Original subtitles

Donnie, thank you. I'm sorry. We'll get another nurse to replace Jesse.

Do we even know when these ice assholes took him?

No, but the hospital attorneys are all over it.

I know you got your own baby.

What's going on?

It's the code Hulu Central 14.

Move, move, move, move, move, move, move, move.

What the hell happened?

He attacked Emma, so I gave him a shot to tell him to die.

You all right?

I'm okay.

Let's see.

How did he get a bloody nose?

He slipped.

Did I see?

He had her in the handbook.

Uh, where's Ogilvy?

Upstairs. They let him scrub in on that kidney stone, turn AAA.

Oh, great.

I know one day med students might actually be useful in the ED.

Oh, present company excluded. You're doing great.

Sure. Hey, can I get a selfie with you?

Me? Yeah, you're kind of a legend among med students.

Really? I call you Phantom of the Pit on account of you secretly living in the

hospital for months.

What? It wasn't months.

Still waiting on labs, x -rays, meds.

PTMC, go ahead, medic command.

Where are all the nurses?

There was a code hula hoop in Central 14.

Oh, no. What's that?

Hospital worker assault.

Ooh.

The new nurse, Emma.

Is she okay?

I don't know. I think so.

Smoke him if you got him. This place is going tits up.

Okay. Are we all good in here? Oh, yeah, boss. We got this.

Are you sure you're all right?

I think so. Good. Come on.

So, what exactly happened?

I grabbed him. He threw up against the wall.

I ran in and gave him a shot. Right, and did he slip before or after the shot?

Before.

Yeah, he had me in a headlock. I didn't see what happened.

What did you give him? Four milligrams of Versed. Who wrote the order?

I had it in my pocket. It was on my way to waste. It was sideways.

What?

Okay, so now he's altered from alcohol, Versed, and a head trauma. Now he's

going to need a head CT to rule out intracranial bleeding and a fracture.

Would you rather be Emma with a head injury or worse?

Don't worry about it. We got this. No, there's no we here.

You need to pass this patient off and report him.

Fine. Emma, you're done with this bastard. I'll handle him now. No, this

emergency department, and I'm telling you to pass it off.

These are my nurses, and I choose what cases they work in. If you think for one

minute I'm putting anyone else from my staff at risk with that asshole, you

better give your fucking head a shake.

Come on.

Come on.

MBA coming in? Okay, I'll be right there. Thank you.

Did I kill my son?

No.

He's not dead.

He's recovering in pediatric ICU.

We'll be back to check on you again shortly, Miss Archimandi.

Has her husband arrived yet?

Yeah, but he went straight upstairs.

Really? He may have just wanted to see his child first. Let's not jump to

conclusions.

Dr. Robbie, can I have a word? Shoot.

In private.

I'm going to start to talk.

Thank you.

What is this about?

I'm going to recommend this ED have two attendings on shift at all times moving

forward.

This department is clearly too much for one person to handle. It's not healthy

for you or the patients, and I'm very concerned by what I've witnessed today

with some of the staff.

What is going on with Langdon and Santos? I saw them having it out like it

fight night.

Dr. Langdon hasn't even been here for ten months, and you told me this morning

there was nothing to worry about with Dr. Santos.

There isn't.

Santos and Langdon have beef because she's the one who turned in for taking

meds. I'm sorry, what?

Santos is responsible for revealing Langdon's benzo addiction.

Was he stealing drugs from this ED?

This ED is the best of the best, and I would put it up against any emergency

department in the country. And it is going to be yours to fuck up, so don't

it up.

You're not supposed to smoke out here.

Really?

Seems to be working for me so far.

How old are you, kid?

I'm 21.

On Tuesday.

Jeez, it's some kind of idiot savant.

We no longer use that term.

It's derogatory.

You bruise easy, millennial. Actually, I'm Gen Z.

Even worse.

I was tripping at purgatory to put myself through school when I was your

No, Flake.

Hey, Amy? Yeah, I'm getting off later than I thought.

I'll give you a call when I get a better idea of when... I need help!

I gotta go. I can't breathe!

I got the airway. You take the pulse?

Yeah.

Oh, my God. Trying jaw thrust?

Radio's weak and thready.

What's his name? My dad.

Oliver. Hey, Oliver. Can you open your eyes for me?

Here we go.

Okay. One, two, three.

Drive -in with severe respiratory distress.

Last -sided dialysis, shunt probable, renal failure, and fluid overload.

Respiratory center, BiPAP.

When was his last dialysis? It was supposed to be yesterday morning.

Couldn't mean a nitro drip ASAP.

You got this? Yeah.

Is that the guy who attacked Emma to go to CT?

Yeah. Ms. Emmer here needs an H &P.

Uh, Cassie, can you give Emma here a workup?

Started chart. Victim of assault.

Really? I'm fine.

He was choking you. He had me by the head most. You're a patient now. Full

in South 18. In case you also need to make a statement to the police.

Is that really necessary?

Yeah. Absolutely.

Don't worry.

I'll be there with you. Come on. Let's get you a spot.

Well, your guy just bought my guy for CT. No, he's my guy. He's a new one

because he's been sitting here forever. I'm never going to get out of here.

Tell it to someone who cares. You know what? You should care because...

If you gave that guy a serious injury with force inflicted from a sedative,

are not licensed to prescribe.

No one else uses force to stop an assault. They're a hero, but a nurse

and we're punished.

You just happen to have a violent reset in your pocket?

It was extra from the medics. Good timing, I guess.

When we waste a controlled substance, we need a witness to sign off. I was on my

way to when I spotted that asshole attacking our girl. Anything else, Nancy

Drew?

Where are you going?

Taking a pee. Do I need your permission to do that too now?

Should we intubate?

Best to avoid that if possible.

Pressure support and afterload reduction. Why is this time for

BiPAP starting at 10 over 5. Good heart squeeze, good lung sliding, but there's

a ton of B -lines.

Pulmonary edema.

Which is best treated by what, Dr. Giovanni?

Nitrate. Do it.

BP 198 over 132. Pulse 120.

Pulse arc's only 85.

Good BP. Let's start at 400 mics per minute for 2 to 5 minutes. I've got team

Dr. Giovanni.

Don't you always start low with nitro, then titrate up?

In flash pulmonary edema, we do the opposite.

What he really needs is dialysis to get the fluid off.

What's his dialysis schedule?

Monday, Wednesday, Friday. He missed yesterday because of a wedding.

We tried to go to the center this morning. It's usually open on Saturday,

think they close for the 4th. Where do you live?

Brookville. It's like an hour and a half away. Yes, ma 'am. I tried Pine Ridge

Hospital in Ford City, but I didn't know they shut down.

Yeah, they sure did.

All right, sister.

How can I help uncluster this clusterfuck?

You ready to finish our conversation?

We talked.

Okay, now I gotta need you. Please.

Talk to me.

I'm tired of this shit. Okay.

The second time that everyone was attacked by a patient today.

I took one of my nurses, and these cyberassholes have thrown us back into

Well, I'm worried about you. You are not yourself today.

Makes two of us stand.

Do you have something you want to say?

Go ahead. I can take it.

All right, Danielle.

Sometimes it's like you're just tempted to death because you don't give a shit

anymore. So this is about the motorcycle? Not just about the

about the whole damn thing.

Robbie, you're actually telling people that you're going to a place called

My Head, Ed. Close. Not quite.

Robbie, your buddy Duke is insisting on leaving and that MBA is here.

Okay, I'll be right there. What's open?

South 15.

78 -year -old woman, very low speed auto versus pedestrian with ground level

falls. Bruising on her left hip, no head trauma. Her husband Eddie came along.

Hi, how do you do, sir? I'm Dr. Robbie. Come with us. We're going to get you set

up right over here.

Sorry,

we'll get you something for the pain shortly.

Thank you.

Do you have any medical problems, Frida?

High blood pressure, low thyroid, AFib.

Any chest pain, shortness of breath?

No. Front row seat, sir.

So what happened?

Well, she...

Walked into the car.

You hit me.

No, I didn't hit you. You hit the car.

You backed up right into me.

I wasn't even moving.

Well, you're both in very good hands now.

Yes.

Before we get you in a gown, we'd like to check your hip.

Of course.

I am sorry. We had a whole bunch of craziness come in, and you got bumped

patient or two for CT.

But take comfort in knowing it was for some pretty nasty stuff.

How am I supposed to find comfort in that? Or anything you've told me since I

got here, for that matter. I don't know, but everything is supposed to come with

a lesson, right?

Oh, this is more of your send motorcycle bullshit.

Maybe. No, no, the truth is I'm just stalling because it's going to be a

longer. Okay, look, I appreciate the effort, but you guys are obviously

up, and I'll just come back when it's not our nation's birthday. You're

here. It's not going to be that much longer, I promise.

Just stay and get your CT.

I will do it all when you get back and this place is less crazy. This place is

always crazy. I don't know when I'm going to get back. Can you just sit the

down and wait a little bit longer?

It won't kill you.

But leaving might.

Okay.

No problem.

Thank you.

That's a nasty bruise.

Do you take aspirin or any blood thinners?

Uh, Eloquist from my AFIP.

Any tenderness here?

No, not really.

Here? Oh, yeah. That hurts.

Four of morphine and zofran. What about up here?

Not really.

All right, so let's start with labs and plain film. No, CT abdomen pelvis will

get a better view of the hip and check for bleeding.

The Eloquist is concerning.

Uh, you think she broke her hip?

If it's broken, you broke it.

Usually for a broken hip, the leg is shortened and rotates out.

But we'll just wait for Tiki results.

Mr. Cohen, I know that you were checked on scene, but I was wondering if I could

do a quick examination of you.

Oh, no, I'm fine. I was in the car.

Just unofficially.

Okay. Deep breath for me.

Good.

Again.

Great. Thanks, Eddie.

Next thing, would you mind taking your shoes off?

What for?

Just being safe.

My back's not what it used to be. Let me help you.

I, uh, could use a pedicure.

You and me both.

Dr. King, what do you think about doing a Romberg test?

What is that?

It's a general evaluation of balance.

Um, can you stand up, sir?

Yep.

How are you doing, Oliver?

Traps are not coming up.

Pressure's holding on 409. Sure, let's up the BiPAP to 20 on 10.

We could try phlebotomy, decrease the fluid burden on the lung.

Old school, but right by time.

Hemoglobin's only 9 .2. He's anemic from renal failure.

And he can't afford more blood loss. We need to intubate. We're losing this war.

Intubation's not a trivial matter for immunosuppressed patients.

So we just draw off a bunch of red tops? No, we do the collection on the floors

if he's given blood. We like medieval bloodletting. Essentially. And that is

something you should step out for, Mason. Casey, thank you. Got a good vein

a 16.

One donor back, 500 cc's, no more.

Okay, let it out.

Same again, deep breath in.

Great. All done. How's she doing?

Pulse box 100%, normal exam, no evidence of injury.

Great. I got way worse for my older brothers. I bet.

All right, I'll go write up a chart.

How about we call it a day?

My shift isn't over.

This was a shift and a half for anyone today, believe me.

If it's all right with you, I'd rather stay.

I'm not a quitter.

Okay, but that would be good for you. But stick close to Donnie for the rest

the day, would you?

Sure. And you also need to make a statement to the police.

If we don't stand up for ourselves, no one else will. We're here to help, not

be punching bags.

Thank you for saving me.

Got you, girl.

Something wrong?

That depends. Are you a four -month -old with severe diaper rash?

No, my door ain't cold, and I'm pretty sure that I broke my collarbone.

Okay, we can help with that. I'll be back. Wait, are you serious?

Can I at least get something for my pain?

Sure. Sit tight. This place sucks. Tell me about it. Try working here.

Boy, you're really working hard to boost those patient satisfaction scores.

The chart for Central 7 doesn't match the patient that's in there. It's

there. We're almost over this. I was over this six hours ago.

Sheriff, it's looking like Mulaney's on St. Paddy's Day. They're going to break

through the doors like zombies if we don't start moving more than me back

Dante Casella, 34.

Blunt trauma from a fireworks explosion in his storage unit.

A &O, good vitals. Large scalp laceration and bruising to the chest. No

allergies. Partial or full thickness burns. No burns.

The blast launched him into a rolled -down garage door frame. Am I fucking

here? Dr. Robbie, this is Dr. Santos.

I can't hear you.

Try the other side.

I'm Dr.

Santos. Can you hear me? Yeah, yeah.

It's Dante.

A lot of ringing.

Hey, McKay! Joy! You with us?

One, two, three.

I need, like, four doctors.

Shit, I knew it was bad.

This is a teaching hospital.

Get all the extra help you need.

Airway and breathing intact.

Good lung sliding bilaterally.

Tender over the sternum. Possible fracture. That's your breastbone.

No ectopy on monitor.

No pericardial effusion. The heart looks good. 130 over 85.

Pulse 108.

Sat 98 on two liters. Good enough for 50 a cent.

He's stuck here with head dressing.

Take a seat. Normally, we don't deal with scapulax on the primary survey,

if there's active bleeding.

With blast injuries, the pressure wave can transmit energy through the body and

cause internal damage without any external visible signs, especially with

that are air -filled. How are we looking, Dr. Santos? CFAS negative, no

fluid in the belly.

Fuck me.

What is it?

It's a pretty big flap.

Checking for bleeding source?

Is that through the gale yet? It is indeed.

Crack my head open or what? Don't worry, your skull is intact. It's just a very

deep cut.

Okay, we got a couple arterials that need control.

Figure of eight sutures? Doctor says it's for 800.

What are rainy clips, Alex, quicker than sutures? Ding, ding, ding, ding. Okay,

clamp those bleeders, call for CT. I'll be next door as Duke's CT line keeps

growing.

500 CTs out.

How you doing, Oliver?

I think it's progress in here.

Can't tell if it was the phlebotomy or if the nitro finally kicked in.

Oh, could have been both.

Potassium is high, 6 .5. Be expected with a missed dialysis and the added

stress. He needs insulin and glucose to shift the potassium intracellular.

Exactly. 10 units, amputee 50.

Start with 5 milligrams of nebulized albuterol. It'll shift some potassium

help his breathing.

He's at risk for arrhythmias.

No peaked T waves, no QRS widening. Insulin puts him at risk for

And you'd tie up nurses with frequent acu -checks.

Dr. Alashimi is right. The nebs will hold them over until dialysis gets here.

You got this? Mm -hmm.

All good in here?

Yep.

Uh, I'm gonna go give this guy's kid an update. He's probably freaking out.

Come find me if you need me?

Uh, yep.

Um, hey.

Where'd you learn that shoe trick?

Oh, I did a clerkship at NJM at senior care.

One of the attendees always said you can learn a lot about your patients just by

looking at their feet.

Bravo, ladies. On to the next lucky customer.

Probably going to have to stay late to catch up with all these patients.

My chief reinforcements will be here soon. We're supposed to be speeding up

the 11th hour and now it's slowing down. They don't call it the final sprint for

nothing. Chop, chop.

Is that the, uh...

Yeah. Do you believe it was just an accident?

Does it matter?

As a doctor, no.

As a mom, sometimes I can't tell if motherhood has made me more

more judgmental.

Dana, got a couple of visitors.

My brother, there was an explosion.

Hi, my mom was in a car accident.

Okay, Monica, can you help these fine folks find their loved ones? No.

And, Princess, what are you still doing here?

Don't you got some crazy Lou Alpigo's barbecue thing to get to?

It's lechon, but yes, I do. I'm going to sneak out on a few.

Yeah, yeah. Go have some fun for both of us, all right?

Don't stay too late.

Okay.

Hello, Miss Stevens. I'm Dr.

McKay. How are you feeling?

Stupid. And really, really sore.

Yeah, we'll get you something for your pain, okay?

And your last patient left her blanket.

Oh, uh, yeah, I... Yeah, I'll take it.

Excuse me.

Um, I'll be right back, Kim.

Fuck!

You good? Yeah, yeah. I, uh, just, um, I'm looking for something to put this

I, uh, the patient left it.

She died, the, uh...

Cancer mom with two kids.

Sounds like a tough one.

Yeah, that one sucked.

Seeing those two young boys say goodbye to their mother was brutal.

Makes you want to cry.

If you cry, you'll feel better.

I wish I could.

I don't even remember the last time I cried.

I'm not even sure I can anymore.

Is that what this place does to you?

You get...

Pretty good at shutting down our feelings.

Yeah, I'm a little scared I've shut them off for so long I don't know how to

turn them back on again.

I just wish I could cry again, you know?

You want a hug?

God, no.

Your mom is stable, but she's still waiting on the imaging for him.

Well, no more soon. You can wait with your dad in the meantime.

I've told him a million times he shouldn't be driving anymore.

May I ask what their home situation's like right now?

I don't know. They live over in Squirrel Hill.

Same house I grew up in, just the two of them.

We noticed your father exhibiting signs of an unsteady gait, along with other

balance and mobility issues.

He's an internist, neurologist, cardiologist, gastroenterologist. He's

whole team of ologists.

Both my parents used to be in pretty great shape, but...

Lately, it's like they can barely get up the stairs. Half their house is

inaccessible to them.

Have you looked into assisted living options?

Yes, but they refuse to even talk about it with me.

Mr. Cullen, we have a visitor.

Care bear.

Dad, you feeling okay?

No, I'm feeling dumb.

Carrie, this is Dr.

King, who will be assisting with your mother's care.

I was just explaining that the treatment depends on the injuries, but there are

complicating factors.

We are required to report impairments that might affect driving, and you will

likely have to take another driver's test to keep your license.

What has that got to do with Frida? Well, if the hip injury is serious and

you're also limited, then it could mean an unsafe -to -return -home

recommendation for your wife. You'd be looking at a temporary move to some form

of assisted living and rehabilitation for Frida's care.

How temporary?

Best case, three to six months.

but she may never return to the functionality she had prior to the

recovery. Okay, well, kill me now.

See what I'm dealing with, Dad?

You need to find somewhere to live that is safer and healthier for both of you.

You know, the new communities are not anything like the old scary nursing

They're really nice, and you get your own apartment.

And, you know, my sister actually lives in Munch. She loves it. When the dog

dies, we can talk.

What if you fall?

What if you have a heart attack or a stroke and there's no one there to help

you? You worry too much. How can I not? Look what happened today.

We're going to leave you two alone.

We'll come back with Mrs. Cohn.

Hey, Robbie.

Our scout victim is back from CT. They're prepping him now.

Shit. Okay, I'm coming.

Is your friend doing okay? He's almost like a risk grader.

Oh, and Dana put an okay on the guy who attacked the new nurse.

Is he okay?

Physically, yes.

I heard you had a little chat with Langdon earlier.

Yeah, water under the bridge.

Have to figure out a way of working with him now that he's back.

Or until he relapses.

He's becoming a very good doctor. Don't let old conflicts get in the way.

Speaking of which, I want you and everybody else to see the trauma

while I'm gone.

Yes? Yes. And I asked Whitaker to house -sit for me while I'm gone. I figured

that would distract from the whole farmer's widow thing. Wait, what? Bring

the mail, water the plants.

Cool. Cool.

Yeah, fine.

That looks good. You can start the repair after this one.

Feeling any pain, sir?

No pain, just wet.

You already numbed him up?

I did.

One percent with Epi. Did you bag it?

No, not yet.

I watched the slices come up.

Isolated sternal fracture.

Everything else looked normal.

Could send him home, but given the mechanism, should probably watch him

overnight. I agree with Dr. Garcia.

I agree with Dr. Garcia, too.

Three -layer closure.

Gallia, sub -Q, skin staples.

Enjoy the fireworks.

And hey, if I don't see you before you leave, don't forget to buy me a

like a custom Alphone -carved hunting blade.

Nothing lasts for my favorite butcher.

You're going to make a great ex -husband one day, Rubinovich.

Hospital's got a defense attorney looking for Jesse. Probably took him to

detention center, so we shouldn't hold our breath, though.

Whatever happened to we the people, huh?

Anything back on that drunk son of a bitch that attacked Emma?

Not yet.

Christ's sake.

I'm making a run now.

I'll ask. Yeah.

That's the guy who attacked Emma?

Some sense.

How you doing?

Beachy.

Oh, that's me.

Hey, you did what you had to do with that guy. Everything's gonna be fine.

From your lips.

Looks like Class B launch tubes to the van. Next second, kaboom!

I get launched 10, 15 feet across the garage, right up into the lift track.

Hit something hard.

I don't really remember the rest.

Oh, just my brother screaming.

I'm lying there thinking, oh, he must be dying.

I guess it was me he was screaming about.

Your brother is in the family room. He's waiting to see you, and he is alive and

well.

Oops.

What's oops mean?

Hello? Nothing to worry about.

We never say oops in front of a patient.

All right, try again.

You sure?

Mm -hmm.

Better? Keep going?

You might want to leave the fireworks to the professionals.

We are professionals.

Got our official PDA consumer license a few years back.

Gum powder's in my blood, man.

Nothing like that.

Ain't no fightin' it.

Amor fati.

More like memento mori.

Am I, like, the only one who didn't study Latin for med school?

Yep. Yes.

And finish.

Nice. We're done.

Can I see my brother now? Yep.

Oh, motherfucker.

Chest pain?

Only when I move. That would be the fracture in your sternum, which we will

you another four morphines for that. Thank you. And try no laughing or

for the next four weeks.

Mr. Haas, we're going to switch you over to a high -flow nasal oxygen instead of

the BiPAP and see how you do.

This looks promising. Repeat potassium at 6 .1 with the albuterol.

Feeling a little better.

Don't you ever tell your mother about how fast you drove here. I thought you

were going to die.

Any longer, any might have, so... Good job.

Boyd just got his permit last week.

Felt like I was living in one of those Fast and the Furious movies.

I can't believe Pine Ridge closed. When did that happen?

I read about it a few months ago.

Medicare spending cuts.

Are there any other emergency rooms in the area?

Nope.

It's going to be a long way to drive for folks out where we live.

Mr. House, you'll need to stay here a few hours. Get you tuned up.

Yeah. I know the job.

Hey, uh... Hey, you know, Mason, if you're hungry, we've got a pretty good

cafeteria. Don't lie to him.

We have a cafeteria.

I'm just gonna stay here with my dad.

Yeah, sure.

Thank you for saving him.

Are you still thinking rural emergency medicine when you're down here?

I'm not thinking.

Doing.

I hope there are still some hospitals left for you to work at. Yeah.

Ah, it's on the march of the Walking Dead night shift again. First one in,

Mattel, you get a gold star. What happened in here? Left you guys with a

this morning.

Don't ask.

Speaking of layups, what up, Dr. J?

Oh, right.

That was some sort of basketball player, wasn't it?

Shame on you.

Only the greatest sixers ever played the game.

Beat one of year four of med school.

You'll be ordering me around before you know it.

You enjoy the dark side when you graduate?

The emergency department?

The night shift, baby.

It's wild.

Um, I haven't even decided what residency I'm applying for yet.

We'll figure it out.

Got a lot of time.

Now that's my parents.

Dana, results are back on your guy.

Oh, give me that.

I choked her?

No, I would never do something like that. But you did.

Can you, uh... Sorry, can you excuse me for a minute?

Jesus Christ.

Great.

What's he saying, anyway?

He's in a bit of shock.

Claims he doesn't remember anything.

Says he was on the golf course getting boozy, maybe a little too boozy.

Things get hazy, next thing you know, he's on the floor and everyone's

at him.

How convenient.

Maybe it's better for both of you that he doesn't remember what happened.

Let me know when you're ready to take my statement.

Well, the good news is your CT was negative for skull fracture and cranial

hemorrhage. You mean that's good news for you and that blonde nurse lady?

But your lab results were positive for alcohol and cocaine.

Okay, you got me. I did a couple of birdie bumps on the turn, but we were

having fun on the golf course.

Look, when alcohol is mixed with cocaine, your liver produces a

called cocaine ethylene.

But what does that have to do with me allegedly doing what you said?

It's a psychoactive molecule more toxic and potent than cocaine.

And it can lead to confusion, paranoia, aggression, and even psychosis.

What happens now?

We're going to monitor you for a few hours, especially giving you a likely

concussion.

And you'll need to give a statement to the police outside in the meantime.

You're lucky this was just a poke.

Spared the muscle. See?

It could have been worse. No shit, Sherman. The triangular bayonets they

back then were designed to leave wounds that are nearly impossible to stitch.

Those bayonets have never met me.

Oh, wow.

What? It's all good. We got it covered. No, are you guys from the Fort Pitt

Museum?

Yeah, you familiar?

Yeah. I love you guys.

My mom would take me to the fort every time we'd come down and visit family as

kid. We've been volunteering there as living historians for over 20 years.

I probably saw you then.

Man, I can't wait to tell my parents about this.

Getting stabbed must have been scary. Yeah, well, Point Dexter here stumbled

over his boots and nearly impaled me.

It wouldn't have mattered if you weren't out of formation. Well, you're in good

hands. This guy could have saved a lot of lives with his sutures back in 1776.

Hi,

Dan. Good news, Mr. Cohen.

Your imaging results show no hip fracture and no internal bleeding.

But you do have a small hairline fracture of the superior pubic ring.

Well, that doesn't sound good.

Well, if you're going to have a fracture, it's the best one to have.

Do I need to stay in the hospital?

Not necessarily.

Your recovery should be pretty straightforward if we can control your

But you need to take it easy and stay off your feet for six to eight weeks.

How can she go home if she can't walk? Oh, she can bear weight and walk with

some help.

And we'll get you a walker and schedule physical therapy.

So? So we can go home.

Dad, you can't take care of Momo by yourself.

We'll manage.

You guys, you need to be realistic.

I don't want strangers hanging around in the house.

It's not strangers, it's helpers. No, no thanks.

Doctors, please.

I am worried about your ability to get the assistance you need, Mrs. Cullen.

It may be time to think about some of those alternative living options we

mentioned.

I can take care of her.

Are you going to be able to get her into the bathroom, onto the toilet in the

middle of the night?

Are you going to help her change her clothes in the morning? We're fine.

Please,

just try it.

You don't have to sell the house right away. Just see if you like it.

You could move in with us. No, I can't. I have work. I have the kids. No, no.

No, okay? Just no.

Terry. Could I speak with you outside for a minute?

Like that every time.

It's tough to find the balance between respecting your loved one's needs for

agency and doing what's best for their safety.

I was wondering if you had your parents' medication lists with you or on your

phone. Yeah.

I'd like to take a quick look at it, if that's okay.

Yeah.

My man, how you doing?

Like you better roll in a bar cart and a happy hour buffet if I'm going to be

stuck in this place much longer. This place is a traffic jam. We're trying to

merge you in, I promise.

That's no traffic jam. It's a 20 -car pileup. The sooner you get out, the

I get out, so you know I'm not bullshitting you.

Why are you jonesing so hard to get out and start your ride for me?

I've got a schedule. I've got places to go. I've got people to see.

I just have to get going.

You're worried if you don't leave tonight, you won't leave at all?

I get it. I can feel it in the air here. This place is like quicksand.

Brother.

Dr. Robbie.

Dante, the fireworks guy.

Something's wrong.

Okay, shit.

Do not go anywhere. You are next up. I'm going to deliver you myself.

I'm starting to feel like a hostage in this place. How do you think I feel?

What's going on?

Fucking chapter hurts.

Systolic's down to 78.

Blood loss and scalp lack? Uh, that's highly unlikely. Dr. Santos?

Good breath sounds, but neck veins are up. Picking the heart now.

Okay, 560 bolus, 100 % non -rebreather, please.

Pericardial effusion, RV collapse, and tamponade. Yeah, pericardial effusion.

What's going on? Is he going to be okay? He said he was fine.

CT scan was normal. Things change.

Um, Dante, there is a collection of blood around your heart. We need to

it. Oh, fuck.

Okay, .5 per kilo, ketamine, please.

Won't that drop the pressure even more?

We don't have a choice. We can undo this on a moving target.

Dante, Jesus fucking Christ, it's my baby brother.

Hey, Perla? Sir, I'm so sorry, but you can't be in the house right now. What's

wrong with him? Hey, Dante.

Dante, just hang in there. Okay.

I'm so sorry. You can't be in there right now. We have to stabilize him.

said he was fine. Okay, there's been a complication. I just need you to take a

couple of breaths. No, no, no.

And try to stay calm. Please. Just breathe with me. In.

Okay, out. Look at me. Breathe in.

Out.

Very good. In.

Out. Okay, stay calm, okay? We got this.

I can't believe you've been there with the loan.

I've been out of the shock. From what? Uh, I'm guessing a small tear in the

right atrium from a sterile fracture. If it was ventricular, he would have

crashed in the field.

Cardiothoracic, see if they have an OR.

Oh, it's down to 64?

Okay, have you ever done an apical approach?

Nope.

It's on my present, collateral to my probe.

Why not subcostal? Uh, this is a shorter distance. There are fewer structures.

If you can see fluid, there's nothing between the probe and the pericardium.

It's there. It's there. The needle's in the fusion.

Mm -hmm. Draw back.

Good blood return.

Okay, sometimes it only takes 20 cc's to let that heart fill again.

Chronic pulse much stronger.

Thanks, be right up.

Cover room ready in five.

All right, that is 40 cc's out.

Blood pressure's up, 90 systolic. Okay, now we're going to place the J -wire,

and we're going to leave the catheter in the three -way stopcock.

Still bleeding from the heart. He can live with a little blood loss, but not

with a pressure bag squeezing his heart so it can't beat.

Good thing we didn't send him home.

Next day, Robbie.

You too, Trinity.

Is that an actual compliment?

Sometimes you guys get lucky.

Got a couple of bad ones. How old is he? 84.

Meclizine for vertigo.

Anticholinergic effects can cause drowsiness. It's PRN, so maybe he

it all the time.

He's also been prescribed metocarbamol, another anticholinergic. Could

definitely impair driving.

And metoclopramide for his stomach.

That could cause gait problems.

Exactly.

Dr. Robbie, may we present?

Yeah, what do you got?

Hey, you should probably get started crossing your T's and dotting your I's

night shift handoff. Right, well, vaya con Dios, or whatever the bikers are

saying these days.

Our elderly couple, Frida and Ed, were anxious about their ability to recover

home or to remain at home in general. But a number of Mr. Cohen's medications

are on the beers list, and they may be contributing to his deteriorating

Maybe. We can't be certain, but none of them are critical meds.

We could have him stop them right now, follow up with his PCP, see how he's

doing in a few weeks. Right by the family, sometimes just affirming a

independence, autonomy, can do a world of good.

Hey,

Dr. Mohan, I heard a rumor that you were looking for an elective. Do you

consider geriatrics as much of an art as a science? There's usually an opening,

and you seem to have a predisposition to the pace.

Have you seen Dan?

Think she went out for a smoke, lucky girl.

You ever gonna tell me what really happened in there?

Nowhere.

You could lose your nursing license.

Let me guess, that violent versed in your pocket, you drew that up for Doug

Driscoll, in case he ever came back, and now you've just been carrying it around

ever since.

I did exactly what I needed to. Now there's a young nurse who gets to go

one piece because of me.

Or Kay can sign the versed order for me, if you will. I will sign the order. I

will sign an extra order so you can have one when I'm gone. That's hardly the

point. It's not exactly like I'm against nurse safety.

I'm trying to advocate for your caution because you're the person who's supposed

to be here keeping this running while I'm gone. Not roaming the halls like a

vigilante with a loaded syringe and a vendetta. It's only do as I say, not as

do with you, isn't it? What is wrong with you today?

Samira, Mr. Triple A.

Mel and Alice had a deposition. McKay's treating people in the park. Fucking

Langdon. At some point, you and Langdon got to work this out. I don't want him

here. He made a mistake and he paid for it. Did he? Did he go to jail? Because I

let him get away with the crime. So what does that make me?

Human! Are you angry? Are you angry at him or are you angry at you? Somebody

could have died. Oh, it's easy.

Somebody's always dying. Go ahead and make jokes. Make jokes instead of

acknowledging. He didn't kill anybody.

Now we know him.

And he saved a lot of lives that we do know of.

Our kids disappoint us sometimes.

Langdon is not a kid. No, but he's your guy and you're taking him personally.

Langdon fucked up and you think that makes you look bad, but it's on him.

How am I supposed to leave this place when it's a shit show?

First you can't stay, now you can't go.

What is it, Rabinovich?

No, I'm going. I just thought I could leave it a little better when I did.

Oh, don't be such a martyr. This place is always teetering on the brink of

disaster, with or without you. We do it every night, every day off. This place

is bringing the one person.

It'll survive without Adamson, it'll survive without me, and it'll survive

without you.

My meds are making me worse?

Not worse, but they may be impacting your balance and mobility.

Why would his doctors prescribe drugs that...

could harm him.

Oh, it's not any one medication. It's the combination that could be impairing

his daily functioning.

We have a case manager that will put together a robust plan that I think will

make everyone happy while allowing you to stay at home.

There's regular physical therapy, an at -home nurse that visits a few times a

week, and even personal shoppers to help with groceries.

This sounds expensive.

Actually, Medicare covers most of it with some assistance from the Area

on Aging. You know, every old person knows what it is to be young, but no

person can know what it is to be old.

Thank you for listening.

You guys are still coming with me to visit a few assisted living places just

case it's ever time.

Well, maybe.

Hey. You, uh, you doing all right?

Never better. Thanks.

Bye.

You're really just going to keep standing there, aren't you? Yeah. What's

on?

It was literally my first day of being a doctor.

In Langdon.

Gas lit me and made me question my skills over and over.

And it's taken me a long time to feel like I belong here. And now he's back.

And I don't even care that he was an addict. I care that he was a fucking

asshole. And it's like no one here even remembers any of this. And everyone here

talks about community and family. All the way they throw you under the bus.

Robbie is the only attending who actually sees through the bullshit. But

he's leaving for some grand ego death spirit quest.

Robo -Doc over there shoots me in the proverbial dick.

Garcia's here.

She likes you, right? She doesn't like me.

She likes getting laid. I'm her stress relief squeeze toy, or was.

You know, she and Langdon would make a great couple.

Yeah, that's dark.

I'm sorry.

Yeah, why do you care?

Because we're friends, I thought, I think. Are we? Because on top of all

you're the one who's being super shady about moving out on me.

Moving out?

Yeah, I heard you're going to go squat at Robbie's sad bachelor pad.

Honestly? I thought that was your idea to get me to move out of the apartment.

No, no, I wanted him to give you some fatherly advice about going all farmers

only and not giving you the keys to his fucking house.

Oh, my God. No, I know.

It was none of my business. No, it's not that. It's...

You actually like living with me, don't you?

What are you talking about?

You leave your dirty clothes everywhere.

You eat all of my avocados as soon as they ripen. You keep popping the TV to

the dumbest questions. No, I'm going back to the avocado thing because I've

never seen someone consume so many of your stuff. Say it and I won't move out,

okay? I'm not going to be doing much of Robbie's. I'm going to be taking in his

mail and re -watering his plants.

Say what?

Admit that you like having me as your roommate.

You are such a fuckleberry. Have fun with Robbie's plants.

You have no idea how much joy that just brought me.

Hey. How much longer until I get these things off and go home?

Oh.

You assaulted a nurse.

Yes. You said it was the cocoa ethylite thing that made me go crazy.

Well, if you're drunk and you killed someone, you still killed someone.

So after we clear you in a few hours, you're going to take a ride with the

uniformed officer outside who's going to take you in for processing. No, no, no,

no. This cannot be happening. No, since you golf and can buy cocaine, I assume

you can post bail after your arraignment.

You're going to ruin my fucking life!

But it'd be in our nation's big, beautiful birthday that hearing may take

than usual. So I'd cancel any grand plans you have for the fourth.

You know, I can leave you with these.

Rehab? Fuck off.

I'm suing this whole hospital and you for personal injury.

Well, good luck convincing your jury of that one.

Oh, fuck this whole place, and fuck all of you!

No, not you, officer.

Fuck! Make sure discharge charts are bundled and placed in the 2B scan bin

nursing notes, order sheets, lab, and x -ray results.

Day shift needs completed T -sheets on every patient and to write on the board

what tests are pending so nothing falls through the cracks while we wait to come

back online.

West Virginia Dominion have settled their cyber dispute.

They paid their answer? Yeah.

Our IT department is confident in our defenses, so they will be rebooting

everything soon.

Slowly but surely.

Okay, so when everything comes back on, all the residents have to do is scan all

the completed paper charts and digitize them into the patient's EHRs before they

go? I'm never getting out of this place.

Means you're clear for takeoff.

Nothing here we can't handle with night shift coming in.

Yeah, right.

Free to go.

Uh, hey, I told you I would get you up there, and I promise I'm not leaving

until you're back and sent packing.

Robbie, buddy, you got me to come in, got me to take my test. You don't got to

babysit me. That's why I have a nurse.

What's your name, sweetheart? Nurse Vivi, sir.

That's why I have the lovely Nurse Vivi here. This will not take very long.

Where have I heard that before?

Hey, so, uh, this is it, huh?

Uh, yeah.

Don't let the place burn down.

You know...

In a previous life, I had a lot of friends who liked to see how close the

was.

As if it was a challenge, they were called to meet.

Trouble is, they all inevitably found it.

Okay.

I'm just picking up on a weird vibe from you today, that's all.

Yeah. It's been a weird day.

You're leaving?

Yeah, my shift is over and I ain't getting paid to be here. Quite literally

opposite, in fact.

Well, I don't know if you noticed, but we're sort of in disaster mode here, so

we put in the extra time if we need it.

You know 62 % of ED docs report suffering from burnout?

Painfully where?

So, maybe all you lunatics need to learn how to set some boundaries.

Like me.

See you tomorrow, Doc.

Good luck on there. Sorry about the mess.

Mess?

Yeah. Yep.

Head trauma.

Unwitnessed fall from the warehouse catwalk where he works as a security

Oh, my God.

Orlando, he left five hours ago.