1 00:00:00,000 --> 00:00:04,162 WWW.MY-SUBS.CO 1 00:00:06,707 --> 00:00:10,051 Sync and corrections by btsix www.MY-SUBS.com 2 00:00:12,262 --> 00:00:14,388 I'm in. 3 00:00:14,389 --> 00:00:15,682 Bag him. 4 00:00:18,936 --> 00:00:21,729 Defib pads are in place. 5 00:00:21,730 --> 00:00:23,689 OK, holding compressions. 6 00:00:23,690 --> 00:00:25,733 Good square line on the End-Tidal CO2. 7 00:00:25,734 --> 00:00:28,361 V-fib, charge to 200. 8 00:00:29,696 --> 00:00:31,030 Charged. 9 00:00:31,031 --> 00:00:34,367 Clear. 10 00:00:34,368 --> 00:00:36,662 Stand by with epi. 11 00:00:40,165 --> 00:00:42,084 Suction that tube. 12 00:00:44,002 --> 00:00:45,294 You're not in the esophagus, are you? 13 00:00:45,295 --> 00:00:46,587 Definitely not. 14 00:00:46,588 --> 00:00:48,005 I passed right through the cords. 15 00:00:48,006 --> 00:00:50,758 Good breath sounds. End-Tidal CO2 confirmed. 16 00:00:50,759 --> 00:00:52,093 His lungs are filling up with blood. 17 00:00:52,094 --> 00:00:53,261 I know. 18 00:00:58,892 --> 00:01:00,268 OK, rhythm check. 19 00:01:01,937 --> 00:01:03,437 Asystole. Push the epi. 20 00:01:03,438 --> 00:01:05,148 Fuck. 21 00:01:08,610 --> 00:01:10,444 Patients with lunch trays have been admitted. 22 00:01:10,445 --> 00:01:11,821 They're boarders. 23 00:01:11,822 --> 00:01:13,656 They're waiting for a bed to open upstairs. 24 00:01:13,657 --> 00:01:15,825 - And what about the others? - Non-admitted patients. 25 00:01:15,826 --> 00:01:17,618 They can have sandwiches or juice boxes. 26 00:01:17,619 --> 00:01:19,996 Just make sure they're not NPO. 27 00:01:19,997 --> 00:01:21,289 That's "nil per os." 28 00:01:21,290 --> 00:01:22,498 It's Latin for "nothing by mouth." 29 00:01:22,499 --> 00:01:24,292 NPOs are waiting for surgery. 30 00:01:24,293 --> 00:01:26,127 They'll beg, spit, and curse for food, 31 00:01:26,128 --> 00:01:27,461 but you got to stay strong. 32 00:01:27,462 --> 00:01:28,963 Hey, I've been waiting for an hour. 33 00:01:28,964 --> 00:01:30,798 When am I gonna see a fucking doctor? 34 00:01:30,799 --> 00:01:32,967 Excuse me! 35 00:01:32,968 --> 00:01:35,011 Perhaps you didn't see this, which is strange, 36 00:01:35,012 --> 00:01:36,804 because they're all over the place. 37 00:01:36,805 --> 00:01:39,307 Aggressive behavior toward healthcare workers is a felony. 38 00:01:39,308 --> 00:01:41,142 $2,000 fine, possible jail time. 39 00:01:41,143 --> 00:01:42,476 Got it? 40 00:01:42,477 --> 00:01:45,062 OK. I was just asking. 41 00:01:45,063 --> 00:01:46,731 We're busy today. 42 00:01:46,732 --> 00:01:48,024 It's a holiday weekend. 43 00:01:48,025 --> 00:01:49,317 We see the sickest patients first, 44 00:01:49,318 --> 00:01:51,861 so be happy you're still waiting. 45 00:01:51,862 --> 00:01:55,990 Jag-off. 46 00:01:55,991 --> 00:01:57,617 PTMC charge nurse. 47 00:01:57,618 --> 00:02:00,369 Go ahead, Medic Command. 48 00:02:00,370 --> 00:02:03,122 OK. Got it. 49 00:02:03,123 --> 00:02:04,332 Incoming trauma. 50 00:02:04,333 --> 00:02:06,834 Come on. 51 00:02:06,835 --> 00:02:08,210 Three minutes since the last epi. 52 00:02:08,211 --> 00:02:10,713 Hold compressions. 53 00:02:10,714 --> 00:02:12,048 Asystole. 54 00:02:12,049 --> 00:02:14,342 Resume CPR. Another amp of epi. 55 00:02:14,343 --> 00:02:16,677 Needs more suction. 56 00:02:22,392 --> 00:02:24,518 Pulmonary hemorrhage from liver failure. 57 00:02:24,519 --> 00:02:26,396 Is he going to make it? 58 00:02:31,652 --> 00:02:33,736 Should we give PCC? 59 00:02:33,737 --> 00:02:36,030 Too late for that. 60 00:02:36,031 --> 00:02:37,907 And he's not an ECMO candidate. 61 00:02:37,908 --> 00:02:39,992 Nothing else we can do? 62 00:02:44,873 --> 00:02:47,208 No, I think we're done. 63 00:02:51,755 --> 00:02:54,383 Louie. 64 00:02:58,387 --> 00:03:00,597 12:07. 65 00:03:07,396 --> 00:03:09,897 Should we do a debrief? 66 00:03:09,898 --> 00:03:11,857 We've got another motorcycle injury coming in, 67 00:03:11,858 --> 00:03:13,109 ETA 10 minutes. 68 00:03:13,110 --> 00:03:14,610 Why don't we get Louie cleaned up, 69 00:03:14,611 --> 00:03:16,654 - move him to the viewing room? - Yeah. 70 00:03:16,655 --> 00:03:19,574 Anybody that wants to pay their respects can join us in there. 71 00:03:21,827 --> 00:03:23,578 Thank you, everyone. 72 00:03:30,877 --> 00:03:32,294 I'll clean him up. 73 00:03:32,295 --> 00:03:34,463 Why don't you take five first? 74 00:03:34,464 --> 00:03:37,091 Or ten. Yeah? 75 00:03:37,092 --> 00:03:38,510 Yep. 76 00:03:48,270 --> 00:03:50,479 This is Dr. Jefferson from psychiatry. 77 00:03:50,480 --> 00:03:53,232 Why do I need to see a psychiatrist? 78 00:03:53,233 --> 00:03:55,609 Jada, why do I need to see a psychiatrist? 79 00:03:55,610 --> 00:03:57,278 It's gonna be OK, Jackson. 80 00:03:57,279 --> 00:03:59,780 Dr. Jefferson says he can help. 81 00:03:59,781 --> 00:04:02,575 Do you know how you got here? 82 00:04:02,576 --> 00:04:04,952 The medics brought me. 83 00:04:04,953 --> 00:04:07,788 I don't really remember. I... I was in the library. 84 00:04:07,789 --> 00:04:10,750 What were you doing there? 85 00:04:10,751 --> 00:04:13,627 I was... I was studying. 86 00:04:13,628 --> 00:04:16,297 I was trying to study. 87 00:04:16,298 --> 00:04:18,007 But then they wouldn't stop talking. 88 00:04:18,008 --> 00:04:20,217 Who wouldn't stop talking? 89 00:04:20,218 --> 00:04:21,886 They don't want me to pass the bar. 90 00:04:21,887 --> 00:04:23,471 Who doesn't want you to pass the bar? 91 00:04:23,472 --> 00:04:25,556 - That's what they told me. - Hey, hey. 92 00:04:25,557 --> 00:04:26,807 Hey, look at me. Look at me. 93 00:04:26,808 --> 00:04:28,142 Who doesn't want you to pass the bar? 94 00:04:28,143 --> 00:04:29,935 Let's give them some privacy. 95 00:04:29,936 --> 00:04:33,272 Dr. Jefferson will let us know when he's done. 96 00:04:33,273 --> 00:04:34,648 They don't want me to pass the bar. 97 00:04:34,649 --> 00:04:36,484 I'll be right outside, OK? 98 00:04:36,485 --> 00:04:39,987 I'll be right outside, Jackson. 99 00:04:39,988 --> 00:04:42,948 Why don't they want you to pass the bar, Jackson? 100 00:04:42,949 --> 00:04:44,950 They're afraid of me becoming a lawyer. 101 00:04:44,951 --> 00:04:47,953 They're afraid of you becoming a lawyer? 102 00:04:47,954 --> 00:04:52,166 He must have been studying with his law school friends. 103 00:04:52,167 --> 00:04:53,834 They... they should know what happened. 104 00:04:53,835 --> 00:04:56,504 I'm gonna call them. 105 00:04:56,505 --> 00:04:58,380 If you need anything, let me know. 106 00:04:58,381 --> 00:05:00,842 - OK, thank you. - Mm-hmm. 107 00:05:10,227 --> 00:05:11,520 Louie. 108 00:05:12,979 --> 00:05:16,190 Pulmonary hemorrhage. 109 00:05:16,191 --> 00:05:18,567 That was quick. 110 00:05:18,568 --> 00:05:21,070 I'm gonna go clean him up. 111 00:05:21,071 --> 00:05:22,446 I'll help. 112 00:05:25,700 --> 00:05:26,951 Go, go. 113 00:05:30,622 --> 00:05:33,916 Everything OK, Roxie? 114 00:05:33,917 --> 00:05:35,751 I can't get off the bedpan. 115 00:05:35,752 --> 00:05:37,879 Oh, that's what I'm here for. 116 00:05:43,885 --> 00:05:46,387 Your husband seems like a saint. 117 00:05:46,388 --> 00:05:49,682 How long you been married? 118 00:05:49,683 --> 00:05:52,143 Too long. 119 00:05:53,603 --> 00:05:56,564 Almost 20 years. 120 00:05:56,565 --> 00:05:58,399 - OK, put your arm around me. - Mm-hmm. 121 00:05:58,400 --> 00:06:00,234 And I'll pull the bedpan on three. 122 00:06:00,235 --> 00:06:01,402 OK. 123 00:06:01,403 --> 00:06:04,905 One, two, three. 124 00:06:04,906 --> 00:06:06,574 One more. 125 00:06:06,575 --> 00:06:08,784 - Great. - Mm. 126 00:06:08,785 --> 00:06:12,538 20? Wow. 127 00:06:12,539 --> 00:06:14,540 Yeah. 128 00:06:14,541 --> 00:06:18,587 He's been by my side through all of this. 129 00:06:20,463 --> 00:06:24,466 I've watched the light go out of him. 130 00:06:24,467 --> 00:06:26,927 So have the kids. 131 00:06:26,928 --> 00:06:28,345 That's what happened to my auntie 132 00:06:28,346 --> 00:06:31,682 when my Uncle Gerald got sick. 133 00:06:31,683 --> 00:06:34,268 But your husband does it because he loves you. 134 00:06:34,269 --> 00:06:35,769 Mm. 135 00:06:35,770 --> 00:06:37,980 I don't know how you do it, 136 00:06:37,981 --> 00:06:40,608 care for people day after day. 137 00:06:40,609 --> 00:06:43,068 I'll tell you my secret. 138 00:06:43,069 --> 00:06:45,946 I go home at the end of every shift, 139 00:06:45,947 --> 00:06:48,574 leave this all behind, 140 00:06:48,575 --> 00:06:50,492 and escape to "Love Island." 141 00:06:52,287 --> 00:06:53,829 How's it going in here? 142 00:06:53,830 --> 00:06:55,706 The higher-demand dose of morphine helped a little, 143 00:06:55,707 --> 00:06:57,791 - but she's still in pain. - OK. 144 00:06:57,792 --> 00:07:00,628 I got your order. 0.1 per kilo. 145 00:07:00,629 --> 00:07:02,296 - Thanks. - Mm-hmm. 146 00:07:02,297 --> 00:07:04,840 This is a very low sub-dissociative dose 147 00:07:04,841 --> 00:07:06,050 of ketamine. 148 00:07:06,051 --> 00:07:07,551 You might feel a little weird, 149 00:07:07,552 --> 00:07:10,138 but I think it's gonna help with the pain. 150 00:07:12,641 --> 00:07:14,683 Is my husband still in the cafeteria? 151 00:07:14,684 --> 00:07:16,769 I think so. Want me to get him? 152 00:07:16,770 --> 00:07:19,438 No, no. 153 00:07:19,439 --> 00:07:22,817 It's good for us to have a little time apart. 154 00:07:25,070 --> 00:07:27,405 I'll get you another blanket. 155 00:07:31,493 --> 00:07:33,160 Here. I'm headed that way. 156 00:07:33,161 --> 00:07:35,037 Thank you. 157 00:07:35,038 --> 00:07:36,705 Back here for good? 158 00:07:36,706 --> 00:07:38,499 Officially out of triage. 159 00:07:38,500 --> 00:07:41,669 They need extra hands with all the Westbridge hullabaloo. 160 00:07:41,670 --> 00:07:43,671 How many cups have you had today? 161 00:07:43,672 --> 00:07:45,172 - Don't judge me. - Just asking. 162 00:07:45,173 --> 00:07:46,508 You're judging. 163 00:07:48,385 --> 00:07:49,718 Did you hear about Louie? 164 00:07:49,719 --> 00:07:51,136 No. 165 00:07:51,137 --> 00:07:53,138 Pulmonary hemorrhage. Didn't make it. 166 00:07:53,139 --> 00:07:55,683 - Shit. - Mm. 167 00:07:55,684 --> 00:07:57,351 He's been here a hundred times. 168 00:07:57,352 --> 00:07:58,936 I know. 169 00:07:58,937 --> 00:08:02,189 Debrief in the viewing room later. 170 00:08:02,190 --> 00:08:03,857 On a happier note, Perlah and I are planning 171 00:08:03,858 --> 00:08:05,442 a birthday party for Javadi. 172 00:08:05,443 --> 00:08:07,194 She's turning 21. 173 00:08:07,195 --> 00:08:10,030 You two are thick as thieves. 174 00:08:10,031 --> 00:08:12,533 I don't have much of a social life these days, 175 00:08:12,534 --> 00:08:15,369 but I'll be sure to keep an eye out for the Partiful. 176 00:08:15,370 --> 00:08:18,372 Let's discuss our incarcerated patient Gus. 177 00:08:18,373 --> 00:08:20,165 Prison infirmaries tend to be short-staffed, 178 00:08:20,166 --> 00:08:22,501 so we need to be thorough. 179 00:08:22,502 --> 00:08:25,713 What's in the differential diagnosis for malnutrition? 180 00:08:25,714 --> 00:08:28,882 Inadequate intake, methamphetamine use, 181 00:08:28,883 --> 00:08:31,927 severe alcoholism, ADHD medication. 182 00:08:31,928 --> 00:08:33,554 What else? 183 00:08:33,555 --> 00:08:35,889 Cancer of the oropharynx, esophageal strictures, 184 00:08:35,890 --> 00:08:38,934 prior strokes, malabsorption, inflammatory bowel disease, 185 00:08:38,935 --> 00:08:40,894 none of which were in his medical record. 186 00:08:40,895 --> 00:08:43,313 What about psychosocial causes? 187 00:08:43,314 --> 00:08:45,649 Could be an intentional hunger strike. 188 00:08:45,650 --> 00:08:47,776 Or refusing food to get to the infirmary. 189 00:08:47,777 --> 00:08:49,611 Could also be abuse or neglect. 190 00:08:49,612 --> 00:08:51,905 Let's start with a nutrition history once he's back from CT. 191 00:08:51,906 --> 00:08:53,323 Do you have a second to talk about Westbridge? 192 00:08:53,324 --> 00:08:55,075 Mm-hmm. 193 00:08:55,076 --> 00:08:56,493 Hey, we need to start moving some patients out of here. 194 00:08:56,494 --> 00:08:57,786 These walls are starting to fill up with gurneys. 195 00:08:57,787 --> 00:08:59,246 Santos, Ogilvie, and King 196 00:08:59,247 --> 00:09:00,748 all have patients on the launching pad. 197 00:09:00,749 --> 00:09:02,583 I'll check in with them. 198 00:09:02,584 --> 00:09:04,251 How many patients have we had rerouted from Westbridge? 199 00:09:04,252 --> 00:09:05,586 Ten, and God knows how many more in the waiting room. 200 00:09:05,587 --> 00:09:07,254 Ambulance will be here in a few minutes 201 00:09:07,255 --> 00:09:09,048 with the accident victim; I'll stick him in Trauma Two. 202 00:09:09,049 --> 00:09:11,467 What is the story with your incarcerated patient? 203 00:09:11,468 --> 00:09:13,427 Gus Varney, three rib fractures 204 00:09:13,428 --> 00:09:16,055 with normal O2 sats currently, waiting on CT results. 205 00:09:16,056 --> 00:09:17,097 OK, if he's stable at the two-hour mark, 206 00:09:17,098 --> 00:09:18,557 I'd say he's good to go. 207 00:09:18,558 --> 00:09:19,725 Let's get the ball rolling on discharge. 208 00:09:19,726 --> 00:09:21,143 Let's wait on the CT results. 209 00:09:21,144 --> 00:09:22,603 We can move him out of Trauma One, at least. 210 00:09:22,604 --> 00:09:23,937 Yes, we can. What's open? 211 00:09:23,938 --> 00:09:25,606 13 and 14 will be discharged soon, 212 00:09:25,607 --> 00:09:27,399 15 once we move Louie to the viewing room 213 00:09:27,400 --> 00:09:28,817 and get it cleaned up. 214 00:09:28,818 --> 00:09:30,694 Our paracentesis patient, Mr. Cloverfield? 215 00:09:30,695 --> 00:09:32,279 V-fib arrest. 216 00:09:32,280 --> 00:09:33,489 We'll do a debrief when we know how many patients 217 00:09:33,490 --> 00:09:34,948 we're getting from Westbridge. 218 00:09:34,949 --> 00:09:37,993 So Gus goes to 13, 14, or 15? 219 00:09:37,994 --> 00:09:39,620 I kind of want to keep him in plain sight. 220 00:09:39,621 --> 00:09:41,622 - What about BH-2? - Sold. 221 00:09:41,623 --> 00:09:43,457 Why not give him some privacy? 222 00:09:43,458 --> 00:09:46,627 Everyone can see him in BH-2 like he's a monkey at the zoo. 223 00:09:46,628 --> 00:09:48,545 Because he came in with an orange jumpsuit, 224 00:09:48,546 --> 00:09:50,464 and we need to think about patient and staff safety. 225 00:09:50,465 --> 00:09:52,508 Safety first. BH-2 beats a prison cell. 226 00:09:52,509 --> 00:09:53,967 Not by much. 227 00:09:53,968 --> 00:09:55,636 Did you guys hear about Louie? 228 00:09:55,637 --> 00:09:58,305 - Yeah. - Yeah, chronic alcoholic. 229 00:09:58,306 --> 00:09:59,890 Go figure. 230 00:09:59,891 --> 00:10:02,476 Hey, fent OD in South 20 is ready for discharge, 231 00:10:02,477 --> 00:10:04,478 but could you get Lupe to call him a ride? 232 00:10:04,479 --> 00:10:05,854 I need to check on Louie. 233 00:10:05,855 --> 00:10:08,941 - Uh, actually, Whitaker... - He croaked. 234 00:10:08,942 --> 00:10:10,776 - What? - Five minutes ago. 235 00:10:10,777 --> 00:10:12,237 Robby called it. 236 00:10:22,330 --> 00:10:23,622 I'm sorry, man. 237 00:10:23,623 --> 00:10:26,458 We didn't have time to find you. 238 00:10:26,459 --> 00:10:28,710 What happened? 239 00:10:28,711 --> 00:10:31,338 He was apneic and pulseless. 240 00:10:31,339 --> 00:10:34,007 We started CPR and intubated him. 241 00:10:34,008 --> 00:10:35,676 He had a massive pulmonary hemorrhage. 242 00:10:35,677 --> 00:10:38,512 Robby called it. 243 00:10:39,681 --> 00:10:41,682 Found this with his stuff. 244 00:10:41,683 --> 00:10:44,017 Guess he was married at some point. 245 00:10:44,018 --> 00:10:45,770 Never knew that. 246 00:10:49,023 --> 00:10:51,733 Oh, didn't miss this part of the job. 247 00:10:51,734 --> 00:10:53,735 Yeah. 248 00:10:53,736 --> 00:10:59,199 Perlah, did Louie ever mention anything about a wife and kids? 249 00:10:59,200 --> 00:11:00,868 Not as far as I know. 250 00:11:00,869 --> 00:11:02,911 He only had eyes for Rita Moreno. 251 00:11:02,912 --> 00:11:06,665 Well, this is not Rita Moreno. 252 00:11:06,666 --> 00:11:08,500 No, it's not. 253 00:11:08,501 --> 00:11:12,588 Can we check to see if there's an emergency contact? 254 00:11:12,589 --> 00:11:15,466 Yeah, there's a number listed. 255 00:11:21,931 --> 00:11:26,059 You were his primary. Do you want to... 256 00:11:26,060 --> 00:11:27,729 No. 257 00:11:37,238 --> 00:11:39,740 PTMC charge nurse. 258 00:11:39,741 --> 00:11:43,911 Langdon? Where are you? 259 00:11:43,912 --> 00:11:45,996 Makes sense that we'd be his emergency contact. 260 00:11:45,997 --> 00:11:49,583 Sorry to get your hopes up. 261 00:11:49,584 --> 00:11:51,501 Our social worker's gonna do their thing. 262 00:11:51,502 --> 00:11:55,297 If Louie had any family left, they'll find them. 263 00:11:55,298 --> 00:11:57,257 OK? 264 00:11:58,968 --> 00:12:01,845 Guess it's good it happened here, not out on the street. 265 00:12:01,846 --> 00:12:03,305 You're off the hook with Louie. 266 00:12:03,306 --> 00:12:06,017 I'ma teach Emma here how to clean a dead body. 267 00:12:08,102 --> 00:12:09,937 I'm sorry, but they need me in LandD. 268 00:12:09,938 --> 00:12:11,605 You might want to call for another interpreter. 269 00:12:11,606 --> 00:12:12,981 Busy day. 270 00:12:12,982 --> 00:12:14,441 Shit, that's the girl in 12? 271 00:12:14,442 --> 00:12:16,151 Yeah, she's been waiting for five hours. 272 00:12:16,152 --> 00:12:17,903 Didn't hear her name called the first time. 273 00:12:17,904 --> 00:12:19,446 You check on her? 274 00:12:19,447 --> 00:12:20,781 Need to brush up on my ASL. 275 00:12:20,782 --> 00:12:22,282 You know sign language too? 276 00:12:22,283 --> 00:12:23,992 Princess here knows six languages. 277 00:12:23,993 --> 00:12:26,578 - I know French. - OK, it's not a contest. 278 00:12:26,579 --> 00:12:28,497 Ah! 279 00:12:28,498 --> 00:12:30,123 No shit talking in front of me. 280 00:12:30,124 --> 00:12:32,459 I get enough of that from her and Perlah. 281 00:12:32,460 --> 00:12:35,254 Guess I'll call for backup. 282 00:12:35,255 --> 00:12:37,297 Yo, Donnie, did you discharge your butt abscess? 283 00:12:37,298 --> 00:12:39,675 Not yet! 284 00:12:39,676 --> 00:12:41,176 What the hell? 285 00:12:41,177 --> 00:12:42,469 Your good friends upstairs sent doughnuts. 286 00:12:42,470 --> 00:12:43,887 Special thank-you for working the holiday. 287 00:12:43,888 --> 00:12:45,681 You got to be kidding me. 288 00:12:45,682 --> 00:12:47,516 What were you expecting, tacos and tequila? 289 00:12:47,517 --> 00:12:49,393 Every single one of them can forget about extra shifts. 290 00:12:49,394 --> 00:12:51,561 - Won't hire more nurses. - Won't pay us a decent wage. 291 00:12:51,562 --> 00:12:53,063 Won't hire security that can actually 292 00:12:53,064 --> 00:12:54,147 protect us from patients. 293 00:12:54,148 --> 00:12:55,816 But absolutely, send doughnuts. 294 00:12:55,817 --> 00:12:57,317 Sure you want to go into this line of work? 295 00:12:57,318 --> 00:12:59,152 Want me get you one? 296 00:12:59,153 --> 00:13:00,654 Of course I do, but I'm not taking admin's blood pastries. 297 00:13:00,655 --> 00:13:03,490 Et tu, Donnie? 298 00:13:03,491 --> 00:13:05,492 OK, move it or lose it. 299 00:13:05,493 --> 00:13:07,953 Meet me in South 15 with gowns and gloves. 300 00:13:07,954 --> 00:13:09,663 Looks like happy hour in here. 301 00:13:09,664 --> 00:13:11,373 Don't ask. What's up with Evel Knievel? 302 00:13:11,374 --> 00:13:13,834 Brandon Li, 52, fell off a motorcycle pyramid 303 00:13:13,835 --> 00:13:15,460 at 25 miles per hour. 304 00:13:15,461 --> 00:13:17,379 Motorcycle pyramid? You recruiting? 305 00:13:17,380 --> 00:13:18,797 Got a fellow rider in your midst. 306 00:13:18,798 --> 00:13:20,048 - No kidding. - How high up were you? 307 00:13:20,049 --> 00:13:21,842 On top of a three, two, one. 308 00:13:21,843 --> 00:13:23,802 But the bottom guys are sitting down driving the choppers. 309 00:13:23,803 --> 00:13:25,470 I'm fine. I don't need all this. 310 00:13:25,471 --> 00:13:27,180 - Were you wearing a helmet? - Of course. 311 00:13:27,181 --> 00:13:29,474 Oh, what do you know? They're still in style. 312 00:13:29,475 --> 00:13:32,060 Good vitals, tender right wrist, and big left knee lac. 313 00:13:32,061 --> 00:13:34,396 Hey, Joy, Perlah, Trauma Two. 314 00:13:34,397 --> 00:13:35,856 Who else can I have? 315 00:13:35,857 --> 00:13:37,482 Santos and Whitaker are in with Louie. 316 00:13:37,483 --> 00:13:39,276 Yeah, give me Whitaker. He could use a distraction. 317 00:13:39,277 --> 00:13:41,028 And Santos has been ducking traumas all day. 318 00:13:41,029 --> 00:13:42,446 Well, she's behind in her charting. 319 00:13:42,447 --> 00:13:43,740 Who isn't? 320 00:13:46,868 --> 00:13:50,412 OK, even when it's not your fault, 321 00:13:50,413 --> 00:13:52,039 sometimes it's worse knowing 322 00:13:52,040 --> 00:13:54,207 that there was nothing you could do. 323 00:13:54,208 --> 00:13:56,543 Uh-huh. 324 00:13:56,544 --> 00:13:58,378 Are you... 325 00:13:58,379 --> 00:13:59,796 Robby needs you both in Trauma Two, 326 00:13:59,797 --> 00:14:01,590 and I need you to discharge sweet Patty in 13 327 00:14:01,591 --> 00:14:02,966 as soon as you're done. 328 00:14:02,967 --> 00:14:04,468 Can't catch a break. 329 00:14:04,469 --> 00:14:06,387 I push you 'cause I know you can take it. 330 00:14:18,733 --> 00:14:21,860 You ever clean a dead body? 331 00:14:21,861 --> 00:14:25,572 Probably never seen one either. 332 00:14:25,573 --> 00:14:28,575 No one tells you what it looks, feels, or smells like, 333 00:14:28,576 --> 00:14:32,746 but you get used to it over time. 334 00:14:32,747 --> 00:14:35,916 You pull off the gown. You wipe him down with towels. 335 00:14:35,917 --> 00:14:38,126 Then we'll roll him on his side, 336 00:14:38,127 --> 00:14:41,421 clean his back, stuff the sheet under him, 337 00:14:41,422 --> 00:14:44,007 wipe down the bed, roll him the other way, 338 00:14:44,008 --> 00:14:45,759 pull out the sheet, and repeat. 339 00:14:45,760 --> 00:14:48,428 Just follow my lead. 340 00:14:48,429 --> 00:14:52,391 Usually, you leave the ET tube in for the coroner, 341 00:14:52,392 --> 00:14:56,269 but Louie's a chronic alcoholic with end-stage liver disease. 342 00:14:56,270 --> 00:15:00,148 Not a coroner's case. 343 00:15:00,149 --> 00:15:03,443 - Did he have family? - Everyone has family. 344 00:15:03,444 --> 00:15:06,613 The social worker always tries to find them. 345 00:15:06,614 --> 00:15:08,949 Sometimes the family loved them, 346 00:15:08,950 --> 00:15:10,575 tried to get them to come home. 347 00:15:10,576 --> 00:15:13,286 Other times, the family wants nothing to do with them. 348 00:15:13,287 --> 00:15:17,124 - That's sad. - That's life. 349 00:15:17,125 --> 00:15:18,834 What happens if no one claims his body? 350 00:15:18,835 --> 00:15:20,460 He'll be cremated. 351 00:15:20,461 --> 00:15:22,003 Where would his ashes go? 352 00:15:22,004 --> 00:15:23,463 They'll keep him for a few months. 353 00:15:23,464 --> 00:15:24,840 Then he gets buried in a mass grave 354 00:15:24,841 --> 00:15:28,802 with all the other unclaimed bodies. 355 00:15:28,803 --> 00:15:31,722 OK, now we roll him. 356 00:15:34,767 --> 00:15:36,601 Ready. 357 00:15:36,602 --> 00:15:38,186 Go. 358 00:15:38,187 --> 00:15:39,604 Oh, my God, is he still alive? 359 00:15:39,605 --> 00:15:41,314 No, that happens. 360 00:15:41,315 --> 00:15:44,151 These frequent fliers. 361 00:15:44,152 --> 00:15:47,988 They can be a real pain in the ass, but... 362 00:15:47,989 --> 00:15:51,075 you miss them when they're gone. 363 00:15:57,748 --> 00:15:59,916 I've been at every Millvale Fourth of July parade 364 00:15:59,917 --> 00:16:01,418 since '08. 365 00:16:01,419 --> 00:16:03,837 World record is 40 men on seven motorcycles. 366 00:16:03,838 --> 00:16:05,422 I plan to beat that someday. 367 00:16:05,423 --> 00:16:07,424 Good lung sliding bilaterally. 368 00:16:07,425 --> 00:16:09,009 Pupils equal and reactive. 369 00:16:09,010 --> 00:16:10,844 - What do you ride? - The Bullet. 370 00:16:10,845 --> 00:16:12,721 Oh, Royal Enfield. Ankle breaker. 371 00:16:12,722 --> 00:16:15,056 - Thumper. - BP 138 over 80. 372 00:16:15,057 --> 00:16:17,225 Pulse 94. Pulse ox 98. 373 00:16:17,226 --> 00:16:19,519 All your vitals sound really good, Brandon. 374 00:16:19,520 --> 00:16:21,146 They call it an ankle breaker 'cause 375 00:16:21,147 --> 00:16:22,814 you got to kick over a big, fat single cylinder 376 00:16:22,815 --> 00:16:25,025 to get it started, sometimes five or six kicks. 377 00:16:25,026 --> 00:16:27,235 Yeah, especially on a cold day. 378 00:16:27,236 --> 00:16:29,529 Um, does anyone have any trauma scissors? 379 00:16:29,530 --> 00:16:31,406 - I'll check the knee. - Uh, not yet. 380 00:16:31,407 --> 00:16:33,241 - Why not? - Dr. Santos. 381 00:16:33,242 --> 00:16:35,702 Primary survey means rule out the life threats. 382 00:16:35,703 --> 00:16:37,829 Don't get distracted by lacerations or fractures. 383 00:16:37,830 --> 00:16:39,539 No free fluid in the belly. 384 00:16:39,540 --> 00:16:42,042 Airway, breathing, circulation are fine. 385 00:16:42,043 --> 00:16:44,252 OK, that's ABC. That just leaves two letters. 386 00:16:44,253 --> 00:16:46,463 Tell her about D, Dr. Santos. 387 00:16:46,464 --> 00:16:48,465 Disability. Wiggle your toes, sir. 388 00:16:48,466 --> 00:16:50,717 Any pain in your arms or legs? 389 00:16:50,718 --> 00:16:52,260 Not really. 390 00:16:52,261 --> 00:16:53,553 Does it hurt when I push here? 391 00:16:53,554 --> 00:16:55,472 - No. - OK, no midline tenderness. 392 00:16:55,473 --> 00:16:57,140 Nexus negative. 393 00:16:57,141 --> 00:16:59,309 With no obvious brain injury or spinal cord injury. 394 00:16:59,310 --> 00:17:02,479 That just leaves E. Joy. 395 00:17:02,480 --> 00:17:04,231 Can I buy another vowel? 396 00:17:04,232 --> 00:17:06,441 - Dr. Whitaker. - Exposure. 397 00:17:06,442 --> 00:17:07,943 AKA strip and flip. 398 00:17:07,944 --> 00:17:10,070 Cut off his clothes, and we'll log roll him. 399 00:17:10,071 --> 00:17:12,113 What do we have? 400 00:17:12,114 --> 00:17:14,032 Helmeted motorcycle acrobat. 401 00:17:14,033 --> 00:17:16,618 8-foot fall standing on top of five riders. 402 00:17:16,619 --> 00:17:18,286 Primary survey normal, E-FAST negative. 403 00:17:18,287 --> 00:17:20,205 Another motorcycle accident. 404 00:17:20,206 --> 00:17:22,415 Hello, sir. I'm Dr. Garcia from surgery. 405 00:17:22,416 --> 00:17:23,917 Hello. 406 00:17:23,918 --> 00:17:29,090 OK, we will roll him in three, two, one. 407 00:17:33,094 --> 00:17:35,554 Well, I grew up a block from Carrick, 408 00:17:35,555 --> 00:17:38,431 but my mom was a teacher at Brashear, so I had to go there. 409 00:17:38,432 --> 00:17:40,934 - The Bullets? - That's right. 410 00:17:40,935 --> 00:17:42,310 They were the Bullets when I was there. 411 00:17:42,311 --> 00:17:44,104 They changed to the Bulls when I left. 412 00:17:44,105 --> 00:17:45,605 Oh. 413 00:17:45,606 --> 00:17:50,110 Hey, you think I could get something to eat? 414 00:17:50,111 --> 00:17:52,696 Gus here is wondering if he's clear to eat. 415 00:17:52,697 --> 00:17:54,656 As long as it's a liquid diet. 416 00:17:54,657 --> 00:17:57,534 We have the results of your CT scan. 417 00:17:57,535 --> 00:18:00,453 Your jaw should heal without surgery, which is good news, 418 00:18:00,454 --> 00:18:03,039 but it will be a few weeks. 419 00:18:03,040 --> 00:18:04,541 Before I can eat? 420 00:18:04,542 --> 00:18:06,334 Solid foods, yes. 421 00:18:06,335 --> 00:18:10,130 Or you can have food pureed with liquid in a blender. 422 00:18:10,131 --> 00:18:12,799 I don't have a blender. 423 00:18:12,800 --> 00:18:14,217 Right. 424 00:18:14,218 --> 00:18:16,136 Sorry. 425 00:18:16,137 --> 00:18:19,514 We have a calorie-rich supplement drink called Ensure. 426 00:18:19,515 --> 00:18:22,976 Comes in chocolate, vanilla, or strawberry. 427 00:18:22,977 --> 00:18:24,811 Chocolate, please. 428 00:18:24,812 --> 00:18:26,479 - Good choice. - How many can I have? 429 00:18:26,480 --> 00:18:27,981 Two a day is recommended. 430 00:18:27,982 --> 00:18:30,108 I'll get it for you. 431 00:18:30,109 --> 00:18:33,486 You have an appetite. That's good. 432 00:18:33,487 --> 00:18:35,655 Mr. Varney, your blood tests indicate 433 00:18:35,656 --> 00:18:38,199 low levels of protein and vitamins. 434 00:18:38,200 --> 00:18:42,162 Can we ask you a few questions about your diet? 435 00:18:42,163 --> 00:18:45,498 How many meals or snacks do you have in a 24-hour period? 436 00:18:45,499 --> 00:18:46,833 I don't know. 437 00:18:46,834 --> 00:18:48,835 Don't count. 438 00:18:48,836 --> 00:18:51,421 Pretty sure it's three trays a day. 439 00:18:51,422 --> 00:18:53,089 OK. 440 00:18:53,090 --> 00:18:56,301 How often do you eat cereals, fruits, or vegetables? 441 00:18:56,302 --> 00:18:59,554 Not many fruits and vegetables in prison. 442 00:18:59,555 --> 00:19:01,223 Slow and steady. 443 00:19:03,225 --> 00:19:05,352 What year is your Bonneville? 444 00:19:05,353 --> 00:19:06,686 '69. 445 00:19:06,687 --> 00:19:09,022 Rescued it from a motor graveyard. 446 00:19:09,023 --> 00:19:10,565 Brought it back to life with a buddy of mine, 447 00:19:10,566 --> 00:19:12,359 who's supposed to be coming in today. 448 00:19:12,360 --> 00:19:13,777 How often do you ride? 449 00:19:13,778 --> 00:19:15,612 I ride it in to work every day. 450 00:19:15,613 --> 00:19:16,863 Good for you. 451 00:19:16,864 --> 00:19:18,531 Don't encourage him. 452 00:19:18,532 --> 00:19:20,241 CT's ready for Brandon. 453 00:19:20,242 --> 00:19:24,245 As soon as we take a look at this knee. 454 00:19:24,246 --> 00:19:26,581 - Whoa. - Through the deep fascia. 455 00:19:26,582 --> 00:19:27,874 How's it look? 456 00:19:27,875 --> 00:19:28,875 Definitely gonna need stitches. 457 00:19:28,876 --> 00:19:30,210 - How many? - A lot. 458 00:19:30,211 --> 00:19:31,753 It could be an open joint. 459 00:19:31,754 --> 00:19:33,672 We'll do a saline load after CT. 460 00:19:33,673 --> 00:19:35,215 OK. 461 00:19:35,216 --> 00:19:37,092 Lever sign negative. ACL intact. 462 00:19:37,093 --> 00:19:38,469 OK, ready to roll. 463 00:19:43,516 --> 00:19:45,350 Are you still coming over tonight? 464 00:19:45,351 --> 00:19:47,102 I think Whitaker is gonna be playing 465 00:19:47,103 --> 00:19:49,187 farm boy again this weekend, so he's not gonna be around. 466 00:19:49,188 --> 00:19:50,855 I may need a rain check. 467 00:19:50,856 --> 00:19:52,565 Hey, do you have an update on that nec fasc patient? 468 00:19:52,566 --> 00:19:53,983 Last I heard, Miller was doing 469 00:19:53,984 --> 00:19:56,153 an above-the-knee amputation with ortho. 470 00:19:58,114 --> 00:20:00,573 Langdon's waitress with the cellulitis? 471 00:20:00,574 --> 00:20:01,866 Yeah. 472 00:20:01,867 --> 00:20:04,494 - Man, that took a turn. - Sure did. 473 00:20:04,495 --> 00:20:08,415 Hey, did you hear about Louie? 474 00:20:08,416 --> 00:20:10,917 - Yeah. - You OK? 475 00:20:10,918 --> 00:20:12,419 Um, 476 00:20:12,420 --> 00:20:15,964 one of my uncles drank himself to death. 477 00:20:15,965 --> 00:20:18,842 I barely recognized him at the end. 478 00:20:18,843 --> 00:20:22,137 At least Louie always seemed happy. 479 00:20:22,138 --> 00:20:23,806 I'm here if you want to talk. 480 00:20:29,395 --> 00:20:32,272 Should've known I'd find you in here. 481 00:20:32,273 --> 00:20:36,109 You steal anyone's lunch, it's a $20 fine. 482 00:20:36,110 --> 00:20:37,777 Made a lot of changes while you were gone. 483 00:20:37,778 --> 00:20:39,446 I can see that. 484 00:20:39,447 --> 00:20:40,905 Look, I'll let you hide out a little bit longer, 485 00:20:40,906 --> 00:20:42,574 but then I need you to pick up more patients. 486 00:20:42,575 --> 00:20:44,117 You're not as fast as you used to be. 487 00:20:44,118 --> 00:20:46,286 Damn doughnuts! 488 00:20:46,287 --> 00:20:48,621 Ouch. 489 00:20:48,622 --> 00:20:51,583 First day back, I get kicked in the nuts. 490 00:20:51,584 --> 00:20:53,752 One dead, one septic bounce-back. 491 00:20:53,753 --> 00:20:56,046 Both of those not your fault. 492 00:20:58,632 --> 00:21:00,341 You expecting a party? 493 00:21:00,342 --> 00:21:02,051 No, not really. 494 00:21:02,052 --> 00:21:04,513 Didn't hear from anyone while I was gone. 495 00:21:06,974 --> 00:21:08,767 Sorry. 496 00:21:08,768 --> 00:21:12,437 They ever, uh, arrest that guy who punched you? 497 00:21:12,438 --> 00:21:14,272 Yeah. 498 00:21:14,273 --> 00:21:16,191 Wanted to know if I wanted to press charges, 499 00:21:16,192 --> 00:21:19,527 but didn't want to go through all that. 500 00:21:19,528 --> 00:21:22,155 Thought I was done, really did, but... 501 00:21:22,156 --> 00:21:25,825 I got bored at home, so only lasted a few weeks. 502 00:21:25,826 --> 00:21:27,619 You? 503 00:21:27,620 --> 00:21:30,330 10 months is a long time to be alone with your thoughts. 504 00:21:30,331 --> 00:21:32,874 I almost lost everything. 505 00:21:32,875 --> 00:21:35,043 I know a lot of women who would have taken the kids and left, 506 00:21:35,044 --> 00:21:38,338 - but Abby stayed. - 'Cause she's a good woman. 507 00:21:38,339 --> 00:21:40,173 'Cause you deserve a second chance. 508 00:21:40,174 --> 00:21:41,800 I'm not sure everyone agrees with you. 509 00:21:41,801 --> 00:21:43,218 Give it time. 510 00:21:43,219 --> 00:21:45,346 Look, I... 511 00:21:49,475 --> 00:21:52,018 I, um... 512 00:21:52,019 --> 00:21:55,897 I've been working the 12 steps, trying to make amends. 513 00:21:55,898 --> 00:21:57,690 I was really selfish. 514 00:21:57,691 --> 00:21:59,526 I lied to myself, and I lied to you. 515 00:21:59,527 --> 00:22:00,902 I'm really sorry. 516 00:22:00,903 --> 00:22:02,362 You can check me off your list, kid. 517 00:22:02,363 --> 00:22:04,239 We're good. 518 00:22:04,240 --> 00:22:06,407 - OK. - Yeah. 519 00:22:06,408 --> 00:22:08,076 Got a lovely patient for you in Two. 520 00:22:08,077 --> 00:22:10,037 Let's get you back on the horse. 521 00:22:13,040 --> 00:22:14,541 Really need to talk with Robby. 522 00:22:14,542 --> 00:22:15,959 I don't know if today's the best day for that. 523 00:22:15,960 --> 00:22:17,252 He leaves on vacation tomorrow. 524 00:22:17,253 --> 00:22:18,753 Let him get through the day in peace. 525 00:22:18,754 --> 00:22:20,255 He's supposed to be gone for three months? 526 00:22:20,256 --> 00:22:22,257 So he says. I give him one. 527 00:22:22,258 --> 00:22:23,676 Go get 'em, kid. 528 00:22:25,886 --> 00:22:29,222 Dr. Langdon, this is Rocky. 529 00:22:29,223 --> 00:22:30,598 Great name. 530 00:22:30,599 --> 00:22:34,227 What brings you in, Rocky? 531 00:22:34,228 --> 00:22:35,937 Very sick. 532 00:22:35,938 --> 00:22:38,231 When did it start? 533 00:22:38,232 --> 00:22:39,774 An hour ago. 534 00:22:39,775 --> 00:22:42,402 After he won a hot dog eating contest. 535 00:22:42,403 --> 00:22:44,905 A hot dog eating contest? How many you eat? 536 00:22:47,741 --> 00:22:49,827 351 hot dogs? 537 00:22:53,956 --> 00:22:55,456 36. 538 00:22:55,457 --> 00:22:57,959 Still a lot. 539 00:22:57,960 --> 00:22:59,961 - I pulled eight of Zofran. - Go for it. 540 00:22:59,962 --> 00:23:01,379 All right, this should help. 541 00:23:01,380 --> 00:23:03,089 Stick it under your tongue. Let it dissolve. 542 00:23:03,090 --> 00:23:04,610 OK, are you taking any prescription... 543 00:23:09,638 --> 00:23:12,015 Oh, thank you. 544 00:23:12,016 --> 00:23:14,601 Thanks. 545 00:23:14,602 --> 00:23:16,853 Santos, what's up with your ileus patient? 546 00:23:16,854 --> 00:23:18,855 Admitted to medicine, and before you ask, 547 00:23:18,856 --> 00:23:20,607 13 has been discharged. 548 00:23:20,608 --> 00:23:22,942 Great. 12 needs a doctor. 549 00:23:22,943 --> 00:23:24,777 No, don't make me go back there. 550 00:23:24,778 --> 00:23:27,947 That disimpaction left a smell and stunk up the whole hallway. 551 00:23:27,948 --> 00:23:29,991 So grab some coffee grounds from the lounge. 552 00:23:29,992 --> 00:23:32,619 We need to admit our incarcerated patient, Gus. 553 00:23:32,620 --> 00:23:34,495 What did the CT show? 554 00:23:34,496 --> 00:23:36,956 Moderate pulmonary contusion, three rib fractures, 555 00:23:36,957 --> 00:23:39,751 no intra-abdominal bleeding, and oblique fracture 556 00:23:39,752 --> 00:23:42,420 in the body of the mandible anterior to the angle. 557 00:23:42,421 --> 00:23:44,631 All favorable for healing. What's the treatment plan? 558 00:23:44,632 --> 00:23:46,466 - A pain med... - Security. 559 00:23:46,467 --> 00:23:47,842 People are trying to sleep. 560 00:23:47,843 --> 00:23:51,346 Pain medication, antibiotics, liquid diet, 561 00:23:51,347 --> 00:23:53,306 um, a pulse ox a few times a day, 562 00:23:53,307 --> 00:23:56,142 and then also dressing changes for the laceration. 563 00:23:56,143 --> 00:23:58,645 Which he can get at his correctional facility. 564 00:23:58,646 --> 00:24:00,939 Or he stays here for a few days, 565 00:24:00,940 --> 00:24:03,816 and we get him on the right track to healing. 566 00:24:03,817 --> 00:24:05,902 Why don't you two go check on your patients? 567 00:24:05,903 --> 00:24:08,655 - Got it. - Sure thing. 568 00:24:08,656 --> 00:24:10,490 What am I missing? 569 00:24:10,491 --> 00:24:11,866 He's not getting enough to eat 570 00:24:11,867 --> 00:24:13,368 at his correctional facility. 571 00:24:13,369 --> 00:24:14,953 The portions are tiny. 572 00:24:14,954 --> 00:24:16,913 Too many carbs, not enough fruits or vegetables. 573 00:24:16,914 --> 00:24:20,375 He's lucky he hasn't developed a chronic illness. 574 00:24:20,376 --> 00:24:22,168 We don't have any inpatient beds. 575 00:24:22,169 --> 00:24:23,711 He would board down here for three days. 576 00:24:23,712 --> 00:24:25,254 We're still getting runs from Westbridge, 577 00:24:25,255 --> 00:24:27,590 and we cannot tie up Behavioral for that long. 578 00:24:27,591 --> 00:24:29,425 Dr. Al-Hashimi, Dr. Jefferson wants to talk 579 00:24:29,426 --> 00:24:31,136 to you about our tasered kid. 580 00:24:35,015 --> 00:24:36,516 Why don't I call the prison doctor 581 00:24:36,517 --> 00:24:38,184 and find out what they're working with over there? 582 00:24:38,185 --> 00:24:40,020 - Thank you. - My pleasure. 583 00:24:42,064 --> 00:24:44,482 Dr. Jefferson seems to have a good rapport with Jackson. 584 00:24:44,483 --> 00:24:45,858 That's excellent. 585 00:24:45,859 --> 00:24:47,193 How's the sister doing? 586 00:24:47,194 --> 00:24:48,528 Still pretty upset. 587 00:24:48,529 --> 00:24:50,029 She's never seen him like this. 588 00:24:50,030 --> 00:24:51,698 It's a lot to process. 589 00:24:51,699 --> 00:24:53,908 - How's he doing? - He's scared. 590 00:24:53,909 --> 00:24:55,493 Droperidol had a positive effect, 591 00:24:55,494 --> 00:24:57,870 but he doesn't understand what's going on. 592 00:24:57,871 --> 00:24:59,872 He's been experiencing auditory hallucinations 593 00:24:59,873 --> 00:25:01,499 and paranoid delusions. 594 00:25:01,500 --> 00:25:04,711 Voices are telling him he isn't safe. 595 00:25:04,712 --> 00:25:05,962 This has been going on for months. 596 00:25:05,963 --> 00:25:07,588 - Months? - Yeah. 597 00:25:07,589 --> 00:25:09,215 Turns out, his sister hasn't seen him in a while. 598 00:25:09,216 --> 00:25:11,217 Family history of mental illness? 599 00:25:11,218 --> 00:25:13,428 Not that we know of. 600 00:25:13,429 --> 00:25:17,265 I'm gonna give him a break and then continue the conversation. 601 00:25:17,266 --> 00:25:18,641 Parents are on their way. 602 00:25:18,642 --> 00:25:19,642 We'll let you know when they get here. 603 00:25:19,643 --> 00:25:21,102 Yes. Do. 604 00:25:21,103 --> 00:25:22,937 OK, hospital bed, wheelchair, 605 00:25:22,938 --> 00:25:25,940 and shower chair have all been ordered. 606 00:25:25,941 --> 00:25:27,650 What do you say, kid? 607 00:25:27,651 --> 00:25:29,611 Ready to go home? 608 00:25:31,905 --> 00:25:34,782 How's your pain, Mrs. Hamler? 609 00:25:34,783 --> 00:25:36,284 The same. 610 00:25:36,285 --> 00:25:38,619 We're gonna write you a script for Keppra. 611 00:25:38,620 --> 00:25:39,954 You'll take that to prevent seizures 612 00:25:39,955 --> 00:25:41,789 once a day, starting tomorrow. 613 00:25:41,790 --> 00:25:43,750 Between your broken leg and the bruises from your seizure, 614 00:25:43,751 --> 00:25:45,793 the pain will probably get a little worse. 615 00:25:45,794 --> 00:25:47,086 Yeah, the most important thing is 616 00:25:47,087 --> 00:25:48,254 to let others help you. 617 00:25:48,255 --> 00:25:49,881 You'll need assistance showering 618 00:25:49,882 --> 00:25:51,382 and getting to the bathroom. 619 00:25:51,383 --> 00:25:53,259 Yeah, no problem. I won't leave her side. 620 00:25:53,260 --> 00:25:55,636 Paul, you need a break. 621 00:25:55,637 --> 00:26:00,099 You're... you're taking care of me, the kids, the house. 622 00:26:00,100 --> 00:26:03,394 It's too much for one person. 623 00:26:03,395 --> 00:26:05,646 I'm not the one battling cancer. 624 00:26:05,647 --> 00:26:06,939 Paul. 625 00:26:06,940 --> 00:26:10,443 Hey, you're in pain every day, 626 00:26:10,444 --> 00:26:12,111 fighting for your life. 627 00:26:12,112 --> 00:26:14,781 I'm happy to do this for you. 628 00:26:14,782 --> 00:26:17,325 You're my wife. 629 00:26:17,326 --> 00:26:20,453 Now, let's go home and forget this day ever happened. 630 00:26:20,454 --> 00:26:21,954 I'll call the transpo ambulance. 631 00:26:21,955 --> 00:26:23,248 Thanks, Princess. 632 00:26:29,797 --> 00:26:31,339 Hey. 633 00:26:31,340 --> 00:26:32,799 Hmm? 634 00:26:32,800 --> 00:26:34,967 Why don't you go ahead? 635 00:26:34,968 --> 00:26:36,052 - What? - Yeah. 636 00:26:36,053 --> 00:26:37,345 You can get the house ready. 637 00:26:37,346 --> 00:26:39,514 I'll be right behind you. 638 00:26:39,515 --> 00:26:41,182 - No. - Mm-hmm. 639 00:26:41,183 --> 00:26:45,311 No, I'm... I'm riding in the back with you. 640 00:26:45,312 --> 00:26:48,232 You know what? I'll stay with her. 641 00:26:49,775 --> 00:26:51,526 Are you sure? 642 00:26:51,527 --> 00:26:53,820 - Mm-hmm. - Yeah. 643 00:26:53,821 --> 00:26:56,989 OK. 644 00:26:56,990 --> 00:26:59,992 Um, call me if you need me to come back. 645 00:26:59,993 --> 00:27:01,828 Mm-hmm. 646 00:27:07,000 --> 00:27:08,459 When will the ambulance get here? 647 00:27:08,460 --> 00:27:09,502 It shouldn't be long. 648 00:27:09,503 --> 00:27:11,587 Mr. Francis, short of breath? 649 00:27:11,588 --> 00:27:13,047 Yeah, I was worried the clot in my leg 650 00:27:13,048 --> 00:27:15,091 could have gone up to my lungs, so... 651 00:27:15,092 --> 00:27:16,926 You're on Eliquis. That shouldn't happen. 652 00:27:16,927 --> 00:27:18,761 - Yeah, I know, but... - Hey, Donnie, I got this. 653 00:27:18,762 --> 00:27:20,263 Don't worry, Mr. Francis. 654 00:27:20,264 --> 00:27:21,931 I'll order the D-dimer. I'll be back to see you. 655 00:27:21,932 --> 00:27:24,517 Thank you, Dr. Mohan. 656 00:27:24,518 --> 00:27:26,519 You know I'm an NP now. 657 00:27:26,520 --> 00:27:28,020 I can pick up a patient with dyspnea. 658 00:27:28,021 --> 00:27:29,522 I'm sorry. 659 00:27:29,523 --> 00:27:31,941 I've seen him before, and he's asked for me. 660 00:27:31,942 --> 00:27:34,068 Why even order the test? He's on Eliquis. 661 00:27:34,069 --> 00:27:35,403 Mr. Francis comes in every month 662 00:27:35,404 --> 00:27:37,405 and always asks for a D-dimer. 663 00:27:37,406 --> 00:27:39,866 Just... he's worried, and it puts his mind at ease. 664 00:27:39,867 --> 00:27:42,535 - Why not? - Yeah, OK. 665 00:27:42,536 --> 00:27:45,371 Donnie's the best. You'll learn a lot from him. 666 00:27:45,372 --> 00:27:47,374 That's right. 667 00:28:13,984 --> 00:28:16,110 All right, fill me in. 668 00:28:16,111 --> 00:28:18,821 This is Harlow Graham. She was seen in triage. 669 00:28:18,822 --> 00:28:21,240 CBC and CMP came back normal. 670 00:28:21,241 --> 00:28:23,743 IT was supposed to bring the VRI down, but they're slammed. 671 00:28:23,744 --> 00:28:25,411 I know a bit of sign language. 672 00:28:25,412 --> 00:28:30,917 Harlow, this is Dr. Santos. 673 00:28:30,918 --> 00:28:32,628 Hi, Harlow. How are you feeling? 674 00:28:35,464 --> 00:28:36,797 She has a headache. 675 00:28:36,798 --> 00:28:38,634 OK. What else? 676 00:28:44,097 --> 00:28:45,765 What is she saying? 677 00:28:45,766 --> 00:28:47,892 I think she had a stomachache, 678 00:28:47,893 --> 00:28:50,687 and she might have passed out. 679 00:28:53,774 --> 00:28:55,566 I'm not 100% sure. 680 00:28:55,567 --> 00:28:58,110 OK, we're just gonna need to wait for an interpreter, 681 00:28:58,111 --> 00:28:59,779 'cause I need to ask a million questions, 682 00:28:59,780 --> 00:29:01,447 and I can't do it this way. 683 00:29:01,448 --> 00:29:03,533 So just call me when IT comes down. 684 00:29:14,836 --> 00:29:17,797 CT head, neck, chest, abdomen, pelvis all negative. 685 00:29:17,798 --> 00:29:20,841 It means we can get this collar off. 686 00:29:20,842 --> 00:29:22,969 Thank you. 687 00:29:22,970 --> 00:29:24,387 Roll to your side. 688 00:29:24,388 --> 00:29:26,639 We'll get you off this board. 689 00:29:26,640 --> 00:29:28,224 How long is your trip? 690 00:29:28,225 --> 00:29:31,143 2,000 miles, all the way from here to Alberta. 691 00:29:31,144 --> 00:29:32,812 Couple stops along the way. 692 00:29:32,813 --> 00:29:34,313 Got the whole thing mapped out. 693 00:29:34,314 --> 00:29:36,524 - Sounds like heaven. - Let's sit you up. 694 00:29:36,525 --> 00:29:38,234 Sorry, I got stuck with a patient. 695 00:29:38,235 --> 00:29:40,319 You know the old saying, four wheels move the body, 696 00:29:40,320 --> 00:29:41,904 two wheels move the soul. 697 00:29:41,905 --> 00:29:43,406 You're gonna be living the dream. 698 00:29:43,407 --> 00:29:44,824 Thank you, Brandon. 699 00:29:44,825 --> 00:29:46,367 Not everybody down here feels that way. 700 00:29:46,368 --> 00:29:48,661 - OK, Whitaker, what's next? - Ortho assessment. 701 00:29:48,662 --> 00:29:51,872 Palpate all long bones, starting with the clavicle. 702 00:29:51,873 --> 00:29:53,165 Got it. 703 00:29:53,166 --> 00:29:55,711 I'll take the lower extremities. 704 00:30:00,299 --> 00:30:01,507 Distal radius tender. No deformities. 705 00:30:01,508 --> 00:30:02,717 Needs an X-ray. 706 00:30:02,718 --> 00:30:04,135 No bony tenderness down here. 707 00:30:04,136 --> 00:30:05,511 No laxity of the knee. 708 00:30:05,512 --> 00:30:08,222 Are you concerned about that knee lac? 709 00:30:08,223 --> 00:30:10,391 If it's an open joint, he'll need a washout in the OR. 710 00:30:10,392 --> 00:30:12,351 We could try a fluorescein injection. 711 00:30:12,352 --> 00:30:13,853 OK, we'll need a... 712 00:30:13,854 --> 00:30:15,521 Wood's lamp, 1% lido with epi, 713 00:30:15,522 --> 00:30:17,940 sterile saline, sterile basin, sterile fluoro-strip, 714 00:30:17,941 --> 00:30:22,069 18- and 27-gauge needles, 5- and 60-cc syringes. 715 00:30:22,070 --> 00:30:24,530 How does she know all that? 716 00:30:24,531 --> 00:30:27,283 She just does. 717 00:30:27,284 --> 00:30:28,701 How are you feeling, Rocky? 718 00:30:28,702 --> 00:30:30,453 Oh, much better. 719 00:30:30,454 --> 00:30:32,204 He's had eight migs of ondansetron. 720 00:30:32,205 --> 00:30:33,706 Any pain in the belly? 721 00:30:33,707 --> 00:30:35,958 No, but my mouth is really dry. 722 00:30:35,959 --> 00:30:39,086 No doubt from consuming mass quantities of salty hot dogs. 723 00:30:39,087 --> 00:30:40,963 Could I have another sip of water? 724 00:30:40,964 --> 00:30:42,548 Sure. A little sip. 725 00:30:42,549 --> 00:30:44,592 Take it slow. 726 00:30:44,593 --> 00:30:46,093 - Here you go. - Thank you. 727 00:30:46,094 --> 00:30:49,847 Just enough to wet your whistle. 728 00:30:49,848 --> 00:30:52,600 So how'd you get your start as a competitive eater? 729 00:31:01,401 --> 00:31:03,861 Any pain here, Mr. Li? 730 00:31:03,862 --> 00:31:05,529 - Can't feel a thing. - Great. 731 00:31:05,530 --> 00:31:06,864 Where is Santos? 732 00:31:06,865 --> 00:31:09,533 Probably catching up on her charting. 733 00:31:09,534 --> 00:31:10,910 - Right. - Lights out. 734 00:31:10,911 --> 00:31:12,788 Wood's lamp on. 735 00:31:14,623 --> 00:31:16,458 OK. 736 00:31:18,085 --> 00:31:19,960 I might want to use some of that on Halloween. 737 00:31:19,961 --> 00:31:22,797 That is 250 ccs of sterile saline 738 00:31:22,798 --> 00:31:25,591 with one small touch of a sterile fluoro-strip. 739 00:31:25,592 --> 00:31:27,343 OK. 740 00:31:27,344 --> 00:31:30,137 We're going to inject this fluid into your knee, Brandon, 741 00:31:30,138 --> 00:31:33,766 and if there's anything glowing in your wound, 742 00:31:33,767 --> 00:31:35,768 we know we have a leak. 743 00:31:35,769 --> 00:31:38,270 - Feeling some pressure. - Yeah, it's normal. 744 00:31:38,271 --> 00:31:41,148 As soon as I finish the test, I'll pull off the fluid. 745 00:31:43,443 --> 00:31:45,027 That looks good. 746 00:31:45,028 --> 00:31:47,113 Laceration did not enter into the joint space. 747 00:31:47,114 --> 00:31:48,614 Surgery not needed. 748 00:31:48,615 --> 00:31:50,282 Excellent. I can get back to the parade. 749 00:31:50,283 --> 00:31:51,742 No, we'll still need to 750 00:31:51,743 --> 00:31:53,119 stitch you up and splint your wrist. 751 00:31:53,120 --> 00:31:54,453 Hanging a gram of Ancef. 752 00:31:54,454 --> 00:31:56,288 Wait, he has a penicillin allergy. 753 00:31:56,289 --> 00:31:58,916 No, PEN-FAST was negative. We're OK. 754 00:31:58,917 --> 00:32:01,669 My mom said I got a rash with amoxicillin when I was two. 755 00:32:01,670 --> 00:32:03,629 Yeah, probably not a true allergy. 756 00:32:03,630 --> 00:32:05,172 Go ahead and give it, Kim. 757 00:32:05,173 --> 00:32:07,174 But have epi and Benadryl standing by, right? 758 00:32:07,175 --> 00:32:09,176 Yes, to be on the safe side. 759 00:32:09,177 --> 00:32:11,470 Most people who think they have a penicillin allergy 760 00:32:11,471 --> 00:32:13,431 actually don't. 761 00:32:13,432 --> 00:32:15,975 Always listen to the nurses. They run the ER. 762 00:32:15,976 --> 00:32:18,019 We just try and stay out of their way. 763 00:32:24,901 --> 00:32:26,986 Now we can really clean him up. 764 00:32:26,987 --> 00:32:28,654 Didn't we already do that? 765 00:32:28,655 --> 00:32:30,823 Dried blood on the face, neck, hands. 766 00:32:30,824 --> 00:32:33,742 If anyone comes, they shouldn't have to see that. 767 00:32:33,743 --> 00:32:35,870 Sometimes the local unhoused folks will pay a visit, 768 00:32:35,871 --> 00:32:37,496 but we always make them presentable 769 00:32:37,497 --> 00:32:39,999 in case anyone comes. 770 00:32:40,000 --> 00:32:43,169 That's the last thing we can do for them. 771 00:32:43,170 --> 00:32:46,839 Didn't get to do that during COVID. 772 00:32:46,840 --> 00:32:49,175 Once he's spotless, we'll tuck him in nice and tight, 773 00:32:49,176 --> 00:32:51,510 but we always leave one arm outside the sheet. 774 00:32:51,511 --> 00:32:53,804 Because? 775 00:32:53,805 --> 00:32:56,390 So loved ones can hold their hand. 776 00:32:56,391 --> 00:32:58,476 - Here you go. - Thanks. 777 00:32:58,477 --> 00:33:00,020 Yeah. 778 00:33:02,063 --> 00:33:04,356 We're ready to discharge our cancer mom, Roxie. 779 00:33:04,357 --> 00:33:05,858 Ambulance is on the way; we just need 780 00:33:05,859 --> 00:33:07,693 - to reconcile her home meds. - Sounds good. 781 00:33:07,694 --> 00:33:09,653 Hey, I thought I saw another charge nurse around here. 782 00:33:09,654 --> 00:33:11,405 Oh, yeah. We travel in packs. 783 00:33:11,406 --> 00:33:12,865 Aren't you sick of this place yet? 784 00:33:12,866 --> 00:33:14,992 Oh, someone is ready for his sabbatical. 785 00:33:14,993 --> 00:33:16,660 Guilty as charged. 786 00:33:16,661 --> 00:33:18,579 Hey, I just got word that the at-home morphine pump 787 00:33:18,580 --> 00:33:19,747 is gonna be delayed. 788 00:33:19,748 --> 00:33:21,415 Hospital pharmacy has to mix it 789 00:33:21,416 --> 00:33:22,958 and then deliver it later today. 790 00:33:22,959 --> 00:33:24,710 Well, should we keep her here until it's ready? 791 00:33:24,711 --> 00:33:26,045 No, you can give her 792 00:33:26,046 --> 00:33:27,713 a 200-milligram tablet of MS Contin. 793 00:33:27,714 --> 00:33:29,882 - 200 milligrams? - Biggest pill they make. 794 00:33:29,883 --> 00:33:33,302 Releases over 12 hours for patients with opiate tolerance. 795 00:33:33,303 --> 00:33:34,887 Got it. 796 00:33:34,888 --> 00:33:36,388 Hey, do you want to stick around a little bit? 797 00:33:36,389 --> 00:33:37,806 Westbridge is closed to internal disaster. 798 00:33:37,807 --> 00:33:39,099 - We're getting all their runs. - Yeah, I heard. 799 00:33:39,100 --> 00:33:40,643 I put 20 bucks on a plumbing issue. 800 00:33:40,644 --> 00:33:42,561 I just watched that poop cruise documentary. 801 00:33:42,562 --> 00:33:44,313 Oh, I cannot stop thinking about it. 802 00:33:44,314 --> 00:33:46,440 That sounds like something I will absolutely never watch. 803 00:33:46,441 --> 00:33:48,025 Dr. Robby, 804 00:33:48,026 --> 00:33:50,611 you gave us a clozapine ileus about an hour ago. 805 00:33:50,612 --> 00:33:52,238 Your resident reported no surgical history, 806 00:33:52,239 --> 00:33:54,532 but the chart says they've had an appendectomy. 807 00:33:54,533 --> 00:33:56,575 We're not admitting the patient without a surgery consult. 808 00:33:56,576 --> 00:33:58,911 - Who called it in? - A Dr. Trinity Santos. 809 00:33:58,912 --> 00:34:02,248 Dr. Santos, you had an ileus patient. 810 00:34:02,249 --> 00:34:04,708 You neglected to mention a history of appendectomy. 811 00:34:04,709 --> 00:34:06,752 There was no history of appendectomy. 812 00:34:06,753 --> 00:34:08,212 It was in your note. 813 00:34:08,213 --> 00:34:10,965 I may have forgotten to proof check it. 814 00:34:10,966 --> 00:34:13,092 I was using the app that Dr. Al-Hashimi suggested 815 00:34:13,093 --> 00:34:14,562 to catch up on my charting. 816 00:34:14,563 --> 00:34:15,761 Wonderful. 817 00:34:15,762 --> 00:34:17,721 - Ah, Dr. Al-Hashimi. - Yes? 818 00:34:17,722 --> 00:34:21,308 Dr. Santos was just using your AI tool for her charting, 819 00:34:21,309 --> 00:34:24,603 and it hallucinated a history of appendicitis. 820 00:34:24,604 --> 00:34:27,898 As I mentioned to Dr. Santos, generative AI is not perfect. 821 00:34:27,899 --> 00:34:30,317 We still need to proofread every chart it creates. 822 00:34:30,318 --> 00:34:32,945 Mm-hmm, the patient also has a history of headache, 823 00:34:32,946 --> 00:34:35,114 followed by Dr. Park from Urology. 824 00:34:35,115 --> 00:34:37,783 That should probably be Neurology. 825 00:34:37,784 --> 00:34:40,035 Unless urologists are now treating migraines. 826 00:34:40,036 --> 00:34:41,453 Another example that should have been caught 827 00:34:41,454 --> 00:34:43,122 by proofreading. 828 00:34:43,123 --> 00:34:45,457 AI's 2% error rate is still better than dictation. 829 00:34:45,458 --> 00:34:46,959 Yeah, I don't really give a shit whether or not 830 00:34:46,960 --> 00:34:48,961 you want to use robots down here. 831 00:34:48,962 --> 00:34:51,463 I need accurate information in the medical record. 832 00:34:51,464 --> 00:34:52,881 - Understood. - OK. 833 00:34:52,882 --> 00:34:55,551 Dr. Santos. 834 00:34:55,552 --> 00:34:57,636 Dr. Santos! 835 00:34:57,637 --> 00:34:59,472 Yup. Won't happen again. 836 00:35:02,142 --> 00:35:03,184 Hoy. 837 00:35:04,853 --> 00:35:06,312 Thanks, Perlah. 838 00:35:06,313 --> 00:35:08,648 Six hours to go. You got this. 839 00:35:10,483 --> 00:35:13,527 When a wound is gaping like this, 840 00:35:13,528 --> 00:35:15,988 you want to use sub-Q to bring the edges together. 841 00:35:15,989 --> 00:35:17,781 A lot of meat to close. 842 00:35:17,782 --> 00:35:21,201 What would happen if we just did a simple wound closure? 843 00:35:21,202 --> 00:35:22,995 You take the stitches out in ten days, 844 00:35:22,996 --> 00:35:24,872 the wound opens, dehisces. 845 00:35:24,873 --> 00:35:26,206 Exactly. 846 00:35:26,207 --> 00:35:28,250 So what suture do we use under the skin? 847 00:35:28,251 --> 00:35:29,835 Vicryl provides support for a month. 848 00:35:29,836 --> 00:35:31,337 It takes two months to dissolve. 849 00:35:31,338 --> 00:35:34,673 Mm-hmm. So 5-0 nylon on the skin. 850 00:35:34,674 --> 00:35:36,759 4-0 vicryl under the skin. 851 00:35:36,760 --> 00:35:38,886 I'd go with a 3-0 vicryl. 852 00:35:38,887 --> 00:35:41,513 - You think? - Most definitely. 853 00:35:41,514 --> 00:35:43,891 Donnie is the master of wound closure. 854 00:35:43,892 --> 00:35:47,269 I do at least ten lacs a day out at triage, so... 855 00:35:47,270 --> 00:35:51,231 Can we see your sub-Q? 856 00:35:51,232 --> 00:35:52,858 Be my guest. 857 00:35:52,859 --> 00:35:54,903 If you insist. 858 00:35:59,366 --> 00:36:01,700 So... 859 00:36:01,701 --> 00:36:05,162 The secret is to be sure your entry point 860 00:36:05,163 --> 00:36:07,915 and exit point on both sides of the wound 861 00:36:07,916 --> 00:36:10,876 matches the depth on the other side. 862 00:36:10,877 --> 00:36:12,128 S... 863 00:36:15,590 --> 00:36:17,383 Start deep. 864 00:36:17,384 --> 00:36:21,345 Come up at the dermis. 865 00:36:21,346 --> 00:36:24,140 Big bites help the tissue close. 866 00:36:26,851 --> 00:36:30,062 It's a mirror image on the other side. 867 00:36:30,063 --> 00:36:32,732 Superficial to deep. 868 00:36:34,567 --> 00:36:37,277 - So you bury the knot. - Bingo. 869 00:36:37,278 --> 00:36:40,114 Avoids bumps on the scar line. 870 00:36:40,115 --> 00:36:43,909 Three ties, not four. 871 00:36:43,910 --> 00:36:46,286 Yeah, that's beautiful. 872 00:36:46,287 --> 00:36:49,456 And then you cut it short. 873 00:36:49,457 --> 00:36:51,083 Not too short. 874 00:36:51,084 --> 00:36:54,753 I like to slide my scissors 875 00:36:54,754 --> 00:36:57,923 down on the knot, 876 00:36:57,924 --> 00:37:03,137 then rotate up 45 degrees before I cut. 877 00:37:03,138 --> 00:37:05,305 Could use two more sub-Qs, 878 00:37:05,306 --> 00:37:08,559 one above, one below. 879 00:37:08,560 --> 00:37:09,686 Have at it. 880 00:37:12,063 --> 00:37:15,108 Interesting ink. Do they mean anything? 881 00:37:17,068 --> 00:37:20,738 This, this is "death and chaos," 882 00:37:20,739 --> 00:37:23,157 and this is "miracles and blessings." 883 00:37:23,158 --> 00:37:26,952 Got this one after the PittFest shooting, 884 00:37:26,953 --> 00:37:31,291 and I got this after my daughter was born. 885 00:37:33,793 --> 00:37:35,127 Put the head of the gurney up 886 00:37:35,128 --> 00:37:37,129 so people can see him, but not so high 887 00:37:37,130 --> 00:37:39,174 that his head flops to the side. 888 00:37:43,386 --> 00:37:44,720 What do you think? 889 00:37:44,721 --> 00:37:47,306 He looks peaceful. 890 00:37:47,307 --> 00:37:49,892 What's the hardest part of this job? 891 00:37:49,893 --> 00:37:51,727 It's pretty thankless, and that can be tough. 892 00:37:51,728 --> 00:37:53,145 You've seen burnout rates. 893 00:37:53,146 --> 00:37:54,980 I'm sure they teach you that in school. 894 00:37:54,981 --> 00:37:58,025 All my closest friends left after COVID. 895 00:37:58,026 --> 00:38:00,068 Some during. 896 00:38:00,069 --> 00:38:01,862 But I don't blame them. 897 00:38:01,863 --> 00:38:04,865 They needed to do what was best for their mental health. 898 00:38:04,866 --> 00:38:07,326 A lot of people broke. 899 00:38:07,327 --> 00:38:09,245 Why do you keep coming back? 900 00:38:11,706 --> 00:38:13,999 Why don't you, um, 901 00:38:14,000 --> 00:38:17,337 just finish up here and then go help Perlah for a bit? 902 00:38:21,508 --> 00:38:23,008 Great. Thank you. 903 00:38:23,009 --> 00:38:24,343 No, that is exactly what I needed to know. 904 00:38:24,344 --> 00:38:25,886 OK. 905 00:38:25,887 --> 00:38:28,514 I just got off the phone with the physician assistant 906 00:38:28,515 --> 00:38:31,016 at the prison; they've got a 16-hour-a-day infirmary 907 00:38:31,017 --> 00:38:33,310 with NP and PA coverage giving everything that we need, 908 00:38:33,311 --> 00:38:35,103 and they've got an RN for overnights. 909 00:38:35,104 --> 00:38:36,730 Even so, he's here because 910 00:38:36,731 --> 00:38:39,358 they're ignoring his basic needs. 911 00:38:39,359 --> 00:38:41,527 He's here because somebody kicked the shit out of him. 912 00:38:41,528 --> 00:38:43,028 I think you're missing the point. 913 00:38:43,029 --> 00:38:44,613 We have more to offer. 914 00:38:44,614 --> 00:38:46,740 Robby, we've got four more coming our way. 915 00:38:46,741 --> 00:38:48,367 OK, got it. 916 00:38:48,368 --> 00:38:49,868 What you're trying to do is very noble. 917 00:38:49,869 --> 00:38:51,245 We don't have the resources to spare. 918 00:38:51,246 --> 00:38:53,539 OK, then why admit the unhoused man, Digby? 919 00:38:53,540 --> 00:38:55,123 Why not send him back to the street 920 00:38:55,124 --> 00:38:56,792 with antibiotics and a roll of gauze? 921 00:38:56,793 --> 00:38:58,418 Because Digby lives on the street, 922 00:38:58,419 --> 00:39:01,046 and your incarcerated patient has a mid-level provider 923 00:39:01,047 --> 00:39:02,589 and a nurse looking after him. 924 00:39:02,590 --> 00:39:04,883 We both know the quality of care is not the same. 925 00:39:04,884 --> 00:39:05,884 Sorry, are you waiting for me? 926 00:39:05,885 --> 00:39:07,219 No. 927 00:39:07,220 --> 00:39:08,887 Dr. Al-Hashimi, for the patient in Seven. 928 00:39:08,888 --> 00:39:10,180 A few days here could make a world of difference 929 00:39:10,181 --> 00:39:11,598 for Gus' health. 930 00:39:11,599 --> 00:39:13,851 We are a safety net, but nets have holes. 931 00:39:13,852 --> 00:39:15,269 We are not admitting him 932 00:39:15,270 --> 00:39:17,104 'cause this is not about social justice. 933 00:39:19,232 --> 00:39:20,774 Everything I've done in my career 934 00:39:20,775 --> 00:39:23,235 is an effort to improve the system. 935 00:39:23,236 --> 00:39:24,945 Just because you know it's broken 936 00:39:24,946 --> 00:39:27,531 doesn't mean you stop trying. 937 00:39:27,532 --> 00:39:28,950 Excuse me. 938 00:39:33,413 --> 00:39:35,539 I talked to Jackson's girlfriend. 939 00:39:35,540 --> 00:39:36,665 OK. 940 00:39:36,666 --> 00:39:38,667 She told me a lot of stuff. 941 00:39:38,668 --> 00:39:41,086 Um, she wants to come see him, 942 00:39:41,087 --> 00:39:43,922 but I just don't think that's a good idea. 943 00:39:43,923 --> 00:39:46,341 And my... my parents are asking a lot of questions. 944 00:39:46,342 --> 00:39:48,260 Can I just take him home? 945 00:39:48,261 --> 00:39:49,803 I'm so sorry. 946 00:39:49,804 --> 00:39:51,972 Your... your brother is on an involuntary psych hold. 947 00:39:51,973 --> 00:39:53,307 He can't leave. 948 00:39:53,308 --> 00:39:54,433 It could take us weeks to figure out 949 00:39:54,434 --> 00:39:55,767 what's wrong with him. 950 00:39:55,768 --> 00:39:57,686 What's wrong with him? 951 00:39:57,687 --> 00:39:59,521 I'm so sorry. I did not mean it like that. 952 00:39:59,522 --> 00:40:00,856 What's... 953 00:40:00,857 --> 00:40:02,190 Why don't we go somewhere quiet, yeah? 954 00:40:02,191 --> 00:40:04,359 What's wrong with him? 955 00:40:04,360 --> 00:40:07,696 - Let's go over here. - What's wrong with him? 956 00:40:07,697 --> 00:40:09,615 What's wrong with him? 957 00:40:11,284 --> 00:40:13,328 What's wrong with him? 958 00:40:23,463 --> 00:40:25,130 How's she doing? 959 00:40:25,131 --> 00:40:27,341 She took three ounces of formula 960 00:40:27,342 --> 00:40:28,800 without vomiting or distress. 961 00:40:28,801 --> 00:40:30,260 Excellent. 962 00:40:30,261 --> 00:40:33,180 Dr. Wolke from Pedes should be down shortly. 963 00:40:33,181 --> 00:40:36,141 Yeah. I think I saw her smile. 964 00:40:36,142 --> 00:40:39,311 A true social smile where the baby is awake, alert, 965 00:40:39,312 --> 00:40:41,104 and responding to facial expressions 966 00:40:41,105 --> 00:40:43,649 usually doesn't happen until six weeks or older. 967 00:40:43,650 --> 00:40:45,359 It was likely a reflex smile that happens 968 00:40:45,360 --> 00:40:48,487 while they're sleeping. 969 00:40:48,488 --> 00:40:52,074 But some parents have reported their babies 970 00:40:52,075 --> 00:40:54,576 smiled socially as early as four weeks, 971 00:40:54,577 --> 00:40:57,537 so who knows? 972 00:40:57,538 --> 00:40:59,164 - Jesse. - Hmm? 973 00:40:59,165 --> 00:41:00,832 North 4 needs a blood draw when you have a sec. 974 00:41:00,833 --> 00:41:01,917 Got it. 975 00:41:01,918 --> 00:41:03,168 How we doing in here? 976 00:41:03,169 --> 00:41:04,336 Almost ready to head out. 977 00:41:04,337 --> 00:41:05,504 Looking good. 978 00:41:05,505 --> 00:41:06,546 Heart rate 91. 979 00:41:06,547 --> 00:41:08,215 BP is 115 over 82. 980 00:41:08,216 --> 00:41:10,175 Oxygen sat's 95%. 981 00:41:10,176 --> 00:41:11,802 Great. 982 00:41:11,803 --> 00:41:13,303 I'm sending him home with some nonstick dressing 983 00:41:13,304 --> 00:41:14,721 in case they don't stock them. 984 00:41:14,722 --> 00:41:16,515 Grab some burn net too. 985 00:41:16,516 --> 00:41:19,142 He's a good guy. He's a local. 986 00:41:19,143 --> 00:41:21,520 Yeah? You're from Pittsburgh? 987 00:41:21,521 --> 00:41:23,146 Yes, ma'am. Born and raised. 988 00:41:23,147 --> 00:41:24,314 Whereabouts? 989 00:41:24,315 --> 00:41:26,566 Bloomfield, Liberty Ave. 990 00:41:26,567 --> 00:41:29,194 Bloomfield? 991 00:41:29,195 --> 00:41:30,862 You know Sonny's Tavern? 992 00:41:30,863 --> 00:41:32,489 Worked there through high school. 993 00:41:32,490 --> 00:41:34,367 - No kidding. - You know Sonny's? 994 00:41:35,868 --> 00:41:39,162 Had my first kiss there. 995 00:41:39,163 --> 00:41:41,581 Hey, Donnie, my buddy Duke hasn't checked in yet? 996 00:41:41,582 --> 00:41:43,291 Nah, I told Lupe to keep an eye out. 997 00:41:43,292 --> 00:41:44,793 - Thank you. - Yep. 998 00:41:44,794 --> 00:41:47,130 Right, left. Right, left. Yeah. That's it. 999 00:41:50,758 --> 00:41:52,217 You back to check our work? 1000 00:41:52,218 --> 00:41:54,386 Nope. I need a silastic loop drain. 1001 00:41:54,387 --> 00:41:56,471 That looks great. 1002 00:41:56,472 --> 00:41:58,265 It's thanks to your fine instruction. 1003 00:41:58,266 --> 00:42:02,269 OK, he's going to need Kerlix and Xeroform. 1004 00:42:02,270 --> 00:42:04,146 You should throw a neoprene sleeve on him. 1005 00:42:04,147 --> 00:42:05,897 Limits the range of motion at the knee 1006 00:42:05,898 --> 00:42:07,733 - so the sutures don't pull out. - That's a good idea. 1007 00:42:07,734 --> 00:42:09,067 Must be fun to work here. 1008 00:42:09,068 --> 00:42:11,820 Oh, sure is. First week for these two. 1009 00:42:11,821 --> 00:42:13,280 How are you guys liking the Pitt? 1010 00:42:13,281 --> 00:42:14,740 I feel like I was born to do this. 1011 00:42:14,741 --> 00:42:17,242 Hard pass. 1012 00:42:17,243 --> 00:42:19,244 I'm shooting for pathology. 1013 00:42:19,245 --> 00:42:20,620 I like medical mysteries, 1014 00:42:20,621 --> 00:42:22,789 but I don't really deal well with people. 1015 00:42:22,790 --> 00:42:24,708 You have an interesting energy. 1016 00:42:24,709 --> 00:42:26,543 What's that for? 1017 00:42:26,544 --> 00:42:28,712 Splint starts at the knuckles, 1018 00:42:28,713 --> 00:42:32,257 comes up and around the elbow, 1019 00:42:32,258 --> 00:42:34,593 and back down to the palm. 1020 00:42:34,594 --> 00:42:37,429 It needs to be smaller. I can't ride with a splint. 1021 00:42:37,430 --> 00:42:38,930 Well, no, you shouldn't be riding at all. 1022 00:42:38,931 --> 00:42:40,891 Right now, that's a non-displaced fracture. 1023 00:42:40,892 --> 00:42:43,935 If you fall on it again, you're gonna need to go to the OR. 1024 00:42:43,936 --> 00:42:47,105 No worries, Doc. I won't fall again. 1025 00:42:47,106 --> 00:42:48,356 Uh-huh. 1026 00:42:50,276 --> 00:42:52,277 Robby, pulse ox just dropped. 1027 00:42:52,278 --> 00:42:53,779 What happened? 1028 00:42:53,780 --> 00:42:55,197 I don't know. I stepped out for a minute. 1029 00:42:55,198 --> 00:42:57,032 It's down to 85%. 1030 00:42:57,033 --> 00:42:58,450 Are you having some trouble breathing? 1031 00:42:58,451 --> 00:42:59,993 A little. 1032 00:42:59,994 --> 00:43:01,661 Start him on 2 liters oxygen, nasal cannula. 1033 00:43:01,662 --> 00:43:03,288 Titrate to 5. 1034 00:43:03,289 --> 00:43:04,873 Keep the pulse ox at 92 or higher 1035 00:43:04,874 --> 00:43:08,293 and have a rebreather standing by just in case. 1036 00:43:08,294 --> 00:43:10,128 He's gonna have to stay. 1037 00:43:10,129 --> 00:43:11,880 For how long? 1038 00:43:11,881 --> 00:43:14,674 Not sure. 1039 00:43:14,675 --> 00:43:16,593 Sorry, boss, I only stepped out for a second. 1040 00:43:16,594 --> 00:43:18,136 Let me know if anything changes. 1041 00:43:18,137 --> 00:43:19,679 You were in the room when his pulse ox dropped? 1042 00:43:19,680 --> 00:43:20,972 - I was. - What were you doing? 1043 00:43:20,973 --> 00:43:22,682 D, still can't get a hold of Ortho. 1044 00:43:22,683 --> 00:43:25,977 Leave them to me. 1045 00:43:25,978 --> 00:43:28,271 - Feeling better? - Oh, so much better. 1046 00:43:28,272 --> 00:43:31,483 Well, I wrote you a script for Zofran, just in case. 1047 00:43:31,484 --> 00:43:33,944 Thanks. I think I cleared it all out. 1048 00:43:33,945 --> 00:43:36,613 - So no more hot dogs, right? - Oh, not today. 1049 00:43:36,614 --> 00:43:38,115 But I'll be back next year. 1050 00:43:38,116 --> 00:43:39,449 - Got to defend my title! - Yo. 1051 00:43:39,450 --> 00:43:40,826 OK, well, best of luck to you. 1052 00:43:40,827 --> 00:43:42,369 They got a Wiener World truck outside. 1053 00:43:42,370 --> 00:43:43,995 You want one? 1054 00:43:43,996 --> 00:43:45,705 I think I'm good on hot dogs for the rest of my life. 1055 00:43:45,706 --> 00:43:47,582 Wait, didn't I just see you eating a doughnut? 1056 00:43:47,583 --> 00:43:49,251 Don't judge. 1057 00:43:49,252 --> 00:43:50,795 Stay here for a sec. 1058 00:43:56,843 --> 00:43:59,219 - Transport ambulance is here. - Thanks, Princess. 1059 00:43:59,220 --> 00:44:01,680 This is a 200-milligram MS Contin. 1060 00:44:01,681 --> 00:44:05,016 This will give you 12 hours of relief. 1061 00:44:05,017 --> 00:44:06,893 - OK. - Mm. 1062 00:44:06,894 --> 00:44:08,312 Yes. 1063 00:44:10,189 --> 00:44:12,023 Whenever you're ready, Rox. 1064 00:44:12,024 --> 00:44:13,900 Hey, guys, this is Roxie Hamler. 1065 00:44:13,901 --> 00:44:15,694 Hello, ma'am. 1066 00:44:15,695 --> 00:44:17,738 - Easy on the transfer, guys. - Yeah. 1067 00:44:24,370 --> 00:44:26,580 OK, on my count. 1068 00:44:26,581 --> 00:44:29,499 No, no, no. This isn't gonna work out. 1069 00:44:29,500 --> 00:44:32,669 I'm sorry. 1070 00:44:32,670 --> 00:44:34,337 I can't... I can't... 1071 00:44:34,338 --> 00:44:37,924 I can't... I can't do this. 1072 00:44:37,925 --> 00:44:41,011 - It's OK. - I want to stay. 1073 00:44:41,012 --> 00:44:44,723 Please. 1074 00:44:44,724 --> 00:44:47,893 It's OK. 1075 00:44:47,894 --> 00:44:49,769 Can I assume that you've already called upstairs 1076 00:44:49,770 --> 00:44:51,646 to get Gus Varney a bed? 1077 00:44:51,647 --> 00:44:53,940 Do you want to tell me what you did? 1078 00:44:53,941 --> 00:44:56,443 I don't know what you're talking about. 1079 00:44:56,444 --> 00:44:59,404 His pulse ox was steady. We were about to discharge him. 1080 00:44:59,405 --> 00:45:01,156 Did Dr. Al-Hashimi put you up to that? 1081 00:45:01,157 --> 00:45:03,491 Al-Hashimi? No. 1082 00:45:03,492 --> 00:45:04,993 You know he's gonna go back to prison 1083 00:45:04,994 --> 00:45:08,788 after they discharge him upstairs. 1084 00:45:08,789 --> 00:45:10,582 I thought you didn't go the extra distance 1085 00:45:10,583 --> 00:45:11,959 for your patients anymore. 1086 00:45:18,591 --> 00:45:21,134 - It's Emma, right? - Yeah. 1087 00:45:21,135 --> 00:45:22,761 How's your first day going? 1088 00:45:22,762 --> 00:45:24,554 Good, I think. 1089 00:45:24,555 --> 00:45:27,933 Haven't killed anyone yet. 1090 00:45:27,934 --> 00:45:31,269 - I'm sorry. I... - It's OK. 1091 00:45:31,270 --> 00:45:34,814 I guess time will tell if I'm cut out for this. 1092 00:45:34,815 --> 00:45:38,568 Well, when in doubt, stick with her, kid. 1093 00:45:38,569 --> 00:45:40,070 She scares me. 1094 00:45:40,071 --> 00:45:42,739 No, that's just a... it's a tough exterior. 1095 00:45:42,740 --> 00:45:46,493 She's warm and gooey on the inside. 1096 00:45:46,494 --> 00:45:49,412 Looks like they're doing the debrief for Louie. 1097 00:45:49,413 --> 00:45:51,414 - You coming? - I paid my respects. 1098 00:45:51,415 --> 00:45:53,626 Besides, who's gonna hold down the fort? 1099 00:46:05,680 --> 00:46:08,181 Remember the day you found him passed out in the park? 1100 00:46:08,182 --> 00:46:09,474 Sure do. 1101 00:46:09,475 --> 00:46:10,976 I had to drag his ass over here. 1102 00:46:10,977 --> 00:46:12,352 Came in soaked to the bone. 1103 00:46:12,353 --> 00:46:14,145 You saved his life. 1104 00:46:14,146 --> 00:46:16,189 How about last summer when we didn't see him for months? 1105 00:46:16,190 --> 00:46:17,649 He said he finally quit drinking, 1106 00:46:17,650 --> 00:46:19,484 - so he didn't need to come in. - Mm-hmm. 1107 00:46:19,485 --> 00:46:21,861 How many times did he say he was gonna quit drinking? 1108 00:46:21,862 --> 00:46:23,989 Mm-hmm. 1109 00:46:23,990 --> 00:46:26,616 He always asked about Harrison. 1110 00:46:26,617 --> 00:46:28,994 - Always said thank you. - Mm-hmm. 1111 00:46:28,995 --> 00:46:32,455 Found this with his stuff. 1112 00:46:32,456 --> 00:46:33,999 Who knew he was married? 1113 00:46:34,000 --> 00:46:36,668 Hmm. 1114 00:46:36,669 --> 00:46:39,212 That's Rhonda, Louie's wife. 1115 00:46:39,213 --> 00:46:41,172 High school sweetheart. 1116 00:46:41,173 --> 00:46:44,301 About five years ago, I was covering a night shift. 1117 00:46:44,302 --> 00:46:47,512 He came in feeling talkative. 1118 00:46:47,513 --> 00:46:49,180 Born and raised in Pittsburgh. 1119 00:46:49,181 --> 00:46:51,516 Lifelong Steelers fan. 1120 00:46:51,517 --> 00:46:53,268 Groundskeeper at Three Rivers Stadium 1121 00:46:53,269 --> 00:46:54,687 until 1998. 1122 00:46:57,440 --> 00:47:00,358 He never really wanted kids, 1123 00:47:00,359 --> 00:47:02,736 but Rhonda wore him down, 1124 00:47:02,737 --> 00:47:04,362 and when she finally got pregnant, 1125 00:47:04,363 --> 00:47:07,115 he changed his tune, he got excited. 1126 00:47:10,453 --> 00:47:12,787 And then about a month before the baby was due, 1127 00:47:12,788 --> 00:47:15,875 Rhonda and the baby were killed in a car crash. 1128 00:47:19,086 --> 00:47:21,589 Louie never really came back from that. 1129 00:47:25,593 --> 00:47:28,053 May his memory be a blessing. 1130 00:47:28,054 --> 00:47:30,389 - Amen. - May his memory be a blessing. 1131 00:47:32,391 --> 00:47:33,725 Yep. 1132 00:47:33,726 --> 00:47:36,728