All language subtitles for Chicago Med - 09x03 - What Happens in the Dark Always Comes to Light.ETHEL.English.C.orig.Addic7ed.com

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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

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