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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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