1 00:00:35,340 --> 00:00:37,220 - Oh, shit. - What? 2 00:00:37,220 --> 00:00:39,300 I think I just broke some ribs. 3 00:00:39,310 --> 00:00:40,810 It means you're doing it right. 4 00:00:40,810 --> 00:00:43,310 Third amp of epi is on board. 5 00:00:43,310 --> 00:00:45,140 Oh, come on. 6 00:00:49,900 --> 00:00:52,110 Call me if there's a resurrection. 7 00:00:54,570 --> 00:00:56,740 - Hey, Perlah. - Doctor? 8 00:00:56,740 --> 00:00:58,740 Your kids have any pets? 9 00:00:58,740 --> 00:01:01,910 - Ugh, my house is like a zoo. - You have a dog? 10 00:01:01,910 --> 00:01:05,460 Ugh, no dogs, no cats. I followed my mother's rule. 11 00:01:05,460 --> 00:01:08,170 No pets that can't be buried at sea. 12 00:01:08,170 --> 00:01:09,630 I'm not sure I follow. 13 00:01:09,630 --> 00:01:12,130 You ever try to flush a guinea pig? 14 00:01:12,130 --> 00:01:14,380 Try explaining that to your plumber. 15 00:01:14,380 --> 00:01:16,130 Good to know. 16 00:01:22,390 --> 00:01:24,020 Hey, what's up with your asthma guy? 17 00:01:24,020 --> 00:01:25,560 Responding to albuterol. 18 00:01:25,560 --> 00:01:27,270 One more neb, and we'll discharge on prednisone. 19 00:01:27,270 --> 00:01:29,020 How's it going out in Chairs? 20 00:01:29,020 --> 00:01:31,020 Oh, it's fine, I guess. 21 00:01:31,020 --> 00:01:33,190 - Dr. McKay seems nice. - Cassie? 22 00:01:33,190 --> 00:01:34,820 Oh, yeah, she's great. 23 00:01:34,820 --> 00:01:37,030 - She been here long? - A little while. Why? 24 00:01:37,030 --> 00:01:38,570 I'm just curious. 25 00:01:38,570 --> 00:01:40,280 Do you know what she did before she came here? 26 00:01:40,280 --> 00:01:42,780 What she did? What do you mean, like, school? 27 00:01:42,790 --> 00:01:46,250 Oh, like school, work, personal life. 28 00:01:48,290 --> 00:01:49,620 I'm just trying to get to know her better. 29 00:01:49,630 --> 00:01:51,840 Um, yeah, I don't-- I don't know. 30 00:01:51,840 --> 00:01:53,130 I don't know that much about her. 31 00:01:53,130 --> 00:01:54,670 She has a son. I know that. 32 00:01:54,670 --> 00:01:57,920 She's a pretty private person. 33 00:01:57,930 --> 00:01:59,930 - Anything else? - No, sorry, I'm good. 34 00:01:59,930 --> 00:02:01,430 Thank you. 35 00:02:03,850 --> 00:02:06,390 Hey, where are we at with opening up some beds? 36 00:02:06,390 --> 00:02:09,020 Our Nepali lady with the crushed foot, 37 00:02:09,020 --> 00:02:10,900 Minu, she still in line for the OR? 38 00:02:10,900 --> 00:02:12,400 Yeah, she got bumped by your Le Fort 39 00:02:12,400 --> 00:02:13,610 three fracture, Ben Kemper. 40 00:02:13,610 --> 00:02:15,070 - He just went up. - Mm. 41 00:02:15,070 --> 00:02:16,190 Still waiting for them to take 42 00:02:16,190 --> 00:02:17,820 the electrocution fasciotomy. 43 00:02:17,820 --> 00:02:19,780 What about our OD in Central 7? 44 00:02:19,780 --> 00:02:22,530 Robby wants a few more tests. He's stable and on a vent. 45 00:02:22,530 --> 00:02:24,450 Is he a candidate for organ donation? 46 00:02:24,450 --> 00:02:25,830 Not sure. 47 00:02:25,830 --> 00:02:27,120 Then why is Robby keeping him here? 48 00:02:27,120 --> 00:02:28,410 I don't know. 49 00:02:28,410 --> 00:02:30,210 Maybe he sees something we don't. 50 00:02:30,210 --> 00:02:32,250 Or maybe he's hoping for something that isn't there. 51 00:02:32,250 --> 00:02:34,040 What's there is an 18-year-old kid 52 00:02:34,040 --> 00:02:36,000 - named Nick Bradley. - Yeah, is he though? 53 00:02:36,010 --> 00:02:37,130 I don't mean to be a dick, but-- 54 00:02:37,130 --> 00:02:38,550 You just can't help it? 55 00:02:38,550 --> 00:02:40,220 No, as sad as it is, that kid is gone. 56 00:02:40,220 --> 00:02:41,840 and if we get him upstairs to the ICU, 57 00:02:41,840 --> 00:02:43,300 we can use that bed to actually help somebody. 58 00:02:43,300 --> 00:02:45,010 Robby is helping somebody. 59 00:02:45,010 --> 00:02:46,810 He's helping two people, in fact. 60 00:02:46,810 --> 00:02:49,810 They're in there right now praying over their dead son. 61 00:02:49,810 --> 00:02:51,690 They just haven't let their hearts accept it yet. 62 00:02:51,690 --> 00:02:55,150 Jesus, 9:00, you're already bumming me out. 63 00:02:55,150 --> 00:02:56,570 OK, let's see. 64 00:02:56,570 --> 00:02:58,190 Who's up next at the deli of death? 65 00:02:58,190 --> 00:03:00,240 Weak and dizzy. No, thanks. 66 00:03:00,240 --> 00:03:02,490 Flank pain. Need a UA first. 67 00:03:02,490 --> 00:03:03,870 And buttock abscess. 68 00:03:03,870 --> 00:03:05,530 Great teaching case for a student. 69 00:03:05,530 --> 00:03:07,330 Don't make me tell Robby you're cherry picking. 70 00:03:07,330 --> 00:03:12,540 I'll take projectile vomiting in North 5 for 200, Alex. 71 00:03:12,540 --> 00:03:14,830 What do you think the chances are it's a demonic possession? 72 00:03:14,840 --> 00:03:16,090 About the same as you going a whole hour 73 00:03:16,090 --> 00:03:18,300 without saying something stupid. 74 00:03:18,300 --> 00:03:20,010 For Christ's sakes, go already. 75 00:03:20,010 --> 00:03:23,090 You're like having a kid I never wanted. 76 00:03:23,090 --> 00:03:25,220 How are you feeling? Any pain, Minu? 77 00:03:32,690 --> 00:03:35,020 No pain, but I'm thirsty. 78 00:03:35,020 --> 00:03:37,150 Oh, nothing to drink before your surgery, 79 00:03:37,150 --> 00:03:39,940 but we can get you some lemon swabs. 80 00:03:47,620 --> 00:03:49,660 Thank you. 81 00:03:52,460 --> 00:03:54,000 Excuse me? 82 00:03:54,000 --> 00:03:57,130 When are you due? 83 00:03:59,000 --> 00:04:00,170 You can always tell. 84 00:04:01,260 --> 00:04:02,760 Congratulations. 85 00:04:02,760 --> 00:04:04,260 Thanks. 86 00:04:13,730 --> 00:04:16,690 How long before we might expect to see some improvement? 87 00:04:16,690 --> 00:04:18,650 It could be hours. It could be days. 88 00:04:18,650 --> 00:04:20,320 It could be never. 89 00:04:20,320 --> 00:04:23,030 I don't expect anything for a little while. 90 00:04:23,030 --> 00:04:24,490 Why don't you guys go get a cup of coffee 91 00:04:24,490 --> 00:04:26,110 in the cafeteria, maybe something to eat? 92 00:04:26,120 --> 00:04:27,450 I'll have a nurse call you if anything changes 93 00:04:27,450 --> 00:04:29,530 - while you're out. - Thank you. 94 00:04:29,540 --> 00:04:31,120 We appreciate that. 95 00:04:31,120 --> 00:04:32,540 - I'm not leaving. - Suit yourself. 96 00:04:32,540 --> 00:04:33,910 I'm gonna get a cup of coffee. 97 00:04:33,910 --> 00:04:35,120 I got to call Sarah and the kids. 98 00:04:35,120 --> 00:04:36,250 Cafeteria? 99 00:04:36,250 --> 00:04:37,670 Straight down that hallway, 100 00:04:37,670 --> 00:04:39,170 through the corridor, and to the right. 101 00:04:39,170 --> 00:04:41,460 Thanks, and I'm-- I'm sorry 102 00:04:41,460 --> 00:04:43,970 if my sister comes across a little strident. 103 00:04:43,970 --> 00:04:47,340 It's OK. This isn't easy. 104 00:04:51,640 --> 00:04:54,230 The parents of teen overdose, Lily and John Bradley, 105 00:04:54,230 --> 00:04:56,640 are asking about the tests you told them about. 106 00:04:56,650 --> 00:04:58,810 - OK, I'll be right there. - What about the rats? 107 00:04:58,810 --> 00:05:00,440 What about them? 108 00:05:00,440 --> 00:05:02,110 - Have they been caught? - I have no idea. 109 00:05:02,110 --> 00:05:04,440 - Well, find out. - Not sure that's my job. 110 00:05:04,450 --> 00:05:07,320 You're in charge of the ER. The rats are in the ER. 111 00:05:07,320 --> 00:05:09,240 That makes you in charge of the rats, 112 00:05:09,240 --> 00:05:11,580 and I have a strict rule about vermin in the workplace. 113 00:05:11,580 --> 00:05:13,000 Good to know. 114 00:05:16,330 --> 00:05:18,290 Could I get your eyes on a sickle cell crisis in South 20? 115 00:05:18,290 --> 00:05:20,170 Headed that way right now. 116 00:05:20,170 --> 00:05:22,170 ICU is insisting they still don't have rooms available. 117 00:05:22,170 --> 00:05:24,880 Bullshit. Esme recon'd for me. 118 00:05:24,880 --> 00:05:26,380 Send our electrocution, Victor Hunt, up there 119 00:05:26,380 --> 00:05:28,470 until the OR is ready please. Thank you. 120 00:05:32,720 --> 00:05:34,850 - Third epi on board? - Three minutes ago. 121 00:05:34,850 --> 00:05:36,770 How long has he been going at it? 122 00:05:36,770 --> 00:05:39,650 10 minutes in here, possibly 30 minutes of prior downtime. 123 00:05:39,650 --> 00:05:42,400 Don't suppose you'd let me try a pericardiocentesis? 124 00:05:42,400 --> 00:05:45,150 - For what? - For practice. 125 00:05:45,150 --> 00:05:48,070 - In case it's tamponade. - None seen on ultrasound. 126 00:05:48,070 --> 00:05:50,570 - This is a teaching hospital. - It's not a cadaver lab. 127 00:05:50,570 --> 00:05:52,330 What do you call this? 128 00:05:54,330 --> 00:05:57,040 - Do you need a break? - I'm fine. 129 00:05:57,040 --> 00:05:59,580 You don't look fine. 130 00:05:59,580 --> 00:06:02,090 Hold compressions. 131 00:06:03,630 --> 00:06:05,920 Still no rhythm. 132 00:06:05,920 --> 00:06:08,170 OK, Whitaker, I think that's enough. 133 00:06:08,180 --> 00:06:10,840 It's been four minutes since the last epi. 134 00:06:10,840 --> 00:06:12,470 One more minute, please. 135 00:06:18,600 --> 00:06:21,480 Help me, please help! Somebody help! 136 00:06:21,480 --> 00:06:23,150 - Please, my friend needs help. - What happened? 137 00:06:23,150 --> 00:06:25,190 - My friend. - Hey, where is she? 138 00:06:25,190 --> 00:06:26,360 My friend, she's in my car. 139 00:06:26,360 --> 00:06:27,900 - She won't wake up. - OK. 140 00:06:27,900 --> 00:06:29,740 OK, Mateo, gurney! 141 00:06:35,870 --> 00:06:37,830 - What's her name? - Jenna. 142 00:06:37,830 --> 00:06:39,460 Come on, Jenna. 143 00:06:39,460 --> 00:06:42,330 Wake up for me, baby. 144 00:06:44,420 --> 00:06:46,210 Pupils pinpoint. I need-- 145 00:06:46,210 --> 00:06:48,260 - Narcan. - Yeah. 146 00:06:48,260 --> 00:06:52,090 Hold her head back, Javadi. OK. 147 00:07:02,060 --> 00:07:04,440 Not responding to Narcan. We might need to intubate. 148 00:07:04,440 --> 00:07:06,770 Find a room and open a crash cart. 149 00:07:06,780 --> 00:07:09,860 I can't find a carotid pulse. 150 00:07:09,860 --> 00:07:12,780 Five minutes since the last epi. 151 00:07:12,780 --> 00:07:15,530 OK, that's it. 152 00:07:15,530 --> 00:07:16,910 Hold compressions. 153 00:07:34,970 --> 00:07:39,270 Welcome back. She's OK. 154 00:07:41,890 --> 00:07:46,650 He took his wife out for dinner last night, 155 00:07:46,650 --> 00:07:48,480 for her birthday. 156 00:07:48,480 --> 00:07:50,030 OK, why doesn't everybody take a minute? 157 00:07:50,030 --> 00:07:51,570 Go check on your other patients. 158 00:07:51,570 --> 00:07:54,860 We'll meet back here to debrief with Kiara. 159 00:07:54,870 --> 00:07:56,780 - Bed four. - Where the hell am I? 160 00:07:56,780 --> 00:07:57,870 Pittsburgh Trauma Medical Center. 161 00:07:57,870 --> 00:07:59,200 Why? 162 00:07:59,200 --> 00:08:00,620 Your friend couldn't wake you. 163 00:08:00,620 --> 00:08:01,910 I'm right here, Jenna. 164 00:08:01,910 --> 00:08:03,250 Came to with one spray of Narcan. 165 00:08:03,250 --> 00:08:05,370 - What'd you take, Jenna? - Nothing. 166 00:08:05,380 --> 00:08:07,540 You had to have taken something to cause this. 167 00:08:07,540 --> 00:08:09,550 No, I was just up late studying, 168 00:08:09,550 --> 00:08:11,090 and I just couldn't fall asleep. 169 00:08:11,090 --> 00:08:12,970 So you took something to help you sleep? 170 00:08:12,970 --> 00:08:16,090 We need to know in order to treat you properly, OK? 171 00:08:16,090 --> 00:08:18,850 - Do you know what she took? - No. 172 00:08:18,850 --> 00:08:20,680 This could be a sign of something really serious, 173 00:08:20,680 --> 00:08:22,140 and we're gonna have to do a lot of tests that you-- 174 00:08:22,140 --> 00:08:23,520 OK, I took, like, half a Xanax. 175 00:08:23,520 --> 00:08:25,810 That's not nothing. 176 00:08:25,810 --> 00:08:28,440 It's OK. OK? 177 00:08:28,440 --> 00:08:31,440 - Have you taken Xanax before? - First time. 178 00:08:31,440 --> 00:08:34,110 OK. 179 00:08:34,110 --> 00:08:36,660 Take a deep breath for me. 180 00:08:40,120 --> 00:08:41,990 Come on, man. You heard Dr. Robby. 181 00:08:42,000 --> 00:08:44,250 Let's take a break. Grab a coffee. 182 00:08:44,250 --> 00:08:46,750 No, I'm fine, thank you. 183 00:09:03,680 --> 00:09:06,060 Did you know him? 184 00:09:06,060 --> 00:09:08,850 No, I didn't. Did you? 185 00:09:08,860 --> 00:09:11,110 I just met him. 186 00:09:11,110 --> 00:09:13,780 He was my first patient to die. 187 00:09:13,780 --> 00:09:17,030 I'm sorry. 188 00:09:22,490 --> 00:09:24,620 - Are you OK? - Mm-hmm, yeah. 189 00:09:24,620 --> 00:09:27,670 - You sure? - Yeah. Just I-- 190 00:09:27,670 --> 00:09:32,590 I just remember the first time that-- 191 00:09:32,590 --> 00:09:35,590 on occasion, I have an emotional response to death. 192 00:09:35,590 --> 00:09:37,090 It's-- 193 00:09:37,090 --> 00:09:39,390 Got to be kind of tough for a doctor. 194 00:09:39,390 --> 00:09:42,100 At times, it can be. 195 00:09:44,890 --> 00:09:48,060 At least I'm not a pathologist. 196 00:09:49,020 --> 00:09:50,690 I was joking. I-- 197 00:09:50,690 --> 00:09:52,060 Oh. 198 00:09:52,070 --> 00:09:55,230 I have nothing against pathologists. 199 00:09:55,240 --> 00:09:58,860 Yeah, no. 200 00:09:58,860 --> 00:10:01,410 New radiodensity in the right middle lobe. 201 00:10:01,410 --> 00:10:03,080 Is it pneumonia? 202 00:10:03,080 --> 00:10:04,910 Possibly, or just changes from vaso-occlusion 203 00:10:04,910 --> 00:10:06,330 of the sickle cells. 204 00:10:06,330 --> 00:10:07,710 It's called acute chest syndrome. 205 00:10:07,710 --> 00:10:09,210 We're gonna cover you with antibiotics 206 00:10:09,210 --> 00:10:10,540 just to be on the safe side. 207 00:10:10,540 --> 00:10:12,210 We've been through this before. 208 00:10:12,210 --> 00:10:15,050 Third generation cephalosporin and a macrolide. 209 00:10:15,050 --> 00:10:18,420 Perfect. You're in good hands. 210 00:10:18,430 --> 00:10:21,300 - Can I do a chest tube? - Which patient? 211 00:10:21,300 --> 00:10:22,800 Any. 212 00:10:22,800 --> 00:10:24,430 I've just never done a chest tube before. 213 00:10:24,430 --> 00:10:26,640 Are you really asking me to reserve 214 00:10:26,640 --> 00:10:30,270 any incoming injury requiring a chest tube for you? 215 00:10:30,270 --> 00:10:31,730 Not all of them. 216 00:10:31,730 --> 00:10:33,730 I'd be more than happy just doing one, 217 00:10:33,730 --> 00:10:35,440 but, hey, if you wanted to give me more, 218 00:10:35,440 --> 00:10:37,530 I'd be fine with that, too, but that's up to you. 219 00:10:37,530 --> 00:10:39,110 I'm down for anything. 220 00:10:39,110 --> 00:10:42,160 Confidence and ambition are great attributes, 221 00:10:42,160 --> 00:10:46,410 especially when paired with respect and humility. 222 00:10:46,410 --> 00:10:50,120 OK, what else? What else went well? 223 00:10:50,120 --> 00:10:52,460 We checked for reversible causes 224 00:10:52,460 --> 00:10:54,000 of cardiac arrest on ultrasound. 225 00:10:54,000 --> 00:10:56,000 OK, good. 226 00:10:56,000 --> 00:10:57,960 Does anybody have anything that they wish had gone differently? 227 00:10:57,960 --> 00:11:00,340 In the hall, he should have been on a cardiac monitor. 228 00:11:00,340 --> 00:11:01,840 We would have caught the arrest right away. 229 00:11:01,840 --> 00:11:03,430 That's true, 230 00:11:03,430 --> 00:11:05,260 but there was no indication for monitoring. 231 00:11:05,260 --> 00:11:07,310 And we now know that his abdominal pain 232 00:11:07,310 --> 00:11:09,680 was not from his gallstones but from unstable angina 233 00:11:09,690 --> 00:11:11,600 due to coronary artery disease. 234 00:11:11,600 --> 00:11:13,480 Then we should have admitted to cardiology. 235 00:11:13,480 --> 00:11:16,440 Mm, we did an EKG. We did a troponin. 236 00:11:16,440 --> 00:11:18,320 He had a HEART score of three. 237 00:11:18,320 --> 00:11:19,740 Who can tell me what that means? 238 00:11:19,740 --> 00:11:21,820 1% chance of an adverse cardiac event 239 00:11:21,820 --> 00:11:23,240 in the next 30 days. 240 00:11:23,240 --> 00:11:25,200 Standard of care is to discharge 241 00:11:25,200 --> 00:11:26,910 with outpatient follow-up. 242 00:11:28,500 --> 00:11:29,870 He was your patient, Dr. Whitaker. 243 00:11:29,870 --> 00:11:31,580 Would you like to say something before 244 00:11:31,580 --> 00:11:35,330 we all take a brief moment of silent reflection? 245 00:11:35,340 --> 00:11:38,050 Um... 246 00:11:38,050 --> 00:11:40,380 He liked Kentucky bourbon. 247 00:11:40,380 --> 00:11:42,170 OK, good. 248 00:11:42,180 --> 00:11:43,680 Me too. 249 00:11:43,680 --> 00:11:45,640 - Anything else? - I don't know. 250 00:11:45,640 --> 00:11:48,350 I just met him. 251 00:11:48,350 --> 00:11:50,600 No, he seemed nice. 252 00:11:50,600 --> 00:11:52,890 He was married. 253 00:11:52,890 --> 00:11:56,110 Um, that's it. That's all I got. I-- 254 00:11:57,770 --> 00:11:59,150 Mm. 255 00:12:00,400 --> 00:12:03,030 I spoke with his wife. She's on her way here. 256 00:12:03,030 --> 00:12:05,530 If anyone needs to talk about this some more, 257 00:12:05,530 --> 00:12:07,780 I'm available. 258 00:12:07,780 --> 00:12:09,700 For now, let's harness some good thoughts 259 00:12:09,700 --> 00:12:11,540 here for Mr. Milton. 260 00:12:22,470 --> 00:12:24,800 OK, that's it. 261 00:12:24,800 --> 00:12:26,390 Let's go save some lives. 262 00:12:29,010 --> 00:12:32,020 Hey, Whitaker. 263 00:12:34,690 --> 00:12:37,690 How are you feeling on this? 264 00:12:37,690 --> 00:12:40,400 I mean, not good. I was just talking to him. 265 00:12:40,400 --> 00:12:41,860 Now he's dead. 266 00:12:41,860 --> 00:12:43,240 That's the hardest way to lose a patient. 267 00:12:43,240 --> 00:12:44,450 It always hurts. 268 00:12:44,450 --> 00:12:46,070 Especially when it's your fault. 269 00:12:46,070 --> 00:12:48,450 This was not your fault. This was nobody's fault. 270 00:12:48,450 --> 00:12:50,660 No doctor on the planet could have caught this. 271 00:12:50,660 --> 00:12:52,620 Listen, it sucks, 272 00:12:52,620 --> 00:12:56,960 but today, today was this guy's day to leave this mortal coil. 273 00:12:56,960 --> 00:12:59,170 150,000 people die every day in the world, 274 00:12:59,170 --> 00:13:02,170 and you got one of them, but you learn to live with it, 275 00:13:02,170 --> 00:13:04,260 and you learn to accept it as much as your own mortality 276 00:13:04,260 --> 00:13:05,880 and find balance if you can. 277 00:13:05,880 --> 00:13:07,720 You've found balance? 278 00:13:07,720 --> 00:13:09,600 No, not even close. 279 00:13:09,600 --> 00:13:14,930 But, you know, you keep trying, which is all you can do. 280 00:13:14,940 --> 00:13:17,690 You're doing great, Whitaker. 281 00:13:17,690 --> 00:13:20,400 - Just, you know, hang in there. - Yeah, thanks. 282 00:13:20,400 --> 00:13:21,610 OK. 283 00:13:21,610 --> 00:13:23,360 - I'm just gonna go. - Yeah. 284 00:13:23,360 --> 00:13:25,400 But, you know, our social worker, Kiara, 285 00:13:25,400 --> 00:13:28,610 is here if you want to talk. 286 00:13:28,620 --> 00:13:30,490 OK, yeah. 287 00:13:33,250 --> 00:13:34,700 OK. 288 00:13:34,700 --> 00:13:37,210 You're gonna recover, OK? 289 00:13:37,210 --> 00:13:38,830 Good luck. 290 00:13:38,830 --> 00:13:41,040 Wait, what happens now? 291 00:13:41,040 --> 00:13:42,420 We monitor her heart and breathing 292 00:13:42,420 --> 00:13:43,590 for the next few hours to make sure 293 00:13:43,590 --> 00:13:44,800 she doesn't need more Narcan. 294 00:13:44,800 --> 00:13:46,880 - That's it? - Yeah. 295 00:13:46,880 --> 00:13:49,090 You should text your friends. 296 00:13:49,090 --> 00:13:51,470 Hell, you should text your whole college. 297 00:13:51,470 --> 00:13:53,010 Tell anyone who will listen 298 00:13:53,010 --> 00:13:54,600 to not take pills without a real prescription 299 00:13:54,600 --> 00:13:56,560 unless they want to end up here. 300 00:13:57,980 --> 00:13:59,810 Seriously, fentanyl is everywhere. 301 00:13:59,810 --> 00:14:01,310 It's in everything on the street these days. 302 00:14:03,650 --> 00:14:05,400 How long would I monitor her pupils for? 303 00:14:05,400 --> 00:14:06,780 You know what, actually, I should go to the bathroom. 304 00:14:06,780 --> 00:14:08,280 Are you OK on your own till I get back? 305 00:14:08,280 --> 00:14:09,360 Absolutely. Take your time. 306 00:14:09,360 --> 00:14:10,700 OK, great. Thanks. 307 00:14:13,580 --> 00:14:15,370 Sometimes I come on too strong. 308 00:14:15,370 --> 00:14:17,000 Excuse me? 309 00:14:17,000 --> 00:14:20,250 It's a defense mechanism against insecurity. 310 00:14:20,250 --> 00:14:23,380 - You're kidding, right? - Yeah. 311 00:14:23,380 --> 00:14:25,130 But I am sorry if I hurt your feelings. 312 00:14:25,130 --> 00:14:27,010 I really-- I want us to get along. 313 00:14:27,010 --> 00:14:29,380 I want us to be friends. 314 00:14:29,380 --> 00:14:30,720 And if I'm really being honest, 315 00:14:30,720 --> 00:14:32,340 I want your mother to write me 316 00:14:32,350 --> 00:14:33,800 a kickass recommendation letter. 317 00:14:33,810 --> 00:14:35,470 You're going into general surgery. 318 00:14:35,470 --> 00:14:39,390 I might. I'm keeping my options open. 319 00:14:39,390 --> 00:14:40,900 You want me to pimp out my mother 320 00:14:40,900 --> 00:14:43,400 for something you might do? 321 00:14:43,400 --> 00:14:46,570 OK, well, when you put it like that, it sounds dirty, 322 00:14:46,570 --> 00:14:49,070 and a little hot, but yes. 323 00:14:49,070 --> 00:14:52,200 In full disclosure, so we can be friends. 324 00:14:52,200 --> 00:14:55,030 - Friends? - You've heard of the concept? 325 00:14:55,040 --> 00:14:58,160 Buddies, compatriots, confidants, pals. 326 00:14:58,160 --> 00:15:00,710 - They even made a show about it. - Yeah. 327 00:15:00,710 --> 00:15:04,210 Boom. Come on. 328 00:15:04,210 --> 00:15:06,840 Don't leave me hanging, Crash. Pound that shit. 329 00:15:06,840 --> 00:15:10,510 I can call you that now that we're friends, right? 330 00:15:12,430 --> 00:15:14,640 - OK. - We'll work on that. 331 00:15:16,470 --> 00:15:20,100 So for the apnea test, we keep him on 100% oxygen, 332 00:15:20,100 --> 00:15:22,230 but the ventilator won't be giving him breaths. 333 00:15:22,230 --> 00:15:24,480 - For how long? - For 10 minutes. 334 00:15:24,480 --> 00:15:26,570 We'll monitor his carbon dioxide levels, 335 00:15:26,570 --> 00:15:28,360 and if they come back way too high, 336 00:15:28,360 --> 00:15:29,940 then we'll know that his brain stem 337 00:15:29,950 --> 00:15:33,280 - is not telling him to breathe. - And that means? 338 00:15:33,280 --> 00:15:36,160 That would mean that there's no brain function 339 00:15:36,160 --> 00:15:38,120 at the most fundamental level. 340 00:15:39,540 --> 00:15:42,580 Princess will monitor him, and I will come back as soon 341 00:15:42,580 --> 00:15:44,580 as we know the test results. 342 00:15:44,580 --> 00:15:46,500 - OK. - Yeah. 343 00:15:46,500 --> 00:15:49,210 OK. 344 00:15:55,100 --> 00:15:56,550 I hate this fucking hospital. 345 00:15:56,550 --> 00:15:57,970 This is Hank. 346 00:15:57,970 --> 00:16:00,140 - What happened? - Nothing. 347 00:16:00,140 --> 00:16:03,560 We were just framing, and then my buddy Joey comes in. 348 00:16:03,560 --> 00:16:06,400 He says, "A guy walks into a bar with a nail in his head," 349 00:16:06,400 --> 00:16:08,820 and then he points his fucking nail gun at my head. 350 00:16:08,820 --> 00:16:10,400 So what would you do? 351 00:16:10,400 --> 00:16:13,650 So I freaked out, and then in the ensuing melee, 352 00:16:13,660 --> 00:16:16,990 - he fucking shoots me. - Melee? 353 00:16:16,990 --> 00:16:19,990 Yeah, you know, like a scuffle, like a donnybrook. 354 00:16:20,000 --> 00:16:21,700 What, you think because I work construction, 355 00:16:21,710 --> 00:16:23,910 not a hospital, I don't have a fucking vocabulary? 356 00:16:23,920 --> 00:16:25,540 Tier one trauma now. 357 00:16:25,540 --> 00:16:26,630 - No, sir, I-- - Whoa. 358 00:16:26,630 --> 00:16:28,340 Definitely intracardiac. 359 00:16:28,340 --> 00:16:30,300 And I got to tell you, this fucking hurts. 360 00:16:30,300 --> 00:16:32,630 Let's just try and relax and dial down the F bombs. 361 00:16:32,630 --> 00:16:34,970 - We have children in here. - You want me to stop swearing? 362 00:16:34,970 --> 00:16:36,800 Take the fucking nail out of my heart. 363 00:16:36,800 --> 00:16:38,350 And, please, something for the pain! 364 00:16:38,350 --> 00:16:39,890 Stabilize the nail. 365 00:16:39,890 --> 00:16:40,930 Hank, we need to cut your shirt off. 366 00:16:40,930 --> 00:16:42,600 Fuck that. 367 00:16:42,600 --> 00:16:44,230 You cut the shirt, you're gonna buy me a new one. 368 00:16:44,230 --> 00:16:46,650 You can have your pick out of our lost and found. 369 00:16:46,650 --> 00:16:48,480 Whew, how did this happen? 370 00:16:48,480 --> 00:16:50,480 Framing nail incident with deep penetration 371 00:16:50,480 --> 00:16:52,650 - of the left chest. - The fuck does it look like? 372 00:16:52,650 --> 00:16:54,150 Hank, do you take medicine every day? 373 00:16:54,150 --> 00:16:56,110 Any allergies to medication? 374 00:16:56,110 --> 00:16:58,030 No. Can you give me something for the fucking pain already? 375 00:16:58,030 --> 00:16:59,870 Is this a hospital or a vet clinic? 376 00:16:59,870 --> 00:17:01,450 Very soon, Hank. Very soon. 377 00:17:01,450 --> 00:17:03,370 I bet you say that to the beagles too. 378 00:17:03,370 --> 00:17:06,330 Pulse 120. BP 100 over 65. 379 00:17:06,330 --> 00:17:08,130 Two milligrams of morphine. 380 00:17:08,130 --> 00:17:10,380 Liver GSW is in recovery. He's good as new. 381 00:17:10,380 --> 00:17:11,840 Whoa, that looks intracardiac. 382 00:17:11,840 --> 00:17:14,380 - Nailed it. - Whoa, you got jokes now. 383 00:17:14,380 --> 00:17:16,380 No jokes, just pushing your pain meds, buddy. 384 00:17:16,380 --> 00:17:19,510 Small pericardial effusion, but no evidence of tamponade. 385 00:17:19,510 --> 00:17:21,350 - Not yet. - Somebody talk to me. 386 00:17:21,350 --> 00:17:22,890 Do I need a priest here? 387 00:17:22,890 --> 00:17:24,350 He's tachycardic with borderline BP. 388 00:17:24,350 --> 00:17:25,680 He could decompensate. 389 00:17:25,690 --> 00:17:27,100 Standby with two units whole blood. 390 00:17:27,100 --> 00:17:29,270 Garcia here. Stat cardiac case. 391 00:17:29,270 --> 00:17:31,400 Am I dying here and nobody's telling me? 392 00:17:31,400 --> 00:17:33,480 Hank, there is blood collecting 393 00:17:33,490 --> 00:17:34,900 in the sac around your heart. 394 00:17:34,900 --> 00:17:36,700 You need surgery before your heart stops 395 00:17:36,700 --> 00:17:38,070 from the pressure around it. 396 00:17:38,070 --> 00:17:39,620 Just pull the fucking nail out! 397 00:17:39,620 --> 00:17:41,280 That would definitely kill you. 398 00:17:41,280 --> 00:17:44,540 I want a second opinion. Where's my fucking phone? 399 00:17:44,540 --> 00:17:47,080 I can Uber to Presby and find a real hospital. 400 00:17:47,080 --> 00:17:48,500 OR can take him in 10 minutes. 401 00:17:48,500 --> 00:17:50,330 Mind if we intubate him first? 402 00:17:50,340 --> 00:17:52,090 The sooner the better for all of us. 403 00:17:52,090 --> 00:17:54,840 Great. 120 of sux, 100 of ketamine. 404 00:17:54,840 --> 00:17:57,170 - Javadi, you're up for this one. - Really? 405 00:17:57,180 --> 00:17:58,930 Now. Let's go. Move. 406 00:17:58,930 --> 00:18:01,010 Code STEMI, ETA five minutes. 407 00:18:01,010 --> 00:18:03,930 Code STEMI, ETA five minutes. 408 00:18:03,930 --> 00:18:05,600 I can start the STEMI with Mel. 409 00:18:05,600 --> 00:18:07,520 - Sounds good. - This place sucks. 410 00:18:07,520 --> 00:18:09,730 I will destroy you on Yelp. 411 00:18:09,730 --> 00:18:11,860 Nobody's ever coming to this shithole again. 412 00:18:11,860 --> 00:18:13,190 I swear to God. 413 00:18:13,190 --> 00:18:15,610 From your mouth to God's ear. 414 00:18:15,610 --> 00:18:17,990 Kiara? Hi. I'm Dr. Melissa King. 415 00:18:17,990 --> 00:18:21,620 - Everyone calls me Mel. - Yes, we met. 416 00:18:22,780 --> 00:18:26,700 Right, um, I wanted to ask you 417 00:18:26,700 --> 00:18:30,290 about Tyler, the little boy who ate the marijuana gummy. 418 00:18:30,290 --> 00:18:32,710 He's been admitted to pediatrics for observation. 419 00:18:32,710 --> 00:18:35,550 - And his parents? - They're upstairs with him. 420 00:18:35,550 --> 00:18:38,340 CYF is going to follow up with a home visit just to be safe, 421 00:18:38,340 --> 00:18:40,800 but no police were involved. Don't worry. 422 00:18:40,800 --> 00:18:42,550 No one is taking their child away from them. 423 00:18:42,550 --> 00:18:44,010 Good. That's a relief. 424 00:18:44,010 --> 00:18:45,510 Yeah, the parents, on the other hand, 425 00:18:45,520 --> 00:18:47,600 may need couples counseling after this, 426 00:18:47,600 --> 00:18:50,060 but I think little Tyler's going to be fine. 427 00:18:50,060 --> 00:18:52,730 - STEMI with me, Mel. - Right behind you. 428 00:18:52,730 --> 00:18:55,730 - Dana, what's open? - Trauma two. 429 00:18:55,730 --> 00:18:57,530 All right, keep it that way. 430 00:18:57,530 --> 00:19:01,110 Our target door to balloon time for STEMIs is 51 minutes. 431 00:19:01,110 --> 00:19:02,660 Ambitious. 432 00:19:02,660 --> 00:19:05,490 But doable, as you're about to find out. 433 00:19:05,490 --> 00:19:07,580 Let's go. 434 00:19:10,250 --> 00:19:12,370 Good view of the glottis. 435 00:19:12,380 --> 00:19:14,920 Eyes off the screen. 436 00:19:14,920 --> 00:19:18,420 Now look down the mouth and insert 437 00:19:18,420 --> 00:19:21,510 the tube around the bend. 438 00:19:21,510 --> 00:19:24,220 You stole my med student from triage? 439 00:19:24,220 --> 00:19:26,470 - How's she doing over here? - She's doing pretty good. 440 00:19:26,470 --> 00:19:29,220 Now look back at the screen. 441 00:19:29,230 --> 00:19:31,980 And advance through the cords. 442 00:19:34,110 --> 00:19:36,770 Good. Good job. 443 00:19:36,770 --> 00:19:38,740 Thanks. 444 00:19:40,280 --> 00:19:42,860 Pressure's down. 72/38. 445 00:19:45,240 --> 00:19:48,370 Effusion has grown, now with the RV collapse. 446 00:19:48,370 --> 00:19:50,040 Pericardiocentesis? 447 00:19:50,040 --> 00:19:51,910 Let's get another unit on that infuser. 448 00:19:51,920 --> 00:19:54,040 Prep for thoracotomy. Coming through. 449 00:19:54,040 --> 00:19:55,420 We should get back to triage. 450 00:19:55,420 --> 00:19:56,960 You don't want to stay for this? 451 00:19:56,960 --> 00:19:58,340 There are like 30 patients still waiting 452 00:19:58,340 --> 00:20:02,130 - to be assessed out there. - OK. 453 00:20:02,130 --> 00:20:04,680 - Did someone say thoracotomy? - Crashing from tamponade. 454 00:20:04,680 --> 00:20:06,260 Dr. Garcia, do you think I-- 455 00:20:06,260 --> 00:20:08,510 Trauma Surgery gets left sided thoracotomies. 456 00:20:08,510 --> 00:20:11,520 ED gets the right if we need to extend. 457 00:20:13,020 --> 00:20:15,060 Glove up, girl. You're on suction. 458 00:20:15,060 --> 00:20:17,980 Let's advance that ET tube to the right main stem please. 459 00:20:17,980 --> 00:20:19,820 Ten blade. 460 00:20:28,160 --> 00:20:29,790 Metz. 461 00:20:29,790 --> 00:20:31,870 Dr. Santos, how do we cut through the intercostals? 462 00:20:31,870 --> 00:20:34,790 Through the superior rib to avoid the neurovascular bundle. 463 00:20:34,790 --> 00:20:37,460 - That is correct. - Finochietto retractor. 464 00:20:41,460 --> 00:20:42,880 Full suction. 465 00:20:42,880 --> 00:20:45,220 And get rid of this nail before I get poked. 466 00:20:45,220 --> 00:20:47,600 On it. 467 00:20:50,970 --> 00:20:54,180 Nail's intact in one piece. 468 00:20:54,190 --> 00:20:57,980 Toothed forceps. Opening the pericardium. 469 00:20:57,980 --> 00:20:59,650 This is so fucking cool. 470 00:20:59,650 --> 00:21:01,730 Dr. Santos, you and this patient 471 00:21:01,730 --> 00:21:03,740 share a common vocabulary. 472 00:21:03,740 --> 00:21:05,740 Yeah, I swear a lot. I know. I'm sorry. 473 00:21:05,740 --> 00:21:07,740 They say it's a sign of intelligence. 474 00:21:07,740 --> 00:21:10,370 I think it shows a lack of self-control. 475 00:21:10,370 --> 00:21:11,990 But what the fuck do I know? 476 00:21:12,000 --> 00:21:14,000 Single puncture wound to the left ventricle. 477 00:21:14,000 --> 00:21:16,420 We've got a finger on it. 478 00:21:16,420 --> 00:21:19,000 First unit is in. Pressure's up. 479 00:21:19,000 --> 00:21:20,880 Heart is filling well. 480 00:21:20,880 --> 00:21:22,800 Throw in a horizontal mattress, and we're out of here. 481 00:21:22,800 --> 00:21:25,550 - Stop the bleed while I sew. - STEMI's arrived. 482 00:21:25,550 --> 00:21:27,050 You got this? 483 00:21:27,050 --> 00:21:28,800 Just wrapping him up for OR delivery. 484 00:21:28,800 --> 00:21:30,510 2-0 Prolene on a tapered needle. 485 00:21:30,510 --> 00:21:33,310 Mr. Ed Gellin is 52 years young 486 00:21:33,310 --> 00:21:35,430 with a history of hypertension and hyperlipidemia. 487 00:21:35,440 --> 00:21:37,480 20 minutes of substernal chest pain. 488 00:21:37,480 --> 00:21:39,650 10 out of 10 with dyspnea and diaphoresis. 489 00:21:39,650 --> 00:21:42,020 BP is 152 over 95. 490 00:21:42,030 --> 00:21:44,070 Currently chewing 324 mgs of baby aspirin. 491 00:21:44,070 --> 00:21:45,360 OK. 492 00:21:45,360 --> 00:21:46,820 Blood's drawn. Second IV started. 493 00:21:46,820 --> 00:21:48,280 BP stable. 494 00:21:48,280 --> 00:21:49,990 Seven millimeters ST elevation... 495 00:21:49,990 --> 00:21:51,660 - One nitro spray, sublingual. - In the anterior leads. 496 00:21:51,660 --> 00:21:53,240 Those are sometimes called tombstones. 497 00:21:53,240 --> 00:21:54,330 - Open up, sir. - Tombstones? 498 00:21:54,330 --> 00:21:55,410 Lift your tongue. 499 00:21:55,410 --> 00:21:56,790 Mr. Gellin, you're having 500 00:21:56,790 --> 00:21:58,330 a very big heart attack right now. 501 00:21:58,330 --> 00:22:00,170 Major artery that carries oxygen to your heart 502 00:22:00,170 --> 00:22:02,170 - is almost totally blocked. - That doesn't sound too good. 503 00:22:02,170 --> 00:22:03,590 No, it's not very good. 504 00:22:03,590 --> 00:22:05,340 We're gonna send you up to the cath lab. 505 00:22:05,340 --> 00:22:06,670 A cardiologist is gonna unblock that with a balloon 506 00:22:06,670 --> 00:22:08,130 and leave it open with a stent. 507 00:22:08,130 --> 00:22:09,470 But I'm still having a heart attack? 508 00:22:09,470 --> 00:22:11,090 If everything goes as planned, 509 00:22:11,100 --> 00:22:12,850 it'll be like you never had a heart attack. 510 00:22:12,850 --> 00:22:14,220 We're gonna put a catheter in this artery right here. 511 00:22:14,220 --> 00:22:15,640 We're gonna shave the hair with a clipper. 512 00:22:15,640 --> 00:22:17,350 Long as you stop short of a Brazilian. 513 00:22:17,350 --> 00:22:19,730 It's an option we offer. Costs a little bit more. 514 00:22:19,730 --> 00:22:21,440 A lot of people's insurance won't cover it. 515 00:22:21,440 --> 00:22:22,440 Don't make me laugh. 516 00:22:22,440 --> 00:22:23,440 - It hurts. - Deal. 517 00:22:23,440 --> 00:22:24,860 Anybody we can call? 518 00:22:24,860 --> 00:22:26,940 - My wife. - Already have her number. 519 00:22:26,940 --> 00:22:28,820 OK, we'll call her. You hang in there. 520 00:22:28,820 --> 00:22:30,910 I'll be right back. 521 00:22:34,830 --> 00:22:37,160 I think they finished the apnea test on Nick. 522 00:22:37,160 --> 00:22:39,000 - Can you check the results? - Not just yet. 523 00:22:39,000 --> 00:22:40,420 The blood test needs to go to the lab. 524 00:22:40,420 --> 00:22:42,210 It takes a few minutes to run the test. 525 00:22:42,210 --> 00:22:44,300 I'll come find you in the room as soon as it's done. 526 00:22:47,130 --> 00:22:49,880 Horizontal mattress in place with excellent hemostasis. 527 00:22:49,880 --> 00:22:51,260 Cut here. 528 00:22:53,760 --> 00:22:56,560 Moist, sterile towel. And away we go. 529 00:22:56,560 --> 00:22:59,390 I spoke to cardiothoracic. They can meet you in the OR. 530 00:22:59,390 --> 00:23:02,190 Good job. 531 00:23:02,190 --> 00:23:04,020 Coming through. 532 00:23:05,730 --> 00:23:08,150 Well done. Well done. 533 00:23:08,150 --> 00:23:10,700 - Good luck, Mr. Gellin. - Thank you so much. 534 00:23:10,700 --> 00:23:12,410 You're very welcome. 535 00:23:15,870 --> 00:23:19,540 Two saves. Totally awesome. 536 00:23:19,540 --> 00:23:21,830 I just held a beating human heart in my hands. 537 00:23:21,830 --> 00:23:23,500 We should celebrate. 538 00:23:23,500 --> 00:23:24,880 We should clean these rooms 539 00:23:24,880 --> 00:23:26,460 and bring some more patients back. 540 00:23:26,460 --> 00:23:28,380 - Sounds like a plan. - No rest for the wicked. 541 00:23:28,380 --> 00:23:31,630 - Code STEMI was fast. - Time is myocardium. 542 00:23:31,630 --> 00:23:34,470 And our statistics for door to balloon time 543 00:23:34,470 --> 00:23:36,220 get reviewed, critiqued, and published online. 544 00:23:36,220 --> 00:23:37,810 Door to balloon time? 545 00:23:37,810 --> 00:23:39,770 That's the time from when they hit our door 546 00:23:39,770 --> 00:23:42,060 to when the angioplasty balloon gets inflated in the cath lab. 547 00:23:42,060 --> 00:23:44,310 We keep it to under 51 minutes, we can reverse a heart attack 548 00:23:44,310 --> 00:23:45,770 and save a life. 549 00:23:45,770 --> 00:23:48,860 Kind of wish Mr. Milton had a STEMI. 550 00:23:48,860 --> 00:23:51,530 Thank you for letting me go the distance on him. 551 00:23:51,530 --> 00:23:53,660 I really thought we'd get him back, you know? 552 00:23:53,660 --> 00:23:55,280 Yeah, well, you know, even though 553 00:23:55,280 --> 00:23:56,530 you do everything right, you don't always 554 00:23:56,530 --> 00:23:58,620 get what you hope for. 555 00:24:00,870 --> 00:24:03,210 My parents both had sickle cell trait, 556 00:24:03,210 --> 00:24:06,460 and I was screened as a newborn with the hemoglobin FS pattern. 557 00:24:06,460 --> 00:24:09,090 - Did you take penicillin? - Mm-hmm, until I was five. 558 00:24:09,090 --> 00:24:10,960 Then the vaccines kicked in. 559 00:24:10,970 --> 00:24:13,340 She has her entire medical history on her phone. 560 00:24:13,340 --> 00:24:14,890 It's extremely long. 561 00:24:14,890 --> 00:24:16,220 Dr. Mohan, do you have a minute? 562 00:24:16,220 --> 00:24:18,310 Yep. Excuse me. 563 00:24:23,560 --> 00:24:24,900 Is there a problem over there? 564 00:24:24,900 --> 00:24:26,560 No, her pain is well controlled. 565 00:24:26,560 --> 00:24:28,270 You understand that's my polite way of asking 566 00:24:28,270 --> 00:24:30,070 why are you spending so much time with one patient? 567 00:24:30,070 --> 00:24:31,990 You're an R3. 568 00:24:31,990 --> 00:24:33,990 As an R3, you should be seeing at least two patients an hour. 569 00:24:33,990 --> 00:24:36,160 I have two, Joyce and Mr. Wallace, 570 00:24:36,160 --> 00:24:38,280 - our Good Samaritan. - Who's comatose and stable. 571 00:24:38,280 --> 00:24:40,040 You should have four by now. 572 00:24:40,040 --> 00:24:41,870 I have the highest patient satisfaction of anyone. 573 00:24:41,870 --> 00:24:43,160 I don't doubt it, 574 00:24:43,160 --> 00:24:44,540 but we just had this conversation 575 00:24:44,540 --> 00:24:45,790 a couple of hours ago. 576 00:24:45,790 --> 00:24:47,420 I know people call me Slow-Mo. 577 00:24:47,420 --> 00:24:49,250 You don't have to confirm or deny. 578 00:24:49,250 --> 00:24:52,550 It used to hurt my feelings a lot, but I can't help it. 579 00:24:52,550 --> 00:24:55,010 I work at the speed I'm comfortable at. 580 00:24:55,010 --> 00:24:58,140 Because you're afraid of making a mistake? 581 00:24:58,140 --> 00:24:59,550 I'm always afraid of making a mistake. 582 00:24:59,560 --> 00:25:00,560 - Aren't you? - Yeah, of course I am. 583 00:25:00,560 --> 00:25:02,020 But you know what I mean. 584 00:25:02,020 --> 00:25:03,640 You make a mistake once, and somebody dies, 585 00:25:03,640 --> 00:25:05,020 and you feel so badly about it, 586 00:25:05,020 --> 00:25:06,020 you'll never let it happen again-- 587 00:25:06,020 --> 00:25:07,230 How is that wrong? 588 00:25:07,230 --> 00:25:09,690 Because you waste time and money 589 00:25:09,690 --> 00:25:11,530 on unnecessary tests. 590 00:25:11,530 --> 00:25:14,150 You keep sick patients waiting too long. 591 00:25:14,150 --> 00:25:15,990 You miss out on cases you could be learning from. 592 00:25:15,990 --> 00:25:17,700 You shortchange your own education. 593 00:25:17,700 --> 00:25:19,370 I'm not saying this to be a hard-ass. 594 00:25:19,370 --> 00:25:20,870 I'm saying this because I know you could do this, 595 00:25:20,870 --> 00:25:22,620 but you need to do it at a level 596 00:25:22,620 --> 00:25:25,660 - I also know you're capable of. - And what if I'm not? 597 00:25:25,670 --> 00:25:26,870 Then you should look into a specialty 598 00:25:26,870 --> 00:25:28,080 that better suits you. 599 00:25:28,080 --> 00:25:29,920 Have you thought about psychiatry? 600 00:25:29,920 --> 00:25:31,040 I don't want to go into psychiatry. 601 00:25:31,050 --> 00:25:32,050 I want to be here. 602 00:25:32,050 --> 00:25:34,130 Being here means 603 00:25:34,130 --> 00:25:36,050 no matter how good you are or how hard you try, 604 00:25:36,050 --> 00:25:37,380 you're gonna make another mistake, 605 00:25:37,390 --> 00:25:39,090 and someone else might even die. 606 00:25:39,100 --> 00:25:43,010 That's called being an emergency medicine doctor. 607 00:25:43,020 --> 00:25:44,520 And if you can't accept that, 608 00:25:44,520 --> 00:25:45,850 then maybe this isn't the place for you. 609 00:25:45,850 --> 00:25:48,400 - I can accept that. - You sure? 610 00:25:48,400 --> 00:25:51,110 - Yes. - OK, good. 611 00:25:51,110 --> 00:25:53,440 Go save some lives. 612 00:25:53,440 --> 00:25:57,280 Clear some beds while you're at it. 613 00:25:57,280 --> 00:26:01,070 I would fancy a spot of tea at some point. 614 00:26:01,080 --> 00:26:03,540 You want some tea, darling? I'll get you some tea. 615 00:26:03,540 --> 00:26:07,120 - Oh, thank you, sweetheart. - Is Dr. Robby available? 616 00:26:07,120 --> 00:26:08,870 He's with a patient. Can I help? 617 00:26:08,870 --> 00:26:11,670 - My father's starting to move. - OK, I'll let him know. 618 00:26:11,670 --> 00:26:13,960 - Thanks. - Yeah. 619 00:26:13,960 --> 00:26:15,420 Is it good or bad? 620 00:26:15,420 --> 00:26:17,380 If there's no spontaneous breathing, 621 00:26:17,380 --> 00:26:20,510 then carbon dioxide levels rise above 60. 622 00:26:20,510 --> 00:26:23,930 So 82 definitely means that Nick's brainstem 623 00:26:23,930 --> 00:26:25,390 is not triggering him to breathe. 624 00:26:25,390 --> 00:26:26,930 Well, how can you fix that? 625 00:26:26,930 --> 00:26:29,060 We can't. I'm sorry. 626 00:26:29,060 --> 00:26:30,980 But with rest and time... 627 00:26:30,980 --> 00:26:33,650 This is not something that heals on its own. 628 00:26:33,650 --> 00:26:36,320 There's got to be something else that we can do. 629 00:26:36,320 --> 00:26:38,070 Nick is our only child. 630 00:26:38,070 --> 00:26:41,160 - Is that test 100% accurate? - It is. 631 00:26:41,160 --> 00:26:43,830 Isn't there anything else? 632 00:26:43,830 --> 00:26:45,990 We can do an imaging test called 633 00:26:46,000 --> 00:26:48,080 - a cerebral perfusion study. - Then let's do it. 634 00:26:48,080 --> 00:26:49,660 But you have to understand that will be the last test 635 00:26:49,670 --> 00:26:51,630 that we would do. 636 00:26:51,630 --> 00:26:54,170 If it comes back that there's no blood flow to Nick's brain, 637 00:26:54,170 --> 00:26:58,260 it would confirm beyond a shadow of a doubt 638 00:26:58,260 --> 00:27:01,640 that there's been brain death, 639 00:27:01,640 --> 00:27:04,850 which would mean that he's gone. 640 00:27:07,350 --> 00:27:10,900 Then we wait and see. 641 00:27:12,560 --> 00:27:14,400 Call Nuclear Medicine. See how soon they can take him. 642 00:27:14,400 --> 00:27:15,770 You got it. 643 00:27:15,780 --> 00:27:17,030 I'll be back in a few minutes. 644 00:27:17,030 --> 00:27:19,110 Thank you. 645 00:27:24,950 --> 00:27:28,160 Hey, Mr. Spencer in Central 9 tried to pull out his ET tube 646 00:27:28,160 --> 00:27:30,830 - and is now in soft restraints. - No surprise there. 647 00:27:30,830 --> 00:27:32,670 We need to up the propofol. 648 00:27:32,670 --> 00:27:35,170 And the sister of the dead MVC vet in the viewing room 649 00:27:35,170 --> 00:27:37,340 - just arrived in Chairs. - Can you, um-- 650 00:27:37,340 --> 00:27:39,550 - Park her in the family room? - Please. 651 00:27:39,550 --> 00:27:42,050 No problem, I'll have Perlah and Princess prep the body 652 00:27:42,050 --> 00:27:43,930 as best they can for viewing. 653 00:27:43,930 --> 00:27:45,180 Any progress in there? 654 00:27:45,180 --> 00:27:46,850 No. 655 00:27:46,850 --> 00:27:50,100 Can you also keep an extra eye on Whitaker today? 656 00:27:50,100 --> 00:27:51,430 Oh, I'm already on it. 657 00:27:51,440 --> 00:27:53,230 I know he lost his first patient. 658 00:27:53,230 --> 00:27:54,850 Yeah, I just don't want it to throw him off his game. 659 00:27:54,860 --> 00:27:58,270 - You think this kid has game? - Not sure yet. 660 00:27:58,280 --> 00:27:59,690 I want to give him a chance to find out. 661 00:27:59,690 --> 00:28:02,240 Copy that. 662 00:28:02,240 --> 00:28:05,320 - Hey, fruitcake. - Myrna. 663 00:28:05,320 --> 00:28:07,530 What brings you in here today, anyway? 664 00:28:07,540 --> 00:28:10,120 - I murdered my husband. - Ah. 665 00:28:10,120 --> 00:28:11,710 How did you do it this time? 666 00:28:11,710 --> 00:28:15,000 I put him through a meat grinder. 667 00:28:15,000 --> 00:28:18,040 Best just to grab one and jump back in. 668 00:28:18,050 --> 00:28:19,840 Yeah, right. 669 00:28:19,840 --> 00:28:24,260 Mr. Fulton in Central 14 just needs a shot of Mylanta 670 00:28:24,260 --> 00:28:26,640 for his GERD, and to avoid eating foods 671 00:28:26,640 --> 00:28:28,260 with the words "flaming hot" in their title 672 00:28:28,260 --> 00:28:29,510 for at least a few days. 673 00:28:29,520 --> 00:28:33,100 - OK, thanks. - Central 14. 674 00:28:33,100 --> 00:28:35,230 Yeah. 675 00:28:35,230 --> 00:28:39,610 Could I get some Mylanta for Mr. Fulton in Central 14? 676 00:28:39,610 --> 00:28:41,150 It'll be a while. 677 00:28:41,150 --> 00:28:42,900 If you want it fast, go check out the employee 678 00:28:42,900 --> 00:28:45,240 - first aid cabinet. - Where is that? 679 00:28:45,240 --> 00:28:47,780 In the lounge. I'll show you. 680 00:28:47,780 --> 00:28:51,160 - How's it going? - Not so great. 681 00:28:51,160 --> 00:28:53,410 - I lost a patient. - So I heard. 682 00:28:53,410 --> 00:28:55,080 I also heard it wasn't your fault. 683 00:28:55,080 --> 00:28:56,580 Doesn't make it feel any better. 684 00:28:56,580 --> 00:28:58,130 Yeah, it doesn't. I'm sorry. 685 00:28:58,130 --> 00:29:00,130 Unfortunately, it comes with the job. 686 00:29:00,130 --> 00:29:03,550 If it's any consolation, I just got scolded for going too slow. 687 00:29:03,550 --> 00:29:05,630 If you hear someone talking about a Slow-Mo, that's me. 688 00:29:05,630 --> 00:29:07,890 Guaranteed you're going faster than me. 689 00:29:07,890 --> 00:29:10,510 I like to say it gets easier. Some days it does. 690 00:29:10,510 --> 00:29:12,140 I'm sure the rest of your shift will be better. 691 00:29:12,140 --> 00:29:13,680 - Shake it first. - Mm-hmm. 692 00:29:13,680 --> 00:29:16,100 Oh, but make sure the lid is... 693 00:29:16,100 --> 00:29:18,690 Screwed down tight. 694 00:29:18,690 --> 00:29:22,940 - OK. - Oh. 695 00:29:24,200 --> 00:29:27,450 Everyone seems to get along like family. 696 00:29:27,450 --> 00:29:31,280 You see a family, I see every man for himself. 697 00:29:31,290 --> 00:29:32,660 Actually, that's not entirely true. 698 00:29:32,660 --> 00:29:34,080 There is some family here. 699 00:29:34,080 --> 00:29:35,960 Javadi's mom is a surgeon upstairs. 700 00:29:35,960 --> 00:29:37,580 - Really? - Yeah. 701 00:29:37,580 --> 00:29:40,290 - Oh, that must be so nice. - Are you kidding? 702 00:29:40,290 --> 00:29:42,090 I don't know about your mom, 703 00:29:42,090 --> 00:29:44,840 but I would not want mine working within 100 miles of me. 704 00:29:44,840 --> 00:29:48,340 - No way. - My mother passed. 705 00:29:48,340 --> 00:29:53,430 She had a very aggressive, malignant pheochromocytoma, 706 00:29:53,430 --> 00:29:56,520 - so... - Sorry. 707 00:29:56,520 --> 00:30:00,150 Unfortunately, my mother is gonna live forever. 708 00:30:01,190 --> 00:30:04,150 No, she was definitely dead. Like, I'm still shaking. 709 00:30:04,150 --> 00:30:06,990 No, she was, like, dead. Like dead-dead. 710 00:30:06,990 --> 00:30:08,570 I mean, I think her heart stopped. 711 00:30:08,570 --> 00:30:10,160 No, she was, like, literally dead. 712 00:30:10,160 --> 00:30:12,780 - Think she was dead? - Who? 713 00:30:12,790 --> 00:30:14,830 Who she was just talking about. 714 00:30:14,830 --> 00:30:16,410 Oh. 715 00:30:16,410 --> 00:30:18,040 In case you didn't realize, I use sarcasm 716 00:30:18,040 --> 00:30:21,080 and comedy as a shield. Or so I've been told. 717 00:30:21,090 --> 00:30:23,130 Thank you for opening up to me. 718 00:30:23,130 --> 00:30:25,300 - Mel, right? - Yes. 719 00:30:25,300 --> 00:30:26,920 Well, it was nice talking to you, Mel. 720 00:30:26,920 --> 00:30:28,760 It was nice talking to you too. 721 00:30:28,760 --> 00:30:30,430 You know, I really hope we can be fri-- 722 00:30:30,430 --> 00:30:32,510 friends. 723 00:30:40,560 --> 00:30:42,940 Is there anything I can assist you with, Dr. Robby? 724 00:30:42,940 --> 00:30:44,730 I think we're best on our own right now, thank you. 725 00:30:44,730 --> 00:30:46,650 He keeps trying to pull away. 726 00:30:46,650 --> 00:30:48,360 We're giving him some more sedation. 727 00:30:48,360 --> 00:30:50,200 Why is he so agitated? 728 00:30:50,200 --> 00:30:52,320 He could have some awareness of the tube in his throat 729 00:30:52,320 --> 00:30:54,660 or that he's in a strange place, 730 00:30:54,660 --> 00:30:57,500 or it could be lack of oxygen to his brain. 731 00:30:57,500 --> 00:30:59,660 - Does he need more oxygen? - He's on 100%. 732 00:30:59,670 --> 00:31:00,960 That's as high as it goes. 733 00:31:02,420 --> 00:31:04,460 That is his blood pressure dropping. 734 00:31:04,460 --> 00:31:06,750 Oh, is that even fixable? 735 00:31:06,760 --> 00:31:09,470 Normally, yes, with IV fluids, 736 00:31:09,470 --> 00:31:11,890 but we now know that that will just fill up his lungs, 737 00:31:11,890 --> 00:31:13,470 drop his oxygen even more. 738 00:31:13,470 --> 00:31:15,430 Well, isn't there something else we can do? 739 00:31:15,430 --> 00:31:19,890 We can place a long, large IV catheter in his jugular vein 740 00:31:19,890 --> 00:31:23,440 down into his heart and administer Levophed, 741 00:31:23,440 --> 00:31:25,190 which is a very powerful medicine 742 00:31:25,190 --> 00:31:28,070 to constrict his arteries, raise his blood pressure. 743 00:31:28,070 --> 00:31:34,030 But that could cause other organ damage, organ failure. 744 00:31:34,030 --> 00:31:39,080 I'm really sorry, but each new step is even more invasive, 745 00:31:39,080 --> 00:31:44,000 could cause more suffering with minimal benefit. 746 00:31:51,010 --> 00:31:53,340 Uh, hi. 747 00:31:53,340 --> 00:31:55,600 Dr. Robby said he'd be back in a few minutes. 748 00:31:55,600 --> 00:31:58,600 Yeah, he's with a patient, but I'll let him know. 749 00:32:00,520 --> 00:32:02,140 My son is dead, isn't he? 750 00:32:02,140 --> 00:32:04,810 I'm not a doctor, Mr. Bradley, 751 00:32:04,810 --> 00:32:08,400 but I do believe in God, and I am praying for your boy 752 00:32:08,400 --> 00:32:10,190 with every beat of my heart. 753 00:32:10,190 --> 00:32:12,360 Thought she'd taken Xanax, but it was actually fent. 754 00:32:12,360 --> 00:32:14,280 - Thank you. - Yeah. 755 00:32:14,280 --> 00:32:16,320 Oh, one second. Yeah? 756 00:32:16,330 --> 00:32:18,450 - She was legitimately dead? - Yeah, like, 100%. 757 00:32:18,450 --> 00:32:22,910 - Mr. Bradley? - Vince? 758 00:32:22,920 --> 00:32:25,630 No, my dad's gonna freak out. 759 00:32:25,630 --> 00:32:27,630 No, I know. I know. 760 00:32:27,630 --> 00:32:31,170 I just needed to sleep. I thought I was. 761 00:32:31,170 --> 00:32:33,220 Where did you get the fucking drugs? 762 00:32:33,220 --> 00:32:35,640 - Who are you? - Did you give them to my son? 763 00:32:35,640 --> 00:32:37,510 Did you give my son drugs? 764 00:32:37,510 --> 00:32:39,060 Mr. Bradley, you can't come in here. 765 00:32:39,060 --> 00:32:40,810 - Mr. Bradley, please. - Who is this? 766 00:32:40,810 --> 00:32:42,350 - Tell me the fucking truth. - Security! 767 00:32:42,350 --> 00:32:44,060 It's Nick's dad. 768 00:32:44,060 --> 00:32:45,940 - Did you drug my son? - Where the hell's security? 769 00:32:45,940 --> 00:32:47,610 Your son gave me the drugs, asshole. 770 00:32:47,610 --> 00:32:49,650 - Ask him. - He's dead. 771 00:32:49,650 --> 00:32:51,990 And you are a fucking liar! 772 00:32:51,990 --> 00:32:56,160 You killed my son! You killed my fucking son! 773 00:33:07,290 --> 00:33:09,000 Hey, there's no scrubs in here. 774 00:33:09,000 --> 00:33:11,170 Yeah, you have to put your old ones in before 775 00:33:11,170 --> 00:33:13,130 it'll give you a new pair. 776 00:33:13,130 --> 00:33:16,340 What? 777 00:33:35,110 --> 00:33:37,700 Forgive me, Mr. Milton. 778 00:33:42,120 --> 00:33:44,620 Hey, you missed the best action of the day. 779 00:33:44,620 --> 00:33:46,500 I heard. What happened? 780 00:33:46,500 --> 00:33:48,170 Father of the brain-dead son 781 00:33:48,170 --> 00:33:50,290 goes after another patient he thinks gave his son 782 00:33:50,290 --> 00:33:52,170 - the drugs that killed him. - Jesus. 783 00:33:52,170 --> 00:33:55,880 - How do you deal with that? - No fucking idea. 784 00:33:55,880 --> 00:33:58,760 Whoa, what happened here? Did we have an accident? 785 00:33:58,760 --> 00:34:00,140 Do you think I'm wearing this by choice? 786 00:34:00,140 --> 00:34:01,890 Was it number one or number two? 787 00:34:01,890 --> 00:34:03,720 I just got some stuff spilled on me. 788 00:34:03,720 --> 00:34:05,390 Was it a bodily fluid, and was it yours? 789 00:34:05,390 --> 00:34:06,930 No and no. 790 00:34:06,940 --> 00:34:08,440 Oh, is it from when you killed that guy? 791 00:34:08,440 --> 00:34:09,850 I did not-- 792 00:34:09,860 --> 00:34:11,860 that guy had a massive MI in his sleep. 793 00:34:11,860 --> 00:34:13,780 Relax, Huckleberry, I'm just fucking with you. 794 00:34:13,780 --> 00:34:16,110 Truth is, you're not a real doctor until 795 00:34:16,110 --> 00:34:18,280 you've lost at least one patient. 796 00:34:18,280 --> 00:34:20,700 You got off easy. It wasn't your fault. 797 00:34:20,700 --> 00:34:24,540 Not all of us can take comfort in saying that. 798 00:34:24,540 --> 00:34:27,870 But try not to kill anybody else. 799 00:34:27,870 --> 00:34:31,420 - What am I looking at? - Mr. Bill Philbin, 46. 800 00:34:31,420 --> 00:34:33,290 He tripped while walking his dog. 801 00:34:33,300 --> 00:34:36,170 He saw a squirrel. And it's my wife's dog. 802 00:34:36,170 --> 00:34:37,840 Damn thing doesn't even like me. 803 00:34:37,840 --> 00:34:39,800 Clearly. Where's the dog now? 804 00:34:39,800 --> 00:34:41,550 Hopefully in a kill shelter. 805 00:34:56,030 --> 00:34:57,150 Come on, baby. 806 00:35:07,250 --> 00:35:10,580 Oh, yes. 807 00:35:12,080 --> 00:35:14,130 I'm sorry. 808 00:35:14,130 --> 00:35:18,300 I just want to understand how this could happen to our son. 809 00:35:18,300 --> 00:35:23,220 I can't stop wondering, why Nick and not her? 810 00:35:23,220 --> 00:35:25,100 I can't help it. 811 00:35:25,100 --> 00:35:26,510 I think it would be helpful for you 812 00:35:26,520 --> 00:35:28,770 to speak with our department social worker. 813 00:35:28,770 --> 00:35:30,690 Would you two be open to that? 814 00:35:30,690 --> 00:35:34,270 - None of this is fair. - No. 815 00:35:34,270 --> 00:35:38,110 - No, it's not. - But he's still breathing. 816 00:35:38,110 --> 00:35:40,070 The ventilator is breathing for him. 817 00:35:40,070 --> 00:35:42,490 Brain death is the same as death. 818 00:35:42,490 --> 00:35:44,370 What about that last test that we're waiting for? 819 00:35:44,370 --> 00:35:47,290 I can almost guarantee it'll stay the same. 820 00:35:47,290 --> 00:35:49,000 I'm so sorry. 821 00:35:50,460 --> 00:35:53,380 I wish I could have done more to save your son. 822 00:35:55,670 --> 00:35:57,340 Our social worker, Kiara, is here to help you 823 00:35:57,340 --> 00:35:59,050 with anything you might need. She's amazing. 824 00:35:59,050 --> 00:36:01,130 I'm gonna go find her and have her come see you. 825 00:36:03,590 --> 00:36:05,090 Go back to the dorm, 826 00:36:05,100 --> 00:36:08,350 and within a couple of minutes... 827 00:36:12,140 --> 00:36:13,850 Get dad sorted out? 828 00:36:13,850 --> 00:36:15,770 I think so. 829 00:36:15,770 --> 00:36:17,400 He and his wife are dealing with a lot right now. 830 00:36:17,400 --> 00:36:20,400 No shit. That's a tough one. 831 00:36:20,400 --> 00:36:22,450 Yeah. Do you know where Kiara is? 832 00:36:22,450 --> 00:36:24,070 Not offhand, but I can page her. 833 00:36:24,070 --> 00:36:25,740 No, it's OK. I'll find her. 834 00:36:25,740 --> 00:36:27,660 I got to hit the restroom anyway. 835 00:36:27,660 --> 00:36:29,200 I'll tell her you're looking for her if she comes this way. 836 00:36:29,200 --> 00:36:30,580 - Thank you. - Yep. 837 00:36:30,580 --> 00:36:32,250 Now I got to pee. 838 00:36:32,250 --> 00:36:35,830 Kevin, take Myrna to pee. 839 00:36:35,830 --> 00:36:38,500 Ask Dana what's open, four of morphine, 840 00:36:38,500 --> 00:36:41,340 - and order an X-ray, OK? - Copy. 841 00:36:41,340 --> 00:36:43,590 Hey, closed injury, forklift versus foot. 842 00:36:43,590 --> 00:36:45,470 - Forklift won. - Got it. 843 00:36:45,470 --> 00:36:47,550 Hey, any news on our incel kid, David? 844 00:36:47,550 --> 00:36:49,310 Uh, I don't think we've heard from him yet, 845 00:36:49,310 --> 00:36:51,270 and I don't know that you should refer to him that way. 846 00:36:51,270 --> 00:36:54,310 Well, he did have a list of girls' names he wanted to hurt. 847 00:36:54,310 --> 00:36:57,100 They could be at risk. Are the cops looking for him? 848 00:36:57,110 --> 00:36:59,150 - Not sure we're there yet. - OK. 849 00:36:59,150 --> 00:37:00,780 I trust your judgment, 850 00:37:00,780 --> 00:37:02,320 and I'm the last person who wants to involve 851 00:37:02,320 --> 00:37:03,860 the police in anything, 852 00:37:03,860 --> 00:37:05,610 but you don't want to be wrong about this one. 853 00:37:05,610 --> 00:37:07,490 I know. I know. 854 00:37:07,490 --> 00:37:09,080 So what's the issue? 855 00:37:09,080 --> 00:37:12,040 Maybe I don't want to ruin this kid's life. 856 00:37:12,040 --> 00:37:13,500 Well, you don't want him ruining 857 00:37:13,500 --> 00:37:15,040 anyone else's life either. 858 00:37:18,710 --> 00:37:21,300 Look, I've personally been on the wrong side 859 00:37:21,300 --> 00:37:23,380 of someone who hates women. 860 00:37:23,380 --> 00:37:26,130 It's not a safe place to be. 861 00:37:26,130 --> 00:37:28,390 OK? 862 00:37:34,100 --> 00:37:36,730 - Any luck reaching David? - Not yet. 863 00:37:36,730 --> 00:37:38,060 Did you try calling the school? 864 00:37:38,060 --> 00:37:41,730 He didn't show up for class. 865 00:37:41,730 --> 00:37:43,780 Any idea where he might have gone? 866 00:37:43,780 --> 00:37:45,320 Friends, relatives. 867 00:37:45,320 --> 00:37:47,490 We don't have any family in state. 868 00:37:47,490 --> 00:37:52,410 And David, he doesn't associate with anyone. 869 00:37:55,870 --> 00:37:58,040 Theresa, do you think that David 870 00:37:58,040 --> 00:38:00,380 would try to hurt any of the girls that are on that list? 871 00:38:01,380 --> 00:38:02,960 No. 872 00:38:02,960 --> 00:38:06,010 Do you remember some of the names on that list? 873 00:38:06,010 --> 00:38:07,720 Not really. 874 00:38:07,720 --> 00:38:09,680 Maybe you could try. 875 00:38:17,060 --> 00:38:18,350 How's she doing? 876 00:38:18,350 --> 00:38:20,480 She's worried sick about her son. 877 00:38:20,480 --> 00:38:22,230 What are you going to do? 878 00:38:22,230 --> 00:38:24,690 I thought he would come back after mom called him. 879 00:38:24,690 --> 00:38:26,110 Hey, what are the ethics about me reaching out 880 00:38:26,110 --> 00:38:27,360 to him under the guise 881 00:38:27,360 --> 00:38:28,860 of a medical emergency with mom? 882 00:38:28,860 --> 00:38:30,700 If he's a danger to himself or others, 883 00:38:30,700 --> 00:38:33,200 I'd argue you have a professional responsibility 884 00:38:33,200 --> 00:38:36,200 to do whatever is necessary. 885 00:38:36,200 --> 00:38:38,370 Right. OK. 886 00:38:38,370 --> 00:38:40,460 Hey, can you come talk to the parents of the OD'd kid 887 00:38:40,460 --> 00:38:42,040 that we brought in earlier? 888 00:38:42,040 --> 00:38:44,300 18-year-old brain-dead from a fentanyl overdose. 889 00:38:44,300 --> 00:38:46,420 - Oh, jeez. - Yeah, only child. 890 00:38:46,420 --> 00:38:47,800 And I just think that the parents 891 00:38:47,800 --> 00:38:48,920 could use a little help processing 892 00:38:48,930 --> 00:38:50,510 what they're going through. 893 00:38:50,510 --> 00:38:52,260 What about donation? Is he a candidate? 894 00:38:52,260 --> 00:38:54,010 If the transplant counselor could get him there, 895 00:38:54,010 --> 00:38:55,560 but I think we're a ways away from calling them in. 896 00:38:55,560 --> 00:38:57,600 - I'll see what I can do. - Thank you. 897 00:38:57,600 --> 00:38:59,190 They're in Central 7. 898 00:38:59,190 --> 00:39:00,390 I would introduce you, but I really have to pee. 899 00:39:00,400 --> 00:39:02,940 - No worries. - Thank you. 900 00:39:08,450 --> 00:39:09,990 What the hell? 901 00:39:09,990 --> 00:39:11,490 I just saw one of those rats. 902 00:39:11,490 --> 00:39:13,280 And you thought you'd start an IV? 903 00:39:13,280 --> 00:39:14,910 It's not funny. 904 00:39:14,910 --> 00:39:16,830 You're not the one who's gonna have nightmares. 905 00:39:16,830 --> 00:39:19,580 I forgot about your phobia with rats. 906 00:39:19,580 --> 00:39:21,830 It is not a phobia. Nobody likes rats. 907 00:39:21,830 --> 00:39:23,630 Some people keep them as pets. 908 00:39:23,630 --> 00:39:27,300 If you are purposely keeping a rat in your house, 909 00:39:27,300 --> 00:39:29,090 that is not a pet. 910 00:39:29,090 --> 00:39:31,090 That is a sign of an underlying mental health problem. 911 00:39:31,090 --> 00:39:32,680 OK, if it makes you feel any better, 912 00:39:32,680 --> 00:39:34,220 just think of them as cute little Disney mice 913 00:39:34,220 --> 00:39:35,600 with a pituitary condition. 914 00:39:35,600 --> 00:39:37,430 Mm-hmm, joke all you want, 915 00:39:37,430 --> 00:39:40,940 but if one of those disgusting things bites a patient 916 00:39:40,940 --> 00:39:42,810 and we get a case of hantavirus, 917 00:39:42,810 --> 00:39:45,560 guess who's gonna have to answer for that one, Chief. 918 00:39:45,570 --> 00:39:47,440 Point taken. 919 00:39:47,440 --> 00:39:49,110 What was the name of that cop you were talking to earlier? 920 00:39:49,110 --> 00:39:50,950 What cop? 921 00:39:50,950 --> 00:39:52,700 The good-looking one that you were talking to earlier. 922 00:39:52,700 --> 00:39:54,780 - How would I know? - It seemed like you guys had-- 923 00:39:54,780 --> 00:39:57,740 - Stay in your own lane. - What? 924 00:39:57,740 --> 00:39:59,500 I'm not even asking like that. 925 00:39:59,500 --> 00:40:02,000 I really did want to talk to him about something. 926 00:40:02,000 --> 00:40:04,670 Uh-huh. 927 00:40:04,670 --> 00:40:06,840 Hey, did the exterminator come yet? 928 00:40:06,840 --> 00:40:08,920 Yeah. Right. Sometimes you can be so cute. 929 00:40:08,920 --> 00:40:10,880 Anything like that has to go through facilities. 930 00:40:10,880 --> 00:40:13,970 - They said they'd handle it. - What does that mean? 931 00:40:13,970 --> 00:40:16,050 It means nothing's gonna happen until next week 932 00:40:16,050 --> 00:40:18,350 at the earliest unless we get a patient in here 933 00:40:18,350 --> 00:40:20,680 with a service cat. 934 00:40:20,680 --> 00:40:22,770 Oh, don't forget, you still have the sister 935 00:40:22,770 --> 00:40:24,480 of Abbot's deceased veteran waiting for you. 936 00:40:24,480 --> 00:40:25,730 Oh, shit, yes, yes, yes. I'll be there. 937 00:40:25,730 --> 00:40:27,820 - I'll be there. - Yeah, go. 938 00:40:29,650 --> 00:40:31,490 Hey, I've been looking all over for you. 939 00:40:31,490 --> 00:40:33,780 We need a cardiovert unstable AFib in North 1. 940 00:40:33,780 --> 00:40:36,240 - OK, just give me a sec. - Systolic's 90. 941 00:40:36,240 --> 00:40:38,030 Fuck me. 942 00:40:39,740 --> 00:40:42,330 35-year-old architect working on a deadline, 943 00:40:42,330 --> 00:40:45,330 vaping nicotine all night. Palpitations this morning. 944 00:40:45,330 --> 00:40:48,630 AFib at 147. Mr. Quinn, this is Dr. Robby. 945 00:40:48,630 --> 00:40:49,800 Hello, sir. How are you feeling? 946 00:40:49,800 --> 00:40:51,210 Like crap. 947 00:40:51,210 --> 00:40:52,760 When did your palpitations start? 948 00:40:52,760 --> 00:40:54,050 A little while ago. 949 00:40:54,050 --> 00:40:55,720 We interrogated his smartwatch. 950 00:40:55,720 --> 00:40:57,050 His heart rate has only been up for 92 minutes. 951 00:40:57,050 --> 00:40:58,680 You understand we need to shock 952 00:40:58,680 --> 00:41:00,350 - your heart back to normal? - Is it gonna hurt? 953 00:41:00,350 --> 00:41:03,230 - You'll be sedated. - So it's really gonna hurt. 954 00:41:03,230 --> 00:41:04,810 Mel, 75 of propofol, slow IV push. 955 00:41:04,810 --> 00:41:06,350 How much did you vape last night? 956 00:41:06,350 --> 00:41:08,770 - A couple of pods. - You vape every day? 957 00:41:08,770 --> 00:41:10,820 I do, but not that much. 958 00:41:10,820 --> 00:41:12,900 - You want to cut back? - I've tried. 959 00:41:12,900 --> 00:41:14,530 It's just really fucking hard. 960 00:41:14,530 --> 00:41:16,030 How much nicotine is in a pod? 961 00:41:16,030 --> 00:41:17,820 - Anybody know? - No idea. 962 00:41:17,820 --> 00:41:19,580 40 milligrams, same as a pack of cigarettes. 963 00:41:19,580 --> 00:41:21,240 Wow, two packs in one night. 964 00:41:21,240 --> 00:41:23,370 Mel, what's the safe window for cardioversion? 965 00:41:23,370 --> 00:41:25,830 - 12 hours. - What happens after that? 966 00:41:25,830 --> 00:41:27,920 Increased risk of embolic stroke 967 00:41:27,920 --> 00:41:29,460 from left atrial blood clot. 968 00:41:29,460 --> 00:41:31,840 Which he does not have. 969 00:41:31,840 --> 00:41:34,090 Mr. Quinn. Mr. Quinn. 970 00:41:34,090 --> 00:41:35,470 OK, he's out. 971 00:41:35,470 --> 00:41:37,180 Sync cardioversion at 200 joules. 972 00:41:37,180 --> 00:41:39,720 - Charged. - Clear. 973 00:41:43,390 --> 00:41:45,430 - Bingo. - Sinus rhythm. 974 00:41:45,440 --> 00:41:46,690 Cycle BP. 975 00:41:46,690 --> 00:41:48,400 We'll monitor for a few hours. 976 00:41:48,400 --> 00:41:50,110 Yeah, let's get addiction services on the case too. 977 00:41:50,110 --> 00:41:51,570 He's gonna need a daily patch 978 00:41:51,570 --> 00:41:53,360 and nicotine gum for breakthrough cravings. 979 00:41:53,360 --> 00:41:54,900 This one's a bitch to kick. 980 00:41:54,900 --> 00:41:56,700 Hey, the sister of Abbot-- 981 00:41:56,700 --> 00:41:59,450 Shit, yes. Shit, yes, yes. 982 00:41:59,450 --> 00:42:02,330 Go get 'em, tiger. 983 00:42:08,040 --> 00:42:10,500 Are you Mr. Orser's sister? 984 00:42:10,500 --> 00:42:13,000 - Fiona. - Hi, Fiona. 985 00:42:13,000 --> 00:42:14,260 I'm Dr. Robinavitch. 986 00:42:14,260 --> 00:42:15,840 Everybody calls me Dr. Robby. 987 00:42:15,840 --> 00:42:18,260 Have a seat, please, and I will tell you 988 00:42:18,260 --> 00:42:19,930 everything that's happened. 989 00:42:23,100 --> 00:42:25,180 Are you looking for something in particular? 990 00:42:25,180 --> 00:42:28,350 Anything with a very low potential for mortality. 991 00:42:28,350 --> 00:42:30,480 Mm-mm. You're not playing that game. 992 00:42:30,480 --> 00:42:32,400 Only thing I'm playing is let's keep the patients alive. 993 00:42:32,400 --> 00:42:36,820 Uh-huh, well, now we're playing face your fears. 994 00:42:36,820 --> 00:42:38,530 That sounds like a terrible game. 995 00:42:38,530 --> 00:42:40,110 What up there scares you the most? 996 00:42:40,120 --> 00:42:43,950 - All of it. - Pick the worst. 997 00:42:43,950 --> 00:42:45,290 South 20. 998 00:42:45,290 --> 00:42:47,250 82-year-old woman, low back pain. 999 00:42:47,250 --> 00:42:50,000 I mean, that's potential leaking AAA, 1000 00:42:50,000 --> 00:42:52,840 cauda equina syndrome, spinal epidural abscess. 1001 00:42:52,840 --> 00:42:54,380 That could go wrong in so many ways. 1002 00:42:54,380 --> 00:42:55,920 Not today, amigo. 1003 00:42:55,920 --> 00:42:57,130 We're gonna work this lady up like a race car. 1004 00:42:57,130 --> 00:42:58,510 What does that mean? 1005 00:42:58,510 --> 00:42:59,880 It means you're on the pit crew now. 1006 00:42:59,880 --> 00:43:01,970 Come on. 1007 00:43:03,810 --> 00:43:06,890 Are you ready to go inside? 1008 00:43:06,890 --> 00:43:09,560 No, not really. 1009 00:43:09,560 --> 00:43:11,230 I'll be with you. 1010 00:43:11,230 --> 00:43:13,940 You can decide when you want to leave. 1011 00:43:31,330 --> 00:43:35,710 You're so cold. 1012 00:43:35,710 --> 00:43:38,090 I'm sorry. 1013 00:43:38,090 --> 00:43:41,930 I'm sorry I wasn't here with you. 1014 00:43:41,930 --> 00:43:45,760 But I'm here now. 1015 00:43:45,760 --> 00:43:48,680 Wherever you are. 1016 00:43:51,060 --> 00:43:54,150 I don't know what the world is without you. 1017 00:44:06,160 --> 00:44:07,740 I really can't look at this letter. 1018 00:44:07,740 --> 00:44:10,870 Would it be too much to ask you to read it to me? 1019 00:44:10,870 --> 00:44:12,120 Oh, I'm sorry. 1020 00:44:12,120 --> 00:44:13,420 That's an inappropriate request. 1021 00:44:13,420 --> 00:44:15,460 No, not at all, not at all. 1022 00:44:15,460 --> 00:44:17,340 I'd be honored by the request. 1023 00:44:28,560 --> 00:44:32,060 "To the family of Raymond Orser, 1024 00:44:32,060 --> 00:44:35,310 "my name is Dr. Jack Abbot. 1025 00:44:35,310 --> 00:44:40,780 "I am the emergency department physician who treated Raymond. 1026 00:44:40,780 --> 00:44:44,990 "I, like Ray, am also a veteran. 1027 00:44:44,990 --> 00:44:48,580 "And though I never met Raymond before today, 1028 00:44:48,580 --> 00:44:51,540 "I served with men like him. 1029 00:44:51,540 --> 00:44:54,000 "So I can only imagine what an outstanding person 1030 00:44:54,000 --> 00:44:56,080 he must have been." 1031 00:45:00,670 --> 00:45:04,220 "I'm sorry I could not save Ray's life. 1032 00:45:04,220 --> 00:45:06,180 "We worked on him for several hours, 1033 00:45:06,180 --> 00:45:09,140 "but his injuries were too severe, 1034 00:45:09,140 --> 00:45:14,480 "even for someone as tough and battle-tested as Raymond. 1035 00:45:14,480 --> 00:45:19,230 "Please take some comfort in knowing he did not suffer. 1036 00:45:19,230 --> 00:45:21,320 "You have my heartfelt condolences. 1037 00:45:21,320 --> 00:45:24,820 Jack Abbot." 1038 00:45:27,780 --> 00:45:31,700 - Thank you. - You're very welcome. 1039 00:45:40,210 --> 00:45:43,210 Again, I'm very, very sorry for your loss. 1040 00:45:56,730 --> 00:45:58,520 Where do you think you're going, Myrna? 1041 00:45:58,520 --> 00:46:02,780 Oh, none of your business, fruitcake. 1042 00:46:02,780 --> 00:46:05,150 Actually, everything that happens in this department 1043 00:46:05,150 --> 00:46:07,200 is my business. And you know what? 1044 00:46:07,200 --> 00:46:08,570 I put up with a lot around here. 1045 00:46:08,570 --> 00:46:10,410 I take very good care of you, 1046 00:46:10,410 --> 00:46:12,370 so you can call me Dr. Robinavitch, 1047 00:46:12,370 --> 00:46:14,080 or you can call me Dr. Robby, 1048 00:46:14,080 --> 00:46:16,250 or you can use my first name of Michael, 1049 00:46:16,250 --> 00:46:18,540 but I do not appreciate you calling me fruitcake. 1050 00:46:18,540 --> 00:46:23,960 Oh, did I hurt your feelings, cocksucker? 1051 00:46:23,960 --> 00:46:26,090 That said, it has a certain whimsical quality 1052 00:46:26,090 --> 00:46:28,180 to it that I can probably learn to live with. 1053 00:46:28,180 --> 00:46:30,180 Whatever you say, fruitcake. 1054 00:46:30,180 --> 00:46:33,100 Excuse me, Doctor, my father is starting to struggle again. 1055 00:46:33,100 --> 00:46:35,230 OK. 1056 00:46:39,150 --> 00:46:40,600 Don't you know those things will kill you? 1057 00:46:40,610 --> 00:46:42,190 I'm not that lucky. 1058 00:46:42,190 --> 00:46:43,480 Ow! 1059 00:46:43,480 --> 00:46:46,650 What the fuck? 1060 00:46:46,650 --> 00:46:48,570 Hey, they're stealing our rig! 1061 00:46:50,410 --> 00:46:51,820 Did you leave the keys in it? 1062 00:46:51,830 --> 00:46:53,870 Always, in case somebody needs to move it. 1063 00:46:53,870 --> 00:46:55,330 Yeah, you probably shouldn't have done that. 1064 00:46:55,330 --> 00:46:56,700 Why don't you come on inside, Ziggler? 1065 00:46:56,700 --> 00:46:58,250 - We'll look you over. - I'm fine. 1066 00:46:58,250 --> 00:47:00,040 Fuck that. 1067 00:47:00,040 --> 00:47:02,330 God, can you believe that shit? 1068 00:47:02,340 --> 00:47:04,420 It happens. 1069 00:47:07,380 --> 00:47:09,340 What can you do to make him more comfortable? 1070 00:47:09,340 --> 00:47:10,760 We can take the tube out. 1071 00:47:10,760 --> 00:47:13,050 But he needs that to breathe. 1072 00:47:13,050 --> 00:47:16,930 If we extubate, we would keep him on oxygen for comfort. 1073 00:47:16,930 --> 00:47:19,850 We would decrease his sedation. 1074 00:47:19,850 --> 00:47:22,270 He might regain consciousness. He could recognize you. 1075 00:47:22,270 --> 00:47:23,940 Maybe even speak. 1076 00:47:23,940 --> 00:47:25,730 Well, I don't want to do anything to jeopardize 1077 00:47:25,730 --> 00:47:29,610 - him getting better. - That's just the point, Helen. 1078 00:47:29,610 --> 00:47:31,200 He's never getting better. 1079 00:47:31,200 --> 00:47:33,410 - You don't know that. - I do know that, OK? 1080 00:47:33,410 --> 00:47:35,370 He knows that. 1081 00:47:35,370 --> 00:47:38,290 And Dad probably even knows it. 1082 00:47:38,290 --> 00:47:40,710 It's time to let him go. 1083 00:47:40,710 --> 00:47:42,620 I'm sorry if you've had your fill of Dad, 1084 00:47:42,630 --> 00:47:47,170 but I haven't, and I am not giving up on him. 1085 00:47:47,170 --> 00:47:49,380 Even if it's hurting him? 1086 00:47:52,050 --> 00:47:54,260 I'm sorry, but if there was anything I could do 1087 00:47:54,260 --> 00:47:56,260 to heal your father, I would do it. 1088 00:47:56,260 --> 00:47:58,470 But the most humane thing that I can do for him 1089 00:47:58,470 --> 00:48:02,390 is to allow him a painless, peaceful passing, 1090 00:48:02,400 --> 00:48:04,980 and that requires removing the breathing tube. 1091 00:48:07,030 --> 00:48:10,900 How long will it take once the tube's out? 1092 00:48:10,900 --> 00:48:12,820 From minutes to hours, 1093 00:48:12,820 --> 00:48:15,450 but we would ensure that he'd be in no physical discomfort. 1094 00:48:21,500 --> 00:48:23,290 OK.