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These are the user uploaded subtitles that are being translated: 1 00:00:06,093 --> 00:00:07,529 Oh, what do you think you're doing? 2 00:00:07,529 --> 00:00:09,444 Sorry, I didn't' feel like we had another choice. 3 00:00:09,444 --> 00:00:11,663 Dr. Ahmad, your residency here 4 00:00:11,663 --> 00:00:14,318 will be on a probationary basis. 5 00:00:14,318 --> 00:00:15,841 What the hell's going on? 6 00:00:15,841 --> 00:00:18,061 Walking off the floor without notifying a supervisor? 7 00:00:18,061 --> 00:00:20,150 There's not gonna be another warning. 8 00:00:20,150 --> 00:00:22,239 Ben is the one who pulled the plug on this marriage. 9 00:00:22,239 --> 00:00:23,458 Come on, Maggie. 10 00:00:23,458 --> 00:00:24,894 We're almost at the finish line. 11 00:00:24,894 --> 00:00:26,983 I really just wanna move on. 12 00:00:26,983 --> 00:00:28,202 Get me out of here! 13 00:00:28,202 --> 00:00:29,333 Get away from me! - Dr. Ripley, 14 00:00:29,333 --> 00:00:30,943 What you did today was reckless. 15 00:00:30,943 --> 00:00:32,032 Reckless? 16 00:00:32,032 --> 00:00:33,381 Impulse control disorder? 17 00:00:33,381 --> 00:00:34,773 Isn't that what you called it back then? 18 00:00:34,773 --> 00:00:37,298 I'm an attending physician at this hospital, 19 00:00:37,298 --> 00:00:42,259 not the boy you knew 20 years ago. 20 00:00:49,788 --> 00:00:51,138 Yo, Asher! 21 00:00:51,138 --> 00:00:52,313 What are you doing here? 22 00:00:52,313 --> 00:00:53,792 Mitch, what are--hey. 23 00:00:53,792 --> 00:00:54,880 What are you drinking? 24 00:00:54,880 --> 00:00:56,404 Um--I'm-- I'm not. 25 00:00:56,404 --> 00:00:58,101 It's club soda. - You don't drink? 26 00:00:58,101 --> 00:00:59,363 I do not. 27 00:00:59,363 --> 00:01:01,887 I'm a recovering addict. 28 00:01:01,887 --> 00:01:05,152 Which--I will tell you all about that another time. 29 00:01:05,152 --> 00:01:08,807 But right now, you have to go away. 30 00:01:08,807 --> 00:01:12,115 You do realize this is a public establishment, right? 31 00:01:12,115 --> 00:01:14,857 I'm--I am waiting on a date. 32 00:01:14,857 --> 00:01:17,077 First date. 33 00:01:17,077 --> 00:01:19,644 And he's going to be here any minute, so-- 34 00:01:19,644 --> 00:01:21,124 What? No. 35 00:01:21,124 --> 00:01:22,473 No, you-- 36 00:01:22,473 --> 00:01:24,171 I got my eyes glued to the door. 37 00:01:24,171 --> 00:01:26,390 I will split the second he gets here. 38 00:01:28,610 --> 00:01:30,351 Fine. 39 00:01:30,351 --> 00:01:31,787 So who's the guy? 40 00:01:31,787 --> 00:01:33,093 How'd you meet? 41 00:01:33,093 --> 00:01:34,616 His name is Kyle. 42 00:01:34,616 --> 00:01:39,142 And he's an architect, and we met on a dating app. 43 00:01:39,142 --> 00:01:41,449 Commercial architecture? Residential? 44 00:01:41,449 --> 00:01:42,798 What's the name of his firm? 45 00:01:42,798 --> 00:01:44,756 OK, what are you doing here, hm? 46 00:01:44,756 --> 00:01:48,412 You don't seem like the type to venture out on a school night. 47 00:01:48,412 --> 00:01:50,240 Is that your polite way of calling me a loser? 48 00:01:50,240 --> 00:01:51,850 No. 49 00:01:51,850 --> 00:01:56,768 You're always working late, running at some ungodly hours. 50 00:01:56,768 --> 00:02:00,250 Those degenerates, they dragged me out. 51 00:02:02,296 --> 00:02:04,689 I've known most of them since grade school. 52 00:02:04,689 --> 00:02:06,865 I didn't know you were a Chicago boy. 53 00:02:06,865 --> 00:02:08,563 Born and raised. 54 00:02:08,563 --> 00:02:12,001 Just been away a lot of years. 55 00:02:12,001 --> 00:02:13,611 It must be nice being home. 56 00:02:18,094 --> 00:02:21,184 I think Romeo has landed. 57 00:02:27,886 --> 00:02:30,280 Whoa, that was-- 58 00:02:30,280 --> 00:02:32,152 Nice break, bro. 59 00:02:37,983 --> 00:02:39,681 Somebody call 911! 60 00:02:39,681 --> 00:02:40,638 I need help! 61 00:02:40,638 --> 00:02:42,640 My girlfriend just passed out! 62 00:02:44,033 --> 00:02:45,469 We're doctors! 63 00:02:45,469 --> 00:02:47,167 You got to help her. Please. 64 00:02:47,167 --> 00:02:48,472 Somebody's calling 911. 65 00:02:48,472 --> 00:02:50,300 Paramedics should be on the way soon. 66 00:02:50,300 --> 00:02:51,649 Her breathing's slow and shallow. 67 00:02:51,649 --> 00:02:53,260 Eyes are pinpoint. What's her name? 68 00:02:53,260 --> 00:02:54,826 - Uh, Becca. - Becca? 69 00:02:54,826 --> 00:02:57,220 Hey, wake up, Becca! - Did she take something? 70 00:02:57,220 --> 00:02:59,309 We need to know so we can help her, man. 71 00:02:59,309 --> 00:03:00,528 Come on! What did she take?! 72 00:03:00,528 --> 00:03:02,312 Coke. But just a hit. 73 00:03:02,312 --> 00:03:03,661 Is this an overdose? 74 00:03:03,661 --> 00:03:05,446 How do you OD off just one hit? 75 00:03:05,446 --> 00:03:07,317 - You wouldn't. - No, Unless-- 76 00:03:07,317 --> 00:03:08,449 Cocaine was laced with fentanyl. 77 00:03:08,449 --> 00:03:10,277 I have Narcan in my purse. 78 00:03:10,277 --> 00:03:11,582 The blue bag under the bar on the hook? 79 00:03:11,582 --> 00:03:13,584 It's OK, I'll get it. 80 00:03:13,584 --> 00:03:14,629 Hey. 81 00:03:14,629 --> 00:03:16,065 Hey, you doing OK? - I--I don't-- 82 00:03:16,065 --> 00:03:17,197 - OK, OK. - I don't feel so good. 83 00:03:17,197 --> 00:03:18,981 Did you take a hit, too? 84 00:03:18,981 --> 00:03:20,156 Here. 85 00:03:20,156 --> 00:03:21,331 Thanks. 86 00:03:21,331 --> 00:03:23,246 You're OK. You're OK. 87 00:03:23,246 --> 00:03:24,552 Mitch? 88 00:03:24,552 --> 00:03:27,032 Yeah. 89 00:03:30,035 --> 00:03:32,342 Come on. 90 00:03:36,303 --> 00:03:37,521 Welcome back, Becca. 91 00:03:37,521 --> 00:03:39,741 Take a breath. - Come on. 92 00:03:39,741 --> 00:03:42,178 It's OK. Just breathe. 93 00:03:42,178 --> 00:03:43,919 Tim? 94 00:03:43,919 --> 00:03:45,312 What's wrong with him? 95 00:03:45,312 --> 00:03:46,661 Got any more Narcan? This didn't do it. 96 00:03:46,661 --> 00:03:47,966 He needs another dose. - No, I don't. 97 00:03:47,966 --> 00:03:48,967 Does anyone have Narcan? 98 00:03:48,967 --> 00:03:50,273 I'll ask around. 99 00:03:50,273 --> 00:03:51,492 Airway's open, but he's not breathing. 100 00:03:51,492 --> 00:03:52,536 Baby, you have to wake up. 101 00:03:52,536 --> 00:03:53,885 I'm gonna start rescue breath. 102 00:03:53,885 --> 00:03:55,147 No, no, Mitch, wait! You don't have a mask. 103 00:03:55,147 --> 00:03:56,105 Wait for the paramedics. - Hannah! 104 00:03:56,105 --> 00:03:57,193 He could cough up blood. 105 00:03:57,193 --> 00:03:58,542 He could-- - I know the risks. 106 00:03:58,542 --> 00:04:00,065 Hey, doc, what do we got? 107 00:04:00,065 --> 00:04:01,415 Suspected fentanyl overdose. 108 00:04:01,415 --> 00:04:02,981 We already administered one dose of Narcan. 109 00:04:07,638 --> 00:04:09,814 Baby, open your eyes. 110 00:04:19,259 --> 00:04:21,870 Welcome back. 111 00:04:30,139 --> 00:04:31,662 CPD tested their drugs. 112 00:04:31,662 --> 00:04:33,360 Came back positive for fentanyl. 113 00:04:33,360 --> 00:04:34,535 There's been a huge uptick 114 00:04:34,535 --> 00:04:36,014 of overdoses in the ED lately. 115 00:04:36,014 --> 00:04:38,147 Yeah, a lot of them just like Becca and Tim. 116 00:04:38,147 --> 00:04:40,932 They're recreational users, no clue their drugs 117 00:04:40,932 --> 00:04:42,151 are laced with fentanyl. 118 00:04:42,151 --> 00:04:43,283 I'll make sure they go home 119 00:04:43,283 --> 00:04:44,414 with some fentanyl testing strips. 120 00:04:44,414 --> 00:04:46,982 Thank you, Juliette. 121 00:04:50,159 --> 00:04:51,334 Your date's waiting. 122 00:04:51,334 --> 00:04:52,901 He is? 123 00:04:52,901 --> 00:04:54,685 Your 6 o'clock. Just be cool. 124 00:05:00,517 --> 00:05:03,651 Well, uh, see you tomorrow. 125 00:05:03,651 --> 00:05:05,305 - Yeah. - Yeah. 126 00:05:05,305 --> 00:05:07,307 Yeah. 127 00:05:10,222 --> 00:05:12,094 Get some sleep tonight, Asher. 128 00:05:17,317 --> 00:05:18,753 Wow. 129 00:05:18,753 --> 00:05:21,277 You're--you're like a real-life superwoman. 130 00:05:21,277 --> 00:05:22,452 No. 131 00:05:22,452 --> 00:05:24,846 No, I'm just glad everyone's OK. 132 00:05:24,846 --> 00:05:27,457 Yeah. 133 00:05:27,457 --> 00:05:31,331 So what do you say we, um-- 134 00:05:31,331 --> 00:05:34,464 we pick up where we left off? 135 00:05:34,464 --> 00:05:37,815 I actually-- I have to get going. 136 00:05:37,815 --> 00:05:40,383 I've got kind of an early start tomorrow. 137 00:05:40,383 --> 00:05:42,429 Oh. 138 00:05:42,429 --> 00:05:44,213 Yeah, I mean, I get it. 139 00:05:44,213 --> 00:05:47,956 But it was really lovely to meet you, Hannah. 140 00:06:10,108 --> 00:06:12,676 Big plans tonight? 141 00:06:12,676 --> 00:06:14,069 No. 142 00:06:14,069 --> 00:06:16,767 I, uh, got a board meeting later. 143 00:06:16,767 --> 00:06:19,117 - Giving a presentation? - No. 144 00:06:19,117 --> 00:06:22,207 I'm actually joining the board. 145 00:06:22,207 --> 00:06:24,384 Well, I must have missed the announcement. 146 00:06:24,384 --> 00:06:25,515 Well, there wasn't one. 147 00:06:25,515 --> 00:06:26,777 My request. 148 00:06:26,777 --> 00:06:28,953 Not big on fanfare. 149 00:06:28,953 --> 00:06:31,434 So the board just created a seat for you? 150 00:06:31,434 --> 00:06:34,045 Well, for a hospital physician, so-- 151 00:06:34,045 --> 00:06:36,439 But they asked you? 152 00:06:36,439 --> 00:06:38,267 Seems that way. 153 00:06:40,225 --> 00:06:42,532 I'm just glad I get to, uh--to advocate 154 00:06:42,532 --> 00:06:43,620 for the medical staff. 155 00:06:43,620 --> 00:06:45,883 Well, congratulations. 156 00:06:45,883 --> 00:06:48,712 You must be very popular with the suits. 157 00:06:48,712 --> 00:06:50,366 Dr. Ahmad! 158 00:06:50,366 --> 00:06:52,977 Got an ambo pulling up, going to treatment three. 159 00:06:52,977 --> 00:06:54,544 Duty calls. 160 00:06:54,544 --> 00:06:56,198 By all means. 161 00:06:59,636 --> 00:07:01,421 - We're going into three. - Got it. 162 00:07:01,421 --> 00:07:03,553 Vince Gonzalez, 38-year-old male, 163 00:07:03,553 --> 00:07:05,425 briefly lost consciousness after vomiting. 164 00:07:05,425 --> 00:07:09,429 BP 85 over 52, gave two liters in the ambo. 165 00:07:09,429 --> 00:07:10,473 Hi, Mr. Gonzalez. 166 00:07:10,473 --> 00:07:11,561 I'm Dr. Ahmad. 167 00:07:11,561 --> 00:07:13,650 It's Vince. 168 00:07:13,650 --> 00:07:15,783 Do you know if he hit his head when he passed out? 169 00:07:15,783 --> 00:07:17,567 No, Vince was already on the ground. 170 00:07:17,567 --> 00:07:19,134 He just kind of slumped over. 171 00:07:19,134 --> 00:07:20,744 And he wasn't out long, just a few seconds. 172 00:07:20,744 --> 00:07:21,919 Thank you. And you are? 173 00:07:21,919 --> 00:07:24,922 Ty. I'm Vince's husband. 174 00:07:24,922 --> 00:07:26,707 We'll take good care of him. 175 00:07:28,926 --> 00:07:31,451 OK, on my count-- one, two, three. 176 00:07:37,544 --> 00:07:39,589 OK, Vince, do you mind leaning forward? 177 00:07:39,589 --> 00:07:40,851 I just want to listen to your lungs from the back. 178 00:07:42,331 --> 00:07:44,986 Clear breath sounds bilaterally. 179 00:07:47,989 --> 00:07:49,599 Oh, honey. 180 00:07:49,599 --> 00:07:50,861 Oh. 181 00:07:50,861 --> 00:07:52,559 I am so sorry. 182 00:07:52,559 --> 00:07:54,648 It is so fine. 183 00:07:54,648 --> 00:07:56,737 It happens more than you think. 184 00:07:56,737 --> 00:07:58,260 4 of Zofran and a KUB. 185 00:07:58,260 --> 00:07:59,609 I'm on it. 186 00:07:59,609 --> 00:08:02,612 Excuse me. 187 00:08:02,612 --> 00:08:05,049 Hey. 188 00:08:05,049 --> 00:08:07,835 You, um--you have some vomit in your hair. 189 00:08:11,839 --> 00:08:13,971 Dennis Washington. 190 00:08:13,971 --> 00:08:15,886 How you been? - Hey, Dan. 191 00:08:15,886 --> 00:08:17,322 How are you? - Dr. Washington. 192 00:08:17,322 --> 00:08:20,238 Good morning. What can I do for you? 193 00:08:20,238 --> 00:08:22,632 I wanted to follow up on that matter I emailed you about. 194 00:08:22,632 --> 00:08:24,460 Oh, right. Of course. 195 00:08:24,460 --> 00:08:25,635 We can talk in my office. 196 00:08:25,635 --> 00:08:27,332 We'll see you later. 197 00:08:27,332 --> 00:08:30,379 I'll see you at the Exec Med Committee meeting Friday. 198 00:08:30,379 --> 00:08:32,337 Only if I can't get out of it. 199 00:08:40,868 --> 00:08:42,696 You forgot it by the toaster. 200 00:08:42,696 --> 00:08:46,177 Stop. 201 00:08:46,177 --> 00:08:48,876 I got to stop leaving my things. 202 00:08:48,876 --> 00:08:50,530 Hey, I don't mind. 203 00:08:52,270 --> 00:08:56,187 It gives me an excuse to come see you during the day. 204 00:08:56,187 --> 00:08:58,276 Dan doesn't know about us, huh? 205 00:08:58,276 --> 00:08:59,539 Dennis. 206 00:08:59,539 --> 00:09:01,323 I know, I know, I know. 207 00:09:01,323 --> 00:09:03,891 You're not telling folks for the time being. 208 00:09:03,891 --> 00:09:05,196 Have you told anyone? 209 00:09:05,196 --> 00:09:07,198 No. I'm confused. 210 00:09:07,198 --> 00:09:09,636 I mean, would it be the worst thing if people knew? 211 00:09:09,636 --> 00:09:10,941 No, no. 212 00:09:10,941 --> 00:09:12,116 Of course not. 213 00:09:12,116 --> 00:09:14,684 It's just that you're the-- 214 00:09:14,684 --> 00:09:17,557 you're the chief of a department, 215 00:09:17,557 --> 00:09:20,777 and I'm a member of hospital leadership. 216 00:09:20,777 --> 00:09:22,518 It's not prohibited. 217 00:09:23,650 --> 00:09:26,348 Sharon, colleagues date all the time. 218 00:09:26,348 --> 00:09:29,699 It's not a big deal. - Yeah, but it is to me. 219 00:09:29,699 --> 00:09:33,877 I've always had this strict policy of not mixing my work 220 00:09:33,877 --> 00:09:36,967 life with my romantic life. 221 00:09:36,967 --> 00:09:39,013 Until now. 222 00:09:40,275 --> 00:09:41,929 And I appreciate you making that exception. 223 00:09:41,929 --> 00:09:42,930 Believe me. 224 00:09:44,540 --> 00:09:46,586 There's no rush. 225 00:09:46,586 --> 00:09:49,632 We'll take our time integrating both worlds. 226 00:09:49,632 --> 00:09:53,331 Besides, it's kind of fun sneaking around. 227 00:10:00,077 --> 00:10:01,078 Got a minute? 228 00:10:01,078 --> 00:10:02,993 Need a surgical consult. 229 00:10:02,993 --> 00:10:04,473 Uh-- 230 00:10:04,473 --> 00:10:06,344 Patient's name is Vince Gonzalez. 231 00:10:06,344 --> 00:10:09,913 He's got metastatic abdominal sarcoma, presented to the ED 232 00:10:09,913 --> 00:10:12,263 with nausea, abdominal distension, 233 00:10:12,263 --> 00:10:14,614 and severe belly pain. 234 00:10:14,614 --> 00:10:16,659 Poor guy can't keep anything down. 235 00:10:16,659 --> 00:10:18,879 Does he have an obstruction or perforation? 236 00:10:18,879 --> 00:10:21,098 Free fluid? - Not on CT. 237 00:10:21,098 --> 00:10:22,926 But the tumor is severely compressing 238 00:10:22,926 --> 00:10:24,536 his stomach, hence the nausea. 239 00:10:24,536 --> 00:10:26,451 Yeah, I'm not seeing why you need a surgical consult. 240 00:10:26,451 --> 00:10:28,018 I mean, if the tumor is metastatic, 241 00:10:28,018 --> 00:10:29,019 it must have been inoperative. 242 00:10:29,019 --> 00:10:30,412 Correct. 243 00:10:30,412 --> 00:10:31,761 And if he's not completely obstructed, 244 00:10:31,761 --> 00:10:33,241 what do you need me for? 245 00:10:33,241 --> 00:10:36,331 Well, if you debulked a portion of the tumor here, 246 00:10:36,331 --> 00:10:39,203 then it would allow food to pass into the small intestine. 247 00:10:39,203 --> 00:10:41,031 So would a feeding tube. 248 00:10:41,031 --> 00:10:42,511 He doesn't want a feeding tube. 249 00:10:42,511 --> 00:10:44,731 Surgery would afford him a much better quality of life. 250 00:10:44,731 --> 00:10:47,472 Or it could cost him whatever time he has left. 251 00:10:47,472 --> 00:10:49,039 I mean, we're talking about a patient 252 00:10:49,039 --> 00:10:51,389 who underwent multiple rounds of chemo, I'm sure, right? 253 00:10:51,389 --> 00:10:52,956 With zero complications. 254 00:10:52,956 --> 00:10:56,133 He's remarkably fit and healthy, despite the cancer. 255 00:10:56,133 --> 00:10:58,222 I know this isn't exactly a sexy surgery. 256 00:10:58,222 --> 00:11:00,572 Whoa. I beg your pardon. 257 00:11:00,572 --> 00:11:03,140 "Sexy surgery"? 258 00:11:03,140 --> 00:11:05,099 I know surgeons don't like to get involved 259 00:11:05,099 --> 00:11:08,145 in palliative care. 260 00:11:08,145 --> 00:11:10,670 Well, that's quite a generalization there. 261 00:11:13,847 --> 00:11:15,936 All right. Let's have a look. 262 00:11:15,936 --> 00:11:18,025 Send me the chart. 263 00:11:21,202 --> 00:11:23,073 Don't be brave, OK? 264 00:11:23,073 --> 00:11:25,467 Tell me if it hurts when I push. 265 00:11:25,467 --> 00:11:26,686 I'm all right. 266 00:11:26,686 --> 00:11:28,122 OK. 267 00:11:28,122 --> 00:11:29,427 Well, your CT didn't show an obstruction, 268 00:11:29,427 --> 00:11:31,691 but just wanted to confirm. 269 00:11:33,997 --> 00:11:35,956 So, Dr. Marcel? 270 00:11:35,956 --> 00:11:38,175 - Yeah. - Here's the thing. 271 00:11:38,175 --> 00:11:39,829 My husband and I are supposed to fly 272 00:11:39,829 --> 00:11:41,352 to Italy in three weeks. 273 00:11:41,352 --> 00:11:43,528 My grandmother was from Positano. 274 00:11:43,528 --> 00:11:46,706 I've always wanted to go, and we figured, 275 00:11:46,706 --> 00:11:49,012 no time like the present. 276 00:11:49,012 --> 00:11:51,536 You know, how are you doing with daily activities, Vince? 277 00:11:51,536 --> 00:11:53,800 Things like dressing, housework, driving? 278 00:11:53,800 --> 00:11:57,238 Before I started vomiting my supper? 279 00:11:57,238 --> 00:11:59,022 I was totally functional. 280 00:11:59,022 --> 00:12:00,371 I can attest to that. 281 00:12:00,371 --> 00:12:03,157 Most days, Vince has more energy than me. 282 00:12:03,157 --> 00:12:05,768 You ever had complications from surgery? 283 00:12:05,768 --> 00:12:08,510 Post-operative issues, issues with anesthesia? 284 00:12:08,510 --> 00:12:11,556 No, I had my appendix out when I was 25, 285 00:12:11,556 --> 00:12:14,168 but I didn't have any problems. 286 00:12:14,168 --> 00:12:16,039 Good. 287 00:12:16,039 --> 00:12:18,259 I'm glad to hear it. 288 00:12:18,259 --> 00:12:20,217 Because there is a surgical option 289 00:12:20,217 --> 00:12:22,742 that could get your GI system working again. 290 00:12:23,873 --> 00:12:26,310 I like the sound of that. 291 00:12:27,834 --> 00:12:30,401 Why don't you present it, Dr. Ahmad, 292 00:12:30,401 --> 00:12:32,490 since it was your suggestion? 293 00:12:32,490 --> 00:12:33,622 OK. 294 00:12:34,710 --> 00:12:36,581 Morning. 295 00:12:36,581 --> 00:12:38,148 Your night turn out all right? 296 00:12:38,148 --> 00:12:39,584 It did, actually. 297 00:12:39,584 --> 00:12:42,413 It ended up being a pretty good first date. 298 00:12:42,413 --> 00:12:44,546 - Oh, yeah? - Yeah. 299 00:12:44,546 --> 00:12:46,896 Dr. Ripley, we have a potential wrist 300 00:12:46,896 --> 00:12:48,855 fracture in treatment six. 301 00:12:48,855 --> 00:12:50,030 You mind starting the workup? 302 00:12:50,030 --> 00:12:51,945 I'm just finishing up with a patient. 303 00:12:51,945 --> 00:12:53,468 You're lucky I like you. 304 00:12:53,468 --> 00:12:54,295 For now. 305 00:12:54,295 --> 00:12:55,600 Thank you, Maggie. 306 00:12:55,600 --> 00:12:56,601 Mm-hmm. 307 00:12:57,907 --> 00:12:59,213 OK. 308 00:12:59,213 --> 00:13:01,171 So, Mrs. Moore, I understand that you fell 309 00:13:01,171 --> 00:13:03,043 getting out of your car. 310 00:13:03,043 --> 00:13:04,784 Mind if I take a look? 311 00:13:06,394 --> 00:13:08,831 I just want to check if it's swollen. 312 00:13:14,097 --> 00:13:15,185 I'll be gentle. 313 00:13:18,449 --> 00:13:20,495 Pam, let her look. 314 00:13:22,410 --> 00:13:24,673 My wrist is fine. 315 00:13:24,673 --> 00:13:26,196 I didn't fall. 316 00:13:26,980 --> 00:13:28,808 What? 317 00:13:28,808 --> 00:13:30,810 I don't understand. 318 00:13:31,723 --> 00:13:34,248 I'm sorry, honey. I didn't have any other choice. 319 00:13:34,248 --> 00:13:36,076 What are you talking about? 320 00:13:37,729 --> 00:13:40,863 My husband is depressed and refuses to get any help. 321 00:13:40,863 --> 00:13:42,386 Pamela! 322 00:13:42,386 --> 00:13:45,128 And I am so afraid he's gonna hurt himself. 323 00:13:54,921 --> 00:13:57,575 Look, I appreciate you have to do your due diligence. 324 00:13:57,575 --> 00:13:59,664 My wife mentioned the possibility of self-harm, 325 00:13:59,664 --> 00:14:01,666 so you can't just send me on my way. 326 00:14:01,666 --> 00:14:04,495 Yeah, she mentioned to Nurse Lockwood a comment you made. 327 00:14:04,495 --> 00:14:05,888 Right. 328 00:14:05,888 --> 00:14:07,934 I said something stupid like, "Going to bed 329 00:14:07,934 --> 00:14:10,066 and never waking up sounds like a nice way to go." 330 00:14:10,066 --> 00:14:11,154 Huh. 331 00:14:11,154 --> 00:14:13,113 Come on. I was speaking generally. 332 00:14:13,113 --> 00:14:14,984 A nice way to go, as opposed to, 333 00:14:14,984 --> 00:14:17,378 I don't know, getting hit by a bus. 334 00:14:17,378 --> 00:14:18,901 OK. 335 00:14:18,901 --> 00:14:21,208 Um, apparently, you have been losing some weight. 336 00:14:21,208 --> 00:14:24,124 I was diagnosed with type 2 diabetes not long ago. 337 00:14:24,124 --> 00:14:25,865 I've been pretty diligent about my diet, 338 00:14:25,865 --> 00:14:27,431 getting regular exercise. 339 00:14:27,431 --> 00:14:29,825 Frankly, I'm glad the hard work's paying off. 340 00:14:29,825 --> 00:14:31,174 Well, then, Paul, help me out. 341 00:14:31,174 --> 00:14:33,437 I mean, why do you think that your wife's 342 00:14:33,437 --> 00:14:34,699 so concerned about you? 343 00:14:36,527 --> 00:14:39,530 I admit I haven't been in the best mood lately. 344 00:14:39,530 --> 00:14:41,271 My fuse is probably shorter. 345 00:14:41,271 --> 00:14:42,794 Yeah. 346 00:14:42,794 --> 00:14:44,927 I mean, she's-- she's concerned that, 347 00:14:44,927 --> 00:14:47,016 you know, you've been isolating, 348 00:14:47,016 --> 00:14:49,366 withdrawing from her, your friends. 349 00:14:49,366 --> 00:14:51,934 I haven't felt like socializing lately. 350 00:14:51,934 --> 00:14:53,196 So when was the last time-- 351 00:14:53,196 --> 00:14:54,545 Let me save you some time, OK? 352 00:14:54,545 --> 00:14:58,027 I have no intention or desire to hurt myself. 353 00:14:58,027 --> 00:14:59,333 And I'm glad to hear it. 354 00:14:59,333 --> 00:15:01,030 So ask whatever questions you need 355 00:15:01,030 --> 00:15:03,641 to cover the hospital's ass. 356 00:15:03,641 --> 00:15:05,948 I am not suicidal, Dr. Charles. 357 00:15:05,948 --> 00:15:08,820 Pam is just making something out of nothing. 358 00:15:08,820 --> 00:15:11,258 Her specialty. 359 00:15:11,258 --> 00:15:13,216 Mm. 360 00:15:16,524 --> 00:15:18,830 Within an hour of posting Vince's surgery, 361 00:15:18,830 --> 00:15:21,181 his insurance company denied it, 362 00:15:21,181 --> 00:15:22,834 rejected it on the grounds of it 363 00:15:22,834 --> 00:15:24,314 not being medically necessary. 364 00:15:24,314 --> 00:15:26,055 There are alternative treatment options. 365 00:15:26,055 --> 00:15:27,752 The feeding tube Vince doesn't want. 366 00:15:27,752 --> 00:15:29,145 Yep. 367 00:15:29,145 --> 00:15:32,583 Man, I am so fed up with prior authorization. 368 00:15:32,583 --> 00:15:35,195 About a dozen times a month, my patients get screwed by it. 369 00:15:35,195 --> 00:15:36,674 What insurance does Vince have? 370 00:15:36,674 --> 00:15:37,849 Berninger Health Network. 371 00:15:37,849 --> 00:15:39,590 Of course, one of the worst. 372 00:15:39,590 --> 00:15:42,071 They deny more patients than any other company, 373 00:15:42,071 --> 00:15:44,856 pay physician reviewers six figures to look at charts 374 00:15:44,856 --> 00:15:46,771 and find reasons to deny. 375 00:15:49,600 --> 00:15:51,515 I guess we should tell him before he gets a form 376 00:15:51,515 --> 00:15:52,690 email from his insurance. 377 00:15:52,690 --> 00:15:54,605 Yeah. 378 00:16:01,177 --> 00:16:02,657 So what's the verdict? 379 00:16:02,657 --> 00:16:05,225 Is his wife right that he's a danger to himself? 380 00:16:05,225 --> 00:16:06,878 You know, I don't know yet. 381 00:16:06,878 --> 00:16:08,750 I mean, he's adamant that he's not, right? 382 00:16:08,750 --> 00:16:11,318 But about 50% of the people with suicidal ideation 383 00:16:11,318 --> 00:16:12,580 deny it. 384 00:16:12,580 --> 00:16:14,408 I'm more concerned by his wife's concern, 385 00:16:14,408 --> 00:16:15,757 if that makes sense. 386 00:16:15,757 --> 00:16:17,541 I mean, she pulled off a pretty elaborate ruse 387 00:16:17,541 --> 00:16:18,629 to get him through our doors. 388 00:16:18,629 --> 00:16:20,022 Exactly. 389 00:16:20,022 --> 00:16:21,589 So what's the game plan? 390 00:16:21,589 --> 00:16:24,244 I want to talk to her some more, all right? 391 00:16:24,244 --> 00:16:26,768 I also want to just look at his medical history a little more 392 00:16:26,768 --> 00:16:30,293 carefully, you know, find out what kind of access, if any, 393 00:16:30,293 --> 00:16:32,121 he has to firearms, to see if I can come 394 00:16:32,121 --> 00:16:33,688 up with any evidence at all 395 00:16:33,688 --> 00:16:34,906 that he's planning to hurt himself. 396 00:16:34,906 --> 00:16:36,517 All right. I'll keep him comfortable. 397 00:16:36,517 --> 00:16:38,519 All right, and Mags, if he gets antsy and starts talking 398 00:16:38,519 --> 00:16:39,433 about getting out of here-- 399 00:16:39,433 --> 00:16:40,782 - I'll page you. - Thank you. 400 00:16:40,782 --> 00:16:41,957 Yeah. 401 00:16:46,918 --> 00:16:48,485 Where is Hannah Asher? 402 00:16:48,485 --> 00:16:49,530 Excuse me? 403 00:16:49,530 --> 00:16:51,140 Where is Hannah Asher? 404 00:16:51,140 --> 00:16:54,491 She's probably with a patient. 405 00:16:54,491 --> 00:16:56,580 Ma'am. 406 00:16:56,580 --> 00:16:58,452 Ma'am, you can't do that. 407 00:17:00,280 --> 00:17:02,195 Ma'am. 408 00:17:02,195 --> 00:17:05,198 OK, this is gonna feel a little cold. 409 00:17:05,198 --> 00:17:06,112 OK? 410 00:17:06,112 --> 00:17:08,027 You're Hannah Asher? 411 00:17:08,027 --> 00:17:09,376 Do you know this woman? 412 00:17:09,376 --> 00:17:12,727 Um, no. 413 00:17:12,727 --> 00:17:14,076 Do you want me to remove her? 414 00:17:14,076 --> 00:17:15,556 - I'd like to see you try. - Hold on. 415 00:17:15,556 --> 00:17:16,687 Hold on a second. 416 00:17:16,687 --> 00:17:18,037 I'm Dr. Hannah Asher. 417 00:17:18,037 --> 00:17:19,038 Is there a problem? 418 00:17:19,038 --> 00:17:20,604 Problem? 419 00:17:20,604 --> 00:17:22,780 Well, you went on a date with my husband last night, 420 00:17:22,780 --> 00:17:24,521 so yeah, we've got a problem. 421 00:17:29,265 --> 00:17:31,006 Vince, we're submitting an appeal 422 00:17:31,006 --> 00:17:33,617 to your insurance company, OK? 423 00:17:33,617 --> 00:17:36,577 We've been through the appeals process. 424 00:17:38,753 --> 00:17:41,582 When Vince's doctor first suspected something was wrong, 425 00:17:41,582 --> 00:17:43,236 he ordered a CT. 426 00:17:43,236 --> 00:17:45,673 Insurance wouldn't approve it initially. 427 00:17:45,673 --> 00:17:48,719 Said there wasn't sufficient evidence to warrant it. 428 00:17:48,719 --> 00:17:51,331 It took them three months to finally get it authorized. 429 00:17:51,331 --> 00:17:52,897 - Yeah. - Who knows how much 430 00:17:52,897 --> 00:17:55,900 the tumor grew in that time? 431 00:17:55,900 --> 00:17:58,381 Vince. 432 00:17:58,381 --> 00:18:00,862 I know you were trying to avoid a feeding tube. 433 00:18:00,862 --> 00:18:02,559 No. 434 00:18:02,559 --> 00:18:05,214 No feeding tube. 435 00:18:05,214 --> 00:18:06,998 Look, we could place a temporary one. 436 00:18:06,998 --> 00:18:08,174 No. 437 00:18:08,174 --> 00:18:09,827 Without a feeding tube-- 438 00:18:09,827 --> 00:18:11,786 I'm gonna lose time. 439 00:18:11,786 --> 00:18:13,266 I understand that. 440 00:18:13,266 --> 00:18:16,007 You could die in weeks, 441 00:18:16,007 --> 00:18:17,748 possibly days. 442 00:18:22,710 --> 00:18:24,015 When we first got the news 443 00:18:24,015 --> 00:18:25,974 that nothing more could be done, 444 00:18:25,974 --> 00:18:28,281 that this was terminal, 445 00:18:28,281 --> 00:18:30,370 we came up with a model for how we were 446 00:18:30,370 --> 00:18:32,633 going to approach this next... 447 00:18:32,633 --> 00:18:33,721 phase. 448 00:18:38,639 --> 00:18:41,032 Quality over time, right? 449 00:18:42,512 --> 00:18:44,558 No feeding tube. 450 00:18:50,868 --> 00:18:53,175 OK. 451 00:18:53,175 --> 00:18:54,263 Get some rest. 452 00:18:54,263 --> 00:18:56,352 Be back in a bit, OK? 453 00:19:03,446 --> 00:19:04,926 Yeah. 454 00:19:04,926 --> 00:19:06,493 Thanks. 455 00:19:06,493 --> 00:19:09,583 I'm gonna talk to a utilization review specialist, 456 00:19:09,583 --> 00:19:12,063 see if I can expedite the appeal process. 457 00:19:12,063 --> 00:19:14,675 You really think that's gonna make much of a difference? 458 00:19:14,675 --> 00:19:16,677 Worth a shot. 459 00:19:27,470 --> 00:19:29,777 I did go out last night, but it wasn't 460 00:19:29,777 --> 00:19:30,995 with anyone that was married. 461 00:19:30,995 --> 00:19:33,215 All right, guys. Come on. 462 00:19:33,215 --> 00:19:34,303 Show's over, huh? 463 00:19:34,303 --> 00:19:36,000 I went out with Kyle. 464 00:19:36,000 --> 00:19:38,307 - Kyle? - Yeah. 465 00:19:39,787 --> 00:19:41,702 Yeah, that's him. 466 00:19:42,964 --> 00:19:44,270 His name is Nick Dunn. 467 00:19:44,270 --> 00:19:46,272 He's not an architect. He's a general contractor. 468 00:19:46,272 --> 00:19:48,709 I'm so--oh, God. 469 00:19:48,709 --> 00:19:51,190 You really didn't know he was married? 470 00:19:51,190 --> 00:19:52,713 No, I swear. 471 00:19:52,713 --> 00:19:54,628 I-- 472 00:19:59,372 --> 00:20:01,025 I'm gonna kill him. 473 00:20:01,025 --> 00:20:02,244 Well, I-- 474 00:20:02,244 --> 00:20:04,768 How could he do this to me? 475 00:20:04,768 --> 00:20:06,074 I'm carrying our child. 476 00:20:06,074 --> 00:20:07,380 It's absolutely terrible. 477 00:20:07,380 --> 00:20:09,643 I agree-- - I knew something was up. 478 00:20:09,643 --> 00:20:11,514 I thought it was just new dad jitters, you know? 479 00:20:11,514 --> 00:20:14,865 In a million years, I never-- 480 00:20:14,865 --> 00:20:15,866 oh. 481 00:20:15,866 --> 00:20:17,825 Are you OK? 482 00:20:17,825 --> 00:20:19,261 I think my water just broke. 483 00:20:25,049 --> 00:20:26,181 How many weeks are you? 484 00:20:26,181 --> 00:20:28,270 38. 485 00:20:28,270 --> 00:20:30,446 I would like to get you on a monitor. 486 00:20:30,446 --> 00:20:32,492 No, no, no, no, I'm going to see my own doct-- 487 00:20:32,492 --> 00:20:34,320 oh! - Hey, hey, hey, breathe. 488 00:20:34,320 --> 00:20:36,583 Breathe with me. - I know how to breathe. 489 00:20:38,280 --> 00:20:40,021 This can't be happening. 490 00:20:47,724 --> 00:20:50,249 Can you put your knees up for me, please? 491 00:20:52,294 --> 00:20:54,253 You're gonna feel a little bit of pressure. 492 00:20:54,253 --> 00:20:56,951 OK. 493 00:20:56,951 --> 00:20:59,997 OK, so, Tessa, you are fully dilated. 494 00:20:59,997 --> 00:21:01,434 What? 495 00:21:01,434 --> 00:21:03,914 Yep, which means there is no time to move upstairs 496 00:21:03,914 --> 00:21:05,220 or wait for your doctor. 497 00:21:05,220 --> 00:21:07,266 No, no, no. I can't have my baby here. 498 00:21:07,266 --> 00:21:08,571 The ED is fully equipped for delivery. 499 00:21:08,571 --> 00:21:10,399 No, I can't have you deliver my baby. 500 00:21:10,399 --> 00:21:11,748 I'm sorry. 501 00:21:11,748 --> 00:21:12,793 Look, I get that I'm not your first option. 502 00:21:12,793 --> 00:21:14,011 In fact, I'm probably your last. 503 00:21:14,011 --> 00:21:16,362 But I am a board-certified OBGYN, 504 00:21:16,362 --> 00:21:18,059 and I have delivered hundreds of babies. 505 00:21:18,059 --> 00:21:21,192 And I will get yours out safely if we work together. 506 00:21:26,285 --> 00:21:27,851 OK, change of plans. 507 00:21:27,851 --> 00:21:29,157 Tessa's ready to deliver now, so we're gonna do it here. 508 00:21:29,157 --> 00:21:30,550 Oh, OK. 509 00:21:30,550 --> 00:21:32,943 Yep, so get me another nurse, a delivery table, 510 00:21:32,943 --> 00:21:35,076 and grab another doctor, whoever's available. 511 00:21:35,076 --> 00:21:37,687 We'll maybe need an extra set of hands. 512 00:21:39,341 --> 00:21:41,125 We got this, OK? 513 00:21:41,125 --> 00:21:42,301 OK. 514 00:21:45,391 --> 00:21:46,783 Where are we at? 515 00:21:46,783 --> 00:21:48,785 Long and short of it, Paul is depressed, 516 00:21:48,785 --> 00:21:50,526 but his risk of suicide is low. 517 00:21:50,526 --> 00:21:53,355 Couldn't find any evidence of any kind of intent 518 00:21:53,355 --> 00:21:54,965 to harm himself. 519 00:21:54,965 --> 00:21:56,706 All right, so I'll get his discharge paperwork ready. 520 00:21:56,706 --> 00:21:58,795 Do you want to include a psych referral? 521 00:21:58,795 --> 00:22:00,928 You know, Mags, I'm actually not quite ready 522 00:22:00,928 --> 00:22:02,190 to discharge him. 523 00:22:02,190 --> 00:22:03,496 OK. 524 00:22:03,496 --> 00:22:04,975 Here's the thing, right? 525 00:22:04,975 --> 00:22:07,369 He gets diagnosed with sudden-onset type 2 diabetes 526 00:22:07,369 --> 00:22:08,457 six months ago. 527 00:22:08,457 --> 00:22:11,460 No family history, low BMI, right? 528 00:22:11,460 --> 00:22:13,984 And we all know that when you get diagnosed with type 2, 529 00:22:13,984 --> 00:22:15,421 you don't lose weight. 530 00:22:15,421 --> 00:22:17,031 No, you gain weight, right? 531 00:22:17,031 --> 00:22:18,989 And then, there's the sudden-onset depression. 532 00:22:18,989 --> 00:22:21,165 Again, no history, right? 533 00:22:21,165 --> 00:22:22,602 No triggers. 534 00:22:22,602 --> 00:22:24,908 I'm just wondering if we're not missing something, 535 00:22:24,908 --> 00:22:27,128 you know, some underlying medical condition. 536 00:22:27,128 --> 00:22:29,130 Do you want to order a set of labs? 537 00:22:29,130 --> 00:22:31,175 Let's start out with a CBC and a CMP, 538 00:22:31,175 --> 00:22:33,395 and I'm gonna dig into the literature, 539 00:22:33,395 --> 00:22:36,616 see if I can't find some kind of common thread. 540 00:22:36,616 --> 00:22:37,791 You got it. 541 00:22:41,272 --> 00:22:45,189 After lambasting them for denying the patient's surgery, 542 00:22:45,189 --> 00:22:49,324 Dr. Ahmad goes on to tag you, Dr. Marcel. 543 00:22:49,324 --> 00:22:51,370 "Berninger is the worst. 544 00:22:51,370 --> 00:22:54,416 "Not only do they deny more patients than anyone, 545 00:22:54,416 --> 00:22:56,679 "they also pay physician reviewers six figures 546 00:22:56,679 --> 00:22:58,768 to find reasons to deny." 547 00:22:58,768 --> 00:23:01,118 Now, while Dr. Ahmad is entitled 548 00:23:01,118 --> 00:23:04,339 to express her personal opinions on her social media-- 549 00:23:04,339 --> 00:23:06,385 You, sir, are a representative 550 00:23:06,385 --> 00:23:08,038 of the board now. 551 00:23:08,038 --> 00:23:10,258 I had no idea she was gonna post this. 552 00:23:10,258 --> 00:23:13,566 She didn't ask you before she publicly quoted you? 553 00:23:13,566 --> 00:23:16,133 No. She did not. 554 00:23:16,133 --> 00:23:18,048 We are on the eve of hammering out 555 00:23:18,048 --> 00:23:20,921 a new three-year contract with Berninger. 556 00:23:20,921 --> 00:23:23,184 And antagonizing them with a PR nightmare 557 00:23:23,184 --> 00:23:25,447 is not exactly the tone we wanted to set. 558 00:23:25,447 --> 00:23:27,362 We're talking about one post here. 559 00:23:27,362 --> 00:23:29,103 I'm sure no one's even gonna see it. 560 00:23:29,103 --> 00:23:32,280 It's going viral, Dr. Marcel. 561 00:23:34,761 --> 00:23:36,240 - What? - Yeah. 562 00:23:36,240 --> 00:23:38,199 So we are gonna need to do major damage control 563 00:23:38,199 --> 00:23:41,420 at the board meeting this afternoon. 564 00:23:41,420 --> 00:23:43,726 Just follow my lead. 565 00:23:49,297 --> 00:23:50,820 What is this? 566 00:23:52,822 --> 00:23:54,911 Now, I share something with you in a clinical setting, 567 00:23:54,911 --> 00:23:56,217 I don't expect to see it plastered 568 00:23:56,217 --> 00:23:57,697 all over social media, you understand? 569 00:23:57,697 --> 00:23:59,263 I should have checked with you before I posted it. 570 00:23:59,263 --> 00:24:01,831 Yeah, that much is obvious. 571 00:24:01,831 --> 00:24:03,267 I don't mean to sound ingenuous, 572 00:24:03,267 --> 00:24:04,921 but I didn't think that you would mind. 573 00:24:04,921 --> 00:24:06,836 Being publicly quoted without my consent? 574 00:24:06,836 --> 00:24:08,577 Yeah, I mind, a lot. 575 00:24:08,577 --> 00:24:10,971 - But what you said was true. - That isn't the point. 576 00:24:10,971 --> 00:24:12,755 Look, you want to have a viral moment? 577 00:24:12,755 --> 00:24:13,974 Be my guest. 578 00:24:13,974 --> 00:24:15,366 But don't do it at my expense. 579 00:24:15,366 --> 00:24:17,281 This isn't about having a viral moment. 580 00:24:17,281 --> 00:24:20,633 I--this strategy might seem unorthodox, but it works. 581 00:24:20,633 --> 00:24:21,938 Strategy? 582 00:24:21,938 --> 00:24:23,418 Since when did venting on social media 583 00:24:23,418 --> 00:24:24,898 become a strategy? 584 00:24:24,898 --> 00:24:26,987 Public shaming is a way to get companies' attention 585 00:24:26,987 --> 00:24:28,467 and move them to act. 586 00:24:28,467 --> 00:24:31,252 Case in point, after the post started trending, 587 00:24:31,252 --> 00:24:34,603 Berninger sent notice, and they escalated Vince's appeal 588 00:24:34,603 --> 00:24:36,605 for a peer-to-peer call. 589 00:24:36,605 --> 00:24:38,172 Really? 590 00:24:38,172 --> 00:24:40,304 Yeah, which is why we can't let up on public pressure. 591 00:24:40,304 --> 00:24:42,481 I got a DM from a local news reporter. 592 00:24:42,481 --> 00:24:44,874 She wants to interview us on Vince's case. 593 00:24:44,874 --> 00:24:46,572 What are you, out of your mind? 594 00:24:46,572 --> 00:24:47,660 I can't do that. 595 00:24:47,660 --> 00:24:49,183 Why not? 596 00:24:49,183 --> 00:24:51,185 Because the hospital's got an upcoming contract 597 00:24:51,185 --> 00:24:54,405 negotiation with Berninger. 598 00:24:54,405 --> 00:24:55,711 Ah. 599 00:24:55,711 --> 00:24:58,801 So this is why the post was such a big issue? 600 00:24:58,801 --> 00:25:01,412 That has nothing to do with my issue, 601 00:25:01,412 --> 00:25:04,328 which is your total disregard for professional courtesy. 602 00:25:08,724 --> 00:25:13,729 You should know that the post wasn't just liked or reposted. 603 00:25:13,729 --> 00:25:16,906 People shared their hellish experiences with Berninger. 604 00:25:16,906 --> 00:25:19,822 Hundreds of people, including MDs. 605 00:25:19,822 --> 00:25:22,172 What you said resonated. 606 00:25:22,172 --> 00:25:24,392 It needed to be said. 607 00:25:26,089 --> 00:25:28,352 OK, Tessa, the head is coming. 608 00:25:28,352 --> 00:25:29,832 You're crowning. 609 00:25:29,832 --> 00:25:31,399 I am? 610 00:25:31,399 --> 00:25:33,532 - You're doing great. - Thank you. 611 00:25:34,576 --> 00:25:36,796 Hannah? 612 00:25:36,796 --> 00:25:38,537 What--what's going on? 613 00:25:38,537 --> 00:25:41,191 The head is out, but the shoulders aren't coming. 614 00:25:41,191 --> 00:25:43,019 What? She's stuck? 615 00:25:43,019 --> 00:25:44,586 This can happen with bigger babies. 616 00:25:44,586 --> 00:25:46,545 Don't worry, we will get her out, Tessa, OK? 617 00:25:46,545 --> 00:25:48,677 Nancy, I need you to switch with Dr. Ripley. 618 00:25:48,677 --> 00:25:49,983 Put her into McRoberts. 619 00:25:49,983 --> 00:25:51,245 Dr. Ripley, I'm gonna need you to apply 620 00:25:51,245 --> 00:25:53,160 suprapubic pressure from above 621 00:25:53,160 --> 00:25:54,074 while I maneuver the baby out, OK? 622 00:25:54,074 --> 00:25:55,249 You got it. 623 00:25:55,249 --> 00:25:56,642 All right, Tessa, you got this. 624 00:25:56,642 --> 00:25:58,905 When I say push, you push as hard as you can, OK? 625 00:25:58,905 --> 00:26:00,384 Let's go. 626 00:26:00,384 --> 00:26:01,647 Go. 627 00:26:05,738 --> 00:26:07,566 Here we go, here we go, here we go! 628 00:26:08,654 --> 00:26:10,830 I got her! 629 00:26:12,266 --> 00:26:13,746 There's your baby girl. 630 00:26:13,746 --> 00:26:16,705 - Oh! - Oh, my baby. 631 00:26:20,709 --> 00:26:22,015 Thank you. 632 00:26:37,726 --> 00:26:39,336 Look, just--just hold on. 633 00:26:39,336 --> 00:26:40,903 Because it says here on my-- what do you call this? 634 00:26:40,903 --> 00:26:43,471 Patient portal--that my blood work all came back normal. 635 00:26:43,471 --> 00:26:44,515 I understand. 636 00:26:44,515 --> 00:26:45,995 So why can't you discharge me? 637 00:26:45,995 --> 00:26:48,084 Because Dr. Charles needs to sign off your chart. 638 00:26:48,084 --> 00:26:49,782 Well, then go get Dr. Charles. 639 00:26:49,782 --> 00:26:50,913 Paul, don't yell at her. 640 00:26:50,913 --> 00:26:52,262 Don't tell me what to do. 641 00:26:52,262 --> 00:26:54,134 This is all your fault. If you had-- 642 00:26:54,134 --> 00:26:55,483 Dr. Charles? 643 00:26:55,483 --> 00:26:57,528 Dr. Charles, I'd like to go home now. 644 00:26:57,528 --> 00:26:59,400 I understand you have to sign off on that. 645 00:26:59,400 --> 00:27:00,880 I do. 646 00:27:00,880 --> 00:27:02,621 And look, Paul, I know you've had a really long day. 647 00:27:02,621 --> 00:27:04,013 I certainly have. 648 00:27:04,013 --> 00:27:05,275 But I'd like to order just a couple more labs 649 00:27:05,275 --> 00:27:07,669 and actually get a CT of your abdomen. 650 00:27:07,669 --> 00:27:09,671 Why? My blood work came back normal. 651 00:27:09,671 --> 00:27:11,325 You know, there are certain illnesses 652 00:27:11,325 --> 00:27:13,457 that, early on, they just kind of fly under the radar. 653 00:27:13,457 --> 00:27:15,198 Like what? What are you looking for? 654 00:27:15,198 --> 00:27:17,070 Well, certain medical conditions, right, 655 00:27:17,070 --> 00:27:19,115 can raise inflammation in the body, 656 00:27:19,115 --> 00:27:21,378 which can cause depression. 657 00:27:21,378 --> 00:27:23,685 Yeah, but you've clearly narrowed that list down now. 658 00:27:23,685 --> 00:27:25,687 Why are you looking at my stomach? 659 00:27:25,687 --> 00:27:29,125 There is evidence that disruptions in the physiologic 660 00:27:29,125 --> 00:27:30,300 functions of the pancreas-- 661 00:27:30,300 --> 00:27:32,520 in this case, neurotransmission-- 662 00:27:32,520 --> 00:27:34,827 can alter mood and anxiety levels. 663 00:27:34,827 --> 00:27:37,873 And in very rare cases, sudden-onset diabetes 664 00:27:37,873 --> 00:27:40,963 has been known to be caused by a growth in the pancreas. 665 00:27:46,534 --> 00:27:48,057 What, you-- 666 00:27:50,190 --> 00:27:52,148 You think I have pancreatic cancer? 667 00:27:52,148 --> 00:27:53,846 I'm more thinking about this as something 668 00:27:53,846 --> 00:27:55,412 I'd like to rule out. 669 00:28:18,653 --> 00:28:20,524 Well, I want to start by welcoming 670 00:28:20,524 --> 00:28:21,351 our newest member to the board, 671 00:28:21,351 --> 00:28:22,657 Dr. Crockett Marcel. 672 00:28:24,746 --> 00:28:26,226 All right, then. Let's dive right in. 673 00:28:26,226 --> 00:28:29,446 Barry, if I may, I'd actually like to address 674 00:28:29,446 --> 00:28:31,535 the elephant in the room. 675 00:28:33,407 --> 00:28:34,887 Sure, Peter. 676 00:28:34,887 --> 00:28:39,152 I think we're all aware of the social media firestorm. 677 00:28:39,152 --> 00:28:41,850 Strike that--"firestorm" is making a mountain out of a-- 678 00:28:41,850 --> 00:28:43,330 Peter. 679 00:28:43,330 --> 00:28:46,072 Get to the point. 680 00:28:46,072 --> 00:28:49,815 An overzealous resident misquoted Dr. Marcel 681 00:28:49,815 --> 00:28:51,599 to serve her own agenda. 682 00:28:51,599 --> 00:28:53,644 No, that's not-- 683 00:28:53,644 --> 00:28:56,169 - Dr. Marcel-- - I was quoted accurately. 684 00:28:56,169 --> 00:28:59,172 OK? Let me start by owning that. 685 00:28:59,172 --> 00:29:02,001 And Dr. Ahmad was not serving her own agenda. 686 00:29:02,001 --> 00:29:04,438 She was trying to help our dying patient 687 00:29:04,438 --> 00:29:06,875 battle his insurance company, 688 00:29:06,875 --> 00:29:09,008 which is a fight doctors typically avoid. 689 00:29:09,008 --> 00:29:10,879 Trust me, I know, it's not our lane. 690 00:29:10,879 --> 00:29:14,013 We don't deal with insurance. 691 00:29:14,013 --> 00:29:15,884 And honestly, I feel it's time we did. 692 00:29:15,884 --> 00:29:18,539 Because these companies are stepping into our lane. 693 00:29:22,717 --> 00:29:25,807 Take the patient Dr. Ahmad posted about. 694 00:29:25,807 --> 00:29:28,723 Now, he was diagnosed with stage four cancer 695 00:29:28,723 --> 00:29:31,204 three months after his doctor first suspected 696 00:29:31,204 --> 00:29:32,205 something was wrong. 697 00:29:32,205 --> 00:29:34,555 Why such a long gap? 698 00:29:34,555 --> 00:29:36,513 Because the CT his doctor ordered 699 00:29:36,513 --> 00:29:38,167 required prior authorization, 700 00:29:38,167 --> 00:29:39,908 and Berninger denied it. 701 00:29:43,085 --> 00:29:45,261 That's the crux of the issue. 702 00:29:55,924 --> 00:29:57,839 Paul, Pamela, I want to introduce you 703 00:29:57,839 --> 00:30:01,060 to Dr. Washington, who is our head of oncology 704 00:30:01,060 --> 00:30:02,888 here at Gaffney. 705 00:30:02,888 --> 00:30:04,585 Oh, wow, top dog. 706 00:30:04,585 --> 00:30:06,326 This must be bad. 707 00:30:06,326 --> 00:30:07,980 Don't read in to the title. 708 00:30:07,980 --> 00:30:10,547 While you do have a small mass in your pancreas... 709 00:30:10,547 --> 00:30:11,722 OK. 710 00:30:11,722 --> 00:30:14,638 It's confined to the tail, 711 00:30:14,638 --> 00:30:16,466 which means it's resectable. 712 00:30:16,466 --> 00:30:18,512 That's good, right? 713 00:30:18,512 --> 00:30:19,861 It's really good. 714 00:30:19,861 --> 00:30:21,602 Surgery is far and away the best treatment 715 00:30:21,602 --> 00:30:23,430 for pancreatic cancer. 716 00:30:23,430 --> 00:30:25,214 And it's rarely an option. 717 00:30:25,214 --> 00:30:26,650 The cancer is usually too advanced 718 00:30:26,650 --> 00:30:28,087 by the time we catch it. 719 00:30:28,087 --> 00:30:30,959 I advise a few rounds of chemo to shrink the tumor 720 00:30:30,959 --> 00:30:34,136 and then the distal pancreatectomy to remove it. 721 00:30:36,312 --> 00:30:39,011 Few doctors would have connected the dots here. 722 00:30:39,011 --> 00:30:41,404 You're lucky you ended up with this one, Mr. Moore. 723 00:30:42,623 --> 00:30:44,538 I'm realizing that. 724 00:30:44,538 --> 00:30:46,670 Thank you, Dr. Charles. 725 00:30:46,670 --> 00:30:49,151 Absolutely a team effort. 726 00:30:53,764 --> 00:30:55,505 Thank you, Pam. 727 00:30:55,505 --> 00:30:57,812 It's not lost on me if you hadn't conned me 728 00:30:57,812 --> 00:30:59,901 into coming in here today-- 729 00:30:59,901 --> 00:31:01,207 You're gonna be OK. 730 00:31:01,207 --> 00:31:02,773 That's all I care about. 731 00:31:18,528 --> 00:31:19,703 Hey. 732 00:31:19,703 --> 00:31:21,444 I'm looking for my wife. 733 00:31:27,407 --> 00:31:28,582 Hannah. 734 00:31:28,582 --> 00:31:29,888 Nick. 735 00:31:31,019 --> 00:31:32,499 H-how do you know-- 736 00:31:32,499 --> 00:31:34,370 I just delivered your baby. 737 00:31:34,370 --> 00:31:35,937 What? 738 00:31:37,199 --> 00:31:39,158 Does Tessa-- - Oh, she knows. 739 00:31:39,158 --> 00:31:41,769 - Oh, no. - She hacked into your phone, 740 00:31:41,769 --> 00:31:43,336 found your messages, and tracked me down. 741 00:31:43,336 --> 00:31:44,337 Oh, my God. 742 00:31:44,337 --> 00:31:45,947 Is that why she's here? - Shh! 743 00:31:45,947 --> 00:31:47,253 She's sleeping. 744 00:31:47,253 --> 00:31:48,950 What did she say? 745 00:31:48,950 --> 00:31:50,691 Is this why she went into labor? 746 00:31:50,691 --> 00:31:53,259 Well, it's definitely possible for emotional stress 747 00:31:53,259 --> 00:31:55,348 to induce labor. 748 00:31:55,348 --> 00:31:59,874 But regardless, Tessa gave birth to a healthy baby girl, 749 00:31:59,874 --> 00:32:02,485 and both mom and baby are doing well. 750 00:32:02,485 --> 00:32:03,834 Oh, thank God. 751 00:32:08,404 --> 00:32:09,840 Look, Hannah, I'm-- 752 00:32:09,840 --> 00:32:11,364 I'm not a cheater. 753 00:32:11,364 --> 00:32:14,106 Yeah, well, last night would suggest otherwise. 754 00:32:14,106 --> 00:32:17,196 You were the only woman I messaged on that app, OK? 755 00:32:17,196 --> 00:32:19,763 And I had no intention of ever seeing you again. 756 00:32:19,763 --> 00:32:21,852 Don't flatter yourself. 757 00:32:21,852 --> 00:32:24,377 Look, I made a horrible mistake. 758 00:32:24,377 --> 00:32:26,509 I was freaking out about becoming a dad, you know, 759 00:32:26,509 --> 00:32:30,209 and I just thought, one last night of freedom-- 760 00:32:30,209 --> 00:32:33,429 OK, save your rationalizations for your wife. 761 00:32:33,429 --> 00:32:36,041 Or better yet, spare her. 762 00:32:36,041 --> 00:32:38,478 I think that your time is best used 763 00:32:38,478 --> 00:32:40,697 begging Tessa for forgiveness. 764 00:33:02,937 --> 00:33:04,460 Hey. 765 00:33:06,375 --> 00:33:07,768 What is it? 766 00:33:07,768 --> 00:33:09,509 Vince just started vomiting blood. 767 00:33:19,345 --> 00:33:20,694 Dr. Charles? 768 00:33:20,694 --> 00:33:22,391 Mrs. Moore? 769 00:33:22,391 --> 00:33:23,827 Are you all right? 770 00:33:23,827 --> 00:33:26,265 Look, we know it's a scary diagnosis, 771 00:33:26,265 --> 00:33:28,006 but in terms of pancreatic cancer, 772 00:33:28,006 --> 00:33:30,443 his prognosis could not be better. 773 00:33:30,443 --> 00:33:32,880 And that's largely because of your efforts. 774 00:33:32,880 --> 00:33:35,317 You saved his life by bringing him in today. 775 00:33:35,317 --> 00:33:38,277 Well, he has quite a way of thanking me. 776 00:33:40,975 --> 00:33:42,803 He wants a divorce. 777 00:33:52,769 --> 00:33:54,771 Vince, we're concerned you may be developing 778 00:33:54,771 --> 00:33:56,077 a tear in your lower esophagus 779 00:33:56,077 --> 00:33:58,514 from all of the vomiting. 780 00:33:58,514 --> 00:34:00,516 I'd like to place an NG tube, Vince. 781 00:34:00,516 --> 00:34:02,040 - No. - Just for the time being. 782 00:34:02,040 --> 00:34:03,345 No, no tubes. 783 00:34:03,345 --> 00:34:04,955 How many times do I have to tell you-- 784 00:34:04,955 --> 00:34:06,131 Hear me out. 785 00:34:06,131 --> 00:34:07,610 It's not a feeding tube. 786 00:34:07,610 --> 00:34:09,264 It's just gonna stop you from vomiting, 787 00:34:09,264 --> 00:34:11,223 and it'll help during surgery 788 00:34:11,223 --> 00:34:12,702 to decompress your stomach, OK? 789 00:34:12,702 --> 00:34:14,530 Wait. 790 00:34:14,530 --> 00:34:16,445 Did you just say surgery? 791 00:34:16,445 --> 00:34:18,186 Yeah, I heard "surgery," too, Dr. Marcel. 792 00:34:18,186 --> 00:34:19,274 Mm-hmm. 793 00:34:19,274 --> 00:34:20,667 That's right. 794 00:34:20,667 --> 00:34:23,017 The board voted unanimously for the hospital 795 00:34:23,017 --> 00:34:25,063 to cover the costs of Vince's surgery. 796 00:34:29,110 --> 00:34:30,764 Seriously? 797 00:34:31,895 --> 00:34:33,984 The hospital is just gonna pay for it? 798 00:34:33,984 --> 00:34:35,725 Yep. 799 00:34:37,510 --> 00:34:39,903 I can't believe this. 800 00:34:39,903 --> 00:34:42,515 Is this real? 801 00:34:42,515 --> 00:34:44,517 It's very real. 802 00:34:44,517 --> 00:34:47,128 In fact, I got you scheduled in the OR 803 00:34:47,128 --> 00:34:48,999 for 8:00 a.m. tomorrow. 804 00:34:51,915 --> 00:34:54,179 Hey, you guys are going to Italy in three weeks. 805 00:34:54,179 --> 00:34:55,745 We got no time to waste. 806 00:35:00,620 --> 00:35:03,318 How can I begin to thank you? 807 00:35:03,318 --> 00:35:06,016 To thank you both? 808 00:35:06,016 --> 00:35:10,108 Well, how about you let us place this NG tube, OK? 809 00:35:15,548 --> 00:35:17,593 All right. 810 00:35:17,593 --> 00:35:19,334 Do you think it was the depression that made him 811 00:35:19,334 --> 00:35:21,858 make such a rash decision? 812 00:35:21,858 --> 00:35:23,556 You know, I don't, actually. 813 00:35:23,556 --> 00:35:25,166 But what possessed him to do it right now? 814 00:35:25,166 --> 00:35:27,037 I mean, he couldn't even wait until they were home? 815 00:35:27,037 --> 00:35:29,301 Your mortality can be a pretty powerful motivator 816 00:35:29,301 --> 00:35:33,218 to do all the stuff that you put off doing, right? 817 00:35:33,218 --> 00:35:34,741 I think that Paul had been thinking 818 00:35:34,741 --> 00:35:36,221 about this for a while. 819 00:35:36,221 --> 00:35:37,396 I wonder if he's gonna regret it. 820 00:35:37,396 --> 00:35:38,701 I mean, speaking from experience, 821 00:35:38,701 --> 00:35:40,877 he's got a long road ahead of him. 822 00:35:40,877 --> 00:35:42,792 One that's not easy to walk alone. 823 00:35:42,792 --> 00:35:45,926 Yeah, but I mean, given his feelings about the marriage, 824 00:35:45,926 --> 00:35:47,754 is it really-- 825 00:35:47,754 --> 00:35:49,538 really fair to Pamela to put her in the position 826 00:35:49,538 --> 00:35:51,758 of being the support system? 827 00:35:57,546 --> 00:35:58,765 I'm sorry. 828 00:35:58,765 --> 00:36:00,680 No apology necessary. 829 00:36:00,680 --> 00:36:03,509 I've been through enough divorces 830 00:36:03,509 --> 00:36:04,901 to be able to say with some authority, 831 00:36:04,901 --> 00:36:07,469 spontaneous weeping is a part of the deal. 832 00:36:10,559 --> 00:36:12,779 Tonight's my annual MRI. 833 00:36:12,779 --> 00:36:15,564 Make sure that my cancer hasn't returned. 834 00:36:15,564 --> 00:36:18,785 I've been dreading it all day. 835 00:36:18,785 --> 00:36:21,788 Ben and I always made our appointments together. 836 00:36:21,788 --> 00:36:22,963 Yeah. 837 00:36:28,751 --> 00:36:31,232 When I saw the appointment approaching on my calendar, 838 00:36:31,232 --> 00:36:33,843 I almost texted Ben. 839 00:36:35,802 --> 00:36:37,282 I wanted to see if he wanted to keep 840 00:36:37,282 --> 00:36:40,241 the tradition alive, but-- 841 00:36:40,241 --> 00:36:41,590 then I remembered-- 842 00:36:44,767 --> 00:36:47,640 He's not my support system anymore. 843 00:36:49,163 --> 00:36:51,209 And I'm not his. 844 00:37:01,741 --> 00:37:03,830 Dr. Ahmad, hey. 845 00:37:04,961 --> 00:37:06,398 What's going on with that interview? 846 00:37:06,398 --> 00:37:07,834 Why? 847 00:37:07,834 --> 00:37:09,270 Did the board give you approval to join me? 848 00:37:09,270 --> 00:37:10,793 Oh, no. 849 00:37:10,793 --> 00:37:12,317 The board would appreciate it if the interview 850 00:37:12,317 --> 00:37:14,449 went away altogether. 851 00:37:14,449 --> 00:37:16,799 There it is, the catch. 852 00:37:16,799 --> 00:37:18,975 This issue is bigger than just one patient. 853 00:37:18,975 --> 00:37:21,282 And the board recognizes that, 854 00:37:21,282 --> 00:37:23,719 which is why they're making prior authorization 855 00:37:23,719 --> 00:37:26,635 a key issue in negotiations with Berninger. 856 00:37:26,635 --> 00:37:28,115 And you trust they'll follow through? 857 00:37:28,115 --> 00:37:29,986 I'll be holding their feet to the fire. 858 00:37:31,423 --> 00:37:34,817 I agreed to serve as an advisor on prior authorization 859 00:37:34,817 --> 00:37:38,125 for the negotiating committee. 860 00:37:38,125 --> 00:37:41,737 So am I still in the doghouse? 861 00:37:41,737 --> 00:37:43,304 Now, you went to the mat for a patient. 862 00:37:43,304 --> 00:37:45,263 Not a grudge-worthy offense in my book. 863 00:37:45,263 --> 00:37:48,266 But for what it's worth. 864 00:37:48,266 --> 00:37:49,658 Here we go. 865 00:37:49,658 --> 00:37:51,704 Look, there's a benefit 866 00:37:51,704 --> 00:37:54,402 to being taken seriously by management. 867 00:37:54,402 --> 00:37:55,621 You get invited into rooms 868 00:37:55,621 --> 00:37:57,318 where you can actually have an impact. 869 00:37:57,318 --> 00:38:00,843 I'm not sure that's the kind of impact I'm trying to make. 870 00:38:00,843 --> 00:38:02,192 I'm not saying it is. 871 00:38:02,192 --> 00:38:07,589 But maybe you want to keep your options open. 872 00:38:09,025 --> 00:38:11,332 Thanks for the pearls, Obi-Wan. 873 00:38:11,332 --> 00:38:13,334 Oh, anytime. 874 00:38:22,169 --> 00:38:26,042 Well, today settles it. 875 00:38:27,217 --> 00:38:28,044 Joining a nunnery? 876 00:38:28,044 --> 00:38:29,959 Deleting all dating apps. 877 00:38:29,959 --> 00:38:31,439 Ah. 878 00:38:31,439 --> 00:38:33,659 Probably for the best. 879 00:38:33,659 --> 00:38:36,096 All that swiping, head buried in your phone. 880 00:38:36,096 --> 00:38:38,228 Might get a crick in my neck. 881 00:38:38,228 --> 00:38:40,318 Might miss out on meeting someone in the-- 882 00:38:40,318 --> 00:38:41,362 what do the kids say? 883 00:38:41,362 --> 00:38:43,233 IRL? 884 00:38:43,233 --> 00:38:45,584 In real life? 885 00:38:45,584 --> 00:38:47,499 - Hmm. - Have a good night, Asher. 886 00:38:55,071 --> 00:38:56,769 Come in. 887 00:38:58,379 --> 00:38:59,946 Hey. - Hey. 888 00:38:59,946 --> 00:39:02,035 I know we're supposed to be meeting at the restaurant, 889 00:39:02,035 --> 00:39:04,254 but I thought you might need a ride. 890 00:39:04,254 --> 00:39:05,778 Close the door. 891 00:39:10,609 --> 00:39:13,742 I was just about to call you, 892 00:39:13,742 --> 00:39:15,744 because I'm gonna actually 893 00:39:15,744 --> 00:39:17,572 need a rain check tonight. 894 00:39:17,572 --> 00:39:20,314 - Oh? - Yeah, something came up. 895 00:39:20,314 --> 00:39:22,098 This is not because of our conversation this morning, 896 00:39:22,098 --> 00:39:24,362 I hope? - No, no, no, no. 897 00:39:24,362 --> 00:39:25,624 Because if it is, I didn't mean to pressure you. 898 00:39:25,624 --> 00:39:27,277 You didn't at all. 899 00:39:27,277 --> 00:39:31,238 In fact, I think we should start telling people. 900 00:39:31,238 --> 00:39:33,414 - I'm sorry, what? 901 00:39:33,414 --> 00:39:35,416 You know, I've always carried myself with 902 00:39:35,416 --> 00:39:38,680 a sense of propriety, and I spend a lot of time 903 00:39:38,680 --> 00:39:41,770 encouraging my colleagues to do the same. 904 00:39:41,770 --> 00:39:46,079 But I just think if you feel strongly 905 00:39:46,079 --> 00:39:49,474 about something in private, 906 00:39:49,474 --> 00:39:51,998 you should own it in public. 907 00:39:51,998 --> 00:39:53,608 "Strongly," you say? 908 00:39:53,608 --> 00:39:55,610 "Strongly," she said. 909 00:39:59,440 --> 00:40:02,095 You sure you don't want to join me for dinner tonight? 910 00:40:03,966 --> 00:40:06,316 I'm suddenly very much in the mood to celebrate. 911 00:40:06,316 --> 00:40:07,535 I can't, I can't. 912 00:40:07,535 --> 00:40:10,451 But I'll tell you what. 913 00:40:10,451 --> 00:40:13,149 If you're up late, 914 00:40:13,149 --> 00:40:16,631 I will stop by for a nightcap. 915 00:40:16,631 --> 00:40:18,807 Then I most definitely will be up late. 916 00:40:23,638 --> 00:40:25,814 I'll see you later. 917 00:40:25,814 --> 00:40:27,729 See you then. 64067

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