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1
00:00:05,639 --> 00:00:07,399
Ben and I are getting a divorce.
2
00:00:07,424 --> 00:00:09,491
I really just wanna move on.
3
00:00:10,760 --> 00:00:13,221
I'll be around the ED more
often if I can ever help out.
4
00:00:13,263 --> 00:00:14,806
Are you flying anywhere today?
5
00:00:14,848 --> 00:00:17,225
- No, shift just ended.
- Treatment seven.
6
00:00:17,267 --> 00:00:20,020
Welcome to the
team, Dr. Johnson.
7
00:00:20,061 --> 00:00:22,147
Something's wrong with Dad.
8
00:00:22,188 --> 00:00:24,149
He's forgetting things.
9
00:00:24,190 --> 00:00:25,358
It's getting worse.
10
00:00:25,400 --> 00:00:27,694
He doesn't know where he is.
11
00:00:27,736 --> 00:00:30,030
Damn.
12
00:00:30,071 --> 00:00:31,948
You've already flamed
out of two hospitals,
13
00:00:31,990 --> 00:00:34,117
and you're doing your best
to flame out of a third?
14
00:00:34,159 --> 00:00:35,618
So I'm not fired?
15
00:00:35,660 --> 00:00:36,995
Medical ethics course.
16
00:00:37,037 --> 00:00:38,913
If I were you, I'd take notes.
17
00:00:41,499 --> 00:00:42,959
Wow.
18
00:00:43,001 --> 00:00:45,628
How does that make you feel?
19
00:00:45,670 --> 00:00:47,047
I'm not sure.
20
00:00:47,088 --> 00:00:48,715
It is what it is.
21
00:00:48,757 --> 00:00:51,885
- Good morning, Peter.
- Morning, Maggie. Dr. Ahmad.
22
00:00:51,926 --> 00:00:53,845
Do we have a notary in house?
23
00:00:53,887 --> 00:00:55,055
I have some papers to sign.
24
00:00:55,096 --> 00:00:56,389
Yeah, Edward.
25
00:00:56,431 --> 00:00:58,071
I'll send him down at
the end of the day.
26
00:00:58,099 --> 00:00:59,684
You need some help?
27
00:00:59,726 --> 00:01:01,561
- Are you a doctor?
- I am. What happened?
28
00:01:01,603 --> 00:01:03,563
I don't know. I've never
seen this man before.
29
00:01:03,605 --> 00:01:05,357
He was wandering a
couple blocks from here.
30
00:01:05,398 --> 00:01:07,150
He kept saying, "Help Betty."
31
00:01:07,192 --> 00:01:08,318
He's really cold.
32
00:01:08,360 --> 00:01:09,861
Okay, let's get him inside.
33
00:01:09,903 --> 00:01:11,446
Betty.
34
00:01:14,199 --> 00:01:15,408
Dr. Sorensen.
35
00:01:15,450 --> 00:01:17,077
No, I'm Dr. Ripley.
36
00:01:17,118 --> 00:01:18,411
Nancy, he's hypothermic.
37
00:01:18,453 --> 00:01:19,513
I need blankets
and warm IV bags.
38
00:01:19,537 --> 00:01:20,872
On it. You're going to five.
39
00:01:20,914 --> 00:01:23,333
Okay.
40
00:01:23,375 --> 00:01:25,877
Help Betty.
41
00:01:25,919 --> 00:01:26,919
Betty?
42
00:01:28,963 --> 00:01:30,256
Hey, Daniel.
43
00:01:30,298 --> 00:01:32,425
- Morning.
- Good morning.
44
00:01:32,467 --> 00:01:34,177
When was the last
time you saw Bert?
45
00:01:34,219 --> 00:01:36,137
Not for a while.
46
00:01:36,179 --> 00:01:37,281
I mean, come to think of it,
47
00:01:37,305 --> 00:01:39,265
I did call him a
couple weeks ago,
48
00:01:39,307 --> 00:01:41,476
and he was in a hurry.
49
00:01:41,518 --> 00:01:43,663
Said he'd call me back, and
I'm now realizing he never did.
50
00:01:43,687 --> 00:01:45,980
Yeah, and is that
something you've noticed
51
00:01:46,022 --> 00:01:47,565
- his memory?
- Not really.
52
00:01:47,607 --> 00:01:49,776
I mean, that could
happen to any of us.
53
00:01:49,818 --> 00:01:51,444
I mean, I do that
stuff all the time.
54
00:01:51,486 --> 00:01:52,546
Why? Are you worried about him?
55
00:01:52,570 --> 00:01:54,739
I don't know, but Tara is.
56
00:01:54,781 --> 00:01:56,116
And he was here.
57
00:01:56,157 --> 00:01:58,993
He fell when he was
watching Isaiah.
58
00:01:59,035 --> 00:02:00,370
He fell?
59
00:02:00,412 --> 00:02:03,498
Yeah, nothing serious,
but he did twist his knee.
60
00:02:03,540 --> 00:02:05,375
He just seemed a
little confused,
61
00:02:05,417 --> 00:02:06,960
and I wouldn't be concerned,
62
00:02:07,002 --> 00:02:10,463
but Bert does have a
family history of dementia.
63
00:02:10,505 --> 00:02:12,716
We should probably
have him checked out.
64
00:02:12,757 --> 00:02:16,928
To get Bert to see a doctor
for anything is an ordeal.
65
00:02:16,970 --> 00:02:18,930
- You know that.
- Right, tell me about it.
66
00:02:18,972 --> 00:02:22,475
But he's coming here today
for a follow-up on his knee.
67
00:02:22,517 --> 00:02:24,561
Oh, well, why don't
I just, you know,
68
00:02:24,602 --> 00:02:27,480
spontaneously stop by,
have a little chat?
69
00:02:27,522 --> 00:02:29,065
That would be great.
70
00:02:29,107 --> 00:02:30,984
Thank you.
71
00:02:32,861 --> 00:02:34,029
Hi, Alex.
72
00:02:34,070 --> 00:02:36,156
- Hi.
- I'm Dr. Ahmad.
73
00:02:36,197 --> 00:02:38,324
Emily. My husband, Mark.
74
00:02:38,366 --> 00:02:41,369
So I see that your
heart rate is fast.
75
00:02:41,411 --> 00:02:43,121
I don't feel it.
76
00:02:43,163 --> 00:02:44,956
But his watch says it's at 140.
77
00:02:44,998 --> 00:02:47,292
It's probably nothing, but
that's why we brought him in.
78
00:02:47,334 --> 00:02:50,211
Well, your watch
isn't lying, 140.
79
00:02:50,253 --> 00:02:52,213
Rest of your vitals are good.
80
00:02:52,255 --> 00:02:53,357
Is there anything bothering you?
81
00:02:53,381 --> 00:02:54,507
No, I feel fine.
82
00:02:54,549 --> 00:02:56,092
Normally, he eats like a horse,
83
00:02:56,134 --> 00:02:58,511
but the last couple of days,
he's hardly had anything.
84
00:02:58,553 --> 00:03:00,347
I just wasn't hungry.
85
00:03:03,224 --> 00:03:05,477
Lungs sound good.
86
00:03:07,562 --> 00:03:09,731
Lymph nodes aren't swollen.
87
00:03:09,773 --> 00:03:11,191
Any tenderness?
88
00:03:11,232 --> 00:03:12,859
Mm-mm.
89
00:03:12,901 --> 00:03:13,860
What about here?
90
00:03:14,903 --> 00:03:17,072
Yeah, a little bit.
91
00:03:17,113 --> 00:03:18,573
What does that mean?
92
00:03:18,615 --> 00:03:21,409
I'm not sure, but I'd like
to order a CT to find out.
93
00:03:23,745 --> 00:03:25,455
- Okay.
- I'll put the order in.
94
00:03:25,497 --> 00:03:26,956
I'll be back to
check on you soon.
95
00:03:26,998 --> 00:03:27,999
- Thank you.
- Yeah.
96
00:03:28,041 --> 00:03:30,168
Thank you.
97
00:03:30,210 --> 00:03:31,711
- Loren?
- Maggie.
98
00:03:31,753 --> 00:03:34,297
Kaitlin Neeley,
28, septic shock.
99
00:03:34,339 --> 00:03:36,883
Leukocytosis and hypotensive.
100
00:03:36,925 --> 00:03:40,220
BP 80/43, temp 103.5.
101
00:03:40,261 --> 00:03:41,429
She was pregnant.
102
00:03:41,471 --> 00:03:43,139
Water broke at 15
weeks pre-viability.
103
00:03:43,181 --> 00:03:44,557
That was two weeks ago.
104
00:03:44,599 --> 00:03:46,226
It's not there. It's not there.
105
00:03:46,267 --> 00:03:47,435
No, don't say it.
106
00:03:47,477 --> 00:03:49,604
- No, no.
- Honey, everything's okay.
107
00:03:49,646 --> 00:03:51,624
We're at the hospital. They're
gonna take care of you.
108
00:03:51,648 --> 00:03:52,917
They were driving here,
but she got so sick,
109
00:03:52,941 --> 00:03:54,442
they had to pull over.
110
00:03:54,484 --> 00:03:55,836
Rural clinic didn't have the
capabilities to care for her,
111
00:03:55,860 --> 00:03:57,779
- so they called me.
- Okay.
112
00:03:57,821 --> 00:03:59,239
Can I help?
113
00:03:59,280 --> 00:04:00,240
No, unfortunately, this is OB.
114
00:04:00,281 --> 00:04:01,616
- Hannah.
- Yeah.
115
00:04:01,658 --> 00:04:03,660
Kaitlin Neeley, 15
weeks, water broke.
116
00:04:03,702 --> 00:04:05,078
White blood count is high.
117
00:04:05,120 --> 00:04:06,454
This is her husband, Eric.
118
00:04:06,496 --> 00:04:08,289
All right, Maggie,
start a second IV.
119
00:04:08,331 --> 00:04:09,976
- You got it, Doc.
- Did they perform a D&E?
120
00:04:10,000 --> 00:04:11,501
No, the doctor said
they had to wait
121
00:04:11,543 --> 00:04:12,937
for her to pass the
remains on her own.
122
00:04:12,961 --> 00:04:16,131
Okay, CBC, CMP, lactate,
and blood cultures.
123
00:04:16,172 --> 00:04:17,924
Oh, honey!
124
00:04:17,966 --> 00:04:19,426
Honey!
125
00:04:19,467 --> 00:04:20,820
I need to start your wife
on antibiotics immediately.
126
00:04:20,844 --> 00:04:22,154
Do you know if she's
allergic to any?
127
00:04:22,178 --> 00:04:23,513
- She isn't.
- Okay.
128
00:04:23,555 --> 00:04:26,016
Triple up... ampicillin,
clindamycin, gentamicin.
129
00:04:26,057 --> 00:04:27,058
Copy that.
130
00:04:27,100 --> 00:04:28,143
Your wife is very sick,
131
00:04:28,184 --> 00:04:29,495
but we're gonna take
good care of her.
132
00:04:43,368 --> 00:04:45,587
She's been carrying fetal
remains for two weeks.
133
00:04:45,612 --> 00:04:47,370
- Oh, my God.
- And she couldn't get a D&E?
134
00:04:47,412 --> 00:04:48,997
No, her doctor wouldn't do it.
135
00:04:49,039 --> 00:04:50,665
Why?
136
00:04:53,918 --> 00:04:55,045
How's our patient?
137
00:04:55,086 --> 00:04:56,087
Better.
138
00:04:56,129 --> 00:04:58,340
Temp's come up to 95.
139
00:04:58,381 --> 00:04:59,674
How is his cognition?
140
00:05:03,303 --> 00:05:04,763
Sir.
141
00:05:07,432 --> 00:05:08,767
Can you tell us your name?
142
00:05:08,808 --> 00:05:10,894
Jimmy.
143
00:05:10,935 --> 00:05:12,312
Did you hurt yourself?
144
00:05:12,354 --> 00:05:14,689
- Maybe hit your head?
- No.
145
00:05:14,731 --> 00:05:15,815
Betty.
146
00:05:15,857 --> 00:05:17,400
Who's Betty?
147
00:05:17,442 --> 00:05:18,985
My sister.
148
00:05:19,027 --> 00:05:21,905
No ID, but he had this
Post-it in his pocket.
149
00:05:21,946 --> 00:05:23,239
It's a telephone number.
150
00:05:23,281 --> 00:05:25,116
- What happened to Betty?
- Where is she?
151
00:05:25,158 --> 00:05:27,786
Home. She got sick.
152
00:05:27,827 --> 00:05:30,705
Get Dr. Sorensen.
153
00:05:30,747 --> 00:05:32,499
Is... is that her
doctor or your doctor?
154
00:05:32,540 --> 00:05:35,210
Dr. Sorensen.
155
00:05:35,251 --> 00:05:36,628
Does he work at this hospital?
156
00:05:36,670 --> 00:05:38,963
- Yes, here.
- Okay.
157
00:05:39,005 --> 00:05:41,216
Okay, see if you can
find this Dr. Sorensen
158
00:05:41,257 --> 00:05:42,509
and try that number.
159
00:05:46,137 --> 00:05:47,698
We're gonna take good
care of you, Jimmy.
160
00:05:47,722 --> 00:05:48,473
Okay?
161
00:05:48,515 --> 00:05:50,475
Oh, thank you.
162
00:05:56,564 --> 00:05:59,067
Dr. Charles?
163
00:05:59,109 --> 00:06:01,277
I've got an elderly patient,
164
00:06:01,319 --> 00:06:03,071
severely hypothermic.
165
00:06:03,113 --> 00:06:06,032
No visible injuries, um,
166
00:06:06,074 --> 00:06:07,784
but he's pretty out of it.
167
00:06:07,826 --> 00:06:09,828
No ID other than a phone number.
168
00:06:09,869 --> 00:06:12,706
I'm thinking he's got dementia
or maybe wandered away
169
00:06:12,747 --> 00:06:14,874
- from a care facility.
- Oh.
170
00:06:14,916 --> 00:06:16,251
You wanna give me your take?
171
00:06:16,292 --> 00:06:18,086
Sure.
172
00:06:18,128 --> 00:06:20,005
His name's Jimmy.
173
00:06:20,046 --> 00:06:22,132
- Shoot me his chart.
- Give me a couple minutes.
174
00:06:22,173 --> 00:06:23,967
Yeah.
175
00:06:24,009 --> 00:06:27,012
Hi, Alex. Mr. and Mrs. Foster.
176
00:06:27,053 --> 00:06:28,614
- This is Dr. Marcel.
- He's one of our surgeons.
177
00:06:28,638 --> 00:06:30,181
I've asked him to consult.
178
00:06:30,223 --> 00:06:31,975
Surgeon? Why?
179
00:06:32,017 --> 00:06:35,145
Well, Radiology said that
Alex's CT was equivocal,
180
00:06:35,186 --> 00:06:37,564
meaning it was inconclusive.
181
00:06:37,605 --> 00:06:41,109
But what it did show is
a possible appendicitis.
182
00:06:41,151 --> 00:06:44,988
And from my experience, with
Alex's elevated heart rate
183
00:06:45,030 --> 00:06:46,031
and loss of appetite,
184
00:06:46,072 --> 00:06:47,699
I believe that is,
indeed, the case.
185
00:06:47,741 --> 00:06:49,617
So I'd like to operate.
186
00:06:49,659 --> 00:06:51,453
Wait, so you're not
sure it's appendicitis?
187
00:06:51,494 --> 00:06:52,662
No.
188
00:06:52,704 --> 00:06:54,164
Why do I have to
have an operation?
189
00:06:54,205 --> 00:06:56,916
Because if it is appendicitis
and your appendix bursts,
190
00:06:56,958 --> 00:06:59,419
that would put you at risk
of an infection in the belly,
191
00:06:59,461 --> 00:07:02,005
and that could be
life-threatening.
192
00:07:02,047 --> 00:07:03,757
Oh.
193
00:07:03,798 --> 00:07:06,051
But we can avoid that
with a minimally invasive
194
00:07:06,092 --> 00:07:08,803
laparoscopic surgery
done with a camera
195
00:07:08,845 --> 00:07:10,805
through several small incisions
196
00:07:10,847 --> 00:07:12,807
what we call a Band-Aid surgery.
197
00:07:12,849 --> 00:07:14,351
I agree with Dr. Marcel.
198
00:07:14,392 --> 00:07:18,355
A laparoscopic appendectomy
is the best course of action.
199
00:07:18,396 --> 00:07:20,076
Most likely, he'd be
done in half an hour.
200
00:07:21,274 --> 00:07:22,734
Mom? Dad?
201
00:07:26,279 --> 00:07:27,947
Yeah, okay.
202
00:07:27,989 --> 00:07:29,532
Okay.
203
00:07:29,574 --> 00:07:30,742
- All right.
- Thank you.
204
00:07:30,784 --> 00:07:32,243
I'll see you after.
205
00:07:32,285 --> 00:07:33,370
- All right.
- Thank you.
206
00:07:33,411 --> 00:07:35,914
Thank you.
207
00:07:35,955 --> 00:07:38,416
- You okay?
- It'll be fine. Mm-hmm.
208
00:07:43,213 --> 00:07:45,382
Is she doing any better?
209
00:07:45,423 --> 00:07:47,550
About the same.
210
00:07:47,592 --> 00:07:48,903
You know, I don't have
any more flights today,
211
00:07:48,927 --> 00:07:50,488
so I think I'll stick
around, if you don't mind.
212
00:07:50,512 --> 00:07:51,971
Mm.
213
00:07:52,013 --> 00:07:55,433
Maybe I can give Eric
some moral support.
214
00:07:55,475 --> 00:07:56,685
That's a good idea.
215
00:07:58,103 --> 00:08:00,897
Are you gonna do that operation?
216
00:08:00,939 --> 00:08:04,067
I recommend we try to
induce instead of a D&E.
217
00:08:04,109 --> 00:08:07,570
Surgery can be much
riskier if she's septic.
218
00:08:10,073 --> 00:08:12,659
Tell me what happened.
219
00:08:12,701 --> 00:08:14,202
Kaitlin's water broke.
220
00:08:14,244 --> 00:08:17,122
Everybody said the fetus
couldn't survive at 15 weeks,
221
00:08:17,163 --> 00:08:18,915
but it was still alive,
222
00:08:18,957 --> 00:08:23,420
so doctors were
afraid to do the D&E.
223
00:08:23,461 --> 00:08:24,754
She didn't wanna get arrested.
224
00:08:26,923 --> 00:08:29,384
Where we live,
that could happen.
225
00:08:29,426 --> 00:08:31,511
They sent us home.
226
00:08:31,553 --> 00:08:33,596
Kaitlin got sicker and sicker.
227
00:08:33,638 --> 00:08:35,557
And I kept calling, and
they kept telling me
228
00:08:35,598 --> 00:08:38,768
it wasn't a
life-threatening emergency.
229
00:08:38,810 --> 00:08:42,313
Finally, I just gave up
and started driving here.
230
00:08:42,355 --> 00:08:44,357
Kaitlin's from Chicago.
231
00:08:44,399 --> 00:08:47,569
When we got married, we
moved to my family's farm,
232
00:08:47,610 --> 00:08:50,321
where I grew up.
233
00:08:50,363 --> 00:08:53,742
We were so excited when
Kaitlin finally got pregnant.
234
00:08:56,161 --> 00:08:59,748
She's been so worried she's
not gonna be able to again.
235
00:09:01,666 --> 00:09:05,295
Eric, I'm gonna do
the best that I can.
236
00:09:05,337 --> 00:09:08,548
But I don't know.
237
00:09:08,590 --> 00:09:09,549
I don't know.
238
00:09:18,266 --> 00:09:20,226
Okay, staple line looks good.
239
00:09:20,268 --> 00:09:21,603
No bleeding.
240
00:09:24,230 --> 00:09:26,107
Nice and easy.
241
00:09:31,446 --> 00:09:32,947
Appendix is in the bag.
242
00:09:32,989 --> 00:09:35,283
Gently wiggle the
bag circularly,
243
00:09:35,325 --> 00:09:37,535
and then pull it up and out.
244
00:09:41,456 --> 00:09:42,582
Hold on.
245
00:09:45,752 --> 00:09:48,171
This feels unusual.
246
00:09:48,213 --> 00:09:50,757
Go ahead and send that for a
stat frozen section, please.
247
00:10:00,225 --> 00:10:02,686
Definitely some
cognitive impairment,
248
00:10:02,727 --> 00:10:04,396
though I'm not quite sure why.
249
00:10:04,437 --> 00:10:07,857
Tox screen's negative,
no sign of head trauma.
250
00:10:07,899 --> 00:10:10,068
The childlike affect, it's
not what you normally see
251
00:10:10,110 --> 00:10:12,362
with Alzheimer's or
vascular dementia,
252
00:10:12,404 --> 00:10:13,988
though you can't rule it out.
253
00:10:14,030 --> 00:10:17,867
I'm thinking some kind
of intellectual deficit.
254
00:10:17,909 --> 00:10:19,703
So I'm thinking we
should get a head CT.
255
00:10:19,744 --> 00:10:20,995
Definitely.
256
00:10:21,037 --> 00:10:22,664
We have no more
information on the guy?
257
00:10:22,706 --> 00:10:23,873
You reach out to CPD?
258
00:10:23,915 --> 00:10:25,458
Yeah, there's no missing persons
259
00:10:25,500 --> 00:10:28,003
matching his description, and
no one's come looking for him.
260
00:10:28,044 --> 00:10:30,797
He can't stop talking about
his sister, Betty, right,
261
00:10:30,839 --> 00:10:33,341
how he is just very
concerned about her.
262
00:10:33,383 --> 00:10:34,968
She's sick. She needs our help.
263
00:10:35,010 --> 00:10:36,469
Yeah, but given
his mental state,
264
00:10:36,511 --> 00:10:38,179
is that even a real person?
265
00:10:38,221 --> 00:10:39,865
You know, maybe it's
someone from his childhood
266
00:10:39,889 --> 00:10:42,058
- or a show he saw on TV.
- Yeah.
267
00:10:42,100 --> 00:10:43,768
I tried the number he had again
268
00:10:43,810 --> 00:10:44,936
still no answer.
269
00:10:44,978 --> 00:10:47,397
- I left another message.
- Okay.
270
00:10:47,439 --> 00:10:49,899
Let's say that is actually
Betty's number, right?
271
00:10:49,941 --> 00:10:51,735
Maybe she's not answering
because she can't
272
00:10:51,776 --> 00:10:54,738
because she is, in
fact, incapacitated.
273
00:10:54,779 --> 00:10:57,866
How about we ask CPD
to run a reverse trace?
274
00:10:57,907 --> 00:10:59,659
That way, at least,
we'll get an address.
275
00:10:59,701 --> 00:11:00,827
Okay.
276
00:11:10,295 --> 00:11:12,380
Dr. Archer, incoming.
277
00:11:12,422 --> 00:11:13,482
You're going to trauma four.
278
00:11:13,506 --> 00:11:14,758
Damon Adams, 28,
279
00:11:14,799 --> 00:11:17,510
shortness of
breath, diaphoretic.
280
00:11:17,552 --> 00:11:20,221
BP 130/90, heart
rate 125. Sats 89.
281
00:11:20,263 --> 00:11:22,432
- Need help.
- It's right there.
282
00:11:22,474 --> 00:11:23,808
Sean.
283
00:11:23,850 --> 00:11:24,910
He lives at the
center where I work.
284
00:11:24,934 --> 00:11:27,604
I've been counseling him.
285
00:11:27,645 --> 00:11:29,439
All right, wait here.
286
00:11:29,481 --> 00:11:31,566
All right, on my count. Ready?
287
00:11:31,608 --> 00:11:34,027
We good? One, two, three.
288
00:11:35,737 --> 00:11:37,238
All right, Damon,
I'm Dr. Archer.
289
00:11:37,280 --> 00:11:38,073
What's going on?
290
00:11:38,114 --> 00:11:40,241
- Real sick.
- Yeah?
291
00:11:40,283 --> 00:11:41,201
When did this start?
292
00:11:41,242 --> 00:11:43,828
A couple days ago.
293
00:11:43,870 --> 00:11:45,181
- I can't catch my breath.
- Well, we can help you.
294
00:11:45,205 --> 00:11:46,790
Come on, let's get him up here.
295
00:11:46,831 --> 00:11:49,459
Lift him up. Start
him on 100% O2.
296
00:11:49,501 --> 00:11:50,710
AP chest stat.
297
00:11:50,752 --> 00:11:54,172
I need a CBC, BNP, and an ABG.
298
00:11:56,508 --> 00:11:59,469
- X-ray.
- Clear.
299
00:11:59,511 --> 00:12:00,929
Pulmonary edema.
300
00:12:00,970 --> 00:12:03,098
Fluid in the lungs.
301
00:12:03,139 --> 00:12:04,891
Call Cardiology for a stat echo.
302
00:12:04,933 --> 00:12:07,644
Yeah, got it.
303
00:12:07,686 --> 00:12:09,604
Okay.
304
00:12:09,646 --> 00:12:10,855
Better?
305
00:12:12,357 --> 00:12:14,442
You okay if I share
some things with Sean?
306
00:12:15,985 --> 00:12:17,445
All right, I'll check back soon.
307
00:12:19,781 --> 00:12:22,659
So...
308
00:12:22,701 --> 00:12:24,160
Your friend's in
pretty bad shape.
309
00:12:24,202 --> 00:12:27,414
Pulmonary edema suggests
that he's in heart failure.
310
00:12:27,455 --> 00:12:29,225
We shouldn't be seeing
that in somebody so young.
311
00:12:29,249 --> 00:12:31,209
Oh, man.
312
00:12:31,251 --> 00:12:33,837
You say that he's living
at the rehab center.
313
00:12:33,878 --> 00:12:35,296
- Is he an addict?
- Recovering,
314
00:12:35,338 --> 00:12:37,215
but I'm pretty sure he's
clean. We talk a lot.
315
00:12:37,257 --> 00:12:38,842
He's really been
working the program.
316
00:12:38,883 --> 00:12:41,177
It's possible
whatever's going on
317
00:12:41,219 --> 00:12:42,321
with his heart might
have something to do
318
00:12:42,345 --> 00:12:43,972
with IV drug use.
319
00:12:44,014 --> 00:12:45,366
Well, you'll be able
to help him, right?
320
00:12:45,390 --> 00:12:47,034
I'll do what I can, but
you need to understand,
321
00:12:47,058 --> 00:12:50,562
Sean, his condition is serious.
322
00:12:50,603 --> 00:12:53,898
Well, if anybody can
help him, you can, Dad.
323
00:12:53,940 --> 00:12:55,692
I know you can.
324
00:13:06,009 --> 00:13:07,152
Is Alex all right?
325
00:13:07,177 --> 00:13:07,876
Yes.
326
00:13:07,901 --> 00:13:09,639
He handled the
surgery like a champ.
327
00:13:09,664 --> 00:13:11,017
And it's a good thing
you brought him in.
328
00:13:11,041 --> 00:13:12,601
His appendix really
needed to come out.
329
00:13:12,625 --> 00:13:14,836
Yeah, the pathology
report showed a contained
330
00:13:14,878 --> 00:13:16,087
appendiceal cancer.
331
00:13:16,129 --> 00:13:17,380
- Cancer?
- Cancer?
332
00:13:17,422 --> 00:13:18,798
Wait, he's only 15.
333
00:13:18,840 --> 00:13:20,091
No need to worry.
334
00:13:20,133 --> 00:13:21,319
It was small, just
one centimeter,
335
00:13:21,343 --> 00:13:22,469
and we got it all.
336
00:13:22,510 --> 00:13:24,179
Good thing he was
wearing that watch.
337
00:13:24,220 --> 00:13:25,430
Oh.
338
00:13:25,472 --> 00:13:26,931
Wow.
339
00:13:26,973 --> 00:13:28,850
And we don't need to
talk to an oncologist?
340
00:13:28,892 --> 00:13:30,536
Well, when you come
back for a follow-up,
341
00:13:30,560 --> 00:13:32,103
we could talk about that.
342
00:13:32,145 --> 00:13:34,540
But the treatment is to remove
the appendix, and we did that.
343
00:13:34,564 --> 00:13:36,816
Mm, okay.
344
00:13:36,858 --> 00:13:38,943
- When can we see Alex?
- Now.
345
00:13:38,985 --> 00:13:40,779
Dr. Ahmad will take
you to recovery.
346
00:13:40,820 --> 00:13:41,905
- Thank you.
- Thank you.
347
00:13:41,946 --> 00:13:43,615
You got it.
348
00:13:43,656 --> 00:13:47,035
No, no, no, no, I'm just here
to have my knee looked at.
349
00:13:47,077 --> 00:13:49,013
When was the last time
you had a physical, Bert?
350
00:13:49,037 --> 00:13:50,121
I don't know.
351
00:13:50,163 --> 00:13:51,623
They did some scans
when I was here.
352
00:13:51,664 --> 00:13:53,458
That is not a physical.
353
00:13:53,500 --> 00:13:54,542
You're already here.
354
00:13:54,584 --> 00:13:56,002
The doctor will make it quick.
355
00:13:56,044 --> 00:13:58,588
Daniel will come
in and say hello.
356
00:13:58,630 --> 00:14:01,216
You owe it to your
children and your grandson
357
00:14:01,257 --> 00:14:04,469
to look after your health.
358
00:14:04,511 --> 00:14:06,805
All right. All right.
359
00:14:06,846 --> 00:14:09,391
Thank you.
360
00:14:09,432 --> 00:14:11,559
I'm seeing pericardial effusion.
361
00:14:11,601 --> 00:14:13,478
That means that there's
a buildup of fluid
362
00:14:13,520 --> 00:14:15,331
in the sac around the heart,
and that puts pressure
363
00:14:15,355 --> 00:14:18,483
on the heart so that it
doesn't pump effectively.
364
00:14:18,525 --> 00:14:20,169
Would you please let me
know when the attending
365
00:14:20,193 --> 00:14:21,545
- has looked at this?
- You got it.
366
00:14:21,569 --> 00:14:22,487
Okay.
367
00:14:22,529 --> 00:14:25,031
So I'm not sure what's going on.
368
00:14:25,073 --> 00:14:26,950
So I'm gonna start
you on antibiotics,
369
00:14:26,991 --> 00:14:28,952
in case it's a
bacterial infection.
370
00:14:28,993 --> 00:14:31,037
We're gonna treat the
pericardial effusion
371
00:14:31,079 --> 00:14:33,373
with steroids and
anti-inflammatories.
372
00:14:33,415 --> 00:14:34,874
Sats are at 83,
373
00:14:34,916 --> 00:14:36,418
and blood pressure's dropping.
374
00:14:38,712 --> 00:14:39,796
Dad?
375
00:14:41,840 --> 00:14:43,025
Okay, I think we need
to put you on a machine
376
00:14:43,049 --> 00:14:44,634
that breathes for you.
377
00:14:44,676 --> 00:14:45,969
- Okay.
- All right?
378
00:14:46,011 --> 00:14:47,154
In order to do that, we
need to put you to sleep.
379
00:14:47,178 --> 00:14:49,347
Is that all right?
380
00:14:49,389 --> 00:14:50,348
All right.
381
00:14:50,390 --> 00:14:52,142
Call respiratory.
382
00:14:52,183 --> 00:14:54,519
All right, 20 of
etomidate and 100 of sux.
383
00:14:54,561 --> 00:14:56,438
On its way.
384
00:15:08,158 --> 00:15:10,535
Okay, I'm in.
385
00:15:10,577 --> 00:15:12,037
Bag him.
386
00:15:15,415 --> 00:15:17,292
All right, this will
let his body rest,
387
00:15:17,334 --> 00:15:20,086
and hopefully, it'll help push
the fluid out of his lungs.
388
00:15:20,128 --> 00:15:21,338
Thanks, Dad.
389
00:15:21,379 --> 00:15:22,922
Put a foley in,
and let's start him
390
00:15:22,964 --> 00:15:27,260
on 125 milligrams of Solumedrol
and 10 milligrams of Lasix.
391
00:15:27,302 --> 00:15:30,430
We won't see any changes for
a while, so I'll check back.
392
00:15:32,140 --> 00:15:34,225
- Dr. Archer.
- Yeah?
393
00:15:34,267 --> 00:15:36,061
- Have you got a minute?
- Yeah.
394
00:15:36,102 --> 00:15:38,730
My ex-husband, Bert,
is here for a follow-up
395
00:15:38,772 --> 00:15:40,815
on a knee injury.
396
00:15:40,857 --> 00:15:42,609
He hasn't had a
physical in ages,
397
00:15:42,650 --> 00:15:45,362
and he has finally
agreed to get one.
398
00:15:45,403 --> 00:15:48,198
Would you mind giving
him a quick look-see?
399
00:15:48,239 --> 00:15:49,616
- Just the basics.
- No problem.
400
00:15:49,657 --> 00:15:50,742
He's in two.
401
00:15:50,784 --> 00:15:53,578
Oh, and um, Dr. Charles,
402
00:15:53,620 --> 00:15:54,913
he might stop by.
403
00:15:54,954 --> 00:15:56,247
He and Bert are old friends.
404
00:15:56,289 --> 00:15:57,457
- Okay.
- Thank you.
405
00:15:57,499 --> 00:15:59,417
Sure.
406
00:15:59,459 --> 00:16:01,127
Hey, Nancy?
407
00:16:01,169 --> 00:16:03,463
- Is Jimmy's CT back?
- Not yet.
408
00:16:03,505 --> 00:16:06,341
Uh, how's CPD doing
on that reverse trace?
409
00:16:06,383 --> 00:16:07,759
They have an address.
410
00:16:07,801 --> 00:16:09,028
They're sending a car over now.
411
00:16:09,052 --> 00:16:10,970
I hope they find a contact.
412
00:16:11,012 --> 00:16:13,682
Jimmy started running a fever
and his chest is congested.
413
00:16:13,723 --> 00:16:16,601
I put him on antibiotics
in case of pneumonia.
414
00:16:16,643 --> 00:16:18,329
Listen, I don't know
if this means anything,
415
00:16:18,353 --> 00:16:21,856
but I did, in the archives,
find a Dr. Sorensen
416
00:16:21,898 --> 00:16:23,191
who worked here.
417
00:16:23,233 --> 00:16:24,943
Great, can we...
can we get in touch?
418
00:16:24,984 --> 00:16:26,653
Unfortunately, no.
419
00:16:26,695 --> 00:16:28,113
He died 50 years ago.
420
00:16:33,118 --> 00:16:35,578
Well, he's not
gonna be any help.
421
00:16:39,207 --> 00:16:40,625
How long is this gonna take?
422
00:16:40,667 --> 00:16:42,502
Longer if you don't keep still.
423
00:16:43,878 --> 00:16:47,173
I heard I had an old pal
in here, making trouble.
424
00:16:47,215 --> 00:16:49,426
Sharon twisted my arm.
425
00:16:49,467 --> 00:16:51,052
- How we doing?
- Where are you guys at?
426
00:16:51,094 --> 00:16:52,971
I took his vitals, got blood.
427
00:16:53,013 --> 00:16:54,806
Treated me like a pincushion.
428
00:16:54,848 --> 00:16:56,266
I have a proposal for you.
429
00:16:56,307 --> 00:16:58,643
What do you say I take
over before this old crank
430
00:16:58,685 --> 00:16:59,936
bites your head off?
431
00:16:59,978 --> 00:17:02,105
I will absolutely take
you up on your offer.
432
00:17:05,567 --> 00:17:06,818
Okay.
433
00:17:06,860 --> 00:17:09,779
Let us see what we have here.
434
00:17:09,821 --> 00:17:12,115
Uh, look up for me, buddy.
435
00:17:14,284 --> 00:17:15,845
So you know we've got
Celtics-Bulls tomorrow night,
436
00:17:15,869 --> 00:17:17,579
- right?
- Right.
437
00:17:17,620 --> 00:17:20,331
I was actually thinking about
putting down a little action.
438
00:17:20,373 --> 00:17:22,542
- You? Action?
- Why not?
439
00:17:22,584 --> 00:17:24,312
Celtics heavily favored,
all right, but I'm just...
440
00:17:24,336 --> 00:17:26,504
I'm really feeling the upset.
441
00:17:26,546 --> 00:17:29,841
If I take the Bulls,
I get 6-to-1 odds.
442
00:17:29,883 --> 00:17:31,134
Hmm.
443
00:17:31,176 --> 00:17:33,345
Yeah?
444
00:17:33,386 --> 00:17:37,057
Okay, now follow with
your eyes, not your head.
445
00:17:37,098 --> 00:17:39,059
Here you go.
446
00:17:40,477 --> 00:17:45,607
So if I put down 20 bucks,
447
00:17:45,648 --> 00:17:46,816
that would get me,
448
00:17:46,858 --> 00:17:48,735
when it's 6 to 1 odds,
that would get me...
449
00:17:48,777 --> 00:17:51,237
Uh, 110?
450
00:17:52,906 --> 00:17:53,865
120, isn't it?
451
00:17:53,907 --> 00:17:54,908
I think it's 120, yeah.
452
00:17:54,949 --> 00:17:57,202
Oh, yeah, yeah, yeah, yeah, 120.
453
00:17:58,328 --> 00:17:59,788
Not bad, huh?
454
00:17:59,829 --> 00:18:01,873
No. No, not bad.
455
00:18:01,915 --> 00:18:03,541
Mm.
456
00:18:03,583 --> 00:18:06,378
You know, we haven't
been to Al's for a while.
457
00:18:06,419 --> 00:18:07,813
You wanna grab some
lunch on Friday?
458
00:18:07,837 --> 00:18:09,506
You got it.
459
00:18:09,547 --> 00:18:10,715
Okay.
460
00:18:15,970 --> 00:18:18,223
Hey, Alex. Can you hear me?
461
00:18:20,392 --> 00:18:21,632
Can you open your eyes for me?
462
00:18:23,937 --> 00:18:26,064
Can you squeeze my hand for me?
463
00:18:26,106 --> 00:18:28,400
Can you do that?
464
00:18:28,441 --> 00:18:29,901
Is something wrong?
465
00:18:29,943 --> 00:18:32,612
No, his body is just
taking longer than expected
466
00:18:32,654 --> 00:18:34,572
to clear the muscle
relaxant that we gave him,
467
00:18:34,614 --> 00:18:35,758
which was part of
the anesthetic.
468
00:18:35,782 --> 00:18:37,117
Is that a problem?
469
00:18:37,158 --> 00:18:39,053
No, we can give Alex a
medication that will help
470
00:18:39,077 --> 00:18:41,329
reverse the muscle relaxant
and help him come back to us
471
00:18:41,371 --> 00:18:42,622
a little bit faster.
472
00:18:42,664 --> 00:18:45,250
- We do this all the time.
- Okay.
473
00:18:45,291 --> 00:18:47,794
Let's give him 0.2 of Exsomadex.
474
00:18:47,836 --> 00:18:48,837
On its way.
475
00:18:48,878 --> 00:18:51,423
This should act fast.
476
00:18:55,051 --> 00:18:56,761
Sinus tachycardia.
477
00:18:56,803 --> 00:18:58,263
BP 80/50.
478
00:18:58,304 --> 00:18:59,681
Oh, what's happening to him?
479
00:18:59,723 --> 00:19:00,807
Let's get him upright.
480
00:19:00,849 --> 00:19:02,475
He's having an
anaphylactoid reaction,
481
00:19:02,517 --> 00:19:03,786
which is like an
allergic reaction.
482
00:19:03,810 --> 00:19:05,770
Oh, God!
483
00:19:05,812 --> 00:19:07,105
Epi 0.3 milligrams IM.
484
00:19:07,147 --> 00:19:08,314
On its way.
485
00:19:08,356 --> 00:19:09,625
You said you do
this all the time.
486
00:19:09,649 --> 00:19:10,942
We do.
487
00:19:10,984 --> 00:19:13,278
BP now 72/45.
488
00:19:13,319 --> 00:19:16,740
Solumedrol 125,
diphenhydramine 50,
489
00:19:16,781 --> 00:19:18,324
Famotidine 20.
490
00:19:18,366 --> 00:19:20,118
Oh, my God. My baby.
491
00:19:20,160 --> 00:19:21,828
Oh, my baby.
492
00:19:25,165 --> 00:19:26,624
Okay, BP's coming up.
493
00:19:26,666 --> 00:19:29,627
87/55.
494
00:19:29,669 --> 00:19:31,796
93/60.
495
00:19:31,838 --> 00:19:33,340
Oh.
496
00:19:36,009 --> 00:19:37,302
He's gonna be okay.
497
00:19:37,344 --> 00:19:38,261
Really, he's gonna be fine.
498
00:19:38,303 --> 00:19:39,971
But why?
499
00:19:40,013 --> 00:19:41,723
Why did this happen?
500
00:19:47,228 --> 00:19:49,439
Dr. Asher, we need you in here.
501
00:19:49,481 --> 00:19:52,317
Her BP keeps dropping.
502
00:19:52,359 --> 00:19:54,986
Okay, up her Levophed to 20.
503
00:19:56,196 --> 00:19:58,239
Oh, God! Oh, God!
504
00:19:58,281 --> 00:20:00,283
Brisk VB.
505
00:20:02,952 --> 00:20:04,555
- She's not dilating.
- What does that mean?
506
00:20:04,579 --> 00:20:07,040
It means that the medication
we used to induce labor
507
00:20:07,082 --> 00:20:08,124
isn't working fast enough.
508
00:20:08,166 --> 00:20:09,459
BP's still low.
509
00:20:09,501 --> 00:20:11,169
Transfuse 2 of red
and 2 of plasma.
510
00:20:11,211 --> 00:20:12,420
Call for 6 and 6.
511
00:20:12,462 --> 00:20:13,797
We need to operate now.
512
00:20:13,838 --> 00:20:15,358
You said it was risky
while she was septic.
513
00:20:15,382 --> 00:20:16,841
We can't wait. Call the OR.
514
00:20:16,883 --> 00:20:19,260
Let them know we're coming
up for an emergent D&E.
515
00:20:26,017 --> 00:20:27,143
Don't let her die.
516
00:20:27,185 --> 00:20:28,812
Please don't let her die.
517
00:20:35,990 --> 00:20:37,528
Can I ask you for
a little favor?
518
00:20:37,553 --> 00:20:38,630
All right?
519
00:20:38,655 --> 00:20:40,383
Just because your blood
pressure is a little high,
520
00:20:40,407 --> 00:20:42,117
do you mind hanging around
521
00:20:42,158 --> 00:20:43,177
till I get your blood work back?
522
00:20:43,201 --> 00:20:44,619
Just for my own peace of mind.
523
00:20:44,661 --> 00:20:46,830
Go to the café. Have
a nice cup of coffee.
524
00:20:46,871 --> 00:20:48,248
It won't be long.
525
00:20:48,289 --> 00:20:49,249
I'll text you one
way or the other.
526
00:20:49,290 --> 00:20:50,959
Okay.
527
00:20:51,001 --> 00:20:53,211
Looking forward to Friday.
528
00:20:53,253 --> 00:20:55,130
Friday?
529
00:20:55,171 --> 00:20:56,798
Lunch. Lunch at Al's.
530
00:20:56,840 --> 00:20:58,967
- 1:00.
- Right.
531
00:20:59,009 --> 00:21:01,136
Right. Lunch at Al's.
532
00:21:01,177 --> 00:21:03,179
1:00. See you, Dan.
533
00:21:03,221 --> 00:21:05,140
See you, pal.
534
00:21:11,021 --> 00:21:12,021
Give me suction.
535
00:21:15,483 --> 00:21:17,777
Marty, how's she looking?
536
00:21:17,819 --> 00:21:20,405
BP's better than pre-op, 100/60.
537
00:21:20,447 --> 00:21:21,656
Good.
538
00:21:21,698 --> 00:21:23,408
Good, good, good, good.
539
00:21:24,576 --> 00:21:26,745
Uterus feels clear.
540
00:21:26,786 --> 00:21:28,621
Marty, how much IVF did she get?
541
00:21:28,663 --> 00:21:33,209
2 liters of NS, 2
PRBC, 2 of plasma.
542
00:21:33,251 --> 00:21:34,753
Urine output is at 300 CC...
543
00:21:34,794 --> 00:21:36,629
Dr. Asher.
544
00:21:36,671 --> 00:21:39,007
She's hemorrhaging!
545
00:21:39,049 --> 00:21:41,676
BP 70/30, heart rate 150.
546
00:21:41,718 --> 00:21:43,636
Start the MTP and
give her 1 gram TXA,
547
00:21:43,678 --> 00:21:46,806
0.2 milligrams methergine IM
now and 1,000 misoprostol.
548
00:21:46,848 --> 00:21:48,975
- Should we open?
- No, get me a Bakri balloon.
549
00:21:49,017 --> 00:21:50,143
Retractor.
550
00:21:54,397 --> 00:21:56,524
Inflating.
551
00:21:57,650 --> 00:21:58,860
The bleeding's slowing.
552
00:21:58,902 --> 00:22:00,320
BP coming up.
553
00:22:12,332 --> 00:22:13,917
How's he doing?
554
00:22:13,958 --> 00:22:15,168
Not great.
555
00:22:15,210 --> 00:22:16,961
He feels helpless.
556
00:22:17,003 --> 00:22:18,603
Is she gonna be able
to keep her uterus?
557
00:22:18,630 --> 00:22:20,382
I don't know.
558
00:22:20,423 --> 00:22:22,759
Right now, it's all
about saving her life.
559
00:22:22,801 --> 00:22:24,386
Yeah.
560
00:22:27,222 --> 00:22:28,390
So you have kids?
561
00:22:28,431 --> 00:22:29,474
One.
562
00:22:29,516 --> 00:22:31,434
She's grown.
563
00:22:31,476 --> 00:22:33,687
My ex and I, we tried to adopt,
564
00:22:33,728 --> 00:22:37,357
but it didn't work out.
565
00:22:37,399 --> 00:22:38,900
What about you?
566
00:22:38,942 --> 00:22:40,151
No.
567
00:22:40,193 --> 00:22:41,695
No, I, um...
568
00:22:41,736 --> 00:22:43,613
I was married young
569
00:22:43,655 --> 00:22:44,989
before I went into the service.
570
00:22:45,031 --> 00:22:47,742
And after I got back
from deployment,
571
00:22:47,784 --> 00:22:51,996
we both agreed that
there was nothing there.
572
00:22:52,038 --> 00:22:54,374
It's all so hard.
573
00:22:54,416 --> 00:22:56,543
And to have this?
574
00:23:03,091 --> 00:23:04,217
Dr. Ripley.
575
00:23:04,259 --> 00:23:05,385
Yeah.
576
00:23:05,427 --> 00:23:07,554
Jimmy's CT.
577
00:23:07,595 --> 00:23:09,973
It doesn't look like
Alzheimer's, does it?
578
00:23:10,015 --> 00:23:11,099
No.
579
00:23:11,141 --> 00:23:13,685
No, brain's not
globally atrophied.
580
00:23:13,727 --> 00:23:17,355
It looks like a lot of
scarring in the frontal area.
581
00:23:17,397 --> 00:23:18,732
Yeah.
582
00:23:18,773 --> 00:23:21,067
So traumatic brain injury?
583
00:23:27,449 --> 00:23:29,993
In a manner of speaking.
584
00:23:30,035 --> 00:23:32,704
I read about this
in medical school.
585
00:23:35,999 --> 00:23:38,084
Dr. Charles.
586
00:23:38,126 --> 00:23:39,210
Hey.
587
00:23:39,252 --> 00:23:41,379
So what do you think?
588
00:23:41,421 --> 00:23:45,759
I think that we could be
looking at some issues.
589
00:23:45,800 --> 00:23:49,220
So he's gonna need
a thorough workup.
590
00:23:49,262 --> 00:23:50,513
It's a good idea.
591
00:23:50,555 --> 00:23:54,684
Convincing him is
not gonna be easy.
592
00:23:54,726 --> 00:23:56,269
Help me out with that?
593
00:23:56,311 --> 00:23:58,730
Actually, I made up a
little excuse about his labs
594
00:23:58,772 --> 00:24:01,441
in order to keep him here.
595
00:24:01,483 --> 00:24:03,526
Tell him together
after I get him back?
596
00:24:03,568 --> 00:24:05,028
Text me.
597
00:24:05,070 --> 00:24:06,070
Thanks.
598
00:24:15,538 --> 00:24:17,582
- How's the kid?
- He's fine.
599
00:24:17,624 --> 00:24:18,875
It was scary.
600
00:24:18,917 --> 00:24:20,335
Yeah.
601
00:24:20,377 --> 00:24:22,337
I think the hospital
should pull Exsomadex.
602
00:24:22,379 --> 00:24:24,547
Whoa. Why?
603
00:24:24,589 --> 00:24:26,091
The anaphylactic
reaction happened
604
00:24:26,132 --> 00:24:27,342
after we administered it.
605
00:24:27,384 --> 00:24:29,344
Temporal connection
doesn't mean anything.
606
00:24:29,386 --> 00:24:30,970
That kid's on 15
other medications.
607
00:24:31,012 --> 00:24:32,847
They could have
a delayed effect.
608
00:24:32,889 --> 00:24:35,308
More likely, it was the
antibiotic or the anesthetic.
609
00:24:35,350 --> 00:24:38,144
I considered that,
so I pulled ADR data.
610
00:24:38,186 --> 00:24:40,814
There have been several similar
reactions to Exsomadex here.
611
00:24:40,855 --> 00:24:42,607
Get this... the
manufacturer report
612
00:24:42,649 --> 00:24:45,652
claims 1 out of 2,500.
613
00:24:45,694 --> 00:24:48,697
Med data shows 1 out of 200.
614
00:24:48,738 --> 00:24:50,907
That's 10 times what
the manufacturer claims.
615
00:24:52,951 --> 00:24:54,452
Well, you might have a case,
616
00:24:54,494 --> 00:24:56,496
but this data is retrospective.
617
00:24:56,538 --> 00:24:58,540
It's not any kind
of clinical study.
618
00:24:58,581 --> 00:25:01,501
So pull Exsomadex
until we have one.
619
00:25:01,543 --> 00:25:03,878
Hold on. It's a
popular medication.
620
00:25:03,920 --> 00:25:05,505
I've used it and
never had a problem.
621
00:25:05,547 --> 00:25:07,841
It doesn't mean that you won't.
622
00:25:07,882 --> 00:25:13,882
Crockett, that boy
almost died today.
623
00:25:14,097 --> 00:25:15,348
All right.
624
00:25:15,390 --> 00:25:16,850
I'll, uh...
625
00:25:16,891 --> 00:25:19,144
I'll bring this up at the
drug and formulary meeting.
626
00:25:19,185 --> 00:25:20,270
Best I can do for now.
627
00:25:20,311 --> 00:25:21,789
In the meantime, make
sure that the nurses
628
00:25:21,813 --> 00:25:24,607
submit an adverse drug
reaction report, okay?
629
00:25:24,649 --> 00:25:26,192
Thank you.
630
00:25:28,737 --> 00:25:31,072
To begin the
transorbital lobotomy,
631
00:25:31,114 --> 00:25:34,200
the orbitoclast is inserted
under the left eyelid
632
00:25:34,242 --> 00:25:36,995
and up against the
top of the eye socket.
633
00:25:37,037 --> 00:25:38,997
The neurosurgeon
drives the point
634
00:25:39,039 --> 00:25:41,541
through the orbital plate
into the frontal lobe
635
00:25:41,583 --> 00:25:44,210
to a depth of 5 centimeters.
636
00:25:44,252 --> 00:25:47,213
He then swings the
handle far laterally.
637
00:25:47,255 --> 00:25:50,550
He now drives the instrument
another 2 centimeters...
638
00:26:05,190 --> 00:26:07,108
Here's Jimmy's CT.
639
00:26:07,150 --> 00:26:10,612
I think we can rule
out Alzheimer's.
640
00:26:10,653 --> 00:26:13,615
Identical scarring on
641
00:26:13,656 --> 00:26:16,576
oh, my God.
642
00:26:16,618 --> 00:26:17,994
He had a lobotomy?
643
00:26:18,036 --> 00:26:20,205
Yeah.
644
00:26:20,246 --> 00:26:22,749
They haven't done those
for, like, 60 years.
645
00:26:22,791 --> 00:26:25,085
I mean, he must have been a kid.
646
00:26:25,126 --> 00:26:28,213
They did the procedure
on difficult patients.
647
00:26:28,254 --> 00:26:30,757
Jimmy was probably a
discipline problem,
648
00:26:30,799 --> 00:26:32,217
hard to control.
649
00:26:32,258 --> 00:26:36,221
So Dr. Sorensen stuck
a skewer into his brain
650
00:26:36,262 --> 00:26:39,849
and... took care of that.
651
00:26:43,687 --> 00:26:45,438
Awful.
652
00:26:55,213 --> 00:26:58,979
Dad said he's getting more
oxygen now, so that's good.
653
00:26:59,285 --> 00:27:00,870
Hey. This is Dr. Collins.
654
00:27:00,912 --> 00:27:03,206
- She started our center.
- Oh, Margo. Please.
655
00:27:03,248 --> 00:27:04,809
I think I've seen you
around the hospital.
656
00:27:04,833 --> 00:27:06,102
Yeah, I recently got privileges.
657
00:27:06,126 --> 00:27:07,836
I'm sorry I couldn't
get here earlier.
658
00:27:07,877 --> 00:27:09,587
Several new residents
were checking in.
659
00:27:09,629 --> 00:27:11,131
So how is Damon doing?
660
00:27:11,172 --> 00:27:13,258
Well, he's sedated.
He's on a ventilator.
661
00:27:13,299 --> 00:27:14,819
Dad's been taking
really good care of him.
662
00:27:14,843 --> 00:27:16,052
I'm sure he has.
663
00:27:16,094 --> 00:27:17,655
Well, we're by no
means out of the woods.
664
00:27:17,679 --> 00:27:19,055
Can I see his chart?
665
00:27:19,097 --> 00:27:21,224
Sure.
666
00:27:21,266 --> 00:27:23,059
Endocarditis.
667
00:27:23,101 --> 00:27:25,061
We're hoping the
antibiotics knock it out.
668
00:27:25,103 --> 00:27:26,563
Listen, if you need to get back,
669
00:27:26,604 --> 00:27:28,106
I can call you if
there's a change.
670
00:27:28,148 --> 00:27:32,986
Uh, no, I'd like to
stay, see how he does.
671
00:27:33,028 --> 00:27:34,821
Is it all right
if I sit with him?
672
00:27:34,863 --> 00:27:37,240
- Of course.
- Thank you.
673
00:27:37,282 --> 00:27:39,117
Hey, just so you know,
674
00:27:39,159 --> 00:27:41,244
your son, he's been
a real godsend.
675
00:27:41,286 --> 00:27:42,662
That's nice to hear.
676
00:27:42,704 --> 00:27:44,724
It's so helpful to have
people around our residents
677
00:27:44,748 --> 00:27:46,708
who understand their challenges.
678
00:27:54,507 --> 00:27:56,634
Kaitlin?
679
00:27:56,676 --> 00:27:58,970
Kaitlin, can you hear me?
680
00:27:59,012 --> 00:28:00,805
Hi.
681
00:28:00,847 --> 00:28:02,599
I got good news.
682
00:28:02,640 --> 00:28:05,268
We were able to
save your uterus.
683
00:28:05,310 --> 00:28:08,438
So if you decide
to conceive again,
684
00:28:08,480 --> 00:28:09,480
you should be able to.
685
00:28:11,441 --> 00:28:13,485
Honey, did you hear?
686
00:28:13,526 --> 00:28:14,736
No.
687
00:28:14,778 --> 00:28:16,279
No, I can't.
688
00:28:16,321 --> 00:28:18,406
I can't do it again.
689
00:28:18,448 --> 00:28:20,450
Please. I'm sorry.
690
00:28:20,492 --> 00:28:22,744
It's okay. It's okay.
691
00:28:22,786 --> 00:28:24,037
Nobody would help.
692
00:28:24,079 --> 00:28:25,246
I know.
693
00:28:25,288 --> 00:28:28,792
They made me feel
like I didn't matter.
694
00:28:30,543 --> 00:28:32,420
I was thinking,
695
00:28:32,462 --> 00:28:34,339
if you agree,
696
00:28:34,381 --> 00:28:35,840
maybe we should move.
697
00:28:35,882 --> 00:28:37,717
But your home, the farm.
698
00:28:37,759 --> 00:28:39,552
I can't go back there.
699
00:28:39,594 --> 00:28:41,346
How could I?
700
00:28:41,388 --> 00:28:44,349
Oh, God, Kaitlin,
701
00:28:44,391 --> 00:28:48,103
I don't think I could stand to
see you suffer like that again.
702
00:28:48,895 --> 00:28:52,774
I know how much you
wanted a family, so
703
00:28:52,816 --> 00:28:57,028
if you decide you
want us to try again,
704
00:28:57,070 --> 00:28:59,155
you don't have to be afraid.
705
00:28:59,197 --> 00:29:01,408
We'll leave you two alone.
706
00:29:06,246 --> 00:29:08,289
Well, it's good to know
707
00:29:08,331 --> 00:29:11,251
there's some good
guys in the world.
708
00:29:11,292 --> 00:29:12,335
Yeah.
709
00:29:15,964 --> 00:29:17,841
How is she?
710
00:29:26,891 --> 00:29:29,436
They're not gonna
pull Exsomadex.
711
00:29:29,477 --> 00:29:31,229
They're submitting
the data to the FDA,
712
00:29:31,271 --> 00:29:33,732
and they'll, uh, follow
their recommendations.
713
00:29:33,773 --> 00:29:36,234
That could take forever.
714
00:29:36,276 --> 00:29:38,069
We need to pull it
now. I'll talk to them.
715
00:29:38,111 --> 00:29:39,946
Hold on. I made the case.
716
00:29:39,988 --> 00:29:42,449
- It's been decided.
- I can still try.
717
00:29:42,490 --> 00:29:45,076
Drop it, Zola.
718
00:29:45,118 --> 00:29:48,246
It's not how things work here.
719
00:29:48,288 --> 00:29:49,622
Of course.
720
00:29:58,798 --> 00:30:00,759
You feeling better, Jimmy?
721
00:30:00,800 --> 00:30:01,968
Uh-huh.
722
00:30:02,010 --> 00:30:03,470
What about Betty?
723
00:30:03,511 --> 00:30:06,139
Dr. Ripley, CPD is here.
724
00:30:06,181 --> 00:30:08,141
I'll be back in a minute.
725
00:30:08,183 --> 00:30:10,852
- Dr. Ripley?
- Hi.
726
00:30:10,894 --> 00:30:12,204
We did a well-being
check on the address
727
00:30:12,228 --> 00:30:13,855
associated with that number.
728
00:30:13,897 --> 00:30:17,650
We found an elderly
woman... deceased.
729
00:30:17,692 --> 00:30:19,277
Medical examiner
is investigating,
730
00:30:19,319 --> 00:30:21,196
but it looks like
natural causes.
731
00:30:21,237 --> 00:30:23,490
I took this off the credenza.
732
00:30:26,826 --> 00:30:28,119
That's my patient.
733
00:30:28,161 --> 00:30:29,788
And that's the woman we found.
734
00:30:29,829 --> 00:30:32,141
I talked to a neighbor who said
they were brother and sister.
735
00:30:32,165 --> 00:30:34,793
And she was her
brother's caregiver.
736
00:30:34,834 --> 00:30:37,962
Sorry I don't have better news.
737
00:30:38,004 --> 00:30:39,130
She must have collapsed,
738
00:30:39,172 --> 00:30:41,341
and Jimmy went looking for help.
739
00:30:45,637 --> 00:30:47,472
Better call social work.
740
00:30:47,514 --> 00:30:48,556
He's not going home.
741
00:30:58,274 --> 00:31:01,486
I thought you'd be more
comfortable waiting in here.
742
00:31:01,528 --> 00:31:04,239
I haven't been in your
office for a long time.
743
00:31:04,280 --> 00:31:05,407
Very nice.
744
00:31:05,448 --> 00:31:07,659
Please. Can I get you anything?
745
00:31:07,701 --> 00:31:09,619
Nah.
746
00:31:09,661 --> 00:31:12,330
- Come on in.
- Daniel.
747
00:31:12,372 --> 00:31:13,665
Go ahead.
748
00:31:13,707 --> 00:31:15,917
Tell her what
great shape I'm in.
749
00:31:15,959 --> 00:31:17,669
Well, I mean, by
and large, you are.
750
00:31:17,711 --> 00:31:20,088
There you go.
751
00:31:20,130 --> 00:31:22,841
Yeah, I noticed a
752
00:31:22,882 --> 00:31:24,259
a minor balance issue.
753
00:31:24,300 --> 00:31:26,219
I hurt my knee.
What do you expect?
754
00:31:26,261 --> 00:31:28,805
And some short-term
memory issues.
755
00:31:28,847 --> 00:31:31,516
Memory?
756
00:31:31,558 --> 00:31:32,684
What do you mean?
757
00:31:32,726 --> 00:31:33,995
Well, you're forgetting
things, Bert.
758
00:31:34,019 --> 00:31:36,438
Well, who doesn't forget things?
759
00:31:36,479 --> 00:31:38,023
What's this about?
760
00:31:39,899 --> 00:31:41,526
Really just about your
761
00:31:41,568 --> 00:31:43,945
your friends and your family
being a little bit concerned.
762
00:31:43,987 --> 00:31:45,655
That's all.
763
00:31:45,697 --> 00:31:47,157
Concerned.
764
00:31:47,198 --> 00:31:50,577
We'd like you to take
some more tests, Bert.
765
00:31:50,618 --> 00:31:53,079
What tests?
766
00:31:53,121 --> 00:31:55,582
Oh, to see if I'm all
there, compos mentis.
767
00:31:55,623 --> 00:31:57,375
Is that what you're
talking about?
768
00:31:57,417 --> 00:31:59,085
Well, I mean, if
there is an issue,
769
00:31:59,127 --> 00:32:01,629
and trust me, big if
770
00:32:01,671 --> 00:32:02,714
don't you wanna know?
771
00:32:02,756 --> 00:32:03,715
I mean, I certainly would.
772
00:32:03,757 --> 00:32:05,258
There isn't.
773
00:32:05,300 --> 00:32:07,218
Well, just in case,
let's make an appointment
774
00:32:07,260 --> 00:32:08,803
with the neurologist.
775
00:32:08,845 --> 00:32:09,846
Oh, yeah.
776
00:32:09,888 --> 00:32:11,056
I get it.
777
00:32:11,097 --> 00:32:12,390
This is a setup.
778
00:32:12,432 --> 00:32:13,892
It was a setup
from the beginning.
779
00:32:13,933 --> 00:32:15,268
Look, I apologize, Bert,
780
00:32:15,310 --> 00:32:17,771
but I knew you wouldn't
come here on your own.
781
00:32:17,812 --> 00:32:19,898
And Tara has been so worried.
782
00:32:19,939 --> 00:32:21,733
Uh-uh. Don't put this on Tara.
783
00:32:21,775 --> 00:32:23,651
This is... this is you.
784
00:32:23,693 --> 00:32:25,570
Yeah, y-you're trying
to put me away.
785
00:32:25,612 --> 00:32:28,323
You wanna put me away so
you can get your hands on
786
00:32:28,365 --> 00:32:30,367
- on my... on my pension!
- Oh, Bert!
787
00:32:30,408 --> 00:32:32,369
And... and you're
in it with her.
788
00:32:32,410 --> 00:32:34,090
The two of you are
cooking up this nonsense
789
00:32:34,120 --> 00:32:35,872
so you can get my money!
790
00:32:35,914 --> 00:32:37,374
Couple of crooks!
791
00:32:37,415 --> 00:32:38,416
Bert.
792
00:32:38,458 --> 00:32:39,542
Bert.
793
00:32:39,584 --> 00:32:41,211
How long have we been
friends for, huh?
794
00:32:41,252 --> 00:32:43,421
- 40 years?
- 40 years, but not anymore.
795
00:32:43,463 --> 00:32:44,940
A-and what was that
power I gave you?
796
00:32:44,964 --> 00:32:46,091
That law power?
797
00:32:46,132 --> 00:32:47,133
Power of attorney.
798
00:32:47,175 --> 00:32:48,134
Well, you don't have it anymore.
799
00:32:48,176 --> 00:32:49,386
You ought to be ashamed!
800
00:32:49,427 --> 00:32:50,887
Bert!
801
00:33:01,899 --> 00:33:04,727
Dr. Ahmad, they discharged Alex.
802
00:33:04,752 --> 00:33:06,169
Great.
803
00:33:06,194 --> 00:33:08,117
Yeah, like you
said, no big deal.
804
00:33:09,197 --> 00:33:10,257
I'm sorry for what happened.
805
00:33:10,281 --> 00:33:12,659
No. Please, it
wasn't your fault.
806
00:33:12,701 --> 00:33:14,327
And Alex is doing fine.
807
00:33:14,369 --> 00:33:15,995
You caught his cancer.
808
00:33:16,037 --> 00:33:17,455
My God.
809
00:33:17,497 --> 00:33:19,666
We are so grateful to
you and Dr. Marcel.
810
00:33:21,418 --> 00:33:23,420
We can't even begin
to thank you enough.
811
00:33:23,461 --> 00:33:25,296
Thank you, guys. Good luck.
812
00:33:25,338 --> 00:33:27,132
- Thank you.
- Thanks.
813
00:33:27,173 --> 00:33:28,550
Thank you.
814
00:33:33,013 --> 00:33:34,556
No pulse.
815
00:33:36,016 --> 00:33:37,183
He's fibrillating.
816
00:33:37,225 --> 00:33:38,727
I'll get on his chest.
817
00:33:38,768 --> 00:33:40,562
Milligram of epi.
818
00:33:40,603 --> 00:33:41,521
Charge to 200.
819
00:33:41,563 --> 00:33:42,689
Charging.
820
00:33:42,731 --> 00:33:44,024
Clear.
821
00:33:45,900 --> 00:33:47,110
Still no pulse.
822
00:33:47,152 --> 00:33:48,153
Epi's in.
823
00:33:48,194 --> 00:33:49,195
Again, charge to 200.
824
00:33:49,237 --> 00:33:50,613
Charging.
825
00:33:50,655 --> 00:33:53,116
Clear.
826
00:33:55,910 --> 00:33:57,996
Huh, nothing.
827
00:33:58,038 --> 00:33:59,664
He's asystole.
828
00:34:05,503 --> 00:34:06,963
No.
829
00:34:07,005 --> 00:34:08,256
No.
830
00:34:11,217 --> 00:34:13,845
Damn it.
831
00:34:16,765 --> 00:34:19,142
Time of death, 1703.
832
00:34:31,654 --> 00:34:34,699
All right, Jimmy, let's get
you into this wheelchair.
833
00:34:38,578 --> 00:34:40,205
That's it.
834
00:34:42,248 --> 00:34:43,625
Now, you see that nice woman?
835
00:34:45,752 --> 00:34:48,171
She's gonna take
you to a new home.
836
00:34:49,881 --> 00:34:52,342
Did you help Betty?
837
00:34:52,384 --> 00:34:54,594
Some very good people
went to help her.
838
00:34:56,513 --> 00:34:59,683
Where I'm going, is Betty there?
839
00:35:01,976 --> 00:35:04,312
No, she isn't.
840
00:35:06,648 --> 00:35:08,483
I-I want Betty.
841
00:35:12,821 --> 00:35:14,781
I'm sorry, Jimmy.
842
00:35:14,823 --> 00:35:16,282
She can't be there.
843
00:35:16,324 --> 00:35:18,451
But she'd want you to go,
844
00:35:18,493 --> 00:35:21,871
and she'd want you to be happy.
845
00:35:21,913 --> 00:35:26,626
I... I want Betty.
846
00:35:26,668 --> 00:35:28,003
Yeah.
847
00:35:28,044 --> 00:35:31,256
Yeah, I know.
848
00:35:31,297 --> 00:35:33,091
I'm sorry, Jimmy.
849
00:35:38,847 --> 00:35:40,223
Here.
850
00:35:43,309 --> 00:35:46,521
That's Betty
851
00:35:46,563 --> 00:35:48,148
and me.
852
00:35:48,189 --> 00:35:49,357
Yeah.
853
00:35:52,027 --> 00:35:53,987
I love Betty.
854
00:36:00,452 --> 00:36:02,495
It's gonna be all right, Jimmy.
855
00:36:02,537 --> 00:36:04,164
I'll come see you, okay?
856
00:36:04,205 --> 00:36:05,915
And we'll talk about Betty then.
857
00:36:08,752 --> 00:36:11,421
I was cold.
858
00:36:11,463 --> 00:36:13,298
Now I'm warm.
859
00:36:15,216 --> 00:36:16,551
Thank you.
860
00:36:18,845 --> 00:36:19,929
You're welcome.
861
00:36:24,225 --> 00:36:25,685
Hi, Jimmy.
862
00:36:25,727 --> 00:36:27,228
I'm Madeline.
863
00:36:33,234 --> 00:36:36,029
Hi, Madeline.
864
00:36:48,416 --> 00:36:51,586
That's a... a tough one, huh?
865
00:36:53,630 --> 00:36:56,174
I just keep wondering
866
00:36:56,216 --> 00:37:00,053
what his life
might have been if,
867
00:37:00,095 --> 00:37:02,305
you know...
868
00:37:02,347 --> 00:37:06,893
If they hadn't given up on him?
869
00:37:06,935 --> 00:37:08,353
Yeah.
870
00:37:10,188 --> 00:37:13,608
You know, I've been
meaning to ask you,
871
00:37:13,650 --> 00:37:15,902
were you ever able to
reconnect with your mom?
872
00:37:17,362 --> 00:37:18,822
No.
873
00:37:18,863 --> 00:37:21,199
I heard she's been
in and out of rehab,
874
00:37:21,241 --> 00:37:22,909
in and out of custody.
875
00:37:22,951 --> 00:37:25,286
Well,
876
00:37:25,328 --> 00:37:27,038
I'm sorry to hear that.
877
00:37:29,958 --> 00:37:33,211
And I'm also...
878
00:37:33,253 --> 00:37:37,132
I'm just so sorry if I
879
00:37:37,173 --> 00:37:39,718
turned out to be
yet another person
880
00:37:39,759 --> 00:37:42,929
that made you feel
abandoned in this life.
881
00:37:42,971 --> 00:37:46,474
You know, I just... I
genuinely regret that.
882
00:37:46,516 --> 00:37:50,520
And I... I hope you'll
accept my apology.
883
00:38:13,168 --> 00:38:15,337
It's real.
884
00:38:15,378 --> 00:38:17,422
I'm sorry.
885
00:38:17,464 --> 00:38:19,966
Yeah.
886
00:38:20,008 --> 00:38:22,260
Thank you for not saying,
"Now you can move on,"
887
00:38:22,302 --> 00:38:24,387
or something
ridiculous like that.
888
00:38:24,429 --> 00:38:25,972
I mean, I was tempted.
889
00:38:26,014 --> 00:38:27,265
Me too.
890
00:38:39,027 --> 00:38:40,278
I'm not ready.
891
00:38:40,320 --> 00:38:41,780
Hmm?
892
00:38:49,329 --> 00:38:50,997
Why?
893
00:38:52,957 --> 00:38:54,209
Why?
894
00:38:54,250 --> 00:38:55,752
Until there's an autopsy,
895
00:38:55,794 --> 00:38:57,021
there's no way to know for sure.
896
00:38:57,045 --> 00:38:59,005
But whatever that infection was,
897
00:38:59,047 --> 00:39:03,677
it just weakened his heart
until we couldn't save him.
898
00:39:03,718 --> 00:39:05,387
Because he used drugs?
899
00:39:05,428 --> 00:39:08,348
Well, we might have a better
idea after the autopsy.
900
00:39:08,390 --> 00:39:10,058
But it's possible.
901
00:39:10,100 --> 00:39:12,060
Street drugs, dirty needles.
902
00:39:15,939 --> 00:39:17,357
Oh, man.
903
00:39:17,399 --> 00:39:19,275
Sean,
904
00:39:19,317 --> 00:39:22,153
I'm sorry I couldn't save him.
905
00:39:28,451 --> 00:39:31,454
You did everything you could.
906
00:39:31,496 --> 00:39:33,832
In my world, you
see a lot of loss.
907
00:39:33,873 --> 00:39:35,667
And no matter how hard you try,
908
00:39:35,709 --> 00:39:38,253
sometimes it's
just never enough.
909
00:39:38,294 --> 00:39:40,839
I can guess how Sean is feeling.
910
00:39:40,880 --> 00:39:43,216
He came to the
center full of hope,
911
00:39:43,258 --> 00:39:44,551
wanting to make a difference.
912
00:39:46,636 --> 00:39:49,014
I'll talk to him.
913
00:39:57,897 --> 00:40:00,358
Bert?
914
00:40:00,400 --> 00:40:03,737
I'll, uh, get tested, just to
915
00:40:03,778 --> 00:40:05,447
just to get you off my back.
916
00:40:07,574 --> 00:40:08,575
Okay.
917
00:40:08,616 --> 00:40:10,660
Satisfied?
918
00:40:23,548 --> 00:40:25,759
Oh.
919
00:40:25,800 --> 00:40:27,844
- Hey.
- Hey.
920
00:40:29,637 --> 00:40:32,265
You, uh, pulling another shift?
921
00:40:32,307 --> 00:40:34,434
Yeah.
922
00:40:34,476 --> 00:40:37,854
I thought I was the only
one into self-flagellation.
923
00:40:39,689 --> 00:40:41,274
No, I'm pretty good at it too.
924
00:40:46,446 --> 00:40:47,572
Rough day?
925
00:40:47,614 --> 00:40:49,282
Yeah.
926
00:40:49,324 --> 00:40:51,451
You?
927
00:40:51,493 --> 00:40:53,119
Yeah.
928
00:41:01,711 --> 00:41:03,254
Get some rest.
929
00:41:08,468 --> 00:41:10,303
You too.62325