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These are the user uploaded subtitles that are being translated: 1 00:00:04,410 --> 00:00:06,200 - You have to work out whatever feelings you're having 2 00:00:06,240 --> 00:00:07,850 about Dr. Marcel. 3 00:00:07,890 --> 00:00:09,150 Fast. 4 00:00:11,720 --> 00:00:12,850 - Give me a Narcan inhaler. 5 00:00:16,210 --> 00:00:18,250 - You overdosed, but you're gonna be all right. 6 00:00:18,300 --> 00:00:20,130 - You're letting this get way too personal, Will. 7 00:00:20,170 --> 00:00:21,170 It's never a good idea. 8 00:00:21,210 --> 00:00:22,690 - For God's sake, isn't it personal? 9 00:00:22,730 --> 00:00:24,470 You lost a brother to drugs. 10 00:00:24,520 --> 00:00:25,690 - Enough! 11 00:00:28,040 --> 00:00:29,090 - I met you this morning. 12 00:00:29,130 --> 00:00:30,740 I'm gonna try to turn things around. 13 00:00:30,790 --> 00:00:31,750 - Good. 14 00:00:37,580 --> 00:00:38,720 - Hey. 15 00:00:38,750 --> 00:00:40,450 Hi. 16 00:00:50,240 --> 00:00:51,410 I love you. 17 00:00:51,460 --> 00:00:52,630 - Easy. - Oh, God, sorry. 18 00:00:52,680 --> 00:00:53,680 - It's only me. 19 00:00:53,720 --> 00:00:55,550 - I wasn't expecting that. 20 00:00:55,590 --> 00:00:58,460 - Hey, I know work's not the place for ambush affection, 21 00:00:58,510 --> 00:01:00,080 but I couldn't help myself. 22 00:01:00,120 --> 00:01:01,600 - I won't hold it against you. 23 00:01:01,640 --> 00:01:03,430 - What's up? 24 00:01:03,470 --> 00:01:06,600 I haven't seen a smile this big since Navy beat Army. 25 00:01:07,690 --> 00:01:10,260 Just thinking about being a dad. 26 00:01:10,300 --> 00:01:12,960 Birthday parties, coaching teams. 27 00:01:13,000 --> 00:01:16,790 - It's a decade down the road. We are three weeks into IVF. 28 00:01:16,830 --> 00:01:18,050 - You know what they say. 29 00:01:18,090 --> 00:01:20,100 "You blink and the kids are grown." 30 00:01:22,230 --> 00:01:23,790 Hey. - What up? 31 00:01:23,840 --> 00:01:25,800 Pelicans covered the spread. 32 00:01:25,840 --> 00:01:28,150 - How many rings do the Pelicans have? 33 00:01:28,190 --> 00:01:29,760 - Go Bulls. 34 00:01:29,800 --> 00:01:31,800 - Yeah, we'll see. 35 00:01:37,030 --> 00:01:38,780 - I'm a horrible person, aren't I? 36 00:01:38,810 --> 00:01:41,810 - No, you're human. 37 00:01:41,860 --> 00:01:43,250 What can I do to help? 38 00:01:43,290 --> 00:01:44,820 - You got a time machine? 39 00:01:48,430 --> 00:01:49,910 - Hey, you. - Hey. 40 00:01:49,950 --> 00:01:51,600 - Date last night. Spill it. 41 00:01:51,650 --> 00:01:53,130 - It was nice. 42 00:01:53,170 --> 00:01:57,310 He was polite, handsome, smart, but I don't think so. 43 00:01:57,350 --> 00:01:59,570 - Huh, well, polite, smart, and handsome. 44 00:01:59,610 --> 00:02:00,740 Sounds awful. - All right. 45 00:02:00,790 --> 00:02:03,490 The real reason, he's a psych professor. 46 00:02:03,530 --> 00:02:05,620 I mean, the way he looked at me, I just couldn't shake 47 00:02:05,660 --> 00:02:07,230 the feeling that I was being analyzed. 48 00:02:07,270 --> 00:02:08,320 - This is the fourth first date 49 00:02:08,360 --> 00:02:10,100 without even considering a second. 50 00:02:10,150 --> 00:02:11,890 - Well, I'm glad you're counting, Mom. 51 00:02:11,930 --> 00:02:13,320 It doesn't matter 52 00:02:13,370 --> 00:02:15,760 because none of those guys were gonna work out anyways. 53 00:02:15,800 --> 00:02:18,760 - Wow. ESP. 54 00:02:18,810 --> 00:02:20,720 Say, 55 00:02:20,770 --> 00:02:23,950 do you know when the Saints are gonna win another Super Bowl? 56 00:02:23,990 --> 00:02:25,300 All right, well, 57 00:02:25,340 --> 00:02:27,610 let me know if you get another vision. 58 00:02:29,170 --> 00:02:32,310 - All I'm saying is the right second date is out there 59 00:02:32,340 --> 00:02:35,000 and I'll know it when I meet him. 60 00:02:35,040 --> 00:02:37,040 - Help, please! My son! 61 00:02:37,090 --> 00:02:39,490 - I got him. Where am I going? 62 00:02:39,520 --> 00:02:41,310 - Trauma 1. - Help my husband and son! 63 00:02:41,350 --> 00:02:44,270 - Help, help, help, help, help! 64 00:02:46,700 --> 00:02:49,310 - Help him. I-I didn't know what to do. 65 00:02:51,930 --> 00:02:56,320 Ow, ow! 66 00:02:58,280 --> 00:03:00,410 - Bruising on his neck. Protect it and bag him. 67 00:03:00,460 --> 00:03:02,850 Hold C-spine. What's his name? 68 00:03:02,890 --> 00:03:05,070 - Jamie. - Jamie? 69 00:03:05,110 --> 00:03:09,200 Hey, Jamie, can you hear me? Okay, okay, take it easy. 70 00:03:09,250 --> 00:03:10,900 You're okay. Take it easy. 71 00:03:10,950 --> 00:03:12,870 What happened? - It was an accident. 72 00:03:12,900 --> 00:03:14,820 Um, I choked him out. 73 00:03:17,080 --> 00:03:18,780 I had to. 74 00:03:35,880 --> 00:03:37,840 - It all happened so fast. 75 00:03:37,890 --> 00:03:39,810 I didn't realize. I just wanted it to stop. 76 00:03:39,840 --> 00:03:42,060 Jamie was screaming, Dylan was crying, and-- 77 00:03:42,110 --> 00:03:43,280 - Gordon. 78 00:03:43,330 --> 00:03:44,940 I want you to take a deep breath, okay? 79 00:03:44,980 --> 00:03:47,290 Take a deep breath. 80 00:03:47,330 --> 00:03:49,420 All right. 81 00:03:49,460 --> 00:03:50,680 Have a seat. Sit down. 82 00:03:51,730 --> 00:03:53,740 Okay. 83 00:03:53,770 --> 00:03:55,690 And, um... 84 00:03:55,730 --> 00:03:58,860 I, uh, I just want you to tell me-- 85 00:03:58,910 --> 00:04:00,120 tell me what happened. 86 00:04:00,170 --> 00:04:01,470 - Okay. 87 00:04:01,520 --> 00:04:03,780 So I was driving, 88 00:04:03,820 --> 00:04:05,560 talking with Bella, my wife. 89 00:04:05,610 --> 00:04:08,130 The, um, the boys were in the back. 90 00:04:08,180 --> 00:04:10,400 Jamie was playing with his iPad. 91 00:04:10,440 --> 00:04:15,490 Dylan grabbed it from him, but wouldn't give it back. 92 00:04:15,530 --> 00:04:16,970 Jamie can't control his anger. 93 00:04:17,010 --> 00:04:18,800 He started punching Dylan, 94 00:04:18,840 --> 00:04:21,190 got out of his seat belt, got on top of him. 95 00:04:21,230 --> 00:04:23,760 He kept pounding. 96 00:04:23,800 --> 00:04:25,720 Bella couldn't pull him off. 97 00:04:29,370 --> 00:04:34,330 I could hear Jamie's fists cracking against Dylan's face. 98 00:04:34,380 --> 00:04:39,290 He was screaming for help, so I pulled over. 99 00:04:41,250 --> 00:04:42,820 Just threw myself on top of Jamie. 100 00:04:42,860 --> 00:04:44,120 I wrapped my arms around him 101 00:04:44,170 --> 00:04:46,480 and held him as tight as I could. 102 00:04:51,870 --> 00:04:53,180 When he gets like this, the bear hugs 103 00:04:53,220 --> 00:04:55,270 are the only thing that bring him back. 104 00:04:55,310 --> 00:04:58,660 - Bring him back? - From his dark place. 105 00:04:59,880 --> 00:05:03,840 - Uh-huh. Okay. 106 00:05:03,880 --> 00:05:05,360 Will you, um, 107 00:05:05,410 --> 00:05:08,020 will you excuse me for a moment, Gordon? 108 00:05:13,150 --> 00:05:17,380 - We're gonna take care of you little, man, okay? 109 00:05:17,420 --> 00:05:18,720 All right. 110 00:05:23,560 --> 00:05:25,040 Ordered a CT. 111 00:05:25,080 --> 00:05:26,300 But I'm almost positive 112 00:05:26,340 --> 00:05:28,690 there's a bilateral mandible fracture. 113 00:05:28,740 --> 00:05:30,920 Gonna need surgery to wire it shut. 114 00:05:33,260 --> 00:05:36,440 Man, Ethan. Kid's only six years old. 115 00:05:37,700 --> 00:05:38,960 Jamie? 116 00:05:40,490 --> 00:05:45,140 - He's stable but tormented. Dad choked him out. 117 00:05:45,190 --> 00:05:49,060 - Probably so he couldn't defend his little brother. 118 00:05:49,100 --> 00:05:50,970 Sometimes I hate the ED. 119 00:05:56,150 --> 00:06:00,030 - Jamie, how are you doing? I'm Dr. Charles. 120 00:06:00,070 --> 00:06:03,730 Um, would you mind if I looked at your hands? 121 00:06:09,390 --> 00:06:11,920 - Fifth metacarpal is broken on each hand. 122 00:06:11,950 --> 00:06:14,080 - That's really gotta hurt. 123 00:06:14,130 --> 00:06:17,910 Um, look, we're gonna get you completely fixed up. 124 00:06:17,960 --> 00:06:21,440 Okay? It was nice to meet you. 125 00:06:24,790 --> 00:06:26,530 This is not child abuse. 126 00:06:38,410 --> 00:06:39,940 - Thanks, man. 127 00:06:39,980 --> 00:06:41,500 - You know, one of the volunteers works 128 00:06:41,550 --> 00:06:43,240 at a rehab center. 129 00:06:43,290 --> 00:06:45,990 If you'd like, she can tell you about their program. 130 00:06:46,030 --> 00:06:49,380 - Yeah. Sure. 131 00:06:49,430 --> 00:06:51,000 Maybe another time. 132 00:06:54,520 --> 00:06:56,210 - If you change your mind, we're here. 133 00:07:01,520 --> 00:07:03,440 - Will. - Yeah? 134 00:07:03,480 --> 00:07:08,050 - You have been here for hours. Go home, get some rest. 135 00:07:08,100 --> 00:07:10,800 - Yeah, I could use some sleep before I start my shift. 136 00:07:10,840 --> 00:07:12,840 Ah, damn it. It starts in a half hour. 137 00:07:12,880 --> 00:07:14,060 Uh, okay. All right. 138 00:07:14,100 --> 00:07:15,840 That woman over there, her name's Susan. 139 00:07:15,890 --> 00:07:17,410 When she comes down, she's gonna be hungry. 140 00:07:17,450 --> 00:07:19,500 I stashed some protein bars-- - I know, I saw. 141 00:07:19,540 --> 00:07:22,280 The electrolyte drinks too. Get to work. 142 00:07:24,020 --> 00:07:25,500 - I'll be back later, you call me 143 00:07:25,550 --> 00:07:28,110 if you need anything. 144 00:07:28,160 --> 00:07:32,160 - That's the cry, that one. 145 00:07:32,210 --> 00:07:35,250 It's not "I'm hungry" or "I'm tired." 146 00:07:35,300 --> 00:07:37,040 It's new. 147 00:07:37,080 --> 00:07:39,820 - Okay. I know, I know, Axel. 148 00:07:39,870 --> 00:07:43,520 You're in pain and my touching you is only making it worse. 149 00:07:43,570 --> 00:07:45,700 Any changes in his sleep pattern? 150 00:07:45,740 --> 00:07:47,480 - No. Every baby book I read said 151 00:07:47,530 --> 00:07:49,530 put your child on a schedule and stick to it. 152 00:07:49,570 --> 00:07:51,440 - Been there. My son's almost four. 153 00:07:51,490 --> 00:07:54,580 I know, I know. Almost finished. 154 00:07:54,620 --> 00:07:56,840 Okay. What about diet? 155 00:07:56,880 --> 00:07:58,750 - I had to start using formula. 156 00:07:58,800 --> 00:08:00,190 Just not enough hours in the day 157 00:08:00,230 --> 00:08:03,800 to pump, work, nurse, do laundry, pump again. 158 00:08:03,850 --> 00:08:07,070 - Single mom? Yeah, me too. 159 00:08:07,110 --> 00:08:09,900 Dad still in the picture? - No, but I'm okay with it. 160 00:08:11,680 --> 00:08:13,680 - Well, I'm not seeing anything out of the ordinary. 161 00:08:13,730 --> 00:08:15,420 I mean, the switch from breast milk to formula 162 00:08:15,470 --> 00:08:17,420 could be upsetting Axel's stomach. 163 00:08:17,470 --> 00:08:19,430 Have you noticed any diarrhea since the change? 164 00:08:19,470 --> 00:08:20,820 - Here and there. 165 00:08:20,860 --> 00:08:23,430 But this cry has been consistent for the last month. 166 00:08:23,480 --> 00:08:26,710 - I'll test for allergies, but infants and crying-- 167 00:08:26,740 --> 00:08:28,310 - Don't say colic. 168 00:08:28,350 --> 00:08:30,050 I've been to three pediatricians. 169 00:08:30,090 --> 00:08:32,400 They all diagnosed colic and sent me home. 170 00:08:33,440 --> 00:08:36,230 No. Something else is going on. 171 00:08:36,270 --> 00:08:39,580 Run tests, X-rays, scans. Just please, figure it out. 172 00:08:39,620 --> 00:08:41,230 - Okay, well, why don't we start 173 00:08:41,280 --> 00:08:43,290 with some basic labs and go from there? 174 00:08:45,930 --> 00:08:47,500 Is that okay? 175 00:08:47,540 --> 00:08:49,370 - Sure. Thank you. 176 00:08:50,720 --> 00:08:53,290 - I'll send a nurse in to get started. 177 00:08:57,120 --> 00:08:59,210 - Thank you. 178 00:08:59,250 --> 00:09:02,380 Hey, Jamie, you hungry? Thirsty? 179 00:09:04,430 --> 00:09:07,430 I know your casts are bulky. I can help you. 180 00:09:07,480 --> 00:09:09,660 I'll leave the tray right here just in case. 181 00:09:14,960 --> 00:09:18,090 - Hi. Nice to meet you. 182 00:09:18,140 --> 00:09:20,010 - They're talking about me. 183 00:09:24,140 --> 00:09:26,670 About what I did to my little brother. 184 00:09:28,980 --> 00:09:30,680 I didn't mean to hurt him. 185 00:09:32,500 --> 00:09:33,460 I'm so sorry. 186 00:09:33,500 --> 00:09:35,630 - It's okay. Okay, okay. 187 00:09:42,990 --> 00:09:45,300 - Well, after two miscarriages and five failed IVF attempts, 188 00:09:45,340 --> 00:09:46,560 we'd had enough heartbreak. 189 00:09:46,600 --> 00:09:49,560 - We adopted Jamie when he was a few days old. 190 00:09:49,610 --> 00:09:51,570 Best day of our lives. 191 00:09:51,610 --> 00:09:53,910 - Do you know anything about his birth parents? 192 00:09:53,960 --> 00:09:58,260 - Nothing really. Mom was young, in foster care. 193 00:09:58,310 --> 00:09:59,440 We don't know anything about dad. 194 00:09:59,480 --> 00:10:00,920 - Well, Jamie's 11 now, 195 00:10:00,960 --> 00:10:03,880 so how old was he when he first started acting out? 196 00:10:03,920 --> 00:10:05,970 - As an infant, he didn't like being held. 197 00:10:06,010 --> 00:10:09,670 Was always fidgety. - Hmm, how about as a toddler? 198 00:10:09,710 --> 00:10:12,450 - Sitting still, taking turns, following directions, 199 00:10:12,500 --> 00:10:14,150 they were all a challenge. 200 00:10:14,190 --> 00:10:17,020 - When did Jamie's behavior start becoming aggressive? 201 00:10:17,070 --> 00:10:18,760 - Elementary school. 202 00:10:18,810 --> 00:10:21,680 Fights with classmates and teachers. 203 00:10:21,720 --> 00:10:23,420 We're homeschooling now. 204 00:10:23,460 --> 00:10:26,820 - And your other son, Dylan, is he adopted as well? 205 00:10:26,860 --> 00:10:28,380 - Yeah. - Mm-hmm. 206 00:10:28,430 --> 00:10:31,560 It was initially Jamie's idea. He wanted to be a big brother. 207 00:10:31,600 --> 00:10:34,950 - And in the beginning, Dylan's presence seemed to calm Jamie. 208 00:10:35,000 --> 00:10:37,910 He would push his stroller, feed him his bottle, 209 00:10:37,960 --> 00:10:39,390 let him climb all over him. 210 00:10:39,440 --> 00:10:43,830 - They are so-- were so close. 211 00:10:43,880 --> 00:10:46,010 - I'm assuming that Jamie's been evaluated 212 00:10:46,050 --> 00:10:47,310 by a psychiatrist. 213 00:10:47,360 --> 00:10:48,530 - Several. 214 00:10:48,580 --> 00:10:51,010 They all just head to the diagnosis. 215 00:10:51,060 --> 00:10:53,190 Intermittent explosive disorder, 216 00:10:53,230 --> 00:10:55,800 comorbid ADHD, 217 00:10:55,850 --> 00:10:58,810 disruptive mood dysregulation disorder. 218 00:10:58,850 --> 00:11:01,850 - Tell me, what meds is he on right now? 219 00:11:01,890 --> 00:11:05,940 - Risperidone, valproic acid, lithium, Adderall, Tenex. 220 00:11:05,990 --> 00:11:08,820 They all work for a bit, but then-- 221 00:11:08,860 --> 00:11:10,990 - He always ends up in his dark place. 222 00:11:11,030 --> 00:11:12,300 - Yeah. 223 00:11:13,990 --> 00:11:16,210 - Mr. and Mrs. Shaw, Dylan's out of surgery. 224 00:11:16,260 --> 00:11:17,910 I'll take you to recovery. 225 00:11:17,950 --> 00:11:19,690 - Look, what I'd like to do 226 00:11:19,740 --> 00:11:21,910 is admit Jamie for a five day hold. 227 00:11:21,960 --> 00:11:24,000 That'll give us a chance to assess the situation 228 00:11:24,050 --> 00:11:25,960 and come up with some treatment options for you. 229 00:11:26,010 --> 00:11:28,230 - Anything. Please, just help him. 230 00:11:28,270 --> 00:11:29,360 - Yeah. 231 00:11:34,840 --> 00:11:36,100 - Shh. He's out. 232 00:11:36,150 --> 00:11:38,890 Cried himself to sleep. What'd the tests say? 233 00:11:38,930 --> 00:11:40,760 - The labs were normal. 234 00:11:40,800 --> 00:11:43,280 But the babygram revealed a mild bowel distention. 235 00:11:43,330 --> 00:11:44,590 There are no obstructions. 236 00:11:44,630 --> 00:11:47,330 However, the stool in Axel's diaper was watery. 237 00:11:47,370 --> 00:11:49,070 That suggests a GI issue. 238 00:11:49,120 --> 00:11:50,910 - Okay. What do you do for that? 239 00:11:50,940 --> 00:11:51,810 - Endoscopy. 240 00:11:51,860 --> 00:11:53,380 So under a general anesthesia, 241 00:11:53,420 --> 00:11:55,730 a surgeon will guide a camera down Axel's throat 242 00:11:55,770 --> 00:11:58,210 into his GI tract to search for abnormalities. 243 00:11:58,260 --> 00:12:00,700 And if necessary, we'll do a colonoscopy as well. 244 00:12:00,740 --> 00:12:02,610 - Mm. Can I be there? 245 00:12:03,830 --> 00:12:05,390 - I wouldn't recommend that. 246 00:12:05,440 --> 00:12:09,310 I mean, seeing the scope inside Axel, it might be upsetting. 247 00:12:09,350 --> 00:12:12,310 - No, I really wanna be there. - Are you sure? 248 00:12:12,360 --> 00:12:14,920 Because I can't overstate how distressing 249 00:12:14,970 --> 00:12:17,060 this procedure can be for a parent to watch. 250 00:12:17,100 --> 00:12:19,410 I mean, seeing your child on the table, unconscious-- 251 00:12:19,450 --> 00:12:22,230 - I'll be okay. 252 00:12:22,280 --> 00:12:23,450 - All right. 253 00:12:23,500 --> 00:12:25,540 Techs will be by shortly to bring up Axel. 254 00:12:25,590 --> 00:12:26,980 I'll be there as well. 255 00:12:29,630 --> 00:12:32,030 - Signed. - Thank you. 256 00:12:34,470 --> 00:12:35,870 - Hey, Doris. 257 00:12:35,900 --> 00:12:38,770 Julia, the mom in Treatment III, did you get a read? 258 00:12:38,820 --> 00:12:40,340 - I like her. 259 00:12:40,380 --> 00:12:43,520 I wish all parents would handle the ED that smoothly. 260 00:12:43,560 --> 00:12:45,170 - You don't think she's too composed? 261 00:12:45,220 --> 00:12:47,050 I mean, her son is clearly in distress 262 00:12:47,090 --> 00:12:48,350 and she hasn't even broken a sweat. 263 00:12:48,390 --> 00:12:50,650 - Oh, there's that Manning ESP again. 264 00:12:50,700 --> 00:12:52,260 - Okay. 265 00:12:52,310 --> 00:12:55,140 She asked me to run more tests on her baby than necessary, 266 00:12:55,180 --> 00:12:57,360 and now she wants to be front row when he gets scoped. 267 00:12:57,400 --> 00:12:59,320 You don't think that's a little odd? 268 00:12:59,360 --> 00:13:01,970 - Uh, if you say so. 269 00:13:03,760 --> 00:13:05,110 - Call Dr. Frisch. 270 00:13:05,150 --> 00:13:07,320 I wanna put Axel on today's schedule for an endoscopy. 271 00:13:07,370 --> 00:13:09,630 - She's busy. Omphalocele repair. 272 00:13:09,670 --> 00:13:11,150 Gonna be locked away all day. 273 00:13:11,200 --> 00:13:13,420 But I'm free to take care of it right now if you'd like. 274 00:13:13,460 --> 00:13:15,590 - Okay. Thanks. 275 00:13:15,640 --> 00:13:18,420 - Meet you upstairs. Ms. Doris? 276 00:13:18,470 --> 00:13:20,520 - Thank you. - Sure. 277 00:13:20,550 --> 00:13:22,690 Nurse April. - Dr. Marcel. 278 00:13:26,340 --> 00:13:28,650 - Okay, stomach and esophagus appear normal. 279 00:13:28,690 --> 00:13:30,430 Let's reset for a colonoscopy. 280 00:13:32,960 --> 00:13:35,130 - Julia, are you okay? 281 00:13:35,180 --> 00:13:36,790 You don't have to keep watching, you know. 282 00:13:36,830 --> 00:13:38,140 - No, I'm okay. 283 00:13:38,180 --> 00:13:39,830 It's just I have a scrape on my stomach. 284 00:13:39,880 --> 00:13:41,100 I forgot to change the bandage 285 00:13:41,140 --> 00:13:42,880 and it's beginning to slide around. 286 00:13:42,930 --> 00:13:44,590 - Why don't I have a nurse change that out for you 287 00:13:44,620 --> 00:13:45,840 when we're back in the ED? 288 00:13:45,880 --> 00:13:48,490 - Oh, okay. Yeah. 289 00:13:48,540 --> 00:13:50,020 Thanks. - Yeah. 290 00:13:50,060 --> 00:13:52,280 - Somehow I keep scraping myself right there. 291 00:13:52,330 --> 00:13:54,860 I don't know how. Mom brain, I guess. 292 00:13:59,070 --> 00:14:01,380 - Ooh, ooh. Right there. 293 00:14:01,420 --> 00:14:03,990 - Okay. Sharp or dull pain, Chloe? 294 00:14:04,030 --> 00:14:06,250 - I think both. Is that even possible? 295 00:14:06,300 --> 00:14:08,040 - Unfortunately. 296 00:14:14,740 --> 00:14:16,170 How long have you been feeling off? 297 00:14:16,220 --> 00:14:18,440 - I don't know. A couple weeks? 298 00:14:18,480 --> 00:14:20,880 - Three months. She downplays everything. 299 00:14:20,920 --> 00:14:24,140 We just got married. 300 00:14:24,180 --> 00:14:26,100 I figured the pain was just nervous energy, 301 00:14:26,140 --> 00:14:29,750 but the wedding's behind us now and I still feel "blah." 302 00:14:29,800 --> 00:14:31,100 - Any constipation? Bloating? 303 00:14:31,150 --> 00:14:34,370 - She hasn't pooped in a week. 304 00:14:34,410 --> 00:14:36,370 - So Chloe, I'm gonna need to take a closer look 305 00:14:36,410 --> 00:14:37,670 to see what's going on. 306 00:14:37,720 --> 00:14:40,200 We'll get some X-rays, a pelvic and a rectal. 307 00:14:40,240 --> 00:14:42,370 - Just keeping the sexy flowing, aren't I? 308 00:14:42,420 --> 00:14:45,200 - Till death do us part. 309 00:14:45,250 --> 00:14:47,210 - Well, a nurse will come in and get things going. 310 00:14:47,250 --> 00:14:49,380 Congratulations, Mr. and Mrs. James. 311 00:14:51,520 --> 00:14:52,740 - Crockett. - Yeah? 312 00:14:52,780 --> 00:14:53,910 - Perfect timing. 313 00:14:53,950 --> 00:14:55,390 Single vehicle accident landing now. 314 00:14:55,430 --> 00:14:57,690 Massive trauma. I'll have Baghdad ready. 315 00:14:57,740 --> 00:14:58,910 - Got it. 316 00:15:01,000 --> 00:15:03,000 What do you got? - Lucy Seaver, 20. 317 00:15:03,050 --> 00:15:05,400 GCS 3. Intubated in the field. 318 00:15:05,440 --> 00:15:07,970 Bilateral femur fractures and traction splints. 319 00:15:08,010 --> 00:15:10,140 SATS 100% on oxygen. 320 00:15:10,190 --> 00:15:12,710 - Okay, Lucy, don't be afraid. You're in the ED. 321 00:15:12,750 --> 00:15:13,970 We're gonna take good care of you. 322 00:15:14,020 --> 00:15:15,540 - Parents should be here any second. 323 00:15:15,580 --> 00:15:16,800 They were on the scene. 324 00:15:16,840 --> 00:15:18,060 They were in the car behind Lucy. 325 00:15:18,110 --> 00:15:20,240 - They saw the crash? - And the aftermath. 326 00:15:20,280 --> 00:15:22,760 Lucy's car was so mangled, it took us 20 minutes 327 00:15:22,810 --> 00:15:24,940 to extricate her and get her in the ambo. 328 00:15:24,980 --> 00:15:26,070 - Okay, all right. Here we go. 329 00:15:26,120 --> 00:15:28,820 On my count. One, two, three. 330 00:15:30,340 --> 00:15:31,380 - All right. 331 00:15:36,080 --> 00:15:38,130 - Good breath sounds bilaterally. 332 00:15:41,870 --> 00:15:44,480 Belly's hard as a rock. - BP's 70s. 333 00:15:44,520 --> 00:15:46,220 - Two of plasma, two of blood on the transfuser. 334 00:15:46,270 --> 00:15:48,580 Trigger the MTP. Let's fast her. 335 00:15:52,010 --> 00:15:55,970 Ton of soft tissue damage. Glass everywhere. 336 00:15:56,010 --> 00:15:58,020 All right, no, scrap the X-ray. No time. 337 00:15:58,060 --> 00:15:59,230 Give me that wand. 338 00:16:04,940 --> 00:16:06,370 Fast is positive. 339 00:16:06,420 --> 00:16:07,980 Yeah, I gotta get into her belly. 340 00:16:08,030 --> 00:16:11,720 All right, let's go. Let's open up the Hybrid OR! 341 00:16:11,770 --> 00:16:12,900 All right. - Oh, my God. 342 00:16:12,940 --> 00:16:14,160 - Get her prepped, all right? - Lucy! 343 00:16:14,210 --> 00:16:17,430 - Let's get her on the move. All right. 344 00:16:17,470 --> 00:16:20,040 Mr. and Mrs. Seaver, if you will. 345 00:16:20,080 --> 00:16:21,780 Your daughter's been seriously injured. 346 00:16:21,820 --> 00:16:24,260 She needs immediate surgery to control internal bleeding. 347 00:16:24,300 --> 00:16:26,130 - It's fixable? She's gonna live? 348 00:16:26,180 --> 00:16:28,360 - We will do everything we can. 349 00:16:39,930 --> 00:16:41,320 - Huh. 350 00:16:41,360 --> 00:16:43,580 So, uh, so what is your favorite sport? 351 00:16:43,630 --> 00:16:46,150 - Football, I guess. 352 00:16:46,200 --> 00:16:49,030 - Bears fan? - My dad likes them. 353 00:16:49,070 --> 00:16:51,810 I like the Chiefs. - Oh, really? 354 00:16:51,850 --> 00:16:54,160 Oh, how'd that happen? - The quarterback. 355 00:16:54,200 --> 00:16:56,860 I saw a video of him throw the ball out of the stadium. 356 00:16:56,900 --> 00:16:59,820 That was cool. - I saw that clip too. 357 00:16:59,860 --> 00:17:02,820 And you're right. It was cool. 358 00:17:02,860 --> 00:17:06,130 You know, I was wondering if we could talk a bit about... 359 00:17:06,170 --> 00:17:08,090 about what happens. 360 00:17:08,130 --> 00:17:12,220 You know, about how it feels when you start to get upset. 361 00:17:14,790 --> 00:17:16,920 - I don't know. Kind of... 362 00:17:18,840 --> 00:17:20,140 It's fuzzy. 363 00:17:20,190 --> 00:17:25,420 - Fuzzy. So kind of like, um, like a dream? 364 00:17:25,450 --> 00:17:27,500 - I guess. 365 00:17:27,540 --> 00:17:30,890 - And--and when it happens, I mean, what does it, uh, 366 00:17:30,940 --> 00:17:32,380 what does it feel like? 367 00:17:32,420 --> 00:17:34,860 I mean, like, you know, in here? 368 00:17:34,900 --> 00:17:38,080 I mean, do you feel anything in your body? 369 00:17:38,120 --> 00:17:40,810 - Feels like I'm gonna explode. 370 00:17:40,860 --> 00:17:42,080 - Wow. 371 00:17:42,120 --> 00:17:45,640 I'm sorry. That must be really scary. 372 00:17:45,690 --> 00:17:47,210 Do you want to take a little break? 373 00:17:47,260 --> 00:17:48,520 - I want this off. It's sticking to me. 374 00:17:48,560 --> 00:17:50,350 I can't stand it. - Okay, okay. 375 00:17:50,390 --> 00:17:52,260 - Don't touch me! Don't touch me! 376 00:17:52,300 --> 00:17:54,040 I hate you! I hate you! 377 00:17:54,090 --> 00:17:56,000 Let go! Stop it! 378 00:17:56,050 --> 00:17:58,050 Go away! Stop it! 379 00:17:58,090 --> 00:17:59,350 Go away! - Two of haldol! 380 00:17:59,400 --> 00:18:01,180 - Go away! Stop it, no! 381 00:18:01,230 --> 00:18:03,660 No, I don't want meds! Stop! 382 00:18:03,710 --> 00:18:06,750 Stop it, no! Stop! No! 383 00:18:06,800 --> 00:18:08,190 I don't want meds, stop! Stop it! 384 00:18:13,280 --> 00:18:15,980 - I wish I could tell you exactly what happened in there, 385 00:18:16,020 --> 00:18:17,590 what triggered Jamie, but honestly, I can't. 386 00:18:17,630 --> 00:18:19,030 I have reviewed his medical records, 387 00:18:19,070 --> 00:18:20,550 I've spoken with several of his doctors, 388 00:18:20,590 --> 00:18:23,860 and what is clear to me is that your son is struggling 389 00:18:23,900 --> 00:18:27,900 with multiple impulse control and mood regulation disorders. 390 00:18:27,950 --> 00:18:30,040 - So what do we do? We just want to help him. 391 00:18:30,080 --> 00:18:31,910 - Well, it's the hospital's recommendation 392 00:18:31,950 --> 00:18:35,130 that Jamie be admitted to a residential facility 393 00:18:35,170 --> 00:18:38,220 where he can receive sustained clinical care 394 00:18:38,260 --> 00:18:40,610 as well as supportive therapy. 395 00:18:40,660 --> 00:18:42,530 - A residential facility? - Mm-hmm. 396 00:18:42,570 --> 00:18:45,230 - Yeah. Mrs. Shaw, Jamie is 11. 397 00:18:45,270 --> 00:18:46,580 Puberty is fast approaching. 398 00:18:46,620 --> 00:18:48,190 And that surge of hormones 399 00:18:48,230 --> 00:18:52,360 is just gonna undoubtedly exacerbate his conditions. 400 00:18:52,410 --> 00:18:54,760 It'll just make him more difficult to treat in general. 401 00:18:54,800 --> 00:18:56,760 You know, find the right balance of meds. 402 00:18:56,800 --> 00:18:58,980 - And a specialized setting like this will have 403 00:18:59,020 --> 00:19:03,110 the behavioral resources Jamie needs for the future. 404 00:19:03,160 --> 00:19:07,250 And it'll be a safe place for him right now. 405 00:19:08,510 --> 00:19:10,690 - Anything for our son. - All right. 406 00:19:10,730 --> 00:19:13,210 I'll take care of all the arrangements. 407 00:19:17,820 --> 00:19:20,220 - Okay. Looking good. 408 00:19:20,260 --> 00:19:22,830 Four tears in the small bowel mesentery tied off. 409 00:19:22,870 --> 00:19:26,010 Liver's packed and hemostatic. 410 00:19:27,140 --> 00:19:28,050 - Pressure's no good. 411 00:19:29,750 --> 00:19:31,660 - We maxed out on pressors? 412 00:19:31,710 --> 00:19:32,750 - Yeah, and I've given ten units of blood 413 00:19:32,800 --> 00:19:34,100 and ten of plasma. 414 00:19:34,150 --> 00:19:36,550 She's still bleeding somewhere. - I don't... 415 00:19:38,410 --> 00:19:40,110 Hematoma on the pelvis. 416 00:19:40,150 --> 00:19:41,890 Bigger than my first look and growing. 417 00:19:41,940 --> 00:19:43,820 Gotta assume the pelvis is shattered and bleeding. 418 00:19:43,850 --> 00:19:45,420 Okay, team, new deal. Preperitoneal packs. 419 00:19:45,460 --> 00:19:46,550 Let's go. 420 00:19:50,340 --> 00:19:51,820 - Hey, Chloe. How you feeling? 421 00:19:51,860 --> 00:19:53,640 - Like a stuffed turkey. 422 00:19:53,690 --> 00:19:56,470 - X-rays show your bowel is FOS. 423 00:19:56,520 --> 00:19:58,570 - Full of-- - Stool. 424 00:19:58,600 --> 00:20:01,170 The pelvic suggests your uterus is enlarged. 425 00:20:01,220 --> 00:20:03,350 So I suspect a fibroid is sitting on the uterus, 426 00:20:03,390 --> 00:20:05,000 putting pressure on the rectum. 427 00:20:05,050 --> 00:20:06,490 - You were right. 428 00:20:06,530 --> 00:20:08,230 The last few weeks, she was scouring the web 429 00:20:08,270 --> 00:20:11,400 with her symptoms, and fibroid fit the bill. 430 00:20:11,440 --> 00:20:13,010 - Yeah, we're trying to have a baby. 431 00:20:13,050 --> 00:20:15,710 Internet says fibroids hinder the ability to conceive. 432 00:20:15,750 --> 00:20:18,140 - Not all fibroids are created equal. 433 00:20:18,190 --> 00:20:19,760 Hey, I'm gonna order a pelvic ultrasound 434 00:20:19,800 --> 00:20:21,320 and a gyne consult. 435 00:20:21,370 --> 00:20:23,590 I'll check back soon. And no more Googling, okay? 436 00:20:23,630 --> 00:20:24,850 Doctor's orders. 437 00:20:26,680 --> 00:20:28,200 - How's it going with your six-month-old? 438 00:20:28,240 --> 00:20:29,330 - Dead end. 439 00:20:29,370 --> 00:20:31,030 Nothing's jumping out in any of the labs 440 00:20:31,070 --> 00:20:33,600 and the endoscopy and colonoscopy report. 441 00:20:33,640 --> 00:20:35,340 I'm starting to wonder if it's really baby Axel 442 00:20:35,380 --> 00:20:36,690 who's the one that's sick. 443 00:20:36,730 --> 00:20:38,120 - What do you mean? 444 00:20:38,170 --> 00:20:40,700 - The mom, she's just-- she's got this air about her, 445 00:20:40,730 --> 00:20:42,910 this nonchalance that screams, 446 00:20:42,950 --> 00:20:45,520 "Yeah, my baby's in the ED, but it's just another day." 447 00:20:45,560 --> 00:20:47,740 - Well, it wouldn't be the first time we see a parent 448 00:20:47,780 --> 00:20:50,350 pretend their child was sick to get attention. 449 00:20:50,400 --> 00:20:52,930 - Yeah, unfortunately. 450 00:20:52,960 --> 00:20:55,400 Have you seen Dr. Charles? - He's upstairs. 451 00:20:55,440 --> 00:20:56,440 I'll page him for you. - Thanks. 452 00:20:56,490 --> 00:20:57,840 - Yeah. 453 00:20:57,880 --> 00:21:00,060 - Dr. Manning, it's Julia. 454 00:21:00,100 --> 00:21:01,710 There's something you need to see. 455 00:21:03,580 --> 00:21:04,800 - You know, I had my appendix taken out 456 00:21:04,840 --> 00:21:06,190 when I was in 10th grade. 457 00:21:06,240 --> 00:21:07,760 - All right. Well, let's take a look. 458 00:21:09,550 --> 00:21:13,300 Oh, my God. This is a fistula. 459 00:21:13,330 --> 00:21:17,510 Basically a tunnel between your small bowel and your skin. 460 00:21:17,550 --> 00:21:19,950 The green fluid is leaking from your intestines. 461 00:21:19,990 --> 00:21:21,640 - Seriously? - Mm-hmm. 462 00:21:21,690 --> 00:21:23,300 - I've been getting these scrapes for years. 463 00:21:23,340 --> 00:21:24,520 They heal up. 464 00:21:24,560 --> 00:21:26,950 It's been my intestines oozing out? 465 00:21:27,000 --> 00:21:29,260 - The tissue sample taken during Axel's endoscopy, 466 00:21:29,300 --> 00:21:30,650 I'd like it biopsied. 467 00:21:30,700 --> 00:21:32,740 - Biopsy? You're testing for cancer? 468 00:21:32,790 --> 00:21:34,010 - No. Something new. 469 00:21:34,050 --> 00:21:36,480 And now I'm thinking you may have it as well. 470 00:21:36,530 --> 00:21:37,790 The test that I ran on your son, 471 00:21:37,830 --> 00:21:40,660 I'd like to run on you as well. 472 00:21:40,710 --> 00:21:42,930 Okay. 473 00:21:42,970 --> 00:21:45,360 - All right. Pelvis is packed. 474 00:21:45,410 --> 00:21:47,280 Bleeding's under control. 475 00:21:47,320 --> 00:21:49,930 Call ICU and tell them Lucy's coming up to rewarm. 476 00:21:49,980 --> 00:21:52,020 - Something's wrong. Pressure's still in the toilet. 477 00:21:52,070 --> 00:21:54,820 74 over 38, falling. - What? 478 00:21:54,850 --> 00:21:57,290 - She's peri-arrest. - She's still bleeding? 479 00:21:58,720 --> 00:22:01,680 The abdomen is dry. Pelvis is contained. 480 00:22:01,730 --> 00:22:03,770 I mean, we're hemostatic, Marty. 481 00:22:03,820 --> 00:22:04,860 - She's bradying down. 482 00:22:06,430 --> 00:22:07,730 No pulse. - Come on. 483 00:22:11,910 --> 00:22:13,170 Milligram of epi. 484 00:22:16,440 --> 00:22:17,610 - Epi's in. Pulse check? 485 00:22:17,660 --> 00:22:18,830 - Go. 486 00:22:20,270 --> 00:22:21,180 - Still nothing. 487 00:22:23,180 --> 00:22:24,920 - Come on, Lucy. 488 00:22:24,970 --> 00:22:26,360 - Hold compressions. 489 00:22:29,360 --> 00:22:30,320 - Be good. 490 00:22:31,930 --> 00:22:34,930 - Asystole. - Come on. 491 00:22:34,980 --> 00:22:37,330 Come on, Lucy. Come on. 492 00:22:43,070 --> 00:22:43,940 Damn it. 493 00:22:57,830 --> 00:23:01,180 Time of death, 16:17. 494 00:23:03,830 --> 00:23:07,790 Okay, everyone, clear the room, please. 495 00:23:07,840 --> 00:23:09,880 I'd like a moment alone with my patient. 496 00:23:23,290 --> 00:23:25,640 - What's going on? 497 00:23:25,680 --> 00:23:27,200 - There's room for Jamie at Meyerbrook, 498 00:23:27,250 --> 00:23:28,860 which is the only residential facility 499 00:23:28,900 --> 00:23:30,550 capable of handling his needs. 500 00:23:30,600 --> 00:23:33,040 Unfortunately, neither his private insurance 501 00:23:33,080 --> 00:23:34,600 nor state Medicaid is gonna cover the cost. 502 00:23:34,650 --> 00:23:37,040 - What about an individual care grant from the state? 503 00:23:37,080 --> 00:23:38,430 - I already looked into it. It's no help. 504 00:23:38,480 --> 00:23:39,870 - Yeah, the grant's so underfunded, 505 00:23:39,910 --> 00:23:42,310 it wouldn't come close to what's needed. 506 00:23:42,350 --> 00:23:43,610 - So what's plan B? 507 00:23:43,660 --> 00:23:46,360 - Well, you know, I'm gonna just try and use 508 00:23:46,400 --> 00:23:48,880 the five-day hold to normalize his meds as best I can. 509 00:23:48,920 --> 00:23:51,100 And I do know a brilliant guy who specializes 510 00:23:51,140 --> 00:23:52,840 in these kind of disorders I want to refer him to. 511 00:23:52,880 --> 00:23:54,880 - An outpatient service? 512 00:23:54,930 --> 00:23:56,490 Jamie pummeled Dylan over an iPad. 513 00:23:56,540 --> 00:23:59,500 The kid's jaw's wired shut. He's only six years old. 514 00:23:59,540 --> 00:24:01,500 He's going to invade his brother's space again. 515 00:24:01,540 --> 00:24:05,590 And when that happens, and Jamie loses his temper, 516 00:24:05,630 --> 00:24:07,240 I'm worried he could kill Dylan. 517 00:24:07,290 --> 00:24:08,720 - I don't like it either, Ethan, 518 00:24:08,770 --> 00:24:10,940 but I mean, you know, I can't hold him here forever. 519 00:24:10,990 --> 00:24:14,860 - I get it, but we have an obligation to protect Dylan. 520 00:24:14,900 --> 00:24:16,910 And he needs our help just as much as Jamie. 521 00:24:25,260 --> 00:24:27,480 - Dr. Halstead, the gyne attending on-call 522 00:24:27,530 --> 00:24:28,840 came down a few minutes ago. 523 00:24:28,870 --> 00:24:32,090 She's with Chloe right now. - Great, thanks. 524 00:24:32,140 --> 00:24:34,180 - If you feel comfortable with that. 525 00:24:34,230 --> 00:24:35,970 Yeah. 526 00:24:40,150 --> 00:24:42,970 -Dr. Hannah Asher, gynecology. 527 00:24:45,150 --> 00:24:48,150 - Will Halstead. - It's nice to meet you. 528 00:24:48,200 --> 00:24:50,290 - Yeah. Likewise. 529 00:24:50,330 --> 00:24:52,460 - I was just explaining to Chloe and David 530 00:24:52,510 --> 00:24:54,250 that I reviewed her pelvic ultrasound. 531 00:24:54,290 --> 00:24:56,600 Considering the location and size of the fibroid, 532 00:24:56,640 --> 00:24:58,210 I believe removing it surgically 533 00:24:58,250 --> 00:24:59,430 is the best course of treatment. 534 00:24:59,470 --> 00:25:02,120 - A myomectomy? By who, when? 535 00:25:02,170 --> 00:25:05,340 - Me. Today. 536 00:25:05,390 --> 00:25:08,570 - Chloe, David, you should know this surgery can be risky. 537 00:25:08,610 --> 00:25:11,530 - Yes, I've explained the pros and cons, Dr. Halstead. 538 00:25:11,570 --> 00:25:13,790 Was clear that while this is a big operation, 539 00:25:13,830 --> 00:25:15,440 it's also a common one. 540 00:25:15,490 --> 00:25:18,920 - Nevertheless, complications could rise. 541 00:25:18,970 --> 00:25:21,140 So I would suggest non-surgical options. 542 00:25:21,190 --> 00:25:23,840 Hormone therapy will shrink the fibroid. 543 00:25:23,890 --> 00:25:25,320 - Well, that's what Dr. Asher said. 544 00:25:25,370 --> 00:25:27,990 But to ensure that it doesn't grow back, 545 00:25:28,020 --> 00:25:29,410 Chloe would have to go on the pill. 546 00:25:29,460 --> 00:25:31,370 - We're anxious to start a family. 547 00:25:31,420 --> 00:25:33,170 The pill takes that off the table. 548 00:25:33,200 --> 00:25:35,290 - In the short term, yes. But not permanently. 549 00:25:35,330 --> 00:25:37,590 - Actually, it kind of does. 550 00:25:37,640 --> 00:25:39,340 I'm 41, Dr. Halstead. 551 00:25:39,380 --> 00:25:41,820 Our window for getting pregnant is already closing. 552 00:25:41,860 --> 00:25:45,080 If I choose hormones, I might as well slam it shut. 553 00:25:45,120 --> 00:25:47,950 - We appreciate your passion, Dr. Halstead. 554 00:25:48,000 --> 00:25:51,170 But surgery is the best for us. 555 00:25:51,220 --> 00:25:52,780 - I'll get that started. 556 00:25:52,830 --> 00:25:55,440 It was so nice meeting both of you. 557 00:25:55,480 --> 00:25:56,740 Doctor. 558 00:25:59,270 --> 00:26:01,790 - Excuse me just a moment. 559 00:26:01,840 --> 00:26:04,230 Doctor Asher? Doctor. 560 00:26:05,670 --> 00:26:06,840 - Hmm? 561 00:26:06,890 --> 00:26:08,160 - You can't perform this surgery. 562 00:26:08,190 --> 00:26:09,320 - Hmm? 563 00:26:09,370 --> 00:26:10,930 - I mean, you shouldn't even be working. 564 00:26:10,980 --> 00:26:12,980 - Look, thank you for your help last week, but I'm better now. 565 00:26:13,020 --> 00:26:14,630 I'm over that hump. 566 00:26:14,680 --> 00:26:16,240 - So heroin addiction is like a cold? 567 00:26:16,290 --> 00:26:17,940 - What, you just get over it? 568 00:26:17,980 --> 00:26:19,510 What I saw at that injection site-- 569 00:26:19,550 --> 00:26:21,200 - Was me having a bad day. 570 00:26:21,250 --> 00:26:22,470 - A bad day? - Mm-hmm. 571 00:26:22,510 --> 00:26:24,210 - You... 572 00:26:26,430 --> 00:26:28,910 You OD'd. 573 00:26:28,950 --> 00:26:30,650 For all I know, you're high right now. 574 00:26:30,690 --> 00:26:31,950 - Right. 575 00:26:32,000 --> 00:26:33,690 But how many all-nighters you pull over there 576 00:26:33,740 --> 00:26:35,650 since I saw you last, huh? 577 00:26:35,700 --> 00:26:39,440 Three? Four? 578 00:26:39,480 --> 00:26:41,700 Maybe I should be the one worried about your judgment. 579 00:26:41,750 --> 00:26:42,920 - Don't twist this. 580 00:26:42,970 --> 00:26:45,670 I'm not an addict about to operate. 581 00:26:45,710 --> 00:26:48,270 You step into that OR, you put Chloe's life in jeopardy. 582 00:26:48,320 --> 00:26:51,450 - I would never risk the well-being of a patient. 583 00:26:53,190 --> 00:26:57,240 Not that it is any of your business, I'm sober now. 584 00:26:57,280 --> 00:26:59,370 - I'd expect an addict to say that. 585 00:27:01,200 --> 00:27:03,380 - Chloe is in good hands with me. 586 00:27:14,300 --> 00:27:17,000 - Axel has Crohn's disease? But he's only six months old. 587 00:27:17,040 --> 00:27:19,570 - Well, it's rare in children, let alone infants, 588 00:27:19,610 --> 00:27:21,130 but not unheard of. 589 00:27:21,180 --> 00:27:22,440 - Isn't Crohn's a diet thing? 590 00:27:22,480 --> 00:27:24,480 I mean, Axel's barely started on solids. 591 00:27:24,530 --> 00:27:25,790 - Well, diet aggravates Crohn's, 592 00:27:25,830 --> 00:27:27,050 but it's not the cause. 593 00:27:27,100 --> 00:27:28,100 Genetics is. 594 00:27:28,140 --> 00:27:30,400 Crohn's tends to cluster in families. 595 00:27:30,450 --> 00:27:32,400 - Whoa, my test results-- 596 00:27:32,450 --> 00:27:34,020 - Show that you have Crohn's as well. 597 00:27:34,060 --> 00:27:36,670 The fistula is just evidence of the severity. 598 00:27:36,710 --> 00:27:37,930 - This doesn't make sense. 599 00:27:37,980 --> 00:27:39,720 If I've got Crohn's badly enough 600 00:27:39,760 --> 00:27:42,890 to burn a hole in my skin, shouldn't it bother me? 601 00:27:42,940 --> 00:27:44,900 - Well, fistulas themselves are painless, 602 00:27:44,940 --> 00:27:48,380 but yes, a Crohn's flare-up is excruciating. 603 00:27:48,420 --> 00:27:50,600 You should be in pain. Agony. 604 00:27:50,640 --> 00:27:54,600 - Yeah, well, I don't feel a thing. 605 00:27:54,650 --> 00:27:57,310 This is weirding you out, isn't it? 606 00:27:57,340 --> 00:27:58,740 - It's definitely unusual. 607 00:28:04,130 --> 00:28:06,610 Or actually, 608 00:28:06,660 --> 00:28:10,620 maybe it's-- maybe it's rare. 609 00:28:10,660 --> 00:28:11,920 Let me ask you a question. 610 00:28:11,970 --> 00:28:16,270 What emotion are you feeling right now? 611 00:28:16,320 --> 00:28:17,750 - I'm not sure what you mean. 612 00:28:17,800 --> 00:28:19,500 - Well, I just told you that you and your son have 613 00:28:19,540 --> 00:28:21,500 an inflammatory bowel disease. 614 00:28:21,540 --> 00:28:23,190 What are you feeling? Stress? 615 00:28:23,240 --> 00:28:25,370 Anxiety? Fear? 616 00:28:25,420 --> 00:28:29,040 - Confusion, that's for sure. 617 00:28:29,070 --> 00:28:31,680 - You know, I'd like to run one more test. 618 00:28:31,730 --> 00:28:32,940 Okay? - Okay. 619 00:28:32,990 --> 00:28:33,990 - Okay. 620 00:28:39,820 --> 00:28:42,130 - Bea, it's taking too long. Check with Dr. Asher. 621 00:28:42,170 --> 00:28:43,560 - Again? 622 00:28:43,610 --> 00:28:45,090 I've already gone in there twice for you, Dr. Halstead. 623 00:28:45,130 --> 00:28:47,130 - Please, I'm treating Chloe in the ED. 624 00:28:47,180 --> 00:28:48,740 I just want to make sure Dr. Asher's 625 00:28:48,790 --> 00:28:50,530 got everything under control. 626 00:28:50,570 --> 00:28:52,880 - Fine. - Thank you. 627 00:29:01,230 --> 00:29:04,280 - Dr. Asher said, "Go away." 628 00:29:04,320 --> 00:29:06,020 - Nope, staying right here. 629 00:29:12,510 --> 00:29:14,820 - Hey, I got your page. 630 00:29:14,860 --> 00:29:16,640 - You have a new plan to help Jamie? 631 00:29:17,950 --> 00:29:20,770 - Yeah. Yep, I do. 632 00:29:23,470 --> 00:29:24,780 So, Mr. and Mrs. Shaw, 633 00:29:24,820 --> 00:29:27,170 I have given this a tremendous amount of thought. 634 00:29:27,220 --> 00:29:30,520 I've consulted with-- with numerous colleagues, 635 00:29:30,570 --> 00:29:31,830 with social workers, 636 00:29:31,870 --> 00:29:35,700 with our Executive Director of Patient Services. 637 00:29:35,750 --> 00:29:38,050 Jamie needs to be at the Meyerbrook 638 00:29:38,100 --> 00:29:39,490 Residential Facility. 639 00:29:39,530 --> 00:29:41,530 - So the insurance companies, they agreed to pay? 640 00:29:41,580 --> 00:29:43,010 - No. 641 00:29:43,060 --> 00:29:46,360 Both your private insurance and Medicaid won't budge. 642 00:29:46,410 --> 00:29:49,370 - Then I'm confused. 643 00:29:49,410 --> 00:29:52,020 - There is a way to force Medicaid 644 00:29:52,070 --> 00:29:55,070 to cover Meyerbrook's cost in full. 645 00:29:55,110 --> 00:29:56,810 It's called a psychiatric lockout. 646 00:29:56,850 --> 00:29:58,510 But it will require you 647 00:29:58,550 --> 00:30:01,160 to surrender Jamie to this hospital. 648 00:30:01,210 --> 00:30:04,950 - Surrender? I don't understand. 649 00:30:04,990 --> 00:30:08,260 - If you were to leave Jamie here and refuse to come back, 650 00:30:08,300 --> 00:30:11,300 Child Protective Services would have to take custody of him. 651 00:30:11,350 --> 00:30:14,960 Then, as a ward of the state, legally, Illinois would have 652 00:30:15,000 --> 00:30:18,660 to provide him with the mental health services that he needs. 653 00:30:18,700 --> 00:30:21,880 - Meyerbrook? - This is insane. 654 00:30:21,920 --> 00:30:24,660 We're not doing this. - So there's no other way? 655 00:30:24,710 --> 00:30:27,970 - I'm so sorry, but there just isn't. 656 00:30:28,020 --> 00:30:30,190 We would absolutely find a way for you to maintain contact 657 00:30:30,240 --> 00:30:31,900 with Jamie, but you also need to know 658 00:30:31,930 --> 00:30:35,280 that legally, you won't have any say in his care. 659 00:30:40,250 --> 00:30:42,210 - We're still his parents. 660 00:30:42,250 --> 00:30:43,990 This doesn't change that. Nothing changes that. 661 00:30:44,030 --> 00:30:45,990 - No. No, no, no. 662 00:30:46,030 --> 00:30:47,950 We're not abandoning our son. 663 00:30:47,990 --> 00:30:50,730 - Mrs. Shaw, you will not be abandoning him. 664 00:30:50,780 --> 00:30:53,080 This--this won't be forever. 665 00:30:55,040 --> 00:30:56,830 - Jamie needs us to do this. 666 00:31:06,180 --> 00:31:07,750 - When? 667 00:31:07,790 --> 00:31:09,880 - I cannot imagine how agonizing 668 00:31:09,930 --> 00:31:12,540 this decision must be. 669 00:31:12,580 --> 00:31:15,930 But the sooner Jamie starts to heal, 670 00:31:15,980 --> 00:31:17,930 the sooner you all can look forward 671 00:31:17,980 --> 00:31:19,940 to becoming a family again. 672 00:31:19,980 --> 00:31:22,160 - Bella. 673 00:31:24,510 --> 00:31:26,070 It's to save him. 674 00:31:59,800 --> 00:32:01,980 - Everything is going to be okay. 675 00:32:02,020 --> 00:32:03,810 - Hey, buddy. It's gonna be okay, buddy. 676 00:32:03,850 --> 00:32:05,460 Right now, it's the best thing. 677 00:32:05,500 --> 00:32:07,850 You'll be better, and so you're just gonna stay 678 00:32:07,900 --> 00:32:10,380 with the doctors. 679 00:32:10,420 --> 00:32:12,210 - You're okay, baby. - No, no. 680 00:32:12,250 --> 00:32:13,770 Please. I'll be better. 681 00:32:13,820 --> 00:32:15,990 I didn't mean to! - It's okay. 682 00:32:16,040 --> 00:32:18,910 - Please, I want to go home. I want to go home. 683 00:32:18,950 --> 00:32:20,910 Please, Mom. 684 00:32:53,940 --> 00:32:55,210 - Dr. Marcel? 685 00:32:55,250 --> 00:32:58,210 Lucy's parents are still in the waiting room. 686 00:32:58,250 --> 00:33:00,560 You haven't told them-- - She should be alive. 687 00:33:00,600 --> 00:33:02,260 - Well, it's been over an hour. 688 00:33:02,300 --> 00:33:05,220 They need to know that their daughter has passed. 689 00:33:05,260 --> 00:33:09,830 - I won't speak to them until I can explain how she died. 690 00:33:09,870 --> 00:33:11,480 Why I couldn't save her. 691 00:33:20,800 --> 00:33:23,710 Can you give me some light? 692 00:33:23,760 --> 00:33:24,930 Right here. 693 00:33:27,540 --> 00:33:31,760 Every other injury was either a tear or a rip in the skin. 694 00:33:31,810 --> 00:33:33,370 This one's a hole. 695 00:33:35,730 --> 00:33:37,740 Something embedded inside. 696 00:33:37,770 --> 00:33:39,770 - More shrapnel from the windshield? 697 00:33:39,820 --> 00:33:41,430 - It doesn't really feel like glass. 698 00:33:41,470 --> 00:33:44,340 Can you, uh, swing that X-ray machine around? 699 00:33:54,660 --> 00:33:56,010 Go ahead. 700 00:34:03,880 --> 00:34:06,020 That's a bullet. 701 00:34:06,060 --> 00:34:08,150 - Lucy was shot? 702 00:34:17,810 --> 00:34:20,550 - Lucy was shot? How? 703 00:34:20,600 --> 00:34:24,770 She was driving down the highway alone in the car. 704 00:34:24,820 --> 00:34:26,990 - The steep angle of entry shows that the bullet struck 705 00:34:27,040 --> 00:34:29,950 from above and launched into Lucy's pelvis. 706 00:34:30,000 --> 00:34:33,090 It severed her external iliac artery. 707 00:34:33,130 --> 00:34:35,700 - Shot from above? - Yes. 708 00:34:35,740 --> 00:34:37,960 Now, the police will run ballistics. 709 00:34:38,000 --> 00:34:40,570 But they believe, and science backs it up, 710 00:34:40,620 --> 00:34:42,660 that someone, somewhere in the city, 711 00:34:42,710 --> 00:34:44,460 fired a gun into the air. 712 00:34:44,490 --> 00:34:48,010 And when that bullet came down, 713 00:34:48,060 --> 00:34:50,280 it struck Lucy. 714 00:34:50,320 --> 00:34:53,630 - Someone. Somewhere. 715 00:34:53,670 --> 00:34:56,020 And now our daughter is dead? 716 00:34:58,160 --> 00:34:59,560 - I'm so sorry. 717 00:35:01,810 --> 00:35:05,340 The nurse will come to take you to see Lucy. 718 00:35:05,380 --> 00:35:06,900 Excuse me. 719 00:35:12,170 --> 00:35:16,830 - Hey, the additional blood work you ordered on Axel's mom. 720 00:35:16,870 --> 00:35:18,780 - Oh, wow. 721 00:35:18,830 --> 00:35:22,180 This whole time, my take on Julia has been off. 722 00:35:22,220 --> 00:35:23,750 Way off. 723 00:35:26,100 --> 00:35:28,840 - ♪ We love fun 724 00:35:28,880 --> 00:35:31,970 ♪ We're going out and having some ♪ 725 00:35:32,020 --> 00:35:34,590 ♪ We love fun 726 00:35:34,630 --> 00:35:37,500 ♪ You know we're gonna have a ton ♪ 727 00:35:37,540 --> 00:35:39,590 - Never heard that song before. 728 00:35:39,630 --> 00:35:42,160 - "We Love Fun" by The Bouncing Souls. 729 00:35:42,200 --> 00:35:45,200 I don't know any real lullabies. 730 00:35:45,250 --> 00:35:47,900 - Julia, all day, I've been troubled by your demeanor 731 00:35:47,940 --> 00:35:51,030 because you didn't seem worried about Axel. 732 00:35:51,080 --> 00:35:54,300 But now I know you really aren't worried. 733 00:35:54,340 --> 00:35:57,910 And I suspect you've never felt anxious, depressed, 734 00:35:57,950 --> 00:36:00,830 or even afraid your entire life, have you? 735 00:36:00,870 --> 00:36:03,520 - No, not really. 736 00:36:03,570 --> 00:36:05,700 - Same goes for physical pain, doesn't it? 737 00:36:07,050 --> 00:36:09,360 - Kind of feels like this is a trick question or something. 738 00:36:09,400 --> 00:36:11,660 - No. Okay. 739 00:36:11,710 --> 00:36:15,450 So when I had my son, labor was a beast. 740 00:36:15,490 --> 00:36:18,670 Intense pressure, cramps, spasms. 741 00:36:18,710 --> 00:36:20,240 But you didn't feel any of that, did you? 742 00:36:20,280 --> 00:36:21,410 - Nope. 743 00:36:21,460 --> 00:36:23,940 Whole thing just kind of tingled. 744 00:36:23,980 --> 00:36:27,200 But I've always had an extremely high pain tolerance. 745 00:36:27,240 --> 00:36:28,380 I know. 746 00:36:28,420 --> 00:36:29,850 There's something wrong with me, right? 747 00:36:29,900 --> 00:36:32,510 My friends have been saying it forever. 748 00:36:32,550 --> 00:36:35,430 Wait, is there something wrong with me? 749 00:36:35,470 --> 00:36:36,820 - No. 750 00:36:36,860 --> 00:36:38,950 No, but there is something missing from you. 751 00:36:39,000 --> 00:36:41,660 So we all have what's called a FAAHP1 pseudogene. 752 00:36:41,690 --> 00:36:44,350 Your preliminary blood work shows that you have a rare 753 00:36:44,390 --> 00:36:47,350 microdeletion which affects your insensitivity to pain. 754 00:36:47,400 --> 00:36:48,540 - When I was a kid, 755 00:36:48,570 --> 00:36:50,700 my dad would say everyone else were wimps. 756 00:36:50,750 --> 00:36:55,010 That we were a hardy breed, that pain was just a word. 757 00:36:55,050 --> 00:36:58,140 - Well, microdeletion is a genetic thing. 758 00:36:58,190 --> 00:37:00,450 So it's likely that your father and other family members 759 00:37:00,500 --> 00:37:01,460 have it as well. 760 00:37:06,110 --> 00:37:07,940 Julia? 761 00:37:15,210 --> 00:37:16,910 - What's wrong? 762 00:37:16,950 --> 00:37:19,730 - I passed Axel the gene for Crohn's, 763 00:37:19,780 --> 00:37:23,000 but not the one so he won't be tortured by it. 764 00:37:23,040 --> 00:37:25,080 And if I didn't know when I hurt myself, 765 00:37:25,130 --> 00:37:27,740 I wouldn't have known when I hurt my son. 766 00:37:27,780 --> 00:37:30,090 I probably made the bath too hot. 767 00:37:30,130 --> 00:37:32,570 Didn't dress him warm enough-- - Hey. 768 00:37:32,610 --> 00:37:34,660 You knew it wasn't colic. 769 00:37:34,700 --> 00:37:38,750 You knew to bring your son into the ED. 770 00:37:38,790 --> 00:37:41,540 You may not feel everything he feels, 771 00:37:41,580 --> 00:37:43,010 but you're his mother. 772 00:37:43,060 --> 00:37:45,970 You'll always know what he needs. 773 00:37:55,810 --> 00:37:57,770 - Uh, keep going. Grab her husband. 774 00:37:57,810 --> 00:37:59,160 I'll meet you in recovery. 775 00:38:01,950 --> 00:38:03,860 Wonderful. You're still here. 776 00:38:03,910 --> 00:38:06,300 - Is Chloe okay? - Yeah, she's fine. 777 00:38:06,340 --> 00:38:08,910 Operation was flawless. 778 00:38:08,950 --> 00:38:12,130 - This time. 779 00:38:12,180 --> 00:38:14,320 - How about you and I keep our distance from one another? 780 00:38:14,350 --> 00:38:15,440 - Yeah, fine. 781 00:38:15,480 --> 00:38:17,440 Just as soon as you stop treating patients 782 00:38:17,490 --> 00:38:18,630 and seek treatment for your addiction. 783 00:38:18,660 --> 00:38:19,960 - Screw you, Halstead. 784 00:38:20,010 --> 00:38:21,620 - In that case, I'm going to submit a letter 785 00:38:21,660 --> 00:38:23,140 to the hospital's Chief Medical Officer. 786 00:38:23,190 --> 00:38:24,580 And that decision will be made for you. 787 00:38:24,620 --> 00:38:26,620 - That's a stupid idea. 788 00:38:26,670 --> 00:38:29,500 You out me, I out your own involvement 789 00:38:29,540 --> 00:38:32,190 in a not-quite-legal injection site. 790 00:38:32,240 --> 00:38:34,460 So if I go down, so do you. 791 00:38:36,330 --> 00:38:40,070 So if you want to report me, 792 00:38:40,120 --> 00:38:41,730 have at it, cowboy. 793 00:38:50,130 --> 00:38:52,210 - Hey. - Hey. 794 00:38:52,260 --> 00:38:54,000 - Heard you had a rough one today. 795 00:38:54,040 --> 00:38:56,740 You all right? - Yeah. 796 00:38:56,790 --> 00:38:58,670 The little boy and his mom. 797 00:38:58,700 --> 00:39:01,660 Your, uh, ESP pan out? 798 00:39:01,700 --> 00:39:04,180 - Not even close. 799 00:39:08,880 --> 00:39:12,370 - I'll see you tomorrow. - Night. 800 00:39:22,550 --> 00:39:23,940 - Hey. 801 00:39:26,990 --> 00:39:28,640 - Today sucked. 802 00:39:28,690 --> 00:39:31,430 Yes, it did. 803 00:39:31,470 --> 00:39:36,430 - We just don't have enough psychiatric resources for kids. 804 00:39:36,480 --> 00:39:39,090 - And unfortunately, the Shaws won't be 805 00:39:39,130 --> 00:39:41,870 the last family to face a lockout. 806 00:39:41,920 --> 00:39:46,310 But Jamie will get the help he needs. 807 00:39:46,360 --> 00:39:48,270 And that's a good thing. 808 00:40:05,550 --> 00:40:08,770 - Hey, buddy. Come on, let's go. 59332

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