1 00:00:04,308 --> 00:00:04,526 . 2 00:00:04,569 --> 00:00:08,138 - Any chance you'd want to be my advisor? 3 00:00:08,182 --> 00:00:10,140 - Yeah, I'd like that. 4 00:00:10,184 --> 00:00:12,490 - We need to be deliberate and tactical 5 00:00:12,534 --> 00:00:14,318 in our approach to medicine. 6 00:00:14,362 --> 00:00:16,755 - We can't just do a three-minute evaluation. 7 00:00:16,799 --> 00:00:18,453 Gotta spend more time with the patients. 8 00:00:18,496 --> 00:00:21,282 - Maybe psychiatry just doesn't belong here. 9 00:00:21,325 --> 00:00:22,805 - I'm Jessa Rinaldi. 10 00:00:22,848 --> 00:00:24,633 We at Vasic want to make the Vas-COM 11 00:00:24,676 --> 00:00:26,156 the new standard of care. 12 00:00:26,200 --> 00:00:28,680 Doctor cooper said that you could be a real asset. 13 00:00:28,724 --> 00:00:30,726 - I am definitely interested. 14 00:00:33,337 --> 00:00:35,774 - So is anything jumping out? 15 00:00:35,818 --> 00:00:36,775 - No. 16 00:00:36,819 --> 00:00:38,168 Each of these patients, 17 00:00:38,212 --> 00:00:40,214 I think Dr. Cooper's choice to use the Vas-COM 18 00:00:40,257 --> 00:00:42,390 was appropriate. - Yeah, I did too. 19 00:00:42,433 --> 00:00:46,220 - But that's good. It's a relief, actually. 20 00:00:47,656 --> 00:00:50,180 - Mm, there he is. 21 00:00:50,224 --> 00:00:51,703 - And the rep, Jessa Rinaldi? 22 00:00:51,747 --> 00:00:54,358 Do you think she's in on it with him? 23 00:00:54,402 --> 00:00:56,708 - As far as device reps go, she's as green as they come. 24 00:00:56,752 --> 00:00:58,493 Hasn't even graduated from the backpack 25 00:00:58,536 --> 00:01:00,408 to the roller board. - [chuckles] 26 00:01:00,451 --> 00:01:02,540 - You should know, she and Dr. Cooper asked me 27 00:01:02,584 --> 00:01:05,239 to pitch the Vas-COM at Grand Rounds. 28 00:01:05,282 --> 00:01:06,849 We're having a practice round today. 29 00:01:06,892 --> 00:01:09,286 - Well, that's good. Show them you're onboard. 30 00:01:09,330 --> 00:01:10,461 Just don't agree 31 00:01:10,505 --> 00:01:13,377 to actually go through with Grand Rounds. 32 00:01:13,421 --> 00:01:14,726 - Yeah, I won't. [phone dings] 33 00:01:14,770 --> 00:01:16,119 - Oh, I gotta go. 34 00:01:16,163 --> 00:01:18,643 Hey, break a leg. 35 00:01:18,687 --> 00:01:19,775 - Thanks. 36 00:01:25,650 --> 00:01:28,784 - Oh! Hi, Dr. Halstead. Good morning. 37 00:01:28,827 --> 00:01:30,525 I didn't even see you sitting here. 38 00:01:30,568 --> 00:01:32,788 - Hiding in plain sight, I guess. 39 00:01:32,831 --> 00:01:35,182 - I am so excited for today. 40 00:01:35,225 --> 00:01:36,487 If everything goes well, 41 00:01:36,531 --> 00:01:39,142 you can start pitching the Vas-COM for real. 42 00:01:39,186 --> 00:01:40,926 - Maybe! One step at a time. 43 00:01:40,970 --> 00:01:42,189 - Can't wait to get you 44 00:01:42,232 --> 00:01:43,799 in front of those department heads. 45 00:01:43,842 --> 00:01:44,843 Go team! 46 00:01:44,887 --> 00:01:46,149 - Well, here, take my table. 47 00:01:46,193 --> 00:01:48,238 I, uh, gotta get to my shift. 48 00:01:48,282 --> 00:01:49,239 - Looking forward to later. 49 00:01:49,283 --> 00:01:52,242 [inquisitive music] 50 00:01:52,286 --> 00:01:57,639 ♪ 51 00:01:57,682 --> 00:02:00,772 - Morning, Dr. Scott. - Morning, Maggie. 52 00:02:00,816 --> 00:02:03,384 - So I was wondering-- 53 00:02:03,427 --> 00:02:04,820 - No thanks, not interested. 54 00:02:04,863 --> 00:02:05,821 - You don't even know what I was gonna 55 00:02:05,864 --> 00:02:07,170 talk to you about. 56 00:02:07,214 --> 00:02:08,258 - You got a friend you think I'd like. 57 00:02:08,302 --> 00:02:10,478 - No, uh, a cousin. 58 00:02:10,521 --> 00:02:11,914 - Mm. - You're sharp. 59 00:02:11,957 --> 00:02:13,568 Once a cop, always a cop, huh? 60 00:02:13,611 --> 00:02:14,960 - Yeah, I made you as soon as you started 61 00:02:15,004 --> 00:02:16,571 walking my way. - Right. 62 00:02:16,614 --> 00:02:19,269 - You know, the cop thing, it doesn't mean that 63 00:02:19,313 --> 00:02:20,792 you can't have some fun. 64 00:02:20,836 --> 00:02:22,272 [phone buzzes] - [chuckles] Right. 65 00:02:22,316 --> 00:02:26,624 Hey, Pam. Yeah, what's up? 66 00:02:26,668 --> 00:02:29,192 Whoa, whoa, slow down. 67 00:02:29,236 --> 00:02:31,281 Uh-huh, yeah. I'm on my way. 68 00:02:31,325 --> 00:02:33,588 Hey, Maggie, I gotta jet. - What's going on? 69 00:02:33,631 --> 00:02:34,763 Family I look after, there's an issue 70 00:02:34,806 --> 00:02:36,243 with the son, Roland. He's in trouble. 71 00:02:36,286 --> 00:02:37,374 - Want me to call the paramedics? 72 00:02:37,418 --> 00:02:39,246 The police? - No, don't call anybody. 73 00:02:39,289 --> 00:02:40,551 - Wha-- 74 00:02:40,595 --> 00:02:44,251 [apprehensive music] 75 00:02:44,294 --> 00:02:46,383 - Mom! Mom, where are you? 76 00:02:46,427 --> 00:02:48,516 - I'm right here, baby. 77 00:02:48,559 --> 00:02:50,779 [siren wailing] - Get back! You're too close. 78 00:02:50,822 --> 00:02:53,303 I--I can't-- - I'm right here, baby. 79 00:02:53,347 --> 00:02:56,698 - No! Get away from me! Leave me alone. 80 00:02:56,741 --> 00:02:58,221 - Dylan, thank God. 81 00:02:58,265 --> 00:02:59,962 - [yells] 82 00:03:00,005 --> 00:03:02,834 - Hey, Roland. It's D. 83 00:03:02,878 --> 00:03:04,532 Roland? 84 00:03:04,575 --> 00:03:06,447 It's all right. I'm here. 85 00:03:06,490 --> 00:03:08,797 You all right? - [sobs] 86 00:03:08,840 --> 00:03:09,972 Dylan. Dylan. 87 00:03:10,015 --> 00:03:12,931 - Yeah, man, it's me. You hear me? 88 00:03:12,975 --> 00:03:14,498 Huh? Roland? 89 00:03:14,542 --> 00:03:17,371 - Hey, sir, step back. 90 00:03:17,414 --> 00:03:18,502 Step back. 91 00:03:18,546 --> 00:03:19,764 - Hey, this man is in the midst 92 00:03:19,808 --> 00:03:21,331 of a psycho-- - Sir, he said step back. 93 00:03:21,375 --> 00:03:22,724 Let us do our jobs. 94 00:03:22,767 --> 00:03:24,029 - Get away from me! 95 00:03:24,073 --> 00:03:25,857 - Show me your hands! 96 00:03:25,901 --> 00:03:27,032 [gun clicks] - Hey... 97 00:03:27,076 --> 00:03:29,383 Look, I'm a doctor, all right? 98 00:03:29,426 --> 00:03:31,515 Look, you see my badge? 99 00:03:31,559 --> 00:03:34,475 This man is experiencing a psychiatric episode. 100 00:03:34,518 --> 00:03:36,520 - [sobs] 101 00:03:38,566 --> 00:03:40,872 - Please, just let me work with him. 102 00:03:40,916 --> 00:03:47,009 ♪ 103 00:03:48,576 --> 00:03:51,883 Hey, Roland. I'm stepping back, okay? 104 00:03:51,927 --> 00:03:53,015 - I don't see you. 105 00:03:53,058 --> 00:03:54,321 Where are you? - Hey, I'm right here. 106 00:03:54,364 --> 00:03:56,323 I'm right here. Just focus on my voice. 107 00:03:56,366 --> 00:03:57,628 All right? 108 00:03:59,369 --> 00:04:01,980 - D--don't hurt me. - I would never hurt you. 109 00:04:02,024 --> 00:04:03,982 I'm your friend. 110 00:04:04,026 --> 00:04:05,419 Hey, Roland? 111 00:04:05,462 --> 00:04:07,812 I just need you to breathe deep for me, okay? 112 00:04:07,856 --> 00:04:10,989 - [breathes deeply] - Uh-huh. 113 00:04:11,033 --> 00:04:13,427 - [inhales deeply] - Come on, don't stop. 114 00:04:16,473 --> 00:04:17,518 Come on. 115 00:04:23,654 --> 00:04:24,916 - D. 116 00:04:24,960 --> 00:04:27,571 There you are. - I'm here. 117 00:04:27,615 --> 00:04:30,357 I'm right here. 118 00:04:30,400 --> 00:04:34,578 - Please, help me. 119 00:04:34,622 --> 00:04:35,971 - I got you. 120 00:04:36,014 --> 00:04:42,020 ♪ 121 00:04:42,064 --> 00:04:44,980 Breathe, Roland. Come on. 122 00:04:49,376 --> 00:04:52,988 Come here, come here. Come here. 123 00:04:53,031 --> 00:04:54,598 It's all right. - Help me. 124 00:04:54,642 --> 00:04:55,599 - It's all right. 125 00:04:55,643 --> 00:04:57,862 - Help me! [sobs] 126 00:04:57,906 --> 00:05:00,343 - I got you. I got you. 127 00:05:01,997 --> 00:05:05,566 - [sobbing] 128 00:05:05,609 --> 00:05:07,742 You all right? You're safe. 129 00:05:15,358 --> 00:05:16,664 - Hey, morning, Dr. Taylor. 130 00:05:16,707 --> 00:05:17,795 - Hi, Dr. Marcel. 131 00:05:17,839 --> 00:05:19,623 I've got three patients in process. 132 00:05:19,667 --> 00:05:21,277 - Oh. - First, a 26-year-old female. 133 00:05:21,321 --> 00:05:23,148 Ankle injury, said she wore heels on the "L" 134 00:05:23,192 --> 00:05:25,150 instead of sneakers and changing at the office. 135 00:05:25,194 --> 00:05:27,327 X-ray's negative. It's just a sprain. 136 00:05:27,370 --> 00:05:29,677 Other two are a father and his teenage daughter. 137 00:05:29,720 --> 00:05:31,940 Single vehicle crash. Driving lesson gone wrong. 138 00:05:31,983 --> 00:05:34,159 Exams were unremarkable, cleared their c-spines. 139 00:05:34,203 --> 00:05:37,685 Both were amnestic to the event so I'm getting CT Heads. 140 00:05:37,728 --> 00:05:39,339 - Wow, well done. 141 00:05:39,382 --> 00:05:40,557 My only confusion-- 142 00:05:40,601 --> 00:05:42,951 I'm 30 minutes early for our shift, 143 00:05:42,994 --> 00:05:44,735 and you're already tripled up on patients? 144 00:05:44,779 --> 00:05:46,911 - I like getting here a little early. 145 00:05:46,955 --> 00:05:49,349 - Uh-huh. - Or a lot early. 146 00:05:49,392 --> 00:05:51,307 I have a lot of energy it needs to go somewhere. 147 00:05:51,351 --> 00:05:54,136 - Okay, look, Vanessa, I'm all for the gung-ho spirit, 148 00:05:54,179 --> 00:05:55,877 but it's important to pace yourself. 149 00:05:55,920 --> 00:05:58,227 These days, residents getting rest is a good thing 150 00:05:58,270 --> 00:05:59,924 And required. 151 00:05:59,968 --> 00:06:01,317 - That's what they say, not what they mean. 152 00:06:01,361 --> 00:06:02,666 - All right, then. 153 00:06:04,712 --> 00:06:05,930 [sighs] 154 00:06:08,193 --> 00:06:09,847 - What's this? 155 00:06:09,891 --> 00:06:11,196 - Your prescription. 156 00:06:11,240 --> 00:06:13,155 Every now and then, take a break. 157 00:06:15,070 --> 00:06:16,811 - [chuckles] 158 00:06:16,854 --> 00:06:20,336 - Did you catch that? Vanessa and Crockett? 159 00:06:20,380 --> 00:06:21,685 - Yup. 160 00:06:21,729 --> 00:06:23,905 - First-year resident falling for their mentor? 161 00:06:23,948 --> 00:06:25,123 That's not good. 162 00:06:25,167 --> 00:06:26,908 Doesn't usually end well for the resident. 163 00:06:26,951 --> 00:06:28,866 [alarm blares] - Nope. 164 00:06:28,910 --> 00:06:30,259 [siren wailing] 165 00:06:30,302 --> 00:06:32,827 Ambo's coming in. We're in Treatment 4. 166 00:06:32,870 --> 00:06:33,871 - On it. 167 00:06:33,915 --> 00:06:35,569 Vanessa, got time for another case? 168 00:06:35,612 --> 00:06:36,831 - Definitely. 169 00:06:36,874 --> 00:06:39,137 - Ashley Bardsley, 48, in line at Starbucks 170 00:06:39,181 --> 00:06:40,269 when she had a seizure. 171 00:06:40,312 --> 00:06:41,618 Witnesses said she fell pretty hard, 172 00:06:41,662 --> 00:06:43,011 hit her head. 173 00:06:43,054 --> 00:06:44,360 - Gross deformity of the left arm. 174 00:06:44,404 --> 00:06:45,927 She was groggy when we arrived, 175 00:06:45,970 --> 00:06:47,232 but protecting her airway. 176 00:06:47,276 --> 00:06:50,061 BP 120 over 80, heart rate 72, 177 00:06:50,105 --> 00:06:52,803 sats 100% on oxygen. 178 00:06:52,847 --> 00:06:53,804 Couldn't get an IV. 179 00:06:53,848 --> 00:06:55,066 - Okay, let's transfer on three. 180 00:06:55,110 --> 00:06:56,372 One, two, three. 181 00:06:56,416 --> 00:06:58,200 - [groans] 182 00:06:58,243 --> 00:06:59,244 - Thank you, Courtney. - Yep. 183 00:06:59,288 --> 00:07:02,378 [suspenseful music] 184 00:07:02,422 --> 00:07:03,858 - Hey. 185 00:07:05,860 --> 00:07:08,253 Good breath sounds. Ashley? 186 00:07:08,297 --> 00:07:09,994 Can you hear me? 187 00:07:10,038 --> 00:07:12,257 Ashley. Still out of it. 188 00:07:12,301 --> 00:07:14,259 - Post-ictal phase is a wildcard. 189 00:07:14,303 --> 00:07:16,653 Fuzziness could last a while. 190 00:07:16,697 --> 00:07:20,265 Get a good IV, CBC, BMP, chest X-ray, and a head CT. 191 00:07:20,309 --> 00:07:21,876 - You got it. 192 00:07:21,919 --> 00:07:23,138 - What about the arm? 193 00:07:23,181 --> 00:07:24,705 - Life over limb. 194 00:07:24,748 --> 00:07:26,097 - We'll deal with it after the CT. 195 00:07:26,141 --> 00:07:29,144 [machinery beeping] 196 00:07:32,147 --> 00:07:33,931 - Mr. Channing, I'm Dr. Halstead. 197 00:07:33,975 --> 00:07:35,280 - Oh, call me Pete. 198 00:07:35,324 --> 00:07:36,412 I'm not going to be Mr. Channing 199 00:07:36,456 --> 00:07:38,980 until at least 35. 200 00:07:39,023 --> 00:07:40,372 - You got it. 201 00:07:40,416 --> 00:07:41,765 Tell me, what's going on? 202 00:07:41,809 --> 00:07:44,072 - I've been puking up a storm. 203 00:07:44,115 --> 00:07:45,377 - How fun. 204 00:07:45,421 --> 00:07:49,773 - Vitals are normal. Temp's elevated, 101.1. 205 00:07:49,817 --> 00:07:52,036 - Not for nothing, Pete, but you smell like a keg. 206 00:07:52,080 --> 00:07:54,299 - Yeah, sorry. 207 00:07:54,343 --> 00:07:56,954 Back on campus after a year and a half online. 208 00:07:56,998 --> 00:07:59,130 Been making up for lost time on the party front. 209 00:07:59,174 --> 00:08:00,871 - Aha. 210 00:08:00,915 --> 00:08:02,960 - [groans] - That hurt? 211 00:08:03,004 --> 00:08:05,136 - Everything kind of hurts. 212 00:08:05,180 --> 00:08:07,269 I thought it was just another bad hangover, 213 00:08:07,312 --> 00:08:11,142 but the elixir that usually knocks them out, isn't. 214 00:08:11,186 --> 00:08:13,014 - May I? 215 00:08:14,450 --> 00:08:16,017 That coconut water? 216 00:08:16,060 --> 00:08:18,149 With some electrolyte powder and ice. 217 00:08:18,193 --> 00:08:20,151 I've been drinking it nonstop all morning, 218 00:08:20,195 --> 00:08:21,979 but I'm not feeling any better. 219 00:08:22,023 --> 00:08:23,894 - Okay, all right, well, let's run some labs, 220 00:08:23,938 --> 00:08:25,200 and we'll go from there, okay? 221 00:08:25,243 --> 00:08:28,159 CBC, BMP, amylase, lipase, and a chest X-ray. 222 00:08:28,203 --> 00:08:29,247 I'll be back in a bit. 223 00:08:31,380 --> 00:08:32,424 - Saw you in the café this morning 224 00:08:32,468 --> 00:08:33,904 with that device rep. 225 00:08:33,948 --> 00:08:35,515 Was gonna say hi, but I didn't want 226 00:08:35,558 --> 00:08:37,429 to be a third wheel. 227 00:08:37,473 --> 00:08:40,171 - Jut business, Dean. - Hey, my mistake. 228 00:08:40,215 --> 00:08:42,173 Must be one hell of a device. 229 00:08:45,829 --> 00:08:48,179 - It's all right, come on. It's okay. 230 00:08:48,223 --> 00:08:50,442 Maggie, what's open? - Treatment 3. 231 00:08:50,486 --> 00:08:52,183 - Okay. - You need a psych tech? 232 00:08:52,227 --> 00:08:53,402 - On standby. Dr. Charles? 233 00:08:53,445 --> 00:08:55,970 - On his way down. - All right. 234 00:08:56,013 --> 00:08:58,973 [apprehensive music] 235 00:08:59,016 --> 00:09:05,719 ♪ 236 00:09:10,027 --> 00:09:11,812 Hey, you need anything? 237 00:09:11,855 --> 00:09:14,336 Water? Something to eat? - No. No, thank you. 238 00:09:14,379 --> 00:09:16,381 - Hey, you call for a psych tech? 239 00:09:16,425 --> 00:09:18,209 - Yeah, just stay close. 240 00:09:18,253 --> 00:09:20,951 - Restraints? - No. 241 00:09:22,387 --> 00:09:25,477 It's okay. It's all right. 242 00:09:27,305 --> 00:09:29,394 Hey, Dr. Charles. 243 00:09:33,224 --> 00:09:35,792 Roland is 22--he was diagnosed with schizophrenia, 244 00:09:35,836 --> 00:09:37,794 like, three months ago. 245 00:09:37,838 --> 00:09:40,449 These are his meds. 246 00:09:40,492 --> 00:09:43,321 - Fluphenazine. First generation antipsychotic. 247 00:09:43,365 --> 00:09:47,325 30 milligrams a day? Heavy dose. 248 00:09:47,369 --> 00:09:50,764 - His mom, Pam Baxter, says he never misses a dose, 249 00:09:50,807 --> 00:09:52,461 yet today he still had a break. 250 00:09:52,504 --> 00:09:53,941 - How you doing? 251 00:09:53,984 --> 00:09:55,899 Nothing I haven't dealt with before, man. 252 00:09:57,509 --> 00:09:59,599 - Ms. Baxter? 253 00:09:59,642 --> 00:10:01,122 How are you doing? I'm Dr. Charles. 254 00:10:01,165 --> 00:10:02,427 It's great to meet you. 255 00:10:02,471 --> 00:10:04,560 - You'll help my son? - That's why I'm here. 256 00:10:04,604 --> 00:10:06,127 Uh, you mind if I say hello to him? 257 00:10:13,569 --> 00:10:15,353 Roland, how you doing? I'm Dr. Charles. 258 00:10:17,486 --> 00:10:19,880 - It's all right. It's okay. 259 00:10:22,491 --> 00:10:25,581 Pam, let me show you to the waiting room, okay? 260 00:10:25,625 --> 00:10:27,365 - Cardiac output and index. 261 00:10:27,409 --> 00:10:29,237 Pulse pressure and stroke volumes. 262 00:10:29,280 --> 00:10:32,109 Central venous pressure, mean arterial pressure, 263 00:10:32,153 --> 00:10:35,417 and calculated values like oxygen delivery. 264 00:10:35,460 --> 00:10:40,161 The Vas-COM is the all-in-one cardiac monitoring device. 265 00:10:40,204 --> 00:10:43,512 It almost makes us unnecessary. Almost. 266 00:10:43,555 --> 00:10:46,341 - [giggles] I love that. 267 00:10:46,384 --> 00:10:47,516 - Dr. Cooper. 268 00:10:47,559 --> 00:10:49,474 - So with Covid cases, it can be useful 269 00:10:49,518 --> 00:10:51,215 to quantify pulmonary edema. 270 00:10:51,259 --> 00:10:53,130 Is that something the Vas-COM is capable of? 271 00:10:53,174 --> 00:10:54,523 - Lung water volume? Absolutely. 272 00:10:54,566 --> 00:10:56,090 - Oh, I'm sorry. I didn't mean to interrupt. 273 00:10:56,133 --> 00:10:58,962 Uh, I just--I left my water bottle there 274 00:10:59,006 --> 00:11:01,312 from the budget meeting. 275 00:11:01,356 --> 00:11:03,445 Gotta stay hydrated, right? [chuckles] 276 00:11:03,488 --> 00:11:06,056 Sorry, just forget I'm not here. 277 00:11:06,100 --> 00:11:08,102 Uh, actually, speaking of water, 278 00:11:08,145 --> 00:11:11,105 what were you saying about lung water volume or... 279 00:11:11,148 --> 00:11:14,151 - Right. Yes. 280 00:11:14,195 --> 00:11:15,979 It can be calculated in seconds. 281 00:11:16,023 --> 00:11:17,285 The reason: 282 00:11:17,328 --> 00:11:19,983 the Vas-COM's sophisticated neural network AI. 283 00:11:20,027 --> 00:11:22,856 This, in combination with a thermistor at the tip 284 00:11:22,899 --> 00:11:25,293 of the central venous line and the waveform analysis 285 00:11:25,336 --> 00:11:28,122 from the arterial side ensures the device delivers 286 00:11:28,165 --> 00:11:29,993 consistent and accurate measurements. 287 00:11:30,037 --> 00:11:32,648 And it's minimally invasive. 288 00:11:32,692 --> 00:11:34,519 - Well, not when it comes to your wallet. 289 00:11:34,563 --> 00:11:38,915 I mean, those catheters are pretty pricey, right? 290 00:11:38,959 --> 00:11:41,439 Oh, I'm sorry, I didn't mean to say that out loud. 291 00:11:41,483 --> 00:11:45,008 - No, I mean, it's a fair point. 292 00:11:45,052 --> 00:11:47,010 What do you think, Dr. Halstead? 293 00:11:47,054 --> 00:11:48,185 - Well, yes and no. 294 00:11:48,229 --> 00:11:49,926 I mean, the Vas-COM is more expensive 295 00:11:49,970 --> 00:11:51,493 than other devices, but it's certainly 296 00:11:51,536 --> 00:11:53,538 not overpriced considering the multitude of functions 297 00:11:53,582 --> 00:11:54,539 it's capable of. 298 00:11:54,583 --> 00:11:56,019 - Oh, yeah, I mean, it is 299 00:11:56,063 --> 00:12:00,023 a Swiss army knife, there's no doubt about that. 300 00:12:00,067 --> 00:12:01,721 - Dr. Archer, that's not a bad thing. 301 00:12:01,764 --> 00:12:04,288 - Uh, no, but it's not necessary, either. 302 00:12:04,332 --> 00:12:06,421 At the end of the day, the Vas-COM just seems 303 00:12:06,464 --> 00:12:09,729 like a high-tech repackaging of all the hemodynamic devices 304 00:12:09,772 --> 00:12:10,991 already out there. 305 00:12:11,034 --> 00:12:12,514 I mean, why complicate things 306 00:12:12,557 --> 00:12:16,039 when info from central venous pressure's been working 307 00:12:16,083 --> 00:12:17,519 perfectly well for decades? 308 00:12:17,562 --> 00:12:19,651 At least, that's, you know, that's how I see it, so. 309 00:12:19,695 --> 00:12:21,088 - Well, I disagree. 310 00:12:21,131 --> 00:12:22,524 I'd liken the CVP you're describing 311 00:12:22,567 --> 00:12:24,395 to a flip phone. 312 00:12:24,439 --> 00:12:26,615 The Vas-COM though, is the smart phone 313 00:12:26,658 --> 00:12:27,616 we all want in our pockets. 314 00:12:27,659 --> 00:12:29,009 - Yeah, well, not all of us. 315 00:12:29,052 --> 00:12:31,489 Some of us just want to make a phone call, right? 316 00:12:31,533 --> 00:12:33,056 And this has been working excellent 317 00:12:33,100 --> 00:12:34,405 for me, still does. 318 00:12:34,449 --> 00:12:35,972 Anyway, I'm old school. 319 00:12:36,016 --> 00:12:39,280 All right, I got my water, and I'll leave you to it. 320 00:12:39,323 --> 00:12:42,283 [tense music] 321 00:12:42,326 --> 00:12:45,503 ♪ 322 00:12:45,547 --> 00:12:48,245 - X-rays on Ashley's arm. Distal radius fracture. 323 00:12:48,289 --> 00:12:49,377 I paged Ortho-- 324 00:12:49,420 --> 00:12:51,509 they're gonna come down and cast it. 325 00:12:51,553 --> 00:12:54,164 Is that her CT? - Take a look. 326 00:12:54,208 --> 00:12:58,168 Oh, man. Lesions. 327 00:12:58,212 --> 00:12:59,691 Four. - Yeah. 328 00:12:59,735 --> 00:13:02,607 And this area here is a resection cavity. 329 00:13:02,651 --> 00:13:05,610 Surrounding tissue shows evidence of radiation necrosis. 330 00:13:05,654 --> 00:13:07,177 So there was a tumor that was removed. 331 00:13:07,221 --> 00:13:10,267 It must have been cancerous given the dead tissue. 332 00:13:10,311 --> 00:13:13,531 - Anaplastic astrocytoma. 333 00:13:13,575 --> 00:13:15,142 I was able to pull up Ashley's medical records 334 00:13:15,185 --> 00:13:16,447 dating back to 2000. 335 00:13:16,491 --> 00:13:18,710 That's when everything started going digital. 336 00:13:18,754 --> 00:13:21,322 Diagnosis was made sometime before that. 337 00:13:21,365 --> 00:13:23,106 Yes, since 2000, 338 00:13:23,150 --> 00:13:25,239 there have been three recurrences. 339 00:13:25,282 --> 00:13:27,154 Appears biopsies on those lesions, though, 340 00:13:27,197 --> 00:13:28,459 were all negative. 341 00:13:28,503 --> 00:13:30,548 - So all benign, but only three recurrences? 342 00:13:30,592 --> 00:13:33,116 I'm counting four here on her CT. 343 00:13:33,160 --> 00:13:36,990 - Yeah, there's a new lesion. The cancer may be back. 344 00:13:42,952 --> 00:13:43,170 . 345 00:13:43,213 --> 00:13:45,912 - So I'm thinking an adverse reaction to his meds 346 00:13:45,955 --> 00:13:48,871 definitely had a lot to do with his episode this morning. 347 00:13:48,915 --> 00:13:50,438 - Yeah, I was leaning that way too. 348 00:13:50,481 --> 00:13:51,787 I noticed some spastic muscle contractions 349 00:13:51,831 --> 00:13:52,832 when I brought him in. 350 00:13:52,875 --> 00:13:54,007 - Yeah, he's also having a hard time 351 00:13:54,050 --> 00:13:55,660 controlling his tongue inside his mouth. 352 00:13:55,704 --> 00:13:58,141 Both of those things, you know, symptoms of overmedication. 353 00:13:58,185 --> 00:14:00,013 I just think his dose is too high. 354 00:14:00,056 --> 00:14:01,884 - He's coming down now, though. - Oh, yeah. 355 00:14:01,928 --> 00:14:04,539 Gave him some Ativan and some Benadryl so he can rest. 356 00:14:04,582 --> 00:14:06,541 I'm gonna reassess in a bit. 357 00:14:06,584 --> 00:14:08,108 - [exhales heavily] 358 00:14:08,151 --> 00:14:10,893 You know, I've known the family since I was a rookie cop. 359 00:14:10,937 --> 00:14:12,025 Roland's always been a bright kid 360 00:14:12,068 --> 00:14:15,593 but shy, sensitive. 361 00:14:15,637 --> 00:14:17,073 Doesn't help that his neighborhood's a war zone. 362 00:14:17,117 --> 00:14:18,422 - Yeah. 363 00:14:18,466 --> 00:14:20,598 I'm sorry that you had to go it alone out there, 364 00:14:20,642 --> 00:14:23,688 but, look, thank God you were there, right? 365 00:14:23,732 --> 00:14:26,561 So a good job. 366 00:14:26,604 --> 00:14:27,605 I'll check back. 367 00:14:34,786 --> 00:14:36,701 - Hey, Mr. Kumar. I'm Dr. Marcel. 368 00:14:36,745 --> 00:14:38,790 I'm the E.D. surgeon on call today. 369 00:14:38,834 --> 00:14:41,532 - Oh, man, I've been upgraded? 370 00:14:41,576 --> 00:14:43,186 That's--that's not a good sign. 371 00:14:43,230 --> 00:14:45,058 - Well, the resident you saw when you came in 372 00:14:45,101 --> 00:14:47,843 asked me to consult because of your chest X-ray results. 373 00:14:47,887 --> 00:14:50,628 It's protocol, not necessarily an omen. 374 00:14:50,672 --> 00:14:53,588 - All right, the X-ray. Lay it on me. 375 00:14:53,631 --> 00:14:55,851 - So it showed a widened mediastinum, 376 00:14:55,895 --> 00:14:57,809 partition between your lungs. 377 00:14:57,853 --> 00:15:02,945 So given your symptoms, fatigue, back pain, 378 00:15:02,989 --> 00:15:04,947 trouble swallowing, hypertension. 379 00:15:04,991 --> 00:15:07,080 The widened mediastinum could by symptomatic 380 00:15:07,123 --> 00:15:10,561 of a lot of things, or it could be nothing. 381 00:15:10,605 --> 00:15:13,477 Nothing. Let's-- Yeah, let's go with that. 382 00:15:13,521 --> 00:15:14,957 - Right. 383 00:15:15,001 --> 00:15:16,872 Well, you know, I'm gonna send you 384 00:15:16,916 --> 00:15:19,092 for a CT of your chest and abdomen. 385 00:15:19,135 --> 00:15:20,528 Get a better look at what's doing, 386 00:15:20,571 --> 00:15:22,965 and then we'll go from there, okay? 387 00:15:23,009 --> 00:15:24,880 - I'd be on my bike by now. 388 00:15:24,924 --> 00:15:26,621 - I'm sorry? 389 00:15:26,664 --> 00:15:31,800 - I had to pull out of a Half-Ironman triathlon. 390 00:15:31,843 --> 00:15:34,498 - Oh. - 1.2 mile saltwater swim, 391 00:15:34,542 --> 00:15:36,500 56 mile bike ride. 392 00:15:36,544 --> 00:15:40,113 Now it tires me out just watching the race online. 393 00:15:40,156 --> 00:15:42,071 - Well, I'm sorry to hear that, man. 394 00:15:42,115 --> 00:15:43,812 Yeah, well, listen, hang in there. 395 00:15:43,855 --> 00:15:46,684 Tech'll be by soon, get you that scan, okay? 396 00:15:46,728 --> 00:15:48,599 - Okay. - All right. 397 00:15:48,643 --> 00:15:50,819 [apprehensive music] 398 00:15:50,862 --> 00:15:54,910 - It started with migraines when I was in the 11th grade, 399 00:15:54,954 --> 00:15:58,653 and they found the tumor a year later. 400 00:15:58,696 --> 00:16:00,829 The day after I graduated from high school, 401 00:16:00,872 --> 00:16:04,659 they took it out, and I felt much better. 402 00:16:04,702 --> 00:16:09,142 No speech issues, no more balance problems. 403 00:16:09,185 --> 00:16:12,580 I was healed, or so I thought. 404 00:16:14,060 --> 00:16:16,888 Turns out the tumor was cancerous. 405 00:16:18,629 --> 00:16:25,158 Anaplastic astrocytoma has been my life since 1991. 406 00:16:25,201 --> 00:16:28,857 - The previous recurrences were benign. 407 00:16:28,900 --> 00:16:32,034 It's possible that this one is too. 408 00:16:32,078 --> 00:16:35,081 But we can't be sure without-- - A biopsy. 409 00:16:37,083 --> 00:16:40,825 Digging out a little more of my brain. 410 00:16:40,869 --> 00:16:41,913 No, thank you. 411 00:16:43,741 --> 00:16:46,048 - Do you not want to know what it is? 412 00:16:46,092 --> 00:16:48,355 - The original chemo and radiation, 413 00:16:48,398 --> 00:16:51,358 they were brutal. 414 00:16:51,401 --> 00:16:52,794 And the biopsies? 415 00:16:52,837 --> 00:16:55,840 Each one has left me a little worse for wear. 416 00:16:55,884 --> 00:16:58,321 My eyesight's bad, my hearing's going, 417 00:16:58,365 --> 00:17:00,323 my hormones are out of whack, 418 00:17:00,367 --> 00:17:04,719 my bones are brittle. 419 00:17:04,762 --> 00:17:07,591 I just don't want to risk anymore damage. 420 00:17:07,635 --> 00:17:09,811 So, okay, you can treat my arm. 421 00:17:09,854 --> 00:17:11,639 But after that, I want to go home. 422 00:17:11,682 --> 00:17:17,079 ♪ 423 00:17:17,123 --> 00:17:19,821 - Okay. 424 00:17:19,864 --> 00:17:21,127 Ortho will be by soon. 425 00:17:27,089 --> 00:17:28,830 - I feel so bad for her. 426 00:17:28,873 --> 00:17:31,659 - She's been through hell, there's no question. 427 00:17:31,702 --> 00:17:34,227 But her diagnosis, Anaplastic astrocytoma, 428 00:17:34,270 --> 00:17:35,271 it doesn't add up. 429 00:17:35,315 --> 00:17:36,359 - What do you mean? 430 00:17:36,403 --> 00:17:37,969 - A.A. is fatal. 431 00:17:38,013 --> 00:17:40,276 Life expectancy post-diagnosis is a few years at best. 432 00:17:40,320 --> 00:17:41,930 Ashley has survived 30. 433 00:17:41,973 --> 00:17:43,975 - You don't think she has it. 434 00:17:44,019 --> 00:17:46,413 - I don't know what's going on. 435 00:17:46,456 --> 00:17:48,328 But whatever's happening, it started in 1991 436 00:17:48,371 --> 00:17:50,373 with that original tumor. 437 00:17:50,417 --> 00:17:51,940 - 30 years. 438 00:17:51,983 --> 00:17:54,029 I mean, any chance a tissue sample still exists? 439 00:17:54,073 --> 00:17:55,117 - Oh, no, I doubt it. 440 00:17:56,901 --> 00:17:59,121 But maybe the pathology report still does. 441 00:17:59,165 --> 00:18:00,427 - Pre-dates 2000, so it won't be 442 00:18:00,470 --> 00:18:01,558 in her electronic file, 443 00:18:01,602 --> 00:18:04,083 but it has to be on paper somewhere. 444 00:18:04,126 --> 00:18:06,172 - Yep. 445 00:18:06,215 --> 00:18:08,174 Let's start looking. - Okay. 446 00:18:10,828 --> 00:18:12,265 - Roland's sleeping now. 447 00:18:12,308 --> 00:18:13,440 When he wakes up, 448 00:18:13,483 --> 00:18:15,050 Dr. Charles will come do another exam. 449 00:18:19,968 --> 00:18:21,926 - We were on the bus when the break happened. 450 00:18:23,841 --> 00:18:25,843 To visit Harold Washington. 451 00:18:25,887 --> 00:18:27,323 - Hmm. City College? 452 00:18:29,108 --> 00:18:31,284 - Since the diagnosis, 453 00:18:31,327 --> 00:18:33,808 Roland hasn't left the apartment. 454 00:18:33,851 --> 00:18:35,375 But yesterday, 455 00:18:35,418 --> 00:18:37,681 he said he wanted to try again at school. 456 00:18:40,423 --> 00:18:42,251 I was so hopeful it was... 457 00:18:43,774 --> 00:18:45,341 The beginning of something for him. 458 00:18:47,430 --> 00:18:49,258 [voice breaking] But the bus was crowded. 459 00:18:51,347 --> 00:18:54,176 And there was traffic. 460 00:18:58,049 --> 00:19:01,227 If you hadn't come, 461 00:19:01,270 --> 00:19:03,707 it was almost my family today. 462 00:19:08,016 --> 00:19:09,887 [sighs] 463 00:19:09,931 --> 00:19:13,239 Roland is a sweet boy. Kind. 464 00:19:13,282 --> 00:19:15,241 - He is. 465 00:19:15,284 --> 00:19:18,200 - I wish we weren't the only ones who knew that. 466 00:19:24,772 --> 00:19:26,165 - Labs are back on Pete, your belly patient. 467 00:19:26,208 --> 00:19:28,210 White count's 21,000. 468 00:19:28,254 --> 00:19:31,344 - That's high. Let me see the chest X-ray? 469 00:19:31,387 --> 00:19:33,041 Motion artifact. Tough to read. 470 00:19:33,084 --> 00:19:34,738 - He vomited just before the image was taken. 471 00:19:34,782 --> 00:19:35,870 He had a hard time staying still. 472 00:19:35,913 --> 00:19:37,045 - All right. 473 00:19:37,088 --> 00:19:38,525 - Oh, Doc, thank God you're back. 474 00:19:38,568 --> 00:19:40,179 My stomach is killing me. 475 00:19:40,222 --> 00:19:41,528 - Yeah, your labs show you're fighting 476 00:19:41,571 --> 00:19:42,790 more than just a hangover. 477 00:19:42,833 --> 00:19:43,921 Let me take another look. 478 00:19:43,965 --> 00:19:45,227 - Ahh! 479 00:19:45,271 --> 00:19:46,750 That hurts way worse than before. 480 00:19:46,794 --> 00:19:48,274 - Okay, Trini, grab Mike. 481 00:19:48,317 --> 00:19:50,972 Sorry, I gotta keep checking. - [yells] 482 00:19:51,015 --> 00:19:52,234 Oh, this is bad isn't it? 483 00:19:52,278 --> 00:19:54,018 Oh, God, okay, no more crap food. 484 00:19:54,062 --> 00:19:56,369 Just give me salads and vegetables. 485 00:19:56,412 --> 00:19:59,154 No, no, full vegan from now on. I promise. 486 00:19:59,198 --> 00:20:00,373 - Let's get another X-ray before you make 487 00:20:00,416 --> 00:20:01,504 any huge life decisions. 488 00:20:01,548 --> 00:20:02,940 Upright chest, 90 degrees. 489 00:20:04,420 --> 00:20:05,900 And Pete, I know you're in a lot of pain, 490 00:20:05,943 --> 00:20:08,772 but you gotta stay really still, okay? 491 00:20:08,816 --> 00:20:11,035 - [groans] - Clear. 492 00:20:12,863 --> 00:20:14,865 - Yep, free air under the right diaphragm. 493 00:20:14,909 --> 00:20:16,911 Trini, find me Dr. Archer. 494 00:20:16,954 --> 00:20:18,391 - [grunts] What's going on? 495 00:20:18,434 --> 00:20:19,957 - So you need surgery. 496 00:20:20,001 --> 00:20:22,351 Your stomach pain is from a tear in your GI tract. 497 00:20:22,395 --> 00:20:24,135 Air is leaking into your belly. 498 00:20:24,179 --> 00:20:26,964 - Leaking? How does that happen? 499 00:20:27,008 --> 00:20:28,531 - Well, around here, typically I see it 500 00:20:28,575 --> 00:20:32,013 from penetrative trauma, uh, bullets, stab wounds... 501 00:20:32,056 --> 00:20:33,406 - Guns and knives? 502 00:20:33,449 --> 00:20:36,235 But I'm keg stands and peer pong. 503 00:20:36,278 --> 00:20:38,585 [retches] 504 00:20:38,628 --> 00:20:40,151 I think I'm gonna puke again. 505 00:20:40,195 --> 00:20:41,544 I need my drink. 506 00:20:41,588 --> 00:20:44,155 - Sorry, man, no liquids before surgery. 507 00:20:46,854 --> 00:20:49,552 Hey, your elixir. I saw you eating ice. 508 00:20:49,596 --> 00:20:50,988 Is that always part of the process? 509 00:20:51,032 --> 00:20:55,384 - Yeah, chewing on a cold cube is just satisfying. 510 00:20:55,428 --> 00:20:57,821 - Well, I think one might have caused the tear. 511 00:20:57,865 --> 00:20:58,996 Yeah, it's likely been getting bigger 512 00:20:59,040 --> 00:21:00,955 with each cube you've swallowed since. 513 00:21:00,998 --> 00:21:03,392 - Seriously? An ice cube? 514 00:21:03,436 --> 00:21:05,089 - It's looking that way. - What's up? 515 00:21:05,133 --> 00:21:06,961 - Hey, so this is the surgeon. I'm gonna fill him in, 516 00:21:07,004 --> 00:21:08,484 then he's gonna take over, okay? 517 00:21:10,051 --> 00:21:11,357 - [groans] 518 00:21:11,400 --> 00:21:12,445 - Pneumoperitoneum. 519 00:21:12,488 --> 00:21:13,968 I suspect the tear's somewhere near 520 00:21:14,011 --> 00:21:15,361 the gastro-esophageal junction. 521 00:21:15,404 --> 00:21:17,058 - Yeah, there's no blood. 522 00:21:17,101 --> 00:21:18,364 - Ah, wasn't shot or stabbed. 523 00:21:18,407 --> 00:21:20,148 I think an ice cube went down the wrong way. 524 00:21:20,191 --> 00:21:23,847 - Get out, really? All right, cool. 525 00:21:23,891 --> 00:21:25,153 - All right, I'll take it from here. 526 00:21:25,196 --> 00:21:27,242 [suspenseful music] 527 00:21:27,286 --> 00:21:30,332 - You know, Dean, kid's a nervous wreck. 528 00:21:30,376 --> 00:21:31,507 Not in the greatest shape, either. 529 00:21:31,551 --> 00:21:34,205 Post-surgery, I think cardiac monitoring 530 00:21:34,249 --> 00:21:35,468 would be appropriate. 531 00:21:35,511 --> 00:21:38,862 - Uh, let me guess, uh, use the Vas-COM? 532 00:21:38,906 --> 00:21:42,257 I know you like your old-school CVP, 533 00:21:42,301 --> 00:21:44,346 but I do think the Vas-COM might be better suited 534 00:21:44,390 --> 00:21:46,000 for this patient. 535 00:21:46,043 --> 00:21:48,524 - Well, I'll consider it. 536 00:21:48,568 --> 00:21:50,004 - Thank you. 537 00:21:50,047 --> 00:21:52,180 - Okay, I've considered it. 538 00:21:52,223 --> 00:21:54,530 No. I'll stick with my device. 539 00:22:05,933 --> 00:22:06,150 . 540 00:22:06,194 --> 00:22:08,805 - Archer's a real ball buster, huh? 541 00:22:08,849 --> 00:22:10,938 - Yeah, he enjoys it, too. 542 00:22:10,981 --> 00:22:12,461 But still, part of me hoped 543 00:22:12,505 --> 00:22:15,943 he would at least consider the Vas-COM. 544 00:22:15,986 --> 00:22:17,945 - You mind if I offer you a little advice? 545 00:22:17,988 --> 00:22:19,076 - Please. 546 00:22:19,120 --> 00:22:20,339 - Look, you nailed highlighting 547 00:22:20,382 --> 00:22:22,166 the Vas-COM's positives. You nailed it. 548 00:22:22,210 --> 00:22:25,866 But you whiffed on pointing out the CVP's negatives. 549 00:22:25,909 --> 00:22:28,216 That monitor has to be leveled and calibrated 550 00:22:28,259 --> 00:22:30,261 before each use. - Right. 551 00:22:30,305 --> 00:22:31,872 - But what if that's not done appropriately? 552 00:22:34,178 --> 00:22:35,266 All the numbers are off. 553 00:22:35,310 --> 00:22:36,877 None of that data can be trusted. 554 00:22:36,920 --> 00:22:39,314 - A bad calibration in the moment. 555 00:22:39,358 --> 00:22:40,968 That's happened before? 556 00:22:41,011 --> 00:22:44,406 - Not to me. Because I use a Vas-COM. 557 00:22:44,450 --> 00:22:47,844 - [chuckles] - Anyway, food for thought. 558 00:22:47,888 --> 00:22:49,193 You know, as we move toward Grand Rounds. 559 00:22:52,066 --> 00:22:54,329 - See? Right there. 560 00:22:54,373 --> 00:22:56,853 CT shows the wall of the aorta has thickened. 561 00:22:56,897 --> 00:22:58,594 I think it's an aortic tumor. 562 00:22:58,638 --> 00:23:00,161 - No way. 563 00:23:00,204 --> 00:23:02,337 Thoracoabdominal aortic aneurysm. 564 00:23:02,381 --> 00:23:04,470 - I don't know, the walls are abnormally shaped. 565 00:23:04,513 --> 00:23:06,167 Aneurysms are symmetrical. 566 00:23:06,210 --> 00:23:07,429 - It isn't a classic presentation, 567 00:23:07,473 --> 00:23:08,865 I'll give you that, but aortic tumors 568 00:23:08,909 --> 00:23:12,173 are super rare, aortic aneurysms are not. 569 00:23:12,216 --> 00:23:14,175 - Okay, look, I get it, Dr. Bickman. 570 00:23:14,218 --> 00:23:15,306 Common things are common, 571 00:23:15,350 --> 00:23:16,786 but that doesn't rule out a curveball. 572 00:23:16,830 --> 00:23:18,962 - No, but your point is moot 'cause that's a fast ball. 573 00:23:19,006 --> 00:23:20,573 Thoracoabdominal aortic aneurysm. 574 00:23:20,616 --> 00:23:22,357 - I'm not comfortable with that diagnosis. 575 00:23:22,401 --> 00:23:24,054 - It's an IR case now, Dr. Marcel. 576 00:23:24,098 --> 00:23:25,099 Send him up to the cath lab. 577 00:23:25,142 --> 00:23:26,100 I'll put in a stent, 578 00:23:26,143 --> 00:23:27,144 and he'll be good as new. 579 00:23:32,367 --> 00:23:33,629 - How's it going? 580 00:23:33,673 --> 00:23:35,892 - I've only come across four cases in which 581 00:23:35,936 --> 00:23:39,330 patients outlived a diagnosis of anaplastic astrocytoma, 582 00:23:39,374 --> 00:23:42,072 and two of them were determined to be misdiagnoses. 583 00:23:42,116 --> 00:23:44,248 - So odds are Ashley likely isn't another medical miracle. 584 00:23:44,292 --> 00:23:46,642 - No. But can we prove it? 585 00:23:46,686 --> 00:23:48,383 - Maggie and I have been trying to dig up 586 00:23:48,427 --> 00:23:50,080 her original files and path reports. 587 00:23:50,124 --> 00:23:51,473 Slow go. 588 00:23:53,083 --> 00:23:55,695 Sweet. She's got something. 589 00:23:55,738 --> 00:23:57,392 Your research, good stuff. 590 00:23:57,436 --> 00:23:59,133 - Hey, Dr. Hammer. 591 00:24:00,961 --> 00:24:02,397 How many cases you working? 592 00:24:02,441 --> 00:24:04,007 - Just one. 593 00:24:04,051 --> 00:24:05,966 - That's an improvement. You had any food? 594 00:24:08,055 --> 00:24:10,144 I'll take that as a no. 595 00:24:10,187 --> 00:24:11,362 - I'll grab something later, 596 00:24:11,406 --> 00:24:13,147 but this is just more important than lunch. 597 00:24:13,190 --> 00:24:15,018 - Yeah, I disagree. 598 00:24:15,062 --> 00:24:17,020 You can't help your patients if you run out of gas. 599 00:24:19,501 --> 00:24:23,505 Dolmeh, koufteh ghelgheli. Made them last night. 600 00:24:23,549 --> 00:24:26,073 Take five. Recharge. 601 00:24:32,732 --> 00:24:34,037 [knock at door] 602 00:24:34,081 --> 00:24:37,040 - Roland. How you feeling? 603 00:24:37,084 --> 00:24:40,174 I'm Dr. Charles. We met earlier. 604 00:24:40,217 --> 00:24:42,176 - I remember. Kind of. 605 00:24:43,612 --> 00:24:46,006 I'm sorry about my behavior earlier, sir. 606 00:24:46,049 --> 00:24:48,269 - You have absolutely nothing to apologize for. 607 00:24:48,312 --> 00:24:50,140 You mind if I come in? We can chat a bit? 608 00:24:51,664 --> 00:24:53,709 - Sure. 609 00:24:53,753 --> 00:24:57,191 Last time the doctor just stayed in the doorway, 610 00:24:57,234 --> 00:24:59,585 wrote me a prescription. 611 00:24:59,628 --> 00:25:02,762 - So, um, I understand that you and Dr. Scott 612 00:25:02,805 --> 00:25:04,677 go way back. 613 00:25:04,720 --> 00:25:07,462 - Long as I can remember. 614 00:25:07,506 --> 00:25:09,682 We not as tight as we used to be, though. 615 00:25:09,725 --> 00:25:11,074 - No? 616 00:25:11,118 --> 00:25:12,206 - I mean, he doesn't send the calls 617 00:25:12,249 --> 00:25:13,990 to voicemail or nothing, it's just... 618 00:25:15,339 --> 00:25:18,560 He's a doc now, so, you know, 619 00:25:18,604 --> 00:25:20,257 he's not around as much anymore. 620 00:25:21,563 --> 00:25:22,695 I miss him. 621 00:25:22,738 --> 00:25:25,132 - I can understand that. I would too. 622 00:25:25,175 --> 00:25:26,699 - Yeah. 623 00:25:26,742 --> 00:25:29,571 I wish I was more like D. 624 00:25:29,615 --> 00:25:31,181 Guy's not afraid of nothing. 625 00:25:32,835 --> 00:25:35,359 Shadow doesn't even mess with him. 626 00:25:35,403 --> 00:25:36,752 - Shadow? 627 00:25:36,796 --> 00:25:39,494 - It's outside. 628 00:25:39,538 --> 00:25:41,235 Waits for me to leave the apartment. 629 00:25:42,715 --> 00:25:47,067 Always feels like it's gonna attack me. 630 00:25:47,110 --> 00:25:49,199 - So do you ever see the shadow inside 631 00:25:49,243 --> 00:25:50,549 when you're at home? 632 00:25:50,592 --> 00:25:53,813 - No. Except when I don't sleep. 633 00:25:53,856 --> 00:25:55,728 - What does the shadow look like? 634 00:25:55,771 --> 00:26:00,167 I mean, is it a person? Does it have a specific shape? 635 00:26:00,210 --> 00:26:03,344 - I don't know. It's just a thing. 636 00:26:03,387 --> 00:26:04,475 A blur. 637 00:26:04,519 --> 00:26:05,651 I see it, but when I turn around, 638 00:26:05,694 --> 00:26:07,522 it's someplace else. 639 00:26:07,566 --> 00:26:08,567 - Shadow ever speak to you? 640 00:26:08,610 --> 00:26:10,177 I mean, does it have a voice? 641 00:26:10,220 --> 00:26:12,788 - No. It don't make any noises. 642 00:26:12,832 --> 00:26:17,401 It's just always there. 643 00:26:17,445 --> 00:26:18,620 Watching. 644 00:26:18,664 --> 00:26:19,621 - You know what, I really appreciate 645 00:26:19,665 --> 00:26:21,188 you sharing all this stuff with me. 646 00:26:21,231 --> 00:26:22,406 Really, I do. 647 00:26:22,450 --> 00:26:25,366 I'm just going to get back with Dr. Scott, 648 00:26:25,409 --> 00:26:29,544 and then come check in on you in a bit, okay? 649 00:26:29,588 --> 00:26:33,679 - That's it? That's all the questions? 650 00:26:33,722 --> 00:26:36,246 - For now, yeah. 651 00:26:36,290 --> 00:26:38,771 - Last time, the doctor had a checklist. 652 00:26:38,814 --> 00:26:40,294 I'd answer yes or no. 653 00:26:42,252 --> 00:26:45,125 - Guess we do things a little bit differently around here. 654 00:26:45,168 --> 00:26:46,387 I'll see you in a bit. 655 00:26:46,430 --> 00:26:49,390 [apprehensive music] 656 00:26:49,433 --> 00:26:52,480 ♪ 657 00:26:52,523 --> 00:26:54,700 - How'd it go? He talk about the shadow? 658 00:26:54,743 --> 00:26:56,615 - He did. He did. 659 00:26:56,658 --> 00:26:57,616 You know, there's no doubt in my mind 660 00:26:57,659 --> 00:26:59,095 that it's very real to him, 661 00:26:59,139 --> 00:27:01,707 but it could be related to irregular sleep cycles. 662 00:27:01,750 --> 00:27:03,099 - Hmm. 663 00:27:03,143 --> 00:27:05,885 - Also, you know, he only sees the shadow, right? 664 00:27:05,928 --> 00:27:08,670 It doesn't talk to him, and with schizophrenia, 665 00:27:08,714 --> 00:27:11,717 you'd think there'd be an auditory hallucination as well. 666 00:27:11,760 --> 00:27:14,676 Also, there's this extreme level of agoraphobia, 667 00:27:14,720 --> 00:27:17,287 and I don't know, it's just not tracking. 668 00:27:17,331 --> 00:27:19,115 - So you don't think it's schizophrenia. 669 00:27:19,159 --> 00:27:20,682 - You know, I'm not ruling it out, 670 00:27:20,726 --> 00:27:23,119 but I honestly have my doubts. 671 00:27:23,163 --> 00:27:24,730 - Let's go ahead and order the labs and imaging. 672 00:27:24,773 --> 00:27:26,383 Hopefully it will point us one way or the other. 673 00:27:26,427 --> 00:27:28,124 - Yeah. - This one. 674 00:27:28,168 --> 00:27:35,175 ♪ 675 00:27:40,441 --> 00:27:42,356 - Oh, hey, Dr. Halstead. 676 00:27:42,399 --> 00:27:43,923 - Hey, hi, Trish. 677 00:27:43,966 --> 00:27:45,185 What's new? 678 00:27:45,228 --> 00:27:46,839 - Same old, same old. 679 00:27:46,882 --> 00:27:48,492 But who knows what tomorrow may bring. 680 00:27:48,536 --> 00:27:50,190 Powerball's up to 68 million. 681 00:27:50,233 --> 00:27:51,408 - Nice. 682 00:27:51,452 --> 00:27:54,542 Might need to get myself a few tickets. 683 00:27:54,585 --> 00:27:55,804 - Oh, were you in here waiting for me? 684 00:27:55,848 --> 00:27:57,240 Did you need anything? 685 00:27:57,284 --> 00:28:01,244 - No, no, I was just checking on the patient, Pete. 686 00:28:01,288 --> 00:28:03,333 But I guess he's, uh-- 687 00:28:03,377 --> 00:28:04,900 - This is what I like to see. Hero's welcome. 688 00:28:04,944 --> 00:28:07,381 Hold your applause, please. 689 00:28:07,424 --> 00:28:10,297 Okay, so, I placed a line during surgery. 690 00:28:10,340 --> 00:28:14,257 Connect him to the CVP, grab a baseline. 691 00:28:14,301 --> 00:28:16,303 I am going to change my scrubs 692 00:28:16,346 --> 00:28:18,827 and, uh, please page me when he wakes up, all right? 693 00:28:18,871 --> 00:28:22,744 So as you suspected, esophageal tear at the GEJ. 694 00:28:22,788 --> 00:28:24,398 That's a hell of an ice cube. 695 00:28:24,441 --> 00:28:26,226 - Guess he needs a new hangover cure. 696 00:28:26,269 --> 00:28:29,185 - Yeah, I got one. Drink less. 697 00:28:29,229 --> 00:28:30,317 - College senior, Dean. 698 00:28:30,360 --> 00:28:32,798 Not sure moderation is realistic. 699 00:28:32,841 --> 00:28:34,538 - Yeah, well, you know, what do I know, right? 700 00:28:34,582 --> 00:28:37,498 - Dr. Archer, there's an issue with the CVP. 701 00:28:37,541 --> 00:28:39,413 Vitals are normal, but a CVP of 38 is-- 702 00:28:39,456 --> 00:28:41,328 - Yeah, way too high. Way high, I see that. 703 00:28:41,371 --> 00:28:42,808 I see that. 704 00:28:42,851 --> 00:28:45,724 Yes. Yes. 705 00:28:47,900 --> 00:28:49,379 I can't zero it out. 706 00:28:49,423 --> 00:28:51,338 - Here, let me try. Maybe I can recalibrate-- 707 00:28:51,381 --> 00:28:52,861 - No, no, just hold on a second. 708 00:28:52,905 --> 00:28:54,907 Let me just check something, let me just check something. 709 00:28:59,259 --> 00:29:01,391 Ah. Look at this. 710 00:29:01,435 --> 00:29:03,785 Cable's got a kink in it. See that? 711 00:29:03,829 --> 00:29:05,744 Can I have a new one, please? - Yeah. 712 00:29:05,787 --> 00:29:07,876 - Yeah, must have snagged on the bed railings 713 00:29:07,920 --> 00:29:12,663 on the trip from the O.R. 714 00:29:12,707 --> 00:29:15,405 [machine beeps] Oh, yeah. 715 00:29:15,449 --> 00:29:19,845 CVP of 11. And problem solved. 716 00:29:19,888 --> 00:29:21,847 That was a close shave, yeah? 717 00:29:21,890 --> 00:29:23,762 - [chuckles] Yeah. Glad it worked out. 718 00:29:23,805 --> 00:29:25,894 - Yeah. See you back in the E.D. 719 00:29:25,938 --> 00:29:27,287 - Yeah. - All right. 720 00:29:27,330 --> 00:29:32,466 ♪ 721 00:29:32,509 --> 00:29:34,773 - [groans] Help me! 722 00:29:34,816 --> 00:29:36,644 Please. Help me, please. 723 00:29:36,687 --> 00:29:38,559 - Hey, Mr. Kumar, I'm here. What's going on? 724 00:29:38,602 --> 00:29:41,388 My back. My back is on fire. 725 00:29:41,431 --> 00:29:42,606 - Okay. - Radiologist said 726 00:29:42,650 --> 00:29:43,956 that the stent would ease the pain, 727 00:29:43,999 --> 00:29:46,654 but it's worse, it's worse. 728 00:29:46,697 --> 00:29:48,656 And my legs are numb. 729 00:29:48,699 --> 00:29:49,875 They're numb. - Okay. 730 00:29:49,918 --> 00:29:50,876 - I can't move them. - Okay, we're gonna 731 00:29:50,919 --> 00:29:52,312 figure this out. 732 00:29:55,576 --> 00:29:57,665 No way this is an aneurysm. [grunts] 733 00:29:57,708 --> 00:30:00,799 - I need an MRI. - Ow! 734 00:30:00,842 --> 00:30:02,844 [sobs] 735 00:30:08,197 --> 00:30:08,415 . 736 00:30:08,458 --> 00:30:11,026 - Damn it. I knew it. 737 00:30:11,070 --> 00:30:12,854 - Tumor in the inner layer of the aorta. 738 00:30:12,898 --> 00:30:14,334 - It's occluding several perforating vessels 739 00:30:14,377 --> 00:30:16,075 to the spine. It's not getting enough blood. 740 00:30:16,118 --> 00:30:17,859 Explains why his legs went numb. 741 00:30:17,903 --> 00:30:19,861 - Looks like blood's leaking into the wall of the aorta. 742 00:30:19,905 --> 00:30:21,080 If it keeps compressing the vessels-- 743 00:30:21,123 --> 00:30:24,083 - His legs will go from numb to paralyzed. 744 00:30:24,126 --> 00:30:25,649 That tumor's gotta come out. 745 00:30:27,042 --> 00:30:29,305 - Roland doesn't have schizophrenia? 746 00:30:29,349 --> 00:30:31,438 - I don't believe he does. 747 00:30:31,481 --> 00:30:34,833 After talking with him, looking at his test results, 748 00:30:34,876 --> 00:30:37,661 getting more medical history from Dr. Scott, 749 00:30:37,705 --> 00:30:39,925 it's my belief that the more appropriate diagnosis 750 00:30:39,968 --> 00:30:41,709 would be bipolar disorder. 751 00:30:41,752 --> 00:30:43,885 - But the other psychiatrist-- - Was wrong. 752 00:30:45,844 --> 00:30:49,151 - But he was so sure. Said he'd seen it before. 753 00:30:49,195 --> 00:30:52,111 - Psychiatry is far from an exact science. 754 00:30:52,154 --> 00:30:55,288 And unfortunately, research does show 755 00:30:55,331 --> 00:30:57,768 that African Americans, particularly males, 756 00:30:57,812 --> 00:31:01,120 are misdiagnosed with schizophrenia 757 00:31:01,163 --> 00:31:02,469 far more than whites. 758 00:31:02,512 --> 00:31:04,906 - We're perceived as dangerous, 759 00:31:04,950 --> 00:31:08,388 and so we get a diagnosis to match that perception. 760 00:31:08,431 --> 00:31:10,303 - This why the dosage on Roland's meds 761 00:31:10,346 --> 00:31:11,913 was so high also? 762 00:31:11,957 --> 00:31:14,742 Because he was assumed to be a threat? 763 00:31:14,785 --> 00:31:17,876 - It's very likely. 764 00:31:17,919 --> 00:31:20,443 And that high dose also probably contributed 765 00:31:20,487 --> 00:31:22,141 to exacerbating the condition that I think 766 00:31:22,184 --> 00:31:24,360 that he actually has. 767 00:31:24,404 --> 00:31:26,928 - Today could have been avoided. 768 00:31:26,972 --> 00:31:28,843 - I'm so sorry. 769 00:31:31,324 --> 00:31:33,979 - Is there a way to make things right? 770 00:31:34,022 --> 00:31:37,025 - We do a complete reassessment, okay? 771 00:31:37,069 --> 00:31:40,855 New meds. The right doses. Therapy. 772 00:31:40,899 --> 00:31:42,161 I know of an outpatient clinic 773 00:31:42,204 --> 00:31:44,859 that I think that Roland would really respond to. 774 00:31:44,903 --> 00:31:46,730 Okay? 775 00:31:46,774 --> 00:31:48,950 I'm gonna leave you two for a minute. 776 00:31:48,994 --> 00:31:51,083 - Thank you. - Of course. 777 00:31:51,126 --> 00:31:54,956 [solemn music] 778 00:31:55,000 --> 00:31:56,871 - What do you think? 779 00:31:56,915 --> 00:31:58,742 - I think he sees the same thing in Roland 780 00:31:58,786 --> 00:32:00,048 that we see. 781 00:32:02,833 --> 00:32:06,228 What do you say? Follow Dr. Charles' advice? 782 00:32:12,234 --> 00:32:15,020 - An anomaly? I don't understand. 783 00:32:15,063 --> 00:32:17,152 According to your medical records, 784 00:32:17,196 --> 00:32:20,199 we have reason to question whether your original tumor 785 00:32:20,242 --> 00:32:23,289 was in fact anaplastic astrocytoma. 786 00:32:23,332 --> 00:32:24,943 - We came across a pathology report 787 00:32:24,986 --> 00:32:27,902 that suggests it might be pilocytic astrocytoma. 788 00:32:27,946 --> 00:32:30,035 - Well, what's the difference? 789 00:32:30,078 --> 00:32:34,256 - Anaplastic is malignant. Pilocytic is benign. 790 00:32:34,300 --> 00:32:37,390 - So I might not have cancer? 791 00:32:37,433 --> 00:32:39,131 - We don't know. 792 00:32:39,174 --> 00:32:40,828 - There's no tissue left from that original tumor 793 00:32:40,871 --> 00:32:42,264 to examine. 794 00:32:42,308 --> 00:32:43,962 In order to make an updated diagnosis, 795 00:32:44,005 --> 00:32:45,920 we'd need to test a new sample. 796 00:32:45,964 --> 00:32:48,488 - Biopsy the latest recurrence. 797 00:32:48,531 --> 00:32:51,012 - In 1991, technology only allowed us 798 00:32:51,056 --> 00:32:53,841 to analyze the tumor's tissue. 799 00:32:53,884 --> 00:32:56,365 Today, we're able to dissect its molecular structure. 800 00:32:56,409 --> 00:32:58,585 Identification will be exact. 801 00:32:58,628 --> 00:33:00,891 - Even so, I might still have cancer. 802 00:33:00,935 --> 00:33:02,067 - More and more I'm suspecting that 803 00:33:02,110 --> 00:33:04,417 that is not the case. - Why? 804 00:33:04,460 --> 00:33:06,071 - Because you're alive. 805 00:33:06,114 --> 00:33:09,944 People with anaplastic astrocytoma 806 00:33:09,988 --> 00:33:11,990 simply don't live as long as you have. 807 00:33:13,992 --> 00:33:16,559 - [sighs] Okay. 808 00:33:18,605 --> 00:33:20,433 Okay, do the biopsy. 809 00:33:20,476 --> 00:33:26,178 ♪ 810 00:33:26,221 --> 00:33:28,919 - Dr. Marcel, I presume. - Yeah. 811 00:33:28,963 --> 00:33:31,357 - Dr. Simms, cardiothoracic surgery. 812 00:33:31,400 --> 00:33:32,575 - Pleasure. 813 00:33:32,619 --> 00:33:34,838 - Radiology filled me in on the patient. 814 00:33:34,882 --> 00:33:36,884 Aortic tumor. - Mm-hmm. 815 00:33:36,927 --> 00:33:38,320 - Nice call. 816 00:33:38,364 --> 00:33:41,236 From the get go and despite the cath lab, I hear. 817 00:33:41,280 --> 00:33:43,891 - Yeah, it wasn't a straight line, but, uh, 818 00:33:43,934 --> 00:33:45,501 we're back on track now. 819 00:33:45,545 --> 00:33:49,201 - I appreciate the head start, but I'll take it from here. 820 00:33:49,244 --> 00:33:52,987 - Uh, I assumed I would perform the surgery. 821 00:33:53,031 --> 00:33:54,206 - I understand, 822 00:33:54,249 --> 00:33:56,469 but this is a cardiovascular procedure. 823 00:33:56,512 --> 00:33:58,862 Not a trauma. Little out of your lane. 824 00:33:58,906 --> 00:34:02,127 - I'm aware of what it is, and I have the skills. 825 00:34:02,170 --> 00:34:05,173 - Maybe, but you don't have the credentials. 826 00:34:05,217 --> 00:34:08,133 You're a general surgeon, not a specialist. 827 00:34:08,176 --> 00:34:09,351 - I just want to make something very clear, 828 00:34:09,395 --> 00:34:10,918 Mr. Kumar is my patient. 829 00:34:10,961 --> 00:34:12,180 - Dr. Marcel. 830 00:34:12,224 --> 00:34:14,052 Do you really want to waste time 831 00:34:14,095 --> 00:34:16,054 fighting an argument you're not going to win? 832 00:34:17,359 --> 00:34:20,319 You're free to watch from the observation room. 833 00:34:20,362 --> 00:34:23,148 [tense music] 834 00:34:23,191 --> 00:34:26,977 ♪ 835 00:34:33,984 --> 00:34:34,333 . 836 00:34:34,376 --> 00:34:37,945 - Wow. What a view. 837 00:34:37,988 --> 00:34:41,601 You can almost see the entire city. 838 00:34:41,644 --> 00:34:45,953 And yet, it's the best spot in the hospital to be alone. 839 00:34:47,781 --> 00:34:49,435 - Rehearsal didn't go well this morning. 840 00:34:51,132 --> 00:34:53,439 - Okay... 841 00:34:53,482 --> 00:34:55,963 - So I flirted with the subtle suggestion 842 00:34:56,006 --> 00:35:00,446 from Dr. Cooper to sabotage Dr. Archer's CVP monitor. 843 00:35:00,489 --> 00:35:02,535 - Sabotage? - Yeah. 844 00:35:02,578 --> 00:35:05,146 So that the Vas-COM could save the day. 845 00:35:05,190 --> 00:35:06,626 And I came this close to doing it. 846 00:35:06,669 --> 00:35:08,410 - But you didn't. 847 00:35:08,454 --> 00:35:10,108 - But I'm afraid I could've. 848 00:35:10,151 --> 00:35:12,022 - Look, in the past, 849 00:35:12,066 --> 00:35:15,374 every time you've acted injudiciously, 850 00:35:15,417 --> 00:35:18,377 you've always kept your patient's best interest 851 00:35:18,420 --> 00:35:21,075 at heart, and I know you always will. 852 00:35:21,119 --> 00:35:23,382 [pensive music] 853 00:35:23,425 --> 00:35:24,644 - Thanks. 854 00:35:27,168 --> 00:35:29,039 - And Dr. Halstead... 855 00:35:30,954 --> 00:35:34,523 If this ever gets to be too much for you, 856 00:35:34,567 --> 00:35:38,353 tell me, and I'll put a stop to the whole thing. 857 00:35:38,397 --> 00:35:45,404 ♪ 858 00:35:47,754 --> 00:35:50,104 - Benign? 859 00:35:50,148 --> 00:35:54,152 So all this time, I never had cancer? 860 00:35:54,195 --> 00:35:55,718 - No. 861 00:35:55,762 --> 00:35:58,678 There are two pathologists listed in your medical records. 862 00:36:00,027 --> 00:36:01,463 The first who examined your tumor 863 00:36:01,507 --> 00:36:03,639 thought that it was benign. 864 00:36:03,683 --> 00:36:07,469 But he was a young attending. Inexperienced. 865 00:36:07,513 --> 00:36:09,515 Wanted a second opinion. 866 00:36:09,558 --> 00:36:12,866 So he sent a sample to a renowned cancer center, 867 00:36:12,909 --> 00:36:13,910 and the pathologist there 868 00:36:13,954 --> 00:36:17,392 diagnosed anaplastic astrocytoma. 869 00:36:17,436 --> 00:36:18,524 - 30 years. 870 00:36:21,091 --> 00:36:23,790 Every headache, every seizure. 871 00:36:23,833 --> 00:36:27,141 Just feeling off, I thought it was the end. 872 00:36:27,185 --> 00:36:30,405 Three decades of facing death every single day, 873 00:36:30,449 --> 00:36:32,929 and my family and my friends, they suffer too. 874 00:36:34,540 --> 00:36:35,541 - Ashley. 875 00:36:37,107 --> 00:36:39,762 I'm so sorry for what you've been through. 876 00:36:41,460 --> 00:36:43,070 But at least 877 00:36:43,113 --> 00:36:46,204 you are no longer living on borrowed time. 878 00:36:49,207 --> 00:36:52,427 Your future can be anything that you want it to be. 879 00:36:55,865 --> 00:36:57,737 [knock at door] 880 00:36:57,780 --> 00:37:00,087 - Heard your door is always open. 881 00:37:00,130 --> 00:37:02,437 - Literally, right? Come on in. 882 00:37:04,787 --> 00:37:06,789 Am I sensing that it might be time 883 00:37:06,833 --> 00:37:08,138 for a little drink? 884 00:37:08,182 --> 00:37:09,966 - Oh, pour it up. 885 00:37:10,010 --> 00:37:12,839 - Have a seat. - Thanks. 886 00:37:12,882 --> 00:37:14,275 Oh, man. 887 00:37:14,319 --> 00:37:16,538 Had I not beaten the cops to the scene today, 888 00:37:16,582 --> 00:37:19,106 Roland could be in the system now, or worse. 889 00:37:19,149 --> 00:37:22,065 Seems like happy endings are hard to come by these days. 890 00:37:22,109 --> 00:37:24,633 - Seems that way, huh? 891 00:37:24,677 --> 00:37:26,113 - Situation like today, 892 00:37:26,156 --> 00:37:28,115 there's nobody else to call for help but the police. 893 00:37:28,158 --> 00:37:29,508 But they're not equipped 894 00:37:29,551 --> 00:37:31,161 to handle mental illness, you know. 895 00:37:32,946 --> 00:37:35,470 I mean, don't get me wrong, there are a few bad cops, 896 00:37:35,514 --> 00:37:38,778 but the rest, most, are just doing the best they can 897 00:37:38,821 --> 00:37:40,301 with the tools they've been given. 898 00:37:40,345 --> 00:37:42,303 - It's a tough job. - Huh. 899 00:37:42,347 --> 00:37:45,698 And in need of some updates. 900 00:37:45,741 --> 00:37:48,657 - So, uh, so what are you thinking? 901 00:37:48,701 --> 00:37:51,834 - CPD is developing a crisis intervention program. 902 00:37:51,878 --> 00:37:54,184 A unit trained specifically for de-escalation. 903 00:37:54,228 --> 00:37:56,970 - Sounds like a solid first step in police reform to me. 904 00:37:57,013 --> 00:37:58,276 - Agreed. 905 00:37:58,319 --> 00:37:59,320 I mean, it's what I did today on the street. 906 00:37:59,364 --> 00:38:01,148 - Which proves that it works. 907 00:38:01,191 --> 00:38:03,106 - Was hoping you'd say that. 908 00:38:03,150 --> 00:38:04,978 So the thing is, the program, it's on the table, 909 00:38:05,021 --> 00:38:06,240 but it's stuck there. 910 00:38:06,284 --> 00:38:07,502 Lots of training needed for police, 911 00:38:07,546 --> 00:38:09,678 but not enough training resources. 912 00:38:09,722 --> 00:38:11,027 I don't know the time commitment, 913 00:38:11,071 --> 00:38:13,813 and I can only imagine that the bureaucracy 914 00:38:13,856 --> 00:38:15,902 will be infuriating-- - I'm in. 915 00:38:19,601 --> 00:38:22,300 - [laughs] That was easy. 916 00:38:30,830 --> 00:38:34,790 - Oh, excuse me. Just grabbing a snack. 917 00:38:34,834 --> 00:38:36,096 - Taking five, I hope? 918 00:38:36,139 --> 00:38:38,228 - More like a 30-second breather. 919 00:38:38,272 --> 00:38:40,709 But, since I've been caught, 920 00:38:40,753 --> 00:38:42,189 I guess I have four and a half minutes to go. 921 00:38:47,890 --> 00:38:49,762 - You okay? 922 00:38:49,805 --> 00:38:50,980 - Yeah. 923 00:38:51,024 --> 00:38:52,852 No. 924 00:38:52,895 --> 00:38:55,028 My aortic patient. 925 00:38:55,071 --> 00:38:57,552 His procedure was a success, I just-- 926 00:38:57,596 --> 00:38:59,685 I wasn't able to see it all the way through. 927 00:38:59,728 --> 00:39:01,687 Got benched by the powers that be. 928 00:39:03,341 --> 00:39:05,865 It's frustrating, you know? 929 00:39:05,908 --> 00:39:07,257 - I'm sorry. 930 00:39:07,301 --> 00:39:08,302 - Yeah. 931 00:39:11,958 --> 00:39:13,307 - Sorry. I, um-- 932 00:39:13,351 --> 00:39:14,917 I didn't mean to, uh-- 933 00:39:14,961 --> 00:39:16,005 you know what, that was inappropriate. 934 00:39:16,049 --> 00:39:17,180 I don't know what I was thinking. 935 00:39:17,224 --> 00:39:19,574 - It's okay. We're good. 936 00:39:19,618 --> 00:39:21,881 Don't worry. - Okay. Cool. 937 00:39:21,924 --> 00:39:26,276 I have to go, uh, check on some test results, so, uh. 938 00:39:30,716 --> 00:39:33,719 Uh, Dr. Hammer, Maggie, I just--I need a minute. 939 00:39:33,762 --> 00:39:36,199 - Sure. 940 00:39:36,243 --> 00:39:39,289 That's gonna sting for a bit. She'll be okay. 941 00:39:39,333 --> 00:39:46,340 ♪ 942 00:39:50,388 --> 00:39:53,913 Heavy day. - Yep. 943 00:39:53,956 --> 00:39:55,436 - And not just the case. 944 00:39:55,480 --> 00:39:57,743 I, um-- 945 00:39:57,786 --> 00:40:00,615 I made a fool of myself for Dr. Marcel. 946 00:40:00,659 --> 00:40:02,182 - The doctors' lounge? 947 00:40:04,358 --> 00:40:08,406 - I'm so embarrassed. I'm crushing on my advisor? 948 00:40:08,449 --> 00:40:11,278 Seriously, I'm a cliché. 949 00:40:11,321 --> 00:40:14,934 - Kind of. Welcome to the club. 950 00:40:14,977 --> 00:40:18,154 - For real? You? - Yeah. 951 00:40:18,198 --> 00:40:21,941 My Crockett was Dr. Andrew Jacobson. 952 00:40:21,984 --> 00:40:23,246 - Well, I'm sure you handled it 953 00:40:23,290 --> 00:40:24,378 better than I did. 954 00:40:24,422 --> 00:40:26,641 - If only. 955 00:40:26,685 --> 00:40:30,123 Would have spared me a lot of heartache. 956 00:40:30,166 --> 00:40:32,299 Instead I married him. 957 00:40:32,342 --> 00:40:34,083 - Oh, I didn't even know that you were married. 958 00:40:34,127 --> 00:40:36,738 - I'm not, no. Didn't work out. 959 00:40:38,871 --> 00:40:41,917 [siren blares] That's our cue. 960 00:40:45,051 --> 00:40:47,445 Get back to it? - Let's go. 961 00:40:59,979 --> 00:41:02,938 [dramatic music] 962 00:41:02,982 --> 00:41:09,989 ♪ 963 00:41:30,009 --> 00:41:33,012 [wolf howls]