1
00:00:00,166 --> 00:00:03,085
[Robert Bradley's
Blackwater Surprise's "Baby"]

2
00:00:03,086 --> 00:00:10,176
♪ ♪

3
00:00:14,389 --> 00:00:17,474
<i>♪ Baby ♪</i>

4
00:00:17,475 --> 00:00:20,686
<i>♪ It's all right ♪</i>

5
00:00:20,687 --> 00:00:23,313
<i>♪ Maybe ♪</i>

6
00:00:23,314 --> 00:00:27,109
<i>♪ You'll stay here tonight ♪</i>

7
00:00:27,110 --> 00:00:30,195
<i>♪ Baby ♪</i>
[siren wailing]

8
00:00:30,196 --> 00:00:33,365
<i>♪ It's all right ♪</i>

9
00:00:33,366 --> 00:00:36,326
<i>♪ Maybe ♪</i>

10
00:00:36,327 --> 00:00:38,787
<i>♪ You can stay here tonight ♪</i>

11
00:00:38,788 --> 00:00:41,040
♪ ♪

12
00:00:41,041 --> 00:00:42,708
<i>♪ Out on the street ♪</i>

13
00:00:42,709 --> 00:00:47,212
<i>♪ Love, music, and my guitar ♪</i>

14
00:00:47,213 --> 00:00:49,089
<i>♪ Drove up a woman ♪</i>

15
00:00:49,090 --> 00:00:53,886
<i>♪ In one of those
old fancy cars ♪</i>

16
00:00:53,887 --> 00:00:56,055
<i>♪ She said, hey, boy ♪</i>

17
00:00:56,056 --> 00:01:00,142
<i>♪ Why don't you get on in? ♪</i>

18
00:01:00,143 --> 00:01:02,144
<i>♪ For tonight ♪</i>

19
00:01:02,145 --> 00:01:04,730
<i>♪ I'll be your lover
and your friend ♪</i>

20
00:01:04,731 --> 00:01:08,276
[indistinct chatter]
[music continues in earbuds]

21
00:01:22,290 --> 00:01:23,458
[door beeps]

22
00:01:38,014 --> 00:01:39,390
Is it true?

23
00:01:39,391 --> 00:01:41,392
Simi told Hector
that Dr. Deranjian said

24
00:01:41,393 --> 00:01:43,102
the hospital was up for sale.

25
00:01:43,103 --> 00:01:45,604
They might turn it into
an ortho center with no ER.

26
00:01:45,605 --> 00:01:47,481
Oh, they're always
threatening to shut us down,

27
00:01:47,482 --> 00:01:49,441
but they never do.

28
00:01:49,442 --> 00:01:52,570
{\an8}[both speaking Tagalog]

29
00:01:55,990 --> 00:01:57,783
Gloria is looking for you.

30
00:01:57,784 --> 00:01:59,284
No guts, no Gloria.

31
00:01:59,285 --> 00:02:00,953
Must be time
for my weekly spanking.

32
00:02:00,954 --> 00:02:03,247
Try to be nice,
for all our sakes.

33
00:02:03,248 --> 00:02:05,958
You sure you're cool
being here today?

34
00:02:05,959 --> 00:02:09,128
Yeah. Why wouldn't I be?

35
00:02:09,129 --> 00:02:10,546
Well, if you need to talk...

36
00:02:10,547 --> 00:02:13,757
Yeah, I won't, but thanks.

37
00:02:13,758 --> 00:02:16,844
Where's Abbot?

38
00:02:16,845 --> 00:02:18,596
Getting some air.

39
00:02:21,391 --> 00:02:23,017
Really?

40
00:02:23,018 --> 00:02:25,936
[retching]

41
00:02:25,937 --> 00:02:28,523
[coughs]
[door creaks]

42
00:02:30,400 --> 00:02:32,484
Hey.

43
00:02:32,485 --> 00:02:35,112
You OK in there?

44
00:02:35,113 --> 00:02:37,656
Uh, awesome.

45
00:02:37,657 --> 00:02:39,783
[both laugh]

46
00:02:39,784 --> 00:02:42,286
I'd like to say it goes away,
but I had morning sickness

47
00:02:42,287 --> 00:02:43,996
for six months
with my second daughter.

48
00:02:43,997 --> 00:02:46,165
[toilet flushes]
Hell, who am I kidding?

49
00:02:46,166 --> 00:02:48,167
That one still worries me sick.

50
00:02:48,168 --> 00:02:49,793
[sighs]

51
00:02:49,794 --> 00:02:52,963
- Thanks.
- But it's worth it.

52
00:02:52,964 --> 00:02:54,673
You tell anybody yet?

53
00:02:54,674 --> 00:02:57,468
Oh, no.

54
00:02:57,469 --> 00:03:00,304
Not until I pass 12 weeks.
Not this time.

55
00:03:00,305 --> 00:03:02,514
Nothing but good vibes.

56
00:03:02,515 --> 00:03:05,351
But just so you know,
Robby's working today.

57
00:03:05,352 --> 00:03:07,019
Today's the day
Doc Adamson died.

58
00:03:07,020 --> 00:03:08,938
He hasn't worked it
in four years.

59
00:03:11,524 --> 00:03:13,150
So why is he here?

60
00:03:13,151 --> 00:03:15,402
All I know is,
he still blames himself

61
00:03:15,403 --> 00:03:18,322
for Adamson's death, so if
he's a little prickly today,

62
00:03:18,323 --> 00:03:20,200
give him a pass, OK?

63
00:03:21,451 --> 00:03:23,577
- Right.
- Thank you.

64
00:03:23,578 --> 00:03:25,496
Hang in there, kid.

65
00:03:25,497 --> 00:03:26,748
[groans]

66
00:03:30,293 --> 00:03:32,002
[sighs]

67
00:03:32,003 --> 00:03:36,048
[distant siren wailing]

68
00:03:36,049 --> 00:03:39,385
Good morning, Jack.

69
00:03:39,386 --> 00:03:42,680
[sighs]
What are you doing here?

70
00:03:42,681 --> 00:03:44,306
I'm working.

71
00:03:44,307 --> 00:03:47,559
And you?

72
00:03:47,560 --> 00:03:49,770
Oh, I don't know.

73
00:03:49,771 --> 00:03:52,106
Had a guy come in.

74
00:03:52,107 --> 00:03:54,733
Hit by a drunk driver
in a crosswalk.

75
00:03:54,734 --> 00:03:57,277
39-year-old vet.

76
00:03:57,278 --> 00:04:00,030
Survived three tours
without a scratch.

77
00:04:00,031 --> 00:04:02,491
[sighs]

78
00:04:02,492 --> 00:04:05,620
I spent the last two hours
coding him.

79
00:04:07,122 --> 00:04:09,498
That's always a rough way
to end the night.

80
00:04:09,499 --> 00:04:10,874
I must have had a reason

81
00:04:10,875 --> 00:04:12,584
at one time to keep coming back,

82
00:04:12,585 --> 00:04:17,923
but I can't think of it
right now.

83
00:04:17,924 --> 00:04:21,218
Because this is the job
that keeps on giving.

84
00:04:21,219 --> 00:04:22,761
Nightmares.

85
00:04:22,762 --> 00:04:24,763
Ulcers.

86
00:04:24,764 --> 00:04:26,808
Suicidal tendencies.

87
00:04:29,686 --> 00:04:32,271
Besides, if you jump
on my shift,

88
00:04:32,272 --> 00:04:36,108
that's just rude, man.

89
00:04:36,109 --> 00:04:39,237
[breathes deeply]

90
00:04:42,615 --> 00:04:45,617
I hope I'm never one
of your patients.

91
00:04:45,618 --> 00:04:49,413
That makes two of us, my friend.

92
00:04:49,414 --> 00:04:52,916
I got a pregnant teen coming
back today for mifepristone

93
00:04:52,917 --> 00:04:55,419
and a small bowel obstruction
waiting on surgery

94
00:04:55,420 --> 00:04:57,504
for the last three hours.

95
00:04:57,505 --> 00:05:00,132
Oh, and unfortunately,

96
00:05:00,133 --> 00:05:02,509
the Kraken is still boarding
in BH.

97
00:05:02,510 --> 00:05:04,303
- Still?
- [elevator dings]

98
00:05:04,304 --> 00:05:06,096
Guy's been here for a week
waiting on the psych ward.

99
00:05:06,097 --> 00:05:08,599
Yep.
He's only getting worse.

100
00:05:08,600 --> 00:05:10,976
He's catching some Zyprexa Z's
at the moment.

101
00:05:10,977 --> 00:05:14,980
But when he wakes up,
God help you all.

102
00:05:14,981 --> 00:05:16,607
[sighs]

103
00:05:16,608 --> 00:05:18,609
I wrote a note
for the family of my dead vet,

104
00:05:18,610 --> 00:05:21,195
if anyone shows.

105
00:05:21,196 --> 00:05:23,197
Oh, and you got the med students

106
00:05:23,198 --> 00:05:26,325
and new interns starting today,
so good luck with that.

107
00:05:26,326 --> 00:05:28,160
Lucky, lucky me.

108
00:05:28,161 --> 00:05:30,704
- Sir, get back here!
- No needles! No needles!

109
00:05:30,705 --> 00:05:32,956
- Oh!
- Sir! Stop!

110
00:05:32,957 --> 00:05:34,458
Somebody help me!
They're gonna hurt me!

111
00:05:34,459 --> 00:05:36,585
Sure you want
to work today, huh?

112
00:05:36,586 --> 00:05:40,964
Sir, I promise
nobody is going to hurt you.

113
00:05:40,965 --> 00:05:42,967
Sir!

114
00:05:44,844 --> 00:05:47,846
[scoffs] Who left this mess?

115
00:05:47,847 --> 00:05:50,265
It was a tough night.

116
00:05:50,266 --> 00:05:52,309
Good morning, sunshine.

117
00:05:52,310 --> 00:05:54,186
You obviously haven't seen
this board.

118
00:05:54,187 --> 00:05:55,854
Oh, we've seen worse.

119
00:05:55,855 --> 00:05:57,856
Nothing like a little challenge
every now and then

120
00:05:57,857 --> 00:05:59,525
to keep everybody on their toes.

121
00:05:59,526 --> 00:06:01,151
- Dr. Robinavitch?
- Yep.

122
00:06:01,152 --> 00:06:03,654
Melissa King.
I will be joining you today.

123
00:06:03,655 --> 00:06:05,030
I just came from two months
at the VA.

124
00:06:05,031 --> 00:06:06,448
Hey, welcome to the Pitt.

125
00:06:06,449 --> 00:06:08,033
This is Dr. Jack Abbot.

126
00:06:08,034 --> 00:06:09,868
Nice to meet you.

127
00:06:09,869 --> 00:06:12,705
I can't tell you how excited
I am to be here today, so...

128
00:06:12,706 --> 00:06:15,290
Talk to me
at the end of the day.

129
00:06:15,291 --> 00:06:17,710
Ignore him.
He had a rough night

130
00:06:17,711 --> 00:06:20,629
and is having
an ongoing existential crisis.

131
00:06:20,630 --> 00:06:23,382
Don't worry,
you'll get there soon enough.

132
00:06:23,383 --> 00:06:27,553
I married my second husband,
Everett, in 1964.

133
00:06:27,554 --> 00:06:31,849
He unfortunately passed in 1976
from a heart attack

134
00:06:31,850 --> 00:06:34,727
while we were vacationing
in Kissimmee, Florida.

135
00:06:34,728 --> 00:06:36,562
- It was awful.
- Good morning.

136
00:06:36,563 --> 00:06:39,815
We're gonna round, Dr. Mohan.

137
00:06:39,816 --> 00:06:42,360
Excuse me, Estelle.
I'll be right back.

138
00:06:44,070 --> 00:06:45,904
So you know we track
every resident's

139
00:06:45,905 --> 00:06:47,322
patients seen per hour.

140
00:06:47,323 --> 00:06:48,991
I was just taking her history.

141
00:06:48,992 --> 00:06:50,534
It's a brief backstory
about what brought them in,

142
00:06:50,535 --> 00:06:51,994
- not an autobiography.
- I was almost done.

143
00:06:51,995 --> 00:06:55,372
You hadn't even made it
to this century.

144
00:06:55,373 --> 00:06:58,375
Patients, they check in
for registration here.

145
00:06:58,376 --> 00:07:01,587
A nurse eyeballs them,
makes sure they're not dying.

146
00:07:01,588 --> 00:07:04,048
If not, they're moved to one
of two triage rooms for vitals

147
00:07:04,049 --> 00:07:05,591
and a quick chair exam
where you can order

148
00:07:05,592 --> 00:07:07,384
your labs and your X-rays.

149
00:07:07,385 --> 00:07:08,927
And then they come back to...

150
00:07:08,928 --> 00:07:11,096
Waiting room,
until a bed opens up.

151
00:07:11,097 --> 00:07:12,598
For how long?

152
00:07:12,599 --> 00:07:14,433
Eight hours, if they're lucky.

153
00:07:14,434 --> 00:07:15,934
A lot of times, 12.

154
00:07:15,935 --> 00:07:18,520
Uh, is it always this busy?

155
00:07:18,521 --> 00:07:19,938
Uh, no.

156
00:07:19,939 --> 00:07:22,191
It gets a lot busier.

157
00:07:22,192 --> 00:07:24,943
[door beeps, buzzes]

158
00:07:24,944 --> 00:07:26,278
Take this.

159
00:07:26,279 --> 00:07:27,321
Hey, Mateo.

160
00:07:27,322 --> 00:07:28,489
Good morning, Cass.

161
00:07:28,490 --> 00:07:30,449
This is Sherry.

162
00:07:30,450 --> 00:07:31,784
Hi.

163
00:07:31,785 --> 00:07:33,660
Sherry, I'm Dr. McKay.

164
00:07:33,661 --> 00:07:35,454
I have some student doctors
with me today.

165
00:07:35,455 --> 00:07:36,830
Do you mind if they observe?

166
00:07:36,831 --> 00:07:39,291
Sure.

167
00:07:39,292 --> 00:07:40,918
What's going on, Sherry?

168
00:07:40,919 --> 00:07:43,462
I... [groans]

169
00:07:43,463 --> 00:07:46,048
I burned my hand on a Sterno.

170
00:07:46,049 --> 00:07:47,800
What were you doing
with a Sterno?

171
00:07:47,801 --> 00:07:49,134
Uh, cooking.

172
00:07:49,135 --> 00:07:50,969
You were cooking with a Sterno?

173
00:07:50,970 --> 00:07:54,473
Yeah, we were making s'mores.

174
00:07:54,474 --> 00:07:55,474
That's sweet.

175
00:07:55,475 --> 00:07:58,352
My son loves s'mores.

176
00:07:58,353 --> 00:08:01,146
Uh, we've...
we've been here for hours,

177
00:08:01,147 --> 00:08:02,773
and I have to get them
to school.

178
00:08:02,774 --> 00:08:04,817
Do you know how much longer
this will take?

179
00:08:04,818 --> 00:08:07,986
Uh, yeah, let's see.

180
00:08:07,987 --> 00:08:10,406
- You take anything for the pain?
- Uh, not yet.

181
00:08:10,407 --> 00:08:12,658
1,000 Tylenol, 400 ibuprofen,
and saline dressing?

182
00:08:12,659 --> 00:08:14,993
- Yes, please.
- [knock at door]

183
00:08:14,994 --> 00:08:16,662
McKay, we're going to round.

184
00:08:16,663 --> 00:08:18,831
And the fun begins.

185
00:08:18,832 --> 00:08:20,499
All right, Sherry,
we're gonna patch you up

186
00:08:20,500 --> 00:08:23,127
and get you out of here
as soon as possible, OK?

187
00:08:23,128 --> 00:08:24,421
I'll be back.

188
00:08:28,008 --> 00:08:31,343
As you can see, we have some
new faces with us this morning.

189
00:08:31,344 --> 00:08:33,178
Good morning, good morning.
Come on over.

190
00:08:33,179 --> 00:08:36,056
Starting with second-year
resident Dr. Melissa King,

191
00:08:36,057 --> 00:08:37,516
fresh from the VA.

192
00:08:37,517 --> 00:08:39,143
Everyone calls me Mel.

193
00:08:39,144 --> 00:08:41,061
I'm so happy to be here.

194
00:08:41,062 --> 00:08:43,063
Trinity Santos, intern.

195
00:08:43,064 --> 00:08:45,399
Victoria Javadi, MS3.

196
00:08:45,400 --> 00:08:47,901
Uh, Dennis Whitaker, MS4.

197
00:08:47,902 --> 00:08:49,361
Welcome to the Pitt.
I'm...

198
00:08:49,362 --> 00:08:50,738
We've got two traumas
from the T.

199
00:08:50,739 --> 00:08:52,364
- Five minutes out.
- OK, copy that.

200
00:08:52,365 --> 00:08:54,033
Actually, this is
the most important person

201
00:08:54,034 --> 00:08:55,534
that you're gonna meet today.
This is Dana.

202
00:08:55,535 --> 00:08:56,910
She's our charge nurse.

203
00:08:56,911 --> 00:08:59,329
She is the ringleader
of our circus.

204
00:08:59,330 --> 00:09:01,373
Do what she says
when she says it.

205
00:09:01,374 --> 00:09:04,793
As you can see,
our house is always packed,

206
00:09:04,794 --> 00:09:07,129
and our department is mostly
clogged up with boarders.

207
00:09:07,130 --> 00:09:09,381
Those are admitted patients
waiting for a room upstairs,

208
00:09:09,382 --> 00:09:11,300
sometimes for days.

209
00:09:11,301 --> 00:09:13,510
Beds are a very precious
commodity around here,

210
00:09:13,511 --> 00:09:14,803
so please be quick and efficient

211
00:09:14,804 --> 00:09:15,804
with your workups.

212
00:09:15,805 --> 00:09:17,222
What else?

213
00:09:17,223 --> 00:09:18,807
We treat the sicker patients
back here,

214
00:09:18,808 --> 00:09:20,476
but please keep your eye
on that waiting room.

215
00:09:20,477 --> 00:09:23,020
Make sure nobody's
gonna die out there.

216
00:09:23,021 --> 00:09:26,315
Your senior residents
are Dr. Collins

217
00:09:26,316 --> 00:09:28,192
and Dr. Langdon.

218
00:09:28,193 --> 00:09:31,362
You report to them,
and they report to me.

219
00:09:31,363 --> 00:09:33,447
Senior residents,
you got your sign-outs?

220
00:09:33,448 --> 00:09:37,284
- Yep.
- OK. Let's do this.

221
00:09:37,285 --> 00:09:39,787
- Virgil Straker.
- [indistinct chatter]

222
00:09:39,788 --> 00:09:42,706
9mm GSW to the left shoulder.

223
00:09:42,707 --> 00:09:44,917
CT angiogram negative,
surgery wants to admit

224
00:09:44,918 --> 00:09:46,585
for overnight observation.

225
00:09:46,586 --> 00:09:48,962
Good vitals.
They repeat a crit?

226
00:09:48,963 --> 00:09:50,547
Stable crits
every two hours times three.

227
00:09:50,548 --> 00:09:52,424
Discharge on Ceftin,
recheck tomorrow.

228
00:09:52,425 --> 00:09:54,426
He'll get way more rest at home.

229
00:09:54,427 --> 00:09:56,428
Good morning, Mr. Straker.
You want to go home?

230
00:09:56,429 --> 00:09:58,764
- Hell yeah.
- OK.

231
00:09:58,765 --> 00:10:00,265
Hey. Hey, Ro.

232
00:10:00,266 --> 00:10:02,143
Hey, Ro, I'm finally
getting out of here!

233
00:10:03,645 --> 00:10:05,562
All right, Murphy Rottenstein.

234
00:10:05,563 --> 00:10:07,398
48-year-old woman with cirrhosis

235
00:10:07,399 --> 00:10:08,774
and upper GI bleed.

236
00:10:08,775 --> 00:10:11,568
Intubated and stable
after one unit.

237
00:10:11,569 --> 00:10:13,195
Awaiting ICU bed.

238
00:10:13,196 --> 00:10:15,072
Hey, Doc.

239
00:10:15,073 --> 00:10:17,783
And we all know
Louie Cloverfield.

240
00:10:17,784 --> 00:10:21,620
Blood alcohol of .420
at 11:00 PM.

241
00:10:21,621 --> 00:10:23,580
- I've been cutting back.
- How is he still breathing?

242
00:10:23,581 --> 00:10:25,124
That's a lethal dose
for you and me.

243
00:10:25,125 --> 00:10:26,709
That's happy hour for Louie.

244
00:10:26,710 --> 00:10:28,460
Sobered up.
Had two rounds of lorazepam.

245
00:10:28,461 --> 00:10:31,630
Hold out your hands
for me, Louie.

246
00:10:31,631 --> 00:10:33,298
- Another two of lorazepam.
- On it.

247
00:10:33,299 --> 00:10:34,425
And a script for Librium.

248
00:10:34,426 --> 00:10:35,509
It's good to see you, Louie.

249
00:10:35,510 --> 00:10:37,636
It's always a pleasure, Doc.

250
00:10:37,637 --> 00:10:39,763
Bar fight with complete avulsion

251
00:10:39,764 --> 00:10:41,765
of tooth number eight.

252
00:10:41,766 --> 00:10:43,434
Smile, Charlie.

253
00:10:43,435 --> 00:10:46,478
Oh!
Where's your tooth, Charlie?

254
00:10:46,479 --> 00:10:48,439
Fuck if I know.

255
00:10:48,440 --> 00:10:50,983
Cancel the discharge.
Order a chest X-ray.

256
00:10:50,984 --> 00:10:52,484
Got to rule out aspiration.

257
00:10:52,485 --> 00:10:55,154
Incoming!

258
00:10:55,155 --> 00:10:56,947
42-year-old male, Sam Wallace.

259
00:10:56,948 --> 00:10:58,782
Blunt head
with agonal respirations.

260
00:10:58,783 --> 00:11:00,492
Dropped down on the T tracks.
Couldn't tube him.

261
00:11:00,493 --> 00:11:01,994
- LMA in place.
- Suicide attempt?

262
00:11:01,995 --> 00:11:03,996
Rescue.
He's a good Samaritan.

263
00:11:03,997 --> 00:11:06,331
Took a spill helping an elderly
woman who fell off the tracks.

264
00:11:06,332 --> 00:11:08,000
- She's right behind us.
- OK. Trauma one. Go ahead.

265
00:11:08,001 --> 00:11:09,251
- Copy.
- [screaming]

266
00:11:09,252 --> 00:11:11,003
Come on.

267
00:11:11,004 --> 00:11:12,838
Elderly woman,
fell from T platform.

268
00:11:12,839 --> 00:11:14,673
Good vitals
and no head injuries.

269
00:11:14,674 --> 00:11:16,300
Degloving injury,
right lower leg

270
00:11:16,301 --> 00:11:18,635
with open fracture dislocation
to the ankle.

271
00:11:18,636 --> 00:11:20,137
Whoa.
OK.

272
00:11:20,138 --> 00:11:22,014
Trauma two.
Trauma two. Let's go!

273
00:11:22,015 --> 00:11:25,101
[crying indistinctly]

274
00:11:28,938 --> 00:11:30,981
How are we doing?
We ready?

275
00:11:30,982 --> 00:11:32,524
OK, here we go.
Ready?

276
00:11:32,525 --> 00:11:35,486
One, two, three.

277
00:11:35,487 --> 00:11:36,820
Good breath sounds bilaterally,

278
00:11:36,821 --> 00:11:38,364
but we need to protect...

279
00:11:38,365 --> 00:11:39,823
Apparently he jumped down
to save the lady.

280
00:11:39,824 --> 00:11:41,367
When he climbed back up,
he slipped,

281
00:11:41,368 --> 00:11:43,160
- fell back, and hit his head.
- OK, thanks.

282
00:11:43,161 --> 00:11:44,661
Uh, Mel, right?

283
00:11:44,662 --> 00:11:46,372
I need you on the E-FAST.

284
00:11:46,373 --> 00:11:48,207
Pupils four millimeters
and reactive.

285
00:11:48,208 --> 00:11:50,042
OK, that's encouraging.

286
00:11:50,043 --> 00:11:52,044
- What do you want for meds?
- 120 ketamine, 80 of rock.

287
00:11:52,045 --> 00:11:54,505
- A-fib on the monitor.
- Courses clear.

288
00:11:54,506 --> 00:11:56,507
That's a lot more blood
than expected.

289
00:11:56,508 --> 00:11:59,760
Um, he's probably
anticoagulated for A-fib.

290
00:11:59,761 --> 00:12:01,845
Check his medical records,
see if he's on a DOAC.

291
00:12:01,846 --> 00:12:04,390
Stand by with four-factor PCC
if there's a brain bleed.

292
00:12:04,391 --> 00:12:06,475
What's in the PCC, Mel?

293
00:12:06,476 --> 00:12:09,520
Uh, clotting factors
two, seven, nine, and ten.

294
00:12:09,521 --> 00:12:11,355
OK. Be right back.

295
00:12:11,356 --> 00:12:12,981
50 of fent didn't touch her.

296
00:12:12,982 --> 00:12:14,566
Did she faint or did she trip
off the platform?

297
00:12:14,567 --> 00:12:16,235
Nobody knows.

298
00:12:16,236 --> 00:12:17,569
The other guy jumped down,
pulled her off the tracks

299
00:12:17,570 --> 00:12:18,654
just as the train
was rolling in.

300
00:12:18,655 --> 00:12:19,905
Isolated injury to the foot.

301
00:12:19,906 --> 00:12:21,240
The train ran over her foot?

302
00:12:21,241 --> 00:12:22,241
Got caught between the platform

303
00:12:22,242 --> 00:12:23,409
and the incoming train.

304
00:12:23,410 --> 00:12:24,827
Ma'am?
Ma'am, what's your name?

305
00:12:24,828 --> 00:12:26,161
All right, type 3 open fracture.

306
00:12:26,162 --> 00:12:27,913
Two grams Cefazolin,
400 of gent.

307
00:12:27,914 --> 00:12:29,748
- Do you speak any English?
- [screams]

308
00:12:29,749 --> 00:12:31,709
Airway and breathing
are perfect.

309
00:12:31,710 --> 00:12:33,252
As is circulation.

310
00:12:33,253 --> 00:12:35,587
BP 140 over 85.

311
00:12:35,588 --> 00:12:38,132
Students, what might have
made her faint on the platform?

312
00:12:38,133 --> 00:12:39,591
- Uh, TIA, CVA.
- Could be an arrhythmia,

313
00:12:39,592 --> 00:12:41,301
- cardiac event.
- So she needs...

314
00:12:41,302 --> 00:12:42,928
- Hed CT.
- EKG and troponin.

315
00:12:42,929 --> 00:12:44,430
- OK, good.
- What do we got, party people?

316
00:12:44,431 --> 00:12:45,931
Subway train degloved her foot

317
00:12:45,932 --> 00:12:47,433
with an open fracture
dislocation.

318
00:12:47,434 --> 00:12:48,934
Ooh, and I thought
my heels were painful.

319
00:12:48,935 --> 00:12:50,728
- Hemodynamically stable.
- E-FAST negative.

320
00:12:50,729 --> 00:12:52,271
Ma'am,
I'm Dr. Yolanda Garcia.

321
00:12:52,272 --> 00:12:54,064
Any pain in your chest or belly?

322
00:12:54,065 --> 00:12:56,775
[sobbing]

323
00:12:56,776 --> 00:12:58,277
Can we please push the morphine?

324
00:12:58,278 --> 00:13:00,279
No, it could cloud
her mental status.

325
00:13:00,280 --> 00:13:03,282
I can't do an exam like this.
Push the damn morphine.

326
00:13:03,283 --> 00:13:04,908
We're doing a popliteal block.

327
00:13:04,909 --> 00:13:06,618
Numbs the lower leg,
no side effects.

328
00:13:06,619 --> 00:13:07,953
Wonderful.
Where's the other guy?

329
00:13:07,954 --> 00:13:09,455
Next door.
He's a bit worse.

330
00:13:09,456 --> 00:13:10,789
Pan scan her.

331
00:13:10,790 --> 00:13:12,791
Let me know
when she stops screaming.

332
00:13:12,792 --> 00:13:15,919
[machine beeping]

333
00:13:15,920 --> 00:13:17,546
The cords are very anterior.

334
00:13:17,547 --> 00:13:19,298
Yeah, that's because
we can't flex the neck.

335
00:13:19,299 --> 00:13:22,259
Keep the hockey stick
straight up.

336
00:13:22,260 --> 00:13:24,136
- I'm in.
- Good. Well done.

337
00:13:24,137 --> 00:13:25,471
Bring me up to speed.

338
00:13:25,472 --> 00:13:27,222
Intubated
for agonal respirations.

339
00:13:27,223 --> 00:13:29,892
GCS 5.
Probably anticoagulated.

340
00:13:29,893 --> 00:13:30,976
With what?

341
00:13:30,977 --> 00:13:32,144
First time here.

342
00:13:32,145 --> 00:13:33,771
There's no medical records.

343
00:13:33,772 --> 00:13:36,398
- Call for FFP?
- No, we got four-factor PCC.

344
00:13:36,399 --> 00:13:38,150
80 of mannitol
to reduce brain swelling,

345
00:13:38,151 --> 00:13:39,318
then right up to CT.

346
00:13:39,319 --> 00:13:40,778
[phone ringing]

347
00:13:40,779 --> 00:13:42,196
Do me a favor.

348
00:13:42,197 --> 00:13:43,489
Swap out with Jesse for me,
would you?

349
00:13:43,490 --> 00:13:44,990
- Of course.
- My attending.

350
00:13:44,991 --> 00:13:46,450
Dr. Robinavitch,
do you have a moment?

351
00:13:46,451 --> 00:13:48,035
I'm just a little busy
right now, Gloria.

352
00:13:48,036 --> 00:13:49,537
One sec.

353
00:13:50,622 --> 00:13:52,373
- [moaning]
- Nerve block complete.

354
00:13:52,374 --> 00:13:53,957
Seems like
it's starting to work.

355
00:13:53,958 --> 00:13:55,459
Swapping out, Jesse.

356
00:13:55,460 --> 00:13:56,960
Takes ten minutes
for the full effect,

357
00:13:56,961 --> 00:13:58,671
and the Marcaine lasts
a good four hours.

358
00:13:58,672 --> 00:14:00,381
She's next for CT.

359
00:14:00,382 --> 00:14:01,674
You have any idea
what language that is?

360
00:14:01,675 --> 00:14:02,966
Definitely not Tagalog.

361
00:14:02,967 --> 00:14:04,718
Maybe Hindi or Urdu.

362
00:14:04,719 --> 00:14:06,303
I'm gonna go get
language services.

363
00:14:06,304 --> 00:14:07,680
Don't you speak,
like, five languages?

364
00:14:07,681 --> 00:14:09,306
Six, but that's not one of them.

365
00:14:09,307 --> 00:14:10,641
Six?

366
00:14:10,642 --> 00:14:11,642
And I thought Collins was smart.

367
00:14:11,643 --> 00:14:13,018
Oh, it's way too early

368
00:14:13,019 --> 00:14:14,520
for you to start being an ass,
Langdon.

369
00:14:14,521 --> 00:14:16,105
Open hostility
in front of the patient?

370
00:14:16,106 --> 00:14:17,648
She doesn't speak English.

371
00:14:17,649 --> 00:14:19,316
Judgmental and dismissive.

372
00:14:19,317 --> 00:14:20,776
How are we doing?

373
00:14:20,777 --> 00:14:22,945
- Vitals stable.
- Unlike these two.

374
00:14:22,946 --> 00:14:25,407
Ooh, good for you.
Princess made a joke.

375
00:14:26,866 --> 00:14:28,283
{\an8}And I thank you
for that beautiful blessing.

376
00:14:28,284 --> 00:14:30,536
- Namaste.
- OK, do we have a phone

377
00:14:30,537 --> 00:14:31,870
or anything
with a relative's name on it?

378
00:14:31,871 --> 00:14:33,956
EMT said
the purse got obliterated

379
00:14:33,957 --> 00:14:36,625
when the subway ran over it.

380
00:14:36,626 --> 00:14:39,003
- Any way I can speak with her?
- Highly doubt it.

381
00:14:39,004 --> 00:14:40,546
We don't know
what language she speaks.

382
00:14:40,547 --> 00:14:44,550
Hey, um, any chance she jumped?

383
00:14:44,551 --> 00:14:46,218
She may have been pushed.

384
00:14:46,219 --> 00:14:47,678
- Jesus.
- Yeah.

385
00:14:47,679 --> 00:14:49,346
Could be looking
at a possible hate crime.

386
00:14:49,347 --> 00:14:50,682
I take it you're free now?

387
00:14:55,645 --> 00:14:57,187
We need to talk
about your numbers.

388
00:14:57,188 --> 00:14:59,565
- Of people we've saved?
- Metrics.

389
00:14:59,566 --> 00:15:01,900
Our door-to-balloon times
beat federal standards.

390
00:15:01,901 --> 00:15:04,778
I'm talking about
Press Ganey scores.

391
00:15:04,779 --> 00:15:06,572
Patient satisfaction.

392
00:15:06,573 --> 00:15:08,615
If they're still alive,
they should be satisfied.

393
00:15:08,616 --> 00:15:11,910
Our goal is 36%
very satisfied with their care.

394
00:15:11,911 --> 00:15:14,371
Your department is at 8%.

395
00:15:14,372 --> 00:15:16,749
Do you know how likely patients
are to recommend this hospital?

396
00:15:16,750 --> 00:15:18,208
This is an emergency department,

397
00:15:18,209 --> 00:15:19,918
not a Taco Bell.

398
00:15:19,919 --> 00:15:21,420
11%.

399
00:15:21,421 --> 00:15:22,755
Well, if you want people
to be happier,

400
00:15:22,756 --> 00:15:24,423
don't make 'em wait
for 12 hours.

401
00:15:24,424 --> 00:15:26,258
There's a nursing shortage
across the country.

402
00:15:26,259 --> 00:15:28,344
Most of our patients
are boarders

403
00:15:28,345 --> 00:15:31,096
who are waiting for a bed
upstairs.

404
00:15:31,097 --> 00:15:32,723
We don't have the beds.

405
00:15:32,724 --> 00:15:34,350
That's bullshit.
The beds are up there.

406
00:15:34,351 --> 00:15:35,601
You just don't want to hire
the staff you need

407
00:15:35,602 --> 00:15:37,686
to care for them.

408
00:15:37,687 --> 00:15:40,272
Oh, Doc.
Doc, it ain't working.

409
00:15:40,273 --> 00:15:42,441
Man, whatever they're
giving me, it's not working.

410
00:15:42,442 --> 00:15:44,109
No response to mag citrate.

411
00:15:44,110 --> 00:15:46,487
Should I send in the Fleet?
[sighs]

412
00:15:46,488 --> 00:15:49,156
OK, sir,
we're gonna try an enema.

413
00:15:49,157 --> 00:15:51,450
Like I said,
there's a nursing shortage.

414
00:15:51,451 --> 00:15:52,826
Well, if you paid them
a living wage,

415
00:15:52,827 --> 00:15:54,286
they'd be lining up
to work here.

416
00:15:54,287 --> 00:15:55,788
Our budget can't support that.

417
00:15:55,789 --> 00:15:57,414
[laughs]
Here's a dirty little secret.

418
00:15:57,415 --> 00:15:58,832
The hospital saves money

419
00:15:58,833 --> 00:16:00,459
keeping patients down here
in the Pitt.

420
00:16:00,460 --> 00:16:02,294
It's way cheaper
than staffing upstairs.

421
00:16:02,295 --> 00:16:04,088
I have asked you repeatedly

422
00:16:04,089 --> 00:16:06,298
to stop referring
to the emergency department

423
00:16:06,299 --> 00:16:08,592
as the Pitt... it is derogatory

424
00:16:08,593 --> 00:16:10,678
and incompatible
to the institution's image.

425
00:16:10,679 --> 00:16:12,346
You know what's incompatible
with the institution's image?

426
00:16:12,347 --> 00:16:14,014
Me speaking to the media

427
00:16:14,015 --> 00:16:15,808
about people who code
in our waiting rooms

428
00:16:15,809 --> 00:16:17,601
and people who get
shitty care in our hallways

429
00:16:17,602 --> 00:16:19,395
waiting for an ICU bed for days.

430
00:16:19,396 --> 00:16:21,397
I've heard about doctors
who have tried that

431
00:16:21,398 --> 00:16:23,065
and find themselves out of work.

432
00:16:23,066 --> 00:16:24,441
Uh-huh.

433
00:16:24,442 --> 00:16:25,818
I know today is
difficult for you.

434
00:16:25,819 --> 00:16:27,444
Every day is difficult
down here.

435
00:16:27,445 --> 00:16:29,613
Boarding is
a nationwide problem.

436
00:16:29,614 --> 00:16:32,074
Your predecessor, Adamson,
sure as hell knew that.

437
00:16:32,075 --> 00:16:33,742
Or wasn't that
something he taught you?

438
00:16:33,743 --> 00:16:36,161
Fuck.
Wow. Really?

439
00:16:36,162 --> 00:16:37,955
Yes, really.

440
00:16:37,956 --> 00:16:39,832
Other hospitals are
managing this crisis

441
00:16:39,833 --> 00:16:41,166
much more effectively.

442
00:16:41,167 --> 00:16:42,960
So you can either
step up your game,

443
00:16:42,961 --> 00:16:44,629
or you can step aside.

444
00:16:50,468 --> 00:16:52,887
[sighs]

445
00:16:55,807 --> 00:16:57,891
Good Samaritan dude has
a small left temporal

446
00:16:57,892 --> 00:16:59,810
intraparenchymal bleed.

447
00:16:59,811 --> 00:17:01,895
No epidural, no subdural,
no midline shift in the brain.

448
00:17:01,896 --> 00:17:03,480
Oh, that's good news.
He could recover.

449
00:17:03,481 --> 00:17:04,857
CT can take her in five.

450
00:17:04,858 --> 00:17:06,650
Let's have a look.
Bandage scissors?

451
00:17:06,651 --> 00:17:08,027
All right.

452
00:17:08,028 --> 00:17:10,029
If an artery is
totally transected,

453
00:17:10,030 --> 00:17:12,031
the smooth muscle
and the tunica media

454
00:17:12,032 --> 00:17:13,699
contracts with hemostasis.

455
00:17:13,700 --> 00:17:16,535
But if it's a partial cut,
get out your umbrella.

456
00:17:16,536 --> 00:17:19,371
Grab a culture from the open
fibula before you reduce.

457
00:17:19,372 --> 00:17:22,124
You're up.

458
00:17:22,125 --> 00:17:24,043
I'll stabilize the knee
for the reduction.

459
00:17:24,044 --> 00:17:26,670
Dr. Langdon will be
distracting distally

460
00:17:26,671 --> 00:17:29,548
before moving medially
to clear the tibia.

461
00:17:29,549 --> 00:17:32,051
Good.

462
00:17:32,052 --> 00:17:33,344
Ready?

463
00:17:33,345 --> 00:17:36,431
- [cracking]
- [groaning softly]

464
00:17:41,436 --> 00:17:42,645
[thuds]

465
00:17:45,440 --> 00:17:47,776
Med student down.

466
00:17:48,818 --> 00:17:50,611
Good catch on Bar Fight Billy.

467
00:17:50,612 --> 00:17:52,613
There was an aspirated tooth
on chest X-ray.

468
00:17:52,614 --> 00:17:54,365
Would have been dead in a week
from a lung abscess

469
00:17:54,366 --> 00:17:55,532
had you let him be discharged.

470
00:17:55,533 --> 00:17:56,784
Good call on the pulmonary.

471
00:17:56,785 --> 00:17:58,619
Cardiac arrest, ETA 10 minutes.

472
00:17:58,620 --> 00:18:00,579
- Where should we put it?
- Anywhere.

473
00:18:00,580 --> 00:18:02,748
We might have to put
somebody in the hall.

474
00:18:02,749 --> 00:18:05,042
Dr. Robby?
She, uh, took a fall.

475
00:18:05,043 --> 00:18:06,752
No, I...
I tripped on the gurney.

476
00:18:06,753 --> 00:18:08,088
I'm fine.

477
00:18:10,382 --> 00:18:12,299
Why don't you go get
a cold drink

478
00:18:12,300 --> 00:18:14,885
in the staff lounge?

479
00:18:14,886 --> 00:18:16,261
I'm fine, really.
I swear.

480
00:18:16,262 --> 00:18:18,138
Oh, I know,
but it's hospital policy.

481
00:18:18,139 --> 00:18:19,932
Anytime someone gets
a paper cut around here,

482
00:18:19,933 --> 00:18:21,726
we have to fill out
a workers' comp report.

483
00:18:27,107 --> 00:18:28,817
Other way.

484
00:18:31,027 --> 00:18:33,112
I was fine
until about two weeks ago,

485
00:18:33,113 --> 00:18:34,446
after the Rochester Marathon.

486
00:18:34,447 --> 00:18:36,782
OK.
Any falls or injuries?

487
00:18:36,783 --> 00:18:38,784
Just tired.
Sore muscles.

488
00:18:38,785 --> 00:18:40,911
Yeah, I'd be in bed for a month.

489
00:18:40,912 --> 00:18:42,454
Was this your first triathlon?

490
00:18:42,455 --> 00:18:43,622
God no.

491
00:18:43,623 --> 00:18:45,874
No, I do one every few months.

492
00:18:45,875 --> 00:18:47,793
Have you seen a doctor yet?

493
00:18:47,794 --> 00:18:49,878
Uh, no.

494
00:18:49,879 --> 00:18:51,630
I went for a run this morning.

495
00:18:51,631 --> 00:18:53,090
Had to quit after a minute.

496
00:18:53,091 --> 00:18:54,258
Pretty short of breath.

497
00:18:54,259 --> 00:18:56,802
This goes under your tongue.

498
00:18:56,803 --> 00:18:58,637
- No current meds, no allergies?
- Mm-mm.

499
00:18:58,638 --> 00:19:00,806
We're gonna check a few labs
and an EKG.

500
00:19:00,807 --> 00:19:03,018
- Draw a red and purple top.
- Yep.

501
00:19:05,270 --> 00:19:08,522
[beeps]
Temp 98.2.

502
00:19:08,523 --> 00:19:10,274
Take a deep breath for me, Otis.

503
00:19:10,275 --> 00:19:11,650
[breathes deeply]

504
00:19:11,651 --> 00:19:13,570
Little pinprick now, OK?

505
00:19:17,157 --> 00:19:19,324
Otis?

506
00:19:19,325 --> 00:19:21,035
Otis.

507
00:19:21,036 --> 00:19:23,038
I didn't take him
for a lightweight, huh?

508
00:19:25,707 --> 00:19:27,082
Oh, shit.
No pulse.

509
00:19:27,083 --> 00:19:29,252
Crash cart!
Lay him flat!

510
00:19:31,379 --> 00:19:33,214
- Let's check a rhythm.
- Saline pads.

511
00:19:35,842 --> 00:19:37,635
Quick look paddles.

512
00:19:40,722 --> 00:19:42,181
- [sustained beeping]
- V-tach.

513
00:19:42,182 --> 00:19:43,807
Charging at 200.

514
00:19:43,808 --> 00:19:45,017
[whirring]
Charged.

515
00:19:45,018 --> 00:19:46,352
Clear!

516
00:19:46,353 --> 00:19:47,853
[steady beeping]

517
00:19:47,854 --> 00:19:49,772
All right,
he's back to normal sinus.

518
00:19:49,773 --> 00:19:51,149
Need a gurney in here!

519
00:19:53,318 --> 00:19:55,152
So what's the plan?

520
00:19:55,153 --> 00:19:59,031
ICU when we can get a bed
and admit for supportive care.

521
00:19:59,032 --> 00:20:02,242
Repeat head CT in three hours.

522
00:20:02,243 --> 00:20:04,411
Or sooner, if he blows a pupil.

523
00:20:04,412 --> 00:20:06,706
- Want a Keppra load?
- Order's already in.

524
00:20:08,333 --> 00:20:09,584
Nice job.

525
00:20:11,836 --> 00:20:13,712
Do you think he'll wake up?

526
00:20:13,713 --> 00:20:15,839
Maybe.

527
00:20:15,840 --> 00:20:18,717
Maybe not.

528
00:20:18,718 --> 00:20:22,846
No good deed goes unpunished.

529
00:20:22,847 --> 00:20:25,850
Oh, has anyone,
um, notified the family?

530
00:20:29,771 --> 00:20:31,397
I could try.

531
00:20:31,398 --> 00:20:33,899
Otis Williams.
Healthy 31-year-old.

532
00:20:33,900 --> 00:20:36,485
V-tach arrest
two weeks after triathlon.

533
00:20:36,486 --> 00:20:38,195
NSR with one shock.

534
00:20:38,196 --> 00:20:40,197
Pulse 98, BP 110 over 60.

535
00:20:40,198 --> 00:20:41,240
He's a little young for an MI.

536
00:20:41,241 --> 00:20:42,741
Exactly right,

537
00:20:42,742 --> 00:20:44,201
What's in the differential,
Dr. Collins?

538
00:20:44,202 --> 00:20:46,912
Drug overdose,
electrolytes, long QT...

539
00:20:46,913 --> 00:20:48,872
ooh, Brugada syndrome, WPW...

540
00:20:48,873 --> 00:20:50,582
How you doing there, Otis?

541
00:20:50,583 --> 00:20:52,418
OK.
What ha...

542
00:20:52,419 --> 00:20:54,169
- [machine flatlines]
- V-tach again.

543
00:20:54,170 --> 00:20:55,546
200 joules.

544
00:20:55,547 --> 00:20:58,757
- [whirring]
- Charged, and clear!

545
00:20:58,758 --> 00:21:00,718
- Back in sinus.
- [steady beeping]

546
00:21:00,719 --> 00:21:01,927
Otis?

547
00:21:01,928 --> 00:21:04,430
[groaning]

548
00:21:04,431 --> 00:21:06,432
Otis?

549
00:21:06,433 --> 00:21:09,560
Oh, groaning's good.
5 of nasal O2, CBC,

550
00:21:09,561 --> 00:21:12,229
CMP, troponin, and D-dimer.

551
00:21:12,230 --> 00:21:13,605
What are you doing?

552
00:21:13,606 --> 00:21:15,315
One gram calcium gluconate,
IV push.

553
00:21:15,316 --> 00:21:17,109
- We don't have the labs back.
- Look at the monitor.

554
00:21:17,110 --> 00:21:18,444
Widened QRS and PT waves.

555
00:21:18,445 --> 00:21:19,987
- Hyperkalemia.
- How'd he get that?

556
00:21:19,988 --> 00:21:21,739
Intense exercise
caused muscle breakdown.

557
00:21:21,740 --> 00:21:23,073
Rhabdomyolysis knocked out
his kidneys.

558
00:21:23,074 --> 00:21:24,158
Now he's not clearing potassium.

559
00:21:24,159 --> 00:21:25,576
I bet it's over 7.5.

560
00:21:25,577 --> 00:21:27,244
Wait two minutes for the i-STAT.

561
00:21:27,245 --> 00:21:28,746
If he arrests again,
we might not get him back.

562
00:21:28,747 --> 00:21:30,205
If it's hypercalcemia,
you could kill him.

563
00:21:30,206 --> 00:21:32,751
- Wait.
- Oh, it's my ass, not yours.

564
00:21:34,669 --> 00:21:38,089
[groaning]

565
00:21:43,345 --> 00:21:44,720
Pan scan is negative.

566
00:21:44,721 --> 00:21:46,388
That means you can admit
to orthopedics.

567
00:21:46,389 --> 00:21:48,265
But there may have been
a medical etiology

568
00:21:48,266 --> 00:21:50,100
- if she fainted.
- That's not surgical.

569
00:21:50,101 --> 00:21:51,727
Get an internal
medicine consult,

570
00:21:51,728 --> 00:21:53,979
or admit to medicine
with ortho consulting.

571
00:21:53,980 --> 00:21:55,272
Either way, I'm off the case.

572
00:21:55,273 --> 00:21:57,483
OK.
Thanks for nothing.

573
00:21:57,484 --> 00:22:00,444
Ancef's in.
I'll grab the gent.

574
00:22:00,445 --> 00:22:02,196
Did we figure out
what she's speaking?

575
00:22:02,197 --> 00:22:04,823
Last interpreter thought
she might be from Pakistan.

576
00:22:04,824 --> 00:22:07,451
There are 77 languages
in Pakistan.

577
00:22:07,452 --> 00:22:10,537
OK, well, I will buy lunch
for whoever figures it out.

578
00:22:10,538 --> 00:22:11,997
Good luck.

579
00:22:11,998 --> 00:22:14,875
If you need me,
I'll be saving lives.

580
00:22:14,876 --> 00:22:16,835
That was wicked.

581
00:22:16,836 --> 00:22:19,171
- [scoffs] That was gross.
- Yeah.

582
00:22:19,172 --> 00:22:21,799
Too much for Little Miss
Crash and Burn.

583
00:22:21,800 --> 00:22:23,342
- What'd you do with her?
- Nothing.

584
00:22:23,343 --> 00:22:25,844
- I think she'll be fine.
- Are you kidding?

585
00:22:25,845 --> 00:22:27,221
If that took her out,
she'll be lucky to make it

586
00:22:27,222 --> 00:22:29,014
through this rotation.

587
00:22:29,015 --> 00:22:30,766
I got 50 bucks says she doesn't
last through this shift.

588
00:22:30,767 --> 00:22:32,518
[scoffs]

589
00:22:32,519 --> 00:22:33,852
Come on.

590
00:22:33,853 --> 00:22:35,187
Put your money
where your mouth is.

591
00:22:35,188 --> 00:22:37,815
Uh, no.
I didn't say anything, OK?

592
00:22:37,816 --> 00:22:40,442
And I sure as hell
don't have 50 bucks.

593
00:22:40,443 --> 00:22:41,860
I'll be this lady's age
by the time

594
00:22:41,861 --> 00:22:43,112
I pay off my student loans.

595
00:22:43,113 --> 00:22:44,406
Not that you're...

596
00:22:45,907 --> 00:22:50,202
Hey, you want to sell a kidney?

597
00:22:50,203 --> 00:22:53,497
I could get you 30K
as soon as this weekend.

598
00:22:53,498 --> 00:22:56,542
That's just between you and me.

599
00:22:56,543 --> 00:22:57,919
Think about it.

600
00:23:02,590 --> 00:23:04,717
How you doing?

601
00:23:04,718 --> 00:23:06,427
Yeah.

602
00:23:06,428 --> 00:23:08,345
QRS has narrowed.

603
00:23:08,346 --> 00:23:09,388
Much better.

604
00:23:09,389 --> 00:23:11,223
Potassium is 7.7.

605
00:23:11,224 --> 00:23:13,517
Creatinine, 5.6.

606
00:23:13,518 --> 00:23:15,227
High potassium
and renal failure.

607
00:23:15,228 --> 00:23:16,520
Just what you thought.

608
00:23:16,521 --> 00:23:18,230
It must be my lucky day.

609
00:23:18,231 --> 00:23:20,399
Ordering 10 units
of regular insulin

610
00:23:20,400 --> 00:23:23,736
and 25 grams of glucose.

611
00:23:23,737 --> 00:23:25,571
Why insulin and glucose?

612
00:23:25,572 --> 00:23:27,364
Shift the potassium
intracellularly.

613
00:23:27,365 --> 00:23:29,074
Exactly, but the definitive
treatment is...

614
00:23:29,075 --> 00:23:30,576
Hemodialysis.
I'll call renal

615
00:23:30,577 --> 00:23:32,536
and get a tech down
with the machine.

616
00:23:32,537 --> 00:23:35,581
Have you ever seen
a dialysis catheter inserted?

617
00:23:35,582 --> 00:23:37,416
Dr. Collins is gonna place
a femoral Quinton

618
00:23:37,417 --> 00:23:38,584
under ultrasound guidance.

619
00:23:38,585 --> 00:23:39,752
It's an excellent way to learn.

620
00:23:39,753 --> 00:23:41,920
[groans] Oh, my chest.

621
00:23:41,921 --> 00:23:43,422
Yeah, we had to shock you.

622
00:23:43,423 --> 00:23:45,257
You're gonna be sore
for a while.

623
00:23:45,258 --> 00:23:46,842
You shocked my heart?

624
00:23:46,843 --> 00:23:49,471
Long story.
Dr. Collins will fill you in.

625
00:23:57,103 --> 00:23:59,356
You got a sec?

626
00:24:02,025 --> 00:24:03,609
You OK?

627
00:24:03,610 --> 00:24:05,569
Why wouldn't I be?
Are you OK?

628
00:24:05,570 --> 00:24:07,405
Why wouldn't I be?

629
00:24:08,823 --> 00:24:10,407
You seem annoyed with me
already,

630
00:24:10,408 --> 00:24:13,118
and I just got here.

631
00:24:13,119 --> 00:24:15,622
It's not always
about you, Robby.

632
00:24:17,499 --> 00:24:19,333
Am I gonna be OK?

633
00:24:19,334 --> 00:24:20,918
Yeah.

634
00:24:20,919 --> 00:24:23,087
You just need to take it easy
on yourself.

635
00:24:23,088 --> 00:24:26,590
Muscle breakdown and myoglobin
damaged your kidneys.

636
00:24:26,591 --> 00:24:28,342
Why'd you shock my heart?

637
00:24:28,343 --> 00:24:30,969
When your kidneys don't work,
potassium builds up

638
00:24:30,970 --> 00:24:35,474
and messes with the electrical
activity in your heart.

639
00:24:35,475 --> 00:24:37,768
Can it happen again?

640
00:24:37,769 --> 00:24:39,728
We gave you medicine
to lower your potassium,

641
00:24:39,729 --> 00:24:42,272
and you'll need dialysis
to clear it all out.

642
00:24:42,273 --> 00:24:44,149
Then I'll be OK?

643
00:24:44,150 --> 00:24:45,401
Yeah.

644
00:24:45,402 --> 00:24:46,819
You might need a week or two

645
00:24:46,820 --> 00:24:49,446
for your kidneys to recover,
but yeah.

646
00:24:49,447 --> 00:24:51,782
You really need
to hydrate like crazy

647
00:24:51,783 --> 00:24:54,660
before and after a triathlon.

648
00:24:54,661 --> 00:24:58,330
Trust me,
I won't let this happen again.

649
00:24:58,331 --> 00:25:01,000
Good.

650
00:25:01,001 --> 00:25:03,545
Be kind to yourself.

651
00:25:11,803 --> 00:25:14,680
[sighs] Oh, hey.

652
00:25:14,681 --> 00:25:16,515
Abbot's told me that he's got
a pregnant teen

653
00:25:16,516 --> 00:25:17,975
coming back today
for mifepristone.

654
00:25:17,976 --> 00:25:19,852
- Let me know when she gets here.
- Yep.

655
00:25:19,853 --> 00:25:21,353
Bowel obstruction, still waiting

656
00:25:21,354 --> 00:25:23,063
on a surgery consult.
What about Garcia?

657
00:25:23,064 --> 00:25:25,065
She was just here
for the traumas.

658
00:25:25,066 --> 00:25:29,486
I think she was waiting
for her attending to sign off.

659
00:25:29,487 --> 00:25:31,989
OK.

660
00:25:31,990 --> 00:25:34,658
Oh, one of the med students
took a header.

661
00:25:34,659 --> 00:25:36,118
I parked her in the lounge
under the guise

662
00:25:36,119 --> 00:25:37,536
of a work comp report.

663
00:25:37,537 --> 00:25:38,704
Will you just go in there,
eyeball her,

664
00:25:38,705 --> 00:25:40,164
and make sure she's all right?

665
00:25:40,165 --> 00:25:41,206
She's gonna miss
the morning arrival

666
00:25:41,207 --> 00:25:42,541
of the living dead.

667
00:25:42,542 --> 00:25:44,126
How many are we expecting?

668
00:25:44,127 --> 00:25:45,878
We were getting three,
but one died en route.

669
00:25:45,879 --> 00:25:47,713
Don't know who's luckier,
us or them.

670
00:25:47,714 --> 00:25:49,381
- What's open?
- 14.

671
00:25:49,382 --> 00:25:51,050
89-year-old woman from a SNF.

672
00:25:51,051 --> 00:25:53,385
History of emphysema, CHF, MS.

673
00:25:53,386 --> 00:25:55,220
V-fib, unresponsive
to three shocks.

674
00:25:55,221 --> 00:25:57,514
- Two rounds of epi.
- What is that?

675
00:25:57,515 --> 00:25:59,058
LUCAS chest compression system.

676
00:25:59,059 --> 00:26:00,559
Robotic CPR.

677
00:26:00,560 --> 00:26:03,062
[machine thumping]

678
00:26:03,063 --> 00:26:05,815
Everybody get a hold.
One, two, three.

679
00:26:08,193 --> 00:26:10,903
[yells]

680
00:26:10,904 --> 00:26:12,780
Students are dropping
like flies.

681
00:26:12,781 --> 00:26:14,531
Take a break.
Ice the finger.

682
00:26:14,532 --> 00:26:16,909
You can count on getting
a couple elderly patients

683
00:26:16,910 --> 00:26:19,536
every day around 7:30,
after the nursing homes

684
00:26:19,537 --> 00:26:21,914
and assisted living facilities
do their morning bed checks.

685
00:26:21,915 --> 00:26:24,083
You can practically
set your watch.

686
00:26:24,084 --> 00:26:25,417
Was there an advanced directive?

687
00:26:25,418 --> 00:26:27,419
No, full code,
per the nursing home.

688
00:26:27,420 --> 00:26:29,713
Seriously?

689
00:26:29,714 --> 00:26:32,257
LUCAS off.

690
00:26:32,258 --> 00:26:33,717
Still V-fib.

691
00:26:33,718 --> 00:26:35,260
LUCAS on.

692
00:26:35,261 --> 00:26:37,680
One more round of epi,
one more shock,

693
00:26:37,681 --> 00:26:38,847
and then we call it?

694
00:26:38,848 --> 00:26:41,935
[machine beeping]

695
00:26:43,311 --> 00:26:44,895
Joseph Spencer, 79.

696
00:26:44,896 --> 00:26:46,855
Fever and cough.
From assisted living.

697
00:26:46,856 --> 00:26:49,608
He has a history
of mild Alzheimer's.

698
00:26:49,609 --> 00:26:52,403
One, two, three.

699
00:26:52,404 --> 00:26:54,279
Pulse 130.
BP 90 over 60.

700
00:26:54,280 --> 00:26:56,448
Gave him 500 cc's normal saline.

701
00:26:56,449 --> 00:26:58,242
Hi, Mr. Spencer.
I'm Dr. King.

702
00:26:58,243 --> 00:26:59,743
This is Dr. Collins.

703
00:26:59,744 --> 00:27:01,286
How are you feeling today?

704
00:27:01,287 --> 00:27:04,540
Is it dinnertime?
I... I'm not really hungry.

705
00:27:04,541 --> 00:27:06,375
Do we have any paperwork
from the facility?

706
00:27:06,376 --> 00:27:07,626
He has a POLST.

707
00:27:07,627 --> 00:27:09,128
IV fluids
and medications are fine,

708
00:27:09,129 --> 00:27:11,130
but no intubation
and no chest compressions.

709
00:27:11,131 --> 00:27:12,589
That's helpful.

710
00:27:12,590 --> 00:27:14,299
Coarse rhonchi here.

711
00:27:14,300 --> 00:27:16,635
Right middle lobe infiltrate.

712
00:27:16,636 --> 00:27:19,471
Temp 102.
Call a code sepsis.

713
00:27:19,472 --> 00:27:20,973
- Mm-hmm.
- Code?

714
00:27:20,974 --> 00:27:22,933
To make sure
we check all of our boxes.

715
00:27:22,934 --> 00:27:25,102
The federal government audits
our sepsis bundle performance

716
00:27:25,103 --> 00:27:26,812
and publishes the data online.

717
00:27:26,813 --> 00:27:28,647
Today, it better be perfect.

718
00:27:28,648 --> 00:27:31,650
Two sets of blood cultures,
lactic acid,

719
00:27:31,651 --> 00:27:35,029
30 cc's per kilo NS,
a gram of ceftriaxone,

720
00:27:35,030 --> 00:27:38,991
500 of azithromycin,
repeat lactic in three hours.

721
00:27:38,992 --> 00:27:40,576
Nice.

722
00:27:40,577 --> 00:27:44,997
Charging, and...

723
00:27:44,998 --> 00:27:46,248
Stop.

724
00:27:46,249 --> 00:27:47,583
Call it.

725
00:27:47,584 --> 00:27:49,335
Nursing home just faxed us
a DNR.

726
00:27:49,336 --> 00:27:51,128
[scoffs] Are you kidding me?

727
00:27:51,129 --> 00:27:52,921
Power off the defibrillator
and the LUCAS.

728
00:27:52,922 --> 00:27:54,256
Complete waste
of time and money.

729
00:27:54,257 --> 00:27:55,674
Who the hell works
at that place?

730
00:27:55,675 --> 00:27:56,842
A nurse taking care
of 60 patients

731
00:27:56,843 --> 00:27:58,510
who couldn't find the form.

732
00:27:58,511 --> 00:28:00,346
She called 911 so she could
take care of the others.

733
00:28:00,347 --> 00:28:01,930
OK, let's move her
to the viewing room

734
00:28:01,931 --> 00:28:04,433
- and notify the family.
- Yep.

735
00:28:04,434 --> 00:28:07,853
One of the things we do here
is to take a moment of silence

736
00:28:07,854 --> 00:28:11,482
when we lose a patient,
to respect their humanity

737
00:28:11,483 --> 00:28:14,026
And also to remember
that this was somebody's child

738
00:28:14,027 --> 00:28:18,239
or sibling or parent, friend.

739
00:28:25,580 --> 00:28:28,499
<i>♪ I like the sound
of funky music ♪</i>

740
00:28:28,500 --> 00:28:31,377
Oh. Ow, ow!

741
00:28:31,378 --> 00:28:32,378
[music stops]

742
00:28:32,379 --> 00:28:34,088
I am so sorry.

743
00:28:34,089 --> 00:28:36,341
Maybe leave it on vibrate
while you're working.

744
00:28:39,594 --> 00:28:41,887
- Later, Doc.
- You behave yourself now.

745
00:28:41,888 --> 00:28:43,431
Always.

746
00:28:45,558 --> 00:28:48,143
Your med student's
back on her feet.

747
00:28:48,144 --> 00:28:50,521
- How old's that kid?
- I don't know. I didn't ask.

748
00:28:50,522 --> 00:28:51,897
What is she,
some sort of savant?

749
00:28:51,898 --> 00:28:53,148
I don't know. Maybe.

750
00:28:53,149 --> 00:28:54,692
Dr. Robinavitch, hi.

751
00:28:54,693 --> 00:28:56,026
I just wanted to apologize
for any trouble

752
00:28:56,027 --> 00:28:57,403
my clumsiness might have caused.

753
00:28:57,404 --> 00:28:58,737
I feel ridiculous.

754
00:28:58,738 --> 00:29:00,072
Oh, I can't tell how many times

755
00:29:00,073 --> 00:29:01,365
I've hit my head
on an overhead lamp.

756
00:29:01,366 --> 00:29:03,242
Twice I needed to get staples.

757
00:29:03,243 --> 00:29:05,744
Why don't you go work
with Dr. McKay in triage?

758
00:29:05,745 --> 00:29:07,538
That would help both of us.

759
00:29:07,539 --> 00:29:10,040
Oh, I... I don't need
special treatment.

760
00:29:10,041 --> 00:29:11,333
Good, because I don't give it.

761
00:29:11,334 --> 00:29:12,669
[exhales]

762
00:29:14,170 --> 00:29:15,587
Look, I know
I might look too young,

763
00:29:15,588 --> 00:29:17,756
but I studied
my ass off to get here.

764
00:29:17,757 --> 00:29:19,883
Probably harder than the others.

765
00:29:19,884 --> 00:29:21,301
I earned this.

766
00:29:21,302 --> 00:29:23,470
OK, look, I respect
your dedication

767
00:29:23,471 --> 00:29:25,389
and your determination,
but while you're here,

768
00:29:25,390 --> 00:29:26,765
you're my responsibility.

769
00:29:26,766 --> 00:29:27,975
And when one
of my responsibilities

770
00:29:27,976 --> 00:29:29,643
takes a header... wow!

771
00:29:29,644 --> 00:29:31,145
Abbot called
for a surgical consult

772
00:29:31,146 --> 00:29:32,438
on the SBO three hours ago.

773
00:29:32,439 --> 00:29:33,731
You're very lucky
they didn't perf.

774
00:29:33,732 --> 00:29:35,607
I'm here to see my daughter.

775
00:29:35,608 --> 00:29:37,109
I'm sorry, is that a patient?

776
00:29:37,110 --> 00:29:38,737
You're talking to her.

777
00:29:41,156 --> 00:29:42,573
Am I interrupting?

778
00:29:42,574 --> 00:29:44,116
No.

779
00:29:44,117 --> 00:29:46,285
No, we're done.
We're good.

780
00:29:46,286 --> 00:29:48,120
Come find me when you're ready
to present your next case.

781
00:29:48,121 --> 00:29:49,330
Thank you.

782
00:29:51,041 --> 00:29:53,083
So how's your first day going?

783
00:29:53,084 --> 00:29:54,376
- It's great.
- Yeah?

784
00:29:54,377 --> 00:29:55,753
Yeah, really great.

785
00:29:55,754 --> 00:29:57,796
Hey, Crash,
they're doing a dialysis

786
00:29:57,797 --> 00:29:59,590
catheter insertion in North One
if you want to check it out.

787
00:29:59,591 --> 00:30:00,966
Mm-hmm.

788
00:30:00,967 --> 00:30:02,885
- The thing...
- Did she say Crash?

789
00:30:02,886 --> 00:30:04,136
No.

790
00:30:04,137 --> 00:30:05,804
No, no, it's not crash.

791
00:30:05,805 --> 00:30:08,432
Um, she said crush,
'cause I'm always crushing it.

792
00:30:08,433 --> 00:30:10,976
[chuckles]

793
00:30:10,977 --> 00:30:12,811
Um, thanks for coming down,
Mom, but I've...

794
00:30:12,812 --> 00:30:14,563
I've got a patient.

795
00:30:14,564 --> 00:30:15,690
Bye.

796
00:30:25,158 --> 00:30:26,825
What do you want?

797
00:30:26,826 --> 00:30:29,661
Um, I... I just wanted to make
sure you're comfortable.

798
00:30:29,662 --> 00:30:34,208
I am taking a dump in a dustpan,

799
00:30:34,209 --> 00:30:36,168
so what's that fucking tell you?

800
00:30:36,169 --> 00:30:37,795
Um, I'm...

801
00:30:37,796 --> 00:30:39,463
I'm clearly...
I'm clearly in the wrong room.

802
00:30:39,464 --> 00:30:40,464
- Yeah.
- I'm sorry.

803
00:30:40,465 --> 00:30:42,174
Mm-hmm.

804
00:30:42,175 --> 00:30:44,719
[grunts, splatters]

805
00:30:46,721 --> 00:30:49,515
So it would have been nice
if someone had told me

806
00:30:49,516 --> 00:30:52,101
that Eileen Shamsi's daughter
was one of our med students.

807
00:30:52,102 --> 00:30:54,436
What, and ruin the surprise?

808
00:30:54,437 --> 00:30:56,188
Was it as awkward
as I hoped it would be?

809
00:30:56,189 --> 00:30:59,024
You... you have a mean streak
in you, you know that?

810
00:30:59,025 --> 00:31:01,026
And what's the deal
with the body in 19?

811
00:31:01,027 --> 00:31:03,195
That's Abbot's MVC vet
from last night.

812
00:31:03,196 --> 00:31:04,446
Still waiting on next of kin.

813
00:31:04,447 --> 00:31:06,031
- Supposedly on their way.
- OK.

814
00:31:06,032 --> 00:31:07,533
Can we move him
to the viewing room, at least?

815
00:31:07,534 --> 00:31:08,701
Nursing home DNR
is heading there,

816
00:31:08,702 --> 00:31:09,993
joining last night's Jane Doe.

817
00:31:09,994 --> 00:31:11,537
Coroner's office is backed up.

818
00:31:11,538 --> 00:31:15,207
Well, then our morgue
needs to take her, then.

819
00:31:15,208 --> 00:31:17,543
Perlah.

820
00:31:17,544 --> 00:31:19,086
Triathlete, Otis?

821
00:31:19,087 --> 00:31:20,212
Oh, he's stable.

822
00:31:20,213 --> 00:31:22,006
Repeat potassium is 6.1.

823
00:31:22,007 --> 00:31:24,008
Renal wrote the dialysis order.

824
00:31:24,009 --> 00:31:25,884
Tech should be down
in 15 minutes.

825
00:31:25,885 --> 00:31:28,595
Good. Thank you.

826
00:31:28,596 --> 00:31:30,055
Language mystery solved yet?

827
00:31:30,056 --> 00:31:31,223
No.

828
00:31:31,224 --> 00:31:35,019
Hey, what's your take on dogs?

829
00:31:35,020 --> 00:31:36,437
In what context?

830
00:31:36,438 --> 00:31:38,188
For kids.

831
00:31:38,189 --> 00:31:40,774
Kids and puppies go together
like fish and chips.

832
00:31:40,775 --> 00:31:42,192
Man's best friend, you know?

833
00:31:42,193 --> 00:31:43,444
Well, you don't have a dog.

834
00:31:43,445 --> 00:31:44,903
I don't have a best friend.

835
00:31:44,904 --> 00:31:46,572
- What am I?
- You're my best resident.

836
00:31:46,573 --> 00:31:47,865
Big difference.

837
00:31:47,866 --> 00:31:49,658
Yeah, but we're still friends.

838
00:31:49,659 --> 00:31:52,494
Not if this conversation
goes on much longer.

839
00:31:52,495 --> 00:31:54,538
I have a lethargic
four-year-old,

840
00:31:54,539 --> 00:31:58,375
no PMH, no antecedent illness,
no fever or vomiting.

841
00:31:58,376 --> 00:32:00,085
Parents just couldn't
wake him up this morning.

842
00:32:00,086 --> 00:32:03,047
- What room?
- Oh, south 15.

843
00:32:03,048 --> 00:32:05,090
There's no nuchal rigidity,

844
00:32:05,091 --> 00:32:09,678
no skin lesions, no focal neuro.

845
00:32:09,679 --> 00:32:12,681
He looks well fed and cared for.

846
00:32:12,682 --> 00:32:14,850
DKA from new-onset diabetes?

847
00:32:14,851 --> 00:32:16,435
No, BG 85.

848
00:32:16,436 --> 00:32:20,939
CBC, BMP, UA, and UDS ordered.

849
00:32:20,940 --> 00:32:23,151
[exhales]

850
00:32:28,740 --> 00:32:31,784
Can you wake up for me, Tyler?

851
00:32:31,785 --> 00:32:33,452
He's not usually this sleepy?

852
00:32:33,453 --> 00:32:35,621
No, and he barely flinched
for the blood test.

853
00:32:35,622 --> 00:32:37,122
He wakes up at 90 miles an hour

854
00:32:37,123 --> 00:32:38,791
and doesn't stop
till he passes out at night.

855
00:32:38,792 --> 00:32:40,125
He passes out?

856
00:32:40,126 --> 00:32:42,127
No, he just means
he goes all day.

857
00:32:42,128 --> 00:32:44,338
Any chance he could have
ingested something?

858
00:32:44,339 --> 00:32:46,632
Any pills, vitamins,

859
00:32:46,633 --> 00:32:48,801
any prescriptions
that may have been left around?

860
00:32:48,802 --> 00:32:51,178
No, that's all kept locked
in the medicine cabinet.

861
00:32:51,179 --> 00:32:53,138
The whole house is childproof.

862
00:32:53,139 --> 00:32:55,933
Uh, what about alcohol?
Anything left out?

863
00:32:55,934 --> 00:32:58,143
- No.
- What about pets?

864
00:32:58,144 --> 00:32:59,645
No.

865
00:32:59,646 --> 00:33:01,605
So he's usually,
like, quite active?

866
00:33:01,606 --> 00:33:04,441
- Very.
- Um, any injuries lately?

867
00:33:04,442 --> 00:33:05,818
No.

868
00:33:05,819 --> 00:33:07,444
Hasn't bumped his head recently?

869
00:33:07,445 --> 00:33:09,113
Not that I'm aware of,
but he does love

870
00:33:09,114 --> 00:33:10,322
roughhousing with Drew.

871
00:33:10,323 --> 00:33:11,657
But he never gets hurt.

872
00:33:11,658 --> 00:33:13,575
Oxygen level is normal.

873
00:33:13,576 --> 00:33:16,662
Good pulse and blood pressure.
No signs of infection.

874
00:33:16,663 --> 00:33:18,664
We're gonna start
with blood and urine tests,

875
00:33:18,665 --> 00:33:21,584
check for any
metabolic abnormalities.

876
00:33:24,295 --> 00:33:26,880
[groans]
It's really throbbing.

877
00:33:26,881 --> 00:33:28,173
Yeah, the blood's
under pressure.

878
00:33:28,174 --> 00:33:30,676
Gotta drain it.

879
00:33:30,677 --> 00:33:32,219
No anesthesia, or...

880
00:33:32,220 --> 00:33:35,180
I'll stop
before I hit the nail bed.

881
00:33:35,181 --> 00:33:36,558
I hope.

882
00:33:39,811 --> 00:33:41,145
Hey, eyes down here.

883
00:33:41,146 --> 00:33:42,521
Watch and learn.

884
00:33:42,522 --> 00:33:44,356
I'm just looking
who to see next.

885
00:33:44,357 --> 00:33:46,859
You're supposed to take them
in the order they arrive.

886
00:33:46,860 --> 00:33:48,318
Yeah, I know how it works.

887
00:33:48,319 --> 00:33:50,362
OK.
No need to cry about it.

888
00:33:50,363 --> 00:33:51,905
Do you want me
to choose for you?

889
00:33:51,906 --> 00:33:53,283
No.

890
00:33:55,577 --> 00:33:57,619
Wow, pain's gone.

891
00:33:57,620 --> 00:33:58,871
Thank you.

892
00:33:58,872 --> 00:34:00,289
All right.

893
00:34:00,290 --> 00:34:02,958
How about a 20-year-old cough
in eight?

894
00:34:02,959 --> 00:34:05,044
Should be easy.
Probably viral.

895
00:34:05,045 --> 00:34:06,879
I don't need an easy one.

896
00:34:06,880 --> 00:34:08,839
Suit yourself, Huckleberry.

897
00:34:08,840 --> 00:34:10,799
I'm gonna take
the splitting headache.

898
00:34:10,800 --> 00:34:13,218
Maybe I'll catch a subarachnoid
hemorrhage or something cool.

899
00:34:13,219 --> 00:34:15,054
Hey, why do you
keep calling me that?

900
00:34:15,055 --> 00:34:16,221
Huckleberry?

901
00:34:16,222 --> 00:34:18,057
It's a term of endearment.

902
00:34:18,058 --> 00:34:19,391
It sounds like sarcasm.

903
00:34:19,392 --> 00:34:20,517
You think?

904
00:34:20,518 --> 00:34:23,354
Bordering on harassment.

905
00:34:23,355 --> 00:34:24,897
Where are you from?

906
00:34:24,898 --> 00:34:26,857
Broken Bow, Nebraska.

907
00:34:26,858 --> 00:34:28,734
Jesus, where the hell is that?

908
00:34:28,735 --> 00:34:31,236
It's about three and a half
hours west of Omaha.

909
00:34:31,237 --> 00:34:33,739
Oh, yeah, just a little
south of nowhere.

910
00:34:33,740 --> 00:34:35,074
What the hell do you do there?

911
00:34:35,075 --> 00:34:37,576
My parents have a farm, so...

912
00:34:37,577 --> 00:34:40,037
You're a farm boy?

913
00:34:40,038 --> 00:34:42,039
Yeah, I guess.

914
00:34:42,040 --> 00:34:44,876
I rest my case, Huckleberry.

915
00:34:46,711 --> 00:34:50,798
[speaking native language]

916
00:34:50,799 --> 00:34:52,216
I'm so sorry, ma'am.

917
00:34:52,217 --> 00:34:54,385
We don't understand you.

918
00:34:54,386 --> 00:34:57,472
[speaking native language]

919
00:34:58,807 --> 00:35:01,433
Oh.

920
00:35:01,434 --> 00:35:04,937
Me, I'm Dr. Heather Collins.

921
00:35:04,938 --> 00:35:07,856
I'm from here.

922
00:35:07,857 --> 00:35:09,441
Portland, Oregon.

923
00:35:09,442 --> 00:35:11,026
You.

924
00:35:11,027 --> 00:35:13,779
Where are you from?

925
00:35:13,780 --> 00:35:15,323
Uh-huh.

926
00:35:16,950 --> 00:35:19,118
Uh, China?
India?

927
00:35:19,119 --> 00:35:20,285
I can't tell
where you're pointing.

928
00:35:20,286 --> 00:35:21,579
Tajikistan?

929
00:35:23,707 --> 00:35:25,082
Nepal.

930
00:35:25,083 --> 00:35:26,458
Mm.

931
00:35:26,459 --> 00:35:28,920
- You're from Nepal.
- Nepali.

932
00:35:30,755 --> 00:35:32,215
[laughs]

933
00:35:34,217 --> 00:35:35,467
Mom's got a bad burn.

934
00:35:35,468 --> 00:35:37,177
Needs wound checks
and hand therapy.

935
00:35:37,178 --> 00:35:40,139
And I got a sneaking suspicion
she may be unhoused.

936
00:35:40,140 --> 00:35:42,141
I'll talk to her.
We can offer some help.

937
00:35:42,142 --> 00:35:45,310
Thank you, I appreciate it.
Ah, you're back.

938
00:35:45,311 --> 00:35:47,646
Dr. Robby suggested
I might be of assistance.

939
00:35:47,647 --> 00:35:49,481
Yeah, I could use the company.

940
00:35:49,482 --> 00:35:51,984
Victoria Javadi,
this is Kiara Alfaro.

941
00:35:51,985 --> 00:35:53,444
She's the department
social worker,

942
00:35:53,445 --> 00:35:55,446
which pretty much makes her
an angel.

943
00:35:55,447 --> 00:35:56,989
- Welcome.
- Thanks.

944
00:35:56,990 --> 00:35:58,198
Thank you.

945
00:35:58,199 --> 00:36:00,117
So what rotation
is this for you?

946
00:36:00,118 --> 00:36:01,160
Um, third.

947
00:36:01,161 --> 00:36:02,661
I've done OB-GYN and pedes.

948
00:36:02,662 --> 00:36:04,163
You have any favorites?

949
00:36:04,164 --> 00:36:05,581
Not really.

950
00:36:05,582 --> 00:36:07,333
Well, what are you
leaning towards?

951
00:36:07,334 --> 00:36:09,251
I'm not really sure yet.

952
00:36:09,252 --> 00:36:11,003
OK, well, you have time.

953
00:36:11,004 --> 00:36:14,631
Uh, can I actually ask you
a personal question?

954
00:36:14,632 --> 00:36:17,801
I'm 20, and I've earned
the right to be here.

955
00:36:17,802 --> 00:36:19,428
Oh.

956
00:36:19,429 --> 00:36:21,430
Yeah, I don't... I don't
doubt that for a minute.

957
00:36:21,431 --> 00:36:25,517
I... I was actually wondering if
Dr. Eileen Shamsi from surgery

958
00:36:25,518 --> 00:36:27,686
is a friend
or relative of yours.

959
00:36:27,687 --> 00:36:29,480
I saw you talking to her
in the hall and I thought...

960
00:36:29,481 --> 00:36:30,899
Yeah, she's my mother.

961
00:36:32,734 --> 00:36:33,692
Oh.

962
00:36:33,693 --> 00:36:35,402
Oh, wow.

963
00:36:35,403 --> 00:36:38,197
Oh, that's cool.

964
00:36:38,198 --> 00:36:40,824
- You're really only 20?
- Yeah.

965
00:36:40,825 --> 00:36:43,202
And for the record, my...
my father also works here.

966
00:36:43,203 --> 00:36:44,661
He's an endocrinologist.

967
00:36:44,662 --> 00:36:46,038
Oh, so it's like
a family business.

968
00:36:46,039 --> 00:36:47,998
[laughs]

969
00:36:47,999 --> 00:36:50,084
I'm sorry. That was a joke.
That was a joke.

970
00:36:50,085 --> 00:36:52,002
And I'm sure that comes
with a lot of pressure.

971
00:36:52,003 --> 00:36:54,838
And as for the age thing,
I'm a 42-year-old R2,

972
00:36:54,839 --> 00:36:57,716
so I have my own haters,
trust me.

973
00:36:57,717 --> 00:36:59,718
[door beeps]
OK.

974
00:36:59,719 --> 00:37:01,220
Um, sometimes when it gets busy,

975
00:37:01,221 --> 00:37:02,888
we'll help the nurses
bring back patients.

976
00:37:02,889 --> 00:37:04,723
- OK.
- Um, OK.

977
00:37:04,724 --> 00:37:06,475
Next to come back is Fred Saeta.

978
00:37:06,476 --> 00:37:08,227
Knee pain after a fall.

979
00:37:08,228 --> 00:37:09,395
- Fred Sa...
- Hey, Doc. Hi.

980
00:37:09,396 --> 00:37:10,729
Hi. Doug Driscoll.

981
00:37:10,730 --> 00:37:12,147
Any chance
someone could see me now?

982
00:37:12,148 --> 00:37:13,899
I've been here
for, like, two hours.

983
00:37:13,900 --> 00:37:15,567
Unfortunately, Mr. Driscoll,
there's a lot of patients

984
00:37:15,568 --> 00:37:17,236
still ahead of you,
some of whom are severely ill.

985
00:37:17,237 --> 00:37:18,737
Yeah, and I got chest pains
that woke me up

986
00:37:18,738 --> 00:37:20,072
- in the middle of the night.
- Chest pain.

987
00:37:20,073 --> 00:37:21,699
- Yeah.
- No, it's not plural.

988
00:37:21,700 --> 00:37:23,909
It's just chest pain,
not chest pains.

989
00:37:23,910 --> 00:37:26,995
Yeah, and if I have more
than one, it's chest pains.

990
00:37:26,996 --> 00:37:29,164
- Are you even a real doctor?
- She's a student doctor.

991
00:37:29,165 --> 00:37:30,749
Yeah, well, keep her
the hell away from me.

992
00:37:30,750 --> 00:37:33,127
I just need to see someone, OK?
Not her.

993
00:37:33,128 --> 00:37:34,920
Isn't chest pain an emergency?
I don't...

994
00:37:34,921 --> 00:37:36,964
It looks here
like you got an EKG

995
00:37:36,965 --> 00:37:39,216
five minutes after arrival,
so it's not a heart attack.

996
00:37:39,217 --> 00:37:42,469
Yeah, but I'm supposed to get
a chest X-ray and blood tests.

997
00:37:42,470 --> 00:37:45,055
Ah, and you are next
in line for the lab tech, OK?

998
00:37:45,056 --> 00:37:47,099
So listen for your name.
Excuse me.

999
00:37:47,100 --> 00:37:49,101
- Fred...
- [retching]

1000
00:37:49,102 --> 00:37:52,146
Actually, can you get me
a wheelchair, please?

1001
00:37:52,147 --> 00:37:53,939
Uh, hi.
I'm... I'm Dr. McKay.

1002
00:37:53,940 --> 00:37:55,607
What's going on?

1003
00:37:55,608 --> 00:37:57,443
I, uh, found her
on the floor in the bathroom.

1004
00:37:57,444 --> 00:37:59,445
- She can't stop puking.
- What's her name?

1005
00:37:59,446 --> 00:38:01,447
Theresa.
She's my mom.

1006
00:38:01,448 --> 00:38:02,948
Theresa?

1007
00:38:02,949 --> 00:38:03,949
Theresa, are you taking
any medication?

1008
00:38:03,950 --> 00:38:05,242
No.

1009
00:38:05,243 --> 00:38:06,243
Any previous stomach problems?

1010
00:38:06,244 --> 00:38:07,411
Oh, no.

1011
00:38:07,412 --> 00:38:08,787
When did the vomiting begin?

1012
00:38:08,788 --> 00:38:10,414
Um, last night.

1013
00:38:10,415 --> 00:38:12,291
Last night.

1014
00:38:12,292 --> 00:38:15,085
Do you have
any dizziness or fatigue?

1015
00:38:15,086 --> 00:38:17,046
Mystery solved.

1016
00:38:17,047 --> 00:38:19,757
Our lady with the degloved foot
is Nepali.

1017
00:38:19,758 --> 00:38:22,551
Oh, hey, congratulations.

1018
00:38:22,552 --> 00:38:24,470
Otis's BP is crashing.
70 over 50.

1019
00:38:24,471 --> 00:38:27,139
Still waiting for dialysis.

1020
00:38:27,140 --> 00:38:29,475
[machine beeping rapidly]

1021
00:38:29,476 --> 00:38:31,643
How you doing there, Otis?

1022
00:38:31,644 --> 00:38:32,978
- Not so good.
- 50 liters.

1023
00:38:32,979 --> 00:38:34,397
Non-rebreather, please.

1024
00:38:39,778 --> 00:38:41,653
Oh, crap.

1025
00:38:41,654 --> 00:38:43,781
Diastolic collapse of the right
atrium and right ventricle.

1026
00:38:43,782 --> 00:38:45,282
Tamponade from uremic effusion.

1027
00:38:45,283 --> 00:38:46,658
- That's why his BP is low?
- Yep.

1028
00:38:46,659 --> 00:38:47,993
Too much fluid and pressure

1029
00:38:47,994 --> 00:38:49,661
around the heart,
chambers can't fill.

1030
00:38:49,662 --> 00:38:51,121
Otis, you've got
some fluid around your heart.

1031
00:38:51,122 --> 00:38:52,289
We need to get it off.

1032
00:38:52,290 --> 00:38:53,832
What's happening?

1033
00:38:53,833 --> 00:38:55,959
25 of Propofol,
10 cc's of lidocaine with epi,

1034
00:38:55,960 --> 00:38:57,336
pericardiocentesis tray.

1035
00:38:57,337 --> 00:38:58,712
I have to get that from central.

1036
00:38:58,713 --> 00:39:00,047
No, no.
Just open a central line kit.

1037
00:39:00,048 --> 00:39:01,674
Dr. Santos,
take the head of the bed

1038
00:39:01,675 --> 00:39:03,050
and bag him
if he stops breathing,

1039
00:39:03,051 --> 00:39:04,885
compressions
if we lose the carotid.

1040
00:39:04,886 --> 00:39:06,470
Prep and drape
the subxiphoid, please.

1041
00:39:06,471 --> 00:39:08,639
- 10 cc's of 1% with.
- Chlorhexidine here.

1042
00:39:08,640 --> 00:39:10,933
- 25 or 27-gauge?
- Long 25, 25.

1043
00:39:10,934 --> 00:39:13,852
Thank you.

1044
00:39:13,853 --> 00:39:16,438
Injecting lidocaine.

1045
00:39:16,439 --> 00:39:18,816
Pressure down.
60 over 40.

1046
00:39:18,817 --> 00:39:20,985
Right.

1047
00:39:22,737 --> 00:39:24,446
Wait, you can't ultrasound
and place.

1048
00:39:24,447 --> 00:39:26,031
I know, that's why
I'm taking the probe.

1049
00:39:26,032 --> 00:39:27,533
18-gauge thin wall

1050
00:39:27,534 --> 00:39:29,368
on a 60 cc syringe,
please, Dr. Collins.

1051
00:39:29,369 --> 00:39:31,453
Let's go.

1052
00:39:31,454 --> 00:39:34,665
You're going in right over
the center of my probe,

1053
00:39:34,666 --> 00:39:36,875
advancing very slowly.

1054
00:39:36,876 --> 00:39:39,712
We're looking
for the hyperechoic tip.

1055
00:39:39,713 --> 00:39:42,214
Very, very slowly.
Do not hit that heart.

1056
00:39:42,215 --> 00:39:43,674
Dr. Santos, do you see
that sea of black?

1057
00:39:43,675 --> 00:39:45,175
That's the effusion.

1058
00:39:45,176 --> 00:39:46,760
We're looking
for a little white dot.

1059
00:39:46,761 --> 00:39:48,554
There it is.

1060
00:39:48,555 --> 00:39:50,180
Got it.

1061
00:39:50,181 --> 00:39:51,515
Aspirating.

1062
00:39:51,516 --> 00:39:53,434
3 cc's should be enough.

1063
00:39:53,435 --> 00:39:56,562
[steady beeping]

1064
00:39:56,563 --> 00:39:57,855
Good.

1065
00:39:57,856 --> 00:39:59,106
Next, we'll place
the guide wire,

1066
00:39:59,107 --> 00:40:01,066
and then
the triple lumen catheter.

1067
00:40:01,067 --> 00:40:02,234
Pulse ox is 99.

1068
00:40:02,235 --> 00:40:05,571
Pressure is up. 124 over 78.

1069
00:40:05,572 --> 00:40:09,033
Looks like things
are back to normal.

1070
00:40:09,034 --> 00:40:10,409
That was cool.

1071
00:40:10,410 --> 00:40:12,578
Four Zofrans on board.

1072
00:40:12,579 --> 00:40:15,414
That should stop the nausea.

1073
00:40:15,415 --> 00:40:17,416
David, have you had
any vomiting?

1074
00:40:17,417 --> 00:40:21,420
- No.
- Anyone else sick at home?

1075
00:40:21,421 --> 00:40:23,714
No, it's just us.

1076
00:40:23,715 --> 00:40:27,092
My husband passed away
a few years ago, from COVID.

1077
00:40:27,093 --> 00:40:29,678
Oh, I'm so sorry.

1078
00:40:29,679 --> 00:40:31,181
Potassium, 3.1.

1079
00:40:32,974 --> 00:40:34,767
Is that bad?

1080
00:40:34,768 --> 00:40:36,101
It can cause heart problems.

1081
00:40:36,102 --> 00:40:37,436
But we're gonna correct it, OK?

1082
00:40:37,437 --> 00:40:40,064
10 in the bag, 20 PO.

1083
00:40:40,065 --> 00:40:42,775
Javadi, any questions?

1084
00:40:42,776 --> 00:40:44,401
Um...

1085
00:40:44,402 --> 00:40:46,236
uh, David, have you two traveled

1086
00:40:46,237 --> 00:40:47,780
out of the country recently?

1087
00:40:47,781 --> 00:40:50,115
We never go anywhere.

1088
00:40:50,116 --> 00:40:52,410
Is she gonna have to stay here?

1089
00:40:54,579 --> 00:40:56,121
If the rest
of the tests are good,

1090
00:40:56,122 --> 00:40:59,501
and she responds to treatment,
she can go home.

1091
00:41:06,466 --> 00:41:08,967
Mr. Milton,
my name is Dennis Whitaker.

1092
00:41:08,968 --> 00:41:10,886
I'm one
of the student doctors here.

1093
00:41:10,887 --> 00:41:12,221
I'll be seeing you first.

1094
00:41:12,222 --> 00:41:13,222
Nice to meet you.

1095
00:41:13,223 --> 00:41:15,057
BP's 150 over 90.

1096
00:41:15,058 --> 00:41:17,559
OK, that's just a touch high.

1097
00:41:17,560 --> 00:41:19,478
I forgot to take my damn
enalapril this morning.

1098
00:41:19,479 --> 00:41:20,979
Oh, we'll get that for you.

1099
00:41:20,980 --> 00:41:22,898
Tell me about this belly pain.

1100
00:41:22,899 --> 00:41:26,485
Uh, it started about here.

1101
00:41:26,486 --> 00:41:29,988
Um, woke me up
at, like, 2:00 AM.

1102
00:41:29,989 --> 00:41:31,782
Pretty intense.

1103
00:41:31,783 --> 00:41:33,909
- Lasted about an hour.
- Mm-hmm.

1104
00:41:33,910 --> 00:41:35,285
Now it's gone.

1105
00:41:35,286 --> 00:41:36,787
Any fever or vomiting?

1106
00:41:36,788 --> 00:41:38,789
Nah, I never get sick.

1107
00:41:38,790 --> 00:41:40,124
OK.

1108
00:41:40,125 --> 00:41:42,167
Uh, what did you eat last night?

1109
00:41:42,168 --> 00:41:43,961
Oh, it was my wife's birthday.

1110
00:41:43,962 --> 00:41:45,796
I took her out to Sullivan's
for a steak.

1111
00:41:45,797 --> 00:41:47,172
OK.

1112
00:41:47,173 --> 00:41:49,008
Well, the exam is pretty benign.

1113
00:41:49,009 --> 00:41:50,801
I'm gonna test for gallstones.

1114
00:41:50,802 --> 00:41:55,889
If there is a stone
and you eat fatty food,

1115
00:41:55,890 --> 00:41:59,852
there can be pain when
the gallbladder contracts.

1116
00:41:59,853 --> 00:42:01,061
Oh.
[chuckles]

1117
00:42:01,062 --> 00:42:02,730
Uh, bingo.

1118
00:42:02,731 --> 00:42:05,649
One stone.
There it is.

1119
00:42:05,650 --> 00:42:07,693
Do I need surgery?

1120
00:42:07,694 --> 00:42:10,320
Uh, you should be able
to manage with a low-fat diet.

1121
00:42:10,321 --> 00:42:13,282
But we'll send off labs
for liver and pancreas.

1122
00:42:13,283 --> 00:42:16,285
Just let us know
if you have any more pain.

1123
00:42:16,286 --> 00:42:17,703
OK.

1124
00:42:17,704 --> 00:42:19,621
Thanks.

1125
00:42:19,622 --> 00:42:21,707
Yeah, you bet.

1126
00:42:21,708 --> 00:42:23,834
Great.

1127
00:42:23,835 --> 00:42:25,669
You want an EKG?

1128
00:42:25,670 --> 00:42:27,379
For?

1129
00:42:27,380 --> 00:42:30,132
Heart attacks can present
as upper abdominal pain.

1130
00:42:30,133 --> 00:42:31,884
Um, yeah.

1131
00:42:31,885 --> 00:42:33,385
No, yeah, that's a great idea.

1132
00:42:33,386 --> 00:42:35,847
Thank you.

1133
00:42:48,610 --> 00:42:50,069
I'm going as fast as I can.

1134
00:42:50,070 --> 00:42:51,403
I'm picking up
two more patients.

1135
00:42:51,404 --> 00:42:54,365
I didn't say anything.

1136
00:42:54,366 --> 00:42:56,408
I, uh... I need
a fresh set of eyes.

1137
00:42:56,409 --> 00:42:58,285
On what?

1138
00:42:58,286 --> 00:43:00,245
54-year-old woman brought in
with intractable vomiting

1139
00:43:00,246 --> 00:43:01,705
by her 18-year-old son.

1140
00:43:01,706 --> 00:43:04,292
I'm, um...
I'm getting a weird vibe.

1141
00:43:06,211 --> 00:43:07,920
How so?

1142
00:43:07,921 --> 00:43:09,880
Like, I don't know,
maybe she was given something.

1143
00:43:09,881 --> 00:43:12,424
Some sort of elder abuse.

1144
00:43:12,425 --> 00:43:14,593
There's just a strange dynamic
I can't quite figure out.

1145
00:43:14,594 --> 00:43:16,595
You're really good at
sussing out that sort of thing.

1146
00:43:16,596 --> 00:43:19,349
[laughs]
I don't know about that.

1147
00:43:21,976 --> 00:43:25,104
Uh, excuse me, Dr. Langdon.

1148
00:43:25,105 --> 00:43:27,856
Almost all of our labs are back
on sleeping boy Tyler.

1149
00:43:27,857 --> 00:43:30,567
All 100% normal.

1150
00:43:30,568 --> 00:43:32,070
What are we missing?

1151
00:43:35,865 --> 00:43:37,282
Is he waking up?

1152
00:43:37,283 --> 00:43:39,576
No, he's...
he's still fast asleep.

1153
00:43:39,577 --> 00:43:42,121
Most of the lab results
are in, and they look great.

1154
00:43:42,122 --> 00:43:44,206
No abnormal blood count, no, uh,

1155
00:43:44,207 --> 00:43:46,917
electrolyte abnormalities,
no diabetes,

1156
00:43:46,918 --> 00:43:49,753
no, um, kidney disease, so...

1157
00:43:49,754 --> 00:43:52,339
Good.
So... so what's wrong with him?

1158
00:43:52,340 --> 00:43:54,633
We're still trying
to figure that out.

1159
00:43:54,634 --> 00:43:57,344
Did he, uh, have a playdate
yesterday, by chance?

1160
00:43:57,345 --> 00:43:58,804
No, he had preschool,

1161
00:43:58,805 --> 00:44:00,305
but he was fine
when I picked him up.

1162
00:44:00,306 --> 00:44:02,141
Any kids in his class ill?

1163
00:44:02,142 --> 00:44:03,642
No, my phone tree
would have lit up

1164
00:44:03,643 --> 00:44:05,144
if someone else was sick.

1165
00:44:05,145 --> 00:44:06,937
He eat anything this morning?

1166
00:44:06,938 --> 00:44:08,605
No.

1167
00:44:08,606 --> 00:44:10,441
Why?

1168
00:44:10,442 --> 00:44:13,360
It looks like
some sort of gelatin.

1169
00:44:13,361 --> 00:44:14,820
Any chance he could have gotten

1170
00:44:14,821 --> 00:44:17,322
into some bath beads
or laundry pods?

1171
00:44:17,323 --> 00:44:19,158
No, there's no such thing
in our house.

1172
00:44:19,159 --> 00:44:20,617
What about gummies?

1173
00:44:20,618 --> 00:44:22,828
No, we're very strict
about candy.

1174
00:44:22,829 --> 00:44:24,122
Right?

1175
00:44:26,708 --> 00:44:29,668
Oh, shit.

1176
00:44:29,669 --> 00:44:30,961
Danny.

1177
00:44:30,962 --> 00:44:32,171
What about Danny?

1178
00:44:32,172 --> 00:44:34,631
Your brother, he...

1179
00:44:34,632 --> 00:44:36,675
he gave me some gummies
he got in Cleveland.

1180
00:44:36,676 --> 00:44:39,511
They were in my coat pocket.

1181
00:44:39,512 --> 00:44:41,180
Are you fucking serious?

1182
00:44:41,181 --> 00:44:42,348
Pot gummies?

1183
00:44:42,349 --> 00:44:44,683
Yes. I'm so sorry.

1184
00:44:44,684 --> 00:44:46,852
Let me call the lab.
Maybe the tox screen is back.

1185
00:44:46,853 --> 00:44:49,063
Hey, this is Dr. Langdon
from the ED.

1186
00:44:49,064 --> 00:44:51,023
Can I fast-track a lab
on a little boy,

1187
00:44:51,024 --> 00:44:52,983
last name Jones,
first name Tyler, tox screen?

1188
00:44:52,984 --> 00:44:54,693
Get the fuck out!
I mean it.

1189
00:44:54,694 --> 00:44:56,528
Why don't we step outside,
and maybe you can help me

1190
00:44:56,529 --> 00:44:59,073
figure out
how much he may have taken.

1191
00:44:59,074 --> 00:45:00,532
Thanks.

1192
00:45:00,533 --> 00:45:03,911
I appreciate
that quick turnaround.

1193
00:45:03,912 --> 00:45:05,371
The labs confirm it.

1194
00:45:05,372 --> 00:45:07,915
Your son tested positive
for cannabis.

1195
00:45:07,916 --> 00:45:09,334
This is a fucking nightmare.

1196
00:45:13,922 --> 00:45:17,841
Theresa, David, this is
my attending, Dr. Robinavitch.

1197
00:45:17,842 --> 00:45:19,385
Hi, I'm Dr. Robby.

1198
00:45:19,386 --> 00:45:21,679
We need to do a pelvic exam.

1199
00:45:21,680 --> 00:45:24,306
And David, I don't think you
want to be in here for that.

1200
00:45:24,307 --> 00:45:26,058
Definitely not.

1201
00:45:26,059 --> 00:45:28,977
Can you have Nurse Perlah
come join me, please?

1202
00:45:28,978 --> 00:45:32,064
Do you want a coffee
or a soda or something?

1203
00:45:32,065 --> 00:45:33,482
Why do I need a pelvic exam?

1204
00:45:33,483 --> 00:45:36,402
Uh, you don't.

1205
00:45:36,403 --> 00:45:38,028
Your son seems like a nice kid.

1206
00:45:38,029 --> 00:45:40,239
He's clearly worried about you.

1207
00:45:40,240 --> 00:45:42,741
But your exam and your labs
are not matching

1208
00:45:42,742 --> 00:45:44,159
any of the usual diagnoses,

1209
00:45:44,160 --> 00:45:45,704
so I'm not really sure
what's going on.

1210
00:45:47,580 --> 00:45:49,331
I'm not here for me.

1211
00:45:49,332 --> 00:45:51,625
- I'm here for David.
- I don't understand.

1212
00:45:51,626 --> 00:45:53,127
He said that you've had
persistent vomiting,

1213
00:45:53,128 --> 00:45:54,461
some... some dehydration.

1214
00:45:54,462 --> 00:45:57,297
I made myself sick with ipecac.

1215
00:45:57,298 --> 00:45:59,758
To induce vomiting?
Why would you do that?

1216
00:45:59,759 --> 00:46:02,928
So David would bring me here.

1217
00:46:02,929 --> 00:46:05,097
My son has some problems.

1218
00:46:05,098 --> 00:46:07,224
He needs professional help.

1219
00:46:07,225 --> 00:46:08,642
OK.
What kind of problems?

1220
00:46:08,643 --> 00:46:11,937
Drugs, alcohol?

1221
00:46:11,938 --> 00:46:15,482
I found some of his writing.

1222
00:46:15,483 --> 00:46:20,612
I thought it was schoolwork,
but it wasn't.

1223
00:46:20,613 --> 00:46:23,992
It was lists of girls
he wanted to hurt.

1224
00:46:37,172 --> 00:46:38,714
Hurt them how?

1225
00:46:38,715 --> 00:46:42,260
He said, "They should all
be eliminated."

1226
00:46:44,804 --> 00:46:46,555
Has David seen a therapist?

1227
00:46:46,556 --> 00:46:48,891
No.

1228
00:46:48,892 --> 00:46:52,478
He's not a bad kid,
but I'm afraid he's troubled,

1229
00:46:52,479 --> 00:46:53,854
and I didn't want
to call the police

1230
00:46:53,855 --> 00:46:55,439
because I was afraid
they'd overreact.

1231
00:46:55,440 --> 00:46:57,816
- He's just a kid.
- How old is David?

1232
00:46:57,817 --> 00:47:01,320
He just turned 18 last month.

1233
00:47:01,321 --> 00:47:02,863
Then he's considered an adult

1234
00:47:02,864 --> 00:47:06,825
and he would have to consent
to treatment.

1235
00:47:06,826 --> 00:47:08,369
Do you have any guns
in the house?

1236
00:47:08,370 --> 00:47:09,661
No.

1237
00:47:09,662 --> 00:47:11,205
My husband did,

1238
00:47:11,206 --> 00:47:13,707
but I got rid of all of them
after he passed.

1239
00:47:13,708 --> 00:47:15,668
He's a good soul.

1240
00:47:15,669 --> 00:47:18,797
I just don't want to see him
hurt anyone or himself.

1241
00:47:21,508 --> 00:47:23,342
How are you feeling, Crash?

1242
00:47:23,343 --> 00:47:25,844
I'd really appreciate
if you didn't call me that.

1243
00:47:25,845 --> 00:47:27,846
Why not?
It's a cool nickname.

1244
00:47:27,847 --> 00:47:31,141
You earned it.
You should own it.

1245
00:47:31,142 --> 00:47:33,519
I don't like it.

1246
00:47:33,520 --> 00:47:36,898
All right.
It's just a joke.

1247
00:47:39,526 --> 00:47:43,028
You know, if it makes you
feel any better,

1248
00:47:43,029 --> 00:47:46,950
I sharted the first time
I saw an emergency C-section.

1249
00:47:48,410 --> 00:47:50,786
Really?

1250
00:47:50,787 --> 00:47:52,580
Of course not.

1251
00:48:01,965 --> 00:48:05,384
Excuse me.
I'll be right back.

1252
00:48:05,385 --> 00:48:07,052
I got a situation.

1253
00:48:07,053 --> 00:48:09,555
18-year-old kid brings in
his dehydrated mom.

1254
00:48:09,556 --> 00:48:11,265
Dad died during the pandemic.

1255
00:48:11,266 --> 00:48:13,559
Mom's vomiting is self-induced
for the sole purpose

1256
00:48:13,560 --> 00:48:15,185
of getting him here
after she finds

1257
00:48:15,186 --> 00:48:17,271
his death list for classmates.

1258
00:48:17,272 --> 00:48:20,691
I... OK.

1259
00:48:20,692 --> 00:48:22,568
What does she want us to do?

1260
00:48:22,569 --> 00:48:24,403
Help him, protect him, save him.

1261
00:48:24,404 --> 00:48:27,906
- Where is he now?
- Talking to McKay.

1262
00:48:27,907 --> 00:48:29,366
How are you doing?

1263
00:48:29,367 --> 00:48:30,826
Me? I'm good.

1264
00:48:30,827 --> 00:48:32,411
I'm always good.
You know that.

1265
00:48:32,412 --> 00:48:34,329
Do I?
Does anybody?

1266
00:48:34,330 --> 00:48:37,249
- I'm an open book.
- Not even close.

1267
00:48:37,250 --> 00:48:39,001
You do know you can always
come talk to me, right?

1268
00:48:39,002 --> 00:48:40,753
Yep.

1269
00:48:40,754 --> 00:48:43,088
Zofran. It's what...

1270
00:48:43,089 --> 00:48:45,841
- How's it going over here?
- Good, good.

1271
00:48:45,842 --> 00:48:48,093
We're just going over
aftercare instructions,

1272
00:48:48,094 --> 00:48:49,720
prescription medications,
special diet

1273
00:48:49,721 --> 00:48:51,347
for the next few days.

1274
00:48:51,348 --> 00:48:53,223
Dr. McKay, can you check
orthostatics on Mom?

1275
00:48:53,224 --> 00:48:54,600
I can.

1276
00:48:54,601 --> 00:48:55,934
David, I wanted you
to meet Kiara.

1277
00:48:55,935 --> 00:48:57,269
She's a social worker here
who helps

1278
00:48:57,270 --> 00:48:59,104
in situations like this.

1279
00:48:59,105 --> 00:49:01,398
We heard about
your father's passing.

1280
00:49:01,399 --> 00:49:02,941
We're really sorry.

1281
00:49:02,942 --> 00:49:05,069
And we know that it can put
a lot of pressure

1282
00:49:05,070 --> 00:49:08,155
on somebody your age,
which combined with school

1283
00:49:08,156 --> 00:49:11,241
and now having to take care
of your mom, that's a lot.

1284
00:49:11,242 --> 00:49:13,118
It's fine.

1285
00:49:13,119 --> 00:49:14,828
We just want to make sure
that when your mom goes home,

1286
00:49:14,829 --> 00:49:16,163
you can handle it.

1287
00:49:16,164 --> 00:49:17,456
We want to make sure
you have someone

1288
00:49:17,457 --> 00:49:18,999
you can talk to if you need to.

1289
00:49:19,000 --> 00:49:20,334
I'm OK.

1290
00:49:20,335 --> 00:49:23,253
I don't need to talk to anybody.

1291
00:49:23,254 --> 00:49:24,672
After a parent dies,

1292
00:49:24,673 --> 00:49:27,091
the sadness can last
a long time.

1293
00:49:27,092 --> 00:49:29,093
How's that going for you?

1294
00:49:29,094 --> 00:49:31,053
It's not a problem.

1295
00:49:31,054 --> 00:49:32,471
What about school?

1296
00:49:32,472 --> 00:49:33,889
What about it?

1297
00:49:33,890 --> 00:49:36,141
Anything you enjoy there?

1298
00:49:36,142 --> 00:49:39,478
Not really.

1299
00:49:39,479 --> 00:49:42,606
A lot of people have thoughts
that can disturb them.

1300
00:49:42,607 --> 00:49:44,817
If you've had any,
it's OK to talk about it.

1301
00:49:44,818 --> 00:49:47,486
What's that have to do
with my mom?

1302
00:49:47,487 --> 00:49:49,988
- Is she gonna be OK?
- Yeah, she's gonna be fine.

1303
00:49:49,989 --> 00:49:51,323
She's probably got
a stomach virus,

1304
00:49:51,324 --> 00:49:52,825
maybe food poisoning.

1305
00:49:52,826 --> 00:49:55,160
I think she's more worried
about you.

1306
00:49:55,161 --> 00:49:57,079
She always worries about me.

1307
00:49:57,080 --> 00:50:00,666
- Does she have a reason to?
- No.

1308
00:50:00,667 --> 00:50:03,836
It's almost 8:00.
I gotta go.

1309
00:50:03,837 --> 00:50:05,963
Are you sure you wouldn't
prefer to wait with your mom?

1310
00:50:05,964 --> 00:50:07,339
I'm late for school.

1311
00:50:07,340 --> 00:50:10,134
She can just call me
when she's ready.

1312
00:50:10,135 --> 00:50:11,552
It would actually be
kind of helpful

1313
00:50:11,553 --> 00:50:12,845
to talk to you some more.

1314
00:50:12,846 --> 00:50:15,514
Hey, David.

1315
00:50:15,515 --> 00:50:17,391
David.

1316
00:50:17,392 --> 00:50:18,517
Just give me five minutes.

1317
00:50:18,518 --> 00:50:19,685
Leave me alone!

1318
00:50:19,686 --> 00:50:22,355
[people gasping]

1319
00:50:28,570 --> 00:50:30,988
Hey, David!

1320
00:50:30,989 --> 00:50:32,449
Shit.

1321
00:50:34,534 --> 00:50:36,368
Robby!

1322
00:50:36,369 --> 00:50:38,537
Robby.

1323
00:50:38,538 --> 00:50:40,289
Got a college kid,
respiratory arrest,

1324
00:50:40,290 --> 00:50:41,458
coming in hot.

1325
00:50:43,960 --> 00:50:46,879
[indistinct chatter]

1326
00:50:46,880 --> 00:50:49,882
[tense music]

1327
00:50:49,883 --> 00:50:56,014
♪ ♪

1328
00:50:57,766 --> 00:51:00,309
[baby crying]

1329
00:51:00,310 --> 00:51:03,270
[high-pitched ringing]

1330
00:51:03,271 --> 00:51:09,568
♪ ♪

1331
00:51:09,569 --> 00:51:12,363
[machine beeping rapidly]

1332
00:51:12,364 --> 00:51:15,532
Robby, we need to intubate here.

1333
00:51:15,533 --> 00:51:16,909
Dr. Adamson just went down

1334
00:51:16,910 --> 00:51:18,577
with a pulse ox of 65.

1335
00:51:18,578 --> 00:51:21,538
[breathing heavily]

1336
00:51:21,539 --> 00:51:24,042
[ringing intensifies]

1337
00:51:26,836 --> 00:51:28,129
Robby!

1338
00:51:36,596 --> 00:51:39,515
[The Smile's "No Words"]

1339
00:51:39,516 --> 00:51:46,648
♪ ♪

1340
00:52:13,591 --> 00:52:16,260
<i>♪ You're not so tough ♪</i>

1341
00:52:16,261 --> 00:52:18,929
<i>♪ Your need to be loved ♪</i>

1342
00:52:18,930 --> 00:52:21,515
<i>♪ You roast in the desert ♪</i>

1343
00:52:21,516 --> 00:52:24,268
<i>♪ A scorched earth ♪</i>

1344
00:52:24,269 --> 00:52:26,812
<i>♪ Your mind come loose ♪</i>

1345
00:52:26,813 --> 00:52:29,648
<i>♪ The monster's back ♪</i>

1346
00:52:29,649 --> 00:52:32,151
<i>♪ Toward a mirage ♪</i>

1347
00:52:32,152 --> 00:52:35,529
<i>♪ No words ♪</i>

1348
00:52:35,530 --> 00:52:37,573
♪ ♪

1349
00:52:37,574 --> 00:52:40,242
<i>♪ You're not so tough ♪</i>

1350
00:52:40,243 --> 00:52:42,953
<i>♪ A whip, no crack ♪</i>

1351
00:52:42,954 --> 00:52:45,622
<i>♪ A sudden switch ♪</i>

1352
00:52:45,623 --> 00:52:48,334
<i>♪ A constant threat that ♪</i>

1353
00:52:48,335 --> 00:52:50,836
{\an8}<i>♪ You'll torch the place ♪</i>

1354
00:52:50,837 --> 00:52:52,588
{\an8}<i>♪ That plants are ♪</i>

1355
00:52:52,589 --> 00:52:54,090
<i>♪ Snakes ♪</i>