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1
00:00:11,637 --> 00:00:14,765
Structural collapse at the water park--
two victims coming in via helicopter.
2
00:00:14,848 --> 00:00:17,351
- ETA, five minutes.
- Time to rally the troops.
3
00:00:17,434 --> 00:00:19,645
I'll get environmental
to clear and prep the trauma rooms.
4
00:00:19,728 --> 00:00:20,729
Emma, restock the crash carts.
5
00:00:20,812 --> 00:00:22,773
Makedah, take the latest scripts
to the drug cage.
6
00:00:22,856 --> 00:00:25,150
- Should be a fun one.
- "Fun one"? What's up?
7
00:00:25,234 --> 00:00:27,778
Slide broke at the water park--
two victims, five minutes to touchdown.
8
00:00:27,861 --> 00:00:30,364
- No information on extent of injuries.
- I can jump in with--
9
00:00:30,447 --> 00:00:34,576
Ogilvie, grab some goggles, gloves, gown.
Go up to the roof.
10
00:00:34,660 --> 00:00:36,745
First patient that lands, bring 'em down.
11
00:00:36,828 --> 00:00:39,373
We got two choppers.
You want to grab some bodies and meet me?
12
00:00:39,456 --> 00:00:42,793
- What injuries are we expecting?
- Structural collapse. Could be anything.
13
00:00:42,876 --> 00:00:46,380
I can increase the morphine drip
to manage the pain,
14
00:00:46,463 --> 00:00:49,049
but that could also slow down
your breathing.
15
00:00:49,132 --> 00:00:52,886
You will likely feel very drowsy.
You may lose consciousness.
16
00:00:54,012 --> 00:00:56,139
And it could cause you
to stop breathing altogether.
17
00:01:06,275 --> 00:01:07,901
I'll be right back.
18
00:01:15,284 --> 00:01:18,412
- Hey, you okay?
- Yeah.
19
00:01:18,495 --> 00:01:19,788
Yeah. Sorry.
20
00:01:19,871 --> 00:01:23,417
Look, it's hard seeing your patients die.
21
00:01:23,500 --> 00:01:27,421
But as professionals, we have to create
emotional boundaries for ourselves.
22
00:01:27,504 --> 00:01:29,923
It's not about us. It's about them.
23
00:01:32,009 --> 00:01:34,011
She's so calm. I just...
24
00:01:34,928 --> 00:01:36,430
Yeah.
25
00:01:36,513 --> 00:01:38,682
She's had a long time
to prepare for this moment.
26
00:01:39,975 --> 00:01:44,938
What she's doing for her sons--
managing this with so much grace--
27
00:01:45,022 --> 00:01:46,648
it's a real gift of love.
28
00:01:46,732 --> 00:01:48,525
I feel like an asshole.
29
00:01:49,568 --> 00:01:51,612
All they want is more time
with their mother.
30
00:01:51,695 --> 00:01:53,447
All I want is less time with mine.
31
00:01:53,530 --> 00:01:55,407
Don't feel guilty.
32
00:01:55,490 --> 00:01:59,661
I mean, you can be grateful
and gracious from a distance.
33
00:01:59,745 --> 00:02:02,456
Just talk to her. Tell her what you want.
She'll understand.
34
00:02:05,125 --> 00:02:06,335
I doubt that.
35
00:02:07,711 --> 00:02:10,839
Give her a chance, you know?
She may surprise you.
36
00:02:13,300 --> 00:02:14,718
Hey.
37
00:02:14,801 --> 00:02:16,678
Two birds headed our way. Need a hand?
38
00:02:16,762 --> 00:02:18,472
That's the rumor.
39
00:02:18,555 --> 00:02:20,390
Santos, trauma incoming.
40
00:02:20,474 --> 00:02:22,976
Grab a gown. You can assist Dr. Langdon.
41
00:02:25,979 --> 00:02:27,272
Fuck me.
42
00:02:27,356 --> 00:02:29,900
Jesus, I got blood tubes
growing moss over here.
43
00:02:29,983 --> 00:02:31,985
Ticktock, people.
44
00:02:32,069 --> 00:02:34,279
Hey, Olive, do me a solid--
run these to the lab.
45
00:02:34,363 --> 00:02:35,489
No problem.
46
00:02:35,572 --> 00:02:37,366
I got more lab results.
47
00:02:37,449 --> 00:02:39,493
Start putting them
on the patient clipboards,
48
00:02:39,576 --> 00:02:41,703
PTMC Emergency. Go ahead, Medic Command.
49
00:02:41,787 --> 00:02:43,372
Do cyberattacks happen often?
50
00:02:43,455 --> 00:02:45,582
- More than you realize.
- I blame the Russkies.
51
00:02:45,666 --> 00:02:48,669
Dr. Mohan, it's your mother?
52
00:02:48,752 --> 00:02:50,379
She sounds pretty upset.
53
00:02:50,462 --> 00:02:52,798
Says she really needs to talk to you.
54
00:02:53,799 --> 00:02:55,801
You're shitting me.
Tell her I'm not available.
55
00:03:06,186 --> 00:03:07,479
How's your shift going?
56
00:03:08,397 --> 00:03:10,524
It's been a lot already.
57
00:03:11,608 --> 00:03:14,194
You know, I worked in an ER before,
up in Vermont,
58
00:03:14,277 --> 00:03:17,948
and we had MVAs and ODs, MIs.
59
00:03:18,031 --> 00:03:19,199
But this place...
60
00:03:20,033 --> 00:03:21,493
...this place is relentless.
61
00:03:22,202 --> 00:03:25,038
Holiday weekend.
We're not normally offline.
62
00:03:26,039 --> 00:03:28,709
I think we have
a very different idea of normal.
63
00:03:28,792 --> 00:03:30,168
It's not for everyone.
64
00:03:30,252 --> 00:03:33,338
- I'm not sure it's healthy for anybody.
- Here's her leg.
65
00:03:34,423 --> 00:03:36,049
Jesus.
66
00:03:43,432 --> 00:03:45,976
- I need more runners.
- Oh, you could shut down the gift shop.
67
00:03:46,059 --> 00:03:48,145
They always have a couple
of volunteers there.
68
00:03:48,228 --> 00:03:50,147
Most of those volunteers use walkers.
69
00:03:50,230 --> 00:03:51,773
Beggars can't be choosers.
70
00:03:51,857 --> 00:03:53,191
Go get 'em.
71
00:03:53,275 --> 00:03:55,569
- Okay, I'm gonna grab a smoke first.
- No time.
72
00:03:55,652 --> 00:03:57,154
Nicotine gum--take the edge off.
73
00:03:57,237 --> 00:03:59,781
You two, head to triage
to help out the front of the house.
74
00:03:59,865 --> 00:04:02,576
They're running out of space,
and there's a line out the door.
75
00:04:02,659 --> 00:04:05,245
- Okay, let's go.
- Hang on, Mohan.
76
00:04:06,872 --> 00:04:08,123
Sign this.
77
00:04:10,459 --> 00:04:12,377
Nicotine patch, 21 milligrams.
78
00:04:12,461 --> 00:04:15,005
- Who's it for?
- Monica. This nicotine gum's shit.
79
00:04:15,088 --> 00:04:18,133
She'll never survive the shift, and I need
her so I don't lose my goddamn mind.
80
00:04:20,886 --> 00:04:22,095
Thanks.
81
00:04:22,179 --> 00:04:23,847
Is Dr. Abbot still around?
82
00:04:23,930 --> 00:04:26,600
He went to get some sleep before
his night shift starts in a couple hours.
83
00:04:26,683 --> 00:04:29,394
Shit. Okay, I should have planned
this better.
84
00:04:29,478 --> 00:04:32,189
I was hoping he'd write me
a letter of rec for an elective
85
00:04:32,272 --> 00:04:34,566
so I could have a shot
at a fellowship next year.
86
00:04:34,649 --> 00:04:35,692
Which one?
87
00:04:36,902 --> 00:04:38,195
Whichever will take me.
88
00:04:38,278 --> 00:04:40,405
Didn't the electives fill up a while ago?
89
00:04:40,489 --> 00:04:42,824
Don't remind me. I'm gonna throw myself
at the mercy of the court,
90
00:04:42,908 --> 00:04:44,826
beg for them to take me anyway.
91
00:04:44,910 --> 00:04:47,621
Just kill me now. It'll be less painful.
92
00:04:47,704 --> 00:04:49,748
Dana, I can't read this handwriting.
93
00:04:49,831 --> 00:04:50,916
It says...
94
00:04:51,917 --> 00:04:56,421
...1,000 milligrams acetaminophen orally,
4 milligrams ondansetron under the tongue,
95
00:04:56,505 --> 00:04:58,632
and trial of clear fluids.
96
00:04:58,715 --> 00:05:00,425
Seriously? It says all that?
97
00:05:00,509 --> 00:05:03,220
If it's not in a text with emojis,
you kids can't read for shit.
98
00:05:06,515 --> 00:05:07,557
What do we have?
99
00:05:07,641 --> 00:05:09,559
A fall from 10 feet onto a metal fence.
100
00:05:09,643 --> 00:05:11,937
Right below the knee. Good vitals.
101
00:05:12,020 --> 00:05:13,688
Oh, it hurts. Oh, my God.
102
00:05:13,772 --> 00:05:16,066
- What's she had so far?
- 50 of fent, repeated 25.
103
00:05:16,149 --> 00:05:17,442
No meds, no allergies.
104
00:05:17,526 --> 00:05:19,778
- Where should I put this?
- Just hang on to it for now.
105
00:05:19,861 --> 00:05:23,657
On my count. One, two, three.
106
00:05:25,450 --> 00:05:28,578
Okay, Whitaker, E-FAST.
Donnie, primary survey, please.
107
00:05:28,662 --> 00:05:30,747
Pupils equal and reactive.
108
00:05:31,456 --> 00:05:33,875
- What's your name?
- My leg hurts really bad.
109
00:05:33,959 --> 00:05:35,669
Did I break it?
110
00:05:35,752 --> 00:05:37,212
I wouldn't say that it's broken exactly.
111
00:05:37,295 --> 00:05:39,464
We're gonna get an X-ray
to determine that.
112
00:05:39,548 --> 00:05:41,466
Put that on the gurney,
line it up for X-ray,
113
00:05:41,550 --> 00:05:42,884
keep your fucking mouth shut.
114
00:05:42,968 --> 00:05:44,761
Good lung sliding right and left.
115
00:05:44,845 --> 00:05:46,847
Airway patent, breath sounds bilaterally.
116
00:05:47,556 --> 00:05:49,933
- Please, it hurts.
- BP 100 over 60.
117
00:05:50,016 --> 00:05:52,978
Pulse 118, pulse ox 98%.
118
00:05:53,061 --> 00:05:56,273
- Does your belly hurt?
- No, asshole! It's my leg!
119
00:05:56,356 --> 00:05:59,401
- Okay, she's really moving here.
- 100 of ketamine?
120
00:05:59,484 --> 00:06:01,319
Yeah, we can't evaluate like this.
121
00:06:02,362 --> 00:06:03,989
Hey, Ogilvie?
122
00:06:04,072 --> 00:06:06,157
- Deep breaths, yeah?
- Yeah, okay.
123
00:06:06,241 --> 00:06:07,701
Whitaker, what's next?
124
00:06:07,784 --> 00:06:10,245
Once she's sedated, finish the E-FAST,
125
00:06:10,328 --> 00:06:12,163
plain X-ray, check her back,
straight to CT.
126
00:06:12,247 --> 00:06:14,499
- What if the ketamine wears off?
- Right.
127
00:06:14,583 --> 00:06:18,128
We should do a popliteal nerve block
before the CT,
128
00:06:18,211 --> 00:06:20,046
anesthetize from the knee down.
129
00:06:20,130 --> 00:06:22,132
- Two view tib-fib.
- Pushing ketamine now.
130
00:06:22,215 --> 00:06:24,926
- What's the bullet?
- 42-year-old male with 20-foot fall.
131
00:06:25,010 --> 00:06:27,012
Blunt chest trauma with hand injury.
132
00:06:27,554 --> 00:06:29,472
Where's my son? Where's my son?
133
00:06:29,556 --> 00:06:31,850
He's tachy to 108, sats 98 on 2 liters,
134
00:06:31,933 --> 00:06:34,561
- BP 122 over 84.
- We'll pan scan due to mechanism.
135
00:06:34,644 --> 00:06:36,521
- You?
- Tib-fib amputation.
136
00:06:36,605 --> 00:06:39,482
Hoping ortho can give us
a little hope for replantation.
137
00:06:39,566 --> 00:06:42,319
- Derek, where are you hurting?
- Chest and my finger.
138
00:06:42,402 --> 00:06:43,445
Did they find my son?
139
00:06:43,528 --> 00:06:45,530
- Did you hit your head?
- Don't think so.
140
00:06:45,614 --> 00:06:46,948
I need to find my son!
141
00:06:47,032 --> 00:06:49,326
We'll find him for you,
but we need to take care of you first.
142
00:06:49,409 --> 00:06:52,329
Pericardium's clear.
No fluid in Morrison's.
143
00:06:52,412 --> 00:06:53,997
Move both arms, wiggle your feet.
144
00:06:54,623 --> 00:06:56,958
- Good. Any pain in your neck?
- No.
145
00:06:57,042 --> 00:06:58,752
- Spleen looks good.
- Start with his chest.
146
00:06:58,835 --> 00:07:00,170
That's where he hurts.
147
00:07:00,253 --> 00:07:02,464
- No hemotympanum.
- Normal sliding.
148
00:07:03,048 --> 00:07:05,008
Best to start with the side
he's complaining about first.
149
00:07:06,635 --> 00:07:08,511
I don't see much sliding there.
150
00:07:08,595 --> 00:07:10,764
His name is Zack. He's seven.
151
00:07:10,847 --> 00:07:12,557
- Pneumothorax?
- Set up for a chest tube.
152
00:07:12,641 --> 00:07:16,770
Not yet. Let's go posterolateral.
Look for fluid first.
153
00:07:16,853 --> 00:07:18,813
Traumatic pneumothorax.
We should prep the chest.
154
00:07:19,522 --> 00:07:21,441
Not necessarily.
He's hemodynamically stable.
155
00:07:22,275 --> 00:07:23,568
Okay.
156
00:07:23,652 --> 00:07:25,320
Does that look like some fluid there?
157
00:07:25,403 --> 00:07:26,780
Hard to say for sure.
158
00:07:26,863 --> 00:07:29,574
Okay, he's tachycardic hemopneumothorax.
He needs a chest tube.
159
00:07:29,658 --> 00:07:33,578
BP and sats are fine. We can wait for CT.
If it's small, it'll resolve on its own.
160
00:07:33,662 --> 00:07:35,997
- We observe and reimage.
- I agree. He's stable for now.
161
00:07:36,081 --> 00:07:37,457
Let's wait for the scan, Dr. Santos.
162
00:07:37,540 --> 00:07:39,793
- Okay, let's order...
- Okay.
163
00:07:39,876 --> 00:07:42,295
...a CT chest, abdomen,
pelvis, and X-ray left hand.
164
00:07:44,089 --> 00:07:46,216
- Major degloving.
- Focus on the primary.
165
00:07:46,299 --> 00:07:48,426
Dr. Langdon's correct.
We need to logroll him.
166
00:07:50,220 --> 00:07:52,347
Oh, okay. How about another 4 of morphine?
167
00:07:52,430 --> 00:07:53,390
Put it in.
168
00:07:53,473 --> 00:07:55,475
Hang in there, Derek. We got you.
169
00:07:57,727 --> 00:07:59,604
Fuck off already.
170
00:07:59,688 --> 00:08:02,232
- Boyfriend?
- Wish. My mom.
171
00:08:02,315 --> 00:08:04,192
Every time I get a second of service,
172
00:08:04,275 --> 00:08:07,028
- another dozen texts come in.
- Hey! How much longer do I have to wait?
173
00:08:07,112 --> 00:08:08,738
I got a broken leg here.
174
00:08:08,822 --> 00:08:10,407
Someone will be with you shortly, sir.
175
00:08:10,490 --> 00:08:13,243
Am I allowed to use the bathroom?
I really have to go.
176
00:08:13,326 --> 00:08:15,203
I don't know, ma'am. I am not your doctor.
177
00:08:15,286 --> 00:08:18,373
- It says right there "doctor."
- Yes, but I'm not your doctor.
178
00:08:18,456 --> 00:08:20,709
But if you go back to your room,
a nurse will come find you.
179
00:08:20,792 --> 00:08:22,460
I wasn't in a room.
180
00:08:22,544 --> 00:08:25,422
I'm sorry.
Are either of you treating my mother?
181
00:08:25,505 --> 00:08:26,506
Nope!
182
00:08:33,638 --> 00:08:35,724
Take a seat. It's gonna be a while.
183
00:08:39,144 --> 00:08:41,187
Helen Torres, come on down.
184
00:08:42,856 --> 00:08:44,858
Helen Torres?
185
00:08:44,941 --> 00:08:46,359
Yes, I'm coming.
186
00:08:48,945 --> 00:08:52,157
- Go through the door on this side.
- Thank you.
187
00:09:00,165 --> 00:09:01,166
Thank you.
188
00:09:06,337 --> 00:09:08,173
I'm Dr. Mohan.
This is Student Doctor Kwon.
189
00:09:08,256 --> 00:09:09,257
Helen.
190
00:09:09,340 --> 00:09:11,509
How long has your leg been swollen, Helen?
191
00:09:11,593 --> 00:09:14,220
It's been getting worse
over the past week.
192
00:09:14,929 --> 00:09:16,681
Dr. Mohan, your mom called again.
193
00:09:16,765 --> 00:09:18,391
- She said you need to call her back.
- Not now!
194
00:09:19,350 --> 00:09:20,560
I'm with a patient.
195
00:09:23,271 --> 00:09:24,397
Sorry about that.
196
00:09:25,774 --> 00:09:27,692
Did you fall or hit your leg?
197
00:09:27,776 --> 00:09:28,902
No.
198
00:09:29,778 --> 00:09:32,697
Have you ever had a blood clot before?
199
00:09:32,781 --> 00:09:33,782
No.
200
00:09:37,410 --> 00:09:39,662
- Are you all right?
- Excuse me?
201
00:09:39,746 --> 00:09:42,916
- Do you need to sit down?
- Oh, no. I'm fine.
202
00:09:42,999 --> 00:09:44,167
You don't look too good.
203
00:09:44,793 --> 00:09:46,211
What?
204
00:09:46,294 --> 00:09:47,962
No, it's just...
205
00:09:48,046 --> 00:09:49,631
it's really hot in here.
206
00:09:49,714 --> 00:09:50,840
And...
207
00:09:52,175 --> 00:09:54,219
- You need to sit down.
- I'm good.
208
00:09:56,012 --> 00:09:57,931
I just need some air.
209
00:09:58,014 --> 00:09:59,599
Excuse me one second.
210
00:10:17,242 --> 00:10:20,078
- You a doctor?
- Sorry, Doctor, does this look infected?
211
00:10:20,161 --> 00:10:22,747
I've been waiting six hours,
and people keep cutting in front of me.
212
00:10:22,831 --> 00:10:25,959
Doctor, can you just look at my throat
just to see if it's strep?
213
00:10:26,042 --> 00:10:27,627
Look out! Make way!
214
00:10:28,837 --> 00:10:30,338
Get in.
215
00:10:30,421 --> 00:10:32,006
No, I'm okay.
216
00:10:32,090 --> 00:10:34,843
- I'm okay.
- Get in the fucking chair.
217
00:10:38,054 --> 00:10:39,180
Excuse me, ma'am.
218
00:10:39,264 --> 00:10:41,391
Excuse me, coming through!
219
00:10:41,474 --> 00:10:42,976
Out of my way!
220
00:10:43,059 --> 00:10:46,354
We were going down the water slide,
and the bottom just fell off.
221
00:10:46,437 --> 00:10:48,982
I grabbed Zack's arm,
and I tried to hold on to the sides,
222
00:10:49,065 --> 00:10:51,192
but my hand slipped,
and my ring got stuck.
223
00:10:51,276 --> 00:10:53,069
My finger was ripping off, and I just...
224
00:10:53,862 --> 00:10:55,446
...and I lost him.
225
00:10:56,072 --> 00:10:59,492
We can numb up your finger as soon
as we gauge the extent of the injury.
226
00:10:59,576 --> 00:11:01,411
You can cut the damn thing off
for all I care.
227
00:11:01,494 --> 00:11:03,037
I just need to find Zack.
228
00:11:03,872 --> 00:11:06,499
- Okay, do you feel anything here?
- Yeah, sharp.
229
00:11:06,583 --> 00:11:08,376
- How about here?
- Sharp again.
230
00:11:08,459 --> 00:11:09,794
A little late for the show, Yoyo.
231
00:11:09,878 --> 00:11:12,005
I am the show, Dr. Langdon.
You're the warm-up act.
232
00:11:12,088 --> 00:11:13,423
I knew somebody missed me.
233
00:11:14,132 --> 00:11:16,801
Mr. Foster suffered a degloving injury
of the ring finger.
234
00:11:16,885 --> 00:11:19,012
Stable pneumothorax awaiting imaging.
235
00:11:19,095 --> 00:11:21,681
Hello, sir. I'm Dr. Garcia
from the trauma service.
236
00:11:22,307 --> 00:11:23,433
I need the ring cutter.
237
00:11:23,516 --> 00:11:25,310
That's why they pay
the surgeons the big bucks.
238
00:11:25,894 --> 00:11:27,896
Possible flexor tendon injury.
239
00:11:29,522 --> 00:11:32,108
Try to bend up your ring finger.
240
00:11:34,652 --> 00:11:36,154
Let's go with the block.
241
00:11:36,237 --> 00:11:39,240
You're gonna feel a pinprick
and some burning.
242
00:11:39,324 --> 00:11:41,826
Which tendon did we test, Dr. Santos?
243
00:11:41,910 --> 00:11:43,745
Seriously? That's a med-student question.
244
00:11:44,537 --> 00:11:47,332
We're a teaching hospital.
It's always good to review.
245
00:11:48,708 --> 00:11:51,628
Flexor digitorum superficialis is intact
246
00:11:51,711 --> 00:11:54,047
as it inserts on the middle phalanx.
247
00:11:54,130 --> 00:11:56,424
- Correct.
- Gee, thanks.
248
00:11:57,133 --> 00:11:58,551
No sign of tension.
249
00:11:59,177 --> 00:12:00,887
At least no tension pneumo.
250
00:12:01,721 --> 00:12:03,640
Let's wait for the CT. I'll be next door.
251
00:12:03,723 --> 00:12:06,434
Langdon, Mel's sister's
been asking for you.
252
00:12:06,517 --> 00:12:08,645
She's getting antsy,
and we could really use the room.
253
00:12:08,728 --> 00:12:10,897
- CT's ready.
- Okay. Let Becca know I'll be there soon.
254
00:12:10,980 --> 00:12:14,275
And Mr. Foster got separated
from his son Zack
255
00:12:14,359 --> 00:12:15,652
at the water park.
256
00:12:15,735 --> 00:12:18,279
- Is there anyone we can call for you?
- My wife, Angela.
257
00:12:18,363 --> 00:12:21,366
Dr. Santos, will you escort
Mr. Foster to CT?
258
00:12:25,745 --> 00:12:26,829
Help!
259
00:12:26,913 --> 00:12:28,581
Need a hand here.
260
00:12:29,374 --> 00:12:32,210
- What the hell happened?
- I think I'm having an MI.
261
00:12:32,293 --> 00:12:34,420
My chest is so tight,
I can barely breathe.
262
00:12:34,504 --> 00:12:37,507
Okay, I got to get a 12 lead.
Perlah, can I get an assist here?
263
00:12:37,590 --> 00:12:38,758
Yeah, I'm on it.
264
00:12:40,218 --> 00:12:41,219
CT's normal.
265
00:12:41,302 --> 00:12:43,096
Why do we take down
the tourniquet, Whitaker?
266
00:12:43,179 --> 00:12:45,974
To give the residual limb blood flow.
267
00:12:46,057 --> 00:12:47,475
Just two little pumpers.
268
00:12:47,558 --> 00:12:49,602
A couple of figure eights
ought to take care of those.
269
00:12:50,395 --> 00:12:51,854
Park.
270
00:12:51,938 --> 00:12:54,399
Park the Shark, orthopedic surgeon.
271
00:12:54,983 --> 00:12:57,110
- Is this a favorable amputation?
- Pretty clean cut.
272
00:12:57,193 --> 00:12:58,903
Fence sliced through like a guillotine.
273
00:12:58,987 --> 00:13:00,154
X-ray?
274
00:13:02,699 --> 00:13:03,992
Not too bad.
275
00:13:06,202 --> 00:13:09,622
Just tying off a couple arterioles.
276
00:13:09,706 --> 00:13:11,207
I'm not blind.
277
00:13:11,916 --> 00:13:14,627
- Where's the amputated leg?
- Double bagged on ice.
278
00:13:15,420 --> 00:13:17,588
Sterile saline on the inner bag.
279
00:13:17,672 --> 00:13:21,551
Ice water in the outer bag.
No direct ice-on-skin contact.
280
00:13:21,634 --> 00:13:25,013
- We spent a lot of time prepping--
- He still needs to look.
281
00:13:29,434 --> 00:13:30,643
Get Robby.
282
00:13:39,861 --> 00:13:42,530
- Antibiotics?
- Cefazolin and gent.
283
00:13:42,613 --> 00:13:44,991
We've cleared her chest,
abdomen, and pelvis.
284
00:13:45,074 --> 00:13:49,245
Clean wound, no crush injury,
rapid transport time.
285
00:13:49,787 --> 00:13:51,372
Replantation is a go.
286
00:13:51,456 --> 00:13:52,582
I'll book an OR.
287
00:13:52,665 --> 00:13:54,167
Irrigate the hell out of this
with 3 liters.
288
00:13:54,250 --> 00:13:56,753
- 3 liters?
- Of saline, genius.
289
00:13:58,629 --> 00:13:59,839
Thanks, Shark.
290
00:14:03,676 --> 00:14:05,345
I knew he meant saline.
291
00:14:06,471 --> 00:14:10,558
Dr. Robby, we need you in Central 6.
Dr. Mohan may be having a heart attack.
292
00:14:10,641 --> 00:14:11,684
What?
293
00:14:13,644 --> 00:14:16,189
- EKG is normal.
- You sure?
294
00:14:16,272 --> 00:14:18,399
Check it out.
You can be your own second opinion.
295
00:14:18,483 --> 00:14:20,568
- What's going on?
- It's okay. I'm okay.
296
00:14:20,651 --> 00:14:22,070
You don't look okay.
297
00:14:22,153 --> 00:14:24,197
- You look like shit.
- I feel like shit.
298
00:14:24,280 --> 00:14:26,783
- What happened?
- I don't know.
299
00:14:26,866 --> 00:14:30,661
I just got really hot,
and I started having trouble breathing.
300
00:14:31,496 --> 00:14:33,706
We should send up
some labs just to be safe.
301
00:14:34,707 --> 00:14:35,917
Any chance you're pregnant?
302
00:14:36,000 --> 00:14:38,711
I'm not sure I feel comfortable
answering that.
303
00:14:40,463 --> 00:14:42,799
- No.
- She was tachy, but it's resolved now.
304
00:14:42,882 --> 00:14:44,717
- Have you eaten anything?
- Yeah.
305
00:14:45,301 --> 00:14:47,095
- You staying hydrated?
- 100%.
306
00:14:47,720 --> 00:14:48,846
I'm doing everything right.
307
00:14:48,930 --> 00:14:51,140
It's everything around me
that's all fucked up.
308
00:14:51,224 --> 00:14:54,102
It's just my mom moving
and calling me over and over again
309
00:14:54,185 --> 00:14:56,020
and now me scrambling
to find a job next year.
310
00:14:56,104 --> 00:14:58,815
I had it all planned out,
and now everything's just out the window.
311
00:14:58,898 --> 00:15:01,776
Wait a minute. Is this a panic attack
because of your mommy issues?
312
00:15:02,443 --> 00:15:03,945
- What? No.
- Jesus.
313
00:15:04,028 --> 00:15:05,238
Do you need to go home?
314
00:15:05,321 --> 00:15:06,948
- You should go home.
- No, I'm fine.
315
00:15:07,031 --> 00:15:08,574
I don't need the fucking liability.
Go home.
316
00:15:09,117 --> 00:15:11,828
And the rest of you, the last time
I checked, the ED is a shit show.
317
00:15:11,911 --> 00:15:13,913
So let's all get back to work, huh?
318
00:15:21,254 --> 00:15:23,714
Sorry for taking so long, Becca.
319
00:15:23,798 --> 00:15:25,800
Nurse Dana said you'd be back
in a few minutes,
320
00:15:25,883 --> 00:15:28,052
but it's definitely been
more than a few minutes.
321
00:15:28,136 --> 00:15:29,929
You're right. My apologies.
322
00:15:30,555 --> 00:15:32,682
- I brought some drink options.
- Okay.
323
00:15:32,765 --> 00:15:36,519
We've got apple juice, cranberry juice,
324
00:15:36,602 --> 00:15:39,647
OJ, and Pittsburgh's finest.
325
00:15:39,730 --> 00:15:41,941
- What's that?
- Water.
326
00:15:42,775 --> 00:15:44,569
- OJ, please.
- Okay.
327
00:15:45,945 --> 00:15:47,363
Let's see.
328
00:15:50,533 --> 00:15:51,576
All right.
329
00:15:52,577 --> 00:15:55,371
Now, I am going to give you two pills.
330
00:15:55,955 --> 00:15:57,999
The first is an antibiotic.
331
00:15:58,082 --> 00:16:00,293
That will get rid of the infection.
332
00:16:00,376 --> 00:16:02,295
The second should take care
of the burning.
333
00:16:02,378 --> 00:16:05,798
You want to take both pills for three days
and drink lots of water.
334
00:16:05,882 --> 00:16:07,300
I'll write it all down.
335
00:16:07,383 --> 00:16:08,593
I hate pills.
336
00:16:09,260 --> 00:16:12,138
Could you mash those up
and put them in the OJ for me?
337
00:16:12,221 --> 00:16:13,598
Coming right up.
338
00:16:15,516 --> 00:16:16,601
Okay.
339
00:16:17,810 --> 00:16:20,480
Mel's gonna be super worried
when you tell her.
340
00:16:21,105 --> 00:16:22,648
You are gonna be just fine.
341
00:16:22,732 --> 00:16:26,110
But as far as telling your sister
what's going on with you,
342
00:16:26,194 --> 00:16:28,362
that is your decision, not mine.
343
00:16:30,615 --> 00:16:33,618
So you're not going to tell Mel?
344
00:16:34,410 --> 00:16:38,372
I can't, not unless you,
my patient, tell me to.
345
00:16:41,626 --> 00:16:45,213
Do you know when Mel's gonna be done
with her important meeting?
346
00:16:46,005 --> 00:16:47,215
Hopefully soon.
347
00:16:48,633 --> 00:16:52,136
Dr. Langdon, they need you
back in Trauma Two.
348
00:16:52,220 --> 00:16:53,221
Hi.
349
00:16:55,556 --> 00:16:57,099
Becca, I got to go. I'll be--
350
00:16:57,183 --> 00:17:00,311
Don't say "in a few minutes"
unless you actually mean in a few minutes.
351
00:17:01,020 --> 00:17:02,230
I would never.
352
00:17:07,151 --> 00:17:10,363
And I need you to be kind to each other.
353
00:17:10,446 --> 00:17:13,866
I am kind.
Shane's just a butthead sometimes.
354
00:17:15,451 --> 00:17:19,038
He's your brother, and he loves you.
355
00:17:21,332 --> 00:17:22,458
Don't go.
356
00:17:23,251 --> 00:17:24,669
I don't want to go.
357
00:17:26,003 --> 00:17:28,756
But it's not up to me.
358
00:17:29,882 --> 00:17:30,967
Hey.
359
00:17:31,050 --> 00:17:33,052
We'll always be connected...
360
00:17:33,886 --> 00:17:35,263
...no matter what.
361
00:17:38,266 --> 00:17:39,892
Invisible string.
362
00:17:43,479 --> 00:17:45,064
Invisible string.
363
00:17:57,285 --> 00:17:58,286
Hey.
364
00:18:00,705 --> 00:18:02,415
You gonna go in and see your mom?
365
00:18:03,916 --> 00:18:05,501
Cancer sucks.
366
00:18:06,502 --> 00:18:07,753
Yeah.
367
00:18:07,837 --> 00:18:09,297
Yeah, it does.
368
00:18:12,300 --> 00:18:15,511
- It's not fair.
- No, it's not.
369
00:18:20,099 --> 00:18:21,684
I don't want to go in there.
370
00:18:23,728 --> 00:18:25,730
Nobody's gonna make you.
371
00:18:32,737 --> 00:18:34,739
She didn't used to look like that.
372
00:18:37,742 --> 00:18:39,327
Yeah, I get that.
373
00:18:42,997 --> 00:18:46,042
But if you don't go in there
and say goodbye
374
00:18:46,125 --> 00:18:48,127
and tell your mom you love her...
375
00:18:49,754 --> 00:18:52,965
...I think you might wish you had
for a very long time.
376
00:18:57,136 --> 00:18:58,554
It's your call.
377
00:19:02,350 --> 00:19:06,562
D-5 half normal saline,
20 of K running at 125 an hour.
378
00:19:07,355 --> 00:19:08,689
One of the most common reasons
379
00:19:08,773 --> 00:19:11,108
for traumatic-replantation failure
is infections.
380
00:19:11,192 --> 00:19:12,568
So we do what, Whitaker?
381
00:19:12,652 --> 00:19:14,737
Rinse and repeat
until surgery calls for us.
382
00:19:16,989 --> 00:19:19,075
Is everything okay with Dr. Mohan?
383
00:19:19,158 --> 00:19:20,660
She's fine. Focus.
384
00:19:25,998 --> 00:19:27,166
Where am I?
385
00:19:28,376 --> 00:19:29,835
Ketamine's wearing off.
386
00:19:33,005 --> 00:19:35,007
I can't feel my leg.
387
00:19:35,091 --> 00:19:37,885
I'm Dr. Michael Robinavitch.
You're at a hospital.
388
00:19:37,968 --> 00:19:40,554
And we gave you a nerve block
so that you can't feel any pain.
389
00:19:40,638 --> 00:19:41,639
Why?
390
00:19:41,722 --> 00:19:45,685
You were on a water slide that collapsed
and did serious injury to your leg.
391
00:19:49,814 --> 00:19:51,065
What the fuck?
392
00:19:51,148 --> 00:19:52,441
Is that my leg?
393
00:19:52,525 --> 00:19:53,526
Is that my...
394
00:19:53,609 --> 00:19:56,362
- Did you cut my fucking leg off?
- Your leg was cut off in the accident.
395
00:19:56,445 --> 00:19:58,572
Our surgeons are going to try
for replantation.
396
00:19:58,656 --> 00:20:00,116
No.
397
00:20:00,199 --> 00:20:01,534
- She needs more ketamine.
- Just wrap up the leg.
398
00:20:01,617 --> 00:20:02,743
Emily, I know that this is really hard.
399
00:20:02,827 --> 00:20:04,245
I need you to focus on me right now,
400
00:20:04,328 --> 00:20:05,746
because we need to get your consent
401
00:20:05,830 --> 00:20:07,540
- to proceed with the surgery.
- Why?
402
00:20:07,623 --> 00:20:08,958
There are risks with the surgery.
403
00:20:09,041 --> 00:20:11,335
There's anesthesia,
and there's no guarantee--
404
00:20:11,419 --> 00:20:12,962
Emily?
405
00:20:13,045 --> 00:20:15,756
Can you just put it back on?
406
00:20:15,840 --> 00:20:18,259
- Can you just put it back on?
- Sounds like consent to me.
407
00:20:18,342 --> 00:20:20,761
- Now can she have sedation?
- Okay, load her up. Ketamine and rock.
408
00:20:20,845 --> 00:20:22,138
It's gonna be okay. It's gonna be okay.
409
00:20:22,221 --> 00:20:24,014
We're gonna intubate before the OR.
410
00:20:24,098 --> 00:20:25,641
It's gonna be okay.
411
00:20:26,267 --> 00:20:29,353
- Finishing second cut.
- Success.
412
00:20:29,437 --> 00:20:32,606
- Can that be saved?
- The finger or the ring?
413
00:20:32,690 --> 00:20:34,275
- The wedding ring.
- Yes, sir.
414
00:20:34,358 --> 00:20:36,652
A jeweler can weld it
back together good as new.
415
00:20:37,403 --> 00:20:40,156
Stop.
Irrigate the ring shavings off first.
416
00:20:42,074 --> 00:20:44,660
- What did I miss?
- Finishing irrigation.
417
00:20:45,453 --> 00:20:46,579
Okay.
418
00:20:46,662 --> 00:20:48,372
Doesn't look like you lost any skin.
419
00:20:48,456 --> 00:20:50,541
It's a little dusky. Might not be viable.
420
00:20:50,624 --> 00:20:52,376
There's intact skin on the dorsum.
421
00:20:52,460 --> 00:20:54,754
More irrigation,
then tack it down with one suture.
422
00:20:54,837 --> 00:20:56,255
Okay, thanks.
423
00:20:56,338 --> 00:21:00,176
- Radiologist reports a 25% pneumothorax.
- Is that bad?
424
00:21:00,259 --> 00:21:03,012
That is a partially collapsed lung
that needs treatment.
425
00:21:03,095 --> 00:21:05,681
- I can put in a chest tube.
- He doesn't need a chest tube.
426
00:21:05,765 --> 00:21:07,850
Okay, what do you want,
a pigtail catheter?
427
00:21:08,684 --> 00:21:10,311
I was thinking a ThoraVent.
428
00:21:10,394 --> 00:21:11,687
What? Why?
429
00:21:11,771 --> 00:21:13,981
It's not a bad idea.
No need for wall suction.
430
00:21:14,064 --> 00:21:17,026
If Hand can operate today, he can go home
tomorrow with the ThoraVent.
431
00:21:17,109 --> 00:21:19,403
You can learn a lot
from your senior residents.
432
00:21:19,487 --> 00:21:21,697
I'm happy to teach Dr. Santos.
433
00:21:21,781 --> 00:21:23,699
Thank you, Dr. Langdon.
434
00:21:27,912 --> 00:21:31,040
Janelle, I need you to take
the samples to the lab
435
00:21:31,123 --> 00:21:32,917
and come back with any results
that are ready.
436
00:21:33,000 --> 00:21:36,837
Geoffrey, head to CT to see if any new
results are printed and bring those back.
437
00:21:36,921 --> 00:21:39,757
Pam, check in
with whoever's running the PDS
438
00:21:39,840 --> 00:21:42,051
to see if any orders
need to go to the pharmacy
439
00:21:42,134 --> 00:21:44,136
and bring back any meds
that are ready for pickup.
440
00:21:44,220 --> 00:21:46,597
Rinse and repeat every 15 minutes.
441
00:21:46,680 --> 00:21:48,599
Double-tie those shoelaces and hydrate.
442
00:21:48,682 --> 00:21:50,726
It's not a sprint. It's a marathon.
443
00:21:51,519 --> 00:21:53,145
Fly, my pretties.
444
00:21:53,938 --> 00:21:56,649
Okay, any word on finding
our water slide dad's kid?
445
00:21:56,732 --> 00:22:00,319
Not yet. Called the wife,
went straight to voicemail.
446
00:22:00,402 --> 00:22:03,072
Police dispatch said that there
were a couple of fatalities on site--
447
00:22:03,155 --> 00:22:05,658
- one adult, one kid.
- Sweet Jesus.
448
00:22:05,741 --> 00:22:06,909
Who the fuck did this?
449
00:22:06,992 --> 00:22:11,247
No sign-off on orders for labs or X-rays,
and it's in the wrong freaking rack?
450
00:22:11,330 --> 00:22:13,749
You guys trying to kill me
and the patient?
451
00:22:13,833 --> 00:22:15,459
- I'll take care of it.
- Thanks.
452
00:22:15,543 --> 00:22:18,879
- Dana, this gum is abso--
- Shit. I know.
453
00:22:18,963 --> 00:22:20,881
Pharmacy said you needed this right away.
454
00:22:20,965 --> 00:22:23,425
Just in time. Slap one on
and give it an hour to kick in.
455
00:22:23,509 --> 00:22:24,510
You're welcome.
456
00:22:25,719 --> 00:22:28,514
- What?
- The prescription is for you.
457
00:22:28,597 --> 00:22:30,432
My insurance will cover it. Hers won't.
458
00:22:31,183 --> 00:22:32,601
Isn't that insurance fraud?
459
00:22:33,561 --> 00:22:35,688
Throw me in jail. I could use a vacation.
460
00:22:39,149 --> 00:22:40,192
Mom.
461
00:22:45,781 --> 00:22:47,283
I'm really glad to see you, Mom. I--
462
00:22:47,366 --> 00:22:49,785
Garcia told me
about the sigmoid volvulus you missed.
463
00:22:49,869 --> 00:22:52,204
- It was an oversight.
- That could have killed her.
464
00:22:52,788 --> 00:22:55,291
Without electronic records, it's been
kind of a challenge to figure out--
465
00:22:55,374 --> 00:22:58,294
Chaos is the status quo in the ED, even
when the computers are working properly.
466
00:22:58,377 --> 00:23:00,546
You have to be hypervigilant
and double-check everything.
467
00:23:00,629 --> 00:23:03,007
- I can handle it.
- Why would you want to?
468
00:23:03,883 --> 00:23:07,136
Down here your learning street-level
medicine, all seat of your pants.
469
00:23:07,219 --> 00:23:08,512
Oh, well, I made a mistake,
470
00:23:08,596 --> 00:23:11,599
but the more talented practitioners
upstairs will fix it.
471
00:23:13,809 --> 00:23:15,269
You are better than this.
472
00:23:16,812 --> 00:23:19,815
I love you, too.
473
00:23:24,194 --> 00:23:28,157
- Well, that is one way to do a debrief.
- You should talk to her.
474
00:23:28,240 --> 00:23:30,868
- Which one?
- Honestly, both of them.
475
00:23:30,951 --> 00:23:33,579
- Can you call in some extra doctors?
- Sure.
476
00:23:33,662 --> 00:23:35,289
Everyone's dying to work
on the Fourth of July.
477
00:23:35,372 --> 00:23:37,458
- Why?
- Dr. Mohan went down.
478
00:23:37,541 --> 00:23:39,710
Yeah. I saw your pep talk.
479
00:23:40,628 --> 00:23:43,339
She's taking a little break
until her labs are back.
480
00:23:43,422 --> 00:23:46,759
She's going to be fine,
but I'm not sure her head is in the game.
481
00:23:47,635 --> 00:23:49,053
I'm on it, Cap.
482
00:23:49,136 --> 00:23:50,971
Small stab incision with the 11 blade,
483
00:23:51,055 --> 00:23:54,350
midclavicular line,
second intercostal space.
484
00:23:54,433 --> 00:23:57,227
- She's gonna stab me?
- It's just a medical term.
485
00:23:57,311 --> 00:23:58,562
Stay superior to the rib.
486
00:24:03,651 --> 00:24:06,612
- Is there a problem?
- Nope, everything's going well.
487
00:24:07,780 --> 00:24:09,073
Place the trocar.
488
00:24:09,865 --> 00:24:12,493
Hold back the adhesive wings
489
00:24:12,576 --> 00:24:15,996
and advance until you see
the red diaphragm move.
490
00:24:16,080 --> 00:24:18,082
That means you're in the pleural space.
491
00:24:18,791 --> 00:24:21,126
Now remove the trocar.
492
00:24:24,630 --> 00:24:25,798
Perfect.
493
00:24:25,881 --> 00:24:29,551
Okay, now we can either hook up
to wall suction,
494
00:24:29,635 --> 00:24:33,013
or we can use this one-way valve
to repeatedly aspirate with a syringe.
495
00:24:33,097 --> 00:24:35,391
Well, with all your vast experience,
Dr. Langdon,
496
00:24:35,474 --> 00:24:37,142
you should probably decide.
497
00:24:39,853 --> 00:24:42,606
We can avoid wall suction
if I pump manually.
498
00:24:42,690 --> 00:24:44,400
- Have at it, Doc.
- Enough.
499
00:24:44,483 --> 00:24:48,028
Apparently, decency and decorum need
to be reintroduced to our R2 curriculum.
500
00:24:48,737 --> 00:24:50,447
Nice work, Dr. Langdon.
501
00:24:50,531 --> 00:24:52,700
I'll go check on an OR for Mr. Foster.
502
00:24:58,122 --> 00:25:00,499
Hey. I'm gonna need you
to pick up the pace.
503
00:25:01,291 --> 00:25:04,420
Can I get a sec?
Dr. Mohan just almost died on me.
504
00:25:04,503 --> 00:25:06,839
Not even close.
She's tougher than she looks.
505
00:25:06,922 --> 00:25:08,716
Propane hero in North 4.
506
00:25:08,799 --> 00:25:10,300
Hey, any word from surgery
507
00:25:10,384 --> 00:25:13,429
on how our big patient Howard's
perforated diverticulitis is doing?
508
00:25:13,512 --> 00:25:16,056
- Still in the OR.
- What about our drunk firework kid?
509
00:25:16,140 --> 00:25:18,100
Waiting his turn
in the surgical conga line.
510
00:25:18,726 --> 00:25:20,352
What about Social Services?
511
00:25:20,436 --> 00:25:22,438
Have they found a temporary foster home
512
00:25:22,521 --> 00:25:24,857
- for our baby Jane Doe?
- Still working on it.
513
00:25:24,940 --> 00:25:27,818
Kid's gonna be old enough to drive
by the time she gets out of here.
514
00:25:27,901 --> 00:25:29,361
You joke...
515
00:25:30,446 --> 00:25:32,072
Oh, for fuck's sake!
516
00:25:32,156 --> 00:25:35,284
Go, quickly, before I change my mind.
517
00:25:35,367 --> 00:25:38,078
Hey, did the county pick up
Louie's body yet?
518
00:25:38,162 --> 00:25:41,081
- No. He's still in the viewing room.
- Jesus. He's just laying in there?
519
00:25:41,165 --> 00:25:44,168
Yeah. Another couple minutes, I'm gonna
wheel him down to the morgue myself.
520
00:25:45,878 --> 00:25:46,879
What's the bullet?
521
00:25:46,962 --> 00:25:48,881
Eight-year-old boy,
part of the water park accident.
522
00:25:48,964 --> 00:25:50,883
- Thrown off the water slide.
- How far did he fall?
523
00:25:50,966 --> 00:25:53,260
Maybe 6 or 7 feet, landed in a tree.
524
00:25:53,343 --> 00:25:55,054
Had to wait for a ladder truck
to get him down.
525
00:25:55,137 --> 00:25:57,264
Major neck trauma.
Must've taken all the impact there.
526
00:25:57,347 --> 00:25:58,682
Couldn't tube him, hard to bag.
527
00:25:58,766 --> 00:26:02,394
Sats in the 80s. BP 85 over 60. Pulse 50.
528
00:26:04,563 --> 00:26:06,982
Okay, one, two, and three.
529
00:26:08,233 --> 00:26:10,903
- Possible laryngeal fracture.
- Hypoxic bradycardic.
530
00:26:10,986 --> 00:26:12,946
Kid needs an airway before he arrests.
531
00:26:13,030 --> 00:26:15,365
Broselow tape, pedes cart, set up suction.
532
00:26:15,449 --> 00:26:17,618
Oh, my God. Is that Zack?
533
00:26:18,327 --> 00:26:20,412
Hey. Hey, kid, can you look at me?
534
00:26:21,121 --> 00:26:23,791
No response,
no purposeful movement to pain.
535
00:26:25,125 --> 00:26:26,168
Oh, my God.
536
00:26:26,251 --> 00:26:27,294
Is this your kid?
537
00:26:28,003 --> 00:26:29,505
- No.
- Sir, go back to your room now.
538
00:26:29,588 --> 00:26:31,465
- Broselow says 25 kilograms.
- Jesse?
539
00:26:31,548 --> 00:26:32,883
5 1/2 ET tube.
540
00:26:32,966 --> 00:26:36,595
- Okay, 30 of rock, 50 ketamine.
- You're gonna paralyze?
541
00:26:36,678 --> 00:26:39,139
- Yep.
- If we can't intubate, we crike?
542
00:26:39,223 --> 00:26:40,516
He's too young for a crike.
543
00:26:40,599 --> 00:26:42,601
- Needle crike?
- Can't ventilate through that.
544
00:26:42,684 --> 00:26:45,646
- Sats down to 78.
- 11 blade, Kelly, and a pedes bougie.
545
00:26:45,729 --> 00:26:46,980
One quick look, and then we cut.
546
00:26:47,689 --> 00:26:50,275
I can't tell if there's lung sliding.
No movement, no air entry.
547
00:26:50,359 --> 00:26:52,361
Way too edematous. I can't see the cords.
548
00:26:52,444 --> 00:26:54,071
Better with cricoid pressure?
549
00:26:55,239 --> 00:26:56,323
Nothing. Fuck.
550
00:26:56,406 --> 00:26:58,158
Okay. Towel roll between
the shoulder blades, please.
551
00:26:58,242 --> 00:27:00,369
Heart rate down to 49.
Headed to cardiac arrest.
552
00:27:00,452 --> 00:27:02,538
Trake's going to take 20 minutes.
This kid's not gonna last 60 seconds.
553
00:27:02,621 --> 00:27:03,956
That's why we're doing a slash trake.
554
00:27:04,039 --> 00:27:05,541
- Don't know it.
- Me neither.
555
00:27:05,624 --> 00:27:07,543
- Boss?
- Show me what you got.
556
00:27:16,844 --> 00:27:20,055
Pull up the trachea between
your thumb and middle finger.
557
00:27:20,722 --> 00:27:23,642
Vertical incision right over the trachea.
558
00:27:24,476 --> 00:27:28,105
Vertical, not horizontal, or you transect
the trachea and cut the jugular veins.
559
00:27:29,565 --> 00:27:30,899
That's a lot of blood.
560
00:27:31,483 --> 00:27:33,318
Now it's a tactile procedure.
561
00:27:33,402 --> 00:27:36,029
2-centimeter incision
through the tracheal rings.
562
00:27:36,655 --> 00:27:38,282
Finger in the trachea.
563
00:27:39,867 --> 00:27:41,618
Bougie into the airway.
564
00:27:43,495 --> 00:27:47,040
- Thoughts on what's next, Dr. Whitaker?
- Insert the ET tube into the trachea.
565
00:27:48,333 --> 00:27:50,335
Suction. Lots of blood in the airway.
566
00:27:57,134 --> 00:27:58,302
Okay, bag him.
567
00:27:59,386 --> 00:28:00,679
Check the CO2.
568
00:28:01,889 --> 00:28:03,807
Sats coming up, in the 80s.
569
00:28:03,891 --> 00:28:06,810
Bilateral breath sounds.
End tidal CO2 is 70.
570
00:28:06,894 --> 00:28:08,604
- That's crazy high.
- It'll come down.
571
00:28:08,687 --> 00:28:10,606
Tie down the tube,
control all the bleeders.
572
00:28:10,689 --> 00:28:13,233
Spray an amp of epi on a stack of 4-by-4s.
573
00:28:13,317 --> 00:28:15,986
Okay. Sats are up to the 90s.
574
00:28:16,069 --> 00:28:18,238
Good. CO2's in the 50s. Good heart rate.
575
00:28:18,322 --> 00:28:19,948
You forgot the last step.
576
00:28:20,032 --> 00:28:21,825
Change your underwear.
577
00:28:21,909 --> 00:28:24,536
- How many of these you done?
- First one.
578
00:28:24,620 --> 00:28:25,746
You serious?
579
00:28:25,829 --> 00:28:27,623
- How about you?
- None.
580
00:28:27,706 --> 00:28:30,250
I practiced in the Sim Lab
when I was at Stanford.
581
00:28:30,334 --> 00:28:31,627
- What'd I miss?
- All the fun.
582
00:28:31,710 --> 00:28:32,961
- Slash trake.
- Seriously?
583
00:28:33,921 --> 00:28:36,798
Fractured larynx.
Couldn't oxygenate, couldn't ventilate.
584
00:28:36,882 --> 00:28:40,594
- You use a meat cleaver on this kid?
- ENT can revise the trake in the OR.
585
00:28:41,303 --> 00:28:42,971
They'll be thrilled to clean up your mess.
586
00:28:43,931 --> 00:28:46,350
Or maybe they'll thank us
for not letting him die.
587
00:28:52,022 --> 00:28:53,982
So we're still waiting
on your prescription,
588
00:28:54,066 --> 00:28:55,859
and the pharmacy is a little backed up.
589
00:28:55,943 --> 00:28:58,403
But I'm glad to see you're doing good.
590
00:28:58,487 --> 00:28:59,446
Well.
591
00:29:00,072 --> 00:29:01,156
I'm well.
592
00:29:02,741 --> 00:29:04,076
Glad to see you're well.
593
00:29:04,159 --> 00:29:06,370
Can't you expedite my medication?
594
00:29:07,079 --> 00:29:09,289
Sure, but it may still be a little while
595
00:29:09,373 --> 00:29:13,460
before Dr. Mohan can sign off
on the discharge, so sit tight.
596
00:29:15,379 --> 00:29:16,588
And do what?
597
00:29:20,759 --> 00:29:23,387
You just keep this handy
for occasions like this?
598
00:29:24,388 --> 00:29:27,015
I thought that I might not have
that much to do today.
599
00:29:27,099 --> 00:29:28,183
But...
600
00:29:28,976 --> 00:29:30,602
...man, I was wrong.
601
00:29:37,317 --> 00:29:38,610
Thank you.
602
00:29:43,407 --> 00:29:46,702
- What brings you in today?
- A friend made me come in.
603
00:29:46,785 --> 00:29:49,913
- Name's Robby. He said I should--
- You're Duke.
604
00:29:50,622 --> 00:29:52,124
- Donnie?
- Yep?
605
00:29:52,207 --> 00:29:54,001
Robby's VIP is here.
606
00:29:57,629 --> 00:30:00,549
Hi. I'm Donnie, nurse practitioner.
607
00:30:00,632 --> 00:30:04,720
Robby's already put in orders
for a numbing spray for your nostril.
608
00:30:04,803 --> 00:30:06,805
"Nostril"? It's my throat.
609
00:30:06,888 --> 00:30:08,724
- It's not my nose.
- Okay.
610
00:30:08,807 --> 00:30:11,226
Let's get you set up in a room.
611
00:30:14,563 --> 00:30:18,233
That was the most unprofessional
deposition I've ever witnessed.
612
00:30:18,317 --> 00:30:20,652
They were nowhere near that aggressive
with Dr. Ellis.
613
00:30:21,820 --> 00:30:23,238
Oh, okay.
614
00:30:25,449 --> 00:30:27,451
It didn't go as badly as you think.
615
00:30:27,993 --> 00:30:29,828
They suggested I was incompetent.
616
00:30:29,911 --> 00:30:33,915
They're posturing to set the stage
for a ridiculous settlement request.
617
00:30:33,999 --> 00:30:35,751
This isn't about those parents
or that kid.
618
00:30:35,834 --> 00:30:38,003
It's only about trying
to make a lot of money.
619
00:30:38,086 --> 00:30:41,256
Well, I don't have a lot of money.
620
00:30:41,340 --> 00:30:43,967
Not your money, Dr. King.
It's an insurance game.
621
00:30:44,051 --> 00:30:47,262
You're protected by the hospital.
This won't affect your career.
622
00:30:53,060 --> 00:30:55,395
Hey. How was your deposition?
623
00:30:55,479 --> 00:30:56,813
Have you seen Dr. Langdon?
624
00:30:57,397 --> 00:30:58,482
No. Why?
625
00:31:00,233 --> 00:31:02,069
Okay, okay. How's Becca?
626
00:31:02,152 --> 00:31:03,612
- Oh, she's fine.
- Yeah?
627
00:31:03,695 --> 00:31:04,988
Okay, I should go see her, then.
628
00:31:05,072 --> 00:31:07,407
How was your deposition?
I'm sure it was stressful.
629
00:31:11,078 --> 00:31:13,288
What's going on with Becca?
What's her diagnosis?
630
00:31:13,372 --> 00:31:14,498
I can't tell you.
631
00:31:15,207 --> 00:31:16,458
Why?
632
00:31:16,541 --> 00:31:18,001
- HIPAA.
- Seriously?
633
00:31:18,085 --> 00:31:19,628
If you want to know what's going on
with Becca,
634
00:31:19,711 --> 00:31:21,213
you're gonna have to ask her yourself.
635
00:31:21,296 --> 00:31:23,048
Hey, you survived your deposition.
636
00:31:23,131 --> 00:31:25,217
Welcome back
to the seventh circle of hell.
637
00:31:25,300 --> 00:31:26,301
What's this?
638
00:31:26,385 --> 00:31:28,804
You're welcome for covering your patients.
They're yours again.
639
00:31:28,887 --> 00:31:31,431
Might want to check
on the pancreatitis in North 3 first.
640
00:31:32,307 --> 00:31:33,350
Okay.
641
00:31:33,433 --> 00:31:36,019
Langdon, I got some intel on Louie.
642
00:31:36,103 --> 00:31:37,604
They move him out of the viewing room?
643
00:31:37,687 --> 00:31:40,232
No, but county's promised
they're on the way to come get him.
644
00:31:40,315 --> 00:31:43,235
- Can I get the county coroner's number?
- What for?
645
00:31:43,318 --> 00:31:45,195
I just want to make sure
if no family shows up,
646
00:31:45,278 --> 00:31:47,447
- Louie gets a proper burial.
- That's expensive.
647
00:31:47,531 --> 00:31:49,741
You may want to run it
by the missus first.
648
00:31:50,325 --> 00:31:53,036
Maybe I'll start a GoFundMe.
I bet people around here would pitch in.
649
00:31:53,120 --> 00:31:56,123
Hey, kid, you can't do this
for every unhoused guy
650
00:31:56,206 --> 00:31:57,999
that dies around here.
651
00:31:58,083 --> 00:31:59,626
There but for the grace of God.
652
00:31:59,709 --> 00:32:03,839
No, the success of your sobriety
is a testament to your support system.
653
00:32:03,922 --> 00:32:05,674
Louie didn't have that.
654
00:32:05,757 --> 00:32:07,801
Still, Louie was a good man.
655
00:32:07,884 --> 00:32:10,053
He deserves to be put
to rest with dignity.
656
00:32:10,137 --> 00:32:12,472
Okay. I'll dig it up.
657
00:32:15,225 --> 00:32:16,560
You heard all that?
658
00:32:18,103 --> 00:32:21,356
Robby, your VIP's here.
Got him in Central 11.
659
00:32:21,440 --> 00:32:22,774
Finally.
660
00:32:26,153 --> 00:32:27,404
About fucking time.
661
00:32:27,487 --> 00:32:30,866
If I knew you were gonna make me wear
a dress, I wouldn't have come at all.
662
00:32:30,949 --> 00:32:34,202
- Dennis Whitaker, meet my buddy Duke.
- Nice to meet you.
663
00:32:34,286 --> 00:32:36,413
Any friend of Dr. Robby's
is a friend of mine.
664
00:32:36,496 --> 00:32:40,083
"Friend" is a vast overstatement.
He's more just a pain in my ass.
665
00:32:40,167 --> 00:32:42,210
Don't let his surly exterior fool you.
666
00:32:42,294 --> 00:32:44,796
Deep down inside, he's just as grumpy.
667
00:32:44,880 --> 00:32:47,382
- How did you two meet?
- Tinder.
668
00:32:48,592 --> 00:32:50,886
Duke is a motorcycle engineer.
669
00:32:50,969 --> 00:32:54,306
You should've seen his Bonneville when
he first brought it in six months ago.
670
00:32:54,389 --> 00:32:56,099
Someone left it for dead.
671
00:32:56,183 --> 00:32:59,102
He helped me bring it back to life.
Today we're going to return the favor.
672
00:32:59,186 --> 00:33:01,313
Dr. Whitaker's one
of our most trusted physicians,
673
00:33:01,396 --> 00:33:03,523
and today he's going to help me
oversee your care.
674
00:33:04,191 --> 00:33:05,984
what seems to be troubling you?
675
00:33:06,067 --> 00:33:08,111
Ask him. He's the one who made me come in.
676
00:33:08,195 --> 00:33:10,864
He's had some hoarseness
on and off for a couple months.
677
00:33:10,947 --> 00:33:13,617
Okay, any history of tobacco
or alcohol use?
678
00:33:14,826 --> 00:33:16,495
Two of my oldest and closest friends.
679
00:33:16,578 --> 00:33:19,539
Former two-pack-a-day smoker
and lover of the drink.
680
00:33:19,623 --> 00:33:21,541
Okay. He on any medication?
681
00:33:21,625 --> 00:33:23,335
Blood-pressure meds.
682
00:33:23,418 --> 00:33:25,045
Which he forgets to take.
683
00:33:25,128 --> 00:33:26,755
He's all numbed up and ready to go.
684
00:33:26,838 --> 00:33:28,673
Okay. Thank you, Donnie.
685
00:33:29,633 --> 00:33:34,554
My man, I am gonna take this scope,
and I'm gonna stick it in your nose,
686
00:33:34,638 --> 00:33:37,349
and we're going to check out
your upper airway.
687
00:33:37,432 --> 00:33:39,768
That seems like a lot of fuss
for a sore throat.
688
00:33:39,851 --> 00:33:41,144
Dr. Whitaker, you want to explain to Duke
689
00:33:41,228 --> 00:33:43,980
why this procedure
is absolutely necessary?
690
00:33:44,064 --> 00:33:46,733
The scope is gonna give us
a better view of your voice box
691
00:33:46,816 --> 00:33:48,443
and your vocal cords.
692
00:33:49,027 --> 00:33:50,320
Here we go.
693
00:33:55,242 --> 00:33:57,536
Gonna feel a little pressure
between your eyes.
694
00:33:57,619 --> 00:33:59,037
I am sorry about that.
695
00:33:59,120 --> 00:34:01,289
Okay, just breathe through your nose.
696
00:34:01,373 --> 00:34:03,959
This is gonna help us see
if there are any abnormalities
697
00:34:04,042 --> 00:34:07,045
like inflammation, tumors, nodules.
698
00:34:07,671 --> 00:34:09,381
That all looks pretty normal.
699
00:34:09,464 --> 00:34:11,925
I don't see too much drainage.
Stick your tongue out for me, all the way.
700
00:34:12,842 --> 00:34:14,678
All the way out. Good. Now say...
701
00:34:16,471 --> 00:34:18,056
Good. Now again, say...
702
00:34:19,558 --> 00:34:21,268
Good. Removing the scope.
703
00:34:22,811 --> 00:34:24,854
Dr. Whitaker, what do you think?
704
00:34:24,938 --> 00:34:27,816
- Looks normal, no abnormalities.
- Told you it was nothing.
705
00:34:27,899 --> 00:34:31,403
With your history of smoking,
I'd like to do a chest X-ray.
706
00:34:31,486 --> 00:34:33,196
If there are growths,
707
00:34:33,280 --> 00:34:36,866
they can push against the recurrent
laryngeal nerve intermittently.
708
00:34:36,950 --> 00:34:41,621
That can paralyze one of the vocal cords
and cause the hoarseness.
709
00:34:41,705 --> 00:34:45,208
That sounds like a lot of bullshit
doctor speak to charge me more.
710
00:34:45,292 --> 00:34:46,418
You've got Medicare.
711
00:34:46,501 --> 00:34:48,003
And, besides,
I finally got you into my ED.
712
00:34:48,086 --> 00:34:51,631
You're gonna get the golden workup
before I leave town tonight.
713
00:34:51,715 --> 00:34:55,302
Only an idiot would ride all night
after working a 12-hour day.
714
00:34:55,385 --> 00:34:57,345
That does sound pretty dangerous.
715
00:34:57,429 --> 00:34:59,222
You gonna stay put,
or do I have to tie you down?
716
00:34:59,306 --> 00:35:01,683
Fine, so long as you keep
your hands where I can see 'em.
717
00:35:01,766 --> 00:35:03,226
No promises.
718
00:35:03,310 --> 00:35:04,853
Let me know when his chest X-ray is back.
719
00:35:04,936 --> 00:35:06,104
Yeah.
720
00:35:09,524 --> 00:35:10,734
- Hey.
- Hey.
721
00:35:11,735 --> 00:35:12,944
Are we okay?
722
00:35:14,529 --> 00:35:17,657
- Yeah. Why?
- I don't know.
723
00:35:17,741 --> 00:35:20,952
You kind of ripped me a new one
in front of Langdon.
724
00:35:21,745 --> 00:35:24,247
- Whose side are you on?
- This isn't middle school.
725
00:35:24,331 --> 00:35:26,249
Langdon made a mistake and owned up to it.
726
00:35:26,333 --> 00:35:28,126
- Let it go.
- He should--
727
00:35:30,754 --> 00:35:32,714
He should have been fired.
728
00:35:32,797 --> 00:35:35,508
But instead, he waltzes
back in here, no big deal.
729
00:35:35,592 --> 00:35:37,802
Meanwhile, I've been a goddamn pariah
for the last 10 months
730
00:35:37,886 --> 00:35:39,512
for doing the right thing.
731
00:35:39,596 --> 00:35:42,641
Or maybe you're a pariah
because you don't play well with others.
732
00:35:44,142 --> 00:35:46,770
If you've still got beef
with Langdon, go tell him.
733
00:35:46,853 --> 00:35:50,231
He's here to stay, so put on
your big-girl panties and work it out.
734
00:35:50,315 --> 00:35:52,192
- He is no--
- Nope.
735
00:35:52,275 --> 00:35:54,903
You want to have sex
and eat ramen in bed, I'm your girl.
736
00:35:54,986 --> 00:35:58,490
But if you want to talk
about this Langdon shit, again,
737
00:35:58,573 --> 00:35:59,949
call a therapist.
738
00:36:09,417 --> 00:36:11,294
How's it hanging, Dr. J?
739
00:36:11,378 --> 00:36:14,881
- Never call me that again.
- It was a joke.
740
00:36:14,964 --> 00:36:18,510
Relax. He's clueless about your TikToks.
741
00:36:18,593 --> 00:36:20,095
But you're not.
742
00:36:20,178 --> 00:36:22,514
- Props on the side hustle.
- There is no hustle.
743
00:36:22,597 --> 00:36:23,723
They're just some stupid videos.
744
00:36:23,807 --> 00:36:25,725
- Wait, are you an influencer?
- No!
745
00:36:25,809 --> 00:36:26,976
Yep.
746
00:36:28,228 --> 00:36:30,271
Yo, pre-docs, it's not happy hour yet.
747
00:36:30,355 --> 00:36:32,607
There's still a shit ton
of patients to be seen.
748
00:36:37,195 --> 00:36:39,906
Ben, our slash-trake kid
from the water park
749
00:36:39,989 --> 00:36:41,950
had some purposeful movement in pre-op.
750
00:36:42,033 --> 00:36:43,326
That's a good sign.
751
00:36:43,410 --> 00:36:44,619
Take the win.
752
00:36:47,205 --> 00:36:48,373
We need to talk.
753
00:36:50,417 --> 00:36:52,419
- We are talking.
- In private.
754
00:37:01,428 --> 00:37:03,930
What the hell was that
with Samira earlier?
755
00:37:04,639 --> 00:37:07,142
- That was tough love.
- You are her superior.
756
00:37:07,225 --> 00:37:10,603
She was obviously struggling,
and your advice was "go home"?
757
00:37:10,687 --> 00:37:12,105
Essentially, yeah.
758
00:37:12,188 --> 00:37:14,691
This is the ED.
It's not for the faint of heart.
759
00:37:14,774 --> 00:37:16,651
It's not for the unempathetic either.
760
00:37:17,444 --> 00:37:19,779
Samira's not having a panic attack
because of her patient.
761
00:37:19,863 --> 00:37:21,573
She's having one
because of personal baggage.
762
00:37:21,656 --> 00:37:24,159
What she needs to do is pull her head
out of her ass and focus on the work.
763
00:37:24,242 --> 00:37:25,285
What about you?
764
00:37:25,368 --> 00:37:28,121
What do you need to get
some basic human empathy back?
765
00:37:30,665 --> 00:37:31,791
I don't know.
766
00:37:31,875 --> 00:37:34,878
Something that gives me a little hope this
place won't fall to shit when I'm gone.
767
00:37:36,463 --> 00:37:38,715
- Found him!
- Found who?
768
00:37:39,424 --> 00:37:41,801
- The water slide dad's kid.
- How'd you manage that?
769
00:37:41,885 --> 00:37:43,803
I went outside, stalked the dad's IG,
770
00:37:43,887 --> 00:37:45,805
found a pic of his son,
sent it to Pittsburgh PD.
771
00:37:45,889 --> 00:37:46,931
Now they're on their way over.
772
00:37:47,682 --> 00:37:49,893
Well, maybe Gen Z
should be working for the FBI.
773
00:37:54,105 --> 00:37:55,690
- Hi, Becca. Hi.
- Mel!
774
00:37:57,901 --> 00:38:00,612
- You doing all right?
- I'm a little bored.
775
00:38:00,695 --> 00:38:01,696
Yeah?
776
00:38:02,906 --> 00:38:04,824
- How are you feeling?
- A lot better.
777
00:38:04,908 --> 00:38:07,243
Dr. Langdon gave me some medicine and OJ.
778
00:38:07,327 --> 00:38:08,828
He's super nice.
779
00:38:08,912 --> 00:38:10,246
I see why you like him.
780
00:38:11,289 --> 00:38:13,958
Did he tell you what the medicine was for?
781
00:38:14,042 --> 00:38:15,210
Yes.
782
00:38:15,293 --> 00:38:16,836
Did you tell her?
783
00:38:16,920 --> 00:38:17,921
I did not.
784
00:38:18,713 --> 00:38:22,425
I explained to Becca that due
to doctor-patient confidentiality,
785
00:38:22,509 --> 00:38:24,427
everything she told me was private
786
00:38:24,511 --> 00:38:26,221
and that it was her decision
787
00:38:26,304 --> 00:38:29,307
if she wanted to share anything
with you or not.
788
00:38:31,142 --> 00:38:33,353
- Do you want to share?
- Yes.
789
00:38:44,531 --> 00:38:47,033
I have a urinary-tract infection.
790
00:38:49,953 --> 00:38:51,079
Okay.
791
00:38:51,162 --> 00:38:55,875
Yeah, those can happen if you, you know,
hold your pee in for too long
792
00:38:55,959 --> 00:38:57,877
or you accidentally wipe
from back to front--
793
00:38:57,961 --> 00:39:00,088
Mel, I know. I know, Mel. He told me.
794
00:39:00,171 --> 00:39:01,881
Oh, good.
795
00:39:01,965 --> 00:39:04,926
You know, he also told me
it can happen from having sex.
796
00:39:06,553 --> 00:39:07,971
Yeah, it can.
797
00:39:08,763 --> 00:39:11,182
- It's not like you're having sex.
- Yes, I am.
798
00:39:15,270 --> 00:39:16,521
I'm sorr--What?
799
00:39:16,604 --> 00:39:18,690
I'm having sex.
800
00:39:20,567 --> 00:39:22,777
- With who?
- My boyfriend.
801
00:39:22,861 --> 00:39:24,946
- You have a boyfriend?
- Yes.
802
00:39:25,029 --> 00:39:29,784
His name is Adam, and we're having sex,
803
00:39:29,868 --> 00:39:31,202
lots of sex.
804
00:39:33,371 --> 00:39:34,581
Okay.
805
00:39:38,376 --> 00:39:41,004
Mel, are you okay?
806
00:39:45,800 --> 00:39:47,760
- Got a sec?
- Sure.
807
00:39:47,844 --> 00:39:50,305
- How you feeling?
- I'm fine.
808
00:39:51,139 --> 00:39:52,640
- Are you sure?
- Yeah.
809
00:39:52,724 --> 00:39:55,018
Troponin, D-dimer, and TSH all normal.
810
00:39:55,810 --> 00:39:57,145
Listen, I'm sorry about earlier.
811
00:39:57,228 --> 00:39:59,022
- I think I was being...
- A dick?
812
00:40:00,607 --> 00:40:03,610
I was gonna say "unprofessional,"
but probably that, too.
813
00:40:04,527 --> 00:40:05,528
I'm sorry.
814
00:40:06,821 --> 00:40:07,822
Thanks.
815
00:40:08,865 --> 00:40:10,867
But now I kind of need you
to stop feeling sorry for yourself
816
00:40:10,950 --> 00:40:12,535
and focus back on your patients.
817
00:40:12,619 --> 00:40:13,703
Think you can do that?
818
00:40:14,829 --> 00:40:16,414
- Sure.
- Great.
819
00:40:20,001 --> 00:40:24,339
With this extra dose
and increased morphine from the pump,
820
00:40:24,422 --> 00:40:25,965
your pain should subside.
821
00:40:26,049 --> 00:40:27,842
Your breathing will slow down.
822
00:40:28,885 --> 00:40:30,553
You may get very sleepy.
823
00:40:31,846 --> 00:40:34,265
Paul, go be with the boys.
824
00:40:35,642 --> 00:40:38,269
They need you more than I do now.
825
00:40:39,228 --> 00:40:40,438
Later.
826
00:40:41,147 --> 00:40:43,650
Right now I'm exactly
where I'm supposed to be.
827
00:40:52,075 --> 00:40:53,076
Yeah.
828
00:40:54,035 --> 00:40:55,370
Okay.
829
00:40:55,453 --> 00:40:56,663
Here we go.
60845
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