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These are the user uploaded subtitles that are being translated: 1 00:00:25,901 --> 00:00:27,818 Oh, okay. 2 00:00:27,819 --> 00:00:29,654 Where are we now? 3 00:00:29,655 --> 00:00:31,656 Got the VRI for our deaf patient in Central 12. 4 00:00:31,657 --> 00:00:33,658 Still waiting on Pedes for Baby Jane Doe. 5 00:00:33,659 --> 00:00:35,618 Central 6 is sitting pretty with his insulin drip. 6 00:00:35,619 --> 00:00:37,161 And the Westbridge diversions are 7 00:00:37,162 --> 00:00:38,496 kindly waiting their turn to sit 8 00:00:38,497 --> 00:00:40,039 for hours in our lovely halls. 9 00:00:40,040 --> 00:00:41,999 You are some kind of savant. 10 00:00:42,000 --> 00:00:43,042 Worthy of a raise? 11 00:00:43,043 --> 00:00:44,919 Just more of my love. 12 00:00:44,920 --> 00:00:46,379 I got enough of that. 13 00:00:46,380 --> 00:00:48,714 I have a sexual assault victim in triage. 14 00:00:48,715 --> 00:00:51,008 I called PAAR, so an advocate is on the way. 15 00:00:51,009 --> 00:00:53,344 Okay. We'll take care of it. 16 00:00:53,345 --> 00:00:56,180 Uh, Dr. McKay, what's going on with your patient in Central 9? 17 00:00:56,181 --> 00:00:57,557 Isn't she good to go? 18 00:00:57,558 --> 00:00:59,350 Oh, she was, but she decided 19 00:00:59,351 --> 00:01:00,851 she wanted to stay in the hospital now 20 00:01:00,852 --> 00:01:02,186 because she's in too much pain. 21 00:01:02,187 --> 00:01:04,146 In our loud and overcrowded ED 22 00:01:04,147 --> 00:01:06,357 with more Westbridge cases arriving every moment? 23 00:01:06,358 --> 00:01:08,317 She would be more comfortable at home. 24 00:01:08,318 --> 00:01:11,696 The debrief was lovely. 25 00:01:11,697 --> 00:01:13,489 Thank you. 26 00:01:13,490 --> 00:01:15,366 Would you mind helping Dana with a sexual assault victim 27 00:01:15,367 --> 00:01:17,368 who just came in? - Of course. Sure. 28 00:01:17,369 --> 00:01:19,203 Why don't you and I go see if we can't convince 29 00:01:19,204 --> 00:01:20,955 your patient to leave? - All right. 30 00:01:20,956 --> 00:01:23,583 I need to take care of a sexual assault victim in triage. 31 00:01:23,584 --> 00:01:25,376 One of you needs to hold down the fort. 32 00:01:25,377 --> 00:01:28,045 - We can call for a SANE. - On a holiday? Could be hours. 33 00:01:28,046 --> 00:01:29,755 We're not gonna make this patient wait. 34 00:01:29,756 --> 00:01:30,881 And since I'm the only SANE on staff-- 35 00:01:30,882 --> 00:01:32,258 Princess will cover. 36 00:01:34,052 --> 00:01:35,886 Hey! Hey! 37 00:01:35,887 --> 00:01:37,388 You two better not be teaching her any bad habits. 38 00:01:37,389 --> 00:01:40,016 Come on. You ready, Doc? - Sure. 39 00:01:40,017 --> 00:01:42,893 A SANE is a Sexual Assault Nurse Examiner. 40 00:01:42,894 --> 00:01:45,104 We do forensic exams, collect evidence, 41 00:01:45,105 --> 00:01:47,773 and hand it over to the police if a report is made. 42 00:01:47,774 --> 00:01:49,775 We also provide resources, support, 43 00:01:49,776 --> 00:01:52,153 sometimes even testimony. - You go to court? 44 00:01:52,154 --> 00:01:55,072 SANEs are very valuable in a hospital, especially an ED. 45 00:01:55,073 --> 00:01:56,949 More nurses should train for it. 46 00:01:56,950 --> 00:01:58,952 That's a not so subtle hint. 47 00:02:07,252 --> 00:02:09,378 Looks like this is the new hot spot, huh? 48 00:02:09,379 --> 00:02:10,921 And only getting hotter. 49 00:02:10,922 --> 00:02:12,757 Any word on what's going on with Westbridge? 50 00:02:12,758 --> 00:02:14,091 I got 20 on lantern flies. 51 00:02:14,092 --> 00:02:16,385 Nope, nothing. 52 00:02:16,386 --> 00:02:19,639 These patient passports have an interesting alternative use. 53 00:02:19,640 --> 00:02:21,098 Where's the sexual assault victim? 54 00:02:21,099 --> 00:02:22,600 She's in Triage, Chair 2. 55 00:02:22,601 --> 00:02:24,602 Thanks, Lupe. 56 00:02:24,603 --> 00:02:25,603 Here's her intake. 57 00:02:25,604 --> 00:02:27,605 Got it. 58 00:02:33,945 --> 00:02:35,946 Hi, Ms. Miller. 59 00:02:35,947 --> 00:02:37,281 I'm Dana. 60 00:02:37,282 --> 00:02:38,949 How are you doing? 61 00:02:38,950 --> 00:02:41,494 - I've been better. - Yeah. 62 00:02:41,495 --> 00:02:42,953 You're in a safe place now. 63 00:02:42,954 --> 00:02:44,789 I'm the charge nurse in the ED 64 00:02:44,790 --> 00:02:46,999 and a sexual assault nurse examiner. 65 00:02:47,000 --> 00:02:48,626 This is Emma, who will be assisting. 66 00:02:48,627 --> 00:02:50,169 And I'm Dr. Al-Hashimi. 67 00:02:50,170 --> 00:02:51,545 I'll be checking you for any injuries 68 00:02:51,546 --> 00:02:54,215 that need immediate attention. 69 00:02:54,216 --> 00:02:56,133 You can just call me Ilana. 70 00:02:56,134 --> 00:02:57,468 I don't have any injuries. 71 00:02:57,469 --> 00:02:59,178 Okay, that's good. 72 00:02:59,179 --> 00:03:01,055 We're gonna get a room ready for you. 73 00:03:01,056 --> 00:03:03,015 Meanwhile, Dr. Al-Hashimi is gonna ask you a few questions. 74 00:03:03,016 --> 00:03:05,142 How long is this gonna take? 75 00:03:05,143 --> 00:03:06,811 I can't promise an exact time, 76 00:03:06,812 --> 00:03:09,689 but we'll try to be as fast as you need. 77 00:03:09,690 --> 00:03:11,024 - Thank you. - Yeah. 78 00:03:15,278 --> 00:03:18,489 Okay, Ilana, do you take any prescription medications? 79 00:03:18,490 --> 00:03:20,533 Just Synthroid, one tab a day. 80 00:03:20,534 --> 00:03:22,368 Okay, and any allergies to medications? 81 00:03:22,369 --> 00:03:24,578 - No. No. - Okay. 82 00:03:24,579 --> 00:03:26,580 Dana will come get you when the room is ready, 83 00:03:26,581 --> 00:03:28,709 and I'll be back to finish your exam. 84 00:03:35,841 --> 00:03:37,216 Come find me when she's in a gown. 85 00:03:37,217 --> 00:03:38,968 Will do. 86 00:03:38,969 --> 00:03:40,845 We're gonna use Triage Exam Rooms 1 and 2 for this. 87 00:03:40,846 --> 00:03:43,723 It's the most private space we have away from the ED. 88 00:03:43,724 --> 00:03:45,474 All right, this can be a lot. 89 00:03:45,475 --> 00:03:47,351 You up for it? 90 00:03:47,352 --> 00:03:48,561 Yeah. 91 00:03:48,562 --> 00:03:50,396 Yes. I'm good. 92 00:03:50,397 --> 00:03:52,607 Let me know if you need to step out. 93 00:03:59,030 --> 00:04:01,450 Yes. 94 00:04:03,702 --> 00:04:05,411 Dr. Ellis. 95 00:04:05,412 --> 00:04:07,538 - Oh, no. - Oh, yes. 96 00:04:07,539 --> 00:04:08,873 Need the room. 97 00:04:08,874 --> 00:04:10,875 Find another place to lay your head. 98 00:04:10,876 --> 00:04:13,544 Not even a 20-minute power nap? 99 00:04:13,545 --> 00:04:15,171 You know, my double is at 1:30. I'm-- 100 00:04:15,172 --> 00:04:17,047 Nope, we're getting Westbridge diversions. 101 00:04:17,048 --> 00:04:18,340 And chairs is insane. 102 00:04:18,341 --> 00:04:19,842 Did you see out there? - No. 103 00:04:19,843 --> 00:04:21,427 I do not come in through that mess. 104 00:04:21,428 --> 00:04:23,137 Okay. 105 00:04:23,138 --> 00:04:24,430 Yeah. 106 00:04:24,431 --> 00:04:26,056 People sleep in here? 107 00:04:26,057 --> 00:04:28,225 Yeah, the night shift docs just need rest, 108 00:04:28,226 --> 00:04:30,060 especially if they have to come in during the day. 109 00:04:30,061 --> 00:04:32,313 But today, we can't waste the space. 110 00:04:32,314 --> 00:04:37,319 I need you to get me a stool on wheels and Esme for a turnover. 111 00:04:40,447 --> 00:04:43,742 So you're having a headache and abdominal pain? 112 00:04:47,412 --> 00:04:49,288 Yeah, that's right. 113 00:04:49,289 --> 00:04:51,833 Okay, and which would you say is worse? 114 00:04:55,420 --> 00:04:57,296 My headache was terrible last week... 115 00:04:57,297 --> 00:05:00,257 But now-- 116 00:05:00,258 --> 00:05:01,425 Hey, you're-- you're breaking up. 117 00:05:01,426 --> 00:05:02,968 Can you run that back again? 118 00:05:02,969 --> 00:05:04,595 Sure. 119 00:05:07,599 --> 00:05:09,934 My headache was terrible last week... 120 00:05:09,935 --> 00:05:13,270 But now my abdominal pain-- 121 00:05:13,271 --> 00:05:14,438 Oh, my God. 122 00:05:14,439 --> 00:05:16,398 Come on, you piece of-- 123 00:05:16,399 --> 00:05:17,942 fuck. 124 00:05:17,943 --> 00:05:19,319 Um-- 125 00:05:45,178 --> 00:05:47,638 I'll--I'll be right back. 126 00:05:47,639 --> 00:05:49,391 Sorry. 127 00:05:55,647 --> 00:05:57,147 Um, Dr. Al-Hashimi? 128 00:05:57,148 --> 00:05:58,858 Jackson's parents are here. 129 00:05:58,859 --> 00:06:01,569 Okay. I'll take that. 130 00:06:01,570 --> 00:06:04,405 Um, Mr. and Mrs. Davis, this is one of my attendings, 131 00:06:04,406 --> 00:06:06,574 Dr. Al-Hashimi. - Hi. Nice to meet you. 132 00:06:06,575 --> 00:06:08,701 - Demi. - Charles. 133 00:06:08,702 --> 00:06:10,536 What the hell's going on? 134 00:06:10,537 --> 00:06:12,621 He's barely conscious. 135 00:06:12,622 --> 00:06:14,290 Jackson's just a little tired due to the sedative 136 00:06:14,291 --> 00:06:16,375 he was given. - You sedated him? 137 00:06:16,376 --> 00:06:18,669 Oh, your son was brought in extremely agitated. 138 00:06:18,670 --> 00:06:20,004 You'd be, too, if you were tased. 139 00:06:20,005 --> 00:06:22,339 And why the fuck did they do that? 140 00:06:22,340 --> 00:06:25,050 This is bullshit. We're taking him home. 141 00:06:25,051 --> 00:06:26,887 Why don't we step out for a second? 142 00:06:35,562 --> 00:06:38,898 Right now, Jackson is on an involuntary psych hold. 143 00:06:38,899 --> 00:06:40,774 What? That's not necessary. 144 00:06:40,775 --> 00:06:42,234 He just needs some rest. 145 00:06:42,235 --> 00:06:44,153 He's been studying for the bar exam. 146 00:06:44,154 --> 00:06:45,654 We can watch him at home. 147 00:06:45,655 --> 00:06:47,197 So far, all of his tests look good, 148 00:06:47,198 --> 00:06:50,200 but Jackson has reported hearing voices. 149 00:06:50,201 --> 00:06:51,911 This could be serious. 150 00:06:51,912 --> 00:06:54,038 Dr. Jefferson will come back and speak with you. 151 00:06:54,039 --> 00:06:57,041 He can explain more of what may be going on with Jackson. 152 00:06:57,042 --> 00:06:58,626 And who is Dr. Jefferson? 153 00:06:58,627 --> 00:07:00,669 He's from Psychiatry, and he's excellent. 154 00:07:00,670 --> 00:07:02,880 He can explain next steps and answer all of your questions. 155 00:07:02,881 --> 00:07:05,215 Javadi, why don't you take the Davises to the family room? 156 00:07:05,216 --> 00:07:06,592 - Sure. - Excuse me. 157 00:07:06,593 --> 00:07:08,052 It's just this way. 158 00:07:29,741 --> 00:07:32,326 You have reached the Pittsburgh Neuroscience Group. 159 00:07:32,327 --> 00:07:34,286 If this is a medical emergency, 160 00:07:34,287 --> 00:07:37,414 please hang up and dial 911. 161 00:07:37,415 --> 00:07:40,417 For our address and office hours, press 1. 162 00:07:40,418 --> 00:07:43,212 To refill a prescription, press 2. 163 00:07:43,213 --> 00:07:47,758 To leave a message for the doctor on call-- 164 00:07:47,759 --> 00:07:49,927 Hi, this is Dr. Baran al-Hashimi. 165 00:07:49,928 --> 00:07:51,887 I'm a patient of Dr. Fairgraves. 166 00:07:51,888 --> 00:07:55,808 I need to speak to him if he's on call. 167 00:07:55,809 --> 00:07:59,061 If he's not, I'll take his next available appointment. 168 00:07:59,062 --> 00:08:02,272 And please call me if he has a cancellation. 169 00:08:02,273 --> 00:08:04,358 Thank you. 170 00:08:04,359 --> 00:08:06,819 Like I said, you're more than welcome to stay down here 171 00:08:06,820 --> 00:08:08,654 until an inpatient bed opens up upstairs. 172 00:08:08,655 --> 00:08:11,949 But that can take a while, sometimes days, 173 00:08:11,950 --> 00:08:14,410 even longer. 174 00:08:14,411 --> 00:08:15,911 It's gonna be really noisy here, 175 00:08:15,912 --> 00:08:17,454 and you won't get any rest. 176 00:08:17,455 --> 00:08:19,164 At home, you'll be surrounded by your family 177 00:08:19,165 --> 00:08:22,668 and be more comfortable. 178 00:08:22,669 --> 00:08:24,796 It's your choice, Roxie. 179 00:08:27,090 --> 00:08:29,925 It's not that I don't wanna go home, but-- 180 00:08:29,926 --> 00:08:32,136 - Hi, Mom. - Mom. 181 00:08:32,137 --> 00:08:35,806 Lena texted me to come back. I figured I'd bring the boys. 182 00:08:35,807 --> 00:08:38,308 What's going on? Is everything okay? 183 00:08:38,309 --> 00:08:41,979 Robby, police officer, incoming trauma. 184 00:08:41,980 --> 00:08:43,188 Coming. 185 00:08:43,189 --> 00:08:44,565 I'll be right back. 186 00:08:44,566 --> 00:08:46,067 We'll give you a chance to talk. 187 00:08:48,653 --> 00:08:51,156 Okay, why don't you have a seat? 188 00:08:59,039 --> 00:09:01,332 Do you need anything before we begin? 189 00:09:06,296 --> 00:09:09,006 You're in control now, Ilana. 190 00:09:09,007 --> 00:09:11,800 We're here to help and support you. 191 00:09:11,801 --> 00:09:15,220 Once I open this kit, I cannot leave the room. 192 00:09:15,221 --> 00:09:18,307 But if you need a break or some air, just let us know. 193 00:09:18,308 --> 00:09:21,560 Okay? Emma can go with you if you like. 194 00:09:21,561 --> 00:09:24,063 An advocate from Pittsburgh Action Against Rape 195 00:09:24,064 --> 00:09:25,689 has been called, and they should arrive soon. 196 00:09:25,690 --> 00:09:28,358 - Can we start? - Sure. 197 00:09:28,359 --> 00:09:29,818 I'm gonna put my face shield on 198 00:09:29,819 --> 00:09:32,029 so I don't contaminate anything. 199 00:09:32,030 --> 00:09:34,990 Emma has already done the same. 200 00:09:34,991 --> 00:09:38,952 Now, in order for the doctor to do her exam, 201 00:09:38,953 --> 00:09:40,537 I need you in a gown, 202 00:09:40,538 --> 00:09:41,747 but I need to collect your clothing first. 203 00:09:41,748 --> 00:09:43,666 Is that okay? 204 00:09:47,754 --> 00:09:50,756 I'm gonna need you to undress on top of these pads. 205 00:09:50,757 --> 00:09:53,717 Put each item of clothing on the pads, okay? 206 00:09:53,718 --> 00:09:57,262 Then we'll package each piece in a separate bag. 207 00:09:57,263 --> 00:09:58,430 We'll get you new clothes. 208 00:09:58,431 --> 00:09:59,807 Don't worry. - All right. 209 00:09:59,808 --> 00:10:01,558 Emma's gonna be behind this curtain, 210 00:10:01,559 --> 00:10:04,561 and I'll be in here with you. 211 00:10:04,562 --> 00:10:07,731 And take off your shoes first. 212 00:10:07,732 --> 00:10:12,069 When you're done, I want you to put on your gown 213 00:10:12,070 --> 00:10:15,197 open in the back. 214 00:10:39,472 --> 00:10:41,765 What if the mom doesn't wanna leave? 215 00:10:41,766 --> 00:10:44,017 Well, then she's gonna have to put up with us. 216 00:10:45,937 --> 00:10:48,772 I can't imagine--her boys. 217 00:10:48,773 --> 00:10:50,607 Oh, don't go there. 218 00:10:50,608 --> 00:10:52,276 I'm gonna see if I can grease the wheels, 219 00:10:52,277 --> 00:10:53,485 get her a room upstairs soon. 220 00:10:53,486 --> 00:10:55,445 Good luck. What was that? 221 00:10:55,446 --> 00:10:56,864 Battle plan for our hall space. 222 00:10:56,865 --> 00:10:58,448 It's filling up fast. 223 00:10:58,449 --> 00:11:00,159 Police officer should be here any minute. 224 00:11:00,160 --> 00:11:01,952 Yeah, well, as soon as you can, please, 225 00:11:01,953 --> 00:11:03,287 I need you to fix the VRI. 226 00:11:03,288 --> 00:11:04,788 All right. Thanks. 227 00:11:04,789 --> 00:11:06,290 Santos, I need you to pick up some more 228 00:11:06,291 --> 00:11:07,749 of these Westbridge diversions. - Sure. 229 00:11:07,750 --> 00:11:09,251 You want my firstborn too? 230 00:11:09,252 --> 00:11:11,420 Maybe. Will they know how to suture? 231 00:11:11,421 --> 00:11:13,088 Intubated neck wound, sats not great. 232 00:11:13,089 --> 00:11:15,090 We were diverted here. Is there a trauma room open? 233 00:11:15,091 --> 00:11:16,842 - Trauma 1! - What's the story? 234 00:11:16,843 --> 00:11:19,428 My buddy, Officer Hiro, high-velocity GSW. 235 00:11:19,429 --> 00:11:20,804 He's getting harder to bag. 236 00:11:20,805 --> 00:11:23,599 Warehouse robbery gone sideways. 237 00:11:23,600 --> 00:11:24,766 One, two, three. 238 00:11:24,767 --> 00:11:26,268 You guys wait here. 239 00:11:26,269 --> 00:11:28,020 We'll take care of him, I promise. 240 00:11:28,021 --> 00:11:29,688 I thought you left us already for the open road? 241 00:11:29,689 --> 00:11:31,315 And miss seeing you in uniform? 242 00:11:31,316 --> 00:11:33,150 You should see me as a flight attendant. 243 00:11:33,151 --> 00:11:35,194 - Did you do this intubation? - Under active fire, yeah. 244 00:11:35,195 --> 00:11:36,945 Are you serious? 245 00:11:36,946 --> 00:11:38,405 I go in with the team in case there's an injury. 246 00:11:38,406 --> 00:11:40,032 That's badass. 247 00:11:40,033 --> 00:11:41,700 Dr. Santos, let's make sure these lungs are up. 248 00:11:41,701 --> 00:11:43,452 Could you see the cords? - Yeah, there was a great view, 249 00:11:43,453 --> 00:11:45,078 but it was hard to pass after I cleared them. 250 00:11:45,079 --> 00:11:47,039 Yeah, sats down to 85. 251 00:11:47,040 --> 00:11:48,999 Dr. Santos, what could cause respiratory failure 252 00:11:49,000 --> 00:11:50,667 in an intubated patient? 253 00:11:50,668 --> 00:11:51,877 There are a lot of possibilities. 254 00:11:51,878 --> 00:11:53,420 Think DOPE. 255 00:11:53,421 --> 00:11:55,672 Displacement, Obstruction, Pneumothorax, 256 00:11:55,673 --> 00:11:57,049 Equipment failure. 257 00:11:57,050 --> 00:11:59,551 Good lung sliding, no pneumo. 258 00:11:59,552 --> 00:12:01,178 It is displacement. 259 00:12:01,179 --> 00:12:03,597 Okay, that is a transected trachea. 260 00:12:05,516 --> 00:12:07,559 Pulling out. 261 00:12:07,560 --> 00:12:09,353 Bag. 262 00:12:09,354 --> 00:12:10,729 But if you intubate again, won't it just come straight 263 00:12:10,730 --> 00:12:12,189 out the wound? - Yep, exactly. 264 00:12:12,190 --> 00:12:13,523 So we're gonna need another plan. 265 00:12:13,524 --> 00:12:15,359 Okay. Sats down to 83. 266 00:12:15,360 --> 00:12:16,818 Yeah, he's not moving any air. 267 00:12:16,819 --> 00:12:18,695 Okay, I need a neonatal mask. 268 00:12:18,696 --> 00:12:21,323 - Neonatal? - Yep. 269 00:12:21,324 --> 00:12:23,825 I'm just going to finish my initial exam. 270 00:12:23,826 --> 00:12:25,745 Let me know if you feel any pain, okay? 271 00:12:29,707 --> 00:12:32,376 My legs are fine. 272 00:12:32,377 --> 00:12:34,086 All looks good. 273 00:12:34,087 --> 00:12:36,505 No need for X-rays or advanced imaging. 274 00:12:36,506 --> 00:12:38,090 Got it. 275 00:12:38,091 --> 00:12:40,550 - Two areas of ecchymosis... - That means bruising. 276 00:12:40,551 --> 00:12:42,261 Over the shoulders bilaterally. 277 00:12:42,262 --> 00:12:44,054 - I'll document with photos. - Okay. 278 00:12:44,055 --> 00:12:46,056 Dana will finish up her work, and I will be in the ER 279 00:12:46,057 --> 00:12:47,724 if you have any questions. 280 00:12:47,725 --> 00:12:49,268 You're in great hands. 281 00:12:49,269 --> 00:12:51,895 Thank you. 282 00:12:51,896 --> 00:12:54,231 All right, Ilana. 283 00:12:54,232 --> 00:12:56,233 I read your intake. 284 00:12:56,234 --> 00:12:57,567 Why don't you give me your description 285 00:12:57,568 --> 00:12:58,987 of exactly what happened? 286 00:13:02,073 --> 00:13:06,118 I was at a 4th of July barbecue 287 00:13:06,119 --> 00:13:08,912 with a bunch of friends. 288 00:13:08,913 --> 00:13:11,707 I helped set up. 289 00:13:19,090 --> 00:13:20,716 Where does it hurt? 290 00:13:20,717 --> 00:13:24,219 Like here, under my belly button. 291 00:13:24,220 --> 00:13:27,597 Okay, do you have any fever, vomiting, diarrhea? 292 00:13:27,598 --> 00:13:31,059 Oh, no. It's--it's just a stomachache. 293 00:13:31,060 --> 00:13:33,061 Okay, well, still, go see the nurse and have her call me. 294 00:13:33,062 --> 00:13:34,771 Okay. 295 00:13:34,772 --> 00:13:37,232 But I'm still having ice cream tonight. 296 00:13:37,233 --> 00:13:39,401 Why don't you see how you feel later? 297 00:13:39,402 --> 00:13:42,821 It--it's not bad. You don't have to get so sad. 298 00:13:42,822 --> 00:13:45,198 I'm not sad. I'm--I'm good. 299 00:13:45,199 --> 00:13:47,451 Your face doesn't look good. 300 00:13:47,452 --> 00:13:49,036 Oh. 301 00:13:49,037 --> 00:13:51,121 Well, you still wanna watch the fireworks tonight? 302 00:13:51,122 --> 00:13:52,331 I have our headphones-- 303 00:13:54,042 --> 00:13:56,544 - I'm not being rude. - Sorry, Becca. I gotta go. 304 00:14:02,592 --> 00:14:05,802 Elliot Green, 17, syncopal episode at football practice. 305 00:14:05,803 --> 00:14:07,721 Look, I just got dizzy, okay? 306 00:14:07,722 --> 00:14:09,181 It's hell week. I need to get back. 307 00:14:09,182 --> 00:14:11,141 Yeah, okay, tough guy. 308 00:14:11,142 --> 00:14:15,020 A and O, systolic of 95, tachy at 122, no meds, no allergies. 309 00:14:15,021 --> 00:14:16,646 How long were you at practice? 310 00:14:16,647 --> 00:14:19,107 I started at 9:00, so, like, four hours. 311 00:14:19,108 --> 00:14:21,485 Four hours in this heat with all that gear? 312 00:14:21,486 --> 00:14:23,488 No pain, no game. 313 00:14:25,531 --> 00:14:27,992 God, I'm hungry. 314 00:14:29,827 --> 00:14:33,163 Hey. When's our break? - There's no breaks down here. 315 00:14:33,164 --> 00:14:36,124 Always make sure you pack a protein bar, something quick. 316 00:14:36,125 --> 00:14:40,003 Ogilvie, Joy, jump in on this. 317 00:14:40,004 --> 00:14:41,546 Syncope at football practice. 318 00:14:41,547 --> 00:14:44,674 No, I just-- I just needed to hydrate. 319 00:14:44,675 --> 00:14:46,093 Possible heatstroke? 320 00:14:46,094 --> 00:14:47,260 Well, with heatstroke, you would have 321 00:14:47,261 --> 00:14:48,720 an altered mental status. 322 00:14:48,721 --> 00:14:50,222 And they're usually dry, not sweaty. 323 00:14:50,223 --> 00:14:52,057 Mortality is 50%, especially in the elderly. 324 00:14:52,058 --> 00:14:54,143 In extreme heat like this... 325 00:14:55,353 --> 00:14:56,853 Langdon, can you cover this? 326 00:14:56,854 --> 00:14:59,272 - No problem. - Mr. Diaz. Orlando. 327 00:14:59,273 --> 00:15:01,233 Orlando, where are you going? 328 00:15:01,234 --> 00:15:03,110 - Home. Can you take these out? - Uh, no. 329 00:15:03,111 --> 00:15:05,195 It takes 48 hours for you to get out of DKA. 330 00:15:05,196 --> 00:15:07,030 Your blood is still full of acid. 331 00:15:07,031 --> 00:15:08,532 Look, I can't add thousands of dollars 332 00:15:08,533 --> 00:15:09,866 to the 100 grand I already owe. 333 00:15:09,867 --> 00:15:11,785 I'm--I'm sorry. 100 grand? 334 00:15:11,786 --> 00:15:14,037 In medical debt. My wife doesn't even know. 335 00:15:14,038 --> 00:15:16,039 I'll never be able to pay it off as it is. 336 00:15:16,040 --> 00:15:17,207 Where are your wife and daughter? 337 00:15:17,208 --> 00:15:18,750 Maybe we can all talk. 338 00:15:18,751 --> 00:15:20,377 I told them to go back to work a couple hours ago. 339 00:15:20,378 --> 00:15:22,003 But the hospital is giving you a big discount. 340 00:15:22,004 --> 00:15:23,755 And, Mr. Diaz, I know it's not ideal, 341 00:15:23,756 --> 00:15:25,549 but can you stay for at least 12 hours? 342 00:15:25,550 --> 00:15:27,175 It would get you out of the danger zone. 343 00:15:27,176 --> 00:15:29,886 No. I really can't. 344 00:15:29,887 --> 00:15:33,265 Every minute I stay is a meal, shoes, school supplies. 345 00:15:33,266 --> 00:15:35,767 Plus, I have a second job I have to get to by 4:00. 346 00:15:35,768 --> 00:15:38,770 - You need fluids! - I drink plenty of water. 347 00:15:38,771 --> 00:15:41,189 And potassium and insulin. Okay, how about this? 348 00:15:41,190 --> 00:15:43,900 You stay and I'll get together everything you'll need at home. 349 00:15:43,901 --> 00:15:48,113 Also, a referral to Northside Christian Health Center. 350 00:15:48,114 --> 00:15:50,574 Come on. You don't work until 4:00. 351 00:15:50,575 --> 00:15:53,076 It'll keep you from passing out on the job again-- 352 00:15:53,077 --> 00:15:54,287 or worse. 353 00:15:58,332 --> 00:15:59,833 Okay, I guess. 354 00:15:59,834 --> 00:16:01,084 Great. 355 00:16:01,085 --> 00:16:02,919 Thank you. Please. 356 00:16:06,257 --> 00:16:08,049 Sats up to 98. 357 00:16:08,050 --> 00:16:10,635 - Neonatal mask is working. - Santos, finish the FAST. 358 00:16:10,636 --> 00:16:11,845 What--what are you injecting? 359 00:16:11,846 --> 00:16:13,263 Lido with epi. 360 00:16:13,264 --> 00:16:14,723 It'll clamp off any little bleeders. 361 00:16:14,724 --> 00:16:16,308 We need some skin hooks. 4 Shiley? 362 00:16:16,309 --> 00:16:18,643 Mm, I don't like the curve of a Shiley. 363 00:16:18,644 --> 00:16:20,228 I didn't know you were so picky. 364 00:16:20,229 --> 00:16:21,396 Santos, take a break. 365 00:16:21,397 --> 00:16:23,440 Help me cut down a 6-0 ET tube. 366 00:16:23,441 --> 00:16:24,941 What is going on here? 367 00:16:24,942 --> 00:16:26,568 You have a field medic assisting you? 368 00:16:26,569 --> 00:16:27,944 Dr. Abbot is an attending, 369 00:16:27,945 --> 00:16:29,613 and he's also a SWAT physician. 370 00:16:29,614 --> 00:16:32,741 My buddy Hiro here is in bad need of an airway. 371 00:16:32,742 --> 00:16:33,992 Cut it right here. - We can do this. 372 00:16:33,993 --> 00:16:35,327 No, no, I got it. 373 00:16:35,328 --> 00:16:36,453 You must be Gloria's new hire. 374 00:16:36,454 --> 00:16:38,079 Yes. Dr. Al-Hashimi. 375 00:16:38,080 --> 00:16:40,165 Well, I'd shake your hand, but my tube is ready. 376 00:16:40,166 --> 00:16:41,833 And if I could find and secure the distal trachea, 377 00:16:41,834 --> 00:16:43,293 we have a shot at this. 378 00:16:43,294 --> 00:16:45,670 Okay, keeping an eye on the sats. 379 00:16:45,671 --> 00:16:47,923 Slow is smooth. Smooth is fast. 380 00:16:47,924 --> 00:16:50,133 You know, you can call me just to say hi sometimes. 381 00:16:50,134 --> 00:16:51,468 What's up now? 382 00:16:51,469 --> 00:16:53,053 GSW with tracheal transection. 383 00:16:53,054 --> 00:16:56,473 Very retracted, but I think I can get it. 384 00:16:56,474 --> 00:16:58,183 Both lungs are up? 385 00:16:58,184 --> 00:17:00,393 - Sats down to 91. - Scanning the belly now. 386 00:17:00,394 --> 00:17:01,854 Okay. 387 00:17:03,523 --> 00:17:05,149 I got it. I got it. 388 00:17:08,277 --> 00:17:10,153 Gently, gently, or we're gonna lose it. 389 00:17:10,154 --> 00:17:11,988 Down to 89. 390 00:17:11,989 --> 00:17:13,156 Oh, no. 391 00:17:13,157 --> 00:17:15,034 I'm in. Balloon up. 392 00:17:17,161 --> 00:17:19,829 End tidal, excellent wave form. 393 00:17:19,830 --> 00:17:22,123 Good breath sounds. 394 00:17:22,124 --> 00:17:25,502 I'll sew the tracheal to the skin, 2-0 silk. 395 00:17:25,503 --> 00:17:27,212 - Sats are coming up. - Whoo. 396 00:17:27,213 --> 00:17:29,798 Not bad, Abbot. 397 00:17:29,799 --> 00:17:31,883 Mm, while you were playing with that airway, 398 00:17:31,884 --> 00:17:33,885 you missed a big bruise in the left upper quadrant. 399 00:17:33,886 --> 00:17:35,345 He was wearing body armor. 400 00:17:35,346 --> 00:17:36,513 High-velocity projectile doesn't have 401 00:17:36,514 --> 00:17:38,682 to penetrate to damage. 402 00:17:38,683 --> 00:17:41,017 There's no fluid in the suprasplenic space. 403 00:17:41,018 --> 00:17:43,186 Let me look. 404 00:17:43,187 --> 00:17:44,355 Okay, right there. 405 00:17:46,857 --> 00:17:49,192 Looks like a subcapsular hematoma of his spleen. 406 00:17:49,193 --> 00:17:50,819 Must have been a big impact. 407 00:17:50,820 --> 00:17:53,572 AR-15 muzzle velocity is 3,000 feet per second. 408 00:17:53,573 --> 00:17:55,198 CT angio of the neck ASAP, 409 00:17:55,199 --> 00:17:57,784 along with CT chest, abdomen, pelvis. 410 00:17:57,785 --> 00:18:00,746 Yep, just as soon as we secure this tube. 411 00:18:04,542 --> 00:18:07,043 - First liter's in. - Mucous membranes dry. 412 00:18:07,044 --> 00:18:09,212 Pupils 4 millimeters reactive. 413 00:18:09,213 --> 00:18:10,589 Did you get tackled today? 414 00:18:10,590 --> 00:18:12,048 No, just running drills. 415 00:18:12,049 --> 00:18:13,883 Any chest pain? Palpitations? 416 00:18:13,884 --> 00:18:15,343 No. 417 00:18:15,344 --> 00:18:16,595 Hands off, please, running the 12 lead. 418 00:18:16,596 --> 00:18:18,138 How are we looking? 419 00:18:18,139 --> 00:18:19,764 Good. Healthy kid. 420 00:18:19,765 --> 00:18:21,391 No history, no trauma. 421 00:18:21,392 --> 00:18:24,269 Differential for syncope in an adolescent? 422 00:18:24,270 --> 00:18:26,438 Cardiac arrhythmia from drugs... 423 00:18:26,439 --> 00:18:27,606 - Hypovolemia, seizure... - Long QT, WPW... 424 00:18:27,607 --> 00:18:29,357 - Sepsis. - Or Brugada. 425 00:18:29,358 --> 00:18:31,568 Uh, Brugada is more common in Asian males. 426 00:18:31,569 --> 00:18:33,028 But still should be considered. 427 00:18:33,029 --> 00:18:34,696 Long odds, though. 428 00:18:34,697 --> 00:18:36,573 Brugada prevalence is 1 in 20,000 in North America, 429 00:18:36,574 --> 00:18:39,242 as high as 1 in 300 in Asia and the Middle East. 430 00:18:39,243 --> 00:18:40,744 And? 431 00:18:40,745 --> 00:18:42,954 First described in 1992, has a high incidence 432 00:18:42,955 --> 00:18:44,748 of sudden death among young patients with otherwise 433 00:18:44,749 --> 00:18:47,250 structurally normal hearts-- - Oof, oof, wait. 434 00:18:47,251 --> 00:18:48,752 Did you just say "sudden death"? 435 00:18:48,753 --> 00:18:50,378 Temp is 102.5. 436 00:18:50,379 --> 00:18:51,755 Sorry, our student doctors are discussing 437 00:18:51,756 --> 00:18:54,257 a rare condition you don't have. 438 00:18:54,258 --> 00:18:57,344 I--I just didn't drink enough water. 439 00:18:57,345 --> 00:19:00,347 I overheated. 440 00:19:00,348 --> 00:19:02,098 Not my type, bud. 441 00:19:02,099 --> 00:19:04,977 Other than standard labs, what else to order? 442 00:19:08,606 --> 00:19:10,482 CK to rule out rhabdo. 443 00:19:10,483 --> 00:19:11,775 To make sure you don't have 444 00:19:11,776 --> 00:19:13,318 any muscle breakdown from the heat. 445 00:19:13,319 --> 00:19:15,487 Let's set up a cooling room for Elliot here 446 00:19:15,488 --> 00:19:18,491 and the other heat exhaustions we'll inevitably get today. 447 00:19:22,286 --> 00:19:24,037 Last photo. 448 00:19:27,958 --> 00:19:29,250 Okay. 449 00:19:29,251 --> 00:19:31,503 We'll take the SD card and seal it 450 00:19:31,504 --> 00:19:34,631 in an evidence envelope with everything else. 451 00:19:34,632 --> 00:19:36,132 Okay. 452 00:19:36,133 --> 00:19:40,136 Next, Emma's gonna turn off the light, 453 00:19:40,137 --> 00:19:42,681 and I'll run a blue light over your skin. 454 00:19:42,682 --> 00:19:48,144 Anything glows, I'll swab it with a wet, then dry Q-tip. 455 00:19:48,145 --> 00:19:49,354 Is that okay? 456 00:19:49,355 --> 00:19:50,398 Yeah, sure. 457 00:19:52,983 --> 00:19:54,317 All right. 458 00:19:54,318 --> 00:19:56,528 Take off your gown on the left side 459 00:19:56,529 --> 00:19:58,906 and turn a little bit towards me, just to the left. 460 00:20:00,908 --> 00:20:02,284 There. 461 00:20:27,017 --> 00:20:28,643 Something on the left wrist. 462 00:20:28,644 --> 00:20:29,729 Swab. 463 00:20:37,194 --> 00:20:38,236 Sorry. 464 00:20:38,237 --> 00:20:39,654 Don't be. 465 00:20:39,655 --> 00:20:41,364 - It's just cold. - Yeah. 466 00:20:41,365 --> 00:20:43,033 Almost done. 467 00:20:49,540 --> 00:20:51,833 - Thanks, Antoine. - No problem. 468 00:20:51,834 --> 00:20:53,376 Keep your head down out there. 469 00:20:53,377 --> 00:20:55,044 What's the story? 470 00:20:55,045 --> 00:20:56,588 Neck angio is negative, missed the carotids. 471 00:20:56,589 --> 00:20:58,506 - He's lucky. - What about the belly? 472 00:20:58,507 --> 00:21:01,301 Small splenic injury, no free fluid in the abdomen. 473 00:21:01,302 --> 00:21:03,136 - That should heal on its own. - What's the plan? 474 00:21:03,137 --> 00:21:04,554 Head and Neck will have an OR ready 475 00:21:04,555 --> 00:21:05,889 with thoracic standing by. 476 00:21:05,890 --> 00:21:07,682 How soon can they take him? 477 00:21:07,683 --> 00:21:09,058 We're a little backed up with Westbridge patients, 478 00:21:09,059 --> 00:21:10,435 but let's bring him up. 479 00:21:10,436 --> 00:21:12,771 I'll get him taken care of for you. 480 00:21:12,772 --> 00:21:14,647 Hey. 481 00:21:14,648 --> 00:21:17,734 You're gonna be okay, Hiro. We're getting you to surgery. 482 00:21:17,735 --> 00:21:18,735 I'll write the procedure note. 483 00:21:18,736 --> 00:21:19,779 Thank you. 484 00:21:24,909 --> 00:21:25,992 SWAT? Really? 485 00:21:25,993 --> 00:21:28,119 I suck at golf. 486 00:21:28,120 --> 00:21:30,413 You spend time in the Middle East? 487 00:21:30,414 --> 00:21:32,123 More than I would have liked. 488 00:21:32,124 --> 00:21:34,918 I worked in Kabul with Médecins Sans Frontières 489 00:21:34,919 --> 00:21:37,712 and in 2020, at the maternity hospital. 490 00:21:37,713 --> 00:21:41,299 I met the most incredible, bravest doctors there. 491 00:21:41,300 --> 00:21:43,593 Dasht-e-Barchi. 492 00:21:43,594 --> 00:21:46,387 Tragedy. 493 00:21:46,388 --> 00:21:49,432 We should grab a beer sometime, share war stories. 494 00:21:49,433 --> 00:21:51,435 I'd like that. 495 00:21:54,563 --> 00:21:55,563 She seems cool. 496 00:21:55,564 --> 00:21:57,273 Yep, maybe. 497 00:21:57,274 --> 00:22:00,902 I'm not gonna be around long enough to find out. 498 00:22:00,903 --> 00:22:03,029 Oh, there she is! Vic! 499 00:22:03,030 --> 00:22:04,322 Dad! 500 00:22:04,323 --> 00:22:07,617 Victoria, this is Dr. Amy Joon. 501 00:22:07,618 --> 00:22:09,494 Dr. Joon is the smartest person I know. 502 00:22:09,495 --> 00:22:10,787 Don't tell your mother. Just kidding. 503 00:22:12,164 --> 00:22:13,206 But seriously, don't. 504 00:22:13,207 --> 00:22:14,624 - Hi. - Hello. 505 00:22:14,625 --> 00:22:16,793 Are--are you here to see a patient? 506 00:22:16,794 --> 00:22:18,378 No. We're here to see you. 507 00:22:18,379 --> 00:22:19,796 Dr. Joon is Chief of Dermatology. 508 00:22:19,797 --> 00:22:21,381 And Victoria's first shift in the ER 509 00:22:21,382 --> 00:22:24,300 was on the day of the PittFest shooting. 510 00:22:24,301 --> 00:22:26,386 I heard all the incredible stories, 511 00:22:26,387 --> 00:22:30,223 including your own acts of med student prowess. 512 00:22:30,224 --> 00:22:31,975 Wow, med student prowess. 513 00:22:31,976 --> 00:22:34,143 That's-- I'm--I'm pretty sure 514 00:22:34,144 --> 00:22:35,770 I was just trying to stay out of the way. 515 00:22:35,771 --> 00:22:37,021 Ah, she's modest, like her dad. 516 00:22:37,022 --> 00:22:38,773 And her mother? 517 00:22:38,774 --> 00:22:40,984 Oh. Sorry. 518 00:22:40,985 --> 00:22:42,819 Dr. Joon. 519 00:22:42,820 --> 00:22:44,863 Yep, coming. 520 00:22:44,864 --> 00:22:46,948 I'm doing a favor for someone at the mayor's office 521 00:22:46,949 --> 00:22:49,826 who needs Mohs surgery on a basal cell carcinoma. 522 00:22:49,827 --> 00:22:51,828 And then I am grilling for 30. 523 00:22:51,829 --> 00:22:53,830 - Oh, wow. - Happy 4th, all. 524 00:22:53,831 --> 00:22:55,164 - Happy 4th. - Yeah. 525 00:22:55,165 --> 00:22:57,375 - Thanks for coming down. - My pleasure. 526 00:22:57,376 --> 00:22:59,460 Let's grab a coffee sometime. - Absolutely. Yes. 527 00:22:59,461 --> 00:23:01,963 Thank you. 528 00:23:01,964 --> 00:23:04,382 You know Mom really wants me to go into surgery. 529 00:23:04,383 --> 00:23:06,342 Ah, your mom wants me to stop drinking 530 00:23:06,343 --> 00:23:08,678 and join a pickleball league. - Oh, that's the same. 531 00:23:08,679 --> 00:23:10,388 - Yeah, well-- - Exact same. 532 00:23:10,389 --> 00:23:12,849 I will risk an Achilles tear before I give up scotch. 533 00:23:12,850 --> 00:23:14,684 Hey, I hope I didn't embarrass you coming down here. 534 00:23:14,685 --> 00:23:16,269 No. 535 00:23:16,270 --> 00:23:17,896 I'm just trying to present you with some options 536 00:23:17,897 --> 00:23:19,522 for your residency. 537 00:23:19,523 --> 00:23:21,441 I--I really appreciate it, Dad. 538 00:23:21,442 --> 00:23:23,693 I do. I just-- 539 00:23:23,694 --> 00:23:25,862 I'm still not sure. 540 00:23:25,863 --> 00:23:27,530 Well, either way, you'll do what's right. 541 00:23:27,531 --> 00:23:28,865 You always do. 542 00:23:28,866 --> 00:23:30,867 Proud of ya. - Okay. 543 00:23:30,868 --> 00:23:33,453 Dr. Javadi, you are a man of many talents. 544 00:23:33,454 --> 00:23:35,204 You don't know the half of it. 545 00:23:35,205 --> 00:23:36,372 Your daughter has some 546 00:23:36,373 --> 00:23:37,999 high standards to live up to. 547 00:23:38,000 --> 00:23:40,544 Oh, you don't know the half of it. 548 00:23:43,714 --> 00:23:46,925 Mr. and Mrs. Davis, this is Dr. Jefferson from Psychiatry. 549 00:23:46,926 --> 00:23:48,927 Please call me Caleb. 550 00:23:48,928 --> 00:23:51,387 Can you tell us what's going on with our son? 551 00:23:51,388 --> 00:23:55,224 All of his labs and X-rays came back normal. 552 00:23:55,225 --> 00:23:58,937 Given his age and his hearing voices, 553 00:23:58,938 --> 00:24:03,441 do either of you have a family history of mental illness? 554 00:24:03,442 --> 00:24:04,777 Not mine. 555 00:24:11,742 --> 00:24:13,409 My brother took his own life. 556 00:24:13,410 --> 00:24:15,745 Wait, what? 557 00:24:15,746 --> 00:24:18,081 Uncle Ken? 558 00:24:18,082 --> 00:24:19,916 You said he drank himself to death. 559 00:24:19,917 --> 00:24:21,751 Ma. - He did that too. 560 00:24:21,752 --> 00:24:23,044 Was he ever formally diagnosed 561 00:24:23,045 --> 00:24:24,128 with a mental health issue? 562 00:24:24,129 --> 00:24:25,588 No. 563 00:24:25,589 --> 00:24:28,716 He was depressed, had mood swings. 564 00:24:28,717 --> 00:24:30,468 But he didn't wanna see anyone. - Oh, my God. 565 00:24:30,469 --> 00:24:32,595 Okay, why am I just now hearing about this? 566 00:24:32,596 --> 00:24:35,014 - Jada, please. - Please what, Mom? 567 00:24:35,015 --> 00:24:37,934 Why would you not tell Jackson or me? 568 00:24:37,935 --> 00:24:39,394 I can't believe this. 569 00:24:39,395 --> 00:24:41,062 - Jada. - Excuse me. 570 00:24:41,063 --> 00:24:42,106 Jada. 571 00:24:49,780 --> 00:24:51,781 What happens next? 572 00:24:51,782 --> 00:24:54,075 We keep your son here for the next three days 573 00:24:54,076 --> 00:24:56,160 for observation and therapy. 574 00:24:56,161 --> 00:24:58,663 And that will help us to understand what is going on. 575 00:24:58,664 --> 00:25:00,289 Jada should really hear this. 576 00:25:00,290 --> 00:25:02,835 Let me see if I can find her, bring her back. 577 00:25:05,796 --> 00:25:08,131 Okay. I'm gonna swab your mouth now. 578 00:25:08,132 --> 00:25:09,966 My mouth? 579 00:25:09,967 --> 00:25:13,845 Two dry swabs along the inside of your cheek 580 00:25:13,846 --> 00:25:15,764 and then along the gum line. 581 00:25:19,560 --> 00:25:21,437 How you feeling? 582 00:25:23,313 --> 00:25:25,356 I wish this day never happened. 583 00:25:25,357 --> 00:25:27,358 Would you like some medicine to help you relax? 584 00:25:27,359 --> 00:25:29,319 You've experienced a horrific trauma. 585 00:25:32,031 --> 00:25:33,990 You've been doing this a while? 586 00:25:33,991 --> 00:25:35,324 Let's just say Florence Nightingale 587 00:25:35,325 --> 00:25:37,368 and I were roommates. 588 00:25:37,369 --> 00:25:39,871 Who? 589 00:25:39,872 --> 00:25:41,539 I rest my case. 590 00:25:41,540 --> 00:25:43,584 She was the founder of modern nursing. 591 00:25:45,794 --> 00:25:48,046 Okay, you can have something to eat or drink now. 592 00:25:48,047 --> 00:25:50,048 - I'm fine. - Are you sure? 593 00:25:50,049 --> 00:25:51,799 I'll just keep going. 594 00:25:51,800 --> 00:25:53,677 Okay. 595 00:26:00,684 --> 00:26:05,354 We now have a heat exhaustion treatment area in North 5. 596 00:26:05,355 --> 00:26:07,857 Evaporated cooling. Great plan. 597 00:26:07,858 --> 00:26:12,737 Yeah, it was Dr. Langdon's idea. 598 00:26:12,738 --> 00:26:16,407 He figured we'd be seeing a lot more patients in this heat. 599 00:26:16,408 --> 00:26:18,201 He's right. 600 00:26:18,202 --> 00:26:19,452 How are you feeling? 601 00:26:19,453 --> 00:26:21,913 That's a loaded question. 602 00:26:21,914 --> 00:26:24,082 It wasn't meant to be. 603 00:26:24,083 --> 00:26:26,292 You have a deposition in a couple of hours? 604 00:26:26,293 --> 00:26:28,544 - Yes. - How are you feeling about it? 605 00:26:28,545 --> 00:26:30,546 Um, trying to think positively 606 00:26:30,547 --> 00:26:33,758 but feeling, um, less so. 607 00:26:33,759 --> 00:26:35,968 This job's really important to me and my sister. 608 00:26:35,969 --> 00:26:37,470 You know, I support both of us. 609 00:26:37,471 --> 00:26:38,596 It's gonna go great. 610 00:26:38,597 --> 00:26:40,389 Just tell them what happened. 611 00:26:40,390 --> 00:26:41,933 You're not at fault. Your job's not in jeopardy. 612 00:26:41,934 --> 00:26:44,060 I mean, the lawyers said that I could-- 613 00:26:44,061 --> 00:26:46,229 The lawyers' job is to try and shake your confidence. 614 00:26:46,230 --> 00:26:48,606 So don't let them. You're a very good doctor. 615 00:26:48,607 --> 00:26:50,733 I have been training residents for years. 616 00:26:50,734 --> 00:26:53,277 You are one of the very best. 617 00:26:53,278 --> 00:26:54,737 I am? 618 00:26:54,738 --> 00:26:55,863 No, we need to stick to the plan. 619 00:26:55,864 --> 00:26:56,906 - I promise. - Look. 620 00:26:56,907 --> 00:26:58,282 Thanks. 621 00:26:58,283 --> 00:26:59,575 She's not thinking clearly, okay? 622 00:26:59,576 --> 00:27:00,743 It's gonna be great. 623 00:27:00,744 --> 00:27:02,078 This is not what she wants. 624 00:27:02,079 --> 00:27:03,913 Then I'm taking her home. That's it. 625 00:27:03,914 --> 00:27:05,915 We have to honor your wife's wishes. 626 00:27:05,916 --> 00:27:07,416 Even if she's loaded up on morphine 627 00:27:07,417 --> 00:27:09,085 and can't think straight? - Especially then. 628 00:27:09,086 --> 00:27:10,878 Hello. 629 00:27:10,879 --> 00:27:12,797 Paul Hamler, this is my attending, Dr. Robinavitch. 630 00:27:12,798 --> 00:27:14,257 - Hi. - Hi. 631 00:27:14,258 --> 00:27:16,759 Uh, my wife is not thinking clearly. 632 00:27:16,760 --> 00:27:19,262 What is it that she's asking for? 633 00:27:19,263 --> 00:27:21,514 Said she wants to stay here. 634 00:27:21,515 --> 00:27:23,308 Why don't we all go in and talk? 635 00:27:24,768 --> 00:27:26,769 Brian Jenkins is allowed to hunt with a .22 636 00:27:26,770 --> 00:27:28,354 on his grandpa's farm. 637 00:27:28,355 --> 00:27:30,356 Sounds like an accident just waiting to happen. 638 00:27:30,357 --> 00:27:32,942 Mm-hmm. And you're not Brian Jenkins. 639 00:27:32,943 --> 00:27:35,528 How are we doing in here, Roxie? 640 00:27:35,529 --> 00:27:37,280 Been better. 641 00:27:37,281 --> 00:27:38,823 Rumor has it you're still interested 642 00:27:38,824 --> 00:27:41,284 in booking a room with us? 643 00:27:41,285 --> 00:27:43,452 I don't wanna go back home yet. 644 00:27:43,453 --> 00:27:44,912 It's all set up, Rox. 645 00:27:44,913 --> 00:27:47,081 You're gonna be more comfortable at home. 646 00:27:47,082 --> 00:27:49,292 Paul, I changed my mind. 647 00:27:49,293 --> 00:27:50,544 It is our home. 648 00:27:52,588 --> 00:27:54,589 I don't-- 649 00:27:54,590 --> 00:27:56,424 I don't want you living with my ghost. 650 00:27:56,425 --> 00:27:58,426 I will happily live with your ghost. 651 00:27:58,427 --> 00:28:01,804 Can we just all stop talking about ghosts, please? 652 00:28:01,805 --> 00:28:03,139 Yes. I'm sorry. 653 00:28:03,140 --> 00:28:05,933 I'm sorry, sweetie. You're right. 654 00:28:05,934 --> 00:28:07,852 Got trauma flying in. ETA, five minutes. 655 00:28:07,853 --> 00:28:10,021 Okay. Um, I'm very sorry. 656 00:28:10,022 --> 00:28:11,480 I will be right back. 657 00:28:11,481 --> 00:28:14,025 Excuse me. 658 00:28:14,026 --> 00:28:16,235 It's a boating accident, swimmer versus propeller. 659 00:28:16,236 --> 00:28:17,737 Ouch. 660 00:28:17,738 --> 00:28:19,322 What body parts involved? - They didn't say. 661 00:28:19,323 --> 00:28:20,823 - How old? - Nope. 662 00:28:20,824 --> 00:28:22,158 Anything? 663 00:28:22,159 --> 00:28:23,659 All I got was boating accident, 664 00:28:23,660 --> 00:28:25,578 swimmer versus propeller. - Propeller. Got it. 665 00:28:56,485 --> 00:28:59,695 Picked a hell of a day to come back, huh? 666 00:28:59,696 --> 00:29:02,698 How's Jake? 667 00:29:02,699 --> 00:29:04,492 He's good. 668 00:29:04,493 --> 00:29:06,702 He's better. He's coping. 669 00:29:06,703 --> 00:29:08,704 He's gonna be a senior this fall. 670 00:29:08,705 --> 00:29:11,249 That's great. 671 00:29:11,250 --> 00:29:14,418 That was a lot for him to go through. 672 00:29:14,419 --> 00:29:16,379 A lot for all of us to go through. 673 00:29:16,380 --> 00:29:17,714 Yeah. 674 00:29:19,466 --> 00:29:21,467 Okay, I'm just gonna say it! 675 00:29:21,468 --> 00:29:22,969 I'm sorry. 676 00:29:22,970 --> 00:29:24,637 I betrayed your trust. 677 00:29:24,638 --> 00:29:26,597 I betrayed our patients' trust. 678 00:29:26,598 --> 00:29:27,974 And I'm really fucking sorry. 679 00:29:27,975 --> 00:29:30,185 It'll never happen again, I swear. 680 00:29:34,606 --> 00:29:38,110 I'm really glad that you got the help that you need. 681 00:29:40,862 --> 00:29:44,533 But I don't know if I want you working in my ER. 682 00:29:52,624 --> 00:29:53,958 Why'd you intubate him? 683 00:29:53,959 --> 00:29:55,418 He was splinting from the pain, 684 00:29:55,419 --> 00:29:56,961 barely moving air with sats in the 80s. 685 00:29:56,962 --> 00:29:58,254 How'd he get sliced up in the propeller? 686 00:29:58,255 --> 00:29:59,755 He was in the Allegheny 687 00:29:59,756 --> 00:30:01,132 trying to untangle a water ski tow line 688 00:30:01,133 --> 00:30:02,133 when his buddy started the engine. 689 00:30:02,134 --> 00:30:03,426 Drunk buddy, I assume? 690 00:30:03,427 --> 00:30:04,885 Well, it's 4th of July. You tell me. 691 00:30:04,886 --> 00:30:06,220 Focus on the patient, please. 692 00:30:06,221 --> 00:30:08,098 Sofie, take over bagging. 693 00:30:10,267 --> 00:30:12,435 Okay. One, two, three. 694 00:30:12,436 --> 00:30:13,437 Watch that buckle. 695 00:30:14,938 --> 00:30:16,314 - Do you need me in here? - Nope. 696 00:30:16,315 --> 00:30:18,941 We have a senior resident and an attending. 697 00:30:18,942 --> 00:30:20,276 Mel, can we start with a-- 698 00:30:20,277 --> 00:30:22,778 - An EFAST? Sure. - Yes, please. 699 00:30:22,779 --> 00:30:24,447 Why? 700 00:30:24,448 --> 00:30:25,823 To check and make sure there's no pneumothorax. 701 00:30:25,824 --> 00:30:27,450 Otherwise, it could become a tension. 702 00:30:27,451 --> 00:30:30,202 Exactly. Oh, wow. 703 00:30:30,203 --> 00:30:32,330 You want O-neg? - Not without a BP first. 704 00:30:32,331 --> 00:30:35,541 108/64, pulse is 102. 705 00:30:35,542 --> 00:30:37,793 Sats are good. - Okay, let's have O-neg ready, 706 00:30:37,794 --> 00:30:40,796 but don't give it just yet. - Anything else? 707 00:30:43,008 --> 00:30:44,592 How about a hemocue? 708 00:30:44,593 --> 00:30:46,636 Uh, yeah. Yeah, yeah, of course. 709 00:30:54,770 --> 00:30:56,396 Next step is fingernails. 710 00:30:58,315 --> 00:31:00,691 We'll go under each nail, 711 00:31:00,692 --> 00:31:05,029 first with the wet swab and then with the dry one. 712 00:31:05,030 --> 00:31:07,490 Do you wanna take a break, hon? 713 00:31:07,491 --> 00:31:09,242 No. 714 00:31:12,329 --> 00:31:15,498 How much longer? 715 00:31:15,499 --> 00:31:17,166 After these, we'll get to external... 716 00:31:18,502 --> 00:31:20,212 And internal vaginal collection. 717 00:31:23,840 --> 00:31:27,593 It's the advocate from PAAR. 718 00:31:27,594 --> 00:31:29,345 They've been doing this longer than I have. 719 00:31:29,346 --> 00:31:31,597 They provide resources, assistance, and support 720 00:31:31,598 --> 00:31:33,308 for sexual assault survivors. 721 00:31:35,519 --> 00:31:38,396 Hey. 722 00:31:38,397 --> 00:31:40,856 This will not define you, okay? 723 00:31:40,857 --> 00:31:44,527 You don't have to talk to them, but I recommend you do. 724 00:31:44,528 --> 00:31:46,405 They're available 24/7. 725 00:31:48,281 --> 00:31:50,492 - Okay. - Okay. 726 00:31:56,581 --> 00:31:58,499 Hi. 727 00:31:58,500 --> 00:32:00,709 I'm Paulette Sanderson from Pittsburgh Action Against Rape. 728 00:32:00,710 --> 00:32:02,837 Hi, Paulette. I'm the SANE, Dana. 729 00:32:02,838 --> 00:32:04,922 And this is Ilana. - Hello. 730 00:32:04,923 --> 00:32:07,508 I'm sorry to meet you under these circumstances, 731 00:32:07,509 --> 00:32:09,510 but I and my organization are here to help you navigate 732 00:32:09,511 --> 00:32:11,554 everything that comes next. 733 00:32:11,555 --> 00:32:14,598 I brought you some clothes and basic necessities. 734 00:32:14,599 --> 00:32:16,225 I can even stay with you through the rest 735 00:32:16,226 --> 00:32:18,311 of your examination if you'd like. 736 00:32:20,605 --> 00:32:22,189 I don't think that's necessary. 737 00:32:22,190 --> 00:32:24,775 - Okay. - That's fine. 738 00:32:24,776 --> 00:32:27,320 Would it be okay if I asked you a few questions? 739 00:32:37,789 --> 00:32:39,165 Sure. 740 00:32:41,418 --> 00:32:44,920 Mm, our VRI isn't working. 741 00:32:44,921 --> 00:32:47,756 Video Relay Interpreter? 742 00:32:47,757 --> 00:32:49,300 Yeah, of course I rebooted it. 743 00:32:49,301 --> 00:32:50,926 Wait, how are you gonna fix it if you don't know 744 00:32:50,927 --> 00:32:53,012 what the hell it is? 745 00:32:53,013 --> 00:32:55,264 Yeah, okay. Whatever. 746 00:32:55,265 --> 00:32:57,266 I wanna do a head and belly scan on Harlow. 747 00:32:57,267 --> 00:32:58,476 Can you try telling her why? 748 00:32:58,477 --> 00:32:59,727 What about the VRI? 749 00:32:59,728 --> 00:33:01,729 It's DOA. 750 00:33:01,730 --> 00:33:04,648 I'm charting every free minute I get. 751 00:33:04,649 --> 00:33:06,484 I wasn't coming over for that. 752 00:33:06,485 --> 00:33:08,153 Good job in the Trauma earlier. 753 00:33:11,406 --> 00:33:12,490 What's this? 754 00:33:12,491 --> 00:33:13,824 Daniel Scott, 32, 755 00:33:13,825 --> 00:33:15,576 weak and dizzy while washing his car. 756 00:33:15,577 --> 00:33:18,078 Tachy at 106, BP 90/60. 757 00:33:18,079 --> 00:33:19,622 Temp's too high to register. 758 00:33:19,623 --> 00:33:21,248 We have a cooling room set up in North 5. 759 00:33:21,249 --> 00:33:22,333 Okay, how are you feeling, Mr. Scott? 760 00:33:22,334 --> 00:33:23,626 Thirsty. 761 00:33:23,627 --> 00:33:25,085 Let's see if we can't fix that. 762 00:33:25,086 --> 00:33:26,962 He's gonna need a core temp, a CMP--whoa. 763 00:33:26,963 --> 00:33:28,464 Oh, hey, we need a trauma room. 764 00:33:28,465 --> 00:33:29,673 What's open? - 2. 765 00:33:29,674 --> 00:33:31,300 I'll grab the Ativan. 766 00:33:31,301 --> 00:33:32,968 - Any past medical history? - No. 767 00:33:32,969 --> 00:33:34,720 Wife says he's healthy. No meds, no allergies. 768 00:33:34,721 --> 00:33:37,349 He needs a core temp. 769 00:33:41,478 --> 00:33:43,062 Ready to transfer. 770 00:33:43,063 --> 00:33:44,355 Let's give 2 of Ativan. 771 00:33:44,356 --> 00:33:45,856 Don't want him seizing again. 772 00:33:45,857 --> 00:33:47,066 I gotta get back to my patients. 773 00:33:47,067 --> 00:33:48,067 Okay. 774 00:33:48,068 --> 00:33:50,819 One, two, three. 775 00:33:50,820 --> 00:33:51,987 Orders? 776 00:33:51,988 --> 00:33:54,156 Second IV with saline open. 777 00:33:54,157 --> 00:33:57,493 Sepsis panel, UA, urine drug screen, EKG, and CK. 778 00:33:57,494 --> 00:33:59,495 I don't see any apparent trauma. 779 00:34:00,997 --> 00:34:03,707 Pupils reactive. - Mr. Scott? Daniel? 780 00:34:03,708 --> 00:34:05,376 Can you talk to me? 781 00:34:05,377 --> 00:34:07,044 Post-ictal, but moving all extremities. 782 00:34:07,045 --> 00:34:09,046 Pulse 137, BP 88/60. 783 00:34:09,047 --> 00:34:10,714 What are you thinking, Dr. Santos? 784 00:34:10,715 --> 00:34:13,552 Uh, heat stroke, but consider sepsis or drugs. 785 00:34:17,138 --> 00:34:20,641 Rectal temp is 104.6. 786 00:34:20,642 --> 00:34:22,643 All right, let's start with four ice packs 787 00:34:22,644 --> 00:34:24,478 on the groin and axilla. 788 00:34:24,479 --> 00:34:26,397 Should we do a full body ice bath? 789 00:34:26,398 --> 00:34:27,690 That'll take too long. Do you have an Arctic Sun? 790 00:34:27,691 --> 00:34:29,191 Yeah, we do. 791 00:34:29,192 --> 00:34:30,776 Get pads on the chest, abdomen, and both legs. 792 00:34:30,777 --> 00:34:32,279 I'll check back in. 793 00:34:34,072 --> 00:34:37,533 Ceftazidime is up, and first hemoglobin, 8.2. 794 00:34:37,534 --> 00:34:40,286 8 is pretty low. He must have bled down from 14. 795 00:34:40,287 --> 00:34:42,037 Anything you wanna do about that? 796 00:34:42,038 --> 00:34:44,790 Um, young, healthy guy. We transfuse at 7. 797 00:34:44,791 --> 00:34:46,458 Do we? 798 00:34:46,459 --> 00:34:48,210 We'd be in real trouble if he equilibrates 799 00:34:48,211 --> 00:34:50,379 from acute blood loss. - Am I interrupting something? 800 00:34:50,380 --> 00:34:52,632 - Multiple deep lacerations-- - Motorboat versus-- 801 00:34:55,385 --> 00:34:56,969 Jesus. 802 00:34:56,970 --> 00:34:58,637 This looks like some "Jurassic Park" shit. 803 00:34:58,638 --> 00:35:00,723 Is that your official surgical diagnosis? 804 00:35:00,724 --> 00:35:02,224 He is hemodynamically stable. 805 00:35:02,225 --> 00:35:04,727 What else do we know? 806 00:35:04,728 --> 00:35:08,397 Uh, intubated in the field due to poor tidal volume. 807 00:35:08,398 --> 00:35:10,608 EFAST was negative for pneumothorax, 808 00:35:10,609 --> 00:35:13,110 so no need to do a chest tube. 809 00:35:13,111 --> 00:35:15,863 And no free fluid in the abdomen, 810 00:35:15,864 --> 00:35:17,573 good hemostasis inside the wounds. 811 00:35:17,574 --> 00:35:19,074 Nothing arterial. 812 00:35:19,075 --> 00:35:20,701 At first, he had a hemoglobin of 8.2. 813 00:35:20,702 --> 00:35:22,369 We'll follow that closely. 814 00:35:22,370 --> 00:35:24,831 With no active bleeding, I wouldn't transfuse just yet. 815 00:35:27,250 --> 00:35:29,084 Dr. Langdon agrees with you. 816 00:35:29,085 --> 00:35:31,420 Let's get him to CT. 817 00:35:31,421 --> 00:35:33,839 Jason Stills, 62, was gathering the makings 818 00:35:33,840 --> 00:35:36,425 of a salad when he started feeling dizzy and nauseated. 819 00:35:36,426 --> 00:35:37,760 Vomited once. 820 00:35:37,761 --> 00:35:38,927 How are you feeling, Mr. Stills? 821 00:35:38,928 --> 00:35:40,763 Like I'm gonna die. 822 00:35:40,764 --> 00:35:42,765 Well, you came to the right place to prevent that. 823 00:35:42,766 --> 00:35:44,767 Do you mind if I touch your abdomen? 824 00:35:44,768 --> 00:35:46,935 - Yeah, sure. - Okay. 825 00:35:46,936 --> 00:35:49,355 Does this hurt at all? - No. 826 00:35:49,356 --> 00:35:52,608 He's tachycardic at 124 with a temp of 102.4. 827 00:35:52,609 --> 00:35:54,610 Hey, Joy, what's your suggestion? 828 00:35:54,611 --> 00:35:56,278 Keep hydrating, check electrolytes, 829 00:35:56,279 --> 00:35:57,321 and move him to the cooling room. 830 00:35:57,322 --> 00:35:58,614 Precisely. 831 00:35:58,615 --> 00:35:59,823 Good luck finding a parking spot. 832 00:35:59,824 --> 00:36:02,785 - North 5. - What? No valet? 833 00:36:06,790 --> 00:36:08,666 Jada. Hey. 834 00:36:08,667 --> 00:36:10,793 I--I've been looking all over for you. 835 00:36:10,794 --> 00:36:12,461 I just went for a walk. 836 00:36:12,462 --> 00:36:15,298 I wanted to talk to you, if that's okay. 837 00:36:17,300 --> 00:36:19,301 So does Dr. Jefferson. 838 00:36:19,302 --> 00:36:21,470 It's important that you get to hear what he has to say. 839 00:36:21,471 --> 00:36:22,930 Why? 840 00:36:22,931 --> 00:36:24,932 He doesn't want me to go crazy like my brother? 841 00:36:24,933 --> 00:36:27,685 Or kill myself like my uncle? 842 00:36:27,686 --> 00:36:29,978 Of course not. 843 00:36:29,979 --> 00:36:32,773 We--we still have no idea what caused Jackson's episode. 844 00:36:32,774 --> 00:36:35,359 Episode. 845 00:36:35,360 --> 00:36:37,653 Right. 846 00:36:37,654 --> 00:36:41,949 Look, I--I know this must be so scary for you. 847 00:36:41,950 --> 00:36:45,494 And you probably feel betrayed by your parents. 848 00:36:45,495 --> 00:36:48,414 But they had no way of knowing about Jackson. 849 00:36:48,415 --> 00:36:50,666 You know, and some families just have a difficult time 850 00:36:50,667 --> 00:36:54,169 talking about mental health. 851 00:36:54,170 --> 00:36:56,213 Now you can help us take the first steps 852 00:36:56,214 --> 00:36:59,342 to finding out what we can do to help your brother. 853 00:37:04,681 --> 00:37:09,893 Mr. Diaz, I have a surprise for you. 854 00:37:09,894 --> 00:37:11,729 Oh. 855 00:37:11,730 --> 00:37:13,021 Sorry. 856 00:37:13,022 --> 00:37:14,523 It's okay. 857 00:37:14,524 --> 00:37:16,358 Have you--have you seen my patient? 858 00:37:16,359 --> 00:37:19,027 Orlando? Mr. Diaz? 859 00:37:19,028 --> 00:37:21,405 Room was empty. 860 00:37:21,406 --> 00:37:24,366 - Seriously? - Yeah. 861 00:37:28,872 --> 00:37:30,539 What happened to you? 862 00:37:30,540 --> 00:37:32,499 Oh. 863 00:37:32,500 --> 00:37:33,876 Bullet grazed my vest. 864 00:37:33,877 --> 00:37:35,043 You were shot? 865 00:37:35,044 --> 00:37:36,920 Shot at. 866 00:37:36,921 --> 00:37:40,090 Geniuses thought today was the day to rob a goods warehouse. 867 00:37:40,091 --> 00:37:41,258 Didn't think about how long it would take 868 00:37:41,259 --> 00:37:42,593 to load the appliances. 869 00:37:42,594 --> 00:37:43,927 They panicked. 870 00:37:43,928 --> 00:37:45,137 All hell broke loose. 871 00:37:45,138 --> 00:37:46,806 Jesus. 872 00:37:49,267 --> 00:37:51,268 Why do you do this? 873 00:37:51,269 --> 00:37:53,312 My therapist said I needed a hobby. 874 00:37:53,313 --> 00:37:54,980 Funny. 875 00:37:54,981 --> 00:37:57,065 Shit. 876 00:37:57,066 --> 00:37:59,276 This--this sucks. 877 00:37:59,277 --> 00:38:01,069 - Oh, it's nothing. - No. 878 00:38:01,070 --> 00:38:03,280 No, don't worry about me. I'm fine. Seriously. 879 00:38:03,281 --> 00:38:04,573 No, my patient. 880 00:38:04,574 --> 00:38:06,366 He didn't have any insurance, 881 00:38:06,367 --> 00:38:10,621 and he was already in a mountain of medical debt. 882 00:38:10,622 --> 00:38:12,456 He couldn't afford any of his meds. 883 00:38:12,457 --> 00:38:14,875 Hmm. 884 00:38:14,876 --> 00:38:16,418 What's in the bag? 885 00:38:16,419 --> 00:38:21,381 Insulin, test strips, electrolyte powder. 886 00:38:21,382 --> 00:38:24,092 I--I got him everything he needed for home care. 887 00:38:24,093 --> 00:38:26,303 So Uber it to his house. 888 00:38:26,304 --> 00:38:28,639 Is the hospital gonna pay for that? 889 00:38:28,640 --> 00:38:30,683 I'll pay for it. 890 00:38:40,860 --> 00:38:42,945 What are you doing? 891 00:38:42,946 --> 00:38:45,614 What you clearly can't. 892 00:38:45,615 --> 00:38:47,282 Did you make a chart? 893 00:38:47,283 --> 00:38:48,700 No. 894 00:38:48,701 --> 00:38:50,285 This can stay off the books. 895 00:38:50,286 --> 00:38:52,204 Don't need the paperwork from the hospital 896 00:38:52,205 --> 00:38:53,997 or the police department. 897 00:38:53,998 --> 00:38:56,124 Okay. 898 00:38:56,125 --> 00:38:57,669 Our little secret. 899 00:39:01,297 --> 00:39:03,632 How's he doing? Any more seizures? 900 00:39:03,633 --> 00:39:04,800 Nope. 901 00:39:04,801 --> 00:39:06,134 Temp 102.9. 902 00:39:06,135 --> 00:39:07,469 Labs back? 903 00:39:07,470 --> 00:39:09,179 Mostly signs of dehydration. 904 00:39:09,180 --> 00:39:12,933 A tad hypernatremic, mild BUN and creatinine bump. 905 00:39:12,934 --> 00:39:15,352 CK 400 something-- nothing worrisome yet. 906 00:39:15,353 --> 00:39:16,979 Okay, good. Keep cooling. 907 00:39:16,980 --> 00:39:19,022 - I'll monitor him. - Great. 908 00:39:19,023 --> 00:39:21,860 That'll give Dr. Santos a chance to get caught up. 909 00:39:25,446 --> 00:39:28,031 Your R2 year can be challenging. 910 00:39:28,032 --> 00:39:30,993 You just have to keep grinding. 911 00:39:30,994 --> 00:39:32,995 What's your dispo plan for Mr. Scott? 912 00:39:32,996 --> 00:39:34,997 Uh, ICU admission. 913 00:39:34,998 --> 00:39:36,999 You should call Neurology to consult. 914 00:39:37,000 --> 00:39:38,792 Yeah, done. 915 00:39:38,793 --> 00:39:41,003 Since it was exertional heat illness in a young person, 916 00:39:41,004 --> 00:39:42,880 the mortality is low. 917 00:39:42,881 --> 00:39:45,757 But non-exertional heatstroke in an elderly person, 918 00:39:45,758 --> 00:39:47,843 you need to worry. - Okay. 919 00:39:47,844 --> 00:39:50,846 I'll put in orders for repeat labs. 920 00:39:50,847 --> 00:39:52,682 Good work in there. 921 00:40:05,904 --> 00:40:09,740 This 49-year-old woman presents to the emergency department-- 922 00:40:13,036 --> 00:40:17,706 Uh, with the chief complaint of right ear pain. 923 00:40:17,707 --> 00:40:20,375 Hey, Donnie, can you do something about that? 924 00:40:20,376 --> 00:40:21,835 What? 925 00:40:21,836 --> 00:40:23,378 Seriously? 926 00:40:23,379 --> 00:40:25,213 That--that's not driving you nuts? 927 00:40:25,214 --> 00:40:27,341 The baby, it won't stop crying. 928 00:40:27,342 --> 00:40:29,343 Oh, that? It's music to my ears now. 929 00:40:29,344 --> 00:40:30,719 I think Jesse's the nurse. 930 00:40:30,720 --> 00:40:33,388 Well, can't you--ugh. 931 00:40:39,395 --> 00:40:40,563 Fuck. 932 00:40:45,735 --> 00:40:48,111 What the hell is going on? 933 00:40:48,112 --> 00:40:50,572 With what? 934 00:40:50,573 --> 00:40:53,617 With her. Can't you make her stop crying? 935 00:40:53,618 --> 00:40:56,578 She's been fed and changed. She's cranky from rhinovirus. 936 00:40:58,247 --> 00:41:00,582 Isn't there something that you can do? 937 00:41:00,583 --> 00:41:03,168 She's due for her next Tylenol. 938 00:41:03,169 --> 00:41:04,586 Give me a minute. I'll be right back. 939 00:41:04,587 --> 00:41:06,755 Wait, no, no, no, I'm not gonna stay here. 940 00:41:09,467 --> 00:41:11,344 What is your problem? 941 00:41:14,305 --> 00:41:18,558 This is precisely why I didn't go into Pedes. 942 00:41:18,559 --> 00:41:19,726 Okay. 943 00:41:19,727 --> 00:41:21,645 Hey, hey. 944 00:41:21,646 --> 00:41:24,607 Hey, little Miss Sunshine. 945 00:41:26,275 --> 00:41:28,610 Is it time for you to take a little nap? 946 00:41:28,611 --> 00:41:30,737 That would be so fucking nice. 947 00:41:30,738 --> 00:41:32,114 Yes, it would. 948 00:41:35,410 --> 00:41:38,453 I'm starting to understand why you got left here. 949 00:41:38,454 --> 00:41:40,540 Hey, shh. 950 00:42:26,961 --> 00:42:28,670 What's the word from CT? 951 00:42:28,671 --> 00:42:31,673 Nothing intrathoracic, nothing intra-abdominal. 952 00:42:31,674 --> 00:42:33,008 Propeller just missed gutting him. 953 00:42:33,009 --> 00:42:34,468 - Very fortunate. - Okay. 954 00:42:34,469 --> 00:42:36,386 Repeat hemoglobin is 8. 955 00:42:36,387 --> 00:42:39,014 We're holding off on transfusing. 956 00:42:39,015 --> 00:42:40,849 Plan? 957 00:42:40,850 --> 00:42:42,893 I'll have Mel and Langdon suture up the lacerations. 958 00:42:42,894 --> 00:42:45,020 Wait, what? That could take days. 959 00:42:45,021 --> 00:42:46,480 I--I can't-- 960 00:42:46,481 --> 00:42:48,440 Calm down, Sadness. I'm kidding. 961 00:42:48,441 --> 00:42:50,901 This is one for my skilled surgical residents upstairs, 962 00:42:50,902 --> 00:42:52,402 not you Boy Scout butchers. 963 00:42:52,403 --> 00:42:53,779 Boy, I missed you, Yoyo. 964 00:42:53,780 --> 00:42:56,114 Mm. Can't say the same. 965 00:42:56,115 --> 00:42:59,534 Okay, let's take up this art project. 966 00:42:59,535 --> 00:43:00,869 So about before-- 967 00:43:00,870 --> 00:43:02,913 Back to it. 968 00:43:02,914 --> 00:43:04,372 Good talk. 969 00:43:04,373 --> 00:43:05,916 How we doing, Princess? 970 00:43:05,917 --> 00:43:07,584 All right. A little bloated. 971 00:43:07,585 --> 00:43:10,921 I had one too many hot dogs from the truck. 972 00:43:10,922 --> 00:43:13,090 You meant the board, huh? 973 00:43:13,091 --> 00:43:16,218 Gus, our incarcerated patient, got a spot upstairs. 974 00:43:16,219 --> 00:43:19,846 Looking for our unhoused patient, Digby, and, of course, 975 00:43:19,847 --> 00:43:22,766 we have Whitaker, Donahue, and the med students 976 00:43:22,767 --> 00:43:25,435 on these diversion intakes, but they just keep coming. 977 00:43:25,436 --> 00:43:27,354 Yeah, we may need to start just sending people up 978 00:43:27,355 --> 00:43:29,564 and ask for forgiveness instead of permission. 979 00:43:29,565 --> 00:43:32,025 Hello? 980 00:43:32,026 --> 00:43:34,402 Oh, okay. 981 00:43:34,403 --> 00:43:36,738 Yes, I will be right there. 982 00:43:36,739 --> 00:43:38,281 C-suite wants to see me upstairs. 983 00:43:38,282 --> 00:43:39,699 Ooh, called to the principal's office 984 00:43:39,700 --> 00:43:42,953 on your first day-- not a good sign. 985 00:43:42,954 --> 00:43:45,580 - I think I'm a baby whisperer. - Hey, great. 986 00:43:45,581 --> 00:43:47,624 We'll add Baby Jane Doe to your patient load. 987 00:43:47,625 --> 00:43:49,209 Forget I said anything. 988 00:43:49,210 --> 00:43:51,128 Where are we with your deaf patient, Harlow? 989 00:43:51,129 --> 00:43:54,756 Uh, the VRI was a bust, but the interpreter's on the way. 990 00:43:54,757 --> 00:43:56,758 Figured I'd just give her a head and belly scan 991 00:43:56,759 --> 00:43:58,927 and go from there. - No, wait for the interpreter. 992 00:43:58,928 --> 00:44:01,263 No need to give the patient unnecessary radiation. 993 00:44:01,264 --> 00:44:03,765 And your charting? 994 00:44:03,766 --> 00:44:05,016 Catching up and checking it twice. 995 00:44:05,017 --> 00:44:06,685 Good. 996 00:44:06,686 --> 00:44:08,895 Hey, have you had a chance to speak to Langdon today? 997 00:44:08,896 --> 00:44:10,772 Uh, no. 998 00:44:10,773 --> 00:44:12,023 Why? Did he say something? 999 00:44:12,024 --> 00:44:13,775 No, just curious. 1000 00:44:13,776 --> 00:44:17,154 How is everything at home with you and Whitaker? 1001 00:44:17,155 --> 00:44:19,447 He's weirder than you'd expect. 1002 00:44:19,448 --> 00:44:21,324 - Hmm. - Yeah. 1003 00:44:21,325 --> 00:44:23,410 But I don't see him all that much. 1004 00:44:23,411 --> 00:44:24,953 He spends a lot of time at Amy's. 1005 00:44:24,954 --> 00:44:27,414 He has a girlfriend? 1006 00:44:27,415 --> 00:44:31,251 I don't know what to call it. 1007 00:44:31,252 --> 00:44:33,795 The--the farmer who got burned last year 1008 00:44:33,796 --> 00:44:36,256 the day of the mass cas, his widow, Amy. 1009 00:44:36,257 --> 00:44:37,632 Oh, he died? 1010 00:44:37,633 --> 00:44:39,676 Yeah, he had burns on 90% of his body. 1011 00:44:39,677 --> 00:44:41,469 His chance of survival was very slim. 1012 00:44:41,470 --> 00:44:43,138 Okay, so I'm an optimist. 1013 00:44:43,139 --> 00:44:45,640 The sun doesn't always come out tomorrow, Annie. 1014 00:44:45,641 --> 00:44:47,517 Wait, wasn't she pregnant? 1015 00:44:47,518 --> 00:44:50,187 No, she was a young orphan. 1016 00:44:50,188 --> 00:44:52,564 No, not Annie. Amy. 1017 00:44:52,565 --> 00:44:56,318 Yes. Yes, very pregnant and young. 1018 00:44:56,319 --> 00:44:58,153 Whitaker is now seeing this Amy? 1019 00:44:58,154 --> 00:45:00,322 And her baby. 1020 00:45:00,323 --> 00:45:02,073 He got really close to the family 1021 00:45:02,074 --> 00:45:04,075 when the husband was dying. 1022 00:45:04,076 --> 00:45:06,203 He really believed that the guy would pull through. 1023 00:45:06,204 --> 00:45:08,663 He helped her through the loss of her husband, 1024 00:45:08,664 --> 00:45:10,332 and then again when she had the kid, 1025 00:45:10,333 --> 00:45:13,501 and now he spends almost every weekend at the farm. 1026 00:45:13,502 --> 00:45:14,836 Huh. 1027 00:45:14,837 --> 00:45:16,338 Plus, he's on the street team, 1028 00:45:16,339 --> 00:45:18,256 and he just wants to help everybody. 1029 00:45:18,257 --> 00:45:21,218 And I just don't wanna see him taken advantage of, you know? 1030 00:45:21,219 --> 00:45:23,470 He's just a fucking Huckleberry. 1031 00:45:23,471 --> 00:45:26,056 Yeah, but he's our fucking Huckleberry. 1032 00:45:26,057 --> 00:45:27,557 I'll talk to him. 1033 00:45:27,558 --> 00:45:28,892 Hey, your call. 1034 00:45:28,893 --> 00:45:30,685 Strong deflection. Well played. 1035 00:45:30,686 --> 00:45:32,145 You're the boss. 1036 00:45:32,146 --> 00:45:33,730 Or you are until end of shift today. 1037 00:45:33,731 --> 00:45:35,065 Still the boss. 1038 00:45:35,066 --> 00:45:37,317 When you see me in here, still the boss. 1039 00:45:37,318 --> 00:45:39,861 Copy that, Boss. 1040 00:45:39,862 --> 00:45:43,198 Dr. Robby, can-- can I grab you for a second? 1041 00:45:43,199 --> 00:45:46,201 Yeah. Sure. What's up? 1042 00:45:46,202 --> 00:45:51,081 Um, can't you order my wife to go home? 1043 00:45:51,082 --> 00:45:52,832 I'm sorry. 1044 00:45:54,961 --> 00:45:56,878 My wife's dying, 1045 00:45:56,879 --> 00:45:59,631 and you're telling me there's nothing I can do? 1046 00:45:59,632 --> 00:46:01,132 Mr. Hamler, that's not-- 1047 00:46:01,133 --> 00:46:02,717 No, no. 1048 00:46:02,718 --> 00:46:05,428 There's gotta be something. 1049 00:46:05,429 --> 00:46:07,389 Please. 1050 00:46:07,390 --> 00:46:09,557 It may not seem like much, but right now, 1051 00:46:09,558 --> 00:46:12,102 you being here for her and respecting her wishes 1052 00:46:12,103 --> 00:46:14,980 is the best thing that you can do for her. 1053 00:46:14,981 --> 00:46:18,900 Supporting her and her choices is the most remarkable gift 1054 00:46:18,901 --> 00:46:22,195 that you can give her at this time. 1055 00:46:22,196 --> 00:46:24,906 And the meds we have her on will help her pain. 1056 00:46:24,907 --> 00:46:26,908 And she may get to a point where 1057 00:46:26,909 --> 00:46:29,412 she feels well enough to go home. 1058 00:46:45,594 --> 00:46:47,638 Give me one second. 1059 00:46:52,977 --> 00:46:54,978 Okay, I'm gonna let you guys get acquainted. 1060 00:46:54,979 --> 00:46:56,396 I will be right back. 1061 00:46:56,397 --> 00:46:57,939 Oh, oh, oh, excuse me! 1062 00:46:57,940 --> 00:47:00,817 I--I'm waiting for Dr. Mohan. Is she available? 1063 00:47:00,818 --> 00:47:03,237 I will try and find her for you, sir. 1064 00:47:07,450 --> 00:47:10,327 Whether you choose to report or not, we're here for you. 1065 00:47:10,328 --> 00:47:11,828 Call me any time. 1066 00:47:11,829 --> 00:47:15,290 It could be a month or a year from now. 1067 00:47:15,291 --> 00:47:16,624 I'll follow up with you too. 1068 00:47:16,625 --> 00:47:18,335 Thank you. 1069 00:47:18,336 --> 00:47:20,046 Thanks. 1070 00:47:23,632 --> 00:47:25,133 You've had a pap smear before? 1071 00:47:25,134 --> 00:47:27,302 Yeah, every few years. 1072 00:47:27,303 --> 00:47:28,803 Good. 1073 00:47:28,804 --> 00:47:31,306 Same position, but I'll start with swabs 1074 00:47:31,307 --> 00:47:34,184 on the outside, external genitalia. 1075 00:47:34,185 --> 00:47:36,478 Then I'll use a speculum to get internal swabs. 1076 00:47:36,479 --> 00:47:38,605 You ready? Okay. 1077 00:47:38,606 --> 00:47:40,982 I'll help you get your feet in the stirrups. 1078 00:47:40,983 --> 00:47:43,985 Good. 1079 00:47:43,986 --> 00:47:46,446 Okay. All right. 1080 00:47:46,447 --> 00:47:49,449 Now, slide your bottom down. 1081 00:47:49,450 --> 00:47:52,035 Oh. Yeah, a little bit more. 1082 00:47:52,036 --> 00:47:53,828 A little more. 1083 00:47:53,829 --> 00:47:56,456 - Sorry. I--I can't. - Okay. It's okay. 1084 00:47:56,457 --> 00:47:58,041 We can take a break. No problem. 1085 00:47:58,042 --> 00:48:00,543 I don't want a break. I wanna stop. 1086 00:48:00,544 --> 00:48:03,421 Okay. Is this about reporting? 1087 00:48:03,422 --> 00:48:05,006 Because you can do this collection 1088 00:48:05,007 --> 00:48:06,716 without a police report for now. 1089 00:48:06,717 --> 00:48:09,260 And none of it goes in your permanent medical record. 1090 00:48:09,261 --> 00:48:11,179 I don't wanna do this anymore. 1091 00:48:11,180 --> 00:48:13,348 Tell me why you wanna stop. 1092 00:48:16,018 --> 00:48:18,853 He's my friend. 1093 00:48:18,854 --> 00:48:22,732 He knows all my friends. 1094 00:48:22,733 --> 00:48:26,236 It was just a dumb-- 1095 00:48:26,237 --> 00:48:28,571 he was drunk, he didn't mean it. 1096 00:48:28,572 --> 00:48:31,157 It didn't mean anything. - Okay. 1097 00:48:31,158 --> 00:48:33,493 Okay. 1098 00:48:33,494 --> 00:48:36,496 It's okay. I understand. 1099 00:48:36,497 --> 00:48:39,165 I do. 1100 00:48:39,166 --> 00:48:44,003 Ilana, this is a difficult process, to say the least. 1101 00:48:44,004 --> 00:48:45,922 Why don't you take a breather and come back? 1102 00:48:45,923 --> 00:48:48,551 And whatever you wanna do, we'll do. 1103 00:48:56,434 --> 00:48:59,270 Let's go find the good snacks. 1104 00:49:22,251 --> 00:49:23,626 Jesus Christ. 1105 00:49:23,627 --> 00:49:25,420 Sorry. 1106 00:49:25,421 --> 00:49:27,922 Giving new meaning to the nickname Crash, huh? 1107 00:49:27,923 --> 00:49:29,340 I've been trying to get to the bathroom 1108 00:49:29,341 --> 00:49:30,925 for over an hour now. 1109 00:49:30,926 --> 00:49:33,761 Yeah, you and me both, sister. 1110 00:49:43,814 --> 00:49:46,441 Uh-oh, this can't be good. 1111 00:49:46,442 --> 00:49:47,901 Who's this? 1112 00:49:47,902 --> 00:49:49,110 That is hospital CEO Trent Norris. 1113 00:49:49,111 --> 00:49:51,613 He's the big boss. 1114 00:49:51,614 --> 00:49:53,114 Hmm. Nice outfit. 1115 00:49:53,115 --> 00:49:55,074 Hey, Rockstar. Gather your staff, please. 1116 00:49:55,075 --> 00:49:57,243 Sure, anything you wanna tell me first? 1117 00:49:57,244 --> 00:49:59,412 - No. - Okay. 1118 00:49:59,413 --> 00:50:01,748 Hey, everybody, can you, uh, gather 'round 1119 00:50:01,749 --> 00:50:04,209 and listen up for a moment, please? 1120 00:50:04,210 --> 00:50:07,670 Can I have your attention, everyone? 1121 00:50:07,671 --> 00:50:10,340 Internal disaster at Westbridge 1122 00:50:10,341 --> 00:50:12,467 has been identified as a cyberattack. 1123 00:50:15,179 --> 00:50:18,389 And now Good Dominion Hospital has been hit as well. 1124 00:50:18,390 --> 00:50:20,808 Their ambulances are being diverted over to St. Mary's, 1125 00:50:20,809 --> 00:50:24,145 but we can expect more walk-ins and Westbridge diversions. 1126 00:50:24,146 --> 00:50:26,022 Uh, for how long? 1127 00:50:26,023 --> 00:50:29,192 We don't know how long. If the ransom is paid-- 1128 00:50:29,193 --> 00:50:30,902 Ransom? 1129 00:50:30,903 --> 00:50:32,737 Are we next? 1130 00:50:32,738 --> 00:50:35,365 Our IT protection system has blocked thousands 1131 00:50:35,366 --> 00:50:36,991 of intrusion attempts in the hours 1132 00:50:36,992 --> 00:50:39,202 since Westbridge was hit this morning. 1133 00:50:39,203 --> 00:50:43,206 But IT believes we're still vulnerable. 1134 00:50:43,207 --> 00:50:45,833 So we're gonna preemptively shut down 1135 00:50:45,834 --> 00:50:47,460 all the computer systems. 1136 00:50:47,461 --> 00:50:50,213 - Oh, my God. - Jesus. 1137 00:50:50,214 --> 00:50:52,966 Patient registration, electronic health records, 1138 00:50:52,967 --> 00:50:56,052 lab and radiology interfaces, email, internet. 1139 00:50:56,053 --> 00:50:57,345 You didn't wanna talk to me first? 1140 00:50:57,346 --> 00:50:58,721 You didn't wanna consult my department? 1141 00:50:58,722 --> 00:51:01,267 I consulted your fellow attending. 1142 00:51:03,185 --> 00:51:06,020 When are we going down? 1143 00:51:06,021 --> 00:51:08,940 Soon. Very soon. 1144 00:51:08,941 --> 00:51:11,317 Okay, hey, somebody get a picture of the board. 1145 00:51:11,318 --> 00:51:14,529 Quickly, quickly! We're about to go analog. 1146 00:51:16,574 --> 00:51:18,199 - No! - Oh, my gosh. 1147 00:51:21,245 --> 00:51:23,621 - Phones work? - They don't work. 1148 00:51:23,622 --> 00:51:25,373 - Oh, my gosh. - Did you get the photo? 1149 00:51:25,374 --> 00:51:28,084 Yeah, yeah, I got it. 1150 00:51:28,085 --> 00:51:29,628 This is gonna be fun. 82092

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