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1
00:00:00,001 --> 00:00:02,202
I'm going through... a split.
2
00:00:03,846 --> 00:00:05,671
Any interest in
a part-time resident practice?
3
00:00:05,680 --> 00:00:07,774
Who better than someone who knows
what it's like to be a cardiac?
4
00:00:07,778 --> 00:00:08,811
I don't think so.
5
00:00:08,816 --> 00:00:11,118
It's not fair, how you see me.
6
00:00:13,057 --> 00:00:14,968
You're a fighter June, I get that.
7
00:00:14,973 --> 00:00:16,372
What are you telling me to do here?
8
00:00:16,376 --> 00:00:19,070
I'm not, I'm just
pointing out the landmines.
9
00:00:19,597 --> 00:00:22,375
- Are you free tonight?
- You're asking me on a date?
10
00:00:22,380 --> 00:00:24,658
You had two major health incidents.
11
00:00:24,663 --> 00:00:25,805
They're pushing you out?
12
00:00:25,809 --> 00:00:27,420
I'm not done, Claire.
13
00:00:27,425 --> 00:00:29,459
_
14
00:00:29,533 --> 00:00:30,812
_
15
00:00:41,178 --> 00:00:43,580
Welcome Brothers.
Couple of quick announcements.
16
00:00:43,585 --> 00:00:46,320
Unfortunately we begin by
offering our condolences
17
00:00:46,325 --> 00:00:49,132
to brother Karif Shahid,
who recently lost his father.
18
00:00:49,387 --> 00:00:51,922
So we pray that Allah grants him mercy
19
00:00:51,927 --> 00:00:54,228
and gives him the highest
place in paradise.
20
00:00:55,060 --> 00:00:57,250
In times of isolation,
21
00:00:57,255 --> 00:01:00,125
we look towards our community for peace.
22
00:01:15,724 --> 00:01:18,692
Hey, those stitches
still need to come out.
23
00:01:20,325 --> 00:01:22,945
Maybe tomorrow after school,
you stop by the hospital?
24
00:01:23,326 --> 00:01:25,859
Rania's coming to get some things.
25
00:01:27,665 --> 00:01:29,937
We're friends, Amira.
26
00:01:29,942 --> 00:01:32,273
She's still in both of our lives.
27
00:02:02,712 --> 00:02:03,757
What time is it?
28
00:02:03,762 --> 00:02:06,132
It's late or early,
29
00:02:06,137 --> 00:02:08,031
depending on your point of view.
30
00:02:08,393 --> 00:02:09,894
You're working?
31
00:02:10,038 --> 00:02:11,905
Yeah, I'm unwinding.
32
00:02:12,963 --> 00:02:14,530
Unwinding.
33
00:02:15,822 --> 00:02:17,774
With Electro Cardiography
Interpretation?
34
00:02:17,779 --> 00:02:19,507
Okay, unless you can
show me how to sleep
35
00:02:19,512 --> 00:02:21,344
like a stress-free
toddler, yes, that is...
36
00:02:21,349 --> 00:02:23,651
- I have stress! I stress!
- Mm-hmm.
37
00:02:23,887 --> 00:02:28,991
But I also just had
a really good stress reliever.
38
00:02:32,566 --> 00:02:34,200
Okay.
39
00:02:36,066 --> 00:02:38,400
- Is that you?
- Mm-hmm.
40
00:02:38,955 --> 00:02:40,962
What stresses do you have?
41
00:02:41,540 --> 00:02:45,910
Well, still trying to impress
Dr. Hunter, that's one.
42
00:02:45,915 --> 00:02:47,182
- Really?
- Yeah.
43
00:02:47,187 --> 00:02:49,188
You never seemed to worry about that.
44
00:02:49,336 --> 00:02:51,504
It's future Jake's problem.
45
00:02:52,313 --> 00:02:55,211
Current Jake is worried
about how he's gonna sleep
46
00:02:55,216 --> 00:02:56,587
with the light on.
47
00:03:03,732 --> 00:03:05,567
Unless you want me to go?
48
00:03:08,465 --> 00:03:10,243
It's okay, I can go.
49
00:03:14,245 --> 00:03:17,281
Try and get some sleep, weirdo.
50
00:03:29,069 --> 00:03:34,069
Synced & corrected by QueenMaddie
www.addic7ed.com
51
00:03:38,882 --> 00:03:39,915
Hey.
52
00:03:39,920 --> 00:03:41,236
Oh, do you need your office back?
53
00:03:41,240 --> 00:03:42,853
This isn't my office this morning.
54
00:03:43,115 --> 00:03:44,582
Actually, I'm not even here.
55
00:03:45,759 --> 00:03:47,876
- Soap me.
- Excuse me?
56
00:03:47,881 --> 00:03:50,616
Mnemonic device for
rapid sequence intubation.
57
00:03:50,621 --> 00:03:53,642
Suction, O2, Airways, Positioning.
58
00:03:54,317 --> 00:03:56,952
Medication and Equipment.
59
00:03:57,496 --> 00:03:59,342
- That's it.
- The exam's at noon?
60
00:03:59,347 --> 00:04:01,949
Yes. Oh, I called in for supplementals,
61
00:04:01,954 --> 00:04:03,822
but somebody had to
cancel, so I told Rhoda
62
00:04:03,827 --> 00:04:05,251
if she needs anything, just text.
63
00:04:05,256 --> 00:04:06,716
We'll be fine, Claire.
64
00:04:06,907 --> 00:04:08,376
Go kill it.
65
00:04:12,977 --> 00:04:15,673
32-year-old found down, incoming.
66
00:04:17,165 --> 00:04:18,782
- You paged me Rhoda?
- Sorry.
67
00:04:18,787 --> 00:04:20,930
By mistake, it's not a pedes trauma.
68
00:04:20,935 --> 00:04:23,112
I'm filling in for Claire and
we're just already swamped.
69
00:04:23,116 --> 00:04:24,229
I have a window if you need help.
70
00:04:24,233 --> 00:04:25,634
We're good.
71
00:04:25,639 --> 00:04:27,840
Fall from a ladder, multiple contusions!
72
00:04:27,845 --> 00:04:31,114
BP's 100 over 80, rate's 130. GCS 10.
73
00:04:31,119 --> 00:04:32,777
- You're a doctor?
- Yes, Kelsey's my daughter!
74
00:04:32,781 --> 00:04:34,494
I found her on the floor
of the bar she owns.
75
00:04:34,498 --> 00:04:35,914
She closed it to renovate.
76
00:04:37,781 --> 00:04:40,583
I did a quick neurological
exam, but she'll need a CT.
77
00:04:40,931 --> 00:04:43,186
I don't know how long she's been there.
78
00:04:43,191 --> 00:04:44,650
Two large bore IVs!
79
00:04:44,655 --> 00:04:46,355
E-FAST. Start with her chest?
80
00:04:49,797 --> 00:04:52,095
Ray Grisholm. Internist at Midcrest.
81
00:04:52,100 --> 00:04:53,732
I would've got her there,
but it's a 20-minute ride.
82
00:04:53,736 --> 00:04:55,454
This is Dr. Bishop,
Chief of our emerg...
83
00:04:55,459 --> 00:04:56,991
I saw you at the Trauma
Association conference
84
00:04:56,995 --> 00:04:59,009
a few years ago.
Is there any free fluid?
85
00:04:59,014 --> 00:05:01,033
Your daughter is in
very good hands, sir.
86
00:05:01,038 --> 00:05:02,705
Fast positive. Belly full of blood.
87
00:05:02,710 --> 00:05:05,056
We'll give her a gram
of TXA and activate MTP!
88
00:05:05,061 --> 00:05:06,565
- I'm calling the blood bank!
- No, no.
89
00:05:06,569 --> 00:05:08,541
She's AB negative, same as
me! You can use mine now!
90
00:05:08,545 --> 00:05:09,777
That's not something that we do.
91
00:05:09,781 --> 00:05:11,837
Well, she's not hemodynamically stable!
92
00:05:12,358 --> 00:05:14,390
Have either one of you ever
done a direct transfusion?
93
00:05:14,394 --> 00:05:15,995
- I have.
- I've got a donor card
94
00:05:16,000 --> 00:05:18,268
in my wallet if you need to confirm.
95
00:05:19,189 --> 00:05:20,957
Set up for a direct transfusion.
96
00:05:20,962 --> 00:05:23,462
Let's take every step
we can, Dr. Grisholm.
97
00:05:23,467 --> 00:05:25,000
Thank you.
98
00:05:25,321 --> 00:05:26,621
Thank you.
99
00:05:26,626 --> 00:05:28,665
Guy brought his wife
in after a car accident.
100
00:05:28,670 --> 00:05:31,298
He's dazed, a little
bit cut up and she's...
101
00:05:31,303 --> 00:05:32,303
Well...
102
00:05:32,740 --> 00:05:34,420
Displaced leg fracture
103
00:05:34,425 --> 00:05:36,548
and when's the last time
you delivered a baby?
104
00:05:37,307 --> 00:05:38,341
Is she okay?
105
00:05:38,346 --> 00:05:39,947
And after you answer that, please,
106
00:05:39,952 --> 00:05:41,719
tell me I can still get the epidural!
107
00:05:41,724 --> 00:05:44,043
Fetal heart rate's
140. I paged OB, but...
108
00:05:44,048 --> 00:05:46,149
It's okay, I'm on it.
Contractions are how far apart?
109
00:05:46,154 --> 00:05:49,256
Not very! Ben was supposed
to time them, but...
110
00:05:49,854 --> 00:05:52,462
It's really happening now?
111
00:05:52,467 --> 00:05:53,877
I just thought the accident might...
112
00:05:53,881 --> 00:05:56,092
What, push it back in, Ben?
113
00:05:56,097 --> 00:05:59,610
Go find someone who
can get me an epidural!
114
00:05:59,615 --> 00:06:02,031
You two got in an accident
on your way to have a baby?
115
00:06:02,036 --> 00:06:04,471
- Ben ran a red...
- You were yelling at me!
116
00:06:04,476 --> 00:06:05,860
- Oh.
- I'm trying here, Tess.
117
00:06:05,865 --> 00:06:07,499
Jake, ultrasound.
118
00:06:09,774 --> 00:06:12,242
- Oh...
- Her stomach's bleeding.
119
00:06:12,247 --> 00:06:13,947
- Tess, oh!
- Ben!
120
00:06:13,952 --> 00:06:16,153
Remember, we took those classes
121
00:06:16,158 --> 00:06:18,665
about how your one job is to stay calm?
122
00:06:18,670 --> 00:06:21,905
Yeah? I need you to do your job, Ben!
123
00:06:22,639 --> 00:06:24,954
My baby's gonna be okay, right?
124
00:06:24,959 --> 00:06:26,493
It's not deep, just oozing.
125
00:06:26,927 --> 00:06:30,235
Grab me a pair of forceps and
a vacuum just in case, Arnold.
126
00:06:30,240 --> 00:06:32,141
- Got it.
- Okay.
127
00:06:32,646 --> 00:06:36,082
Baby's heartrate looks good,
but it is sunny-side-up.
128
00:06:36,087 --> 00:06:39,368
- Which is what Jake?
- Occiput posterior position.
129
00:06:39,373 --> 00:06:41,525
- Is that bad?
- For the baby, no.
130
00:06:41,687 --> 00:06:44,355
For mom, it could mean
a tougher delivery,
131
00:06:44,360 --> 00:06:45,927
but to answer your question, Tessa,
132
00:06:45,932 --> 00:06:47,556
I have to get you in position to push,
133
00:06:47,561 --> 00:06:50,930
there's no time for an epidural,
this baby is on its way now!
134
00:06:50,935 --> 00:06:53,900
You're ready? And one, two, three!
135
00:07:00,764 --> 00:07:02,892
Sorry about the heavy hand before.
136
00:07:04,392 --> 00:07:07,094
I had a boss who used to say,
137
00:07:07,099 --> 00:07:10,150
"What this situation needs
is two of me and none of you."
138
00:07:11,535 --> 00:07:13,353
I maybe followed a little too closely
139
00:07:13,358 --> 00:07:15,927
- in his footsteps.
- Pelvic fracture wrapped.
140
00:07:15,932 --> 00:07:17,473
You're both what year?
141
00:07:17,478 --> 00:07:20,647
- I'm emerg PGY-two.
- I'm PGY-one.
142
00:07:20,652 --> 00:07:22,165
But this is his second residency.
143
00:07:22,170 --> 00:07:23,637
He was a trauma surgeon in Syria.
144
00:07:23,642 --> 00:07:26,143
Oh so you're ahead of your
peers, but also behind them?
145
00:07:27,059 --> 00:07:29,293
It's a good thing Kelsey
isn't awake to see this.
146
00:07:29,298 --> 00:07:31,432
She hates it when
I insert myself in her life.
147
00:07:31,437 --> 00:07:33,819
I'm guessing this is one
time she'd make an exception.
148
00:07:33,824 --> 00:07:36,041
You know, I told her that the
bar would be the death of her,
149
00:07:36,045 --> 00:07:37,696
I meant it was a money pit, not this.
150
00:07:37,701 --> 00:07:39,669
You said you didn't know
how long she was alone?
151
00:07:39,674 --> 00:07:42,836
I knew she was trying to get
the place ready to re-open
152
00:07:42,993 --> 00:07:45,205
and we hadn't talked in a few days.
153
00:07:45,663 --> 00:07:47,698
She used to always call her mom, but...
154
00:07:48,321 --> 00:07:51,321
We buried her a month ago.
Ovarian cancer.
155
00:07:51,656 --> 00:07:53,447
I'm sorry.
156
00:07:54,382 --> 00:07:56,312
When it happens,
157
00:07:56,317 --> 00:08:00,087
you're distracted.
Then... everybody goes.
158
00:08:01,556 --> 00:08:03,824
We're still figuring out...
159
00:08:03,896 --> 00:08:06,297
not having her mom as our bridge.
160
00:08:08,959 --> 00:08:10,159
Temp's 39.
161
00:08:10,164 --> 00:08:12,096
I'd feel a lot better if
her temp wasn't so high.
162
00:08:12,100 --> 00:08:15,268
It could be an inflammatory
response due to the trauma.
163
00:08:15,273 --> 00:08:17,808
We'll get Kelsey up to
interventional radiology
164
00:08:17,813 --> 00:08:20,782
for an angio-embolization
to stop the pelvic bleed,
165
00:08:20,787 --> 00:08:22,888
and after that, just let her rest.
166
00:08:24,798 --> 00:08:26,365
Okay, the baby's crowning, mom.
167
00:08:26,370 --> 00:08:28,672
I just need a couple more pushes, okay?
168
00:08:29,393 --> 00:08:31,414
- Hang in there, Tess.
- Shut up.
169
00:08:31,545 --> 00:08:33,145
I thought I was supposed to...
170
00:08:33,150 --> 00:08:35,284
No, no, no, don't speak, don't move,
171
00:08:35,289 --> 00:08:36,757
don't even look at me!
172
00:08:37,344 --> 00:08:39,555
Okay, Tessa, let's
try one more big push!
173
00:08:39,560 --> 00:08:42,211
I can't, I can't, I just can't anymore!
174
00:08:42,216 --> 00:08:44,284
It hurts too much.
175
00:08:44,289 --> 00:08:46,857
Please, can you just cut it out of me.
176
00:08:47,030 --> 00:08:50,566
My stomach's already bleeding,
you could use that opening.
177
00:08:50,571 --> 00:08:53,365
The delivery I remember
the most was my youngest.
178
00:08:53,370 --> 00:08:55,671
My wife was up all night with our oldest
179
00:08:55,676 --> 00:08:57,144
who was sick with a stomach flu.
180
00:08:57,149 --> 00:08:58,714
She called me to tell
me she was in labour,
181
00:08:58,718 --> 00:09:01,420
but she couldn't leave Abby home
alone to come to the hospital.
182
00:09:01,425 --> 00:09:04,977
So I drove like a maniac
and got there just in time
183
00:09:04,982 --> 00:09:07,416
to deliver Grace on our kitchen floor.
184
00:09:07,421 --> 00:09:09,515
It was insane, just like this.
185
00:09:09,520 --> 00:09:10,520
- Yeah?
- Okay.
186
00:09:10,525 --> 00:09:12,156
When we look back on it now, we laugh.
187
00:09:12,161 --> 00:09:14,742
You two will have
the same kind of story!
188
00:09:14,747 --> 00:09:16,748
- I don't know...
- Yes, you will.
189
00:09:16,753 --> 00:09:19,054
But Tessa, believe me.
190
00:09:19,059 --> 00:09:22,432
You've got this.
I need you to push. Okay?
191
00:09:22,466 --> 00:09:24,967
Come on, you can do this. Push.
192
00:09:24,972 --> 00:09:26,640
Here she is, she's coming.
193
00:09:26,645 --> 00:09:28,638
She's coming, she's coming.
194
00:09:28,643 --> 00:09:31,383
Here she is. Here she is.
195
00:09:33,181 --> 00:09:35,125
Here she is.
196
00:09:39,724 --> 00:09:41,224
That's a man down.
197
00:09:42,086 --> 00:09:44,287
- Seriously?
- We'll check him out.
198
00:09:44,292 --> 00:09:45,937
You did it.
199
00:09:46,227 --> 00:09:47,794
Okay.
200
00:09:48,247 --> 00:09:49,525
Congratulations!
201
00:09:49,530 --> 00:09:51,298
I already gave her the head laceration.
202
00:09:51,303 --> 00:09:53,071
The fractured wrist went to imaging,
203
00:09:53,076 --> 00:09:54,610
back pain's on deck,
204
00:09:54,615 --> 00:09:57,445
Bash has a found down in two and...
205
00:09:57,982 --> 00:10:00,250
Have you been able to find Peter?
206
00:10:00,255 --> 00:10:02,538
Still looking, love. Dementia.
207
00:10:02,543 --> 00:10:04,308
Doesn't know Peter's last
name, or how to reach him.
208
00:10:04,312 --> 00:10:06,847
Okay. I'll get him back to his room.
209
00:10:06,852 --> 00:10:08,052
Sir?
210
00:10:08,057 --> 00:10:10,048
Hey. If you guys are
swamped, I can grab a patient.
211
00:10:10,052 --> 00:10:12,654
Nausea in D? Already been there awhile.
212
00:10:13,812 --> 00:10:15,102
York emergency!
213
00:10:15,107 --> 00:10:16,674
Shouldn't be too long.
214
00:10:17,732 --> 00:10:18,999
Ms. Crawford?
215
00:10:19,004 --> 00:10:22,000
Hi, I'm Dr. Curtis. I heard
you're feeling nauseated.
216
00:10:22,005 --> 00:10:23,930
Nothing'll stay down. Even water.
217
00:10:23,935 --> 00:10:25,437
I was trying to ride it out.
218
00:10:25,442 --> 00:10:27,148
She refused to go to the doctor.
219
00:10:27,153 --> 00:10:30,143
But then the cramping started,
and my sister strong-armed me.
220
00:10:30,148 --> 00:10:33,102
Sometimes severe food
poisoning can cause dehydration.
221
00:10:33,107 --> 00:10:35,648
Actually, I had a gastric
bypass three months ago.
222
00:10:35,653 --> 00:10:37,773
I've been sick on and off ever since.
223
00:10:37,808 --> 00:10:40,443
Before you ask, yes, I
stick to the diet plan.
224
00:10:40,448 --> 00:10:43,344
Yes, I exercise, no, I don't
have high blood pressure,
225
00:10:43,349 --> 00:10:45,181
diabetes, or heart problems.
226
00:10:45,186 --> 00:10:47,625
So about this bypass, did
you have that done here?
227
00:10:47,630 --> 00:10:49,798
Yes. Dr. Evelyn Roche.
228
00:10:53,526 --> 00:10:56,141
Okay, well, sometimes, after a bypass,
229
00:10:56,146 --> 00:10:59,148
our stomach will react
by rapidly emptying food
230
00:10:59,153 --> 00:11:00,796
in a way that can make you feel sick.
231
00:11:00,801 --> 00:11:02,719
Dumping syndrome. I'm aware.
232
00:11:02,724 --> 00:11:05,868
That's only supposed to happen
if you reintroduce food too fast,
233
00:11:05,873 --> 00:11:08,781
but I've been following the eye-dropper
meal plan like a zealot.
234
00:11:08,786 --> 00:11:10,840
Did you let them know
that in your postop visit?
235
00:11:10,845 --> 00:11:13,580
All Roche said was my
system will only adjust
236
00:11:13,585 --> 00:11:16,787
when I commit to the lifestyle.
Didn't even run a single test.
237
00:11:16,792 --> 00:11:19,922
Right. Well, Dr. Roche
is a renowned surgeon.
238
00:11:19,927 --> 00:11:22,555
She's also a jerk, who has
a problem with fat people.
239
00:11:22,560 --> 00:11:24,336
- Maya!
- What can I say.
240
00:11:24,341 --> 00:11:25,908
The woman contains multitudes.
241
00:11:26,157 --> 00:11:27,757
I'm gonna order a CT.
242
00:11:27,937 --> 00:11:29,703
- You will?
- I can't rule out
243
00:11:29,708 --> 00:11:31,352
rapid gastric emptying,
244
00:11:31,357 --> 00:11:34,159
but we should consider other
post-surgical complications,
245
00:11:34,164 --> 00:11:37,633
like a bowel obstruction, or
another acute digestive problem.
246
00:11:37,638 --> 00:11:39,360
In the meantime, I'm
gonna get you some fluids
247
00:11:39,364 --> 00:11:40,799
and an anti-nauseant.
248
00:11:40,804 --> 00:11:42,281
You'll need to change into a gown.
249
00:11:42,286 --> 00:11:44,244
I'll need a second one
to wrap around the back.
250
00:11:44,249 --> 00:11:45,950
I'll get you one, hon.
251
00:11:49,735 --> 00:11:51,636
You shouldn't have done that.
252
00:11:52,449 --> 00:11:54,276
- Excuse me?
- Given her false hope.
253
00:11:54,281 --> 00:11:56,196
So you wanted me to tell her
to exercise and eat right?
254
00:11:56,200 --> 00:11:57,999
Because it seems like
she's already doing that.
255
00:11:58,003 --> 00:11:59,589
Maya needs to hear this is normal
256
00:11:59,594 --> 00:12:01,579
and that she just needs to
get through the worst of it.
257
00:12:01,583 --> 00:12:03,966
But when you don't find something,
258
00:12:03,971 --> 00:12:06,453
I'll have to pick her up
and get her back on track.
259
00:12:08,047 --> 00:12:09,547
Is there anything else?
260
00:12:09,770 --> 00:12:12,008
Yes. Who can I ask for a gown?
261
00:12:13,445 --> 00:12:15,492
- Here, this desk.
- Okay.
262
00:12:17,511 --> 00:12:19,980
At the end of your message, press 1.
263
00:12:20,703 --> 00:12:22,370
I know you're screening me, Mel.
264
00:12:22,375 --> 00:12:25,043
We need to talk about
you wanting sole custody.
265
00:12:25,319 --> 00:12:26,920
We only speak now through lawyers,
266
00:12:26,925 --> 00:12:28,298
and every time I go
for pick up or drop off
267
00:12:28,302 --> 00:12:30,236
your mom's there just glaring at me.
268
00:12:31,092 --> 00:12:33,633
I don't understand why
you're treating me like this.
269
00:12:40,529 --> 00:12:42,315
What is it, Jake?
270
00:12:42,320 --> 00:12:45,968
Ben Lyons is still complaining
about left upper quadrant pain.
271
00:12:45,973 --> 00:12:47,941
Chest X-ray for pneumothorax
272
00:12:47,946 --> 00:12:49,739
and broken ribs came back normal.
273
00:12:49,744 --> 00:12:50,844
Okay?
274
00:12:50,849 --> 00:12:52,450
You said to rule those two things out.
275
00:12:52,542 --> 00:12:55,511
Yes, I did. Can you
think of any other organs
276
00:12:55,516 --> 00:12:58,203
in that quadrant which might
be affected by blunt trauma?
277
00:12:58,208 --> 00:13:00,182
Kidney, spleen, pancreas.
278
00:13:00,187 --> 00:13:02,022
But you didn't say to rule those out.
279
00:13:04,255 --> 00:13:05,388
Ultrasound?
280
00:13:05,393 --> 00:13:08,695
- CT with contrast.
- CT with contrast.
281
00:13:11,991 --> 00:13:15,727
So what this situation calls
for is two of you and none of him?
282
00:13:16,336 --> 00:13:18,742
- You're defending him?
- No, I mean...
283
00:13:18,747 --> 00:13:20,982
You know, you could've walked
him through your thinking.
284
00:13:20,987 --> 00:13:22,972
I have, Mags. More than once.
285
00:13:22,977 --> 00:13:24,774
He's gotta start showing
up for work, which means
286
00:13:24,778 --> 00:13:27,477
coming to me with answers
instead of questions.
287
00:13:27,744 --> 00:13:30,880
- Kelsey Grisholm?
- Her bleed's under control,
288
00:13:30,885 --> 00:13:33,367
- but her temp's still high.
- We're waiting on labs.
289
00:13:33,372 --> 00:13:34,606
And her father?
290
00:13:34,611 --> 00:13:36,422
Still insistent about being looped-in.
291
00:13:36,427 --> 00:13:38,027
I want you both to stay on this.
292
00:13:38,032 --> 00:13:40,281
Ray's pretty senior at Midcrest and eh,
293
00:13:40,286 --> 00:13:42,487
easier for all of us if he's managed.
294
00:13:49,013 --> 00:13:50,614
Bash?
295
00:13:52,199 --> 00:13:55,268
About the thing that we're not...
296
00:13:55,605 --> 00:13:57,867
About the elevator and like...
297
00:13:57,872 --> 00:14:00,207
That had nothing to do with you. Okay?
298
00:14:01,885 --> 00:14:04,920
The person in there
wasn't even me really.
299
00:14:05,902 --> 00:14:07,502
Who was it?
300
00:14:08,892 --> 00:14:11,627
Someone who'd had a messed
up day and a messed up...
301
00:14:11,632 --> 00:14:13,266
few months.
302
00:14:14,273 --> 00:14:16,474
You're not alone there.
303
00:14:17,093 --> 00:14:18,694
Listen, I...
304
00:14:18,699 --> 00:14:22,102
I don't want it to get
between us either so...
305
00:14:23,137 --> 00:14:25,438
Let's just pretend it never happened.
306
00:14:25,443 --> 00:14:27,680
Exactly what I was gonna say.
307
00:14:31,409 --> 00:14:34,266
You really gave me a scare,
kid. What happened?
308
00:14:34,271 --> 00:14:36,112
I was painting the crown moulding.
309
00:14:36,117 --> 00:14:37,734
I told you to call the contractor.
310
00:14:37,739 --> 00:14:39,664
I told you I wanted to do it myself.
311
00:14:40,092 --> 00:14:41,759
How are you feeling now?
312
00:14:42,599 --> 00:14:45,868
Ah headache, neck's a bit stiff,
313
00:14:45,956 --> 00:14:48,156
but I guess that's what
happens when you lie
314
00:14:48,161 --> 00:14:49,594
on the concrete for a few hours.
315
00:14:49,599 --> 00:14:52,728
We did a CT, no intracranial injury.
316
00:14:52,762 --> 00:14:55,097
So, you just fell?
317
00:14:55,102 --> 00:14:57,070
Dad. The world is an imperfect place.
318
00:14:57,075 --> 00:14:58,609
People fall.
319
00:14:58,614 --> 00:14:59,981
There's, uh...
320
00:15:00,103 --> 00:15:02,905
concern because you're
maintaining a high fever,
321
00:15:02,910 --> 00:15:04,511
and we'd like to know why.
322
00:15:04,516 --> 00:15:08,277
Were you feeling unwell
before this? Any dizziness?
323
00:15:08,282 --> 00:15:09,758
She's always run down.
324
00:15:09,763 --> 00:15:11,789
Barely eats, works until 2:00 AM,
325
00:15:11,794 --> 00:15:13,595
pouring all her energy
into slinging drinks.
326
00:15:13,600 --> 00:15:15,098
I'm not bartending,
I'm running a business.
327
00:15:15,102 --> 00:15:17,203
Look, that lifestyle
was fine in your 20s,
328
00:15:17,208 --> 00:15:18,508
but it's time to grow up!
329
00:15:18,513 --> 00:15:21,211
- We can give you a minute...
- No, it's fine.
330
00:15:22,463 --> 00:15:24,497
You may as well all hear this.
331
00:15:28,156 --> 00:15:29,923
I have ALS.
332
00:15:30,271 --> 00:15:32,338
That's why I fell.
333
00:15:33,107 --> 00:15:35,408
I found out near the end with Mom.
334
00:15:36,640 --> 00:15:40,641
No, that can't be right, because...
335
00:15:40,937 --> 00:15:42,735
Wait a minute, you're not
showing any of the signs.
336
00:15:42,739 --> 00:15:44,039
I've been covering.
337
00:15:44,654 --> 00:15:47,633
I noticed I was having a
hard time gripping things.
338
00:15:47,638 --> 00:15:49,739
I ignored it at first, but...
339
00:15:51,445 --> 00:15:54,180
Then I started having
weakness in my legs.
340
00:15:54,933 --> 00:15:57,201
Do you know how advanced it is?
341
00:15:59,250 --> 00:16:01,730
The neurologist said that
I should expect more trouble
342
00:16:01,735 --> 00:16:04,945
with mobility and eating
as I enter the mid-stage...
343
00:16:06,008 --> 00:16:08,469
And the average survival
rate is two to five years.
344
00:16:08,474 --> 00:16:11,687
So I guess... that's where we are.
345
00:16:12,228 --> 00:16:14,229
Which neurologist? What's his name?
346
00:16:14,234 --> 00:16:15,945
Dr. Vedder. She's been great.
347
00:16:15,950 --> 00:16:18,218
Never heard of her.
Joe Yoshida is a great neurologist.
348
00:16:18,223 --> 00:16:19,688
I'll call him and get a second opinion.
349
00:16:19,692 --> 00:16:21,656
Dr. Vedder's done weeks
of tests. She's sure.
350
00:16:21,661 --> 00:16:23,519
Honey, you gotta trust me here.
351
00:16:23,524 --> 00:16:25,291
I can help us get to the bottom of this.
352
00:16:25,296 --> 00:16:28,431
Dad. Okay, this is why I
haven't told you for so long.
353
00:16:28,795 --> 00:16:30,016
I have doctors.
354
00:16:30,021 --> 00:16:32,522
Just help me by being my dad.
355
00:16:37,671 --> 00:16:40,139
Let me get Yoshida on the phone.
356
00:16:47,173 --> 00:16:49,841
Did you discharge the
guy in three? The new dad?
357
00:16:49,846 --> 00:16:52,581
No, actually, I was going to
explain his imaging results.
358
00:16:52,645 --> 00:16:54,813
I found this in
his room. I called OB,
359
00:16:54,818 --> 00:16:56,952
- and he's not there either.
- We lost him?
360
00:16:56,957 --> 00:16:58,724
Are you guys doing okay in there?
361
00:16:58,729 --> 00:17:00,085
We didn't lose him, he left.
362
00:17:00,090 --> 00:17:02,406
And yes, we're having
a small staffing issue,
363
00:17:02,411 --> 00:17:04,337
but we're managing just fine.
364
00:17:04,661 --> 00:17:06,228
I got it!
365
00:17:06,293 --> 00:17:07,993
Peter's not here yet, sir.
366
00:17:07,998 --> 00:17:09,965
Let's wait in your room, okay?
367
00:17:10,422 --> 00:17:12,423
Did you start her on the antibiotics?
368
00:17:12,436 --> 00:17:13,903
Let me call you back.
369
00:17:13,908 --> 00:17:17,043
Broad spectrum, until we
figure out the cause of her fever.
370
00:17:17,354 --> 00:17:19,456
Well, that was the neurologist I like.
371
00:17:19,461 --> 00:17:22,144
He advises we run a few
exams to rule out ALS.
372
00:17:22,149 --> 00:17:23,816
Spinal tap and EMG.
373
00:17:23,909 --> 00:17:26,478
Kelsey was pretty firm
on not wanting to re-test.
374
00:17:26,594 --> 00:17:29,084
She's febrile with a
headache and soar neck.
375
00:17:29,089 --> 00:17:31,579
An LP will rule out
meningitis, would it not?
376
00:17:31,584 --> 00:17:33,785
Yes, and while meningitis is plausible,
377
00:17:33,790 --> 00:17:37,193
there are less invasive ways
of narrowing down a fever.
378
00:17:37,198 --> 00:17:39,533
My daughter runs on emotion, Dr. Hamed.
379
00:17:40,078 --> 00:17:42,761
She'll make the right
choice if we lead her to it.
380
00:17:42,766 --> 00:17:44,917
Your boss said to do everything we can.
381
00:17:44,922 --> 00:17:46,756
If you want to sign-off,
he's right over there,
382
00:17:46,760 --> 00:17:49,596
talking to the co-head of
emerg at UHN of all people.
383
00:17:54,101 --> 00:17:56,932
I've got three minutes before
a consult if you need me.
384
00:17:56,937 --> 00:18:00,749
Uh, yeah. Actually, I just
caught this patient in emerg.
385
00:18:00,754 --> 00:18:03,189
She's 12 weeks post-op
from a gastric bypass,
386
00:18:03,194 --> 00:18:05,917
has nausea and vomiting.
But her imaging's clear.
387
00:18:05,922 --> 00:18:07,356
She's aware of dumping syndrome?
388
00:18:07,361 --> 00:18:09,362
She is, but it could
be something else right,
389
00:18:09,367 --> 00:18:12,157
like a peptic ulcer, an
obstruction or Crohn's or...
390
00:18:12,162 --> 00:18:13,963
What are you asking me to approve, June?
391
00:18:13,968 --> 00:18:15,836
A C-scope and a G-scope.
392
00:18:16,187 --> 00:18:18,997
Okay, but you could have
ordered those anyway.
393
00:18:19,032 --> 00:18:20,799
Right, but not everybody would,
394
00:18:20,804 --> 00:18:22,633
based on her symptoms so...
395
00:18:23,936 --> 00:18:26,040
Okay, you're the one who's
always telling me to watch out
396
00:18:26,044 --> 00:18:27,378
for landmines.
397
00:18:28,240 --> 00:18:31,576
Statistically, you know it's
unlikely this is anything
398
00:18:31,581 --> 00:18:34,143
other than side effects from her bypass.
399
00:18:34,148 --> 00:18:36,052
What I know is that I've
made the mistake in the past
400
00:18:36,056 --> 00:18:38,824
of listening to
statistics over patients.
401
00:18:40,357 --> 00:18:42,258
Keep me in the loop.
402
00:18:43,523 --> 00:18:45,351
Keep you in the loop.
403
00:18:47,242 --> 00:18:49,528
We're monitoring
Kelsey Grisholm closely.
404
00:18:49,533 --> 00:18:51,901
Her father's a handful,
but we're on top of it.
405
00:18:52,232 --> 00:18:54,733
Let me know if you need any input.
406
00:18:55,397 --> 00:18:57,898
Hey, I meant to ask, how's your sister?
407
00:18:58,308 --> 00:18:59,642
Since her head laceration.
408
00:18:59,647 --> 00:19:03,241
Oh, uh... she's healing fine.
409
00:19:03,246 --> 00:19:05,973
I doubt it'll scar.
410
00:19:05,978 --> 00:19:07,012
Good.
411
00:19:07,684 --> 00:19:11,287
The woman she came in with,
I'm told that's your fiancé?
412
00:19:11,350 --> 00:19:13,585
She was. Uh...
413
00:19:13,817 --> 00:19:16,659
Now, she's the reason
Amira won't talk to me.
414
00:19:17,459 --> 00:19:18,823
Sorry to hear that.
415
00:19:18,828 --> 00:19:21,677
Amira, she takes everything on
416
00:19:21,682 --> 00:19:24,238
and I think she learned that from me.
417
00:19:25,335 --> 00:19:27,670
You're not alone, Bashir.
418
00:19:29,735 --> 00:19:35,699
Sir, that doctor that you
were speaking with earlier,
419
00:19:35,704 --> 00:19:37,872
are you hiring a co-chief?
420
00:19:42,886 --> 00:19:44,320
No.
421
00:19:45,392 --> 00:19:47,819
I've been asked to meet candidates
422
00:19:47,824 --> 00:19:50,426
and lead the transition to a new chief.
423
00:19:51,828 --> 00:19:54,129
You're being pushed out?
424
00:19:55,027 --> 00:19:57,729
Well, let's just keep
this between us for now.
425
00:19:57,940 --> 00:19:59,404
It's not something I
wanted, and to be frank,
426
00:19:59,408 --> 00:20:00,574
I don't know where it goes.
427
00:20:00,579 --> 00:20:02,634
There must be something that we can do.
428
00:20:02,639 --> 00:20:04,573
Let me handle, okay.
I'll find a way to get
429
00:20:04,578 --> 00:20:06,345
the board on side again.
430
00:20:10,417 --> 00:20:12,948
I know you think you're
only here because of me,
431
00:20:12,953 --> 00:20:14,587
but you're not.
432
00:20:14,813 --> 00:20:16,581
You're here because of you.
433
00:20:16,586 --> 00:20:18,287
Do you understand?
434
00:20:22,212 --> 00:20:23,946
Can we put her oxygen up to eight litres
435
00:20:23,951 --> 00:20:26,324
and find out where her chest X-ray is?
436
00:20:26,329 --> 00:20:29,498
Any nausea? Cold extremities at all?
437
00:20:30,467 --> 00:20:32,368
Just a bit short of breath.
438
00:20:33,161 --> 00:20:35,196
I assumed it was a touch of the flu.
439
00:20:35,201 --> 00:20:38,270
Which could be more
dangerous for ALS patients.
440
00:20:38,275 --> 00:20:40,098
You sound like my dad.
441
00:20:42,075 --> 00:20:43,742
He's not a bad guy.
442
00:20:44,262 --> 00:20:47,516
I know how badly he wants to fix me.
443
00:20:48,347 --> 00:20:49,814
Fix this.
444
00:20:50,136 --> 00:20:52,128
But when it comes to relating to me?
445
00:20:52,185 --> 00:20:54,319
That's all he's ever known.
446
00:20:54,488 --> 00:20:56,525
And what about you?
447
00:20:56,847 --> 00:20:58,615
What do you want?
448
00:20:59,639 --> 00:21:02,108
To somehow meet this on my own terms?
449
00:21:04,067 --> 00:21:06,035
Buying that bar was a dream come true
450
00:21:06,240 --> 00:21:09,606
and I want to run it
for as long as I can.
451
00:21:14,007 --> 00:21:15,675
Her temp's up again.
452
00:21:18,877 --> 00:21:20,011
Um...
453
00:21:20,016 --> 00:21:22,384
I was wondering if you
would consider letting us
454
00:21:22,389 --> 00:21:23,982
do a lumbar puncture?
455
00:21:23,987 --> 00:21:26,822
It would help us rule out
meningitis, source your fever and...
456
00:21:26,827 --> 00:21:29,362
Re-confirm my ALS diagnosis?
457
00:21:29,959 --> 00:21:32,227
My father ask you to float that?
458
00:21:32,831 --> 00:21:34,159
Yes, he did.
459
00:21:34,379 --> 00:21:36,565
Resistance is futile with Ray.
460
00:21:37,667 --> 00:21:39,635
Is that true about my fever?
461
00:21:40,590 --> 00:21:42,157
Wait, you're in control here.
462
00:21:42,353 --> 00:21:44,502
Nothing's gonna happen
without your consent.
463
00:21:44,843 --> 00:21:46,770
- Okay?
- Okay.
464
00:22:00,090 --> 00:22:02,418
The maternity ward's the other way.
465
00:22:04,156 --> 00:22:05,590
I can't go up there.
466
00:22:05,595 --> 00:22:07,629
So you... Uh, you're just...
467
00:22:07,894 --> 00:22:09,204
You're leaving?
468
00:22:09,209 --> 00:22:11,559
But then, I remembered
I totalled our car.
469
00:22:11,715 --> 00:22:14,158
I just finished paying
it off last month too,
470
00:22:14,163 --> 00:22:15,730
after nine years.
471
00:22:15,934 --> 00:22:17,769
I don't even have a job right now.
472
00:22:17,774 --> 00:22:19,508
Ben, why don't you come with me?
473
00:22:19,513 --> 00:22:21,715
I didn't want a baby, Dr. Hunter.
474
00:22:21,720 --> 00:22:23,087
It kinda just happened.
475
00:22:23,209 --> 00:22:25,310
I thought if I cut my losses now,
476
00:22:25,315 --> 00:22:27,516
I'd be doing that kid a favour.
477
00:22:30,249 --> 00:22:32,262
I can see you judging me.
478
00:22:32,267 --> 00:22:35,469
Look I would never say
running out on a new-born baby
479
00:22:35,474 --> 00:22:38,723
is a good idea, but
that's not why I'm here.
480
00:22:38,728 --> 00:22:41,196
You spleen is ruptured.
481
00:22:41,261 --> 00:22:42,694
You need surgery.
482
00:22:42,878 --> 00:22:44,145
What?
483
00:22:44,763 --> 00:22:47,403
- So I guess...
- Yeah.
484
00:22:47,408 --> 00:22:48,775
Oh, okay.
485
00:22:56,231 --> 00:22:57,832
Imaging's up.
486
00:23:02,519 --> 00:23:04,353
Guys, what's happening?
487
00:23:04,918 --> 00:23:06,451
Just tell me, I can take it.
488
00:23:06,456 --> 00:23:08,423
I'm hearing crackles in your lungs.
489
00:23:08,428 --> 00:23:09,995
Crackles? From what?
490
00:23:10,000 --> 00:23:12,836
Based on your chest X-rays,
it's likely pneumonia.
491
00:23:12,841 --> 00:23:13,974
Wouldn't I be coughing?
492
00:23:13,979 --> 00:23:15,579
ALS makes it hard to cough
493
00:23:15,584 --> 00:23:17,518
due to the degeneration of the airway.
494
00:23:17,730 --> 00:23:19,097
Then you accept my diagnosis?
495
00:23:19,102 --> 00:23:21,403
Until we get the results
back from the lumbar puncture,
496
00:23:21,408 --> 00:23:22,802
- we have to assume...
- She's not...
497
00:23:22,806 --> 00:23:25,308
doing a lumbar puncture, Dr. Grisholm.
498
00:23:27,207 --> 00:23:28,807
Stop trying to work him, Dad.
499
00:23:29,342 --> 00:23:31,276
I've done the tests.
500
00:23:31,527 --> 00:23:34,441
- I've come to terms...
- Let me talk next steps.
501
00:23:35,014 --> 00:23:37,718
Well, we'll continue O2 therapy,
502
00:23:37,723 --> 00:23:39,903
target the pneumonia
with macrolide antibiotics
503
00:23:39,908 --> 00:23:41,624
and monitor her levels carefully.
504
00:23:41,629 --> 00:23:44,726
Also, we should consider
mechanical ventilation.
505
00:23:44,731 --> 00:23:46,987
What does that mean? Is that intubation?
506
00:23:46,992 --> 00:23:49,727
Yes. You're not coughing due to the ALS,
507
00:23:49,732 --> 00:23:52,234
which means that without help
your body might not be able
508
00:23:52,239 --> 00:23:54,107
to clear the secretions
caused by pneumonia.
509
00:23:54,335 --> 00:23:56,100
Dr. Hamed's right. It's aggressive,
510
00:23:56,105 --> 00:23:57,898
but it's the best way
to prevent hypoxia.
511
00:23:57,903 --> 00:24:00,104
Yes, but it's not your
only option here, Kelsey.
512
00:24:00,109 --> 00:24:02,678
We can try BIPAP for supplemental O2.
513
00:24:02,683 --> 00:24:05,051
There's also postural
drainage and percussion...
514
00:24:05,056 --> 00:24:07,055
Which might not be enough
to keep dangerous amounts
515
00:24:07,059 --> 00:24:08,408
of fluids from building.
516
00:24:08,413 --> 00:24:10,248
But there's a chance I could still
517
00:24:10,253 --> 00:24:11,900
recover on my own, right?
518
00:24:11,905 --> 00:24:13,985
Yes. This is your choice.
519
00:24:13,990 --> 00:24:16,625
And intubation is the right one.
520
00:24:24,648 --> 00:24:26,583
I've done my homework.
521
00:24:28,526 --> 00:24:29,926
If I'm intubated,
522
00:24:29,931 --> 00:24:31,832
I may never come off
the ventilator, right?
523
00:24:31,837 --> 00:24:33,624
That's what happens with ALS, right?
524
00:24:33,629 --> 00:24:35,130
No, this is an end-stage, Kel.
525
00:24:35,135 --> 00:24:37,568
It'll only help you breathe
until you fight off the pneumonia,
526
00:24:37,572 --> 00:24:39,639
then they extubate you in a day or two.
527
00:24:43,544 --> 00:24:46,264
- No.
- Come on, Kel.
528
00:24:46,269 --> 00:24:47,944
I said no. I don't
want to be intubated.
529
00:24:47,949 --> 00:24:50,800
Dammit, Kelsey! You need
a plan to deal with this!
530
00:24:50,805 --> 00:24:52,437
This is what I do!
Why can't you trust me?
531
00:24:52,441 --> 00:24:54,058
Because you're not hearing me!
532
00:24:55,602 --> 00:24:57,952
Just stop and listen for once!
533
00:25:01,038 --> 00:25:03,906
You are doing exactly
what you did with Mom.
534
00:25:04,474 --> 00:25:07,276
And not just when she
was sick, her whole life.
535
00:25:07,644 --> 00:25:10,178
Your voice is always the loudest.
536
00:25:10,747 --> 00:25:12,581
If I'm intubated,
537
00:25:12,586 --> 00:25:14,420
then you get to call all the shots.
538
00:25:14,425 --> 00:25:16,061
You get to make all my choices
539
00:25:16,066 --> 00:25:18,383
and I can't give that
kind of power to someone
540
00:25:18,388 --> 00:25:20,656
who's never listened to me.
541
00:25:42,403 --> 00:25:44,537
Oh, apparently, he
wandered into an exam room
542
00:25:44,542 --> 00:25:46,137
while a patient was getting changed?
543
00:25:46,142 --> 00:25:48,040
Not intentionally. He's
just confused about...
544
00:25:48,045 --> 00:25:50,677
We should've located his people by now.
What's the hold up, Arnold?
545
00:25:50,681 --> 00:25:51,914
We're trying.
546
00:25:53,402 --> 00:25:56,134
The reason I put both
of you on Kelsey Grisholm
547
00:25:56,139 --> 00:25:58,981
was to make sure things went smoothly.
548
00:26:00,317 --> 00:26:02,606
Well, I know it took
a while to catch the pneumonia,
549
00:26:02,611 --> 00:26:04,161
but that's because she didn't
show the regular signs...
550
00:26:04,165 --> 00:26:05,731
No, I understand the diagnosis.
551
00:26:05,736 --> 00:26:08,606
What I don't understand
is why people I report to
552
00:26:08,611 --> 00:26:11,180
are telling me that my resident
is standing in the way
553
00:26:11,185 --> 00:26:13,420
of a patient getting the care she needs.
554
00:26:15,081 --> 00:26:16,590
Ray has friends in high places.
555
00:26:16,595 --> 00:26:18,155
No, that's not at all how it happened.
556
00:26:18,160 --> 00:26:20,328
He was steamrolling his
daughter into intubating...
557
00:26:20,333 --> 00:26:22,106
I recommended mechanical ventilation
558
00:26:22,111 --> 00:26:24,270
because I think Kelsey
should consider it.
559
00:26:24,275 --> 00:26:27,202
Dr. Grisholm agreed and
made a strong case for it.
560
00:26:27,207 --> 00:26:29,582
- By ignoring hers.
- We are never going to intubate
561
00:26:29,587 --> 00:26:31,855
a patient against their
will, Mags, you know that,
562
00:26:32,143 --> 00:26:34,645
but there's no law
against giving an opinion
563
00:26:34,650 --> 00:26:37,285
and Ray feels that you weren't
legitimately considering
564
00:26:37,290 --> 00:26:38,790
all the options.
565
00:26:40,174 --> 00:26:41,307
Fine.
566
00:26:41,545 --> 00:26:43,746
Fine, I'll tread more carefully.
567
00:26:45,891 --> 00:26:47,358
Can you handle this on your own?
568
00:26:47,950 --> 00:26:50,020
What? You're taking me off?
569
00:26:50,025 --> 00:26:52,473
I'm ensuring there are no
more calls from upstairs.
570
00:26:52,478 --> 00:26:54,606
- Doctor Bishop, that is not...
- Mags!
571
00:26:55,080 --> 00:26:56,814
Don't push it.
572
00:26:57,657 --> 00:26:59,357
Since when does Bishop let politics
573
00:26:59,362 --> 00:27:00,840
get in the way of a patient?
574
00:27:00,845 --> 00:27:02,646
That's not what he's doing.
575
00:27:20,811 --> 00:27:22,387
- Dr. Roche.
- Dr. Curtis.
576
00:27:22,392 --> 00:27:25,027
Why is one of my post-op
patients in the endoscopy suite?
577
00:27:25,638 --> 00:27:29,207
Maya Crawford presented in
emerg with significant discomfort,
578
00:27:29,212 --> 00:27:31,146
thought it warranted
investigation, so I...
579
00:27:31,151 --> 00:27:32,752
Decided to waste time and resources?
580
00:27:32,757 --> 00:27:34,491
Ms. Crawford was here two weeks ago.
581
00:27:34,496 --> 00:27:36,397
Her issue was diet. She's my patient
582
00:27:36,402 --> 00:27:39,137
and I'm telling you this
procedure isn't necessary.
583
00:27:39,553 --> 00:27:42,238
With respect, Dr. Roche,
Maya's following her diet.
584
00:27:42,243 --> 00:27:44,811
With respect, they all say that.
585
00:27:44,888 --> 00:27:46,820
And when you've been doing
this as long as I have,
586
00:27:46,824 --> 00:27:48,658
you learn to see the patterns, right?
587
00:27:51,440 --> 00:27:53,535
She's not a pattern, she's a person.
588
00:27:53,540 --> 00:27:56,137
Doesn't she warrant the same
investigation as any other patient?
589
00:27:56,546 --> 00:27:58,080
Put her back on a liquid diet.
590
00:27:58,085 --> 00:28:00,084
If there's no change, I'll
be happy to see her again
591
00:28:00,088 --> 00:28:02,690
- in four to six weeks.
- She doesn't want to see you.
592
00:28:02,799 --> 00:28:04,440
You're out of line, June.
593
00:28:04,445 --> 00:28:07,027
It's fine, Aajay.
Let's see what she turns up.
594
00:28:25,999 --> 00:28:27,856
Awn, she looks peaceful.
595
00:28:27,861 --> 00:28:29,394
Now, she does.
596
00:28:29,399 --> 00:28:31,676
We just fought over my boob for an hour.
597
00:28:31,681 --> 00:28:34,916
She refuses to latch, even
though I know she's starving.
598
00:28:35,475 --> 00:28:37,276
You want them to be fighters.
599
00:28:37,281 --> 00:28:38,848
Well, you've met her parents.
600
00:28:38,853 --> 00:28:41,221
Speaking of, there was an
ER nurse that came looking
601
00:28:41,226 --> 00:28:43,465
for Ben earlier. Have you seen him?
602
00:28:43,470 --> 00:28:45,370
He's in surgery.
603
00:28:45,375 --> 00:28:47,509
- What?
- He had a ruptured spleen,
604
00:28:47,514 --> 00:28:48,887
but he's gonna be fine.
605
00:28:48,892 --> 00:28:50,949
Why didn't he tell me?
606
00:28:51,091 --> 00:28:53,993
Or respond to my texts?
607
00:28:54,666 --> 00:28:56,027
I know we're that couple.
608
00:28:56,032 --> 00:28:58,961
You know, that breaks up
a thousand times and...
609
00:28:58,966 --> 00:29:01,285
gets married to try to
save the relationship,
610
00:29:01,290 --> 00:29:03,558
and then when that doesn't work...
611
00:29:07,687 --> 00:29:10,856
The nurse that was looking for
him didn't know where he was.
612
00:29:12,048 --> 00:29:13,849
He was gonna leave, wasn't he?
613
00:29:14,869 --> 00:29:16,348
I'm sorry.
614
00:29:18,097 --> 00:29:21,024
That's probably because...
615
00:29:21,721 --> 00:29:25,023
I didn't exactly let
Ben in on my decision
616
00:29:25,028 --> 00:29:26,628
to forget taking the pill.
617
00:29:26,633 --> 00:29:30,574
But I'm 36 and I wanted a baby.
618
00:29:30,579 --> 00:29:32,723
So you planned to get pregnant?
619
00:29:32,728 --> 00:29:34,596
I know, I'm the worst.
620
00:29:35,502 --> 00:29:37,970
Money's tight, things have been hard.
621
00:29:38,170 --> 00:29:39,737
I know I should probably end things,
622
00:29:39,742 --> 00:29:41,505
but every time I think
about doing this on my own,
623
00:29:41,509 --> 00:29:43,209
I just chicken out.
624
00:29:47,337 --> 00:29:49,137
Time for round two.
625
00:29:49,142 --> 00:29:50,942
Let me help.
626
00:29:54,636 --> 00:29:56,285
Oh, yes.
627
00:30:00,574 --> 00:30:01,574
Arnold.
628
00:30:01,579 --> 00:30:02,888
Her BP dropped so I came to check.
629
00:30:02,892 --> 00:30:04,192
She'd vomited bright red blood.
630
00:30:04,197 --> 00:30:06,020
Hematemesis. I'll ultrasound!
631
00:30:06,025 --> 00:30:07,492
A bleed from pneumonia?
632
00:30:07,997 --> 00:30:10,449
- What's happening?
- Possible esophageal bleed.
633
00:30:10,454 --> 00:30:12,255
- From what?
- Blunt force trauma
634
00:30:12,260 --> 00:30:15,195
can cause portal vein thrombosis.
Could she have genetic varices?
635
00:30:15,327 --> 00:30:16,927
It's possible.
636
00:30:17,599 --> 00:30:18,866
Talk to me!
637
00:30:18,871 --> 00:30:20,801
She's going into hemorrhagic shock.
638
00:30:20,806 --> 00:30:23,762
- We need to stop the bleed.
- Rhythm's erratic.
639
00:30:23,767 --> 00:30:26,059
Give her her own
fluids and activate MTP.
640
00:30:27,182 --> 00:30:29,027
Unstable V-tach, we need to cardiovert!
641
00:30:29,032 --> 00:30:31,324
Stay with me, kid. Stay with me.
642
00:30:43,660 --> 00:30:45,528
Charging up to 100 J.
643
00:30:45,533 --> 00:30:46,800
Clear!
644
00:30:48,394 --> 00:30:49,863
Charge it to 200, try again.
645
00:30:49,868 --> 00:30:52,069
- Her rhythm's going nowhere.
- Charging.
646
00:30:52,364 --> 00:30:54,098
Clear!
647
00:30:54,777 --> 00:30:56,801
We're losing her!
We have to do something!
648
00:30:56,806 --> 00:30:58,305
- I could do a Blakemore.
- It's risky,
649
00:30:58,309 --> 00:31:00,343
considering the ALS.
Could damage her airway.
650
00:31:00,348 --> 00:31:01,599
We don't even train for that anymore!
651
00:31:01,603 --> 00:31:03,704
No, I know how and we
need to stop the bleed.
652
00:31:03,741 --> 00:31:05,209
You do it.
653
00:31:05,367 --> 00:31:07,234
It has to be Dr. Hamed.
654
00:31:07,635 --> 00:31:10,104
Please. Save my little girl.
655
00:31:12,363 --> 00:31:13,832
Give us room to work, Dr. Grisholm.
656
00:31:13,837 --> 00:31:15,528
I'll prep the Blakemore
kit. I'll need a laryngoscope
657
00:31:15,532 --> 00:31:16,897
and portable X-ray to confirm placement!
658
00:31:16,901 --> 00:31:18,635
And have 50 mics of octreotide
659
00:31:18,640 --> 00:31:19,996
and a gram of ceftriaxone ready.
660
00:31:20,001 --> 00:31:21,001
On it!
661
00:31:36,989 --> 00:31:38,190
- Mags.
- What?
662
00:31:38,195 --> 00:31:40,763
- You almost done?
- There's other terminals.
663
00:31:46,399 --> 00:31:47,966
What's up?
664
00:31:48,234 --> 00:31:50,559
I think I hate everybody we work with.
665
00:31:50,738 --> 00:31:52,671
Except you, obviously.
666
00:31:54,103 --> 00:31:55,870
Well, give it time.
667
00:31:56,104 --> 00:31:57,567
If there's one thing that I've learned,
668
00:31:57,571 --> 00:32:00,770
it's that everyone
disappoints you eventually.
669
00:32:16,562 --> 00:32:18,330
Dr. Grisholm?
670
00:32:19,340 --> 00:32:21,996
The surgeons will update us
as soon as they know more,
671
00:32:22,001 --> 00:32:24,691
but we stopped the bleed long
enough to get Kelsey to the OR.
672
00:32:24,696 --> 00:32:26,197
Thank you.
673
00:32:27,192 --> 00:32:29,227
Thank you, Dr. Hamed.
674
00:32:29,879 --> 00:32:33,074
My daughter didn't even want to tell
me she had this horrible disease.
675
00:32:35,184 --> 00:32:37,809
She needs to know I'm listening now.
676
00:32:44,339 --> 00:32:46,874
Why would Mel play my
voice mail for her lawyer?
677
00:32:46,879 --> 00:32:48,654
So he could play it for yours,
678
00:32:48,659 --> 00:32:51,093
before we all have to hear
it in front of a judge.
679
00:32:51,098 --> 00:32:53,465
All you're doing is
making this worse, Theo.
680
00:32:53,470 --> 00:32:56,226
It's her lawyers that
are making this worse!
681
00:32:56,231 --> 00:32:58,803
They're acting like nothing
good ever happened between us!
682
00:32:58,808 --> 00:33:02,441
Suddenly, I'm this
villain who isn't worthy
683
00:33:02,446 --> 00:33:04,047
of parenting his own kids!
684
00:33:04,143 --> 00:33:05,443
Theo.
685
00:33:05,448 --> 00:33:08,550
You chose to take a job in a
different city from your family.
686
00:33:08,555 --> 00:33:09,989
You can't erase that.
687
00:33:09,994 --> 00:33:12,272
Of course, she was going
to ask for custody.
688
00:33:12,277 --> 00:33:15,149
And as your lawyer, I'm telling
you that if you don't stop
689
00:33:15,154 --> 00:33:17,889
being so stubborn then
you could lose everything.
690
00:33:19,655 --> 00:33:20,955
Dr. Curtis!
691
00:33:20,960 --> 00:33:23,161
Maya's having some kind of episode!
692
00:33:27,797 --> 00:33:29,130
She said her heart's racing,
693
00:33:29,135 --> 00:33:31,569
she's shaking like a leaf, so
I'm putting her on a monitor.
694
00:33:31,574 --> 00:33:33,475
Can you do a bedside glucose?
695
00:33:35,137 --> 00:33:36,871
What's wrong with her?
696
00:33:38,596 --> 00:33:39,862
She's tachycardic.
697
00:33:39,867 --> 00:33:41,748
Maya, if you can hear
me, can you say something?
698
00:33:41,921 --> 00:33:43,655
Something.
699
00:33:45,630 --> 00:33:47,531
So there is a problem?
700
00:33:47,859 --> 00:33:49,860
The testing. What did you find?
701
00:33:51,209 --> 00:33:54,121
- Nothing.
- Yeah. There's no blockage.
702
00:33:54,126 --> 00:33:55,827
No polyps. No ulcer.
703
00:33:55,832 --> 00:33:57,526
Glucose is 3,4.
704
00:33:57,531 --> 00:33:59,397
Alright, she gonna need one amp of D-50,
705
00:33:59,402 --> 00:34:01,403
then could you just give us a second?
706
00:34:01,408 --> 00:34:03,682
What does that mean? The glucose?
707
00:34:03,687 --> 00:34:06,838
Well, rapid emptying can cause
acute episodes of hypoglycemia.
708
00:34:06,843 --> 00:34:08,642
It's hard to keep your
sugars stable when your body
709
00:34:08,646 --> 00:34:10,166
rejects everything you put in it.
710
00:34:10,171 --> 00:34:12,008
So, we're back where we started,
711
00:34:12,013 --> 00:34:13,603
with you telling me to eat less.
712
00:34:13,608 --> 00:34:15,242
No, Maya. It's not what I'm saying.
713
00:34:15,247 --> 00:34:16,524
You haven't done anything wrong.
714
00:34:16,528 --> 00:34:18,328
Then why is this happening?
715
00:34:20,254 --> 00:34:22,796
I don't know if
Dr. Roche made this clear,
716
00:34:22,801 --> 00:34:25,293
but gastric bypass is a complex surgery
717
00:34:25,305 --> 00:34:26,926
that can have various outcomes.
718
00:34:27,199 --> 00:34:28,835
And mine varied into hell.
719
00:34:28,840 --> 00:34:31,292
You had an extreme reaction
and it's gonna take some time
720
00:34:31,297 --> 00:34:33,732
for your stomach to recover
so you can intake normally.
721
00:34:35,231 --> 00:34:38,132
I didn't even want the damn
surgery in the first place.
722
00:34:38,137 --> 00:34:40,672
If I'd know it would be this bad...
723
00:34:41,434 --> 00:34:43,041
There's nothing else you can do?
724
00:34:43,684 --> 00:34:45,702
Well, there are some
medications we can try.
725
00:34:45,707 --> 00:34:48,713
They slow the emptying from
the stomach into the intestine.
726
00:34:48,723 --> 00:34:51,319
And I can find a nutritionist
who's committed
727
00:34:51,324 --> 00:34:52,880
to something called Health at Any Size,
728
00:34:52,884 --> 00:34:55,282
and they help you manage
meals and side effects.
729
00:34:55,287 --> 00:34:58,953
What if I never adjust?
I just live like this?
730
00:34:59,196 --> 00:35:01,288
You come back here when
things get bad again
731
00:35:01,293 --> 00:35:03,574
and bypass reversal is an option.
732
00:35:03,579 --> 00:35:06,081
Reversal. You mean more surgery.
733
00:35:06,086 --> 00:35:08,596
If you're serious about
wanting another choice, then yeah.
734
00:35:08,938 --> 00:35:11,407
Could that make things worse?
735
00:35:12,249 --> 00:35:14,769
It's an open surgery, so
it can have complications,
736
00:35:14,774 --> 00:35:16,571
I would talk it over
carefully with your surgeon.
737
00:35:16,575 --> 00:35:20,879
But I can refer you to
someone who is not Dr. Roche.
738
00:35:21,985 --> 00:35:25,020
Think about it, Maya.
I'm here if you need me.
739
00:35:28,811 --> 00:35:31,361
The surgeons have managed
to repair your spleen.
740
00:35:31,366 --> 00:35:33,334
A couple more days and
you'll be up and around.
741
00:35:34,587 --> 00:35:37,673
Ben, I didn't mean
to judge you before...
742
00:35:37,678 --> 00:35:39,779
I thought we could call her Crash?
743
00:35:39,784 --> 00:35:42,686
Dr. Hunter, do you mind
bringing her over to her daddy?
744
00:35:42,691 --> 00:35:44,159
Of course.
745
00:35:59,321 --> 00:36:00,889
Hello, there.
746
00:36:02,378 --> 00:36:03,945
Oh my God, hi.
747
00:36:05,660 --> 00:36:07,294
Welcome to the world.
748
00:36:11,817 --> 00:36:13,509
She has your eyes.
749
00:36:15,225 --> 00:36:16,792
I love you, Tess.
750
00:36:16,797 --> 00:36:18,431
I love you too.
751
00:36:18,563 --> 00:36:21,031
We can make it work, I know it.
752
00:36:27,762 --> 00:36:29,496
Here. Uh...
753
00:36:30,126 --> 00:36:32,161
It's a beat-up 2013 Sedan,
754
00:36:32,166 --> 00:36:34,534
but she's got some
good miles left in her
755
00:36:35,341 --> 00:36:37,114
and there's an old
car seat in the trunk.
756
00:36:37,119 --> 00:36:38,887
You're giving us your car?
757
00:36:38,892 --> 00:36:40,806
Dr. Hunter, I mean, thanks, but...
758
00:36:40,811 --> 00:36:42,079
You're gonna need one.
759
00:36:42,084 --> 00:36:44,056
That is so generous,
but we can't accept.
760
00:36:44,061 --> 00:36:46,057
You have to. I...
761
00:36:46,397 --> 00:36:48,415
I need to purge a few things.
762
00:36:48,747 --> 00:36:51,079
And I'll start jogging to work,
763
00:36:51,084 --> 00:36:53,464
so I mean, really,
you're doing me a favour.
764
00:36:53,469 --> 00:36:55,571
We don't know what to say.
765
00:36:56,566 --> 00:36:58,934
Just say you'll give
that kid a great life.
766
00:37:25,758 --> 00:37:27,884
They stopped the bleed, but...
767
00:37:28,375 --> 00:37:31,143
apparently, the Blakemore
tube damaged the airway.
768
00:37:31,148 --> 00:37:33,016
They had to do a tracheotomy.
769
00:37:34,017 --> 00:37:35,704
I was careful with the inflation.
770
00:37:35,709 --> 00:37:36,709
I know.
771
00:37:36,714 --> 00:37:37,981
And the surgeons agree,
772
00:37:37,986 --> 00:37:40,077
if you hadn't acted,
she would have died.
773
00:37:40,082 --> 00:37:43,681
But her body's weak and
couldn't take the pressure.
774
00:37:45,341 --> 00:37:47,943
Kelsey will live, but she'll
be attached to a ventilator
775
00:37:47,948 --> 00:37:50,267
for the rest of her
life and unable to speak.
776
00:37:50,272 --> 00:37:52,106
Oh, my God...
777
00:37:53,528 --> 00:37:55,884
This is exactly what she
didn't want to happen.
778
00:37:56,196 --> 00:37:58,131
I'm sorry, Bash.
779
00:38:05,876 --> 00:38:07,877
We made the call together.
780
00:38:08,577 --> 00:38:11,361
A lot of doctors would've been
paralyzed, you stopped the bleed.
781
00:38:11,366 --> 00:38:13,734
And then, ruined this woman's life.
782
00:38:16,219 --> 00:38:18,574
It could've easily rolled the other way.
783
00:38:23,866 --> 00:38:25,367
But it didn't.
784
00:38:43,176 --> 00:38:44,777
You wanted to see me?
785
00:38:45,212 --> 00:38:47,246
You're called into a meeting.
786
00:38:47,477 --> 00:38:50,493
Roche isn't happy about your
little dispute over Maya Crawford
787
00:38:50,498 --> 00:38:52,566
and she's making it known
to the division heads.
788
00:38:54,120 --> 00:38:56,255
I came to you for advice.
789
00:38:56,438 --> 00:38:58,186
You just let me walk right into that.
790
00:38:58,220 --> 00:39:00,743
I didn't tell you to go
toe-to-toe with the head of GI.
791
00:39:00,748 --> 00:39:02,247
But you stood there
and watched it happen.
792
00:39:02,251 --> 00:39:03,818
I just... I thought you had my back.
793
00:39:05,569 --> 00:39:08,538
You made an enemy of
the wrong person today.
794
00:39:09,160 --> 00:39:11,628
Maybe stop at one.
795
00:39:27,368 --> 00:39:29,229
This is my last coin.
796
00:39:30,169 --> 00:39:31,670
Sir, we need to talk.
797
00:39:33,304 --> 00:39:35,772
You're never wrong to fight
for your patients, Mags.
798
00:39:36,128 --> 00:39:37,261
Thank you.
799
00:39:37,962 --> 00:39:41,048
Although, I'm not sure that
actually counts as an apology.
800
00:39:43,857 --> 00:39:46,392
Ray was out of line, as was I.
801
00:39:47,270 --> 00:39:49,158
Why do I get the impression
you're here to register
802
00:39:49,162 --> 00:39:50,525
another complaint?
803
00:39:50,710 --> 00:39:52,344
Cardiology.
804
00:39:52,408 --> 00:39:54,282
I told you I wanted to explore it.
805
00:39:54,287 --> 00:39:55,681
But you didn't hear me.
806
00:39:55,686 --> 00:39:57,020
You also told me emerg
807
00:39:57,025 --> 00:39:58,424
was the only thing you ever wanted.
808
00:39:58,428 --> 00:40:00,695
- What's changed?
- I don't know.
809
00:40:01,491 --> 00:40:02,725
I don't know.
810
00:40:02,730 --> 00:40:05,865
I just know that I can't
get it out of my head
811
00:40:05,870 --> 00:40:08,923
and you need to let
me explore my future.
812
00:40:08,928 --> 00:40:10,665
Even if I mess it up.
813
00:40:12,750 --> 00:40:14,818
Okay, well, I'm hearing you now.
814
00:40:16,131 --> 00:40:18,790
I don't like the idea of sharing
you with another department,
815
00:40:18,795 --> 00:40:20,663
but if it's what you want...
816
00:40:23,040 --> 00:40:24,806
I'll talk to Dr. Fisher.
817
00:40:24,811 --> 00:40:26,178
Appreciate that.
818
00:40:26,702 --> 00:40:28,876
You should really
watch your sugar intake.
819
00:40:32,188 --> 00:40:37,519
His eyes are green, actually
they're sometimes blue.
820
00:40:37,524 --> 00:40:39,228
And he's funny.
821
00:40:39,233 --> 00:40:42,251
- I'm sorry. Sir...
- No, this is important.
822
00:40:42,256 --> 00:40:45,392
He gets very frightened
when he's on his own.
823
00:40:45,732 --> 00:40:48,111
- Gilbert?
- Claire!
824
00:40:48,173 --> 00:40:50,509
Where've you been all day?
825
00:40:51,662 --> 00:40:54,263
When did I get to the hospital?
826
00:40:54,268 --> 00:40:55,735
This morning, sir.
827
00:40:56,223 --> 00:40:58,091
Ah, right.
828
00:40:58,376 --> 00:41:00,556
I'm looking for Peter.
829
00:41:00,561 --> 00:41:02,228
We've lost him again.
830
00:41:02,233 --> 00:41:05,001
Your cat lives with
your son in Belleville.
831
00:41:05,251 --> 00:41:08,017
Andre takes very good care of him.
832
00:41:08,022 --> 00:41:10,023
- Peter's a cat?
- Mm-hmm.
833
00:41:10,028 --> 00:41:11,696
You never mentioned that.
834
00:41:11,769 --> 00:41:13,970
You never asked.
835
00:41:14,833 --> 00:41:17,335
I think I have your son's
number in my phone,
836
00:41:17,340 --> 00:41:19,694
- should I give him a ring?
- Never leave again.
837
00:41:19,699 --> 00:41:22,634
Also, Bishop needs to
see you in his office.
838
00:41:23,032 --> 00:41:25,467
How about you tell me
more about your cat?
839
00:41:25,472 --> 00:41:26,805
Okay.
840
00:41:34,689 --> 00:41:36,957
Oh, wow!
841
00:41:43,816 --> 00:41:45,171
- Ta-da!
- What?
842
00:41:45,176 --> 00:41:47,077
Congratulations, Claire.
843
00:41:55,585 --> 00:41:57,620
You're going to feel
really bad if I failed.
844
00:41:59,798 --> 00:42:02,312
Oh, thank you.
845
00:42:22,866 --> 00:42:25,161
I had a chance to fix things.
846
00:42:27,087 --> 00:42:29,555
To get to know her
the way I should have.
847
00:42:30,336 --> 00:42:34,006
Now, I never will.
848
00:42:35,742 --> 00:42:37,905
I'm very sorry that it went this way.
849
00:42:40,532 --> 00:42:42,819
After what you took from us...
850
00:42:44,119 --> 00:42:46,854
Sorry won't be good enough, Dr. Hamed.
851
00:42:48,166 --> 00:42:50,101
This is your fault.
63960