1 00:00:11,970 --> 00:00:15,474 [indistinct chatter] 2 00:00:15,557 --> 00:00:17,226 - Next time, maybe inform the department chair 3 00:00:17,309 --> 00:00:18,268 before the shit hits the fan. 4 00:00:18,310 --> 00:00:19,937 - I was on my way to tell you. 5 00:00:19,978 --> 00:00:21,271 - Make sure you get everything you need. 6 00:00:21,313 --> 00:00:22,314 - OK, let's do this. 7 00:00:22,397 --> 00:00:23,941 - IT called me up because 8 00:00:23,982 --> 00:00:26,276 I've trained in cyberattack prevention and response. 9 00:00:26,318 --> 00:00:27,569 - Then you can tell everybody what to do. 10 00:00:27,653 --> 00:00:28,946 - No, thank you. 11 00:00:28,987 --> 00:00:30,197 Best if it comes from the department chair. 12 00:00:30,280 --> 00:00:31,323 - Oh, you think? 13 00:00:33,784 --> 00:00:35,953 All right, everybody, circle up. 14 00:00:35,994 --> 00:00:37,204 - What the fuck? 15 00:00:37,287 --> 00:00:39,122 - We may have had a cyberattack. 16 00:00:39,206 --> 00:00:41,500 - No, we shut down to prevent a cyberattack. 17 00:00:43,210 --> 00:00:45,254 - OK, everybody, settle down. Listen up. 18 00:00:45,337 --> 00:00:46,630 As you can see, we're doing a little 19 00:00:46,672 --> 00:00:49,132 redecorating in the central work area. 20 00:00:49,174 --> 00:00:51,969 Our hospital computers are at risk for a cyberattack, 21 00:00:52,052 --> 00:00:53,971 so we are going old school, analog. 22 00:00:54,054 --> 00:00:55,430 - For how long? - Great question. 23 00:00:55,514 --> 00:00:57,474 - Our IT department has shut everything down 24 00:00:57,516 --> 00:00:59,810 to give them time to bolster our cyber defenses. 25 00:00:59,851 --> 00:01:01,728 - I believe the question was, for how long? 26 00:01:01,812 --> 00:01:02,980 - Uh, hard to say. 27 00:01:03,063 --> 00:01:04,313 Could be up to 24 hours. 28 00:01:04,355 --> 00:01:05,941 [all murmuring] - Jesus Christ. 29 00:01:06,024 --> 00:01:07,568 - So first order of business, 30 00:01:07,651 --> 00:01:09,486 we need to replicate the electronic patient boards 31 00:01:09,570 --> 00:01:10,821 on these dry-erase boards. 32 00:01:10,904 --> 00:01:11,947 So please, somebody tell me 33 00:01:12,030 --> 00:01:13,073 they got a photo of the boards. 34 00:01:13,156 --> 00:01:14,074 - Uh, yeah, yeah, yeah. 35 00:01:14,157 --> 00:01:15,534 Right here. OK. 36 00:01:15,617 --> 00:01:16,702 Oh, uh... 37 00:01:18,870 --> 00:01:20,998 It's a little blurry. 38 00:01:21,039 --> 00:01:23,625 - No, more than a little blurry. 39 00:01:23,709 --> 00:01:26,378 - Sorry. - Oh, my God. 40 00:01:26,461 --> 00:01:28,170 - I remember. - Great. 41 00:01:28,213 --> 00:01:30,132 If everybody else can remember their patient names 42 00:01:30,215 --> 00:01:31,508 and their room numbers, that would be awesome. 43 00:01:31,550 --> 00:01:33,509 - No, I mean I can remember all of it. 44 00:01:33,551 --> 00:01:34,636 - All of what? 45 00:01:34,720 --> 00:01:36,847 - Names, doctors, room numbers. 46 00:01:36,888 --> 00:01:39,265 I kind of have a photographic memory. 47 00:01:39,348 --> 00:01:41,351 - Seriously? The whole board? 48 00:01:41,435 --> 00:01:43,770 - Central 12, Harlow Graham, headache, 49 00:01:43,854 --> 00:01:46,523 abdominal pain, ASL only. - Oh, shit. 50 00:01:46,565 --> 00:01:48,400 I have an interpreter waiting for me. 51 00:01:48,483 --> 00:01:50,527 - Go. - OK, for patient privacy, 52 00:01:50,610 --> 00:01:52,237 all chief complaints will be abbreviated. 53 00:01:52,321 --> 00:01:53,572 So HA for headache, 54 00:01:53,655 --> 00:01:55,532 AP for abdominal pain, and so forth. 55 00:01:55,616 --> 00:01:58,827 - Central 10, Jackson Davis, new-onset psychosis. 56 00:01:58,910 --> 00:02:00,245 Javadi, psych admission. 57 00:02:00,329 --> 00:02:02,289 - Greek letter psi for psych. 58 00:02:02,372 --> 00:02:04,541 - Pedes is Baby Jane Doe, fever, Dr. Mohan, 59 00:02:04,583 --> 00:02:06,043 awaiting admission orders. 60 00:02:06,126 --> 00:02:07,794 - Nurses need to convert to a zone defense-- 61 00:02:07,878 --> 00:02:08,836 north, central, south, trauma. 62 00:02:08,919 --> 00:02:10,005 - Where's Dana? 63 00:02:10,088 --> 00:02:11,673 - In with a sexual assault case. 64 00:02:11,757 --> 00:02:13,216 She can't leave until the exam is finished. 65 00:02:13,300 --> 00:02:14,551 - Yeah, it could be a while. 66 00:02:14,593 --> 00:02:15,969 - Princess has charge nurse experience. 67 00:02:16,053 --> 00:02:17,387 - Not really. - That's a great idea. 68 00:02:17,471 --> 00:02:18,680 - Princess it is. 69 00:02:18,764 --> 00:02:19,681 You can make the nursing assignments. 70 00:02:19,765 --> 00:02:21,016 - Next. - Central 9, 71 00:02:21,099 --> 00:02:22,934 Roxie Hamler, end-stage lung cancer. 72 00:02:23,018 --> 00:02:24,353 - Sorry, do we have to stand here while 73 00:02:24,436 --> 00:02:25,562 she recites the whole board? - No. 74 00:02:25,603 --> 00:02:26,772 In fact, go check on your patients 75 00:02:26,855 --> 00:02:28,273 and then please come back here. 76 00:02:28,357 --> 00:02:29,858 Thank you. 77 00:02:29,900 --> 00:02:31,693 - How many hours a day are you on your laptop? 78 00:02:34,738 --> 00:02:35,989 - At least eight hours. 79 00:02:36,073 --> 00:02:37,406 I work from home. 80 00:02:37,449 --> 00:02:39,368 - And are you at a desk all day? 81 00:02:41,244 --> 00:02:42,496 - No, no. 82 00:02:42,579 --> 00:02:43,914 I will either sit on the sofa, 83 00:02:43,997 --> 00:02:46,208 or sometimes I'll be in bed, 84 00:02:46,291 --> 00:02:48,377 kind of sitting up with the computer on my lap, 85 00:02:48,460 --> 00:02:49,920 that kind of thing. 86 00:02:49,961 --> 00:02:52,547 - So you're always looking down at the screen? 87 00:02:52,589 --> 00:02:54,132 - Yeah. - OK. 88 00:02:54,216 --> 00:02:56,677 I'm going to check the muscles in your neck. 89 00:03:03,350 --> 00:03:04,393 - Ooh! - Ooh! 90 00:03:04,476 --> 00:03:06,603 Ow, that hurts. 91 00:03:06,645 --> 00:03:09,272 - All right. Well, I think we can help. 92 00:03:09,356 --> 00:03:11,441 - Come on over. 93 00:03:11,525 --> 00:03:13,026 OK, gather up. 94 00:03:13,110 --> 00:03:15,237 Listen up, everybody. This is our chart rack. 95 00:03:15,278 --> 00:03:17,197 So as you can see, each slot and clipboard 96 00:03:17,280 --> 00:03:18,281 has a room number on it. 97 00:03:18,365 --> 00:03:19,741 When you pick up a new patient, 98 00:03:19,825 --> 00:03:22,119 you grab a fresh chart from the T-system. 99 00:03:22,160 --> 00:03:25,122 - Pick your chart by chief complaint. 100 00:03:25,163 --> 00:03:27,290 Use the cartoon to find it. 101 00:03:27,374 --> 00:03:29,084 - Why are there two bodies? 102 00:03:29,126 --> 00:03:31,086 - Trauma on the left, medical on the right. 103 00:03:31,169 --> 00:03:32,462 So head injury, you go left. 104 00:03:32,504 --> 00:03:33,964 Headache, go right. 105 00:03:34,047 --> 00:03:35,549 - Are those fish swimming in seaweed? 106 00:03:35,632 --> 00:03:36,633 - No. 107 00:03:36,675 --> 00:03:37,968 That is bees and grass. 108 00:03:38,009 --> 00:03:39,219 That's the section for insect bites, 109 00:03:39,302 --> 00:03:40,762 skin rash, allergies. 110 00:03:40,846 --> 00:03:42,305 - OK, let's say, for example, 111 00:03:42,389 --> 00:03:44,474 Dr. Al-Hashimi has a new patient with belly pain. 112 00:03:44,516 --> 00:03:47,102 - For the history, circle the positives, 113 00:03:47,185 --> 00:03:49,062 like vomiting and diarrhea. 114 00:03:49,146 --> 00:03:51,648 Backslash the negative, such as recent travel, 115 00:03:51,732 --> 00:03:53,275 sick contacts, fever. 116 00:03:53,316 --> 00:03:57,154 For physical exam, checkmark normals on the left, 117 00:03:57,237 --> 00:03:59,448 and circle any abnormal findings on the right. 118 00:03:59,531 --> 00:04:00,490 Questions? 119 00:04:00,574 --> 00:04:01,700 - Is your generative AI program 120 00:04:01,783 --> 00:04:02,701 still gonna be working? 121 00:04:02,784 --> 00:04:04,119 - [chuckles] 122 00:04:04,202 --> 00:04:05,370 - Not for a while. 123 00:04:05,454 --> 00:04:07,122 And ditch your SpectraLink phones. 124 00:04:07,205 --> 00:04:08,749 Those are voice over internet. 125 00:04:08,832 --> 00:04:11,752 [phone ringing] 126 00:04:11,835 --> 00:04:12,961 - PTMC Emergency. 127 00:04:13,044 --> 00:04:14,504 Go ahead, Medic Command. 128 00:04:14,546 --> 00:04:15,672 - That is how we will hear about incoming runs. 129 00:04:15,714 --> 00:04:17,132 - Thanks. 130 00:04:17,173 --> 00:04:18,841 Two minutes out with abdominal pain and fever. 131 00:04:18,884 --> 00:04:20,302 - OK, has everybody got that so far? 132 00:04:20,385 --> 00:04:21,845 - How do we write orders? 133 00:04:21,928 --> 00:04:23,513 - Physician order form in triplicate. 134 00:04:23,555 --> 00:04:26,308 Labs, X-rays, IV fluid, medication. 135 00:04:26,391 --> 00:04:27,684 - Will the labs still be able to run blood tests? 136 00:04:27,768 --> 00:04:29,060 - Yes. 137 00:04:29,144 --> 00:04:30,520 - Are the CT scanners still working? 138 00:04:30,562 --> 00:04:31,855 - Yes, but the results will come back 139 00:04:31,897 --> 00:04:34,149 on paper from the radiologist. 140 00:04:34,232 --> 00:04:35,650 - This is the dark ages. 141 00:04:35,692 --> 00:04:37,861 - So if you have orders with labs or X-rays, 142 00:04:37,903 --> 00:04:39,362 they go into the clerk file here. 143 00:04:39,446 --> 00:04:40,697 They will sign them off. 144 00:04:40,739 --> 00:04:42,157 They will add a downtime slip on them, 145 00:04:42,240 --> 00:04:43,450 make sure they go to the correct department. 146 00:04:43,533 --> 00:04:44,993 - I'm sorry, who are the clerks? 147 00:04:45,076 --> 00:04:46,286 - You're looking at them. - At your service. 148 00:04:46,369 --> 00:04:47,537 - Larry and Antoine are filling in 149 00:04:47,621 --> 00:04:49,122 until more help arrives. - We got this. 150 00:04:49,206 --> 00:04:51,207 - After the clerk orders, chart gets moved 151 00:04:51,249 --> 00:04:52,918 to the nursing order rack here for IVs, 152 00:04:53,001 --> 00:04:54,711 medications, procedures. 153 00:04:54,753 --> 00:04:56,880 - Medications are locked up in the PDS. 154 00:04:56,963 --> 00:04:59,716 - The PDS is getting unlocked by a clinical pharmacist, 155 00:04:59,758 --> 00:05:01,259 Dr. Megan Nordt. - We've got your back. 156 00:05:01,343 --> 00:05:02,260 - This is a lot. 157 00:05:02,344 --> 00:05:04,221 Any questions? Yes. 158 00:05:04,304 --> 00:05:05,555 - Uh, no. 159 00:05:05,597 --> 00:05:07,057 - What's up with the third rack? 160 00:05:07,140 --> 00:05:08,642 - When your patient is ready to be discharged, 161 00:05:08,725 --> 00:05:09,893 chart goes here. 162 00:05:09,935 --> 00:05:11,144 [bell dings] This lets everybody know 163 00:05:11,228 --> 00:05:12,395 we're about to have an open bed. 164 00:05:12,437 --> 00:05:14,189 - Or that your tuna melt is up. 165 00:05:14,272 --> 00:05:15,524 - Jesse? 166 00:05:16,775 --> 00:05:18,735 - What is that? - What is that? 167 00:05:18,819 --> 00:05:20,570 - That is a fax machine. 168 00:05:20,612 --> 00:05:22,030 - They still make those? 169 00:05:22,113 --> 00:05:23,865 - This is our lifeline to labs and X-rays. 170 00:05:23,907 --> 00:05:25,742 When the results come back, they will fax to us, 171 00:05:25,784 --> 00:05:27,410 and the clerks will put them on the charts. 172 00:05:27,494 --> 00:05:28,745 Yes? - If you say so. 173 00:05:28,829 --> 00:05:30,539 - Incoming. 174 00:05:30,580 --> 00:05:33,750 - OK, Dr. McKay, Dr. Whitaker, Ogilvie, you're with me. 175 00:05:33,834 --> 00:05:36,586 - The rest of you, build your clipboards. 176 00:05:36,670 --> 00:05:38,922 [phone rings] 177 00:05:38,964 --> 00:05:41,591 - Howard Knox, 52, abdominal pain and fever. 178 00:05:41,675 --> 00:05:44,261 152 over 90, tachy at 120. 179 00:05:44,344 --> 00:05:46,054 Couldn't get an IV. - I wonder why. 180 00:05:46,137 --> 00:05:47,597 - Hello, sir. My name is Dr. Robby. 181 00:05:47,681 --> 00:05:50,058 - Howard. - This is a teaching hospital. 182 00:05:50,141 --> 00:05:52,185 I'll be supervising Doctors McKay and Dr. Whitaker 183 00:05:52,269 --> 00:05:53,436 and student Dr. Ogilvie. - Hey. 184 00:05:53,478 --> 00:05:54,604 - Hello. - How are you feeling? 185 00:05:54,646 --> 00:05:55,981 - Not so great. - OK. 186 00:05:56,064 --> 00:05:57,482 Princess, what's free? - Trauma 1. 187 00:05:57,566 --> 00:05:58,942 Perlah? 188 00:06:01,361 --> 00:06:04,948 - All right, orders for Mylanta and bupivacaine, Central 12. 189 00:06:04,990 --> 00:06:06,283 - Wrong spot, Dr. Santos. 190 00:06:06,366 --> 00:06:08,326 And you need a sticker. 191 00:06:10,036 --> 00:06:11,288 - Put it in the nursing orders rack. 192 00:06:11,371 --> 00:06:12,789 And meet me over at PDS. 193 00:06:12,873 --> 00:06:14,416 - How much does this suck? 194 00:06:14,499 --> 00:06:16,126 - I didn't think today could get any worse. 195 00:06:16,167 --> 00:06:18,253 - This is how we rolled when I was a resident. 196 00:06:18,336 --> 00:06:19,796 - Was that in the 1900s? 197 00:06:19,880 --> 00:06:22,132 - Yeah, when charts were written by candlelight. 198 00:06:22,173 --> 00:06:23,967 - Hey, today will be an adventure. 199 00:06:24,009 --> 00:06:26,261 Think of it like "Back to the Future." 200 00:06:28,847 --> 00:06:30,807 - Or possibly "Titanic." 201 00:06:30,891 --> 00:06:32,683 - Here is your antacid. 202 00:06:32,767 --> 00:06:34,102 Cheers. 203 00:06:34,185 --> 00:06:35,812 And I marked the trigger point 204 00:06:35,896 --> 00:06:37,355 that is bringing out your headache, 205 00:06:37,439 --> 00:06:39,149 and a shot of local anesthetic in that area 206 00:06:39,190 --> 00:06:41,192 could really help. 207 00:06:42,402 --> 00:06:43,445 - Yeah, let's do it. 208 00:06:43,528 --> 00:06:44,738 - All right. 209 00:06:45,906 --> 00:06:48,658 You are going to feel a little pinprick 210 00:06:48,700 --> 00:06:50,368 and some burning. 211 00:06:55,999 --> 00:06:57,834 OK. 212 00:06:57,918 --> 00:06:59,836 - Oh, ow, ow, that really hurts. 213 00:06:59,920 --> 00:07:04,341 - Temp 101.4, tachy at 128, pulse ox 92 on 2 liters. 214 00:07:04,424 --> 00:07:05,717 - When did the pain start? 215 00:07:05,800 --> 00:07:07,302 - It's been on and off for about a week. 216 00:07:07,385 --> 00:07:09,054 - And where do you feel it? - All over. 217 00:07:09,137 --> 00:07:11,640 It started on the left, and now there's some on the right. 218 00:07:11,723 --> 00:07:12,849 - How about that fever? 219 00:07:12,891 --> 00:07:14,184 - Since last night. 220 00:07:14,225 --> 00:07:15,518 I was burning up. 221 00:07:15,602 --> 00:07:17,354 Then I had chills pretty bad. 222 00:07:17,437 --> 00:07:18,355 - I can't find a vein here. 223 00:07:18,438 --> 00:07:19,439 - We'll try for a midline. 224 00:07:19,522 --> 00:07:21,191 - Let us know if this hurts. 225 00:07:21,232 --> 00:07:22,525 - Ah, ah. - Sorry. 226 00:07:22,609 --> 00:07:24,444 - And on this side? - Yeah, yeah! 227 00:07:24,527 --> 00:07:25,528 - Sorry, sir. 228 00:07:25,612 --> 00:07:26,655 - Guarding with no rigidity. 229 00:07:26,738 --> 00:07:28,823 For pain, 100 of fent IM? 230 00:07:28,907 --> 00:07:30,158 Plan, Dr. Whitaker? 231 00:07:30,241 --> 00:07:32,869 - Blood cultures, lactate, Zosyn. 232 00:07:32,911 --> 00:07:35,372 We're gonna need a CT to figure out what's going on. 233 00:07:35,413 --> 00:07:36,748 - Ah-ah. 234 00:07:36,831 --> 00:07:38,832 - Yeah, it's not gonna work. - Yep. 235 00:07:38,917 --> 00:07:40,168 Write neatly. Penmanship counts. 236 00:07:40,251 --> 00:07:41,503 - Howard, for the scan, we're gonna have 237 00:07:41,586 --> 00:07:42,545 to lay you flat on your back. 238 00:07:42,629 --> 00:07:43,838 Can you do that? 239 00:07:43,922 --> 00:07:45,048 - I could ten years ago, 240 00:07:45,131 --> 00:07:46,675 but now it's too hard to breathe. 241 00:07:46,758 --> 00:07:48,385 - If we can't lay you flat, 242 00:07:48,426 --> 00:07:49,886 then we're gonna have to put a tube in your windpipe 243 00:07:49,928 --> 00:07:51,388 to help you breathe-- are you OK with that? 244 00:07:51,429 --> 00:07:52,889 - Intubation with rapid sequence induction? 245 00:07:52,931 --> 00:07:54,224 - No, we can't lay him down. 246 00:07:54,265 --> 00:07:55,392 - The tube will go in your nose 247 00:07:55,433 --> 00:07:56,518 while you're awake, sir. 248 00:07:56,601 --> 00:07:57,560 - Well... - Right. 249 00:07:57,602 --> 00:07:58,853 - Does it hurt? 250 00:07:58,937 --> 00:08:00,021 - You'll be numbed up completely. 251 00:08:00,105 --> 00:08:01,398 You won't feel any discomfort. 252 00:08:01,481 --> 00:08:04,275 Do you happen to know your weight? 253 00:08:04,359 --> 00:08:05,944 - A little over 400. 254 00:08:06,027 --> 00:08:07,278 - When was the last time you checked? 255 00:08:07,362 --> 00:08:08,780 - It's been a while. 256 00:08:08,863 --> 00:08:11,241 - Is it possible that you might be over 450? 257 00:08:11,324 --> 00:08:13,243 - Possibly. 258 00:08:13,284 --> 00:08:15,537 - Perlah, let's call for the Hoyer. 259 00:08:15,578 --> 00:08:18,540 So we're gonna place the tube and get you ready for the scan. 260 00:08:18,623 --> 00:08:20,207 - Is this something serious? 261 00:08:20,291 --> 00:08:22,002 - Well, it's hard to tell without a CT. 262 00:08:22,085 --> 00:08:23,712 - You could just need antibiotics, 263 00:08:23,795 --> 00:08:25,505 or you could require an operation. 264 00:08:25,588 --> 00:08:26,756 - [sighs] - If surgery is necessary, 265 00:08:26,840 --> 00:08:28,091 then your weight could make things 266 00:08:28,174 --> 00:08:29,551 a little bit more complicated. - I know. 267 00:08:29,634 --> 00:08:31,094 I'm sorry. - Not to worry. 268 00:08:31,177 --> 00:08:32,554 We're gonna take very good care of you. 269 00:08:32,636 --> 00:08:33,804 Team. 270 00:08:33,888 --> 00:08:34,931 - OK. 271 00:08:35,015 --> 00:08:36,433 Pain medication for you, OK? 272 00:08:36,515 --> 00:08:38,308 - Let's try for a midline, 273 00:08:38,393 --> 00:08:40,227 basilic vein with ultrasound guidance. 274 00:08:40,270 --> 00:08:41,645 - Can ultrasound check for an appy? 275 00:08:41,730 --> 00:08:43,565 - He's a little too large for an ultrasound. 276 00:08:43,648 --> 00:08:45,942 Plus, our CT can only handle 450 pounds. 277 00:08:46,026 --> 00:08:48,528 - And so if he's over that, we send him to the zoo? 278 00:08:49,529 --> 00:08:50,905 - He's right there. 279 00:08:53,199 --> 00:08:56,161 - I--I heard that there's a large animal CT at the zoo. 280 00:08:56,244 --> 00:08:58,163 - Presby's CT can handle 650. 281 00:08:58,246 --> 00:09:00,415 - Yeah, if Presby's still up and running. 282 00:09:00,498 --> 00:09:01,916 - Wh... 283 00:09:02,000 --> 00:09:03,918 - That--that's not a jinx. It's-- 284 00:09:04,002 --> 00:09:06,546 - Have any of you ever done an awake naso-tracheal? 285 00:09:06,629 --> 00:09:07,797 OK. 286 00:09:07,881 --> 00:09:08,923 Perlah, can you also ask 287 00:09:09,007 --> 00:09:10,091 Dr. Al-Hashimi to come in? 288 00:09:10,175 --> 00:09:11,134 I'm gonna need an assist. 289 00:09:11,217 --> 00:09:12,552 - Yep. You got it. 290 00:09:12,635 --> 00:09:14,596 - Ah, sorry. Signed. 291 00:09:15,722 --> 00:09:18,933 - Hall bed F, George Francis, shortness of breath, 292 00:09:19,017 --> 00:09:21,394 Dr. Mohan, awaiting D-dimer. 293 00:09:21,478 --> 00:09:22,979 - Wow. She's still going? 294 00:09:23,063 --> 00:09:25,148 - Yeah. Remarkable, really. 295 00:09:25,190 --> 00:09:26,733 - Dr. Al, Robby's asking for you. 296 00:09:26,816 --> 00:09:27,942 - Uh, OK. 297 00:09:28,026 --> 00:09:29,652 In Trauma if you need me, Princess. 298 00:09:29,736 --> 00:09:30,904 - Got it. 299 00:09:30,987 --> 00:09:32,447 [indistinct chatter] 300 00:09:32,530 --> 00:09:33,990 - Who's supposed to run the downtime slips 301 00:09:34,074 --> 00:09:35,200 to X-ray and lab? 302 00:09:35,283 --> 00:09:37,702 - Uh, the charge nurse? 303 00:09:37,786 --> 00:09:39,496 - Don't look at me. 304 00:09:39,579 --> 00:09:40,997 - My plate's full! 305 00:09:43,040 --> 00:09:45,627 - Uh, parents of Roxie Hamler? 306 00:09:45,710 --> 00:09:46,836 - Central 9. 307 00:09:46,920 --> 00:09:48,171 - Oh, I got it, Donnie. 308 00:09:48,213 --> 00:09:49,464 Hi, I'm Victoria Javadi, 309 00:09:49,547 --> 00:09:50,882 one of the student doctors here. 310 00:09:50,965 --> 00:09:52,467 I've been assisting with Roxie's care. 311 00:09:52,550 --> 00:09:53,843 - Oh, thank you so much. 312 00:09:53,885 --> 00:09:56,012 I'm Lloyd. - Cora. 313 00:09:56,096 --> 00:09:57,180 - It's nice to meet you. 314 00:09:57,222 --> 00:09:58,348 - She broke her leg? 315 00:09:58,389 --> 00:09:59,682 - Um, yeah. 316 00:09:59,724 --> 00:10:01,392 There's a fracture down by the ankle. 317 00:10:01,476 --> 00:10:03,978 She's in a boot now, so there's not quite so much pain. 318 00:10:04,062 --> 00:10:06,397 But I'll take you. She's just in 9. 319 00:10:11,778 --> 00:10:13,154 - The hospital Wi-Fi isn't working. 320 00:10:13,238 --> 00:10:14,531 - Oh, it'll be down for a while. 321 00:10:14,572 --> 00:10:16,366 Sorry. 322 00:10:16,407 --> 00:10:18,868 - Mom broke her leg, Grandpa. 323 00:10:18,910 --> 00:10:20,995 - We heard. 324 00:10:21,079 --> 00:10:22,747 - How are you, honey? 325 00:10:24,916 --> 00:10:27,293 - You've got this, kiddo. 326 00:10:27,377 --> 00:10:29,546 - Yeah. 327 00:10:29,629 --> 00:10:31,673 - How long will she stay in the ER? 328 00:10:31,756 --> 00:10:35,260 - Oh, until a bed opens up upstairs. 329 00:10:35,343 --> 00:10:36,928 Could be a while. 330 00:10:42,183 --> 00:10:43,893 - You know, it's getting pretty crowded in here. 331 00:10:43,935 --> 00:10:45,603 Maybe we should take Tucker and Shane out for ice cream. 332 00:10:45,687 --> 00:10:49,065 - Yes, please. - No, no. I'm OK. 333 00:10:49,149 --> 00:10:52,235 - Maybe your mom would like some time to rest. 334 00:10:52,318 --> 00:10:54,487 - Yeah. Go. 335 00:10:56,156 --> 00:10:58,533 - Can she have ice cream? 336 00:10:58,616 --> 00:11:01,744 - She can have anything she wants. 337 00:11:01,786 --> 00:11:04,706 - Come on, let's go. 338 00:11:04,789 --> 00:11:06,624 - [sighs] Bye, Mom. 339 00:11:08,293 --> 00:11:10,545 - Ice cream, ice cream. 340 00:11:13,798 --> 00:11:15,091 - Yep. 341 00:11:15,175 --> 00:11:17,093 - [groaning] - Listen up. 342 00:11:17,177 --> 00:11:18,595 This is Oxymetazoline. 343 00:11:18,678 --> 00:11:19,596 This will open up the passage. 344 00:11:19,679 --> 00:11:20,763 - [groaning] 345 00:11:20,847 --> 00:11:22,265 - What medication do you take? 346 00:11:22,307 --> 00:11:25,059 - Uh, Lisinopril and Metformin. 347 00:11:25,101 --> 00:11:26,936 - Ozempic? Wegovy? 348 00:11:27,020 --> 00:11:28,897 - No. Kind of expensive. 349 00:11:28,938 --> 00:11:30,857 - I'm going to squirt some numbing gel in your nose. 350 00:11:30,940 --> 00:11:34,360 If it drips back in your throat, that's OK. 351 00:11:34,444 --> 00:11:36,613 - Here, in case you need it. 352 00:11:36,696 --> 00:11:38,448 - Do you smoke? 353 00:11:38,531 --> 00:11:39,782 Alcohol? 354 00:11:39,824 --> 00:11:41,826 - Never. - Do you exercise? 355 00:11:41,910 --> 00:11:44,287 - Moving from the bedroom to the kitchen. 356 00:11:44,370 --> 00:11:45,788 No, I'd walk more, 357 00:11:45,872 --> 00:11:48,458 but I need a bench to rest on every block. 358 00:11:48,499 --> 00:11:49,959 - What about water aerobics? 359 00:11:50,001 --> 00:11:52,253 - Let's focus on helping Mr. Knox. 360 00:11:52,337 --> 00:11:53,630 - Agreed. 361 00:11:53,713 --> 00:11:55,632 - It took me 25 years to get this way. 362 00:11:55,715 --> 00:11:58,301 Car crash, burn unit, 363 00:11:58,343 --> 00:12:01,095 four leg surgeries over ten years. 364 00:12:01,179 --> 00:12:03,306 Laid me up so much, I lost my job. 365 00:12:03,348 --> 00:12:04,974 - I need to numb the back of your tongue. 366 00:12:05,016 --> 00:12:06,809 This is gonna taste pretty bad. 367 00:12:06,851 --> 00:12:08,186 - Is there anyone you'd like us to call? 368 00:12:08,269 --> 00:12:09,395 - No. 369 00:12:09,479 --> 00:12:10,939 - Any family? 370 00:12:11,022 --> 00:12:13,483 - Mm. My parents passed. 371 00:12:13,566 --> 00:12:14,734 I'm single. 372 00:12:14,817 --> 00:12:15,735 Go figure. 373 00:12:15,818 --> 00:12:16,945 - Siblings? 374 00:12:17,028 --> 00:12:18,947 - Sister in Arizona. 375 00:12:19,030 --> 00:12:21,324 We don't talk much. 376 00:12:21,407 --> 00:12:23,243 - Now that we've numbed up the back of your tongue, 377 00:12:23,326 --> 00:12:26,788 we can anesthetize a bit deeper. 378 00:12:26,871 --> 00:12:27,789 - Um, sorry to interrupt. 379 00:12:27,872 --> 00:12:28,790 I have a middle-aged woman 380 00:12:28,873 --> 00:12:30,458 with sudden onset blindness. 381 00:12:30,541 --> 00:12:31,834 - I can go. - OK. 382 00:12:31,876 --> 00:12:33,086 Will you see if Abbot's still around? 383 00:12:33,169 --> 00:12:34,087 - Yeah. - Thank you. 384 00:12:34,170 --> 00:12:35,672 - What's your sister's name? 385 00:12:35,755 --> 00:12:37,423 - Lauren Milford. 386 00:12:37,507 --> 00:12:38,925 - Where in Arizona? 387 00:12:39,008 --> 00:12:40,510 - Flagstaff, I think. 388 00:12:40,593 --> 00:12:41,719 - Just gonna go over your tongue 389 00:12:41,803 --> 00:12:42,971 and numb your vocal cords. 390 00:12:43,054 --> 00:12:43,972 - Ah. 391 00:12:44,055 --> 00:12:46,349 Ah... [groaning] 392 00:12:46,391 --> 00:12:47,517 - How many fingers? 393 00:12:47,558 --> 00:12:49,686 - I don't see any fingers. 394 00:12:49,769 --> 00:12:51,688 - And now? 395 00:12:51,729 --> 00:12:54,190 - I can see a little bit of light. 396 00:12:54,274 --> 00:12:55,984 - Um, Brooke, you've met Dr. King. 397 00:12:56,067 --> 00:12:57,485 This is Dr. Al-Hashimi. 398 00:12:57,568 --> 00:12:58,820 - Nice to meet you. - And her wife, Wendy. 399 00:12:58,903 --> 00:13:00,071 - Hello. - Hello. 400 00:13:00,154 --> 00:13:01,864 - OK if we discuss your symptoms? 401 00:13:01,906 --> 00:13:04,033 - As long as I can correct you if you get anything wrong. 402 00:13:04,117 --> 00:13:05,868 - Trust me, she will. 403 00:13:05,910 --> 00:13:08,913 - One hour of sudden, painless vision loss in the left eye. 404 00:13:08,997 --> 00:13:10,748 No history of hypercoagulable state 405 00:13:10,832 --> 00:13:12,166 or vascular disease. 406 00:13:12,250 --> 00:13:13,710 Could you look straight ahead, please? 407 00:13:13,751 --> 00:13:16,170 - Could be a central retinal artery occlusion. 408 00:13:16,254 --> 00:13:17,630 - In English, please? 409 00:13:17,714 --> 00:13:19,799 - A little blood clot can block the artery 410 00:13:19,882 --> 00:13:22,385 at the back of the eye and decrease your vision. 411 00:13:22,427 --> 00:13:24,012 - Sometimes it's called an eye stroke. 412 00:13:24,053 --> 00:13:25,013 - Stroke? 413 00:13:25,096 --> 00:13:26,389 Like she could be paralyzed? 414 00:13:26,472 --> 00:13:27,974 - No, this would be limited to the eye. 415 00:13:28,057 --> 00:13:29,392 - Is it permanent? 416 00:13:29,434 --> 00:13:31,728 - First, we have to make the diagnosis. 417 00:13:31,811 --> 00:13:32,979 Retinal exam? 418 00:13:33,062 --> 00:13:34,022 - Hard to get a good look. 419 00:13:34,105 --> 00:13:35,565 - We need the FOP. 420 00:13:35,648 --> 00:13:37,358 - The what? 421 00:13:37,442 --> 00:13:39,652 [indistinct chatter] 422 00:13:39,736 --> 00:13:41,404 - Oh, Princess. 423 00:13:41,446 --> 00:13:43,364 We need patient stickers on each of these order sheets, 424 00:13:43,448 --> 00:13:45,450 or the pharmacy won't know who to give meds to. 425 00:13:45,533 --> 00:13:46,909 - We're on it. 426 00:13:46,951 --> 00:13:49,078 - Princess, smartphone fundoscope? 427 00:13:49,120 --> 00:13:50,413 - Equipment corridor, eye cart. 428 00:13:50,496 --> 00:13:53,583 - Thanks. - You seem a little confused. 429 00:13:53,624 --> 00:13:55,376 - How do I figure out which new patient to pick up? 430 00:13:55,460 --> 00:13:56,711 - Top of the board. 431 00:13:56,794 --> 00:13:57,920 They're listed in the order they arrive. 432 00:13:57,962 --> 00:13:59,130 You erase the first one, then put 433 00:13:59,213 --> 00:14:00,590 your initials in the MD box. 434 00:14:00,673 --> 00:14:02,258 - OK. Thanks. 435 00:14:02,300 --> 00:14:03,593 - Caleb. - Michael. 436 00:14:03,676 --> 00:14:05,428 Are you managing this chaos OK? 437 00:14:05,511 --> 00:14:08,097 - Well, it's all pretty easy when you're a short-timer. 438 00:14:08,139 --> 00:14:10,725 - Any more comatose patients for me to have a chat with? 439 00:14:12,477 --> 00:14:13,770 I'm kidding. 440 00:14:13,811 --> 00:14:15,355 - OK. 441 00:14:15,438 --> 00:14:17,023 - Victoria, this is Nicole Steadman. 442 00:14:17,106 --> 00:14:18,232 - I run the parent support group 443 00:14:18,316 --> 00:14:19,692 for the psychiatric service. 444 00:14:19,776 --> 00:14:21,444 - Yeah. Nicole's daughter was diagnosed 445 00:14:21,527 --> 00:14:23,237 sophomore year in college. 446 00:14:23,279 --> 00:14:26,366 You think Jackson's parents might have a chat with her? 447 00:14:26,449 --> 00:14:28,284 - We can certainly ask. 448 00:14:28,326 --> 00:14:29,952 - Now we can see the whole retina 449 00:14:29,994 --> 00:14:31,454 without dilating the pupil. 450 00:14:31,496 --> 00:14:32,580 [camera shutter clicks] 451 00:14:32,663 --> 00:14:34,207 - You're looking in the wrong eye. 452 00:14:34,290 --> 00:14:36,459 - Oh, we start with the good eye for comparison. 453 00:14:36,501 --> 00:14:38,544 - Oh. 454 00:14:38,628 --> 00:14:39,629 - Retina looks great. 455 00:14:39,670 --> 00:14:40,797 - Now for the bad eye? 456 00:14:40,838 --> 00:14:42,173 - Eyes wide open. 457 00:14:44,550 --> 00:14:45,843 - How's it look? [camera shutter clicks] 458 00:14:45,927 --> 00:14:47,470 - Extremely pale, no blood flow. 459 00:14:47,512 --> 00:14:49,597 - Digital massage, 10 seconds on, 5 seconds off. 460 00:14:49,680 --> 00:14:53,017 Order non-contrast head CT. 461 00:14:53,101 --> 00:14:54,602 [knocking on door] 462 00:14:54,685 --> 00:14:56,687 - Come in. 463 00:14:56,771 --> 00:14:57,855 - Hi. 464 00:14:57,939 --> 00:14:59,315 Heard your patient took off. 465 00:14:59,357 --> 00:15:00,817 - She's taking a little break. 466 00:15:00,900 --> 00:15:03,194 - How long are you gonna wait? 467 00:15:03,277 --> 00:15:05,113 You know about the cyber shutdown thing? 468 00:15:05,154 --> 00:15:06,656 - Yeah. 469 00:15:06,697 --> 00:15:08,116 Wish I could help, but I gotta stay here 470 00:15:08,199 --> 00:15:09,492 till all the evidence is collected, so... 471 00:15:09,575 --> 00:15:11,160 - It's a hot mess out there. 472 00:15:11,202 --> 00:15:12,495 - This whole day is. 473 00:15:12,578 --> 00:15:13,621 [door clicks] 474 00:15:13,704 --> 00:15:16,165 - Sorry. I was just leaving. 475 00:15:16,207 --> 00:15:18,334 - You OK? 476 00:15:18,376 --> 00:15:19,794 - I'm good. 477 00:15:19,877 --> 00:15:21,504 - I'm glad to hear it. 478 00:15:21,587 --> 00:15:22,588 You get something to eat? 479 00:15:22,672 --> 00:15:25,466 - No. 480 00:15:25,550 --> 00:15:27,593 - Let's keep going. 481 00:15:27,677 --> 00:15:28,928 - OK. 482 00:15:29,011 --> 00:15:30,054 Yeah. 483 00:15:40,523 --> 00:15:42,942 - Why don't we keep one in the ER? 484 00:15:43,025 --> 00:15:46,612 - Because our intubated patients are usually sedated. 485 00:15:46,696 --> 00:15:48,072 - Right. 486 00:15:48,156 --> 00:15:49,699 - Maybe you could ease up 487 00:15:49,782 --> 00:15:51,367 with your comments about his weight. 488 00:15:51,451 --> 00:15:52,743 [elevator dings] 489 00:15:52,827 --> 00:15:54,704 - I was just wondering how he got so big 490 00:15:54,787 --> 00:15:56,372 and how we could help. 491 00:15:56,456 --> 00:15:58,082 - We can help by finding out what's wrong with him 492 00:15:58,165 --> 00:15:59,167 and treating him with respect. 493 00:15:59,250 --> 00:16:00,168 - How's your belly now? 494 00:16:00,251 --> 00:16:01,502 - Second pain shot helped. 495 00:16:01,586 --> 00:16:03,379 - OK. There's more if you need it. 496 00:16:03,421 --> 00:16:04,589 - Diminished bowel sounds. 497 00:16:04,672 --> 00:16:05,923 - VidaTalk from the ICU. 498 00:16:06,007 --> 00:16:07,550 - Great. 499 00:16:07,592 --> 00:16:08,843 Howard, we need to open up that passageway now 500 00:16:08,926 --> 00:16:10,052 so we can pass the tube. 501 00:16:10,136 --> 00:16:11,679 - I'm gonna start with my pinky. 502 00:16:11,762 --> 00:16:13,055 Slowly, over a few minutes, I'm gonna go deeper, 503 00:16:13,139 --> 00:16:14,557 all the way to the back of my knuckle. 504 00:16:14,599 --> 00:16:16,225 - Once the tube's through your vocal cords, 505 00:16:16,309 --> 00:16:17,727 you won't be able to talk. 506 00:16:17,810 --> 00:16:19,520 But this is a communication device. 507 00:16:19,604 --> 00:16:22,190 Swipe through the screen for anything you want to say. 508 00:16:22,273 --> 00:16:24,692 Hit the icon, and it talks to us. 509 00:16:24,775 --> 00:16:26,903 - I would like some pain medicine. 510 00:16:26,986 --> 00:16:28,738 My pain is a nine. 511 00:16:28,821 --> 00:16:30,406 - Can I get it to order a pizza? 512 00:16:30,490 --> 00:16:32,825 - [chuckles] [door clicks] 513 00:16:32,909 --> 00:16:34,660 - There's cell service in the ambulance bay. 514 00:16:34,744 --> 00:16:37,205 I found his sister's new number, left a voicemail. 515 00:16:37,288 --> 00:16:38,414 - OK, I'm gonna start. 516 00:16:38,498 --> 00:16:39,665 You ready? 517 00:16:39,749 --> 00:16:41,083 - Not really. 518 00:16:41,167 --> 00:16:42,084 Go ahead. 519 00:16:42,168 --> 00:16:43,503 - Robby, over here. 520 00:16:43,586 --> 00:16:45,796 - Here we go. Head back. 521 00:16:47,256 --> 00:16:48,424 - You thinking it's surgical? 522 00:16:48,508 --> 00:16:49,926 - I'm hoping for a non-perfed appy. 523 00:16:49,967 --> 00:16:51,469 - Can you do it with a scope? - Possibly, 524 00:16:51,552 --> 00:16:53,137 but he could be treated with antibiotics alone. 525 00:16:53,221 --> 00:16:55,139 - And if he needs surgery? 526 00:16:55,223 --> 00:16:58,142 - With his size, an emergency open laparotomy, 527 00:16:58,226 --> 00:17:00,269 death rate's close to 50%. 528 00:17:00,353 --> 00:17:01,896 - OK, one step at a time. 529 00:17:01,938 --> 00:17:04,440 Let's keep trying his sister every 15 minutes. 530 00:17:04,523 --> 00:17:05,900 She'll get it. 531 00:17:09,779 --> 00:17:12,906 - Half the downtime slips are blank. 532 00:17:12,990 --> 00:17:14,951 - What are you talking about? 533 00:17:15,034 --> 00:17:17,118 - Here and here. 534 00:17:17,203 --> 00:17:19,247 - Larry, are you using a felt tip pen? 535 00:17:19,329 --> 00:17:21,540 - Maybe. 536 00:17:21,624 --> 00:17:24,794 - It's not going through for the copies. 537 00:17:24,877 --> 00:17:26,628 Ballpoint pen only. 538 00:17:26,671 --> 00:17:28,047 - OK. 539 00:17:30,466 --> 00:17:31,801 - Digby still MIA? 540 00:17:31,842 --> 00:17:32,969 - Is that the homeless guy? 541 00:17:33,052 --> 00:17:34,845 - We need the bed if he eloped. 542 00:17:36,222 --> 00:17:38,099 - What do you need? - An attending. 543 00:17:38,182 --> 00:17:39,934 - Or a senior resident? - Nope, I'm good. 544 00:17:40,017 --> 00:17:42,144 Dr. Al-Hashimi, can I present? - Yes. 545 00:17:42,186 --> 00:17:44,730 - 32-year-old deaf woman with myofascial headache. 546 00:17:44,814 --> 00:17:46,983 Ibuprofen caused gastritis and epigastric pain, 547 00:17:47,066 --> 00:17:49,235 and she vasovagalled, but now pain-free 548 00:17:49,318 --> 00:17:51,279 after Mylanta and a trigger point injection. 549 00:17:51,362 --> 00:17:52,488 - Excellent. That can take care of the pain 550 00:17:52,530 --> 00:17:54,156 for several months. - Yeah. 551 00:17:54,198 --> 00:17:56,492 It shouldn't recur if she keeps her screen at eye level. 552 00:17:56,534 --> 00:17:57,827 [phone ringing] [sighs] There was a delay 553 00:17:57,910 --> 00:17:59,453 in getting an ASL interpreter. 554 00:17:59,537 --> 00:18:01,122 And I almost gave up and ordered 555 00:18:01,205 --> 00:18:03,291 an unnecessary brain and abdominal CT. 556 00:18:03,374 --> 00:18:04,500 - Good thing you didn't. 557 00:18:04,584 --> 00:18:07,169 - Dr. Al-Hashimi, for you. 558 00:18:07,253 --> 00:18:08,546 - Nice job on the trigger point. 559 00:18:08,629 --> 00:18:09,797 - Yeah, I know. 560 00:18:09,880 --> 00:18:11,507 - How's the T-system going? 561 00:18:11,591 --> 00:18:13,634 - Quick and easy. - Yeah. 562 00:18:13,718 --> 00:18:15,845 On these MDMs, don't just circle your diagnosis. 563 00:18:15,928 --> 00:18:17,680 Also put a backslash through all the ones 564 00:18:17,722 --> 00:18:18,681 that you've ruled out. 565 00:18:18,764 --> 00:18:19,724 - No problem. 566 00:18:19,807 --> 00:18:21,392 - Thank you very much. 567 00:18:21,475 --> 00:18:23,436 Princess, bump Central 13 to the front of the CT line. 568 00:18:23,519 --> 00:18:24,604 - What do you got? 569 00:18:24,687 --> 00:18:25,980 - Sudden onset blindness patient 570 00:18:26,063 --> 00:18:27,523 has central retinal artery occlusion. 571 00:18:27,565 --> 00:18:29,191 I just spoke to an ophthalmologist 572 00:18:29,233 --> 00:18:30,776 at the VA, principal investigator 573 00:18:30,860 --> 00:18:32,445 for thrombolytics in cases like this. 574 00:18:32,528 --> 00:18:33,863 - Not exactly standard of care. 575 00:18:33,946 --> 00:18:34,947 Kind of risky. 576 00:18:35,031 --> 00:18:36,532 - We'll do informed consent. 577 00:18:36,616 --> 00:18:38,117 It's our best shot at saving some of her vision. 578 00:18:38,200 --> 00:18:39,869 - Your patient, your call. 579 00:18:39,952 --> 00:18:41,912 I'm not gonna be around long enough for any complications. 580 00:18:44,874 --> 00:18:48,502 - I'll be taking two swabs from the vagina, 581 00:18:48,586 --> 00:18:50,588 two swabs from the cervix. 582 00:18:53,924 --> 00:18:56,719 Let me know if you feel any discomfort. 583 00:18:56,802 --> 00:18:58,763 - OK. 584 00:18:58,846 --> 00:19:02,933 - Each swab gets labeled-- first vaginal, second vaginal. 585 00:19:03,017 --> 00:19:05,227 Smear a slide with both, and let it air dry. 586 00:19:05,311 --> 00:19:06,437 - Same for the cervix? 587 00:19:06,520 --> 00:19:07,438 - Yeah. 588 00:19:07,521 --> 00:19:08,856 No slide needed. 589 00:19:10,483 --> 00:19:12,610 How you doing, Ilana? 590 00:19:12,693 --> 00:19:14,695 - Hanging in there. 591 00:19:14,779 --> 00:19:16,197 - OK. 592 00:19:16,280 --> 00:19:17,698 Almost done. 593 00:19:20,451 --> 00:19:23,204 All these samples go in the vaginal contact envelope. 594 00:19:23,287 --> 00:19:24,580 - I can help with that. - No. 595 00:19:24,664 --> 00:19:26,332 It's gotta be me. 596 00:19:26,415 --> 00:19:29,710 I'm gonna pull this out. 597 00:19:29,794 --> 00:19:31,504 OK. 598 00:19:31,587 --> 00:19:32,588 All good here. 599 00:19:32,630 --> 00:19:34,048 Legs can come down. 600 00:19:37,843 --> 00:19:39,762 - Are we done? 601 00:19:39,804 --> 00:19:41,097 - One last thing. 602 00:19:41,138 --> 00:19:43,516 Four more swabs inside your mouth. 603 00:19:43,599 --> 00:19:45,226 - Didn't you do that already? 604 00:19:45,267 --> 00:19:48,229 - This one's different-- inside your cheek for your DNA, 605 00:19:48,312 --> 00:19:49,897 not for his. 606 00:19:52,608 --> 00:19:57,947 - So it could be bipolar or schizophrenia? 607 00:19:58,030 --> 00:20:00,282 - Those are the two most likely possibilities. 608 00:20:00,324 --> 00:20:01,784 - How do they know which it is? 609 00:20:01,867 --> 00:20:03,953 - Based on response to medicine, 610 00:20:04,036 --> 00:20:06,580 but also with therapy and observation on the ward. 611 00:20:06,664 --> 00:20:10,000 They'll monitor his mood and interactions with others. 612 00:20:10,084 --> 00:20:11,919 - [sighs] 613 00:20:12,002 --> 00:20:14,755 Is there a blood test or a brain scan 614 00:20:14,797 --> 00:20:15,798 that will tell us for sure? 615 00:20:15,840 --> 00:20:17,758 - Unfortunately not. 616 00:20:17,800 --> 00:20:20,678 - When properly medicated, people with bipolar disorder 617 00:20:20,761 --> 00:20:23,431 can have successful careers. 618 00:20:23,514 --> 00:20:25,307 - So we hope for bipolar? 619 00:20:25,391 --> 00:20:27,309 - You can hope for your son's happiness. 620 00:20:27,393 --> 00:20:29,979 - With early treatment, 20% of people 621 00:20:30,020 --> 00:20:32,732 with schizophrenia have a complete recovery. 622 00:20:32,815 --> 00:20:34,650 - So 80% don't? 623 00:20:34,692 --> 00:20:36,944 - This is a new version of Jackson. 624 00:20:39,697 --> 00:20:40,823 - How old was your daughter? 625 00:20:40,865 --> 00:20:42,742 - 20. 626 00:20:42,825 --> 00:20:46,162 Studying architecture at Georgetown. 627 00:20:46,203 --> 00:20:47,830 Schizophrenia. 628 00:20:47,913 --> 00:20:50,082 - I'm sorry. 629 00:20:50,166 --> 00:20:51,751 - Oh, she's good. 630 00:20:51,834 --> 00:20:56,630 Living at home, working as a cashier at Giant Eagle. 631 00:20:56,714 --> 00:20:59,049 Employee of the Month. 632 00:20:59,133 --> 00:21:01,302 We still have struggles, 633 00:21:01,385 --> 00:21:04,346 but there's also laughter and love. 634 00:21:09,393 --> 00:21:11,520 [monitors beeping] 635 00:21:11,562 --> 00:21:13,022 - Good to go. 636 00:21:13,063 --> 00:21:14,023 - How'd that feel? 637 00:21:14,064 --> 00:21:15,524 - Very weird. 638 00:21:15,608 --> 00:21:17,651 There's no pain. Just weird. 639 00:21:17,693 --> 00:21:19,904 - OK, the next step is, we're gonna take this tube 640 00:21:19,987 --> 00:21:21,906 and pass it through your nose, 641 00:21:21,989 --> 00:21:24,408 stopping at the back of your tongue. 642 00:21:24,492 --> 00:21:26,327 Best not to talk for that. 643 00:21:26,368 --> 00:21:29,955 - Tube's soaking in warm water to make it more flexible. 644 00:21:30,039 --> 00:21:32,666 - Do you wanna try it? 645 00:21:32,750 --> 00:21:34,543 - What day and time is it? 646 00:21:34,585 --> 00:21:36,879 - 4th of July, 2:31 p.m. 647 00:21:36,962 --> 00:21:38,839 - When is my tube coming out? 648 00:21:38,923 --> 00:21:41,717 - We have to put it in first. 649 00:21:41,759 --> 00:21:42,718 - I know. 650 00:21:42,760 --> 00:21:44,345 Just practicing. 651 00:21:44,428 --> 00:21:47,723 - Sounds like you're an expert already. 652 00:21:47,765 --> 00:21:50,726 - Before I can't talk, 653 00:21:50,810 --> 00:21:53,521 I just wanna say 654 00:21:53,604 --> 00:21:56,982 thank you for everything. 655 00:21:57,066 --> 00:21:59,109 - You're very welcome. 656 00:22:04,865 --> 00:22:06,283 - Here we go. 657 00:22:10,955 --> 00:22:12,289 - STI prevention. 658 00:22:12,373 --> 00:22:13,916 One shot treats gonorrhea, 659 00:22:13,999 --> 00:22:16,293 then pills for chlamydia and trichomonas. 660 00:22:16,377 --> 00:22:17,878 - Thank you. 661 00:22:17,920 --> 00:22:19,630 - We also have morning-after contraception. 662 00:22:19,713 --> 00:22:20,756 - She has an IUD. 663 00:22:20,798 --> 00:22:23,259 - Over 99% effective, not 100%. 664 00:22:23,342 --> 00:22:24,802 We still offer. 665 00:22:24,885 --> 00:22:26,428 - I'll pass. 666 00:22:26,470 --> 00:22:29,890 - For HIV, we got PEP, Post-Exposure Prophylaxis. 667 00:22:29,974 --> 00:22:31,392 28 days. 668 00:22:31,433 --> 00:22:34,603 The sooner you start, the more effective. 669 00:22:34,687 --> 00:22:36,397 Emma, I'm pretty sure they could use 670 00:22:36,480 --> 00:22:39,567 an extra set of hands out there. 671 00:22:39,650 --> 00:22:42,027 - It's nice to meet you, Ilana. 672 00:22:42,111 --> 00:22:43,445 You're a very brave woman. 673 00:22:43,487 --> 00:22:44,572 - Yeah. 674 00:22:48,993 --> 00:22:51,620 [door clicks] 675 00:22:51,662 --> 00:22:53,122 - She's a good nurse. 676 00:22:53,163 --> 00:22:57,626 - She's still learning, but she will be. 677 00:22:57,668 --> 00:22:59,587 - After this, we're done? 678 00:22:59,628 --> 00:23:01,255 - Yeah. 679 00:23:01,338 --> 00:23:02,882 - [sighs] 680 00:23:04,508 --> 00:23:06,719 I'm glad you were here today. 681 00:23:11,181 --> 00:23:13,767 - Me too. 682 00:23:13,851 --> 00:23:16,812 - We have a decision to make. 683 00:23:16,896 --> 00:23:18,814 Studies have shown that some vision 684 00:23:18,898 --> 00:23:21,650 can be restored with a clot-busting medication. 685 00:23:21,692 --> 00:23:23,027 - So give it. 686 00:23:23,110 --> 00:23:25,195 - But there are possible risks. 687 00:23:25,279 --> 00:23:29,825 For eye stroke, only 17% get better without any treatment. 688 00:23:29,867 --> 00:23:31,827 - Only 17%? - Yes. 689 00:23:31,869 --> 00:23:36,165 But with the medicine, another 20% can improve. 690 00:23:36,206 --> 00:23:38,667 But there can be complications. 691 00:23:38,709 --> 00:23:42,296 2% of patients who receive the medication get worse, 692 00:23:42,379 --> 00:23:47,217 and 1% have severe disability or death. 693 00:23:52,723 --> 00:23:56,310 - Honey, this one has to be your call. 694 00:23:57,561 --> 00:24:00,773 - No, it's our call. 695 00:24:00,856 --> 00:24:02,650 What would you do without me? 696 00:24:02,733 --> 00:24:04,902 - I'd figure out how to get by. 697 00:24:06,779 --> 00:24:09,698 And I'd probably cry for two years solid. 698 00:24:09,782 --> 00:24:12,242 - Two years? That's all? 699 00:24:13,452 --> 00:24:14,870 I want the medication. 700 00:24:14,912 --> 00:24:16,830 - OK. 701 00:24:20,334 --> 00:24:22,252 - OK, we need your full name to make a chart. 702 00:24:22,336 --> 00:24:24,380 - [muffled] Jackie Liddell. 703 00:24:24,421 --> 00:24:26,048 - Jackie Liddell. 704 00:24:26,090 --> 00:24:27,049 - And you are? 705 00:24:27,132 --> 00:24:28,509 - Her friend Jaquie. 706 00:24:28,592 --> 00:24:30,386 - You have the same name? - No, no. 707 00:24:30,469 --> 00:24:32,596 She's Jackie with a C-K. I'm Jaquie with a Q. 708 00:24:32,680 --> 00:24:34,390 - You can call me CK. 709 00:24:34,473 --> 00:24:35,516 - Oh. 710 00:24:35,599 --> 00:24:36,850 Best not to talk, CK, OK? 711 00:24:36,934 --> 00:24:38,352 Just chill. - Chill? 712 00:24:38,435 --> 00:24:41,689 Q, I bit off half my tongue! - What? 713 00:24:41,772 --> 00:24:43,524 - She said, I bit off half my tongue. 714 00:24:43,607 --> 00:24:44,900 - You can understand that? 715 00:24:44,942 --> 00:24:46,568 - Oh, you should hear her when she's had 716 00:24:46,610 --> 00:24:48,487 two pitchers of margaritas, fucked up and slurring. 717 00:24:48,570 --> 00:24:51,031 - Ooh, you are such an idiot! - [laughs] 718 00:24:51,115 --> 00:24:52,658 - Princess, what's open? 719 00:24:52,741 --> 00:24:54,410 - South 15's clean. 720 00:24:54,451 --> 00:24:55,911 - Deep tongue laceration. 721 00:24:55,995 --> 00:24:58,664 - I can jump on this. 722 00:24:58,747 --> 00:25:01,583 Robby and Al-Hashimi are both with critical patients. 723 00:25:01,667 --> 00:25:02,918 Hello. 724 00:25:03,002 --> 00:25:04,211 I'm Dr. Langdon. 725 00:25:04,294 --> 00:25:06,046 I'll be supervising your care. 726 00:25:08,048 --> 00:25:10,634 - Jesus, CK, your doctor's fucking hot. 727 00:25:10,718 --> 00:25:12,386 - [groans] 728 00:25:13,554 --> 00:25:15,931 - Tube's at 14 centimeters, just above the airway. 729 00:25:15,973 --> 00:25:18,267 - OK, Howard, I'm going to start. 730 00:25:18,350 --> 00:25:22,438 If you want me to stop, you just put your hand up, OK? 731 00:25:22,521 --> 00:25:25,149 Blue mark tells me I'm in the tube. 732 00:25:28,527 --> 00:25:30,612 - Looks like he cleared it. 733 00:25:30,696 --> 00:25:33,240 If he inhales, we should see chords. 734 00:25:33,323 --> 00:25:35,617 - OK, deep breath for me, Howard. 735 00:25:35,659 --> 00:25:38,287 - [inhaling] 736 00:25:38,370 --> 00:25:40,789 - OK. - Beautiful. 737 00:25:40,831 --> 00:25:42,416 - Chords are sensitive, so we spray lidocaine 738 00:25:42,499 --> 00:25:44,877 in the scope. - OK. 739 00:25:44,960 --> 00:25:48,422 1 cc going in now. 740 00:25:48,505 --> 00:25:51,133 - And we'll just give that a second to work. 741 00:25:51,175 --> 00:25:52,676 - How you doing, Howard? 742 00:25:53,969 --> 00:25:55,763 - Once the tube's in, you'll have to breathe 743 00:25:55,846 --> 00:25:57,097 through your nose. 744 00:25:57,181 --> 00:25:58,474 - OK, Howard, hold still. 745 00:25:58,557 --> 00:26:01,977 I am now going in past your vocal cords 746 00:26:02,061 --> 00:26:04,605 until we see the carina. 747 00:26:06,190 --> 00:26:07,775 Ogilvie. 748 00:26:07,858 --> 00:26:08,984 - Uh, there. 749 00:26:09,068 --> 00:26:10,152 Right and left mainstem. 750 00:26:10,194 --> 00:26:12,988 - And the tube slides in. 751 00:26:16,867 --> 00:26:20,120 - And then the scope comes out. 752 00:26:21,914 --> 00:26:23,457 Great. 753 00:26:23,540 --> 00:26:24,792 OK, inflate the balloon. 754 00:26:24,875 --> 00:26:26,168 Deep breath through your nose. 755 00:26:26,251 --> 00:26:27,377 - Amazing. 756 00:26:27,461 --> 00:26:29,505 - You good? 757 00:26:29,588 --> 00:26:31,173 - Great end-tidal waveform. 758 00:26:31,215 --> 00:26:32,382 - Does he need a vent? 759 00:26:32,466 --> 00:26:33,634 - He's breathing on his own, 760 00:26:33,717 --> 00:26:35,010 but a little CPAP wouldn't hurt. 761 00:26:35,094 --> 00:26:37,221 - Starting at 5, titrate to 10. 762 00:26:37,304 --> 00:26:39,223 - OK, that went really well, Howard. 763 00:26:39,306 --> 00:26:41,058 Now we're going to check your weight. 764 00:26:43,018 --> 00:26:44,520 - So the nurse examiner is supposed 765 00:26:44,603 --> 00:26:46,438 to lock up the rape kit in this fridge, 766 00:26:46,522 --> 00:26:49,608 where it stays until it gets turned over to law enforcement. 767 00:26:49,691 --> 00:26:52,319 It's called preserving the chain of evidence. 768 00:26:52,402 --> 00:26:54,613 Are you fucking kidding me? 769 00:26:54,696 --> 00:26:56,490 - Is there a problem? 770 00:26:56,573 --> 00:26:58,784 - [sighs] Jesus Christ. 771 00:26:58,867 --> 00:27:01,870 Police are supposed to pick up the rape kits within 72 hours. 772 00:27:01,912 --> 00:27:04,873 This one I did two weeks ago. 773 00:27:04,915 --> 00:27:06,416 God damn it. 774 00:27:08,585 --> 00:27:10,796 - So how exactly did this happen? 775 00:27:10,879 --> 00:27:13,674 - We were in between pubs taking a selfie. 776 00:27:13,757 --> 00:27:14,716 - Very nice. 777 00:27:14,800 --> 00:27:17,219 - Until she jerked her head up. 778 00:27:17,261 --> 00:27:18,679 - Ooh. 779 00:27:18,762 --> 00:27:20,013 - Ouch. 780 00:27:20,097 --> 00:27:21,682 - OK, topical epi did the trick. 781 00:27:21,765 --> 00:27:23,058 No more bleeding. - Sweet. 782 00:27:23,142 --> 00:27:24,434 I can go home now? 783 00:27:24,518 --> 00:27:26,353 - I don't think so. 784 00:27:26,436 --> 00:27:27,896 It looks like the Grand Canyon across the back of your tongue. 785 00:27:27,980 --> 00:27:29,898 - We need to put in some stitches. 786 00:27:29,982 --> 00:27:30,899 - I don't want stitches. 787 00:27:30,983 --> 00:27:33,026 - Oh. Listen to the doctor. 788 00:27:33,110 --> 00:27:34,736 - Don't tell me what to do. 789 00:27:34,820 --> 00:27:36,238 This is all your fault. 790 00:27:36,321 --> 00:27:38,282 - No, it's not. - Uh, yes, it is. 791 00:27:38,365 --> 00:27:39,950 - Uh, Princess. - No, it's not. 792 00:27:40,033 --> 00:27:41,577 - Princess, hey, why don't you show Q 793 00:27:41,618 --> 00:27:43,370 where she can wait while we patch up her friend? 794 00:27:43,453 --> 00:27:44,872 - Of course. 795 00:27:44,955 --> 00:27:47,082 - OK, this is a numbing shot for the tip. 796 00:27:47,124 --> 00:27:48,083 - The tip? 797 00:27:48,125 --> 00:27:50,002 That's not where I bit it. 798 00:27:50,085 --> 00:27:51,503 - One step at a time. 799 00:27:54,173 --> 00:27:55,883 - [whimpers] 800 00:27:57,134 --> 00:27:58,594 [squealing] 801 00:27:58,677 --> 00:28:01,013 - That's 20 migs of TNK. 802 00:28:01,096 --> 00:28:04,057 - In at 14:39. 803 00:28:04,141 --> 00:28:06,351 - Feeling anything? 804 00:28:06,435 --> 00:28:07,436 - Not yet. 805 00:28:07,519 --> 00:28:10,397 - Could take an hour or two. 806 00:28:10,439 --> 00:28:11,857 - We're going to move you to another room 807 00:28:11,940 --> 00:28:13,734 for better monitoring. 808 00:28:13,817 --> 00:28:15,360 Dr. King. 809 00:28:18,155 --> 00:28:21,491 I'd like you to stay with her. 810 00:28:21,575 --> 00:28:22,826 - Why? 811 00:28:22,910 --> 00:28:24,453 - In case there are complications. 812 00:28:24,536 --> 00:28:26,246 You'll be there to respond quickly 813 00:28:26,330 --> 00:28:29,124 to a blown pupil, a seizure, altered mental status. 814 00:28:29,208 --> 00:28:31,168 - Or I could catch up on my charts. 815 00:28:31,251 --> 00:28:33,128 And my deposition's coming up. 816 00:28:33,170 --> 00:28:35,631 - Think of this as a great way to steal some quiet time 817 00:28:35,672 --> 00:28:36,924 and get mentally prepared. 818 00:28:37,007 --> 00:28:39,218 Jesse, Mel's with you. 819 00:28:41,011 --> 00:28:42,930 - Oh, excuse me, Dr. Mohan. 820 00:28:43,013 --> 00:28:44,014 Excuse me. 821 00:28:44,097 --> 00:28:45,015 Dr. Mohan. 822 00:28:45,098 --> 00:28:46,475 - Uh, in a minute, George. 823 00:28:46,516 --> 00:28:47,559 - I've got this. 824 00:28:47,643 --> 00:28:48,769 - Thank you. 825 00:28:48,852 --> 00:28:51,104 - Oh, uh, I, um-- 826 00:28:51,188 --> 00:28:53,273 D-dimer is back normal. 827 00:28:53,357 --> 00:28:54,274 Oh. 828 00:28:54,358 --> 00:28:55,609 I'm ready to go. 829 00:28:55,692 --> 00:28:57,486 - Are you feeling better? 830 00:28:57,527 --> 00:29:01,240 - I--I really wasn't short of breath this time. 831 00:29:02,366 --> 00:29:03,992 - Then why'd you come in? 832 00:29:04,076 --> 00:29:05,494 - [sighs] 833 00:29:05,577 --> 00:29:07,579 When I found out about the blood clot in my leg, 834 00:29:07,663 --> 00:29:10,499 I just kept thinking it's gonna go to my lung and kill me. 835 00:29:10,540 --> 00:29:13,669 - We've talked before about how the Eliquis would prevent that. 836 00:29:13,710 --> 00:29:16,338 - I know. 837 00:29:16,421 --> 00:29:18,715 Well, I finally took your advice. 838 00:29:18,799 --> 00:29:21,176 I got out of the house, and I joined 839 00:29:21,260 --> 00:29:23,136 the Frick Park Lawn Bowling Club. 840 00:29:23,220 --> 00:29:24,388 [chuckles] - Wonderful. 841 00:29:24,471 --> 00:29:25,514 - Yeah. 842 00:29:25,597 --> 00:29:27,349 I mean, you're right, you know? 843 00:29:27,432 --> 00:29:29,434 We all need a community. 844 00:29:33,438 --> 00:29:34,856 - You're gonna do what? 845 00:29:34,898 --> 00:29:36,525 - In order to fix your tongue, 846 00:29:36,566 --> 00:29:39,027 we need to move it forward to access the laceration. 847 00:29:39,111 --> 00:29:40,696 You're just gonna feel some pulling, OK? 848 00:29:40,737 --> 00:29:44,032 - I guess so. 849 00:29:44,116 --> 00:29:46,743 - Go for it. 850 00:29:46,827 --> 00:29:48,161 - What size suture is that? 851 00:29:48,245 --> 00:29:51,957 - O-silk, the biggest one we got. 852 00:29:52,040 --> 00:29:54,918 - As soon as I cut the needle, you're on traction, Joy. 853 00:30:03,719 --> 00:30:05,178 Oh. 854 00:30:05,262 --> 00:30:07,389 - That is pretty deep. 855 00:30:07,431 --> 00:30:08,974 - And now we can numb up the cut. 856 00:30:09,057 --> 00:30:10,309 It's best to start with-- 857 00:30:10,392 --> 00:30:11,727 - Proximal side first so she doesn't 858 00:30:11,768 --> 00:30:14,896 feel the distal injection. 859 00:30:14,980 --> 00:30:15,897 - Give it ten minutes. 860 00:30:15,981 --> 00:30:17,524 I'll be back for the repair. 861 00:30:21,695 --> 00:30:23,572 - I got a rape kit sitting here for two weeks 862 00:30:23,613 --> 00:30:26,074 that was supposed to be picked up within 72 hours. 863 00:30:26,116 --> 00:30:27,075 I don't care! 864 00:30:27,159 --> 00:30:29,119 Get someone over here now! No. 865 00:30:29,202 --> 00:30:30,620 You expect us to treat your officers 866 00:30:30,704 --> 00:30:32,247 as soon as they come in, 867 00:30:32,331 --> 00:30:34,082 you get a detective to pick these kits up ASAP. 868 00:30:34,166 --> 00:30:35,083 I gotta go. 869 00:30:35,167 --> 00:30:36,710 - Dana-- - Hey, Dana. 870 00:30:36,793 --> 00:30:37,878 - South 19 got their head CT before we went down. 871 00:30:37,961 --> 00:30:39,212 No results yet. 872 00:30:39,296 --> 00:30:40,380 - All right, I'll send a reminder. 873 00:30:40,464 --> 00:30:41,381 - Hey, Dana. - Dana. 874 00:30:41,465 --> 00:30:42,841 - Hang on. 875 00:30:43,842 --> 00:30:45,552 What's up? 876 00:30:45,635 --> 00:30:47,471 - We put in an order for more pain meds for Roxie. 877 00:30:47,554 --> 00:30:49,598 - All right, so put it in the nursing racks. 878 00:30:49,639 --> 00:30:52,225 - Oh, I did, a long time ago. 879 00:30:52,309 --> 00:30:54,102 - All right. I'll bump it to the front. 880 00:30:54,144 --> 00:30:55,604 - Thank you. [fax machine whirring] 881 00:30:55,687 --> 00:30:57,356 - Uh, what's that noise? - [sighs] 882 00:30:57,439 --> 00:30:58,440 UFO landed. 883 00:30:58,482 --> 00:30:59,441 Aliens are invading. 884 00:30:59,483 --> 00:31:00,942 - Hey, Dana. 885 00:31:00,984 --> 00:31:02,778 Chem 7's not back on Trauma 2 yet. 886 00:31:02,861 --> 00:31:05,113 - Let me see the chart. 887 00:31:05,155 --> 00:31:06,615 Oh, Jesus. 888 00:31:06,698 --> 00:31:08,200 I bet your Chem 7 rec went to Radiology. 889 00:31:08,283 --> 00:31:10,035 Larry, Antoine. 890 00:31:10,118 --> 00:31:12,537 You put labs and chest X-ray on the same downtime form. 891 00:31:12,621 --> 00:31:14,790 You need two slips--one for labs, one for radiology. 892 00:31:14,873 --> 00:31:16,458 - Got it. - Won't happen again. 893 00:31:16,541 --> 00:31:17,626 - I'll run it down myself. 894 00:31:17,667 --> 00:31:19,294 - Use the iStat at bedside. 895 00:31:19,378 --> 00:31:20,754 They won't take him to CT without a creatinine. 896 00:31:20,837 --> 00:31:21,963 - Oh, perfect. 897 00:31:22,005 --> 00:31:23,090 - Nice to have you back. 898 00:31:23,173 --> 00:31:24,341 - Thrilled to be here. 899 00:31:24,424 --> 00:31:25,467 You trying to text? 900 00:31:25,550 --> 00:31:27,010 - I am just composing. 901 00:31:27,094 --> 00:31:28,595 I'm gonna send it from the bay. 902 00:31:28,678 --> 00:31:30,806 My mechanic friend, Duke, never showed up. 903 00:31:30,889 --> 00:31:32,349 - I thought he was coming in this morning. 904 00:31:32,432 --> 00:31:33,600 - That was the plan. 905 00:31:33,683 --> 00:31:35,852 I guess he got busy. 906 00:31:35,936 --> 00:31:37,104 - What if he's a no-show? 907 00:31:37,187 --> 00:31:38,688 Tell me what he needs. 908 00:31:38,772 --> 00:31:39,815 I'll pass it on to the night shift. 909 00:31:39,856 --> 00:31:40,816 - That won't be necessary. 910 00:31:40,857 --> 00:31:43,527 [fax machine whirring] 911 00:31:43,610 --> 00:31:45,362 - Oh, Princess. 912 00:31:45,445 --> 00:31:46,488 Ask and you shall receive. 913 00:31:46,530 --> 00:31:47,614 Normal head CT. 914 00:31:47,697 --> 00:31:49,991 - Thanks. I'll get him discharged. 915 00:31:50,033 --> 00:31:51,827 - How's your day going? 916 00:31:51,868 --> 00:31:54,329 - I think I'm getting writer's cramp. 917 00:31:54,371 --> 00:31:55,664 - You with the big guy? 918 00:31:55,705 --> 00:31:57,916 - Yeah. It's sad. 919 00:31:57,999 --> 00:32:01,837 Bad car accident, multiple operations, tons of stress. 920 00:32:01,878 --> 00:32:03,839 - [screaming] 921 00:32:03,880 --> 00:32:05,674 - Lidocaine shot to a sensitive area. 922 00:32:05,757 --> 00:32:07,467 I got a binge-drinking party girl with a tongue lac. 923 00:32:07,551 --> 00:32:08,802 - Mm. 924 00:32:08,885 --> 00:32:10,011 Sounds like she needs some help. 925 00:32:10,095 --> 00:32:12,764 - In more ways than one. - [chuckles] 926 00:32:12,848 --> 00:32:16,476 How's, uh--how's your first shift back going? 927 00:32:16,560 --> 00:32:18,687 - One day at a time. 928 00:32:18,728 --> 00:32:20,272 - First year sober is the hardest. 929 00:32:20,355 --> 00:32:21,523 - That's what they keep telling me. 930 00:32:21,565 --> 00:32:24,234 - I'm nine years and counting. 931 00:32:26,611 --> 00:32:28,155 Oh. 932 00:32:28,238 --> 00:32:31,700 Special delivery for my guy. 933 00:32:31,741 --> 00:32:33,660 If you, um--if you need anything, call me. 934 00:32:33,743 --> 00:32:35,328 - Thanks. 935 00:32:41,293 --> 00:32:42,878 - Where are you going? 936 00:32:42,919 --> 00:32:44,212 - Blisters in North 3. 937 00:32:44,296 --> 00:32:45,714 - That's where I'm going. 938 00:32:45,797 --> 00:32:47,591 - Did you sign up for the patient? 939 00:32:47,674 --> 00:32:49,384 - I pulled the chart from the rack. 940 00:32:49,468 --> 00:32:51,178 - You're supposed to sign up on the dry-erase board. 941 00:32:51,219 --> 00:32:53,054 - You're supposed to have a clipboard for the patient. 942 00:32:53,096 --> 00:32:54,848 - I thought the nurses had that. 943 00:32:54,931 --> 00:32:56,475 - Whatever. 944 00:32:56,558 --> 00:32:57,559 Hi. 945 00:32:57,642 --> 00:32:59,019 I'm Student Doctor Ogilvie. 946 00:32:59,102 --> 00:33:01,229 And this is--wow. 947 00:33:01,271 --> 00:33:02,689 That is some rash. 948 00:33:02,731 --> 00:33:05,567 - Yeah. Tell me about it. - Student Doctor Javadi. 949 00:33:05,609 --> 00:33:07,736 When did this start? - Last night. 950 00:33:07,819 --> 00:33:09,321 - And have you been on any hikes recently 951 00:33:09,404 --> 00:33:10,405 around poison ivy? 952 00:33:10,489 --> 00:33:12,365 - Nope. Haven't left the house. 953 00:33:12,449 --> 00:33:15,368 - What about new medications, lotions, soaps, 954 00:33:15,452 --> 00:33:16,369 detergents, even? 955 00:33:16,453 --> 00:33:17,662 - I don't take medicine. 956 00:33:17,746 --> 00:33:19,331 Nothing new with all that other stuff. 957 00:33:19,414 --> 00:33:20,415 - Uh-huh. And where did this start? 958 00:33:20,457 --> 00:33:21,833 - Everywhere, all at once. 959 00:33:21,917 --> 00:33:25,170 Just a lot of pain, really itchy. 960 00:33:25,253 --> 00:33:26,880 What is it? 961 00:33:26,963 --> 00:33:28,381 - I'm not sure yet. 962 00:33:28,465 --> 00:33:31,092 Um, be back in a second. 963 00:33:31,176 --> 00:33:32,761 - Can't--will you-- 964 00:33:32,802 --> 00:33:34,137 [sighs] 965 00:33:36,973 --> 00:33:38,934 - What are you thinking? 966 00:33:39,017 --> 00:33:40,060 - I have no idea. 967 00:33:40,143 --> 00:33:41,311 - Agreed. 968 00:33:43,146 --> 00:33:44,648 - Bullous pemphigoid? 969 00:33:44,731 --> 00:33:46,399 Autoimmune severe pruritis? 970 00:33:46,483 --> 00:33:47,984 - Yeah, but not as deadly as pemphigus vulgaris. 971 00:33:48,068 --> 00:33:49,986 Untreated, the death rate is over 90%. 972 00:33:50,070 --> 00:33:51,446 - We need to check for pustules, 973 00:33:51,488 --> 00:33:52,572 mucous membrane involvement-- 974 00:33:52,656 --> 00:33:54,032 - And the Nikolsky sign. 975 00:33:56,493 --> 00:33:57,911 - Here you go. 976 00:33:59,371 --> 00:34:00,413 - What? 977 00:34:00,497 --> 00:34:02,040 - For your progress note. 978 00:34:03,375 --> 00:34:06,294 - Did I hear we're making progress? 979 00:34:06,378 --> 00:34:08,630 - Oh, um, it's just what we call it 980 00:34:08,672 --> 00:34:11,841 when we write down things to describe a clinical course. 981 00:34:13,342 --> 00:34:14,302 Any changes? 982 00:34:14,344 --> 00:34:15,303 [timer chiming] 983 00:34:15,344 --> 00:34:16,596 - Not so far. 984 00:34:16,679 --> 00:34:18,974 - It's time for the next neuro check. 985 00:34:19,014 --> 00:34:21,268 - Excuse me, Dr. King, do you have a minute? 986 00:34:21,309 --> 00:34:22,811 - Um, no. 987 00:34:22,893 --> 00:34:24,646 I'm observing a patient right now. 988 00:34:24,688 --> 00:34:27,065 - 60 seconds tops. 989 00:34:28,483 --> 00:34:29,775 - I'll check pupils. 990 00:34:29,859 --> 00:34:31,402 We're good here. 991 00:34:37,033 --> 00:34:38,868 Hey. 992 00:34:38,952 --> 00:34:41,204 - I just finished my deposition. 993 00:34:41,288 --> 00:34:43,665 - Oh, should I go up now? 994 00:34:43,748 --> 00:34:45,375 - Yeah. Just wait until you get a call. 995 00:34:45,458 --> 00:34:46,793 - OK. 996 00:34:46,876 --> 00:34:48,210 Well, I'd ask how it went, 997 00:34:48,295 --> 00:34:50,297 but we're not supposed to discuss the case. 998 00:34:50,380 --> 00:34:51,797 - This isn't a discussion. 999 00:34:51,880 --> 00:34:55,010 It's a monologue, so shut up and listen. 1000 00:34:55,092 --> 00:34:57,220 The malpractice case is frivolous. 1001 00:34:57,304 --> 00:34:58,805 The mother of the measles kid claims 1002 00:34:58,888 --> 00:35:00,181 we caused intellectual decline 1003 00:35:00,265 --> 00:35:02,309 by performing a spinal tap. 1004 00:35:02,350 --> 00:35:05,520 But the tap was perfect with no complications. 1005 00:35:05,562 --> 00:35:07,272 Her son presented with altered mental status 1006 00:35:07,355 --> 00:35:10,692 due to low oxygen from measles pneumonia. 1007 00:35:10,775 --> 00:35:13,194 Any change in intellect was due to hypoxic brain injury. 1008 00:35:13,236 --> 00:35:16,865 It had nothing to do with your spinal tap. 1009 00:35:16,906 --> 00:35:18,533 End of monologue. 1010 00:35:18,617 --> 00:35:21,328 We never discussed the case. 1011 00:35:21,411 --> 00:35:23,663 I gotta get some sleep. 1012 00:35:23,747 --> 00:35:27,000 - Thanks, I guess. 1013 00:35:28,627 --> 00:35:30,879 - OK, are you ready to lay down? 1014 00:35:30,920 --> 00:35:31,880 - I got your head. 1015 00:35:31,921 --> 00:35:33,048 - Nice and slow. 1016 00:35:33,131 --> 00:35:35,300 One, two, three. 1017 00:35:36,676 --> 00:35:37,594 - OK. 1018 00:35:37,677 --> 00:35:38,803 How's that feel? 1019 00:35:41,681 --> 00:35:42,849 - Lifting up now. 1020 00:35:42,932 --> 00:35:45,935 [machinery whirring] 1021 00:35:52,817 --> 00:35:54,486 - Keep going. 1022 00:35:57,113 --> 00:36:00,367 And...that ought to do it right about there. 1023 00:36:02,118 --> 00:36:03,870 - 215? 1024 00:36:03,953 --> 00:36:05,872 - Oh, that's in kilos. 1025 00:36:08,166 --> 00:36:09,793 OK, team. 1026 00:36:15,423 --> 00:36:17,092 - It's not that much over 450. 1027 00:36:17,133 --> 00:36:19,886 - No, we can't risk breaking our CT on a holiday weekend. 1028 00:36:19,969 --> 00:36:22,013 - Would the medics take him while he's intubated? 1029 00:36:22,097 --> 00:36:24,391 - If I go along for the ride, I could still get a nap in 1030 00:36:24,474 --> 00:36:26,017 before my night shift. 1031 00:36:29,979 --> 00:36:32,899 - 474. 1032 00:36:32,941 --> 00:36:34,776 - Our CT can't handle your weight, 1033 00:36:34,818 --> 00:36:38,113 but we're gonna take you over to Presbyterian Hospital. 1034 00:36:38,196 --> 00:36:40,073 - Road trip. - [laughs] 1035 00:36:40,156 --> 00:36:42,450 - I'll keep you company the whole time. 1036 00:36:44,994 --> 00:36:46,955 - Sorry for all this trouble. 1037 00:36:47,038 --> 00:36:48,164 - It's OK. 1038 00:36:48,248 --> 00:36:49,708 This is what we do. 1039 00:36:55,171 --> 00:36:56,673 - So sub Q starts deep. 1040 00:36:56,756 --> 00:36:57,799 You want to bury the knot. 1041 00:36:57,882 --> 00:36:59,342 - Yeah, I've done these before. 1042 00:36:59,426 --> 00:37:01,636 - Joy, how do we cut the ends? 1043 00:37:01,720 --> 00:37:03,179 - Short. Slide to the knot. 1044 00:37:03,263 --> 00:37:04,180 Turn 45 degrees. 1045 00:37:04,264 --> 00:37:06,307 - Excellent. 1046 00:37:06,391 --> 00:37:08,143 - Um, Dr. Langdon, we have a case. 1047 00:37:08,226 --> 00:37:09,144 - It'll have to wait. 1048 00:37:09,227 --> 00:37:10,311 - It could be urgent. 1049 00:37:10,353 --> 00:37:14,149 - Find Robby or Al-Hashimi. 1050 00:37:14,190 --> 00:37:16,484 - This girl is wasted. 1051 00:37:16,526 --> 00:37:18,486 - Drunk as a skunk. 1052 00:37:18,570 --> 00:37:20,280 - Should we check her blood alcohol level? 1053 00:37:20,363 --> 00:37:21,906 - No, it won't change what we do. 1054 00:37:21,990 --> 00:37:23,491 She can go home when she has a steady gait. 1055 00:37:23,533 --> 00:37:25,660 - I already sent one off. 1056 00:37:25,702 --> 00:37:28,329 Joy, do you want to guess her blood alcohol? 1057 00:37:28,371 --> 00:37:29,831 - Why would I want to do that? 1058 00:37:29,873 --> 00:37:31,958 - I don't know. 'Cause it's fun. 1059 00:37:37,922 --> 00:37:39,507 - When will you have a bed? 1060 00:37:39,591 --> 00:37:41,342 - I'm not sure she needs a bed. 1061 00:37:41,426 --> 00:37:43,178 - She's a febrile infant. 1062 00:37:43,219 --> 00:37:45,138 - Who is clearly over a month old and looks amazing. 1063 00:37:45,221 --> 00:37:47,056 Every marker is normal. She has a cold virus. 1064 00:37:47,140 --> 00:37:48,850 - Infants with rhinovirus can still have 1065 00:37:48,892 --> 00:37:50,226 a serious bacterial infection. 1066 00:37:50,310 --> 00:37:51,728 - Not this one. 1067 00:37:51,811 --> 00:37:53,354 We send kids like this home all the time. 1068 00:37:53,438 --> 00:37:56,441 - Except this one doesn't have a home or a parent. 1069 00:37:57,776 --> 00:37:59,235 - All right. 1070 00:37:59,319 --> 00:38:01,029 I can't put a kid with a virus in the nursery, 1071 00:38:01,070 --> 00:38:03,239 and I can't waste a private room on a healthy baby. 1072 00:38:03,323 --> 00:38:04,699 - Then what do you propose? 1073 00:38:04,741 --> 00:38:06,659 - CYF can place her in emergency foster care 1074 00:38:06,743 --> 00:38:08,203 by tomorrow morning. 1075 00:38:08,244 --> 00:38:10,371 - You want to leave her down here overnight? 1076 00:38:10,455 --> 00:38:12,791 - Seems to be the standard of care these days. 1077 00:38:12,874 --> 00:38:14,125 - Have your attending give me a call. 1078 00:38:14,209 --> 00:38:15,168 - Will do. 1079 00:38:15,251 --> 00:38:16,503 - I can't believe this. 1080 00:38:16,586 --> 00:38:18,296 - Let CYF know it's very urgent. 1081 00:38:18,379 --> 00:38:19,798 - Got it. 1082 00:38:19,881 --> 00:38:22,342 - This is turning into quite the day. 1083 00:38:22,425 --> 00:38:24,219 - You know, I've been thinking 1084 00:38:24,302 --> 00:38:25,804 about applying for a fellowship. 1085 00:38:25,887 --> 00:38:27,722 - I thought you had a job lined up in New Jersey. 1086 00:38:27,806 --> 00:38:29,891 - I did, to be close to my mom. 1087 00:38:29,933 --> 00:38:33,394 But she sold her house to travel the world 1088 00:38:33,478 --> 00:38:35,396 with her new boyfriend. 1089 00:38:35,480 --> 00:38:37,232 So what's the point of New Jersey? 1090 00:38:37,315 --> 00:38:38,691 - Yeah, good question. 1091 00:38:38,775 --> 00:38:40,276 Which fellowship? 1092 00:38:40,360 --> 00:38:44,030 - I've narrowed it down to ultrasound, toxicology, 1093 00:38:44,113 --> 00:38:47,242 and sports medicine. 1094 00:38:47,325 --> 00:38:48,618 - Those are very disparate fields 1095 00:38:48,701 --> 00:38:50,119 leading to very different careers. 1096 00:38:50,203 --> 00:38:51,287 - I know. 1097 00:38:51,371 --> 00:38:53,414 I'm a little undecided. 1098 00:38:53,456 --> 00:38:55,041 - Do you have research experience? 1099 00:38:55,083 --> 00:38:57,585 - I was a part of a study on racial disparities 1100 00:38:57,669 --> 00:38:59,462 in health care until the White House 1101 00:38:59,546 --> 00:39:01,047 cut the funding last year. 1102 00:39:01,130 --> 00:39:03,424 - Yeah. You are not alone. 1103 00:39:03,508 --> 00:39:06,386 Have you considered a geriatrics fellowship? 1104 00:39:06,469 --> 00:39:08,263 - I have not. 1105 00:39:08,346 --> 00:39:10,431 - I've seen your skills with the elderly, 1106 00:39:10,473 --> 00:39:12,559 and there are a lot of openings. 1107 00:39:12,642 --> 00:39:14,394 It might be your best shot. 1108 00:39:14,477 --> 00:39:17,230 Think about it. 1109 00:39:17,313 --> 00:39:18,231 - Last stitch. 1110 00:39:18,314 --> 00:39:19,274 You want me to cut? 1111 00:39:19,357 --> 00:39:20,859 - I got it. 1112 00:39:22,527 --> 00:39:23,778 - It looks good. 1113 00:39:23,862 --> 00:39:25,905 OK. Let's pull the traction suture. 1114 00:39:25,989 --> 00:39:27,365 - With pleasure. 1115 00:39:29,325 --> 00:39:31,369 - OK, Jackie. 1116 00:39:31,452 --> 00:39:32,787 Jackie. - Stop it. 1117 00:39:32,829 --> 00:39:33,788 Stop. 1118 00:39:33,830 --> 00:39:35,081 - All done. 1119 00:39:35,164 --> 00:39:36,624 - All done with what? 1120 00:39:36,708 --> 00:39:38,293 - Sewing up your tongue. 1121 00:39:38,376 --> 00:39:40,044 - What happened to my tongue? 1122 00:39:40,128 --> 00:39:41,254 - You bit it. 1123 00:39:41,337 --> 00:39:42,255 - Ha. 1124 00:39:42,338 --> 00:39:43,923 No, I didn't. 1125 00:39:43,965 --> 00:39:45,758 - That is called a blackout. 1126 00:39:45,842 --> 00:39:47,594 - How much did you drink? 1127 00:39:47,677 --> 00:39:49,804 - A couple Bloody Marys. 1128 00:39:49,888 --> 00:39:51,014 - Only a couple? 1129 00:39:51,097 --> 00:39:53,182 - I don't know. Maybe more. 1130 00:39:53,266 --> 00:39:55,935 It's a holiday, a pub crawl. 1131 00:39:56,019 --> 00:39:58,646 - Do you usually have a couple cocktails every day? 1132 00:39:58,688 --> 00:39:59,856 - Only on weekends. 1133 00:39:59,939 --> 00:40:01,190 - How about during the week? 1134 00:40:01,274 --> 00:40:02,650 - Nothing much. 1135 00:40:02,692 --> 00:40:07,655 Just wine with dinner or a few beers. 1136 00:40:07,697 --> 00:40:10,825 - Maybe we should recommend rehab? 1137 00:40:10,867 --> 00:40:11,910 - Yeah. 1138 00:40:11,993 --> 00:40:13,411 We could try. 1139 00:40:17,999 --> 00:40:20,335 - Ready to roll. 1140 00:40:20,418 --> 00:40:22,003 - How are you feeling? 1141 00:40:22,045 --> 00:40:23,338 - My pain is a two. 1142 00:40:23,421 --> 00:40:24,964 - We got meds if you need them. 1143 00:40:25,048 --> 00:40:26,507 - Scan will be quicker than the ride to Presby. 1144 00:40:26,549 --> 00:40:27,842 - We'll keep trying to reach your sister. 1145 00:40:27,926 --> 00:40:29,510 - You guys are the best. - See you later. 1146 00:40:29,552 --> 00:40:31,304 - Can I put a new patient in T1? 1147 00:40:31,387 --> 00:40:33,681 - Uh, no, I kind of want to leave one trauma room open. 1148 00:40:33,723 --> 00:40:37,310 Why don't you double up the north if you have to? 1149 00:40:37,393 --> 00:40:40,188 - Mr. Digby? 1150 00:40:40,271 --> 00:40:42,106 - It's just Digby. - Right. 1151 00:40:42,190 --> 00:40:44,651 We've been looking all over. Where you been? 1152 00:40:44,734 --> 00:40:46,194 - With Louie. 1153 00:40:46,235 --> 00:40:47,695 - You've been in there for an hour? 1154 00:40:47,737 --> 00:40:49,697 - He was my friend. 1155 00:40:49,781 --> 00:40:51,658 I had a lot to say. - Hmm. 1156 00:40:51,741 --> 00:40:54,035 Well, let's get you back to your bed. 1157 00:40:54,077 --> 00:40:56,037 [bell dings] 1158 00:40:56,079 --> 00:40:57,872 - Louie got his wings. 1159 00:40:57,956 --> 00:40:59,832 - Dr. Robby. - Dr. Robby. 1160 00:40:59,916 --> 00:41:01,376 We picked up a patient together. 1161 00:41:01,459 --> 00:41:02,835 - Teamwork! 1162 00:41:02,919 --> 00:41:04,379 - It's a concerning bullous rash. 1163 00:41:04,420 --> 00:41:05,922 - We might need a biopsy for pemphigus vulgaris. 1164 00:41:06,005 --> 00:41:07,382 - It's phytophotodermatitis. 1165 00:41:07,465 --> 00:41:09,175 - What? - I asked. 1166 00:41:09,258 --> 00:41:11,260 He was making three gallons of margaritas for a party, 1167 00:41:11,344 --> 00:41:13,554 squeezing fresh limes out in the sun. 1168 00:41:13,596 --> 00:41:14,973 - Let's go take a peek. 1169 00:41:15,056 --> 00:41:16,933 - I don't need to see it again. 1170 00:41:19,435 --> 00:41:20,812 - How's it going out there? 1171 00:41:20,895 --> 00:41:22,397 - Standing room only. 1172 00:41:22,438 --> 00:41:23,815 If I call the fire department, will they clear 1173 00:41:23,898 --> 00:41:25,066 that waiting room? - I wish. 1174 00:41:25,149 --> 00:41:26,234 What's up? 1175 00:41:26,275 --> 00:41:28,236 - 12 patients need med refills. 1176 00:41:28,319 --> 00:41:29,862 - Shouldn't they see their doctors? 1177 00:41:29,904 --> 00:41:31,572 - With the Medicaid cuts, we are their doctor. 1178 00:41:31,656 --> 00:41:33,324 - No, I can't e-prescribe to their pharmacies. 1179 00:41:33,408 --> 00:41:35,034 - So get out your pen. Go old school. 1180 00:41:35,118 --> 00:41:37,370 - Dana, on what? 1181 00:41:37,453 --> 00:41:39,831 - Nordt, you got the security pads? 1182 00:41:39,914 --> 00:41:41,082 - Sure do. 1183 00:41:41,165 --> 00:41:42,917 Just need a patient sticker. 1184 00:41:42,959 --> 00:41:45,253 - Any other questions? - Yeah. 1185 00:41:45,336 --> 00:41:47,755 What would have happened if you weren't here today? 1186 00:41:48,923 --> 00:41:50,717 - You'd all be curled up in the fetal position, 1187 00:41:50,800 --> 00:41:53,052 crying like babies. 1188 00:41:53,136 --> 00:41:54,637 - Were you wearing flip-flops? 1189 00:41:54,721 --> 00:41:55,972 - I was. 1190 00:41:56,055 --> 00:41:57,932 What is it? - Phytophotodermatitis. 1191 00:41:57,974 --> 00:42:00,101 - Otherwise known as margarita burn. 1192 00:42:00,184 --> 00:42:01,644 - For some people, limes plus sunshine 1193 00:42:01,728 --> 00:42:02,979 can cause a horrible rash. 1194 00:42:03,062 --> 00:42:05,106 - This is all because of limes? 1195 00:42:05,189 --> 00:42:07,942 - Have you ever squeezed limes outside in the sun before? 1196 00:42:08,026 --> 00:42:09,610 - I don't think so. 1197 00:42:09,694 --> 00:42:12,113 - You will feel better after a day of steroid pills. 1198 00:42:12,155 --> 00:42:13,990 But once these heal, you gotta wear sunscreen. 1199 00:42:14,073 --> 00:42:16,117 Because these blisters can turn into dark scars 1200 00:42:16,200 --> 00:42:17,410 and stay a while if you don't. 1201 00:42:17,493 --> 00:42:19,037 - [sighs] 1202 00:42:19,120 --> 00:42:22,373 - I'll be right back with your aftercare instructions. 1203 00:42:22,457 --> 00:42:24,292 - Hey, Robby. - Yep. 1204 00:42:24,375 --> 00:42:26,461 - My, uh-- my hospice patient Roxie 1205 00:42:26,544 --> 00:42:28,421 is still in a ton of pain. 1206 00:42:28,504 --> 00:42:29,714 - Where are we with the morphine? 1207 00:42:29,797 --> 00:42:31,632 - 10 milligrams an hour. 1208 00:42:31,716 --> 00:42:34,218 - OK, you can bolus another 2 and go up to 12. 1209 00:42:34,302 --> 00:42:35,595 I will let Princess know. 1210 00:42:35,678 --> 00:42:36,971 - 12 an hour is a lot. 1211 00:42:37,013 --> 00:42:38,431 - Yeah, on top of the MS Contin, 1212 00:42:38,514 --> 00:42:41,392 she could stop breathing. 1213 00:42:41,476 --> 00:42:44,729 - Are you familiar with the doctrine of double effect? 1214 00:42:44,812 --> 00:42:46,814 - Not really. - No. 1215 00:42:46,856 --> 00:42:49,317 - It is an ethical principle in palliative care. 1216 00:42:49,358 --> 00:42:50,985 We treat pain. 1217 00:42:51,069 --> 00:42:52,987 And if, in doing so, there's a negative side effect, 1218 00:42:53,029 --> 00:42:54,614 we accept it. 1219 00:42:54,697 --> 00:42:57,450 - Even if the negative side effect is death? 1220 00:42:57,533 --> 00:43:00,161 - In some cases, that could be the best outcome. 1221 00:43:01,788 --> 00:43:04,832 [indistinct chatter] 1222 00:43:05,958 --> 00:43:07,335 - Maybe the nurse has it. 1223 00:43:07,418 --> 00:43:10,046 - Emma. Emma, where does-- 1224 00:43:10,129 --> 00:43:11,839 - Maybe the fax ran out of paper? 1225 00:43:11,881 --> 00:43:14,509 - No, there is enough paper. I don't know what's wrong. 1226 00:43:14,592 --> 00:43:16,010 - Could be in another room. - We should call IT. 1227 00:43:16,094 --> 00:43:18,012 - You want me to check every room? 1228 00:43:18,096 --> 00:43:19,639 - How are we gonna get through this mess? 1229 00:43:19,722 --> 00:43:22,600 - I was about to ask you. 1230 00:43:22,683 --> 00:43:24,143 - Ask the pharmacist. 1231 00:43:24,227 --> 00:43:25,686 - She can't leave the PDS. 1232 00:43:25,770 --> 00:43:27,480 - Nothing's getting done here. 1233 00:43:27,563 --> 00:43:30,566 [indistinct chatter] 1234 00:43:36,739 --> 00:43:39,659 [soft music] 1235 00:43:39,742 --> 00:43:46,749 ♪ ♪