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These are the user uploaded subtitles that are being translated: 1 00:00:21,813 --> 00:00:23,731 Oh, okay. 2 00:00:23,732 --> 00:00:25,566 Where are we now? 3 00:00:25,567 --> 00:00:27,568 {\an8}Got the VRI for our deaf patient in Central 12. 4 00:00:27,569 --> 00:00:29,570 {\an8}Still waiting on Pedes for Baby Jane Doe. 5 00:00:29,571 --> 00:00:31,531 {\an8}Central 6 is sitting pretty with his insulin drip. 6 00:00:31,532 --> 00:00:33,074 {\an8}And the Westbridge diversions are 7 00:00:33,075 --> 00:00:34,408 kindly waiting their turn to sit 8 00:00:34,409 --> 00:00:35,952 for hours in our lovely halls. 9 00:00:35,953 --> 00:00:37,912 You are some kind of savant. 10 00:00:37,913 --> 00:00:38,955 Worthy of a raise? 11 00:00:38,956 --> 00:00:40,831 Just more of my love. 12 00:00:40,832 --> 00:00:42,291 I got enough of that. 13 00:00:42,292 --> 00:00:44,627 I have a sexual assault victim in triage. 14 00:00:44,628 --> 00:00:46,921 I called PAAR, so an advocate is on the way. 15 00:00:46,922 --> 00:00:49,257 Okay. We'll take care of it. 16 00:00:49,258 --> 00:00:52,093 Uh, Dr. McKay, what's going on with your patient in Central 9? 17 00:00:52,094 --> 00:00:53,469 Isn't she good to go? 18 00:00:53,470 --> 00:00:55,263 Oh, she was, but she decided 19 00:00:55,264 --> 00:00:56,764 she wanted to stay in the hospital now 20 00:00:56,765 --> 00:00:58,099 because she's in too much pain. 21 00:00:58,100 --> 00:01:00,059 In our loud and overcrowded ED 22 00:01:00,060 --> 00:01:02,270 with more Westbridge cases arriving every moment? 23 00:01:02,271 --> 00:01:04,230 She would be more comfortable at home. 24 00:01:04,231 --> 00:01:07,608 The debrief was lovely. 25 00:01:07,609 --> 00:01:09,402 Thank you. 26 00:01:09,403 --> 00:01:11,279 Would you mind helping Dana with a sexual assault victim 27 00:01:11,280 --> 00:01:13,281 who just came in? - Of course. Sure. 28 00:01:13,282 --> 00:01:15,116 Why don't you and I go see if we can't convince 29 00:01:15,117 --> 00:01:16,867 your patient to leave? - All right. 30 00:01:16,868 --> 00:01:19,495 I need to take care of a sexual assault victim in triage. 31 00:01:19,496 --> 00:01:21,289 One of you needs to hold down the fort. 32 00:01:21,290 --> 00:01:23,958 - We can call for a SANE. - On a holiday? Could be hours. 33 00:01:23,959 --> 00:01:25,668 We're not gonna make this patient wait. 34 00:01:25,669 --> 00:01:26,794 And since I'm the only SANE on staff-- 35 00:01:26,795 --> 00:01:28,170 Princess will cover. 36 00:01:29,965 --> 00:01:31,799 Hey! Hey! 37 00:01:31,800 --> 00:01:33,301 You two better not be teaching her any bad habits. 38 00:01:33,302 --> 00:01:35,928 Come on. You ready, Doc? - Sure. 39 00:01:35,929 --> 00:01:38,806 A SANE is a Sexual Assault Nurse Examiner. 40 00:01:38,807 --> 00:01:41,017 We do forensic exams, collect evidence, 41 00:01:41,018 --> 00:01:43,686 and hand it over to the police if a report is made. 42 00:01:43,687 --> 00:01:45,688 We also provide resources, support, 43 00:01:45,689 --> 00:01:48,065 sometimes even testimony. - You go to court? 44 00:01:48,066 --> 00:01:50,985 SANEs are very valuable in a hospital, especially an ED. 45 00:01:50,986 --> 00:01:52,862 More nurses should train for it. 46 00:01:52,863 --> 00:01:54,865 That's a not so subtle hint. 47 00:02:03,165 --> 00:02:05,291 Looks like this is the new hot spot, huh? 48 00:02:05,292 --> 00:02:06,834 And only getting hotter. 49 00:02:06,835 --> 00:02:08,669 Any word on what's going on with Westbridge? 50 00:02:08,670 --> 00:02:10,004 I got 20 on lantern flies. 51 00:02:10,005 --> 00:02:12,298 Nope, nothing. 52 00:02:12,299 --> 00:02:15,551 These patient passports have an interesting alternative use. 53 00:02:15,552 --> 00:02:17,011 Where's the sexual assault victim? 54 00:02:17,012 --> 00:02:18,512 She's in Triage, Chair 2. 55 00:02:18,513 --> 00:02:20,514 Thanks, Lupe. 56 00:02:20,515 --> 00:02:21,515 Here's her intake. 57 00:02:21,516 --> 00:02:23,517 Got it. 58 00:02:29,858 --> 00:02:31,859 Hi, Ms. Miller. 59 00:02:31,860 --> 00:02:33,194 I'm Dana. 60 00:02:33,195 --> 00:02:34,862 How are you doing? 61 00:02:34,863 --> 00:02:37,406 - I've been better. - Yeah. 62 00:02:37,407 --> 00:02:38,866 You're in a safe place now. 63 00:02:38,867 --> 00:02:40,701 I'm the charge nurse in the ED 64 00:02:40,702 --> 00:02:42,912 and a sexual assault nurse examiner. 65 00:02:42,913 --> 00:02:44,538 This is Emma, who will be assisting. 66 00:02:44,539 --> 00:02:46,082 And I'm Dr. Al-Hashimi. 67 00:02:46,083 --> 00:02:47,458 I'll be checking you for any injuries 68 00:02:47,459 --> 00:02:50,127 that need immediate attention. 69 00:02:50,128 --> 00:02:52,046 You can just call me Ilana. 70 00:02:52,047 --> 00:02:53,381 I don't have any injuries. 71 00:02:53,382 --> 00:02:55,091 Okay, that's good. 72 00:02:55,092 --> 00:02:56,967 We're gonna get a room ready for you. 73 00:02:56,968 --> 00:02:58,928 Meanwhile, Dr. Al-Hashimi is gonna ask you a few questions. 74 00:02:58,929 --> 00:03:01,055 How long is this gonna take? 75 00:03:01,056 --> 00:03:02,723 I can't promise an exact time, 76 00:03:02,724 --> 00:03:05,601 but we'll try to be as fast as you need. 77 00:03:05,602 --> 00:03:06,937 - Thank you. - Yeah. 78 00:03:11,191 --> 00:03:14,402 Okay, Ilana, do you take any prescription medications? 79 00:03:14,403 --> 00:03:16,445 Just Synthroid, one tab a day. 80 00:03:16,446 --> 00:03:18,280 Okay, and any allergies to medications? 81 00:03:18,281 --> 00:03:20,491 - No. No. - Okay. 82 00:03:20,492 --> 00:03:22,493 Dana will come get you when the room is ready, 83 00:03:22,494 --> 00:03:24,621 and I'll be back to finish your exam. 84 00:03:31,753 --> 00:03:33,129 Come find me when she's in a gown. 85 00:03:33,130 --> 00:03:34,880 Will do. 86 00:03:34,881 --> 00:03:36,757 We're gonna use Triage Exam Rooms 1 and 2 for this. 87 00:03:36,758 --> 00:03:39,635 It's the most private space we have away from the ED. 88 00:03:39,636 --> 00:03:41,387 All right, this can be a lot. 89 00:03:41,388 --> 00:03:43,264 You up for it? 90 00:03:43,265 --> 00:03:44,473 Yeah. 91 00:03:44,474 --> 00:03:46,308 Yes. I'm good. 92 00:03:46,309 --> 00:03:48,520 Let me know if you need to step out. 93 00:03:54,943 --> 00:03:57,362 Yes. 94 00:03:59,614 --> 00:04:01,323 Dr. Ellis. 95 00:04:01,324 --> 00:04:03,451 - Oh, no. - Oh, yes. 96 00:04:03,452 --> 00:04:04,785 Need the room. 97 00:04:04,786 --> 00:04:06,787 Find another place to lay your head. 98 00:04:06,788 --> 00:04:09,457 Not even a 20-minute power nap? 99 00:04:09,458 --> 00:04:11,083 You know, my double is at 1:30. I'm-- 100 00:04:11,084 --> 00:04:12,960 Nope, we're getting Westbridge diversions. 101 00:04:12,961 --> 00:04:14,253 And chairs is insane. 102 00:04:14,254 --> 00:04:15,755 Did you see out there? - No. 103 00:04:15,756 --> 00:04:17,339 I do not come in through that mess. 104 00:04:17,340 --> 00:04:19,049 Okay. 105 00:04:19,050 --> 00:04:20,342 Yeah. 106 00:04:20,343 --> 00:04:21,969 People sleep in here? 107 00:04:21,970 --> 00:04:24,138 Yeah, the night shift docs just need rest, 108 00:04:24,139 --> 00:04:25,973 especially if they have to come in during the day. 109 00:04:25,974 --> 00:04:28,225 But today, we can't waste the space. 110 00:04:28,226 --> 00:04:33,231 I need you to get me a stool on wheels and Esme for a turnover. 111 00:04:36,359 --> 00:04:39,654 So you're having a headache and abdominal pain? 112 00:04:43,325 --> 00:04:45,201 Yeah, that's right. 113 00:04:45,202 --> 00:04:47,746 Okay, and which would you say is worse? 114 00:04:51,333 --> 00:04:53,209 My headache was terrible last week... 115 00:04:53,210 --> 00:04:56,170 But now-- 116 00:04:56,171 --> 00:04:57,338 Hey, you're-- you're breaking up. 117 00:04:57,339 --> 00:04:58,881 Can you run that back again? 118 00:04:58,882 --> 00:05:00,508 Sure. 119 00:05:03,512 --> 00:05:05,846 My headache was terrible last week... 120 00:05:05,847 --> 00:05:09,183 But now my abdominal pain-- 121 00:05:09,184 --> 00:05:10,351 Oh, my God. 122 00:05:10,352 --> 00:05:12,311 Come on, you piece of-- 123 00:05:12,312 --> 00:05:13,854 fuck. 124 00:05:13,855 --> 00:05:15,232 Um-- 125 00:05:41,091 --> 00:05:43,551 I'll--I'll be right back. 126 00:05:43,552 --> 00:05:45,303 Sorry. 127 00:05:51,560 --> 00:05:53,060 Um, Dr. Al-Hashimi? 128 00:05:53,061 --> 00:05:54,770 Jackson's parents are here. 129 00:05:54,771 --> 00:05:57,481 Okay. I'll take that. 130 00:05:57,482 --> 00:06:00,317 Um, Mr. and Mrs. Davis, this is one of my attendings, 131 00:06:00,318 --> 00:06:02,486 Dr. Al-Hashimi. - Hi. Nice to meet you. 132 00:06:02,487 --> 00:06:04,613 - Demi. - Charles. 133 00:06:04,614 --> 00:06:06,448 What the hell's going on? 134 00:06:06,449 --> 00:06:08,534 He's barely conscious. 135 00:06:08,535 --> 00:06:10,202 Jackson's just a little tired due to the sedative 136 00:06:10,203 --> 00:06:12,288 he was given. - You sedated him? 137 00:06:12,289 --> 00:06:14,582 Oh, your son was brought in extremely agitated. 138 00:06:14,583 --> 00:06:15,916 You'd be, too, if you were tased. 139 00:06:15,917 --> 00:06:18,252 And why the fuck did they do that? 140 00:06:18,253 --> 00:06:20,963 This is bullshit. We're taking him home. 141 00:06:20,964 --> 00:06:22,799 Why don't we step out for a second? 142 00:06:31,474 --> 00:06:34,810 Right now, Jackson is on an involuntary psych hold. 143 00:06:34,811 --> 00:06:36,687 What? That's not necessary. 144 00:06:36,688 --> 00:06:38,147 He just needs some rest. 145 00:06:38,148 --> 00:06:40,065 He's been studying for the bar exam. 146 00:06:40,066 --> 00:06:41,567 We can watch him at home. 147 00:06:41,568 --> 00:06:43,110 So far, all of his tests look good, 148 00:06:43,111 --> 00:06:46,113 but Jackson has reported hearing voices. 149 00:06:46,114 --> 00:06:47,823 This could be serious. 150 00:06:47,824 --> 00:06:49,950 Dr. Jefferson will come back and speak with you. 151 00:06:49,951 --> 00:06:52,953 He can explain more of what may be going on with Jackson. 152 00:06:52,954 --> 00:06:54,538 And who is Dr. Jefferson? 153 00:06:54,539 --> 00:06:56,582 He's from Psychiatry, and he's excellent. 154 00:06:56,583 --> 00:06:58,792 He can explain next steps and answer all of your questions. 155 00:06:58,793 --> 00:07:01,128 Javadi, why don't you take the Davises to the family room? 156 00:07:01,129 --> 00:07:02,504 - Sure. - Excuse me. 157 00:07:02,505 --> 00:07:03,964 It's just this way. 158 00:07:25,654 --> 00:07:28,238 You have reached the Pittsburgh Neuroscience Group. 159 00:07:28,239 --> 00:07:30,199 If this is a medical emergency, 160 00:07:30,200 --> 00:07:33,327 please hang up and dial 911. 161 00:07:33,328 --> 00:07:36,330 For our address and office hours, press 1. 162 00:07:36,331 --> 00:07:39,124 To refill a prescription, press 2. 163 00:07:39,125 --> 00:07:43,671 To leave a message for the doctor on call-- 164 00:07:43,672 --> 00:07:45,839 Hi, this is Dr. Baran al-Hashimi. 165 00:07:45,840 --> 00:07:47,800 I'm a patient of Dr. Fairgraves. 166 00:07:47,801 --> 00:07:51,720 I need to speak to him if he's on call. 167 00:07:51,721 --> 00:07:54,974 If he's not, I'll take his next available appointment. 168 00:07:54,975 --> 00:07:58,185 And please call me if he has a cancellation. 169 00:07:58,186 --> 00:08:00,270 Thank you. 170 00:08:00,271 --> 00:08:02,731 Like I said, you're more than welcome to stay down here 171 00:08:02,732 --> 00:08:04,566 until an inpatient bed opens up upstairs. 172 00:08:04,567 --> 00:08:07,861 But that can take a while, sometimes days, 173 00:08:07,862 --> 00:08:10,322 even longer. 174 00:08:10,323 --> 00:08:11,824 It's gonna be really noisy here, 175 00:08:11,825 --> 00:08:13,367 and you won't get any rest. 176 00:08:13,368 --> 00:08:15,077 At home, you'll be surrounded by your family 177 00:08:15,078 --> 00:08:18,580 and be more comfortable. 178 00:08:18,581 --> 00:08:20,709 It's your choice, Roxie. 179 00:08:23,003 --> 00:08:25,838 It's not that I don't wanna go home, but-- 180 00:08:25,839 --> 00:08:28,048 - Hi, Mom. - Mom. 181 00:08:28,049 --> 00:08:31,719 Lena texted me to come back. I figured I'd bring the boys. 182 00:08:31,720 --> 00:08:34,221 What's going on? Is everything okay? 183 00:08:34,222 --> 00:08:37,891 Robby, police officer, incoming trauma. 184 00:08:37,892 --> 00:08:39,101 Coming. 185 00:08:39,102 --> 00:08:40,477 I'll be right back. 186 00:08:40,478 --> 00:08:41,980 We'll give you a chance to talk. 187 00:08:44,566 --> 00:08:47,068 Okay, why don't you have a seat? 188 00:08:54,951 --> 00:08:57,245 Do you need anything before we begin? 189 00:09:02,208 --> 00:09:04,918 You're in control now, Ilana. 190 00:09:04,919 --> 00:09:07,713 We're here to help and support you. 191 00:09:07,714 --> 00:09:11,133 Once I open this kit, I cannot leave the room. 192 00:09:11,134 --> 00:09:14,219 But if you need a break or some air, just let us know. 193 00:09:14,220 --> 00:09:17,473 Okay? Emma can go with you if you like. 194 00:09:17,474 --> 00:09:19,975 An advocate from Pittsburgh Action Against Rape 195 00:09:19,976 --> 00:09:21,602 has been called, and they should arrive soon. 196 00:09:21,603 --> 00:09:24,271 - Can we start? - Sure. 197 00:09:24,272 --> 00:09:25,731 I'm gonna put my face shield on 198 00:09:25,732 --> 00:09:27,941 so I don't contaminate anything. 199 00:09:27,942 --> 00:09:30,903 Emma has already done the same. 200 00:09:30,904 --> 00:09:34,865 Now, in order for the doctor to do her exam, 201 00:09:34,866 --> 00:09:36,450 I need you in a gown, 202 00:09:36,451 --> 00:09:37,659 but I need to collect your clothing first. 203 00:09:37,660 --> 00:09:39,579 Is that okay? 204 00:09:43,666 --> 00:09:46,668 I'm gonna need you to undress on top of these pads. 205 00:09:46,669 --> 00:09:49,630 Put each item of clothing on the pads, okay? 206 00:09:49,631 --> 00:09:53,175 Then we'll package each piece in a separate bag. 207 00:09:53,176 --> 00:09:54,343 We'll get you new clothes. 208 00:09:54,344 --> 00:09:55,719 Don't worry. - All right. 209 00:09:55,720 --> 00:09:57,471 Emma's gonna be behind this curtain, 210 00:09:57,472 --> 00:10:00,474 and I'll be in here with you. 211 00:10:00,475 --> 00:10:03,644 And take off your shoes first. 212 00:10:03,645 --> 00:10:07,981 When you're done, I want you to put on your gown 213 00:10:07,982 --> 00:10:11,110 open in the back. 214 00:10:35,385 --> 00:10:37,678 What if the mom doesn't wanna leave? 215 00:10:37,679 --> 00:10:39,930 Well, then she's gonna have to put up with us. 216 00:10:41,850 --> 00:10:44,685 I can't imagine--her boys. 217 00:10:44,686 --> 00:10:46,520 Oh, don't go there. 218 00:10:46,521 --> 00:10:48,188 I'm gonna see if I can grease the wheels, 219 00:10:48,189 --> 00:10:49,398 get her a room upstairs soon. 220 00:10:49,399 --> 00:10:51,358 Good luck. What was that? 221 00:10:51,359 --> 00:10:52,776 Battle plan for our hall space. 222 00:10:52,777 --> 00:10:54,361 It's filling up fast. 223 00:10:54,362 --> 00:10:56,071 Police officer should be here any minute. 224 00:10:56,072 --> 00:10:57,865 Yeah, well, as soon as you can, please, 225 00:10:57,866 --> 00:10:59,199 I need you to fix the VRI. 226 00:10:59,200 --> 00:11:00,701 All right. Thanks. 227 00:11:00,702 --> 00:11:02,202 Santos, I need you to pick up some more 228 00:11:02,203 --> 00:11:03,662 of these Westbridge diversions. - Sure. 229 00:11:03,663 --> 00:11:05,164 You want my firstborn too? 230 00:11:05,165 --> 00:11:07,332 Maybe. Will they know how to suture? 231 00:11:07,333 --> 00:11:09,001 Intubated neck wound, sats not great. 232 00:11:09,002 --> 00:11:11,003 We were diverted here. Is there a trauma room open? 233 00:11:11,004 --> 00:11:12,754 - Trauma 1! - What's the story? 234 00:11:12,755 --> 00:11:15,340 My buddy, Officer Hiro, high-velocity GSW. 235 00:11:15,341 --> 00:11:16,717 He's getting harder to bag. 236 00:11:16,718 --> 00:11:19,511 Warehouse robbery gone sideways. 237 00:11:19,512 --> 00:11:20,679 One, two, three. 238 00:11:20,680 --> 00:11:22,181 You guys wait here. 239 00:11:22,182 --> 00:11:23,932 We'll take care of him, I promise. 240 00:11:23,933 --> 00:11:25,601 I thought you left us already for the open road? 241 00:11:25,602 --> 00:11:27,227 And miss seeing you in uniform? 242 00:11:27,228 --> 00:11:29,062 You should see me as a flight attendant. 243 00:11:29,063 --> 00:11:31,106 - Did you do this intubation? - Under active fire, yeah. 244 00:11:31,107 --> 00:11:32,858 Are you serious? 245 00:11:32,859 --> 00:11:34,318 I go in with the team in case there's an injury. 246 00:11:34,319 --> 00:11:35,944 That's badass. 247 00:11:35,945 --> 00:11:37,613 Dr. Santos, let's make sure these lungs are up. 248 00:11:37,614 --> 00:11:39,364 Could you see the cords? - Yeah, there was a great view, 249 00:11:39,365 --> 00:11:40,991 but it was hard to pass after I cleared them. 250 00:11:40,992 --> 00:11:42,951 Yeah, sats down to 85. 251 00:11:42,952 --> 00:11:44,912 Dr. Santos, what could cause respiratory failure 252 00:11:44,913 --> 00:11:46,580 in an intubated patient? 253 00:11:46,581 --> 00:11:47,789 There are a lot of possibilities. 254 00:11:47,790 --> 00:11:49,333 Think DOPE. 255 00:11:49,334 --> 00:11:51,585 Displacement, Obstruction, Pneumothorax, 256 00:11:51,586 --> 00:11:52,961 Equipment failure. 257 00:11:52,962 --> 00:11:55,464 Good lung sliding, no pneumo. 258 00:11:55,465 --> 00:11:57,090 It is displacement. 259 00:11:57,091 --> 00:11:59,509 Okay, that is a transected trachea. 260 00:12:01,429 --> 00:12:03,472 Pulling out. 261 00:12:03,473 --> 00:12:05,265 Bag. 262 00:12:05,266 --> 00:12:06,642 But if you intubate again, won't it just come straight 263 00:12:06,643 --> 00:12:08,101 out the wound? - Yep, exactly. 264 00:12:08,102 --> 00:12:09,436 So we're gonna need another plan. 265 00:12:09,437 --> 00:12:11,271 Okay. Sats down to 83. 266 00:12:11,272 --> 00:12:12,731 Yeah, he's not moving any air. 267 00:12:12,732 --> 00:12:14,608 Okay, I need a neonatal mask. 268 00:12:14,609 --> 00:12:17,236 - Neonatal? - Yep. 269 00:12:17,237 --> 00:12:19,738 I'm just going to finish my initial exam. 270 00:12:19,739 --> 00:12:21,658 Let me know if you feel any pain, okay? 271 00:12:25,620 --> 00:12:28,288 My legs are fine. 272 00:12:28,289 --> 00:12:29,998 All looks good. 273 00:12:29,999 --> 00:12:32,417 No need for X-rays or advanced imaging. 274 00:12:32,418 --> 00:12:34,002 Got it. 275 00:12:34,003 --> 00:12:36,463 - Two areas of ecchymosis... - That means bruising. 276 00:12:36,464 --> 00:12:38,173 Over the shoulders bilaterally. 277 00:12:38,174 --> 00:12:39,967 - I'll document with photos. - Okay. 278 00:12:39,968 --> 00:12:41,969 Dana will finish up her work, and I will be in the ER 279 00:12:41,970 --> 00:12:43,637 if you have any questions. 280 00:12:43,638 --> 00:12:45,180 You're in great hands. 281 00:12:45,181 --> 00:12:47,808 Thank you. 282 00:12:47,809 --> 00:12:50,143 All right, Ilana. 283 00:12:50,144 --> 00:12:52,145 I read your intake. 284 00:12:52,146 --> 00:12:53,480 Why don't you give me your description 285 00:12:53,481 --> 00:12:54,899 of exactly what happened? 286 00:12:57,986 --> 00:13:02,030 I was at a 4th of July barbecue 287 00:13:02,031 --> 00:13:04,825 with a bunch of friends. 288 00:13:04,826 --> 00:13:07,619 I helped set up. 289 00:13:15,003 --> 00:13:16,628 Where does it hurt? 290 00:13:16,629 --> 00:13:20,132 Like here, under my belly button. 291 00:13:20,133 --> 00:13:23,510 Okay, do you have any fever, vomiting, diarrhea? 292 00:13:23,511 --> 00:13:26,972 Oh, no. It's--it's just a stomachache. 293 00:13:26,973 --> 00:13:28,974 Okay, well, still, go see the nurse and have her call me. 294 00:13:28,975 --> 00:13:30,684 Okay. 295 00:13:30,685 --> 00:13:33,145 But I'm still having ice cream tonight. 296 00:13:33,146 --> 00:13:35,314 Why don't you see how you feel later? 297 00:13:35,315 --> 00:13:38,734 It--it's not bad. You don't have to get so sad. 298 00:13:38,735 --> 00:13:41,111 I'm not sad. I'm--I'm good. 299 00:13:41,112 --> 00:13:43,363 Your face doesn't look good. 300 00:13:43,364 --> 00:13:44,948 Oh. 301 00:13:44,949 --> 00:13:47,034 Well, you still wanna watch the fireworks tonight? 302 00:13:47,035 --> 00:13:48,243 {\an8}I have our headphones-- 303 00:13:49,954 --> 00:13:52,457 {\an8}- I'm not being rude. - Sorry, Becca. I gotta go. 304 00:13:58,504 --> 00:14:01,715 Elliot Green, 17, syncopal episode at football practice. 305 00:14:01,716 --> 00:14:03,633 Look, I just got dizzy, okay? 306 00:14:03,634 --> 00:14:05,093 It's hell week. I need to get back. 307 00:14:05,094 --> 00:14:07,054 Yeah, okay, tough guy. 308 00:14:07,055 --> 00:14:10,932 A and O, systolic of 95, tachy at 122, no meds, no allergies. 309 00:14:10,933 --> 00:14:12,559 How long were you at practice? 310 00:14:12,560 --> 00:14:15,020 I started at 9:00, so, like, four hours. 311 00:14:15,021 --> 00:14:17,397 Four hours in this heat with all that gear? 312 00:14:17,398 --> 00:14:19,400 No pain, no game. 313 00:14:21,444 --> 00:14:23,905 God, I'm hungry. 314 00:14:25,740 --> 00:14:29,076 Hey. When's our break? - There's no breaks down here. 315 00:14:29,077 --> 00:14:32,037 Always make sure you pack a protein bar, something quick. 316 00:14:32,038 --> 00:14:35,916 Ogilvie, Joy, jump in on this. 317 00:14:35,917 --> 00:14:37,459 Syncope at football practice. 318 00:14:37,460 --> 00:14:40,587 No, I just-- I just needed to hydrate. 319 00:14:40,588 --> 00:14:42,005 Possible heatstroke? 320 00:14:42,006 --> 00:14:43,173 Well, with heatstroke, you would have 321 00:14:43,174 --> 00:14:44,633 an altered mental status. 322 00:14:44,634 --> 00:14:46,134 And they're usually dry, not sweaty. 323 00:14:46,135 --> 00:14:47,969 Mortality is 50%, especially in the elderly. 324 00:14:47,970 --> 00:14:50,056 In extreme heat like this... 325 00:14:51,265 --> 00:14:52,766 Langdon, can you cover this? 326 00:14:52,767 --> 00:14:55,185 - No problem. - Mr. Diaz. Orlando. 327 00:14:55,186 --> 00:14:57,145 Orlando, where are you going? 328 00:14:57,146 --> 00:14:59,022 - Home. Can you take these out? - Uh, no. 329 00:14:59,023 --> 00:15:01,108 It takes 48 hours for you to get out of DKA. 330 00:15:01,109 --> 00:15:02,943 Your blood is still full of acid. 331 00:15:02,944 --> 00:15:04,444 Look, I can't add thousands of dollars 332 00:15:04,445 --> 00:15:05,779 to the 100 grand I already owe. 333 00:15:05,780 --> 00:15:07,697 I'm--I'm sorry. 100 grand? 334 00:15:07,698 --> 00:15:09,950 In medical debt. My wife doesn't even know. 335 00:15:09,951 --> 00:15:11,952 I'll never be able to pay it off as it is. 336 00:15:11,953 --> 00:15:13,120 Where are your wife and daughter? 337 00:15:13,121 --> 00:15:14,663 Maybe we can all talk. 338 00:15:14,664 --> 00:15:16,289 I told them to go back to work a couple hours ago. 339 00:15:16,290 --> 00:15:17,916 But the hospital is giving you a big discount. 340 00:15:17,917 --> 00:15:19,668 And, Mr. Diaz, I know it's not ideal, 341 00:15:19,669 --> 00:15:21,461 but can you stay for at least 12 hours? 342 00:15:21,462 --> 00:15:23,088 It would get you out of the danger zone. 343 00:15:23,089 --> 00:15:25,799 No. I really can't. 344 00:15:25,800 --> 00:15:29,177 Every minute I stay is a meal, shoes, school supplies. 345 00:15:29,178 --> 00:15:31,680 Plus, I have a second job I have to get to by 4:00. 346 00:15:31,681 --> 00:15:34,683 - You need fluids! - I drink plenty of water. 347 00:15:34,684 --> 00:15:37,102 And potassium and insulin. Okay, how about this? 348 00:15:37,103 --> 00:15:39,813 You stay and I'll get together everything you'll need at home. 349 00:15:39,814 --> 00:15:44,025 Also, a referral to Northside Christian Health Center. 350 00:15:44,026 --> 00:15:46,486 Come on. You don't work until 4:00. 351 00:15:46,487 --> 00:15:48,989 It'll keep you from passing out on the job again-- 352 00:15:48,990 --> 00:15:50,199 or worse. 353 00:15:54,245 --> 00:15:55,745 Okay, I guess. 354 00:15:55,746 --> 00:15:56,997 Great. 355 00:15:56,998 --> 00:15:58,832 Thank you. Please. 356 00:16:02,170 --> 00:16:03,962 Sats up to 98. 357 00:16:03,963 --> 00:16:06,548 - Neonatal mask is working. - Santos, finish the FAST. 358 00:16:06,549 --> 00:16:07,757 What--what are you injecting? 359 00:16:07,758 --> 00:16:09,176 Lido with epi. 360 00:16:09,177 --> 00:16:10,635 It'll clamp off any little bleeders. 361 00:16:10,636 --> 00:16:12,220 We need some skin hooks. 4 Shiley? 362 00:16:12,221 --> 00:16:14,556 Mm, I don't like the curve of a Shiley. 363 00:16:14,557 --> 00:16:16,141 I didn't know you were so picky. 364 00:16:16,142 --> 00:16:17,309 Santos, take a break. 365 00:16:17,310 --> 00:16:19,352 Help me cut down a 6-0 ET tube. 366 00:16:19,353 --> 00:16:20,854 What is going on here? 367 00:16:20,855 --> 00:16:22,481 You have a field medic assisting you? 368 00:16:22,482 --> 00:16:23,857 Dr. Abbot is an attending, 369 00:16:23,858 --> 00:16:25,525 and he's also a SWAT physician. 370 00:16:25,526 --> 00:16:28,653 My buddy Hiro here is in bad need of an airway. 371 00:16:28,654 --> 00:16:29,905 Cut it right here. - We can do this. 372 00:16:29,906 --> 00:16:31,239 No, no, I got it. 373 00:16:31,240 --> 00:16:32,365 You must be Gloria's new hire. 374 00:16:32,366 --> 00:16:33,992 Yes. Dr. Al-Hashimi. 375 00:16:33,993 --> 00:16:36,077 Well, I'd shake your hand, but my tube is ready. 376 00:16:36,078 --> 00:16:37,746 And if I could find and secure the distal trachea, 377 00:16:37,747 --> 00:16:39,206 we have a shot at this. 378 00:16:39,207 --> 00:16:41,583 Okay, keeping an eye on the sats. 379 00:16:41,584 --> 00:16:43,835 Slow is smooth. Smooth is fast. 380 00:16:43,836 --> 00:16:46,046 You know, you can call me just to say hi sometimes. 381 00:16:46,047 --> 00:16:47,380 What's up now? 382 00:16:47,381 --> 00:16:48,965 GSW with tracheal transection. 383 00:16:48,966 --> 00:16:52,385 Very retracted, but I think I can get it. 384 00:16:52,386 --> 00:16:54,095 Both lungs are up? 385 00:16:54,096 --> 00:16:56,306 - Sats down to 91. - Scanning the belly now. 386 00:16:56,307 --> 00:16:57,767 Okay. 387 00:16:59,435 --> 00:17:01,062 I got it. I got it. 388 00:17:04,190 --> 00:17:06,066 Gently, gently, or we're gonna lose it. 389 00:17:06,067 --> 00:17:07,901 Down to 89. 390 00:17:07,902 --> 00:17:09,069 Oh, no. 391 00:17:09,070 --> 00:17:10,947 I'm in. Balloon up. 392 00:17:13,074 --> 00:17:15,742 End tidal, excellent wave form. 393 00:17:15,743 --> 00:17:18,036 Good breath sounds. 394 00:17:18,037 --> 00:17:21,414 I'll sew the tracheal to the skin, 2-0 silk. 395 00:17:21,415 --> 00:17:23,124 - Sats are coming up. - Whoo. 396 00:17:23,125 --> 00:17:25,710 Not bad, Abbot. 397 00:17:25,711 --> 00:17:27,796 Mm, while you were playing with that airway, 398 00:17:27,797 --> 00:17:29,798 you missed a big bruise in the left upper quadrant. 399 00:17:29,799 --> 00:17:31,258 He was wearing body armor. 400 00:17:31,259 --> 00:17:32,425 High-velocity projectile doesn't have 401 00:17:32,426 --> 00:17:34,594 to penetrate to damage. 402 00:17:34,595 --> 00:17:36,930 There's no fluid in the suprasplenic space. 403 00:17:36,931 --> 00:17:39,099 Let me look. 404 00:17:39,100 --> 00:17:40,268 Okay, right there. 405 00:17:42,770 --> 00:17:45,105 Looks like a subcapsular hematoma of his spleen. 406 00:17:45,106 --> 00:17:46,731 Must have been a big impact. 407 00:17:46,732 --> 00:17:49,484 AR-15 muzzle velocity is 3,000 feet per second. 408 00:17:49,485 --> 00:17:51,111 CT angio of the neck ASAP, 409 00:17:51,112 --> 00:17:53,697 along with CT chest, abdomen, pelvis. 410 00:17:53,698 --> 00:17:56,659 Yep, just as soon as we secure this tube. 411 00:18:00,454 --> 00:18:02,956 - First liter's in. - Mucous membranes dry. 412 00:18:02,957 --> 00:18:05,125 Pupils 4 millimeters reactive. 413 00:18:05,126 --> 00:18:06,501 Did you get tackled today? 414 00:18:06,502 --> 00:18:07,961 No, just running drills. 415 00:18:07,962 --> 00:18:09,796 Any chest pain? Palpitations? 416 00:18:09,797 --> 00:18:11,256 No. 417 00:18:11,257 --> 00:18:12,507 Hands off, please, running the 12 lead. 418 00:18:12,508 --> 00:18:14,050 How are we looking? 419 00:18:14,051 --> 00:18:15,677 Good. Healthy kid. 420 00:18:15,678 --> 00:18:17,304 No history, no trauma. 421 00:18:17,305 --> 00:18:20,181 Differential for syncope in an adolescent? 422 00:18:20,182 --> 00:18:22,350 Cardiac arrhythmia from drugs... 423 00:18:22,351 --> 00:18:23,518 - Hypovolemia, seizure... - Long QT, WPW... 424 00:18:23,519 --> 00:18:25,270 - Sepsis. - Or Brugada. 425 00:18:25,271 --> 00:18:27,480 Uh, Brugada is more common in Asian males. 426 00:18:27,481 --> 00:18:28,940 But still should be considered. 427 00:18:28,941 --> 00:18:30,609 Long odds, though. 428 00:18:30,610 --> 00:18:32,485 Brugada prevalence is 1 in 20,000 in North America, 429 00:18:32,486 --> 00:18:35,155 as high as 1 in 300 in Asia and the Middle East. 430 00:18:35,156 --> 00:18:36,656 And? 431 00:18:36,657 --> 00:18:38,867 First described in 1992, has a high incidence 432 00:18:38,868 --> 00:18:40,660 of sudden death among young patients with otherwise 433 00:18:40,661 --> 00:18:43,163 structurally normal hearts-- - Oof, oof, wait. 434 00:18:43,164 --> 00:18:44,664 Did you just say "sudden death"? 435 00:18:44,665 --> 00:18:46,291 Temp is 102.5. 436 00:18:46,292 --> 00:18:47,667 Sorry, our student doctors are discussing 437 00:18:47,668 --> 00:18:50,170 a rare condition you don't have. 438 00:18:50,171 --> 00:18:53,256 I--I just didn't drink enough water. 439 00:18:53,257 --> 00:18:56,259 I overheated. 440 00:18:56,260 --> 00:18:58,011 Not my type, bud. 441 00:18:58,012 --> 00:19:00,890 Other than standard labs, what else to order? 442 00:19:04,518 --> 00:19:06,394 CK to rule out rhabdo. 443 00:19:06,395 --> 00:19:07,687 To make sure you don't have 444 00:19:07,688 --> 00:19:09,230 any muscle breakdown from the heat. 445 00:19:09,231 --> 00:19:11,399 Let's set up a cooling room for Elliot here 446 00:19:11,400 --> 00:19:14,403 and the other heat exhaustions we'll inevitably get today. 447 00:19:18,199 --> 00:19:19,949 Last photo. 448 00:19:23,871 --> 00:19:25,163 Okay. 449 00:19:25,164 --> 00:19:27,415 We'll take the SD card and seal it 450 00:19:27,416 --> 00:19:30,543 in an evidence envelope with everything else. 451 00:19:30,544 --> 00:19:32,045 Okay. 452 00:19:32,046 --> 00:19:36,049 Next, Emma's gonna turn off the light, 453 00:19:36,050 --> 00:19:38,593 and I'll run a blue light over your skin. 454 00:19:38,594 --> 00:19:44,057 Anything glows, I'll swab it with a wet, then dry Q-tip. 455 00:19:44,058 --> 00:19:45,266 Is that okay? 456 00:19:45,267 --> 00:19:46,310 Yeah, sure. 457 00:19:48,896 --> 00:19:50,230 All right. 458 00:19:50,231 --> 00:19:52,440 Take off your gown on the left side 459 00:19:52,441 --> 00:19:54,819 and turn a little bit towards me, just to the left. 460 00:19:56,821 --> 00:19:58,197 There. 461 00:20:22,930 --> 00:20:24,556 Something on the left wrist. 462 00:20:24,557 --> 00:20:25,641 Swab. 463 00:20:33,107 --> 00:20:34,149 Sorry. 464 00:20:34,150 --> 00:20:35,567 Don't be. 465 00:20:35,568 --> 00:20:37,277 - It's just cold. - Yeah. 466 00:20:37,278 --> 00:20:38,946 Almost done. 467 00:20:45,453 --> 00:20:47,746 - Thanks, Antoine. - No problem. 468 00:20:47,747 --> 00:20:49,289 Keep your head down out there. 469 00:20:49,290 --> 00:20:50,957 What's the story? 470 00:20:50,958 --> 00:20:52,500 Neck angio is negative, missed the carotids. 471 00:20:52,501 --> 00:20:54,419 - He's lucky. - What about the belly? 472 00:20:54,420 --> 00:20:57,213 Small splenic injury, no free fluid in the abdomen. 473 00:20:57,214 --> 00:20:59,048 - That should heal on its own. - What's the plan? 474 00:20:59,049 --> 00:21:00,467 Head and Neck will have an OR ready 475 00:21:00,468 --> 00:21:01,801 with thoracic standing by. 476 00:21:01,802 --> 00:21:03,595 How soon can they take him? 477 00:21:03,596 --> 00:21:04,971 We're a little backed up with Westbridge patients, 478 00:21:04,972 --> 00:21:06,347 but let's bring him up. 479 00:21:06,348 --> 00:21:08,683 I'll get him taken care of for you. 480 00:21:08,684 --> 00:21:10,560 Hey. 481 00:21:10,561 --> 00:21:13,646 You're gonna be okay, Hiro. We're getting you to surgery. 482 00:21:13,647 --> 00:21:14,647 I'll write the procedure note. 483 00:21:14,648 --> 00:21:15,691 Thank you. 484 00:21:20,821 --> 00:21:21,905 SWAT? Really? 485 00:21:21,906 --> 00:21:24,032 I suck at golf. 486 00:21:24,033 --> 00:21:26,326 You spend time in the Middle East? 487 00:21:26,327 --> 00:21:28,036 More than I would have liked. 488 00:21:28,037 --> 00:21:30,830 I worked in Kabul with Médecins Sans Frontières 489 00:21:30,831 --> 00:21:33,625 and in 2020, at the maternity hospital. 490 00:21:33,626 --> 00:21:37,212 I met the most incredible, bravest doctors there. 491 00:21:37,213 --> 00:21:39,506 Dasht-e-Barchi. 492 00:21:39,507 --> 00:21:42,300 Tragedy. 493 00:21:42,301 --> 00:21:45,345 We should grab a beer sometime, share war stories. 494 00:21:45,346 --> 00:21:47,348 I'd like that. 495 00:21:50,476 --> 00:21:51,476 She seems cool. 496 00:21:51,477 --> 00:21:53,186 Yep, maybe. 497 00:21:53,187 --> 00:21:56,815 I'm not gonna be around long enough to find out. 498 00:21:56,816 --> 00:21:58,942 Oh, there she is! Vic! 499 00:21:58,943 --> 00:22:00,235 Dad! 500 00:22:00,236 --> 00:22:03,530 Victoria, this is Dr. Amy Joon. 501 00:22:03,531 --> 00:22:05,406 Dr. Joon is the smartest person I know. 502 00:22:05,407 --> 00:22:06,699 Don't tell your mother. Just kidding. 503 00:22:08,077 --> 00:22:09,118 But seriously, don't. 504 00:22:09,119 --> 00:22:10,537 - Hi. - Hello. 505 00:22:10,538 --> 00:22:12,705 Are--are you here to see a patient? 506 00:22:12,706 --> 00:22:14,290 No. We're here to see you. 507 00:22:14,291 --> 00:22:15,708 Dr. Joon is Chief of Dermatology. 508 00:22:15,709 --> 00:22:17,293 And Victoria's first shift in the ER 509 00:22:17,294 --> 00:22:20,213 was on the day of the PittFest shooting. 510 00:22:20,214 --> 00:22:22,298 I heard all the incredible stories, 511 00:22:22,299 --> 00:22:26,135 including your own acts of med student prowess. 512 00:22:26,136 --> 00:22:27,887 Wow, med student prowess. 513 00:22:27,888 --> 00:22:30,056 That's-- I'm--I'm pretty sure 514 00:22:30,057 --> 00:22:31,683 I was just trying to stay out of the way. 515 00:22:31,684 --> 00:22:32,934 Ah, she's modest, like her dad. 516 00:22:32,935 --> 00:22:34,686 And her mother? 517 00:22:34,687 --> 00:22:36,896 Oh. Sorry. 518 00:22:36,897 --> 00:22:38,731 Dr. Joon. 519 00:22:38,732 --> 00:22:40,775 Yep, coming. 520 00:22:40,776 --> 00:22:42,861 I'm doing a favor for someone at the mayor's office 521 00:22:42,862 --> 00:22:45,738 who needs Mohs surgery on a basal cell carcinoma. 522 00:22:45,739 --> 00:22:47,740 And then I am grilling for 30. 523 00:22:47,741 --> 00:22:49,742 - Oh, wow. - Happy 4th, all. 524 00:22:49,743 --> 00:22:51,077 - Happy 4th. - Yeah. 525 00:22:51,078 --> 00:22:53,288 - Thanks for coming down. - My pleasure. 526 00:22:53,289 --> 00:22:55,373 Let's grab a coffee sometime. - Absolutely. Yes. 527 00:22:55,374 --> 00:22:57,876 Thank you. 528 00:22:57,877 --> 00:23:00,295 You know Mom really wants me to go into surgery. 529 00:23:00,296 --> 00:23:02,255 Ah, your mom wants me to stop drinking 530 00:23:02,256 --> 00:23:04,591 and join a pickleball league. - Oh, that's the same. 531 00:23:04,592 --> 00:23:06,301 - Yeah, well-- - Exact same. 532 00:23:06,302 --> 00:23:08,761 I will risk an Achilles tear before I give up scotch. 533 00:23:08,762 --> 00:23:10,597 Hey, I hope I didn't embarrass you coming down here. 534 00:23:10,598 --> 00:23:12,181 No. 535 00:23:12,182 --> 00:23:13,808 I'm just trying to present you with some options 536 00:23:13,809 --> 00:23:15,435 for your residency. 537 00:23:15,436 --> 00:23:17,353 I--I really appreciate it, Dad. 538 00:23:17,354 --> 00:23:19,606 I do. I just-- 539 00:23:19,607 --> 00:23:21,774 I'm still not sure. 540 00:23:21,775 --> 00:23:23,443 Well, either way, you'll do what's right. 541 00:23:23,444 --> 00:23:24,777 You always do. 542 00:23:24,778 --> 00:23:26,779 Proud of ya. - Okay. 543 00:23:26,780 --> 00:23:29,365 Dr. Javadi, you are a man of many talents. 544 00:23:29,366 --> 00:23:31,117 You don't know the half of it. 545 00:23:31,118 --> 00:23:32,285 Your daughter has some 546 00:23:32,286 --> 00:23:33,912 high standards to live up to. 547 00:23:33,913 --> 00:23:36,457 Oh, you don't know the half of it. 548 00:23:39,627 --> 00:23:42,837 Mr. and Mrs. Davis, this is Dr. Jefferson from Psychiatry. 549 00:23:42,838 --> 00:23:44,839 Please call me Caleb. 550 00:23:44,840 --> 00:23:47,300 Can you tell us what's going on with our son? 551 00:23:47,301 --> 00:23:51,137 All of his labs and X-rays came back normal. 552 00:23:51,138 --> 00:23:54,849 Given his age and his hearing voices, 553 00:23:54,850 --> 00:23:59,354 do either of you have a family history of mental illness? 554 00:23:59,355 --> 00:24:00,689 Not mine. 555 00:24:07,655 --> 00:24:09,322 My brother took his own life. 556 00:24:09,323 --> 00:24:11,658 Wait, what? 557 00:24:11,659 --> 00:24:13,993 Uncle Ken? 558 00:24:13,994 --> 00:24:15,828 You said he drank himself to death. 559 00:24:15,829 --> 00:24:17,664 Ma. - He did that too. 560 00:24:17,665 --> 00:24:18,957 Was he ever formally diagnosed 561 00:24:18,958 --> 00:24:20,041 with a mental health issue? 562 00:24:20,042 --> 00:24:21,501 No. 563 00:24:21,502 --> 00:24:24,629 He was depressed, had mood swings. 564 00:24:24,630 --> 00:24:26,381 But he didn't wanna see anyone. - Oh, my God. 565 00:24:26,382 --> 00:24:28,508 Okay, why am I just now hearing about this? 566 00:24:28,509 --> 00:24:30,927 - Jada, please. - Please what, Mom? 567 00:24:30,928 --> 00:24:33,846 Why would you not tell Jackson or me? 568 00:24:33,847 --> 00:24:35,306 I can't believe this. 569 00:24:35,307 --> 00:24:36,975 - Jada. - Excuse me. 570 00:24:36,976 --> 00:24:38,018 Jada. 571 00:24:45,693 --> 00:24:47,694 What happens next? 572 00:24:47,695 --> 00:24:49,988 We keep your son here for the next three days 573 00:24:49,989 --> 00:24:52,073 for observation and therapy. 574 00:24:52,074 --> 00:24:54,575 And that will help us to understand what is going on. 575 00:24:54,576 --> 00:24:56,202 Jada should really hear this. 576 00:24:56,203 --> 00:24:58,747 Let me see if I can find her, bring her back. 577 00:25:01,709 --> 00:25:04,043 Okay. I'm gonna swab your mouth now. 578 00:25:04,044 --> 00:25:05,878 My mouth? 579 00:25:05,879 --> 00:25:09,757 Two dry swabs along the inside of your cheek 580 00:25:09,758 --> 00:25:11,677 and then along the gum line. 581 00:25:15,472 --> 00:25:17,349 How you feeling? 582 00:25:19,226 --> 00:25:21,269 I wish this day never happened. 583 00:25:21,270 --> 00:25:23,271 Would you like some medicine to help you relax? 584 00:25:23,272 --> 00:25:25,232 You've experienced a horrific trauma. 585 00:25:27,943 --> 00:25:29,902 You've been doing this a while? 586 00:25:29,903 --> 00:25:31,237 Let's just say Florence Nightingale 587 00:25:31,238 --> 00:25:33,281 and I were roommates. 588 00:25:33,282 --> 00:25:35,783 Who? 589 00:25:35,784 --> 00:25:37,452 I rest my case. 590 00:25:37,453 --> 00:25:39,496 She was the founder of modern nursing. 591 00:25:41,707 --> 00:25:43,958 Okay, you can have something to eat or drink now. 592 00:25:43,959 --> 00:25:45,960 - I'm fine. - Are you sure? 593 00:25:45,961 --> 00:25:47,712 I'll just keep going. 594 00:25:47,713 --> 00:25:49,590 Okay. 595 00:25:56,597 --> 00:26:01,267 We now have a heat exhaustion treatment area in North 5. 596 00:26:01,268 --> 00:26:03,770 Evaporated cooling. Great plan. 597 00:26:03,771 --> 00:26:08,649 Yeah, it was Dr. Langdon's idea. 598 00:26:08,650 --> 00:26:12,320 He figured we'd be seeing a lot more patients in this heat. 599 00:26:12,321 --> 00:26:14,113 He's right. 600 00:26:14,114 --> 00:26:15,364 How are you feeling? 601 00:26:15,365 --> 00:26:17,825 That's a loaded question. 602 00:26:17,826 --> 00:26:19,994 It wasn't meant to be. 603 00:26:19,995 --> 00:26:22,205 You have a deposition in a couple of hours? 604 00:26:22,206 --> 00:26:24,457 - Yes. - How are you feeling about it? 605 00:26:24,458 --> 00:26:26,459 Um, trying to think positively 606 00:26:26,460 --> 00:26:29,670 but feeling, um, less so. 607 00:26:29,671 --> 00:26:31,881 This job's really important to me and my sister. 608 00:26:31,882 --> 00:26:33,382 You know, I support both of us. 609 00:26:33,383 --> 00:26:34,509 It's gonna go great. 610 00:26:34,510 --> 00:26:36,302 Just tell them what happened. 611 00:26:36,303 --> 00:26:37,845 You're not at fault. Your job's not in jeopardy. 612 00:26:37,846 --> 00:26:39,972 I mean, the lawyers said that I could-- 613 00:26:39,973 --> 00:26:42,141 The lawyers' job is to try and shake your confidence. 614 00:26:42,142 --> 00:26:44,519 So don't let them. You're a very good doctor. 615 00:26:44,520 --> 00:26:46,646 I have been training residents for years. 616 00:26:46,647 --> 00:26:49,190 You are one of the very best. 617 00:26:49,191 --> 00:26:50,650 I am? 618 00:26:50,651 --> 00:26:51,776 No, we need to stick to the plan. 619 00:26:51,777 --> 00:26:52,819 - I promise. - Look. 620 00:26:52,820 --> 00:26:54,195 Thanks. 621 00:26:54,196 --> 00:26:55,488 She's not thinking clearly, okay? 622 00:26:55,489 --> 00:26:56,656 It's gonna be great. 623 00:26:56,657 --> 00:26:57,990 This is not what she wants. 624 00:26:57,991 --> 00:26:59,826 Then I'm taking her home. That's it. 625 00:26:59,827 --> 00:27:01,828 We have to honor your wife's wishes. 626 00:27:01,829 --> 00:27:03,329 Even if she's loaded up on morphine 627 00:27:03,330 --> 00:27:04,997 and can't think straight? - Especially then. 628 00:27:04,998 --> 00:27:06,791 Hello. 629 00:27:06,792 --> 00:27:08,709 Paul Hamler, this is my attending, Dr. Robinavitch. 630 00:27:08,710 --> 00:27:10,169 - Hi. - Hi. 631 00:27:10,170 --> 00:27:12,672 Uh, my wife is not thinking clearly. 632 00:27:12,673 --> 00:27:15,174 What is it that she's asking for? 633 00:27:15,175 --> 00:27:17,426 Said she wants to stay here. 634 00:27:17,427 --> 00:27:19,221 Why don't we all go in and talk? 635 00:27:20,681 --> 00:27:22,682 Brian Jenkins is allowed to hunt with a .22 636 00:27:22,683 --> 00:27:24,267 on his grandpa's farm. 637 00:27:24,268 --> 00:27:26,269 Sounds like an accident just waiting to happen. 638 00:27:26,270 --> 00:27:28,855 Mm-hmm. And you're not Brian Jenkins. 639 00:27:28,856 --> 00:27:31,440 How are we doing in here, Roxie? 640 00:27:31,441 --> 00:27:33,192 Been better. 641 00:27:33,193 --> 00:27:34,735 Rumor has it you're still interested 642 00:27:34,736 --> 00:27:37,196 in booking a room with us? 643 00:27:37,197 --> 00:27:39,365 I don't wanna go back home yet. 644 00:27:39,366 --> 00:27:40,825 It's all set up, Rox. 645 00:27:40,826 --> 00:27:42,994 You're gonna be more comfortable at home. 646 00:27:42,995 --> 00:27:45,204 Paul, I changed my mind. 647 00:27:45,205 --> 00:27:46,456 It is our home. 648 00:27:48,500 --> 00:27:50,501 I don't-- 649 00:27:50,502 --> 00:27:52,336 I don't want you living with my ghost. 650 00:27:52,337 --> 00:27:54,338 I will happily live with your ghost. 651 00:27:54,339 --> 00:27:57,717 Can we just all stop talking about ghosts, please? 652 00:27:57,718 --> 00:27:59,051 Yes. I'm sorry. 653 00:27:59,052 --> 00:28:01,846 I'm sorry, sweetie. You're right. 654 00:28:01,847 --> 00:28:03,764 Got trauma flying in. ETA, five minutes. 655 00:28:03,765 --> 00:28:05,933 Okay. Um, I'm very sorry. 656 00:28:05,934 --> 00:28:07,393 I will be right back. 657 00:28:07,394 --> 00:28:09,937 Excuse me. 658 00:28:09,938 --> 00:28:12,148 It's a boating accident, swimmer versus propeller. 659 00:28:12,149 --> 00:28:13,649 Ouch. 660 00:28:13,650 --> 00:28:15,234 What body parts involved? - They didn't say. 661 00:28:15,235 --> 00:28:16,736 - How old? - Nope. 662 00:28:16,737 --> 00:28:18,070 Anything? 663 00:28:18,071 --> 00:28:19,572 All I got was boating accident, 664 00:28:19,573 --> 00:28:21,490 swimmer versus propeller. - Propeller. Got it. 665 00:28:52,397 --> 00:28:55,608 Picked a hell of a day to come back, huh? 666 00:28:55,609 --> 00:28:58,611 How's Jake? 667 00:28:58,612 --> 00:29:00,404 He's good. 668 00:29:00,405 --> 00:29:02,615 He's better. He's coping. 669 00:29:02,616 --> 00:29:04,617 He's gonna be a senior this fall. 670 00:29:04,618 --> 00:29:07,161 That's great. 671 00:29:07,162 --> 00:29:10,331 That was a lot for him to go through. 672 00:29:10,332 --> 00:29:12,291 A lot for all of us to go through. 673 00:29:12,292 --> 00:29:13,627 Yeah. 674 00:29:15,379 --> 00:29:17,380 Okay, I'm just gonna say it! 675 00:29:17,381 --> 00:29:18,881 I'm sorry. 676 00:29:18,882 --> 00:29:20,549 I betrayed your trust. 677 00:29:20,550 --> 00:29:22,510 I betrayed our patients' trust. 678 00:29:22,511 --> 00:29:23,886 And I'm really fucking sorry. 679 00:29:23,887 --> 00:29:26,098 It'll never happen again, I swear. 680 00:29:30,519 --> 00:29:34,022 I'm really glad that you got the help that you need. 681 00:29:36,775 --> 00:29:40,445 But I don't know if I want you working in my ER. 682 00:29:48,537 --> 00:29:49,870 Why'd you intubate him? 683 00:29:49,871 --> 00:29:51,330 He was splinting from the pain, 684 00:29:51,331 --> 00:29:52,873 barely moving air with sats in the 80s. 685 00:29:52,874 --> 00:29:54,166 How'd he get sliced up in the propeller? 686 00:29:54,167 --> 00:29:55,668 He was in the Allegheny 687 00:29:55,669 --> 00:29:57,044 trying to untangle a water ski tow line 688 00:29:57,045 --> 00:29:58,045 when his buddy started the engine. 689 00:29:58,046 --> 00:29:59,338 Drunk buddy, I assume? 690 00:29:59,339 --> 00:30:00,798 Well, it's 4th of July. You tell me. 691 00:30:00,799 --> 00:30:02,133 Focus on the patient, please. 692 00:30:02,134 --> 00:30:04,011 Sofie, take over bagging. 693 00:30:06,179 --> 00:30:08,347 Okay. One, two, three. 694 00:30:08,348 --> 00:30:09,349 Watch that buckle. 695 00:30:10,851 --> 00:30:12,226 - Do you need me in here? - Nope. 696 00:30:12,227 --> 00:30:14,854 We have a senior resident and an attending. 697 00:30:14,855 --> 00:30:16,188 Mel, can we start with a-- 698 00:30:16,189 --> 00:30:18,691 - An EFAST? Sure. - Yes, please. 699 00:30:18,692 --> 00:30:20,359 Why? 700 00:30:20,360 --> 00:30:21,736 To check and make sure there's no pneumothorax. 701 00:30:21,737 --> 00:30:23,362 Otherwise, it could become a tension. 702 00:30:23,363 --> 00:30:26,115 Exactly. Oh, wow. 703 00:30:26,116 --> 00:30:28,242 You want O-neg? - Not without a BP first. 704 00:30:28,243 --> 00:30:31,454 108/64, pulse is 102. 705 00:30:31,455 --> 00:30:33,706 Sats are good. - Okay, let's have O-neg ready, 706 00:30:33,707 --> 00:30:36,709 but don't give it just yet. - Anything else? 707 00:30:38,920 --> 00:30:40,504 How about a hemocue? 708 00:30:40,505 --> 00:30:42,549 Uh, yeah. Yeah, yeah, of course. 709 00:30:50,682 --> 00:30:52,309 Next step is fingernails. 710 00:30:54,227 --> 00:30:56,604 We'll go under each nail, 711 00:30:56,605 --> 00:31:00,941 first with the wet swab and then with the dry one. 712 00:31:00,942 --> 00:31:03,402 Do you wanna take a break, hon? 713 00:31:03,403 --> 00:31:05,155 No. 714 00:31:08,241 --> 00:31:11,410 How much longer? 715 00:31:11,411 --> 00:31:13,079 After these, we'll get to external... 716 00:31:14,414 --> 00:31:16,124 And internal vaginal collection. 717 00:31:19,753 --> 00:31:23,506 It's the advocate from PAAR. 718 00:31:23,507 --> 00:31:25,257 They've been doing this longer than I have. 719 00:31:25,258 --> 00:31:27,510 They provide resources, assistance, and support 720 00:31:27,511 --> 00:31:29,221 for sexual assault survivors. 721 00:31:31,431 --> 00:31:34,308 Hey. 722 00:31:34,309 --> 00:31:36,769 This will not define you, okay? 723 00:31:36,770 --> 00:31:40,439 You don't have to talk to them, but I recommend you do. 724 00:31:40,440 --> 00:31:42,317 They're available 24/7. 725 00:31:44,194 --> 00:31:46,405 - Okay. - Okay. 726 00:31:52,494 --> 00:31:54,412 Hi. 727 00:31:54,413 --> 00:31:56,622 I'm Paulette Sanderson from Pittsburgh Action Against Rape. 728 00:31:56,623 --> 00:31:58,749 Hi, Paulette. I'm the SANE, Dana. 729 00:31:58,750 --> 00:32:00,835 And this is Ilana. - Hello. 730 00:32:00,836 --> 00:32:03,421 I'm sorry to meet you under these circumstances, 731 00:32:03,422 --> 00:32:05,423 but I and my organization are here to help you navigate 732 00:32:05,424 --> 00:32:07,466 everything that comes next. 733 00:32:07,467 --> 00:32:10,511 I brought you some clothes and basic necessities. 734 00:32:10,512 --> 00:32:12,138 I can even stay with you through the rest 735 00:32:12,139 --> 00:32:14,224 of your examination if you'd like. 736 00:32:16,518 --> 00:32:18,102 I don't think that's necessary. 737 00:32:18,103 --> 00:32:20,688 - Okay. - That's fine. 738 00:32:20,689 --> 00:32:23,233 Would it be okay if I asked you a few questions? 739 00:32:33,702 --> 00:32:35,077 Sure. 740 00:32:37,330 --> 00:32:40,833 Mm, our VRI isn't working. 741 00:32:40,834 --> 00:32:43,669 Video Relay Interpreter? 742 00:32:43,670 --> 00:32:45,212 Yeah, of course I rebooted it. 743 00:32:45,213 --> 00:32:46,839 Wait, how are you gonna fix it if you don't know 744 00:32:46,840 --> 00:32:48,924 what the hell it is? 745 00:32:48,925 --> 00:32:51,177 Yeah, okay. Whatever. 746 00:32:51,178 --> 00:32:53,179 I wanna do a head and belly scan on Harlow. 747 00:32:53,180 --> 00:32:54,388 Can you try telling her why? 748 00:32:54,389 --> 00:32:55,639 What about the VRI? 749 00:32:55,640 --> 00:32:57,641 It's DOA. 750 00:32:57,642 --> 00:33:00,561 I'm charting every free minute I get. 751 00:33:00,562 --> 00:33:02,396 I wasn't coming over for that. 752 00:33:02,397 --> 00:33:04,065 Good job in the Trauma earlier. 753 00:33:07,319 --> 00:33:08,402 What's this? 754 00:33:08,403 --> 00:33:09,737 Daniel Scott, 32, 755 00:33:09,738 --> 00:33:11,489 weak and dizzy while washing his car. 756 00:33:11,490 --> 00:33:13,991 Tachy at 106, BP 90/60. 757 00:33:13,992 --> 00:33:15,534 Temp's too high to register. 758 00:33:15,535 --> 00:33:17,161 We have a cooling room set up in North 5. 759 00:33:17,162 --> 00:33:18,245 Okay, how are you feeling, Mr. Scott? 760 00:33:18,246 --> 00:33:19,538 Thirsty. 761 00:33:19,539 --> 00:33:20,998 Let's see if we can't fix that. 762 00:33:20,999 --> 00:33:22,875 He's gonna need a core temp, a CMP--whoa. 763 00:33:22,876 --> 00:33:24,376 Oh, hey, we need a trauma room. 764 00:33:24,377 --> 00:33:25,586 What's open? - 2. 765 00:33:25,587 --> 00:33:27,213 I'll grab the Ativan. 766 00:33:27,214 --> 00:33:28,881 - Any past medical history? - No. 767 00:33:28,882 --> 00:33:30,633 Wife says he's healthy. No meds, no allergies. 768 00:33:30,634 --> 00:33:33,261 He needs a core temp. 769 00:33:37,390 --> 00:33:38,974 Ready to transfer. 770 00:33:38,975 --> 00:33:40,267 Let's give 2 of Ativan. 771 00:33:40,268 --> 00:33:41,769 Don't want him seizing again. 772 00:33:41,770 --> 00:33:42,978 I gotta get back to my patients. 773 00:33:42,979 --> 00:33:43,979 Okay. 774 00:33:43,980 --> 00:33:46,732 One, two, three. 775 00:33:46,733 --> 00:33:47,900 Orders? 776 00:33:47,901 --> 00:33:50,069 Second IV with saline open. 777 00:33:50,070 --> 00:33:53,405 Sepsis panel, UA, urine drug screen, EKG, and CK. 778 00:33:53,406 --> 00:33:55,407 I don't see any apparent trauma. 779 00:33:56,910 --> 00:33:59,620 Pupils reactive. - Mr. Scott? Daniel? 780 00:33:59,621 --> 00:34:01,288 Can you talk to me? 781 00:34:01,289 --> 00:34:02,957 Post-ictal, but moving all extremities. 782 00:34:02,958 --> 00:34:04,959 Pulse 137, BP 88/60. 783 00:34:04,960 --> 00:34:06,627 What are you thinking, Dr. Santos? 784 00:34:06,628 --> 00:34:09,464 Uh, heat stroke, but consider sepsis or drugs. 785 00:34:13,051 --> 00:34:16,554 Rectal temp is 104.6. 786 00:34:16,555 --> 00:34:18,556 All right, let's start with four ice packs 787 00:34:18,557 --> 00:34:20,391 on the groin and axilla. 788 00:34:20,392 --> 00:34:22,309 Should we do a full body ice bath? 789 00:34:22,310 --> 00:34:23,602 That'll take too long. Do you have an Arctic Sun? 790 00:34:23,603 --> 00:34:25,104 Yeah, we do. 791 00:34:25,105 --> 00:34:26,689 Get pads on the chest, abdomen, and both legs. 792 00:34:26,690 --> 00:34:28,191 I'll check back in. 793 00:34:29,985 --> 00:34:33,445 Ceftazidime is up, and first hemoglobin, 8.2. 794 00:34:33,446 --> 00:34:36,198 8 is pretty low. He must have bled down from 14. 795 00:34:36,199 --> 00:34:37,950 Anything you wanna do about that? 796 00:34:37,951 --> 00:34:40,703 Um, young, healthy guy. We transfuse at 7. 797 00:34:40,704 --> 00:34:42,371 Do we? 798 00:34:42,372 --> 00:34:44,123 We'd be in real trouble if he equilibrates 799 00:34:44,124 --> 00:34:46,292 from acute blood loss. - Am I interrupting something? 800 00:34:46,293 --> 00:34:48,545 - Multiple deep lacerations-- - Motorboat versus-- 801 00:34:51,298 --> 00:34:52,881 Jesus. 802 00:34:52,882 --> 00:34:54,550 This looks like some "Jurassic Park" shit. 803 00:34:54,551 --> 00:34:56,635 Is that your official surgical diagnosis? 804 00:34:56,636 --> 00:34:58,137 He is hemodynamically stable. 805 00:34:58,138 --> 00:35:00,639 What else do we know? 806 00:35:00,640 --> 00:35:04,310 Uh, intubated in the field due to poor tidal volume. 807 00:35:04,311 --> 00:35:06,520 EFAST was negative for pneumothorax, 808 00:35:06,521 --> 00:35:09,023 so no need to do a chest tube. 809 00:35:09,024 --> 00:35:11,775 And no free fluid in the abdomen, 810 00:35:11,776 --> 00:35:13,485 good hemostasis inside the wounds. 811 00:35:13,486 --> 00:35:14,987 Nothing arterial. 812 00:35:14,988 --> 00:35:16,614 At first, he had a hemoglobin of 8.2. 813 00:35:16,615 --> 00:35:18,282 We'll follow that closely. 814 00:35:18,283 --> 00:35:20,744 With no active bleeding, I wouldn't transfuse just yet. 815 00:35:23,163 --> 00:35:24,997 Dr. Langdon agrees with you. 816 00:35:24,998 --> 00:35:27,333 Let's get him to CT. 817 00:35:27,334 --> 00:35:29,752 Jason Stills, 62, was gathering the makings 818 00:35:29,753 --> 00:35:32,338 of a salad when he started feeling dizzy and nauseated. 819 00:35:32,339 --> 00:35:33,672 Vomited once. 820 00:35:33,673 --> 00:35:34,840 How are you feeling, Mr. Stills? 821 00:35:34,841 --> 00:35:36,675 Like I'm gonna die. 822 00:35:36,676 --> 00:35:38,677 Well, you came to the right place to prevent that. 823 00:35:38,678 --> 00:35:40,679 Do you mind if I touch your abdomen? 824 00:35:40,680 --> 00:35:42,848 - Yeah, sure. - Okay. 825 00:35:42,849 --> 00:35:45,267 Does this hurt at all? - No. 826 00:35:45,268 --> 00:35:48,520 He's tachycardic at 124 with a temp of 102.4. 827 00:35:48,521 --> 00:35:50,522 Hey, Joy, what's your suggestion? 828 00:35:50,523 --> 00:35:52,191 Keep hydrating, check electrolytes, 829 00:35:52,192 --> 00:35:53,233 and move him to the cooling room. 830 00:35:53,234 --> 00:35:54,526 Precisely. 831 00:35:54,527 --> 00:35:55,736 Good luck finding a parking spot. 832 00:35:55,737 --> 00:35:58,697 - North 5. - What? No valet? 833 00:36:02,702 --> 00:36:04,578 Jada. Hey. 834 00:36:04,579 --> 00:36:06,705 I--I've been looking all over for you. 835 00:36:06,706 --> 00:36:08,374 I just went for a walk. 836 00:36:08,375 --> 00:36:11,211 I wanted to talk to you, if that's okay. 837 00:36:13,213 --> 00:36:15,214 So does Dr. Jefferson. 838 00:36:15,215 --> 00:36:17,383 It's important that you get to hear what he has to say. 839 00:36:17,384 --> 00:36:18,842 Why? 840 00:36:18,843 --> 00:36:20,844 He doesn't want me to go crazy like my brother? 841 00:36:20,845 --> 00:36:23,597 Or kill myself like my uncle? 842 00:36:23,598 --> 00:36:25,891 Of course not. 843 00:36:25,892 --> 00:36:28,686 We--we still have no idea what caused Jackson's episode. 844 00:36:28,687 --> 00:36:31,271 Episode. 845 00:36:31,272 --> 00:36:33,565 Right. 846 00:36:33,566 --> 00:36:37,861 Look, I--I know this must be so scary for you. 847 00:36:37,862 --> 00:36:41,407 And you probably feel betrayed by your parents. 848 00:36:41,408 --> 00:36:44,326 But they had no way of knowing about Jackson. 849 00:36:44,327 --> 00:36:46,578 You know, and some families just have a difficult time 850 00:36:46,579 --> 00:36:50,082 talking about mental health. 851 00:36:50,083 --> 00:36:52,126 Now you can help us take the first steps 852 00:36:52,127 --> 00:36:55,255 to finding out what we can do to help your brother. 853 00:37:00,593 --> 00:37:05,806 Mr. Diaz, I have a surprise for you. 854 00:37:05,807 --> 00:37:07,641 Oh. 855 00:37:07,642 --> 00:37:08,934 Sorry. 856 00:37:08,935 --> 00:37:10,436 It's okay. 857 00:37:10,437 --> 00:37:12,271 Have you--have you seen my patient? 858 00:37:12,272 --> 00:37:14,940 Orlando? Mr. Diaz? 859 00:37:14,941 --> 00:37:17,317 Room was empty. 860 00:37:17,318 --> 00:37:20,279 - Seriously? - Yeah. 861 00:37:24,784 --> 00:37:26,452 What happened to you? 862 00:37:26,453 --> 00:37:28,412 Oh. 863 00:37:28,413 --> 00:37:29,788 Bullet grazed my vest. 864 00:37:29,789 --> 00:37:30,956 You were shot? 865 00:37:30,957 --> 00:37:32,833 Shot at. 866 00:37:32,834 --> 00:37:36,003 Geniuses thought today was the day to rob a goods warehouse. 867 00:37:36,004 --> 00:37:37,171 Didn't think about how long it would take 868 00:37:37,172 --> 00:37:38,505 to load the appliances. 869 00:37:38,506 --> 00:37:39,840 They panicked. 870 00:37:39,841 --> 00:37:41,049 All hell broke loose. 871 00:37:41,050 --> 00:37:42,719 Jesus. 872 00:37:45,180 --> 00:37:47,181 Why do you do this? 873 00:37:47,182 --> 00:37:49,224 My therapist said I needed a hobby. 874 00:37:49,225 --> 00:37:50,893 Funny. 875 00:37:50,894 --> 00:37:52,978 Shit. 876 00:37:52,979 --> 00:37:55,189 This--this sucks. 877 00:37:55,190 --> 00:37:56,982 - Oh, it's nothing. - No. 878 00:37:56,983 --> 00:37:59,193 No, don't worry about me. I'm fine. Seriously. 879 00:37:59,194 --> 00:38:00,486 No, my patient. 880 00:38:00,487 --> 00:38:02,279 He didn't have any insurance, 881 00:38:02,280 --> 00:38:06,533 and he was already in a mountain of medical debt. 882 00:38:06,534 --> 00:38:08,368 He couldn't afford any of his meds. 883 00:38:08,369 --> 00:38:10,788 Hmm. 884 00:38:10,789 --> 00:38:12,331 What's in the bag? 885 00:38:12,332 --> 00:38:17,294 Insulin, test strips, electrolyte powder. 886 00:38:17,295 --> 00:38:20,005 I--I got him everything he needed for home care. 887 00:38:20,006 --> 00:38:22,216 So Uber it to his house. 888 00:38:22,217 --> 00:38:24,551 Is the hospital gonna pay for that? 889 00:38:24,552 --> 00:38:26,596 I'll pay for it. 890 00:38:36,773 --> 00:38:38,857 What are you doing? 891 00:38:38,858 --> 00:38:41,527 What you clearly can't. 892 00:38:41,528 --> 00:38:43,195 Did you make a chart? 893 00:38:43,196 --> 00:38:44,613 No. 894 00:38:44,614 --> 00:38:46,198 This can stay off the books. 895 00:38:46,199 --> 00:38:48,116 Don't need the paperwork from the hospital 896 00:38:48,117 --> 00:38:49,910 or the police department. 897 00:38:49,911 --> 00:38:52,037 Okay. 898 00:38:52,038 --> 00:38:53,581 Our little secret. 899 00:38:57,210 --> 00:38:59,545 How's he doing? Any more seizures? 900 00:38:59,546 --> 00:39:00,712 Nope. 901 00:39:00,713 --> 00:39:02,047 Temp 102.9. 902 00:39:02,048 --> 00:39:03,382 Labs back? 903 00:39:03,383 --> 00:39:05,092 Mostly signs of dehydration. 904 00:39:05,093 --> 00:39:08,846 A tad hypernatremic, mild BUN and creatinine bump. 905 00:39:08,847 --> 00:39:11,265 CK 400 something-- nothing worrisome yet. 906 00:39:11,266 --> 00:39:12,891 Okay, good. Keep cooling. 907 00:39:12,892 --> 00:39:14,935 - I'll monitor him. - Great. 908 00:39:14,936 --> 00:39:17,772 That'll give Dr. Santos a chance to get caught up. 909 00:39:21,359 --> 00:39:23,944 Your R2 year can be challenging. 910 00:39:23,945 --> 00:39:26,905 You just have to keep grinding. 911 00:39:26,906 --> 00:39:28,907 What's your dispo plan for Mr. Scott? 912 00:39:28,908 --> 00:39:30,909 Uh, ICU admission. 913 00:39:30,910 --> 00:39:32,911 You should call Neurology to consult. 914 00:39:32,912 --> 00:39:34,705 Yeah, done. 915 00:39:34,706 --> 00:39:36,915 Since it was exertional heat illness in a young person, 916 00:39:36,916 --> 00:39:38,792 the mortality is low. 917 00:39:38,793 --> 00:39:41,670 But non-exertional heatstroke in an elderly person, 918 00:39:41,671 --> 00:39:43,755 you need to worry. - Okay. 919 00:39:43,756 --> 00:39:46,758 I'll put in orders for repeat labs. 920 00:39:46,759 --> 00:39:48,595 Good work in there. 921 00:40:01,816 --> 00:40:05,652 This 49-year-old woman presents to the emergency department-- 922 00:40:08,948 --> 00:40:13,619 Uh, with the chief complaint of right ear pain. 923 00:40:13,620 --> 00:40:16,288 Hey, Donnie, can you do something about that? 924 00:40:16,289 --> 00:40:17,748 What? 925 00:40:17,749 --> 00:40:19,291 Seriously? 926 00:40:19,292 --> 00:40:21,126 That--that's not driving you nuts? 927 00:40:21,127 --> 00:40:23,253 The baby, it won't stop crying. 928 00:40:23,254 --> 00:40:25,255 Oh, that? It's music to my ears now. 929 00:40:25,256 --> 00:40:26,632 I think Jesse's the nurse. 930 00:40:26,633 --> 00:40:29,301 Well, can't you--ugh. 931 00:40:35,308 --> 00:40:36,476 Fuck. 932 00:40:41,648 --> 00:40:44,024 What the hell is going on? 933 00:40:44,025 --> 00:40:46,485 With what? 934 00:40:46,486 --> 00:40:49,529 With her. Can't you make her stop crying? 935 00:40:49,530 --> 00:40:52,491 She's been fed and changed. She's cranky from rhinovirus. 936 00:40:54,160 --> 00:40:56,495 Isn't there something that you can do? 937 00:40:56,496 --> 00:40:59,081 She's due for her next Tylenol. 938 00:40:59,082 --> 00:41:00,499 Give me a minute. I'll be right back. 939 00:41:00,500 --> 00:41:02,668 Wait, no, no, no, I'm not gonna stay here. 940 00:41:05,380 --> 00:41:07,256 What is your problem? 941 00:41:10,218 --> 00:41:14,471 This is precisely why I didn't go into Pedes. 942 00:41:14,472 --> 00:41:15,639 Okay. 943 00:41:15,640 --> 00:41:17,557 Hey, hey. 944 00:41:17,558 --> 00:41:20,520 Hey, little Miss Sunshine. 945 00:41:22,188 --> 00:41:24,523 Is it time for you to take a little nap? 946 00:41:24,524 --> 00:41:26,650 That would be so fucking nice. 947 00:41:26,651 --> 00:41:28,026 Yes, it would. 948 00:41:31,322 --> 00:41:34,366 I'm starting to understand why you got left here. 949 00:41:34,367 --> 00:41:36,452 Hey, shh. 950 00:42:22,874 --> 00:42:24,583 What's the word from CT? 951 00:42:24,584 --> 00:42:27,586 Nothing intrathoracic, nothing intra-abdominal. 952 00:42:27,587 --> 00:42:28,920 Propeller just missed gutting him. 953 00:42:28,921 --> 00:42:30,380 - Very fortunate. - Okay. 954 00:42:30,381 --> 00:42:32,299 Repeat hemoglobin is 8. 955 00:42:32,300 --> 00:42:34,926 We're holding off on transfusing. 956 00:42:34,927 --> 00:42:36,762 Plan? 957 00:42:36,763 --> 00:42:38,805 I'll have Mel and Langdon suture up the lacerations. 958 00:42:38,806 --> 00:42:40,932 Wait, what? That could take days. 959 00:42:40,933 --> 00:42:42,392 I--I can't-- 960 00:42:42,393 --> 00:42:44,352 Calm down, Sadness. I'm kidding. 961 00:42:44,353 --> 00:42:46,813 This is one for my skilled surgical residents upstairs, 962 00:42:46,814 --> 00:42:48,315 not you Boy Scout butchers. 963 00:42:48,316 --> 00:42:49,691 Boy, I missed you, Yoyo. 964 00:42:49,692 --> 00:42:52,027 Mm. Can't say the same. 965 00:42:52,028 --> 00:42:55,447 Okay, let's take up this art project. 966 00:42:55,448 --> 00:42:56,782 So about before-- 967 00:42:56,783 --> 00:42:58,825 Back to it. 968 00:42:58,826 --> 00:43:00,285 Good talk. 969 00:43:00,286 --> 00:43:01,828 How we doing, Princess? 970 00:43:01,829 --> 00:43:03,497 All right. A little bloated. 971 00:43:03,498 --> 00:43:06,833 I had one too many hot dogs from the truck. 972 00:43:06,834 --> 00:43:09,002 You meant the board, huh? 973 00:43:09,003 --> 00:43:12,130 Gus, our incarcerated patient, got a spot upstairs. 974 00:43:12,131 --> 00:43:15,759 Looking for our unhoused patient, Digby, and, of course, 975 00:43:15,760 --> 00:43:18,678 we have Whitaker, Donahue, and the med students 976 00:43:18,679 --> 00:43:21,348 on these diversion intakes, but they just keep coming. 977 00:43:21,349 --> 00:43:23,266 Yeah, we may need to start just sending people up 978 00:43:23,267 --> 00:43:25,477 and ask for forgiveness instead of permission. 979 00:43:25,478 --> 00:43:27,938 Hello? 980 00:43:27,939 --> 00:43:30,315 Oh, okay. 981 00:43:30,316 --> 00:43:32,651 Yes, I will be right there. 982 00:43:32,652 --> 00:43:34,194 C-suite wants to see me upstairs. 983 00:43:34,195 --> 00:43:35,612 Ooh, called to the principal's office 984 00:43:35,613 --> 00:43:38,865 on your first day-- not a good sign. 985 00:43:38,866 --> 00:43:41,493 - I think I'm a baby whisperer. - Hey, great. 986 00:43:41,494 --> 00:43:43,537 We'll add Baby Jane Doe to your patient load. 987 00:43:43,538 --> 00:43:45,122 Forget I said anything. 988 00:43:45,123 --> 00:43:47,040 Where are we with your deaf patient, Harlow? 989 00:43:47,041 --> 00:43:50,669 Uh, the VRI was a bust, but the interpreter's on the way. 990 00:43:50,670 --> 00:43:52,671 Figured I'd just give her a head and belly scan 991 00:43:52,672 --> 00:43:54,840 and go from there. - No, wait for the interpreter. 992 00:43:54,841 --> 00:43:57,175 No need to give the patient unnecessary radiation. 993 00:43:57,176 --> 00:43:59,678 And your charting? 994 00:43:59,679 --> 00:44:00,929 Catching up and checking it twice. 995 00:44:00,930 --> 00:44:02,597 Good. 996 00:44:02,598 --> 00:44:04,808 Hey, have you had a chance to speak to Langdon today? 997 00:44:04,809 --> 00:44:06,685 Uh, no. 998 00:44:06,686 --> 00:44:07,936 Why? Did he say something? 999 00:44:07,937 --> 00:44:09,688 No, just curious. 1000 00:44:09,689 --> 00:44:13,066 How is everything at home with you and Whitaker? 1001 00:44:13,067 --> 00:44:15,360 He's weirder than you'd expect. 1002 00:44:15,361 --> 00:44:17,237 - Hmm. - Yeah. 1003 00:44:17,238 --> 00:44:19,322 But I don't see him all that much. 1004 00:44:19,323 --> 00:44:20,866 He spends a lot of time at Amy's. 1005 00:44:20,867 --> 00:44:23,326 He has a girlfriend? 1006 00:44:23,327 --> 00:44:27,164 I don't know what to call it. 1007 00:44:27,165 --> 00:44:29,708 The--the farmer who got burned last year 1008 00:44:29,709 --> 00:44:32,169 the day of the mass cas, his widow, Amy. 1009 00:44:32,170 --> 00:44:33,545 Oh, he died? 1010 00:44:33,546 --> 00:44:35,589 Yeah, he had burns on 90% of his body. 1011 00:44:35,590 --> 00:44:37,382 His chance of survival was very slim. 1012 00:44:37,383 --> 00:44:39,050 Okay, so I'm an optimist. 1013 00:44:39,051 --> 00:44:41,553 The sun doesn't always come out tomorrow, Annie. 1014 00:44:41,554 --> 00:44:43,430 Wait, wasn't she pregnant? 1015 00:44:43,431 --> 00:44:46,099 No, she was a young orphan. 1016 00:44:46,100 --> 00:44:48,476 No, not Annie. Amy. 1017 00:44:48,477 --> 00:44:52,230 Yes. Yes, very pregnant and young. 1018 00:44:52,231 --> 00:44:54,065 Whitaker is now seeing this Amy? 1019 00:44:54,066 --> 00:44:56,234 And her baby. 1020 00:44:56,235 --> 00:44:57,986 He got really close to the family 1021 00:44:57,987 --> 00:44:59,988 when the husband was dying. 1022 00:44:59,989 --> 00:45:02,115 He really believed that the guy would pull through. 1023 00:45:02,116 --> 00:45:04,576 He helped her through the loss of her husband, 1024 00:45:04,577 --> 00:45:06,244 and then again when she had the kid, 1025 00:45:06,245 --> 00:45:09,414 and now he spends almost every weekend at the farm. 1026 00:45:09,415 --> 00:45:10,749 Huh. 1027 00:45:10,750 --> 00:45:12,250 Plus, he's on the street team, 1028 00:45:12,251 --> 00:45:14,169 and he just wants to help everybody. 1029 00:45:14,170 --> 00:45:17,130 And I just don't wanna see him taken advantage of, you know? 1030 00:45:17,131 --> 00:45:19,382 He's just a fucking Huckleberry. 1031 00:45:19,383 --> 00:45:21,968 Yeah, but he's our fucking Huckleberry. 1032 00:45:21,969 --> 00:45:23,470 I'll talk to him. 1033 00:45:23,471 --> 00:45:24,804 Hey, your call. 1034 00:45:24,805 --> 00:45:26,598 Strong deflection. Well played. 1035 00:45:26,599 --> 00:45:28,058 You're the boss. 1036 00:45:28,059 --> 00:45:29,643 Or you are until end of shift today. 1037 00:45:29,644 --> 00:45:30,977 Still the boss. 1038 00:45:30,978 --> 00:45:33,230 When you see me in here, still the boss. 1039 00:45:33,231 --> 00:45:35,774 Copy that, Boss. 1040 00:45:35,775 --> 00:45:39,110 Dr. Robby, can-- can I grab you for a second? 1041 00:45:39,111 --> 00:45:42,113 Yeah. Sure. What's up? 1042 00:45:42,114 --> 00:45:46,993 Um, can't you order my wife to go home? 1043 00:45:46,994 --> 00:45:48,745 I'm sorry. 1044 00:45:50,873 --> 00:45:52,791 My wife's dying, 1045 00:45:52,792 --> 00:45:55,543 and you're telling me there's nothing I can do? 1046 00:45:55,544 --> 00:45:57,045 Mr. Hamler, that's not-- 1047 00:45:57,046 --> 00:45:58,630 No, no. 1048 00:45:58,631 --> 00:46:01,341 There's gotta be something. 1049 00:46:01,342 --> 00:46:03,301 Please. 1050 00:46:03,302 --> 00:46:05,470 It may not seem like much, but right now, 1051 00:46:05,471 --> 00:46:08,014 you being here for her and respecting her wishes 1052 00:46:08,015 --> 00:46:10,892 is the best thing that you can do for her. 1053 00:46:10,893 --> 00:46:14,813 Supporting her and her choices is the most remarkable gift 1054 00:46:14,814 --> 00:46:18,108 that you can give her at this time. 1055 00:46:18,109 --> 00:46:20,819 And the meds we have her on will help her pain. 1056 00:46:20,820 --> 00:46:22,821 And she may get to a point where 1057 00:46:22,822 --> 00:46:25,324 she feels well enough to go home. 1058 00:46:41,507 --> 00:46:43,551 {\an8}Give me one second. 1059 00:46:48,889 --> 00:46:50,890 {\an8}Okay, I'm gonna let you guys get acquainted. 1060 00:46:50,891 --> 00:46:52,309 I will be right back. 1061 00:46:52,310 --> 00:46:53,852 Oh, oh, oh, excuse me! 1062 00:46:53,853 --> 00:46:56,730 I--I'm waiting for Dr. Mohan. Is she available? 1063 00:46:56,731 --> 00:46:59,150 I will try and find her for you, sir. 1064 00:47:03,362 --> 00:47:06,239 Whether you choose to report or not, we're here for you. 1065 00:47:06,240 --> 00:47:07,741 Call me any time. 1066 00:47:07,742 --> 00:47:11,202 It could be a month or a year from now. 1067 00:47:11,203 --> 00:47:12,537 I'll follow up with you too. 1068 00:47:12,538 --> 00:47:14,247 Thank you. 1069 00:47:14,248 --> 00:47:15,958 Thanks. 1070 00:47:19,545 --> 00:47:21,046 You've had a pap smear before? 1071 00:47:21,047 --> 00:47:23,214 Yeah, every few years. 1072 00:47:23,215 --> 00:47:24,716 Good. 1073 00:47:24,717 --> 00:47:27,218 Same position, but I'll start with swabs 1074 00:47:27,219 --> 00:47:30,096 on the outside, external genitalia. 1075 00:47:30,097 --> 00:47:32,390 Then I'll use a speculum to get internal swabs. 1076 00:47:32,391 --> 00:47:34,517 You ready? Okay. 1077 00:47:34,518 --> 00:47:36,895 I'll help you get your feet in the stirrups. 1078 00:47:36,896 --> 00:47:39,898 Good. 1079 00:47:39,899 --> 00:47:42,359 Okay. All right. 1080 00:47:42,360 --> 00:47:45,362 Now, slide your bottom down. 1081 00:47:45,363 --> 00:47:47,947 Oh. Yeah, a little bit more. 1082 00:47:47,948 --> 00:47:49,741 A little more. 1083 00:47:49,742 --> 00:47:52,369 - Sorry. I--I can't. - Okay. It's okay. 1084 00:47:52,370 --> 00:47:53,953 We can take a break. No problem. 1085 00:47:53,954 --> 00:47:56,456 I don't want a break. I wanna stop. 1086 00:47:56,457 --> 00:47:59,334 Okay. Is this about reporting? 1087 00:47:59,335 --> 00:48:00,919 Because you can do this collection 1088 00:48:00,920 --> 00:48:02,629 without a police report for now. 1089 00:48:02,630 --> 00:48:05,173 And none of it goes in your permanent medical record. 1090 00:48:05,174 --> 00:48:07,092 I don't wanna do this anymore. 1091 00:48:07,093 --> 00:48:09,260 Tell me why you wanna stop. 1092 00:48:11,931 --> 00:48:14,766 He's my friend. 1093 00:48:14,767 --> 00:48:18,645 He knows all my friends. 1094 00:48:18,646 --> 00:48:22,148 It was just a dumb-- 1095 00:48:22,149 --> 00:48:24,484 he was drunk, he didn't mean it. 1096 00:48:24,485 --> 00:48:27,070 It didn't mean anything. - Okay. 1097 00:48:27,071 --> 00:48:29,406 Okay. 1098 00:48:29,407 --> 00:48:32,409 It's okay. I understand. 1099 00:48:32,410 --> 00:48:35,078 I do. 1100 00:48:35,079 --> 00:48:39,916 Ilana, this is a difficult process, to say the least. 1101 00:48:39,917 --> 00:48:41,835 Why don't you take a breather and come back? 1102 00:48:41,836 --> 00:48:44,463 And whatever you wanna do, we'll do. 1103 00:48:52,346 --> 00:48:55,182 Let's go find the good snacks. 1104 00:49:18,164 --> 00:49:19,539 Jesus Christ. 1105 00:49:19,540 --> 00:49:21,332 Sorry. 1106 00:49:21,333 --> 00:49:23,835 Giving new meaning to the nickname Crash, huh? 1107 00:49:23,836 --> 00:49:25,253 I've been trying to get to the bathroom 1108 00:49:25,254 --> 00:49:26,838 for over an hour now. 1109 00:49:26,839 --> 00:49:29,674 Yeah, you and me both, sister. 1110 00:49:39,727 --> 00:49:42,353 Uh-oh, this can't be good. 1111 00:49:42,354 --> 00:49:43,813 Who's this? 1112 00:49:43,814 --> 00:49:45,023 That is hospital CEO Trent Norris. 1113 00:49:45,024 --> 00:49:47,525 He's the big boss. 1114 00:49:47,526 --> 00:49:49,027 Hmm. Nice outfit. 1115 00:49:49,028 --> 00:49:50,987 Hey, Rockstar. Gather your staff, please. 1116 00:49:50,988 --> 00:49:53,156 Sure, anything you wanna tell me first? 1117 00:49:53,157 --> 00:49:55,325 - No. - Okay. 1118 00:49:55,326 --> 00:49:57,660 Hey, everybody, can you, uh, gather 'round 1119 00:49:57,661 --> 00:50:00,121 and listen up for a moment, please? 1120 00:50:00,122 --> 00:50:03,583 Can I have your attention, everyone? 1121 00:50:03,584 --> 00:50:06,252 Internal disaster at Westbridge 1122 00:50:06,253 --> 00:50:08,379 has been identified as a cyberattack. 1123 00:50:11,091 --> 00:50:14,302 And now Good Dominion Hospital has been hit as well. 1124 00:50:14,303 --> 00:50:16,721 Their ambulances are being diverted over to St. Mary's, 1125 00:50:16,722 --> 00:50:20,058 but we can expect more walk-ins and Westbridge diversions. 1126 00:50:20,059 --> 00:50:21,935 Uh, for how long? 1127 00:50:21,936 --> 00:50:25,104 We don't know how long. If the ransom is paid-- 1128 00:50:25,105 --> 00:50:26,814 Ransom? 1129 00:50:26,815 --> 00:50:28,650 Are we next? 1130 00:50:28,651 --> 00:50:31,277 Our IT protection system has blocked thousands 1131 00:50:31,278 --> 00:50:32,904 of intrusion attempts in the hours 1132 00:50:32,905 --> 00:50:35,114 since Westbridge was hit this morning. 1133 00:50:35,115 --> 00:50:39,118 But IT believes we're still vulnerable. 1134 00:50:39,119 --> 00:50:41,746 So we're gonna preemptively shut down 1135 00:50:41,747 --> 00:50:43,373 all the computer systems. 1136 00:50:43,374 --> 00:50:46,125 - Oh, my God. - Jesus. 1137 00:50:46,126 --> 00:50:48,878 Patient registration, electronic health records, 1138 00:50:48,879 --> 00:50:51,965 lab and radiology interfaces, email, internet. 1139 00:50:51,966 --> 00:50:53,258 You didn't wanna talk to me first? 1140 00:50:53,259 --> 00:50:54,634 You didn't wanna consult my department? 1141 00:50:54,635 --> 00:50:57,179 I consulted your fellow attending. 1142 00:50:59,098 --> 00:51:01,933 When are we going down? 1143 00:51:01,934 --> 00:51:04,852 Soon. Very soon. 1144 00:51:04,853 --> 00:51:07,230 Okay, hey, somebody get a picture of the board. 1145 00:51:07,231 --> 00:51:10,441 Quickly, quickly! We're about to go analog. 1146 00:51:12,486 --> 00:51:14,112 - No! - Oh, my gosh. 1147 00:51:17,157 --> 00:51:19,534 - Phones work? - They don't work. 1148 00:51:19,535 --> 00:51:21,286 - Oh, my gosh. - Did you get the photo? 1149 00:51:21,287 --> 00:51:23,997 Yeah, yeah, I got it. 1150 00:51:23,998 --> 00:51:25,541 This is gonna be fun. 76883

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