1 00:00:09,134 --> 00:00:10,759 [panting] 2 00:00:10,760 --> 00:00:13,847 [vitals monitor beeping] 3 00:00:31,364 --> 00:00:33,282 - Oh, shit. - What? 4 00:00:33,283 --> 00:00:35,325 I think I just broke some ribs. 5 00:00:35,326 --> 00:00:36,827 It means you're doing it right. 6 00:00:36,828 --> 00:00:39,329 Third amp of epi is on board. 7 00:00:39,330 --> 00:00:41,207 Oh, come on. 8 00:00:45,920 --> 00:00:48,173 Call me if there's a resurrection. 9 00:00:50,592 --> 00:00:52,801 - Hey, Perlah. - Doctor? 10 00:00:52,802 --> 00:00:54,803 Your kids have any pets? 11 00:00:54,804 --> 00:00:57,973 - Ugh, my house is like a zoo. - You have a dog? 12 00:00:57,974 --> 00:01:01,518 Ugh, no dogs, no cats. I followed my mother's rule. 13 00:01:01,519 --> 00:01:04,188 No pets that can't be buried at sea. 14 00:01:04,189 --> 00:01:05,689 I'm not sure I follow. 15 00:01:05,690 --> 00:01:08,192 You ever try to flush a guinea pig? 16 00:01:08,193 --> 00:01:10,402 Try explaining that to your plumber. 17 00:01:10,403 --> 00:01:12,197 Good to know. 18 00:01:18,411 --> 00:01:20,037 Hey, what's up with your asthma guy? 19 00:01:20,038 --> 00:01:21,580 Responding to albuterol. 20 00:01:21,581 --> 00:01:23,332 One more neb, and we'll discharge on prednisone. 21 00:01:23,333 --> 00:01:25,042 How's it going out in Chairs? 22 00:01:25,043 --> 00:01:27,044 Oh, it's fine, I guess. 23 00:01:27,045 --> 00:01:29,213 - Dr. McKay seems nice. - Cassie? 24 00:01:29,214 --> 00:01:30,881 Oh, yeah, she's great. 25 00:01:30,882 --> 00:01:33,050 - She been here long? - A little while. Why? 26 00:01:33,051 --> 00:01:34,635 I'm just curious. 27 00:01:34,636 --> 00:01:36,345 Do you know what she did before she came here? 28 00:01:36,346 --> 00:01:38,847 What she did? What do you mean, like, school? 29 00:01:38,848 --> 00:01:42,310 Oh, like school, work, personal life. 30 00:01:44,312 --> 00:01:45,687 I'm just trying to get to know her better. 31 00:01:45,688 --> 00:01:47,898 Um, yeah, I don't... I don't know. 32 00:01:47,899 --> 00:01:49,191 I don't know that much about her. 33 00:01:49,192 --> 00:01:50,734 She has a son. I know that. 34 00:01:50,735 --> 00:01:53,946 She's a pretty private person. 35 00:01:53,947 --> 00:01:55,948 - Anything else? - No, sorry, I'm good. 36 00:01:55,949 --> 00:01:57,492 Thank you. 37 00:01:59,911 --> 00:02:02,412 Hey, where are we at with opening up some beds? 38 00:02:02,413 --> 00:02:05,082 Our Nepali lady with the crushed foot, 39 00:02:05,083 --> 00:02:06,917 Minu, she still in line for the OR? 40 00:02:06,918 --> 00:02:08,418 Yeah, she got bumped by your Le Fort 41 00:02:08,419 --> 00:02:09,670 three fracture, Ben Kemper. 42 00:02:09,671 --> 00:02:11,088 - He just went up. - Mm. 43 00:02:11,089 --> 00:02:12,256 Still waiting for them to take 44 00:02:12,257 --> 00:02:13,882 the electrocution fasciotomy. 45 00:02:13,883 --> 00:02:15,801 What about our OD in Central 7? 46 00:02:15,802 --> 00:02:18,595 Robby wants a few more tests. He's stable and on a vent. 47 00:02:18,596 --> 00:02:20,472 Is he a candidate for organ donation? 48 00:02:20,473 --> 00:02:21,890 Not sure. 49 00:02:21,891 --> 00:02:23,142 Then why is Robby keeping him here? 50 00:02:23,143 --> 00:02:24,434 I don't know. 51 00:02:24,435 --> 00:02:26,270 Maybe he sees something we don't. 52 00:02:26,271 --> 00:02:28,272 Or maybe he's hoping for something that isn't there. 53 00:02:28,273 --> 00:02:30,107 What's there is an 18-year-old kid 54 00:02:30,108 --> 00:02:32,067 - named Nick Bradley. - Yeah, is he though? 55 00:02:32,068 --> 00:02:33,193 I don't mean to be a dick, but... 56 00:02:33,194 --> 00:02:34,611 You just can't help it? 57 00:02:34,612 --> 00:02:36,280 No, as sad as it is, that kid is gone. 58 00:02:36,281 --> 00:02:37,906 And if we get him upstairs to the ICU, 59 00:02:37,907 --> 00:02:39,366 we can use that bed to actually help somebody. 60 00:02:39,367 --> 00:02:41,076 Robby is helping somebody. 61 00:02:41,077 --> 00:02:42,870 He's helping two people, in fact. 62 00:02:42,871 --> 00:02:45,831 They're in there right now praying over their dead son. 63 00:02:45,832 --> 00:02:47,749 They just haven't let their hearts accept it yet. 64 00:02:47,750 --> 00:02:51,170 Jesus, 9:00, you're already bumming me out. 65 00:02:51,171 --> 00:02:52,629 OK, let's see. 66 00:02:52,630 --> 00:02:54,256 Who's up next at the deli of death? 67 00:02:54,257 --> 00:02:56,300 Weak and dizzy. No, thanks. 68 00:02:56,301 --> 00:02:58,510 Flank pain. Need a UA first. 69 00:02:58,511 --> 00:02:59,928 And buttock abscess. 70 00:02:59,929 --> 00:03:01,597 Great teaching case for a student. 71 00:03:01,598 --> 00:03:03,390 Don't make me tell Robby you're cherry picking. 72 00:03:03,391 --> 00:03:08,604 I'll take projectile vomiting in North 5 for 200, Alex. 73 00:03:08,605 --> 00:03:10,898 What do you think the chances are it's a demonic possession? 74 00:03:10,899 --> 00:03:12,149 About the same as you going a whole hour 75 00:03:12,150 --> 00:03:14,318 without saying something stupid. 76 00:03:14,319 --> 00:03:16,028 For Christ's sakes, go already. 77 00:03:16,029 --> 00:03:19,156 You're like having a kid I never wanted. 78 00:03:19,157 --> 00:03:21,283 How are you feeling? Any pain, Minu? 79 00:03:21,284 --> 00:03:24,661 [speaking Nepali] 80 00:03:24,662 --> 00:03:28,665 [speaking Nepali] 81 00:03:28,666 --> 00:03:31,084 No pain, but I'm thirsty. 82 00:03:31,085 --> 00:03:33,170 Oh, nothing to drink before your surgery, 83 00:03:33,171 --> 00:03:36,006 but we can get you some lemon swabs. 84 00:03:36,007 --> 00:03:38,843 [speaking Nepali] 85 00:03:41,763 --> 00:03:43,597 [speaking Nepali] 86 00:03:43,598 --> 00:03:45,682 Thank you. 87 00:03:45,683 --> 00:03:48,393 [speaking Nepali] 88 00:03:48,394 --> 00:03:50,020 Excuse me? 89 00:03:50,021 --> 00:03:53,190 When are you due? 90 00:03:53,191 --> 00:03:54,983 [speaking Nepali] 91 00:03:54,984 --> 00:03:56,193 You can always tell. 92 00:03:56,194 --> 00:03:57,194 [speaking Nepali] 93 00:03:57,195 --> 00:03:58,820 Congratulations. 94 00:03:58,821 --> 00:04:00,323 [chuckles] Thanks. 95 00:04:09,749 --> 00:04:12,709 How long before we might expect to see some improvement? 96 00:04:12,710 --> 00:04:14,711 It could be hours. It could be days. 97 00:04:14,712 --> 00:04:16,380 It could be never. 98 00:04:16,381 --> 00:04:19,049 I don't expect anything for a little while. 99 00:04:19,050 --> 00:04:20,550 Why don't you guys go get a cup of coffee 100 00:04:20,551 --> 00:04:22,177 in the cafeteria, maybe something to eat? 101 00:04:22,178 --> 00:04:23,512 I'll have a nurse call you if anything changes 102 00:04:23,513 --> 00:04:25,555 - while you're out. - Thank you. 103 00:04:25,556 --> 00:04:27,182 We appreciate that. 104 00:04:27,183 --> 00:04:28,558 - I'm not leaving. - Suit yourself. 105 00:04:28,559 --> 00:04:29,935 I'm gonna get a cup of coffee. 106 00:04:29,936 --> 00:04:31,186 I got to call Sarah and the kids. 107 00:04:31,187 --> 00:04:32,271 Cafeteria? 108 00:04:32,272 --> 00:04:33,730 Straight down that hallway, 109 00:04:33,731 --> 00:04:35,232 through the corridor, and to the right. 110 00:04:35,233 --> 00:04:37,526 Thanks, and I'm... I'm sorry 111 00:04:37,527 --> 00:04:40,028 if my sister comes across a little strident. 112 00:04:40,029 --> 00:04:43,408 It's OK. This isn't easy. 113 00:04:47,662 --> 00:04:50,247 The parents of teen overdose, Lily and John Bradley, 114 00:04:50,248 --> 00:04:52,708 are asking about the tests you told them about. 115 00:04:52,709 --> 00:04:54,876 - OK, I'll be right there. - What about the rats? 116 00:04:54,877 --> 00:04:56,461 What about them? 117 00:04:56,462 --> 00:04:58,130 - Have they been caught? - I have no idea. 118 00:04:58,131 --> 00:05:00,465 - Well, find out. - Not sure that's my job. 119 00:05:00,466 --> 00:05:03,385 You're in charge of the ER. The rats are in the ER. 120 00:05:03,386 --> 00:05:05,262 That makes you in charge of the rats, 121 00:05:05,263 --> 00:05:07,597 and I have a strict rule about vermin in the workplace. 122 00:05:07,598 --> 00:05:09,058 [chuckles] Good to know. 123 00:05:12,353 --> 00:05:14,354 Could I get your eyes on a sickle cell crisis in South 20? 124 00:05:14,355 --> 00:05:16,231 Headed that way right now. 125 00:05:16,232 --> 00:05:18,233 ICU is insisting they still don't have rooms available. 126 00:05:18,234 --> 00:05:20,944 Bullshit. Esme recon'd for me. 127 00:05:20,945 --> 00:05:22,446 Send our electrocution, Victor Hunt, up there 128 00:05:22,447 --> 00:05:24,532 until the OR is ready please. Thank you. 129 00:05:28,745 --> 00:05:30,912 - Third epi on board? - Three minutes ago. 130 00:05:30,913 --> 00:05:32,789 How long has he been going at it? 131 00:05:32,790 --> 00:05:35,709 10 minutes in here, possibly 30 minutes of prior downtime. 132 00:05:35,710 --> 00:05:38,462 Don't suppose you'd let me try a pericardiocentesis? 133 00:05:38,463 --> 00:05:41,214 - For what? - For practice. 134 00:05:41,215 --> 00:05:44,134 - In case it's tamponade. - None seen on ultrasound. 135 00:05:44,135 --> 00:05:46,636 - This is a teaching hospital. - It's not a cadaver lab. 136 00:05:46,637 --> 00:05:48,389 What do you call this? 137 00:05:50,350 --> 00:05:53,101 - Do you need a break? - I'm fine. 138 00:05:53,102 --> 00:05:55,645 You don't look fine. 139 00:05:55,646 --> 00:05:58,148 Hold compressions. 140 00:05:58,149 --> 00:05:59,608 [vitals monitor droning] 141 00:05:59,609 --> 00:06:01,985 Still no rhythm. 142 00:06:01,986 --> 00:06:04,196 OK, Whitaker, I think that's enough. 143 00:06:04,197 --> 00:06:06,907 It's been four minutes since the last epi. 144 00:06:06,908 --> 00:06:08,492 One more minute, please. 145 00:06:08,493 --> 00:06:11,829 [vitals monitor beeping] 146 00:06:14,665 --> 00:06:17,501 Help me, please help! Somebody help! 147 00:06:17,502 --> 00:06:19,169 - Please, my friend needs help. - What happened? 148 00:06:19,170 --> 00:06:21,254 - My friend. - Hey, where is she? 149 00:06:21,255 --> 00:06:22,381 My friend, she's in my car. 150 00:06:22,382 --> 00:06:23,965 - She won't wake up. - OK. 151 00:06:23,966 --> 00:06:25,801 OK, Mateo, gurney! 152 00:06:25,802 --> 00:06:28,804 [tense music] 153 00:06:28,805 --> 00:06:31,848 ♪ ♪ 154 00:06:31,849 --> 00:06:33,850 - What's her name? - Jenna. 155 00:06:33,851 --> 00:06:35,519 Come on, Jenna. 156 00:06:35,520 --> 00:06:38,398 Wake up for me, baby. 157 00:06:40,441 --> 00:06:42,275 Pupils pinpoint. I need... 158 00:06:42,276 --> 00:06:44,319 - Narcan. - Yeah. 159 00:06:44,320 --> 00:06:48,156 Hold her head back, Javadi. OK. 160 00:06:48,157 --> 00:06:51,244 [panting] 161 00:06:58,084 --> 00:07:00,502 Not responding to Narcan. We might need to intubate. 162 00:07:00,503 --> 00:07:02,838 Find a room and open a crash cart. 163 00:07:02,839 --> 00:07:05,882 I can't find a carotid pulse. 164 00:07:05,883 --> 00:07:08,844 Five minutes since the last epi. 165 00:07:08,845 --> 00:07:11,555 OK, that's it. 166 00:07:11,556 --> 00:07:12,974 Hold compressions. 167 00:07:15,560 --> 00:07:18,563 [vitals monitor droning] 168 00:07:28,197 --> 00:07:30,907 [screams] 169 00:07:30,908 --> 00:07:35,329 Welcome back. She's OK. 170 00:07:37,915 --> 00:07:42,711 He took his wife out for dinner last night, 171 00:07:42,712 --> 00:07:44,546 for her birthday. 172 00:07:44,547 --> 00:07:46,089 OK, why doesn't everybody take a minute? 173 00:07:46,090 --> 00:07:47,591 Go check on your other patients. 174 00:07:47,592 --> 00:07:50,927 We'll meet back here to debrief with Kiara. 175 00:07:50,928 --> 00:07:52,846 - Bed four. - Where the hell am I? 176 00:07:52,847 --> 00:07:53,930 Pittsburgh Trauma Medical Center. 177 00:07:53,931 --> 00:07:55,265 Why? 178 00:07:55,266 --> 00:07:56,641 Your friend couldn't wake you. 179 00:07:56,642 --> 00:07:57,934 I'm right here, Jenna. 180 00:07:57,935 --> 00:07:59,269 Came to with one spray of Narcan. 181 00:07:59,270 --> 00:08:01,438 - What'd you take, Jenna? - Nothing. 182 00:08:01,439 --> 00:08:03,607 You had to have taken something to cause this. 183 00:08:03,608 --> 00:08:05,609 No, I was just up late studying, 184 00:08:05,610 --> 00:08:07,110 and I just couldn't fall asleep. 185 00:08:07,111 --> 00:08:09,029 So you took something to help you sleep? 186 00:08:09,030 --> 00:08:12,115 We need to know in order to treat you properly, OK? 187 00:08:12,116 --> 00:08:14,910 - Do you know what she took? - No. 188 00:08:14,911 --> 00:08:16,745 This could be a sign of something really serious, 189 00:08:16,746 --> 00:08:18,205 and we're gonna have to do a lot of tests that you... 190 00:08:18,206 --> 00:08:19,581 OK, I took, like, half a Xanax. 191 00:08:19,582 --> 00:08:21,875 That's not nothing. 192 00:08:21,876 --> 00:08:24,461 It's OK. OK? 193 00:08:24,462 --> 00:08:27,464 - Have you taken Xanax before? - First time. 194 00:08:27,465 --> 00:08:30,133 OK. 195 00:08:30,134 --> 00:08:32,720 Take a deep breath for me. 196 00:08:36,140 --> 00:08:38,016 Come on, man. You heard Dr. Robby. 197 00:08:38,017 --> 00:08:40,310 Let's take a break. Grab a coffee. 198 00:08:40,311 --> 00:08:42,813 No, I'm fine, thank you. 199 00:08:46,442 --> 00:08:50,321 [humming melody] 200 00:08:59,705 --> 00:09:02,123 Did you know him? 201 00:09:02,124 --> 00:09:04,918 No, I didn't. Did you? 202 00:09:04,919 --> 00:09:07,170 I just met him. 203 00:09:07,171 --> 00:09:09,839 He was my first patient to die. 204 00:09:09,840 --> 00:09:13,093 I'm sorry. 205 00:09:13,094 --> 00:09:16,180 [humming melody] 206 00:09:18,516 --> 00:09:20,684 - Are you OK? - Mm-hmm, yeah. 207 00:09:20,685 --> 00:09:23,687 - You sure? - Yeah. Just I... 208 00:09:23,688 --> 00:09:28,650 I just remember the first time that... 209 00:09:28,651 --> 00:09:31,653 on occasion, I have an emotional response to death. 210 00:09:31,654 --> 00:09:33,154 It's... 211 00:09:33,155 --> 00:09:35,407 Got to be kind of tough for a doctor. 212 00:09:35,408 --> 00:09:38,160 At times, it can be. 213 00:09:40,913 --> 00:09:44,125 At least I'm not a pathologist. [chuckles] 214 00:09:45,042 --> 00:09:46,710 I was joking. I... 215 00:09:46,711 --> 00:09:48,086 Oh. 216 00:09:48,087 --> 00:09:51,256 I have nothing against pathologists. 217 00:09:51,257 --> 00:09:54,884 Yeah, no. 218 00:09:54,885 --> 00:09:57,429 New radiodensity in the right middle lobe. 219 00:09:57,430 --> 00:09:59,097 Is it pneumonia? 220 00:09:59,098 --> 00:10:00,974 Possibly, or just changes from vaso-occlusion 221 00:10:00,975 --> 00:10:02,392 of the sickle cells. 222 00:10:02,393 --> 00:10:03,727 It's called acute chest syndrome. 223 00:10:03,728 --> 00:10:05,228 We're gonna cover you with antibiotics 224 00:10:05,229 --> 00:10:06,563 just to be on the safe side. 225 00:10:06,564 --> 00:10:08,231 We've been through this before. 226 00:10:08,232 --> 00:10:11,067 Third generation cephalosporin and a macrolide. 227 00:10:11,068 --> 00:10:14,487 Perfect. You're in good hands. 228 00:10:14,488 --> 00:10:17,365 - Can I do a chest tube? - Which patient? 229 00:10:17,366 --> 00:10:18,867 Any. 230 00:10:18,868 --> 00:10:20,493 I've just never done a chest tube before. 231 00:10:20,494 --> 00:10:22,704 Are you really asking me to reserve 232 00:10:22,705 --> 00:10:26,333 any incoming injury requiring a chest tube for you? 233 00:10:26,334 --> 00:10:27,751 Not all of them. 234 00:10:27,752 --> 00:10:29,753 I'd be more than happy just doing one, 235 00:10:29,754 --> 00:10:31,463 but, hey, if you wanted to give me more, 236 00:10:31,464 --> 00:10:33,590 I'd be fine with that, too, but that's up to you. 237 00:10:33,591 --> 00:10:35,133 I'm down for anything. 238 00:10:35,134 --> 00:10:38,219 Confidence and ambition are great attributes, 239 00:10:38,220 --> 00:10:42,432 especially when paired with respect and humility. 240 00:10:42,433 --> 00:10:46,144 OK, what else? What else went well? 241 00:10:46,145 --> 00:10:48,480 We checked for reversible causes 242 00:10:48,481 --> 00:10:50,065 of cardiac arrest on ultrasound. 243 00:10:50,066 --> 00:10:52,067 OK, good. 244 00:10:52,068 --> 00:10:53,985 Does anybody have anything that they wish had gone differently? 245 00:10:53,986 --> 00:10:56,404 In the hall, he should have been on a cardiac monitor. 246 00:10:56,405 --> 00:10:57,906 We would have caught the arrest right away. 247 00:10:57,907 --> 00:10:59,449 That's true, 248 00:10:59,450 --> 00:11:01,284 but there was no indication for monitoring. 249 00:11:01,285 --> 00:11:03,370 And we now know that his abdominal pain 250 00:11:03,371 --> 00:11:05,747 was not from his gallstones but from unstable angina 251 00:11:05,748 --> 00:11:07,624 due to coronary artery disease. 252 00:11:07,625 --> 00:11:09,542 Then we should have admitted to cardiology. 253 00:11:09,543 --> 00:11:12,462 Mm, we did an EKG. We did a troponin. 254 00:11:12,463 --> 00:11:14,381 He had a HEART score of three. 255 00:11:14,382 --> 00:11:15,799 Who can tell me what that means? 256 00:11:15,800 --> 00:11:17,884 1% chance of an adverse cardiac event 257 00:11:17,885 --> 00:11:19,302 in the next 30 days. 258 00:11:19,303 --> 00:11:21,262 Standard of care is to discharge 259 00:11:21,263 --> 00:11:22,973 with outpatient follow-up. 260 00:11:24,517 --> 00:11:25,934 He was your patient, Dr. Whitaker. 261 00:11:25,935 --> 00:11:27,644 Would you like to say something before 262 00:11:27,645 --> 00:11:31,398 we all take a brief moment of silent reflection? 263 00:11:31,399 --> 00:11:34,109 Um... [chuckles] 264 00:11:34,110 --> 00:11:36,444 He liked Kentucky bourbon. 265 00:11:36,445 --> 00:11:38,196 [chuckles] OK, good. 266 00:11:38,197 --> 00:11:39,698 [chuckles] Me too. 267 00:11:39,699 --> 00:11:41,658 - Anything else? - I don't know. 268 00:11:41,659 --> 00:11:44,369 I just met him. 269 00:11:44,370 --> 00:11:46,663 No, he seemed nice. 270 00:11:46,664 --> 00:11:48,957 He was married. 271 00:11:48,958 --> 00:11:52,127 Um, that's it. That's all I got. I... 272 00:11:52,128 --> 00:11:55,256 - [claps] - Mm. 273 00:11:56,424 --> 00:11:59,050 I spoke with his wife. She's on her way here. 274 00:11:59,051 --> 00:12:01,553 If anyone needs to talk about this some more, 275 00:12:01,554 --> 00:12:03,847 I'm available. 276 00:12:03,848 --> 00:12:05,765 For now, let's harness some good thoughts 277 00:12:05,766 --> 00:12:07,601 here for Mr. Milton. 278 00:12:18,529 --> 00:12:20,864 OK, that's it. 279 00:12:20,865 --> 00:12:22,450 Let's go save some lives. 280 00:12:25,035 --> 00:12:28,080 Hey, Whitaker. [clears throat] 281 00:12:30,708 --> 00:12:33,710 - How are you feeling on this? - [chuckles] 282 00:12:33,711 --> 00:12:36,421 I mean, not good. I was just talking to him. 283 00:12:36,422 --> 00:12:37,881 Now he's dead. 284 00:12:37,882 --> 00:12:39,257 That's the hardest way to lose a patient. 285 00:12:39,258 --> 00:12:40,508 It always hurts. 286 00:12:40,509 --> 00:12:42,093 Especially when it's your fault. 287 00:12:42,094 --> 00:12:44,512 This was not your fault. This was nobody's fault. 288 00:12:44,513 --> 00:12:46,723 No doctor on the planet could have caught this. 289 00:12:46,724 --> 00:12:48,683 Listen, it sucks, 290 00:12:48,684 --> 00:12:53,021 but today, today was this guy's day to leave this mortal coil. 291 00:12:53,022 --> 00:12:55,231 150,000 people die every day in the world, 292 00:12:55,232 --> 00:12:58,234 and you got one of them, but you learn to live with it, 293 00:12:58,235 --> 00:13:00,278 and you learn to accept it as much as your own mortality 294 00:13:00,279 --> 00:13:01,905 and find balance if you can. 295 00:13:01,906 --> 00:13:03,740 You've found balance? 296 00:13:03,741 --> 00:13:05,617 No, not even close. 297 00:13:05,618 --> 00:13:10,997 But, you know, you keep trying, which is all you can do. 298 00:13:10,998 --> 00:13:13,750 You're doing great, Whitaker. 299 00:13:13,751 --> 00:13:16,419 - Just, you know, hang in there. - Yeah, thanks. 300 00:13:16,420 --> 00:13:17,670 OK. 301 00:13:17,671 --> 00:13:19,422 - I'm just gonna go. - Yeah. 302 00:13:19,423 --> 00:13:21,424 But, you know, our social worker, Kiara, 303 00:13:21,425 --> 00:13:24,677 is here if you want to talk. 304 00:13:24,678 --> 00:13:26,555 OK, yeah. 305 00:13:29,266 --> 00:13:30,767 OK. 306 00:13:30,768 --> 00:13:33,269 You're gonna recover, OK? 307 00:13:33,270 --> 00:13:34,896 Good luck. 308 00:13:34,897 --> 00:13:37,106 Wait, what happens now? 309 00:13:37,107 --> 00:13:38,441 We monitor her heart and breathing 310 00:13:38,442 --> 00:13:39,609 for the next few hours to make sure 311 00:13:39,610 --> 00:13:40,819 she doesn't need more Narcan. 312 00:13:40,820 --> 00:13:42,946 - That's it? - Yeah. 313 00:13:42,947 --> 00:13:45,114 You should text your friends. 314 00:13:45,115 --> 00:13:47,492 Hell, you should text your whole college. 315 00:13:47,493 --> 00:13:49,077 Tell anyone who will listen 316 00:13:49,078 --> 00:13:50,620 to not take pills without a real prescription 317 00:13:50,621 --> 00:13:52,623 unless they want to end up here. 318 00:13:53,999 --> 00:13:55,834 Seriously, fentanyl is everywhere. 319 00:13:55,835 --> 00:13:57,378 It's in everything on the street these days. 320 00:13:59,672 --> 00:14:01,464 How long would I monitor her pupils for? 321 00:14:01,465 --> 00:14:02,799 You know what, actually, I should go to the bathroom. 322 00:14:02,800 --> 00:14:04,300 Are you OK on your own till I get back? 323 00:14:04,301 --> 00:14:05,426 Absolutely. Take your time. 324 00:14:05,427 --> 00:14:06,762 OK, great. Thanks. 325 00:14:09,640 --> 00:14:11,432 Sometimes I come on too strong. 326 00:14:11,433 --> 00:14:13,059 Excuse me? 327 00:14:13,060 --> 00:14:16,312 It's a defense mechanism against insecurity. 328 00:14:16,313 --> 00:14:19,440 - You're kidding, right? - Yeah. 329 00:14:19,441 --> 00:14:21,150 But I am sorry if I hurt your feelings. 330 00:14:21,151 --> 00:14:23,069 I really... I want us to get along. 331 00:14:23,070 --> 00:14:25,446 I want us to be friends. 332 00:14:25,447 --> 00:14:26,781 And if I'm really being honest, 333 00:14:26,782 --> 00:14:28,408 I want your mother to write me 334 00:14:28,409 --> 00:14:29,826 a kickass recommendation letter. 335 00:14:29,827 --> 00:14:31,494 You're going into general surgery. 336 00:14:31,495 --> 00:14:35,456 I might. I'm keeping my options open. 337 00:14:35,457 --> 00:14:36,958 You want me to pimp out my mother 338 00:14:36,959 --> 00:14:39,460 for something you might do? 339 00:14:39,461 --> 00:14:42,630 OK, well, when you put it like that, it sounds dirty, 340 00:14:42,631 --> 00:14:45,133 and a little hot, but yes. 341 00:14:45,134 --> 00:14:48,219 In full disclosure, so we can be friends. 342 00:14:48,220 --> 00:14:51,055 - Friends? - You've heard of the concept? 343 00:14:51,056 --> 00:14:54,183 Buddies, compatriots, confidants, pals. 344 00:14:54,184 --> 00:14:56,728 - They even made a show about it. - Yeah. 345 00:14:56,729 --> 00:15:00,231 Boom. Come on. 346 00:15:00,232 --> 00:15:02,859 Don't leave me hanging, Crash. Pound that shit. 347 00:15:02,860 --> 00:15:06,572 I can call you that now that we're friends, right? 348 00:15:08,449 --> 00:15:10,701 - OK. - We'll work on that. 349 00:15:12,536 --> 00:15:16,164 So for the apnea test, we keep him on 100% oxygen, 350 00:15:16,165 --> 00:15:18,291 but the ventilator won't be giving him breaths. 351 00:15:18,292 --> 00:15:20,543 - For how long? - For 10 minutes. 352 00:15:20,544 --> 00:15:22,629 We'll monitor his carbon dioxide levels, 353 00:15:22,630 --> 00:15:24,380 and if they come back way too high, 354 00:15:24,381 --> 00:15:26,007 then we'll know that his brain stem 355 00:15:26,008 --> 00:15:29,344 - is not telling him to breathe. - And that means? 356 00:15:29,345 --> 00:15:32,221 That would mean that there's no brain function 357 00:15:32,222 --> 00:15:34,183 at the most fundamental level. 358 00:15:35,559 --> 00:15:38,645 Princess will monitor him, and I will come back as soon 359 00:15:38,646 --> 00:15:40,647 as we know the test results. 360 00:15:40,648 --> 00:15:42,565 - OK. - Yeah. 361 00:15:42,566 --> 00:15:45,234 OK. 362 00:15:45,235 --> 00:15:48,364 [indistinct chatter] 363 00:15:51,116 --> 00:15:52,575 I hate this fucking hospital. 364 00:15:52,576 --> 00:15:54,035 This is Hank. 365 00:15:54,036 --> 00:15:56,204 - What happened? - Nothing. 366 00:15:56,205 --> 00:15:59,582 We were just framing, and then my buddy Joey comes in. 367 00:15:59,583 --> 00:16:02,418 He says, "A guy walks into a bar with a nail in his head," 368 00:16:02,419 --> 00:16:04,879 and then he points his fucking nail gun at my head. 369 00:16:04,880 --> 00:16:06,422 So what would you do? 370 00:16:06,423 --> 00:16:09,717 So I freaked out, and then in the ensuing melee, 371 00:16:09,718 --> 00:16:13,054 - he fucking shoots me. - Melee? 372 00:16:13,055 --> 00:16:16,057 Yeah, you know, like a scuffle, like a donnybrook. 373 00:16:16,058 --> 00:16:17,767 What, you think because I work construction, 374 00:16:17,768 --> 00:16:19,936 not a hospital, I don't have a fucking vocabulary? 375 00:16:19,937 --> 00:16:21,604 Tier one trauma now. 376 00:16:21,605 --> 00:16:22,689 - No, sir, I... - Whoa. 377 00:16:22,690 --> 00:16:24,399 Definitely intracardiac. 378 00:16:24,400 --> 00:16:26,359 And I got to tell you, this fucking hurts. 379 00:16:26,360 --> 00:16:28,695 Let's just try and relax and dial down the F bombs. 380 00:16:28,696 --> 00:16:31,030 - We have children in here. - You want me to stop swearing? 381 00:16:31,031 --> 00:16:32,865 Take the fucking nail out of my heart. 382 00:16:32,866 --> 00:16:34,409 And, please, something for the pain! 383 00:16:34,410 --> 00:16:35,952 Stabilize the nail. 384 00:16:35,953 --> 00:16:36,953 Hank, we need to cut your shirt off. 385 00:16:36,954 --> 00:16:38,621 Fuck that. 386 00:16:38,622 --> 00:16:40,289 You cut the shirt, you're gonna buy me a new one. 387 00:16:40,290 --> 00:16:42,709 You can have your pick out of our lost and found. 388 00:16:42,710 --> 00:16:44,544 Whew, how did this happen? 389 00:16:44,545 --> 00:16:46,504 Framing nail incident with deep penetration 390 00:16:46,505 --> 00:16:48,673 - of the left chest. - The fuck does it look like? 391 00:16:48,674 --> 00:16:50,174 Hank, do you take medicine every day? 392 00:16:50,175 --> 00:16:52,135 - [grunts] - Any allergies to medication? 393 00:16:52,136 --> 00:16:54,095 No. Can you give me something for the fucking pain already? 394 00:16:54,096 --> 00:16:55,930 Is this a hospital or a vet clinic? 395 00:16:55,931 --> 00:16:57,473 Very soon, Hank. Very soon. 396 00:16:57,474 --> 00:16:59,434 I bet you say that to the beagles too. 397 00:16:59,435 --> 00:17:02,353 Pulse 120. BP 100 over 65. 398 00:17:02,354 --> 00:17:04,147 Two milligrams of morphine. 399 00:17:04,148 --> 00:17:06,441 Liver GSW is in recovery. He's good as new. 400 00:17:06,442 --> 00:17:07,859 Whoa, that looks intracardiac. 401 00:17:07,860 --> 00:17:10,445 - Nailed it. - Whoa, you got jokes now. 402 00:17:10,446 --> 00:17:12,447 No jokes, just pushing your pain meds, buddy. 403 00:17:12,448 --> 00:17:15,533 Small pericardial effusion, but no evidence of tamponade. 404 00:17:15,534 --> 00:17:17,410 - Not yet. - Somebody talk to me. 405 00:17:17,411 --> 00:17:18,953 Do I need a priest here? 406 00:17:18,954 --> 00:17:20,413 He's tachycardic with borderline BP. 407 00:17:20,414 --> 00:17:21,748 He could decompensate. 408 00:17:21,749 --> 00:17:23,166 Standby with two units whole blood. 409 00:17:23,167 --> 00:17:25,334 Garcia here. Stat cardiac case. 410 00:17:25,335 --> 00:17:27,462 Am I dying here and nobody's telling me? 411 00:17:27,463 --> 00:17:29,505 Hank, there is blood collecting 412 00:17:29,506 --> 00:17:30,965 in the sac around your heart. 413 00:17:30,966 --> 00:17:32,759 You need surgery before your heart stops 414 00:17:32,760 --> 00:17:34,135 from the pressure around it. 415 00:17:34,136 --> 00:17:35,678 Just pull the fucking nail out! 416 00:17:35,679 --> 00:17:37,346 That would definitely kill you. 417 00:17:37,347 --> 00:17:40,600 I want a second opinion. Where's my fucking phone? 418 00:17:40,601 --> 00:17:43,144 I can Uber to Presby and find a real hospital. 419 00:17:43,145 --> 00:17:44,520 OR can take him in 10 minutes. 420 00:17:44,521 --> 00:17:46,355 Mind if we intubate him first? 421 00:17:46,356 --> 00:17:48,149 The sooner the better for all of us. 422 00:17:48,150 --> 00:17:50,860 Great. 120 of sux, 100 of ketamine. 423 00:17:50,861 --> 00:17:53,196 - Javadi, you're up for this one. - Really? 424 00:17:53,197 --> 00:17:54,989 Now. Let's go. Move. 425 00:17:54,990 --> 00:17:57,033 Code STEMI, ETA five minutes. 426 00:17:57,034 --> 00:17:59,994 Code STEMI, ETA five minutes. 427 00:17:59,995 --> 00:18:01,662 I can start the STEMI with Mel. 428 00:18:01,663 --> 00:18:03,539 - Sounds good. - This place sucks. 429 00:18:03,540 --> 00:18:05,750 I will destroy you on Yelp. 430 00:18:05,751 --> 00:18:07,877 Nobody's ever coming to this shithole again. 431 00:18:07,878 --> 00:18:09,212 I swear to God. 432 00:18:09,213 --> 00:18:11,672 From your mouth to God's ear. 433 00:18:11,673 --> 00:18:14,050 Kiara? Hi. I'm Dr. Melissa King. 434 00:18:14,051 --> 00:18:17,679 - Everyone calls me Mel. - Yes, we met. 435 00:18:18,806 --> 00:18:22,725 Right, um, I wanted to ask you 436 00:18:22,726 --> 00:18:26,354 about Tyler, the little boy who ate the marijuana gummy. 437 00:18:26,355 --> 00:18:28,731 He's been admitted to pediatrics for observation. 438 00:18:28,732 --> 00:18:31,567 - And his parents? - They're upstairs with him. 439 00:18:31,568 --> 00:18:34,403 CYF is going to follow up with a home visit just to be safe, 440 00:18:34,404 --> 00:18:36,864 but no police were involved. Don't worry. 441 00:18:36,865 --> 00:18:38,574 No one is taking their child away from them. 442 00:18:38,575 --> 00:18:40,076 Good. That's a relief. 443 00:18:40,077 --> 00:18:41,577 Yeah, the parents, on the other hand, 444 00:18:41,578 --> 00:18:43,663 may need couples counseling after this, 445 00:18:43,664 --> 00:18:46,082 but I think little Tyler's going to be fine. 446 00:18:46,083 --> 00:18:48,751 - STEMI with me, Mel. - Right behind you. 447 00:18:48,752 --> 00:18:51,754 - Dana, what's open? - Trauma two. 448 00:18:51,755 --> 00:18:53,589 All right, keep it that way. 449 00:18:53,590 --> 00:18:57,135 Our target door to balloon time for STEMIs is 51 minutes. 450 00:18:57,136 --> 00:18:58,719 Ambitious. 451 00:18:58,720 --> 00:19:01,556 But doable, as you're about to find out. 452 00:19:01,557 --> 00:19:03,642 Let's go. 453 00:19:06,270 --> 00:19:08,437 Good view of the glottis. 454 00:19:08,438 --> 00:19:10,940 Eyes off the screen. 455 00:19:10,941 --> 00:19:14,443 Now look down the mouth and insert 456 00:19:14,444 --> 00:19:17,572 the tube around the bend. 457 00:19:17,573 --> 00:19:20,283 You stole my med student from triage? 458 00:19:20,284 --> 00:19:22,535 - How's she doing over here? - She's doing pretty good. 459 00:19:22,536 --> 00:19:25,288 Now look back at the screen. 460 00:19:25,289 --> 00:19:28,041 And advance through the cords. 461 00:19:30,127 --> 00:19:32,795 Good. Good job. 462 00:19:32,796 --> 00:19:34,797 Thanks. 463 00:19:34,798 --> 00:19:36,257 [vitals monitor beeping rapidly] 464 00:19:36,258 --> 00:19:38,927 Pressure's down. 72/38. 465 00:19:41,305 --> 00:19:44,432 Effusion has grown, now with the RV collapse. 466 00:19:44,433 --> 00:19:46,100 Pericardiocentesis? 467 00:19:46,101 --> 00:19:47,977 Let's get another unit on that infuser. 468 00:19:47,978 --> 00:19:50,104 Prep for thoracotomy. Coming through. 469 00:19:50,105 --> 00:19:51,480 We should get back to triage. 470 00:19:51,481 --> 00:19:52,982 You don't want to stay for this? 471 00:19:52,983 --> 00:19:54,358 There are like 30 patients still waiting 472 00:19:54,359 --> 00:19:58,154 - to be assessed out there. - OK. 473 00:19:58,155 --> 00:20:00,698 - Did someone say thoracotomy? - Crashing from tamponade. 474 00:20:00,699 --> 00:20:02,325 Dr. Garcia, do you think I... 475 00:20:02,326 --> 00:20:04,535 Trauma Surgery gets left sided thoracotomies. 476 00:20:04,536 --> 00:20:07,538 ED gets the right if we need to extend. 477 00:20:07,539 --> 00:20:08,998 [vitals monitor beeping rapidly] 478 00:20:08,999 --> 00:20:11,125 Glove up, girl. You're on suction. 479 00:20:11,126 --> 00:20:14,003 Let's advance that ET tube to the right main stem please. 480 00:20:14,004 --> 00:20:15,881 Ten blade. 481 00:20:24,181 --> 00:20:25,848 Metz. 482 00:20:25,849 --> 00:20:27,934 Dr. Santos, how do we cut through the intercostals? 483 00:20:27,935 --> 00:20:30,853 Through the superior rib to avoid the neurovascular bundle. 484 00:20:30,854 --> 00:20:33,523 - That is correct. - Finochietto retractor. 485 00:20:37,527 --> 00:20:38,945 Full suction. 486 00:20:38,946 --> 00:20:41,280 And get rid of this nail before I get poked. 487 00:20:41,281 --> 00:20:43,659 On it. 488 00:20:47,037 --> 00:20:50,206 Nail's intact in one piece. 489 00:20:50,207 --> 00:20:54,043 Toothed forceps. Opening the pericardium. 490 00:20:54,044 --> 00:20:55,711 This is so fucking cool. 491 00:20:55,712 --> 00:20:57,755 Dr. Santos, you and this patient 492 00:20:57,756 --> 00:20:59,757 share a common vocabulary. 493 00:20:59,758 --> 00:21:01,759 Yeah, I swear a lot. I know. I'm sorry. 494 00:21:01,760 --> 00:21:03,761 They say it's a sign of intelligence. 495 00:21:03,762 --> 00:21:06,389 I think it shows a lack of self-control. 496 00:21:06,390 --> 00:21:08,057 But what the fuck do I know? 497 00:21:08,058 --> 00:21:10,059 Single puncture wound to the left ventricle. 498 00:21:10,060 --> 00:21:12,436 We've got a finger on it. 499 00:21:12,437 --> 00:21:15,064 First unit is in. Pressure's up. 500 00:21:15,065 --> 00:21:16,899 Heart is filling well. 501 00:21:16,900 --> 00:21:18,859 Throw in a horizontal mattress, and we're out of here. 502 00:21:18,860 --> 00:21:21,570 - Stop the bleed while I sew. - STEMI's arrived. 503 00:21:21,571 --> 00:21:23,072 You got this? 504 00:21:23,073 --> 00:21:24,865 Just wrapping him up for OR delivery. 505 00:21:24,866 --> 00:21:26,575 2-0 Prolene on a tapered needle. 506 00:21:26,576 --> 00:21:29,370 Mr. Ed Gellin is 52 years young 507 00:21:29,371 --> 00:21:31,497 with a history of hypertension and hyperlipidemia. 508 00:21:31,498 --> 00:21:33,541 20 minutes of substernal chest pain. 509 00:21:33,542 --> 00:21:35,710 10 out of 10 with dyspnea and diaphoresis. 510 00:21:35,711 --> 00:21:38,087 BP is 152 over 95. 511 00:21:38,088 --> 00:21:40,089 Currently chewing 324 mgs of baby aspirin. 512 00:21:40,090 --> 00:21:41,424 OK. 513 00:21:41,425 --> 00:21:42,883 Blood's drawn. Second IV started. 514 00:21:42,884 --> 00:21:44,343 BP stable. 515 00:21:44,344 --> 00:21:46,053 Seven millimeters ST elevation... 516 00:21:46,054 --> 00:21:47,722 - One nitro spray, sublingual. - In the anterior leads. 517 00:21:47,723 --> 00:21:49,265 Those are sometimes called tombstones. 518 00:21:49,266 --> 00:21:50,391 - Open up, sir. - Tombstones? 519 00:21:50,392 --> 00:21:51,434 Lift your tongue. 520 00:21:51,435 --> 00:21:52,852 Mr. Gellin, you're having 521 00:21:52,853 --> 00:21:54,395 a very big heart attack right now. 522 00:21:54,396 --> 00:21:56,230 Major artery that carries oxygen to your heart 523 00:21:56,231 --> 00:21:58,232 - is almost totally blocked. - That doesn't sound too good. 524 00:21:58,233 --> 00:21:59,608 No, it's not very good. 525 00:21:59,609 --> 00:22:01,402 We're gonna send you up to the cath lab. 526 00:22:01,403 --> 00:22:02,737 A cardiologist is gonna unblock that with a balloon 527 00:22:02,738 --> 00:22:04,155 and leave it open with a stent. 528 00:22:04,156 --> 00:22:05,489 But I'm still having a heart attack? 529 00:22:05,490 --> 00:22:07,116 If everything goes as planned, 530 00:22:07,117 --> 00:22:08,909 it'll be like you never had a heart attack. 531 00:22:08,910 --> 00:22:10,286 We're gonna put a catheter in this artery right here. 532 00:22:10,287 --> 00:22:11,662 We're gonna shave the hair with a clipper. 533 00:22:11,663 --> 00:22:13,414 Long as you stop short of a Brazilian. 534 00:22:13,415 --> 00:22:15,791 It's an option we offer. Costs a little bit more. 535 00:22:15,792 --> 00:22:17,460 A lot of people's insurance won't cover it. 536 00:22:17,461 --> 00:22:18,461 [chuckles] Don't make me laugh. 537 00:22:18,462 --> 00:22:19,462 - It hurts. - Deal. 538 00:22:19,463 --> 00:22:20,921 Anybody we can call? 539 00:22:20,922 --> 00:22:22,965 - My wife. - Already have her number. 540 00:22:22,966 --> 00:22:24,842 OK, we'll call her. You hang in there. 541 00:22:24,843 --> 00:22:26,970 I'll be right back. 542 00:22:28,305 --> 00:22:30,806 [razor buzzing] 543 00:22:30,807 --> 00:22:33,225 I think they finished the apnea test on Nick. 544 00:22:33,226 --> 00:22:35,061 - Can you check the results? - Not just yet. 545 00:22:35,062 --> 00:22:36,479 The blood test needs to go to the lab. 546 00:22:36,480 --> 00:22:38,272 It takes a few minutes to run the test. 547 00:22:38,273 --> 00:22:40,359 I'll come find you in the room as soon as it's done. 548 00:22:43,153 --> 00:22:45,946 Horizontal mattress in place with excellent hemostasis. 549 00:22:45,947 --> 00:22:47,324 Cut here. 550 00:22:49,826 --> 00:22:52,620 Moist, sterile towel. And away we go. 551 00:22:52,621 --> 00:22:55,456 I spoke to cardiothoracic. They can meet you in the OR. 552 00:22:55,457 --> 00:22:58,250 Good job. 553 00:22:58,251 --> 00:23:00,087 Coming through. 554 00:23:01,755 --> 00:23:04,173 Well done. Well done. 555 00:23:04,174 --> 00:23:06,717 - Good luck, Mr. Gellin. - Thank you so much. 556 00:23:06,718 --> 00:23:08,470 You're very welcome. 557 00:23:11,890 --> 00:23:15,559 Two saves. Totally awesome. 558 00:23:15,560 --> 00:23:17,853 I just held a beating human heart in my hands. 559 00:23:17,854 --> 00:23:19,522 We should celebrate. 560 00:23:19,523 --> 00:23:20,898 We should clean these rooms 561 00:23:20,899 --> 00:23:22,525 and bring some more patients back. 562 00:23:22,526 --> 00:23:24,402 - Sounds like a plan. - No rest for the wicked. 563 00:23:24,403 --> 00:23:27,696 - Code STEMI was fast. - Time is myocardium. 564 00:23:27,697 --> 00:23:30,533 And our statistics for door to balloon time 565 00:23:30,534 --> 00:23:32,284 get reviewed, critiqued, and published online. 566 00:23:32,285 --> 00:23:33,869 Door to balloon time? 567 00:23:33,870 --> 00:23:35,830 That's the time from when they hit our door 568 00:23:35,831 --> 00:23:38,124 to when the angioplasty balloon gets inflated in the cath lab. 569 00:23:38,125 --> 00:23:40,376 We keep it to under 51 minutes, we can reverse a heart attack 570 00:23:40,377 --> 00:23:41,836 and save a life. 571 00:23:41,837 --> 00:23:44,880 Kind of wish Mr. Milton had a STEMI. 572 00:23:44,881 --> 00:23:47,550 Thank you for letting me go the distance on him. 573 00:23:47,551 --> 00:23:49,718 I really thought we'd get him back, you know? 574 00:23:49,719 --> 00:23:51,345 Yeah, well, you know, even though 575 00:23:51,346 --> 00:23:52,555 you do everything right, you don't always 576 00:23:52,556 --> 00:23:54,683 get what you hope for. 577 00:23:56,893 --> 00:23:59,228 My parents both had sickle cell trait, 578 00:23:59,229 --> 00:24:02,523 and I was screened as a newborn with the hemoglobin FS pattern. 579 00:24:02,524 --> 00:24:05,109 - Did you take penicillin? - Mm-hmm, until I was five. 580 00:24:05,110 --> 00:24:07,027 Then the vaccines kicked in. 581 00:24:07,028 --> 00:24:09,405 She has her entire medical history on her phone. 582 00:24:09,406 --> 00:24:10,906 It's extremely long. 583 00:24:10,907 --> 00:24:12,241 Dr. Mohan, do you have a minute? 584 00:24:12,242 --> 00:24:14,369 Yep. Excuse me. 585 00:24:19,583 --> 00:24:20,916 Is there a problem over there? 586 00:24:20,917 --> 00:24:22,585 No, her pain is well controlled. 587 00:24:22,586 --> 00:24:24,295 You understand that's my polite way of asking 588 00:24:24,296 --> 00:24:26,088 why are you spending so much time with one patient? 589 00:24:26,089 --> 00:24:28,048 You're an R3. 590 00:24:28,049 --> 00:24:30,050 As an R3, you should be seeing at least two patients an hour. 591 00:24:30,051 --> 00:24:32,219 I have two, Joyce and Mr. Wallace, 592 00:24:32,220 --> 00:24:34,346 - our Good Samaritan. - Who's comatose and stable. 593 00:24:34,347 --> 00:24:36,098 You should have four by now. 594 00:24:36,099 --> 00:24:37,933 I have the highest patient satisfaction of anyone. 595 00:24:37,934 --> 00:24:39,226 I don't doubt it, 596 00:24:39,227 --> 00:24:40,603 but we just had this conversation 597 00:24:40,604 --> 00:24:41,854 a couple of hours ago. 598 00:24:41,855 --> 00:24:43,439 I know people call me Slow-Mo. 599 00:24:43,440 --> 00:24:45,274 You don't have to confirm or deny. 600 00:24:45,275 --> 00:24:48,611 It used to hurt my feelings a lot, but I can't help it. 601 00:24:48,612 --> 00:24:51,071 I work at the speed I'm comfortable at. 602 00:24:51,072 --> 00:24:54,200 Because you're afraid of making a mistake? 603 00:24:54,201 --> 00:24:55,618 I'm always afraid of making a mistake. 604 00:24:55,619 --> 00:24:56,619 - Aren't you? - Yeah, of course I am. 605 00:24:56,620 --> 00:24:58,078 But you know what I mean. 606 00:24:58,079 --> 00:24:59,705 You make a mistake once, and somebody dies, 607 00:24:59,706 --> 00:25:01,081 and you feel so badly about it, 608 00:25:01,082 --> 00:25:02,082 you'll never let it happen again... 609 00:25:02,083 --> 00:25:03,292 How is that wrong? 610 00:25:03,293 --> 00:25:05,753 Because you waste time and money 611 00:25:05,754 --> 00:25:07,588 on unnecessary tests. 612 00:25:07,589 --> 00:25:10,174 You keep sick patients waiting too long. 613 00:25:10,175 --> 00:25:12,009 You miss out on cases you could be learning from. 614 00:25:12,010 --> 00:25:13,761 You shortchange your own education. 615 00:25:13,762 --> 00:25:15,429 I'm not saying this to be a hard-ass. 616 00:25:15,430 --> 00:25:16,931 I'm saying this because I know you could do this, 617 00:25:16,932 --> 00:25:18,641 but you need to do it at a level 618 00:25:18,642 --> 00:25:21,685 - I also know you're capable of. - And what if I'm not? 619 00:25:21,686 --> 00:25:22,937 Then you should look into a specialty 620 00:25:22,938 --> 00:25:24,146 that better suits you. 621 00:25:24,147 --> 00:25:25,981 Have you thought about psychiatry? 622 00:25:25,982 --> 00:25:27,107 I don't want to go into psychiatry. 623 00:25:27,108 --> 00:25:28,108 I want to be here. 624 00:25:28,109 --> 00:25:30,152 Being here means 625 00:25:30,153 --> 00:25:32,112 no matter how good you are or how hard you try, 626 00:25:32,113 --> 00:25:33,447 you're gonna make another mistake, 627 00:25:33,448 --> 00:25:35,157 and someone else might even die. 628 00:25:35,158 --> 00:25:39,078 That's called being an emergency medicine doctor. 629 00:25:39,079 --> 00:25:40,579 And if you can't accept that, 630 00:25:40,580 --> 00:25:41,914 then maybe this isn't the place for you. 631 00:25:41,915 --> 00:25:44,458 - I can accept that. - You sure? 632 00:25:44,459 --> 00:25:47,169 - Yes. - OK, good. 633 00:25:47,170 --> 00:25:49,505 Go save some lives. 634 00:25:49,506 --> 00:25:53,342 Clear some beds while you're at it. 635 00:25:53,343 --> 00:25:57,137 I would fancy a spot of tea at some point. 636 00:25:57,138 --> 00:25:59,598 You want some tea, darling? I'll get you some tea. 637 00:25:59,599 --> 00:26:03,185 - Oh, thank you, sweetheart. - Is Dr. Robby available? 638 00:26:03,186 --> 00:26:04,937 He's with a patient. Can I help? 639 00:26:04,938 --> 00:26:07,690 - My father's starting to move. - OK, I'll let him know. 640 00:26:07,691 --> 00:26:10,025 - Thanks. - Yeah. 641 00:26:10,026 --> 00:26:11,485 Is it good or bad? 642 00:26:11,486 --> 00:26:13,404 If there's no spontaneous breathing, 643 00:26:13,405 --> 00:26:16,532 then carbon dioxide levels rise above 60. 644 00:26:16,533 --> 00:26:19,994 So 82 definitely means that Nick's brainstem 645 00:26:19,995 --> 00:26:21,412 is not triggering him to breathe. 646 00:26:21,413 --> 00:26:22,997 Well, how can you fix that? 647 00:26:22,998 --> 00:26:25,082 We can't. I'm sorry. 648 00:26:25,083 --> 00:26:27,042 But with rest and time... 649 00:26:27,043 --> 00:26:29,712 This is not something that heals on its own. 650 00:26:29,713 --> 00:26:32,381 There's got to be something else that we can do. 651 00:26:32,382 --> 00:26:34,091 Nick is our only child. 652 00:26:34,092 --> 00:26:37,219 - Is that test 100% accurate? - It is. 653 00:26:37,220 --> 00:26:39,888 Isn't there anything else? 654 00:26:39,889 --> 00:26:42,057 We can do an imaging test called 655 00:26:42,058 --> 00:26:44,143 - a cerebral perfusion study. - Then let's do it. 656 00:26:44,144 --> 00:26:45,728 But you have to understand that will be the last test 657 00:26:45,729 --> 00:26:47,688 that we would do. 658 00:26:47,689 --> 00:26:50,232 If it comes back that there's no blood flow to Nick's brain, 659 00:26:50,233 --> 00:26:54,320 it would confirm beyond a shadow of a doubt 660 00:26:54,321 --> 00:26:57,698 that there's been brain death, 661 00:26:57,699 --> 00:27:00,910 which would mean that he's gone. 662 00:27:03,413 --> 00:27:06,958 Then we wait and see. 663 00:27:08,585 --> 00:27:10,419 - Call Nuclear Medicine. - See how soon they can take him. 664 00:27:10,420 --> 00:27:11,795 You got it. 665 00:27:11,796 --> 00:27:13,088 I'll be back in a few minutes. 666 00:27:13,089 --> 00:27:15,175 - Thank you. - [clears throat] 667 00:27:20,972 --> 00:27:24,224 Hey, Mr. Spencer in Central 9 tried to pull out his ET tube 668 00:27:24,225 --> 00:27:26,894 - and is now in soft restraints. - No surprise there. 669 00:27:26,895 --> 00:27:28,729 We need to up the propofol. 670 00:27:28,730 --> 00:27:31,231 And the sister of the dead MVC vet in the viewing room 671 00:27:31,232 --> 00:27:33,400 - just arrived in Chairs. - Can you, um... 672 00:27:33,401 --> 00:27:35,611 - Park her in the family room? - Please. 673 00:27:35,612 --> 00:27:38,113 No problem, I'll have Perlah and Princess prep the body 674 00:27:38,114 --> 00:27:39,948 as best they can for viewing. 675 00:27:39,949 --> 00:27:41,241 Any progress in there? 676 00:27:41,242 --> 00:27:42,910 No. 677 00:27:42,911 --> 00:27:46,121 Can you also keep an extra eye on Whitaker today? 678 00:27:46,122 --> 00:27:47,456 Oh, I'm already on it. 679 00:27:47,457 --> 00:27:49,291 I know he lost his first patient. 680 00:27:49,292 --> 00:27:50,918 Yeah, I just don't want it to throw him off his game. 681 00:27:50,919 --> 00:27:54,296 - You think this kid has game? - Not sure yet. 682 00:27:54,297 --> 00:27:55,756 I want to give him a chance to find out. 683 00:27:55,757 --> 00:27:58,300 Copy that. 684 00:27:58,301 --> 00:28:01,387 - Hey, fruitcake. - [sighs] Myrna. 685 00:28:01,388 --> 00:28:03,597 What brings you in here today, anyway? 686 00:28:03,598 --> 00:28:06,141 - I murdered my husband. - Ah. 687 00:28:06,142 --> 00:28:07,768 How did you do it this time? 688 00:28:07,769 --> 00:28:11,021 I put him through a meat grinder. 689 00:28:11,022 --> 00:28:14,108 Best just to grab one and jump back in. 690 00:28:14,109 --> 00:28:15,859 Yeah, right. 691 00:28:15,860 --> 00:28:20,322 Mr. Fulton in Central 14 just needs a shot of Mylanta 692 00:28:20,323 --> 00:28:22,658 for his GERD, and to avoid eating foods 693 00:28:22,659 --> 00:28:24,326 with the words "flaming hot" in their title 694 00:28:24,327 --> 00:28:25,536 for at least a few days. 695 00:28:25,537 --> 00:28:29,164 - OK, thanks. - Central 14. 696 00:28:29,165 --> 00:28:31,291 Yeah. 697 00:28:31,292 --> 00:28:35,671 Could I get some Mylanta for Mr. Fulton in Central 14? 698 00:28:35,672 --> 00:28:37,172 It'll be a while. 699 00:28:37,173 --> 00:28:38,966 If you want it fast, go check out the employee 700 00:28:38,967 --> 00:28:41,301 - first aid cabinet. - Where is that? 701 00:28:41,302 --> 00:28:43,846 In the lounge. I'll show you. 702 00:28:43,847 --> 00:28:47,182 - How's it going? - Not so great. 703 00:28:47,183 --> 00:28:49,476 - I lost a patient. - So I heard. 704 00:28:49,477 --> 00:28:51,145 I also heard it wasn't your fault. 705 00:28:51,146 --> 00:28:52,646 Doesn't make it feel any better. 706 00:28:52,647 --> 00:28:54,189 Yeah, it doesn't. I'm sorry. 707 00:28:54,190 --> 00:28:56,191 Unfortunately, it comes with the job. 708 00:28:56,192 --> 00:28:59,611 If it's any consolation, I just got scolded for going too slow. 709 00:28:59,612 --> 00:29:01,697 If you hear someone talking about a Slow-Mo, that's me. 710 00:29:01,698 --> 00:29:03,949 Guaranteed you're going faster than me. 711 00:29:03,950 --> 00:29:06,535 I like to say it gets easier. Some days it does. 712 00:29:06,536 --> 00:29:08,203 I'm sure the rest of your shift will be better. 713 00:29:08,204 --> 00:29:09,705 - Shake it first. - Mm-hmm. 714 00:29:09,706 --> 00:29:12,166 Oh, but make sure the lid is...[gasps] 715 00:29:12,167 --> 00:29:14,710 Screwed down tight. 716 00:29:14,711 --> 00:29:19,007 - OK. - Oh. 717 00:29:20,216 --> 00:29:23,510 Everyone seems to get along like family. 718 00:29:23,511 --> 00:29:27,347 You see a family, I see every man for himself. 719 00:29:27,348 --> 00:29:28,724 Actually, that's not entirely true. 720 00:29:28,725 --> 00:29:30,100 There is some family here. 721 00:29:30,101 --> 00:29:32,019 Javadi's mom is a surgeon upstairs. 722 00:29:32,020 --> 00:29:33,604 - Really? - Yeah. 723 00:29:33,605 --> 00:29:36,356 - Oh, that must be so nice. - Are you kidding? 724 00:29:36,357 --> 00:29:38,108 I don't know about your mom, 725 00:29:38,109 --> 00:29:40,903 but I would not want mine working within 100 miles of me. 726 00:29:40,904 --> 00:29:44,406 - No way. - My mother passed. 727 00:29:44,407 --> 00:29:49,495 She had a very aggressive, malignant pheochromocytoma, 728 00:29:49,496 --> 00:29:52,581 - so... - Sorry. 729 00:29:52,582 --> 00:29:56,211 Unfortunately, my mother is gonna live forever. 730 00:29:57,253 --> 00:30:00,214 No, she was definitely dead. Like, I'm still shaking. 731 00:30:00,215 --> 00:30:03,050 No, she was, like, dead. Like dead-dead. 732 00:30:03,051 --> 00:30:04,593 I mean, I think her heart stopped. 733 00:30:04,594 --> 00:30:06,220 No, she was, like, literally dead. 734 00:30:06,221 --> 00:30:08,847 - Think she was dead? - Who? 735 00:30:08,848 --> 00:30:10,891 Who she was just talking about. 736 00:30:10,892 --> 00:30:12,434 Oh. 737 00:30:12,435 --> 00:30:14,102 In case you didn't realize, I use sarcasm 738 00:30:14,103 --> 00:30:17,105 and comedy as a shield. Or so I've been told. 739 00:30:17,106 --> 00:30:19,149 Thank you for opening up to me. 740 00:30:19,150 --> 00:30:21,318 - Mel, right? - Yes. 741 00:30:21,319 --> 00:30:22,945 Well, it was nice talking to you, Mel. 742 00:30:22,946 --> 00:30:24,780 It was nice talking to you too. 743 00:30:24,781 --> 00:30:26,448 You know, I really hope we can be fri... 744 00:30:26,449 --> 00:30:28,576 friends. 745 00:30:36,584 --> 00:30:38,961 Is there anything I can assist you with, Dr. Robby? 746 00:30:38,962 --> 00:30:40,796 I think we're best on our own right now, thank you. 747 00:30:40,797 --> 00:30:42,673 He keeps trying to pull away. 748 00:30:42,674 --> 00:30:44,424 We're giving him some more sedation. 749 00:30:44,425 --> 00:30:46,260 Why is he so agitated? 750 00:30:46,261 --> 00:30:48,387 He could have some awareness of the tube in his throat 751 00:30:48,388 --> 00:30:50,722 or that he's in a strange place, 752 00:30:50,723 --> 00:30:53,559 or it could be lack of oxygen to his brain. 753 00:30:53,560 --> 00:30:55,727 - Does he need more oxygen? - He's on 100%. 754 00:30:55,728 --> 00:30:56,979 That's as high as it goes. 755 00:30:56,980 --> 00:30:58,397 [vitals monitor beeping rapidly] 756 00:30:58,398 --> 00:31:00,482 That is his blood pressure dropping. 757 00:31:00,483 --> 00:31:02,818 Oh, is that even fixable? 758 00:31:02,819 --> 00:31:05,487 Normally, yes, with IV fluids, 759 00:31:05,488 --> 00:31:07,948 but we now know that that will just fill up his lungs, 760 00:31:07,949 --> 00:31:09,491 drop his oxygen even more. 761 00:31:09,492 --> 00:31:11,493 Well, isn't there something else we can do? 762 00:31:11,494 --> 00:31:15,956 We can place a long, large IV catheter in his jugular vein 763 00:31:15,957 --> 00:31:19,501 down into his heart and administer Levophed, 764 00:31:19,502 --> 00:31:21,211 which is a very powerful medicine 765 00:31:21,212 --> 00:31:24,131 to constrict his arteries, raise his blood pressure. 766 00:31:24,132 --> 00:31:30,053 But that could cause other organ damage, organ failure. 767 00:31:30,054 --> 00:31:35,142 I'm really sorry, but each new step is even more invasive, 768 00:31:35,143 --> 00:31:40,064 could cause more suffering with minimal benefit. 769 00:31:47,030 --> 00:31:49,364 Uh, hi. 770 00:31:49,365 --> 00:31:51,658 Dr. Robby said he'd be back in a few minutes. 771 00:31:51,659 --> 00:31:54,662 Yeah, he's with a patient, but I'll let him know. 772 00:31:56,539 --> 00:31:58,206 My son is dead, isn't he? 773 00:31:58,207 --> 00:32:00,876 I'm not a doctor, Mr. Bradley, 774 00:32:00,877 --> 00:32:04,463 but I do believe in God, and I am praying for your boy 775 00:32:04,464 --> 00:32:06,214 with every beat of my heart. 776 00:32:06,215 --> 00:32:08,383 Thought she'd taken Xanax, but it was actually fent. 777 00:32:08,384 --> 00:32:10,344 - Thank you. - Yeah. 778 00:32:10,345 --> 00:32:12,387 Oh, one second. Yeah? 779 00:32:12,388 --> 00:32:14,514 - She was legitimately dead? - Yeah, like, 100%. 780 00:32:14,515 --> 00:32:18,977 - Mr. Bradley? - Vince? 781 00:32:18,978 --> 00:32:21,688 No, my dad's gonna freak out. 782 00:32:21,689 --> 00:32:23,690 No, I know. I know. 783 00:32:23,691 --> 00:32:27,235 I just needed to sleep. I thought I was. 784 00:32:27,236 --> 00:32:29,237 Where did you get the fucking drugs? 785 00:32:29,238 --> 00:32:31,698 - Who are you? - Did you give them to my son? 786 00:32:31,699 --> 00:32:33,575 Did you give my son drugs? 787 00:32:33,576 --> 00:32:35,077 Mr. Bradley, you can't come in here. 788 00:32:35,078 --> 00:32:36,870 - Mr. Bradley, please. - Who is this? 789 00:32:36,871 --> 00:32:38,413 - Tell me the fucking truth. - Security! 790 00:32:38,414 --> 00:32:40,082 It's Nick's dad. 791 00:32:40,083 --> 00:32:41,959 - Did you drug my son? - Where the hell's security? 792 00:32:41,960 --> 00:32:43,627 Your son gave me the drugs, asshole. 793 00:32:43,628 --> 00:32:45,712 - Ask him. - He's dead. 794 00:32:45,713 --> 00:32:48,048 And you are a fucking liar! 795 00:32:48,049 --> 00:32:52,220 You killed my son! You killed my fucking son! 796 00:32:55,306 --> 00:32:58,433 [keycard pad beeps] 797 00:32:58,434 --> 00:33:00,394 [touchpad beeps] 798 00:33:00,395 --> 00:33:03,271 [drawer rattling] 799 00:33:03,272 --> 00:33:05,065 Hey, there's no scrubs in here. 800 00:33:05,066 --> 00:33:07,234 Yeah, you have to put your old ones in before 801 00:33:07,235 --> 00:33:09,194 it'll give you a new pair. 802 00:33:09,195 --> 00:33:12,407 What? 803 00:33:31,134 --> 00:33:33,761 Forgive me, Mr. Milton. 804 00:33:38,141 --> 00:33:40,642 Hey, you missed the best action of the day. 805 00:33:40,643 --> 00:33:42,519 I heard. What happened? 806 00:33:42,520 --> 00:33:44,187 Father of the brain-dead son 807 00:33:44,188 --> 00:33:46,314 goes after another patient he thinks gave his son 808 00:33:46,315 --> 00:33:48,191 - the drugs that killed him. - Jesus. 809 00:33:48,192 --> 00:33:51,945 - How do you deal with that? - No fucking idea. 810 00:33:51,946 --> 00:33:54,823 Whoa, what happened here? Did we have an accident? 811 00:33:54,824 --> 00:33:56,158 Do you think I'm wearing this by choice? 812 00:33:56,159 --> 00:33:57,951 Was it number one or number two? 813 00:33:57,952 --> 00:33:59,786 I just got some stuff spilled on me. 814 00:33:59,787 --> 00:34:01,455 Was it a bodily fluid, and was it yours? 815 00:34:01,456 --> 00:34:02,998 No and no. 816 00:34:02,999 --> 00:34:04,499 Oh, is it from when you killed that guy? 817 00:34:04,500 --> 00:34:05,917 I did not... 818 00:34:05,918 --> 00:34:07,919 that guy had a massive MI in his sleep. 819 00:34:07,920 --> 00:34:09,838 Relax, Huckleberry, I'm just fucking with you. 820 00:34:09,839 --> 00:34:12,174 Truth is, you're not a real doctor until 821 00:34:12,175 --> 00:34:14,342 you've lost at least one patient. 822 00:34:14,343 --> 00:34:16,762 You got off easy. It wasn't your fault. 823 00:34:16,763 --> 00:34:20,599 Not all of us can take comfort in saying that. 824 00:34:20,600 --> 00:34:23,935 But try not to kill anybody else. 825 00:34:23,936 --> 00:34:27,481 - What am I looking at? - Mr. Bill Philbin, 46. 826 00:34:27,482 --> 00:34:29,357 He tripped while walking his dog. 827 00:34:29,358 --> 00:34:32,194 He saw a squirrel. And it's my wife's dog. 828 00:34:32,195 --> 00:34:33,862 Damn thing doesn't even like me. 829 00:34:33,863 --> 00:34:35,864 Clearly. Where's the dog now? 830 00:34:35,865 --> 00:34:37,574 Hopefully in a kill shelter. 831 00:34:37,575 --> 00:34:40,703 [keycard pad beeps] 832 00:34:52,048 --> 00:34:53,215 Come on, baby. 833 00:34:53,216 --> 00:34:56,552 [machine whirs] 834 00:34:59,222 --> 00:35:01,641 [machine whirrs] 835 00:35:03,267 --> 00:35:06,646 [sighs] Oh, yes. 836 00:35:08,106 --> 00:35:10,190 I'm sorry. 837 00:35:10,191 --> 00:35:14,361 I just want to understand how this could happen to our son. 838 00:35:14,362 --> 00:35:19,241 I can't stop wondering, why Nick and not her? 839 00:35:19,242 --> 00:35:21,159 I can't help it. 840 00:35:21,160 --> 00:35:22,577 I think it would be helpful for you 841 00:35:22,578 --> 00:35:24,830 to speak with our department social worker. 842 00:35:24,831 --> 00:35:26,748 Would you two be open to that? 843 00:35:26,749 --> 00:35:30,293 - None of this is fair. - No. 844 00:35:30,294 --> 00:35:34,131 - No, it's not. - But he's still breathing. 845 00:35:34,132 --> 00:35:36,091 The ventilator is breathing for him. 846 00:35:36,092 --> 00:35:38,552 Brain death is the same as death. 847 00:35:38,553 --> 00:35:40,428 What about that last test that we're waiting for? 848 00:35:40,429 --> 00:35:43,306 I can almost guarantee it'll stay the same. 849 00:35:43,307 --> 00:35:45,059 I'm so sorry. 850 00:35:46,477 --> 00:35:49,438 I wish I could have done more to save your son. 851 00:35:51,691 --> 00:35:53,400 Our social worker, Kiara, is here to help you 852 00:35:53,401 --> 00:35:55,110 with anything you might need. She's amazing. 853 00:35:55,111 --> 00:35:57,196 I'm gonna go find her and have her come see you. 854 00:35:59,615 --> 00:36:01,116 Go back to the dorm, 855 00:36:01,117 --> 00:36:04,412 and within a couple of minutes... 856 00:36:08,166 --> 00:36:09,916 Get dad sorted out? 857 00:36:09,917 --> 00:36:11,793 I think so. 858 00:36:11,794 --> 00:36:13,461 He and his wife are dealing with a lot right now. 859 00:36:13,462 --> 00:36:16,464 No shit. That's a tough one. 860 00:36:16,465 --> 00:36:18,466 Yeah. Do you know where Kiara is? 861 00:36:18,467 --> 00:36:20,135 Not offhand, but I can page her. 862 00:36:20,136 --> 00:36:21,803 No, it's OK. I'll find her. 863 00:36:21,804 --> 00:36:23,722 I got to hit the restroom anyway. 864 00:36:23,723 --> 00:36:25,265 I'll tell her you're looking for her if she comes this way. 865 00:36:25,266 --> 00:36:26,641 - Thank you. - Yep. 866 00:36:26,642 --> 00:36:28,310 Now I got to pee. 867 00:36:28,311 --> 00:36:31,855 Kevin, take Myrna to pee. 868 00:36:31,856 --> 00:36:34,524 Ask Dana what's open, four of morphine, 869 00:36:34,525 --> 00:36:37,360 - and order an X-ray, OK? - Copy. 870 00:36:37,361 --> 00:36:39,654 Hey, closed injury, forklift versus foot. 871 00:36:39,655 --> 00:36:41,489 - Forklift won. - Got it. 872 00:36:41,490 --> 00:36:43,617 Hey, any news on our incel kid, David? 873 00:36:43,618 --> 00:36:45,327 Uh, I don't think we've heard from him yet, 874 00:36:45,328 --> 00:36:47,329 and I don't know that you should refer to him that way. 875 00:36:47,330 --> 00:36:50,332 Well, he did have a list of girls' names he wanted to hurt. 876 00:36:50,333 --> 00:36:53,168 They could be at risk. Are the cops looking for him? 877 00:36:53,169 --> 00:36:55,170 - Not sure we're there yet. - OK. 878 00:36:55,171 --> 00:36:56,838 I trust your judgment, 879 00:36:56,839 --> 00:36:58,340 and I'm the last person who wants to involve 880 00:36:58,341 --> 00:36:59,883 the police in anything, 881 00:36:59,884 --> 00:37:01,676 but you don't want to be wrong about this one. 882 00:37:01,677 --> 00:37:03,511 I know. I know. 883 00:37:03,512 --> 00:37:05,138 So what's the issue? 884 00:37:05,139 --> 00:37:08,099 Maybe I don't want to ruin this kid's life. 885 00:37:08,100 --> 00:37:09,517 Well, you don't want him ruining 886 00:37:09,518 --> 00:37:11,103 anyone else's life either. 887 00:37:14,732 --> 00:37:17,359 Look, I've personally been on the wrong side 888 00:37:17,360 --> 00:37:19,444 of someone who hates women. 889 00:37:19,445 --> 00:37:22,197 It's not a safe place to be. 890 00:37:22,198 --> 00:37:24,450 OK? 891 00:37:30,122 --> 00:37:32,749 - Any luck reaching David? - Not yet. 892 00:37:32,750 --> 00:37:34,084 Did you try calling the school? 893 00:37:34,085 --> 00:37:37,754 He didn't show up for class. 894 00:37:37,755 --> 00:37:39,839 Any idea where he might have gone? 895 00:37:39,840 --> 00:37:41,383 Friends, relatives. 896 00:37:41,384 --> 00:37:43,551 We don't have any family in state. 897 00:37:43,552 --> 00:37:48,474 And David, he doesn't associate with anyone. 898 00:37:51,894 --> 00:37:54,062 Theresa, do you think that David 899 00:37:54,063 --> 00:37:56,440 would try to hurt any of the girls that are on that list? 900 00:37:57,400 --> 00:37:59,025 No. 901 00:37:59,026 --> 00:38:02,070 Do you remember some of the names on that list? 902 00:38:02,071 --> 00:38:03,738 Not really. 903 00:38:03,739 --> 00:38:05,741 Maybe you could try. 904 00:38:13,082 --> 00:38:14,416 How's she doing? 905 00:38:14,417 --> 00:38:16,543 She's worried sick about her son. 906 00:38:16,544 --> 00:38:18,253 What are you going to do? 907 00:38:18,254 --> 00:38:20,755 I thought he would come back after mom called him. 908 00:38:20,756 --> 00:38:22,173 Hey, what are the ethics about me reaching out 909 00:38:22,174 --> 00:38:23,425 to him under the guise 910 00:38:23,426 --> 00:38:24,926 of a medical emergency with mom? 911 00:38:24,927 --> 00:38:26,761 If he's a danger to himself or others, 912 00:38:26,762 --> 00:38:29,264 I'd argue you have a professional responsibility 913 00:38:29,265 --> 00:38:32,267 to do whatever is necessary. 914 00:38:32,268 --> 00:38:34,436 Right. OK. 915 00:38:34,437 --> 00:38:36,479 Hey, can you come talk to the parents of the OD'd kid 916 00:38:36,480 --> 00:38:38,106 that we brought in earlier? 917 00:38:38,107 --> 00:38:40,317 18-year-old brain-dead from a fentanyl overdose. 918 00:38:40,318 --> 00:38:42,444 - Oh, jeez. - Yeah, only child. 919 00:38:42,445 --> 00:38:43,820 And I just think that the parents 920 00:38:43,821 --> 00:38:44,946 could use a little help processing 921 00:38:44,947 --> 00:38:46,573 what they're going through. 922 00:38:46,574 --> 00:38:48,283 What about donation? Is he a candidate? 923 00:38:48,284 --> 00:38:50,076 If the transplant counselor could get him there, 924 00:38:50,077 --> 00:38:51,619 but I think we're a ways away from calling them in. 925 00:38:51,620 --> 00:38:53,621 - I'll see what I can do. - Thank you. 926 00:38:53,622 --> 00:38:55,248 They're in Central 7. 927 00:38:55,249 --> 00:38:56,458 I would introduce you, but I really have to pee. 928 00:38:56,459 --> 00:38:58,960 - No worries. - Thank you. 929 00:38:58,961 --> 00:39:00,337 [loud banging] 930 00:39:00,338 --> 00:39:03,299 [metal clatters] 931 00:39:04,467 --> 00:39:06,051 What the hell? [laughs] 932 00:39:06,052 --> 00:39:07,552 I just saw one of those rats. 933 00:39:07,553 --> 00:39:09,304 And you thought you'd start an IV? 934 00:39:09,305 --> 00:39:10,972 It's not funny. 935 00:39:10,973 --> 00:39:12,891 You're not the one who's gonna have nightmares. 936 00:39:12,892 --> 00:39:15,643 I forgot about your phobia with rats. 937 00:39:15,644 --> 00:39:17,896 It is not a phobia. Nobody likes rats. 938 00:39:17,897 --> 00:39:19,647 Some people keep them as pets. 939 00:39:19,648 --> 00:39:23,318 If you are purposely keeping a rat in your house, 940 00:39:23,319 --> 00:39:25,153 that is not a pet. 941 00:39:25,154 --> 00:39:27,155 That is a sign of an underlying mental health problem. 942 00:39:27,156 --> 00:39:28,740 OK, if it makes you feel any better, 943 00:39:28,741 --> 00:39:30,283 just think of them as cute little Disney mice 944 00:39:30,284 --> 00:39:31,659 with a pituitary condition. 945 00:39:31,660 --> 00:39:33,495 Mm-hmm, joke all you want, 946 00:39:33,496 --> 00:39:36,998 but if one of those disgusting things bites a patient 947 00:39:36,999 --> 00:39:38,833 and we get a case of hantavirus, 948 00:39:38,834 --> 00:39:41,628 guess who's gonna have to answer for that one, Chief. 949 00:39:41,629 --> 00:39:43,505 Point taken. 950 00:39:43,506 --> 00:39:45,173 What was the name of that cop you were talking to earlier? 951 00:39:45,174 --> 00:39:47,008 What cop? 952 00:39:47,009 --> 00:39:48,718 The good-looking one that you were talking to earlier. 953 00:39:48,719 --> 00:39:50,845 - How would I know? - It seemed like you guys had... 954 00:39:50,846 --> 00:39:53,807 - Stay in your own lane. - What? 955 00:39:53,808 --> 00:39:55,517 I'm not even asking like that. 956 00:39:55,518 --> 00:39:58,019 I really did want to talk to him about something. 957 00:39:58,020 --> 00:40:00,688 - Uh-huh. - [both chuckle] 958 00:40:00,689 --> 00:40:02,857 Hey, did the exterminator come yet? 959 00:40:02,858 --> 00:40:04,984 Yeah. Right. Sometimes you can be so cute. 960 00:40:04,985 --> 00:40:06,903 Anything like that has to go through facilities. 961 00:40:06,904 --> 00:40:10,031 - They said they'd handle it. - What does that mean? 962 00:40:10,032 --> 00:40:12,117 It means nothing's gonna happen until next week 963 00:40:12,118 --> 00:40:14,369 at the earliest unless we get a patient in here 964 00:40:14,370 --> 00:40:16,704 with a service cat. 965 00:40:16,705 --> 00:40:18,832 Oh, don't forget, you still have the sister 966 00:40:18,833 --> 00:40:20,542 of Abbot's deceased veteran waiting for you. 967 00:40:20,543 --> 00:40:21,793 Oh, shit, yes, yes, yes. I'll be there. 968 00:40:21,794 --> 00:40:23,879 - I'll be there. - Yeah, go. 969 00:40:25,714 --> 00:40:27,549 Hey, I've been looking all over for you. 970 00:40:27,550 --> 00:40:29,843 We need a cardiovert unstable AFib in North 1. 971 00:40:29,844 --> 00:40:32,303 - OK, just give me a sec. - Systolic's 90. 972 00:40:32,304 --> 00:40:34,098 Fuck me. 973 00:40:35,766 --> 00:40:38,393 35-year-old architect working on a deadline, 974 00:40:38,394 --> 00:40:41,396 vaping nicotine all night. Palpitations this morning. 975 00:40:41,397 --> 00:40:44,691 AFib at 147. Mr. Quinn, this is Dr. Robby. 976 00:40:44,692 --> 00:40:45,859 Hello, sir. How are you feeling? 977 00:40:45,860 --> 00:40:47,235 Like crap. 978 00:40:47,236 --> 00:40:48,778 When did your palpitations start? 979 00:40:48,779 --> 00:40:50,071 A little while ago. 980 00:40:50,072 --> 00:40:51,739 We interrogated his smartwatch. 981 00:40:51,740 --> 00:40:53,074 His heart rate has only been up for 92 minutes. 982 00:40:53,075 --> 00:40:54,742 You understand we need to shock 983 00:40:54,743 --> 00:40:56,411 - your heart back to normal? - Is it gonna hurt? 984 00:40:56,412 --> 00:40:59,247 - You'll be sedated. - So it's really gonna hurt. 985 00:40:59,248 --> 00:41:00,874 Mel, 75 of propofol, slow IV push. 986 00:41:00,875 --> 00:41:02,417 How much did you vape last night? 987 00:41:02,418 --> 00:41:04,794 - A couple of pods. - You vape every day? 988 00:41:04,795 --> 00:41:06,880 I do, but not that much. 989 00:41:06,881 --> 00:41:08,923 - You want to cut back? - I've tried. 990 00:41:08,924 --> 00:41:10,592 It's just really fucking hard. 991 00:41:10,593 --> 00:41:12,093 How much nicotine is in a pod? 992 00:41:12,094 --> 00:41:13,887 - Anybody know? - No idea. 993 00:41:13,888 --> 00:41:15,597 40 milligrams, same as a pack of cigarettes. 994 00:41:15,598 --> 00:41:17,265 Wow, two packs in one night. 995 00:41:17,266 --> 00:41:19,434 Mel, what's the safe window for cardioversion? 996 00:41:19,435 --> 00:41:21,895 - 12 hours. - What happens after that? 997 00:41:21,896 --> 00:41:23,938 Increased risk of embolic stroke 998 00:41:23,939 --> 00:41:25,523 from left atrial blood clot. 999 00:41:25,524 --> 00:41:27,901 Which he does not have. 1000 00:41:27,902 --> 00:41:30,111 Mr. Quinn. Mr. Quinn. 1001 00:41:30,112 --> 00:41:31,529 OK, he's out. 1002 00:41:31,530 --> 00:41:33,239 Sync cardioversion at 200 joules. 1003 00:41:33,240 --> 00:41:35,783 - Charged. - Clear. 1004 00:41:35,784 --> 00:41:39,370 [vitals monitor beeping] 1005 00:41:39,371 --> 00:41:41,456 - Bingo. - Sinus rhythm. 1006 00:41:41,457 --> 00:41:42,749 Cycle BP. 1007 00:41:42,750 --> 00:41:44,459 We'll monitor for a few hours. 1008 00:41:44,460 --> 00:41:46,127 Yeah, let's get addiction services on the case too. 1009 00:41:46,128 --> 00:41:47,629 He's gonna need a daily patch 1010 00:41:47,630 --> 00:41:49,422 and nicotine gum for breakthrough cravings. 1011 00:41:49,423 --> 00:41:50,965 This one's a bitch to kick. 1012 00:41:50,966 --> 00:41:52,759 Hey, the sister of Abbot... 1013 00:41:52,760 --> 00:41:55,470 Shit, yes. Shit, yes, yes. 1014 00:41:55,471 --> 00:41:58,390 Go get 'em, tiger. 1015 00:42:04,063 --> 00:42:06,523 Are you Mr. Orser's sister? 1016 00:42:06,524 --> 00:42:09,025 - Fiona. - Hi, Fiona. 1017 00:42:09,026 --> 00:42:10,318 I'm Dr. Robinavitch. 1018 00:42:10,319 --> 00:42:11,861 Everybody calls me Dr. Robby. 1019 00:42:11,862 --> 00:42:14,322 Have a seat, please, and I will tell you 1020 00:42:14,323 --> 00:42:15,991 everything that's happened. 1021 00:42:19,161 --> 00:42:21,246 Are you looking for something in particular? 1022 00:42:21,247 --> 00:42:24,415 Anything with a very low potential for mortality. 1023 00:42:24,416 --> 00:42:26,501 Mm-mm. You're not playing that game. 1024 00:42:26,502 --> 00:42:28,461 Only thing I'm playing is let's keep the patients alive. 1025 00:42:28,462 --> 00:42:32,840 Uh-huh, well, now we're playing face your fears. 1026 00:42:32,841 --> 00:42:34,592 That sounds like a terrible game. 1027 00:42:34,593 --> 00:42:36,177 What up there scares you the most? 1028 00:42:36,178 --> 00:42:40,014 - All of it. - Pick the worst. 1029 00:42:40,015 --> 00:42:41,349 South 20. 1030 00:42:41,350 --> 00:42:43,309 82-year-old woman, low back pain. 1031 00:42:43,310 --> 00:42:46,020 I mean, that's potential leaking AAA, 1032 00:42:46,021 --> 00:42:48,856 cauda equina syndrome, spinal epidural abscess. 1033 00:42:48,857 --> 00:42:50,400 That could go wrong in so many ways. 1034 00:42:50,401 --> 00:42:51,985 Not today, amigo. 1035 00:42:51,986 --> 00:42:53,194 We're gonna work this lady up like a race car. 1036 00:42:53,195 --> 00:42:54,529 What does that mean? 1037 00:42:54,530 --> 00:42:55,905 It means you're on the pit crew now. 1038 00:42:55,906 --> 00:42:58,033 Come on. 1039 00:42:59,827 --> 00:43:02,912 Are you ready to go inside? 1040 00:43:02,913 --> 00:43:05,582 No, not really. 1041 00:43:05,583 --> 00:43:07,250 I'll be with you. 1042 00:43:07,251 --> 00:43:10,004 You can decide when you want to leave. 1043 00:43:27,396 --> 00:43:31,733 [sobbing] You're so cold. 1044 00:43:31,734 --> 00:43:34,152 I'm sorry. 1045 00:43:34,153 --> 00:43:37,989 I'm sorry I wasn't here with you. 1046 00:43:37,990 --> 00:43:41,826 But I'm here now. 1047 00:43:41,827 --> 00:43:44,747 Wherever you are. 1048 00:43:47,082 --> 00:43:50,210 I don't know what the world is without you. 1049 00:43:52,713 --> 00:43:55,549 [sobbing] 1050 00:44:02,181 --> 00:44:03,765 I really can't look at this letter. 1051 00:44:03,766 --> 00:44:06,934 Would it be too much to ask you to read it to me? 1052 00:44:06,935 --> 00:44:08,144 Oh, I'm sorry. 1053 00:44:08,145 --> 00:44:09,437 That's an inappropriate request. 1054 00:44:09,438 --> 00:44:11,481 No, not at all, not at all. 1055 00:44:11,482 --> 00:44:13,400 I'd be honored by the request. 1056 00:44:24,620 --> 00:44:28,122 "To the family of Raymond Orser, 1057 00:44:28,123 --> 00:44:31,376 "my name is Dr. Jack Abbot. 1058 00:44:31,377 --> 00:44:36,798 "I am the emergency department physician who treated Raymond. 1059 00:44:36,799 --> 00:44:41,052 "I, like Ray, am also a veteran. 1060 00:44:41,053 --> 00:44:44,639 "And though I never met Raymond before today, 1061 00:44:44,640 --> 00:44:47,600 "I served with men like him. 1062 00:44:47,601 --> 00:44:50,019 "So I can only imagine what an outstanding person 1063 00:44:50,020 --> 00:44:52,147 he must have been." 1064 00:44:54,149 --> 00:44:56,651 [clears throat] 1065 00:44:56,652 --> 00:45:00,279 "I'm sorry I could not save Ray's life. 1066 00:45:00,280 --> 00:45:02,198 "We worked on him for several hours, 1067 00:45:02,199 --> 00:45:05,159 "but his injuries were too severe, 1068 00:45:05,160 --> 00:45:10,498 "even for someone as tough and battle-tested as Raymond. 1069 00:45:10,499 --> 00:45:15,294 "Please take some comfort in knowing he did not suffer. 1070 00:45:15,295 --> 00:45:17,338 "You have my heartfelt condolences. 1071 00:45:17,339 --> 00:45:20,884 Jack Abbot." 1072 00:45:23,846 --> 00:45:27,766 - Thank you. - You're very welcome. 1073 00:45:36,233 --> 00:45:39,278 Again, I'm very, very sorry for your loss. 1074 00:45:52,750 --> 00:45:54,542 Where do you think you're going, Myrna? 1075 00:45:54,543 --> 00:45:58,838 Oh, none of your business, fruitcake. 1076 00:45:58,839 --> 00:46:01,215 Actually, everything that happens in this department 1077 00:46:01,216 --> 00:46:03,217 is my business. And you know what? 1078 00:46:03,218 --> 00:46:04,594 I put up with a lot around here. 1079 00:46:04,595 --> 00:46:06,429 I take very good care of you, 1080 00:46:06,430 --> 00:46:08,389 so you can call me Dr. Robinavitch, 1081 00:46:08,390 --> 00:46:10,099 or you can call me Dr. Robby, 1082 00:46:10,100 --> 00:46:12,268 or you can use my first name of Michael, 1083 00:46:12,269 --> 00:46:14,562 but I do not appreciate you calling me fruitcake. 1084 00:46:14,563 --> 00:46:20,026 Oh, did I hurt your feelings, cocksucker? 1085 00:46:20,027 --> 00:46:22,153 That said, it has a certain whimsical quality 1086 00:46:22,154 --> 00:46:24,238 to it that I can probably learn to live with. 1087 00:46:24,239 --> 00:46:26,240 Whatever you say, fruitcake. 1088 00:46:26,241 --> 00:46:29,160 Excuse me, Doctor, my father is starting to struggle again. 1089 00:46:29,161 --> 00:46:31,288 OK. 1090 00:46:35,167 --> 00:46:36,667 Don't you know those things will kill you? 1091 00:46:36,668 --> 00:46:38,252 I'm not that lucky. 1092 00:46:38,253 --> 00:46:39,545 - [tires squealing] - Ow! 1093 00:46:39,546 --> 00:46:42,715 What the fuck? 1094 00:46:42,716 --> 00:46:44,635 Hey, they're stealing our rig! 1095 00:46:46,428 --> 00:46:47,887 Did you leave the keys in it? 1096 00:46:47,888 --> 00:46:49,931 Always, in case somebody needs to move it. 1097 00:46:49,932 --> 00:46:51,390 Yeah, you probably shouldn't have done that. 1098 00:46:51,391 --> 00:46:52,767 Why don't you come on inside, Ziggler? 1099 00:46:52,768 --> 00:46:54,268 - We'll look you over. - I'm fine. 1100 00:46:54,269 --> 00:46:56,103 Fuck that. 1101 00:46:56,104 --> 00:46:58,397 God, can you believe that shit? 1102 00:46:58,398 --> 00:47:00,484 It happens. 1103 00:47:03,403 --> 00:47:05,404 What can you do to make him more comfortable? 1104 00:47:05,405 --> 00:47:06,781 We can take the tube out. 1105 00:47:06,782 --> 00:47:09,116 But he needs that to breathe. 1106 00:47:09,117 --> 00:47:12,954 If we extubate, we would keep him on oxygen for comfort. 1107 00:47:12,955 --> 00:47:15,915 We would decrease his sedation. 1108 00:47:15,916 --> 00:47:18,292 He might regain consciousness. He could recognize you. 1109 00:47:18,293 --> 00:47:19,961 Maybe even speak. 1110 00:47:19,962 --> 00:47:21,796 Well, I don't want to do anything to jeopardize 1111 00:47:21,797 --> 00:47:25,633 - him getting better. - That's just the point, Helen. 1112 00:47:25,634 --> 00:47:27,260 He's never getting better. 1113 00:47:27,261 --> 00:47:29,470 - You don't know that. - I do know that, OK? 1114 00:47:29,471 --> 00:47:31,430 He knows that. 1115 00:47:31,431 --> 00:47:34,308 And Dad probably even knows it. 1116 00:47:34,309 --> 00:47:36,769 It's time to let him go. 1117 00:47:36,770 --> 00:47:38,646 I'm sorry if you've had your fill of Dad, 1118 00:47:38,647 --> 00:47:43,234 but I haven't, and I am not giving up on him. 1119 00:47:43,235 --> 00:47:45,445 Even if it's hurting him? 1120 00:47:48,073 --> 00:47:50,324 I'm sorry, but if there was anything I could do 1121 00:47:50,325 --> 00:47:52,326 to heal your father, I would do it. 1122 00:47:52,327 --> 00:47:54,495 But the most humane thing that I can do for him 1123 00:47:54,496 --> 00:47:58,457 is to allow him a painless, peaceful passing, 1124 00:47:58,458 --> 00:48:01,044 and that requires removing the breathing tube. 1125 00:48:03,046 --> 00:48:06,966 How long will it take once the tube's out? 1126 00:48:06,967 --> 00:48:08,843 From minutes to hours, 1127 00:48:08,844 --> 00:48:11,513 but we would ensure that he'd be in no physical discomfort. 1128 00:48:17,519 --> 00:48:19,354 OK. 1129 00:48:21,607 --> 00:48:24,525 [sobbing] 1130 00:48:24,526 --> 00:48:27,528 [somber music] 1131 00:48:27,529 --> 00:48:34,661 ♪ ♪ 1132 00:48:51,553 --> 00:48:54,472 [soft dramatic music] 1133 00:48:54,473 --> 00:49:01,437 ♪ ♪ 1134 00:49:01,438 --> 00:49:04,440 [upbeat music] 1135 00:49:04,441 --> 00:49:11,573 ♪ ♪