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Would you like to inspect the original subtitles? These are the user uploaded subtitles that are being translated: 1 00:00:01,164 --> 00:00:02,694 Whoa, whoa, whoa, we're live. 2 00:00:02,719 --> 00:00:04,019 Naima? 3 00:00:04,044 --> 00:00:05,320 22-year-old male, 4 00:00:05,345 --> 00:00:07,250 gunshot wound to the abdomen. GCS 15. 5 00:00:07,275 --> 00:00:09,296 - Dr. Choi, GSW! - On it! 6 00:00:09,321 --> 00:00:11,104 - BP, 100 over 50. - Oh, wait a second. 7 00:00:11,129 --> 00:00:12,539 Wait a sec. Whoa. 8 00:00:12,564 --> 00:00:14,580 - Get this one up to surgery. - All right, let's go. 9 00:00:14,605 --> 00:00:16,853 - [groaning, coughing] - Okay, here we go. 10 00:00:17,160 --> 00:00:19,227 - Dr. Choi, you're good? - Good. 11 00:00:19,252 --> 00:00:21,519 All right, Monique... 12 00:00:21,741 --> 00:00:23,931 Seven treatment rooms on the East side, 13 00:00:23,956 --> 00:00:25,823 four trauma bays on the West. 14 00:00:25,848 --> 00:00:28,749 Bays three and four combine to treat gunshot wounds, 15 00:00:28,774 --> 00:00:31,741 a place affectionately known as Baghdad. 16 00:00:32,072 --> 00:00:33,908 4,000 shootings in Chicago. 17 00:00:33,933 --> 00:00:35,610 - Some days, we get... - [yells] 18 00:00:35,635 --> 00:00:36,634 A dozen. 19 00:00:36,659 --> 00:00:39,008 [yelling] 20 00:00:39,600 --> 00:00:43,392 Drug dispensers are in the North and South end of the E.D, 21 00:00:43,417 --> 00:00:46,947 extra gurneys, isolations suites in the ambulance bay. 22 00:00:46,972 --> 00:00:50,643 Uh, Band-Aid, wound dressings, gauze, and extra weaponry 23 00:00:50,668 --> 00:00:52,846 are in the supply closet next to the elevator, 24 00:00:52,871 --> 00:00:55,181 which brings us right here to the command center. 25 00:00:55,206 --> 00:00:57,164 - Deer in the headlights. - Mm-hmm. 26 00:00:57,189 --> 00:00:58,806 - Nursling? - Monique Lawson. 27 00:00:58,831 --> 00:01:01,509 She's got her Pediatric Advanced Life Support certification, 28 00:01:01,534 --> 00:01:04,268 and is doing her E.D. check-off skills training 29 00:01:04,293 --> 00:01:06,066 with yours truly. 30 00:01:06,091 --> 00:01:08,024 Be careful, she bites. 31 00:01:08,049 --> 00:01:10,571 Monique, Doris, move. 32 00:01:11,364 --> 00:01:14,565 I hardly slept last night. [laughs] 33 00:01:14,590 --> 00:01:15,876 I couldn't stop thinking. 34 00:01:15,912 --> 00:01:17,454 I mean, so many people coming in, 35 00:01:17,479 --> 00:01:18,564 horrible injuries. 36 00:01:18,589 --> 00:01:20,548 And this isn't even a busy day. 37 00:01:20,573 --> 00:01:22,532 I just hope I'm up to it. 38 00:01:22,557 --> 00:01:24,352 Quick, nurses' credo? 39 00:01:24,966 --> 00:01:28,377 Uh, cure sometimes, treat often, comfort always. 40 00:01:28,402 --> 00:01:30,517 Uh-uh. Don't kill your patient... 41 00:01:30,542 --> 00:01:32,470 all: Because that's the doctor's job. 42 00:01:32,495 --> 00:01:35,028 - I heard that. - [laughs] 43 00:01:35,053 --> 00:01:36,820 Maggie, what you got for me? 44 00:01:36,845 --> 00:01:38,094 Alzheimer's patient, 45 00:01:38,119 --> 00:01:39,752 here from long-term care facility. 46 00:01:39,777 --> 00:01:42,845 Hypotensive and high fever in Treatment 2. 47 00:01:42,870 --> 00:01:44,322 Any family? Advanced directives? 48 00:01:44,347 --> 00:01:46,447 No, surrogate just passed away, 49 00:01:46,472 --> 00:01:49,155 and no one else was designated, so it's going to be our call. 50 00:01:50,043 --> 00:01:53,793 Okay, and you need to be initiating catheter duty. 51 00:01:53,818 --> 00:01:56,825 Patient in Treatment 6. Have a stab at her. 52 00:02:02,124 --> 00:02:04,991 Wait, we need to page Will. 53 00:02:05,016 --> 00:02:05,975 What is it? 54 00:02:06,000 --> 00:02:08,459 This is Bella Rowan... Dr. Rowan. 55 00:02:08,484 --> 00:02:10,380 She was Will's teacher, his mentor. 56 00:02:10,405 --> 00:02:11,971 Okay. 57 00:02:22,962 --> 00:02:29,478 - Synced and corrected by martythecrazy - - www.addic7ed.com - 58 00:02:34,651 --> 00:02:36,251 Lungs are wet. 59 00:02:39,722 --> 00:02:41,889 Does this hurt, Dr. Rowan? 60 00:02:41,914 --> 00:02:45,165 [laboring exhale] 61 00:02:46,174 --> 00:02:49,385 - Oh... - Okay, all right, all right. 62 00:02:51,484 --> 00:02:53,965 Who are you? 63 00:02:54,924 --> 00:02:56,722 I'm Dr. Halstead. 64 00:02:57,365 --> 00:02:59,397 Oh... 65 00:02:59,501 --> 00:03:02,931 I'm gonna help Dr. Manning here take care of you. 66 00:03:02,956 --> 00:03:05,354 - Is that all right? - Oh, good. 67 00:03:05,379 --> 00:03:08,981 - Okay. - Gotta go. 68 00:03:09,006 --> 00:03:12,182 - Why is that? - Mm, miss my bus. 69 00:03:12,207 --> 00:03:15,571 Oh, where are you going? 70 00:03:17,237 --> 00:03:18,949 What? 71 00:03:19,578 --> 00:03:23,776 [coughing] 72 00:03:25,659 --> 00:03:27,197 Okay, okay, okay... 73 00:03:27,222 --> 00:03:28,955 - [moans] - Tell you what, Dr. Rowan... 74 00:03:28,980 --> 00:03:30,337 [moaning] 75 00:03:31,255 --> 00:03:33,073 We promise to do our best, 76 00:03:33,098 --> 00:03:35,799 to get you out of here so you can catch that bus. 77 00:03:35,824 --> 00:03:38,386 - How's that sound? - Good. 78 00:03:38,411 --> 00:03:39,774 - Good. - Good. 79 00:03:39,799 --> 00:03:42,056 [labored breathing] 80 00:03:42,081 --> 00:03:43,723 All right. 81 00:03:44,910 --> 00:03:47,394 I'll be back to check on you in a few minutes. 82 00:03:52,219 --> 00:03:54,719 I'm pretty sure she's got aspiration pneumonia. 83 00:03:54,744 --> 00:03:56,917 - Yeah. - You start antibiotics? 84 00:03:56,942 --> 00:03:59,827 Vanc and Zosyn, plus Levophed to maintain her pressure. 85 00:03:59,852 --> 00:04:01,088 Metabolic panel, urine analysis, 86 00:04:01,113 --> 00:04:03,410 and blood cultures are all pending. 87 00:04:03,435 --> 00:04:05,248 She's obviously been sick for days. 88 00:04:05,273 --> 00:04:07,139 Why did they wait so long to bring her in? 89 00:04:07,164 --> 00:04:08,323 I'm sorry, Will. 90 00:04:08,348 --> 00:04:11,716 Dr. Halstead, I came as soon as I heard. 91 00:04:11,741 --> 00:04:14,213 I was an O.R. nurse under Dr. Rowan 92 00:04:14,238 --> 00:04:16,090 when I was starting out. 93 00:04:16,115 --> 00:04:17,716 How is she? 94 00:04:17,741 --> 00:04:21,053 Not good, and we're playing catchup. 95 00:04:22,790 --> 00:04:24,970 All right, let's put in a central line 96 00:04:24,995 --> 00:04:26,026 and get a chest X-Ray, 97 00:04:26,051 --> 00:04:27,924 and I wanna keep close tabs on her volume status. 98 00:04:27,950 --> 00:04:29,573 Please, keep me updated every 20 minutes. 99 00:04:29,598 --> 00:04:31,098 Of course. 100 00:04:36,157 --> 00:04:37,956 Hey, we went to Joe's last night. 101 00:04:37,981 --> 00:04:39,881 My sister loves stone crab. 102 00:04:39,906 --> 00:04:41,039 It was nice. 103 00:04:41,071 --> 00:04:41,932 I mean, there were a lot of years 104 00:04:41,958 --> 00:04:42,932 when Claire wasn't speaking to me. 105 00:04:42,957 --> 00:04:45,620 Eh, I'm sure she had very good reason. 106 00:04:45,865 --> 00:04:48,581 Well, she can tell you all about it herself. 107 00:04:48,720 --> 00:04:51,362 - What do you mean? - She wants to meet you. 108 00:04:51,387 --> 00:04:53,187 She wants to have you over for dinner. 109 00:04:53,212 --> 00:04:55,078 By meet, you mean grill? 110 00:04:55,103 --> 00:04:56,962 Make sure I'm worthy of a Rhodes? 111 00:04:56,987 --> 00:04:59,026 No, that's more my father. Claire's not like that. 112 00:04:59,051 --> 00:05:02,469 She's happy if I'm happy, and I'm happy. 113 00:05:03,893 --> 00:05:08,026 I'm not sure if I'm ready to, uh, meet the family. 114 00:05:08,377 --> 00:05:10,344 Morning, Dr. Rhodes. 115 00:05:10,369 --> 00:05:12,477 - Robin... - Leah. 116 00:05:12,502 --> 00:05:15,487 Dr. Bardovi, are you ready for your first coarctation repair? 117 00:05:15,512 --> 00:05:16,682 I've been studying cases all week. 118 00:05:16,707 --> 00:05:17,612 Good. 119 00:05:17,637 --> 00:05:20,003 Course there's nothing like watching the maestro. 120 00:05:20,371 --> 00:05:22,123 [chuckles] 121 00:05:22,918 --> 00:05:26,257 I will catch you at lunch, Maestro. 122 00:05:26,282 --> 00:05:28,057 We'll continue this conversation later. 123 00:05:28,083 --> 00:05:30,183 Let's go. 124 00:05:30,632 --> 00:05:32,384 Patient's 13. 125 00:05:32,409 --> 00:05:34,370 Pretty late to get a coarctation diagnosis. 126 00:05:34,395 --> 00:05:38,182 Uh, his dad's an oil worker. He did a stint in Nigeria. 127 00:05:38,207 --> 00:05:39,840 Nobody there caught it. 128 00:05:40,840 --> 00:05:42,773 Knock, knock? 129 00:05:43,143 --> 00:05:45,543 - Dr. Rhodes. - Mitch, how are you doing? 130 00:05:45,568 --> 00:05:46,690 This is Dr. Bardovi. 131 00:05:46,715 --> 00:05:48,640 She's gonna be assisting me in the surgery. 132 00:05:49,186 --> 00:05:51,483 Brandon, how are we doing this morning, bud? 133 00:05:51,508 --> 00:05:52,753 We are both looking forward to getting on 134 00:05:52,778 --> 00:05:55,375 the other side of this thing. Ain't that right, buddy? 135 00:05:56,007 --> 00:05:58,407 Uh, yeah, sure. 136 00:05:58,682 --> 00:06:01,495 Hey, are you guys gonna have to saw me open to do this? 137 00:06:01,520 --> 00:06:03,651 Yes. Yes, we are. [chuckles] 138 00:06:03,676 --> 00:06:04,956 I'm not scared. 139 00:06:04,981 --> 00:06:08,184 I'm just wondering if Halloran's gonna have a cool scar 140 00:06:08,209 --> 00:06:10,287 after the battle of Madigan. 141 00:06:10,476 --> 00:06:12,937 - Halloran? - It's a character 142 00:06:12,962 --> 00:06:15,167 in some dumb online game that he plays. 143 00:06:15,192 --> 00:06:18,587 Dad, it's not a game. It's fan fiction. 144 00:06:19,145 --> 00:06:20,778 I published a chapter today, 145 00:06:20,803 --> 00:06:23,401 and my followers are gonna wanna know what happens to Halloran 146 00:06:23,426 --> 00:06:25,594 after he slays the High Locust. 147 00:06:26,071 --> 00:06:27,452 That's you. 148 00:06:27,477 --> 00:06:29,393 All right, then. Well, I am honored. 149 00:06:29,418 --> 00:06:33,653 And yes, Halloran's gonna have a pretty gnarly battle scar. 150 00:06:33,683 --> 00:06:34,937 Sweet. 151 00:06:34,962 --> 00:06:38,315 Well, at least one of us isn't nervous. 152 00:06:39,312 --> 00:06:42,362 So, coarctation repair. 153 00:06:42,387 --> 00:06:43,526 It sounds complicated, 154 00:06:43,551 --> 00:06:46,018 but it's actually a relatively simple procedure. 155 00:06:46,043 --> 00:06:48,807 Uh, I'm gonna make an incision in Brandon's left chest. 156 00:06:48,832 --> 00:06:50,814 We'll place him on partial bypass, 157 00:06:50,839 --> 00:06:52,784 and then resect, or cut out, 158 00:06:52,809 --> 00:06:54,385 the narrowed portion of his aorta, 159 00:06:54,410 --> 00:06:55,707 and place a graft. 160 00:06:55,836 --> 00:06:57,627 Now I know all this is a lot, 161 00:06:57,652 --> 00:06:59,319 but any questions, feel free. 162 00:06:59,344 --> 00:07:02,088 Uh, yeah, I was doing some research online, 163 00:07:02,113 --> 00:07:04,341 and it seems that, uh, 164 00:07:04,555 --> 00:07:07,127 Brandon's chicken legs and his puny size 165 00:07:07,152 --> 00:07:09,182 are because of his condition? 166 00:07:09,207 --> 00:07:11,974 I mean, any chance that that'll change? 167 00:07:12,673 --> 00:07:17,646 Uh, obviously, Brandon's health is our primary concern, 168 00:07:17,671 --> 00:07:20,354 uh, but yes, he may grow at a more rapid rate 169 00:07:20,379 --> 00:07:22,667 once the blood flow issue is corrected. 170 00:07:23,159 --> 00:07:26,060 Good. [exhales] Okay. 171 00:07:26,085 --> 00:07:29,245 All right, Brandon, see ya on the battle field. 172 00:07:39,438 --> 00:07:41,420 Dr. Reese? 173 00:07:41,638 --> 00:07:43,588 You didn't answer your page. 174 00:07:44,109 --> 00:07:45,976 Oh, sorry. 175 00:07:46,001 --> 00:07:49,136 I... I was just... 176 00:07:51,265 --> 00:07:53,366 Uh... 177 00:07:58,413 --> 00:08:01,815 When Jason Wheeler jumped, do you think he was scared? 178 00:08:02,678 --> 00:08:04,311 Was... 179 00:08:04,570 --> 00:08:08,530 I mean, was... was he at peace? 180 00:08:10,532 --> 00:08:12,102 Right before he stepped off, 181 00:08:12,127 --> 00:08:14,162 was there a moment of regret? 182 00:08:16,849 --> 00:08:20,667 I just... I just can't stop thinking about him. 183 00:08:23,939 --> 00:08:25,696 Yeah. 184 00:08:26,089 --> 00:08:28,603 But see, I... I don't want to, 185 00:08:28,628 --> 00:08:32,189 and then I feel guilty, because I don't. 186 00:08:33,968 --> 00:08:36,224 The thing about suicide, 187 00:08:36,535 --> 00:08:38,769 it's never really a lone act. 188 00:08:39,671 --> 00:08:42,472 It tends to leave a lot of victims in its wake. 189 00:08:44,332 --> 00:08:48,079 I'd be lying if I said I'd been sleeping too well recently. 190 00:08:51,499 --> 00:08:54,663 But, um... but you and I... 191 00:08:55,614 --> 00:08:57,380 We've got work to do. 192 00:09:00,500 --> 00:09:02,420 Excuse me. 193 00:09:03,077 --> 00:09:05,585 Sean Adams, formal Naval aviator, 194 00:09:05,610 --> 00:09:07,280 now flies for a private charter company. 195 00:09:07,305 --> 00:09:08,813 And he was doing his pre-flight check 196 00:09:08,839 --> 00:09:09,532 and felt faint. 197 00:09:09,557 --> 00:09:12,024 Co-pilot brought him in. Says it's not the first time. 198 00:09:12,049 --> 00:09:14,577 Now I checked Mr. Adams out. Can't find anything wrong. 199 00:09:14,602 --> 00:09:16,402 Probably just dehydrated and overworked. 200 00:09:16,427 --> 00:09:18,000 Says he feels fine and wants to go. 201 00:09:18,025 --> 00:09:19,945 So, um... so why are we here? 202 00:09:20,021 --> 00:09:22,312 Charter company wants a psych evaluation. 203 00:09:22,337 --> 00:09:24,189 Uh-huh. 204 00:09:24,910 --> 00:09:27,678 Co-pilot says he's also been acting different. 205 00:09:27,890 --> 00:09:29,473 Doesn't go out with the boys anymore, 206 00:09:29,498 --> 00:09:31,364 naps a lot, 207 00:09:31,452 --> 00:09:33,319 seems to be low energy. Huh. 208 00:09:33,344 --> 00:09:34,672 Sounds like depression. 209 00:09:34,697 --> 00:09:36,608 - Possibly. - In any case, 210 00:09:36,633 --> 00:09:38,930 the company won't let him fly till you sign off. 211 00:09:38,955 --> 00:09:40,274 Why don't we have a little chat? 212 00:09:40,299 --> 00:09:41,732 Thanks. 213 00:09:43,553 --> 00:09:45,460 Code blue! 214 00:09:46,911 --> 00:09:49,278 Unresponsive two-year-old. Quick, what do we do first? 215 00:09:49,303 --> 00:09:51,290 Check pulse, start compressions. 216 00:09:51,461 --> 00:09:54,385 - There is no pulse. - Compressions at what rate? 217 00:09:54,410 --> 00:09:56,946 - 150 beats per minute. - Good. 218 00:09:56,971 --> 00:09:59,618 You got a team behind you. What's next? 219 00:09:59,643 --> 00:10:01,643 I tell them to start bagging. 220 00:10:01,668 --> 00:10:03,032 Pulse check. 221 00:10:03,057 --> 00:10:05,087 Okay, but there's still no pulse. 222 00:10:05,682 --> 00:10:07,248 Patient's dying. What now? 223 00:10:07,273 --> 00:10:10,303 Use the paddles to do a quick look. 224 00:10:10,650 --> 00:10:12,771 Shows v-fib. She's coding, so? 225 00:10:13,148 --> 00:10:15,701 Need to shock at 4 joules per kilo? 226 00:10:15,726 --> 00:10:18,260 Well, move then. You're losing her. 227 00:10:18,285 --> 00:10:20,248 Charge to 28 joules. 228 00:10:20,273 --> 00:10:21,787 I'm shocking the patient. 229 00:10:21,812 --> 00:10:23,093 Great. 230 00:10:23,230 --> 00:10:24,896 You just killed me. 231 00:10:24,921 --> 00:10:26,483 - I did? - Mm-hmm. 232 00:10:26,508 --> 00:10:28,608 You forgot to yell "clear" before shocking. 233 00:10:28,633 --> 00:10:30,568 Just one of those minor details. 234 00:10:30,593 --> 00:10:33,175 Reset. Let's take it from the top. 235 00:10:33,237 --> 00:10:35,802 Come on. 236 00:10:36,012 --> 00:10:38,247 It just seems like everyone's overreacting. 237 00:10:38,272 --> 00:10:39,576 But you can see their point of view. 238 00:10:39,607 --> 00:10:41,420 I mean, people put their lives in your hands. 239 00:10:41,445 --> 00:10:42,482 And I'm fine. 240 00:10:42,507 --> 00:10:45,443 I've answered your question. I know what today is. 241 00:10:45,468 --> 00:10:47,272 I know where I am. 242 00:10:47,630 --> 00:10:49,945 Aside from lack of energy, 243 00:10:49,970 --> 00:10:53,450 your co-pilot says that at times you seem mildly confused. 244 00:10:53,475 --> 00:10:55,099 I have no idea what he's talking about. 245 00:10:55,124 --> 00:10:56,423 [stammers, laughs] 246 00:10:56,448 --> 00:10:58,282 Maybe he's the one that's confused. 247 00:10:58,441 --> 00:11:01,873 Mr. Adams, I imagine there's a lot of pressure at your job. 248 00:11:02,406 --> 00:11:05,404 I used to land F-14s on an aircraft carrier. 249 00:11:05,429 --> 00:11:07,229 That's pressure. 250 00:11:07,459 --> 00:11:09,500 Have you ever had thoughts of hurting yourself? 251 00:11:09,525 --> 00:11:11,577 What? No. 252 00:11:11,676 --> 00:11:14,217 Let's see here. Are you on any medication? 253 00:11:14,242 --> 00:11:15,408 You mean do I take anything 254 00:11:15,433 --> 00:11:16,725 that might affect my performance? 255 00:11:16,750 --> 00:11:18,260 No. 256 00:11:18,419 --> 00:11:21,431 I take a statin, like 10 million other Americans. 257 00:11:21,610 --> 00:11:24,327 And no, I don't drink, if that's your next question. 258 00:11:24,352 --> 00:11:27,795 All right, Mr. Adams, well, thank you for your time. 259 00:11:34,131 --> 00:11:37,060 Getting, um, a little ahead of yourself. 260 00:11:37,085 --> 00:11:37,757 Don't you think? 261 00:11:37,782 --> 00:11:40,454 Well, he is exhibiting signs of depression, 262 00:11:40,479 --> 00:11:42,669 and there is a high rate of suicide among pilots. 263 00:11:42,694 --> 00:11:43,671 Dr. Reese, trust me, 264 00:11:43,696 --> 00:11:46,908 I understand what's on your mind, but suicidality 265 00:11:46,933 --> 00:11:49,367 should not necessarily be a default diagnosis. 266 00:11:49,401 --> 00:11:50,483 So what do you think? 267 00:11:50,508 --> 00:11:53,146 I think that Mr. Adams is linear, lucid. 268 00:11:53,171 --> 00:11:54,561 I mean, he's certainly not confused. 269 00:11:54,586 --> 00:11:56,300 Are you gonna sign off on him? 270 00:11:56,325 --> 00:11:57,711 Well, I didn't say that. 271 00:11:57,736 --> 00:12:00,136 I mean, I thought he was a little defensive 272 00:12:00,161 --> 00:12:01,761 around the medication issue. 273 00:12:01,786 --> 00:12:03,796 Well, the man has to prove himself to keep his job. 274 00:12:03,821 --> 00:12:05,221 That would make me defensive. 275 00:12:05,246 --> 00:12:07,060 And you know what, that could be all there is to it. 276 00:12:07,085 --> 00:12:10,014 But look, he's a pilot. Let's just take the extra step. 277 00:12:10,039 --> 00:12:12,264 You know, run a tox screen, make sure he's clean. 278 00:12:12,289 --> 00:12:13,688 Okay. 279 00:12:13,713 --> 00:12:16,233 To your point, depressives often self-medicate, 280 00:12:16,258 --> 00:12:19,155 so I'm not ruling out the diagnosis. 281 00:12:21,131 --> 00:12:22,858 Dr. Rowan's LFTs are high, 282 00:12:22,883 --> 00:12:24,545 her creatinine's through the roof. 283 00:12:24,570 --> 00:12:26,270 Kidneys are struggling. 284 00:12:26,295 --> 00:12:27,961 White cell count's high too. 285 00:12:27,986 --> 00:12:31,459 Multiple organ failure and pending respiratory failure. 286 00:12:31,811 --> 00:12:34,721 - We need to intubate her. - What... at her age? 287 00:12:34,746 --> 00:12:36,772 - Nurse! - No, mm, Will... 288 00:12:36,797 --> 00:12:39,631 you know what this means. She might never get off. 289 00:12:39,796 --> 00:12:41,528 What if we bridge her with BiPAP? 290 00:12:41,553 --> 00:12:42,829 That'll take the stress off the lungs, 291 00:12:42,854 --> 00:12:44,132 until the infection cools. 292 00:12:44,157 --> 00:12:45,690 We'd still wind up intubating her, 293 00:12:45,715 --> 00:12:48,282 - and we'd have lost time. - Dr. Halstead... 294 00:12:48,307 --> 00:12:50,959 there's a Mr. Sherwood here from the nursing home. 295 00:12:50,984 --> 00:12:53,577 He wants to know how Dr. Rowan is doing. 296 00:12:53,602 --> 00:12:56,359 I'll be happy to tell him. 297 00:12:57,000 --> 00:12:59,321 Sherwood, is it? 298 00:13:00,265 --> 00:13:02,298 You mind telling me how you and your staff 299 00:13:02,324 --> 00:13:04,162 let a textbook case of aspiration pneumonia 300 00:13:04,187 --> 00:13:05,577 go unattended? 301 00:13:05,823 --> 00:13:08,383 I-I don't think that happened. 302 00:13:08,408 --> 00:13:09,460 You don't? 303 00:13:09,485 --> 00:13:11,740 Then... then how was she allowed to aspirate in the first place? 304 00:13:11,765 --> 00:13:13,832 - Dr. Halstead... - 'cause I... 305 00:13:13,857 --> 00:13:15,498 I visited her every month. 306 00:13:15,523 --> 00:13:16,780 I knew she had trouble swallowing. 307 00:13:16,805 --> 00:13:17,983 Your staff knew she had trouble swallowing. 308 00:13:18,008 --> 00:13:20,072 Okay, I-I promise you I'll look into this. 309 00:13:20,097 --> 00:13:22,802 - I'm sure you will. - Oh, you better. 310 00:13:22,827 --> 00:13:25,826 I mean, that she... that Dr. Rowan should come to this, 311 00:13:25,851 --> 00:13:29,086 all because you denied her the most basic... hey! 312 00:13:29,111 --> 00:13:30,991 Dr. Halstead... 313 00:13:32,522 --> 00:13:35,148 Thank you, Mr. Sherwood. 314 00:13:36,382 --> 00:13:37,859 Will... 315 00:13:37,945 --> 00:13:39,945 They're criminals. 316 00:13:40,698 --> 00:13:43,897 I mean, we should call IDPH, have their license revoked. 317 00:13:50,514 --> 00:13:54,373 You've all achieved something very special today. 318 00:13:54,785 --> 00:13:58,631 Now you're physicians, doctors. 319 00:13:58,878 --> 00:14:01,946 In a few months, you'll begin your residencies, 320 00:14:02,049 --> 00:14:04,640 caring for people in need. 321 00:14:04,753 --> 00:14:08,202 If you take one thing away from me today, 322 00:14:08,227 --> 00:14:10,308 let it be this. 323 00:14:11,698 --> 00:14:15,670 Treat the patient, not the disease. 324 00:14:17,494 --> 00:14:19,897 - Brought you some Vitner's. - Ah... 325 00:14:19,922 --> 00:14:22,487 - Triple cheese. [chuckles] - Thanks. 326 00:14:23,294 --> 00:14:25,128 Dr. Rowan? 327 00:14:27,023 --> 00:14:29,023 I'm really sorry, Will. 328 00:14:29,351 --> 00:14:31,451 - I know how hard it'll be... - No. 329 00:14:31,476 --> 00:14:34,124 No, if we can get her temp down and her sats up, 330 00:14:34,714 --> 00:14:36,542 I think we'll be over the hump. 331 00:14:36,865 --> 00:14:38,545 Hm. 332 00:14:39,160 --> 00:14:40,726 Kay. 333 00:14:44,299 --> 00:14:45,932 I just remember when my grandma got sick, 334 00:14:45,957 --> 00:14:48,053 how tough it was for my mom. 335 00:14:48,161 --> 00:14:51,226 The options, decisions... [chuckles] 336 00:14:51,251 --> 00:14:54,619 Seeing my grandma so ill. 337 00:14:54,644 --> 00:14:57,377 It was awful. 338 00:14:57,402 --> 00:14:59,983 Yeah, I hear what you're saying. 339 00:15:00,560 --> 00:15:03,903 But, Nina, she can beat this. 340 00:15:04,885 --> 00:15:07,266 Dr. Rowan gave me so much. 341 00:15:07,655 --> 00:15:09,852 Getting her through this, 342 00:15:10,317 --> 00:15:12,578 it's the least I can do. 343 00:15:16,343 --> 00:15:18,576 Enter the patient's first and last name, 344 00:15:18,601 --> 00:15:20,555 select an urgency level, 345 00:15:20,580 --> 00:15:23,068 pick your labs, and then hit submit. 346 00:15:23,093 --> 00:15:24,325 Okay. 347 00:15:25,870 --> 00:15:27,176 - Excuse me... - Yep. 348 00:15:27,201 --> 00:15:29,568 I'm looking for my husband, Sean Adams. 349 00:15:29,593 --> 00:15:31,526 He's in Treatment 4. I'll page his doctor. 350 00:15:31,551 --> 00:15:33,183 Thank you. 351 00:15:36,157 --> 00:15:37,790 How's it look? 352 00:15:37,815 --> 00:15:40,085 Systolic's still 50 higher in the arms, 353 00:15:40,110 --> 00:15:42,376 but that's not uncommon right after surgery. 354 00:15:42,400 --> 00:15:44,797 It should come down in the next 24 hours or so. 355 00:15:46,587 --> 00:15:50,623 It looks like Halloran slayed the High Locust after all. 356 00:15:55,014 --> 00:15:58,045 Hey, um, so how much longer 357 00:15:58,070 --> 00:16:00,711 before he's up and running around? 358 00:16:01,314 --> 00:16:02,939 Uh, well, over the next few months, 359 00:16:02,964 --> 00:16:04,523 you should see an increase in energy 360 00:16:04,548 --> 00:16:07,416 and some improvement in muscle development. 361 00:16:07,577 --> 00:16:09,235 Oh, thanks. I can't tell ya. 362 00:16:09,260 --> 00:16:12,311 I've been dreaming about the day I could get out in the yard 363 00:16:12,336 --> 00:16:15,767 and toss a football with my son, like my dad did with me. 364 00:16:15,954 --> 00:16:17,954 Well, hopefully that'll happen. 365 00:16:18,065 --> 00:16:21,199 Right now, why don't you just let him get some rest? 366 00:16:25,801 --> 00:16:28,035 See, Mr. Adams, as part of our evaluation, 367 00:16:28,060 --> 00:16:29,652 we run a toxicology screen, 368 00:16:29,677 --> 00:16:31,920 and I'm happy to say that yours was normal. 369 00:16:32,517 --> 00:16:34,517 I told you I don't take drugs. 370 00:16:34,574 --> 00:16:36,808 However, we did find something else. 371 00:16:36,833 --> 00:16:38,933 - Profound anemia. - Anemia? 372 00:16:38,958 --> 00:16:41,263 It could explain your feeling faint. 373 00:16:41,594 --> 00:16:44,010 Okay, I-I guess I gotta eat more steak. [chuckles] 374 00:16:44,035 --> 00:16:45,669 It's actually more serious than that. 375 00:16:45,694 --> 00:16:46,827 We need to transfuse you 376 00:16:46,852 --> 00:16:48,396 with several units of blood right away. 377 00:16:48,421 --> 00:16:50,018 We also need to find out what's causing it, 378 00:16:50,043 --> 00:16:51,977 so I'd like to admit you for a battery of scans and tests. 379 00:16:52,002 --> 00:16:53,287 Uh-uh, I've got my own doctor. 380 00:16:53,312 --> 00:16:54,623 I'll make an appointment with him. 381 00:16:54,648 --> 00:16:56,576 Mr. Adams, we don't want you to leave in this condition. 382 00:16:56,601 --> 00:16:57,912 - You're not well. - I feel fine. 383 00:16:57,937 --> 00:16:59,365 Sean, are you sure about that? 384 00:16:59,390 --> 00:17:01,289 Yes, and a car ride home 385 00:17:01,314 --> 00:17:03,365 and sleeping in my own bed isn't gonna hurt me. 386 00:17:03,390 --> 00:17:04,889 That may not be true. 387 00:17:04,914 --> 00:17:08,153 I-I emphatically recommend that you take Dr. Choi's advice. 388 00:17:08,238 --> 00:17:09,804 As far as the psych evaluation goes, 389 00:17:09,829 --> 00:17:11,197 am I in the clear? 390 00:17:11,513 --> 00:17:13,943 Well, not listening to your physician 391 00:17:13,968 --> 00:17:15,396 isn't the greatest sign to me. 392 00:17:15,421 --> 00:17:17,489 Well, you're not the only psychiatrist in Chicago. 393 00:17:17,514 --> 00:17:19,091 I'll get a referral from my primary. 394 00:17:19,116 --> 00:17:20,482 - Sean... - Viv, we're going. 395 00:17:20,507 --> 00:17:21,673 Hand me my clothes. 396 00:17:21,698 --> 00:17:23,498 Please get me whatever paperwork I need to sign, 397 00:17:23,523 --> 00:17:24,877 so I can get out of here. 398 00:17:24,902 --> 00:17:26,768 I'll be back shortly. 399 00:17:29,597 --> 00:17:31,160 Something's just not right with him. 400 00:17:31,185 --> 00:17:33,318 - I agree. - But is it physical or mental? 401 00:17:33,343 --> 00:17:34,816 Your guess is as good as mine. 402 00:17:34,841 --> 00:17:37,181 Unfortunately, we have no grounds to hold him. 403 00:17:37,603 --> 00:17:39,603 I'll get the paperwork ready. 404 00:17:43,296 --> 00:17:45,739 Okay, so your patient is in SVT. 405 00:17:45,764 --> 00:17:47,233 What do you do? 406 00:17:47,862 --> 00:17:51,278 Um, cardiovert at 7 joules. 407 00:17:51,303 --> 00:17:52,091 Right. 408 00:17:52,116 --> 00:17:53,912 So she's back in sinus rhythm. What now? 409 00:17:53,937 --> 00:17:55,169 - Check her vitals... - Mm-hmm. 410 00:17:55,194 --> 00:17:57,201 Establish IV access, 411 00:17:57,226 --> 00:17:59,842 provide fluids if her BP drops below 75 systolic. 412 00:17:59,866 --> 00:18:02,934 And? The adenosine? You got a dose? 413 00:18:02,959 --> 00:18:04,392 Um... 414 00:18:05,938 --> 00:18:07,506 Adenosine is scratched out. 415 00:18:07,531 --> 00:18:08,930 Calculate then. 416 00:18:08,955 --> 00:18:10,786 Your patient's gonna revert back to SVT. 417 00:18:10,811 --> 00:18:12,377 - Come on. - Um... 418 00:18:12,402 --> 00:18:13,825 It's a life and death situation here. 419 00:18:13,850 --> 00:18:16,346 6.5 milligrams of adenosine. 420 00:18:16,923 --> 00:18:19,177 ♪ Dum, dum, duh-dum ♪ 421 00:18:19,202 --> 00:18:21,703 ♪ Dum, dum, dum, dum, dum, dum, dum ♪ 422 00:18:21,728 --> 00:18:24,937 It's 0.65, not 6.5. Here. 423 00:18:25,130 --> 00:18:27,505 Oh... [sighs] I'm sorry. 424 00:18:27,530 --> 00:18:28,796 [sighs] 425 00:18:31,326 --> 00:18:35,114 - What happened? - He can't feel his left arm. 426 00:18:35,680 --> 00:18:37,604 All right, left BP is 80 over 30. 427 00:18:37,629 --> 00:18:39,696 Check the right. Sat's at 70. 428 00:18:39,721 --> 00:18:42,193 Hey, Brandon, can you squeeze my hand? 429 00:18:42,466 --> 00:18:44,775 [gasps] No. No, I can't. 430 00:18:44,800 --> 00:18:47,300 - Okay. - Right arm's 150 over 100. 431 00:18:47,325 --> 00:18:48,858 What's... what's going on? 432 00:18:48,883 --> 00:18:51,214 All right, legs are cold. We need a CT angio now! 433 00:18:51,239 --> 00:18:51,958 Got it! 434 00:18:52,139 --> 00:18:54,443 - Dad? - What is happening? 435 00:18:54,468 --> 00:18:56,451 Brandon's not getting blood to his left arm, 436 00:18:56,476 --> 00:18:58,176 but I need a picture of it to see. 437 00:18:58,201 --> 00:19:00,811 It's possible that the graft we put in has become occluded. 438 00:19:00,836 --> 00:19:02,670 Occlud... occluded? What does that mean? 439 00:19:02,695 --> 00:19:04,155 The first surgery may not have worked. 440 00:19:04,180 --> 00:19:05,882 So you have to do it again? 441 00:19:05,907 --> 00:19:09,357 It may be more complicated than that. 442 00:19:16,006 --> 00:19:18,074 She's in v-fib! 443 00:19:20,629 --> 00:19:22,119 Paddles. Start compressions. 444 00:19:22,144 --> 00:19:25,692 - Will, I'll break her ribs. - Charge to 200 joules. 445 00:19:26,223 --> 00:19:27,944 Star compressions now! 446 00:19:27,969 --> 00:19:30,123 Are you sure? I... 447 00:19:30,148 --> 00:19:32,629 - Out of my way. - No, Will. 448 00:19:32,654 --> 00:19:35,091 [valve hissing] 449 00:19:35,996 --> 00:19:38,430 - Are we charged? - 200 joules. 450 00:19:38,455 --> 00:19:40,989 Holding the CPR. Clear. 451 00:19:43,046 --> 00:19:46,215 One milligram of epi, charge to 200 again. 452 00:19:46,978 --> 00:19:49,856 - 200. - All right, clear. 453 00:19:52,225 --> 00:19:54,610 Pulse is good. 454 00:20:13,138 --> 00:20:14,927 Hey. 455 00:20:16,268 --> 00:20:19,661 Dr. Halstead decided to intubate. 456 00:20:23,176 --> 00:20:27,208 You know, this woman is the reason I stayed in nursing. 457 00:20:27,681 --> 00:20:30,215 My first year as an O.R. nurse, 458 00:20:30,240 --> 00:20:32,224 I actually thought about quitting. 459 00:20:32,249 --> 00:20:34,558 - You? - Oh, I had a rough time. 460 00:20:34,583 --> 00:20:35,997 [chuckles] 461 00:20:36,151 --> 00:20:39,833 There was this, um, surgery I scrubbed on. 462 00:20:39,858 --> 00:20:41,762 I think it was a vascular case. 463 00:20:41,787 --> 00:20:44,779 The resident asked for a ten blade scalpel. 464 00:20:45,091 --> 00:20:48,459 It slipped out of my hand, dropped in the incision. 465 00:20:48,484 --> 00:20:51,385 - Oh, my God. - It didn't hurt the patient, 466 00:20:51,410 --> 00:20:55,107 but that resident reamed me out. 467 00:20:55,437 --> 00:20:58,621 Dr. Rowan stepped in, called him out, 468 00:20:58,646 --> 00:21:03,576 said everyone in the O.R. deserved civility. 469 00:21:03,601 --> 00:21:04,771 Everyone. 470 00:21:05,673 --> 00:21:07,934 Bella Rowan. 471 00:21:09,715 --> 00:21:11,951 Wonderful woman. 472 00:21:13,616 --> 00:21:16,209 Extraordinary teacher. 473 00:21:20,544 --> 00:21:22,912 Sean? Sean, oh, my God. 474 00:21:22,937 --> 00:21:26,098 Oh, my God. Uh, help, someone! 475 00:21:26,123 --> 00:21:28,290 Help my husband, please. 476 00:21:28,315 --> 00:21:30,114 Okay, hey, I need a gurney here. 477 00:21:30,139 --> 00:21:31,576 Whoa! Mr. Adams, can you hear me? 478 00:21:31,601 --> 00:21:33,767 - What's wrong with him? - Unresponsive, 479 00:21:33,792 --> 00:21:35,471 has a pulse. Let's get him in a room. 480 00:21:35,496 --> 00:21:37,546 Bring it over here. 481 00:21:37,571 --> 00:21:39,131 [whimpers] 482 00:21:39,156 --> 00:21:41,734 Let's transfer on my count. Ready, one, two, three. 483 00:21:41,759 --> 00:21:42,992 - [grunts] - [whimpers] 484 00:21:43,017 --> 00:21:44,669 - Here we go. - All right, he's not breathing. 485 00:21:44,694 --> 00:21:47,091 Get a laryngoscope and a 7.5 ET tube. 486 00:21:47,116 --> 00:21:49,516 - Sean! - Trauma 1 to prep. 487 00:21:50,129 --> 00:21:52,724 He's totally flaccid. Don't need drugs. 488 00:21:54,297 --> 00:21:56,264 Monique, you start the IV. 489 00:21:56,289 --> 00:21:57,733 Okay. 490 00:21:58,327 --> 00:21:59,787 Sean... 491 00:21:59,812 --> 00:22:01,574 - Okay, you stand right here. - Okay. 492 00:22:01,599 --> 00:22:03,107 He's got a massive upper GI bleed. 493 00:22:03,132 --> 00:22:04,607 His stomach's filling with blood. 494 00:22:04,938 --> 00:22:06,865 I'm in. April, listen to his lungs. 495 00:22:06,890 --> 00:22:08,389 Yep. 496 00:22:11,027 --> 00:22:12,393 Good breath sounds bilaterally. 497 00:22:12,418 --> 00:22:13,428 All right, hang two units of blood 498 00:22:13,461 --> 00:22:15,108 - and get another four ready. - What's going on? 499 00:22:15,132 --> 00:22:16,442 - Why... why is this happening? - I don't know, 500 00:22:16,467 --> 00:22:18,147 but we're gonna find out. 501 00:22:18,576 --> 00:22:20,215 - [valve hissing] - Hang saline. 502 00:22:20,240 --> 00:22:23,068 - Saline's up. - All right, stay on it. 503 00:22:31,267 --> 00:22:33,269 Got your page. 504 00:22:33,536 --> 00:22:35,646 Dr. Rowan's latest labs. 505 00:22:36,568 --> 00:22:38,870 I am so sorry. She's in acute renal failure. 506 00:22:38,895 --> 00:22:41,694 Hyperkalemic and still acidotic. 507 00:22:43,476 --> 00:22:46,667 All right, we'll start her on low flow dialysis. 508 00:22:46,692 --> 00:22:48,468 It should correct her electrolytes and PH. 509 00:22:48,493 --> 00:22:49,753 Will... 510 00:22:50,352 --> 00:22:52,329 I won't stand by and let her die. 511 00:22:54,885 --> 00:22:56,852 Tell April to call renal. 512 00:22:59,386 --> 00:23:01,097 [sighs] 513 00:23:03,367 --> 00:23:06,652 Graft occlusion is a possible outcome of any vascular surgery. 514 00:23:06,677 --> 00:23:08,471 It's nobody's fault. 515 00:23:08,842 --> 00:23:10,814 Okay, so there are two options, right? 516 00:23:10,839 --> 00:23:13,934 - We could either... - Just let me handle this, okay? 517 00:23:15,784 --> 00:23:17,916 Mitch, a moment? 518 00:23:17,941 --> 00:23:19,474 Uh... 519 00:23:22,048 --> 00:23:23,903 What is it? 520 00:23:24,393 --> 00:23:26,430 So the CT revealed that the graft 521 00:23:26,454 --> 00:23:28,174 I placed in Brandon's chest kinked, 522 00:23:28,199 --> 00:23:29,892 causing re-coarctation, 523 00:23:29,917 --> 00:23:33,768 or essentially a, uh... A narrowing of his aorta. 524 00:23:33,793 --> 00:23:35,582 Like before? 525 00:23:36,249 --> 00:23:37,982 I'm sorry. 526 00:23:38,203 --> 00:23:41,904 So... so what? We're just back at square one? 527 00:23:41,929 --> 00:23:45,423 Yes, but this time, things are more complicated. 528 00:23:45,610 --> 00:23:47,893 Now I can repair the graft by placing a stent, 529 00:23:47,918 --> 00:23:49,430 and we would do that in the cath lab. 530 00:23:49,869 --> 00:23:51,449 But the stent will cover 531 00:23:51,474 --> 00:23:54,433 the opening of his left subclavian artery. 532 00:23:54,877 --> 00:23:58,270 That will cut off circulation to his left arm, 533 00:23:59,023 --> 00:24:02,274 meaning Brandon will lose that arm. 534 00:24:03,098 --> 00:24:06,111 - Lose his arm? - Mm-hmm. 535 00:24:12,002 --> 00:24:13,869 Uh, no. 536 00:24:13,894 --> 00:24:17,269 No... [stammers]... he can't. He can't. 537 00:24:17,294 --> 00:24:19,708 It... there must be something else you can do. 538 00:24:21,131 --> 00:24:23,045 I'm sorry, but no. 539 00:24:23,231 --> 00:24:25,714 I'm afraid this is our only viable option. 540 00:24:27,712 --> 00:24:30,025 Oh, God. 541 00:24:30,860 --> 00:24:31,992 Hey, look, Mitch, 542 00:24:32,017 --> 00:24:34,084 why don't you go be with your son, okay? 543 00:24:34,109 --> 00:24:36,350 We'll take him up to surgery soon. 544 00:24:36,672 --> 00:24:38,172 I'm very sorry. 545 00:24:39,691 --> 00:24:41,588 [sighs] 546 00:24:42,719 --> 00:24:44,419 Pardon me, Dr. Rhodes. 547 00:24:44,444 --> 00:24:46,080 I know you must've had a very good reason, 548 00:24:46,105 --> 00:24:48,206 but you didn't present the other option, 549 00:24:48,231 --> 00:24:49,853 the carotid subclavian bypass. 550 00:24:49,878 --> 00:24:52,268 Wouldn't that preserve Brandon's arm? 551 00:24:52,293 --> 00:24:55,595 Dr. Bardovi, 20 to 30% of young patients 552 00:24:55,620 --> 00:24:57,987 will stroke out and possibly die 553 00:24:58,012 --> 00:24:59,456 when you clamp their carotid. 554 00:24:59,481 --> 00:25:00,673 It's too big of a risk. Okay, but still- 555 00:25:00,698 --> 00:25:03,265 It's too big of a risk. 556 00:25:10,337 --> 00:25:12,553 What was that all about? 557 00:25:13,682 --> 00:25:16,750 Look, this boy's father... I know the type. 558 00:25:16,775 --> 00:25:18,051 I grew up with one. 559 00:25:18,076 --> 00:25:20,087 He wants his son to be something he isn't. 560 00:25:20,112 --> 00:25:23,150 He'll choose the bypass. It's too dangerous. 561 00:25:23,190 --> 00:25:25,523 But it's his decision, not yours. 562 00:25:25,626 --> 00:25:27,430 I already opened Brandon up once. 563 00:25:27,455 --> 00:25:28,290 I'm not gonna do it again. 564 00:25:28,315 --> 00:25:29,580 I'm not gonna risk this boy's life 565 00:25:29,605 --> 00:25:31,472 just to save his arm. 566 00:25:33,176 --> 00:25:36,165 [sighs] 567 00:25:42,052 --> 00:25:43,586 Huge gastric ulcer. 568 00:25:43,611 --> 00:25:45,279 That's where all the blood was coming from. 569 00:25:45,304 --> 00:25:46,490 Were you able to stop the bleeding? 570 00:25:46,515 --> 00:25:49,286 Yeah, GI cauterized it, but that's not the headline. 571 00:25:49,467 --> 00:25:53,238 Sean's endoscopy shows chronic caustic esophageal erosions. 572 00:25:53,730 --> 00:25:55,559 And his chest X-Ray... 573 00:25:55,683 --> 00:25:58,418 - Pneumonitis. - Yeah. 574 00:25:58,498 --> 00:26:00,121 This is a pattern suggestive of ingesting 575 00:26:00,146 --> 00:26:02,106 some sort of hydrocarbon. 576 00:26:02,350 --> 00:26:04,028 Isn't that in cleaning products? 577 00:26:04,053 --> 00:26:07,021 And lighter fluid, motor oil, gasoline. 578 00:26:07,217 --> 00:26:09,816 Extremely toxic, so we must be talking about 579 00:26:09,996 --> 00:26:12,053 low doses over a long period of time. 580 00:26:12,078 --> 00:26:13,377 So I was right. 581 00:26:13,402 --> 00:26:14,945 We should be concerned he's suicidal. 582 00:26:14,970 --> 00:26:16,674 Why assume he's doing this to himself? 583 00:26:16,676 --> 00:26:19,327 Well, what, you think someone's poisoning him? 584 00:26:19,352 --> 00:26:20,933 I don't know. It's possible. 585 00:26:20,958 --> 00:26:22,581 I had a case where a wife was slipping something 586 00:26:22,606 --> 00:26:23,865 into her husband's food. 587 00:26:23,890 --> 00:26:25,488 So you think it's his wife? 588 00:26:26,199 --> 00:26:28,510 You know, hydrocarbons are extremely noxious, 589 00:26:28,535 --> 00:26:31,090 - so he would've smelled it. - Not necessarily. 590 00:26:31,205 --> 00:26:32,979 They're all over any aircraft hanger. 591 00:26:33,004 --> 00:26:34,949 With constant exposure, he could be nose blind. 592 00:26:34,974 --> 00:26:37,254 I don't know. Suicide? 593 00:26:37,279 --> 00:26:38,847 Attempted murder? 594 00:26:39,173 --> 00:26:41,707 I think it might be something else altogether. 595 00:26:52,791 --> 00:26:55,814 I just checked in on Dr. Rowan. 596 00:26:56,066 --> 00:26:58,369 I heard you ordered dialysis. 597 00:26:58,580 --> 00:27:00,148 She's in renal failure. 598 00:27:00,173 --> 00:27:01,406 That's the appropriate treatment. 599 00:27:01,431 --> 00:27:04,498 I understand the medicine, doctor. 600 00:27:05,678 --> 00:27:08,602 - Even if you dialyze her... - I am. 601 00:27:08,627 --> 00:27:10,384 Even if you dialyze her, 602 00:27:10,409 --> 00:27:13,043 she's unlikely to come off the vent. 603 00:27:13,068 --> 00:27:15,509 That means she'll be bedridden. 604 00:27:15,613 --> 00:27:18,790 Eventually, she'll need a tracheostomy. 605 00:27:21,363 --> 00:27:23,781 You've already broken her ribs. 606 00:27:24,668 --> 00:27:28,257 Now she'll have bed sores, a feeding tube. 607 00:27:29,835 --> 00:27:35,487 Shouldn't quality of life be a consideration? 608 00:27:52,972 --> 00:27:55,781 I mean, remember that ballplayer I told you about? 609 00:27:55,806 --> 00:27:59,178 He was a pitcher with one arm. He was one of the best. 610 00:27:59,508 --> 00:28:03,413 All right, so, you know, be strong. 611 00:28:03,438 --> 00:28:05,226 We can do this. 612 00:28:05,251 --> 00:28:07,895 I mean, the important thing is that you're gonna be alive. 613 00:28:07,920 --> 00:28:09,563 And healthy. 614 00:28:10,848 --> 00:28:14,317 We'll figure out the rest, okay? Together. 615 00:28:15,973 --> 00:28:17,758 - Mitch... - Yeah. 616 00:28:17,783 --> 00:28:19,490 Guys, if you can hold on for a second. 617 00:28:19,515 --> 00:28:22,633 - Have a word with you? - Okay, buddy. 618 00:28:25,788 --> 00:28:28,415 So, I've been thinking about Brandon's case, 619 00:28:28,824 --> 00:28:32,419 and there is something else we can try. 620 00:28:34,627 --> 00:28:37,084 - [device whirs] - Wrong angle. 621 00:28:37,109 --> 00:28:40,038 You need to go in perpendicular, or you'll stay in the cortex. 622 00:28:40,063 --> 00:28:41,874 Okay. 623 00:28:42,813 --> 00:28:45,557 [device whirring] 624 00:28:45,993 --> 00:28:47,293 You're too shallow. 625 00:28:47,318 --> 00:28:50,312 You need to keep on drilling until you hub the needle. 626 00:28:54,623 --> 00:28:56,423 Not like that. 627 00:28:56,729 --> 00:28:58,811 Who taught her how to do an IO? An orangutan? 628 00:28:58,836 --> 00:29:01,281 Okay. She'll get there. 629 00:29:02,545 --> 00:29:05,869 We've all gone through this. Just take it slowly. 630 00:29:07,179 --> 00:29:09,039 Go ahead. 631 00:29:10,040 --> 00:29:13,168 [device whirs] 632 00:29:14,111 --> 00:29:15,610 There you go. 633 00:29:23,320 --> 00:29:26,557 White board says carotid subclavian bypass. 634 00:29:26,993 --> 00:29:28,560 It's just, I thought... 635 00:29:28,585 --> 00:29:31,007 I presented both options to the patient's father. 636 00:29:31,281 --> 00:29:35,148 As I suspected, he chose the carotid subclavian bypass. 637 00:29:35,625 --> 00:29:38,092 And you're gonna do a great job, Dr. Rhodes. 638 00:29:38,250 --> 00:29:40,092 You're an exceptional surgeon, and it is an honor to be... 639 00:29:40,117 --> 00:29:42,156 Dr. Bardovi, you don't have to do that. 640 00:29:43,512 --> 00:29:45,450 You're a fine surgeon, 641 00:29:45,904 --> 00:29:48,507 and trust me, I'm a less than perfect teacher. 642 00:29:54,119 --> 00:29:57,337 Mr. Adams, can I ask you, um... 643 00:29:58,031 --> 00:30:00,362 You ever find yourself doing something 644 00:30:00,387 --> 00:30:02,273 that you know you shouldn't, 645 00:30:02,391 --> 00:30:04,303 but you just can't stop? 646 00:30:04,852 --> 00:30:07,281 I have no idea what you're talking about. 647 00:30:07,306 --> 00:30:09,006 [chuckles] 648 00:30:09,277 --> 00:30:12,177 My wife would say that I... I watch too much football. 649 00:30:12,202 --> 00:30:13,937 [chuckles] 650 00:30:14,032 --> 00:30:16,599 Can I tell you my dirty little secret? 651 00:30:16,773 --> 00:30:17,975 I went through this phase 652 00:30:18,000 --> 00:30:20,742 where I would come home every night, 653 00:30:21,391 --> 00:30:25,125 cut my nails every night, like down to the quick. 654 00:30:25,801 --> 00:30:27,768 Hm, couldn't stop. 655 00:30:27,950 --> 00:30:32,085 On some level, I must've been satisfying some urge, 656 00:30:32,110 --> 00:30:34,562 but my hands were bleeding. 657 00:30:34,786 --> 00:30:36,652 [stammers] 658 00:30:36,677 --> 00:30:38,195 It wasn't good. 659 00:30:38,368 --> 00:30:39,900 And the point of this? 660 00:30:39,925 --> 00:30:43,094 The point is that I understand compulsive behavior. 661 00:30:43,887 --> 00:30:46,037 You know, it's not rational. You can't explain it. 662 00:30:46,062 --> 00:30:48,382 You just... you just do it. 663 00:30:49,417 --> 00:30:51,430 Yeah, but eventually, 664 00:30:52,043 --> 00:30:55,257 like with me, your fingers bleed, 665 00:30:55,465 --> 00:30:57,226 or something similar. 666 00:30:57,774 --> 00:31:01,094 And it just starts to... To cost you too much, 667 00:31:01,549 --> 00:31:03,383 and you wanna stop. 668 00:31:04,027 --> 00:31:07,156 I mean, you realize that it's interfering with your life, 669 00:31:07,181 --> 00:31:10,375 and you... you just really, really wanna stop. 670 00:31:13,007 --> 00:31:15,390 Sean, I think you have a compulsion, 671 00:31:15,415 --> 00:31:18,783 and you're tired, 672 00:31:18,808 --> 00:31:20,820 and you're also getting scared. 673 00:31:20,856 --> 00:31:22,046 I mean, who wouldn't be scared? 674 00:31:22,071 --> 00:31:25,342 All that... all that blood? All that vomiting? 675 00:31:35,058 --> 00:31:36,552 Yes. 676 00:31:39,411 --> 00:31:41,177 I'm tired. 677 00:31:46,883 --> 00:31:48,557 Mr. Adams, we think you're ingesting 678 00:31:48,582 --> 00:31:51,076 something very harmful. 679 00:31:52,062 --> 00:31:53,762 Can you tell us what it is? 680 00:31:58,194 --> 00:32:01,775 Mr. Adams, please, we can help you. 681 00:32:06,546 --> 00:32:08,144 Gasoline. 682 00:32:08,169 --> 00:32:10,139 I'm sorry? Say again? 683 00:32:13,441 --> 00:32:15,267 I drank gasoline. 684 00:32:25,059 --> 00:32:27,724 Is my husband crazy? 685 00:32:28,911 --> 00:32:31,676 Why would anyone drink gasoline? 686 00:32:31,701 --> 00:32:34,317 I know it's very difficult to fathom, 687 00:32:34,591 --> 00:32:37,441 but I'm quite sure that your husband is suffering from 688 00:32:37,466 --> 00:32:40,364 a psychiatric disorder known as Pica, 689 00:32:40,740 --> 00:32:45,090 which involves the compulsive consumption of non-nutritive, 690 00:32:45,115 --> 00:32:48,052 and sometimes even hazardous, substances. 691 00:32:48,356 --> 00:32:50,456 For some, it's paint chips. 692 00:32:50,544 --> 00:32:52,720 For others, dirt. 693 00:32:53,208 --> 00:32:55,557 For your husband, it's gasoline. 694 00:32:55,829 --> 00:32:57,462 Why? 695 00:32:57,487 --> 00:33:00,567 There's no unified theory as to the cause. 696 00:33:00,702 --> 00:33:03,737 All we know is that it manifests itself as a compulsion, 697 00:33:03,762 --> 00:33:07,841 an irresistible urge, against one's conscious wishes. 698 00:33:08,059 --> 00:33:10,572 [sighs] Can he stop? 699 00:33:10,597 --> 00:33:12,630 Probably not on his own, 700 00:33:12,655 --> 00:33:15,122 but if he'll allow us, we can help him. 701 00:33:15,797 --> 00:33:17,443 Okay. 702 00:33:18,084 --> 00:33:20,817 We'll do whatever it takes to get him healthy. 703 00:33:21,507 --> 00:33:23,808 Before we discuss the course of psychotherapy, 704 00:33:23,833 --> 00:33:25,287 I'd like to talk to you and your husband 705 00:33:25,312 --> 00:33:26,536 about repairing the physical damage. 706 00:33:26,561 --> 00:33:27,958 - Of course. - Thanks. 707 00:33:27,983 --> 00:33:29,516 Yes. 708 00:33:32,812 --> 00:33:35,054 He could've killed himself. 709 00:33:36,374 --> 00:33:38,392 Sometimes we get a win, right? 710 00:33:38,771 --> 00:33:40,975 Sometimes we get a win. 711 00:33:41,345 --> 00:33:44,689 If you take one thing away from me today, 712 00:33:44,714 --> 00:33:46,741 let it be this: 713 00:33:47,574 --> 00:33:51,642 treat the patient, not the disease. 714 00:34:20,812 --> 00:34:22,678 Good. You haven't started. 715 00:34:22,703 --> 00:34:24,937 Just finished the line. Why? 716 00:34:25,710 --> 00:34:28,796 You were right. We shouldn't do this. 717 00:34:29,332 --> 00:34:30,773 What changed your mind? 718 00:34:30,798 --> 00:34:33,321 Treat the patient, not the disease. 719 00:34:35,797 --> 00:34:38,578 Our patient wouldn't have wanted this. 720 00:34:39,272 --> 00:34:41,175 April, 10 milligrams of morphine, 721 00:34:41,200 --> 00:34:42,956 and hang a drip, please. 722 00:34:48,055 --> 00:34:49,921 Dr. Rowan... 723 00:34:50,816 --> 00:34:52,924 I'm going to extubate you. 724 00:34:53,751 --> 00:34:56,136 I promise you won't feel any pain. 725 00:34:59,498 --> 00:35:02,391 I'll let you two be alone with her now. 726 00:35:21,396 --> 00:35:24,464 [coughing] 727 00:35:53,907 --> 00:35:56,348 Okay, going to start the carotid anastomosis. 728 00:35:56,373 --> 00:35:58,115 Everybody get ready. 729 00:35:58,232 --> 00:36:00,332 We're going to clamp the left carotid. 730 00:36:00,357 --> 00:36:03,239 Carla, tell me if you see any change on the EEG. 731 00:36:03,264 --> 00:36:04,746 Right. 732 00:36:05,282 --> 00:36:07,911 Peripheral cross clamp times two? 733 00:36:23,368 --> 00:36:26,386 - Carotid is cross-clamped. - Brain waves look good. 734 00:36:26,864 --> 00:36:30,901 Okay, eleven blade, followed by 5-0 prolene. 735 00:36:40,747 --> 00:36:43,243 Let's sew this graft in quickly. 736 00:36:44,128 --> 00:36:46,362 Brain waves flattening on the right. 737 00:36:46,387 --> 00:36:48,547 He's impending infarct. 738 00:36:49,723 --> 00:36:52,924 We only have four minutes of hypoxia before deficits occur. 739 00:36:52,949 --> 00:36:54,428 Do we unclamp him? 740 00:36:54,453 --> 00:36:56,286 We can still call this off and take him to the cath lab. 741 00:36:56,311 --> 00:36:58,216 It's safer. 742 00:36:58,638 --> 00:37:00,245 Dr. Rhodes... 743 00:37:00,270 --> 00:37:03,721 No. This kid's not losing his arm. 744 00:37:05,779 --> 00:37:07,345 Coming around the front wall now. 745 00:37:07,370 --> 00:37:09,737 Left side brain's 50, right side's 70. 746 00:37:09,762 --> 00:37:13,606 Dr. Bardovi, follow me. Eyes on the field. 747 00:37:14,282 --> 00:37:16,208 Dr. Rhodes, you need to get those clamps off. 748 00:37:16,240 --> 00:37:18,571 Thank you, Marty, I'm almost there. 749 00:37:20,856 --> 00:37:23,657 Left side's 30, right side's 50. 750 00:37:26,952 --> 00:37:30,123 Okay, done. 751 00:37:30,148 --> 00:37:32,292 Coming off cross clamp. 752 00:37:33,369 --> 00:37:35,569 Cross clamps are off. 753 00:37:35,594 --> 00:37:37,761 I've reestablished flow. 754 00:37:39,553 --> 00:37:41,886 EEG is normalizing. 755 00:37:43,244 --> 00:37:45,555 You have a good wave pattern. 756 00:37:45,797 --> 00:37:47,677 He's good. 757 00:37:48,235 --> 00:37:49,802 Nice work, Dr. Rhodes. 758 00:37:49,875 --> 00:37:52,943 Okay, everyone, let's get set up for the stent. 759 00:37:56,430 --> 00:37:57,929 - Good night. - Good night. 760 00:37:57,954 --> 00:38:00,402 How could you do this to us? 761 00:38:00,778 --> 00:38:04,177 - Uh, excuse me? - My husband told me. 762 00:38:04,856 --> 00:38:06,660 He'll lose his pilot's license. 763 00:38:06,685 --> 00:38:08,373 We'll lose everything. 764 00:38:08,398 --> 00:38:11,065 I'm very sorry. Uh, I had no choice. 765 00:38:11,090 --> 00:38:14,000 I am legally obligated to report him. 766 00:38:14,253 --> 00:38:16,096 It's his life. 767 00:38:24,941 --> 00:38:27,222 I called the FAA. I had to. 768 00:38:27,642 --> 00:38:31,010 Every time he gets on a plane, he puts his own life 769 00:38:31,035 --> 00:38:33,474 and the lives of all of his passengers at risk. 770 00:38:34,970 --> 00:38:37,169 I know this wasn't, um, 771 00:38:37,868 --> 00:38:40,263 necessarily the win that you were looking for, 772 00:38:40,288 --> 00:38:43,446 but at least we saved a man's life. 773 00:38:44,383 --> 00:38:46,250 See you in the morning? 774 00:39:03,084 --> 00:39:05,472 I heard the surgery went well. 775 00:39:06,158 --> 00:39:07,862 Yeah, thankfully. 776 00:39:07,887 --> 00:39:09,853 [chuckles] 777 00:39:09,878 --> 00:39:12,417 Yeah, don't worry, I won't tell anyone. 778 00:39:12,774 --> 00:39:15,792 - Tell 'em what? - Mm, that you were scared. 779 00:39:15,821 --> 00:39:17,503 Oh, that's what you think, huh? 780 00:39:17,528 --> 00:39:19,190 Yeah. 781 00:39:19,985 --> 00:39:23,861 [sighs] Man, you're definitely a Charles. 782 00:39:24,047 --> 00:39:26,463 - You're very perceptive. - Hm. 783 00:39:29,032 --> 00:39:30,832 I was after that first time. 784 00:39:30,857 --> 00:39:31,990 I was... I was afraid. 785 00:39:32,015 --> 00:39:33,913 I was afraid I was gonna lose him. 786 00:39:34,429 --> 00:39:35,762 [soft exhale] 787 00:39:35,787 --> 00:39:38,839 I have fears of my own, you know. 788 00:39:39,254 --> 00:39:42,144 - Cholera? Typhus? - [chuckles] Yeah. 789 00:39:42,169 --> 00:39:44,799 And relationships. [chuckles] 790 00:39:45,658 --> 00:39:48,612 There are a lot of pitfalls in dating a surgeon. 791 00:39:48,785 --> 00:39:51,815 It's crazy hours, stress of the job... 792 00:39:51,840 --> 00:39:55,081 Great case, Dr. Rhodes. Very impressive. 793 00:39:55,309 --> 00:39:58,104 And thanks for the vote of confidence. 794 00:40:00,165 --> 00:40:03,371 Fawning women falling at your feet. 795 00:40:03,872 --> 00:40:06,205 Yeah, I don't know if I can compete with all of that. 796 00:40:06,230 --> 00:40:07,401 [laughs] 797 00:40:07,706 --> 00:40:09,950 You don't have to compete. 798 00:40:10,450 --> 00:40:12,317 I'm all in. 799 00:40:18,957 --> 00:40:22,525 So your sister... 800 00:40:22,550 --> 00:40:24,756 [both laugh] 801 00:40:25,133 --> 00:40:28,326 Let's see, is she a red or white wine drinker? 802 00:40:28,351 --> 00:40:30,351 Mm, white. 803 00:40:30,376 --> 00:40:33,222 Not Chardonnay. Uh, Sauvignon Blanc. 804 00:40:37,401 --> 00:40:40,506 - Will? - [sniffles] 805 00:40:40,936 --> 00:40:42,648 Hey. 806 00:40:44,414 --> 00:40:49,118 I'm... I'm so sorry for your loss. 807 00:40:56,899 --> 00:40:59,999 [sobbing] 808 00:41:16,570 --> 00:41:22,827 - Synced and corrected by martythecrazy - - www.addic7ed.com - 58173

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