1 00:01:38,070 --> 00:01:39,410 Is it true? 2 00:01:39,410 --> 00:01:41,410 Simi told Hector that Dr. Deranjian said 3 00:01:41,410 --> 00:01:43,120 the hospital was up for sale. 4 00:01:43,120 --> 00:01:45,620 They might turn it into an ortho center with no ER. 5 00:01:45,620 --> 00:01:47,540 Oh, they're always threatening to shut us down, 6 00:01:47,540 --> 00:01:49,500 but they never do. 7 00:01:49,500 --> 00:01:51,090 Do you believe him? 8 00:01:52,460 --> 00:01:54,840 I never trust the doctors. 9 00:01:56,050 --> 00:01:57,800 Gloria is looking for you. 10 00:01:57,800 --> 00:01:59,300 No guts, no Gloria. 11 00:01:59,300 --> 00:02:01,010 Must be time for my weekly spanking. 12 00:02:01,010 --> 00:02:03,260 Try to be nice, for all our sakes. 13 00:02:03,260 --> 00:02:05,970 You sure you're cool being here today? 14 00:02:05,980 --> 00:02:09,190 Yeah. Why wouldn't I be? 15 00:02:09,190 --> 00:02:10,560 Well, if you need to talk... 16 00:02:10,560 --> 00:02:13,770 Yeah, I won't, but thanks. 17 00:02:13,770 --> 00:02:16,900 Where's Abbot? 18 00:02:16,900 --> 00:02:18,610 Getting some air. 19 00:02:30,460 --> 00:02:32,540 Hey. 20 00:02:32,540 --> 00:02:35,130 You OK in there? 21 00:02:35,130 --> 00:02:37,720 Uh, awesome. 22 00:02:39,880 --> 00:02:42,300 I'd like to say it goes away, but I had morning sickness 23 00:02:42,300 --> 00:02:44,010 for six months with my second daughter. 24 00:02:44,850 --> 00:02:46,220 Hell, who am I kidding? 25 00:02:46,220 --> 00:02:48,230 That one still worries me sick. 26 00:02:49,890 --> 00:02:52,980 - Thanks. - But it's worth it. 27 00:02:52,980 --> 00:02:54,690 You tell anybody yet? 28 00:02:54,690 --> 00:02:57,480 Oh, no. 29 00:02:57,490 --> 00:03:00,320 Not until I pass 12 weeks. Not this time. 30 00:03:00,320 --> 00:03:02,530 Nothing but good vibes. 31 00:03:02,530 --> 00:03:05,410 But just so you know, Robby's working today. 32 00:03:05,410 --> 00:03:07,040 Today's the day Doc Adamson died. 33 00:03:07,040 --> 00:03:08,950 He hasn't worked it in four years. 34 00:03:11,540 --> 00:03:13,170 So why is he here? 35 00:03:13,170 --> 00:03:15,460 All I know is, he still blames himself 36 00:03:15,460 --> 00:03:18,340 for Adamson's death, so if he's a little prickly today, 37 00:03:18,340 --> 00:03:20,220 give him a pass, OK? 38 00:03:21,510 --> 00:03:23,640 - Right. - Thank you. 39 00:03:23,640 --> 00:03:25,510 Hang in there, kid. 40 00:03:36,190 --> 00:03:37,650 Good morning, Jack. 41 00:03:40,240 --> 00:03:42,700 What are you doing here? 42 00:03:42,700 --> 00:03:44,320 I'm working. 43 00:03:44,320 --> 00:03:47,620 And you? 44 00:03:47,620 --> 00:03:49,830 Oh, I don't know. 45 00:03:49,830 --> 00:03:52,160 Had a guy come in. 46 00:03:52,160 --> 00:03:54,750 Hit by a drunk driver in a crosswalk. 47 00:03:54,750 --> 00:03:57,340 39-year-old vet. 48 00:03:57,340 --> 00:04:00,130 Survived three tours without a scratch. 49 00:04:02,590 --> 00:04:05,590 I spent the last two hours coding him. 50 00:04:07,180 --> 00:04:09,510 That's always a rough way to end the night. 51 00:04:09,520 --> 00:04:10,890 I must have had a reason 52 00:04:10,890 --> 00:04:12,640 at one time to keep coming back, 53 00:04:12,640 --> 00:04:17,940 but I can't think of it right now. 54 00:04:17,940 --> 00:04:21,230 Because this is the job that keeps on giving. 55 00:04:21,240 --> 00:04:22,820 Nightmares. 56 00:04:22,820 --> 00:04:24,780 Ulcers. 57 00:04:24,780 --> 00:04:26,820 Suicidal tendencies. 58 00:04:29,740 --> 00:04:32,290 Besides, if you jump on my shift, 59 00:04:32,290 --> 00:04:36,170 that's just rude, man. 60 00:04:42,630 --> 00:04:45,680 I hope I'm never one of your patients. 61 00:04:45,680 --> 00:04:49,430 That makes two of us, my friend. 62 00:04:49,430 --> 00:04:52,930 I got a pregnant teen coming back today for mifepristone 63 00:04:52,930 --> 00:04:55,440 and a small bowel obstruction waiting on surgery 64 00:04:55,440 --> 00:04:57,560 for the last three hours. 65 00:04:57,560 --> 00:05:00,190 Oh, and unfortunately, 66 00:05:00,190 --> 00:05:02,570 the Kraken is still boarding in BH. 67 00:05:02,570 --> 00:05:04,190 Still? 68 00:05:04,200 --> 00:05:06,110 Guy's been here for a week waiting on a psych bed. 69 00:05:06,110 --> 00:05:08,620 Yep. He's only getting worse. 70 00:05:08,620 --> 00:05:11,030 He's catching some Zyprexa Z's at the moment. 71 00:05:11,040 --> 00:05:15,040 But when he wakes up, God help you all. 72 00:05:16,710 --> 00:05:18,630 I wrote a note for the family of my dead vet, 73 00:05:18,630 --> 00:05:21,250 if anyone shows. 74 00:05:21,250 --> 00:05:23,250 Oh, and you got the med students 75 00:05:23,260 --> 00:05:26,380 and new interns starting today, so good luck with that. 76 00:05:26,380 --> 00:05:28,220 Lucky, lucky me. 77 00:05:28,220 --> 00:05:30,760 - Sir, come back here! - No more needles! 78 00:05:30,760 --> 00:05:31,890 - Oh! - Sir! 79 00:05:31,890 --> 00:05:34,060 - No more needles! - Stop! 80 00:05:34,060 --> 00:05:35,560 Sure you want to work today, huh? 81 00:05:35,560 --> 00:05:36,980 Help me! They're gonna hurt me! 82 00:05:36,980 --> 00:05:40,980 Sir, I promise nobody is going to hurt you. 83 00:05:40,980 --> 00:05:42,980 Sir! 84 00:05:45,700 --> 00:05:47,860 Who left this mess? 85 00:05:47,860 --> 00:05:50,280 They had a rough night. 86 00:05:50,280 --> 00:05:52,330 Good morning, sunshine. 87 00:05:52,330 --> 00:05:54,200 You obviously haven't seen this board. 88 00:05:54,200 --> 00:05:55,910 Oh, we've seen worse. 89 00:05:55,910 --> 00:05:57,910 Nothing like a little challenge every now and then 90 00:05:57,920 --> 00:05:59,540 to keep everybody on their toes. 91 00:05:59,540 --> 00:06:01,170 - Dr. Robinavitch? - Yep. 92 00:06:01,170 --> 00:06:03,670 Melissa King. I will be joining you today. 93 00:06:03,670 --> 00:06:05,090 I just came from two months at the VA. 94 00:06:05,090 --> 00:06:06,460 Hey, welcome to the Pitt. 95 00:06:06,470 --> 00:06:08,090 This is Dr. Jack Abbot. 96 00:06:08,090 --> 00:06:09,930 Nice to meet you. 97 00:06:09,930 --> 00:06:12,720 I can't tell you how excited I am to be here today, so... 98 00:06:12,720 --> 00:06:15,310 Talk to me at the end of the day. 99 00:06:15,310 --> 00:06:17,730 Ignore him. He had a rough night 100 00:06:17,730 --> 00:06:20,650 and is having an ongoing existential crisis. 101 00:06:20,650 --> 00:06:23,440 Don't worry, you'll get there soon enough. 102 00:06:23,440 --> 00:06:27,570 I married my second husband, Everett, in 1964. 103 00:06:27,570 --> 00:06:31,870 He unfortunately passed in 1976 from a heart attack 104 00:06:31,870 --> 00:06:34,740 while we were vacationing in Kissimmee, Florida. 105 00:06:34,740 --> 00:06:36,620 - It was awful. - Good morning. 106 00:06:36,620 --> 00:06:39,830 We're gonna round, Dr. Mohan. 107 00:06:39,830 --> 00:06:42,380 Excuse me, Estelle. I'll be right back. 108 00:06:44,130 --> 00:06:45,960 So you know we track every resident's 109 00:06:45,960 --> 00:06:47,340 patients seen per hour. 110 00:06:47,340 --> 00:06:49,010 I was just taking her history. 111 00:06:49,010 --> 00:06:50,550 It's a brief backstory about what brought them in, 112 00:06:50,550 --> 00:06:52,010 - not an autobiography. - I was almost done. 113 00:06:52,010 --> 00:06:55,390 You hadn't even made it to this century. 114 00:06:55,390 --> 00:06:58,390 Patients, they check in for registration here. 115 00:06:58,390 --> 00:07:01,600 A nurse eyeballs them, makes sure they're not dying. 116 00:07:01,600 --> 00:07:04,060 If not, they're moved to one of two triage rooms for vitals 117 00:07:04,070 --> 00:07:05,650 and a quick chair exam where you can order 118 00:07:05,650 --> 00:07:07,400 your labs and your X-rays. 119 00:07:07,400 --> 00:07:08,990 And then they come back to... 120 00:07:08,990 --> 00:07:11,150 Waiting room, until a bed opens up. 121 00:07:11,160 --> 00:07:12,660 For how long? 122 00:07:12,660 --> 00:07:14,490 Eight hours, if they're lucky. 123 00:07:14,490 --> 00:07:15,950 A lot of times, 12. 124 00:07:15,950 --> 00:07:18,540 Uh, is it always this busy? 125 00:07:18,540 --> 00:07:20,120 Uh, no. 126 00:07:20,120 --> 00:07:22,630 It gets a lot busier. 127 00:07:25,090 --> 00:07:26,340 Take this. 128 00:07:26,340 --> 00:07:27,380 Hey, Mateo. 129 00:07:27,380 --> 00:07:28,550 Good morning, Cass. 130 00:07:28,550 --> 00:07:30,470 This is Sherry. 131 00:07:30,470 --> 00:07:31,840 Hi. 132 00:07:31,840 --> 00:07:33,720 Sherry, I'm Dr. McKay. 133 00:07:33,720 --> 00:07:35,470 I have some student doctors with me today. 134 00:07:35,470 --> 00:07:36,890 Do you mind if they observe? 135 00:07:36,890 --> 00:07:39,350 - Sure. - OK. 136 00:07:39,350 --> 00:07:40,930 What's going on, Sherry? 137 00:07:40,940 --> 00:07:43,480 I-- 138 00:07:43,480 --> 00:07:46,060 I burned my hand on a Sterno. 139 00:07:46,070 --> 00:07:47,820 What were you doing with a Sterno? 140 00:07:47,820 --> 00:07:49,150 Uh, cooking. 141 00:07:49,150 --> 00:07:51,030 You were cooking with a Sterno? 142 00:07:51,030 --> 00:07:54,490 Yeah, we were making s'mores. 143 00:07:54,490 --> 00:07:55,530 That's sweet. 144 00:07:55,530 --> 00:07:58,410 My son loves s'mores. 145 00:07:58,410 --> 00:08:01,200 Uh, we've-- we've been here for hours, 146 00:08:01,210 --> 00:08:02,790 and I have to get them to school. 147 00:08:02,790 --> 00:08:04,830 Do you know how much longer this will take? 148 00:08:04,830 --> 00:08:08,000 Uh, yeah, let's see. 149 00:08:08,000 --> 00:08:10,420 - You take anything for the pain? - Uh, not yet. 150 00:08:10,420 --> 00:08:11,720 1,000 of Tylenol, 151 00:08:11,720 --> 00:08:12,920 400 ibuprofen, and saline dressing? 152 00:08:12,930 --> 00:08:15,010 Yes, please. 153 00:08:15,010 --> 00:08:16,720 McKay, we're gonna round. 154 00:08:16,720 --> 00:08:18,890 And the fun begins. 155 00:08:18,890 --> 00:08:20,560 All right, Sherry, we're gonna patch you up 156 00:08:20,560 --> 00:08:23,140 and get you out of here as soon as possible, OK? 157 00:08:23,140 --> 00:08:24,940 - I'll be back. - OK. 158 00:08:28,070 --> 00:08:31,360 As you can see, we have some new faces with us this morning. 159 00:08:31,360 --> 00:08:33,190 Good morning, good morning. Come on over. 160 00:08:33,200 --> 00:08:36,110 Starting with second-year resident Dr. Melissa King, 161 00:08:36,120 --> 00:08:37,570 fresh from the VA. 162 00:08:37,580 --> 00:08:39,160 Everyone calls me Mel. 163 00:08:39,160 --> 00:08:41,120 I'm so happy to be here. 164 00:08:41,120 --> 00:08:43,120 Trinity Santos, intern. 165 00:08:43,120 --> 00:08:45,460 Victoria Javadi, MS3. 166 00:08:45,460 --> 00:08:47,960 Uh, Dennis Whitaker, MS4. 167 00:08:47,960 --> 00:08:49,380 Welcome to the Pitt. I'm-- 168 00:08:49,380 --> 00:08:50,800 We've got two traumas from the T. 169 00:08:50,800 --> 00:08:52,420 - Five minutes out. - OK, copy that. 170 00:08:52,420 --> 00:08:54,090 Actually, this is the most important person 171 00:08:54,090 --> 00:08:55,550 that you're gonna meet today. This is Dana. 172 00:08:55,550 --> 00:08:56,970 She's our charge nurse. 173 00:08:56,970 --> 00:08:59,350 She is the ringleader of our circus. 174 00:08:59,350 --> 00:09:01,430 Do what she says when she says it. 175 00:09:01,430 --> 00:09:04,810 As you can see, our house is always packed, 176 00:09:04,810 --> 00:09:07,150 and our department is mostly clogged up with boarders. 177 00:09:07,150 --> 00:09:09,400 Those are admitted patients waiting for a room upstairs, 178 00:09:09,400 --> 00:09:11,320 sometimes for days. 179 00:09:11,320 --> 00:09:13,530 Beds are a very precious commodity around here, 180 00:09:13,530 --> 00:09:14,820 so please be quick and efficient 181 00:09:14,820 --> 00:09:15,820 with your workups. 182 00:09:15,820 --> 00:09:17,280 What else? 183 00:09:17,280 --> 00:09:18,820 We treat the sicker patients back here, 184 00:09:18,820 --> 00:09:20,490 but please keep your eye on that waiting room. 185 00:09:20,490 --> 00:09:23,240 Make sure nobody's gonna die out there. 186 00:09:23,250 --> 00:09:25,750 Your senior residents are Dr. Collins 187 00:09:25,750 --> 00:09:27,420 and Dr. Langdon. 188 00:09:27,420 --> 00:09:30,130 You report to them, and they report to me. 189 00:09:30,130 --> 00:09:31,630 OK? Great. 190 00:09:31,630 --> 00:09:32,960 Senior residents, you got your sign-outs? 191 00:09:32,960 --> 00:09:34,300 - Yep. - Yep. 192 00:09:34,300 --> 00:09:37,340 OK. Let's do this. 193 00:09:37,340 --> 00:09:39,840 Virgil Straker. 194 00:09:39,850 --> 00:09:42,720 9mm GSW to the left shoulder. 195 00:09:42,720 --> 00:09:44,930 CT angiogram negative, surgery wants to admit 196 00:09:44,930 --> 00:09:46,640 for overnight observation. 197 00:09:46,640 --> 00:09:49,020 Good vitals. They repeat a crit? 198 00:09:49,020 --> 00:09:50,560 Stable crits every two hours times three. 199 00:09:50,560 --> 00:09:52,480 Discharge on Ceftin, recheck tomorrow. 200 00:09:52,480 --> 00:09:54,440 He'll get way more rest at home. 201 00:09:54,440 --> 00:09:56,440 Good morning, Mr. Straker. You want to go home? 202 00:09:56,450 --> 00:09:58,200 - Hell yeah. - OK. 203 00:09:58,200 --> 00:09:59,610 Hey. Hey, Ro. 204 00:09:59,620 --> 00:10:01,700 Hey, Ro, I'm finally getting out of here! 205 00:10:03,700 --> 00:10:05,580 All right, Murphy Rottenstein. 206 00:10:05,580 --> 00:10:07,410 48-year-old woman with cirrhosis 207 00:10:07,420 --> 00:10:08,830 and upper GI bleed. 208 00:10:08,830 --> 00:10:11,580 Intubated and stable after one unit. 209 00:10:11,590 --> 00:10:13,210 Awaiting ICU bed. 210 00:10:13,210 --> 00:10:15,090 Hey, Doc. 211 00:10:15,090 --> 00:10:17,840 And we all know Louie Cloverfield. 212 00:10:17,840 --> 00:10:21,640 Blood alcohol of .420 at 11:00 PM. 213 00:10:21,640 --> 00:10:23,600 - I've been cutting back. - How is he still breathing? 214 00:10:23,600 --> 00:10:25,180 That's a lethal dose for you and me. 215 00:10:25,180 --> 00:10:26,730 That's happy hour for Louie. 216 00:10:26,730 --> 00:10:28,480 Sobered up. Had two rounds of lorazepam. 217 00:10:28,480 --> 00:10:31,690 Hold out your hands for me, Louie. 218 00:10:31,690 --> 00:10:33,310 - Another two of lorazepam. - On it. 219 00:10:33,320 --> 00:10:34,440 And a script for Librium. 220 00:10:34,440 --> 00:10:35,570 It's good to see you, Louie. 221 00:10:35,570 --> 00:10:37,690 It's always a pleasure, Doc. 222 00:10:37,700 --> 00:10:39,780 Bar fight with complete avulsion 223 00:10:39,780 --> 00:10:41,780 of tooth number eight. 224 00:10:41,780 --> 00:10:43,450 Smile, Charlie. 225 00:10:43,450 --> 00:10:46,540 Oh! Where's your tooth, Charlie? 226 00:10:46,540 --> 00:10:48,460 Fuck if I know. 227 00:10:48,460 --> 00:10:51,000 Cancel the discharge. Order a chest X-ray. 228 00:10:51,000 --> 00:10:52,540 Got to rule out aspiration. 229 00:10:52,540 --> 00:10:55,210 Incoming! 230 00:10:55,210 --> 00:10:56,960 42-year-old male, Sam Wallace. 231 00:10:56,960 --> 00:10:58,800 Blunt head with agonal respirations. 232 00:10:58,800 --> 00:11:00,550 Dropped down on the T tracks. Couldn't tube him. 233 00:11:00,550 --> 00:11:02,050 - LMA in place. - Suicide attempt? 234 00:11:02,050 --> 00:11:04,050 Rescue. He's a good Samaritan. 235 00:11:04,060 --> 00:11:06,180 Took a spill helping a woman who fell off the track. 236 00:11:06,180 --> 00:11:08,060 - She's right behind us. - OK. Trauma one. Go ahead. 237 00:11:08,060 --> 00:11:09,270 Copy. 238 00:11:09,270 --> 00:11:11,440 Come on. 239 00:11:11,440 --> 00:11:12,850 Woman fell from T platform. 240 00:11:12,860 --> 00:11:14,730 Good vitals and no head injuries. 241 00:11:14,730 --> 00:11:16,320 Degloving injury, right lower leg 242 00:11:16,320 --> 00:11:18,650 with open fracture dislocation to the ankle. 243 00:11:18,650 --> 00:11:20,150 Whoa. OK. 244 00:11:20,150 --> 00:11:22,030 Trauma two. Trauma two. Let's go! 245 00:11:29,000 --> 00:11:31,000 How are we doing? We ready? 246 00:11:31,000 --> 00:11:32,540 OK, here we go. Ready? 247 00:11:32,540 --> 00:11:35,500 One, two, three. 248 00:11:35,500 --> 00:11:36,840 Good breath sounds bilaterally, 249 00:11:36,840 --> 00:11:38,380 but we need to protect... 250 00:11:38,380 --> 00:11:39,840 Apparently he jumped down to save the lady. 251 00:11:39,840 --> 00:11:41,380 When he climbed back up, he slipped, 252 00:11:41,380 --> 00:11:43,180 - fell back, and hit his head. - OK, thanks. 253 00:11:43,180 --> 00:11:44,680 Uh, Mel, right? 254 00:11:44,680 --> 00:11:46,390 I need you on the E-FAST. 255 00:11:46,390 --> 00:11:48,260 Pupils 4 millimeters and reactive. 256 00:11:48,270 --> 00:11:50,100 OK, that's encouraging. 257 00:11:50,100 --> 00:11:52,100 - What do you want for meds? - 120 ketamine, 80 of rock. 258 00:11:52,100 --> 00:11:54,520 - A-fib on a monitor. - Courses clear. 259 00:11:54,520 --> 00:11:56,520 That's a lot more blood than expected. 260 00:11:56,520 --> 00:11:59,820 Um, he's probably anticoagulated for A-fib. 261 00:11:59,820 --> 00:12:01,860 Check his medical records, see if he's on a DOAC. 262 00:12:01,860 --> 00:12:04,450 Stand by with four-factor PCC if there's a brain bleed. 263 00:12:04,450 --> 00:12:06,490 What's in the PCC, Mel? 264 00:12:06,490 --> 00:12:09,540 Uh, clotting factors two, seven, nine, and ten. 265 00:12:09,540 --> 00:12:11,370 OK. Be right back. 266 00:12:11,370 --> 00:12:13,000 50 of fent didn't touch her. 267 00:12:13,000 --> 00:12:14,580 Did she faint or did she trip off the platform? 268 00:12:14,580 --> 00:12:16,250 Nobody knows. 269 00:12:16,250 --> 00:12:17,590 The other guy jumped down, pulled her off the tracks 270 00:12:17,590 --> 00:12:18,670 just as the train was rolling in. 271 00:12:18,670 --> 00:12:19,960 Isolated injury to the foot. 272 00:12:19,960 --> 00:12:21,300 The train ran over her foot? 273 00:12:21,300 --> 00:12:22,300 Got caught between the platform 274 00:12:22,300 --> 00:12:23,470 and the incoming train. 275 00:12:23,470 --> 00:12:24,840 Ma'am? Ma'am, what's your name? 276 00:12:24,840 --> 00:12:26,180 All right, type 3 open fracture. 277 00:12:26,180 --> 00:12:27,970 Two grams Cefazolin, 400 of gent. 278 00:12:27,970 --> 00:12:29,810 Do you speak any English? 279 00:12:29,810 --> 00:12:31,730 Airway and breathing are perfect. 280 00:12:31,730 --> 00:12:33,270 As is circulation. 281 00:12:33,270 --> 00:12:35,650 BP 140 over 85. 282 00:12:35,650 --> 00:12:38,190 Students, what might have made her faint on the platform? 283 00:12:38,190 --> 00:12:39,610 - Uh, TIA, CVA. - Could be an arrhythmia, 284 00:12:39,610 --> 00:12:41,360 - cardiac event. - So she needs... 285 00:12:41,360 --> 00:12:42,940 - Hed CT. - EKG and troponin. 286 00:12:42,950 --> 00:12:44,450 - OK, good. - What do we got, party people? 287 00:12:44,450 --> 00:12:45,950 Subway train degloved her foot 288 00:12:45,950 --> 00:12:47,490 with an open fracture dislocation. 289 00:12:47,490 --> 00:12:48,990 Ooh, and I thought my heels were painful. 290 00:12:48,990 --> 00:12:50,740 - Hemodynamically stable. - E-FAST negative. 291 00:12:50,750 --> 00:12:52,290 Ma'am, I'm Dr. Yolanda Garcia. 292 00:12:52,290 --> 00:12:54,080 Any pain in your chest or belly? 293 00:12:56,880 --> 00:12:58,290 Can we please push the morphine? 294 00:12:58,290 --> 00:13:00,340 No, it could cloud her mental status. 295 00:13:00,340 --> 00:13:03,340 I can't do an exam like this. Push the damn morphine. 296 00:13:03,340 --> 00:13:04,920 We're doing a popliteal block. 297 00:13:04,930 --> 00:13:06,630 Numbs the lower leg, no side effects. 298 00:13:06,640 --> 00:13:07,970 Wonderful. Where's the other guy? 299 00:13:07,970 --> 00:13:09,470 Next door. He's a bit worse. 300 00:13:09,470 --> 00:13:10,850 Pan scan her. 301 00:13:10,850 --> 00:13:12,850 Let me know when she stops screaming. 302 00:13:16,020 --> 00:13:17,560 The cords are very anterior. 303 00:13:17,560 --> 00:13:19,360 Yeah, that's because we can't flex the neck. 304 00:13:19,360 --> 00:13:22,280 Keep the hockey stick straight up. 305 00:13:22,280 --> 00:13:24,150 - I'm in. - Good. Well done. 306 00:13:24,150 --> 00:13:25,490 Bring me up to speed. 307 00:13:25,490 --> 00:13:27,240 Intubated for agonal respirations. 308 00:13:27,240 --> 00:13:29,910 GCS 5. Probably anticoagulated. 309 00:13:29,910 --> 00:13:31,030 With what? 310 00:13:31,040 --> 00:13:32,160 First time here. 311 00:13:32,160 --> 00:13:33,790 There's no medical records. 312 00:13:33,790 --> 00:13:36,410 - Call for FFP? - No, we got four-factor PCC. 313 00:13:36,420 --> 00:13:38,210 80 of mannitol to reduce brain swelling, 314 00:13:38,210 --> 00:13:39,380 then right up to CT. 315 00:13:40,880 --> 00:13:42,250 Do me a favor. 316 00:13:42,250 --> 00:13:43,510 Swap out with Jesse for me, would you? 317 00:13:43,510 --> 00:13:44,920 Of course. 318 00:13:44,920 --> 00:13:46,470 Dr. Robinavitch, do you have a moment? 319 00:13:46,470 --> 00:13:48,090 I'm just a little busy right now, Gloria. 320 00:13:48,090 --> 00:13:49,550 One sec. 321 00:13:50,680 --> 00:13:52,430 Nerve block complete. 322 00:13:52,430 --> 00:13:53,970 Seems like it's starting to work. 323 00:13:53,970 --> 00:13:55,480 Swapping out, Jesse. 324 00:13:55,480 --> 00:13:56,980 Takes ten minutes for the full effect, 325 00:13:56,980 --> 00:13:58,690 and the Marcaine lasts a good four hours. 326 00:13:58,690 --> 00:14:00,440 She's next for CT. 327 00:14:00,440 --> 00:14:01,730 You have any idea what language that is? 328 00:14:01,730 --> 00:14:02,980 Definitely not Tagalog. 329 00:14:02,980 --> 00:14:04,780 Maybe Hindi or Urdu. 330 00:14:04,780 --> 00:14:06,320 I'm gonna go get language services. 331 00:14:06,320 --> 00:14:07,740 Don't you speak, like, five languages? 332 00:14:07,740 --> 00:14:09,320 Six, but that's not one of them. 333 00:14:09,320 --> 00:14:10,660 Six? 334 00:14:10,660 --> 00:14:11,660 And I thought Collins was smart. 335 00:14:11,660 --> 00:14:13,030 Oh, it's way too early 336 00:14:13,040 --> 00:14:14,580 for you to start being an ass, Langdon. 337 00:14:14,580 --> 00:14:16,120 Open hostility in front of the patient? 338 00:14:16,120 --> 00:14:17,660 She doesn't speak English. 339 00:14:17,670 --> 00:14:19,330 Judgmental and dismissive. 340 00:14:19,330 --> 00:14:20,790 How are we doing? 341 00:14:20,790 --> 00:14:22,960 - Vitals stable. - Unlike these two. 342 00:14:22,960 --> 00:14:25,300 Ooh, good for you. Princess made a joke. 343 00:14:25,300 --> 00:14:26,800 Why are you always an asshole? 344 00:14:26,800 --> 00:14:28,300 And I thank you for that beautiful blessing. 345 00:14:28,300 --> 00:14:30,550 - Namaste. - OK, do we have a phone 346 00:14:30,550 --> 00:14:31,890 or anything with a relative's name on it? 347 00:14:31,890 --> 00:14:33,970 EMT said the purse got obliterated 348 00:14:33,970 --> 00:14:36,640 when the subway ran over it. 349 00:14:36,640 --> 00:14:39,020 - Any way I can speak with her? - Highly doubt it. 350 00:14:39,020 --> 00:14:40,600 We don't know what language she speaks. 351 00:14:40,600 --> 00:14:44,570 Hey, um, any chance she jumped? 352 00:14:44,570 --> 00:14:46,280 She may have been pushed. 353 00:14:46,280 --> 00:14:47,690 - Jesus. - Yeah. 354 00:14:47,700 --> 00:14:49,360 Could be looking at a possible hate crime. 355 00:14:49,360 --> 00:14:50,700 I take it you're free now? 356 00:14:55,700 --> 00:14:57,200 We need to talk about your numbers. 357 00:14:57,200 --> 00:14:59,580 - Of people we've saved? - Metrics. 358 00:14:59,580 --> 00:15:01,920 Our door-to-balloon times beat federal standards. 359 00:15:01,920 --> 00:15:04,840 I'm talking about Press Ganey scores. 360 00:15:04,840 --> 00:15:06,630 Patient satisfaction. 361 00:15:06,630 --> 00:15:08,670 If they're still alive, they should be satisfied. 362 00:15:08,670 --> 00:15:11,970 Our goal is 36% very satisfied with their care. 363 00:15:11,970 --> 00:15:14,390 Your department is at 8. 364 00:15:14,390 --> 00:15:16,810 Do you know how likely patients are to recommend this hospital? 365 00:15:16,810 --> 00:15:18,220 This is an emergency department, 366 00:15:18,230 --> 00:15:19,930 not a Taco Bell. 367 00:15:19,940 --> 00:15:21,440 11%. 368 00:15:21,440 --> 00:15:22,810 Well, if you want people to be happier, 369 00:15:22,810 --> 00:15:24,480 don't make 'em wait for 12 hours. 370 00:15:24,480 --> 00:15:26,320 There's a nursing shortage across the country. 371 00:15:26,320 --> 00:15:28,360 Most of our patients are boarders 372 00:15:28,360 --> 00:15:31,110 who are waiting for a bed upstairs. 373 00:15:31,110 --> 00:15:32,740 We don't have the beds. 374 00:15:32,740 --> 00:15:34,370 That's bullshit. The beds are up there. 375 00:15:34,370 --> 00:15:35,660 You just don't want to hire the staff you need 376 00:15:35,660 --> 00:15:37,700 to care for them. 377 00:15:37,700 --> 00:15:40,290 Oh, Doc. Doc, it ain't working. 378 00:15:40,290 --> 00:15:42,460 Man, whatever they're giving me, it's not working. 379 00:15:42,460 --> 00:15:44,170 No response to mag citrate. 380 00:15:44,170 --> 00:15:46,540 Should I send in the Fleet? 381 00:15:46,550 --> 00:15:49,210 OK, sir, we're gonna try an enema. 382 00:15:49,220 --> 00:15:51,510 Like I said, there's a nursing shortage. 383 00:15:51,510 --> 00:15:52,880 Well, if you paid them a living wage, 384 00:15:52,890 --> 00:15:54,300 they'd be lining up to work here. 385 00:15:54,300 --> 00:15:55,800 Our budget can't support that. 386 00:15:55,810 --> 00:15:57,430 Here's a dirty little secret. 387 00:15:57,430 --> 00:15:58,890 The hospital saves money 388 00:15:58,890 --> 00:16:00,520 keeping patients down here in the Pitt. 389 00:16:00,520 --> 00:16:02,350 It's way cheaper than staffing upstairs. 390 00:16:02,350 --> 00:16:04,100 I have asked you repeatedly 391 00:16:04,110 --> 00:16:06,310 to stop referring to the emergency department 392 00:16:06,320 --> 00:16:08,610 as the Pitt--it is derogatory 393 00:16:08,610 --> 00:16:10,740 and incompatible to the institution's image. 394 00:16:10,740 --> 00:16:12,400 You know what's incompatible with the institution's image? 395 00:16:12,410 --> 00:16:14,070 Me speaking to the media 396 00:16:14,070 --> 00:16:15,870 about people who code in our waiting rooms 397 00:16:15,870 --> 00:16:17,620 and people who get shitty care in our hallways 398 00:16:17,620 --> 00:16:19,410 waiting for an ICU bed for days. 399 00:16:19,410 --> 00:16:21,410 I've heard about doctors who have tried that 400 00:16:21,410 --> 00:16:23,080 and find themselves out of work. 401 00:16:23,080 --> 00:16:24,460 Uh-huh. 402 00:16:24,460 --> 00:16:25,830 I know today is difficult for you. 403 00:16:25,840 --> 00:16:27,460 Every day is difficult down here. 404 00:16:27,460 --> 00:16:29,630 Boarding is a nationwide problem. 405 00:16:29,630 --> 00:16:32,090 Your predecessor, Adamson, sure as hell knew that. 406 00:16:32,090 --> 00:16:33,760 Or wasn't that something he taught you? 407 00:16:33,760 --> 00:16:36,180 Fuck. Wow. Really? 408 00:16:36,180 --> 00:16:37,970 Yes, really. 409 00:16:37,970 --> 00:16:39,890 Other hospitals are managing this crisis 410 00:16:39,890 --> 00:16:41,220 much more effectively. 411 00:16:41,230 --> 00:16:42,980 So you can either step up your game, 412 00:16:42,980 --> 00:16:44,650 or you can step aside. 413 00:16:55,870 --> 00:16:57,950 Good Samaritan dude has a small left temporal 414 00:16:57,950 --> 00:16:59,830 intraparenchymal bleed. 415 00:16:59,830 --> 00:17:01,950 No epidural, no subdural, no midline shift in the brain. 416 00:17:01,950 --> 00:17:03,500 Oh, that's good news. He could recover. 417 00:17:03,500 --> 00:17:04,910 CT can take her in five. 418 00:17:04,920 --> 00:17:06,670 Let's have a look. Bandage scissors? 419 00:17:06,670 --> 00:17:08,080 All right. 420 00:17:08,090 --> 00:17:10,090 If an artery is totally transected, 421 00:17:10,090 --> 00:17:12,050 the smooth muscle and the tunica media 422 00:17:12,050 --> 00:17:13,760 contracts with hemostasis. 423 00:17:13,760 --> 00:17:16,550 But if it's a partial cut, get out your umbrella. 424 00:17:16,550 --> 00:17:19,430 Grab a culture from the open fibula before you reduce. 425 00:17:19,430 --> 00:17:22,140 You're up. 426 00:17:22,140 --> 00:17:24,100 I'll stabilize the knee for the reduction. 427 00:17:24,100 --> 00:17:26,690 Dr. Langdon will be distracting distally 428 00:17:26,690 --> 00:17:29,560 before moving medially to clear the tibia. 429 00:17:29,570 --> 00:17:32,070 Good. 430 00:17:32,070 --> 00:17:33,360 Ready? 431 00:17:45,500 --> 00:17:47,790 Med student down. 432 00:17:48,880 --> 00:17:50,670 Good catch on Bar Fight Billy. 433 00:17:50,670 --> 00:17:52,670 There was an aspirated tooth on chest X-ray. 434 00:17:52,670 --> 00:17:54,380 Would have been dead in a week from a lung abscess 435 00:17:54,380 --> 00:17:55,550 had you let him be discharged. 436 00:17:55,550 --> 00:17:56,840 Good call on the pulmonary. 437 00:17:56,840 --> 00:17:58,680 Cardiac arrest, ETA 10 minutes. 438 00:17:58,680 --> 00:18:00,600 - Where should we put it? - Anywhere. 439 00:18:00,600 --> 00:18:02,760 We might have to put somebody in the hall. 440 00:18:02,770 --> 00:18:05,060 Dr. Robby? She, uh, took a fall. 441 00:18:05,060 --> 00:18:06,810 No, I-- I tripped on the gurney. 442 00:18:06,810 --> 00:18:08,100 I'm fine. 443 00:18:10,440 --> 00:18:12,360 Why don't you go get a cold drink 444 00:18:12,360 --> 00:18:14,900 in the staff lounge? 445 00:18:14,900 --> 00:18:16,320 I'm fine, really. I swear. 446 00:18:16,320 --> 00:18:18,200 Oh, I know, but it's hospital policy. 447 00:18:18,200 --> 00:18:19,950 Anytime someone gets a paper cut around here, 448 00:18:19,950 --> 00:18:21,740 we have to fill out a workers' comp report. 449 00:18:27,120 --> 00:18:28,830 Other way. 450 00:18:31,090 --> 00:18:33,130 I was fine until about two weeks ago, 451 00:18:33,130 --> 00:18:34,460 after the Rochester Marathon. 452 00:18:34,460 --> 00:18:36,840 OK. Any falls or injuries? 453 00:18:36,840 --> 00:18:38,800 Just tired. Sore muscles. 454 00:18:38,800 --> 00:18:40,930 Yeah, I'd be in bed for a month. 455 00:18:40,930 --> 00:18:42,510 Was this your first triathlon? 456 00:18:42,510 --> 00:18:43,640 God no. 457 00:18:43,640 --> 00:18:45,890 No, I do one every few months. 458 00:18:45,890 --> 00:18:47,810 Have you seen a doctor yet? 459 00:18:47,810 --> 00:18:49,890 Uh, no. 460 00:18:49,900 --> 00:18:51,690 I went for a run this morning. 461 00:18:51,690 --> 00:18:53,110 Had to quit after a minute. 462 00:18:53,110 --> 00:18:54,270 Pretty short of breath. 463 00:18:54,280 --> 00:18:56,860 This goes under your tongue. 464 00:18:56,860 --> 00:18:58,700 - No current meds, no allergies? - Mm-mm. 465 00:18:58,700 --> 00:19:00,820 We're gonna check a few labs and an EKG. 466 00:19:00,820 --> 00:19:03,030 - Draw a red and purple top. - Yep. 467 00:19:06,080 --> 00:19:08,580 Temp 98.2. 468 00:19:08,580 --> 00:19:10,290 Take a deep breath for me, Otis. 469 00:19:11,750 --> 00:19:13,590 Little pinprick now, OK? 470 00:19:17,210 --> 00:19:19,380 Otis? 471 00:19:19,380 --> 00:19:21,090 Otis. 472 00:19:21,090 --> 00:19:23,010 I didn't take him for a lightweight, huh? 473 00:19:25,770 --> 00:19:27,100 Oh, shit. No pulse. 474 00:19:27,100 --> 00:19:29,270 Crash cart! Lay him flat! 475 00:19:31,440 --> 00:19:33,230 - Let's check a rhythm. - Saline pads. 476 00:19:35,860 --> 00:19:37,650 Quick look paddles. 477 00:19:40,780 --> 00:19:42,200 V-tach. 478 00:19:42,200 --> 00:19:43,820 Charging at 200. 479 00:19:43,820 --> 00:19:45,080 Charged. 480 00:19:45,080 --> 00:19:46,410 Clear! 481 00:19:47,950 --> 00:19:49,790 All right, he's back to normal sinus. 482 00:19:49,790 --> 00:19:51,170 Need a gurney in here! 483 00:19:53,380 --> 00:19:55,170 So what's the plan? 484 00:19:55,170 --> 00:19:59,090 ICU when we can get a bed and admit for supportive care. 485 00:19:59,090 --> 00:20:02,300 Repeat head CT in three hours. 486 00:20:02,300 --> 00:20:04,470 Or sooner, if he blows a pupil. 487 00:20:04,470 --> 00:20:06,720 - Want a Keppra load? - Order's already in. 488 00:20:08,390 --> 00:20:09,600 Nice job. 489 00:20:11,890 --> 00:20:13,770 Do you think he'll wake up? 490 00:20:13,770 --> 00:20:15,860 Maybe. 491 00:20:15,860 --> 00:20:18,780 Maybe not. 492 00:20:18,780 --> 00:20:22,860 No good deed goes unpunished. 493 00:20:22,860 --> 00:20:25,870 Oh, has anyone, um, notified the family? 494 00:20:29,790 --> 00:20:31,450 I could try. 495 00:20:31,460 --> 00:20:33,920 Otis Williams. Healthy 31-year-old. 496 00:20:33,920 --> 00:20:36,500 V-tach arrest two weeks after triathlon. 497 00:20:36,500 --> 00:20:38,210 NSR with one shock. 498 00:20:38,210 --> 00:20:40,210 Pulse 98, BP 110 over 60. 499 00:20:40,210 --> 00:20:41,300 He's a little young for an MI. 500 00:20:41,300 --> 00:20:42,800 Exactly right, 501 00:20:42,800 --> 00:20:44,220 What's in the differential, Dr. Collins? 502 00:20:44,220 --> 00:20:46,930 Drug overdose, electrolytes, long QT-- 503 00:20:46,930 --> 00:20:48,890 ooh, Brugada syndrome, WPW... 504 00:20:48,890 --> 00:20:50,600 How you doing there, Otis? 505 00:20:50,600 --> 00:20:52,480 OK. What ha-- 506 00:20:53,140 --> 00:20:54,190 V-tach again. 507 00:20:54,190 --> 00:20:55,560 200 joules. 508 00:20:55,560 --> 00:20:58,820 Charged, and clear! 509 00:20:58,820 --> 00:21:00,730 Back in sinus. 510 00:21:00,740 --> 00:21:01,940 Otis? 511 00:21:04,530 --> 00:21:06,450 Otis? 512 00:21:06,450 --> 00:21:09,580 Oh, groaning's good. 5 of nasal O2, CBC, 513 00:21:09,580 --> 00:21:12,250 CMP, troponin, and D-dimer. 514 00:21:12,250 --> 00:21:13,620 What are you doing? 515 00:21:13,620 --> 00:21:15,370 One gram calcium gluconate, IV push. 516 00:21:15,370 --> 00:21:17,130 - We don't have the labs back. - Look at the monitor. 517 00:21:17,130 --> 00:21:18,500 Widened QRS and PT waves. 518 00:21:18,500 --> 00:21:20,050 - Hyperkalemia. - How'd he get that? 519 00:21:20,050 --> 00:21:21,760 Intense exercise caused muscle breakdown. 520 00:21:21,760 --> 00:21:23,090 Rhabdomyolysis knocked out his kidneys. 521 00:21:23,090 --> 00:21:24,220 Now he's not clearing potassium. 522 00:21:24,220 --> 00:21:25,590 I bet it's over 7.5. 523 00:21:25,590 --> 00:21:27,260 Wait two minutes for the i-STAT. 524 00:21:27,260 --> 00:21:28,760 If he arrests again, we might not get him back. 525 00:21:28,760 --> 00:21:30,220 If it's hypercalcemia, you could kill him. 526 00:21:30,220 --> 00:21:32,770 - Wait. - Oh, it's my ass, not yours. 527 00:21:43,400 --> 00:21:44,740 Pan scan is negative. 528 00:21:44,740 --> 00:21:46,400 That means you can admit to orthopedics. 529 00:21:46,410 --> 00:21:48,280 But there may have been a medical etiology 530 00:21:48,280 --> 00:21:50,120 - if she fainted. - That's not surgical. 531 00:21:50,120 --> 00:21:51,740 Get an internal medicine consult, 532 00:21:51,740 --> 00:21:54,000 or admit to medicine with ortho consulting. 533 00:21:54,000 --> 00:21:55,290 Either way, I'm off the case. 534 00:21:55,290 --> 00:21:57,540 OK. Thanks for nothing. 535 00:21:57,540 --> 00:22:00,460 Ancef's in. I'll grab the gent. 536 00:22:00,460 --> 00:22:02,250 Did we figure out what she's speaking? 537 00:22:02,250 --> 00:22:04,840 Last interpreter thought she might be from Pakistan. 538 00:22:04,840 --> 00:22:07,470 There are 77 languages in Pakistan. 539 00:22:07,470 --> 00:22:10,600 OK, well, I will buy lunch for whoever figures it out. 540 00:22:10,600 --> 00:22:12,060 Good luck. 541 00:22:12,060 --> 00:22:14,930 If you need me, I'll be saving lives. 542 00:22:14,930 --> 00:22:16,890 That was wicked. 543 00:22:16,890 --> 00:22:19,600 - That was gross. - Yeah. 544 00:22:19,610 --> 00:22:21,820 Too much for Little Miss Crash and Burn. 545 00:22:21,820 --> 00:22:23,360 - What'd you do with her? - Nothing. 546 00:22:23,360 --> 00:22:25,860 - I think she'll be fine. - Are you kidding? 547 00:22:25,860 --> 00:22:27,280 If that took her out, she'll be lucky to make it 548 00:22:27,280 --> 00:22:29,030 through this rotation. 549 00:22:29,030 --> 00:22:30,780 I got 50 bucks says she doesn't last through this shift. 550 00:22:32,620 --> 00:22:33,910 Come on. 551 00:22:33,910 --> 00:22:35,250 Put your money where your mouth is. 552 00:22:35,250 --> 00:22:37,830 Uh, no. I didn't say anything, OK? 553 00:22:37,830 --> 00:22:40,460 And I sure as hell don't have 50 bucks. 554 00:22:40,460 --> 00:22:41,880 I'll be this lady's age by the time 555 00:22:41,880 --> 00:22:43,130 I pay off my student loans. 556 00:22:43,130 --> 00:22:44,420 Not that you're-- 557 00:22:45,970 --> 00:22:47,720 Hey. 558 00:22:47,720 --> 00:22:50,260 You want to sell a kidney? 559 00:22:50,260 --> 00:22:53,510 I could get you 30K as soon as this weekend. 560 00:22:53,510 --> 00:22:56,600 That's just between you and me. 561 00:22:56,600 --> 00:22:57,890 Think about it. 562 00:23:02,610 --> 00:23:04,770 How you doing? 563 00:23:04,780 --> 00:23:06,480 Yeah. 564 00:23:06,490 --> 00:23:08,360 QRS has narrowed. 565 00:23:08,360 --> 00:23:09,400 Much better. 566 00:23:09,410 --> 00:23:11,280 Potassium is 7.7. 567 00:23:11,280 --> 00:23:13,530 Creatinine, 5.6. 568 00:23:13,530 --> 00:23:15,290 High potassium and renal failure. 569 00:23:15,290 --> 00:23:16,540 Just what you thought. 570 00:23:16,540 --> 00:23:18,290 It must be my lucky day. 571 00:23:18,290 --> 00:23:20,460 Ordering 10 units of regular insulin 572 00:23:20,460 --> 00:23:23,750 and 25 grams of glucose. 573 00:23:23,750 --> 00:23:25,630 Why insulin and glucose? 574 00:23:25,630 --> 00:23:27,380 Shift the potassium intracellularly. 575 00:23:27,380 --> 00:23:29,130 Exactly, but the definitive treatment is... 576 00:23:29,130 --> 00:23:30,630 Hemodialysis. I'll call renal 577 00:23:30,630 --> 00:23:32,550 and get a tech down with the machine. 578 00:23:32,550 --> 00:23:35,640 Have you ever seen a dialysis catheter inserted? 579 00:23:35,640 --> 00:23:37,430 Dr. Collins is gonna place a femoral Quinton 580 00:23:37,430 --> 00:23:38,600 under ultrasound guidance. 581 00:23:38,600 --> 00:23:39,770 It's an excellent way to learn. 582 00:23:39,770 --> 00:23:41,980 Oh, my chest. 583 00:23:41,980 --> 00:23:43,440 Yeah, we had to shock you. 584 00:23:43,440 --> 00:23:45,270 You're gonna be sore for a while. 585 00:23:45,270 --> 00:23:46,860 You shocked my heart? 586 00:23:46,860 --> 00:23:49,030 Long story. Dr. Collins will fill you in. 587 00:23:57,120 --> 00:23:59,370 You got a sec? 588 00:24:02,080 --> 00:24:03,670 You OK? 589 00:24:03,670 --> 00:24:05,590 Why wouldn't I be? Are you OK? 590 00:24:05,590 --> 00:24:07,420 Why wouldn't I be? 591 00:24:08,880 --> 00:24:10,420 You seem annoyed with me already, 592 00:24:10,420 --> 00:24:13,130 and I just got here. 593 00:24:13,140 --> 00:24:15,640 It's not always about you, Robby. 594 00:24:17,560 --> 00:24:19,390 Am I gonna be OK? 595 00:24:19,390 --> 00:24:20,930 Yeah. 596 00:24:20,940 --> 00:24:23,100 You just need to take it easy on yourself. 597 00:24:23,100 --> 00:24:26,610 Muscle breakdown and myoglobin damaged your kidneys. 598 00:24:26,610 --> 00:24:28,400 Why'd you shock my heart? 599 00:24:28,400 --> 00:24:31,030 When your kidneys don't work, potassium builds up 600 00:24:31,030 --> 00:24:35,530 and messes with the electrical activity in your heart. 601 00:24:35,530 --> 00:24:37,780 Can it happen again? 602 00:24:37,790 --> 00:24:39,740 We gave you medicine to lower your potassium, 603 00:24:39,750 --> 00:24:42,290 and you'll need dialysis to clear it all out. 604 00:24:42,290 --> 00:24:44,170 Then I'll be OK? 605 00:24:44,170 --> 00:24:45,420 Yeah. 606 00:24:45,420 --> 00:24:46,840 You might need a week or two 607 00:24:46,840 --> 00:24:49,460 for your kidneys to recover, but yeah. 608 00:24:49,460 --> 00:24:51,800 You really need to hydrate like crazy 609 00:24:51,800 --> 00:24:54,720 before and after a triathlon. 610 00:24:54,720 --> 00:24:58,390 Trust me, I won't let this happen again. 611 00:24:58,390 --> 00:25:01,020 Good. 612 00:25:01,020 --> 00:25:03,560 Be kind to yourself, OK? 613 00:25:13,780 --> 00:25:14,700 Oh, hey. 614 00:25:14,700 --> 00:25:16,530 Abbot's told me that he's got a pregnant teen 615 00:25:16,530 --> 00:25:17,990 coming back today for mifepristone. 616 00:25:17,990 --> 00:25:19,870 - Let me know when she gets here. - Yep. 617 00:25:19,870 --> 00:25:21,370 Bowel obstruction, still waiting 618 00:25:21,370 --> 00:25:23,120 on a surgery consult. What about Garcia? 619 00:25:23,120 --> 00:25:25,120 She was just here for the traumas. 620 00:25:25,120 --> 00:25:27,460 I think she was waiting for her attending to sign off. 621 00:25:29,590 --> 00:25:32,010 OK. 622 00:25:32,010 --> 00:25:34,670 Oh, one of the med students took a header. 623 00:25:34,680 --> 00:25:36,130 I parked her in the lounge under the guise 624 00:25:36,140 --> 00:25:37,590 of a work comp report. 625 00:25:37,600 --> 00:25:38,720 Will you just go in there, eyeball her, 626 00:25:38,720 --> 00:25:40,180 and make sure she's all right? 627 00:25:40,180 --> 00:25:41,260 She's gonna miss the morning arrival 628 00:25:41,270 --> 00:25:42,600 of the living dead. 629 00:25:42,600 --> 00:25:44,140 How many are we expecting? 630 00:25:44,140 --> 00:25:45,890 We were getting three, but one died en route. 631 00:25:45,900 --> 00:25:47,770 Don't know who's luckier, us or them. 632 00:25:47,770 --> 00:25:49,440 - What's open? - 14. 633 00:25:49,440 --> 00:25:51,070 89-year-old woman from a SNF. 634 00:25:51,070 --> 00:25:53,440 History of emphysema, CHF, MS. 635 00:25:53,440 --> 00:25:55,280 V-fib, unresponsive to three shocks. 636 00:25:55,280 --> 00:25:57,530 - Two rounds of epi. - What is that? 637 00:25:57,530 --> 00:25:59,070 LUCAS chest compression system. 638 00:25:59,080 --> 00:26:00,580 Robotic CPR. 639 00:26:03,200 --> 00:26:05,830 Everybody get a hold. One, two, three. 640 00:26:11,050 --> 00:26:12,840 Students are dropping like flies. 641 00:26:12,840 --> 00:26:14,550 Take a break. Ice the finger. 642 00:26:14,550 --> 00:26:16,930 You can count on getting a couple elderly patients 643 00:26:16,930 --> 00:26:19,550 every day around 7:30, after the nursing homes 644 00:26:19,550 --> 00:26:21,930 and assisted living facilities do their morning bed checks. 645 00:26:21,930 --> 00:26:24,100 You can practically set your watch. 646 00:26:24,100 --> 00:26:25,480 Was there an advanced directive? 647 00:26:25,480 --> 00:26:27,480 No, full code, per the nursing home. 648 00:26:27,480 --> 00:26:29,730 Seriously? 649 00:26:29,730 --> 00:26:32,270 LUCAS off. 650 00:26:32,270 --> 00:26:33,730 Still V-fib. 651 00:26:33,730 --> 00:26:35,280 LUCAS on. 652 00:26:35,280 --> 00:26:37,700 One more round of epi, one more shock, 653 00:26:37,700 --> 00:26:39,820 and then we call it? 654 00:26:43,370 --> 00:26:44,910 Joseph Spencer, 79. 655 00:26:44,910 --> 00:26:46,870 Fever and cough. From assisted living. 656 00:26:46,870 --> 00:26:49,620 He has a history of mild Alzheimer's. 657 00:26:49,630 --> 00:26:52,420 One, two, three. 658 00:26:52,420 --> 00:26:54,340 Heart rate 130. BP 90 over 60. 659 00:26:54,340 --> 00:26:56,510 Gave him 500 cc's normal saline. 660 00:26:56,510 --> 00:26:58,260 Hi, Mr. Spencer. I'm Dr. King. 661 00:26:58,260 --> 00:26:59,760 This is Dr. Collins. 662 00:26:59,760 --> 00:27:01,300 How are you feeling today? 663 00:27:01,300 --> 00:27:04,560 Is it dinnertime? I--I'm not really hungry. 664 00:27:04,560 --> 00:27:06,390 Do we have any paperwork from the facility? 665 00:27:06,390 --> 00:27:07,640 He has a POLST. 666 00:27:07,640 --> 00:27:09,140 IV fluids and medications are fine, 667 00:27:09,150 --> 00:27:11,190 but no intubation and no chest compressions. 668 00:27:11,190 --> 00:27:12,610 That's helpful. 669 00:27:12,610 --> 00:27:14,320 Coarse rhonchi here. 670 00:27:14,320 --> 00:27:16,650 Right middle lobe infiltrate. 671 00:27:16,650 --> 00:27:19,530 Temp 102. Call a code sepsis. 672 00:27:19,530 --> 00:27:21,030 - Mm-hmm. - Code? 673 00:27:21,030 --> 00:27:22,950 To make sure we check all of our boxes. 674 00:27:22,950 --> 00:27:25,120 The federal government audits our sepsis bundle performance 675 00:27:25,120 --> 00:27:26,830 and publishes the data online. 676 00:27:26,830 --> 00:27:28,710 Today, it better be perfect. 677 00:27:28,710 --> 00:27:31,670 Two sets of blood cultures, lactic acid, 678 00:27:31,670 --> 00:27:35,090 30 cc's per kilo NS, a gram of ceftriaxone, 679 00:27:35,090 --> 00:27:39,050 500 of azithromycin, repeat lactic in three hours. 680 00:27:39,050 --> 00:27:40,590 Nice. 681 00:27:40,590 --> 00:27:45,010 Charging, and... 682 00:27:45,010 --> 00:27:46,260 Stop. 683 00:27:46,270 --> 00:27:47,600 Call it. 684 00:27:47,600 --> 00:27:49,350 Nursing home just faxed us a DNR. 685 00:27:49,350 --> 00:27:51,140 Are you kidding me? 686 00:27:51,150 --> 00:27:52,940 Power off the defibrillator and the LUCAS. 687 00:27:52,940 --> 00:27:54,270 Complete waste of time and money. 688 00:27:54,270 --> 00:27:55,690 Who the hell works at that place? 689 00:27:55,690 --> 00:27:56,860 A nurse taking care of 60 patients 690 00:27:56,860 --> 00:27:58,570 who couldn't find the form. 691 00:27:58,570 --> 00:28:00,400 She called 911 so she could take care of the others. 692 00:28:00,400 --> 00:28:01,950 OK, let's move her to the viewing room 693 00:28:01,950 --> 00:28:04,450 - and notify the family. - Yep. 694 00:28:04,450 --> 00:28:07,910 One of the things we do here is to take a moment of silence 695 00:28:07,910 --> 00:28:11,500 when we lose a patient, to respect their humanity 696 00:28:11,500 --> 00:28:14,080 and also to remember that this was somebody's child 697 00:28:14,090 --> 00:28:18,260 or sibling or parent, friend. 698 00:28:28,600 --> 00:28:31,390 Oh. Ow, ow! 699 00:28:32,480 --> 00:28:34,150 I am so sorry. 700 00:28:34,150 --> 00:28:36,360 Maybe leave it on vibrate while you're working. 701 00:28:39,650 --> 00:28:41,900 - Later, Doc. - You behave yourself now. 702 00:28:41,900 --> 00:28:43,450 Always. 703 00:28:45,570 --> 00:28:48,160 Your med student's back on her feet. 704 00:28:48,160 --> 00:28:50,540 - How old's that kid? - I don't know. I didn't ask. 705 00:28:50,540 --> 00:28:51,910 What is she, some sort of savant? 706 00:28:51,910 --> 00:28:53,160 I don't know. Maybe. 707 00:28:53,170 --> 00:28:54,620 Dr. Robinavitch. 708 00:28:54,630 --> 00:28:56,040 I just wanted to apologize for any trouble 709 00:28:56,040 --> 00:28:57,420 my clumsiness might have caused. 710 00:28:57,420 --> 00:28:58,750 I feel ridiculous. 711 00:28:58,750 --> 00:29:00,090 Oh, I can't tell how many times 712 00:29:00,090 --> 00:29:01,380 I've hit my head on an overhead lamp. 713 00:29:01,380 --> 00:29:03,630 Twice I needed to get staples. 714 00:29:03,630 --> 00:29:05,760 Why don't you go work with Dr. McKay in triage? 715 00:29:05,760 --> 00:29:07,550 That would help both of us. 716 00:29:07,560 --> 00:29:10,060 Oh, I--I don't need special treatment. 717 00:29:10,060 --> 00:29:11,350 Good, because I don't give it. 718 00:29:14,230 --> 00:29:15,600 Look, I know I might look too young, 719 00:29:15,600 --> 00:29:17,770 but I studied my ass off to get here. 720 00:29:17,770 --> 00:29:19,900 Probably harder than the others. 721 00:29:19,900 --> 00:29:21,360 I earned this. 722 00:29:21,360 --> 00:29:23,530 OK, look, I respect your dedication 723 00:29:23,530 --> 00:29:25,410 and your determination, but while you're here, 724 00:29:25,410 --> 00:29:26,780 you're my responsibility. 725 00:29:26,780 --> 00:29:28,030 And when one of my responsibilities 726 00:29:28,030 --> 00:29:29,700 takes a header--wow! 727 00:29:29,700 --> 00:29:31,200 Abbot called for a surgical consult 728 00:29:31,200 --> 00:29:32,500 on the SBO three hours ago. 729 00:29:32,500 --> 00:29:33,750 You're very lucky they didn't perf. 730 00:29:33,750 --> 00:29:35,670 I'm here to see my daughter. 731 00:29:35,670 --> 00:29:37,130 I'm sorry, is that a patient? 732 00:29:37,130 --> 00:29:38,750 You're talking to her. 733 00:29:41,170 --> 00:29:42,590 Am I interrupting? 734 00:29:42,590 --> 00:29:44,170 No. 735 00:29:44,180 --> 00:29:46,340 No, we're done. We're good. 736 00:29:46,340 --> 00:29:48,180 Come find me when you're ready to present your next case. 737 00:29:48,180 --> 00:29:49,350 Thank you. 738 00:29:51,100 --> 00:29:53,100 So how's your first day going? 739 00:29:53,100 --> 00:29:54,390 - It's great. - Yeah? 740 00:29:54,390 --> 00:29:55,770 Yeah, really great. 741 00:29:55,770 --> 00:29:57,810 Hey, Crash, they're doing a dialysis 742 00:29:57,810 --> 00:29:59,610 catheter insertion in North One if you want to check it out. 743 00:29:59,610 --> 00:30:01,020 Mm-hmm. 744 00:30:01,030 --> 00:30:02,900 - That thing-- - Did she say Crash? 745 00:30:02,900 --> 00:30:04,150 No. 746 00:30:04,150 --> 00:30:05,860 No, no, it's not crash. 747 00:30:05,860 --> 00:30:08,450 Um, she said crush, 'cause I'm always crushing it. 748 00:30:11,080 --> 00:30:12,830 Um, thanks for coming down, Mom, but I've-- 749 00:30:12,830 --> 00:30:14,580 I've got a patient. 750 00:30:14,580 --> 00:30:15,660 Bye. 751 00:30:25,220 --> 00:30:26,840 What do you want? 752 00:30:26,840 --> 00:30:29,680 Um, I--I just wanted to make sure you're comfortable. 753 00:30:29,680 --> 00:30:34,270 I am taking a dump in a dustpan, 754 00:30:34,270 --> 00:30:36,230 so what's that fucking tell you? 755 00:30:36,230 --> 00:30:37,810 Um, I'm-- 756 00:30:37,810 --> 00:30:39,480 I'm clearly-- I'm clearly in the wrong room. 757 00:30:39,480 --> 00:30:40,480 - Yeah. - I'm sorry. 758 00:30:40,480 --> 00:30:41,980 Mm-hmm. 759 00:30:46,740 --> 00:30:49,530 So it would have been nice if someone had told me 760 00:30:49,530 --> 00:30:52,120 that Eileen Shamsi's daughter was one of our med students. 761 00:30:52,120 --> 00:30:54,450 What, and ruin the surprise? 762 00:30:54,450 --> 00:30:56,200 Was it as awkward as I hoped it would be? 763 00:30:56,210 --> 00:30:59,500 You--you have a mean streak in you, you know that? 764 00:30:59,500 --> 00:31:01,080 What's the deal with the body in 19? 765 00:31:01,090 --> 00:31:03,250 That's Abbot's MVC vet from last night. 766 00:31:03,250 --> 00:31:04,460 Still waiting on next of kin. 767 00:31:04,460 --> 00:31:06,090 - Supposedly on their way. - OK. 768 00:31:06,090 --> 00:31:07,550 Can we move him to the viewing room, at least? 769 00:31:07,550 --> 00:31:08,720 Nursing home DNR is heading there, 770 00:31:08,720 --> 00:31:10,010 joining last night's Jane Doe. 771 00:31:10,010 --> 00:31:11,590 Coroner's office is backed up. 772 00:31:11,600 --> 00:31:15,270 Well, then our morgue needs to take her, then. 773 00:31:15,270 --> 00:31:17,560 Perlah. 774 00:31:17,560 --> 00:31:19,140 Triathlete, Otis? 775 00:31:19,150 --> 00:31:20,230 Oh, he's stable. 776 00:31:20,230 --> 00:31:22,020 Repeat potassium is 6.1. 777 00:31:22,020 --> 00:31:24,020 Renal wrote the dialysis order. 778 00:31:24,030 --> 00:31:25,940 Tech should be down in 15 minutes. 779 00:31:25,940 --> 00:31:28,650 Good. Thank you. 780 00:31:28,650 --> 00:31:30,110 Language mystery solved yet? 781 00:31:30,110 --> 00:31:31,280 No. 782 00:31:31,280 --> 00:31:35,040 Hey, what's your take on dogs? 783 00:31:35,040 --> 00:31:36,490 In what context? 784 00:31:36,500 --> 00:31:38,200 For kids. 785 00:31:38,210 --> 00:31:40,830 Kids and puppies go together like fish and chips. 786 00:31:40,830 --> 00:31:42,210 Man's best friend, you know? 787 00:31:42,210 --> 00:31:43,500 Well, you don't have a dog. 788 00:31:43,500 --> 00:31:44,960 I don't have a best friend. 789 00:31:44,960 --> 00:31:46,630 - What am I? - You're my best resident. 790 00:31:46,630 --> 00:31:47,880 Big difference. 791 00:31:47,880 --> 00:31:49,670 Yeah, but we're still friends. 792 00:31:49,680 --> 00:31:52,510 Not if this conversation goes on much longer. 793 00:31:52,510 --> 00:31:54,550 I have a lethargic four-year-old, 794 00:31:54,560 --> 00:31:58,390 no PMH, no antecedent illness, no fever or vomiting. 795 00:31:58,390 --> 00:32:00,100 Parents just couldn't wake him up this morning. 796 00:32:00,100 --> 00:32:03,060 - What room? - Oh, South 15. 797 00:32:03,060 --> 00:32:05,110 There's no nuchal rigidity, 798 00:32:05,110 --> 00:32:09,690 no skin lesions, no focal neuro. 799 00:32:09,700 --> 00:32:12,700 He looks well fed and cared for. 800 00:32:12,700 --> 00:32:14,870 DKA from new-onset diabetes? 801 00:32:14,870 --> 00:32:16,490 No, BG 85. 802 00:32:16,490 --> 00:32:21,000 CBC, BMP, UA, and UDS ordered. 803 00:32:28,800 --> 00:32:31,800 Can you wake up for me, Tyler? 804 00:32:31,800 --> 00:32:33,510 He's not usually this sleepy? 805 00:32:33,510 --> 00:32:35,640 No, and he barely flinched for the blood test. 806 00:32:35,640 --> 00:32:37,140 He wakes up at 90 miles an hour 807 00:32:37,140 --> 00:32:38,810 and doesn't stop till he passes out at night. 808 00:32:38,810 --> 00:32:40,180 He passes out? 809 00:32:40,180 --> 00:32:42,140 No, he just means he goes all day. 810 00:32:42,140 --> 00:32:44,400 Any chance he could have ingested something? 811 00:32:44,400 --> 00:32:46,650 Any pills, vitamins, 812 00:32:46,650 --> 00:32:48,860 any prescriptions that may have been left around? 813 00:32:48,860 --> 00:32:51,240 No, that's all kept locked in the medicine cabinet. 814 00:32:51,240 --> 00:32:53,200 The whole house is childproof. 815 00:32:53,200 --> 00:32:55,950 Uh, what about alcohol? Anything left out? 816 00:32:55,950 --> 00:32:58,160 - No. - What about pets? 817 00:32:58,160 --> 00:32:59,660 No. 818 00:32:59,660 --> 00:33:01,620 So he's usually, like, quite active? 819 00:33:01,620 --> 00:33:04,460 - Very. - Um, any injuries lately? 820 00:33:04,460 --> 00:33:05,880 No. 821 00:33:05,880 --> 00:33:07,460 Hasn't bumped his head recently? 822 00:33:07,460 --> 00:33:09,130 Not that I'm aware of, but he does love 823 00:33:09,130 --> 00:33:10,380 roughhousing with Drew. 824 00:33:10,380 --> 00:33:11,720 But he never gets hurt. 825 00:33:11,720 --> 00:33:13,590 Oxygen level is normal. 826 00:33:13,590 --> 00:33:16,720 Good pulse and blood pressure. No signs of infection. 827 00:33:16,720 --> 00:33:18,680 We're gonna start with blood and urine tests, 828 00:33:18,680 --> 00:33:21,600 check for any metabolic abnormalities. 829 00:33:24,350 --> 00:33:26,940 It's really throbbing. 830 00:33:26,940 --> 00:33:28,190 Yeah, the blood's under pressure. 831 00:33:28,190 --> 00:33:30,690 Gotta drain it. 832 00:33:30,690 --> 00:33:32,280 No anesthesia, or-- 833 00:33:32,280 --> 00:33:35,200 I'll stop before I hit the nail bed. 834 00:33:35,200 --> 00:33:36,570 I hope. 835 00:33:39,870 --> 00:33:41,160 Hey, eyes down here. 836 00:33:41,160 --> 00:33:42,580 Watch and learn. 837 00:33:42,580 --> 00:33:44,370 I'm just looking who to see next. 838 00:33:44,370 --> 00:33:46,920 You're supposed to take them in the order they arrive. 839 00:33:46,920 --> 00:33:48,330 Yeah, I know how it works. 840 00:33:48,340 --> 00:33:50,420 OK. No need to cry about it. 841 00:33:50,420 --> 00:33:51,960 Do you want me to choose for you? 842 00:33:51,960 --> 00:33:53,300 No. 843 00:33:55,630 --> 00:33:57,640 Wow, pain's gone. 844 00:33:57,640 --> 00:33:58,890 - Thank you. - Yeah. 845 00:33:58,890 --> 00:34:00,310 All right. 846 00:34:00,310 --> 00:34:02,970 How about a 20-year-old cough in eight? 847 00:34:02,980 --> 00:34:05,100 Should be easy. Probably viral. 848 00:34:05,100 --> 00:34:06,940 I don't need an easy one. 849 00:34:06,940 --> 00:34:08,860 Suit yourself, Huckleberry. 850 00:34:08,860 --> 00:34:10,820 I'm gonna take the splitting headache. 851 00:34:10,820 --> 00:34:13,280 Maybe I'll catch a subarachnoid hemorrhage or something cool. 852 00:34:13,280 --> 00:34:15,110 Hey, why do you keep calling me that? 853 00:34:15,110 --> 00:34:16,240 Huckleberry? 854 00:34:16,240 --> 00:34:18,110 It's a term of endearment. 855 00:34:18,120 --> 00:34:19,450 It sounds like sarcasm. 856 00:34:19,450 --> 00:34:20,530 You think? 857 00:34:20,530 --> 00:34:23,370 Bordering on harassment. 858 00:34:23,370 --> 00:34:24,950 Where are you from? 859 00:34:24,960 --> 00:34:26,870 Broken Bow, Nebraska. 860 00:34:26,870 --> 00:34:28,790 Jesus, where the hell is that? 861 00:34:28,790 --> 00:34:31,290 It's about three and a half hours west of Omaha. 862 00:34:31,300 --> 00:34:33,760 Oh, yeah, just a little south of nowhere. 863 00:34:33,760 --> 00:34:35,090 What the hell do you do there? 864 00:34:35,090 --> 00:34:37,590 My parents have a farm, so... 865 00:34:37,590 --> 00:34:40,050 You're a farm boy? 866 00:34:40,050 --> 00:34:42,060 Yeah, I guess. 867 00:34:42,060 --> 00:34:44,890 I rest my case, Huckleberry. 868 00:34:50,940 --> 00:34:52,230 I'm so sorry, ma'am. 869 00:34:52,230 --> 00:34:54,400 We don't understand you. 870 00:34:58,820 --> 00:35:01,490 Oh. 871 00:35:01,490 --> 00:35:04,950 Me, I'm Dr. Heather Collins. 872 00:35:04,950 --> 00:35:07,870 I'm from here. 873 00:35:07,870 --> 00:35:09,460 Portland, Oregon. 874 00:35:09,460 --> 00:35:11,040 You. 875 00:35:11,040 --> 00:35:13,840 Where are you from? 876 00:35:13,840 --> 00:35:15,300 Uh-huh. 877 00:35:17,010 --> 00:35:19,180 Uh, China? India? 878 00:35:19,180 --> 00:35:20,300 I can't tell where you're pointing. 879 00:35:20,300 --> 00:35:21,600 Tajikistan? 880 00:35:23,760 --> 00:35:25,100 Nepal. 881 00:35:25,100 --> 00:35:26,520 Mm. 882 00:35:26,520 --> 00:35:28,940 - You're from Nepal. - Nepali. 883 00:35:34,280 --> 00:35:35,530 Mom's got a bad burn. 884 00:35:35,530 --> 00:35:37,240 Needs wound checks and hand therapy. 885 00:35:37,240 --> 00:35:40,160 And I got a sneaking suspicion she may be unhoused. 886 00:35:40,160 --> 00:35:42,160 I'll talk to her. We can offer some help. 887 00:35:42,160 --> 00:35:45,330 Thank you, I appreciate it. Ah, you're back. 888 00:35:45,330 --> 00:35:47,700 Dr. Robby suggested I might be of assistance. 889 00:35:47,710 --> 00:35:49,500 Yeah, I could use the company. 890 00:35:49,500 --> 00:35:52,040 Victoria Javadi, this is Kiara Alfaro. 891 00:35:52,040 --> 00:35:53,460 She's the department social worker, 892 00:35:53,460 --> 00:35:55,250 which pretty much makes her an angel. 893 00:35:55,250 --> 00:35:57,050 - Welcome. - Thanks. 894 00:35:57,050 --> 00:35:58,260 Thank you. 895 00:35:58,260 --> 00:36:00,130 So what rotation is this for you? 896 00:36:00,130 --> 00:36:01,220 Um, third. 897 00:36:01,220 --> 00:36:02,720 I've done OB-GYN and pedes. 898 00:36:02,720 --> 00:36:04,220 You have any favorites? 899 00:36:04,220 --> 00:36:05,600 Not really. 900 00:36:05,600 --> 00:36:07,390 Well, what are you leaning towards? 901 00:36:07,390 --> 00:36:09,270 I'm not really sure yet. 902 00:36:09,270 --> 00:36:11,060 OK, well, you have time. 903 00:36:11,060 --> 00:36:14,650 Uh, can I actually ask you a personal question? 904 00:36:14,650 --> 00:36:17,820 I'm 20, and I've earned the right to be here. 905 00:36:17,820 --> 00:36:19,440 Oh. 906 00:36:19,450 --> 00:36:21,450 Yeah, I don't--I don't doubt that for a minute. 907 00:36:21,450 --> 00:36:25,580 I--I was actually wondering if Dr. Eileen Shamsi from surgery 908 00:36:25,580 --> 00:36:27,700 is a friend or relative of yours. 909 00:36:27,700 --> 00:36:29,500 I saw you talking to her in the hall and I thought-- 910 00:36:29,500 --> 00:36:30,920 Yeah, she's my mother. 911 00:36:32,750 --> 00:36:33,750 Oh. 912 00:36:33,750 --> 00:36:35,460 Oh, wow. 913 00:36:35,460 --> 00:36:38,210 Oh, that's cool. 914 00:36:38,210 --> 00:36:40,840 - You're really only 20? - Yeah. 915 00:36:40,840 --> 00:36:43,220 And for the record, my-- my father also works here. 916 00:36:43,220 --> 00:36:44,680 He's an endocrinologist. 917 00:36:44,680 --> 00:36:46,060 Oh, so it's like a family business. 918 00:36:48,100 --> 00:36:50,140 I'm sorry. That was a joke. That was a joke. 919 00:36:50,140 --> 00:36:52,020 And I'm sure that comes with a lot of pressure. 920 00:36:52,020 --> 00:36:54,850 And as for the age thing, I'm a 42-year-old R2, 921 00:36:54,860 --> 00:36:58,480 so I have my own haters, trust me. 922 00:36:58,480 --> 00:36:59,730 OK. 923 00:36:59,740 --> 00:37:01,280 Um, sometimes when it gets busy, 924 00:37:01,280 --> 00:37:02,950 we'll help the nurses bring back patients. 925 00:37:02,950 --> 00:37:04,780 - OK. - Um, OK. 926 00:37:04,780 --> 00:37:06,490 Next to come back is Fred Saeta. 927 00:37:06,490 --> 00:37:08,280 - Knee pain after a fall. - Great. 928 00:37:08,290 --> 00:37:09,410 - Fred Sa-- - Doc. Hey, Doc. Hi. 929 00:37:09,410 --> 00:37:10,750 Hi. Doug Driscoll. 930 00:37:10,750 --> 00:37:12,160 Any chance someone could see me now? 931 00:37:12,160 --> 00:37:13,920 I've been here for, like, two hours. 932 00:37:13,920 --> 00:37:15,630 Unfortunately, Mr. Driscoll, there's a lot of patients 933 00:37:15,630 --> 00:37:17,250 still ahead of you, some of whom are severely ill. 934 00:37:17,250 --> 00:37:18,800 Yeah, and I got chest pains that woke me up 935 00:37:18,800 --> 00:37:20,090 - in the middle of the night. - Chest pain. 936 00:37:20,090 --> 00:37:21,720 - Yeah. - No, it's not plural. 937 00:37:21,720 --> 00:37:24,470 It's just chest pain, not chest pains. 938 00:37:24,470 --> 00:37:27,010 Yeah, and if I have more than one, it's chest pains. 939 00:37:27,010 --> 00:37:29,180 - Are you even a real doctor? - She's a student doctor. 940 00:37:29,180 --> 00:37:30,810 Yeah, well, keep her the hell away from me. 941 00:37:30,810 --> 00:37:33,180 I just need to see someone, OK? Not her. 942 00:37:33,190 --> 00:37:34,980 Isn't chest pain an emergency? I don't-- 943 00:37:34,980 --> 00:37:37,020 It looks here like you got an EKG 944 00:37:37,020 --> 00:37:39,230 five minutes after arrival, so it's not a heart attack. 945 00:37:39,230 --> 00:37:42,530 Yeah, but I'm supposed to get a chest X-ray and blood tests. 946 00:37:42,530 --> 00:37:45,070 Ah, and you are next in line for lab tech, OK? 947 00:37:45,070 --> 00:37:47,160 So listen for your name. Excuse me. 948 00:37:47,160 --> 00:37:49,160 Fred-- 949 00:37:49,160 --> 00:37:52,200 Actually, can you get me a wheelchair, please? 950 00:37:52,200 --> 00:37:54,000 Uh, hi. I'm--I'm Dr. McKay. 951 00:37:54,000 --> 00:37:55,670 What's going on? 952 00:37:55,670 --> 00:37:57,460 I, uh, found her on the floor in the bathroom. 953 00:37:57,460 --> 00:37:59,460 - She can't stop puking. - What's her name? 954 00:37:59,460 --> 00:38:01,460 Theresa. She's my mom. 955 00:38:01,460 --> 00:38:02,960 Theresa? 956 00:38:02,970 --> 00:38:04,010 Theresa, are you taking any medication? 957 00:38:04,010 --> 00:38:05,260 No. 958 00:38:05,260 --> 00:38:06,260 Any previous stomach problems? 959 00:38:06,260 --> 00:38:07,430 No. 960 00:38:07,430 --> 00:38:08,850 When did the vomiting begin? 961 00:38:08,850 --> 00:38:10,430 Um, last night. 962 00:38:10,430 --> 00:38:12,350 - Last night. - Oh, come on! 963 00:38:12,350 --> 00:38:15,100 Do you have any dizziness or fatigue? 964 00:38:15,100 --> 00:38:17,060 Mystery solved. 965 00:38:17,060 --> 00:38:19,770 Our lady with the degloved foot is Nepali. 966 00:38:19,770 --> 00:38:22,570 Oh, hey, congratulations. 967 00:38:22,570 --> 00:38:24,490 Otis's BP is crashing. 70 over 50. 968 00:38:24,490 --> 00:38:27,160 Still waiting for dialysis. 969 00:38:29,620 --> 00:38:31,660 How you doing there, Otis? 970 00:38:31,660 --> 00:38:33,040 - Not so good. - 50 liters. 971 00:38:33,040 --> 00:38:34,410 Non-rebreather, please. 972 00:38:39,840 --> 00:38:41,670 Oh, crap. 973 00:38:41,670 --> 00:38:43,800 Diastolic collapse of the right atrium and right ventricle. 974 00:38:43,800 --> 00:38:45,300 Tamponade from uremic effusion. 975 00:38:45,300 --> 00:38:46,670 - That's why his BP is low? - Yep. 976 00:38:46,680 --> 00:38:48,050 Too much fluid and pressure 977 00:38:48,050 --> 00:38:49,720 around the heart, chambers can't fill. 978 00:38:49,720 --> 00:38:51,140 Otis, you've got some fluid around your heart. 979 00:38:51,140 --> 00:38:52,310 We need to get it off. 980 00:38:52,310 --> 00:38:53,890 What's happening? 981 00:38:53,890 --> 00:38:55,980 25 of Propofol, 10 cc's of lidocaine with epi, 982 00:38:55,980 --> 00:38:57,350 pericardiocentesis tray. 983 00:38:57,350 --> 00:38:58,770 I have to get that from central. 984 00:38:58,770 --> 00:39:00,110 No, no. Just open a central line kit. 985 00:39:00,110 --> 00:39:01,690 Dr. Santos, take the head of the bed 986 00:39:01,690 --> 00:39:03,110 and bag him if he stops breathing, 987 00:39:03,110 --> 00:39:04,940 compressions if we lose the carotid. 988 00:39:04,940 --> 00:39:06,490 Prep and drape the subxiphoid, please. 989 00:39:06,490 --> 00:39:08,660 - 10 cc's of 1% with. - Chlorhexidine here. 990 00:39:08,660 --> 00:39:10,950 - 25 or 27-gauge? - Long 25, 25. 991 00:39:10,950 --> 00:39:13,910 Thank you. 992 00:39:13,910 --> 00:39:16,450 Injecting lidocaine. 993 00:39:16,460 --> 00:39:18,830 Pressure down. 60 over 40. 994 00:39:18,830 --> 00:39:21,000 Right. 995 00:39:22,800 --> 00:39:24,460 Wait, you can't ultrasound and place. 996 00:39:24,460 --> 00:39:26,050 I know, that's why I'm taking the probe. 997 00:39:26,050 --> 00:39:27,550 18-gauge thin wall 998 00:39:27,550 --> 00:39:29,430 on a 60 cc syringe, please, Dr. Collins. 999 00:39:29,430 --> 00:39:31,470 Let's go. 1000 00:39:31,470 --> 00:39:34,680 You're going in right over the center of my probe, 1001 00:39:34,680 --> 00:39:36,890 advancing very slowly. 1002 00:39:36,890 --> 00:39:39,730 We're looking for the hyperechoic tip. 1003 00:39:39,730 --> 00:39:42,270 Very, very slowly. Do not hit that heart. 1004 00:39:42,270 --> 00:39:43,690 Dr. Santos, do you see that sea of black? 1005 00:39:43,690 --> 00:39:45,190 That's the effusion. 1006 00:39:45,190 --> 00:39:46,820 We're looking for a little white dot. 1007 00:39:46,820 --> 00:39:48,570 There it is. 1008 00:39:48,570 --> 00:39:50,200 Got it. 1009 00:39:50,200 --> 00:39:51,530 Aspirating. 1010 00:39:51,530 --> 00:39:53,490 3 cc's should be enough. 1011 00:39:56,660 --> 00:39:57,870 Good. 1012 00:39:57,870 --> 00:39:59,160 Next, we'll place the guide wire, 1013 00:39:59,170 --> 00:40:01,120 and then the triple lumen catheter. 1014 00:40:01,130 --> 00:40:02,290 Pulse ox is 99. 1015 00:40:02,290 --> 00:40:05,590 Pressure is up. 124 over 78. 1016 00:40:05,590 --> 00:40:09,050 Looks like things are back to normal. 1017 00:40:09,050 --> 00:40:10,470 That was cool. 1018 00:40:10,470 --> 00:40:12,590 Four Zofrans on board. 1019 00:40:12,600 --> 00:40:15,430 That should stop the nausea. 1020 00:40:15,430 --> 00:40:17,470 David, have you had any vomiting? 1021 00:40:17,480 --> 00:40:21,480 - No. - Anyone else sick at home? 1022 00:40:21,480 --> 00:40:23,730 No, it's just us. 1023 00:40:23,730 --> 00:40:27,110 My husband passed away a few years ago, from COVID. 1024 00:40:27,110 --> 00:40:29,690 Oh, I'm so sorry. 1025 00:40:29,700 --> 00:40:31,200 Potassium, 3.1. 1026 00:40:32,990 --> 00:40:34,780 Is that bad? 1027 00:40:34,780 --> 00:40:36,120 It can cause heart problems. 1028 00:40:36,120 --> 00:40:37,450 But we're gonna correct it, OK? 1029 00:40:37,450 --> 00:40:40,080 10 in the bag, 20 PO. 1030 00:40:40,080 --> 00:40:42,790 Javadi, any questions? 1031 00:40:42,790 --> 00:40:44,420 Um... 1032 00:40:44,420 --> 00:40:46,250 uh, David, have you two traveled 1033 00:40:46,250 --> 00:40:47,800 out of the country recently? 1034 00:40:47,800 --> 00:40:50,170 We never go anywhere. 1035 00:40:50,170 --> 00:40:52,430 Is she gonna have to stay here? 1036 00:40:54,640 --> 00:40:56,180 If the rest of the tests are good, 1037 00:40:56,180 --> 00:40:59,520 and she responds to treatment, she can go home. 1038 00:41:06,520 --> 00:41:08,980 Mr. Milton, my name is Dennis Whitaker. 1039 00:41:08,980 --> 00:41:10,900 I'm one of the student doctors here. 1040 00:41:10,900 --> 00:41:12,240 I'll be seeing you first. 1041 00:41:12,240 --> 00:41:13,240 Nice to meet you. 1042 00:41:13,240 --> 00:41:15,620 BP's 150 over 90. 1043 00:41:15,620 --> 00:41:17,580 That's just a touch high. 1044 00:41:17,580 --> 00:41:19,490 I forgot to take my damn enalapril this morning. 1045 00:41:19,500 --> 00:41:21,000 Oh, we'll get that for you. 1046 00:41:21,000 --> 00:41:22,910 Tell me about this belly pain. 1047 00:41:22,920 --> 00:41:26,540 Uh, it started about here. 1048 00:41:26,540 --> 00:41:30,000 Um, woke me up at, like, 2:00 AM. 1049 00:41:30,010 --> 00:41:31,800 Pretty intense. 1050 00:41:31,800 --> 00:41:33,930 Lasted about an hour. 1051 00:41:33,930 --> 00:41:35,300 Now it's gone. 1052 00:41:35,300 --> 00:41:36,800 Any fever or vomiting? 1053 00:41:36,800 --> 00:41:38,810 Nah, I never get sick. 1054 00:41:38,810 --> 00:41:40,140 OK. 1055 00:41:40,140 --> 00:41:42,180 Uh, what did you eat last night? 1056 00:41:42,180 --> 00:41:43,980 Oh, it was my wife's birthday. 1057 00:41:43,980 --> 00:41:45,810 I took her out to Sullivan's for a steak. 1058 00:41:45,810 --> 00:41:47,190 Oh. 1059 00:41:47,190 --> 00:41:49,020 Well, the exam is pretty benign. 1060 00:41:49,030 --> 00:41:50,820 I'm gonna test for gallstones. 1061 00:41:50,820 --> 00:41:55,950 If there is a stone and you eat fatty food, 1062 00:41:55,950 --> 00:41:59,870 there can be pain when the gallbladder contracts. 1063 00:41:59,870 --> 00:42:01,120 Oh. 1064 00:42:01,120 --> 00:42:02,790 Uh, bingo. 1065 00:42:02,790 --> 00:42:05,670 One stone. There it is. 1066 00:42:05,670 --> 00:42:07,750 Do I need surgery? 1067 00:42:07,750 --> 00:42:10,340 Uh, you should be able to manage with a low-fat diet. 1068 00:42:10,340 --> 00:42:13,300 But we'll send off labs for liver and pancreas. 1069 00:42:13,300 --> 00:42:16,300 Just let us know if you have any more pain. 1070 00:42:16,300 --> 00:42:17,720 OK. 1071 00:42:17,720 --> 00:42:19,640 Thanks. 1072 00:42:19,640 --> 00:42:21,770 Yeah, you bet. 1073 00:42:21,770 --> 00:42:23,850 Great. 1074 00:42:23,850 --> 00:42:25,690 You want an EKG? 1075 00:42:25,690 --> 00:42:27,400 For? 1076 00:42:27,400 --> 00:42:30,150 Heart attacks can present as upper abdominal pain. 1077 00:42:30,150 --> 00:42:31,900 Um, yeah. 1078 00:42:31,900 --> 00:42:33,440 No, yeah, that's a great idea. 1079 00:42:33,440 --> 00:42:35,860 Thank you. 1080 00:42:48,670 --> 00:42:50,090 I'm going as fast as I can. 1081 00:42:50,090 --> 00:42:51,420 I'm picking up two more patients. 1082 00:42:51,420 --> 00:42:54,380 I didn't say anything. 1083 00:42:54,380 --> 00:42:56,470 I, uh--I need a fresh set of eyes. 1084 00:42:56,470 --> 00:42:58,340 On what? 1085 00:42:58,340 --> 00:43:00,260 54-year-old woman brought in with intractable vomiting 1086 00:43:00,260 --> 00:43:01,720 by her 18-year-old son. 1087 00:43:01,720 --> 00:43:04,310 I'm, um-- I'm getting a weird vibe. 1088 00:43:06,270 --> 00:43:07,940 How so? 1089 00:43:07,940 --> 00:43:09,900 Like, I don't know, maybe she was given something. 1090 00:43:09,900 --> 00:43:12,480 Some sort of elder abuse. 1091 00:43:12,480 --> 00:43:14,650 There's just a strange dynamic I can't quite figure out. 1092 00:43:14,650 --> 00:43:16,650 You're really good at sussing out that sort of thing. 1093 00:43:18,030 --> 00:43:19,370 I don't know about that. 1094 00:43:22,030 --> 00:43:25,160 Uh, excuse me, Dr. Langdon. 1095 00:43:25,160 --> 00:43:27,870 Almost all of our labs are back on sleeping boy Tyler. 1096 00:43:27,870 --> 00:43:30,580 All 100% normal. 1097 00:43:30,580 --> 00:43:32,090 What are we missing? 1098 00:43:35,920 --> 00:43:37,300 Is he waking up? 1099 00:43:37,300 --> 00:43:39,590 No, he's-- he's still fast asleep. 1100 00:43:39,590 --> 00:43:42,140 Most of the lab results are in, and they look great. 1101 00:43:42,140 --> 00:43:44,220 No abnormal blood count, no, uh, 1102 00:43:44,220 --> 00:43:46,930 electrolyte abnormalities, no diabetes, 1103 00:43:46,930 --> 00:43:49,770 no, um, kidney disease, so... 1104 00:43:49,770 --> 00:43:52,400 Good. So--so what's wrong with him? 1105 00:43:52,400 --> 00:43:54,690 We're still trying to figure that out. 1106 00:43:54,690 --> 00:43:57,400 Did he, uh, have a playdate yesterday, by chance? 1107 00:43:57,400 --> 00:43:58,860 No, he had preschool, 1108 00:43:58,860 --> 00:44:00,360 but he was fine when I picked him up. 1109 00:44:00,360 --> 00:44:02,160 Any kids in his class ill? 1110 00:44:02,160 --> 00:44:03,700 No, my phone tree would have lit up 1111 00:44:03,700 --> 00:44:05,200 if someone else was sick. 1112 00:44:05,200 --> 00:44:06,950 He eat anything this morning? 1113 00:44:06,950 --> 00:44:08,620 No. 1114 00:44:08,620 --> 00:44:10,460 Why? 1115 00:44:10,460 --> 00:44:13,420 It looks like some sort of gelatin. 1116 00:44:13,420 --> 00:44:14,880 Any chance he could have gotten 1117 00:44:14,880 --> 00:44:17,340 into some bath beads or laundry pods? 1118 00:44:17,340 --> 00:44:19,220 No, there's no such thing in our house. 1119 00:44:19,220 --> 00:44:20,630 What about gummies? 1120 00:44:20,630 --> 00:44:22,890 No, we're very strict about candy. 1121 00:44:22,890 --> 00:44:24,140 Right? 1122 00:44:26,770 --> 00:44:29,730 Oh, shit. 1123 00:44:29,730 --> 00:44:30,980 Danny. 1124 00:44:30,980 --> 00:44:32,190 What about Danny? 1125 00:44:32,190 --> 00:44:34,650 Your brother, he-- 1126 00:44:34,650 --> 00:44:36,690 he gave me some gummies he got in Cleveland. 1127 00:44:36,690 --> 00:44:39,530 They were in my coat pocket. 1128 00:44:39,530 --> 00:44:41,240 Are you fucking serious? 1129 00:44:41,240 --> 00:44:42,360 Pot gummies? 1130 00:44:42,370 --> 00:44:44,740 Yes. I'm so sorry. 1131 00:44:44,740 --> 00:44:46,870 Let me call the lab. Maybe the tox screen is back. 1132 00:44:46,870 --> 00:44:49,120 Hey, this is Dr. Langdon from the ED. 1133 00:44:49,120 --> 00:44:51,040 Can I fast-track a lab on a little boy, 1134 00:44:51,040 --> 00:44:53,000 last name Jones, first name Tyler, tox screen? 1135 00:44:53,000 --> 00:44:54,750 Get the fuck out! I mean it. 1136 00:44:54,750 --> 00:44:56,540 Why don't we step outside, and maybe you can help me 1137 00:44:56,550 --> 00:44:59,130 figure out how much he may have taken. 1138 00:44:59,130 --> 00:45:00,590 Thanks. 1139 00:45:00,590 --> 00:45:03,970 I appreciate that quick turnaround. 1140 00:45:03,970 --> 00:45:05,430 The labs confirm it. 1141 00:45:05,430 --> 00:45:07,970 Your son tested positive for cannabis. 1142 00:45:07,970 --> 00:45:09,350 This is a fucking nightmare. 1143 00:45:13,980 --> 00:45:17,860 Theresa, David, this is my attending, Dr. Robinavitch. 1144 00:45:17,860 --> 00:45:19,440 Hi, I'm Dr. Robby. 1145 00:45:19,440 --> 00:45:21,700 We need to do a pelvic exam. 1146 00:45:21,700 --> 00:45:24,320 And David, I don't think you want to be in here for that. 1147 00:45:24,320 --> 00:45:26,070 Definitely not. 1148 00:45:26,080 --> 00:45:28,990 Can you have Nurse Perlah come join me, please? 1149 00:45:28,990 --> 00:45:32,080 Do you want a coffee or a soda or something? 1150 00:45:32,080 --> 00:45:33,710 Why do I need a pelvic exam? 1151 00:45:33,710 --> 00:45:36,420 Uh, you don't. 1152 00:45:36,420 --> 00:45:38,040 Your son seems like a nice kid. 1153 00:45:38,050 --> 00:45:40,260 He's clearly worried about you. 1154 00:45:40,260 --> 00:45:42,800 But your exam and your labs are not matching 1155 00:45:42,800 --> 00:45:44,180 any of the usual diagnoses, 1156 00:45:44,180 --> 00:45:45,720 so I'm not really sure what's going on. 1157 00:45:47,600 --> 00:45:49,350 I'm not here for me. 1158 00:45:49,350 --> 00:45:51,680 - I'm here for David. - I don't understand. 1159 00:45:51,680 --> 00:45:53,180 He said that you've had persistent vomiting, 1160 00:45:53,190 --> 00:45:54,520 some--some dehydration. 1161 00:45:54,520 --> 00:45:57,360 I made myself sick with ipecac. 1162 00:45:57,360 --> 00:45:59,770 To induce vomiting? Why would you do that? 1163 00:45:59,780 --> 00:46:02,940 So David would bring me here. 1164 00:46:02,950 --> 00:46:05,110 My son has some problems. 1165 00:46:05,110 --> 00:46:07,240 He needs professional help. 1166 00:46:07,240 --> 00:46:08,700 OK. What kind of problems? 1167 00:46:08,700 --> 00:46:10,240 Drugs, alcohol? 1168 00:46:12,080 --> 00:46:15,540 I found some of his writing. 1169 00:46:15,540 --> 00:46:18,840 I thought it was schoolwork, but it wasn't. 1170 00:46:20,710 --> 00:46:24,010 It was lists of girls he wanted to hurt. 1171 00:46:37,230 --> 00:46:38,730 Hurt them how? 1172 00:46:38,730 --> 00:46:42,280 He said, "They should all be eliminated." 1173 00:46:44,820 --> 00:46:46,570 Has David seen a therapist? 1174 00:46:46,570 --> 00:46:48,910 No. 1175 00:46:48,910 --> 00:46:52,490 He's not a bad kid, but I'm afraid he's troubled, 1176 00:46:52,500 --> 00:46:53,910 and I didn't want to call the police 1177 00:46:53,910 --> 00:46:55,460 because I was afraid they'd overreact. 1178 00:46:55,460 --> 00:46:57,830 - He's just a kid. - How old is David? 1179 00:46:57,830 --> 00:47:01,340 He just turned 18 last month. 1180 00:47:01,340 --> 00:47:02,920 Then he's considered an adult 1181 00:47:02,920 --> 00:47:06,840 and he would have to consent to treatment. 1182 00:47:06,840 --> 00:47:08,430 Do you have any guns in the house? 1183 00:47:08,430 --> 00:47:09,720 No. 1184 00:47:09,720 --> 00:47:11,260 My husband did, 1185 00:47:11,260 --> 00:47:13,770 but I got rid of all of them after he passed. 1186 00:47:13,770 --> 00:47:15,730 He's a good soul. 1187 00:47:15,730 --> 00:47:18,810 I just don't want to see him hurt anyone or himself. 1188 00:47:21,570 --> 00:47:23,360 How are you feeling, Crash? 1189 00:47:23,360 --> 00:47:25,860 I'd really appreciate if you didn't call me that. 1190 00:47:25,860 --> 00:47:27,900 Why not? It's a cool nickname. 1191 00:47:27,910 --> 00:47:31,160 You earned it. You should own it. 1192 00:47:31,160 --> 00:47:33,540 I don't like it. 1193 00:47:33,540 --> 00:47:36,870 All right. It's just a joke. 1194 00:47:39,540 --> 00:47:43,090 You know, if it makes you feel any better, 1195 00:47:43,090 --> 00:47:46,970 I sharted the first time I saw an emergency C-section. 1196 00:47:48,470 --> 00:47:50,800 Really? 1197 00:47:50,800 --> 00:47:52,600 Of course not. 1198 00:48:02,020 --> 00:48:05,440 Excuse me. I'll be right back. 1199 00:48:05,440 --> 00:48:07,070 I got a situation. 1200 00:48:07,070 --> 00:48:09,610 18-year-old kid brings in his dehydrated mom. 1201 00:48:09,610 --> 00:48:11,320 Dad died during the pandemic. 1202 00:48:11,320 --> 00:48:13,620 Mom's vomiting is self-induced for the sole purpose 1203 00:48:13,620 --> 00:48:15,200 of getting him here after she finds 1204 00:48:15,200 --> 00:48:17,330 his death list for classmates. 1205 00:48:17,330 --> 00:48:20,710 I--OK. 1206 00:48:20,710 --> 00:48:22,630 What does she want us to do? 1207 00:48:22,630 --> 00:48:24,420 Help him, protect him, save him. 1208 00:48:24,420 --> 00:48:27,920 - Where is he now? - Talking to McKay. 1209 00:48:27,920 --> 00:48:29,380 How are you doing? 1210 00:48:29,380 --> 00:48:30,840 Me? I'm good. 1211 00:48:30,840 --> 00:48:32,430 I'm always good. You know that. 1212 00:48:32,430 --> 00:48:34,350 Do I? Does anybody? 1213 00:48:34,350 --> 00:48:37,270 - I'm an open book. - Not even close. 1214 00:48:37,270 --> 00:48:39,020 You do know you can always come talk to me, right? 1215 00:48:39,020 --> 00:48:40,810 Yep. 1216 00:48:43,230 --> 00:48:45,860 - How's it going over here? - Good, good. 1217 00:48:45,860 --> 00:48:48,150 We're just going over aftercare instructions, 1218 00:48:48,150 --> 00:48:49,740 prescription medications, special diet 1219 00:48:49,740 --> 00:48:51,360 for the next few days. 1220 00:48:51,360 --> 00:48:53,240 Dr. McKay, can you check orthostatics on Mom? 1221 00:48:53,240 --> 00:48:54,660 I can. 1222 00:48:54,660 --> 00:48:55,990 David, I wanted you to meet Kiara. 1223 00:48:55,990 --> 00:48:57,330 She's a social worker here who helps 1224 00:48:57,330 --> 00:48:59,120 in situations like this. 1225 00:48:59,120 --> 00:49:01,410 We heard about your father's passing. 1226 00:49:01,420 --> 00:49:02,960 We're really sorry. 1227 00:49:02,960 --> 00:49:05,090 And we know that it can put a lot of pressure 1228 00:49:05,090 --> 00:49:08,210 on somebody your age, which, combined with school 1229 00:49:08,210 --> 00:49:11,260 and now having to take care of your mom, that's a lot. 1230 00:49:11,260 --> 00:49:13,130 It's fine. 1231 00:49:13,140 --> 00:49:14,890 We just want to make sure that when your mom goes home, 1232 00:49:14,890 --> 00:49:16,220 you can handle it. 1233 00:49:16,220 --> 00:49:17,510 We want to make sure you have someone 1234 00:49:17,520 --> 00:49:19,060 you can talk to if you need to. 1235 00:49:19,060 --> 00:49:20,390 I'm OK. 1236 00:49:20,390 --> 00:49:23,270 I don't need to talk to anybody. 1237 00:49:23,270 --> 00:49:24,730 After a parent dies, 1238 00:49:24,730 --> 00:49:27,110 the sadness can last a long time. 1239 00:49:27,110 --> 00:49:29,110 How's that going for you? 1240 00:49:29,110 --> 00:49:31,070 It's not a problem. 1241 00:49:31,070 --> 00:49:32,490 What about school? 1242 00:49:32,490 --> 00:49:33,910 What about it? 1243 00:49:33,910 --> 00:49:36,200 Anything you enjoy there? 1244 00:49:36,200 --> 00:49:39,540 Not really. 1245 00:49:39,540 --> 00:49:42,620 A lot of people have thoughts that can disturb them. 1246 00:49:42,620 --> 00:49:44,830 If you've had any, it's OK to talk about it. 1247 00:49:44,830 --> 00:49:47,540 What's that have to do with my mom? 1248 00:49:47,550 --> 00:49:50,000 - Is she gonna be OK? - Yeah, she's gonna be fine. 1249 00:49:50,010 --> 00:49:51,380 She's probably got a stomach virus, 1250 00:49:51,380 --> 00:49:52,840 maybe food poisoning. 1251 00:49:52,840 --> 00:49:55,180 I think she's more worried about you. 1252 00:49:55,180 --> 00:49:57,100 She always worries about me. 1253 00:49:57,100 --> 00:50:00,270 - Does she have a reason to? - No. 1254 00:50:00,270 --> 00:50:02,180 It's almost 8:00. I gotta go. 1255 00:50:03,940 --> 00:50:05,980 Are you sure you wouldn't prefer to wait with your mom? 1256 00:50:05,980 --> 00:50:07,360 I'm late for school. 1257 00:50:07,360 --> 00:50:10,150 She can just call me when she's ready. 1258 00:50:10,150 --> 00:50:11,610 It would actually be kind of helpful 1259 00:50:11,610 --> 00:50:12,900 to talk to you some more. 1260 00:50:12,900 --> 00:50:15,530 Hey, David. 1261 00:50:15,530 --> 00:50:17,450 David. 1262 00:50:17,450 --> 00:50:18,530 Just give me five minutes. 1263 00:50:18,530 --> 00:50:19,740 Leave me alone! 1264 00:50:28,590 --> 00:50:31,000 Hey, David! 1265 00:50:31,010 --> 00:50:32,470 Shit. 1266 00:50:34,550 --> 00:50:36,430 Robby! 1267 00:50:36,430 --> 00:50:38,600 Robby. 1268 00:50:38,600 --> 00:50:40,310 Got a college kid, respiratory arrest, 1269 00:50:40,310 --> 00:50:41,470 coming in hot. 1270 00:51:12,460 --> 00:51:15,670 Robby, we need to intubate here. 1271 00:51:15,670 --> 00:51:18,590 Dr. Adamson just went down with a pulse ox of 65. 1272 00:51:26,890 --> 00:51:28,650 Robby!