Would you like to inspect the original subtitles? These are the user uploaded subtitles that are being translated:
1
00:00:03,742 --> 00:00:05,483
Move the CR!
2
00:00:05,527 --> 00:00:06,528
Stay with me.
3
00:00:06,571 --> 00:00:07,833
So this is how it's gonna be?
4
00:00:07,877 --> 00:00:09,618
All day long, you've been
talking down to me.
5
00:00:09,661 --> 00:00:11,098
I should have given you credit.
6
00:00:11,141 --> 00:00:13,796
I was very impressed with the way
you nearly killed our patient.
7
00:00:15,928 --> 00:00:20,411
We are running low
on a number of key supplies.
8
00:00:20,455 --> 00:00:22,674
No, no, no, no, no!
Stop! Stop! I need that dye.
9
00:00:22,718 --> 00:00:25,938
We can't have one patient
depleting our supplies.
10
00:00:25,982 --> 00:00:27,027
So call into the hospital.
11
00:00:27,070 --> 00:00:28,767
We're all in the same boat.
12
00:00:28,811 --> 00:00:30,726
Dr. Cuevas and I have a strong hunch
13
00:00:30,769 --> 00:00:33,207
that David is developing
schizoaffective disorder.
14
00:00:33,250 --> 00:00:35,035
No! My boy isn't crazy.
15
00:00:35,078 --> 00:00:36,514
Stay away from us.
16
00:00:36,558 --> 00:00:39,213
How is that boy
supposed to get any help?
17
00:00:40,779 --> 00:00:44,174
It is a real pleasure
to finally meet you, Dr. Hawthorne.
18
00:00:44,218 --> 00:00:47,177
My colleague at Med, David Kwan,
19
00:00:47,221 --> 00:00:49,701
he sings your praises highly.
20
00:00:49,745 --> 00:00:51,529
Oh, I'm not the doctor.
21
00:00:51,573 --> 00:00:53,749
I'm her assistant, Katherine.
22
00:00:53,792 --> 00:00:55,055
Okay.
23
00:00:55,098 --> 00:00:57,753
Sign and date these forms, please.
24
00:01:01,844 --> 00:01:04,238
Just wherever you see a highlight.
25
00:01:07,154 --> 00:01:08,459
While you're finishing up with that,
26
00:01:08,503 --> 00:01:11,245
I'll go over our
policies and procedures.
27
00:01:13,856 --> 00:01:15,553
Everything you discuss
with Dr. Hawthorne
28
00:01:15,597 --> 00:01:17,729
is confidential,
except in the event she feels
29
00:01:17,773 --> 00:01:19,340
- you're a danger to yourself.
- You know what, Katherine?
30
00:01:19,383 --> 00:01:21,385
I'm... I'm actually a
practicing psychiatrist myself,
31
00:01:21,429 --> 00:01:24,693
so, I mean, if you'd like,
you can skip that part.
32
00:01:24,736 --> 00:01:25,998
I totally get it,
33
00:01:26,042 --> 00:01:28,479
but Dr. Hawthorne,
who you'll meet next week,
34
00:01:28,523 --> 00:01:31,265
requires we go through
the policies together.
35
00:01:31,308 --> 00:01:33,745
If the doctor feels that you're
a danger to yourself or others,
36
00:01:33,789 --> 00:01:35,573
- she's required to report...
- You know what, Katherine?
37
00:01:35,617 --> 00:01:38,185
I appreciate you're just
trying to do your job.
38
00:01:38,228 --> 00:01:42,102
But, um, maybe you could tell
Dr. Hawthorne
39
00:01:42,145 --> 00:01:45,496
to give me a call when she has a chance
40
00:01:45,540 --> 00:01:48,108
to meet me herself in person, okay?
41
00:01:49,152 --> 00:01:51,502
Um, you know what?
42
00:01:51,546 --> 00:01:56,116
On second thought,
maybe tell her not to bother.
43
00:01:57,943 --> 00:01:59,671
Yeah.
44
00:02:02,339 --> 00:02:05,168
It's been a long time since
you had to hunt for a therapist.
45
00:02:05,212 --> 00:02:06,818
Want me to shoot you some names?
46
00:02:06,843 --> 00:02:08,867
I got a small stockpile of referrals.
47
00:02:08,911 --> 00:02:11,435
I gotta be honest, Sharon,
after these last two experiences,
48
00:02:11,479 --> 00:02:13,785
my interest in the process
might be waning.
49
00:02:13,829 --> 00:02:16,614
I mean, this morning in particular
50
00:02:16,658 --> 00:02:18,877
actually had me questioning
the state of psychiatry.
51
00:02:18,921 --> 00:02:21,533
Well, that assembly-line mentality
52
00:02:21,558 --> 00:02:23,560
is plaguing much of medicine these days,
53
00:02:23,603 --> 00:02:25,039
not just psychiatry.
54
00:02:25,083 --> 00:02:27,607
But don't worry,
you'll find your person.
55
00:02:27,651 --> 00:02:29,696
- See you later.
- No coffee?
56
00:02:29,740 --> 00:02:31,306
Ugh, no. I don't have any time.
57
00:02:31,350 --> 00:02:34,005
We're implementing a new
drug shortage protocol,
58
00:02:34,048 --> 00:02:36,703
so I'll be in the ED all
morning walking the staff
59
00:02:36,747 --> 00:02:38,139
through the new guidelines.
60
00:02:38,183 --> 00:02:39,924
You couldn't get the enforcer,
61
00:02:39,967 --> 00:02:41,752
otherwise known
as Maggie Lockwood on that?
62
00:02:41,795 --> 00:02:43,536
She's in Paris.
63
00:02:43,580 --> 00:02:45,233
She and Ben never took their honeymoon,
64
00:02:45,277 --> 00:02:47,627
and she was gonna
lose her vacation days.
65
00:02:47,671 --> 00:02:49,324
- Wow.
- Yeah.
66
00:02:49,368 --> 00:02:50,500
Well, still, not a great time
67
00:02:50,543 --> 00:02:51,544
to be short-staffed, though, right?
68
00:02:51,588 --> 00:02:53,241
There's never a good time.
69
00:02:53,285 --> 00:02:55,461
- Yep, you got that right.
- See you later.
70
00:02:56,854 --> 00:02:58,420
Get these off me!
71
00:02:58,464 --> 00:02:59,683
David Sullivan, 17-year-old male.
72
00:02:59,726 --> 00:03:01,728
Oh, we've met.
David, it's me, Dr. Archer.
73
00:03:01,772 --> 00:03:03,034
- Do you remember me?
- I can't stay here.
74
00:03:03,077 --> 00:03:04,818
They're gonna find me.
I have to keep moving.
75
00:03:04,862 --> 00:03:06,385
- I can't stay in one place!
- It's okay, honey.
76
00:03:06,428 --> 00:03:07,821
- You're safe. You're safe.
- He ran naked into the street.
77
00:03:07,865 --> 00:03:09,997
Dad managed to grab him
before he got hit by a car.
78
00:03:10,041 --> 00:03:11,912
No visible injuries that I can see.
79
00:03:11,956 --> 00:03:14,175
Gave him 0.5 of lorazepam en route.
80
00:03:14,219 --> 00:03:16,569
Hello, again, Mrs. Sullivan.
Is your husband all right?
81
00:03:16,613 --> 00:03:19,485
He's fine, yeah.
He's just a bit shaken up.
82
00:03:19,529 --> 00:03:21,226
He drove behind us,
should be here any minute.
83
00:03:21,269 --> 00:03:23,358
- Doris, would you...
- Page psych. I'm on it.
84
00:03:23,402 --> 00:03:25,012
Okay, finish my sentences
for me, why don't you?
85
00:03:25,056 --> 00:03:27,493
Okay, David, we're gonna
loosen your restraints now
86
00:03:27,537 --> 00:03:29,190
and move you to the bed.
87
00:03:29,234 --> 00:03:31,149
I need you to stay still.
88
00:03:31,192 --> 00:03:33,760
Keep your hands by your side, all right?
89
00:03:33,804 --> 00:03:35,022
Okay, ready, everybody?
90
00:03:35,066 --> 00:03:38,548
On my count, one, two, three.
91
00:03:38,591 --> 00:03:41,202
Good. Okay.
92
00:03:41,246 --> 00:03:42,856
Very good, okay.
93
00:03:42,900 --> 00:03:44,423
- Oh, no, no, no, no, no!
- It's all right.
94
00:03:44,466 --> 00:03:45,729
- It's all right.
- David, please.
95
00:03:45,772 --> 00:03:47,557
Just let the doctor
look at you, okay, honey?
96
00:03:47,600 --> 00:03:48,993
They came inside the light.
97
00:03:49,036 --> 00:03:52,213
They're trying to steal
my DNA so they can clone me.
98
00:03:52,257 --> 00:03:53,867
Okay, so what do you think
could have triggered this?
99
00:03:53,911 --> 00:03:55,652
We were at a stoplight,
100
00:03:55,695 --> 00:03:57,479
and David became fixated
on this billboard.
101
00:03:57,523 --> 00:03:59,699
It was just some random man
selling car insurance.
102
00:03:59,743 --> 00:04:01,919
He's not random. He works for them.
103
00:04:01,962 --> 00:04:03,398
- There's a whole network.
- I don't know.
104
00:04:03,442 --> 00:04:05,226
He started taking
his clothes off and telling us
105
00:04:05,270 --> 00:04:08,316
that they were... they were
bugged with recording devices.
106
00:04:08,360 --> 00:04:09,753
And then right when the light
turned green, he bolted.
107
00:04:09,796 --> 00:04:12,016
He ran across four lanes
of oncoming traffic.
108
00:04:12,059 --> 00:04:13,260
There was...
109
00:04:14,888 --> 00:04:16,890
There was a pickup truck
that was coming right at him.
110
00:04:16,942 --> 00:04:18,813
- And he...
- Eric.
111
00:04:18,849 --> 00:04:20,067
- Sir, are you all right?
- Oh, my God, Eric!
112
00:04:20,111 --> 00:04:21,591
All right, let's get him to the ground.
113
00:04:21,634 --> 00:04:23,027
- Eric! Eric!
- Come on.
114
00:04:23,070 --> 00:04:24,332
- What's going on with him?
- It was meant for me.
115
00:04:24,376 --> 00:04:25,638
- They're gonna kill us all!
- It's okay, honey.
116
00:04:25,682 --> 00:04:26,944
Mom, we gotta get out of here now.
117
00:04:26,987 --> 00:04:27,988
- Let's get a gurney over here!
- It's okay.
118
00:04:28,013 --> 00:04:29,069
- Come on!
- Oh, my God.
119
00:04:29,094 --> 00:04:30,879
No, no, no! No, no!
120
00:04:39,968 --> 00:04:43,675
Your husband's CT angiogram
showed an aortic dissection.
121
00:04:43,700 --> 00:04:46,703
That's essentially a tear
in the wall of his aorta.
122
00:04:46,746 --> 00:04:48,665
So Eric didn't have a heart attack?
123
00:04:48,690 --> 00:04:50,909
Well, a dissection can often mimic
124
00:04:50,953 --> 00:04:52,694
heart attacks in presentation.
125
00:04:52,737 --> 00:04:55,871
This particular tear
is very close to his heart,
126
00:04:55,914 --> 00:04:59,004
which is why we need to get him
to surgery as soon as possible
127
00:04:59,048 --> 00:05:00,397
in order to repair it.
128
00:05:00,440 --> 00:05:02,704
- Open heart surgery?
- Mm-hmm, yes.
129
00:05:02,747 --> 00:05:05,402
Dr. Morris, one of our
cardiothoracic surgeons,
130
00:05:05,445 --> 00:05:06,838
will be performing the operation.
131
00:05:06,882 --> 00:05:08,884
He's on his way here now.
132
00:05:08,927 --> 00:05:10,363
Oh.
133
00:05:10,407 --> 00:05:13,192
Okay, can I see Eric
before he goes under?
134
00:05:13,236 --> 00:05:14,890
Yes, of course.
135
00:05:14,933 --> 00:05:17,283
Once we get him to pre-op,
I'll have a nurse come get you.
136
00:05:19,634 --> 00:05:21,418
How about we go somewhere
and chat for a bit?
137
00:05:21,461 --> 00:05:23,028
Thank you.
138
00:05:23,072 --> 00:05:24,334
Okay.
139
00:05:24,377 --> 00:05:25,857
I don't understand.
140
00:05:25,901 --> 00:05:29,034
Why would David think that
this man on a billboard
141
00:05:29,078 --> 00:05:30,732
was after him?
142
00:05:30,775 --> 00:05:32,777
It's what we call
a delusion of persecution.
143
00:05:32,821 --> 00:05:36,607
Yeah, one becomes convinced
that some individual,
144
00:05:36,651 --> 00:05:39,262
you know, or group is
conspiring to harm them
145
00:05:39,305 --> 00:05:40,655
or the people that they love.
146
00:05:40,698 --> 00:05:44,267
And these delusions,
that's something that
147
00:05:44,310 --> 00:05:45,703
you see with schizophrenia?
148
00:05:45,747 --> 00:05:46,835
It is, yeah.
149
00:05:49,489 --> 00:05:53,885
I know Eric and I
weren't exactly receptive
150
00:05:53,929 --> 00:05:55,147
the last time we all spoke.
151
00:05:55,191 --> 00:05:56,279
We completely understand.
152
00:05:56,322 --> 00:05:58,194
It's... it's a lot to take in.
153
00:05:58,237 --> 00:05:59,761
I Just thought that David was going
154
00:05:59,804 --> 00:06:04,530
through some kind of phase,
growing pains, you know?
155
00:06:05,418 --> 00:06:10,402
But in these last couple
of days, it's like he's...
156
00:06:10,641 --> 00:06:14,471
He's lost all touch with reality.
157
00:06:14,514 --> 00:06:18,518
It's just like,
I feel him slipping away.
158
00:06:18,562 --> 00:06:21,739
Mrs. Sullivan, I promise you,
David is still there.
159
00:06:21,783 --> 00:06:24,437
Yeah, and with treatment,
these episodes will become
160
00:06:24,481 --> 00:06:26,483
less severe and less frequent.
161
00:06:26,526 --> 00:06:29,225
And with proper management,
they can even go away.
162
00:06:29,268 --> 00:06:30,661
What do you mean, medication?
163
00:06:30,705 --> 00:06:33,751
That's a crucial component, yeah.
164
00:06:33,795 --> 00:06:36,754
David thinks people
are trying to poison him.
165
00:06:36,798 --> 00:06:39,670
How am I going to convince him
to take pills?
166
00:06:39,714 --> 00:06:41,977
There are actually injectable versions
167
00:06:42,020 --> 00:06:44,501
of many antipsychotics.
168
00:06:44,544 --> 00:06:46,155
Though we don't generally start there.
169
00:06:46,198 --> 00:06:47,547
Those are usually held in reserve
170
00:06:47,591 --> 00:06:49,332
for non-compliant patients.
171
00:06:49,375 --> 00:06:50,942
Of course.
172
00:06:50,986 --> 00:06:54,380
I'm just saying, if he refuses
or becomes non-cooperative,
173
00:06:54,424 --> 00:06:56,556
- they're an option.
- Right.
174
00:06:56,600 --> 00:06:59,342
But we'll cross that bridge
if and when we get there.
175
00:06:59,385 --> 00:07:00,822
In the long run, it's just much better
176
00:07:00,865 --> 00:07:03,650
if we can get David on board
with taking medication.
177
00:07:03,694 --> 00:07:05,783
Okay.
178
00:07:08,655 --> 00:07:10,919
Ms. Martin, I'm Doctor...
179
00:07:10,962 --> 00:07:15,010
Liza.
180
00:07:15,053 --> 00:07:17,795
Sorry, you were saying?
181
00:07:17,839 --> 00:07:19,318
Uh, I'm Dr. Choi.
182
00:07:19,362 --> 00:07:21,190
I understand you haven't
been feeling well.
183
00:07:21,233 --> 00:07:23,192
Yeah I can't keep anything down.
184
00:07:23,235 --> 00:07:25,585
And you're 12 weeks along.
185
00:07:25,629 --> 00:07:29,633
Uh, that's just an estimate.
186
00:07:29,676 --> 00:07:33,637
I only just recently
found out I was pregnant.
187
00:07:33,680 --> 00:07:36,640
I haven't gotten around
to see a doctor just yet.
188
00:07:36,683 --> 00:07:39,599
Well, in that case, we'll go
ahead and run an ultrasound.
189
00:07:39,643 --> 00:07:41,340
Doris, will you mind grabbing Dr. Asher?
190
00:07:41,384 --> 00:07:43,821
- Sure thing.
- Thanks.
191
00:07:43,865 --> 00:07:46,215
So when did the vomiting
and diarrhea start?
192
00:07:46,258 --> 00:07:47,433
Just last night.
193
00:07:47,477 --> 00:07:49,044
And you haven't taken any medication?
194
00:07:49,087 --> 00:07:51,786
No, nothing.
195
00:07:51,829 --> 00:07:54,049
I don't want to take anything
while I'm pregnant.
196
00:07:54,092 --> 00:07:56,399
Well, you know there are
some nausea medications
197
00:07:56,442 --> 00:07:57,792
that are safe for pregnancy.
198
00:07:57,835 --> 00:07:59,968
Still, I just...
199
00:08:00,011 --> 00:08:01,665
I would rather not.
200
00:08:03,362 --> 00:08:04,886
I'll be fine.
201
00:08:04,929 --> 00:08:07,845
I just really came in here
to make sure the baby's okay.
202
00:08:07,889 --> 00:08:10,369
Understood.
Mind if I press on your belly?
203
00:08:10,413 --> 00:08:12,067
I just want to see
if anything feels tender.
204
00:08:12,110 --> 00:08:13,938
Mm-hmm.
205
00:08:16,288 --> 00:08:18,073
No, no, no. No, no, no.
206
00:08:18,116 --> 00:08:19,901
I don't want her.
207
00:08:19,944 --> 00:08:21,903
You'll have to get me another doctor.
208
00:08:21,946 --> 00:08:23,469
Dr. Asher?
209
00:08:23,513 --> 00:08:25,776
Hannah Asher, right?
210
00:08:25,820 --> 00:08:27,430
Yeah. She's an excellent physician.
211
00:08:27,473 --> 00:08:30,041
She's an addict.
212
00:08:30,085 --> 00:08:31,738
You get me another doctor,
or I'm leaving.
213
00:08:31,782 --> 00:08:33,262
Whoa, whoa, whoa. Okay, okay, okay.
214
00:08:33,287 --> 00:08:34,436
Just hold on a moment.
215
00:08:38,920 --> 00:08:42,488
Hey, Hannah, sorry,
I jumped the gun, actually.
216
00:08:42,532 --> 00:08:44,186
We're all good.
217
00:08:44,229 --> 00:08:45,883
Oh, okay.
218
00:08:45,927 --> 00:08:47,319
Well, in that case,
I'm grabbing breakfast
219
00:08:47,363 --> 00:08:50,540
if anybody's looking for me.
220
00:08:57,460 --> 00:08:59,592
Dr. Tanaka-Reed, hold up a minute.
221
00:08:59,636 --> 00:09:01,464
Can you have them update that for me?
222
00:09:01,507 --> 00:09:02,900
Thank you.
223
00:09:02,944 --> 00:09:05,729
Look, I... I wanted to clear the air.
224
00:09:05,772 --> 00:09:09,515
The other day, I may have come
off a little condescending.
225
00:09:09,559 --> 00:09:11,822
I appreciate the
acknowledgment, Dr. Marcel.
226
00:09:11,866 --> 00:09:15,957
Of course, and if there's
anything you'd like to say...
227
00:09:16,000 --> 00:09:18,307
No, don't think so.
228
00:09:18,350 --> 00:09:20,918
We're all good.
229
00:09:20,962 --> 00:09:22,354
What, you didn't have time to grab him
230
00:09:22,398 --> 00:09:24,748
flowers from the gift shop?
231
00:09:24,791 --> 00:09:26,532
Huh?
232
00:09:26,576 --> 00:09:27,794
I mean, I expect the other docs
233
00:09:27,838 --> 00:09:30,667
to go soft on the residents.
234
00:09:30,710 --> 00:09:32,495
I thought you had grit.
235
00:09:32,538 --> 00:09:34,105
Well, no man's an island, right?
236
00:09:34,149 --> 00:09:35,498
Aha.
237
00:09:35,541 --> 00:09:36,847
You know, island life's
really not so bad.
238
00:09:36,891 --> 00:09:38,675
Maybe you just don't
have the stomach for it.
239
00:09:38,718 --> 00:09:41,069
Dr. Marcel, you've got
a trauma incoming.
240
00:09:41,112 --> 00:09:43,332
Well, thanks for that pep talk, coach.
241
00:09:43,375 --> 00:09:44,899
Any time.
242
00:09:47,205 --> 00:09:48,641
What do we got?
243
00:09:48,685 --> 00:09:51,079
Marcus Walker, 50-year-old
male, fall from standing.
244
00:09:51,122 --> 00:09:53,603
Gave him a 500 liter bolus en route.
245
00:09:53,646 --> 00:09:55,300
Pressure's hanging around 100, systolic.
246
00:09:55,344 --> 00:09:56,736
Heart rate's 120.
247
00:09:56,780 --> 00:09:58,738
Yeah, I've never seen him
in this much pain.
248
00:09:58,782 --> 00:10:01,132
It hasn't let up since
he hit the pavement.
249
00:10:01,176 --> 00:10:02,177
This is his sister, Janet.
250
00:10:02,220 --> 00:10:03,743
Did you witness the fall, Janet?
251
00:10:03,787 --> 00:10:05,180
He lost his balance
stepping off the sidewalk.
252
00:10:05,223 --> 00:10:07,138
It didn't look that bad,
but then he couldn't get up.
253
00:10:07,182 --> 00:10:08,618
Okay, we'll give him
something for the pain.
254
00:10:08,661 --> 00:10:09,793
We just got to find
the source of it first.
255
00:10:09,836 --> 00:10:10,837
Any medications we should know about?
256
00:10:10,881 --> 00:10:12,230
Dialysis.
257
00:10:12,274 --> 00:10:13,666
Oh, and he takes ramipril
for his blood pressure.
258
00:10:13,710 --> 00:10:14,841
Okay, here we go, guys.
259
00:10:14,885 --> 00:10:16,191
Nice and easy on my count, okay?
260
00:10:16,234 --> 00:10:17,932
One, two, three.
261
00:10:17,975 --> 00:10:20,499
I'm sorry, Marcus.
262
00:10:20,543 --> 00:10:22,937
I'm right here, Marcus. I'm right here.
263
00:10:22,980 --> 00:10:24,982
Janet, let's give the doctor
some room to work, okay?
264
00:10:25,026 --> 00:10:26,897
We're gonna take care of him,
Janet, we got this.
265
00:10:26,941 --> 00:10:28,290
Let's hang a unit of whole blood.
266
00:10:28,333 --> 00:10:29,726
Pressure it in, Ron.
267
00:10:29,769 --> 00:10:32,729
Hey, Marcus, put your arms
by your side for me.
268
00:10:32,772 --> 00:10:34,600
There you go, bud. Deep breaths.
269
00:10:34,644 --> 00:10:35,993
Okay, lungs are clear.
270
00:10:36,037 --> 00:10:37,734
- He's still shocking.
- Yeah.
271
00:10:37,777 --> 00:10:39,301
He's bleeding from somewhere.
272
00:10:39,344 --> 00:10:41,085
Let's fast him, Dr. Taylor.
273
00:10:48,397 --> 00:10:49,789
Belly's negative.
274
00:10:49,833 --> 00:10:51,356
Really?
275
00:10:51,400 --> 00:10:53,097
Yeah.
276
00:10:53,141 --> 00:10:55,143
All right, let's get him on his side.
277
00:10:55,186 --> 00:10:57,972
Herbert, come over, please.
278
00:10:58,015 --> 00:11:00,017
All right, here we go.
Nice and easy, all right?
279
00:11:00,061 --> 00:11:01,497
One, two, three.
280
00:11:03,194 --> 00:11:04,456
There you go. You're doing great.
281
00:11:04,500 --> 00:11:06,241
You're doing great, Marcus.
282
00:11:10,288 --> 00:11:12,203
What is it?
283
00:11:12,247 --> 00:11:13,248
Oh.
284
00:11:13,291 --> 00:11:14,423
An abscess.
285
00:11:14,448 --> 00:11:16,773
Looks like it. Pus under pressure.
286
00:11:16,816 --> 00:11:18,340
It's gotta be the source of the pain.
287
00:11:18,383 --> 00:11:20,951
All right, let's drain it.
288
00:11:20,995 --> 00:11:22,083
Scalpel.
289
00:11:28,089 --> 00:11:29,873
Hematoma.
290
00:11:36,401 --> 00:11:37,533
Yep.
291
00:11:37,576 --> 00:11:40,231
Hold pressure and pack it in.
292
00:11:40,275 --> 00:11:41,450
- You got it?
- Yeah.
293
00:11:41,493 --> 00:11:42,842
- Okay.
- Got it.
294
00:11:42,886 --> 00:11:44,801
All right, give me
another unit of whole blood.
295
00:11:44,844 --> 00:11:49,153
Start DDAVP and a unit
of platelets, stat.
296
00:11:49,197 --> 00:11:50,763
Come on, let's move, folks.
297
00:11:57,935 --> 00:11:59,903
Ms. Arya, hello again.
298
00:11:59,946 --> 00:12:01,557
Indrani, please.
299
00:12:01,600 --> 00:12:04,299
Indrani, I got the results
back on your culture.
300
00:12:04,342 --> 00:12:07,650
Unfortunately, you tested positive
for an infection called MRSA.
301
00:12:07,693 --> 00:12:11,132
From an ingrown toenail?
302
00:12:11,175 --> 00:12:14,222
MRSA is really hard to treat, isn't it?
303
00:12:14,265 --> 00:12:16,354
While it is resistant
to many antibiotics,
304
00:12:16,398 --> 00:12:18,226
luckily, there are a couple
that still work for it.
305
00:12:18,269 --> 00:12:20,358
How long do I have to be on antibiotics?
306
00:12:20,402 --> 00:12:22,143
- About seven to ten days.
- Oh.
307
00:12:22,186 --> 00:12:25,363
See, I told you you wouldn't
have to cancel your trip.
308
00:12:25,407 --> 00:12:27,104
Oh, yeah? Where are you headed?
309
00:12:27,148 --> 00:12:29,106
Well, I'm going to Scotland
in a few weeks
310
00:12:29,150 --> 00:12:30,716
to hike the West Highland Way.
311
00:12:30,760 --> 00:12:34,111
It's a 96-mile trail
through the Scottish Highlands.
312
00:12:34,155 --> 00:12:35,417
96 miles?
313
00:12:35,460 --> 00:12:37,636
I've been training for the last year.
314
00:12:37,680 --> 00:12:40,422
I may be pushing 60,
but I don't feel it.
315
00:12:40,465 --> 00:12:42,424
Let's start with vancomycin.
316
00:12:42,467 --> 00:12:45,079
No, I can't take vancomycin.
I'm allergic.
317
00:12:45,122 --> 00:12:46,645
Aha, I see that.
318
00:12:46,689 --> 00:12:48,952
I had a terrible reaction
when I was a kid.
319
00:12:48,995 --> 00:12:50,214
My throat closed up.
320
00:12:50,258 --> 00:12:52,042
Then we will steer clear. Nancy?
321
00:12:52,086 --> 00:12:54,436
- Linezolid? On it.
- Mm-hmm.
322
00:12:54,479 --> 00:12:56,220
We'll get you in tip top
shape for Scotland, Indrani.
323
00:12:56,264 --> 00:12:58,266
I've been wanting
to do this a long time.
324
00:12:58,309 --> 00:13:01,269
Um, Dr. Halstead, the pharmacy
325
00:13:01,312 --> 00:13:03,793
won't release the medication.
326
00:13:03,836 --> 00:13:05,621
What?
327
00:13:05,664 --> 00:13:06,665
Is there a problem?
328
00:13:09,494 --> 00:13:12,323
No, just probably a system glitch.
329
00:13:12,367 --> 00:13:14,456
Sit tight, and I'll be right back.
330
00:13:14,499 --> 00:13:16,806
Look, per the new protocol,
331
00:13:16,849 --> 00:13:19,287
you're gonna have to go through
Infectious Disease first.
332
00:13:19,330 --> 00:13:21,985
And they're going to want
to try incising
333
00:13:22,028 --> 00:13:23,639
and draining the infected tissue
334
00:13:23,682 --> 00:13:26,076
before they approve giving linezolid.
335
00:13:26,120 --> 00:13:27,164
Incising and draining?
336
00:13:27,208 --> 00:13:28,644
So source control.
337
00:13:28,687 --> 00:13:30,211
That is not gonna cut it, Ms. Goodwin.
338
00:13:30,254 --> 00:13:32,082
She needs linezolid.
339
00:13:34,476 --> 00:13:36,478
I mean, can't we just say that, um,
340
00:13:36,521 --> 00:13:39,307
you know, Infectious Disease
already signed off?
341
00:13:39,350 --> 00:13:41,309
No, we cannot, Dr. Halstead.
342
00:13:41,352 --> 00:13:43,398
Linezolid is on the restricted list
343
00:13:43,441 --> 00:13:45,878
due to extremely low inventory.
344
00:13:45,922 --> 00:13:48,577
There's a region-wide shortage.
345
00:13:48,620 --> 00:13:51,145
And we are dealing
with a systemic MRSA infection.
346
00:13:51,188 --> 00:13:53,973
You're looking at the patient
in front of you.
347
00:13:54,017 --> 00:13:57,194
But the Oversight Committee
designed the guidelines
348
00:13:57,238 --> 00:14:01,198
to ration these drugs
to the most severe cases.
349
00:14:01,242 --> 00:14:06,160
I have seen early
source control work wonders.
350
00:14:06,203 --> 00:14:07,813
Give it a shot.
351
00:14:13,079 --> 00:14:14,690
Dr. Marcel.
352
00:14:14,733 --> 00:14:16,866
- Yeah?
- I got Marcus' CAT scans.
353
00:14:16,909 --> 00:14:18,215
Uh-huh.
354
00:14:18,259 --> 00:14:20,086
Two very severe lumbar burst fractures.
355
00:14:20,130 --> 00:14:21,523
All from a spill on the sidewalk?
356
00:14:21,566 --> 00:14:22,567
Take a look.
357
00:14:24,090 --> 00:14:25,353
Oof.
358
00:14:25,396 --> 00:14:27,442
Renal disease definitely
sped up his bone loss.
359
00:14:27,485 --> 00:14:29,705
He's gonna need spinal
stabilization surgery.
360
00:14:29,748 --> 00:14:33,535
Yeah, agreed, only option
to get him walking again.
361
00:14:33,578 --> 00:14:35,232
Given his co-morbidities, without it,
362
00:14:35,276 --> 00:14:37,408
he's just gonna circle the drain.
363
00:14:37,452 --> 00:14:41,369
All right, let's...
Let's go talk to neurosurgery.
364
00:14:42,761 --> 00:14:45,677
And David, this voice
that you're hearing,
365
00:14:45,721 --> 00:14:48,158
is it male or female?
366
00:14:48,202 --> 00:14:49,681
I don't know.
367
00:14:49,725 --> 00:14:52,554
It's more like it has its own language,
368
00:14:52,597 --> 00:14:54,512
its own way of communicating.
369
00:14:54,556 --> 00:14:57,385
And then my brain translates messages
370
00:14:57,428 --> 00:14:59,387
- so I can understand them.
- Mm.
371
00:14:59,430 --> 00:15:01,606
Are you getting any messages right now?
372
00:15:01,650 --> 00:15:03,739
That you're writing down everything
373
00:15:03,782 --> 00:15:05,828
I say because you work for them.
374
00:15:10,746 --> 00:15:14,097
You're one of their spies, aren't you?
375
00:15:14,140 --> 00:15:15,533
No, I'm not a spy.
376
00:15:15,577 --> 00:15:17,709
Then give me your notebook.
377
00:15:17,753 --> 00:15:19,189
I'm not gonna give you
my notebook, David.
378
00:15:19,233 --> 00:15:20,321
Give it to me.
379
00:15:20,364 --> 00:15:22,262
David, I need you to listen to me.
I'm a doctor.
380
00:15:22,287 --> 00:15:24,934
I'm writing things down so I can
better understand what's going...
381
00:15:24,977 --> 00:15:26,622
Get out of here!
382
00:15:26,647 --> 00:15:28,040
Out, now!
383
00:15:28,065 --> 00:15:29,762
David, David, how about Dr. Cuevas
384
00:15:29,787 --> 00:15:31,220
puts her notebook away for now.
385
00:15:31,245 --> 00:15:33,421
Would that make you feel better?
386
00:15:33,464 --> 00:15:37,512
And I notice you've been
checking out this vent.
387
00:15:37,555 --> 00:15:38,774
There's a camera in there.
388
00:15:40,140 --> 00:15:42,055
Huh.
389
00:15:42,080 --> 00:15:43,779
They're always watching me.
390
00:15:43,822 --> 00:15:45,694
There isn't a camera in there, David.
391
00:15:45,737 --> 00:15:47,783
Yeah, I'm pretty sure that there isn't.
392
00:15:47,826 --> 00:15:49,175
But, you know, we're...
393
00:15:49,219 --> 00:15:52,962
We're happy to cover it up if it'll
make you more comfortable.
394
00:15:53,005 --> 00:15:54,012
Okay, good.
395
00:15:54,037 --> 00:15:57,158
So why don't I go see
what I can scrounge up.
396
00:15:57,183 --> 00:15:59,316
And I have another couple of patients
397
00:15:59,360 --> 00:16:00,796
I need to check in on,
but in the meantime,
398
00:16:00,839 --> 00:16:02,319
is there anything else I can get you?
399
00:16:02,363 --> 00:16:03,799
Can I have a Coke?
400
00:16:03,842 --> 00:16:04,843
Absolutely.
401
00:16:06,804 --> 00:16:08,327
Okay, so back in a bit.
402
00:16:08,352 --> 00:16:11,616
And Dr. Cuevas, can I just
get a quick word, please?
403
00:16:18,770 --> 00:16:21,295
So with patients experiencing paranoia,
404
00:16:21,338 --> 00:16:24,602
I've found that it's probably
not the best idea to push back
405
00:16:24,646 --> 00:16:26,212
too hard on their version of events,
406
00:16:26,256 --> 00:16:28,302
you know, especially at the outset.
407
00:16:28,345 --> 00:16:30,173
There's actually evidence-based research
408
00:16:30,216 --> 00:16:32,088
suggesting the opposite,
409
00:16:32,131 --> 00:16:34,656
that you shouldn't reinforce
a patient's delusion.
410
00:16:34,699 --> 00:16:36,310
Instead, you should
try to explain to them
411
00:16:36,353 --> 00:16:38,486
why they're experiencing
things differently.
412
00:16:38,529 --> 00:16:42,359
I hear you, except that that's
pretty much impossible if you haven't
413
00:16:42,403 --> 00:16:44,230
first established trust.
414
00:16:44,274 --> 00:16:47,712
But very glad to hear that you are
keeping up on the literature.
415
00:16:47,756 --> 00:16:49,323
Way to go.
416
00:16:54,900 --> 00:16:57,163
Ooh, got Choi as your advisor.
417
00:16:57,418 --> 00:16:59,543
Luck really isn't on your side.
418
00:16:59,568 --> 00:17:00,714
Why?
419
00:17:00,739 --> 00:17:02,354
He's been really cool with me.
420
00:17:02,379 --> 00:17:04,163
Yeah, well, I wouldn't
get too comfortable.
421
00:17:04,207 --> 00:17:06,383
Word is, he's a real hard-ass.
422
00:17:06,427 --> 00:17:08,472
Got his last resident fired.
423
00:17:13,434 --> 00:17:15,305
Olga, what are you doing down here?
424
00:17:15,349 --> 00:17:16,698
I was gonna ask you the same thing.
425
00:17:16,741 --> 00:17:19,048
- I assumed you were out today.
- Why's that?
426
00:17:19,091 --> 00:17:22,268
Oh, well, Dr. Choi asked me to
ultrasound his pregnant patient.
427
00:17:25,141 --> 00:17:27,361
I don't understand.
Why would he ask you?
428
00:17:27,404 --> 00:17:29,058
I cover the ED.
429
00:17:33,454 --> 00:17:35,456
So do you have a question
about my qualifications
430
00:17:35,499 --> 00:17:37,414
- or something?
- Of course not, Hannah.
431
00:17:37,458 --> 00:17:39,460
Then why would you
ask another obstetrician
432
00:17:39,503 --> 00:17:41,879
to do an ultrasound
in the ED when I'm here?
433
00:17:41,904 --> 00:17:43,602
Obviously, you don't trust me.
434
00:17:43,627 --> 00:17:45,030
It's not that.
435
00:17:45,074 --> 00:17:47,206
I...
436
00:17:47,250 --> 00:17:49,426
The patient requested another doctor.
437
00:17:49,470 --> 00:17:53,082
She... she knew about your past.
438
00:17:53,125 --> 00:17:54,388
What? How?
439
00:17:55,676 --> 00:17:57,565
Does she know me personally?
440
00:17:57,608 --> 00:17:58,870
She didn't volunteer that information,
441
00:17:58,914 --> 00:18:00,611
- so I didn't press it.
- Fine.
442
00:18:00,655 --> 00:18:02,396
- Forget it.
- Hannah.
443
00:18:02,439 --> 00:18:05,950
I'm just so sick of this
following me everywhere I go.
444
00:18:05,975 --> 00:18:07,941
No matter how much progress I make,
445
00:18:07,966 --> 00:18:10,491
everyone's still judging me
for who I used to be.
446
00:18:15,694 --> 00:18:16,826
Nope.
447
00:18:16,989 --> 00:18:18,600
Medically, it's just too risky.
448
00:18:18,643 --> 00:18:21,081
Chronic hypertension,
end-stage renal disease...
449
00:18:21,124 --> 00:18:22,734
The list goes on and on
with this patient.
450
00:18:22,778 --> 00:18:24,388
The real kicker is that platelet count.
451
00:18:24,432 --> 00:18:27,217
I'm not touching anyone whose
platelet count's below 100k.
452
00:18:27,261 --> 00:18:29,828
Listen, we know that he's
not an ideal candidate.
453
00:18:29,872 --> 00:18:31,134
Oh, wait, I almost forgot.
454
00:18:31,178 --> 00:18:33,093
You guys also hacked
his back open in the ED,
455
00:18:33,136 --> 00:18:35,182
making a posterior approach impossible.
456
00:18:35,225 --> 00:18:36,618
Should I go on?
457
00:18:36,661 --> 00:18:38,750
Look, I can give you
great anterior exposure.
458
00:18:38,794 --> 00:18:40,622
All you have to do
is stabilize his spine.
459
00:18:40,665 --> 00:18:42,145
I'll take care of everything else.
460
00:18:42,189 --> 00:18:44,756
Oh, you'd be assisting me on this one?
461
00:18:44,800 --> 00:18:47,629
Wow, way to save your
strongest argument for last.
462
00:18:47,672 --> 00:18:50,104
Maybe you're just worried
about your stats, Sam.
463
00:18:51,807 --> 00:18:53,738
Send him up to interventional radiology.
464
00:18:53,763 --> 00:18:55,765
Have them inject cement
into his fractures.
465
00:18:55,809 --> 00:18:57,724
That'll at least get him sitting up.
466
00:18:57,767 --> 00:18:59,421
But that won't get him walking.
467
00:18:59,465 --> 00:19:02,340
And lack of movement is dangerous
in Marcus's condition.
468
00:19:02,365 --> 00:19:04,880
He can develop pressure sores,
blood clots, pneumonia.
469
00:19:04,905 --> 00:19:07,298
All preferable to him
bleeding out on my table.
470
00:19:13,957 --> 00:19:16,395
We just need
to get his platelet count up.
471
00:19:16,438 --> 00:19:17,918
Yeah, it's the only way to get Marcus
472
00:19:17,961 --> 00:19:20,224
healthy enough for surgery
and Abrams on board.
473
00:19:20,268 --> 00:19:21,878
All right, I'll...
474
00:19:21,922 --> 00:19:24,446
I'll order a couple of units
of platelets, all right?
475
00:19:30,626 --> 00:19:33,760
Patty, any updates on your husband?
476
00:19:33,803 --> 00:19:35,457
Oh, he just went into surgery.
477
00:19:35,501 --> 00:19:37,067
Dr. Archer said it will be a while
478
00:19:37,111 --> 00:19:38,286
before there's any updates.
479
00:19:38,329 --> 00:19:40,288
Okay, well, he's in very good hands.
480
00:19:40,331 --> 00:19:41,985
You can trust me on that.
481
00:19:42,029 --> 00:19:44,597
David, got that Coke you asked for
482
00:19:44,640 --> 00:19:46,599
and some stuff for the vent.
483
00:19:46,642 --> 00:19:49,471
Do you think you might
be up for chatting a bit?
484
00:19:52,387 --> 00:19:53,519
You all right, pal?
485
00:19:56,173 --> 00:19:59,394
Trini gave him something
just to calm him down.
486
00:19:59,438 --> 00:20:00,526
Huh.
487
00:20:03,354 --> 00:20:06,009
Okay, back in a second.
488
00:20:07,614 --> 00:20:08,950
What did you give him?
489
00:20:08,975 --> 00:20:10,542
6 of risperidone.
490
00:20:10,567 --> 00:20:11,729
What?
491
00:20:11,754 --> 00:20:13,713
Who the hell ordered that?
492
00:20:13,756 --> 00:20:14,933
I did.
493
00:20:23,555 --> 00:20:26,402
He became extremely agitated
and was resisting restraints.
494
00:20:26,427 --> 00:20:28,093
Lorazepam worked this morning.
495
00:20:28,118 --> 00:20:29,642
You didn't see how upset he was.
496
00:20:29,685 --> 00:20:30,991
Haldol then.
497
00:20:31,034 --> 00:20:32,906
He was going to tear out his IV.
498
00:20:32,949 --> 00:20:34,298
His mom was freaking out,
begging me to do...
499
00:20:34,342 --> 00:20:35,909
Well, you cannot let a family member
500
00:20:35,952 --> 00:20:38,041
pressure you into making
a rushed treatment call.
501
00:20:38,085 --> 00:20:41,001
It wasn't rushed. It was necessary.
502
00:20:41,044 --> 00:20:43,133
And besides, the meds
will clear his system
503
00:20:43,177 --> 00:20:44,526
by tomorrow morning at the latest.
504
00:20:44,570 --> 00:20:45,875
At which point,
we'll be back at square one
505
00:20:45,919 --> 00:20:47,747
with David, if we're lucky, all right?
506
00:20:47,790 --> 00:20:50,358
Any trust established, down the drain.
507
00:20:50,401 --> 00:20:52,534
How about this, in the future,
maybe at least page me
508
00:20:52,578 --> 00:20:55,798
before administering a very
high dose of antipsychotics
509
00:20:55,842 --> 00:20:58,192
to a patient we're still evaluating?
510
00:20:58,235 --> 00:21:01,369
With all due respect, Dr. Charles,
511
00:21:01,412 --> 00:21:03,676
I am not a trainee.
512
00:21:03,719 --> 00:21:06,766
And 6 milligrams is well within
the standard of care, I...
513
00:21:06,809 --> 00:21:08,332
Standard of care, whatever that is,
514
00:21:08,376 --> 00:21:10,596
is not some blanket template you follow
515
00:21:10,639 --> 00:21:13,555
without any regard
for the person in front of you
516
00:21:13,599 --> 00:21:14,904
you're supposed to be helping!
517
00:21:27,917 --> 00:21:29,397
Hey, Janet.
518
00:21:29,440 --> 00:21:31,486
I just want to let you know,
the nurse will be by soon
519
00:21:31,530 --> 00:21:33,706
to start Marcus'
platelet transfusion, okay?
520
00:21:40,539 --> 00:21:42,976
I know it's been a rough day.
521
00:21:43,019 --> 00:21:46,022
More like a rough year.
522
00:21:46,066 --> 00:21:48,721
Lost my husband in January.
523
00:21:48,764 --> 00:21:51,550
I'm so sorry.
524
00:21:51,593 --> 00:21:54,378
Marcus came out from
California for the funeral
525
00:21:54,422 --> 00:21:58,600
and just never went home,
526
00:21:58,644 --> 00:22:00,123
moved in with me.
527
00:22:00,167 --> 00:22:01,951
You must really get on.
528
00:22:03,649 --> 00:22:08,567
Never had a choice in the matter.
529
00:22:08,610 --> 00:22:11,395
We're twins, actually.
530
00:22:11,439 --> 00:22:15,617
Marcus was born 45 seconds before me,
531
00:22:15,661 --> 00:22:19,490
but you'd think he was
years older, the way he acts.
532
00:22:19,534 --> 00:22:24,161
Seeing him here like this, so fragile...
533
00:22:27,498 --> 00:22:29,718
It's really hard.
534
00:22:38,858 --> 00:22:42,209
I want you to know that, uh,
535
00:22:42,252 --> 00:22:46,184
we're gonna do everything
we can for Marcus, I promise.
536
00:22:47,910 --> 00:22:49,129
Okay.
537
00:22:53,655 --> 00:22:55,918
What is it?
538
00:22:55,962 --> 00:22:58,138
I was just looking back
in Marcus's history.
539
00:22:58,181 --> 00:23:00,314
His platelets have always been low.
540
00:23:00,357 --> 00:23:01,433
Huh.
541
00:23:01,458 --> 00:23:02,894
Do you think this is chronic?
542
00:23:02,919 --> 00:23:05,773
Some kind of undiagnosed
blood disorder, or...?
543
00:23:05,798 --> 00:23:07,843
- ITP would be my guess.
- Oh, man.
544
00:23:07,887 --> 00:23:10,367
And if that's the case,
a transfusion is not gonna do much.
545
00:23:10,411 --> 00:23:11,804
I mean, his body would just
keep chewing up
546
00:23:11,847 --> 00:23:13,327
any new platelets we give him.
547
00:23:13,370 --> 00:23:15,677
Well, unless...
548
00:23:15,721 --> 00:23:17,374
Unless what?
549
00:23:19,159 --> 00:23:22,684
Um, forget it, actually.
550
00:23:22,728 --> 00:23:24,077
I thought I had something.
551
00:23:24,120 --> 00:23:28,559
But let's just hope the transfusion
moves the needle a little, okay?
552
00:23:36,524 --> 00:23:39,353
Podiatry incised and drained the toe.
553
00:23:39,396 --> 00:23:42,269
They had to cut the nail out.
554
00:23:42,312 --> 00:23:45,141
I'm not a doctor, but it looks like
it's getting worse to me.
555
00:23:45,185 --> 00:23:47,143
Don't worry. I'm on it.
556
00:23:47,187 --> 00:23:48,492
We're gonna get you
the medicine you need.
557
00:23:48,536 --> 00:23:52,018
Dr. Halstead, can I
speak with you outside?
558
00:23:52,061 --> 00:23:54,716
What's wrong?
559
00:23:54,760 --> 00:23:57,066
Just give us a moment.
560
00:24:02,430 --> 00:24:05,310
We're now completely out of linezolid.
561
00:24:05,335 --> 00:24:07,860
You've gotta be kidding me.
562
00:24:07,903 --> 00:24:12,125
I knew it. I knew source
control wasn't gonna cut it.
563
00:24:12,168 --> 00:24:13,779
How soon are we expecting
to get it back in stock?
564
00:24:13,822 --> 00:24:15,911
Tomorrow morning, at the earliest.
565
00:24:19,247 --> 00:24:21,118
Order vancomycin.
566
00:24:21,143 --> 00:24:22,348
She's allergic.
567
00:24:22,373 --> 00:24:25,158
I know, all right, but I've got an idea.
568
00:24:29,272 --> 00:24:31,710
Hey, Liza.
569
00:24:33,581 --> 00:24:35,626
So got your labs back,
and they look good.
570
00:24:35,670 --> 00:24:38,238
Your white blood count
is slightly elevated,
571
00:24:38,281 --> 00:24:40,544
but that's pretty common in pregnancy.
572
00:24:40,588 --> 00:24:43,460
I think we're just looking
at a stomach bug.
573
00:24:43,504 --> 00:24:46,159
Makes sense. I can go home then?
574
00:24:46,202 --> 00:24:50,098
Yeah, Dr. Patchefsky sent down a list
of OB-GYN referrals,
575
00:24:50,123 --> 00:24:52,473
as well as some
genetic testing counselors.
576
00:24:52,687 --> 00:24:54,994
We'll just add those to your discharge.
577
00:24:55,037 --> 00:24:56,909
Genetic testing?
578
00:24:56,952 --> 00:24:58,693
I thought she said the...
579
00:24:58,737 --> 00:25:01,261
The baby looked healthy
on the ultrasound.
580
00:25:01,304 --> 00:25:05,098
Genetic testing for hereditary
conditions is completely optional.
581
00:25:06,135 --> 00:25:09,791
But the baby's healthy, right?
582
00:25:09,835 --> 00:25:10,966
Yeah.
583
00:25:13,229 --> 00:25:15,057
Hey, listen, if...
584
00:25:15,101 --> 00:25:16,755
Liza, my dear.
585
00:25:18,582 --> 00:25:20,976
I have your discharge paperwork.
586
00:25:25,633 --> 00:25:28,854
I'm not sure I'm following you.
587
00:25:28,897 --> 00:25:32,292
You want to give me a drug
I told you almost killed me?
588
00:25:32,335 --> 00:25:34,598
And we'll do everything
we can to mitigate the chances
589
00:25:34,642 --> 00:25:36,818
- of another adverse reaction.
- How, exactly?
590
00:25:36,862 --> 00:25:39,342
Through a process called desensitizing.
591
00:25:39,386 --> 00:25:41,605
We'll pre-medicate you with
steroids and antihistamines
592
00:25:41,649 --> 00:25:44,695
and then administer the
vancomycin via a slow IV drip.
593
00:25:44,739 --> 00:25:47,655
And can you promise me that my throat
594
00:25:47,698 --> 00:25:48,874
won't close up again?
595
00:25:48,917 --> 00:25:50,614
I can't promise that, no.
596
00:25:50,658 --> 00:25:53,574
But if you do go into anaphylaxis,
we'll have epinephrine at the ready.
597
00:25:53,617 --> 00:25:55,184
Worst case scenario,
we might need to intubate,
598
00:25:55,228 --> 00:25:56,838
but that would only be temporary.
599
00:25:56,882 --> 00:25:58,231
Intubate me? No, no.
600
00:25:58,274 --> 00:25:59,623
I'll go to another hospital.
601
00:25:59,667 --> 00:26:01,161
Well, we've called everywhere.
602
00:26:01,186 --> 00:26:02,993
The earliest anyone has
linezolid is tomorrow.
603
00:26:03,018 --> 00:26:04,933
So I'll wait.
604
00:26:04,977 --> 00:26:07,327
As you're seeing, MRSA moves fast.
605
00:26:07,370 --> 00:26:08,676
I am afraid if we wait until tomorrow,
606
00:26:08,719 --> 00:26:10,547
it will have already spread to the bone.
607
00:26:10,591 --> 00:26:11,940
You could lose your leg, Indrani.
608
00:26:19,342 --> 00:26:21,344
Give me the vancomycin.
609
00:26:21,369 --> 00:26:22,965
Okay.
610
00:26:26,825 --> 00:26:30,002
Marcus' platelet count rose
from 50,000 to 105,000.
611
00:26:30,045 --> 00:26:32,787
- Can you believe it?
- That's great.
612
00:26:32,831 --> 00:26:34,528
It's fantastic.
613
00:26:34,571 --> 00:26:36,573
He must not have ITP after all.
614
00:26:36,617 --> 00:26:37,836
Do me a favor.
615
00:26:37,879 --> 00:26:39,838
Show Abrams these updated labs.
616
00:26:39,881 --> 00:26:43,711
I think he'll be more receptive
if you deliver them solo.
617
00:26:43,754 --> 00:26:45,887
How could he possibly
refuse to operate now?
618
00:26:45,931 --> 00:26:47,671
It's Abrams.
619
00:26:47,715 --> 00:26:49,412
I'll get him on board.
620
00:26:49,456 --> 00:26:53,590
Dr. Choi? We've got a problem.
621
00:26:53,634 --> 00:26:55,897
Liza?
622
00:26:55,941 --> 00:26:56,985
I thought she had left.
623
00:26:57,029 --> 00:26:59,335
I came in to turn over the room,
and I found her passed out.
624
00:26:59,379 --> 00:27:01,511
Let's get her back in the bed
and up on the monitors. Ready?
625
00:27:01,555 --> 00:27:03,905
One, two, three.
626
00:27:03,949 --> 00:27:06,038
All right. All right.
627
00:27:06,075 --> 00:27:07,909
Liza? Liza, can you hear me?
628
00:27:07,953 --> 00:27:10,042
All right, let's re-start
her IV and get a Foley in her.
629
00:27:10,085 --> 00:27:11,217
- Grab OB.
- Patchefsky, right?
630
00:27:11,242 --> 00:27:12,255
No, no, no. No time.
631
00:27:12,280 --> 00:27:13,629
- Grab Asher.
- Okay.
632
00:27:13,654 --> 00:27:16,048
She's hypotensive. BP 85/43.
633
00:27:16,091 --> 00:27:17,571
Maybe she vasovagaled?
634
00:27:17,614 --> 00:27:19,660
Her white count was more
significant than I thought.
635
00:27:22,010 --> 00:27:23,577
Liza.
636
00:27:23,620 --> 00:27:25,884
- You know her?
- Yeah, Doris filled me in.
637
00:27:25,927 --> 00:27:28,234
How long had she been experiencing
symptoms when she came in?
638
00:27:28,277 --> 00:27:29,496
Less than 24 hours.
639
00:27:29,539 --> 00:27:31,541
And that's self-reported
from the patient?
640
00:27:31,585 --> 00:27:32,847
Yeah, why?
641
00:27:36,285 --> 00:27:37,591
Bolus a liter of normal saline.
642
00:27:37,634 --> 00:27:39,071
Hannah, we've been giving her fluids.
643
00:27:39,114 --> 00:27:40,594
Could this be sepsis?
644
00:27:40,637 --> 00:27:42,074
We could start a broad
spectrum antibiotic.
645
00:27:42,117 --> 00:27:43,423
Let's just see what this does first.
646
00:27:43,466 --> 00:27:44,946
I don't think we're looking at sepsis.
647
00:27:44,990 --> 00:27:48,950
I think she's hypovolemic
from massive volume depletion.
648
00:27:48,994 --> 00:27:53,085
I suspect she's been sick
a lot longer than she reported.
649
00:27:53,128 --> 00:27:55,043
BP's starting to come up.
650
00:28:15,769 --> 00:28:18,990
Appreciate you stepping up
to the plate on this one, Sam.
651
00:28:19,015 --> 00:28:21,915
His platelets sure turned
around fast, didn't they?
652
00:28:21,940 --> 00:28:23,158
Marcus is a fighter.
653
00:28:25,392 --> 00:28:26,916
All right, this is my show.
654
00:28:26,941 --> 00:28:29,226
Once we get to the spine,
you follow my lead, understood?
655
00:28:29,251 --> 00:28:30,731
Fair enough.
656
00:28:30,774 --> 00:28:33,473
Mia, start my playlist.
657
00:28:34,996 --> 00:28:37,259
All right, after you.
658
00:28:37,303 --> 00:28:38,434
Scalpel.
659
00:28:51,839 --> 00:28:53,058
Where are we at?
660
00:28:53,101 --> 00:28:55,364
I gave 125 of the methylprednisolone
661
00:28:55,408 --> 00:28:57,323
and 50 of diphenhydramine.
662
00:28:57,366 --> 00:29:00,065
All right, we're ready
to start the vancomycin.
663
00:29:00,108 --> 00:29:01,805
Now, we're gonna take it slowly,
664
00:29:01,849 --> 00:29:03,807
gradually increase the dose over time.
665
00:29:03,851 --> 00:29:05,592
Are you ready?
666
00:29:05,635 --> 00:29:07,333
As I'll ever be.
667
00:29:19,910 --> 00:29:22,130
Something doesn't feel right.
668
00:29:22,174 --> 00:29:23,827
- Okay.
- Oh, my God.
669
00:29:23,871 --> 00:29:25,742
Oh, my God.
My throat... I can't swallow.
670
00:29:25,786 --> 00:29:28,006
Okay, we got you. Nancy, 0.3 of Epi.
671
00:29:28,049 --> 00:29:31,444
I can't...
672
00:29:31,487 --> 00:29:34,186
It takes time to work.
Just stay calm. Keep your eyes on me.
673
00:29:37,145 --> 00:29:40,192
Another 0.3 of Epi and another
50 of diphenhydramine.
674
00:29:43,760 --> 00:29:45,675
Mask.
675
00:29:45,719 --> 00:29:47,025
There you go.
676
00:29:52,150 --> 00:29:55,022
Get ready to intubate.
677
00:29:55,294 --> 00:29:56,686
Just a precaution.
678
00:30:11,005 --> 00:30:12,528
I think it's working.
679
00:30:12,572 --> 00:30:15,923
Slow, deep breaths. In through
the nose, out through the mouth.
680
00:30:21,132 --> 00:30:22,700
That's it.
681
00:30:30,155 --> 00:30:33,462
So how long have you actually been sick?
682
00:30:33,506 --> 00:30:35,899
This is day six.
683
00:30:35,943 --> 00:30:40,904
Ever since I stopped using.
684
00:30:42,123 --> 00:30:46,867
Did you know that these
symptoms are a result of withdrawal?
685
00:30:46,910 --> 00:30:48,956
I figured.
686
00:30:51,480 --> 00:30:54,701
Dr. Asher, if I outed you
to your colleagues...
687
00:30:54,744 --> 00:30:56,572
No.
688
00:30:56,616 --> 00:30:57,739
No, you didn't.
689
00:30:57,764 --> 00:31:01,550
Everyone here knows
that I'm in recovery.
690
00:31:01,925 --> 00:31:05,451
And you don't have to call me Dr. Asher.
691
00:31:06,495 --> 00:31:10,543
It does feel kind of weird
calling you by your last name.
692
00:31:11,979 --> 00:31:14,286
I won't tell anyone in group.
693
00:31:14,329 --> 00:31:16,114
Thank you.
694
00:31:16,157 --> 00:31:20,422
I don't even know if the drugs
have cleared my system yet.
695
00:31:20,466 --> 00:31:23,251
I couldn't risk you
running a drug test on me,
696
00:31:23,295 --> 00:31:25,645
given everything you know about me.
697
00:31:25,688 --> 00:31:30,302
I just... I don't want
anyone taking my baby away.
698
00:31:32,391 --> 00:31:36,395
Well, I commend you for quitting, Liza.
699
00:31:36,438 --> 00:31:38,788
Going cold turkey is really hard.
700
00:31:40,877 --> 00:31:44,142
There are some medications
like Suboxone and methadone
701
00:31:44,185 --> 00:31:46,709
that can help curb the cravings.
702
00:31:46,753 --> 00:31:48,755
Those are opiates, right?
703
00:31:48,798 --> 00:31:50,452
Yes.
704
00:31:50,496 --> 00:31:52,759
But when you're medically supervised,
705
00:31:52,802 --> 00:31:55,892
you are allowed to be
on them while you're pregnant.
706
00:31:55,936 --> 00:31:57,633
The risk to the fetus is minimal...
707
00:31:57,677 --> 00:31:59,200
No.
708
00:31:59,244 --> 00:32:02,290
If there are any risks, then no.
709
00:32:04,162 --> 00:32:08,209
I probably shot up,
710
00:32:08,253 --> 00:32:11,604
like, a half dozen times
during my first trimester.
711
00:32:13,846 --> 00:32:17,581
And still, by some miracle,
712
00:32:17,606 --> 00:32:20,396
the baby seems to be okay.
713
00:32:22,484 --> 00:32:26,488
I can't do anything to jeopardize that.
714
00:32:26,532 --> 00:32:27,981
I won't.
715
00:32:31,885 --> 00:32:33,060
Come in.
716
00:32:39,022 --> 00:32:40,894
I was going to check with Mrs. Sullivan
717
00:32:40,937 --> 00:32:43,201
to see if she would agree
to David spending
718
00:32:43,244 --> 00:32:45,942
a couple of nights in the psych ward.
719
00:32:45,986 --> 00:32:48,249
I figure we can talk to him more,
720
00:32:48,293 --> 00:32:52,949
begin to find the correct
medication and dosage.
721
00:32:52,993 --> 00:32:56,214
Well, that sounds good, Dr. Cuevas.
Thank you.
722
00:32:56,257 --> 00:32:58,825
Oh, and his father is out of surgery.
723
00:32:58,868 --> 00:33:00,261
No complications.
724
00:33:00,305 --> 00:33:04,309
Well, good stuff.
I'm glad to... glad to hear too.
725
00:33:09,009 --> 00:33:13,143
I should have spoken to you
first before medicating David.
726
00:33:13,187 --> 00:33:15,798
Look, you know it was
a chaotic situation,
727
00:33:15,842 --> 00:33:18,975
and I understand that you felt
the need to act swiftly.
728
00:33:19,019 --> 00:33:20,200
I do.
729
00:33:20,225 --> 00:33:23,359
I probably did jump
to medication too quickly,
730
00:33:23,384 --> 00:33:24,646
if I'm being honest.
731
00:33:27,655 --> 00:33:31,746
I know I rely heavily on the literature
732
00:33:31,771 --> 00:33:34,034
and the standard of care,
733
00:33:34,077 --> 00:33:38,821
but I just don't always feel
734
00:33:38,865 --> 00:33:42,042
like I can trust my own instincts.
735
00:33:45,045 --> 00:33:49,832
I mean, it took me years, years.
736
00:33:49,876 --> 00:33:54,477
And still, I have...
I have my days when... you know?
737
00:33:55,316 --> 00:33:58,363
But this, I can promise you,
you will get there.
738
00:33:58,406 --> 00:34:01,409
You will. There's not a
shred of doubt in my mind.
739
00:34:02,932 --> 00:34:04,194
Trust me on that.
740
00:34:19,976 --> 00:34:22,065
Hey, Janet.
741
00:34:22,499 --> 00:34:24,065
Marcus did great.
742
00:34:27,957 --> 00:34:29,611
I can't thank you both enough.
743
00:34:29,655 --> 00:34:32,092
No need. He's got a long road ahead,
744
00:34:32,135 --> 00:34:36,226
but with physical therapy, I'm confident
he'll be back on his feet.
745
00:34:36,270 --> 00:34:37,823
Can... can I see him?
746
00:34:37,848 --> 00:34:39,621
Of course. I'll take you to recovery.
747
00:34:39,665 --> 00:34:42,363
Now, he's just waking up, so he
might be a bit groggy, okay?
748
00:34:42,407 --> 00:34:43,625
This way.
749
00:34:48,064 --> 00:34:50,110
Dr. Abrams, I heard the good news.
750
00:34:50,153 --> 00:34:51,459
I really appreciate...
751
00:34:51,503 --> 00:34:53,983
Yeah, you two ever pull
a stunt like that again,
752
00:34:54,027 --> 00:34:56,464
I won't keep it to myself.
I'll go straight to Goodwin.
753
00:34:56,508 --> 00:34:57,622
Excuse me?
754
00:34:57,647 --> 00:34:59,616
I don't appreciate
being conned into surgery
755
00:34:59,641 --> 00:35:01,643
- under false pretenses.
- Wait.
756
00:35:01,687 --> 00:35:03,863
I'm sorry, Dr. Abrams.
What are you talking about?
757
00:35:07,649 --> 00:35:09,782
My antenna went up
when Marcus's platelets
758
00:35:09,825 --> 00:35:11,218
corrected so quickly.
759
00:35:11,261 --> 00:35:13,307
So I had the lab run
an anti-platelet antibody test
760
00:35:13,351 --> 00:35:14,569
while we were in surgery.
761
00:35:14,613 --> 00:35:17,224
You might be interested in the results.
762
00:35:21,583 --> 00:35:23,491
- Marcus has ITP.
- Mm-hmm.
763
00:35:23,535 --> 00:35:24,971
But this doesn't make any sense.
764
00:35:25,014 --> 00:35:26,494
If Marcus has ITP, the transfusion
765
00:35:26,538 --> 00:35:28,844
- shouldn't have worked.
- Correct.
766
00:35:28,888 --> 00:35:31,717
Unless someone gave him
a little assistance.
767
00:35:41,383 --> 00:35:44,239
You gave Marcus steroids, didn't you?
768
00:35:44,294 --> 00:35:45,600
And that's why
his platelet count went up.
769
00:35:45,644 --> 00:35:47,428
I know steroids can be controversial
770
00:35:47,472 --> 00:35:49,430
- in the surgical settings...
- To put it lightly.
771
00:35:49,474 --> 00:35:52,564
You put him at greater risk
of post-op infection.
772
00:35:52,607 --> 00:35:56,611
Vanessa, believe me when I tell you,
this was our only play.
773
00:35:56,636 --> 00:35:57,941
Our only play?
774
00:35:58,004 --> 00:36:00,572
I was left in the dark.
775
00:36:00,615 --> 00:36:02,269
Look, I didn't want you
catching any heat
776
00:36:02,312 --> 00:36:03,792
if things went south, okay?
777
00:36:03,836 --> 00:36:06,099
I have more cover as an attending.
778
00:36:06,142 --> 00:36:07,448
I was trying to protect you.
779
00:36:09,407 --> 00:36:11,060
I do not need your protection.
780
00:36:11,104 --> 00:36:12,279
I need your respect.
781
00:36:12,322 --> 00:36:14,281
Vanessa, of course I respect you.
782
00:36:14,324 --> 00:36:16,457
It does not feel that way right now.
783
00:36:25,248 --> 00:36:27,381
Looking much better, Indrani.
784
00:36:27,425 --> 00:36:29,339
Some techs will be back soon
to move you upstairs.
785
00:36:29,383 --> 00:36:31,690
We're gonna keep you on IV
vancomycin for a few days
786
00:36:31,733 --> 00:36:34,562
and then switch you over
to the oral version.
787
00:36:34,606 --> 00:36:37,565
Dr. Halstead, I can't thank you enough.
788
00:36:37,609 --> 00:36:39,598
I'm just sorry we had to
put you through all that.
789
00:36:39,623 --> 00:36:42,247
Oh, it was worth it, believe me.
790
00:36:44,703 --> 00:36:46,574
That's where I'm going to be next month.
791
00:36:48,576 --> 00:36:50,360
I'm adding it to my bucket list.
792
00:36:54,520 --> 00:36:56,105
Would you excuse me for a moment?
793
00:36:56,149 --> 00:36:57,367
Of course.
794
00:36:59,644 --> 00:37:01,516
Ms. Goodwin.
795
00:37:01,541 --> 00:37:04,045
Stop by my office
before you leave tonight.
796
00:37:04,070 --> 00:37:05,375
I'd like a word.
797
00:37:07,465 --> 00:37:09,336
Will do.
798
00:37:13,209 --> 00:37:15,864
Dr. Choi,
799
00:37:15,908 --> 00:37:19,433
uh, this is for you.
800
00:37:19,477 --> 00:37:21,108
I saw you were staying on
for the night shift,
801
00:37:21,133 --> 00:37:24,003
so I figured you might
need a caffeine boost.
802
00:37:24,046 --> 00:37:25,613
Oh, and these are also for you.
803
00:37:25,657 --> 00:37:28,007
It's my CV, in-progress research papers,
804
00:37:28,050 --> 00:37:29,836
and all my case logs to date.
805
00:37:30,664 --> 00:37:32,971
For our first advisor meeting tomorrow.
806
00:37:33,578 --> 00:37:37,922
Ah, well, you are really prepared, Zach.
807
00:37:38,250 --> 00:37:39,758
Will you excuse me?
808
00:37:39,801 --> 00:37:41,716
Yeah, of course.
809
00:37:41,760 --> 00:37:43,718
See you tomorrow.
810
00:37:43,762 --> 00:37:46,025
See you tomorrow.
811
00:37:46,068 --> 00:37:48,375
- Hey.
- Hey.
812
00:37:48,418 --> 00:37:50,986
Liza agreed to be admitted
overnight for observation.
813
00:37:51,030 --> 00:37:52,901
Good.
814
00:37:52,945 --> 00:37:55,295
She's in withdrawal, I take it.
815
00:37:55,338 --> 00:37:57,210
Don't worry, I won't say anything.
816
00:37:57,253 --> 00:37:59,299
I appreciate that, Ethan.
817
00:37:59,342 --> 00:38:02,389
And while I suspect that the drugs
have already cleared her system,
818
00:38:02,432 --> 00:38:04,130
she's terrified someone
might report her.
819
00:38:04,173 --> 00:38:08,086
The last thing she needs is to be
penalized for seeking care.
820
00:38:09,352 --> 00:38:11,398
Look, you were
absolutely right, by the way,
821
00:38:11,441 --> 00:38:13,443
to bring in Dr. Patchefsky.
822
00:38:13,487 --> 00:38:15,315
I never should have
given you flack for that.
823
00:38:15,358 --> 00:38:18,318
Look, I know how frustrating it is
824
00:38:18,361 --> 00:38:21,060
to always feel like you're being held
825
00:38:21,103 --> 00:38:23,715
to some former version of yourself.
826
00:38:23,758 --> 00:38:26,413
But on the flip side,
because of who you were
827
00:38:26,456 --> 00:38:28,154
and what you went through,
828
00:38:28,197 --> 00:38:29,764
you were able to connect to Liza
829
00:38:29,808 --> 00:38:31,679
in a way no one else could.
830
00:38:33,202 --> 00:38:35,335
Yeah.
831
00:38:35,378 --> 00:38:36,597
I guess that's true.
832
00:38:38,381 --> 00:38:40,601
Maybe it's not always such a bad thing,
833
00:38:40,645 --> 00:38:42,777
having your reputation precede you.
834
00:38:50,742 --> 00:38:52,831
Great work today, Sam.
835
00:38:59,054 --> 00:39:00,229
Goodnight, Dr. Taylor.
836
00:39:05,609 --> 00:39:07,393
Ooh, ouch.
837
00:39:07,672 --> 00:39:12,372
Why, I see you've got yourself
quite the fan club.
838
00:39:12,415 --> 00:39:14,374
You know, maybe I was wrong about you.
839
00:39:14,417 --> 00:39:16,942
You might be cut out
for island life after all.
840
00:39:21,337 --> 00:39:24,645
So let me get this straight.
841
00:39:24,689 --> 00:39:27,517
You gave the patient an antibiotic
842
00:39:27,561 --> 00:39:29,519
you knew she was allergic to...
843
00:39:29,563 --> 00:39:32,131
Only after I advised her
of the potential risks
844
00:39:32,174 --> 00:39:33,872
and with her full consent.
845
00:39:33,915 --> 00:39:36,178
Which, trust me,
wouldn't hold up in court
846
00:39:36,222 --> 00:39:38,790
if this thing had gone sideways.
847
00:39:38,833 --> 00:39:40,835
Well, Ms. Goodwin,
it wasn't my first choice.
848
00:39:40,879 --> 00:39:43,229
I understand the new protocols got off
849
00:39:43,272 --> 00:39:45,057
to a bit of a rocky start today, but...
850
00:39:45,100 --> 00:39:47,320
They're not working.
851
00:39:47,363 --> 00:39:50,192
I have no doubt they were designed
with the best of intentions,
852
00:39:50,236 --> 00:39:52,542
but as your boots on the ground,
I have to give it to you straight.
853
00:39:52,586 --> 00:39:54,849
Let me give it to you straight.
854
00:39:54,893 --> 00:39:59,288
These supply chain issues are
not gonna resolve anytime soon,
855
00:39:59,332 --> 00:40:02,291
and not for lack of trying on my part.
856
00:40:02,335 --> 00:40:06,687
So as imperfect as these
new protocols may be,
857
00:40:06,731 --> 00:40:09,468
we need some sort of semblance
858
00:40:09,493 --> 00:40:12,824
of order in the ED.
859
00:40:12,867 --> 00:40:16,741
I can't have it turning
into the Wild West!
860
00:40:18,568 --> 00:40:21,746
Honestly, Ms. Goodwin,
I think we're already there.
861
00:40:33,389 --> 00:40:37,389
- Synced and corrected by synk -
- www.addic7ed.com -
63910
Can't find what you're looking for?
Get subtitles in any language from opensubtitles.com, and translate them here.