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1
00:01:14,657 --> 00:01:16,576
Hey, I need my cast off.
2
00:01:16,659 --> 00:01:17,869
As soon as you
park that outside.
3
00:01:17,952 --> 00:01:19,579
- Morning, Doc.
- Olsen.
4
00:01:19,662 --> 00:01:20,997
Happy Fourth.
5
00:01:21,081 --> 00:01:22,665
Excuse me, guys.
6
00:01:22,749 --> 00:01:25,668
Sorry.
7
00:01:50,318 --> 00:01:52,028
Hey, how's it going, Dad?
8
00:01:52,112 --> 00:01:53,488
I'm so sleep-deprived.
9
00:01:53,571 --> 00:01:55,532
My house is starting to feel
like a CIA black site.
10
00:01:55,615 --> 00:01:57,492
Have you considered hiring
a night nurse?
11
00:01:57,575 --> 00:01:59,244
- You're looking at him.
- You got a ripe one coming in
12
00:01:59,327 --> 00:02:00,912
you're gonna have to deal with
before everybody out there
13
00:02:00,995 --> 00:02:02,330
- starts puking.
- Lovely.
14
00:02:02,413 --> 00:02:03,915
Your replacement came in early.
15
00:02:03,998 --> 00:02:05,708
She brought in a full
bagel spread.
16
00:02:05,792 --> 00:02:07,502
- I'm just saying.
- She's not my replacement.
17
00:02:07,585 --> 00:02:09,045
She's just covering as chief
while I go
18
00:02:09,129 --> 00:02:10,421
- on my little sabbatical.
- Three months?
19
00:02:10,505 --> 00:02:11,965
I'll be back
before your daughter
20
00:02:12,048 --> 00:02:13,800
- sleeps through the night.
- Hey, dude, that's cold.
21
00:02:13,883 --> 00:02:15,552
- Morning.
- Good morning.
22
00:02:30,191 --> 00:02:31,734
Good morning, John.
23
00:02:31,818 --> 00:02:33,736
I could have sworn
it was still around 4:00 a.m...
24
00:02:33,820 --> 00:02:35,488
Did you guys have
an easy night last night?
25
00:02:35,572 --> 00:02:37,198
The waiting room
actually looks manageable.
26
00:02:37,282 --> 00:02:39,117
I wouldn't call it easy,
but not too bad.
27
00:02:39,200 --> 00:02:41,286
I figured we'd have hands
and burns down here a bunch,
28
00:02:41,369 --> 00:02:43,371
but so far nobody's
blown off any fingers.
29
00:02:43,454 --> 00:02:45,248
Oh, you know
you just jinxed it.
30
00:02:45,331 --> 00:02:46,624
You guys and your jinxes.
31
00:02:46,708 --> 00:02:49,335
- Please, Jesus, please.
- Hail Mary again.
32
00:02:49,419 --> 00:02:51,337
- In the sanctified flesh.
- Don't let me die alone.
33
00:02:51,421 --> 00:02:54,591
- Just try to relax, Margaret.
- I need a priest.
34
00:02:54,674 --> 00:02:57,260
- Hey, hey, Dr. Robby.
- What's the good word, Perlah?
35
00:02:57,343 --> 00:02:59,179
All your results came
back normal, Mrs. Walker.
36
00:02:59,262 --> 00:03:00,180
I'm dying.
37
00:03:00,263 --> 00:03:01,598
You're not dying,
Mrs. Walker, I promise.
38
00:03:01,681 --> 00:03:03,016
Jesus is coming for me.
39
00:03:03,099 --> 00:03:05,310
If He is, He hasn't checked
in at registration yet.
40
00:03:05,393 --> 00:03:06,644
Please don't let me die
a sinner.
41
00:03:06,728 --> 00:03:08,229
Don't worry, Margaret--
we're going to have
42
00:03:08,313 --> 00:03:10,190
the hospital chaplain come
and see you in a moment.
43
00:03:10,273 --> 00:03:11,691
I'm not going
to last that long.
44
00:03:11,774 --> 00:03:13,526
Yes, you will, because we're
going to give you a shot
45
00:03:13,610 --> 00:03:14,986
to keep you alive
until they get here.
46
00:03:15,069 --> 00:03:16,613
What are you thinking,
Dr. Robinavitch?
47
00:03:16,696 --> 00:03:18,489
500 mikes of cyanocobalamin?
48
00:03:18,573 --> 00:03:20,658
In her condition,
I'd push a full 1,000.
49
00:03:20,742 --> 00:03:23,703
Whoo.
You heard the man, Perlah.
50
00:03:23,786 --> 00:03:25,997
God bless you.
God bless all of you.
51
00:03:26,080 --> 00:03:27,582
Amen to that.
52
00:03:27,665 --> 00:03:29,584
Hail Mary, full of grace,
the Lord is with thee...
53
00:03:29,667 --> 00:03:31,419
Ooh, nothing like
the miracle healing powers
54
00:03:31,502 --> 00:03:32,921
of a good old B12 shot.
55
00:03:33,004 --> 00:03:36,049
- How does she hold down a job?
- She doesn't.
56
00:03:36,132 --> 00:03:37,717
She's wearing
a waitress uniform.
57
00:03:37,800 --> 00:03:39,302
Yeah, from a diner
that closed 20 years ago.
58
00:03:39,385 --> 00:03:41,596
Tier One Trauma,
ETA six minutes.
59
00:03:41,679 --> 00:03:43,431
And so it begins.
60
00:03:43,514 --> 00:03:45,892
My husband is still waiting
to see a doctor.
61
00:03:45,975 --> 00:03:47,185
I apologize for the wait,
62
00:03:47,268 --> 00:03:48,978
but here are two doctors
just for you.
63
00:03:49,062 --> 00:03:51,147
Mr. Burgess
has been complaining
64
00:03:51,231 --> 00:03:52,649
of leg cramps for a day.
65
00:03:52,732 --> 00:03:56,236
Slightly tachy at 110,
BP 128 over 75.
66
00:03:56,319 --> 00:03:58,196
Afebrile, good sats.
67
00:03:58,279 --> 00:04:00,156
I'm Dr. Shen,
but I'm going off shift.
68
00:04:00,240 --> 00:04:02,408
Dr. Robinavitch will be one of
the doctors looking after you.
69
00:04:02,492 --> 00:04:03,701
What other medications
70
00:04:03,785 --> 00:04:05,662
are you currently taking,
Mr. Burgess?
71
00:04:05,745 --> 00:04:07,747
I brought his meds.
72
00:04:07,830 --> 00:04:09,791
Thank you.
73
00:04:09,874 --> 00:04:11,334
These are his supplements,
74
00:04:11,417 --> 00:04:13,503
mostly all-natural and organic
where possible.
75
00:04:13,586 --> 00:04:16,256
And these are
his homeopathic prescriptions.
76
00:04:16,339 --> 00:04:20,343
I also have a list
of his refrigerated probiotics.
77
00:04:23,137 --> 00:04:25,014
Where the hell is everybody?
78
00:04:25,098 --> 00:04:27,267
Our new attending
is torturing
79
00:04:27,350 --> 00:04:29,519
our intern and med students
in Trauma One.
80
00:04:29,602 --> 00:04:31,813
She came in early
to meet the night shift
81
00:04:31,896 --> 00:04:33,398
and took things over.
82
00:04:33,481 --> 00:04:36,317
Okay, that takes giant balls
of disrespect.
83
00:04:36,401 --> 00:04:37,694
Giant Balls of Disrespect
84
00:04:37,777 --> 00:04:39,487
was the name
of my band in high school.
85
00:04:39,570 --> 00:04:41,698
And my nickname
for my ex-husband.
86
00:04:41,781 --> 00:04:43,866
Hey, uh,
is this your last shift?
87
00:04:43,950 --> 00:04:47,829
- For a while, yeah.
- Oh, I am so jealous.
88
00:04:47,912 --> 00:04:50,498
Hey, I'll pay you a grand
if you take my second husband.
89
00:04:50,581 --> 00:04:51,749
Tempting.
90
00:04:51,833 --> 00:04:53,710
So tell me about
this new attending.
91
00:04:53,793 --> 00:04:56,838
Uh, she's pretty,
divorced, one kid.
92
00:04:56,921 --> 00:04:59,382
Can already tell
she is a strict rule follower.
93
00:04:59,465 --> 00:05:01,301
I'm probably going
to grow to hate her.
94
00:05:01,384 --> 00:05:05,054
- What's her name, again?
- Dr. Baran Al-Hashimi.
95
00:05:05,138 --> 00:05:07,724
Al-Hashimi?
What is that?
96
00:05:07,807 --> 00:05:10,101
Irish?
97
00:05:10,184 --> 00:05:13,062
She's some sort
of clinical informatics expert.
98
00:05:13,146 --> 00:05:14,939
Once she started
talking about AI,
99
00:05:15,023 --> 00:05:18,318
I started thinking about robots
and kind of stopped listening.
100
00:05:18,401 --> 00:05:20,820
Clear.
Off the chest, Ogilvie.
101
00:05:20,903 --> 00:05:22,405
Get ready to step up here, Joy.
102
00:05:22,488 --> 00:05:24,657
Ogilvie, off the chest!
103
00:05:24,741 --> 00:05:26,117
Clear!
104
00:05:26,200 --> 00:05:27,952
Still V-tach,
but it looks weird.
105
00:05:28,036 --> 00:05:29,704
- Agreed.
- No pulse.
106
00:05:29,787 --> 00:05:31,831
No effusion,
good lung sliding.
107
00:05:31,914 --> 00:05:32,874
Start compressions, Joy.
108
00:05:32,957 --> 00:05:34,000
We haven't considered
all the Ts.
109
00:05:34,083 --> 00:05:36,002
I checked for tamponade
and tension pneumo.
110
00:05:36,085 --> 00:05:37,211
What if it's thrombosis?
111
00:05:37,295 --> 00:05:39,422
If it's a pulmonary or cardiac
clot, TNK could save him.
112
00:05:39,505 --> 00:05:41,507
We are sticking
with the algorithm for now.
113
00:05:41,591 --> 00:05:43,551
- Algorithm's not working.
- Faster and deeper, please.
114
00:05:43,634 --> 00:05:46,429
- Uh, you need a break, Joy?
- No, I need an attending.
115
00:05:46,512 --> 00:05:48,806
I'm right here.
116
00:05:48,890 --> 00:05:50,725
Stop compressions.
We're calling it.
117
00:05:52,268 --> 00:05:54,062
Sorry, the patient's dead.
118
00:05:56,939 --> 00:05:59,400
All right.
Who can tell me what went well?
119
00:05:59,484 --> 00:06:01,110
We followed
the V-tach algorithm.
120
00:06:01,194 --> 00:06:02,862
We checked
for reversible causes.
121
00:06:02,945 --> 00:06:04,614
We limited our rhythm
and pulse checks to 10 seconds.
122
00:06:04,697 --> 00:06:05,990
Excellent.
123
00:06:06,074 --> 00:06:07,283
Should we have
given thrombolytics?
124
00:06:07,367 --> 00:06:08,659
No, you should have
recognized
125
00:06:08,743 --> 00:06:10,787
that the cardiac rhythm
on the monitor was polymorphic,
126
00:06:10,870 --> 00:06:12,622
not just V-tach.
127
00:06:12,705 --> 00:06:14,540
It was torsades de pointes.
128
00:06:14,624 --> 00:06:16,793
That's French--
"twisting of the points."
129
00:06:16,876 --> 00:06:18,669
From prolonged QT,
antiarrhythmics,
130
00:06:18,753 --> 00:06:20,004
electrolyte disorders.
131
00:06:20,088 --> 00:06:21,255
Your patient would have lived
132
00:06:21,339 --> 00:06:22,965
if you had pushed
magnesium sulfate.
133
00:06:23,049 --> 00:06:24,842
Good news is
he's an organ donor.
134
00:06:24,926 --> 00:06:26,594
Parts of him are going to get
used to make Frisbees
135
00:06:26,677 --> 00:06:28,805
and water bottles and end up
as microplastics
136
00:06:28,888 --> 00:06:30,515
in our brains
and reproductive organs.
137
00:06:30,598 --> 00:06:32,183
Thank you for the words
of encouragement, boss.
138
00:06:32,266 --> 00:06:33,810
Dr. Al-Hashimi,
Dr. Michael Robinavitch.
139
00:06:33,893 --> 00:06:35,770
- Everybody calls me Robby.
- Baran, please.
140
00:06:35,853 --> 00:06:37,397
- Welcome to the Pitt.
- Yeah, about that--
141
00:06:37,480 --> 00:06:38,773
Trauma's a minute out.
142
00:06:38,856 --> 00:06:40,733
Ooh, who wants to treat
a real patient?
143
00:06:40,817 --> 00:06:42,151
Yes, please.
144
00:06:42,235 --> 00:06:44,070
This thing's going
to give me nightmares.
145
00:06:45,822 --> 00:06:47,782
I hope you don't mind me
jumping right into things.
146
00:06:47,865 --> 00:06:49,534
I find that a mock code
is a great way
147
00:06:49,617 --> 00:06:51,285
to assess
the students' capabilities.
148
00:06:51,369 --> 00:06:53,871
Well, it might have been nice
if we'd had a little time
149
00:06:53,955 --> 00:06:55,623
to go over how we do things.
150
00:06:55,706 --> 00:06:58,626
Did you not get a packet
from Dr. Underwood? Gloria?
151
00:06:58,709 --> 00:07:00,711
It outlined
the quality-improvement changes
152
00:07:00,795 --> 00:07:02,547
I instituted at the VA.
153
00:07:02,630 --> 00:07:03,840
We're adopting the program
154
00:07:03,923 --> 00:07:05,633
at all
of the university hospitals.
155
00:07:05,716 --> 00:07:08,010
- You didn't read it?
- No, I did. I mean, I will.
156
00:07:08,094 --> 00:07:09,554
I'm going to.
I want to.
157
00:07:09,637 --> 00:07:11,222
I thought I had
a little bit more time
158
00:07:11,305 --> 00:07:13,182
- before you came in today.
- We've already distributed
159
00:07:13,266 --> 00:07:15,685
patient passports
to everyone at registration.
160
00:07:15,768 --> 00:07:18,229
What is a patient passport?
161
00:07:18,312 --> 00:07:20,773
So glad you asked.
162
00:07:20,857 --> 00:07:22,650
- Samira?
- Dr. Al.
163
00:07:22,733 --> 00:07:25,278
We worked together
at the VA a few years ago.
164
00:07:25,361 --> 00:07:27,238
- And now you're an R4.
- Yes.
165
00:07:27,321 --> 00:07:29,323
And I'm so excited
you're joining us.
166
00:07:29,407 --> 00:07:30,783
Dr. Mel King is here, too.
167
00:07:30,867 --> 00:07:32,201
I think you worked
with her as well.
168
00:07:32,285 --> 00:07:33,911
- Incoming!
- I did indeed.
169
00:07:33,995 --> 00:07:35,872
John Doe--dishwasher,
penetrating trauma
170
00:07:35,955 --> 00:07:37,874
from a kitchen knife
to the right chest.
171
00:07:37,957 --> 00:07:39,333
- Assault or accident?
- Unclear.
172
00:07:39,417 --> 00:07:42,044
Initially had a pulse,
lost it two blocks away.
173
00:07:44,505 --> 00:07:46,466
What do we got, party people?
174
00:07:46,549 --> 00:07:49,677
Dr. Yolanda Garcia,
trauma surgery fellow,
175
00:07:49,760 --> 00:07:52,555
meet Dr. Baran Al-Hashimi,
new E.D. attending.
176
00:07:52,638 --> 00:07:54,432
She's gonna be covering for me
while I'm gone.
177
00:07:54,515 --> 00:07:55,975
So nice to meet you.
178
00:07:56,058 --> 00:07:57,477
About time they replaced you,
Rabbit-bitch.
179
00:07:57,560 --> 00:07:59,270
I'm gonna miss you,
too, Yolo.
180
00:07:59,353 --> 00:08:01,606
Dr. Garcia has a hard time
expressing her feelings.
181
00:08:01,689 --> 00:08:02,648
Not all of them.
182
00:08:02,732 --> 00:08:06,152
One, two, three.
183
00:08:06,235 --> 00:08:09,489
- Prep for a left thoracotomy.
- I'm on it.
184
00:08:09,572 --> 00:08:11,699
What's up, White Chocolate?
185
00:08:11,782 --> 00:08:15,536
Did you know our farm boy here
is a vintage-funk freak?
186
00:08:15,620 --> 00:08:17,914
Unfortunately,
he also likes to use
187
00:08:17,997 --> 00:08:20,458
- other people's toothbrushes.
- It was one time.
188
00:08:20,541 --> 00:08:22,084
They were the same color.
189
00:08:22,168 --> 00:08:24,086
- What's your plan, Samira?
- Dr. Mohan, next steps?
190
00:08:24,170 --> 00:08:25,421
Chest tube to the right.
191
00:08:25,505 --> 00:08:27,173
Stand by with massive
transfusion protocol.
192
00:08:27,256 --> 00:08:28,466
I put two units
on the infuser.
193
00:08:28,549 --> 00:08:29,800
Sterile gloves, 6 1/2.
194
00:08:29,884 --> 00:08:30,885
Here, we let the fellows
195
00:08:30,968 --> 00:08:32,303
and the residents
kind of take charge.
196
00:08:32,386 --> 00:08:34,472
I'll hold on to them
just in case.
197
00:08:34,555 --> 00:08:37,475
Is the VA even
a trauma center?
198
00:08:37,558 --> 00:08:41,062
Not for medic runs,
but they walk in--
199
00:08:41,145 --> 00:08:45,107
falls, major MVCs, GSWs.
200
00:08:45,191 --> 00:08:46,609
Stab wound's on the right.
201
00:08:46,692 --> 00:08:48,194
Why are we opening
the left chest?
202
00:08:48,277 --> 00:08:50,112
Better access
if it's tamponade,
203
00:08:50,196 --> 00:08:52,031
and you can cross-clamp
the aorta.
204
00:08:52,114 --> 00:08:53,658
Javadi, Whitaker,
sterile gloves.
205
00:08:53,741 --> 00:08:54,742
Can I glove up?
206
00:08:54,825 --> 00:08:57,328
It's best if you
watch the first one.
207
00:08:57,411 --> 00:08:59,080
This guy's dead anyway.
208
00:09:01,082 --> 00:09:04,126
- 10 blade.
- 28 French on a long Kelly.
209
00:09:05,336 --> 00:09:06,796
Javadi, you're on suction,
210
00:09:06,879 --> 00:09:09,715
Whitaker, get ready
for internal compressions.
211
00:09:11,592 --> 00:09:13,469
Sorry, that's my phone.
212
00:09:15,096 --> 00:09:16,556
Finochietto retractor.
213
00:09:16,639 --> 00:09:17,890
Whitaker,
give me a little room.
214
00:09:17,974 --> 00:09:19,141
I need to get to his heart.
215
00:09:19,225 --> 00:09:20,768
I'm in.
Hook up the Thora-Seal.
216
00:09:22,270 --> 00:09:23,479
You want me
to get that for you?
217
00:09:23,563 --> 00:09:25,648
Not right now.
218
00:09:34,031 --> 00:09:36,075
No tamponade,
pretty dry in here.
219
00:09:37,702 --> 00:09:39,203
Heart's empty.
220
00:09:39,287 --> 00:09:40,830
Somebody start cardiac massage,
I'll cross-clamp.
221
00:09:40,913 --> 00:09:41,998
Yeah, I got it.
222
00:09:42,081 --> 00:09:43,416
You do these one-handed,
223
00:09:43,499 --> 00:09:45,459
pushing up against the
breastbone with four fingers.
224
00:09:45,543 --> 00:09:47,420
- Very good.
- Not much blood to suction.
225
00:09:47,503 --> 00:09:50,006
- Okay, team, I think we need--
- Samira, next steps?
226
00:09:50,089 --> 00:09:51,090
Keep transfusing.
227
00:09:51,173 --> 00:09:52,592
- Open the right chest.
- That is correct.
228
00:09:52,675 --> 00:09:54,385
Booties on, kids.
There will be blood.
229
00:09:56,846 --> 00:09:58,681
Frank?
230
00:10:00,224 --> 00:10:03,269
Langdon.
231
00:10:03,352 --> 00:10:05,438
Frank?
232
00:10:12,570 --> 00:10:14,614
You should be good
to go now, hon.
233
00:10:14,697 --> 00:10:16,741
- Thanks, Lupe.
- Of course.
234
00:10:16,824 --> 00:10:18,659
Hey, go get 'em.
235
00:10:21,662 --> 00:10:23,998
Hey, Doc.
236
00:10:24,081 --> 00:10:27,001
It's been a while.
237
00:10:27,084 --> 00:10:30,630
I got a-a bad toothache today.
238
00:10:30,713 --> 00:10:33,299
We'll take care
of that, Louie.
239
00:10:33,382 --> 00:10:34,717
All right.
240
00:11:08,084 --> 00:11:10,252
There's too much blood
to suction.
241
00:11:10,336 --> 00:11:12,254
Uh, retracting the lung.
242
00:11:12,338 --> 00:11:14,632
- Try to identify the source.
- Could be the right ventricle.
243
00:11:14,715 --> 00:11:16,592
Or more likely, the hilum.
244
00:11:16,676 --> 00:11:18,344
Fresh lap pads.
245
00:11:19,720 --> 00:11:23,015
Siri, turn on silent mode!
246
00:12:13,607 --> 00:12:15,109
Good morning.
247
00:12:15,192 --> 00:12:16,861
If it was a good morning,
I'd still be in bed.
248
00:12:16,944 --> 00:12:18,529
So what are you doing here?
249
00:12:18,612 --> 00:12:20,531
Benji's mom is visiting
for the holiday.
250
00:12:20,614 --> 00:12:22,533
- She's still alive?
- That woman's too mean to die.
251
00:12:22,616 --> 00:12:24,160
Plus, who else is going
to get this place
252
00:12:24,243 --> 00:12:25,953
through
the Fourth of July weekend?
253
00:12:26,036 --> 00:12:27,747
Sure as hell
ain't going to be me.
254
00:12:27,830 --> 00:12:30,082
I rest my case.
What am I walking into?
255
00:12:30,166 --> 00:12:31,667
Nothing too bad, yet.
256
00:12:31,751 --> 00:12:33,878
Uh, these are the ones
I'd keep an eye on.
257
00:12:35,796 --> 00:12:38,674
The prodigal son returns.
258
00:12:38,758 --> 00:12:39,842
Too soon?
259
00:12:39,925 --> 00:12:42,303
No, I guess not.
260
00:12:42,386 --> 00:12:44,972
- You're back.
- I took some time.
261
00:12:45,055 --> 00:12:48,184
I'm like an old trail horse--
I always find my way back home.
262
00:12:48,267 --> 00:12:49,935
You look good, kid.
How you feeling?
263
00:12:50,019 --> 00:12:51,896
Uh, yeah, great.
264
00:12:51,979 --> 00:12:54,482
You know, it's been a...
265
00:12:54,565 --> 00:12:56,984
- it's been a journey.
- I bet.
266
00:12:57,067 --> 00:12:58,652
Thanks.
Robby around?
267
00:12:58,736 --> 00:13:00,571
Uh, he's in with a trauma.
268
00:13:00,654 --> 00:13:02,990
But if you hurry back, you can
catch some of the pass-ons.
269
00:13:03,073 --> 00:13:05,284
- They're in North.
- Uh, thanks.
270
00:13:07,077 --> 00:13:09,079
I'll keep an eye on him.
271
00:13:11,207 --> 00:13:13,417
I think we have
a lost little lamb.
272
00:13:13,501 --> 00:13:16,045
Uh, excuse me, hon.
Can we help you?
273
00:13:16,128 --> 00:13:18,005
I'm looking
for the charge nurse.
274
00:13:18,088 --> 00:13:20,090
Oh, well,
you found two of 'em.
275
00:13:20,174 --> 00:13:21,509
I'm Lena.
This is Dana.
276
00:13:21,592 --> 00:13:22,802
I'm night shift, going home,
277
00:13:22,885 --> 00:13:25,137
but Dana is queen
of the day shift.
278
00:13:25,221 --> 00:13:27,223
Emma Nolan.
Nice to meet you both.
279
00:13:27,306 --> 00:13:29,683
Uh, I'm a new grad RN
here to shadow.
280
00:13:29,767 --> 00:13:31,227
Welcome to the Pitt,
Emma Nolan.
281
00:13:31,310 --> 00:13:32,937
Here, let me put some
of your stuff behind the desk,
282
00:13:33,020 --> 00:13:35,731
- and I'll give you a quick tour.
- Okay.
283
00:13:35,815 --> 00:13:38,234
- Where you from, sweetheart?
- Sault Ste. Marie.
284
00:13:38,317 --> 00:13:39,693
Oh.
285
00:13:39,777 --> 00:13:42,238
It's in Upper Michigan,
practically Canada.
286
00:13:42,321 --> 00:13:45,074
My great-grandmother
was from up that way--
287
00:13:45,157 --> 00:13:48,244
nice area, a lot of bugs.
288
00:13:48,327 --> 00:13:50,079
How about a cup of coffee?
289
00:13:51,539 --> 00:13:53,040
Can't locate the source.
290
00:13:53,123 --> 00:13:54,834
Proximal hilum
is under the sternum.
291
00:13:54,917 --> 00:13:56,836
Along with most
of the right ventricle.
292
00:13:56,919 --> 00:13:59,630
- You need better exposure.
- Convert to a clamshell.
293
00:13:59,713 --> 00:14:02,049
- Exactly.
- Trauma shears.
294
00:14:02,132 --> 00:14:04,677
Would've been nice to let
them come up with that plan.
295
00:14:04,760 --> 00:14:06,762
Heart's going to need double
compressions just like this.
296
00:14:08,222 --> 00:14:10,599
Squeeze from the apex
to the aorta.
297
00:14:12,226 --> 00:14:13,769
Right ventricle looks good.
298
00:14:13,853 --> 00:14:15,187
Massive hemorrhage
from the hilum.
299
00:14:15,271 --> 00:14:18,732
Second MTP pack is going,
additional four units.
300
00:14:18,816 --> 00:14:21,151
Hilar injury
looks very proximal--
301
00:14:21,235 --> 00:14:23,362
may be pulmonary artery
and vein.
302
00:14:23,445 --> 00:14:26,073
Clamp's on.
Nope, no good.
303
00:14:26,156 --> 00:14:27,575
Still bleeding
like a stuck pig.
304
00:14:27,658 --> 00:14:28,576
I can give it a try.
305
00:14:28,659 --> 00:14:29,952
Dr. Garcia is
a very skilled surgeon.
306
00:14:30,035 --> 00:14:31,620
If she can't get it, we need
to think of something else.
307
00:14:31,704 --> 00:14:32,872
Like what?
308
00:14:36,375 --> 00:14:37,793
Hilar flip.
309
00:14:37,877 --> 00:14:39,461
We're going to rotate
the lung 180 degrees,
310
00:14:39,545 --> 00:14:41,088
like putting a kink
in the garden hose.
311
00:14:41,171 --> 00:14:43,841
- It'll stop the bleeding.
- That could possibly work.
312
00:14:43,924 --> 00:14:47,595
Or he'll die when you rip
the entire lung off the hilum.
313
00:14:47,678 --> 00:14:50,431
Gently, very, very gently,
very, very slowly.
314
00:15:06,155 --> 00:15:07,907
- Blood loss is slowing down.
- That's a good sign.
315
00:15:07,990 --> 00:15:09,199
Hilum looks dry.
316
00:15:09,283 --> 00:15:11,035
Yeah, but the heart
feels empty.
317
00:15:11,118 --> 00:15:13,579
Okay, we fixed the leak.
Now let's fill the tank.
318
00:15:15,831 --> 00:15:17,833
You are very popular today.
319
00:15:17,917 --> 00:15:20,669
Sorry, I'll turn it off
when I can.
320
00:15:24,882 --> 00:15:26,508
Nine-year-old Kylie Connors--
321
00:15:26,592 --> 00:15:28,719
brought in by
her dad's girlfriend, Gina.
322
00:15:28,802 --> 00:15:31,138
Kylie took a tumble
on the stairs this morning.
323
00:15:31,221 --> 00:15:34,099
3-centimeter chin lac
and a chipped front incisor.
324
00:15:34,183 --> 00:15:36,060
She's got LET
on a pressure dressing.
325
00:15:36,143 --> 00:15:37,895
Bleeding pretty good
on arrival.
326
00:15:37,978 --> 00:15:40,064
Dermabond should do the trick.
327
00:15:40,147 --> 00:15:42,107
Any questions?
328
00:15:42,191 --> 00:15:44,526
Dr. King?
329
00:15:44,610 --> 00:15:45,945
Mel?
330
00:15:46,028 --> 00:15:48,614
Oh, um,
I didn't say anything.
331
00:15:51,450 --> 00:15:54,161
- Uh, how you feeling, Kylie?
- Tired.
332
00:15:54,244 --> 00:15:56,956
- We've been here since 5:30.
- Oh, that makes two of us.
333
00:15:57,039 --> 00:15:59,333
But don't worry.
We'll patch you up good as new.
334
00:15:59,416 --> 00:16:01,961
And we will get you out of here
as soon as we can.
335
00:16:02,044 --> 00:16:03,379
- Any questions?
- Can you raise your chin?
336
00:16:03,462 --> 00:16:05,255
No, I'm just
her dad's girlfriend,
337
00:16:05,339 --> 00:16:07,299
- so I'm new to all this.
- No worries. We got you.
338
00:16:07,383 --> 00:16:08,634
Next.
339
00:16:10,260 --> 00:16:14,056
26-year-old Liam Sanders--
took a fall from his bicycle.
340
00:16:14,139 --> 00:16:16,183
No LOC, nonfocal neuro,
341
00:16:16,266 --> 00:16:18,477
lower-leg lac
with no bony tenderness.
342
00:16:18,560 --> 00:16:20,312
Were you wearing
a helmet, Liam?
343
00:16:20,396 --> 00:16:22,231
No, I was just riding
in my neighborhood.
344
00:16:22,314 --> 00:16:23,983
You should always
wear a helmet.
345
00:16:24,066 --> 00:16:25,484
Hey, nice of you to join us.
346
00:16:25,567 --> 00:16:27,653
- Hey.
- Dr. Langdon!
347
00:16:30,114 --> 00:16:32,825
Sold to Dr. Langdon.
348
00:16:32,908 --> 00:16:35,160
Candace O'Grady, 82...
349
00:16:35,244 --> 00:16:39,415
Brought in by her son Richard
for intractable vomiting.
350
00:16:41,291 --> 00:16:43,002
Hardly any hemorrhage
on the right.
351
00:16:43,085 --> 00:16:44,461
- Looks like the flip worked.
- How's the heart, Whitaker?
352
00:16:44,545 --> 00:16:46,422
Feels full of blood.
First time since we started.
353
00:16:46,505 --> 00:16:50,342
Hold compressions.
354
00:16:50,426 --> 00:16:53,012
- Quivering bag of worms.
- Resume compressions.
355
00:16:53,095 --> 00:16:55,514
When the heart quivers
like that, it's obvious V-fib.
356
00:16:55,597 --> 00:16:58,809
- Okay, internal paddles ready.
- Mm-hmm. Charge to...?
357
00:16:58,892 --> 00:17:00,602
- 25 joules.
- 50 joules.
358
00:17:00,686 --> 00:17:02,521
50 gets it right
the first time.
359
00:17:02,604 --> 00:17:04,690
Charged.
360
00:17:04,773 --> 00:17:05,983
Okay, Whitaker,
when you're ready.
361
00:17:06,066 --> 00:17:08,068
Clear.
362
00:17:10,696 --> 00:17:12,781
That's what normal sinus
looks like.
363
00:17:14,616 --> 00:17:15,617
Strong carotid.
364
00:17:15,701 --> 00:17:18,746
Saline lap pads
and up to the OR.
365
00:17:18,829 --> 00:17:21,040
That's a hell of a way
to start the day.
366
00:17:21,123 --> 00:17:24,877
Unconventional,
but a decent outcome.
367
00:17:24,960 --> 00:17:27,212
Why don't we split up
for efficiency?
368
00:17:27,296 --> 00:17:29,631
Residents present to either
one of us but not both.
369
00:17:31,133 --> 00:17:33,093
We can certainly
discuss that.
370
00:17:37,598 --> 00:17:39,475
Were you feeling weak
or dizzy?
371
00:17:39,558 --> 00:17:40,851
No.
372
00:17:40,934 --> 00:17:42,561
I-I got up to pee,
and I tripped over
373
00:17:42,644 --> 00:17:44,605
a laundry basket that
I couldn't see in the dark.
374
00:17:44,688 --> 00:17:46,148
Did you hit your head?
375
00:17:46,231 --> 00:17:48,067
Does my chart say
that I hit my head?
376
00:17:48,150 --> 00:17:50,277
No, we just
want to be thorough
377
00:17:50,360 --> 00:17:52,529
to make sure
you don't miss anything.
378
00:17:52,613 --> 00:17:54,865
How about we focus
on patching me up?
379
00:17:54,948 --> 00:17:56,492
Ah!
380
00:17:56,575 --> 00:17:58,494
All right, Mr. Williams,
381
00:17:58,577 --> 00:18:00,287
we're going to check an X-ray
of your wrist
382
00:18:00,370 --> 00:18:02,498
and try to get you out of here
as quickly as possible.
383
00:18:02,581 --> 00:18:05,000
Great. And let's keep
the bullshit extra charges
384
00:18:05,084 --> 00:18:06,502
to a minimum, huh?
385
00:18:06,585 --> 00:18:08,796
My deductible
is already a bitch.
386
00:18:11,381 --> 00:18:13,175
Sure.
387
00:18:34,905 --> 00:18:36,240
Bye.
388
00:18:36,323 --> 00:18:38,700
My mother is trying
to destroy my life.
389
00:18:38,784 --> 00:18:40,869
Yeah, they seem
to take pleasure in that.
390
00:18:40,953 --> 00:18:42,704
I committed
to a partnership-track position
391
00:18:42,788 --> 00:18:44,540
next year at a hospital
back in Jersey
392
00:18:44,623 --> 00:18:46,542
so I could be close
and support her.
393
00:18:46,625 --> 00:18:49,545
But now she's getting married
and selling our house
394
00:18:49,628 --> 00:18:52,089
to go on a year-long cruise
around the world.
395
00:18:52,172 --> 00:18:54,675
Wow.
I mean, that's a--
396
00:18:54,758 --> 00:18:56,635
Pretty fucking stupid idea,
if you ask me.
397
00:18:56,718 --> 00:18:58,720
She's known this guy
less than a year.
398
00:18:58,804 --> 00:19:02,099
What if he's a player?
What if she disappears at sea?
399
00:19:02,182 --> 00:19:03,851
I mean,
what if they're in love?
400
00:19:03,934 --> 00:19:05,519
Lust is more like it.
401
00:19:05,602 --> 00:19:08,647
That is even better.
402
00:19:08,730 --> 00:19:11,942
Man, it has been a while,
403
00:19:12,025 --> 00:19:15,362
and I'm solo this weekend.
404
00:19:15,445 --> 00:19:17,656
I need to get laid.
405
00:19:21,577 --> 00:19:23,620
It's a little much
before 8:00 a.m., right?
406
00:19:23,704 --> 00:19:25,497
Yeah.
407
00:19:27,040 --> 00:19:28,792
Or ever.
408
00:19:34,256 --> 00:19:35,757
How's it going, Esme?
409
00:19:35,841 --> 00:19:38,051
Oh, just another day
in paradise.
410
00:19:55,277 --> 00:19:57,946
Heard you're going on a trip.
411
00:19:58,030 --> 00:20:00,199
Taking a sabbatical.
Leave tonight.
412
00:20:00,282 --> 00:20:02,034
Where you going?
413
00:20:02,117 --> 00:20:05,871
Um, Head-Smashed-In
Buffalo Jump.
414
00:20:05,954 --> 00:20:08,665
Captain Crunch
flying squirrel socks.
415
00:20:08,749 --> 00:20:11,960
What, are we talking in code,
or are you having a stroke?
416
00:20:12,044 --> 00:20:15,422
It's an Aboriginal UNESCO
Heritage Site in Alberta.
417
00:20:15,505 --> 00:20:17,424
I've never seen the Badlands.
418
00:20:17,507 --> 00:20:20,636
What is this, like, uh,
some sort of spirit quest?
419
00:20:20,719 --> 00:20:23,931
Uh, yeah,
something like that.
420
00:20:24,014 --> 00:20:26,558
Look, I, uh--
I guess we should talk.
421
00:20:26,642 --> 00:20:28,894
- Got a lot of things I need to--
- At some point, not right now.
422
00:20:28,977 --> 00:20:30,562
Right now
I got to hit the head,
423
00:20:30,646 --> 00:20:32,564
and I would like you to go
help Donnie out in Triage.
424
00:20:32,648 --> 00:20:33,941
Triage?
425
00:20:34,024 --> 00:20:35,484
N-no.
426
00:20:35,567 --> 00:20:37,194
No, I already picked up
a patient in North 2,
427
00:20:37,277 --> 00:20:38,612
a bicycle fall leg lac,
so maybe--
428
00:20:38,695 --> 00:20:39,738
Pretty sure
we can cover for you.
429
00:20:39,821 --> 00:20:43,033
We've been doing it for months.
430
00:20:43,116 --> 00:20:44,618
Right.
431
00:20:44,701 --> 00:20:47,204
No, and I--and I am--
I am very, uh--
432
00:20:47,287 --> 00:20:48,914
both very sorry
and appreciative of that.
433
00:20:48,997 --> 00:20:50,415
I just would hate to think
434
00:20:50,499 --> 00:20:53,085
that this is some kind
of a punishment for...
435
00:20:53,168 --> 00:20:55,045
but, uh, yeah.
Yeah. No, for sure.
436
00:20:55,128 --> 00:20:58,674
We'll--we'll talk later,
before you go.
437
00:20:58,757 --> 00:21:01,134
Like I said, not right now.
438
00:21:01,218 --> 00:21:03,512
Donnie just passed
his NP certification.
439
00:21:03,595 --> 00:21:05,472
He can help if you get in
over your head.
440
00:21:08,976 --> 00:21:10,852
Hey, Mel...
441
00:21:10,936 --> 00:21:13,730
can you take over
a bike fall leg lac in North 2
442
00:21:13,814 --> 00:21:15,607
for Langdon
while he's out in Triage?
443
00:21:15,691 --> 00:21:17,401
Um, you know, I-I can work
in Triage if you want--
444
00:21:17,484 --> 00:21:19,278
No, I want to keep Langdon
out in Triage,
445
00:21:19,361 --> 00:21:20,988
and I want to keep you
back here.
446
00:21:21,071 --> 00:21:23,490
- You okay with that?
- Sure.
447
00:21:23,573 --> 00:21:25,534
- Great.
- Absolutely.
448
00:21:31,581 --> 00:21:33,208
So...
449
00:21:33,292 --> 00:21:35,460
who should I pick up?
450
00:21:35,544 --> 00:21:37,504
We're about to get
the morning rush.
451
00:21:37,587 --> 00:21:38,714
What do you mean?
452
00:21:38,797 --> 00:21:40,215
Every morning
around this time,
453
00:21:40,299 --> 00:21:42,634
the nursing homes
and assisted-living facilities
454
00:21:42,718 --> 00:21:45,387
- do their morning bed checks.
- Uh-huh.
455
00:21:48,181 --> 00:21:50,684
It looks pretty quiet to me.
456
00:21:53,979 --> 00:21:56,106
Huh.
457
00:21:56,189 --> 00:21:57,816
Incoming.
458
00:21:57,899 --> 00:21:59,526
Oh, like I said.
459
00:21:59,609 --> 00:22:01,069
Come on.
460
00:22:01,153 --> 00:22:02,612
Ethan Bostick, 79--
461
00:22:02,696 --> 00:22:04,698
found altered this morning
at assisted living.
462
00:22:04,781 --> 00:22:06,033
No history of dementia.
463
00:22:06,116 --> 00:22:07,909
- Has a POLST.
- What's a POLST?
464
00:22:07,993 --> 00:22:10,537
Physician Orders
for Life-Sustaining Treatment--
465
00:22:10,620 --> 00:22:12,998
no CPR, no intubation.
466
00:22:13,081 --> 00:22:15,083
Then there's--
there's nothing for us to do.
467
00:22:15,167 --> 00:22:16,918
South 15 is open.
468
00:22:17,002 --> 00:22:19,921
Uh, well, "do not resuscitate"
does not mean "do not treat."
469
00:22:20,005 --> 00:22:24,092
He may perk up with fluids,
IV antibiotics.
470
00:22:28,638 --> 00:22:29,848
What's the good word, Crash?
471
00:22:29,931 --> 00:22:32,184
You save
that ventriloquist dummy?
472
00:22:32,267 --> 00:22:33,935
- Yeah.
- Really?
473
00:22:34,019 --> 00:22:36,355
No.
474
00:22:36,438 --> 00:22:38,357
Wait, tell me
you're not actually charting
475
00:22:38,440 --> 00:22:40,567
- about losing a mannequin.
- It's part of the exercise.
476
00:22:40,650 --> 00:22:42,361
Dr. Al-Hashimi
asked us to do it.
477
00:22:42,444 --> 00:22:44,363
Who's his next of kin--
Barbie?
478
00:22:46,031 --> 00:22:49,951
What's your, uh, take
on the new attending?
479
00:22:50,035 --> 00:22:51,661
Too soon to tell.
480
00:22:53,622 --> 00:22:54,873
You?
481
00:22:54,956 --> 00:22:56,166
She's already bugging me
482
00:22:56,249 --> 00:22:57,793
about being behind
on my charting.
483
00:22:57,876 --> 00:22:59,461
Now I know why everyone says
484
00:22:59,544 --> 00:23:01,713
being a second-year resident
sucks--because it does.
485
00:23:01,797 --> 00:23:03,548
I must've slept through
the part of med school
486
00:23:03,632 --> 00:23:06,385
where they tell you 90% of
your time will be spent typing.
487
00:23:06,468 --> 00:23:07,969
Which is just one more reason
488
00:23:08,053 --> 00:23:10,180
surgery is
a better lifestyle choice.
489
00:23:10,263 --> 00:23:13,183
Hey, Dr. Shamsi.
Dr. Trinity Santos.
490
00:23:13,266 --> 00:23:15,394
Ah, yes, the ER intern
who's interested
491
00:23:15,477 --> 00:23:17,396
- in my surgery program.
- That's me.
492
00:23:17,479 --> 00:23:19,981
But I'm an R2 now and thinking
of double boarding
493
00:23:20,065 --> 00:23:21,817
in surgery
and emergency medicine,
494
00:23:21,900 --> 00:23:24,319
which I know would sound
ridiculously ambitious
495
00:23:24,403 --> 00:23:26,655
if I didn't have the talent
to back it up.
496
00:23:26,738 --> 00:23:28,281
And the required attitude.
497
00:23:29,950 --> 00:23:31,618
Are you here to see a patient?
498
00:23:31,701 --> 00:23:33,412
I was. I did.
499
00:23:33,495 --> 00:23:34,788
And now I'm here to learn
500
00:23:34,871 --> 00:23:37,416
why you aren't returning
my calls or texts.
501
00:23:37,499 --> 00:23:39,000
Okay, I'm out.
502
00:23:39,084 --> 00:23:41,086
Nice seeing you again,
Dr. Shamsi.
503
00:23:41,169 --> 00:23:42,671
As soon as I get
a little free time,
504
00:23:42,754 --> 00:23:44,756
I will make plans for all of us
to do something together.
505
00:23:44,840 --> 00:23:46,633
- What about Tuesday?
- I'm working.
506
00:23:46,716 --> 00:23:48,510
On your birthday?
507
00:23:48,593 --> 00:23:50,262
I will call you
and Dad tomorrow,
508
00:23:50,345 --> 00:23:52,013
and we'll come up with something
to do together, I promise.
509
00:23:52,097 --> 00:23:54,015
But right now I actually have
510
00:23:54,099 --> 00:23:56,309
a bunch
of night-shift hand-offs.
511
00:24:03,442 --> 00:24:07,112
We have schedules.
You have chaos.
512
00:24:07,195 --> 00:24:09,239
You know she's wasting
her talents down here.
513
00:24:09,322 --> 00:24:12,242
Victoria is a big girl.
She can make her own decisions.
514
00:24:12,325 --> 00:24:15,829
She's also a young girl who's
still very impressionable.
515
00:24:15,912 --> 00:24:18,874
- And you can be very...
- "Pressionable"?
516
00:24:21,543 --> 00:24:22,836
Yes?
517
00:24:22,919 --> 00:24:24,212
Who?
518
00:24:24,296 --> 00:24:25,672
Who?
519
00:24:25,755 --> 00:24:28,467
Oh, for God's sake.
I'll be right there.
520
00:24:28,550 --> 00:24:30,969
We need to talk.
521
00:24:31,052 --> 00:24:33,346
How about same time tomorrow?
522
00:24:35,974 --> 00:24:37,726
Next Tuesday's your birthday?
523
00:24:37,809 --> 00:24:39,978
No.
524
00:24:40,061 --> 00:24:42,272
- Yes.
- Your 21st birthday?
525
00:24:42,355 --> 00:24:43,690
Please don't
say anything, okay?
526
00:24:43,773 --> 00:24:45,066
I-I get a little anxious
about--
527
00:24:45,150 --> 00:24:46,568
Dr. Santos, little girl
with the chin lac
528
00:24:46,651 --> 00:24:48,069
is getting into a gown.
529
00:24:48,153 --> 00:24:50,697
Don't want anyone to know what?
530
00:24:50,780 --> 00:24:52,991
Nothing.
531
00:24:53,074 --> 00:24:55,202
- Have a good day.
- You too.
532
00:24:56,953 --> 00:24:57,996
Oh.
533
00:24:59,414 --> 00:25:02,083
Hey, Duke, I'm just calling
to remind you
534
00:25:02,167 --> 00:25:05,086
that this is my last shift
for a while.
535
00:25:05,170 --> 00:25:07,631
So I need you to come in
before 3:00
536
00:25:07,714 --> 00:25:11,092
in case we need
to run some tests.
537
00:25:11,176 --> 00:25:13,803
Okay?
We had a deal, brother.
538
00:25:15,889 --> 00:25:17,933
- Oh. Hello.
- Hi.
539
00:25:18,016 --> 00:25:20,101
- I know you're crazy busy.
- Always.
540
00:25:20,185 --> 00:25:22,187
But I figured we should
really go over a few things
541
00:25:22,270 --> 00:25:23,730
- before you're gone.
- Sure.
542
00:25:23,813 --> 00:25:25,815
Where would you like to start?
543
00:25:25,899 --> 00:25:27,526
Well, one little thing
that I think
544
00:25:27,609 --> 00:25:30,111
would have a big impact
with staff and patients alike
545
00:25:30,195 --> 00:25:31,947
is if we launched a campaign
546
00:25:32,030 --> 00:25:35,116
to eradicate referring
to this wonderful department
547
00:25:35,200 --> 00:25:37,744
- as the Pitt.
- Really?
548
00:25:37,827 --> 00:25:39,746
I know you think
it's silly and petty.
549
00:25:39,829 --> 00:25:41,748
No, I think it's
just kind of endearing,
550
00:25:41,831 --> 00:25:45,627
- pretty damn accurate.
- I would argue the opposite.
551
00:25:45,710 --> 00:25:48,129
I think subconsciously
it affects those who work here.
552
00:25:48,213 --> 00:25:49,756
It also lowers expectations,
553
00:25:49,839 --> 00:25:52,133
which in turn lowers
patient-satisfaction scores.
554
00:25:52,217 --> 00:25:53,969
You have been talking
to Gloria.
555
00:25:54,052 --> 00:25:57,389
- Yes, and she agrees with me.
- Don't doubt that for a moment.
556
00:25:57,472 --> 00:25:59,266
You have to see the man
over there right now!
557
00:25:59,349 --> 00:26:01,851
We see people in order
of severity, ma'am.
558
00:26:05,313 --> 00:26:06,731
I don't know
what you're saying.
559
00:26:06,815 --> 00:26:09,067
I can taste the shit
in the back of my throat.
560
00:26:09,150 --> 00:26:10,360
Actually, the lady's right.
561
00:26:10,443 --> 00:26:11,987
He's going to make
all of us sick.
562
00:26:12,070 --> 00:26:13,071
Yes, please.
563
00:26:19,953 --> 00:26:21,454
All right.
564
00:26:21,538 --> 00:26:22,998
We'll get him back.
565
00:26:23,081 --> 00:26:25,417
Tell Dana
we're bringing the funk.
566
00:26:25,500 --> 00:26:27,502
- Oh, my God.
- Whew!
567
00:26:28,378 --> 00:26:30,797
So when did your eye start
bothering you, Ms. Mathews?
568
00:26:30,880 --> 00:26:32,841
Sister Grace, please.
569
00:26:32,924 --> 00:26:34,884
I'm only married to God.
570
00:26:34,968 --> 00:26:36,595
Of course, I'm sorry.
571
00:26:36,678 --> 00:26:40,181
A few days ago.
I thought it was pink eye
572
00:26:40,265 --> 00:26:42,392
or maybe I scratched it
while gardening.
573
00:26:42,475 --> 00:26:44,603
It's a very bad case
of conjunctivitis.
574
00:26:44,686 --> 00:26:46,396
We should send a sample
to the lab
575
00:26:46,479 --> 00:26:47,856
to direct our treatment.
576
00:26:47,939 --> 00:26:49,774
Look up for me.
Thank you.
577
00:26:53,028 --> 00:26:55,822
Okay, I'll put a numbing drop
in your eye
578
00:26:55,905 --> 00:26:58,908
and check for a scratch
with a special lamp.
579
00:27:01,911 --> 00:27:03,830
And I'll get you
to look up for me again.
580
00:27:03,913 --> 00:27:05,624
Thank you.
581
00:27:05,707 --> 00:27:08,126
Have you ever considered
serving God?
582
00:27:08,209 --> 00:27:09,294
Which one?
583
00:27:09,377 --> 00:27:11,630
Excuse me?
584
00:27:11,713 --> 00:27:13,423
My family is Hindu,
585
00:27:13,506 --> 00:27:16,217
so we have, like,
33 different kinds of deities.
586
00:27:16,301 --> 00:27:18,470
Oh, we have the one.
587
00:27:18,553 --> 00:27:21,514
Some people
only need one, right?
588
00:27:21,598 --> 00:27:23,016
Okay.
589
00:27:25,226 --> 00:27:28,021
Most important rule
around here--be smart, be safe.
590
00:27:28,104 --> 00:27:30,065
I can't warn you enough
about protecting yourself
591
00:27:30,148 --> 00:27:31,483
and your fellow nurses.
592
00:27:31,566 --> 00:27:33,943
We use the STAMP acronym
to assess patients.
593
00:27:34,027 --> 00:27:35,362
You know it?
594
00:27:35,445 --> 00:27:37,906
Uh, S is for staring
or refusal to make eye contact.
595
00:27:37,989 --> 00:27:39,574
If they're staring,
they're scaring.
596
00:27:39,658 --> 00:27:41,117
- T?
- Tone of voice.
597
00:27:41,201 --> 00:27:43,495
Often the threat level
rises with their voice.
598
00:27:43,578 --> 00:27:44,954
A is for anxiety.
599
00:27:45,038 --> 00:27:46,623
You can also think
"aggression."
600
00:27:46,706 --> 00:27:47,999
M is mumbling.
601
00:27:48,083 --> 00:27:49,250
Which, if you
listen closely enough,
602
00:27:49,334 --> 00:27:50,919
is often them saying
what they're thinking of doing
603
00:27:51,002 --> 00:27:52,587
as they talk themselves
up to it.
604
00:27:52,671 --> 00:27:54,130
- And P?
- Pacing.
605
00:27:54,214 --> 00:27:55,507
Good.
606
00:27:55,590 --> 00:27:57,467
We also have a safe word--
"hula hoop."
607
00:27:57,550 --> 00:27:59,260
I guess technically
it's two words, but whatever.
608
00:27:59,344 --> 00:28:01,262
If there's a threat,
say "hula hoop,"
609
00:28:01,346 --> 00:28:04,683
and we'll all respond.
610
00:28:04,766 --> 00:28:06,267
Yeah?
611
00:28:06,351 --> 00:28:07,727
Lovely.
612
00:28:07,811 --> 00:28:11,898
Okay, I'll be right there
with reinforcements.
613
00:28:11,981 --> 00:28:14,776
Duty calls.
We're headed for Triage.
614
00:28:20,573 --> 00:28:22,450
We're going to get
your cast off--
615
00:28:41,594 --> 00:28:44,222
The antibiotics
should clear everything up,
616
00:28:44,305 --> 00:28:47,142
but you should try to stay
off it for a few days.
617
00:28:47,225 --> 00:28:50,520
Uh, I have to work.
I'm late as it is.
618
00:28:50,603 --> 00:28:54,524
Well, um, take breaks
and elevate when you can.
619
00:28:54,607 --> 00:28:56,359
Tylenol and Advil for the pain.
620
00:28:56,443 --> 00:28:59,112
If the pain persists or feel
like it's getting worse,
621
00:28:59,195 --> 00:29:00,321
come on back.
622
00:29:00,405 --> 00:29:02,657
- We'll get you fixed up.
- Thanks.
623
00:29:02,741 --> 00:29:05,702
They said give this
to the doctor.
624
00:29:05,785 --> 00:29:08,747
- What the hell is it?
- Patient passport.
625
00:29:08,830 --> 00:29:10,749
Lets patients know
what they're waiting for
626
00:29:10,832 --> 00:29:12,250
and how long it'll take.
627
00:29:12,333 --> 00:29:14,544
You check off if he needs labs,
X-rays, CT.
628
00:29:14,627 --> 00:29:16,504
None of the above.
When did we start this?
629
00:29:16,588 --> 00:29:18,548
Today, the new attending.
630
00:29:20,383 --> 00:29:22,635
What's up
with your tooth, Louie?
631
00:29:22,719 --> 00:29:25,346
It's been going on
for a while,
632
00:29:25,430 --> 00:29:27,348
but it got bad last night.
633
00:29:27,432 --> 00:29:29,976
Lower-left side.
634
00:29:30,059 --> 00:29:32,145
Okay.
635
00:29:32,228 --> 00:29:35,607
Oh, yeah.
636
00:29:35,690 --> 00:29:37,484
It could be an infection
at the root.
637
00:29:37,567 --> 00:29:40,653
We can drain it, but then...
638
00:29:40,737 --> 00:29:42,822
you're, uh--you're breathing
kind of fast.
639
00:29:42,906 --> 00:29:44,741
Yeah, I've been--
640
00:29:44,824 --> 00:29:48,203
well, I've been,
uh, walking more,
641
00:29:48,286 --> 00:29:49,871
trying to get in shape.
642
00:29:49,954 --> 00:29:52,707
But sometimes I get
a little short of breath.
643
00:29:52,791 --> 00:29:55,752
Yeah, you need to walk past
the liquor store, not into it.
644
00:29:55,835 --> 00:29:58,379
Only shape you're getting in
is for a liver transplant.
645
00:29:58,463 --> 00:30:01,382
I don't need a new liver.
Just get rid of this toothache.
646
00:30:01,466 --> 00:30:02,801
Deep breath.
647
00:30:06,679 --> 00:30:08,223
One more.
648
00:30:08,306 --> 00:30:10,809
- Is my heart still ticking?
- Like a jackrabbit.
649
00:30:10,892 --> 00:30:14,062
- How long you been sitting down?
- Oh, just for a few minutes.
650
00:30:14,145 --> 00:30:15,605
Not that long.
651
00:30:15,688 --> 00:30:17,482
Um, Louie...
652
00:30:19,317 --> 00:30:21,486
There's something
I need to tell you.
653
00:30:23,863 --> 00:30:27,033
Last time I saw you,
about ten months ago,
654
00:30:27,116 --> 00:30:31,830
I treated you, and I took
some of your medicine.
655
00:30:31,913 --> 00:30:34,916
I'm not sure I follow.
656
00:30:34,999 --> 00:30:37,585
I have an addiction
to benzos,
657
00:30:37,669 --> 00:30:41,256
and I helped myself to some
of the Librium I prescribed you
658
00:30:41,339 --> 00:30:42,882
for your withdrawal.
659
00:30:42,966 --> 00:30:44,843
You stole my pills?
660
00:30:46,594 --> 00:30:48,012
Yeah.
661
00:30:48,096 --> 00:30:50,515
Yes, um...
662
00:30:50,598 --> 00:30:53,142
I'm sorry.
It was, uh...
663
00:30:53,226 --> 00:30:56,062
it was not only wrong
and utterly unprofessional,
664
00:30:56,145 --> 00:30:58,815
but it was a betrayal
of my Hippocratic Oath,
665
00:30:58,898 --> 00:31:02,068
and it was a fucking crime.
666
00:31:02,151 --> 00:31:06,531
That's where I've been--
rehab and counseling.
667
00:31:08,366 --> 00:31:10,869
- Huh.
- I'm sorry.
668
00:31:10,952 --> 00:31:13,788
I-I understand if you'd prefer
a different doctor.
669
00:31:13,872 --> 00:31:17,208
Hey, Doc,
we have a situation.
670
00:31:17,292 --> 00:31:19,669
Excuse me.
671
00:31:19,752 --> 00:31:21,087
What kind of situation?
672
00:31:21,170 --> 00:31:23,673
Someone left a little baby
in the restroom.
673
00:31:31,931 --> 00:31:33,766
Okay, let's think
674
00:31:33,850 --> 00:31:36,686
about reversible causes
of confusion in the elderly.
675
00:31:36,769 --> 00:31:40,315
Uh, hypo or hypernatremia,
infection, but he's afebrile,
676
00:31:40,398 --> 00:31:42,233
good O2 sats,
and urine dip is negative.
677
00:31:42,317 --> 00:31:46,321
Yeah, great.
Joy, anything to add?
678
00:31:46,404 --> 00:31:48,907
Nah.
679
00:31:48,990 --> 00:31:51,409
- V-tach. Can I--
- Yeah.
680
00:31:53,202 --> 00:31:55,038
No pulse.
Should we call for a code blue?
681
00:31:55,121 --> 00:31:59,042
No CPR, no shock, we honor
his POLST and his wishes.
682
00:31:59,125 --> 00:32:02,629
So what does that leave us?
683
00:32:02,712 --> 00:32:05,256
Making sure he's comfortable.
684
00:32:05,340 --> 00:32:06,799
I'll suction.
685
00:32:06,883 --> 00:32:09,010
Altered mental
in the elderly can also be
686
00:32:09,093 --> 00:32:13,473
toxicity from anticholinergics,
sedative-hypnotics, opioids.
687
00:32:14,974 --> 00:32:17,143
A-am I missing something?
688
00:32:17,226 --> 00:32:19,228
Social skills?
689
00:32:19,312 --> 00:32:21,522
What?
690
00:32:24,150 --> 00:32:25,401
He looks so peaceful.
691
00:32:25,485 --> 00:32:26,611
Shouldn't we go find
a new patient?
692
00:32:26,694 --> 00:32:29,238
No, stay here.
693
00:32:31,115 --> 00:32:33,117
Asystole.
694
00:32:42,085 --> 00:32:44,295
Quick and painless.
695
00:32:44,379 --> 00:32:46,089
We should all be so lucky.
696
00:32:46,172 --> 00:32:48,174
I'll try to contact
some family.
697
00:32:49,842 --> 00:32:53,262
Yeah, one of the things
we like to do here...
698
00:32:56,182 --> 00:32:58,142
When we have the time...
699
00:32:58,226 --> 00:33:00,979
is to take a moment of silence
when we lose a patient
700
00:33:01,062 --> 00:33:03,398
to respect their humanity.
701
00:33:03,481 --> 00:33:07,527
He was someone's son,
perhaps a father himself,
702
00:33:07,610 --> 00:33:10,071
a brother or a friend.
703
00:33:12,865 --> 00:33:16,244
Oh, uh, make sure
your phones are on silent.
704
00:33:20,415 --> 00:33:23,001
Great, great, great.
Okay. Uh...
705
00:33:23,084 --> 00:33:26,421
Is anyone missing a baby?
706
00:33:26,504 --> 00:33:30,758
Did anyone leave their child
in the restroom?
707
00:33:30,842 --> 00:33:34,262
Do you, uh, remember seeing
a woman enter with a baby
708
00:33:34,345 --> 00:33:36,139
but leave without one?
709
00:33:36,222 --> 00:33:38,433
No, sorry.
710
00:33:38,516 --> 00:33:40,435
Might be on the security tapes.
711
00:33:40,518 --> 00:33:42,687
- I'll have Ahmad check it out.
- Please.
712
00:33:42,770 --> 00:33:43,855
Yeah.
713
00:33:43,938 --> 00:33:46,190
Harlow Graham to window one.
714
00:33:46,274 --> 00:33:49,527
Harlow Graham to window one.
715
00:33:49,610 --> 00:33:53,531
Harlow Graham to window one,
please.
716
00:33:58,369 --> 00:34:00,038
Donnie Donahue,
nurse practitioner.
717
00:34:00,121 --> 00:34:01,456
This is Emma, new grad nurse.
718
00:34:01,539 --> 00:34:02,999
- Hey.
- Nice to meet you.
719
00:34:03,082 --> 00:34:04,834
- What's going on?
- Somebody dumped their kid.
720
00:34:04,917 --> 00:34:07,462
Maybe Mom just stepped out
for a smoke or something.
721
00:34:07,545 --> 00:34:09,255
What?
I'm being helpful.
722
00:34:09,338 --> 00:34:10,798
Sometimes they just need
a little break,
723
00:34:10,882 --> 00:34:13,259
and then they come back.
724
00:34:13,342 --> 00:34:14,886
At least they didn't leave her
in a suitcase
725
00:34:14,969 --> 00:34:17,263
- at the bus station.
- Does that happen?
726
00:34:17,346 --> 00:34:19,140
If that's a true story,
I don't want to know about it.
727
00:34:19,223 --> 00:34:21,267
- It ain't the worst I've seen.
- Please, don't tell me.
728
00:34:21,350 --> 00:34:23,728
- I'm a new dad, remember?
- Okay.
729
00:34:30,735 --> 00:34:32,653
There you go.
I'll get Robby.
730
00:34:32,737 --> 00:34:34,363
- Should I come with?
- No, stay here.
731
00:34:34,447 --> 00:34:36,699
Donnie, Jesse,
teach her something.
732
00:34:39,452 --> 00:34:43,122
You know how to check
a rectal temp on an infant?
733
00:34:43,206 --> 00:34:44,749
Uh...
734
00:34:44,832 --> 00:34:46,709
theoretically.
735
00:34:52,256 --> 00:34:55,051
Mr. Williams, how's the pain?
736
00:34:55,134 --> 00:34:56,677
Nothing I can't manage
737
00:34:56,761 --> 00:34:58,679
with some Vicodin
and a little scotch.
738
00:34:58,763 --> 00:35:01,265
Well, it's best
not to mix the two.
739
00:35:01,349 --> 00:35:03,601
James here is going to take you
to get an X-ray of your wrist.
740
00:35:03,684 --> 00:35:05,520
I'm going to be fine.
741
00:35:05,603 --> 00:35:07,980
Well, it'll tell us
if you need a cast.
742
00:35:08,064 --> 00:35:09,649
Oh, I doubt it.
743
00:35:09,732 --> 00:35:11,901
I should probably go home,
keep some ice on it.
744
00:35:11,984 --> 00:35:14,695
I know you guys
always need the beds.
745
00:35:14,779 --> 00:35:17,073
Well, uh,
it'll only take a minute,
746
00:35:17,156 --> 00:35:18,783
and then we'll know for sure.
747
00:35:18,866 --> 00:35:20,910
Yeah, I-I really don't think
it's necessary.
748
00:35:20,993 --> 00:35:23,496
And I have a busy day,
but I appreciate your concern.
749
00:35:26,791 --> 00:35:29,252
I'd really like to observe you
for a little bit,
750
00:35:29,335 --> 00:35:31,838
in case you did hit your head.
751
00:35:31,921 --> 00:35:33,422
My head?
752
00:35:33,506 --> 00:35:35,883
I hit my schnoz on my arm,
I think, nothing more.
753
00:35:35,967 --> 00:35:38,177
You think?
You don't remember?
754
00:35:38,261 --> 00:35:39,637
No.
755
00:35:39,720 --> 00:35:41,472
Or, yes.
756
00:35:41,556 --> 00:35:44,517
I'm going to be fine, really.
757
00:35:44,600 --> 00:35:46,811
But thank you for your concern.
758
00:35:50,565 --> 00:35:52,275
Okay.
759
00:35:54,652 --> 00:35:58,239
How about we take that X-ray
just to be safe?
760
00:35:58,322 --> 00:36:00,741
- Yeah. Yeah, okay.
- Yeah?
761
00:36:00,825 --> 00:36:02,952
- Okay.
- Okay, good idea.
762
00:36:04,954 --> 00:36:06,956
- Somebody found a baby?
- Yeah.
763
00:36:07,039 --> 00:36:09,333
Not the first time
it's happened.
764
00:36:09,417 --> 00:36:11,210
So, about those pills I took--
765
00:36:11,294 --> 00:36:14,255
Oh, don't worry
about it, Doc.
766
00:36:14,338 --> 00:36:17,633
If the pills helped you, great.
767
00:36:17,717 --> 00:36:19,844
I never really liked
taking 'em.
768
00:36:21,888 --> 00:36:23,389
I appreciate that, Louie.
769
00:36:23,472 --> 00:36:25,391
That's not really
the point, but...
770
00:36:25,474 --> 00:36:27,810
I need to lift up
your shirt for a second.
771
00:36:33,858 --> 00:36:36,152
How long has your belly
been hard like that?
772
00:36:36,235 --> 00:36:37,612
I don't know.
773
00:36:37,695 --> 00:36:39,739
I figured I could wait
another week.
774
00:36:39,822 --> 00:36:41,782
You need, uh, some lab tests
775
00:36:41,866 --> 00:36:44,619
and a procedure to drain off
some of this fluid.
776
00:36:44,702 --> 00:36:46,621
Yeah, I know the drill.
777
00:36:46,704 --> 00:36:48,998
I've been tapped
a few times before.
778
00:36:49,081 --> 00:36:52,210
Three times
in the last six months.
779
00:36:52,293 --> 00:36:55,004
You need to give your liver
a break, Louie.
780
00:36:55,087 --> 00:36:56,464
Yeah, I know.
781
00:37:01,093 --> 00:37:03,012
I just heard somebody
dumped a baby
782
00:37:03,095 --> 00:37:04,430
in the waiting-room bathroom.
783
00:37:04,513 --> 00:37:07,642
- How sad is that?
- Huh?
784
00:37:07,725 --> 00:37:10,728
What's up with you today,
Mel... ancholia?
785
00:37:10,811 --> 00:37:13,189
What makes you think
there's something up with me?
786
00:37:13,272 --> 00:37:14,982
You're moping
around here all day
787
00:37:15,066 --> 00:37:17,443
like somebody gunned down
your favorite K-Pop band.
788
00:37:17,526 --> 00:37:19,445
I don't really have
a favorite K-Pop band.
789
00:37:19,528 --> 00:37:21,280
It's not that I don't like
the genre.
790
00:37:21,364 --> 00:37:23,032
- It's just kinda--
- Okay, forget K-Pop.
791
00:37:23,115 --> 00:37:24,659
What's going on with you?
792
00:37:24,742 --> 00:37:26,035
You usually ride in here
793
00:37:26,118 --> 00:37:27,828
on your unicorn
tossing wildflowers.
794
00:37:27,912 --> 00:37:30,539
- "Unicorn"?
- Never mind.
795
00:37:30,623 --> 00:37:33,042
Is everything okay
with your sister?
796
00:37:33,125 --> 00:37:34,752
Oh, yeah, she's great.
797
00:37:34,835 --> 00:37:36,837
It's just this...
798
00:37:38,589 --> 00:37:40,675
Spill, girl.
799
00:37:40,758 --> 00:37:42,301
Um...
800
00:37:42,385 --> 00:37:45,680
well, a-a couple months ago,
I got named in a...
801
00:37:45,763 --> 00:37:47,848
Malpractice lawsuit.
802
00:37:47,932 --> 00:37:51,727
And so, um, today
is the--the deposition.
803
00:37:51,811 --> 00:37:53,437
That's it?
804
00:37:53,521 --> 00:37:56,607
Every emergency-medicine doc
gets sued sooner or later.
805
00:37:56,691 --> 00:37:59,026
Seriously, don't sweat it.
You're still a resident.
806
00:37:59,110 --> 00:38:00,695
We're protected
by the hospital.
807
00:38:00,778 --> 00:38:04,532
You could cut somebody's head
off and get away with it.
808
00:38:04,615 --> 00:38:06,951
But, you know, like, don't.
809
00:38:07,034 --> 00:38:09,412
You don't want to become
known as the one
810
00:38:09,495 --> 00:38:11,998
who put Mel in mel-practice.
811
00:38:12,081 --> 00:38:14,792
Hey, Santos, our little girl,
Kylie, has been
812
00:38:14,875 --> 00:38:18,087
in the West Penn Emergency
Department a couple times.
813
00:38:18,170 --> 00:38:20,715
I'm not saying this
is necessarily the case here,
814
00:38:20,798 --> 00:38:23,509
but recent studies
have linked bullying behavior
815
00:38:23,592 --> 00:38:26,429
to different
personality disorders.
816
00:38:26,512 --> 00:38:29,098
On the other hand, though,
I-I am known to be a bit
817
00:38:29,181 --> 00:38:30,558
overly sensitive sometimes--
818
00:38:30,641 --> 00:38:31,767
- Mel.
- Yes?
819
00:38:31,851 --> 00:38:33,102
You're talking
to yourself again.
820
00:38:33,185 --> 00:38:34,937
- You need something?
- Uh, yeah, a good lawyer.
821
00:38:35,021 --> 00:38:36,731
I don't know. I'm kidding.
822
00:38:36,814 --> 00:38:38,065
I'm--
823
00:38:40,026 --> 00:38:42,153
Yo, Robinavitch, somebody
ditched a bundle of joy
824
00:38:42,236 --> 00:38:43,446
in chairs.
825
00:38:43,529 --> 00:38:44,905
- How old?
- Couple months maybe.
826
00:38:44,989 --> 00:38:46,324
Donahue's got her in Pedes.
827
00:38:46,407 --> 00:38:48,784
- No one saw who left her?
- Apparently not.
828
00:38:48,868 --> 00:38:50,536
- That's so sad.
- Tell me about it.
829
00:38:50,619 --> 00:38:52,079
Who throws away
a perfectly good baby?
830
00:38:53,331 --> 00:38:54,623
Make a lane!
831
00:38:54,707 --> 00:38:57,126
Ah, sweet baby Jesus,
Antoine!
832
00:38:57,209 --> 00:38:59,253
- Right to the outdoor shower!
- I just drive 'em.
833
00:38:59,337 --> 00:39:00,713
I'm not
a wash and detail service.
834
00:39:00,796 --> 00:39:03,090
Yeah, yeah,
God forbid you prove useful.
835
00:39:03,174 --> 00:39:04,675
Ah, good timing, Ms. Emma.
836
00:39:04,759 --> 00:39:07,386
Time for you and me to do
the Lord's work. This way.
837
00:39:07,470 --> 00:39:09,305
Ooh, God, what is that?
838
00:39:09,388 --> 00:39:13,059
Okay, big breath.
839
00:39:13,142 --> 00:39:17,063
All right, lungs sound great.
Can you lean forward for me?
840
00:39:22,651 --> 00:39:26,322
Uh, did you hit your back
when you fell down the stairs?
841
00:39:26,405 --> 00:39:27,448
No.
842
00:39:27,531 --> 00:39:29,325
Okay, there's
a pretty good bruise here.
843
00:39:29,408 --> 00:39:31,243
I got knocked down in soccer.
844
00:39:33,287 --> 00:39:36,082
Oh, no, you broke your wrist
last year, too, huh?
845
00:39:36,165 --> 00:39:38,876
Fell off my skateboard.
Got a purple cast.
846
00:39:38,959 --> 00:39:40,503
Cool color.
847
00:39:40,586 --> 00:39:42,463
And you were treated
at West Penn?
848
00:39:42,546 --> 00:39:44,924
Is that your closest hospital?
849
00:39:45,007 --> 00:39:46,675
Uh, I guess
that would make sense.
850
00:39:46,759 --> 00:39:48,677
I've only been dating her dad
a few months.
851
00:39:48,761 --> 00:39:51,430
Uh, he lived in Garfield
before the divorce.
852
00:39:51,514 --> 00:39:53,933
- And, uh, what about these?
- Soccer.
853
00:39:54,016 --> 00:39:55,643
Do you wear shin guards?
854
00:39:55,726 --> 00:39:57,311
My dad ordered them.
855
00:39:57,395 --> 00:40:00,689
Okay. What does your dad do
for work?
856
00:40:00,773 --> 00:40:03,567
He draws buildings,
but he's not an architect.
857
00:40:03,651 --> 00:40:05,986
He's a draftsman
for a firm in Newcastle.
858
00:40:06,070 --> 00:40:10,408
Okay. Um, Kylie,
any chance you can pee?
859
00:40:10,491 --> 00:40:12,827
- Mm, maybe.
- Okay.
860
00:40:12,910 --> 00:40:14,870
Well, with the bruise
on your back,
861
00:40:14,954 --> 00:40:16,414
we need to check your urine.
862
00:40:16,497 --> 00:40:18,082
- Okay.
- Okay.
863
00:40:21,001 --> 00:40:23,337
Did you eat anything
out of the ordinary recently?
864
00:40:23,421 --> 00:40:24,755
No.
865
00:40:24,839 --> 00:40:27,216
Sorry, but we went
through this a bunch.
866
00:40:27,299 --> 00:40:28,884
Don't you people communicate?
867
00:40:28,968 --> 00:40:30,761
You're the third nurse
we've told her story to.
868
00:40:30,845 --> 00:40:32,096
I'm a doctor.
869
00:40:32,179 --> 00:40:35,141
Richard, would you go
to the cafeteria
870
00:40:35,224 --> 00:40:37,560
and get me
a large chamomile tea?
871
00:40:37,643 --> 00:40:39,728
What can we get you, my dear?
872
00:40:39,812 --> 00:40:42,106
I'm fine, thank you.
873
00:40:44,108 --> 00:40:45,901
Yeah, I'll be right back.
874
00:40:49,780 --> 00:40:52,116
Please excuse my son.
875
00:40:52,199 --> 00:40:54,034
Ever since my husband died,
876
00:40:54,118 --> 00:40:56,454
he's been
a little overprotective.
877
00:40:56,537 --> 00:40:58,497
I think it's sweet.
878
00:40:58,581 --> 00:41:01,417
- You're very lucky to have him.
- I am.
879
00:41:03,043 --> 00:41:06,881
Are you still taking your
loperamide and cholestyramine?
880
00:41:06,964 --> 00:41:09,675
Um, mm, not so much.
881
00:41:09,758 --> 00:41:11,385
No?
882
00:41:11,469 --> 00:41:13,804
That may be why you're
experiencing the abdominal pain
883
00:41:13,888 --> 00:41:15,431
and vomiting.
884
00:41:15,514 --> 00:41:17,641
When did you stop taking
your meds?
885
00:41:17,725 --> 00:41:19,894
Last winter or so.
886
00:41:21,937 --> 00:41:25,483
My neighbor Helen and I bingo
in Wintersville.
887
00:41:25,566 --> 00:41:28,194
There's a dispensary next door.
888
00:41:28,277 --> 00:41:30,237
And we got some marijuana.
889
00:41:30,321 --> 00:41:34,492
And I swear
it cleared everything up.
890
00:41:34,575 --> 00:41:38,078
A few cookies
every few hours...
891
00:41:38,162 --> 00:41:40,748
and no more pain.
892
00:41:40,831 --> 00:41:43,292
"A few cookies"?
893
00:41:43,375 --> 00:41:45,419
How many are you eating
in a day?
894
00:41:45,503 --> 00:41:47,505
Oh, uh...
895
00:41:47,588 --> 00:41:50,174
I don't know.
896
00:41:50,257 --> 00:41:55,095
Probably a dozen or so,
but they're not very big.
897
00:41:55,179 --> 00:41:57,097
There have been some studies
898
00:41:57,181 --> 00:41:59,308
that show
an added dementia risk
899
00:41:59,391 --> 00:42:02,353
with marijuana use
in older adults.
900
00:42:03,771 --> 00:42:06,398
Well, that sucks
for old people.
901
00:42:07,816 --> 00:42:09,693
Kylie,
there are some questions
902
00:42:09,777 --> 00:42:13,739
that we ask every kid
who comes in with an injury.
903
00:42:13,822 --> 00:42:15,282
Like what?
904
00:42:15,366 --> 00:42:18,744
Like, sometimes the people
that you live with
905
00:42:18,827 --> 00:42:23,749
can get so mad that
they hit you or hurt you,
906
00:42:23,832 --> 00:42:25,960
maybe without even meaning to.
907
00:42:26,043 --> 00:42:27,419
Does that ever happen?
908
00:42:27,503 --> 00:42:29,880
No, not to me.
909
00:42:29,964 --> 00:42:32,132
Or sometimes kids
can get punished
910
00:42:32,216 --> 00:42:33,759
for doing something wrong
911
00:42:33,842 --> 00:42:37,304
with maybe a spanking
or a belt.
912
00:42:37,388 --> 00:42:39,974
I get time-outs.
913
00:42:40,057 --> 00:42:42,101
How about at school, Kylie?
914
00:42:42,184 --> 00:42:45,563
You know, is anybody being,
you know, mean or bullying you?
915
00:42:45,646 --> 00:42:48,232
No, I have lots of friends.
916
00:43:09,086 --> 00:43:11,171
Yo, Whitaker.
917
00:43:11,255 --> 00:43:14,008
Dr. Langdon.
918
00:43:14,091 --> 00:43:17,803
- You, uh, meet Louie here?
- Uh, yeah, yeah, many times.
919
00:43:17,886 --> 00:43:20,180
- Good morning, Mr. Cloverfield.
- What's up, Doc?
920
00:43:20,264 --> 00:43:22,391
Where's your new resident
badge buddy, buddy?
921
00:43:22,474 --> 00:43:26,729
Oh, uh, yeah, they--they
didn't give me a new one yet.
922
00:43:26,812 --> 00:43:28,063
Bummer.
923
00:43:28,147 --> 00:43:29,607
You and, uh,
your ducklings got time
924
00:43:29,690 --> 00:43:31,317
to tap a six-pack
off our friend here?
925
00:43:31,400 --> 00:43:33,861
- Louie needs a paracentesis.
- Yeah, sure.
926
00:43:33,944 --> 00:43:35,821
It's good to see you
again, Louie--
927
00:43:35,904 --> 00:43:37,573
not in this condition,
of course.
928
00:43:37,656 --> 00:43:38,616
How you feeling?
929
00:43:38,699 --> 00:43:41,994
Feeling like I need
a drink pretty soon.
930
00:43:42,077 --> 00:43:43,829
Okay, well,
first things first--
931
00:43:43,912 --> 00:43:46,081
we are going to make you
more comfortable
932
00:43:46,165 --> 00:43:47,708
by draining some fluid.
933
00:43:47,791 --> 00:43:49,418
You're gonna take off
a big volume,
934
00:43:49,501 --> 00:43:52,546
so start with 60 grams
of 25% albumin IV.
935
00:43:52,630 --> 00:43:55,132
- You tapped him before?
- No.
936
00:43:55,215 --> 00:43:57,635
That's okay, Doc.
I'll talk him through it.
937
00:43:57,718 --> 00:43:59,428
Okay.
938
00:44:01,096 --> 00:44:04,475
Sats 99 on room air,
normal BP, normal pulse.
939
00:44:07,311 --> 00:44:08,896
Oh, well hydrated.
940
00:44:08,979 --> 00:44:10,648
No obvious source
of infection.
941
00:44:10,731 --> 00:44:13,651
Could be a benign virus,
but can't assume that.
942
00:44:13,734 --> 00:44:16,278
- Is this the abandoned baby?
- Mm-hmm.
943
00:44:16,362 --> 00:44:18,656
- How old?
- How old do you think she is?
944
00:44:18,739 --> 00:44:22,076
- Month, month and a half?
- It's tricky.
945
00:44:22,159 --> 00:44:25,454
Under 28 days is a Safe Haven
drop-off, no questions asked.
946
00:44:25,537 --> 00:44:28,916
But over 28 days is a crime,
child abandonment.
947
00:44:28,999 --> 00:44:31,085
How should we assess?
948
00:44:31,168 --> 00:44:34,171
Under 28 days gets everything,
including an LP.
949
00:44:34,254 --> 00:44:36,507
But over 28 days,
950
00:44:36,590 --> 00:44:38,676
you can follow PECARN
or Step-by-step
951
00:44:38,759 --> 00:44:41,428
to determine risk of invasive
bacterial infection.
952
00:44:41,512 --> 00:44:42,930
This baby looks great.
953
00:44:43,013 --> 00:44:44,890
But we know nothing
about the birth history.
954
00:44:44,973 --> 00:44:48,686
Did Mom have group B strep,
active HSV lesions?
955
00:44:48,769 --> 00:44:52,773
We should assume the worst.
Put in your orders, Dr. Mohan.
956
00:44:52,856 --> 00:44:54,817
CBC...
957
00:44:54,900 --> 00:44:57,319
Blood culture, chem panel,
958
00:44:57,403 --> 00:45:00,197
chest X-ray, UA and culture,
959
00:45:00,280 --> 00:45:02,408
respiratory virus panel.
960
00:45:02,491 --> 00:45:06,704
Check inflammatory markers--
procalcitonin and CRP--
961
00:45:06,787 --> 00:45:08,789
then take it from there.
962
00:45:08,872 --> 00:45:10,999
That sounds like a plan.
963
00:45:11,083 --> 00:45:13,168
Dr. Robby,
Santos needs you in North 1.
964
00:45:13,252 --> 00:45:14,712
Okay, I'll be right there.
965
00:45:14,795 --> 00:45:17,214
If you'll excuse me,
if you'll excuse me.
966
00:45:19,591 --> 00:45:23,762
- Mind if I join with?
- Uh, no, I got this.
967
00:45:23,846 --> 00:45:25,514
It will help me
get a better sense
968
00:45:25,597 --> 00:45:27,725
of how you like to do things
by seeing you in action
969
00:45:27,808 --> 00:45:29,268
with the residents.
970
00:45:29,351 --> 00:45:31,019
Be my guest.
971
00:45:33,772 --> 00:45:35,941
I will be right back.
972
00:45:41,071 --> 00:45:43,741
Um, nine-year-old
Kylie Connors--
973
00:45:43,824 --> 00:45:45,826
took a tumble running up
the stairs this morning.
974
00:45:45,909 --> 00:45:47,578
Chin lac and fractured tooth.
975
00:45:47,661 --> 00:45:49,830
Brought in by her dad's
girlfriend, Gina.
976
00:45:49,913 --> 00:45:52,958
Supposedly, the dad had
to leave early for work.
977
00:45:53,041 --> 00:45:55,753
Kylie has a lot of bruising
on her body--
978
00:45:55,836 --> 00:45:57,337
some old, some new.
979
00:45:57,421 --> 00:46:00,924
Are you concerned
about non-accidental trauma?
980
00:46:01,008 --> 00:46:02,551
Or worse.
981
00:46:02,634 --> 00:46:05,012
Her urine sample shows
gross hematuria,
982
00:46:05,095 --> 00:46:08,223
which could be renal injury,
or vaginal bleeding from trauma
983
00:46:08,307 --> 00:46:10,476
could have contaminated
the specimen.
984
00:46:10,559 --> 00:46:13,395
Lots to consider.
What's your plan?
985
00:46:13,479 --> 00:46:16,064
Labs, ultrasound,
social-work consult,
986
00:46:16,148 --> 00:46:18,108
then decide
if this is reportable.
987
00:46:18,192 --> 00:46:19,568
Mm-hmm.
988
00:46:22,821 --> 00:46:24,573
Let me know
if you can feel this.
989
00:46:24,656 --> 00:46:26,408
No.
Am I supposed to?
990
00:46:26,492 --> 00:46:27,659
No.
991
00:46:31,914 --> 00:46:33,999
Your hair's
such a pretty color.
992
00:46:34,082 --> 00:46:35,209
Thank you.
993
00:46:35,292 --> 00:46:37,711
Reminds me of my mom.
994
00:46:37,795 --> 00:46:41,006
- She died when I was nine.
- Oh, I'm sorry about that.
995
00:46:41,089 --> 00:46:43,592
She wore glasses
like you, too.
996
00:46:43,675 --> 00:46:45,594
Weird.
997
00:46:45,677 --> 00:46:48,972
What do you like to do
when you're not working?
998
00:46:49,056 --> 00:46:51,433
Um, spend some time
with my sister,
999
00:46:51,517 --> 00:46:53,227
read.
1000
00:46:53,310 --> 00:46:54,812
Do you drink coffee?
1001
00:46:54,895 --> 00:46:58,482
Uh, no, I avoid caffeine.
1002
00:46:58,565 --> 00:46:59,608
Me too.
1003
00:46:59,691 --> 00:47:01,276
Um...
1004
00:47:01,360 --> 00:47:03,320
what about boba?
1005
00:47:04,905 --> 00:47:08,367
I love boba.
1006
00:47:11,036 --> 00:47:12,955
I'd offer you some gum,
but it's laced with nicotine.
1007
00:47:13,038 --> 00:47:14,832
Trying to quit smoking.
1008
00:47:14,915 --> 00:47:17,417
That's good.
1009
00:47:17,501 --> 00:47:19,169
Verdict's still out.
1010
00:47:19,253 --> 00:47:21,547
Get in all those nooks
and crannies, Mr. Digby.
1011
00:47:21,630 --> 00:47:23,423
Your skin will thank you.
1012
00:47:23,507 --> 00:47:25,342
We all will.
1013
00:47:25,425 --> 00:47:29,346
Oh, I could stay
in here all day.
1014
00:47:29,429 --> 00:47:31,640
It's a miracle what little
soap, water, and human decency
1015
00:47:31,723 --> 00:47:33,642
can do sometimes.
1016
00:47:33,725 --> 00:47:35,060
Don't forget the ears, pal.
1017
00:47:35,143 --> 00:47:37,020
Don't want anything
growing in there either.
1018
00:47:37,104 --> 00:47:38,647
Okay. Okay.
1019
00:47:38,730 --> 00:47:40,566
What's your story, Emma?
1020
00:47:40,649 --> 00:47:43,443
What'd your parents do?
Got siblings? Boyfriend?
1021
00:47:43,527 --> 00:47:46,363
Ever kill a man in a bar fight?
1022
00:47:46,446 --> 00:47:47,739
Uh...
1023
00:47:57,207 --> 00:47:59,459
So, Mr. Williams,
1024
00:47:59,543 --> 00:48:01,879
sometimes a fracture
of the scaphoid bone
1025
00:48:01,962 --> 00:48:03,755
doesn't show up on day one.
1026
00:48:03,839 --> 00:48:07,467
So my advice to be safe is
wear a splint for two weeks
1027
00:48:07,551 --> 00:48:09,678
and then come back
for a repeat X-ray,
1028
00:48:09,761 --> 00:48:11,471
and we'll see
if it's really there.
1029
00:48:13,849 --> 00:48:16,393
My knee hurts.
1030
00:48:16,476 --> 00:48:19,730
Oh, did you hurt your knee?
1031
00:48:19,813 --> 00:48:21,523
I must have.
1032
00:48:28,113 --> 00:48:30,115
What is this?
1033
00:48:30,198 --> 00:48:33,035
That's, um, for your wrist.
1034
00:48:33,118 --> 00:48:35,954
And I need this?
1035
00:48:36,038 --> 00:48:38,707
Well, um, if it's a, uh--
1036
00:48:38,790 --> 00:48:40,751
John, can you?
1037
00:48:40,834 --> 00:48:43,337
If it's a fracture
and we don't immobilize,
1038
00:48:43,420 --> 00:48:45,589
the bone might not heal
properly.
1039
00:48:47,591 --> 00:48:51,345
How long is this gonna take?
1040
00:48:51,428 --> 00:48:53,805
Just a few minutes
to fit you.
1041
00:48:56,725 --> 00:48:59,186
Is this place new?
1042
00:49:01,939 --> 00:49:05,901
Mr. Williams,
do you know what day it is?
1043
00:49:09,488 --> 00:49:11,949
It's Taco Tuesday.
1044
00:49:12,032 --> 00:49:14,242
Do you know where you are?
1045
00:49:15,786 --> 00:49:18,956
Yeah, I'm in the slowest
medical clinic in the West.
1046
00:49:19,039 --> 00:49:21,416
Do you know what year it is?
1047
00:49:21,500 --> 00:49:23,543
How about you just
fix my wrist
1048
00:49:23,627 --> 00:49:27,756
and you stop
with all the questions?
1049
00:49:27,839 --> 00:49:30,884
I am not here to be profiled.
1050
00:49:35,097 --> 00:49:37,933
Yeah, of course.
1051
00:49:38,016 --> 00:49:40,102
I'll be back, okay?
1052
00:49:50,862 --> 00:49:53,490
All right, Mr. Digby,
looking better already.
1053
00:49:53,573 --> 00:49:55,450
Certainly smell
a little better.
1054
00:49:55,534 --> 00:49:56,952
Do you have any conditioner?
1055
00:49:57,035 --> 00:49:59,079
Let's get you dried off
and back inside.
1056
00:49:59,162 --> 00:50:00,747
Get him gowned up
and put him in South 21,
1057
00:50:00,831 --> 00:50:01,915
across from the old nun.
1058
00:50:01,999 --> 00:50:05,210
Maybe some of her divine grace
will wear off on him.
1059
00:50:05,293 --> 00:50:06,545
Who do we have here?
1060
00:50:06,628 --> 00:50:09,464
Evelyn Bostick, 81,
with Alzheimer's.
1061
00:50:09,548 --> 00:50:11,717
We brought her husband in
about 30 minutes ago.
1062
00:50:11,800 --> 00:50:13,343
She was supposed
to get a ride in,
1063
00:50:13,427 --> 00:50:15,012
but they found her
wandering in traffic.
1064
00:50:15,095 --> 00:50:17,055
- Where are we?
- You're at the hospital, dear.
1065
00:50:17,139 --> 00:50:18,432
I'm not sick.
1066
00:50:18,515 --> 00:50:20,434
We brought you
to see your husband.
1067
00:50:20,517 --> 00:50:22,436
Oh, no.
Is Ethan okay?
1068
00:50:22,519 --> 00:50:25,022
I'll be in to chat with you,
Mrs. Bostick.
1069
00:50:25,105 --> 00:50:27,566
He died.
1070
00:50:27,649 --> 00:50:29,443
What you got, Amboy?
1071
00:50:29,526 --> 00:50:32,654
Allen Billings--had a pallet
fall onto his outstretched arm.
1072
00:50:32,738 --> 00:50:35,073
- Looks like an open dislocation.
- Yeah, that's got to hurt.
1073
00:50:35,157 --> 00:50:36,783
Don't worry, sir.
We got you.
1074
00:50:42,914 --> 00:50:46,043
- How's she doing?
- Seems happy enough.
1075
00:50:46,126 --> 00:50:48,045
- Yeah. Hi.
- Hi.
1076
00:50:48,128 --> 00:50:50,839
Just got a quick
point-of-care CBC.
1077
00:50:57,345 --> 00:50:59,306
Is there a problem?
1078
00:51:02,851 --> 00:51:04,603
Did I miss something?
1079
00:51:04,686 --> 00:51:07,647
Dr. Al? Dr. Al?
74675
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