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1
00:00:12,641 --> 00:00:15,175
I asked you to plant one
bug then walk away.
2
00:00:15,200 --> 00:00:16,513
But no, you couldn't do that.
3
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Hell, you don't seem to get it.
4
00:00:17,862 --> 00:00:19,574
As a physician, I have
a responsibility...
5
00:00:19,599 --> 00:00:21,192
I'm so tired of hearing that.
6
00:00:21,527 --> 00:00:23,359
After the MRI fiasco, Ray Burke said
7
00:00:23,384 --> 00:00:25,916
he was done with you and
still you called him.
8
00:00:25,941 --> 00:00:28,204
Well, I need to speak to
him about his MRI results.
9
00:00:28,326 --> 00:00:29,768
I'm concerned.
10
00:00:29,793 --> 00:00:31,192
Concerned how?
11
00:00:31,800 --> 00:00:33,603
There are some subdural hematomas
12
00:00:33,628 --> 00:00:35,349
and plaques in both his carotids.
13
00:00:35,778 --> 00:00:37,452
It could mean he's at
risk for a stroke.
14
00:00:37,636 --> 00:00:38,296
Could?
15
00:00:38,321 --> 00:00:39,665
I can't make a diagnosis
16
00:00:39,690 --> 00:00:40,693
without more of a work-up.
17
00:00:40,718 --> 00:00:43,339
That case, there's nothing
to report to Ray about.
18
00:00:43,536 --> 00:00:45,490
We could have nailed
that scumbag a week ago
19
00:00:45,515 --> 00:00:47,138
if you hadn't screwed things up.
20
00:00:47,163 --> 00:00:48,342
No more calls.
21
00:00:48,367 --> 00:00:49,936
I can't just walk away.
22
00:00:50,350 --> 00:00:52,836
You can and you will.
23
00:00:52,861 --> 00:00:54,905
It's over, Dr. Halstead.
24
00:00:55,478 --> 00:00:58,721
Hey, you made this mess when
you took Ray's kickback.
25
00:00:58,978 --> 00:01:00,682
This is on you.
26
00:01:04,972 --> 00:01:07,573
Will, who was that woman?
27
00:01:07,759 --> 00:01:09,282
Oh, just a drug rep.
28
00:01:09,307 --> 00:01:10,945
They just won't leave me alone.
29
00:01:11,105 --> 00:01:12,705
Really? I've never seen her before.
30
00:01:12,730 --> 00:01:14,591
So, listen, the DJ texted me.
31
00:01:14,778 --> 00:01:15,970
The wedding's only three weeks away.
32
00:01:15,995 --> 00:01:17,383
We haven't given him a song list.
33
00:01:17,408 --> 00:01:18,986
What was she pushing?
34
00:01:19,074 --> 00:01:20,307
The drug rep.
35
00:01:20,500 --> 00:01:23,215
Oh, just some calcium channel blocker.
36
00:01:23,420 --> 00:01:25,121
Uh, so about the DJ...
37
00:01:25,187 --> 00:01:27,356
- It's Maggie.
- Yeah, me too.
38
00:01:31,594 --> 00:01:33,244
Father and daughter
hit and run victims.
39
00:01:33,269 --> 00:01:35,274
This is Abigail Jones, two years old.
40
00:01:35,299 --> 00:01:37,857
GCS nine, blunt head
trauma with lacerations.
41
00:01:37,882 --> 00:01:39,465
IO line in the left leg.
42
00:01:39,490 --> 00:01:41,502
Abigail, it's gonna be okay.
43
00:01:41,527 --> 00:01:43,401
- Where's the father?
- En route.
44
00:01:43,426 --> 00:01:44,882
Other ambo was trying to get an airway
45
00:01:44,907 --> 00:01:46,230
when we rolled away from the scene.
46
00:01:46,255 --> 00:01:48,327
They were in crosswalk.
They had the signal.
47
00:01:48,352 --> 00:01:49,904
Car plowed right through them.
48
00:01:50,821 --> 00:01:53,324
Let's transfer on my
count: One, two, three.
49
00:01:58,203 --> 00:02:00,240
Abigail? Abigail?
50
00:02:00,265 --> 00:02:01,890
She's unresponsive. I need to intubate.
51
00:02:01,915 --> 00:02:02,942
Broselow tape.
52
00:02:02,967 --> 00:02:04,152
And a chest X-ray.
53
00:02:06,148 --> 00:02:08,640
Just about 12 to 14 kilos.
54
00:02:08,665 --> 00:02:09,837
Yellow drawer.
55
00:02:09,862 --> 00:02:11,836
Four etomidate. 20 of sux.
56
00:02:11,861 --> 00:02:13,403
BP 100 over 70.
57
00:02:13,428 --> 00:02:14,982
Heart rate 136.
58
00:02:15,007 --> 00:02:16,339
Sats 88.
59
00:02:19,734 --> 00:02:22,163
X-rays in place. Nat, tell us when.
60
00:02:22,493 --> 00:02:24,118
All right, I'm in.
61
00:02:25,069 --> 00:02:26,398
Go.
62
00:02:30,133 --> 00:02:31,925
Clear.
63
00:02:31,950 --> 00:02:33,225
Right side's whited out.
64
00:02:33,250 --> 00:02:34,469
Chest tube.
65
00:02:34,680 --> 00:02:36,030
Ultrasound.
66
00:02:37,110 --> 00:02:38,595
Sats down to 80.
67
00:02:44,803 --> 00:02:46,981
Fastscan's negative.
No blood in the belly.
68
00:02:50,070 --> 00:02:51,538
Tubes in.
69
00:02:51,563 --> 00:02:53,827
Sats coming back up. 100%.
70
00:02:53,852 --> 00:02:55,674
BP and heart rate's
stabilizing, as well.
71
00:02:57,207 --> 00:02:59,668
Pupils are reactive but sluggish.
72
00:02:59,693 --> 00:03:01,196
Heads up, paramedics are coming in
73
00:03:01,221 --> 00:03:02,523
with the father right now.
74
00:03:02,791 --> 00:03:04,835
You go take him. I'll finish this.
75
00:03:06,231 --> 00:03:07,640
Marc Jones, 32.
76
00:03:07,665 --> 00:03:09,770
GCS 3, intubated in the field.
77
00:03:09,795 --> 00:03:11,240
Suspect a C-spine injury.
78
00:03:11,265 --> 00:03:12,897
There's a step off on
the back of his neck.
79
00:03:12,922 --> 00:03:14,956
All right. Let's transfer him.
80
00:03:15,053 --> 00:03:17,066
One... two... three.
81
00:03:19,710 --> 00:03:21,222
- Thank you, Cesar.
- Yep.
82
00:03:28,489 --> 00:03:30,828
Good breath sounds bilaterally.
83
00:03:31,857 --> 00:03:34,984
BP 88 over 58. Heart rate 120.
84
00:03:35,009 --> 00:03:36,049
Should we start a neo bag?
85
00:03:36,074 --> 00:03:37,716
Yes, titrate to a pressure of 110.
86
00:03:37,741 --> 00:03:39,092
Need a chest X-ray and an ultrasound.
87
00:03:39,117 --> 00:03:40,020
Yep.
88
00:03:43,700 --> 00:03:45,761
Oh, my God.
89
00:03:45,786 --> 00:03:47,322
Dr. Halstead.
90
00:03:48,670 --> 00:03:50,089
Hold on.
91
00:03:51,846 --> 00:03:55,900
_
92
00:04:01,429 --> 00:04:06,927
- Synced and corrected by martythecrazy -
- www.addic7ed.com -
93
00:04:15,311 --> 00:04:16,877
How's the little girl?
94
00:04:16,946 --> 00:04:19,279
Her vitals are stable and
no long bone fractures.
95
00:04:19,348 --> 00:04:22,434
But CT Head shows diffuse
intraparenchymal bleeding.
96
00:04:22,459 --> 00:04:24,230
And what did neuro say?
97
00:04:24,255 --> 00:04:25,467
I just got off the phone with them.
98
00:04:25,492 --> 00:04:27,543
They put in a pressure monitor,
and they agreed with me
99
00:04:27,568 --> 00:04:29,340
to treat with
hyperventilation and mannitol
100
00:04:29,365 --> 00:04:30,903
to reduce the intracranial pressure.
101
00:04:30,972 --> 00:04:32,578
And what about the father?
102
00:04:32,603 --> 00:04:35,146
Intubated but unresponsive
without sedation.
103
00:04:35,280 --> 00:04:37,683
- So, a brain injury?
- I'm not sure.
104
00:04:37,708 --> 00:04:39,801
Pupils are equal and reactive,
so that's a good sign.
105
00:04:39,826 --> 00:04:41,356
We're just waiting on
scan results to see
106
00:04:41,381 --> 00:04:42,839
how bad the injuries are.
107
00:04:42,864 --> 00:04:45,623
Look, Marc's stable now, but
what if he goes downhill?
108
00:04:45,754 --> 00:04:47,184
He's wearing a lot of ink.
109
00:04:47,209 --> 00:04:49,331
Is this "Do No Resuscitate"
a legit advanced directive?
110
00:04:49,434 --> 00:04:51,420
The hospital's got a team of lawyers
111
00:04:51,445 --> 00:04:52,904
trying to figure that out.
112
00:04:52,929 --> 00:04:54,180
What about his family?
113
00:04:54,205 --> 00:04:55,657
Do they know if he meant it or not?
114
00:04:55,682 --> 00:04:56,609
We're looking for them too.
115
00:04:56,634 --> 00:04:58,488
It seems it's just Mr. Jones
116
00:04:58,513 --> 00:05:00,499
and his daughter,
Abigail, in the world.
117
00:05:00,524 --> 00:05:02,172
He had on a wedding ring.
There's no wife?
118
00:05:02,197 --> 00:05:04,999
There was, Melinda. Legal
found an obituary.
119
00:05:05,024 --> 00:05:07,859
She died last year. Ovarian cancer.
120
00:05:07,972 --> 00:05:09,509
If his wife had to be intubated
121
00:05:09,534 --> 00:05:11,208
and wasn't able to get off the vent,
122
00:05:11,233 --> 00:05:14,171
seeing her like that could
be why he got that tattoo.
123
00:05:14,874 --> 00:05:16,471
Yeah, maybe that's what
he was feeling then,
124
00:05:16,496 --> 00:05:17,660
but what about now?
125
00:05:17,685 --> 00:05:18,883
He's all Abigail has.
126
00:05:18,908 --> 00:05:20,825
I can't see him not wanting
us to do everything
127
00:05:20,850 --> 00:05:22,538
in our power to keep him alive for her.
128
00:05:22,563 --> 00:05:24,068
Well, the truth is, we don't know why
129
00:05:24,093 --> 00:05:27,256
Mr. Jones got the tattoo or
how he feels about it now.
130
00:05:27,281 --> 00:05:29,202
So, let's not jump to conclusions
131
00:05:29,227 --> 00:05:31,301
until we have real facts.
132
00:05:31,475 --> 00:05:32,975
And in the meantime?
133
00:05:33,000 --> 00:05:35,676
While the hospital does
their due diligence,
134
00:05:35,701 --> 00:05:37,247
err on the side of life.
135
00:05:37,332 --> 00:05:38,682
Thank you.
136
00:05:44,423 --> 00:05:47,016
Keegan and I have been
neighbors for a few months.
137
00:05:47,041 --> 00:05:48,239
Since I moved back.
138
00:05:48,264 --> 00:05:50,497
I'm only here 'cause
Vicki talked me into it.
139
00:05:50,522 --> 00:05:52,874
At this point, I've
given up on doctors.
140
00:05:53,341 --> 00:05:56,024
Whoa, no, no, no. No more scratching.
141
00:05:56,049 --> 00:05:58,901
I can't help it. It's been three years.
142
00:05:58,958 --> 00:06:00,685
Three years. Never stops.
143
00:06:00,710 --> 00:06:02,042
And it started with a MRSA infection?
144
00:06:02,067 --> 00:06:03,617
The antibiotics to treat it.
145
00:06:03,642 --> 00:06:06,191
Linezolid. Side effect was pruritus.
146
00:06:06,216 --> 00:06:08,168
- Bad itch, huh?
- Mm, the worst.
147
00:06:08,193 --> 00:06:11,527
Everywhere. And I mean everywhere.
148
00:06:11,552 --> 00:06:13,027
But the reaction went away
149
00:06:13,052 --> 00:06:14,620
when she stopped taking the pills.
150
00:06:14,645 --> 00:06:16,245
Except for right here,
and it is killing me
151
00:06:16,270 --> 00:06:17,788
not to scratch it right now.
152
00:06:17,813 --> 00:06:19,466
The itch never lets up?
153
00:06:19,596 --> 00:06:21,297
In the shower? When you're sleeping?
154
00:06:21,322 --> 00:06:22,254
Never.
155
00:06:22,279 --> 00:06:23,917
I've used toothbrushes,
156
00:06:23,942 --> 00:06:26,722
pencils, even steel wool once.
157
00:06:26,843 --> 00:06:28,951
Nothing stops the itch.
158
00:06:29,060 --> 00:06:31,011
- Easy, Keegan. Keegan.
- Stop. Stop-
159
00:06:31,050 --> 00:06:32,558
- Stop.
- I know it's hard.
160
00:06:32,583 --> 00:06:34,552
Just try not to scratch.
161
00:06:34,798 --> 00:06:36,297
All right, I'm gonna clean it out
162
00:06:36,322 --> 00:06:38,020
and apply some steroid cream.
163
00:06:38,045 --> 00:06:39,780
Should help calm it down.
164
00:06:40,266 --> 00:06:41,999
That won't do anything.
165
00:06:42,068 --> 00:06:45,100
I've tried creams and
antihistamines, acupuncture.
166
00:06:45,125 --> 00:06:48,943
I've seen dozens of doctors,
dermatologists, allergists.
167
00:06:48,968 --> 00:06:50,449
Nothing helps.
168
00:06:50,956 --> 00:06:52,790
I... I just can't stop.
169
00:06:53,779 --> 00:06:54,827
D... don't. Don't. Don't. Don't.
170
00:06:54,852 --> 00:06:57,226
- Doesn't that hurt?
- All I feel is the itch.
171
00:06:57,251 --> 00:06:59,050
It's all day, every day.
172
00:06:59,075 --> 00:07:01,121
Please just find it and cut it out.
173
00:07:01,371 --> 00:07:02,933
Okay.
174
00:07:02,958 --> 00:07:05,682
Let's get a full set of
labs and go from there.
175
00:07:07,902 --> 00:07:09,577
I'll be back with the results.
176
00:07:10,864 --> 00:07:12,565
No more scratching.
177
00:07:12,590 --> 00:07:14,074
Thank you.
178
00:07:18,604 --> 00:07:20,581
I've never seen anything like this.
179
00:07:20,606 --> 00:07:21,875
She's down to the muscle.
180
00:07:21,900 --> 00:07:23,676
And she was serious about
trying everything.
181
00:07:23,701 --> 00:07:25,259
I looked inside her medicine cabinet,
182
00:07:25,284 --> 00:07:26,767
it's like a pharmacy.
183
00:07:26,911 --> 00:07:28,979
I tried to help her,
but she didn't serve,
184
00:07:29,004 --> 00:07:30,450
so I can't bring her to the VA.
185
00:07:30,682 --> 00:07:33,484
How much do you know about
Keegan outside of the itch?
186
00:07:33,509 --> 00:07:34,983
Is she...
187
00:07:35,008 --> 00:07:36,298
Crazy?
188
00:07:36,906 --> 00:07:40,172
I don't think so, but an
itch for three years...
189
00:07:40,197 --> 00:07:41,101
Yeah.
190
00:07:41,753 --> 00:07:43,380
I'm gonna get psych involved.
191
00:07:43,405 --> 00:07:44,704
Thanks for bringing her in.
192
00:07:44,729 --> 00:07:45,813
Thanks.
193
00:07:45,838 --> 00:07:46,837
Yeah.
194
00:07:50,630 --> 00:07:53,176
So, Vicki's here.
195
00:07:53,858 --> 00:07:55,738
She just brought in a patient.
196
00:07:57,200 --> 00:07:59,701
This is the only hospital in Chicago?
197
00:08:01,141 --> 00:08:03,936
You trying to tell me something?
198
00:08:05,827 --> 00:08:07,468
No.
199
00:08:08,788 --> 00:08:10,521
Okay.
200
00:08:12,326 --> 00:08:15,361
April, I appreciate you covering for me
201
00:08:15,386 --> 00:08:17,247
every time I'm in the Hybrid OR.
202
00:08:17,272 --> 00:08:18,994
Of course I don't expect you to know
203
00:08:19,019 --> 00:08:20,029
everything that I've learned,
204
00:08:20,054 --> 00:08:22,713
so I made a reference guide for you.
205
00:08:22,750 --> 00:08:24,444
Well, I haven't had any problems.
206
00:08:24,660 --> 00:08:27,651
Well, not yet, but it's
good to be prepared.
207
00:08:27,790 --> 00:08:29,534
"Obligations and Proficiencies
208
00:08:29,559 --> 00:08:31,384
of the Charge Nurse."
209
00:08:31,602 --> 00:08:34,459
People don't realize how
complex the job can be.
210
00:08:34,770 --> 00:08:36,705
How many pages is this thing?
211
00:08:37,032 --> 00:08:39,705
Is there a PowerPoint
presentation to go with it?
212
00:08:39,927 --> 00:08:41,426
Is that gonna be a problem?
213
00:08:42,011 --> 00:08:43,811
No problem.
214
00:08:45,946 --> 00:08:47,645
Vicki brought in the patient.
215
00:08:47,714 --> 00:08:50,148
Vicki. Your... uh...
your friend, Vicki?
216
00:08:50,216 --> 00:08:51,823
Former friend. Yeah.
217
00:08:52,020 --> 00:08:53,686
Keegan. I'm Dr. Charles.
218
00:08:53,711 --> 00:08:54,910
How you doing?
219
00:08:57,383 --> 00:08:59,569
Of course. The shrink.
220
00:08:59,745 --> 00:09:02,687
Look, this isn't because of feelings,
221
00:09:02,712 --> 00:09:03,795
and it's not OCD.
222
00:09:03,820 --> 00:09:05,888
I don't have delusional parasitosis
223
00:09:05,913 --> 00:09:07,540
or a conversion disorder.
224
00:09:07,565 --> 00:09:09,042
And the itching didn't
start after my dad died
225
00:09:09,067 --> 00:09:10,834
or my boyfriend left me.
226
00:09:11,387 --> 00:09:13,040
Look, I'm not insane.
227
00:09:13,151 --> 00:09:15,936
My head just itches and
I want it to stop.
228
00:09:16,013 --> 00:09:17,203
Okay.
229
00:09:17,228 --> 00:09:19,538
Well, let's try to make that happen.
230
00:09:19,882 --> 00:09:21,104
Really?
231
00:09:21,129 --> 00:09:24,230
Usually docs are writing me
a referral so I'll leave.
232
00:09:24,255 --> 00:09:25,497
Well, you came to us for help,
233
00:09:25,522 --> 00:09:26,989
so we're gonna help ya.
234
00:09:27,073 --> 00:09:28,406
Just for now though,
do you think you can
235
00:09:28,431 --> 00:09:29,765
keep your hand away from the wound?
236
00:09:30,323 --> 00:09:31,742
I can't help it.
237
00:09:31,767 --> 00:09:33,080
Okay.
238
00:09:33,105 --> 00:09:36,443
So Dr. Choi told me that
you've tried OTC's,
239
00:09:36,515 --> 00:09:39,066
prescriptions, host of home remedies.
240
00:09:39,091 --> 00:09:40,839
How 'bout bupivacaine?
241
00:09:40,978 --> 00:09:42,162
What's that?
242
00:09:42,187 --> 00:09:43,816
A local anesthetic.
243
00:09:43,841 --> 00:09:45,411
Five mil should do it.
244
00:09:45,436 --> 00:09:47,793
I'd like to apply a
little bit to the area.
245
00:09:47,818 --> 00:09:49,805
If it provides relief,
it would suggest that
246
00:09:49,830 --> 00:09:52,445
the problem might lie in your
cutaneous nerve endings.
247
00:09:52,470 --> 00:09:55,020
And that would help suggest a
treatment plan going forward.
248
00:09:55,599 --> 00:09:57,530
Then stop talking and get to it.
249
00:09:57,555 --> 00:09:58,919
You're gonna feel a pinch.
250
00:09:59,136 --> 00:10:00,794
Do it.
251
00:10:01,532 --> 00:10:02,924
Whoa.
252
00:10:03,715 --> 00:10:05,157
Okay.
253
00:10:07,036 --> 00:10:08,535
It feels different.
254
00:10:08,560 --> 00:10:09,792
Different how?
255
00:10:10,100 --> 00:10:11,211
Better.
256
00:10:11,236 --> 00:10:14,248
I mean, it tingles a little,
but it itches less.
257
00:10:14,630 --> 00:10:17,123
Hmm. That's a good start.
258
00:10:17,159 --> 00:10:18,424
Yeah.
259
00:10:18,477 --> 00:10:20,074
We'll check on you in a bit.
260
00:10:25,760 --> 00:10:27,724
So, anesthetic should provide relief
261
00:10:27,749 --> 00:10:29,330
for like, three or four hours.
262
00:10:29,355 --> 00:10:31,218
Itch doesn't come back, then set her up
263
00:10:31,243 --> 00:10:32,968
with some topical patches to take home.
264
00:10:32,993 --> 00:10:34,326
Sounds good.
265
00:10:35,115 --> 00:10:36,615
Mannequins?
266
00:10:36,640 --> 00:10:38,548
Look, I was a department
store latchkey kid.
267
00:10:38,573 --> 00:10:40,350
So, I took what I could get.
268
00:10:40,375 --> 00:10:41,819
Jenny was basically
my first girlfriend.
269
00:10:41,844 --> 00:10:44,320
Which is why I am such a good kisser.
270
00:10:44,566 --> 00:10:46,633
I don't think I know how
to feel about this.
271
00:10:46,658 --> 00:10:48,205
On the one hand, it's very disturbing.
272
00:10:48,230 --> 00:10:50,907
On the other, I should
probably be thanking Jenny
273
00:10:50,932 --> 00:10:52,873
for those years of practice.
274
00:10:52,898 --> 00:10:55,006
Hold on. It wasn't years, okay?
275
00:10:55,031 --> 00:10:57,798
Dr. Rhodes... was looking for you.
276
00:10:57,993 --> 00:11:00,439
I wanted to tell you
before you got the memo.
277
00:11:00,665 --> 00:11:02,339
The Hybrid Room will be used
278
00:11:02,364 --> 00:11:04,540
for general surgeries when needed.
279
00:11:04,752 --> 00:11:05,985
General surgeries?
280
00:11:06,010 --> 00:11:07,632
Appendectomies, gall bladders...
281
00:11:07,657 --> 00:11:09,699
So, everything but trauma, which is why
282
00:11:09,724 --> 00:11:10,945
we built it in the first place.
283
00:11:10,970 --> 00:11:13,464
Look, the Hybrid Room was expensive.
284
00:11:13,489 --> 00:11:14,955
It came in over budget.
285
00:11:15,098 --> 00:11:17,662
Using it when we can will
help balance the books.
286
00:11:17,687 --> 00:11:18,874
You mean, pad them?
287
00:11:18,899 --> 00:11:20,724
Well, profit's not a bad thing.
288
00:11:20,749 --> 00:11:21,982
Ms. Goodwin, this is Chicago.
289
00:11:22,007 --> 00:11:23,847
We get six traumas before lunch.
290
00:11:23,872 --> 00:11:24,986
What are those patients supposed to do?
291
00:11:25,011 --> 00:11:26,649
I don't know, take a number?
292
00:11:26,674 --> 00:11:31,020
Well, your displeasure is noted, Dr.
Rhodes.
293
00:11:31,408 --> 00:11:32,908
And overruled.
294
00:11:34,791 --> 00:11:36,512
When does all this start?
295
00:11:37,061 --> 00:11:38,463
Today.
296
00:11:38,594 --> 00:11:41,777
In fact, Dr. Lanik will take the lead.
297
00:11:45,736 --> 00:11:47,646
This is a terrible idea.
298
00:11:48,206 --> 00:11:50,206
It's gotta be Gwen Garrett.
299
00:11:52,950 --> 00:11:54,075
Let it go.
300
00:11:54,264 --> 00:11:56,041
This isn't a hill to die on.
301
00:12:02,317 --> 00:12:04,228
Damn it!
302
00:12:04,260 --> 00:12:05,685
Call Dr. Charles.
303
00:12:06,718 --> 00:12:07,917
Keegan, stop. Don't scratch.
304
00:12:07,942 --> 00:12:09,762
Oh, the itch is back and
it's worse than before.
305
00:12:09,787 --> 00:12:10,841
You have to stop scratching.
306
00:12:10,866 --> 00:12:13,252
Oh, then you have to tie me down.
307
00:12:13,277 --> 00:12:15,122
- Five milligrams of diazepam.
- On it.
308
00:12:15,147 --> 00:12:17,694
I can't live like this anymore.
309
00:12:17,719 --> 00:12:19,368
I'd rather be dead.
310
00:12:19,393 --> 00:12:20,732
What happened?
311
00:12:22,693 --> 00:12:24,765
Oh, God.
312
00:12:25,464 --> 00:12:27,532
She scratched through to her skull.
313
00:12:40,328 --> 00:12:41,494
How's Abigail?
314
00:12:41,563 --> 00:12:43,963
Fighting. How's the dad?
315
00:12:44,678 --> 00:12:46,111
Scans are back.
316
00:12:46,136 --> 00:12:48,421
CT brain revealed no
bleeding, and there's no
317
00:12:48,446 --> 00:12:49,845
obvious brain trauma.
318
00:12:49,870 --> 00:12:51,403
Well, that's good news.
319
00:12:51,472 --> 00:12:54,353
Yeah, except the CT C-spine
320
00:12:54,378 --> 00:12:56,796
revealed a subluxation at C3 on 4.
321
00:12:57,038 --> 00:12:58,504
MRI confirmed?
322
00:12:58,529 --> 00:13:00,522
Complete spinal cord transection.
323
00:13:00,732 --> 00:13:02,702
He's paralyzed from the neck down.
324
00:13:03,445 --> 00:13:05,160
I'm sorry.
325
00:13:05,565 --> 00:13:06,649
I just spoke with Jay.
326
00:13:06,674 --> 00:13:08,501
PD caught the driver who hit them.
327
00:13:09,732 --> 00:13:11,810
He blew through a red light
because he was texting.
328
00:13:13,146 --> 00:13:16,981
BP's spiked, 146 over 94.
Heart rate's down, 54.
329
00:13:18,200 --> 00:13:19,827
Cushing's Reflex.
330
00:13:19,852 --> 00:13:21,919
Her intracranial pressure is worsening.
331
00:13:21,944 --> 00:13:22,951
She needs more hyperventilation.
332
00:13:22,976 --> 00:13:24,142
Get her off the vent.
333
00:13:26,093 --> 00:13:27,559
Heart rate's still dropping.
334
00:13:27,584 --> 00:13:28,750
47.
335
00:13:28,775 --> 00:13:30,215
Two milligrams of atropine.
336
00:13:34,277 --> 00:13:35,659
It's in.
337
00:13:35,992 --> 00:13:38,390
Come on. Come on.
338
00:13:38,579 --> 00:13:41,562
Heart rate's coming back up. 49....
339
00:13:41,705 --> 00:13:42,961
51...
340
00:13:42,986 --> 00:13:45,630
Come on. Come on.
341
00:13:45,749 --> 00:13:47,340
Come on, Abigail.
342
00:13:52,395 --> 00:13:53,862
Dr. Rhodes, you're gonna bag that.
343
00:13:53,887 --> 00:13:55,411
Yep. Talk to me.
344
00:13:55,436 --> 00:13:56,638
James Brice, 24.
345
00:13:56,663 --> 00:13:58,675
GCS 7. Hypotensive.
346
00:13:58,707 --> 00:14:00,768
Intubated en route. Belly's distended.
347
00:14:00,793 --> 00:14:01,557
What happened?
348
00:14:01,582 --> 00:14:03,248
He was putting in storm
windows for the nursery.
349
00:14:03,273 --> 00:14:04,638
He fell off the ladder.
350
00:14:04,663 --> 00:14:05,829
At least 20 feet.
351
00:14:05,854 --> 00:14:07,602
I was worried the baby
would be cold this winter.
352
00:14:07,627 --> 00:14:09,111
It's okay. Don't worry.
353
00:14:09,136 --> 00:14:10,329
It's not your fault. Maggie?
354
00:14:10,354 --> 00:14:11,175
I got her.
355
00:14:11,200 --> 00:14:12,252
Mrs. Brice, why don't you come with me,
356
00:14:12,277 --> 00:14:13,784
and let the doctors work, okay?
357
00:14:13,809 --> 00:14:15,235
He keeps trying to die on us.
358
00:14:15,260 --> 00:14:16,693
All right. On my count.
359
00:14:16,718 --> 00:14:18,364
One, two, three.
360
00:14:24,808 --> 00:14:26,571
Good breath sounds on
the left and the right.
361
00:14:26,596 --> 00:14:27,983
Let's get a chest X-ray.
362
00:14:28,008 --> 00:14:30,054
Field IV is blown. We
don't have access.
363
00:14:30,079 --> 00:14:31,272
All right.
364
00:14:31,297 --> 00:14:33,241
Ava, can you get a line in?
365
00:14:33,266 --> 00:14:34,784
Give me a kit.
366
00:14:36,218 --> 00:14:37,718
X-ray's up.
367
00:14:37,743 --> 00:14:39,017
Everybody clear.
368
00:14:40,774 --> 00:14:42,012
Looks good.
369
00:14:43,993 --> 00:14:46,958
Belly's hard as a rock.
Give me a Fastscan.
370
00:14:53,629 --> 00:14:55,045
It's full of blood.
371
00:14:55,070 --> 00:14:56,803
I need to get in there
and find the bleed.
372
00:14:59,155 --> 00:15:00,809
We'll use the Hybrid OR.
373
00:15:00,989 --> 00:15:02,151
We can make it upstairs.
374
00:15:02,176 --> 00:15:03,236
There are operating rooms available.
375
00:15:03,261 --> 00:15:04,789
There's also one right across the ED.
376
00:15:04,814 --> 00:15:06,464
- Much closer.
- Connor, Goodwin just to you...
377
00:15:06,489 --> 00:15:07,578
I know what she said.
378
00:15:07,603 --> 00:15:09,447
Find Maggie. Have her page my team.
379
00:15:10,504 --> 00:15:11,907
It's probably CT looking for you.
380
00:15:11,932 --> 00:15:12,975
I got this.
381
00:15:13,000 --> 00:15:14,457
You're going to get
yourself into trouble.
382
00:15:14,482 --> 00:15:15,713
I can't worry about that now.
383
00:15:15,738 --> 00:15:17,335
Get James ready to go.
384
00:15:19,607 --> 00:15:21,846
Lanik. I'm taking the Hybrid OR.
385
00:15:21,871 --> 00:15:23,805
My patient is on the table.
386
00:15:23,830 --> 00:15:26,247
His gall bladder can wait.
Bring him back next week.
387
00:15:26,272 --> 00:15:27,510
I'm not your resident, Connor.
388
00:15:27,535 --> 00:15:29,004
You can't order me around.
389
00:15:29,476 --> 00:15:32,464
Is your patient about to die?
Because mine sure is.
390
00:15:36,068 --> 00:15:38,946
Get Dr. Lanik's patient out and
re-prep the room for mine.
391
00:15:57,570 --> 00:15:58,803
Natalie.
392
00:15:58,918 --> 00:16:00,350
I just need a moment.
393
00:16:00,543 --> 00:16:02,287
Yeah, of course.
394
00:16:05,697 --> 00:16:07,890
All right. Thank you.
395
00:16:08,121 --> 00:16:10,399
April, I'm getting pulled into surgery.
396
00:16:10,424 --> 00:16:12,247
Okay, I'll hold it down out here.
397
00:16:12,272 --> 00:16:14,539
Oh, and I've got a delivery
of NG Tubes, Hep Locks,
398
00:16:14,564 --> 00:16:15,825
and ABD Pads coming in.
399
00:16:15,850 --> 00:16:17,233
I called it in late last night.
400
00:16:17,258 --> 00:16:18,624
I'll double check the order
against the invoice,
401
00:16:18,649 --> 00:16:19,673
make sure it's all there.
402
00:16:19,698 --> 00:16:20,862
All right. Oh.
403
00:16:20,887 --> 00:16:23,521
And it's payroll week, so
it means that you have...
404
00:16:23,546 --> 00:16:26,093
All the nurses need to sign
off on their timecards.
405
00:16:26,118 --> 00:16:28,226
Maggie, you're driving me crazy.
406
00:16:28,338 --> 00:16:30,088
If anything happens, I'll handle it.
407
00:16:30,270 --> 00:16:31,668
Okay, and you've got
the reference guide
408
00:16:31,693 --> 00:16:34,300
that I wrote, so we're all good.
409
00:16:34,325 --> 00:16:36,621
All good. Good, good, good.
410
00:16:40,776 --> 00:16:42,121
You want some company?
411
00:16:42,146 --> 00:16:43,856
I get it if you'd rather be alone.
412
00:16:43,881 --> 00:16:45,748
No, I'm glad to see you.
413
00:16:45,816 --> 00:16:47,516
How's Marc?
414
00:16:47,585 --> 00:16:50,253
No change. Still unconscious.
415
00:16:51,900 --> 00:16:54,025
Abigail was only two.
416
00:16:54,465 --> 00:16:56,832
And now she's gone.
417
00:16:56,857 --> 00:17:00,125
All because some guy couldn't
look away from his phone.
418
00:17:02,029 --> 00:17:04,741
But maybe something good
could come from all of this.
419
00:17:04,766 --> 00:17:08,614
I mean, all these kids
waiting for transplants.
420
00:17:08,639 --> 00:17:10,806
There are so few pediatric donors
421
00:17:10,831 --> 00:17:14,024
in comparison to the thousands
of children in need.
422
00:17:14,099 --> 00:17:16,435
Abigail could be an organ donor.
423
00:17:17,557 --> 00:17:19,223
As a minor, you know, she's gotta get
424
00:17:19,248 --> 00:17:20,719
a parent or guardian to sign off
425
00:17:20,744 --> 00:17:21,710
before she can donate.
426
00:17:21,735 --> 00:17:23,150
Yeah, I know that.
427
00:17:23,175 --> 00:17:25,346
And if Goodwin can't track
down any of her other family,
428
00:17:25,371 --> 00:17:29,273
then all that's left is her father.
429
00:17:30,754 --> 00:17:32,421
Do you think Marc will wake up?
430
00:17:34,216 --> 00:17:36,611
I've seen patients in
worse shape turn around.
431
00:17:46,962 --> 00:17:48,218
Well, that's a new one.
432
00:17:48,243 --> 00:17:50,290
Usually I have to cut them open
myself to get to the brain.
433
00:17:50,315 --> 00:17:51,530
So, what do you think?
434
00:17:51,555 --> 00:17:53,443
Well, for whatever reason,
the cutaneous nerves
435
00:17:53,468 --> 00:17:55,409
in that part of her scalp went haywire.
436
00:17:55,465 --> 00:17:57,669
Makes them always feel itchy,
so she keep scratching.
437
00:17:57,694 --> 00:17:58,745
There a fix?
438
00:17:58,770 --> 00:17:59,914
Yeah, surgery.
439
00:17:59,939 --> 00:18:01,005
Sever the nerve.
440
00:18:01,030 --> 00:18:02,600
No more feeling, no more itching.
441
00:18:02,625 --> 00:18:03,762
And no more scratching.
442
00:18:03,787 --> 00:18:06,980
Yeah, and possible serious,
irreversible side effects.
443
00:18:07,076 --> 00:18:08,712
Facial paralysis, blurred vision.
444
00:18:08,737 --> 00:18:10,211
Worst case, she ends
up in a wheelchair.
445
00:18:10,236 --> 00:18:12,872
I'm not cutting her open
in an alley, Daniel.
446
00:18:12,897 --> 00:18:14,931
The risks you're describing
are dwarfed by the reward.
447
00:18:14,956 --> 00:18:16,526
- Yeah, we hope.
- What do you suggest?
448
00:18:16,551 --> 00:18:18,360
Twice a week counseling sessions?
449
00:18:18,385 --> 00:18:19,667
Of course, we'd have to put
a cone around her neck
450
00:18:19,692 --> 00:18:21,022
to keep her from scratching.
451
00:18:21,047 --> 00:18:22,617
Sam, all those years of scratching,
452
00:18:22,642 --> 00:18:24,054
those nerves are shot.
453
00:18:24,079 --> 00:18:25,300
There's nothing left to go haywire.
454
00:18:25,325 --> 00:18:26,604
Dr. Charles, if that were the case,
455
00:18:26,629 --> 00:18:27,872
Keegan shouldn't feel anything.
456
00:18:27,897 --> 00:18:29,024
Let alone an itch.
457
00:18:29,049 --> 00:18:31,684
If those nerves were active,
that anesthetic would have
458
00:18:31,709 --> 00:18:33,032
provided relief for hours.
459
00:18:33,064 --> 00:18:34,371
- It didn't.
- You only used 5 mil.
460
00:18:34,396 --> 00:18:35,848
- It wasn't enough.
- I agree.
461
00:18:35,873 --> 00:18:37,734
The anesthetic didn't work
for long, but it did work.
462
00:18:37,759 --> 00:18:39,111
Proves the nerves are involved.
463
00:18:39,136 --> 00:18:41,002
Great, we have a majority.
Not that I care.
464
00:18:41,027 --> 00:18:42,934
- We done?
- Sam?
465
00:18:43,007 --> 00:18:44,953
All I'm saying, I don't think operating
466
00:18:44,978 --> 00:18:46,333
is gonna do a damn thing.
467
00:18:46,365 --> 00:18:47,814
Thanks for you input.
468
00:18:47,839 --> 00:18:50,252
But the last time I checked,
I was the neurosurgeon.
469
00:18:50,399 --> 00:18:52,266
Put her on the schedule.
470
00:18:53,726 --> 00:18:56,444
Isn't surgery supposed
to be the last option?
471
00:18:57,979 --> 00:19:01,070
Dr. Charles, she scratched
into her skull.
472
00:19:06,991 --> 00:19:08,724
What happened?
473
00:19:09,015 --> 00:19:10,688
He suddenly went into V-fib.
474
00:19:10,713 --> 00:19:12,666
Shocked him multiple times
and then he went asystolic.
475
00:19:12,691 --> 00:19:13,974
Another round of epi.
476
00:19:18,652 --> 00:19:20,116
It's in.
477
00:19:20,892 --> 00:19:22,120
Check for a pulse.
478
00:19:24,823 --> 00:19:26,358
Nothing.
479
00:19:26,383 --> 00:19:27,974
Come on, Marc.
480
00:19:29,883 --> 00:19:32,052
Don't you give up.
481
00:19:34,639 --> 00:19:36,806
Pulse is back. Sinus tach.
482
00:19:37,095 --> 00:19:38,294
He's back.
483
00:19:38,319 --> 00:19:39,895
All right.
484
00:19:40,087 --> 00:19:41,462
Prep him to move.
485
00:19:41,487 --> 00:19:43,907
I'll call ICU, tell them we're
sending him up for cooling.
486
00:19:46,769 --> 00:19:48,553
How long was he asystole?
487
00:19:48,578 --> 00:19:50,553
Almost ten minutes.
488
00:19:50,902 --> 00:19:52,671
What's your boyfriend thinking?
489
00:19:52,696 --> 00:19:54,294
This guy's not waking up.
490
00:20:09,599 --> 00:20:12,410
Hey, is your ulcer getting worse?
491
00:20:12,459 --> 00:20:13,992
Today's not helping.
492
00:20:14,017 --> 00:20:15,374
Yeah.
493
00:20:15,775 --> 00:20:17,986
So, I looked at the Paramedic's report
494
00:20:18,011 --> 00:20:19,778
from the accident scene.
495
00:20:19,960 --> 00:20:21,728
Marc was down at least five minutes
496
00:20:21,753 --> 00:20:23,085
before help arrived.
497
00:20:23,109 --> 00:20:25,723
And after this last
code it was almost ten.
498
00:20:25,748 --> 00:20:28,364
I mean, that's almost 15
minutes with no oxygen.
499
00:20:28,389 --> 00:20:29,255
I know.
500
00:20:29,314 --> 00:20:30,624
Increases the chances
the brain function
501
00:20:30,649 --> 00:20:32,312
he has is now compromised.
502
00:20:32,337 --> 00:20:33,690
But we won't know if that's the case
503
00:20:33,715 --> 00:20:35,125
until he wakes up.
504
00:20:35,150 --> 00:20:36,566
You think he really will?
505
00:20:36,591 --> 00:20:37,690
After he coded?
506
00:20:37,715 --> 00:20:38,948
I don't know.
507
00:20:40,747 --> 00:20:43,041
Maybe it's time to start thinking about
508
00:20:43,066 --> 00:20:45,266
honoring his advanced directive.
509
00:20:45,622 --> 00:20:46,988
Advanced directive?
510
00:20:47,013 --> 00:20:49,921
Nat, it is a tattoo,
not a legal document.
511
00:20:50,027 --> 00:20:52,027
It might be a proxy to one.
512
00:20:52,198 --> 00:20:54,452
And what if Marc does have
the paperwork to back it up?
513
00:20:54,477 --> 00:20:56,370
I mean, it could be at home in a file
514
00:20:56,395 --> 00:20:57,687
or in a safety deposit box.
515
00:20:57,712 --> 00:20:59,306
If something binding exists,
516
00:20:59,331 --> 00:21:00,843
the hospital's lawyers will find it,
517
00:21:00,868 --> 00:21:02,249
and I'll obey whatever it says.
518
00:21:02,274 --> 00:21:03,531
But until then, it's just a tattoo,
519
00:21:03,556 --> 00:21:04,699
and one of many.
520
00:21:04,724 --> 00:21:08,395
Will, Abigail's organs
are still healthy.
521
00:21:08,506 --> 00:21:10,163
But they won't be viable for long.
522
00:21:10,375 --> 00:21:12,127
Without Marc or any family to consent,
523
00:21:12,152 --> 00:21:13,818
we can't donate them.
524
00:21:14,283 --> 00:21:17,417
But if we honor his
tattoo and we let him go,
525
00:21:17,549 --> 00:21:19,039
then the hospital can
petition to become
526
00:21:19,064 --> 00:21:21,742
Abigail's legal guardian, and
we can make the decision
527
00:21:21,767 --> 00:21:24,666
to donate her organs
before they go to waste.
528
00:21:24,691 --> 00:21:27,109
Natalie, you are asking
me to let Marc die.
529
00:21:27,134 --> 00:21:28,620
I can't do that.
530
00:21:28,924 --> 00:21:32,083
Well, if by some miracle
he does wake up,
531
00:21:32,108 --> 00:21:34,156
it'll be to brain damage, paralysis,
532
00:21:34,181 --> 00:21:35,878
and the loss of his daughter.
533
00:21:35,903 --> 00:21:38,881
So, please help me understand
534
00:21:38,906 --> 00:21:40,339
why you won't even consider this.
535
00:21:40,364 --> 00:21:42,397
I have a responsibility to my patients
536
00:21:42,422 --> 00:21:44,551
to do everything I can
to save their lives.
537
00:21:44,576 --> 00:21:46,814
Anything less, then I am failing them.
538
00:21:50,226 --> 00:21:51,558
Okay.
539
00:21:59,681 --> 00:22:01,863
He's losing blood faster
than I can replace it.
540
00:22:01,888 --> 00:22:04,732
Massive bleed from behind the liver.
541
00:22:04,757 --> 00:22:07,531
There must be a hole in the vena cava.
542
00:22:08,845 --> 00:22:10,718
Long Allis clamps.
543
00:22:15,555 --> 00:22:17,093
Damn it, this isn't working.
544
00:22:17,558 --> 00:22:20,592
I can't reach the tear
without making it worse.
545
00:22:20,617 --> 00:22:22,612
All right, Maggie, get
your hands in here.
546
00:22:23,796 --> 00:22:25,576
Push on these packs. Press hard.
547
00:22:25,601 --> 00:22:26,700
All right.
548
00:22:26,725 --> 00:22:28,278
That'll buy us some time.
549
00:22:28,303 --> 00:22:30,422
Call Dr. Lanik, get him in here.
550
00:22:30,447 --> 00:22:32,355
I don't care what he's doing.
Just make sure he's scrubbed up
551
00:22:32,380 --> 00:22:33,579
and ready to work.
552
00:22:33,604 --> 00:22:35,999
Give me an 8 ET tube and a sternal saw.
553
00:22:36,024 --> 00:22:37,627
Sternotomy?
554
00:22:37,652 --> 00:22:38,846
You're gonna open up his chest?
555
00:22:38,871 --> 00:22:40,787
I gotta get to the bleed somehow.
556
00:22:41,546 --> 00:22:43,239
Hey, got your page.
557
00:22:43,264 --> 00:22:44,663
Come on in.
558
00:22:44,688 --> 00:22:46,432
Dr. Abrams is in surgery right now.
559
00:22:46,457 --> 00:22:48,757
As soon as he's done, Keegan's next.
560
00:22:48,782 --> 00:22:49,719
Uh-huh.
561
00:22:49,744 --> 00:22:51,996
- What's all this?
- It's an experiment.
562
00:22:52,915 --> 00:22:54,056
For what?
563
00:22:54,081 --> 00:22:56,026
Well, you don't think that
564
00:22:56,051 --> 00:22:58,866
Keegan can experience her itch
without cutaneous nerves.
565
00:22:58,891 --> 00:23:01,348
And I do. I think I can prove it.
566
00:23:04,609 --> 00:23:06,096
Have a seat.
567
00:23:08,025 --> 00:23:09,846
Okay.
568
00:23:09,871 --> 00:23:12,482
So, can you take your left arm
569
00:23:12,507 --> 00:23:15,057
and put it on the other
side of the partition here?
570
00:23:17,568 --> 00:23:19,008
Thank you.
571
00:23:19,452 --> 00:23:21,151
So, is this like a magic trick?
572
00:23:21,294 --> 00:23:22,996
Yeah, kinda.
573
00:23:25,345 --> 00:23:30,704
Okay, so I'm gonna start
to brush your real hand
574
00:23:30,745 --> 00:23:32,550
and the fake hand simultaneously.
575
00:23:32,575 --> 00:23:34,420
But I just want you to
look at the fake hand.
576
00:23:34,445 --> 00:23:35,644
Okay?
577
00:23:35,669 --> 00:23:37,402
Whatever you say.
578
00:23:37,427 --> 00:23:41,147
So, amputees sometimes still feel
579
00:23:41,172 --> 00:23:42,527
the missing limb, right?
580
00:23:42,673 --> 00:23:44,536
Yeah. A phantom limb.
581
00:23:44,561 --> 00:23:47,240
The nerves are transmitting
confusing signals.
582
00:23:47,413 --> 00:23:50,301
Or do amputees still feel
missing limbs because
583
00:23:50,326 --> 00:23:53,206
the brain is just assuming
that it's still there?
584
00:23:53,503 --> 00:23:56,437
'Cause if that were the case,
the nerves would be irrelevant.
585
00:23:56,462 --> 00:23:57,651
Right?
586
00:23:57,807 --> 00:24:01,176
So, you're suggesting
Keegan's got a phantom itch?
587
00:24:01,201 --> 00:24:02,453
Her brain is telling her it's there,
588
00:24:02,478 --> 00:24:03,544
even though it isn't?
589
00:24:03,569 --> 00:24:04,666
Yeah.
590
00:24:04,965 --> 00:24:09,153
Just like amputees perceive a
limb that used to be there.
591
00:24:09,178 --> 00:24:12,102
Keegan still perceives an itch
that she got three years ago
592
00:24:12,127 --> 00:24:13,514
from a drug reaction.
593
00:24:13,539 --> 00:24:15,372
I mean, the brain's basically
playing a trick on her.
594
00:24:16,634 --> 00:24:18,400
Interesting theory.
595
00:24:18,766 --> 00:24:20,199
Where are you going with all this?
596
00:24:20,224 --> 00:24:22,391
That's not your hand. Right?
597
00:24:22,416 --> 00:24:24,156
But the more you stare at it,
598
00:24:24,181 --> 00:24:26,667
while feeling me brush your real hand,
599
00:24:26,692 --> 00:24:29,543
the more your brain might
start to blend them together.
600
00:24:29,568 --> 00:24:31,262
Well, I guess I can buy that.
601
00:24:31,287 --> 00:24:32,319
Yeah.
602
00:24:32,808 --> 00:24:35,617
Very powerful, the connection
between what we see
603
00:24:35,670 --> 00:24:37,169
and what we feel.
604
00:24:38,653 --> 00:24:41,254
But Dr. Charles, I still
know which one's my arm.
605
00:24:41,323 --> 00:24:44,191
Huh. Do ya?
606
00:24:46,791 --> 00:24:48,323
Ah.
607
00:24:51,701 --> 00:24:53,230
Uh, for a second there...
608
00:24:53,255 --> 00:24:54,800
You felt the hammer.
609
00:24:55,392 --> 00:24:56,948
Yeah, I did.
610
00:24:57,612 --> 00:24:59,116
Yeah.
611
00:24:59,141 --> 00:25:01,508
Well, and we both know there aren't
612
00:25:01,539 --> 00:25:04,071
any nerve endings in this thing, right?
613
00:25:05,216 --> 00:25:08,110
Amazing the tricks the
brain can play on us.
614
00:25:10,624 --> 00:25:12,386
Keegan. Keegan, wait.
615
00:25:12,534 --> 00:25:13,597
I've changed my mind.
616
00:25:13,622 --> 00:25:15,203
I don't think you should
have surgery just yet.
617
00:25:15,228 --> 00:25:16,619
Oh, here we go.
618
00:25:16,644 --> 00:25:18,861
What crazy idea has Dr.
Charles talked you into?
619
00:25:18,886 --> 00:25:20,786
It may not be a nerve problem.
620
00:25:20,851 --> 00:25:22,446
It could be a perception problem.
621
00:25:22,837 --> 00:25:25,422
In fact, I'm not sure
your itch is real.
622
00:25:25,447 --> 00:25:27,003
Not real? Are you two serious?
623
00:25:27,028 --> 00:25:28,122
Look at me.
624
00:25:28,147 --> 00:25:29,578
I have to be tied to the bed
625
00:25:29,603 --> 00:25:31,713
so I don't scratch a
bigger hole in my head.
626
00:25:31,738 --> 00:25:33,775
If surgery will work, I have to do it.
627
00:25:33,800 --> 00:25:35,232
But what if it doesn't?
628
00:25:35,298 --> 00:25:36,970
What if you wake up and
nothing's changed?
629
00:25:36,995 --> 00:25:38,545
It has to work.
630
00:25:38,570 --> 00:25:40,393
Because I can't live like this anymore.
631
00:25:40,418 --> 00:25:41,864
I want my life back.
632
00:25:41,889 --> 00:25:43,646
Surgery will give it to you.
633
00:25:43,980 --> 00:25:45,312
All right, let's go.
634
00:25:45,522 --> 00:25:47,789
Wait, Keegan. Wait, wait.
635
00:25:47,838 --> 00:25:50,628
The brain can change. It
responds to experience.
636
00:25:50,653 --> 00:25:52,362
It's called neuroplasticity.
637
00:25:52,387 --> 00:25:54,972
Three years ago, a
drug reaction created
638
00:25:54,997 --> 00:25:56,750
a chronic itch that you
can't seem to satisfy,
639
00:25:56,775 --> 00:25:58,676
because it rewired your brain.
640
00:25:58,878 --> 00:26:01,104
No surgery is gonna fix that. Trust me.
641
00:26:01,129 --> 00:26:02,338
Daniel.
642
00:26:02,363 --> 00:26:04,031
Please. Please, Keegan.
643
00:26:04,056 --> 00:26:06,375
Let me try something before
you go under the knife.
644
00:26:07,180 --> 00:26:08,913
It's been three years.
645
00:26:09,274 --> 00:26:12,221
What can you do for me that
no other doctor has tried?
646
00:26:12,423 --> 00:26:14,379
A trick.
647
00:26:20,113 --> 00:26:21,531
What the hell is going on?
648
00:26:21,556 --> 00:26:23,583
I was told you needed
help with a liver bleed.
649
00:26:23,608 --> 00:26:25,511
Retro-hepatic cava tear.
650
00:26:25,536 --> 00:26:27,277
Can't fix anything until
I control the bleed.
651
00:26:27,302 --> 00:26:29,527
I'm gonna do that with
an atrial caval shunt.
652
00:26:29,552 --> 00:26:30,788
You gotta be kidding.
653
00:26:30,813 --> 00:26:32,776
Nope, I'm gonna snake an ET tube
654
00:26:32,801 --> 00:26:35,351
down his heart and bypass the tear.
655
00:26:35,376 --> 00:26:37,388
What, you couldn't think
of a riskier move?
656
00:26:37,413 --> 00:26:40,328
Atrial caval shunts have
an abysmal success rate.
657
00:26:40,353 --> 00:26:41,948
Yep, I'm aware.
658
00:26:41,973 --> 00:26:44,573
Then you also know that he's
cold and coagulopathic.
659
00:26:44,598 --> 00:26:46,909
So, if you don't pack him up,
and get him up to the ICU
660
00:26:46,934 --> 00:26:49,363
to be warmed, he's gonna
die here on this table.
661
00:26:49,388 --> 00:26:50,928
At least this gives him a shot.
662
00:26:50,953 --> 00:26:52,341
If we send him up to the ICU,
663
00:26:52,366 --> 00:26:54,166
he bleeds out and dies for sure.
664
00:26:54,457 --> 00:26:56,126
Scissors and ET tube.
665
00:26:56,676 --> 00:26:59,143
If you cut into that heart,
there is no going back.
666
00:26:59,168 --> 00:27:00,836
Yeah, I know.
667
00:27:01,454 --> 00:27:03,054
Don't do it.
668
00:27:08,017 --> 00:27:09,973
God damn it.
669
00:27:10,540 --> 00:27:12,373
You kick me out of
here only to force me
670
00:27:12,398 --> 00:27:13,378
to help you kill this guy.
671
00:27:13,403 --> 00:27:15,498
You're a prick, Rhodes.
672
00:27:15,523 --> 00:27:17,067
Yeah, maybe.
673
00:27:26,919 --> 00:27:28,987
If her father doesn't wake up,
674
00:27:29,155 --> 00:27:31,303
what happens to Abigail's organs?
675
00:27:31,792 --> 00:27:33,851
They're no good to anyone.
676
00:27:41,372 --> 00:27:44,006
Ms. Goodwin, can I speak
to you about something?
677
00:27:48,598 --> 00:27:49,931
Could've driven a truck
through this hole.
678
00:27:49,956 --> 00:27:52,175
He never would have
survived in the ICU.
679
00:27:52,355 --> 00:27:53,788
This is the right call.
680
00:27:53,951 --> 00:27:56,714
Don't act like you didn't
get lucky as hell.
681
00:27:57,579 --> 00:27:59,439
Let's finish this up.
682
00:28:04,581 --> 00:28:05,877
What do I do?
683
00:28:05,902 --> 00:28:07,539
I don't know how long I can
go without scratching.
684
00:28:07,564 --> 00:28:08,405
Okay.
685
00:28:08,430 --> 00:28:09,800
I want you to look at your reflection
686
00:28:09,825 --> 00:28:12,986
and scratch the non-itchy
side of your head.
687
00:28:14,647 --> 00:28:17,533
In the mirror, the image
is gonna be reversed.
688
00:28:17,558 --> 00:28:18,374
It's gonna look like you're actually
689
00:28:18,399 --> 00:28:19,740
scratching the itchy side.
690
00:28:19,765 --> 00:28:21,983
Oh, I see it.
691
00:28:22,564 --> 00:28:24,288
But how is scratching
this side of my head
692
00:28:24,313 --> 00:28:26,234
gonna make the itch go
away on the other side?
693
00:28:26,259 --> 00:28:27,363
Keegan, trust me.
694
00:28:27,388 --> 00:28:29,519
We know that you've been
feeling this thing.
695
00:28:29,544 --> 00:28:32,770
But I just want you to consider
the possibility that maybe,
696
00:28:32,795 --> 00:28:35,096
just maybe that this itch isn't real.
697
00:28:35,121 --> 00:28:37,635
And no amount of scratching
is gonna satisfy it.
698
00:28:37,660 --> 00:28:39,426
Well, then what the hell am I doing?
699
00:28:39,451 --> 00:28:41,618
Giving your brain new visual input
700
00:28:41,643 --> 00:28:44,199
to the override the experience
you had three years ago,
701
00:28:44,224 --> 00:28:46,212
so it can begin to rewire itself.
702
00:28:46,603 --> 00:28:48,630
Okay, you're losing me.
703
00:28:48,655 --> 00:28:50,714
By feeling yourself scratch
one side of your head
704
00:28:50,739 --> 00:28:53,106
while you're seeing
yourself scratch the other,
705
00:28:53,535 --> 00:28:55,282
your brain will be tricked.
706
00:28:55,307 --> 00:28:57,007
And realize something's not right.
707
00:28:57,329 --> 00:29:00,265
Now, hopefully, that
experience will force you
708
00:29:00,290 --> 00:29:01,777
to perceive a new reality.
709
00:29:01,802 --> 00:29:05,218
A reality in which the
itch doesn't exist.
710
00:29:06,020 --> 00:29:08,985
So you say, but nothing's changing.
711
00:29:09,189 --> 00:29:10,593
And I feel stupid.
712
00:29:10,872 --> 00:29:13,360
The exercise is designed
to confuse your brain,
713
00:29:13,385 --> 00:29:14,481
so don't worry about that.
714
00:29:14,506 --> 00:29:16,410
Just keep scratching.
715
00:29:16,959 --> 00:29:20,178
Like this? Harder? Softer?
716
00:29:20,203 --> 00:29:21,721
- Just like you're doing.
- Yes.
717
00:29:21,746 --> 00:29:23,301
Be patient.
718
00:29:24,785 --> 00:29:26,443
Give it a chance.
719
00:29:28,710 --> 00:29:30,380
Keegan, we'll be just outside.
720
00:29:31,731 --> 00:29:33,231
You're doing great.
721
00:29:39,122 --> 00:29:41,407
How long are we gonna let
her keep scratching?
722
00:29:41,432 --> 00:29:44,648
She's been dealing with
this for what, three years?
723
00:29:44,673 --> 00:29:47,328
I mean, honestly Ethan,
724
00:29:47,353 --> 00:29:48,699
I don't know how long it might take.
725
00:29:48,724 --> 00:29:49,819
If it takes.
726
00:29:50,203 --> 00:29:52,399
The phantom itch theory makes sense,
727
00:29:52,509 --> 00:29:54,113
but it's still just a theory.
728
00:29:54,138 --> 00:29:57,458
I just really don't wanna
give her any false hope.
729
00:29:58,127 --> 00:29:59,580
Dr. Charles.
730
00:29:59,605 --> 00:30:02,101
Something's definitely happening.
731
00:30:02,468 --> 00:30:05,815
The itch, it's less.
732
00:30:10,091 --> 00:30:11,772
Okay.
733
00:30:13,607 --> 00:30:15,240
All right, I'll be back in five.
734
00:30:15,265 --> 00:30:18,024
I'm gonna run these over
to sterile processing.
735
00:30:23,662 --> 00:30:25,962
Hey. Have you seen April?
736
00:30:25,987 --> 00:30:27,992
- I wanted to check in on her.
- Nope.
737
00:30:28,040 --> 00:30:29,809
She's probably putting
out a fire somewhere.
738
00:30:29,834 --> 00:30:31,380
That girl is on it.
739
00:30:31,665 --> 00:30:33,797
So, things went well
while I was in surgery?
740
00:30:33,987 --> 00:30:36,306
Yeah, didn't even
realize you were gone.
741
00:30:37,245 --> 00:30:38,817
Oh.
742
00:30:38,842 --> 00:30:40,387
That's great.
743
00:30:40,412 --> 00:30:42,191
Yeah.
744
00:30:45,810 --> 00:30:48,781
Dr. Halstead, could I have a moment?
745
00:30:48,806 --> 00:30:49,905
Of course.
746
00:30:49,930 --> 00:30:53,094
An emergency ethics committee
was formed to evaluate
747
00:30:53,119 --> 00:30:56,621
Marc Jones' current condition
and future prognosis.
748
00:30:56,646 --> 00:30:59,250
Wait, was formed? Who asked for that?
749
00:30:59,275 --> 00:31:03,126
Between his spinal cord injury
and the high probability
750
00:31:03,151 --> 00:31:05,884
for irreparable brain damage,
the committee concluded
751
00:31:05,909 --> 00:31:08,277
with reasonable medical certainty
752
00:31:08,302 --> 00:31:10,913
that he has no quality of life.
753
00:31:10,938 --> 00:31:11,816
No.
754
00:31:11,841 --> 00:31:15,580
Listen, the hospital will honor
755
00:31:15,605 --> 00:31:19,227
Mr. Jones's tattoo as
an advanced directive.
756
00:31:19,252 --> 00:31:23,316
If he codes again, you
will not resuscitate.
757
00:31:23,341 --> 00:31:25,319
I cannot just walk away.
758
00:31:25,344 --> 00:31:29,391
I'm sorry, but it's over, Dr. Halstead.
759
00:31:34,266 --> 00:31:35,933
I wanna talk to you.
760
00:31:41,775 --> 00:31:44,278
An emergency ethics committee?
761
00:31:44,303 --> 00:31:46,827
What, I don't bow down to
your decision on my patient,
762
00:31:46,852 --> 00:31:48,618
so you go over me to
Goodwin and bench me?
763
00:31:48,643 --> 00:31:49,768
You forced my hand.
764
00:31:49,793 --> 00:31:52,199
I tried talking to you.
You shut me down.
765
00:31:52,224 --> 00:31:54,543
Because you'd already
decided Marc should die.
766
00:31:54,568 --> 00:31:56,812
He has a tattoo across
his chest that says,
767
00:31:56,837 --> 00:31:58,247
"Do Not Resuscitate."
768
00:31:58,272 --> 00:32:00,204
We don't know that's how he feels.
769
00:32:00,229 --> 00:32:01,582
We don't know he doesn't.
770
00:32:01,607 --> 00:32:04,201
But what I do know is
that if we don't act now,
771
00:32:04,226 --> 00:32:05,993
we will lose Abigail's organs.
772
00:32:06,018 --> 00:32:08,549
Those are children's
lives in our hands.
773
00:32:08,574 --> 00:32:09,923
No, don't turn this on me.
774
00:32:09,948 --> 00:32:11,784
Don't guilt me into thinking
that I'm the bad guy.
775
00:32:11,809 --> 00:32:13,752
You don't think I know
the stakes of this case?
776
00:32:13,777 --> 00:32:16,665
I am sick of everyone
telling me what I can
777
00:32:16,690 --> 00:32:17,759
and what I cannot do.
778
00:32:17,784 --> 00:32:20,597
I am just trying to save my patients.
779
00:32:20,622 --> 00:32:22,109
What are you talking about?
780
00:32:22,134 --> 00:32:23,443
Who is everyone?
781
00:32:25,619 --> 00:32:27,188
You betrayed me.
782
00:32:27,635 --> 00:32:29,331
How can I ever trust you?
783
00:32:30,278 --> 00:32:32,247
How can I trust you?
784
00:32:32,272 --> 00:32:34,602
In the past, you have let patients go
785
00:32:34,627 --> 00:32:36,340
who you knew were hopeless.
786
00:32:36,528 --> 00:32:38,052
But you know what? It
is more than that.
787
00:32:38,077 --> 00:32:39,268
No, look at me.
788
00:32:39,293 --> 00:32:40,675
It is more than that.
789
00:32:40,700 --> 00:32:43,020
You have been acting strange for weeks.
790
00:32:43,045 --> 00:32:44,961
And this morning, that ridiculous story
791
00:32:44,986 --> 00:32:47,098
about a drug rep, really?
792
00:32:50,263 --> 00:32:51,756
Well then, here we are.
793
00:32:51,781 --> 00:32:53,424
And about to get married.
794
00:32:59,333 --> 00:33:00,953
- Maggie.
- Yep.
795
00:33:00,978 --> 00:33:04,051
Thanks for approving
my PTO for next month.
796
00:33:04,430 --> 00:33:06,725
I didn't think there was
a way to make it happen.
797
00:33:06,921 --> 00:33:09,657
Oh, yeah. Sure.
798
00:33:10,620 --> 00:33:12,287
April.
799
00:33:12,638 --> 00:33:15,832
Did you sign off on Monique's
paid time off for next month?
800
00:33:15,857 --> 00:33:16,619
Yeah.
801
00:33:16,644 --> 00:33:18,528
Saw her request had been
siting there for three weeks.
802
00:33:18,553 --> 00:33:19,506
I hate it when I put in
803
00:33:19,531 --> 00:33:21,197
for vacation times and nothing happens.
804
00:33:21,222 --> 00:33:22,248
It takes a long time
805
00:33:22,273 --> 00:33:24,732
because someone's
always asking for PTO.
806
00:33:24,757 --> 00:33:26,151
Especially Monique.
807
00:33:26,176 --> 00:33:28,582
She took eight days off last month.
808
00:33:28,703 --> 00:33:31,918
Well, her sister is pregnant,
on bed rest and needs help.
809
00:33:31,943 --> 00:33:33,620
So, how could I say no?
810
00:33:33,645 --> 00:33:35,144
- What?
- Lisa.
811
00:33:35,438 --> 00:33:36,918
I'm talking to you.
812
00:33:36,943 --> 00:33:38,867
I have a system for handling PTO's.
813
00:33:38,892 --> 00:33:41,017
You can't take time off if
you're out of vacation.
814
00:33:41,042 --> 00:33:42,976
Monique was out.
815
00:33:43,059 --> 00:33:44,912
Doris gave her some of hers.
816
00:33:45,229 --> 00:33:47,530
Oh, my God. You let them swap?
817
00:33:47,555 --> 00:33:49,351
Doris said she wasn't gonna use them.
818
00:33:49,376 --> 00:33:50,994
No sense letting them gather dust.
819
00:33:51,019 --> 00:33:52,244
You know what's gonna happen now?
820
00:33:52,269 --> 00:33:54,368
I'm gonna get hammered
with requests from nurses
821
00:33:54,393 --> 00:33:55,877
who wanna swap days.
822
00:33:55,966 --> 00:33:58,032
- Thanks a lot.
- You know what?
823
00:33:58,057 --> 00:33:59,424
You don't like the way I handle things
824
00:33:59,449 --> 00:34:01,211
when I'm doing you a favor...
825
00:34:01,236 --> 00:34:02,702
A favor?
826
00:34:02,771 --> 00:34:05,371
This is a privilege.
827
00:34:06,273 --> 00:34:09,356
Give your privilege to someone else.
828
00:34:36,500 --> 00:34:38,534
Time of death, 19:22.
829
00:34:48,633 --> 00:34:50,633
There, he's gone.
830
00:34:50,982 --> 00:34:52,464
You won.
831
00:34:58,862 --> 00:35:00,398
I was about to give up,
832
00:35:00,423 --> 00:35:02,169
but then there was this moment.
833
00:35:02,197 --> 00:35:04,564
Look at me, I'm not scratching.
834
00:35:05,440 --> 00:35:07,916
I am so happy for you.
835
00:35:07,941 --> 00:35:10,669
Dr. Choi, I can keep
these mirrors, right?
836
00:35:10,970 --> 00:35:12,531
It's so much better.
837
00:35:12,556 --> 00:35:14,377
Of course. And keep it up.
838
00:35:14,402 --> 00:35:16,689
Over time, they should
fade away completely.
839
00:35:17,905 --> 00:35:19,259
Excuse me.
840
00:35:19,284 --> 00:35:22,257
Dr. Charles, surgery would
have been a mistake.
841
00:35:22,429 --> 00:35:24,072
Good call steering her away.
842
00:35:24,097 --> 00:35:25,790
Yeah, but, you know, I
certainly understood
843
00:35:25,815 --> 00:35:27,776
her desperation for relief.
844
00:35:29,029 --> 00:35:30,520
Do you know that scientifically,
845
00:35:30,545 --> 00:35:32,686
itching is ranked as one of the most
846
00:35:32,711 --> 00:35:35,540
distressing sensations a
human being can experience?
847
00:35:35,565 --> 00:35:37,164
Really?
848
00:35:39,517 --> 00:35:43,169
You know what, Dr. Charles,
maybe it's not a good idea,
849
00:35:43,194 --> 00:35:46,907
but some itches you
just have to scratch.
850
00:35:49,904 --> 00:35:53,093
Vicki. Hey.
851
00:35:56,368 --> 00:35:58,297
What do you say we go for a run?
852
00:35:58,805 --> 00:36:00,457
Like old times?
853
00:36:00,881 --> 00:36:02,261
Sure.
854
00:36:02,286 --> 00:36:03,675
Call me sometime.
855
00:36:03,731 --> 00:36:06,334
My shift's over.
856
00:36:07,645 --> 00:36:08,868
How 'bout now?
857
00:36:11,450 --> 00:36:13,850
Okay. Let's do it.
858
00:36:20,784 --> 00:36:24,552
Okay, look, my way isn't the only way.
859
00:36:24,577 --> 00:36:26,189
You're doing a good job.
860
00:36:26,324 --> 00:36:27,969
Thanks.
861
00:36:28,197 --> 00:36:30,497
And I confess, it sucks
when you realize
862
00:36:30,522 --> 00:36:32,817
that you can be replaced.
863
00:36:33,182 --> 00:36:35,649
Yeah, I know.
864
00:36:39,748 --> 00:36:40,814
Oh.
865
00:36:44,745 --> 00:36:46,492
Wanna get a drink?
866
00:36:47,132 --> 00:36:48,622
Maybe two?
867
00:36:51,682 --> 00:36:53,336
Yeah.
868
00:37:01,381 --> 00:37:02,913
Oh, Sam.
869
00:37:02,938 --> 00:37:05,669
You'll be happy to hear that
Keegan's feeling much better.
870
00:37:05,718 --> 00:37:07,451
Oh, your smoke and mirrors?
871
00:37:07,476 --> 00:37:09,076
Temporary fix.
872
00:37:09,392 --> 00:37:10,929
She'll be back here in six weeks
873
00:37:10,954 --> 00:37:12,201
to get that surgery.
874
00:37:12,226 --> 00:37:14,202
Well, that's the way you see it,
875
00:37:14,227 --> 00:37:16,789
I, uh, I guess I see it
a little differently.
876
00:37:18,000 --> 00:37:19,625
Until next time, Daniel.
877
00:37:19,650 --> 00:37:21,349
Good night.
878
00:37:29,190 --> 00:37:31,806
An atrial caval shunt.
879
00:37:32,515 --> 00:37:34,148
My cowboy.
880
00:37:35,730 --> 00:37:37,330
Dr. Rhodes.
881
00:37:38,129 --> 00:37:41,246
Three operating rooms
upstairs were open.
882
00:37:41,271 --> 00:37:42,939
You could have treated your patient
883
00:37:42,972 --> 00:37:44,252
in any one of them.
884
00:37:44,277 --> 00:37:46,372
Maybe, but I didn't want to
risk him dying in transit.
885
00:37:46,397 --> 00:37:48,264
That is why we have a Hybrid OR.
886
00:37:50,091 --> 00:37:52,058
The gall bladder surgery
you interrupted,
887
00:37:52,083 --> 00:37:54,307
I'm rescheduling it for tomorrow.
888
00:37:54,332 --> 00:37:55,863
In the Hybrid OR.
889
00:37:55,888 --> 00:37:58,118
Ms. Goodwin, this idea
to repurpose my room
890
00:37:58,143 --> 00:38:00,543
is misguided and reckless.
891
00:38:00,568 --> 00:38:01,957
Your room?
892
00:38:02,154 --> 00:38:05,622
Well, the board is considering
closing your room
893
00:38:05,647 --> 00:38:07,880
unless it starts proving its worth.
894
00:38:07,993 --> 00:38:11,588
That's why I'm gonna make sure
it is always earning money.
895
00:38:11,726 --> 00:38:14,075
Great. Then I'm gonna
keep fighting back,
896
00:38:14,100 --> 00:38:15,865
because I'm not gonna let Gwen Garrett
897
00:38:15,890 --> 00:38:17,751
turn the Hybrid OR into an ATM.
898
00:38:17,776 --> 00:38:20,003
Gwen Garrett has nothing
to do with this.
899
00:38:20,028 --> 00:38:23,124
I decided to put general
surgeries in there.
900
00:38:23,294 --> 00:38:25,931
So you pull this little stunt again,
901
00:38:26,050 --> 00:38:28,124
and I'll show you the door.
902
00:38:31,888 --> 00:38:33,445
I don't care what she says.
903
00:38:33,841 --> 00:38:36,559
I saved his life. I'd do it again.
904
00:38:36,665 --> 00:38:38,520
Come here.
905
00:38:54,210 --> 00:38:56,280
We're a lot alike, you know.
906
00:38:56,487 --> 00:38:58,889
You'd do anything to get what you want.
907
00:39:03,532 --> 00:39:05,418
You're that bad, huh?
908
00:39:06,078 --> 00:39:07,925
I'm that bad.
909
00:39:31,224 --> 00:39:33,692
Abigail's organs are off to recipients.
910
00:39:36,374 --> 00:39:38,000
That's good.
911
00:39:51,832 --> 00:39:53,901
Maybe you want this back?
912
00:40:08,080 --> 00:40:10,162
No, I don't.
913
00:40:15,782 --> 00:40:18,261
Natalie, I wanna marry you.
914
00:40:25,538 --> 00:40:33,108
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