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1
00:00:06,093 --> 00:00:07,529
Oh, what do you think
you're doing?
2
00:00:07,529 --> 00:00:09,444
Sorry, I didn't' feel like
we had another choice.
3
00:00:09,444 --> 00:00:11,663
Dr. Ahmad,
your residency here
4
00:00:11,663 --> 00:00:14,318
will be on
a probationary basis.
5
00:00:14,318 --> 00:00:15,841
What the hell's going on?
6
00:00:15,841 --> 00:00:18,061
Walking off the floor without
notifying a supervisor?
7
00:00:18,061 --> 00:00:20,150
There's not gonna be
another warning.
8
00:00:20,150 --> 00:00:22,239
Ben is the one who pulled
the plug on this marriage.
9
00:00:22,239 --> 00:00:23,458
Come on, Maggie.
10
00:00:23,458 --> 00:00:24,894
We're almost at
the finish line.
11
00:00:24,894 --> 00:00:26,983
I really just wanna move on.
12
00:00:26,983 --> 00:00:28,202
Get me out of here!
13
00:00:28,202 --> 00:00:29,333
Get away from me!
- Dr. Ripley,
14
00:00:29,333 --> 00:00:30,943
What you did today
was reckless.
15
00:00:30,943 --> 00:00:32,032
Reckless?
16
00:00:32,032 --> 00:00:33,381
Impulse control disorder?
17
00:00:33,381 --> 00:00:34,773
Isn't that what you called it
back then?
18
00:00:34,773 --> 00:00:37,298
I'm an attending physician
at this hospital,
19
00:00:37,298 --> 00:00:42,259
not the boy you knew
20 years ago.
20
00:00:49,788 --> 00:00:51,138
Yo, Asher!
21
00:00:51,138 --> 00:00:52,313
What are you doing here?
22
00:00:52,313 --> 00:00:53,792
Mitch, what are--hey.
23
00:00:53,792 --> 00:00:54,880
What are you drinking?
24
00:00:54,880 --> 00:00:56,404
Um--I'm--
I'm not.
25
00:00:56,404 --> 00:00:58,101
It's club soda.
- You don't drink?
26
00:00:58,101 --> 00:00:59,363
I do not.
27
00:00:59,363 --> 00:01:01,887
I'm a recovering addict.
28
00:01:01,887 --> 00:01:05,152
Which--I will tell you
all about that another time.
29
00:01:05,152 --> 00:01:08,807
But right now,
you have to go away.
30
00:01:08,807 --> 00:01:12,115
You do realize this is
a public establishment, right?
31
00:01:12,115 --> 00:01:14,857
I'm--I am waiting on a date.
32
00:01:14,857 --> 00:01:17,077
First date.
33
00:01:17,077 --> 00:01:19,644
And he's going to be here
any minute, so--
34
00:01:19,644 --> 00:01:21,124
What? No.
35
00:01:21,124 --> 00:01:22,473
No, you--
36
00:01:22,473 --> 00:01:24,171
I got my eyes
glued to the door.
37
00:01:24,171 --> 00:01:26,390
I will split
the second he gets here.
38
00:01:28,610 --> 00:01:30,351
Fine.
39
00:01:30,351 --> 00:01:31,787
So who's the guy?
40
00:01:31,787 --> 00:01:33,093
How'd you meet?
41
00:01:33,093 --> 00:01:34,616
His name is Kyle.
42
00:01:34,616 --> 00:01:39,142
And he's an architect,
and we met on a dating app.
43
00:01:39,142 --> 00:01:41,449
Commercial architecture?
Residential?
44
00:01:41,449 --> 00:01:42,798
What's the name of his firm?
45
00:01:42,798 --> 00:01:44,756
OK, what are you
doing here, hm?
46
00:01:44,756 --> 00:01:48,412
You don't seem like the type to
venture out on a school night.
47
00:01:48,412 --> 00:01:50,240
Is that your polite way
of calling me a loser?
48
00:01:50,240 --> 00:01:51,850
No.
49
00:01:51,850 --> 00:01:56,768
You're always working late,
running at some ungodly hours.
50
00:01:56,768 --> 00:02:00,250
Those degenerates,
they dragged me out.
51
00:02:02,296 --> 00:02:04,689
I've known most of them
since grade school.
52
00:02:04,689 --> 00:02:06,865
I didn't know
you were a Chicago boy.
53
00:02:06,865 --> 00:02:08,563
Born and raised.
54
00:02:08,563 --> 00:02:12,001
Just been away a lot of years.
55
00:02:12,001 --> 00:02:13,611
It must be nice being home.
56
00:02:18,094 --> 00:02:21,184
I think Romeo has landed.
57
00:02:27,886 --> 00:02:30,280
Whoa, that was--
58
00:02:30,280 --> 00:02:32,152
Nice break, bro.
59
00:02:37,983 --> 00:02:39,681
Somebody call 911!
60
00:02:39,681 --> 00:02:40,638
I need help!
61
00:02:40,638 --> 00:02:42,640
My girlfriend just passed out!
62
00:02:44,033 --> 00:02:45,469
We're doctors!
63
00:02:45,469 --> 00:02:47,167
You got to help her. Please.
64
00:02:47,167 --> 00:02:48,472
Somebody's calling 911.
65
00:02:48,472 --> 00:02:50,300
Paramedics should
be on the way soon.
66
00:02:50,300 --> 00:02:51,649
Her breathing's
slow and shallow.
67
00:02:51,649 --> 00:02:53,260
Eyes are pinpoint.
What's her name?
68
00:02:53,260 --> 00:02:54,826
- Uh, Becca.
- Becca?
69
00:02:54,826 --> 00:02:57,220
Hey, wake up, Becca!
- Did she take something?
70
00:02:57,220 --> 00:02:59,309
We need to know
so we can help her, man.
71
00:02:59,309 --> 00:03:00,528
Come on!
What did she take?!
72
00:03:00,528 --> 00:03:02,312
Coke. But just a hit.
73
00:03:02,312 --> 00:03:03,661
Is this an overdose?
74
00:03:03,661 --> 00:03:05,446
How do you OD off just one hit?
75
00:03:05,446 --> 00:03:07,317
- You wouldn't.
- No, Unless--
76
00:03:07,317 --> 00:03:08,449
Cocaine was laced
with fentanyl.
77
00:03:08,449 --> 00:03:10,277
I have Narcan in my purse.
78
00:03:10,277 --> 00:03:11,582
The blue bag under
the bar on the hook?
79
00:03:11,582 --> 00:03:13,584
It's OK, I'll get it.
80
00:03:13,584 --> 00:03:14,629
Hey.
81
00:03:14,629 --> 00:03:16,065
Hey, you doing OK?
- I--I don't--
82
00:03:16,065 --> 00:03:17,197
- OK, OK.
- I don't feel so good.
83
00:03:17,197 --> 00:03:18,981
Did you take a hit, too?
84
00:03:18,981 --> 00:03:20,156
Here.
85
00:03:20,156 --> 00:03:21,331
Thanks.
86
00:03:21,331 --> 00:03:23,246
You're OK. You're OK.
87
00:03:23,246 --> 00:03:24,552
Mitch?
88
00:03:24,552 --> 00:03:27,032
Yeah.
89
00:03:30,035 --> 00:03:32,342
Come on.
90
00:03:36,303 --> 00:03:37,521
Welcome back, Becca.
91
00:03:37,521 --> 00:03:39,741
Take a breath.
- Come on.
92
00:03:39,741 --> 00:03:42,178
It's OK.
Just breathe.
93
00:03:42,178 --> 00:03:43,919
Tim?
94
00:03:43,919 --> 00:03:45,312
What's wrong with him?
95
00:03:45,312 --> 00:03:46,661
Got any more Narcan?
This didn't do it.
96
00:03:46,661 --> 00:03:47,966
He needs another dose.
- No, I don't.
97
00:03:47,966 --> 00:03:48,967
Does anyone have Narcan?
98
00:03:48,967 --> 00:03:50,273
I'll ask around.
99
00:03:50,273 --> 00:03:51,492
Airway's open,
but he's not breathing.
100
00:03:51,492 --> 00:03:52,536
Baby, you have to wake up.
101
00:03:52,536 --> 00:03:53,885
I'm gonna start
rescue breath.
102
00:03:53,885 --> 00:03:55,147
No, no, Mitch, wait!
You don't have a mask.
103
00:03:55,147 --> 00:03:56,105
Wait for the paramedics.
- Hannah!
104
00:03:56,105 --> 00:03:57,193
He could cough up blood.
105
00:03:57,193 --> 00:03:58,542
He could--
- I know the risks.
106
00:03:58,542 --> 00:04:00,065
Hey, doc, what do we got?
107
00:04:00,065 --> 00:04:01,415
Suspected fentanyl overdose.
108
00:04:01,415 --> 00:04:02,981
We already administered
one dose of Narcan.
109
00:04:07,638 --> 00:04:09,814
Baby, open your eyes.
110
00:04:19,259 --> 00:04:21,870
Welcome back.
111
00:04:30,139 --> 00:04:31,662
CPD tested their drugs.
112
00:04:31,662 --> 00:04:33,360
Came back positive
for fentanyl.
113
00:04:33,360 --> 00:04:34,535
There's been a huge uptick
114
00:04:34,535 --> 00:04:36,014
of overdoses in the ED lately.
115
00:04:36,014 --> 00:04:38,147
Yeah, a lot of them
just like Becca and Tim.
116
00:04:38,147 --> 00:04:40,932
They're recreational users,
no clue their drugs
117
00:04:40,932 --> 00:04:42,151
are laced with fentanyl.
118
00:04:42,151 --> 00:04:43,283
I'll make sure they go home
119
00:04:43,283 --> 00:04:44,414
with some fentanyl
testing strips.
120
00:04:44,414 --> 00:04:46,982
Thank you, Juliette.
121
00:04:50,159 --> 00:04:51,334
Your date's waiting.
122
00:04:51,334 --> 00:04:52,901
He is?
123
00:04:52,901 --> 00:04:54,685
Your 6 o'clock.
Just be cool.
124
00:05:00,517 --> 00:05:03,651
Well, uh, see you tomorrow.
125
00:05:03,651 --> 00:05:05,305
- Yeah.
- Yeah.
126
00:05:05,305 --> 00:05:07,307
Yeah.
127
00:05:10,222 --> 00:05:12,094
Get some sleep
tonight, Asher.
128
00:05:17,317 --> 00:05:18,753
Wow.
129
00:05:18,753 --> 00:05:21,277
You're--you're like
a real-life superwoman.
130
00:05:21,277 --> 00:05:22,452
No.
131
00:05:22,452 --> 00:05:24,846
No, I'm just glad
everyone's OK.
132
00:05:24,846 --> 00:05:27,457
Yeah.
133
00:05:27,457 --> 00:05:31,331
So what do you say we, um--
134
00:05:31,331 --> 00:05:34,464
we pick up where we left off?
135
00:05:34,464 --> 00:05:37,815
I actually--
I have to get going.
136
00:05:37,815 --> 00:05:40,383
I've got kind of
an early start tomorrow.
137
00:05:40,383 --> 00:05:42,429
Oh.
138
00:05:42,429 --> 00:05:44,213
Yeah, I mean, I get it.
139
00:05:44,213 --> 00:05:47,956
But it was really lovely
to meet you, Hannah.
140
00:06:10,108 --> 00:06:12,676
Big plans tonight?
141
00:06:12,676 --> 00:06:14,069
No.
142
00:06:14,069 --> 00:06:16,767
I, uh,
got a board meeting later.
143
00:06:16,767 --> 00:06:19,117
- Giving a presentation?
- No.
144
00:06:19,117 --> 00:06:22,207
I'm actually joining the board.
145
00:06:22,207 --> 00:06:24,384
Well, I must have missed
the announcement.
146
00:06:24,384 --> 00:06:25,515
Well, there wasn't one.
147
00:06:25,515 --> 00:06:26,777
My request.
148
00:06:26,777 --> 00:06:28,953
Not big on fanfare.
149
00:06:28,953 --> 00:06:31,434
So the board just
created a seat for you?
150
00:06:31,434 --> 00:06:34,045
Well, for a hospital
physician, so--
151
00:06:34,045 --> 00:06:36,439
But they asked you?
152
00:06:36,439 --> 00:06:38,267
Seems that way.
153
00:06:40,225 --> 00:06:42,532
I'm just glad I get to,
uh--to advocate
154
00:06:42,532 --> 00:06:43,620
for the medical staff.
155
00:06:43,620 --> 00:06:45,883
Well, congratulations.
156
00:06:45,883 --> 00:06:48,712
You must be very popular
with the suits.
157
00:06:48,712 --> 00:06:50,366
Dr. Ahmad!
158
00:06:50,366 --> 00:06:52,977
Got an ambo pulling up,
going to treatment three.
159
00:06:52,977 --> 00:06:54,544
Duty calls.
160
00:06:54,544 --> 00:06:56,198
By all means.
161
00:06:59,636 --> 00:07:01,421
- We're going into three.
- Got it.
162
00:07:01,421 --> 00:07:03,553
Vince Gonzalez,
38-year-old male,
163
00:07:03,553 --> 00:07:05,425
briefly lost consciousness
after vomiting.
164
00:07:05,425 --> 00:07:09,429
BP 85 over 52,
gave two liters in the ambo.
165
00:07:09,429 --> 00:07:10,473
Hi, Mr. Gonzalez.
166
00:07:10,473 --> 00:07:11,561
I'm Dr. Ahmad.
167
00:07:11,561 --> 00:07:13,650
It's Vince.
168
00:07:13,650 --> 00:07:15,783
Do you know if he hit
his head when he passed out?
169
00:07:15,783 --> 00:07:17,567
No, Vince was already
on the ground.
170
00:07:17,567 --> 00:07:19,134
He just kind of slumped over.
171
00:07:19,134 --> 00:07:20,744
And he wasn't out long,
just a few seconds.
172
00:07:20,744 --> 00:07:21,919
Thank you.
And you are?
173
00:07:21,919 --> 00:07:24,922
Ty. I'm Vince's husband.
174
00:07:24,922 --> 00:07:26,707
We'll take good care of him.
175
00:07:28,926 --> 00:07:31,451
OK, on my count--
one, two, three.
176
00:07:37,544 --> 00:07:39,589
OK, Vince,
do you mind leaning forward?
177
00:07:39,589 --> 00:07:40,851
I just want to listen to
your lungs from the back.
178
00:07:42,331 --> 00:07:44,986
Clear breath
sounds bilaterally.
179
00:07:47,989 --> 00:07:49,599
Oh, honey.
180
00:07:49,599 --> 00:07:50,861
Oh.
181
00:07:50,861 --> 00:07:52,559
I am so sorry.
182
00:07:52,559 --> 00:07:54,648
It is so fine.
183
00:07:54,648 --> 00:07:56,737
It happens more than you think.
184
00:07:56,737 --> 00:07:58,260
4 of Zofran and a KUB.
185
00:07:58,260 --> 00:07:59,609
I'm on it.
186
00:07:59,609 --> 00:08:02,612
Excuse me.
187
00:08:02,612 --> 00:08:05,049
Hey.
188
00:08:05,049 --> 00:08:07,835
You, um--you
have some vomit in your hair.
189
00:08:11,839 --> 00:08:13,971
Dennis Washington.
190
00:08:13,971 --> 00:08:15,886
How you been?
- Hey, Dan.
191
00:08:15,886 --> 00:08:17,322
How are you?
- Dr. Washington.
192
00:08:17,322 --> 00:08:20,238
Good morning.
What can I do for you?
193
00:08:20,238 --> 00:08:22,632
I wanted to follow up on that
matter I emailed you about.
194
00:08:22,632 --> 00:08:24,460
Oh, right.
Of course.
195
00:08:24,460 --> 00:08:25,635
We can talk in my office.
196
00:08:25,635 --> 00:08:27,332
We'll see you later.
197
00:08:27,332 --> 00:08:30,379
I'll see you at the Exec
Med Committee meeting Friday.
198
00:08:30,379 --> 00:08:32,337
Only if I can't
get out of it.
199
00:08:40,868 --> 00:08:42,696
You forgot it by the toaster.
200
00:08:42,696 --> 00:08:46,177
Stop.
201
00:08:46,177 --> 00:08:48,876
I got to stop
leaving my things.
202
00:08:48,876 --> 00:08:50,530
Hey, I don't mind.
203
00:08:52,270 --> 00:08:56,187
It gives me an excuse to
come see you during the day.
204
00:08:56,187 --> 00:08:58,276
Dan doesn't know about us, huh?
205
00:08:58,276 --> 00:08:59,539
Dennis.
206
00:08:59,539 --> 00:09:01,323
I know, I know, I know.
207
00:09:01,323 --> 00:09:03,891
You're not telling folks
for the time being.
208
00:09:03,891 --> 00:09:05,196
Have you told anyone?
209
00:09:05,196 --> 00:09:07,198
No. I'm confused.
210
00:09:07,198 --> 00:09:09,636
I mean, would it be the
worst thing if people knew?
211
00:09:09,636 --> 00:09:10,941
No, no.
212
00:09:10,941 --> 00:09:12,116
Of course not.
213
00:09:12,116 --> 00:09:14,684
It's just that you're the--
214
00:09:14,684 --> 00:09:17,557
you're the chief
of a department,
215
00:09:17,557 --> 00:09:20,777
and I'm a member
of hospital leadership.
216
00:09:20,777 --> 00:09:22,518
It's not prohibited.
217
00:09:23,650 --> 00:09:26,348
Sharon,
colleagues date all the time.
218
00:09:26,348 --> 00:09:29,699
It's not a big deal.
- Yeah, but it is to me.
219
00:09:29,699 --> 00:09:33,877
I've always had this strict
policy of not mixing my work
220
00:09:33,877 --> 00:09:36,967
life with my romantic life.
221
00:09:36,967 --> 00:09:39,013
Until now.
222
00:09:40,275 --> 00:09:41,929
And I appreciate you
making that exception.
223
00:09:41,929 --> 00:09:42,930
Believe me.
224
00:09:44,540 --> 00:09:46,586
There's no rush.
225
00:09:46,586 --> 00:09:49,632
We'll take our time
integrating both worlds.
226
00:09:49,632 --> 00:09:53,331
Besides, it's kind of fun
sneaking around.
227
00:10:00,077 --> 00:10:01,078
Got a minute?
228
00:10:01,078 --> 00:10:02,993
Need a surgical consult.
229
00:10:02,993 --> 00:10:04,473
Uh--
230
00:10:04,473 --> 00:10:06,344
Patient's name
is Vince Gonzalez.
231
00:10:06,344 --> 00:10:09,913
He's got metastatic abdominal
sarcoma, presented to the ED
232
00:10:09,913 --> 00:10:12,263
with nausea,
abdominal distension,
233
00:10:12,263 --> 00:10:14,614
and severe belly pain.
234
00:10:14,614 --> 00:10:16,659
Poor guy can't
keep anything down.
235
00:10:16,659 --> 00:10:18,879
Does he have an obstruction
or perforation?
236
00:10:18,879 --> 00:10:21,098
Free fluid?
- Not on CT.
237
00:10:21,098 --> 00:10:22,926
But the tumor is
severely compressing
238
00:10:22,926 --> 00:10:24,536
his stomach, hence the nausea.
239
00:10:24,536 --> 00:10:26,451
Yeah, I'm not seeing why
you need a surgical consult.
240
00:10:26,451 --> 00:10:28,018
I mean,
if the tumor is metastatic,
241
00:10:28,018 --> 00:10:29,019
it must have been inoperative.
242
00:10:29,019 --> 00:10:30,412
Correct.
243
00:10:30,412 --> 00:10:31,761
And if he's not
completely obstructed,
244
00:10:31,761 --> 00:10:33,241
what do you need me for?
245
00:10:33,241 --> 00:10:36,331
Well, if you debulked
a portion of the tumor here,
246
00:10:36,331 --> 00:10:39,203
then it would allow food to
pass into the small intestine.
247
00:10:39,203 --> 00:10:41,031
So would a feeding tube.
248
00:10:41,031 --> 00:10:42,511
He doesn't want
a feeding tube.
249
00:10:42,511 --> 00:10:44,731
Surgery would afford him
a much better quality of life.
250
00:10:44,731 --> 00:10:47,472
Or it could cost him
whatever time he has left.
251
00:10:47,472 --> 00:10:49,039
I mean, we're talking
about a patient
252
00:10:49,039 --> 00:10:51,389
who underwent multiple rounds
of chemo, I'm sure, right?
253
00:10:51,389 --> 00:10:52,956
With zero complications.
254
00:10:52,956 --> 00:10:56,133
He's remarkably fit and
healthy, despite the cancer.
255
00:10:56,133 --> 00:10:58,222
I know this isn't
exactly a sexy surgery.
256
00:10:58,222 --> 00:11:00,572
Whoa. I beg your pardon.
257
00:11:00,572 --> 00:11:03,140
"Sexy surgery"?
258
00:11:03,140 --> 00:11:05,099
I know surgeons
don't like to get involved
259
00:11:05,099 --> 00:11:08,145
in palliative care.
260
00:11:08,145 --> 00:11:10,670
Well, that's quite
a generalization there.
261
00:11:13,847 --> 00:11:15,936
All right. Let's have a look.
262
00:11:15,936 --> 00:11:18,025
Send me the chart.
263
00:11:21,202 --> 00:11:23,073
Don't be brave, OK?
264
00:11:23,073 --> 00:11:25,467
Tell me if it hurts
when I push.
265
00:11:25,467 --> 00:11:26,686
I'm all right.
266
00:11:26,686 --> 00:11:28,122
OK.
267
00:11:28,122 --> 00:11:29,427
Well, your CT didn't show
an obstruction,
268
00:11:29,427 --> 00:11:31,691
but just wanted to confirm.
269
00:11:33,997 --> 00:11:35,956
So, Dr. Marcel?
270
00:11:35,956 --> 00:11:38,175
- Yeah.
- Here's the thing.
271
00:11:38,175 --> 00:11:39,829
My husband and I
are supposed to fly
272
00:11:39,829 --> 00:11:41,352
to Italy in three weeks.
273
00:11:41,352 --> 00:11:43,528
My grandmother
was from Positano.
274
00:11:43,528 --> 00:11:46,706
I've always wanted to go,
and we figured,
275
00:11:46,706 --> 00:11:49,012
no time like the present.
276
00:11:49,012 --> 00:11:51,536
You know, how are you doing
with daily activities, Vince?
277
00:11:51,536 --> 00:11:53,800
Things like dressing,
housework, driving?
278
00:11:53,800 --> 00:11:57,238
Before I started
vomiting my supper?
279
00:11:57,238 --> 00:11:59,022
I was totally functional.
280
00:11:59,022 --> 00:12:00,371
I can attest to that.
281
00:12:00,371 --> 00:12:03,157
Most days, Vince has
more energy than me.
282
00:12:03,157 --> 00:12:05,768
You ever had complications
from surgery?
283
00:12:05,768 --> 00:12:08,510
Post-operative issues,
issues with anesthesia?
284
00:12:08,510 --> 00:12:11,556
No, I had my appendix out
when I was 25,
285
00:12:11,556 --> 00:12:14,168
but I didn't have any problems.
286
00:12:14,168 --> 00:12:16,039
Good.
287
00:12:16,039 --> 00:12:18,259
I'm glad to hear it.
288
00:12:18,259 --> 00:12:20,217
Because there is
a surgical option
289
00:12:20,217 --> 00:12:22,742
that could get your GI system
working again.
290
00:12:23,873 --> 00:12:26,310
I like the sound of that.
291
00:12:27,834 --> 00:12:30,401
Why don't you present it,
Dr. Ahmad,
292
00:12:30,401 --> 00:12:32,490
since it was your suggestion?
293
00:12:32,490 --> 00:12:33,622
OK.
294
00:12:34,710 --> 00:12:36,581
Morning.
295
00:12:36,581 --> 00:12:38,148
Your night turn out all right?
296
00:12:38,148 --> 00:12:39,584
It did, actually.
297
00:12:39,584 --> 00:12:42,413
It ended up being
a pretty good first date.
298
00:12:42,413 --> 00:12:44,546
- Oh, yeah?
- Yeah.
299
00:12:44,546 --> 00:12:46,896
Dr. Ripley,
we have a potential wrist
300
00:12:46,896 --> 00:12:48,855
fracture in treatment six.
301
00:12:48,855 --> 00:12:50,030
You mind starting the workup?
302
00:12:50,030 --> 00:12:51,945
I'm just finishing up
with a patient.
303
00:12:51,945 --> 00:12:53,468
You're lucky I like you.
304
00:12:53,468 --> 00:12:54,295
For now.
305
00:12:54,295 --> 00:12:55,600
Thank you, Maggie.
306
00:12:55,600 --> 00:12:56,601
Mm-hmm.
307
00:12:57,907 --> 00:12:59,213
OK.
308
00:12:59,213 --> 00:13:01,171
So, Mrs. Moore,
I understand that you fell
309
00:13:01,171 --> 00:13:03,043
getting out of your car.
310
00:13:03,043 --> 00:13:04,784
Mind if I take a look?
311
00:13:06,394 --> 00:13:08,831
I just want to check
if it's swollen.
312
00:13:14,097 --> 00:13:15,185
I'll be gentle.
313
00:13:18,449 --> 00:13:20,495
Pam, let her look.
314
00:13:22,410 --> 00:13:24,673
My wrist is fine.
315
00:13:24,673 --> 00:13:26,196
I didn't fall.
316
00:13:26,980 --> 00:13:28,808
What?
317
00:13:28,808 --> 00:13:30,810
I don't understand.
318
00:13:31,723 --> 00:13:34,248
I'm sorry, honey.
I didn't have any other choice.
319
00:13:34,248 --> 00:13:36,076
What are you talking about?
320
00:13:37,729 --> 00:13:40,863
My husband is depressed
and refuses to get any help.
321
00:13:40,863 --> 00:13:42,386
Pamela!
322
00:13:42,386 --> 00:13:45,128
And I am so afraid
he's gonna hurt himself.
323
00:13:54,921 --> 00:13:57,575
Look, I appreciate you have
to do your due diligence.
324
00:13:57,575 --> 00:13:59,664
My wife mentioned the
possibility of self-harm,
325
00:13:59,664 --> 00:14:01,666
so you can't just
send me on my way.
326
00:14:01,666 --> 00:14:04,495
Yeah, she mentioned to Nurse
Lockwood a comment you made.
327
00:14:04,495 --> 00:14:05,888
Right.
328
00:14:05,888 --> 00:14:07,934
I said something stupid
like, "Going to bed
329
00:14:07,934 --> 00:14:10,066
and never waking up sounds
like a nice way to go."
330
00:14:10,066 --> 00:14:11,154
Huh.
331
00:14:11,154 --> 00:14:13,113
Come on.
I was speaking generally.
332
00:14:13,113 --> 00:14:14,984
A nice way to go,
as opposed to,
333
00:14:14,984 --> 00:14:17,378
I don't know,
getting hit by a bus.
334
00:14:17,378 --> 00:14:18,901
OK.
335
00:14:18,901 --> 00:14:21,208
Um, apparently, you have
been losing some weight.
336
00:14:21,208 --> 00:14:24,124
I was diagnosed with type 2
diabetes not long ago.
337
00:14:24,124 --> 00:14:25,865
I've been pretty diligent
about my diet,
338
00:14:25,865 --> 00:14:27,431
getting regular exercise.
339
00:14:27,431 --> 00:14:29,825
Frankly, I'm glad
the hard work's paying off.
340
00:14:29,825 --> 00:14:31,174
Well, then, Paul,
help me out.
341
00:14:31,174 --> 00:14:33,437
I mean, why do you think
that your wife's
342
00:14:33,437 --> 00:14:34,699
so concerned about you?
343
00:14:36,527 --> 00:14:39,530
I admit I haven't been
in the best mood lately.
344
00:14:39,530 --> 00:14:41,271
My fuse is probably shorter.
345
00:14:41,271 --> 00:14:42,794
Yeah.
346
00:14:42,794 --> 00:14:44,927
I mean, she's--
she's concerned that,
347
00:14:44,927 --> 00:14:47,016
you know, you've been isolating,
348
00:14:47,016 --> 00:14:49,366
withdrawing from her,
your friends.
349
00:14:49,366 --> 00:14:51,934
I haven't felt like
socializing lately.
350
00:14:51,934 --> 00:14:53,196
So when was the last time--
351
00:14:53,196 --> 00:14:54,545
Let me save you
some time, OK?
352
00:14:54,545 --> 00:14:58,027
I have no intention
or desire to hurt myself.
353
00:14:58,027 --> 00:14:59,333
And I'm glad to hear it.
354
00:14:59,333 --> 00:15:01,030
So ask whatever questions
you need
355
00:15:01,030 --> 00:15:03,641
to cover the hospital's ass.
356
00:15:03,641 --> 00:15:05,948
I am not suicidal, Dr. Charles.
357
00:15:05,948 --> 00:15:08,820
Pam is just making something
out of nothing.
358
00:15:08,820 --> 00:15:11,258
Her specialty.
359
00:15:11,258 --> 00:15:13,216
Mm.
360
00:15:16,524 --> 00:15:18,830
Within an hour
of posting Vince's surgery,
361
00:15:18,830 --> 00:15:21,181
his insurance company
denied it,
362
00:15:21,181 --> 00:15:22,834
rejected it on
the grounds of it
363
00:15:22,834 --> 00:15:24,314
not being medically necessary.
364
00:15:24,314 --> 00:15:26,055
There are alternative
treatment options.
365
00:15:26,055 --> 00:15:27,752
The feeding tube
Vince doesn't want.
366
00:15:27,752 --> 00:15:29,145
Yep.
367
00:15:29,145 --> 00:15:32,583
Man, I am so fed up
with prior authorization.
368
00:15:32,583 --> 00:15:35,195
About a dozen times a month,
my patients get screwed by it.
369
00:15:35,195 --> 00:15:36,674
What insurance does Vince have?
370
00:15:36,674 --> 00:15:37,849
Berninger Health Network.
371
00:15:37,849 --> 00:15:39,590
Of course, one of the worst.
372
00:15:39,590 --> 00:15:42,071
They deny more patients
than any other company,
373
00:15:42,071 --> 00:15:44,856
pay physician reviewers
six figures to look at charts
374
00:15:44,856 --> 00:15:46,771
and find reasons to deny.
375
00:15:49,600 --> 00:15:51,515
I guess we should tell him
before he gets a form
376
00:15:51,515 --> 00:15:52,690
email from his insurance.
377
00:15:52,690 --> 00:15:54,605
Yeah.
378
00:16:01,177 --> 00:16:02,657
So what's the verdict?
379
00:16:02,657 --> 00:16:05,225
Is his wife right
that he's a danger to himself?
380
00:16:05,225 --> 00:16:06,878
You know, I don't know yet.
381
00:16:06,878 --> 00:16:08,750
I mean, he's adamant
that he's not, right?
382
00:16:08,750 --> 00:16:11,318
But about 50% of the people
with suicidal ideation
383
00:16:11,318 --> 00:16:12,580
deny it.
384
00:16:12,580 --> 00:16:14,408
I'm more concerned
by his wife's concern,
385
00:16:14,408 --> 00:16:15,757
if that makes sense.
386
00:16:15,757 --> 00:16:17,541
I mean, she pulled off
a pretty elaborate ruse
387
00:16:17,541 --> 00:16:18,629
to get him through our doors.
388
00:16:18,629 --> 00:16:20,022
Exactly.
389
00:16:20,022 --> 00:16:21,589
So what's the game plan?
390
00:16:21,589 --> 00:16:24,244
I want to talk to her
some more, all right?
391
00:16:24,244 --> 00:16:26,768
I also want to just look at his
medical history a little more
392
00:16:26,768 --> 00:16:30,293
carefully, you know, find out
what kind of access, if any,
393
00:16:30,293 --> 00:16:32,121
he has to firearms,
to see if I can come
394
00:16:32,121 --> 00:16:33,688
up with any evidence at all
395
00:16:33,688 --> 00:16:34,906
that he's planning
to hurt himself.
396
00:16:34,906 --> 00:16:36,517
All right.
I'll keep him comfortable.
397
00:16:36,517 --> 00:16:38,519
All right, and Mags, if he
gets antsy and starts talking
398
00:16:38,519 --> 00:16:39,433
about getting out of here--
399
00:16:39,433 --> 00:16:40,782
- I'll page you.
- Thank you.
400
00:16:40,782 --> 00:16:41,957
Yeah.
401
00:16:46,918 --> 00:16:48,485
Where is Hannah Asher?
402
00:16:48,485 --> 00:16:49,530
Excuse me?
403
00:16:49,530 --> 00:16:51,140
Where is Hannah Asher?
404
00:16:51,140 --> 00:16:54,491
She's probably
with a patient.
405
00:16:54,491 --> 00:16:56,580
Ma'am.
406
00:16:56,580 --> 00:16:58,452
Ma'am, you can't do that.
407
00:17:00,280 --> 00:17:02,195
Ma'am.
408
00:17:02,195 --> 00:17:05,198
OK, this is gonna feel
a little cold.
409
00:17:05,198 --> 00:17:06,112
OK?
410
00:17:06,112 --> 00:17:08,027
You're Hannah Asher?
411
00:17:08,027 --> 00:17:09,376
Do you know this woman?
412
00:17:09,376 --> 00:17:12,727
Um, no.
413
00:17:12,727 --> 00:17:14,076
Do you want me to remove her?
414
00:17:14,076 --> 00:17:15,556
- I'd like to see you try.
- Hold on.
415
00:17:15,556 --> 00:17:16,687
Hold on a second.
416
00:17:16,687 --> 00:17:18,037
I'm Dr. Hannah Asher.
417
00:17:18,037 --> 00:17:19,038
Is there a problem?
418
00:17:19,038 --> 00:17:20,604
Problem?
419
00:17:20,604 --> 00:17:22,780
Well, you went on a date
with my husband last night,
420
00:17:22,780 --> 00:17:24,521
so yeah, we've got a problem.
421
00:17:29,265 --> 00:17:31,006
Vince,
we're submitting an appeal
422
00:17:31,006 --> 00:17:33,617
to your insurance company, OK?
423
00:17:33,617 --> 00:17:36,577
We've been through
the appeals process.
424
00:17:38,753 --> 00:17:41,582
When Vince's doctor first
suspected something was wrong,
425
00:17:41,582 --> 00:17:43,236
he ordered a CT.
426
00:17:43,236 --> 00:17:45,673
Insurance wouldn't approve it initially.
427
00:17:45,673 --> 00:17:48,719
Said there wasn't sufficient
evidence to warrant it.
428
00:17:48,719 --> 00:17:51,331
It took them three months
to finally get it authorized.
429
00:17:51,331 --> 00:17:52,897
- Yeah.
- Who knows how much
430
00:17:52,897 --> 00:17:55,900
the tumor grew in that time?
431
00:17:55,900 --> 00:17:58,381
Vince.
432
00:17:58,381 --> 00:18:00,862
I know you were trying
to avoid a feeding tube.
433
00:18:00,862 --> 00:18:02,559
No.
434
00:18:02,559 --> 00:18:05,214
No feeding tube.
435
00:18:05,214 --> 00:18:06,998
Look, we could place
a temporary one.
436
00:18:06,998 --> 00:18:08,174
No.
437
00:18:08,174 --> 00:18:09,827
Without a feeding tube--
438
00:18:09,827 --> 00:18:11,786
I'm gonna lose time.
439
00:18:11,786 --> 00:18:13,266
I understand that.
440
00:18:13,266 --> 00:18:16,007
You could die in weeks,
441
00:18:16,007 --> 00:18:17,748
possibly days.
442
00:18:22,710 --> 00:18:24,015
When we first got the news
443
00:18:24,015 --> 00:18:25,974
that nothing more
could be done,
444
00:18:25,974 --> 00:18:28,281
that this was terminal,
445
00:18:28,281 --> 00:18:30,370
we came up with a model
for how we were
446
00:18:30,370 --> 00:18:32,633
going to approach this next...
447
00:18:32,633 --> 00:18:33,721
phase.
448
00:18:38,639 --> 00:18:41,032
Quality over time, right?
449
00:18:42,512 --> 00:18:44,558
No feeding tube.
450
00:18:50,868 --> 00:18:53,175
OK.
451
00:18:53,175 --> 00:18:54,263
Get some rest.
452
00:18:54,263 --> 00:18:56,352
Be back in a bit, OK?
453
00:19:03,446 --> 00:19:04,926
Yeah.
454
00:19:04,926 --> 00:19:06,493
Thanks.
455
00:19:06,493 --> 00:19:09,583
I'm gonna talk to a
utilization review specialist,
456
00:19:09,583 --> 00:19:12,063
see if I can expedite
the appeal process.
457
00:19:12,063 --> 00:19:14,675
You really think that's gonna
make much of a difference?
458
00:19:14,675 --> 00:19:16,677
Worth a shot.
459
00:19:27,470 --> 00:19:29,777
I did go out last night,
but it wasn't
460
00:19:29,777 --> 00:19:30,995
with anyone that was married.
461
00:19:30,995 --> 00:19:33,215
All right, guys. Come on.
462
00:19:33,215 --> 00:19:34,303
Show's over, huh?
463
00:19:34,303 --> 00:19:36,000
I went out with Kyle.
464
00:19:36,000 --> 00:19:38,307
- Kyle?
- Yeah.
465
00:19:39,787 --> 00:19:41,702
Yeah, that's him.
466
00:19:42,964 --> 00:19:44,270
His name is Nick Dunn.
467
00:19:44,270 --> 00:19:46,272
He's not an architect.
He's a general contractor.
468
00:19:46,272 --> 00:19:48,709
I'm so--oh, God.
469
00:19:48,709 --> 00:19:51,190
You really didn't know
he was married?
470
00:19:51,190 --> 00:19:52,713
No, I swear.
471
00:19:52,713 --> 00:19:54,628
I--
472
00:19:59,372 --> 00:20:01,025
I'm gonna kill him.
473
00:20:01,025 --> 00:20:02,244
Well, I--
474
00:20:02,244 --> 00:20:04,768
How could he do this to me?
475
00:20:04,768 --> 00:20:06,074
I'm carrying our child.
476
00:20:06,074 --> 00:20:07,380
It's absolutely terrible.
477
00:20:07,380 --> 00:20:09,643
I agree--
- I knew something was up.
478
00:20:09,643 --> 00:20:11,514
I thought it was just
new dad jitters, you know?
479
00:20:11,514 --> 00:20:14,865
In a million years, I never--
480
00:20:14,865 --> 00:20:15,866
oh.
481
00:20:15,866 --> 00:20:17,825
Are you OK?
482
00:20:17,825 --> 00:20:19,261
I think my water just broke.
483
00:20:25,049 --> 00:20:26,181
How many weeks are you?
484
00:20:26,181 --> 00:20:28,270
38.
485
00:20:28,270 --> 00:20:30,446
I would like
to get you on a monitor.
486
00:20:30,446 --> 00:20:32,492
No, no, no, no,
I'm going to see my own doct--
487
00:20:32,492 --> 00:20:34,320
oh!
- Hey, hey, hey, breathe.
488
00:20:34,320 --> 00:20:36,583
Breathe with me.
- I know how to breathe.
489
00:20:38,280 --> 00:20:40,021
This can't be happening.
490
00:20:47,724 --> 00:20:50,249
Can you put your
knees up for me, please?
491
00:20:52,294 --> 00:20:54,253
You're gonna feel
a little bit of pressure.
492
00:20:54,253 --> 00:20:56,951
OK.
493
00:20:56,951 --> 00:20:59,997
OK, so, Tessa,
you are fully dilated.
494
00:20:59,997 --> 00:21:01,434
What?
495
00:21:01,434 --> 00:21:03,914
Yep, which means there
is no time to move upstairs
496
00:21:03,914 --> 00:21:05,220
or wait for your doctor.
497
00:21:05,220 --> 00:21:07,266
No, no, no.
I can't have my baby here.
498
00:21:07,266 --> 00:21:08,571
The ED is fully equipped
for delivery.
499
00:21:08,571 --> 00:21:10,399
No, I can't have you
deliver my baby.
500
00:21:10,399 --> 00:21:11,748
I'm sorry.
501
00:21:11,748 --> 00:21:12,793
Look, I get that I'm not
your first option.
502
00:21:12,793 --> 00:21:14,011
In fact,
I'm probably your last.
503
00:21:14,011 --> 00:21:16,362
But I am
a board-certified OBGYN,
504
00:21:16,362 --> 00:21:18,059
and I have delivered
hundreds of babies.
505
00:21:18,059 --> 00:21:21,192
And I will get yours out safely
if we work together.
506
00:21:26,285 --> 00:21:27,851
OK, change of plans.
507
00:21:27,851 --> 00:21:29,157
Tessa's ready to deliver now,
so we're gonna do it here.
508
00:21:29,157 --> 00:21:30,550
Oh, OK.
509
00:21:30,550 --> 00:21:32,943
Yep, so get me another nurse,
a delivery table,
510
00:21:32,943 --> 00:21:35,076
and grab another doctor,
whoever's available.
511
00:21:35,076 --> 00:21:37,687
We'll maybe need
an extra set of hands.
512
00:21:39,341 --> 00:21:41,125
We got this, OK?
513
00:21:41,125 --> 00:21:42,301
OK.
514
00:21:45,391 --> 00:21:46,783
Where are we at?
515
00:21:46,783 --> 00:21:48,785
Long and short of it,
Paul is depressed,
516
00:21:48,785 --> 00:21:50,526
but his risk of suicide is low.
517
00:21:50,526 --> 00:21:53,355
Couldn't find any evidence
of any kind of intent
518
00:21:53,355 --> 00:21:54,965
to harm himself.
519
00:21:54,965 --> 00:21:56,706
All right, so I'll get his
discharge paperwork ready.
520
00:21:56,706 --> 00:21:58,795
Do you want to include
a psych referral?
521
00:21:58,795 --> 00:22:00,928
You know, Mags,
I'm actually not quite ready
522
00:22:00,928 --> 00:22:02,190
to discharge him.
523
00:22:02,190 --> 00:22:03,496
OK.
524
00:22:03,496 --> 00:22:04,975
Here's the thing, right?
525
00:22:04,975 --> 00:22:07,369
He gets diagnosed with
sudden-onset type 2 diabetes
526
00:22:07,369 --> 00:22:08,457
six months ago.
527
00:22:08,457 --> 00:22:11,460
No family history,
low BMI, right?
528
00:22:11,460 --> 00:22:13,984
And we all know that when you
get diagnosed with type 2,
529
00:22:13,984 --> 00:22:15,421
you don't lose weight.
530
00:22:15,421 --> 00:22:17,031
No, you gain weight, right?
531
00:22:17,031 --> 00:22:18,989
And then, there's
the sudden-onset depression.
532
00:22:18,989 --> 00:22:21,165
Again, no history, right?
533
00:22:21,165 --> 00:22:22,602
No triggers.
534
00:22:22,602 --> 00:22:24,908
I'm just wondering
if we're not missing something,
535
00:22:24,908 --> 00:22:27,128
you know, some underlying
medical condition.
536
00:22:27,128 --> 00:22:29,130
Do you want to order
a set of labs?
537
00:22:29,130 --> 00:22:31,175
Let's start out
with a CBC and a CMP,
538
00:22:31,175 --> 00:22:33,395
and I'm gonna dig into
the literature,
539
00:22:33,395 --> 00:22:36,616
see if I can't find
some kind of common thread.
540
00:22:36,616 --> 00:22:37,791
You got it.
541
00:22:41,272 --> 00:22:45,189
After lambasting them for
denying the patient's surgery,
542
00:22:45,189 --> 00:22:49,324
Dr. Ahmad goes on to tag you,
Dr. Marcel.
543
00:22:49,324 --> 00:22:51,370
"Berninger is the worst.
544
00:22:51,370 --> 00:22:54,416
"Not only do they deny
more patients than anyone,
545
00:22:54,416 --> 00:22:56,679
"they also pay physician
reviewers six figures
546
00:22:56,679 --> 00:22:58,768
to find reasons to deny."
547
00:22:58,768 --> 00:23:01,118
Now,
while Dr. Ahmad is entitled
548
00:23:01,118 --> 00:23:04,339
to express her personal
opinions on her social media--
549
00:23:04,339 --> 00:23:06,385
You, sir,
are a representative
550
00:23:06,385 --> 00:23:08,038
of the board now.
551
00:23:08,038 --> 00:23:10,258
I had no idea
she was gonna post this.
552
00:23:10,258 --> 00:23:13,566
She didn't ask you
before she publicly quoted you?
553
00:23:13,566 --> 00:23:16,133
No. She did not.
554
00:23:16,133 --> 00:23:18,048
We are on the eve
of hammering out
555
00:23:18,048 --> 00:23:20,921
a new three-year contract
with Berninger.
556
00:23:20,921 --> 00:23:23,184
And antagonizing them
with a PR nightmare
557
00:23:23,184 --> 00:23:25,447
is not exactly the tone
we wanted to set.
558
00:23:25,447 --> 00:23:27,362
We're talking about
one post here.
559
00:23:27,362 --> 00:23:29,103
I'm sure no one's
even gonna see it.
560
00:23:29,103 --> 00:23:32,280
It's going viral, Dr. Marcel.
561
00:23:34,761 --> 00:23:36,240
- What?
- Yeah.
562
00:23:36,240 --> 00:23:38,199
So we are gonna need
to do major damage control
563
00:23:38,199 --> 00:23:41,420
at the board meeting
this afternoon.
564
00:23:41,420 --> 00:23:43,726
Just follow my lead.
565
00:23:49,297 --> 00:23:50,820
What is this?
566
00:23:52,822 --> 00:23:54,911
Now, I share something with you
in a clinical setting,
567
00:23:54,911 --> 00:23:56,217
I don't expect
to see it plastered
568
00:23:56,217 --> 00:23:57,697
all over social media,
you understand?
569
00:23:57,697 --> 00:23:59,263
I should have checked
with you before I posted it.
570
00:23:59,263 --> 00:24:01,831
Yeah, that much is obvious.
571
00:24:01,831 --> 00:24:03,267
I don't mean
to sound ingenuous,
572
00:24:03,267 --> 00:24:04,921
but I didn't think
that you would mind.
573
00:24:04,921 --> 00:24:06,836
Being publicly quoted
without my consent?
574
00:24:06,836 --> 00:24:08,577
Yeah, I mind, a lot.
575
00:24:08,577 --> 00:24:10,971
- But what you said was true.
- That isn't the point.
576
00:24:10,971 --> 00:24:12,755
Look, you want to have
a viral moment?
577
00:24:12,755 --> 00:24:13,974
Be my guest.
578
00:24:13,974 --> 00:24:15,366
But don't do it at my expense.
579
00:24:15,366 --> 00:24:17,281
This isn't about
having a viral moment.
580
00:24:17,281 --> 00:24:20,633
I--this strategy might seem
unorthodox, but it works.
581
00:24:20,633 --> 00:24:21,938
Strategy?
582
00:24:21,938 --> 00:24:23,418
Since when did venting
on social media
583
00:24:23,418 --> 00:24:24,898
become a strategy?
584
00:24:24,898 --> 00:24:26,987
Public shaming is a way
to get companies' attention
585
00:24:26,987 --> 00:24:28,467
and move them to act.
586
00:24:28,467 --> 00:24:31,252
Case in point, after
the post started trending,
587
00:24:31,252 --> 00:24:34,603
Berninger sent notice, and
they escalated Vince's appeal
588
00:24:34,603 --> 00:24:36,605
for a peer-to-peer call.
589
00:24:36,605 --> 00:24:38,172
Really?
590
00:24:38,172 --> 00:24:40,304
Yeah, which is why we can't
let up on public pressure.
591
00:24:40,304 --> 00:24:42,481
I got a DM from
a local news reporter.
592
00:24:42,481 --> 00:24:44,874
She wants to interview us
on Vince's case.
593
00:24:44,874 --> 00:24:46,572
What are you,
out of your mind?
594
00:24:46,572 --> 00:24:47,660
I can't do that.
595
00:24:47,660 --> 00:24:49,183
Why not?
596
00:24:49,183 --> 00:24:51,185
Because the hospital's
got an upcoming contract
597
00:24:51,185 --> 00:24:54,405
negotiation with Berninger.
598
00:24:54,405 --> 00:24:55,711
Ah.
599
00:24:55,711 --> 00:24:58,801
So this is why the post
was such a big issue?
600
00:24:58,801 --> 00:25:01,412
That has nothing to do
with my issue,
601
00:25:01,412 --> 00:25:04,328
which is your total disregard
for professional courtesy.
602
00:25:08,724 --> 00:25:13,729
You should know that the post
wasn't just liked or reposted.
603
00:25:13,729 --> 00:25:16,906
People shared their hellish
experiences with Berninger.
604
00:25:16,906 --> 00:25:19,822
Hundreds of people,
including MDs.
605
00:25:19,822 --> 00:25:22,172
What you said resonated.
606
00:25:22,172 --> 00:25:24,392
It needed to be said.
607
00:25:26,089 --> 00:25:28,352
OK, Tessa,
the head is coming.
608
00:25:28,352 --> 00:25:29,832
You're crowning.
609
00:25:29,832 --> 00:25:31,399
I am?
610
00:25:31,399 --> 00:25:33,532
- You're doing great.
- Thank you.
611
00:25:34,576 --> 00:25:36,796
Hannah?
612
00:25:36,796 --> 00:25:38,537
What--what's going on?
613
00:25:38,537 --> 00:25:41,191
The head is out, but the
shoulders aren't coming.
614
00:25:41,191 --> 00:25:43,019
What? She's stuck?
615
00:25:43,019 --> 00:25:44,586
This can happen
with bigger babies.
616
00:25:44,586 --> 00:25:46,545
Don't worry, we will
get her out, Tessa, OK?
617
00:25:46,545 --> 00:25:48,677
Nancy, I need you to switch
with Dr. Ripley.
618
00:25:48,677 --> 00:25:49,983
Put her into McRoberts.
619
00:25:49,983 --> 00:25:51,245
Dr. Ripley,
I'm gonna need you to apply
620
00:25:51,245 --> 00:25:53,160
suprapubic pressure from above
621
00:25:53,160 --> 00:25:54,074
while I maneuver the baby out,
OK?
622
00:25:54,074 --> 00:25:55,249
You got it.
623
00:25:55,249 --> 00:25:56,642
All right, Tessa,
you got this.
624
00:25:56,642 --> 00:25:58,905
When I say push, you push
as hard as you can, OK?
625
00:25:58,905 --> 00:26:00,384
Let's go.
626
00:26:00,384 --> 00:26:01,647
Go.
627
00:26:05,738 --> 00:26:07,566
Here we go,
here we go, here we go!
628
00:26:08,654 --> 00:26:10,830
I got her!
629
00:26:12,266 --> 00:26:13,746
There's your baby girl.
630
00:26:13,746 --> 00:26:16,705
- Oh!
- Oh, my baby.
631
00:26:20,709 --> 00:26:22,015
Thank you.
632
00:26:37,726 --> 00:26:39,336
Look, just--just hold on.
633
00:26:39,336 --> 00:26:40,903
Because it says here on my--
what do you call this?
634
00:26:40,903 --> 00:26:43,471
Patient portal--that my blood
work all came back normal.
635
00:26:43,471 --> 00:26:44,515
I understand.
636
00:26:44,515 --> 00:26:45,995
So why can't
you discharge me?
637
00:26:45,995 --> 00:26:48,084
Because Dr. Charles needs
to sign off your chart.
638
00:26:48,084 --> 00:26:49,782
Well,
then go get Dr. Charles.
639
00:26:49,782 --> 00:26:50,913
Paul, don't yell at her.
640
00:26:50,913 --> 00:26:52,262
Don't tell me what to do.
641
00:26:52,262 --> 00:26:54,134
This is all your fault.
If you had--
642
00:26:54,134 --> 00:26:55,483
Dr. Charles?
643
00:26:55,483 --> 00:26:57,528
Dr. Charles,
I'd like to go home now.
644
00:26:57,528 --> 00:26:59,400
I understand
you have to sign off on that.
645
00:26:59,400 --> 00:27:00,880
I do.
646
00:27:00,880 --> 00:27:02,621
And look, Paul, I know
you've had a really long day.
647
00:27:02,621 --> 00:27:04,013
I certainly have.
648
00:27:04,013 --> 00:27:05,275
But I'd like to order
just a couple more labs
649
00:27:05,275 --> 00:27:07,669
and actually get a CT
of your abdomen.
650
00:27:07,669 --> 00:27:09,671
Why?
My blood work came back normal.
651
00:27:09,671 --> 00:27:11,325
You know,
there are certain illnesses
652
00:27:11,325 --> 00:27:13,457
that, early on, they just
kind of fly under the radar.
653
00:27:13,457 --> 00:27:15,198
Like what?
What are you looking for?
654
00:27:15,198 --> 00:27:17,070
Well, certain
medical conditions, right,
655
00:27:17,070 --> 00:27:19,115
can raise inflammation
in the body,
656
00:27:19,115 --> 00:27:21,378
which can cause depression.
657
00:27:21,378 --> 00:27:23,685
Yeah, but you've clearly
narrowed that list down now.
658
00:27:23,685 --> 00:27:25,687
Why are you looking
at my stomach?
659
00:27:25,687 --> 00:27:29,125
There is evidence that
disruptions in the physiologic
660
00:27:29,125 --> 00:27:30,300
functions of the pancreas--
661
00:27:30,300 --> 00:27:32,520
in this case,
neurotransmission--
662
00:27:32,520 --> 00:27:34,827
can alter mood
and anxiety levels.
663
00:27:34,827 --> 00:27:37,873
And in very rare cases,
sudden-onset diabetes
664
00:27:37,873 --> 00:27:40,963
has been known to be caused
by a growth in the pancreas.
665
00:27:46,534 --> 00:27:48,057
What, you--
666
00:27:50,190 --> 00:27:52,148
You think I have
pancreatic cancer?
667
00:27:52,148 --> 00:27:53,846
I'm more thinking
about this as something
668
00:27:53,846 --> 00:27:55,412
I'd like to rule out.
669
00:28:18,653 --> 00:28:20,524
Well, I want to start
by welcoming
670
00:28:20,524 --> 00:28:21,351
our newest member to the board,
671
00:28:21,351 --> 00:28:22,657
Dr. Crockett Marcel.
672
00:28:24,746 --> 00:28:26,226
All right, then.
Let's dive right in.
673
00:28:26,226 --> 00:28:29,446
Barry, if I may,
I'd actually like to address
674
00:28:29,446 --> 00:28:31,535
the elephant in the room.
675
00:28:33,407 --> 00:28:34,887
Sure, Peter.
676
00:28:34,887 --> 00:28:39,152
I think we're all aware of
the social media firestorm.
677
00:28:39,152 --> 00:28:41,850
Strike that--"firestorm" is
making a mountain out of a--
678
00:28:41,850 --> 00:28:43,330
Peter.
679
00:28:43,330 --> 00:28:46,072
Get to the point.
680
00:28:46,072 --> 00:28:49,815
An overzealous resident
misquoted Dr. Marcel
681
00:28:49,815 --> 00:28:51,599
to serve her own agenda.
682
00:28:51,599 --> 00:28:53,644
No, that's not--
683
00:28:53,644 --> 00:28:56,169
- Dr. Marcel--
- I was quoted accurately.
684
00:28:56,169 --> 00:28:59,172
OK?
Let me start by owning that.
685
00:28:59,172 --> 00:29:02,001
And Dr. Ahmad was not
serving her own agenda.
686
00:29:02,001 --> 00:29:04,438
She was trying to help
our dying patient
687
00:29:04,438 --> 00:29:06,875
battle his insurance company,
688
00:29:06,875 --> 00:29:09,008
which is a fight
doctors typically avoid.
689
00:29:09,008 --> 00:29:10,879
Trust me, I know,
it's not our lane.
690
00:29:10,879 --> 00:29:14,013
We don't deal with insurance.
691
00:29:14,013 --> 00:29:15,884
And honestly,
I feel it's time we did.
692
00:29:15,884 --> 00:29:18,539
Because these companies
are stepping into our lane.
693
00:29:22,717 --> 00:29:25,807
Take the patient
Dr. Ahmad posted about.
694
00:29:25,807 --> 00:29:28,723
Now, he was diagnosed
with stage four cancer
695
00:29:28,723 --> 00:29:31,204
three months after
his doctor first suspected
696
00:29:31,204 --> 00:29:32,205
something was wrong.
697
00:29:32,205 --> 00:29:34,555
Why such a long gap?
698
00:29:34,555 --> 00:29:36,513
Because the CT
his doctor ordered
699
00:29:36,513 --> 00:29:38,167
required prior authorization,
700
00:29:38,167 --> 00:29:39,908
and Berninger denied it.
701
00:29:43,085 --> 00:29:45,261
That's the crux of the issue.
702
00:29:55,924 --> 00:29:57,839
Paul, Pamela,
I want to introduce you
703
00:29:57,839 --> 00:30:01,060
to Dr. Washington,
who is our head of oncology
704
00:30:01,060 --> 00:30:02,888
here at Gaffney.
705
00:30:02,888 --> 00:30:04,585
Oh, wow, top dog.
706
00:30:04,585 --> 00:30:06,326
This must be bad.
707
00:30:06,326 --> 00:30:07,980
Don't read in to the title.
708
00:30:07,980 --> 00:30:10,547
While you do have a small mass
in your pancreas...
709
00:30:10,547 --> 00:30:11,722
OK.
710
00:30:11,722 --> 00:30:14,638
It's confined to the tail,
711
00:30:14,638 --> 00:30:16,466
which means it's resectable.
712
00:30:16,466 --> 00:30:18,512
That's good, right?
713
00:30:18,512 --> 00:30:19,861
It's really good.
714
00:30:19,861 --> 00:30:21,602
Surgery is far and away
the best treatment
715
00:30:21,602 --> 00:30:23,430
for pancreatic cancer.
716
00:30:23,430 --> 00:30:25,214
And it's rarely an option.
717
00:30:25,214 --> 00:30:26,650
The cancer is usually
too advanced
718
00:30:26,650 --> 00:30:28,087
by the time we catch it.
719
00:30:28,087 --> 00:30:30,959
I advise a few rounds
of chemo to shrink the tumor
720
00:30:30,959 --> 00:30:34,136
and then the distal
pancreatectomy to remove it.
721
00:30:36,312 --> 00:30:39,011
Few doctors would have
connected the dots here.
722
00:30:39,011 --> 00:30:41,404
You're lucky you ended up
with this one, Mr. Moore.
723
00:30:42,623 --> 00:30:44,538
I'm realizing that.
724
00:30:44,538 --> 00:30:46,670
Thank you, Dr. Charles.
725
00:30:46,670 --> 00:30:49,151
Absolutely a team effort.
726
00:30:53,764 --> 00:30:55,505
Thank you, Pam.
727
00:30:55,505 --> 00:30:57,812
It's not lost on me
if you hadn't conned me
728
00:30:57,812 --> 00:30:59,901
into coming in here today--
729
00:30:59,901 --> 00:31:01,207
You're gonna be OK.
730
00:31:01,207 --> 00:31:02,773
That's all I care about.
731
00:31:18,528 --> 00:31:19,703
Hey.
732
00:31:19,703 --> 00:31:21,444
I'm looking for my wife.
733
00:31:27,407 --> 00:31:28,582
Hannah.
734
00:31:28,582 --> 00:31:29,888
Nick.
735
00:31:31,019 --> 00:31:32,499
H-how do you know--
736
00:31:32,499 --> 00:31:34,370
I just delivered your baby.
737
00:31:34,370 --> 00:31:35,937
What?
738
00:31:37,199 --> 00:31:39,158
Does Tessa--
- Oh, she knows.
739
00:31:39,158 --> 00:31:41,769
- Oh, no.
- She hacked into your phone,
740
00:31:41,769 --> 00:31:43,336
found your messages,
and tracked me down.
741
00:31:43,336 --> 00:31:44,337
Oh, my God.
742
00:31:44,337 --> 00:31:45,947
Is that why she's here?
- Shh!
743
00:31:45,947 --> 00:31:47,253
She's sleeping.
744
00:31:47,253 --> 00:31:48,950
What did she say?
745
00:31:48,950 --> 00:31:50,691
Is this why
she went into labor?
746
00:31:50,691 --> 00:31:53,259
Well, it's definitely
possible for emotional stress
747
00:31:53,259 --> 00:31:55,348
to induce labor.
748
00:31:55,348 --> 00:31:59,874
But regardless, Tessa gave
birth to a healthy baby girl,
749
00:31:59,874 --> 00:32:02,485
and both mom and baby
are doing well.
750
00:32:02,485 --> 00:32:03,834
Oh, thank God.
751
00:32:08,404 --> 00:32:09,840
Look, Hannah, I'm--
752
00:32:09,840 --> 00:32:11,364
I'm not a cheater.
753
00:32:11,364 --> 00:32:14,106
Yeah, well, last night
would suggest otherwise.
754
00:32:14,106 --> 00:32:17,196
You were the only woman
I messaged on that app, OK?
755
00:32:17,196 --> 00:32:19,763
And I had no intention
of ever seeing you again.
756
00:32:19,763 --> 00:32:21,852
Don't flatter yourself.
757
00:32:21,852 --> 00:32:24,377
Look,
I made a horrible mistake.
758
00:32:24,377 --> 00:32:26,509
I was freaking out about
becoming a dad, you know,
759
00:32:26,509 --> 00:32:30,209
and I just thought,
one last night of freedom--
760
00:32:30,209 --> 00:32:33,429
OK, save your
rationalizations for your wife.
761
00:32:33,429 --> 00:32:36,041
Or better yet, spare her.
762
00:32:36,041 --> 00:32:38,478
I think that your time
is best used
763
00:32:38,478 --> 00:32:40,697
begging Tessa for forgiveness.
764
00:33:02,937 --> 00:33:04,460
Hey.
765
00:33:06,375 --> 00:33:07,768
What is it?
766
00:33:07,768 --> 00:33:09,509
Vince just started
vomiting blood.
767
00:33:19,345 --> 00:33:20,694
Dr. Charles?
768
00:33:20,694 --> 00:33:22,391
Mrs. Moore?
769
00:33:22,391 --> 00:33:23,827
Are you all right?
770
00:33:23,827 --> 00:33:26,265
Look, we know
it's a scary diagnosis,
771
00:33:26,265 --> 00:33:28,006
but in terms
of pancreatic cancer,
772
00:33:28,006 --> 00:33:30,443
his prognosis could
not be better.
773
00:33:30,443 --> 00:33:32,880
And that's largely
because of your efforts.
774
00:33:32,880 --> 00:33:35,317
You saved his life
by bringing him in today.
775
00:33:35,317 --> 00:33:38,277
Well, he has quite a way
of thanking me.
776
00:33:40,975 --> 00:33:42,803
He wants a divorce.
777
00:33:52,769 --> 00:33:54,771
Vince, we're concerned
you may be developing
778
00:33:54,771 --> 00:33:56,077
a tear in your lower esophagus
779
00:33:56,077 --> 00:33:58,514
from all of the vomiting.
780
00:33:58,514 --> 00:34:00,516
I'd like to place
an NG tube, Vince.
781
00:34:00,516 --> 00:34:02,040
- No.
- Just for the time being.
782
00:34:02,040 --> 00:34:03,345
No, no tubes.
783
00:34:03,345 --> 00:34:04,955
How many times
do I have to tell you--
784
00:34:04,955 --> 00:34:06,131
Hear me out.
785
00:34:06,131 --> 00:34:07,610
It's not a feeding tube.
786
00:34:07,610 --> 00:34:09,264
It's just gonna stop you
from vomiting,
787
00:34:09,264 --> 00:34:11,223
and it'll help during surgery
788
00:34:11,223 --> 00:34:12,702
to decompress
your stomach, OK?
789
00:34:12,702 --> 00:34:14,530
Wait.
790
00:34:14,530 --> 00:34:16,445
Did you just say surgery?
791
00:34:16,445 --> 00:34:18,186
Yeah, I heard "surgery,"
too, Dr. Marcel.
792
00:34:18,186 --> 00:34:19,274
Mm-hmm.
793
00:34:19,274 --> 00:34:20,667
That's right.
794
00:34:20,667 --> 00:34:23,017
The board voted unanimously
for the hospital
795
00:34:23,017 --> 00:34:25,063
to cover the costs
of Vince's surgery.
796
00:34:29,110 --> 00:34:30,764
Seriously?
797
00:34:31,895 --> 00:34:33,984
The hospital is just
gonna pay for it?
798
00:34:33,984 --> 00:34:35,725
Yep.
799
00:34:37,510 --> 00:34:39,903
I can't believe this.
800
00:34:39,903 --> 00:34:42,515
Is this real?
801
00:34:42,515 --> 00:34:44,517
It's very real.
802
00:34:44,517 --> 00:34:47,128
In fact, I got you scheduled
in the OR
803
00:34:47,128 --> 00:34:48,999
for 8:00 a.m. tomorrow.
804
00:34:51,915 --> 00:34:54,179
Hey, you guys are going
to Italy in three weeks.
805
00:34:54,179 --> 00:34:55,745
We got no time to waste.
806
00:35:00,620 --> 00:35:03,318
How can I begin to thank you?
807
00:35:03,318 --> 00:35:06,016
To thank you both?
808
00:35:06,016 --> 00:35:10,108
Well, how about you let us
place this NG tube, OK?
809
00:35:15,548 --> 00:35:17,593
All right.
810
00:35:17,593 --> 00:35:19,334
Do you think it was
the depression that made him
811
00:35:19,334 --> 00:35:21,858
make such a rash decision?
812
00:35:21,858 --> 00:35:23,556
You know, I don't, actually.
813
00:35:23,556 --> 00:35:25,166
But what possessed him
to do it right now?
814
00:35:25,166 --> 00:35:27,037
I mean, he couldn't even wait
until they were home?
815
00:35:27,037 --> 00:35:29,301
Your mortality can be
a pretty powerful motivator
816
00:35:29,301 --> 00:35:33,218
to do all the stuff
that you put off doing, right?
817
00:35:33,218 --> 00:35:34,741
I think that Paul
had been thinking
818
00:35:34,741 --> 00:35:36,221
about this for a while.
819
00:35:36,221 --> 00:35:37,396
I wonder if he's
gonna regret it.
820
00:35:37,396 --> 00:35:38,701
I mean,
speaking from experience,
821
00:35:38,701 --> 00:35:40,877
he's got a long road
ahead of him.
822
00:35:40,877 --> 00:35:42,792
One that's not easy
to walk alone.
823
00:35:42,792 --> 00:35:45,926
Yeah, but I mean, given his
feelings about the marriage,
824
00:35:45,926 --> 00:35:47,754
is it really--
825
00:35:47,754 --> 00:35:49,538
really fair to Pamela
to put her in the position
826
00:35:49,538 --> 00:35:51,758
of being the support system?
827
00:35:57,546 --> 00:35:58,765
I'm sorry.
828
00:35:58,765 --> 00:36:00,680
No apology necessary.
829
00:36:00,680 --> 00:36:03,509
I've been through
enough divorces
830
00:36:03,509 --> 00:36:04,901
to be able to say
with some authority,
831
00:36:04,901 --> 00:36:07,469
spontaneous weeping
is a part of the deal.
832
00:36:10,559 --> 00:36:12,779
Tonight's my annual MRI.
833
00:36:12,779 --> 00:36:15,564
Make sure that my cancer
hasn't returned.
834
00:36:15,564 --> 00:36:18,785
I've been dreading it all day.
835
00:36:18,785 --> 00:36:21,788
Ben and I always made our
appointments together.
836
00:36:21,788 --> 00:36:22,963
Yeah.
837
00:36:28,751 --> 00:36:31,232
When I saw the appointment
approaching on my calendar,
838
00:36:31,232 --> 00:36:33,843
I almost texted Ben.
839
00:36:35,802 --> 00:36:37,282
I wanted to see
if he wanted to keep
840
00:36:37,282 --> 00:36:40,241
the tradition alive, but--
841
00:36:40,241 --> 00:36:41,590
then I remembered--
842
00:36:44,767 --> 00:36:47,640
He's not
my support system anymore.
843
00:36:49,163 --> 00:36:51,209
And I'm not his.
844
00:37:01,741 --> 00:37:03,830
Dr. Ahmad, hey.
845
00:37:04,961 --> 00:37:06,398
What's going on
with that interview?
846
00:37:06,398 --> 00:37:07,834
Why?
847
00:37:07,834 --> 00:37:09,270
Did the board give you
approval to join me?
848
00:37:09,270 --> 00:37:10,793
Oh, no.
849
00:37:10,793 --> 00:37:12,317
The board would appreciate
it if the interview
850
00:37:12,317 --> 00:37:14,449
went away altogether.
851
00:37:14,449 --> 00:37:16,799
There it is, the catch.
852
00:37:16,799 --> 00:37:18,975
This issue is bigger
than just one patient.
853
00:37:18,975 --> 00:37:21,282
And the board
recognizes that,
854
00:37:21,282 --> 00:37:23,719
which is why they're making
prior authorization
855
00:37:23,719 --> 00:37:26,635
a key issue in negotiations
with Berninger.
856
00:37:26,635 --> 00:37:28,115
And you trust
they'll follow through?
857
00:37:28,115 --> 00:37:29,986
I'll be holding
their feet to the fire.
858
00:37:31,423 --> 00:37:34,817
I agreed to serve as an advisor
on prior authorization
859
00:37:34,817 --> 00:37:38,125
for the negotiating committee.
860
00:37:38,125 --> 00:37:41,737
So am I still
in the doghouse?
861
00:37:41,737 --> 00:37:43,304
Now, you went to the mat
for a patient.
862
00:37:43,304 --> 00:37:45,263
Not a grudge-worthy offense
in my book.
863
00:37:45,263 --> 00:37:48,266
But for what it's worth.
864
00:37:48,266 --> 00:37:49,658
Here we go.
865
00:37:49,658 --> 00:37:51,704
Look, there's a benefit
866
00:37:51,704 --> 00:37:54,402
to being taken seriously
by management.
867
00:37:54,402 --> 00:37:55,621
You get invited into rooms
868
00:37:55,621 --> 00:37:57,318
where you can actually
have an impact.
869
00:37:57,318 --> 00:38:00,843
I'm not sure that's the kind
of impact I'm trying to make.
870
00:38:00,843 --> 00:38:02,192
I'm not saying it is.
871
00:38:02,192 --> 00:38:07,589
But maybe you want
to keep your options open.
872
00:38:09,025 --> 00:38:11,332
Thanks for the pearls,
Obi-Wan.
873
00:38:11,332 --> 00:38:13,334
Oh, anytime.
874
00:38:22,169 --> 00:38:26,042
Well, today settles it.
875
00:38:27,217 --> 00:38:28,044
Joining a nunnery?
876
00:38:28,044 --> 00:38:29,959
Deleting all dating apps.
877
00:38:29,959 --> 00:38:31,439
Ah.
878
00:38:31,439 --> 00:38:33,659
Probably for the best.
879
00:38:33,659 --> 00:38:36,096
All that swiping,
head buried in your phone.
880
00:38:36,096 --> 00:38:38,228
Might get a crick in my neck.
881
00:38:38,228 --> 00:38:40,318
Might miss out
on meeting someone in the--
882
00:38:40,318 --> 00:38:41,362
what do the kids say?
883
00:38:41,362 --> 00:38:43,233
IRL?
884
00:38:43,233 --> 00:38:45,584
In real life?
885
00:38:45,584 --> 00:38:47,499
- Hmm.
- Have a good night, Asher.
886
00:38:55,071 --> 00:38:56,769
Come in.
887
00:38:58,379 --> 00:38:59,946
Hey.
- Hey.
888
00:38:59,946 --> 00:39:02,035
I know we're supposed to be
meeting at the restaurant,
889
00:39:02,035 --> 00:39:04,254
but I thought
you might need a ride.
890
00:39:04,254 --> 00:39:05,778
Close the door.
891
00:39:10,609 --> 00:39:13,742
I was just about to call you,
892
00:39:13,742 --> 00:39:15,744
because I'm gonna actually
893
00:39:15,744 --> 00:39:17,572
need a rain check tonight.
894
00:39:17,572 --> 00:39:20,314
- Oh?
- Yeah, something came up.
895
00:39:20,314 --> 00:39:22,098
This is not because of our
conversation this morning,
896
00:39:22,098 --> 00:39:24,362
I hope?
- No, no, no, no.
897
00:39:24,362 --> 00:39:25,624
Because if it is,
I didn't mean to pressure you.
898
00:39:25,624 --> 00:39:27,277
You didn't at all.
899
00:39:27,277 --> 00:39:31,238
In fact, I think we should
start telling people.
900
00:39:31,238 --> 00:39:33,414
I'm sorry, what?
901
00:39:33,414 --> 00:39:35,416
You know,
I've always carried myself with
902
00:39:35,416 --> 00:39:38,680
a sense of propriety,
and I spend a lot of time
903
00:39:38,680 --> 00:39:41,770
encouraging my colleagues
to do the same.
904
00:39:41,770 --> 00:39:46,079
But I just think
if you feel strongly
905
00:39:46,079 --> 00:39:49,474
about something in private,
906
00:39:49,474 --> 00:39:51,998
you should own it in public.
907
00:39:51,998 --> 00:39:53,608
"Strongly," you say?
908
00:39:53,608 --> 00:39:55,610
"Strongly," she said.
909
00:39:59,440 --> 00:40:02,095
You sure you don't want
to join me for dinner tonight?
910
00:40:03,966 --> 00:40:06,316
I'm suddenly very much
in the mood to celebrate.
911
00:40:06,316 --> 00:40:07,535
I can't, I can't.
912
00:40:07,535 --> 00:40:10,451
But I'll tell you what.
913
00:40:10,451 --> 00:40:13,149
If you're up late,
914
00:40:13,149 --> 00:40:16,631
I will stop by for a nightcap.
915
00:40:16,631 --> 00:40:18,807
Then I most definitely
will be up late.
916
00:40:23,638 --> 00:40:25,814
I'll see you later.
917
00:40:25,814 --> 00:40:27,729
See you then.
64062
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