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1
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E. R.
2
00:00:05,102 --> 00:00:06,332
Previously on E. R.
3
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- What do you want me to call you?
- How about introducing me as "Abby"?
4
00:00:09,616 --> 00:00:11,442
You don't want people to know
we're going out.
5
00:00:11,543 --> 00:00:14,122
- I'm Dr. Pratt.
- Olivia Evans. I'm with Ceasefire.
6
00:00:14,223 --> 00:00:16,053
- Ceasefire?
- Violence prevention program.
7
00:00:16,154 --> 00:00:17,278
What's she like?
8
00:00:17,335 --> 00:00:19,492
She's a health professional, Ray.
Don't be such a dog.
9
00:00:19,593 --> 00:00:20,535
Where did this happen?
10
00:00:20,636 --> 00:00:22,160
- Twenty-third.
- Wabash.
11
00:00:22,661 --> 00:00:24,531
Well, it- It was near the corner.
12
00:00:24,732 --> 00:00:26,940
- Did you file a police report?
- What's the point?
13
00:00:27,041 --> 00:00:30,263
She and her sister panhandle on Wabash.
I give them a buck once in a while.
14
00:00:30,364 --> 00:00:32,658
I need this publication
for my Chief Resident application.
15
00:00:32,759 --> 00:00:35,320
Trust me. It's gonna take
a hell of a lot more than that.
16
00:00:37,020 --> 00:00:39,940
E. R. 11x19 "RUDY REDUX"
Subt�tulos subXpacio
17
00:00:41,733 --> 00:00:45,570
Yeah, I called Sid. And, no, he doesn't
have anything new to show us.
18
00:00:45,737 --> 00:00:47,990
We need a new realtor.
He's shown us 17 houses...
19
00:00:48,157 --> 00:00:51,077
- ...not one of them close.
- Don't think the problem could be us?
20
00:00:51,243 --> 00:00:53,287
All right, what about this one? No.
21
00:00:53,454 --> 00:00:55,581
It doesn't seem fair
to schedule it like that.
22
00:00:55,748 --> 00:00:59,294
You work all night, now you gotta
rush back. You're tired.
23
00:00:59,461 --> 00:01:01,922
What do you mean, I'm tired?
Do I look like I'm tired?
24
00:01:03,632 --> 00:01:05,801
Of course not. No.
You look chipper. It's just-
25
00:01:05,968 --> 00:01:08,720
- Smoodge.
- You're just- You're worrying so much.
26
00:01:08,887 --> 00:01:12,058
You know, they don't schedule
tenure meetings around the candidates.
27
00:01:12,225 --> 00:01:14,352
Hey, at least you're overthinking
the wardrobe.
28
00:01:14,519 --> 00:01:17,438
I am not worrying.
And I am not overthinking.
29
00:01:17,605 --> 00:01:19,941
You know, tenure
means financial security.
30
00:01:20,108 --> 00:01:23,404
We could get a house,
start a college fund for Cosmo.
31
00:01:23,570 --> 00:01:25,572
What if Cosmo doesn't
want to go to college?
32
00:01:25,739 --> 00:01:28,701
- What?
- Baby, I can go back to work.
33
00:01:30,619 --> 00:01:33,164
- I know.
- You can make more at a private hospital.
34
00:01:33,331 --> 00:01:36,167
No. It's not about the money.
I want to be at County.
35
00:01:36,334 --> 00:01:38,128
It's where I belong.
36
00:01:38,294 --> 00:01:41,715
Okay. I'm gonna leave these here.
Promise me you'll step over them.
37
00:01:41,881 --> 00:01:44,677
- I promise.
- All right. I gotta go, baby.
38
00:01:44,844 --> 00:01:48,264
I love you. And you too.
39
00:01:48,639 --> 00:01:51,892
- Oh, Susan.
- I have one meeting, then I will be home.
40
00:01:52,059 --> 00:01:53,394
- Susan.
- How do I look?
41
00:01:53,561 --> 00:01:55,313
You look great except just:
42
00:01:57,482 --> 00:01:58,734
Smoodge.
43
00:02:02,446 --> 00:02:03,780
Jules Rubadoux, 85.
44
00:02:03,947 --> 00:02:05,658
- Who are you?
- I'm Dr. Rasgotra.
45
00:02:05,825 --> 00:02:08,369
You're a doctor?
You got a high school diploma?
46
00:02:08,536 --> 00:02:09,829
Eighty-five, fainted.
47
00:02:09,996 --> 00:02:13,583
- I did not faint. I was tripped.
- It was witnessed.
48
00:02:13,749 --> 00:02:16,085
Syncopal event at his club.
Unconscious 30 seconds.
49
00:02:16,252 --> 00:02:18,464
Who told you that? Those old geezers?
50
00:02:18,630 --> 00:02:20,674
They're unconscious most of the day.
51
00:02:20,841 --> 00:02:23,093
- Must've been a long ride.
- Oh, tell me about it.
52
00:02:23,260 --> 00:02:25,053
Get out of here! Bring back the omelet!
53
00:02:25,220 --> 00:02:26,972
- Okay, we'll see what we can do.
- Now!
54
00:02:27,139 --> 00:02:29,267
Delirium, tachycardia,
hyperthermia, mydriasis.
55
00:02:29,434 --> 00:02:31,352
- Better not have spinach!
- What do you think?
56
00:02:31,519 --> 00:02:33,396
Don't get high by snorting
antihistamines?
57
00:02:33,563 --> 00:02:34,606
I hate spinach.
58
00:02:35,398 --> 00:02:38,526
Come on, guys. This is classic.
Mad as a hatter, red as a beet...
59
00:02:38,694 --> 00:02:40,696
- Dry as a bone.
- Anticholinergic toxicity.
60
00:02:40,863 --> 00:02:42,656
Bingo. What's your plan?
61
00:02:42,823 --> 00:02:45,326
IV, tox screen, activated charcoal.
62
00:02:45,493 --> 00:02:48,579
- Yes. What else?
- EKG, rule out cardiac effects.
63
00:02:48,746 --> 00:02:50,999
- Ativan for the agitation.
- Excellent.
64
00:02:51,166 --> 00:02:55,378
And what happens if the delirium
worsens despite benzos?
65
00:02:57,047 --> 00:03:00,467
Physostigmine. The only
acetylcholinesterase inhibitor...
66
00:03:00,634 --> 00:03:03,471
...that crosses the blood-brain barrier.
Everybody get that?
67
00:03:03,638 --> 00:03:05,473
Where do I sign to get out of here?
68
00:03:05,640 --> 00:03:07,058
We need to examine you first.
69
00:03:07,225 --> 00:03:10,394
If I wanted help, I wouldn't
come to this place looking for it.
70
00:03:10,561 --> 00:03:13,232
- I want another hospital.
- We're just gonna check you out.
71
00:03:13,398 --> 00:03:15,943
- I don't want this place.
- It won't take long.
72
00:03:16,109 --> 00:03:18,654
- I don't want your doctors.
- Dr. Carter, we need you.
73
00:03:18,820 --> 00:03:20,656
- Okay.
- Especially that one.
74
00:03:20,822 --> 00:03:24,577
I don't want that one
anywhere near me.
75
00:03:24,744 --> 00:03:26,246
He killed my wife.
76
00:04:24,434 --> 00:04:26,310
Sam, what's the deal
with my lymphoma guy?
77
00:04:26,477 --> 00:04:28,271
CT was ready for him 40 minutes ago.
78
00:04:28,438 --> 00:04:30,315
Man, I totally spaced. I'll go take him.
79
00:04:30,482 --> 00:04:33,694
Don't bother. They got a seizing
ICU player. Be backed up a while.
80
00:04:33,861 --> 00:04:35,362
Okay.
81
00:04:35,529 --> 00:04:37,906
- Crap. Sorry.
- That was the Guatemalan blend.
82
00:04:38,073 --> 00:04:40,284
- I said sorry.
- Come on. Let's move some bodies.
83
00:04:40,451 --> 00:04:42,829
Transfer from Seashore House,
fever and incontinence.
84
00:04:42,996 --> 00:04:46,666
I got stuck with the last dump.
Abby, I'll trade you. Whatever you get.
85
00:04:46,833 --> 00:04:49,836
- No, Ray. I don't think so.
- Neela, 85-year-old man with syncope.
86
00:04:50,003 --> 00:04:52,590
- The one you brought in.
- The guy that yelled at Carter?
87
00:04:52,757 --> 00:04:56,218
Afraid so. And as much as I hate
doing this to you, I'm out of here.
88
00:04:57,303 --> 00:04:59,013
Exam 3.
89
00:05:00,264 --> 00:05:03,935
I've served on the curriculum and
admissions committees for three years.
90
00:05:04,102 --> 00:05:07,481
And we appreciate that. We're also
looking for excellence in teaching.
91
00:05:07,647 --> 00:05:10,484
You've won the Resident
teaching award three years running.
92
00:05:10,650 --> 00:05:13,195
- That's very impressive.
- Seven years as an Attending...
93
00:05:13,361 --> 00:05:16,365
- ...only four publications?
- No original research? First author?
94
00:05:16,532 --> 00:05:19,702
I just submitted a review article.
And I have other studies lined up.
95
00:05:19,869 --> 00:05:23,372
- I'm waiting to hear about the grants.
- Emergency medicine's a smorgasbord.
96
00:05:23,539 --> 00:05:25,583
Sometimes it's hard to find your niche.
97
00:05:26,293 --> 00:05:27,669
Excuse me?
98
00:05:28,545 --> 00:05:31,965
The university is willing to float
junior faculty for a few years. But-
99
00:05:32,132 --> 00:05:35,010
Tenured Attendings need
the ability to carry their own weight.
100
00:05:35,177 --> 00:05:38,515
You mean, bring in grant money.
Okay, my focus hasn't been research.
101
00:05:38,681 --> 00:05:41,976
I've spent the last seven years
becoming a good clinician and teacher.
102
00:05:42,143 --> 00:05:46,231
That's clear, Susan. And we put
a great deal of value on that.
103
00:05:47,941 --> 00:05:52,029
Well, I don't want you to do anything
until I can talk to my own doctor...
104
00:05:52,196 --> 00:05:55,658
- ...Stanley Obermeyer.
- Right. We have a call in to him.
105
00:05:55,824 --> 00:05:59,621
Yeah? Well, Stanley's not gonna like what
you guys are doing, prodding me here.
106
00:05:59,788 --> 00:06:02,040
Mr. Rubadoux, I can't hear
while you're talking.
107
00:06:02,207 --> 00:06:05,585
- You've been listening for 5 minutes.
- You've been talking for 5 minutes.
108
00:06:10,090 --> 00:06:12,510
- Anyone ever tell you you have a murmur?
- A what?
109
00:06:12,677 --> 00:06:15,263
A murmur? The sound of blood
rushing through the heart.
110
00:06:16,347 --> 00:06:18,849
- You think I have that?
- I'm pretty sure, yeah.
111
00:06:19,016 --> 00:06:22,563
Oh, "pretty sure"?
Is that all you can say?
112
00:06:22,729 --> 00:06:23,939
I'd like to run some tests.
113
00:06:24,106 --> 00:06:27,192
- What tests?
- EKG, chest x-ray.
114
00:06:27,359 --> 00:06:28,902
Draw some blood.
115
00:06:29,069 --> 00:06:33,533
Look, no offense, but I don't want
some nurse calling the shots around here.
116
00:06:33,700 --> 00:06:37,787
Mr. Rubadoux, I am not a nurse.
I am a doctor.
117
00:06:37,954 --> 00:06:39,872
Well, you're not my doctor.
118
00:06:40,039 --> 00:06:44,044
And I'm not gonna let you
do anything else until I talk to him.
119
00:06:44,211 --> 00:06:46,422
- Okay.
- Okay.
120
00:06:53,220 --> 00:06:54,263
Jeez.
121
00:06:54,430 --> 00:06:57,767
- I'm Dr. Pratt. Take a deep breath for me.
- Sats 88 on a nonrebreather.
122
00:06:57,934 --> 00:07:01,313
- Is he dead? Is my husband dead?
- Behind us. Doctors are working on him.
123
00:07:01,479 --> 00:07:02,647
He's alive?
124
00:07:03,064 --> 00:07:05,150
Wife fired a couple of rounds
to his chest.
125
00:07:05,317 --> 00:07:08,112
Pulse at 133, BP, 90 palp,
went apneic in the rig.
126
00:07:08,279 --> 00:07:10,531
- Access?
- Two large-bore IVs. Liter en route.
127
00:07:10,698 --> 00:07:14,785
- Another day, another happy couple.
- All right, on my count: One, two, three.
128
00:07:14,952 --> 00:07:17,497
- Two of Versed right away.
- Your husband stabbed you?
129
00:07:17,664 --> 00:07:20,751
He cornered me in the kitchen,
had a knife to my throat.
130
00:07:20,917 --> 00:07:23,503
- Definite ETOH.
- Have you been drinking, Mrs. Casey?
131
00:07:23,670 --> 00:07:26,631
I didn't know what to do.
I grabbed his gun from the kitchen.
132
00:07:26,798 --> 00:07:30,511
Decreased breath sounds. You have
a collapsed lung. I need to reinflate it.
133
00:07:30,678 --> 00:07:33,139
Sam, you were supposed to check
the airway boxes.
134
00:07:33,306 --> 00:07:35,433
- I don't think so.
- According to the schedule.
135
00:07:35,600 --> 00:07:38,478
- I thought it was Malik's turn.
- We're out of 8.Os.
136
00:07:38,644 --> 00:07:42,399
- Malcolm, who's sorry now, you bastard?
- What did you do? Take a vacation?
137
00:07:42,566 --> 00:07:44,693
Not my fault Sam
didn't stock the shelves.
138
00:07:44,860 --> 00:07:47,446
- Tube.
- I can barely palpate a femoral.
139
00:07:47,613 --> 00:07:49,156
Heart rate's up to 140.
140
00:07:49,323 --> 00:07:51,826
Okay. Hang the O-neg
and call for type-specific.
141
00:07:51,993 --> 00:07:55,371
- Ray, he needs an IJ.
- And a surgeon. O.R. 3's on hold.
142
00:07:55,538 --> 00:07:58,625
You got this?
I need to check next door.
143
00:07:58,792 --> 00:08:00,543
- How's she doing?
- Her lungs are down.
144
00:08:00,710 --> 00:08:03,547
She's stable but she's agitated.
Sam, where's that Versed?
145
00:08:03,714 --> 00:08:05,466
- What are they doing?
- Here you go.
146
00:08:05,633 --> 00:08:07,885
- I was getting it.
- Okay. I was just right here.
147
00:08:08,052 --> 00:08:09,595
- I've got it covered, Luka.
- Okay.
148
00:08:09,762 --> 00:08:13,350
They better not send him home. I'm
changing the locks, not gonna let him in.
149
00:08:13,517 --> 00:08:16,394
Mary, you need to calm down
and answer some questions for me.
150
00:08:16,561 --> 00:08:18,146
- Where are you?
- Some hospital.
151
00:08:18,313 --> 00:08:20,732
- And what year is it?
-2005.
152
00:08:20,899 --> 00:08:23,235
- Good. And where do you live?
- West Garfield.
153
00:08:24,403 --> 00:08:26,072
West Garfield?
154
00:08:26,239 --> 00:08:27,698
Do you got a problem with that?
155
00:08:28,157 --> 00:08:31,369
Bilateral crackles, 3/6,
harsh systolic murmur JVD...
156
00:08:31,536 --> 00:08:33,913
...and the liver's down four centimeters.
157
00:08:34,080 --> 00:08:36,041
You heard him.
He doesn't wanna see me.
158
00:08:36,208 --> 00:08:38,669
- Why don't you present to Kovac?
- Tied up in a trauma.
159
00:08:38,836 --> 00:08:41,630
We're waiting on call from his doc.
I got him to calm down...
160
00:08:41,797 --> 00:08:44,383
...by promising to bring in
an experienced physician.
161
00:08:44,550 --> 00:08:48,054
- Which means an Attending. Means you.
- All right. Any cardiac history there?
162
00:08:48,221 --> 00:08:51,891
Chronic CHF and evidence
of an old infarct.
163
00:08:57,815 --> 00:09:00,359
I sent off troponins.
I'll get an EKG when you're done.
164
00:09:00,526 --> 00:09:02,778
And did Obermeyer call yet?
165
00:09:03,946 --> 00:09:05,781
Hello.
166
00:09:05,948 --> 00:09:07,241
I'm Dr. Carter.
167
00:09:07,408 --> 00:09:10,579
Don't worry. I remember your name.
168
00:09:10,996 --> 00:09:12,956
Ten years, I don't forget.
169
00:09:13,748 --> 00:09:15,917
- I understand-
- You remember my name?
170
00:09:16,084 --> 00:09:17,752
Rubadoux?
171
00:09:18,628 --> 00:09:21,882
- That's a very unusual name.
- You don't even remember.
172
00:09:22,049 --> 00:09:24,468
And you don't remember
my wife then either, do you?
173
00:09:25,136 --> 00:09:28,472
Just some other old person.
Give them the old song and dance...
174
00:09:28,639 --> 00:09:30,892
...and ship them off.
175
00:09:31,476 --> 00:09:34,313
Okay. We need to hear from your doctor.
So in the meantime-
176
00:09:34,479 --> 00:09:36,982
I knew she didn't have much time left.
177
00:09:37,149 --> 00:09:40,110
But why did you have
to put her through all that?
178
00:09:41,069 --> 00:09:45,325
My sweet Sylvie. Keeping a smile
every step of the way.
179
00:09:46,993 --> 00:09:49,120
- Let's take a quick listen.
- No, no, no.
180
00:09:49,287 --> 00:09:51,497
I want my own doctor.
181
00:09:52,373 --> 00:09:55,669
Mr. Rubadoux, he's the Attending.
He has to examine you.
182
00:09:55,836 --> 00:09:58,714
What do you mean, "has to"?
What is there, a law around here...
183
00:09:58,881 --> 00:10:00,758
...a rule when you come into this place?
184
00:10:00,924 --> 00:10:02,259
Yes. Actually, there is.
185
00:10:04,387 --> 00:10:07,640
All right. Make it fast.
186
00:10:17,735 --> 00:10:19,195
What was that about?
187
00:10:19,445 --> 00:10:21,447
A very unsatisfied customer.
188
00:10:21,822 --> 00:10:23,991
- He needs an echo.
- I called Kayson. He's on it.
189
00:10:24,158 --> 00:10:26,703
Radiology called about
that kid with the huge head.
190
00:10:26,870 --> 00:10:28,538
- Hydroceph-?
- Hydrocephalus, yeah.
191
00:10:28,705 --> 00:10:30,665
I'll call Neurosurg.
192
00:10:33,210 --> 00:10:37,255
- Even more of a handful than before.
- You remember him?
193
00:10:37,422 --> 00:10:40,176
Don't let him get to you, Carter.
It was a long time ago...
194
00:10:40,343 --> 00:10:42,470
...and you were just a student.
195
00:10:47,558 --> 00:10:49,937
Dr. Lewis, thought you were off.
What are you doing?
196
00:10:50,104 --> 00:10:51,438
- Don't ask.
- Been paging you.
197
00:10:51,605 --> 00:10:53,524
I was in a meeting.
I turned my pager off.
198
00:10:53,690 --> 00:10:55,651
Got a double trauma.
Long as you are here-
199
00:10:55,818 --> 00:10:59,655
- I'm not here.
- The meeting got changed to 3:30.
200
00:11:00,365 --> 00:11:02,158
- What?
- That's why I've been paging you.
201
00:11:02,325 --> 00:11:04,661
I just worked all night.
I can't stay till 3:30.
202
00:11:08,581 --> 00:11:10,041
"Rubba-ducks"?
203
00:11:10,208 --> 00:11:12,962
Rubadoux, Sylvie.
How long will this take?
204
00:11:13,129 --> 00:11:15,381
Ten-year-old chart? Could be a while.
205
00:11:17,007 --> 00:11:18,926
I'll wait.
206
00:11:29,563 --> 00:11:32,315
Certainly thinks highly of you.
207
00:11:32,482 --> 00:11:34,819
Well, that's very flattering
coming from him.
208
00:11:34,986 --> 00:11:38,114
Oh, and don't get me wrong.
He was brilliant. But he drove us crazy.
209
00:11:38,281 --> 00:11:40,533
Made us do a full workup
on every single sniffle.
210
00:11:41,200 --> 00:11:45,539
Well, that's my Dr. Obermeyer.
211
00:11:45,873 --> 00:11:47,958
Nothing if not thorough.
212
00:11:48,125 --> 00:11:51,962
- Dilated left ventricle, gradient's 86.
- Those calcifications?
213
00:11:52,129 --> 00:11:54,256
I'm listening to the doctor, please.
214
00:11:54,423 --> 00:11:57,176
Ejection fraction's only 45,
but seeing as he presented...
215
00:11:57,343 --> 00:12:01,347
...with both syncope and failure,
there's really only one option.
216
00:12:03,516 --> 00:12:05,727
Mr. Rubadoux,
you have critical aortic stenosis.
217
00:12:05,894 --> 00:12:08,147
One of the valves
in your heart is narrowed.
218
00:12:08,314 --> 00:12:11,984
- We have to operate to open that valve.
- Operate?
219
00:12:13,527 --> 00:12:15,154
- When?
- Well, as soon as possible.
220
00:12:15,321 --> 00:12:19,784
Your heart's not generating enough force
to push blood through that constriction.
221
00:12:19,951 --> 00:12:22,412
And you can do something about that?
222
00:12:22,579 --> 00:12:25,415
Well, we have to run a few tests.
But, yes, we can.
223
00:12:25,582 --> 00:12:29,503
I'll talk to Anspaugh. You check his BUN,
creatinine, order PFTs.
224
00:12:29,670 --> 00:12:32,465
- Hang in there, Mr. Rubadoux.
- Call me Ruby.
225
00:12:33,257 --> 00:12:34,884
Ruby.
226
00:12:38,554 --> 00:12:42,517
Hey, pretty lucky, huh?
Same school as my doc.
227
00:12:45,354 --> 00:12:46,605
Nothing personal...
228
00:12:46,772 --> 00:12:50,859
...but they both have a little bit
more water under the bridge...
229
00:12:51,026 --> 00:12:54,739
- ...if you know what I mean.
- I know what you mean.
230
00:12:55,156 --> 00:12:58,534
- Did you understand everything he said?
- Yeah.
231
00:12:58,701 --> 00:13:01,037
Yeah, I need a heart operation.
232
00:13:01,204 --> 00:13:03,040
Do you have any questions?
233
00:13:03,999 --> 00:13:06,835
- Heart surgery's a big deal.
- I know that.
234
00:13:07,002 --> 00:13:08,295
What, am I an idiot?
235
00:13:09,630 --> 00:13:12,383
Well, do you also know that,
given your age...
236
00:13:12,549 --> 00:13:14,719
...the risks of surgery are higher?
237
00:13:16,096 --> 00:13:18,807
- What risks?
- Complications.
238
00:13:19,391 --> 00:13:21,518
I mean, I need to get
some more information...
239
00:13:21,684 --> 00:13:23,645
...on your lung function
and your kidneys.
240
00:13:23,812 --> 00:13:27,316
- Something wrong with my kidneys?
- No. I don't know. I don't know yet.
241
00:13:27,483 --> 00:13:31,904
Yeah. Well, why don't you come back
when you're less confused.
242
00:13:34,490 --> 00:13:37,494
Okay. Mr. Rubadoux,
I just want you to understand...
243
00:13:37,661 --> 00:13:40,455
...that this surgery is very serious.
244
00:13:40,622 --> 00:13:43,333
And that we don't know yet
if you're even a good candidate.
245
00:13:43,792 --> 00:13:47,672
And that it's important
you consider all of your options.
246
00:13:49,674 --> 00:13:51,759
Listen, doll...
247
00:13:52,969 --> 00:13:54,929
...can you fix my heart?
248
00:13:56,222 --> 00:13:57,265
No.
249
00:13:57,432 --> 00:14:01,186
Then I'm going with the guy who can.
All right?
250
00:14:05,566 --> 00:14:07,442
Bye.
251
00:14:23,460 --> 00:14:27,214
Prior Ml, marginal ventricular function,
and his creatinine's 2.3.
252
00:14:27,381 --> 00:14:28,632
He's 85.
253
00:14:28,799 --> 00:14:30,843
He has significant
coronary-artery disease...
254
00:14:31,010 --> 00:14:33,221
...renal insufficiency
and a history of COPD.
255
00:14:33,388 --> 00:14:36,725
- What do you think about his lungs?
- We can check his PFTs, but he's old.
256
00:14:36,892 --> 00:14:39,561
- They're not gonna be perfect.
- Anything else you want?
257
00:14:39,728 --> 00:14:41,521
Send coags.
Have him typed and crossed.
258
00:14:41,688 --> 00:14:44,942
Excuse me. I'm sorry,
but don't you think, just maybe...
259
00:14:45,109 --> 00:14:48,070
...open-heart surgery might not be
such a good idea for this man?
260
00:14:48,237 --> 00:14:51,407
Don't you think just maybe
that's the surgeon's call?
261
00:14:52,408 --> 00:14:54,828
Actually, no.
I think it's the patient's call.
262
00:14:55,245 --> 00:14:57,915
He could spend the rest of his life
on a beach in Miami...
263
00:14:58,081 --> 00:15:00,918
- ...or hooked up to a ventilator.
- He wants the surgery.
264
00:15:01,084 --> 00:15:03,337
She's trying to advocate
on behalf of her patient.
265
00:15:03,503 --> 00:15:07,425
CICU's full and Mr. Rubadoux needs a
bed. She could advocate for him there.
266
00:15:07,592 --> 00:15:09,761
Anspaugh's on his way down.
267
00:15:14,474 --> 00:15:15,975
What?
268
00:15:18,562 --> 00:15:21,774
- So how's it going in there?
- I'll take a 12-year-old gangster...
269
00:15:21,941 --> 00:15:24,777
...over a domestic-violence case
any day.
270
00:15:25,194 --> 00:15:28,573
She said she was from West Garfield.
I figured I should give you a call.
271
00:15:28,740 --> 00:15:31,368
But I wasn't sure
if this was a Ceasefire kind of thing.
272
00:15:31,534 --> 00:15:33,244
Every shooting is a Ceasefire thing.
273
00:15:33,411 --> 00:15:36,456
If she gets out of this mess,
there's a lot we could do for her.
274
00:15:36,623 --> 00:15:38,793
I don't know. She seems
pretty far gone to me.
275
00:15:38,960 --> 00:15:41,087
- How do you stay so optimistic?
- How do you?
276
00:15:41,253 --> 00:15:45,174
What? Stay optimistic? I don't. Three
years in this place, I'm jaded as hell.
277
00:15:45,341 --> 00:15:48,719
You just saw a drunk, battered woman
who shot her abusive husband...
278
00:15:48,886 --> 00:15:51,556
- ...and saw some hope in the situation.
- I did?
279
00:15:51,723 --> 00:15:54,643
You wouldn't have called me
if you didn't think I could help.
280
00:15:55,727 --> 00:15:57,729
I see right through you, Dr. Pratt.
281
00:15:59,189 --> 00:16:00,983
Is that right?
282
00:16:02,819 --> 00:16:05,405
We'll follow up with her
after she's discharged.
283
00:16:05,571 --> 00:16:07,323
- So that's it? You're done?
- For now.
284
00:16:07,490 --> 00:16:10,243
Shouldn't you stick around?
She's bound to have questions...
285
00:16:10,410 --> 00:16:12,579
- ...once sedation wears off.
- You can handle it.
286
00:16:12,746 --> 00:16:15,541
But I don't know too much
about domestic-violence counseling.
287
00:16:15,874 --> 00:16:18,001
I would love to give you
a lengthy tutorial...
288
00:16:18,168 --> 00:16:20,921
- ...but I'm out of time.
- How about later?
289
00:16:21,088 --> 00:16:23,466
You can school me over dinner.
290
00:16:28,054 --> 00:16:30,432
Pick me up at the office at 7.
291
00:16:35,271 --> 00:16:38,774
- Is this gonna take long?
- We've already been here quite a while.
292
00:16:38,941 --> 00:16:40,693
We'll need to be going soon.
293
00:16:40,860 --> 00:16:43,863
You had a low-grade temperature
when the nurse took it earlier.
294
00:16:44,029 --> 00:16:45,866
Beautiful girl.
295
00:16:46,032 --> 00:16:49,077
- Caramel skin.
- Like a young June Allyson.
296
00:16:49,244 --> 00:16:51,204
- Maureen O'Sullivan.
- Susan Hayward.
297
00:16:51,371 --> 00:16:52,914
- Ava Gardner.
- Myrna Loy.
298
00:16:53,081 --> 00:16:56,586
- Sophia Loren.
- Sophia Loren?
299
00:16:59,422 --> 00:17:02,008
Okay. I heard some crackles
on the right side.
300
00:17:02,175 --> 00:17:03,968
Could be a sign of a lung infection.
301
00:17:04,135 --> 00:17:06,554
- You'll need to have a chest x-ray.
- Crackles?
302
00:17:06,721 --> 00:17:09,850
- The other doctor didn't mention crackles.
- No.
303
00:17:10,017 --> 00:17:12,603
That's right. You were in here
over a week ago.
304
00:17:12,769 --> 00:17:14,146
You saw Dr. Lockhart?
305
00:17:14,771 --> 00:17:16,064
Lovely woman.
306
00:17:16,231 --> 00:17:17,816
Like a young Patty Duke.
307
00:17:19,819 --> 00:17:24,407
Now, your aortic valve right here
is stiff and stuck shut.
308
00:17:24,574 --> 00:17:27,577
What we're going to do is
cut out all of the stenotic material...
309
00:17:27,744 --> 00:17:29,997
...and replace it with a porcine valve.
310
00:17:30,164 --> 00:17:31,957
So it's definite he's having surgery?
311
00:17:34,585 --> 00:17:36,128
It is.
312
00:17:36,462 --> 00:17:40,591
Isn't it? I mean, it's-
It's the only way to go, right?
313
00:17:40,758 --> 00:17:44,930
We could treat you with digoxin and
diuretics, but that would be short-term.
314
00:17:45,096 --> 00:17:48,058
At this stage, surgery's
the only definitive treatment.
315
00:17:48,225 --> 00:17:51,436
Just so you know, Dr. Anspaugh,
his FEV 1 is only 53 percent.
316
00:17:52,605 --> 00:17:54,565
- Thank you.
- Make him NPO after midnight.
317
00:17:54,732 --> 00:17:58,486
And don't his decreased lung capacity
and renal insufficiency strongly con-?
318
00:18:04,284 --> 00:18:07,162
What I mean is, shouldn't
we be discussing the risks?
319
00:18:07,329 --> 00:18:09,289
Yeah. But we talked about all that.
320
00:18:09,456 --> 00:18:12,668
The risk, the complications, the kidneys.
321
00:18:12,834 --> 00:18:15,338
We're going to talk
about them again, Mr. Rubadoux.
322
00:18:16,464 --> 00:18:17,757
Call me Ruby.
323
00:18:18,216 --> 00:18:20,677
- Will you excuse me for just a minute?
- Certainly.
324
00:18:20,843 --> 00:18:22,887
Dr. Lockhart.
325
00:18:29,061 --> 00:18:32,481
I take it you have a problem with
Mr. Rubadoux's decision to have surgery.
326
00:18:32,648 --> 00:18:34,858
I'm concerned it's not
an informed decision, yes.
327
00:18:35,025 --> 00:18:37,988
And is that because you failed
to adequately explain the risks?
328
00:18:39,322 --> 00:18:43,076
Do you think I would operate on this man
if he didn't understand the consequences?
329
00:18:43,410 --> 00:18:46,037
Why would I do that?
Because I have nothing better to do?
330
00:18:46,454 --> 00:18:48,416
- No, certainly.
- If you have concerns...
331
00:18:48,582 --> 00:18:51,460
...you ask the consulting doctor
to step outside.
332
00:18:51,627 --> 00:18:54,547
You do not, in front of a patient,
attempt to subtly disagree...
333
00:18:54,714 --> 00:18:57,466
...with the senior cardiologist
and the chief of surgery.
334
00:18:58,134 --> 00:19:01,763
That kind of behavior
is helpful to no one.
335
00:19:02,514 --> 00:19:05,225
- Do you understand?
- Yes.
336
00:19:08,520 --> 00:19:09,855
I have concerns.
337
00:19:22,035 --> 00:19:24,413
Knowing you as well as I do...
338
00:19:24,580 --> 00:19:27,249
...I'm gonna guess you really
hate it when people do this.
339
00:19:27,416 --> 00:19:30,210
The come-from-behind-
and-put-your-hands-over-the-eyes thing?
340
00:19:30,377 --> 00:19:33,757
Yeah. Words cannot express
exactly how much I hate it.
341
00:19:34,841 --> 00:19:36,926
Pretty cool that I knew that,
don't you think?
342
00:19:38,261 --> 00:19:39,512
- Bad timing?
- Yes.
343
00:19:39,679 --> 00:19:41,848
- Want to talk about it?
- No.
344
00:19:42,807 --> 00:19:44,894
So I'm back.
345
00:19:45,060 --> 00:19:47,730
Oh, my God, Jake.
I'm sorry. I'm sorry.
346
00:19:47,897 --> 00:19:49,607
- It's okay.
- How was San Francisco?
347
00:19:49,774 --> 00:19:51,901
Amazing faculty. Lots of O.R. time.
348
00:19:52,067 --> 00:19:54,236
I thought Boston was first
until I saw UCSF...
349
00:19:54,403 --> 00:19:57,240
- ...but it's a long shot.
- They wouldn't have invited you...
350
00:19:57,407 --> 00:19:59,493
...if they weren't interested.
Where's Carter?
351
00:19:59,659 --> 00:20:02,621
- MRI.
- Thanks. So UCSF, huh?
352
00:20:02,787 --> 00:20:06,667
Yes. I liked it. But, you know,
I still could match right here.
353
00:20:06,834 --> 00:20:09,253
- Yup.
- What would happen if I did that?
354
00:20:09,420 --> 00:20:12,423
Well, Jake, then you'd
be working at County.
355
00:20:12,840 --> 00:20:15,551
Dirk Harmon, 14. Crashed headfirst
into a retaining wall...
356
00:20:15,718 --> 00:20:17,763
- ...while luging down Sheridan Road.
- Luging?
357
00:20:17,930 --> 00:20:20,182
Street luge.
Don't you watch those guys on ESPN?
358
00:20:20,349 --> 00:20:24,269
- When do you watch ESPN?
- Pulse, 72. BP, 112/65. Sats 100.
359
00:20:24,436 --> 00:20:26,313
I'm Dr. Pratt. How fast were you going?
360
00:20:26,480 --> 00:20:28,775
- Forty, maybe 50.
- All right.
361
00:20:28,942 --> 00:20:31,945
- Come on, you guys.
- He's one of the qualifiers at Super Mass.
362
00:20:32,111 --> 00:20:33,655
But I'm really more into dual.
363
00:20:33,821 --> 00:20:35,823
- Where do you find hills in Chicago?
- Luka.
364
00:20:35,990 --> 00:20:38,076
- You do snow too?
- Totally.
365
00:20:38,243 --> 00:20:40,704
Hello, everyone.
He just rammed his head into a wall.
366
00:20:40,871 --> 00:20:42,623
- Yes.
- Yes.
367
00:20:44,083 --> 00:20:48,379
- Hey, dude. My hands are numb.
- Weird.
368
00:20:48,545 --> 00:20:50,507
- When did that start?
- Just noticed it.
369
00:20:50,674 --> 00:20:53,134
Pratt, hold the C-spine.
Let's move him carefully.
370
00:20:53,718 --> 00:20:56,930
Hey. I need to talk to you
about the Rubadoux thing.
371
00:20:57,097 --> 00:21:00,225
Birdy Chaddock, 72-year-old female
with cough and low-grade temp.
372
00:21:00,392 --> 00:21:03,896
Sats fine. No shortness of breath,
right middle lobe infiltrate on the film.
373
00:21:04,063 --> 00:21:07,191
She was your patient last week
so perhaps for continuity of care...
374
00:21:07,358 --> 00:21:09,860
- In with the same thing?
- No. Had facial contusions.
375
00:21:10,027 --> 00:21:12,864
- Her sister was with her?
- Oh, yeah. She's here this time too.
376
00:21:13,031 --> 00:21:16,243
She's got family support. Treat her
like an outpatient, send her home.
377
00:21:16,410 --> 00:21:19,329
- They're panhandlers. Both.
- Everybody's gotta make a living.
378
00:21:19,705 --> 00:21:20,956
What is wrong with you?
379
00:21:22,207 --> 00:21:25,336
- She won't get better on the streets.
- Call Social Services...
380
00:21:25,503 --> 00:21:30,049
- ...hook her up with elder assistance.
- They did express interest in leaving soon.
381
00:21:30,425 --> 00:21:32,802
Call Social Services.
382
00:21:33,469 --> 00:21:36,807
Okay, about Mr. Rubadoux.
Nobody is painting him a clear picture.
383
00:21:36,974 --> 00:21:38,350
Surgery is a lousy choice.
384
00:21:38,517 --> 00:21:40,769
- His choice.
- He does not have an objective view.
385
00:21:40,936 --> 00:21:44,523
Seventeen-year-old, avulsed finger.
Sign so we can treat without the parents.
386
00:21:44,690 --> 00:21:47,027
- How'd he do it?
- Slammed his hand in the car door.
387
00:21:47,235 --> 00:21:49,571
- Somebody needs to talk to him.
- You're his doctor.
388
00:21:49,738 --> 00:21:51,489
You're the Attending.
He's old school.
389
00:21:51,656 --> 00:21:53,366
He needs to hear it from a guy.
390
00:21:53,533 --> 00:21:56,494
It's that time. Girl Scout cookies.
I'm feeling the pressure.
391
00:21:56,661 --> 00:21:58,622
- Okay.
- We'll find you later, all right?
392
00:21:58,789 --> 00:22:00,207
- Just...
- Okay.
393
00:22:00,374 --> 00:22:02,752
What is going on with you?
Why keep blowing this off?
394
00:22:02,918 --> 00:22:05,087
- I'm not.
- You tried to stop our conversation...
395
00:22:05,254 --> 00:22:06,756
...to buy Girl Scout cookies.
396
00:22:07,548 --> 00:22:09,926
- Talk to this guy.
- I'm not the one to do it.
397
00:22:10,093 --> 00:22:14,723
Okay. I don't know exactly what went
on between you and him, but right now-
398
00:22:14,890 --> 00:22:17,517
Look. Once in a while
you're gonna find these old guys...
399
00:22:17,684 --> 00:22:20,938
...that would rather be treated by
a gray-haired guy with a white coat.
400
00:22:21,105 --> 00:22:25,276
- Figure out a way of getting to him.
- Been trying for an hour. He's a wall.
401
00:22:25,443 --> 00:22:26,986
Well, then you did your job.
402
00:22:27,153 --> 00:22:29,071
Move on.
403
00:22:34,203 --> 00:22:36,371
Dr. Lewis?
404
00:22:36,538 --> 00:22:39,249
- Dr. Lewis?
- Yes, Jerry.
405
00:22:39,416 --> 00:22:41,503
Are you sleeping?
406
00:22:42,712 --> 00:22:45,965
Probably not, huh?
The Chief Residency meeting is starting.
407
00:22:46,424 --> 00:22:49,052
Thank you, Jerry.
408
00:22:49,219 --> 00:22:51,888
Are you really up?
Because I have to leave now.
409
00:22:52,055 --> 00:22:54,934
Yes, Jerry.
410
00:23:09,950 --> 00:23:11,785
Eighteen hundred
Solu-Medrol going in.
411
00:23:11,952 --> 00:23:14,621
- What do you got?
- Keep your eyes closed, Dirk.
412
00:23:14,788 --> 00:23:17,959
Traumatic C-spine injury.
I didn't wanna just yank the helmet off.
413
00:23:18,125 --> 00:23:19,335
Pretty cool, huh?
414
00:23:19,502 --> 00:23:21,796
Dude, one move,
they'll slice through your head.
415
00:23:21,963 --> 00:23:23,839
Shut up, man. This is gnarly.
416
00:23:24,006 --> 00:23:26,802
Compared to the Gravity Games,
this is nothing, man.
417
00:23:26,969 --> 00:23:28,804
Except for a little cord compression.
418
00:23:30,639 --> 00:23:31,974
Anybody seen Carter?
419
00:23:32,140 --> 00:23:35,143
He's probably at the meeting
where Luka and I are supposed to be.
420
00:23:35,310 --> 00:23:38,439
Anspaugh wants a central line
on our aortic-stenosis patient.
421
00:23:38,606 --> 00:23:40,817
- Pratt, go help Abby. I'll finish that.
- Okay.
422
00:23:40,984 --> 00:23:43,820
Sterile 9s and prep for a cordis.
423
00:23:47,907 --> 00:23:50,202
- Nice suit, Morris.
- Thank you.
424
00:23:50,369 --> 00:23:54,164
It's important for the Chief Resident
to project a certain professionalism.
425
00:23:54,331 --> 00:23:58,502
And I must say, life in the ER doesn't
offer enough opportunity to dress up.
426
00:23:59,796 --> 00:24:02,340
- Sorry I'm late.
- You haven't missed anything.
427
00:24:02,507 --> 00:24:05,176
Dr. Lewis, if you don't mind.
428
00:24:06,761 --> 00:24:07,846
The lights, please.
429
00:24:13,561 --> 00:24:15,004
"CHIEF RESIDENT"
430
00:24:15,071 --> 00:24:19,191
The Chief Resident in a busy,
urban ER must wear many hats:
431
00:24:19,775 --> 00:24:23,165
Teacher, mentor, counselor, friend.
432
00:24:23,200 --> 00:24:24,656
SCHEDULING TASK MASTER
433
00:24:25,532 --> 00:24:27,534
- Over the course of the next hour...
- Hour?
434
00:24:27,701 --> 00:24:31,413
...I will review my proposed strategy
for making the Residents' schedule...
435
00:24:31,580 --> 00:24:36,002
...and address how the new ACGME/RRC
work-hour mandates apply.
436
00:24:36,169 --> 00:24:39,964
I will also identify common stumbling
blocks that may affect the schedule...
437
00:24:40,131 --> 00:24:45,262
...and present my patented win-win
approach to problems and changes.
438
00:24:45,429 --> 00:24:46,680
Next slide.
439
00:24:47,181 --> 00:24:48,349
You can't just leave.
440
00:24:48,515 --> 00:24:50,976
Oh, yes, at our age we can.
441
00:24:51,143 --> 00:24:55,273
I'm sorry Social Services is backed up but
we need them to see you before you go.
442
00:24:55,440 --> 00:24:58,276
We saw them the last time
we were here. Lovely woman.
443
00:24:58,443 --> 00:25:00,695
- Oh, a regular young-
- No, no. God, no, please.
444
00:25:00,862 --> 00:25:03,907
- Please, just-
- Dr. Barnett, we are grateful.
445
00:25:04,074 --> 00:25:06,076
And we're gonna do the best we can.
446
00:25:06,242 --> 00:25:08,913
But it's important that we leave now.
447
00:25:09,080 --> 00:25:11,874
We cannot miss the rush hour at the El.
448
00:25:12,041 --> 00:25:15,920
And if it gets you in any kind of trouble,
I'm so sorry.
449
00:25:16,087 --> 00:25:18,381
- We could write you a note.
- A note?
450
00:25:18,548 --> 00:25:19,925
It's not gonna be good enough.
451
00:25:20,092 --> 00:25:21,885
You see...
452
00:25:22,052 --> 00:25:25,263
...last week, two of my other patients,
they left on me.
453
00:25:25,430 --> 00:25:27,641
And my boss is really unhappy with me.
454
00:25:28,935 --> 00:25:31,604
He says if this happens again,
they're gonna send me to-
455
00:25:31,938 --> 00:25:34,774
- Away?
- Well, to...
456
00:25:34,941 --> 00:25:36,734
...the morgue.
457
00:25:37,485 --> 00:25:39,905
- The morgue?
- Yeah.
458
00:25:40,072 --> 00:25:41,698
It's a...
459
00:25:41,865 --> 00:25:43,408
...big demotion.
460
00:25:46,495 --> 00:25:47,913
- He's clever.
- Oh, yeah.
461
00:25:48,497 --> 00:25:50,290
You gotta give him that.
462
00:25:51,501 --> 00:25:54,546
Page me from MRl.
I wanna see the scan.
463
00:26:04,598 --> 00:26:08,310
- Sam, what's going on?
- Nothing. I'm cleaning up and restocking.
464
00:26:08,477 --> 00:26:11,146
- Is this about the luge boy?
- You were encouraging him.
465
00:26:11,313 --> 00:26:13,817
- I wasn't.
- Pratt and Ray, that I can understand.
466
00:26:13,984 --> 00:26:16,820
Sam, I wasn't.
And you're overreacting.
467
00:26:26,539 --> 00:26:27,790
A little bit?
468
00:26:30,459 --> 00:26:32,920
I'm just having a bad day.
I have a headache.
469
00:26:33,087 --> 00:26:35,382
Just- Hey, just tell them
you wanna leave early.
470
00:26:35,549 --> 00:26:36,842
- I'm fine.
- No, really.
471
00:26:37,009 --> 00:26:40,637
Tell them you wanna go home. If there
are any complaints, they can talk to me.
472
00:26:40,804 --> 00:26:42,723
Okay.
473
00:26:47,437 --> 00:26:50,815
- You're okay.
- I'm okay.
474
00:26:57,196 --> 00:26:59,700
Okay, aim your needle inferiorly.
475
00:26:59,867 --> 00:27:02,995
And watch the screen
as you enter the vein.
476
00:27:03,162 --> 00:27:04,872
How are we doing, Mr. Rubadoux?
477
00:27:05,039 --> 00:27:07,207
I don't know. You tell me.
478
00:27:08,042 --> 00:27:11,046
- Doing just great.
- Got a flash.
479
00:27:12,088 --> 00:27:13,340
Guidewire.
480
00:27:18,345 --> 00:27:22,350
- What is that? What's going on?
- It's okay, Mr. Rubadoux.
481
00:27:22,516 --> 00:27:23,893
- Throwing PVCs.
- Pull back.
482
00:27:27,730 --> 00:27:28,939
- Run of V-tach.
- Pull back.
483
00:27:29,106 --> 00:27:31,193
Yeah, I am.
I'm nowhere near the myocardium.
484
00:27:31,360 --> 00:27:32,736
I don't feel right.
485
00:27:33,236 --> 00:27:35,322
- V-tach again.
- All right, I'm coming out.
486
00:27:36,156 --> 00:27:38,033
- What's happening?
- Hang in there.
487
00:27:38,200 --> 00:27:40,911
- A hundred of lido.
- Mr. Rubadoux?
488
00:27:41,286 --> 00:27:45,249
Mr. Rubadoux? All right, let's get him into
a trauma room now. Come on, let's go.
489
00:27:45,416 --> 00:27:48,628
With the Morris-modified
circadian scheduling system...
490
00:27:48,795 --> 00:27:51,297
...we can build needed
flexibility into the program.
491
00:27:51,464 --> 00:27:53,842
A sample sequence might go like this:
492
00:27:54,176 --> 00:27:58,680
Three days, two off, three evenings,
two off, three nights, two off-
493
00:27:59,932 --> 00:28:02,393
- 911. It's the ER.
- Liar.
494
00:28:02,559 --> 00:28:05,480
- Morris, I apologize.
- I'll put a hard copy in your box.
495
00:28:05,647 --> 00:28:08,066
- That would be great.
- Get on with it, Dr. Morris.
496
00:28:08,733 --> 00:28:12,529
Three nights, two off,
and repeat until the end of the block.
497
00:28:12,695 --> 00:28:14,114
Next slide.
498
00:28:14,614 --> 00:28:16,492
Good news. Social Services is-
499
00:28:16,659 --> 00:28:18,035
- Hello.
- Hi.
500
00:28:18,202 --> 00:28:20,913
This is our niece, Shelley.
501
00:28:21,080 --> 00:28:24,625
I just found out they were here.
Thank you for taking care of them.
502
00:28:24,792 --> 00:28:28,338
- We wanted to leave, didn't we, doctor?
- Yes, we did try, right?
503
00:28:28,505 --> 00:28:31,007
- You made- You made us stay.
- Yes, I did.
504
00:28:31,174 --> 00:28:33,343
So now Shelley's here,
we can go with her.
505
00:28:33,510 --> 00:28:36,096
- No, no, no. You have to wait-
- Could we talk?
506
00:28:38,432 --> 00:28:40,643
Oh, yes. Go ahead. That's fine.
507
00:28:41,144 --> 00:28:43,146
Okay.
508
00:28:47,316 --> 00:28:50,696
Listen, we're waiting on Social Services
to come down here.
509
00:28:50,863 --> 00:28:53,824
Yes. And they're wonderful.
They've been so helpful.
510
00:28:53,991 --> 00:28:56,660
But, you know, it's been a long day
and they're both...
511
00:28:56,827 --> 00:28:59,830
- They're really getting tired.
- It shouldn't be too much longer.
512
00:29:03,334 --> 00:29:06,171
They're both so stubborn...
513
00:29:07,005 --> 00:29:08,756
...those two. I-
514
00:29:08,923 --> 00:29:12,178
I've been trying to get them
to move in with me.
515
00:29:12,344 --> 00:29:15,347
You know, they just-
They want their independence.
516
00:29:15,514 --> 00:29:18,183
So they can panhandle.
Isn't that unbelievable?
517
00:29:18,350 --> 00:29:19,602
Yeah.
518
00:29:19,768 --> 00:29:22,647
I told them that I could
get them right home, into a hot bath.
519
00:29:22,814 --> 00:29:24,900
Our oldest moved in with her boyfriend.
520
00:29:25,066 --> 00:29:26,735
We've got the extra bedroom now.
521
00:29:27,527 --> 00:29:30,488
I just- I've tried everything.
I don't know what else to do.
522
00:29:30,655 --> 00:29:33,450
I don't know how to make them
accept some family support.
523
00:29:33,618 --> 00:29:35,786
Okay, let me talk to them, all right?
524
00:29:36,621 --> 00:29:38,289
Okay.
525
00:29:38,748 --> 00:29:40,291
Birdy? Rebecca?
526
00:29:41,626 --> 00:29:44,922
- Still V-tach.
- All right, another epi. Chase it with lido.
527
00:29:45,088 --> 00:29:47,716
All right, switch out.
Set up to intubate.
528
00:29:48,926 --> 00:29:50,802
- What happened?
- A central line.
529
00:29:50,969 --> 00:29:53,388
It was fine until he started having
runs of V-tach.
530
00:29:53,555 --> 00:29:57,393
- Must have an irritable myocardium.
- Three-sixty. Clear.
531
00:29:59,062 --> 00:30:00,855
No change.
532
00:30:01,022 --> 00:30:03,399
- Why is Anspaugh opening this guy up?
- Critical AS.
533
00:30:03,900 --> 00:30:05,234
- Epi's in.
- Move that.
534
00:30:05,401 --> 00:30:08,614
Man can't tolerate a central line,
he isn't gonna do well in the O.R.
535
00:30:08,781 --> 00:30:10,240
- He wants the surgery.
- So what?
536
00:30:10,407 --> 00:30:13,994
- So we're giving it to him.
- Those guys got nothing better to do?
537
00:30:14,453 --> 00:30:15,913
Damn it.
I think I broke his rib.
538
00:30:18,750 --> 00:30:20,752
All right, clear.
539
00:30:24,172 --> 00:30:27,092
- Normal sinus.
- That's what I'm talking about.
540
00:30:55,623 --> 00:30:58,292
The Chief Resident position
is 90 percent administrative.
541
00:30:58,459 --> 00:30:59,710
Morris can handle that.
542
00:30:59,877 --> 00:31:02,130
Yeah. But even the med students
think he's a joke.
543
00:31:02,296 --> 00:31:05,968
- We should get someone from the outside.
- It's very difficult on the staff.
544
00:31:06,135 --> 00:31:08,303
You came from the outside.
545
00:31:08,804 --> 00:31:12,182
- How did the Morris meeting go?
- You missed a fascinating lecture...
546
00:31:12,349 --> 00:31:14,269
...on circadian scheduling.
547
00:31:14,436 --> 00:31:17,147
- We're not giving it to him though, right?
- Considering it.
548
00:31:17,313 --> 00:31:19,399
- You out of your mind?
- If you don't show up-
549
00:31:19,566 --> 00:31:22,152
I was in a trauma.
What did Carter say? We should vote.
550
00:31:22,318 --> 00:31:25,656
- You can't. You weren't there.
- I don't care. On 36 hours. I have to go.
551
00:31:25,823 --> 00:31:27,783
- And I'm late.
- John.
552
00:31:27,950 --> 00:31:30,411
- What happened on the meeting?
- I don't know. I left.
553
00:31:30,578 --> 00:31:34,623
- Kerry's leaning towards him.
- Yeah. Well, okay.
554
00:31:34,790 --> 00:31:36,209
"Well, okay"?
555
00:31:36,376 --> 00:31:37,669
We've had worse.
556
00:31:37,836 --> 00:31:40,297
- Don't think so.
- Then maybe she won't give it to him.
557
00:31:40,464 --> 00:31:43,925
Hey, Frank, can you come and find me
when the labs are back on Gase in 2?
558
00:31:44,092 --> 00:31:49,432
Yeah. Got it. You were gonna take
that haggard mom, five kids, Exam 3.
559
00:31:53,436 --> 00:31:57,982
Rubadoux's back, complaining about
his tube and telling the nurses no Jell-O.
560
00:31:58,149 --> 00:31:59,526
Good.
561
00:31:59,693 --> 00:32:04,072
I told Kayson and Anspaugh about the
ribs and the resultant pneumothorax.
562
00:32:04,239 --> 00:32:06,533
- What about the surgery?
- Not right away.
563
00:32:06,700 --> 00:32:10,872
They're going to stabilize him in CICU
for a few days, let the pneumo resolve.
564
00:32:11,039 --> 00:32:12,874
But everyone remains hopeful.
565
00:32:13,041 --> 00:32:15,168
We're just waiting on a bed.
566
00:32:19,797 --> 00:32:21,842
DON'T SHOOT.
I WANT TO GROW UP.
567
00:32:27,723 --> 00:32:30,601
- Can I help you?
- How you doing? Looking for Olivia Evans.
568
00:32:30,768 --> 00:32:32,896
- I'm supposed to meet her.
- She's in the back.
569
00:32:33,730 --> 00:32:36,191
- Follow me.
- Okay.
570
00:32:41,112 --> 00:32:45,910
Three grandmothers reclaimed 78th
and Hermitage by opening a bakery.
571
00:32:46,077 --> 00:32:49,413
Turned one of the roughest corners
in our city into a coffee klatch.
572
00:32:52,500 --> 00:32:55,170
Dr. Pratt, just in time.
Everyone, this is Greg Pratt.
573
00:32:55,337 --> 00:32:57,130
He's an ER doc at County.
574
00:32:57,297 --> 00:32:59,633
- Hello.
- How y'all doing?
575
00:32:59,800 --> 00:33:02,386
Dr. Pratt gets to see
how senseless shootings...
576
00:33:02,552 --> 00:33:04,471
...are overwhelming our city's hospitals.
577
00:33:04,638 --> 00:33:09,227
And we were just talking about various
job opportunities in the neighborhood.
578
00:33:09,394 --> 00:33:13,815
So maybe you'd like to say something
about jobs in health care?
579
00:33:25,369 --> 00:33:28,373
- Felix, get back here.
- This is for Tasha's ear infection.
580
00:33:28,540 --> 00:33:31,084
- Twice a day for a week.
- Holly's the one with the ear.
581
00:33:31,251 --> 00:33:33,128
Right. Tasha has the eczema.
582
00:33:33,294 --> 00:33:36,506
Apply to the affected area
three times a day for a week.
583
00:33:36,673 --> 00:33:38,801
- Just like the ears.
- No.
584
00:33:38,968 --> 00:33:41,470
Ears twice a day. Rash, three.
585
00:33:41,637 --> 00:33:43,764
Found him. He was running off
with your hammer.
586
00:33:43,931 --> 00:33:45,850
Thanks, Chuny.
587
00:33:46,308 --> 00:33:48,185
Just a minute.
588
00:33:51,189 --> 00:33:54,067
- I'm gonna go. Good night.
- I could use a little help here.
589
00:33:54,526 --> 00:33:59,030
One, two, three, four, five. I'm off.
590
00:33:59,698 --> 00:34:01,868
I'll be home by 8.
You wanna grab a dinner?
591
00:34:02,034 --> 00:34:03,995
I'm kind of beat.
Maybe stay in tonight.
592
00:34:04,370 --> 00:34:06,998
Okay. See you later.
593
00:34:14,131 --> 00:34:15,841
Good night.
594
00:34:24,476 --> 00:34:26,019
- Coffee?
- Yeah.
595
00:34:26,186 --> 00:34:27,437
Sorry to hear it.
596
00:34:28,521 --> 00:34:30,690
- Really awful this time of night.
- Oh, I know.
597
00:34:37,031 --> 00:34:38,491
"EMERGENCY"
598
00:34:42,828 --> 00:34:47,542
When I was a student on my surgical
rotation, Rubadoux's wife was very sick.
599
00:34:49,127 --> 00:34:51,463
She was part of this research study.
600
00:34:52,881 --> 00:34:55,509
When her results-
601
00:34:56,009 --> 00:34:58,679
When she wasn't useful,
there was pressure to get her out.
602
00:34:58,846 --> 00:35:01,015
So I did. I dumped her
into a nursing home.
603
00:35:02,350 --> 00:35:03,601
Did she belong in one?
604
00:35:05,770 --> 00:35:09,024
We all figured
she'd end up back in the hospital.
605
00:35:09,399 --> 00:35:11,902
But she'd be on the Medical Service
and not ours.
606
00:35:12,569 --> 00:35:13,820
So...
607
00:35:14,404 --> 00:35:16,490
...Surgery dumps
another patient on Medicine.
608
00:35:17,532 --> 00:35:18,742
Happens every day.
609
00:35:22,247 --> 00:35:25,250
I told Rubadoux
that she was gonna get better.
610
00:35:29,420 --> 00:35:32,591
I told him that her situation
was gonna improve.
611
00:35:32,758 --> 00:35:34,635
I told him what he wanted to hear.
612
00:35:37,596 --> 00:35:39,807
You know, when you're a student...
613
00:35:40,933 --> 00:35:42,978
...you're so desperate for approval.
614
00:35:43,144 --> 00:35:45,814
You want patients to like you,
their families to like you.
615
00:35:46,898 --> 00:35:51,319
You gotta be efficient too, though.
You gotta impress your superiors.
616
00:35:52,697 --> 00:35:55,950
You don't have to tell me. I'm still
on the bottom rung of the ladder.
617
00:35:56,117 --> 00:35:58,828
When the Chief of Surgery says,
"Get rid of her," you do.
618
00:35:58,995 --> 00:36:00,830
Yeah.
619
00:36:04,584 --> 00:36:07,004
And then she came back
about three days later...
620
00:36:07,170 --> 00:36:09,339
...and she died...
621
00:36:11,174 --> 00:36:13,176
...and Rubadoux was so surprised.
622
00:36:19,726 --> 00:36:22,103
Ultimately, it was the Attending's call.
623
00:36:22,270 --> 00:36:24,814
Wasn't my responsibility.
624
00:36:26,442 --> 00:36:28,610
You wanna help with this?
625
00:36:33,824 --> 00:36:36,535
- All right.
- Take it easy, man. You too, man. Right.
626
00:36:36,702 --> 00:36:38,955
One of my guys
has a real thing for science.
627
00:36:39,122 --> 00:36:41,541
I could bring him to County,
have you show him around.
628
00:36:41,708 --> 00:36:42,751
Sure.
629
00:36:42,917 --> 00:36:44,544
Never been out of the neighborhood.
630
00:36:44,711 --> 00:36:46,588
- Don't realize there's a city.
- I know.
631
00:36:46,755 --> 00:36:48,507
I was 10 before I saw Lake Michigan.
632
00:36:48,674 --> 00:36:50,468
You from Chicago?
633
00:36:50,634 --> 00:36:52,094
Any relation to Charlie Pratt?
634
00:36:52,845 --> 00:36:55,681
Charlie Pratt who works
for Parks and Recs over on Lamont?
635
00:36:55,848 --> 00:36:58,434
- Yeah. The older fellow.
- I don't know him.
636
00:36:58,601 --> 00:37:00,812
Hey, that was
a really nice meeting tonight.
637
00:37:01,021 --> 00:37:02,898
- I gotta run.
- Okay.
638
00:37:03,064 --> 00:37:04,691
- It's nice meeting you.
- You too.
639
00:37:05,692 --> 00:37:07,527
You're still speaking to me.
640
00:37:07,694 --> 00:37:09,529
- Yeah, I think so.
- I'm not sorry.
641
00:37:09,696 --> 00:37:12,408
I want you to see what we do.
You'd never come on your own.
642
00:37:12,575 --> 00:37:15,369
And I'm not apologizing
about the tuna casserole.
643
00:37:15,536 --> 00:37:19,791
But since you're being such a good
sport, I'm willing to buy dessert.
644
00:37:19,957 --> 00:37:23,378
So ice cream or key-lime pie?
645
00:37:23,754 --> 00:37:26,340
- I'm sorry. What?
- Dessert?
646
00:37:27,883 --> 00:37:29,426
Past your bedtime?
647
00:37:29,593 --> 00:37:34,390
No, no. It's just that I have this patient
I have to check back on in the ER.
648
00:37:34,557 --> 00:37:38,394
Well, then, I guess-
I guess you'd better be going.
649
00:37:39,145 --> 00:37:41,064
I'll call you.
650
00:37:54,078 --> 00:37:55,121
"PREGNANCY TEST"
651
00:37:55,288 --> 00:37:56,540
Fifteen ninety-five.
652
00:38:14,892 --> 00:38:17,187
Where you going, Ray?
653
00:38:17,896 --> 00:38:21,525
Look, I know I'm on for another half-hour,
but I have taken care of everything.
654
00:38:21,692 --> 00:38:24,236
Filled in Abby on all my cases.
655
00:38:24,861 --> 00:38:27,364
Is Abby your Attending?
656
00:38:28,408 --> 00:38:29,784
Right.
657
00:38:29,951 --> 00:38:32,161
Ulnar fracture
up getting casted in Ortho.
658
00:38:32,328 --> 00:38:34,580
Malignant otitis admitted to ENT.
659
00:38:34,747 --> 00:38:37,667
Tongue lac wants a vasectomy,
you know, as long as he's here.
660
00:38:37,834 --> 00:38:39,545
Gonna follow that up with Urology.
661
00:38:39,712 --> 00:38:43,299
Oh, and the Olsen twins. They decided
to leave with their niece and a Z-PAK.
662
00:38:43,465 --> 00:38:45,718
Follow-up in a week.
663
00:38:45,884 --> 00:38:47,511
What did Social Services say?
664
00:38:48,971 --> 00:38:52,058
They actually didn't make it down.
I mean, in time.
665
00:38:53,643 --> 00:38:54,978
But you released them anyway?
666
00:38:55,895 --> 00:38:58,231
I felt they had a strong
family support system.
667
00:38:58,398 --> 00:39:00,400
These are the panhandlers, right?
668
00:39:01,484 --> 00:39:04,113
You felt comfortable releasing them
to a family member...
669
00:39:04,280 --> 00:39:06,407
...who obviously hasn't been
much help so far.
670
00:39:06,574 --> 00:39:09,994
Their niece, yes. She admitted it's been
hard getting them to accept help.
671
00:39:10,161 --> 00:39:13,540
- They are moving in with her now.
- Is Social Services going to follow up?
672
00:39:13,707 --> 00:39:17,461
I mean, seeing as how you prevented
them from doing their job today.
673
00:39:19,880 --> 00:39:21,798
I will make those arrangements.
674
00:39:21,965 --> 00:39:23,508
I need to know everything.
675
00:39:23,675 --> 00:39:25,720
I need to know the status of every one:
676
00:39:25,887 --> 00:39:29,724
How they are, where they are, where
they're going, why they're going...
677
00:39:29,891 --> 00:39:31,601
You're still an intern, Ray.
678
00:39:31,768 --> 00:39:33,227
I'm the Attending.
679
00:39:33,394 --> 00:39:35,522
I'm responsible.
680
00:39:42,321 --> 00:39:43,864
I'm sorry.
681
00:39:46,701 --> 00:39:49,579
- Hernia guy's HMO is refusing to cover.
- He's not stable.
682
00:39:49,746 --> 00:39:51,790
- I'm not discharging.
- You wanna tell them?
683
00:39:51,956 --> 00:39:53,750
- I'll call.
- Sedation for Mr. Garrity.
684
00:39:53,917 --> 00:39:56,795
- Kovac was there. He can sign them.
- Okay.
685
00:39:56,961 --> 00:39:59,048
Won't believe this.
Your tibial fracture's...
686
00:39:59,215 --> 00:40:02,051
- ...requesting an organic cast.
- I'll be right there.
687
00:40:09,351 --> 00:40:10,727
Mr. Rubadoux?
688
00:40:13,230 --> 00:40:15,232
I'm not feeling well.
689
00:40:15,398 --> 00:40:16,775
So if you don't mind.
690
00:40:20,863 --> 00:40:22,782
I just wanted to...
691
00:40:22,949 --> 00:40:24,826
...say that I'm sorry.
692
00:40:26,953 --> 00:40:29,121
I couldn't believe it when I saw you.
693
00:40:30,331 --> 00:40:32,626
You're still here.
694
00:40:33,752 --> 00:40:36,296
Been 10 years since my...
695
00:40:36,463 --> 00:40:40,092
My Silvie's gone
and you're still here.
696
00:40:41,385 --> 00:40:42,595
Yeah.
697
00:40:44,097 --> 00:40:45,932
And you didn't even remember.
698
00:40:47,767 --> 00:40:49,018
Oh, well.
699
00:40:51,479 --> 00:40:54,733
They gave me six other doctors...
700
00:40:55,442 --> 00:40:57,111
...so I won't need you this time.
701
00:41:03,450 --> 00:41:06,246
I made a mistake with your wife.
702
00:41:07,789 --> 00:41:09,624
And I made a mistake with you.
703
00:41:09,791 --> 00:41:11,459
You don't think I know that?
704
00:41:13,628 --> 00:41:17,300
You don't think I regret
ever bringing my poor Silvie...
705
00:41:17,466 --> 00:41:20,219
...down to this damn place?
706
00:41:20,636 --> 00:41:22,513
You and your fancy tests.
707
00:41:22,680 --> 00:41:26,977
"We'll put her through this.
We'll put her through that."
708
00:41:27,144 --> 00:41:32,858
"Oh, Sylvie? Oh, she'll practically
be back on-stage dancing again."
709
00:41:33,025 --> 00:41:35,652
- Well, we did try.
- You tried?
710
00:41:35,819 --> 00:41:37,572
You tried?
711
00:41:38,615 --> 00:41:42,118
It became a very complicated situation.
712
00:41:44,329 --> 00:41:47,248
And I didn't have the experience
to handle it properly.
713
00:41:47,415 --> 00:41:50,878
All you had to be was a human being.
714
00:41:52,254 --> 00:41:54,465
You lied to me.
715
00:41:54,631 --> 00:41:56,592
And I believed you.
716
00:42:03,266 --> 00:42:06,019
My Silvie. My Silvie.
717
00:42:06,186 --> 00:42:09,397
She was really something.
718
00:42:21,243 --> 00:42:23,413
Mr. Rubadoux...
719
00:42:24,748 --> 00:42:27,167
...what you have wrong with you,
aortic stenosis...
720
00:42:27,334 --> 00:42:29,711
...can oftentimes
be corrected with surgery.
721
00:42:29,878 --> 00:42:33,674
But that doesn't mean that that's
the right thing for you to do.
722
00:42:35,176 --> 00:42:36,928
You're 85 years old.
723
00:42:37,095 --> 00:42:39,847
You have chronic respiratory problems.
724
00:42:40,014 --> 00:42:42,100
The chances of you
coming through surgery...
725
00:42:42,266 --> 00:42:45,145
...and getting back to the shape
that you're in right now:
726
00:42:45,312 --> 00:42:46,772
Pretty slim.
727
00:42:47,689 --> 00:42:49,983
If you go ahead with it,
there is a good chance...
728
00:42:50,150 --> 00:42:52,861
...that you will never leave
this hospital again.
729
00:42:53,028 --> 00:42:55,322
You'll be connected to a ventilator...
730
00:42:55,490 --> 00:42:59,577
...and you will live out the remainder
of your life in the Intensive Care Unit.
731
00:43:01,913 --> 00:43:05,834
Now, without the surgery, it's true,
you're not gonna get any better.
732
00:43:07,419 --> 00:43:13,008
But I believe that you will leave
this hospital under your own power.
733
00:43:13,175 --> 00:43:16,637
And you will have more time
with the people that you love.
734
00:43:18,140 --> 00:43:20,600
You will have more time...
735
00:43:21,768 --> 00:43:24,604
...being the person that you are today.
736
00:43:34,240 --> 00:43:36,242
And, yes...
737
00:43:36,450 --> 00:43:39,495
...10 years ago
I lied to you about your wife.
738
00:43:45,544 --> 00:43:48,630
But I am not lying to you right now.
739
00:44:04,120 --> 00:44:07,128
Ripped by subXpacio y TusSeries
740
00:44:32,803 --> 00:44:34,889
Subtitles by SDI Media Group
741
00:44:35,056 --> 00:44:37,142
[ENGLISH]
61768
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