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1
00:00:03,437 --> 00:00:04,572
Previously on ER.
2
00:00:04,572 --> 00:00:06,574
SAM:
Got a letter from your dad.
3
00:00:06,574 --> 00:00:09,610
Steve was saying that he's got
some new job in Colorado.
4
00:00:09,610 --> 00:00:12,046
KOVAC:
Sam, you've got to tell
Alex the truth.
5
00:00:12,046 --> 00:00:13,147
Alex!
6
00:00:15,116 --> 00:00:16,550
It's all going to be okay.
7
00:00:36,770 --> 00:00:38,206
He's 12.
8
00:00:38,206 --> 00:00:40,441
MAN:
When was the last time
you saw him?
9
00:00:40,441 --> 00:00:42,843
Around 8:30.
10
00:00:42,843 --> 00:00:45,279
So four and a half
hours ago?
11
00:00:45,279 --> 00:00:48,349
Friends, relatives, anyone
he might be with?
12
00:00:48,349 --> 00:00:50,851
We've been calling and driving
around.
13
00:00:50,851 --> 00:00:52,253
There's nothing.
14
00:00:52,253 --> 00:00:54,488
Any fights,
school problems?
15
00:00:54,488 --> 00:00:56,190
We had an argument.
16
00:00:56,190 --> 00:00:59,760
I went upstairs to take a shower
and get ready for bed.
17
00:00:59,760 --> 00:01:02,463
And about an hour later,
18
00:01:02,463 --> 00:01:06,267
Visa called for an authorization
on my card.
19
00:01:06,267 --> 00:01:09,337
He went to the bus station
and tried to buy a ticket.
20
00:01:09,337 --> 00:01:10,704
A ticket to where?
21
00:01:10,704 --> 00:01:12,573
Colorado.
22
00:01:12,573 --> 00:01:14,208
Why Colorado?
23
00:01:14,208 --> 00:01:15,643
His dad is there.
24
00:01:15,643 --> 00:01:16,877
What about
his home situation?
25
00:01:16,877 --> 00:01:19,213
Is it stable?
Drugs? Violence?
26
00:01:19,213 --> 00:01:21,282
Alex has a good home.
27
00:01:21,282 --> 00:01:25,219
What about dad?
Did you tell him Alex maybe
on his way or call him?
28
00:01:25,219 --> 00:01:27,255
He's not easy
to get a hold of.
29
00:01:27,255 --> 00:01:28,322
Why's that?
30
00:01:31,359 --> 00:01:32,793
He's in prison.
31
00:01:32,793 --> 00:01:34,795
SAM:
Alex doesn't know that
32
00:01:34,795 --> 00:01:36,464
his dad's in jail.
33
00:01:36,464 --> 00:01:39,700
He's been asking me if he can go
live with him.
34
00:01:39,700 --> 00:01:42,836
I'm sorry, shouldn't we be
calling Amtrak or the airlines?
35
00:01:42,836 --> 00:01:45,373
No. They won't board a minor
without parental consent.
36
00:01:45,373 --> 00:01:47,375
You got a recent photo?
37
00:01:47,375 --> 00:01:49,277
MAN:
This happens
all the time.
38
00:01:49,277 --> 00:01:52,413
Nine times out of ten, they're
back in 24 hours or less.
39
00:01:52,413 --> 00:01:55,183
Alex doesn't have 24 hours.
He's diabetic.
40
00:01:55,183 --> 00:01:56,617
He could be in a coma by this
time tomorrow,
41
00:01:56,617 --> 00:01:58,886
if he doesn't get his insulin.
42
00:01:58,886 --> 00:02:00,354
KOVAC:
Sam.
43
00:02:00,354 --> 00:02:01,822
We've gotta go by Shelley's.
Sam.
44
00:02:01,822 --> 00:02:03,857
Union Station and the park...
Sam, the car...
45
00:02:03,857 --> 00:02:06,327
He likes Navy Pier.
Maybe he went over there.
46
00:02:06,327 --> 00:02:08,362
And then we'll circle back
to the school
47
00:02:08,362 --> 00:02:10,331
and uh, the, the, the....
the arcade...
48
00:02:10,331 --> 00:02:12,366
We should be at
home when he calls.
49
00:02:12,366 --> 00:02:13,834
We'll check out Denny's
and McDonald's.
50
00:02:13,834 --> 00:02:15,669
Open the door open...
Sam, he's not...
51
00:02:15,669 --> 00:02:17,471
Please, open the door!
52
00:02:21,442 --> 00:02:23,511
Sam, when he calls,
53
00:02:23,511 --> 00:02:24,878
he'll call home.
54
00:02:24,878 --> 00:02:27,548
They said
we should be there.
55
00:02:27,548 --> 00:02:30,618
He knows how to monitor
his carbs, stay hydrated...
56
00:02:30,618 --> 00:02:35,323
He's too smart.
57
00:02:35,323 --> 00:02:38,559
He's stubborn and resourceful
and smart.
58
00:02:41,895 --> 00:02:43,897
He's not coming back.
59
00:02:50,571 --> 00:02:52,273
( sobbing )
60
00:04:43,517 --> 00:04:46,053
Oh... the day shift.
61
00:04:46,053 --> 00:04:47,555
( loud kiss )
62
00:04:47,555 --> 00:04:48,889
There is a God.
63
00:04:48,889 --> 00:04:50,858
Ew.
Hard night?
64
00:04:50,858 --> 00:04:52,059
Okay, everybody's here?
Good.
65
00:04:52,059 --> 00:04:54,362
It's 8:02, time for rounds.
66
00:04:54,362 --> 00:04:55,396
Curtain number one.
67
00:04:55,396 --> 00:04:56,430
Wait.
Ray, you're on.
68
00:04:56,430 --> 00:04:57,798
What?
69
00:04:57,798 --> 00:05:00,067
You're an R-2 now.
R-2s run the board.
70
00:05:00,067 --> 00:05:02,069
Uh, okay.
71
00:05:02,069 --> 00:05:03,671
Well, uh, okay,
curtain one.
72
00:05:03,671 --> 00:05:04,905
Foreign body
in the eye.
73
00:05:04,905 --> 00:05:06,740
Sanding his boat
without any eye gear.
74
00:05:06,740 --> 00:05:08,376
Shard of glass
under the lid.
75
00:05:08,376 --> 00:05:09,610
Corneal abrasion?
76
00:05:09,610 --> 00:05:11,044
Didn't get a chance
to check.
77
00:05:11,044 --> 00:05:12,546
Okay.
Jane, he's yours.
78
00:05:12,546 --> 00:05:14,382
Fluorescein, slit lamp,
exam, and home.
79
00:05:14,382 --> 00:05:16,484
In curtain three we have an
altered 19-year-old.
80
00:05:16,484 --> 00:05:17,951
Drank a gallon of antifreeze.
81
00:05:17,951 --> 00:05:20,421
Responding to fomepizole,
waiting on psych and ICU bed.
82
00:05:20,421 --> 00:05:21,755
Great, moving on.
83
00:05:21,755 --> 00:05:23,591
Whoa. This is a good teaching
case.
84
00:05:23,591 --> 00:05:26,927
Yeah. Take a minute and tell us
all about fomepizole.
85
00:05:26,927 --> 00:05:31,131
Uh, well,
it's pretty new.
86
00:05:31,131 --> 00:05:32,700
Yeah, what
does it do?
87
00:05:34,702 --> 00:05:36,570
Lowers the ethylene glycol
level?
88
00:05:36,570 --> 00:05:38,406
Tell them how.
89
00:05:38,406 --> 00:05:41,074
Increases renal excretion.
90
00:05:41,074 --> 00:05:42,510
LEWIS:
Anyone else?
91
00:05:42,510 --> 00:05:45,546
Does it inhibit alcohol
dehydrogenase?
92
00:05:45,546 --> 00:05:48,015
I think it might prevent
formation of acidic metabolites.
93
00:05:48,015 --> 00:05:49,850
Get it in early,
you'll avoid dialysis.
94
00:05:49,850 --> 00:05:52,720
I'm gonna read about this and
make a hand-out for you.
95
00:05:52,720 --> 00:05:54,755
No, R2's have to read
before rounds start.
96
00:05:54,755 --> 00:05:57,525
How? I just got here.
Then get here early.
97
00:05:57,525 --> 00:05:59,159
Teaching should
be spontaneous,
off the cuff.
98
00:05:59,159 --> 00:06:00,861
WOMAN:
Excuse me.
Is there somewhere
99
00:06:00,861 --> 00:06:03,931
I can breast feed? Been here
three hours. Kid needs to eat.
100
00:06:03,931 --> 00:06:07,768
Oh, yeah, yeah. There's a, uh,
family room down the hall.
101
00:06:07,768 --> 00:06:10,571
Mom, I'm starving.
102
00:06:10,571 --> 00:06:12,440
MORRIS:
All the way
on your left.
103
00:06:12,440 --> 00:06:13,741
How old is that kid?
104
00:06:13,741 --> 00:06:14,975
He's got
to be six.
105
00:06:14,975 --> 00:06:16,977
That is a little freaky.
106
00:06:16,977 --> 00:06:19,447
KOVAC:
Sam? Hey...
107
00:06:19,447 --> 00:06:21,148
( gasps ):
What?
It's okay.
108
00:06:21,148 --> 00:06:23,050
Did they call?
109
00:06:23,050 --> 00:06:25,553
No, just his picture on the TV.
110
00:06:33,461 --> 00:06:35,195
How long was I asleep for?
111
00:06:35,195 --> 00:06:37,631
About an hour.
112
00:06:37,631 --> 00:06:39,867
All right, we got to start
calling everybody again.
113
00:06:39,867 --> 00:06:41,201
You already called
everybody.
114
00:06:41,201 --> 00:06:43,871
They're going to
call us if some...
115
00:06:46,173 --> 00:06:49,977
Hi, Debbie.
116
00:06:49,977 --> 00:06:51,845
Yeah.
117
00:06:51,845 --> 00:06:54,682
No.
118
00:06:54,682 --> 00:06:55,849
No, huh?
119
00:06:55,849 --> 00:06:58,218
Okay, yeah, yeah,
of course.
120
00:06:58,218 --> 00:06:59,887
As soon as I hear anything.
121
00:06:59,887 --> 00:07:02,122
Hi, yes, this is Luka Kovac,
again.
122
00:07:02,122 --> 00:07:04,157
( phone ringing )
123
00:07:07,661 --> 00:07:08,729
Hello.
124
00:07:08,729 --> 00:07:09,763
LEWIS:
What is it?
125
00:07:09,763 --> 00:07:11,064
Altered traffic collision.
126
00:07:11,064 --> 00:07:13,100
GCS eight, systolic 100.
Let's bag her.
127
00:07:13,100 --> 00:07:14,668
What's your plan, Ray?
128
00:07:14,668 --> 00:07:17,705
All right, intubation, FAST exam
and a head CT.
129
00:07:17,705 --> 00:07:19,139
Okay, I'll be in curtain two.
130
00:07:19,139 --> 00:07:20,240
Dr. Lewis...
131
00:07:20,240 --> 00:07:21,909
Call me if you need me.
132
00:07:21,909 --> 00:07:23,744
I guess she trusts you.
133
00:07:23,744 --> 00:07:24,778
Uh, yeah.
134
00:07:24,778 --> 00:07:26,213
20 of etomidate,
100 of sux,
135
00:07:26,213 --> 00:07:27,881
portable c-spine and chest
to follow.
136
00:07:27,881 --> 00:07:29,850
Let's get that Sonosite ready.
Come here.
137
00:07:29,850 --> 00:07:31,251
You mind if I intubate?
138
00:07:31,251 --> 00:07:33,086
You might want to observe
one, first.
139
00:07:33,086 --> 00:07:34,688
Why do you use Etomidate?
140
00:07:34,688 --> 00:07:36,624
You need a sedative
with the paralytic.
141
00:07:36,624 --> 00:07:38,859
I know, but isn't it
true that Ketamine causes
142
00:07:38,859 --> 00:07:39,927
less respiratory
depression?
143
00:07:39,927 --> 00:07:41,629
Uh, maybe.
144
00:07:41,629 --> 00:07:44,097
Well, does it have a more
favorable hemodynamic profile?
145
00:07:44,097 --> 00:07:46,700
I mean, if you're concerned
about intra-abdominal
hemorrhaging,
146
00:07:46,700 --> 00:07:48,936
then it seems like you would
definitely want to...
147
00:07:48,936 --> 00:07:50,971
we use Etomidate because
it's a good drug.
148
00:07:50,971 --> 00:07:52,606
Okay, let me
take a look.
149
00:07:52,606 --> 00:07:54,007
Sat's up to 92.
150
00:07:54,007 --> 00:07:56,243
All right. Now pull the handle
at 45 degrees
151
00:07:56,243 --> 00:07:58,546
and never rock back
against the teeth.
152
00:07:58,546 --> 00:08:00,581
Shouldn't you give a
de-fasciculating
dose of Pavulon?
153
00:08:00,581 --> 00:08:01,715
Uh, sometimes we do.
154
00:08:01,715 --> 00:08:03,150
Is sux okay in crush injuries?
155
00:08:03,150 --> 00:08:04,985
Uh-huh.
Cricoid pressure.
156
00:08:04,985 --> 00:08:06,587
What about
hyperkalemia?
157
00:08:06,587 --> 00:08:08,255
Look, this is never
going to happen.
158
00:08:08,255 --> 00:08:10,090
Okay, the 8-0, it won't
pull through.
159
00:08:10,090 --> 00:08:12,626
All right, we need
a smaller tube. Bag her.
160
00:08:12,626 --> 00:08:14,161
Is sux okay in burn patients?
161
00:08:14,161 --> 00:08:16,096
Look, more observation,
and less conversation.
162
00:08:16,096 --> 00:08:17,931
We tube her and then
we chat.
163
00:08:17,931 --> 00:08:19,199
Okay?
Okay.
164
00:08:19,199 --> 00:08:20,768
Seven and a half.
165
00:08:20,768 --> 00:08:23,937
Okay, thank you.
166
00:08:23,937 --> 00:08:27,007
Sergeant Parker wont tell us
what this is about on the phone.
167
00:08:27,007 --> 00:08:28,709
We haven't found your son yet.
168
00:08:28,709 --> 00:08:29,977
12,000 fliers went out--
169
00:08:29,977 --> 00:08:32,112
precincts, hospitals,
state police.
170
00:08:32,112 --> 00:08:33,914
We notified the folks
in Colorado
171
00:08:33,914 --> 00:08:36,183
and we're getting some play
on local television.
172
00:08:36,183 --> 00:08:38,085
Please, have a seat.
173
00:08:38,085 --> 00:08:42,823
We canvassed the airline ticket
counters, Union Station, buses,
174
00:08:44,124 --> 00:08:46,694
nobody recognized
your son.
175
00:08:46,694 --> 00:08:48,929
Hey, thanks for
coming back down.
176
00:08:50,864 --> 00:08:52,332
Still nothing from Alex?
177
00:08:52,332 --> 00:08:54,635
No, you know, I'm sorry,
I don't understand
178
00:08:54,635 --> 00:08:56,303
why you couldn't
have over the phone.
179
00:08:56,303 --> 00:08:58,806
Why did you want us
to come down here?
180
00:08:59,973 --> 00:09:01,609
We got a report
181
00:09:01,609 --> 00:09:03,944
of an unidentified diabetic
kid in a coma.
182
00:09:03,944 --> 00:09:06,013
It matches your son's
general description.
183
00:09:06,013 --> 00:09:07,280
Where is he?
184
00:09:07,280 --> 00:09:09,049
In all likelihood,
it's not him.
185
00:09:09,049 --> 00:09:11,084
We're waiting for them
to fax a photo,
186
00:09:11,084 --> 00:09:12,953
but, uh,
187
00:09:12,953 --> 00:09:15,222
they're still working on him
at the hospital.
188
00:09:15,222 --> 00:09:17,224
Where is he?
189
00:09:17,224 --> 00:09:18,826
Iowa, Davenport, Iowa.
190
00:09:18,826 --> 00:09:20,694
It's 200 miles.
I'll drive.
191
00:09:20,694 --> 00:09:23,330
They'll figure out if it's him
before we can get there.
192
00:09:23,330 --> 00:09:25,365
If it's him, we'll be
that much closer.
193
00:09:25,365 --> 00:09:27,635
If it's not, we'll be
that much further.
194
00:09:27,635 --> 00:09:30,871
I can't just sit
waiting for a call
that they found Alex
195
00:09:30,871 --> 00:09:32,640
in a ditch or
a Dumpster!
196
00:09:32,640 --> 00:09:34,041
I can't, okay?
I can't.
197
00:09:38,245 --> 00:09:40,681
Tell Dubenko the second hemocue
was 12.1.
198
00:09:40,681 --> 00:09:41,915
Going to the O.R.?
199
00:09:41,915 --> 00:09:44,351
Yeah, FAST was positive,
needs an ex-lap.
200
00:09:44,351 --> 00:09:46,053
How did it go, Haleh?
201
00:09:46,053 --> 00:09:48,021
It was a little rough.
202
00:09:48,021 --> 00:09:50,257
Do you want to
give Dr. Barnett
some feedback?
203
00:09:50,257 --> 00:09:51,892
There wasn't much teaching.
204
00:09:51,892 --> 00:09:55,062
You seemed distracted by
questions from the interns.
205
00:09:55,062 --> 00:09:57,397
Well, they wouldn't
shut up.
Ray.
206
00:09:57,397 --> 00:10:00,133
His frustration prevented the
team from working together.
207
00:10:00,133 --> 00:10:01,935
There was a lot
of tension.
208
00:10:01,935 --> 00:10:04,905
It could have caused a delay in
diagnosing the splenic lac.
209
00:10:04,905 --> 00:10:06,073
Oh, please.
210
00:10:06,073 --> 00:10:07,240
Thank you, Haleh.
211
00:10:07,240 --> 00:10:09,977
Thank you. Thanks.
What was that about?
212
00:10:09,977 --> 00:10:12,813
Improving your skills,
making you a better teacher,
a better leader.
213
00:10:12,813 --> 00:10:14,915
And since when do nurses
evaluate the residents?
214
00:10:14,915 --> 00:10:16,784
Haleh has been here
long. She knows.
215
00:10:16,784 --> 00:10:18,318
I needed to treat this patient.
216
00:10:18,318 --> 00:10:20,754
You also need to create a
positive learning climate.
217
00:10:20,754 --> 00:10:23,390
Are you torturing all the R-2s
or is it just me?
218
00:10:23,390 --> 00:10:26,026
Ray, resolving TIA.
219
00:10:26,026 --> 00:10:28,128
Go.
220
00:10:37,404 --> 00:10:39,406
We must have missed it.
221
00:10:39,406 --> 00:10:42,042
Well, they said it's over a mile
from the Interstate...
222
00:10:42,042 --> 00:10:44,011
We've only gone...
Ah, that's it.
223
00:11:12,172 --> 00:11:15,208
Hello?
Anybody here?
224
00:11:15,208 --> 00:11:17,110
Excuse me?
225
00:11:17,110 --> 00:11:18,879
There's a button.
226
00:11:19,747 --> 00:11:20,881
Over there.
227
00:11:20,881 --> 00:11:24,217
( bell ringing )
228
00:11:24,217 --> 00:11:25,753
WOMAN:
Hold your horses,
229
00:11:25,753 --> 00:11:28,321
I'm coming.
230
00:11:28,321 --> 00:11:30,023
You have a boy in DKA?
231
00:11:30,023 --> 00:11:31,191
Security guard found him
232
00:11:31,191 --> 00:11:32,826
down behind Penney's
at the mall.
233
00:11:32,826 --> 00:11:34,194
Didn't have any ID.
234
00:11:34,194 --> 00:11:38,198
His blood sugar was
764, PH 7.10,
235
00:11:38,198 --> 00:11:41,835
GCS eight, ketones were
positive at 1 to 64.
236
00:11:41,835 --> 00:11:44,337
He's on I.V. saline,
insulin and potassium.
237
00:11:44,337 --> 00:11:47,808
He just started opening
his eyes on command.
You just missed Dr. Hahn.
238
00:11:47,808 --> 00:11:49,843
He went home to get
his digital camera
239
00:11:49,843 --> 00:11:54,414
so that we could send a picture
to the police in Chicago.
240
00:11:54,414 --> 00:11:56,116
KOVAC:
No, it wasn't him.
241
00:11:56,116 --> 00:11:58,251
Right. Thanks.
242
00:11:59,887 --> 00:12:00,988
Anything?
243
00:12:00,988 --> 00:12:04,792
No, not yet.
244
00:12:04,792 --> 00:12:05,826
( screaming )
245
00:12:05,826 --> 00:12:07,327
Damn it, Alex!
246
00:12:21,408 --> 00:12:23,310
Erica's fine to stay
at the apartment
247
00:12:23,310 --> 00:12:26,513
until we get back.
248
00:12:26,513 --> 00:12:28,982
He's not coming home, Luka.
249
00:12:49,036 --> 00:12:52,539
The keys?
250
00:12:52,539 --> 00:12:54,274
Where we going?
251
00:12:54,274 --> 00:12:56,977
Colorado.
252
00:13:05,886 --> 00:13:07,154
No infiltrate.
253
00:13:07,154 --> 00:13:08,856
Like I said,
fever without source.
254
00:13:08,856 --> 00:13:10,057
Everything okay?
255
00:13:10,057 --> 00:13:12,525
Well, he doesn't
have pneumonia.
256
00:13:12,525 --> 00:13:14,094
Urine?
All clear.
257
00:13:14,094 --> 00:13:15,262
Rapid strep?
258
00:13:15,262 --> 00:13:16,296
No clinical indication.
259
00:13:16,296 --> 00:13:17,865
Okay.
260
00:13:17,865 --> 00:13:20,067
Mason, can you open up
your mouth for me?
261
00:13:20,067 --> 00:13:21,101
I don't like that.
262
00:13:21,101 --> 00:13:22,535
Come on.
You're a big boy.
263
00:13:22,535 --> 00:13:23,971
I already did it.
264
00:13:23,971 --> 00:13:27,174
Okay, real quick-- ah?
265
00:13:27,174 --> 00:13:28,241
Ah.
266
00:13:28,241 --> 00:13:29,276
A little bigger.
267
00:13:29,276 --> 00:13:30,343
Ah.
268
00:13:30,343 --> 00:13:31,378
Any rash?
269
00:13:31,378 --> 00:13:32,379
No.
No.
270
00:13:32,379 --> 00:13:33,881
He looks good.
271
00:13:33,881 --> 00:13:35,482
Can you remove
his pajamas for me?
272
00:13:35,482 --> 00:13:37,317
Dr. Babinski had him
in a gown.
273
00:13:37,317 --> 00:13:39,552
I don't want to take off
my clothes again.
274
00:13:39,552 --> 00:13:41,188
I'm sorry, but
it's important, okay?
275
00:13:41,188 --> 00:13:43,356
You said we can go home.
276
00:13:43,356 --> 00:13:46,126
I want to go home!
Mason...
277
00:13:46,126 --> 00:13:48,095
I want to go home now!
278
00:13:48,095 --> 00:13:49,897
Mason, come on.
Ray?
279
00:13:49,897 --> 00:13:51,131
Two seconds.
280
00:13:51,131 --> 00:13:52,565
Excuse me.
I'll be right back.
281
00:13:52,565 --> 00:13:53,934
No!
One more time.
282
00:13:53,934 --> 00:13:55,002
No!
283
00:13:55,002 --> 00:13:56,569
Come on, Mason.
One more time.
284
00:13:56,569 --> 00:13:58,071
How's it going
in there?
285
00:13:58,071 --> 00:14:00,407
Uh, just looking
for a fever source.
286
00:14:00,407 --> 00:14:02,409
Babinski said
there wasn't one.
287
00:14:02,409 --> 00:14:05,412
You know how
it is with interns.
You got to check up on them.
288
00:14:05,412 --> 00:14:07,314
But not for 20 minutes.
289
00:14:07,314 --> 00:14:10,183
Ray, the interns are doctors.
You have to trust their skills.
290
00:14:10,183 --> 00:14:13,020
They were students
last week. They don't know
what they're doing.
291
00:14:13,020 --> 00:14:15,122
You're micromanaging every case.
It's bad for patient flow.
292
00:14:15,122 --> 00:14:16,589
Yeah, we were
caught up.
293
00:14:16,589 --> 00:14:19,026
Now we've got six and
20 in the rack.
294
00:14:19,026 --> 00:14:20,360
And that's my fault?
295
00:14:20,360 --> 00:14:22,562
I liked you better when
you were the closer.
296
00:14:30,637 --> 00:14:32,405
Still no service.
297
00:14:32,405 --> 00:14:34,107
We're about 30 miles
from Omaha,
298
00:14:34,107 --> 00:14:36,944
so we'll probably
get service soon.
299
00:14:36,944 --> 00:14:38,478
Where in Colorado?
300
00:14:38,478 --> 00:14:40,513
Huh?
301
00:14:40,513 --> 00:14:42,415
Where is Steve?
302
00:14:42,415 --> 00:14:44,351
Uh, Canon City.
303
00:14:44,351 --> 00:14:46,486
Where's that?
304
00:14:46,486 --> 00:14:49,056
In the mountains somewhere,
I think.
305
00:14:49,056 --> 00:14:51,191
I've never been.
306
00:14:51,191 --> 00:14:53,126
What?
307
00:14:53,126 --> 00:14:54,361
Colorado.
308
00:14:54,361 --> 00:14:56,496
I always wanted to go.
309
00:14:56,496 --> 00:14:58,131
I heard it's beautiful.
310
00:14:58,131 --> 00:15:00,968
Yeah.
311
00:15:03,170 --> 00:15:05,973
What were you and Alex fighting
about
312
00:15:05,973 --> 00:15:09,042
last night?
313
00:15:09,042 --> 00:15:10,978
The usual.
314
00:15:12,312 --> 00:15:13,513
Me?
315
00:15:15,382 --> 00:15:17,517
Us.
316
00:15:19,352 --> 00:15:20,988
( sighs )
317
00:15:20,988 --> 00:15:22,990
I should have
just told him
the truth.
318
00:15:24,624 --> 00:15:26,293
He knew
we were having trouble.
319
00:15:26,293 --> 00:15:28,595
No, the truth
about his father.
320
00:15:40,740 --> 00:15:42,575
So after the attending leaves
you high and dry in trauma,
321
00:15:42,575 --> 00:15:45,212
you're going
to be critiqued
by a nurse.
That's weird.
322
00:15:45,212 --> 00:15:47,680
Even if the patient's crashing,
make nice with the newbies,
or be dinged.
323
00:15:47,680 --> 00:15:50,317
Ray, can I give another four
of morphine to McKenzie?
324
00:15:50,317 --> 00:15:51,751
Do you think he needs it?
325
00:15:51,751 --> 00:15:54,021
No, I just want him
to stop breathing.
326
00:15:54,021 --> 00:15:56,456
Fine. You're responsible
for every little thing
the intern does.
327
00:15:56,456 --> 00:15:59,526
But you question the history,
and they get all testy on you.
328
00:15:59,526 --> 00:16:01,561
Sounds like you
had a great day.
Yeah.
329
00:16:01,561 --> 00:16:04,031
You ready, Neela?
Tonight's all about you and me.
330
00:16:04,031 --> 00:16:06,033
And me.
Teddy Marsh,
new intern.
331
00:16:06,033 --> 00:16:07,267
Hello.
332
00:16:07,267 --> 00:16:09,469
My first shift--
an overnight, awesome.
333
00:16:09,469 --> 00:16:12,105
This is Neela.
She's the R-2.
She's in charge.
334
00:16:12,105 --> 00:16:13,773
You're mission:
clear that board by morning.
335
00:16:13,773 --> 00:16:15,642
I'm screwed.
336
00:16:15,642 --> 00:16:18,778
Antifreeze overdose
has been here all night
waiting on the ICU.
337
00:16:18,778 --> 00:16:22,049
Step it up. The day shift
wants to get out of here.
338
00:16:22,049 --> 00:16:23,683
Just remember,
fomepizole's an alcohol
dehydrogenase inhibitor
339
00:16:23,683 --> 00:16:25,385
and you'll be fine.
What?
340
00:16:25,385 --> 00:16:27,320
Neela, you're running rounds,
so let's start.
341
00:16:51,278 --> 00:16:52,712
It's about nine hours
to Denver.
342
00:16:52,712 --> 00:16:54,514
Think we'll
make it by dawn.
343
00:16:54,514 --> 00:16:55,748
You should sleep.
I'll drive.
344
00:16:55,748 --> 00:16:57,384
No, I'm okay.
No, I'm awake.
345
00:16:57,384 --> 00:16:59,619
Not sure I'll be
in the next four hours.
346
00:16:59,619 --> 00:17:01,788
Shoot. My cell phone battery
is almost dead.
347
00:17:01,788 --> 00:17:04,091
I should have
brought my charger.
348
00:17:06,526 --> 00:17:08,361
( sighs )
349
00:17:13,166 --> 00:17:14,167
Hey, Luka.
350
00:17:17,604 --> 00:17:19,106
Thank you.
351
00:17:25,578 --> 00:17:27,747
NEELA:
The calculated osmolality
is approximated
352
00:17:27,747 --> 00:17:29,649
by multiplying the sodium
concentration by two
353
00:17:29,649 --> 00:17:33,786
and adding glucose divided by 18
and the BUN over 2.8.
354
00:17:33,786 --> 00:17:35,855
Anyone have the numbers handy?
355
00:17:35,855 --> 00:17:38,125
That's okay, we'll make some up.
356
00:17:38,125 --> 00:17:40,160
Let's say his measured osms
are 300...
357
00:17:40,160 --> 00:17:42,395
What's this have
to do with a fractured rib?
358
00:17:42,395 --> 00:17:43,563
Absolutely nothing.
359
00:17:43,563 --> 00:17:44,764
I have a date.
360
00:17:44,764 --> 00:17:46,599
Go, we could be
here all night.
361
00:17:46,599 --> 00:17:47,700
Thank you.
362
00:17:47,700 --> 00:17:49,602
NEELA:
...divided by 2.8.
363
00:17:49,602 --> 00:17:51,538
20 minutes and we're only
on our second patient.
364
00:17:51,538 --> 00:17:53,140
Neela, try
to stay focused
365
00:17:53,140 --> 00:17:54,807
on the clinically relevant
teaching points.
366
00:17:54,807 --> 00:17:56,843
This is clinically relevant.
There's an osmolar gap.
367
00:17:56,843 --> 00:17:58,478
The interns need
to know meanings.
368
00:17:58,478 --> 00:17:59,546
Not right now.
369
00:17:59,546 --> 00:18:01,348
Stab wound!
Need some help here.
370
00:18:01,348 --> 00:18:02,615
Neela, take it with Marsh.
371
00:18:02,615 --> 00:18:04,451
Pratt and Morris,
finish running the board.
372
00:18:04,451 --> 00:18:05,652
Ready?
373
00:18:05,652 --> 00:18:08,255
My first trauma
as a doc. All right.
374
00:18:08,255 --> 00:18:11,524
Single stab to the right
chest. Agonal resps,
sats 84 on 15 liters.
375
00:18:11,524 --> 00:18:13,526
All right, trauma one,
let's go.
376
00:18:17,397 --> 00:18:20,500
Now enter the thoracic cavity
through the intercostal.
377
00:18:20,500 --> 00:18:21,734
Okay, I felt a pop.
378
00:18:21,734 --> 00:18:23,370
Okay, insert finger.
379
00:18:23,370 --> 00:18:27,407
Feel lung tissue, pass the tube
on a curved clamp.
380
00:18:27,407 --> 00:18:28,541
Pretty cool.
381
00:18:28,541 --> 00:18:30,410
My first night,
my first chest tube.
382
00:18:30,410 --> 00:18:32,445
The key is to avoid
the neurovascular bundle
383
00:18:32,445 --> 00:18:34,747
at the inferior margin
of the rib.
384
00:18:34,747 --> 00:18:35,882
The tube won't pass.
385
00:18:35,882 --> 00:18:38,218
All right, let me try.
386
00:18:41,188 --> 00:18:43,490
I can't find the tract.
387
00:18:43,490 --> 00:18:46,359
Sometimes you need to check
again with a finger.
388
00:18:47,794 --> 00:18:51,664
There is no tract. Did you enter
the thoracic cavity?
389
00:18:51,664 --> 00:18:52,932
I thought I did.
390
00:18:52,932 --> 00:18:54,534
Did you feel lung tissue?
391
00:18:54,534 --> 00:18:56,336
It was warm and soft.
392
00:18:56,336 --> 00:18:58,838
Lung tissue expands and
contracts with ventilation.
393
00:18:58,838 --> 00:19:01,908
Right.
394
00:19:01,908 --> 00:19:03,843
Now we're into
the pleura.
395
00:19:03,843 --> 00:19:05,778
I'm sorry.
I thought I was in.
396
00:19:05,778 --> 00:19:08,381
I'll do better
next time.
How you doing?
397
00:19:08,381 --> 00:19:10,617
Finishing up a chest tube.
Start a central line?
398
00:19:10,617 --> 00:19:13,253
I've got a cue ball vs.
cheek to sew up.
399
00:19:13,253 --> 00:19:14,521
A trauma patient
takes priority.
400
00:19:14,521 --> 00:19:16,256
O-silk?
Pulse is 98,
401
00:19:16,256 --> 00:19:18,725
BP is stable.
What's the big deal?
My guy needs
402
00:19:18,725 --> 00:19:20,960
a three-layer closure
on a complex stellate
facial lac.
403
00:19:20,960 --> 00:19:23,296
That could
take two hours.
Yeah.
404
00:19:23,296 --> 00:19:25,798
Let Plastics do it. Someone
needs check the board.
405
00:19:25,798 --> 00:19:27,234
I already told
the nurses
406
00:19:27,234 --> 00:19:29,269
to send labs
and X rays on everyone.
407
00:19:29,269 --> 00:19:30,703
Morris!
You've got
everything under control.
408
00:19:30,703 --> 00:19:31,938
Is that a vertical
mattress?
409
00:19:31,938 --> 00:19:33,940
No, it's horizontal!
410
00:19:57,930 --> 00:20:00,267
What are you doing?
411
00:20:00,267 --> 00:20:02,702
Bugs. It's
difficult to see.
412
00:20:02,702 --> 00:20:03,836
( sighs )
413
00:20:03,836 --> 00:20:05,372
Where are we?
414
00:20:05,372 --> 00:20:08,508
We passed Grand Island
about an hour ago.
415
00:20:10,443 --> 00:20:13,780
We should get to a phone
and call Chicago.
416
00:20:13,780 --> 00:20:14,814
Okay.
417
00:20:14,814 --> 00:20:17,550
What time is it?
418
00:20:17,550 --> 00:20:18,951
1:30.
419
00:20:20,920 --> 00:20:23,623
I was dreaming about Alex.
420
00:20:23,623 --> 00:20:27,660
He was two or three.
421
00:20:27,660 --> 00:20:30,363
And I needed a bathing suit,
422
00:20:30,363 --> 00:20:35,368
so I was looking through the
racks at some department store.
423
00:20:35,368 --> 00:20:39,806
When I looked back,
Alex was gone.
424
00:20:39,806 --> 00:20:41,974
He just vanished.
425
00:20:41,974 --> 00:20:44,010
I guess you don't have
to be Freud
426
00:20:44,010 --> 00:20:46,379
to figure that one out.
427
00:20:53,019 --> 00:20:54,854
I lost my son at the ocean.
428
00:21:00,026 --> 00:21:02,495
Daniella didn't want me
to take him,
429
00:21:02,495 --> 00:21:05,998
but I insisted. I was mad that
she didn't trust me.
430
00:21:05,998 --> 00:21:11,338
So, uh... we had a big fight
and she let us go.
431
00:21:12,439 --> 00:21:13,473
What happened?
432
00:21:13,473 --> 00:21:14,907
It was a very hot day,
433
00:21:14,907 --> 00:21:17,710
so everyone had come
to the beach.
434
00:21:17,710 --> 00:21:21,681
They have beaches
in Croatia?
435
00:21:21,681 --> 00:21:24,851
Beautiful beaches,
miles of them.
436
00:21:24,851 --> 00:21:29,856
Anyway, so, uh,
we found about
an inch of sand
437
00:21:29,856 --> 00:21:33,526
that wasn't already
taken and, uh,
438
00:21:33,526 --> 00:21:35,428
we went
down to the water.
439
00:21:35,428 --> 00:21:37,063
He wanted to build
a sand castle,
440
00:21:37,063 --> 00:21:44,404
so I went back up to pick up
his little shovel and bucket.
441
00:21:44,404 --> 00:21:47,039
And when I came back
he was gone.
442
00:21:48,040 --> 00:21:49,876
I looked everywhere.
443
00:21:49,876 --> 00:21:51,511
Ran up and down
the beach,
444
00:21:51,511 --> 00:21:55,448
the shops by the road,
into the water,
445
00:21:55,448 --> 00:21:57,016
couldn't find him.
446
00:21:57,016 --> 00:21:59,386
How long was he missing?
447
00:22:01,087 --> 00:22:02,889
Two hours.
448
00:22:05,692 --> 00:22:08,661
( sighs )
449
00:22:08,661 --> 00:22:10,697
Where was he?
450
00:22:10,697 --> 00:22:12,899
Some boy had a dog.
451
00:22:12,899 --> 00:22:16,102
The police found
him wandering.
452
00:22:16,102 --> 00:22:18,538
He knew his name
so they called our house
453
00:22:18,538 --> 00:22:20,006
and Daniella answered.
454
00:22:23,576 --> 00:22:26,846
When I got home, he was sitting
in a bathtub with his sister
455
00:22:26,846 --> 00:22:28,981
having a wonderful time.
456
00:22:33,920 --> 00:22:38,758
I went to the kitchen
and I cried by the sink
457
00:22:38,758 --> 00:22:40,927
with the water running.
458
00:22:40,927 --> 00:22:43,563
Mm.
459
00:22:43,563 --> 00:22:45,732
What was his name?
460
00:22:45,732 --> 00:22:47,434
Marco.
461
00:22:51,438 --> 00:22:53,940
Alex is going
to be all right, Sam.
462
00:22:53,940 --> 00:22:57,109
We're going to find
him and he's going
to be all right.
463
00:23:04,517 --> 00:23:05,685
It's 3:00 a.m.
464
00:23:05,685 --> 00:23:07,487
Shouldn't this be
slowing down by now?
465
00:23:07,487 --> 00:23:08,921
You've got a
dark cloud, Neela.
466
00:23:08,921 --> 00:23:10,457
Always have.
467
00:23:10,457 --> 00:23:12,492
12 more out there
triaging as we speak.
468
00:23:12,492 --> 00:23:15,161
Neurosurg's coming to see the
subdural, he'll need a unit bed.
469
00:23:15,161 --> 00:23:17,597
I'm going to lay down
for a couple hours?
470
00:23:17,597 --> 00:23:19,866
We've got three intubated
patients and a full board.
471
00:23:19,866 --> 00:23:22,835
You are more than capable
of managing whatever comes in.
472
00:23:22,835 --> 00:23:27,106
That's the fun of being
the big R-2. You get to be
queen of the night shift.
473
00:23:27,106 --> 00:23:31,177
I don't wanna be the queen.
I wanna get the board cleared
before the day shift.
474
00:23:31,177 --> 00:23:34,481
Give me a copy of your schedule?
Gonna avoid nights you're on.
475
00:23:34,481 --> 00:23:36,716
You going to bed
leaving me with this mess?
476
00:23:36,716 --> 00:23:37,950
You have him.
You busy?
477
00:23:37,950 --> 00:23:39,786
Want to present
my guy in three.
478
00:23:39,786 --> 00:23:42,489
Wake me only if it's
really, really important.
479
00:23:42,489 --> 00:23:43,856
He's going to bed?
480
00:23:43,856 --> 00:23:46,693
Yep, it's you and me
against the world.
481
00:23:46,693 --> 00:23:48,795
Chuny had me correct
your fentanyl order.
482
00:23:48,795 --> 00:23:50,129
It's "micrograms,"
not "milligrams."
483
00:23:50,129 --> 00:23:51,798
Oh, God.
484
00:23:51,798 --> 00:23:53,733
That could've led
to a serious mistake.
485
00:23:53,733 --> 00:23:55,134
Caught in time.
No harm.
486
00:23:55,134 --> 00:23:57,169
I am so sorry.
Thanks for fixing it.
487
00:23:57,169 --> 00:23:58,938
It's okay.
Got to learn somehow.
488
00:23:58,938 --> 00:24:00,573
What do you got?
37-year-old
489
00:24:00,573 --> 00:24:03,042
with a deltoid abscess.
Never done an I and D,
490
00:24:03,042 --> 00:24:05,878
thought you might
want to supervise.
Any other history?
491
00:24:05,878 --> 00:24:08,014
Chronic I.V. drug use,
that's about it.
492
00:24:08,014 --> 00:24:09,215
Physical?
493
00:24:09,215 --> 00:24:10,917
Four-by-five
fluctuant lesion
494
00:24:10,917 --> 00:24:12,952
on the lateral aspect
of the upper arm.
495
00:24:12,952 --> 00:24:14,987
The remainder
of the exam was
entirely normal.
496
00:24:14,987 --> 00:24:17,890
Hey, Doc, you ready to slice
open this bad boy?
497
00:24:17,890 --> 00:24:20,259
This is Dr. Rasgotra,
she's my supervisor.
498
00:24:20,259 --> 00:24:22,529
I just want to take
a quick listen.
499
00:24:22,529 --> 00:24:24,731
It's so satisfying
when you guys cut it open
500
00:24:24,731 --> 00:24:26,566
and all that pus
comes pouring out.
501
00:24:26,566 --> 00:24:27,967
Shh.
Ten blade,
502
00:24:27,967 --> 00:24:31,704
saline, swabs,
packing gauze,
503
00:24:31,704 --> 00:24:33,640
anything else?
504
00:24:33,640 --> 00:24:36,208
Mister...
Uh, Kingsley.
505
00:24:36,208 --> 00:24:38,110
We'll be back
in a minute, okay?
506
00:24:44,250 --> 00:24:45,952
Did you listen
to his heart?
507
00:24:45,952 --> 00:24:47,620
Of course I did.
508
00:24:47,620 --> 00:24:49,922
So when you said his exam
was entirely normal,
509
00:24:49,922 --> 00:24:51,758
were you just forgetting
to mention his murmur?
510
00:24:51,758 --> 00:24:53,760
He has a murmur?
511
00:24:53,760 --> 00:24:57,063
Four over six at
the left sternal border.
Has a thrill, not subtle.
512
00:24:57,063 --> 00:25:00,733
Wow, big miss.
I'll listen again.
513
00:25:00,733 --> 00:25:04,571
You can't miss a murmur
in an I.V. drug user.
Could be endocarditis.
514
00:25:04,571 --> 00:25:07,206
He needs an echo and antibiotics
before the I and D.
515
00:25:07,206 --> 00:25:08,841
I heard you were smart,
516
00:25:08,841 --> 00:25:12,311
but I had no idea you were
such an awesome teacher.
517
00:25:12,311 --> 00:25:14,881
Thanks for saving my ass.
518
00:25:59,058 --> 00:26:01,160
( screaming )
519
00:26:05,898 --> 00:26:07,967
What was that?
520
00:26:10,837 --> 00:26:12,004
I don't know.
521
00:26:16,075 --> 00:26:17,777
( door beeping )
522
00:26:20,980 --> 00:26:23,650
( panting )
523
00:26:24,817 --> 00:26:25,985
Oh, God.
524
00:26:25,985 --> 00:26:27,654
( panting )
525
00:26:35,695 --> 00:26:36,896
Wait here.
526
00:26:41,801 --> 00:26:44,203
What is it?
527
00:26:44,203 --> 00:26:45,672
A deer, I think.
528
00:26:47,674 --> 00:26:49,809
Is it dead?
529
00:26:49,809 --> 00:26:53,245
No, I...
( motor revving )
530
00:26:53,245 --> 00:26:55,214
I don't think so.
531
00:26:55,214 --> 00:26:58,718
What do we do?
532
00:26:58,718 --> 00:26:59,719
I don't know.
533
00:27:01,153 --> 00:27:03,255
MAN:
You folks need help?
534
00:27:03,255 --> 00:27:05,792
I didn't, uh, I didn't...
I didn't see it.
535
00:27:05,792 --> 00:27:06,993
Antelope.
536
00:27:06,993 --> 00:27:09,128
Did a real number
to your car.
537
00:27:11,263 --> 00:27:12,965
You both all right?
538
00:27:12,965 --> 00:27:14,967
Yeah.
539
00:27:14,967 --> 00:27:17,203
I got a rifle
in the truck.
540
00:27:25,812 --> 00:27:26,846
Sam?
541
00:27:26,846 --> 00:27:28,781
We got to keep going.
542
00:27:28,781 --> 00:27:30,049
Sam, the car's wrecked.
543
00:27:30,049 --> 00:27:31,283
The radiator is leaking.
544
00:27:31,283 --> 00:27:33,419
( door beeping )
545
00:27:33,419 --> 00:27:34,721
The windshield
is shattered.
546
00:27:34,721 --> 00:27:36,155
You won't be
able to see.
547
00:27:36,155 --> 00:27:39,826
Come on.
548
00:27:39,826 --> 00:27:41,193
Come on! God!
549
00:27:41,193 --> 00:27:43,429
( gunshot )
550
00:27:43,429 --> 00:27:44,731
( gun cocks )
551
00:28:00,479 --> 00:28:02,481
Our syphilis guy's
had over 50 partners
552
00:28:02,481 --> 00:28:06,352
in the last 90 days.
Wants to know if they can
come here for treatment.
553
00:28:06,352 --> 00:28:10,022
As long as they wait
until sunrise. Pen G, 2.4
million units, IM.
554
00:28:10,022 --> 00:28:13,425
Neela! Your COPD'er isn't
looking so good.
555
00:28:13,425 --> 00:28:15,995
Sats dropped to 87 on room air.
556
00:28:15,995 --> 00:28:17,830
( pants ):
I can hardly catch my breath.
557
00:28:17,830 --> 00:28:20,266
He was fine when I saw him,
wasn't even wheezing.
558
00:28:20,266 --> 00:28:22,301
You can't wheeze
if you're not moving air.
559
00:28:22,301 --> 00:28:24,136
We're gonna give you
some medicine to help.
560
00:28:24,136 --> 00:28:26,773
Albuterol, five migs
with 500 of atrovent.
561
00:28:26,773 --> 00:28:29,408
Sure that's a good idea?
His theophylline's 53,
and he's throwing PVC's.
562
00:28:29,408 --> 00:28:31,310
What?
563
00:28:31,310 --> 00:28:33,479
You didn't bother mentioning
a toxic theophylline level?
564
00:28:33,479 --> 00:28:35,848
I didn't know.
I hadn't checked.
565
00:28:35,848 --> 00:28:38,084
I didn't think we'd
have the level back
until tomorrow.
566
00:28:38,084 --> 00:28:39,819
CANBERRA:
My breathing's been bad.
567
00:28:39,819 --> 00:28:42,822
I took some extra pills.
568
00:28:42,822 --> 00:28:46,292
100 of lidocaine and move him
to trauma. And hold off
on the Albuterol
569
00:28:46,292 --> 00:28:48,160
until we stabilize
his arrhythmia.
570
00:28:48,160 --> 00:28:49,796
You got it.
571
00:28:49,796 --> 00:28:51,798
We'll be right back,
Mr. Canberra.
572
00:28:56,402 --> 00:28:58,838
You were great in there.
You really took control.
573
00:28:58,838 --> 00:29:00,239
Teddy, listen.
574
00:29:00,239 --> 00:29:02,041
I'm sorry about the
theophylline thing.
575
00:29:02,041 --> 00:29:05,812
I'll have to thank
Chuny for...
Just listen, okay?
576
00:29:05,812 --> 00:29:07,346
You want to know a secret?
577
00:29:07,346 --> 00:29:10,416
You don't have to be that smart
to be a good doctor.
578
00:29:10,416 --> 00:29:13,085
You just have to be thorough,
systematic and meticulous.
579
00:29:13,085 --> 00:29:14,854
I'm trying.
580
00:29:14,854 --> 00:29:17,223
Not hard enough. You've missed
glaring physical findings,
581
00:29:17,223 --> 00:29:18,858
overlooked critical labs,
582
00:29:18,858 --> 00:29:22,895
and I've been correcting
your med orders all night.
583
00:29:22,895 --> 00:29:24,063
It's my first shift.
584
00:29:24,063 --> 00:29:25,397
I realize that,
585
00:29:25,397 --> 00:29:27,934
but you're responsible
for real people here,
586
00:29:27,934 --> 00:29:30,269
and I can't watch
your every move.
587
00:29:30,269 --> 00:29:32,071
I know that.
588
00:29:32,071 --> 00:29:34,340
And I want to thank you.
589
00:29:34,340 --> 00:29:37,043
And your attitude...
590
00:29:37,043 --> 00:29:39,078
It's just so...
591
00:29:39,078 --> 00:29:42,048
contrite and appreciative.
592
00:29:44,884 --> 00:29:46,886
It's just weird.
593
00:29:53,025 --> 00:29:55,862
I...
594
00:29:55,862 --> 00:29:57,496
I guess I just don't get it.
595
00:29:57,496 --> 00:29:59,165
Wait.
596
00:29:59,165 --> 00:30:01,200
I'm going to get some coffee.
Need anything?
597
00:30:01,200 --> 00:30:02,935
Teddy, wait!
598
00:30:02,935 --> 00:30:06,005
We'll do a head-to-toe
H and P together.
599
00:30:06,005 --> 00:30:08,440
It might help identify where
some of your deficiencies are.
600
00:30:14,881 --> 00:30:16,448
Bollocks.
601
00:30:29,495 --> 00:30:33,232
They're gonna send a truck
to tow the car in.
602
00:30:33,232 --> 00:30:35,267
Did you call Chicago?
603
00:30:41,974 --> 00:30:44,010
The guy inside
gets off at 7:00.
604
00:30:44,010 --> 00:30:47,313
Offered us a ride back
to North Platte.
605
00:30:47,313 --> 00:30:51,417
From there we can
catch a bus to Denver,
or maybe rent a car.
606
00:30:51,417 --> 00:30:52,952
North Platte's an hour east?
607
00:31:03,129 --> 00:31:05,331
What are you doing?
608
00:31:07,433 --> 00:31:09,101
( sighs )
609
00:31:09,101 --> 00:31:11,003
Sam!
610
00:31:13,339 --> 00:31:15,507
Sam!
611
00:31:15,507 --> 00:31:16,575
( truck approaching )
612
00:31:16,575 --> 00:31:20,646
Sam!
613
00:31:20,646 --> 00:31:23,515
What are you doing?
What does it look
like I'm doing?
614
00:31:23,515 --> 00:31:25,251
You're going
to hitchhike?
615
00:31:25,251 --> 00:31:27,486
He's been off his insulin
for two days, Luka!
616
00:31:27,486 --> 00:31:28,554
He's out there dying.
617
00:31:30,957 --> 00:31:32,959
Hey!
618
00:31:32,959 --> 00:31:35,161
How'd it go?
Not well.
619
00:31:35,161 --> 00:31:37,196
Will you take a look
at this board?
620
00:31:37,196 --> 00:31:40,032
Not even 8:00,
and the day sucks.
Good morning,
Pratt.
621
00:31:40,032 --> 00:31:41,467
Neela, you should
have called me.
622
00:31:41,467 --> 00:31:43,502
Hate leaving a mess
for the day shift.
623
00:31:43,502 --> 00:31:45,972
Most of them are waiting
down here for beds.
624
00:31:45,972 --> 00:31:48,407
This is ridiculous. Antifreeze
overdose has been here
625
00:31:48,407 --> 00:31:50,176
since yesterday morning.
626
00:31:50,176 --> 00:31:52,244
Case in point.
627
00:31:52,244 --> 00:31:54,013
What have you been doing?
628
00:31:54,013 --> 00:31:56,615
Taking a bubble bath
and eating bonbons.
629
00:31:56,615 --> 00:31:59,451
Lewis is going to make
you run the board.
I know.
630
00:31:59,451 --> 00:32:00,552
Just remember
that fomepizole's
631
00:32:00,552 --> 00:32:02,721
an alcohol dehydrogenase
inhibitor.
632
00:32:02,721 --> 00:32:05,357
( snaps ):
Hey, come on, come on.
Present this thing already.
633
00:32:05,357 --> 00:32:06,425
Okay.
634
00:32:06,425 --> 00:32:08,060
Let's get the night shift home.
635
00:32:08,060 --> 00:32:09,495
You are...?
Lana Clemons,
new intern.
636
00:32:09,495 --> 00:32:11,263
You've met Dr. Sackowitz.
637
00:32:11,263 --> 00:32:13,499
Pratt's the senior and
Dr. Lewis is our attending.
638
00:32:13,499 --> 00:32:15,067
Neela, where's your intern?
639
00:32:15,067 --> 00:32:17,169
Sent him home a bit early.
640
00:32:17,169 --> 00:32:20,306
Okay, day shift, let's go.
Curtain number one.
641
00:32:20,306 --> 00:32:22,008
22-year-old with
myelomenigocoele.
642
00:32:22,008 --> 00:32:23,609
What is that?
Spina bifida?
643
00:32:23,609 --> 00:32:26,345
Excellent. The most common
congenital neurologic deficit,
644
00:32:26,345 --> 00:32:28,614
compatible with life.
How does it happen?
645
00:32:28,614 --> 00:32:30,449
SACKOWITZ:
Neural tube doesn't
close in utero.
646
00:32:30,449 --> 00:32:32,551
Most likely due
to an interaction of genetic
647
00:32:32,551 --> 00:32:34,020
and environmental factors.
648
00:32:34,020 --> 00:32:35,687
Ladies, remember
to take your folate.
649
00:32:35,687 --> 00:32:37,723
Okay, on to why
the patient is here.
650
00:32:37,723 --> 00:32:39,691
Rule out shunt obstruction--
common ER complaint--
651
00:32:39,691 --> 00:32:41,460
what's your approach?
Shunt series?
652
00:32:41,460 --> 00:32:44,063
Before that?
Tap the reservoir.
653
00:32:44,063 --> 00:32:45,631
Guys...
654
00:32:45,631 --> 00:32:47,699
before you do anything?
655
00:32:47,699 --> 00:32:49,735
Take a history.
656
00:32:49,735 --> 00:32:50,702
Classic symptoms
657
00:32:50,702 --> 00:32:51,537
of shunt obstruction:
658
00:32:51,537 --> 00:32:52,604
headache, nausea,
659
00:32:52,604 --> 00:32:54,040
vomiting, lethargy.
660
00:33:01,580 --> 00:33:06,352
I'm like a bad trailer park
version of myself.
661
00:33:14,460 --> 00:33:16,195
What are you
doing here, Luka?
662
00:33:19,631 --> 00:33:21,733
Sam, I care about Alex.
663
00:33:23,635 --> 00:33:25,671
But you can't
replace his father.
664
00:33:25,671 --> 00:33:27,506
I know that.
665
00:33:29,175 --> 00:33:33,379
Just not ready for this to be
all there is in my life.
666
00:33:37,483 --> 00:33:41,087
I can't bring
your kids back.
667
00:33:41,087 --> 00:33:43,155
I have a child
of my own,
668
00:33:43,155 --> 00:33:45,824
and if it's a choice
between you and Alex,
669
00:33:45,824 --> 00:33:48,194
I am always going
to choose Alex.
670
00:33:48,194 --> 00:33:49,795
I'm not asking you to choose.
671
00:33:49,795 --> 00:33:51,797
Of course you are.
672
00:33:54,100 --> 00:33:56,202
I don't want
what happened to my family
673
00:33:56,202 --> 00:34:01,107
to be the end of my story.
674
00:34:01,107 --> 00:34:04,176
I was a good father.
I can be a good father again.
675
00:34:04,176 --> 00:34:07,179
What if it's not what I want?
676
00:34:07,179 --> 00:34:08,680
Why...
677
00:34:08,680 --> 00:34:11,117
Why don't you want
to have children with me?
678
00:34:11,117 --> 00:34:14,586
It's not about you.
679
00:34:14,586 --> 00:34:16,788
I don't want to have
any more kids.
680
00:34:18,790 --> 00:34:20,259
I'm done.
681
00:34:20,259 --> 00:34:23,395
I want my life back.
682
00:34:36,842 --> 00:34:39,711
Oh, they can stop the run, but
the secondary's kind of suspect,
683
00:34:39,711 --> 00:34:41,613
champ or no champ.
684
00:34:41,613 --> 00:34:43,882
I tell you what,
they make the playoffs again,
685
00:34:43,882 --> 00:34:46,152
Colts'll eat them up.
My brother and I
686
00:34:46,152 --> 00:34:47,753
got tickets in
a couple of weeks.
687
00:34:47,753 --> 00:34:49,688
Raiders.
( chuckles )
688
00:34:49,688 --> 00:34:52,158
Should be able to beat up
on those jokers.
689
00:34:52,158 --> 00:34:53,459
What's this idiot doing?
690
00:34:55,561 --> 00:34:57,163
You want to ticket him?
691
00:34:58,664 --> 00:35:00,332
Hang on, I'll be right back.
692
00:35:00,332 --> 00:35:02,501
What do you got?
693
00:35:14,480 --> 00:35:16,915
Alex Taggart?
694
00:35:16,915 --> 00:35:20,252
Hey, Alex?
Are you Alex Taggart?
695
00:35:46,612 --> 00:35:48,814
( gasping )
696
00:35:59,358 --> 00:36:01,493
I'm Samantha Taggart.
697
00:36:01,493 --> 00:36:02,694
Dr. Collins.
698
00:36:02,694 --> 00:36:04,363
How is he?
699
00:36:04,363 --> 00:36:06,898
He was lethargic when
they brought him in here.
700
00:36:06,898 --> 00:36:08,767
Glucose was 375.
701
00:36:08,767 --> 00:36:11,237
That's not too critical.
702
00:36:11,237 --> 00:36:14,606
After a little insulin and
saline, he's doing much better.
703
00:36:15,707 --> 00:36:17,309
( sniffles )
704
00:36:17,309 --> 00:36:19,511
Can you give us
a minute, please?
705
00:36:24,883 --> 00:36:27,419
Damn it, Alex.
706
00:36:27,419 --> 00:36:30,256
I'm okay. I drank
lots of water.
707
00:36:30,256 --> 00:36:31,457
You were lucky.
708
00:36:31,457 --> 00:36:33,325
I know how to
monitor my sugar.
709
00:36:33,325 --> 00:36:34,760
You're 12 years old
and diabetic.
710
00:36:34,760 --> 00:36:36,762
What the hell
are you thinking?
711
00:36:43,535 --> 00:36:45,404
I couldn't find him.
712
00:36:45,971 --> 00:36:49,007
What?
713
00:36:49,007 --> 00:36:50,809
Dad.
714
00:36:50,809 --> 00:36:52,744
I looked in
the phone books.
715
00:36:52,744 --> 00:36:56,615
I called information,
a bunch of different
rafting companies.
716
00:36:56,615 --> 00:36:59,418
He's not here.
717
00:36:59,918 --> 00:37:01,920
Come here.
718
00:37:09,728 --> 00:37:11,530
ABBY:
How we doing?
719
00:37:11,530 --> 00:37:14,466
We're losing the battle
and we're knee-deep in triage.
720
00:37:14,466 --> 00:37:16,535
Well, I'm going
as fast as I can.
721
00:37:16,535 --> 00:37:18,937
Yeah, more than I can say
for your interns.
722
00:37:18,937 --> 00:37:20,972
Well, say no more.
723
00:37:20,972 --> 00:37:23,742
Dr. Sackowitz.
Four-centimeter
scalp lac.
724
00:37:23,742 --> 00:37:25,944
After copious
irrigation,
725
00:37:25,944 --> 00:37:28,480
I'm using a 4-0
nylon interrupted.
726
00:37:28,480 --> 00:37:30,616
The wound's edges
are evert...
727
00:37:30,616 --> 00:37:34,353
Abby?
Cosmetic repair is not
an issue with the scalp.
728
00:37:34,353 --> 00:37:35,821
I've never used
a skin stapler.
729
00:37:35,821 --> 00:37:37,856
You'll will next time.
Just point and shoot.
730
00:37:37,856 --> 00:37:39,825
grab another
two patients.
Dr. Lockhart,
731
00:37:39,825 --> 00:37:42,661
there's a guy with
abdominal pain in
a lot of distress.
732
00:37:42,661 --> 00:37:44,696
I sent off a CBC, Chem 20, uh,
733
00:37:44,696 --> 00:37:47,966
I ordered an abdominal series
and a surgical consult.
Hello.
734
00:37:47,966 --> 00:37:49,768
George, how are you feeling?
735
00:37:49,768 --> 00:37:50,902
I can't get comfortable.
736
00:37:50,902 --> 00:37:52,904
Okay, tell me...
737
00:37:52,904 --> 00:37:55,407
does it feel worse
when I do this?
( shrieks )
738
00:37:55,407 --> 00:37:56,708
Okay.
( groans )
739
00:37:56,708 --> 00:37:58,544
All right,
you have a kidney stone.
740
00:37:58,544 --> 00:38:00,946
How'd you know that?
I... just do.
741
00:38:00,946 --> 00:38:02,080
Four plus blood.
742
00:38:02,080 --> 00:38:04,416
30 I.V. toradol,
and ten of MS.
743
00:38:04,416 --> 00:38:07,486
Get a CT urogram and cancel
all the other orders.
Got it.
744
00:38:07,486 --> 00:38:09,721
Ten minutes,
you'll be feeling no pain.
Thank you.
745
00:38:09,721 --> 00:38:12,358
Should I wait and see
if the analgesics take effect?
746
00:38:12,358 --> 00:38:14,460
No, you should pick up
another chart.
747
00:38:29,841 --> 00:38:31,643
Are you sure?
748
00:38:31,643 --> 00:38:32,844
'Cause you
don't have to.
749
00:38:42,754 --> 00:38:44,790
I'm sorry, Alex.
750
00:38:47,092 --> 00:38:49,060
I wish that this
wasn't your life.
751
00:38:51,397 --> 00:38:53,632
I can't tell you
how much I wish that.
752
00:38:57,403 --> 00:38:59,137
It's okay, Mom.
753
00:38:59,137 --> 00:39:01,440
I want to go.
754
00:39:19,024 --> 00:39:20,859
Here?
755
00:39:20,859 --> 00:39:21,893
Here?
756
00:39:21,893 --> 00:39:22,928
How about here?
757
00:39:22,928 --> 00:39:24,430
Ah!
758
00:39:24,430 --> 00:39:25,997
Three cc's, one
percent lidocaine.
759
00:39:25,997 --> 00:39:27,433
Lidocaine?
760
00:39:27,433 --> 00:39:29,668
You have a knot
in your muscle,
761
00:39:29,668 --> 00:39:31,102
which this shot
should help.
762
00:39:31,102 --> 00:39:32,571
( gasps ):
Ah!
Okay.
763
00:39:32,571 --> 00:39:35,607
All right...
I'll be right back.
764
00:39:35,607 --> 00:39:37,008
Okay.
765
00:39:37,008 --> 00:39:40,011
Uh, right lower quadrant
tenderness, low-grade fever,
766
00:39:40,011 --> 00:39:42,848
no white count,
anorexia or rebound.
767
00:39:42,848 --> 00:39:44,483
Can you stand up for me?
768
00:39:44,483 --> 00:39:45,584
Is it appendicitis?
769
00:39:45,584 --> 00:39:47,653
I'll tell you
in a minute.
770
00:39:47,653 --> 00:39:49,588
Okay.
771
00:39:49,588 --> 00:39:51,490
Can you do this?
772
00:39:51,490 --> 00:39:54,526
Yeah.
Let's see.
773
00:39:54,526 --> 00:39:56,728
Can you do
it again?
774
00:39:56,728 --> 00:39:57,963
( laughs )
775
00:39:57,963 --> 00:39:59,831
Okay, excellent.
It's not an appy.
776
00:39:59,831 --> 00:40:01,667
Clear liquids,
recheck in the a.m.
777
00:40:01,667 --> 00:40:03,535
How's your headache?
Completely gone.
778
00:40:03,535 --> 00:40:05,136
Thank you, Doctor.
779
00:40:05,136 --> 00:40:07,706
I'm about to clear
the rack.
Oh, yeah?
780
00:40:07,706 --> 00:40:10,542
If I saw all the patients
myself, we wouldn't get behind.
781
00:40:10,542 --> 00:40:13,445
Bet you're feeling
pretty good about that.
Mm-hmm.
782
00:40:13,445 --> 00:40:16,982
I can't believe it took me
so long to figure it out.
You haven't.
783
00:40:16,982 --> 00:40:18,584
What?
784
00:40:18,584 --> 00:40:20,519
You didn't show Sackowitz
how to staple.
785
00:40:20,519 --> 00:40:22,954
You didn't teach Clemons about
your approach to kidney stones.
786
00:40:22,954 --> 00:40:26,024
You did a trigger point,
a jump test, and
ignored your interns.
787
00:40:26,024 --> 00:40:28,894
They were moving
slow you told me
to step it up.
788
00:40:28,894 --> 00:40:32,564
But your job isn't to just
move the meat, Abby,
you're a resident now.
789
00:40:32,564 --> 00:40:35,501
Um, the lady in exam three
spiked to 104.
790
00:40:38,537 --> 00:40:40,872
Guess I better go.
791
00:40:40,872 --> 00:40:43,642
Nice job on the board, Abby.
792
00:40:43,642 --> 00:40:46,177
What's the matter
with her?
She's a new R2.
793
00:40:46,177 --> 00:40:49,047
It's gonna be
a long year.
She'll catch on.
794
00:40:49,047 --> 00:40:51,550
But she's not supervising,
she's not teaching,
795
00:40:51,550 --> 00:40:53,084
and she's doing
everything herself.
796
00:40:53,084 --> 00:40:56,021
You know, that reminds me
of someone I used to know.
797
00:41:14,640 --> 00:41:16,942
How is he?
798
00:41:16,942 --> 00:41:18,910
Full of crap,
like always.
799
00:41:18,910 --> 00:41:21,046
I meant Alex.
800
00:41:22,648 --> 00:41:24,650
He's okay.
801
00:41:24,650 --> 00:41:28,253
He wants to spend
some time alone
with his dad, so...
802
00:41:28,253 --> 00:41:30,589
It's only ten more minutes
of visiting hours.
803
00:41:30,589 --> 00:41:35,293
So... I figure Steve
can't screw him up that
bad in ten minutes.
804
00:41:35,293 --> 00:41:37,295
God knows, I'm
sure he'll try.
805
00:41:37,295 --> 00:41:40,065
Alex is a good kid,
he'll figure it out.
806
00:41:40,065 --> 00:41:41,967
Damn it, that bastard.
807
00:41:41,967 --> 00:41:43,935
He couldn't care
less about us.
808
00:41:43,935 --> 00:41:45,837
But that little boy
loves him anyway.
809
00:41:45,837 --> 00:41:47,806
What the hell is
right about that?
810
00:41:59,685 --> 00:42:01,853
Thank you.
811
00:42:01,853 --> 00:42:03,188
For what?
812
00:42:04,923 --> 00:42:06,958
Coming.
813
00:42:08,860 --> 00:42:10,896
( sighs )
814
00:42:14,633 --> 00:42:16,001
Now what?
815
00:42:21,339 --> 00:42:23,074
Home, I guess.
I don't...
816
00:42:23,074 --> 00:42:25,677
Luka, you cannot
possibly want this
for your life.
817
00:42:25,677 --> 00:42:26,878
Want what?
818
00:42:26,878 --> 00:42:30,115
This. This mess.
819
00:42:30,115 --> 00:42:32,751
Isn't that something
I get to decide for myself?
820
00:42:34,953 --> 00:42:36,354
No.
821
00:42:36,354 --> 00:42:38,990
If it were just me...
822
00:42:38,990 --> 00:42:40,692
maybe.
823
00:42:48,900 --> 00:42:50,936
I better go in
and check on him.
824
00:43:01,747 --> 00:43:03,114
Steve's in prison.
825
00:43:04,750 --> 00:43:06,952
You don't have
to run anymore.
826
00:43:10,055 --> 00:43:12,090
I'm not running.
827
00:43:14,893 --> 00:43:17,328
I just don't want what you want.
828
00:43:25,837 --> 00:43:27,839
( sighs )
58495
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