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These are the user uploaded subtitles that are being translated: 1 00:00:01,585 --> 00:00:03,040 Oh, what do you think you're doing? 2 00:00:03,065 --> 00:00:05,196 Sorry, I didn't' feel like we had another choice. 3 00:00:05,330 --> 00:00:07,500 Dr. Ahmad, your residency here 4 00:00:07,540 --> 00:00:10,160 will be on a probationary basis. 5 00:00:10,210 --> 00:00:11,562 What the hell's going on? 6 00:00:11,587 --> 00:00:13,837 Walking off the floor without notifying a supervisor? 7 00:00:13,862 --> 00:00:16,025 There's not gonna be another warning. 8 00:00:16,050 --> 00:00:18,106 Ben is the one who pulled the plug on this marriage. 9 00:00:18,130 --> 00:00:19,300 Come on, Maggie. 10 00:00:19,340 --> 00:00:20,720 We're almost at the finish line. 11 00:00:20,760 --> 00:00:22,800 I really just wanna move on. 12 00:00:22,825 --> 00:00:24,035 Get me out of here! 13 00:00:24,060 --> 00:00:25,156 - Get away from me! - Dr. Ripley, 14 00:00:25,181 --> 00:00:26,721 What you did today was reckless. 15 00:00:26,746 --> 00:00:27,786 Reckless? 16 00:00:27,811 --> 00:00:29,151 Impulse control disorder? 17 00:00:29,176 --> 00:00:30,616 Isn't that what you called it back then? 18 00:00:30,640 --> 00:00:33,132 I'm an attending physician at this hospital, 19 00:00:33,157 --> 00:00:36,335 not the boy you knew 20 years ago. 20 00:00:45,660 --> 00:00:46,990 Yo, Asher! 21 00:00:47,030 --> 00:00:48,160 What are you doing here? 22 00:00:48,200 --> 00:00:49,620 Mitch, what are... hey. 23 00:00:49,660 --> 00:00:50,710 What are you drinking? 24 00:00:50,750 --> 00:00:52,250 Um... I'm... I'm not. 25 00:00:52,290 --> 00:00:53,920 - It's club soda. - You don't drink? 26 00:00:53,960 --> 00:00:55,210 I do not. 27 00:00:55,250 --> 00:00:57,710 I'm a recovering addict. 28 00:00:57,750 --> 00:01:01,010 Which... I will tell you all about that another time. 29 00:01:01,050 --> 00:01:04,640 But right now, you have to go away. 30 00:01:04,680 --> 00:01:07,970 You do realize this is a public establishment, right? 31 00:01:08,010 --> 00:01:10,680 I'm... I am waiting on a date. 32 00:01:10,730 --> 00:01:12,915 First date. 33 00:01:12,940 --> 00:01:15,480 And he's going to be here any minute, so... 34 00:01:15,520 --> 00:01:16,980 What? No. 35 00:01:17,005 --> 00:01:18,305 No, you... 36 00:01:18,330 --> 00:01:20,000 I got my eyes glued to the door. 37 00:01:20,025 --> 00:01:22,195 I will split the second he gets here. 38 00:01:24,450 --> 00:01:25,890 Fine. 39 00:01:26,023 --> 00:01:27,620 So who's the guy? 40 00:01:27,660 --> 00:01:28,910 How'd you meet? 41 00:01:28,950 --> 00:01:30,450 His name is Kyle. 42 00:01:30,500 --> 00:01:34,921 And he's an architect, and we met on a dating app. 43 00:01:34,946 --> 00:01:37,196 Commercial architecture? Residential? 44 00:01:37,221 --> 00:01:38,630 What's the name of his firm? 45 00:01:38,670 --> 00:01:40,590 OK, what are you doing here, hm? 46 00:01:40,630 --> 00:01:44,054 You don't seem like the type to venture out on a school night. 47 00:01:44,079 --> 00:01:46,023 Is that your polite way of calling me a loser? 48 00:01:46,048 --> 00:01:47,548 No. 49 00:01:47,573 --> 00:01:52,062 You're always working late, running at some ungodly hours. 50 00:01:52,640 --> 00:01:56,100 Those degenerates, they dragged me out. 51 00:01:58,009 --> 00:02:00,389 I've known most of them since grade school. 52 00:02:00,499 --> 00:02:02,619 I didn't know you were a Chicago boy. 53 00:02:02,644 --> 00:02:04,304 Born and raised. 54 00:02:04,450 --> 00:02:07,820 Just been away a lot of years. 55 00:02:07,870 --> 00:02:09,450 It must be nice being home. 56 00:02:13,910 --> 00:02:17,040 I think Romeo has landed. 57 00:02:23,705 --> 00:02:25,875 Whoa, that was... 58 00:02:26,180 --> 00:02:27,970 Nice break, bro. 59 00:02:33,850 --> 00:02:35,359 Somebody call 911! 60 00:02:35,384 --> 00:02:36,304 I need help! 61 00:02:36,329 --> 00:02:38,109 My girlfriend just passed out! 62 00:02:39,860 --> 00:02:41,320 We're doctors! 63 00:02:41,360 --> 00:02:42,765 You got to help her. Please. 64 00:02:42,790 --> 00:02:44,080 Somebody's calling 911. 65 00:02:44,105 --> 00:02:45,895 Paramedics should be on the way soon. 66 00:02:45,920 --> 00:02:47,506 Her breathing's slow and shallow. 67 00:02:47,530 --> 00:02:49,120 Eyes are pinpoint. What's her name? 68 00:02:49,160 --> 00:02:50,539 - Uh, Becca. - Becca? 69 00:02:50,564 --> 00:02:52,944 - Hey, wake up, Becca! - Did she take something? 70 00:02:52,969 --> 00:02:55,009 We need to know so we can help her, man. 71 00:02:55,034 --> 00:02:56,204 Come on! What did she take?! 72 00:02:56,229 --> 00:02:58,185 Coke. But just a hit. 73 00:02:58,210 --> 00:02:59,500 Is this an overdose? 74 00:02:59,540 --> 00:03:01,290 How do you OD off just one hit? 75 00:03:01,340 --> 00:03:02,986 - You wouldn't. - No, Unless... 76 00:03:03,011 --> 00:03:04,316 Cocaine was laced with fentanyl. 77 00:03:04,340 --> 00:03:05,650 I have Narcan in my purse. 78 00:03:05,675 --> 00:03:07,446 The blue bag under the bar on the hook? 79 00:03:07,470 --> 00:03:09,430 It's OK, I'll get it. 80 00:03:09,470 --> 00:03:10,345 Hey. 81 00:03:10,370 --> 00:03:11,906 - Hey, you doing OK? - I... I don't... 82 00:03:11,930 --> 00:03:13,036 - OK, OK. - I don't feel so good. 83 00:03:13,060 --> 00:03:14,810 Did you take a hit, too? 84 00:03:14,850 --> 00:03:15,806 Here. 85 00:03:15,830 --> 00:03:17,000 Thanks. 86 00:03:17,025 --> 00:03:18,855 You're OK. You're OK. 87 00:03:18,896 --> 00:03:20,196 Mitch? 88 00:03:20,283 --> 00:03:21,742 Yeah. 89 00:03:25,900 --> 00:03:27,001 Come on. 90 00:03:31,939 --> 00:03:33,370 Welcome back, Becca. 91 00:03:33,410 --> 00:03:35,580 - Take a breath. - Come on. 92 00:03:35,620 --> 00:03:38,000 It's OK. Just breathe. 93 00:03:38,040 --> 00:03:39,283 Tim? 94 00:03:39,532 --> 00:03:40,806 What's wrong with him? 95 00:03:40,831 --> 00:03:42,410 Got any more Narcan? This didn't do it. 96 00:03:42,435 --> 00:03:43,588 - He needs another dose. - No, I don't. 97 00:03:43,613 --> 00:03:44,815 Does anyone have Narcan? 98 00:03:44,840 --> 00:03:46,064 I'll ask around. 99 00:03:46,089 --> 00:03:47,356 Airway's open, but he's not breathing. 100 00:03:47,380 --> 00:03:48,345 Baby, you have to wake up. 101 00:03:48,370 --> 00:03:49,670 I'm gonna start rescue breath. 102 00:03:49,695 --> 00:03:50,921 - No, no, Mitch, wait! - You don't have a mask. 103 00:03:50,946 --> 00:03:51,866 - Wait for the paramedics. - Hannah! 104 00:03:51,891 --> 00:03:52,931 He could cough up blood. 105 00:03:52,956 --> 00:03:54,189 - He could... - I know the risks. 106 00:03:54,214 --> 00:03:55,718 Hey, doc, what do we got? 107 00:03:55,743 --> 00:03:57,083 Suspected fentanyl overdose. 108 00:03:57,108 --> 00:03:58,624 We already administered one dose of Narcan. 109 00:04:03,304 --> 00:04:05,650 Baby, open your eyes. 110 00:04:15,105 --> 00:04:17,462 Welcome back. 111 00:04:25,960 --> 00:04:27,510 CPD tested their drugs. 112 00:04:27,550 --> 00:04:29,220 Came back positive for fentanyl. 113 00:04:29,260 --> 00:04:30,380 There's been a huge uptick 114 00:04:30,420 --> 00:04:31,840 of overdoses in the ED lately. 115 00:04:31,880 --> 00:04:33,970 Yeah, a lot of them just like Becca and Tim. 116 00:04:34,010 --> 00:04:36,760 They're recreational users, no clue their drugs 117 00:04:36,810 --> 00:04:37,900 are laced with fentanyl. 118 00:04:37,925 --> 00:04:39,116 I'll make sure they go home 119 00:04:39,140 --> 00:04:40,173 with some fentanyl testing strips. 120 00:04:40,198 --> 00:04:41,970 Thank you, Juliette. 121 00:04:45,980 --> 00:04:47,314 Your date's waiting. 122 00:04:47,533 --> 00:04:48,361 He is? 123 00:04:48,386 --> 00:04:50,530 Your 6 o'clock. Just be cool. 124 00:04:56,410 --> 00:04:59,500 Well, uh, see you tomorrow. 125 00:04:59,540 --> 00:05:00,806 - Yeah. - Yeah. 126 00:05:00,831 --> 00:05:02,330 Yeah. 127 00:05:05,663 --> 00:05:07,305 Get some sleep tonight, Asher. 128 00:05:13,052 --> 00:05:14,400 Wow. 129 00:05:14,425 --> 00:05:16,885 You're... you're like a real-life superwoman. 130 00:05:16,936 --> 00:05:17,869 No. 131 00:05:17,894 --> 00:05:20,680 No, I'm just glad everyone's OK. 132 00:05:20,705 --> 00:05:22,298 Yeah. 133 00:05:23,350 --> 00:05:27,150 So what do you say we, um 134 00:05:27,190 --> 00:05:30,205 we pick up where we left off? 135 00:05:30,230 --> 00:05:33,520 I actually... I have to get going. 136 00:05:33,566 --> 00:05:36,106 I've got kind of an early start tomorrow. 137 00:05:36,131 --> 00:05:37,080 Oh. 138 00:05:38,205 --> 00:05:39,915 Yeah, I mean, I get it. 139 00:05:39,940 --> 00:05:43,650 But it was really lovely to meet you, Hannah. 140 00:06:03,500 --> 00:06:04,922 Big plans tonight? 141 00:06:06,317 --> 00:06:07,647 No. 142 00:06:07,672 --> 00:06:10,342 I, uh, got a board meeting later. 143 00:06:10,540 --> 00:06:12,830 - Giving a presentation? - No. 144 00:06:12,870 --> 00:06:15,920 I'm actually joining the board. 145 00:06:15,960 --> 00:06:18,090 Well, I must have missed the announcement. 146 00:06:18,130 --> 00:06:19,250 Well, there wasn't one. 147 00:06:19,300 --> 00:06:20,510 My request. 148 00:06:20,550 --> 00:06:22,408 Not big on fanfare. 149 00:06:22,433 --> 00:06:24,893 So the board just created a seat for you? 150 00:06:25,220 --> 00:06:27,760 Well, for a hospital physician, so... 151 00:06:27,800 --> 00:06:30,180 But they asked you? 152 00:06:30,220 --> 00:06:31,980 Seems that way. 153 00:06:33,861 --> 00:06:36,191 I'm just glad I get to, uh... to advocate 154 00:06:36,216 --> 00:06:37,375 for the medical staff. 155 00:06:37,400 --> 00:06:39,610 Well, congratulations. 156 00:06:39,650 --> 00:06:42,440 You must be very popular with the suits. 157 00:06:42,490 --> 00:06:43,947 Dr. Ahmad! 158 00:06:43,972 --> 00:06:46,562 Got an ambo pulling up, going to treatment three. 159 00:06:46,661 --> 00:06:48,201 Duty calls. 160 00:06:48,226 --> 00:06:49,816 By all means. 161 00:06:53,410 --> 00:06:55,120 - We're going into three. - Got it. 162 00:06:55,170 --> 00:06:57,290 Vince Gonzalez, 38-year-old male, 163 00:06:57,330 --> 00:06:59,130 briefly lost consciousness after vomiting. 164 00:06:59,170 --> 00:07:02,775 BP 85 over 52, gave two liters in the ambo. 165 00:07:02,800 --> 00:07:04,170 Hi, Mr. Gonzalez. 166 00:07:04,220 --> 00:07:05,300 I'm Dr. Ahmad. 167 00:07:05,340 --> 00:07:07,390 It's Vince. 168 00:07:07,430 --> 00:07:09,510 Do you know if he hit his head when he passed out? 169 00:07:09,550 --> 00:07:11,310 No, Vince was already on the ground. 170 00:07:11,350 --> 00:07:12,850 He just kind of slumped over. 171 00:07:12,890 --> 00:07:14,496 And he wasn't out long, just a few seconds. 172 00:07:14,520 --> 00:07:15,640 Thank you. And you are? 173 00:07:15,690 --> 00:07:18,650 Ty. I'm Vince's husband. 174 00:07:18,690 --> 00:07:20,440 We'll take good care of him. 175 00:07:22,690 --> 00:07:25,150 OK, on my count... one, two, three. 176 00:07:31,280 --> 00:07:33,330 OK, Vince, do you mind leaning forward? 177 00:07:33,370 --> 00:07:34,596 I just want to listen to your lungs from the back. 178 00:07:36,080 --> 00:07:38,710 Clear breath sounds bilaterally. 179 00:07:41,710 --> 00:07:43,340 Oh, honey. 180 00:07:43,380 --> 00:07:44,590 Oh. 181 00:07:44,630 --> 00:07:46,300 I am so sorry. 182 00:07:46,340 --> 00:07:48,380 It is so fine. 183 00:07:48,430 --> 00:07:50,470 It happens more than you think. 184 00:07:50,510 --> 00:07:51,970 4 of Zofran and a KUB. 185 00:07:52,010 --> 00:07:53,350 I'm on it. 186 00:07:53,390 --> 00:07:56,350 Excuse me. 187 00:07:56,390 --> 00:07:58,770 Hey. 188 00:07:58,810 --> 00:08:01,560 You, um... you have some vomit in your hair. 189 00:08:05,570 --> 00:08:07,700 Dennis Washington. 190 00:08:07,740 --> 00:08:09,610 - How you been? - Hey, Dan. 191 00:08:09,660 --> 00:08:11,030 - How are you? - Dr. Washington. 192 00:08:11,070 --> 00:08:13,950 Good morning. What can I do for you? 193 00:08:13,990 --> 00:08:16,370 I wanted to follow up on that matter I emailed you about. 194 00:08:16,410 --> 00:08:18,160 Oh, right. Of course. 195 00:08:18,210 --> 00:08:19,370 We can talk in my office. 196 00:08:19,420 --> 00:08:21,040 We'll see you later. 197 00:08:21,080 --> 00:08:24,090 I'll see you at the Exec Med Committee meeting Friday. 198 00:08:24,130 --> 00:08:26,050 Only if I can't get out of it. 199 00:08:34,600 --> 00:08:36,430 You forgot it by the toaster. 200 00:08:36,470 --> 00:08:39,890 Stop. 201 00:08:39,940 --> 00:08:42,610 I got to stop leaving my things. 202 00:08:42,650 --> 00:08:44,230 Hey, I don't mind. 203 00:08:46,030 --> 00:08:49,900 It gives me an excuse to come see you during the day. 204 00:08:49,950 --> 00:08:51,990 Dan doesn't know about us, huh? 205 00:08:52,030 --> 00:08:53,240 Dennis. 206 00:08:53,280 --> 00:08:55,030 I know, I know, I know. 207 00:08:55,080 --> 00:08:57,620 You're not telling folks for the time being. 208 00:08:57,660 --> 00:08:58,910 Have you told anyone? 209 00:08:58,960 --> 00:09:00,920 No. I'm confused. 210 00:09:00,960 --> 00:09:03,380 I mean, would it be the worst thing if people knew? 211 00:09:03,420 --> 00:09:04,670 No, no. 212 00:09:04,710 --> 00:09:05,840 Of course not. 213 00:09:05,880 --> 00:09:08,420 It's just that you're the 214 00:09:08,470 --> 00:09:11,260 you're the chief of a department, 215 00:09:11,300 --> 00:09:14,510 and I'm a member of hospital leadership. 216 00:09:14,550 --> 00:09:16,220 It's not prohibited. 217 00:09:17,310 --> 00:09:20,060 Sharon, colleagues date all the time. 218 00:09:20,100 --> 00:09:23,440 - It's not a big deal. - Yeah, but it is to me. 219 00:09:23,480 --> 00:09:27,610 I've always had this strict policy of not mixing my work 220 00:09:27,650 --> 00:09:30,700 life with my romantic life. 221 00:09:30,740 --> 00:09:32,740 Until now. 222 00:09:33,950 --> 00:09:35,676 And I appreciate you making that exception. 223 00:09:35,700 --> 00:09:36,660 Believe me. 224 00:09:38,290 --> 00:09:40,290 There's no rush. 225 00:09:40,330 --> 00:09:43,330 We'll take our time integrating both worlds. 226 00:09:43,370 --> 00:09:47,050 Besides, it's kind of fun sneaking around. 227 00:09:53,840 --> 00:09:54,800 Got a minute? 228 00:09:54,840 --> 00:09:56,720 Need a surgical consult. 229 00:09:56,760 --> 00:09:58,180 Uh... 230 00:09:58,220 --> 00:10:00,060 Patient's name is Vince Gonzalez. 231 00:10:00,100 --> 00:10:03,650 He's got metastatic abdominal sarcoma, presented to the ED 232 00:10:03,690 --> 00:10:05,980 with nausea, abdominal distension, 233 00:10:06,020 --> 00:10:08,320 and severe belly pain. 234 00:10:08,360 --> 00:10:10,400 Poor guy can't keep anything down. 235 00:10:10,440 --> 00:10:12,610 Does he have an obstruction or perforation? 236 00:10:12,650 --> 00:10:14,820 - Free fluid? - Not on CT. 237 00:10:14,860 --> 00:10:16,660 But the tumor is severely compressing 238 00:10:16,700 --> 00:10:18,240 his stomach, hence the nausea. 239 00:10:18,280 --> 00:10:20,176 Yeah, I'm not seeing why you need a surgical consult. 240 00:10:20,200 --> 00:10:21,750 I mean, if the tumor is metastatic, 241 00:10:21,790 --> 00:10:22,750 it must have been inoperative. 242 00:10:22,790 --> 00:10:24,120 Correct. 243 00:10:24,170 --> 00:10:25,516 And if he's not completely obstructed, 244 00:10:25,540 --> 00:10:26,960 what do you need me for? 245 00:10:27,000 --> 00:10:30,050 Well, if you debulked a portion of the tumor here, 246 00:10:30,090 --> 00:10:32,920 then it would allow food to pass into the small intestine. 247 00:10:32,970 --> 00:10:34,760 So would a feeding tube. 248 00:10:34,800 --> 00:10:36,220 He doesn't want a feeding tube. 249 00:10:36,260 --> 00:10:38,470 Surgery would afford him a much better quality of life. 250 00:10:38,510 --> 00:10:41,180 Or it could cost him whatever time he has left. 251 00:10:41,220 --> 00:10:42,700 I mean, we're talking about a patient 252 00:10:42,730 --> 00:10:45,100 who underwent multiple rounds of chemo, I'm sure, right? 253 00:10:45,150 --> 00:10:46,690 With zero complications. 254 00:10:46,730 --> 00:10:49,860 He's remarkably fit and healthy, despite the cancer. 255 00:10:49,900 --> 00:10:51,940 I know this isn't exactly a sexy surgery. 256 00:10:51,990 --> 00:10:54,280 Whoa. I beg your pardon. 257 00:10:54,320 --> 00:10:56,870 "Sexy surgery"? 258 00:10:56,910 --> 00:10:58,830 I know surgeons don't like to get involved 259 00:10:58,870 --> 00:11:01,870 in palliative care. 260 00:11:01,910 --> 00:11:04,370 Well, that's quite a generalization there. 261 00:11:07,630 --> 00:11:09,670 All right. Let's have a look. 262 00:11:09,710 --> 00:11:11,750 Send me the chart. 263 00:11:14,920 --> 00:11:16,800 Don't be brave, OK? 264 00:11:16,840 --> 00:11:19,180 Tell me if it hurts when I push. 265 00:11:19,220 --> 00:11:20,390 I'm all right. 266 00:11:20,430 --> 00:11:21,850 OK. 267 00:11:21,890 --> 00:11:23,156 Well, your CT didn't show an obstruction, 268 00:11:23,180 --> 00:11:25,440 but just wanted to confirm. 269 00:11:27,730 --> 00:11:29,690 So, Dr. Marcel? 270 00:11:29,730 --> 00:11:31,900 - Yeah. - Here's the thing. 271 00:11:31,940 --> 00:11:33,570 My husband and I are supposed to fly 272 00:11:33,610 --> 00:11:35,070 to Italy in three weeks. 273 00:11:35,110 --> 00:11:37,240 My grandmother was from Positano. 274 00:11:37,280 --> 00:11:40,410 I've always wanted to go, and we figured, 275 00:11:40,450 --> 00:11:42,740 no time like the present. 276 00:11:42,790 --> 00:11:45,250 You know, how are you doing with daily activities, Vince? 277 00:11:45,290 --> 00:11:47,540 Things like dressing, housework, driving? 278 00:11:47,580 --> 00:11:50,960 Before I started vomiting my supper? 279 00:11:51,000 --> 00:11:52,750 I was totally functional. 280 00:11:52,800 --> 00:11:54,090 I can attest to that. 281 00:11:54,130 --> 00:11:56,880 Most days, Vince has more energy than me. 282 00:11:56,930 --> 00:11:59,510 You ever had complications from surgery? 283 00:11:59,550 --> 00:12:02,220 Post-operative issues, issues with anesthesia? 284 00:12:02,260 --> 00:12:05,270 No, I had my appendix out when I was 25, 285 00:12:05,310 --> 00:12:07,890 but I didn't have any problems. 286 00:12:07,940 --> 00:12:09,770 Good. 287 00:12:09,810 --> 00:12:11,980 I'm glad to hear it. 288 00:12:12,020 --> 00:12:13,940 Because there is a surgical option 289 00:12:13,980 --> 00:12:16,490 that could get your GI system working again. 290 00:12:17,610 --> 00:12:20,030 I like the sound of that. 291 00:12:21,530 --> 00:12:24,120 Why don't you present it, Dr. Ahmad, 292 00:12:24,160 --> 00:12:26,200 since it was your suggestion? 293 00:12:26,250 --> 00:12:27,330 OK. 294 00:12:28,410 --> 00:12:30,290 Morning. 295 00:12:30,330 --> 00:12:31,880 Your night turn out all right? 296 00:12:31,920 --> 00:12:33,290 It did, actually. 297 00:12:33,340 --> 00:12:36,130 It ended up being a pretty good first date. 298 00:12:36,170 --> 00:12:38,260 - Oh, yeah? - Yeah. 299 00:12:38,300 --> 00:12:40,640 Dr. Ripley, we have a potential wrist 300 00:12:40,680 --> 00:12:42,600 fracture in treatment six. 301 00:12:42,640 --> 00:12:43,736 You mind starting the workup? 302 00:12:43,760 --> 00:12:45,680 I'm just finishing up with a patient. 303 00:12:45,720 --> 00:12:47,180 You're lucky I like you. 304 00:12:47,230 --> 00:12:48,020 For now. 305 00:12:48,060 --> 00:12:49,310 Thank you, Maggie. 306 00:12:49,350 --> 00:12:50,350 Mm-hmm. 307 00:12:51,650 --> 00:12:52,940 OK. 308 00:12:52,980 --> 00:12:54,900 So, Mrs. Moore, I understand that you fell 309 00:12:54,940 --> 00:12:56,780 getting out of your car. 310 00:12:56,820 --> 00:12:58,530 Mind if I take a look? 311 00:13:00,110 --> 00:13:02,570 I just want to check if it's swollen. 312 00:13:07,830 --> 00:13:08,910 I'll be gentle. 313 00:13:12,170 --> 00:13:14,210 Pam, let her look. 314 00:13:16,130 --> 00:13:18,380 My wrist is fine. 315 00:13:18,420 --> 00:13:19,920 I didn't fall. 316 00:13:20,720 --> 00:13:22,510 What? 317 00:13:22,550 --> 00:13:24,550 I don't understand. 318 00:13:25,430 --> 00:13:27,970 - I'm sorry, honey. - I didn't have any other choice. 319 00:13:28,020 --> 00:13:29,810 What are you talking about? 320 00:13:31,480 --> 00:13:34,560 My husband is depressed and refuses to get any help. 321 00:13:34,610 --> 00:13:36,110 Pamela! 322 00:13:36,150 --> 00:13:38,860 And I am so afraid he's gonna hurt himself. 323 00:13:48,678 --> 00:13:51,505 Look, I appreciate you have to do your due diligence. 324 00:13:51,530 --> 00:13:53,660 My wife mentioned the possibility of self-harm, 325 00:13:53,700 --> 00:13:55,660 so you can't just send me on my way. 326 00:13:55,700 --> 00:13:58,500 Yeah, she mentioned to Nurse Lockwood a comment you made. 327 00:13:58,540 --> 00:13:59,920 Right. 328 00:13:59,960 --> 00:14:01,960 I said something stupid like, "Going to bed 329 00:14:02,000 --> 00:14:04,090 and never waking up sounds like a nice way to go." 330 00:14:04,130 --> 00:14:05,130 Huh. 331 00:14:05,170 --> 00:14:07,130 Come on. I was speaking generally. 332 00:14:07,170 --> 00:14:09,010 A nice way to go, as opposed to, 333 00:14:09,050 --> 00:14:11,390 I don't know, getting hit by a bus. 334 00:14:11,430 --> 00:14:12,930 OK. 335 00:14:12,970 --> 00:14:15,220 Um, apparently, you have been losing some weight. 336 00:14:15,260 --> 00:14:18,140 I was diagnosed with type 2 diabetes not long ago. 337 00:14:18,180 --> 00:14:19,850 I've been pretty diligent about my diet, 338 00:14:19,890 --> 00:14:21,440 getting regular exercise. 339 00:14:21,480 --> 00:14:23,810 Frankly, I'm glad the hard work's paying off. 340 00:14:23,860 --> 00:14:25,190 Well, then, Paul, help me out. 341 00:14:25,230 --> 00:14:27,440 I mean, why do you think that your wife's 342 00:14:27,490 --> 00:14:28,690 so concerned about you? 343 00:14:30,570 --> 00:14:33,530 I admit I haven't been in the best mood lately. 344 00:14:33,570 --> 00:14:35,280 My fuse is probably shorter. 345 00:14:35,330 --> 00:14:36,790 Yeah. 346 00:14:36,830 --> 00:14:38,910 I mean, she's... she's concerned that, 347 00:14:38,960 --> 00:14:41,040 you know, you've been isolating, 348 00:14:41,080 --> 00:14:43,380 withdrawing from her, your friends. 349 00:14:43,420 --> 00:14:45,920 I haven't felt like socializing lately. 350 00:14:45,960 --> 00:14:47,210 So when was the last time... 351 00:14:47,260 --> 00:14:48,550 Let me save you some time, OK? 352 00:14:48,590 --> 00:14:52,050 I have no intention or desire to hurt myself. 353 00:14:52,090 --> 00:14:53,340 And I'm glad to hear it. 354 00:14:53,390 --> 00:14:55,050 So ask whatever questions you need 355 00:14:55,100 --> 00:14:57,640 to cover the hospital's ass. 356 00:14:57,680 --> 00:14:59,930 I am not suicidal, Dr. Charles. 357 00:14:59,980 --> 00:15:02,810 Pam is just making something out of nothing. 358 00:15:02,850 --> 00:15:05,270 Her specialty. 359 00:15:05,310 --> 00:15:07,230 Mm. 360 00:15:10,570 --> 00:15:12,820 Within an hour of posting Vince's surgery, 361 00:15:12,860 --> 00:15:15,200 his insurance company denied it, 362 00:15:15,240 --> 00:15:16,830 rejected it on the grounds of it 363 00:15:16,870 --> 00:15:18,330 not being medically necessary. 364 00:15:18,370 --> 00:15:20,080 There are alternative treatment options. 365 00:15:20,120 --> 00:15:21,750 The feeding tube Vince doesn't want. 366 00:15:21,790 --> 00:15:23,170 Yep. 367 00:15:23,210 --> 00:15:26,590 Man, I am so fed up with prior authorization. 368 00:15:26,630 --> 00:15:29,210 About a dozen times a month, my patients get screwed by it. 369 00:15:29,260 --> 00:15:30,670 What insurance does Vince have? 370 00:15:30,720 --> 00:15:31,840 Berninger Health Network. 371 00:15:31,880 --> 00:15:33,590 Of course, one of the worst. 372 00:15:33,630 --> 00:15:36,100 They deny more patients than any other company, 373 00:15:36,140 --> 00:15:38,850 pay physician reviewers six figures to look at charts 374 00:15:38,890 --> 00:15:40,770 and find reasons to deny. 375 00:15:43,640 --> 00:15:45,536 I guess we should tell him before he gets a form 376 00:15:45,560 --> 00:15:46,690 email from his insurance. 377 00:15:46,730 --> 00:15:48,610 Yeah. 378 00:15:55,240 --> 00:15:56,660 So what's the verdict? 379 00:15:56,700 --> 00:15:59,240 Is his wife right that he's a danger to himself? 380 00:15:59,290 --> 00:16:00,870 You know, I don't know yet. 381 00:16:00,910 --> 00:16:02,750 I mean, he's adamant that he's not, right? 382 00:16:02,790 --> 00:16:05,330 But about 50% of the people with suicidal ideation 383 00:16:05,370 --> 00:16:06,580 deny it. 384 00:16:06,630 --> 00:16:08,420 I'm more concerned by his wife's concern, 385 00:16:08,460 --> 00:16:09,710 if that makes sense. 386 00:16:09,750 --> 00:16:11,566 I mean, she pulled off a pretty elaborate ruse 387 00:16:11,590 --> 00:16:12,646 to get him through our doors. 388 00:16:12,670 --> 00:16:14,050 Exactly. 389 00:16:14,090 --> 00:16:15,590 So what's the game plan? 390 00:16:15,640 --> 00:16:18,260 I want to talk to her some more, all right? 391 00:16:18,300 --> 00:16:20,770 I also want to just look at his medical history a little more 392 00:16:20,810 --> 00:16:24,310 carefully, you know, find out what kind of access, if any, 393 00:16:24,350 --> 00:16:26,150 he has to firearms, to see if I can come 394 00:16:26,190 --> 00:16:27,690 up with any evidence at all 395 00:16:27,730 --> 00:16:28,916 that he's planning to hurt himself. 396 00:16:28,940 --> 00:16:30,456 All right. I'll keep him comfortable. 397 00:16:30,480 --> 00:16:32,546 All right, and Mags, if he gets antsy and starts talking 398 00:16:32,570 --> 00:16:33,400 about getting out of here... 399 00:16:33,440 --> 00:16:34,780 - I'll page you. - Thank you. 400 00:16:34,820 --> 00:16:35,950 Yeah. 401 00:16:40,910 --> 00:16:42,500 Where is Hannah Asher? 402 00:16:42,540 --> 00:16:43,540 Excuse me? 403 00:16:43,580 --> 00:16:45,160 Where is Hannah Asher? 404 00:16:45,210 --> 00:16:48,500 She's probably with a patient. 405 00:16:48,540 --> 00:16:50,590 Ma'am. 406 00:16:50,630 --> 00:16:52,460 Ma'am, you can't do that. 407 00:16:54,300 --> 00:16:56,220 Ma'am. 408 00:16:56,260 --> 00:16:59,220 OK, this is gonna feel a little cold. 409 00:16:59,260 --> 00:17:00,140 OK? 410 00:17:00,180 --> 00:17:02,010 You're Hannah Asher? 411 00:17:02,060 --> 00:17:03,390 Do you know this woman? 412 00:17:03,430 --> 00:17:06,730 Um, no. 413 00:17:06,770 --> 00:17:08,100 Do you want me to remove her? 414 00:17:08,150 --> 00:17:09,586 - I'd like to see you try. - Hold on. 415 00:17:09,610 --> 00:17:10,690 Hold on a second. 416 00:17:10,730 --> 00:17:12,020 I'm Dr. Hannah Asher. 417 00:17:12,070 --> 00:17:13,030 Is there a problem? 418 00:17:13,070 --> 00:17:14,610 Problem? 419 00:17:14,650 --> 00:17:16,780 Well, you went on a date with my husband last night, 420 00:17:16,820 --> 00:17:18,530 so yeah, we've got a problem. 421 00:17:23,330 --> 00:17:25,000 Vince, we're submitting an appeal 422 00:17:25,040 --> 00:17:27,620 to your insurance company, OK? 423 00:17:27,670 --> 00:17:30,590 We've been through the appeals process. 424 00:17:32,750 --> 00:17:35,590 When Vince's doctor first suspected something was wrong, 425 00:17:35,630 --> 00:17:37,260 he ordered a CT. 426 00:17:37,300 --> 00:17:39,680 Insurance wouldn't approve it initially. 427 00:17:39,720 --> 00:17:42,720 Said there wasn't sufficient evidence to warrant it. 428 00:17:42,760 --> 00:17:45,350 It took them three months to finally get it authorized. 429 00:17:45,390 --> 00:17:46,890 - Yeah. - Who knows how much 430 00:17:46,930 --> 00:17:49,900 the tumor grew in that time? 431 00:17:49,940 --> 00:17:52,400 Vince. 432 00:17:52,440 --> 00:17:54,860 I know you were trying to avoid a feeding tube. 433 00:17:54,900 --> 00:17:56,570 No. 434 00:17:56,610 --> 00:17:59,240 No feeding tube. 435 00:17:59,280 --> 00:18:00,990 Look, we could place a temporary one. 436 00:18:01,030 --> 00:18:02,200 No. 437 00:18:02,240 --> 00:18:03,830 Without a feeding tube... 438 00:18:03,870 --> 00:18:05,790 I'm gonna lose time. 439 00:18:05,830 --> 00:18:07,290 I understand that. 440 00:18:07,330 --> 00:18:10,000 You could die in weeks, 441 00:18:10,040 --> 00:18:11,750 possibly days. 442 00:18:16,760 --> 00:18:18,010 When we first got the news 443 00:18:18,050 --> 00:18:19,970 that nothing more could be done, 444 00:18:20,010 --> 00:18:22,300 that this was terminal, 445 00:18:22,350 --> 00:18:24,390 we came up with a model for how we were 446 00:18:24,430 --> 00:18:26,640 going to approach this next 447 00:18:26,680 --> 00:18:27,730 phase. 448 00:18:32,650 --> 00:18:35,020 Quality over time, right? 449 00:18:36,530 --> 00:18:38,570 No feeding tube. 450 00:18:44,910 --> 00:18:47,160 OK. 451 00:18:47,200 --> 00:18:48,290 Get some rest. 452 00:18:48,330 --> 00:18:50,370 Be back in a bit, OK? 453 00:18:57,460 --> 00:18:58,920 Yeah. 454 00:18:58,970 --> 00:19:00,510 Thanks. 455 00:19:00,550 --> 00:19:03,590 I'm gonna talk to a utilization review specialist, 456 00:19:03,640 --> 00:19:06,060 see if I can expedite the appeal process. 457 00:19:06,100 --> 00:19:08,680 You really think that's gonna make much of a difference? 458 00:19:08,720 --> 00:19:10,690 Worth a shot. 459 00:19:21,490 --> 00:19:23,780 I did go out last night, but it wasn't 460 00:19:23,820 --> 00:19:24,990 with anyone that was married. 461 00:19:25,030 --> 00:19:27,200 All right, guys. Come on. 462 00:19:27,240 --> 00:19:28,330 Show's over, huh? 463 00:19:28,370 --> 00:19:30,000 I went out with Kyle. 464 00:19:30,040 --> 00:19:32,330 - Kyle? - Yeah. 465 00:19:33,790 --> 00:19:35,710 Yeah, that's him. 466 00:19:36,960 --> 00:19:38,300 His name is Nick Dunn. 467 00:19:38,340 --> 00:19:40,300 He's not an architect. He's a general contractor. 468 00:19:40,340 --> 00:19:42,720 I'm so... oh, God. 469 00:19:42,760 --> 00:19:45,180 You really didn't know he was married? 470 00:19:45,220 --> 00:19:46,720 No, I swear. 471 00:19:46,760 --> 00:19:48,640 I... 472 00:19:53,440 --> 00:19:55,020 I'm gonna kill him. 473 00:19:55,060 --> 00:19:56,230 Well, I... 474 00:19:56,270 --> 00:19:58,770 How could he do this to me? 475 00:19:58,820 --> 00:20:00,070 I'm carrying our child. 476 00:20:00,110 --> 00:20:01,400 It's absolutely terrible. 477 00:20:01,440 --> 00:20:03,650 - I agree... - I knew something was up. 478 00:20:03,700 --> 00:20:05,546 I thought it was just new dad jitters, you know? 479 00:20:05,570 --> 00:20:08,870 In a million years, I never 480 00:20:08,910 --> 00:20:09,870 oh. 481 00:20:09,910 --> 00:20:11,830 Are you OK? 482 00:20:11,870 --> 00:20:13,250 I think my water just broke. 483 00:20:19,050 --> 00:20:20,170 How many weeks are you? 484 00:20:20,210 --> 00:20:22,260 38. 485 00:20:22,300 --> 00:20:24,470 I would like to get you on a monitor. 486 00:20:24,510 --> 00:20:26,510 No, no, no, no, I'm going to see my own doct 487 00:20:26,550 --> 00:20:28,350 - oh! - Hey, hey, hey, breathe. 488 00:20:28,390 --> 00:20:30,600 - Breathe with me. - I know how to breathe. 489 00:20:32,270 --> 00:20:34,020 This can't be happening. 490 00:20:40,095 --> 00:20:43,360 Can you put your knees up for me, please? 491 00:20:45,370 --> 00:20:47,330 You're gonna feel a little bit of pressure. 492 00:20:47,355 --> 00:20:48,470 OK. 493 00:20:50,080 --> 00:20:53,080 OK, so, Tessa, you are fully dilated. 494 00:20:53,120 --> 00:20:54,540 What? 495 00:20:54,580 --> 00:20:57,000 Yep, which means there is no time to move upstairs 496 00:20:57,040 --> 00:20:58,300 or wait for your doctor. 497 00:20:58,340 --> 00:21:00,340 No, no, no. I can't have my baby here. 498 00:21:00,380 --> 00:21:01,696 The ED is fully equipped for delivery. 499 00:21:01,720 --> 00:21:03,510 No, I can't have you deliver my baby. 500 00:21:03,550 --> 00:21:04,840 I'm sorry. 501 00:21:04,890 --> 00:21:05,906 Look, I get that I'm not your first option. 502 00:21:05,930 --> 00:21:07,116 In fact, I'm probably your last. 503 00:21:07,140 --> 00:21:09,470 But I am a board-certified OBGYN, 504 00:21:09,510 --> 00:21:11,140 and I have delivered hundreds of babies. 505 00:21:11,180 --> 00:21:14,270 And I will get yours out safely if we work together. 506 00:21:19,400 --> 00:21:20,860 OK, change of plans. 507 00:21:20,900 --> 00:21:22,256 Tessa's ready to deliver now, so we're gonna do it here. 508 00:21:22,280 --> 00:21:23,570 Oh, OK. 509 00:21:23,610 --> 00:21:26,030 Yep, so get me another nurse, a delivery table, 510 00:21:26,070 --> 00:21:28,160 and grab another doctor, whoever's available. 511 00:21:28,200 --> 00:21:30,790 We'll maybe need an extra set of hands. 512 00:21:32,410 --> 00:21:34,210 We got this, OK? 513 00:21:34,250 --> 00:21:35,420 OK. 514 00:21:38,500 --> 00:21:39,880 Where are we at? 515 00:21:39,920 --> 00:21:41,880 Long and short of it, Paul is depressed, 516 00:21:41,920 --> 00:21:43,630 but his risk of suicide is low. 517 00:21:43,670 --> 00:21:46,430 Couldn't find any evidence of any kind of intent 518 00:21:46,470 --> 00:21:48,050 to harm himself. 519 00:21:48,100 --> 00:21:49,826 All right, so I'll get his discharge paperwork ready. 520 00:21:49,850 --> 00:21:51,890 Do you want to include a psych referral? 521 00:21:51,930 --> 00:21:54,020 You know, Mags, I'm actually not quite ready 522 00:21:54,060 --> 00:21:55,270 to discharge him. 523 00:21:55,310 --> 00:21:56,600 OK. 524 00:21:56,650 --> 00:21:58,060 Here's the thing, right? 525 00:21:58,110 --> 00:22:00,480 He gets diagnosed with sudden-onset type 2 diabetes 526 00:22:00,520 --> 00:22:01,530 six months ago. 527 00:22:01,570 --> 00:22:04,570 No family history, low BMI, right? 528 00:22:04,610 --> 00:22:07,070 And we all know that when you get diagnosed with type 2, 529 00:22:07,110 --> 00:22:08,530 you don't lose weight. 530 00:22:08,570 --> 00:22:10,120 No, you gain weight, right? 531 00:22:10,160 --> 00:22:12,080 And then, there's the sudden-onset depression. 532 00:22:12,120 --> 00:22:14,250 Again, no history, right? 533 00:22:14,290 --> 00:22:15,620 No triggers. 534 00:22:15,660 --> 00:22:18,000 I'm just wondering if we're not missing something, 535 00:22:18,040 --> 00:22:20,210 you know, some underlying medical condition. 536 00:22:20,250 --> 00:22:22,210 Do you want to order a set of labs? 537 00:22:22,250 --> 00:22:24,260 Let's start out with a CBC and a CMP, 538 00:22:24,300 --> 00:22:26,510 and I'm gonna dig into the literature, 539 00:22:26,550 --> 00:22:29,720 see if I can't find some kind of common thread. 540 00:22:29,760 --> 00:22:30,890 You got it. 541 00:22:34,350 --> 00:22:38,270 After lambasting them for denying the patient's surgery, 542 00:22:38,310 --> 00:22:42,400 Dr. Ahmad goes on to tag you, Dr. Marcel. 543 00:22:42,440 --> 00:22:44,440 "Berninger is the worst. 544 00:22:44,480 --> 00:22:47,490 "Not only do they deny more patients than anyone, 545 00:22:47,530 --> 00:22:49,780 "they also pay physician reviewers six figures 546 00:22:49,820 --> 00:22:51,870 to find reasons to deny." 547 00:22:51,910 --> 00:22:54,200 Now, while Dr. Ahmad is entitled 548 00:22:54,240 --> 00:22:57,410 to express her personal opinions on her social media... 549 00:22:57,460 --> 00:22:59,460 You, sir, are a representative 550 00:22:59,500 --> 00:23:01,130 of the board now. 551 00:23:01,170 --> 00:23:03,340 I had no idea she was gonna post this. 552 00:23:03,380 --> 00:23:06,670 She didn't ask you before she publicly quoted you? 553 00:23:06,720 --> 00:23:09,220 No. She did not. 554 00:23:09,260 --> 00:23:11,140 We are on the eve of hammering out 555 00:23:11,180 --> 00:23:14,010 a new three-year contract with Berninger. 556 00:23:14,060 --> 00:23:16,270 And antagonizing them with a PR nightmare 557 00:23:16,310 --> 00:23:18,560 is not exactly the tone we wanted to set. 558 00:23:18,600 --> 00:23:20,440 We're talking about one post here. 559 00:23:20,480 --> 00:23:22,190 I'm sure no one's even gonna see it. 560 00:23:22,230 --> 00:23:25,360 It's going viral, Dr. Marcel. 561 00:23:27,860 --> 00:23:29,320 - What? - Yeah. 562 00:23:29,360 --> 00:23:31,280 So we are gonna need to do major damage control 563 00:23:31,320 --> 00:23:34,490 at the board meeting this afternoon. 564 00:23:34,530 --> 00:23:36,830 Just follow my lead. 565 00:23:42,420 --> 00:23:43,920 What is this? 566 00:23:45,920 --> 00:23:48,026 Now, I share something with you in a clinical setting, 567 00:23:48,050 --> 00:23:49,316 I don't expect to see it plastered 568 00:23:49,340 --> 00:23:50,816 all over social media, you understand? 569 00:23:50,840 --> 00:23:52,366 I should have checked with you before I posted it. 570 00:23:52,390 --> 00:23:54,930 Yeah, that much is obvious. 571 00:23:54,970 --> 00:23:56,350 I don't mean to sound ingenuous, 572 00:23:56,390 --> 00:23:58,020 but I didn't think that you would mind. 573 00:23:58,060 --> 00:23:59,940 Being publicly quoted without my consent? 574 00:23:59,980 --> 00:24:01,690 Yeah, I mind, a lot. 575 00:24:01,730 --> 00:24:04,060 - But what you said was true. - That isn't the point. 576 00:24:04,110 --> 00:24:05,860 Look, you want to have a viral moment? 577 00:24:05,900 --> 00:24:07,070 Be my guest. 578 00:24:07,110 --> 00:24:08,440 But don't do it at my expense. 579 00:24:08,490 --> 00:24:10,360 This isn't about having a viral moment. 580 00:24:10,400 --> 00:24:13,740 I... this strategy might seem unorthodox, but it works. 581 00:24:13,780 --> 00:24:15,030 Strategy? 582 00:24:15,080 --> 00:24:16,516 Since when did venting on social media 583 00:24:16,540 --> 00:24:17,910 become a strategy? 584 00:24:17,950 --> 00:24:20,080 Public shaming is a way to get companies' attention 585 00:24:20,120 --> 00:24:21,540 and move them to act. 586 00:24:21,580 --> 00:24:24,330 Case in point, after the post started trending, 587 00:24:24,380 --> 00:24:27,710 Berninger sent notice, and they escalated Vince's appeal 588 00:24:27,750 --> 00:24:29,720 for a peer-to-peer call. 589 00:24:29,760 --> 00:24:31,260 Really? 590 00:24:31,300 --> 00:24:33,406 Yeah, which is why we can't let up on public pressure. 591 00:24:33,430 --> 00:24:35,550 I got a DM from a local news reporter. 592 00:24:35,600 --> 00:24:37,970 She wants to interview us on Vince's case. 593 00:24:38,020 --> 00:24:39,680 What are you, out of your mind? 594 00:24:39,730 --> 00:24:40,770 I can't do that. 595 00:24:40,810 --> 00:24:42,270 Why not? 596 00:24:42,310 --> 00:24:44,270 Because the hospital's got an upcoming contract 597 00:24:44,310 --> 00:24:47,480 negotiation with Berninger. 598 00:24:47,520 --> 00:24:48,820 Ah. 599 00:24:48,860 --> 00:24:51,900 So this is why the post was such a big issue? 600 00:24:51,950 --> 00:24:54,490 That has nothing to do with my issue, 601 00:24:54,530 --> 00:24:57,410 which is your total disregard for professional courtesy. 602 00:25:01,870 --> 00:25:06,840 You should know that the post wasn't just liked or reposted. 603 00:25:06,880 --> 00:25:10,010 People shared their hellish experiences with Berninger. 604 00:25:10,050 --> 00:25:12,920 Hundreds of people, including MDs. 605 00:25:12,970 --> 00:25:15,260 What you said resonated. 606 00:25:15,300 --> 00:25:17,470 It needed to be said. 607 00:25:19,180 --> 00:25:21,430 OK, Tessa, the head is coming. 608 00:25:21,480 --> 00:25:22,930 You're crowning. 609 00:25:22,980 --> 00:25:24,480 I am? 610 00:25:24,520 --> 00:25:26,650 - You're doing great. - Thank you. 611 00:25:27,650 --> 00:25:29,900 Hannah? 612 00:25:29,940 --> 00:25:31,610 What... what's going on? 613 00:25:31,650 --> 00:25:34,280 The head is out, but the shoulders aren't coming. 614 00:25:34,320 --> 00:25:36,110 What? She's stuck? 615 00:25:36,160 --> 00:25:37,700 This can happen with bigger babies. 616 00:25:37,740 --> 00:25:39,620 Don't worry, we will get her out, Tessa, OK? 617 00:25:39,660 --> 00:25:41,790 Nancy, I need you to switch with Dr. Ripley. 618 00:25:41,830 --> 00:25:43,080 Put her into McRoberts. 619 00:25:43,120 --> 00:25:44,346 Dr. Ripley, I'm gonna need you to apply 620 00:25:44,370 --> 00:25:46,250 suprapubic pressure from above 621 00:25:46,290 --> 00:25:47,170 while I maneuver the baby out, OK? 622 00:25:47,210 --> 00:25:48,340 You got it. 623 00:25:48,380 --> 00:25:49,670 All right, Tessa, you got this. 624 00:25:49,710 --> 00:25:52,010 When I say push, you push as hard as you can, OK? 625 00:25:52,050 --> 00:25:53,470 Let's go. 626 00:25:53,510 --> 00:25:54,760 Go. 627 00:25:58,800 --> 00:26:00,640 Here we go, here we go, here we go! 628 00:26:01,720 --> 00:26:03,930 I got her! 629 00:26:05,390 --> 00:26:06,850 There's your baby girl. 630 00:26:06,900 --> 00:26:09,820 - Oh! - Oh, my baby. 631 00:26:13,820 --> 00:26:15,110 Thank you. 632 00:26:30,880 --> 00:26:32,420 Look, just... just hold on. 633 00:26:32,460 --> 00:26:33,936 Because it says here on my... what do you call this? 634 00:26:33,960 --> 00:26:36,550 Patient portal... that my blood work all came back normal. 635 00:26:36,590 --> 00:26:37,590 I understand. 636 00:26:37,630 --> 00:26:39,010 So why can't you discharge me? 637 00:26:39,050 --> 00:26:41,180 Because Dr. Charles needs to sign off your chart. 638 00:26:41,220 --> 00:26:42,890 Well, then go get Dr. Charles. 639 00:26:42,930 --> 00:26:44,020 Paul, don't yell at her. 640 00:26:44,060 --> 00:26:45,350 Don't tell me what to do. 641 00:26:45,390 --> 00:26:47,230 This is all your fault. If you had... 642 00:26:47,270 --> 00:26:48,560 Dr. Charles? 643 00:26:48,600 --> 00:26:50,610 Dr. Charles, I'd like to go home now. 644 00:26:50,650 --> 00:26:52,480 I understand you have to sign off on that. 645 00:26:52,520 --> 00:26:53,900 I do. 646 00:26:53,940 --> 00:26:55,716 And look, Paul, I know you've had a really long day. 647 00:26:55,740 --> 00:26:57,030 I certainly have. 648 00:26:57,070 --> 00:26:58,386 But I'd like to order just a couple more labs 649 00:26:58,410 --> 00:27:00,740 and actually get a CT of your abdomen. 650 00:27:00,780 --> 00:27:02,740 - Why? - My blood work came back normal. 651 00:27:02,780 --> 00:27:04,410 You know, there are certain illnesses 652 00:27:04,450 --> 00:27:06,556 that, early on, they just kind of fly under the radar. 653 00:27:06,580 --> 00:27:08,290 Like what? What are you looking for? 654 00:27:08,330 --> 00:27:10,170 Well, certain medical conditions, right, 655 00:27:10,210 --> 00:27:12,210 can raise inflammation in the body, 656 00:27:12,250 --> 00:27:14,460 which can cause depression. 657 00:27:14,500 --> 00:27:16,760 Yeah, but you've clearly narrowed that list down now. 658 00:27:16,800 --> 00:27:18,800 Why are you looking at my stomach? 659 00:27:18,840 --> 00:27:22,220 There is evidence that disruptions in the physiologic 660 00:27:22,260 --> 00:27:23,390 functions of the pancreas 661 00:27:23,430 --> 00:27:25,600 in this case, neurotransmission 662 00:27:25,640 --> 00:27:27,930 can alter mood and anxiety levels. 663 00:27:27,980 --> 00:27:30,980 And in very rare cases, sudden-onset diabetes 664 00:27:31,020 --> 00:27:34,070 has been known to be caused by a growth in the pancreas. 665 00:27:39,660 --> 00:27:41,160 What, you... 666 00:27:43,330 --> 00:27:45,240 You think I have pancreatic cancer? 667 00:27:45,290 --> 00:27:46,970 I'm more thinking about this as something 668 00:27:47,000 --> 00:27:48,500 I'd like to rule out. 669 00:28:10,910 --> 00:28:12,273 Well, I want to start by welcoming 670 00:28:12,298 --> 00:28:13,620 our newest member to the board, 671 00:28:13,670 --> 00:28:14,920 Dr. Crockett Marcel. 672 00:28:17,040 --> 00:28:18,520 All right, then. Let's dive right in. 673 00:28:18,550 --> 00:28:21,720 Barry, if I may, I'd actually like to address 674 00:28:21,760 --> 00:28:23,800 the elephant in the room. 675 00:28:25,680 --> 00:28:27,180 Sure, Peter. 676 00:28:27,220 --> 00:28:31,430 I think we're all aware of the social media firestorm. 677 00:28:31,480 --> 00:28:34,150 Strike that... "firestorm" is making a mountain out of a... 678 00:28:34,190 --> 00:28:35,610 Peter. 679 00:28:35,650 --> 00:28:38,360 Get to the point. 680 00:28:38,400 --> 00:28:42,110 An overzealous resident misquoted Dr. Marcel 681 00:28:42,150 --> 00:28:43,860 to serve her own agenda. 682 00:28:43,900 --> 00:28:45,910 No, that's not... 683 00:28:45,950 --> 00:28:48,450 - Dr. Marcel... - I was quoted accurately. 684 00:28:48,490 --> 00:28:51,450 OK? Let me start by owning that. 685 00:28:51,500 --> 00:28:54,290 And Dr. Ahmad was not serving her own agenda. 686 00:28:54,330 --> 00:28:56,710 She was trying to help our dying patient 687 00:28:56,750 --> 00:28:59,170 battle his insurance company, 688 00:28:59,210 --> 00:29:01,300 which is a fight doctors typically avoid. 689 00:29:01,340 --> 00:29:03,170 Trust me, I know, it's not our lane. 690 00:29:03,220 --> 00:29:06,300 We don't deal with insurance. 691 00:29:06,340 --> 00:29:08,180 And honestly, I feel it's time we did. 692 00:29:08,220 --> 00:29:10,810 Because these companies are stepping into our lane. 693 00:29:15,020 --> 00:29:18,060 Take the patient Dr. Ahmad posted about. 694 00:29:18,110 --> 00:29:20,980 Now, he was diagnosed with stage four cancer 695 00:29:21,030 --> 00:29:23,490 three months after his doctor first suspected 696 00:29:23,530 --> 00:29:24,490 something was wrong. 697 00:29:24,530 --> 00:29:26,820 Why such a long gap? 698 00:29:26,860 --> 00:29:28,780 Because the CT his doctor ordered 699 00:29:28,820 --> 00:29:30,450 required prior authorization, 700 00:29:30,490 --> 00:29:32,200 and Berninger denied it. 701 00:29:35,370 --> 00:29:37,540 That's the crux of the issue. 702 00:29:48,260 --> 00:29:50,100 Paul, Pamela, I want to introduce you 703 00:29:50,140 --> 00:29:53,350 to Dr. Washington, who is our head of oncology 704 00:29:53,390 --> 00:29:55,180 here at Gaffney. 705 00:29:55,230 --> 00:29:56,850 Oh, wow, top dog. 706 00:29:56,890 --> 00:29:58,600 This must be bad. 707 00:29:58,650 --> 00:30:00,270 Don't read in to the title. 708 00:30:00,310 --> 00:30:02,820 While you do have a small mass in your pancreas... 709 00:30:02,860 --> 00:30:03,990 OK. 710 00:30:04,030 --> 00:30:06,900 It's confined to the tail, 711 00:30:06,950 --> 00:30:08,740 which means it's resectable. 712 00:30:08,780 --> 00:30:10,780 That's good, right? 713 00:30:10,830 --> 00:30:12,120 It's really good. 714 00:30:12,160 --> 00:30:13,870 Surgery is far and away the best treatment 715 00:30:13,910 --> 00:30:15,710 for pancreatic cancer. 716 00:30:15,750 --> 00:30:17,500 And it's rarely an option. 717 00:30:17,540 --> 00:30:18,920 The cancer is usually too advanced 718 00:30:18,960 --> 00:30:20,380 by the time we catch it. 719 00:30:20,420 --> 00:30:23,250 I advise a few rounds of chemo to shrink the tumor 720 00:30:23,300 --> 00:30:26,420 and then the distal pancreatectomy to remove it. 721 00:30:28,590 --> 00:30:31,300 Few doctors would have connected the dots here. 722 00:30:31,350 --> 00:30:33,680 You're lucky you ended up with this one, Mr. Moore. 723 00:30:34,890 --> 00:30:36,810 I'm realizing that. 724 00:30:36,850 --> 00:30:38,940 Thank you, Dr. Charles. 725 00:30:38,980 --> 00:30:41,440 Absolutely a team effort. 726 00:30:46,070 --> 00:30:47,780 Thank you, Pam. 727 00:30:47,820 --> 00:30:50,070 It's not lost on me if you hadn't conned me 728 00:30:50,110 --> 00:30:52,200 into coming in here today... 729 00:30:52,240 --> 00:30:53,490 You're gonna be OK. 730 00:30:53,530 --> 00:30:55,040 That's all I care about. 731 00:31:10,800 --> 00:31:11,970 Hey. 732 00:31:12,010 --> 00:31:13,720 I'm looking for my wife. 733 00:31:19,690 --> 00:31:20,850 Hannah. 734 00:31:20,900 --> 00:31:22,150 Nick. 735 00:31:23,310 --> 00:31:24,770 H-how do you know... 736 00:31:24,820 --> 00:31:26,650 I just delivered your baby. 737 00:31:26,690 --> 00:31:28,240 What? 738 00:31:29,490 --> 00:31:31,450 - Does Tessa... - Oh, she knows. 739 00:31:31,490 --> 00:31:34,030 - Oh, no. - She hacked into your phone, 740 00:31:34,080 --> 00:31:35,636 found your messages, and tracked me down. 741 00:31:35,660 --> 00:31:36,580 Oh, my God. 742 00:31:36,620 --> 00:31:38,200 - Is that why she's here? - Shh! 743 00:31:38,250 --> 00:31:39,540 She's sleeping. 744 00:31:39,580 --> 00:31:41,210 What did she say? 745 00:31:41,250 --> 00:31:42,960 Is this why she went into labor? 746 00:31:43,000 --> 00:31:45,540 Well, it's definitely possible for emotional stress 747 00:31:45,590 --> 00:31:47,630 to induce labor. 748 00:31:47,670 --> 00:31:52,130 But regardless, Tessa gave birth to a healthy baby girl, 749 00:31:52,180 --> 00:31:54,760 and both mom and baby are doing well. 750 00:31:54,800 --> 00:31:56,100 Oh, thank God. 751 00:32:00,730 --> 00:32:02,100 Look, Hannah, I'm... 752 00:32:02,140 --> 00:32:03,650 I'm not a cheater. 753 00:32:03,690 --> 00:32:06,400 Yeah, well, last night would suggest otherwise. 754 00:32:06,440 --> 00:32:09,490 You were the only woman I messaged on that app, OK? 755 00:32:09,530 --> 00:32:12,030 And I had no intention of ever seeing you again. 756 00:32:12,070 --> 00:32:14,120 Don't flatter yourself. 757 00:32:14,160 --> 00:32:16,660 Look, I made a horrible mistake. 758 00:32:16,700 --> 00:32:18,790 I was freaking out about becoming a dad, you know, 759 00:32:18,830 --> 00:32:22,500 and I just thought, one last night of freedom... 760 00:32:22,540 --> 00:32:25,710 OK, save your rationalizations for your wife. 761 00:32:25,750 --> 00:32:28,340 Or better yet, spare her. 762 00:32:28,380 --> 00:32:30,760 I think that your time is best used 763 00:32:30,800 --> 00:32:32,970 begging Tessa for forgiveness. 764 00:32:55,200 --> 00:32:56,740 Hey. 765 00:32:58,660 --> 00:33:00,040 What is it? 766 00:33:00,080 --> 00:33:01,790 Vince just started vomiting blood. 767 00:33:11,630 --> 00:33:12,970 Dr. Charles? 768 00:33:13,010 --> 00:33:14,680 Mrs. Moore? 769 00:33:14,720 --> 00:33:16,090 Are you all right? 770 00:33:16,140 --> 00:33:18,550 Look, we know it's a scary diagnosis, 771 00:33:18,600 --> 00:33:20,260 but in terms of pancreatic cancer, 772 00:33:20,310 --> 00:33:22,730 his prognosis could not be better. 773 00:33:22,770 --> 00:33:25,140 And that's largely because of your efforts. 774 00:33:25,190 --> 00:33:27,610 You saved his life by bringing him in today. 775 00:33:27,650 --> 00:33:30,570 Well, he has quite a way of thanking me. 776 00:33:33,240 --> 00:33:35,070 He wants a divorce. 777 00:33:44,520 --> 00:33:46,320 Vince, we're concerned you may be developing 778 00:33:46,345 --> 00:33:47,860 a tear in your lower esophagus 779 00:33:47,900 --> 00:33:50,280 from all of the vomiting. 780 00:33:50,320 --> 00:33:52,280 I'd like to place an NG tube, Vince. 781 00:33:52,320 --> 00:33:53,780 - No. - Just for the time being. 782 00:33:53,830 --> 00:33:54,902 No, no tubes. 783 00:33:54,927 --> 00:33:56,716 How many times do I have to tell you... 784 00:33:56,740 --> 00:33:57,910 Hear me out. 785 00:33:57,950 --> 00:33:59,370 It's not a feeding tube. 786 00:33:59,410 --> 00:34:01,040 It's just gonna stop you from vomiting, 787 00:34:01,080 --> 00:34:03,000 and it'll help during surgery 788 00:34:03,040 --> 00:34:04,460 to decompress your stomach, OK? 789 00:34:04,500 --> 00:34:06,300 Wait. 790 00:34:06,340 --> 00:34:08,210 Did you just say surgery? 791 00:34:08,260 --> 00:34:09,970 Yeah, I heard "surgery," too, Dr. Marcel. 792 00:34:10,010 --> 00:34:11,050 Mm-hmm. 793 00:34:11,090 --> 00:34:12,430 That's right. 794 00:34:12,470 --> 00:34:14,760 The board voted unanimously for the hospital 795 00:34:14,800 --> 00:34:16,810 to cover the costs of Vince's surgery. 796 00:34:20,940 --> 00:34:22,520 Seriously? 797 00:34:23,610 --> 00:34:25,730 The hospital is just gonna pay for it? 798 00:34:25,770 --> 00:34:27,480 Yep. 799 00:34:29,280 --> 00:34:31,650 I can't believe this. 800 00:34:31,700 --> 00:34:34,280 Is this real? 801 00:34:34,320 --> 00:34:36,280 It's very real. 802 00:34:36,330 --> 00:34:38,910 In fact, I got you scheduled in the OR 803 00:34:38,950 --> 00:34:40,750 for 8:00 a.m. tomorrow. 804 00:34:43,670 --> 00:34:45,960 Hey, you guys are going to Italy in three weeks. 805 00:34:46,000 --> 00:34:47,500 We got no time to waste. 806 00:34:52,380 --> 00:34:55,090 How can I begin to thank you? 807 00:34:55,140 --> 00:34:57,760 To thank you both? 808 00:34:57,810 --> 00:35:01,890 Well, how about you let us place this NG tube, OK? 809 00:35:07,320 --> 00:35:09,360 All right. 810 00:35:09,400 --> 00:35:11,126 Do you think it was the depression that made him 811 00:35:11,150 --> 00:35:13,610 make such a rash decision? 812 00:35:13,660 --> 00:35:15,320 You know, I don't, actually. 813 00:35:15,370 --> 00:35:16,966 But what possessed him to do it right now? 814 00:35:16,990 --> 00:35:18,806 I mean, he couldn't even wait until they were home? 815 00:35:18,830 --> 00:35:21,080 Your mortality can be a pretty powerful motivator 816 00:35:21,120 --> 00:35:25,000 to do all the stuff that you put off doing, right? 817 00:35:25,040 --> 00:35:26,500 I think that Paul had been thinking 818 00:35:26,540 --> 00:35:28,000 about this for a while. 819 00:35:28,040 --> 00:35:29,186 I wonder if he's gonna regret it. 820 00:35:29,210 --> 00:35:30,486 I mean, speaking from experience, 821 00:35:30,510 --> 00:35:32,630 he's got a long road ahead of him. 822 00:35:32,670 --> 00:35:34,550 One that's not easy to walk alone. 823 00:35:34,590 --> 00:35:37,680 Yeah, but I mean, given his feelings about the marriage, 824 00:35:37,720 --> 00:35:39,510 is it really 825 00:35:39,560 --> 00:35:41,326 really fair to Pamela to put her in the position 826 00:35:41,350 --> 00:35:43,520 of being the support system? 827 00:35:49,320 --> 00:35:50,530 I'm sorry. 828 00:35:50,570 --> 00:35:52,440 No apology necessary. 829 00:35:52,490 --> 00:35:55,280 I've been through enough divorces 830 00:35:55,320 --> 00:35:56,676 to be able to say with some authority, 831 00:35:56,700 --> 00:35:59,240 spontaneous weeping is a part of the deal. 832 00:36:02,370 --> 00:36:04,540 Tonight's my annual MRI. 833 00:36:04,580 --> 00:36:07,330 Make sure that my cancer hasn't returned. 834 00:36:07,380 --> 00:36:10,550 I've been dreading it all day. 835 00:36:10,590 --> 00:36:13,550 Ben and I always made our appointments together. 836 00:36:13,590 --> 00:36:14,720 Yeah. 837 00:36:20,560 --> 00:36:22,970 When I saw the appointment approaching on my calendar, 838 00:36:23,020 --> 00:36:25,600 I almost texted Ben. 839 00:36:27,560 --> 00:36:29,060 I wanted to see if he wanted to keep 840 00:36:29,110 --> 00:36:32,030 the tradition alive, but 841 00:36:32,070 --> 00:36:33,360 then I remembered... 842 00:36:36,570 --> 00:36:39,410 He's not my support system anymore. 843 00:36:40,910 --> 00:36:42,950 And I'm not his. 844 00:36:53,510 --> 00:36:55,590 Dr. Ahmad, hey. 845 00:36:56,720 --> 00:36:58,180 What's going on with that interview? 846 00:36:58,220 --> 00:36:59,590 Why? 847 00:36:59,640 --> 00:37:01,026 Did the board give you approval to join me? 848 00:37:01,050 --> 00:37:02,560 Oh, no. 849 00:37:02,600 --> 00:37:04,116 The board would appreciate it if the interview 850 00:37:04,140 --> 00:37:06,230 went away altogether. 851 00:37:06,270 --> 00:37:08,560 There it is, the catch. 852 00:37:08,600 --> 00:37:10,730 This issue is bigger than just one patient. 853 00:37:10,770 --> 00:37:13,020 And the board recognizes that, 854 00:37:13,070 --> 00:37:15,490 which is why they're making prior authorization 855 00:37:15,530 --> 00:37:18,400 a key issue in negotiations with Berninger. 856 00:37:18,450 --> 00:37:19,886 And you trust they'll follow through? 857 00:37:19,910 --> 00:37:21,740 I'll be holding their feet to the fire. 858 00:37:23,120 --> 00:37:26,580 I agreed to serve as an advisor on prior authorization 859 00:37:26,620 --> 00:37:29,870 for the negotiating committee. 860 00:37:29,920 --> 00:37:33,500 So am I still in the doghouse? 861 00:37:33,550 --> 00:37:35,066 Now, you went to the mat for a patient. 862 00:37:35,090 --> 00:37:37,010 Not a grudge-worthy offense in my book. 863 00:37:37,050 --> 00:37:40,010 But for what it's worth. 864 00:37:40,050 --> 00:37:41,430 Here we go. 865 00:37:41,470 --> 00:37:43,470 Look, there's a benefit 866 00:37:43,510 --> 00:37:46,180 to being taken seriously by management. 867 00:37:46,220 --> 00:37:47,390 You get invited into rooms 868 00:37:47,430 --> 00:37:49,060 where you can actually have an impact. 869 00:37:49,100 --> 00:37:52,610 I'm not sure that's the kind of impact I'm trying to make. 870 00:37:52,650 --> 00:37:53,940 I'm not saying it is. 871 00:37:53,980 --> 00:37:59,360 But maybe you want to keep your options open. 872 00:38:00,780 --> 00:38:03,120 Thanks for the pearls, Obi-Wan. 873 00:38:03,160 --> 00:38:05,120 Oh, anytime. 874 00:38:13,960 --> 00:38:17,800 Well, today settles it. 875 00:38:18,970 --> 00:38:19,760 Joining a nunnery? 876 00:38:19,800 --> 00:38:21,720 Deleting all dating apps. 877 00:38:21,760 --> 00:38:23,220 Ah. 878 00:38:23,260 --> 00:38:25,430 Probably for the best. 879 00:38:25,470 --> 00:38:27,850 All that swiping, head buried in your phone. 880 00:38:27,890 --> 00:38:29,980 Might get a crick in my neck. 881 00:38:30,020 --> 00:38:32,060 Might miss out on meeting someone in the 882 00:38:32,100 --> 00:38:33,100 what do the kids say? 883 00:38:33,150 --> 00:38:34,980 IRL? 884 00:38:35,020 --> 00:38:37,360 In real life? 885 00:38:37,400 --> 00:38:39,280 - Hmm. - Have a good night, Asher. 886 00:38:46,870 --> 00:38:48,540 Come in. 887 00:38:50,120 --> 00:38:51,710 - Hey. - Hey. 888 00:38:51,750 --> 00:38:53,806 I know we're supposed to be meeting at the restaurant, 889 00:38:53,830 --> 00:38:56,000 but I thought you might need a ride. 890 00:38:56,040 --> 00:38:57,550 Close the door. 891 00:39:02,380 --> 00:39:05,510 I was just about to call you, 892 00:39:05,550 --> 00:39:07,510 because I'm gonna actually 893 00:39:07,560 --> 00:39:09,350 need a rain check tonight. 894 00:39:09,390 --> 00:39:12,060 - Oh? - Yeah, something came up. 895 00:39:12,100 --> 00:39:13,876 This is not because of our conversation this morning, 896 00:39:13,900 --> 00:39:16,110 - I hope? - No, no, no, no. 897 00:39:16,150 --> 00:39:17,416 Because if it is, I didn't mean to pressure you. 898 00:39:17,440 --> 00:39:19,030 You didn't at all. 899 00:39:19,070 --> 00:39:22,990 In fact, I think we should start telling people. 900 00:39:23,030 --> 00:39:25,160 I'm sorry, what? 901 00:39:25,200 --> 00:39:27,160 You know, I've always carried myself with 902 00:39:27,200 --> 00:39:30,450 a sense of propriety, and I spend a lot of time 903 00:39:30,500 --> 00:39:33,540 encouraging my colleagues to do the same. 904 00:39:33,580 --> 00:39:37,840 But I just think if you feel strongly 905 00:39:37,880 --> 00:39:41,260 about something in private, 906 00:39:41,300 --> 00:39:43,760 you should own it in public. 907 00:39:43,800 --> 00:39:45,390 "Strongly," you say? 908 00:39:45,430 --> 00:39:47,390 "Strongly," she said. 909 00:39:51,270 --> 00:39:53,850 You sure you don't want to join me for dinner tonight? 910 00:39:55,770 --> 00:39:58,060 I'm suddenly very much in the mood to celebrate. 911 00:39:58,110 --> 00:39:59,320 I can't, I can't. 912 00:39:59,360 --> 00:40:02,240 But I'll tell you what. 913 00:40:02,280 --> 00:40:04,900 If you're up late, 914 00:40:04,950 --> 00:40:08,410 I will stop by for a nightcap. 915 00:40:08,450 --> 00:40:10,580 Then I most definitely will be up late. 916 00:40:15,460 --> 00:40:17,580 I'll see you later. 917 00:40:17,630 --> 00:40:19,500 See you then.64060

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