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1
00:00:11,258 --> 00:00:12,816
Oh, God!
2
00:00:12,993 --> 00:00:16,952
The flight rotation was
the highlight of my residency.
3
00:00:17,131 --> 00:00:22,034
I'll be thousands of feet in the air
in something shaped like a potato.
4
00:00:22,169 --> 00:00:25,036
Well, actually,
it's only hundreds of feet.
5
00:00:29,109 --> 00:00:30,736
Oh, God!
6
00:00:32,813 --> 00:00:36,180
Don't they have
ambulances in this sticks?
7
00:00:36,350 --> 00:00:39,945
They don't have a trauma center
in Boone County. If it's bad, we go.
8
00:00:40,120 --> 00:00:43,385
- How far?
- Fifty, 60 miles.
9
00:00:43,557 --> 00:00:49,621
Head up. Didn't you know this
was a requirement of your residency?
10
00:00:49,797 --> 00:00:54,200
All right, deep breath.
Let it out slowly.
11
00:00:55,202 --> 00:00:58,103
Okay. My knees won't move!
12
00:00:58,272 --> 00:01:00,740
Come on. Stay low.
13
00:01:12,119 --> 00:01:16,818
- Dee McManus, Susan Lewis.
- Hi. First flight?
14
00:01:25,432 --> 00:01:29,766
The sum of the angles of a triangle
equals 180 degrees, right?
15
00:01:29,903 --> 00:01:33,566
- Hey, Carol.
- Hi, Doug.
16
00:01:33,774 --> 00:01:37,232
- Hi.
- Doug Ross, this is William Litman.
17
00:01:37,444 --> 00:01:41,972
- William is my lab partner.
- No kidding?
18
00:01:42,149 --> 00:01:43,241
How's it going?
19
00:01:43,417 --> 00:01:47,581
I have an intuitive 19th-century
Euclidean mind.
20
00:01:47,755 --> 00:01:51,885
It's actually crippling to the
understanding of the geometric...
21
00:01:52,059 --> 00:01:55,256
- I'm flunking out.
- What are you working on?
22
00:01:55,429 --> 00:02:01,561
String theory. The multi-dimensional
curvature of time and space.
23
00:02:01,702 --> 00:02:05,263
The Riemannian manifold is
"M" dimensional space...
24
00:02:05,439 --> 00:02:07,964
...that locally looks
like "N" dimensional space...
25
00:02:08,175 --> 00:02:11,406
...when "M" is less than "N."
26
00:02:18,752 --> 00:02:22,848
Susan, take a look. It's beautiful.
27
00:02:23,023 --> 00:02:27,050
- What are you doing?
- Hyperventilating. Leave me alone.
28
00:02:29,063 --> 00:02:34,558
You should really check out this view.
It helps you set your gyroscope.
29
00:02:35,569 --> 00:02:37,537
- What was that?
- The pilot.
30
00:02:37,704 --> 00:02:43,540
He was just adjusting
the rotor pitch. Absolutely normal.
31
00:02:43,710 --> 00:02:46,474
Right. Normal.
32
00:02:47,581 --> 00:02:49,947
There it is.
33
00:02:52,252 --> 00:02:56,211
Oh, man! We're first on scene.
34
00:02:56,390 --> 00:02:58,449
We're gonna need
the O-neg and blood Y's.
35
00:02:58,625 --> 00:03:01,093
There's a field near 5:00.
36
00:03:01,261 --> 00:03:03,695
Oh, God!
37
00:03:31,725 --> 00:03:33,989
Stay low and watch the tail rotors.
38
00:03:34,161 --> 00:03:38,222
We've got five victims.
Hay truck and a van hit head-on.
39
00:03:38,398 --> 00:03:40,559
Two ejected and three are trapped.
40
00:03:40,701 --> 00:03:43,534
- Where is the fire response?
- Two engines and an ambulance en route.
41
00:03:43,704 --> 00:03:46,502
- ETA?
- Thirty minutes.
42
00:03:46,707 --> 00:03:49,335
Triage first.
Susan, you check the car.
43
00:03:55,382 --> 00:03:58,317
It's all right, sweetie.
44
00:04:01,588 --> 00:04:04,182
Please get us out of this car!
45
00:04:55,142 --> 00:04:58,737
Yes, I'm still holding
for authorization. Hello?
46
00:04:58,946 --> 00:05:01,471
Dallas by three, you think?
47
00:05:01,648 --> 00:05:03,377
ER. Hold on.
48
00:05:03,550 --> 00:05:07,953
ICU's got no beds till 1999,
and they're sending us two vents.
49
00:05:08,121 --> 00:05:10,521
Way to go, Mr. Gomez!
50
00:05:10,691 --> 00:05:12,488
Chuny, we need
more IVAC's in 3.
51
00:05:12,659 --> 00:05:15,890
Patric Brazil,
metastatic prostate cancer.
52
00:05:16,063 --> 00:05:19,897
Cough, fever, two months
progressive weakness.
53
00:05:20,067 --> 00:05:25,004
Gave 300 cc's of saline.
He's a no-code.
54
00:05:25,138 --> 00:05:28,904
I've been Mr. B's
caretaker for 22 years.
55
00:05:29,109 --> 00:05:32,772
He wants to be cryogenically preserved
when he deanimates.
56
00:05:32,946 --> 00:05:37,007
- He wants to what?
- Be put on ice when he croaks.
57
00:05:37,184 --> 00:05:41,587
He's been waiting eight years to join
Mrs. B in their suspension capsule.
58
00:05:43,790 --> 00:05:46,156
His wife's been frozen
for eight years?
59
00:05:46,326 --> 00:05:52,128
It was their 50th anniversary
present to each other.
60
00:05:52,299 --> 00:05:56,326
They want to be preserved so that
they could come back in the future.
61
00:05:56,470 --> 00:06:00,031
Just like those dinosaurs
in that movie.
62
00:06:00,240 --> 00:06:02,800
Isn't it romantic?
63
00:06:03,010 --> 00:06:07,572
Let's hang a dobutamine drip.
Start at 10 mcg per kilo...
64
00:06:07,748 --> 00:06:10,182
- Watch the IV.
- Settle down, Mr. Sotcheck.
65
00:06:10,350 --> 00:06:13,183
Rescue 1-16 for you to rule out MI.
66
00:06:13,353 --> 00:06:17,289
- We're swamped.
- Who's covering Haleh's vacation?
67
00:06:17,457 --> 00:06:21,223
The last nurse who floated down here
hid in the bathroom.
68
00:06:21,395 --> 00:06:24,057
- Sterling from Med-Surg West.
- Rhonda Sterling?
69
00:06:24,231 --> 00:06:27,860
- Yeah, what's wrong with her?
- She's a floor nurse.
70
00:06:28,001 --> 00:06:31,232
- I'm not babysitting her.
- Me neither.
71
00:06:33,407 --> 00:06:34,806
The fire's out!
72
00:06:34,975 --> 00:06:38,103
- What's your name?
- Gail. She's only 10 days old.
73
00:06:38,312 --> 00:06:42,271
- Is she all right?
- She's moving and crying.
74
00:06:43,116 --> 00:06:46,381
- I'm Dr. Lewis. What's your name?
- Zach.
75
00:06:46,553 --> 00:06:49,784
- Gail, does your neck hurt?
- Is he all right?
76
00:06:49,956 --> 00:06:51,821
Get a C-collar on her.
77
00:06:51,992 --> 00:06:54,688
Sir? Sir, can you hear me?
78
00:06:54,861 --> 00:06:57,830
It's brain matter. The guy's a goner.
79
00:07:07,474 --> 00:07:09,635
Get him on oxygen.
80
00:07:20,787 --> 00:07:23,813
Where, Zach? Your neck?
81
00:07:24,791 --> 00:07:27,089
Does this hurt?
82
00:07:27,260 --> 00:07:30,821
David? Where's my husband?
83
00:07:30,997 --> 00:07:33,864
Gail, where are you hurt?
84
00:07:34,000 --> 00:07:38,528
My right leg and my side.
David. Please!
85
00:07:38,705 --> 00:07:42,436
- Dr. Greene's working on him.
- My husband is a doctor.
86
00:07:42,642 --> 00:07:45,543
He has to check on the children.
87
00:07:45,712 --> 00:07:48,180
- He's a pediatrician.
- Go, I'll stand by.
88
00:07:48,382 --> 00:07:52,045
Okay, I'm gonna
go check on your husband.
89
00:07:58,091 --> 00:08:00,787
The trucker's gone.
I need you here.
90
00:08:00,961 --> 00:08:02,485
He's still moving.
91
00:08:02,662 --> 00:08:05,495
He's pulseless
with massive head trauma.
92
00:08:05,665 --> 00:08:09,624
I've got a tension hemopneumo
that we can save.
93
00:08:10,637 --> 00:08:12,605
Needle him, left side.
94
00:08:18,078 --> 00:08:20,478
He's decompressing.
95
00:08:26,820 --> 00:08:29,584
Thirty-two French.
96
00:08:29,756 --> 00:08:31,986
This guy's a pediatrician.
97
00:08:32,159 --> 00:08:35,026
- Really?
- His family's in the van.
98
00:08:35,195 --> 00:08:37,220
Wife and newborn baby girl.
99
00:08:37,397 --> 00:08:41,356
Wife's stable.
There's a boy about 8 years old.
100
00:08:41,501 --> 00:08:44,800
Number four-two facial fracture.
I'm worried about his airway.
101
00:08:44,971 --> 00:08:47,201
I'm in. Hook it up to the Foley bag.
102
00:08:47,407 --> 00:08:49,136
He's hemorrhaging.
103
00:08:49,342 --> 00:08:51,606
Grab two units
O-neg out of the cooler.
104
00:08:51,778 --> 00:08:53,837
I'll start a line.
105
00:08:55,715 --> 00:08:58,843
- What about my husband?
- Gail, we're getting you out.
106
00:08:59,019 --> 00:09:01,988
Yeah, I'm still holding.
107
00:09:03,023 --> 00:09:07,722
Do you like Green Bay
minus seven over Washington?
108
00:09:07,894 --> 00:09:11,125
- Excuse me.
- Hang on one second.
109
00:09:13,366 --> 00:09:16,267
Please don't tell!
Mommy!
110
00:09:16,436 --> 00:09:18,700
Where do you want him?
111
00:09:18,872 --> 00:09:22,069
Curtain Area 3. End of the hall.
112
00:09:22,275 --> 00:09:24,402
Don't tell her!
113
00:09:31,184 --> 00:09:34,711
- Carol Hathaway?
- Carol.
114
00:09:36,790 --> 00:09:39,918
I was pulled off my ward
and assigned down here.
115
00:09:40,093 --> 00:09:41,856
What patient do you want me to take?
116
00:09:42,028 --> 00:09:46,624
Actually, we share our patients here.
Let me show you.
117
00:09:47,634 --> 00:09:50,797
Here are the patients
that are waiting to be seen.
118
00:09:50,971 --> 00:09:54,031
Nursing orders are flagged
and put over here, so when you're...
119
00:09:54,241 --> 00:09:58,302
I'll take Mr. Washington.
Where is Curtain Area 3?
120
00:09:58,512 --> 00:10:00,446
- There.
- Thank you.
121
00:10:05,185 --> 00:10:08,746
- Secure his head.
- We need to start a second line.
122
00:10:08,922 --> 00:10:12,085
Dr. Lewis!
The boy's stopped breathing.
123
00:10:12,259 --> 00:10:13,886
Go!
124
00:10:14,361 --> 00:10:16,329
Watch his C-spine!
125
00:10:20,600 --> 00:10:22,898
Keep in-line traction.
126
00:10:24,938 --> 00:10:27,736
You're in the way.
127
00:10:27,941 --> 00:10:32,037
Too much blood. I need suction.
6.0 tube.
128
00:10:33,780 --> 00:10:37,944
- Another 6.0.
- That was it.
129
00:10:38,118 --> 00:10:41,315
Okay, 5.5.
130
00:10:41,488 --> 00:10:43,319
Mark, I need your help.
131
00:10:43,490 --> 00:10:45,788
Get him on the chopper.
132
00:10:47,060 --> 00:10:49,790
We're taking care of him, Gail.
133
00:10:50,630 --> 00:10:55,465
Please don't let him die!
134
00:10:55,602 --> 00:10:58,127
- I can't see. Turn it up.
- It is up.
135
00:10:58,305 --> 00:11:01,274
There's better control in the chopper.
136
00:11:04,177 --> 00:11:07,669
Ready? One, two, three.
137
00:11:10,250 --> 00:11:14,482
- Doctor, I need you to start this IV.
- Okay.
138
00:11:15,522 --> 00:11:18,650
Go on, I'll check it out.
139
00:11:18,825 --> 00:11:20,884
- What's up?
- She needs an IV.
140
00:11:21,061 --> 00:11:24,519
Usually we try a few times
before we call a doc.
141
00:11:24,698 --> 00:11:28,998
Up in Med-Surg
we call the doctor when we miss.
142
00:11:29,135 --> 00:11:35,131
I'll do it. Mrs. Fesmire needs
20 of KCL in her IV in 3.
143
00:11:35,342 --> 00:11:40,279
- Where's the potassium?
- In the Med Room under "P."
144
00:11:43,583 --> 00:11:47,075
I can see the vocal cords.
I'm in.
145
00:11:52,492 --> 00:11:55,461
- I'll be right back.
- Susan!
146
00:11:55,629 --> 00:11:58,291
All right, Fred, fire it up.
147
00:11:58,465 --> 00:11:59,932
Susan!
148
00:12:02,836 --> 00:12:06,363
- How much longer?
- 20 or 30 minutes.
149
00:12:08,174 --> 00:12:14,079
Gail, we're taking your son and your
husband to County General Hospital.
150
00:12:14,247 --> 00:12:17,444
- Are they all right?
- They need to go to a trauma center.
151
00:12:17,617 --> 00:12:20,882
- How will I know what's happening?
- I will get word to you, Gail.
152
00:12:21,054 --> 00:12:23,614
- Please!
- I promise.
153
00:12:33,633 --> 00:12:36,363
- Are you okay?
- Yeah.
154
00:13:01,361 --> 00:13:04,762
- It's Dr. Greene from the whirlybird.
- Where's Mrs. Fesmire's potassium?
155
00:13:04,932 --> 00:13:07,867
I'm on break. I'm getting to her.
156
00:13:08,001 --> 00:13:10,162
This is County General on Beta-two.
Go ahead.
157
00:13:10,337 --> 00:13:15,741
We're incoming on Air-vac Onewith two major traumas.
158
00:13:15,909 --> 00:13:18,810
Grab Lydia and Chuny.
Tell them to clear the trauma rooms.
159
00:13:18,979 --> 00:13:21,447
- Go ahead, Air-Vac One.
- I'm gonna need a vent...
160
00:13:23,083 --> 00:13:25,711
Goodbye, Mr. B.
161
00:13:32,526 --> 00:13:37,122
You will keep him cold
until they come for him, won't you?
162
00:13:38,165 --> 00:13:42,465
So that he could be with his wife.
163
00:13:42,603 --> 00:13:45,003
- Please?
- Sure.
164
00:13:47,875 --> 00:13:50,207
Should I clean out the fridge?
165
00:14:06,160 --> 00:14:10,927
The dad's got
a hemopneumo and a head trauma.
166
00:14:11,098 --> 00:14:16,058
7-year-old had an obstructed
airway. He's getting shocky.
167
00:14:18,539 --> 00:14:20,769
- Good job, Susan.
- What?
168
00:14:20,974 --> 00:14:23,204
I said good job.
169
00:14:23,410 --> 00:14:25,310
Draw up meds.
170
00:14:26,547 --> 00:14:29,141
Watch that IV. Fluids wide open.
171
00:14:29,316 --> 00:14:34,015
Let's get a cross-table, CBC,
type and cross for four units...
172
00:14:34,188 --> 00:14:37,021
Draw up a saline-flush crash cart.
173
00:14:38,058 --> 00:14:42,427
- Where is the saline?
- Pulse 160, thready...
174
00:14:42,596 --> 00:14:44,655
- He's waking up.
- Hey, Zach.
175
00:14:44,831 --> 00:14:48,528
That tube in your throat
is helping you breathe.
176
00:14:48,669 --> 00:14:52,196
- Set up for lavage.
- Want a gas?
177
00:14:52,406 --> 00:14:54,897
Got it. You bet.
178
00:15:02,149 --> 00:15:04,879
Chuny, give me a hand right here.
179
00:15:07,321 --> 00:15:10,950
Okay, we got a bloody tap.
Page Benton.
180
00:15:11,124 --> 00:15:14,287
See if the dad will sign
a consent form for an ex-lap.
181
00:15:14,828 --> 00:15:18,594
- Put that O-neg on the rapid infuser.
- Is he conscious?
182
00:15:18,732 --> 00:15:22,429
He's responding to pain.
Dr. Herlihy, open your eyes.
183
00:15:24,271 --> 00:15:27,536
Somebody needs to sign
his son's surgical consent.
184
00:15:27,741 --> 00:15:30,471
BP's low, 70 palp.
Pulse ox is only 85.
185
00:15:30,677 --> 00:15:33,339
Ask Jerry to track down
the number of the hospital...
186
00:15:33,513 --> 00:15:37,210
...in Boone County where they're
taking the mother and the baby.
187
00:15:37,384 --> 00:15:39,579
Do the heart sounds
seem distant to you?
188
00:15:39,753 --> 00:15:42,153
Tamponade?
189
00:15:42,322 --> 00:15:45,018
- Hang in there, Zach.
- Hold him still.
190
00:15:45,192 --> 00:15:48,958
- He's gotta be sedated.
- Give him Versed, one milligram IV.
191
00:15:49,129 --> 00:15:51,097
Where is it?
192
00:15:52,566 --> 00:15:55,535
It's clotted.
I need that saline.
193
00:15:55,702 --> 00:15:57,363
- Another liter.
- Let's go!
194
00:15:57,537 --> 00:16:01,997
Zach, I'm gonna give you
something to help you sleep, okay?
195
00:16:02,209 --> 00:16:03,904
Hold him.
196
00:16:05,245 --> 00:16:07,440
What was that? Did it hurt?
197
00:16:07,614 --> 00:16:09,548
Are you sure that's saline?
198
00:16:11,918 --> 00:16:15,911
- Oh, my God! That's potassium.
- How much went in?
199
00:16:16,089 --> 00:16:18,284
- About a quarter cc.
- Insulin and glucose.
200
00:16:18,458 --> 00:16:21,689
- Where is it?
- Second drawer.
201
00:16:21,862 --> 00:16:26,094
Hold on. It's probably
not enough to stop his heart.
202
00:16:28,235 --> 00:16:29,327
I think we're gonna be okay.
203
00:16:29,503 --> 00:16:33,269
- What do you got?
- 7-year-old TC.
204
00:16:33,473 --> 00:16:37,569
Airway compromised at the scene.
Peritoneal lavage was positive.
205
00:16:40,647 --> 00:16:45,641
- BP's crashing, 60 palp.
- Pericardiocentesis tray.
206
00:16:45,819 --> 00:16:48,652
- Go ahead.
- I'll drop the central line.
207
00:16:48,822 --> 00:16:53,225
Hook an alligator clip
to an EKG lead. Use V-1.
208
00:16:54,261 --> 00:16:56,286
Not mine.
209
00:16:57,331 --> 00:16:59,162
It's the patient's.
210
00:16:59,299 --> 00:17:03,099
He's a doctor. It might be his office.
Why don't you dial the number?
211
00:17:03,270 --> 00:17:05,830
Jerry called Dwight Hospital.
The baby and wife haven't arrived.
212
00:17:06,006 --> 00:17:09,032
- Are they on their way?
- I don't know.
213
00:17:11,144 --> 00:17:12,941
- What do we have?
- Blunt abdominal trauma.
214
00:17:13,113 --> 00:17:16,810
Hypotensive intraperitoneal hemorrhage
confirmed by lavage.
215
00:17:16,983 --> 00:17:21,079
Facial trauma intubated in the field
with an RSI. H&H is 11, 32.
216
00:17:21,254 --> 00:17:24,587
Type and cross four, 650 cc's
of saline. We're set onboard.
217
00:17:24,758 --> 00:17:27,488
- Way to go, Carter!
- Let's take him up.
218
00:17:27,661 --> 00:17:30,255
Where are his parents?
219
00:17:30,430 --> 00:17:32,295
Second unit's in.
220
00:17:32,466 --> 00:17:37,768
So you got his partner to take calls?
Okay, we'll let you know.
221
00:17:38,972 --> 00:17:44,308
Forty cc's non-clotting blood, out.
222
00:17:44,478 --> 00:17:49,211
Dr. Herlihy, you've been
in an accident. You're in the ER.
223
00:17:50,250 --> 00:17:53,242
BP's back up, 120 over 80.
224
00:17:53,420 --> 00:17:56,446
I'm worried about
an intracranial bleed.
225
00:17:56,623 --> 00:17:58,887
- The nurse goes with him.
- Am I on call?
226
00:17:59,059 --> 00:18:04,827
You're a patient.
You were involved in traffic accident.
227
00:18:04,998 --> 00:18:08,434
Your son, Zach, has just
been taken up to surgery.
228
00:18:08,568 --> 00:18:12,197
- Surgery?
- He was injured in the accident.
229
00:18:12,372 --> 00:18:13,999
What accident?
230
00:18:14,674 --> 00:18:16,767
Get a rush on that head CT.
231
00:18:16,977 --> 00:18:19,912
Zach, everything's gonna be okay.
232
00:18:28,522 --> 00:18:31,616
- We could've killed that boy.
- I got confused.
233
00:18:31,858 --> 00:18:36,625
- You have no business working the ER.
- You think I don't know that?
234
00:18:36,797 --> 00:18:40,426
I want you to restock supplies
for the rest of the day.
235
00:18:40,567 --> 00:18:44,128
This is Carol Hathaway in the ER.
Clear a CT room, please.
236
00:18:48,408 --> 00:18:51,707
Where's the number
for chopper dispatch?
237
00:18:55,782 --> 00:18:57,841
Mark, can I run something past you?
238
00:18:58,018 --> 00:19:02,978
A guy died, and I don't know what to do
about his cryogenics request.
239
00:19:03,156 --> 00:19:06,990
He and his wife bought a tank so
they could be frozen when they died.
240
00:19:07,160 --> 00:19:11,028
- Where is his wife now?
- In the tank.
241
00:19:11,198 --> 00:19:15,294
I have an number for
a cryogenics company in California.
242
00:19:16,803 --> 00:19:19,601
Yeah, still holding.
243
00:19:25,846 --> 00:19:29,111
- What?
- Nothing.
244
00:19:30,383 --> 00:19:33,352
Page me as soon as you know.
245
00:19:34,387 --> 00:19:38,517
The helicopter's standing by.
We may have to get the wife and baby.
246
00:19:40,527 --> 00:19:44,156
- Okay, DeBakey.
- 5.0 Prolene on a Castroviejo.
247
00:19:44,331 --> 00:19:46,492
- Retract caudally.
- Retractor.
248
00:19:46,633 --> 00:19:50,262
Splenic vein's repaired.
What about this pancreas?
249
00:19:50,437 --> 00:19:54,464
I'd resect rather than
do a subtotal pancreatectomy.
250
00:19:54,674 --> 00:19:59,168
I agree. Metz.
How would you repair after resection?
251
00:19:59,379 --> 00:20:04,214
Interrupted horizontal mattresses and
a figure eight in the pancreatic duct.
252
00:20:04,384 --> 00:20:08,252
- 3.0 silk on a needle driver.
- Anything else to do?
253
00:20:08,421 --> 00:20:10,355
Irrigate. Run the bowel under control.
254
00:20:10,524 --> 00:20:13,755
Insert a Jackson-Pratt drain
through a separate stab wound.
255
00:20:13,927 --> 00:20:17,954
And use cautery instead of a scalpel
to minimize bleeding.
256
00:20:18,131 --> 00:20:22,534
- Then close.
- Do exactly what you just described.
257
00:20:22,669 --> 00:20:26,833
All right, cut the suture
three millimeters, no longer.
258
00:20:27,040 --> 00:20:30,009
Irrigate. Normal saline.
Make sure it's warm.
259
00:20:33,547 --> 00:20:35,777
Park her in the hall
till we can clear an exam room.
260
00:20:35,949 --> 00:20:39,282
- Have you seen Susan?
- She got paged to chopper duty.
261
00:20:45,625 --> 00:20:49,117
- What's up?
- I need ice, lots of ice.
262
00:20:49,296 --> 00:20:54,097
California Cryonics said to put him
on ice until their local rep arrives.
263
00:20:54,234 --> 00:20:56,634
They better hurry.
264
00:20:58,271 --> 00:21:00,739
Dr. Lewis!
265
00:21:01,775 --> 00:21:07,008
- Susan, are you all right?
- Yeah, I want to bring them in.
266
00:21:07,180 --> 00:21:10,377
- I'll go.
- No, I'm fine.
267
00:21:10,550 --> 00:21:13,747
Really?
You can stay here with Herlihy.
268
00:21:13,920 --> 00:21:16,787
Dr. Lewis.
We gotta go.
269
00:21:42,716 --> 00:21:45,708
May I?
See your orders?
270
00:21:49,122 --> 00:21:53,024
John, take these to ICU
and make sure they're carried out...
271
00:21:53,193 --> 00:21:55,127
...as meticulously as written.
272
00:21:55,295 --> 00:21:58,594
Peter, care to join me
in a sarcoma resection?
273
00:21:58,732 --> 00:22:01,098
- Yeah, I'd love to.
- Good.
274
00:22:01,267 --> 00:22:05,431
Gant can cover any trauma calls.
Scrub in, in 45 minutes.
275
00:22:05,605 --> 00:22:07,835
Don't you just love her?
276
00:22:10,977 --> 00:22:15,277
- Where's Zach? Where's my husband?
- Your husband was unconscious.
277
00:22:15,448 --> 00:22:17,382
He woke up confused and disoriented.
278
00:22:17,584 --> 00:22:20,985
He has a head injury?
What about my son?
279
00:22:21,154 --> 00:22:24,988
- He's in surgery.
- Don't worry. They're in good hands.
280
00:22:25,158 --> 00:22:26,216
Move!
281
00:22:27,460 --> 00:22:29,428
Does this hurt?
282
00:22:31,631 --> 00:22:33,758
BP's okay, 115 over 65.
283
00:22:33,900 --> 00:22:38,667
Let's get a C-spine.
H&H, type and cross for four.
284
00:22:39,773 --> 00:22:43,140
- Good set of lungs on her.
- Respiratory rate's kind of high.
285
00:22:43,309 --> 00:22:46,335
- Who knows with all that crying?
- It's 60, pulse 160.
286
00:22:46,546 --> 00:22:51,108
Abdomen's distended.
She's been taking in a lot of air.
287
00:22:51,284 --> 00:22:55,448
Get a baby Gram,
CBC and a gas.
288
00:22:55,622 --> 00:23:00,082
Darling, are you hurt
or just mad at the world?
289
00:23:04,464 --> 00:23:06,898
- What'll it be?
- Do you believe in reincarnation?
290
00:23:07,033 --> 00:23:11,527
Next life I'm coming back
as Cindy Crawford.
291
00:23:11,705 --> 00:23:15,971
A deceased patient wants
to be cryogenically preserved.
292
00:23:16,176 --> 00:23:19,509
We gotta freeze a dead guy.
You got any ice?
293
00:23:19,679 --> 00:23:22,113
- Neck looks okay.
- CT was normal.
294
00:23:22,315 --> 00:23:24,749
Dad's still altered,
they're doing an MRI.
295
00:23:24,918 --> 00:23:28,945
- Why did they take Megan away?
- She's just next door.
296
00:23:29,122 --> 00:23:32,455
- Zach's out of surgery.
- He's gonna be all right?
297
00:23:32,625 --> 00:23:35,458
He's in ICU.
I'll check on him as soon as I can.
298
00:23:35,628 --> 00:23:38,995
Oh, God! I need my husband.
299
00:23:39,165 --> 00:23:42,259
Please. Where is David?
300
00:23:44,738 --> 00:23:49,198
- Her abdomen's kind of firm.
- She swallowed a lot of air.
301
00:23:49,409 --> 00:23:52,469
- What shall we do?
- What is it, Gant?
302
00:23:52,679 --> 00:23:55,876
Her abdomen's persistently distended.
She keeps crying.
303
00:23:56,049 --> 00:23:59,109
Her resps are high.
The BP, the pulses and color are okay.
304
00:23:59,285 --> 00:24:02,379
- Why didn't you drop an NG?
- We considered it...
305
00:24:02,555 --> 00:24:06,218
- In such a small baby?
- Do it off the rectal thermometer.
306
00:24:06,392 --> 00:24:11,352
You didn't do a full surgical
evaluation of the patient, Dr. Gant.
307
00:24:14,033 --> 00:24:16,331
It's positive for blood.
Prep a cutdown tray.
308
00:24:16,503 --> 00:24:18,698
Type and cross for two units
and page Keaton.
309
00:24:18,872 --> 00:24:22,035
- Where's her mother?
- Trauma 1.
310
00:24:22,242 --> 00:24:25,507
Dr. Ross and I thought
it was an equivocal exam.
311
00:24:25,678 --> 00:24:28,476
If you don't know what you're doing,
call someone who does.
312
00:24:28,648 --> 00:24:30,878
Hi, I'm Dr. Benton.
313
00:24:31,050 --> 00:24:34,508
Your daughter has internal injuries
that's gonna require an operation.
314
00:24:34,687 --> 00:24:36,814
She's only 10 days old.
315
00:24:36,990 --> 00:24:39,356
It's okay.
Dr. Keaton will be with her.
316
00:24:39,526 --> 00:24:42,495
And she's the best
pediatric surgeon in Chicago.
317
00:24:42,662 --> 00:24:46,496
We need your consent
for an exploratory laparotomy.
318
00:24:46,633 --> 00:24:49,602
Where's my husband?
I want him to sign for it.
319
00:24:49,769 --> 00:24:52,932
Her husband's a pediatrician.
He can't do it right now.
320
00:24:53,106 --> 00:24:56,940
He handles all
the family medical decisions.
321
00:24:57,811 --> 00:25:00,780
- You can do this, Gail.
- But I don't know.
322
00:25:00,980 --> 00:25:03,710
Your baby needs it.
323
00:25:07,921 --> 00:25:09,889
Okay.
324
00:25:15,495 --> 00:25:18,692
Cutdown tray. Use a volutrol.
We may have to transfuse.
325
00:25:18,865 --> 00:25:21,265
Gant was on track.
I talked him out of it.
326
00:25:21,401 --> 00:25:23,369
Hang D5, 40 normal.
327
00:25:23,536 --> 00:25:27,495
- What do you think, Peter?
- She has an acute abdomen.
328
00:25:27,707 --> 00:25:29,902
Hi, pretty girl.
329
00:25:30,109 --> 00:25:33,670
- Vitals?
- BP's 80 over 40, pulse 160.
330
00:25:33,880 --> 00:25:36,815
Resps 65, temp's 101.4.
331
00:25:37,016 --> 00:25:41,009
- Oh, what blue, blue eyes!
- 92 room air.
332
00:25:42,555 --> 00:25:44,819
Teacup, that's too low.
333
00:25:44,991 --> 00:25:48,722
Let's get her on O-2,
four liters by mask.
334
00:25:49,996 --> 00:25:52,590
Did you appreciate
the periumbilical redness?
335
00:25:52,732 --> 00:25:55,530
- The abdomen's a little tight.
- No, I missed it.
336
00:25:55,702 --> 00:25:57,795
Well, it's easy to miss.
337
00:25:57,971 --> 00:25:59,700
- Why a cutdown?
- No veins.
338
00:25:59,906 --> 00:26:03,535
Twenty-two angio.
This was a nice pickup, Peter.
339
00:26:03,743 --> 00:26:05,677
Thank you.
340
00:26:06,746 --> 00:26:10,147
Ah, yes. There we go.
341
00:26:11,050 --> 00:26:13,610
I couldn't see or feel a vein.
342
00:26:13,786 --> 00:26:16,755
It's just a matter
of knowing where it is.
343
00:26:16,923 --> 00:26:20,723
Let's get her a cross-table lateral
and check for free air.
344
00:26:20,894 --> 00:26:22,862
- Any thoughts on antibiotics?
- Since you don't need...
345
00:26:23,029 --> 00:26:27,363
...anaerobic coverage on newborns,
I'd go with amp and gent.
346
00:26:27,500 --> 00:26:30,958
Dennis, since you did the trauma
assessment, why don't you scrub in?
347
00:26:31,137 --> 00:26:33,230
Peter, let's go talk to Mom.
348
00:26:39,746 --> 00:26:41,111
Good girl.
349
00:26:47,820 --> 00:26:51,187
There you go, Mr. Brazil.
Shrimp cocktail time.
350
00:26:51,357 --> 00:26:55,293
Hubert Skinner, California Cryonics.
Mr. Brazil.
351
00:26:55,461 --> 00:26:59,192
- You got some kind of I.D.?
- It's all there.
352
00:26:59,365 --> 00:27:02,300
Give him
10,000 units of heparin stat.
353
00:27:02,435 --> 00:27:05,836
I'll pack him up,
and we'll be on our way.
354
00:27:06,005 --> 00:27:09,031
- Is he a doctor?
- I don't think so. What do we do?
355
00:27:09,242 --> 00:27:11,642
The heparin can't hurt,
him being dead and all.
356
00:27:11,811 --> 00:27:16,077
In the newborn, I use
a transverse abdominal incision.
357
00:27:16,249 --> 00:27:19,377
The rectus is thin
so there's less pain post-op.
358
00:27:20,420 --> 00:27:23,548
We're using a respirator,
so atelectasis isn't an issue.
359
00:27:23,723 --> 00:27:25,486
Zap that little bleeder.
360
00:27:25,658 --> 00:27:27,319
- Cautery.
- Fifteen blade.
361
00:27:27,493 --> 00:27:28,892
If there's a perforation...
362
00:27:29,062 --> 00:27:33,362
...we should get a gush of air
when I nick the peritoneum.
363
00:27:33,499 --> 00:27:36,696
- There it is.
- She's easier to ventilate.
364
00:27:36,869 --> 00:27:39,133
Dennis, why do we want
to keep bleeding to a minimum?
365
00:27:39,305 --> 00:27:41,273
Transfusions are dangerous.
366
00:27:41,474 --> 00:27:45,035
You can't type and cross-match blood
because of the fetal hemoglobin.
367
00:27:45,244 --> 00:27:50,409
There it is. Perfed jejunum.
You're teaching your interns well.
368
00:27:54,153 --> 00:27:57,054
He's in and out. MRI was normal.
369
00:27:57,223 --> 00:28:00,215
Dr. Herlihy,
do you remember my name?
370
00:28:01,260 --> 00:28:03,990
- Where's my wife and kids?
- I'm Mark Greene.
371
00:28:04,163 --> 00:28:06,688
Your family was involved
in a traffic accident.
372
00:28:06,833 --> 00:28:09,563
Your wife's in the ER,
with a tib-fib fracture.
373
00:28:09,736 --> 00:28:12,796
Zach had facial trauma
and hemoperitoneum.
374
00:28:12,972 --> 00:28:14,872
He's out of surgery in ICU.
375
00:28:15,074 --> 00:28:18,202
- Was it his spleen?
- No. Pancreatic injury.
376
00:28:18,411 --> 00:28:19,844
What about Megan?
377
00:28:20,013 --> 00:28:23,779
Megan just went up
to rule out intestinal perforation.
378
00:28:23,950 --> 00:28:26,180
Why? What happened to her?
379
00:28:26,352 --> 00:28:29,515
She was in the accident with you.
380
00:28:29,689 --> 00:28:32,317
What accident?
381
00:28:32,492 --> 00:28:34,483
Do you know my name?
382
00:28:34,660 --> 00:28:36,787
No. Should I?
383
00:28:42,035 --> 00:28:43,866
It's okay.
384
00:28:44,470 --> 00:28:49,237
Gently. To repair it, we use
a 4.0 silk, interrupted Hufnagel.
385
00:28:49,442 --> 00:28:51,171
Field looks dry.
386
00:28:51,377 --> 00:28:53,777
You don't need
a two-layer in anastomosis.
387
00:28:53,946 --> 00:28:56,847
Cautery alone gives you hemostasis.
388
00:28:57,016 --> 00:28:58,574
Let's irrigate. Warm saline, please.
389
00:28:58,751 --> 00:29:01,151
Zach's abdomen is distending.
390
00:29:01,320 --> 00:29:04,551
- Any changes in his vitals or pulse?
- I think he's bleeding.
391
00:29:04,724 --> 00:29:08,820
Damn! Peter, do you think
you're ready to finish alone?
392
00:29:08,995 --> 00:29:11,190
- Yeah.
- Nothing fancy. Just close.
393
00:29:15,168 --> 00:29:18,797
All right, people. Let's go.
Thank you. One more.
394
00:29:19,672 --> 00:29:22,163
His abdomen is more distended.
395
00:29:22,375 --> 00:29:24,741
- Has he regained consciousness?
- No.
396
00:29:25,745 --> 00:29:29,146
Four-by-eight. Thank you.
397
00:29:30,483 --> 00:29:34,783
- All right. Completely dry.
- What's that?
398
00:29:35,822 --> 00:29:39,724
Looks like a little fiber and debris
on the liver surface.
399
00:29:39,892 --> 00:29:42,759
- Should I call Dr. Keaton?
- No. I'll clean it out.
400
00:29:47,834 --> 00:29:52,168
Okay, got it. Let's close
the peritoneum first. 3.0 Vicryl.
401
00:29:56,309 --> 00:30:00,143
Now, retract medially. Cut.
402
00:30:03,316 --> 00:30:04,578
Good.
403
00:30:04,750 --> 00:30:07,048
- There's a little blood.
- Where?
404
00:30:07,220 --> 00:30:10,678
Oozing from the liver
where you just touched it.
405
00:30:10,857 --> 00:30:15,817
I'll put a little pressure on it.
Use suction. Gently, okay?
406
00:30:21,801 --> 00:30:24,201
Damn it!
407
00:30:25,771 --> 00:30:28,001
- It's still oozing.
- I'm not closing while it's bleeding.
408
00:30:28,207 --> 00:30:32,439
I'll put a stitch in for hemostasis.
4.0 chromic on an S-H now.
409
00:30:35,314 --> 00:30:37,782
Retract caudally.
410
00:30:38,518 --> 00:30:41,078
Come on, Gant. Retractor.
411
00:30:43,656 --> 00:30:46,625
- Is Anesthesia standing by?
- I called them.
412
00:30:51,998 --> 00:30:57,095
- He is distended. Vitals?
- Stable. BP 90 over 60. Pulse is 96.
413
00:30:57,236 --> 00:31:00,967
Pulse ox is 99 percent.
Should I clear an O.R.?
414
00:31:01,174 --> 00:31:05,133
Hang on.
Disconnect the NG from the wall.
415
00:31:09,282 --> 00:31:13,742
Sometimes you get
an erosive gastritis. Hook it back up.
416
00:31:17,023 --> 00:31:19,821
Clots can block the NG
causing acute dilatation.
417
00:31:19,992 --> 00:31:23,428
Irrigate it out
and crisis resolved.
418
00:31:26,432 --> 00:31:29,401
It's just experience, doctor.
419
00:31:32,038 --> 00:31:34,063
- She's still bleeding!
- I can see that.
420
00:31:34,273 --> 00:31:36,833
I'll put a gelfoam
on the bleeding site.
421
00:31:37,043 --> 00:31:40,376
You apply pressure. Come on.
422
00:31:40,546 --> 00:31:43,174
- Do you want me to get Dr. Keaton?
- No.
423
00:31:43,349 --> 00:31:48,810
More suction. I'm gonna oversew.
2.0 chromic on an S-H.
424
00:31:48,988 --> 00:31:50,580
Heart rate's starting to fluctuate.
425
00:31:50,756 --> 00:31:53,247
Give me a bolus
of normal saline, 40 cc's.
426
00:31:53,426 --> 00:31:56,327
The liver's so fragile,
my stitch cut right through.
427
00:31:56,495 --> 00:31:58,929
I'm gonna take a bigger bite.
Retract this way.
428
00:31:59,065 --> 00:32:01,795
You need to get this baby
off the table.
429
00:32:01,968 --> 00:32:04,402
All right, bag her faster, damn it!
430
00:32:06,839 --> 00:32:08,807
- I'm getting Keaton.
- No!
431
00:32:08,975 --> 00:32:10,909
Go! Go!
432
00:32:16,382 --> 00:32:20,648
Do you think it'll help her
to see her husband like this?
433
00:32:23,155 --> 00:32:27,455
Megan's in surgery. Zach's in ICU.
Your husband got out of X-ray.
434
00:32:27,627 --> 00:32:30,221
- He's okay?
- His tests are normal, but...
435
00:32:30,396 --> 00:32:32,557
...there's still memory loss.
436
00:32:32,698 --> 00:32:34,859
Could it be permanent?
437
00:32:35,034 --> 00:32:38,526
You can see these things
in a concussion.
438
00:32:38,704 --> 00:32:42,970
- But it might be?
- We just have to wait and see.
439
00:32:44,043 --> 00:32:46,170
- Blood loss?
- A hundred cc's.
440
00:32:46,379 --> 00:32:48,973
One third of her volume.
What did you do to her liver?
441
00:32:49,148 --> 00:32:53,084
I was trying to peel away
some fiber and debris.
442
00:32:54,120 --> 00:32:55,678
Move.
443
00:32:55,855 --> 00:33:00,053
- 2.0 chromic on an S-H.
- It started to ooze. Clear.
444
00:33:00,226 --> 00:33:02,524
There's no way
to control the bleeding.
445
00:33:02,695 --> 00:33:05,994
Peter, handle the suction.
Dennis, retract distally.
446
00:33:06,132 --> 00:33:08,999
Cautery. Crank it up to 18.
447
00:33:09,168 --> 00:33:10,795
Pulse and BP are destabilizing.
448
00:33:10,970 --> 00:33:13,200
We have to transfuse
with unwashed O-neg.
449
00:33:13,406 --> 00:33:14,771
2.0 chromic. Keep them coming.
450
00:33:14,974 --> 00:33:17,374
She's bradying down. Rate's 80.
451
00:33:17,543 --> 00:33:21,309
3.0 Vicryl for the peritoneum
muscles and staples for the skin.
452
00:33:30,489 --> 00:33:32,423
David?
453
00:33:32,658 --> 00:33:34,922
Oh, my God! David.
454
00:33:35,094 --> 00:33:37,528
- What happened?
- Didn't you tell him?
455
00:33:37,697 --> 00:33:42,157
- We did. Many times.
- Zach's condition is stabilized.
456
00:33:42,301 --> 00:33:44,826
Zach?
457
00:33:45,004 --> 00:33:48,838
- What about Megan?
- Dr. Benton's closing right now.
458
00:33:49,041 --> 00:33:51,066
That's wonderful news.
459
00:33:52,144 --> 00:33:55,079
Was there a truck?
460
00:33:56,382 --> 00:34:00,785
Yeah. Yeah, there was a truck.
461
00:34:06,559 --> 00:34:09,187
- What were you thinking?
- There was debris.
462
00:34:09,362 --> 00:34:11,853
- I only told you to close.
- In my judgment...
463
00:34:12,031 --> 00:34:16,695
I didn't ask for your judgment!
Perry, Dennis, set up a vent.
464
00:34:17,703 --> 00:34:20,695
F-I O-2 at 100 percent.
Stand by with dopamine...
465
00:34:39,959 --> 00:34:44,191
- Does that say chicken belt?
- Conjunctivitis.
466
00:34:44,363 --> 00:34:46,991
I hate chart QA.
467
00:34:53,873 --> 00:34:57,502
- What?
- Nothing.
468
00:34:59,044 --> 00:35:02,013
Thanks for helping me in the chopper.
469
00:35:02,214 --> 00:35:04,842
No problem.
470
00:35:17,530 --> 00:35:19,725
Things can get pressured in here.
471
00:35:19,865 --> 00:35:24,029
It just isn't a place
for someone who is inexperienced.
472
00:35:25,070 --> 00:35:26,970
I can't have you work here again.
473
00:35:50,563 --> 00:35:52,554
Zach?
474
00:35:52,698 --> 00:35:55,098
Oh, God!
475
00:35:55,267 --> 00:35:57,827
- Can I touch him?
- Sure.
476
00:36:10,115 --> 00:36:13,084
Zach, honey, it's Mommy.
477
00:36:14,553 --> 00:36:18,683
I'm gonna stay right here
until you wake up.
478
00:36:25,431 --> 00:36:30,835
- What about Megan?
- No one from Surgery's talked to you?
479
00:36:31,837 --> 00:36:35,364
- I'll go find out what's going on.
- Thank you.
480
00:36:40,479 --> 00:36:43,880
- Why hasn't anyone talked to her?
- I don't know.
481
00:36:44,083 --> 00:36:45,710
Benton was closing over an hour ago.
482
00:36:47,786 --> 00:36:50,687
- Blood gas has improved.
- Not by much.
483
00:36:50,856 --> 00:36:53,984
Could you excuse us, Kit?
Dennis? Thank you.
484
00:36:55,194 --> 00:36:57,628
I should never
have left you unsupervised.
485
00:36:57,796 --> 00:37:02,062
There are nuances in neonatal surgery.
The liver's more friable.
486
00:37:02,201 --> 00:37:06,934
I wanted a clean field before
I closed. It seemed appropriate.
487
00:37:07,106 --> 00:37:12,134
What's at issue here is that you
ignored my specific instructions.
488
00:37:12,344 --> 00:37:14,369
I followed standard
operative procedures.
489
00:37:14,580 --> 00:37:17,048
I've done it a dozen times
in other patients.
490
00:37:17,249 --> 00:37:20,377
This is not an "other" patient.
This is an infant!
491
00:37:20,553 --> 00:37:22,578
Outside now.
492
00:37:27,893 --> 00:37:31,659
You don't know anything
about pediatric surgery.
493
00:37:31,830 --> 00:37:33,821
Are you unwilling
to learn from your mistakes?
494
00:37:33,966 --> 00:37:35,695
Does it say not to stitch a liver?
495
00:37:35,868 --> 00:37:40,635
You didn't know what you were doing.
You should've called me!
496
00:37:40,806 --> 00:37:42,569
Why did I find
three stitches in there?
497
00:37:42,775 --> 00:37:46,370
Because you arrogantly and blindly
think you have all the answers.
498
00:37:46,579 --> 00:37:49,013
If that baby dies,
it'll be my responsibility...
499
00:37:49,214 --> 00:37:52,274
...but it'll be your fault.
- Dr. Keaton, she's crashing.
500
00:37:52,885 --> 00:37:55,251
Pulse ox is 86.
Heart rate's down to 45.
501
00:37:55,421 --> 00:37:58,481
Decreased breath sounds on the right.
502
00:37:58,657 --> 00:38:01,023
Sounds like a pneumothorax.
Chest x-ray.
503
00:38:01,193 --> 00:38:03,161
Don't need it.
504
00:38:03,329 --> 00:38:06,093
Increase transillumination
on the right side.
505
00:38:06,231 --> 00:38:09,667
- Chest-tube tray.
- This is no longer a teaching case.
506
00:38:09,835 --> 00:38:13,601
- She's gonna need a repeat ABG.
- Pulse is up to 72.
507
00:38:13,806 --> 00:38:16,934
- Dynamap's not registering a BP.
- Get ready with Thermo-Seal.
508
00:38:17,810 --> 00:38:20,745
She's arresting.
Heart rate's down to 20.
509
00:38:20,913 --> 00:38:25,247
Let's start CPR.
Epi one to ten thousand point four.
510
00:38:25,417 --> 00:38:28,045
Atropine.08 milligrams.
How's the blood gas?
511
00:38:28,220 --> 00:38:31,849
PH 7.3. PO-245. PCO-230
on 100 percent oxygen.
512
00:38:32,024 --> 00:38:34,117
We have to put her
on an ECMO bypass.
513
00:38:34,293 --> 00:38:38,127
Kit, call the tech. Get
two units O-neg to prime the system.
514
00:38:38,297 --> 00:38:43,166
- Do we bring her back up to the O.R.?
- No, we'll bring the O.R. To her.
515
00:38:44,403 --> 00:38:46,200
Dr. Greene?
516
00:38:47,239 --> 00:38:48,866
Dr. Herlihy?
517
00:38:49,942 --> 00:38:52,877
- What time is it?
- Eight o'clock.
518
00:38:53,045 --> 00:38:55,946
P.M.?
Where's my family?
519
00:38:56,115 --> 00:38:59,710
Your wife's upstairs.
Both the kids had laparotomies.
520
00:38:59,885 --> 00:39:01,853
A bed opened up for you in ICU.
521
00:39:02,021 --> 00:39:04,046
How'd they do?
522
00:39:04,223 --> 00:39:08,216
Your son's out of surgery.
I don't know about your daughter.
523
00:39:08,394 --> 00:39:12,023
- How do I find out about my daughter?
- I'll check on her.
524
00:39:12,197 --> 00:39:14,563
- Thank you, Dr. Greene.
- Mark.
525
00:39:14,700 --> 00:39:16,258
Mark.
526
00:39:20,105 --> 00:39:24,599
Pedes O.R. Called. His daughter
decompensated in surgery.
527
00:39:41,093 --> 00:39:45,689
- She's still flatline.
- Repeat.04 of epi.
528
00:39:47,533 --> 00:39:50,730
Go ahead, Kit.
How long has she been down?
529
00:39:50,903 --> 00:39:53,098
Twenty-two minutes.
530
00:39:54,173 --> 00:39:57,006
- Is the ECMO circuit primed?
- Yes.
531
00:39:57,176 --> 00:40:00,270
Good. I'm ready.
Venous connection first.
532
00:40:01,647 --> 00:40:03,877
Arterial.
533
00:40:04,717 --> 00:40:06,685
Turn it on.
534
00:40:20,332 --> 00:40:24,359
- We've got a heartbeat and a pulse.
- Faint.
535
00:40:25,337 --> 00:40:26,429
She's pinking up.
536
00:40:26,605 --> 00:40:30,097
Let's get a repeat gas.
We need to anti-coagulate her.
537
00:40:30,309 --> 00:40:34,143
Heparin, 150 units IV.
Start drip at 10 units an hour.
538
00:40:34,313 --> 00:40:37,976
- How come we anti-coagulate her?
- We have to, or her blood will clot.
539
00:40:38,150 --> 00:40:40,778
- Won't she bleed out?
- We have to hope that she doesn't.
540
00:40:40,953 --> 00:40:44,719
I'll dictate an operative report.
Meet me in Pedes ICU in five minutes.
541
00:40:44,890 --> 00:40:47,188
We gotta tell the parents.
542
00:40:54,199 --> 00:40:57,066
Peter, how'd it go?
543
00:40:57,236 --> 00:41:00,865
- How's the baby?
- Not good.
544
00:41:06,378 --> 00:41:09,142
Dr. Benton...
545
00:41:09,314 --> 00:41:11,874
You didn't sign the code sheet.
546
00:41:15,587 --> 00:41:18,147
Hey, we're all human.
547
00:41:18,323 --> 00:41:20,348
We all make mistakes.
548
00:41:20,526 --> 00:41:24,155
Any other words of wisdom, Gant?
549
00:41:26,265 --> 00:41:29,359
You're a real prick, you know that?
550
00:41:31,804 --> 00:41:37,333
Mrs. Herlihy, this is Dr. Keaton.
She operated on both Zach and Megan.
551
00:41:37,543 --> 00:41:38,840
Mrs. Herlihy...
552
00:41:39,011 --> 00:41:42,674
Megan had a perforated intestine
from the accident.
553
00:41:42,848 --> 00:41:47,217
When we operated to repair it,
there were complications.
554
00:41:50,889 --> 00:41:55,588
- What are you saying?
- She's in the NICU on a device...
555
00:41:55,761 --> 00:41:59,663
...that helps her heart and lungs
oxygenate her blood.
556
00:41:59,798 --> 00:42:04,292
There was bleeding during
the operation, and she went into shock.
557
00:42:04,469 --> 00:42:08,269
Then her lung collapsed,
and finally, her heart stopped.
558
00:42:09,308 --> 00:42:12,709
We got it started again by
putting her on a bypass machine.
559
00:42:30,429 --> 00:42:32,920
Is she gonna die?
560
00:42:33,065 --> 00:42:35,533
She's in extremely critical condition.
561
00:42:35,701 --> 00:42:39,102
It's... It is a possibility.
562
00:43:45,837 --> 00:43:51,241
The Lord is my shepherd,
I shall not want.
563
00:43:53,211 --> 00:43:57,375
He makes me lie down
in green pastures.
564
00:43:57,549 --> 00:43:59,517
He...
565
00:44:03,288 --> 00:44:04,915
The Lord is my shepherd,
I shall not want.
566
00:44:05,090 --> 00:44:08,526
He makes me lie down
in green pastures. He's...
567
00:44:08,694 --> 00:44:10,662
Dr. Benton?
568
00:44:15,200 --> 00:44:18,169
I can't remember the words.
45593
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