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1
00:00:04,200 --> 00:00:05,367
Previously on ER:
2
00:00:05,433 --> 00:00:07,400
Okay, I'll be back
to work next month.
3
00:00:07,467 --> 00:00:10,033
Ray Barnett. I don't think
we've officially met.
Katey.
4
00:00:10,100 --> 00:00:11,100
You two
live together?
5
00:00:11,167 --> 00:00:12,167
Oh, we were
roommates.
6
00:00:12,233 --> 00:00:13,533
Hope you had benefits.
7
00:00:13,600 --> 00:00:15,233
You don't want to have
anything to do with me.
8
00:00:15,300 --> 00:00:16,433
What about yourlittlebrother?
9
00:00:16,500 --> 00:00:17,933
He'd like to get
to know you, Greg.
10
00:00:18,000 --> 00:00:19,100
He just met me.
11
00:00:19,167 --> 00:00:20,900
I mean, ain't we brothers?
12
00:00:22,567 --> 00:00:24,200
Curtis Ames?
Left-sided
13
00:00:24,267 --> 00:00:26,500
paralysis following
an embolic stroke.
14
00:00:26,567 --> 00:00:27,967
But I thought
the case had no merit.
15
00:00:28,033 --> 00:00:29,933
Guy wants his day in court.
16
00:00:30,000 --> 00:00:32,933
It doesn't reflect
on your abilities
as a physician.
17
00:00:37,600 --> 00:00:40,167
Skiles has got them working.
And, with big ol' Ben Wallace,
18
00:00:40,233 --> 00:00:41,867
they're definitely
going to the
playoffs again.
19
00:00:41,933 --> 00:00:44,367
Yeah, I remember when
the NBA used to mean something.
20
00:00:44,433 --> 00:00:46,867
Oscar Robertson,
Walt Frazier.
21
00:00:46,933 --> 00:00:48,900
Now it's all a bunch
of gangsters with tattoos.
22
00:00:48,967 --> 00:00:51,000
And cornrows.
And slam dunks.
23
00:00:51,067 --> 00:00:52,933
Oh, my! Hey, now,
oh, now, hey, now
24
00:00:53,000 --> 00:00:54,200
Set of lungs
on that one!
25
00:00:54,267 --> 00:00:56,500
Boy, if I was
20 years younger...
26
00:00:56,567 --> 00:00:57,833
You'd still be
her granddaddy.
27
00:00:57,900 --> 00:01:00,233
(all laughing)
28
00:01:00,300 --> 00:01:01,867
Is that Dr. Gregory Pratt?
29
00:01:01,933 --> 00:01:03,333
The one and only.
30
00:01:03,400 --> 00:01:05,033
What are you doing down
here on the South Side?
31
00:01:05,100 --> 00:01:07,833
I heard you bought a condo
on the Gold Coast.
32
00:01:07,900 --> 00:01:09,867
You drive down here
in the Beemer or the Benz?
33
00:01:09,933 --> 00:01:11,167
Hey, I walked from my apartment.
34
00:01:11,233 --> 00:01:12,200
How long has your
hand been shaking?
35
00:01:12,267 --> 00:01:13,533
Long as I can remember.
36
00:01:13,600 --> 00:01:15,300
Been to the doctor?
37
00:01:15,367 --> 00:01:17,367
What for? Lou Sanders' wife
was having headaches.
38
00:01:17,433 --> 00:01:20,267
20 grand in tests so they could
tell her to take an aspirin.
39
00:01:20,333 --> 00:01:22,067
Lanny Cole checked
in the hospital
40
00:01:22,133 --> 00:01:24,900
for a stomachache. Next day, he
checked out through the morgue.
41
00:01:24,967 --> 00:01:26,933
So what are you saying?
Nobody here goes to the doctor?
42
00:01:27,000 --> 00:01:28,300
Hell, no.
Not me.
43
00:01:28,367 --> 00:01:29,533
Well, you should.
That's right.
44
00:01:29,600 --> 00:01:32,200
Dr. Pratt needs
to make them car payments.
45
00:01:32,267 --> 00:01:35,367
But seriously, you need
to get your pressure checked.
46
00:01:35,433 --> 00:01:37,033
They do that
at the drugstore.
47
00:01:37,100 --> 00:01:38,333
Your sugar,
your prostate...
48
00:01:38,400 --> 00:01:40,233
No!
No!
No!
49
00:01:40,300 --> 00:01:42,367
I wouldn't let Halle Berry
stick her finger up my ass.
50
00:01:42,433 --> 00:01:44,933
I sure as hell ain't going
to let you.
51
00:01:45,000 --> 00:01:47,267
I'll see you
fools later.
52
00:01:47,333 --> 00:01:49,867
Now, that's what
I'm talking about.
53
00:01:49,933 --> 00:01:50,900
Ooh!
Uh-huh!
54
00:01:50,967 --> 00:01:53,067
Greg! Greg!
55
00:01:53,133 --> 00:01:54,400
Chaz. What's up, man?
56
00:01:54,467 --> 00:01:56,100
What's up? It's
been a while, man.
57
00:01:56,167 --> 00:01:57,567
Yeah, man. Too long.
What are you doing
around here?
58
00:01:57,633 --> 00:02:00,100
I'm just waiting
for a friend before class.
59
00:02:00,167 --> 00:02:01,433
Okay. Where'd you
wind up at school?
60
00:02:01,500 --> 00:02:03,100
UIC.
That's good, man.
61
00:02:03,167 --> 00:02:04,833
So how's it going
over there?
62
00:02:04,900 --> 00:02:06,833
It's going all right.
I'm running a little late.
63
00:02:06,900 --> 00:02:09,167
Yeah. Me, too. I got
to get out of here.
64
00:02:09,233 --> 00:02:11,133
We should
kick it sometime.
65
00:02:11,200 --> 00:02:13,000
Definitely. You
know where I am.
66
00:02:13,067 --> 00:02:15,467
Cool. Good seeing you, man.
67
00:02:15,533 --> 00:02:17,300
You, too. Be safe.
68
00:02:17,367 --> 00:02:19,333
You'll probably be home
before me,
69
00:02:19,400 --> 00:02:22,167
and Miriam
has to leave at 6:00.
70
00:02:22,233 --> 00:02:25,600
Okay. Okay, Joe,
71
00:02:25,667 --> 00:02:29,400
let's review PEA, hmm?
Treatable conditions
72
00:02:29,467 --> 00:02:33,433
include hypovolemia,
tension pneumothorax,
73
00:02:33,500 --> 00:02:36,967
cardiac tamponade,
MI and... and...
74
00:02:37,033 --> 00:02:39,167
What's another
cause of PEA?
Hmm?
75
00:02:39,233 --> 00:02:41,133
A reversible
etiology of PEA.
76
00:02:41,200 --> 00:02:42,900
Umm... Massive
pulmonary embolus.
77
00:02:42,967 --> 00:02:44,100
See, how could
I forget that?
78
00:02:44,167 --> 00:02:45,400
You'll be fine.
79
00:02:45,467 --> 00:02:47,067
I don't know.
My brain is like...
80
00:02:47,133 --> 00:02:48,833
Oh!
Oh! Sorry.
81
00:02:48,900 --> 00:02:51,133
Sorry, sorry.
82
00:02:51,200 --> 00:02:53,000
I have to review this.
83
00:02:53,067 --> 00:02:54,067
Ten times?
84
00:02:54,133 --> 00:02:55,500
I gave my deposition
a year ago.
85
00:02:55,567 --> 00:02:57,933
It looks really bad
if I contradict myself.
86
00:02:58,000 --> 00:02:59,833
You didn't do
anything wrong.
Just tell the truth.
87
00:02:59,900 --> 00:03:01,867
You didn't do
anything... Sorry.
88
00:03:01,933 --> 00:03:03,900
(doorbell rings)
89
00:03:03,967 --> 00:03:04,967
Okay.
90
00:03:07,900 --> 00:03:09,300
Who's that, huh?
91
00:03:09,367 --> 00:03:11,933
Want to go see
who's at the door? Hmm?
92
00:03:12,000 --> 00:03:14,467
Who's at the door?
It's Miriam.
93
00:03:14,533 --> 00:03:16,467
She's going to take you
to the park.
94
00:03:16,533 --> 00:03:18,167
I suppose, if I really
can't remember something,
95
00:03:18,233 --> 00:03:19,467
I could run it
by the Attending,
96
00:03:19,533 --> 00:03:21,200
but I just don't want
to bug them all day,
97
00:03:21,267 --> 00:03:24,967
like I'm a med student
or something.
98
00:03:25,033 --> 00:03:26,867
You okay?
99
00:03:26,933 --> 00:03:30,867
No. The guy's going
to be so sympathetic
to the jury...
100
00:03:30,933 --> 00:03:32,367
But he doesn't
have a case.
101
00:03:32,433 --> 00:03:33,867
You're going
to be fine.
102
00:03:33,933 --> 00:03:34,967
If I lose,
they report me
103
00:03:35,033 --> 00:03:36,233
to the National
Data Bank.
104
00:03:36,300 --> 00:03:37,400
It follows me
wherever I go
105
00:03:37,467 --> 00:03:38,867
for the rest
of my career.
106
00:03:38,933 --> 00:03:40,467
I could be turned
down for a job.
107
00:03:40,533 --> 00:03:42,433
It could cut back
our income. It can...
108
00:03:42,500 --> 00:03:43,500
You want me
to come to court?
109
00:03:43,567 --> 00:03:45,067
No. You got a shift.
110
00:03:45,133 --> 00:03:47,533
Well, they've been doing
just fine without me
111
00:03:47,600 --> 00:03:49,367
for the past
couple of months.
112
00:03:49,433 --> 00:03:52,533
No. It's more
important for you
to be at work.
113
00:03:53,900 --> 00:03:55,900
Okay. Good luck.
114
00:03:57,200 --> 00:03:58,267
Thanks.
115
00:03:58,333 --> 00:03:59,967
Call me.
116
00:04:06,933 --> 00:04:08,200
MAN:
The plaintiff's attorney
117
00:04:08,267 --> 00:04:10,300
will provoke you--
try to get under your skin.
118
00:04:10,367 --> 00:04:12,067
So you need
to stay cool.
119
00:04:12,133 --> 00:04:13,867
If you get defensive,
the jury will turn against you.
120
00:04:13,933 --> 00:04:15,900
Yeah.
And keep it brief.
121
00:04:15,967 --> 00:04:17,567
If you elaborate,
they'll think
you're being evasive.
122
00:04:17,633 --> 00:04:19,533
Don't worry about getting
the whole story out at once.
123
00:04:19,600 --> 00:04:21,933
I'll have a chance to ask
follow-up questions later.
124
00:04:22,000 --> 00:04:24,367
Right. Um... I'll, uh...
125
00:04:24,433 --> 00:04:26,000
I'll meet you inside.
126
00:04:37,067 --> 00:04:38,167
(unzips fly)
127
00:04:40,000 --> 00:04:41,933
(door latch clicks)
128
00:05:04,067 --> 00:05:06,867
Mr. Ames, I'm...
I'm sorry we're here.
129
00:05:06,933 --> 00:05:10,300
I was hoping this wouldn't
have to go to trial.
130
00:05:13,300 --> 00:05:15,433
I came in
with a cough,
131
00:05:15,500 --> 00:05:18,833
and you sent me
out a cripple.
132
00:05:40,167 --> 00:05:41,533
We need to pick up
a few boarders from
the night shift.
133
00:05:41,600 --> 00:05:44,233
Diverticular
abscess awaiting
CT guided drain...
134
00:05:44,300 --> 00:05:46,367
Hey stranger, welcome back.
Thanks.
135
00:05:46,433 --> 00:05:48,133
I want to see pictures.
136
00:05:48,200 --> 00:05:50,800
Diverticular abscess
awaiting CT guided drainage.
137
00:05:50,867 --> 00:05:51,833
A-fib patient...
Hey, Abby.
138
00:05:51,900 --> 00:05:53,600
This is kind of embarrassing,
139
00:05:53,667 --> 00:05:55,267
but I never got around
to wrapping your baby gift.
140
00:05:55,333 --> 00:05:56,333
Oh, that's great.
141
00:05:56,400 --> 00:05:58,467
Ray?
What?
142
00:05:58,533 --> 00:06:00,300
Thanks.
A-fib patient
143
00:06:00,367 --> 00:06:02,100
with rapid ventricular
response going to tele.
144
00:06:02,167 --> 00:06:03,633
I dispo'd Mr. Kerosene
to psych.
145
00:06:03,700 --> 00:06:05,600
He drank kerosene?
146
00:06:05,667 --> 00:06:06,733
More like
a high colonic.
147
00:06:06,800 --> 00:06:08,100
Hi, Abby. I'm Tony Gates.
148
00:06:08,167 --> 00:06:09,533
Hi. Didn't
you used to be...?
149
00:06:09,600 --> 00:06:10,833
A paramedic. Yeah.
Now I'm an intern.
150
00:06:10,900 --> 00:06:12,567
Next week, he wants
to be a cowboy.
151
00:06:12,633 --> 00:06:14,267
Astronaut.
152
00:06:14,333 --> 00:06:15,400
(muffled yelling)
153
00:06:15,467 --> 00:06:17,200
I could use
some help here.
154
00:06:17,267 --> 00:06:18,533
I got half
his tongue on ice.
155
00:06:18,600 --> 00:06:19,667
Oh, man. How
did that happen?
156
00:06:19,733 --> 00:06:20,833
(muffled yelling)
Wife bit it off.
157
00:06:20,900 --> 00:06:22,567
Why did she do that?
158
00:06:22,633 --> 00:06:24,700
(muffled yelling)
She says he
talks too much.
159
00:06:24,767 --> 00:06:26,733
All right, come on.
Let's put him in Curtain Two.
160
00:06:26,800 --> 00:06:29,367
Liter of saline and a crit.
Ray, you're with me.
161
00:06:29,433 --> 00:06:32,567
Abby, grab some charts and, uh,
Gates, you're with Abby.
162
00:06:32,633 --> 00:06:34,600
Cunnilingus
interruptus.
163
00:06:34,667 --> 00:06:36,200
They did a Grand Rounds
on it last year.
164
00:06:36,267 --> 00:06:38,833
Abdominal fullness.
This isn't too bad.
165
00:06:38,900 --> 00:06:40,433
Congratulations
on the bambino.
166
00:06:40,500 --> 00:06:43,100
It's a boy, right?
Yep.
167
00:06:43,167 --> 00:06:45,333
Can you check
the BP?
All right.
168
00:06:45,400 --> 00:06:47,233
Hey, Mr. Dolan.
How you feeling?
169
00:06:47,300 --> 00:06:48,333
Must be weird
coming back
170
00:06:48,400 --> 00:06:49,400
after all this
time, huh?
171
00:06:49,467 --> 00:06:51,767
A little bit.
70 palp.
172
00:06:51,833 --> 00:06:53,100
Pulsatile
abdominal mass.
173
00:06:53,167 --> 00:06:55,833
We'd better move him.
174
00:06:55,900 --> 00:06:57,433
Sam, this guy
is hypotensive.
175
00:06:57,500 --> 00:06:59,100
What? His vitals were normal
at triage.
176
00:06:59,167 --> 00:07:00,167
Not anymore.
177
00:07:00,233 --> 00:07:01,700
Add a second line,
four of O-neg.
178
00:07:01,767 --> 00:07:03,533
Labs?
Dr. Gates?
179
00:07:03,600 --> 00:07:07,133
CBC with platelets,
chem-7, protime,
type and cross four.
180
00:07:07,200 --> 00:07:09,467
Good, but add a hemocue,
EKG, and let's get
surgery in on this.
181
00:07:09,533 --> 00:07:10,533
All right.
What do you think?
182
00:07:10,600 --> 00:07:11,867
Abdominal
aortic aneurysm?
183
00:07:11,933 --> 00:07:13,300
Classic presentation
for a triple-A.
184
00:07:13,367 --> 00:07:14,800
You think it burst?
185
00:07:14,867 --> 00:07:17,200
No. He'd be dead.
It's probably
a steady leak.
186
00:07:17,267 --> 00:07:18,700
You set up for ultrasound?
187
00:07:18,767 --> 00:07:20,333
We're going to have
to call radiology for that.
188
00:07:20,400 --> 00:07:21,533
I'm talking
about the ER ultrasound.
189
00:07:21,600 --> 00:07:22,733
It's still out
for repair.
190
00:07:22,800 --> 00:07:23,800
Well, how are
we supposed to...?
191
00:07:23,867 --> 00:07:24,833
Radiology
brings it over.
192
00:07:24,900 --> 00:07:26,100
How long
does that take?
193
00:07:26,167 --> 00:07:27,200
Depends on how
busy they are.
194
00:07:27,267 --> 00:07:29,167
Wow! Great
to be back.
195
00:07:29,233 --> 00:07:30,500
Pressure's up to 90
with saline.
196
00:07:30,567 --> 00:07:32,200
All right.
He looks like he's okay.
197
00:07:32,267 --> 00:07:34,433
I'll call for your ultrasound.
198
00:07:34,500 --> 00:07:37,400
O-neg is here.
199
00:07:37,467 --> 00:07:39,667
So, what's the big guy
doing today?
200
00:07:39,733 --> 00:07:40,800
Watching the baby?
201
00:07:40,867 --> 00:07:42,767
No. He's in court.
202
00:07:42,833 --> 00:07:45,933
WOMAN:
Mr. Ames,
what made you go
203
00:07:46,000 --> 00:07:51,733
to the E.R.
on February 13, 2004?
204
00:07:51,800 --> 00:07:53,333
Because I had a cough.
205
00:07:53,400 --> 00:07:54,933
My boss, he
brought me in.
206
00:07:55,000 --> 00:07:57,267
I thought
it was nothing,
207
00:07:57,333 --> 00:07:58,867
but he didn't
want me working
208
00:07:58,933 --> 00:08:00,767
until I got
it checked out.
209
00:08:02,200 --> 00:08:03,300
How long is the wait?
210
00:08:03,367 --> 00:08:07,900
Don't talk, please.
(beep)
211
00:08:07,967 --> 00:08:09,367
(coughs) How long until
I see the doctor?
212
00:08:09,433 --> 00:08:12,000
I don't know.
Could be 12 hours.
213
00:08:12,067 --> 00:08:14,067
12 hours?
(coughing)
214
00:08:14,133 --> 00:08:16,300
12 is good.
We're not that busy.
215
00:08:16,367 --> 00:08:18,233
It's okay, Curtis.
I'll get someone to cover you.
216
00:08:18,300 --> 00:08:21,200
No, no. I can work.
(coughing)
217
00:08:21,267 --> 00:08:23,467
How about I sign in
and come back later tonight?
218
00:08:23,533 --> 00:08:25,433
You'll lose your
place in line.
219
00:08:25,500 --> 00:08:28,333
So I just sit here in the
waiting room for 12 hours?
220
00:08:28,400 --> 00:08:30,267
That's how it works.
Be right back.
221
00:08:35,933 --> 00:08:37,100
This seems kind of crazy.
222
00:08:37,167 --> 00:08:38,300
How about I just
get checked tomorrow?
223
00:08:38,367 --> 00:08:41,133
I need a note
you're not contagious.
224
00:08:41,200 --> 00:08:43,200
I got insurance issues.
225
00:08:43,267 --> 00:08:44,833
Don't give this job away.
226
00:08:44,900 --> 00:08:46,867
I'm going to be there tomorrow.
227
00:08:46,933 --> 00:08:50,533
WALTON:
Dr. Kovac, when did
you first see Mr. Ames?
228
00:08:50,600 --> 00:08:52,500
I was working
at the Admit Desk
229
00:08:52,567 --> 00:08:54,467
when he signed in
at Triage.
230
00:08:54,533 --> 00:08:55,567
AMES:
So how long till
I see the doctor?
231
00:08:55,633 --> 00:08:57,167
MARQUEZ:
Hard to say, sir.
232
00:08:57,233 --> 00:08:59,267
If you're stable,
it could be up to 12 hours.
233
00:08:59,333 --> 00:09:00,433
AMES:
12 hours?!
234
00:09:00,500 --> 00:09:01,533
(coughing)
235
00:09:01,600 --> 00:09:03,433
We have a lot
of sick people here.
236
00:09:03,500 --> 00:09:06,467
Let me just sign in, and I'll
just come back later tonight.
237
00:09:06,533 --> 00:09:08,167
I'm sorry.
We can't do that.
238
00:09:08,233 --> 00:09:10,367
So I got to wait in
the waiting room for 12 hours?
239
00:09:10,433 --> 00:09:12,000
I'll be right back.
240
00:09:15,267 --> 00:09:17,533
They can't do this!
241
00:09:17,600 --> 00:09:18,867
Everything okay, Chuny?
242
00:09:18,933 --> 00:09:20,233
Yeah. He'll
settle down.
243
00:09:20,300 --> 00:09:21,300
Do not give
that job away!
244
00:09:21,367 --> 00:09:22,833
I will be there.
245
00:09:22,900 --> 00:09:25,967
A lot of patients get angry
about the wait.
246
00:09:26,033 --> 00:09:27,933
Nurse Marquez was able
to defuse
247
00:09:28,000 --> 00:09:31,033
the situation
before it escalated.
248
00:09:31,100 --> 00:09:32,267
I'm in.
You can do the next one.
249
00:09:32,333 --> 00:09:33,567
Sorry. I just had to...
250
00:09:33,633 --> 00:09:34,900
No, that's cool.
Good breath sounds.
251
00:09:34,967 --> 00:09:35,967
You haven't
lost your touch.
252
00:09:36,033 --> 00:09:37,167
BP's 80.
253
00:09:37,233 --> 00:09:38,533
All right,
I need the ultrasound.
254
00:09:38,600 --> 00:09:40,067
They're doing
a rule out ectopic.
255
00:09:40,133 --> 00:09:41,333
And where's surgery?
256
00:09:41,400 --> 00:09:42,833
Their med student's
right there.
257
00:09:42,900 --> 00:09:44,200
Well, that's not
doing us any good.
258
00:09:44,267 --> 00:09:45,833
I paged them twice.
259
00:09:45,900 --> 00:09:47,467
Listen.
How did it go yesterday?
260
00:09:47,533 --> 00:09:48,900
How did what go?
261
00:09:48,967 --> 00:09:49,967
Court. I heard you
had to testify.
262
00:09:50,033 --> 00:09:51,333
Oh. It was fine.
263
00:09:51,400 --> 00:09:54,067
Uh, a lot of questions
about procedure and policy.
264
00:09:54,133 --> 00:09:55,800
But I don't think
they have a case.
265
00:09:55,867 --> 00:09:58,433
Here come the cavalry!
266
00:09:58,500 --> 00:10:00,533
Enlighten me.
267
00:10:00,600 --> 00:10:03,133
Hypotensive pulsatile
abdominal mass.
268
00:10:03,200 --> 00:10:04,567
Say no more.
Red line to the O.R.
269
00:10:04,633 --> 00:10:06,100
GATES:
We're waiting
on ultrasound.
270
00:10:06,167 --> 00:10:08,433
Wrong.
We're not waiting on ultrasound?
271
00:10:08,500 --> 00:10:10,900
Neela, what happens when we wait
for diagnostic tests
272
00:10:10,967 --> 00:10:12,233
on a ruptured triple-A?
273
00:10:12,300 --> 00:10:13,567
Attempts to stabilize are
fruitless.
274
00:10:13,633 --> 00:10:15,233
Investigations delay definitive
therapies
275
00:10:15,300 --> 00:10:16,533
and increase the
risk of exsanguination.
276
00:10:16,600 --> 00:10:17,800
With a 90% mortality.
277
00:10:17,867 --> 00:10:19,500
His crit's not
so bad-- 32.
278
00:10:19,567 --> 00:10:21,500
Meaningless drivel.
Uh, what if it's not
a triple A?
279
00:10:21,567 --> 00:10:23,467
Then it's something else
that requires surgery.
280
00:10:23,533 --> 00:10:25,533
Radiology's bringing
over ultrasound now.
281
00:10:25,600 --> 00:10:27,300
He'll be dead by then.
It'll be a few seconds.
282
00:10:27,367 --> 00:10:30,167
Just zip it, Sparky.
Look, we are admitting him.
Sparky?
283
00:10:30,233 --> 00:10:32,033
Let's go!
284
00:10:32,100 --> 00:10:33,533
Did you need me
to keep bagging?
285
00:10:33,600 --> 00:10:35,400
Sure, as long as
you don't talk.
286
00:10:35,467 --> 00:10:38,500
Oh, by the way, Abby Lockhart.
Lovely to meet you.
287
00:10:38,567 --> 00:10:41,300
Shh!
288
00:10:41,367 --> 00:10:44,367
When did you
assume responsibility
for Mr. Ames' care?
289
00:10:44,433 --> 00:10:46,567
The nurse was concerned about
his oxygen level,
290
00:10:46,633 --> 00:10:48,433
so she asked me to see him.
291
00:10:52,067 --> 00:10:54,333
Curtis Ames?
292
00:11:01,167 --> 00:11:03,433
Hi, I'm Doctor Kovac.
293
00:11:03,500 --> 00:11:04,800
What is that?
294
00:11:04,867 --> 00:11:07,267
Uh, low oxygen.
295
00:11:08,900 --> 00:11:13,933
Or just maybe
a dirty fingernail.
296
00:11:14,000 --> 00:11:16,267
Wood stains-- they don't
wash off so good.
297
00:11:16,333 --> 00:11:18,267
What kind of work
do you do?
298
00:11:18,333 --> 00:11:19,900
Custom carpentry.
299
00:11:19,967 --> 00:11:24,467
Doors, built-in bookshelves,
armoires, you name it.
300
00:11:24,533 --> 00:11:27,467
My father had a wood shop
when I was a kid.
301
00:11:27,533 --> 00:11:29,867
I used to play with the
shavings from the lathe.
302
00:11:29,933 --> 00:11:30,900
I love the smell.
303
00:11:30,967 --> 00:11:32,867
(coughs)
304
00:11:34,933 --> 00:11:35,900
How's it sound?
305
00:11:35,967 --> 00:11:37,300
Well, like pneumonia.
306
00:11:37,367 --> 00:11:39,000
You should be admitted
to the hospital.
307
00:11:39,067 --> 00:11:40,367
Admitted?
308
00:11:40,433 --> 00:11:42,167
Yeah, stay for
a couple of days.
309
00:11:42,233 --> 00:11:44,567
No, no. I start
a custom remodel today.
310
00:11:44,633 --> 00:11:48,433
Your temp is 102, your oxygen
level is down to 90
311
00:11:48,500 --> 00:11:51,833
and your X ray shows
your right middle lobe
is full of infection.
312
00:11:51,900 --> 00:11:55,467
Look, if you want
to get better,
313
00:11:55,533 --> 00:11:57,833
we need to give you
I.V. antibiotics, okay?
314
00:12:00,500 --> 00:12:04,067
KELLERMAN:
After he examined you,
then what happened?
315
00:12:04,133 --> 00:12:06,467
He left me alone with a nurse
who couldn't start an I.V.
316
00:12:10,367 --> 00:12:13,267
CHUNY:
Okay, this time
I get a flash.
317
00:12:13,333 --> 00:12:15,300
Good.
That's good, right?
318
00:12:15,367 --> 00:12:17,467
But it won't
thread... I'm sorry.
319
00:12:17,533 --> 00:12:19,167
Keep pressure
on this.
320
00:12:19,233 --> 00:12:21,033
I know the drill.
321
00:12:21,100 --> 00:12:23,967
Anyone ever tell you
you have bad veins?
322
00:12:24,033 --> 00:12:26,033
How about just giving me
a shot in the butt?
323
00:12:26,100 --> 00:12:28,333
The antibiotics
are ordered I.V.
324
00:12:28,400 --> 00:12:30,367
Can I talk to my doctor?
325
00:12:30,433 --> 00:12:32,900
He's with a trauma patient
right now.
326
00:12:32,967 --> 00:12:35,400
How about after he's done?
327
00:12:35,467 --> 00:12:36,867
It could be a while...
328
00:12:36,933 --> 00:12:37,933
Here we go,
329
00:12:38,000 --> 00:12:40,167
fourth time's the charm.
330
00:12:45,233 --> 00:12:46,833
KELLERMAN:
And how long was it
331
00:12:46,900 --> 00:12:50,100
before Doctor Kovac came
to your bedside?
332
00:12:50,167 --> 00:12:53,467
It was more than an hour.
333
00:12:53,533 --> 00:12:56,733
Uh... I saw him working
on the computer,
334
00:12:56,800 --> 00:13:00,233
he was talking
to some nurses,
335
00:13:00,300 --> 00:13:05,267
then... he ate a bagel
with cream cheese.
336
00:13:05,333 --> 00:13:09,500
I think it was poppy seed.
337
00:13:09,567 --> 00:13:11,400
And how did that make you feel?
338
00:13:11,467 --> 00:13:13,100
Objection, irrelevant.
339
00:13:13,167 --> 00:13:15,100
On the contrary, Your Honor,
it goes to state of mind
340
00:13:15,167 --> 00:13:16,400
and his ability
to make decisions.
341
00:13:16,467 --> 00:13:19,167
Overruled.
You may answer.
342
00:13:23,433 --> 00:13:26,567
I felt alone...
343
00:13:27,633 --> 00:13:30,100
forgotten.
344
00:13:30,167 --> 00:13:32,267
Like nobody
there cared about me.
345
00:13:35,900 --> 00:13:38,200
LOCKHART:
I'm just saying
he's a frail old man
346
00:13:38,267 --> 00:13:40,800
who deserves the benefit of
diagnostic confirmation.
347
00:13:40,867 --> 00:13:42,633
CRENSHAW:
The patient is now on
the surgical service,
348
00:13:42,700 --> 00:13:44,267
not the ER service.
349
00:13:44,333 --> 00:13:46,233
Why don't you go downstairs
and pull a cockroach
350
00:13:46,300 --> 00:13:47,567
out of someone's ear?
351
00:13:47,633 --> 00:13:48,600
Neela...
He's not stable, Abby.
352
00:13:48,667 --> 00:13:50,400
BP's 90 systolic.
353
00:13:50,467 --> 00:13:52,767
Five minutes for an ultrasound
is not going to kill him.
354
00:13:52,833 --> 00:13:54,567
GATES:
I picked up a sterile sleeve.
355
00:13:54,633 --> 00:13:56,367
CRENSHAW:
Why do you people insist
on annoying me?
356
00:13:56,433 --> 00:13:57,800
GATES:
It'll only take a few minutes.
357
00:13:57,867 --> 00:14:00,167
10 blade...
I want these two
out of my O.R.
358
00:14:00,233 --> 00:14:01,233
Shirley, call security.
359
00:14:01,300 --> 00:14:02,300
All right, all right.
360
00:14:02,367 --> 00:14:03,467
Dab the bleeders, Katey.
361
00:14:03,533 --> 00:14:04,633
Nice working with you guys.
Bovie.
362
00:14:04,700 --> 00:14:05,833
Stand back!
363
00:14:05,900 --> 00:14:06,800
Irrigation! Saline!
364
00:14:06,867 --> 00:14:07,800
(panicked shouts)
365
00:14:07,867 --> 00:14:09,533
What the hell happened?
366
00:14:09,600 --> 00:14:11,100
Unplug the Bovie!
367
00:14:11,167 --> 00:14:12,700
Unplug
the Bovie.
368
00:14:12,767 --> 00:14:15,600
And turn off that oxygen,
before the whole room goes up.
369
00:14:20,433 --> 00:14:23,500
Dr. Kovac, when the nurses
couldn't start an I.V.,
370
00:14:23,567 --> 00:14:27,333
what action
did you take?
371
00:14:27,400 --> 00:14:32,000
I knew I needed to place a
catheter into a deeper vein.
372
00:14:32,067 --> 00:14:34,900
How you doing?
373
00:14:34,967 --> 00:14:37,200
I didn't know you
ordered acupuncture.
374
00:14:37,267 --> 00:14:39,000
(coughs)
I'm Sonya Ames.
375
00:14:39,067 --> 00:14:40,167
Hi. Luka Kovac.
376
00:14:40,233 --> 00:14:42,200
Thanks for
taking care of him.
377
00:14:42,267 --> 00:14:44,767
Well, since we can't get
an I.V. in your arm,
378
00:14:44,833 --> 00:14:48,267
I'd like to place
a central line under
your collarbone.
379
00:14:48,333 --> 00:14:50,900
That sounds
pretty involved.
380
00:14:50,967 --> 00:14:53,067
We need a route
to give I.V.
antibiotics,
381
00:14:53,133 --> 00:14:55,800
or we cannot treat
the pneumonia effectively.
382
00:14:55,867 --> 00:14:57,933
I'll numb up your skin
and guide
383
00:14:58,000 --> 00:15:00,933
a catheter in at the top
of your chest.
384
00:15:01,000 --> 00:15:02,867
There are risks of bleeding,
infection,
385
00:15:02,933 --> 00:15:04,833
collapsed lung,
but all of those
386
00:15:04,900 --> 00:15:07,167
can be treated.
387
00:15:07,233 --> 00:15:10,833
I've got to think about...
(coughs) I've got to
think about it.
388
00:15:10,900 --> 00:15:13,467
Wait. No, he doesn't.
389
00:15:13,533 --> 00:15:16,600
If you need some time
to consider...
390
00:15:16,667 --> 00:15:17,867
He's just being stubborn.
391
00:15:17,933 --> 00:15:19,767
He hasn't been to
a doctor in 20 years.
392
00:15:19,833 --> 00:15:20,500
I never get sick, baby.
393
00:15:20,567 --> 00:15:22,233
You can barely
394
00:15:22,300 --> 00:15:24,733
catch your breath, you've
been coughing so much.
395
00:15:24,800 --> 00:15:26,800
It's not that
bad, really.
396
00:15:26,867 --> 00:15:28,700
Listen, I just want
him to get better.
397
00:15:28,767 --> 00:15:29,867
We'll do whatever
it takes, okay?
398
00:15:29,933 --> 00:15:31,633
Well, if you want
the procedure
399
00:15:31,700 --> 00:15:33,600
you need to sign
this form.
400
00:15:36,900 --> 00:15:39,467
Now come on, baby,
I've got to get back to work.
401
00:15:42,533 --> 00:15:44,233
(pen clicks)
402
00:15:44,300 --> 00:15:45,333
(sighs)
403
00:15:45,400 --> 00:15:47,200
(signing form)
404
00:15:47,267 --> 00:15:49,767
KOVAC:
He didn't want to be
in the E.R.
405
00:15:49,833 --> 00:15:51,367
He didn't like doctors,
406
00:15:51,433 --> 00:15:53,933
so I felt I needed to treat him
aggressively.
407
00:15:54,000 --> 00:15:55,733
He said it was
the only way to go.
408
00:15:55,800 --> 00:15:57,200
If he left, I was worried
he'd get worse
409
00:15:57,267 --> 00:15:58,533
and wouldn't come back.
410
00:15:58,600 --> 00:16:00,467
He told me complications
were extremely rare.
411
00:16:00,533 --> 00:16:03,033
It was no big deal,
that he does these every day.
412
00:16:03,100 --> 00:16:05,167
His wife works, he's all alone.
413
00:16:05,233 --> 00:16:07,067
My opinion didn't matter.
414
00:16:07,133 --> 00:16:08,367
If he took pills, he could
have died at home
415
00:16:08,433 --> 00:16:09,900
and no one would know.
416
00:16:09,967 --> 00:16:11,967
He gave me and my wife
no other options,
417
00:16:12,033 --> 00:16:15,367
no other choices.
418
00:16:15,433 --> 00:16:17,867
We were both really,
really scared.
419
00:16:24,000 --> 00:16:25,667
Can we grab
you a sandwich?
420
00:16:25,733 --> 00:16:26,967
No, thanks.
421
00:16:43,300 --> 00:16:48,200
Hey, Timmy.
Uh, is Abby around?
422
00:16:48,267 --> 00:16:51,367
No, no, if she's
in surgery, then don't bother.
423
00:16:51,433 --> 00:16:53,667
That's okay, I'll try later.
424
00:16:53,733 --> 00:16:55,167
Thanks.
425
00:17:02,967 --> 00:17:04,900
Hmm?
Tricuspid regurg.
426
00:17:04,967 --> 00:17:06,933
Ah, the irony.
A bad heart valve.
427
00:17:07,000 --> 00:17:09,333
Mm-hmm, left him
with right-sided failure
and a big, pulsating liver.
428
00:17:09,400 --> 00:17:11,367
So the mass
was his liver?
429
00:17:11,433 --> 00:17:14,700
Yep, and the fire saved him
from unnecessary surgery.
430
00:17:14,767 --> 00:17:16,667
So a slightly scorched
med student
431
00:17:16,733 --> 00:17:18,733
and some burned drapes
saved the guy's life.
432
00:17:18,800 --> 00:17:20,167
Lucky guy.
Had minor burns.
433
00:17:20,233 --> 00:17:21,800
Excuse me.
434
00:17:27,300 --> 00:17:28,933
Forget how to use
that thing?
435
00:17:29,000 --> 00:17:31,833
No, I just...
436
00:17:31,900 --> 00:17:33,767
I didn't want to be one
of those crazy mothers
437
00:17:33,833 --> 00:17:36,067
that checks in with
the baby-sitter every hour.
438
00:17:36,133 --> 00:17:38,300
My baby-sitter used to tie
me to my high chair.
439
00:17:38,367 --> 00:17:41,667
I'm sure yours
is much better.
440
00:17:41,733 --> 00:17:44,100
KELLERMAN:
After your first dose
of antibiotics,
441
00:17:44,167 --> 00:17:45,667
how long were you
in the E.R.?
442
00:17:47,300 --> 00:17:49,833
A long time.
443
00:17:49,900 --> 00:17:51,633
Over three days.
444
00:17:51,700 --> 00:17:54,933
Three days? In the E.R.?
445
00:17:56,033 --> 00:17:57,333
They said that
446
00:17:57,400 --> 00:18:00,133
there were no other beds
in the hospital, so...
447
00:18:00,200 --> 00:18:01,833
Excuse me, uh, I need
to use the bathroom.
448
00:18:01,900 --> 00:18:03,333
I'll let
your nurse know.
449
00:18:03,400 --> 00:18:05,700
(coughs) I don't think that
I'll be able to...
450
00:18:05,767 --> 00:18:08,367
I said I'll let
your nurse know.
It's kind of urgent. Please.
451
00:18:08,433 --> 00:18:11,000
KELLERMAN:
So you stayed
452
00:18:11,067 --> 00:18:14,033
in the hall all that time?
453
00:18:14,100 --> 00:18:16,267
AMES:
I mean, they put me
in the back at night
454
00:18:16,333 --> 00:18:19,767
so that I could try
to get some sleep.
455
00:18:19,833 --> 00:18:21,533
MAN:
Get off me, bitch!
Let me go!
456
00:18:21,600 --> 00:18:23,333
OLBES:
Louie partied
a little too hard.
457
00:18:23,400 --> 00:18:25,233
I'd say we're dealing
with coke, PCP, and EtOH.
I'm gonna puke all over you!
458
00:18:25,300 --> 00:18:26,633
You can't do this!
Pulled his line.
459
00:18:26,700 --> 00:18:28,067
You're going to
need hard restraints.
I'm gonna mess you up!
460
00:18:28,133 --> 00:18:29,933
I'll rip your head off,
I swear to God!
461
00:18:30,000 --> 00:18:31,700
AMES:
They kept saying I'd get
a regular room
462
00:18:31,767 --> 00:18:37,467
after the first day, but...
it never happened.
463
00:18:37,533 --> 00:18:38,633
Nurse?
464
00:18:38,700 --> 00:18:39,867
(clearing throat)
465
00:18:39,933 --> 00:18:41,867
Nurse?
466
00:18:41,933 --> 00:18:43,500
I never got my breakfast.
467
00:18:43,567 --> 00:18:46,433
You may be NPO.
468
00:18:46,500 --> 00:18:47,700
What's that?
469
00:18:47,767 --> 00:18:51,567
We have to look
at your orders.
470
00:18:51,633 --> 00:18:53,500
Where's Dr. Kovac?
471
00:18:53,567 --> 00:18:55,467
He's not working today.
472
00:18:55,533 --> 00:18:57,900
So who... who's
my doctor, then?
473
00:18:57,967 --> 00:19:00,967
I have to check.
474
00:19:01,033 --> 00:19:03,800
KOVAC:
Every 12 hours
an oncoming resident
475
00:19:03,867 --> 00:19:07,467
assumed responsibility
for Mr. Ames' care.
476
00:19:07,533 --> 00:19:10,267
His progress was discussed,
and he was improving.
477
00:19:10,333 --> 00:19:12,633
KELLERMAN:
So it was the nurses who
were watching him more closely?
478
00:19:12,700 --> 00:19:14,567
Yes.
479
00:19:14,633 --> 00:19:18,567
Dr. Kovac, the State
recommends an E.R.
patient-to-nurse ratio
480
00:19:18,633 --> 00:19:19,867
of four-to-one.
481
00:19:19,933 --> 00:19:22,200
Yet, during
Mr. Ames' stay,
482
00:19:22,267 --> 00:19:24,333
the ratio
was eight-to-one.
483
00:19:24,400 --> 00:19:28,467
That's eight patients
for every nurse.
484
00:19:28,533 --> 00:19:30,400
How is that
possible?
485
00:19:30,467 --> 00:19:32,800
We can't control how many
patients come into the E.R.
486
00:19:32,867 --> 00:19:34,867
Dr. Kovac, you know
that those standards
are in place
487
00:19:34,933 --> 00:19:36,333
for patient safety.
488
00:19:36,400 --> 00:19:38,200
So on a day when the standards
were off
489
00:19:38,267 --> 00:19:40,833
by a factor of 100%,
490
00:19:40,900 --> 00:19:44,767
did you discuss this with
a hospital administrator?
No.
491
00:19:44,833 --> 00:19:46,500
With a director of nursing?
492
00:19:46,567 --> 00:19:49,300
No, no, it's not uncommon...
With a nurse manager?
493
00:19:49,367 --> 00:19:52,367
Look, we're always
short staffed.
494
00:19:52,433 --> 00:19:54,933
Did you bring this deficiency
to anyone's attention
495
00:19:55,000 --> 00:19:57,800
or do anything to address
the situation?
496
00:19:57,867 --> 00:20:00,833
It doesn't work like that.
497
00:20:04,867 --> 00:20:07,133
Mariko Shimane, history
of Crohn's Disease,
498
00:20:07,200 --> 00:20:08,200
vomited blood twice.
499
00:20:08,267 --> 00:20:09,600
Systolic's 88.
500
00:20:09,667 --> 00:20:12,100
Two liters of saline,
type and cross for four.
501
00:20:12,167 --> 00:20:13,167
Is there anyone we
can call, Mariko?
502
00:20:13,233 --> 00:20:14,400
Dr. Derezin.
503
00:20:14,467 --> 00:20:15,733
From Gastroenterology,
I paged him.
504
00:20:15,800 --> 00:20:17,233
How about a
family member?
505
00:20:17,300 --> 00:20:18,300
It's just me and my son.
506
00:20:18,367 --> 00:20:19,433
Where is he?
507
00:20:19,500 --> 00:20:21,400
Oregon.
Sophomore in college.
508
00:20:21,467 --> 00:20:23,233
We can call him.
I'm sure he'd
want to know.
509
00:20:23,300 --> 00:20:24,633
I'm in the hospital a lot.
510
00:20:24,700 --> 00:20:26,100
Your condition's
pretty serious.
511
00:20:26,167 --> 00:20:27,400
That's what they
always say.
512
00:20:27,467 --> 00:20:29,600
Upper GI bleed?
513
00:20:29,667 --> 00:20:31,167
Sure looks like it.
514
00:20:31,233 --> 00:20:32,500
Hello, Mariko.
515
00:20:32,567 --> 00:20:34,100
Sorry to bother you,
Neil.
516
00:20:34,167 --> 00:20:35,233
That's all right.
Any blood in your stool?
517
00:20:35,300 --> 00:20:36,600
Yeah.
518
00:20:36,667 --> 00:20:37,700
TAGGART:
She'd didn't
mention that.
519
00:20:37,767 --> 00:20:39,233
Red blood?
520
00:20:39,300 --> 00:20:40,767
Yeah.
521
00:20:40,833 --> 00:20:42,500
Endoscopy here or
in the GI lab?
522
00:20:42,567 --> 00:20:44,500
Excuse us for a minute.
523
00:20:46,833 --> 00:20:49,200
Dr. Pratt, dude on line
two says he's your brother.
524
00:20:49,267 --> 00:20:51,267
Yeah, take a message.
525
00:20:51,333 --> 00:20:53,467
And hey, Doc Lockhart,
big daddy called while
you were upstairs.
526
00:20:53,533 --> 00:20:54,733
Thanks.
I can't scope her.
527
00:20:54,800 --> 00:20:56,333
Why not?
528
00:20:56,400 --> 00:20:58,333
Crohn's can cause
inflammation, erosion
529
00:20:58,400 --> 00:21:00,300
into a vessel anywhere
along the intestinal tract.
530
00:21:00,367 --> 00:21:01,867
25 feet of possibilities.
531
00:21:01,933 --> 00:21:03,400
It's not something
I can reach.
532
00:21:03,467 --> 00:21:05,133
She needs surgical
exploration.
533
00:21:05,200 --> 00:21:06,600
I'll call the O.R.
534
00:21:06,667 --> 00:21:08,333
So...
what's the good news?
535
00:21:08,400 --> 00:21:10,567
We're going tomove you to a
different room.
536
00:21:10,633 --> 00:21:12,200
Looks like you may
need an operation.
537
00:21:12,267 --> 00:21:13,533
Again?
538
00:21:13,600 --> 00:21:15,200
Maybe it's time
to call your son?
539
00:21:15,267 --> 00:21:17,567
He's got mid-terms, no.
540
00:21:17,633 --> 00:21:19,833
On the afternoon of his
third hospital day
541
00:21:19,900 --> 00:21:22,333
Mr. Ames complained
of numbness in the left hand.
542
00:21:22,400 --> 00:21:26,300
WALTON:
And what was your impression?
543
00:21:26,367 --> 00:21:28,700
KOVAC:
How long
did it last?
544
00:21:28,767 --> 00:21:31,200
About ten minutes.
545
00:21:31,267 --> 00:21:33,767
Okay, squeeze
my hands.
546
00:21:35,667 --> 00:21:36,967
Okay.
547
00:21:37,033 --> 00:21:39,567
Now spread your
fingers like this.
548
00:21:39,633 --> 00:21:41,967
Don't let me close them.
549
00:21:42,033 --> 00:21:43,533
Good.
550
00:21:43,600 --> 00:21:46,400
What do you
think happened?
551
00:21:46,467 --> 00:21:48,467
It could be a number
of things.
552
00:21:48,533 --> 00:21:50,033
How's it feel now?
Back to normal?
553
00:21:50,100 --> 00:21:52,933
Yeah, yeah...
554
00:21:53,000 --> 00:21:54,700
Yeah, I guess.
555
00:21:54,767 --> 00:21:57,900
The same on both sides?
556
00:21:57,967 --> 00:21:59,833
It was kind of weird.
557
00:21:59,900 --> 00:22:01,200
You probably
compressed a nerve
558
00:22:01,267 --> 00:22:03,367
while you were resting
on your side.
559
00:22:03,433 --> 00:22:08,033
I've-I've slept on floors more
comfortable than this-this bed.
560
00:22:08,100 --> 00:22:11,100
Here, let me take care of that.
561
00:22:15,767 --> 00:22:17,533
Hi, bed control.
562
00:22:17,600 --> 00:22:19,500
Yeah, this is Dr. Kovac.
563
00:22:19,567 --> 00:22:23,133
Yeah, I need, I need a med surge
bed for my patient, please.
564
00:22:23,200 --> 00:22:24,867
KELLERMAN:
And when did the numbness
565
00:22:24,933 --> 00:22:26,667
return?
566
00:22:26,733 --> 00:22:28,967
It was about
three hours later.
567
00:22:29,033 --> 00:22:32,400
And was there something
different about this episode?
568
00:22:32,467 --> 00:22:34,033
I didn't have any feeling
for a half an hour.
569
00:22:34,100 --> 00:22:35,667
But you're okay now?
570
00:22:35,733 --> 00:22:37,600
It's worse.
Went up higher.
571
00:22:37,667 --> 00:22:38,967
Where's Dr. Kovac?
572
00:22:39,033 --> 00:22:40,533
He checked, he said
you were okay.
573
00:22:40,600 --> 00:22:42,567
I'm not okay.
I need to talk to him.
574
00:22:42,633 --> 00:22:43,633
Not right now.
575
00:22:43,700 --> 00:22:45,667
Why? Where is he?
(coughs)
576
00:22:45,733 --> 00:22:48,400
He's taking care of
a patient with a heart attack.
577
00:22:48,467 --> 00:22:51,467
Repeat the 12 lead and call
the cath lab.
Tell him to come
and see me.
578
00:22:51,533 --> 00:22:53,633
When he's through.
No, no, now.
579
00:22:53,700 --> 00:22:56,067
Mr. Ames, there are
people in this E.R.
who are much sicker
580
00:22:56,133 --> 00:22:58,033
and need
immediate attention.
581
00:22:58,100 --> 00:23:00,600
Hey.
If he won't come to
see me, then I'm gonna...
582
00:23:00,667 --> 00:23:02,633
Hey! Get back
in the bed.
...go see him.
583
00:23:02,700 --> 00:23:04,900
Something is seriously
wrong, and I need to
talk to my doctor.
584
00:23:04,967 --> 00:23:06,033
I need you back
on the monitor.
585
00:23:06,100 --> 00:23:07,067
Frank, help me
get him back.
586
00:23:07,133 --> 00:23:08,367
Take it easy
there, fella.
587
00:23:08,433 --> 00:23:09,733
Take it easy.
Take it easy?!
588
00:23:09,800 --> 00:23:11,033
You people have ignored
me for three days.
589
00:23:11,100 --> 00:23:12,800
No one will tell me
what's going on.
590
00:23:12,867 --> 00:23:14,367
Nobody gives a damn
about my care!
591
00:23:14,433 --> 00:23:16,100
No one will even
talk to me!
592
00:23:16,167 --> 00:23:17,567
How am I supposed
to take it easy?!
Mr. Ames, sit down.
593
00:23:17,633 --> 00:23:19,067
Easy!
I'm not sitting down
594
00:23:19,133 --> 00:23:20,667
until my doctor does
what he's supposed to do!
595
00:23:23,500 --> 00:23:24,567
(groans)
596
00:23:24,633 --> 00:23:26,533
CHUNY:
I need some help here!
597
00:23:26,600 --> 00:23:28,033
Open your eyes, sir.
598
00:23:28,100 --> 00:23:29,833
FRANK:
Hey, let's get a
gurney over here!
599
00:23:31,133 --> 00:23:32,467
Mr. Ames.
600
00:23:32,533 --> 00:23:33,567
Look at me.
601
00:23:33,633 --> 00:23:35,533
Luka, he had a stroke.
602
00:23:37,467 --> 00:23:38,500
Upgoing toe.
603
00:23:38,567 --> 00:23:40,567
CT can take him now.
604
00:23:40,633 --> 00:23:41,667
Okay, we're on our way.
605
00:23:41,733 --> 00:23:43,467
Let's go.
606
00:23:43,533 --> 00:23:45,467
KOVAC:
We recognized the stroke,
607
00:23:45,533 --> 00:23:46,933
immediately moved him
for close monitoring
608
00:23:47,000 --> 00:23:48,833
and had him to CT
as soon as possible.
609
00:23:48,900 --> 00:23:52,133
From what I remember,
it was... it was pretty chaotic.
610
00:23:52,200 --> 00:23:53,900
Why should this guy
have a stroke?
I have no idea.
611
00:23:53,967 --> 00:23:55,067
Follow my finger, sir.
612
00:23:55,133 --> 00:23:57,767
Sir, look over here.
Over here.
613
00:23:57,833 --> 00:23:59,467
Frank, I need
a monitored bed.
614
00:23:59,533 --> 00:24:00,600
There aren't any.
615
00:24:00,667 --> 00:24:02,433
Uh, okay, uh,
Trauma Two, then.
616
00:24:02,500 --> 00:24:03,500
GSW just took it.
617
00:24:03,567 --> 00:24:05,067
Let's move him to CT.
618
00:24:05,133 --> 00:24:06,500
FRANK:
CT's backed up
for half an hour.
619
00:24:06,567 --> 00:24:07,733
Okay, where can
we put him?!
620
00:24:07,800 --> 00:24:08,933
MARQUEZ:
I'll see what I can find.
621
00:24:09,000 --> 00:24:10,933
Okay, uh, chart.
I need his chart.
622
00:24:11,000 --> 00:24:12,400
I'm looking for it.
Chuny, where's the chart?
623
00:24:12,467 --> 00:24:14,933
I never saw it.
624
00:24:15,000 --> 00:24:16,767
It's okay, Mariko, just
take some deep breaths.
625
00:24:16,833 --> 00:24:18,033
Where the hell's surgery?
626
00:24:18,100 --> 00:24:19,967
Crenshaw called,
said the patient's
627
00:24:20,033 --> 00:24:21,933
not a candidate for anesthesia
till the systolic's up to 80.
628
00:24:22,000 --> 00:24:23,233
All right, well,
let's tank her up.
629
00:24:23,300 --> 00:24:24,767
Eight French cordis
into the femoral.
630
00:24:24,833 --> 00:24:26,733
You know, I had another idea.
631
00:24:26,800 --> 00:24:28,267
Oh, man.
632
00:24:28,333 --> 00:24:29,867
Hey, has anyone seen
a pocket doppler?
633
00:24:29,933 --> 00:24:32,067
Uh, yeah, top drawer
by the sink.
All right.
634
00:24:32,133 --> 00:24:33,933
What about an
intra-aortic balloon?
635
00:24:34,000 --> 00:24:35,133
This girl
in heart failure?
636
00:24:35,200 --> 00:24:37,233
No, it's a GI bleed.
637
00:24:37,300 --> 00:24:39,700
What? We inflate the balloon
in the chest,
638
00:24:39,767 --> 00:24:40,967
completely block off the
blood supply to the abdomen.
639
00:24:41,033 --> 00:24:42,133
No, you can't do that.
640
00:24:42,200 --> 00:24:43,167
Damn it.
641
00:24:43,233 --> 00:24:44,533
Why not?
That's a great idea.
Hey, she's
642
00:24:44,600 --> 00:24:46,233
not your patient.
Adios, Gates.
643
00:24:46,300 --> 00:24:48,033
Okay, could be
a publishable case report.
644
00:24:48,100 --> 00:24:49,967
It's a non-invasive way
to occlude the aorta.
645
00:24:50,033 --> 00:24:51,100
It'll stop the bleeding.
646
00:24:51,167 --> 00:24:52,867
Oh, crap, crap.
647
00:24:52,933 --> 00:24:54,267
Crap.
What?
648
00:24:54,333 --> 00:24:56,800
Pratt, can you come with me?
649
00:24:58,467 --> 00:25:01,000
Four units of red
cells, one of FFP,
650
00:25:01,067 --> 00:25:03,167
a ten-pack of platelets.
We'll be right back.
651
00:25:03,233 --> 00:25:04,900
Hey, hey, hey.
652
00:25:04,967 --> 00:25:06,033
What is this, some kind of
postpartum power trip?
653
00:25:06,100 --> 00:25:08,167
Okay, the aortic balloon
will work.
654
00:25:08,233 --> 00:25:10,833
It's an unproven therapy.
What, you'd rather
let her bleed to death?
655
00:25:10,900 --> 00:25:13,200
No, I'd rather have the surgeons
take her up to the O.R.
656
00:25:13,267 --> 00:25:14,733
It doesn't look like
that's gonna happen.
657
00:25:14,800 --> 00:25:16,100
And what's your problem
with the balloon?
658
00:25:16,167 --> 00:25:17,833
Because it cuts off
all the circulation
659
00:25:17,900 --> 00:25:19,767
to the bowel, liver,
kidneys and legs.
660
00:25:19,833 --> 00:25:21,433
Everything could die
from the chest down.
661
00:25:21,500 --> 00:25:22,967
What are we doing in here?
662
00:25:23,033 --> 00:25:24,767
You know, you used
to be such a cowboy.
663
00:25:24,833 --> 00:25:25,867
Why is this a big deal?
664
00:25:25,933 --> 00:25:27,233
I don't agree with you.
665
00:25:27,300 --> 00:25:28,867
Gates thinks it'll work.
666
00:25:28,933 --> 00:25:31,300
Gates is a knucklehead
who would defibrillate
667
00:25:31,367 --> 00:25:33,333
with a car battery
and some jumper cables.
668
00:25:33,400 --> 00:25:35,333
I am the attending.
The buck stops here.
669
00:25:35,400 --> 00:25:37,133
So if there's going
to be a bad outcome,
670
00:25:37,200 --> 00:25:39,300
let surgery be to blame
for not showing up in time.
671
00:25:39,367 --> 00:25:40,500
So you let her die?
672
00:25:40,567 --> 00:25:42,733
No, I just don't
want to be the guy
673
00:25:42,800 --> 00:25:44,167
who kills her with
some crazy-ass therapy.
674
00:25:44,233 --> 00:25:45,233
Look.
675
00:25:45,300 --> 00:25:46,333
This is her last chance.
676
00:25:46,400 --> 00:25:47,900
She's pre-arrest.
677
00:25:47,967 --> 00:25:49,767
I mean, if her pressure
continues to drop
678
00:25:49,833 --> 00:25:50,967
despite massive
transfusions...
679
00:25:51,033 --> 00:25:52,067
Then maybe I would
consider it.
680
00:25:52,133 --> 00:25:53,100
What are you doing?
681
00:25:53,167 --> 00:25:54,300
I'm pumping.
Sorry.
682
00:25:54,367 --> 00:25:56,133
My boobs were about to explode.
683
00:25:56,200 --> 00:26:00,933
(electronic pumping)
684
00:26:05,467 --> 00:26:07,500
KELLERMAN:
When did your wife arrive?
685
00:26:07,567 --> 00:26:09,800
Right after the CAT scan.
686
00:26:09,867 --> 00:26:12,133
By then I could talk again,
you know.
687
00:26:12,200 --> 00:26:14,267
It looks okay.
688
00:26:14,333 --> 00:26:18,767
I... st... still can't
move my arm...
689
00:26:18,833 --> 00:26:20,167
and leg.
690
00:26:20,233 --> 00:26:22,367
There's no mass,
no bleeding.
691
00:26:22,433 --> 00:26:23,967
That's... that's good.
692
00:26:24,033 --> 00:26:25,933
Then why did he
have a stroke?
693
00:26:26,000 --> 00:26:29,433
Probably a blood clot
in the brain artery.
694
00:26:29,500 --> 00:26:31,933
But, uh...
695
00:26:32,000 --> 00:26:33,933
there is something
we can try.
696
00:26:34,000 --> 00:26:36,033
What?
697
00:26:36,100 --> 00:26:38,000
What should I do?
698
00:26:38,067 --> 00:26:40,467
A medicine called TPA
699
00:26:40,533 --> 00:26:44,467
could probably
dissolve the clot.
700
00:26:44,533 --> 00:26:48,000
You're-You're saying
that could work?
701
00:26:48,067 --> 00:26:49,467
That I might...
702
00:26:49,533 --> 00:26:51,200
I can get better, right?
703
00:26:51,267 --> 00:26:55,100
There's some chance
of recovery
704
00:26:55,167 --> 00:26:57,400
30% of the time.
705
00:26:57,467 --> 00:26:59,900
And, uh, full recovery,
706
00:26:59,967 --> 00:27:01,233
ten percent
of the time.
707
00:27:05,167 --> 00:27:07,100
We've got to do something.
708
00:27:10,033 --> 00:27:13,900
What about the si...
side effects?
709
00:27:13,967 --> 00:27:16,900
There's always side effects.
710
00:27:16,967 --> 00:27:18,933
Well, there's a
ten percent chance
711
00:27:19,000 --> 00:27:21,200
of bleeding in the brain,
712
00:27:21,267 --> 00:27:23,000
causing more
disability and death.
713
00:27:23,067 --> 00:27:26,800
Ten percent chance
of recovery?!
714
00:27:26,867 --> 00:27:29,833
There's a ten percent
chance of-of death?
715
00:27:29,900 --> 00:27:32,467
What if we don't
use the drug?
716
00:27:34,467 --> 00:27:37,867
There can be
some improvement,
717
00:27:37,933 --> 00:27:39,867
uh, with time and
physical therapy,
718
00:27:39,933 --> 00:27:41,833
but probably not
full recovery.
719
00:27:43,900 --> 00:27:47,267
(sobbing)
720
00:27:47,333 --> 00:27:49,900
Look...
721
00:27:49,967 --> 00:27:54,733
I... I've been in this hospital
722
00:27:54,800 --> 00:27:59,067
long enough to know that
if something can go wrong,
723
00:27:59,133 --> 00:28:01,967
it...
724
00:28:02,033 --> 00:28:07,700
I don't want it.
725
00:28:07,767 --> 00:28:09,233
WALTON:
And what do you
726
00:28:09,300 --> 00:28:13,167
recall of Mr. Ames' reaction to
your recommendation of TPA?
727
00:28:13,233 --> 00:28:15,867
I brought in Dr. Saunders,
a neurologist,
728
00:28:15,933 --> 00:28:17,667
to try to explain options
729
00:28:17,733 --> 00:28:19,100
in an objective manner.
730
00:28:19,167 --> 00:28:21,833
The statistics are averages
for all patients,
731
00:28:21,900 --> 00:28:23,900
even ones
in their 70s and 80s.
732
00:28:23,967 --> 00:28:26,800
KOVAC:
Your risk of bleeding is
much less, given your age
733
00:28:26,867 --> 00:28:28,967
and the fact that it's
been only 90 minutes
734
00:28:29,033 --> 00:28:30,733
since the onset
of symptoms.
735
00:28:33,267 --> 00:28:34,867
I don't... I don't know.
736
00:28:34,933 --> 00:28:38,933
The TPA is your only shot
at complete recovery.
737
00:28:42,533 --> 00:28:45,300
Forget it.
I'm-I'm not taking it.
738
00:28:45,367 --> 00:28:47,133
Settle down, baby.
739
00:28:47,200 --> 00:28:48,867
Look, if it was me,
740
00:28:48,933 --> 00:28:51,133
I'd-I'd take the TPA.
741
00:28:51,200 --> 00:28:54,933
If it was you, if it was you,
you'd be in intensive care
742
00:28:55,000 --> 00:28:57,800
with-with-with
ten doctors and nurses
743
00:28:57,867 --> 00:28:59,267
watching your ass every second,
744
00:28:59,333 --> 00:29:01,467
day and night.
Curtis...
745
00:29:01,533 --> 00:29:03,600
You wouldn't be getting
the runaround for three days.
746
00:29:03,667 --> 00:29:04,900
Not sleeping,
747
00:29:04,967 --> 00:29:08,200
not eating.
Pissing in a pan.
748
00:29:08,267 --> 00:29:10,500
And now I'm supposed
to trust you
749
00:29:10,567 --> 00:29:13,400
with a medicine
that can kill me,
750
00:29:13,467 --> 00:29:16,400
when all I've seen
since I've been here
751
00:29:16,467 --> 00:29:18,900
is total incompetence!
752
00:29:21,133 --> 00:29:23,767
WALTON:
Mr. Ames, did you refuse
a therapy
753
00:29:23,833 --> 00:29:27,900
that had the potential
to reverse the stroke?
754
00:29:27,967 --> 00:29:30,033
There were no guarantees.
755
00:29:30,100 --> 00:29:32,233
Experts have agreed that TPA
756
00:29:32,300 --> 00:29:35,433
gave you the only chance
for a complete recovery.
757
00:29:35,500 --> 00:29:37,400
And you didn't want it?
758
00:29:40,200 --> 00:29:42,500
It was a lot more complicated
than that, really.
759
00:29:42,567 --> 00:29:46,400
Did you refuse a medicine that
could've cured you?
760
00:29:52,567 --> 00:29:55,433
I refused what they were
pushing,
761
00:29:55,500 --> 00:29:56,900
and you would've done
the same thing.
762
00:29:56,967 --> 00:30:00,267
So you did refuse the cure?
763
00:30:03,367 --> 00:30:05,067
Systolic's only 50
after four unites.
764
00:30:05,133 --> 00:30:08,000
All right,
hang another two units.
765
00:30:08,067 --> 00:30:09,900
I'm above the diaphragm.
Go ahead, inject.
766
00:30:09,967 --> 00:30:11,233
I'm putting in
40ccs of saline.
767
00:30:11,300 --> 00:30:12,900
Let's hope this
damn thing works.
768
00:30:12,967 --> 00:30:14,267
Doc Lock, you got a call.
769
00:30:14,333 --> 00:30:16,467
Kind of busy right now.
Balloon is up.
770
00:30:16,533 --> 00:30:19,433
It's your baby-sitter.
They said it was important.
771
00:30:19,500 --> 00:30:20,767
Pressure's up to 90.
772
00:30:20,833 --> 00:30:22,467
All right, go ahead,
go, take it.
773
00:30:22,533 --> 00:30:24,767
We're out of the woods.
Mark the time.
774
00:30:24,833 --> 00:30:26,333
Surgeons have one hour
to get it up and fix her,
775
00:30:26,400 --> 00:30:27,967
or the game is over.
776
00:30:28,033 --> 00:30:30,300
Hello.
TAGGART: They should be
here any minute.
777
00:30:30,367 --> 00:30:32,267
What's happening?
Well, we've got your
bleeding controlled.
778
00:30:32,333 --> 00:30:33,867
But now we're getting
ready to take you
up to the O.R.
779
00:30:33,933 --> 00:30:35,000
Is he hungry?
Did you try the stroller?
780
00:30:35,067 --> 00:30:37,233
Thanks for
joining us.
781
00:30:37,300 --> 00:30:39,100
What's up with the fluoro?
I thought E.R. docs
had X-ray vision.
782
00:30:39,167 --> 00:30:41,033
Okay, okay.
783
00:30:41,100 --> 00:30:43,367
We put a balloon in the thoracic
Put the phone
next to his ear.
784
00:30:43,433 --> 00:30:45,233
...aorta to stop
a Crohn's patient from
intra-abdominal exsanguination.
785
00:30:45,300 --> 00:30:47,067
Rather unconventional,
dare I say, idiotic.
786
00:30:47,133 --> 00:30:49,233
TAGGART:
Well, it worked.
BP's 122/78.
787
00:30:49,300 --> 00:30:51,200
* If I go, there will
be trouble.. *
It's like a cross clamp
788
00:30:51,267 --> 00:30:52,533
without the thoracacotomy.
It's very cool.
789
00:30:52,600 --> 00:30:53,833
What's not cool
is that her kidneys
790
00:30:53,900 --> 00:30:55,200
will be dead
within an hour.
791
00:30:55,267 --> 00:30:56,967
Let's go,
clock is ticking.
Abby?
792
00:30:57,033 --> 00:30:59,200
It's his favorite song,
it puts him right to sleep.
793
00:30:59,267 --> 00:31:01,500
* This indecision's bugging me *
794
00:31:01,567 --> 00:31:03,133
Aren't you glad you don't
work here anymore?
795
00:31:03,200 --> 00:31:04,433
She's auditioning
for American Idol.
796
00:31:04,500 --> 00:31:06,233
* If you don't want me,
set me free *
797
00:31:06,300 --> 00:31:07,833
Hey, nice work, Abby.
798
00:31:07,900 --> 00:31:09,267
Thanks.
799
00:31:09,333 --> 00:31:12,900
* Exactly whom I'm
supposed to be? *
800
00:31:12,967 --> 00:31:15,967
* Don't you know which clothes
even fit me? *
801
00:31:16,033 --> 00:31:18,900
Upstairs, the neurologists
recognized a faint
802
00:31:18,967 --> 00:31:21,233
mid-systolic murmur.
803
00:31:21,300 --> 00:31:22,900
What does that mean?
804
00:31:22,967 --> 00:31:26,400
A murmur is from turbulent blood
flow through the heart.
805
00:31:26,467 --> 00:31:28,933
So because of the murmur,
a cardiac echo was ordered
806
00:31:29,000 --> 00:31:31,000
showing a patent foramen ovale.
807
00:31:31,067 --> 00:31:34,033
Do you know what a patent
foramen ovale is, Dr. Kovac?
808
00:31:34,100 --> 00:31:36,200
A small hole between the upper
chambers of the heart.
809
00:31:36,267 --> 00:31:40,133
So that hole
could have allowed
a blood clot
810
00:31:40,200 --> 00:31:42,400
from your subclavian catheter
to pass
811
00:31:42,467 --> 00:31:46,167
from the right side
to the left side of the heart
812
00:31:46,233 --> 00:31:50,033
and then... up to the brain.
813
00:31:50,100 --> 00:31:52,933
Could happen.
But that's extremely rare.
814
00:31:53,000 --> 00:31:54,967
I didn't ask you how rare
it was, Dr. Kovac.
815
00:31:55,033 --> 00:31:56,133
I asked you whether a patent
816
00:31:56,200 --> 00:31:57,767
foramen provides
a pathway for a clot
817
00:31:57,833 --> 00:32:00,200
to travel to the brain
and cause a stroke.
818
00:32:00,267 --> 00:32:01,933
Yes.
819
00:32:02,000 --> 00:32:04,067
So if you had heard the murmur,
if you had pulled
820
00:32:04,133 --> 00:32:06,267
the catheter when the numbness
began, is it possible
821
00:32:06,333 --> 00:32:08,867
that you could have prevented
Mr. Ames' stroke?
822
00:32:08,933 --> 00:32:09,900
Objection.
823
00:32:09,967 --> 00:32:11,233
Calls for speculation.
824
00:32:11,300 --> 00:32:12,500
Sustained.
825
00:32:13,500 --> 00:32:14,900
When the numbness began,
826
00:32:14,967 --> 00:32:16,800
did you consider
a cardiac source,
827
00:32:16,867 --> 00:32:19,167
or did you ignore an
important warning sign
828
00:32:19,233 --> 00:32:21,167
of impending stroke?
829
00:32:21,233 --> 00:32:22,900
I didn't ignore anything.
830
00:32:22,967 --> 00:32:25,833
I considered what was probable
and acted accordingly.
831
00:32:25,900 --> 00:32:28,067
After Mr. Ames
complained of numbness,
832
00:32:28,133 --> 00:32:30,600
did you then appreciate
his heart murmur?
833
00:32:30,667 --> 00:32:32,000
The E.R. is a noisy place.
834
00:32:32,067 --> 00:32:34,067
You can't always
hear subtle murmurs.
835
00:32:34,133 --> 00:32:36,000
Dr. Kovac,
I'm not asking you
836
00:32:36,067 --> 00:32:37,900
about the noise level
in your E.R.
837
00:32:37,967 --> 00:32:41,033
I'm asking did you at
any time in the three
838
00:32:41,100 --> 00:32:42,833
days that you cared
for Mr. Ames
839
00:32:42,900 --> 00:32:44,967
recognize his heart murmur?
840
00:32:45,033 --> 00:32:46,933
At the time
of Mr. Ames' numbness,
841
00:32:47,000 --> 00:32:48,833
there were 47 patients
in the E.R.,
842
00:32:48,900 --> 00:32:50,767
82 in the waiting room.
843
00:32:50,833 --> 00:32:52,133
I was taking care
of a young mother
844
00:32:52,200 --> 00:32:53,167
who was the victim
of domestic violence,
845
00:32:53,233 --> 00:32:54,767
nearly beaten to death,
846
00:32:54,833 --> 00:32:56,567
an eight-year-old,
hit by a car...
Dr. Kovac.
847
00:32:56,633 --> 00:32:58,033
And a 53-year-old
heart attack victim.
Dr. Kovac.
848
00:32:58,100 --> 00:32:59,667
Dr. Kovac, you're not
answering my question.
849
00:32:59,733 --> 00:33:01,033
There are always
sicker patients...
LAHN: Order!
850
00:33:01,100 --> 00:33:03,067
I asked if he had a heart murmur
Order! Order!
851
00:33:03,133 --> 00:33:05,067
that you failed
to recognize.
It was reasonable to believe
852
00:33:05,133 --> 00:33:06,167
that Mr. Ames' numbness
could wait!
Order.
853
00:33:06,233 --> 00:33:07,633
Order!
854
00:33:07,700 --> 00:33:09,267
Only one of you can speak
at a time.
855
00:33:09,333 --> 00:33:10,967
Your Honor, I move to
strike that that entire tirade
856
00:33:11,033 --> 00:33:12,933
be stricken from the record
as non-responsive,
857
00:33:13,000 --> 00:33:14,667
and I request that the
court admonish the witness
858
00:33:14,733 --> 00:33:15,800
to answer my question.
859
00:33:15,867 --> 00:33:17,233
LAHN:
Restate the question.
860
00:33:17,300 --> 00:33:19,100
And, Doctor, I'm instructing
you to answer it.
861
00:33:19,167 --> 00:33:21,567
If you had heard
the murmur,
862
00:33:21,633 --> 00:33:24,067
is it possible that you could
have prevented the stroke?
863
00:33:24,133 --> 00:33:25,633
WALTON:
Objection.
864
00:33:25,700 --> 00:33:27,167
Possibility is not the issue.
865
00:33:27,233 --> 00:33:29,033
LAHN:
Sustained.
866
00:33:29,100 --> 00:33:32,100
Dr. Kovac, is it true that you
could have prevented the stroke?
867
00:33:35,933 --> 00:33:37,133
Well, Doctor?
868
00:33:37,200 --> 00:33:39,000
Counselor, I'm warning you.
869
00:33:39,067 --> 00:33:41,600
No need, I'm done
with this witness.
870
00:33:46,067 --> 00:33:47,667
Scabies family went home,
871
00:33:47,733 --> 00:33:49,300
and lost rectal thermometer
went up to surgery.
872
00:33:49,367 --> 00:33:51,300
Gates needs you for
an extubation in Trauma Two.
All right.
873
00:33:51,367 --> 00:33:54,000
LOCKHART:
I'm here till 7:00,
so call me if you get a break.
874
00:33:54,067 --> 00:33:55,867
Hey, any news from Kovac?
Not yet.
875
00:33:55,933 --> 00:33:57,133
Greg?
876
00:33:57,200 --> 00:33:59,333
Hey.
877
00:33:59,400 --> 00:34:00,967
Am I too early?
Yeah, yeah, yeah.
878
00:34:01,033 --> 00:34:03,100
Just have a seat in
Triage for a few minutes.
879
00:34:03,167 --> 00:34:04,233
I'll be right back.
All right.
880
00:34:04,300 --> 00:34:05,900
It's Abby, right?
881
00:34:05,967 --> 00:34:07,033
Yes. Oh, hi.
882
00:34:07,100 --> 00:34:08,633
Sorry about your arms.
883
00:34:08,700 --> 00:34:10,133
Oh, it's okay,
they fixed me up pretty good,
884
00:34:10,200 --> 00:34:11,633
but the med school
wants me
885
00:34:11,700 --> 00:34:12,800
to make a chart
for their insurance.
886
00:34:12,867 --> 00:34:14,733
It's no problem,
I got it.
887
00:34:14,800 --> 00:34:15,867
Thank you, Ray.
888
00:34:15,933 --> 00:34:19,667
Thanks, Ray.
889
00:34:19,733 --> 00:34:21,167
I guess we can do
it in Curtain Four.
890
00:34:21,233 --> 00:34:22,500
Great.
891
00:34:22,567 --> 00:34:24,100
You might need
a little debridement.
892
00:34:24,167 --> 00:34:25,667
Go for it.
893
00:34:25,733 --> 00:34:28,567
So, your shift
almost over?
Mm-hmm.
894
00:34:28,633 --> 00:34:30,700
They're giving me
two days off to heal.
895
00:34:30,767 --> 00:34:32,567
Well, that's very generous
of the surgeons.
896
00:34:32,633 --> 00:34:35,567
(chuckles)
First free night
in forever.
897
00:34:35,633 --> 00:34:37,700
Have you been to Rednofive?
898
00:34:37,767 --> 00:34:39,567
Uh, no.
899
00:34:39,633 --> 00:34:41,400
They remodeled,
900
00:34:41,467 --> 00:34:44,467
and I hear the DJ on Thursday
nights is ridiculous.
901
00:34:46,567 --> 00:34:48,667
You want to check
it out tonight?
902
00:34:49,800 --> 00:34:52,167
WALTON:
Both emergency
903
00:34:52,233 --> 00:34:54,200
and infectious disease
experts agree
904
00:34:54,267 --> 00:34:57,833
that Dr. Kovac
gave superior treatment,
905
00:34:57,900 --> 00:35:00,633
above and beyond
the standard of care.
906
00:35:03,867 --> 00:35:07,500
The stroke was
a one-in-a-million
907
00:35:07,567 --> 00:35:11,333
complication that no one
could have either predicted
908
00:35:11,400 --> 00:35:13,500
or prevented.
909
00:35:13,567 --> 00:35:20,100
Dr. Kovac treats
the patients that no
other doctor will treat.
910
00:35:20,167 --> 00:35:23,333
His E.R. is the safety net
for millions
911
00:35:23,400 --> 00:35:24,800
with no health insurance.
912
00:35:24,867 --> 00:35:26,333
Every day,
913
00:35:26,400 --> 00:35:28,433
he is out there
on the front lines,
914
00:35:28,500 --> 00:35:31,500
providing the best
health care possible
915
00:35:31,567 --> 00:35:34,433
for the people
who need it the most.
916
00:35:34,500 --> 00:35:38,533
If you find against Dr. Kovac,
what message do you send
917
00:35:38,600 --> 00:35:42,233
to other health care providers
like him, who make
918
00:35:42,300 --> 00:35:45,267
that daily struggle
their personal mission?
919
00:35:45,333 --> 00:35:48,533
Dr. Kovac could have sent
Mr. Ames home
920
00:35:48,600 --> 00:35:51,533
with antibiotic pills,
but he didn't.
921
00:35:51,600 --> 00:35:54,467
He assumed that Mr. Ames
was unreliable,
922
00:35:54,533 --> 00:35:56,533
that he couldn't be trusted.
923
00:35:56,600 --> 00:36:00,500
And so Dr. Kovac took
responsibility for his care.
924
00:36:00,567 --> 00:36:03,467
And then, he abandoned
that responsibility
925
00:36:03,533 --> 00:36:06,267
by subjecting Mr. Ames
to substandard conditions
926
00:36:06,333 --> 00:36:08,867
in an understaffed E.R.,
where that man was shoved
927
00:36:08,933 --> 00:36:10,600
into a corner and neglected.
928
00:36:10,667 --> 00:36:15,567
And the warning signs
of a major stroke were ignored,
929
00:36:15,633 --> 00:36:18,733
resulting in
a devastating disability.
930
00:36:18,800 --> 00:36:22,500
Before the stroke, Mr. Ames
was a skilled craftsman.
931
00:36:22,567 --> 00:36:25,367
He supported a wife
and two children.
932
00:36:25,433 --> 00:36:28,500
And now, with a paralyzed
left arm, loss of perception
933
00:36:28,567 --> 00:36:32,800
in his left visual field, that
livelihood has been taken away.
934
00:36:33,933 --> 00:36:36,467
Loss of income,
935
00:36:36,533 --> 00:36:41,200
loss of self-esteem
has resulted in profound stress
936
00:36:41,267 --> 00:36:45,433
and led to a divorce and
separation from his children.
937
00:36:45,500 --> 00:36:47,433
Mr. Ames now lives alone.
938
00:36:47,500 --> 00:36:50,200
He's trying to get by
on a disability benefit
939
00:36:50,267 --> 00:36:52,233
of $1,300 a month.
940
00:36:52,300 --> 00:36:56,167
He cannot drive, he sees
his children one day a week,
941
00:36:56,233 --> 00:36:59,333
and he is being treated
for depression.
942
00:36:59,400 --> 00:37:03,600
Your award must fairly
compensate Mr. Ames
943
00:37:03,667 --> 00:37:06,200
for past and ongoing
medical care,
944
00:37:06,267 --> 00:37:08,200
for 25 years of lost wages,
945
00:37:08,267 --> 00:37:10,333
and for the pain and suffering
946
00:37:10,400 --> 00:37:13,133
that this man
will experience every day
947
00:37:13,200 --> 00:37:16,767
for the rest of his life.
948
00:37:16,833 --> 00:37:18,367
LOCKHART:
And you want to make sure
that this part
949
00:37:18,433 --> 00:37:21,200
rests against your
ribcage, not your armpits.
950
00:37:21,267 --> 00:37:23,833
And then, you
just-- whoops!
951
00:37:23,900 --> 00:37:25,533
I'm okay. I'm okay.
952
00:37:25,600 --> 00:37:27,367
You sure those
things are safe?
953
00:37:27,433 --> 00:37:29,200
Yeah, I think they just
need an adjustment,
954
00:37:29,267 --> 00:37:32,500
or you can go to the
pharmacy and get a new pair.
955
00:37:32,567 --> 00:37:34,600
Good idea.
956
00:37:34,667 --> 00:37:36,567
Be careful.
957
00:37:38,367 --> 00:37:40,200
Should we sign you in
as a trauma patient?
958
00:37:40,267 --> 00:37:42,233
I would say yes,
but my shift is over.
959
00:37:42,300 --> 00:37:44,767
Call me if your
spleen ruptures.
960
00:37:44,833 --> 00:37:45,833
Excuse me. Hi.
Hi.
961
00:37:45,900 --> 00:37:47,433
Is Dr. Pratt around?
962
00:37:47,500 --> 00:37:49,100
He's with a patient--
can I help you?
963
00:37:49,167 --> 00:37:51,167
He told me he was going
to be right back.
964
00:37:51,233 --> 00:37:53,333
If you see him, will you let him
know that Chaz is still waiting?
965
00:37:53,400 --> 00:37:54,667
Okay.
966
00:37:54,733 --> 00:37:56,133
RAY:
Hey, Neela, you
have a minute?
967
00:37:56,200 --> 00:37:57,733
I have 12 hours,
I'm on all night.
968
00:37:57,800 --> 00:37:59,500
Okay, it's about Katey,
your med student.
969
00:37:59,567 --> 00:38:00,600
Ray...
Hey, hey.
970
00:38:00,667 --> 00:38:01,733
She asked me
out, all right?
971
00:38:01,800 --> 00:38:03,167
You know that residents
972
00:38:03,233 --> 00:38:04,600
are not allowed
to date their students.
973
00:38:04,667 --> 00:38:06,100
She's not my student,
she never will be.
974
00:38:06,167 --> 00:38:07,467
She's not doing
an E.R. elective,
975
00:38:07,533 --> 00:38:08,767
so technically,
it's not even against policy.
976
00:38:08,833 --> 00:38:10,700
Well, then why even ask?
977
00:38:10,767 --> 00:38:13,433
Thanks, appreciate
your help.
978
00:38:13,500 --> 00:38:16,533
I'm sorry, I got to go.
979
00:38:16,600 --> 00:38:18,333
Tell Greg I'll call him.
Okay.
980
00:38:18,400 --> 00:38:19,400
Hey, Mayday.
Hello.
981
00:38:19,467 --> 00:38:20,500
What are you doing here?
982
00:38:20,567 --> 00:38:21,567
Small bowel obstruction.
983
00:38:21,633 --> 00:38:23,133
Good times.
984
00:38:23,200 --> 00:38:24,767
So, uh, how's the guy
who went up in flames?
985
00:38:24,833 --> 00:38:27,100
Minor partial thickness
burns to the chest and abdomen.
986
00:38:27,167 --> 00:38:29,500
You know, I hear his aorta
was just fine.
987
00:38:29,567 --> 00:38:31,500
You know, there's a lesson
to be learned here.
988
00:38:31,567 --> 00:38:32,833
Wise men say,
"Only fools rush in."
Hey.
989
00:38:32,900 --> 00:38:35,133
Oh, you missed a
guy called Chaz.
990
00:38:35,200 --> 00:38:36,867
He left?
991
00:38:36,933 --> 00:38:39,433
You were saying?
992
00:38:42,233 --> 00:38:43,567
Hey, Chaz,
Chaz, hold up, man.
993
00:38:43,633 --> 00:38:45,867
Sorry about that, I got
caught up with a patient.
994
00:38:45,933 --> 00:38:47,733
It's okay. I got to go.
995
00:38:47,800 --> 00:38:49,233
No, come on, man.
996
00:38:49,300 --> 00:38:50,567
It sounded like
something serious.
997
00:38:50,633 --> 00:38:51,667
Nah, it's all good.
998
00:38:51,733 --> 00:38:52,700
Hey.
999
00:38:55,167 --> 00:38:57,467
Things just aren't
going so well at home.
1000
00:38:57,533 --> 00:38:59,400
Really?
1001
00:38:59,467 --> 00:39:01,333
When I want to study,
it's too noisy.
1002
00:39:01,400 --> 00:39:03,367
When I want to bring
my friends over,
Dad won't let me.
1003
00:39:03,433 --> 00:39:04,733
I'm always late to class,
1004
00:39:04,800 --> 00:39:06,433
because the commute
takes forever.
1005
00:39:06,500 --> 00:39:07,467
What about the dorm?
1006
00:39:07,533 --> 00:39:09,400
Costs too much.
1007
00:39:09,467 --> 00:39:10,767
When you saw me
out there earlier,
1008
00:39:10,833 --> 00:39:12,667
I was looking for
apartments to share,
1009
00:39:12,733 --> 00:39:15,733
but... they all
kind of sucked.
1010
00:39:15,800 --> 00:39:18,267
Look, I know this is
going to sound crazy,
1011
00:39:18,333 --> 00:39:21,467
but... I was thinking
1012
00:39:21,533 --> 00:39:23,367
maybe I could move
into your place.
1013
00:39:23,433 --> 00:39:24,867
(chuckles)
1014
00:39:24,933 --> 00:39:26,433
My place?
1015
00:39:26,500 --> 00:39:27,567
(laughing):
Yeah, your place.
1016
00:39:27,633 --> 00:39:29,567
I mean, it's close to campus.
1017
00:39:29,633 --> 00:39:32,567
I can get a part-time job,
to help you out with the rent.
1018
00:39:32,633 --> 00:39:34,433
I'm quiet.
1019
00:39:34,500 --> 00:39:36,267
We'll probably never
even see each other.
1020
00:39:36,333 --> 00:39:38,400
You're serious?
1021
00:39:39,700 --> 00:39:40,833
Chaz, come on, man.
1022
00:39:40,900 --> 00:39:42,733
You know,
I got my own style.
1023
00:39:42,800 --> 00:39:46,633
Aw, come on. You say the word,
and I'm gonna clear out for you.
1024
00:39:46,700 --> 00:39:49,600
And if it doesn't
work, I'll...
1025
00:39:49,667 --> 00:39:53,433
I'll be gone...
real fast, man.
1026
00:39:58,467 --> 00:40:00,533
Never mind,
it's a bad idea.
1027
00:40:00,600 --> 00:40:03,667
All right, look.
1028
00:40:03,733 --> 00:40:06,500
Let's try it for a month.
1029
00:40:06,567 --> 00:40:08,400
You for real?
1030
00:40:08,467 --> 00:40:10,633
Yeah, I'll talk to your mom.
1031
00:40:10,700 --> 00:40:12,633
(chuckles)
Thank you.
1032
00:40:12,700 --> 00:40:14,133
All right.
Thank you.
1033
00:40:14,200 --> 00:40:15,233
(chuckles)
1034
00:40:15,300 --> 00:40:16,633
I'm going to
holler at you.
1035
00:40:16,700 --> 00:40:18,333
All right, man,
take it easy.
1036
00:40:21,233 --> 00:40:22,467
(sighs)
1037
00:40:22,533 --> 00:40:23,600
Hey!
Yeah.
1038
00:40:23,667 --> 00:40:24,800
(chuckles)
1039
00:40:24,867 --> 00:40:26,433
So, how was the
first day back?
1040
00:40:26,500 --> 00:40:28,467
It was a piece of cake.
1041
00:40:28,533 --> 00:40:29,733
(chuckling):
Like riding a bike.
1042
00:40:29,800 --> 00:40:31,567
Yeah? You miss
your little man?
1043
00:40:31,633 --> 00:40:33,133
Yeah, but that's okay.
1044
00:40:33,200 --> 00:40:35,167
I'll bond with him again
when I feed him
1045
00:40:35,233 --> 00:40:37,200
at 11:00 and 2:00
and 5:00 a.m.
1046
00:40:37,267 --> 00:40:38,400
(laughs)
1047
00:40:38,467 --> 00:40:40,433
But you know what
was nice about today?
1048
00:40:40,500 --> 00:40:44,167
For 12 hours, I talked
like a grown-up to grown-ups.
1049
00:40:44,233 --> 00:40:46,633
Well, except for
when you had to deal
with the surgeons.
1050
00:40:46,700 --> 00:40:48,867
Yeah, but at least they
don't spit up on you.
1051
00:40:48,933 --> 00:40:50,867
Much.
(chuckles)
1052
00:40:50,933 --> 00:40:52,500
Good night.
1053
00:40:52,567 --> 00:40:54,100
Try to get some rest.
1054
00:40:54,167 --> 00:40:55,667
It's a nice idea.
1055
00:40:57,767 --> 00:40:59,833
How long do you think
they'll deliberate?
1056
00:40:59,900 --> 00:41:02,367
Shouldn't take more
than a day or two.
1057
00:41:02,433 --> 00:41:05,367
Ames' lawyer is a
publicity hound.
1058
00:41:05,433 --> 00:41:08,800
Local news is having a
field day trashing County.
1059
00:41:08,867 --> 00:41:10,800
It'll be good to get you
in front of the press
1060
00:41:10,867 --> 00:41:13,433
as "the doctor
found not guilty."
1061
00:41:13,500 --> 00:41:15,133
Well, you're very
optimistic.
1062
00:41:15,200 --> 00:41:17,467
People need to hear our
side of the story
1063
00:41:17,533 --> 00:41:20,467
to reassure them that the
county health system works.
1064
00:41:22,200 --> 00:41:24,100
During that videotape,
1065
00:41:24,167 --> 00:41:26,733
did you see the looks
on the jurors' faces?
1066
00:41:26,800 --> 00:41:28,700
Doctors get sued
for ignoring
1067
00:41:28,767 --> 00:41:32,600
and undertreating patients,
not for doing too much.
1068
00:41:32,667 --> 00:41:35,833
Plus, you did a great
job on the stand.
1069
00:41:35,900 --> 00:41:38,533
Well, I don't think so.
1070
00:41:38,600 --> 00:41:41,267
I've been to at least
a hundred trials.
1071
00:41:41,333 --> 00:41:43,667
I can tell when a jury
likes the doctor.
1072
00:41:45,833 --> 00:41:48,133
WOMAN:
He's just another greedy M.D.
1073
00:41:48,200 --> 00:41:49,767
getting rich by overtreating.
1074
00:41:49,833 --> 00:41:52,433
What are you
talking about?
I've read about it.
1075
00:41:52,500 --> 00:41:54,367
The drug companies
give kickbacks
1076
00:41:54,433 --> 00:41:56,767
to doctors who use
their expensive drugs.
1077
00:41:56,833 --> 00:41:58,600
Mm-hmm.
WOMAN 2:
The judge instructed us
1078
00:41:58,667 --> 00:42:00,200
not to decide this case
based on anything
1079
00:42:00,267 --> 00:42:01,833
we've heard outside
of the courtroom.
1080
00:42:01,900 --> 00:42:05,233
WOMAN 1:
They neglected this
guy for three days.
1081
00:42:05,300 --> 00:42:07,233
WOMAN 2:
His pneumonia
was improving.
1082
00:42:07,300 --> 00:42:10,567
MAN:
That doctor used a hand grenade
to kill a mosquito.
1083
00:42:10,633 --> 00:42:12,800
To me, that's bad
medical judgment.
1084
00:42:12,867 --> 00:42:14,300
You're not a doctor.
1085
00:42:14,367 --> 00:42:15,600
We've got to to decide
this thing
1086
00:42:15,667 --> 00:42:16,767
based on the expert witness
definition
1087
00:42:16,833 --> 00:42:18,633
of the standard of care.
1088
00:42:18,700 --> 00:42:20,767
Well, when you're talking
about County General,
1089
00:42:20,833 --> 00:42:23,333
the term "standard
of care" is a joke.
1090
00:42:23,400 --> 00:42:26,400
That's right,
Kovac is part of the system.
1091
00:42:26,467 --> 00:42:28,667
We all know the system sucks.
79645
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