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Previously on The Resident...
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00:00:02,665 --> 00:00:04,872
Everything you thought you
knew about medicine is wrong.
3
00:00:04,882 --> 00:00:06,922
All the rules you followed, we'll break.
4
00:00:06,932 --> 00:00:08,878
You don't have the right
to play God, Conrad.
5
00:00:08,888 --> 00:00:11,693
I will do whatever
it takes to get you back.
6
00:00:11,703 --> 00:00:13,125
Chief of surgery.
7
00:00:13,760 --> 00:00:15,763
Resident. Try to remember that.
8
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Dr. Okafor.
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00:00:20,467 --> 00:00:22,459
Don't be nervous.
I'll talk you through it.
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Acute leukemic, on chemo.
11
00:00:25,438 --> 00:00:26,964
Lily means a lot to all of us.
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00:00:26,974 --> 00:00:29,433
She's been in and out of the ER
so often we're all invested.
13
00:00:29,443 --> 00:00:31,386
- Where's Lily Kendall?
- She went home.
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Her count improved substantially.
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- We're in third place.
- Now or never.
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Sir, yes, sir.
17
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Second place. Oh, I know
how you feel about losing.
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00:01:19,404 --> 00:01:20,817
- We got this.
- We do?
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I do.
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15th Marine Expeditionary.
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Valor, honor... Whoa...
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- Victory.
- Yo!
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Dudes. Awesome race!
24
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Of course... random drunk guy.
25
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Cold ones on me.
26
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Aah... aah!
27
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My leg! I need a doct...
28
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It's broke.
29
00:02:14,380 --> 00:02:15,538
Doctor!
30
00:02:21,355 --> 00:02:23,179
Right fibula. Compound fracture.
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We need a splint.
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- Oh, it hurts. It hurts so bad.
- Deep breaths, buddy,
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00:02:29,062 --> 00:02:31,543
we don't want you going
into shock. What's your name?
34
00:02:31,554 --> 00:02:33,055
- Ooh. Hank.
- That's the best we got.
35
00:02:33,065 --> 00:02:36,038
- We'll just wrap him up.
- Like old times... medic and surgeon?
36
00:02:36,049 --> 00:02:37,546
He's about to tell us how much he misses
37
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the good ol' days when we were
in Afghanistan together.
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Give me some credit, hey.
All right, listen,
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this is gonna sting.
Might want to bite down on that.
40
00:02:44,076 --> 00:02:46,602
- But I do miss it sometimes. Don't you?
- I don't miss
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00:02:46,612 --> 00:02:48,272
being shot at. No sane person would.
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00:02:48,282 --> 00:02:50,150
Not trying to take that personally.
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Setting the leg...
44
00:02:53,286 --> 00:02:55,112
now!
45
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There we go. All right.
46
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Doing great, buddy.
47
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Let's go!
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- Synced and corrected by Shazi89 -
- www.addic7ed.com -
49
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Lily, hey.
50
00:03:27,119 --> 00:03:28,779
Oh, hey, Nic.
51
00:03:28,789 --> 00:03:31,280
You left Chastain so abruptly
the other day. I was worried.
52
00:03:31,290 --> 00:03:32,983
Yeah, I'm fine. Thank you.
53
00:03:32,993 --> 00:03:35,084
Just grabbing a prescription.
54
00:03:35,460 --> 00:03:37,719
You feeling okay?
55
00:03:37,730 --> 00:03:40,122
You want to come upstairs?
I can take your temperature,
56
00:03:40,132 --> 00:03:41,956
- make sure you don't have a fever.
- No, no, I'm good.
57
00:03:41,967 --> 00:03:44,348
Yeah, I'll stop by Dr. Hunter's
clinic if I need anything.
58
00:03:44,359 --> 00:03:45,461
- You sure?
- Mm-hmm.
59
00:03:45,471 --> 00:03:47,774
- 'Kay.
- Thanks.
60
00:03:54,880 --> 00:03:56,205
Come on, Mr. Rosenthal.
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00:03:56,215 --> 00:03:58,642
I got to take you for some
fresh air, and then to PT.
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00:03:58,652 --> 00:03:59,976
No, thanks.
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00:03:59,986 --> 00:04:02,478
What I need is a drink and smoke.
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00:04:02,488 --> 00:04:05,214
Good morning, Mr. Rosenthal.
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Lucky you... a free ride with Louisa,
our most popular transpo worker.
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00:04:08,495 --> 00:04:10,152
Ah, just a quick spin.
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00:04:10,162 --> 00:04:12,488
Don't want a spin around nothing.
68
00:04:12,498 --> 00:04:14,358
- You need sunshine.
- Vitamin D,
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00:04:14,368 --> 00:04:15,692
helps you absorb calcium.
70
00:04:15,702 --> 00:04:17,149
Which promotes bone density.
71
00:04:17,160 --> 00:04:19,181
You don't want to
break your hip again, do you?
72
00:04:19,192 --> 00:04:21,548
You know, you should really
listen to Louisa. You know why?
73
00:04:21,559 --> 00:04:23,993
- No, why?
- She's studying to be a doctor.
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00:04:24,004 --> 00:04:25,400
Med school, huh?
75
00:04:25,411 --> 00:04:26,883
You got a ways to go.
76
00:04:26,894 --> 00:04:28,185
How old are you, 12?
77
00:04:28,195 --> 00:04:29,853
Ah, close. 22.
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00:04:29,863 --> 00:04:32,255
And she volunteered at Chastain
all through high school.
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00:04:32,265 --> 00:04:33,723
- Hmm.
- Hi, Louisa.
80
00:04:33,733 --> 00:04:34,892
- Hey.
- Nic, seriously,
81
00:04:34,902 --> 00:04:36,627
what is this mandatory meeting about?
82
00:04:36,637 --> 00:04:37,961
I have 30 patients to see.
83
00:04:37,971 --> 00:04:39,396
- Billing.
- Billing?
84
00:04:39,406 --> 00:04:42,468
Whoa, sign me up. Love me some billing.
85
00:04:42,479 --> 00:04:43,760
Enough already.
86
00:04:43,771 --> 00:04:46,049
You okay?
87
00:04:46,060 --> 00:04:49,205
Yeah. Diagnosed myself with
a muscle pull this morning.
88
00:04:49,923 --> 00:04:51,447
Some kind of softball injury.
89
00:04:51,458 --> 00:04:53,931
Might have to, uh, skip out early today.
90
00:04:53,942 --> 00:04:56,480
Plus, I have to cram.
Midterms next week.
91
00:04:56,490 --> 00:04:57,508
Bio and calc.
92
00:04:57,519 --> 00:04:58,949
Well, if you need any help at all,
93
00:04:58,959 --> 00:05:01,063
I got a 132 on the bio section
of my MCATs.
94
00:05:01,074 --> 00:05:02,885
Kid brags a lot, doesn't he?
95
00:05:02,895 --> 00:05:04,053
Thanks, Dr. Pravesh.
96
00:05:04,063 --> 00:05:06,166
I might take you up on that offer.
97
00:05:19,851 --> 00:05:22,272
Compound fracture of the right fibula.
98
00:05:22,282 --> 00:05:24,942
Now, we reset it in the field,
but he might need surgery.
99
00:05:24,952 --> 00:05:26,343
All right. I'll be right there.
100
00:05:26,353 --> 00:05:28,277
- We'll see you inside.
- Okay.
101
00:05:28,287 --> 00:05:30,247
- Thanks, Doc.
- Let's go.
102
00:05:30,257 --> 00:05:32,449
You did great, Hank.
103
00:05:32,459 --> 00:05:33,950
Yeah, except for the crying.
104
00:05:33,960 --> 00:05:36,919
- And screaming for a doctor.
- And breaking all those beer bottles.
105
00:05:38,052 --> 00:05:39,789
The truth? That was like old times.
106
00:05:39,799 --> 00:05:41,723
Well, you miss it so much,
why don't you go back?
107
00:05:41,734 --> 00:05:43,192
Yeah, I've been meaning to tell you.
108
00:05:43,202 --> 00:05:44,967
Jude, I was joking.
109
00:05:46,280 --> 00:05:47,740
Thinking about re-enlisting.
110
00:05:47,751 --> 00:05:49,725
- Back into the Marines?
- Yeah.
111
00:05:50,476 --> 00:05:52,214
- Do boys ever grow up?
- Yes.
112
00:05:52,225 --> 00:05:53,803
- No.
- Mandatory meeting, we're late.
113
00:05:53,814 --> 00:05:55,538
I thought you were gonna
get us out of this?
114
00:05:55,548 --> 00:05:57,490
Yeah, well, I told her
we had seven open cases...
115
00:05:57,501 --> 00:06:00,461
All residents, all nurses. Let's go.
116
00:06:02,133 --> 00:06:03,312
You smell like a barn.
117
00:06:03,322 --> 00:06:05,315
- I like barns.
- Never been in one.
118
00:06:05,325 --> 00:06:06,884
What? I grew up in Queens.
119
00:06:06,894 --> 00:06:08,819
I've smelled worse, trust me.
120
00:06:08,829 --> 00:06:10,792
- Excuse me.
- Morning, everyone.
121
00:06:10,803 --> 00:06:14,158
We're here today
to talk about reimbursement.
122
00:06:14,168 --> 00:06:16,159
No one's favorite part
of the day, right?
123
00:06:16,169 --> 00:06:17,436
Okay, put that away, sweetie.
124
00:06:17,447 --> 00:06:20,163
Now, to simplify,
doctors and nurses at Chastain
125
00:06:20,173 --> 00:06:21,998
need to charge more per procedure.
126
00:06:22,008 --> 00:06:24,507
For example: ear infection.
127
00:06:24,518 --> 00:06:27,737
Typically billed to insurance
as service code one
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00:06:27,748 --> 00:06:29,884
at about... yeah?
129
00:06:31,584 --> 00:06:33,122
$200.
130
00:06:33,133 --> 00:06:36,012
But what if that ear infection
took a trip to the brain?
131
00:06:36,022 --> 00:06:39,348
That's now a code four. Serious.
132
00:06:39,358 --> 00:06:40,550
Costly.
133
00:06:40,560 --> 00:06:42,519
We can bill in the thousands.
134
00:06:42,529 --> 00:06:46,139
Illness is unpredictable,
so billing must be proactive.
135
00:06:46,150 --> 00:06:48,900
Right? It's called upcoding.
136
00:06:49,514 --> 00:06:52,141
Think... CUTE.
137
00:06:52,339 --> 00:06:55,765
Code. Up. To. Excellence.
138
00:06:55,775 --> 00:06:59,368
Enjoy. I'm out.
139
00:06:59,378 --> 00:07:01,070
Third year. First year.
140
00:07:01,080 --> 00:07:04,221
Welcome to American healthcare 101.
141
00:07:05,351 --> 00:07:08,455
Okay, what are we all concerned about?
142
00:07:10,457 --> 00:07:12,082
How much did you have to drink today?
143
00:07:12,092 --> 00:07:13,584
Not really sure.
144
00:07:13,594 --> 00:07:15,351
You were at the race all morning?
145
00:07:15,361 --> 00:07:18,021
Which Conrad and I won, by the way.
146
00:07:18,031 --> 00:07:20,089
I had a beer before the race.
147
00:07:20,099 --> 00:07:22,425
Jaundiced skin, scleral icterus.
148
00:07:22,435 --> 00:07:24,627
I'm sending him for
a liver panel and an ultrasound.
149
00:07:24,637 --> 00:07:26,096
How's our number one fan?
150
00:07:26,106 --> 00:07:27,479
You see this?
151
00:07:27,490 --> 00:07:30,280
This is a stateside doctor,
doing what he was born to do...
152
00:07:30,291 --> 00:07:34,103
running liver function tests
in a cushy, big-city ER.
153
00:07:35,948 --> 00:07:38,346
♪ I am the very model ♪
♪ Of a modern major-general ♪
154
00:07:38,357 --> 00:07:40,577
♪ I've information vegetable, ♪
♪ animal and mineral ♪
155
00:07:40,587 --> 00:07:43,813
♪ I know the kings of England and I
quote the fights historical... ♪
156
00:07:43,823 --> 00:07:45,392
I was also born to sing.
157
00:07:50,935 --> 00:07:52,421
You get out on the boat this weekend?
158
00:07:52,431 --> 00:07:54,457
Yeah, the fish weren't biting. You?
159
00:07:54,467 --> 00:07:56,270
Well, a little golf.
160
00:07:58,471 --> 00:08:00,430
You know, actually,
I had a question for you.
161
00:08:00,440 --> 00:08:02,955
Old guy I was playing with has
developed a bit of a tremor.
162
00:08:02,966 --> 00:08:05,447
And it's giving him the yips. And
I prescribed the standard...
163
00:08:05,458 --> 00:08:07,903
beta blockers... but it hasn't helped.
164
00:08:07,914 --> 00:08:10,482
You know, I know there's surgery,
but it seems a little drastic.
165
00:08:10,493 --> 00:08:13,127
Well, cracking open his head for a
missed putt is a bit much, huh?
166
00:08:13,138 --> 00:08:14,508
Yeah, what about benzodiazepines?
167
00:08:14,519 --> 00:08:17,114
Last resort, he can try 'em.
But the side effects are gonna be...
168
00:08:17,124 --> 00:08:19,482
- Aggression and cognitive impairment.
- Yeah.
169
00:08:19,492 --> 00:08:21,952
I guess it just depends how
desperate the guy is, though.
170
00:08:21,962 --> 00:08:23,750
- Cheers.
- Cheers.
171
00:08:33,207 --> 00:08:36,433
Rosenthal in 5931...
catheter out and discharge.
172
00:08:36,443 --> 00:08:38,135
Anderson 5942...
173
00:08:38,145 --> 00:08:41,038
Monitor her rhythm. Where were
you and Dr. Silva deployed?
174
00:08:41,048 --> 00:08:42,806
Afghanistan.
175
00:08:42,816 --> 00:08:44,341
If she spikes a fever, you add...
176
00:08:44,351 --> 00:08:45,942
IV piperacillin.
177
00:08:45,952 --> 00:08:48,312
My brother was in the army,
two tours in Iraq.
178
00:08:48,322 --> 00:08:50,447
He came back a very different guy.
179
00:08:50,457 --> 00:08:53,183
Did you see any action?
180
00:08:53,193 --> 00:08:55,686
I was a corpsman in the Marines.
181
00:08:55,696 --> 00:08:56,986
Jude was a base surgeon.
182
00:08:56,996 --> 00:08:58,721
We tried to save lives, not take them.
183
00:08:58,731 --> 00:09:00,657
But mostly, we had each other's back.
184
00:09:00,667 --> 00:09:04,027
Now let's move on to medicine.
We have a busy day ahead of us.
185
00:09:04,038 --> 00:09:06,529
Let me know if there's anything
in the marketing department...
186
00:09:06,539 --> 00:09:07,563
Look busy.
187
00:09:07,573 --> 00:09:10,229
- ...the upcoding system.
- Don't forget testing.
188
00:09:10,240 --> 00:09:11,846
A well-insured patient should be tested
189
00:09:11,857 --> 00:09:13,981
for all possible outcomes,
no matter how unlikely.
190
00:09:15,848 --> 00:09:19,176
Dr. Hawkins, have you met Barb Olsen?
191
00:09:19,186 --> 00:09:20,370
She's our billing consultant.
192
00:09:20,381 --> 00:09:22,678
Here for two weeks to help
Chastain become more efficient.
193
00:09:22,688 --> 00:09:24,514
Of course. The bike shorts.
194
00:09:24,524 --> 00:09:27,384
Yeah, I already saw you at my
presentation... well, briefly.
195
00:09:27,394 --> 00:09:28,518
I got paged.
196
00:09:28,528 --> 00:09:30,697
Didn't I get paged?
197
00:09:31,697 --> 00:09:33,067
I didn't hear anything.
198
00:09:35,202 --> 00:09:37,027
Well, nice meeting you.
199
00:09:37,037 --> 00:09:39,196
Barb, there's, um...
200
00:09:39,206 --> 00:09:42,499
Payback. For making me sit
in that presentation.
201
00:09:42,509 --> 00:09:44,400
What's your problem?
202
00:09:44,410 --> 00:09:46,602
A strong kid like you...
can't you go any faster?
203
00:09:46,612 --> 00:09:48,038
I got a life to lead.
204
00:09:48,048 --> 00:09:50,374
Hey, Louisa, how's my man
Rosenthal treating you?
205
00:09:50,384 --> 00:09:52,042
Like the daughter he never had.
206
00:09:52,052 --> 00:09:53,110
A nightmare.
207
00:09:53,120 --> 00:09:56,045
The Chastain softball team
crushed Emory yesterday.
208
00:09:56,055 --> 00:09:58,115
Yeah, we did.
209
00:09:58,125 --> 00:10:00,216
Is your back still bothering you?
210
00:10:00,226 --> 00:10:02,218
Uh, yeah, it's no big deal.
211
00:10:02,228 --> 00:10:05,054
Now I'm thinking it's
a pinched nerve, lumbar spine.
212
00:10:05,064 --> 00:10:07,499
Pain that, uh, radiates along
the affected nerve.
213
00:10:07,510 --> 00:10:10,392
That's impressive, but you're not quite
a doctor yet. Let me have a look.
214
00:10:10,403 --> 00:10:11,428
Uh, maybe later.
215
00:10:11,438 --> 00:10:14,096
I told Joey in Ped Onc
I'd take him to the play area.
216
00:10:14,106 --> 00:10:17,200
Man, that munchkin is cute.
217
00:10:19,578 --> 00:10:21,203
Check back in with her in an hour.
218
00:10:21,213 --> 00:10:22,639
I just want to examine her
and make sure...
219
00:10:24,284 --> 00:10:26,386
Hey! We need some help in here!
220
00:10:29,722 --> 00:10:32,548
- Oh, my God, I'm sorry.
- It's okay.
221
00:10:33,726 --> 00:10:34,750
It's okay, stay still.
222
00:10:34,760 --> 00:10:36,253
We got you.
223
00:10:37,239 --> 00:10:39,270
I'm too young for kidney stones.
224
00:10:39,281 --> 00:10:41,958
I'm thinking it's just a gas bubble.
It's really no big deal.
225
00:10:41,968 --> 00:10:44,293
How long have you been short of breath?
226
00:10:44,303 --> 00:10:45,595
Just a few days.
227
00:10:45,605 --> 00:10:47,764
I was thinking it was from the pain.
228
00:10:47,774 --> 00:10:50,766
Your lungs sound congested.
229
00:10:50,776 --> 00:10:53,102
We need a full workup.
230
00:10:53,112 --> 00:10:54,303
This could be serious.
231
00:10:54,313 --> 00:10:56,273
No, I'm okay. I swear.
232
00:10:56,283 --> 00:10:58,353
I can't be sick,
they'll send me back home.
233
00:10:58,364 --> 00:11:00,248
And I need every dime to make ends meet.
234
00:11:00,259 --> 00:11:01,798
And a CT scan as well.
235
00:11:01,809 --> 00:11:03,569
MRI's probably the better option.
236
00:11:03,580 --> 00:11:05,849
Actually, maybe we should
check her insurance first.
237
00:11:05,859 --> 00:11:07,516
- Uh, can this wait?
- No.
238
00:11:07,526 --> 00:11:09,186
Can I a moment with the patient, please?
239
00:11:09,196 --> 00:11:11,204
We're conducting an exam here.
240
00:11:11,215 --> 00:11:13,876
Dr. Hawkins, the administration
has given me license
241
00:11:13,887 --> 00:11:16,298
to inspect all hospital finances.
242
00:11:17,009 --> 00:11:19,129
You're a subcontractor
to the hospital, right?
243
00:11:19,139 --> 00:11:20,797
Yes. Is this really necessary?
244
00:11:20,807 --> 00:11:22,665
I'm feeling better.
I just want to go home.
245
00:11:22,675 --> 00:11:24,134
Rest up.
246
00:11:24,144 --> 00:11:25,802
She wants to go home. Great.
247
00:11:25,812 --> 00:11:28,304
She can't. She needs an MRI.
248
00:11:28,314 --> 00:11:30,807
Do you know if your company
will cover an MRI?
249
00:11:30,817 --> 00:11:33,176
Does anyone know that stuff?
250
00:11:33,186 --> 00:11:35,542
Then if it doesn't, an X-ray
is more than sufficient.
251
00:11:35,553 --> 00:11:37,076
Actually, it isn't.
252
00:11:37,087 --> 00:11:38,717
Louisa is part of the Chastain family.
253
00:11:38,728 --> 00:11:41,118
- She deserves our best care.
- Well, I can see
254
00:11:41,129 --> 00:11:42,619
that she's a wonderful young woman...
255
00:11:42,629 --> 00:11:43,886
I can't do this.
256
00:11:43,896 --> 00:11:45,832
I'm sorry, thank you,
but I'll just leave.
257
00:11:47,833 --> 00:11:51,338
It would be wise for you to let her go.
258
00:11:57,177 --> 00:11:59,180
Wow. Really?
259
00:12:01,814 --> 00:12:03,173
Louisa...
260
00:12:06,844 --> 00:12:08,678
Easy. Easy.
261
00:12:08,688 --> 00:12:09,756
There you go.
262
00:12:11,406 --> 00:12:12,528
Pulse is weak.
263
00:12:12,539 --> 00:12:15,217
Distant heart sounds,
distended jugular veins.
264
00:12:15,227 --> 00:12:16,352
Cardiac tamponade.
265
00:12:16,362 --> 00:12:17,721
Too unstable to move.
266
00:12:17,731 --> 00:12:21,119
I need 18-gauge spinal needle
with a 20cc syringe.
267
00:12:21,130 --> 00:12:22,819
I'll prep the ultrasound
in exam room four.
268
00:12:22,830 --> 00:12:23,833
Good. Go.
269
00:12:23,844 --> 00:12:25,361
Louisa, you have fluid
around your heart.
270
00:12:25,372 --> 00:12:27,151
We're going to relieve the pressure.
271
00:12:27,162 --> 00:12:28,614
You cut, I draw.
272
00:12:41,621 --> 00:12:43,112
Quickly, we're losing her.
273
00:12:43,122 --> 00:12:44,253
Ready.
274
00:12:46,359 --> 00:12:49,396
Now, Louisa, you're gonna feel pressure
and then stinging.
275
00:13:00,741 --> 00:13:02,476
You're okay, Louisa.
276
00:13:13,527 --> 00:13:15,548
Another loud noise
277
00:13:15,559 --> 00:13:17,284
and we're almost done.
278
00:13:17,294 --> 00:13:19,253
Don't worry, just a few more minutes.
279
00:13:22,437 --> 00:13:23,716
Get her out of that machine.
280
00:13:23,727 --> 00:13:25,500
- We're almost finished.
- She's not insured.
281
00:13:25,511 --> 00:13:27,758
She can't pay for her treatment,
that's why she ran away.
282
00:13:27,769 --> 00:13:29,403
Or maybe she didn't want
to burden the hospital.
283
00:13:29,414 --> 00:13:31,965
Well, it's a little late for that,
'cause Chastain is gonna have
284
00:13:31,975 --> 00:13:33,754
to eat the cost of that MRI.
That's $10,000.
285
00:13:33,765 --> 00:13:35,834
$10,000 is what
they charge the insurance company.
286
00:13:35,845 --> 00:13:37,636
It doesn't cost the hospital
anything like that.
287
00:13:37,647 --> 00:13:39,673
Are you offering to pay?
288
00:13:39,683 --> 00:13:42,009
Here, for your intake files.
289
00:13:42,019 --> 00:13:44,923
I will call her employer,
see what I can negotiate.
290
00:13:48,727 --> 00:13:51,151
God, I hate that woman.
291
00:13:51,162 --> 00:13:53,789
You and I will run point
on Louisa's care.
292
00:13:53,931 --> 00:13:55,853
We need to get as much done as we can
293
00:13:55,864 --> 00:13:57,501
before the administration
pulls the plug.
294
00:13:57,512 --> 00:13:58,798
We can't let them kick her out.
295
00:13:58,809 --> 00:14:00,142
Well, don't panic yet.
296
00:14:00,153 --> 00:14:02,051
Worst case, we guide her
to another hospital.
297
00:14:02,062 --> 00:14:05,389
Where she never even
makes it past ER triage.
298
00:14:05,777 --> 00:14:06,894
Trust me.
299
00:14:11,816 --> 00:14:13,285
LFT panel.
300
00:14:15,352 --> 00:14:17,336
Hank, you have acute hepatitis.
301
00:14:18,281 --> 00:14:19,714
Is that bad?
302
00:14:19,724 --> 00:14:22,146
It means that you've
consumed so much alcohol
303
00:14:22,157 --> 00:14:23,903
that your liver's temporarily paralyzed.
304
00:14:23,914 --> 00:14:26,854
- It's quite a feat, actually.
- Exactly how many beers did you have?
305
00:14:26,864 --> 00:14:30,002
- Two...
- Two beers?
306
00:14:32,403 --> 00:14:35,696
Two dozen.
307
00:14:35,706 --> 00:14:38,132
If you don't cut back, your
liver's gonna stop functioning.
308
00:14:38,142 --> 00:14:41,165
Your stomach will swell, you're
gonna become confused, then sleepy,
309
00:14:41,176 --> 00:14:43,301
you slip into a coma, then you die.
310
00:14:43,312 --> 00:14:45,546
I'm not trying to scare you,
it's just the truth.
311
00:14:45,557 --> 00:14:47,793
You're drinking yourself to death.
312
00:14:51,749 --> 00:14:53,359
I know.
313
00:14:54,567 --> 00:14:55,601
Help me?
314
00:14:56,640 --> 00:14:58,437
I can get you into a rehab facility.
315
00:14:58,448 --> 00:14:59,916
I can't do rehab.
316
00:14:59,927 --> 00:15:01,502
I'd lose my job.
317
00:15:01,872 --> 00:15:03,885
But the rest of it, yeah.
318
00:15:04,170 --> 00:15:06,130
I'm ready to quit.
319
00:15:06,141 --> 00:15:08,400
I am. I've struggled
with alcohol my whole life.
320
00:15:08,840 --> 00:15:10,539
Look, the moment I walk out of there,
321
00:15:10,550 --> 00:15:12,567
I swear, I will go
straight to a meeting.
322
00:15:12,578 --> 00:15:16,104
I'll get a sponsor, I'll stay
in AA the rest of my life.
323
00:15:16,114 --> 00:15:19,825
That's easy to say, pal.
It's hard to do.
324
00:15:24,700 --> 00:15:28,295
Atwood, Henry,
two of Lorazepam for withdrawal.
325
00:15:28,860 --> 00:15:30,145
Thank you, Doctor.
326
00:15:30,156 --> 00:15:32,385
You can do whatever you want,
it's not gonna help.
327
00:15:32,395 --> 00:15:34,621
His problem is self-inflicted.
328
00:15:34,631 --> 00:15:36,717
Hell, 90% of the patients
that come in here
329
00:15:36,728 --> 00:15:38,232
have done stupid stuff to themselves.
330
00:15:38,243 --> 00:15:40,061
Remind me how you got
that scar on your thumb.
331
00:15:40,071 --> 00:15:42,631
- Wasn't it field-dressing a possum?
- I was nine years old.
332
00:15:42,642 --> 00:15:44,383
And I treated the injury myself.
333
00:15:44,394 --> 00:15:45,448
Of course you did.
334
00:15:45,459 --> 00:15:47,251
It still doesn't explain
why you eat possum.
335
00:15:47,611 --> 00:15:50,409
Yeah, we all didn't have moms
who would shop and cook for us.
336
00:15:50,420 --> 00:15:52,832
Or dads who were sober enough
to drive us to the ER.
337
00:15:52,843 --> 00:15:54,739
Exactly, and that's why I'm here...
338
00:15:54,949 --> 00:15:57,434
to help whoever walks in that door
who can't help themselves.
339
00:15:57,445 --> 00:15:59,827
It doesn't matter whether they
eat lobster or road kill.
340
00:15:59,838 --> 00:16:01,101
I take care of them.
341
00:16:02,093 --> 00:16:03,417
All right.
342
00:16:04,130 --> 00:16:05,294
Let me ask you this.
343
00:16:06,911 --> 00:16:09,923
What is the most fun
you have had in the last week?
344
00:16:10,800 --> 00:16:12,292
My guess?
345
00:16:12,302 --> 00:16:16,096
You and me fixing up Hank
in the back of that pickup truck.
346
00:16:16,106 --> 00:16:19,160
Seat-of-our-pants medicine.
Nobody telling us what to do
347
00:16:19,171 --> 00:16:20,796
or making us fill out forms.
348
00:16:21,481 --> 00:16:23,269
Then what happens?
349
00:16:23,841 --> 00:16:25,638
We come back to work,
350
00:16:25,649 --> 00:16:29,217
and a patient is trying to run away
because she doesn't have insurance.
351
00:16:29,546 --> 00:16:32,078
We can't even treat someone
who's worked at Chastain
352
00:16:32,089 --> 00:16:33,624
for the past two years.
353
00:16:35,427 --> 00:16:38,864
How many wounded Marines did you
ever ask for proof of insurance?
354
00:16:39,496 --> 00:16:41,121
Well...
355
00:16:41,131 --> 00:16:44,325
I guess I got my work
cut out for me, then, don't I?
356
00:16:44,335 --> 00:16:46,037
You keep tilting at windmills, huh?
357
00:16:47,705 --> 00:16:50,698
- Currently on any medications?
- No, but I'm...
358
00:16:50,708 --> 00:16:52,755
Have you eaten anything
in the last eight hours?
359
00:16:52,766 --> 00:16:54,168
I'm not having surgery today.
360
00:16:55,946 --> 00:16:59,563
It says here, "Reynolds,
hernia surgery, 2:15."
361
00:16:59,574 --> 00:17:02,188
- I'll be assisting.
- I'm having some more tests.
362
00:17:02,199 --> 00:17:04,777
- Excuse me?
- A very nice lady came in
363
00:17:04,788 --> 00:17:07,433
and talked my doctor into
ordering some more blood work.
364
00:17:07,444 --> 00:17:09,756
Another CT scan and an MRI.
365
00:17:09,767 --> 00:17:12,225
You don't need an MRI,
you need hernia surgery.
366
00:17:12,236 --> 00:17:14,521
She said I needed it
to be on the safe side.
367
00:17:14,531 --> 00:17:16,367
She was very convincing.
368
00:17:17,891 --> 00:17:19,829
Why is my hernia patient
having more tests?
369
00:17:19,840 --> 00:17:22,697
- He doesn't need more tests.
- Another Barb victim.
370
00:17:22,707 --> 00:17:25,893
Profit before patients...
the new healthcare mantra.
371
00:17:25,904 --> 00:17:28,398
Barb is like a migraine.
You can feel it coming,
372
00:17:28,409 --> 00:17:29,503
but you can't stop it.
373
00:17:29,514 --> 00:17:31,557
Then it gets worse and worse,
and you throw up.
374
00:17:31,568 --> 00:17:34,641
What do you guys think
of the name "Say Ah"
375
00:17:34,652 --> 00:17:37,075
for a resident-nurse a cappella group?
376
00:17:37,654 --> 00:17:39,747
"Say Ah"?
377
00:17:39,757 --> 00:17:42,727
Yeah, you know, to serenade patients.
378
00:17:45,005 --> 00:17:46,965
No one wants you to sing them a song.
379
00:17:50,293 --> 00:17:52,964
The meaner she is to me,
the more I'm in awe of her.
380
00:17:52,975 --> 00:17:55,045
Yeah, that's kind of how it works.
381
00:17:56,560 --> 00:17:58,029
Wow.
382
00:18:02,680 --> 00:18:05,049
You got Louisa's results?
383
00:18:07,331 --> 00:18:09,308
This is a T2 hyperintense,
384
00:18:09,319 --> 00:18:11,611
enhancing mass, encasing
the spleen, kidney,
385
00:18:11,622 --> 00:18:13,606
and vertebral bodies.
Most consistent with...
386
00:18:13,617 --> 00:18:15,249
A retroperitoneal sarcoma.
387
00:18:15,259 --> 00:18:17,278
Which would explain
the fluid in her heart.
388
00:18:17,289 --> 00:18:19,815
She lied to us. And to her employer.
389
00:18:19,826 --> 00:18:22,054
She didn't run away because
she doesn't have insurance,
390
00:18:22,065 --> 00:18:24,846
she ran away because she's
an undocumented immigrant.
391
00:18:30,529 --> 00:18:32,621
She has a highly aggressive tumor.
392
00:18:32,881 --> 00:18:35,518
If she doesn't get surgery
right away, she dies.
393
00:18:38,047 --> 00:18:39,712
No more tests,
394
00:18:39,723 --> 00:18:41,782
no more treatment on our dime.
395
00:18:42,005 --> 00:18:43,940
This hospital isn't a charity.
396
00:18:53,927 --> 00:18:56,579
I felt this was important enough
to bring to the CEO's office
397
00:18:56,590 --> 00:18:58,490
right away.
Ms. Rodriguez is an uninsured,
398
00:18:58,501 --> 00:19:00,292
undocumented immigrant.
399
00:19:00,303 --> 00:19:02,257
She has no family in this country.
400
00:19:02,267 --> 00:19:05,090
She was brought here
from El Salvador as a child.
401
00:19:05,101 --> 00:19:07,596
No one can take her
once she leaves the hospital.
402
00:19:07,606 --> 00:19:09,320
State rules are clear on this.
403
00:19:09,331 --> 00:19:13,335
Ms. Rodriguez cannot be released
into her own care.
404
00:19:13,345 --> 00:19:16,238
That means Chastain would be
stuck with her for a long time.
405
00:19:16,248 --> 00:19:20,176
She'd be living here at our expense.
406
00:19:20,186 --> 00:19:21,477
She would be a Perma Patient.
407
00:19:21,487 --> 00:19:23,112
Not every CEO knows that term.
408
00:19:23,122 --> 00:19:25,015
Claire is not your average CEO.
409
00:19:25,025 --> 00:19:27,016
Dr. Bell, what's her prognosis?
410
00:19:27,026 --> 00:19:29,119
Well, the five-to ten-year
survival rate is excellent
411
00:19:29,129 --> 00:19:31,574
if we operate right away, but...
412
00:19:32,465 --> 00:19:34,358
the longer we wait, the worse her odds.
413
00:19:34,369 --> 00:19:36,793
And if her surgery is
successful, what's the rehab?
414
00:19:36,803 --> 00:19:40,130
Six months to a year.
415
00:19:41,029 --> 00:19:43,693
Okay, best-case scenario,
416
00:19:43,704 --> 00:19:45,935
what is Louisa's care gonna cost us?
417
00:19:45,945 --> 00:19:48,772
Chastain does the surgery,
it goes well, post-op,
418
00:19:48,782 --> 00:19:51,105
she can walk with a physical
therapist down the hall...
419
00:19:51,116 --> 00:19:52,609
half a million dollars.
420
00:19:52,619 --> 00:19:54,944
And worst case?
421
00:19:54,954 --> 00:19:58,143
Post-op, Ms. Rodriguez can't
even get out of the bed...
422
00:19:58,154 --> 00:19:59,723
two million dollars.
423
00:20:10,303 --> 00:20:13,287
Hang in there, your count is
moving in the right direction.
424
00:20:13,907 --> 00:20:15,230
Lane.
425
00:20:15,240 --> 00:20:18,333
Hey, Conrad. How are you?
426
00:20:18,577 --> 00:20:20,969
I'd like to call you in
for an oncology consult.
427
00:20:21,455 --> 00:20:23,206
Okay. Who's the patient?
428
00:20:23,216 --> 00:20:26,508
Louisa Rodriquez, transport
worker here at Chastain.
429
00:20:26,518 --> 00:20:30,513
Good person. She's uninsured
and an undocumented immigrant.
430
00:20:30,523 --> 00:20:33,315
Um, a full course
of radiation and chemotherapy
431
00:20:33,325 --> 00:20:34,751
is, uh, very expensive.
432
00:20:34,761 --> 00:20:36,585
I understand,
but don't you have a foundation
433
00:20:36,595 --> 00:20:38,849
- for cases like this?
- Yes, I do,
434
00:20:38,860 --> 00:20:41,259
but it's not for the undocumented.
435
00:20:41,829 --> 00:20:44,602
Look, I'll make some inquiries,
but I can't make any promises.
436
00:20:44,613 --> 00:20:46,763
- That'd be fantastic.
- Conrad.
437
00:20:47,241 --> 00:20:49,144
Administration just put Louisa's surgery
438
00:20:49,155 --> 00:20:52,334
- on indefinite hold.
- Lane...
439
00:20:52,742 --> 00:20:55,579
- Louisa's all alone.
- I'll see what I can do.
440
00:20:58,584 --> 00:21:00,674
I forgot to tell you I saw Lily earlier.
441
00:21:00,685 --> 00:21:01,844
She didn't look good.
442
00:21:01,854 --> 00:21:03,012
Nic, she has cancer.
443
00:21:03,022 --> 00:21:04,616
I know we've been through this,
444
00:21:04,627 --> 00:21:07,082
and I'm sure Lane had every
reason to discharge Lily,
445
00:21:07,092 --> 00:21:11,019
- but my instincts are...
- Lane will take care of her.
446
00:21:11,029 --> 00:21:14,067
Lily's in good hands.
447
00:21:17,704 --> 00:21:19,394
Okay, well, I'll be going...
Oh, excuse me.
448
00:21:19,404 --> 00:21:21,096
Oh, Nurse Nevin.
449
00:21:21,106 --> 00:21:22,431
If I could just have a moment?
450
00:21:22,441 --> 00:21:24,133
I'm actually really busy right now.
451
00:21:24,143 --> 00:21:26,694
Okay, but I don't think
the nurses are getting the hang
452
00:21:26,705 --> 00:21:29,471
of the upcoding system
and the multiple-test vectors.
453
00:21:29,481 --> 00:21:31,290
Our nurses are laser-focused
on patient care.
454
00:21:31,301 --> 00:21:32,876
That is their primary responsibility.
455
00:21:32,886 --> 00:21:37,241
♪ Too late to go back to sleep ♪
456
00:21:37,259 --> 00:21:39,959
- ♪ It's time to trust my instincts ♪
- Excuse me.
457
00:21:39,970 --> 00:21:42,819
♪ Close my eyes ♪
458
00:21:42,829 --> 00:21:44,821
♪ And leap ♪
459
00:21:44,831 --> 00:21:47,322
♪ It's time to try ♪
460
00:21:47,333 --> 00:21:50,655
♪ Defying gravity ♪
461
00:21:50,666 --> 00:21:53,176
♪ I think I'll try ♪
462
00:21:53,187 --> 00:21:55,798
♪ Defying gravity ♪
463
00:21:55,808 --> 00:22:00,279
♪ And you can't hold me down. ♪
464
00:22:01,514 --> 00:22:02,938
A little flat.
465
00:22:02,948 --> 00:22:04,439
You're a little flat.
466
00:22:05,919 --> 00:22:07,153
Next!
467
00:22:07,606 --> 00:22:10,412
Claire, this is Jim Phillips,
CEO of Atlanta General,
468
00:22:10,422 --> 00:22:12,401
and Stuart Green from our Lady of Mercy.
469
00:22:12,412 --> 00:22:14,143
The three of us go way back.
470
00:22:14,154 --> 00:22:16,276
Ms. Thorpe took over as CEO of Chastain,
471
00:22:16,295 --> 00:22:17,986
- what, six months ago?
- Yes.
472
00:22:18,730 --> 00:22:20,289
They're all yours.
473
00:22:20,300 --> 00:22:22,175
Gentlemen, it's lovely to meet you both,
474
00:22:22,186 --> 00:22:24,133
and thank you for coming in
on such short notice.
475
00:22:24,144 --> 00:22:25,609
I'll get right to the point.
476
00:22:25,620 --> 00:22:28,900
We have a patient,
uninsured, undocumented,
477
00:22:28,911 --> 00:22:30,867
with a retroperitoneal sarcoma.
478
00:22:30,877 --> 00:22:33,254
Possible six months to a year rehab.
479
00:22:33,265 --> 00:22:35,103
Given our fixed costs per bed,
480
00:22:35,113 --> 00:22:38,006
this patient represents a
considerable burden on Chastain.
481
00:22:38,016 --> 00:22:39,676
As they would for Atlanta General.
482
00:22:39,686 --> 00:22:42,211
Yes, but Atlanta General and
Our Lady of Mercy's fixed costs
483
00:22:42,221 --> 00:22:43,979
are much lower than ours.
484
00:22:43,990 --> 00:22:46,649
What are you suggesting, Ms. Thorpe?
485
00:22:46,659 --> 00:22:49,416
If either one of you will take
this patient off our hands,
486
00:22:49,427 --> 00:22:50,756
pre-surgery,
487
00:22:50,767 --> 00:22:54,538
we'll pay a fee, one-time, of $250,000.
488
00:22:56,502 --> 00:22:58,955
If you can funnel us five
Medicare patients
489
00:22:58,966 --> 00:23:02,338
and up the fee to $300,000,
we'll consider it.
490
00:23:02,349 --> 00:23:04,300
What if I offered you
491
00:23:04,310 --> 00:23:08,470
five Medicaid patients and $250,000?
492
00:23:08,480 --> 00:23:10,503
Medicaid reimbursements are junk.
493
00:23:11,503 --> 00:23:12,809
Ten Medicaid and 300 grand.
494
00:23:14,338 --> 00:23:17,394
I'm offering seven Medicaid and 275.
495
00:23:18,524 --> 00:23:20,643
Too low. We're out.
496
00:23:25,024 --> 00:23:27,081
Stuart, Our Lady of Mercy
has a charity fund.
497
00:23:27,092 --> 00:23:29,214
What if we did the surgery
and you did the rehab?
498
00:23:29,225 --> 00:23:32,896
We could give your fund $100,000 that
you could use at your discretion.
499
00:23:32,906 --> 00:23:34,754
We just built a new cardiac wing.
500
00:23:34,765 --> 00:23:36,941
Which is a-a beautiful wing.
501
00:23:36,952 --> 00:23:38,476
Cost us $40 million.
502
00:23:38,487 --> 00:23:41,004
And I am sure that you will make
that back in fees in no time.
503
00:23:41,896 --> 00:23:44,207
My board would kill me if
we took another Perma Patient.
504
00:23:44,217 --> 00:23:46,508
I'm gonna to have to pass.
505
00:23:46,518 --> 00:23:48,054
I'm sorry.
506
00:23:55,924 --> 00:23:58,220
Who can we call, Louisa?
507
00:23:58,893 --> 00:24:00,838
You must have family here.
508
00:24:02,006 --> 00:24:04,583
My parents brought me here
when I was three years old.
509
00:24:04,927 --> 00:24:07,229
My mom died two years ago,
510
00:24:07,240 --> 00:24:10,033
and my dad moved back to El Salvador.
511
00:24:10,043 --> 00:24:12,200
I'm alone.
512
00:24:14,420 --> 00:24:16,147
And you support yourself?
513
00:24:16,842 --> 00:24:18,408
Yeah.
514
00:24:20,433 --> 00:24:22,687
I guess I was crazy to think
I'd make it to med school
515
00:24:22,698 --> 00:24:24,046
without being found out.
516
00:24:24,056 --> 00:24:26,060
If Immigration gets their hands on me,
517
00:24:26,071 --> 00:24:28,051
they'll send me back,
no questions asked.
518
00:24:28,907 --> 00:24:31,621
But this is the only country
I've ever known.
519
00:24:31,631 --> 00:24:33,732
And to be a doctor...
520
00:24:35,247 --> 00:24:37,158
that's my dream.
521
00:24:38,457 --> 00:24:41,543
I'm so sorry to cause
all this trouble, Dr. Pravesh.
522
00:24:41,832 --> 00:24:44,633
Everyone at Chastain
has been nothing but good to me.
523
00:24:45,080 --> 00:24:48,504
Louisa, we're going to help you,
and you deserve better than this.
524
00:24:49,576 --> 00:24:51,607
I looked up the surgery on my phone.
525
00:24:52,912 --> 00:24:55,445
Cancer wrapped around a lot of organs.
526
00:24:56,821 --> 00:24:58,915
Pretty dangerous stuff, huh?
527
00:24:59,642 --> 00:25:00,681
Yes.
528
00:25:01,103 --> 00:25:02,150
It is.
529
00:25:02,160 --> 00:25:05,455
But we both know
it is the only road to a cure.
530
00:25:06,315 --> 00:25:09,385
Do you know how some people say
they're not afraid of dying?
531
00:25:09,602 --> 00:25:11,794
That's crazy, right?
532
00:25:11,804 --> 00:25:16,165
It scares the hell out of me.
533
00:25:16,175 --> 00:25:19,634
Louisa, you're going to be
a doctor someday.
534
00:25:19,644 --> 00:25:22,170
Helping you get there...
535
00:25:22,180 --> 00:25:25,017
that's our dream.
536
00:25:34,859 --> 00:25:35,961
Hey.
537
00:25:36,953 --> 00:25:39,255
I, uh, checked with my foundation,
538
00:25:39,266 --> 00:25:41,188
and got a fast, hard no.
539
00:25:41,995 --> 00:25:45,794
Our donors expect their gifts to pay
for the treatment of U.S. citizens.
540
00:25:45,804 --> 00:25:49,816
There are plenty of deserving Americans
out there waiting for a chance.
541
00:25:51,783 --> 00:25:53,274
Ugh.
542
00:25:53,285 --> 00:25:56,378
I hate to disappoint you,
Conrad, that's the hardest part.
543
00:25:56,389 --> 00:25:58,245
Thanks for trying.
544
00:26:00,736 --> 00:26:04,155
You know, we do the best we can,
545
00:26:04,166 --> 00:26:06,276
as often as we can.
546
00:26:08,349 --> 00:26:10,341
But we can't save everyone.
547
00:26:18,130 --> 00:26:20,645
You're all post-surgery,
and you all want to go home.
548
00:26:20,656 --> 00:26:22,241
So today, we're going to have a race.
549
00:26:22,252 --> 00:26:25,127
Whoever gets to the end of the
hallway first gets discharged.
550
00:26:25,137 --> 00:26:27,161
No more poking, needles, BP checks.
551
00:26:27,171 --> 00:26:30,324
You can cook your own meals,
take a warm shower. Sound good?
552
00:26:30,335 --> 00:26:32,234
If you can't walk
to the end of the hallway,
553
00:26:32,244 --> 00:26:33,502
you're here for another week.
554
00:26:33,512 --> 00:26:35,236
One, two, three. Go.
555
00:26:38,649 --> 00:26:40,242
Too slow, Mrs. Pill. You're done.
556
00:26:42,220 --> 00:26:44,222
Mr. Farragut, the same.
557
00:26:49,227 --> 00:26:50,752
No time to treat a heart attack,
558
00:26:50,762 --> 00:26:52,598
Mr. Smith, off you go.
559
00:26:55,033 --> 00:26:58,046
Discharge the winners.
The losers can go back to their rooms.
560
00:26:58,057 --> 00:27:00,194
Take it easy, all right?
You're gonna be fine.
561
00:27:00,205 --> 00:27:01,530
- Culling the herd?
- Yep.
562
00:27:01,540 --> 00:27:02,826
Administration won't allow.
563
00:27:02,837 --> 00:27:04,433
- Louisa's surgery.
- Unfortunate.
564
00:27:04,443 --> 00:27:05,833
But I heard she is undocumented.
565
00:27:05,843 --> 00:27:07,202
Rules are rules.
566
00:27:07,212 --> 00:27:09,474
Am I crazy, but aren't
you and me supposed to be
567
00:27:09,485 --> 00:27:12,040
in the trenches together
on situations like this?
568
00:27:12,050 --> 00:27:14,320
Please, tell me this is not
actually how you feel.
569
00:27:14,331 --> 00:27:15,577
What I feel doesn't matter.
570
00:27:15,854 --> 00:27:16,945
What I feel doesn't help.
571
00:27:16,955 --> 00:27:18,513
I deal in facts.
572
00:27:18,523 --> 00:27:20,047
Okay. Fine.
573
00:27:20,057 --> 00:27:23,552
Because the hospital is trying
to save money, Louisa might die.
574
00:27:23,562 --> 00:27:24,585
Fact.
575
00:27:24,595 --> 00:27:27,490
She might die from surgery, too. Fact.
576
00:27:27,501 --> 00:27:29,257
Love the optimism.
577
00:27:29,267 --> 00:27:30,926
How dangerous is it, Mina?
578
00:27:30,936 --> 00:27:33,562
Very intricate, very demanding.
579
00:27:33,572 --> 00:27:35,731
Seven, eight hours.
580
00:27:36,483 --> 00:27:38,031
But glorious.
581
00:27:38,042 --> 00:27:40,111
Sounds like it's right up your alley.
582
00:28:07,072 --> 00:28:10,275
Conrad, we all feel terrible for Louisa.
583
00:28:11,310 --> 00:28:13,302
She's an enormous liability.
584
00:28:13,312 --> 00:28:16,618
As much as two million dollars
over the course of her treatment.
585
00:28:18,529 --> 00:28:21,654
Look, I get that
it's a bottom-line world.
586
00:28:21,665 --> 00:28:22,744
You made that clear.
587
00:28:22,754 --> 00:28:24,612
But I want you to think back
for a moment,
588
00:28:24,622 --> 00:28:26,415
to when you were in med school.
589
00:28:26,425 --> 00:28:29,784
It wasn't all about making money.
590
00:28:29,794 --> 00:28:31,786
That was a long time ago.
591
00:28:31,796 --> 00:28:33,421
Healthcare has changed since then.
592
00:28:33,431 --> 00:28:35,424
We need to deal with the new reality.
593
00:28:35,434 --> 00:28:38,193
I think we can both agree
594
00:28:38,203 --> 00:28:40,965
that every doctor
has that singular moment
595
00:28:40,976 --> 00:28:42,770
when they decide
they're going into medicine.
596
00:28:42,781 --> 00:28:44,933
For you, to be a surgeon.
597
00:28:44,943 --> 00:28:47,669
And even if it was decades ago,
I'd bet everything I got
598
00:28:47,680 --> 00:28:49,364
you remember it like it was yesterday.
599
00:28:49,375 --> 00:28:51,439
And I don't buy for one second
600
00:28:51,449 --> 00:28:56,878
that it had anything to do with money.
601
00:28:56,888 --> 00:28:58,546
It didn't.
602
00:28:58,888 --> 00:29:00,649
I fell in love with cutting.
603
00:29:01,395 --> 00:29:04,218
I fell in love with the OR.
604
00:29:04,939 --> 00:29:06,118
I love it.
605
00:29:07,767 --> 00:29:08,915
Still.
606
00:29:09,501 --> 00:29:13,462
But the money
has to come from somewhere.
607
00:29:13,472 --> 00:29:16,164
If we treat Louisa,
our other patients will suffer.
608
00:29:16,174 --> 00:29:17,998
Services will be cut.
609
00:29:18,008 --> 00:29:20,004
Hours, staff.
610
00:29:20,015 --> 00:29:22,399
You know, I don't like the idea
of putting a price tag
611
00:29:22,410 --> 00:29:23,871
on a life any more than you do.
612
00:29:23,881 --> 00:29:27,141
But the system doesn't run on air.
613
00:29:27,151 --> 00:29:29,477
No matter how much we love Louisa,
614
00:29:29,487 --> 00:29:31,012
her price tag
615
00:29:31,022 --> 00:29:34,493
is not two million dollars.
616
00:29:40,432 --> 00:29:41,758
Don't say anything.
617
00:29:41,768 --> 00:29:42,947
Nothing.
618
00:29:51,097 --> 00:29:52,189
Catch you at a bad time?
619
00:29:52,612 --> 00:29:54,170
I'd like to shove CUTE right up her...
620
00:29:54,180 --> 00:29:55,270
Throw it in the trash.
621
00:29:55,280 --> 00:29:56,450
You'll feel better.
622
00:29:59,952 --> 00:30:01,109
Look at that.
623
00:30:01,119 --> 00:30:02,778
Stress management.
624
00:30:03,702 --> 00:30:06,848
I'm guessing you didn't come up here
to talk to me about upcoding.
625
00:30:06,858 --> 00:30:08,217
No.
626
00:30:08,227 --> 00:30:09,841
It's about your boy, Conrad.
627
00:30:09,852 --> 00:30:11,520
Look, he's taking things hard.
628
00:30:11,530 --> 00:30:14,100
If he doesn't start to choose his
battles, he's gonna burn out.
629
00:30:16,686 --> 00:30:19,362
Yeah, well, I can't control Conrad.
Never could.
630
00:30:19,372 --> 00:30:21,530
And he's not my boy.
631
00:30:21,540 --> 00:30:23,799
Not anymore.
632
00:30:24,473 --> 00:30:26,074
Sorry to hear that.
633
00:30:30,028 --> 00:30:32,942
Alabama Shakes is playing
Terminal West next week.
634
00:30:32,952 --> 00:30:35,211
- Oh, yeah?
- Mm-hmm.
635
00:30:35,221 --> 00:30:36,578
I got an extra ticket.
636
00:30:36,588 --> 00:30:38,413
I remember you saying
you liked their music.
637
00:30:38,423 --> 00:30:39,960
I do.
638
00:30:42,319 --> 00:30:43,553
It's not a date.
639
00:30:43,563 --> 00:30:45,421
Just a concert.
640
00:30:45,431 --> 00:30:46,756
Have a little fun.
641
00:30:48,067 --> 00:30:51,461
Rapid response, 5922. Let's go.
642
00:30:51,471 --> 00:30:53,243
She's crashing.
643
00:30:53,254 --> 00:30:54,882
- Blood pressure?
- 70/40.
644
00:30:54,893 --> 00:30:56,932
- Cycling right now.
- Her IV blew in the MRI.
645
00:30:56,942 --> 00:30:58,793
We haven't been able
to get another line since.
646
00:30:58,804 --> 00:31:01,086
- She's bleeding internally.
- Now it's 60/30.
647
00:31:02,949 --> 00:31:04,673
She's a hard stick.
648
00:31:04,683 --> 00:31:07,576
Her vessels are clamped down,
she's too volume-depleted.
649
00:31:08,422 --> 00:31:09,578
Emergency IO.
650
00:31:10,234 --> 00:31:12,347
- Yeah, I've never done that before.
- Get the kit.
651
00:31:12,357 --> 00:31:13,527
You're doing it now.
652
00:31:19,298 --> 00:31:20,957
Push the needle in.
653
00:31:20,967 --> 00:31:23,259
Once you hit the bone, drill.
654
00:31:28,775 --> 00:31:30,777
Keep it steady.
655
00:31:39,519 --> 00:31:41,477
Drill.
656
00:31:41,487 --> 00:31:43,156
Okay, release.
657
00:31:47,894 --> 00:31:49,328
Flush.
658
00:31:58,837 --> 00:31:59,996
Running in fluids.
659
00:32:00,850 --> 00:32:02,076
We're in the clear.
660
00:32:02,087 --> 00:32:03,651
- For now.
- She'll keep bleeding
661
00:32:03,662 --> 00:32:05,668
until we get her to surgery.
662
00:32:05,678 --> 00:32:07,336
There are four
oncology surgeons on call.
663
00:32:07,346 --> 00:32:10,138
Why can't we ask one of them
to do the operation?
664
00:32:10,148 --> 00:32:11,641
Good idea. Let's practice that.
665
00:32:11,651 --> 00:32:12,741
I'll be Dr. Hillis.
666
00:32:12,751 --> 00:32:14,076
Go ahead, pitch me the surgery.
667
00:32:14,086 --> 00:32:17,816
Hi, Dr. Hillis,
I need a surgical oncologist
668
00:32:17,827 --> 00:32:19,548
to operate on a patient right away.
669
00:32:19,558 --> 00:32:21,851
- Okay, sure, who's the patient?
- Louisa Rodriguez.
670
00:32:21,861 --> 00:32:23,586
Actually, I forgot.
671
00:32:23,596 --> 00:32:25,922
I'm booked solid today.
672
00:32:25,932 --> 00:32:27,256
Ask Dr. Miller.
673
00:32:27,266 --> 00:32:29,304
Dr. Miller,
I need an oncology surgeon...
674
00:32:29,315 --> 00:32:32,321
Would love to, but I'm headed
to Aruba today with my fiancée.
675
00:32:32,332 --> 00:32:35,285
Dr. Singh says the failure rate
for this surgery is through the roof.
676
00:32:35,296 --> 00:32:37,700
Dr. Weiss heard the administration
is dead set against it...
677
00:32:37,710 --> 00:32:39,669
- The administration is wrong.
- Maybe they are,
678
00:32:39,679 --> 00:32:42,171
but Dr. Weiss makes 400K a year,
really wants to keep his job.
679
00:32:42,181 --> 00:32:43,671
Okay.
680
00:32:45,017 --> 00:32:48,243
They're gonna wiggle their way
out of it any way they can.
681
00:32:48,253 --> 00:32:50,956
But we know someone dying
to do the operation.
682
00:32:53,974 --> 00:32:55,852
But it's not in your specialty.
683
00:32:55,862 --> 00:32:58,713
So? I'm arrogant enough
to believe I can do it.
684
00:32:58,724 --> 00:33:00,088
And I'm your only option.
685
00:33:00,098 --> 00:33:01,567
Just get an attending to sign off.
686
00:33:03,419 --> 00:33:05,560
I need you to sign off on a surgery.
687
00:33:05,570 --> 00:33:07,896
It's not in your specialty.
You'll just be supervising.
688
00:33:07,906 --> 00:33:09,432
Yeah, and what's the catch?
689
00:33:09,442 --> 00:33:11,067
No catch.
690
00:33:12,160 --> 00:33:13,786
Look, I know you, pal.
691
00:33:14,677 --> 00:33:16,371
What rules am I gonna break?
692
00:33:16,382 --> 00:33:18,441
Not breaking. Bending.
693
00:33:18,451 --> 00:33:19,875
Bending, okay.
694
00:33:19,885 --> 00:33:22,788
- Who's the patient?
- Louisa Rodriguez.
695
00:33:26,369 --> 00:33:27,401
Oh, I'm in.
696
00:33:31,654 --> 00:33:33,944
Surgery's a go. Mina's on deck.
697
00:33:33,955 --> 00:33:36,436
Conrad, someone called Immigration.
They're coming for Louisa.
698
00:33:47,212 --> 00:33:48,509
How can I help you, gentlemen?
699
00:33:48,520 --> 00:33:50,415
- Sir, you need to move aside.
- I will,
700
00:33:50,426 --> 00:33:51,676
if you tell me what's going on.
701
00:33:51,686 --> 00:33:54,698
Hospitals are sensitive areas,
along with schools and churches.
702
00:33:54,709 --> 00:33:57,748
And sensitive areas cannot be
accessed by immigration officials
703
00:33:57,758 --> 00:34:00,156
without arrest warrants
or under investigation
704
00:34:00,167 --> 00:34:02,020
of an imminent national security threat.
705
00:34:02,030 --> 00:34:05,656
ICE policy letter, October 24, 2011.
706
00:34:05,666 --> 00:34:08,426
You're interfering with the actions
of authorized federal agents.
707
00:34:08,436 --> 00:34:10,181
- You're gonna regret this.
- I doubt that.
708
00:34:10,192 --> 00:34:12,071
Well then, you better drag us
both out of here.
709
00:34:12,082 --> 00:34:13,214
Conrad.
710
00:34:13,642 --> 00:34:14,706
Stop.
711
00:34:15,010 --> 00:34:17,646
Step aside or you will both be fired.
712
00:34:20,148 --> 00:34:21,859
It's okay. Let them pass.
713
00:34:44,987 --> 00:34:46,397
We need to hurry.
714
00:34:57,084 --> 00:35:00,212
Dr. Okafor, you may proceed.
715
00:35:05,226 --> 00:35:07,185
Surgery's underway. Sterile environment.
716
00:35:07,195 --> 00:35:09,932
You cannot enter under
any circumstance. No one can.
717
00:35:28,950 --> 00:35:31,843
Pushing us to charge more,
and order endless tests.
718
00:35:31,853 --> 00:35:34,384
Yeah, Dr. Pravesh wants
the feeding tube out for 4710.
719
00:35:34,395 --> 00:35:36,214
Barb called Immigration. I'm sure of it.
720
00:35:36,224 --> 00:35:38,250
MRI order from Dr. Williams.
721
00:35:38,260 --> 00:35:39,528
Wait. Give that back to me.
722
00:35:41,229 --> 00:35:43,132
- Is this scheduled for right now?
- Mm-hmm.
723
00:35:50,472 --> 00:35:52,225
- Pull him out.
- What are you doing?
724
00:35:52,236 --> 00:35:53,980
Did you push his doctor
to order this test?
725
00:35:53,991 --> 00:35:57,055
- I did.
- Without checking the patient history?
726
00:35:58,907 --> 00:36:00,423
Open the microphone.
727
00:36:01,595 --> 00:36:03,911
Mr. Reynolds, do you know
how an MRI works?
728
00:36:03,922 --> 00:36:06,310
It has incredibly powerful magnets.
729
00:36:06,320 --> 00:36:08,747
Magnets that will rip
anything metal out of your body.
730
00:36:08,757 --> 00:36:10,358
Anything at all.
731
00:36:10,444 --> 00:36:13,917
Do you have anything metal
in your body, Mr. Reynolds?
732
00:36:14,146 --> 00:36:16,122
Mr. Reynolds has a penile implant,
733
00:36:16,133 --> 00:36:19,122
a metal-based penile implant.
734
00:36:19,708 --> 00:36:21,792
How much is your penis
worth to you, Mr. Reynolds?
735
00:36:21,802 --> 00:36:24,439
Say, in a lawsuit? A million dollars?
Five million dollars?
736
00:36:24,450 --> 00:36:26,431
Stop the machine!
737
00:36:26,441 --> 00:36:28,832
You are not a doctor
and you are not a nurse.
738
00:36:28,842 --> 00:36:31,770
Not every test is safe.
Not every procedure should be billed
739
00:36:31,780 --> 00:36:33,181
for ten times what it's worth.
740
00:36:33,192 --> 00:36:34,906
You're gonna end up
getting someone killed.
741
00:36:34,916 --> 00:36:37,007
- Now wait just a second...
- I'll be filing an incident report
742
00:36:37,017 --> 00:36:38,676
with the Comptroller's office
and the CEO.
743
00:36:38,686 --> 00:36:41,824
Good luck getting hired
at Chastain again.
744
00:36:52,267 --> 00:36:53,591
Louisa.
745
00:36:53,601 --> 00:36:55,160
Do you have any nausea?
746
00:36:55,170 --> 00:36:56,428
No.
747
00:36:56,438 --> 00:36:58,763
I feel okay.
748
00:36:59,898 --> 00:37:02,266
You've been so kind to me, all of you.
749
00:37:02,276 --> 00:37:04,268
I'll never be able
to repay you for this.
750
00:37:05,020 --> 00:37:07,971
But I'll still need some help
on my bio midterm.
751
00:37:07,981 --> 00:37:09,050
Anytime.
752
00:37:10,179 --> 00:37:11,203
So...
753
00:37:11,385 --> 00:37:13,544
the operation came off without a hitch.
754
00:37:13,554 --> 00:37:15,952
You had a spectacular surgeon.
755
00:37:16,523 --> 00:37:17,614
Cake.
756
00:37:18,421 --> 00:37:20,051
What are her rehab markers?
757
00:37:20,514 --> 00:37:22,991
Well, if she can walk to
the door, we're in the clear.
758
00:37:23,287 --> 00:37:24,428
If not...
759
00:37:26,800 --> 00:37:28,802
Hey. Well, you look good.
760
00:37:31,872 --> 00:37:33,832
You know, it's really important
761
00:37:33,842 --> 00:37:35,866
that we get you up
on your feet right away.
762
00:37:35,876 --> 00:37:38,335
So... how about you get out of bed
763
00:37:38,345 --> 00:37:40,403
and show us how you can
walk to the door?
764
00:37:41,586 --> 00:37:44,253
- Okay.
- Let's really concentrate.
765
00:37:46,011 --> 00:37:47,292
Here we go.
766
00:38:05,324 --> 00:38:06,893
I'm so sorry.
767
00:38:10,744 --> 00:38:12,714
Two million.
768
00:38:15,849 --> 00:38:17,067
It's okay.
769
00:38:17,078 --> 00:38:18,947
You'll be fine.
770
00:38:32,767 --> 00:38:33,939
Louisa,
771
00:38:33,950 --> 00:38:36,572
rehab is gonna be a long, hard road,
772
00:38:37,137 --> 00:38:39,564
but we all know how tough you are.
773
00:38:39,574 --> 00:38:40,931
You'll get through this.
774
00:38:40,941 --> 00:38:42,266
With some time and care,
775
00:38:42,276 --> 00:38:44,402
you'll be right back
where you were in a year or so.
776
00:38:44,412 --> 00:38:46,648
We've got your back the whole way.
777
00:39:01,655 --> 00:39:02,716
Hey, Art.
778
00:39:02,727 --> 00:39:03,804
Randolph.
779
00:39:09,915 --> 00:39:12,562
Hey, uh, how's your golfing buddy doing?
780
00:39:12,977 --> 00:39:15,474
The one with the tremor?
He sink any more putts?
781
00:39:16,508 --> 00:39:18,312
Oh, uh...
782
00:39:19,187 --> 00:39:20,902
He just started taking the medication.
783
00:39:20,912 --> 00:39:23,138
- Probably too soon to tell.
- Okay.
784
00:39:23,148 --> 00:39:24,674
Well, keep me updated.
785
00:39:24,684 --> 00:39:26,086
Yeah. Yeah. Will do.
786
00:39:59,116 --> 00:40:01,691
Jude and I are gonna go grab a beer.
787
00:40:01,702 --> 00:40:03,255
You want to join?
788
00:40:05,900 --> 00:40:08,618
She's a lot cuter
than either of you guys.
789
00:40:08,924 --> 00:40:10,659
True enough.
790
00:40:15,365 --> 00:40:17,467
Enjoying your victory, Dr. Hawkins?
791
00:40:21,139 --> 00:40:22,308
Did you call Immigration?
792
00:40:25,248 --> 00:40:27,737
You had your billing consultant
do it for you.
793
00:40:27,747 --> 00:40:30,473
Barb Olsen's contract
with this hospital has been suspended.
794
00:40:30,483 --> 00:40:34,076
But I have to pull two million
dollars out of thin air.
795
00:40:34,086 --> 00:40:35,312
- I understand...
- No.
796
00:40:35,323 --> 00:40:38,046
You will understand full well
when I take that money
797
00:40:38,057 --> 00:40:40,449
out of the Internal Medicine
and ER budgets.
798
00:40:41,123 --> 00:40:44,830
Be prepared to be woefully understaffed
for the next 12 months.
799
00:41:02,782 --> 00:41:06,641
By the way, thank you for today.
800
00:41:06,651 --> 00:41:08,009
Yeah.
801
00:41:08,019 --> 00:41:10,446
Thorpe could've had you
canned on the spot.
802
00:41:10,456 --> 00:41:12,748
Well, I get fired, it makes
the decision for me, right?
803
00:41:12,758 --> 00:41:15,917
I show up tomorrow
at Fort Benning, 6:00 a.m.
804
00:41:15,927 --> 00:41:19,688
Hell, you could be there with me.
805
00:41:19,698 --> 00:41:21,323
Hmm?
806
00:41:21,627 --> 00:41:23,491
All right, so you're
starting to come around.
807
00:41:23,501 --> 00:41:25,407
What are you so damn happy about?
808
00:41:25,418 --> 00:41:27,696
Because I know exactly where
I'm supposed to be tomorrow,
809
00:41:27,706 --> 00:41:29,608
and it's at Chastain.
810
00:41:31,209 --> 00:41:32,679
Yeah.
811
00:41:35,280 --> 00:41:38,507
Valor, honor...
812
00:41:38,517 --> 00:41:40,487
Victory.
813
00:41:42,945 --> 00:41:44,045
Mm.
814
00:41:44,055 --> 00:41:47,126
I got these.
815
00:41:50,729 --> 00:41:53,455
So, you know, I've been meaning
to ask, you and Nic...
816
00:41:53,465 --> 00:41:55,156
that still a thing?
817
00:41:55,166 --> 00:41:57,536
She doesn't think so, but...
818
00:41:59,121 --> 00:42:00,894
I think she's worth
fighting for. Don't you?
819
00:42:00,905 --> 00:42:04,299
Oh, hell yeah. Game on.
820
00:42:47,218 --> 00:42:50,379
28-year-old female. Cancer patient.
821
00:42:50,389 --> 00:42:53,616
Short of breath and vomiting.
BP's dropping.
822
00:42:53,626 --> 00:42:55,750
Volts and a liter of saline right now...
823
00:43:04,273 --> 00:43:06,734
- Synced and corrected by Shazi89 -
- www.addic7ed.com -
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