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These are the user uploaded subtitles that are being translated: 1 00:00:01,071 --> 00:00:02,638 She still isn't answering. 2 00:00:02,663 --> 00:00:04,451 She's probably not allowed to have her phone 3 00:00:04,476 --> 00:00:05,554 at the poker table. 4 00:00:05,579 --> 00:00:07,538 She shouldn't be at the poker table at 7:00 a.m. 5 00:00:07,563 --> 00:00:09,592 She should be back with my car, so I can get to work. 6 00:00:09,617 --> 00:00:11,397 Babe, it's your day off. 7 00:00:11,422 --> 00:00:12,859 From the hospital. 8 00:00:12,884 --> 00:00:14,834 Emily knows I check on the kids at the homeless camp. 9 00:00:14,859 --> 00:00:15,984 They count on me. 10 00:00:16,009 --> 00:00:17,250 They'll understand if you're a few minutes late. 11 00:00:17,275 --> 00:00:18,297 If Emily's gonna live here, 12 00:00:18,322 --> 00:00:19,952 she needs to get her act together, make a plan. 13 00:00:19,977 --> 00:00:21,968 This isn't some vacation. 14 00:00:23,562 --> 00:00:25,511 Come on, I'll give you a ride. 15 00:00:31,220 --> 00:00:32,819 I've come to recognize 16 00:00:32,844 --> 00:00:36,312 your expressions pretty well. 17 00:00:36,337 --> 00:00:39,305 This one's my least favorite. 18 00:00:39,649 --> 00:00:41,834 I wish I had better news. 19 00:00:42,681 --> 00:00:44,180 But look... 20 00:00:44,205 --> 00:00:47,389 even though your cardiac output is decreasing, 21 00:00:47,414 --> 00:00:50,141 you are still highest status on the transplant list. 22 00:00:50,166 --> 00:00:51,265 You're first in line. 23 00:00:51,290 --> 00:00:53,657 I appreciate your optimism, 24 00:00:53,682 --> 00:00:55,473 Dr. Rhodes, 25 00:00:55,498 --> 00:00:57,141 as always. 26 00:00:57,367 --> 00:00:59,515 - Hang in there, Bob. - Uh-huh. 27 00:01:02,873 --> 00:01:04,206 You know, for my part, 28 00:01:04,231 --> 00:01:06,217 I'm just not seeing any organic causes. 29 00:01:06,242 --> 00:01:08,156 Excuse me, I... Sorry to interrupt. 30 00:01:08,181 --> 00:01:12,084 Um... Sarah, I've just been up to see your father. 31 00:01:12,109 --> 00:01:15,312 His stroke volume, systolic arterial pressure, 32 00:01:15,337 --> 00:01:18,338 and pulse pressure have all decreased since yesterday. 33 00:01:18,363 --> 00:01:21,285 I... I... I just can't keep the fluid off of his lungs. 34 00:01:21,310 --> 00:01:22,478 I see. 35 00:01:22,503 --> 00:01:25,187 I promise you, we're doing everything we can 36 00:01:25,212 --> 00:01:27,671 to find him a new heart, but... 37 00:01:28,351 --> 00:01:31,008 if you wanna say good-bye, 38 00:01:31,184 --> 00:01:33,345 I would consider doing it today. 39 00:01:33,662 --> 00:01:35,346 I'm very sorry. 40 00:01:35,919 --> 00:01:37,243 Okay. 41 00:01:43,423 --> 00:01:49,445 - Synced and corrected by martythecrazy - - www.addic7ed.com - 42 00:01:50,569 --> 00:01:52,335 - How long have you had a fever? 43 00:01:52,360 --> 00:01:54,030 A few days now. 44 00:01:54,055 --> 00:01:56,033 And are you always this short of breath? 45 00:01:56,058 --> 00:01:57,538 Lately, yeah. 46 00:01:57,563 --> 00:01:59,523 Athena, stop! 47 00:01:59,548 --> 00:02:01,455 Hey, Dr. Choi. 48 00:02:01,628 --> 00:02:03,702 Hey, Deb. Can I take a look at your legs? 49 00:02:03,727 --> 00:02:05,334 Yeah, sure. 50 00:02:06,666 --> 00:02:08,437 How long have you been getting these spots? 51 00:02:08,462 --> 00:02:10,829 - Why? Are they bad? - I'm not sure... 52 00:02:10,854 --> 00:02:12,671 but I'd like to prick your finger to check your blood. 53 00:02:12,696 --> 00:02:14,156 Okay, yeah. 54 00:02:16,351 --> 00:02:19,133 All right. 55 00:02:21,523 --> 00:02:24,123 Ethan, I know, I'm sorry, I promised I'd be home, 56 00:02:24,148 --> 00:02:25,692 but I had half the table on tilt, 57 00:02:25,717 --> 00:02:27,156 and I just lost track of time. 58 00:02:27,181 --> 00:02:29,374 Whatever. Take the car. I'll get a cab. 59 00:02:29,602 --> 00:02:31,602 I'm not gonna just leave you here. 60 00:02:31,627 --> 00:02:33,226 What can I do to help? 61 00:02:33,251 --> 00:02:35,217 I don't want your help. 62 00:02:35,260 --> 00:02:37,577 Ethan, you don't have to be like that. 63 00:02:37,714 --> 00:02:39,493 He doesn't have to be like that. 64 00:02:39,739 --> 00:02:41,625 Hi. Emily. 65 00:02:41,650 --> 00:02:43,145 - Josh. - Nice to meet you. 66 00:02:43,170 --> 00:02:45,179 - Uh, cute dog. - Thank you. 67 00:02:45,204 --> 00:02:47,306 - What kinda tent do you use? - Uh, it's an old Coleman. 68 00:02:47,331 --> 00:02:49,131 - Has a rain fly. - Nice. 69 00:02:50,140 --> 00:02:51,840 Hold on. 70 00:02:53,330 --> 00:02:56,431 Josh... I'm seeing some cells in your blood 71 00:02:56,457 --> 00:02:58,228 called lymphoblasts. 72 00:02:58,253 --> 00:03:01,260 That plus your other symptoms make me concerned enough 73 00:03:01,285 --> 00:03:03,328 that I'd like to bring you into the hospital. 74 00:03:03,353 --> 00:03:04,698 Why? What do you think it is? 75 00:03:04,723 --> 00:03:06,956 It could be all sorts of things... 76 00:03:07,093 --> 00:03:09,193 but what I'm worried about is leukemia. 77 00:03:09,297 --> 00:03:11,502 - Isn't that a kind of cancer? - It is. 78 00:03:11,527 --> 00:03:13,307 Josh, this is important. 79 00:03:13,332 --> 00:03:15,799 Look, I mean, Athena needs me out here. 80 00:03:15,824 --> 00:03:16,979 And if I go back with you, 81 00:03:17,004 --> 00:03:18,283 you're gonna have to call my parents, 82 00:03:18,308 --> 00:03:20,346 the people that adopted me, 83 00:03:20,406 --> 00:03:22,373 and I don't think I want that. 84 00:03:22,446 --> 00:03:25,313 - Did they mistreat you? - No, no, no, they're okay. 85 00:03:25,338 --> 00:03:27,166 It's just, uh... 86 00:03:27,191 --> 00:03:30,092 things didn't really work out with them, you know? 87 00:03:30,250 --> 00:03:33,094 You don't have to call his parents, right? 88 00:03:33,119 --> 00:03:34,757 Em... 89 00:03:34,787 --> 00:03:36,287 Is that true? 90 00:03:36,579 --> 00:03:38,284 You're only 16. 91 00:03:38,309 --> 00:03:40,479 Legally, they need to be notified. 92 00:03:40,597 --> 00:03:43,057 I mean, if his life is on the line, 93 00:03:43,272 --> 00:03:45,309 you could make an exception. 94 00:03:45,521 --> 00:03:47,455 I mean, if you could do that, I'm sure I could get Deb 95 00:03:47,480 --> 00:03:50,189 to watch Athena, if it's just for the afternoon. 96 00:03:50,898 --> 00:03:53,150 We could run some tests first, 97 00:03:53,175 --> 00:03:55,175 make sure we know what's going on. 98 00:03:55,208 --> 00:03:56,534 Hey, Deb, 99 00:03:56,559 --> 00:03:58,369 could I ask you a favor? 100 00:03:59,097 --> 00:04:00,926 You shouldn't have done that. 101 00:04:00,951 --> 00:04:02,712 Eventually I'm gonna have to call his parents. 102 00:04:02,737 --> 00:04:04,448 What are you busting on me for? 103 00:04:04,473 --> 00:04:06,127 Got him to come in, didn't I? 104 00:04:13,517 --> 00:04:15,150 Wow. 105 00:04:15,175 --> 00:04:17,367 One of our patients is well loved. 106 00:04:17,490 --> 00:04:19,632 Actually, they came for me. 107 00:04:20,206 --> 00:04:22,173 - Really? - Mm. 108 00:04:22,198 --> 00:04:25,182 The enchanting Dr. Bekker. 109 00:04:27,525 --> 00:04:29,024 What? 110 00:04:30,672 --> 00:04:33,273 Uh, seems they're from your father. 111 00:04:33,404 --> 00:04:35,859 - My father? - Yeah. 112 00:04:38,218 --> 00:04:41,073 Uh, you've been seeing him? 113 00:04:41,312 --> 00:04:43,012 Is, uh... is that a problem? 114 00:04:43,037 --> 00:04:44,219 No, no, it's not a problem. 115 00:04:44,244 --> 00:04:47,289 Just... uh, he's just... 116 00:04:51,102 --> 00:04:52,534 You know what, forget it. 117 00:04:52,825 --> 00:04:54,792 Enjoy the flowers. 118 00:05:05,077 --> 00:05:06,852 Are you two still at it? 119 00:05:06,877 --> 00:05:08,576 At what? 120 00:05:08,860 --> 00:05:10,414 I've barely seen you speak two words 121 00:05:10,439 --> 00:05:11,937 to each other in a week. 122 00:05:12,521 --> 00:05:14,254 Whatever this is, you need to work it out. 123 00:05:14,286 --> 00:05:16,592 - Everything's fine. - Oh, everything's fine? 124 00:05:16,617 --> 00:05:17,899 - Mm-hmm. - Good. 125 00:05:17,924 --> 00:05:19,492 Dr. Manning, Dr. Halstead, 126 00:05:19,517 --> 00:05:21,417 you're up, Treatment Four. 127 00:05:23,821 --> 00:05:25,221 - Hey. - Hey. 128 00:05:25,246 --> 00:05:27,468 Kevin Parks: He's ten years old. 129 00:05:27,493 --> 00:05:29,741 He woke up with 8 out of 10 abdominal pain 130 00:05:29,766 --> 00:05:31,180 and a fever of 103. 131 00:05:31,205 --> 00:05:32,780 We gave him Tylenol and a cool bath, 132 00:05:32,805 --> 00:05:34,539 - but nothing's worked. - Okay. 133 00:05:34,564 --> 00:05:36,897 All right, Kevin, let's get you up on the bed. 134 00:05:36,988 --> 00:05:39,356 Ow, ow. That hurts. 135 00:05:39,381 --> 00:05:41,914 - That hurts? All right. - All right, you got it. 136 00:05:41,939 --> 00:05:44,664 - We're gonna figure out why. - There you go. 137 00:05:44,969 --> 00:05:47,061 Hi, Kevin, I'm Dr. Manning. This is Dr. Halstead. 138 00:05:47,086 --> 00:05:49,309 Can you show us where it hurts? 139 00:05:49,334 --> 00:05:51,518 - Right here? - Right there? Okay. 140 00:05:51,955 --> 00:05:54,055 Has anything like this ever happened before? 141 00:05:54,080 --> 00:05:55,898 No, never. 142 00:05:56,397 --> 00:05:58,130 Abdomen is tender but not rigid, 143 00:05:58,171 --> 00:06:00,138 with no rebound. 144 00:06:00,171 --> 00:06:01,905 Bowel sounds are decreased. I don't like it. 145 00:06:01,930 --> 00:06:03,749 It could still be his appendix, Crohn's disease, 146 00:06:03,774 --> 00:06:05,584 ulcerative colitis. 147 00:06:05,609 --> 00:06:07,493 Temp's up to 104. 148 00:06:07,518 --> 00:06:10,120 Give Ibuprofen to start cooling measures. 149 00:06:10,469 --> 00:06:12,569 Is there any other medical history we should be aware of? 150 00:06:12,583 --> 00:06:15,219 Yes, he's been diagnosed with PANDAS. 151 00:06:15,244 --> 00:06:16,430 PANDAS? 152 00:06:16,455 --> 00:06:18,765 Uh, Pediatric Autoimmune Neuropsychiatric Disorder 153 00:06:18,790 --> 00:06:20,657 Associated with Streptococcal Infection. 154 00:06:20,682 --> 00:06:22,866 Kevin started getting tics and OCD 155 00:06:22,891 --> 00:06:24,875 after a strep infection two years ago. 156 00:06:24,900 --> 00:06:27,016 Nobody else could figure out what it was, 157 00:06:27,041 --> 00:06:29,414 until finally Dr. Kravitz diagnosed him. 158 00:06:29,439 --> 00:06:31,339 Okay, we'll be sure to give him a call. 159 00:06:31,364 --> 00:06:32,809 I've heard of Dr. Kravitz. 160 00:06:32,834 --> 00:06:34,561 He sees a lot of kids with PANDAS, right? 161 00:06:34,586 --> 00:06:36,367 He's one of the nation's top experts. 162 00:06:36,392 --> 00:06:37,704 I'm guessing Dr. Kravitz put Kevin 163 00:06:37,729 --> 00:06:39,718 on long-term prophylactic antibiotics 164 00:06:39,743 --> 00:06:41,008 to fight the residual strep? 165 00:06:41,033 --> 00:06:42,236 Yes, he did. 166 00:06:42,261 --> 00:06:44,242 CBC, chem panel, blood cultures, 167 00:06:44,267 --> 00:06:46,866 abdominal CT, and hang a gram of vanco STAT. 168 00:06:46,891 --> 00:06:48,760 We're gonna start him on some medications 169 00:06:48,785 --> 00:06:49,891 while we run some tests 170 00:06:49,916 --> 00:06:51,325 to try to figure out what's going on, okay? 171 00:06:51,350 --> 00:06:53,198 We'll be back to check on him shortly. 172 00:06:53,223 --> 00:06:54,656 Thank you. 173 00:06:58,405 --> 00:07:00,382 Hey, you've heard of this Dr. Kravitz. 174 00:07:00,407 --> 00:07:01,702 He labels every kid's 175 00:07:01,727 --> 00:07:03,664 neurological condition as PANDAS. 176 00:07:03,689 --> 00:07:06,289 It's not even an officially recognized diagnosis. 177 00:07:06,331 --> 00:07:07,586 Either way, right now, 178 00:07:07,611 --> 00:07:09,821 that child is in real pain with a real fever. 179 00:07:09,846 --> 00:07:12,030 Right, because he's been on three different antibiotics 180 00:07:12,055 --> 00:07:13,375 for over 12 months, 181 00:07:13,400 --> 00:07:14,742 which we both know has wiped out 182 00:07:14,767 --> 00:07:16,180 all the healthy flora in his gut, 183 00:07:16,205 --> 00:07:18,606 causing a massive superinfection. 184 00:07:18,966 --> 00:07:21,366 I mean, all because his parents shopped around for a doctor 185 00:07:21,391 --> 00:07:24,141 willing to blame Kevin's neurologic tics on strep, 186 00:07:24,166 --> 00:07:25,156 instead of admitting 187 00:07:25,181 --> 00:07:27,045 they most likely passed it on to him genetically. 188 00:07:27,070 --> 00:07:28,694 Okay, but dismissing them isn't gonna help. 189 00:07:28,719 --> 00:07:30,538 They are upset and worried. 190 00:07:30,563 --> 00:07:31,766 And what they're doing to try and fix him 191 00:07:31,798 --> 00:07:33,579 might wind up killing him. 192 00:07:33,800 --> 00:07:35,944 Dr. Sexton, Treatment Six is open. 193 00:07:35,969 --> 00:07:36,938 You're up. 194 00:07:36,963 --> 00:07:38,812 We got Frank Larson: 74. 195 00:07:38,837 --> 00:07:40,570 He was found unconscious in an abandoned warehouse. 196 00:07:40,595 --> 00:07:42,891 Bradycardic at 45, BP's 90 over 60, 197 00:07:42,916 --> 00:07:45,532 respiration's 10, and satting at 91%. 198 00:07:45,557 --> 00:07:47,342 Mr. Larson, do you know where you are? 199 00:07:48,329 --> 00:07:50,912 Let's move him on one, two, three. 200 00:07:59,512 --> 00:08:01,746 Dad? Dad, what happened? 201 00:08:01,771 --> 00:08:03,039 Is he... is he all right? 202 00:08:03,064 --> 00:08:04,148 That's what we're trying to figure out. 203 00:08:04,173 --> 00:08:06,593 Frank, can you hear me? Can you hear me Frank? 204 00:08:06,618 --> 00:08:08,297 He... he... he goes around feeding the stray cats, 205 00:08:08,322 --> 00:08:10,272 but he has dementia and he gets lost. 206 00:08:10,297 --> 00:08:11,586 Does he have any other medical conditions? 207 00:08:11,611 --> 00:08:14,210 No. You're the one examining him. 208 00:08:14,235 --> 00:08:16,679 - What do you think it could be? - It's hard to say right now. 209 00:08:16,704 --> 00:08:19,234 We need to let the doctor run some tests. 210 00:08:19,259 --> 00:08:21,584 It looks like he doesn't have any injuries, 211 00:08:21,609 --> 00:08:23,477 but yes, I would like to run some more tests 212 00:08:23,502 --> 00:08:25,374 - to figure out what's going on. - Okay. 213 00:08:25,399 --> 00:08:26,594 - Okay? - Okay. 214 00:08:26,618 --> 00:08:29,018 Dad, I'll be right here, okay? 215 00:08:29,043 --> 00:08:30,623 I'm right here. I'm not going anywhere. 216 00:08:30,648 --> 00:08:32,548 - Sorry. Big sister moment. - Yep. 217 00:08:32,573 --> 00:08:34,483 Anyway, let's get an EKG, 218 00:08:34,508 --> 00:08:36,843 CBC, chem panels, troponins, 219 00:08:36,868 --> 00:08:39,500 tox screens, and a head CT. 220 00:08:39,820 --> 00:08:41,563 We'll figure this out. 221 00:08:46,321 --> 00:08:48,488 Dr. Reese, I was just, um... 222 00:08:48,513 --> 00:08:50,523 I was just heading up to... 223 00:08:50,548 --> 00:08:52,481 To check on your dad. 224 00:08:52,517 --> 00:08:54,183 Okay. 225 00:08:56,531 --> 00:08:58,556 Listen, I, um... 226 00:08:58,980 --> 00:09:01,647 I know you've had a very complicated relationship, 227 00:09:01,672 --> 00:09:04,109 and this is really none of my business, 228 00:09:04,134 --> 00:09:08,278 but... I think that if he should die 229 00:09:08,303 --> 00:09:10,425 before you have a chance to speak to him, 230 00:09:11,006 --> 00:09:13,779 that that could very possibly be something 231 00:09:13,804 --> 00:09:15,540 you would come to regret. 232 00:09:15,565 --> 00:09:18,734 My father... has clearly stated 233 00:09:18,759 --> 00:09:21,233 that he doesn't want me to be a part of his life, 234 00:09:21,258 --> 00:09:25,594 so, uh, whatever regrets I may have... 235 00:09:26,444 --> 00:09:28,440 I just don't think any of them will be resolved 236 00:09:28,465 --> 00:09:29,727 by me talking to him. 237 00:09:29,752 --> 00:09:31,785 Okay. 238 00:09:37,347 --> 00:09:39,955 You, uh... you accepting visitors? 239 00:09:40,388 --> 00:09:42,023 It depends. 240 00:09:42,048 --> 00:09:43,981 Is it professional... 241 00:09:44,110 --> 00:09:45,776 or is it personal? 242 00:09:46,110 --> 00:09:48,781 Uh... personal? 243 00:09:48,839 --> 00:09:50,461 Then by all means. 244 00:09:52,327 --> 00:09:54,461 I, um... 245 00:09:54,817 --> 00:09:57,547 I heard about your situation. Mm. 246 00:09:57,727 --> 00:09:59,960 Really so sorry that it's come to this. 247 00:09:59,985 --> 00:10:01,766 Yeah, what can I say? 248 00:10:03,616 --> 00:10:06,835 It's been kind of a chess game between the two of us, 249 00:10:06,860 --> 00:10:08,766 hasn't it? 250 00:10:08,819 --> 00:10:10,652 I regret that you see it that way. 251 00:10:10,805 --> 00:10:12,905 Uh... uh, I would hope that you would... 252 00:10:12,930 --> 00:10:15,102 Ha. 253 00:10:15,127 --> 00:10:16,593 It's ironic. 254 00:10:18,577 --> 00:10:21,811 You made me cut Sarah out of my life 255 00:10:21,836 --> 00:10:23,679 to get a heart, 256 00:10:23,704 --> 00:10:25,686 and I end up with neither. 257 00:10:25,711 --> 00:10:28,523 Robert, it was never my intention 258 00:10:28,548 --> 00:10:30,305 to have you cut Sarah out of your life. 259 00:10:30,330 --> 00:10:32,382 Semantics. 260 00:10:32,695 --> 00:10:35,052 Uh, in any case... 261 00:10:35,497 --> 00:10:37,594 you play a good game. 262 00:10:49,853 --> 00:10:51,654 Dr. Bekker... 263 00:10:52,315 --> 00:10:55,252 - You're looking lovely. - Thank you. 264 00:10:55,376 --> 00:10:57,492 And thank you for the flowers. 265 00:10:57,517 --> 00:10:59,079 That was quite unnecessary. 266 00:10:59,104 --> 00:11:00,881 Did you like them? 267 00:11:01,115 --> 00:11:02,603 They're beautiful. 268 00:11:02,699 --> 00:11:04,505 Though, I must admit, the money would've been better spent 269 00:11:04,568 --> 00:11:07,302 as part of your donation to the department. 270 00:11:07,327 --> 00:11:09,563 Speaking of which, I glanced at that information 271 00:11:09,588 --> 00:11:11,103 you gave me concerning... 272 00:11:11,128 --> 00:11:12,757 Da Vinci robotic surgical system? 273 00:11:12,782 --> 00:11:15,024 Yes, that's, uh... It was very impressive, 274 00:11:15,049 --> 00:11:18,156 but a little technical for a layman like myself. 275 00:11:18,181 --> 00:11:20,197 Perhaps you could explain the details to me? 276 00:11:20,222 --> 00:11:22,489 - Of course. - How 'bout tonight? 277 00:11:23,991 --> 00:11:25,977 Over dinner? 278 00:11:29,492 --> 00:11:31,191 Mr. Rhodes... 279 00:11:31,239 --> 00:11:33,595 the flowers? Dinner? 280 00:11:33,620 --> 00:11:36,634 Is it me or are you trying to make your son crazy? 281 00:11:36,659 --> 00:11:39,806 Dr. Bekker... you are... 282 00:11:40,101 --> 00:11:42,202 an intelligent... 283 00:11:42,453 --> 00:11:44,853 attractive, dynamic woman, 284 00:11:45,144 --> 00:11:48,087 and if this makes Connor crazy, 285 00:11:48,112 --> 00:11:50,244 then so be it. 286 00:11:50,791 --> 00:11:54,329 Look, I and the entire cardiothoracic department 287 00:11:54,354 --> 00:11:57,040 truly appreciate your patronage, 288 00:11:57,228 --> 00:11:59,367 but you and I are going to keep our relationship 289 00:11:59,392 --> 00:12:01,471 on a professional level. 290 00:12:01,587 --> 00:12:03,969 Oh... all right. 291 00:12:03,994 --> 00:12:05,359 I'll have the head of philanthropy services 292 00:12:05,384 --> 00:12:06,884 give you a call this afternoon. 293 00:12:06,909 --> 00:12:08,375 Thank you. 294 00:12:12,270 --> 00:12:14,442 - Dr. Rhodes, Trauma Three. - Yep. 295 00:12:14,467 --> 00:12:15,583 All right, Brett, what do we got? 296 00:12:15,608 --> 00:12:17,091 David Gray: 50-year-old bystander 297 00:12:17,116 --> 00:12:18,215 in an attempted robbery. 298 00:12:18,240 --> 00:12:20,144 He got shot in the head. GCS, 6. 299 00:12:20,169 --> 00:12:21,823 He's only responding to painful stimuli. 300 00:12:21,848 --> 00:12:23,044 We couldn't intubate in the field. 301 00:12:23,069 --> 00:12:24,262 All right, give me an intubation kit. 302 00:12:24,287 --> 00:12:27,086 - 150 of mannitol, 500 of keppra. - Got it. 303 00:12:30,290 --> 00:12:32,156 All right, on my count, 304 00:12:32,181 --> 00:12:34,448 one, two, three. 305 00:12:38,333 --> 00:12:41,067 Entry wound, left parietal skull, no exit. 306 00:12:41,092 --> 00:12:42,754 Get a neurosurg down here ASAP. 307 00:12:42,779 --> 00:12:44,763 - And get me a Cordis kit. - Yep. 308 00:12:45,810 --> 00:12:48,177 There we go. 309 00:12:49,346 --> 00:12:51,396 No reactions to light. 310 00:12:54,043 --> 00:12:55,901 All right, I'm in. 311 00:12:56,637 --> 00:12:58,651 No corneal reflex either. We're losing him. 312 00:12:58,676 --> 00:13:00,655 Cordis kit. 313 00:13:01,255 --> 00:13:03,389 Brainstem reflexes are completely absent, 314 00:13:03,414 --> 00:13:05,012 and his pupils are fixed and blown. 315 00:13:05,161 --> 00:13:07,028 He was responding to pain in the ambo. 316 00:13:07,061 --> 00:13:08,670 Dr. Rhodes, he's GCS 3. 317 00:13:12,046 --> 00:13:14,637 Dr. Rhodes, he's braindead. Is he a donor? 318 00:13:18,082 --> 00:13:19,515 Yeah. 319 00:13:19,540 --> 00:13:22,378 Okay... let's get an angio to confirm brain death, 320 00:13:22,403 --> 00:13:23,714 then get a cardiac echo. 321 00:13:23,739 --> 00:13:25,519 I've got a patient who needs a heart. 322 00:13:25,544 --> 00:13:27,207 You're wasting your time on this one, Dr. Rhodes. 323 00:13:27,232 --> 00:13:29,950 I heard significant mitral regurg on auscultation. 324 00:13:29,975 --> 00:13:31,675 There's no way that heart is viable. 325 00:13:31,700 --> 00:13:34,240 Maybe not now, but that doesn't mean I can't fix it. 326 00:13:34,642 --> 00:13:36,386 Let's get him up to Radiology now. 327 00:13:44,574 --> 00:13:46,519 - A drug overdose? - Opioids. 328 00:13:46,544 --> 00:13:48,933 Your father's tox screen showed extremely high levels. 329 00:13:48,958 --> 00:13:51,153 Bolus him with 2 of narcan, then start a drip. 330 00:13:51,248 --> 00:13:53,706 It can't be. My dad doesn't do drugs. 331 00:13:53,731 --> 00:13:55,957 I mean, he... he never has. He... he doesn't even drink. 332 00:13:55,982 --> 00:13:58,971 - What about pain medication? - He doesn't take anything. 333 00:13:58,996 --> 00:14:00,848 You need to run some more tests. 334 00:14:00,873 --> 00:14:02,809 Ma'am, Dr. Sexton has run all the appropriate... 335 00:14:02,834 --> 00:14:05,894 Is there anything around the house? 336 00:14:05,919 --> 00:14:08,464 Um, Vicodin? Tylenol with codeine? 337 00:14:08,489 --> 00:14:10,133 No, I... I cleaned all the medicine cabinets out. 338 00:14:10,158 --> 00:14:11,653 We don't have anything. 339 00:14:11,678 --> 00:14:14,145 Hmm, then he may have gotten it outside the house. 340 00:14:14,170 --> 00:14:16,512 What? You think I'm letting him shoot up or something? 341 00:14:16,537 --> 00:14:18,908 - No, I'm just saying... - Look, your test is wrong. 342 00:14:18,933 --> 00:14:20,301 You need to redo it. 343 00:14:22,468 --> 00:14:24,835 These tests, they are usually pretty accurate... 344 00:14:24,860 --> 00:14:27,242 And I know my father. 345 00:14:27,685 --> 00:14:29,519 Look, if you need to consult with another doctor, 346 00:14:29,544 --> 00:14:31,481 - then maybe... - No. 347 00:14:32,271 --> 00:14:33,770 I'll redo the test. 348 00:14:33,795 --> 00:14:35,371 But in the meantime, 349 00:14:35,396 --> 00:14:36,636 I'm gonna give him some medicine 350 00:14:36,661 --> 00:14:37,949 to reverse the opioids, 351 00:14:37,996 --> 00:14:40,380 just so we can try and wake him up. 352 00:14:41,111 --> 00:14:43,712 - Okay. - Thanks. 353 00:14:43,737 --> 00:14:45,567 Administer the narcan. 354 00:14:53,540 --> 00:14:55,364 Hi. 355 00:14:55,762 --> 00:14:59,019 So, Kevin's scans indicate toxic megacolon. 356 00:14:59,128 --> 00:15:00,995 It's a dangerous intestinal infection 357 00:15:01,020 --> 00:15:03,487 caused by an overgrowth of opportunistic bacteria. 358 00:15:03,512 --> 00:15:06,387 Which is most likely due to his long-term antibiotic use. 359 00:15:06,412 --> 00:15:08,879 So the new medicine you're giving him should fix it? 360 00:15:08,990 --> 00:15:10,590 It's not that simple. 361 00:15:10,615 --> 00:15:12,715 Kevin's bowel is so inflamed, 362 00:15:12,740 --> 00:15:14,418 it's become dangerously dilated. 363 00:15:14,443 --> 00:15:16,995 And if it perforates, it's a life threatening situation, 364 00:15:17,020 --> 00:15:19,480 which is why we need to release the pressure from his colon 365 00:15:19,512 --> 00:15:21,546 to try and prevent that. 366 00:15:21,855 --> 00:15:23,488 We appreciate your help, 367 00:15:23,513 --> 00:15:25,713 but we've spoken with Dr. Kravitz, 368 00:15:25,738 --> 00:15:27,742 and he wants Kevin transferred over there. 369 00:15:27,767 --> 00:15:30,293 Dr. Kravitz says if we treat him incorrectly, 370 00:15:30,318 --> 00:15:32,701 it's only going to make Kevin's neurologic symptoms worse. 371 00:15:32,726 --> 00:15:34,581 He wants to give him an infusion of IVlg 372 00:15:34,606 --> 00:15:35,637 to prevent that. 373 00:15:35,662 --> 00:15:38,059 Kevin's tics are the least of his problems right now. 374 00:15:38,199 --> 00:15:40,433 We need to focus on treating his infection. 375 00:15:40,458 --> 00:15:41,543 We want that too, 376 00:15:41,568 --> 00:15:43,778 but Kevin's tics are a big problem. 377 00:15:44,086 --> 00:15:46,537 They're odd, and the kids at school 378 00:15:46,562 --> 00:15:48,097 are starting to stare at him. 379 00:15:48,122 --> 00:15:49,543 We just don't wanna do anything 380 00:15:49,568 --> 00:15:51,692 - to compromise his future. - I understand, but... 381 00:15:51,717 --> 00:15:53,590 We'll do the IVig here. 382 00:15:53,615 --> 00:15:55,015 Natalie... 383 00:15:55,040 --> 00:15:56,762 That would work. 384 00:15:56,787 --> 00:15:58,387 Great, we'll get started right away. 385 00:15:58,412 --> 00:16:00,377 - Thank you so much. - Yeah. 386 00:16:02,124 --> 00:16:03,623 Why are you indulging them like this? 387 00:16:03,648 --> 00:16:04,732 Indulging them? 388 00:16:04,757 --> 00:16:06,924 You know full well the IVlg 389 00:16:06,974 --> 00:16:09,199 will have exactly zero therapeutic benefit. 390 00:16:09,224 --> 00:16:10,379 It's keeping Kevin in the hospital. 391 00:16:10,404 --> 00:16:12,332 Why are you being so negative? 392 00:16:12,481 --> 00:16:13,778 I'm just being realistic. 393 00:16:13,803 --> 00:16:16,332 The more you humor then, the less likely they'll ever be 394 00:16:16,357 --> 00:16:17,923 to seek out an actual effective therapy 395 00:16:17,948 --> 00:16:20,762 for what is most likely a genetic neurologic condition. 396 00:16:20,787 --> 00:16:22,082 So what do you want me to do, Will? 397 00:16:22,107 --> 00:16:23,941 Have them sign out and leave? 398 00:16:23,966 --> 00:16:26,653 Nah, you should just give them a placebo: IVlg. 399 00:16:26,677 --> 00:16:28,410 If that's what's gonna allow us to do our job, 400 00:16:28,435 --> 00:16:30,949 then that's exactly what I'm gonna do. 401 00:16:33,504 --> 00:16:35,098 Just a little bit longer. 402 00:16:35,123 --> 00:16:36,490 I need to get back to Athena. 403 00:16:36,528 --> 00:16:38,362 I'm still waiting on a few more tests, 404 00:16:38,387 --> 00:16:40,654 so please, don't go anywhere yet. 405 00:16:48,047 --> 00:16:49,718 Dr. Charles... 406 00:16:50,407 --> 00:16:52,774 I've got a runaway kid with confirmed leukemia, 407 00:16:52,799 --> 00:16:54,041 but I can't get him to give me 408 00:16:54,066 --> 00:16:55,641 his parents' contact information, 409 00:16:55,666 --> 00:16:57,688 and Oncology won't begin treatment 410 00:16:57,713 --> 00:16:59,134 till they're sure he's not gonna be living 411 00:16:59,166 --> 00:17:00,930 in a tent on the streets during his recovery. 412 00:17:00,955 --> 00:17:03,127 Figure his parents might have abused him? 413 00:17:03,298 --> 00:17:04,730 Apparently not. 414 00:17:04,755 --> 00:17:06,580 He's adopted, but he says they're nice people. 415 00:17:06,605 --> 00:17:08,127 It just wasn't a good fit. 416 00:17:08,152 --> 00:17:10,345 And you're sure he understands the danger here? 417 00:17:10,370 --> 00:17:12,729 Cancer? Life or death? 418 00:17:13,080 --> 00:17:16,035 Says he does, but I don't know. 419 00:17:16,175 --> 00:17:18,965 - Let me have a chat with him. - Thanks. 420 00:17:22,125 --> 00:17:24,024 There's too much retrograde flow. 421 00:17:24,049 --> 00:17:26,283 The leaflet's totally eaten away. 422 00:17:26,692 --> 00:17:28,676 Shame to have an otherwise perfectly good heart 423 00:17:28,701 --> 00:17:29,766 go to waste. 424 00:17:29,791 --> 00:17:31,517 It's not gonna go to waste. 425 00:17:31,591 --> 00:17:32,838 Excuse me? 426 00:17:32,863 --> 00:17:36,259 This heart is an HLA match for my patient. 427 00:17:36,364 --> 00:17:37,933 I'm gonna do a valve repair. 428 00:17:37,958 --> 00:17:39,400 You're joking. 429 00:17:39,652 --> 00:17:41,977 Get him prepped for surgery, thanks. 430 00:17:45,342 --> 00:17:48,744 You're going to do major surgery on this heart, 431 00:17:48,768 --> 00:17:50,609 which by itself contains significant morbidity 432 00:17:50,635 --> 00:17:52,579 and mortality, and then turn around 433 00:17:52,604 --> 00:17:54,064 and transplant it into someone else? 434 00:17:54,089 --> 00:17:55,574 Uh-huh. 435 00:17:55,599 --> 00:17:57,733 You'll kill the recipient on the table. 436 00:17:57,958 --> 00:17:59,621 So don't scrub in. 437 00:17:59,730 --> 00:18:01,430 I'm sure with your active social life, 438 00:18:01,455 --> 00:18:03,213 there are things you'd rather be doing anyways. 439 00:18:03,238 --> 00:18:04,538 Now, if you will excuse me, 440 00:18:04,563 --> 00:18:08,004 I am going to prep for my valve repair. 441 00:18:15,587 --> 00:18:17,203 Ms. Larson... 442 00:18:17,228 --> 00:18:20,884 the retests once again show high levels of opioids. 443 00:18:20,986 --> 00:18:22,330 I'm sorry. 444 00:18:22,355 --> 00:18:23,782 Well, then why isn't he waking up? 445 00:18:23,807 --> 00:18:25,556 Should we be doing something else? 446 00:18:25,581 --> 00:18:27,766 Well, with overdoses that large, it can sometimes... 447 00:18:27,791 --> 00:18:29,234 Dr. Sexton... 448 00:18:34,183 --> 00:18:36,216 Okay, um, we need to step out. 449 00:18:36,241 --> 00:18:37,354 Let's clear the room. 450 00:18:37,522 --> 00:18:39,604 - Wha... what's going on? - Step out. 451 00:18:39,936 --> 00:18:41,936 That white powder on his jacket, 452 00:18:42,291 --> 00:18:44,205 I'm guessing that's fentanyl. 453 00:18:44,230 --> 00:18:45,971 - What's that? - A synthetic opiate. 454 00:18:45,996 --> 00:18:48,101 Now, he could have either inhaled it 455 00:18:48,126 --> 00:18:49,914 or even just touched it, 456 00:18:49,939 --> 00:18:51,752 but it's 100 times stronger than heroin. 457 00:18:51,777 --> 00:18:54,196 That could explain why the narcan's moving so slow. 458 00:18:54,221 --> 00:18:55,580 But how did he get it? 459 00:18:55,605 --> 00:18:57,064 They smuggle it in from China 460 00:18:57,096 --> 00:18:58,299 and cut it in abandoned buildings. 461 00:18:58,324 --> 00:19:00,091 All your dad had to do was brush up against some 462 00:19:00,116 --> 00:19:01,649 while he was feeding stray cats. 463 00:19:01,674 --> 00:19:03,258 We're notifying CPD, CFD, 464 00:19:03,283 --> 00:19:04,729 anyone who might've come in contact, 465 00:19:04,754 --> 00:19:07,728 Now, um, you have to test it, but I think we have fentanyl. 466 00:19:07,869 --> 00:19:09,584 Okay, I'll set up the decon protocol 467 00:19:09,609 --> 00:19:11,013 out in the ambulance bay, and I'll call Goodwin. 468 00:19:11,038 --> 00:19:12,018 - Doris, door. - Okay, got it. 469 00:19:12,043 --> 00:19:14,127 We will get you back in the room, but please come. 470 00:19:35,652 --> 00:19:37,385 You gotta strip. 471 00:19:37,410 --> 00:19:39,795 I feel fine. Come on, Maggie. 472 00:19:39,820 --> 00:19:41,211 You come on. 473 00:19:41,236 --> 00:19:42,904 Even absorbed through the skin, fentanyl can cause 474 00:19:42,929 --> 00:19:45,491 mental status changes and respiratory distress. 475 00:19:45,516 --> 00:19:47,936 - Strip. - She's right, Cesar. 476 00:19:47,961 --> 00:19:49,814 Go get some clean clothes. 477 00:19:50,516 --> 00:19:52,617 I don't like this at all, Maggie. 478 00:19:52,642 --> 00:19:55,936 We got too many sick people in here to take any chances. 479 00:19:55,961 --> 00:19:58,687 We need to scrub down the back half of the ED, 480 00:19:58,712 --> 00:20:01,233 and put us on bypass until we get the go-ahead 481 00:20:01,258 --> 00:20:03,085 from the decontamination team. 482 00:20:03,110 --> 00:20:04,702 - Yes, ma'am. - All right. 483 00:20:10,479 --> 00:20:11,812 All finished. 484 00:20:11,837 --> 00:20:13,633 You okay, Kevin? 485 00:20:13,776 --> 00:20:15,242 Can I have a word? 486 00:20:20,070 --> 00:20:23,456 Kevin's latest scans show increasing edema 487 00:20:23,481 --> 00:20:24,990 across the wall of his bowel, 488 00:20:25,015 --> 00:20:26,889 indicating lack of blood flow. 489 00:20:26,914 --> 00:20:29,663 At this point, we need to consider surgical resection. 490 00:20:29,688 --> 00:20:30,460 Surgery? 491 00:20:30,485 --> 00:20:31,937 Shouldn't we finish the IVig first 492 00:20:31,962 --> 00:20:33,404 to see if it helps? 493 00:20:33,431 --> 00:20:34,577 He can keep getting it, 494 00:20:34,602 --> 00:20:36,318 but we really need to move him upstairs. 495 00:20:36,343 --> 00:20:37,851 We need to call Dr. Kravitz. 496 00:20:37,876 --> 00:20:40,502 Mr. and Mrs. Parks, your son is running out of time. 497 00:20:40,527 --> 00:20:42,014 My wife works tirelessly 498 00:20:42,039 --> 00:20:43,679 to try to fix our son's problems, 499 00:20:43,704 --> 00:20:45,871 and if she has any hesitation at all, 500 00:20:45,896 --> 00:20:47,499 then we need to listen to her. 501 00:20:47,524 --> 00:20:48,964 How 'bout I call Dr. Kravitz 502 00:20:48,989 --> 00:20:50,570 and explain the situation to him, okay? 503 00:20:50,595 --> 00:20:52,866 - Could you do that? - Of course. 504 00:20:52,891 --> 00:20:55,922 - Is there a bathroom nearby? - Right down the hall. 505 00:20:57,374 --> 00:20:59,180 So, you're just gonna keep encouraging them 506 00:20:59,205 --> 00:21:00,491 to follow this quack? 507 00:21:00,516 --> 00:21:02,929 Now is not the time to start an argument with them. 508 00:21:03,480 --> 00:21:05,598 You know, it must be nice always being right. 509 00:21:05,623 --> 00:21:07,016 Sorry? 510 00:21:07,041 --> 00:21:08,679 From the moment we started this case, 511 00:21:08,704 --> 00:21:10,770 everything's been your way. 512 00:21:10,804 --> 00:21:12,748 "We can't do this, we have to do that." 513 00:21:12,773 --> 00:21:14,179 What are you talking about? 514 00:21:14,204 --> 00:21:16,483 I'm talking about everything always being done your way: 515 00:21:16,508 --> 00:21:17,554 how we treat patients, 516 00:21:17,579 --> 00:21:19,070 what we can or can't tell them... 517 00:21:19,095 --> 00:21:19,898 What? 518 00:21:19,923 --> 00:21:21,562 Whether you and I are together or split up 519 00:21:21,587 --> 00:21:22,453 or on a break. 520 00:21:22,478 --> 00:21:24,518 Is that what this is about? You and me? 521 00:21:24,543 --> 00:21:25,865 Because it definitely wasn't my idea 522 00:21:25,890 --> 00:21:27,929 to go hook up with some woman in a bar. 523 00:21:27,954 --> 00:21:29,998 I told you, it went nowhere. 524 00:21:30,023 --> 00:21:31,437 Oh, and that's supposed to make me feel better? 525 00:21:31,462 --> 00:21:32,628 I made a mistake. 526 00:21:32,653 --> 00:21:34,627 I'm not perfect. 527 00:21:34,652 --> 00:21:36,618 But at least I admit it. 528 00:21:36,865 --> 00:21:38,740 I don't think I'm perfect. 529 00:21:38,765 --> 00:21:40,928 Okay, all I can say, Natalie, is that it's very hard 530 00:21:40,953 --> 00:21:43,327 for us mere mortals to measure up to you. 531 00:21:47,680 --> 00:21:50,433 Thanks, Officer Burgess, I appreciate your help. 532 00:21:50,730 --> 00:21:52,196 What are you still doing here? 533 00:21:52,221 --> 00:21:53,748 I wanted to see how Josh is doing. 534 00:21:53,773 --> 00:21:55,039 He's not letting us treat him. 535 00:21:55,064 --> 00:21:56,731 Luckily, PD's got a lead on his parents. 536 00:21:56,808 --> 00:21:58,908 Wait, you said you weren't going to call his parents. 537 00:21:58,933 --> 00:22:00,765 I said I'd end up calling them eventually. 538 00:22:00,790 --> 00:22:01,999 Yeah, but you don't have to. 539 00:22:02,024 --> 00:22:03,039 I mean, there are other ways to do this. 540 00:22:03,064 --> 00:22:04,576 This is what Josh needs to stay alive. 541 00:22:04,601 --> 00:22:06,162 You don't know what Josh needs. 542 00:22:06,187 --> 00:22:08,562 And you do? 543 00:22:08,587 --> 00:22:10,663 Look, you're not adopted. 544 00:22:11,087 --> 00:22:13,040 You don't know what it's like. 545 00:22:13,832 --> 00:22:16,295 Josh needs a bone marrow transplant, 546 00:22:16,320 --> 00:22:18,412 and he won't get it if he's living on the streets. 547 00:22:18,437 --> 00:22:20,633 So you're just gonna do whatever you want? 548 00:22:21,015 --> 00:22:23,412 Yeah, because you always know better than everyone. 549 00:22:23,437 --> 00:22:24,867 No, I don't, 550 00:22:24,892 --> 00:22:26,406 but I do know that when his immune system 551 00:22:26,431 --> 00:22:28,721 is obliterated by chemo, he's gonna need to recover 552 00:22:28,746 --> 00:22:30,279 in a stable, clean environment, 553 00:22:30,304 --> 00:22:32,382 and if you're too irresponsible to understand that, 554 00:22:32,407 --> 00:22:34,979 then stay out of my way. 555 00:22:47,185 --> 00:22:49,020 Mrs. Parks? 556 00:22:49,045 --> 00:22:51,913 I'm sorry, I was just finishing up. 557 00:22:53,167 --> 00:22:55,333 Are you all right? 558 00:22:58,770 --> 00:23:01,856 I'm just stressed. 559 00:23:02,228 --> 00:23:04,528 - Does that help? - What? 560 00:23:04,812 --> 00:23:06,245 The handwashing. 561 00:23:10,382 --> 00:23:12,516 It used to... 562 00:23:12,633 --> 00:23:14,602 in high school, 563 00:23:14,909 --> 00:23:18,314 but I stopped for a long time, till Kevin got sick. 564 00:23:18,972 --> 00:23:21,255 Having a child with uncontrollable tics 565 00:23:21,280 --> 00:23:23,152 must be so stressful. 566 00:23:23,177 --> 00:23:24,977 That's why we've seen so many doctors. 567 00:23:25,002 --> 00:23:28,170 My husband likes answers. 568 00:23:28,272 --> 00:23:30,034 Does he know about this? 569 00:23:30,431 --> 00:23:32,398 He's already got enough that he didn't sign up for. 570 00:23:32,423 --> 00:23:33,823 What would be the point? 571 00:23:33,848 --> 00:23:36,481 It might help you and Kevin. 572 00:23:36,506 --> 00:23:38,340 I don't see how. 573 00:23:38,365 --> 00:23:41,511 Kathy, you have OCD, like Kevin, 574 00:23:41,536 --> 00:23:43,982 and it's not caused by any bacterial infection. 575 00:23:44,007 --> 00:23:45,013 It's genetic, 576 00:23:45,038 --> 00:23:48,052 something a child inherits from the parents. 577 00:23:49,608 --> 00:23:52,014 I appreciate your concern, 578 00:23:52,039 --> 00:23:53,641 but please, 579 00:23:53,730 --> 00:23:55,663 just take care of Kevin's intestines. 580 00:23:55,688 --> 00:23:57,154 I'll worry about the rest. 581 00:24:13,170 --> 00:24:15,191 Excuse me, are you all right? 582 00:24:15,396 --> 00:24:17,363 Um, sorry, I'm... I'm fine. 583 00:24:17,388 --> 00:24:18,933 I'm Dr. Reese from Psychiatry. 584 00:24:18,958 --> 00:24:20,300 Can I help? 585 00:24:20,325 --> 00:24:22,036 Uh... 586 00:24:22,061 --> 00:24:25,214 my dad ran into some trouble today. 587 00:24:25,643 --> 00:24:27,419 He has dementia. 588 00:24:27,444 --> 00:24:31,095 Oh, I'm sorry. I know that's really hard. 589 00:24:33,661 --> 00:24:35,808 It's completely normal 590 00:24:35,833 --> 00:24:37,726 to feel overwhelmed. 591 00:24:38,372 --> 00:24:41,063 It's like he's a different person. 592 00:24:43,416 --> 00:24:46,319 And sometimes, I wonder if maybe... 593 00:24:49,552 --> 00:24:52,024 If maybe it would be better if he... 594 00:24:53,972 --> 00:24:56,455 Does that make me a horrible person? 595 00:24:57,104 --> 00:24:58,745 No. 596 00:24:58,817 --> 00:25:00,717 No, it doesn't make you horrible. 597 00:25:00,742 --> 00:25:03,567 Almost anyone in your position would have these thoughts. 598 00:25:14,552 --> 00:25:16,654 Talked to your patient. Nice kid. 599 00:25:16,679 --> 00:25:18,457 Is he still insisting on 600 00:25:18,482 --> 00:25:20,231 going back to the homeless encampment? 601 00:25:20,256 --> 00:25:21,865 He feels pretty strongly about it. 602 00:25:21,890 --> 00:25:23,083 Is he suicidal? 603 00:25:23,108 --> 00:25:25,242 Nope, he definitely seems to wanna live. 604 00:25:25,267 --> 00:25:27,465 Then he shouldn't object so much to me calling his parents. 605 00:25:27,490 --> 00:25:29,388 I need to spend a little more time with him, 606 00:25:29,425 --> 00:25:30,380 but off the top of my head, 607 00:25:30,405 --> 00:25:32,449 I'd say that Josh is dealing with 608 00:25:32,474 --> 00:25:35,052 a classic case of attachment disorder. 609 00:25:35,077 --> 00:25:37,287 Does that explain why he'd rather risk his life 610 00:25:37,312 --> 00:25:38,888 than live with his parents for a couple of months? 611 00:25:38,913 --> 00:25:40,302 I know it seems bizarre, 612 00:25:40,327 --> 00:25:41,960 but those two years that he was at the orphanage, 613 00:25:41,985 --> 00:25:43,318 it's that critical period 614 00:25:43,343 --> 00:25:46,575 when babies need parental affection the most. 615 00:25:46,600 --> 00:25:48,380 And if they're in a facility where they don't get it, 616 00:25:48,405 --> 00:25:50,825 their brains actually become wired differently, 617 00:25:51,068 --> 00:25:54,144 leaving them poorly adapted to cope with the complexities 618 00:25:54,169 --> 00:25:56,716 of giving and receiving love, 619 00:25:56,741 --> 00:25:59,041 I mean, sometimes for the rest of their lives. 620 00:26:00,095 --> 00:26:02,296 I hear what you're saying, Dr. Charles... 621 00:26:03,567 --> 00:26:05,066 But Josh has his whole life 622 00:26:05,091 --> 00:26:07,391 to live as far from his parents as he wants, 623 00:26:07,416 --> 00:26:09,483 if we treat his cancer. 624 00:26:13,052 --> 00:26:15,724 - Scissors to Dr. Bekker. - Scissors. 625 00:26:15,758 --> 00:26:19,637 So, what's the story with you and my friend with the flowers? 626 00:26:19,662 --> 00:26:22,200 I'm definitely picking up on some rancor. 627 00:26:22,225 --> 00:26:24,750 How do I put this? Uh... 628 00:26:25,234 --> 00:26:28,420 my father and I have always had an... 629 00:26:28,693 --> 00:26:30,989 - unhealthy competition. - Competition? 630 00:26:31,014 --> 00:26:32,781 You're a cardiothoracic surgeon. 631 00:26:32,806 --> 00:26:34,700 What is there to compete over? 632 00:26:34,725 --> 00:26:37,160 Well... next time you two get together, 633 00:26:37,185 --> 00:26:39,059 you can ask him about it. 634 00:26:39,084 --> 00:26:40,724 Snip. 635 00:26:41,972 --> 00:26:44,854 Let's take him off pump. Paddles. 636 00:26:48,023 --> 00:26:50,440 And clear. 637 00:26:53,124 --> 00:26:55,018 No retrograde flow. 638 00:26:55,043 --> 00:26:57,330 Congratulations, we have a working valve. 639 00:26:57,411 --> 00:26:58,944 I'm gonna go let my patient know 640 00:26:58,969 --> 00:27:00,969 that he's about to get a new heart. 641 00:27:03,864 --> 00:27:06,098 Okay, I'll let her know. 642 00:27:08,330 --> 00:27:09,586 - Sharon? - Yeah? 643 00:27:09,611 --> 00:27:11,077 That was Peter Kalmick. 644 00:27:11,276 --> 00:27:12,743 Apparently the board 645 00:27:12,768 --> 00:27:14,334 is refusing to let us go on bypass. 646 00:27:14,359 --> 00:27:16,392 They're overriding my decision? 647 00:27:16,481 --> 00:27:18,181 They didn't find sufficient reason 648 00:27:18,206 --> 00:27:19,627 to take such drastic action. 649 00:27:19,652 --> 00:27:21,797 There were enough opioids on that man's coat 650 00:27:21,822 --> 00:27:24,268 - to drop a herd of elephants. - Yep. 651 00:27:24,434 --> 00:27:26,343 You keep us on bypass. 652 00:27:26,375 --> 00:27:29,042 - I'll deal with the board. - I got you. 653 00:27:30,393 --> 00:27:32,426 Mr. and Mrs. Logan? 654 00:27:33,667 --> 00:27:36,401 I'm Dr. Choi. I've been taking care of Josh. 655 00:27:36,426 --> 00:27:38,221 Thank you so much for contacting us. 656 00:27:38,246 --> 00:27:39,955 Of course. Please. 657 00:27:39,980 --> 00:27:42,649 Uh, he's run away before, but he'd always come back, 658 00:27:42,674 --> 00:27:44,088 and then this time... 659 00:27:44,113 --> 00:27:45,618 We contacted the police. 660 00:27:45,643 --> 00:27:47,518 We tried every way we could to find him. 661 00:27:47,543 --> 00:27:49,572 I do have to warn you, 662 00:27:49,762 --> 00:27:52,296 calling you was my idea, not his, 663 00:27:52,321 --> 00:27:54,118 but he's very ill and he needs help, 664 00:27:54,143 --> 00:27:56,444 so please, no matter how this goes, 665 00:27:56,469 --> 00:27:59,033 try to understand and be patient. 666 00:27:59,058 --> 00:28:00,628 Of course. 667 00:28:00,653 --> 00:28:02,932 He's right over here. 668 00:28:07,157 --> 00:28:08,771 April... 669 00:28:08,796 --> 00:28:11,129 my patient in Two didn't go for anymore tests, did he? 670 00:28:13,761 --> 00:28:15,653 Doesn't look like it. 671 00:28:16,081 --> 00:28:18,369 I'm sorry. Just give me a minute. 672 00:28:22,955 --> 00:28:25,079 Leah, did you see my patient? 673 00:28:25,104 --> 00:28:26,735 16-year-old boy, tall, brown hair? 674 00:28:26,760 --> 00:28:27,917 Yeah, I think so. 675 00:28:27,942 --> 00:28:30,760 Left with a young woman about 20 minutes ago. 676 00:28:38,603 --> 00:28:41,271 Now, this shows distribution of aggregate hospital costs 677 00:28:41,296 --> 00:28:43,889 and stays by payer for our last fiscal year. 678 00:28:43,914 --> 00:28:45,421 Excuse me... 679 00:28:45,884 --> 00:28:47,914 I'm sorry to interrupt. 680 00:28:47,939 --> 00:28:49,484 Ms. Goodwin. 681 00:28:49,681 --> 00:28:52,913 As Executive Director of Patient and Medical Services, 682 00:28:52,938 --> 00:28:55,461 the safety of our staff and patients 683 00:28:55,486 --> 00:28:57,653 is my responsibility. 684 00:28:57,839 --> 00:29:00,554 There are few substances 685 00:29:00,579 --> 00:29:04,593 more dangerous and terrifying than fentanyl. 686 00:29:04,737 --> 00:29:06,741 Even a minute amount inhaled 687 00:29:06,766 --> 00:29:09,132 or absorbed through the skin 688 00:29:09,157 --> 00:29:11,576 can cause an overdose and even death, 689 00:29:11,601 --> 00:29:14,164 and while I understand going on bypass 690 00:29:14,189 --> 00:29:16,689 costs this hospital money, 691 00:29:16,714 --> 00:29:20,367 if just one person goes into respiratory failure 692 00:29:20,392 --> 00:29:22,859 from coming in contact with this drug, 693 00:29:22,884 --> 00:29:24,515 I guarantee... 694 00:29:24,540 --> 00:29:27,541 that the damage to this hospital's reputation 695 00:29:27,566 --> 00:29:29,977 will be far costlier. 696 00:29:30,138 --> 00:29:32,887 So, I'm sure you'll all agree 697 00:29:32,912 --> 00:29:35,639 that keeping us on bypass 698 00:29:35,664 --> 00:29:38,850 is medically and fiscally 699 00:29:38,875 --> 00:29:40,908 the best course of action. 700 00:29:40,933 --> 00:29:42,466 Well... 701 00:29:42,491 --> 00:29:44,291 since you put it like that... 702 00:29:44,316 --> 00:29:45,784 Thank you. 703 00:29:45,809 --> 00:29:47,319 I'll be in my office 704 00:29:47,344 --> 00:29:49,537 if anyone has anymore questions. 705 00:29:55,636 --> 00:29:57,006 Sharon... 706 00:29:58,468 --> 00:29:59,663 You shouldn't have done that. 707 00:29:59,688 --> 00:30:01,451 I don't see that I had a choice. 708 00:30:01,476 --> 00:30:03,663 Listen, I'm up here with them, okay? 709 00:30:03,688 --> 00:30:05,225 I hear which way the wind is blowing, 710 00:30:05,249 --> 00:30:06,582 and lately, the board feels 711 00:30:06,607 --> 00:30:08,123 that you are not making decisions 712 00:30:08,148 --> 00:30:10,326 that are aligned with this hospital's interests. 713 00:30:10,351 --> 00:30:12,051 Well, I'm sorry, Peter, 714 00:30:12,076 --> 00:30:15,350 but I thought this hospital's foremost interest 715 00:30:15,375 --> 00:30:17,232 was in treatment of patients. 716 00:30:17,257 --> 00:30:19,464 You're not hearing me, and you keep taking 717 00:30:19,489 --> 00:30:22,279 an adversarial position vis-à-vis the board 718 00:30:22,304 --> 00:30:24,114 and they will fire you. 719 00:30:34,217 --> 00:30:37,086 Hey, Dad. 720 00:30:37,111 --> 00:30:38,962 Sarah... 721 00:30:39,335 --> 00:30:41,342 So nice of you to come. 722 00:30:41,367 --> 00:30:44,401 I just wanted to, um, see how you're doing. 723 00:30:44,426 --> 00:30:46,136 Did you? 724 00:30:46,575 --> 00:30:49,412 - No ulterior motive? - What? 725 00:30:49,591 --> 00:30:52,740 Sure you didn't come here to make yourself feel better 726 00:30:52,765 --> 00:30:55,270 by doing the right thing? 727 00:30:55,588 --> 00:30:57,826 That this visit isn't all about you? 728 00:30:57,851 --> 00:30:58,967 Dad, n... 729 00:30:58,992 --> 00:31:01,300 Maybe I'm not the only one 730 00:31:01,325 --> 00:31:03,325 with personality disorder. 731 00:31:03,350 --> 00:31:05,286 Are you serious? 732 00:31:05,311 --> 00:31:08,645 Oh, don't be so sensitive. 733 00:31:08,670 --> 00:31:10,337 Come now. 734 00:31:10,629 --> 00:31:12,498 Let's see what I can do 735 00:31:12,523 --> 00:31:14,722 to leave you with a good memory. 736 00:31:14,747 --> 00:31:16,225 Okay, this was clearly a mistake. 737 00:31:16,250 --> 00:31:19,006 Should we sit and reminisce? 738 00:31:19,031 --> 00:31:21,750 Perhaps order some hot cocoa? 739 00:31:21,775 --> 00:31:23,225 Goodbye, Dad. 740 00:31:23,250 --> 00:31:24,717 No, stay. 741 00:31:24,742 --> 00:31:26,210 Let's focus... 742 00:31:26,235 --> 00:31:28,388 on getting you some closure. 743 00:31:32,730 --> 00:31:34,607 I found your dad a heart. 744 00:31:37,214 --> 00:31:38,747 Thank you. 745 00:31:38,772 --> 00:31:41,732 We're gonna take him to do the transplant now. 746 00:31:53,122 --> 00:31:56,123 - Dr. Choi? - Please wait here a second. 747 00:31:58,538 --> 00:31:59,756 What do you think you're doing? 748 00:31:59,781 --> 00:32:01,420 He wanted to come back to Athena, 749 00:32:01,445 --> 00:32:03,256 - so I called us an Uber. - Emma, I get it. 750 00:32:03,281 --> 00:32:05,296 He needs his dog, and I don't wanna take that for him, 751 00:32:05,321 --> 00:32:06,803 but right now, he needs our help even more. 752 00:32:06,828 --> 00:32:09,100 - This isn't a game. - Like I don't know that? 753 00:32:09,125 --> 00:32:11,558 But you don't understand him. I do. 754 00:32:11,583 --> 00:32:13,557 I've been there. 755 00:32:13,733 --> 00:32:16,018 What do you mean? You've been homeless? 756 00:32:16,474 --> 00:32:18,228 Yeah. 757 00:32:18,517 --> 00:32:19,990 But that's not important. 758 00:32:20,015 --> 00:32:21,904 What matters is that this dog 759 00:32:21,929 --> 00:32:24,830 is the only thing in the world Josh can relate to. 760 00:32:24,855 --> 00:32:26,355 I think he needs her so much 761 00:32:26,380 --> 00:32:28,217 that if he had to go on without her, 762 00:32:28,242 --> 00:32:30,491 he'd rather die. 763 00:32:31,121 --> 00:32:32,826 All right. 764 00:32:33,693 --> 00:32:36,594 Tell Josh to pack his clothes, and we'll take the dog with us. 765 00:32:43,881 --> 00:32:45,857 H... help! Somebody! 766 00:32:45,882 --> 00:32:47,848 Uh, wh... wh... what's going on? 767 00:32:47,873 --> 00:32:49,510 Wh... what's happening? 768 00:32:52,437 --> 00:32:54,437 His lungs are full of fluid. He must've been coming to 769 00:32:54,463 --> 00:32:56,431 and inhaled against his glottis. 770 00:32:56,456 --> 00:32:58,394 Sats down to 83. 771 00:32:59,153 --> 00:33:00,562 He lost his IV. 772 00:33:01,074 --> 00:33:02,640 Uh, do something! Save him! 773 00:33:02,665 --> 00:33:05,111 Just so you understand, with the lack of oxygen, 774 00:33:05,136 --> 00:33:06,869 there's no guarantee that he won't have 775 00:33:06,894 --> 00:33:08,697 new physical or neurological deficits. 776 00:33:08,722 --> 00:33:10,321 Just save him, please. 777 00:33:10,346 --> 00:33:11,837 Do you understand what Dr. Sexton is saying? 778 00:33:11,862 --> 00:33:14,156 He's my father. Please, don't let him die. 779 00:33:14,181 --> 00:33:16,868 Okay, give 20 of Lasix, 20 of etomidate, 50 of sux. 780 00:33:16,893 --> 00:33:19,400 Open an intubation kit and a central line kit, now. 781 00:33:19,425 --> 00:33:20,868 - Can you intubate? - Yeah. 782 00:33:23,416 --> 00:33:24,673 Sats at 65. 783 00:33:26,776 --> 00:33:28,751 He's in PEA. Bag him. 784 00:33:28,776 --> 00:33:31,266 Give me a milligram of epinephrine. I'll start CPR. 785 00:33:35,026 --> 00:33:37,048 Epinephrine's in. 786 00:33:37,073 --> 00:33:39,079 He's still in PEA. Another milligram. 787 00:33:42,563 --> 00:33:45,555 - Second milligram in. - Come on, Dad. 788 00:33:45,580 --> 00:33:47,399 Still in PEA. Another milligram. 789 00:33:49,712 --> 00:33:51,462 Third milligram's in. 790 00:33:56,918 --> 00:34:00,053 What? No. No, no, no, no. 791 00:34:00,078 --> 00:34:01,696 I'm sorry. 792 00:34:01,721 --> 00:34:03,420 Daddy! 793 00:34:05,237 --> 00:34:07,337 Time of death, 17:13. 794 00:34:14,807 --> 00:34:16,947 I'm sorry. 795 00:34:32,515 --> 00:34:34,680 His abdomen's more distended, 796 00:34:34,705 --> 00:34:36,485 and his pain is getting worse. 797 00:34:36,510 --> 00:34:38,949 Like I was saying, we need to take him up to surgery. 798 00:34:38,974 --> 00:34:40,748 Dale, maybe we should let them. 799 00:34:40,773 --> 00:34:42,540 Are you sure that that's necessary? 800 00:34:42,565 --> 00:34:44,251 Did you even talk to Dr. Kravitz? 801 00:34:44,276 --> 00:34:47,508 He says that general anesthesia will exacerbate Kevin's PANDAS. 802 00:34:47,533 --> 00:34:48,650 You're not hearing me. 803 00:34:48,675 --> 00:34:50,798 At the moment, that is not our biggest concern. 804 00:34:50,823 --> 00:34:52,954 - But Dr. Kravitz says... - Forget about Dr. Kravitz. 805 00:34:52,979 --> 00:34:55,135 Kevin doesn't have PANDAS. 806 00:34:56,139 --> 00:34:58,138 His tics are from me. 807 00:34:59,252 --> 00:35:01,308 What are you talking about? 808 00:35:01,589 --> 00:35:03,423 He has OCD. 809 00:35:03,721 --> 00:35:06,271 It's not from step; it's genetic. 810 00:35:06,913 --> 00:35:09,775 He inherited it from me. 811 00:35:10,384 --> 00:35:12,717 It's a far more likely explanation. 812 00:35:12,742 --> 00:35:15,376 So the antibiotics, the... all of it... 813 00:35:15,401 --> 00:35:17,079 He never needed them. 814 00:35:17,104 --> 00:35:18,670 It's... it's my fault. 815 00:35:18,695 --> 00:35:20,410 All my fault. 816 00:35:21,295 --> 00:35:24,040 Why didn't you tell me you had OCD? 817 00:35:24,065 --> 00:35:26,365 I thought if you knew something was wrong with me, 818 00:35:26,390 --> 00:35:28,210 you wouldn't love me. 819 00:35:32,699 --> 00:35:34,800 Do the surgery. 820 00:35:34,825 --> 00:35:37,594 Dale, wait... 821 00:35:38,035 --> 00:35:40,063 We'll get Kevin ready to go upstairs. 822 00:35:57,704 --> 00:36:01,006 His temperature is 99.6. 823 00:36:01,313 --> 00:36:03,549 It could signal the onset of infection, 824 00:36:03,574 --> 00:36:05,374 which would be a contraindication 825 00:36:05,399 --> 00:36:06,694 for performing the transplant. 826 00:36:06,719 --> 00:36:09,292 He won't get the heart? 827 00:36:09,317 --> 00:36:11,294 No, I'm sorry. 828 00:36:19,007 --> 00:36:20,940 He always runs warm. 829 00:36:22,455 --> 00:36:24,766 - What? - My dad, um... 830 00:36:24,791 --> 00:36:27,091 his temperature always runs high. 831 00:36:27,116 --> 00:36:28,147 It's normal for him, 832 00:36:28,172 --> 00:36:30,381 which would mean that this isn't an infection. 833 00:36:30,406 --> 00:36:32,273 You're sure? Because if that's the case, 834 00:36:32,298 --> 00:36:34,748 then he could still get the heart. 835 00:36:35,065 --> 00:36:37,866 Yes, I'm sure he's fine. 836 00:36:37,891 --> 00:36:40,162 Let's get Dr. Haywood up to the O.R. 837 00:36:40,187 --> 00:36:42,254 Yes, sir. 838 00:36:59,258 --> 00:37:00,824 All right. 839 00:37:01,445 --> 00:37:03,597 Ejection fraction looks good. 840 00:37:03,622 --> 00:37:05,850 Normal rate and rhythm. 841 00:37:06,780 --> 00:37:08,213 I think we did it. 842 00:37:08,238 --> 00:37:10,722 - Well done, Dr. Rhodes. - You as well. 843 00:37:10,747 --> 00:37:12,480 Dr. Mehta, will you please close? 844 00:37:12,505 --> 00:37:14,230 - Yes, sir. - Thank you. 845 00:37:20,584 --> 00:37:23,503 I must admit, despite your overall surliness, 846 00:37:23,528 --> 00:37:25,218 your determination today 847 00:37:25,243 --> 00:37:28,199 in the face of great odds was admirable. 848 00:37:28,550 --> 00:37:30,116 I will take that as a compliment. 849 00:37:30,141 --> 00:37:31,833 You should. 850 00:37:33,056 --> 00:37:35,127 I'm gonna go take my flowers home. 851 00:37:35,824 --> 00:37:37,323 Ava... 852 00:37:39,916 --> 00:37:42,871 It's not that it's my dad you're dating... 853 00:37:49,085 --> 00:37:51,855 I wish that you weren't dating anybody at all. 854 00:37:54,348 --> 00:37:57,441 As long as we're making confessions, 855 00:37:57,976 --> 00:38:01,261 I was never dating your father. 856 00:38:02,242 --> 00:38:04,550 But you didn't mind me thinking so. 857 00:38:04,575 --> 00:38:06,617 No, I didn't mind. 858 00:38:14,244 --> 00:38:16,503 Oh, Josh. 859 00:38:16,886 --> 00:38:19,152 - Hello, Josh. - Hi. 860 00:38:19,765 --> 00:38:22,866 Uh, Dr. Choi told us about what's going on, 861 00:38:22,891 --> 00:38:25,428 and we're gonna get through this, honey, together. 862 00:38:26,394 --> 00:38:28,460 I'm sorry I caused you so much trouble. 863 00:38:28,485 --> 00:38:30,517 We're just glad to see you again, 864 00:38:30,542 --> 00:38:32,519 and that you're safe. 865 00:38:36,183 --> 00:38:39,329 Josh will need to stay here for about two weeks, 866 00:38:39,514 --> 00:38:42,157 but after that, he's agreed to go home with you, 867 00:38:42,182 --> 00:38:44,462 if you let him bring his dog. 868 00:38:44,487 --> 00:38:46,782 - Of course. - Anything. 869 00:38:46,807 --> 00:38:49,975 - What's its name? - Athena. 870 00:38:50,369 --> 00:38:52,770 Well, we'll take care of Athena. 871 00:38:55,651 --> 00:38:57,340 Please follow me. 872 00:38:59,049 --> 00:39:02,118 Uh, we'll get Athena after we settle Josh in. 873 00:39:02,143 --> 00:39:03,595 Of course. 874 00:39:11,690 --> 00:39:14,774 He's never really gonna be able to love them back, is he? 875 00:39:14,927 --> 00:39:16,774 By our definition? 876 00:39:17,057 --> 00:39:18,657 Unlikely. 877 00:39:20,421 --> 00:39:23,360 I don't know who to feel more sorry for, 878 00:39:23,385 --> 00:39:25,642 the parents or him. 879 00:39:34,283 --> 00:39:36,166 Thanks. 880 00:39:36,533 --> 00:39:38,066 Really? 881 00:39:38,091 --> 00:39:39,724 For what? 882 00:39:39,749 --> 00:39:41,448 You did good today. 883 00:39:45,287 --> 00:39:47,021 Maybe we could use you around here. 884 00:39:49,934 --> 00:39:52,201 Athena... 885 00:40:04,088 --> 00:40:06,589 It'd be so hard to do that all alone. 886 00:40:12,223 --> 00:40:13,828 What? 887 00:40:13,853 --> 00:40:15,753 It's just... 888 00:40:15,778 --> 00:40:18,110 I know when mom and dad get old, 889 00:40:18,344 --> 00:40:20,543 at least we'll face it together. 890 00:40:29,364 --> 00:40:32,432 Kevin's fever is coming down, and his numbers all look great. 891 00:40:32,473 --> 00:40:34,940 - I think he's gonna be okay. - Thank you, Dr. Manning. 892 00:40:47,976 --> 00:40:49,993 At least they can start getting Kevin 893 00:40:50,027 --> 00:40:51,459 - the help he needs. - Yeah. 894 00:40:51,484 --> 00:40:52,868 Hey, Will... 895 00:40:54,902 --> 00:40:56,621 I'm not perfect. 896 00:40:56,977 --> 00:41:00,376 I have got a million fears and insecurities 897 00:41:00,401 --> 00:41:03,086 about being a doctor, a mother, 898 00:41:03,426 --> 00:41:04,592 everything. 899 00:41:06,155 --> 00:41:07,855 It's exhausting. 900 00:41:09,925 --> 00:41:12,804 But yes, sometimes, I... 901 00:41:13,766 --> 00:41:15,974 push it too far. 902 00:41:16,474 --> 00:41:17,976 It's okay. 903 00:41:18,176 --> 00:41:19,894 I understand. 904 00:41:19,922 --> 00:41:21,896 Good. 905 00:41:22,884 --> 00:41:25,233 It still doesn't mean you get a pass for the other night. 906 00:41:34,696 --> 00:41:36,662 Looks like he's gonna live. 907 00:41:38,480 --> 00:41:39,979 Yeah. 908 00:41:42,726 --> 00:41:44,241 Now what? 909 00:41:47,346 --> 00:41:54,451 - Synced and corrected by martythecrazy - - www.addic7ed.com - 64950

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