Would you like to inspect the original subtitles? These are the user uploaded subtitles that are being translated:
1
00:00:07,173 --> 00:00:08,508
Oh, what do you think you're doing?
2
00:00:08,550 --> 00:00:10,468
Sorry, I didn't' feel like
we had another choice.
3
00:00:10,510 --> 00:00:12,679
Dr. Ahmad, your residency here
4
00:00:12,721 --> 00:00:15,348
will be on a probationary basis.
5
00:00:15,390 --> 00:00:16,808
What the hell's going on?
6
00:00:16,850 --> 00:00:19,102
Walking off the floor without
notifying a supervisor?
7
00:00:19,144 --> 00:00:21,187
There's not gonna be another warning.
8
00:00:21,229 --> 00:00:23,273
Ben is the one who pulled
the plug on this marriage.
9
00:00:23,314 --> 00:00:24,482
Come on, Maggie.
10
00:00:24,524 --> 00:00:25,900
We're almost at the finish line.
11
00:00:25,942 --> 00:00:27,986
I really just wanna move on.
12
00:00:28,028 --> 00:00:29,237
Get me out of here!
13
00:00:29,279 --> 00:00:30,363
- Get away from me!
- Dr. Ripley,
14
00:00:30,405 --> 00:00:31,948
What you did today was reckless.
15
00:00:31,990 --> 00:00:33,033
Reckless?
16
00:00:33,074 --> 00:00:34,409
Impulse control disorder?
17
00:00:34,451 --> 00:00:35,785
Isn't that what you called it back then?
18
00:00:35,827 --> 00:00:38,329
I'm an attending physician
at this hospital,
19
00:00:38,371 --> 00:00:43,293
not the boy you knew 20 years ago.
20
00:00:50,842 --> 00:00:53,345
Yo, Asher! What are you doing here?
21
00:00:53,386 --> 00:00:54,804
Mitch, what are... hey.
22
00:00:54,846 --> 00:00:55,889
What are you drinking?
23
00:00:55,930 --> 00:00:57,432
Um... I'm... I'm not.
24
00:00:57,474 --> 00:00:59,100
- It's club soda.
- You don't drink?
25
00:00:59,142 --> 00:01:00,393
I do not.
26
00:01:00,435 --> 00:01:02,896
I'm a recovering addict.
27
00:01:02,937 --> 00:01:06,191
Which... I will tell you
all about that another time.
28
00:01:06,232 --> 00:01:09,819
But right now, you have to go away.
29
00:01:09,861 --> 00:01:13,156
You do realize this is
a public establishment, right?
30
00:01:13,198 --> 00:01:15,867
I'm... I am waiting on a date.
31
00:01:15,909 --> 00:01:18,078
First date.
32
00:01:18,119 --> 00:01:20,663
And he's going to be here
any minute, so...
33
00:01:20,705 --> 00:01:22,165
What? No.
34
00:01:22,207 --> 00:01:23,500
No, you...
35
00:01:23,541 --> 00:01:25,210
I got my eyes glued to the door.
36
00:01:25,251 --> 00:01:27,420
I will split the second he gets here.
37
00:01:29,631 --> 00:01:31,383
Fine.
38
00:01:31,424 --> 00:01:34,094
So who's the guy? How'd you meet?
39
00:01:34,135 --> 00:01:35,637
His name is Kyle.
40
00:01:35,679 --> 00:01:40,183
And he's an architect,
and we met on a dating app.
41
00:01:40,225 --> 00:01:42,477
Commercial architecture? Residential?
42
00:01:42,519 --> 00:01:43,812
What's the name of his firm?
43
00:01:43,853 --> 00:01:45,772
OK, what are you doing here, hm?
44
00:01:45,814 --> 00:01:49,442
You don't seem like the type to
venture out on a school night.
45
00:01:49,484 --> 00:01:51,277
Is that your polite way
of calling me a loser?
46
00:01:51,319 --> 00:01:52,821
No.
47
00:01:52,862 --> 00:01:57,784
You're always working late,
running at some ungodly hours.
48
00:01:57,826 --> 00:02:01,287
Those degenerates, they dragged me out.
49
00:02:03,331 --> 00:02:05,709
I've known most of them
since grade school.
50
00:02:05,750 --> 00:02:07,877
I didn't know you were a Chicago boy.
51
00:02:07,919 --> 00:02:09,587
Born and raised.
52
00:02:09,629 --> 00:02:13,008
Just been away a lot of years.
53
00:02:13,049 --> 00:02:14,634
It must be nice being home.
54
00:02:19,097 --> 00:02:22,225
I think Romeo has landed.
55
00:02:28,940 --> 00:02:31,317
Whoa, that was...
56
00:02:31,359 --> 00:02:33,153
Nice break, bro.
57
00:02:39,034 --> 00:02:40,702
Somebody call 911!
58
00:02:40,744 --> 00:02:43,663
I need help!
My girlfriend just passed out!
59
00:02:45,040 --> 00:02:46,499
We're doctors!
60
00:02:46,541 --> 00:02:48,168
You got to help her. Please.
61
00:02:48,209 --> 00:02:51,338
Somebody's calling 911.
Paramedics should be on the way soon.
62
00:02:51,379 --> 00:02:52,672
Her breathing's slow and shallow.
63
00:02:52,714 --> 00:02:54,299
Eyes are pinpoint. What's her name?
64
00:02:54,341 --> 00:02:55,842
- Uh, Becca.
- Becca?
65
00:02:55,884 --> 00:02:58,261
- Hey, wake up, Becca!
- Did she take something?
66
00:02:58,303 --> 00:03:00,347
We need to know so we can help her, man.
67
00:03:00,388 --> 00:03:01,556
Come on! What did she take?!
68
00:03:01,598 --> 00:03:03,350
Coke. But just a hit.
69
00:03:03,391 --> 00:03:04,684
Is this an overdose?
70
00:03:04,726 --> 00:03:06,478
How do you OD off just one hit?
71
00:03:06,519 --> 00:03:08,355
- You wouldn't.
- No, Unless...
72
00:03:08,396 --> 00:03:09,481
Cocaine was laced with fentanyl.
73
00:03:09,522 --> 00:03:11,316
I have Narcan in my purse.
74
00:03:11,358 --> 00:03:12,906
The blue bag under the bar on the hook?
75
00:03:12,931 --> 00:03:14,454
It's OK, I'll get it.
76
00:03:14,479 --> 00:03:15,612
Hey.
77
00:03:15,661 --> 00:03:17,080
- Hey, you doing OK?
- I... I don't...
78
00:03:17,113 --> 00:03:18,198
- OK, OK.
- I don't feel so good.
79
00:03:18,239 --> 00:03:19,991
Did you take a hit, too?
80
00:03:20,033 --> 00:03:21,159
Here.
81
00:03:21,201 --> 00:03:22,369
Thanks.
82
00:03:22,410 --> 00:03:24,245
You're OK. You're OK.
83
00:03:24,287 --> 00:03:25,580
Mitch?
84
00:03:25,622 --> 00:03:28,041
Yeah.
85
00:03:31,086 --> 00:03:33,380
Come on.
86
00:03:37,384 --> 00:03:38,551
Welcome back, Becca.
87
00:03:38,593 --> 00:03:40,762
- Take a breath.
- Come on.
88
00:03:40,804 --> 00:03:43,181
It's OK. Just breathe.
89
00:03:43,223 --> 00:03:44,933
Tim?
90
00:03:44,974 --> 00:03:46,111
What's wrong with him?
91
00:03:46,136 --> 00:03:47,702
Got any more Narcan? This didn't do it.
92
00:03:47,727 --> 00:03:48,978
- He needs another dose.
- No, I don't.
93
00:03:49,020 --> 00:03:50,125
Does anyone have Narcan?
94
00:03:50,150 --> 00:03:51,314
I'll ask around.
95
00:03:51,356 --> 00:03:52,524
Airway's open, but he's not breathing.
96
00:03:52,565 --> 00:03:53,566
Baby, you have to wake up.
97
00:03:53,608 --> 00:03:54,901
I'm gonna start rescue breath.
98
00:03:54,943 --> 00:03:56,014
No, no, Mitch, wait!
You don't have a mask.
99
00:03:56,039 --> 00:03:57,112
- Wait for the paramedics.
- Hannah!
100
00:03:57,153 --> 00:03:58,196
He could cough up blood.
101
00:03:58,238 --> 00:03:59,572
- He could...
- I know the risks.
102
00:03:59,614 --> 00:04:00,697
Hey, doc, what do we got?
103
00:04:00,722 --> 00:04:02,056
Suspected fentanyl overdose.
104
00:04:02,081 --> 00:04:04,010
We already administered
one dose of Narcan.
105
00:04:08,707 --> 00:04:10,834
Baby, open your eyes.
106
00:04:20,301 --> 00:04:22,887
Welcome back.
107
00:04:31,146 --> 00:04:32,689
CPD tested their drugs.
108
00:04:32,731 --> 00:04:34,399
Came back positive for fentanyl.
109
00:04:34,441 --> 00:04:37,027
There's been a huge uptick
of overdoses in the ED lately.
110
00:04:37,068 --> 00:04:39,154
Yeah, a lot of them
just like Becca and Tim.
111
00:04:39,195 --> 00:04:41,948
They're recreational users,
no clue their drugs
112
00:04:41,990 --> 00:04:43,158
are laced with fentanyl.
113
00:04:43,199 --> 00:04:45,452
I'll make sure they go home
with some fentanyl testing strips.
114
00:04:45,477 --> 00:04:47,980
Thank you, Juliette.
115
00:04:51,166 --> 00:04:52,375
Your date's waiting.
116
00:04:52,417 --> 00:04:53,720
He is?
117
00:04:53,745 --> 00:04:55,497
Your 6 o'clock. Just be cool.
118
00:05:01,593 --> 00:05:04,679
Well, uh, see you tomorrow.
119
00:05:04,721 --> 00:05:06,306
- Yeah.
- Yeah.
120
00:05:06,348 --> 00:05:08,350
Yeah.
121
00:05:10,953 --> 00:05:12,830
Get some sleep tonight, Asher.
122
00:05:18,318 --> 00:05:19,778
Wow.
123
00:05:19,819 --> 00:05:22,280
You're... you're like
a real-life superwoman.
124
00:05:22,322 --> 00:05:23,490
No.
125
00:05:23,531 --> 00:05:25,867
No, I'm just glad everyone's OK.
126
00:05:25,909 --> 00:05:28,495
Yeah.
127
00:05:28,536 --> 00:05:32,332
So what do you say we, um...
128
00:05:32,374 --> 00:05:35,502
we pick up where we left off?
129
00:05:35,543 --> 00:05:38,838
I actually... I have to get going.
130
00:05:38,880 --> 00:05:41,424
I've got kind of
an early start tomorrow.
131
00:05:41,466 --> 00:05:43,468
Oh.
132
00:05:43,510 --> 00:05:45,220
Yeah, I mean, I get it.
133
00:05:45,261 --> 00:05:48,973
But it was really lovely
to meet you, Hannah.
134
00:06:02,861 --> 00:06:06,861
- Synced and corrected by synk -
- www.addic7ed.com -
135
00:06:12,706 --> 00:06:14,501
Big plans tonight?
136
00:06:15,333 --> 00:06:16,668
No.
137
00:06:16,710 --> 00:06:19,379
I, uh, got a board meeting later.
138
00:06:19,421 --> 00:06:21,715
- Giving a presentation?
- No.
139
00:06:21,756 --> 00:06:24,801
I'm actually joining the board.
140
00:06:24,843 --> 00:06:26,970
Well, I must have missed
the announcement.
141
00:06:27,012 --> 00:06:29,389
Well, there wasn't one. My request.
142
00:06:29,431 --> 00:06:31,558
Not big on fanfare.
143
00:06:31,599 --> 00:06:34,060
So the board just
created a seat for you?
144
00:06:34,102 --> 00:06:36,646
Well, for a hospital physician, so...
145
00:06:36,688 --> 00:06:39,065
But they asked you?
146
00:06:39,107 --> 00:06:40,859
Seems that way.
147
00:06:42,819 --> 00:06:45,155
I'm just glad I get to,
uh... to advocate
148
00:06:45,196 --> 00:06:46,239
for the medical staff.
149
00:06:46,281 --> 00:06:48,491
Well, congratulations.
150
00:06:48,533 --> 00:06:51,327
You must be very popular with the suits.
151
00:06:51,369 --> 00:06:52,954
Dr. Ahmad!
152
00:06:52,996 --> 00:06:55,582
Got an ambo pulling up,
going to treatment three.
153
00:06:55,623 --> 00:06:57,167
Duty calls.
154
00:06:57,208 --> 00:06:58,793
By all means.
155
00:07:02,297 --> 00:07:04,007
- We're going into three.
- Got it.
156
00:07:04,049 --> 00:07:06,176
Vince Gonzalez, 38-year-old male,
157
00:07:06,217 --> 00:07:08,011
briefly lost consciousness
after vomiting.
158
00:07:08,053 --> 00:07:12,015
BP 85 over 52,
gave two liters in the ambo.
159
00:07:12,057 --> 00:07:14,184
Hi, Mr. Gonzalez. I'm Dr. Ahmad.
160
00:07:14,225 --> 00:07:16,269
It's Vince.
161
00:07:16,311 --> 00:07:18,396
Do you know if he hit
his head when he passed out?
162
00:07:18,438 --> 00:07:20,190
No, Vince was already on the ground.
163
00:07:20,231 --> 00:07:21,733
He just kind of slumped over.
164
00:07:21,775 --> 00:07:23,360
And he wasn't out long,
just a few seconds.
165
00:07:23,401 --> 00:07:24,527
Thank you. And you are?
166
00:07:24,569 --> 00:07:27,530
Ty. I'm Vince's husband.
167
00:07:27,572 --> 00:07:29,324
We'll take good care of him.
168
00:07:31,576 --> 00:07:34,037
OK, on my count... one, two, three.
169
00:07:40,168 --> 00:07:42,212
OK, Vince, do you mind leaning forward?
170
00:07:42,253 --> 00:07:43,463
I just want to listen to
your lungs from the back.
171
00:07:44,964 --> 00:07:47,592
Clear breath sounds bilaterally.
172
00:07:50,595 --> 00:07:52,222
Oh, honey.
173
00:07:52,263 --> 00:07:53,473
Oh.
174
00:07:53,515 --> 00:07:55,183
I am so sorry.
175
00:07:55,225 --> 00:07:57,268
It is so fine.
176
00:07:57,310 --> 00:07:59,354
It happens more than you think.
177
00:07:59,396 --> 00:08:00,855
4 of Zofran and a KUB.
178
00:08:00,897 --> 00:08:02,232
I'm on it.
179
00:08:02,273 --> 00:08:05,235
Excuse me.
180
00:08:05,276 --> 00:08:07,654
Hey.
181
00:08:07,696 --> 00:08:10,448
You, um... you
have some vomit in your hair.
182
00:08:14,452 --> 00:08:16,579
Dennis Washington.
183
00:08:16,621 --> 00:08:18,498
- How you been?
- Hey, Dan.
184
00:08:18,540 --> 00:08:19,916
- How are you?
- Dr. Washington.
185
00:08:19,958 --> 00:08:22,836
Good morning. What can I do for you?
186
00:08:22,877 --> 00:08:25,255
I wanted to follow up on that
matter I emailed you about.
187
00:08:25,296 --> 00:08:27,048
Oh, right. Of course.
188
00:08:27,090 --> 00:08:29,926
We can talk in my office.
We'll see you later.
189
00:08:29,968 --> 00:08:32,971
I'll see you at the Exec
Med Committee meeting Friday.
190
00:08:33,013 --> 00:08:34,931
Only if I can't get out of it.
191
00:08:43,481 --> 00:08:45,316
You forgot it by the toaster.
192
00:08:45,358 --> 00:08:48,778
Stop.
193
00:08:48,820 --> 00:08:51,489
I got to stop leaving my things.
194
00:08:51,531 --> 00:08:53,116
Hey, I don't mind.
195
00:08:54,909 --> 00:08:58,788
It gives me an excuse to
come see you during the day.
196
00:08:58,830 --> 00:09:00,874
Dan doesn't know about us, huh?
197
00:09:00,915 --> 00:09:02,125
Dennis.
198
00:09:02,167 --> 00:09:03,918
I know, I know, I know.
199
00:09:03,960 --> 00:09:06,504
You're not telling folks
for the time being.
200
00:09:06,546 --> 00:09:07,797
Have you told anyone?
201
00:09:07,839 --> 00:09:09,799
No. I'm confused.
202
00:09:09,841 --> 00:09:12,260
I mean, would it be the
worst thing if people knew?
203
00:09:12,302 --> 00:09:13,553
No, no.
204
00:09:13,595 --> 00:09:17,307
Of course not.
It's just that you're the...
205
00:09:17,349 --> 00:09:20,143
you're the chief of a department,
206
00:09:20,185 --> 00:09:23,396
and I'm a member of hospital leadership.
207
00:09:23,438 --> 00:09:25,106
It's not prohibited.
208
00:09:26,191 --> 00:09:28,943
Sharon, colleagues date all the time.
209
00:09:28,985 --> 00:09:32,322
- It's not a big deal.
- Yeah, but it is to me.
210
00:09:32,364 --> 00:09:36,493
I've always had this strict
policy of not mixing my work
211
00:09:36,534 --> 00:09:39,579
life with my romantic life.
212
00:09:39,621 --> 00:09:41,623
Until now.
213
00:09:42,832 --> 00:09:44,542
And I appreciate you
making that exception.
214
00:09:44,584 --> 00:09:45,712
Believe me.
215
00:09:47,170 --> 00:09:49,172
There's no rush.
216
00:09:49,214 --> 00:09:52,217
We'll take our time
integrating both worlds.
217
00:09:52,258 --> 00:09:55,929
Besides, it's kind of fun
sneaking around.
218
00:10:02,727 --> 00:10:03,884
Got a minute?
219
00:10:03,909 --> 00:10:05,605
Need a surgical consult.
220
00:10:05,647 --> 00:10:07,065
Uh...
221
00:10:07,107 --> 00:10:08,942
Patient's name is Vince Gonzalez.
222
00:10:08,983 --> 00:10:12,529
He's got metastatic abdominal
sarcoma, presented to the ED
223
00:10:12,570 --> 00:10:14,864
with nausea, abdominal distension,
224
00:10:14,906 --> 00:10:17,200
and severe belly pain.
225
00:10:17,242 --> 00:10:19,285
Poor guy can't keep anything down.
226
00:10:19,327 --> 00:10:21,496
Does he have an obstruction
or perforation?
227
00:10:21,538 --> 00:10:23,707
- Free fluid?
- Not on CT.
228
00:10:23,748 --> 00:10:25,542
But the tumor is severely compressing
229
00:10:25,583 --> 00:10:27,127
his stomach, hence the nausea.
230
00:10:27,168 --> 00:10:29,045
Yeah, I'm not seeing why
you need a surgical consult.
231
00:10:29,087 --> 00:10:31,854
I mean, if the tumor is metastatic,
it must have been inoperative.
232
00:10:31,879 --> 00:10:33,008
Correct.
233
00:10:33,049 --> 00:10:35,270
And if he's not completely obstructed,
what do you need me for?
234
00:10:35,295 --> 00:10:38,340
Well, if you debulked
a portion of the tumor here,
235
00:10:38,667 --> 00:10:41,503
then it would allow food to
pass into the small intestine.
236
00:10:41,850 --> 00:10:43,643
So would a feeding tube.
237
00:10:43,685 --> 00:10:45,103
He doesn't want a feeding tube.
238
00:10:45,145 --> 00:10:47,355
Surgery would afford him
a much better quality of life.
239
00:10:47,397 --> 00:10:50,066
Or it could cost him
whatever time he has left.
240
00:10:50,108 --> 00:10:51,568
I mean, we're talking about a patient
241
00:10:51,609 --> 00:10:53,987
who underwent multiple rounds
of chemo, I'm sure, right?
242
00:10:54,029 --> 00:10:55,588
With zero complications.
243
00:10:55,613 --> 00:10:58,742
He's remarkably fit and
healthy, despite the cancer.
244
00:10:58,783 --> 00:11:00,827
I know this isn't
exactly a sexy surgery.
245
00:11:00,869 --> 00:11:03,163
Whoa. I beg your pardon.
246
00:11:03,204 --> 00:11:05,749
"Sexy surgery"?
247
00:11:05,790 --> 00:11:07,709
I know surgeons
don't like to get involved
248
00:11:07,751 --> 00:11:10,754
in palliative care.
249
00:11:10,795 --> 00:11:13,256
Well, that's quite
a generalization there.
250
00:11:16,509 --> 00:11:18,553
All right. Let's have a look.
251
00:11:18,595 --> 00:11:20,638
Send me the chart.
252
00:11:23,808 --> 00:11:25,685
Don't be brave, OK?
253
00:11:25,727 --> 00:11:28,063
Tell me if it hurts when I push.
254
00:11:28,104 --> 00:11:29,272
I'm all right.
255
00:11:29,314 --> 00:11:30,426
OK.
256
00:11:30,451 --> 00:11:32,025
Well, your CT didn't show
an obstruction,
257
00:11:32,067 --> 00:11:34,319
but just wanted to confirm.
258
00:11:36,613 --> 00:11:38,573
So, Dr. Marcel?
259
00:11:38,615 --> 00:11:40,784
- Yeah.
- Here's the thing.
260
00:11:40,825 --> 00:11:43,953
My husband and I are supposed to fly
to Italy in three weeks.
261
00:11:43,995 --> 00:11:46,122
My grandmother was from Positano.
262
00:11:46,164 --> 00:11:49,292
I've always wanted to go,
and we figured,
263
00:11:49,334 --> 00:11:51,628
no time like the present.
264
00:11:51,670 --> 00:11:54,130
You know, how are you doing
with daily activities, Vince?
265
00:11:54,172 --> 00:11:56,424
Things like dressing,
housework, driving?
266
00:11:56,466 --> 00:11:59,844
Before I started vomiting my supper?
267
00:11:59,886 --> 00:12:01,638
I was totally functional.
268
00:12:01,680 --> 00:12:02,972
I can attest to that.
269
00:12:03,014 --> 00:12:05,767
Most days, Vince has
more energy than me.
270
00:12:05,809 --> 00:12:08,395
You ever had complications from surgery?
271
00:12:08,436 --> 00:12:11,106
Post-operative issues,
issues with anesthesia?
272
00:12:11,147 --> 00:12:14,150
No, I had my appendix out when I was 25,
273
00:12:14,192 --> 00:12:16,778
but I didn't have any problems.
274
00:12:16,820 --> 00:12:18,655
Good.
275
00:12:18,697 --> 00:12:20,865
I'm glad to hear it.
276
00:12:20,907 --> 00:12:22,826
Because there is a surgical option
277
00:12:22,867 --> 00:12:25,370
that could get your GI system
working again.
278
00:12:26,496 --> 00:12:28,915
I like the sound of that.
279
00:12:30,417 --> 00:12:33,003
Why don't you present it, Dr. Ahmad,
280
00:12:33,044 --> 00:12:35,088
since it was your suggestion?
281
00:12:35,130 --> 00:12:36,214
OK.
282
00:12:37,298 --> 00:12:39,175
Morning.
283
00:12:39,217 --> 00:12:40,760
Your night turn out all right?
284
00:12:40,802 --> 00:12:42,178
It did, actually.
285
00:12:42,220 --> 00:12:45,015
It ended up being
a pretty good first date.
286
00:12:45,056 --> 00:12:47,142
- Oh, yeah?
- Yeah.
287
00:12:47,183 --> 00:12:49,519
Dr. Ripley, we have a potential wrist
288
00:12:49,561 --> 00:12:51,479
fracture in treatment six.
289
00:12:51,521 --> 00:12:54,566
You mind starting the workup?
I'm just finishing up with a patient.
290
00:12:54,607 --> 00:12:56,067
You're lucky I like you.
291
00:12:56,109 --> 00:12:57,198
For now.
292
00:12:57,223 --> 00:12:58,366
Thank you, Maggie.
293
00:12:58,391 --> 00:12:59,512
Mm-hmm.
294
00:13:00,530 --> 00:13:01,823
OK.
295
00:13:01,865 --> 00:13:03,783
So, Mrs. Moore,
I understand that you fell
296
00:13:03,825 --> 00:13:05,660
getting out of your car.
297
00:13:05,702 --> 00:13:07,412
Mind if I take a look?
298
00:13:08,997 --> 00:13:11,458
I just want to check if it's swollen.
299
00:13:16,713 --> 00:13:17,797
I'll be gentle.
300
00:13:21,051 --> 00:13:23,094
Pam, let her look.
301
00:13:25,013 --> 00:13:27,265
My wrist is fine.
302
00:13:27,307 --> 00:13:28,808
I didn't fall.
303
00:13:29,601 --> 00:13:31,394
What?
304
00:13:31,436 --> 00:13:33,438
I don't understand.
305
00:13:34,314 --> 00:13:36,858
I'm sorry, honey.
I didn't have any other choice.
306
00:13:36,900 --> 00:13:38,693
What are you talking about?
307
00:13:40,362 --> 00:13:43,448
My husband is depressed
and refuses to get any help.
308
00:13:43,490 --> 00:13:44,991
Pamela!
309
00:13:45,033 --> 00:13:47,744
And I am so afraid
he's gonna hurt himself.
310
00:13:59,130 --> 00:14:01,691
Look, I appreciate you have
to do your due diligence.
311
00:14:01,716 --> 00:14:03,843
My wife mentioned the
possibility of self-harm,
312
00:14:03,885 --> 00:14:06,151
so you can't just send me on my way.
313
00:14:06,176 --> 00:14:08,682
Yeah, she mentioned to Nurse
Lockwood a comment you made.
314
00:14:08,723 --> 00:14:09,934
Right.
315
00:14:09,959 --> 00:14:12,160
I said something stupid
like, "Going to bed
316
00:14:12,185 --> 00:14:14,270
and never waking up sounds
like a nice way to go."
317
00:14:14,312 --> 00:14:15,313
Huh.
318
00:14:15,355 --> 00:14:17,315
Come on. I was speaking generally.
319
00:14:17,357 --> 00:14:19,192
A nice way to go, as opposed to,
320
00:14:19,234 --> 00:14:21,569
I don't know, getting hit by a bus.
321
00:14:21,611 --> 00:14:22,622
OK.
322
00:14:22,647 --> 00:14:25,423
Um, apparently, you have
been losing some weight.
323
00:14:25,448 --> 00:14:28,326
I was diagnosed with type 2
diabetes not long ago.
324
00:14:28,368 --> 00:14:31,621
I've been pretty diligent about my diet,
getting regular exercise.
325
00:14:31,663 --> 00:14:33,998
Frankly, I'm glad
the hard work's paying off.
326
00:14:34,040 --> 00:14:35,375
Well, then, Paul, help me out.
327
00:14:35,417 --> 00:14:37,627
I mean, why do you think
that your wife's
328
00:14:37,669 --> 00:14:38,878
so concerned about you?
329
00:14:40,755 --> 00:14:43,717
I admit I haven't been
in the best mood lately.
330
00:14:43,758 --> 00:14:45,468
My fuse is probably shorter.
331
00:14:45,510 --> 00:14:46,970
Yeah.
332
00:14:47,012 --> 00:14:49,097
I mean, she's... she's concerned that,
333
00:14:49,139 --> 00:14:51,224
you know, you've been isolating,
334
00:14:51,266 --> 00:14:53,560
withdrawing from her, your friends.
335
00:14:53,601 --> 00:14:56,104
I haven't felt like socializing lately.
336
00:14:56,146 --> 00:14:57,397
So when was the last time...
337
00:14:57,439 --> 00:14:59,050
Let me save you some time, OK?
338
00:14:59,075 --> 00:15:02,235
I have no intention
or desire to hurt myself.
339
00:15:02,277 --> 00:15:03,528
And I'm glad to hear it.
340
00:15:03,570 --> 00:15:05,238
So ask whatever questions you need
341
00:15:05,280 --> 00:15:07,824
to cover the hospital's ass.
342
00:15:07,866 --> 00:15:10,118
I am not suicidal, Dr. Charles.
343
00:15:10,160 --> 00:15:12,996
Pam is just making something
out of nothing.
344
00:15:13,038 --> 00:15:15,457
Her specialty.
345
00:15:15,498 --> 00:15:17,417
Mm.
346
00:15:20,754 --> 00:15:23,006
Within an hour
of posting Vince's surgery,
347
00:15:23,048 --> 00:15:25,383
his insurance company denied it,
348
00:15:25,425 --> 00:15:28,511
rejected it on the grounds of it
not being medically necessary.
349
00:15:28,553 --> 00:15:30,263
There are alternative treatment options.
350
00:15:30,305 --> 00:15:31,931
The feeding tube Vince doesn't want.
351
00:15:31,973 --> 00:15:33,350
Yep.
352
00:15:33,391 --> 00:15:36,770
Man, I am so fed up
with prior authorization.
353
00:15:36,811 --> 00:15:39,397
About a dozen times a month,
my patients get screwed by it.
354
00:15:39,439 --> 00:15:40,857
What insurance does Vince have?
355
00:15:40,899 --> 00:15:42,025
Berninger Health Network.
356
00:15:42,067 --> 00:15:43,777
Of course, one of the worst.
357
00:15:43,818 --> 00:15:46,279
They deny more patients
than any other company,
358
00:15:46,321 --> 00:15:49,032
pay physician reviewers
six figures to look at charts
359
00:15:49,074 --> 00:15:50,950
and find reasons to deny.
360
00:15:53,828 --> 00:15:55,705
I guess we should tell him
before he gets a form
361
00:15:55,747 --> 00:15:57,284
email from his insurance.
362
00:15:57,309 --> 00:15:58,792
Yeah.
363
00:16:05,423 --> 00:16:06,841
So what's the verdict?
364
00:16:06,883 --> 00:16:09,427
Is his wife right
that he's a danger to himself?
365
00:16:09,469 --> 00:16:11,054
You know, I don't know yet.
366
00:16:11,096 --> 00:16:12,931
I mean, he's adamant
that he's not, right?
367
00:16:12,972 --> 00:16:16,768
But about 50% of the people
with suicidal ideation deny it.
368
00:16:16,810 --> 00:16:19,896
I'm more concerned by his
wife's concern, if that makes sense.
369
00:16:19,938 --> 00:16:21,731
I mean, she pulled off
a pretty elaborate ruse
370
00:16:21,773 --> 00:16:22,816
to get him through our doors.
371
00:16:22,857 --> 00:16:24,234
Exactly.
372
00:16:24,275 --> 00:16:25,777
So what's the game plan?
373
00:16:25,819 --> 00:16:28,446
I want to talk to her
some more, all right?
374
00:16:28,488 --> 00:16:30,949
I also want to just look at his
medical history a little more
375
00:16:30,990 --> 00:16:34,494
carefully, you know, find out
what kind of access, if any,
376
00:16:34,536 --> 00:16:36,329
he has to firearms, to see if I can come
377
00:16:36,371 --> 00:16:39,082
up with any evidence at all
that he's planning to hurt himself.
378
00:16:39,124 --> 00:16:40,625
All right. I'll keep him comfortable.
379
00:16:40,667 --> 00:16:42,711
All right, and Mags, if he
gets antsy and starts talking
380
00:16:42,752 --> 00:16:43,846
about getting out of here...
381
00:16:43,871 --> 00:16:45,206
- I'll page you.
- Thank you.
382
00:16:45,231 --> 00:16:46,357
Yeah.
383
00:16:51,094 --> 00:16:52,679
Where is Hannah Asher?
384
00:16:52,721 --> 00:16:53,722
Excuse me?
385
00:16:53,763 --> 00:16:55,348
Where is Hannah Asher?
386
00:16:55,390 --> 00:16:58,685
She's probably with a patient.
387
00:16:58,727 --> 00:17:00,770
Ma'am.
388
00:17:00,812 --> 00:17:02,647
Ma'am, you can't do that.
389
00:17:04,482 --> 00:17:06,401
Ma'am.
390
00:17:06,443 --> 00:17:10,321
OK, this is gonna feel a little cold.
OK?
391
00:17:10,363 --> 00:17:12,198
You're Hannah Asher?
392
00:17:12,240 --> 00:17:13,575
Do you know this woman?
393
00:17:13,616 --> 00:17:16,911
Um, no.
394
00:17:16,953 --> 00:17:18,288
Do you want me to remove her?
395
00:17:18,329 --> 00:17:19,748
- I'd like to see you try.
- Hold on.
396
00:17:19,789 --> 00:17:20,874
Hold on a second.
397
00:17:20,915 --> 00:17:23,226
I'm Dr. Hannah Asher.
Is there a problem?
398
00:17:23,251 --> 00:17:24,794
Problem?
399
00:17:24,836 --> 00:17:26,963
Well, you went on a date
with my husband last night,
400
00:17:27,005 --> 00:17:28,715
so yeah, we've got a problem.
401
00:17:33,511 --> 00:17:37,807
Vince, we're submitting an appeal
to your insurance company, OK?
402
00:17:37,849 --> 00:17:40,769
We've been through the appeals process.
403
00:17:42,937 --> 00:17:45,774
When Vince's doctor first
suspected something was wrong,
404
00:17:45,815 --> 00:17:47,442
he ordered a CT.
405
00:17:47,484 --> 00:17:49,861
Insurance wouldn't approve it initially.
406
00:17:49,903 --> 00:17:52,906
Said there wasn't sufficient
evidence to warrant it.
407
00:17:52,947 --> 00:17:55,533
It took them three months
to finally get it authorized.
408
00:17:55,575 --> 00:17:57,077
- Yeah.
- Who knows how much
409
00:17:57,118 --> 00:18:00,080
the tumor grew in that time?
410
00:18:00,121 --> 00:18:02,582
Vince.
411
00:18:02,624 --> 00:18:05,043
I know you were trying
to avoid a feeding tube.
412
00:18:05,085 --> 00:18:06,753
No.
413
00:18:06,795 --> 00:18:09,422
No feeding tube.
414
00:18:09,464 --> 00:18:11,174
Look, we could place a temporary one.
415
00:18:11,216 --> 00:18:12,384
No.
416
00:18:12,425 --> 00:18:14,010
Without a feeding tube...
417
00:18:14,052 --> 00:18:15,970
I'm gonna lose time.
418
00:18:16,012 --> 00:18:17,472
I understand that.
419
00:18:17,514 --> 00:18:20,183
You could die in weeks,
420
00:18:20,225 --> 00:18:21,935
possibly days.
421
00:18:26,940 --> 00:18:30,151
When we first got the news
that nothing more could be done,
422
00:18:30,193 --> 00:18:32,487
that this was terminal,
423
00:18:32,529 --> 00:18:34,572
we came up with a model for how we were
424
00:18:34,614 --> 00:18:36,825
going to approach this next...
425
00:18:36,866 --> 00:18:37,909
phase.
426
00:18:42,831 --> 00:18:45,208
Quality over time, right?
427
00:18:46,710 --> 00:18:48,753
No feeding tube.
428
00:18:55,093 --> 00:18:57,345
OK.
429
00:18:57,387 --> 00:18:58,471
Get some rest.
430
00:18:58,513 --> 00:19:00,557
Be back in a bit, OK?
431
00:19:07,647 --> 00:19:09,107
Yeah.
432
00:19:09,149 --> 00:19:10,379
Thanks.
433
00:19:10,404 --> 00:19:13,795
I'm gonna talk to a
utilization review specialist,
434
00:19:13,820 --> 00:19:16,239
see if I can expedite
the appeal process.
435
00:19:16,281 --> 00:19:18,867
You really think that's gonna
make much of a difference?
436
00:19:18,908 --> 00:19:20,869
Worth a shot.
437
00:19:31,671 --> 00:19:33,965
I did go out last night, but it wasn't
438
00:19:34,007 --> 00:19:35,175
with anyone that was married.
439
00:19:35,216 --> 00:19:37,385
All right, guys. Come on.
440
00:19:37,427 --> 00:19:38,511
Show's over, huh?
441
00:19:38,553 --> 00:19:40,180
I went out with Kyle.
442
00:19:40,221 --> 00:19:42,515
- Kyle?
- Yeah.
443
00:19:43,975 --> 00:19:45,894
Yeah, that's him.
444
00:19:47,145 --> 00:19:48,480
His name is Nick Dunn.
445
00:19:48,521 --> 00:19:50,831
He's not an architect.
He's a general contractor.
446
00:19:50,856 --> 00:19:52,901
I'm so... oh, God.
447
00:19:52,942 --> 00:19:55,362
You really didn't know he was married?
448
00:19:55,403 --> 00:19:56,905
No, I swear.
449
00:19:56,946 --> 00:19:58,823
I...
450
00:20:03,620 --> 00:20:05,205
I'm gonna kill him.
451
00:20:05,246 --> 00:20:06,414
Well, I...
452
00:20:06,456 --> 00:20:08,958
How could he do this to me?
453
00:20:09,000 --> 00:20:10,251
I'm carrying our child.
454
00:20:10,293 --> 00:20:11,586
It's absolutely terrible.
455
00:20:11,628 --> 00:20:13,838
- I agree...
- I knew something was up.
456
00:20:13,880 --> 00:20:15,715
I thought it was just
new dad jitters, you know?
457
00:20:15,757 --> 00:20:19,052
In a million years, I never...
458
00:20:19,094 --> 00:20:20,227
oh.
459
00:20:20,252 --> 00:20:22,013
Are you OK?
460
00:20:22,055 --> 00:20:23,431
I think my water just broke.
461
00:20:29,229 --> 00:20:30,680
How many weeks are you?
462
00:20:30,705 --> 00:20:32,440
38.
463
00:20:32,482 --> 00:20:34,651
I would like to get you on a monitor.
464
00:20:34,693 --> 00:20:36,695
No, no, no, no,
I'm going to see my own doct...
465
00:20:36,736 --> 00:20:38,530
- oh!
- Hey, hey, hey, breathe.
466
00:20:38,571 --> 00:20:40,782
- Breathe with me.
- I know how to breathe.
467
00:20:42,450 --> 00:20:44,202
This can't be happening.
468
00:20:52,627 --> 00:20:55,171
Can you put your
knees up for me, please?
469
00:20:58,049 --> 00:21:00,010
You're gonna feel
a little bit of pressure.
470
00:21:00,051 --> 00:21:02,721
OK.
471
00:21:02,762 --> 00:21:05,765
OK, so, Tessa, you are fully dilated.
472
00:21:05,807 --> 00:21:07,225
What?
473
00:21:07,267 --> 00:21:09,686
Yep, which means there
is no time to move upstairs
474
00:21:09,728 --> 00:21:10,979
or wait for your doctor.
475
00:21:11,021 --> 00:21:13,023
No, no, no. I can't have my baby here.
476
00:21:13,064 --> 00:21:14,357
The ED is fully equipped for delivery.
477
00:21:14,399 --> 00:21:17,031
No, I can't have you deliver my baby.
I'm sorry.
478
00:21:17,056 --> 00:21:18,586
Look, I get that I'm not
your first option.
479
00:21:18,611 --> 00:21:20,084
In fact, I'm probably your last.
480
00:21:20,109 --> 00:21:22,157
But I am a board-certified OBGYN,
481
00:21:22,198 --> 00:21:23,825
and I have delivered hundreds of babies.
482
00:21:23,867 --> 00:21:26,953
And I will get yours out safely
if we work together.
483
00:21:32,083 --> 00:21:33,543
OK, change of plans.
484
00:21:33,568 --> 00:21:34,902
Tessa's ready to deliver now,
so we're gonna do it here.
485
00:21:34,927 --> 00:21:36,094
Oh, OK.
486
00:21:36,119 --> 00:21:38,732
Yep, so get me another nurse,
a delivery table,
487
00:21:38,757 --> 00:21:41,015
and grab another doctor,
whoever's available.
488
00:21:41,040 --> 00:21:43,626
We'll maybe need an extra set of hands.
489
00:21:45,096 --> 00:21:46,890
We got this, OK?
490
00:21:46,931 --> 00:21:48,099
OK.
491
00:21:51,186 --> 00:21:52,562
Where are we at?
492
00:21:52,604 --> 00:21:54,564
Long and short of it, Paul is depressed,
493
00:21:54,606 --> 00:21:56,316
but his risk of suicide is low.
494
00:21:56,358 --> 00:21:59,110
Couldn't find any evidence
of any kind of intent
495
00:21:59,152 --> 00:22:00,273
to harm himself.
496
00:22:00,298 --> 00:22:02,505
All right, so I'll get his
discharge paperwork ready.
497
00:22:02,530 --> 00:22:04,574
Do you want to include a psych referral?
498
00:22:04,616 --> 00:22:06,701
You know, Mags,
I'm actually not quite ready
499
00:22:06,743 --> 00:22:07,952
to discharge him.
500
00:22:07,994 --> 00:22:09,287
OK.
501
00:22:09,329 --> 00:22:10,747
Here's the thing, right?
502
00:22:10,789 --> 00:22:13,166
He gets diagnosed with
sudden-onset type 2 diabetes
503
00:22:13,208 --> 00:22:14,209
six months ago.
504
00:22:14,250 --> 00:22:17,253
No family history, low BMI, right?
505
00:22:17,295 --> 00:22:19,756
And we all know that when you
get diagnosed with type 2,
506
00:22:19,798 --> 00:22:21,216
you don't lose weight.
507
00:22:21,257 --> 00:22:22,801
No, you gain weight, right?
508
00:22:22,842 --> 00:22:24,761
And then, there's
the sudden-onset depression.
509
00:22:24,803 --> 00:22:26,930
Again, no history, right?
510
00:22:26,971 --> 00:22:28,306
No triggers.
511
00:22:28,348 --> 00:22:30,684
I'm just wondering
if we're not missing something,
512
00:22:30,725 --> 00:22:32,894
you know, some underlying
medical condition.
513
00:22:32,936 --> 00:22:34,896
Do you want to order a set of labs?
514
00:22:34,938 --> 00:22:36,940
Let's start out with a CBC and a CMP,
515
00:22:36,981 --> 00:22:39,192
and I'm gonna dig into the literature,
516
00:22:39,234 --> 00:22:42,404
see if I can't find
some kind of common thread.
517
00:22:42,445 --> 00:22:43,571
You got it.
518
00:22:47,033 --> 00:22:50,954
After lambasting them for
denying the patient's surgery,
519
00:22:50,995 --> 00:22:55,083
Dr. Ahmad goes on to tag you,
Dr. Marcel.
520
00:22:55,125 --> 00:22:57,127
"Berninger is the worst.
521
00:22:57,168 --> 00:23:00,171
"Not only do they deny
more patients than anyone,
522
00:23:00,213 --> 00:23:02,465
"they also pay physician
reviewers six figures
523
00:23:02,507 --> 00:23:04,394
to find reasons to deny."
524
00:23:04,419 --> 00:23:06,903
Now, while Dr. Ahmad is entitled
525
00:23:06,928 --> 00:23:10,115
to express her personal
opinions on her social media...
526
00:23:10,140 --> 00:23:12,142
You, sir, are a representative
527
00:23:12,183 --> 00:23:13,810
of the board now.
528
00:23:13,852 --> 00:23:16,021
I had no idea she was gonna post this.
529
00:23:16,062 --> 00:23:19,357
She didn't ask you
before she publicly quoted you?
530
00:23:19,399 --> 00:23:21,901
No. She did not.
531
00:23:21,943 --> 00:23:23,820
We are on the eve of hammering out
532
00:23:23,862 --> 00:23:26,698
a new three-year contract
with Berninger.
533
00:23:26,740 --> 00:23:28,950
And antagonizing them
with a PR nightmare
534
00:23:28,992 --> 00:23:31,244
is not exactly the tone
we wanted to set.
535
00:23:31,286 --> 00:23:33,364
We're talking about one post here.
536
00:23:33,389 --> 00:23:35,099
I'm sure no one's even gonna see it.
537
00:23:35,124 --> 00:23:38,253
It's going viral, Dr. Marcel.
538
00:23:40,545 --> 00:23:42,005
- What?
- Yeah.
539
00:23:42,047 --> 00:23:43,965
So we are gonna need
to do major damage control
540
00:23:44,007 --> 00:23:47,177
at the board meeting this afternoon.
541
00:23:47,218 --> 00:23:49,512
Just follow my lead.
542
00:23:55,101 --> 00:23:56,603
What is this?
543
00:23:58,605 --> 00:24:00,690
Now, I share something with you
in a clinical setting,
544
00:24:00,732 --> 00:24:01,983
I don't expect to see it plastered
545
00:24:02,025 --> 00:24:03,485
all over social media, you understand?
546
00:24:03,526 --> 00:24:05,322
I should have checked
with you before I posted it.
547
00:24:05,347 --> 00:24:07,614
Yeah, that much is obvious.
548
00:24:07,655 --> 00:24:09,032
I don't mean to sound ingenuous,
549
00:24:09,074 --> 00:24:10,700
but I didn't think that you would mind.
550
00:24:10,742 --> 00:24:12,619
Being publicly quoted
without my consent?
551
00:24:12,660 --> 00:24:14,371
Yeah, I mind, a lot.
552
00:24:14,412 --> 00:24:16,748
- But what you said was true.
- That isn't the point.
553
00:24:16,790 --> 00:24:19,751
Look, you want to have a viral moment?
Be my guest.
554
00:24:19,793 --> 00:24:21,127
But don't do it at my expense.
555
00:24:21,169 --> 00:24:23,046
This isn't about having a viral moment.
556
00:24:23,088 --> 00:24:26,424
I... this strategy might seem
unorthodox, but it works.
557
00:24:26,466 --> 00:24:27,717
Strategy?
558
00:24:27,759 --> 00:24:30,324
Since when did venting on social media
become a strategy?
559
00:24:30,349 --> 00:24:32,781
Public shaming is a way
to get companies' attention
560
00:24:32,806 --> 00:24:34,224
and move them to act.
561
00:24:34,265 --> 00:24:37,018
Case in point, after
the post started trending,
562
00:24:37,060 --> 00:24:40,397
Berninger sent notice, and
they escalated Vince's appeal
563
00:24:40,438 --> 00:24:42,399
for a peer-to-peer call.
564
00:24:42,440 --> 00:24:43,707
Really?
565
00:24:43,732 --> 00:24:46,086
Yeah, which is why we can't
let up on public pressure.
566
00:24:46,111 --> 00:24:48,518
I got a DM from a local news reporter.
567
00:24:48,543 --> 00:24:50,657
She wants to interview us
on Vince's case.
568
00:24:50,699 --> 00:24:52,367
What are you, out of your mind?
569
00:24:52,409 --> 00:24:53,451
I can't do that.
570
00:24:53,493 --> 00:24:54,953
Why not?
571
00:24:54,994 --> 00:24:56,955
Because the hospital's
got an upcoming contract
572
00:24:56,996 --> 00:25:00,166
negotiation with Berninger.
573
00:25:00,208 --> 00:25:01,501
Ah.
574
00:25:01,543 --> 00:25:04,587
So this is why the post
was such a big issue?
575
00:25:04,629 --> 00:25:07,173
That has nothing to do with my issue,
576
00:25:07,215 --> 00:25:10,093
which is your total disregard
for professional courtesy.
577
00:25:14,556 --> 00:25:19,519
You should know that the post
wasn't just liked or reposted.
578
00:25:19,561 --> 00:25:22,689
People shared their hellish
experiences with Berninger.
579
00:25:22,731 --> 00:25:25,608
Hundreds of people, including MDs.
580
00:25:25,650 --> 00:25:27,944
What you said resonated.
581
00:25:27,986 --> 00:25:30,155
It needed to be said.
582
00:25:31,865 --> 00:25:34,117
OK, Tessa, the head is coming.
583
00:25:34,159 --> 00:25:35,618
You're crowning.
584
00:25:35,660 --> 00:25:37,162
I am?
585
00:25:37,203 --> 00:25:39,330
- You're doing great.
- Thank you.
586
00:25:40,331 --> 00:25:42,584
Hannah?
587
00:25:42,625 --> 00:25:44,294
What... what's going on?
588
00:25:44,336 --> 00:25:46,963
The head is out, but the
shoulders aren't coming.
589
00:25:47,005 --> 00:25:48,798
What? She's stuck?
590
00:25:48,840 --> 00:25:50,383
This can happen with bigger babies.
591
00:25:50,425 --> 00:25:52,302
Don't worry, we will
get her out, Tessa, OK?
592
00:25:52,344 --> 00:25:54,471
Nancy, I need you to switch
with Dr. Ripley.
593
00:25:54,512 --> 00:25:57,015
Put her into McRoberts.
Dr. Ripley, I'm gonna need you to apply
594
00:25:57,057 --> 00:25:58,933
suprapubic pressure from above
595
00:25:58,975 --> 00:26:01,019
- while I maneuver the baby out, OK?
- You got it.
596
00:26:01,061 --> 00:26:02,354
All right, Tessa, you got this.
597
00:26:02,395 --> 00:26:04,689
When I say push, you push
as hard as you can, OK?
598
00:26:04,731 --> 00:26:05,915
Let's go.
599
00:26:05,940 --> 00:26:07,191
Go.
600
00:26:11,229 --> 00:26:13,697
Here we go, here we go, here we go!
601
00:26:14,407 --> 00:26:16,618
I got her!
602
00:26:18,078 --> 00:26:19,537
There's your baby girl.
603
00:26:19,579 --> 00:26:22,499
- Oh!
- Oh, my baby.
604
00:26:26,151 --> 00:26:27,444
Thank you.
605
00:26:43,561 --> 00:26:45,105
Look, just... just hold on.
606
00:26:45,146 --> 00:26:46,606
Because it says here on my...
what do you call this?
607
00:26:46,648 --> 00:26:49,234
Patient portal... that my blood
work all came back normal.
608
00:26:49,275 --> 00:26:50,276
I understand.
609
00:26:50,318 --> 00:26:51,695
So why can't you discharge me?
610
00:26:51,736 --> 00:26:53,863
Because Dr. Charles needs
to sign off your chart.
611
00:26:53,905 --> 00:26:55,573
Well, then go get Dr. Charles.
612
00:26:55,615 --> 00:26:56,700
Paul, don't yell at her.
613
00:26:56,741 --> 00:26:58,320
Don't tell me what to do.
614
00:26:58,345 --> 00:26:59,911
This is all your fault. If you had...
615
00:26:59,953 --> 00:27:01,246
Dr. Charles?
616
00:27:01,287 --> 00:27:03,289
Dr. Charles, I'd like to go home now.
617
00:27:03,485 --> 00:27:05,320
I understand
you have to sign off on that.
618
00:27:05,345 --> 00:27:08,378
I do. And look, Paul, I know
you've had a really long day.
619
00:27:08,420 --> 00:27:09,713
I certainly have.
620
00:27:09,754 --> 00:27:11,367
But I'd like to order
just a couple more labs
621
00:27:11,392 --> 00:27:13,425
and actually get a CT of your abdomen.
622
00:27:13,466 --> 00:27:15,427
Why? My blood work came back normal.
623
00:27:15,468 --> 00:27:17,095
You know, there are certain illnesses
624
00:27:17,137 --> 00:27:19,222
that, early on, they just
kind of fly under the radar.
625
00:27:19,264 --> 00:27:20,974
Like what? What are you looking for?
626
00:27:21,016 --> 00:27:22,851
Well, certain medical conditions, right,
627
00:27:22,892 --> 00:27:24,894
can raise inflammation in the body,
628
00:27:24,936 --> 00:27:27,147
which can cause depression.
629
00:27:27,188 --> 00:27:29,441
Yeah, but you've clearly
narrowed that list down now.
630
00:27:29,482 --> 00:27:31,484
Why are you looking at my stomach?
631
00:27:31,526 --> 00:27:34,904
There is evidence that
disruptions in the physiologic
632
00:27:34,946 --> 00:27:38,283
functions of the pancreas...
in this case, neurotransmission...
633
00:27:38,324 --> 00:27:40,618
can alter mood and anxiety levels.
634
00:27:40,660 --> 00:27:43,663
And in very rare cases,
sudden-onset diabetes
635
00:27:43,705 --> 00:27:46,750
has been known to be caused
by a growth in the pancreas.
636
00:27:52,339 --> 00:27:53,840
What, you...
637
00:27:56,009 --> 00:27:57,927
You think I have pancreatic cancer?
638
00:27:57,969 --> 00:28:01,181
I'm more thinking about this
as something I'd like to rule out.
639
00:28:25,997 --> 00:28:28,708
Well, I want to start by welcoming
our newest member to the board,
640
00:28:28,750 --> 00:28:30,312
Dr. Crockett Marcel.
641
00:28:32,128 --> 00:28:33,758
All right, then. Let's dive right in.
642
00:28:33,783 --> 00:28:36,800
Barry, if I may,
I'd actually like to address
643
00:28:36,841 --> 00:28:38,885
the elephant in the room.
644
00:28:40,762 --> 00:28:42,263
Sure, Peter.
645
00:28:42,305 --> 00:28:46,518
I think we're all aware of
the social media firestorm.
646
00:28:46,559 --> 00:28:49,229
Strike that... "firestorm" is
making a mountain out of a...
647
00:28:49,270 --> 00:28:50,689
Peter.
648
00:28:50,730 --> 00:28:53,441
Get to the point.
649
00:28:53,483 --> 00:28:57,195
An overzealous resident
misquoted Dr. Marcel
650
00:28:57,237 --> 00:28:58,947
to serve her own agenda.
651
00:28:58,988 --> 00:29:00,990
No, that's not...
652
00:29:01,032 --> 00:29:03,535
- Dr. Marcel...
- I was quoted accurately.
653
00:29:03,576 --> 00:29:06,538
OK? Let me start by owning that.
654
00:29:06,579 --> 00:29:09,374
And Dr. Ahmad was not
serving her own agenda.
655
00:29:09,416 --> 00:29:11,793
She was trying to help our dying patient
656
00:29:11,835 --> 00:29:14,254
battle his insurance company,
657
00:29:14,507 --> 00:29:16,593
which is a fight
doctors typically avoid.
658
00:29:16,618 --> 00:29:18,570
Trust me, I know, it's not our lane.
659
00:29:18,595 --> 00:29:21,386
We don't deal with insurance.
660
00:29:21,428 --> 00:29:23,263
And honestly, I feel it's time we did.
661
00:29:23,304 --> 00:29:25,890
Because these companies
are stepping into our lane.
662
00:29:30,103 --> 00:29:33,148
Take the patient Dr. Ahmad posted about.
663
00:29:33,189 --> 00:29:36,067
Now, he was diagnosed
with stage four cancer
664
00:29:36,109 --> 00:29:39,571
three months after his doctor first
suspected something was wrong.
665
00:29:39,612 --> 00:29:41,906
Why such a long gap?
666
00:29:41,948 --> 00:29:45,535
Because the CT his doctor ordered
required prior authorization,
667
00:29:45,577 --> 00:29:47,287
and Berninger denied it.
668
00:29:50,457 --> 00:29:52,625
That's the crux of the issue.
669
00:30:03,345 --> 00:30:05,180
Paul, Pamela, I want to introduce you
670
00:30:05,221 --> 00:30:08,433
to Dr. Washington,
who is our head of oncology
671
00:30:08,475 --> 00:30:10,268
here at Gaffney.
672
00:30:10,310 --> 00:30:13,688
Oh, wow, top dog. This must be bad.
673
00:30:13,730 --> 00:30:15,357
Don't read in to the title.
674
00:30:15,398 --> 00:30:17,901
While you do have a small mass
in your pancreas...
675
00:30:17,942 --> 00:30:19,069
OK.
676
00:30:19,110 --> 00:30:21,988
It's confined to the tail,
677
00:30:22,030 --> 00:30:23,823
which means it's resectable.
678
00:30:23,865 --> 00:30:25,867
That's good, right?
679
00:30:25,909 --> 00:30:27,202
It's really good.
680
00:30:27,243 --> 00:30:30,789
Surgery is far and away the best
treatment for pancreatic cancer.
681
00:30:30,830 --> 00:30:32,582
And it's rarely an option.
682
00:30:32,624 --> 00:30:35,460
The cancer is usually too advanced
by the time we catch it.
683
00:30:35,502 --> 00:30:38,338
I advise a few rounds
of chemo to shrink the tumor
684
00:30:38,380 --> 00:30:41,508
and then the distal
pancreatectomy to remove it.
685
00:30:43,677 --> 00:30:46,388
Few doctors would have
connected the dots here.
686
00:30:46,429 --> 00:30:48,765
You're lucky you ended up
with this one, Mr. Moore.
687
00:30:49,974 --> 00:30:51,893
I'm realizing that.
688
00:30:51,935 --> 00:30:54,020
Thank you, Dr. Charles.
689
00:30:54,062 --> 00:30:56,523
Absolutely a team effort.
690
00:31:01,152 --> 00:31:02,862
Thank you, Pam.
691
00:31:02,904 --> 00:31:05,156
It's not lost on me
if you hadn't conned me
692
00:31:05,198 --> 00:31:07,283
into coming in here today...
693
00:31:07,325 --> 00:31:08,576
You're gonna be OK.
694
00:31:08,618 --> 00:31:10,120
That's all I care about.
695
00:31:25,885 --> 00:31:28,805
Hey. I'm looking for my wife.
696
00:31:34,769 --> 00:31:35,937
Hannah.
697
00:31:35,979 --> 00:31:37,230
Nick.
698
00:31:38,398 --> 00:31:39,858
H-how do you know...
699
00:31:39,899 --> 00:31:41,735
I just delivered your baby.
700
00:31:41,776 --> 00:31:43,319
What?
701
00:31:44,571 --> 00:31:46,531
- Does Tessa...
- Oh, she knows.
702
00:31:46,573 --> 00:31:49,117
- Oh, no.
- She hacked into your phone,
703
00:31:49,159 --> 00:31:50,702
found your messages,
and tracked me down.
704
00:31:50,744 --> 00:31:51,849
Oh, my God.
705
00:31:51,874 --> 00:31:53,288
- Is that why she's here?
- Shh!
706
00:31:53,329 --> 00:31:54,622
She's sleeping.
707
00:31:54,664 --> 00:31:56,291
What did she say?
708
00:31:56,332 --> 00:31:58,043
Is this why she went into labor?
709
00:31:58,084 --> 00:32:00,628
Well, it's definitely
possible for emotional stress
710
00:32:00,670 --> 00:32:02,714
to induce labor.
711
00:32:02,756 --> 00:32:07,218
But regardless, Tessa gave
birth to a healthy baby girl,
712
00:32:07,260 --> 00:32:09,846
and both mom and baby are doing well.
713
00:32:09,888 --> 00:32:11,181
Oh, thank God.
714
00:32:15,810 --> 00:32:17,187
Look, Hannah, I'm...
715
00:32:17,228 --> 00:32:18,730
I'm not a cheater.
716
00:32:18,772 --> 00:32:21,483
Yeah, well, last night
would suggest otherwise.
717
00:32:21,524 --> 00:32:24,569
You were the only woman
I messaged on that app, OK?
718
00:32:24,611 --> 00:32:27,113
And I had no intention
of ever seeing you again.
719
00:32:27,155 --> 00:32:29,199
Don't flatter yourself.
720
00:32:29,240 --> 00:32:31,743
Look, I made a horrible mistake.
721
00:32:31,785 --> 00:32:33,870
I was freaking out about
becoming a dad, you know,
722
00:32:33,912 --> 00:32:37,582
and I just thought,
one last night of freedom...
723
00:32:37,624 --> 00:32:40,794
OK, save your
rationalizations for your wife.
724
00:32:40,835 --> 00:32:43,421
Or better yet, spare her.
725
00:32:43,463 --> 00:32:45,840
I think that your time is best used
726
00:32:45,882 --> 00:32:48,051
begging Tessa for forgiveness.
727
00:33:10,281 --> 00:33:11,825
Hey.
728
00:33:13,743 --> 00:33:15,120
What is it?
729
00:33:15,161 --> 00:33:16,871
Vince just started vomiting blood.
730
00:33:26,715 --> 00:33:28,049
Dr. Charles?
731
00:33:28,091 --> 00:33:29,759
Mrs. Moore?
732
00:33:29,801 --> 00:33:31,177
Are you all right?
733
00:33:31,219 --> 00:33:33,638
Look, we know it's a scary diagnosis,
734
00:33:33,680 --> 00:33:35,348
but in terms of pancreatic cancer,
735
00:33:35,390 --> 00:33:37,809
his prognosis could not be better.
736
00:33:37,851 --> 00:33:40,228
And that's largely
because of your efforts.
737
00:33:40,270 --> 00:33:42,689
You saved his life
by bringing him in today.
738
00:33:42,731 --> 00:33:45,650
Well, he has quite a way of thanking me.
739
00:33:48,319 --> 00:33:50,155
He wants a divorce.
740
00:34:01,708 --> 00:34:03,643
Vince, we're concerned
you may be developing
741
00:34:03,668 --> 00:34:07,464
a tear in your lower esophagus
from all of the vomiting.
742
00:34:07,505 --> 00:34:09,466
I'd like to place an NG tube, Vince.
743
00:34:09,507 --> 00:34:10,967
- No.
- Just for the time being.
744
00:34:11,009 --> 00:34:13,887
No, no tubes.
How many times do I have to tell you...
745
00:34:13,928 --> 00:34:15,096
Hear me out.
746
00:34:15,138 --> 00:34:16,556
It's not a feeding tube.
747
00:34:16,598 --> 00:34:20,185
It's just gonna stop you from vomiting,
and it'll help during surgery
748
00:34:20,226 --> 00:34:21,644
to decompress your stomach, OK?
749
00:34:21,686 --> 00:34:23,480
Wait.
750
00:34:23,521 --> 00:34:25,398
Did you just say surgery?
751
00:34:25,440 --> 00:34:27,150
Yeah, I heard "surgery,"
too, Dr. Marcel.
752
00:34:27,192 --> 00:34:28,234
Mm-hmm.
753
00:34:28,276 --> 00:34:29,611
That's right.
754
00:34:29,652 --> 00:34:31,946
The board voted unanimously
for the hospital
755
00:34:31,988 --> 00:34:33,990
to cover the costs of Vince's surgery.
756
00:34:38,119 --> 00:34:39,704
Seriously?
757
00:34:40,789 --> 00:34:42,916
The hospital is just gonna pay for it?
758
00:34:42,957 --> 00:34:44,668
Yep.
759
00:34:46,461 --> 00:34:48,838
I can't believe this.
760
00:34:48,880 --> 00:34:51,466
Is this real?
761
00:34:51,508 --> 00:34:53,468
It's very real.
762
00:34:53,510 --> 00:34:56,096
In fact, I got you scheduled in the OR
763
00:34:56,137 --> 00:34:57,931
for 8:00 a.m. tomorrow.
764
00:35:00,850 --> 00:35:03,144
Hey, you guys are going
to Italy in three weeks.
765
00:35:03,186 --> 00:35:04,688
We got no time to waste.
766
00:35:09,567 --> 00:35:12,278
How can I begin to thank you?
767
00:35:12,320 --> 00:35:14,948
To thank you both?
768
00:35:14,989 --> 00:35:19,077
Well, how about you let us
place this NG tube, OK?
769
00:35:24,499 --> 00:35:26,543
All right.
770
00:35:26,584 --> 00:35:28,294
Do you think it was
the depression that made him
771
00:35:28,336 --> 00:35:30,797
make such a rash decision?
772
00:35:30,839 --> 00:35:32,507
You know, I don't, actually.
773
00:35:32,549 --> 00:35:34,392
But what possessed him
to do it right now?
774
00:35:34,417 --> 00:35:35,969
I mean, he couldn't even wait
until they were home?
775
00:35:36,011 --> 00:35:38,263
Your mortality can be
a pretty powerful motivator
776
00:35:38,304 --> 00:35:42,183
to do all the stuff
that you put off doing, right?
777
00:35:42,225 --> 00:35:45,186
I think that Paul had been thinking
about this for a while.
778
00:35:45,228 --> 00:35:46,354
I wonder if he's gonna regret it.
779
00:35:46,396 --> 00:35:47,647
I mean, speaking from experience,
780
00:35:47,689 --> 00:35:49,816
he's got a long road ahead of him.
781
00:35:49,858 --> 00:35:51,735
One that's not easy to walk alone.
782
00:35:51,776 --> 00:35:54,863
Yeah, but I mean, given his
feelings about the marriage,
783
00:35:54,904 --> 00:35:56,698
is it really...
784
00:35:56,740 --> 00:35:58,491
really fair to Pamela
to put her in the position
785
00:35:58,533 --> 00:36:00,702
of being the support system?
786
00:36:06,499 --> 00:36:07,709
I'm sorry.
787
00:36:07,751 --> 00:36:09,627
No apology necessary.
788
00:36:09,669 --> 00:36:12,464
I've been through enough divorces
789
00:36:12,505 --> 00:36:14,057
to be able to say with some authority,
790
00:36:14,082 --> 00:36:16,426
spontaneous weeping
is a part of the deal.
791
00:36:19,554 --> 00:36:21,723
Tonight's my annual MRI.
792
00:36:21,765 --> 00:36:24,517
Make sure that my cancer
hasn't returned.
793
00:36:24,559 --> 00:36:27,729
I've been dreading it all day.
794
00:36:27,771 --> 00:36:30,732
Ben and I always made our
appointments together.
795
00:36:30,774 --> 00:36:31,900
Yeah.
796
00:36:37,739 --> 00:36:40,158
When I saw the appointment
approaching on my calendar,
797
00:36:40,200 --> 00:36:42,786
I almost texted Ben.
798
00:36:44,746 --> 00:36:46,247
I wanted to see if he wanted to keep
799
00:36:46,289 --> 00:36:49,209
the tradition alive, but...
800
00:36:49,250 --> 00:36:50,543
then I remembered...
801
00:36:53,755 --> 00:36:56,591
He's not my support system anymore.
802
00:36:58,093 --> 00:37:00,136
And I'm not his.
803
00:37:10,689 --> 00:37:12,774
Dr. Ahmad, hey.
804
00:37:13,900 --> 00:37:15,360
What's going on with that interview?
805
00:37:15,402 --> 00:37:16,778
Why?
806
00:37:16,820 --> 00:37:18,353
Did the board give you
approval to join me?
807
00:37:18,378 --> 00:37:19,739
Oh, no.
808
00:37:19,781 --> 00:37:21,282
The board would appreciate
it if the interview
809
00:37:21,324 --> 00:37:23,410
went away altogether.
810
00:37:23,451 --> 00:37:25,745
There it is, the catch.
811
00:37:25,787 --> 00:37:27,914
This issue is bigger
than just one patient.
812
00:37:27,956 --> 00:37:30,208
And the board recognizes that,
813
00:37:30,250 --> 00:37:32,669
which is why they're making
prior authorization
814
00:37:32,711 --> 00:37:35,588
a key issue in negotiations
with Berninger.
815
00:37:35,630 --> 00:37:37,048
And you trust they'll follow through?
816
00:37:37,090 --> 00:37:38,925
I'll be holding their feet to the fire.
817
00:37:40,301 --> 00:37:43,763
I agreed to serve as an advisor
on prior authorization
818
00:37:43,805 --> 00:37:47,058
for the negotiating committee.
819
00:37:47,100 --> 00:37:50,687
So am I still in the doghouse?
820
00:37:50,729 --> 00:37:52,230
Now, you went to the mat for a patient.
821
00:37:52,272 --> 00:37:54,190
Not a grudge-worthy offense in my book.
822
00:37:54,232 --> 00:37:57,193
But for what it's worth.
823
00:37:57,235 --> 00:37:58,611
Here we go.
824
00:37:58,653 --> 00:38:00,655
Look, there's a benefit
825
00:38:00,697 --> 00:38:03,366
to being taken seriously by management.
826
00:38:03,408 --> 00:38:06,244
You get invited into rooms
where you can actually have an impact.
827
00:38:06,286 --> 00:38:09,789
I'm not sure that's the kind
of impact I'm trying to make.
828
00:38:09,831 --> 00:38:11,124
I'm not saying it is.
829
00:38:11,149 --> 00:38:16,113
But maybe you want
to keep your options open.
830
00:38:17,964 --> 00:38:20,300
Thanks for the pearls, Obi-Wan.
831
00:38:20,342 --> 00:38:22,302
Oh, anytime.
832
00:38:31,144 --> 00:38:34,981
Well, today settles it.
833
00:38:35,613 --> 00:38:36,941
Joining a nunnery?
834
00:38:36,983 --> 00:38:38,902
Deleting all dating apps.
835
00:38:38,943 --> 00:38:40,403
Ah.
836
00:38:40,445 --> 00:38:42,614
Probably for the best.
837
00:38:42,655 --> 00:38:45,033
All that swiping,
head buried in your phone.
838
00:38:45,075 --> 00:38:47,160
Might get a crick in my neck.
839
00:38:47,202 --> 00:38:49,245
Might miss out
on meeting someone in the...
840
00:38:49,287 --> 00:38:50,288
what do the kids say?
841
00:38:50,330 --> 00:38:52,165
IRL?
842
00:38:52,207 --> 00:38:54,542
In real life?
843
00:38:54,584 --> 00:38:56,461
- Hmm.
- Have a good night, Asher.
844
00:39:04,052 --> 00:39:05,720
Come in.
845
00:39:07,305 --> 00:39:08,890
- Hey.
- Hey.
846
00:39:08,932 --> 00:39:10,975
I know we're supposed to be
meeting at the restaurant,
847
00:39:11,017 --> 00:39:13,186
but I thought you might need a ride.
848
00:39:13,228 --> 00:39:14,729
Close the door.
849
00:39:19,567 --> 00:39:22,696
I was just about to call you,
850
00:39:22,737 --> 00:39:24,698
because I'm gonna actually
851
00:39:24,739 --> 00:39:26,533
need a rain check tonight.
852
00:39:26,574 --> 00:39:29,244
- Oh?
- Yeah, something came up.
853
00:39:29,285 --> 00:39:31,037
This is not because of our
conversation this morning,
854
00:39:31,079 --> 00:39:33,289
- I hope?
- No, no, no, no.
855
00:39:33,331 --> 00:39:34,582
Because if it is,
I didn't mean to pressure you.
856
00:39:34,624 --> 00:39:36,209
You didn't at all.
857
00:39:36,251 --> 00:39:40,171
In fact, I think we should
start telling people.
858
00:39:40,213 --> 00:39:42,340
I'm sorry, what?
859
00:39:42,382 --> 00:39:44,342
You know,
I've always carried myself with
860
00:39:44,384 --> 00:39:47,637
a sense of propriety,
and I spend a lot of time
861
00:39:47,679 --> 00:39:50,724
encouraging my colleagues
to do the same.
862
00:39:50,765 --> 00:39:55,020
But I just think if you feel strongly
863
00:39:55,061 --> 00:39:58,440
about something in private,
864
00:39:58,481 --> 00:40:00,942
you should own it in public.
865
00:40:00,984 --> 00:40:02,569
"Strongly," you say?
866
00:40:02,610 --> 00:40:04,571
"Strongly," she said.
867
00:40:08,450 --> 00:40:11,036
You sure you don't want
to join me for dinner tonight?
868
00:40:12,954 --> 00:40:15,248
I'm suddenly very much
in the mood to celebrate.
869
00:40:15,290 --> 00:40:16,499
I can't, I can't.
870
00:40:16,541 --> 00:40:19,419
But I'll tell you what.
871
00:40:19,461 --> 00:40:22,088
If you're up late,
872
00:40:22,130 --> 00:40:25,592
I will stop by for a nightcap.
873
00:40:25,633 --> 00:40:27,761
Then I most definitely will be up late.
874
00:40:32,640 --> 00:40:34,768
I'll see you later.
875
00:40:34,809 --> 00:40:36,686
See you then.
876
00:40:48,965 --> 00:40:52,965
- Synced and corrected by synk -
- www.addic7ed.com -
62593
Can't find what you're looking for?
Get subtitles in any language from opensubtitles.com, and translate them here.