1 00:00:21,521 --> 00:00:24,314 {\an8}- The man is in his element. - What's he doing? 2 00:00:24,315 --> 00:00:26,108 Age-old ritual, meant to capitalize 3 00:00:26,109 --> 00:00:27,484 off the unknown origins 4 00:00:27,485 --> 00:00:31,196 of Westbridge's current state of affairs. 5 00:00:31,197 --> 00:00:33,615 Whoever guesses the reason they went code black wins the pot. 6 00:00:33,616 --> 00:00:37,036 Ah, interesting. We didn't do this at the VA. 7 00:00:37,037 --> 00:00:38,287 - You game? - Of course. 8 00:00:38,288 --> 00:00:40,122 Now, how's this look to you? 9 00:00:40,123 --> 00:00:41,707 My wager is on flooding. 10 00:00:41,708 --> 00:00:43,125 They're going to be down for 3 hours, 11 00:00:43,126 --> 00:00:44,918 and we're going to get 20 of their patients. 12 00:00:44,919 --> 00:00:49,006 Put me down for flooding, 4 hours and 30 patients. 13 00:00:49,007 --> 00:00:50,591 Okay, okay, okay. 14 00:00:50,592 --> 00:00:52,217 Hey, Dr. Robby, looks like you got some competition. 15 00:00:52,218 --> 00:00:53,635 Yes, it would appear that I do. 16 00:00:53,636 --> 00:00:55,387 All right, guys and gals, enough fun. 17 00:00:55,388 --> 00:00:57,264 We have people to take care of. 18 00:00:57,265 --> 00:00:58,974 You want to bring Langdon back from triage 19 00:00:58,975 --> 00:01:00,392 for the extra hands? 20 00:01:00,393 --> 00:01:02,227 No, I do not. I don't think that's necessary. 21 00:01:02,228 --> 00:01:03,979 We're doing just fine without him. 22 00:01:03,980 --> 00:01:05,147 You're the boss, boss. 23 00:01:07,233 --> 00:01:11,654 Daniel Ortiz, tu licencia en el mostrador. 24 00:01:12,989 --> 00:01:15,115 Next. 25 00:01:15,116 --> 00:01:17,409 Hi. Uh, the doctor guy told me 26 00:01:17,410 --> 00:01:19,995 to put this mineral oil on my eye for 20 minutes. 27 00:01:19,996 --> 00:01:21,955 That was 2 hours ago. 28 00:01:21,956 --> 00:01:24,208 We're really busy, but we'll get to you. 29 00:01:24,209 --> 00:01:26,460 - Oh, my God. Okay, when? - I will check. 30 00:01:26,461 --> 00:01:28,587 Listen for your name to be called. 31 00:01:28,588 --> 00:01:31,090 - Thanks. - Next. 32 00:01:31,091 --> 00:01:32,341 Excuse me. 33 00:01:32,342 --> 00:01:34,343 Uh, hi. I heard my brother was brought here. 34 00:01:34,344 --> 00:01:36,845 His name is Jackson Davis. - Do you have ID? 35 00:01:36,846 --> 00:01:38,555 Yes, yes, um, 36 00:01:38,556 --> 00:01:41,768 I am his sister Jada Davis. 37 00:01:43,770 --> 00:01:45,395 I'm sorry. I just, uh-- 38 00:01:45,396 --> 00:01:47,940 my friend told me that he was brought in by campus police. 39 00:01:47,941 --> 00:01:49,775 There was some sort of fight that broke out at his school. 40 00:01:49,776 --> 00:01:52,069 Is he okay? Is he here? - Don't know, hon. 41 00:01:52,070 --> 00:01:53,737 Can you just tell me if he's a patient here? 42 00:01:53,738 --> 00:01:57,282 I'll check. Take a seat. And I'll let you know. 43 00:01:57,283 --> 00:01:59,868 - Okay. - Next. 44 00:01:59,869 --> 00:02:02,789 Is Harlow feeling lightheaded or faint now? 45 00:02:05,041 --> 00:02:07,209 It's not as bad as it was before, 46 00:02:07,210 --> 00:02:09,419 but my head still hurts. 47 00:02:09,420 --> 00:02:11,713 And now my stomach does, too. 48 00:02:11,714 --> 00:02:14,968 Well, did she eat before she took her ibuprofen? 49 00:02:16,136 --> 00:02:18,303 Ugh, it's not my... 50 00:02:18,304 --> 00:02:21,015 Breakfast is my least favorite meal of the day. 51 00:02:25,728 --> 00:02:28,438 It's okay to look at me. 52 00:02:28,439 --> 00:02:29,773 I don't bite. 53 00:02:29,774 --> 00:02:31,859 I'm sorry. 54 00:02:31,860 --> 00:02:35,572 Um, we're going to get started with some blood tests. 55 00:02:37,991 --> 00:02:40,450 Is that baby from the bathroom going to be okay? 56 00:02:40,451 --> 00:02:41,493 She'll be fine. 57 00:02:41,494 --> 00:02:43,162 Uh, good news-- 58 00:02:43,163 --> 00:02:46,748 nose swab came back negative for COVID, 59 00:02:46,749 --> 00:02:48,584 influenza, and RSV, 60 00:02:48,585 --> 00:02:51,003 but a lot of other viruses can cause a cough. 61 00:02:51,004 --> 00:02:52,379 Lucky me. 62 00:02:52,380 --> 00:02:54,464 You can take off your mask. 63 00:02:54,465 --> 00:02:57,384 Pulse ox is at 91. 64 00:02:57,385 --> 00:02:59,219 Your oxygen level is down 65 00:02:59,220 --> 00:03:01,054 since we checked you an hour ago, 66 00:03:01,055 --> 00:03:03,432 and your temp is up to 102.4. 67 00:03:03,433 --> 00:03:05,017 Let's get you some Tylenol. 68 00:03:05,018 --> 00:03:07,436 Have you been outside today? It's already stifling. 69 00:03:07,437 --> 00:03:09,771 Could be heat-related, but we're going to take you 70 00:03:09,772 --> 00:03:12,941 back to the big ER for a full evaluation. 71 00:03:12,942 --> 00:03:14,526 Can't you just 72 00:03:14,527 --> 00:03:16,361 write me a prescription for some medicine? 73 00:03:16,362 --> 00:03:18,322 I'm sure it's just a summer cold. 74 00:03:18,323 --> 00:03:21,409 - Got somewhere to be? - Work. 75 00:03:23,494 --> 00:03:25,120 I know. It's Saturday. 76 00:03:25,121 --> 00:03:27,956 But I don't think I've had a day off since... 77 00:03:27,957 --> 00:03:31,210 Well, your holiday weekend starts now. 78 00:03:31,211 --> 00:03:32,669 Hey, Javadi. 79 00:03:32,670 --> 00:03:34,796 What are you doing for your birthday? 80 00:03:34,797 --> 00:03:37,466 - Who told you? - Word gets around. 81 00:03:37,467 --> 00:03:40,636 Nothing. I hate celebrating my birthday. 82 00:03:40,637 --> 00:03:42,137 You only turn 21 once. 83 00:03:42,138 --> 00:03:43,722 It's your birthday? 84 00:03:43,723 --> 00:03:47,226 Oh, that makes you a Cancer, right? 85 00:03:47,227 --> 00:03:49,686 I didn't peg you for an astrology girlie. 86 00:03:49,687 --> 00:03:51,313 Yeah. 87 00:03:51,314 --> 00:03:53,315 Been spending too much time around Santos. 88 00:03:53,316 --> 00:03:54,650 Yes, you have. 89 00:03:54,651 --> 00:03:55,692 I don't know how you guys do it. 90 00:03:55,693 --> 00:03:58,278 Live together and work together? 91 00:03:58,279 --> 00:04:00,113 It's my cross to bear. 92 00:04:00,114 --> 00:04:02,783 It can't be as bad as having to live with your parents. 93 00:04:02,784 --> 00:04:04,701 I don't know. I haven't lived at home in years. 94 00:04:04,702 --> 00:04:06,703 I kind of miss it. - I can tell. 95 00:04:06,704 --> 00:04:08,830 You've been spending a lot of time on that farm. 96 00:04:08,831 --> 00:04:10,415 "Farm"? 97 00:04:10,416 --> 00:04:12,376 Remember the burned farmer who came in last year? 98 00:04:12,377 --> 00:04:14,544 Propane tank exploded, he died in the ICU? 99 00:04:14,545 --> 00:04:16,380 Yeah, that was sad. 100 00:04:16,381 --> 00:04:18,173 Well, this guy has been playing house 101 00:04:18,174 --> 00:04:20,509 with his widow and their baby. 102 00:04:20,510 --> 00:04:22,094 Oh, that's messy. 103 00:04:22,095 --> 00:04:23,136 No. 104 00:04:23,137 --> 00:04:25,347 It's not like that, okay? 105 00:04:25,348 --> 00:04:27,015 I've been helping Amy out on the farm 106 00:04:27,016 --> 00:04:29,559 after her husband died, and she is a friend. 107 00:04:29,560 --> 00:04:30,936 She's just a friend. 108 00:04:30,937 --> 00:04:33,730 Sure, just a friend, with farm benefits. 109 00:04:33,731 --> 00:04:35,816 What are farm benefits? 110 00:04:35,817 --> 00:04:37,693 Oh, use your imagination. 111 00:04:37,694 --> 00:04:39,528 You ever see a milking machine? 112 00:04:39,529 --> 00:04:41,613 Oh, can we not talk about this, please? 113 00:04:41,614 --> 00:04:43,115 We're getting two runs rerouted 114 00:04:43,116 --> 00:04:45,450 from Westbridge already-- chest pain and belly pain. 115 00:04:45,451 --> 00:04:47,869 Robby wants you three out back. - Thank you. 116 00:04:47,870 --> 00:04:49,288 Come on. 117 00:04:49,289 --> 00:04:52,374 Dr. Santos, making progress on your charting, I hope? 118 00:04:52,375 --> 00:04:53,875 Getting there. 119 00:04:53,876 --> 00:04:55,711 Deficient charts leave a gap for the providers 120 00:04:55,712 --> 00:04:59,006 who give continuity of care and delays hospital billing. 121 00:04:59,007 --> 00:05:01,384 Oh, I'd hate to delay billing. 122 00:05:03,303 --> 00:05:05,887 Timely documentation is essential. 123 00:05:05,888 --> 00:05:08,557 Let's fix this before end of shift. 124 00:05:08,558 --> 00:05:11,643 - I'm on it, boss. - Good. 125 00:05:11,644 --> 00:05:14,062 You wouldn't want to repeat your R2 year again 126 00:05:14,063 --> 00:05:15,940 because of this. 127 00:05:18,818 --> 00:05:20,902 Fuck. 128 00:05:20,903 --> 00:05:24,489 God, it's humid as shit out here. 129 00:05:24,490 --> 00:05:25,949 It is. 130 00:05:25,950 --> 00:05:27,617 What's going on at Westbridge? 131 00:05:27,618 --> 00:05:29,661 They're closed, so we're covering their paramedic runs 132 00:05:29,662 --> 00:05:31,079 until they come back up. 133 00:05:31,080 --> 00:05:33,498 As if a holiday weekend wasn't enough. 134 00:05:33,499 --> 00:05:36,501 So, Dr. Al-Hashimi... 135 00:05:36,502 --> 00:05:37,502 Yes? 136 00:05:37,503 --> 00:05:39,838 Do we like her? 137 00:05:39,839 --> 00:05:42,007 She seems pretty cool so far. 138 00:05:42,008 --> 00:05:45,010 You're trying to gossip about an attending with an attending? 139 00:05:45,011 --> 00:05:48,014 Dr. Robby doesn't mind. Do you? 140 00:05:50,183 --> 00:05:52,601 Oh, uh, that's a nice bike, by the way. 141 00:05:52,602 --> 00:05:54,645 - Thank you. - Yeah. 142 00:05:56,856 --> 00:05:59,066 Pamela Perry, 48, abdominal pain 143 00:05:59,067 --> 00:06:02,110 with vomiting after eating chilaquiles with fried eggs. 144 00:06:02,111 --> 00:06:05,364 BP 108 over 64, pulse 98, good sats. 145 00:06:05,365 --> 00:06:08,408 Okay, let's see how she feels with some Zofran 146 00:06:08,409 --> 00:06:10,035 and a liter wide open. - Got it. 147 00:06:10,036 --> 00:06:12,287 - Yo, Whitaker. - How are you feeling? OK? 148 00:06:12,288 --> 00:06:13,831 Not so good. 149 00:06:18,002 --> 00:06:19,795 - Who do we have here? - Jean Samba-- 150 00:06:19,796 --> 00:06:22,005 54, half an hour of left-sided chest pain. 151 00:06:22,006 --> 00:06:25,300 History of hypertension, on lisinopril and Crestor. 152 00:06:25,301 --> 00:06:27,010 Some relief with two nitro. 153 00:06:27,011 --> 00:06:29,429 Decent vitals, no STEMI on 12-lead. 154 00:06:29,430 --> 00:06:31,264 Gave him 324 of chewable aspirin. 155 00:06:31,265 --> 00:06:33,392 Okay, we're going to give you a full evaluation, sir. 156 00:06:33,393 --> 00:06:36,561 Oh, if I am to die, God willing, 157 00:06:36,562 --> 00:06:38,897 I will see His pearly gates. 158 00:06:38,898 --> 00:06:40,273 What's the plan? 159 00:06:40,274 --> 00:06:41,733 Repeat 12-lead, check a troponin, 160 00:06:41,734 --> 00:06:43,068 admit for new onset angina. 161 00:06:43,069 --> 00:06:44,736 Evaluate for PE, aortic dissection. 162 00:06:44,737 --> 00:06:46,655 - That goes without saying. - Sounds good. 163 00:06:46,656 --> 00:06:48,323 I'm a minute behind you. 164 00:07:02,505 --> 00:07:04,172 And who do we have here? 165 00:07:04,173 --> 00:07:07,008 Vince Cole, 23, fell through the skylight of a florist shop, 166 00:07:07,009 --> 00:07:08,677 10 feet down to a bunch of ferns. 167 00:07:08,678 --> 00:07:10,637 Complained of headache, asking repetitive questions, 168 00:07:10,638 --> 00:07:12,305 and only responds to pain. 169 00:07:12,306 --> 00:07:13,849 Multiple lacs from the glass. 170 00:07:13,850 --> 00:07:18,019 BP, 118 over 72, pulse 98, sats, 99 on 5 liters. 171 00:07:18,020 --> 00:07:19,438 No meds, no allergies. 172 00:07:19,439 --> 00:07:21,356 Hey, Vince, how'd you fall through a skylight? 173 00:07:21,357 --> 00:07:22,691 Vince? 174 00:07:22,692 --> 00:07:24,234 Were you with him? 175 00:07:24,235 --> 00:07:26,278 Yeah, we were parkouring, and he overshot a kong vault. 176 00:07:26,279 --> 00:07:27,529 What, like, jumping off of buildings? 177 00:07:27,530 --> 00:07:28,822 People still do that? 178 00:07:28,823 --> 00:07:29,865 It was almost an Olympic sport. 179 00:07:29,866 --> 00:07:32,368 Now we know why it isn't. 180 00:07:34,912 --> 00:07:36,329 Pupils are equal and reactive. 181 00:07:36,330 --> 00:07:38,165 - What do you got? - A 10-foot fall, altered. 182 00:07:38,166 --> 00:07:40,208 - That's a long way down. - 10 feet is the threshold 183 00:07:40,209 --> 00:07:42,419 for trauma center activation-- 10 feet, 10% mortality. 184 00:07:42,420 --> 00:07:45,088 0%, anything over 0% is a concern. 185 00:07:45,089 --> 00:07:47,924 Somebody's annoying, and it's not me. 186 00:07:47,925 --> 00:07:50,760 Hey, you said two. You missed one. 187 00:07:50,761 --> 00:07:52,220 Sent you backup, didn't I? 188 00:07:52,221 --> 00:07:54,556 One, two, three. 189 00:07:54,557 --> 00:07:57,601 Okay. Thanks, guys. Good to see you. 190 00:07:57,602 --> 00:07:58,727 Get the EFAST. 191 00:07:58,728 --> 00:08:01,104 Ogilvie, Joy, GCS, please. 192 00:08:01,105 --> 00:08:03,273 Uh, open your eyes, sir. 193 00:08:03,274 --> 00:08:05,358 Two for eyes, two for verbal. 194 00:08:05,359 --> 00:08:07,235 Uh, good lung sliding bilaterally. 195 00:08:07,236 --> 00:08:09,988 Joy, finish GCS. 196 00:08:09,989 --> 00:08:12,741 Squeeze my hand. 197 00:08:12,742 --> 00:08:14,576 He gets a 4 for motor. 198 00:08:14,577 --> 00:08:18,997 Pulse ox 99, heart rate 102, blood pressure 114 over 78. 199 00:08:18,998 --> 00:08:21,666 - And EFAST is negative. - Music to my ears. 200 00:08:21,667 --> 00:08:23,460 Somebody shooting a documentary here? 201 00:08:23,461 --> 00:08:25,253 Whoa, whoa, whoa, you can't film in here. 202 00:08:25,254 --> 00:08:27,088 We've got patient-privacy laws. 203 00:08:27,089 --> 00:08:28,798 What happened to your hand? - Cut it. 204 00:08:28,799 --> 00:08:32,010 Can somebody show Spielberg here out to the waiting room 205 00:08:32,011 --> 00:08:33,637 and get her registered at triage, please? 206 00:08:33,638 --> 00:08:35,680 He's my creative partner-- I have his written consent 207 00:08:35,681 --> 00:08:37,474 to film everything for our TikTok page. 208 00:08:37,475 --> 00:08:39,059 Put the camera down. 209 00:08:39,060 --> 00:08:40,769 We have to drop this video for the Fourth tonight. 210 00:08:40,770 --> 00:08:42,354 That literally means nothing to me. 211 00:08:42,355 --> 00:08:44,064 Seriously, Sean, can you escort her out, please? 212 00:08:44,065 --> 00:08:45,941 Somebody will come and find you once he's stabilized. 213 00:08:45,942 --> 00:08:47,359 Thank you. 214 00:08:47,360 --> 00:08:49,236 I would have let her stay if she'd asked nicely. 215 00:08:49,237 --> 00:08:50,946 What is the, uh, story with surgery? 216 00:08:50,947 --> 00:08:52,697 You guys getting any Westbridge transfers yet? 217 00:08:52,698 --> 00:08:54,324 Not yet, but I'm sure it's coming. 218 00:08:54,325 --> 00:08:56,868 Pan scan, head through pelvis. Let's get him to CT ASAP. 219 00:08:56,869 --> 00:08:58,495 Absent gag. 220 00:08:58,496 --> 00:09:01,831 We need to intubate before CT. 221 00:09:01,832 --> 00:09:03,291 C-can I do it? 222 00:09:03,292 --> 00:09:04,709 Uh, I'm keeping a procedure log, 223 00:09:04,710 --> 00:09:06,545 and I need more intubations on this rotation. 224 00:09:06,546 --> 00:09:08,880 If Dr. McKay wants to teach? 225 00:09:08,881 --> 00:09:10,632 Sure. 226 00:09:10,633 --> 00:09:12,300 Okay, uh, I need suction. 227 00:09:12,301 --> 00:09:15,220 8-oh tube, etomidate and sux, end tidal CO2. 228 00:09:15,221 --> 00:09:16,638 Ambitious. 229 00:09:16,639 --> 00:09:19,140 He reminds me of someone I know very well. 230 00:09:21,644 --> 00:09:23,562 Can you not? 231 00:09:23,563 --> 00:09:24,896 Yeah, sorry. 232 00:09:24,897 --> 00:09:26,898 Hot off the press. 233 00:09:26,899 --> 00:09:28,316 Okay. 234 00:09:28,317 --> 00:09:31,988 No STEMI, doesn't need to go right to the cath lab. 235 00:09:33,948 --> 00:09:35,240 And orders are in. 236 00:09:35,241 --> 00:09:36,533 Whitaker, try another nitro 237 00:09:36,534 --> 00:09:38,159 and let me know when the troponin's back. 238 00:09:38,160 --> 00:09:40,620 Yeah. Hey, hey, Jesse? 239 00:09:40,621 --> 00:09:42,372 Do you think you could repeat this 240 00:09:42,373 --> 00:09:45,375 but with the chest leads on his back? 241 00:09:45,376 --> 00:09:46,835 Why? 242 00:09:46,836 --> 00:09:49,671 T Waves are kind of high with ST depression anterior. 243 00:09:49,672 --> 00:09:51,381 We see ST depression all the time. 244 00:09:51,382 --> 00:09:53,967 Yeah, but it could be a posterior MI. 245 00:09:53,968 --> 00:09:55,510 All right, run it by the attending. 246 00:09:55,511 --> 00:09:57,137 If they agree, we'll do it. 247 00:09:57,138 --> 00:09:58,763 Thank you. 248 00:09:58,764 --> 00:10:02,350 Uh, Victoria, if his CT's normal, he'll need an LP. 249 00:10:02,351 --> 00:10:04,436 Got it. 250 00:10:04,437 --> 00:10:05,604 Dr. Al-Hashimi. 251 00:10:05,605 --> 00:10:08,189 This is Jada Davis, Jackson's sister. 252 00:10:08,190 --> 00:10:10,525 - Oh, thank you. Hi. - Is he okay? 253 00:10:10,526 --> 00:10:12,027 And why is he asleep? 254 00:10:12,028 --> 00:10:14,362 Well, he was uncooperative when he first arrived 255 00:10:14,363 --> 00:10:17,365 and needed to be sedated. - "Uncooperative"? 256 00:10:17,366 --> 00:10:20,535 That doesn't make any sense. What happened? 257 00:10:20,536 --> 00:10:22,704 We're still trying to piece the story together. 258 00:10:22,705 --> 00:10:24,789 He was brought in by a campus security guard 259 00:10:24,790 --> 00:10:26,625 who Tased him after he was allegedly... 260 00:10:26,626 --> 00:10:28,209 - "Tased him"? - Combative and violent. 261 00:10:28,210 --> 00:10:29,753 Wait, what do you mean, Tased him? 262 00:10:29,754 --> 00:10:31,546 We've treated his injury, and now we're trying 263 00:10:31,547 --> 00:10:34,382 to understand why he was so agitated. 264 00:10:34,383 --> 00:10:36,259 Okay, this doesn't sound like my brother. 265 00:10:36,260 --> 00:10:37,969 Well, his drug screen came back negative, 266 00:10:37,970 --> 00:10:40,138 so now we're taking Jackson to get a CT scan of his brain 267 00:10:40,139 --> 00:10:42,557 to look for any abnormalities. - Can I go with him? 268 00:10:42,558 --> 00:10:44,142 You can't go into the CT, 269 00:10:44,143 --> 00:10:46,686 but you can wait for him to come back. 270 00:10:46,687 --> 00:10:49,981 And then we can discuss next steps. 271 00:10:49,982 --> 00:10:52,150 Okay. 272 00:10:52,151 --> 00:10:53,902 Just did my first ER intubation. 273 00:10:53,903 --> 00:10:55,654 - That's great, man. - Such a prick. 274 00:10:55,655 --> 00:10:57,238 - You got a second? - What's up? 275 00:10:57,239 --> 00:10:59,741 12-lead on my chest-pain patient shows no STEMI, 276 00:10:59,742 --> 00:11:03,787 but the anterior leads might be suspicious for a posterior MI? 277 00:11:03,788 --> 00:11:05,789 Uh... agreed. 278 00:11:05,790 --> 00:11:07,749 Yeah, I was going to repeat, but with the chest leads 279 00:11:07,750 --> 00:11:09,334 on the back. - V7 through V9. 280 00:11:09,335 --> 00:11:11,128 Good idea. - Thank you. 281 00:11:13,923 --> 00:11:16,257 Hey, Dr. Robby gave the go-ahead for the back leads. 282 00:11:16,258 --> 00:11:18,093 Sorry, man, I got a call report 283 00:11:18,094 --> 00:11:20,637 on a septic patient going to the ICU. 284 00:11:20,638 --> 00:11:22,263 Busy today, huh? 285 00:11:22,264 --> 00:11:24,516 Uh, well, it's 10:15. 286 00:11:24,517 --> 00:11:26,601 We're actually just getting started. 287 00:11:26,602 --> 00:11:28,103 - Oh. - There she is. 288 00:11:28,104 --> 00:11:32,440 Dr. Mohan, uh, this is Lorrie Diaz, Orlando's wife. 289 00:11:32,441 --> 00:11:33,942 - Thank you, Perlah. - Thank you. 290 00:11:33,943 --> 00:11:35,110 - Hi, Mrs. Diaz. - Hi. 291 00:11:35,111 --> 00:11:36,861 Let me take you to your husband. 292 00:11:36,862 --> 00:11:38,488 Ay, mi amor. 293 00:11:38,489 --> 00:11:40,824 I'm sorry you have to be here alone. 294 00:11:40,825 --> 00:11:44,035 I missed my first bus transfer and-- 295 00:11:44,036 --> 00:11:46,121 Anyway... 296 00:11:46,122 --> 00:11:47,122 Hey. 297 00:11:47,123 --> 00:11:49,332 How'd I get here? 298 00:11:49,333 --> 00:11:51,000 You fell at your construction site. 299 00:11:51,001 --> 00:11:52,711 A coworker brought you in. 300 00:11:52,712 --> 00:11:54,921 He's a lot better but doesn't remember anything. 301 00:11:54,922 --> 00:11:58,299 That's common after a concussion or DKA. 302 00:11:58,300 --> 00:11:59,926 DKA? 303 00:11:59,927 --> 00:12:03,221 It's a serious complication of your husband's diabetes. 304 00:12:03,222 --> 00:12:05,181 How serious? Can he go home? 305 00:12:05,182 --> 00:12:07,642 We still have to clear the ketones from his bloodstream. 306 00:12:07,643 --> 00:12:10,562 He'll need to be on an insulin drip for a while 307 00:12:10,563 --> 00:12:12,981 until things get back to normal. 308 00:12:12,982 --> 00:12:16,317 Best if he stays in the hospital. 309 00:12:16,318 --> 00:12:17,819 It's okay, Mom. 310 00:12:17,820 --> 00:12:20,071 Things are headed in the right direction, Mrs. Diaz. 311 00:12:20,072 --> 00:12:22,490 He's going to be better. - Mm. 312 00:12:24,827 --> 00:12:27,328 Sorry. I got to check his blood sugar. 313 00:12:27,329 --> 00:12:29,999 - Oh, do you mind? - Absolutely. 314 00:12:31,083 --> 00:12:34,210 So the thing is... 315 00:12:34,211 --> 00:12:36,838 we don't have health insurance. 316 00:12:36,839 --> 00:12:38,214 So... 317 00:12:38,215 --> 00:12:41,593 I don't think that we can afford this. 318 00:12:41,594 --> 00:12:45,263 I'll have our case manager, Noelle Hastings, come by. 319 00:12:45,264 --> 00:12:47,515 She's an expert in health insurance. 320 00:12:47,516 --> 00:12:50,226 She might have some options for you for coverage. 321 00:12:50,227 --> 00:12:51,895 Okay. - Thank you. 322 00:12:56,734 --> 00:12:58,943 Crap. - What's wrong? 323 00:12:58,944 --> 00:13:01,821 Uh, some of the leads aren't sticking here. 324 00:13:01,822 --> 00:13:03,948 Can I lay down now? I'm tired. 325 00:13:03,949 --> 00:13:05,658 Yeah, as soon as we're done here. 326 00:13:05,659 --> 00:13:08,411 Whitaker, Louie's all numb. His tooth is ready for you. 327 00:13:08,412 --> 00:13:09,829 That's great. 328 00:13:09,830 --> 00:13:12,916 Hey, I'm having some trouble here with adherence. 329 00:13:12,917 --> 00:13:14,876 Oh. Of course you are. 330 00:13:14,877 --> 00:13:16,711 Uh, try this. 331 00:13:16,712 --> 00:13:18,421 Oh, yeah. That makes sense. 332 00:13:18,422 --> 00:13:21,633 Uh, you think you could-- 333 00:13:22,927 --> 00:13:25,094 Do you mind if I paint some sticky stuff on you? 334 00:13:25,095 --> 00:13:26,387 Oh. 335 00:13:26,388 --> 00:13:30,058 If you must prolong the inevitable, so be it. 336 00:13:30,059 --> 00:13:32,727 You'll get to lie down afterwards. 337 00:13:32,728 --> 00:13:34,562 No success with the mineral oil. 338 00:13:34,563 --> 00:13:36,731 That's what I said. 339 00:13:36,732 --> 00:13:38,483 So now what? 340 00:13:38,484 --> 00:13:39,901 You can wait one to two weeks 341 00:13:39,902 --> 00:13:42,153 for the superglue to break down on its own. 342 00:13:42,154 --> 00:13:44,239 I'm hosting a Fourth of July party tonight. 343 00:13:44,240 --> 00:13:46,449 You want me to show up like this? 344 00:13:46,450 --> 00:13:50,495 The other option is I trim your eyelashes halfway down. 345 00:13:50,496 --> 00:13:53,331 That'll lower the strength of the glue holding them together. 346 00:13:53,332 --> 00:13:55,708 Let's do that. 347 00:13:55,709 --> 00:13:57,920 Lie back, please. 348 00:14:01,590 --> 00:14:04,092 I need you to hold your head perfectly still, 349 00:14:04,093 --> 00:14:05,635 keep your eye closed. 350 00:14:05,636 --> 00:14:08,304 My eye can't open. That's why I'm here. 351 00:14:08,305 --> 00:14:10,933 No, I mean, your other eye, too. 352 00:14:15,688 --> 00:14:17,438 Okay, here we go. 353 00:14:17,439 --> 00:14:19,524 Perfect, Mr. Samba. 354 00:14:19,525 --> 00:14:21,818 All good here. 355 00:14:21,819 --> 00:14:24,487 Feeling... dizzy. 356 00:14:24,488 --> 00:14:28,324 We'll put you down in a second. 357 00:14:28,325 --> 00:14:29,868 Holy shit. 358 00:14:29,869 --> 00:14:33,621 ST elevation, V7, V8, V9. 359 00:14:33,622 --> 00:14:36,291 It's a posterior STEMI. - What's that? 360 00:14:36,292 --> 00:14:38,293 It's the worst kind of heart attack. 361 00:14:38,294 --> 00:14:40,962 Mr. Samba. 362 00:14:40,963 --> 00:14:42,380 Mr. Samba! 363 00:14:42,381 --> 00:14:44,883 Hey, I could use a second set of hands here! 364 00:14:44,884 --> 00:14:46,467 Pulseless V tach. 365 00:14:46,468 --> 00:14:48,720 Start compressions. 366 00:14:48,721 --> 00:14:50,513 Charging to 200. 367 00:14:53,100 --> 00:14:55,602 Clear. 368 00:14:55,603 --> 00:14:57,979 Okay, resume compressions. 369 00:14:57,980 --> 00:14:59,606 Code STEMI. It was posterior. 370 00:14:59,607 --> 00:15:01,107 Yeah, good call. 371 00:15:01,108 --> 00:15:03,776 - You put the defib pads on? - Yeah, just in case. 372 00:15:03,777 --> 00:15:05,653 Hold compressions. 373 00:15:08,532 --> 00:15:11,034 Normal sinus. - All right. 374 00:15:11,035 --> 00:15:12,785 Got a strong pulse. Check the BP. 375 00:15:12,786 --> 00:15:15,121 All right, we'll prep him for cath lab. 376 00:15:16,415 --> 00:15:19,584 Hey, Mr. Samba, you're going to be okay. 377 00:15:19,585 --> 00:15:21,002 No pearly gates today. 378 00:15:21,003 --> 00:15:24,672 - Really good pickup, Whitaker. - Thank you. 379 00:15:24,673 --> 00:15:26,716 Ah... 380 00:15:26,717 --> 00:15:28,885 Has a patient ever flirted with you? 381 00:15:28,886 --> 00:15:30,553 Sure. Why? 382 00:15:30,554 --> 00:15:32,847 There was this guy this morning-- 383 00:15:32,848 --> 00:15:34,515 he turned out to be a criminal, 384 00:15:34,516 --> 00:15:36,351 but, yeah, it was a nice distraction 385 00:15:36,352 --> 00:15:37,518 from the deposition. 386 00:15:37,519 --> 00:15:38,853 You still worried about that? 387 00:15:38,854 --> 00:15:40,355 Yep. Yeah, counting down the hours. 388 00:15:40,356 --> 00:15:42,607 There are five left, if you're wondering. 389 00:15:45,694 --> 00:15:47,153 Hi, Miss Ronson. 390 00:15:47,154 --> 00:15:48,404 Phylicia, please. 391 00:15:48,405 --> 00:15:49,989 Phylicia, I'm Dr. King. 392 00:15:49,990 --> 00:15:51,574 This is my colleague Dr. Santos. 393 00:15:51,575 --> 00:15:53,076 What brings you in today? 394 00:15:53,077 --> 00:15:55,495 I've had this pretty bad cough for a few days now. 395 00:15:55,496 --> 00:15:56,746 Do you smoke? 396 00:15:56,747 --> 00:15:58,414 Are coughing up anything, any chest pain? 397 00:15:58,415 --> 00:16:00,208 No, no, and no. 398 00:16:00,209 --> 00:16:02,418 I honestly think I picked it up at work. 399 00:16:02,419 --> 00:16:04,212 It was going around. - Oh, where do you work? 400 00:16:04,213 --> 00:16:06,965 - I'm in corporate at PNC Bank. - Sit forward, please. 401 00:16:06,966 --> 00:16:08,675 It could be an office bug. 402 00:16:08,676 --> 00:16:12,054 Or I got it from the gym. I'm there all the time. 403 00:16:16,266 --> 00:16:18,893 Do you have anything to ask, Dr. Santos? 404 00:16:18,894 --> 00:16:20,395 What? 405 00:16:20,396 --> 00:16:22,313 Do you have any questions to ask our patient? 406 00:16:22,314 --> 00:16:24,232 Uh, no, I'm good. 407 00:16:24,233 --> 00:16:25,817 Okay. What'd you hear? 408 00:16:25,818 --> 00:16:28,111 Maybe some crackles at the right base. 409 00:16:28,112 --> 00:16:31,739 Okay, well, we're going to need a chest X-ray 410 00:16:31,740 --> 00:16:32,991 to check your lungs. 411 00:16:32,992 --> 00:16:34,409 Will that take long? 412 00:16:34,410 --> 00:16:36,119 Maybe I can still make it to the office. 413 00:16:36,120 --> 00:16:38,830 It shouldn't. 414 00:16:38,831 --> 00:16:42,292 You can go put the orders in. - Yeah. 415 00:16:44,753 --> 00:16:47,588 - How are we doing in here? - Oh, this is thrilling. 416 00:16:47,589 --> 00:16:50,341 Definitely worth $200,000 worth of student debt. 417 00:16:50,342 --> 00:16:51,718 Ha. 418 00:16:51,719 --> 00:16:53,386 Superficial ones get a steri-strip. 419 00:16:53,387 --> 00:16:55,388 Full thickness, try Dermabond. 420 00:16:55,389 --> 00:16:57,557 How can you tell they need a suture, Joy? 421 00:16:57,558 --> 00:16:59,726 If the edges are under significant tension. 422 00:16:59,727 --> 00:17:01,602 I didn't realize your name was Joy. 423 00:17:01,603 --> 00:17:04,188 I'm going to have to tell my parents how trendy they were. 424 00:17:05,858 --> 00:17:08,359 CT head, neck, chest, abdomen, and pelvis, 425 00:17:08,360 --> 00:17:10,445 all normal on preliminary read. - Lucky guy. 426 00:17:10,446 --> 00:17:11,904 Little bit of oozing. 427 00:17:11,905 --> 00:17:13,573 Uh, pressure for two minutes. 428 00:17:13,574 --> 00:17:16,200 Lidocaine and epi if that doesn't work. 429 00:17:16,201 --> 00:17:18,327 Are the admit orders in for Surgical ICU? 430 00:17:18,328 --> 00:17:19,996 Fuck! 431 00:17:19,997 --> 00:17:21,289 What? 432 00:17:21,290 --> 00:17:23,791 - This. - Ah. 433 00:17:23,792 --> 00:17:26,794 - Irrigation saline. - It's just a small cut. 434 00:17:26,795 --> 00:17:28,838 It is a work-related blood exposure, 435 00:17:28,839 --> 00:17:30,673 which means you're a patient now. 436 00:17:30,674 --> 00:17:31,883 - Are you serious? - Needle stick? 437 00:17:31,884 --> 00:17:33,468 Piece of glass. 438 00:17:33,469 --> 00:17:35,636 - Here you go. - Thanks. 439 00:17:36,805 --> 00:17:38,473 No past records on this guy. 440 00:17:38,474 --> 00:17:40,475 We don't know HIV or hepatitis status. 441 00:17:40,476 --> 00:17:44,187 I'll put the orders in, HIV antibody, Hep B surface, 442 00:17:44,188 --> 00:17:45,563 and Hep C. 443 00:17:45,564 --> 00:17:47,565 She needs post-exposure medication. 444 00:17:47,566 --> 00:17:48,900 Maybe not. 445 00:17:48,901 --> 00:17:51,319 For occupational exposure, the rapid HIV test 446 00:17:51,320 --> 00:17:54,280 takes an hour or two. - Subcutaneous puncture wound. 447 00:17:54,281 --> 00:17:56,908 No risk of joint or tendon involvement. 448 00:17:56,909 --> 00:17:59,452 Elevate, pressure, and then a Band-Aid. 449 00:17:59,453 --> 00:18:01,496 Give yourself a dose of PEP if you want 450 00:18:01,497 --> 00:18:02,955 while you're waiting for results. 451 00:18:02,956 --> 00:18:04,624 Start a chart, and I'll find another nurse 452 00:18:04,625 --> 00:18:05,875 for your blood draw. 453 00:18:05,876 --> 00:18:07,668 Great. 454 00:18:07,669 --> 00:18:10,046 Looks like we've got a couple more diverted from Westbridge. 455 00:18:10,047 --> 00:18:12,048 Any estimate on their downtime? 456 00:18:12,049 --> 00:18:14,675 Not yet. 457 00:18:14,676 --> 00:18:16,552 Time to pull Dr. Langdon from triage? 458 00:18:16,553 --> 00:18:18,262 No, no. First day back. 459 00:18:18,263 --> 00:18:20,848 I want to let him kind of ease into things. 460 00:18:20,849 --> 00:18:23,101 Understood. I'll keep an eye on it. 461 00:18:23,102 --> 00:18:25,186 Thank you very much. 462 00:18:25,187 --> 00:18:26,771 Thinking about changing your bet? 463 00:18:26,772 --> 00:18:29,232 I am just weighing my odds. 464 00:18:29,233 --> 00:18:33,194 Don't worry. I'll buy you a drink with my winnings. 465 00:18:38,617 --> 00:18:40,368 Your brother should be back shortly. 466 00:18:40,369 --> 00:18:43,204 There was a little holdup at CT. 467 00:18:43,205 --> 00:18:45,540 Um, should I be worried? 468 00:18:45,541 --> 00:18:48,709 Let's wait and see what his test results say. 469 00:18:48,710 --> 00:18:51,379 This is just, um... 470 00:18:51,380 --> 00:18:53,798 this just doesn't make any sense. 471 00:18:53,799 --> 00:18:55,925 It doesn't sound like my brother at all. 472 00:18:55,926 --> 00:18:58,719 He's the--the friendliest guy I know. 473 00:18:58,720 --> 00:19:01,013 He never even gets angry, barely yells. 474 00:19:01,014 --> 00:19:03,641 He's never had an episode like this in the past? 475 00:19:03,642 --> 00:19:07,061 No, or not that I know of. 476 00:19:07,062 --> 00:19:09,230 He's in a great relationship. 477 00:19:09,231 --> 00:19:10,982 And he's in law school 478 00:19:10,983 --> 00:19:13,693 'cause he wants to help people. 479 00:19:13,694 --> 00:19:16,654 He always tells me that I should, um... 480 00:19:16,655 --> 00:19:18,948 follow my dreams, 481 00:19:18,949 --> 00:19:22,244 even if it means my parents may disown me. 482 00:19:24,037 --> 00:19:25,580 Should I call them? 483 00:19:25,581 --> 00:19:28,583 I think that's a good idea. 484 00:19:28,584 --> 00:19:31,086 This--this could be pretty serious. 485 00:19:35,674 --> 00:19:37,843 Thanks. - Mm-hmm. 486 00:19:43,765 --> 00:19:46,350 The new radiologist is a hottie. 487 00:19:46,351 --> 00:19:47,935 Okay. 488 00:19:47,936 --> 00:19:49,353 Um... 489 00:19:49,354 --> 00:19:52,523 his head CT is normal, as are his blood and urine tests. 490 00:19:52,524 --> 00:19:54,442 Then--then what's wrong with him? 491 00:19:54,443 --> 00:19:56,485 We're not, um, sure yet. 492 00:19:56,486 --> 00:19:59,197 There is another test-- a-a spinal tap. 493 00:19:59,198 --> 00:20:00,907 This could be, um, an infection 494 00:20:00,908 --> 00:20:03,451 in the fluid that surrounds the brain--viral encephalitis. 495 00:20:03,452 --> 00:20:05,786 Um, it can also cause... 496 00:20:05,787 --> 00:20:08,915 altered mental status and confusion. 497 00:20:08,916 --> 00:20:11,375 Can you treat it, if it is? 498 00:20:11,376 --> 00:20:12,753 Yes. 499 00:20:14,338 --> 00:20:17,173 Okay. 500 00:20:17,174 --> 00:20:19,508 I'll go find Dr. Al-Hashimi, and--and we'll do it together. 501 00:20:19,509 --> 00:20:21,678 - Thank you. - Of course. 502 00:20:25,557 --> 00:20:28,976 Just what we thought-- it's a fracture of your coccyx. 503 00:20:28,977 --> 00:20:30,478 It's your tailbone. 504 00:20:30,479 --> 00:20:32,813 Yeah, see, these pieces here 505 00:20:32,814 --> 00:20:35,983 should be lined up with that part here. 506 00:20:35,984 --> 00:20:37,985 - Do I need surgery? - No. 507 00:20:37,986 --> 00:20:41,698 No, no, these heal pretty well, but it'll take about six weeks. 508 00:20:43,158 --> 00:20:45,368 "Six weeks"? 509 00:20:45,369 --> 00:20:47,828 I have dinner dates every weekend. 510 00:20:47,829 --> 00:20:50,164 You can keep your-- 511 00:20:50,165 --> 00:20:52,208 still keep your dinner plans. 512 00:20:52,209 --> 00:20:56,337 Dinner starts at Pino's, the best Italian in town. 513 00:20:56,338 --> 00:20:57,672 Mm-hmm. 514 00:20:57,673 --> 00:20:59,924 A nightcap at my place usually follows, 515 00:20:59,925 --> 00:21:02,343 and then breakfast in bed. 516 00:21:02,344 --> 00:21:04,595 Ah, okay. 517 00:21:04,596 --> 00:21:06,055 Well, in that case, you might-- 518 00:21:06,056 --> 00:21:08,766 you might need to take a little break. 519 00:21:08,767 --> 00:21:12,395 My greatest joy in life is my social calendar. 520 00:21:12,396 --> 00:21:14,564 - Mm. - Hmm? 521 00:21:19,278 --> 00:21:22,071 Is there something else you can do? 522 00:21:22,072 --> 00:21:25,449 W-well, there-- there is a procedure 523 00:21:25,450 --> 00:21:27,702 to push the fragments back in place. 524 00:21:27,703 --> 00:21:30,705 It could help it heal faster. - Now we're talking. 525 00:21:30,706 --> 00:21:33,207 Yeah, but it'll hurt pretty bad but only for a second. 526 00:21:33,208 --> 00:21:35,002 I can take it. 527 00:21:36,628 --> 00:21:38,129 Okay. 528 00:21:38,130 --> 00:21:40,590 Come here. Back in the gown. 529 00:21:50,559 --> 00:21:52,560 How's it going over here? 530 00:21:52,561 --> 00:21:54,855 Better now. 531 00:21:56,898 --> 00:21:58,984 Uh... 532 00:22:00,110 --> 00:22:04,238 Oh, the X-ray is back on your foot, 533 00:22:04,239 --> 00:22:06,782 and no fracture. 534 00:22:06,783 --> 00:22:10,328 So, um, ACE wrap, ice, rest, and elevate, 535 00:22:10,329 --> 00:22:12,998 and you can take ibuprofen if you need it. 536 00:22:14,333 --> 00:22:15,750 So that's it? 537 00:22:15,751 --> 00:22:17,752 Well, if it's--if it's too painful to bear weight, 538 00:22:17,753 --> 00:22:21,047 we can give you crutches to use for a day or two. 539 00:22:21,048 --> 00:22:23,341 So I won't be seeing you again. 540 00:22:23,342 --> 00:22:26,302 Uh... 541 00:22:26,303 --> 00:22:28,763 as a patient, no, but... 542 00:22:28,764 --> 00:22:31,349 it was nice meeting you, Brian. 543 00:22:31,350 --> 00:22:34,019 It was nice meeting you, too, Dr. McKay. 544 00:22:49,159 --> 00:22:51,952 You know, I was-- I was going to go check out 545 00:22:51,953 --> 00:22:55,498 a few of the art galleries in Lawrenceville tonight. 546 00:22:55,499 --> 00:22:58,376 Have you been to that one on 40th and Butler? 547 00:22:58,377 --> 00:23:00,878 No, I was, um, gonna go by. 548 00:23:00,879 --> 00:23:03,297 Maybe around 9:00? 549 00:23:03,298 --> 00:23:05,591 Okay. 550 00:23:05,592 --> 00:23:07,719 Cool. - Cool. 551 00:23:09,971 --> 00:23:12,056 Dude, I resuscitated that parkour guy 552 00:23:12,057 --> 00:23:13,265 and--and intubated a STEMI. 553 00:23:13,266 --> 00:23:14,600 I think I can handle this. 554 00:23:14,601 --> 00:23:16,852 It's best if you watch the first one. 555 00:23:16,853 --> 00:23:18,437 How's that tooth feeling? 556 00:23:18,438 --> 00:23:21,023 The whole side of my face is numb. 557 00:23:21,024 --> 00:23:23,442 That's how we like it. 558 00:23:23,443 --> 00:23:26,862 Okay, we've got a... 559 00:23:26,863 --> 00:23:28,948 a fluctuant gumline at-- 560 00:23:28,949 --> 00:23:31,617 Tooth number 23, lateral incisor. 561 00:23:31,618 --> 00:23:35,162 - With an extension to an-- - Apical abscess. 562 00:23:35,163 --> 00:23:38,082 - Right again. - Ah, the kid's smart. 563 00:23:38,083 --> 00:23:41,252 Hook up the Yankauer. Get ready to retract the gum. 564 00:23:41,253 --> 00:23:43,838 Hey, Louie, this is a temporary fix, okay? 565 00:23:43,839 --> 00:23:46,340 You're going to need to get that tooth pulled by a dentist. 566 00:23:46,341 --> 00:23:48,217 Hey, you going to find me one? 567 00:23:48,218 --> 00:23:50,845 We can have you talk to Dylan. 568 00:23:50,846 --> 00:23:53,097 Is Dr. Collins around? 569 00:23:53,098 --> 00:23:55,599 Sister always helps me out. 570 00:23:55,600 --> 00:23:59,019 Uh, Dr. Collins finished her residency, 571 00:23:59,020 --> 00:24:01,897 took up a job in Portland as an attending physician. 572 00:24:01,898 --> 00:24:03,107 "Portland"? 573 00:24:03,108 --> 00:24:05,109 Yeah, I think that's where she's from. 574 00:24:05,110 --> 00:24:06,402 She's adopting a baby. 575 00:24:06,403 --> 00:24:08,612 Wanted to be closer to her family. 576 00:24:08,613 --> 00:24:10,531 Well, that's a beautiful thing. 577 00:24:10,532 --> 00:24:13,577 - We're set. - Okay. Ready? 578 00:24:15,078 --> 00:24:18,581 Okay, 3-cc syringe, 579 00:24:18,582 --> 00:24:22,585 20-gauge needle entering at the juiciest part, 580 00:24:22,586 --> 00:24:25,130 aiming for the apex. 581 00:24:27,174 --> 00:24:29,133 - Send that for culture? - No. 582 00:24:29,134 --> 00:24:30,676 Pen V.K. for a few days. 583 00:24:30,677 --> 00:24:32,928 Bugs in the mouth are old school. 584 00:24:32,929 --> 00:24:35,181 Ah, just like me. 585 00:24:36,808 --> 00:24:38,142 Both parents work, 586 00:24:38,143 --> 00:24:40,060 but neither of them have health coverage? 587 00:24:40,061 --> 00:24:43,230 Orlando and his wife have multiple part-time jobs 588 00:24:43,231 --> 00:24:45,316 that don't offer insurance. 589 00:24:45,317 --> 00:24:46,942 Can they qualify for Medicaid? 590 00:24:46,943 --> 00:24:49,820 Unfortunately, no, because their combined annual income 591 00:24:49,821 --> 00:24:52,156 is over the Medicaid threshold for a family of five. 592 00:24:52,157 --> 00:24:53,741 So they make too much money? 593 00:24:53,742 --> 00:24:55,910 And not enough at the same time. 594 00:24:55,911 --> 00:24:57,786 They live over the poverty line, 595 00:24:57,787 --> 00:25:01,749 and yet they are still living paycheck to paycheck. 596 00:25:01,750 --> 00:25:03,584 I think their best option 597 00:25:03,585 --> 00:25:05,920 would be to buy private insurance 598 00:25:05,921 --> 00:25:07,796 through the Affordable Care Act. 599 00:25:07,797 --> 00:25:09,757 Thank you. 600 00:25:09,758 --> 00:25:12,635 My parents don't have insurance? 601 00:25:12,636 --> 00:25:14,595 I'm sorry, Ana. 602 00:25:14,596 --> 00:25:17,348 How much will it cost to keep my dad in the hospital? 603 00:25:17,349 --> 00:25:19,975 I don't know. 604 00:25:19,976 --> 00:25:25,147 But the ER visit alone will likely be in the thousands. 605 00:25:25,148 --> 00:25:28,818 We will figure something out, okay? 606 00:25:33,114 --> 00:25:34,823 Purple top for the CBC. 607 00:25:34,824 --> 00:25:37,785 Red top for chemistries and serologies. 608 00:25:37,786 --> 00:25:39,204 Okay. 609 00:25:40,830 --> 00:25:42,790 Ready? - Uh, yeah. 610 00:25:42,791 --> 00:25:46,627 I can be a hard stick, though. 611 00:25:46,628 --> 00:25:48,421 Now or never, hon. 612 00:25:49,798 --> 00:25:51,840 Okay. 613 00:25:51,841 --> 00:25:54,843 One, two... 614 00:25:54,844 --> 00:25:56,637 three. 615 00:25:56,638 --> 00:25:58,847 - Good blood return. - Oh, thank God. 616 00:25:58,848 --> 00:26:00,225 Pop one on. 617 00:26:04,646 --> 00:26:06,814 You're supposed to release the tourniquet now. 618 00:26:06,815 --> 00:26:08,900 Right. Sorry. 619 00:26:12,112 --> 00:26:14,029 Lab won't take it without your initials, 620 00:26:14,030 --> 00:26:15,447 time, and date drawn. 621 00:26:15,448 --> 00:26:16,907 How you feeling? - Peachy. 622 00:26:16,908 --> 00:26:20,452 Hopefully I get to do this several times every day. 623 00:26:20,453 --> 00:26:22,038 All set. 624 00:26:23,248 --> 00:26:25,666 Keep some pressure here for a minute. 625 00:26:25,667 --> 00:26:27,877 Initials, time, and date. 626 00:26:29,754 --> 00:26:31,047 Oh. 627 00:26:33,675 --> 00:26:35,468 Shit. 628 00:26:37,053 --> 00:26:38,846 Environmental to North. 629 00:26:38,847 --> 00:26:41,140 Sorry. 630 00:26:41,141 --> 00:26:42,933 How is he? 631 00:26:42,934 --> 00:26:45,519 He's stable. He's doing great. 632 00:26:45,520 --> 00:26:48,272 Doesn't look great. 633 00:26:48,273 --> 00:26:49,857 Is there brain damage? 634 00:26:49,858 --> 00:26:53,027 The head CT showed no bleeding or skull fracture. 635 00:26:53,028 --> 00:26:54,737 It's most likely a bad concussion. 636 00:26:54,738 --> 00:26:57,906 It's hard to know when he'll regain consciousness. 637 00:26:57,907 --> 00:26:59,950 - Did he break any bones? - We don't think so. 638 00:26:59,951 --> 00:27:02,536 He should thank those ferns. 639 00:27:02,537 --> 00:27:04,371 Uh, chest and abdomen CT scans 640 00:27:04,372 --> 00:27:06,915 also showed no major internal injuries. 641 00:27:06,916 --> 00:27:08,751 Mm-hmm. 642 00:27:08,752 --> 00:27:10,503 What's that? 643 00:27:13,840 --> 00:27:15,883 Whoa, whoa, whoa, whoa, whoa. 644 00:27:15,884 --> 00:27:18,720 We need respiratory therapy in here! 645 00:27:20,138 --> 00:27:21,680 Okay. 646 00:27:21,681 --> 00:27:24,224 One, two, three, over. 647 00:27:24,225 --> 00:27:25,684 You got a problem with the vent? 648 00:27:25,685 --> 00:27:27,061 No, he's bleeding from the back. 649 00:27:27,062 --> 00:27:28,479 Got to prone him to take a look. 650 00:27:28,480 --> 00:27:30,856 Back away, Tanya. One, two, three, up. 651 00:27:30,857 --> 00:27:32,691 One, two, three, over. 652 00:27:32,692 --> 00:27:34,610 Good. - Oh, shit. 653 00:27:34,611 --> 00:27:36,487 - Left-flank area. - Careful. Careful, everybody. 654 00:27:36,488 --> 00:27:38,113 There might be glass. - That's a lot of blood. 655 00:27:38,114 --> 00:27:39,490 2-centimeter simple laceration. 656 00:27:39,491 --> 00:27:41,033 Open a suture kit, 4-0 Prolene. 657 00:27:41,034 --> 00:27:42,785 He wasn't bleeding when we flipped him on arrival. 658 00:27:42,786 --> 00:27:44,620 No, but when we moved him around for CT, 659 00:27:44,621 --> 00:27:46,413 it might have rubbed off a clot. 660 00:27:46,414 --> 00:27:47,623 Slow venous oozing. 661 00:27:47,624 --> 00:27:50,084 I might need a figure of eight. 662 00:27:54,756 --> 00:27:56,840 Yeah, little piece of glass in there. 663 00:27:56,841 --> 00:27:58,509 It's just under the skin. 664 00:27:58,510 --> 00:28:00,302 - Is it a loose fragment? - Yeah, I can wiggle it around. 665 00:28:00,303 --> 00:28:01,679 Here, I'll pull it out. - No, don't-- 666 00:28:01,680 --> 00:28:03,097 Shit. 667 00:28:03,098 --> 00:28:05,099 Uh, that's--it's bigger than I thought it would be. 668 00:28:05,100 --> 00:28:06,517 - Shit. - That looks arterial. 669 00:28:06,518 --> 00:28:08,602 Can I get some 4-by-4s over here, please? 670 00:28:08,603 --> 00:28:10,104 Oh, I'm going to be sick. 671 00:28:10,105 --> 00:28:11,605 Put some pressure on this from all sides. 672 00:28:11,606 --> 00:28:12,773 Hard and deep, please. 673 00:28:12,774 --> 00:28:14,149 I can push it back in. both: No! 674 00:28:14,150 --> 00:28:15,484 No, you've done enough damage. 675 00:28:15,485 --> 00:28:17,069 Should I keep pulling it out, then? 676 00:28:17,070 --> 00:28:19,488 Absolutely not. The glass was tamponading a vessel. 677 00:28:19,489 --> 00:28:22,616 Not anymore. BP's down. Page surgery! 678 00:28:26,204 --> 00:28:29,206 - Ah, I was looking for you. - Well, you found me. 679 00:28:29,207 --> 00:28:32,000 Um, the X-ray came back on the lady with the cough. 680 00:28:32,001 --> 00:28:34,002 Weird infiltrate. Have you seen it yet? 681 00:28:34,003 --> 00:28:36,130 No, I've been trying to catch up on my charting. 682 00:28:36,131 --> 00:28:37,673 Right here. 683 00:28:37,674 --> 00:28:39,925 Yep, stringy right lower lobe. 684 00:28:39,926 --> 00:28:42,845 It looks like aspiration pneumonia. 685 00:28:42,846 --> 00:28:44,263 Think about it. 686 00:28:44,264 --> 00:28:47,391 How do oral and gastric fluids end up in lungs? 687 00:28:47,392 --> 00:28:50,310 Um, dysphagia, swallowing disorders. 688 00:28:50,311 --> 00:28:52,980 But she's not an old person choking on their food. 689 00:28:52,981 --> 00:28:55,149 Right, and there's protracted vomiting. 690 00:28:55,150 --> 00:28:56,859 Okay, maybe recent gastroenteritis, 691 00:28:56,860 --> 00:28:58,652 food poisoning. 692 00:28:58,653 --> 00:29:00,821 Yeah, or... 693 00:29:00,822 --> 00:29:02,364 or... 694 00:29:02,365 --> 00:29:04,366 An eating disorder. 695 00:29:04,367 --> 00:29:06,160 You think she's bulimic? 696 00:29:06,161 --> 00:29:09,371 I mean, she's fixated on working out. 697 00:29:09,372 --> 00:29:13,041 Check the, uh, enamel behind her front incisors. 698 00:29:13,042 --> 00:29:15,002 Um, oh, it's, uh-- 699 00:29:15,003 --> 00:29:17,713 if it's not in the differential, 700 00:29:17,714 --> 00:29:20,799 it won't be in the diagnosis. 701 00:29:20,800 --> 00:29:22,176 You know that-- 702 00:29:22,177 --> 00:29:25,054 Yeah, you know-- you know that. 703 00:29:29,934 --> 00:29:31,351 Nice job on the tap. 704 00:29:31,352 --> 00:29:32,853 Thanks. 705 00:29:32,854 --> 00:29:36,231 Hi. You called for a consult on Jackson Davis? 706 00:29:36,232 --> 00:29:37,858 Yes, we did. 707 00:29:37,859 --> 00:29:41,862 I'll let Victoria present the case. 708 00:29:41,863 --> 00:29:43,530 This is Jada, Jackson's sister. 709 00:29:43,531 --> 00:29:45,824 This is Dr. Jefferson from psychiatry. 710 00:29:45,825 --> 00:29:47,159 "Psychiatry"? 711 00:29:47,160 --> 00:29:48,869 Do you think this is a mental-health problem? 712 00:29:48,870 --> 00:29:50,913 We thought it best to cover all our bases. 713 00:29:50,914 --> 00:29:53,290 We'll know more once I speak with your brother. 714 00:29:53,291 --> 00:29:55,251 Okay. 715 00:29:57,045 --> 00:29:59,546 Hi, Jackson. 716 00:29:59,547 --> 00:30:02,716 Jackson, can you wake up? 717 00:30:02,717 --> 00:30:05,178 Jackson. - They said he's sedated. 718 00:30:07,722 --> 00:30:10,016 I'll come back a little later. 719 00:30:11,893 --> 00:30:13,393 - Oh, that was fast. - Yeah. 720 00:30:13,394 --> 00:30:16,063 Next time, maybe wait until the patient wakes up 721 00:30:16,064 --> 00:30:17,606 before calling me down. 722 00:30:17,607 --> 00:30:18,982 Psychiatrists do best 723 00:30:18,983 --> 00:30:22,653 when we can actually talk to our patients. 724 00:30:22,654 --> 00:30:24,738 I got a little ahead of myself. 725 00:30:24,739 --> 00:30:26,865 Um, will do. 726 00:30:26,866 --> 00:30:28,992 Thank you. 727 00:30:28,993 --> 00:30:30,994 Sorry. 728 00:30:30,995 --> 00:30:33,956 Pressure's up with one unit type specific. 729 00:30:36,042 --> 00:30:37,835 What the fuck? He was stable. 730 00:30:37,836 --> 00:30:40,754 - Slight change in status. - Okay, get the clamp ready. 731 00:30:40,755 --> 00:30:43,131 Who's the genius who pulled that out? 732 00:30:43,132 --> 00:30:45,133 I thought it was a loose fragment. 733 00:30:45,134 --> 00:30:47,177 Next time, leave the decisions to the adults. 734 00:30:47,178 --> 00:30:49,514 Okay, Dr. McKay, ready to go? 735 00:30:53,977 --> 00:30:55,644 - Whoa. - Hoo. 736 00:30:55,645 --> 00:30:56,979 Looks like an icicle. 737 00:30:56,980 --> 00:30:59,022 Christmas in July. 738 00:30:59,023 --> 00:31:01,942 Hey, Sophie, can you answer that? 739 00:31:01,943 --> 00:31:03,944 Okay, I am injecting the X-stat. 740 00:31:03,945 --> 00:31:04,945 - Hello? - What is that? 741 00:31:04,946 --> 00:31:06,488 It's a syringe filled 742 00:31:06,489 --> 00:31:09,283 with tiny, rapid-expanding hemostatic sponges. 743 00:31:09,284 --> 00:31:10,784 Okay, got it. Thanks. 744 00:31:10,785 --> 00:31:13,161 Radiology attending says a resident missed something. 745 00:31:13,162 --> 00:31:14,788 There's a radiopaque foreign body 746 00:31:14,789 --> 00:31:17,124 in the left paralumbar musculature. 747 00:31:17,125 --> 00:31:18,458 Not anymore. 748 00:31:18,459 --> 00:31:20,335 Sounds like "first week in July" syndrome. 749 00:31:20,336 --> 00:31:21,837 Mm-hmm. 750 00:31:21,838 --> 00:31:24,256 Okay. 751 00:31:24,257 --> 00:31:27,718 That looks pretty dry. - On the surface. 752 00:31:27,719 --> 00:31:30,345 Okay, let's turn him back down. 753 00:31:30,346 --> 00:31:34,182 Okay, one, two, three, over. 754 00:31:34,183 --> 00:31:36,852 One, two, three, flip. 755 00:31:36,853 --> 00:31:39,771 One, two, three, down. 756 00:31:39,772 --> 00:31:41,690 All right, CT is ready to rescan. 757 00:31:41,691 --> 00:31:43,609 Interventional radiology is holding a room. 758 00:31:43,610 --> 00:31:46,069 Look at you-- so on top of things. 759 00:31:46,070 --> 00:31:47,946 Hasta la próxima. 760 00:31:47,947 --> 00:31:50,282 How you doing over here? 761 00:31:50,283 --> 00:31:51,909 Definitely not great. 762 00:31:51,910 --> 00:31:54,202 Right, well, let's get you a ginger ale. 763 00:31:54,203 --> 00:31:57,205 So we never, ever remove a deep foreign body in the ER. 764 00:31:57,206 --> 00:31:59,166 We always leave that to surgery. 765 00:31:59,167 --> 00:32:01,543 It won't happen again. 766 00:32:01,544 --> 00:32:04,171 I was just coming to find you. 767 00:32:04,172 --> 00:32:05,339 Sure you were. 768 00:32:05,340 --> 00:32:07,215 It's almost like you're avoiding me. 769 00:32:07,216 --> 00:32:08,592 Me? Never. 770 00:32:08,593 --> 00:32:10,218 No, I'm just having one of those busy days, 771 00:32:10,219 --> 00:32:12,512 you know, living the dream, saving America's tired, 772 00:32:12,513 --> 00:32:14,723 poor, huddled masses yearning to breathe free. 773 00:32:14,724 --> 00:32:17,517 - You're a saint. - I tell myself that every day. 774 00:32:17,518 --> 00:32:20,062 I heard you had a, uh, motorcycle crash 775 00:32:20,063 --> 00:32:23,065 come through about an hour ago. - Yeah. 776 00:32:23,066 --> 00:32:24,942 Couldn't save him. 777 00:32:24,943 --> 00:32:27,277 And, no, he was not wearing a helmet. 778 00:32:27,278 --> 00:32:28,904 Interesting. 779 00:32:28,905 --> 00:32:31,448 One motorcycle crash is not going to scare me off my trip. 780 00:32:31,449 --> 00:32:33,408 I didn't say it should. 781 00:32:33,409 --> 00:32:36,662 I hope he died doing what he loved. 782 00:32:36,663 --> 00:32:39,456 That's... optimistic. 783 00:32:39,457 --> 00:32:41,751 "Glass half full" kind of guy. 784 00:32:43,252 --> 00:32:45,921 I am not on your couch. - I'm aware. 785 00:32:45,922 --> 00:32:48,548 Conflict of interest here. - Why? Because we're friends? 786 00:32:48,549 --> 00:32:51,635 Ooh, look at you, using the F word. 787 00:32:51,636 --> 00:32:53,095 That's growth. 788 00:32:53,096 --> 00:32:54,388 I use F words all the time. 789 00:32:54,389 --> 00:32:55,889 I guess this therapy must be working. 790 00:32:55,890 --> 00:32:58,392 Ah, I got somebody new for you. 791 00:32:58,393 --> 00:33:00,978 She takes no shit. You'll love her. 792 00:33:00,979 --> 00:33:02,270 I hope so. 793 00:33:02,271 --> 00:33:05,941 The last two have not exactly been... my speed. 794 00:33:05,942 --> 00:33:09,236 Meaning what, empathetic? 795 00:33:09,237 --> 00:33:11,738 Look, sometimes it just takes a little while 796 00:33:11,739 --> 00:33:13,573 to, you know, find the right fit. 797 00:33:13,574 --> 00:33:14,950 Well, it's going to have to wait, 798 00:33:14,951 --> 00:33:16,243 because I'm going on my sabbatical tomorrow. 799 00:33:16,244 --> 00:33:17,786 There's always Zoom therapy. 800 00:33:17,787 --> 00:33:20,873 Motorcycle trip is zoom therapy. 801 00:33:22,834 --> 00:33:25,794 I'll bet somebody set off fireworks in the shitter. 802 00:33:25,795 --> 00:33:28,171 How dumb is that? 803 00:33:28,172 --> 00:33:30,298 You think people are smart? 804 00:33:30,299 --> 00:33:32,593 Yeah. 805 00:33:34,470 --> 00:33:36,054 What's up, man? 806 00:33:36,055 --> 00:33:38,306 You want to get on the books? 807 00:33:38,307 --> 00:33:39,683 Uh, yeah. 808 00:33:39,684 --> 00:33:41,435 Yeah, yeah. May--maybe. Yeah. 809 00:33:41,436 --> 00:33:42,436 Hey, look here. 810 00:33:42,437 --> 00:33:44,187 I only take real money, 811 00:33:44,188 --> 00:33:46,189 none of that "I owe you" bullshit. 812 00:33:47,775 --> 00:33:49,359 Okay, I have money, okay? 813 00:33:49,360 --> 00:33:52,654 My first direct deposit finally hit, so... 814 00:33:52,655 --> 00:33:54,823 Nice. Hmm. 815 00:33:54,824 --> 00:33:58,326 Put me down for $40... 816 00:33:58,327 --> 00:34:00,787 for power outage. 817 00:34:00,788 --> 00:34:02,831 Nice. 818 00:34:02,832 --> 00:34:05,459 We got a big baller on our hands. 819 00:34:05,460 --> 00:34:07,127 - Congrats, Doctor. - Thank you. 820 00:34:07,128 --> 00:34:09,004 I like this side of you, man. 821 00:34:09,005 --> 00:34:11,715 - Any improvement? - No. 822 00:34:11,716 --> 00:34:13,341 What kind of super glue did you use? 823 00:34:13,342 --> 00:34:16,303 Does it matter? My eye is still fucking shut. 824 00:34:16,304 --> 00:34:18,138 Okay, there's one other thing I can try. 825 00:34:18,139 --> 00:34:20,140 No. I'm done. I asked for Dr. J earlier, 826 00:34:20,141 --> 00:34:22,225 and I would like to see her now. 827 00:34:22,226 --> 00:34:24,144 I haven't been in the hospital for a while. 828 00:34:24,145 --> 00:34:25,979 I don't know a Dr. J. 829 00:34:25,980 --> 00:34:29,442 She's one of the best doctors in Pittsburgh. 830 00:34:34,238 --> 00:34:37,532 Oh, Dr. J. 831 00:34:37,533 --> 00:34:38,658 Hmm. 832 00:34:38,659 --> 00:34:40,744 - Do what you must, milady. - Mm-hmm. 833 00:34:40,745 --> 00:34:44,664 Okay, first, I need to get a good grip for the reduction. 834 00:34:44,665 --> 00:34:46,958 Uh-huh. 835 00:34:46,959 --> 00:34:48,460 Here we go. 836 00:34:48,461 --> 00:34:50,087 Try to relax. 837 00:34:50,088 --> 00:34:53,131 Deep breath, with your mouth open. 838 00:34:53,132 --> 00:34:54,549 Not how I imagined 839 00:34:54,550 --> 00:34:57,052 our first intimate encounter. 840 00:34:57,053 --> 00:35:00,138 Okay, got it. 841 00:35:00,139 --> 00:35:02,849 Now, on three, okay? 842 00:35:02,850 --> 00:35:04,893 One... 843 00:35:04,894 --> 00:35:08,188 Ah! Motherfucker. 844 00:35:08,189 --> 00:35:10,732 Ho-ho! You said "on three." 845 00:35:10,733 --> 00:35:11,942 I--I know. 846 00:35:11,943 --> 00:35:14,361 Sorry. It keeps you from tensing up. 847 00:35:14,362 --> 00:35:16,196 Okay, I think that worked. 848 00:35:16,197 --> 00:35:18,281 How does it feel? - Can I sit up? 849 00:35:18,282 --> 00:35:21,368 - Uh-huh. - Oh. 850 00:35:21,369 --> 00:35:22,620 Oh. 851 00:35:25,081 --> 00:35:28,125 Oh, my God. 852 00:35:28,126 --> 00:35:30,377 Oh. 853 00:35:30,378 --> 00:35:33,463 That is definitely better. 854 00:35:33,464 --> 00:35:35,465 Oh, my God. 855 00:35:35,466 --> 00:35:37,509 Great. 856 00:35:37,510 --> 00:35:39,094 Can I give you a hug? 857 00:35:39,095 --> 00:35:41,680 Mm, maybe--maybe later, okay? 858 00:35:44,350 --> 00:35:47,310 Aspiration pneumonia? How does that happen? 859 00:35:47,311 --> 00:35:49,980 It's when bacteria from the mouth or stomach 860 00:35:49,981 --> 00:35:52,023 get into the breathing tube, 861 00:35:52,024 --> 00:35:53,775 uh, when you're choking, 862 00:35:53,776 --> 00:35:57,028 if you're eating or vomiting. 863 00:35:57,029 --> 00:35:58,155 Oh. 864 00:35:58,156 --> 00:36:00,031 Do you ever drink a lot of alcohol, 865 00:36:00,032 --> 00:36:02,242 maybe so much that you pass out? 866 00:36:02,243 --> 00:36:04,286 No, I'm not a big drinker. 867 00:36:04,287 --> 00:36:07,998 Have you had the stomach flu recently, food poisoning? 868 00:36:07,999 --> 00:36:09,625 No and no. 869 00:36:10,918 --> 00:36:13,838 Do you mind if we take a look inside your mouth? 870 00:36:20,428 --> 00:36:23,930 You can lean your head back... 871 00:36:23,931 --> 00:36:25,765 and open up wide. 872 00:36:29,645 --> 00:36:31,313 What? 873 00:36:31,314 --> 00:36:35,400 The enamel on the back of your teeth is worn away. 874 00:36:35,401 --> 00:36:37,485 What does that mean? 875 00:36:37,486 --> 00:36:38,945 Um, it can happen 876 00:36:38,946 --> 00:36:41,448 if someone makes themselves vomit repeatedly. 877 00:36:41,449 --> 00:36:44,659 All the stomach acid dissolves the enamel. 878 00:36:44,660 --> 00:36:47,746 What does that have to do with having pneumonia? 879 00:36:47,747 --> 00:36:49,373 It may have caused it. 880 00:36:51,417 --> 00:36:54,294 Can you just give me some medicine? 881 00:36:54,295 --> 00:36:55,880 Yeah, we can do that. 882 00:36:59,342 --> 00:37:02,010 Dr. J, finally. 883 00:37:02,011 --> 00:37:04,804 It is so nice to meet you, Dr. J. 884 00:37:04,805 --> 00:37:08,309 This is Willow, your new patient. 885 00:37:09,477 --> 00:37:11,645 I'm actually a student doctor. 886 00:37:11,646 --> 00:37:14,231 I, uh, watch all of your videos. 887 00:37:14,232 --> 00:37:16,233 The one about coping with difficult coworkers 888 00:37:16,234 --> 00:37:17,901 was super helpful. 889 00:37:17,902 --> 00:37:19,486 I got to watch that. 890 00:37:19,487 --> 00:37:22,197 Um, um, so--so what is Willow's health issue? 891 00:37:22,198 --> 00:37:26,076 Uh, my eye-- it's superglued shut. 892 00:37:26,077 --> 00:37:28,870 Halfway trim and mineral oil didn't work? 893 00:37:28,871 --> 00:37:30,372 Nope. 894 00:37:30,373 --> 00:37:33,416 Then--then I would suggest cutting the full lash down. 895 00:37:33,417 --> 00:37:36,378 I concur, Dr. J. 896 00:37:36,379 --> 00:37:39,839 As long as you're the one doing it. 897 00:37:39,840 --> 00:37:41,424 Oh. 898 00:37:41,425 --> 00:37:43,468 Okay, yeah, sure. 899 00:37:43,469 --> 00:37:45,679 Um, yeah. 900 00:37:45,680 --> 00:37:49,015 Uh, sit back for me. 901 00:37:49,016 --> 00:37:51,059 I'll get you to close both your eyes 902 00:37:51,060 --> 00:37:53,144 and be as still as possible. 903 00:37:53,145 --> 00:37:54,145 Okay. 904 00:37:54,146 --> 00:37:55,522 All you, Doc. 905 00:37:55,523 --> 00:37:58,942 Thank you, Dr. Langdon. 906 00:37:58,943 --> 00:38:01,570 Okay, here we go. 907 00:38:03,531 --> 00:38:06,574 How many followers do you have, Dr. J? 908 00:38:06,575 --> 00:38:09,578 More than you'd guess, Dr. Langdon. 909 00:38:12,456 --> 00:38:13,623 There. 910 00:38:17,795 --> 00:38:19,546 You did it. 911 00:38:25,219 --> 00:38:27,971 Oh, my God. This looks terrible. 912 00:38:27,972 --> 00:38:32,768 I can still put a false lash on it, though, right? 913 00:38:36,230 --> 00:38:38,773 How are you feeling, Mr. Diaz? 914 00:38:38,774 --> 00:38:41,109 Much better. 915 00:38:41,110 --> 00:38:43,278 We need to talk about how your diabetes 916 00:38:43,279 --> 00:38:46,865 progressed to this place. 917 00:38:46,866 --> 00:38:49,284 This is Student Dr. Kwon. 918 00:38:49,285 --> 00:38:51,996 What you say here remains between us. 919 00:38:54,123 --> 00:38:58,043 I'm taking a lower dose of insulin than I should be. 920 00:38:58,044 --> 00:39:01,504 How much of your prescribed dose are you using at a time? 921 00:39:01,505 --> 00:39:03,131 Half. 922 00:39:03,132 --> 00:39:05,091 I used to have insurance through work, 923 00:39:05,092 --> 00:39:07,969 but I lost that job when the pandemic hit. 924 00:39:07,970 --> 00:39:10,638 It was easy to keep up with my medication then. 925 00:39:10,639 --> 00:39:13,099 I had a great primary doctor, too. 926 00:39:13,100 --> 00:39:15,977 Now I'm kind of on my own. 927 00:39:15,978 --> 00:39:18,355 Do you have a glucose monitor? 928 00:39:18,356 --> 00:39:20,106 Uh, yes. 929 00:39:20,107 --> 00:39:22,484 But I can't afford the test strips every week. 930 00:39:22,485 --> 00:39:24,110 They're too expensive. 931 00:39:24,111 --> 00:39:26,488 Can we not talk about this in front of my family? 932 00:39:26,489 --> 00:39:28,114 - Hi. - Hi. 933 00:39:28,115 --> 00:39:29,949 There are my girls. 934 00:39:29,950 --> 00:39:32,327 Did you call your brothers? - They're still at soccer. 935 00:39:32,328 --> 00:39:35,455 I have good news. I started a GoFundMe for Dad. 936 00:39:35,456 --> 00:39:36,790 A what? 937 00:39:36,791 --> 00:39:38,500 To help raise money for Dad's medical care 938 00:39:38,501 --> 00:39:41,086 since we don't have insurance. - No, no. 939 00:39:41,087 --> 00:39:44,130 Take it down, now. - But why? 940 00:39:44,131 --> 00:39:46,091 I work hard. I don't need charity. 941 00:39:46,092 --> 00:39:47,675 But, Dad, we've already-- 942 00:39:47,676 --> 00:39:49,886 Ana, you heard me! 943 00:39:49,887 --> 00:39:50,929 Take it down. 944 00:39:50,930 --> 00:39:52,514 Jesus, Orlando. 945 00:39:52,515 --> 00:39:55,934 No necesito eso. 946 00:39:55,935 --> 00:39:59,062 Louie, thought I'd sneak back here to check on you. 947 00:39:59,063 --> 00:40:01,189 - How we doing in here? - Good. 948 00:40:01,190 --> 00:40:05,110 Tooth's feeling much better. - Glad to hear it. 949 00:40:05,111 --> 00:40:07,779 Looks like you're stuck with us for the next three hours. 950 00:40:07,780 --> 00:40:09,697 We need to monitor your blood pressure. 951 00:40:09,698 --> 00:40:11,699 How about a drink while I wait? 952 00:40:13,160 --> 00:40:14,702 Water or orange juice? 953 00:40:14,703 --> 00:40:17,747 Uh, never mind. 954 00:40:17,748 --> 00:40:19,582 So, uh... 955 00:40:19,583 --> 00:40:22,085 how are the kids doing? 956 00:40:22,086 --> 00:40:25,672 Oh, they're perfect little monsters. 957 00:40:25,673 --> 00:40:28,341 Tanner's five now. Penny's three. 958 00:40:28,342 --> 00:40:31,010 Oh, ain't that a blessing. 959 00:40:31,011 --> 00:40:34,055 It is, but they have zero interest in bedtime. 960 00:40:34,056 --> 00:40:36,599 And there's the dog always digging up the yard. 961 00:40:38,269 --> 00:40:40,270 How much sun does your lawn get? 962 00:40:40,271 --> 00:40:42,397 I don't know. Plenty. 963 00:40:42,398 --> 00:40:45,525 Seed it with perennial ryegrass. 964 00:40:45,526 --> 00:40:48,153 And you want to lightly water it 965 00:40:48,154 --> 00:40:52,073 and put up a temporary fence so the dog can't get back to it. 966 00:40:52,074 --> 00:40:54,242 Color me impressed. 967 00:40:54,243 --> 00:40:57,370 What can I say? I like grass. 968 00:40:59,331 --> 00:41:02,292 No, seriously, how do you-- how do you know all that? 969 00:41:02,293 --> 00:41:04,961 I was a groundskeeper. 970 00:41:04,962 --> 00:41:09,341 I worked with gardens and lawns back in the day. 971 00:41:10,634 --> 00:41:12,136 Robby. 972 00:41:14,180 --> 00:41:15,931 Got a sec? 973 00:41:18,559 --> 00:41:21,227 - Dr. Langdon. - Dr. Al-Hashimi. 974 00:41:21,228 --> 00:41:23,271 How's triage looking? 975 00:41:23,272 --> 00:41:24,981 Donnie and I have it under control. 976 00:41:24,982 --> 00:41:27,233 Good. I want you to wrap up what you're doing out there 977 00:41:27,234 --> 00:41:28,651 and join us back here. 978 00:41:28,652 --> 00:41:31,237 We're expecting more diverted traffic from Westbridge. 979 00:41:31,238 --> 00:41:32,489 Will do. 980 00:41:32,490 --> 00:41:34,574 And I just want to say, I think it's great 981 00:41:34,575 --> 00:41:36,826 that you're in the Physicians' Health Program. 982 00:41:36,827 --> 00:41:39,078 I know it's a big commitment. 983 00:41:39,079 --> 00:41:43,166 Uh, yeah, it was hard at the beginning, 984 00:41:43,167 --> 00:41:45,668 but, you know, I'm almost done with year one now. 985 00:41:45,669 --> 00:41:48,880 Only four more years to go. 986 00:41:48,881 --> 00:41:50,673 Penny for your thoughts. 987 00:41:50,674 --> 00:41:53,092 Oh, they're way more expensive than that. 988 00:41:53,093 --> 00:41:55,261 I'm on a budget. Take it or leave it. 989 00:41:55,262 --> 00:41:57,722 My day is not turning out the way that I expected. 990 00:41:57,723 --> 00:42:00,892 We had a callout. Langdon was available. 991 00:42:00,893 --> 00:42:03,269 I was sort of hoping to be on my sabbatical 992 00:42:03,270 --> 00:42:04,938 when he came back. 993 00:42:04,939 --> 00:42:06,606 You two were very close. 994 00:42:06,607 --> 00:42:08,525 Maybe this is the universe's way 995 00:42:08,526 --> 00:42:11,194 of telling you it's time to clear the air. 996 00:42:11,195 --> 00:42:13,238 Maybe it is. 997 00:42:13,239 --> 00:42:15,199 Maybe it isn't. 998 00:42:19,370 --> 00:42:22,288 Okay, so, um, we'll need to keep you for the day 999 00:42:22,289 --> 00:42:26,960 for your IV antibiotics and to monitor your oxygen level. 1000 00:42:26,961 --> 00:42:30,631 Okay. 1001 00:42:35,636 --> 00:42:37,470 What if... 1002 00:42:40,349 --> 00:42:43,435 I have been making myself vomit? 1003 00:42:45,312 --> 00:42:47,814 Well... 1004 00:42:47,815 --> 00:42:50,401 bulimia is treatable. 1005 00:42:52,194 --> 00:42:54,362 I was going to stop. 1006 00:42:54,363 --> 00:42:56,448 I stopped before. 1007 00:42:58,909 --> 00:43:02,495 My family gathers around food. 1008 00:43:02,496 --> 00:43:05,456 We eat when we're celebrating. We eat when we're mourning. 1009 00:43:05,457 --> 00:43:06,874 We just eat. 1010 00:43:06,875 --> 00:43:08,293 But then I got to college, 1011 00:43:08,294 --> 00:43:10,712 and it was all about how you looked. 1012 00:43:10,713 --> 00:43:13,007 That's a lot of pressure. 1013 00:43:17,386 --> 00:43:20,263 I started vomiting. 1014 00:43:20,264 --> 00:43:22,849 Everyone said I looked great. 1015 00:43:22,850 --> 00:43:25,018 So I went to the gym more. 1016 00:43:25,019 --> 00:43:28,730 I didn't need to purge as much. 1017 00:43:31,233 --> 00:43:32,942 Last year, I went through a breakup. 1018 00:43:32,943 --> 00:43:36,571 It all came back. 1019 00:43:40,075 --> 00:43:41,451 You're... 1020 00:43:41,452 --> 00:43:45,204 doing long-term damage to your body. 1021 00:43:45,205 --> 00:43:49,042 And it doesn't just go away on its own. 1022 00:43:49,043 --> 00:43:51,502 It's okay to ask for help. 1023 00:43:51,503 --> 00:43:52,670 We can set you up 1024 00:43:52,671 --> 00:43:54,756 with our eating-disorder program upstairs. 1025 00:43:54,757 --> 00:43:58,509 - It's here in the hospital? - It's an outpatient program. 1026 00:43:58,510 --> 00:44:00,136 You'd meet with a therapist 1027 00:44:00,137 --> 00:44:04,266 for individual and group therapy once or twice a week. 1028 00:44:05,517 --> 00:44:08,771 Would you be open to meeting with a therapist? 1029 00:44:10,397 --> 00:44:12,649 I guess. 1030 00:44:12,650 --> 00:44:14,776 Do you have any preference for type of therapist-- 1031 00:44:14,777 --> 00:44:16,861 male, female? 1032 00:44:16,862 --> 00:44:19,822 If there's a Black woman, I'd like that. 1033 00:44:21,116 --> 00:44:23,451 Yeah, we can arrange that. 1034 00:44:25,579 --> 00:44:27,414 Thank you. 1035 00:44:30,584 --> 00:44:32,669 That was a good catch. 1036 00:44:32,670 --> 00:44:34,462 Black women tend to go underdiagnosed 1037 00:44:34,463 --> 00:44:36,089 when it comes to eating disorders. 1038 00:44:36,090 --> 00:44:38,174 - Really? - Yeah, unfortunately. 1039 00:44:38,175 --> 00:44:41,094 You know, I thought I had an eating disorder in high school, 1040 00:44:41,095 --> 00:44:43,513 and so I did a lot of research on the subject. 1041 00:44:43,514 --> 00:44:46,432 I didn't--no, I just-- 1042 00:44:46,433 --> 00:44:49,644 My sister and I were really picky eaters growing up, 1043 00:44:49,645 --> 00:44:51,187 you know? 1044 00:44:51,188 --> 00:44:53,398 Color and texture. 1045 00:44:53,399 --> 00:44:55,233 Vegetables and fish. 1046 00:44:55,234 --> 00:44:57,068 Oh, eggs. 1047 00:44:57,069 --> 00:45:00,279 Slimy okra, asparagus-- ugh, disgusting. 1048 00:45:00,280 --> 00:45:01,739 Drove our parents crazy. 1049 00:45:01,740 --> 00:45:04,409 Oh, eggs, weird. 1050 00:45:04,410 --> 00:45:05,702 It's not that weird. 1051 00:45:05,703 --> 00:45:08,830 I got to catch up on my charting. 1052 00:45:08,831 --> 00:45:10,248 Ah. 1053 00:45:10,249 --> 00:45:13,459 You know, if--if you want to talk, I'm around. 1054 00:45:13,460 --> 00:45:14,627 Talk about what? 1055 00:45:14,628 --> 00:45:16,254 Being an R2? 1056 00:45:16,255 --> 00:45:17,797 Way harder than intern year. 1057 00:45:17,798 --> 00:45:19,173 Oh, yeah, um... 1058 00:45:19,174 --> 00:45:22,593 yeah, overseeing the med students, the interns, 1059 00:45:22,594 --> 00:45:24,554 having no time to do my own charts. 1060 00:45:24,555 --> 00:45:26,973 Yeah, just wait until you get into Medical, 1061 00:45:26,974 --> 00:45:28,516 Surgical, and Cardiac ICU. 1062 00:45:28,517 --> 00:45:30,476 I stands for "intense." 1063 00:45:30,477 --> 00:45:33,396 Somehow that seems like an understatement. 1064 00:45:33,397 --> 00:45:36,149 Well, it does help you grow your clinical skills, 1065 00:45:36,150 --> 00:45:38,192 you know, caring for the sickest patients. 1066 00:45:38,193 --> 00:45:40,528 Tell that to these charts. 1067 00:45:40,529 --> 00:45:43,490 Um, dictate. Helps you go faster. 1068 00:45:46,243 --> 00:45:49,537 Oh, uh, what happened with our patient from Westbridge? 1069 00:45:49,538 --> 00:45:51,372 You never grabbed me for his troponin. 1070 00:45:51,373 --> 00:45:53,916 Mr. Samba-- it was a posterior STEMI. 1071 00:45:53,917 --> 00:45:56,252 What? Didn't show on the 12-lead. 1072 00:45:56,253 --> 00:45:57,837 Oh, usually doesn't. 1073 00:45:57,838 --> 00:46:01,090 And I think most clinicians would have missed it. 1074 00:46:01,091 --> 00:46:02,341 But you didn't. 1075 00:46:03,927 --> 00:46:05,721 Guess I got lucky. 1076 00:46:07,264 --> 00:46:10,057 Whatever, Fuckleberry. 1077 00:46:10,058 --> 00:46:12,518 Okay, I'm sorry. Did I do something to bother you? 1078 00:46:12,519 --> 00:46:13,854 Nope. 1079 00:46:15,856 --> 00:46:18,566 Okay. 1080 00:46:18,567 --> 00:46:20,318 - Yo. - What's up? 1081 00:46:20,319 --> 00:46:23,529 I got a bounce-back. You remember Debbie Cohen? 1082 00:46:23,530 --> 00:46:25,740 Not really. I've seen 16 patients this morning. 1083 00:46:25,741 --> 00:46:27,575 The restaurant worker with cellulitis 1084 00:46:27,576 --> 00:46:29,869 on the dorsum of the foot? - Yes, yes, she's on Keflex. 1085 00:46:29,870 --> 00:46:31,454 I marked the border. 1086 00:46:31,455 --> 00:46:35,000 Yeah, I got a hot pack on it, but, uh, you should take a look. 1087 00:46:38,712 --> 00:46:40,546 Hi. Dr. Langdon. 1088 00:46:40,547 --> 00:46:43,257 I wasn't expecting to see you back so soon. 1089 00:46:43,258 --> 00:46:45,760 Meds upset your stomach? - Uh, no. 1090 00:46:45,761 --> 00:46:48,763 The pain got worse, and you said to come back 1091 00:46:48,764 --> 00:46:51,307 if the redness spread outside the Sharpie line. 1092 00:46:51,308 --> 00:46:53,101 Let's take a look. 1093 00:46:55,062 --> 00:46:56,480 Ah. 1094 00:47:02,694 --> 00:47:04,111 It looks like the infection 1095 00:47:04,112 --> 00:47:06,155 isn't responding to the pills I prescribed you, 1096 00:47:06,156 --> 00:47:08,658 so we need to get you on some IV antibiotics 1097 00:47:08,659 --> 00:47:10,701 and get you back to the ED now. 1098 00:47:10,702 --> 00:47:12,578 Uh, i-is it bad? 1099 00:47:12,579 --> 00:47:15,248 Not if we can get a handle on it. 1100 00:47:15,249 --> 00:47:17,917 - MRSA? - Or maybe worse.