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These are the user uploaded subtitles that are being translated: 1 00:01:14,569 --> 00:01:16,570 Hey, I need my cast off. 2 00:01:16,572 --> 00:01:17,864 As soon as you park that outside. 3 00:01:17,864 --> 00:01:19,573 Morning, Doc. - Olsen. 4 00:01:19,575 --> 00:01:20,992 Happy Fourth. 5 00:01:20,992 --> 00:01:22,659 Excuse me, guys. 6 00:01:22,661 --> 00:01:25,662 Sorry. 7 00:01:50,230 --> 00:01:51,647 Hey, how's it going, Dad? 8 00:01:51,649 --> 00:01:53,483 I'm so sleep-deprived. 9 00:01:53,484 --> 00:01:55,527 My house is starting to feel like a CIA black site. 10 00:01:55,527 --> 00:01:57,486 Have you considered hiring a night nurse? 11 00:01:57,487 --> 00:01:59,239 - You're looking at him. - You got a ripe one coming in 12 00:01:59,240 --> 00:02:00,906 you're gonna have to deal with before everybody out there 13 00:02:00,908 --> 00:02:02,325 starts puking. - Lovely. 14 00:02:02,325 --> 00:02:03,909 Your replacement came in early. 15 00:02:03,911 --> 00:02:05,703 She brought in a full bagel spread. 16 00:02:05,703 --> 00:02:07,496 I'm just saying. - She's not my replacement. 17 00:02:07,498 --> 00:02:09,039 She's just covering as chief while I go 18 00:02:09,040 --> 00:02:10,415 on my little sabbatical. - Three months? 19 00:02:10,417 --> 00:02:12,001 I'll be back before your daughter 20 00:02:12,002 --> 00:02:13,836 sleeps through the night. - Hey, dude, that's cold. 21 00:02:13,837 --> 00:02:15,506 - Morning. - Good morning. 22 00:02:30,103 --> 00:02:31,728 Good morning, John. 23 00:02:31,729 --> 00:02:33,730 I could have sworn it was still around 4:00 a.m... 24 00:02:33,731 --> 00:02:35,525 Did you guys have an easy night last night? 25 00:02:35,526 --> 00:02:37,192 The waiting room actually looks manageable. 26 00:02:37,194 --> 00:02:39,111 I wouldn't call it easy, but not too bad. 27 00:02:39,112 --> 00:02:41,281 I figured we'd have hands and burns down here a bunch, 28 00:02:41,281 --> 00:02:43,365 but so far nobody's blown off any fingers. 29 00:02:43,366 --> 00:02:45,242 Oh, you know you just jinxed it. 30 00:02:45,243 --> 00:02:46,618 You guys and your jinxes. 31 00:02:46,620 --> 00:02:49,329 - Please, Jesus, please. - Hail Mary again. 32 00:02:49,331 --> 00:02:51,331 - In the sanctified flesh. - Don't let me die alone. 33 00:02:51,332 --> 00:02:54,586 - Just try to relax, Margaret. - I need a priest. 34 00:02:54,586 --> 00:02:57,254 - Hey, hey, Dr. Robby. - What's the good word, Perlah? 35 00:02:57,256 --> 00:02:59,174 All your results came back normal, Mrs. Walker. 36 00:02:59,175 --> 00:03:00,175 I'm dying. 37 00:03:00,175 --> 00:03:01,592 You're not dying, Mrs. Walker, I promise. 38 00:03:01,593 --> 00:03:03,010 Jesus is coming for me. 39 00:03:03,012 --> 00:03:05,305 If He is, He hasn't checked in at registration yet. 40 00:03:05,306 --> 00:03:06,639 Please don't let me die a sinner. 41 00:03:06,639 --> 00:03:08,223 Don't worry, Margaret... we're going to have 42 00:03:08,224 --> 00:03:10,225 the hospital chaplain come and see you in a moment. 43 00:03:10,227 --> 00:03:11,728 I'm not going to last that long. 44 00:03:11,728 --> 00:03:13,562 Yes, you will, because we're going to give you a shot 45 00:03:13,563 --> 00:03:14,980 to keep you alive until they get here. 46 00:03:14,981 --> 00:03:16,608 What are you thinking, Dr. Robinavitch? 47 00:03:16,609 --> 00:03:18,484 500 mikes of cyanocobalamin? 48 00:03:18,485 --> 00:03:20,652 In her condition, I'd push a full 1,000. 49 00:03:20,653 --> 00:03:23,698 Whoo. You heard the man, Perlah. 50 00:03:23,699 --> 00:03:25,991 God bless you. God bless all of you. 51 00:03:25,992 --> 00:03:27,576 Amen to that. 52 00:03:27,578 --> 00:03:29,579 Hail Mary, full of grace, the Lord is with thee... 53 00:03:29,579 --> 00:03:31,413 Ooh, nothing like the miracle healing powers 54 00:03:31,414 --> 00:03:32,915 of a good old B12 shot. 55 00:03:32,917 --> 00:03:36,085 How does she hold down a job? - She doesn't. 56 00:03:36,086 --> 00:03:37,753 She's wearing a waitress uniform. 57 00:03:37,754 --> 00:03:39,296 Yeah, from a diner that closed 20 years ago. 58 00:03:39,298 --> 00:03:41,591 Tier One Trauma, ETA six minutes. 59 00:03:41,591 --> 00:03:43,425 And so it begins. 60 00:03:43,426 --> 00:03:45,929 My husband is still waiting to see a doctor. 61 00:03:45,930 --> 00:03:47,180 I apologize for the wait, 62 00:03:47,180 --> 00:03:48,973 but here are two doctors just for you. 63 00:03:48,973 --> 00:03:51,141 Mr. Burgess has been complaining 64 00:03:51,143 --> 00:03:52,644 of leg cramps for a day. 65 00:03:52,645 --> 00:03:56,230 Slightly tachy at 110, BP 128 over 75. 66 00:03:56,231 --> 00:03:58,191 Afebrile, good sats. 67 00:03:58,192 --> 00:04:00,151 I'm Dr. Shen, but I'm going off shift. 68 00:04:00,151 --> 00:04:02,402 Dr. Robinavitch will be one of the doctors looking after you. 69 00:04:02,403 --> 00:04:03,695 What other medications 70 00:04:03,697 --> 00:04:05,657 are you currently taking, Mr. Burgess? 71 00:04:05,657 --> 00:04:07,783 I brought his meds. 72 00:04:07,784 --> 00:04:09,786 Thank you. 73 00:04:09,787 --> 00:04:11,329 These are his supplements, 74 00:04:11,330 --> 00:04:13,497 mostly all-natural and organic where possible. 75 00:04:13,498 --> 00:04:16,292 And these are his homeopathic prescriptions. 76 00:04:16,293 --> 00:04:20,338 I also have a list of his refrigerated probiotics. 77 00:04:23,050 --> 00:04:25,009 Where the hell is everybody? 78 00:04:25,009 --> 00:04:27,262 Our new attending is torturing 79 00:04:27,262 --> 00:04:29,514 our intern and med students in Trauma One. 80 00:04:29,514 --> 00:04:31,807 She came in early to meet the night shift 81 00:04:31,809 --> 00:04:33,393 and took things over. 82 00:04:33,394 --> 00:04:36,312 Okay, that takes giant balls of disrespect. 83 00:04:36,312 --> 00:04:37,689 Giant Balls of Disrespect 84 00:04:37,689 --> 00:04:39,481 was the name of my band in high school. 85 00:04:39,483 --> 00:04:41,692 And my nickname for my ex-husband. 86 00:04:41,694 --> 00:04:43,860 Hey, uh, is this your last shift? 87 00:04:43,862 --> 00:04:47,824 - For a while, yeah. - Oh, I am so jealous. 88 00:04:47,824 --> 00:04:50,492 Hey, I'll pay you a grand if you take my second husband. 89 00:04:50,494 --> 00:04:51,744 Tempting. 90 00:04:51,745 --> 00:04:53,704 So tell me about this new attending. 91 00:04:53,706 --> 00:04:56,832 Uh, she's pretty, divorced, one kid. 92 00:04:56,834 --> 00:04:59,377 Can already tell she is a strict rule follower. 93 00:04:59,377 --> 00:05:01,295 I'm probably going to grow to hate her. 94 00:05:01,297 --> 00:05:05,048 - What's her name, again? - Dr. Baran Al-Hashimi. 95 00:05:05,050 --> 00:05:07,718 Al-Hashimi? What is that? 96 00:05:07,720 --> 00:05:10,096 Irish? 97 00:05:10,096 --> 00:05:13,057 She's some sort of clinical informatics expert. 98 00:05:13,057 --> 00:05:14,934 Once she started talking about AI, 99 00:05:14,935 --> 00:05:18,353 I started thinking about robots and kind of stopped listening. 100 00:05:18,355 --> 00:05:20,856 Clear. Off the chest, Ogilvie. 101 00:05:20,858 --> 00:05:22,399 Get ready to step up here, Joy. 102 00:05:22,401 --> 00:05:24,651 Ogilvie, off the chest! 103 00:05:24,653 --> 00:05:26,112 Clear! 104 00:05:26,112 --> 00:05:27,947 Still V-tach, but it looks weird. 105 00:05:27,947 --> 00:05:29,699 - Agreed. - No pulse. 106 00:05:29,699 --> 00:05:31,826 No effusion, good lung sliding. 107 00:05:31,826 --> 00:05:32,869 Start compressions, Joy. 108 00:05:32,870 --> 00:05:33,995 We haven't considered all the Ts. 109 00:05:33,995 --> 00:05:35,997 I checked for tamponade and tension pneumo. 110 00:05:35,997 --> 00:05:37,206 What if it's thrombosis? 111 00:05:37,206 --> 00:05:39,417 If it's a pulmonary or cardiac clot, TNK could save him. 112 00:05:39,418 --> 00:05:41,543 We are sticking with the algorithm for now. 113 00:05:41,545 --> 00:05:43,545 - Algorithm's not working. - Faster and deeper, please. 114 00:05:43,547 --> 00:05:46,423 - Uh, you need a break, Joy? - No, I need an attending. 115 00:05:46,425 --> 00:05:48,800 I'm right here. 116 00:05:48,802 --> 00:05:50,720 Stop compressions. We're calling it. 117 00:05:52,221 --> 00:05:54,057 Sorry, the patient's dead. 118 00:05:56,851 --> 00:05:59,394 All right. Who can tell me what went well? 119 00:05:59,396 --> 00:06:01,105 We followed the V-tach algorithm. 120 00:06:01,105 --> 00:06:02,857 We checked for reversible causes. 121 00:06:02,858 --> 00:06:04,608 We limited our rhythm and pulse checks to 10 seconds. 122 00:06:04,610 --> 00:06:05,985 Excellent. 123 00:06:05,985 --> 00:06:07,278 Should we have given thrombolytics? 124 00:06:07,278 --> 00:06:08,653 No, you should have recognized 125 00:06:08,654 --> 00:06:10,781 that the cardiac rhythm on the monitor was polymorphic, 126 00:06:10,783 --> 00:06:12,617 not just V-tach. 127 00:06:12,617 --> 00:06:14,576 It was torsades de pointes. 128 00:06:14,577 --> 00:06:16,788 That's French... "twisting of the points." 129 00:06:16,788 --> 00:06:18,663 From prolonged QT, antiarrhythmics, 130 00:06:18,665 --> 00:06:19,999 electrolyte disorders. 131 00:06:20,000 --> 00:06:21,250 Your patient would have lived 132 00:06:21,250 --> 00:06:22,959 if you had pushed magnesium sulfate. 133 00:06:22,961 --> 00:06:24,836 Good news is he's an organ donor. 134 00:06:24,838 --> 00:06:26,588 Parts of him are going to get used to make Frisbees 135 00:06:26,589 --> 00:06:28,800 and water bottles and end up as microplastics 136 00:06:28,800 --> 00:06:30,509 in our brains and reproductive organs. 137 00:06:30,511 --> 00:06:32,177 Thank you for the words of encouragement, boss. 138 00:06:32,178 --> 00:06:33,805 Dr. Al-Hashimi, Dr. Michael Robinavitch. 139 00:06:33,805 --> 00:06:35,764 Everybody calls me Robby. - Baran, please. 140 00:06:35,766 --> 00:06:37,391 - Welcome to the Pitt. - Yeah, about that... 141 00:06:37,393 --> 00:06:38,768 Trauma's a minute out. 142 00:06:38,769 --> 00:06:40,728 Ooh, who wants to treat a real patient? 143 00:06:40,728 --> 00:06:42,146 Yes, please. 144 00:06:42,146 --> 00:06:44,024 This thing's going to give me nightmares. 145 00:06:45,776 --> 00:06:47,776 I hope you don't mind me jumping right into things. 146 00:06:47,778 --> 00:06:49,528 I find that a mock code is a great way 147 00:06:49,529 --> 00:06:51,279 to assess the students' capabilities. 148 00:06:51,281 --> 00:06:53,865 Well, it might have been nice if we'd had a little time 149 00:06:53,867 --> 00:06:55,617 to go over how we do things. 150 00:06:55,619 --> 00:06:58,620 Did you not get a packet from Dr. Underwood? Gloria? 151 00:06:58,622 --> 00:07:00,706 It outlined the quality-improvement changes 152 00:07:00,706 --> 00:07:02,541 I instituted at the VA. 153 00:07:02,543 --> 00:07:03,834 We're adopting the program 154 00:07:03,836 --> 00:07:05,627 at all of the university hospitals. 155 00:07:05,629 --> 00:07:08,004 You didn't read it? - No, I did. I mean, I will. 156 00:07:08,005 --> 00:07:09,548 I'm going to. I want to. 157 00:07:09,550 --> 00:07:11,216 I thought I had a little bit more time 158 00:07:11,218 --> 00:07:13,177 before you came in today. - We've already distributed 159 00:07:13,177 --> 00:07:15,680 patient passports to everyone at registration. 160 00:07:15,680 --> 00:07:18,223 What is a patient passport? 161 00:07:18,225 --> 00:07:20,810 So glad you asked. 162 00:07:20,810 --> 00:07:22,644 Samira? - Dr. Al. 163 00:07:22,646 --> 00:07:25,314 We worked together at the VA a few years ago. 164 00:07:25,314 --> 00:07:27,233 And now you're an R4. - Yes. 165 00:07:27,233 --> 00:07:29,317 And I'm so excited you're joining us. 166 00:07:29,319 --> 00:07:30,778 Dr. Mel King is here, too. 167 00:07:30,778 --> 00:07:32,196 I think you worked with her as well. 168 00:07:32,197 --> 00:07:33,906 - Incoming! - I did indeed. 169 00:07:33,906 --> 00:07:35,867 John Doe... dishwasher, penetrating trauma 170 00:07:35,867 --> 00:07:37,869 from a kitchen knife to the right chest. 171 00:07:37,870 --> 00:07:39,327 - Assault or accident? - Unclear. 172 00:07:39,329 --> 00:07:42,038 Initially had a pulse, lost it two blocks away. 173 00:07:44,418 --> 00:07:46,502 What do we got, party people? 174 00:07:46,502 --> 00:07:49,672 Dr. Yolanda Garcia, trauma surgery fellow, 175 00:07:49,673 --> 00:07:52,550 meet Dr. Baran Al-Hashimi, new E.D. attending. 176 00:07:52,550 --> 00:07:54,427 She's gonna be covering for me while I'm gone. 177 00:07:54,427 --> 00:07:56,012 So nice to meet you. 178 00:07:56,012 --> 00:07:57,512 About time they replaced you, Rabbit-bitch. 179 00:07:57,514 --> 00:07:59,264 I'm gonna miss you, too, Yolo. 180 00:07:59,266 --> 00:08:01,600 Dr. Garcia has a hard time expressing her feelings. 181 00:08:01,601 --> 00:08:02,642 Not all of them. 182 00:08:02,644 --> 00:08:06,146 One, two, three. 183 00:08:06,148 --> 00:08:09,483 Prep for a left thoracotomy. - I'm on it. 184 00:08:09,485 --> 00:08:11,694 What's up, White Chocolate? 185 00:08:11,694 --> 00:08:15,531 Did you know our farm boy here is a vintage-funk freak? 186 00:08:15,531 --> 00:08:17,908 Unfortunately, he also likes to use 187 00:08:17,910 --> 00:08:20,452 other people's toothbrushes. - It was one time. 188 00:08:20,454 --> 00:08:22,079 They were the same color. 189 00:08:22,079 --> 00:08:24,081 - What's your plan, Samira? - Dr. Mohan, next steps? 190 00:08:24,081 --> 00:08:25,415 Chest tube to the right. 191 00:08:25,417 --> 00:08:27,209 Stand by with massive transfusion protocol. 192 00:08:27,211 --> 00:08:28,461 I put two units on the infuser. 193 00:08:28,461 --> 00:08:29,795 Sterile gloves, 6 1/2. 194 00:08:29,795 --> 00:08:30,879 Here, we let the fellows 195 00:08:30,880 --> 00:08:32,298 and the residents kind of take charge. 196 00:08:32,298 --> 00:08:34,466 I'll hold on to them just in case. 197 00:08:34,467 --> 00:08:37,470 Is the VA even a trauma center? 198 00:08:37,471 --> 00:08:41,057 Not for medic runs, but they walk in... 199 00:08:41,057 --> 00:08:45,101 falls, major MVCs, GSWs. 200 00:08:45,102 --> 00:08:46,604 Stab wound's on the right. 201 00:08:46,605 --> 00:08:48,188 Why are we opening the left chest? 202 00:08:48,190 --> 00:08:50,106 Better access if it's tamponade, 203 00:08:50,107 --> 00:08:52,025 and you can cross-clamp the aorta. 204 00:08:52,027 --> 00:08:53,653 Javadi, Whitaker, sterile gloves. 205 00:08:53,653 --> 00:08:54,736 Can I glove up? 206 00:08:54,738 --> 00:08:57,322 It's best if you watch the first one. 207 00:08:57,323 --> 00:08:59,033 This guy's dead anyway. 208 00:09:00,994 --> 00:09:04,081 - 10 blade. - 28 French on a long Kelly. 209 00:09:05,249 --> 00:09:06,791 Javadi, you're on suction, 210 00:09:06,792 --> 00:09:09,751 Whitaker, get ready for internal compressions. 211 00:09:11,504 --> 00:09:13,423 Sorry, that's my phone. 212 00:09:15,008 --> 00:09:16,591 Finochietto retractor. 213 00:09:16,592 --> 00:09:17,927 Whitaker, give me a little room. 214 00:09:17,927 --> 00:09:19,135 I need to get to his heart. 215 00:09:19,136 --> 00:09:20,763 I'm in. Hook up the Thora-Seal. 216 00:09:22,182 --> 00:09:23,474 You want me to get that for you? 217 00:09:23,475 --> 00:09:25,643 Not right now. 218 00:09:33,943 --> 00:09:36,028 No tamponade, pretty dry in here. 219 00:09:37,614 --> 00:09:39,197 Heart's empty. 220 00:09:39,198 --> 00:09:40,825 Somebody start cardiac massage, I'll cross-clamp. 221 00:09:40,826 --> 00:09:41,993 Yeah, I got it. 222 00:09:41,994 --> 00:09:43,411 You do these one-handed, 223 00:09:43,412 --> 00:09:45,453 pushing up against the breastbone with four fingers. 224 00:09:45,455 --> 00:09:47,414 - Very good. - Not much blood to suction. 225 00:09:47,415 --> 00:09:50,000 - Okay, team, I think we need... - Samira, next steps? 226 00:09:50,001 --> 00:09:51,085 Keep transfusing. 227 00:09:51,086 --> 00:09:52,586 Open the right chest. - That is correct. 228 00:09:52,587 --> 00:09:54,379 Booties on, kids. There will be blood. 229 00:09:56,758 --> 00:09:58,634 Frank? 230 00:10:00,136 --> 00:10:03,264 Langdon. 231 00:10:03,264 --> 00:10:05,474 Frank? 232 00:10:12,481 --> 00:10:14,649 You should be good to go now, hon. 233 00:10:14,650 --> 00:10:16,735 - Thanks, Lupe. - Of course. 234 00:10:16,736 --> 00:10:18,614 Hey, go get 'em. 235 00:10:21,575 --> 00:10:23,993 Hey, Doc. 236 00:10:23,994 --> 00:10:26,995 It's been a while. 237 00:10:26,996 --> 00:10:30,666 I got a-a bad toothache today. 238 00:10:30,667 --> 00:10:33,336 We'll take care of that, Louie. 239 00:10:33,336 --> 00:10:34,671 All right. 240 00:11:08,038 --> 00:11:10,246 There's too much blood to suction. 241 00:11:10,248 --> 00:11:12,249 Uh, retracting the lung. 242 00:11:12,250 --> 00:11:14,626 - Try to identify the source. - Could be the right ventricle. 243 00:11:14,628 --> 00:11:16,586 Or more likely, the hilum. 244 00:11:16,587 --> 00:11:18,380 Fresh lap pads. 245 00:11:19,633 --> 00:11:22,969 Siri, turn on silent mode! 246 00:12:13,519 --> 00:12:15,104 Good morning. 247 00:12:15,105 --> 00:12:16,855 If it was a good morning, I'd still be in bed. 248 00:12:16,856 --> 00:12:18,524 So what are you doing here? 249 00:12:18,524 --> 00:12:20,525 Benji's mom is visiting for the holiday. 250 00:12:20,527 --> 00:12:22,528 - She's still alive? - That woman's too mean to die. 251 00:12:22,528 --> 00:12:24,154 Plus, who else is going to get this place 252 00:12:24,155 --> 00:12:25,947 through the Fourth of July weekend? 253 00:12:25,948 --> 00:12:27,783 Sure as hell ain't going to be me. 254 00:12:27,783 --> 00:12:30,119 I rest my case. What am I walking into? 255 00:12:30,120 --> 00:12:31,662 Nothing too bad, yet. 256 00:12:31,663 --> 00:12:34,664 Uh, these are the ones I'd keep an eye on. 257 00:12:34,665 --> 00:12:38,668 The prodigal son returns. 258 00:12:38,669 --> 00:12:39,836 Too soon? 259 00:12:39,837 --> 00:12:42,298 No, I guess not. 260 00:12:42,298 --> 00:12:44,966 You're back. - I took some time. 261 00:12:44,967 --> 00:12:48,178 I'm like an old trail horse... I always find my way back home. 262 00:12:48,179 --> 00:12:49,929 You look good, kid. How you feeling? 263 00:12:49,931 --> 00:12:51,890 Uh, yeah, great. 264 00:12:51,892 --> 00:12:54,476 You know, it's been a... 265 00:12:54,477 --> 00:12:56,979 it's been a journey. - I bet. 266 00:12:56,980 --> 00:12:58,647 Thanks. Robby around? 267 00:12:58,648 --> 00:13:00,566 Uh, he's in with a trauma. 268 00:13:00,567 --> 00:13:02,985 But if you hurry back, you can catch some of the pass-ons. 269 00:13:02,985 --> 00:13:05,238 They're in North. - Uh, thanks. 270 00:13:06,990 --> 00:13:09,033 I'll keep an eye on him. 271 00:13:11,160 --> 00:13:13,412 I think we have a lost little lamb. 272 00:13:13,413 --> 00:13:16,039 Uh, excuse me, hon. Can we help you? 273 00:13:16,041 --> 00:13:18,000 I'm looking for the charge nurse. 274 00:13:18,000 --> 00:13:20,085 Oh, well, you found two of 'em. 275 00:13:20,086 --> 00:13:21,504 I'm Lena. This is Dana. 276 00:13:21,504 --> 00:13:22,837 I'm night shift, going home, 277 00:13:22,838 --> 00:13:25,173 but Dana is queen of the day shift. 278 00:13:25,174 --> 00:13:27,217 Emma Nolan. Nice to meet you both. 279 00:13:27,219 --> 00:13:29,677 Uh, I'm a new grad RN here to shadow. 280 00:13:29,678 --> 00:13:31,221 Welcome to the Pitt, Emma Nolan. 281 00:13:31,222 --> 00:13:32,932 Here, let me put some of your stuff behind the desk, 282 00:13:32,932 --> 00:13:35,725 and I'll give you a quick tour. - Okay. 283 00:13:35,726 --> 00:13:38,229 - Where you from, sweetheart? - Sault Ste. Marie. 284 00:13:38,230 --> 00:13:39,687 Oh. 285 00:13:39,688 --> 00:13:42,232 It's in Upper Michigan, practically Canada. 286 00:13:42,234 --> 00:13:45,068 My great-grandmother was from up that way... 287 00:13:45,070 --> 00:13:48,239 nice area, a lot of bugs. 288 00:13:48,240 --> 00:13:50,073 How about a cup of coffee? 289 00:13:51,451 --> 00:13:53,034 Can't locate the source. 290 00:13:53,036 --> 00:13:54,828 Proximal hilum is under the sternum. 291 00:13:54,830 --> 00:13:56,831 Along with most of the right ventricle. 292 00:13:56,831 --> 00:13:59,625 - You need better exposure. - Convert to a clamshell. 293 00:13:59,625 --> 00:14:02,043 - Exactly. - Trauma shears. 294 00:14:02,044 --> 00:14:04,672 Would've been nice to let them come up with that plan. 295 00:14:04,673 --> 00:14:06,756 Heart's going to need double compressions just like this. 296 00:14:08,134 --> 00:14:10,594 Squeeze from the apex to the aorta. 297 00:14:12,138 --> 00:14:13,764 Right ventricle looks good. 298 00:14:13,764 --> 00:14:15,224 Massive hemorrhage from the hilum. 299 00:14:15,225 --> 00:14:18,726 Second MTP pack is going, additional four units. 300 00:14:18,727 --> 00:14:21,145 Hilar injury looks very proximal... 301 00:14:21,147 --> 00:14:23,399 may be pulmonary artery and vein. 302 00:14:23,399 --> 00:14:26,067 Clamp's on. Nope, no good. 303 00:14:26,068 --> 00:14:27,570 Still bleeding like a stuck pig. 304 00:14:27,571 --> 00:14:28,571 I can give it a try. 305 00:14:28,572 --> 00:14:29,947 Dr. Garcia is a very skilled surgeon. 306 00:14:29,947 --> 00:14:31,615 If she can't get it, we need to think of something else. 307 00:14:31,615 --> 00:14:32,826 Like what? 308 00:14:36,288 --> 00:14:37,788 Hilar flip. 309 00:14:37,788 --> 00:14:39,456 We're going to rotate the lung 180 degrees, 310 00:14:39,456 --> 00:14:41,082 like putting a kink in the garden hose. 311 00:14:41,084 --> 00:14:43,836 It'll stop the bleeding. - That could possibly work. 312 00:14:43,836 --> 00:14:47,590 Or he'll die when you rip the entire lung off the hilum. 313 00:14:47,591 --> 00:14:50,426 Gently, very, very gently, very, very slowly. 314 00:15:06,067 --> 00:15:07,902 - Blood loss is slowing down. - That's a good sign. 315 00:15:07,903 --> 00:15:09,193 Hilum looks dry. 316 00:15:09,195 --> 00:15:11,029 Yeah, but the heart feels empty. 317 00:15:11,030 --> 00:15:13,573 Okay, we fixed the leak. Now let's fill the tank. 318 00:15:15,744 --> 00:15:17,827 You are very popular today. 319 00:15:17,828 --> 00:15:20,624 Sorry, I'll turn it off when I can. 320 00:15:24,793 --> 00:15:26,503 Nine-year-old Kylie Connors... 321 00:15:26,504 --> 00:15:28,713 brought in by her dad's girlfriend, Gina. 322 00:15:28,715 --> 00:15:31,133 Kylie took a tumble on the stairs this morning. 323 00:15:31,134 --> 00:15:34,135 3-centimeter chin lac and a chipped front incisor. 324 00:15:34,136 --> 00:15:36,054 She's got LET on a pressure dressing. 325 00:15:36,056 --> 00:15:37,889 Bleeding pretty good on arrival. 326 00:15:37,890 --> 00:15:40,058 Dermabond should do the trick. 327 00:15:40,059 --> 00:15:42,144 Any questions? 328 00:15:42,144 --> 00:15:44,520 Dr. King? 329 00:15:44,522 --> 00:15:45,980 Mel? 330 00:15:45,981 --> 00:15:48,567 Oh, um, I didn't say anything. 331 00:15:51,363 --> 00:15:54,155 - Uh, how you feeling, Kylie? - Tired. 332 00:15:54,157 --> 00:15:56,951 - We've been here since 5:30. - Oh, that makes two of us. 333 00:15:56,951 --> 00:15:59,327 But don't worry. We'll patch you up good as new. 334 00:15:59,328 --> 00:16:01,956 And we will get you out of here as soon as we can. 335 00:16:01,956 --> 00:16:03,374 Any questions? - Can you raise your chin? 336 00:16:03,375 --> 00:16:05,250 No, I'm just her dad's girlfriend, 337 00:16:05,250 --> 00:16:07,293 so I'm new to all this. - No worries. We got you. 338 00:16:07,294 --> 00:16:08,587 Next. 339 00:16:10,173 --> 00:16:14,051 26-year-old Liam Sanders... took a fall from his bicycle. 340 00:16:14,052 --> 00:16:16,177 No LOC, nonfocal neuro, 341 00:16:16,178 --> 00:16:18,514 lower-leg lac with no bony tenderness. 342 00:16:18,514 --> 00:16:20,349 Were you wearing a helmet, Liam? 343 00:16:20,350 --> 00:16:22,225 No, I was just riding in my neighborhood. 344 00:16:22,226 --> 00:16:24,019 You should always wear a helmet. 345 00:16:24,019 --> 00:16:25,520 Hey, nice of you to join us. 346 00:16:25,522 --> 00:16:27,606 - Hey. - Dr. Langdon! 347 00:16:30,025 --> 00:16:32,860 Sold to Dr. Langdon. 348 00:16:32,861 --> 00:16:35,197 Candace O'Grady, 82... 349 00:16:35,197 --> 00:16:39,369 Brought in by her son Richard for intractable vomiting. 350 00:16:41,203 --> 00:16:43,038 Hardly any hemorrhage on the right. 351 00:16:43,038 --> 00:16:44,456 - Looks like the flip worked. - How's the heart, Whitaker? 352 00:16:44,456 --> 00:16:46,417 Feels full of blood. First time since we started. 353 00:16:46,418 --> 00:16:50,336 Hold compressions. 354 00:16:50,337 --> 00:16:53,006 - Quivering bag of worms. - Resume compressions. 355 00:16:53,008 --> 00:16:55,509 When the heart quivers like that, it's obvious V-fib. 356 00:16:55,509 --> 00:16:58,803 - Okay, internal paddles ready. - Mm-hmm. Charge to...? 357 00:16:58,804 --> 00:17:00,596 - 25 joules. - 50 joules. 358 00:17:00,597 --> 00:17:02,515 50 gets it right the first time. 359 00:17:02,517 --> 00:17:04,684 Charged. 360 00:17:04,685 --> 00:17:05,978 Okay, Whitaker, when you're ready. 361 00:17:05,979 --> 00:17:08,022 Clear. 362 00:17:10,607 --> 00:17:12,736 That's what normal sinus looks like. 363 00:17:14,528 --> 00:17:15,612 Strong carotid. 364 00:17:15,613 --> 00:17:18,740 Saline lap pads and up to the OR. 365 00:17:18,741 --> 00:17:21,076 That's a hell of a way to start the day. 366 00:17:21,076 --> 00:17:24,913 Unconventional, but a decent outcome. 367 00:17:24,913 --> 00:17:27,249 Why don't we split up for efficiency? 368 00:17:27,250 --> 00:17:29,586 Residents present to either one of us but not both. 369 00:17:31,086 --> 00:17:33,048 We can certainly discuss that. 370 00:17:37,509 --> 00:17:39,470 Were you feeling weak or dizzy? 371 00:17:39,471 --> 00:17:40,846 No. 372 00:17:40,846 --> 00:17:42,597 I-I got up to pee, and I tripped over 373 00:17:42,598 --> 00:17:44,599 a laundry basket that I couldn't see in the dark. 374 00:17:44,601 --> 00:17:46,143 Did you hit your head? 375 00:17:46,144 --> 00:17:48,103 Does my chart say that I hit my head? 376 00:17:48,104 --> 00:17:50,271 No, we just want to be thorough 377 00:17:50,272 --> 00:17:52,523 to make sure you don't miss anything. 378 00:17:52,525 --> 00:17:54,859 How about we focus on patching me up? 379 00:17:54,861 --> 00:17:56,487 Ah! 380 00:17:56,488 --> 00:17:58,489 All right, Mr. Williams, 381 00:17:58,490 --> 00:18:00,281 we're going to check an X-ray of your wrist 382 00:18:00,282 --> 00:18:02,492 and try to get you out of here as quickly as possible. 383 00:18:02,493 --> 00:18:04,994 Great. And let's keep the bullshit extra charges 384 00:18:04,996 --> 00:18:06,497 to a minimum, huh? 385 00:18:06,498 --> 00:18:08,790 My deductible is already a bitch. 386 00:18:11,294 --> 00:18:13,128 Sure. 387 00:18:34,817 --> 00:18:36,234 Bye. 388 00:18:36,236 --> 00:18:38,694 My mother is trying to destroy my life. 389 00:18:38,695 --> 00:18:40,864 Yeah, they seem to take pleasure in that. 390 00:18:40,865 --> 00:18:42,699 I committed to a partnership-track position 391 00:18:42,700 --> 00:18:44,535 next year at a hospital back in Jersey 392 00:18:44,536 --> 00:18:46,537 so I could be close and support her. 393 00:18:46,538 --> 00:18:49,539 But now she's getting married and selling our house 394 00:18:49,540 --> 00:18:52,084 to go on a year-long cruise around the world. 395 00:18:52,085 --> 00:18:54,670 Wow. I mean, that's a... 396 00:18:54,671 --> 00:18:56,630 Pretty fucking stupid idea, if you ask me. 397 00:18:56,631 --> 00:18:58,714 She's known this guy less than a year. 398 00:18:58,715 --> 00:19:02,094 What if he's a player? What if she disappears at sea? 399 00:19:02,095 --> 00:19:03,846 I mean, what if they're in love? 400 00:19:03,846 --> 00:19:05,513 Lust is more like it. 401 00:19:05,515 --> 00:19:08,642 That is even better. 402 00:19:08,643 --> 00:19:11,936 Man, it has been a while, 403 00:19:11,938 --> 00:19:15,356 and I'm solo this weekend. 404 00:19:15,357 --> 00:19:17,609 I need to get laid. 405 00:19:21,489 --> 00:19:23,615 It's a little much before 8:00 a.m., right? 406 00:19:23,615 --> 00:19:25,451 Yeah. 407 00:19:26,952 --> 00:19:28,746 Or ever. 408 00:19:34,210 --> 00:19:35,751 How's it going, Esme? 409 00:19:35,752 --> 00:19:38,006 Oh, just another day in paradise. 410 00:19:55,230 --> 00:19:57,941 Heard you're going on a trip. 411 00:19:57,942 --> 00:20:00,193 Taking a sabbatical. Leave tonight. 412 00:20:00,194 --> 00:20:02,028 Where you going? 413 00:20:02,029 --> 00:20:05,865 Um, Head-Smashed-In Buffalo Jump. 414 00:20:05,866 --> 00:20:08,660 Captain Crunch flying squirrel socks. 415 00:20:08,661 --> 00:20:11,954 What, are we talking in code, or are you having a stroke? 416 00:20:11,955 --> 00:20:15,416 It's an Aboriginal UNESCO Heritage Site in Alberta. 417 00:20:15,417 --> 00:20:17,419 I've never seen the Badlands. 418 00:20:17,420 --> 00:20:20,631 What is this, like, uh, some sort of spirit quest? 419 00:20:20,632 --> 00:20:23,925 Uh, yeah, something like that. 420 00:20:23,926 --> 00:20:26,553 Look, I, uh... I guess we should talk. 421 00:20:26,554 --> 00:20:28,931 Got a lot of things I need to... - At some point, not right now. 422 00:20:28,932 --> 00:20:30,598 Right now I got to hit the head, 423 00:20:30,599 --> 00:20:32,601 and I would like you to go help Donnie out in Triage. 424 00:20:32,602 --> 00:20:33,935 Triage? 425 00:20:33,936 --> 00:20:35,479 N-no. 426 00:20:35,480 --> 00:20:37,189 No, I already picked up a patient in North 2, 427 00:20:37,190 --> 00:20:38,606 a bicycle fall leg lac, so maybe... 428 00:20:38,607 --> 00:20:39,775 Pretty sure we can cover for you. 429 00:20:39,776 --> 00:20:43,028 We've been doing it for months. 430 00:20:43,028 --> 00:20:44,613 Right. 431 00:20:44,614 --> 00:20:47,199 No, and I... and I am... I am very, uh... 432 00:20:47,200 --> 00:20:48,951 both very sorry and appreciative of that. 433 00:20:48,951 --> 00:20:50,451 I just would hate to think 434 00:20:50,452 --> 00:20:53,121 that this is some kind of a punishment for... 435 00:20:53,122 --> 00:20:55,039 but, uh, yeah. Yeah. No, for sure. 436 00:20:55,040 --> 00:20:58,669 We'll... we'll talk later, before you go. 437 00:20:58,670 --> 00:21:01,128 Like I said, not right now. 438 00:21:01,130 --> 00:21:03,507 Donnie just passed his NP certification. 439 00:21:03,508 --> 00:21:05,425 He can help if you get in over your head. 440 00:21:08,887 --> 00:21:10,846 Hey, Mel... 441 00:21:10,847 --> 00:21:13,724 can you take over a bike fall leg lac in North 2 442 00:21:13,726 --> 00:21:15,602 for Langdon while he's out in Triage? 443 00:21:15,603 --> 00:21:17,395 Um, you know, I-I can work in Triage if you want... 444 00:21:17,396 --> 00:21:19,272 No, I want to keep Langdon out in Triage, 445 00:21:19,273 --> 00:21:20,982 and I want to keep you back here. 446 00:21:20,983 --> 00:21:23,484 You okay with that? - Sure. 447 00:21:23,486 --> 00:21:25,488 - Great. - Absolutely. 448 00:21:31,493 --> 00:21:33,202 So... 449 00:21:33,203 --> 00:21:35,497 who should I pick up? 450 00:21:35,498 --> 00:21:37,499 We're about to get the morning rush. 451 00:21:37,500 --> 00:21:38,709 What do you mean? 452 00:21:38,710 --> 00:21:40,210 Every morning around this time, 453 00:21:40,211 --> 00:21:42,671 the nursing homes and assisted-living facilities 454 00:21:42,672 --> 00:21:45,340 do their morning bed checks. - Uh-huh. 455 00:21:48,094 --> 00:21:50,637 It looks pretty quiet to me. 456 00:21:53,891 --> 00:21:56,101 Huh. 457 00:21:56,102 --> 00:21:57,853 Incoming. 458 00:21:57,854 --> 00:21:59,520 Oh, like I said. 459 00:21:59,521 --> 00:22:01,064 Come on. 460 00:22:01,065 --> 00:22:02,606 Ethan Bostick, 79... 461 00:22:02,607 --> 00:22:04,692 found altered this morning at assisted living. 462 00:22:04,693 --> 00:22:06,028 No history of dementia. 463 00:22:06,028 --> 00:22:07,903 Has a POLST. - What's a POLST? 464 00:22:07,904 --> 00:22:10,531 Physician Orders for Life-Sustaining Treatment... 465 00:22:10,532 --> 00:22:12,992 no CPR, no intubation. 466 00:22:12,993 --> 00:22:15,077 Then there's... there's nothing for us to do. 467 00:22:15,078 --> 00:22:16,913 South 15 is open. 468 00:22:16,913 --> 00:22:19,915 Uh, well, "do not resuscitate" does not mean "do not treat." 469 00:22:19,916 --> 00:22:23,753 He may perk up with fluids, IV antibiotics. 470 00:22:28,550 --> 00:22:29,843 What's the good word, Crash? 471 00:22:29,844 --> 00:22:32,220 You save that ventriloquist dummy? 472 00:22:32,221 --> 00:22:33,930 - Yeah. - Really? 473 00:22:33,931 --> 00:22:36,391 No. 474 00:22:36,392 --> 00:22:38,393 Wait, tell me you're not actually charting 475 00:22:38,394 --> 00:22:40,561 about losing a mannequin. - It's part of the exercise. 476 00:22:40,563 --> 00:22:42,396 Dr. Al-Hashimi asked us to do it. 477 00:22:42,397 --> 00:22:44,398 Who's his next of kin... Barbie? 478 00:22:45,942 --> 00:22:49,945 What's your, uh, take on the new attending? 479 00:22:49,947 --> 00:22:51,615 Too soon to tell. 480 00:22:53,576 --> 00:22:54,910 You? 481 00:22:54,911 --> 00:22:56,161 She's already bugging me 482 00:22:56,162 --> 00:22:57,788 about being behind on my charting. 483 00:22:57,788 --> 00:22:59,455 Now I know why everyone says 484 00:22:59,457 --> 00:23:01,750 being a second-year resident sucks... because it does. 485 00:23:01,750 --> 00:23:03,542 I must've slept through the part of med school 486 00:23:03,544 --> 00:23:06,380 where they tell you 90% of your time will be spent typing. 487 00:23:06,381 --> 00:23:07,963 Which is just one more reason 488 00:23:07,964 --> 00:23:10,174 surgery is a better lifestyle choice. 489 00:23:10,175 --> 00:23:13,178 Hey, Dr. Shamsi. Dr. Trinity Santos. 490 00:23:13,179 --> 00:23:15,388 Ah, yes, the ER intern who's interested 491 00:23:15,390 --> 00:23:17,391 in my surgery program. - That's me. 492 00:23:17,392 --> 00:23:19,976 But I'm an R2 now and thinking of double boarding 493 00:23:19,977 --> 00:23:21,811 in surgery and emergency medicine, 494 00:23:21,813 --> 00:23:24,314 which I know would sound ridiculously ambitious 495 00:23:24,315 --> 00:23:26,650 if I didn't have the talent to back it up. 496 00:23:26,651 --> 00:23:28,236 And the required attitude. 497 00:23:29,862 --> 00:23:31,613 Are you here to see a patient? 498 00:23:31,614 --> 00:23:33,406 I was. I did. 499 00:23:33,407 --> 00:23:34,782 And now I'm here to learn 500 00:23:34,784 --> 00:23:37,451 why you aren't returning my calls or texts. 501 00:23:37,452 --> 00:23:38,994 Okay, I'm out. 502 00:23:38,996 --> 00:23:41,123 Nice seeing you again, Dr. Shamsi. 503 00:23:41,124 --> 00:23:42,665 As soon as I get a little free time, 504 00:23:42,666 --> 00:23:44,792 I will make plans for all of us to do something together. 505 00:23:44,794 --> 00:23:46,627 - What about Tuesday? - I'm working. 506 00:23:46,628 --> 00:23:48,505 On your birthday? 507 00:23:48,506 --> 00:23:50,298 I will call you and Dad tomorrow, 508 00:23:50,298 --> 00:23:52,008 and we'll come up with something to do together, I promise. 509 00:23:52,009 --> 00:23:54,009 But right now I actually have 510 00:23:54,010 --> 00:23:56,263 a bunch of night-shift hand-offs. 511 00:24:03,354 --> 00:24:07,106 We have schedules. You have chaos. 512 00:24:07,107 --> 00:24:09,233 You know she's wasting her talents down here. 513 00:24:09,234 --> 00:24:12,237 Victoria is a big girl. She can make her own decisions. 514 00:24:12,238 --> 00:24:15,824 She's also a young girl who's still very impressionable. 515 00:24:15,825 --> 00:24:18,868 And you can be very... - "Pressionable"? 516 00:24:21,455 --> 00:24:22,830 Yes? 517 00:24:22,832 --> 00:24:25,666 Who? 518 00:24:25,667 --> 00:24:28,461 Oh, for God's sake. I'll be right there. 519 00:24:28,462 --> 00:24:30,963 We need to talk. 520 00:24:30,964 --> 00:24:33,300 How about same time tomorrow? 521 00:24:35,886 --> 00:24:37,721 Next Tuesday's your birthday? 522 00:24:37,721 --> 00:24:40,015 No. 523 00:24:40,016 --> 00:24:42,267 Yes. - Your 21st birthday? 524 00:24:42,268 --> 00:24:43,684 Please don't say anything, okay? 525 00:24:43,685 --> 00:24:45,060 I-I get a little anxious about... 526 00:24:45,061 --> 00:24:46,563 Dr. Santos, little girl with the chin lac 527 00:24:46,564 --> 00:24:48,064 is getting into a gown. 528 00:24:48,065 --> 00:24:50,692 Don't want anyone to know what? 529 00:24:50,692 --> 00:24:53,028 Nothing. 530 00:24:53,028 --> 00:24:54,945 - Have a good day. - You too. 531 00:24:56,615 --> 00:24:57,950 Oh. 532 00:24:59,367 --> 00:25:02,077 Hey, Duke, I'm just calling to remind you 533 00:25:02,078 --> 00:25:05,080 that this is my last shift for a while. 534 00:25:05,082 --> 00:25:07,625 So I need you to come in before 3:00 535 00:25:07,626 --> 00:25:11,086 in case we need to run some tests. 536 00:25:11,087 --> 00:25:13,758 Okay? We had a deal, brother. 537 00:25:15,800 --> 00:25:17,928 Oh. Hello. - Hi. 538 00:25:17,929 --> 00:25:20,096 I know you're crazy busy. - Always. 539 00:25:20,096 --> 00:25:22,182 But I figured we should really go over a few things 540 00:25:22,182 --> 00:25:23,724 before you're gone. - Sure. 541 00:25:23,726 --> 00:25:25,809 Where would you like to start? 542 00:25:25,810 --> 00:25:27,520 Well, one little thing that I think 543 00:25:27,521 --> 00:25:30,105 would have a big impact with staff and patients alike 544 00:25:30,106 --> 00:25:31,942 is if we launched a campaign 545 00:25:31,942 --> 00:25:35,111 to eradicate referring to this wonderful department 546 00:25:35,112 --> 00:25:37,739 as the Pitt. - Really? 547 00:25:37,740 --> 00:25:39,740 I know you think it's silly and petty. 548 00:25:39,741 --> 00:25:41,742 No, I think it's just kind of endearing, 549 00:25:41,743 --> 00:25:45,622 pretty damn accurate. - I would argue the opposite. 550 00:25:45,623 --> 00:25:48,124 I think subconsciously it affects those who work here. 551 00:25:48,125 --> 00:25:49,750 It also lowers expectations, 552 00:25:49,751 --> 00:25:52,127 which in turn lowers patient-satisfaction scores. 553 00:25:52,128 --> 00:25:53,963 You have been talking to Gloria. 554 00:25:53,964 --> 00:25:57,424 - Yes, and she agrees with me. - Don't doubt that for a moment. 555 00:25:57,425 --> 00:25:59,260 You have to see the man over there right now! 556 00:25:59,261 --> 00:26:01,846 We see people in order of severity, ma'am. 557 00:26:05,268 --> 00:26:06,768 I don't know what you're saying. 558 00:26:06,769 --> 00:26:09,104 I can taste the shit in the back of my throat. 559 00:26:09,105 --> 00:26:10,355 Actually, the lady's right. 560 00:26:10,355 --> 00:26:11,981 He's going to make all of us sick. 561 00:26:11,982 --> 00:26:13,066 Yes, please. 562 00:26:19,865 --> 00:26:21,449 All right. 563 00:26:21,450 --> 00:26:22,992 We'll get him back. 564 00:26:22,993 --> 00:26:25,412 Tell Dana we're bringing the funk. 565 00:26:25,413 --> 00:26:27,455 - Oh, my God. - Whew! 566 00:26:28,290 --> 00:26:30,791 So when did your eye start bothering you, Ms. Mathews? 567 00:26:30,792 --> 00:26:32,836 Sister Grace, please. 568 00:26:32,836 --> 00:26:34,878 I'm only married to God. 569 00:26:34,880 --> 00:26:36,589 Of course, I'm sorry. 570 00:26:36,590 --> 00:26:40,175 A few days ago. I thought it was pink eye 571 00:26:40,176 --> 00:26:42,386 or maybe I scratched it while gardening. 572 00:26:42,387 --> 00:26:44,638 It's a very bad case of conjunctivitis. 573 00:26:44,640 --> 00:26:46,391 We should send a sample to the lab 574 00:26:46,392 --> 00:26:47,851 to direct our treatment. 575 00:26:47,852 --> 00:26:49,729 Look up for me. Thank you. 576 00:26:52,981 --> 00:26:55,817 Okay, I'll put a numbing drop in your eye 577 00:26:55,817 --> 00:26:58,863 and check for a scratch with a special lamp. 578 00:27:01,824 --> 00:27:03,825 And I'll get you to look up for me again. 579 00:27:03,826 --> 00:27:05,660 Thank you. 580 00:27:05,661 --> 00:27:08,163 Have you ever considered serving God? 581 00:27:08,163 --> 00:27:09,330 Which one? 582 00:27:09,332 --> 00:27:11,665 Excuse me? 583 00:27:11,666 --> 00:27:13,417 My family is Hindu, 584 00:27:13,419 --> 00:27:16,211 so we have, like, 33 different kinds of deities. 585 00:27:16,212 --> 00:27:18,464 Oh, we have the one. 586 00:27:18,465 --> 00:27:21,509 Some people only need one, right? 587 00:27:21,509 --> 00:27:23,010 Okay. 588 00:27:25,138 --> 00:27:28,016 Most important rule around here... be smart, be safe. 589 00:27:28,017 --> 00:27:30,059 I can't warn you enough about protecting yourself 590 00:27:30,060 --> 00:27:31,478 and your fellow nurses. 591 00:27:31,479 --> 00:27:33,938 We use the STAMP acronym to assess patients. 592 00:27:33,939 --> 00:27:35,356 You know it? 593 00:27:35,357 --> 00:27:37,901 Uh, S is for staring or refusal to make eye contact. 594 00:27:37,902 --> 00:27:39,568 If they're staring, they're scaring. 595 00:27:39,569 --> 00:27:41,112 T? - Tone of voice. 596 00:27:41,113 --> 00:27:43,490 Often the threat level rises with their voice. 597 00:27:43,490 --> 00:27:44,949 A is for anxiety. 598 00:27:44,950 --> 00:27:46,617 You can also think "aggression." 599 00:27:46,618 --> 00:27:48,036 M is mumbling. 600 00:27:48,037 --> 00:27:49,244 Which, if you listen closely enough, 601 00:27:49,246 --> 00:27:50,913 is often them saying what they're thinking of doing 602 00:27:50,914 --> 00:27:52,582 as they talk themselves up to it. 603 00:27:52,583 --> 00:27:54,125 And P? - Pacing. 604 00:27:54,125 --> 00:27:55,542 Good. 605 00:27:55,544 --> 00:27:57,461 We also have a safe word... "hula hoop." 606 00:27:57,462 --> 00:27:59,255 I guess technically it's two words, but whatever. 607 00:27:59,256 --> 00:28:01,257 If there's a threat, say "hula hoop," 608 00:28:01,258 --> 00:28:04,719 and we'll all respond. 609 00:28:04,720 --> 00:28:06,261 Yeah? 610 00:28:06,262 --> 00:28:07,721 Lovely. 611 00:28:07,722 --> 00:28:11,893 Okay, I'll be right there with reinforcements. 612 00:28:11,894 --> 00:28:14,730 Duty calls. We're headed for Triage. 613 00:28:20,486 --> 00:28:22,444 We're going to get your cast off... 614 00:28:41,507 --> 00:28:44,217 The antibiotics should clear everything up, 615 00:28:44,218 --> 00:28:47,136 but you should try to stay off it for a few days. 616 00:28:47,137 --> 00:28:50,515 Uh, I have to work. I'm late as it is. 617 00:28:50,516 --> 00:28:54,519 Well, um, take breaks and elevate when you can. 618 00:28:54,519 --> 00:28:56,354 Tylenol and Advil for the pain. 619 00:28:56,355 --> 00:28:59,106 If the pain persists or feel like it's getting worse, 620 00:28:59,107 --> 00:29:00,316 come on back. 621 00:29:00,317 --> 00:29:02,652 We'll get you fixed up. - Thanks. 622 00:29:02,653 --> 00:29:05,696 They said give this to the doctor. 623 00:29:05,698 --> 00:29:08,782 - What the hell is it? - Patient passport. 624 00:29:08,784 --> 00:29:10,785 Lets patients know what they're waiting for 625 00:29:10,786 --> 00:29:12,287 and how long it'll take. 626 00:29:12,288 --> 00:29:14,538 You check off if he needs labs, X-rays, CT. 627 00:29:14,539 --> 00:29:16,499 None of the above. When did we start this? 628 00:29:16,500 --> 00:29:18,542 Today, the new attending. 629 00:29:20,296 --> 00:29:22,630 What's up with your tooth, Louie? 630 00:29:22,631 --> 00:29:25,340 It's been going on for a while, 631 00:29:25,342 --> 00:29:27,343 but it got bad last night. 632 00:29:27,344 --> 00:29:29,971 Lower-left side. 633 00:29:29,971 --> 00:29:32,140 Okay. 634 00:29:32,141 --> 00:29:35,602 Oh, yeah. 635 00:29:35,603 --> 00:29:37,479 It could be an infection at the root. 636 00:29:37,480 --> 00:29:40,647 We can drain it, but then... 637 00:29:40,648 --> 00:29:42,817 you're, uh... you're breathing kind of fast. 638 00:29:42,817 --> 00:29:44,736 Yeah, I've been... 639 00:29:44,737 --> 00:29:48,198 well, I've been, uh, walking more, 640 00:29:48,199 --> 00:29:49,865 trying to get in shape. 641 00:29:49,866 --> 00:29:52,701 But sometimes I get a little short of breath. 642 00:29:52,702 --> 00:29:55,747 Yeah, you need to walk past the liquor store, not into it. 643 00:29:55,748 --> 00:29:58,374 Only shape you're getting in is for a liver transplant. 644 00:29:58,375 --> 00:30:01,376 I don't need a new liver. Just get rid of this toothache. 645 00:30:01,377 --> 00:30:02,836 Deep breath. 646 00:30:06,592 --> 00:30:08,218 One more. 647 00:30:08,219 --> 00:30:10,845 - Is my heart still ticking? - Like a jackrabbit. 648 00:30:10,846 --> 00:30:14,057 How long you been sitting down? - Oh, just for a few minutes. 649 00:30:14,057 --> 00:30:15,599 Not that long. 650 00:30:15,601 --> 00:30:17,435 Um, Louie... 651 00:30:19,230 --> 00:30:21,440 There's something I need to tell you. 652 00:30:23,776 --> 00:30:27,028 Last time I saw you, about ten months ago, 653 00:30:27,028 --> 00:30:31,825 I treated you, and I took some of your medicine. 654 00:30:31,826 --> 00:30:34,911 I'm not sure I follow. 655 00:30:34,912 --> 00:30:37,579 I have an addiction to benzos, 656 00:30:37,580 --> 00:30:41,250 and I helped myself to some of the Librium I prescribed you 657 00:30:41,251 --> 00:30:42,876 for your withdrawal. 658 00:30:42,877 --> 00:30:44,797 You stole my pills? 659 00:30:46,507 --> 00:30:48,007 Yeah. 660 00:30:48,008 --> 00:30:50,509 Yes, um... 661 00:30:50,510 --> 00:30:53,136 I'm sorry. It was, uh... 662 00:30:53,137 --> 00:30:56,057 it was not only wrong and utterly unprofessional, 663 00:30:56,057 --> 00:30:58,809 but it was a betrayal of my Hippocratic Oath, 664 00:30:58,810 --> 00:31:02,063 and it was a fucking crime. 665 00:31:02,064 --> 00:31:06,484 That's where I've been... rehab and counseling. 666 00:31:08,278 --> 00:31:10,904 - Huh. - I'm sorry. 667 00:31:10,905 --> 00:31:13,782 I-I understand if you'd prefer a different doctor. 668 00:31:13,784 --> 00:31:17,244 Hey, Doc, we have a situation. 669 00:31:17,246 --> 00:31:19,663 Excuse me. 670 00:31:19,664 --> 00:31:21,082 What kind of situation? 671 00:31:21,083 --> 00:31:23,667 Someone left a little baby in the restroom. 672 00:31:31,844 --> 00:31:33,760 Okay, let's think 673 00:31:33,761 --> 00:31:36,681 about reversible causes of confusion in the elderly. 674 00:31:36,682 --> 00:31:40,309 Uh, hypo or hypernatremia, infection, but he's afebrile, 675 00:31:40,310 --> 00:31:42,228 good O2 sats, and urine dip is negative. 676 00:31:42,229 --> 00:31:46,316 Yeah, great. Joy, anything to add? 677 00:31:46,317 --> 00:31:48,902 Nah. 678 00:31:48,903 --> 00:31:51,363 - V-tach. Can I... - Yeah. 679 00:31:53,115 --> 00:31:55,032 No pulse. Should we call for a code blue? 680 00:31:55,034 --> 00:31:59,037 No CPR, no shock, we honor his POLST and his wishes. 681 00:31:59,038 --> 00:32:02,624 So what does that leave us? 682 00:32:02,625 --> 00:32:05,292 Making sure he's comfortable. 683 00:32:05,294 --> 00:32:06,794 I'll suction. 684 00:32:06,795 --> 00:32:09,005 Altered mental in the elderly can also be 685 00:32:09,006 --> 00:32:13,426 toxicity from anticholinergics, sedative-hypnotics, opioids. 686 00:32:14,886 --> 00:32:17,137 A-am I missing something? 687 00:32:17,138 --> 00:32:19,222 Social skills? 688 00:32:19,223 --> 00:32:21,517 What? 689 00:32:24,063 --> 00:32:25,395 He looks so peaceful. 690 00:32:25,396 --> 00:32:26,605 Shouldn't we go find a new patient? 691 00:32:26,606 --> 00:32:29,232 No, stay here. 692 00:32:31,028 --> 00:32:33,072 Asystole. 693 00:32:41,997 --> 00:32:44,289 Quick and painless. 694 00:32:44,290 --> 00:32:46,084 We should all be so lucky. 695 00:32:46,085 --> 00:32:48,169 I'll try to contact some family. 696 00:32:49,755 --> 00:32:53,217 Yeah, one of the things we like to do here... 697 00:32:56,095 --> 00:32:58,179 When we have the time... 698 00:32:58,180 --> 00:33:01,015 is to take a moment of silence when we lose a patient 699 00:33:01,016 --> 00:33:03,393 to respect their humanity. 700 00:33:03,394 --> 00:33:07,521 He was someone's son, perhaps a father himself, 701 00:33:07,522 --> 00:33:10,025 a brother or a friend. 702 00:33:12,778 --> 00:33:16,198 Oh, uh, make sure your phones are on silent. 703 00:33:20,368 --> 00:33:23,037 Great, great, great. Okay. Uh... 704 00:33:23,038 --> 00:33:26,415 Is anyone missing a baby? 705 00:33:26,416 --> 00:33:30,752 Did anyone leave their child in the restroom? 706 00:33:30,753 --> 00:33:34,257 Do you, uh, remember seeing a woman enter with a baby 707 00:33:34,258 --> 00:33:36,134 but leave without one? 708 00:33:36,134 --> 00:33:38,427 No, sorry. 709 00:33:38,429 --> 00:33:40,430 Might be on the security tapes. 710 00:33:40,431 --> 00:33:42,682 I'll have Ahmad check it out. - Please. 711 00:33:42,682 --> 00:33:43,849 Yeah. 712 00:33:43,851 --> 00:33:46,184 Harlow Graham to window one. 713 00:33:46,185 --> 00:33:49,521 Harlow Graham to window one. 714 00:33:49,522 --> 00:33:53,484 Harlow Graham to window one, please. 715 00:33:58,281 --> 00:34:00,074 Donnie Donahue, nurse practitioner. 716 00:34:00,075 --> 00:34:01,451 This is Emma, new grad nurse. 717 00:34:01,451 --> 00:34:02,993 - Hey. - Nice to meet you. 718 00:34:02,994 --> 00:34:04,828 - What's going on? - Somebody dumped their kid. 719 00:34:04,829 --> 00:34:07,457 Maybe Mom just stepped out for a smoke or something. 720 00:34:07,458 --> 00:34:09,250 What? I'm being helpful. 721 00:34:09,251 --> 00:34:10,793 Sometimes they just need a little break, 722 00:34:10,793 --> 00:34:13,253 and then they come back. 723 00:34:13,255 --> 00:34:14,922 At least they didn't leave her in a suitcase 724 00:34:14,922 --> 00:34:17,257 at the bus station. - Does that happen? 725 00:34:17,259 --> 00:34:19,135 If that's a true story, I don't want to know about it. 726 00:34:19,135 --> 00:34:21,262 - It ain't the worst I've seen. - Please, don't tell me. 727 00:34:21,262 --> 00:34:23,681 I'm a new dad, remember? - Okay. 728 00:34:30,646 --> 00:34:32,648 There you go. I'll get Robby. 729 00:34:32,648 --> 00:34:34,358 - Should I come with? - No, stay here. 730 00:34:34,358 --> 00:34:36,652 Donnie, Jesse, teach her something. 731 00:34:39,364 --> 00:34:43,117 You know how to check a rectal temp on an infant? 732 00:34:43,117 --> 00:34:44,744 Uh... 733 00:34:44,744 --> 00:34:46,663 theoretically. 734 00:34:52,168 --> 00:34:55,045 Mr. Williams, how's the pain? 735 00:34:55,047 --> 00:34:56,672 Nothing I can't manage 736 00:34:56,672 --> 00:34:58,673 with some Vicodin and a little scotch. 737 00:34:58,675 --> 00:35:01,302 Well, it's best not to mix the two. 738 00:35:01,302 --> 00:35:03,637 James here is going to take you to get an X-ray of your wrist. 739 00:35:03,639 --> 00:35:05,514 I'm going to be fine. 740 00:35:05,516 --> 00:35:07,974 Well, it'll tell us if you need a cast. 741 00:35:07,976 --> 00:35:09,643 Oh, I doubt it. 742 00:35:09,644 --> 00:35:11,896 I should probably go home, keep some ice on it. 743 00:35:11,896 --> 00:35:14,690 I know you guys always need the beds. 744 00:35:14,690 --> 00:35:17,068 Well, uh, it'll only take a minute, 745 00:35:17,068 --> 00:35:18,820 and then we'll know for sure. 746 00:35:18,820 --> 00:35:20,905 Yeah, I-I really don't think it's necessary. 747 00:35:20,905 --> 00:35:23,449 And I have a busy day, but I appreciate your concern. 748 00:35:26,702 --> 00:35:29,246 I'd really like to observe you for a little bit, 749 00:35:29,248 --> 00:35:31,833 in case you did hit your head. 750 00:35:31,833 --> 00:35:33,416 My head? 751 00:35:33,418 --> 00:35:35,878 I hit my schnoz on my arm, I think, nothing more. 752 00:35:35,878 --> 00:35:38,172 You think? You don't remember? 753 00:35:38,172 --> 00:35:39,632 No. 754 00:35:39,632 --> 00:35:41,467 Or, yes. 755 00:35:41,467 --> 00:35:44,512 I'm going to be fine, really. 756 00:35:44,512 --> 00:35:46,764 But thank you for your concern. 757 00:35:50,476 --> 00:35:52,269 Okay. 758 00:35:54,565 --> 00:35:58,233 How about we take that X-ray just to be safe? 759 00:35:58,235 --> 00:36:00,735 - Yeah. Yeah, okay. - Yeah? 760 00:36:00,737 --> 00:36:02,947 Okay. - Okay, good idea. 761 00:36:04,867 --> 00:36:06,951 Somebody found a baby? - Yeah. 762 00:36:06,952 --> 00:36:09,369 Not the first time it's happened. 763 00:36:09,371 --> 00:36:11,204 So, about those pills I took... 764 00:36:11,206 --> 00:36:14,250 Oh, don't worry about it, Doc. 765 00:36:14,251 --> 00:36:17,628 If the pills helped you, great. 766 00:36:17,628 --> 00:36:19,880 I never really liked taking 'em. 767 00:36:21,800 --> 00:36:23,384 I appreciate that, Louie. 768 00:36:23,385 --> 00:36:25,385 That's not really the point, but... 769 00:36:25,387 --> 00:36:27,804 I need to lift up your shirt for a second. 770 00:36:33,769 --> 00:36:36,146 How long has your belly been hard like that? 771 00:36:36,148 --> 00:36:37,606 I don't know. 772 00:36:37,608 --> 00:36:39,733 I figured I could wait another week. 773 00:36:39,735 --> 00:36:41,777 You need, uh, some lab tests 774 00:36:41,777 --> 00:36:44,614 and a procedure to drain off some of this fluid. 775 00:36:44,614 --> 00:36:46,615 Yeah, I know the drill. 776 00:36:46,617 --> 00:36:48,992 I've been tapped a few times before. 777 00:36:48,994 --> 00:36:52,204 Three times in the last six months. 778 00:36:52,206 --> 00:36:54,998 You need to give your liver a break, Louie. 779 00:36:55,000 --> 00:36:56,418 Yeah, I know. 780 00:37:01,005 --> 00:37:03,007 I just heard somebody dumped a baby 781 00:37:03,007 --> 00:37:04,425 in the waiting-room bathroom. 782 00:37:04,425 --> 00:37:07,637 How sad is that? - Huh? 783 00:37:07,637 --> 00:37:10,764 What's up with you today, Mel... ancholia? 784 00:37:10,766 --> 00:37:13,184 What makes you think there's something up with me? 785 00:37:13,184 --> 00:37:14,976 You're moping around here all day 786 00:37:14,978 --> 00:37:17,438 like somebody gunned down your favorite K-Pop band. 787 00:37:17,438 --> 00:37:19,440 I don't really have a favorite K-Pop band. 788 00:37:19,440 --> 00:37:21,275 It's not that I don't like the genre. 789 00:37:21,275 --> 00:37:23,027 It's just kinda... - Okay, forget K-Pop. 790 00:37:23,027 --> 00:37:24,653 What's going on with you? 791 00:37:24,655 --> 00:37:26,030 You usually ride in here 792 00:37:26,030 --> 00:37:27,822 on your unicorn tossing wildflowers. 793 00:37:27,824 --> 00:37:30,534 - "Unicorn"? - Never mind. 794 00:37:30,534 --> 00:37:33,036 Is everything okay with your sister? 795 00:37:33,038 --> 00:37:34,789 Oh, yeah, she's great. 796 00:37:34,789 --> 00:37:36,831 It's just this... 797 00:37:38,501 --> 00:37:40,670 Spill, girl. 798 00:37:40,670 --> 00:37:42,295 Um... 799 00:37:42,297 --> 00:37:45,675 well, a-a couple months ago, I got named in a... 800 00:37:45,675 --> 00:37:47,842 Malpractice lawsuit. 801 00:37:47,844 --> 00:37:51,722 And so, um, today is the... the deposition. 802 00:37:51,722 --> 00:37:53,431 That's it? 803 00:37:53,432 --> 00:37:56,601 Every emergency-medicine doc gets sued sooner or later. 804 00:37:56,603 --> 00:37:59,021 Seriously, don't sweat it. You're still a resident. 805 00:37:59,021 --> 00:38:00,690 We're protected by the hospital. 806 00:38:00,690 --> 00:38:04,527 You could cut somebody's head off and get away with it. 807 00:38:04,527 --> 00:38:06,945 But, you know, like, don't. 808 00:38:06,947 --> 00:38:09,407 You don't want to become known as the one 809 00:38:09,407 --> 00:38:11,992 who put Mel in mel-practice. 810 00:38:11,994 --> 00:38:14,829 Hey, Santos, our little girl, Kylie, has been 811 00:38:14,829 --> 00:38:18,081 in the West Penn Emergency Department a couple times. 812 00:38:18,083 --> 00:38:20,710 I'm not saying this is necessarily the case here, 813 00:38:20,710 --> 00:38:23,503 but recent studies have linked bullying behavior 814 00:38:23,505 --> 00:38:26,423 to different personality disorders. 815 00:38:26,425 --> 00:38:29,092 On the other hand, though, I-I am known to be a bit 816 00:38:29,094 --> 00:38:30,552 overly sensitive sometimes... 817 00:38:30,554 --> 00:38:31,762 - Mel. - Yes? 818 00:38:31,762 --> 00:38:33,097 You're talking to yourself again. 819 00:38:33,097 --> 00:38:34,931 You need something? - Uh, yeah, a good lawyer. 820 00:38:34,932 --> 00:38:36,726 I don't know. I'm kidding. 821 00:38:36,726 --> 00:38:38,019 I'm... 822 00:38:39,938 --> 00:38:42,148 Yo, Robinavitch, somebody ditched a bundle of joy 823 00:38:42,148 --> 00:38:43,440 in chairs. 824 00:38:43,442 --> 00:38:44,900 - How old? - Couple months maybe. 825 00:38:44,900 --> 00:38:46,318 Donahue's got her in Pedes. 826 00:38:46,320 --> 00:38:48,778 - No one saw who left her? - Apparently not. 827 00:38:48,780 --> 00:38:50,530 - That's so sad. - Tell me about it. 828 00:38:50,532 --> 00:38:52,074 Who throws away a perfectly good baby? 829 00:38:53,242 --> 00:38:54,617 Make a lane! 830 00:38:54,619 --> 00:38:57,121 Ah, sweet baby Jesus, Antoine! 831 00:38:57,121 --> 00:38:59,248 Right to the outdoor shower! - I just drive 'em. 832 00:38:59,248 --> 00:39:00,708 I'm not a wash and detail service. 833 00:39:00,708 --> 00:39:03,085 Yeah, yeah, God forbid you prove useful. 834 00:39:03,085 --> 00:39:04,670 Ah, good timing, Ms. Emma. 835 00:39:04,670 --> 00:39:07,380 Time for you and me to do the Lord's work. This way. 836 00:39:07,382 --> 00:39:09,300 Ooh, God, what is that? 837 00:39:09,300 --> 00:39:13,054 Okay, big breath. 838 00:39:13,054 --> 00:39:17,016 All right, lungs sound great. Can you lean forward for me? 839 00:39:22,563 --> 00:39:26,317 Uh, did you hit your back when you fell down the stairs? 840 00:39:26,318 --> 00:39:27,443 No. 841 00:39:27,443 --> 00:39:29,320 Okay, there's a pretty good bruise here. 842 00:39:29,320 --> 00:39:31,197 I got knocked down in soccer. 843 00:39:33,240 --> 00:39:36,077 Oh, no, you broke your wrist last year, too, huh? 844 00:39:36,077 --> 00:39:38,913 Fell off my skateboard. Got a purple cast. 845 00:39:38,914 --> 00:39:40,498 Cool color. 846 00:39:40,498 --> 00:39:42,458 And you were treated at West Penn? 847 00:39:42,458 --> 00:39:44,918 Is that your closest hospital? 848 00:39:44,920 --> 00:39:46,670 Uh, I guess that would make sense. 849 00:39:46,670 --> 00:39:48,672 I've only been dating her dad a few months. 850 00:39:48,672 --> 00:39:51,425 Uh, he lived in Garfield before the divorce. 851 00:39:51,425 --> 00:39:53,927 - And, uh, what about these? - Soccer. 852 00:39:53,929 --> 00:39:55,637 Do you wear shin guards? 853 00:39:55,639 --> 00:39:57,306 My dad ordered them. 854 00:39:57,306 --> 00:40:00,684 Okay. What does your dad do for work? 855 00:40:00,684 --> 00:40:03,561 He draws buildings, but he's not an architect. 856 00:40:03,563 --> 00:40:05,981 He's a draftsman for a firm in Newcastle. 857 00:40:05,981 --> 00:40:10,402 Okay. Um, Kylie, any chance you can pee? 858 00:40:10,403 --> 00:40:12,822 - Mm, maybe. - Okay. 859 00:40:12,822 --> 00:40:14,864 Well, with the bruise on your back, 860 00:40:14,865 --> 00:40:16,449 we need to check your urine. 861 00:40:16,451 --> 00:40:18,036 - Okay. - Okay. 862 00:40:20,956 --> 00:40:23,331 Did you eat anything out of the ordinary recently? 863 00:40:23,333 --> 00:40:24,791 No. 864 00:40:24,793 --> 00:40:27,210 Sorry, but we went through this a bunch. 865 00:40:27,211 --> 00:40:28,878 Don't you people communicate? 866 00:40:28,880 --> 00:40:30,797 You're the third nurse we've told her story to. 867 00:40:30,798 --> 00:40:32,132 I'm a doctor. 868 00:40:32,134 --> 00:40:35,135 Richard, would you go to the cafeteria 869 00:40:35,137 --> 00:40:37,554 and get me a large chamomile tea? 870 00:40:37,556 --> 00:40:39,722 What can we get you, my dear? 871 00:40:39,724 --> 00:40:42,059 I'm fine, thank you. 872 00:40:44,019 --> 00:40:45,856 Yeah, I'll be right back. 873 00:40:49,693 --> 00:40:52,110 Please excuse my son. 874 00:40:52,112 --> 00:40:54,028 Ever since my husband died, 875 00:40:54,030 --> 00:40:56,449 he's been a little overprotective. 876 00:40:56,449 --> 00:40:58,492 I think it's sweet. 877 00:40:58,492 --> 00:41:01,371 You're very lucky to have him. - I am. 878 00:41:02,956 --> 00:41:06,876 Are you still taking your loperamide and cholestyramine? 879 00:41:06,876 --> 00:41:09,670 Um, mm, not so much. 880 00:41:09,670 --> 00:41:11,380 No? 881 00:41:11,380 --> 00:41:13,798 That may be why you're experiencing the abdominal pain 882 00:41:13,800 --> 00:41:15,425 and vomiting. 883 00:41:15,427 --> 00:41:17,677 When did you stop taking your meds? 884 00:41:17,679 --> 00:41:19,847 Last winter or so. 885 00:41:21,849 --> 00:41:25,518 My neighbor Helen and I bingo in Wintersville. 886 00:41:25,519 --> 00:41:28,188 There's a dispensary next door. 887 00:41:28,190 --> 00:41:30,231 And we got some marijuana. 888 00:41:30,233 --> 00:41:34,527 And I swear it cleared everything up. 889 00:41:34,528 --> 00:41:38,072 A few cookies every few hours... 890 00:41:38,074 --> 00:41:40,742 and no more pain. 891 00:41:40,744 --> 00:41:43,286 "A few cookies"? 892 00:41:43,288 --> 00:41:45,414 How many are you eating in a day? 893 00:41:45,414 --> 00:41:47,500 Oh, uh... 894 00:41:47,501 --> 00:41:50,168 I don't know. 895 00:41:50,170 --> 00:41:55,090 Probably a dozen or so, but they're not very big. 896 00:41:55,090 --> 00:41:57,092 There have been some studies 897 00:41:57,092 --> 00:41:59,302 that show an added dementia risk 898 00:41:59,304 --> 00:42:02,306 with marijuana use in older adults. 899 00:42:03,682 --> 00:42:06,393 Well, that sucks for old people. 900 00:42:07,728 --> 00:42:09,688 Kylie, there are some questions 901 00:42:09,688 --> 00:42:13,733 that we ask every kid who comes in with an injury. 902 00:42:13,735 --> 00:42:15,277 Like what? 903 00:42:15,277 --> 00:42:18,739 Like, sometimes the people that you live with 904 00:42:18,739 --> 00:42:23,744 can get so mad that they hit you or hurt you, 905 00:42:23,744 --> 00:42:25,954 maybe without even meaning to. 906 00:42:25,956 --> 00:42:27,414 Does that ever happen? 907 00:42:27,414 --> 00:42:29,916 No, not to me. 908 00:42:29,918 --> 00:42:32,126 Or sometimes kids can get punished 909 00:42:32,128 --> 00:42:33,753 for doing something wrong 910 00:42:33,755 --> 00:42:37,298 with maybe a spanking or a belt. 911 00:42:37,300 --> 00:42:39,969 I get time-outs. 912 00:42:39,969 --> 00:42:42,096 How about at school, Kylie? 913 00:42:42,097 --> 00:42:45,599 You know, is anybody being, you know, mean or bullying you? 914 00:42:45,599 --> 00:42:48,186 No, I have lots of friends. 915 00:43:08,998 --> 00:43:11,166 Yo, Whitaker. 916 00:43:11,166 --> 00:43:14,003 Dr. Langdon. 917 00:43:14,003 --> 00:43:17,797 - You, uh, meet Louie here? - Uh, yeah, yeah, many times. 918 00:43:17,798 --> 00:43:20,175 Good morning, Mr. Cloverfield. - What's up, Doc? 919 00:43:20,175 --> 00:43:22,385 Where's your new resident badge buddy, buddy? 920 00:43:22,387 --> 00:43:26,724 Oh, uh, yeah, they... they didn't give me a new one yet. 921 00:43:26,724 --> 00:43:28,057 Bummer. 922 00:43:28,059 --> 00:43:29,643 You and, uh, your ducklings got time 923 00:43:29,643 --> 00:43:31,311 to tap a six-pack off our friend here? 924 00:43:31,313 --> 00:43:33,856 Louie needs a paracentesis. - Yeah, sure. 925 00:43:33,856 --> 00:43:35,815 It's good to see you again, Louie... 926 00:43:35,817 --> 00:43:37,568 not in this condition, of course. 927 00:43:37,568 --> 00:43:38,652 How you feeling? 928 00:43:38,652 --> 00:43:41,989 Feeling like I need a drink pretty soon. 929 00:43:41,989 --> 00:43:43,824 Okay, well, first things first... 930 00:43:43,824 --> 00:43:46,076 we are going to make you more comfortable 931 00:43:46,077 --> 00:43:47,702 by draining some fluid. 932 00:43:47,704 --> 00:43:49,413 You're gonna take off a big volume, 933 00:43:49,414 --> 00:43:52,541 so start with 60 grams of 25% albumin IV. 934 00:43:52,541 --> 00:43:55,126 You tapped him before? - No. 935 00:43:55,128 --> 00:43:57,630 That's okay, Doc. I'll talk him through it. 936 00:43:57,630 --> 00:43:59,382 Okay. 937 00:44:01,009 --> 00:44:04,429 Sats 99 on room air, normal BP, normal pulse. 938 00:44:07,222 --> 00:44:08,891 Oh, well hydrated. 939 00:44:08,891 --> 00:44:10,643 No obvious source of infection. 940 00:44:10,643 --> 00:44:13,646 Could be a benign virus, but can't assume that. 941 00:44:13,646 --> 00:44:16,273 - Is this the abandoned baby? - Mm-hmm. 942 00:44:16,273 --> 00:44:18,650 - How old? - How old do you think she is? 943 00:44:18,652 --> 00:44:22,070 - Month, month and a half? - It's tricky. 944 00:44:22,072 --> 00:44:25,449 Under 28 days is a Safe Haven drop-off, no questions asked. 945 00:44:25,449 --> 00:44:28,911 But over 28 days is a crime, child abandonment. 946 00:44:28,911 --> 00:44:31,079 How should we assess? 947 00:44:31,081 --> 00:44:34,208 Under 28 days gets everything, including an LP. 948 00:44:34,208 --> 00:44:36,543 But over 28 days, 949 00:44:36,543 --> 00:44:38,711 you can follow PECARN or Step-by-step 950 00:44:38,713 --> 00:44:41,422 to determine risk of invasive bacterial infection. 951 00:44:41,423 --> 00:44:42,925 This baby looks great. 952 00:44:42,925 --> 00:44:44,885 But we know nothing about the birth history. 953 00:44:44,885 --> 00:44:48,722 Did Mom have group B strep, active HSV lesions? 954 00:44:48,722 --> 00:44:52,768 We should assume the worst. Put in your orders, Dr. Mohan. 955 00:44:52,768 --> 00:44:54,811 CBC... 956 00:44:54,813 --> 00:44:57,313 Blood culture, chem panel, 957 00:44:57,315 --> 00:45:00,192 chest X-ray, UA and culture, 958 00:45:00,193 --> 00:45:02,402 respiratory virus panel. 959 00:45:02,403 --> 00:45:06,699 Check inflammatory markers... procalcitonin and CRP... 960 00:45:06,699 --> 00:45:08,784 then take it from there. 961 00:45:08,784 --> 00:45:10,994 That sounds like a plan. 962 00:45:10,994 --> 00:45:13,163 Dr. Robby, Santos needs you in North 1. 963 00:45:13,164 --> 00:45:14,706 Okay, I'll be right there. 964 00:45:14,708 --> 00:45:17,168 If you'll excuse me, if you'll excuse me. 965 00:45:19,503 --> 00:45:23,757 - Mind if I join with? - Uh, no, I got this. 966 00:45:23,757 --> 00:45:25,509 It will help me get a better sense 967 00:45:25,510 --> 00:45:27,760 of how you like to do things by seeing you in action 968 00:45:27,762 --> 00:45:29,262 with the residents. 969 00:45:29,264 --> 00:45:30,974 Be my guest. 970 00:45:33,684 --> 00:45:35,894 I will be right back. 971 00:45:40,983 --> 00:45:43,777 Um, nine-year-old Kylie Connors... 972 00:45:43,777 --> 00:45:45,820 took a tumble running up the stairs this morning. 973 00:45:45,822 --> 00:45:47,614 Chin lac and fractured tooth. 974 00:45:47,614 --> 00:45:49,824 Brought in by her dad's girlfriend, Gina. 975 00:45:49,826 --> 00:45:52,952 Supposedly, the dad had to leave early for work. 976 00:45:52,954 --> 00:45:55,748 Kylie has a lot of bruising on her body... 977 00:45:55,748 --> 00:45:57,331 some old, some new. 978 00:45:57,333 --> 00:46:00,918 Are you concerned about non-accidental trauma? 979 00:46:00,920 --> 00:46:02,545 Or worse. 980 00:46:02,547 --> 00:46:05,007 Her urine sample shows gross hematuria, 981 00:46:05,007 --> 00:46:08,217 which could be renal injury, or vaginal bleeding from trauma 982 00:46:08,219 --> 00:46:10,471 could have contaminated the specimen. 983 00:46:10,472 --> 00:46:13,389 Lots to consider. What's your plan? 984 00:46:13,391 --> 00:46:16,059 Labs, ultrasound, social-work consult, 985 00:46:16,059 --> 00:46:18,103 then decide if this is reportable. 986 00:46:18,103 --> 00:46:19,521 Mm-hmm. 987 00:46:22,733 --> 00:46:24,568 Let me know if you can feel this. 988 00:46:24,568 --> 00:46:26,402 No. Am I supposed to? 989 00:46:26,403 --> 00:46:27,614 No. 990 00:46:31,826 --> 00:46:33,994 Your hair's such a pretty color. 991 00:46:33,994 --> 00:46:35,204 Thank you. 992 00:46:35,204 --> 00:46:37,706 Reminds me of my mom. 993 00:46:37,706 --> 00:46:41,001 She died when I was nine. - Oh, I'm sorry about that. 994 00:46:41,001 --> 00:46:43,586 She wore glasses like you, too. 995 00:46:43,588 --> 00:46:45,588 Weird. 996 00:46:45,590 --> 00:46:49,009 What do you like to do when you're not working? 997 00:46:49,010 --> 00:46:51,427 Um, spend some time with my sister, 998 00:46:51,429 --> 00:46:53,222 read. 999 00:46:53,222 --> 00:46:54,847 Do you drink coffee? 1000 00:46:54,849 --> 00:46:58,476 Uh, no, I avoid caffeine. 1001 00:46:58,478 --> 00:46:59,603 Me too. 1002 00:46:59,603 --> 00:47:01,271 Um... 1003 00:47:01,271 --> 00:47:03,273 what about boba? 1004 00:47:04,818 --> 00:47:08,320 I love boba. 1005 00:47:10,949 --> 00:47:12,949 I'd offer you some gum, but it's laced with nicotine. 1006 00:47:12,951 --> 00:47:14,827 Trying to quit smoking. 1007 00:47:14,827 --> 00:47:17,411 That's good. 1008 00:47:17,413 --> 00:47:19,164 Verdict's still out. 1009 00:47:19,164 --> 00:47:21,541 Get in all those nooks and crannies, Mr. Digby. 1010 00:47:21,543 --> 00:47:23,418 Your skin will thank you. 1011 00:47:23,418 --> 00:47:25,336 We all will. 1012 00:47:25,338 --> 00:47:29,382 Oh, I could stay in here all day. 1013 00:47:29,384 --> 00:47:31,635 It's a miracle what little soap, water, and human decency 1014 00:47:31,635 --> 00:47:33,637 can do sometimes. 1015 00:47:33,637 --> 00:47:35,054 Don't forget the ears, pal. 1016 00:47:35,056 --> 00:47:37,056 Don't want anything growing in there either. 1017 00:47:37,057 --> 00:47:38,641 Okay. Okay. 1018 00:47:38,643 --> 00:47:40,561 What's your story, Emma? 1019 00:47:40,561 --> 00:47:43,438 What'd your parents do? Got siblings? Boyfriend? 1020 00:47:43,438 --> 00:47:46,400 Ever kill a man in a bar fight? 1021 00:47:46,400 --> 00:47:47,693 Uh... 1022 00:47:57,119 --> 00:47:59,454 So, Mr. Williams, 1023 00:47:59,454 --> 00:48:01,873 sometimes a fracture of the scaphoid bone 1024 00:48:01,875 --> 00:48:03,750 doesn't show up on day one. 1025 00:48:03,751 --> 00:48:07,461 So my advice to be safe is wear a splint for two weeks 1026 00:48:07,463 --> 00:48:09,672 and then come back for a repeat X-ray, 1027 00:48:09,673 --> 00:48:11,465 and we'll see if it's really there. 1028 00:48:13,760 --> 00:48:16,387 My knee hurts. 1029 00:48:16,389 --> 00:48:19,724 Oh, did you hurt your knee? 1030 00:48:19,726 --> 00:48:21,476 I must have. 1031 00:48:28,025 --> 00:48:30,110 What is this? 1032 00:48:30,110 --> 00:48:33,030 That's, um, for your wrist. 1033 00:48:33,030 --> 00:48:35,949 And I need this? 1034 00:48:35,949 --> 00:48:38,702 Well, um, if it's a, uh... 1035 00:48:38,702 --> 00:48:40,786 John, can you? 1036 00:48:40,788 --> 00:48:43,331 If it's a fracture and we don't immobilize, 1037 00:48:43,333 --> 00:48:45,543 the bone might not heal properly. 1038 00:48:47,503 --> 00:48:51,340 How long is this gonna take? 1039 00:48:51,340 --> 00:48:53,760 Just a few minutes to fit you. 1040 00:48:56,637 --> 00:48:59,139 Is this place new? 1041 00:49:01,851 --> 00:49:05,855 Mr. Williams, do you know what day it is? 1042 00:49:09,400 --> 00:49:11,943 It's Taco Tuesday. 1043 00:49:11,945 --> 00:49:14,197 Do you know where you are? 1044 00:49:15,697 --> 00:49:18,951 Yeah, I'm in the slowest medical clinic in the West. 1045 00:49:18,952 --> 00:49:21,411 Do you know what year it is? 1046 00:49:21,411 --> 00:49:23,538 How about you just fix my wrist 1047 00:49:23,539 --> 00:49:27,751 and you stop with all the questions? 1048 00:49:27,751 --> 00:49:30,838 I am not here to be profiled. 1049 00:49:35,009 --> 00:49:37,927 Yeah, of course. 1050 00:49:37,929 --> 00:49:40,056 I'll be back, okay? 1051 00:49:50,775 --> 00:49:53,527 All right, Mr. Digby, looking better already. 1052 00:49:53,527 --> 00:49:55,445 Certainly smell a little better. 1053 00:49:55,445 --> 00:49:56,947 Do you have any conditioner? 1054 00:49:56,947 --> 00:49:59,074 Let's get you dried off and back inside. 1055 00:49:59,074 --> 00:50:00,742 Get him gowned up and put him in South 21, 1056 00:50:00,742 --> 00:50:01,909 across from the old nun. 1057 00:50:01,911 --> 00:50:05,204 Maybe some of her divine grace will wear off on him. 1058 00:50:05,206 --> 00:50:06,539 Who do we have here? 1059 00:50:06,541 --> 00:50:09,458 Evelyn Bostick, 81, with Alzheimer's. 1060 00:50:09,460 --> 00:50:11,711 We brought her husband in about 30 minutes ago. 1061 00:50:11,713 --> 00:50:13,338 She was supposed to get a ride in, 1062 00:50:13,338 --> 00:50:15,007 but they found her wandering in traffic. 1063 00:50:15,007 --> 00:50:17,050 - Where are we? - You're at the hospital, dear. 1064 00:50:17,050 --> 00:50:18,427 I'm not sick. 1065 00:50:18,427 --> 00:50:20,429 We brought you to see your husband. 1066 00:50:20,429 --> 00:50:22,431 Oh, no. Is Ethan okay? 1067 00:50:22,431 --> 00:50:25,016 I'll be in to chat with you, Mrs. Bostick. 1068 00:50:25,018 --> 00:50:27,561 He died. 1069 00:50:27,561 --> 00:50:29,438 What you got, Amboy? 1070 00:50:29,438 --> 00:50:32,648 Allen Billings... had a pallet fall onto his outstretched arm. 1071 00:50:32,650 --> 00:50:35,068 Looks like an open dislocation. - Yeah, that's got to hurt. 1072 00:50:35,068 --> 00:50:36,777 Don't worry, sir. We got you. 1073 00:50:42,827 --> 00:50:46,079 - How's she doing? - Seems happy enough. 1074 00:50:46,079 --> 00:50:48,081 - Yeah. Hi. - Hi. 1075 00:50:48,081 --> 00:50:50,833 Just got a quick point-of-care CBC. 1076 00:50:57,257 --> 00:50:59,260 Is there a problem? 1077 00:51:02,764 --> 00:51:04,597 Did I miss something? 1078 00:51:04,599 --> 00:51:07,601 Dr. Al? Dr. Al? 78844

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