1 00:00:21,855 --> 00:00:23,898 Oh, okay. 2 00:00:23,899 --> 00:00:25,483 Where are we now? 3 00:00:25,484 --> 00:00:27,485 {\an8}Got the VRI for our deaf patient in Central 12. 4 00:00:27,486 --> 00:00:29,529 {\an8}Still waiting on Pedes for Baby Jane Doe. 5 00:00:29,530 --> 00:00:31,489 {\an8}Central 6 is sitting pretty with his insulin drip. 6 00:00:31,490 --> 00:00:33,115 {\an8}And the Westbridge diversions are 7 00:00:33,116 --> 00:00:34,450 kindly waiting their turn to sit 8 00:00:34,451 --> 00:00:36,035 for hours in our lovely halls. 9 00:00:36,036 --> 00:00:37,995 You are some kind of savant. 10 00:00:37,996 --> 00:00:39,080 Worthy of a raise? 11 00:00:39,081 --> 00:00:40,957 Just more of my love. 12 00:00:40,958 --> 00:00:42,333 I got enough of that. 13 00:00:42,334 --> 00:00:44,585 I have a sexual assault victim in triage. 14 00:00:44,586 --> 00:00:46,963 I called PAAR, so an advocate is on the way. 15 00:00:46,964 --> 00:00:49,090 Okay. We'll take care of it. 16 00:00:49,091 --> 00:00:52,218 Uh, Dr. McKay, what's going on with your patient in Central 9? 17 00:00:52,219 --> 00:00:53,553 Isn't she good to go? 18 00:00:53,554 --> 00:00:55,263 Oh, she was, but she decided 19 00:00:55,264 --> 00:00:56,764 she wanted to stay in the hospital now 20 00:00:56,765 --> 00:00:58,099 because she's in too much pain. 21 00:00:58,100 --> 00:00:59,976 In our loud and overcrowded ED 22 00:00:59,977 --> 00:01:02,311 with more Westbridge cases arriving every moment? 23 00:01:02,312 --> 00:01:04,313 She would be more comfortable at home. 24 00:01:04,314 --> 00:01:07,733 The debrief was lovely. 25 00:01:07,734 --> 00:01:09,277 Thank you. 26 00:01:09,278 --> 00:01:11,320 Would you mind helping Dana with a sexual assault victim 27 00:01:11,321 --> 00:01:13,239 - who just came in? - Of course. Sure. 28 00:01:13,240 --> 00:01:15,074 Why don't you and I go see if we can't convince 29 00:01:15,075 --> 00:01:16,826 - your patient to leave? - All right. 30 00:01:16,827 --> 00:01:19,495 I need to take care of a sexual assault victim in triage. 31 00:01:19,496 --> 00:01:21,247 One of you needs to hold down the fort. 32 00:01:21,248 --> 00:01:23,916 We can call for a SANE. On a holiday? Could be hours. 33 00:01:23,917 --> 00:01:25,668 We're not gonna make this patient wait. 34 00:01:25,669 --> 00:01:26,877 And since I'm the only SANE on staff-- 35 00:01:26,878 --> 00:01:28,213 Princess will cover. 36 00:01:30,090 --> 00:01:31,757 Hey! Hey! 37 00:01:31,758 --> 00:01:33,301 You two better not be teaching her any bad habits. 38 00:01:33,302 --> 00:01:35,886 - Come on. You ready, Doc? - Sure. 39 00:01:35,887 --> 00:01:38,848 A SANE is a Sexual Assault Nurse Examiner. 40 00:01:38,849 --> 00:01:40,975 We do forensic exams, collect evidence, 41 00:01:40,976 --> 00:01:43,686 and hand it over to the police if a report is made. 42 00:01:43,687 --> 00:01:45,688 We also provide resources, support, 43 00:01:45,689 --> 00:01:47,982 - sometimes even testimony. - You go to court? 44 00:01:47,983 --> 00:01:50,943 SANEs are very valuable in a hospital, especially an ED. 45 00:01:50,944 --> 00:01:52,903 More nurses should train for it. 46 00:01:52,904 --> 00:01:55,073 That's a not so subtle hint. 47 00:02:03,165 --> 00:02:05,333 Looks like this is the new hot spot, huh? 48 00:02:05,334 --> 00:02:06,834 And only getting hotter. 49 00:02:06,835 --> 00:02:08,753 Any word on what's going on with Westbridge? 50 00:02:08,754 --> 00:02:10,087 I got 20 on lantern flies. 51 00:02:10,088 --> 00:02:12,131 Nope, nothing. 52 00:02:12,132 --> 00:02:15,551 These patient passports have an interesting alternative use. 53 00:02:15,552 --> 00:02:17,053 Where's the sexual assault victim? 54 00:02:17,054 --> 00:02:18,638 She's in Triage, Chair 2. 55 00:02:18,639 --> 00:02:20,640 Thanks, Lupe. 56 00:02:20,641 --> 00:02:21,682 Here's her intake. 57 00:02:21,683 --> 00:02:23,602 Got it. 58 00:02:29,983 --> 00:02:32,026 Hi, Ms. Miller. 59 00:02:32,027 --> 00:02:33,319 I'm Dana. 60 00:02:33,320 --> 00:02:34,862 How are you doing? 61 00:02:34,863 --> 00:02:37,490 - I've been better. - Yeah. 62 00:02:37,491 --> 00:02:38,908 You're in a safe place now. 63 00:02:38,909 --> 00:02:40,660 I'm the charge nurse in the ED 64 00:02:40,661 --> 00:02:42,912 and a sexual assault nurse examiner. 65 00:02:42,913 --> 00:02:44,622 This is Emma, who will be assisting. 66 00:02:44,623 --> 00:02:46,123 And I'm Dr. Al-Hashimi. 67 00:02:46,124 --> 00:02:47,500 I'll be checking you for any injuries 68 00:02:47,501 --> 00:02:50,211 that need immediate attention. 69 00:02:50,212 --> 00:02:52,088 You can just call me Ilana. 70 00:02:52,089 --> 00:02:53,422 I don't have any injuries. 71 00:02:53,423 --> 00:02:55,091 Okay, that's good. 72 00:02:55,092 --> 00:02:56,884 We're gonna get a room ready for you. 73 00:02:56,885 --> 00:02:58,969 Meanwhile, Dr. Al-Hashimi is gonna ask you a few questions. 74 00:02:58,970 --> 00:03:01,055 How long is this gonna take? 75 00:03:01,056 --> 00:03:02,640 I can't promise an exact time, 76 00:03:02,641 --> 00:03:05,643 but we'll try to be as fast as you need. 77 00:03:05,644 --> 00:03:07,145 - Thank you. - Yeah. 78 00:03:11,108 --> 00:03:14,443 Okay, Ilana, do you take any prescription medications? 79 00:03:14,444 --> 00:03:16,445 Just Synthroid, one tab a day. 80 00:03:16,446 --> 00:03:18,406 Okay, and any allergies to medications? 81 00:03:18,407 --> 00:03:20,449 - No. No. - Okay. 82 00:03:20,450 --> 00:03:22,493 Dana will come get you when the room is ready, 83 00:03:22,494 --> 00:03:24,830 and I'll be back to finish your exam. 84 00:03:31,712 --> 00:03:33,254 Come find me when she's in a gown. 85 00:03:33,255 --> 00:03:34,839 Will do. 86 00:03:34,840 --> 00:03:36,674 We're gonna use Triage Exam Rooms 1 and 2 for this. 87 00:03:36,675 --> 00:03:39,677 It's the most private space we have away from the ED. 88 00:03:39,678 --> 00:03:41,470 All right, this can be a lot. 89 00:03:41,471 --> 00:03:43,431 You up for it? 90 00:03:43,432 --> 00:03:44,598 Yeah. 91 00:03:44,599 --> 00:03:46,308 Yes. I'm good. 92 00:03:46,309 --> 00:03:48,729 Let me know if you need to step out. 93 00:03:55,026 --> 00:03:57,571 Yes. 94 00:03:59,740 --> 00:04:01,407 Dr. Ellis. 95 00:04:01,408 --> 00:04:03,576 - Oh, no. - Oh, yes. 96 00:04:03,577 --> 00:04:04,827 Need the room. 97 00:04:04,828 --> 00:04:06,829 Find another place to lay your head. 98 00:04:06,830 --> 00:04:09,415 Not even a 20-minute power nap? 99 00:04:09,416 --> 00:04:11,041 You know, my double is at 1:30. I'm-- 100 00:04:11,042 --> 00:04:13,043 Nope, we're getting Westbridge diversions. 101 00:04:13,044 --> 00:04:14,253 And chairs is insane. 102 00:04:14,254 --> 00:04:15,755 - Did you see out there? - No. 103 00:04:15,756 --> 00:04:17,465 I do not come in through that mess. 104 00:04:17,466 --> 00:04:19,216 Okay. 105 00:04:19,217 --> 00:04:20,426 Yeah. 106 00:04:20,427 --> 00:04:21,886 People sleep in here? 107 00:04:21,887 --> 00:04:24,096 Yeah, the night shift docs just need rest, 108 00:04:24,097 --> 00:04:26,015 especially if they have to come in during the day. 109 00:04:26,016 --> 00:04:28,100 But today, we can't waste the space. 110 00:04:28,101 --> 00:04:33,440 I need you to get me a stool on wheels and Esme for a turnover. 111 00:04:36,318 --> 00:04:39,821 So you're having a headache and abdominal pain? 112 00:04:43,408 --> 00:04:45,201 Yeah, that's right. 113 00:04:45,202 --> 00:04:47,954 Okay, and which would you say is worse? 114 00:04:51,291 --> 00:04:53,125 My headache was terrible last week... 115 00:04:53,126 --> 00:04:56,170 But now-- 116 00:04:56,171 --> 00:04:57,421 Hey, you're-- you're breaking up. 117 00:04:57,422 --> 00:04:59,048 Can you run that back again? 118 00:04:59,049 --> 00:05:00,550 Sure. 119 00:05:03,470 --> 00:05:05,721 My headache was terrible last week... 120 00:05:05,722 --> 00:05:09,308 But now my abdominal pain-- 121 00:05:09,309 --> 00:05:10,392 Oh, my God. 122 00:05:10,393 --> 00:05:12,436 Come on, you piece of-- 123 00:05:12,437 --> 00:05:14,021 fuck. 124 00:05:14,022 --> 00:05:15,440 Um-- 125 00:05:41,216 --> 00:05:43,717 I'll--I'll be right back. 126 00:05:43,718 --> 00:05:45,512 Sorry. 127 00:05:51,643 --> 00:05:53,102 Um, Dr. Al-Hashimi? 128 00:05:53,103 --> 00:05:54,854 Jackson's parents are here. 129 00:05:54,855 --> 00:05:57,398 Okay. I'll take that. 130 00:05:57,399 --> 00:06:00,317 Um, Mr. and Mrs. Davis, this is one of my attendings, 131 00:06:00,318 --> 00:06:02,570 - Dr. Al-Hashimi. - Hi. Nice to meet you. 132 00:06:02,571 --> 00:06:04,697 - Demi. - Charles. 133 00:06:04,698 --> 00:06:06,532 What the hell's going on? 134 00:06:06,533 --> 00:06:08,450 He's barely conscious. 135 00:06:08,451 --> 00:06:10,160 Jackson's just a little tired due to the sedative 136 00:06:10,161 --> 00:06:12,246 - he was given. - You sedated him? 137 00:06:12,247 --> 00:06:14,623 Oh, your son was brought in extremely agitated. 138 00:06:14,624 --> 00:06:15,958 You'd be, too, if you were tased. 139 00:06:15,959 --> 00:06:18,210 And why the fuck did they do that? 140 00:06:18,211 --> 00:06:20,963 This is bullshit. We're taking him home. 141 00:06:20,964 --> 00:06:23,008 Why don't we step out for a second? 142 00:06:31,433 --> 00:06:34,852 Right now, Jackson is on an involuntary psych hold. 143 00:06:34,853 --> 00:06:36,770 What? That's not necessary. 144 00:06:36,771 --> 00:06:38,147 He just needs some rest. 145 00:06:38,148 --> 00:06:40,107 He's been studying for the bar exam. 146 00:06:40,108 --> 00:06:41,525 We can watch him at home. 147 00:06:41,526 --> 00:06:43,110 So far, all of his tests look good, 148 00:06:43,111 --> 00:06:46,196 but Jackson has reported hearing voices. 149 00:06:46,197 --> 00:06:47,781 This could be serious. 150 00:06:47,782 --> 00:06:49,867 Dr. Jefferson will come back and speak with you. 151 00:06:49,868 --> 00:06:53,037 He can explain more of what may be going on with Jackson. 152 00:06:53,038 --> 00:06:54,538 And who is Dr. Jefferson? 153 00:06:54,539 --> 00:06:56,498 He's from Psychiatry, and he's excellent. 154 00:06:56,499 --> 00:06:58,626 He can explain next steps and answer all of your questions. 155 00:06:58,627 --> 00:07:01,211 Javadi, why don't you take the Davises to the family room? 156 00:07:01,212 --> 00:07:02,588 - Sure. - Excuse me. 157 00:07:02,589 --> 00:07:03,965 It's just this way. 158 00:07:25,528 --> 00:07:28,238 You have reached the Pittsburgh Neuroscience Group. 159 00:07:28,239 --> 00:07:30,282 If this is a medical emergency, 160 00:07:30,283 --> 00:07:33,285 please hang up and dial 911. 161 00:07:33,286 --> 00:07:36,330 For our address and office hours, press 1. 162 00:07:36,331 --> 00:07:39,083 To refill a prescription, press 2. 163 00:07:39,084 --> 00:07:43,671 To leave a message for the doctor on call-- 164 00:07:43,672 --> 00:07:45,839 Hi, this is Dr. Baran al-Hashimi. 165 00:07:45,840 --> 00:07:47,758 I'm a patient of Dr. Fairgraves. 166 00:07:47,759 --> 00:07:51,637 I need to speak to him if he's on call. 167 00:07:51,638 --> 00:07:54,974 If he's not, I'll take his next available appointment. 168 00:07:54,975 --> 00:07:58,310 And please call me if he has a cancellation. 169 00:07:58,311 --> 00:08:00,187 Thank you. 170 00:08:00,188 --> 00:08:02,731 Like I said, you're more than welcome to stay down here 171 00:08:02,732 --> 00:08:04,566 until an inpatient bed opens up upstairs. 172 00:08:04,567 --> 00:08:07,945 But that can take a while, sometimes days, 173 00:08:07,946 --> 00:08:10,280 even longer. 174 00:08:10,281 --> 00:08:11,865 It's gonna be really noisy here, 175 00:08:11,866 --> 00:08:13,367 and you won't get any rest. 176 00:08:13,368 --> 00:08:15,160 At home, you'll be surrounded by your family 177 00:08:15,161 --> 00:08:18,664 and be more comfortable. 178 00:08:18,665 --> 00:08:20,875 It's your choice, Roxie. 179 00:08:22,919 --> 00:08:25,879 It's not that I don't wanna go home, but-- 180 00:08:25,880 --> 00:08:27,965 - Hi, Mom. - Mom. 181 00:08:27,966 --> 00:08:31,760 Lena texted me to come back. I figured I'd bring the boys. 182 00:08:31,761 --> 00:08:34,263 What's going on? Is everything okay? 183 00:08:34,264 --> 00:08:38,058 Robby, police officer, incoming trauma. 184 00:08:38,059 --> 00:08:39,184 Coming. 185 00:08:39,185 --> 00:08:40,519 I'll be right back. 186 00:08:40,520 --> 00:08:42,188 We'll give you a chance to talk. 187 00:08:44,566 --> 00:08:47,277 Okay, why don't you have a seat? 188 00:08:54,951 --> 00:08:57,454 Do you need anything before we begin? 189 00:09:02,208 --> 00:09:04,918 You're in control now, Ilana. 190 00:09:04,919 --> 00:09:07,629 We're here to help and support you. 191 00:09:07,630 --> 00:09:11,091 Once I open this kit, I cannot leave the room. 192 00:09:11,092 --> 00:09:14,178 But if you need a break or some air, just let us know. 193 00:09:14,179 --> 00:09:17,431 Okay? Emma can go with you if you like. 194 00:09:17,432 --> 00:09:19,975 An advocate from Pittsburgh Action Against Rape 195 00:09:19,976 --> 00:09:21,643 has been called, and they should arrive soon. 196 00:09:21,644 --> 00:09:24,354 - Can we start? - Sure. 197 00:09:24,355 --> 00:09:25,731 I'm gonna put my face shield on 198 00:09:25,732 --> 00:09:27,941 so I don't contaminate anything. 199 00:09:27,942 --> 00:09:30,903 Emma has already done the same. 200 00:09:30,904 --> 00:09:34,990 Now, in order for the doctor to do her exam, 201 00:09:34,991 --> 00:09:36,366 I need you in a gown, 202 00:09:36,367 --> 00:09:37,785 but I need to collect your clothing first. 203 00:09:37,786 --> 00:09:39,788 Is that okay? 204 00:09:43,583 --> 00:09:46,668 I'm gonna need you to undress on top of these pads. 205 00:09:46,669 --> 00:09:49,588 Put each item of clothing on the pads, okay? 206 00:09:49,589 --> 00:09:53,258 Then we'll package each piece in a separate bag. 207 00:09:53,259 --> 00:09:54,384 We'll get you new clothes. 208 00:09:54,385 --> 00:09:55,761 - Don't worry. - All right. 209 00:09:55,762 --> 00:09:57,513 Emma's gonna be behind this curtain, 210 00:09:57,514 --> 00:10:00,557 and I'll be in here with you. 211 00:10:00,558 --> 00:10:03,560 And take off your shoes first. 212 00:10:03,561 --> 00:10:08,107 When you're done, I want you to put on your gown 213 00:10:08,108 --> 00:10:11,111 open in the back. 214 00:10:35,385 --> 00:10:37,636 What if the mom doesn't wanna leave? 215 00:10:37,637 --> 00:10:40,014 Well, then she's gonna have to put up with us. 216 00:10:41,891 --> 00:10:44,768 I can't imagine--her boys. 217 00:10:44,769 --> 00:10:46,478 Oh, don't go there. 218 00:10:46,479 --> 00:10:48,230 I'm gonna see if I can grease the wheels, 219 00:10:48,231 --> 00:10:49,439 get her a room upstairs soon. 220 00:10:49,440 --> 00:10:51,358 Good luck. What was that? 221 00:10:51,359 --> 00:10:52,860 Battle plan for our hall space. 222 00:10:52,861 --> 00:10:54,361 It's filling up fast. 223 00:10:54,362 --> 00:10:56,029 Police officer should be here any minute. 224 00:10:56,030 --> 00:10:57,948 Yeah, well, as soon as you can, please, 225 00:10:57,949 --> 00:10:59,283 I need you to fix the VRI. 226 00:10:59,284 --> 00:11:00,617 All right. Thanks. 227 00:11:00,618 --> 00:11:02,161 Santos, I need you to pick up some more 228 00:11:02,162 --> 00:11:03,704 - of these Westbridge diversions. - Sure. 229 00:11:03,705 --> 00:11:05,122 You want my firstborn too? 230 00:11:05,123 --> 00:11:07,291 Maybe. Will they know how to suture? 231 00:11:07,292 --> 00:11:08,917 Intubated neck wound, sats not great. 232 00:11:08,918 --> 00:11:11,003 We were diverted here. Is there a trauma room open? 233 00:11:11,004 --> 00:11:12,713 - Trauma 1! - What's the story? 234 00:11:12,714 --> 00:11:15,382 My buddy, Officer Hiro, high-velocity GSW. 235 00:11:15,383 --> 00:11:16,758 He's getting harder to bag. 236 00:11:16,759 --> 00:11:19,595 Warehouse robbery gone sideways. 237 00:11:19,596 --> 00:11:20,762 One, two, three. 238 00:11:20,763 --> 00:11:22,139 You guys wait here. 239 00:11:22,140 --> 00:11:23,891 We'll take care of him, I promise. 240 00:11:23,892 --> 00:11:25,642 I thought you left us already for the open road? 241 00:11:25,643 --> 00:11:27,227 And miss seeing you in uniform? 242 00:11:27,228 --> 00:11:28,979 You should see me as a flight attendant. 243 00:11:28,980 --> 00:11:31,190 - Did you do this intubation? - Under active fire, yeah. 244 00:11:31,191 --> 00:11:32,774 Are you serious? 245 00:11:32,775 --> 00:11:34,443 I go in with the team in case there's an injury. 246 00:11:34,444 --> 00:11:35,903 That's badass. 247 00:11:35,904 --> 00:11:37,529 Dr. Santos, let's make sure these lungs are up. 248 00:11:37,530 --> 00:11:39,323 - Could you see the cords? - Yeah, there was a great view, 249 00:11:39,324 --> 00:11:41,116 but it was hard to pass after I cleared them. 250 00:11:41,117 --> 00:11:42,951 Yeah, sats down to 85. 251 00:11:42,952 --> 00:11:44,995 Dr. Santos, what could cause respiratory failure 252 00:11:44,996 --> 00:11:46,580 in an intubated patient? 253 00:11:46,581 --> 00:11:47,915 There are a lot of possibilities. 254 00:11:47,916 --> 00:11:49,333 Think DOPE. 255 00:11:49,334 --> 00:11:51,710 Displacement, Obstruction, Pneumothorax, 256 00:11:51,711 --> 00:11:53,045 Equipment failure. 257 00:11:53,046 --> 00:11:55,589 Good lung sliding, no pneumo. 258 00:11:55,590 --> 00:11:57,090 It is displacement. 259 00:11:57,091 --> 00:11:59,552 Okay, that is a transected trachea. 260 00:12:01,554 --> 00:12:03,639 Pulling out. 261 00:12:03,640 --> 00:12:05,140 Bag. 262 00:12:05,141 --> 00:12:06,683 But if you intubate again, won't it just come straight 263 00:12:06,684 --> 00:12:08,143 - out the wound? - Yep, exactly. 264 00:12:08,144 --> 00:12:09,561 So we're gonna need another plan. 265 00:12:09,562 --> 00:12:11,271 Okay. Sats down to 83. 266 00:12:11,272 --> 00:12:12,773 Yeah, he's not moving any air. 267 00:12:12,774 --> 00:12:14,691 Okay, I need a neonatal mask. 268 00:12:14,692 --> 00:12:17,194 - Neonatal? - Yep. 269 00:12:17,195 --> 00:12:19,696 I'm just going to finish my initial exam. 270 00:12:19,697 --> 00:12:21,866 Let me know if you feel any pain, okay? 271 00:12:25,662 --> 00:12:28,372 My legs are fine. 272 00:12:28,373 --> 00:12:29,998 All looks good. 273 00:12:29,999 --> 00:12:32,542 No need for X-rays or advanced imaging. 274 00:12:32,543 --> 00:12:33,961 Got it. 275 00:12:33,962 --> 00:12:36,505 - Two areas of ecchymosis... - That means bruising. 276 00:12:36,506 --> 00:12:38,173 Over the shoulders bilaterally. 277 00:12:38,174 --> 00:12:39,883 - I'll document with photos. - Okay. 278 00:12:39,884 --> 00:12:42,010 Dana will finish up her work, and I will be in the ER 279 00:12:42,011 --> 00:12:43,720 if you have any questions. 280 00:12:43,721 --> 00:12:45,305 You're in great hands. 281 00:12:45,306 --> 00:12:47,891 Thank you. 282 00:12:47,892 --> 00:12:50,227 All right, Ilana. 283 00:12:50,228 --> 00:12:52,187 I read your intake. 284 00:12:52,188 --> 00:12:53,563 Why don't you give me your description 285 00:12:53,564 --> 00:12:55,108 of exactly what happened? 286 00:12:57,986 --> 00:13:02,114 I was at a 4th of July barbecue 287 00:13:02,115 --> 00:13:04,950 with a bunch of friends. 288 00:13:04,951 --> 00:13:07,662 I helped set up. 289 00:13:15,044 --> 00:13:16,586 Where does it hurt? 290 00:13:16,587 --> 00:13:20,048 Like here, under my belly button. 291 00:13:20,049 --> 00:13:23,427 Okay, do you have any fever, vomiting, diarrhea? 292 00:13:23,428 --> 00:13:26,847 Oh, no. It's--it's just a stomachache. 293 00:13:26,848 --> 00:13:29,141 Okay, well, still, go see the nurse and have her call me. 294 00:13:29,142 --> 00:13:30,600 Okay. 295 00:13:30,601 --> 00:13:33,061 But I'm still having ice cream tonight. 296 00:13:33,062 --> 00:13:35,230 Why don't you see how you feel later? 297 00:13:35,231 --> 00:13:38,775 It--it's not bad. You don't have to get so sad. 298 00:13:38,776 --> 00:13:41,153 I'm not sad. I'm--I'm good. 299 00:13:41,154 --> 00:13:43,488 Your face doesn't look good. 300 00:13:43,489 --> 00:13:44,906 Oh. 301 00:13:44,907 --> 00:13:46,992 Well, you still wanna watch the fireworks tonight? 302 00:13:46,993 --> 00:13:48,286 {\an8}I have our headphones-- 303 00:13:49,912 --> 00:13:52,373 {\an8}- I'm not being rude. - Sorry, Becca. I gotta go. 304 00:13:58,379 --> 00:14:01,757 Elliot Green, 17, syncopal episode at football practice. 305 00:14:01,758 --> 00:14:03,633 Look, I just got dizzy, okay? 306 00:14:03,634 --> 00:14:05,218 It's hell week. I need to get back. 307 00:14:05,219 --> 00:14:06,970 Yeah, okay, tough guy. 308 00:14:06,971 --> 00:14:10,974 A and O, systolic of 95, tachy at 122, no meds, no allergies. 309 00:14:10,975 --> 00:14:12,476 How long were you at practice? 310 00:14:12,477 --> 00:14:14,978 I started at 9:00, so, like, four hours. 311 00:14:14,979 --> 00:14:17,439 Four hours in this heat with all that gear? 312 00:14:17,440 --> 00:14:19,567 No pain, no game. 313 00:14:21,527 --> 00:14:24,072 God, I'm hungry. 314 00:14:25,615 --> 00:14:28,992 Hey. When's our break? There's no breaks down here. 315 00:14:28,993 --> 00:14:32,037 Always make sure you pack a protein bar, something quick. 316 00:14:32,038 --> 00:14:35,957 Ogilvie, Joy, jump in on this. 317 00:14:35,958 --> 00:14:37,459 Syncope at football practice. 318 00:14:37,460 --> 00:14:40,629 No, I just-- I just needed to hydrate. 319 00:14:40,630 --> 00:14:42,005 Possible heatstroke? 320 00:14:42,006 --> 00:14:43,256 Well, with heatstroke, you would have 321 00:14:43,257 --> 00:14:44,633 an altered mental status. 322 00:14:44,634 --> 00:14:46,134 And they're usually dry, not sweaty. 323 00:14:46,135 --> 00:14:48,011 Mortality is 50%, especially in the elderly. 324 00:14:48,012 --> 00:14:50,264 In extreme heat like this... 325 00:14:51,307 --> 00:14:52,766 Langdon, can you cover this? 326 00:14:52,767 --> 00:14:55,268 - No problem. - Mr. Diaz. Orlando. 327 00:14:55,269 --> 00:14:57,145 Orlando, where are you going? 328 00:14:57,146 --> 00:14:58,980 - Home. Can you take these out? - Uh, no. 329 00:14:58,981 --> 00:15:01,108 It takes 48 hours for you to get out of DKA. 330 00:15:01,109 --> 00:15:02,901 Your blood is still full of acid. 331 00:15:02,902 --> 00:15:04,486 Look, I can't add thousands of dollars 332 00:15:04,487 --> 00:15:05,779 to the 100 grand I already owe. 333 00:15:05,780 --> 00:15:07,697 I'm--I'm sorry. 100 grand? 334 00:15:07,698 --> 00:15:09,950 In medical debt. My wife doesn't even know. 335 00:15:09,951 --> 00:15:11,952 I'll never be able to pay it off as it is. 336 00:15:11,953 --> 00:15:13,161 Where are your wife and daughter? 337 00:15:13,162 --> 00:15:14,621 Maybe we can all talk. 338 00:15:14,622 --> 00:15:16,206 I told them to go back to work a couple hours ago. 339 00:15:16,207 --> 00:15:17,874 But the hospital is giving you a big discount. 340 00:15:17,875 --> 00:15:19,668 And, Mr. Diaz, I know it's not ideal, 341 00:15:19,669 --> 00:15:21,420 but can you stay for at least 12 hours? 342 00:15:21,421 --> 00:15:23,130 It would get you out of the danger zone. 343 00:15:23,131 --> 00:15:25,715 No. I really can't. 344 00:15:25,716 --> 00:15:29,177 Every minute I stay is a meal, shoes, school supplies. 345 00:15:29,178 --> 00:15:31,680 Plus, I have a second job I have to get to by 4:00. 346 00:15:31,681 --> 00:15:34,599 - You need fluids! - I drink plenty of water. 347 00:15:34,600 --> 00:15:36,977 And potassium and insulin. Okay, how about this? 348 00:15:36,978 --> 00:15:39,729 You stay and I'll get together everything you'll need at home. 349 00:15:39,730 --> 00:15:44,067 Also, a referral to Northside Christian Health Center. 350 00:15:44,068 --> 00:15:46,445 Come on. You don't work until 4:00. 351 00:15:46,446 --> 00:15:49,156 It'll keep you from passing out on the job again-- 352 00:15:49,157 --> 00:15:50,408 or worse. 353 00:15:54,370 --> 00:15:55,912 Okay, I guess. 354 00:15:55,913 --> 00:15:57,080 Great. 355 00:15:57,081 --> 00:15:58,916 Thank you. Please. 356 00:16:02,295 --> 00:16:03,879 Sats up to 98. 357 00:16:03,880 --> 00:16:06,631 - Neonatal mask is working. - Santos, finish the FAST. 358 00:16:06,632 --> 00:16:07,924 What--what are you injecting? 359 00:16:07,925 --> 00:16:09,176 Lido with epi. 360 00:16:09,177 --> 00:16:10,677 It'll clamp off any little bleeders. 361 00:16:10,678 --> 00:16:12,179 We need some skin hooks. 4 Shiley? 362 00:16:12,180 --> 00:16:14,556 Mm, I don't like the curve of a Shiley. 363 00:16:14,557 --> 00:16:16,224 I didn't know you were so picky. 364 00:16:16,225 --> 00:16:17,309 Santos, take a break. 365 00:16:17,310 --> 00:16:19,436 Help me cut down a 6-0 ET tube. 366 00:16:19,437 --> 00:16:20,854 What is going on here? 367 00:16:20,855 --> 00:16:22,564 You have a field medic assisting you? 368 00:16:22,565 --> 00:16:23,940 Dr. Abbot is an attending, 369 00:16:23,941 --> 00:16:25,484 and he's also a SWAT physician. 370 00:16:25,485 --> 00:16:28,653 My buddy Hiro here is in bad need of an airway. 371 00:16:28,654 --> 00:16:30,030 - Cut it right here. - We can do this. 372 00:16:30,031 --> 00:16:31,281 No, no, I got it. 373 00:16:31,282 --> 00:16:32,407 You must be Gloria's new hire. 374 00:16:32,408 --> 00:16:33,909 Yes. Dr. Al-Hashimi. 375 00:16:33,910 --> 00:16:36,036 Well, I'd shake your hand, but my tube is ready. 376 00:16:36,037 --> 00:16:37,829 And if I could find and secure the distal trachea, 377 00:16:37,830 --> 00:16:39,164 we have a shot at this. 378 00:16:39,165 --> 00:16:41,625 Okay, keeping an eye on the sats. 379 00:16:41,626 --> 00:16:43,752 Slow is smooth. Smooth is fast. 380 00:16:43,753 --> 00:16:46,129 You know, you can call me just to say hi sometimes. 381 00:16:46,130 --> 00:16:47,422 What's up now? 382 00:16:47,423 --> 00:16:48,965 GSW with tracheal transection. 383 00:16:48,966 --> 00:16:52,344 Very retracted, but I think I can get it. 384 00:16:52,345 --> 00:16:54,095 Both lungs are up? 385 00:16:54,096 --> 00:16:56,473 - Sats down to 91. - Scanning the belly now. 386 00:16:56,474 --> 00:16:57,975 Okay. 387 00:16:59,519 --> 00:17:01,270 I got it. I got it. 388 00:17:04,190 --> 00:17:06,191 Gently, gently, or we're gonna lose it. 389 00:17:06,192 --> 00:17:08,026 Down to 89. 390 00:17:08,027 --> 00:17:09,194 Oh, no. 391 00:17:09,195 --> 00:17:11,155 I'm in. Balloon up. 392 00:17:13,074 --> 00:17:15,784 End tidal, excellent wave form. 393 00:17:15,785 --> 00:17:17,953 Good breath sounds. 394 00:17:17,954 --> 00:17:21,456 I'll sew the tracheal to the skin, 2-0 silk. 395 00:17:21,457 --> 00:17:23,166 - Sats are coming up. - Whoo. 396 00:17:23,167 --> 00:17:25,627 Not bad, Abbot. 397 00:17:25,628 --> 00:17:27,754 Mm, while you were playing with that airway, 398 00:17:27,755 --> 00:17:29,839 you missed a big bruise in the left upper quadrant. 399 00:17:29,840 --> 00:17:31,258 He was wearing body armor. 400 00:17:31,259 --> 00:17:32,509 High-velocity projectile doesn't have 401 00:17:32,510 --> 00:17:34,553 to penetrate to damage. 402 00:17:34,554 --> 00:17:37,013 There's no fluid in the suprasplenic space. 403 00:17:37,014 --> 00:17:39,224 Let me look. 404 00:17:39,225 --> 00:17:40,434 Okay, right there. 405 00:17:42,728 --> 00:17:45,105 Looks like a subcapsular hematoma of his spleen. 406 00:17:45,106 --> 00:17:46,648 Must have been a big impact. 407 00:17:46,649 --> 00:17:49,568 AR-15 muzzle velocity is 3,000 feet per second. 408 00:17:49,569 --> 00:17:51,069 CT angio of the neck ASAP, 409 00:17:51,070 --> 00:17:53,697 along with CT chest, abdomen, pelvis. 410 00:17:53,698 --> 00:17:56,867 Yep, just as soon as we secure this tube. 411 00:18:00,413 --> 00:18:02,998 - First liter's in. - Mucous membranes dry. 412 00:18:02,999 --> 00:18:05,208 Pupils 4 millimeters reactive. 413 00:18:05,209 --> 00:18:06,585 Did you get tackled today? 414 00:18:06,586 --> 00:18:08,003 No, just running drills. 415 00:18:08,004 --> 00:18:09,921 Any chest pain? Palpitations? 416 00:18:09,922 --> 00:18:11,256 No. 417 00:18:11,257 --> 00:18:12,632 Hands off, please, running the 12 lead. 418 00:18:12,633 --> 00:18:14,134 How are we looking? 419 00:18:14,135 --> 00:18:15,760 Good. Healthy kid. 420 00:18:15,761 --> 00:18:17,262 No history, no trauma. 421 00:18:17,263 --> 00:18:20,223 Differential for syncope in an adolescent? 422 00:18:20,224 --> 00:18:22,350 Cardiac arrhythmia from drugs... 423 00:18:22,351 --> 00:18:23,602 - Hypovolemia, seizure... - Long QT, WPW... 424 00:18:23,603 --> 00:18:25,228 - Sepsis. - Or Brugada. 425 00:18:25,229 --> 00:18:27,522 Uh, Brugada is more common in Asian males. 426 00:18:27,523 --> 00:18:29,024 But still should be considered. 427 00:18:29,025 --> 00:18:30,525 Long odds, though. 428 00:18:30,526 --> 00:18:32,444 Brugada prevalence is 1 in 20,000 in North America, 429 00:18:32,445 --> 00:18:35,280 as high as 1 in 300 in Asia and the Middle East. 430 00:18:35,281 --> 00:18:36,615 And? 431 00:18:36,616 --> 00:18:38,783 First described in 1992, has a high incidence 432 00:18:38,784 --> 00:18:40,660 of sudden death among young patients with otherwise 433 00:18:40,661 --> 00:18:43,163 - structurally normal hearts-- - Oof, oof, wait. 434 00:18:43,164 --> 00:18:44,789 Did you just say "sudden death"? 435 00:18:44,790 --> 00:18:46,249 Temp is 102.5. 436 00:18:46,250 --> 00:18:47,667 Sorry, our student doctors are discussing 437 00:18:47,668 --> 00:18:50,170 a rare condition you don't have. 438 00:18:50,171 --> 00:18:53,381 I--I just didn't drink enough water. 439 00:18:53,382 --> 00:18:56,384 I overheated. 440 00:18:56,385 --> 00:18:57,927 Not my type, bud. 441 00:18:57,928 --> 00:19:01,098 Other than standard labs, what else to order? 442 00:19:04,560 --> 00:19:06,436 CK to rule out rhabdo. 443 00:19:06,437 --> 00:19:07,687 To make sure you don't have 444 00:19:07,688 --> 00:19:09,230 any muscle breakdown from the heat. 445 00:19:09,231 --> 00:19:11,316 Let's set up a cooling room for Elliot here 446 00:19:11,317 --> 00:19:14,612 and the other heat exhaustions we'll inevitably get today. 447 00:19:18,324 --> 00:19:19,950 Last photo. 448 00:19:23,954 --> 00:19:25,121 Okay. 449 00:19:25,122 --> 00:19:27,374 We'll take the SD card and seal it 450 00:19:27,375 --> 00:19:30,669 in an evidence envelope with everything else. 451 00:19:30,670 --> 00:19:32,045 Okay. 452 00:19:32,046 --> 00:19:36,007 Next, Emma's gonna turn off the light, 453 00:19:36,008 --> 00:19:38,510 and I'll run a blue light over your skin. 454 00:19:38,511 --> 00:19:44,140 Anything glows, I'll swab it with a wet, then dry Q-tip. 455 00:19:44,141 --> 00:19:45,392 Is that okay? 456 00:19:45,393 --> 00:19:46,519 Yeah, sure. 457 00:19:48,979 --> 00:19:50,230 All right. 458 00:19:50,231 --> 00:19:52,357 Take off your gown on the left side 459 00:19:52,358 --> 00:19:55,027 and turn a little bit towards me, just to the left. 460 00:19:56,987 --> 00:19:58,406 There. 461 00:20:23,013 --> 00:20:24,681 Something on the left wrist. 462 00:20:24,682 --> 00:20:25,850 Swab. 463 00:20:33,232 --> 00:20:34,274 Sorry. 464 00:20:34,275 --> 00:20:35,608 Don't be. 465 00:20:35,609 --> 00:20:37,402 - It's just cold. - Yeah. 466 00:20:37,403 --> 00:20:39,155 Almost done. 467 00:20:45,411 --> 00:20:47,746 - Thanks, Antoine. - No problem. 468 00:20:47,747 --> 00:20:49,372 Keep your head down out there. 469 00:20:49,373 --> 00:20:50,915 What's the story? 470 00:20:50,916 --> 00:20:52,500 Neck angio is negative, missed the carotids. 471 00:20:52,501 --> 00:20:54,294 - He's lucky. - What about the belly? 472 00:20:54,295 --> 00:20:57,172 Small splenic injury, no free fluid in the abdomen. 473 00:20:57,173 --> 00:20:59,048 - That should heal on its own. - What's the plan? 474 00:20:59,049 --> 00:21:00,508 Head and Neck will have an OR ready 475 00:21:00,509 --> 00:21:01,843 with thoracic standing by. 476 00:21:01,844 --> 00:21:03,553 How soon can they take him? 477 00:21:03,554 --> 00:21:05,096 We're a little backed up with Westbridge patients, 478 00:21:05,097 --> 00:21:06,347 but let's bring him up. 479 00:21:06,348 --> 00:21:08,850 I'll get him taken care of for you. 480 00:21:08,851 --> 00:21:10,477 Hey. 481 00:21:10,478 --> 00:21:13,605 You're gonna be okay, Hiro. We're getting you to surgery. 482 00:21:13,606 --> 00:21:14,773 I'll write the procedure note. 483 00:21:14,774 --> 00:21:15,900 Thank you. 484 00:21:20,905 --> 00:21:22,030 SWAT? Really? 485 00:21:22,031 --> 00:21:24,032 I suck at golf. 486 00:21:24,033 --> 00:21:26,367 You spend time in the Middle East? 487 00:21:26,368 --> 00:21:27,952 More than I would have liked. 488 00:21:27,953 --> 00:21:30,789 I worked in Kabul with Médecins Sans Frontières 489 00:21:30,790 --> 00:21:33,541 and in 2020, at the maternity hospital. 490 00:21:33,542 --> 00:21:37,337 I met the most incredible, bravest doctors there. 491 00:21:37,338 --> 00:21:39,672 Dasht-e-Barchi. 492 00:21:39,673 --> 00:21:42,217 Tragedy. 493 00:21:42,218 --> 00:21:45,470 We should grab a beer sometime, share war stories. 494 00:21:45,471 --> 00:21:47,556 I'd like that. 495 00:21:50,559 --> 00:21:51,559 She seems cool. 496 00:21:51,560 --> 00:21:53,144 Yep, maybe. 497 00:21:53,145 --> 00:21:56,856 I'm not gonna be around long enough to find out. 498 00:21:56,857 --> 00:21:59,108 Oh, there she is! Vic! 499 00:21:59,109 --> 00:22:00,276 Dad! 500 00:22:00,277 --> 00:22:03,571 Victoria, this is Dr. Amy Joon. 501 00:22:03,572 --> 00:22:05,406 Dr. Joon is the smartest person I know. 502 00:22:05,407 --> 00:22:06,784 Don't tell your mother. Just kidding. 503 00:22:08,160 --> 00:22:09,202 But seriously, don't. 504 00:22:09,203 --> 00:22:10,537 - Hi. - Hello. 505 00:22:10,538 --> 00:22:12,705 Are--are you here to see a patient? 506 00:22:12,706 --> 00:22:14,332 No. We're here to see you. 507 00:22:14,333 --> 00:22:15,708 Dr. Joon is Chief of Dermatology. 508 00:22:15,709 --> 00:22:17,293 And Victoria's first shift in the ER 509 00:22:17,294 --> 00:22:20,171 was on the day of the PittFest shooting. 510 00:22:20,172 --> 00:22:22,257 I heard all the incredible stories, 511 00:22:22,258 --> 00:22:26,177 including your own acts of med student prowess. 512 00:22:26,178 --> 00:22:27,929 Wow, med student prowess. 513 00:22:27,930 --> 00:22:30,056 That's-- I'm--I'm pretty sure 514 00:22:30,057 --> 00:22:31,641 I was just trying to stay out of the way. 515 00:22:31,642 --> 00:22:32,976 Ah, she's modest, like her dad. 516 00:22:32,977 --> 00:22:34,811 And her mother? 517 00:22:34,812 --> 00:22:37,021 Oh. Sorry. 518 00:22:37,022 --> 00:22:38,815 Dr. Joon. 519 00:22:38,816 --> 00:22:40,692 Yep, coming. 520 00:22:40,693 --> 00:22:42,819 I'm doing a favor for someone at the mayor's office 521 00:22:42,820 --> 00:22:45,780 who needs Mohs surgery on a basal cell carcinoma. 522 00:22:45,781 --> 00:22:47,740 And then I am grilling for 30. 523 00:22:47,741 --> 00:22:49,742 - Oh, wow. - Happy 4th, all. 524 00:22:49,743 --> 00:22:51,035 - Happy 4th. - Yeah. 525 00:22:51,036 --> 00:22:53,246 - Thanks for coming down. - My pleasure. 526 00:22:53,247 --> 00:22:55,456 - Let's grab a coffee sometime. - Absolutely. Yes. 527 00:22:55,457 --> 00:22:57,792 Thank you. 528 00:22:57,793 --> 00:23:00,336 You know Mom really wants me to go into surgery. 529 00:23:00,337 --> 00:23:02,171 Ah, your mom wants me to stop drinking 530 00:23:02,172 --> 00:23:04,632 - and join a pickleball league. - Oh, that's the same. 531 00:23:04,633 --> 00:23:06,259 - Yeah, well-- - Exact same. 532 00:23:06,260 --> 00:23:08,636 I will risk an Achilles tear before I give up scotch. 533 00:23:08,637 --> 00:23:10,722 Hey, I hope I didn't embarrass you coming down here. 534 00:23:10,723 --> 00:23:12,140 No. 535 00:23:12,141 --> 00:23:13,933 I'm just trying to present you with some options 536 00:23:13,934 --> 00:23:15,393 for your residency. 537 00:23:15,394 --> 00:23:17,478 I--I really appreciate it, Dad. 538 00:23:17,479 --> 00:23:19,647 I do. I just-- 539 00:23:19,648 --> 00:23:21,774 I'm still not sure. 540 00:23:21,775 --> 00:23:23,526 Well, either way, you'll do what's right. 541 00:23:23,527 --> 00:23:24,861 You always do. 542 00:23:24,862 --> 00:23:26,779 - Proud of ya. - Okay. 543 00:23:26,780 --> 00:23:29,365 Dr. Javadi, you are a man of many talents. 544 00:23:29,366 --> 00:23:31,159 You don't know the half of it. 545 00:23:31,160 --> 00:23:32,327 Your daughter has some 546 00:23:32,328 --> 00:23:33,912 high standards to live up to. 547 00:23:33,913 --> 00:23:36,624 Oh, you don't know the half of it. 548 00:23:39,543 --> 00:23:42,962 Mr. and Mrs. Davis, this is Dr. Jefferson from Psychiatry. 549 00:23:42,963 --> 00:23:44,839 Please call me Caleb. 550 00:23:44,840 --> 00:23:47,258 Can you tell us what's going on with our son? 551 00:23:47,259 --> 00:23:51,095 All of his labs and X-rays came back normal. 552 00:23:51,096 --> 00:23:54,766 Given his age and his hearing voices, 553 00:23:54,767 --> 00:23:59,479 do either of you have a family history of mental illness? 554 00:23:59,480 --> 00:24:00,898 Not mine. 555 00:24:07,738 --> 00:24:09,405 My brother took his own life. 556 00:24:09,406 --> 00:24:11,783 Wait, what? 557 00:24:11,784 --> 00:24:13,993 Uncle Ken? 558 00:24:13,994 --> 00:24:15,870 You said he drank himself to death. 559 00:24:15,871 --> 00:24:17,705 - Ma. - He did that too. 560 00:24:17,706 --> 00:24:18,998 Was he ever formally diagnosed 561 00:24:18,999 --> 00:24:20,208 with a mental health issue? 562 00:24:20,209 --> 00:24:21,501 No. 563 00:24:21,502 --> 00:24:24,587 He was depressed, had mood swings. 564 00:24:24,588 --> 00:24:26,381 - But he didn't wanna see anyone. - Oh, my God. 565 00:24:26,382 --> 00:24:28,549 Okay, why am I just now hearing about this? 566 00:24:28,550 --> 00:24:30,927 - Jada, please. - Please what, Mom? 567 00:24:30,928 --> 00:24:33,888 Why would you not tell Jackson or me? 568 00:24:33,889 --> 00:24:35,348 I can't believe this. 569 00:24:35,349 --> 00:24:37,100 - Jada. - Excuse me. 570 00:24:37,101 --> 00:24:38,185 Jada. 571 00:24:45,734 --> 00:24:47,610 What happens next? 572 00:24:47,611 --> 00:24:50,029 We keep your son here for the next three days 573 00:24:50,030 --> 00:24:52,031 for observation and therapy. 574 00:24:52,032 --> 00:24:54,659 And that will help us to understand what is going on. 575 00:24:54,660 --> 00:24:56,160 Jada should really hear this. 576 00:24:56,161 --> 00:24:58,956 Let me see if I can find her, bring her back. 577 00:25:01,625 --> 00:25:04,127 Okay. I'm gonna swab your mouth now. 578 00:25:04,128 --> 00:25:05,837 My mouth? 579 00:25:05,838 --> 00:25:09,841 Two dry swabs along the inside of your cheek 580 00:25:09,842 --> 00:25:11,885 and then along the gum line. 581 00:25:15,597 --> 00:25:17,558 How you feeling? 582 00:25:19,226 --> 00:25:21,227 I wish this day never happened. 583 00:25:21,228 --> 00:25:23,271 Would you like some medicine to help you relax? 584 00:25:23,272 --> 00:25:25,441 You've experienced a horrific trauma. 585 00:25:27,943 --> 00:25:29,861 You've been doing this a while? 586 00:25:29,862 --> 00:25:31,362 Let's just say Florence Nightingale 587 00:25:31,363 --> 00:25:33,364 and I were roommates. 588 00:25:33,365 --> 00:25:35,908 Who? 589 00:25:35,909 --> 00:25:37,452 I rest my case. 590 00:25:37,453 --> 00:25:39,705 She was the founder of modern nursing. 591 00:25:41,623 --> 00:25:44,000 Okay, you can have something to eat or drink now. 592 00:25:44,001 --> 00:25:46,044 - I'm fine. - Are you sure? 593 00:25:46,045 --> 00:25:47,837 I'll just keep going. 594 00:25:47,838 --> 00:25:49,798 Okay. 595 00:25:56,513 --> 00:26:01,309 We now have a heat exhaustion treatment area in North 5. 596 00:26:01,310 --> 00:26:03,811 Evaporated cooling. Great plan. 597 00:26:03,812 --> 00:26:08,524 Yeah, it was Dr. Langdon's idea. 598 00:26:08,525 --> 00:26:12,445 He figured we'd be seeing a lot more patients in this heat. 599 00:26:12,446 --> 00:26:14,197 He's right. 600 00:26:14,198 --> 00:26:15,406 How are you feeling? 601 00:26:15,407 --> 00:26:17,909 That's a loaded question. 602 00:26:17,910 --> 00:26:19,952 It wasn't meant to be. 603 00:26:19,953 --> 00:26:22,205 You have a deposition in a couple of hours? 604 00:26:22,206 --> 00:26:24,457 - Yes. - How are you feeling about it? 605 00:26:24,458 --> 00:26:26,542 Um, trying to think positively 606 00:26:26,543 --> 00:26:29,629 but feeling, um, less so. 607 00:26:29,630 --> 00:26:31,923 This job's really important to me and my sister. 608 00:26:31,924 --> 00:26:33,508 You know, I support both of us. 609 00:26:33,509 --> 00:26:34,550 It's gonna go great. 610 00:26:34,551 --> 00:26:36,219 Just tell them what happened. 611 00:26:36,220 --> 00:26:37,804 You're not at fault. Your job's not in jeopardy. 612 00:26:37,805 --> 00:26:39,889 I mean, the lawyers said that I could-- 613 00:26:39,890 --> 00:26:42,058 The lawyers' job is to try and shake your confidence. 614 00:26:42,059 --> 00:26:44,477 So don't let them. You're a very good doctor. 615 00:26:44,478 --> 00:26:46,646 I have been training residents for years. 616 00:26:46,647 --> 00:26:49,357 You are one of the very best. 617 00:26:49,358 --> 00:26:50,650 I am? 618 00:26:50,651 --> 00:26:51,818 No, we need to stick to the plan. 619 00:26:51,819 --> 00:26:52,985 - I promise. - Look. 620 00:26:52,986 --> 00:26:54,195 Thanks. 621 00:26:54,196 --> 00:26:55,530 She's not thinking clearly, okay? 622 00:26:55,531 --> 00:26:56,656 It's gonna be great. 623 00:26:56,657 --> 00:26:57,990 This is not what she wants. 624 00:26:57,991 --> 00:26:59,784 Then I'm taking her home. That's it. 625 00:26:59,785 --> 00:27:01,828 We have to honor your wife's wishes. 626 00:27:01,829 --> 00:27:03,329 Even if she's loaded up on morphine 627 00:27:03,330 --> 00:27:05,164 - and can't think straight? - Especially then. 628 00:27:05,165 --> 00:27:06,707 Hello. 629 00:27:06,708 --> 00:27:08,793 Paul Hamler, this is my attending, Dr. Robinavitch. 630 00:27:08,794 --> 00:27:10,169 - Hi. - Hi. 631 00:27:10,170 --> 00:27:12,672 Uh, my wife is not thinking clearly. 632 00:27:12,673 --> 00:27:15,216 What is it that she's asking for? 633 00:27:15,217 --> 00:27:17,468 Said she wants to stay here. 634 00:27:17,469 --> 00:27:19,429 Why don't we all go in and talk? 635 00:27:20,722 --> 00:27:22,765 Brian Jenkins is allowed to hunt with a .22 636 00:27:22,766 --> 00:27:24,225 on his grandpa's farm. 637 00:27:24,226 --> 00:27:26,269 Sounds like an accident just waiting to happen. 638 00:27:26,270 --> 00:27:28,813 Mm-hmm. And you're not Brian Jenkins. 639 00:27:28,814 --> 00:27:31,566 How are we doing in here, Roxie? 640 00:27:31,567 --> 00:27:33,192 Been better. 641 00:27:33,193 --> 00:27:34,819 Rumor has it you're still interested 642 00:27:34,820 --> 00:27:37,238 in booking a room with us? 643 00:27:37,239 --> 00:27:39,448 I don't wanna go back home yet. 644 00:27:39,449 --> 00:27:40,825 It's all set up, Rox. 645 00:27:40,826 --> 00:27:43,035 You're gonna be more comfortable at home. 646 00:27:43,036 --> 00:27:45,288 Paul, I changed my mind. 647 00:27:45,289 --> 00:27:46,665 It is our home. 648 00:27:48,625 --> 00:27:50,459 I don't-- 649 00:27:50,460 --> 00:27:52,295 I don't want you living with my ghost. 650 00:27:52,296 --> 00:27:54,255 I will happily live with your ghost. 651 00:27:54,256 --> 00:27:57,842 Can we just all stop talking about ghosts, please? 652 00:27:57,843 --> 00:27:59,051 Yes. I'm sorry. 653 00:27:59,052 --> 00:28:01,804 I'm sorry, sweetie. You're right. 654 00:28:01,805 --> 00:28:03,806 Got trauma flying in. ETA, five minutes. 655 00:28:03,807 --> 00:28:06,017 Okay. Um, I'm very sorry. 656 00:28:06,018 --> 00:28:07,560 I will be right back. 657 00:28:07,561 --> 00:28:09,896 Excuse me. 658 00:28:09,897 --> 00:28:12,315 It's a boating accident, swimmer versus propeller. 659 00:28:12,316 --> 00:28:13,649 Ouch. 660 00:28:13,650 --> 00:28:15,318 - What body parts involved? - They didn't say. 661 00:28:15,319 --> 00:28:16,819 - How old? - Nope. 662 00:28:16,820 --> 00:28:18,070 Anything? 663 00:28:18,071 --> 00:28:19,572 All I got was boating accident, 664 00:28:19,573 --> 00:28:21,533 - swimmer versus propeller. - Propeller. Got it. 665 00:28:52,397 --> 00:28:55,775 Picked a hell of a day to come back, huh? 666 00:28:55,776 --> 00:28:58,736 How's Jake? 667 00:28:58,737 --> 00:29:00,446 He's good. 668 00:29:00,447 --> 00:29:02,615 He's better. He's coping. 669 00:29:02,616 --> 00:29:04,742 He's gonna be a senior this fall. 670 00:29:04,743 --> 00:29:07,161 That's great. 671 00:29:07,162 --> 00:29:10,331 That was a lot for him to go through. 672 00:29:10,332 --> 00:29:12,416 A lot for all of us to go through. 673 00:29:12,417 --> 00:29:13,835 Yeah. 674 00:29:15,462 --> 00:29:17,505 Okay, I'm just gonna say it! 675 00:29:17,506 --> 00:29:18,965 I'm sorry. 676 00:29:18,966 --> 00:29:20,591 I betrayed your trust. 677 00:29:20,592 --> 00:29:22,593 I betrayed our patients' trust. 678 00:29:22,594 --> 00:29:23,928 And I'm really fucking sorry. 679 00:29:23,929 --> 00:29:26,306 It'll never happen again, I swear. 680 00:29:30,435 --> 00:29:34,231 I'm really glad that you got the help that you need. 681 00:29:36,733 --> 00:29:40,654 But I don't know if I want you working in my ER. 682 00:29:48,620 --> 00:29:49,912 Why'd you intubate him? 683 00:29:49,913 --> 00:29:51,289 He was splinting from the pain, 684 00:29:51,290 --> 00:29:52,873 barely moving air with sats in the 80s. 685 00:29:52,874 --> 00:29:54,250 How'd he get sliced up in the propeller? 686 00:29:54,251 --> 00:29:55,626 He was in the Allegheny 687 00:29:55,627 --> 00:29:57,044 trying to untangle a water ski tow line 688 00:29:57,045 --> 00:29:58,129 when his buddy started the engine. 689 00:29:58,130 --> 00:29:59,338 Drunk buddy, I assume? 690 00:29:59,339 --> 00:30:00,798 Well, it's 4th of July. You tell me. 691 00:30:00,799 --> 00:30:02,174 Focus on the patient, please. 692 00:30:02,175 --> 00:30:04,219 Sofie, take over bagging. 693 00:30:06,221 --> 00:30:08,431 Okay. One, two, three. 694 00:30:08,432 --> 00:30:09,558 Watch that buckle. 695 00:30:10,851 --> 00:30:12,226 - Do you need me in here? - Nope. 696 00:30:12,227 --> 00:30:14,937 We have a senior resident and an attending. 697 00:30:14,938 --> 00:30:16,230 Mel, can we start with a-- 698 00:30:16,231 --> 00:30:18,816 - An EFAST? Sure. - Yes, please. 699 00:30:18,817 --> 00:30:20,318 Why? 700 00:30:20,319 --> 00:30:21,777 To check and make sure there's no pneumothorax. 701 00:30:21,778 --> 00:30:23,487 Otherwise, it could become a tension. 702 00:30:23,488 --> 00:30:26,115 Exactly. Oh, wow. 703 00:30:26,116 --> 00:30:28,367 - You want O-neg? - Not without a BP first. 704 00:30:28,368 --> 00:30:31,412 108/64, pulse is 102. 705 00:30:31,413 --> 00:30:33,664 - Sats are good. - Okay, let's have O-neg ready, 706 00:30:33,665 --> 00:30:36,752 - but don't give it just yet. - Anything else? 707 00:30:39,004 --> 00:30:40,546 How about a hemocue? 708 00:30:40,547 --> 00:30:42,758 Uh, yeah. Yeah, yeah, of course. 709 00:30:50,724 --> 00:30:52,517 Next step is fingernails. 710 00:30:54,311 --> 00:30:56,562 We'll go under each nail, 711 00:30:56,563 --> 00:31:01,025 first with the wet swab and then with the dry one. 712 00:31:01,026 --> 00:31:03,569 Do you wanna take a break, hon? 713 00:31:03,570 --> 00:31:05,364 No. 714 00:31:08,241 --> 00:31:11,410 How much longer? 715 00:31:11,411 --> 00:31:13,121 After these, we'll get to external... 716 00:31:14,414 --> 00:31:16,333 And internal vaginal collection. 717 00:31:19,795 --> 00:31:23,506 It's the advocate from PAAR. 718 00:31:23,507 --> 00:31:25,174 They've been doing this longer than I have. 719 00:31:25,175 --> 00:31:27,551 They provide resources, assistance, and support 720 00:31:27,552 --> 00:31:29,429 for sexual assault survivors. 721 00:31:31,598 --> 00:31:34,392 Hey. 722 00:31:34,393 --> 00:31:36,685 This will not define you, okay? 723 00:31:36,686 --> 00:31:40,523 You don't have to talk to them, but I recommend you do. 724 00:31:40,524 --> 00:31:42,526 They're available 24/7. 725 00:31:44,277 --> 00:31:46,613 - Okay. - Okay. 726 00:31:52,619 --> 00:31:54,286 Hi. 727 00:31:54,287 --> 00:31:56,622 I'm Paulette Sanderson from Pittsburgh Action Against Rape. 728 00:31:56,623 --> 00:31:58,791 Hi, Paulette. I'm the SANE, Dana. 729 00:31:58,792 --> 00:32:00,793 - And this is Ilana. - Hello. 730 00:32:00,794 --> 00:32:03,295 I'm sorry to meet you under these circumstances, 731 00:32:03,296 --> 00:32:05,464 but I and my organization are here to help you navigate 732 00:32:05,465 --> 00:32:07,425 everything that comes next. 733 00:32:07,426 --> 00:32:10,511 I brought you some clothes and basic necessities. 734 00:32:10,512 --> 00:32:12,138 I can even stay with you through the rest 735 00:32:12,139 --> 00:32:14,433 of your examination if you'd like. 736 00:32:16,518 --> 00:32:18,144 I don't think that's necessary. 737 00:32:18,145 --> 00:32:20,646 - Okay. - That's fine. 738 00:32:20,647 --> 00:32:23,442 Would it be okay if I asked you a few questions? 739 00:32:33,869 --> 00:32:35,120 Sure. 740 00:32:37,414 --> 00:32:40,916 Mm, our VRI isn't working. 741 00:32:40,917 --> 00:32:43,669 Video Relay Interpreter? 742 00:32:43,670 --> 00:32:45,212 Yeah, of course I rebooted it. 743 00:32:45,213 --> 00:32:46,881 Wait, how are you gonna fix it if you don't know 744 00:32:46,882 --> 00:32:49,008 what the hell it is? 745 00:32:49,009 --> 00:32:51,177 Yeah, okay. Whatever. 746 00:32:51,178 --> 00:32:53,220 I wanna do a head and belly scan on Harlow. 747 00:32:53,221 --> 00:32:54,513 Can you try telling her why? 748 00:32:54,514 --> 00:32:55,723 What about the VRI? 749 00:32:55,724 --> 00:32:57,600 It's DOA. 750 00:32:57,601 --> 00:33:00,603 I'm charting every free minute I get. 751 00:33:00,604 --> 00:33:02,438 I wasn't coming over for that. 752 00:33:02,439 --> 00:33:04,274 Good job in the Trauma earlier. 753 00:33:07,402 --> 00:33:08,527 What's this? 754 00:33:08,528 --> 00:33:09,737 Daniel Scott, 32, 755 00:33:09,738 --> 00:33:11,530 weak and dizzy while washing his car. 756 00:33:11,531 --> 00:33:14,033 Tachy at 106, BP 90/60. 757 00:33:14,034 --> 00:33:15,493 Temp's too high to register. 758 00:33:15,494 --> 00:33:17,119 We have a cooling room set up in North 5. 759 00:33:17,120 --> 00:33:18,370 Okay, how are you feeling, Mr. Scott? 760 00:33:18,371 --> 00:33:19,538 Thirsty. 761 00:33:19,539 --> 00:33:20,915 Let's see if we can't fix that. 762 00:33:20,916 --> 00:33:22,875 He's gonna need a core temp, a CMP--whoa. 763 00:33:22,876 --> 00:33:24,418 Oh, hey, we need a trauma room. 764 00:33:24,419 --> 00:33:25,669 - What's open? - 2. 765 00:33:25,670 --> 00:33:27,213 I'll grab the Ativan. 766 00:33:27,214 --> 00:33:28,839 - Any past medical history? - No. 767 00:33:28,840 --> 00:33:30,716 Wife says he's healthy. No meds, no allergies. 768 00:33:30,717 --> 00:33:33,470 He needs a core temp. 769 00:33:37,474 --> 00:33:39,058 Ready to transfer. 770 00:33:39,059 --> 00:33:40,351 Let's give 2 of Ativan. 771 00:33:40,352 --> 00:33:41,810 Don't want him seizing again. 772 00:33:41,811 --> 00:33:43,103 I gotta get back to my patients. 773 00:33:43,104 --> 00:33:44,104 Okay. 774 00:33:44,105 --> 00:33:46,857 One, two, three. 775 00:33:46,858 --> 00:33:47,900 Orders? 776 00:33:47,901 --> 00:33:50,027 Second IV with saline open. 777 00:33:50,028 --> 00:33:53,405 Sepsis panel, UA, urine drug screen, EKG, and CK. 778 00:33:53,406 --> 00:33:55,408 I don't see any apparent trauma. 779 00:33:56,952 --> 00:33:59,745 - Pupils reactive. - Mr. Scott? Daniel? 780 00:33:59,746 --> 00:34:01,288 Can you talk to me? 781 00:34:01,289 --> 00:34:03,040 Post-ictal, but moving all extremities. 782 00:34:03,041 --> 00:34:04,959 Pulse 137, BP 88/60. 783 00:34:04,960 --> 00:34:06,585 What are you thinking, Dr. Santos? 784 00:34:06,586 --> 00:34:09,673 Uh, heat stroke, but consider sepsis or drugs. 785 00:34:13,093 --> 00:34:16,512 Rectal temp is 104.6. 786 00:34:16,513 --> 00:34:18,597 All right, let's start with four ice packs 787 00:34:18,598 --> 00:34:20,391 on the groin and axilla. 788 00:34:20,392 --> 00:34:22,268 Should we do a full body ice bath? 789 00:34:22,269 --> 00:34:23,727 That'll take too long. Do you have an Arctic Sun? 790 00:34:23,728 --> 00:34:25,104 Yeah, we do. 791 00:34:25,105 --> 00:34:26,772 Get pads on the chest, abdomen, and both legs. 792 00:34:26,773 --> 00:34:28,400 I'll check back in. 793 00:34:29,943 --> 00:34:33,404 Ceftazidime is up, and first hemoglobin, 8.2. 794 00:34:33,405 --> 00:34:36,240 8 is pretty low. He must have bled down from 14. 795 00:34:36,241 --> 00:34:37,866 Anything you wanna do about that? 796 00:34:37,867 --> 00:34:40,869 Um, young, healthy guy. We transfuse at 7. 797 00:34:40,870 --> 00:34:42,371 Do we? 798 00:34:42,372 --> 00:34:44,081 We'd be in real trouble if he equilibrates 799 00:34:44,082 --> 00:34:46,166 - from acute blood loss. - Am I interrupting something? 800 00:34:46,167 --> 00:34:48,753 - Multiple deep lacerations-- - Motorboat versus-- 801 00:34:51,423 --> 00:34:52,881 Jesus. 802 00:34:52,882 --> 00:34:54,550 This looks like some "Jurassic Park" shit. 803 00:34:54,551 --> 00:34:56,719 Is that your official surgical diagnosis? 804 00:34:56,720 --> 00:34:58,220 He is hemodynamically stable. 805 00:34:58,221 --> 00:35:00,556 What else do we know? 806 00:35:00,557 --> 00:35:04,310 Uh, intubated in the field due to poor tidal volume. 807 00:35:04,311 --> 00:35:06,562 EFAST was negative for pneumothorax, 808 00:35:06,563 --> 00:35:09,064 so no need to do a chest tube. 809 00:35:09,065 --> 00:35:11,734 And no free fluid in the abdomen, 810 00:35:11,735 --> 00:35:13,569 good hemostasis inside the wounds. 811 00:35:13,570 --> 00:35:14,945 Nothing arterial. 812 00:35:14,946 --> 00:35:16,697 At first, he had a hemoglobin of 8.2. 813 00:35:16,698 --> 00:35:18,198 We'll follow that closely. 814 00:35:18,199 --> 00:35:20,952 With no active bleeding, I wouldn't transfuse just yet. 815 00:35:23,204 --> 00:35:25,122 Dr. Langdon agrees with you. 816 00:35:25,123 --> 00:35:27,291 Let's get him to CT. 817 00:35:27,292 --> 00:35:29,710 Jason Stills, 62, was gathering the makings 818 00:35:29,711 --> 00:35:32,463 of a salad when he started feeling dizzy and nauseated. 819 00:35:32,464 --> 00:35:33,672 Vomited once. 820 00:35:33,673 --> 00:35:34,923 How are you feeling, Mr. Stills? 821 00:35:34,924 --> 00:35:36,592 Like I'm gonna die. 822 00:35:36,593 --> 00:35:38,636 Well, you came to the right place to prevent that. 823 00:35:38,637 --> 00:35:40,721 Do you mind if I touch your abdomen? 824 00:35:40,722 --> 00:35:42,890 - Yeah, sure. - Okay. 825 00:35:42,891 --> 00:35:45,225 - Does this hurt at all? - No. 826 00:35:45,226 --> 00:35:48,479 He's tachycardic at 124 with a temp of 102.4. 827 00:35:48,480 --> 00:35:50,481 Hey, Joy, what's your suggestion? 828 00:35:50,482 --> 00:35:52,149 Keep hydrating, check electrolytes, 829 00:35:52,150 --> 00:35:53,359 and move him to the cooling room. 830 00:35:53,360 --> 00:35:54,568 Precisely. 831 00:35:54,569 --> 00:35:55,778 Good luck finding a parking spot. 832 00:35:55,779 --> 00:35:58,740 - North 5. - What? No valet? 833 00:36:02,869 --> 00:36:04,620 Jada. Hey. 834 00:36:04,621 --> 00:36:06,830 I--I've been looking all over for you. 835 00:36:06,831 --> 00:36:08,332 I just went for a walk. 836 00:36:08,333 --> 00:36:11,419 I wanted to talk to you, if that's okay. 837 00:36:13,254 --> 00:36:15,089 So does Dr. Jefferson. 838 00:36:15,090 --> 00:36:17,508 It's important that you get to hear what he has to say. 839 00:36:17,509 --> 00:36:18,801 Why? 840 00:36:18,802 --> 00:36:20,886 He doesn't want me to go crazy like my brother? 841 00:36:20,887 --> 00:36:23,764 Or kill myself like my uncle? 842 00:36:23,765 --> 00:36:25,808 Of course not. 843 00:36:25,809 --> 00:36:28,727 We--we still have no idea what caused Jackson's episode. 844 00:36:28,728 --> 00:36:31,438 Episode. 845 00:36:31,439 --> 00:36:33,565 Right. 846 00:36:33,566 --> 00:36:37,820 Look, I--I know this must be so scary for you. 847 00:36:37,821 --> 00:36:41,365 And you probably feel betrayed by your parents. 848 00:36:41,366 --> 00:36:44,243 But they had no way of knowing about Jackson. 849 00:36:44,244 --> 00:36:46,620 You know, and some families just have a difficult time 850 00:36:46,621 --> 00:36:50,040 talking about mental health. 851 00:36:50,041 --> 00:36:52,084 Now you can help us take the first steps 852 00:36:52,085 --> 00:36:55,463 to finding out what we can do to help your brother. 853 00:37:00,552 --> 00:37:05,973 Mr. Diaz, I have a surprise for you. 854 00:37:05,974 --> 00:37:07,808 Oh. 855 00:37:07,809 --> 00:37:09,059 Sorry. 856 00:37:09,060 --> 00:37:10,477 It's okay. 857 00:37:10,478 --> 00:37:12,312 Have you--have you seen my patient? 858 00:37:12,313 --> 00:37:15,065 Orlando? Mr. Diaz? 859 00:37:15,066 --> 00:37:17,401 Room was empty. 860 00:37:17,402 --> 00:37:20,321 - Seriously? - Yeah. 861 00:37:24,868 --> 00:37:26,577 What happened to you? 862 00:37:26,578 --> 00:37:28,454 Oh. 863 00:37:28,455 --> 00:37:29,872 Bullet grazed my vest. 864 00:37:29,873 --> 00:37:31,081 You were shot? 865 00:37:31,082 --> 00:37:32,750 Shot at. 866 00:37:32,751 --> 00:37:35,961 Geniuses thought today was the day to rob a goods warehouse. 867 00:37:35,962 --> 00:37:37,254 Didn't think about how long it would take 868 00:37:37,255 --> 00:37:38,630 to load the appliances. 869 00:37:38,631 --> 00:37:39,923 They panicked. 870 00:37:39,924 --> 00:37:41,216 All hell broke loose. 871 00:37:41,217 --> 00:37:42,927 Jesus. 872 00:37:45,263 --> 00:37:47,222 Why do you do this? 873 00:37:47,223 --> 00:37:49,391 My therapist said I needed a hobby. 874 00:37:49,392 --> 00:37:50,976 Funny. 875 00:37:50,977 --> 00:37:53,061 Shit. 876 00:37:53,062 --> 00:37:55,230 This--this sucks. 877 00:37:55,231 --> 00:37:56,899 - Oh, it's nothing. - No. 878 00:37:56,900 --> 00:37:59,318 No, don't worry about me. I'm fine. Seriously. 879 00:37:59,319 --> 00:38:00,569 No, my patient. 880 00:38:00,570 --> 00:38:02,237 He didn't have any insurance, 881 00:38:02,238 --> 00:38:06,575 and he was already in a mountain of medical debt. 882 00:38:06,576 --> 00:38:08,535 He couldn't afford any of his meds. 883 00:38:08,536 --> 00:38:10,871 Hmm. 884 00:38:10,872 --> 00:38:12,289 What's in the bag? 885 00:38:12,290 --> 00:38:17,252 Insulin, test strips, electrolyte powder. 886 00:38:17,253 --> 00:38:20,047 I--I got him everything he needed for home care. 887 00:38:20,048 --> 00:38:22,257 So Uber it to his house. 888 00:38:22,258 --> 00:38:24,676 Is the hospital gonna pay for that? 889 00:38:24,677 --> 00:38:26,805 I'll pay for it. 890 00:38:36,898 --> 00:38:38,941 What are you doing? 891 00:38:38,942 --> 00:38:41,568 What you clearly can't. 892 00:38:41,569 --> 00:38:43,362 Did you make a chart? 893 00:38:43,363 --> 00:38:44,655 No. 894 00:38:44,656 --> 00:38:46,240 This can stay off the books. 895 00:38:46,241 --> 00:38:48,242 Don't need the paperwork from the hospital 896 00:38:48,243 --> 00:38:50,077 or the police department. 897 00:38:50,078 --> 00:38:52,162 Okay. 898 00:38:52,163 --> 00:38:53,790 Our little secret. 899 00:38:57,168 --> 00:38:59,711 How's he doing? Any more seizures? 900 00:38:59,712 --> 00:39:00,838 Nope. 901 00:39:00,839 --> 00:39:02,130 Temp 102.9. 902 00:39:02,131 --> 00:39:03,423 Labs back? 903 00:39:03,424 --> 00:39:05,050 Mostly signs of dehydration. 904 00:39:05,051 --> 00:39:08,762 A tad hypernatremic, mild BUN and creatinine bump. 905 00:39:08,763 --> 00:39:11,348 CK 400 something-- nothing worrisome yet. 906 00:39:11,349 --> 00:39:12,891 Okay, good. Keep cooling. 907 00:39:12,892 --> 00:39:14,893 - I'll monitor him. - Great. 908 00:39:14,894 --> 00:39:17,981 That'll give Dr. Santos a chance to get caught up. 909 00:39:21,317 --> 00:39:24,027 Your R2 year can be challenging. 910 00:39:24,028 --> 00:39:26,864 You just have to keep grinding. 911 00:39:26,865 --> 00:39:29,032 What's your dispo plan for Mr. Scott? 912 00:39:29,033 --> 00:39:30,868 Uh, ICU admission. 913 00:39:30,869 --> 00:39:33,036 You should call Neurology to consult. 914 00:39:33,037 --> 00:39:34,580 Yeah, done. 915 00:39:34,581 --> 00:39:37,040 Since it was exertional heat illness in a young person, 916 00:39:37,041 --> 00:39:38,750 the mortality is low. 917 00:39:38,751 --> 00:39:41,712 But non-exertional heatstroke in an elderly person, 918 00:39:41,713 --> 00:39:43,755 - you need to worry. - Okay. 919 00:39:43,756 --> 00:39:46,842 I'll put in orders for repeat labs. 920 00:39:46,843 --> 00:39:48,803 Good work in there. 921 00:40:01,691 --> 00:40:05,695 This 49-year-old woman presents to the emergency department-- 922 00:40:08,907 --> 00:40:13,619 Uh, with the chief complaint of right ear pain. 923 00:40:13,620 --> 00:40:16,413 Hey, Donnie, can you do something about that? 924 00:40:16,414 --> 00:40:17,831 What? 925 00:40:17,832 --> 00:40:19,333 Seriously? 926 00:40:19,334 --> 00:40:21,168 That--that's not driving you nuts? 927 00:40:21,169 --> 00:40:23,211 The baby, it won't stop crying. 928 00:40:23,212 --> 00:40:25,297 Oh, that? It's music to my ears now. 929 00:40:25,298 --> 00:40:26,673 I think Jesse's the nurse. 930 00:40:26,674 --> 00:40:29,302 Well, can't you--ugh. 931 00:40:35,433 --> 00:40:36,684 Fuck. 932 00:40:41,731 --> 00:40:44,191 What the hell is going on? 933 00:40:44,192 --> 00:40:46,401 With what? 934 00:40:46,402 --> 00:40:49,404 With her. Can't you make her stop crying? 935 00:40:49,405 --> 00:40:52,492 She's been fed and changed. She's cranky from rhinovirus. 936 00:40:54,118 --> 00:40:56,495 Isn't there something that you can do? 937 00:40:56,496 --> 00:40:59,122 She's due for her next Tylenol. 938 00:40:59,123 --> 00:41:00,499 Give me a minute. I'll be right back. 939 00:41:00,500 --> 00:41:02,669 Wait, no, no, no, I'm not gonna stay here. 940 00:41:05,463 --> 00:41:07,465 What is your problem? 941 00:41:10,176 --> 00:41:14,596 This is precisely why I didn't go into Pedes. 942 00:41:14,597 --> 00:41:15,806 Okay. 943 00:41:15,807 --> 00:41:17,641 Hey, hey. 944 00:41:17,642 --> 00:41:20,687 Hey, little Miss Sunshine. 945 00:41:22,188 --> 00:41:24,606 Is it time for you to take a little nap? 946 00:41:24,607 --> 00:41:26,775 That would be so fucking nice. 947 00:41:26,776 --> 00:41:28,027 Yes, it would. 948 00:41:31,239 --> 00:41:34,491 I'm starting to understand why you got left here. 949 00:41:34,492 --> 00:41:36,661 Hey, shh. 950 00:42:22,915 --> 00:42:24,541 What's the word from CT? 951 00:42:24,542 --> 00:42:27,544 Nothing intrathoracic, nothing intra-abdominal. 952 00:42:27,545 --> 00:42:29,004 Propeller just missed gutting him. 953 00:42:29,005 --> 00:42:30,422 - Very fortunate. - Okay. 954 00:42:30,423 --> 00:42:32,340 Repeat hemoglobin is 8. 955 00:42:32,341 --> 00:42:35,052 We're holding off on transfusing. 956 00:42:35,053 --> 00:42:36,636 Plan? 957 00:42:36,637 --> 00:42:38,805 I'll have Mel and Langdon suture up the lacerations. 958 00:42:38,806 --> 00:42:41,058 Wait, what? That could take days. 959 00:42:41,059 --> 00:42:42,350 I--I can't-- 960 00:42:42,351 --> 00:42:44,311 Calm down, Sadness. I'm kidding. 961 00:42:44,312 --> 00:42:46,897 This is one for my skilled surgical residents upstairs, 962 00:42:46,898 --> 00:42:48,398 not you Boy Scout butchers. 963 00:42:48,399 --> 00:42:49,775 Boy, I missed you, Yoyo. 964 00:42:49,776 --> 00:42:52,027 Mm. Can't say the same. 965 00:42:52,028 --> 00:42:55,572 Okay, let's take up this art project. 966 00:42:55,573 --> 00:42:56,907 So about before-- 967 00:42:56,908 --> 00:42:58,950 Back to it. 968 00:42:58,951 --> 00:43:00,368 Good talk. 969 00:43:00,369 --> 00:43:01,870 How we doing, Princess? 970 00:43:01,871 --> 00:43:03,455 All right. A little bloated. 971 00:43:03,456 --> 00:43:06,917 I had one too many hot dogs from the truck. 972 00:43:06,918 --> 00:43:08,960 You meant the board, huh? 973 00:43:08,961 --> 00:43:12,089 Gus, our incarcerated patient, got a spot upstairs. 974 00:43:12,090 --> 00:43:15,717 Looking for our unhoused patient, Digby, and, of course, 975 00:43:15,718 --> 00:43:18,595 we have Whitaker, Donahue, and the med students 976 00:43:18,596 --> 00:43:21,264 on these diversion intakes, but they just keep coming. 977 00:43:21,265 --> 00:43:23,225 Yeah, we may need to start just sending people up 978 00:43:23,226 --> 00:43:25,560 and ask for forgiveness instead of permission. 979 00:43:25,561 --> 00:43:28,063 Hello? 980 00:43:28,064 --> 00:43:30,357 Oh, okay. 981 00:43:30,358 --> 00:43:32,609 Yes, I will be right there. 982 00:43:32,610 --> 00:43:34,194 C-suite wants to see me upstairs. 983 00:43:34,195 --> 00:43:35,570 Ooh, called to the principal's office 984 00:43:35,571 --> 00:43:38,824 on your first day-- not a good sign. 985 00:43:38,825 --> 00:43:41,409 - I think I'm a baby whisperer. - Hey, great. 986 00:43:41,410 --> 00:43:43,620 We'll add Baby Jane Doe to your patient load. 987 00:43:43,621 --> 00:43:45,080 Forget I said anything. 988 00:43:45,081 --> 00:43:46,957 Where are we with your deaf patient, Harlow? 989 00:43:46,958 --> 00:43:50,585 Uh, the VRI was a bust, but the interpreter's on the way. 990 00:43:50,586 --> 00:43:52,546 Figured I'd just give her a head and belly scan 991 00:43:52,547 --> 00:43:54,756 - and go from there. - No, wait for the interpreter. 992 00:43:54,757 --> 00:43:57,259 No need to give the patient unnecessary radiation. 993 00:43:57,260 --> 00:43:59,636 And your charting? 994 00:43:59,637 --> 00:44:01,096 Catching up and checking it twice. 995 00:44:01,097 --> 00:44:02,556 Good. 996 00:44:02,557 --> 00:44:04,975 Hey, have you had a chance to speak to Langdon today? 997 00:44:04,976 --> 00:44:06,768 Uh, no. 998 00:44:06,769 --> 00:44:08,061 Why? Did he say something? 999 00:44:08,062 --> 00:44:09,688 No, just curious. 1000 00:44:09,689 --> 00:44:13,066 How is everything at home with you and Whitaker? 1001 00:44:13,067 --> 00:44:15,443 He's weirder than you'd expect. 1002 00:44:15,444 --> 00:44:17,237 - Hmm. - Yeah. 1003 00:44:17,238 --> 00:44:19,322 But I don't see him all that much. 1004 00:44:19,323 --> 00:44:20,949 He spends a lot of time at Amy's. 1005 00:44:20,950 --> 00:44:23,326 He has a girlfriend? 1006 00:44:23,327 --> 00:44:27,122 I don't know what to call it. 1007 00:44:27,123 --> 00:44:29,666 The--the farmer who got burned last year 1008 00:44:29,667 --> 00:44:32,252 the day of the mass cas, his widow, Amy. 1009 00:44:32,253 --> 00:44:33,545 Oh, he died? 1010 00:44:33,546 --> 00:44:35,589 Yeah, he had burns on 90% of his body. 1011 00:44:35,590 --> 00:44:37,465 His chance of survival was very slim. 1012 00:44:37,466 --> 00:44:39,050 Okay, so I'm an optimist. 1013 00:44:39,051 --> 00:44:41,636 The sun doesn't always come out tomorrow, Annie. 1014 00:44:41,637 --> 00:44:43,513 Wait, wasn't she pregnant? 1015 00:44:43,514 --> 00:44:46,183 No, she was a young orphan. 1016 00:44:46,184 --> 00:44:48,518 No, not Annie. Amy. 1017 00:44:48,519 --> 00:44:52,230 Yes. Yes, very pregnant and young. 1018 00:44:52,231 --> 00:44:54,191 Whitaker is now seeing this Amy? 1019 00:44:54,192 --> 00:44:56,234 And her baby. 1020 00:44:56,235 --> 00:44:58,069 He got really close to the family 1021 00:44:58,070 --> 00:44:59,905 when the husband was dying. 1022 00:44:59,906 --> 00:45:02,073 He really believed that the guy would pull through. 1023 00:45:02,074 --> 00:45:04,576 He helped her through the loss of her husband, 1024 00:45:04,577 --> 00:45:06,203 and then again when she had the kid, 1025 00:45:06,204 --> 00:45:09,539 and now he spends almost every weekend at the farm. 1026 00:45:09,540 --> 00:45:10,790 Huh. 1027 00:45:10,791 --> 00:45:12,250 Plus, he's on the street team, 1028 00:45:12,251 --> 00:45:14,044 and he just wants to help everybody. 1029 00:45:14,045 --> 00:45:17,172 And I just don't wanna see him taken advantage of, you know? 1030 00:45:17,173 --> 00:45:19,341 He's just a fucking Huckleberry. 1031 00:45:19,342 --> 00:45:22,093 Yeah, but he's our fucking Huckleberry. 1032 00:45:22,094 --> 00:45:23,595 I'll talk to him. 1033 00:45:23,596 --> 00:45:24,804 Hey, your call. 1034 00:45:24,805 --> 00:45:26,723 Strong deflection. Well played. 1035 00:45:26,724 --> 00:45:28,058 You're the boss. 1036 00:45:28,059 --> 00:45:29,768 Or you are until end of shift today. 1037 00:45:29,769 --> 00:45:30,977 Still the boss. 1038 00:45:30,978 --> 00:45:33,313 When you see me in here, still the boss. 1039 00:45:33,314 --> 00:45:35,732 Copy that, Boss. 1040 00:45:35,733 --> 00:45:39,194 Dr. Robby, can-- can I grab you for a second? 1041 00:45:39,195 --> 00:45:42,072 Yeah. Sure. What's up? 1042 00:45:42,073 --> 00:45:47,118 Um, can't you order my wife to go home? 1043 00:45:47,119 --> 00:45:48,788 I'm sorry. 1044 00:45:50,998 --> 00:45:52,749 My wife's dying, 1045 00:45:52,750 --> 00:45:55,627 and you're telling me there's nothing I can do? 1046 00:45:55,628 --> 00:45:57,212 Mr. Hamler, that's not-- 1047 00:45:57,213 --> 00:45:58,713 No, no. 1048 00:45:58,714 --> 00:46:01,508 There's gotta be something. 1049 00:46:01,509 --> 00:46:03,301 Please. 1050 00:46:03,302 --> 00:46:05,428 It may not seem like much, but right now, 1051 00:46:05,429 --> 00:46:07,973 you being here for her and respecting her wishes 1052 00:46:07,974 --> 00:46:10,809 is the best thing that you can do for her. 1053 00:46:10,810 --> 00:46:14,771 Supporting her and her choices is the most remarkable gift 1054 00:46:14,772 --> 00:46:18,066 that you can give her at this time. 1055 00:46:18,067 --> 00:46:20,860 And the meds we have her on will help her pain. 1056 00:46:20,861 --> 00:46:22,821 And she may get to a point where 1057 00:46:22,822 --> 00:46:25,533 she feels well enough to go home. 1058 00:46:41,590 --> 00:46:42,883 Give me one second. 1059 00:46:49,098 --> 00:46:51,016 {\an8}Okay, I'm gonna let you guys get acquainted. 1060 00:46:51,017 --> 00:46:52,392 I will be right back. 1061 00:46:52,393 --> 00:46:53,810 Oh, oh, oh, excuse me! 1062 00:46:53,811 --> 00:46:56,730 I--I'm waiting for Dr. Mohan. Is she available? 1063 00:46:56,731 --> 00:46:59,358 I will try and find her for you, sir. 1064 00:47:03,279 --> 00:47:06,364 Whether you choose to report or not, we're here for you. 1065 00:47:06,365 --> 00:47:07,741 Call me any time. 1066 00:47:07,742 --> 00:47:11,286 It could be a month or a year from now. 1067 00:47:11,287 --> 00:47:12,620 I'll follow up with you too. 1068 00:47:12,621 --> 00:47:14,414 Thank you. 1069 00:47:14,415 --> 00:47:16,167 Thanks. 1070 00:47:19,545 --> 00:47:21,171 You've had a pap smear before? 1071 00:47:21,172 --> 00:47:23,340 Yeah, every few years. 1072 00:47:23,341 --> 00:47:24,716 Good. 1073 00:47:24,717 --> 00:47:27,218 Same position, but I'll start with swabs 1074 00:47:27,219 --> 00:47:30,096 on the outside, external genitalia. 1075 00:47:30,097 --> 00:47:32,557 Then I'll use a speculum to get internal swabs. 1076 00:47:32,558 --> 00:47:34,476 You ready? Okay. 1077 00:47:34,477 --> 00:47:37,020 I'll help you get your feet in the stirrups. 1078 00:47:37,021 --> 00:47:40,065 Good. 1079 00:47:40,066 --> 00:47:42,442 Okay. All right. 1080 00:47:42,443 --> 00:47:45,403 Now, slide your bottom down. 1081 00:47:45,404 --> 00:47:48,073 Oh. Yeah, a little bit more. 1082 00:47:48,074 --> 00:47:49,699 A little more. 1083 00:47:49,700 --> 00:47:52,369 - Sorry. I--I can't. - Okay. It's okay. 1084 00:47:52,370 --> 00:47:53,953 We can take a break. No problem. 1085 00:47:53,954 --> 00:47:56,498 I don't want a break. I wanna stop. 1086 00:47:56,499 --> 00:47:59,334 Okay. Is this about reporting? 1087 00:47:59,335 --> 00:48:00,960 Because you can do this collection 1088 00:48:00,961 --> 00:48:02,587 without a police report for now. 1089 00:48:02,588 --> 00:48:05,215 And none of it goes in your permanent medical record. 1090 00:48:05,216 --> 00:48:07,133 I don't wanna do this anymore. 1091 00:48:07,134 --> 00:48:09,303 Tell me why you wanna stop. 1092 00:48:12,056 --> 00:48:14,766 He's my friend. 1093 00:48:14,767 --> 00:48:18,770 He knows all my friends. 1094 00:48:18,771 --> 00:48:22,190 It was just a dumb-- 1095 00:48:22,191 --> 00:48:24,526 he was drunk, he didn't mean it. 1096 00:48:24,527 --> 00:48:27,195 - It didn't mean anything. - Okay. 1097 00:48:27,196 --> 00:48:29,447 Okay. 1098 00:48:29,448 --> 00:48:32,534 It's okay. I understand. 1099 00:48:32,535 --> 00:48:35,036 I do. 1100 00:48:35,037 --> 00:48:39,833 Ilana, this is a difficult process, to say the least. 1101 00:48:39,834 --> 00:48:41,876 Why don't you take a breather and come back? 1102 00:48:41,877 --> 00:48:44,630 And whatever you wanna do, we'll do. 1103 00:48:52,388 --> 00:48:55,391 Let's go find the good snacks. 1104 00:49:18,289 --> 00:49:19,706 Jesus Christ. 1105 00:49:19,707 --> 00:49:21,249 Sorry. 1106 00:49:21,250 --> 00:49:23,793 Giving new meaning to the nickname Crash, huh? 1107 00:49:23,794 --> 00:49:25,336 I've been trying to get to the bathroom 1108 00:49:25,337 --> 00:49:26,880 for over an hour now. 1109 00:49:26,881 --> 00:49:29,717 Yeah, you and me both, sister. 1110 00:49:39,810 --> 00:49:42,479 Uh-oh, this can't be good. 1111 00:49:42,480 --> 00:49:43,813 Who's this? 1112 00:49:43,814 --> 00:49:45,106 That is hospital CEO Trent Norris. 1113 00:49:45,107 --> 00:49:47,609 He's the big boss. 1114 00:49:47,610 --> 00:49:49,027 Hmm. Nice outfit. 1115 00:49:49,028 --> 00:49:50,945 Hey, Rockstar. Gather your staff, please. 1116 00:49:50,946 --> 00:49:53,239 Sure, anything you wanna tell me first? 1117 00:49:53,240 --> 00:49:55,283 - No. - Okay. 1118 00:49:55,284 --> 00:49:57,619 Hey, everybody, can you, uh, gather 'round 1119 00:49:57,620 --> 00:50:00,121 and listen up for a moment, please? 1120 00:50:00,122 --> 00:50:03,666 Can I have your attention, everyone? 1121 00:50:03,667 --> 00:50:06,294 Internal disaster at Westbridge 1122 00:50:06,295 --> 00:50:08,422 has been identified as a cyberattack. 1123 00:50:11,050 --> 00:50:14,219 And now Good Dominion Hospital has been hit as well. 1124 00:50:14,220 --> 00:50:16,638 Their ambulances are being diverted over to St. Mary's, 1125 00:50:16,639 --> 00:50:20,141 but we can expect more walk-ins and Westbridge diversions. 1126 00:50:20,142 --> 00:50:21,935 Uh, for how long? 1127 00:50:21,936 --> 00:50:25,271 We don't know how long. If the ransom is paid-- 1128 00:50:25,272 --> 00:50:26,940 Ransom? 1129 00:50:26,941 --> 00:50:28,608 Are we next? 1130 00:50:28,609 --> 00:50:31,319 Our IT protection system has blocked thousands 1131 00:50:31,320 --> 00:50:32,904 of intrusion attempts in the hours 1132 00:50:32,905 --> 00:50:35,073 since Westbridge was hit this morning. 1133 00:50:35,074 --> 00:50:39,118 But IT believes we're still vulnerable. 1134 00:50:39,119 --> 00:50:41,829 So we're gonna preemptively shut down 1135 00:50:41,830 --> 00:50:43,414 all the computer systems. 1136 00:50:43,415 --> 00:50:46,084 - Oh, my God. - Jesus. 1137 00:50:46,085 --> 00:50:48,836 Patient registration, electronic health records, 1138 00:50:48,837 --> 00:50:52,006 lab and radiology interfaces, email, internet. 1139 00:50:52,007 --> 00:50:53,258 You didn't wanna talk to me first? 1140 00:50:53,259 --> 00:50:54,634 You didn't wanna consult my department? 1141 00:50:54,635 --> 00:50:57,388 I consulted your fellow attending. 1142 00:50:59,181 --> 00:51:02,016 When are we going down? 1143 00:51:02,017 --> 00:51:04,811 Soon. Very soon. 1144 00:51:04,812 --> 00:51:07,230 Okay, hey, somebody get a picture of the board. 1145 00:51:07,231 --> 00:51:10,401 Quickly, quickly! We're about to go analog. 1146 00:51:12,570 --> 00:51:14,154 - No! - Oh, my gosh. 1147 00:51:17,199 --> 00:51:19,534 - Phones work? - They don't work. 1148 00:51:19,535 --> 00:51:21,327 - Oh, my gosh. - Did you get the photo? 1149 00:51:21,328 --> 00:51:24,080 Yeah, yeah, I got it. 1150 00:51:24,081 --> 00:51:25,499 This is gonna be fun.