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1
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{\an8}Structural collapse at the water park...
two victims coming in via helicopter.
2
00:00:18,936 --> 00:00:21,521
{\an8}- ETA, five minutes.
- Time to rally the troops.
3
00:00:21,522 --> 00:00:23,814
{\an8}I'll get environmental
to clear and prep the trauma rooms.
4
00:00:23,815 --> 00:00:24,899
Emma, restock the crash carts.
5
00:00:24,900 --> 00:00:26,943
Makedah, take the latest scripts
to the drug cage.
6
00:00:26,944 --> 00:00:29,320
- Should be a fun one.
- "Fun one"? What's up?
7
00:00:29,321 --> 00:00:31,948
Slide broke at the water park...
two victims, five minutes to touchdown.
8
00:00:31,949 --> 00:00:34,534
- No information on extent of injuries.
- I can jump in with...
9
00:00:34,535 --> 00:00:38,746
Ogilvie, grab some goggles, gloves, gown.
Go up to the roof.
10
00:00:38,747 --> 00:00:40,915
First patient that lands, bring 'em down.
11
00:00:40,916 --> 00:00:43,543
We got two choppers.
You want to grab some bodies and meet me?
12
00:00:43,544 --> 00:00:46,963
- What injuries are we expecting?
- Structural collapse. Could be anything.
13
00:00:46,964 --> 00:00:50,550
I can increase the morphine drip
to manage the pain,
14
00:00:50,551 --> 00:00:53,219
but that could also slow down
your breathing.
15
00:00:53,220 --> 00:00:56,974
You will likely feel very drowsy.
You may lose consciousness.
16
00:00:58,100 --> 00:01:00,227
And it could cause you
to stop breathing altogether.
17
00:01:10,362 --> 00:01:11,989
I'll be right back.
18
00:01:19,371 --> 00:01:22,582
- Hey, you okay?
- Yeah.
19
00:01:22,583 --> 00:01:23,958
Yeah. Sorry.
20
00:01:23,959 --> 00:01:27,587
Look, it's hard seeing your patients die.
21
00:01:27,588 --> 00:01:31,591
But as professionals, we have to create
emotional boundaries for ourselves.
22
00:01:31,592 --> 00:01:34,011
It's not about us. It's about them.
23
00:01:36,096 --> 00:01:38,098
She's so calm. I just...
24
00:01:39,016 --> 00:01:40,600
Yeah.
25
00:01:40,601 --> 00:01:42,769
She's had a long time
to prepare for this moment.
26
00:01:44,062 --> 00:01:49,108
What she's doing for her sons...
managing this with so much grace...
27
00:01:49,109 --> 00:01:50,818
it's a real gift of love.
28
00:01:50,819 --> 00:01:52,613
I feel like an asshole.
29
00:01:53,655 --> 00:01:55,781
All they want is more time
with their mother.
30
00:01:55,782 --> 00:01:57,617
All I want is less time with mine.
31
00:01:57,618 --> 00:01:59,577
Don't feel guilty.
32
00:01:59,578 --> 00:02:03,831
I mean, you can be grateful
and gracious from a distance.
33
00:02:03,832 --> 00:02:06,543
Just talk to her. Tell her what you want.
She'll understand.
34
00:02:09,212 --> 00:02:10,422
I doubt that.
35
00:02:11,798 --> 00:02:14,926
Give her a chance, you know?
She may surprise you.
36
00:02:17,387 --> 00:02:18,888
Hey.
37
00:02:18,889 --> 00:02:20,848
Two birds headed our way. Need a hand?
38
00:02:20,849 --> 00:02:22,642
That's the rumor.
39
00:02:22,643 --> 00:02:24,560
Santos, trauma incoming.
40
00:02:24,561 --> 00:02:27,064
Grab a gown. You can assist Dr. Langdon.
41
00:02:30,067 --> 00:02:31,442
Fuck me.
42
00:02:31,443 --> 00:02:34,070
Jesus, I got blood tubes
growing moss over here.
43
00:02:34,071 --> 00:02:36,155
Ticktock, people.
44
00:02:36,156 --> 00:02:38,449
Hey, Olive, do me a solid...
run these to the lab.
45
00:02:38,450 --> 00:02:39,659
No problem.
46
00:02:39,660 --> 00:02:41,535
I got more lab results.
47
00:02:41,536 --> 00:02:43,663
Start putting them
on the patient clipboards,
48
00:02:43,664 --> 00:02:45,873
PTMC Emergency. Go ahead, Medic Command.
49
00:02:45,874 --> 00:02:47,541
Do cyberattacks happen often?
50
00:02:47,542 --> 00:02:49,752
- More than you realize.
- I blame the Russkies.
51
00:02:49,753 --> 00:02:52,838
Dr. Mohan, it's your mother?
52
00:02:52,839 --> 00:02:54,548
She sounds pretty upset.
53
00:02:54,549 --> 00:02:56,885
Says she really needs to talk to you.
54
00:02:57,886 --> 00:02:59,888
You're shitting me.
Tell her I'm not available.
55
00:03:10,273 --> 00:03:11,566
How's your shift going?
56
00:03:12,484 --> 00:03:14,611
It's been a lot already.
57
00:03:15,696 --> 00:03:18,364
You know, I worked in an ER before,
up in Vermont,
58
00:03:18,365 --> 00:03:22,118
and we had MVAs and ODs, MIs.
59
00:03:22,119 --> 00:03:23,286
But this place...
60
00:03:24,121 --> 00:03:25,580
this place is relentless.
61
00:03:26,289 --> 00:03:29,126
Holiday weekend.
We're not normally offline.
62
00:03:30,127 --> 00:03:32,878
I think we have
a very different idea of normal.
63
00:03:32,879 --> 00:03:34,338
It's not for everyone.
64
00:03:34,339 --> 00:03:37,426
- I'm not sure it's healthy for anybody.
- Here's her leg.
65
00:03:38,510 --> 00:03:40,137
Jesus.
66
00:03:47,519 --> 00:03:50,146
- I need more runners.
- Oh, you could shut down the gift shop.
67
00:03:50,147 --> 00:03:52,314
They always have a couple
of volunteers there.
68
00:03:52,315 --> 00:03:54,316
Most of those volunteers use walkers.
69
00:03:54,317 --> 00:03:55,943
Beggars can't be choosers.
70
00:03:55,944 --> 00:03:57,361
Go get 'em.
71
00:03:57,362 --> 00:03:59,739
- Okay, I'm gonna grab a smoke first.
- No time.
72
00:03:59,740 --> 00:04:01,323
Nicotine gum... take the edge off.
73
00:04:01,324 --> 00:04:03,951
You two, head to triage
to help out the front of the house.
74
00:04:03,952 --> 00:04:06,746
They're running out of space,
and there's a line out the door.
75
00:04:06,747 --> 00:04:09,332
- Okay, let's go.
- Hang on, Mohan.
76
00:04:10,959 --> 00:04:12,210
Sign this.
77
00:04:14,546 --> 00:04:16,547
Nicotine patch, 21 milligrams.
78
00:04:16,548 --> 00:04:19,175
- Who's it for?
- Monica. This nicotine gum's shit.
79
00:04:19,176 --> 00:04:22,220
She'll never survive the shift, and I need
her so I don't lose my goddamn mind.
80
00:04:24,973 --> 00:04:26,265
Thanks.
81
00:04:26,266 --> 00:04:28,017
Is Dr. Abbot still around?
82
00:04:28,018 --> 00:04:30,770
He went to get some sleep before
his night shift starts in a couple hours.
83
00:04:30,771 --> 00:04:33,564
Shit. Okay, I should have planned
this better.
84
00:04:33,565 --> 00:04:36,358
I was hoping he'd write me
a letter of rec for an elective
85
00:04:36,359 --> 00:04:38,736
so I could have a shot
at a fellowship next year.
86
00:04:38,737 --> 00:04:39,780
Which one?
87
00:04:40,989 --> 00:04:42,364
Whichever will take me.
88
00:04:42,365 --> 00:04:44,575
Didn't the electives fill up a while ago?
89
00:04:44,576 --> 00:04:46,994
Don't remind me. I'm gonna throw myself
at the mercy of the court,
90
00:04:46,995 --> 00:04:48,996
beg for them to take me anyway.
91
00:04:48,997 --> 00:04:51,791
Just kill me now. It'll be less painful.
92
00:04:51,792 --> 00:04:53,918
Dana, I can't read this handwriting.
93
00:04:53,919 --> 00:04:55,003
It says...
94
00:04:56,004 --> 00:05:00,591
1,000 milligrams acetaminophen orally,
4 milligrams ondansetron under the tongue,
95
00:05:00,592 --> 00:05:02,802
and trial of clear fluids.
96
00:05:02,803 --> 00:05:04,595
Seriously? It says all that?
97
00:05:04,596 --> 00:05:07,307
If it's not in a text with emojis,
you kids can't read for shit.
98
00:05:10,602 --> 00:05:11,727
What do we have?
99
00:05:11,728 --> 00:05:13,729
A fall from 10 feet onto a metal fence.
100
00:05:13,730 --> 00:05:16,106
Right below the knee. Good vitals.
101
00:05:16,107 --> 00:05:17,858
Oh, it hurts. Oh, my God.
102
00:05:17,859 --> 00:05:20,236
- What's she had so far?
- 50 of fent, repeated 25.
103
00:05:20,237 --> 00:05:21,612
No meds, no allergies.
104
00:05:21,613 --> 00:05:23,948
- Where should I put this?
- Just hang on to it for now.
105
00:05:23,949 --> 00:05:27,744
On my count. One, two, three.
106
00:05:29,538 --> 00:05:32,748
Okay, Whitaker, E-FAST.
Donnie, primary survey, please.
107
00:05:32,749 --> 00:05:34,835
Pupils equal and reactive.
108
00:05:35,544 --> 00:05:38,045
- What's your name?
- My leg hurts really bad.
109
00:05:38,046 --> 00:05:39,839
Did I break it?
110
00:05:39,840 --> 00:05:41,382
I wouldn't say that it's broken exactly.
111
00:05:41,383 --> 00:05:43,634
We're gonna get an X-ray
to determine that.
112
00:05:43,635 --> 00:05:45,636
Put that on the gurney,
line it up for X-ray,
113
00:05:45,637 --> 00:05:47,054
keep your fucking mouth shut.
114
00:05:47,055 --> 00:05:48,931
Good lung sliding right and left.
115
00:05:48,932 --> 00:05:50,934
Airway patent, breath sounds bilaterally.
116
00:05:51,643 --> 00:05:54,103
- Please, it hurts.
- BP 100 over 60.
117
00:05:54,104 --> 00:05:57,147
Pulse 118, pulse ox 98%.
118
00:05:57,148 --> 00:06:00,442
- Does your belly hurt?
- No, asshole! It's my leg!
119
00:06:00,443 --> 00:06:03,571
- Okay, she's really moving here.
- 100 of ketamine?
120
00:06:03,572 --> 00:06:05,407
Yeah, we can't evaluate like this.
121
00:06:06,449 --> 00:06:08,158
Hey, Ogilvie?
122
00:06:08,159 --> 00:06:10,327
- Deep breaths, yeah?
- Yeah, okay.
123
00:06:10,328 --> 00:06:11,871
Whitaker, what's next?
124
00:06:11,872 --> 00:06:14,415
Once she's sedated, finish the E-FAST,
125
00:06:14,416 --> 00:06:16,333
plain X-ray, check her back,
straight to CT.
126
00:06:16,334 --> 00:06:18,669
- What if the ketamine wears off?
- Right.
127
00:06:18,670 --> 00:06:22,298
We should do a popliteal nerve block
before the CT,
128
00:06:22,299 --> 00:06:24,216
anesthetize from the knee down.
129
00:06:24,217 --> 00:06:26,302
- Two view tib-fib.
- Pushing ketamine now.
130
00:06:26,303 --> 00:06:29,096
- What's the bullet?
- 42-year-old male with 20-foot fall.
131
00:06:29,097 --> 00:06:31,099
Blunt chest trauma with hand injury.
132
00:06:31,641 --> 00:06:33,642
Where's my son? Where's my son?
133
00:06:33,643 --> 00:06:36,020
He's tachy to 108, sats 98 on 2 liters,
134
00:06:36,021 --> 00:06:38,731
- BP 122 over 84.
- We'll pan scan due to mechanism.
135
00:06:38,732 --> 00:06:40,691
- You?
- Tib-fib amputation.
136
00:06:40,692 --> 00:06:43,652
Hoping ortho can give us
a little hope for replantation.
137
00:06:43,653 --> 00:06:46,488
- Derek, where are you hurting?
- Chest and my finger.
138
00:06:46,489 --> 00:06:47,615
Did they find my son?
139
00:06:47,616 --> 00:06:49,700
- Did you hit your head?
- Don't think so.
140
00:06:49,701 --> 00:06:51,118
I need to find my son!
141
00:06:51,119 --> 00:06:53,495
We'll find him for you,
but we need to take care of you first.
142
00:06:53,496 --> 00:06:56,498
Pericardium's clear.
No fluid in Morrison's.
143
00:06:56,499 --> 00:06:58,084
Move both arms, wiggle your feet.
144
00:06:58,710 --> 00:07:01,128
- Good. Any pain in your neck?
- No.
145
00:07:01,129 --> 00:07:02,922
- Spleen looks good.
- Start with his chest.
146
00:07:02,923 --> 00:07:04,340
That's where he hurts.
147
00:07:04,341 --> 00:07:06,551
- No hemotympanum.
- Normal sliding.
148
00:07:07,135 --> 00:07:09,095
Best to start with the side
he's complaining about first.
149
00:07:10,722 --> 00:07:12,681
I don't see much sliding there.
150
00:07:12,682 --> 00:07:14,934
His name is Zack. He's seven.
151
00:07:14,935 --> 00:07:16,727
- Pneumothorax?
- Set up for a chest tube.
152
00:07:16,728 --> 00:07:20,940
Not yet. Let's go posterolateral.
Look for fluid first.
153
00:07:20,941 --> 00:07:22,901
Traumatic pneumothorax.
We should prep the chest.
154
00:07:23,610 --> 00:07:25,528
Not necessarily.
He's hemodynamically stable.
155
00:07:26,363 --> 00:07:27,738
Okay.
156
00:07:27,739 --> 00:07:29,490
Does that look like some fluid there?
157
00:07:29,491 --> 00:07:30,950
Hard to say for sure.
158
00:07:30,951 --> 00:07:33,744
Okay, he's tachycardic hemopneumothorax.
He needs a chest tube.
159
00:07:33,745 --> 00:07:37,748
BP and sats are fine. We can wait for CT.
If it's small, it'll resolve on its own.
160
00:07:37,749 --> 00:07:40,167
- We observe and reimage.
- I agree. He's stable for now.
161
00:07:40,168 --> 00:07:41,627
Let's wait for the scan, Dr. Santos.
162
00:07:41,628 --> 00:07:43,963
- Okay, let's order...
- Okay.
163
00:07:43,964 --> 00:07:46,383
A CT chest, abdomen,
pelvis, and X-ray left hand.
164
00:07:48,176 --> 00:07:50,386
- Major degloving.
- Focus on the primary.
165
00:07:50,387 --> 00:07:52,514
Dr. Langdon's correct.
We need to logroll him.
166
00:07:54,307 --> 00:07:56,517
Oh, okay. How about another 4 of morphine?
167
00:07:56,518 --> 00:07:57,559
Put it in.
168
00:07:57,560 --> 00:07:59,562
Hang in there, Derek. We got you.
169
00:08:01,815 --> 00:08:03,774
Fuck off already.
170
00:08:03,775 --> 00:08:06,402
- Boyfriend?
- Wish. My mom.
171
00:08:06,403 --> 00:08:08,362
Every time I get a second of service,
172
00:08:08,363 --> 00:08:11,198
- another dozen texts come in.
- Hey! How much longer do I have to wait?
173
00:08:11,199 --> 00:08:12,908
I got a broken leg here.
174
00:08:12,909 --> 00:08:14,576
Someone will be with you shortly, sir.
175
00:08:14,577 --> 00:08:17,413
Am I allowed to use the bathroom?
I really have to go.
176
00:08:17,414 --> 00:08:19,373
I don't know, ma'am. I am not your doctor.
177
00:08:19,374 --> 00:08:22,543
- It says right there "doctor."
- Yes, but I'm not your doctor.
178
00:08:22,544 --> 00:08:24,878
But if you go back to your room,
a nurse will come find you.
179
00:08:24,879 --> 00:08:26,630
I wasn't in a room.
180
00:08:26,631 --> 00:08:29,591
I'm sorry.
Are either of you treating my mother?
181
00:08:29,592 --> 00:08:30,593
Nope!
182
00:08:37,726 --> 00:08:39,811
Take a seat. It's gonna be a while.
183
00:08:43,231 --> 00:08:45,275
Helen Torres, come on down.
184
00:08:46,943 --> 00:08:49,028
Helen Torres?
185
00:08:49,029 --> 00:08:50,447
Yes, I'm coming.
186
00:08:53,033 --> 00:08:56,244
- Go through the door on this side.
- Thank you.
187
00:09:04,252 --> 00:09:05,253
Thank you.
188
00:09:10,425 --> 00:09:12,342
I'm Dr. Mohan.
This is Student Doctor Kwon.
189
00:09:12,343 --> 00:09:13,427
Helen.
190
00:09:13,428 --> 00:09:15,679
How long has your leg been swollen, Helen?
191
00:09:15,680 --> 00:09:18,308
It's been getting worse
over the past week.
192
00:09:19,017 --> 00:09:20,851
Dr. Mohan, your mom called again.
193
00:09:20,852 --> 00:09:22,479
- She said you need to call her back.
- Not now!
194
00:09:23,438 --> 00:09:24,647
I'm with a patient.
195
00:09:27,358 --> 00:09:28,485
Sorry about that.
196
00:09:29,861 --> 00:09:31,862
Did you fall or hit your leg?
197
00:09:31,863 --> 00:09:32,989
No.
198
00:09:33,865 --> 00:09:36,867
Have you ever had a blood clot before?
199
00:09:36,868 --> 00:09:37,869
No.
200
00:09:41,498 --> 00:09:43,832
- Are you all right?
- Excuse me?
201
00:09:43,833 --> 00:09:47,086
- Do you need to sit down?
- Oh, no. I'm fine.
202
00:09:47,087 --> 00:09:48,254
You don't look too good.
203
00:09:48,880 --> 00:09:50,380
What?
204
00:09:50,381 --> 00:09:52,132
No, it's just...
205
00:09:52,133 --> 00:09:53,801
it's really hot in here.
206
00:09:53,802 --> 00:09:54,928
And...
207
00:09:56,262 --> 00:09:58,306
- You need to sit down.
- I'm good.
208
00:10:00,100 --> 00:10:02,101
I just need some air.
209
00:10:02,102 --> 00:10:03,686
Excuse me one second.
210
00:10:21,329 --> 00:10:24,248
- You a doctor?
- Sorry, Doctor, does this look infected?
211
00:10:24,249 --> 00:10:26,917
I've been waiting six hours,
and people keep cutting in front of me.
212
00:10:26,918 --> 00:10:30,129
Doctor, can you just look at my throat
just to see if it's strep?
213
00:10:30,130 --> 00:10:31,714
Look out! Make way!
214
00:10:32,924 --> 00:10:34,508
Get in.
215
00:10:34,509 --> 00:10:36,176
No, I'm okay.
216
00:10:36,177 --> 00:10:38,930
- I'm okay.
- Get in the fucking chair.
217
00:10:42,142 --> 00:10:43,350
Excuse me, ma'am.
218
00:10:43,351 --> 00:10:45,561
Excuse me, coming through!
219
00:10:45,562 --> 00:10:47,146
Out of my way!
220
00:10:47,147 --> 00:10:50,524
We were going down the water slide,
and the bottom just fell off.
221
00:10:50,525 --> 00:10:53,152
I grabbed Zack's arm,
and I tried to hold on to the sides,
222
00:10:53,153 --> 00:10:55,362
but my hand slipped,
and my ring got stuck.
223
00:10:55,363 --> 00:10:57,157
My finger was ripping off, and I just...
224
00:10:57,949 --> 00:10:59,534
and I lost him.
225
00:11:00,160 --> 00:11:03,662
We can numb up your finger as soon
as we gauge the extent of the injury.
226
00:11:03,663 --> 00:11:05,581
You can cut the damn thing off
for all I care.
227
00:11:05,582 --> 00:11:07,125
I just need to find Zack.
228
00:11:07,959 --> 00:11:10,669
- Okay, do you feel anything here?
- Yeah, sharp.
229
00:11:10,670 --> 00:11:12,546
- How about here?
- Sharp again.
230
00:11:12,547 --> 00:11:13,964
A little late for the show, Yoyo.
231
00:11:13,965 --> 00:11:16,175
I am the show, Dr. Langdon.
You're the warm-up act.
232
00:11:16,176 --> 00:11:17,510
I knew somebody missed me.
233
00:11:18,219 --> 00:11:20,971
Mr. Foster suffered a degloving injury
of the ring finger.
234
00:11:20,972 --> 00:11:23,182
Stable pneumothorax awaiting imaging.
235
00:11:23,183 --> 00:11:25,768
Hello, sir. I'm Dr. Garcia
from the trauma service.
236
00:11:26,394 --> 00:11:27,603
I need the ring cutter.
237
00:11:27,604 --> 00:11:29,397
That's why they pay
the surgeons the big bucks.
238
00:11:29,981 --> 00:11:31,983
Possible flexor tendon injury.
239
00:11:33,610 --> 00:11:36,196
Try to bend up your ring finger.
240
00:11:38,740 --> 00:11:40,324
Let's go with the block.
241
00:11:40,325 --> 00:11:43,410
You're gonna feel a pinprick
and some burning.
242
00:11:43,411 --> 00:11:45,996
Which tendon did we test, Dr. Santos?
243
00:11:45,997 --> 00:11:47,832
Seriously? That's a med-student question.
244
00:11:48,625 --> 00:11:51,419
We're a teaching hospital.
It's always good to review.
245
00:11:52,795 --> 00:11:55,797
Flexor digitorum superficialis is intact
246
00:11:55,798 --> 00:11:58,217
as it inserts on the middle phalanx.
247
00:11:58,218 --> 00:12:00,511
- Correct.
- Gee, thanks.
248
00:12:01,221 --> 00:12:02,639
No sign of tension.
249
00:12:03,264 --> 00:12:04,974
At least no tension pneumo.
250
00:12:05,808 --> 00:12:07,809
Let's wait for the CT. I'll be next door.
251
00:12:07,810 --> 00:12:10,604
Langdon, Mel's sister's
been asking for you.
252
00:12:10,605 --> 00:12:12,814
She's getting antsy,
and we could really use the room.
253
00:12:12,815 --> 00:12:15,067
- CT's ready.
- Okay. Let Becca know I'll be there soon.
254
00:12:15,068 --> 00:12:18,445
And Mr. Foster got separated
from his son Zack
255
00:12:18,446 --> 00:12:19,821
at the water park.
256
00:12:19,822 --> 00:12:22,449
- Is there anyone we can call for you?
- My wife, Angela.
257
00:12:22,450 --> 00:12:25,453
Dr. Santos, will you escort
Mr. Foster to CT?
258
00:12:29,832 --> 00:12:30,999
Help!
259
00:12:31,000 --> 00:12:32,669
Need a hand here.
260
00:12:33,461 --> 00:12:36,380
- What the hell happened?
- I think I'm having an MI.
261
00:12:36,381 --> 00:12:38,590
My chest is so tight,
I can barely breathe.
262
00:12:38,591 --> 00:12:41,677
Okay, I got to get a 12 lead.
Perlah, can I get an assist here?
263
00:12:41,678 --> 00:12:42,845
Yeah, I'm on it.
264
00:12:44,305 --> 00:12:45,389
CT's normal.
265
00:12:45,390 --> 00:12:47,266
Why do we take down
the tourniquet, Whitaker?
266
00:12:47,267 --> 00:12:50,143
To give the residual limb blood flow.
267
00:12:50,144 --> 00:12:51,645
Just two little pumpers.
268
00:12:51,646 --> 00:12:53,690
A couple of figure eights
ought to take care of those.
269
00:12:54,482 --> 00:12:56,024
Park.
270
00:12:56,025 --> 00:12:58,486
Park the Shark, orthopedic surgeon.
271
00:12:59,070 --> 00:13:01,280
- Is this a favorable amputation?
- Pretty clean cut.
272
00:13:01,281 --> 00:13:03,073
Fence sliced through like a guillotine.
273
00:13:03,074 --> 00:13:04,242
X-ray?
274
00:13:06,786 --> 00:13:08,079
Not too bad.
275
00:13:10,290 --> 00:13:13,792
Just tying off a couple arterioles.
276
00:13:13,793 --> 00:13:15,295
I'm not blind.
277
00:13:16,004 --> 00:13:18,715
- Where's the amputated leg?
- Double bagged on ice.
278
00:13:19,507 --> 00:13:21,758
Sterile saline on the inner bag.
279
00:13:21,759 --> 00:13:25,721
Ice water in the outer bag.
No direct ice-on-skin contact.
280
00:13:25,722 --> 00:13:29,100
- We spent a lot of time prepping...
- He still needs to look.
281
00:13:33,521 --> 00:13:34,731
Get Robby.
282
00:13:43,948 --> 00:13:46,700
- Antibiotics?
- Cefazolin and gent.
283
00:13:46,701 --> 00:13:49,161
We've cleared her chest,
abdomen, and pelvis.
284
00:13:49,162 --> 00:13:53,333
Clean wound, no crush injury,
rapid transport time.
285
00:13:53,875 --> 00:13:55,542
Replantation is a go.
286
00:13:55,543 --> 00:13:56,752
I'll book an OR.
287
00:13:56,753 --> 00:13:58,337
Irrigate the hell out of this
with 3 liters.
288
00:13:58,338 --> 00:14:00,840
- 3 liters?
- Of saline, genius.
289
00:14:02,717 --> 00:14:03,926
Thanks, Shark.
290
00:14:07,764 --> 00:14:09,432
I knew he meant saline.
291
00:14:10,558 --> 00:14:14,728
Dr. Robby, we need you in Central 6.
Dr. Mohan may be having a heart attack.
292
00:14:14,729 --> 00:14:15,772
What?
293
00:14:17,732 --> 00:14:20,359
- EKG is normal.
- You sure?
294
00:14:20,360 --> 00:14:22,569
Check it out.
You can be your own second opinion.
295
00:14:22,570 --> 00:14:24,738
- What's going on?
- It's okay. I'm okay.
296
00:14:24,739 --> 00:14:26,239
You don't look okay.
297
00:14:26,240 --> 00:14:28,367
- You look like shit.
- I feel like shit.
298
00:14:28,368 --> 00:14:30,952
- What happened?
- I don't know.
299
00:14:30,953 --> 00:14:34,749
I just got really hot,
and I started having trouble breathing.
300
00:14:35,583 --> 00:14:37,794
We should send up
some labs just to be safe.
301
00:14:38,795 --> 00:14:40,087
Any chance you're pregnant?
302
00:14:40,088 --> 00:14:42,799
I'm not sure I feel comfortable
answering that.
303
00:14:44,550 --> 00:14:46,968
- No.
- She was tachy, but it's resolved now.
304
00:14:46,969 --> 00:14:48,805
- Have you eaten anything?
- Yeah.
305
00:14:49,389 --> 00:14:51,182
- You staying hydrated?
- 100%.
306
00:14:51,808 --> 00:14:53,016
I'm doing everything right.
307
00:14:53,017 --> 00:14:55,310
It's everything around me
that's all fucked up.
308
00:14:55,311 --> 00:14:58,271
It's just my mom moving
and calling me over and over again
309
00:14:58,272 --> 00:15:00,190
and now me scrambling
to find a job next year.
310
00:15:00,191 --> 00:15:02,984
I had it all planned out,
and now everything's just out the window.
311
00:15:02,985 --> 00:15:05,863
Wait a minute. Is this a panic attack
because of your mommy issues?
312
00:15:06,531 --> 00:15:08,115
- What? No.
- Jesus.
313
00:15:08,116 --> 00:15:09,408
Do you need to go home?
314
00:15:09,409 --> 00:15:11,118
- You should go home.
- No, I'm fine.
315
00:15:11,119 --> 00:15:12,662
I don't need the fucking liability.
Go home.
316
00:15:13,204 --> 00:15:15,997
And the rest of you, the last time
I checked, the ED is a shit show.
317
00:15:15,998 --> 00:15:18,000
So let's all get back to work, huh?
318
00:15:25,341 --> 00:15:27,884
Sorry for taking so long, Becca.
319
00:15:27,885 --> 00:15:29,970
Nurse Dana said you'd be back
in a few minutes,
320
00:15:29,971 --> 00:15:32,222
but it's definitely been
more than a few minutes.
321
00:15:32,223 --> 00:15:34,016
You're right. My apologies.
322
00:15:34,642 --> 00:15:36,852
- I brought some drink options.
- Okay.
323
00:15:36,853 --> 00:15:40,689
We've got apple juice, cranberry juice,
324
00:15:40,690 --> 00:15:43,817
OJ, and Pittsburgh's finest.
325
00:15:43,818 --> 00:15:46,028
- What's that?
- Water.
326
00:15:46,863 --> 00:15:48,656
- OJ, please.
- Okay.
327
00:15:50,032 --> 00:15:51,451
Let's see.
328
00:15:54,620 --> 00:15:55,663
All right.
329
00:15:56,664 --> 00:15:59,459
Now, I am going to give you two pills.
330
00:16:00,042 --> 00:16:02,169
The first is an antibiotic.
331
00:16:02,170 --> 00:16:04,463
That will get rid of the infection.
332
00:16:04,464 --> 00:16:06,465
The second should take care
of the burning.
333
00:16:06,466 --> 00:16:09,968
You want to take both pills for three days
and drink lots of water.
334
00:16:09,969 --> 00:16:11,470
I'll write it all down.
335
00:16:11,471 --> 00:16:12,680
I hate pills.
336
00:16:13,347 --> 00:16:16,308
Could you mash those up
and put them in the OJ for me?
337
00:16:16,309 --> 00:16:17,685
Coming right up.
338
00:16:19,604 --> 00:16:20,688
Okay.
339
00:16:21,898 --> 00:16:24,567
Mel's gonna be super worried
when you tell her.
340
00:16:25,193 --> 00:16:26,818
You are gonna be just fine.
341
00:16:26,819 --> 00:16:30,280
But as far as telling your sister
what's going on with you,
342
00:16:30,281 --> 00:16:32,450
that is your decision, not mine.
343
00:16:34,702 --> 00:16:37,705
So you're not going to tell Mel?
344
00:16:38,498 --> 00:16:42,460
I can't, not unless you,
my patient, tell me to.
345
00:16:45,713 --> 00:16:49,300
Do you know when Mel's gonna be done
with her important meeting?
346
00:16:50,092 --> 00:16:51,302
Hopefully soon.
347
00:16:52,720 --> 00:16:56,306
Dr. Langdon, they need you
back in Trauma Two.
348
00:16:56,307 --> 00:16:57,308
Hi.
349
00:16:59,644 --> 00:17:01,269
Becca, I got to go. I'll be...
350
00:17:01,270 --> 00:17:04,398
Don't say "in a few minutes"
unless you actually mean in a few minutes.
351
00:17:05,107 --> 00:17:06,317
I would never.
352
00:17:11,239 --> 00:17:14,533
And I need you to be kind to each other.
353
00:17:14,534 --> 00:17:17,954
I am kind.
Shane's just a butthead sometimes.
354
00:17:19,539 --> 00:17:23,125
He's your brother, and he loves you.
355
00:17:25,419 --> 00:17:26,546
Don't go.
356
00:17:27,338 --> 00:17:28,756
I don't want to go.
357
00:17:30,091 --> 00:17:32,843
But it's not up to me.
358
00:17:33,970 --> 00:17:35,136
Hey.
359
00:17:35,137 --> 00:17:37,139
We'll always be connected...
360
00:17:37,974 --> 00:17:39,350
no matter what.
361
00:17:42,353 --> 00:17:43,980
Invisible string.
362
00:17:47,567 --> 00:17:49,151
Invisible string.
363
00:18:01,372 --> 00:18:02,373
Hey.
364
00:18:04,792 --> 00:18:06,502
You gonna go in and see your mom?
365
00:18:08,004 --> 00:18:09,589
Cancer sucks.
366
00:18:10,590 --> 00:18:11,923
Yeah.
367
00:18:11,924 --> 00:18:13,384
Yeah, it does.
368
00:18:16,387 --> 00:18:19,599
- It's not fair.
- No, it's not.
369
00:18:24,186 --> 00:18:25,771
I don't want to go in there.
370
00:18:27,815 --> 00:18:29,817
Nobody's gonna make you.
371
00:18:36,824 --> 00:18:38,826
She didn't used to look like that.
372
00:18:41,829 --> 00:18:43,414
Yeah, I get that.
373
00:18:47,084 --> 00:18:50,211
But if you don't go in there
and say goodbye
374
00:18:50,212 --> 00:18:52,214
and tell your mom you love her...
375
00:18:53,841 --> 00:18:57,053
I think you might wish you had
for a very long time.
376
00:19:01,223 --> 00:19:02,642
It's your call.
377
00:19:06,437 --> 00:19:10,650
D-5 half normal saline,
20 of K running at 125 an hour.
378
00:19:11,442 --> 00:19:12,859
One of the most common reasons
379
00:19:12,860 --> 00:19:15,278
for traumatic-replantation failure
is infections.
380
00:19:15,279 --> 00:19:16,738
So we do what, Whitaker?
381
00:19:16,739 --> 00:19:18,824
Rinse and repeat
until surgery calls for us.
382
00:19:21,077 --> 00:19:23,244
Is everything okay with Dr. Mohan?
383
00:19:23,245 --> 00:19:24,747
She's fine. Focus.
384
00:19:30,086 --> 00:19:31,253
Where am I?
385
00:19:32,463 --> 00:19:33,923
Ketamine's wearing off.
386
00:19:37,093 --> 00:19:39,177
I can't feel my leg.
387
00:19:39,178 --> 00:19:42,055
I'm Dr. Michael Robinavitch.
You're at a hospital.
388
00:19:42,056 --> 00:19:44,724
And we gave you a nerve block
so that you can't feel any pain.
389
00:19:44,725 --> 00:19:45,809
Why?
390
00:19:45,810 --> 00:19:49,772
You were on a water slide that collapsed
and did serious injury to your leg.
391
00:19:53,901 --> 00:19:55,235
What the fuck?
392
00:19:55,236 --> 00:19:56,611
Is that my leg?
393
00:19:56,612 --> 00:19:57,696
Is that my...
394
00:19:57,697 --> 00:20:00,532
- Did you cut my fucking leg off?
- Your leg was cut off in the accident.
395
00:20:00,533 --> 00:20:02,742
Our surgeons are going to try
for replantation.
396
00:20:02,743 --> 00:20:04,285
No.
397
00:20:04,286 --> 00:20:05,704
- She needs more ketamine.
- Just wrap up the leg.
398
00:20:05,705 --> 00:20:06,913
Emily, I know that this is really hard.
399
00:20:06,914 --> 00:20:08,415
I need you to focus on me right now,
400
00:20:08,416 --> 00:20:09,916
because we need to get your consent
401
00:20:09,917 --> 00:20:11,710
- to proceed with the surgery.
- Why?
402
00:20:11,711 --> 00:20:13,128
There are risks with the surgery.
403
00:20:13,129 --> 00:20:15,505
There's anesthesia,
and there's no guarantee...
404
00:20:15,506 --> 00:20:17,132
Emily?
405
00:20:17,133 --> 00:20:19,926
Can you just put it back on?
406
00:20:19,927 --> 00:20:22,429
- Can you just put it back on?
- Sounds like consent to me.
407
00:20:22,430 --> 00:20:24,931
- Now can she have sedation?
- Okay, load her up. Ketamine and rock.
408
00:20:24,932 --> 00:20:26,307
It's gonna be okay. It's gonna be okay.
409
00:20:26,308 --> 00:20:28,184
We're gonna intubate before the OR.
410
00:20:28,185 --> 00:20:29,729
It's gonna be okay.
411
00:20:30,354 --> 00:20:33,523
- Finishing second cut.
- Success.
412
00:20:33,524 --> 00:20:36,776
- Can that be saved?
- The finger or the ring?
413
00:20:36,777 --> 00:20:38,445
- The wedding ring.
- Yes, sir.
414
00:20:38,446 --> 00:20:40,740
A jeweler can weld it
back together good as new.
415
00:20:41,490 --> 00:20:44,243
Stop.
Irrigate the ring shavings off first.
416
00:20:46,162 --> 00:20:48,748
- What did I miss?
- Finishing irrigation.
417
00:20:49,540 --> 00:20:50,749
Okay.
418
00:20:50,750 --> 00:20:52,542
Doesn't look like you lost any skin.
419
00:20:52,543 --> 00:20:54,711
It's a little dusky. Might not be viable.
420
00:20:54,712 --> 00:20:56,546
There's intact skin on the dorsum.
421
00:20:56,547 --> 00:20:58,923
More irrigation,
then tack it down with one suture.
422
00:20:58,924 --> 00:21:00,425
Okay, thanks.
423
00:21:00,426 --> 00:21:04,345
- Radiologist reports a 25% pneumothorax.
- Is that bad?
424
00:21:04,346 --> 00:21:07,182
That is a partially collapsed lung
that needs treatment.
425
00:21:07,183 --> 00:21:09,851
- I can put in a chest tube.
- He doesn't need a chest tube.
426
00:21:09,852 --> 00:21:11,937
Okay, what do you want,
a pigtail catheter?
427
00:21:12,772 --> 00:21:14,481
I was thinking a ThoraVent.
428
00:21:14,482 --> 00:21:15,857
What? Why?
429
00:21:15,858 --> 00:21:18,151
It's not a bad idea.
No need for wall suction.
430
00:21:18,152 --> 00:21:21,196
If Hand can operate today, he can go home
tomorrow with the ThoraVent.
431
00:21:21,197 --> 00:21:23,573
You can learn a lot
from your senior residents.
432
00:21:23,574 --> 00:21:25,867
I'm happy to teach Dr. Santos.
433
00:21:25,868 --> 00:21:27,787
Thank you, Dr. Langdon.
434
00:21:31,999 --> 00:21:35,210
Janelle, I need you to take
the samples to the lab
435
00:21:35,211 --> 00:21:37,086
and come back with any results
that are ready.
436
00:21:37,087 --> 00:21:41,007
Geoffrey, head to CT to see if any new
results are printed and bring those back.
437
00:21:41,008 --> 00:21:43,927
Pam, check in
with whoever's running the PDS
438
00:21:43,928 --> 00:21:46,221
to see if any orders
need to go to the pharmacy
439
00:21:46,222 --> 00:21:48,306
and bring back any meds
that are ready for pickup.
440
00:21:48,307 --> 00:21:50,767
Rinse and repeat every 15 minutes.
441
00:21:50,768 --> 00:21:52,769
Double-tie those shoelaces and hydrate.
442
00:21:52,770 --> 00:21:54,814
It's not a sprint. It's a marathon.
443
00:21:55,606 --> 00:21:57,233
Fly, my pretties.
444
00:21:58,025 --> 00:22:00,819
Okay, any word on finding
our water slide dad's kid?
445
00:22:00,820 --> 00:22:04,489
Not yet. Called the wife,
went straight to voicemail.
446
00:22:04,490 --> 00:22:07,242
Police dispatch said that there
were a couple of fatalities on site...
447
00:22:07,243 --> 00:22:09,828
- one adult, one kid.
- Sweet Jesus.
448
00:22:09,829 --> 00:22:11,079
Who the fuck did this?
449
00:22:11,080 --> 00:22:15,416
No sign-off on orders for labs or X-rays,
and it's in the wrong freaking rack?
450
00:22:15,417 --> 00:22:17,919
You guys trying to kill me
and the patient?
451
00:22:17,920 --> 00:22:19,629
- I'll take care of it.
- Thanks.
452
00:22:19,630 --> 00:22:23,049
- Dana, this gum is abso...
- Shit. I know.
453
00:22:23,050 --> 00:22:25,051
Pharmacy said you needed this right away.
454
00:22:25,052 --> 00:22:27,595
Just in time. Slap one on
and give it an hour to kick in.
455
00:22:27,596 --> 00:22:28,597
You're welcome.
456
00:22:29,807 --> 00:22:32,684
- What?
- The prescription is for you.
457
00:22:32,685 --> 00:22:34,520
My insurance will cover it. Hers won't.
458
00:22:35,271 --> 00:22:36,689
Isn't that insurance fraud?
459
00:22:37,648 --> 00:22:39,775
Throw me in jail. I could use a vacation.
460
00:22:43,237 --> 00:22:44,280
Mom.
461
00:22:49,869 --> 00:22:51,452
I'm really glad to see you, Mom. I...
462
00:22:51,453 --> 00:22:53,955
Garcia told me
about the sigmoid volvulus you missed.
463
00:22:53,956 --> 00:22:56,292
- It was an oversight.
- That could have killed her.
464
00:22:56,876 --> 00:22:59,460
Without electronic records, it's been
kind of a challenge to figure out...
465
00:22:59,461 --> 00:23:02,463
Chaos is the status quo in the ED, even
when the computers are working properly.
466
00:23:02,464 --> 00:23:04,716
You have to be hypervigilant
and double-check everything.
467
00:23:04,717 --> 00:23:07,094
- I can handle it.
- Why would you want to?
468
00:23:07,970 --> 00:23:11,306
Down here your learning street-level
medicine, all seat of your pants.
469
00:23:11,307 --> 00:23:12,682
Oh, well, I made a mistake,
470
00:23:12,683 --> 00:23:15,686
but the more talented practitioners
upstairs will fix it.
471
00:23:17,897 --> 00:23:19,356
You are better than this.
472
00:23:20,900 --> 00:23:23,903
I love you, too.
473
00:23:28,282 --> 00:23:32,327
- Well, that is one way to do a debrief.
- You should talk to her.
474
00:23:32,328 --> 00:23:35,038
- Which one?
- Honestly, both of them.
475
00:23:35,039 --> 00:23:37,749
- Can you call in some extra doctors?
- Sure.
476
00:23:37,750 --> 00:23:39,459
Everyone's dying to work
on the Fourth of July.
477
00:23:39,460 --> 00:23:41,628
- Why?
- Dr. Mohan went down.
478
00:23:41,629 --> 00:23:43,797
Yeah. I saw your pep talk.
479
00:23:44,715 --> 00:23:47,508
She's taking a little break
until her labs are back.
480
00:23:47,509 --> 00:23:50,846
She's going to be fine,
but I'm not sure her head is in the game.
481
00:23:51,722 --> 00:23:53,222
I'm on it, Cap.
482
00:23:53,223 --> 00:23:55,141
Small stab incision with the 11 blade,
483
00:23:55,142 --> 00:23:58,519
midclavicular line,
second intercostal space.
484
00:23:58,520 --> 00:24:01,397
- She's gonna stab me?
- It's just a medical term.
485
00:24:01,398 --> 00:24:02,650
Stay superior to the rib.
486
00:24:07,738 --> 00:24:10,699
- Is there a problem?
- Nope, everything's going well.
487
00:24:11,867 --> 00:24:13,160
Place the trocar.
488
00:24:13,953 --> 00:24:16,663
Hold back the adhesive wings
489
00:24:16,664 --> 00:24:20,166
and advance until you see
the red diaphragm move.
490
00:24:20,167 --> 00:24:22,169
That means you're in the pleural space.
491
00:24:22,878 --> 00:24:25,214
Now remove the trocar.
492
00:24:28,717 --> 00:24:29,968
Perfect.
493
00:24:29,969 --> 00:24:33,721
Okay, now we can either hook up
to wall suction,
494
00:24:33,722 --> 00:24:37,183
or we can use this one-way valve
to repeatedly aspirate with a syringe.
495
00:24:37,184 --> 00:24:39,560
Well, with all your vast experience,
Dr. Langdon,
496
00:24:39,561 --> 00:24:41,230
you should probably decide.
497
00:24:43,941 --> 00:24:46,776
We can avoid wall suction
if I pump manually.
498
00:24:46,777 --> 00:24:48,569
- Have at it, Doc.
- Enough.
499
00:24:48,570 --> 00:24:52,116
Apparently, decency and decorum need
to be reintroduced to our R2 curriculum.
500
00:24:52,825 --> 00:24:54,617
Nice work, Dr. Langdon.
501
00:24:54,618 --> 00:24:56,787
I'll go check on an OR for Mr. Foster.
502
00:25:02,209 --> 00:25:04,586
Hey. I'm gonna need you
to pick up the pace.
503
00:25:05,379 --> 00:25:08,589
Can I get a sec?
Dr. Mohan just almost died on me.
504
00:25:08,590 --> 00:25:11,009
Not even close.
She's tougher than she looks.
505
00:25:11,010 --> 00:25:12,885
Propane hero in North 4.
506
00:25:12,886 --> 00:25:14,470
Hey, any word from surgery
507
00:25:14,471 --> 00:25:17,598
on how our big patient Howard's
perforated diverticulitis is doing?
508
00:25:17,599 --> 00:25:20,226
- Still in the OR.
- What about our drunk firework kid?
509
00:25:20,227 --> 00:25:22,187
Waiting his turn
in the surgical conga line.
510
00:25:22,813 --> 00:25:24,522
What about Social Services?
511
00:25:24,523 --> 00:25:26,607
Have they found a temporary foster home
512
00:25:26,608 --> 00:25:29,027
- for our baby Jane Doe?
- Still working on it.
513
00:25:29,028 --> 00:25:31,988
Kid's gonna be old enough to drive
by the time she gets out of here.
514
00:25:31,989 --> 00:25:33,449
You joke...
515
00:25:34,533 --> 00:25:36,242
Oh, for fuck's sake!
516
00:25:36,243 --> 00:25:39,454
Go, quickly, before I change my mind.
517
00:25:39,455 --> 00:25:42,248
Hey, did the county pick up
Louie's body yet?
518
00:25:42,249 --> 00:25:45,251
- No. He's still in the viewing room.
- Jesus. He's just laying in there?
519
00:25:45,252 --> 00:25:48,255
Yeah. Another couple minutes, I'm gonna
wheel him down to the morgue myself.
520
00:25:49,965 --> 00:25:51,049
What's the bullet?
521
00:25:51,050 --> 00:25:53,051
Eight-year-old boy,
part of the water park accident.
522
00:25:53,052 --> 00:25:55,053
- Thrown off the water slide.
- How far did he fall?
523
00:25:55,054 --> 00:25:57,430
Maybe 6 or 7 feet, landed in a tree.
524
00:25:57,431 --> 00:25:59,223
Had to wait for a ladder truck
to get him down.
525
00:25:59,224 --> 00:26:01,434
Major neck trauma.
Must've taken all the impact there.
526
00:26:01,435 --> 00:26:02,852
Couldn't tube him, hard to bag.
527
00:26:02,853 --> 00:26:06,482
Sats in the 80s. BP 85 over 60. Pulse 50.
528
00:26:08,650 --> 00:26:11,070
Okay, one, two, and three.
529
00:26:12,321 --> 00:26:15,073
- Possible laryngeal fracture.
- Hypoxic bradycardic.
530
00:26:15,074 --> 00:26:17,116
Kid needs an airway before he arrests.
531
00:26:17,117 --> 00:26:19,535
Broselow tape, pedes cart, set up suction.
532
00:26:19,536 --> 00:26:21,705
Oh, my God. Is that Zack?
533
00:26:22,414 --> 00:26:24,500
Hey. Hey, kid, can you look at me?
534
00:26:25,209 --> 00:26:27,878
No response,
no purposeful movement to pain.
535
00:26:29,213 --> 00:26:30,338
Oh, my God.
536
00:26:30,339 --> 00:26:31,381
Is this your kid?
537
00:26:32,091 --> 00:26:33,674
- No.
- Sir, go back to your room now.
538
00:26:33,675 --> 00:26:35,635
- Broselow says 25 kilograms.
- Jesse?
539
00:26:35,636 --> 00:26:37,053
5 1/2 ET tube.
540
00:26:37,054 --> 00:26:40,765
- Okay, 30 of rock, 50 ketamine.
- You're gonna paralyze?
541
00:26:40,766 --> 00:26:43,309
- Yep.
- If we can't intubate, we crike?
542
00:26:43,310 --> 00:26:44,685
He's too young for a crike.
543
00:26:44,686 --> 00:26:46,771
- Needle crike?
- Can't ventilate through that.
544
00:26:46,772 --> 00:26:49,816
- Sats down to 78.
- 11 blade, Kelly, and a pedes bougie.
545
00:26:49,817 --> 00:26:51,068
One quick look, and then we cut.
546
00:26:51,777 --> 00:26:54,445
I can't tell if there's lung sliding.
No movement, no air entry.
547
00:26:54,446 --> 00:26:56,531
Way too edematous. I can't see the cords.
548
00:26:56,532 --> 00:26:58,158
Better with cricoid pressure?
549
00:26:59,326 --> 00:27:00,493
Nothing. Fuck.
550
00:27:00,494 --> 00:27:02,328
Okay. Towel roll between
the shoulder blades, please.
551
00:27:02,329 --> 00:27:04,539
Heart rate down to 49.
Headed to cardiac arrest.
552
00:27:04,540 --> 00:27:06,707
Trake's going to take 20 minutes.
This kid's not gonna last 60 seconds.
553
00:27:06,708 --> 00:27:08,126
That's why we're doing a slash trake.
554
00:27:08,127 --> 00:27:09,710
- Don't know it.
- Me neither.
555
00:27:09,711 --> 00:27:11,630
- Boss?
- Show me what you got.
556
00:27:20,931 --> 00:27:24,143
Pull up the trachea between
your thumb and middle finger.
557
00:27:24,810 --> 00:27:27,729
Vertical incision right over the trachea.
558
00:27:28,564 --> 00:27:32,192
Vertical, not horizontal, or you transect
the trachea and cut the jugular veins.
559
00:27:33,652 --> 00:27:34,987
That's a lot of blood.
560
00:27:35,571 --> 00:27:37,488
Now it's a tactile procedure.
561
00:27:37,489 --> 00:27:40,117
2-centimeter incision
through the tracheal rings.
562
00:27:40,742 --> 00:27:42,369
Finger in the trachea.
563
00:27:43,954 --> 00:27:45,706
Bougie into the airway.
564
00:27:47,583 --> 00:27:51,128
- Thoughts on what's next, Dr. Whitaker?
- Insert the ET tube into the trachea.
565
00:27:52,421 --> 00:27:54,423
Suction. Lots of blood in the airway.
566
00:28:01,221 --> 00:28:02,389
Okay, bag him.
567
00:28:03,473 --> 00:28:04,766
Check the CO2.
568
00:28:05,976 --> 00:28:07,977
Sats coming up, in the 80s.
569
00:28:07,978 --> 00:28:10,980
Bilateral breath sounds.
End tidal CO2 is 70.
570
00:28:10,981 --> 00:28:12,773
- That's crazy high.
- It'll come down.
571
00:28:12,774 --> 00:28:14,775
Tie down the tube,
control all the bleeders.
572
00:28:14,776 --> 00:28:17,403
Spray an amp of epi on a stack of 4-by-4s.
573
00:28:17,404 --> 00:28:20,156
Okay. Sats are up to the 90s.
574
00:28:20,157 --> 00:28:22,408
Good. CO2's in the 50s. Good heart rate.
575
00:28:22,409 --> 00:28:24,118
You forgot the last step.
576
00:28:24,119 --> 00:28:25,995
Change your underwear.
577
00:28:25,996 --> 00:28:28,706
- How many of these you done?
- First one.
578
00:28:28,707 --> 00:28:29,916
You serious?
579
00:28:29,917 --> 00:28:31,792
- How about you?
- None.
580
00:28:31,793 --> 00:28:34,420
I practiced in the Sim Lab
when I was at Stanford.
581
00:28:34,421 --> 00:28:35,796
- What'd I miss?
- All the fun.
582
00:28:35,797 --> 00:28:37,049
- Slash trake.
- Seriously?
583
00:28:38,008 --> 00:28:40,968
Fractured larynx.
Couldn't oxygenate, couldn't ventilate.
584
00:28:40,969 --> 00:28:44,681
- You use a meat cleaver on this kid?
- ENT can revise the trake in the OR.
585
00:28:45,390 --> 00:28:47,059
They'll be thrilled to clean up your mess.
586
00:28:48,018 --> 00:28:50,437
Or maybe they'll thank us
for not letting him die.
587
00:28:56,109 --> 00:28:58,152
So we're still waiting
on your prescription,
588
00:28:58,153 --> 00:29:00,029
and the pharmacy is a little backed up.
589
00:29:00,030 --> 00:29:02,573
But I'm glad to see you're doing good.
590
00:29:02,574 --> 00:29:03,533
Well.
591
00:29:04,159 --> 00:29:05,244
I'm well.
592
00:29:06,828 --> 00:29:08,246
Glad to see you're well.
593
00:29:08,247 --> 00:29:10,457
Can't you expedite my medication?
594
00:29:11,166 --> 00:29:13,459
Sure, but it may still be a little while
595
00:29:13,460 --> 00:29:17,547
before Dr. Mohan can sign off
on the discharge, so sit tight.
596
00:29:19,466 --> 00:29:20,676
And do what?
597
00:29:24,846 --> 00:29:27,474
You just keep this handy
for occasions like this?
598
00:29:28,475 --> 00:29:31,185
I thought that I might not have
that much to do today.
599
00:29:31,186 --> 00:29:32,271
But...
600
00:29:33,063 --> 00:29:34,690
man, I was wrong.
601
00:29:41,405 --> 00:29:42,698
Thank you.
602
00:29:47,494 --> 00:29:50,871
- What brings you in today?
- A friend made me come in.
603
00:29:50,872 --> 00:29:54,001
- Name's Robby. He said I should...
- You're Duke.
604
00:29:54,710 --> 00:29:56,294
- Donnie?
- Yep?
605
00:29:56,295 --> 00:29:58,088
Robby's VIP is here.
606
00:30:01,717 --> 00:30:04,719
Hi. I'm Donnie, nurse practitioner.
607
00:30:04,720 --> 00:30:08,889
Robby's already put in orders
for a numbing spray for your nostril.
608
00:30:08,890 --> 00:30:10,975
"Nostril"? It's my throat.
609
00:30:10,976 --> 00:30:12,893
- It's not my nose.
- Okay.
610
00:30:12,894 --> 00:30:15,314
Let's get you set up in a room.
611
00:30:18,650 --> 00:30:22,403
That was the most unprofessional
deposition I've ever witnessed.
612
00:30:22,404 --> 00:30:24,740
They were nowhere near that aggressive
with Dr. Ellis.
613
00:30:25,907 --> 00:30:27,326
Oh, okay.
614
00:30:29,536 --> 00:30:31,538
It didn't go as badly as you think.
615
00:30:32,080 --> 00:30:33,998
They suggested I was incompetent.
616
00:30:33,999 --> 00:30:38,085
They're posturing to set the stage
for a ridiculous settlement request.
617
00:30:38,086 --> 00:30:39,920
This isn't about those parents
or that kid.
618
00:30:39,921 --> 00:30:42,173
It's only about trying
to make a lot of money.
619
00:30:42,174 --> 00:30:45,426
Well, I don't have a lot of money.
620
00:30:45,427 --> 00:30:48,137
Not your money, Dr. King.
It's an insurance game.
621
00:30:48,138 --> 00:30:51,350
You're protected by the hospital.
This won't affect your career.
622
00:30:57,147 --> 00:30:59,565
Hey. How was your deposition?
623
00:30:59,566 --> 00:31:00,901
Have you seen Dr. Langdon?
624
00:31:01,485 --> 00:31:02,569
No. Why?
625
00:31:04,321 --> 00:31:06,238
Okay, okay. How's Becca?
626
00:31:06,239 --> 00:31:07,782
- Oh, she's fine.
- Yeah?
627
00:31:07,783 --> 00:31:09,158
Okay, I should go see her, then.
628
00:31:09,159 --> 00:31:11,495
How was your deposition?
I'm sure it was stressful.
629
00:31:15,165 --> 00:31:17,458
What's going on with Becca?
What's her diagnosis?
630
00:31:17,459 --> 00:31:18,585
I can't tell you.
631
00:31:19,294 --> 00:31:20,628
Why?
632
00:31:20,629 --> 00:31:22,171
- HIPAA.
- Seriously?
633
00:31:22,172 --> 00:31:23,798
If you want to know what's going on
with Becca,
634
00:31:23,799 --> 00:31:25,383
you're gonna have to ask her yourself.
635
00:31:25,384 --> 00:31:27,218
Hey, you survived your deposition.
636
00:31:27,219 --> 00:31:29,387
Welcome back
to the seventh circle of hell.
637
00:31:29,388 --> 00:31:30,471
What's this?
638
00:31:30,472 --> 00:31:32,973
You're welcome for covering your patients.
They're yours again.
639
00:31:32,974 --> 00:31:35,519
Might want to check
on the pancreatitis in North 3 first.
640
00:31:36,395 --> 00:31:37,520
Okay.
641
00:31:37,521 --> 00:31:40,189
Langdon, I got some intel on Louie.
642
00:31:40,190 --> 00:31:41,774
They move him out of the viewing room?
643
00:31:41,775 --> 00:31:44,402
No, but county's promised
they're on the way to come get him.
644
00:31:44,403 --> 00:31:47,405
- Can I get the county coroner's number?
- What for?
645
00:31:47,406 --> 00:31:49,365
I just want to make sure
if no family shows up,
646
00:31:49,366 --> 00:31:51,617
- Louie gets a proper burial.
- That's expensive.
647
00:31:51,618 --> 00:31:53,829
You may want to run it
by the missus first.
648
00:31:54,413 --> 00:31:57,206
Maybe I'll start a GoFundMe.
I bet people around here would pitch in.
649
00:31:57,207 --> 00:32:00,292
Hey, kid, you can't do this
for every unhoused guy
650
00:32:00,293 --> 00:32:02,169
that dies around here.
651
00:32:02,170 --> 00:32:03,796
There but for the grace of God.
652
00:32:03,797 --> 00:32:08,008
No, the success of your sobriety
is a testament to your support system.
653
00:32:08,009 --> 00:32:09,844
Louie didn't have that.
654
00:32:09,845 --> 00:32:11,971
Still, Louie was a good man.
655
00:32:11,972 --> 00:32:14,223
He deserves to be put
to rest with dignity.
656
00:32:14,224 --> 00:32:16,560
Okay. I'll dig it up.
657
00:32:19,312 --> 00:32:20,647
You heard all that?
658
00:32:22,190 --> 00:32:25,526
Robby, your VIP's here.
Got him in Central 11.
659
00:32:25,527 --> 00:32:26,862
Finally.
660
00:32:30,240 --> 00:32:31,574
About fucking time.
661
00:32:31,575 --> 00:32:35,035
If I knew you were gonna make me wear
a dress, I wouldn't have come at all.
662
00:32:35,036 --> 00:32:38,372
- Dennis Whitaker, meet my buddy Duke.
- Nice to meet you.
663
00:32:38,373 --> 00:32:40,583
Any friend of Dr. Robby's
is a friend of mine.
664
00:32:40,584 --> 00:32:44,253
"Friend" is a vast overstatement.
He's more just a pain in my ass.
665
00:32:44,254 --> 00:32:46,380
Don't let his surly exterior fool you.
666
00:32:46,381 --> 00:32:48,966
Deep down inside, he's just as grumpy.
667
00:32:48,967 --> 00:32:51,470
- How did you two meet?
- Tinder.
668
00:32:52,679 --> 00:32:55,055
Duke is a motorcycle engineer.
669
00:32:55,056 --> 00:32:58,476
You should've seen his Bonneville when
he first brought it in six months ago.
670
00:32:58,477 --> 00:33:00,269
Someone left it for dead.
671
00:33:00,270 --> 00:33:03,272
He helped me bring it back to life.
Today we're going to return the favor.
672
00:33:03,273 --> 00:33:05,483
Dr. Whitaker's one
of our most trusted physicians,
673
00:33:05,484 --> 00:33:07,611
and today he's going to help me
oversee your care.
674
00:33:08,278 --> 00:33:10,154
What seems to be troubling you?
675
00:33:10,155 --> 00:33:12,281
Ask him. He's the one who made me come in.
676
00:33:12,282 --> 00:33:15,034
He's had some hoarseness
on and off for a couple months.
677
00:33:15,035 --> 00:33:17,704
Okay, any history of tobacco
or alcohol use?
678
00:33:18,914 --> 00:33:20,664
Two of my oldest and closest friends.
679
00:33:20,665 --> 00:33:23,709
Former two-pack-a-day smoker
and lover of the drink.
680
00:33:23,710 --> 00:33:25,711
Okay. He on any medication?
681
00:33:25,712 --> 00:33:27,505
Blood-pressure meds.
682
00:33:27,506 --> 00:33:29,215
Which he forgets to take.
683
00:33:29,216 --> 00:33:30,925
He's all numbed up and ready to go.
684
00:33:30,926 --> 00:33:32,761
Okay. Thank you, Donnie.
685
00:33:33,720 --> 00:33:38,724
My man, I am gonna take this scope,
and I'm gonna stick it in your nose,
686
00:33:38,725 --> 00:33:41,519
and we're going to check out
your upper airway.
687
00:33:41,520 --> 00:33:43,938
That seems like a lot of fuss
for a sore throat.
688
00:33:43,939 --> 00:33:45,314
Dr. Whitaker, you want to explain to Duke
689
00:33:45,315 --> 00:33:48,150
why this procedure
is absolutely necessary?
690
00:33:48,151 --> 00:33:50,903
The scope is gonna give us
a better view of your voice box
691
00:33:50,904 --> 00:33:52,531
and your vocal cords.
692
00:33:53,114 --> 00:33:54,407
Here we go.
693
00:33:59,329 --> 00:34:01,705
Gonna feel a little pressure
between your eyes.
694
00:34:01,706 --> 00:34:03,207
I am sorry about that.
695
00:34:03,208 --> 00:34:05,459
Okay, just breathe through your nose.
696
00:34:05,460 --> 00:34:08,128
This is gonna help us see
if there are any abnormalities
697
00:34:08,129 --> 00:34:11,132
like inflammation, tumors, nodules.
698
00:34:11,758 --> 00:34:13,551
That all looks pretty normal.
699
00:34:13,552 --> 00:34:16,012
I don't see too much drainage.
Stick your tongue out for me, all the way.
700
00:34:16,930 --> 00:34:18,765
All the way out. Good. Now say...
701
00:34:20,559 --> 00:34:22,143
Good. Now again, say...
702
00:34:23,645 --> 00:34:25,355
Good. Removing the scope.
703
00:34:26,898 --> 00:34:29,024
Dr. Whitaker, what do you think?
704
00:34:29,025 --> 00:34:31,986
- Looks normal, no abnormalities.
- Told you it was nothing.
705
00:34:31,987 --> 00:34:35,573
With your history of smoking,
I'd like to do a chest X-ray.
706
00:34:35,574 --> 00:34:37,366
If there are growths,
707
00:34:37,367 --> 00:34:41,036
they can push against the recurrent
laryngeal nerve intermittently.
708
00:34:41,037 --> 00:34:45,791
That can paralyze one of the vocal cords
and cause the hoarseness.
709
00:34:45,792 --> 00:34:49,378
That sounds like a lot of bullshit
doctor speak to charge me more.
710
00:34:49,379 --> 00:34:50,588
You've got Medicare.
711
00:34:50,589 --> 00:34:52,172
And, besides,
I finally got you into my ED.
712
00:34:52,173 --> 00:34:55,801
You're gonna get the golden workup
before I leave town tonight.
713
00:34:55,802 --> 00:34:59,471
Only an idiot would ride all night
after working a 12-hour day.
714
00:34:59,472 --> 00:35:01,515
That does sound pretty dangerous.
715
00:35:01,516 --> 00:35:03,392
You gonna stay put,
or do I have to tie you down?
716
00:35:03,393 --> 00:35:05,853
Fine, so long as you keep
your hands where I can see 'em.
717
00:35:05,854 --> 00:35:07,396
No promises.
718
00:35:07,397 --> 00:35:09,023
Let me know when his chest X-ray is back.
719
00:35:09,024 --> 00:35:10,191
Yeah.
720
00:35:13,612 --> 00:35:14,821
- Hey.
- Hey.
721
00:35:15,822 --> 00:35:17,032
Are we okay?
722
00:35:18,617 --> 00:35:21,827
- Yeah. Why?
- I don't know.
723
00:35:21,828 --> 00:35:25,040
You kind of ripped me a new one
in front of Langdon.
724
00:35:25,832 --> 00:35:28,417
- Whose side are you on?
- This isn't middle school.
725
00:35:28,418 --> 00:35:30,419
Langdon made a mistake and owned up to it.
726
00:35:30,420 --> 00:35:32,213
- Let it go.
- He should...
727
00:35:34,841 --> 00:35:36,884
He should have been fired.
728
00:35:36,885 --> 00:35:39,678
But instead, he waltzes
back in here, no big deal.
729
00:35:39,679 --> 00:35:41,972
Meanwhile, I've been a goddamn pariah
for the last 10 months
730
00:35:41,973 --> 00:35:43,682
for doing the right thing.
731
00:35:43,683 --> 00:35:46,728
Or maybe you're a pariah
because you don't play well with others.
732
00:35:48,229 --> 00:35:50,939
If you've still got beef
with Langdon, go tell him.
733
00:35:50,940 --> 00:35:54,401
He's here to stay, so put on
your big-girl panties and work it out.
734
00:35:54,402 --> 00:35:56,362
- He is no...
- Nope.
735
00:35:56,363 --> 00:35:59,073
You want to have sex
and eat ramen in bed, I'm your girl.
736
00:35:59,074 --> 00:36:02,660
But if you want to talk
about this Langdon shit, again,
737
00:36:02,661 --> 00:36:04,037
call a therapist.
738
00:36:13,505 --> 00:36:15,464
How's it hanging, Dr. J?
739
00:36:15,465 --> 00:36:19,051
- Never call me that again.
- It was a joke.
740
00:36:19,052 --> 00:36:22,680
Relax. He's clueless about your TikToks.
741
00:36:22,681 --> 00:36:24,264
But you're not.
742
00:36:24,265 --> 00:36:26,684
- Props on the side hustle.
- There is no hustle.
743
00:36:26,685 --> 00:36:27,893
They're just some stupid videos.
744
00:36:27,894 --> 00:36:29,895
- Wait, are you an influencer?
- No!
745
00:36:29,896 --> 00:36:31,064
Yep.
746
00:36:32,315 --> 00:36:34,441
Yo, pre-docs, it's not happy hour yet.
747
00:36:34,442 --> 00:36:36,695
There's still a shit ton
of patients to be seen.
748
00:36:41,282 --> 00:36:44,076
Ben, our slash-trake kid
from the water park
749
00:36:44,077 --> 00:36:46,120
had some purposeful movement in pre-op.
750
00:36:46,121 --> 00:36:47,496
That's a good sign.
751
00:36:47,497 --> 00:36:48,707
Take the win.
752
00:36:51,292 --> 00:36:52,460
We need to talk.
753
00:36:54,504 --> 00:36:56,506
- We are talking.
- In private.
754
00:37:05,515 --> 00:37:08,017
What the hell was that
with Samira earlier?
755
00:37:08,727 --> 00:37:11,311
- That was tough love.
- You are her superior.
756
00:37:11,312 --> 00:37:14,773
She was obviously struggling,
and your advice was "go home"?
757
00:37:14,774 --> 00:37:16,275
Essentially, yeah.
758
00:37:16,276 --> 00:37:18,861
This is the ED.
It's not for the faint of heart.
759
00:37:18,862 --> 00:37:20,739
It's not for the unempathetic either.
760
00:37:21,531 --> 00:37:23,949
Samira's not having a panic attack
because of her patient.
761
00:37:23,950 --> 00:37:25,743
She's having one
because of personal baggage.
762
00:37:25,744 --> 00:37:28,328
What she needs to do is pull her head
out of her ass and focus on the work.
763
00:37:28,329 --> 00:37:29,455
What about you?
764
00:37:29,456 --> 00:37:32,208
What do you need to get
some basic human empathy back?
765
00:37:34,753 --> 00:37:35,961
I don't know.
766
00:37:35,962 --> 00:37:38,965
Something that gives me a little hope this
place won't fall to shit when I'm gone.
767
00:37:40,550 --> 00:37:42,802
- Found him!
- Found who?
768
00:37:43,511 --> 00:37:45,971
- The water slide dad's kid.
- How'd you manage that?
769
00:37:45,972 --> 00:37:47,973
I went outside, stalked the dad's IG,
770
00:37:47,974 --> 00:37:49,975
found a pic of his son,
sent it to Pittsburgh PD.
771
00:37:49,976 --> 00:37:51,019
Now they're on their way over.
772
00:37:51,770 --> 00:37:53,980
Well, maybe Gen Z
should be working for the FBI.
773
00:37:58,193 --> 00:37:59,778
- Hi, Becca. Hi.
- Mel!
774
00:38:01,988 --> 00:38:04,782
- You doing all right?
- I'm a little bored.
775
00:38:04,783 --> 00:38:05,784
Yeah?
776
00:38:06,993 --> 00:38:08,994
- How are you feeling?
- A lot better.
777
00:38:08,995 --> 00:38:11,413
Dr. Langdon gave me some medicine and OJ.
778
00:38:11,414 --> 00:38:12,998
He's super nice.
779
00:38:12,999 --> 00:38:14,334
I see why you like him.
780
00:38:15,376 --> 00:38:18,128
Did he tell you what the medicine was for?
781
00:38:18,129 --> 00:38:19,379
Yes.
782
00:38:19,380 --> 00:38:21,006
Did you tell her?
783
00:38:21,007 --> 00:38:22,008
I did not.
784
00:38:22,801 --> 00:38:26,595
I explained to Becca that due
to doctor-patient confidentiality,
785
00:38:26,596 --> 00:38:28,597
everything she told me was private
786
00:38:28,598 --> 00:38:30,390
and that it was her decision
787
00:38:30,391 --> 00:38:33,394
if she wanted to share anything
with you or not.
788
00:38:35,230 --> 00:38:37,440
- Do you want to share?
- Yes.
789
00:38:48,618 --> 00:38:51,120
I have a urinary-tract infection.
790
00:38:54,040 --> 00:38:55,249
Okay.
791
00:38:55,250 --> 00:39:00,045
Yeah, those can happen if you, you know,
hold your pee in for too long
792
00:39:00,046 --> 00:39:02,047
or you accidentally wipe
from back to front...
793
00:39:02,048 --> 00:39:04,258
Mel, I know. I know, Mel. He told me.
794
00:39:04,259 --> 00:39:06,051
Oh, good.
795
00:39:06,052 --> 00:39:09,013
You know, he also told me
it can happen from having sex.
796
00:39:10,640 --> 00:39:12,058
Yeah, it can.
797
00:39:12,851 --> 00:39:15,270
- It's not like you're having sex.
- Yes, I am.
798
00:39:19,357 --> 00:39:20,691
I'm sorr... What?
799
00:39:20,692 --> 00:39:22,777
I'm having sex.
800
00:39:24,654 --> 00:39:26,947
- With who?
- My boyfriend.
801
00:39:26,948 --> 00:39:29,116
- You have a boyfriend?
- Yes.
802
00:39:29,117 --> 00:39:33,954
His name is Adam, and we're having sex,
803
00:39:33,955 --> 00:39:35,290
lots of sex.
804
00:39:37,458 --> 00:39:38,668
Okay.
805
00:39:42,463 --> 00:39:45,091
Mel, are you okay?
806
00:39:49,888 --> 00:39:51,930
- Got a sec?
- Sure.
807
00:39:51,931 --> 00:39:54,392
- How you feeling?
- I'm fine.
808
00:39:55,226 --> 00:39:56,810
- Are you sure?
- Yeah.
809
00:39:56,811 --> 00:39:59,105
Troponin, D-dimer, and TSH all normal.
810
00:39:59,898 --> 00:40:01,315
Listen, I'm sorry about earlier.
811
00:40:01,316 --> 00:40:03,109
- I think I was being...
- A dick?
812
00:40:04,694 --> 00:40:07,697
I was gonna say "unprofessional,"
but probably that, too.
813
00:40:08,615 --> 00:40:09,616
I'm sorry.
814
00:40:10,909 --> 00:40:11,910
Thanks.
815
00:40:12,952 --> 00:40:15,037
But now I kind of need you
to stop feeling sorry for yourself
816
00:40:15,038 --> 00:40:16,705
and focus back on your patients.
817
00:40:16,706 --> 00:40:17,790
Think you can do that?
818
00:40:18,917 --> 00:40:20,501
- Sure.
- Great.
819
00:40:24,088 --> 00:40:28,508
With this extra dose
and increased morphine from the pump,
820
00:40:28,509 --> 00:40:30,135
your pain should subside.
821
00:40:30,136 --> 00:40:31,930
Your breathing will slow down.
822
00:40:32,972 --> 00:40:34,641
You may get very sleepy.
823
00:40:35,934 --> 00:40:38,353
Paul, go be with the boys.
824
00:40:39,729 --> 00:40:42,357
They need you more than I do now.
825
00:40:43,316 --> 00:40:44,525
Later.
826
00:40:45,234 --> 00:40:47,737
Right now I'm exactly
where I'm supposed to be.
827
00:40:56,162 --> 00:40:57,163
Yeah.
828
00:40:58,122 --> 00:40:59,539
Okay.
829
00:40:59,540 --> 00:41:00,750
Here we go.
64179
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