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Would you like to inspect the original subtitles? These are the user uploaded subtitles that are being translated: 1 00:00:01,039 --> 00:00:02,655 Previously on The Resident... 2 00:00:02,665 --> 00:00:04,872 Everything you thought you knew about medicine is wrong. 3 00:00:04,882 --> 00:00:06,922 All the rules you followed, we'll break. 4 00:00:06,932 --> 00:00:08,878 You don't have the right to play God, Conrad. 5 00:00:08,888 --> 00:00:11,693 I will do whatever it takes to get you back. 6 00:00:11,703 --> 00:00:13,125 Chief of surgery. 7 00:00:13,760 --> 00:00:15,763 Resident. Try to remember that. 8 00:00:18,665 --> 00:00:20,457 Dr. Okafor. 9 00:00:20,467 --> 00:00:22,459 Don't be nervous. I'll talk you through it. 10 00:00:22,669 --> 00:00:25,428 Acute leukemic, on chemo. 11 00:00:25,438 --> 00:00:26,964 Lily means a lot to all of us. 12 00:00:26,974 --> 00:00:29,433 She's been in and out of the ER so often we're all invested. 13 00:00:29,443 --> 00:00:31,386 - Where's Lily Kendall? - She went home. 14 00:00:31,397 --> 00:00:33,067 Her count improved substantially. 15 00:00:53,632 --> 00:00:55,692 - We're in third place. - Now or never. 16 00:00:55,702 --> 00:00:57,038 Sir, yes, sir. 17 00:00:59,940 --> 00:01:04,668 Second place. Oh, I know how you feel about losing. 18 00:01:19,404 --> 00:01:20,817 - We got this. - We do? 19 00:01:20,827 --> 00:01:22,285 I do. 20 00:01:50,157 --> 00:01:52,048 15th Marine Expeditionary. 21 00:01:52,058 --> 00:01:55,219 Valor, honor... Whoa... 22 00:01:55,229 --> 00:01:57,253 - Victory. - Yo! 23 00:01:57,263 --> 00:02:00,223 Dudes. Awesome race! 24 00:02:00,233 --> 00:02:02,659 Of course... random drunk guy. 25 00:02:02,669 --> 00:02:03,737 Cold ones on me. 26 00:02:07,074 --> 00:02:09,699 Aah... aah! 27 00:02:09,709 --> 00:02:12,703 My leg! I need a doct... 28 00:02:12,713 --> 00:02:14,370 It's broke. 29 00:02:14,380 --> 00:02:15,538 Doctor! 30 00:02:21,355 --> 00:02:23,179 Right fibula. Compound fracture. 31 00:02:23,189 --> 00:02:26,549 We need a splint. 32 00:02:26,559 --> 00:02:29,052 - Oh, it hurts. It hurts so bad. - Deep breaths, buddy, 33 00:02:29,062 --> 00:02:31,543 we don't want you going into shock. What's your name? 34 00:02:31,554 --> 00:02:33,055 - Ooh. Hank. - That's the best we got. 35 00:02:33,065 --> 00:02:36,038 - We'll just wrap him up. - Like old times... medic and surgeon? 36 00:02:36,049 --> 00:02:37,546 He's about to tell us how much he misses 37 00:02:37,557 --> 00:02:39,730 the good ol' days when we were in Afghanistan together. 38 00:02:39,741 --> 00:02:41,931 Give me some credit, hey. All right, listen, 39 00:02:41,941 --> 00:02:44,066 this is gonna sting. Might want to bite down on that. 40 00:02:44,076 --> 00:02:46,602 - But I do miss it sometimes. Don't you? - I don't miss 41 00:02:46,612 --> 00:02:48,272 being shot at. No sane person would. 42 00:02:48,282 --> 00:02:50,150 Not trying to take that personally. 43 00:02:51,218 --> 00:02:53,276 Setting the leg... 44 00:02:53,286 --> 00:02:55,112 now! 45 00:02:55,122 --> 00:02:57,280 There we go. All right. 46 00:02:57,290 --> 00:02:59,615 Doing great, buddy. 47 00:03:03,296 --> 00:03:05,665 Let's go! 48 00:03:17,796 --> 00:03:20,209 - Synced and corrected by Shazi89 - - www.addic7ed.com - 49 00:03:25,118 --> 00:03:27,109 Lily, hey. 50 00:03:27,119 --> 00:03:28,779 Oh, hey, Nic. 51 00:03:28,789 --> 00:03:31,280 You left Chastain so abruptly the other day. I was worried. 52 00:03:31,290 --> 00:03:32,983 Yeah, I'm fine. Thank you. 53 00:03:32,993 --> 00:03:35,084 Just grabbing a prescription. 54 00:03:35,460 --> 00:03:37,719 You feeling okay? 55 00:03:37,730 --> 00:03:40,122 You want to come upstairs? I can take your temperature, 56 00:03:40,132 --> 00:03:41,956 - make sure you don't have a fever. - No, no, I'm good. 57 00:03:41,967 --> 00:03:44,348 Yeah, I'll stop by Dr. Hunter's clinic if I need anything. 58 00:03:44,359 --> 00:03:45,461 - You sure? - Mm-hmm. 59 00:03:45,471 --> 00:03:47,774 - 'Kay. - Thanks. 60 00:03:54,880 --> 00:03:56,205 Come on, Mr. Rosenthal. 61 00:03:56,215 --> 00:03:58,642 I got to take you for some fresh air, and then to PT. 62 00:03:58,652 --> 00:03:59,976 No, thanks. 63 00:03:59,986 --> 00:04:02,478 What I need is a drink and smoke. 64 00:04:02,488 --> 00:04:05,214 Good morning, Mr. Rosenthal. 65 00:04:05,224 --> 00:04:08,485 Lucky you... a free ride with Louisa, our most popular transpo worker. 66 00:04:08,495 --> 00:04:10,152 Ah, just a quick spin. 67 00:04:10,162 --> 00:04:12,488 Don't want a spin around nothing. 68 00:04:12,498 --> 00:04:14,358 - You need sunshine. - Vitamin D, 69 00:04:14,368 --> 00:04:15,692 helps you absorb calcium. 70 00:04:15,702 --> 00:04:17,149 Which promotes bone density. 71 00:04:17,160 --> 00:04:19,181 You don't want to break your hip again, do you? 72 00:04:19,192 --> 00:04:21,548 You know, you should really listen to Louisa. You know why? 73 00:04:21,559 --> 00:04:23,993 - No, why? - She's studying to be a doctor. 74 00:04:24,004 --> 00:04:25,400 Med school, huh? 75 00:04:25,411 --> 00:04:26,883 You got a ways to go. 76 00:04:26,894 --> 00:04:28,185 How old are you, 12? 77 00:04:28,195 --> 00:04:29,853 Ah, close. 22. 78 00:04:29,863 --> 00:04:32,255 And she volunteered at Chastain all through high school. 79 00:04:32,265 --> 00:04:33,723 - Hmm. - Hi, Louisa. 80 00:04:33,733 --> 00:04:34,892 - Hey. - Nic, seriously, 81 00:04:34,902 --> 00:04:36,627 what is this mandatory meeting about? 82 00:04:36,637 --> 00:04:37,961 I have 30 patients to see. 83 00:04:37,971 --> 00:04:39,396 - Billing. - Billing? 84 00:04:39,406 --> 00:04:42,468 Whoa, sign me up. Love me some billing. 85 00:04:42,479 --> 00:04:43,760 Enough already. 86 00:04:43,771 --> 00:04:46,049 You okay? 87 00:04:46,060 --> 00:04:49,205 Yeah. Diagnosed myself with a muscle pull this morning. 88 00:04:49,923 --> 00:04:51,447 Some kind of softball injury. 89 00:04:51,458 --> 00:04:53,931 Might have to, uh, skip out early today. 90 00:04:53,942 --> 00:04:56,480 Plus, I have to cram. Midterms next week. 91 00:04:56,490 --> 00:04:57,508 Bio and calc. 92 00:04:57,519 --> 00:04:58,949 Well, if you need any help at all, 93 00:04:58,959 --> 00:05:01,063 I got a 132 on the bio section of my MCATs. 94 00:05:01,074 --> 00:05:02,885 Kid brags a lot, doesn't he? 95 00:05:02,895 --> 00:05:04,053 Thanks, Dr. Pravesh. 96 00:05:04,063 --> 00:05:06,166 I might take you up on that offer. 97 00:05:19,851 --> 00:05:22,272 Compound fracture of the right fibula. 98 00:05:22,282 --> 00:05:24,942 Now, we reset it in the field, but he might need surgery. 99 00:05:24,952 --> 00:05:26,343 All right. I'll be right there. 100 00:05:26,353 --> 00:05:28,277 - We'll see you inside. - Okay. 101 00:05:28,287 --> 00:05:30,247 - Thanks, Doc. - Let's go. 102 00:05:30,257 --> 00:05:32,449 You did great, Hank. 103 00:05:32,459 --> 00:05:33,950 Yeah, except for the crying. 104 00:05:33,960 --> 00:05:36,919 - And screaming for a doctor. - And breaking all those beer bottles. 105 00:05:38,052 --> 00:05:39,789 The truth? That was like old times. 106 00:05:39,799 --> 00:05:41,723 Well, you miss it so much, why don't you go back? 107 00:05:41,734 --> 00:05:43,192 Yeah, I've been meaning to tell you. 108 00:05:43,202 --> 00:05:44,967 Jude, I was joking. 109 00:05:46,280 --> 00:05:47,740 Thinking about re-enlisting. 110 00:05:47,751 --> 00:05:49,725 - Back into the Marines? - Yeah. 111 00:05:50,476 --> 00:05:52,214 - Do boys ever grow up? - Yes. 112 00:05:52,225 --> 00:05:53,803 - No. - Mandatory meeting, we're late. 113 00:05:53,814 --> 00:05:55,538 I thought you were gonna get us out of this? 114 00:05:55,548 --> 00:05:57,490 Yeah, well, I told her we had seven open cases... 115 00:05:57,501 --> 00:06:00,461 All residents, all nurses. Let's go. 116 00:06:02,133 --> 00:06:03,312 You smell like a barn. 117 00:06:03,322 --> 00:06:05,315 - I like barns. - Never been in one. 118 00:06:05,325 --> 00:06:06,884 What? I grew up in Queens. 119 00:06:06,894 --> 00:06:08,819 I've smelled worse, trust me. 120 00:06:08,829 --> 00:06:10,792 - Excuse me. - Morning, everyone. 121 00:06:10,803 --> 00:06:14,158 We're here today to talk about reimbursement. 122 00:06:14,168 --> 00:06:16,159 No one's favorite part of the day, right? 123 00:06:16,169 --> 00:06:17,436 Okay, put that away, sweetie. 124 00:06:17,447 --> 00:06:20,163 Now, to simplify, doctors and nurses at Chastain 125 00:06:20,173 --> 00:06:21,998 need to charge more per procedure. 126 00:06:22,008 --> 00:06:24,507 For example: ear infection. 127 00:06:24,518 --> 00:06:27,737 Typically billed to insurance as service code one 128 00:06:27,748 --> 00:06:29,884 at about... yeah? 129 00:06:31,584 --> 00:06:33,122 $200. 130 00:06:33,133 --> 00:06:36,012 But what if that ear infection took a trip to the brain? 131 00:06:36,022 --> 00:06:39,348 That's now a code four. Serious. 132 00:06:39,358 --> 00:06:40,550 Costly. 133 00:06:40,560 --> 00:06:42,519 We can bill in the thousands. 134 00:06:42,529 --> 00:06:46,139 Illness is unpredictable, so billing must be proactive. 135 00:06:46,150 --> 00:06:48,900 Right? It's called upcoding. 136 00:06:49,514 --> 00:06:52,141 Think... CUTE. 137 00:06:52,339 --> 00:06:55,765 Code. Up. To. Excellence. 138 00:06:55,775 --> 00:06:59,368 Enjoy. I'm out. 139 00:06:59,378 --> 00:07:01,070 Third year. First year. 140 00:07:01,080 --> 00:07:04,221 Welcome to American healthcare 101. 141 00:07:05,351 --> 00:07:08,455 Okay, what are we all concerned about? 142 00:07:10,457 --> 00:07:12,082 How much did you have to drink today? 143 00:07:12,092 --> 00:07:13,584 Not really sure. 144 00:07:13,594 --> 00:07:15,351 You were at the race all morning? 145 00:07:15,361 --> 00:07:18,021 Which Conrad and I won, by the way. 146 00:07:18,031 --> 00:07:20,089 I had a beer before the race. 147 00:07:20,099 --> 00:07:22,425 Jaundiced skin, scleral icterus. 148 00:07:22,435 --> 00:07:24,627 I'm sending him for a liver panel and an ultrasound. 149 00:07:24,637 --> 00:07:26,096 How's our number one fan? 150 00:07:26,106 --> 00:07:27,479 You see this? 151 00:07:27,490 --> 00:07:30,280 This is a stateside doctor, doing what he was born to do... 152 00:07:30,291 --> 00:07:34,103 running liver function tests in a cushy, big-city ER. 153 00:07:35,948 --> 00:07:38,346 ♪ I am the very model ♪ ♪ Of a modern major-general ♪ 154 00:07:38,357 --> 00:07:40,577 ♪ I've information vegetable, ♪ ♪ animal and mineral ♪ 155 00:07:40,587 --> 00:07:43,813 ♪ I know the kings of England and I quote the fights historical... ♪ 156 00:07:43,823 --> 00:07:45,392 I was also born to sing. 157 00:07:50,935 --> 00:07:52,421 You get out on the boat this weekend? 158 00:07:52,431 --> 00:07:54,457 Yeah, the fish weren't biting. You? 159 00:07:54,467 --> 00:07:56,270 Well, a little golf. 160 00:07:58,471 --> 00:08:00,430 You know, actually, I had a question for you. 161 00:08:00,440 --> 00:08:02,955 Old guy I was playing with has developed a bit of a tremor. 162 00:08:02,966 --> 00:08:05,447 And it's giving him the yips. And I prescribed the standard... 163 00:08:05,458 --> 00:08:07,903 beta blockers... but it hasn't helped. 164 00:08:07,914 --> 00:08:10,482 You know, I know there's surgery, but it seems a little drastic. 165 00:08:10,493 --> 00:08:13,127 Well, cracking open his head for a missed putt is a bit much, huh? 166 00:08:13,138 --> 00:08:14,508 Yeah, what about benzodiazepines? 167 00:08:14,519 --> 00:08:17,114 Last resort, he can try 'em. But the side effects are gonna be... 168 00:08:17,124 --> 00:08:19,482 - Aggression and cognitive impairment. - Yeah. 169 00:08:19,492 --> 00:08:21,952 I guess it just depends how desperate the guy is, though. 170 00:08:21,962 --> 00:08:23,750 - Cheers. - Cheers. 171 00:08:33,207 --> 00:08:36,433 Rosenthal in 5931... catheter out and discharge. 172 00:08:36,443 --> 00:08:38,135 Anderson 5942... 173 00:08:38,145 --> 00:08:41,038 Monitor her rhythm. Where were you and Dr. Silva deployed? 174 00:08:41,048 --> 00:08:42,806 Afghanistan. 175 00:08:42,816 --> 00:08:44,341 If she spikes a fever, you add... 176 00:08:44,351 --> 00:08:45,942 IV piperacillin. 177 00:08:45,952 --> 00:08:48,312 My brother was in the army, two tours in Iraq. 178 00:08:48,322 --> 00:08:50,447 He came back a very different guy. 179 00:08:50,457 --> 00:08:53,183 Did you see any action? 180 00:08:53,193 --> 00:08:55,686 I was a corpsman in the Marines. 181 00:08:55,696 --> 00:08:56,986 Jude was a base surgeon. 182 00:08:56,996 --> 00:08:58,721 We tried to save lives, not take them. 183 00:08:58,731 --> 00:09:00,657 But mostly, we had each other's back. 184 00:09:00,667 --> 00:09:04,027 Now let's move on to medicine. We have a busy day ahead of us. 185 00:09:04,038 --> 00:09:06,529 Let me know if there's anything in the marketing department... 186 00:09:06,539 --> 00:09:07,563 Look busy. 187 00:09:07,573 --> 00:09:10,229 - ...the upcoding system. - Don't forget testing. 188 00:09:10,240 --> 00:09:11,846 A well-insured patient should be tested 189 00:09:11,857 --> 00:09:13,981 for all possible outcomes, no matter how unlikely. 190 00:09:15,848 --> 00:09:19,176 Dr. Hawkins, have you met Barb Olsen? 191 00:09:19,186 --> 00:09:20,370 She's our billing consultant. 192 00:09:20,381 --> 00:09:22,678 Here for two weeks to help Chastain become more efficient. 193 00:09:22,688 --> 00:09:24,514 Of course. The bike shorts. 194 00:09:24,524 --> 00:09:27,384 Yeah, I already saw you at my presentation... well, briefly. 195 00:09:27,394 --> 00:09:28,518 I got paged. 196 00:09:28,528 --> 00:09:30,697 Didn't I get paged? 197 00:09:31,697 --> 00:09:33,067 I didn't hear anything. 198 00:09:35,202 --> 00:09:37,027 Well, nice meeting you. 199 00:09:37,037 --> 00:09:39,196 Barb, there's, um... 200 00:09:39,206 --> 00:09:42,499 Payback. For making me sit in that presentation. 201 00:09:42,509 --> 00:09:44,400 What's your problem? 202 00:09:44,410 --> 00:09:46,602 A strong kid like you... can't you go any faster? 203 00:09:46,612 --> 00:09:48,038 I got a life to lead. 204 00:09:48,048 --> 00:09:50,374 Hey, Louisa, how's my man Rosenthal treating you? 205 00:09:50,384 --> 00:09:52,042 Like the daughter he never had. 206 00:09:52,052 --> 00:09:53,110 A nightmare. 207 00:09:53,120 --> 00:09:56,045 The Chastain softball team crushed Emory yesterday. 208 00:09:56,055 --> 00:09:58,115 Yeah, we did. 209 00:09:58,125 --> 00:10:00,216 Is your back still bothering you? 210 00:10:00,226 --> 00:10:02,218 Uh, yeah, it's no big deal. 211 00:10:02,228 --> 00:10:05,054 Now I'm thinking it's a pinched nerve, lumbar spine. 212 00:10:05,064 --> 00:10:07,499 Pain that, uh, radiates along the affected nerve. 213 00:10:07,510 --> 00:10:10,392 That's impressive, but you're not quite a doctor yet. Let me have a look. 214 00:10:10,403 --> 00:10:11,428 Uh, maybe later. 215 00:10:11,438 --> 00:10:14,096 I told Joey in Ped Onc I'd take him to the play area. 216 00:10:14,106 --> 00:10:17,200 Man, that munchkin is cute. 217 00:10:19,578 --> 00:10:21,203 Check back in with her in an hour. 218 00:10:21,213 --> 00:10:22,639 I just want to examine her and make sure... 219 00:10:24,284 --> 00:10:26,386 Hey! We need some help in here! 220 00:10:29,722 --> 00:10:32,548 - Oh, my God, I'm sorry. - It's okay. 221 00:10:33,726 --> 00:10:34,750 It's okay, stay still. 222 00:10:34,760 --> 00:10:36,253 We got you. 223 00:10:37,239 --> 00:10:39,270 I'm too young for kidney stones. 224 00:10:39,281 --> 00:10:41,958 I'm thinking it's just a gas bubble. It's really no big deal. 225 00:10:41,968 --> 00:10:44,293 How long have you been short of breath? 226 00:10:44,303 --> 00:10:45,595 Just a few days. 227 00:10:45,605 --> 00:10:47,764 I was thinking it was from the pain. 228 00:10:47,774 --> 00:10:50,766 Your lungs sound congested. 229 00:10:50,776 --> 00:10:53,102 We need a full workup. 230 00:10:53,112 --> 00:10:54,303 This could be serious. 231 00:10:54,313 --> 00:10:56,273 No, I'm okay. I swear. 232 00:10:56,283 --> 00:10:58,353 I can't be sick, they'll send me back home. 233 00:10:58,364 --> 00:11:00,248 And I need every dime to make ends meet. 234 00:11:00,259 --> 00:11:01,798 And a CT scan as well. 235 00:11:01,809 --> 00:11:03,569 MRI's probably the better option. 236 00:11:03,580 --> 00:11:05,849 Actually, maybe we should check her insurance first. 237 00:11:05,859 --> 00:11:07,516 - Uh, can this wait? - No. 238 00:11:07,526 --> 00:11:09,186 Can I a moment with the patient, please? 239 00:11:09,196 --> 00:11:11,204 We're conducting an exam here. 240 00:11:11,215 --> 00:11:13,876 Dr. Hawkins, the administration has given me license 241 00:11:13,887 --> 00:11:16,298 to inspect all hospital finances. 242 00:11:17,009 --> 00:11:19,129 You're a subcontractor to the hospital, right? 243 00:11:19,139 --> 00:11:20,797 Yes. Is this really necessary? 244 00:11:20,807 --> 00:11:22,665 I'm feeling better. I just want to go home. 245 00:11:22,675 --> 00:11:24,134 Rest up. 246 00:11:24,144 --> 00:11:25,802 She wants to go home. Great. 247 00:11:25,812 --> 00:11:28,304 She can't. She needs an MRI. 248 00:11:28,314 --> 00:11:30,807 Do you know if your company will cover an MRI? 249 00:11:30,817 --> 00:11:33,176 Does anyone know that stuff? 250 00:11:33,186 --> 00:11:35,542 Then if it doesn't, an X-ray is more than sufficient. 251 00:11:35,553 --> 00:11:37,076 Actually, it isn't. 252 00:11:37,087 --> 00:11:38,717 Louisa is part of the Chastain family. 253 00:11:38,728 --> 00:11:41,118 - She deserves our best care. - Well, I can see 254 00:11:41,129 --> 00:11:42,619 that she's a wonderful young woman... 255 00:11:42,629 --> 00:11:43,886 I can't do this. 256 00:11:43,896 --> 00:11:45,832 I'm sorry, thank you, but I'll just leave. 257 00:11:47,833 --> 00:11:51,338 It would be wise for you to let her go. 258 00:11:57,177 --> 00:11:59,180 Wow. Really? 259 00:12:01,814 --> 00:12:03,173 Louisa... 260 00:12:06,844 --> 00:12:08,678 Easy. Easy. 261 00:12:08,688 --> 00:12:09,756 There you go. 262 00:12:11,406 --> 00:12:12,528 Pulse is weak. 263 00:12:12,539 --> 00:12:15,217 Distant heart sounds, distended jugular veins. 264 00:12:15,227 --> 00:12:16,352 Cardiac tamponade. 265 00:12:16,362 --> 00:12:17,721 Too unstable to move. 266 00:12:17,731 --> 00:12:21,119 I need 18-gauge spinal needle with a 20cc syringe. 267 00:12:21,130 --> 00:12:22,819 I'll prep the ultrasound in exam room four. 268 00:12:22,830 --> 00:12:23,833 Good. Go. 269 00:12:23,844 --> 00:12:25,361 Louisa, you have fluid around your heart. 270 00:12:25,372 --> 00:12:27,151 We're going to relieve the pressure. 271 00:12:27,162 --> 00:12:28,614 You cut, I draw. 272 00:12:41,621 --> 00:12:43,112 Quickly, we're losing her. 273 00:12:43,122 --> 00:12:44,253 Ready. 274 00:12:46,359 --> 00:12:49,396 Now, Louisa, you're gonna feel pressure and then stinging. 275 00:13:00,741 --> 00:13:02,476 You're okay, Louisa. 276 00:13:13,527 --> 00:13:15,548 Another loud noise 277 00:13:15,559 --> 00:13:17,284 and we're almost done. 278 00:13:17,294 --> 00:13:19,253 Don't worry, just a few more minutes. 279 00:13:22,437 --> 00:13:23,716 Get her out of that machine. 280 00:13:23,727 --> 00:13:25,500 - We're almost finished. - She's not insured. 281 00:13:25,511 --> 00:13:27,758 She can't pay for her treatment, that's why she ran away. 282 00:13:27,769 --> 00:13:29,403 Or maybe she didn't want to burden the hospital. 283 00:13:29,414 --> 00:13:31,965 Well, it's a little late for that, 'cause Chastain is gonna have 284 00:13:31,975 --> 00:13:33,754 to eat the cost of that MRI. That's $10,000. 285 00:13:33,765 --> 00:13:35,834 $10,000 is what they charge the insurance company. 286 00:13:35,845 --> 00:13:37,636 It doesn't cost the hospital anything like that. 287 00:13:37,647 --> 00:13:39,673 Are you offering to pay? 288 00:13:39,683 --> 00:13:42,009 Here, for your intake files. 289 00:13:42,019 --> 00:13:44,923 I will call her employer, see what I can negotiate. 290 00:13:48,727 --> 00:13:51,151 God, I hate that woman. 291 00:13:51,162 --> 00:13:53,789 You and I will run point on Louisa's care. 292 00:13:53,931 --> 00:13:55,853 We need to get as much done as we can 293 00:13:55,864 --> 00:13:57,501 before the administration pulls the plug. 294 00:13:57,512 --> 00:13:58,798 We can't let them kick her out. 295 00:13:58,809 --> 00:14:00,142 Well, don't panic yet. 296 00:14:00,153 --> 00:14:02,051 Worst case, we guide her to another hospital. 297 00:14:02,062 --> 00:14:05,389 Where she never even makes it past ER triage. 298 00:14:05,777 --> 00:14:06,894 Trust me. 299 00:14:11,816 --> 00:14:13,285 LFT panel. 300 00:14:15,352 --> 00:14:17,336 Hank, you have acute hepatitis. 301 00:14:18,281 --> 00:14:19,714 Is that bad? 302 00:14:19,724 --> 00:14:22,146 It means that you've consumed so much alcohol 303 00:14:22,157 --> 00:14:23,903 that your liver's temporarily paralyzed. 304 00:14:23,914 --> 00:14:26,854 - It's quite a feat, actually. - Exactly how many beers did you have? 305 00:14:26,864 --> 00:14:30,002 - Two... - Two beers? 306 00:14:32,403 --> 00:14:35,696 Two dozen. 307 00:14:35,706 --> 00:14:38,132 If you don't cut back, your liver's gonna stop functioning. 308 00:14:38,142 --> 00:14:41,165 Your stomach will swell, you're gonna become confused, then sleepy, 309 00:14:41,176 --> 00:14:43,301 you slip into a coma, then you die. 310 00:14:43,312 --> 00:14:45,546 I'm not trying to scare you, it's just the truth. 311 00:14:45,557 --> 00:14:47,793 You're drinking yourself to death. 312 00:14:51,749 --> 00:14:53,359 I know. 313 00:14:54,567 --> 00:14:55,601 Help me? 314 00:14:56,640 --> 00:14:58,437 I can get you into a rehab facility. 315 00:14:58,448 --> 00:14:59,916 I can't do rehab. 316 00:14:59,927 --> 00:15:01,502 I'd lose my job. 317 00:15:01,872 --> 00:15:03,885 But the rest of it, yeah. 318 00:15:04,170 --> 00:15:06,130 I'm ready to quit. 319 00:15:06,141 --> 00:15:08,400 I am. I've struggled with alcohol my whole life. 320 00:15:08,840 --> 00:15:10,539 Look, the moment I walk out of there, 321 00:15:10,550 --> 00:15:12,567 I swear, I will go straight to a meeting. 322 00:15:12,578 --> 00:15:16,104 I'll get a sponsor, I'll stay in AA the rest of my life. 323 00:15:16,114 --> 00:15:19,825 That's easy to say, pal. It's hard to do. 324 00:15:24,700 --> 00:15:28,295 Atwood, Henry, two of Lorazepam for withdrawal. 325 00:15:28,860 --> 00:15:30,145 Thank you, Doctor. 326 00:15:30,156 --> 00:15:32,385 You can do whatever you want, it's not gonna help. 327 00:15:32,395 --> 00:15:34,621 His problem is self-inflicted. 328 00:15:34,631 --> 00:15:36,717 Hell, 90% of the patients that come in here 329 00:15:36,728 --> 00:15:38,232 have done stupid stuff to themselves. 330 00:15:38,243 --> 00:15:40,061 Remind me how you got that scar on your thumb. 331 00:15:40,071 --> 00:15:42,631 - Wasn't it field-dressing a possum? - I was nine years old. 332 00:15:42,642 --> 00:15:44,383 And I treated the injury myself. 333 00:15:44,394 --> 00:15:45,448 Of course you did. 334 00:15:45,459 --> 00:15:47,251 It still doesn't explain why you eat possum. 335 00:15:47,611 --> 00:15:50,409 Yeah, we all didn't have moms who would shop and cook for us. 336 00:15:50,420 --> 00:15:52,832 Or dads who were sober enough to drive us to the ER. 337 00:15:52,843 --> 00:15:54,739 Exactly, and that's why I'm here... 338 00:15:54,949 --> 00:15:57,434 to help whoever walks in that door who can't help themselves. 339 00:15:57,445 --> 00:15:59,827 It doesn't matter whether they eat lobster or road kill. 340 00:15:59,838 --> 00:16:01,101 I take care of them. 341 00:16:02,093 --> 00:16:03,417 All right. 342 00:16:04,130 --> 00:16:05,294 Let me ask you this. 343 00:16:06,911 --> 00:16:09,923 What is the most fun you have had in the last week? 344 00:16:10,800 --> 00:16:12,292 My guess? 345 00:16:12,302 --> 00:16:16,096 You and me fixing up Hank in the back of that pickup truck. 346 00:16:16,106 --> 00:16:19,160 Seat-of-our-pants medicine. Nobody telling us what to do 347 00:16:19,171 --> 00:16:20,796 or making us fill out forms. 348 00:16:21,481 --> 00:16:23,269 Then what happens? 349 00:16:23,841 --> 00:16:25,638 We come back to work, 350 00:16:25,649 --> 00:16:29,217 and a patient is trying to run away because she doesn't have insurance. 351 00:16:29,546 --> 00:16:32,078 We can't even treat someone who's worked at Chastain 352 00:16:32,089 --> 00:16:33,624 for the past two years. 353 00:16:35,427 --> 00:16:38,864 How many wounded Marines did you ever ask for proof of insurance? 354 00:16:39,496 --> 00:16:41,121 Well... 355 00:16:41,131 --> 00:16:44,325 I guess I got my work cut out for me, then, don't I? 356 00:16:44,335 --> 00:16:46,037 You keep tilting at windmills, huh? 357 00:16:47,705 --> 00:16:50,698 - Currently on any medications? - No, but I'm... 358 00:16:50,708 --> 00:16:52,755 Have you eaten anything in the last eight hours? 359 00:16:52,766 --> 00:16:54,168 I'm not having surgery today. 360 00:16:55,946 --> 00:16:59,563 It says here, "Reynolds, hernia surgery, 2:15." 361 00:16:59,574 --> 00:17:02,188 - I'll be assisting. - I'm having some more tests. 362 00:17:02,199 --> 00:17:04,777 - Excuse me? - A very nice lady came in 363 00:17:04,788 --> 00:17:07,433 and talked my doctor into ordering some more blood work. 364 00:17:07,444 --> 00:17:09,756 Another CT scan and an MRI. 365 00:17:09,767 --> 00:17:12,225 You don't need an MRI, you need hernia surgery. 366 00:17:12,236 --> 00:17:14,521 She said I needed it to be on the safe side. 367 00:17:14,531 --> 00:17:16,367 She was very convincing. 368 00:17:17,891 --> 00:17:19,829 Why is my hernia patient having more tests? 369 00:17:19,840 --> 00:17:22,697 - He doesn't need more tests. - Another Barb victim. 370 00:17:22,707 --> 00:17:25,893 Profit before patients... the new healthcare mantra. 371 00:17:25,904 --> 00:17:28,398 Barb is like a migraine. You can feel it coming, 372 00:17:28,409 --> 00:17:29,503 but you can't stop it. 373 00:17:29,514 --> 00:17:31,557 Then it gets worse and worse, and you throw up. 374 00:17:31,568 --> 00:17:34,641 What do you guys think of the name "Say Ah" 375 00:17:34,652 --> 00:17:37,075 for a resident-nurse a cappella group? 376 00:17:37,654 --> 00:17:39,747 "Say Ah"? 377 00:17:39,757 --> 00:17:42,727 Yeah, you know, to serenade patients. 378 00:17:45,005 --> 00:17:46,965 No one wants you to sing them a song. 379 00:17:50,293 --> 00:17:52,964 The meaner she is to me, the more I'm in awe of her. 380 00:17:52,975 --> 00:17:55,045 Yeah, that's kind of how it works. 381 00:17:56,560 --> 00:17:58,029 Wow. 382 00:18:02,680 --> 00:18:05,049 You got Louisa's results? 383 00:18:07,331 --> 00:18:09,308 This is a T2 hyperintense, 384 00:18:09,319 --> 00:18:11,611 enhancing mass, encasing the spleen, kidney, 385 00:18:11,622 --> 00:18:13,606 and vertebral bodies. Most consistent with... 386 00:18:13,617 --> 00:18:15,249 A retroperitoneal sarcoma. 387 00:18:15,259 --> 00:18:17,278 Which would explain the fluid in her heart. 388 00:18:17,289 --> 00:18:19,815 She lied to us. And to her employer. 389 00:18:19,826 --> 00:18:22,054 She didn't run away because she doesn't have insurance, 390 00:18:22,065 --> 00:18:24,846 she ran away because she's an undocumented immigrant. 391 00:18:30,529 --> 00:18:32,621 She has a highly aggressive tumor. 392 00:18:32,881 --> 00:18:35,518 If she doesn't get surgery right away, she dies. 393 00:18:38,047 --> 00:18:39,712 No more tests, 394 00:18:39,723 --> 00:18:41,782 no more treatment on our dime. 395 00:18:42,005 --> 00:18:43,940 This hospital isn't a charity. 396 00:18:53,927 --> 00:18:56,579 I felt this was important enough to bring to the CEO's office 397 00:18:56,590 --> 00:18:58,490 right away. Ms. Rodriguez is an uninsured, 398 00:18:58,501 --> 00:19:00,292 undocumented immigrant. 399 00:19:00,303 --> 00:19:02,257 She has no family in this country. 400 00:19:02,267 --> 00:19:05,090 She was brought here from El Salvador as a child. 401 00:19:05,101 --> 00:19:07,596 No one can take her once she leaves the hospital. 402 00:19:07,606 --> 00:19:09,320 State rules are clear on this. 403 00:19:09,331 --> 00:19:13,335 Ms. Rodriguez cannot be released into her own care. 404 00:19:13,345 --> 00:19:16,238 That means Chastain would be stuck with her for a long time. 405 00:19:16,248 --> 00:19:20,176 She'd be living here at our expense. 406 00:19:20,186 --> 00:19:21,477 She would be a Perma Patient. 407 00:19:21,487 --> 00:19:23,112 Not every CEO knows that term. 408 00:19:23,122 --> 00:19:25,015 Claire is not your average CEO. 409 00:19:25,025 --> 00:19:27,016 Dr. Bell, what's her prognosis? 410 00:19:27,026 --> 00:19:29,119 Well, the five-to ten-year survival rate is excellent 411 00:19:29,129 --> 00:19:31,574 if we operate right away, but... 412 00:19:32,465 --> 00:19:34,358 the longer we wait, the worse her odds. 413 00:19:34,369 --> 00:19:36,793 And if her surgery is successful, what's the rehab? 414 00:19:36,803 --> 00:19:40,130 Six months to a year. 415 00:19:41,029 --> 00:19:43,693 Okay, best-case scenario, 416 00:19:43,704 --> 00:19:45,935 what is Louisa's care gonna cost us? 417 00:19:45,945 --> 00:19:48,772 Chastain does the surgery, it goes well, post-op, 418 00:19:48,782 --> 00:19:51,105 she can walk with a physical therapist down the hall... 419 00:19:51,116 --> 00:19:52,609 half a million dollars. 420 00:19:52,619 --> 00:19:54,944 And worst case? 421 00:19:54,954 --> 00:19:58,143 Post-op, Ms. Rodriguez can't even get out of the bed... 422 00:19:58,154 --> 00:19:59,723 two million dollars. 423 00:20:10,303 --> 00:20:13,287 Hang in there, your count is moving in the right direction. 424 00:20:13,907 --> 00:20:15,230 Lane. 425 00:20:15,240 --> 00:20:18,333 Hey, Conrad. How are you? 426 00:20:18,577 --> 00:20:20,969 I'd like to call you in for an oncology consult. 427 00:20:21,455 --> 00:20:23,206 Okay. Who's the patient? 428 00:20:23,216 --> 00:20:26,508 Louisa Rodriquez, transport worker here at Chastain. 429 00:20:26,518 --> 00:20:30,513 Good person. She's uninsured and an undocumented immigrant. 430 00:20:30,523 --> 00:20:33,315 Um, a full course of radiation and chemotherapy 431 00:20:33,325 --> 00:20:34,751 is, uh, very expensive. 432 00:20:34,761 --> 00:20:36,585 I understand, but don't you have a foundation 433 00:20:36,595 --> 00:20:38,849 - for cases like this? - Yes, I do, 434 00:20:38,860 --> 00:20:41,259 but it's not for the undocumented. 435 00:20:41,829 --> 00:20:44,602 Look, I'll make some inquiries, but I can't make any promises. 436 00:20:44,613 --> 00:20:46,763 - That'd be fantastic. - Conrad. 437 00:20:47,241 --> 00:20:49,144 Administration just put Louisa's surgery 438 00:20:49,155 --> 00:20:52,334 - on indefinite hold. - Lane... 439 00:20:52,742 --> 00:20:55,579 - Louisa's all alone. - I'll see what I can do. 440 00:20:58,584 --> 00:21:00,674 I forgot to tell you I saw Lily earlier. 441 00:21:00,685 --> 00:21:01,844 She didn't look good. 442 00:21:01,854 --> 00:21:03,012 Nic, she has cancer. 443 00:21:03,022 --> 00:21:04,616 I know we've been through this, 444 00:21:04,627 --> 00:21:07,082 and I'm sure Lane had every reason to discharge Lily, 445 00:21:07,092 --> 00:21:11,019 - but my instincts are... - Lane will take care of her. 446 00:21:11,029 --> 00:21:14,067 Lily's in good hands. 447 00:21:17,704 --> 00:21:19,394 Okay, well, I'll be going... Oh, excuse me. 448 00:21:19,404 --> 00:21:21,096 Oh, Nurse Nevin. 449 00:21:21,106 --> 00:21:22,431 If I could just have a moment? 450 00:21:22,441 --> 00:21:24,133 I'm actually really busy right now. 451 00:21:24,143 --> 00:21:26,694 Okay, but I don't think the nurses are getting the hang 452 00:21:26,705 --> 00:21:29,471 of the upcoding system and the multiple-test vectors. 453 00:21:29,481 --> 00:21:31,290 Our nurses are laser-focused on patient care. 454 00:21:31,301 --> 00:21:32,876 That is their primary responsibility. 455 00:21:32,886 --> 00:21:37,241 ♪ Too late to go back to sleep ♪ 456 00:21:37,259 --> 00:21:39,959 - ♪ It's time to trust my instincts ♪ - Excuse me. 457 00:21:39,970 --> 00:21:42,819 ♪ Close my eyes ♪ 458 00:21:42,829 --> 00:21:44,821 ♪ And leap ♪ 459 00:21:44,831 --> 00:21:47,322 ♪ It's time to try ♪ 460 00:21:47,333 --> 00:21:50,655 ♪ Defying gravity ♪ 461 00:21:50,666 --> 00:21:53,176 ♪ I think I'll try ♪ 462 00:21:53,187 --> 00:21:55,798 ♪ Defying gravity ♪ 463 00:21:55,808 --> 00:22:00,279 ♪ And you can't hold me down. ♪ 464 00:22:01,514 --> 00:22:02,938 A little flat. 465 00:22:02,948 --> 00:22:04,439 You're a little flat. 466 00:22:05,919 --> 00:22:07,153 Next! 467 00:22:07,606 --> 00:22:10,412 Claire, this is Jim Phillips, CEO of Atlanta General, 468 00:22:10,422 --> 00:22:12,401 and Stuart Green from our Lady of Mercy. 469 00:22:12,412 --> 00:22:14,143 The three of us go way back. 470 00:22:14,154 --> 00:22:16,276 Ms. Thorpe took over as CEO of Chastain, 471 00:22:16,295 --> 00:22:17,986 - what, six months ago? - Yes. 472 00:22:18,730 --> 00:22:20,289 They're all yours. 473 00:22:20,300 --> 00:22:22,175 Gentlemen, it's lovely to meet you both, 474 00:22:22,186 --> 00:22:24,133 and thank you for coming in on such short notice. 475 00:22:24,144 --> 00:22:25,609 I'll get right to the point. 476 00:22:25,620 --> 00:22:28,900 We have a patient, uninsured, undocumented, 477 00:22:28,911 --> 00:22:30,867 with a retroperitoneal sarcoma. 478 00:22:30,877 --> 00:22:33,254 Possible six months to a year rehab. 479 00:22:33,265 --> 00:22:35,103 Given our fixed costs per bed, 480 00:22:35,113 --> 00:22:38,006 this patient represents a considerable burden on Chastain. 481 00:22:38,016 --> 00:22:39,676 As they would for Atlanta General. 482 00:22:39,686 --> 00:22:42,211 Yes, but Atlanta General and Our Lady of Mercy's fixed costs 483 00:22:42,221 --> 00:22:43,979 are much lower than ours. 484 00:22:43,990 --> 00:22:46,649 What are you suggesting, Ms. Thorpe? 485 00:22:46,659 --> 00:22:49,416 If either one of you will take this patient off our hands, 486 00:22:49,427 --> 00:22:50,756 pre-surgery, 487 00:22:50,767 --> 00:22:54,538 we'll pay a fee, one-time, of $250,000. 488 00:22:56,502 --> 00:22:58,955 If you can funnel us five Medicare patients 489 00:22:58,966 --> 00:23:02,338 and up the fee to $300,000, we'll consider it. 490 00:23:02,349 --> 00:23:04,300 What if I offered you 491 00:23:04,310 --> 00:23:08,470 five Medicaid patients and $250,000? 492 00:23:08,480 --> 00:23:10,503 Medicaid reimbursements are junk. 493 00:23:11,503 --> 00:23:12,809 Ten Medicaid and 300 grand. 494 00:23:14,338 --> 00:23:17,394 I'm offering seven Medicaid and 275. 495 00:23:18,524 --> 00:23:20,643 Too low. We're out. 496 00:23:25,024 --> 00:23:27,081 Stuart, Our Lady of Mercy has a charity fund. 497 00:23:27,092 --> 00:23:29,214 What if we did the surgery and you did the rehab? 498 00:23:29,225 --> 00:23:32,896 We could give your fund $100,000 that you could use at your discretion. 499 00:23:32,906 --> 00:23:34,754 We just built a new cardiac wing. 500 00:23:34,765 --> 00:23:36,941 Which is a-a beautiful wing. 501 00:23:36,952 --> 00:23:38,476 Cost us $40 million. 502 00:23:38,487 --> 00:23:41,004 And I am sure that you will make that back in fees in no time. 503 00:23:41,896 --> 00:23:44,207 My board would kill me if we took another Perma Patient. 504 00:23:44,217 --> 00:23:46,508 I'm gonna to have to pass. 505 00:23:46,518 --> 00:23:48,054 I'm sorry. 506 00:23:55,924 --> 00:23:58,220 Who can we call, Louisa? 507 00:23:58,893 --> 00:24:00,838 You must have family here. 508 00:24:02,006 --> 00:24:04,583 My parents brought me here when I was three years old. 509 00:24:04,927 --> 00:24:07,229 My mom died two years ago, 510 00:24:07,240 --> 00:24:10,033 and my dad moved back to El Salvador. 511 00:24:10,043 --> 00:24:12,200 I'm alone. 512 00:24:14,420 --> 00:24:16,147 And you support yourself? 513 00:24:16,842 --> 00:24:18,408 Yeah. 514 00:24:20,433 --> 00:24:22,687 I guess I was crazy to think I'd make it to med school 515 00:24:22,698 --> 00:24:24,046 without being found out. 516 00:24:24,056 --> 00:24:26,060 If Immigration gets their hands on me, 517 00:24:26,071 --> 00:24:28,051 they'll send me back, no questions asked. 518 00:24:28,907 --> 00:24:31,621 But this is the only country I've ever known. 519 00:24:31,631 --> 00:24:33,732 And to be a doctor... 520 00:24:35,247 --> 00:24:37,158 that's my dream. 521 00:24:38,457 --> 00:24:41,543 I'm so sorry to cause all this trouble, Dr. Pravesh. 522 00:24:41,832 --> 00:24:44,633 Everyone at Chastain has been nothing but good to me. 523 00:24:45,080 --> 00:24:48,504 Louisa, we're going to help you, and you deserve better than this. 524 00:24:49,576 --> 00:24:51,607 I looked up the surgery on my phone. 525 00:24:52,912 --> 00:24:55,445 Cancer wrapped around a lot of organs. 526 00:24:56,821 --> 00:24:58,915 Pretty dangerous stuff, huh? 527 00:24:59,642 --> 00:25:00,681 Yes. 528 00:25:01,103 --> 00:25:02,150 It is. 529 00:25:02,160 --> 00:25:05,455 But we both know it is the only road to a cure. 530 00:25:06,315 --> 00:25:09,385 Do you know how some people say they're not afraid of dying? 531 00:25:09,602 --> 00:25:11,794 That's crazy, right? 532 00:25:11,804 --> 00:25:16,165 It scares the hell out of me. 533 00:25:16,175 --> 00:25:19,634 Louisa, you're going to be a doctor someday. 534 00:25:19,644 --> 00:25:22,170 Helping you get there... 535 00:25:22,180 --> 00:25:25,017 that's our dream. 536 00:25:34,859 --> 00:25:35,961 Hey. 537 00:25:36,953 --> 00:25:39,255 I, uh, checked with my foundation, 538 00:25:39,266 --> 00:25:41,188 and got a fast, hard no. 539 00:25:41,995 --> 00:25:45,794 Our donors expect their gifts to pay for the treatment of U.S. citizens. 540 00:25:45,804 --> 00:25:49,816 There are plenty of deserving Americans out there waiting for a chance. 541 00:25:51,783 --> 00:25:53,274 Ugh. 542 00:25:53,285 --> 00:25:56,378 I hate to disappoint you, Conrad, that's the hardest part. 543 00:25:56,389 --> 00:25:58,245 Thanks for trying. 544 00:26:00,736 --> 00:26:04,155 You know, we do the best we can, 545 00:26:04,166 --> 00:26:06,276 as often as we can. 546 00:26:08,349 --> 00:26:10,341 But we can't save everyone. 547 00:26:18,130 --> 00:26:20,645 You're all post-surgery, and you all want to go home. 548 00:26:20,656 --> 00:26:22,241 So today, we're going to have a race. 549 00:26:22,252 --> 00:26:25,127 Whoever gets to the end of the hallway first gets discharged. 550 00:26:25,137 --> 00:26:27,161 No more poking, needles, BP checks. 551 00:26:27,171 --> 00:26:30,324 You can cook your own meals, take a warm shower. Sound good? 552 00:26:30,335 --> 00:26:32,234 If you can't walk to the end of the hallway, 553 00:26:32,244 --> 00:26:33,502 you're here for another week. 554 00:26:33,512 --> 00:26:35,236 One, two, three. Go. 555 00:26:38,649 --> 00:26:40,242 Too slow, Mrs. Pill. You're done. 556 00:26:42,220 --> 00:26:44,222 Mr. Farragut, the same. 557 00:26:49,227 --> 00:26:50,752 No time to treat a heart attack, 558 00:26:50,762 --> 00:26:52,598 Mr. Smith, off you go. 559 00:26:55,033 --> 00:26:58,046 Discharge the winners. The losers can go back to their rooms. 560 00:26:58,057 --> 00:27:00,194 Take it easy, all right? You're gonna be fine. 561 00:27:00,205 --> 00:27:01,530 - Culling the herd? - Yep. 562 00:27:01,540 --> 00:27:02,826 Administration won't allow. 563 00:27:02,837 --> 00:27:04,433 - Louisa's surgery. - Unfortunate. 564 00:27:04,443 --> 00:27:05,833 But I heard she is undocumented. 565 00:27:05,843 --> 00:27:07,202 Rules are rules. 566 00:27:07,212 --> 00:27:09,474 Am I crazy, but aren't you and me supposed to be 567 00:27:09,485 --> 00:27:12,040 in the trenches together on situations like this? 568 00:27:12,050 --> 00:27:14,320 Please, tell me this is not actually how you feel. 569 00:27:14,331 --> 00:27:15,577 What I feel doesn't matter. 570 00:27:15,854 --> 00:27:16,945 What I feel doesn't help. 571 00:27:16,955 --> 00:27:18,513 I deal in facts. 572 00:27:18,523 --> 00:27:20,047 Okay. Fine. 573 00:27:20,057 --> 00:27:23,552 Because the hospital is trying to save money, Louisa might die. 574 00:27:23,562 --> 00:27:24,585 Fact. 575 00:27:24,595 --> 00:27:27,490 She might die from surgery, too. Fact. 576 00:27:27,501 --> 00:27:29,257 Love the optimism. 577 00:27:29,267 --> 00:27:30,926 How dangerous is it, Mina? 578 00:27:30,936 --> 00:27:33,562 Very intricate, very demanding. 579 00:27:33,572 --> 00:27:35,731 Seven, eight hours. 580 00:27:36,483 --> 00:27:38,031 But glorious. 581 00:27:38,042 --> 00:27:40,111 Sounds like it's right up your alley. 582 00:28:07,072 --> 00:28:10,275 Conrad, we all feel terrible for Louisa. 583 00:28:11,310 --> 00:28:13,302 She's an enormous liability. 584 00:28:13,312 --> 00:28:16,618 As much as two million dollars over the course of her treatment. 585 00:28:18,529 --> 00:28:21,654 Look, I get that it's a bottom-line world. 586 00:28:21,665 --> 00:28:22,744 You made that clear. 587 00:28:22,754 --> 00:28:24,612 But I want you to think back for a moment, 588 00:28:24,622 --> 00:28:26,415 to when you were in med school. 589 00:28:26,425 --> 00:28:29,784 It wasn't all about making money. 590 00:28:29,794 --> 00:28:31,786 That was a long time ago. 591 00:28:31,796 --> 00:28:33,421 Healthcare has changed since then. 592 00:28:33,431 --> 00:28:35,424 We need to deal with the new reality. 593 00:28:35,434 --> 00:28:38,193 I think we can both agree 594 00:28:38,203 --> 00:28:40,965 that every doctor has that singular moment 595 00:28:40,976 --> 00:28:42,770 when they decide they're going into medicine. 596 00:28:42,781 --> 00:28:44,933 For you, to be a surgeon. 597 00:28:44,943 --> 00:28:47,669 And even if it was decades ago, I'd bet everything I got 598 00:28:47,680 --> 00:28:49,364 you remember it like it was yesterday. 599 00:28:49,375 --> 00:28:51,439 And I don't buy for one second 600 00:28:51,449 --> 00:28:56,878 that it had anything to do with money. 601 00:28:56,888 --> 00:28:58,546 It didn't. 602 00:28:58,888 --> 00:29:00,649 I fell in love with cutting. 603 00:29:01,395 --> 00:29:04,218 I fell in love with the OR. 604 00:29:04,939 --> 00:29:06,118 I love it. 605 00:29:07,767 --> 00:29:08,915 Still. 606 00:29:09,501 --> 00:29:13,462 But the money has to come from somewhere. 607 00:29:13,472 --> 00:29:16,164 If we treat Louisa, our other patients will suffer. 608 00:29:16,174 --> 00:29:17,998 Services will be cut. 609 00:29:18,008 --> 00:29:20,004 Hours, staff. 610 00:29:20,015 --> 00:29:22,399 You know, I don't like the idea of putting a price tag 611 00:29:22,410 --> 00:29:23,871 on a life any more than you do. 612 00:29:23,881 --> 00:29:27,141 But the system doesn't run on air. 613 00:29:27,151 --> 00:29:29,477 No matter how much we love Louisa, 614 00:29:29,487 --> 00:29:31,012 her price tag 615 00:29:31,022 --> 00:29:34,493 is not two million dollars. 616 00:29:40,432 --> 00:29:41,758 Don't say anything. 617 00:29:41,768 --> 00:29:42,947 Nothing. 618 00:29:51,097 --> 00:29:52,189 Catch you at a bad time? 619 00:29:52,612 --> 00:29:54,170 I'd like to shove CUTE right up her... 620 00:29:54,180 --> 00:29:55,270 Throw it in the trash. 621 00:29:55,280 --> 00:29:56,450 You'll feel better. 622 00:29:59,952 --> 00:30:01,109 Look at that. 623 00:30:01,119 --> 00:30:02,778 Stress management. 624 00:30:03,702 --> 00:30:06,848 I'm guessing you didn't come up here to talk to me about upcoding. 625 00:30:06,858 --> 00:30:08,217 No. 626 00:30:08,227 --> 00:30:09,841 It's about your boy, Conrad. 627 00:30:09,852 --> 00:30:11,520 Look, he's taking things hard. 628 00:30:11,530 --> 00:30:14,100 If he doesn't start to choose his battles, he's gonna burn out. 629 00:30:16,686 --> 00:30:19,362 Yeah, well, I can't control Conrad. Never could. 630 00:30:19,372 --> 00:30:21,530 And he's not my boy. 631 00:30:21,540 --> 00:30:23,799 Not anymore. 632 00:30:24,473 --> 00:30:26,074 Sorry to hear that. 633 00:30:30,028 --> 00:30:32,942 Alabama Shakes is playing Terminal West next week. 634 00:30:32,952 --> 00:30:35,211 - Oh, yeah? - Mm-hmm. 635 00:30:35,221 --> 00:30:36,578 I got an extra ticket. 636 00:30:36,588 --> 00:30:38,413 I remember you saying you liked their music. 637 00:30:38,423 --> 00:30:39,960 I do. 638 00:30:42,319 --> 00:30:43,553 It's not a date. 639 00:30:43,563 --> 00:30:45,421 Just a concert. 640 00:30:45,431 --> 00:30:46,756 Have a little fun. 641 00:30:48,067 --> 00:30:51,461 Rapid response, 5922. Let's go. 642 00:30:51,471 --> 00:30:53,243 She's crashing. 643 00:30:53,254 --> 00:30:54,882 - Blood pressure? - 70/40. 644 00:30:54,893 --> 00:30:56,932 - Cycling right now. - Her IV blew in the MRI. 645 00:30:56,942 --> 00:30:58,793 We haven't been able to get another line since. 646 00:30:58,804 --> 00:31:01,086 - She's bleeding internally. - Now it's 60/30. 647 00:31:02,949 --> 00:31:04,673 She's a hard stick. 648 00:31:04,683 --> 00:31:07,576 Her vessels are clamped down, she's too volume-depleted. 649 00:31:08,422 --> 00:31:09,578 Emergency IO. 650 00:31:10,234 --> 00:31:12,347 - Yeah, I've never done that before. - Get the kit. 651 00:31:12,357 --> 00:31:13,527 You're doing it now. 652 00:31:19,298 --> 00:31:20,957 Push the needle in. 653 00:31:20,967 --> 00:31:23,259 Once you hit the bone, drill. 654 00:31:28,775 --> 00:31:30,777 Keep it steady. 655 00:31:39,519 --> 00:31:41,477 Drill. 656 00:31:41,487 --> 00:31:43,156 Okay, release. 657 00:31:47,894 --> 00:31:49,328 Flush. 658 00:31:58,837 --> 00:31:59,996 Running in fluids. 659 00:32:00,850 --> 00:32:02,076 We're in the clear. 660 00:32:02,087 --> 00:32:03,651 - For now. - She'll keep bleeding 661 00:32:03,662 --> 00:32:05,668 until we get her to surgery. 662 00:32:05,678 --> 00:32:07,336 There are four oncology surgeons on call. 663 00:32:07,346 --> 00:32:10,138 Why can't we ask one of them to do the operation? 664 00:32:10,148 --> 00:32:11,641 Good idea. Let's practice that. 665 00:32:11,651 --> 00:32:12,741 I'll be Dr. Hillis. 666 00:32:12,751 --> 00:32:14,076 Go ahead, pitch me the surgery. 667 00:32:14,086 --> 00:32:17,816 Hi, Dr. Hillis, I need a surgical oncologist 668 00:32:17,827 --> 00:32:19,548 to operate on a patient right away. 669 00:32:19,558 --> 00:32:21,851 - Okay, sure, who's the patient? - Louisa Rodriguez. 670 00:32:21,861 --> 00:32:23,586 Actually, I forgot. 671 00:32:23,596 --> 00:32:25,922 I'm booked solid today. 672 00:32:25,932 --> 00:32:27,256 Ask Dr. Miller. 673 00:32:27,266 --> 00:32:29,304 Dr. Miller, I need an oncology surgeon... 674 00:32:29,315 --> 00:32:32,321 Would love to, but I'm headed to Aruba today with my fiancée. 675 00:32:32,332 --> 00:32:35,285 Dr. Singh says the failure rate for this surgery is through the roof. 676 00:32:35,296 --> 00:32:37,700 Dr. Weiss heard the administration is dead set against it... 677 00:32:37,710 --> 00:32:39,669 - The administration is wrong. - Maybe they are, 678 00:32:39,679 --> 00:32:42,171 but Dr. Weiss makes 400K a year, really wants to keep his job. 679 00:32:42,181 --> 00:32:43,671 Okay. 680 00:32:45,017 --> 00:32:48,243 They're gonna wiggle their way out of it any way they can. 681 00:32:48,253 --> 00:32:50,956 But we know someone dying to do the operation. 682 00:32:53,974 --> 00:32:55,852 But it's not in your specialty. 683 00:32:55,862 --> 00:32:58,713 So? I'm arrogant enough to believe I can do it. 684 00:32:58,724 --> 00:33:00,088 And I'm your only option. 685 00:33:00,098 --> 00:33:01,567 Just get an attending to sign off. 686 00:33:03,419 --> 00:33:05,560 I need you to sign off on a surgery. 687 00:33:05,570 --> 00:33:07,896 It's not in your specialty. You'll just be supervising. 688 00:33:07,906 --> 00:33:09,432 Yeah, and what's the catch? 689 00:33:09,442 --> 00:33:11,067 No catch. 690 00:33:12,160 --> 00:33:13,786 Look, I know you, pal. 691 00:33:14,677 --> 00:33:16,371 What rules am I gonna break? 692 00:33:16,382 --> 00:33:18,441 Not breaking. Bending. 693 00:33:18,451 --> 00:33:19,875 Bending, okay. 694 00:33:19,885 --> 00:33:22,788 - Who's the patient? - Louisa Rodriguez. 695 00:33:26,369 --> 00:33:27,401 Oh, I'm in. 696 00:33:31,654 --> 00:33:33,944 Surgery's a go. Mina's on deck. 697 00:33:33,955 --> 00:33:36,436 Conrad, someone called Immigration. They're coming for Louisa. 698 00:33:47,212 --> 00:33:48,509 How can I help you, gentlemen? 699 00:33:48,520 --> 00:33:50,415 - Sir, you need to move aside. - I will, 700 00:33:50,426 --> 00:33:51,676 if you tell me what's going on. 701 00:33:51,686 --> 00:33:54,698 Hospitals are sensitive areas, along with schools and churches. 702 00:33:54,709 --> 00:33:57,748 And sensitive areas cannot be accessed by immigration officials 703 00:33:57,758 --> 00:34:00,156 without arrest warrants or under investigation 704 00:34:00,167 --> 00:34:02,020 of an imminent national security threat. 705 00:34:02,030 --> 00:34:05,656 ICE policy letter, October 24, 2011. 706 00:34:05,666 --> 00:34:08,426 You're interfering with the actions of authorized federal agents. 707 00:34:08,436 --> 00:34:10,181 - You're gonna regret this. - I doubt that. 708 00:34:10,192 --> 00:34:12,071 Well then, you better drag us both out of here. 709 00:34:12,082 --> 00:34:13,214 Conrad. 710 00:34:13,642 --> 00:34:14,706 Stop. 711 00:34:15,010 --> 00:34:17,646 Step aside or you will both be fired. 712 00:34:20,148 --> 00:34:21,859 It's okay. Let them pass. 713 00:34:44,987 --> 00:34:46,397 We need to hurry. 714 00:34:57,084 --> 00:35:00,212 Dr. Okafor, you may proceed. 715 00:35:05,226 --> 00:35:07,185 Surgery's underway. Sterile environment. 716 00:35:07,195 --> 00:35:09,932 You cannot enter under any circumstance. No one can. 717 00:35:28,950 --> 00:35:31,843 Pushing us to charge more, and order endless tests. 718 00:35:31,853 --> 00:35:34,384 Yeah, Dr. Pravesh wants the feeding tube out for 4710. 719 00:35:34,395 --> 00:35:36,214 Barb called Immigration. I'm sure of it. 720 00:35:36,224 --> 00:35:38,250 MRI order from Dr. Williams. 721 00:35:38,260 --> 00:35:39,528 Wait. Give that back to me. 722 00:35:41,229 --> 00:35:43,132 - Is this scheduled for right now? - Mm-hmm. 723 00:35:50,472 --> 00:35:52,225 - Pull him out. - What are you doing? 724 00:35:52,236 --> 00:35:53,980 Did you push his doctor to order this test? 725 00:35:53,991 --> 00:35:57,055 - I did. - Without checking the patient history? 726 00:35:58,907 --> 00:36:00,423 Open the microphone. 727 00:36:01,595 --> 00:36:03,911 Mr. Reynolds, do you know how an MRI works? 728 00:36:03,922 --> 00:36:06,310 It has incredibly powerful magnets. 729 00:36:06,320 --> 00:36:08,747 Magnets that will rip anything metal out of your body. 730 00:36:08,757 --> 00:36:10,358 Anything at all. 731 00:36:10,444 --> 00:36:13,917 Do you have anything metal in your body, Mr. Reynolds? 732 00:36:14,146 --> 00:36:16,122 Mr. Reynolds has a penile implant, 733 00:36:16,133 --> 00:36:19,122 a metal-based penile implant. 734 00:36:19,708 --> 00:36:21,792 How much is your penis worth to you, Mr. Reynolds? 735 00:36:21,802 --> 00:36:24,439 Say, in a lawsuit? A million dollars? Five million dollars? 736 00:36:24,450 --> 00:36:26,431 Stop the machine! 737 00:36:26,441 --> 00:36:28,832 You are not a doctor and you are not a nurse. 738 00:36:28,842 --> 00:36:31,770 Not every test is safe. Not every procedure should be billed 739 00:36:31,780 --> 00:36:33,181 for ten times what it's worth. 740 00:36:33,192 --> 00:36:34,906 You're gonna end up getting someone killed. 741 00:36:34,916 --> 00:36:37,007 - Now wait just a second... - I'll be filing an incident report 742 00:36:37,017 --> 00:36:38,676 with the Comptroller's office and the CEO. 743 00:36:38,686 --> 00:36:41,824 Good luck getting hired at Chastain again. 744 00:36:52,267 --> 00:36:53,591 Louisa. 745 00:36:53,601 --> 00:36:55,160 Do you have any nausea? 746 00:36:55,170 --> 00:36:56,428 No. 747 00:36:56,438 --> 00:36:58,763 I feel okay. 748 00:36:59,898 --> 00:37:02,266 You've been so kind to me, all of you. 749 00:37:02,276 --> 00:37:04,268 I'll never be able to repay you for this. 750 00:37:05,020 --> 00:37:07,971 But I'll still need some help on my bio midterm. 751 00:37:07,981 --> 00:37:09,050 Anytime. 752 00:37:10,179 --> 00:37:11,203 So... 753 00:37:11,385 --> 00:37:13,544 the operation came off without a hitch. 754 00:37:13,554 --> 00:37:15,952 You had a spectacular surgeon. 755 00:37:16,523 --> 00:37:17,614 Cake. 756 00:37:18,421 --> 00:37:20,051 What are her rehab markers? 757 00:37:20,514 --> 00:37:22,991 Well, if she can walk to the door, we're in the clear. 758 00:37:23,287 --> 00:37:24,428 If not... 759 00:37:26,800 --> 00:37:28,802 Hey. Well, you look good. 760 00:37:31,872 --> 00:37:33,832 You know, it's really important 761 00:37:33,842 --> 00:37:35,866 that we get you up on your feet right away. 762 00:37:35,876 --> 00:37:38,335 So... how about you get out of bed 763 00:37:38,345 --> 00:37:40,403 and show us how you can walk to the door? 764 00:37:41,586 --> 00:37:44,253 - Okay. - Let's really concentrate. 765 00:37:46,011 --> 00:37:47,292 Here we go. 766 00:38:05,324 --> 00:38:06,893 I'm so sorry. 767 00:38:10,744 --> 00:38:12,714 Two million. 768 00:38:15,849 --> 00:38:17,067 It's okay. 769 00:38:17,078 --> 00:38:18,947 You'll be fine. 770 00:38:32,767 --> 00:38:33,939 Louisa, 771 00:38:33,950 --> 00:38:36,572 rehab is gonna be a long, hard road, 772 00:38:37,137 --> 00:38:39,564 but we all know how tough you are. 773 00:38:39,574 --> 00:38:40,931 You'll get through this. 774 00:38:40,941 --> 00:38:42,266 With some time and care, 775 00:38:42,276 --> 00:38:44,402 you'll be right back where you were in a year or so. 776 00:38:44,412 --> 00:38:46,648 We've got your back the whole way. 777 00:39:01,655 --> 00:39:02,716 Hey, Art. 778 00:39:02,727 --> 00:39:03,804 Randolph. 779 00:39:09,915 --> 00:39:12,562 Hey, uh, how's your golfing buddy doing? 780 00:39:12,977 --> 00:39:15,474 The one with the tremor? He sink any more putts? 781 00:39:16,508 --> 00:39:18,312 Oh, uh... 782 00:39:19,187 --> 00:39:20,902 He just started taking the medication. 783 00:39:20,912 --> 00:39:23,138 - Probably too soon to tell. - Okay. 784 00:39:23,148 --> 00:39:24,674 Well, keep me updated. 785 00:39:24,684 --> 00:39:26,086 Yeah. Yeah. Will do. 786 00:39:59,116 --> 00:40:01,691 Jude and I are gonna go grab a beer. 787 00:40:01,702 --> 00:40:03,255 You want to join? 788 00:40:05,900 --> 00:40:08,618 She's a lot cuter than either of you guys. 789 00:40:08,924 --> 00:40:10,659 True enough. 790 00:40:15,365 --> 00:40:17,467 Enjoying your victory, Dr. Hawkins? 791 00:40:21,139 --> 00:40:22,308 Did you call Immigration? 792 00:40:25,248 --> 00:40:27,737 You had your billing consultant do it for you. 793 00:40:27,747 --> 00:40:30,473 Barb Olsen's contract with this hospital has been suspended. 794 00:40:30,483 --> 00:40:34,076 But I have to pull two million dollars out of thin air. 795 00:40:34,086 --> 00:40:35,312 - I understand... - No. 796 00:40:35,323 --> 00:40:38,046 You will understand full well when I take that money 797 00:40:38,057 --> 00:40:40,449 out of the Internal Medicine and ER budgets. 798 00:40:41,123 --> 00:40:44,830 Be prepared to be woefully understaffed for the next 12 months. 799 00:41:02,782 --> 00:41:06,641 By the way, thank you for today. 800 00:41:06,651 --> 00:41:08,009 Yeah. 801 00:41:08,019 --> 00:41:10,446 Thorpe could've had you canned on the spot. 802 00:41:10,456 --> 00:41:12,748 Well, I get fired, it makes the decision for me, right? 803 00:41:12,758 --> 00:41:15,917 I show up tomorrow at Fort Benning, 6:00 a.m. 804 00:41:15,927 --> 00:41:19,688 Hell, you could be there with me. 805 00:41:19,698 --> 00:41:21,323 Hmm? 806 00:41:21,627 --> 00:41:23,491 All right, so you're starting to come around. 807 00:41:23,501 --> 00:41:25,407 What are you so damn happy about? 808 00:41:25,418 --> 00:41:27,696 Because I know exactly where I'm supposed to be tomorrow, 809 00:41:27,706 --> 00:41:29,608 and it's at Chastain. 810 00:41:31,209 --> 00:41:32,679 Yeah. 811 00:41:35,280 --> 00:41:38,507 Valor, honor... 812 00:41:38,517 --> 00:41:40,487 Victory. 813 00:41:42,945 --> 00:41:44,045 Mm. 814 00:41:44,055 --> 00:41:47,126 I got these. 815 00:41:50,729 --> 00:41:53,455 So, you know, I've been meaning to ask, you and Nic... 816 00:41:53,465 --> 00:41:55,156 that still a thing? 817 00:41:55,166 --> 00:41:57,536 She doesn't think so, but... 818 00:41:59,121 --> 00:42:00,894 I think she's worth fighting for. Don't you? 819 00:42:00,905 --> 00:42:04,299 Oh, hell yeah. Game on. 820 00:42:47,218 --> 00:42:50,379 28-year-old female. Cancer patient. 821 00:42:50,389 --> 00:42:53,616 Short of breath and vomiting. BP's dropping. 822 00:42:53,626 --> 00:42:55,750 Volts and a liter of saline right now... 823 00:43:04,273 --> 00:43:06,734 - Synced and corrected by Shazi89 - - www.addic7ed.com - 57467

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