:03,782 --> 00:15:05,828 I say because you work for them. 374 00:15:10,746 --> 00:15:14,097 You're one of their spies, aren't you? 375 00:15:14,140 --> 00:15:15,533 No, I'm not a spy. 376 00:15:15,577 --> 00:15:17,709 Then give me your notebook. 377 00:15:17,753 --> 00:15:19,189 I'm not gonna give you my notebook, David. 378 00:15:19,233 --> 00:15:20,321 Give it to me. 379 00:15:20,364 --> 00:15:22,262 David, I need you to listen to me. I'm a doctor. 380 00:15:22,287 --> 00:15:24,934 I'm writing things down so I can better understand what's going... 381 00:15:24,977 --> 00:15:26,622 Get out of here! 382 00:15:26,647 --> 00:15:28,040 Out, now! 383 00:15:28,065 --> 00:15:29,762 David, David, how about Dr. Cuevas 384 00:15:29,787 --> 00:15:31,220 puts her notebook away for now. 385 00:15:31,245 --> 00:15:33,421 Would that make you feel better? 386 00:15:33,464 --> 00:15:37,512 And I notice you've been checking out this vent. 387 00:15:37,555 --> 00:15:38,774 There's a camera in there. 388 00:15:40,140 --> 00:15:42,055 Huh. 389 00:15:42,080 --> 00:15:43,779 They're always watching me. 390 00:15:43,822 --> 00:15:45,694 There isn't a camera in there, David. 391 00:15:45,737 --> 00:15:47,783 Yeah, I'm pretty sure that there isn't. 392 00:15:47,826 --> 00:15:49,175 But, you know, we're... 393 00:15:49,219 --> 00:15:52,962 We're happy to cover it up if it'll make you more comfortable. 394 00:15:53,005 --> 00:15:54,012 Okay, good. 395 00:15:54,037 --> 00:15:57,158 So why don't I go see what I can scrounge up. 396 00:15:57,183 --> 00:15:59,316 And I have another couple of patients 397 00:15:59,360 --> 00:16:00,796 I need to check in on, but in the meantime, 398 00:16:00,839 --> 00:16:02,319 is there anything else I can get you? 399 00:16:02,363 --> 00:16:03,799 Can I have a Coke? 400 00:16:03,842 --> 00:16:04,843 Absolutely. 401 00:16:06,804 --> 00:16:08,327 Okay, so back in a bit. 402 00:16:08,352 --> 00:16:11,616 And Dr. Cuevas, can I just get a quick word, please? 403 00:16:18,770 --> 00:16:21,295 So with patients experiencing paranoia, 404 00:16:21,338 --> 00:16:24,602 I've found that it's probably not the best idea to push back 405 00:16:24,646 --> 00:16:26,212 too hard on their version of events, 406 00:16:26,256 --> 00:16:28,302 you know, especially at the outset. 407 00:16:28,345 --> 00:16:30,173 There's actually evidence-based research 408 00:16:30,216 --> 00:16:32,088 suggesting the opposite, 409 00:16:32,131 --> 00:16:34,656 that you shouldn't reinforce a patient's delusion. 410 00:16:34,699 --> 00:16:36,310 Instead, you should try to explain to them 411 00:16:36,353 --> 00:16:38,486 why they're experiencing things differently. 412 00:16:38,529 --> 00:16:42,359 I hear you, except that that's pretty much impossible if you haven't 413 00:16:42,403 --> 00:16:44,230 first established trust. 414 00:16:44,274 --> 00:16:47,712 But very glad to hear that you are keeping up on the literature. 415 00:16:47,756 --> 00:16:49,323 Way to go. 416 00:16:54,900 --> 00:16:57,163 Ooh, got Choi as your advisor. 417 00:16:57,418 --> 00:16:59,543 Luck really isn't on your side. 418 00:16:59,568 --> 00:17:00,714 Why? 419 00:17:00,739 --> 00:17:02,354 He's been really cool with me. 420 00:17:02,379 --> 00:17:04,163 Yeah, well, I wouldn't get too comfortable. 421 00:17:04,207 --> 00:17:06,383 Word is, he's a real hard-ass. 422 00:17:06,427 --> 00:17:08,472 Got his last resident fired. 423 00:17:13,434 --> 00:17:15,305 Olga, what are you doing down here? 424 00:17:15,349 --> 00:17:16,698 I was gonna ask you the same thing. 425 00:17:16,741 --> 00:17:19,048 - I assumed you were out today. - Why's that? 426 00:17:19,091 --> 00:17:22,268 Oh, well, Dr. Choi asked me to ultrasound his pregnant patient. 427 00:17:25,141 --> 00:17:27,361 I don't understand. Why would he ask you? 428 00:17:27,404 --> 00:17:29,058 I cover the ED. 429 00:17:33,454 --> 00:17:35,456 So do you have a question about my qualifications 430 00:17:35,499 --> 00:17:37,414 - or something? - Of course not, Hannah. 431 00:17:37,458 --> 00:17:39,460 Then why would you ask another obstetrician 432 00:17:39,503 --> 00:17:41,879 to do an ultrasound in the ED when I'm here? 433 00:17:41,904 --> 00:17:43,602 Obviously, you don't trust me. 434 00:17:43,627 --> 00:17:45,030 It's not that. 435 00:17:45,074 --> 00:17:47,206 I... 436 00:17:47,250 --> 00:17:49,426 The patient requested another doctor. 437 00:17:49,470 --> 00:17:53,082 She... she knew about your past. 438 00:17:53,125 --> 00:17:54,388 What? How? 439 00:17:55,676 --> 00:17:57,565 Does she know me personally? 440 00:17:57,608 --> 00:17:58,870 She didn't volunteer that information, 441 00:17:58,914 --> 00:18:00,611 - so I didn't press it. - Fine. 442 00:18:00,655 --> 00:18:02,396 - Forget it. - Hannah. 443 00:18:02,439 --> 00:18:05,950 I'm just so sick of this following me everywhere I go. 444 00:18:05,975 --> 00:18:07,941 No matter how much progress I make, 445 00:18:07,966 --> 00:18:10,491 everyone's still judging me for who I used to be. 446 00:18:15,694 --> 00:18:16,826 Nope. 447 00:18:16,989 --> 00:18:18,600 Medically, it's just too risky. 448 00:18:18,643 --> 00:18:21,081 Chronic hypertension, end-stage renal disease... 449 00:18:21,124 --> 00:18:22,734 The list goes on and on with this patient. 450 00:18:22,778 --> 00:18:24,388 The real kicker is that platelet count. 451 00:18:24,432 --> 00:18:27,217 I'm not touching anyone whose platelet count's below 100k. 452 00:18:27,261 --> 00:18:29,828 Listen, we know that he's not an ideal candidate. 453 00:18:29,872 --> 00:18:31,134 Oh, wait, I almost forgot. 454 00:18:31,178 --> 00:18:33,093 You guys also hacked his back open in the ED, 455 00:18:33,136 --> 00:18:35,182 making a posterior approach impossible. 456 00:18:35,225 --> 00:18:36,618 Should I go on? 457 00:18:36,661 --> 00:18:38,750 Look, I can give you great anterior exposure. 458 00:18:38,794 --> 00:18:40,622 All you have to do is stabilize his spine. 459 00:18:40,665 --> 00:18:42,145 I'll take care of everything else. 460 00:18:42,189 --> 00:18:44,756 Oh, you'd be assisting me on this one? 461 00:18:44,800 --> 00:18:47,629 Wow, way to save your strongest argument for last. 462 00:18:47,672 --> 00:18:50,104 Maybe you're just worried about your stats, Sam. 463 00:18:51,807 --> 00:18:53,738 Send him up to interventional radiology. 464 00:18:53,763 --> 00:18:55,765 Have them inject cement into his fractures. 465 00:18:55,809 --> 00:18:57,724 That'll at least get him sitting up. 466 00:18:57,767 --> 00:18:59,421 But that won't get him walking. 467 00:18:59,465 --> 00:19:02,340 And lack of movement is dangerous in Marcus's condition. 468 00:19:02,365 --> 00:19:04,880 He can develop pressure sores, blood clots, pneumonia. 469 00:19:04,905 --> 00:19:07,298 All preferable to him bleeding out on my table. 470 00:19:13,957 --> 00:19:16,395 We just need to get his platelet count up. 471 00:19:16,438 --> 00:19:17,918 Yeah, it's the only way to get Marcus 472 00:19:17,961 --> 00:19:20,224 healthy enough for surgery and Abrams on board. 473 00:19:20,268 --> 00:19:21,878 All right, I'll... 474 00:19:21,922 --> 00:19:24,446 I'll order a couple of units of platelets, all right? 475 00:19:30,626 --> 00:19:33,760 Patty, any updates on your husband? 476 00:19:33,803 --> 00:19:35,457 Oh, he just went into surgery. 477 00:19:35,501 --> 00:19:37,067 Dr. Archer said it will be a while 478 00:19:37,111 --> 00:19:38,286 before there's any updates. 479 00:19:38,329 --> 00:19:40,288 Okay, well, he's in very good hands. 480 00:19:40,331 --> 00:19:41,985 You can trust me on that. 481 00:19:42,029 --> 00:19:44,597 David, got that Coke you asked for 482 00:19:44,640 --> 00:19:46,599 and some stuff for the vent. 483 00:19:46,642 --> 00:19:49,471 Do you think you might be up for chatting a bit? 484 00:19:52,387 --> 00:19:53,519 You all right, pal? 485 00:19:56,173 --> 00:19:59,394 Trini gave him something just to calm him down. 486 00:19:59,438 --> 00:20:00,526 Huh. 487 00:20:03,354 --> 00:20:06,009 Okay, back in a second. 488 00:20:07,614 --> 00:20:08,950 What did you give him? 489 00:20:08,975 --> 00:20:10,542 6 of risperidone. 490 00:20:10,567 --> 00:20:11,729 What? 491 00:20:11,754 --> 00:20:13,713 Who the hell ordered that? 492 00:20:13,756 --> 00:20:14,933 I did. 493 00:20:23,555 --> 00:20:26,402 He became extremely agitated and was resisting restraints. 494 00:20:26,427 --> 00:20:28,093 Lorazepam worked this morning. 495 00:20:28,118 --> 00:20:29,642 You didn't see how upset he was. 496 00:20:29,685 --> 00:20:30,991 Haldol then. 497 00:20:31,034 --> 00:20:32,906 He was going to tear out his IV. 498 00:20:32,949 --> 00:20:34,298 His mom was freaking out, begging me to do... 499 00:20:34,342 --> 00:20:35,909 Well, you cannot let a family member 500 00:20:35,952 --> 00:20:38,041 pressure you into making a rushed treatment call. 501 00:20:38,085 --> 00:20:41,001 It wasn't rushed. It was necessary. 502 00:20:41,044 --> 00:20:43,133 And besides, the meds will clear his system 503 00:20:43,177 --> 00:20:44,526 by tomorrow morning at the latest. 504 00:20:44,570 --> 00:20:45,875 At which point, we'll be back at square one 505 00:20:45,919 --> 00:20:47,747 with David, if we're lucky, all right? 506 00:20:47,790 --> 00:20:50,358 Any trust established, down the drain. 507 00:20:50,401 --> 00:20:52,534 How about this, in the future, maybe at least page me 508 00:20:52,578 --> 00:20:55,798 before administering a very high dose of antipsychotics 509 00:20:55,842 --> 00:20:58,192 to a patient we're still evaluating? 510 00:20:58,235 --> 00:21:01,369 With all due respect, Dr. Charles, 511 00:21:01,412 --> 00:21:03,676 I am not a trainee. 512 00:21:03,719 --> 00:21:06,766 And 6 milligrams is well within the standard of care, I... 513 00:21:06,809 --> 00:21:08,332 Standard of care, whatever that is, 514 00:21:08,376 --> 00:21:10,596 is not some blanket template you follow 515 00:21:10,639 --> 00:21:13,555 without any regard for the person in front of you 516 00:21:13,599 --> 00:21:14,904 you're supposed to be helping! 517 00:21:27,917 --> 00:21:29,397 Hey, Janet. 518 00:21:29,440 --> 00:21:31,486 I just want to let you know, the nurse will be by soon 519 00:21:31,530 --> 00:21:33,706 to start Marcus' platelet transfusion, okay? 520 00:21:40,539 --> 00:21:42,976 I know it's been a rough day. 521 00:21:43,019 --> 00:21:46,022 More like a rough year. 522 00:21:46,066 --> 00:21:48,721 Lost my husband in January. 523 00:21:48,764 --> 00:21:51,550 I'm so sorry. 524 00:21:51,593 --> 00:21:54,378 Marcus came out from California for the funeral 525 00:21:54,422 --> 00:21:58,600 and just never went home, 526 00:21:58,644 --> 00:22:00,123 moved in with me. 527 00:22:00,167 --> 00:22:01,951 You must really get on. 528 00:22:03,649 --> 00:22:08,567 Never had a choice in the matter. 529 00:22:08,610 --> 00:22:11,395 We're twins, actually. 530 00:22:11,439 --> 00:22:15,617 Marcus was born 45 seconds before me, 531 00:22:15,661 --> 00:22:19,490 but you'd think he was years older, the way he acts. 532 00:22:19,534 --> 00:22:24,161 Seeing him here like this, so fragile... 533 00:22:27,498 --> 00:22:29,718 It's really hard. 534 00:22:38,858 --> 00:22:42,209 I want you to know that, uh, 535 00:22:42,252 --> 00:22:46,184 we're gonna do everything we can for Marcus, I promise. 536 00:22:47,910 --> 00:22:49,129 Okay. 537 00:22:53,655 --> 00:22:55,918 What is it? 538 00:22:55,962 --> 00:22:58,138 I was just looking back in Marcus's history. 539 00:22:58,181 --> 00:23:00,314 His platelets have always been low. 540 00:23:00,357 --> 00:23:01,433 Huh. 541 00:23:01,458 --> 00:23:02,894 Do you think this is chronic? 542 00:23:02,919 --> 00:23:05,773 Some kind of undiagnosed blood disorder, or...? 543 00:23:05,798 --> 00:23:07,843 - ITP would be my guess. - Oh, man. 544 00:23:07,887 --> 00:23:10,367 And if that's the case, a transfusion is not gonna do much. 545 00:23:10,411 --> 00:23:11,804 I mean, his body would just keep chewing up 546 00:23:11,847 --> 00:23:13,327 any new platelets we give him. 547 00:23:13,370 --> 00:23:15,677 Well, unless... 548 00:23:15,721 --> 00:23:17,374 Unless what? 549 00:23:19,159 --> 00:23:22,684 Um, forget it, actually. 550 00:23:22,728 --> 00:23:24,077 I thought I had something. 551 00:23:24,120 --> 00:23:28,559 But let's just hope the transfusion moves the needle a little, okay? 552 00:23:36,524 --> 00:23:39,353 Podiatry incised and drained the toe. 553 00:23:39,396 --> 00:23:42,269 They had to cut the nail out. 554 00:23:42,312 --> 00:23:45,141 I'm not a doctor, but it looks like it's getting worse to me. 555 00:23:45,185 --> 00:23:47,143 Don't worry. I'm on it. 556 00:23:47,187 --> 00:23:48,492 We're gonna get you the medicine you need. 557 00:23:48,536 --> 00:23:52,018 Dr. Halstead, can I speak with you outside? 558 00:23:52,061 --> 00:23:54,716 What's wrong? 559 00:23:54,760 --> 00:23:57,066 Just give us a moment. 560 00:24:02,430 --> 00:24:05,310 We're now completely out of linezolid. 561 00:24:05,335 --> 00:24:07,860 You've gotta be kidding me. 562 00:24:07,903 --> 00:24:12,125 I knew it. I knew source control wasn't gonna cut it. 563 00:24:12,168 --> 00:24:13,779 How soon are we expecting to get it back in stock? 564 00:24:13,822 --> 00:24:15,911 Tomorrow morning, at the earliest. 565 00:24:19,247 --> 00:24:21,118 Order vancomycin. 566 00:24:21,143 --> 00:24:22,348 She's allergic. 567 00:24:22,373 --> 00:24:25,158 I know, all right, but I've got an idea. 568 00:24:29,272 --> 00:24:31,710 Hey, Liza. 569 00:24:33,581 --> 00:24:35,626 So got your labs back, and they look good. 570 00:24:35,670 --> 00:24:38,238 Your white blood count is slightly elevated, 571 00:24:38,281 --> 00:24:40,544 but that's pretty common in pregnancy. 572 00:24:40,588 --> 00:24:43,460 I think we're just looking at a stomach bug. 573 00:24:43,504 --> 00:24:46,159 Makes sense. I can go home then? 574 00:24:46,202 --> 00:24:50,098 Yeah, Dr. Patchefsky sent down a list of OB-GYN referrals, 575 00:24:50,123 --> 00:24:52,473 as well as some genetic testing counselors. 576 00:24:52,687 --> 00:24:54,994 We'll just add those to your discharge. 577 00:24:55,037 --> 00:24:56,909 Genetic testing? 578 00:24:56,952 --> 00:24:58,693 I thought she said the... 579 00:24:58,737 --> 00:25:01,261 The baby looked healthy on the ultrasound. 580 00:25:01,304 --> 00:25:05,098 Genetic testing for hereditary conditions is completely optional. 581 00:25:06,135 --> 00:25:09,791 But the baby's healthy, right? 582 00:25:09,835 --> 00:25:10,966 Yeah. 583 00:25:13,229 --> 00:25:15,057 Hey, listen, if... 584 00:25:15,101 --> 00:25:16,755 Liza, my dear. 585 00:25:18,582 --> 00:25:20,976 I have your discharge paperwork. 586 00:25:25,633 --> 00:25:28,854 I'm not sure I'm following you. 587 00:25:28,897 --> 00:25:32,292 You want to give me a drug I told you almost killed me? 588 00:25:32,335 --> 00:25:34,598 And we'll do everything we can to mitigate the chances 589 00:25:34,642 --> 00:25:36,818 - of another adverse reaction. - How, exactly? 590 00:25:36,862 --> 00:25:39,342 Through a process called desensitizing. 591 00:25:39,386 --> 00:25:41,605 We'll pre-medicate you with steroids and antihistamines 592 00:25:41,649 --> 00:25:44,695 and then administer the vancomycin via a slow IV drip. 593 00:25:44,739 --> 00:25:47,655 And can you promise me that my throat 594 00:25:47,698 --> 00:25:48,874 won't close up again? 595 00:25:48,917 --> 00:25:50,614 I can't promise that, no. 596 00:25:50,658 --> 00:25:53,574 But if you do go into anaphylaxis, we'll have epinephrine at the ready. 597 00:25:53,617 --> 00:25:55,184 Worst case scenario, we might need to intubate, 598 00:25:55,228 --> 00:25:56,838 but that would only be temporary. 599 00:25:56,882 --> 00:25:58,231 Intubate me? No, no. 600 00:25:58,274 --> 00:25:59,623 I'll go to another hospital. 601 00:25:59,667 --> 00:26:01,161 Well, we've called everywhere. 602 00:26:01,186 --> 00:26:02,993 The earliest anyone has linezolid is tomorrow. 603 00:26:03,018 --> 00:26:04,933 So I'll wait. 604 00:26:04,977 --> 00:26:07,327 As you're seeing, MRSA moves fast. 605 00:26:07,370 --> 00:26:08,676 I am afraid if we wait until tomorrow, 606 00:26:08,719 --> 00:26:10,547 it will have already spread to the bone. 607 00:26:10,591 --> 00:26:11,940 You could lose your leg, Indrani. 608 00:26:19,342 --> 00:26:21,344 Give me the vancomycin. 609 00:26:21,369 --> 00:26:22,965 Okay. 610 00:26:26,825 --> 00:26:30,002 Marcus' platelet count rose from 50,000 to 105,000. 611 00:26:30,045 --> 00:26:32,787 - Can you believe it? - That's great. 612 00:26:32,831 --> 00:26:34,528 It's fantastic. 613 00:26:34,571 --> 00:26:36,573 He must not have ITP after all. 614 00:26:36,617 --> 00:26:37,836 Do me a favor. 615 00:26:37,879 --> 00:26:39,838 Show Abrams these updated labs. 616 00:26:39,881 --> 00:26:43,711 I think he'll be more receptive if you deliver them solo. 617 00:26:43,754 --> 00:26:45,887 How could he possibly refuse to operate now? 618 00:26:45,931 --> 00:26:47,671 It's Abrams. 619 00:26:47,715 --> 00:26:49,412 I'll get him on board. 620 00:26:49,456 --> 00:26:53,590 Dr. Choi? We've got a problem. 621 00:26:53,634 --> 00:26:55,897 Liza? 622 00:26:55,941 --> 00:26:56,985 I thought she had left. 623 00:26:57,029 --> 00:26:59,335 I came in to turn over the room, and I found her passed out. 624 00:26:59,379 --> 00:27:01,511 Let's get her back in the bed and up on the monitors. Ready? 625 00:27:01,555 --> 00:27:03,905 One, two, three. 626 00:27:03,949 --> 00:27:06,038 All right. All right. 627 00:27:06,075 --> 00:27:07,909 Liza? Liza, can you hear me? 628 00:27:07,953 --> 00:27:10,042 All right, let's re-start her IV and get a Foley in her. 629 00:27:10,085 --> 00:27:11,217 - Grab OB. - Patchefsky, right? 630 00:27:11,242 --> 00:27:12,255 No, no, no. No time. 631 00:27:12,280 --> 00:27:13,629 - Grab Asher. - Okay. 632 00:27:13,654 --> 00:27:16,048 She's hypotensive. BP 85/43. 633 00:27:16,091 --> 00:27:17,571 Maybe she vasovagaled? 634 00:27:17,614 --> 00:27:19,660 Her white count was more significant than I thought. 635 00:27:22,010 --> 00:27:23,577 Liza. 636 00:27:23,620 --> 00:27:25,884 - You know her? - Yeah, Doris filled me in. 637 00:27:25,927 --> 00:27:28,234 How long had she been experiencing symptoms when she came in? 638 00:27:28,277 --> 00:27:29,496 Less than 24 hours. 639 00:27:29,539 --> 00:27:31,541 And that's self-reported from the patient? 640 00:27:31,585 --> 00:27:32,847 Yeah, why? 641 00:27:36,285 --> 00:27:37,591 Bolus a liter of normal saline. 642 00:27:37,634 --> 00:27:39,071 Hannah, we've been giving her fluids. 643 00:27:39,114 --> 00:27:40,594 Could this be sepsis? 644 00:27:40,637 --> 00:27:42,074 We could start a broad spectrum antibiotic. 645 00:27:42,117 --> 00:27:43,423 Let's just see what this does first. 646 00:27:43,466 --> 00:27:44,946 I don't think we're looking at sepsis. 647 00:27:44,990 --> 00:27:48,950 I think she's hypovolemic from massive volume depletion. 648 00:27:48,994 --> 00:27:53,085 I suspect she's been sick a lot longer than she reported. 649 00:27:53,128 --> 00:27:55,043 BP's starting to come up. 650 00:28:15,769 --> 00:28:18,990 Appreciate you stepping up to the plate on this one, Sam. 651 00:28:19,015 --> 00:28:21,915 His platelets sure turned around fast, didn't they? 652 00:28:21,940 --> 00:28:23,158 Marcus is a fighter. 653 00:28:25,392 --> 00:28:26,916 All right, this is my show. 654 00:28:26,941 --> 00:28:29,226 Once we get to the spine, you follow my lead, understood? 655 00:28:29,251 --> 00:28:30,731 Fair enough. 656 00:28:30,774 --> 00:28:33,473 Mia, start my playlist. 657 00:28:34,996 --> 00:28:37,259 All right, after you. 658 00:28:37,303 --> 00:28:38,434 Scalpel. 659 00:28:51,839 --> 00:28:53,058 Where are we at? 660 00:28:53,101 --> 00:28:55,364 I gave 125 of the methylprednisolone 661 00:28:55,408 --> 00:28:57,323 and 50 of diphenhydramine. 662 00:28:57,366 --> 00:29:00,065 All right, we're ready to start the vancomycin. 663 00:29:00,108 --> 00:29:01,805 Now, we're gonna take it slowly, 664 00:29:01,849 --> 00:29:03,807 gradually increase the dose over time. 665 00:29:03,851 --> 00:29:05,592 Are you ready? 666 00:29:05,635 --> 00:29:07,333 As I'll ever be. 667 00:29:19,910 --> 00:29:22,130 Something doesn't feel right. 668 00:29:22,174 --> 00:29:23,827 - Okay. - Oh, my God. 669 00:29:23,871 --> 00:29:25,742 Oh, my God. My throat... I can't swallow. 670 00:29:25,786 --> 00:29:28,006 Okay, we got you. Nancy, 0.3 of Epi. 671 00:29:28,049 --> 00:29:31,444 I can't... 672 00:29:31,487 --> 00:29:34,186 It takes time to work. Just stay calm. Keep your eyes on me. 673 00:29:37,145 --> 00:29:40,192 Another 0.3 of Epi and another 50 of diphenhydramine. 674 00:29:43,760 --> 00:29:45,675 Mask. 675 00:29:45,719 --> 00:29:47,025 There you go. 676 00:29:52,150 --> 00:29:55,022 Get ready to intubate. 677 00:29:55,294 --> 00:29:56,686 Just a precaution. 678 00:30:11,005 --> 00:30:12,528 I think it's working. 679 00:30:12,572 --> 00:30:15,923 Slow, deep breaths. In through the nose, out through the mouth. 680 00:30:21,132 --> 00:30:22,700 That's it. 681 00:30:30,155 --> 00:30:33,462 So how long have you actually been sick? 682 00:30:33,506 --> 00:30:35,899 This is day six. 683 00:30:35,943 --> 00:30:40,904 Ever since I stopped using. 684 00:30:42,123 --> 00:30:46,867 Did you know that these symptoms are a result of withdrawal? 685 00:30:46,910 --> 00:30:48,956 I figured. 686 00:30:51,480 --> 00:30:54,701 Dr. Asher, if I outed you to your colleagues... 687 00:30:54,744 --> 00:30:56,572 No. 688 00:30:56,616 --> 00:30:57,739 No, you didn't. 689 00:30:57,764 --> 00:31:01,550 Everyone here knows that I'm in recovery. 690 00:31:01,925 --> 00:31:05,451 And you don't have to call me Dr. Asher. 691 00:31:06,495 --> 00:31:10,543 It does feel kind of weird calling you by your last name. 692 00:31:11,979 --> 00:31:14,286 I won't tell anyone in group. 693 00:31:14,329 --> 00:31:16,114 Thank you. 694 00:31:16,157 --> 00:31:20,422 I don't even know if the drugs have cleared my system yet. 695 00:31:20,466 --> 00:31:23,251 I couldn't risk you running a drug test on me, 696 00:31:23,295 --> 00:31:25,645 given everything you know about me. 697 00:31:25,688 --> 00:31:30,302 I just... I don't want anyone taking my baby away. 698 00:31:32,391 --> 00:31:36,395 Well, I commend you for quitting, Liza. 699 00:31:36,438 --> 00:31:38,788 Going cold turkey is really hard. 700 00:31:40,877 --> 00:31:44,142 There are some medications like Suboxone and methadone 701 00:31:44,185 --> 00:31:46,709 that can help curb the cravings. 702 00:31:46,753 --> 00:31:48,755 Those are opiates, right? 703 00:31:48,798 --> 00:31:50,452 Yes. 704 00:31:50,496 --> 00:31:52,759 But when you're medically supervised, 705 00:31:52,802 --> 00:31:55,892 you are allowed to be on them while you're pregnant. 706 00:31:55,936 --> 00:31:57,633 The risk to the fetus is minimal... 707 00:31:57,677 --> 00:31:59,200 No. 708 00:31:59,244 --> 00:32:02,290 If there are any risks, then no. 709 00:32:04,162 --> 00:32:08,209 I probably shot up, 710 00:32:08,253 --> 00:32:11,604 like, a half dozen times during my first trimester. 711 00:32:13,846 --> 00:32:17,581 And still, by some miracle, 712 00:32:17,606 --> 00:32:20,396 the baby seems to be okay. 713 00:32:22,484 --> 00:32:26,488 I can't do anything to jeopardize that. 714 00:32:26,532 --> 00:32:27,981 I won't. 715 00:32:31,885 --> 00:32:33,060 Come in. 716 00:32:39,022 --> 00:32:40,894 I was going to check with Mrs. Sullivan 717 00:32:40,937 --> 00:32:43,201 to see if she would agree to David spending 718 00:32:43,244 --> 00:32:45,942 a couple of nights in the psych ward. 719 00:32:45,986 --> 00:32:48,249 I figure we can talk to him more, 720 00:32:48,293 --> 00:32:52,949 begin to find the correct medication and dosage. 721 00:32:52,993 --> 00:32:56,214 Well, that sounds good, Dr. Cuevas. Thank you. 722 00:32:56,257 --> 00:32:58,825 Oh, and his father is out of surgery. 723 00:32:58,868 --> 00:33:00,261 No complications. 724 00:33:00,305 --> 00:33:04,309 Well, good stuff. I'm glad to... glad to hear too. 725 00:33:09,009 --> 00:33:13,143 I should have spoken to you first before medicating David. 726 00:33:13,187 --> 00:33:15,798 Look, you know it was a chaotic situation, 727 00:33:15,842 --> 00:33:18,975 and I understand that you felt the need to act swiftly. 728 00:33:19,019 --> 00:33:20,200 I do. 729 00:33:20,225 --> 00:33:23,359 I probably did jump to medication too quickly, 730 00:33:23,384 --> 00:33:24,646 if I'm being honest. 731 00:33:27,655 --> 00:33:31,746 I know I rely heavily on the literature 732 00:33:31,771 --> 00:33:34,034 and the standard of care, 733 00:33:34,077 --> 00:33:38,821 but I just don't always feel 734 00:33:38,865 --> 00:33:42,042 like I can trust my own instincts. 735 00:33:45,045 --> 00:33:49,832 I mean, it took me years, years. 736 00:33:49,876 --> 00:33:54,477 And still, I have... I have my days when... you know? 737 00:33:55,316 --> 00:33:58,363 But this, I can promise you, you will get there. 738 00:33:58,406 --> 00:34:01,409 You will. There's not a shred of doubt in my mind. 739 00:34:02,932 --> 00:34:04,194 Trust me on that. 740 00:34:19,976 --> 00:34:22,065 Hey, Janet. 741 00:34:22,499 --> 00:34:24,065 Marcus did great. 742 00:34:27,957 --> 00:34:29,611 I can't thank you both enough. 743 00:34:29,655 --> 00:34:32,092 No need. He's got a long road ahead, 744 00:34:32,135 --> 00:34:36,226 but with physical therapy, I'm confident he'll be back on his feet. 745 00:34:36,270 --> 00:34:37,823 Can... can I see him? 746 00:34:37,848 --> 00:34:39,621 Of course. I'll take you to recovery. 747 00:34:39,665 --> 00:34:42,363 Now, he's just waking up, so he might be a bit groggy, okay? 748 00:34:42,407 --> 00:34:43,625 This way. 749 00:34:48,064 --> 00:34:50,110 Dr. Abrams, I heard the good news. 750 00:34:50,153 --> 00:34:51,459 I really appreciate... 751 00:34:51,503 --> 00:34:53,983 Yeah, you two ever pull a stunt like that again, 752 00:34:54,027 --> 00:34:56,464 I won't keep it to myself. I'll go straight to Goodwin. 753 00:34:56,508 --> 00:34:57,622 Excuse me? 754 00:34:57,647 --> 00:34:59,616 I don't appreciate being conned into surgery 755 00:34:59,641 --> 00:35:01,643 - under false pretenses. - Wait. 756 00:35:01,687 --> 00:35:03,863 I'm sorry, Dr. Abrams. What are you talking about? 757 00:35:07,649 --> 00:35:09,782 My antenna went up when Marcus's platelets 758 00:35:09,825 --> 00:35:11,218 corrected so quickly. 759 00:35:11,261 --> 00:35:13,307 So I had the lab run an anti-platelet antibody test 760 00:35:13,351 --> 00:35:14,569 while we were in surgery. 761 00:35:14,613 --> 00:35:17,224 You might be interested in the results. 762 00:35:21,583 --> 00:35:23,491 - Marcus has ITP. - Mm-hmm. 763 00:35:23,535 --> 00:35:24,971 But this doesn't make any sense. 764 00:35:25,014 --> 00:35:26,494 If Marcus has ITP, the transfusion 765 00:35:26,538 --> 00:35:28,844 - shouldn't have worked. - Correct. 766 00:35:28,888 --> 00:35:31,717 Unless someone gave him a little assistance. 767 00:35:41,383 --> 00:35:44,239 You gave Marcus steroids, didn't you? 768 00:35:44,294 --> 00:35:45,600 And that's why his platelet count went up. 769 00:35:45,644 --> 00:35:47,428 I know steroids can be controversial 770 00:35:47,472 --> 00:35:49,430 - in the surgical settings... - To put it lightly. 771 00:35:49,474 --> 00:35:52,564 You put him at greater risk of post-op infection. 772 00:35:52,607 --> 00:35:56,611 Vanessa, believe me when I tell you, this was our only play. 773 00:35:56,636 --> 00:35:57,941 Our only play? 774 00:35:58,004 --> 00:36:00,572 I was left in the dark. 775 00:36:00,615 --> 00:36:02,269 Look, I didn't want you catching any heat 776 00:36:02,312 --> 00:36:03,792 if things went south, okay? 777 00:36:03,836 --> 00:36:06,099 I have more cover as an attending. 778 00:36:06,142 --> 00:36:07,448 I was trying to protect you. 779 00:36:09,407 --> 00:36:11,060 I do not need your protection. 780 00:36:11,104 --> 00:36:12,279 I need your respect. 781 00:36:12,322 --> 00:36:14,281 Vanessa, of course I respect you. 782 00:36:14,324 --> 00:36:16,457 It does not feel that way right now. 783 00:36:25,248 --> 00:36:27,381 Looking much better, Indrani. 784 00:36:27,425 --> 00:36:29,339 Some techs will be back soon to move you upstairs. 785 00:36:29,383 --> 00:36:31,690 We're gonna keep you on IV vancomycin for a few days 786 00:36:31,733 --> 00:36:34,562 and then switch you over to the oral version. 787 00:36:34,606 --> 00:36:37,565 Dr. Halstead, I can't thank you enough. 788 00:36:37,609 --> 00:36:39,598 I'm just sorry we had to put you through all that. 789 00:36:39,623 --> 00:36:42,247 Oh, it was worth it, believe me. 790 00:36:44,703 --> 00:36:46,574 That's where I'm going to be next month. 791 00:36:48,576 --> 00:36:50,360 I'm adding it to my bucket list. 792 00:36:54,520 --> 00:36:56,105 Would you excuse me for a moment? 793 00:36:56,149 --> 00:36:57,367 Of course. 794 00:36:59,644 --> 00:37:01,516 Ms. Goodwin. 795 00:37:01,541 --> 00:37:04,045 Stop by my office before you leave tonight. 796 00:37:04,070 --> 00:37:05,375 I'd like a word. 797 00:37:07,465 --> 00:37:09,336 Will do. 798 00:37:13,209 --> 00:37:15,864 Dr. Choi, 799 00:37:15,908 --> 00:37:19,433 uh, this is for you. 800 00:37:19,477 --> 00:37:21,108 I saw you were staying on for the night shift, 801 00:37:21,133 --> 00:37:24,003 so I figured you might need a caffeine boost. 802 00:37:24,046 --> 00:37:25,613 Oh, and these are also for you. 803 00:37:25,657 --> 00:37:28,007 It's my CV, in-progress research papers, 804 00:37:28,050 --> 00:37:29,836 and all my case logs to date. 805 00:37:30,664 --> 00:37:32,971 For our first advisor meeting tomorrow. 806 00:37:33,578 --> 00:37:37,922 Ah, well, you are really prepared, Zach. 807 00:37:38,250 --> 00:37:39,758 Will you excuse me? 808 00:37:39,801 --> 00:37:41,716 Yeah, of course. 809 00:37:41,760 --> 00:37:43,718 See you tomorrow. 810 00:37:43,762 --> 00:37:46,025 See you tomorrow. 811 00:37:46,068 --> 00:37:48,375 - Hey. - Hey. 812 00:37:48,418 --> 00:37:50,986 Liza agreed to be admitted overnight for observation. 813 00:37:51,030 --> 00:37:52,901 Good. 814 00:37:52,945 --> 00:37:55,295 She's in withdrawal, I take it. 815 00:37:55,338 --> 00:37:57,210 Don't worry, I won't say anything. 816 00:37:57,253 --> 00:37:59,299 I appreciate that, Ethan. 817 00:37:59,342 --> 00:38:02,389 And while I suspect that the drugs have already cleared her system, 818 00:38:02,432 --> 00:38:04,130 she's terrified someone might report her. 819 00:38:04,173 --> 00:38:08,086 The last thing she needs is to be penalized for seeking care. 820 00:38:09,352 --> 00:38:11,398 Look, you were absolutely right, by the way, 821 00:38:11,441 --> 00:38:13,443 to bring in Dr. Patchefsky. 822 00:38:13,487 --> 00:38:15,315 I never should have given you flack for that. 823 00:38:15,358 --> 00:38:18,318 Look, I know how frustrating it is 824 00:38:18,361 --> 00:38:21,060 to always feel like you're being held 825 00:38:21,103 --> 00:38:23,715 to some former version of yourself. 826 00:38:23,758 --> 00:38:26,413 But on the flip side, because of who you were 827 00:38:26,456 --> 00:38:28,154 and what you went through, 828 00:38:28,197 --> 00:38:29,764 you were able to connect to Liza 829 00:38:29,808 --> 00:38:31,679 in a way no one else could. 830 00:38:33,202 --> 00:38:35,335 Yeah. 831 00:38:35,378 --> 00:38:36,597 I guess that's true. 832 00:38:38,381 --> 00:38:40,601 Maybe it's not always such a bad thing, 833 00:38:40,645 --> 00:38:42,777 having your reputation precede you. 834 00:38:50,742 --> 00:38:52,831 Great work today, Sam. 835 00:38:59,054 --> 00:39:00,229 Goodnight, Dr. Taylor. 836 00:39:05,609 --> 00:39:07,393 Ooh, ouch. 837 00:39:07,672 --> 00:39:12,372 Why, I see you've got yourself quite the fan club. 838 00:39:12,415 --> 00:39:14,374 You know, maybe I was wrong about you. 839 00:39:14,417 --> 00:39:16,942 You might be cut out for island life after all. 840 00:39:21,337 --> 00:39:24,645 So let me get this straight. 841 00:39:24,689 --> 00:39:27,517 You gave the patient an antibiotic 842 00:39:27,561 --> 00:39:29,519 you knew she was allergic to... 843 00:39:29,563 --> 00:39:32,131 Only after I advised her of the potential risks 844 00:39:32,174 --> 00:39:33,872 and with her full consent. 845 00:39:33,915 --> 00:39:36,178 Which, trust me, wouldn't hold up in court 846 00:39:36,222 --> 00:39:38,790 if this thing had gone sideways. 847 00:39:38,833 --> 00:39:40,835 Well, Ms. Goodwin, it wasn't my first choice. 848 00:39:40,879 --> 00:39:43,229 I understand the new protocols got off 849 00:39:43,272 --> 00:39:45,057 to a bit of a rocky start today, but... 850 00:39:45,100 --> 00:39:47,320 They're not working. 851 00:39:47,363 --> 00:39:50,192 I have no doubt they were designed with the best of intentions, 852 00:39:50,236 --> 00:39:52,542 but as your boots on the ground, I have to give it to you straight. 853 00:39:52,586 --> 00:39:54,849 Let me give it to you straight. 854 00:39:54,893 --> 00:39:59,288 These supply chain issues are not gonna resolve anytime soon, 855 00:39:59,332 --> 00:40:02,291 and not for lack of trying on my part. 856 00:40:02,335 --> 00:40:06,687 So as imperfect as these new protocols may be, 857 00:40:06,731 --> 00:40:09,468 we need some sort of semblance 858 00:40:09,493 --> 00:40:12,824 of order in the ED. 859 00:40:12,867 --> 00:40:16,741 I can't have it turning into the Wild West! 860 00:40:18,568 --> 00:40:21,746 Honestly, Ms. Goodwin, I think we're already there. 861 00:40:33,389 --> 00:40:37,389 - Synced and corrected by synk - - www.addic7ed.com - 63852

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