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These are the user uploaded subtitles that are being translated: 1 00:00:00,699 --> 00:00:02,575 Ben and I are getting a divorce. 2 00:00:02,577 --> 00:00:04,872 I really just wanna move on. 3 00:00:05,666 --> 00:00:08,168 I'll be around the ED more often if I can ever help out. 4 00:00:08,169 --> 00:00:09,753 Are you flying anywhere today? 5 00:00:09,754 --> 00:00:12,172 - No, shift just ended. - Treatment seven. 6 00:00:12,173 --> 00:00:14,966 Welcome to the team, Dr. Johnson. 7 00:00:14,967 --> 00:00:17,143 Something's wrong with Dad. 8 00:00:17,144 --> 00:00:18,970 He's forgetting things. 9 00:00:18,972 --> 00:00:20,355 It's getting worse. 10 00:00:20,356 --> 00:00:22,691 He doesn't know where he is. 11 00:00:22,692 --> 00:00:25,026 Damn. 12 00:00:25,027 --> 00:00:26,945 You've already flamed out of two hospitals, 13 00:00:26,946 --> 00:00:29,114 and you're doing your best to flame out of a third? 14 00:00:29,115 --> 00:00:30,615 So I'm not fired? 15 00:00:30,616 --> 00:00:31,992 Medical ethics course. 16 00:00:31,993 --> 00:00:33,869 If I were you, I'd take notes. 17 00:00:36,182 --> 00:00:37,683 Wow. 18 00:00:37,685 --> 00:00:40,388 How does that make you feel? 19 00:00:40,390 --> 00:00:41,943 I'm not sure. 20 00:00:41,944 --> 00:00:43,612 It is what it is. 21 00:00:43,613 --> 00:00:46,781 - Good morning, Peter. - Morning, Maggie. Dr. Ahmad. 22 00:00:46,782 --> 00:00:48,742 Do we have a notary in house? 23 00:00:48,743 --> 00:00:49,951 I have some papers to sign. 24 00:00:49,952 --> 00:00:51,286 Yeah, Edward. 25 00:00:51,287 --> 00:00:52,954 I'll send him down at the end of the day. 26 00:00:52,955 --> 00:00:54,581 You need some help? 27 00:00:54,582 --> 00:00:56,458 - Are you a doctor? - I am. What happened? 28 00:00:56,459 --> 00:00:58,460 I don't know. I've never seen this man before. 29 00:00:58,461 --> 00:01:00,253 He was wandering a couple blocks from here. 30 00:01:00,254 --> 00:01:02,047 He kept saying, "Help Betty." 31 00:01:02,048 --> 00:01:03,215 He's really cold. 32 00:01:03,216 --> 00:01:04,758 Okay, let's get him inside. 33 00:01:04,759 --> 00:01:06,302 Betty. 34 00:01:08,955 --> 00:01:10,205 Dr. Sorensen. 35 00:01:10,206 --> 00:01:11,873 No, I'm Dr. Ripley. 36 00:01:11,874 --> 00:01:13,208 Nancy, he's hypothermic. 37 00:01:13,209 --> 00:01:14,292 I need blankets and warm IV bags. 38 00:01:14,293 --> 00:01:15,669 On it. You're going to five. 39 00:01:15,670 --> 00:01:18,130 Okay. 40 00:01:18,131 --> 00:01:20,674 Help Betty. 41 00:01:20,675 --> 00:01:21,875 Betty? 42 00:01:23,719 --> 00:01:25,053 Hey, Daniel. 43 00:01:25,054 --> 00:01:27,222 - Morning. - Good morning. 44 00:01:27,223 --> 00:01:28,974 When was the last time you saw Bert? 45 00:01:28,975 --> 00:01:30,934 Not for a while. 46 00:01:30,935 --> 00:01:32,060 I mean, come to think of it, 47 00:01:32,061 --> 00:01:34,062 I did call him a couple weeks ago, 48 00:01:34,063 --> 00:01:36,273 and he was in a hurry. 49 00:01:36,274 --> 00:01:38,442 Said he'd call me back, and I'm now realizing he never did. 50 00:01:38,443 --> 00:01:40,777 Yeah, and is that something you've noticed... 51 00:01:40,778 --> 00:01:42,362 - his memory? - Not really. 52 00:01:42,363 --> 00:01:44,573 I mean, that could happen to any of us. 53 00:01:44,574 --> 00:01:46,241 I mean, I do that stuff all the time. 54 00:01:46,242 --> 00:01:47,325 Why? Are you worried about him? 55 00:01:47,326 --> 00:01:49,536 I don't know, but Tara is. 56 00:01:49,537 --> 00:01:50,912 And he was here. 57 00:01:50,913 --> 00:01:53,790 He fell when he was watching Isaiah. 58 00:01:53,791 --> 00:01:55,167 He fell? 59 00:01:55,168 --> 00:01:58,295 Yeah, nothing serious, but he did twist his knee. 60 00:01:58,296 --> 00:02:00,172 He just seemed a little confused, 61 00:02:00,173 --> 00:02:01,757 and I wouldn't be concerned, 62 00:02:01,758 --> 00:02:05,260 but Bert does have a family history of dementia. 63 00:02:05,261 --> 00:02:07,512 We should probably have him checked out. 64 00:02:07,513 --> 00:02:11,725 To get Bert to see a doctor for anything is an ordeal. 65 00:02:11,726 --> 00:02:13,727 - You know that. - Right, tell me about it. 66 00:02:13,728 --> 00:02:17,272 But he's coming here today for a follow-up on his knee. 67 00:02:17,273 --> 00:02:19,357 Oh, well, why don't I just, you know, 68 00:02:19,358 --> 00:02:22,277 spontaneously stop by, have a little chat? 69 00:02:22,278 --> 00:02:23,862 That would be great. 70 00:02:23,863 --> 00:02:25,740 Thank you. 71 00:02:27,617 --> 00:02:28,825 Hi, Alex. 72 00:02:28,826 --> 00:02:30,952 - Hi. - I'm Dr. Ahmad. 73 00:02:30,953 --> 00:02:33,121 Emily. My husband, Mark. 74 00:02:33,122 --> 00:02:36,166 So I see that your heart rate is fast. 75 00:02:36,167 --> 00:02:37,918 I don't feel it. 76 00:02:37,919 --> 00:02:39,753 But his watch says it's at 140. 77 00:02:39,754 --> 00:02:42,089 It's probably nothing, but that's why we brought him in. 78 00:02:42,090 --> 00:02:45,008 Well, your watch isn't lying, 140. 79 00:02:45,009 --> 00:02:47,010 Rest of your vitals are good. 80 00:02:47,011 --> 00:02:48,136 Is there anything bothering you? 81 00:02:48,137 --> 00:02:49,304 No, I feel fine. 82 00:02:49,305 --> 00:02:50,889 Normally, he eats like a horse, 83 00:02:50,890 --> 00:02:53,308 but the last couple of days, he's hardly had anything. 84 00:02:53,309 --> 00:02:55,103 I just wasn't hungry. 85 00:02:57,980 --> 00:03:00,233 Lungs sound good. 86 00:03:02,318 --> 00:03:04,528 Lymph nodes aren't swollen. 87 00:03:04,529 --> 00:03:05,987 Any tenderness? 88 00:03:05,988 --> 00:03:07,656 Mm-mm. 89 00:03:07,657 --> 00:03:08,857 What about here? 90 00:03:09,659 --> 00:03:11,868 Yeah, a little bit. 91 00:03:11,869 --> 00:03:13,370 What does that mean? 92 00:03:13,371 --> 00:03:16,165 I'm not sure, but I'd like to order a CT to find out. 93 00:03:18,501 --> 00:03:20,252 - Okay. - I'll put the order in. 94 00:03:20,253 --> 00:03:21,753 I'll be back to check on you soon. 95 00:03:21,754 --> 00:03:22,796 - Thank you. - Yeah. 96 00:03:22,797 --> 00:03:24,965 Thank you. 97 00:03:24,966 --> 00:03:26,508 - Loren? - Maggie. 98 00:03:26,509 --> 00:03:29,094 Kaitlin Neeley, 28, septic shock. 99 00:03:29,095 --> 00:03:31,680 Leukocytosis and hypotensive. 100 00:03:31,681 --> 00:03:35,016 BP 80/43, temp 103.5. 101 00:03:35,017 --> 00:03:36,226 She was pregnant. 102 00:03:36,227 --> 00:03:37,936 Water broke at 15 weeks pre-viability. 103 00:03:37,937 --> 00:03:39,354 That was two weeks ago. 104 00:03:39,355 --> 00:03:41,022 It's not there. It's not there. 105 00:03:41,023 --> 00:03:42,232 No, don't say it. 106 00:03:42,233 --> 00:03:44,401 - No, no. - Honey, everything's okay. 107 00:03:44,402 --> 00:03:46,403 We're at the hospital. They're gonna take care of you. 108 00:03:46,404 --> 00:03:49,239 They were driving here, but she got so sick, they had to pull over. 109 00:03:49,240 --> 00:03:50,615 Rural clinic didn't have the capabilities to care for her, 110 00:03:50,616 --> 00:03:52,576 - so they called me. - Okay. 111 00:03:52,577 --> 00:03:54,035 Can I help? 112 00:03:54,036 --> 00:03:55,036 No, unfortunately, this is OB. 113 00:03:55,037 --> 00:03:56,413 - Hannah. - Yeah. 114 00:03:56,414 --> 00:03:58,457 Kaitlin Neeley, 15 weeks, water broke. 115 00:03:58,458 --> 00:03:59,875 White blood count is high. 116 00:03:59,876 --> 00:04:01,251 This is her husband, Eric. 117 00:04:01,252 --> 00:04:03,086 All right, Maggie, start a second IV. 118 00:04:03,087 --> 00:04:04,755 - You got it, Doc. - Did they perform a D&E? 119 00:04:04,756 --> 00:04:06,298 No, the doctor said they had to wait 120 00:04:06,299 --> 00:04:07,716 for her to pass the remains on her own. 121 00:04:07,717 --> 00:04:10,927 Okay, CBC, CMP, lactate, and blood cultures. 122 00:04:10,928 --> 00:04:12,721 Oh, honey! 123 00:04:12,722 --> 00:04:14,222 Honey! 124 00:04:14,223 --> 00:04:15,599 I need to start your wife on antibiotics immediately. 125 00:04:15,600 --> 00:04:16,933 Do you know if she's allergic to any? 126 00:04:16,934 --> 00:04:18,310 - She isn't. - Okay. 127 00:04:18,311 --> 00:04:20,812 Triple up... ampicillin, clindamycin, gentamicin. 128 00:04:20,813 --> 00:04:21,855 Copy that. 129 00:04:21,856 --> 00:04:22,939 Your wife is very sick, 130 00:04:22,940 --> 00:04:24,460 but we're gonna take good care of her. 131 00:04:36,514 --> 00:04:38,865 She's been carrying fetal remains for two weeks. 132 00:04:38,867 --> 00:04:40,767 Oh, my God. And she couldn't get a D&E? 133 00:04:40,768 --> 00:04:42,394 No, her doctor wouldn't do it. 134 00:04:42,395 --> 00:04:44,021 Why? 135 00:04:47,151 --> 00:04:48,441 How's our patient? 136 00:04:48,442 --> 00:04:49,484 Better. 137 00:04:49,485 --> 00:04:51,736 Temp's come up to 95. 138 00:04:51,737 --> 00:04:53,030 How is his cognition? 139 00:04:56,459 --> 00:04:57,919 Sir. 140 00:05:00,123 --> 00:05:02,162 Can you tell us your name? 141 00:05:02,164 --> 00:05:04,290 Jimmy. 142 00:05:04,291 --> 00:05:05,709 Did you hurt yourself? 143 00:05:05,710 --> 00:05:08,086 - Maybe hit your head? - No. 144 00:05:08,087 --> 00:05:09,212 Betty. 145 00:05:09,213 --> 00:05:10,797 Who's Betty? 146 00:05:10,798 --> 00:05:12,382 My sister. 147 00:05:12,383 --> 00:05:15,301 No ID, but he had this Post-it in his pocket. 148 00:05:15,302 --> 00:05:16,636 It's a telephone number. 149 00:05:16,637 --> 00:05:18,513 What happened to Betty? Where is she? 150 00:05:18,514 --> 00:05:21,182 Home. She got sick. 151 00:05:21,183 --> 00:05:24,102 Get Dr. Sorensen. 152 00:05:24,103 --> 00:05:25,895 Is... is that her doctor or your doctor? 153 00:05:25,896 --> 00:05:28,606 Dr. Sorensen. 154 00:05:28,607 --> 00:05:30,025 Does he work at this hospital? 155 00:05:30,026 --> 00:05:32,360 - Yes, here. - Okay. 156 00:05:32,361 --> 00:05:34,612 Okay, see if you can find this Dr. Sorensen 157 00:05:34,613 --> 00:05:35,865 and try that number. 158 00:05:39,493 --> 00:05:41,077 We're gonna take good care of you, Jimmy. 159 00:05:41,078 --> 00:05:41,870 Okay? 160 00:05:41,871 --> 00:05:43,831 Oh, thank you. 161 00:05:49,920 --> 00:05:52,464 Dr. Charles? 162 00:05:52,465 --> 00:05:54,674 I've got an elderly patient, 163 00:05:54,675 --> 00:05:56,468 severely hypothermic. 164 00:05:56,469 --> 00:05:59,429 No visible injuries, um, 165 00:05:59,430 --> 00:06:01,181 but he's pretty out of it. 166 00:06:01,182 --> 00:06:03,224 No ID other than a phone number. 167 00:06:03,225 --> 00:06:06,102 I'm thinking he's got dementia or maybe wandered away 168 00:06:06,103 --> 00:06:08,271 - from a care facility. - Oh. 169 00:06:08,272 --> 00:06:09,647 You wanna give me your take? 170 00:06:09,648 --> 00:06:11,483 Sure. 171 00:06:11,484 --> 00:06:13,401 His name's Jimmy. 172 00:06:13,402 --> 00:06:15,528 Shoot me his chart. Give me a couple minutes. 173 00:06:15,529 --> 00:06:17,364 Yeah. 174 00:06:17,365 --> 00:06:20,408 Hi, Alex. Mr. and Mrs. Foster. 175 00:06:20,409 --> 00:06:21,993 This is Dr. Marcel. He's one of our surgeons. 176 00:06:21,994 --> 00:06:23,578 I've asked him to consult. 177 00:06:23,579 --> 00:06:25,372 Surgeon? Why? 178 00:06:25,373 --> 00:06:28,541 Well, Radiology said that Alex's CT was equivocal, 179 00:06:28,542 --> 00:06:30,960 meaning it was inconclusive. 180 00:06:30,961 --> 00:06:34,506 But what it did show is a possible appendicitis. 181 00:06:34,507 --> 00:06:38,385 And from my experience, with Alex's elevated heart rate 182 00:06:38,386 --> 00:06:39,427 and loss of appetite, 183 00:06:39,428 --> 00:06:41,096 I believe that is, indeed, the case. 184 00:06:41,097 --> 00:06:43,014 So I'd like to operate. 185 00:06:43,015 --> 00:06:44,849 Wait, so you're not sure it's appendicitis? 186 00:06:44,850 --> 00:06:46,059 No. 187 00:06:46,060 --> 00:06:47,560 Why do I have to have an operation? 188 00:06:47,561 --> 00:06:50,313 Because if it is appendicitis and your appendix bursts, 189 00:06:50,314 --> 00:06:52,816 that would put you at risk of an infection in the belly, 190 00:06:52,817 --> 00:06:55,402 and that could be life-threatening. 191 00:06:55,403 --> 00:06:57,153 Oh. 192 00:06:57,154 --> 00:06:59,447 But we can avoid that with a minimally invasive 193 00:06:59,448 --> 00:07:02,200 laparoscopic surgery done with a camera 194 00:07:02,201 --> 00:07:04,202 through several small incisions... 195 00:07:04,203 --> 00:07:06,204 what we call a Band-Aid surgery. 196 00:07:06,205 --> 00:07:07,747 I agree with Dr. Marcel. 197 00:07:07,748 --> 00:07:11,751 A laparoscopic appendectomy is the best course of action. 198 00:07:11,752 --> 00:07:13,392 Most likely, he'd be done in half an hour. 199 00:07:14,630 --> 00:07:16,090 Mom? Dad? 200 00:07:19,635 --> 00:07:21,344 Yeah, okay. 201 00:07:21,345 --> 00:07:22,929 Okay. 202 00:07:22,930 --> 00:07:24,139 - All right. - Thank you. 203 00:07:24,140 --> 00:07:25,640 I'll see you after. 204 00:07:25,641 --> 00:07:26,766 - All right. - Thank you. 205 00:07:26,767 --> 00:07:29,310 Thank you. 206 00:07:29,311 --> 00:07:31,772 - You okay? - It'll be fine. Mm-hmm. 207 00:07:36,569 --> 00:07:38,778 Is she doing any better? 208 00:07:38,779 --> 00:07:40,947 About the same. 209 00:07:40,948 --> 00:07:42,282 You know, I don't have any more flights today, 210 00:07:42,283 --> 00:07:43,867 so I think I'll stick around, if you don't mind. 211 00:07:43,868 --> 00:07:45,368 Mm. 212 00:07:45,369 --> 00:07:48,830 Maybe I can give Eric some moral support. 213 00:07:48,831 --> 00:07:50,041 That's a good idea. 214 00:07:51,459 --> 00:07:54,294 Are you gonna do that operation? 215 00:07:54,295 --> 00:07:57,464 I recommend we try to induce instead of a D&E. 216 00:07:57,465 --> 00:08:00,926 Surgery can be much riskier if she's septic. 217 00:08:03,429 --> 00:08:06,056 Tell me what happened. 218 00:08:06,057 --> 00:08:07,599 Kaitlin's water broke. 219 00:08:07,600 --> 00:08:10,518 Everybody said the fetus couldn't survive at 15 weeks, 220 00:08:10,519 --> 00:08:12,312 but it was still alive, 221 00:08:12,313 --> 00:08:16,816 so doctors were afraid to do the D&E. 222 00:08:16,817 --> 00:08:18,110 She didn't wanna get arrested. 223 00:08:20,279 --> 00:08:22,781 Where we live, that could happen. 224 00:08:22,782 --> 00:08:24,908 They sent us home. 225 00:08:24,909 --> 00:08:26,993 Kaitlin got sicker and sicker. 226 00:08:26,994 --> 00:08:28,953 And I kept calling, and they kept telling me 227 00:08:28,954 --> 00:08:32,165 it wasn't a life-threatening emergency. 228 00:08:32,166 --> 00:08:35,710 Finally, I just gave up and started driving here. 229 00:08:35,711 --> 00:08:37,754 Kaitlin's from Chicago. 230 00:08:37,755 --> 00:08:41,265 When we got married, we moved to my family's farm, 231 00:08:41,266 --> 00:08:43,718 where I grew up. 232 00:08:43,719 --> 00:08:47,098 We were so excited when Kaitlin finally got pregnant. 233 00:08:49,517 --> 00:08:53,104 She's been so worried she's not gonna be able to again. 234 00:08:55,022 --> 00:08:58,692 Eric, I'm gonna do the best that I can. 235 00:08:58,693 --> 00:09:01,945 But I don't know. 236 00:09:01,946 --> 00:09:03,146 I don't know. 237 00:09:11,622 --> 00:09:13,623 Okay, staple line looks good. 238 00:09:13,624 --> 00:09:14,959 No bleeding. 239 00:09:17,586 --> 00:09:19,463 Nice and easy. 240 00:09:24,802 --> 00:09:26,344 Appendix is in the bag. 241 00:09:26,345 --> 00:09:28,680 Gently wiggle the bag circularly, 242 00:09:28,681 --> 00:09:30,891 and then pull it up and out. 243 00:09:34,812 --> 00:09:36,012 Hold on. 244 00:09:39,108 --> 00:09:41,568 This feels unusual. 245 00:09:41,569 --> 00:09:44,113 Go ahead and send that for a stat frozen section, please. 246 00:09:53,581 --> 00:09:56,082 Definitely some cognitive impairment, 247 00:09:56,083 --> 00:09:57,792 though I'm not quite sure why. 248 00:09:57,793 --> 00:10:01,254 Tox screen's negative, no sign of head trauma. 249 00:10:01,255 --> 00:10:03,465 The childlike affect, it's not what you normally see 250 00:10:03,466 --> 00:10:05,759 with Alzheimer's or vascular dementia, 251 00:10:05,760 --> 00:10:07,385 though you can't rule it out. 252 00:10:07,386 --> 00:10:11,264 I'm thinking some kind of intellectual deficit. 253 00:10:11,265 --> 00:10:13,099 So I'm thinking we should get a head CT. 254 00:10:13,100 --> 00:10:14,392 Definitely. 255 00:10:14,393 --> 00:10:16,061 We have no more information on the guy? 256 00:10:16,062 --> 00:10:17,270 You reach out to CPD? 257 00:10:17,271 --> 00:10:18,855 Yeah, there's no missing persons 258 00:10:18,856 --> 00:10:21,399 matching his description, and no one's come looking for him. 259 00:10:21,400 --> 00:10:24,194 He can't stop talking about his sister, Betty, right, 260 00:10:24,195 --> 00:10:26,738 how he is just very concerned about her. 261 00:10:26,739 --> 00:10:28,365 She's sick. She needs our help. 262 00:10:28,366 --> 00:10:29,866 Yeah, but given his mental state, 263 00:10:29,867 --> 00:10:31,576 is that even a real person? 264 00:10:31,577 --> 00:10:33,244 You know, maybe it's someone from his childhood 265 00:10:33,245 --> 00:10:35,455 - or a show he saw on TV. - Yeah. 266 00:10:35,456 --> 00:10:37,165 I tried the number he had again... 267 00:10:37,166 --> 00:10:38,333 still no answer. 268 00:10:38,334 --> 00:10:40,794 - I left another message. - Okay. 269 00:10:40,795 --> 00:10:43,296 Let's say that is actually Betty's number, right? 270 00:10:43,297 --> 00:10:45,131 Maybe she's not answering because she can't 271 00:10:45,132 --> 00:10:48,134 because she is, in fact, incapacitated. 272 00:10:48,135 --> 00:10:51,262 How about we ask CPD to run a reverse trace? 273 00:10:51,263 --> 00:10:53,056 That way, at least, we'll get an address. 274 00:10:53,057 --> 00:10:54,257 Okay. 275 00:11:03,651 --> 00:11:05,777 Dr. Archer, incoming. 276 00:11:05,778 --> 00:11:06,861 You're going to trauma four. 277 00:11:06,862 --> 00:11:08,154 Damon Adams, 28, 278 00:11:08,155 --> 00:11:10,907 shortness of breath, diaphoretic. 279 00:11:10,908 --> 00:11:13,618 BP 130/90, heart rate 125. Sats 89. 280 00:11:13,619 --> 00:11:15,829 - Need help. - It's right there. 281 00:11:15,830 --> 00:11:17,205 Sean. 282 00:11:17,206 --> 00:11:18,289 He lives at the center where I work. 283 00:11:18,290 --> 00:11:21,000 I've been counseling him. 284 00:11:21,001 --> 00:11:22,836 All right, wait here. 285 00:11:22,837 --> 00:11:24,963 All right, on my count. Ready? 286 00:11:24,964 --> 00:11:27,383 We good? One, two, three. 287 00:11:29,093 --> 00:11:30,635 All right, Damon, I'm Dr. Archer. 288 00:11:30,636 --> 00:11:31,469 What's going on? 289 00:11:31,470 --> 00:11:33,638 - Real sick. - Yeah? 290 00:11:33,639 --> 00:11:34,597 When did this start? 291 00:11:34,598 --> 00:11:37,225 A couple days ago. 292 00:11:37,226 --> 00:11:38,560 - I can't catch my breath. - Well, we can help you. 293 00:11:38,561 --> 00:11:40,186 Come on, let's get him up here. 294 00:11:40,187 --> 00:11:42,856 Lift him up. Start him on 100% O2. 295 00:11:42,857 --> 00:11:44,107 AP chest stat. 296 00:11:44,108 --> 00:11:47,528 I need a CBC, BNP, and an ABG. 297 00:11:49,864 --> 00:11:52,866 - X-ray. - Clear. 298 00:11:52,867 --> 00:11:54,325 Pulmonary edema. 299 00:11:54,326 --> 00:11:56,494 Fluid in the lungs. 300 00:11:56,495 --> 00:11:58,288 Call Cardiology for a stat echo. 301 00:11:58,289 --> 00:12:01,041 Yeah, got it. 302 00:12:01,042 --> 00:12:03,001 Okay. 303 00:12:03,002 --> 00:12:04,211 Better? 304 00:12:05,713 --> 00:12:07,798 You okay if I share some things with Sean? 305 00:12:09,341 --> 00:12:10,801 All right, I'll check back soon. 306 00:12:13,137 --> 00:12:16,056 So... 307 00:12:16,057 --> 00:12:17,557 Your friend's in pretty bad shape. 308 00:12:17,558 --> 00:12:20,810 Pulmonary edema suggests that he's in heart failure. 309 00:12:20,811 --> 00:12:22,604 We shouldn't be seeing that in somebody so young. 310 00:12:22,605 --> 00:12:24,606 Oh, man. 311 00:12:24,607 --> 00:12:27,233 You say that he's living at the rehab center. 312 00:12:27,234 --> 00:12:28,693 - Is he an addict? - Recovering, 313 00:12:28,694 --> 00:12:30,612 but I'm pretty sure he's clean. We talk a lot. 314 00:12:30,613 --> 00:12:32,238 He's really been working the program. 315 00:12:32,239 --> 00:12:34,574 It's possible whatever's going on 316 00:12:34,575 --> 00:12:35,700 with his heart might have something to do 317 00:12:35,701 --> 00:12:37,369 with IV drug use. 318 00:12:37,370 --> 00:12:38,745 Well, you'll be able to help him, right? 319 00:12:38,746 --> 00:12:40,413 I'll do what I can, but you need to understand, 320 00:12:40,414 --> 00:12:43,958 Sean, his condition is serious. 321 00:12:43,959 --> 00:12:47,295 Well, if anybody can help him, you can, Dad. 322 00:12:47,296 --> 00:12:49,048 I know you can. 323 00:12:58,004 --> 00:12:59,421 Is Alex all right? 324 00:12:59,423 --> 00:13:02,119 - Yes. - He handled the surgery like a champ. 325 00:13:02,120 --> 00:13:03,496 And it's a good thing you brought him in. 326 00:13:03,497 --> 00:13:05,080 His appendix really needed to come out. 327 00:13:05,081 --> 00:13:08,584 Yeah, the pathology report showed a contained appendiceal cancer. 328 00:13:08,585 --> 00:13:09,877 - Cancer? - Cancer? 329 00:13:09,878 --> 00:13:11,295 Wait, he's only 15. 330 00:13:11,296 --> 00:13:12,588 No need to worry. 331 00:13:12,589 --> 00:13:14,965 It was small, just one centimeter, and we got it all. 332 00:13:14,966 --> 00:13:16,675 Good thing he was wearing that watch. 333 00:13:16,676 --> 00:13:17,927 Oh. 334 00:13:17,928 --> 00:13:19,428 Wow. 335 00:13:19,429 --> 00:13:21,347 And we don't need to talk to an oncologist? 336 00:13:21,348 --> 00:13:23,015 Well, when you come back for a follow-up, 337 00:13:23,016 --> 00:13:24,600 we could talk about that. 338 00:13:24,601 --> 00:13:27,019 But the treatment is to remove the appendix, and we did that. 339 00:13:27,020 --> 00:13:29,069 Mm, okay. 340 00:13:29,071 --> 00:13:31,197 - When can we see Alex? - Now. 341 00:13:31,199 --> 00:13:33,275 Dr. Ahmad will take you to recovery. 342 00:13:33,276 --> 00:13:34,401 - Thank you. - Thank you. 343 00:13:34,402 --> 00:13:36,111 You got it. 344 00:13:36,112 --> 00:13:39,532 No, no, no, no, I'm just here to have my knee looked at. 345 00:13:39,533 --> 00:13:41,492 When was the last time you had a physical, Bert? 346 00:13:41,493 --> 00:13:42,618 I don't know. 347 00:13:42,619 --> 00:13:44,119 They did some scans when I was here. 348 00:13:44,120 --> 00:13:45,955 That is not a physical. 349 00:13:45,956 --> 00:13:47,039 You're already here. 350 00:13:47,040 --> 00:13:48,499 The doctor will make it quick. 351 00:13:48,500 --> 00:13:51,085 Daniel will come in and say hello. 352 00:13:51,086 --> 00:13:53,712 You owe it to your children and your grandson 353 00:13:53,713 --> 00:13:56,966 to look after your health. 354 00:13:56,967 --> 00:13:59,301 All right. All right. 355 00:13:59,302 --> 00:14:01,887 Thank you. 356 00:14:01,888 --> 00:14:04,056 I'm seeing pericardial effusion. 357 00:14:04,057 --> 00:14:05,975 That means that there's a buildup of fluid 358 00:14:05,976 --> 00:14:07,810 in the sac around the heart, and that puts pressure 359 00:14:07,811 --> 00:14:10,980 on the heart so that it doesn't pump effectively. 360 00:14:10,981 --> 00:14:12,648 Would you please let me know when the attending 361 00:14:12,649 --> 00:14:14,024 - has looked at this? - You got it. 362 00:14:14,025 --> 00:14:14,984 Okay. 363 00:14:14,985 --> 00:14:17,528 So I'm not sure what's going on. 364 00:14:17,529 --> 00:14:19,446 So I'm gonna start you on antibiotics, 365 00:14:19,447 --> 00:14:21,448 in case it's a bacterial infection. 366 00:14:21,449 --> 00:14:23,534 We're gonna treat the pericardial effusion 367 00:14:23,535 --> 00:14:25,870 with steroids and anti-inflammatories. 368 00:14:25,871 --> 00:14:27,371 Sats are at 83, 369 00:14:27,372 --> 00:14:28,874 and blood pressure's dropping. 370 00:14:31,168 --> 00:14:32,368 Dad? 371 00:14:34,296 --> 00:14:37,131 Okay, I think we need to put you on a machine that breathes for you. 372 00:14:37,132 --> 00:14:38,466 - Okay. - All right? 373 00:14:38,467 --> 00:14:39,633 In order to do that, we need to put you to sleep. 374 00:14:39,634 --> 00:14:41,844 Is that all right? 375 00:14:41,845 --> 00:14:42,845 All right. 376 00:14:42,846 --> 00:14:44,638 Call respiratory. 377 00:14:44,639 --> 00:14:47,016 All right, 20 of etomidate and 100 of sux. 378 00:14:47,017 --> 00:14:48,894 On its way. 379 00:15:00,614 --> 00:15:03,032 Okay, I'm in. 380 00:15:03,033 --> 00:15:04,493 Bag him. 381 00:15:07,871 --> 00:15:09,789 All right, this will let his body rest, 382 00:15:09,790 --> 00:15:12,583 and hopefully, it'll help push the fluid out of his lungs. 383 00:15:12,584 --> 00:15:13,834 Thanks, Dad. 384 00:15:13,835 --> 00:15:15,419 Put a foley in, and let's start him 385 00:15:15,420 --> 00:15:19,757 on 125 milligrams of Solumedrol and 10 milligrams of Lasix. 386 00:15:19,758 --> 00:15:22,886 We won't see any changes for a while, so I'll check back. 387 00:15:24,596 --> 00:15:26,722 - Dr. Archer. - Yeah? 388 00:15:26,723 --> 00:15:28,557 - Have you got a minute? - Yeah. 389 00:15:28,558 --> 00:15:33,312 My ex-husband, Bert, is here for a follow-up on a knee injury. 390 00:15:33,313 --> 00:15:35,105 He hasn't had a physical in ages, 391 00:15:35,106 --> 00:15:37,858 and he has finally agreed to get one. 392 00:15:37,859 --> 00:15:40,694 Would you mind giving him a quick look-see? 393 00:15:40,695 --> 00:15:42,112 - Just the basics. - No problem. 394 00:15:42,113 --> 00:15:43,239 He's in two. 395 00:15:43,240 --> 00:15:46,075 Oh, and um, Dr. Charles, 396 00:15:46,076 --> 00:15:47,409 he might stop by. 397 00:15:47,410 --> 00:15:48,744 He and Bert are old friends. 398 00:15:48,745 --> 00:15:49,954 - Okay. - Thank you. 399 00:15:49,955 --> 00:15:51,914 Sure. 400 00:15:51,915 --> 00:15:53,624 Hey, Nancy? 401 00:15:53,625 --> 00:15:55,960 - Is Jimmy's CT back? - Not yet. 402 00:15:55,961 --> 00:15:58,838 Uh, how's CPD doing on that reverse trace? 403 00:15:58,839 --> 00:16:00,256 They have an address. 404 00:16:00,257 --> 00:16:01,507 They're sending a car over now. 405 00:16:01,508 --> 00:16:03,467 I hope they find a contact. 406 00:16:03,468 --> 00:16:06,178 Jimmy started running a fever and his chest is congested. 407 00:16:06,179 --> 00:16:09,098 I put him on antibiotics in case of pneumonia. 408 00:16:09,099 --> 00:16:10,808 Listen, I don't know if this means anything, 409 00:16:10,809 --> 00:16:15,688 but I did, in the archives, find a Dr. Sorensen who worked here. 410 00:16:15,689 --> 00:16:17,439 Great, can we... can we get in touch? 411 00:16:17,440 --> 00:16:19,150 Unfortunately, no. 412 00:16:19,151 --> 00:16:20,569 He died 50 years ago. 413 00:16:25,574 --> 00:16:28,034 Well, he's not gonna be any help. 414 00:16:31,663 --> 00:16:33,122 How long is this gonna take? 415 00:16:33,123 --> 00:16:34,958 Longer if you don't keep still. 416 00:16:36,334 --> 00:16:39,670 I heard I had an old pal in here, making trouble. 417 00:16:39,671 --> 00:16:41,922 Sharon twisted my arm. 418 00:16:41,923 --> 00:16:43,549 How we doing? Where are you guys at? 419 00:16:43,550 --> 00:16:45,468 I took his vitals, got blood. 420 00:16:45,469 --> 00:16:47,303 Treated me like a pincushion. 421 00:16:47,304 --> 00:16:48,762 I have a proposal for you. 422 00:16:48,763 --> 00:16:51,140 What do you say I take over before this old crank 423 00:16:51,141 --> 00:16:52,433 bites your head off? 424 00:16:52,434 --> 00:16:54,561 I will absolutely take you up on your offer. 425 00:16:58,023 --> 00:16:59,315 Okay. 426 00:16:59,316 --> 00:17:02,276 Let us see what we have here. 427 00:17:02,277 --> 00:17:04,571 Uh, look up for me, buddy. 428 00:17:06,740 --> 00:17:09,017 So you know we've got Celtics-Bulls tomorrow night, right? 429 00:17:09,018 --> 00:17:10,056 Right. 430 00:17:10,057 --> 00:17:12,828 I was actually thinking about putting down a little action. 431 00:17:12,829 --> 00:17:15,039 - You? Action? - Why not? 432 00:17:15,040 --> 00:17:16,791 Celtics heavily favored, all right, but I'm just... 433 00:17:16,792 --> 00:17:19,001 I'm really feeling the upset. 434 00:17:19,002 --> 00:17:22,338 If I take the Bulls, I get 6-to-1 odds. 435 00:17:22,339 --> 00:17:23,631 Hmm. 436 00:17:23,632 --> 00:17:25,841 Yeah? 437 00:17:25,842 --> 00:17:29,553 Okay, now follow with your eyes, not your head. 438 00:17:29,554 --> 00:17:31,515 Here you go. 439 00:17:32,933 --> 00:17:38,103 So if I put down 20 bucks, 440 00:17:38,104 --> 00:17:39,313 that would get me, 441 00:17:39,314 --> 00:17:41,232 when it's 6 to 1 odds, that would get me... 442 00:17:41,233 --> 00:17:43,693 Uh, 110? 443 00:17:45,362 --> 00:17:46,362 120, isn't it? 444 00:17:46,363 --> 00:17:47,404 I think it's 120, yeah. 445 00:17:47,405 --> 00:17:49,658 Oh, yeah, yeah, yeah, yeah, 120. 446 00:17:50,784 --> 00:17:52,284 Not bad, huh? 447 00:17:52,285 --> 00:17:54,370 No. No, not bad. 448 00:17:54,371 --> 00:17:56,038 Mm. 449 00:17:56,039 --> 00:17:58,874 You know, we haven't been to Al's for a while. 450 00:17:58,875 --> 00:18:00,292 You wanna grab some lunch on Friday? 451 00:18:00,293 --> 00:18:02,002 You got it. 452 00:18:02,003 --> 00:18:03,203 Okay. 453 00:18:08,426 --> 00:18:10,679 Hey, Alex. Can you hear me? 454 00:18:12,848 --> 00:18:14,048 Can you open your eyes for me? 455 00:18:16,393 --> 00:18:18,561 Can you squeeze my hand for me? 456 00:18:18,562 --> 00:18:20,896 Can you do that? 457 00:18:20,897 --> 00:18:22,398 Is something wrong? 458 00:18:22,399 --> 00:18:25,109 No, his body is just taking longer than expected 459 00:18:25,110 --> 00:18:27,069 to clear the muscle relaxant that we gave him, 460 00:18:27,070 --> 00:18:28,237 which was part of the anesthetic. 461 00:18:28,238 --> 00:18:29,613 Is that a problem? 462 00:18:29,614 --> 00:18:31,532 No, we can give Alex a medication that will help 463 00:18:31,533 --> 00:18:34,126 reverse the muscle relaxant and help him come back to us 464 00:18:34,127 --> 00:18:35,151 a little bit faster. 465 00:18:35,152 --> 00:18:37,746 - We do this all the time. - Okay. 466 00:18:37,747 --> 00:18:40,291 Let's give him 0.2 of Exsomadex. 467 00:18:40,292 --> 00:18:41,333 On its way. 468 00:18:41,334 --> 00:18:43,879 This should act fast. 469 00:18:47,507 --> 00:18:49,258 Sinus tachycardia. 470 00:18:49,259 --> 00:18:50,759 BP 80/50. 471 00:18:50,760 --> 00:18:52,178 Oh, what's happening to him? 472 00:18:52,179 --> 00:18:53,304 Let's get him upright. 473 00:18:53,305 --> 00:18:54,972 He's having an anaphylactoid reaction, 474 00:18:54,973 --> 00:18:56,265 which is like an allergic reaction. 475 00:18:56,266 --> 00:18:58,267 Oh, God! 476 00:18:58,268 --> 00:18:59,602 Epi 0.3 milligrams IM. 477 00:18:59,603 --> 00:19:00,811 On its way. 478 00:19:00,812 --> 00:19:02,104 You said you do this all the time. 479 00:19:02,105 --> 00:19:03,439 We do. 480 00:19:03,440 --> 00:19:05,774 BP now 72/45. 481 00:19:05,775 --> 00:19:09,236 Solumedrol 125, diphenhydramine 50, 482 00:19:09,237 --> 00:19:10,821 Famotidine 20. 483 00:19:10,822 --> 00:19:12,615 Oh, my God. My baby. 484 00:19:12,616 --> 00:19:14,284 Oh, my baby. 485 00:19:17,621 --> 00:19:19,121 Okay, BP's coming up. 486 00:19:19,122 --> 00:19:22,124 87/55. 487 00:19:22,125 --> 00:19:24,293 93/60. 488 00:19:24,294 --> 00:19:25,796 Oh. 489 00:19:28,465 --> 00:19:29,799 He's gonna be okay. 490 00:19:29,800 --> 00:19:30,758 Really, he's gonna be fine. 491 00:19:30,759 --> 00:19:32,468 But why? 492 00:19:32,469 --> 00:19:34,179 Why did this happen? 493 00:19:39,684 --> 00:19:41,936 Dr. Asher, we need you in here. 494 00:19:41,937 --> 00:19:44,814 Her BP keeps dropping. 495 00:19:44,815 --> 00:19:47,442 Okay, up her Levophed to 20. 496 00:19:48,652 --> 00:19:50,736 Oh, God! Oh, God! 497 00:19:50,737 --> 00:19:52,739 Brisk VB. 498 00:19:55,408 --> 00:19:57,034 - She's not dilating. - What does that mean? 499 00:19:57,035 --> 00:19:59,537 It means that the medication we used to induce labor 500 00:19:59,538 --> 00:20:00,621 isn't working fast enough. 501 00:20:00,622 --> 00:20:01,956 BP's still low. 502 00:20:01,957 --> 00:20:03,666 Transfuse 2 of red and 2 of plasma. 503 00:20:03,667 --> 00:20:04,917 Call for 6 and 6. 504 00:20:04,918 --> 00:20:06,293 We need to operate now. 505 00:20:06,294 --> 00:20:07,837 You said it was risky while she was septic. 506 00:20:07,838 --> 00:20:09,338 We can't wait. Call the OR. 507 00:20:09,339 --> 00:20:11,716 Let them know we're coming up for an emergent D&E. 508 00:20:18,306 --> 00:20:19,473 Don't let her die. 509 00:20:19,475 --> 00:20:21,102 Please don't let her die. 510 00:20:25,700 --> 00:20:28,183 Can I ask you for a little favor? All right? 511 00:20:28,185 --> 00:20:30,161 Just because your blood pressure is a little high, 512 00:20:30,163 --> 00:20:31,913 do you mind hanging around 513 00:20:31,914 --> 00:20:32,956 till I get your blood work back? 514 00:20:32,957 --> 00:20:34,416 Just for my own peace of mind. 515 00:20:34,417 --> 00:20:36,626 Go to the café. Have a nice cup of coffee. 516 00:20:36,627 --> 00:20:38,044 It won't be long. 517 00:20:38,045 --> 00:20:39,395 I'll text you one way or the other. 518 00:20:39,396 --> 00:20:40,756 Okay. 519 00:20:40,757 --> 00:20:43,008 Looking forward to Friday. 520 00:20:43,009 --> 00:20:44,926 Friday? 521 00:20:44,927 --> 00:20:46,595 Lunch. Lunch at Al's. 522 00:20:46,596 --> 00:20:48,764 - 1:00. - Right. 523 00:20:48,765 --> 00:20:50,932 Right. Lunch at Al's. 524 00:20:50,933 --> 00:20:52,976 1:00. See you, Dan. 525 00:20:52,977 --> 00:20:54,896 See you, pal. 526 00:21:00,777 --> 00:21:01,977 Give me suction. 527 00:21:05,239 --> 00:21:07,574 Marty, how's she looking? 528 00:21:07,575 --> 00:21:10,202 BP's better than pre-op, 100/60. 529 00:21:10,203 --> 00:21:11,453 Good. 530 00:21:11,454 --> 00:21:13,164 Good, good, good, good. 531 00:21:14,332 --> 00:21:16,541 Uterus feels clear. 532 00:21:16,542 --> 00:21:18,418 Marty, how much IVF did she get? 533 00:21:18,419 --> 00:21:23,006 2 liters of NS, 2 PRBC, 2 of plasma. 534 00:21:23,007 --> 00:21:24,549 Urine output is at 300 CC... 535 00:21:24,550 --> 00:21:26,426 Dr. Asher. 536 00:21:26,427 --> 00:21:28,804 She's hemorrhaging! 537 00:21:28,805 --> 00:21:31,473 BP 70/30, heart rate 150. 538 00:21:31,474 --> 00:21:33,433 Start the MTP and give her 1 gram TXA, 539 00:21:33,434 --> 00:21:36,603 0.2 milligrams methergine IM now and 1,000 misoprostol. 540 00:21:36,604 --> 00:21:38,772 - Should we open? - No, get me a Bakri balloon. 541 00:21:38,773 --> 00:21:39,973 Retractor. 542 00:21:44,153 --> 00:21:46,280 Inflating. 543 00:21:47,406 --> 00:21:48,657 The bleeding's slowing. 544 00:21:48,658 --> 00:21:50,076 BP coming up. 545 00:22:02,088 --> 00:22:03,713 How's he doing? 546 00:22:03,714 --> 00:22:04,965 Not great. 547 00:22:04,966 --> 00:22:06,758 He feels helpless. 548 00:22:06,759 --> 00:22:08,385 Is she gonna be able to keep her uterus? 549 00:22:08,386 --> 00:22:10,178 I don't know. 550 00:22:10,179 --> 00:22:12,556 Right now, it's all about saving her life. 551 00:22:12,557 --> 00:22:14,142 Yeah. 552 00:22:16,978 --> 00:22:18,186 So you have kids? 553 00:22:18,187 --> 00:22:19,271 One. 554 00:22:19,272 --> 00:22:21,231 She's grown. 555 00:22:21,232 --> 00:22:23,483 My ex and I, we tried to adopt, 556 00:22:23,484 --> 00:22:27,154 but it didn't work out. 557 00:22:27,155 --> 00:22:28,697 What about you? 558 00:22:28,698 --> 00:22:29,948 No. 559 00:22:29,949 --> 00:22:31,491 No, I, um... 560 00:22:31,492 --> 00:22:33,410 I was married young 561 00:22:33,411 --> 00:22:34,786 before I went into the service. 562 00:22:34,787 --> 00:22:37,539 And after I got back from deployment, 563 00:22:37,540 --> 00:22:41,793 we both agreed that there was nothing there. 564 00:22:41,794 --> 00:22:44,171 It's all so hard. 565 00:22:44,172 --> 00:22:46,299 And to have this? 566 00:22:52,847 --> 00:22:54,014 Dr. Ripley. 567 00:22:54,015 --> 00:22:55,182 Yeah. 568 00:22:55,183 --> 00:22:57,350 Jimmy's CT. 569 00:22:57,351 --> 00:22:59,770 It doesn't look like Alzheimer's, does it? 570 00:22:59,771 --> 00:23:00,896 No. 571 00:23:00,897 --> 00:23:03,482 No, brain's not globally atrophied. 572 00:23:03,483 --> 00:23:07,152 It looks like a lot of scarring in the frontal area. 573 00:23:07,153 --> 00:23:08,528 Yeah. 574 00:23:08,529 --> 00:23:10,823 So traumatic brain injury? 575 00:23:17,205 --> 00:23:19,790 In a manner of speaking. 576 00:23:19,791 --> 00:23:22,460 I read about this in medical school. 577 00:23:25,755 --> 00:23:27,881 Dr. Charles. 578 00:23:27,882 --> 00:23:29,007 Hey. 579 00:23:29,008 --> 00:23:31,176 So what do you think? 580 00:23:31,177 --> 00:23:35,555 I think that we could be looking at some issues. 581 00:23:35,556 --> 00:23:39,017 So he's gonna need a thorough workup. 582 00:23:39,018 --> 00:23:40,310 It's a good idea. 583 00:23:40,311 --> 00:23:44,481 Convincing him is not gonna be easy. 584 00:23:44,482 --> 00:23:46,066 Help me out with that? 585 00:23:46,067 --> 00:23:48,527 Actually, I made up a little excuse about his labs 586 00:23:48,528 --> 00:23:51,238 in order to keep him here. 587 00:23:51,239 --> 00:23:53,323 Tell him together after I get him back? 588 00:23:53,324 --> 00:23:54,825 Text me. 589 00:23:54,826 --> 00:23:56,026 Thanks. 590 00:24:05,294 --> 00:24:07,379 - How's the kid? - He's fine. 591 00:24:07,380 --> 00:24:08,672 It was scary. 592 00:24:08,673 --> 00:24:10,132 Yeah. 593 00:24:10,133 --> 00:24:12,134 I think the hospital should pull Exsomadex. 594 00:24:12,135 --> 00:24:14,344 Whoa. Why? 595 00:24:14,345 --> 00:24:15,887 The anaphylactic reaction happened 596 00:24:15,888 --> 00:24:17,139 after we administered it. 597 00:24:17,140 --> 00:24:19,141 Temporal connection doesn't mean anything. 598 00:24:19,142 --> 00:24:20,767 That kid's on 15 other medications. 599 00:24:20,768 --> 00:24:22,644 They could have a delayed effect. 600 00:24:22,645 --> 00:24:25,105 More likely, it was the antibiotic or the anesthetic. 601 00:24:25,106 --> 00:24:27,941 I considered that, so I pulled ADR data. 602 00:24:27,942 --> 00:24:30,610 There have been several similar reactions to Exsomadex here. 603 00:24:30,611 --> 00:24:35,449 Get this... the manufacturer report claims 1 out of 2,500. 604 00:24:35,450 --> 00:24:38,493 Med data shows 1 out of 200. 605 00:24:38,494 --> 00:24:40,663 That's 10 times what the manufacturer claims. 606 00:24:42,707 --> 00:24:44,249 Well, you might have a case, 607 00:24:44,250 --> 00:24:46,293 but this data is retrospective. 608 00:24:46,294 --> 00:24:48,336 It's not any kind of clinical study. 609 00:24:48,337 --> 00:24:51,298 So pull Exsomadex until we have one. 610 00:24:51,299 --> 00:24:53,675 Hold on. It's a popular medication. 611 00:24:53,676 --> 00:24:55,302 I've used it and never had a problem. 612 00:24:55,303 --> 00:24:57,637 It doesn't mean that you won't. 613 00:24:57,638 --> 00:25:03,852 Crockett, that boy almost died today. 614 00:25:03,853 --> 00:25:05,145 All right. 615 00:25:05,146 --> 00:25:06,646 I'll, uh... 616 00:25:06,647 --> 00:25:08,940 I'll bring this up at the drug and formulary meeting. 617 00:25:08,941 --> 00:25:10,066 Best I can do for now. 618 00:25:10,067 --> 00:25:11,568 In the meantime, make sure that the nurses 619 00:25:11,569 --> 00:25:14,404 submit an adverse drug reaction report, okay? 620 00:25:14,405 --> 00:25:15,948 Thank you. 621 00:25:18,493 --> 00:25:20,869 To begin the transorbital lobotomy, 622 00:25:20,870 --> 00:25:23,997 the orbitoclast is inserted under the left eyelid 623 00:25:23,998 --> 00:25:26,792 and up against the top of the eye socket. 624 00:25:26,793 --> 00:25:28,794 The neurosurgeon drives the point 625 00:25:28,795 --> 00:25:31,338 through the orbital plate into the frontal lobe 626 00:25:31,339 --> 00:25:34,007 to a depth of 5 centimeters. 627 00:25:34,008 --> 00:25:37,010 He then swings the handle far laterally. 628 00:25:37,011 --> 00:25:40,306 He now drives the instrument another 2 centimeters... 629 00:25:54,946 --> 00:25:56,905 Here's Jimmy's CT. 630 00:25:56,906 --> 00:26:00,408 I think we can rule out Alzheimer's. 631 00:26:00,409 --> 00:26:03,411 Identical scarring on... 632 00:26:03,412 --> 00:26:06,373 oh, my God. 633 00:26:06,374 --> 00:26:07,791 He had a lobotomy? 634 00:26:07,792 --> 00:26:10,001 Yeah. 635 00:26:10,002 --> 00:26:12,546 They haven't done those for, like, 60 years. 636 00:26:12,547 --> 00:26:14,881 I mean, he must have been a kid. 637 00:26:14,882 --> 00:26:18,009 They did the procedure on difficult patients. 638 00:26:18,010 --> 00:26:20,554 Jimmy was probably a discipline problem, 639 00:26:20,555 --> 00:26:22,013 hard to control. 640 00:26:22,014 --> 00:26:26,017 So Dr. Sorensen stuck a skewer into his brain 641 00:26:26,018 --> 00:26:29,605 and... took care of that. 642 00:26:33,443 --> 00:26:35,194 Awful. 643 00:26:42,274 --> 00:26:46,014 Dad said he's getting more oxygen now, so that's good. 644 00:26:46,541 --> 00:26:48,167 Hey. This is Dr. Collins. 645 00:26:48,168 --> 00:26:50,503 - She started our center. - Oh, Margo. Please. 646 00:26:50,504 --> 00:26:52,088 I think I've seen you around the hospital. 647 00:26:52,089 --> 00:26:53,381 Yeah, I recently got privileges. 648 00:26:53,382 --> 00:26:55,132 I'm sorry I couldn't get here earlier. 649 00:26:55,133 --> 00:26:56,884 Several new residents were checking in. 650 00:26:56,885 --> 00:26:58,427 So how is Damon doing? 651 00:26:58,428 --> 00:27:00,554 Well, he's sedated. He's on a ventilator. 652 00:27:00,555 --> 00:27:02,098 Dad's been taking really good care of him. 653 00:27:02,099 --> 00:27:03,349 I'm sure he has. 654 00:27:03,350 --> 00:27:04,934 Well, we're by no means out of the woods. 655 00:27:04,935 --> 00:27:06,352 Can I see his chart? 656 00:27:06,353 --> 00:27:08,521 Sure. 657 00:27:08,522 --> 00:27:10,356 Endocarditis. 658 00:27:10,357 --> 00:27:12,358 We're hoping the antibiotics knock it out. 659 00:27:12,359 --> 00:27:13,859 Listen, if you need to get back, 660 00:27:13,860 --> 00:27:15,403 I can call you if there's a change. 661 00:27:15,404 --> 00:27:20,283 Uh, no, I'd like to stay, see how he does. 662 00:27:20,284 --> 00:27:22,118 Is it all right if I sit with him? 663 00:27:22,119 --> 00:27:24,537 - Of course. - Thank you. 664 00:27:24,538 --> 00:27:26,414 Hey, just so you know, 665 00:27:26,415 --> 00:27:28,541 your son, he's been a real godsend. 666 00:27:28,542 --> 00:27:29,959 That's nice to hear. 667 00:27:29,960 --> 00:27:32,003 It's so helpful to have people around our residents 668 00:27:32,004 --> 00:27:33,964 who understand their challenges. 669 00:27:41,763 --> 00:27:43,931 Kaitlin? 670 00:27:43,932 --> 00:27:46,267 Kaitlin, can you hear me? 671 00:27:46,268 --> 00:27:48,102 Hi. 672 00:27:48,103 --> 00:27:49,895 I got good news. 673 00:27:49,896 --> 00:27:52,565 We were able to save your uterus. 674 00:27:52,566 --> 00:27:55,735 So if you decide to conceive again, 675 00:27:55,736 --> 00:27:56,936 you should be able to. 676 00:27:58,697 --> 00:28:00,781 Honey, did you hear? 677 00:28:00,782 --> 00:28:02,033 No. 678 00:28:02,034 --> 00:28:03,576 No, I can't. 679 00:28:03,577 --> 00:28:05,703 I can't do it again. 680 00:28:05,704 --> 00:28:07,747 Please. I'm sorry. 681 00:28:07,748 --> 00:28:10,041 It's okay. It's okay. 682 00:28:10,042 --> 00:28:11,334 Nobody would help. 683 00:28:11,335 --> 00:28:12,543 I know. 684 00:28:12,544 --> 00:28:16,048 They made me feel like I didn't matter. 685 00:28:17,799 --> 00:28:19,717 I was thinking, 686 00:28:19,718 --> 00:28:21,636 if you agree, 687 00:28:21,637 --> 00:28:23,137 maybe we should move. 688 00:28:23,138 --> 00:28:25,014 But your home, the farm. 689 00:28:25,015 --> 00:28:26,849 I can't go back there. 690 00:28:26,850 --> 00:28:28,643 How could I? 691 00:28:28,644 --> 00:28:31,646 Oh, God, Kaitlin, 692 00:28:31,647 --> 00:28:35,359 I don't think I could stand to see you suffer like that again. 693 00:28:36,151 --> 00:28:40,071 I know how much you wanted a family, so... 694 00:28:40,072 --> 00:28:44,325 if you decide you want us to try again, 695 00:28:44,326 --> 00:28:46,452 you don't have to be afraid. 696 00:28:46,453 --> 00:28:48,664 We'll leave you two alone. 697 00:28:53,502 --> 00:28:55,586 Well, it's good to know 698 00:28:55,587 --> 00:28:58,547 there's some good guys in the world. 699 00:28:58,548 --> 00:28:59,748 Yeah. 700 00:29:03,220 --> 00:29:05,097 How is she? 701 00:29:14,147 --> 00:29:16,732 They're not gonna pull Exsomadex. 702 00:29:16,733 --> 00:29:18,526 They're submitting the data to the FDA, 703 00:29:18,527 --> 00:29:21,028 and they'll, uh, follow their recommendations. 704 00:29:21,029 --> 00:29:23,531 That could take forever. 705 00:29:23,532 --> 00:29:25,366 We need to pull it now. I'll talk to them. 706 00:29:25,367 --> 00:29:27,243 Hold on. I made the case. 707 00:29:27,244 --> 00:29:29,745 - It's been decided. - I can still try. 708 00:29:29,746 --> 00:29:32,373 Drop it, Zola. 709 00:29:32,374 --> 00:29:35,543 It's not how things work here. 710 00:29:35,544 --> 00:29:36,878 Of course. 711 00:29:46,054 --> 00:29:48,055 You feeling better, Jimmy? 712 00:29:48,056 --> 00:29:49,265 Uh-huh. 713 00:29:49,266 --> 00:29:50,766 What about Betty? 714 00:29:50,767 --> 00:29:53,436 Dr. Ripley, CPD is here. 715 00:29:53,437 --> 00:29:55,438 I'll be back in a minute. 716 00:29:55,439 --> 00:29:58,149 - Dr. Ripley? - Hi. 717 00:29:58,150 --> 00:29:59,483 We did a well-being check on the address 718 00:29:59,484 --> 00:30:01,152 associated with that number. 719 00:30:01,153 --> 00:30:04,947 We found an elderly woman... deceased. 720 00:30:04,948 --> 00:30:06,574 Medical examiner is investigating, 721 00:30:06,575 --> 00:30:08,492 but it looks like natural causes. 722 00:30:08,493 --> 00:30:10,746 I took this off the credenza. 723 00:30:14,082 --> 00:30:15,416 That's my patient. 724 00:30:15,417 --> 00:30:17,084 And that's the woman we found. 725 00:30:17,085 --> 00:30:19,420 I talked to a neighbor who said they were brother and sister. 726 00:30:19,421 --> 00:30:22,089 And she was her brother's caregiver. 727 00:30:22,090 --> 00:30:25,259 Sorry I don't have better news. 728 00:30:25,260 --> 00:30:26,427 She must have collapsed, 729 00:30:26,428 --> 00:30:28,597 and Jimmy went looking for help. 730 00:30:32,893 --> 00:30:34,769 Better call social work. 731 00:30:34,770 --> 00:30:35,970 He's not going home. 732 00:30:45,530 --> 00:30:48,783 I thought you'd be more comfortable waiting in here. 733 00:30:48,784 --> 00:30:51,535 I haven't been in your office for a long time. 734 00:30:51,536 --> 00:30:52,703 Very nice. 735 00:30:52,704 --> 00:30:54,956 Please. Can I get you anything? 736 00:30:54,957 --> 00:30:56,916 Nah. 737 00:30:56,917 --> 00:30:59,627 - Come on in. - Daniel. 738 00:30:59,628 --> 00:31:00,962 Go ahead. 739 00:31:00,963 --> 00:31:03,214 Tell her what great shape I'm in. 740 00:31:03,215 --> 00:31:04,966 Well, I mean, by and large, you are. 741 00:31:04,967 --> 00:31:07,385 There you go. 742 00:31:07,386 --> 00:31:10,137 Yeah, I noticed a... 743 00:31:10,138 --> 00:31:11,555 a minor balance issue. 744 00:31:11,556 --> 00:31:13,516 I hurt my knee. What do you expect? 745 00:31:13,517 --> 00:31:16,102 And some short-term memory issues. 746 00:31:16,103 --> 00:31:18,813 Memory? 747 00:31:18,814 --> 00:31:19,981 What do you mean? 748 00:31:19,982 --> 00:31:21,274 Well, you're forgetting things, Bert. 749 00:31:21,275 --> 00:31:23,734 Well, who doesn't forget things? 750 00:31:23,735 --> 00:31:25,279 What's this about? 751 00:31:27,155 --> 00:31:28,823 Really just about your... 752 00:31:28,824 --> 00:31:31,242 your friends and your family being a little bit concerned. 753 00:31:31,243 --> 00:31:32,952 That's all. 754 00:31:32,953 --> 00:31:34,453 Concerned. 755 00:31:34,454 --> 00:31:37,873 We'd like you to take some more tests, Bert. 756 00:31:37,874 --> 00:31:40,376 What tests? 757 00:31:40,377 --> 00:31:42,878 Oh, to see if I'm all there, compos mentis. 758 00:31:42,879 --> 00:31:44,672 Is that what you're talking about? 759 00:31:44,673 --> 00:31:46,382 Well, I mean, if there is an issue... 760 00:31:46,383 --> 00:31:48,926 and trust me, big if... 761 00:31:48,927 --> 00:31:50,011 don't you wanna know? 762 00:31:50,012 --> 00:31:51,012 I mean, I certainly would. 763 00:31:51,013 --> 00:31:52,555 There isn't. 764 00:31:52,556 --> 00:31:56,100 Well, just in case, let's make an appointment with the neurologist. 765 00:31:56,101 --> 00:31:57,143 Oh, yeah. 766 00:31:57,144 --> 00:31:58,352 I get it. 767 00:31:58,353 --> 00:31:59,687 This is a setup. 768 00:31:59,688 --> 00:32:01,188 It was a setup from the beginning. 769 00:32:01,189 --> 00:32:02,565 Look, I apologize, Bert, 770 00:32:02,566 --> 00:32:05,067 but I knew you wouldn't come here on your own. 771 00:32:05,068 --> 00:32:07,494 And Tara has been so worried. 772 00:32:07,495 --> 00:32:09,030 Uh-uh. Don't put this on Tara. 773 00:32:09,031 --> 00:32:10,948 This is... this is you. 774 00:32:10,949 --> 00:32:12,867 Yeah, y-you're trying to put me away. 775 00:32:12,868 --> 00:32:15,620 You wanna put me away so you can get your hands on... 776 00:32:15,621 --> 00:32:17,663 - on my... on my pension! - Oh, Bert! 777 00:32:17,664 --> 00:32:19,665 And... and you're in it with her. 778 00:32:19,666 --> 00:32:21,375 The two of you are cooking up this nonsense 779 00:32:21,376 --> 00:32:23,169 so you can get my money! 780 00:32:23,170 --> 00:32:24,670 Couple of crooks! 781 00:32:24,671 --> 00:32:26,839 Bert. 782 00:32:26,840 --> 00:32:28,507 How long have we been friends for, huh? 783 00:32:28,508 --> 00:32:30,718 - 40 years? - 40 years, but not anymore. 784 00:32:30,719 --> 00:32:32,219 A-and what was that power I gave you? 785 00:32:32,220 --> 00:32:33,387 That law power? 786 00:32:33,388 --> 00:32:34,430 Power of attorney. 787 00:32:34,431 --> 00:32:35,431 Well, you don't have it anymore. 788 00:32:35,432 --> 00:32:36,682 You ought to be ashamed! 789 00:32:36,683 --> 00:32:38,143 Bert! 790 00:32:46,756 --> 00:32:49,729 Dr. Ahmad, they discharged Alex. 791 00:32:49,731 --> 00:32:50,981 Great. 792 00:32:50,982 --> 00:32:53,984 Yeah, like you said, no big deal. 793 00:32:53,985 --> 00:32:55,068 I'm sorry for what happened. 794 00:32:55,069 --> 00:32:57,488 No. Please, it wasn't your fault. 795 00:32:57,489 --> 00:32:59,156 And Alex is doing fine. 796 00:32:59,157 --> 00:33:00,824 You caught his cancer. 797 00:33:00,825 --> 00:33:02,284 My God. 798 00:33:02,285 --> 00:33:04,454 We are so grateful to you and Dr. Marcel. 799 00:33:06,206 --> 00:33:08,248 We can't even begin to thank you enough. 800 00:33:08,249 --> 00:33:10,125 Thank you, guys. Good luck. 801 00:33:10,126 --> 00:33:11,960 - Thank you. - Thanks. 802 00:33:11,961 --> 00:33:13,338 Thank you. 803 00:33:17,801 --> 00:33:19,344 No pulse. 804 00:33:20,804 --> 00:33:22,012 He's fibrillating. 805 00:33:22,013 --> 00:33:23,555 I'll get on his chest. 806 00:33:23,556 --> 00:33:25,390 Milligram of epi. 807 00:33:25,391 --> 00:33:26,350 Charge to 200. 808 00:33:26,351 --> 00:33:27,518 Charging. 809 00:33:27,519 --> 00:33:28,812 Clear. 810 00:33:30,688 --> 00:33:31,939 Still no pulse. 811 00:33:31,940 --> 00:33:32,981 Epi's in. 812 00:33:32,982 --> 00:33:34,024 Again, charge to 200. 813 00:33:34,025 --> 00:33:35,442 Charging. 814 00:33:35,443 --> 00:33:37,904 Clear. 815 00:33:40,698 --> 00:33:42,825 Huh, nothing. 816 00:33:42,826 --> 00:33:44,452 He's asystole. 817 00:33:50,291 --> 00:33:53,044 No. 818 00:33:56,005 --> 00:33:58,633 Damn it. 819 00:34:01,553 --> 00:34:03,930 Time of death, 1703. 820 00:34:16,442 --> 00:34:19,487 All right, Jimmy, let's get you into this wheelchair. 821 00:34:23,366 --> 00:34:24,993 That's it. 822 00:34:27,036 --> 00:34:28,413 Now, you see that nice woman? 823 00:34:30,540 --> 00:34:32,959 She's gonna take you to a new home. 824 00:34:34,669 --> 00:34:37,171 Did you help Betty? 825 00:34:37,172 --> 00:34:39,382 Some very good people went to help her. 826 00:34:41,301 --> 00:34:44,471 Where I'm going, is Betty there? 827 00:34:46,764 --> 00:34:49,100 No, she isn't. 828 00:34:51,436 --> 00:34:53,271 I-I want Betty. 829 00:34:57,609 --> 00:34:59,069 I'm sorry, Jimmy. 830 00:34:59,611 --> 00:35:01,111 She can't be there. 831 00:35:01,112 --> 00:35:03,280 But she'd want you to go, 832 00:35:03,281 --> 00:35:06,700 and she'd want you to be happy. 833 00:35:06,701 --> 00:35:11,455 I... I want Betty. 834 00:35:11,456 --> 00:35:12,831 Yeah. 835 00:35:12,832 --> 00:35:16,084 Yeah, I know. 836 00:35:16,085 --> 00:35:17,879 I'm sorry, Jimmy. 837 00:35:23,635 --> 00:35:25,011 Here. 838 00:35:28,097 --> 00:35:31,350 That's Betty 839 00:35:31,351 --> 00:35:32,976 and me. 840 00:35:32,977 --> 00:35:34,177 Yeah. 841 00:35:36,815 --> 00:35:38,775 I love Betty. 842 00:35:45,240 --> 00:35:47,324 It's gonna be all right, Jimmy. 843 00:35:47,325 --> 00:35:48,992 I'll come see you, okay? 844 00:35:48,993 --> 00:35:50,703 And we'll talk about Betty then. 845 00:35:53,540 --> 00:35:56,250 I was cold. 846 00:35:56,251 --> 00:35:58,086 Now I'm warm. 847 00:36:00,004 --> 00:36:01,339 Thank you. 848 00:36:03,633 --> 00:36:04,833 You're welcome. 849 00:36:09,013 --> 00:36:10,514 Hi, Jimmy. 850 00:36:10,515 --> 00:36:12,016 I'm Madeline. 851 00:36:18,022 --> 00:36:20,817 Hi, Madeline. 852 00:36:33,204 --> 00:36:36,374 That's a... a tough one, huh? 853 00:36:38,418 --> 00:36:40,262 I just keep wondering 854 00:36:41,004 --> 00:36:44,882 what his life might have been if, 855 00:36:44,883 --> 00:36:47,134 you know... 856 00:36:47,135 --> 00:36:51,722 If they hadn't given up on him? 857 00:36:51,723 --> 00:36:53,141 Yeah. 858 00:36:54,976 --> 00:36:58,437 You know, I've been meaning to ask you, 859 00:36:58,438 --> 00:37:00,690 were you ever able to reconnect with your mom? 860 00:37:02,150 --> 00:37:03,650 No. 861 00:37:03,651 --> 00:37:06,028 I heard she's been in and out of rehab, 862 00:37:06,029 --> 00:37:07,738 in and out of custody. 863 00:37:07,739 --> 00:37:10,115 Well, 864 00:37:10,116 --> 00:37:11,826 I'm sorry to hear that. 865 00:37:14,746 --> 00:37:18,040 And I'm also... 866 00:37:18,041 --> 00:37:21,960 I'm just so sorry if I... 867 00:37:21,961 --> 00:37:24,546 turned out to be yet another person 868 00:37:24,547 --> 00:37:27,758 that made you feel abandoned in this life. 869 00:37:27,759 --> 00:37:31,303 You know, I just... I genuinely regret that. 870 00:37:31,304 --> 00:37:35,308 And I... I hope you'll accept my apology. 871 00:37:57,956 --> 00:38:00,165 It's real. 872 00:38:00,166 --> 00:38:02,251 I'm sorry. 873 00:38:02,252 --> 00:38:04,795 Yeah. 874 00:38:04,796 --> 00:38:07,089 Thank you for not saying, "Now you can move on," 875 00:38:07,090 --> 00:38:09,216 or something ridiculous like that. 876 00:38:09,217 --> 00:38:10,801 I mean, I was tempted. 877 00:38:10,802 --> 00:38:12,053 Me too. 878 00:38:23,815 --> 00:38:25,107 I'm not ready. 879 00:38:25,108 --> 00:38:26,568 Hmm? 880 00:38:34,117 --> 00:38:35,785 Why? 881 00:38:37,745 --> 00:38:39,037 Why? 882 00:38:39,038 --> 00:38:40,581 Until there's an autopsy, 883 00:38:40,582 --> 00:38:41,832 there's no way to know for sure. 884 00:38:41,833 --> 00:38:43,834 But whatever that infection was, 885 00:38:43,835 --> 00:38:48,505 it just weakened his heart until we couldn't save him. 886 00:38:48,506 --> 00:38:50,215 Because he used drugs? 887 00:38:50,216 --> 00:38:53,177 Well, we might have a better idea after the autopsy. 888 00:38:53,178 --> 00:38:54,887 But it's possible. 889 00:38:54,888 --> 00:38:56,848 Street drugs, dirty needles. 890 00:39:00,727 --> 00:39:02,186 Oh, man. 891 00:39:02,187 --> 00:39:04,104 Sean, 892 00:39:04,105 --> 00:39:06,941 I'm sorry I couldn't save him. 893 00:39:13,239 --> 00:39:16,283 You did everything you could. 894 00:39:16,284 --> 00:39:18,660 In my world, you see a lot of loss. 895 00:39:18,661 --> 00:39:20,496 And no matter how hard you try, 896 00:39:20,497 --> 00:39:23,081 sometimes it's just never enough. 897 00:39:23,082 --> 00:39:25,667 I can guess how Sean is feeling. 898 00:39:25,668 --> 00:39:28,045 He came to the center full of hope, 899 00:39:28,046 --> 00:39:29,339 wanting to make a difference. 900 00:39:31,424 --> 00:39:33,802 I'll talk to him. 901 00:39:42,685 --> 00:39:45,187 Bert? 902 00:39:45,188 --> 00:39:48,565 I'll, uh, get tested, just to... 903 00:39:48,566 --> 00:39:50,235 just to get you off my back. 904 00:39:52,362 --> 00:39:53,403 Okay. 905 00:39:53,404 --> 00:39:55,448 Satisfied? 906 00:40:08,336 --> 00:40:10,587 Oh. 907 00:40:10,588 --> 00:40:12,632 - Hey. - Hey. 908 00:40:14,425 --> 00:40:17,094 You, uh, pulling another shift? 909 00:40:17,095 --> 00:40:19,263 Yeah. 910 00:40:19,264 --> 00:40:22,642 I thought I was the only one into self-flagellation. 911 00:40:24,477 --> 00:40:26,062 No, I'm pretty good at it too. 912 00:40:31,234 --> 00:40:32,401 Rough day? 913 00:40:32,402 --> 00:40:34,111 Yeah. 914 00:40:34,112 --> 00:40:36,280 You? 915 00:40:36,281 --> 00:40:37,907 Yeah. 916 00:40:46,499 --> 00:40:48,042 Get some rest. 917 00:40:53,256 --> 00:40:55,091 You too. 61727

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