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