All language subtitles for The.Pitt.S01E03.WEB-DLRip.RGzsRutracker.eng

- Oh, shit.
- What?

I think
I just broke some ribs.

It means
you're doing it right.

Third amp of epi is on board.

Oh, come on.

Call me if there's
a resurrection.

- Hey, Perlah.
- Doctor?

Your kids have any pets?

- Ugh, my house is like a zoo.
- You have a dog?

Ugh, no dogs, no cats.
I followed my mother's rule.

No pets that can't be
buried at sea.

I'm not sure I follow.

You ever try to flush
a guinea pig?

Try explaining that
to your plumber.

Good to know.

Hey, what's up
with your asthma guy?

Responding to albuterol.

One more neb, and we'll
discharge on prednisone.

How's it going out in Chairs?

Oh, it's fine, I guess.

- Dr. McKay seems nice.
- Cassie?

Oh, yeah, she's great.

- She been here long?
- A little while. Why?

I'm just curious.

Do you know what she did
before she came here?

What she did?
What do you mean, like, school?

Oh, like school, work,
personal life.

I'm just trying to get
to know her better.

Um, yeah, I don't--
I don't know.

I don't know
that much about her.

She has a son.
I know that.

She's a pretty private person.

- Anything else?
- No, sorry, I'm good.

Thank you.

Hey, where are we at
with opening up some beds?

Our Nepali lady
with the crushed foot,

Minu, she still in line
for the OR?

Yeah, she got bumped
by your Le Fort

three fracture, Ben Kemper.

- He just went up.
- Mm.

Still waiting for them
to take

the electrocution fasciotomy.

What about our OD
in Central 7?

Robby wants a few more tests.
He's stable and on a vent.

Is he a candidate
for organ donation?

Not sure.

Then why is Robby
keeping him here?

I don't know.

Maybe he sees something
we don't.

Or maybe he's hoping for
something that isn't there.

What's there
is an 18-year-old kid

- named Nick Bradley.
- Yeah, is he though?

I don't mean
to be a dick, but--

You just can't help it?

No, as sad as it is,
that kid is gone.

and if we get him upstairs
to the ICU,

we can use that bed to
actually help somebody.

Robby is helping somebody.

He's helping two people,
in fact.

They're in there right now
praying over their dead son.

They just haven't let
their hearts accept it yet.

Jesus, 9:00,
you're already bumming me out.

OK, let's see.

Who's up next
at the deli of death?

Weak and dizzy.
No, thanks.

Flank pain.
Need a UA first.

And buttock abscess.

Great teaching case
for a student.

Don't make me tell Robby
you're cherry picking.

I'll take projectile vomiting
in North 5 for 200, Alex.

What do you think the chances
are it's a demonic possession?

About the same as you
going a whole hour

without saying
something stupid.

For Christ's sakes, go already.

You're like having a kid
I never wanted.

How are you feeling?
Any pain, Minu?

No pain, but I'm thirsty.

Oh, nothing to drink
before your surgery,

but we can get you
some lemon swabs.

Thank you.

Excuse me?

When are you due?

You can always tell.

Congratulations.

Thanks.

How long before we might
expect to see some improvement?

It could be hours.
It could be days.

It could be never.

I don't expect anything
for a little while.

Why don't you guys go get
a cup of coffee

in the cafeteria,
maybe something to eat?

I'll have a nurse call you
if anything changes

- while you're out.
- Thank you.

We appreciate that.

- I'm not leaving.
- Suit yourself.

I'm gonna get a cup of coffee.

I got to call Sarah
and the kids.

Cafeteria?

Straight down that hallway,

through the corridor,
and to the right.

Thanks, and I'm-- I'm sorry

if my sister comes across
a little strident.

It's OK.
This isn't easy.

The parents of teen overdose,
Lily and John Bradley,

are asking about the tests
you told them about.

- OK, I'll be right there.
- What about the rats?

What about them?

- Have they been caught?
- I have no idea.

- Well, find out.
- Not sure that's my job.

You're in charge of the ER.
The rats are in the ER.

That makes you in charge
of the rats,

and I have a strict rule
about vermin in the workplace.

Good to know.

Could I get your eyes on a
sickle cell crisis in South 20?

Headed that way right now.

ICU is insisting they still
don't have rooms available.

Bullshit.
Esme recon'd for me.

Send our electrocution,
Victor Hunt, up there

until the OR is ready please.
Thank you.

- Third epi on board?
- Three minutes ago.

How long has he
been going at it?

10 minutes in here, possibly
30 minutes of prior downtime.

Don't suppose you'd let me
try a pericardiocentesis?

- For what?
- For practice.

- In case it's tamponade.
- None seen on ultrasound.

- This is a teaching hospital.
- It's not a cadaver lab.

What do you call this?

- Do you need a break?
- I'm fine.

You don't look fine.

Hold compressions.

Still no rhythm.

OK, Whitaker,
I think that's enough.

It's been four minutes
since the last epi.

One more minute, please.

Help me, please help!
Somebody help!

- Please, my friend needs help.
- What happened?

- My friend.
- Hey, where is she?

My friend, she's in my car.

- She won't wake up.
- OK.

OK, Mateo, gurney!

- What's her name?
- Jenna.

Come on, Jenna.

Wake up for me, baby.

Pupils pinpoint.
I need--

- Narcan.
- Yeah.

Hold her head back, Javadi.
OK.

Not responding to Narcan.
We might need to intubate.

Find a room
and open a crash cart.

I can't find a carotid pulse.

Five minutes
since the last epi.

OK, that's it.

Hold compressions.

Welcome back.
She's OK.

He took his wife out
for dinner last night,

for her birthday.

OK, why doesn't everybody
take a minute?

Go check on
your other patients.

We'll meet back here
to debrief with Kiara.

- Bed four.
- Where the hell am I?

Pittsburgh Trauma
Medical Center.

Why?

Your friend
couldn't wake you.

I'm right here, Jenna.

Came to with one spray
of Narcan.

- What'd you take, Jenna?
- Nothing.

You had to have taken
something to cause this.

No, I was just
up late studying,

and I just couldn't
fall asleep.

So you took something
to help you sleep?

We need to know in order
to treat you properly, OK?

- Do you know what she took?
- No.

This could be a sign
of something really serious,

and we're gonna have to do
a lot of tests that you--

OK, I took, like,
half a Xanax.

That's not nothing.

It's OK.
OK?

- Have you taken Xanax before?
- First time.

OK.

Take a deep breath for me.

Come on, man.
You heard Dr. Robby.

Let's take a break.
Grab a coffee.

No, I'm fine, thank you.

Did you know him?

No, I didn't.
Did you?

I just met him.

He was my first patient to die.

I'm sorry.

- Are you OK?
- Mm-hmm, yeah.

- You sure?
- Yeah. Just I--

I just remember
the first time that--

on occasion, I have
an emotional response to death.

It's--

Got to be kind of tough
for a doctor.

At times, it can be.

At least I'm not a pathologist.

I was joking.
I--

Oh.

I have nothing
against pathologists.

Yeah, no.

New radiodensity
in the right middle lobe.

Is it pneumonia?

Possibly, or just changes
from vaso-occlusion

of the sickle cells.

It's called
acute chest syndrome.

We're gonna cover you
with antibiotics

just to be on the safe side.

We've been through
this before.

Third generation
cephalosporin and a macrolide.

Perfect.
You're in good hands.

- Can I do a chest tube?
- Which patient?

Any.

I've just never done
a chest tube before.

Are you really
asking me to reserve

any incoming injury requiring
a chest tube for you?

Not all of them.

I'd be more than happy
just doing one,

but, hey, if you wanted
to give me more,

I'd be fine with that, too,
but that's up to you.

I'm down for anything.

Confidence and ambition
are great attributes,

especially when paired
with respect and humility.

OK, what else?
What else went well?

We checked
for reversible causes

of cardiac arrest
on ultrasound.

OK, good.

Does anybody have anything that
they wish had gone differently?

In the hall, he should have
been on a cardiac monitor.

We would have caught
the arrest right away.

That's true,

but there was no indication
for monitoring.

And we now know
that his abdominal pain

was not from his gallstones
but from unstable angina

due to coronary artery disease.

Then we should have
admitted to cardiology.

Mm, we did an EKG.
We did a troponin.

He had a HEART score of three.

Who can tell me
what that means?

1% chance of
an adverse cardiac event

in the next 30 days.

Standard of care
is to discharge

with outpatient follow-up.

He was your patient,
Dr. Whitaker.

Would you like
to say something before

we all take a brief moment
of silent reflection?

Um...

He liked Kentucky bourbon.

OK, good.

Me too.

- Anything else?
- I don't know.

I just met him.

No, he seemed nice.

He was married.

Um, that's it.
That's all I got. I--

Mm.

I spoke with his wife.
She's on her way here.

If anyone needs to talk
about this some more,

I'm available.

For now, let's harness
some good thoughts

here for Mr. Milton.

OK, that's it.

Let's go save some lives.

Hey, Whitaker.

How are you feeling on this?

I mean, not good.
I was just talking to him.

Now he's dead.

That's the hardest way
to lose a patient.

It always hurts.

Especially when
it's your fault.

This was not your fault.
This was nobody's fault.

No doctor on the planet
could have caught this.

Listen, it sucks,

but today, today was this guy's
day to leave this mortal coil.

150,000 people die
every day in the world,

and you got one of them,
but you learn to live with it,

and you learn to accept it
as much as your own mortality

and find balance if you can.

You've found balance?

No, not even close.

But, you know, you keep trying,
which is all you can do.

You're doing great, Whitaker.

- Just, you know, hang in there.
- Yeah, thanks.

OK.

- I'm just gonna go.
- Yeah.

But, you know,
our social worker, Kiara,

is here if you want to talk.

OK, yeah.

OK.

You're gonna recover, OK?

Good luck.

Wait, what happens now?

We monitor her heart
and breathing

for the next few hours
to make sure

she doesn't need more Narcan.

- That's it?
- Yeah.

You should text your friends.

Hell, you should text
your whole college.

Tell anyone who will listen

to not take pills
without a real prescription

unless they want
to end up here.

Seriously,
fentanyl is everywhere.

It's in everything
on the street these days.

How long would I monitor
her pupils for?

You know what, actually,
I should go to the bathroom.

Are you OK on your own
till I get back?

Absolutely.
Take your time.

OK, great.
Thanks.

Sometimes I come on
too strong.

Excuse me?

It's a defense mechanism
against insecurity.

- You're kidding, right?
- Yeah.

But I am sorry
if I hurt your feelings.

I really--
I want us to get along.

I want us to be friends.

And if I'm really being honest,

I want your mother to write me

a kickass
recommendation letter.

You're going
into general surgery.

I might.
I'm keeping my options open.

You want me
to pimp out my mother

for something you might do?

OK, well, when you put it
like that, it sounds dirty,

and a little hot, but yes.

In full disclosure,
so we can be friends.

- Friends?
- You've heard of the concept?

Buddies, compatriots,
confidants, pals.

- They even made a show about it.
- Yeah.

Boom.
Come on.

Don't leave me hanging, Crash.
Pound that shit.

I can call you that
now that we're friends, right?

- OK.
- We'll work on that.

So for the apnea test,
we keep him on 100% oxygen,

but the ventilator
won't be giving him breaths.

- For how long?
- For 10 minutes.

We'll monitor his
carbon dioxide levels,

and if they come back
way too high,

then we'll know
that his brain stem

- is not telling him to breathe.
- And that means?

That would mean that
there's no brain function

at the most fundamental level.

Princess will monitor him,
and I will come back as soon

as we know the test results.

- OK.
- Yeah.

OK.

I hate
this fucking hospital.

This is Hank.

- What happened?
- Nothing.

We were just framing, and
then my buddy Joey comes in.

He says, "A guy walks into
a bar with a nail in his head,"

and then he points his
fucking nail gun at my head.

So what would you do?

So I freaked out,
and then in the ensuing melee,

- he fucking shoots me.
- Melee?

Yeah, you know, like
a scuffle, like a donnybrook.

What, you think because
I work construction,

not a hospital, I don't have
a fucking vocabulary?

Tier one trauma now.

- No, sir, I--
- Whoa.

Definitely intracardiac.

And I got to tell you,
this fucking hurts.

Let's just try and relax
and dial down the F bombs.

- We have children in here.
- You want me to stop swearing?

Take the fucking nail
out of my heart.

And, please,
something for the pain!

Stabilize the nail.

Hank, we need to cut
your shirt off.

Fuck that.

You cut the shirt,
you're gonna buy me a new one.

You can have your pick
out of our lost and found.

Whew, how did this happen?

Framing nail incident
with deep penetration

- of the left chest.
- The fuck does it look like?

Hank, do you take
medicine every day?

Any allergies to medication?

No. Can you give me something
for the fucking pain already?

Is this a hospital
or a vet clinic?

Very soon, Hank.
Very soon.

I bet you say that
to the beagles too.

Pulse 120.
BP 100 over 65.

Two milligrams of morphine.

Liver GSW is in recovery.
He's good as new.

Whoa, that looks
intracardiac.

- Nailed it.
- Whoa, you got jokes now.

No jokes, just pushing
your pain meds, buddy.

Small pericardial effusion,
but no evidence of tamponade.

- Not yet.
- Somebody talk to me.

Do I need a priest here?

He's tachycardic
with borderline BP.

He could decompensate.

Standby with two units
whole blood.

Garcia here.
Stat cardiac case.

Am I dying here
and nobody's telling me?

Hank,
there is blood collecting

in the sac around your heart.

You need surgery
before your heart stops

from the pressure around it.

Just pull
the fucking nail out!

That would
definitely kill you.

I want a second opinion.
Where's my fucking phone?

I can Uber to Presby
and find a real hospital.

OR can take him
in 10 minutes.

Mind if we
intubate him first?

The sooner the better
for all of us.

Great.
120 of sux, 100 of ketamine.

- Javadi, you're up for this one.
- Really?

Now. Let's go.
Move.

Code STEMI,
ETA five minutes.

Code STEMI, ETA five minutes.

I can start
the STEMI with Mel.

- Sounds good.
- This place sucks.

I will destroy you on Yelp.

Nobody's ever coming
to this shithole again.

I swear to God.

From your mouth to God's ear.

Kiara? Hi.
I'm Dr. Melissa King.

- Everyone calls me Mel.
- Yes, we met.

Right, um,
I wanted to ask you

about Tyler, the little boy
who ate the marijuana gummy.

He's been admitted
to pediatrics for observation.

- And his parents?
- They're upstairs with him.

CYF is going to follow up with
a home visit just to be safe,

but no police were involved.
Don't worry.

No one is taking
their child away from them.

Good.
That's a relief.

Yeah, the parents,
on the other hand,

may need couples counseling
after this,

but I think little Tyler's
going to be fine.

- STEMI with me, Mel.
- Right behind you.

- Dana, what's open?
- Trauma two.

All right, keep it that way.

Our target door to balloon time
for STEMIs is 51 minutes.

Ambitious.

But doable,
as you're about to find out.

Let's go.

Good view of the glottis.

Eyes off the screen.

Now look down
the mouth and insert

the tube around the bend.

You stole my med student
from triage?

- How's she doing over here?
- She's doing pretty good.

Now look back at the screen.

And advance through the cords.

Good.
Good job.

Thanks.

Pressure's down.
72/38.

Effusion has grown,
now with the RV collapse.

Pericardiocentesis?

Let's get another unit
on that infuser.

Prep for thoracotomy.
Coming through.

We should get back to triage.

You don't want
to stay for this?

There are like 30 patients
still waiting

- to be assessed out there.
- OK.

- Did someone say thoracotomy?
- Crashing from tamponade.

Dr. Garcia, do you think I--

Trauma Surgery gets
left sided thoracotomies.

ED gets the right
if we need to extend.

Glove up, girl.
You're on suction.

Let's advance that ET tube
to the right main stem please.

Ten blade.

Metz.

Dr. Santos, how do we cut
through the intercostals?

Through the superior rib to
avoid the neurovascular bundle.

- That is correct.
- Finochietto retractor.

Full suction.

And get rid of this nail
before I get poked.

On it.

Nail's intact in one piece.

Toothed forceps.
Opening the pericardium.

This is so fucking cool.

Dr. Santos,
you and this patient

share a common vocabulary.

Yeah, I swear a lot.
I know. I'm sorry.

They say it's a sign
of intelligence.

I think it shows
a lack of self-control.

But what the fuck do I know?

Single puncture wound
to the left ventricle.

We've got a finger on it.

First unit is in.
Pressure's up.

Heart is filling well.

Throw in a horizontal mattress,
and we're out of here.

- Stop the bleed while I sew.
- STEMI's arrived.

You got this?

Just wrapping him up
for OR delivery.

2-0 Prolene
on a tapered needle.

Mr. Ed Gellin
is 52 years young

with a history of hypertension
and hyperlipidemia.

20 minutes of
substernal chest pain.

10 out of 10 with
dyspnea and diaphoresis.

BP is 152 over 95.

Currently chewing
324 mgs of baby aspirin.

OK.

Blood's drawn.
Second IV started.

BP stable.

Seven millimeters
ST elevation...

- One nitro spray, sublingual.
- In the anterior leads.

Those are sometimes
called tombstones.

- Open up, sir.
- Tombstones?

Lift your tongue.

Mr. Gellin, you're having

a very big heart attack
right now.

Major artery that carries
oxygen to your heart

- is almost totally blocked.
- That doesn't sound too good.

No, it's not very good.

We're gonna send you up
to the cath lab.

A cardiologist is gonna
unblock that with a balloon

and leave it open with a stent.

But I'm still having
a heart attack?

If everything goes
as planned,

it'll be like you never
had a heart attack.

We're gonna put a catheter
in this artery right here.

We're gonna shave
the hair with a clipper.

Long as you stop short
of a Brazilian.

It's an option we offer.
Costs a little bit more.

A lot of people's insurance
won't cover it.

Don't make me laugh.

- It hurts.
- Deal.

Anybody we can call?

- My wife.
- Already have her number.

OK, we'll call her.
You hang in there.

I'll be right back.

I think they finished
the apnea test on Nick.

- Can you check the results?
- Not just yet.

The blood test needs
to go to the lab.

It takes a few minutes
to run the test.

I'll come find you in the room
as soon as it's done.

Horizontal mattress in place
with excellent hemostasis.

Cut here.

Moist, sterile towel.
And away we go.

I spoke to cardiothoracic.
They can meet you in the OR.

Good job.

Coming through.

Well done.
Well done.

- Good luck, Mr. Gellin.
- Thank you so much.

You're very welcome.

Two saves.
Totally awesome.

I just held a beating
human heart in my hands.

We should celebrate.

We should clean these rooms

and bring
some more patients back.

- Sounds like a plan.
- No rest for the wicked.

- Code STEMI was fast.
- Time is myocardium.

And our statistics
for door to balloon time

get reviewed, critiqued,
and published online.

Door to balloon time?

That's the time from
when they hit our door

to when the angioplasty balloon
gets inflated in the cath lab.

We keep it to under 51 minutes,
we can reverse a heart attack

and save a life.

Kind of wish
Mr. Milton had a STEMI.

Thank you for letting me
go the distance on him.

I really thought
we'd get him back, you know?

Yeah, well, you know,
even though

you do everything right,
you don't always

get what you hope for.

My parents both had
sickle cell trait,

and I was screened as a newborn
with the hemoglobin FS pattern.

- Did you take penicillin?
- Mm-hmm, until I was five.

Then the vaccines kicked in.

She has her entire medical
history on her phone.

It's extremely long.

Dr. Mohan,
do you have a minute?

Yep.
Excuse me.

Is there a problem
over there?

No, her pain
is well controlled.

You understand that's
my polite way of asking

why are you spending
so much time with one patient?

You're an R3.

As an R3, you should be seeing
at least two patients an hour.

I have two,
Joyce and Mr. Wallace,

- our Good Samaritan.
- Who's comatose and stable.

You should have four by now.

I have the highest patient
satisfaction of anyone.

I don't doubt it,

but we just had
this conversation

a couple of hours ago.

I know people
call me Slow-Mo.

You don't have to
confirm or deny.

It used to hurt my feelings
a lot, but I can't help it.

I work at the speed
I'm comfortable at.

Because you're afraid
of making a mistake?

I'm always afraid
of making a mistake.

- Aren't you?
- Yeah, of course I am.

But you know what I mean.

You make a mistake once,
and somebody dies,

and you feel so badly
about it,

you'll never let it
happen again--

How is that wrong?

Because you waste time
and money

on unnecessary tests.

You keep sick patients
waiting too long.

You miss out on cases
you could be learning from.

You shortchange
your own education.

I'm not saying this
to be a hard-ass.

I'm saying this because
I know you could do this,

but you need
to do it at a level

- I also know you're capable of.
- And what if I'm not?

Then you should look
into a specialty

that better suits you.

Have you thought
about psychiatry?

I don't want to go
into psychiatry.

I want to be here.

Being here means

no matter how good you are
or how hard you try,

you're gonna make
another mistake,

and someone else
might even die.

That's called being
an emergency medicine doctor.

And if you can't accept that,

then maybe this isn't
the place for you.

- I can accept that.
- You sure?

- Yes.
- OK, good.

Go save some lives.

Clear some beds
while you're at it.

I would fancy a spot of tea
at some point.

You want some tea, darling?
I'll get you some tea.

- Oh, thank you, sweetheart.
- Is Dr. Robby available?

He's with a patient.
Can I help?

- My father's starting to move.
- OK, I'll let him know.

- Thanks.
- Yeah.

Is it good or bad?

If there's no
spontaneous breathing,

then carbon dioxide levels
rise above 60.

So 82 definitely means
that Nick's brainstem

is not triggering him
to breathe.

Well, how can you fix that?

We can't.
I'm sorry.

But with rest and time...

This is not something
that heals on its own.

There's got to be
something else that we can do.

Nick is our only child.

- Is that test 100% accurate?
- It is.

Isn't there anything else?

We can do
an imaging test called

- a cerebral perfusion study.
- Then let's do it.

But you have to understand
that will be the last test

that we would do.

If it comes back that there's
no blood flow to Nick's brain,

it would confirm beyond
a shadow of a doubt

that there's been brain death,

which would mean
that he's gone.

Then we wait and see.

Call Nuclear Medicine.
See how soon they can take him.

You got it.

I'll be back
in a few minutes.

Thank you.

Hey, Mr. Spencer in Central 9
tried to pull out his ET tube

- and is now in soft restraints.
- No surprise there.

We need to up the propofol.

And the sister of the dead
MVC vet in the viewing room

- just arrived in Chairs.
- Can you, um--

- Park her in the family room?
- Please.

No problem, I'll have Perlah
and Princess prep the body

as best they can for viewing.

Any progress in there?

No.

Can you also keep an extra eye
on Whitaker today?

Oh, I'm already on it.

I know he lost
his first patient.

Yeah, I just don't want it
to throw him off his game.

- You think this kid has game?
- Not sure yet.

I want to give him
a chance to find out.

Copy that.

- Hey, fruitcake.
- Myrna.

What brings you
in here today, anyway?

- I murdered my husband.
- Ah.

How did you do it this time?

I put him through
a meat grinder.

Best just to grab one
and jump back in.

Yeah, right.

Mr. Fulton in Central 14
just needs a shot of Mylanta

for his GERD,
and to avoid eating foods

with the words
"flaming hot" in their title

for at least a few days.

- OK, thanks.
- Central 14.

Yeah.

Could I get some Mylanta
for Mr. Fulton in Central 14?

It'll be a while.

If you want it fast,
go check out the employee

- first aid cabinet.
- Where is that?

In the lounge.
I'll show you.

- How's it going?
- Not so great.

- I lost a patient.
- So I heard.

I also heard
it wasn't your fault.

Doesn't make it
feel any better.

Yeah, it doesn't.
I'm sorry.

Unfortunately,
it comes with the job.

If it's any consolation, I just
got scolded for going too slow.

If you hear someone talking
about a Slow-Mo, that's me.

Guaranteed you're going
faster than me.

I like to say it gets easier.
Some days it does.

I'm sure the rest of your shift
will be better.

- Shake it first.
- Mm-hmm.

Oh, but make sure
the lid is...

Screwed down tight.

- OK.
- Oh.

Everyone seems
to get along like family.

You see a family,
I see every man for himself.

Actually,
that's not entirely true.

There is some family here.

Javadi's mom is
a surgeon upstairs.

- Really?
- Yeah.

- Oh, that must be so nice.
- Are you kidding?

I don't know about your mom,

but I would not want mine
working within 100 miles of me.

- No way.
- My mother passed.

She had a very aggressive,
malignant pheochromocytoma,

- so...
- Sorry.

Unfortunately, my mother
is gonna live forever.

No, she was definitely dead.
Like, I'm still shaking.

No, she was, like, dead.
Like dead-dead.

I mean, I think
her heart stopped.

No, she was, like,
literally dead.

- Think she was dead?
- Who?

Who she was
just talking about.

Oh.

In case you didn't realize,
I use sarcasm

and comedy as a shield.
Or so I've been told.

Thank you
for opening up to me.

- Mel, right?
- Yes.

Well, it was nice
talking to you, Mel.

It was nice
talking to you too.

You know, I really hope
we can be fri--

friends.

Is there anything I can
assist you with, Dr. Robby?

I think we're best on
our own right now, thank you.

He keeps trying to pull away.

We're giving him
some more sedation.

Why is he so agitated?

He could have some awareness
of the tube in his throat

or that he's
in a strange place,

or it could be lack
of oxygen to his brain.

- Does he need more oxygen?
- He's on 100%.

That's as high as it goes.

That is his blood
pressure dropping.

Oh, is that even fixable?

Normally, yes,
with IV fluids,

but we now know that that
will just fill up his lungs,

drop his oxygen even more.

Well, isn't there
something else we can do?

We can place a long, large
IV catheter in his jugular vein

down into his heart
and administer Levophed,

which is
a very powerful medicine

to constrict his arteries,
raise his blood pressure.

But that could cause other
organ damage, organ failure.

I'm really sorry, but each
new step is even more invasive,

could cause more suffering
with minimal benefit.

Uh, hi.

Dr. Robby said he'd be back
in a few minutes.

Yeah, he's with a patient,
but I'll let him know.

My son is dead, isn't he?

I'm not a doctor,
Mr. Bradley,

but I do believe in God,
and I am praying for your boy

with every beat of my heart.

Thought she'd taken Xanax,
but it was actually fent.

- Thank you.
- Yeah.

Oh, one second.
Yeah?

- She was legitimately dead?
- Yeah, like, 100%.

- Mr. Bradley?
- Vince?

No, my dad's
gonna freak out.

No, I know.
I know.

I just needed to sleep.
I thought I was.

Where did you get
the fucking drugs?

- Who are you?
- Did you give them to my son?

Did you give my son drugs?

Mr. Bradley,
you can't come in here.

- Mr. Bradley, please.
- Who is this?

- Tell me the fucking truth.
- Security!

It's Nick's dad.

- Did you drug my son?
- Where the hell's security?

Your son gave me
the drugs, asshole.

- Ask him.
- He's dead.

And you are a fucking liar!

You killed my son!
You killed my fucking son!

Hey, there's no scrubs
in here.

Yeah, you have to put
your old ones in before

it'll give you a new pair.

What?

Forgive me, Mr. Milton.

Hey, you missed
the best action of the day.

I heard.
What happened?

Father of
the brain-dead son

goes after another patient
he thinks gave his son

- the drugs that killed him.
- Jesus.

- How do you deal with that?
- No fucking idea.

Whoa, what happened here?
Did we have an accident?

Do you think
I'm wearing this by choice?

Was it number one
or number two?

I just got some stuff
spilled on me.

Was it a bodily fluid,
and was it yours?

No and no.

Oh, is it from when
you killed that guy?

I did not--

that guy had a massive MI
in his sleep.

Relax, Huckleberry,
I'm just fucking with you.

Truth is, you're not
a real doctor until

you've lost
at least one patient.

You got off easy.
It wasn't your fault.

Not all of us can take comfort
in saying that.

But try not
to kill anybody else.

- What am I looking at?
- Mr. Bill Philbin, 46.

He tripped while
walking his dog.

He saw a squirrel.
And it's my wife's dog.

Damn thing
doesn't even like me.

Clearly.
Where's the dog now?

Hopefully in a kill shelter.

Come on, baby.

Oh, yes.

I'm sorry.

I just want to understand how
this could happen to our son.

I can't stop wondering,
why Nick and not her?

I can't help it.

I think it would
be helpful for you

to speak with our
department social worker.

Would you two be open to that?

- None of this is fair.
- No.

- No, it's not.
- But he's still breathing.

The ventilator
is breathing for him.

Brain death is
the same as death.

What about that last test
that we're waiting for?

I can almost guarantee
it'll stay the same.

I'm so sorry.

I wish I could have done more
to save your son.

Our social worker, Kiara,
is here to help you

with anything you might need.
She's amazing.

I'm gonna go find her
and have her come see you.

Go back to the dorm,

and within
a couple of minutes...

Get dad sorted out?

I think so.

He and his wife are dealing
with a lot right now.

No shit.
That's a tough one.

Yeah.
Do you know where Kiara is?

Not offhand,
but I can page her.

No, it's OK.
I'll find her.

I got to hit
the restroom anyway.

I'll tell her you're looking
for her if she comes this way.

- Thank you.
- Yep.

Now I got to pee.

Kevin, take Myrna to pee.

Ask Dana what's open,
four of morphine,

- and order an X-ray, OK?
- Copy.

Hey, closed injury,
forklift versus foot.

- Forklift won.
- Got it.

Hey, any news on
our incel kid, David?

Uh, I don't think
we've heard from him yet,

and I don't know that you
should refer to him that way.

Well, he did have a list of
girls' names he wanted to hurt.

They could be at risk.
Are the cops looking for him?

- Not sure we're there yet.
- OK.

I trust your judgment,

and I'm the last person
who wants to involve

the police in anything,

but you don't want to be
wrong about this one.

I know.
I know.

So what's the issue?

Maybe I don't want
to ruin this kid's life.

Well, you don't
want him ruining

anyone else's life either.

Look, I've personally
been on the wrong side

of someone who hates women.

It's not a safe place to be.

OK?

- Any luck reaching David?
- Not yet.

Did you try
calling the school?

He didn't show up for class.

Any idea where
he might have gone?

Friends, relatives.

We don't have
any family in state.

And David, he doesn't
associate with anyone.

Theresa,
do you think that David

would try to hurt any of the
girls that are on that list?

No.

Do you remember some
of the names on that list?

Not really.

Maybe you could try.

How's she doing?

She's worried sick
about her son.

What are you going to do?

I thought he would come back
after mom called him.

Hey, what are the ethics
about me reaching out

to him under the guise

of a medical emergency
with mom?

If he's a danger
to himself or others,

I'd argue you have
a professional responsibility

to do whatever is necessary.

Right.
OK.

Hey, can you come talk
to the parents of the OD'd kid

that we brought in earlier?

18-year-old brain-dead
from a fentanyl overdose.

- Oh, jeez.
- Yeah, only child.

And I just think
that the parents

could use a little help
processing

what they're going through.

What about donation?
Is he a candidate?

If the transplant counselor
could get him there,

but I think we're a ways away
from calling them in.

- I'll see what I can do.
- Thank you.

They're in Central 7.

I would introduce you,
but I really have to pee.

- No worries.
- Thank you.

What the hell?

I just saw one of those rats.

And you thought
you'd start an IV?

It's not funny.

You're not the one
who's gonna have nightmares.

I forgot about
your phobia with rats.

It is not a phobia.
Nobody likes rats.

Some people
keep them as pets.

If you are purposely
keeping a rat in your house,

that is not a pet.

That is a sign of an underlying
mental health problem.

OK, if it makes you
feel any better,

just think of them
as cute little Disney mice

with a pituitary condition.

Mm-hmm, joke all you want,

but if one of those disgusting
things bites a patient

and we get a case
of hantavirus,

guess who's gonna have to
answer for that one, Chief.

Point taken.

What was the name of that cop
you were talking to earlier?

What cop?

The good-looking one that
you were talking to earlier.

- How would I know?
- It seemed like you guys had--

- Stay in your own lane.
- What?

I'm not even asking like that.

I really did want to talk
to him about something.

Uh-huh.

Hey, did the exterminator
come yet?

Yeah. Right.
Sometimes you can be so cute.

Anything like that has
to go through facilities.

- They said they'd handle it.
- What does that mean?

It means nothing's gonna
happen until next week

at the earliest unless
we get a patient in here

with a service cat.

Oh, don't forget,
you still have the sister

of Abbot's deceased veteran
waiting for you.

Oh, shit, yes, yes, yes.
I'll be there.

- I'll be there.
- Yeah, go.

Hey, I've been looking
all over for you.

We need a cardiovert
unstable AFib in North 1.

- OK, just give me a sec.
- Systolic's 90.

Fuck me.

35-year-old architect
working on a deadline,

vaping nicotine all night.
Palpitations this morning.

AFib at 147.
Mr. Quinn, this is Dr. Robby.

Hello, sir.
How are you feeling?

Like crap.

When did your
palpitations start?

A little while ago.

We interrogated
his smartwatch.

His heart rate has only
been up for 92 minutes.

You understand
we need to shock

- your heart back to normal?
- Is it gonna hurt?

- You'll be sedated.
- So it's really gonna hurt.

Mel, 75 of propofol,
slow IV push.

How much did you vape
last night?

- A couple of pods.
- You vape every day?

I do, but not that much.

- You want to cut back?
- I've tried.

It's just really fucking hard.

How much nicotine
is in a pod?

- Anybody know?
- No idea.

40 milligrams,
same as a pack of cigarettes.

Wow, two packs in one night.

Mel, what's the safe window
for cardioversion?

- 12 hours.
- What happens after that?

Increased risk
of embolic stroke

from left atrial blood clot.

Which he does not have.

Mr. Quinn.
Mr. Quinn.

OK, he's out.

Sync cardioversion
at 200 joules.

- Charged.
- Clear.

- Bingo.
- Sinus rhythm.

Cycle BP.

We'll monitor
for a few hours.

Yeah, let's get addiction
services on the case too.

He's gonna need a daily patch

and nicotine gum
for breakthrough cravings.

This one's a bitch to kick.

Hey, the sister of Abbot--

Shit, yes.
Shit, yes, yes.

Go get 'em, tiger.

Are you Mr. Orser's sister?

- Fiona.
- Hi, Fiona.

I'm Dr. Robinavitch.

Everybody calls me Dr. Robby.

Have a seat, please,
and I will tell you

everything that's happened.

Are you looking for
something in particular?

Anything with a very low
potential for mortality.

Mm-mm.
You're not playing that game.

Only thing I'm playing is
let's keep the patients alive.

Uh-huh, well, now we're
playing face your fears.

That sounds like
a terrible game.

What up there
scares you the most?

- All of it.
- Pick the worst.

South 20.

82-year-old woman,
low back pain.

I mean, that's potential
leaking AAA,

cauda equina syndrome,
spinal epidural abscess.

That could go wrong
in so many ways.

Not today, amigo.

We're gonna work this
lady up like a race car.

What does that mean?

It means you're on
the pit crew now.

Come on.

Are you ready to go inside?

No, not really.

I'll be with you.

You can decide
when you want to leave.

You're so cold.

I'm sorry.

I'm sorry
I wasn't here with you.

But I'm here now.

Wherever you are.

I don't know what
the world is without you.

I really can't look
at this letter.

Would it be too much
to ask you to read it to me?

Oh, I'm sorry.

That's an
inappropriate request.

No, not at all, not at all.

I'd be honored by the request.

"To the family
of Raymond Orser,

"my name is Dr. Jack Abbot.

"I am the emergency department
physician who treated Raymond.

"I, like Ray,
am also a veteran.

"And though I never met
Raymond before today,

"I served with men like him.

"So I can only imagine
what an outstanding person

he must have been."

"I'm sorry I could not
save Ray's life.

"We worked on him
for several hours,

"but his injuries
were too severe,

"even for someone as tough
and battle-tested as Raymond.

"Please take some comfort
in knowing he did not suffer.

"You have my heartfelt
condolences.

Jack Abbot."

- Thank you.
- You're very welcome.

Again, I'm very, very sorry
for your loss.

Where do you think
you're going, Myrna?

Oh, none of your
business, fruitcake.

Actually, everything that
happens in this department

is my business.
And you know what?

I put up with
a lot around here.

I take very good care of you,

so you can call me
Dr. Robinavitch,

or you can call me Dr. Robby,

or you can use my first name
of Michael,

but I do not appreciate
you calling me fruitcake.

Oh, did I hurt
your feelings, cocksucker?

That said, it has
a certain whimsical quality

to it that I can probably
learn to live with.

Whatever you say, fruitcake.

Excuse me, Doctor, my father
is starting to struggle again.

OK.

Don't you know
those things will kill you?

I'm not that lucky.

Ow!

What the fuck?

Hey, they're stealing our rig!

Did you leave the keys in it?

Always, in case
somebody needs to move it.

Yeah, you probably
shouldn't have done that.

Why don't you come on
inside, Ziggler?

- We'll look you over.
- I'm fine.

Fuck that.

God, can you believe that shit?

It happens.

What can you do to make him
more comfortable?

We can take the tube out.

But he needs that to breathe.

If we extubate, we would
keep him on oxygen for comfort.

We would decrease his sedation.

He might regain consciousness.
He could recognize you.

Maybe even speak.

Well, I don't want to do
anything to jeopardize

- him getting better.
- That's just the point, Helen.

He's never getting better.

- You don't know that.
- I do know that, OK?

He knows that.

And Dad probably even knows it.

It's time to let him go.

I'm sorry if you've
had your fill of Dad,

but I haven't, and I am
not giving up on him.

Even if it's hurting him?

I'm sorry, but if there was
anything I could do

to heal your father,
I would do it.

But the most humane thing
that I can do for him

is to allow him a painless,
peaceful passing,

and that requires removing
the breathing tube.

How long will it take
once the tube's out?

From minutes to hours,

but we would ensure that he'd
be in no physical discomfort.

OK.