All language subtitles for the.pitt.s01e05

You sent labs?

No indication.

Normal vitals,
normal neuro exam.

Dude just dropped... no warning.

- What's open?
- Trauma 1.

Grab Langdon
or whoever else is avail.

What have we got?

Seizure in chairs.

Thank you.

How is it out there?

Chaos.
We're never gonna catch up.

Lorazepam's on board.

Okay, draw up another 4.

Yeah, no history.

Doesn't look like
he's been here before.

Satting low 90s on 5 liters.

Another 4 milligrams.

I can't get the top off.

It's... it's just the plastic,
not the metal.

No, I know.
I know, I know.

Here, give it to me.

No, I got it.

Okay.

Ordering CBC, CMP,

and a straight cath
for a urine tox.

All right.
Pushing the second 4.

If this doesn't work,
we need to prep Keppra.

No, we'll give more lorazepam.

It's already ordered.

He's already had 8 milligrams.

He'll stop breathing.
- Then we'll intubate.

Sometimes a patient
needs a little more.

- How long has he been seizing?
- About four minutes ago.

He started seizing in chairs.

He's already had 8 of lorazepam.

I want to move on to Keppra,
but Dr. Langdon disagrees.

I just want us to try another
2 milligrams before moving on.

Dr. Langdon's patient,
Dr. Langdon's call.

Dennis Whitaker,
meet Bob Chazen,

a 53-year-old cyclist
who injured his leg

about ten days ago
on a trip to Utah.

I was in Moab,
coming downhill fast,

and jammed my pedal into my leg.

Ooh, ouch.

That's some gnarly road rash.

White Rim Trail.

I've been putting Neosporin
on it a couple times a day,

but now it hurts to walk.

What do you see, Whitaker?

Um, outside of the
wound looks cellulitic.

What's that?

It's a bacterial infection.

We'll need to get you
on oral antibiotics.

Figured.

What about the center
of the wound?

Uh, it's a simple hematoma.

Which you can now debride.

Whitaker will take off the
dead skin covering the blister

to help it heal better.

I'll be right back.

Yeah, uh, quick question.

Get some Iris scissors,
toothed forceps, sterile gauze.

No, it's just, um...

Blister guy? Really?

Mr. Chazen was
the next patient on deck.

I know I screwed up earlier.

You didn't screw up.

The patient died.

It happens.

Just don't amputate
Mr. Chazen's leg.

Okay. Hey.

Another 2 of lorazepam.

- For a total of 10.
- I'm well aware.

He's still seizing.

Call respiratory.

I'm setting up an
intubation tray.

Which we won't need.

Dr. Santos,
what is the definition

of status epilepticus?

A seizure lasting
more than five minutes

or at least two seizures

without full recovery
in between.

Excellent.

Seizure activity has stopped.

Also excellent.

Spontaneous breathing,
good tidal volume.

Sats up to 98.

Welcome back, Mr. Marino.

Now we can do a Keppra load
slowly and safely.

Nice work, Dr. Langdon.

I will be at Central
if you need me.

This must have been a bad vial.

8 milligrams should have worked.

According to your textbook
of emergency medicine.

But sometimes they
need a little bit more.

You'll learn that with time.

Well, why couldn't
I open the vial?

Because you're an intern

who also needs to learn
to trust her senior resident,

especially in front
of an attending.

Now check his labs,

babysit him until he goes to CT,

and get some blankets
on these side rails

as a seizure precaution.

- Is this gonna hurt?
- Oh, no.

Skin's dead.
You won't feel a thing.

First time in Moab?

No, no.

I belong to a club,
Gears and Beers.

We started riding to Frick Park
during the pandemic...

you know, just something
to do to get out of the house.

But we all stuck with it,
and now we go on biking trips.

Huh.

Ahh! Ahh!

Oh! Whoa, oh!

Help!
Do something, man!

- Um...
- Oh!

- Uh...
- Dude!

Oh, ow!

I need a little help here!

Jesus!

Hey. What's up?

Arterial pumper
under a blood blister.

- Let's see.
- Oh.

- Jesus!
- Oh, God.

Noob.

Hi, I'm Dr. King.
Um, we can fix this.

- Did you cut an artery?
- No, no.

I-I punctured the top
of the blood blister,

but there was an artery
hiding under there.

Hiding?

Like... like you didn't
know it was there?

Don't you have to know basic
anatomy to become a doctor?

He's a student doctor.

What the fuck?

Student?

Oh, hell, no.
No, no, no.

Can... can you help me?

Can you fix it?
- Oh, absolutely.

First, we are going
to put this BP cuff on

to stop the bleeding.

A little forward.

There we go.

All right, you can let go.

- Yeah?
- Mm-hmm.

- Thank God.
- Oh, thank God.

All right, Whitaker, 10 ccs
of 1% lidocaine with epi.

Yep.

Uh, the shot is
gonna numb the area

and also constrict
any blood vessels

so that we can put
a little stitch in there.

What happened in here?

Uh, hidden laceration of
an arteriole under the vesicle.

Uh, bleeding stopped at 180
on the BP cuff,

and we are now injecting
lidocaine with epi.

Thank you, Dr. King.

Let's set up a suture tray
with 3-0 nylon.

Okay.
A pinprick and some burning...

Doc, Doc, can you
step in here, please?

You got this, Whitaker.

That ambulance chase
is on live TV.

- What channel?
- Every channel.

Ooh, what do you think
the over-under

on clipped cars should be?

- 15.
- Mm!

Come on.

Can I put it on the TVs
in the waiting room?

Fine by me.

I just hope wherever it ends up,

it's out of our catchment zone.

Got a second?

It's never a second, but shoot.

I think there was an issue
with a vial of lorazepam used

on our last patient
and it should be reported

to the drug manufacturer.

What kind of issue?

The cap was really hard
to take off,

almost like it was
super-sealed shut.

I'm worried it could be
a bigger issue.

Like?

Like maybe
the temperature wasn't

properly controlled
during transportation

and the seal on the vial
melted shut,

which could mean the medication
is compromised.

Any other vials affected?

Uh, just this one.

Okay.

Check the manufacturer's
website,

see if there's been
a recall of the lot number.

And what if this is
the first irregular vial?

Then hold on to the vial in case

there are any other issues.

Hey, look who's in the house!

Hey.

Jake the Snake!
It's 11:00 a.m.

Aren't you supposed
to be in school?

Mom let me ditch for Pittfest.

How's your mama?

Oh, she's restoring some house

in Squirrel Hill, so, you know,
she's pretty busy.

That's cool.
You, uh... you looking for Robby?

Yeah, he's got
our festival passes.

Oh, you going together?

We were supposed to,
but, you know,

I decided to go with a friend.
- What's her name?

- Leah.
- Okay. Okay.

- Okay, okay.
- Don't hold out on us.

We need details.
Where'd you meet?

How long have you been together?

We met at junior
lifeguards this summer.

And we've been dating
for two months.

Yeah, she's pretty great.
- That's sweet.

I'm happy for you, kiddo.

I'm gonna go find Robby,
let him know you're here.

Hey.

A little advice, man-to-man...

always compliment her outfit,

hold her hand
in front of your friends,

and always wrap it
before you tap it.

Okay.

Slowly letting down
the cuff pressure

until we can identify
the exact spot.

Oh, I see it.
I see it.

Right... right there.

Okay.

Now you can place
a figure-of-eight suture.

Uh, I've never done
one of those before.

Look, maybe you
should just do it.

You should definitely do it.

Whitaker's got this.

It's easy,
just two stitches in one.

Take a big bite,
a simple interrupted suture

anterior to the bleeder.

Okay.

Okay.

Now instead of tying,
throw another one posterior.

Looks good.

Now a normal tie
for a figure-of-eight.

What did I miss in here?

I am so sorry.
I-I just...

Made an excellent catch
and saved Mr. Chazen's life.

- Really?
- Really?

Really?

There was a cut arteriole

under a ballotable vesicle.

If Mr. Chazen had gone home
without debridement,

the blister could have eroded
with uncontrollable hemorrhage.

Nice work.

Jackson Pollock here might want
to go hit the scrubs exchange.

Yeah.

All right.

Next up is an ingrown toenail.

It should be pretty quick, though.

And... ah.

Sherry, you're back.

The kids get to school okay?

- Yeah. Thanks.
- Hey, cool.

Well, come with me,

and we'll finish up
your wound care, okay?

Earl, what are you
doing out here?

I'm hungry.

Head back inside,
and we'll get you a sandwich.

- No egg salad.
- Sure. Come on.

Excuse me.
Excuse me.

I've been here
for over five hours,

okay, way longer
than that chick.

Can you check the list?
Driscoll?

Doug Driscoll.

E-everybody is seen
as quickly as possible

and in order
of medical care needed.

Unless they die waiting.

Would you look at that,
Mr. Driscoll?

It's actually time
to bring you back.

Thank God.

Would you take care
of Mr. Driscoll?

Yeah, absolutely.

Sherry, you're with me.

Oh, yeah.

Yeah, let's take care of this.

Hey, I need a minute.

I already put $20
on disgruntled ex-EMT

caught outside of our catchment.

And I will gladly take your
money when that mess is over,

but this is about a patient.

Kristi Wheeler,
17 years old, pregnant.

These are Abbot's fetal
measurements from yesterday,

and these are mine.

10-5 and 11-2.

Well, ultrasound is an art,
not a science.

Even in the very best hands,
the EGA differential can be

within three to five days
in the first trimester.

Definitely room for error.

Not if you're here
for a medication abortion

and you're past
the mandated 11-week cutoff.

There can also be
inter-operator variability.

I measured
the gestational sac, 11-3,

and the biparietal diameter,
11-1.

I didn't get a single
measurement under 11 weeks.

So what are you saying,

that Abbot lowballed his
measurements to help a teen

get the abortion that she wants?

Maybe.

Well, then you've
got two choices.

You can go with
Abbot's measurements,

or you can redo
your measurements,

go back in, and pick an angle
that shows 11 weeks or less.

Please tell me you're joking.

You were ready
to roll up your sleeves

and arm-wrestle the Ethics
Committee a couple hours ago

to override
Mr. Spencer's children.

What changed?
- Apples and oranges.

There was a clear,
bright line that Mr. Spencer

was never going to make it.

Falsifying medical records
for Kristi is flat-out illegal.

She's 17.
She deserves a life.

Of course she does.

But I will not jeopardize
my future in the process.

You'll be fine.

Someone finds out
I falsified medical records,

I'll get booted
from the residency program.

You've got tenure.

Worst case, you have
to take a job in Youngstown.

The risks are not the same
for you as they are for me.

You're right.

I'll do it.

- What?
- Erase your history, physical,

and impression
from Kristi's chart.

It'll be like you never
saw the patient.

I will take over.

I will complete a new chart
and upload my own image.

Robby, I'm not asking you to...

As your attending,
it is my decision.

I am a certified provider
for Mifepristone.

You are not.

And as a prudent physician,
I should examine

every patient before
I order medication...

- Robby.
- Yeah.

- Jake's here.
- Hey. Great.

Uh, any word back
on Nick Bradley's

perfusion study results?
- Still waiting.

Will you come find me
when the imaging's back?

These people have already
been through enough.

Is that Mr. Spencer?
- Yeah.

- Robby?
- Excuse me for one second.

I want to go see if I can find
Mr. Spencer's children

before they leave.

You look a little peaked.
You okay?

I just need
a good night's sleep.

I'm gonna grab you
a grilled cheese

before the noon lunch rush;
it'll help some color

back to your cheeks.
- Thank you.

I got you.

Uh, can someone please help?

It's my mother.

She fell.

What happened?

I fell in the yard.

I hurt my arm.
That's all.

Yo, we've been hugging
this wall for almost an hour.

Relax. We're just gonna
take her vitals.

Oh, Mom,
you've got cuts all over.

I fell in the rose bush.

I'll be fine.

I'm Dr. King.
This is Perlah.

What's your name?
- Ginger Kitajima.

Uh, I'm her daughter, Rita.

Ginger, did you hit your head?

No.

Any chance she
could have fainted?

- I told you. I tripped.
- I don't know.

I was taking a shower,
and she went outside.

She's not supposed to go
outside anywhere without me.

She needs 24-7
assistance with ADLs.

Are you the primary caregiver?

I'm her only caregiver.

Ma'am, what medications
are you on?

Oh, uh, just one.

Risperidone.

My mom has schizophrenia.

BP 132 over 78.

Pulse 84.
Sats 98.

I haven't seen this
young lady around before.

Somebody new?

Flattery will
get you everywhere.

Ground-level fall.
Good vitals.

No head trauma, no AMS,

and just an isolated
shoulder injury.

You have any pain in your belly?

No, but next time,

buy me dinner
before you do that.

Okay, let's order
some basic labs

and get some pain meds on board.

And call me when
the X-rays are back.

Your mom's in very good hands.

You're leaving so soon?

Oh, I'm never far away.

I'll save a dance for you.

I'll be counting on it.

Looks like more
than just vitals to me.

That's it.
You're on the list, Harley.

Aw, shit. No.

Perlah, I'm sorry!

I take it back!
- Too late!

You're on the list.

Mm.

Okay.

What?

Oh.

I like big butts,
and I cannot lie.

Whoa.

You scared me there.

Want a pony ride, big boy?

- What?
- Excuse me, Myrna.

I need to discuss
a confidential patient issue

with my colleague here.

We need a little privacy.

Catch you later, sweet cheeks.

Don't mind Myrna.
She's harmless.

She's handcuffed.

That's why she's harmless.

You gotta stay on top
of Ozzie's ear infection.

His meds are in the fridge.

Our dog has really bad
allergies.

And I changed Ruby's
food order to Monday.

Bougie bitch.

She only likes the good stuff.
- Mm-hmm.

Like mother, like daughter.

Nice to know you still
make each other laugh.

Make each other laugh.

Make each other
deliriously happy.

Sorry. Didn't mean to get
all mushy in front of you.

Are you kidding me?

You two are the sweetest.

I never got to see this kind of
love between a married couple.

Your parents weren't
the lovey-dovey type?

My dad died when I was 13.

Aw.

I'm so sorry.

Yeah, me too.

He's the reason why
I got into medicine

and the reason why
I'm conducting research

on racial disparity in the ER.

I'm doing
a retrospective chart review

on our past five years
of patients of color.

Is that how you knew
what was going on with me?

We don't treat sickle cell here

as well as they do
in other hospitals,

but I'm hoping to change that.

Status, Dr. Mohan?

Still on exchange transfusion
and high flow nasal oxygen,

but oxygen sats are dropping.

She's at 84.

- That's really low.
- Yes, it is.

The goal of
exchange transfusion is

to reduce the percentage of
sickle hemoglobin to under 30%.

That is not happening
at the rate

that your wife needs,
which is causing

your blood to be unable
to carry oxygen,

causing further
blocked blood cells.

- What does that mean?
- Dr. Mohan.

To prevent stroke
or heart attack,

we need to get you more oxygen,
but we will need to intubate.

How long can we wait to see
if that's really necessary?

Acute chest syndrome
can progress very quickly.

It is the most common
cause of death

for patients with sickle cell.

It is imperative
that we intubate.

I-I...

I-I-I don't know.

Why don't we give you and Ondine

some privacy so you can talk?

Look, you want to be
their friend, but right now,

you need to be Joyce's doctor.

So get her to sign
the consent form

and prep for the intubation.

43, 44, 45...

Whoa!
- 46, 47.

Ugh.

You're not gonna beat my record.

Ohh.

How the hell did you
stay on for 80?

I'm 17,
and I'm more fit than you.

That kid looks my age.

Yeah, he is.

What happened to him?

Stressed-out 18-year-old took
some pills off the internet

to help him sleep.

They were laced with fentanyl.

- Is he gonna make it?
- Mm.

Poor Huckleberry.

Not even 11:30 and you've
already been demoted.

They had only morgue scrubs
left in my size.

Then I guess you better not

fuck anything else up today, huh?

Yo, Donahue.
- Yo.

You get in on that
ambulance-chase action?

Yeah, $20 on catch,
chop shop, out of our zone.

Bold.

I like it.

What can I do you for?

Hypothetical question...

would you ever go over
a resident's head

to the attending?

Hypothetically,
I wouldn't recommend it

unless it's a behavioral issue
or harassment.

And in that case, you can make
a confidential report to HR.

What if it's more
patient care related?

Depends.

If it's something minor,
leave it alone.

If it's something
that endangers the patient,

then definitely yes.

Pick your battles.

You don't want to be
the intern who cried wolf.

- Ahh!
- Yeah?

Okay, still pretty raw.
- Yeah.

Let me put some more
anesthetic on there,

numb you up some more.

It's my own fault.

I should have known better
than to try to make

s'mores over a Sterno,

but they kept asking.

Yeah.
The things we do for our kids.

Yeah.

You have a kid, right?
- Yeah.

He's 11.

And when he, um...
when he turned 8,

he begged me
to go camping for his birthday.

We drove four hours
to New River Gorge.

Took me an hour
to set up the tent.

Guess how long we lasted.

Three hours?

37 minutes.

A thunderstorm came
out of nowhere,

filled the tent
with water so fast,

I felt like I was being
flushed down a toilet.

I'm so sorry.

Ran out of there like
a couple of gutter rats.

Ended up celebrating
his birthday

at 2:00 a.m. with a Happy Meal.

Oh, what my kids wouldn't
give for a Happy Meal.

Yeah, they must, um, have
some pretty fancy McDonald's

up there in Shadyside.

Yeah.

That's, uh... that's
where you live?

It's the address
on your patient file.

Um, technically, no.

I just use the address so my
kids can go to a decent school.

Right.

I know it's illegal,
but it's just temporary.

- Oh, God.
- I promise.

No judgment here.

My son always comes first,
no matter what.

Yeah.

Even If it means
I have to do without.

I know, I'm a doctor, right?

How bad could it be?

But I, uh...
I used to be an addict.

I even lost custody of my kid.

Huh, I never would have guessed.

Mm. Yeah.

I went through some
really dark times

before I finally got help.

And I've been sober now 9 years,

5 months, and 11 days.

And your son?

He's good.

- Okay.
- You know, we're good.

He gets to stay with me
every other weekend.

And, um...

We'll be back to joint custody

just as soon as I get this
stupid thing off next week.

Oh.

Don't worry.
I only killed three people.

Oh, God, I'm kidding.

- Oh.
- I'm kidding.

I'm sorry.
It was a bad joke.

The whole thing was just this...

giant misunderstanding.

I guess I'm oversharing
because I want you to know,

not everybody has it
all figured out all the time.

Yeah.

Um, I'm struggling.

And I feel like such a bad mom.

And every day is so hard.

And I don't know what's
gonna happen tomorrow

or the next day.

Sometimes I wonder if they would

just be better off without me.

Yeah?

Do you...

Not like that.

I just...

I've just messed up so much.

- Yeah.
- And I don't know.

You're their mom.

You love them, and nothing
and no one can replace that.

Yeah.

You deserve a little grace,
you know.

Be kind to yourself.

Well, you had a normal EKG
and chest X-ray.

But it looks like you sustained

a proximal humerus fracture
on the left upper arm.

There goes my backhand.

That was a joke, dear.

Okay, um, because
the fracture isn't displaced,

the good news is,
you don't need surgery.

Oh, that's a relief.

The bad news is,
you do need to wear a sling

for at least six weeks.

And I have to insist,
absolutely no shoulder mobility

for the first few weeks.

And that means you're gonna
have to step up even more,

because on top
of your usual ADLs,

you're also gonna have
to help your mom bathe,

dress, and use the toilet.

I'm so sorry, Mom.

This would never have happened
if I was more on top of things.

Any more on top,
you'd be back in my womb.

It's going to be fine.

I know how hard it can be.

I was my sister's
primary caregiver

until a few weeks ago.

Where is she now?

Um, she's in an amazing
facility in North Hills.

I know I can be a burden,

but I like being in my own home,

just me and my girl.

You're not a burden.

You're my mom.

I'll refer you to Ortho.

They'll get you set up
with PT and exercises.

You're very lucky to have
such a caring daughter.

Don't I know it.

Park a red Subaru
in the ambulance bay?

Oh.
Yes, that's me.

Gonna need to move that to
open the space for ambulances.

Oh.
I'm so sorry.

- Okay.
- Um...

I'll walk Rita out.

Perlah, would you stay
with Ginger for a minute?

I'll be right back.
- Yeah, no problem.

Okay.
Um, after you.

Look, I-I put
your mom's prescription in

at the pharmacy,
and, uh, by the time

you get back from parking,

she should be ready
to be discharged.

Just don't worry.

Things will be back to normal
in a few weeks.

I'm not sure
what normal is anymore.

I can't even remember the last
time I slept through the night.

It's just...

It's a lot.

Um, do you have
any support at home?

I wish.

It's just us.

You know, I hired
a part-time aide for my sister

to cover me when I was at work.

It was really helpful.

It's out of our price range.

I mean, I already
work from home.

And then there's
the cooking and the cleaning

and the doctor's appointments.

It never ends.

You know, caretaker's fatigue
is a real thing.

You have to take care
of yourself.

Otherwise, you're gonna
end up in here, too.

I still don't understand
why Kristi needs

to go through this a third time
with a third doctor.

Yeah, that's our bad.

Our computerized medical records

have been glitching lately,
and Dr. Collins' image

didn't upload properly.

Okay, crown to rump...
that's top of the head

to the bottom of the butt...

is how you measure
gestational age.

And we are at
10 weeks and 6 days.

I made it by one day?

I will order the medication.

Dr. Collins will go
over instructions

on taking the pills when they
come back from the pharmacy.

Thank you so much, Dr. Robby.

Oh, I'm glad I could help.

Even more glad to see you have
such a supportive mom.

Okay, take care.

Appreciate you stepping up.

All good.
I got you.

Robby, I have Emma Isaacs
on line 3 for you.

She's the organ donation
counselor coming

to speak to Nick's parents.
- Thank you.

What was that all about?

- Oh, nothing.
- Didn't look like nothing.

- Please.
- What?

You two were once a thing.

We dated briefly
a million years ago.

Never again.
- Never say never.

Settle down, Jane Austen.

The lady doth protest too much.

- Mm.
- Mm.

Jake!

There he is...
the man, the myth, the legend.

And there's the kid
who stole my concert pass

and gave it to a girl.

Where is she?
Do I get to meet her?

Need an assist!

- Hold that thought.
- Okay.

Travis Johnson, 17,
had a tonsillectomy

ten days ago at St. Michael's.

Started spitting blood
about an hour ago.

Good vitals.
- Hey, Travis. I'm Dr. Robby.

How much blood?
- Couple mouthfuls.

Can you open up for me?

Hey, Whitaker, Jesse.

Got a post-tonsillectomy
hemorrhage.

Nebulized TXA, quick as you can.

- I'm on it. Let's go.
- Let's go, Trauma 2.

So this can go south
pretty quickly.

You up for it?
- Well, I can...

Of course you are.

Ready?
Here we go.

One, two, three.

Take long, slow,
deep breaths on that.

The TXA is gonna
help your blood clot.

Uh, any medical problems?

No, just a ton of strep.

That's why I had the surgery.

You take aspirin?

Any other medications?
- Mm-mm.

Lungs are clear bilaterally,
no stridor.

Okay, sure.

You feel like throwing up?
Any pain in your belly?

No.

Labs?

Uh, CBC, BMP, maybe coags?

Add a type and screen,
just in case.

Yeah.

Good sats at 98%.

BP is 115 over 80.

Okay, good.

Four by four on a ring forceps.

Let's take a look.
- Okay.

Head back, open wide for me.

- What do you see?
- No active bleeding,

but there's some white
and dark brown stuff

where the tonsils used to be.
- Oh, that's good.

That's a fibrinous clot.
That means the TXA is working.

Your parents on the way?

They're in Baltimore
for a wedding.

I didn't want to bother them.

Trust me.
They're your parents,

and you are in
an emergency room.

It is never a bother.

Write their numbers down,
and I will call them.

Call Head and Neck.

Stay with him until
they get here, okay?

Good.

Pen.

Can I get the...

Sam Wallace,
our Good Samaritan who saved

a Nepali lady, is in line
for a repeat head CT

to be sure there's no extension
of the intraparenchymal bleed.

Okay, so we can dial down
the sedation, and,

if he's alert,
check extubation parameters.

- Copy.
- Did you get the consent form

signed by Joyce the sickler

for the intubation?
- Not yet.

- Jesus fucking...
- She's scared.

I just wanted to give her
some time to talk to her...

To do what,
make funeral arrangements?

Joyce is hypoxic at 84.

84.
This goes on much longer,

she runs the risk
of permanent lung damage,

heart attack...
- I know.

- Stroke, death.
- I know.

Then move!

Now.

Just have a seat,
and we'll be with you shortly.

Oh, I've heard that load
of bullshit before.

My fucking God.

Took me all the way
back there just to

stick a goddamn thermometer
in my mouth, you know.

Repeat vitals every four hours.

Oh, dang!

Saw how it swerved
and almost hit the taxi?

Mm-hmm.

I gotta get out of here;
I mean, this thing is

totally gonna screw up
the traffic to Pittfest.

Nice score.
You going with Robby?

Well, I was supposed to.

But I have this new girlfriend,

and she's super excited
about the lineup, so...

So you ditched the old man
for a hot piece of ass.

Been there, done that.

Senior year, Lollapalooza,
I met this guy.

Think his name was Rich...

or was it Rick?

Doesn't matter.

But he looked like Dave Navarro.

Warm breeze, cool grass,

a million stars in the sky.

Best sex of my life.

You had sex in public?

We were under a blanket.

Oh!
It's turning around.

It's turning around, baby.

Come home to Papa.
- Shit.

I had money on it crashing
in Beaver County.

Better safe than sorry.

Okay.

- Jake, what's up?
- Hey, how are you?

Where's Rita?

Um, she went to park the car.

Shouldn't have been
more than five minutes.

Why don't you dial
her number for me?

- Did she pick up?
- Straight to voicemail.

- That's weird.
- Yo.

Sole caretaker, overwhelmed,

exhausted.

I told her to take a break,
but you don't...

you don't think she ditched
her mom, do you?

I mean, it happens.

You're gonna need to use the
antibiotic ointment twice a day

and come in for a wound check
in two days, okay?

Mateo, can you grab me
enough samples

to last a couple weeks?
- Yeah, I'm on it.

Thank you.

Thanks.

I really appreciate it.

Yeah. No problem.

Has Kiara been here yet?

No, who's Kiara?

Oh, she's the hospital
social worker.

She can help you out with,
like, housing and childcare

and food and security...
- You told her?

- No, I-I...
- No, no, it's all free.

The system works if you use it.

You just have to...
- Enough!

I don't need your help.

Nice speech.

Next time,
mind your own business.

You ever heard
of impact over intent?

I would never intentionally
embarrass anybody.

But you did.

You didn't have
a conversation with Sherry

or ask her what she needed.

Instead, you walked in here
and told her what to do.

You gotta slow down,
take a beat, and listen

instead of judging people.

- I don't judge.
- Please.

You've been eyeing me
sideways all day.

Look, maybe I have a better
perspective because I've been

on both sides,
but we gotta try to at least

put ourselves in their shoes.

Listening and building trust
will make us better doctors...

and better people.

Um, I'm sorry.

I'm not telling you this
to reprimand you.

I'm trying to teach you
to help you.

Wait, uh, what about Sherry?

I doubt she'll be back.

But sadly, there will be many,
many more just like her.

No. No, no, no.

He... he had the surgery
at St. Michael's,

but he's here now.

No, he doesn't have a car.

His parents are out of town.

Okay, okay, well,

how am I to send him
back to St. Michael's,

call him an Uber?

You can't... that doesn't make...

hey, hello.

Hello!

What's wrong?

Um...

They said it is not
their job to fix

another hospital's problem.

Don't worry about it, though.
I'll talk to my attending...

Oh, shit!

Uh, I need a little help here!

Okay, come on, open up.

It's a post-tonsillectomy
hemorrhage.

Uh, Yankauer and sponge stick.

He was stable.
Then it just opened.

Call the blood bank.

Two units, whole blood.
Get a second line.

Head and Neck wouldn't
come down to see him.

- Assholes.
- Tachy to 120.

His sats are down to 90%.

Okay, get a high-flow
nasal cannula,

100 of ketamine.

Set up the GlideScope.

Hold suction.

I'm gonna try
for direct pressure.

If Head and Neck still won't
come down, call Garcia.

You're good.
You're good.

Okay, before we begin,
let's take a time-out.

This is Joyce St. Claire.

Procedure is
endotracheal intubation

for hypoxia due
to acute chest syndrome.

We'll be using
video laryngoscopy

and an 8-0 ET tube
with a 7.5 on standby.

Induction with 75 of propofol,
100 rocuronium.

Got it.

For backup, we have
a bougie and an LMA ready.

Yep.

Any questions or concerns
before we start?

I wanna be awake.

We can't perform
an intubation that way.

I mean after.

After, we will
lighten your sedation.

You won't be able to talk,
but you can use a pen and paper

or an iPad to communicate.

I love you.

Till the end of time.

Robby, Trauma 2 right now.

- Cover the intubation?
- Of course.

- What happened?
- Bleeder opened up.

Ketamine on board to intubate.

Sats holding at 97.

- Can you get an airway?
- Come on.

Let's lie him down.

Keep pressure on the scab.

Nothing but blood.

Can't see the cords.

Sats 94.

Not sure we have room for
the tube with the sponge stick.

If I pull out, there's
gonna be even more blood.

Doesn't look like
you secured that airway.

- He's working on it.
- Bougie.

Open a crike tray
and prep the neck.

Hold on, I'm going in blind
with the bougie.

I might be able to feel
the tracheal rings.

And I might have
a three-way with Madonna.

Move.

Not happening.

Pressure.

Make room for the grown-ups.

Okay, okay.
Hold on, hold on.

We can try
a retrograde intubation.

- A what?
- There's no obstruction.

We just can't see
what we're doing.

So we take a needle,

and we put it
in the cricothyroid.

We run a guide wire
up and out the mouth,

and we slide the ET tube
up over the wire.

- Never seen one before.
- Sats 90.

No time to play MacGyver
with this kid.

Time to crike.
- It'll be quick.

You got one shot,
and then I cut.

Propofol and rock are on board.

Now we wait for the sedative
and paralytic to start working.

Should Dr. Robby be in here?

Between Dr. Mohan and myself,
we've done hundreds of these.

I'm getting sleepy.

I'm right here, babe.

Okay, I'm in.

Guide wire.

Let me know when you start
to feel it up top.

Nothing yet.

More suction.
- I'm trying.

Mm.
Still can't find it.

Well, keep feeling in there.

It's gotta be there somewhere.

- Maybe it's curling up.
- Sats down to 89.

- Guys, this is not working.
- Just give me a second.

- Until he arrests?
- Oh, my God.

I'm gonna lose another patient.

Shut up, Whitaker.
Let's get on this.

Sats down to 87.

Okay, I'm gonna
redirect the wire.

Sats still dropping.
86.

- You got this.
- Mm-hmm.

Ondine, if you'd like,
you can watch on the screen.

I'm okay.

Excellent view
of the cords, Dr. Mohan.

I'm in.

Inflate the balloon.

Good breath sounds bilaterally.

Sats 92 and rising.

That's it?
You're done?

Yes.

It all went perfectly.

How long until she gets better?

Depends.

It can take anywhere
from a few days

to a few weeks
for the lungs to heal

from acute chest syndrome.

I can ask the ICU to set up
a recliner for you

in Joyce's room
so you can stay with her.

Thank you both so much.

You're welcome.

Take care.

Sats 84.
We need to bag him.

- Still not seeing it.
- I'm suctioning like crazy.

Okay, we're done playing doctor.

Lose the wire.
I'm criking this kid.

All right, we tried.
I'm sorry.

No, wait.
Wait.

I've got it.

You still don't have an airway.

Okay, keep the laryngoscope
in place

so the tube passes easily.

Pass the T,
the T tube over the wire.

- Come on.
- Hang on to that wire.

Do not let go of that wire.

Okay.

Okay, I'm gonna give you
a little slack

so you can get past the cords.

Yeah, yeah.
I feel you at the trachea.

25 centimeters at the lips.

That ought to do it.

Pull the wire, bag him.

Balloon's up.

Yellow on CO2.
That's good.

That is very good.

Good breath sounds bilaterally.

Sats coming up.

90, 92.

Guess you're gonna have
to save that scalpel

for another day.
- You guys got lucky.

No, we got skills, baby.

We got skills!

Keep gauze on the clot.

Yeah, copy.

Ordering propofol
and fentanyl drips.

Oh, nice of you to join us,
Dr. Flores.

Sorry, I got stuck in a nasty
radical neck dissection.

Still bleeding?
- Not with direct pressure.

We got the airway.
You get the bleeder.

OR's standing by.

So I can cancel the Uber?

Let's get him upstairs.

Fresh sponge stick
for you, Whitaker.

You need me to stay with the...

Your patient.
You did a good job.

It's only till the
anesthesiologist takes over.

You got it?
- Yeah, I got it.

Get yourself
a fresh pair of scrubs

on your way back down.

Um, I'm sorry that took so long.

I was just...
- Don't apologize.

What you did in there,
building a relationship

with your patients,
earning their trust,

that's what this is all about.

Robby doesn't seem to think so.

Don't worry about him.

You know, I should be
apologizing to you.

Slo-Mo, you deserve better.

Keep doing you, Dr. Mohan.

Where'd you get that move?

Retrograde intubation,
that's an Adamson special.

I learned that from the best.

Well, you're not too shabby
yourself, Professor.

Yeah, that got
kind of rough in there.

You kept your composure,
though...

exactly the kind
of candidate they want

for the ED Medical
Education Fellowship.

Oh, there's probably over 50
applicants for that one slot.

Yeah, probably.

But I know that they like
to go with someone that they

know from firsthand
experience has

the skills to be successful.

At least that's what
I told them in my letter

of recommendation.

Thank you.

Mm-hmm.

Glad you stuck around.

It's not like I had
a choice, did I?

No, not really.

So how's your day going?

Uh, it's going.

Cool, cool, cool.

Why do you ask?

Guy can't ask?

You never ask me about my work.

What gives?

Mom wanted me to ask
because she just wants

to make sure that you're
doing okay.

That's very sweet of her.
I'm doing fine.

Thank you for these again.

You can thank me
by finally introducing me

to your girlfriend.

- Not today but soon.
- Have fun.

Hey, I know it goes without
saying, but please be safe.

- I will.
- Seriously.

Don't take anything from anyone.

I've already seen
two fentanyl overdoses today.

It's not even noon.
- I promise.

- Okay.
- Basketball Sunday?

Yep, wouldn't miss it.

Hey, before you go,
before you go.

Please don't hand me a condom.

Condom?

I was gonna give you extra cash.

Wait, are you having sex?

Thank you.

Looks like the driver lost
control as the police cars

were closing in.
- Oh.

Uh, the ambulance
has definitely stopped.

Check it out.

It's difficult to tell
from this angle,

but it does look like
they may have hit something.

- Damn!
- That's in our zone.

Ambulance crashed
in our catchment.

Get ready for incoming.

How many you think?

Other than the driver?
No idea.

Since you're past ten weeks,

you'll need to take
mifepristone twice,

once now and once in 24 hours.

Then 24 hours after that,
you'll take misoprostol,

two pills which dissolve
between the cheek and the gum,

then two more of the same
pills six hours later.

That's a lot to remember.

Everything is clearly labeled
with the names of the meds,

the dose, and the exact time
to take them.

Will it hurt?

You can expect
some vaginal bleeding.

There may be some cramping,

like when you're on your period.

If you're bleeding more
than two pads an hour

or the pain gets to be too much,

come back in and see us.

And I'll be with you
the whole time.

Kristi?

Kristi!

What the hell
are you doing here?

Hey, language!

And I should be asking you
the same thing.

Excuse me.
Who are you?

- I'm her mom.
- Mom?

Aren't you her mom?

I can explain.

No, that's my sister, Lynette.

I am Kristi's mother.

Kris... Kris, baby,
what are you doing here?

I'm here for an abortion.

Did you do it already?

- Not yet.
- Okay. Thank God.

Okay, okay, can we all just
take a step back here and...

Mom, I want this.
This is my decision.

- No.
- Just listen to her, El.

You can shut up!

You have done enough.

My daughter is a minor,

so she can't get this abortion

without my say-so, right?

Is that right?

That's correct.

Then there is no way
this is happening.

Not now, not ever.