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Would you like to inspect the original subtitles? These are the user uploaded subtitles that are being translated: 1 00:00:11,030 --> 00:00:12,360 You sent labs? 2 00:00:12,360 --> 00:00:13,700 No indication. 3 00:00:13,700 --> 00:00:15,030 Normal vitals, normal neuro exam. 4 00:00:15,030 --> 00:00:16,660 Dude just dropped--no warning. 5 00:00:16,660 --> 00:00:19,120 - What's open? - Trauma 1. 6 00:00:19,120 --> 00:00:21,870 Grab Langdon or whoever else is avail. 7 00:00:24,370 --> 00:00:25,620 What have we got? 8 00:00:25,620 --> 00:00:27,210 Seizure in chairs. 9 00:00:27,210 --> 00:00:28,290 Thank you. 10 00:00:28,290 --> 00:00:29,630 How is it out there? 11 00:00:29,630 --> 00:00:32,010 Chaos. We're never gonna catch up. 12 00:00:33,550 --> 00:00:35,180 Lorazepam's on board. 13 00:00:35,180 --> 00:00:36,970 Okay, draw up another 4. 14 00:00:38,970 --> 00:00:40,430 Yeah, no history. 15 00:00:40,430 --> 00:00:42,520 Doesn't look like he's been here before. 16 00:00:42,520 --> 00:00:45,020 Satting low 90s on 5 liters. 17 00:00:45,020 --> 00:00:46,600 Another 4 milligrams. 18 00:00:46,600 --> 00:00:49,270 I can't get the top off. 19 00:00:49,270 --> 00:00:51,190 It's just the plastic, not the metal. 20 00:00:51,190 --> 00:00:52,650 No, I know. I know, I know. 21 00:00:52,650 --> 00:00:53,690 Here, give it to me. 22 00:00:53,690 --> 00:00:55,070 No, I got it. 23 00:00:55,070 --> 00:00:56,910 Okay. 24 00:00:56,910 --> 00:00:59,200 Ordering CBC, CMP, 25 00:00:59,200 --> 00:01:01,740 and a straight cath for a urine tox. 26 00:01:01,740 --> 00:01:05,160 All right. Pushing the second 4. 27 00:01:05,160 --> 00:01:07,040 If this doesn't work, we need to prep Keppra. 28 00:01:07,040 --> 00:01:09,000 No, we'll give more lorazepam. 29 00:01:09,000 --> 00:01:10,290 It's already ordered. 30 00:01:10,290 --> 00:01:11,880 He's already had 8 milligrams. 31 00:01:11,880 --> 00:01:13,380 - He'll stop breathing. - Then we'll intubate. 32 00:01:13,380 --> 00:01:15,090 Sometimes a patient needs a little more. 33 00:01:15,090 --> 00:01:17,220 - How long has he been seizing? - About four minutes ago. 34 00:01:17,220 --> 00:01:18,720 He started seizing in chairs. 35 00:01:18,720 --> 00:01:20,510 He's already had 8 of lorazepam. 36 00:01:20,510 --> 00:01:22,970 I want to move on to Keppra, but Dr. Langdon disagrees. 37 00:01:22,970 --> 00:01:25,020 I just want us to try another 2 milligrams before moving on. 38 00:01:25,020 --> 00:01:27,980 Dr. Langdon's patient, Dr. Langdon's call. 39 00:01:33,650 --> 00:01:35,940 Dennis Whitaker, meet Bob Chazen, 40 00:01:35,950 --> 00:01:38,490 a 53-year-old cyclist who injured his leg 41 00:01:38,490 --> 00:01:40,780 about ten days ago on a trip to Utah. 42 00:01:40,780 --> 00:01:43,580 I was in Moab, coming downhill fast, 43 00:01:43,580 --> 00:01:46,540 and jammed my pedal into my leg. 44 00:01:46,540 --> 00:01:47,660 Ouch. 45 00:01:47,670 --> 00:01:49,580 That's some gnarly road rash. 46 00:01:49,580 --> 00:01:51,420 White Rim Trail. 47 00:01:51,420 --> 00:01:53,960 I've been putting Neosporin on it a couple times a day, 48 00:01:53,960 --> 00:01:56,550 but now it hurts to walk. 49 00:01:56,550 --> 00:01:57,840 What do you see, Whitaker? 50 00:01:58,840 --> 00:02:00,840 Outside of the wound looks cellulitic. 51 00:02:00,850 --> 00:02:02,010 What's that? 52 00:02:02,010 --> 00:02:03,560 It's a bacterial infection. 53 00:02:03,560 --> 00:02:05,600 We'll need to get you on oral antibiotics. 54 00:02:05,600 --> 00:02:06,770 Figured. 55 00:02:06,770 --> 00:02:08,060 What about the center of the wound? 56 00:02:09,270 --> 00:02:11,980 It's a simple hematoma. 57 00:02:11,980 --> 00:02:14,110 Which you can now debride. 58 00:02:14,110 --> 00:02:15,690 Whitaker will take off the dead skin covering the blister 59 00:02:15,690 --> 00:02:16,990 to help it heal better. 60 00:02:16,990 --> 00:02:18,490 I'll be right back. 61 00:02:18,490 --> 00:02:20,280 Yeah, quick question. 62 00:02:20,280 --> 00:02:22,200 Get some Iris scissors, toothed forceps, sterile gauze. 63 00:02:22,200 --> 00:02:24,160 No, it's just... 64 00:02:26,950 --> 00:02:28,620 Blister guy? Really? 65 00:02:28,620 --> 00:02:30,370 Mr. Chazen was the next patient on deck. 66 00:02:30,370 --> 00:02:31,880 I know I screwed up earlier. 67 00:02:31,880 --> 00:02:33,000 You didn't screw up. 68 00:02:33,000 --> 00:02:34,500 The patient died. 69 00:02:34,500 --> 00:02:36,000 It happens. 70 00:02:36,010 --> 00:02:39,430 Just don't amputate Mr. Chazen's leg. 71 00:02:43,220 --> 00:02:45,430 Okay. Hey. 72 00:02:45,430 --> 00:02:46,930 Another 2 of lorazepam. 73 00:02:46,930 --> 00:02:49,310 - For a total of 10. - I'm well aware. 74 00:02:49,310 --> 00:02:50,690 He's still seizing. 75 00:02:51,980 --> 00:02:53,100 Call respiratory. 76 00:02:53,110 --> 00:02:54,360 I'm setting up an intubation tray. 77 00:02:54,360 --> 00:02:55,820 Which we won't need. 78 00:02:55,820 --> 00:02:59,110 Dr. Santos, what is the definition of status epilepticus? 79 00:02:59,110 --> 00:03:01,820 A seizure lasting more than five minutes or at least two seizures 80 00:03:01,820 --> 00:03:03,410 without full recovery in between. 81 00:03:03,410 --> 00:03:04,780 Excellent. 82 00:03:06,540 --> 00:03:07,950 Seizure activity has stopped. 83 00:03:07,950 --> 00:03:09,790 Also excellent. 84 00:03:09,790 --> 00:03:13,370 Spontaneous breathing, good tidal volume. 85 00:03:13,380 --> 00:03:15,210 Sats up to 98. 86 00:03:15,210 --> 00:03:16,880 Welcome back, Mr. Marino. 87 00:03:16,880 --> 00:03:19,710 Now we can do a Keppra load slowly and safely. 88 00:03:19,720 --> 00:03:21,340 Nice work, Dr. Langdon. 89 00:03:21,340 --> 00:03:23,590 I will be at Central if you need me. 90 00:03:23,590 --> 00:03:25,050 This must have been a bad vial. 91 00:03:25,050 --> 00:03:26,760 8 milligrams should have worked. 92 00:03:26,760 --> 00:03:28,310 According to your textbook of emergency medicine. 93 00:03:28,310 --> 00:03:29,600 But sometimes they need a little bit more. 94 00:03:29,600 --> 00:03:30,930 You'll learn that with time. 95 00:03:30,940 --> 00:03:32,140 Well, why couldn't I open the vial? 96 00:03:32,140 --> 00:03:33,940 Because you're an intern 97 00:03:33,940 --> 00:03:35,980 who also needs to learn to trust her senior resident, 98 00:03:35,980 --> 00:03:38,280 especially in front of an attending. 99 00:03:39,610 --> 00:03:41,650 Now check his labs, 100 00:03:41,650 --> 00:03:43,530 babysit him until he goes to CT, 101 00:03:43,530 --> 00:03:46,530 and get some blankets on these side rails 102 00:03:46,530 --> 00:03:48,290 as a seizure precaution. 103 00:03:56,380 --> 00:03:58,290 - Is this gonna hurt? - Oh, no. 104 00:03:58,300 --> 00:04:00,380 Skin's dead. You won't feel a thing. 105 00:04:00,380 --> 00:04:01,800 First time in Moab? 106 00:04:01,800 --> 00:04:03,130 No, no. 107 00:04:03,130 --> 00:04:06,180 I belong to a club, Gears and Beers. 108 00:04:06,180 --> 00:04:09,260 We started riding to Frick Park during the pandemic-- 109 00:04:09,270 --> 00:04:11,640 you know, just something to do to get out of the house. 110 00:04:11,640 --> 00:04:15,600 But we all stuck with it, and now we go on biking trips. 111 00:04:21,610 --> 00:04:23,030 Help! Do something, man! 112 00:04:24,410 --> 00:04:25,700 Dude! 113 00:04:25,700 --> 00:04:27,320 I need a little help here! 114 00:04:27,320 --> 00:04:28,370 Jesus! 115 00:04:30,910 --> 00:04:32,410 Hey. What's up? 116 00:04:32,410 --> 00:04:34,620 Arterial pumper under a blood blister. 117 00:04:34,620 --> 00:04:36,210 Let's see. 118 00:04:36,210 --> 00:04:38,130 - Jesus! - Oh, God. 119 00:04:38,130 --> 00:04:39,630 Noob. 120 00:04:39,630 --> 00:04:41,710 Hi, I'm Dr. King. We can fix this. 121 00:04:41,710 --> 00:04:43,880 - Did you cut an artery? - No, no. 122 00:04:43,880 --> 00:04:45,760 I punctured the top of the blood blister, 123 00:04:45,760 --> 00:04:47,340 but there was an artery hiding under there. 124 00:04:47,340 --> 00:04:48,850 Hiding? 125 00:04:48,850 --> 00:04:50,680 Like you didn't know it was there? 126 00:04:50,680 --> 00:04:53,060 Don't you have to know basic anatomy to become a doctor? 127 00:04:53,060 --> 00:04:54,350 He's a student doctor. 128 00:04:54,350 --> 00:04:56,060 What the fuck? 129 00:04:56,060 --> 00:04:57,350 Student? 130 00:04:57,350 --> 00:04:58,900 Oh, hell, no. No, no, no. 131 00:04:58,900 --> 00:05:00,190 Can you help me? 132 00:05:00,190 --> 00:05:02,150 - Can you fix it? - Oh, absolutely. 133 00:05:02,150 --> 00:05:06,950 First, we are going to put this BP cuff on to stop the bleeding. 134 00:05:06,950 --> 00:05:08,200 A little forward. 135 00:05:08,200 --> 00:05:09,580 There we go. 136 00:05:12,910 --> 00:05:15,120 All right, you can let go. 137 00:05:15,120 --> 00:05:17,250 Yeah? 138 00:05:17,250 --> 00:05:19,540 - Thank God. - Oh, thank God. 139 00:05:19,540 --> 00:05:22,750 All right, Whitaker, 10 ccs of 1% lidocaine with epi. 140 00:05:22,760 --> 00:05:24,170 Yep. 141 00:05:24,170 --> 00:05:28,010 The shot is gonna numb the area and also constrict any blood vessels 142 00:05:28,010 --> 00:05:30,050 so that we can put a little stitch in there. 143 00:05:32,720 --> 00:05:34,560 What happened in here? 144 00:05:34,560 --> 00:05:38,520 Hidden laceration of an arteriole under the vesicle. 145 00:05:38,520 --> 00:05:40,860 Bleeding stopped at 180 on the BP cuff, 146 00:05:40,860 --> 00:05:43,070 and we are now injecting lidocaine with epi. 147 00:05:43,070 --> 00:05:44,610 Thank you, Dr. King. 148 00:05:44,610 --> 00:05:46,900 Let's set up a suture tray with 3-0 nylon. 149 00:05:46,900 --> 00:05:48,650 Okay. A pinprick and some burning-- 150 00:05:48,660 --> 00:05:51,660 Doc, Doc, can you step in here, please? 151 00:05:51,660 --> 00:05:53,740 You got this, Whitaker. 152 00:05:56,330 --> 00:05:58,750 That ambulance chase is on live TV. 153 00:05:58,750 --> 00:06:00,580 - What channel? - Every channel. 154 00:06:00,580 --> 00:06:03,460 What do you think the over-under on clipped cars should be? 155 00:06:03,460 --> 00:06:04,670 15. 156 00:06:04,670 --> 00:06:06,260 Come on. 157 00:06:06,260 --> 00:06:08,220 Can I put it on the TVs in the waiting room? 158 00:06:08,220 --> 00:06:12,220 Fine by me. I just hope wherever it ends up, it's out of our catchment zone. 159 00:06:15,470 --> 00:06:17,140 Got a second? 160 00:06:17,140 --> 00:06:19,100 It's never a second, but shoot. 161 00:06:19,100 --> 00:06:21,600 I think there was an issue with a vial of lorazepam used 162 00:06:21,610 --> 00:06:23,400 on our last patient and it should be reported 163 00:06:23,400 --> 00:06:24,730 to the drug manufacturer. 164 00:06:24,730 --> 00:06:26,190 What kind of issue? 165 00:06:26,190 --> 00:06:30,450 The cap was really hard to take off, almost like it was super-sealed shut. 166 00:06:30,450 --> 00:06:32,030 I'm worried it could be a bigger issue. 167 00:06:32,030 --> 00:06:33,830 Like? 168 00:06:33,830 --> 00:06:37,790 Like maybe the temperature wasn't properly controlled during transportation 169 00:06:37,790 --> 00:06:40,160 and the seal on the vial melted shut, 170 00:06:40,170 --> 00:06:41,920 which could mean the medication is compromised. 171 00:06:41,920 --> 00:06:43,920 Any other vials affected? 172 00:06:45,340 --> 00:06:47,630 Just this one. 173 00:06:47,630 --> 00:06:49,130 Okay. 174 00:06:49,130 --> 00:06:50,800 Check the manufacturer's website, 175 00:06:50,800 --> 00:06:52,550 see if there's been a recall of the lot number. 176 00:06:52,550 --> 00:06:54,800 And what if this is the first irregular vial? 177 00:06:54,810 --> 00:06:57,890 Then hold on to the vial in case there are any other issues. 178 00:06:57,890 --> 00:06:59,770 Hey, look who's in the house! 179 00:06:59,770 --> 00:07:01,480 Hey. 180 00:07:01,480 --> 00:07:03,270 Jake the Snake! 181 00:07:03,270 --> 00:07:05,570 It's 11:00 a.m. Aren't you supposed to be in school? 182 00:07:05,570 --> 00:07:07,980 - Mom let me ditch for Pittfest. - How's your mama? 183 00:07:07,990 --> 00:07:10,400 Oh, she's restoring some house in Squirrel Hill, 184 00:07:10,400 --> 00:07:13,280 - so, you know, she's pretty busy. - That's cool. You looking for Robby? 185 00:07:13,280 --> 00:07:14,570 Yeah, he's got our festival passes. 186 00:07:14,580 --> 00:07:15,990 Oh, you going together? 187 00:07:15,990 --> 00:07:17,660 We were supposed to, but, you know, 188 00:07:17,660 --> 00:07:20,660 - I decided to go with a friend. - What's her name? 189 00:07:20,660 --> 00:07:22,250 - Leah. - Okay. Okay. 190 00:07:22,250 --> 00:07:23,920 - Okay, okay. - Don't hold out on us. 191 00:07:23,920 --> 00:07:28,090 We need details. Where'd you meet? How long have you been together? 192 00:07:28,090 --> 00:07:31,760 We met at junior lifeguards this summer, and we've been dating for two months. 193 00:07:31,760 --> 00:07:34,180 - Yeah, she's pretty great. - That's sweet. 194 00:07:34,180 --> 00:07:35,760 I'm happy for you, kiddo. 195 00:07:35,760 --> 00:07:38,430 I'm gonna go find Robby, let him know you're here. 196 00:07:38,430 --> 00:07:40,480 Hey. 197 00:07:40,480 --> 00:07:42,850 A little advice, man-to-man-- 198 00:07:42,850 --> 00:07:45,060 always compliment her outfit, 199 00:07:45,060 --> 00:07:48,610 hold her hand in front of your friends, 200 00:07:48,610 --> 00:07:51,110 and always wrap it before you tap it. 201 00:07:51,110 --> 00:07:53,530 Okay. 202 00:07:53,530 --> 00:07:55,740 Slowly letting down the cuff pressure 203 00:07:55,740 --> 00:07:58,530 until we can identify the exact spot. 204 00:07:58,540 --> 00:08:00,160 Oh, I see it. I see it. 205 00:08:00,160 --> 00:08:01,500 Right there. 206 00:08:01,500 --> 00:08:03,080 Okay. 207 00:08:03,080 --> 00:08:04,870 Now you can place a figure-of-eight suture. 208 00:08:04,880 --> 00:08:06,710 I've never done one of those before. 209 00:08:08,840 --> 00:08:10,250 Look, maybe you should just do it. 210 00:08:10,260 --> 00:08:11,880 You should definitely do it. 211 00:08:11,880 --> 00:08:13,340 Whitaker's got this. 212 00:08:13,340 --> 00:08:15,300 It's easy, just two stitches in one. 213 00:08:15,300 --> 00:08:17,640 Take a big bite, a simple interrupted suture 214 00:08:17,640 --> 00:08:18,890 anterior to the bleeder. 215 00:08:18,890 --> 00:08:20,350 Okay. 216 00:08:22,850 --> 00:08:24,230 Okay. 217 00:08:29,730 --> 00:08:33,070 Now instead of tying, throw another one posterior. 218 00:08:35,200 --> 00:08:36,490 Looks good. 219 00:08:36,490 --> 00:08:38,160 Now a normal tie for a figure-of-eight. 220 00:08:38,160 --> 00:08:40,490 What did I miss in here? 221 00:08:40,490 --> 00:08:42,250 I am so sorry. I just-- 222 00:08:42,250 --> 00:08:44,500 Made an excellent catch and saved Mr. Chazen's life. 223 00:08:44,500 --> 00:08:46,120 - Really? - Really? 224 00:08:46,120 --> 00:08:47,380 Really? 225 00:08:47,380 --> 00:08:50,460 There was a cut arteriole under a ballotable vesicle. 226 00:08:50,460 --> 00:08:52,420 If Mr. Chazen had gone home without debridement, 227 00:08:52,420 --> 00:08:55,260 the blister could have eroded with uncontrollable hemorrhage. 228 00:08:55,260 --> 00:08:57,220 Nice work. 229 00:08:57,220 --> 00:09:00,510 Jackson Pollock here might want to go hit the scrubs exchange. 230 00:09:00,510 --> 00:09:02,140 Yeah. 231 00:09:15,700 --> 00:09:17,110 All right. 232 00:09:17,110 --> 00:09:19,820 Next up is an ingrown toenail. 233 00:09:19,830 --> 00:09:21,580 It should be pretty quick, though. 234 00:09:21,580 --> 00:09:22,700 And... 235 00:09:24,370 --> 00:09:26,210 Sherry, you're back. 236 00:09:26,210 --> 00:09:27,750 The kids get to school okay? 237 00:09:27,750 --> 00:09:29,460 - Yeah. Thanks. - Hey, cool. 238 00:09:29,460 --> 00:09:31,000 Well, come with me, 239 00:09:31,000 --> 00:09:32,670 and we'll finish up your wound care, okay? 240 00:09:32,670 --> 00:09:34,710 Earl, what are you doing out here? 241 00:09:34,720 --> 00:09:36,420 I'm hungry. 242 00:09:36,430 --> 00:09:37,800 Head back inside, and we'll get you a sandwich. 243 00:09:37,800 --> 00:09:40,260 - No egg salad. - Sure. Come on. 244 00:09:40,260 --> 00:09:41,800 Excuse me. Excuse me. 245 00:09:41,810 --> 00:09:44,930 I've been here for over five hours, okay, way longer than that chick. 246 00:09:44,930 --> 00:09:46,730 Can you check the list? Driscoll? 247 00:09:46,730 --> 00:09:48,480 Doug Driscoll. 248 00:09:50,270 --> 00:09:54,360 Everybody is seen as quickly as possible and in order of medical care needed. 249 00:09:54,360 --> 00:09:55,780 Unless they die waiting. 250 00:09:55,780 --> 00:09:57,190 Would you look at that, Mr. Driscoll? 251 00:09:57,200 --> 00:09:58,400 It's actually time to bring you back. 252 00:09:58,410 --> 00:09:59,780 Thank God. 253 00:09:59,780 --> 00:10:01,120 Would you take care of Mr. Driscoll? 254 00:10:01,120 --> 00:10:02,910 Yeah, absolutely. 255 00:10:02,910 --> 00:10:04,540 Sherry, you're with me. 256 00:10:05,540 --> 00:10:07,080 Oh, yeah. 257 00:10:07,080 --> 00:10:08,960 Yeah, let's take care of this. 258 00:10:15,340 --> 00:10:17,090 Hey, I need a minute. 259 00:10:17,090 --> 00:10:20,180 I already put $20 on disgruntled ex-EMT 260 00:10:20,180 --> 00:10:22,090 caught outside of our catchment. 261 00:10:22,100 --> 00:10:24,560 And I will gladly take your money when that mess is over, 262 00:10:24,560 --> 00:10:26,390 but this is about a patient. 263 00:10:26,390 --> 00:10:28,730 Kristi Wheeler, 17 years old, pregnant. 264 00:10:28,730 --> 00:10:31,150 These are Abbot's fetal measurements from yesterday, 265 00:10:31,150 --> 00:10:33,770 and these are mine. 266 00:10:33,770 --> 00:10:35,780 10-5 and 11-2. 267 00:10:35,780 --> 00:10:38,360 Well, ultrasound is an art, not a science. 268 00:10:38,360 --> 00:10:40,860 Even in the very best hands, the EGA differential can be 269 00:10:40,860 --> 00:10:42,820 within three to five days in the first trimester. 270 00:10:42,820 --> 00:10:44,370 Definitely room for error. 271 00:10:44,370 --> 00:10:45,950 Not if you're here for a medication abortion 272 00:10:45,950 --> 00:10:49,080 and you're past the mandated 11-week cutoff. 273 00:10:49,080 --> 00:10:51,870 There can also be inter-operator variability. 274 00:10:51,880 --> 00:10:54,040 I measured the gestational sac, 11-3, 275 00:10:54,040 --> 00:10:56,500 and the biparietal diameter, 11-1. 276 00:10:56,510 --> 00:10:58,710 I didn't get a single measurement under 11 weeks. 277 00:10:58,720 --> 00:11:00,420 So what are you saying, 278 00:11:00,430 --> 00:11:02,390 that Abbot lowballed his measurements to help a teen 279 00:11:02,390 --> 00:11:04,390 get the abortion that she wants? 280 00:11:06,180 --> 00:11:07,390 Maybe. 281 00:11:07,390 --> 00:11:08,850 Well, then you've got two choices. 282 00:11:08,850 --> 00:11:12,100 You can go with Abbot's measurements, or you can redo your measurements, 283 00:11:12,100 --> 00:11:14,650 go back in, and pick an angle that shows 11 weeks or less. 284 00:11:14,650 --> 00:11:16,070 Please tell me you're joking. 285 00:11:16,070 --> 00:11:17,860 You were ready to roll up your sleeves 286 00:11:17,860 --> 00:11:19,360 and arm-wrestle the Ethics Committee a couple hours ago 287 00:11:19,360 --> 00:11:20,990 to override Mr. Spencer's children. 288 00:11:20,990 --> 00:11:23,570 - What changed? - Apples and oranges. 289 00:11:23,570 --> 00:11:25,570 There was a clear, bright line that Mr. Spencer 290 00:11:25,580 --> 00:11:27,450 was never going to make it. 291 00:11:27,450 --> 00:11:30,370 Falsifying medical records for Kristi is flat-out illegal. 292 00:11:30,370 --> 00:11:32,620 She's 17. She deserves a life. 293 00:11:32,620 --> 00:11:34,290 Of course she does. 294 00:11:34,290 --> 00:11:37,130 But I will not jeopardize my future in the process. 295 00:11:37,130 --> 00:11:39,000 You'll be fine. 296 00:11:39,010 --> 00:11:42,430 Someone finds out I falsified medical records, 297 00:11:42,430 --> 00:11:44,340 I'll get booted from the residency program. 298 00:11:44,340 --> 00:11:46,010 You've got tenure. 299 00:11:46,010 --> 00:11:49,890 Worst case, you have to take a job in Youngstown. 300 00:11:49,890 --> 00:11:53,690 The risks are not the same for you as they are for me. 301 00:11:56,770 --> 00:11:58,190 You're right. 302 00:11:58,190 --> 00:12:00,570 - I'll do it. - What? 303 00:12:00,570 --> 00:12:03,200 Erase your history, physical, and impression from Kristi's chart. 304 00:12:03,200 --> 00:12:04,410 It'll be like you never saw the patient. 305 00:12:04,410 --> 00:12:06,070 I will take over. 306 00:12:06,070 --> 00:12:07,660 I will complete a new chart and upload my own image. 307 00:12:07,660 --> 00:12:09,200 Robby, I'm not asking you to-- 308 00:12:09,200 --> 00:12:10,620 As your attending, it is my decision. 309 00:12:10,620 --> 00:12:12,200 I am a certified provider for Mifepristone. 310 00:12:12,210 --> 00:12:13,710 You are not. 311 00:12:13,710 --> 00:12:15,420 And as a prudent physician, I should examine 312 00:12:15,420 --> 00:12:16,630 every patient before I order medication-- 313 00:12:16,630 --> 00:12:18,130 - Robby. - Yeah. 314 00:12:18,130 --> 00:12:20,380 - Jake's here. - Hey. Great. 315 00:12:20,380 --> 00:12:22,010 Any word back on Nick Bradley's 316 00:12:22,010 --> 00:12:23,630 - perfusion study results? - Still waiting. 317 00:12:23,630 --> 00:12:25,180 Will you come find me when the imaging's back? 318 00:12:25,180 --> 00:12:27,970 These people have already been through enough. 319 00:12:27,970 --> 00:12:30,850 - Is that Mr. Spencer? - Yeah. 320 00:12:30,850 --> 00:12:33,350 - Robby? - Excuse me for one second. 321 00:12:33,350 --> 00:12:34,940 I want to go see if I can find Mr. Spencer's children 322 00:12:34,940 --> 00:12:36,310 before they leave. 323 00:12:36,310 --> 00:12:38,230 You look a little peaked. You okay? 324 00:12:38,230 --> 00:12:40,190 I just need a good night's sleep. 325 00:12:40,190 --> 00:12:41,900 I'm gonna grab you a grilled cheese 326 00:12:41,900 --> 00:12:43,240 before the noon lunch rush; it'll help some color 327 00:12:43,240 --> 00:12:44,990 - back to your cheeks. - Thank you. 328 00:12:44,990 --> 00:12:46,320 I got you. 329 00:12:48,700 --> 00:12:50,450 Can someone please help? 330 00:12:50,450 --> 00:12:51,700 It's my mother. 331 00:12:51,700 --> 00:12:52,910 She fell. 332 00:12:52,910 --> 00:12:54,370 What happened? 333 00:12:54,370 --> 00:12:55,750 I fell in the yard. 334 00:12:55,750 --> 00:12:58,420 I hurt my arm. That's all. 335 00:12:58,420 --> 00:13:00,210 We've been hugging this wall for almost an hour. 336 00:13:00,210 --> 00:13:01,880 Relax. We're just gonna take her vitals. 337 00:13:01,880 --> 00:13:03,460 Oh, Mom, you've got cuts all over. 338 00:13:03,470 --> 00:13:05,510 I fell in the rose bush. 339 00:13:05,510 --> 00:13:07,550 I'll be fine. 340 00:13:10,720 --> 00:13:13,020 I'm Dr. King. This is Perlah. 341 00:13:13,020 --> 00:13:15,140 - What's your name? - Ginger Kitajima. 342 00:13:15,730 --> 00:13:17,230 I'm her daughter, Rita. 343 00:13:17,230 --> 00:13:18,810 Ginger, did you hit your head? 344 00:13:18,810 --> 00:13:20,150 No. 345 00:13:20,150 --> 00:13:21,820 Any chance she could have fainted? 346 00:13:21,820 --> 00:13:24,320 - I told you. I tripped. - I don't know. 347 00:13:24,320 --> 00:13:26,280 I was taking a shower, and she went outside. 348 00:13:26,280 --> 00:13:29,240 She's not supposed to go outside anywhere without me. 349 00:13:29,240 --> 00:13:31,370 She needs 24-7 assistance with ADLs. 350 00:13:31,370 --> 00:13:32,740 Are you the primary caregiver? 351 00:13:32,740 --> 00:13:34,950 I'm her only caregiver. 352 00:13:34,960 --> 00:13:37,750 Ma'am, what medications are you on? 353 00:13:37,750 --> 00:13:40,420 Oh, just one. 354 00:13:40,420 --> 00:13:42,130 Risperidone. 355 00:13:42,130 --> 00:13:43,880 My mom has schizophrenia. 356 00:13:43,880 --> 00:13:46,260 BP 132 over 78. 357 00:13:46,260 --> 00:13:47,840 Pulse 84. Sats 98. 358 00:13:47,840 --> 00:13:49,470 I haven't seen this young lady around before. 359 00:13:49,470 --> 00:13:50,890 Somebody new? 360 00:13:50,890 --> 00:13:52,760 Flattery will get you everywhere. 361 00:13:52,760 --> 00:13:55,060 Ground-level fall. Good vitals. 362 00:13:55,060 --> 00:13:56,520 No head trauma, no AMS, 363 00:13:56,520 --> 00:13:58,230 and just an isolated shoulder injury. 364 00:13:58,230 --> 00:13:59,770 You have any pain in your belly? 365 00:13:59,770 --> 00:14:01,310 No, but next time, 366 00:14:01,310 --> 00:14:03,150 buy me dinner before you do that. 367 00:14:04,610 --> 00:14:06,900 Okay, let's order some basic labs 368 00:14:06,900 --> 00:14:09,110 and get some pain meds on board. 369 00:14:09,110 --> 00:14:10,490 And call me when the X-rays are back. 370 00:14:10,490 --> 00:14:11,990 Your mom's in very good hands. 371 00:14:11,990 --> 00:14:13,280 You're leaving so soon? 372 00:14:13,290 --> 00:14:15,040 Oh, I'm never far away. 373 00:14:15,040 --> 00:14:16,620 I'll save a dance for you. 374 00:14:16,620 --> 00:14:18,660 I'll be counting on it. 375 00:14:18,670 --> 00:14:20,830 Looks like more than just vitals to me. 376 00:14:20,830 --> 00:14:22,750 That's it. You're on the list, Harley. 377 00:14:22,750 --> 00:14:24,590 Aw, shit. No. 378 00:14:24,590 --> 00:14:26,170 Perlah, I'm sorry! 379 00:14:26,170 --> 00:14:27,460 - I take it back! - Too late! 380 00:14:27,470 --> 00:14:29,010 You're on the list. 381 00:14:44,480 --> 00:14:45,820 Okay. 382 00:14:50,570 --> 00:14:51,620 What? 383 00:14:57,750 --> 00:15:01,000 I like big butts, and I cannot lie. 384 00:15:02,330 --> 00:15:03,710 You scared me there. 385 00:15:03,710 --> 00:15:05,500 Want a pony ride, big boy? 386 00:15:05,500 --> 00:15:07,380 - What? - Excuse me, Myrna. 387 00:15:07,380 --> 00:15:08,920 I need to discuss a confidential patient issue 388 00:15:08,920 --> 00:15:10,130 with my colleague here. 389 00:15:10,130 --> 00:15:11,470 We need a little privacy. 390 00:15:11,470 --> 00:15:13,050 Catch you later, sweet cheeks. 391 00:15:13,050 --> 00:15:14,800 Don't mind Myrna. She's harmless. 392 00:15:14,800 --> 00:15:16,010 She's handcuffed. 393 00:15:16,010 --> 00:15:17,850 That's why she's harmless. 394 00:15:21,690 --> 00:15:24,650 You gotta stay on top of Ozzie's ear infection. 395 00:15:24,650 --> 00:15:26,480 His meds are in the fridge. 396 00:15:26,480 --> 00:15:28,650 Our dog has really bad allergies. 397 00:15:29,650 --> 00:15:32,070 And I changed Ruby's food order to Monday. 398 00:15:33,070 --> 00:15:35,620 Bougie bitch. She only likes the good stuff. 399 00:15:35,620 --> 00:15:37,240 Like mother, like daughter. 400 00:15:42,420 --> 00:15:44,420 Nice to know you still make each other laugh. 401 00:15:44,420 --> 00:15:45,920 Make each other laugh. 402 00:15:45,920 --> 00:15:48,000 Make each other deliriously happy. 403 00:15:53,470 --> 00:15:56,430 Sorry. Didn't mean to get all mushy in front of you. 404 00:15:56,430 --> 00:15:57,640 Are you kidding me? 405 00:15:57,640 --> 00:15:59,600 You two are the sweetest. 406 00:15:59,600 --> 00:16:02,480 I never got to see this kind of love between a married couple. 407 00:16:02,480 --> 00:16:05,230 Your parents weren't the lovey-dovey type? 408 00:16:05,230 --> 00:16:07,230 My dad died when I was 13. 409 00:16:08,400 --> 00:16:09,610 I'm so sorry. 410 00:16:09,610 --> 00:16:11,110 Yeah, me too. 411 00:16:11,110 --> 00:16:13,490 He's the reason why I got into medicine 412 00:16:13,490 --> 00:16:15,700 and the reason why I'm conducting research 413 00:16:15,700 --> 00:16:17,570 on racial disparity in the ER. 414 00:16:17,580 --> 00:16:19,160 I'm doing a retrospective chart review 415 00:16:19,160 --> 00:16:21,500 on our past five years of patients of color. 416 00:16:21,500 --> 00:16:24,250 Is that how you knew what was going on with me? 417 00:16:24,250 --> 00:16:27,580 We don't treat sickle cell here as well as they do in other hospitals, 418 00:16:27,590 --> 00:16:29,340 but I'm hoping to change that. 419 00:16:29,340 --> 00:16:31,260 Status, Dr. Mohan? 420 00:16:31,260 --> 00:16:33,670 Still on exchange transfusion and high flow nasal oxygen, 421 00:16:33,680 --> 00:16:35,010 but oxygen sats are dropping. 422 00:16:35,010 --> 00:16:36,430 She's at 84. 423 00:16:36,430 --> 00:16:38,640 - That's really low. - Yes, it is. 424 00:16:38,640 --> 00:16:40,850 The goal of exchange transfusion is 425 00:16:40,850 --> 00:16:44,020 to reduce the percentage of sickle hemoglobin to under 30%. 426 00:16:44,020 --> 00:16:46,230 That is not happening at the rate that your wife needs, 427 00:16:46,230 --> 00:16:48,560 which is causing your blood to be unable to carry oxygen, 428 00:16:48,570 --> 00:16:49,980 causing further blocked blood cells. 429 00:16:49,980 --> 00:16:52,900 - What does that mean? - Dr. Mohan. 430 00:16:52,900 --> 00:16:55,200 To prevent stroke or heart attack, 431 00:16:55,200 --> 00:17:00,200 we need to get you more oxygen, but we will need to intubate. 432 00:17:02,910 --> 00:17:05,370 How long can we wait to see if that's really necessary? 433 00:17:05,370 --> 00:17:07,830 Acute chest syndrome can progress very quickly. 434 00:17:07,830 --> 00:17:09,500 It is the most common cause of death 435 00:17:09,500 --> 00:17:10,880 for patients with sickle cell. 436 00:17:10,880 --> 00:17:14,010 It is imperative that we intubate. 437 00:17:14,010 --> 00:17:15,180 I... 438 00:17:16,970 --> 00:17:18,550 I don't know. 439 00:17:18,550 --> 00:17:22,680 Why don't we give you and Ondine some privacy so you can talk? 440 00:17:27,690 --> 00:17:29,190 Look, you want to be their friend, but right now, 441 00:17:29,190 --> 00:17:30,520 you need to be Joyce's doctor. 442 00:17:30,520 --> 00:17:33,400 So get her to sign the consent form and prep for the intubation. 443 00:17:36,650 --> 00:17:39,700 43, 44, 45, 444 00:17:39,700 --> 00:17:42,700 46, 47. 445 00:17:42,700 --> 00:17:44,580 You're not gonna beat my record. 446 00:17:45,790 --> 00:17:47,660 How the hell did you stay on for 80? 447 00:17:47,670 --> 00:17:50,290 I'm 17, and I'm more fit than you. 448 00:17:53,050 --> 00:17:54,710 That kid looks my age. 449 00:17:54,710 --> 00:17:56,300 Yeah, he is. 450 00:17:56,300 --> 00:17:58,470 What happened to him? 451 00:17:58,470 --> 00:18:00,800 Stressed-out 18-year-old took some pills off the internet 452 00:18:00,800 --> 00:18:02,390 to help him sleep. 453 00:18:02,390 --> 00:18:04,850 They were laced with fentanyl. 454 00:18:04,850 --> 00:18:07,230 Is he gonna make it? 455 00:18:17,400 --> 00:18:18,900 Poor Huckleberry. 456 00:18:18,910 --> 00:18:22,120 Not even 11:30 and you've already been demoted. 457 00:18:22,120 --> 00:18:24,410 They had only morgue scrubs left in my size. 458 00:18:24,410 --> 00:18:25,740 Then I guess you better not 459 00:18:25,750 --> 00:18:27,540 fuck anything else up today, huh? 460 00:18:33,630 --> 00:18:34,750 Donahue. 461 00:18:34,750 --> 00:18:36,710 You get in on that ambulance-chase action? 462 00:18:36,710 --> 00:18:40,010 Yeah, $20 on catch, chop shop, out of our zone. 463 00:18:40,010 --> 00:18:41,550 Bold. 464 00:18:41,550 --> 00:18:43,470 I like it. 465 00:18:43,470 --> 00:18:46,180 What can I do you for? 466 00:18:46,180 --> 00:18:48,100 Hypothetical question-- 467 00:18:48,100 --> 00:18:52,560 would you ever go over a resident's head to the attending? 468 00:18:52,560 --> 00:18:54,980 Hypothetically, I wouldn't recommend it 469 00:18:54,980 --> 00:18:57,440 unless it's a behavioral issue or harassment. 470 00:18:57,440 --> 00:19:00,450 And in that case, you can make a confidential report to HR. 471 00:19:00,450 --> 00:19:02,530 What if it's more patient care related? 472 00:19:02,530 --> 00:19:03,950 Depends. 473 00:19:03,950 --> 00:19:05,530 If it's something minor, leave it alone. 474 00:19:05,540 --> 00:19:07,700 If it's something that endangers the patient, 475 00:19:07,700 --> 00:19:09,540 then definitely yes. 476 00:19:09,540 --> 00:19:11,170 Pick your battles. 477 00:19:11,170 --> 00:19:13,380 You don't want to be the intern who cried wolf. 478 00:19:16,380 --> 00:19:19,210 - Yeah? Okay, still pretty raw. - Yeah. 479 00:19:19,220 --> 00:19:22,590 Let me put some more anesthetic on there, numb you up some more. 480 00:19:22,590 --> 00:19:24,850 It's my own fault. 481 00:19:24,850 --> 00:19:28,810 I should have known better than to try to make s'mores over a Sterno, 482 00:19:28,810 --> 00:19:30,770 but they kept asking. 483 00:19:30,770 --> 00:19:32,940 Yeah. The things we do for our kids. 484 00:19:32,940 --> 00:19:34,230 Yeah. 485 00:19:34,230 --> 00:19:36,110 - You have a kid, right? - Yeah. 486 00:19:36,110 --> 00:19:39,230 He's 11. 487 00:19:39,240 --> 00:19:41,240 And when he turned 8, 488 00:19:41,240 --> 00:19:43,200 he begged me to go camping for his birthday. 489 00:19:44,820 --> 00:19:47,780 We drove four hours to New River Gorge. 490 00:19:47,790 --> 00:19:51,080 Took me an hour to set up the tent. 491 00:19:51,080 --> 00:19:53,670 Guess how long we lasted. 492 00:19:53,670 --> 00:19:55,500 Three hours? 493 00:19:55,500 --> 00:19:57,500 37 minutes. 494 00:19:57,500 --> 00:19:58,960 A thunderstorm came out of nowhere, 495 00:19:58,960 --> 00:20:00,590 filled the tent with water so fast, 496 00:20:00,590 --> 00:20:03,260 I felt like I was being flushed down a toilet. 497 00:20:03,260 --> 00:20:05,550 I'm so sorry. 498 00:20:05,550 --> 00:20:08,600 Ran out of there like a couple of gutter rats. 499 00:20:08,600 --> 00:20:11,850 Ended up celebrating his birthday at 2:00 a.m. with a Happy Meal. 500 00:20:11,850 --> 00:20:14,440 Oh, what my kids wouldn't give for a Happy Meal. 501 00:20:17,110 --> 00:20:21,610 Yeah, they must have some pretty fancy McDonald's 502 00:20:21,610 --> 00:20:24,200 up there in Shadyside. 503 00:20:24,200 --> 00:20:25,370 Yeah. 504 00:20:26,160 --> 00:20:27,990 That's where you live? 505 00:20:27,990 --> 00:20:30,160 It's the address on your patient file. 506 00:20:31,540 --> 00:20:34,040 Technically, no. 507 00:20:34,040 --> 00:20:38,500 I just use the address so my kids can go to a decent school. 508 00:20:38,500 --> 00:20:40,050 Right. 509 00:20:40,050 --> 00:20:41,760 I know it's illegal, but it's just temporary. 510 00:20:41,760 --> 00:20:42,920 - Oh, God. - I promise. 511 00:20:42,920 --> 00:20:44,760 No judgment here. 512 00:20:44,760 --> 00:20:46,550 My son always comes first, no matter what. 513 00:20:46,550 --> 00:20:48,050 Yeah. 514 00:20:48,050 --> 00:20:50,010 Even If it means I have to do without. 515 00:20:54,440 --> 00:20:56,190 I know, I'm a doctor, right? 516 00:20:56,190 --> 00:20:58,730 How bad could it be? 517 00:20:58,730 --> 00:21:01,900 But I used to be an addict. 518 00:21:01,900 --> 00:21:03,950 I even lost custody of my kid. 519 00:21:06,200 --> 00:21:08,120 I never would have guessed. 520 00:21:08,120 --> 00:21:09,830 Yeah. 521 00:21:09,830 --> 00:21:13,830 I went through some really dark times before I finally got help. 522 00:21:13,830 --> 00:21:16,000 And I've been sober now 9 years, 523 00:21:16,000 --> 00:21:18,630 5 months, and 11 days. 524 00:21:19,920 --> 00:21:21,500 And your son? 525 00:21:21,500 --> 00:21:22,840 He's good. 526 00:21:22,840 --> 00:21:25,800 - Okay. - You know, we're good. 527 00:21:25,800 --> 00:21:27,930 He gets to stay with me every other weekend. 528 00:21:27,930 --> 00:21:29,850 And... 529 00:21:32,100 --> 00:21:34,560 We'll be back to joint custody 530 00:21:34,560 --> 00:21:38,400 just as soon as I get this stupid thing off next week. 531 00:21:44,530 --> 00:21:47,070 Don't worry. I only killed three people. 532 00:21:47,070 --> 00:21:49,160 Oh, God, I'm kidding. 533 00:21:49,160 --> 00:21:51,830 I'm kidding. I'm sorry. It was a bad joke. 534 00:21:54,330 --> 00:21:57,910 The whole thing was just this... 535 00:21:57,920 --> 00:22:00,040 giant misunderstanding. 536 00:22:03,760 --> 00:22:07,420 I guess I'm oversharing because I want you to know, 537 00:22:07,430 --> 00:22:10,470 not everybody has it all figured out all the time. 538 00:22:11,470 --> 00:22:12,560 Yeah. 539 00:22:20,270 --> 00:22:22,190 I'm struggling. 540 00:22:23,780 --> 00:22:26,190 And I feel like such a bad mom. 541 00:22:29,490 --> 00:22:32,280 And every day is so hard. 542 00:22:33,830 --> 00:22:37,660 And I don't know what's gonna happen tomorrow or the next day. 543 00:22:41,080 --> 00:22:45,250 Sometimes I wonder if they would just be better off without me. 544 00:22:48,800 --> 00:22:50,430 Yeah? 545 00:22:50,430 --> 00:22:52,050 Do you... 546 00:22:52,050 --> 00:22:53,890 Not like that. I just... 547 00:22:55,140 --> 00:22:56,850 I've just messed up so much. 548 00:22:56,850 --> 00:22:59,230 - Yeah. - And I don't know. 549 00:23:05,190 --> 00:23:07,610 You're their mom. 550 00:23:07,610 --> 00:23:10,740 You love them, and nothing and no one can replace that. 551 00:23:10,740 --> 00:23:12,120 Yeah. 552 00:23:15,120 --> 00:23:18,950 You deserve a little grace, you know. 553 00:23:18,960 --> 00:23:21,370 Be kind to yourself. 554 00:23:24,670 --> 00:23:27,250 Well, you had a normal EKG and chest X-ray. 555 00:23:27,260 --> 00:23:30,420 But it looks like you sustained 556 00:23:30,430 --> 00:23:34,590 a proximal humerus fracture on the left upper arm. 557 00:23:34,600 --> 00:23:37,680 There goes my backhand. 558 00:23:39,680 --> 00:23:41,310 That was a joke, dear. 559 00:23:41,310 --> 00:23:44,560 Okay, because the fracture isn't displaced, 560 00:23:44,560 --> 00:23:46,860 the good news is, you don't need surgery. 561 00:23:46,860 --> 00:23:49,320 Oh, that's a relief. 562 00:23:49,320 --> 00:23:51,740 The bad news is, you do need to wear a sling 563 00:23:51,740 --> 00:23:53,780 for at least six weeks. 564 00:23:53,780 --> 00:23:56,580 And I have to insist, absolutely no shoulder mobility 565 00:23:56,580 --> 00:23:58,370 for the first few weeks. 566 00:23:58,370 --> 00:24:01,120 And that means you're gonna have to step up even more, 567 00:24:01,120 --> 00:24:03,000 because on top of your usual ADLs, 568 00:24:03,000 --> 00:24:05,000 you're also gonna have to help your mom bathe, 569 00:24:05,000 --> 00:24:07,630 dress, and use the toilet. 570 00:24:07,630 --> 00:24:09,590 I'm so sorry, Mom. 571 00:24:09,590 --> 00:24:12,590 This would never have happened if I was more on top of things. 572 00:24:12,590 --> 00:24:17,390 Any more on top, you'd be back in my womb. 573 00:24:17,390 --> 00:24:20,390 It's going to be fine. 574 00:24:20,390 --> 00:24:23,020 I know how hard it can be. 575 00:24:23,020 --> 00:24:24,850 I was my sister's primary caregiver 576 00:24:24,850 --> 00:24:27,230 until a few weeks ago. 577 00:24:27,230 --> 00:24:29,320 Where is she now? 578 00:24:29,320 --> 00:24:31,530 She's in an amazing facility in North Hills. 579 00:24:34,530 --> 00:24:37,280 I know I can be a burden, 580 00:24:37,280 --> 00:24:41,120 but I like being in my own home, 581 00:24:41,120 --> 00:24:43,910 just me and my girl. 582 00:24:43,920 --> 00:24:46,120 You're not a burden. 583 00:24:46,130 --> 00:24:48,460 You're my mom. 584 00:24:48,460 --> 00:24:50,550 I'll refer you to Ortho. 585 00:24:50,550 --> 00:24:54,170 They'll get you set up with PT and exercises. 586 00:24:54,180 --> 00:24:57,430 You're very lucky to have such a caring daughter. 587 00:24:57,430 --> 00:24:59,930 Don't I know it. 588 00:24:59,930 --> 00:25:02,560 Park a red Subaru in the ambulance bay? 589 00:25:02,560 --> 00:25:03,810 Yes, that's me. 590 00:25:03,810 --> 00:25:06,270 Gonna need to move that to open the space for ambulances. 591 00:25:06,270 --> 00:25:07,350 I'm so sorry. 592 00:25:07,360 --> 00:25:08,860 Okay. 593 00:25:08,860 --> 00:25:12,030 I'll walk Rita out. Perlah, would you stay with Ginger for a minute? 594 00:25:12,030 --> 00:25:13,860 - I'll be right back. - Yeah, no problem. 595 00:25:13,860 --> 00:25:15,570 Okay. After you. 596 00:25:19,580 --> 00:25:23,580 Look, I put your mom's prescription in at the pharmacy, 597 00:25:23,580 --> 00:25:28,540 and by the time you get back from parking, she should be ready to be discharged. 598 00:25:28,540 --> 00:25:31,130 Just don't worry. 599 00:25:31,130 --> 00:25:34,420 Things will be back to normal in a few weeks. 600 00:25:36,220 --> 00:25:38,640 I'm not sure what normal is anymore. 601 00:25:38,640 --> 00:25:41,180 I can't even remember the last time I slept through the night. 602 00:25:41,180 --> 00:25:43,180 It's just... 603 00:25:43,180 --> 00:25:44,390 It's a lot. 604 00:25:46,690 --> 00:25:48,600 Do you have any support at home? 605 00:25:49,480 --> 00:25:50,860 I wish. 606 00:25:50,860 --> 00:25:52,280 It's just us. 607 00:25:53,280 --> 00:25:55,940 You know, I hired a part-time aide for my sister 608 00:25:55,950 --> 00:25:57,360 to cover me when I was at work. 609 00:25:57,360 --> 00:26:00,200 It was really helpful. 610 00:26:00,200 --> 00:26:02,120 It's out of our price range. 611 00:26:02,120 --> 00:26:03,700 I mean, I already work from home. 612 00:26:03,700 --> 00:26:05,750 And then there's the cooking and the cleaning 613 00:26:05,750 --> 00:26:08,160 and the doctor's appointments. 614 00:26:08,170 --> 00:26:10,290 It never ends. 615 00:26:10,290 --> 00:26:14,170 You know, caretaker's fatigue is a real thing. 616 00:26:14,170 --> 00:26:15,920 You have to take care of yourself. 617 00:26:15,920 --> 00:26:18,760 Otherwise, you're gonna end up in here, too. 618 00:26:25,980 --> 00:26:28,270 I still don't understand why Kristi needs 619 00:26:28,270 --> 00:26:30,810 to go through this a third time with a third doctor. 620 00:26:30,810 --> 00:26:32,270 Yeah, that's our bad. 621 00:26:32,270 --> 00:26:34,940 Our computerized medical records have been glitching lately, 622 00:26:34,940 --> 00:26:38,070 and Dr. Collins' image didn't upload properly. 623 00:26:38,070 --> 00:26:40,660 Okay, crown to rump--that's top of the head to the bottom of the butt-- 624 00:26:40,660 --> 00:26:44,580 is how you measure gestational age, and we are at 10 weeks and 6 days. 625 00:26:45,750 --> 00:26:47,500 I made it by one day? 626 00:26:47,500 --> 00:26:49,000 I will order the medication. 627 00:26:49,000 --> 00:26:50,870 Dr. Collins will go over instructions 628 00:26:50,880 --> 00:26:53,000 on taking the pills when they come back from the pharmacy. 629 00:26:53,000 --> 00:26:54,500 Thank you so much, Dr. Robby. 630 00:26:54,500 --> 00:26:56,250 Oh, I'm glad I could help. 631 00:26:56,260 --> 00:26:59,090 Even more glad to see you have such a supportive mom. 632 00:26:59,090 --> 00:27:01,050 Okay, take care. 633 00:27:06,850 --> 00:27:08,730 Appreciate you stepping up. 634 00:27:08,730 --> 00:27:10,440 All good. I got you. 635 00:27:12,310 --> 00:27:14,520 Robby, I have Emma Isaacs on line 3 for you. 636 00:27:14,520 --> 00:27:16,020 She's the organ donation counselor coming 637 00:27:16,030 --> 00:27:17,690 - to speak to Nick's parents. - Thank you. 638 00:27:17,690 --> 00:27:19,240 What was that all about? 639 00:27:19,240 --> 00:27:20,860 - Oh, nothing. - Didn't look like nothing. 640 00:27:20,860 --> 00:27:22,200 - Please. - What? 641 00:27:22,200 --> 00:27:23,660 You two were once a thing. 642 00:27:23,660 --> 00:27:26,280 We dated briefly a million years ago. 643 00:27:26,290 --> 00:27:28,410 - Never again. - Never say never. 644 00:27:28,410 --> 00:27:30,330 Settle down, Jane Austen. 645 00:27:30,330 --> 00:27:32,380 The lady doth protest too much. 646 00:27:35,710 --> 00:27:37,500 Jake! 647 00:27:37,510 --> 00:27:39,710 There he is-- the man, the myth, the legend. 648 00:27:39,720 --> 00:27:41,340 And there's the kid who stole my concert pass 649 00:27:41,340 --> 00:27:42,800 and gave it to a girl. 650 00:27:42,800 --> 00:27:43,800 Where is she? Do I get to meet her? 651 00:27:43,800 --> 00:27:45,050 Need an assist! 652 00:27:45,050 --> 00:27:46,600 - Hold that thought. - Okay. 653 00:27:46,600 --> 00:27:48,010 Travis Johnson, 17, had a tonsillectomy 654 00:27:48,020 --> 00:27:49,520 ten days ago at St. Michael's. 655 00:27:49,520 --> 00:27:51,230 Started spitting blood about an hour ago. 656 00:27:51,230 --> 00:27:53,350 - Good vitals. - Hey, Travis. I'm Dr. Robby. 657 00:27:53,350 --> 00:27:54,980 - How much blood? - Couple mouthfuls. 658 00:27:54,980 --> 00:27:56,190 Can you open up for me? 659 00:27:58,900 --> 00:28:01,700 Hey, Whitaker, Jesse. Got a post-tonsillectomy hemorrhage. 660 00:28:01,700 --> 00:28:03,570 Nebulized TXA, quick as you can. 661 00:28:03,570 --> 00:28:05,410 - I'm on it. Let's go. - Let's go, Trauma 2. 662 00:28:05,410 --> 00:28:07,200 So this can go south pretty quickly. 663 00:28:07,200 --> 00:28:08,490 - You up for it? - Well, I can... 664 00:28:08,490 --> 00:28:09,580 Of course you are. 665 00:28:15,840 --> 00:28:17,420 Ready? Here we go. 666 00:28:17,420 --> 00:28:19,630 One, two, three. 667 00:28:25,260 --> 00:28:26,720 Take long, slow, deep breaths on that. 668 00:28:26,720 --> 00:28:28,560 The TXA is gonna help your blood clot. 669 00:28:28,560 --> 00:28:30,180 Any medical problems? 670 00:28:30,180 --> 00:28:31,470 No, just a ton of strep. 671 00:28:31,480 --> 00:28:32,640 That's why I had the surgery. 672 00:28:32,640 --> 00:28:33,850 You take aspirin? 673 00:28:33,850 --> 00:28:36,270 Any other medications? 674 00:28:36,270 --> 00:28:38,520 Lungs are clear bilaterally, no stridor. 675 00:28:38,520 --> 00:28:40,150 Okay, sure. 676 00:28:40,150 --> 00:28:42,320 You feel like throwing up? Any pain in your belly? 677 00:28:42,320 --> 00:28:44,110 No. 678 00:28:44,110 --> 00:28:45,280 Labs? 679 00:28:45,280 --> 00:28:48,280 CBC, BMP, maybe coags? 680 00:28:48,280 --> 00:28:49,830 Add a type and screen, just in case. 681 00:28:49,830 --> 00:28:50,910 Yeah. 682 00:28:50,910 --> 00:28:52,450 Good sats at 98%. 683 00:28:52,460 --> 00:28:54,580 BP is 115 over 80. 684 00:28:54,580 --> 00:28:55,750 Okay, good. 685 00:28:55,750 --> 00:28:57,040 Four by four on a ring forceps. 686 00:28:57,040 --> 00:28:59,420 - Let's take a look. - Okay. 687 00:28:59,420 --> 00:29:01,960 Head back, open wide for me. 688 00:29:03,510 --> 00:29:05,720 - What do you see? - No active bleeding, 689 00:29:05,720 --> 00:29:07,390 but there's some white and dark brown stuff 690 00:29:07,390 --> 00:29:09,100 - where the tonsils used to be. - Oh, that's good. 691 00:29:09,100 --> 00:29:11,140 That's a fibrinous clot. That means the TXA is working. 692 00:29:11,140 --> 00:29:12,560 Your parents on the way? 693 00:29:12,560 --> 00:29:13,890 They're in Baltimore for a wedding. 694 00:29:13,890 --> 00:29:15,270 I didn't want to bother them. 695 00:29:15,270 --> 00:29:18,400 Trust me. They're your parents, and you are in an emergency room. 696 00:29:18,400 --> 00:29:19,980 It is never a bother. 697 00:29:19,980 --> 00:29:21,360 Write their numbers down, and I will call them. 698 00:29:21,360 --> 00:29:22,860 Call Head and Neck. 699 00:29:22,860 --> 00:29:24,190 Stay with him until they get here, okay? 700 00:29:24,200 --> 00:29:25,240 Good. 701 00:29:25,240 --> 00:29:26,860 Pen. 702 00:29:26,860 --> 00:29:28,070 Can I get the... 703 00:29:35,920 --> 00:29:38,830 Sam Wallace, our Good Samaritan who saved a Nepali lady, 704 00:29:38,830 --> 00:29:40,670 is in line for a repeat head CT 705 00:29:40,670 --> 00:29:43,250 to be sure there's no extension of the intraparenchymal bleed. 706 00:29:43,260 --> 00:29:44,840 Okay, so we can dial down the sedation, 707 00:29:44,840 --> 00:29:46,840 and, if he's alert, check extubation parameters. 708 00:29:46,840 --> 00:29:48,220 - Copy. - Did you get the consent form 709 00:29:48,220 --> 00:29:49,300 signed by Joyce the sickler 710 00:29:49,300 --> 00:29:50,600 - for the intubation? - Not yet. 711 00:29:50,600 --> 00:29:52,310 - Jesus fucking-- - She's scared. 712 00:29:52,310 --> 00:29:53,810 I just wanted to give her some time to talk to her... 713 00:29:53,810 --> 00:29:55,180 To do what, make funeral arrangements? 714 00:29:55,180 --> 00:29:57,190 Joyce is hypoxic at 84. 715 00:29:57,190 --> 00:29:59,520 84. This goes on much longer, 716 00:29:59,520 --> 00:30:01,480 she runs the risk of permanent lung damage, 717 00:30:01,480 --> 00:30:02,690 - heart attack... - I know. 718 00:30:02,690 --> 00:30:04,190 - Stroke, death. - I know. 719 00:30:04,190 --> 00:30:05,320 Then move! 720 00:30:05,320 --> 00:30:06,780 Now. 721 00:30:17,500 --> 00:30:19,830 Just have a seat, and we'll be with you shortly. 722 00:30:19,830 --> 00:30:22,250 Oh, I've heard that load of bullshit before. 723 00:30:26,340 --> 00:30:27,930 My fucking God. 724 00:30:43,400 --> 00:30:46,690 Took me all the way back there just to stick a goddamn thermometer 725 00:30:46,690 --> 00:30:48,320 in my mouth, you know. 726 00:30:48,320 --> 00:30:51,320 Repeat vitals every four hours. 727 00:30:56,370 --> 00:30:57,950 Oh, dang! 728 00:30:57,960 --> 00:31:00,170 Saw how it swerved and almost hit the taxi? 729 00:31:01,580 --> 00:31:03,040 I gotta get out of here; I mean, this thing is 730 00:31:03,040 --> 00:31:04,790 totally gonna screw up the traffic to Pittfest. 731 00:31:04,800 --> 00:31:06,800 Nice score. You going with Robby? 732 00:31:06,800 --> 00:31:08,300 Well, I was supposed to. 733 00:31:08,300 --> 00:31:09,970 But I have this new girlfriend, 734 00:31:09,970 --> 00:31:11,720 and she's super excited about the lineup, so... 735 00:31:11,720 --> 00:31:14,510 So you ditched the old man for a hot piece of ass. 736 00:31:14,510 --> 00:31:17,220 Been there, done that. 737 00:31:17,220 --> 00:31:19,810 Senior year, Lollapalooza, I met this guy. 738 00:31:19,810 --> 00:31:21,270 Think his name was Rich-- 739 00:31:21,270 --> 00:31:22,440 or was it Rick? 740 00:31:22,440 --> 00:31:23,810 Doesn't matter. 741 00:31:23,810 --> 00:31:25,980 But he looked like Dave Navarro. 742 00:31:27,860 --> 00:31:31,530 Warm breeze, cool grass, 743 00:31:31,530 --> 00:31:34,280 a million stars in the sky. 744 00:31:35,660 --> 00:31:37,450 Best sex of my life. 745 00:31:37,450 --> 00:31:39,370 You had sex in public? 746 00:31:39,370 --> 00:31:41,120 We were under a blanket. 747 00:31:42,040 --> 00:31:43,120 It's turning around. 748 00:31:43,130 --> 00:31:44,630 It's turning around, baby. 749 00:31:44,630 --> 00:31:47,170 - Come home to Papa. - Shit. 750 00:31:47,170 --> 00:31:49,970 I had money on it crashing in Beaver County. 751 00:32:00,850 --> 00:32:02,770 Better safe than sorry. 752 00:32:02,770 --> 00:32:04,310 Okay. 753 00:32:06,770 --> 00:32:08,940 - Jake, what's up? - Hey, how are you? 754 00:32:12,950 --> 00:32:14,660 Where's Rita? 755 00:32:16,240 --> 00:32:17,410 She went to park the car. 756 00:32:17,410 --> 00:32:19,040 Shouldn't have been more than five minutes. 757 00:32:19,040 --> 00:32:21,870 Why don't you dial her number for me? 758 00:32:29,880 --> 00:32:32,010 - Did she pick up? - Straight to voicemail. 759 00:32:32,010 --> 00:32:33,090 That's weird. 760 00:32:37,470 --> 00:32:42,100 Sole caretaker, overwhelmed, exhausted. 761 00:32:45,100 --> 00:32:50,030 I told her to take a break, but you don't think she ditched her mom, do you? 762 00:32:50,900 --> 00:32:51,940 I mean, it happens. 763 00:32:54,910 --> 00:32:57,620 You're gonna need to use the antibiotic ointment twice a day 764 00:32:57,620 --> 00:33:00,990 and come in for a wound check in two days, okay? 765 00:33:01,000 --> 00:33:03,200 Mateo, can you grab me enough samples to last a couple weeks? 766 00:33:03,210 --> 00:33:04,710 - Yeah, I'm on it. - Thank you. 767 00:33:06,210 --> 00:33:07,670 Thanks. 768 00:33:07,670 --> 00:33:09,380 I really appreciate it. 769 00:33:09,380 --> 00:33:11,460 Yeah. No problem. 770 00:33:11,460 --> 00:33:14,090 Has Kiara been here yet? 771 00:33:14,090 --> 00:33:16,090 No, who's Kiara? 772 00:33:16,090 --> 00:33:17,890 Oh, she's the hospital social worker. 773 00:33:17,890 --> 00:33:19,640 She can help you out with, like, housing and childcare 774 00:33:19,640 --> 00:33:21,060 - and food and security... - You told her? 775 00:33:21,060 --> 00:33:23,310 - No, I... - No, no, it's all free. 776 00:33:23,310 --> 00:33:24,640 The system works if you use it. 777 00:33:24,640 --> 00:33:25,850 - You just have to... - Enough! 778 00:33:27,100 --> 00:33:28,940 I don't need your help. 779 00:33:30,610 --> 00:33:31,940 Nice speech. 780 00:33:31,940 --> 00:33:34,110 Next time, mind your own business. 781 00:33:39,780 --> 00:33:42,290 You ever heard of impact over intent? 782 00:33:44,120 --> 00:33:46,460 I would never intentionally embarrass anybody. 783 00:33:46,460 --> 00:33:48,420 But you did. 784 00:33:48,420 --> 00:33:52,550 You didn't have a conversation with Sherry or ask her what she needed. 785 00:33:52,550 --> 00:33:54,590 Instead, you walked in here and told her what to do. 786 00:33:54,590 --> 00:33:58,510 You gotta slow down, take a beat, and listen 787 00:33:58,510 --> 00:34:00,390 instead of judging people. 788 00:34:01,810 --> 00:34:03,140 - I don't judge. - Please. 789 00:34:03,140 --> 00:34:05,430 You've been eyeing me sideways all day. 790 00:34:07,190 --> 00:34:09,690 Look, maybe I have a better perspective because I've been 791 00:34:09,690 --> 00:34:12,400 on both sides, but we gotta try to at least 792 00:34:12,400 --> 00:34:15,190 put ourselves in their shoes. 793 00:34:15,190 --> 00:34:18,950 Listening and building trust will make us better doctors... 794 00:34:18,950 --> 00:34:20,570 and better people. 795 00:34:24,200 --> 00:34:25,500 I'm sorry. 796 00:34:25,500 --> 00:34:28,290 I'm not telling you this to reprimand you. 797 00:34:28,290 --> 00:34:31,960 I'm trying to teach you to help you. 798 00:34:33,710 --> 00:34:36,840 Wait, what about Sherry? 799 00:34:36,840 --> 00:34:38,840 I doubt she'll be back. 800 00:34:38,840 --> 00:34:41,970 But sadly, there will be many, many more just like her. 801 00:34:46,310 --> 00:34:47,640 No. No, no, no. 802 00:34:47,640 --> 00:34:50,940 He had the surgery at St. Michael's, but he's here now. 803 00:34:52,020 --> 00:34:53,860 No, he doesn't have a car. 804 00:34:53,860 --> 00:34:55,610 His parents are out of town. 805 00:34:57,780 --> 00:34:59,240 Okay, okay, well, 806 00:34:59,240 --> 00:35:00,610 how am I to send him back to St. Michael's, 807 00:35:00,610 --> 00:35:02,570 call him an Uber? 808 00:35:02,570 --> 00:35:05,160 You can't--that doesn't make... 809 00:35:05,160 --> 00:35:07,200 Hey, hello. 810 00:35:07,200 --> 00:35:08,540 Hello! 811 00:35:08,540 --> 00:35:10,420 What's wrong? 812 00:35:14,250 --> 00:35:18,380 They said it is not their job to fix another hospital's problem. 813 00:35:18,380 --> 00:35:20,470 Don't worry about it, though. I'll talk to my attending-- 814 00:35:21,640 --> 00:35:23,550 Oh, shit! 815 00:35:24,850 --> 00:35:26,390 I need a little help here! 816 00:35:27,720 --> 00:35:29,350 Okay, come on, open up. 817 00:35:29,350 --> 00:35:31,270 It's a post-tonsillectomy hemorrhage. 818 00:35:32,270 --> 00:35:34,230 Yankauer and sponge stick. 819 00:35:34,230 --> 00:35:35,940 He was stable. Then it just opened. 820 00:35:35,940 --> 00:35:37,480 Call the blood bank. 821 00:35:37,480 --> 00:35:40,150 Two units, whole blood. Get a second line. 822 00:35:40,150 --> 00:35:41,570 Head and Neck wouldn't come down to see him. 823 00:35:41,570 --> 00:35:43,320 - Assholes. - Tachy to 120. 824 00:35:43,320 --> 00:35:45,200 His sats are down to 90%. 825 00:35:45,200 --> 00:35:47,290 Okay, get a high-flow nasal cannula, 826 00:35:47,290 --> 00:35:48,700 100 of ketamine. 827 00:35:48,700 --> 00:35:50,790 Set up the GlideScope. 828 00:35:52,460 --> 00:35:53,750 Hold suction. 829 00:35:53,750 --> 00:35:55,960 I'm gonna try for direct pressure. 830 00:35:55,960 --> 00:36:00,090 If Head and Neck still won't come down, call Garcia. 831 00:36:00,090 --> 00:36:02,430 You're good. You're good. 832 00:36:02,430 --> 00:36:05,640 Okay, before we begin, let's take a time-out. 833 00:36:05,640 --> 00:36:07,600 This is Joyce St. Claire. 834 00:36:07,600 --> 00:36:09,890 Procedure is endotracheal intubation 835 00:36:09,890 --> 00:36:12,310 for hypoxia due to acute chest syndrome. 836 00:36:12,310 --> 00:36:14,190 We'll be using video laryngoscopy 837 00:36:14,190 --> 00:36:17,190 and an 8-0 ET tube with a 7.5 on standby. 838 00:36:17,190 --> 00:36:20,990 Induction with 75 of propofol, 100 rocuronium. 839 00:36:20,990 --> 00:36:22,650 Got it. 840 00:36:22,650 --> 00:36:25,360 For backup, we have a bougie and an LMA ready. 841 00:36:25,370 --> 00:36:26,870 Yep. 842 00:36:26,870 --> 00:36:28,910 Any questions or concerns before we start? 843 00:36:28,910 --> 00:36:30,830 I wanna be awake. 844 00:36:30,830 --> 00:36:33,120 We can't perform an intubation that way. 845 00:36:33,120 --> 00:36:34,920 I mean after. 846 00:36:34,920 --> 00:36:37,500 After, we will lighten your sedation. 847 00:36:37,500 --> 00:36:40,500 You won't be able to talk, but you can use a pen and paper 848 00:36:40,510 --> 00:36:42,550 or an iPad to communicate. 849 00:36:45,300 --> 00:36:48,600 I love you. 850 00:36:48,600 --> 00:36:50,470 Till the end of time. 851 00:36:51,980 --> 00:36:53,730 Robby, Trauma 2 right now. 852 00:36:53,730 --> 00:36:56,360 - Cover the intubation? - Of course. 853 00:36:58,400 --> 00:37:00,400 - What happened? - Bleeder opened up. 854 00:37:00,400 --> 00:37:01,570 Ketamine on board to intubate. 855 00:37:01,570 --> 00:37:02,940 Sats holding at 97. 856 00:37:02,950 --> 00:37:04,950 - Can you get an airway? - Come on. 857 00:37:04,950 --> 00:37:06,410 Let's lie him down. 858 00:37:06,410 --> 00:37:08,030 Keep pressure on the scab. 859 00:37:09,530 --> 00:37:10,910 Nothing but blood. 860 00:37:10,910 --> 00:37:12,750 Can't see the cords. 861 00:37:12,750 --> 00:37:14,660 Sats 94. 862 00:37:14,670 --> 00:37:16,210 Not sure we have room for the tube with the sponge stick. 863 00:37:16,210 --> 00:37:17,960 If I pull out, there's gonna be even more blood. 864 00:37:17,960 --> 00:37:19,460 Doesn't look like you secured that airway. 865 00:37:19,460 --> 00:37:21,090 - He's working on it. - Bougie. 866 00:37:21,090 --> 00:37:22,670 Open a crike tray and prep the neck. 867 00:37:24,800 --> 00:37:26,590 Hold on, I'm going in blind with the bougie. 868 00:37:26,590 --> 00:37:28,180 I might be able to feel the tracheal rings. 869 00:37:28,180 --> 00:37:30,260 And I might have a three-way with Madonna. 870 00:37:30,260 --> 00:37:32,560 Move. 871 00:37:32,560 --> 00:37:33,720 Not happening. 872 00:37:33,730 --> 00:37:34,930 Pressure. 873 00:37:34,940 --> 00:37:36,440 Make room for the grown-ups. 874 00:37:37,650 --> 00:37:38,980 Okay, okay. Hold on, hold on. 875 00:37:38,980 --> 00:37:40,440 We can try a retrograde intubation. 876 00:37:40,440 --> 00:37:41,860 - A what? - There's no obstruction. 877 00:37:41,860 --> 00:37:43,230 We just can't see what we're doing. 878 00:37:43,240 --> 00:37:44,820 So we take a needle, 879 00:37:44,820 --> 00:37:46,700 and we put it in the cricothyroid. 880 00:37:46,700 --> 00:37:50,620 We run a guide wire up and out the mouth, and we slide the ET tube up over the wire. 881 00:37:50,620 --> 00:37:52,580 - Never seen one before. - Sats 90. 882 00:37:52,580 --> 00:37:53,950 No time to play MacGyver with this kid. 883 00:37:53,950 --> 00:37:55,910 - Time to crike. - It'll be quick. 884 00:37:55,910 --> 00:37:57,580 You got one shot, and then I cut. 885 00:38:00,250 --> 00:38:02,340 Propofol and rock are on board. 886 00:38:02,340 --> 00:38:05,630 Now we wait for the sedative and paralytic to start working. 887 00:38:05,630 --> 00:38:08,220 Should Dr. Robby be in here? 888 00:38:08,220 --> 00:38:11,260 Between Dr. Mohan and myself, we've done hundreds of these. 889 00:38:11,260 --> 00:38:13,760 I'm getting sleepy. 890 00:38:13,770 --> 00:38:15,520 I'm right here, babe. 891 00:38:25,150 --> 00:38:27,110 Okay, I'm in. 892 00:38:27,110 --> 00:38:29,740 Guide wire. 893 00:38:33,580 --> 00:38:36,120 Let me know when you start to feel it up top. 894 00:38:37,870 --> 00:38:39,500 Nothing yet. 895 00:38:39,500 --> 00:38:41,250 - More suction. - I'm trying. 896 00:38:42,040 --> 00:38:43,170 Still can't find it. 897 00:38:43,170 --> 00:38:44,380 Well, keep feeling in there. 898 00:38:44,380 --> 00:38:45,840 It's gotta be there somewhere. 899 00:38:45,840 --> 00:38:48,550 - Maybe it's curling up. - Sats down to 89. 900 00:38:48,550 --> 00:38:50,800 - Guys, this is not working. - Just give me a second. 901 00:38:50,800 --> 00:38:52,220 - Until he arrests? - Oh, my God. 902 00:38:52,220 --> 00:38:53,680 I'm gonna lose another patient. 903 00:38:53,680 --> 00:38:55,260 Shut up, Whitaker. Let's get on this. 904 00:38:55,270 --> 00:38:56,640 Sats down to 87. 905 00:38:56,640 --> 00:38:58,730 Okay, I'm gonna redirect the wire. 906 00:39:01,150 --> 00:39:03,270 Sats still dropping. 86. 907 00:39:05,150 --> 00:39:06,280 You got this. 908 00:39:11,950 --> 00:39:15,080 Ondine, if you'd like, you can watch on the screen. 909 00:39:15,080 --> 00:39:16,830 I'm okay. 910 00:39:18,790 --> 00:39:20,920 Excellent view of the cords, Dr. Mohan. 911 00:39:22,830 --> 00:39:25,170 I'm in. 912 00:39:25,170 --> 00:39:27,050 Inflate the balloon. 913 00:39:35,680 --> 00:39:37,260 Good breath sounds bilaterally. 914 00:39:37,270 --> 00:39:39,890 Sats 92 and rising. 915 00:39:39,890 --> 00:39:42,190 That's it? You're done? 916 00:39:42,190 --> 00:39:43,270 Yes. 917 00:39:43,270 --> 00:39:45,820 It all went perfectly. 918 00:39:48,110 --> 00:39:49,820 How long until she gets better? 919 00:39:49,820 --> 00:39:51,240 Depends. 920 00:39:51,240 --> 00:39:53,990 It can take anywhere from a few days to a few weeks for the lungs to heal 921 00:39:53,990 --> 00:39:55,620 from acute chest syndrome. 922 00:39:55,620 --> 00:39:57,620 I can ask the ICU to set up a recliner for you 923 00:39:57,620 --> 00:39:59,660 in Joyce's room so you can stay with her. 924 00:39:59,660 --> 00:40:02,160 Thank you both so much. 925 00:40:02,170 --> 00:40:03,330 You're welcome. 926 00:40:03,330 --> 00:40:05,340 Take care. 927 00:40:10,760 --> 00:40:12,380 Sats 84. We need to bag him. 928 00:40:12,380 --> 00:40:14,260 - Still not seeing it. - I'm suctioning like crazy. 929 00:40:14,260 --> 00:40:15,680 Okay, we're done playing doctor. 930 00:40:15,680 --> 00:40:17,010 Lose the wire. I'm criking this kid. 931 00:40:17,010 --> 00:40:18,180 All right, we tried. I'm sorry. 932 00:40:18,180 --> 00:40:19,680 No, wait. Wait. 933 00:40:19,680 --> 00:40:22,180 I've got it. 934 00:40:22,190 --> 00:40:23,810 You still don't have an airway. 935 00:40:23,810 --> 00:40:26,860 Okay, keep the laryngoscope in place so the tube passes easily. 936 00:40:26,860 --> 00:40:30,110 Pass the T, the T tube over the wire. 937 00:40:30,110 --> 00:40:31,740 - Come on. - Hang on to that wire. 938 00:40:31,740 --> 00:40:33,990 Do not let go of that wire. 939 00:40:33,990 --> 00:40:37,200 Okay. 940 00:40:37,200 --> 00:40:40,370 Okay, I'm gonna give you a little slack so you can get past the cords. 941 00:40:42,000 --> 00:40:43,830 Yeah, yeah. I feel you at the trachea. 942 00:40:43,830 --> 00:40:46,000 25 centimeters at the lips. 943 00:40:46,000 --> 00:40:47,080 That ought to do it. 944 00:40:47,090 --> 00:40:49,250 Pull the wire, bag him. 945 00:40:49,250 --> 00:40:50,840 Balloon's up. 946 00:40:53,340 --> 00:40:55,010 Yellow on CO2. That's good. 947 00:40:55,010 --> 00:40:57,890 That is very good. 948 00:40:57,890 --> 00:40:59,680 Good breath sounds bilaterally. 949 00:40:59,680 --> 00:41:00,890 Sats coming up. 950 00:41:00,890 --> 00:41:03,480 90, 92. 951 00:41:03,480 --> 00:41:05,690 Guess you're gonna have to save that scalpel for another day. 952 00:41:05,690 --> 00:41:08,230 - You guys got lucky. - No, we got skills, baby. 953 00:41:08,230 --> 00:41:09,610 We got skills! 954 00:41:10,860 --> 00:41:11,900 Keep gauze on the clot. 955 00:41:11,900 --> 00:41:13,400 Yeah, copy. 956 00:41:13,400 --> 00:41:15,280 Ordering propofol and fentanyl drips. 957 00:41:16,950 --> 00:41:19,120 Oh, nice of you to join us, Dr. Flores. 958 00:41:19,120 --> 00:41:22,370 Sorry, I got stuck in a nasty radical neck dissection. 959 00:41:22,370 --> 00:41:24,040 - Still bleeding? - Not with direct pressure. 960 00:41:24,040 --> 00:41:25,960 We got the airway. You get the bleeder. 961 00:41:25,960 --> 00:41:27,290 OR's standing by. 962 00:41:27,290 --> 00:41:30,540 So I can cancel the Uber? 963 00:41:30,550 --> 00:41:32,380 Let's get him upstairs. 964 00:41:33,800 --> 00:41:35,970 Fresh sponge stick for you, Whitaker. 965 00:41:35,970 --> 00:41:37,380 You need me to stay with the-- 966 00:41:37,390 --> 00:41:39,010 Your patient. You did a good job. 967 00:41:39,010 --> 00:41:40,430 It's only till the anesthesiologist takes over. 968 00:41:40,430 --> 00:41:41,850 - You got it? - Yeah, I got it. 969 00:41:41,850 --> 00:41:43,890 Get yourself a fresh pair of scrubs on your way back down. 970 00:41:51,230 --> 00:41:52,980 I'm sorry that took so long. 971 00:41:52,980 --> 00:41:54,780 - I was just-- - Don't apologize. 972 00:41:54,780 --> 00:41:57,570 What you did in there, building a relationship with your patients, 973 00:41:57,570 --> 00:42:01,080 earning their trust, that's what this is all about. 974 00:42:01,080 --> 00:42:03,240 Robby doesn't seem to think so. 975 00:42:03,250 --> 00:42:05,370 Don't worry about him. 976 00:42:05,370 --> 00:42:09,250 You know, I should be apologizing to you. 977 00:42:09,250 --> 00:42:13,250 Slo-Mo, you deserve better. 978 00:42:13,260 --> 00:42:15,260 Keep doing you, Dr. Mohan. 979 00:42:17,300 --> 00:42:18,840 Where'd you get that move? 980 00:42:18,840 --> 00:42:21,140 Retrograde intubation, that's an Adamson special. 981 00:42:21,140 --> 00:42:22,850 I learned that from the best. 982 00:42:22,850 --> 00:42:24,560 Well, you're not too shabby yourself, Professor. 983 00:42:24,560 --> 00:42:26,430 Yeah, that got kind of rough in there. 984 00:42:26,430 --> 00:42:28,140 You kept your composure, though-- 985 00:42:28,140 --> 00:42:31,560 exactly the kind of candidate they want for the ED Medical Education Fellowship. 986 00:42:31,570 --> 00:42:34,610 Oh, there's probably over 50 applicants for that one slot. 987 00:42:34,610 --> 00:42:36,030 Yeah, probably. 988 00:42:36,030 --> 00:42:38,200 But I know that they like to go with someone that they know 989 00:42:38,200 --> 00:42:41,370 from firsthand experience has the skills to be successful. 990 00:42:41,370 --> 00:42:44,370 At least that's what I told them in my letter of recommendation. 991 00:42:44,370 --> 00:42:45,580 Thank you. 992 00:42:47,870 --> 00:42:49,250 Glad you stuck around. 993 00:42:49,250 --> 00:42:50,750 It's not like I had a choice, did I? 994 00:42:50,750 --> 00:42:53,130 No, not really. 995 00:42:53,130 --> 00:42:56,420 So how's your day going? 996 00:42:56,420 --> 00:42:57,630 It's going. 997 00:42:57,630 --> 00:43:00,220 Cool, cool, cool. 998 00:43:00,220 --> 00:43:01,680 Why do you ask? 999 00:43:01,680 --> 00:43:03,140 Guy can't ask? 1000 00:43:03,140 --> 00:43:04,680 You never ask me about my work. 1001 00:43:04,680 --> 00:43:06,720 What gives? 1002 00:43:06,730 --> 00:43:08,520 Mom wanted me to ask because she just wants 1003 00:43:08,520 --> 00:43:10,100 to make sure that you're doing okay. 1004 00:43:10,100 --> 00:43:12,150 That's very sweet of her. I'm doing fine. 1005 00:43:12,150 --> 00:43:13,650 Thank you for these again. 1006 00:43:13,650 --> 00:43:16,280 You can thank me by finally introducing me to your girlfriend. 1007 00:43:16,280 --> 00:43:18,440 - Not today but soon. - Have fun. 1008 00:43:18,450 --> 00:43:21,780 Hey, I know it goes without saying, but please be safe. 1009 00:43:21,780 --> 00:43:23,160 - I will. - Seriously. 1010 00:43:23,160 --> 00:43:24,740 Don't take anything from anyone. 1011 00:43:24,740 --> 00:43:26,290 I've already seen two fentanyl overdoses today. 1012 00:43:26,290 --> 00:43:27,830 - It's not even noon. - I promise. 1013 00:43:27,830 --> 00:43:29,040 - Okay. - Basketball Sunday? 1014 00:43:29,040 --> 00:43:30,460 Yep, wouldn't miss it. 1015 00:43:30,460 --> 00:43:31,790 Hey, before you go, before you go. 1016 00:43:31,790 --> 00:43:33,080 Please don't hand me a condom. 1017 00:43:33,080 --> 00:43:34,420 Condom? 1018 00:43:34,420 --> 00:43:35,880 I was gonna give you extra cash. 1019 00:43:35,880 --> 00:43:36,880 Wait, are you having sex? 1020 00:43:36,880 --> 00:43:38,470 Thank you. 1021 00:43:40,220 --> 00:43:44,220 Looks like the driver lost control as the police cars were closing in. 1022 00:43:44,220 --> 00:43:46,390 The ambulance has definitely stopped. 1023 00:43:46,390 --> 00:43:47,890 Check it out. 1024 00:43:47,890 --> 00:43:49,480 It's difficult to tell from this angle, 1025 00:43:49,480 --> 00:43:51,770 but it does look like they may have hit something. 1026 00:43:51,770 --> 00:43:54,310 - Damn! - That's in our zone. 1027 00:43:54,310 --> 00:43:56,070 Ambulance crashed in our catchment. 1028 00:43:56,070 --> 00:43:57,480 Get ready for incoming. 1029 00:43:57,480 --> 00:44:01,200 - How many you think? - Other than the driver? No idea. 1030 00:44:01,200 --> 00:44:05,450 Since you're past ten weeks, you'll need to take mifepristone twice, 1031 00:44:05,450 --> 00:44:08,160 once now and once in 24 hours. 1032 00:44:08,160 --> 00:44:10,790 Then 24 hours after that, you'll take misoprostol, 1033 00:44:10,790 --> 00:44:13,420 two pills which dissolve between the cheek and the gum, 1034 00:44:13,420 --> 00:44:16,040 then two more of the same pills six hours later. 1035 00:44:16,040 --> 00:44:17,290 That's a lot to remember. 1036 00:44:17,300 --> 00:44:19,630 Everything is clearly labeled with the names of the meds, 1037 00:44:19,630 --> 00:44:22,880 the dose, and the exact time to take them. 1038 00:44:22,880 --> 00:44:24,510 Will it hurt? 1039 00:44:24,510 --> 00:44:27,260 You can expect some vaginal bleeding. 1040 00:44:27,260 --> 00:44:30,140 There may be some cramping, like when you're on your period. 1041 00:44:30,140 --> 00:44:32,270 If you're bleeding more than two pads an hour 1042 00:44:32,270 --> 00:44:34,520 or the pain gets to be too much, 1043 00:44:34,520 --> 00:44:36,150 come back in and see us. 1044 00:44:36,150 --> 00:44:38,440 And I'll be with you the whole time. 1045 00:44:43,660 --> 00:44:45,360 Kristi? 1046 00:44:45,370 --> 00:44:47,410 Kristi! 1047 00:44:47,410 --> 00:44:48,530 What the hell are you doing here? 1048 00:44:48,540 --> 00:44:50,080 Hey, language! 1049 00:44:50,080 --> 00:44:51,580 And I should be asking you the same thing. 1050 00:44:51,580 --> 00:44:52,790 Excuse me. Who are you? 1051 00:44:52,790 --> 00:44:55,170 - I'm her mom. - Mom? 1052 00:44:55,170 --> 00:44:56,250 Aren't you her mom? 1053 00:44:56,250 --> 00:44:57,710 I can explain. 1054 00:44:57,710 --> 00:44:59,090 No, that's my sister, Lynette. 1055 00:44:59,090 --> 00:45:00,800 I am Kristi's mother. 1056 00:45:00,800 --> 00:45:02,010 Kris... 1057 00:45:03,010 --> 00:45:05,090 Kris, baby, what are you doing here? 1058 00:45:06,930 --> 00:45:08,640 I'm here for an abortion. 1059 00:45:10,390 --> 00:45:12,100 Did you do it already? 1060 00:45:12,100 --> 00:45:14,390 - Not yet. - Okay. Thank God. 1061 00:45:14,390 --> 00:45:16,650 Okay, okay, can we all just take a step back here and-- 1062 00:45:16,650 --> 00:45:19,270 Mom, I want this. This is my decision. 1063 00:45:19,270 --> 00:45:20,360 - No. - Just listen to her, El. 1064 00:45:20,360 --> 00:45:21,610 You can shut up! 1065 00:45:21,610 --> 00:45:23,860 You have done enough. 1066 00:45:23,860 --> 00:45:28,780 My daughter is a minor, so she can't get this abortion 1067 00:45:28,780 --> 00:45:30,660 without my say-so, right? 1068 00:45:32,290 --> 00:45:33,460 Is that right? 1069 00:45:34,660 --> 00:45:37,040 That's correct. 1070 00:45:39,590 --> 00:45:42,590 Then there is no way this is happening. 1071 00:45:42,590 --> 00:45:44,170 Not now, not ever. 77166

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