All language subtitles for The.Pitt.S02E11.1080p.WEB.h264-ETHEL-HI

[soft beeping]

[whooshing]

[indistinct chatter]

- What now?

- Now we wait.

- How long before...

- I have no idea.

Could be hours.
[device whirs]

- This doesn't feel right.

- Remember,
Robby talked about--

- It still feels wrong.

- OK. This is Roxie's decision.

Everything else in her life is
out of her control except this.

She wants to go out
on her own terms.

Very few of us get to do that.

- I should pick up
more patients.

- So Adam lives at Middle Hill?

- He lives at Middle Hill.

- And he's three years
older than you?

- He's three years
older than me.

- And he asked you
to be his girlfriend

6 months ago?

- He asked me to be
his girlfriend at game night,

and I said yes.

- Got a patient waiting
for a doctor.

Vertigo in 13.

- OK. I'll be right there.

[door closes]

Did Adam ask you
if you wanted to have sex?

- I--Mel, I don't know
if I can tell you.

- Of course you can tell me.
I'm your sister.

- Well, it's private.

- Look, it's just--it's
really important that I know.

- Why?
- Because.

- Well...[sighs]
I can tell Dr. Langdon

because Dr. Langdon
is my doctor,

but I don't think
I can tell you.

- Becca, just tell me!

- Why are you yelling?
- I'm not yelling.

It's just--look, it's
really important that I know.

- You're definitely yelling.
- Becca--

- Uh, maybe--maybe we should
step outside for a minute.

- Why won't you tell me?

- Dr. King.
- [crying]

- Why don't you get some air?

- [crying]

- Sorry.

Sorry.

[door closes]

- Hey, have you seen any
of the X-ray techs around?

- Nope.

- Got an update for me?

- I'm just checking in.

- What are the chances of me
getting out of here on time,

do you think?
- That's up to you, Cap.

We can handle this.

Question is, will you let us?

How are you two getting along?

- I can play nice
for another two hours.

- [scoffs] OK.

- Kept calling me "Doc."

Didn't know he was the real doc
until a few months in.

He was keeping his
secret life from me.

- Hmm.

Where are we
with his chest X-ray?

- Uh, X-rays are still
six or seven behind.

- When's the last time
you checked?

- Maybe 10 minutes ago,
but I--

- Stay on them.
- Yeah.

- Come on,
give the kid a break.

It says here it takes an hour
to get an X-ray.

- You're the first person

who read this fucking thing
all day.

[shout in distance]

[chuckles]

Don't get me started on those.

- How are you feeling?

- I'm good.

- You know, I take Lexapro.

It helps with panic attacks,
not just depression.

- Promise, I'm fine.

Sorry about that, Mrs. Torres.

- Are you OK?

I thought you were
going to pass out.

- Yep, all good.

Let's just pick up
where we left off.

- Mrs. Torres presents
with one week

of painful, swollen right calf.

No trauma, no fever,

no history
of hypercoagulable state.

However, she did take
a 15-hour bus ride

from Orlando to Pittsburgh
last week.

- Mrs. Torres,
we're concerned about

a possible blood clot
in your leg

that can lead
to serious complications.

We need to do an ultrasound,
but no need to worry.

If it's positive,

we can treat
with a blood thinner.

- Bueno.

If there's something
I've learned,

it's to stop worrying.

Can all your worries add
a single moment to your life?

[bell dings]
- Fresh from the lab.

They said one's critical.
- They're supposed to

call those up.
- I know.

Every time they try,
the red phone's been busy.

- Jesus Christ.

This was resulted
25 minutes ago.

Sodium 112.

Mohan!

Sprinkle some salt on
your patient before he seizes.

- Where are we?

- Kidney stone patient's
not obstructed.

Just waiting on meds.

Ortho is performing
the replantation

on our water slide trauma.

Our perforated diverticulitis
patient, Howard,

made it through surgery.

And I'm calling
the CYF resource navigator

to see if
we're getting anywhere

with emergency foster care
for Baby Jane Doe.

Other than that,
labs and X-rays are way behind,

but our Golden Girls are
getting their steps in.

- Does Robby usually leave
as soon as his shift ends,

or does he like to stick around

for all the handoffs
to night shift?

- Depends,
but he's usually pretty good

about getting out of here.

[bell dings]

- Shortness of breath
in South 16.

He could totally decompensate.

I'm hoping to catch another
intubation before 7:00.

One more gets me to three
in my first week.

Probably a record.

- I'm looking for an easy one.

[sighs] Shift ends in 2 hours.

- You're supposed to pick up
the stable patients in order.

- Do you need a--
a second opinion on that?

- No.

- Dr. McKay.
- Yeah.

- A girl named Kiki came
into reception looking for you.

- Kiki?

- She said
she'll be in the park.

- Yeah, great, thanks.

[indistinct chatter]

- Hey, I think the labs are
back on your PID patient.

- Thanks. [sighs]

- Is everything OK?

- Uh, fantastic.

- Langdon?

- Kind of hoping
I would never see him again.

- Well, you know,
maybe he's changed.

When you got a sec,
there's something--

- Santos!

I need you to pick up
food poisoning in 12.

- Yeah, sure. Why not?

- What?

No snark? No pushback?

What have you done with Santos?

- Only 2 hours to go.

I surrender.

- That's the spirit.

[bell dings]

- How's Becca?

- She's good.

- I'm trying to call
her living community,

but they are not picking up.

- Why you calling 'em?

- Because I don't know anything
about this Adam person.

I mean, they've been dating
for 6 months, and--and--

and I don't know anything.

She never said anything
about wanting a boyfriend

or even liking anyone.

- Yeah, but that doesn't mean
she hasn't thought about it.

- No, I don't--I don't want
to think about my sister

thinking about having sex.

I mean, who's to say he didn't
take advantage of her?

Middle Hill just let it happen.

Why didn't they tell me?

- Well, maybe they
didn't know about it.

- Six months,
they had to have known.

I just--maybe it was a mistake
choosing Middle Hill.

I--I mean, we saw
a lot of good places,

but that--that is where
Becca wanted to go.

I--

- Are you Becca's
legal guardian?

- No, I have durable
power of attorney.

But we did this thing called
supportive decision-making,

where she can...

make her own decisions.

- There you go.
[tires screeching]

- Well, this is different.
- Why?

- Because it is.

I--
[horn honking]

[tires screeching]

- My son, he's--
he's not moving.

- OK.

Come on, buddy.

Come on.

I got a hot
and unresponsive child.

I need a room, Dana.

- Trauma Two.

- We need a core temp ASAP.

Hi, I'm Dr. Al-Hashimi.
Are you Mom?

- Brenda Azurmendi.
- And this is?

- Micah.

- Has Micah been sick
with a fever?

- No. He was fine all day.

I found him in the car.

[beeping]

- Pupils are sluggish,
but reactive.

No reaction to pain.

[chiming]

- Uh, airway is patent
with low tidal volume.

Uh, let's set up
for intubation.

- Heart rate is
22 in 10 seconds.

That's 132.
- Do you know his weight?

- No.
- Joy, the Broselow.

- The what?
- The Broselow tape gives us

all the drug doses
based on length.

- Assisting with ventilation.

Somebody call respiratory.

- You said you just
found him in the car?

- I was working in the garden

while he rode his trike
in the driveway.

One minute he was there,
and then he wasn't.

I--I thought he had gone
into the house,

but I couldn't find him
anywhere.

He must have gotten tired

and--and climbed in
and fallen asleep.

By the time I found him,
I--I couldn't wake him up.

- How long was he in there?

- Uh, m-m-maybe--

maybe 15 minutes or--or 20.

- And the car was
just unlocked?

- It's a safe neighborhood.

- Uh, Joy.

OK, so you're gonna want
to start at the head,

measure the length,
and then read it off.

- Uh, approximate weight
is 25 kilograms.

- 250 bolus of LR.

- I have doses
for rock and ketamine.

- Almost no tone.
I can do this without meds.

Uh, it's easy enough to bag.

Let's wait for RT.

- When the temperature
is this high,

the muscles can lose
their strength,

so we're going to help him
breathe with a tube.

- Uh, rectal temp is 105.5.

- Heatstroke.

- Ice packs
to the groin and axilla.

- See if we have an Arctic Sun
that's not in use.

We need all the ice we can get.

[softly]
And a pediatric body bag.

- Still waiting on
your ketorolac pills.

I will keep following up
with the pharmacy.

- I told my son
I would meet him at the park.

We always watch
the fireworks together.

- Sorry, Mr. Green.

We won't forget about you.

- Mm.

- Heard you had a heart attack.

- I did not have
a heart attack.

- Hey, Samira,
how are you feeling?

- I am totally fine.

- Uh, glad to hear it.

Hey, do you mind
watching my patients

for 5 minutes?

I have to step out for a sec.

- No problem.

- Ogilvie, you, uh,
want to get some air?

Got a good case for you.

- Might an intubation
be required?

- No.

It's an unhoused patient

I've treated
on the street team.

- Thank you so much.

- Hi, Becca.
- Hey.

- I'm sorry I yelled at you.

I was just...

surprised.

- The nurse said I can leave.

- Yeah, um,

can we just finish
our conversation first?

- About what?

- Look, I--I know you don't
have to tell me anything.

I just...

kind of hope you'd want to.

When Adam asked you
to have sex--

- He didn't ask me.

I asked him.

- So he didn't pressure--

- No.

- So you wanted to have sex.

- I wanted to have sex.

Sex is great!

We talked about sex
in my mind and body class.

I told my therapist too.

- Hey, the, uh,
pancreatitis in North 3's

still waiting for you.
- OK.

- Can I go now?
- Uh, just one second.

Uh, I'll be right there.

I'm just gonna
walk my sister out.

Yeah, sorry,
I'm right behind you.

- Curtis Larson, 42.

Called to the golf course
for combative behavior

with his buddies.

No signs of trauma,
just alcohol on the breath.

- Seems to have
calmed down a bit.

- He was fighting us so hard,

had to give
4 milligrams of Versed

to get vitals and a line.

Good BP, pulse ox 99
on two liters.

- Between the booze
and the Versed,

he'll be sleeping it off
for a while.

- Central 14, guys.

[beeping]

- [sighs]

Roxie's gone.

- Is the husband still
in there with her?

- Yeah, Javadi's with him.

She needs a death note.
I can't find McKay.

- OK, I'll be right there.

- OK.

- Have you seen McKay anywhere?

- No.

- Have you ever seen
a xylazine wound?

- No.
- But you know what it is?

- Yes.

- Then you know
its street name is Tranq,

and this shit is nasty

and can lead to skin necrosis.

- I've never understood
drug addiction.

- Well, you need to try.

A little empathy goes
a long way in this job.

- I am empathetic, I ju--

I don't understand how
an intelligent person

allows themselves to--
- Can make mistakes?

Heal themselves?
Take away the pain?

Hide from the abuse?

We're healers, not judges.

- Shouldn't we go
to the crosswalk?

No?

OK, this is what we're doing.

I see organ donation
in my future.

Sorry!
[tires screeching]

[horn honking]

[muffled chatter]

- How's it going, Kiki?

- Who's this?

- Oh, it's, uh, Ogilvie.

He's a student doctor
here to help me.

So what's happening with you?

- My leg's getting
stinky again.

- Yeah?
OK, let's take a look.

- [softly] OK.

- Is that an injection site?

- No.
- No.

Xylazine wounds can
show up anywhere.

You, uh--
you still using Tranq?

- Sometimes.

- Sometimes is not good, Kiki.

You know it's nasty stuff.

- I'm trying to quit.

- How you going about that?

- I go to meetings sometimes.

- Meetings are good.

Uh, not using's even better.

Uh, OK.
What's your plan, Ogilvie?

Ogilvie, you OK?

- Yes.
- Yeah?

- Absolutely.

Uh, my plan is
clean with saline.

Antibiotics?

- Medihoney to break down
the eschar.

And then?

- Um, redress with Xeroform

and an ABD pad
and a Kerlix wrap.

- Yeah, that'll do it.

You need to change this
dressing every day, Kiki, OK?

- I don't think I can do that.

- We'll give you
all the supplies.

You can do it yourself.

You won't even have
to come back here.

- Yeah. OK.

- OK.

OK, pass the saline.

[indistinct chatter]

- Hey, I'm Dr. Whitaker.

This is Dr. Santos.

- Roberto.
Like Roberto Clemente.

- Oh, sorry.
I--I don't know who that is.

- Pirates Hall of Famer
Roberto Clemente.

You--you don't watch baseball?

- Well, I am from Nebraska.

We went to a few
Storm Chasers games as a kid.

That's about it.

No Major League team, you know.

- All right.
What happened to your elbow?

- [chuckles] Oneil Cruz hits
a walk-off tater, right?

And I--I--I catch it, you know,

um, but then somebody
fell on top of me,

and I--I think I heard a pop,

but hard to tell
with all the screaming.

- That sounds pretty dangerous.
- Yeah.

- You're not one of those guys

who steals balls from kids,
are you?

- I didn't steal this.
I wouldn't do that.

I would never do that.
I would never do that.

[scoffs]
- OK.

Can you move your fingers
for me?

- And the thumb?

- Uh...

No.
- OK, you know what?

We can put that
in a belongings bag--

- [laughs] No, thanks.

I, um--I think
I will hold on to this.

- OK. Uh, you know what?

We can put you in a sling,

and then you can
hold on to the ball

while we examine you.

- OK. Yeah, I guess.

[grunts]

- Uh, you're gonna
throw in an IV

and start with 4 of morphine.

- No, no, no, no.
I don't want to be knocked out.

- No, it's a low dose.
You won't be knocked out.

It'll just help with the pain.

Might make you a little drowsy.

- No. I need to stay alert.

- OK.

Uh, we will order you an X-ray.

Just please let us know
if you change your mind.

- OK, yeah.

[beeping]

- Temp is down to 103.5.

- Long way to 98.6.

- 102, we take him
off the ice.

Otherwise, we can overshoot
and cause hypothermia.

I put in orders for CK.

- What does the CK
tell us, Joy?

- Rhabdo from muscle breakdown
can take out the kidneys.

- I'm more concerned
about his brain.

- It's two times a day
for three days,

and, uh, a nurse can
crush it up.

- Dr. Langdon already told me.

OK, bye, Mel.

- I'll see you, uh--
I'll see you at fireworks.

- Oh, I was going
to watch fireworks

with Adam and his parents.

- Where?
- At the park.

They're picking us up.
They go every year.

- But we always watch
the fireworks together.

I have your headphones.

- Adam said that he has extra.

- OK, well, um, do you have
Adam's parents' phone number?

- Why?

- Just in case
I need to reach them.

- I want to go now.

- Well, I guess I could call--
- Bye, Mel!

- So how long have you been
part of the street team?

- Oh, about a year.

- And why do you do it?

- Oh, most of these unhoused
folks feel abandoned.

Sorry.

They, uh, don't trust easily.

Meeting them where they're at
makes a big difference.

I've been trying to get Kiki
to come by for months.

You should, uh, volunteer.

It's great training.

Street team could always
use the help.

- Yeah, uh, maybe.

- Thank you.

Hey, how did the deposition go?

- Um, I'm glad it's over,

but I didn't feel good
about it at all.

You know, I'm still not
supposed to talk about it.

- No, but you can talk
about how you feel.

Who do you have to talk to when
things aren't going so good?

Friends? Family?

- Actually, I don't really
have anyone--

- Hey, McKay,
where have you been?

- Oh, I, uh--I stepped out.

- Did you tell anybody?

- Oh, I was, uh,
treating a young woman

I met on the street team.

- Did she check in
as a patient?

- No, we treated her
in the park.

- "We"?

- I, uh--I took Ogilvie.

- Oh, OK, so you treated her

outside the ED on PTMC's dime

and you brought
a medical student with you,

right when we're in
the middle of crisis mode,

and we need all hands on deck.

- We were gone
for 10 minutes, tops.

- When you're here,
I need you to be here.

And while you stepped out,
Roxie died.

- What?

Oh, man, I'm sorry.

I didn't think she would
be gone that quickly.

- Shit.

- Excuse me.

Um, she took a nasty fall.
Her shoulder.

Screamed in pain
when we put the ties on her.

- Hello, I'm Dr. Robinavitch.

This is Dr. McKay.

- Agents Correa and Russo.

She needs to be looked at
before we process her.

- What's your name, ma'am?

- Pranita.

- We're gonna take care of you,
OK?

- You said she fell?

- We were conducting
a sweep at her restaurant.

Everyone in the kitchen
took off.

She was shoved down
some alley stairs.

- Right.
- Could be a rotator cuff tear

or an AC separation.

- Let's put her in a chair,
find her a room.

- South 19.

- Yeah. Just through here.

- Curtis, dude.

[chuckles] What happened?

- Medics had to sedate him
to transport.

- [sighs]

I didn't realize he was
such an angry drunk.

- So you've seen him
drunk before?

- Sure, yeah,
but never like this.

He tried to pick a fight
with the guys in front of us.

He said they were
going too slow.

That's when
they called the cops.

- Could he have taken drugs?

- If he did, they were not
the performance-enhancing kind.

[chuckles]

He shot a 112.

- We'll order labs,
see what we can figure out.

- Uh, any family
we can contact?

- I have no idea.
We don't talk about that shit.

How long is he gonna be here?

- At least 3 or 4 hours,
till he sobers up.

- Cool.

Is it OK if I just come back
around 9:00?

- Sure.
- Great, thanks.

- I need those removed
so I can check her vital signs.

- [gasps]

- OK, tender over the AC.

- Can you, uh,
lift your right arm up

above your shoulder like this?

- Ah!
- Heart rate's 110.

Pulse ox 98.

- Painful arc test is positive.

- Try the drop arm test.

- I'm gonna lift
your arm up, OK?

And you just lower it
as slowly as you can, OK?

OK.

Positive drop arm test.
- What's that mean?

- That means that
she's gonna require an X-ray.

It's most likely
a rotator cuff tear,

which sometimes can come
with a fracture.

We need an X-ray
to rule it out.

- How long is that gonna take?

- [sighs]
Our computers are down today.

Everything's moving
a little slower than usual,

but we will fast-track her.

- Is there anyone you want us
to call, Pranita?

- No phone calls.

Got a bathroom?

- Right there.

- I do not want these guys here

any longer than
they need to be,

so let's find X-ray
and fast-track this one.

- Her family might be worried.
Maybe I can call them--

- No, no, no.
Just stay with her.

Make sure she has
everything she needs.

We treat her injury,
and that's it.

- OK.

- Jamie Guerrero
to window three, please.

Jamie Guerrero to window three.

[indistinct chatter]

[both speaking Spanish]

- Got a lateral.

Best I could.

- Posterior dislocation,
no fracture.

Thanks.
- Mm-hmm.

- OK, good news, Roberto.

No broken bones, but the elbow
joint is dislocated

and we need to get the ball
back in the socket.

The best way is with
sedation and pain meds.

- No, no, no.
- I know you said no morphine,

but we can put local
anesthetic into the joint

to block the pain.

That way you won't be sedated.

- No, thanks, Doc.
[chuckles]

Just--just give me
a bullet to bite on.

- They raided Joe's
over in Green Tree.

- Oh, man, I love that place.

- Brought in one
of the employees.

- So ICE is here?

People are leaving
the waiting room.

Ten patients already.
What should I do?

- Just tell them the truth
and hope they stay

for the treatment
that they need.

- Martha took off.

I'm gonna call her
when I get a chance.

- Oh, shit.
Yeah, make sure she's OK.

Will you call
the EVS department too

and let 'em know?
- Will do.

- All right,
hold down the fort.

Let us know if you need backup.

- You got it.

- Can't we just tell
the agents to fuck off?

- They are not gonna leave
without their patient.

We just need to treat her.

- Even if she's undocumented?

- All patients, regardless
of immigration status,

have the right to emergency
care under EMTALA.

- Pranita is next in line
for X-ray.

- OK, good. Thank you.

- Propofol is down
to 100 mikes per minute.

- Temp is 101.8.

- Great, let's get him
off the ice.

- OK, hands.

On my count.
One, two, three.

- What's the latest?

- Uh, we got some arm movement.

- That's a good sign.

- And pupils are
minimally reactive.

- Plantars are downgoing.

- All encouraging signs.

Any luck getting a lawyer
for our detainee?

- Uh, no.

- Keep me posted.

- Yeah.

[beeping]

- That's a pretty bracelet.

- [sighs]

My daughter made it for me.

She doesn't know where I am.

I just want her to know
that I'm OK.

- You seriously won't let her
make a phone call?

- Not until she's processed.

- Unbelievable.

- Thanks, and just let me know
when she gets back.

Uh, one other thing.

Uh, do you have a resident
named Adam?

I was wondering if I could get
his parents' phone number.

- Nope!
- I--

- Red phone is
for emergencies only.

- This is kind of an emergency.

Sorry. Bye.

- Hey, Mel, we need an R3

to supervise a reduction
in North 4.

Are you free?
- Uh, I guess.

- Should we move
the deceased woman

in Central 9 to viewing?

- Uh, no, let's leave
the husband in there

for a little while longer.
- We need the room.

- We're not moving her yet!

- OK, sorry.

- [sighs]
I'm gonna do a room check.

- Pedes ICU says
they'll have a bed soon.

- OK.

[indistinct chatter]

- So what do we think?

- About what?

- The mom of our
heatstroke kid.

- Uh, that is not our job.

That is what CYF is for.

- So you think
it was on purpose?

- No, I did not say that.

- I just don't buy it.

She lost her kid at home?

Plus, she just looks guilty.

Has anyone seen her cry?

- People don't always
respond to trauma

the way you expect them to.

Stay focused on the kid.

[rapid beeping]

- BP 78 over 42, sats 87.

- You having some pain
again, Mr. Green?

Mr. Green?
- This one's yours?

- Yeah, a kidney stone.
Possible vasovagal.

- Can't assume that.
We need some help here!

Does he have an IV?

- N-no, he didn't need one.

- Hypotensive and hypoxic.

- Clear a trauma room.

- Yeah.

- Uh, he was just waiting on
his discharge meds.

Pain-free.

- A few more patients
are gone from chairs.

South 15 took off too.

- History of renal colic.

Heme-positive urine.
BP crashing.

- Heme-positive urine doesn't
always mean kidney stone.

Two antecubital lines,
biggest ones we've got,

E-FAST, and let's get two units
of whole blood hung, please.

Good.

Who worked up this patient?
- I did.

Ultrasound showed
dilated ureter a--

and mild left hydronephrosis

consistent with his history
of renal colic.

- What about the aorta?

- I didn't look at the aorta.

- Who did you present to?
- Dr. Mohan.

- You said the rest
of the ultrasound was normal.

- I meant that the other
kidney was normal.

- [sighs]
- [sighs]

8-centimeter triple-A
with massive free fluid.

- Ruptured aortic aneurysm.
He's bleeding out.

- OK, go with the MTP.

- 16-gauge in the left AC.

Two units whole blood
on the infuser.

[rapid beeping]

- Assisting ventilations.

Resps are agonal.

- OK, who wants to intubate?

Javadi?
- Sure.

- OK, call for six more units
of whole blood.

Eusebio, call surgery.

If we stay ahead of him,
we might get him up to the OR.

Here you go.

[rapid beeping]

- We're lightening up
his sedation

to see if he has
any purposeful movement.

If so, that will be
an encouraging sign.

- He'll be back to normal?

- There's no certainty

as to how much recovery
Micah will have.

His response over
the next 24 hours will tell.

There is a chance
of cognitive impairment,

but also a chance
of meaningful recovery.

- Dr. Al-Hashimi,
the patient in 22 needs you.

- I will be right back.

- I'm in. Bag him.

- Nicely done. Good job.

- Unit three is up and running.

- I've got a 16-gauge EJ.

- That one goes
on the rapid infuser.

- Good end tidal waveform.

[rapid beeping]

- Strong radial pulse.
That's a very good sign.

- BP's up. 86 over 52.

- Some progress.

How about 2 grams TXA?
- Yeah.

What else do we give
after four units of blood?

- Um--
- Calcium gluconate

to counteract hypocalcemia

caused by the citrate
anticoagulant.

- Why don't you see
if you can't squeeze a unit

into that peripheral line?

[machinery beeping]

- Should somebody place
a central line?

- Long central line
is slower than

short large-bore peripheral.

- Flow is proportional

to the fourth power
of the radius.

Physics.

- Right.

- OK.

Bite down on this.

- OK.

I'm stabilizing the humerus.
- All right.

After I supinate with traction,

Dr. Whitaker will apply
downward pressure

on the proximal forearm.

- [grunting]
- OK.

This is gonna hurt like hell,
Roberto.

- Mm, mm.

- One, two, three.

- [muffled scream]
[cracking]

[screaming]
- OK.

I'm flexing at the elbow.

- [screaming]

- Systolic's down to 68.

- Units five and six
are up and running.

[rapid beeping]

- I'm here for Garcia.
Vascular can't come down.

- Triple A with
hemorrhagic shock.

- Most of these die
in the field.

- He was stable.

Presented with a history
of renal colic.

- And nobody saw
the triple A on ultrasound?

Was this you?

- No. It was me.

[flatlining]
- Looks like sinus tach.

- Nope, lost the pulse.
It's PEA.

- Bag him.
Ogilvie, start compressions.

- We're having a hard time

staying ahead
of the blood loss.

- Sterile gloves.
Prep for a thoracotomy.

- Dr. Javadi, why don't you
glove up and show Dr. Shamsi

why you belong in the ED?

If we can cross-clamp
the aorta,

we can stop the blood flow
from below the diaphragm.

We can perfuse
the heart and the brain.

- Ten blade.
- Right in there.

[rapid beeping]

- Mayo scissors.

- Rib spreader.

- Satinsky.

- Let me know when you have
enough exposure.

- Right there.

- Do you need me on suction?

- No, there's no blood
in the chest.

It's all in the belly.

Here, keep squeezing.

- Aorta's clamped.

Heart is empty.

- OK, Javadi, get in there.

Internal compressions, go.

Put two more units
on the rapid infuser, please.

- That'll be units
seven and eight.

- All right. Neuro's intact.

So we'll do a posterior splint,

a sling, and an ortho referral.

- You know, I'm actually
kind of impressed

you did that without pain meds.

- [chuckles]
Definitely worth it.

You know, last year I caught
McCutchen's 300th career homer,

but another fan
stole it from me.

I promised myself I would never
let that happen again.

- Whitaker, can you write
the procedure note?

- Yeah, you already filled
in the T-sheet, so--

- Yeah, well, I'm already here.

- Yeah, I kind of had
a handle--

- I just did everything else,

so can you just
fill out the chart?

- You should probably
finish it.

- Well--
- OK, someone do this!

I don't--I don't--
I don't care who.

- Yeah.

[sighs]

[beeping]

- Where's Mrs. Azurmendi?

- She stepped out.

- Stepped out?

- Feels like the heart's
filling back up.

- Let's have a peek.

[steady beeping]

- Looks good. Really good.

- Strong radial pulse.

- Moist lap pads.
Prep for transfer.

- Systolic of 94.
That's the best so far.

- Can I go with you?

He's my patient.

- OK by me.

- Bring two extra units.

- [sighs]

[softly]
ICE is in the building?

- Word travels fast. Yeah.

We have a detainee
with a rotator cuff tear.

- Two of our nurses went home.

They have temporary
protected status,

but they just don't feel safe.

- Um, I'm really sorry,
Dr. Robby.

I should have checked
the aorta.

- It's an easy one to miss.

Got a heartbeat back, though,
so still some hope.

- I'm sorry too.

I--I should have asked Ogilvie

if he'd checked the aorta.

It's--it's my fault.
- It is.

You're the senior resident.

You don't look to others.
Others look to you.

- I know. I'm really sorry.
- This is what happens

when you bring your
personal life into work.

Patient almost died.
- I know.

- You have to think of these
walls like a force field.

You cannot let anything in.

Your mother's not in here.
She is out there.

You keep everything out there.
That is the key.

That is the difference
between the best doctors

and the ones
that don't make it.

- You're right.

Maybe I just don't belong here.

- [sighs]

- Pranita's X-ray results.

No fracture.
- OK.

We'll just have Jesse fit her
for a sling, I guess,

and then we have to
discharge her.

- To the immigration guys?

- I'm afraid so.

OK, time for you to go.

- I was just having a chat
with Ms. Peters here.

- You can see how busy
this department is, right?

You've been nothing
but a distraction

and a disruption
since you've been here.

I'm already short-staffed,
and I just lost five nurses

and half my environmental
services team

because you walked in.

You know patients come in
here for help, right?

Because they're either sick
or they're injured,

and documented or undocumented,

they have a right
to emergency care.

TB, measles, fractures--
none of it's getting treated

'cause everybody's
too scared to come in.

But then they end up
here anyway,

but then it's too fucking late!

So please, for the love of God,
can you just go

wait over there in the room
with your detainee,

so I don't lose any more
patients or staff?

- No problem, Doc.

- Mrs. Azurmendi.

Brenda.

Where are you going?

[horn blares]
Brenda!

- [crying]
- OK, OK.

It's OK.

Let's get you back inside
to your son.

It's OK. It's OK.
It's OK. It's OK.

- Come on. She's cleared to go.

- Wait. Hold on.
She needs a sling.

- This will only take a minute.
- We're leaving.

- [whimpers]
- Hey, man, you're hurting her!

[objects clattering]
[shouting]

- Jesus Christ.
What's going on now?

- [screams]
- Robby!

- Help!
[shouting]

- You can't do this!
What are you doing?

- This is bullshit.
- What the hell is going on?

- Get your hands off me.
- He hurt her,

and Jesse stepped in!

- Robby, I didn't do shit.
- I know.

I know. I'm just gonna--
- [speaking indistinctly]

[indistinct shouting, chatter]

No!
- We gotta go.

- No, don't!
- Come on.

- Don't say anything.
You don't have to say anything.

They can't make you
say anything.

We'll get you an attorney.

I promise we'll get you out.

Call the hospital attorney
again.

- No, no!
- Can't believe this shit!

- Can you at least tell us
where you're taking them?

- No!

- Is there a detention center
near Pittsburgh?

That's gotta be where
they're going, right?

- It could be hours
before he's processed.

- I'll stay on it.

- What can we do?

- Uh--hey, Javadi!

Javadi, please come back.

Everybody, just go
check on your patients.

Assure them.
Tell them what happened.

But please,
everybody get back to work.

- Who's gonna take
Jesse's patients?

- I can do it, D.
- Thanks, Perlah.

[indistinct chatter]

- Hey, you OK?
- Yeah, I'm OK.

Are you OK?
- Yeah.

- The lawyers are tied up
with the cyberattacks upstairs.

They probably won't come down
for a while.

[beeping]

- What's the latest
with the heatstroke kid?

- I sent him up to Pedes ICU.

- [softly] What's going on?

- I found her outside,
wandering into the street.

She almost got hit by a truck.

[sighs]
I think it was intentional.

- Christ almighty.

- I told Nurse Kim not
to let her out of her sight.

We need to call a 302
and observe her.

- Danger to self.

- Is she gonna be able
to see her kid?

- Not if she's on
an involuntary psych hold.

- Well, what happens if
he's ready to be discharged

before she is?

- Does she have a partner
or a relative we can call?

- I can find out.

- Why don't you and I
talk to her together?

- Sure, I just need
to check on a patient,

and I will meet you there.
- OK.

[indistinct chatter]

- Uh, OK.

- Hey, Emma,

have you seen this patient?

- Oh, I--I haven't.

- Oh, she took off
when those ICE guys

arrested your nurse.

- Damn it.

- [whispering]
I tried to get him

to help me in the garden,

but he just wanted
to ride his trike.

So I let him.

Every time I looked over,

he was just riding around.

And then he wasn't.

- Have you ever thought
about hurting yourself?

- CBC and blood alcohol are

back on your golfer,
Curtis Larson.

0.14.
- Copy that.

OK, we'll wait
for the other labs.

He'll need to sleep it off
in the meantime.

- Hey, Gabriel,
can you wait up a sec?

Do you have Duke Ekins'
chest X-ray?

- Yeah.
- How's it look?

- Radiologists still
need to read it.

- Can you pull it up for me?

Shit.

- [sighs]
I gotta call the funeral home,

start making arrangements.

- Or you could slow down,

take some time for yourself.

How you doing?

- Oh, you know, been better.

You spend so much time
with these people,

you become a part
of their family.

It's not like it is here,
where patients come and go.

- Don't stay
for the night shift.

We got reinforcements
coming in.

- I'd rather work.

I don't know if I want
to sit with this at home.

- Try.
For once, just listen to me.

Take the night off.

I'll cover for you until

I can find someone else
to come in.

Go.
- OK.

- OK.

- You think she's gonna be OK?

- I don't know.

I just hope she can
forgive herself.

[bell dings]

I've noticed some tension
between you and Dr. Santos.

You two have history?

- Uh, yeah.

She doesn't like me very much.

Uh...

we worked together one time.

I was a pretty big asshole.

She called me out
on some things that I...

wasn't ready to face,
and I overreacted.

I'm gonna talk to her.

I just haven't found
the right time.

- Good.

Do.

- Thought you might be in here.

What's going on?
- [sighs]

It's just the deposition
and my sister coming in.

It's been a--a day.

- Oh.

Screw the deposition.

Is your sister OK?

- Yeah, it's just a UTI,

so meds will clear it up.

- Well, that's good.

- She has a boyfriend
she didn't tell me about,

and other things
she didn't tell me about.

- Well, maybe
she didn't know how.

- She's having sex.

Great s-sex.

And she lied to me.

I mean, she--she lied
to my face for 6 months.

My sister is a fucking liar.

- Did you just curse?

- It's how I feel.

- Look, kid,

I say this with love.

People got their own reasons
for keeping secrets.

Most of the time, it's got
nothing to do with you.

- I've seen "Elf" 164 times.

Becca loves "Elf,"
so we watch "Elf."

And she's got everything,

and n--and now
she's got a boyfriend,

and they're gonna fall in love
and they're gonna get married,

and I'm gonna be
completely alone.

- Did it feel good
to say that out loud?

- No.

- Mel, you're a good egg,

but this is not about you.

I learned a long time ago

to quit feeling
sorry for myself.

Now come on.

Pity party's over.

- OK, so this is your heart,

and these are your lungs.

- They look OK?
- Yeah.

It's this part right here,

this space right
between your lungs.

It's called the mediastinum,
and it is enlarged.

It is too wide.

- From what?

- Can't really tell
from the plain film.

Could be any number of things.

- Yeah, stop the bullshit.

- It could be
an enlarged thyroid.

It could be
enlarged lymph nodes

from an infection.

It could possibly be a tumor.

- You think I have lung cancer?

- Nope, I don't see that.

But cancer of the lymph nodes
is called lymphoma.

And there are a lot
of diseases of the aorta,

which is this big artery
that comes off the heart,

which can get enlarged

because of weak spot
in the wall.

Kind of like a, uh, bubble in
a tire that can have a blowout.

And the only way to make sure

is to do a CT scan
of your chest.

Today.

- How long does that take?

- A few hours, couple hours.

- You still gonna be here?

- Yeah, I would not feel good
about riding if I rushed this.

- This is important?

- Hey.

I think the, uh, labs are back

on your COPD patient.

Saw 'em in the rack.

- Thanks.

- Uh, look.

I don't know how to say this.

Um...

I know you don't like me,
and--and that's fine.

You don't have to. I just--

I want to say I'm sorry

for being an asshole
on your first day.

That was completely
inappropriate,

and if I could take back
what happened,

I would, but I can't.

- OK.

[bell dings]

OK, I'm sorry, I just--

I don't buy it.

Everyone thinks
you're just an addict

who went to rehab,

and you've convinced
everyone here

that you've changed

and you're owning up
to your mistakes,

and they welcome you back
with open arms

because you're still
the golden boy,

and I think it's bullshit.

- I'm genuinely sorry.

And I can promise you,
I have faced my fair share

of punishment for what I did.

- You fucking stole drugs
from the hospital.

Only three people here
actually know that.

Have you told anyone else
what you did?

Have you?
- Look.

I'm just trying to get through
my first day back.

- You shouldn't even be here!

I should have reported you
to the state medical board.

You should have lost your
license and gone to prison.

- You don't know
what I've been through.

- What you've been through?

- My wife threatened
to divorce me, OK?

I almost lost my kids.

- Yeah, that's what happens
when you fuck up.

- [sighs]

You don't have to accept
my apology.

I just--
I wanted to say it, OK?

- You really want
to atone for your sins?

Tell everyone here
you stole drugs

and got kicked out of the ED
because of it.

Until then, stay out of my way.

[soft beeping]

- [gasps]
- Oh, hi.

- What the fuck?

- I'm just checking
your vital signs.

- [grunts]
- Oh.

- Where am I?

- Oh!
- What did you do to me?

- [whimpers]
- Huh?

- [gasping]
- [grunting]

[dramatic music]

♪ ♪

[soft acoustic music]

♪ ♪

[upbeat music]

♪ ♪