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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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