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1
00:00:06,895 --> 00:00:08,350
Oh, what do you
think you're doing?
2
00:00:08,375 --> 00:00:10,506
Sorry, I didn't' feel like
we had another choice.
3
00:00:10,530 --> 00:00:12,700
Dr. Ahmad, your residency here
4
00:00:12,740 --> 00:00:15,360
will be on a probationary basis.
5
00:00:15,410 --> 00:00:16,820
What the hell's going on?
6
00:00:16,870 --> 00:00:19,120
Walking off the floor without
notifying a supervisor?
7
00:00:19,160 --> 00:00:21,200
There's not gonna
be another warning.
8
00:00:21,250 --> 00:00:23,306
Ben is the one who pulled
the plug on this marriage.
9
00:00:23,330 --> 00:00:24,500
Come on, Maggie.
10
00:00:24,540 --> 00:00:25,920
We're almost at the finish line.
11
00:00:25,960 --> 00:00:28,000
I really just wanna move on.
12
00:00:28,040 --> 00:00:29,250
Get me out of here!
13
00:00:29,300 --> 00:00:30,396
- Get away from me!
- Dr. Ripley,
14
00:00:30,420 --> 00:00:31,960
What you did today was reckless.
15
00:00:32,010 --> 00:00:33,050
Reckless?
16
00:00:33,090 --> 00:00:34,430
Impulse control disorder?
17
00:00:34,470 --> 00:00:35,816
Isn't that what you
called it back then?
18
00:00:35,840 --> 00:00:38,350
I'm an attending physician
at this hospital,
19
00:00:38,390 --> 00:00:43,310
not the boy you
knew 20 years ago.
20
00:00:50,860 --> 00:00:52,190
Yo, Asher!
21
00:00:52,230 --> 00:00:53,360
What are you doing here?
22
00:00:53,400 --> 00:00:54,820
Mitch, what are... hey.
23
00:00:54,860 --> 00:00:55,910
What are you drinking?
24
00:00:55,950 --> 00:00:57,450
Um... I'm... I'm not.
25
00:00:57,490 --> 00:00:59,120
- It's club soda.
- You don't drink?
26
00:00:59,160 --> 00:01:00,410
I do not.
27
00:01:00,450 --> 00:01:02,910
I'm a recovering addict.
28
00:01:02,950 --> 00:01:06,210
Which... I will tell you
all about that another time.
29
00:01:06,250 --> 00:01:09,840
But right now, you
have to go away.
30
00:01:09,880 --> 00:01:13,170
You do realize this is a
public establishment, right?
31
00:01:13,210 --> 00:01:15,880
I'm... I am waiting on a date.
32
00:01:15,930 --> 00:01:18,090
First date.
33
00:01:18,140 --> 00:01:20,680
And he's going to be
here any minute, so...
34
00:01:20,720 --> 00:01:22,180
What? No.
35
00:01:22,220 --> 00:01:23,520
No, you...
36
00:01:23,560 --> 00:01:25,230
I got my eyes glued to the door.
37
00:01:25,270 --> 00:01:27,440
I will split the
second he gets here.
38
00:01:29,650 --> 00:01:31,400
Fine.
39
00:01:31,440 --> 00:01:32,820
So who's the guy?
40
00:01:32,860 --> 00:01:34,110
How'd you meet?
41
00:01:34,150 --> 00:01:35,650
His name is Kyle.
42
00:01:35,700 --> 00:01:40,200
And he's an architect, and
we met on a dating app.
43
00:01:40,240 --> 00:01:42,490
Commercial architecture?
Residential?
44
00:01:42,540 --> 00:01:43,830
What's the name of his firm?
45
00:01:43,870 --> 00:01:45,790
OK, what are you doing here, hm?
46
00:01:45,830 --> 00:01:49,460
You don't seem like the type to
venture out on a school night.
47
00:01:49,500 --> 00:01:51,316
Is that your polite way
of calling me a loser?
48
00:01:51,340 --> 00:01:52,840
No.
49
00:01:52,880 --> 00:01:57,800
You're always working late,
running at some ungodly hours.
50
00:01:57,840 --> 00:02:01,300
Those degenerates,
they dragged me out.
51
00:02:03,350 --> 00:02:05,730
I've known most of them
since grade school.
52
00:02:05,770 --> 00:02:07,890
I didn't know you
were a Chicago boy.
53
00:02:07,940 --> 00:02:09,600
Born and raised.
54
00:02:09,650 --> 00:02:13,020
Just been away a lot of years.
55
00:02:13,070 --> 00:02:14,650
It must be nice being home.
56
00:02:19,110 --> 00:02:22,240
I think Romeo has landed.
57
00:02:28,960 --> 00:02:31,330
Whoa, that was...
58
00:02:31,380 --> 00:02:33,170
Nice break, bro.
59
00:02:39,050 --> 00:02:40,720
Somebody call 911!
60
00:02:40,760 --> 00:02:41,680
I need help!
61
00:02:41,720 --> 00:02:43,680
My girlfriend just passed out!
62
00:02:45,060 --> 00:02:46,520
We're doctors!
63
00:02:46,560 --> 00:02:48,180
You got to help her. Please.
64
00:02:48,230 --> 00:02:49,520
Somebody's calling 911.
65
00:02:49,560 --> 00:02:51,350
Paramedics should
be on the way soon.
66
00:02:51,400 --> 00:02:52,706
Her breathing's
slow and shallow.
67
00:02:52,730 --> 00:02:54,320
Eyes are pinpoint.
What's her name?
68
00:02:54,360 --> 00:02:55,860
- Uh, Becca.
- Becca?
69
00:02:55,900 --> 00:02:58,280
- Hey, wake up, Becca!
- Did she take something?
70
00:02:58,320 --> 00:03:00,360
We need to know so
we can help her, man.
71
00:03:00,400 --> 00:03:01,570
Come on! What did she take?!
72
00:03:01,610 --> 00:03:03,370
Coke. But just a hit.
73
00:03:03,410 --> 00:03:04,700
Is this an overdose?
74
00:03:04,740 --> 00:03:06,490
How do you OD off just one hit?
75
00:03:06,540 --> 00:03:08,370
- You wouldn't.
- No, Unless...
76
00:03:08,410 --> 00:03:09,516
Cocaine was laced with fentanyl.
77
00:03:09,540 --> 00:03:11,042
I have Narcan in my purse.
78
00:03:11,067 --> 00:03:12,646
The blue bag under
the bar on the hook?
79
00:03:12,670 --> 00:03:14,630
It's OK, I'll get it.
80
00:03:14,670 --> 00:03:15,630
Hey.
81
00:03:15,670 --> 00:03:17,106
- Hey, you doing OK?
- I... I don't...
82
00:03:17,130 --> 00:03:18,236
- OK, OK.
- I don't feel so good.
83
00:03:18,260 --> 00:03:20,010
Did you take a hit, too?
84
00:03:20,050 --> 00:03:21,107
Here.
85
00:03:21,132 --> 00:03:22,302
Thanks.
86
00:03:22,327 --> 00:03:24,157
You're OK. You're OK.
87
00:03:24,206 --> 00:03:25,506
Mitch?
88
00:03:25,531 --> 00:03:26,990
Yeah.
89
00:03:31,100 --> 00:03:32,201
Come on.
90
00:03:37,400 --> 00:03:38,570
Welcome back, Becca.
91
00:03:38,610 --> 00:03:40,780
- Take a breath.
- Come on.
92
00:03:40,820 --> 00:03:43,200
It's OK. Just breathe.
93
00:03:43,240 --> 00:03:44,950
Tim?
94
00:03:44,990 --> 00:03:46,370
What's wrong with him?
95
00:03:46,410 --> 00:03:47,716
Got any more Narcan?
This didn't do it.
96
00:03:47,740 --> 00:03:49,016
- He needs another dose.
- No, I don't.
97
00:03:49,040 --> 00:03:50,000
Does anyone have Narcan?
98
00:03:50,040 --> 00:03:51,330
I'll ask around.
99
00:03:51,370 --> 00:03:52,556
Airway's open, but
he's not breathing.
100
00:03:52,580 --> 00:03:53,596
Baby, you have to wake up.
101
00:03:53,620 --> 00:03:54,920
I'm gonna start rescue breath.
102
00:03:54,960 --> 00:03:56,186
- No, no, Mitch, wait!
- You don't have a mask.
103
00:03:56,210 --> 00:03:57,130
- Wait for the paramedics.
- Hannah!
104
00:03:57,170 --> 00:03:58,210
He could cough up blood.
105
00:03:58,250 --> 00:03:59,590
- He could...
- I know the risks.
106
00:03:59,630 --> 00:04:01,090
Hey, doc, what do we got?
107
00:04:01,130 --> 00:04:02,470
Suspected fentanyl overdose.
108
00:04:02,510 --> 00:04:04,026
We already administered
one dose of Narcan.
109
00:04:08,720 --> 00:04:10,850
Baby, open your eyes.
110
00:04:20,320 --> 00:04:22,900
Welcome back.
111
00:04:31,160 --> 00:04:32,710
CPD tested their drugs.
112
00:04:32,750 --> 00:04:34,420
Came back positive for fentanyl.
113
00:04:34,460 --> 00:04:35,580
There's been a huge uptick
114
00:04:35,620 --> 00:04:37,040
of overdoses in the ED lately.
115
00:04:37,080 --> 00:04:39,170
Yeah, a lot of them
just like Becca and Tim.
116
00:04:39,210 --> 00:04:41,960
They're recreational
users, no clue their drugs
117
00:04:42,010 --> 00:04:43,170
are laced with fentanyl.
118
00:04:43,220 --> 00:04:44,316
I'll make sure they go home
119
00:04:44,340 --> 00:04:45,486
with some fentanyl
testing strips.
120
00:04:45,510 --> 00:04:48,010
Thank you, Juliette.
121
00:04:51,180 --> 00:04:52,390
Your date's waiting.
122
00:04:52,430 --> 00:04:53,930
He is?
123
00:04:53,980 --> 00:04:55,730
Your 6 o'clock. Just be cool.
124
00:05:01,610 --> 00:05:04,700
Well, uh, see you tomorrow.
125
00:05:04,740 --> 00:05:06,320
- Yeah.
- Yeah.
126
00:05:06,360 --> 00:05:08,370
Yeah.
127
00:05:11,240 --> 00:05:13,120
Get some sleep tonight, Asher.
128
00:05:18,330 --> 00:05:19,790
Wow.
129
00:05:19,840 --> 00:05:22,300
You're... you're like
a real-life superwoman.
130
00:05:22,340 --> 00:05:23,510
No.
131
00:05:23,550 --> 00:05:25,880
No, I'm just glad everyone's OK.
132
00:05:25,930 --> 00:05:28,510
Yeah.
133
00:05:28,550 --> 00:05:32,350
So what do you say we, um
134
00:05:32,390 --> 00:05:35,520
we pick up where we left off?
135
00:05:35,560 --> 00:05:38,850
I actually... I
have to get going.
136
00:05:38,900 --> 00:05:41,440
I've got kind of an
early start tomorrow.
137
00:05:41,480 --> 00:05:43,480
Oh.
138
00:05:43,530 --> 00:05:45,240
Yeah, I mean, I get it.
139
00:05:45,280 --> 00:05:48,990
But it was really lovely
to meet you, Hannah.
140
00:06:12,400 --> 00:06:13,822
Big plans tonight?
141
00:06:15,303 --> 00:06:16,633
No.
142
00:06:16,658 --> 00:06:19,328
I, uh, got a board
meeting later.
143
00:06:19,440 --> 00:06:21,730
- Giving a presentation?
- No.
144
00:06:21,770 --> 00:06:24,820
I'm actually joining the board.
145
00:06:24,860 --> 00:06:26,990
Well, I must have
missed the announcement.
146
00:06:27,030 --> 00:06:28,150
Well, there wasn't one.
147
00:06:28,200 --> 00:06:29,410
My request.
148
00:06:29,450 --> 00:06:31,570
Not big on fanfare.
149
00:06:31,620 --> 00:06:34,080
So the board just
created a seat for you?
150
00:06:34,120 --> 00:06:36,660
Well, for a hospital
physician, so...
151
00:06:36,700 --> 00:06:39,080
But they asked you?
152
00:06:39,120 --> 00:06:40,880
Seems that way.
153
00:06:42,840 --> 00:06:45,170
I'm just glad I get
to, uh... to advocate
154
00:06:45,210 --> 00:06:46,260
for the medical staff.
155
00:06:46,300 --> 00:06:48,510
Well, congratulations.
156
00:06:48,550 --> 00:06:51,340
You must be very
popular with the suits.
157
00:06:51,390 --> 00:06:52,970
Dr. Ahmad!
158
00:06:53,010 --> 00:06:55,600
Got an ambo pulling up,
going to treatment three.
159
00:06:55,640 --> 00:06:57,180
Duty calls.
160
00:06:57,220 --> 00:06:58,810
By all means.
161
00:07:02,310 --> 00:07:04,020
- We're going into three.
- Got it.
162
00:07:04,070 --> 00:07:06,190
Vince Gonzalez,
38-year-old male,
163
00:07:06,230 --> 00:07:08,030
briefly lost consciousness
after vomiting.
164
00:07:08,070 --> 00:07:12,030
BP 85 over 52, gave
two liters in the ambo.
165
00:07:12,070 --> 00:07:13,070
Hi, Mr. Gonzalez.
166
00:07:13,120 --> 00:07:14,200
I'm Dr. Ahmad.
167
00:07:14,240 --> 00:07:16,290
It's Vince.
168
00:07:16,330 --> 00:07:18,410
Do you know if he hit his
head when he passed out?
169
00:07:18,450 --> 00:07:20,210
No, Vince was already
on the ground.
170
00:07:20,250 --> 00:07:21,750
He just kind of slumped over.
171
00:07:21,790 --> 00:07:23,396
And he wasn't out long,
just a few seconds.
172
00:07:23,420 --> 00:07:24,540
Thank you. And you are?
173
00:07:24,590 --> 00:07:27,550
Ty. I'm Vince's husband.
174
00:07:27,590 --> 00:07:29,340
We'll take good care of him.
175
00:07:31,590 --> 00:07:34,050
OK, on my count...
one, two, three.
176
00:07:40,180 --> 00:07:42,230
OK, Vince, do you
mind leaning forward?
177
00:07:42,270 --> 00:07:43,496
I just want to listen to
your lungs from the back.
178
00:07:44,980 --> 00:07:47,610
Clear breath sounds bilaterally.
179
00:07:50,610 --> 00:07:52,240
Oh, honey.
180
00:07:52,280 --> 00:07:53,490
Oh.
181
00:07:53,530 --> 00:07:55,200
I am so sorry.
182
00:07:55,240 --> 00:07:57,280
It is so fine.
183
00:07:57,330 --> 00:07:59,370
It happens more than you think.
184
00:07:59,410 --> 00:08:00,870
4 of Zofran and a KUB.
185
00:08:00,910 --> 00:08:02,250
I'm on it.
186
00:08:02,290 --> 00:08:05,250
Excuse me.
187
00:08:05,290 --> 00:08:07,670
Hey.
188
00:08:07,710 --> 00:08:10,460
You, um... you
have some vomit in your hair.
189
00:08:14,470 --> 00:08:16,600
Dennis Washington.
190
00:08:16,640 --> 00:08:18,510
- How you been?
- Hey, Dan.
191
00:08:18,560 --> 00:08:19,930
- How are you?
- Dr. Washington.
192
00:08:19,970 --> 00:08:22,850
Good morning. What
can I do for you?
193
00:08:22,890 --> 00:08:25,270
I wanted to follow up on that
matter I emailed you about.
194
00:08:25,310 --> 00:08:27,060
Oh, right. Of course.
195
00:08:27,110 --> 00:08:28,270
We can talk in my office.
196
00:08:28,320 --> 00:08:29,940
We'll see you later.
197
00:08:29,980 --> 00:08:32,990
I'll see you at the Exec Med
Committee meeting Friday.
198
00:08:33,030 --> 00:08:34,950
Only if I can't get out of it.
199
00:08:43,500 --> 00:08:45,330
You forgot it by the toaster.
200
00:08:45,370 --> 00:08:48,790
Stop.
201
00:08:48,840 --> 00:08:51,510
I got to stop leaving my things.
202
00:08:51,550 --> 00:08:53,130
Hey, I don't mind.
203
00:08:54,930 --> 00:08:58,800
It gives me an excuse to
come see you during the day.
204
00:08:58,850 --> 00:09:00,890
Dan doesn't know about us, huh?
205
00:09:00,930 --> 00:09:02,140
Dennis.
206
00:09:02,180 --> 00:09:03,930
I know, I know, I know.
207
00:09:03,980 --> 00:09:06,520
You're not telling folks
for the time being.
208
00:09:06,560 --> 00:09:07,810
Have you told anyone?
209
00:09:07,860 --> 00:09:09,820
No. I'm confused.
210
00:09:09,860 --> 00:09:12,280
I mean, would it be the
worst thing if people knew?
211
00:09:12,320 --> 00:09:13,570
No, no.
212
00:09:13,610 --> 00:09:14,740
Of course not.
213
00:09:14,780 --> 00:09:17,320
It's just that you're the
214
00:09:17,370 --> 00:09:20,160
you're the chief
of a department,
215
00:09:20,200 --> 00:09:23,410
and I'm a member of
hospital leadership.
216
00:09:23,450 --> 00:09:25,120
It's not prohibited.
217
00:09:26,210 --> 00:09:28,960
Sharon, colleagues
date all the time.
218
00:09:29,000 --> 00:09:32,340
- It's not a big deal.
- Yeah, but it is to me.
219
00:09:32,380 --> 00:09:36,510
I've always had this strict
policy of not mixing my work
220
00:09:36,550 --> 00:09:39,600
life with my romantic life.
221
00:09:39,640 --> 00:09:41,640
Until now.
222
00:09:42,850 --> 00:09:44,576
And I appreciate you
making that exception.
223
00:09:44,600 --> 00:09:45,560
Believe me.
224
00:09:47,190 --> 00:09:49,190
There's no rush.
225
00:09:49,230 --> 00:09:52,230
We'll take our time
integrating both worlds.
226
00:09:52,270 --> 00:09:55,950
Besides, it's kind of
fun sneaking around.
227
00:10:02,740 --> 00:10:03,700
Got a minute?
228
00:10:03,740 --> 00:10:05,620
Need a surgical consult.
229
00:10:05,660 --> 00:10:07,080
Uh...
230
00:10:07,120 --> 00:10:08,960
Patient's name is
Vince Gonzalez.
231
00:10:09,000 --> 00:10:12,550
He's got metastatic abdominal
sarcoma, presented to the ED
232
00:10:12,590 --> 00:10:14,880
with nausea,
abdominal distension,
233
00:10:14,920 --> 00:10:17,220
and severe belly pain.
234
00:10:17,260 --> 00:10:19,300
Poor guy can't
keep anything down.
235
00:10:19,340 --> 00:10:21,510
Does he have an
obstruction or perforation?
236
00:10:21,550 --> 00:10:23,720
- Free fluid?
- Not on CT.
237
00:10:23,760 --> 00:10:25,560
But the tumor is
severely compressing
238
00:10:25,600 --> 00:10:27,140
his stomach, hence the nausea.
239
00:10:27,180 --> 00:10:29,076
Yeah, I'm not seeing why
you need a surgical consult.
240
00:10:29,100 --> 00:10:30,650
I mean, if the
tumor is metastatic,
241
00:10:30,690 --> 00:10:31,650
it must have been inoperative.
242
00:10:31,690 --> 00:10:33,020
Correct.
243
00:10:33,070 --> 00:10:34,416
And if he's not
completely obstructed,
244
00:10:34,440 --> 00:10:35,860
what do you need me for?
245
00:10:35,900 --> 00:10:38,950
Well, if you debulked a
portion of the tumor here,
246
00:10:38,990 --> 00:10:41,820
then it would allow food to
pass into the small intestine.
247
00:10:41,870 --> 00:10:43,660
So would a feeding tube.
248
00:10:43,700 --> 00:10:45,120
He doesn't want a feeding tube.
249
00:10:45,160 --> 00:10:47,370
Surgery would afford him a
much better quality of life.
250
00:10:47,410 --> 00:10:50,080
Or it could cost him
whatever time he has left.
251
00:10:50,120 --> 00:10:51,600
I mean, we're talking
about a patient
252
00:10:51,630 --> 00:10:54,000
who underwent multiple rounds
of chemo, I'm sure, right?
253
00:10:54,050 --> 00:10:55,590
With zero complications.
254
00:10:55,630 --> 00:10:58,760
He's remarkably fit and
healthy, despite the cancer.
255
00:10:58,800 --> 00:11:00,840
I know this isn't
exactly a sexy surgery.
256
00:11:00,890 --> 00:11:03,180
Whoa. I beg your pardon.
257
00:11:03,220 --> 00:11:05,770
"Sexy surgery"?
258
00:11:05,810 --> 00:11:07,730
I know surgeons don't
like to get involved
259
00:11:07,770 --> 00:11:10,770
in palliative care.
260
00:11:10,810 --> 00:11:13,270
Well, that's quite a
generalization there.
261
00:11:16,530 --> 00:11:18,570
All right. Let's have a look.
262
00:11:18,610 --> 00:11:20,650
Send me the chart.
263
00:11:23,820 --> 00:11:25,700
Don't be brave, OK?
264
00:11:25,740 --> 00:11:28,080
Tell me if it hurts when I push.
265
00:11:28,120 --> 00:11:29,290
I'm all right.
266
00:11:29,330 --> 00:11:30,750
OK.
267
00:11:30,790 --> 00:11:32,056
Well, your CT didn't
show an obstruction,
268
00:11:32,080 --> 00:11:34,340
but just wanted to confirm.
269
00:11:36,630 --> 00:11:38,590
So, Dr. Marcel?
270
00:11:38,630 --> 00:11:40,800
- Yeah.
- Here's the thing.
271
00:11:40,840 --> 00:11:42,470
My husband and I
are supposed to fly
272
00:11:42,510 --> 00:11:43,970
to Italy in three weeks.
273
00:11:44,010 --> 00:11:46,140
My grandmother
was from Positano.
274
00:11:46,180 --> 00:11:49,310
I've always wanted to
go, and we figured,
275
00:11:49,350 --> 00:11:51,640
no time like the present.
276
00:11:51,690 --> 00:11:54,150
You know, how are you doing
with daily activities, Vince?
277
00:11:54,190 --> 00:11:56,440
Things like dressing,
housework, driving?
278
00:11:56,480 --> 00:11:59,860
Before I started
vomiting my supper?
279
00:11:59,900 --> 00:12:01,650
I was totally functional.
280
00:12:01,700 --> 00:12:02,990
I can attest to that.
281
00:12:03,030 --> 00:12:05,780
Most days, Vince has
more energy than me.
282
00:12:05,830 --> 00:12:08,410
You ever had complications
from surgery?
283
00:12:08,450 --> 00:12:11,120
Post-operative issues,
issues with anesthesia?
284
00:12:11,160 --> 00:12:14,170
No, I had my appendix
out when I was 25,
285
00:12:14,210 --> 00:12:16,790
but I didn't have any problems.
286
00:12:16,840 --> 00:12:18,670
Good.
287
00:12:18,710 --> 00:12:20,880
I'm glad to hear it.
288
00:12:20,920 --> 00:12:22,840
Because there is
a surgical option
289
00:12:22,880 --> 00:12:25,390
that could get your GI
system working again.
290
00:12:26,510 --> 00:12:28,930
I like the sound of that.
291
00:12:30,430 --> 00:12:33,020
Why don't you present
it, Dr. Ahmad,
292
00:12:33,060 --> 00:12:35,100
since it was your suggestion?
293
00:12:35,150 --> 00:12:36,230
OK.
294
00:12:37,310 --> 00:12:39,190
Morning.
295
00:12:39,230 --> 00:12:40,780
Your night turn out all right?
296
00:12:40,820 --> 00:12:42,190
It did, actually.
297
00:12:42,240 --> 00:12:45,030
It ended up being a
pretty good first date.
298
00:12:45,070 --> 00:12:47,160
- Oh, yeah?
- Yeah.
299
00:12:47,200 --> 00:12:49,540
Dr. Ripley, we have
a potential wrist
300
00:12:49,580 --> 00:12:51,500
fracture in treatment six.
301
00:12:51,540 --> 00:12:52,636
You mind starting the workup?
302
00:12:52,660 --> 00:12:54,580
I'm just finishing
up with a patient.
303
00:12:54,620 --> 00:12:56,080
You're lucky I like you.
304
00:12:56,130 --> 00:12:56,920
For now.
305
00:12:56,960 --> 00:12:58,210
Thank you, Maggie.
306
00:12:58,250 --> 00:12:59,250
Mm-hmm.
307
00:13:00,550 --> 00:13:01,840
OK.
308
00:13:01,880 --> 00:13:03,800
So, Mrs. Moore, I
understand that you fell
309
00:13:03,840 --> 00:13:05,680
getting out of your car.
310
00:13:05,720 --> 00:13:07,430
Mind if I take a look?
311
00:13:09,010 --> 00:13:11,470
I just want to check
if it's swollen.
312
00:13:16,730 --> 00:13:17,810
I'll be gentle.
313
00:13:21,070 --> 00:13:23,110
Pam, let her look.
314
00:13:25,030 --> 00:13:27,280
My wrist is fine.
315
00:13:27,320 --> 00:13:28,820
I didn't fall.
316
00:13:29,620 --> 00:13:31,410
What?
317
00:13:31,450 --> 00:13:33,450
I don't understand.
318
00:13:34,330 --> 00:13:36,870
- I'm sorry, honey.
- I didn't have any other choice.
319
00:13:36,920 --> 00:13:38,710
What are you talking about?
320
00:13:40,380 --> 00:13:43,460
My husband is depressed and
refuses to get any help.
321
00:13:43,510 --> 00:13:45,010
Pamela!
322
00:13:45,050 --> 00:13:47,760
And I am so afraid he's
gonna hurt himself.
323
00:13:58,878 --> 00:14:01,705
Look, I appreciate you have
to do your due diligence.
324
00:14:01,730 --> 00:14:03,860
My wife mentioned the
possibility of self-harm,
325
00:14:03,900 --> 00:14:05,860
so you can't just
send me on my way.
326
00:14:05,900 --> 00:14:08,700
Yeah, she mentioned to Nurse
Lockwood a comment you made.
327
00:14:08,740 --> 00:14:10,120
Right.
328
00:14:10,160 --> 00:14:12,160
I said something stupid
like, "Going to bed
329
00:14:12,200 --> 00:14:14,290
and never waking up sounds
like a nice way to go."
330
00:14:14,330 --> 00:14:15,330
Huh.
331
00:14:15,370 --> 00:14:17,330
Come on. I was
speaking generally.
332
00:14:17,370 --> 00:14:19,210
A nice way to go, as opposed to,
333
00:14:19,250 --> 00:14:21,590
I don't know,
getting hit by a bus.
334
00:14:21,630 --> 00:14:23,130
OK.
335
00:14:23,170 --> 00:14:25,420
Um, apparently, you have
been losing some weight.
336
00:14:25,460 --> 00:14:28,340
I was diagnosed with type
2 diabetes not long ago.
337
00:14:28,380 --> 00:14:30,050
I've been pretty
diligent about my diet,
338
00:14:30,090 --> 00:14:31,640
getting regular exercise.
339
00:14:31,680 --> 00:14:34,010
Frankly, I'm glad the
hard work's paying off.
340
00:14:34,060 --> 00:14:35,390
Well, then, Paul, help me out.
341
00:14:35,430 --> 00:14:37,640
I mean, why do you
think that your wife's
342
00:14:37,690 --> 00:14:38,890
so concerned about you?
343
00:14:40,770 --> 00:14:43,730
I admit I haven't been
in the best mood lately.
344
00:14:43,770 --> 00:14:45,480
My fuse is probably shorter.
345
00:14:45,530 --> 00:14:46,990
Yeah.
346
00:14:47,030 --> 00:14:49,110
I mean, she's...
she's concerned that,
347
00:14:49,160 --> 00:14:51,240
you know, you've been isolating,
348
00:14:51,280 --> 00:14:53,580
withdrawing from
her, your friends.
349
00:14:53,620 --> 00:14:56,120
I haven't felt like
socializing lately.
350
00:14:56,160 --> 00:14:57,410
So when was the last time...
351
00:14:57,460 --> 00:14:58,750
Let me save you some time, OK?
352
00:14:58,790 --> 00:15:02,250
I have no intention or
desire to hurt myself.
353
00:15:02,290 --> 00:15:03,540
And I'm glad to hear it.
354
00:15:03,590 --> 00:15:05,250
So ask whatever
questions you need
355
00:15:05,300 --> 00:15:07,840
to cover the hospital's ass.
356
00:15:07,880 --> 00:15:10,130
I am not suicidal, Dr. Charles.
357
00:15:10,180 --> 00:15:13,010
Pam is just making
something out of nothing.
358
00:15:13,050 --> 00:15:15,470
Her specialty.
359
00:15:15,510 --> 00:15:17,430
Mm.
360
00:15:20,770 --> 00:15:23,020
Within an hour of
posting Vince's surgery,
361
00:15:23,060 --> 00:15:25,400
his insurance company denied it,
362
00:15:25,440 --> 00:15:27,030
rejected it on the grounds of it
363
00:15:27,070 --> 00:15:28,530
not being medically necessary.
364
00:15:28,570 --> 00:15:30,280
There are alternative
treatment options.
365
00:15:30,320 --> 00:15:31,950
The feeding tube
Vince doesn't want.
366
00:15:31,990 --> 00:15:33,370
Yep.
367
00:15:33,410 --> 00:15:36,790
Man, I am so fed up with
prior authorization.
368
00:15:36,830 --> 00:15:39,410
About a dozen times a month,
my patients get screwed by it.
369
00:15:39,460 --> 00:15:40,870
What insurance does Vince have?
370
00:15:40,920 --> 00:15:42,040
Berninger Health Network.
371
00:15:42,080 --> 00:15:43,790
Of course, one of the worst.
372
00:15:43,830 --> 00:15:46,300
They deny more patients
than any other company,
373
00:15:46,340 --> 00:15:49,050
pay physician reviewers six
figures to look at charts
374
00:15:49,090 --> 00:15:50,970
and find reasons to deny.
375
00:15:53,840 --> 00:15:55,736
I guess we should tell
him before he gets a form
376
00:15:55,760 --> 00:15:56,890
email from his insurance.
377
00:15:56,930 --> 00:15:58,810
Yeah.
378
00:16:05,440 --> 00:16:06,860
So what's the verdict?
379
00:16:06,900 --> 00:16:09,440
Is his wife right that
he's a danger to himself?
380
00:16:09,490 --> 00:16:11,070
You know, I don't know yet.
381
00:16:11,110 --> 00:16:12,950
I mean, he's adamant
that he's not, right?
382
00:16:12,990 --> 00:16:15,530
But about 50% of the people
with suicidal ideation
383
00:16:15,570 --> 00:16:16,780
deny it.
384
00:16:16,830 --> 00:16:18,620
I'm more concerned by
his wife's concern,
385
00:16:18,660 --> 00:16:19,910
if that makes sense.
386
00:16:19,950 --> 00:16:21,766
I mean, she pulled off
a pretty elaborate ruse
387
00:16:21,790 --> 00:16:22,846
to get him through our doors.
388
00:16:22,870 --> 00:16:24,250
Exactly.
389
00:16:24,290 --> 00:16:25,790
So what's the game plan?
390
00:16:25,840 --> 00:16:28,460
I want to talk to her
some more, all right?
391
00:16:28,500 --> 00:16:30,970
I also want to just look at his
medical history a little more
392
00:16:31,010 --> 00:16:34,510
carefully, you know, find out
what kind of access, if any,
393
00:16:34,550 --> 00:16:36,350
he has to firearms,
to see if I can come
394
00:16:36,390 --> 00:16:37,890
up with any evidence at all
395
00:16:37,930 --> 00:16:39,116
that he's planning
to hurt himself.
396
00:16:39,140 --> 00:16:40,656
All right. I'll keep
him comfortable.
397
00:16:40,680 --> 00:16:42,746
All right, and Mags, if he
gets antsy and starts talking
398
00:16:42,770 --> 00:16:43,600
about getting out of here...
399
00:16:43,640 --> 00:16:44,980
- I'll page you.
- Thank you.
400
00:16:45,020 --> 00:16:46,150
Yeah.
401
00:16:51,110 --> 00:16:52,700
Where is Hannah Asher?
402
00:16:52,740 --> 00:16:53,740
Excuse me?
403
00:16:53,780 --> 00:16:55,360
Where is Hannah Asher?
404
00:16:55,410 --> 00:16:58,700
She's probably with a patient.
405
00:16:58,740 --> 00:17:00,790
Ma'am.
406
00:17:00,830 --> 00:17:02,660
Ma'am, you can't do that.
407
00:17:04,500 --> 00:17:06,420
Ma'am.
408
00:17:06,460 --> 00:17:09,420
OK, this is gonna
feel a little cold.
409
00:17:09,460 --> 00:17:10,340
OK?
410
00:17:10,380 --> 00:17:12,210
You're Hannah Asher?
411
00:17:12,260 --> 00:17:13,590
Do you know this woman?
412
00:17:13,630 --> 00:17:16,930
Um, no.
413
00:17:16,970 --> 00:17:18,300
Do you want me to remove her?
414
00:17:18,350 --> 00:17:19,786
- I'd like to see you try.
- Hold on.
415
00:17:19,810 --> 00:17:20,890
Hold on a second.
416
00:17:20,930 --> 00:17:22,220
I'm Dr. Hannah Asher.
417
00:17:22,270 --> 00:17:23,230
Is there a problem?
418
00:17:23,270 --> 00:17:24,810
Problem?
419
00:17:24,850 --> 00:17:26,980
Well, you went on a date
with my husband last night,
420
00:17:27,020 --> 00:17:28,730
so yeah, we've got a problem.
421
00:17:33,530 --> 00:17:35,200
Vince, we're
submitting an appeal
422
00:17:35,240 --> 00:17:37,820
to your insurance company, OK?
423
00:17:37,870 --> 00:17:40,790
We've been through
the appeals process.
424
00:17:42,950 --> 00:17:45,790
When Vince's doctor first
suspected something was wrong,
425
00:17:45,830 --> 00:17:47,460
he ordered a CT.
426
00:17:47,500 --> 00:17:49,880
Insurance wouldn't
approve it initially.
427
00:17:49,920 --> 00:17:52,920
Said there wasn't sufficient
evidence to warrant it.
428
00:17:52,960 --> 00:17:55,550
It took them three months to
finally get it authorized.
429
00:17:55,590 --> 00:17:57,090
- Yeah.
- Who knows how much
430
00:17:57,130 --> 00:18:00,100
the tumor grew in that time?
431
00:18:00,140 --> 00:18:02,600
Vince.
432
00:18:02,640 --> 00:18:05,060
I know you were trying
to avoid a feeding tube.
433
00:18:05,100 --> 00:18:06,770
No.
434
00:18:06,810 --> 00:18:09,440
No feeding tube.
435
00:18:09,480 --> 00:18:11,190
Look, we could place
a temporary one.
436
00:18:11,230 --> 00:18:12,400
No.
437
00:18:12,440 --> 00:18:14,030
Without a feeding tube...
438
00:18:14,070 --> 00:18:15,990
I'm gonna lose time.
439
00:18:16,030 --> 00:18:17,490
I understand that.
440
00:18:17,530 --> 00:18:20,200
You could die in weeks,
441
00:18:20,240 --> 00:18:21,950
possibly days.
442
00:18:26,960 --> 00:18:28,210
When we first got the news
443
00:18:28,250 --> 00:18:30,170
that nothing more could be done,
444
00:18:30,210 --> 00:18:32,500
that this was terminal,
445
00:18:32,550 --> 00:18:34,590
we came up with a
model for how we were
446
00:18:34,630 --> 00:18:36,840
going to approach this next
447
00:18:36,880 --> 00:18:37,930
phase.
448
00:18:42,850 --> 00:18:45,220
Quality over time, right?
449
00:18:46,730 --> 00:18:48,770
No feeding tube.
450
00:18:55,110 --> 00:18:57,360
OK.
451
00:18:57,400 --> 00:18:58,490
Get some rest.
452
00:18:58,530 --> 00:19:00,570
Be back in a bit, OK?
453
00:19:07,660 --> 00:19:09,120
Yeah.
454
00:19:09,170 --> 00:19:10,710
Thanks.
455
00:19:10,750 --> 00:19:13,790
I'm gonna talk to a
utilization review specialist,
456
00:19:13,840 --> 00:19:16,260
see if I can expedite
the appeal process.
457
00:19:16,300 --> 00:19:18,880
You really think that's gonna
make much of a difference?
458
00:19:18,920 --> 00:19:20,890
Worth a shot.
459
00:19:31,690 --> 00:19:33,980
I did go out last
night, but it wasn't
460
00:19:34,020 --> 00:19:35,190
with anyone that was married.
461
00:19:35,230 --> 00:19:37,400
All right, guys. Come on.
462
00:19:37,440 --> 00:19:38,530
Show's over, huh?
463
00:19:38,570 --> 00:19:40,200
I went out with Kyle.
464
00:19:40,240 --> 00:19:42,530
- Kyle?
- Yeah.
465
00:19:43,990 --> 00:19:45,910
Yeah, that's him.
466
00:19:47,160 --> 00:19:48,500
His name is Nick Dunn.
467
00:19:48,540 --> 00:19:50,500
He's not an architect.
He's a general contractor.
468
00:19:50,540 --> 00:19:52,920
I'm so... oh, God.
469
00:19:52,960 --> 00:19:55,380
You really didn't
know he was married?
470
00:19:55,420 --> 00:19:56,920
No, I swear.
471
00:19:56,960 --> 00:19:58,840
I...
472
00:20:03,640 --> 00:20:05,220
I'm gonna kill him.
473
00:20:05,260 --> 00:20:06,430
Well, I...
474
00:20:06,470 --> 00:20:08,970
How could he do this to me?
475
00:20:09,020 --> 00:20:10,270
I'm carrying our child.
476
00:20:10,310 --> 00:20:11,600
It's absolutely terrible.
477
00:20:11,640 --> 00:20:13,850
- I agree...
- I knew something was up.
478
00:20:13,900 --> 00:20:15,746
I thought it was just new
dad jitters, you know?
479
00:20:15,770 --> 00:20:19,070
In a million years, I never
480
00:20:19,110 --> 00:20:20,070
oh.
481
00:20:20,110 --> 00:20:22,030
Are you OK?
482
00:20:22,070 --> 00:20:23,450
I think my water just broke.
483
00:20:29,250 --> 00:20:30,370
How many weeks are you?
484
00:20:30,410 --> 00:20:32,460
38.
485
00:20:32,500 --> 00:20:34,670
I would like to get
you on a monitor.
486
00:20:34,710 --> 00:20:36,710
No, no, no, no, I'm
going to see my own doct
487
00:20:36,750 --> 00:20:38,550
- oh!
- Hey, hey, hey, breathe.
488
00:20:38,590 --> 00:20:40,800
- Breathe with me.
- I know how to breathe.
489
00:20:42,470 --> 00:20:44,220
This can't be happening.
490
00:20:52,795 --> 00:20:56,060
Can you put your knees
up for me, please?
491
00:20:58,070 --> 00:21:00,030
You're gonna feel a
little bit of pressure.
492
00:21:00,055 --> 00:21:01,170
OK.
493
00:21:02,780 --> 00:21:05,780
OK, so, Tessa, you
are fully dilated.
494
00:21:05,820 --> 00:21:07,240
What?
495
00:21:07,280 --> 00:21:09,700
Yep, which means there is
no time to move upstairs
496
00:21:09,740 --> 00:21:11,000
or wait for your doctor.
497
00:21:11,040 --> 00:21:13,040
No, no, no. I can't
have my baby here.
498
00:21:13,080 --> 00:21:14,396
The ED is fully
equipped for delivery.
499
00:21:14,420 --> 00:21:16,210
No, I can't have
you deliver my baby.
500
00:21:16,250 --> 00:21:17,540
I'm sorry.
501
00:21:17,590 --> 00:21:18,606
Look, I get that I'm
not your first option.
502
00:21:18,630 --> 00:21:19,816
In fact, I'm probably your last.
503
00:21:19,840 --> 00:21:22,170
But I am a
board-certified OBGYN,
504
00:21:22,210 --> 00:21:23,840
and I have delivered
hundreds of babies.
505
00:21:23,880 --> 00:21:26,970
And I will get yours out
safely if we work together.
506
00:21:32,100 --> 00:21:33,560
OK, change of plans.
507
00:21:33,600 --> 00:21:34,956
Tessa's ready to deliver now,
so we're gonna do it here.
508
00:21:34,980 --> 00:21:36,270
Oh, OK.
509
00:21:36,310 --> 00:21:38,730
Yep, so get me another
nurse, a delivery table,
510
00:21:38,770 --> 00:21:40,860
and grab another doctor,
whoever's available.
511
00:21:40,900 --> 00:21:43,490
We'll maybe need an
extra set of hands.
512
00:21:45,110 --> 00:21:46,910
We got this, OK?
513
00:21:46,950 --> 00:21:48,120
OK.
514
00:21:51,200 --> 00:21:52,580
Where are we at?
515
00:21:52,620 --> 00:21:54,580
Long and short of it,
Paul is depressed,
516
00:21:54,620 --> 00:21:56,330
but his risk of suicide is low.
517
00:21:56,370 --> 00:21:59,130
Couldn't find any evidence
of any kind of intent
518
00:21:59,170 --> 00:22:00,750
to harm himself.
519
00:22:00,800 --> 00:22:02,526
All right, so I'll get his
discharge paperwork ready.
520
00:22:02,550 --> 00:22:04,590
Do you want to include
a psych referral?
521
00:22:04,630 --> 00:22:06,720
You know, Mags, I'm
actually not quite ready
522
00:22:06,760 --> 00:22:07,970
to discharge him.
523
00:22:08,010 --> 00:22:09,300
OK.
524
00:22:09,350 --> 00:22:10,760
Here's the thing, right?
525
00:22:10,810 --> 00:22:13,180
He gets diagnosed with
sudden-onset type 2 diabetes
526
00:22:13,220 --> 00:22:14,230
six months ago.
527
00:22:14,270 --> 00:22:17,270
No family history,
low BMI, right?
528
00:22:17,310 --> 00:22:19,770
And we all know that when you
get diagnosed with type 2,
529
00:22:19,810 --> 00:22:21,230
you don't lose weight.
530
00:22:21,270 --> 00:22:22,820
No, you gain weight, right?
531
00:22:22,860 --> 00:22:24,780
And then, there's the
sudden-onset depression.
532
00:22:24,820 --> 00:22:26,950
Again, no history, right?
533
00:22:26,990 --> 00:22:28,320
No triggers.
534
00:22:28,360 --> 00:22:30,700
I'm just wondering if we're
not missing something,
535
00:22:30,740 --> 00:22:32,910
you know, some underlying
medical condition.
536
00:22:32,950 --> 00:22:34,910
Do you want to
order a set of labs?
537
00:22:34,950 --> 00:22:36,960
Let's start out with
a CBC and a CMP,
538
00:22:37,000 --> 00:22:39,210
and I'm gonna dig
into the literature,
539
00:22:39,250 --> 00:22:42,420
see if I can't find some
kind of common thread.
540
00:22:42,460 --> 00:22:43,590
You got it.
541
00:22:47,050 --> 00:22:50,970
After lambasting them for
denying the patient's surgery,
542
00:22:51,010 --> 00:22:55,100
Dr. Ahmad goes on to
tag you, Dr. Marcel.
543
00:22:55,140 --> 00:22:57,140
"Berninger is the worst.
544
00:22:57,180 --> 00:23:00,190
"Not only do they deny
more patients than anyone,
545
00:23:00,230 --> 00:23:02,480
"they also pay physician
reviewers six figures
546
00:23:02,520 --> 00:23:04,570
to find reasons to deny."
547
00:23:04,610 --> 00:23:06,900
Now, while Dr. Ahmad is entitled
548
00:23:06,940 --> 00:23:10,110
to express her personal
opinions on her social media...
549
00:23:10,160 --> 00:23:12,160
You, sir, are a representative
550
00:23:12,200 --> 00:23:13,830
of the board now.
551
00:23:13,870 --> 00:23:16,040
I had no idea she
was gonna post this.
552
00:23:16,080 --> 00:23:19,370
She didn't ask you before
she publicly quoted you?
553
00:23:19,420 --> 00:23:21,920
No. She did not.
554
00:23:21,960 --> 00:23:23,840
We are on the eve
of hammering out
555
00:23:23,880 --> 00:23:26,710
a new three-year
contract with Berninger.
556
00:23:26,760 --> 00:23:28,970
And antagonizing them
with a PR nightmare
557
00:23:29,010 --> 00:23:31,260
is not exactly the
tone we wanted to set.
558
00:23:31,300 --> 00:23:33,140
We're talking about
one post here.
559
00:23:33,180 --> 00:23:34,890
I'm sure no one's
even gonna see it.
560
00:23:34,930 --> 00:23:38,060
It's going viral, Dr. Marcel.
561
00:23:40,560 --> 00:23:42,020
- What?
- Yeah.
562
00:23:42,060 --> 00:23:43,980
So we are gonna need to
do major damage control
563
00:23:44,020 --> 00:23:47,190
at the board meeting
this afternoon.
564
00:23:47,230 --> 00:23:49,530
Just follow my lead.
565
00:23:55,120 --> 00:23:56,620
What is this?
566
00:23:58,620 --> 00:24:00,726
Now, I share something with
you in a clinical setting,
567
00:24:00,750 --> 00:24:02,016
I don't expect to
see it plastered
568
00:24:02,040 --> 00:24:03,516
all over social
media, you understand?
569
00:24:03,540 --> 00:24:05,066
I should have checked with
you before I posted it.
570
00:24:05,090 --> 00:24:07,630
Yeah, that much is obvious.
571
00:24:07,670 --> 00:24:09,050
I don't mean to sound ingenuous,
572
00:24:09,090 --> 00:24:10,720
but I didn't think
that you would mind.
573
00:24:10,760 --> 00:24:12,640
Being publicly quoted
without my consent?
574
00:24:12,680 --> 00:24:14,390
Yeah, I mind, a lot.
575
00:24:14,430 --> 00:24:16,760
- But what you said was true.
- That isn't the point.
576
00:24:16,810 --> 00:24:18,560
Look, you want to
have a viral moment?
577
00:24:18,600 --> 00:24:19,770
Be my guest.
578
00:24:19,810 --> 00:24:21,140
But don't do it at my expense.
579
00:24:21,190 --> 00:24:23,060
This isn't about
having a viral moment.
580
00:24:23,100 --> 00:24:26,440
I... this strategy might seem
unorthodox, but it works.
581
00:24:26,480 --> 00:24:27,730
Strategy?
582
00:24:27,780 --> 00:24:29,216
Since when did venting
on social media
583
00:24:29,240 --> 00:24:30,610
become a strategy?
584
00:24:30,650 --> 00:24:32,780
Public shaming is a way to
get companies' attention
585
00:24:32,820 --> 00:24:34,240
and move them to act.
586
00:24:34,280 --> 00:24:37,030
Case in point, after the
post started trending,
587
00:24:37,080 --> 00:24:40,410
Berninger sent notice, and
they escalated Vince's appeal
588
00:24:40,450 --> 00:24:42,420
for a peer-to-peer call.
589
00:24:42,460 --> 00:24:43,960
Really?
590
00:24:44,000 --> 00:24:46,106
Yeah, which is why we can't
let up on public pressure.
591
00:24:46,130 --> 00:24:48,250
I got a DM from a
local news reporter.
592
00:24:48,300 --> 00:24:50,670
She wants to interview
us on Vince's case.
593
00:24:50,720 --> 00:24:52,380
What are you, out of your mind?
594
00:24:52,430 --> 00:24:53,470
I can't do that.
595
00:24:53,510 --> 00:24:54,970
Why not?
596
00:24:55,010 --> 00:24:56,970
Because the hospital's
got an upcoming contract
597
00:24:57,010 --> 00:25:00,180
negotiation with Berninger.
598
00:25:00,220 --> 00:25:01,520
Ah.
599
00:25:01,560 --> 00:25:04,600
So this is why the post
was such a big issue?
600
00:25:04,650 --> 00:25:07,190
That has nothing to
do with my issue,
601
00:25:07,230 --> 00:25:10,110
which is your total disregard
for professional courtesy.
602
00:25:14,570 --> 00:25:19,540
You should know that the post
wasn't just liked or reposted.
603
00:25:19,580 --> 00:25:22,710
People shared their hellish
experiences with Berninger.
604
00:25:22,750 --> 00:25:25,620
Hundreds of people,
including MDs.
605
00:25:25,670 --> 00:25:27,960
What you said resonated.
606
00:25:28,000 --> 00:25:30,170
It needed to be said.
607
00:25:31,880 --> 00:25:34,130
OK, Tessa, the head is coming.
608
00:25:34,180 --> 00:25:35,630
You're crowning.
609
00:25:35,680 --> 00:25:37,180
I am?
610
00:25:37,220 --> 00:25:39,350
- You're doing great.
- Thank you.
611
00:25:40,350 --> 00:25:42,600
Hannah?
612
00:25:42,640 --> 00:25:44,310
What... what's going on?
613
00:25:44,350 --> 00:25:46,980
The head is out, but the
shoulders aren't coming.
614
00:25:47,020 --> 00:25:48,810
What? She's stuck?
615
00:25:48,860 --> 00:25:50,400
This can happen
with bigger babies.
616
00:25:50,440 --> 00:25:52,320
Don't worry, we will
get her out, Tessa, OK?
617
00:25:52,360 --> 00:25:54,490
Nancy, I need you to
switch with Dr. Ripley.
618
00:25:54,530 --> 00:25:55,780
Put her into McRoberts.
619
00:25:55,820 --> 00:25:57,046
Dr. Ripley, I'm gonna
need you to apply
620
00:25:57,070 --> 00:25:58,950
suprapubic pressure from above
621
00:25:58,990 --> 00:25:59,870
while I maneuver
the baby out, OK?
622
00:25:59,910 --> 00:26:01,040
You got it.
623
00:26:01,080 --> 00:26:02,370
All right, Tessa, you got this.
624
00:26:02,410 --> 00:26:04,710
When I say push, you push
as hard as you can, OK?
625
00:26:04,750 --> 00:26:06,170
Let's go.
626
00:26:06,210 --> 00:26:07,460
Go.
627
00:26:11,500 --> 00:26:13,340
Here we go, here
we go, here we go!
628
00:26:14,420 --> 00:26:16,630
I got her!
629
00:26:18,090 --> 00:26:19,550
There's your baby girl.
630
00:26:19,600 --> 00:26:22,520
- Oh!
- Oh, my baby.
631
00:26:26,520 --> 00:26:27,810
Thank you.
632
00:26:43,580 --> 00:26:45,120
Look, just... just hold on.
633
00:26:45,160 --> 00:26:46,636
Because it says here on
my... what do you call this?
634
00:26:46,660 --> 00:26:49,250
Patient portal... that my blood
work all came back normal.
635
00:26:49,290 --> 00:26:50,290
I understand.
636
00:26:50,330 --> 00:26:51,710
So why can't you discharge me?
637
00:26:51,750 --> 00:26:53,880
Because Dr. Charles needs
to sign off your chart.
638
00:26:53,920 --> 00:26:55,590
Well, then go get Dr. Charles.
639
00:26:55,630 --> 00:26:56,720
Paul, don't yell at her.
640
00:26:56,760 --> 00:26:58,050
Don't tell me what to do.
641
00:26:58,090 --> 00:26:59,930
This is all your
fault. If you had...
642
00:26:59,970 --> 00:27:01,260
Dr. Charles?
643
00:27:01,300 --> 00:27:03,310
Dr. Charles, I'd
like to go home now.
644
00:27:03,350 --> 00:27:05,180
I understand you have
to sign off on that.
645
00:27:05,220 --> 00:27:06,600
I do.
646
00:27:06,640 --> 00:27:08,416
And look, Paul, I know
you've had a really long day.
647
00:27:08,440 --> 00:27:09,730
I certainly have.
648
00:27:09,770 --> 00:27:11,086
But I'd like to order
just a couple more labs
649
00:27:11,110 --> 00:27:13,440
and actually get a
CT of your abdomen.
650
00:27:13,480 --> 00:27:15,440
- Why?
- My blood work came back normal.
651
00:27:15,480 --> 00:27:17,110
You know, there are
certain illnesses
652
00:27:17,150 --> 00:27:19,256
that, early on, they just
kind of fly under the radar.
653
00:27:19,280 --> 00:27:20,990
Like what? What are
you looking for?
654
00:27:21,030 --> 00:27:22,870
Well, certain medical
conditions, right,
655
00:27:22,910 --> 00:27:24,910
can raise inflammation
in the body,
656
00:27:24,950 --> 00:27:27,160
which can cause depression.
657
00:27:27,200 --> 00:27:29,460
Yeah, but you've clearly
narrowed that list down now.
658
00:27:29,500 --> 00:27:31,500
Why are you looking
at my stomach?
659
00:27:31,540 --> 00:27:34,920
There is evidence that
disruptions in the physiologic
660
00:27:34,960 --> 00:27:36,090
functions of the pancreas
661
00:27:36,130 --> 00:27:38,300
in this case, neurotransmission
662
00:27:38,340 --> 00:27:40,630
can alter mood and
anxiety levels.
663
00:27:40,680 --> 00:27:43,680
And in very rare cases,
sudden-onset diabetes
664
00:27:43,720 --> 00:27:46,770
has been known to be caused
by a growth in the pancreas.
665
00:27:52,360 --> 00:27:53,860
What, you...
666
00:27:56,030 --> 00:27:57,940
You think I have
pancreatic cancer?
667
00:27:57,990 --> 00:27:59,670
I'm more thinking
about this as something
668
00:27:59,700 --> 00:28:01,200
I'd like to rule out.
669
00:28:26,010 --> 00:28:27,373
Well, I want to
start by welcoming
670
00:28:27,398 --> 00:28:28,720
our newest member to the board,
671
00:28:28,770 --> 00:28:30,020
Dr. Crockett Marcel.
672
00:28:32,140 --> 00:28:33,620
All right, then.
Let's dive right in.
673
00:28:33,650 --> 00:28:36,820
Barry, if I may, I'd
actually like to address
674
00:28:36,860 --> 00:28:38,900
the elephant in the room.
675
00:28:40,780 --> 00:28:42,280
Sure, Peter.
676
00:28:42,320 --> 00:28:46,530
I think we're all aware of
the social media firestorm.
677
00:28:46,580 --> 00:28:49,250
Strike that... "firestorm" is
making a mountain out of a...
678
00:28:49,290 --> 00:28:50,710
Peter.
679
00:28:50,750 --> 00:28:53,460
Get to the point.
680
00:28:53,500 --> 00:28:57,210
An overzealous resident
misquoted Dr. Marcel
681
00:28:57,250 --> 00:28:58,960
to serve her own agenda.
682
00:28:59,000 --> 00:29:01,010
No, that's not...
683
00:29:01,050 --> 00:29:03,550
- Dr. Marcel...
- I was quoted accurately.
684
00:29:03,590 --> 00:29:06,550
OK? Let me start by owning that.
685
00:29:06,600 --> 00:29:09,390
And Dr. Ahmad was not
serving her own agenda.
686
00:29:09,430 --> 00:29:11,810
She was trying to
help our dying patient
687
00:29:11,850 --> 00:29:14,270
battle his insurance company,
688
00:29:14,310 --> 00:29:16,400
which is a fight
doctors typically avoid.
689
00:29:16,440 --> 00:29:18,270
Trust me, I know,
it's not our lane.
690
00:29:18,320 --> 00:29:21,400
We don't deal with insurance.
691
00:29:21,440 --> 00:29:23,280
And honestly, I feel
it's time we did.
692
00:29:23,320 --> 00:29:25,910
Because these companies
are stepping into our lane.
693
00:29:30,120 --> 00:29:33,160
Take the patient
Dr. Ahmad posted about.
694
00:29:33,210 --> 00:29:36,080
Now, he was diagnosed
with stage four cancer
695
00:29:36,130 --> 00:29:38,590
three months after his
doctor first suspected
696
00:29:38,630 --> 00:29:39,590
something was wrong.
697
00:29:39,630 --> 00:29:41,920
Why such a long gap?
698
00:29:41,960 --> 00:29:43,880
Because the CT
his doctor ordered
699
00:29:43,920 --> 00:29:45,550
required prior authorization,
700
00:29:45,590 --> 00:29:47,300
and Berninger denied it.
701
00:29:50,470 --> 00:29:52,640
That's the crux of the issue.
702
00:30:03,360 --> 00:30:05,200
Paul, Pamela, I want
to introduce you
703
00:30:05,240 --> 00:30:08,450
to Dr. Washington, who
is our head of oncology
704
00:30:08,490 --> 00:30:10,280
here at Gaffney.
705
00:30:10,330 --> 00:30:11,950
Oh, wow, top dog.
706
00:30:11,990 --> 00:30:13,700
This must be bad.
707
00:30:13,750 --> 00:30:15,370
Don't read in to the title.
708
00:30:15,410 --> 00:30:17,920
While you do have a small
mass in your pancreas...
709
00:30:17,960 --> 00:30:19,090
OK.
710
00:30:19,130 --> 00:30:22,000
It's confined to the tail,
711
00:30:22,050 --> 00:30:23,840
which means it's resectable.
712
00:30:23,880 --> 00:30:25,880
That's good, right?
713
00:30:25,930 --> 00:30:27,220
It's really good.
714
00:30:27,260 --> 00:30:28,970
Surgery is far and
away the best treatment
715
00:30:29,010 --> 00:30:30,810
for pancreatic cancer.
716
00:30:30,850 --> 00:30:32,600
And it's rarely an option.
717
00:30:32,640 --> 00:30:34,020
The cancer is
usually too advanced
718
00:30:34,060 --> 00:30:35,480
by the time we catch it.
719
00:30:35,520 --> 00:30:38,350
I advise a few rounds of
chemo to shrink the tumor
720
00:30:38,400 --> 00:30:41,520
and then the distal
pancreatectomy to remove it.
721
00:30:43,690 --> 00:30:46,400
Few doctors would have
connected the dots here.
722
00:30:46,450 --> 00:30:48,780
You're lucky you ended up
with this one, Mr. Moore.
723
00:30:49,990 --> 00:30:51,910
I'm realizing that.
724
00:30:51,950 --> 00:30:54,040
Thank you, Dr. Charles.
725
00:30:54,080 --> 00:30:56,540
Absolutely a team effort.
726
00:31:01,170 --> 00:31:02,880
Thank you, Pam.
727
00:31:02,920 --> 00:31:05,170
It's not lost on me if
you hadn't conned me
728
00:31:05,210 --> 00:31:07,300
into coming in here today...
729
00:31:07,340 --> 00:31:08,590
You're gonna be OK.
730
00:31:08,630 --> 00:31:10,140
That's all I care about.
731
00:31:25,900 --> 00:31:27,070
Hey.
732
00:31:27,110 --> 00:31:28,820
I'm looking for my wife.
733
00:31:34,790 --> 00:31:35,950
Hannah.
734
00:31:36,000 --> 00:31:37,250
Nick.
735
00:31:38,410 --> 00:31:39,870
H-how do you know...
736
00:31:39,920 --> 00:31:41,750
I just delivered your baby.
737
00:31:41,790 --> 00:31:43,340
What?
738
00:31:44,590 --> 00:31:46,550
- Does Tessa...
- Oh, she knows.
739
00:31:46,590 --> 00:31:49,130
- Oh, no.
- She hacked into your phone,
740
00:31:49,180 --> 00:31:50,736
found your messages,
and tracked me down.
741
00:31:50,760 --> 00:31:51,680
Oh, my God.
742
00:31:51,720 --> 00:31:53,300
- Is that why she's here?
- Shh!
743
00:31:53,350 --> 00:31:54,640
She's sleeping.
744
00:31:54,680 --> 00:31:56,310
What did she say?
745
00:31:56,350 --> 00:31:58,060
Is this why she went into labor?
746
00:31:58,100 --> 00:32:00,640
Well, it's definitely
possible for emotional stress
747
00:32:00,690 --> 00:32:02,730
to induce labor.
748
00:32:02,770 --> 00:32:07,230
But regardless, Tessa gave
birth to a healthy baby girl,
749
00:32:07,280 --> 00:32:09,860
and both mom and
baby are doing well.
750
00:32:09,900 --> 00:32:11,200
Oh, thank God.
751
00:32:15,830 --> 00:32:17,200
Look, Hannah, I'm...
752
00:32:17,240 --> 00:32:18,750
I'm not a cheater.
753
00:32:18,790 --> 00:32:21,500
Yeah, well, last night
would suggest otherwise.
754
00:32:21,540 --> 00:32:24,590
You were the only woman I
messaged on that app, OK?
755
00:32:24,630 --> 00:32:27,130
And I had no intention
of ever seeing you again.
756
00:32:27,170 --> 00:32:29,220
Don't flatter yourself.
757
00:32:29,260 --> 00:32:31,760
Look, I made a horrible mistake.
758
00:32:31,800 --> 00:32:33,890
I was freaking out about
becoming a dad, you know,
759
00:32:33,930 --> 00:32:37,600
and I just thought, one
last night of freedom...
760
00:32:37,640 --> 00:32:40,810
OK, save your rationalizations
for your wife.
761
00:32:40,850 --> 00:32:43,440
Or better yet, spare her.
762
00:32:43,480 --> 00:32:45,860
I think that your
time is best used
763
00:32:45,900 --> 00:32:48,070
begging Tessa for forgiveness.
764
00:33:10,300 --> 00:33:11,840
Hey.
765
00:33:13,760 --> 00:33:15,140
What is it?
766
00:33:15,180 --> 00:33:16,890
Vince just started
vomiting blood.
767
00:33:26,730 --> 00:33:28,070
Dr. Charles?
768
00:33:28,110 --> 00:33:29,780
Mrs. Moore?
769
00:33:29,820 --> 00:33:31,190
Are you all right?
770
00:33:31,240 --> 00:33:33,650
Look, we know it's
a scary diagnosis,
771
00:33:33,700 --> 00:33:35,360
but in terms of
pancreatic cancer,
772
00:33:35,410 --> 00:33:37,830
his prognosis could
not be better.
773
00:33:37,870 --> 00:33:40,240
And that's largely
because of your efforts.
774
00:33:40,290 --> 00:33:42,710
You saved his life by
bringing him in today.
775
00:33:42,750 --> 00:33:45,670
Well, he has quite a
way of thanking me.
776
00:33:48,340 --> 00:33:50,170
He wants a divorce.
777
00:34:01,720 --> 00:34:03,520
Vince, we're concerned
you may be developing
778
00:34:03,545 --> 00:34:05,060
a tear in your lower esophagus
779
00:34:05,100 --> 00:34:07,480
from all of the vomiting.
780
00:34:07,520 --> 00:34:09,480
I'd like to place
an NG tube, Vince.
781
00:34:09,520 --> 00:34:10,980
- No.
- Just for the time being.
782
00:34:11,030 --> 00:34:12,102
No, no tubes.
783
00:34:12,127 --> 00:34:13,916
How many times do I
have to tell you...
784
00:34:13,940 --> 00:34:15,110
Hear me out.
785
00:34:15,150 --> 00:34:16,570
It's not a feeding tube.
786
00:34:16,610 --> 00:34:18,240
It's just gonna stop
you from vomiting,
787
00:34:18,280 --> 00:34:20,200
and it'll help during surgery
788
00:34:20,240 --> 00:34:21,660
to decompress your stomach, OK?
789
00:34:21,700 --> 00:34:23,500
Wait.
790
00:34:23,540 --> 00:34:25,410
Did you just say surgery?
791
00:34:25,460 --> 00:34:27,170
Yeah, I heard "surgery,"
too, Dr. Marcel.
792
00:34:27,210 --> 00:34:28,250
Mm-hmm.
793
00:34:28,290 --> 00:34:29,630
That's right.
794
00:34:29,670 --> 00:34:31,960
The board voted unanimously
for the hospital
795
00:34:32,000 --> 00:34:34,010
to cover the costs
of Vince's surgery.
796
00:34:38,140 --> 00:34:39,720
Seriously?
797
00:34:40,810 --> 00:34:42,930
The hospital is just
gonna pay for it?
798
00:34:42,970 --> 00:34:44,680
Yep.
799
00:34:46,480 --> 00:34:48,850
I can't believe this.
800
00:34:48,900 --> 00:34:51,480
Is this real?
801
00:34:51,520 --> 00:34:53,480
It's very real.
802
00:34:53,530 --> 00:34:56,110
In fact, I got you
scheduled in the OR
803
00:34:56,150 --> 00:34:57,950
for 8:00 a.m. tomorrow.
804
00:35:00,870 --> 00:35:03,160
Hey, you guys are going
to Italy in three weeks.
805
00:35:03,200 --> 00:35:04,700
We got no time to waste.
806
00:35:09,580 --> 00:35:12,290
How can I begin to thank you?
807
00:35:12,340 --> 00:35:14,960
To thank you both?
808
00:35:15,010 --> 00:35:19,090
Well, how about you let
us place this NG tube, OK?
809
00:35:24,520 --> 00:35:26,560
All right.
810
00:35:26,600 --> 00:35:28,326
Do you think it was the
depression that made him
811
00:35:28,350 --> 00:35:30,810
make such a rash decision?
812
00:35:30,860 --> 00:35:32,520
You know, I don't, actually.
813
00:35:32,570 --> 00:35:34,166
But what possessed him
to do it right now?
814
00:35:34,190 --> 00:35:36,006
I mean, he couldn't even
wait until they were home?
815
00:35:36,030 --> 00:35:38,280
Your mortality can be a
pretty powerful motivator
816
00:35:38,320 --> 00:35:42,200
to do all the stuff that
you put off doing, right?
817
00:35:42,240 --> 00:35:43,700
I think that Paul
had been thinking
818
00:35:43,740 --> 00:35:45,200
about this for a while.
819
00:35:45,240 --> 00:35:46,386
I wonder if he's
gonna regret it.
820
00:35:46,410 --> 00:35:47,686
I mean, speaking
from experience,
821
00:35:47,710 --> 00:35:49,830
he's got a long
road ahead of him.
822
00:35:49,870 --> 00:35:51,750
One that's not
easy to walk alone.
823
00:35:51,790 --> 00:35:54,880
Yeah, but I mean, given his
feelings about the marriage,
824
00:35:54,920 --> 00:35:56,710
is it really
825
00:35:56,760 --> 00:35:58,526
really fair to Pamela to
put her in the position
826
00:35:58,550 --> 00:36:00,720
of being the support system?
827
00:36:06,520 --> 00:36:07,730
I'm sorry.
828
00:36:07,770 --> 00:36:09,640
No apology necessary.
829
00:36:09,690 --> 00:36:12,480
I've been through
enough divorces
830
00:36:12,520 --> 00:36:13,876
to be able to say
with some authority,
831
00:36:13,900 --> 00:36:16,440
spontaneous weeping
is a part of the deal.
832
00:36:19,570 --> 00:36:21,740
Tonight's my annual MRI.
833
00:36:21,780 --> 00:36:24,530
Make sure that my
cancer hasn't returned.
834
00:36:24,580 --> 00:36:27,750
I've been dreading it all day.
835
00:36:27,790 --> 00:36:30,750
Ben and I always made our
appointments together.
836
00:36:30,790 --> 00:36:31,920
Yeah.
837
00:36:37,760 --> 00:36:40,170
When I saw the appointment
approaching on my calendar,
838
00:36:40,220 --> 00:36:42,800
I almost texted Ben.
839
00:36:44,760 --> 00:36:46,260
I wanted to see if
he wanted to keep
840
00:36:46,310 --> 00:36:49,230
the tradition alive, but
841
00:36:49,270 --> 00:36:50,560
then I remembered...
842
00:36:53,770 --> 00:36:56,610
He's not my support
system anymore.
843
00:36:58,110 --> 00:37:00,150
And I'm not his.
844
00:37:10,710 --> 00:37:12,790
Dr. Ahmad, hey.
845
00:37:13,920 --> 00:37:15,380
What's going on
with that interview?
846
00:37:15,420 --> 00:37:16,790
Why?
847
00:37:16,840 --> 00:37:18,226
Did the board give you
approval to join me?
848
00:37:18,250 --> 00:37:19,760
Oh, no.
849
00:37:19,800 --> 00:37:21,316
The board would appreciate
it if the interview
850
00:37:21,340 --> 00:37:23,430
went away altogether.
851
00:37:23,470 --> 00:37:25,760
There it is, the catch.
852
00:37:25,800 --> 00:37:27,930
This issue is bigger
than just one patient.
853
00:37:27,970 --> 00:37:30,220
And the board recognizes that,
854
00:37:30,270 --> 00:37:32,690
which is why they're
making prior authorization
855
00:37:32,730 --> 00:37:35,600
a key issue in negotiations
with Berninger.
856
00:37:35,650 --> 00:37:37,086
And you trust they'll
follow through?
857
00:37:37,110 --> 00:37:38,940
I'll be holding their
feet to the fire.
858
00:37:40,320 --> 00:37:43,780
I agreed to serve as an
advisor on prior authorization
859
00:37:43,820 --> 00:37:47,070
for the negotiating committee.
860
00:37:47,120 --> 00:37:50,700
So am I still in the doghouse?
861
00:37:50,750 --> 00:37:52,266
Now, you went to the
mat for a patient.
862
00:37:52,290 --> 00:37:54,210
Not a grudge-worthy
offense in my book.
863
00:37:54,250 --> 00:37:57,210
But for what it's worth.
864
00:37:57,250 --> 00:37:58,630
Here we go.
865
00:37:58,670 --> 00:38:00,670
Look, there's a benefit
866
00:38:00,710 --> 00:38:03,380
to being taken
seriously by management.
867
00:38:03,420 --> 00:38:04,590
You get invited into rooms
868
00:38:04,630 --> 00:38:06,260
where you can actually
have an impact.
869
00:38:06,300 --> 00:38:09,810
I'm not sure that's the kind
of impact I'm trying to make.
870
00:38:09,850 --> 00:38:11,140
I'm not saying it is.
871
00:38:11,180 --> 00:38:16,560
But maybe you want to
keep your options open.
872
00:38:17,980 --> 00:38:20,320
Thanks for the pearls, Obi-Wan.
873
00:38:20,360 --> 00:38:22,320
Oh, anytime.
874
00:38:31,160 --> 00:38:35,000
Well, today settles it.
875
00:38:36,170 --> 00:38:36,960
Joining a nunnery?
876
00:38:37,000 --> 00:38:38,920
Deleting all dating apps.
877
00:38:38,960 --> 00:38:40,420
Ah.
878
00:38:40,460 --> 00:38:42,630
Probably for the best.
879
00:38:42,670 --> 00:38:45,050
All that swiping, head
buried in your phone.
880
00:38:45,090 --> 00:38:47,180
Might get a crick in my neck.
881
00:38:47,220 --> 00:38:49,260
Might miss out on
meeting someone in the
882
00:38:49,300 --> 00:38:50,300
what do the kids say?
883
00:38:50,350 --> 00:38:52,180
IRL?
884
00:38:52,220 --> 00:38:54,560
In real life?
885
00:38:54,600 --> 00:38:56,480
- Hmm.
- Have a good night, Asher.
886
00:39:04,070 --> 00:39:05,740
Come in.
887
00:39:07,320 --> 00:39:08,910
- Hey.
- Hey.
888
00:39:08,950 --> 00:39:11,006
I know we're supposed to be
meeting at the restaurant,
889
00:39:11,030 --> 00:39:13,200
but I thought you
might need a ride.
890
00:39:13,240 --> 00:39:14,750
Close the door.
891
00:39:19,580 --> 00:39:22,710
I was just about to call you,
892
00:39:22,750 --> 00:39:24,710
because I'm gonna actually
893
00:39:24,760 --> 00:39:26,550
need a rain check tonight.
894
00:39:26,590 --> 00:39:29,260
- Oh?
- Yeah, something came up.
895
00:39:29,300 --> 00:39:31,076
This is not because of our
conversation this morning,
896
00:39:31,100 --> 00:39:33,310
- I hope?
- No, no, no, no.
897
00:39:33,350 --> 00:39:34,616
Because if it is, I didn't
mean to pressure you.
898
00:39:34,640 --> 00:39:36,230
You didn't at all.
899
00:39:36,270 --> 00:39:40,190
In fact, I think we should
start telling people.
900
00:39:40,230 --> 00:39:42,360
I'm sorry, what?
901
00:39:42,400 --> 00:39:44,360
You know, I've always
carried myself with
902
00:39:44,400 --> 00:39:47,650
a sense of propriety,
and I spend a lot of time
903
00:39:47,700 --> 00:39:50,740
encouraging my colleagues
to do the same.
904
00:39:50,780 --> 00:39:55,040
But I just think if
you feel strongly
905
00:39:55,080 --> 00:39:58,460
about something in private,
906
00:39:58,500 --> 00:40:00,960
you should own it in public.
907
00:40:01,000 --> 00:40:02,590
"Strongly," you say?
908
00:40:02,630 --> 00:40:04,590
"Strongly," she said.
909
00:40:08,470 --> 00:40:11,050
You sure you don't want to
join me for dinner tonight?
910
00:40:12,970 --> 00:40:15,260
I'm suddenly very much
in the mood to celebrate.
911
00:40:15,310 --> 00:40:16,520
I can't, I can't.
912
00:40:16,560 --> 00:40:19,440
But I'll tell you what.
913
00:40:19,480 --> 00:40:22,100
If you're up late,
914
00:40:22,150 --> 00:40:25,610
I will stop by for a nightcap.
915
00:40:25,650 --> 00:40:27,780
Then I most definitely
will be up late.
916
00:40:32,660 --> 00:40:34,780
I'll see you later.
917
00:40:34,830 --> 00:40:36,700
See you then.64060
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