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Would you like to inspect the original subtitles? These are the user uploaded subtitles that are being translated: 1 00:00:02,945 --> 00:00:04,901 E. R. 2 00:00:05,102 --> 00:00:06,332 Previously on E. R. 3 00:00:06,433 --> 00:00:09,415 - 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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