1 00:00:25,580 --> 00:00:30,340 Can you--can you just put him on the phone for a second? 2 00:00:30,420 --> 00:00:33,590 I just want to hear his voice. 3 00:00:33,670 --> 00:00:36,720 There's my guy. 4 00:00:36,800 --> 00:00:39,510 How you doing, buddy? 5 00:00:39,600 --> 00:00:42,480 I would love to hear your--your song. 6 00:01:00,160 --> 00:01:02,500 You should go home. 7 00:01:02,580 --> 00:01:04,710 Oh, that is the last place I want to be. 8 00:01:04,790 --> 00:01:07,080 Are you sure you shouldn't see your OB? 9 00:01:07,170 --> 00:01:09,710 I checked myself. 10 00:01:09,790 --> 00:01:11,800 Uterus is empty, barely spotting now. 11 00:01:11,880 --> 00:01:13,260 I'm fine. 12 00:01:14,220 --> 00:01:15,510 Oh, honey. 13 00:01:15,590 --> 00:01:17,800 I'm so sorry. 14 00:01:17,890 --> 00:01:20,810 Oh, I shouldn't have bought that fucking stroller. 15 00:01:20,890 --> 00:01:22,180 Oh. 16 00:01:22,260 --> 00:01:24,020 Fuck that fucking stroller. 17 00:01:30,110 --> 00:01:33,730 Losing a kid is hard on everybody. 18 00:01:45,660 --> 00:01:47,370 That's as hard as it gets. 19 00:01:47,460 --> 00:01:49,500 We do these debriefs 20 00:01:49,580 --> 00:01:53,710 to try to give a sense of closure, meaning, 21 00:01:53,800 --> 00:01:56,550 to difficult cases so that they won't linger. 22 00:01:56,630 --> 00:02:01,350 But trust me, the kids you'll lose will linger. 23 00:02:01,430 --> 00:02:04,100 So what do you do? 24 00:02:04,180 --> 00:02:07,140 I did my residency at Big Charity in New Orleans. 25 00:02:07,230 --> 00:02:11,190 And day one, I got a kid, five-year-old boy, 26 00:02:11,270 --> 00:02:12,690 accidentally shot by his brother 27 00:02:12,770 --> 00:02:14,940 playing with Dad's gun, 28 00:02:15,030 --> 00:02:17,700 worried he was gonna get in trouble 29 00:02:17,780 --> 00:02:19,660 right up until he coded and died. 30 00:02:23,450 --> 00:02:26,660 That night, I asked myself, like, 31 00:02:26,750 --> 00:02:29,080 what do I do with this kid? 32 00:02:29,170 --> 00:02:31,170 Where do I put this feeling? 33 00:02:31,250 --> 00:02:32,960 And I found myself walking all night. 34 00:02:33,040 --> 00:02:34,340 I was walking and walking and walking. 35 00:02:34,420 --> 00:02:35,750 Then I found myself back at the gates 36 00:02:35,840 --> 00:02:37,210 of Big Charity Cemetery, and I'm looking 37 00:02:37,300 --> 00:02:38,970 at all those mausoleums and those crypts 38 00:02:39,050 --> 00:02:40,800 and I'm thinking to myself, OK, that's what I need. 39 00:02:40,890 --> 00:02:42,890 I just need a safe place where I can put these feelings-- 40 00:02:42,970 --> 00:02:44,760 Yo, we got patients throwing punches in chairs. 41 00:02:46,810 --> 00:02:48,810 Uh, OK, everybody. Let's get back to it. 42 00:02:48,890 --> 00:02:50,770 Just remember, the Employee Assistance Program 43 00:02:50,850 --> 00:02:52,650 is available, as are Kiara and myself, 44 00:02:52,730 --> 00:02:54,650 if anybody needs to talk. 45 00:02:54,730 --> 00:02:56,190 - Where's McKay? - In Central 11 46 00:02:56,280 --> 00:02:58,070 with our UTI accounting assistant 47 00:02:58,150 --> 00:03:00,400 while we keep her boss on ice in North 2. 48 00:03:00,490 --> 00:03:02,200 Robby, critical case flying in-- 49 00:03:02,280 --> 00:03:04,200 possible MDMA overdose, high temp, 50 00:03:04,280 --> 00:03:05,910 en route from PittFest. Five minutes out. 51 00:03:05,990 --> 00:03:07,330 Stay here. Set up for that. 52 00:03:07,410 --> 00:03:08,750 - Ahmad and I got chairs. - Hey, hey. 53 00:03:08,830 --> 00:03:10,330 Is everything all right with Collins? 54 00:03:10,410 --> 00:03:11,870 Something's bothering her. I asked her about it. 55 00:03:11,960 --> 00:03:13,210 She said she doesn't want to talk to me about it. 56 00:03:13,290 --> 00:03:14,540 Oh. Imagine that. 57 00:03:14,630 --> 00:03:16,170 She probably learned it from you. 58 00:03:16,250 --> 00:03:18,460 Seriously? You just gave a speech titled 59 00:03:18,550 --> 00:03:20,130 "How to Literally Bury your Feelings." 60 00:03:20,220 --> 00:03:23,260 Now, if you'll excuse me, I gotta break up a fight. 61 00:03:24,800 --> 00:03:25,930 Yo, you need to control your wife, man! 62 00:03:26,010 --> 00:03:27,140 Shut it, man! 63 00:03:28,390 --> 00:03:30,180 Hey, hey, Olsen! 64 00:03:30,270 --> 00:03:32,020 - Olsen, what the fuck, man? - Took you long enough! 65 00:03:32,100 --> 00:03:33,100 - Calm down. - No. 66 00:03:33,190 --> 00:03:34,610 Don't tell me to calm down. 67 00:03:34,690 --> 00:03:36,190 How hard is it to put a mask on your kid? 68 00:03:36,270 --> 00:03:38,610 He has allergies, you fucking Fauci zombie. 69 00:03:38,690 --> 00:03:40,780 - What? - Allergies! Fuck you. 70 00:03:42,280 --> 00:03:43,240 - You fucking bitch! - Hey! 71 00:03:43,320 --> 00:03:45,030 Hey! That's enough! 72 00:03:45,120 --> 00:03:47,530 Jesus almighty, I don't believe what I'm seeing. 73 00:03:47,620 --> 00:03:50,040 Where do you people think you are, huh? 74 00:03:50,120 --> 00:03:51,540 This ain't Philly. 75 00:03:51,620 --> 00:03:53,330 This is a hospital, for Christ's sakes. 76 00:03:53,420 --> 00:03:56,000 What's the matter with you? 77 00:03:56,090 --> 00:03:58,500 You call yourselves adults? Huh? 78 00:03:58,590 --> 00:04:00,340 There are children in here. 79 00:04:00,420 --> 00:04:03,380 You should be ashamed of yourselves. 80 00:04:03,470 --> 00:04:05,890 Olsen, you catch any shrapnel? 81 00:04:05,970 --> 00:04:08,850 Craziest shit I've seen since I've been here, but I'm good. 82 00:04:08,930 --> 00:04:10,720 - I'm good, seriously. - Jack-offs. 83 00:04:10,810 --> 00:04:14,730 Ladies, are we finished with the craziness? 84 00:04:14,810 --> 00:04:16,270 This is fucking ridiculous. 85 00:04:16,360 --> 00:04:18,270 All I did was offer to put a mask on her child 86 00:04:18,360 --> 00:04:19,980 who's been coughing for over an hour. 87 00:04:20,070 --> 00:04:21,740 And--and now I'm missing half my goddamn tooth 88 00:04:21,820 --> 00:04:23,150 and talking like this. 89 00:04:23,240 --> 00:04:24,570 First of all, masks are bullshit. 90 00:04:24,660 --> 00:04:26,320 - Oh, my God. - And B, it's an allergy. 91 00:04:26,410 --> 00:04:28,740 He's allergic to cat dander, like I fucking told you. 92 00:04:28,830 --> 00:04:30,290 My sister brought her two Persians-- 93 00:04:30,370 --> 00:04:32,330 Shut up. Shut up right now, please. 94 00:04:32,410 --> 00:04:34,580 And only answer the questions I ask. 95 00:04:34,670 --> 00:04:37,670 What happened to the tooth? Did you swallow it? 96 00:04:37,750 --> 00:04:38,920 I don't think so. 97 00:04:39,000 --> 00:04:40,000 I think it's still in my hand. 98 00:04:40,090 --> 00:04:41,420 It sure is. 99 00:04:41,510 --> 00:04:42,970 I hope you both have all your shots. 100 00:04:43,050 --> 00:04:44,510 What do you mean, like, vaccines? 101 00:04:44,590 --> 00:04:46,140 Jesus, please don't stir this pot. 102 00:04:46,220 --> 00:04:47,430 Let's take these ladies back 103 00:04:47,510 --> 00:04:48,890 and get them treated, separately. 104 00:04:48,970 --> 00:04:50,680 - Stick with me. - Come on. 105 00:04:50,760 --> 00:04:51,850 Ma'am, it's time to go. 106 00:04:51,930 --> 00:04:54,230 Guess that makes us a team. 107 00:04:54,310 --> 00:04:55,890 I guess it does. 108 00:04:55,980 --> 00:04:58,610 Ma'am, come with Mateo and I-- 109 00:04:58,690 --> 00:05:00,020 Mateo and me. 110 00:05:00,110 --> 00:05:01,780 Yes, with us both. 111 00:05:01,860 --> 00:05:03,490 OK, Earl, let's take a look at you. 112 00:05:03,570 --> 00:05:04,950 Oof, she really tagged you. 113 00:05:05,030 --> 00:05:07,530 Red's got a left hook like Billy Conn. 114 00:05:07,610 --> 00:05:08,740 Well, let's get you cleaned up. 115 00:05:08,820 --> 00:05:11,700 Come on, baby. 116 00:05:11,790 --> 00:05:12,870 Excuse me, sir. 117 00:05:12,950 --> 00:05:15,160 You're not allowed back there. 118 00:05:15,250 --> 00:05:17,460 Unless, what, I start a fight? 119 00:05:17,540 --> 00:05:18,830 Become homeless? 120 00:05:18,920 --> 00:05:20,000 Apparently, that's what it takes. 121 00:05:20,090 --> 00:05:21,090 I understand your frustration. 122 00:05:21,170 --> 00:05:22,420 I promise you'll be seen 123 00:05:22,500 --> 00:05:23,960 as soon as a provider is available. 124 00:05:24,050 --> 00:05:25,670 But how can they become available 125 00:05:25,760 --> 00:05:27,380 if new people keep cutting the fucking line? 126 00:05:27,470 --> 00:05:28,720 There's no line. 127 00:05:28,800 --> 00:05:30,510 We see patients by severity of need. 128 00:05:30,600 --> 00:05:33,430 As soon as we have your tests and labs, you will be seen. 129 00:05:33,520 --> 00:05:35,640 This place is fucking unbelievable. 130 00:05:35,730 --> 00:05:38,230 Runaround after runaround. 131 00:05:38,310 --> 00:05:40,400 Hey. What's up, Erik Estrada? 132 00:05:40,480 --> 00:05:41,820 Still keeping your eye on me? 133 00:05:41,900 --> 00:05:43,730 Always, my friend. 134 00:05:43,820 --> 00:05:45,400 Always. 135 00:05:45,490 --> 00:05:48,070 - Who's Erik Estrada? - Shame on you. "CHiPs." 136 00:05:48,160 --> 00:05:49,370 Know your television history. 137 00:05:49,450 --> 00:05:50,950 - And thank you. - Yeah. 138 00:05:53,120 --> 00:05:55,000 Crazy people. 139 00:05:55,080 --> 00:05:56,660 If you do get my tooth out, I don't want it 140 00:05:56,750 --> 00:05:58,710 after it's been inside that woman. 141 00:05:58,790 --> 00:06:00,540 Reattachment wouldn't be possible. 142 00:06:00,630 --> 00:06:02,250 A type two fracture into the dentin. 143 00:06:02,340 --> 00:06:03,550 Seal with dental cement. 144 00:06:03,630 --> 00:06:05,460 Prescription for Pen VK, soft diet. 145 00:06:05,550 --> 00:06:07,590 Follow up with the dentist in one to three days for a crown. 146 00:06:07,670 --> 00:06:10,930 You handle Spinks while I check on Ali. 147 00:06:11,010 --> 00:06:11,970 You got this. 148 00:06:12,050 --> 00:06:13,890 Don't worry, partner. 149 00:06:13,970 --> 00:06:15,430 Yes. 150 00:06:15,520 --> 00:06:16,930 I totally got this. 151 00:06:20,270 --> 00:06:21,900 How are we doing in here? 152 00:06:21,980 --> 00:06:23,690 You should write that bitch a script for calcium 153 00:06:23,770 --> 00:06:25,570 because I didn't even hit her that hard. 154 00:06:25,650 --> 00:06:28,990 Too much almond milk in your soy lattes. 155 00:06:29,070 --> 00:06:30,820 That doesn't even make sense. 156 00:06:30,910 --> 00:06:33,160 You know, most commercial almond and soy milks 157 00:06:33,240 --> 00:06:35,240 are fortified with calcium, so they end up having 158 00:06:35,330 --> 00:06:37,830 a higher percentage of calcium than cows' milk. 159 00:06:37,910 --> 00:06:39,710 Prepped with Betadine and draped. 160 00:06:39,790 --> 00:06:40,830 Very nice. 161 00:06:40,920 --> 00:06:42,210 Let's have a closer look. 162 00:06:42,290 --> 00:06:44,090 Dr. King, can you please grab me 163 00:06:44,170 --> 00:06:46,670 a 10 cc syringe, a 20 gauge needle, 164 00:06:46,760 --> 00:06:48,260 and some sterile saline, please? 165 00:06:48,340 --> 00:06:50,220 Pluck it out, stitch me up, and send me home. 166 00:06:50,300 --> 00:06:51,800 I've got to get back out there to my kid, 167 00:06:51,890 --> 00:06:53,680 who is still waiting to be seen, by the way. 168 00:06:53,760 --> 00:06:55,560 Afraid it's a little more complicated than that. 169 00:06:55,640 --> 00:06:58,230 You got yourself a fight bite, which means a couple things. 170 00:06:58,310 --> 00:06:59,770 First, we need to determine 171 00:06:59,850 --> 00:07:01,690 if the bite extended into the joint space. 172 00:07:01,770 --> 00:07:03,610 If it did, you're gonna need IV antibiotics 173 00:07:03,690 --> 00:07:05,650 and a trip to the OR to see a hand surgeon. 174 00:07:05,730 --> 00:07:08,530 - Pinprick and a little burning. - An operation? 175 00:07:08,610 --> 00:07:11,160 Well, you were just shouting a minute ago about infection, 176 00:07:11,240 --> 00:07:13,030 and with good reason. 177 00:07:13,120 --> 00:07:16,790 While I am sure you are in the clear for rabies and HIV, 178 00:07:16,870 --> 00:07:19,540 human mouths are filthy, some more than others. 179 00:07:19,620 --> 00:07:20,910 How can you tell if it's bad? 180 00:07:21,000 --> 00:07:22,620 Good question. Dr. K? 181 00:07:24,170 --> 00:07:25,630 I'm sorry? 182 00:07:25,710 --> 00:07:28,590 I am going to inject some sterile saline 183 00:07:28,670 --> 00:07:30,090 into your knuckle joint, which you won't feel 184 00:07:30,170 --> 00:07:31,300 'cause of the anesthetic. 185 00:07:31,380 --> 00:07:33,720 If it comes spraying back out of the bite wound, we'll know. 186 00:07:33,800 --> 00:07:35,140 - Ready? - I guess. 187 00:07:37,510 --> 00:07:38,850 There she blows. 188 00:07:38,930 --> 00:07:40,390 Ah, shit. 189 00:07:40,480 --> 00:07:41,770 Are you serious? 190 00:07:41,850 --> 00:07:43,850 You hear that, you fucking bitch? 191 00:07:43,940 --> 00:07:46,110 I've got to have surgery, thanks to you. 192 00:07:46,190 --> 00:07:49,900 - Good. You assaulted me! - Damn right. 193 00:07:49,990 --> 00:07:51,820 And I'll bet next time, you keep your masks 194 00:07:51,900 --> 00:07:54,030 and opinions to yourself. 195 00:07:54,110 --> 00:07:55,370 You OK? 196 00:07:55,450 --> 00:07:56,780 Yes. 197 00:07:56,870 --> 00:08:00,040 3 grams Unasyn IV. Call the OR. 198 00:08:00,120 --> 00:08:02,460 Tell them we have a fight bite that needs to be washed out. 199 00:08:02,540 --> 00:08:03,790 Then go take 20 minutes in the lounge. 200 00:08:03,870 --> 00:08:05,250 I'll come find you if I need you. 201 00:08:05,330 --> 00:08:07,170 - I don't need a break. - Yes, you do. 202 00:08:09,590 --> 00:08:11,010 OK. 203 00:08:11,090 --> 00:08:14,010 Oh, did you want me to tell the surgeons 204 00:08:14,090 --> 00:08:16,850 - to go no masks for surgery? - What? 205 00:08:16,930 --> 00:08:19,060 Well, those of us who save lives for a living 206 00:08:19,140 --> 00:08:21,430 believe strongly that masks minimize risk 207 00:08:21,520 --> 00:08:23,190 when it comes to spreading disease and infection. 208 00:08:23,270 --> 00:08:25,350 But I--I want to respect your beliefs, 209 00:08:25,440 --> 00:08:27,230 so what do you think? 210 00:08:27,310 --> 00:08:28,820 With or without for surgery? Without? 211 00:08:28,900 --> 00:08:32,650 Um...I want with. 212 00:08:32,740 --> 00:08:35,700 Good call. 213 00:08:35,780 --> 00:08:37,570 Helicopter's here. Cafeteria send the ice? 214 00:08:37,660 --> 00:08:39,280 - Yeah, everything they got. - Hey. 215 00:08:39,370 --> 00:08:40,740 I hear they're gonna start you 216 00:08:40,830 --> 00:08:42,120 working on the Middle East peace plan. 217 00:08:42,200 --> 00:08:43,910 Not since the Dalai Lama or Gandhi. 218 00:08:44,000 --> 00:08:45,080 They'd be fucking-A right to. 219 00:08:45,170 --> 00:08:46,290 You should have seen me. 220 00:08:46,380 --> 00:08:48,040 I was inspiring, also terrifying, 221 00:08:48,130 --> 00:08:49,290 and a little bit shaming. 222 00:08:49,380 --> 00:08:50,920 Holy Trinity of crowd control. 223 00:08:51,000 --> 00:08:52,260 Hey, can we pick it up in here, please? 224 00:08:52,340 --> 00:08:55,180 Overdose is here. 225 00:08:55,260 --> 00:08:56,760 PittFest OD. 226 00:08:56,840 --> 00:08:58,350 Keely Ralston, brought to the first aid tent 227 00:08:58,430 --> 00:09:00,600 at PittFest with altered mental status and fever. 228 00:09:00,680 --> 00:09:02,180 Temp too high for a field thermometer. 229 00:09:02,270 --> 00:09:03,430 Intubated en route. 230 00:09:03,520 --> 00:09:04,940 We got to cool this lady down. 231 00:09:05,020 --> 00:09:06,440 Get some ice packs, head, neck, groin. 232 00:09:06,520 --> 00:09:08,900 - Send off for a rainbow. - On it. 233 00:09:08,980 --> 00:09:11,480 Heart rate 132, BP 210 over 120. 234 00:09:11,570 --> 00:09:14,070 - Jesus, that's high. - Four of Ativan in the field. 235 00:09:14,150 --> 00:09:16,240 Pupils are dilated. Definitely MDMA overdose. 236 00:09:16,320 --> 00:09:18,030 Dr. Mohan, how do you want to treat the BP? 237 00:09:18,120 --> 00:09:19,410 - Beta blockers? - No. 238 00:09:19,490 --> 00:09:20,490 Unopposed alpha could kill her. 239 00:09:20,580 --> 00:09:21,540 Four more of Ativan, please. 240 00:09:21,620 --> 00:09:22,910 Seriously? 241 00:09:23,000 --> 00:09:24,540 She might need another 40. 242 00:09:24,620 --> 00:09:26,420 Hypertension and tachycardia from MDMA 243 00:09:26,500 --> 00:09:28,040 is centrally mediated. 244 00:09:28,130 --> 00:09:29,130 Ativan is the drug of choice. 245 00:09:29,210 --> 00:09:31,210 Damn. Core temp, 107.3. 246 00:09:31,300 --> 00:09:32,630 OK, can we get another hose in here 247 00:09:32,710 --> 00:09:33,960 before she fries her brain, please? 248 00:09:34,050 --> 00:09:36,170 Let's go. Come on. 249 00:09:39,180 --> 00:09:41,050 I'll be right back. 250 00:09:41,140 --> 00:09:43,560 Hi. You look lost. 251 00:09:43,640 --> 00:09:45,020 No, it's my assistant 252 00:09:45,100 --> 00:09:46,520 who actually seems to have been misplaced. 253 00:09:46,600 --> 00:09:48,400 I mean, how long does a CT take? 254 00:09:48,480 --> 00:09:49,650 Certainly not this long. 255 00:09:49,730 --> 00:09:51,020 They can get pretty backed up. 256 00:09:51,110 --> 00:09:52,230 Can I get you a cup of bad coffee? 257 00:09:52,320 --> 00:09:54,190 - Dry sandwich? - No, thank you. 258 00:09:54,280 --> 00:09:55,900 How about a cold LaCroix from my secret stash in the lounge? 259 00:09:55,990 --> 00:09:57,650 I'm going for one myself. I'm freaking addicted. 260 00:09:57,740 --> 00:09:59,910 I'm good on drinks. Can you take me to radiology? 261 00:09:59,990 --> 00:10:02,280 Yeah, right this way. Right this way. 262 00:10:07,080 --> 00:10:09,120 Piper, while we still have a few minutes, 263 00:10:09,210 --> 00:10:10,580 there are some things I want to say. 264 00:10:10,670 --> 00:10:12,290 Yeah, use protection. 265 00:10:12,380 --> 00:10:14,420 - I know. I'm sorry. - Totally. 266 00:10:14,500 --> 00:10:17,130 - It was a mistake. - Totally. 267 00:10:17,220 --> 00:10:19,430 I'm a part of the street team here. 268 00:10:19,510 --> 00:10:21,390 It's a group of doctors and nurses 269 00:10:21,470 --> 00:10:24,100 who go out into the community and help people 270 00:10:24,180 --> 00:10:27,020 who can't or won't ask for help-- 271 00:10:27,100 --> 00:10:30,770 addicts, unhoused, runaways. 272 00:10:30,850 --> 00:10:32,940 And I'll be honest with you, Piper. 273 00:10:33,020 --> 00:10:35,860 I think you need some help. 274 00:10:35,940 --> 00:10:37,780 What are you talking about? 275 00:10:37,860 --> 00:10:40,280 If you're in trouble, we can help you. 276 00:10:40,360 --> 00:10:43,120 I'm not. OK? 277 00:10:43,200 --> 00:10:46,790 And if we're done here, I think I'd like to go. 278 00:10:46,870 --> 00:10:51,330 Will you at least take a look at this? 279 00:10:51,420 --> 00:10:53,170 There's a list of resources on the back. 280 00:10:53,250 --> 00:10:55,460 I don't need that. 281 00:10:55,550 --> 00:10:57,920 I know you don't have a phone, 282 00:10:58,010 --> 00:11:02,220 but if you could just take my number, OK? 283 00:11:02,300 --> 00:11:04,140 You never know. 284 00:11:04,220 --> 00:11:06,350 Where's Laura? 285 00:11:06,430 --> 00:11:08,180 How about taking the pen? 286 00:11:08,270 --> 00:11:11,230 If you ever feel unsafe or in danger, call this number. 287 00:11:11,310 --> 00:11:12,770 It's a national hotline. 288 00:11:12,850 --> 00:11:15,190 There's somebody on the other end 24/7, 289 00:11:15,270 --> 00:11:17,150 a trained professional who can help with anything. 290 00:11:17,230 --> 00:11:18,440 I have all the help I need. 291 00:11:18,530 --> 00:11:20,820 I want to go. Now. 292 00:11:20,900 --> 00:11:23,070 OK, on my count. One, two, three. 293 00:11:23,160 --> 00:11:24,830 Gentle, gentle, gentle. 294 00:11:24,910 --> 00:11:26,950 Houston, we have splashdown. 295 00:11:27,040 --> 00:11:28,250 Good luck. See you on the next one. 296 00:11:28,330 --> 00:11:30,290 - Yep. - Temp's down to 107.1. 297 00:11:30,370 --> 00:11:32,080 How long does she need to stay in the ice, Dr. Santos? 298 00:11:32,170 --> 00:11:33,630 My PB in the ice is 13 minutes. 299 00:11:33,710 --> 00:11:35,590 - Dr. Santos. - Until her temp is normal. 300 00:11:35,670 --> 00:11:37,210 Wrong. You pull her out at 102. 301 00:11:37,300 --> 00:11:39,300 Otherwise we could overshoot and cause hypothermia. 302 00:11:39,380 --> 00:11:42,050 Heart rate 120. Pressure 198 over 116. 303 00:11:42,130 --> 00:11:44,180 More Ativan? Another four, please. 304 00:11:44,260 --> 00:11:45,800 Why is she on the ice, Dr. Santos? 305 00:11:45,890 --> 00:11:47,470 - To bring her temp down. - Wow, state the obvious, 306 00:11:47,560 --> 00:11:49,220 yet still don't answer the question. 307 00:11:49,310 --> 00:11:50,730 The quicker we bring it down, the less of a chance 308 00:11:50,810 --> 00:11:52,020 for permanent damage to the brain, 309 00:11:52,100 --> 00:11:53,520 - liver, or kidneys. - Exactly. 310 00:11:53,600 --> 00:11:55,440 - Was she sweating? - Profusely. 311 00:11:55,520 --> 00:11:56,690 What if she wasn't, Dr. Santos? 312 00:11:56,770 --> 00:11:58,280 What if she was dry as a bone? 313 00:11:58,360 --> 00:11:59,900 Then we'd have to think anticholinergic overdose, 314 00:11:59,990 --> 00:12:01,030 not sympathetic. 315 00:12:04,280 --> 00:12:05,450 Very good. 316 00:12:12,750 --> 00:12:14,750 Hey. 317 00:12:14,830 --> 00:12:17,170 I found you scrubs that should fit. 318 00:12:17,250 --> 00:12:18,500 Oh. 319 00:12:18,590 --> 00:12:20,210 Thank you. That's great. 320 00:12:20,300 --> 00:12:23,550 - I appreciate that. - But they come with a catch. 321 00:12:23,630 --> 00:12:25,590 Mr. Krakozhia is asking to see you. 322 00:12:25,680 --> 00:12:27,640 The guy who peed on me? 323 00:12:27,720 --> 00:12:29,680 - Why me? - I didn't ask. 324 00:12:29,770 --> 00:12:31,930 But maybe you should wait to put these scrubs on 325 00:12:32,020 --> 00:12:33,810 until after you've-- 326 00:12:33,890 --> 00:12:34,940 That's a good idea. 327 00:12:35,020 --> 00:12:36,400 Oh, God. 328 00:12:38,480 --> 00:12:40,320 Oh, man. We got a load of the-- 329 00:12:40,400 --> 00:12:42,360 Oh, my God. 330 00:12:42,440 --> 00:12:43,530 Whoa! Hey! 331 00:12:48,070 --> 00:12:49,700 Yeah, I see you. 332 00:12:52,200 --> 00:12:53,620 Your days are numbered, buddy. 333 00:12:53,710 --> 00:12:55,080 Trauma to ER Two. ETA now. 334 00:12:55,170 --> 00:12:56,630 That's another four of Ativan. 335 00:12:56,710 --> 00:12:58,210 Rectal temp's down to 105. 336 00:12:58,290 --> 00:12:59,380 OK, moving in the right direction. 337 00:12:59,460 --> 00:13:00,710 We might get lucky here. 338 00:13:00,800 --> 00:13:02,380 Double trauma at the back door. 339 00:13:02,460 --> 00:13:04,380 Auto versus pedestrian before hitting a telephone pole. 340 00:13:04,470 --> 00:13:06,430 - You got this? - Yep. 341 00:13:06,510 --> 00:13:08,470 Dr. Robby, I finished with Dr. Ozeki, 342 00:13:08,550 --> 00:13:09,550 the therapist upstairs. 343 00:13:09,640 --> 00:13:11,180 Yes, yes, yes. How did that go? 344 00:13:11,260 --> 00:13:13,020 - Well. - Excellent. 345 00:13:16,100 --> 00:13:17,400 Have you heard from David? 346 00:13:17,480 --> 00:13:18,730 No. 347 00:13:18,810 --> 00:13:20,230 Has David seen the therapist? 348 00:13:26,240 --> 00:13:27,990 Do you think that he's still gonna pick you up today? 349 00:13:28,070 --> 00:13:29,620 - I think so. - OK, well-- 350 00:13:29,700 --> 00:13:31,660 - Robby, here they come. - OK. 351 00:13:31,740 --> 00:13:33,700 Well, you're medically cleared, so why don't you stay here 352 00:13:33,790 --> 00:13:36,210 for a little while longer in the hopes that he does? 353 00:13:36,290 --> 00:13:37,750 I still would like him to talk to somebody. 354 00:13:37,830 --> 00:13:39,580 Perlah, this is Theresa. She's a friend of mine, 355 00:13:39,670 --> 00:13:41,590 so I expect concierge service, yes? 356 00:13:41,670 --> 00:13:42,840 - VIP treatment. - Thank you. 357 00:13:42,920 --> 00:13:44,300 You're in good hands. 358 00:13:44,380 --> 00:13:46,380 Just let me know if David shows up or if he calls. 359 00:13:46,470 --> 00:13:48,550 Good boy. Good boy. 360 00:13:48,640 --> 00:13:50,180 Walter Pernell, 52, 361 00:13:50,260 --> 00:13:51,680 walking his dog in the crosswalk, 362 00:13:51,760 --> 00:13:53,810 got struck by a Chevy Impala at low velocity. 363 00:13:53,890 --> 00:13:57,140 Ambulatory on scene, no KO, no neck, chest, or belly pain. 364 00:13:57,230 --> 00:13:59,690 - Good vitals. - Whoa. Major road rash. 365 00:13:59,770 --> 00:14:02,360 Yeah, the car didn't hit me so much as throw me. 366 00:14:02,440 --> 00:14:04,440 But I slid for a good 10 feet. 367 00:14:04,530 --> 00:14:05,690 Of course, this is the first day 368 00:14:05,780 --> 00:14:07,280 I've worn shorts all effin' year. 369 00:14:07,360 --> 00:14:09,200 No deformity at the knee or ankle. 370 00:14:09,280 --> 00:14:10,620 Distal pulse is intact. 371 00:14:10,700 --> 00:14:11,950 Four of morphine so far. 372 00:14:12,030 --> 00:14:13,370 Yeah, feel free to be more generous. 373 00:14:13,450 --> 00:14:14,790 Don't worry. We will patch you up. 374 00:14:14,870 --> 00:14:16,250 We will get you right. Who's your friend? 375 00:14:16,330 --> 00:14:17,580 Oh, this is Crosby, 376 00:14:17,660 --> 00:14:19,500 who thankfully barked and warned me 377 00:14:19,580 --> 00:14:21,420 so I had half a second to try to move out of the way. 378 00:14:21,500 --> 00:14:22,960 Crosby, you're a hero. 379 00:14:23,040 --> 00:14:24,670 Donahue, you think you could find a Milk-Bone 380 00:14:24,750 --> 00:14:26,550 for our little lifesaver here in the doctor's lounge? 381 00:14:26,630 --> 00:14:28,260 Absolutely. I'll take good care of him. 382 00:14:28,340 --> 00:14:29,970 Can't he stay with me? He's a very good boy. 383 00:14:30,050 --> 00:14:31,430 No doubt. Let's get you settled first. 384 00:14:31,510 --> 00:14:32,850 - You're going to South 20. - Got it. 385 00:14:32,930 --> 00:14:34,310 Is that the driver? 386 00:14:34,390 --> 00:14:35,850 28-year-old lady, had her seat belt on. 387 00:14:35,930 --> 00:14:37,100 Clipped the guy with the dog and went 388 00:14:37,180 --> 00:14:38,600 straight into a telephone pole. 389 00:14:38,690 --> 00:14:39,900 Blood's from a scalp lac. 390 00:14:39,980 --> 00:14:41,100 Also complained of chest pain. 391 00:14:41,190 --> 00:14:42,360 Sleepy but arousable. 392 00:14:42,440 --> 00:14:44,070 - What's your name? - Paula. 393 00:14:44,150 --> 00:14:46,740 Heart rate's a bit tachy. 112. BP's fine. 394 00:14:46,820 --> 00:14:48,400 Paula, are you in any pain right now? 395 00:14:48,490 --> 00:14:50,280 Yeah, I got hurt. 396 00:14:50,360 --> 00:14:52,700 Witnesses say she was driving erratically before the crash. 397 00:14:52,780 --> 00:14:55,660 No ETOH on her breath. Maybe drugs? 398 00:14:55,740 --> 00:14:58,370 - Core temp's 104.2. - Heart rate 116. 399 00:14:58,460 --> 00:15:00,330 BP 180 over 110. 400 00:15:00,420 --> 00:15:01,750 Better, but still too high. 401 00:15:01,830 --> 00:15:03,000 Another four of Ativan. 402 00:15:03,080 --> 00:15:04,090 That'll make 20. 403 00:15:04,170 --> 00:15:05,420 Good counting. 404 00:15:05,500 --> 00:15:06,840 Pedestrian in South 20 needs a doctor. 405 00:15:06,920 --> 00:15:08,970 - You got this? - Yep. Keep chilling. 406 00:15:09,050 --> 00:15:11,010 - All hands on deck. You ready? - Ready. 407 00:15:11,090 --> 00:15:13,300 OK, here we go. One, two, three. 408 00:15:17,810 --> 00:15:19,600 I heard motor vehicle collision with chest pain 409 00:15:19,680 --> 00:15:20,730 and altered mental status. 410 00:15:20,810 --> 00:15:22,060 - Qué más? - Meet Paula. 411 00:15:22,150 --> 00:15:24,400 Restrained driver versus telephone pole. 412 00:15:24,480 --> 00:15:26,820 Altered before the crash. Good BP, but tachy. 413 00:15:26,900 --> 00:15:28,780 Second line and run a liter of LR wide open. 414 00:15:28,860 --> 00:15:31,570 Still tachy at 115. BP's 180 over 72. 415 00:15:31,660 --> 00:15:32,820 Airway's patent. 416 00:15:32,910 --> 00:15:34,120 Good breath sounds bilaterally. 417 00:15:34,200 --> 00:15:35,780 Pupils are equal and reactive. 418 00:15:35,870 --> 00:15:37,580 Paula, do you know what today's date is? 419 00:15:37,660 --> 00:15:39,450 It's, uh... 420 00:15:39,540 --> 00:15:40,830 Sats 94%. 421 00:15:40,910 --> 00:15:42,120 How about the city we're in? 422 00:15:42,210 --> 00:15:43,330 Pittsburgh? 423 00:15:43,420 --> 00:15:44,880 Bruising on the chest. 424 00:15:44,960 --> 00:15:47,130 Possible sternal fracture. 425 00:15:47,210 --> 00:15:48,840 - Pericardium's clear. - Good. Good. 426 00:15:48,920 --> 00:15:50,630 No marked tenderness. 427 00:15:50,720 --> 00:15:52,880 Nothing in Morrison's pouch. 428 00:15:52,970 --> 00:15:54,390 She's a little tachypneic. 429 00:15:54,470 --> 00:15:55,800 I don't think she needs intubation. 430 00:15:55,890 --> 00:15:57,310 Might just be concussed. 431 00:15:57,390 --> 00:15:58,930 I worry about her crumping in the scanner. 432 00:15:59,020 --> 00:16:00,890 She's protecting her airway. I see lung sliding. 433 00:16:00,980 --> 00:16:02,520 - No pneumo. - With a head injury? 434 00:16:02,600 --> 00:16:04,150 You guys are supposed to be the airway experts. 435 00:16:04,230 --> 00:16:05,980 Stop fighting. Make a decision. 436 00:16:06,060 --> 00:16:07,610 Call me when she goes to CT. 437 00:16:07,690 --> 00:16:10,240 Paula, can you raise your right arm for me? 438 00:16:10,320 --> 00:16:12,490 Good sign. Follows commands. 439 00:16:12,570 --> 00:16:14,450 You want to intubate with a GCS of 13? 440 00:16:14,530 --> 00:16:15,910 OK. We can hold off and monitor. 441 00:16:15,990 --> 00:16:18,080 - What's your plan? - Pan scan, head to pelvis. 442 00:16:18,160 --> 00:16:19,790 EKG, troponin. 443 00:16:19,870 --> 00:16:21,910 Straight cath urine for UA and tox screen. 444 00:16:22,000 --> 00:16:24,620 - Agreed. - I'm on it. 445 00:16:24,710 --> 00:16:26,920 - Gotta bend those knees. - I gotta quit showing off. 446 00:16:27,000 --> 00:16:29,590 - Is that what you were doing? - Always. 447 00:16:31,050 --> 00:16:33,170 It's a ten-day course of doxycycline, 448 00:16:33,260 --> 00:16:35,050 one pill twice a day. 449 00:16:35,140 --> 00:16:38,680 I'll make sure she takes it on a full stomach. 450 00:16:38,760 --> 00:16:41,430 I can give you your first dose now, Piper, if you like. 451 00:16:41,520 --> 00:16:42,890 - Get you started. - That'd be great. 452 00:16:42,980 --> 00:16:46,100 Actually, I need Piper to answer that one. 453 00:16:46,190 --> 00:16:47,900 Sure. That'd be great. 454 00:16:47,980 --> 00:16:49,770 OK. 455 00:16:50,820 --> 00:16:51,940 Hello, everyone. 456 00:16:52,030 --> 00:16:53,700 Looks like we're finishing up here. 457 00:16:53,780 --> 00:16:55,200 I come bearing gifts. 458 00:16:55,280 --> 00:16:56,820 Everything you always wanted to know about STIs 459 00:16:56,910 --> 00:16:58,120 but never wanted to read. 460 00:16:58,200 --> 00:17:00,120 No gross pictures, I promise. 461 00:17:00,200 --> 00:17:01,370 I think we're good. 462 00:17:01,450 --> 00:17:03,540 - You sure? - Mm-hmm. 463 00:17:03,620 --> 00:17:05,330 Yeah. I learned my lesson. 464 00:17:05,420 --> 00:17:06,920 It won't happen again. 465 00:17:09,460 --> 00:17:13,010 I guess that's it, then. 466 00:17:13,090 --> 00:17:15,010 Well, if you change your mind, 467 00:17:15,090 --> 00:17:17,590 it comes with a free pen. 468 00:17:17,680 --> 00:17:19,550 Thank you both so much for your help. 469 00:17:19,640 --> 00:17:21,350 - Yeah. - Thanks. 470 00:17:23,980 --> 00:17:25,310 OK. 471 00:17:25,390 --> 00:17:27,060 Good luck to you both. 472 00:17:31,610 --> 00:17:32,690 Fuck. 473 00:17:34,740 --> 00:17:35,740 Fuck. 474 00:17:35,820 --> 00:17:38,200 That sums it up. 475 00:17:38,280 --> 00:17:39,700 She'll be back. 476 00:17:39,780 --> 00:17:41,450 Only she'll have slipped a little further. 477 00:17:41,530 --> 00:17:44,200 Sometimes it takes a few visits. 478 00:17:44,290 --> 00:17:45,580 How can I keep her here? 479 00:17:45,660 --> 00:17:47,120 You got anything? 480 00:17:47,210 --> 00:17:49,750 Maybe Kiara has a social services card to play. 481 00:17:49,830 --> 00:17:51,500 She was by Trauma One last I saw her. 482 00:17:51,590 --> 00:17:53,710 Brilliant. Brilliant. Thank you. 483 00:17:53,800 --> 00:17:56,800 That's why I'm here, to be brilliant 484 00:17:56,880 --> 00:17:58,680 and bring peace. 485 00:17:58,760 --> 00:17:59,840 Heart rate's 84. 486 00:17:59,930 --> 00:18:01,810 BP 126 over 78. 487 00:18:01,890 --> 00:18:03,810 Pulse ox, 99 on room air. 488 00:18:03,890 --> 00:18:05,230 Good news, Mr. Pernell. 489 00:18:05,310 --> 00:18:07,600 Your heart, lungs, and belly all look good. 490 00:18:07,690 --> 00:18:09,850 Yeah, just the leg. 491 00:18:09,940 --> 00:18:11,690 Whoo, this might be a road rash record. 492 00:18:11,770 --> 00:18:13,190 We might have to bust out the tape. 493 00:18:13,270 --> 00:18:14,980 I'm getting a little worried about Crosby. 494 00:18:15,070 --> 00:18:16,070 Who's Crosby? 495 00:18:16,150 --> 00:18:17,240 - His dog. - My dog. 496 00:18:17,320 --> 00:18:18,860 Where is Crosby? 497 00:18:18,950 --> 00:18:21,030 - He's in the break room. - Your break room, I think. 498 00:18:21,120 --> 00:18:22,410 I'm sure he's fine. 499 00:18:22,490 --> 00:18:24,330 We got a lot of dog lovers around here. 500 00:18:24,410 --> 00:18:26,330 I'm the new owner of a nine-week-old Goldendoodle. 501 00:18:26,410 --> 00:18:27,750 Oh, nice. 502 00:18:27,830 --> 00:18:28,960 Crosby's a terrier. 503 00:18:29,960 --> 00:18:31,170 Great dogs. 504 00:18:31,250 --> 00:18:33,290 Determined, courageous, love to dig. 505 00:18:33,380 --> 00:18:35,090 Who's he named for, Sidney or David? 506 00:18:35,170 --> 00:18:36,380 David. 507 00:18:36,460 --> 00:18:37,420 Still my Sunday morning soundtrack. 508 00:18:37,510 --> 00:18:39,380 - Ow. Ow. - Oh. Sorry. 509 00:18:39,470 --> 00:18:41,090 Yeah, anyways, great name. 510 00:18:41,180 --> 00:18:42,850 So the knee looks stable. 511 00:18:42,930 --> 00:18:45,430 There's no laxity to suggest a torn ligament. 512 00:18:45,520 --> 00:18:47,640 I think the pain's probably just from the road rash, 513 00:18:47,730 --> 00:18:49,020 but let's get an X-ray just to be sure. 514 00:18:49,100 --> 00:18:50,440 Some more morphine? 515 00:18:50,520 --> 00:18:52,020 You're a wonderful human being. 516 00:18:52,110 --> 00:18:53,610 Let's start with LET, no more than 30 cc's. 517 00:18:53,690 --> 00:18:56,150 We're gonna try a topical anesthetic 518 00:18:56,230 --> 00:18:57,860 to numb the raw skin 519 00:18:57,940 --> 00:18:59,740 before we start picking out all the gravel. 520 00:18:59,820 --> 00:19:02,280 Well, my morning horoscope didn't mention any of this. 521 00:19:02,370 --> 00:19:04,030 Well, hey, look on the bright side. 522 00:19:04,120 --> 00:19:05,620 Now you can tell people that you got hit by a car. 523 00:19:05,700 --> 00:19:07,290 Not a lot of people can live to say that. 524 00:19:07,370 --> 00:19:11,500 Yeah, I hope whoever hit me is rich and well insured. 525 00:19:11,580 --> 00:19:14,590 I'll let him know. OK. Thanks. 526 00:19:14,670 --> 00:19:15,920 Flag on the play. 527 00:19:16,000 --> 00:19:17,840 Positive pregnancy test. 528 00:19:17,920 --> 00:19:19,260 You still want a scan? 529 00:19:19,340 --> 00:19:21,550 Maybe she's bleeding from an ectopic. 530 00:19:21,630 --> 00:19:23,470 No, she delivered a healthy baby here 531 00:19:23,550 --> 00:19:24,760 ten days ago. 532 00:19:24,850 --> 00:19:28,350 Normal vaginal delivery, no complications. 533 00:19:28,430 --> 00:19:30,350 Pregnancy tests stay positive for a few weeks. 534 00:19:30,440 --> 00:19:31,940 - So are we good to go? - Good to go. 535 00:19:32,020 --> 00:19:33,230 We'll let the tech know. 536 00:19:38,610 --> 00:19:40,150 Oh, man. 537 00:19:40,240 --> 00:19:42,320 She was seen here this morning by Dr. McKay. 538 00:19:42,410 --> 00:19:44,700 - For what? - Urinary tract infection. 539 00:19:44,780 --> 00:19:47,790 Discharged with oral antibiotics. 540 00:19:47,870 --> 00:19:49,660 You think it has something to do with the crash? 541 00:19:49,750 --> 00:19:51,040 Yes. No. Maybe. 542 00:19:51,120 --> 00:19:52,830 Ask me again after I've had 543 00:19:52,920 --> 00:19:55,790 the scans, labs, and tox screen. 544 00:19:57,630 --> 00:19:58,630 No. 545 00:19:58,710 --> 00:20:00,170 OK. 546 00:20:00,260 --> 00:20:03,340 So I need to talk to you about something. 547 00:20:03,430 --> 00:20:05,140 - About what? - Do me a favor. 548 00:20:05,220 --> 00:20:07,560 Look at me, and don't turn around 549 00:20:07,640 --> 00:20:09,060 - and just watch-- - Oh, hell no! 550 00:20:09,140 --> 00:20:11,890 I told you not to turn around. 551 00:20:15,190 --> 00:20:16,690 I wish there was a way to keep her, 552 00:20:16,770 --> 00:20:18,360 but there just isn't. 553 00:20:18,440 --> 00:20:19,980 Well--well, then fuck it. 554 00:20:20,070 --> 00:20:21,690 We'll just say that we need another urine sample, 555 00:20:21,780 --> 00:20:23,240 that the lab left the last one out too long 556 00:20:23,320 --> 00:20:24,570 and couldn't culture it. 557 00:20:24,660 --> 00:20:26,070 OK. Then what? 558 00:20:26,160 --> 00:20:27,530 I'll give Piper the sample cup 559 00:20:27,620 --> 00:20:29,450 and send her down the hall to the bathroom. 560 00:20:29,540 --> 00:20:31,370 I'll stay with Laura in the room with some bullshit. 561 00:20:31,450 --> 00:20:32,790 You wait for Piper by the bathroom. 562 00:20:32,870 --> 00:20:34,750 To say what exactly? 563 00:20:34,830 --> 00:20:36,500 I don't know. 564 00:20:36,580 --> 00:20:39,380 Just be another voice saying, I see you in danger. 565 00:20:39,460 --> 00:20:41,760 There are limits to what we can legally do, 566 00:20:41,840 --> 00:20:43,720 but I can try to talk to her. 567 00:20:43,800 --> 00:20:46,010 Thank you. 568 00:20:46,090 --> 00:20:48,180 Hi. It's Dr. McKay again. 569 00:20:48,260 --> 00:20:49,350 Can I come in? 570 00:20:51,810 --> 00:20:54,480 Sorry. 571 00:20:54,560 --> 00:20:56,770 Yeah. 572 00:20:56,850 --> 00:21:00,070 Well, it was a long shot anyway. 573 00:21:00,150 --> 00:21:01,530 Hey. 574 00:21:01,610 --> 00:21:03,780 I think Piper took a pen. 575 00:21:03,860 --> 00:21:05,070 Yeah. 576 00:21:11,540 --> 00:21:12,910 Temp is 103.2. 577 00:21:13,000 --> 00:21:15,790 Nice. Almost there. 578 00:21:15,870 --> 00:21:17,710 My God, there are literally hundreds 579 00:21:17,790 --> 00:21:19,880 of different MDMA pills. 580 00:21:19,960 --> 00:21:22,550 And the milligram dosage range is all over the place. 581 00:21:22,630 --> 00:21:26,630 These names--BMW5, Jurassic Park, Red Superman. 582 00:21:27,890 --> 00:21:29,260 Whoa. Why is she seizing? 583 00:21:29,350 --> 00:21:30,430 Febrile seizure? 584 00:21:30,510 --> 00:21:31,680 No, her temp is down. 585 00:21:31,760 --> 00:21:32,680 Maybe she needs more Ativan. 586 00:21:32,770 --> 00:21:33,770 No, she's had 20 already. 587 00:21:33,850 --> 00:21:34,770 And her vitals are stabilizing. 588 00:21:34,850 --> 00:21:35,890 Another four of Ativan. 589 00:21:35,980 --> 00:21:37,270 And prep a gram of Keppra. 590 00:21:37,350 --> 00:21:40,150 I don't think this is a CNS problem. 591 00:21:40,230 --> 00:21:42,110 She needs saline. 592 00:21:42,190 --> 00:21:43,570 We don't have her labs back yet. 593 00:21:43,650 --> 00:21:45,150 At festivals, you dance for hours. 594 00:21:45,240 --> 00:21:47,360 You sweat, you drink gallons of water, 595 00:21:47,450 --> 00:21:49,200 but nobody thinks to replenish their salts. 596 00:21:49,280 --> 00:21:50,950 It's low sodium. Hyponatremia. 597 00:21:51,030 --> 00:21:52,660 She needs 100 cc's of hot saline. 598 00:21:52,740 --> 00:21:54,500 We don't know her sodium levels. 599 00:21:54,580 --> 00:21:56,710 Drop 100 cc's of 3% and have it ready. 600 00:21:56,790 --> 00:21:58,000 OK? 601 00:21:58,080 --> 00:22:00,340 Do it. And prep a gram of Keppra now. 602 00:22:14,140 --> 00:22:15,480 Start the Keppra, please. 603 00:22:15,560 --> 00:22:16,980 It's not gonna help. 604 00:22:17,060 --> 00:22:18,190 Trauma One. 605 00:22:18,270 --> 00:22:20,560 What are you doing? 606 00:22:20,650 --> 00:22:22,020 Got it. Thanks. 607 00:22:22,110 --> 00:22:23,190 It's hyponatremia. 608 00:22:23,270 --> 00:22:24,320 Serum sodium is critical. 609 00:22:24,400 --> 00:22:25,320 Only 112. 610 00:22:25,400 --> 00:22:26,610 Knew it. 611 00:22:26,690 --> 00:22:28,740 OK, I'll push the other 50 cc's. 612 00:22:28,820 --> 00:22:30,820 - What the hell? - She's seizing. 613 00:22:30,910 --> 00:22:32,160 You think? How long? 614 00:22:32,240 --> 00:22:33,490 About three minutes. 615 00:22:33,580 --> 00:22:34,830 Why did you not come get me? 616 00:22:34,910 --> 00:22:36,750 Hello? I was--I was across the hall. 617 00:22:36,830 --> 00:22:38,540 I was 30 feet away. What has she had already? 618 00:22:40,380 --> 00:22:41,830 It's hyponatremia. 619 00:22:41,920 --> 00:22:43,540 We pushed 100 cc's of 3% saline. 620 00:22:43,630 --> 00:22:44,880 That did the trick. 621 00:22:44,960 --> 00:22:47,670 Again, why did you not come get me? 622 00:22:47,760 --> 00:22:49,630 It was my fault. Yeah, I want-- 623 00:22:49,720 --> 00:22:52,140 I wanted to keep going with Ativan and Keppra, 624 00:22:52,220 --> 00:22:54,350 but Dr. Mohan had an excellent idea 625 00:22:54,430 --> 00:22:58,350 to treat for hyponatremia even before her labs came back. 626 00:22:58,430 --> 00:23:00,850 Temp's down to 102.4. 627 00:23:00,940 --> 00:23:02,270 Good call, Dr. Mohan. 628 00:23:02,360 --> 00:23:04,150 Another minute, and we'll de-ice her. 629 00:23:04,230 --> 00:23:08,440 I am going to take that minute to try to instill in Dr. Santos 630 00:23:08,530 --> 00:23:11,530 a very clear understanding of what her role is here 631 00:23:11,610 --> 00:23:13,320 and how she is expected to function. 632 00:23:13,410 --> 00:23:15,990 - Dr. Langdon-- - Dr. Santos-- 633 00:23:16,080 --> 00:23:18,330 and I say doctor in such a fashion 634 00:23:18,410 --> 00:23:21,040 to draw attention to the ridiculous fact 635 00:23:21,120 --> 00:23:24,500 that you have enjoyed that title for, what, 90 days? 636 00:23:24,590 --> 00:23:26,460 So yeah, I'm confused. 637 00:23:26,550 --> 00:23:28,970 Is it--is it hubris or ignorance 638 00:23:29,050 --> 00:23:31,760 that makes you think that you know more than other residents 639 00:23:31,840 --> 00:23:34,010 that have two to three years more experience 640 00:23:34,100 --> 00:23:36,140 and have helped thousands more patients 641 00:23:36,220 --> 00:23:37,770 in the emergency department than you have? 642 00:23:37,850 --> 00:23:40,770 Not to mention the over 500 hours 643 00:23:40,850 --> 00:23:42,100 of advanced training 644 00:23:42,190 --> 00:23:44,270 with lectures and simulation labs 645 00:23:44,360 --> 00:23:45,690 with senior faculty instruction. 646 00:23:45,770 --> 00:23:47,360 It doesn't matter! 647 00:23:47,440 --> 00:23:49,490 Stupid or arrogant, you need to realize 648 00:23:49,570 --> 00:23:52,070 that you are a beginner, which means your job 649 00:23:52,160 --> 00:23:53,700 is to shut up, listen, and learn 650 00:23:53,780 --> 00:23:55,320 because so far today, the only thing you have been 651 00:23:55,410 --> 00:23:57,410 successful at is proving repeatedly 652 00:23:57,490 --> 00:23:58,580 that you know nothing. 653 00:23:58,660 --> 00:23:59,700 Dr. Langdon. 654 00:24:01,710 --> 00:24:04,500 Is the patient stable? 655 00:24:04,580 --> 00:24:05,880 Temp's 102. 656 00:24:05,960 --> 00:24:07,250 Just about to take her out of the ice. 657 00:24:07,340 --> 00:24:09,840 Proceed. Dr. Langdon, a word, please. 658 00:24:16,640 --> 00:24:18,100 Look, I know that sounded rough, 659 00:24:18,180 --> 00:24:19,430 - but you only caught the tail. - Stop talking. 660 00:24:19,520 --> 00:24:21,020 I can give you a list a mile-- 661 00:24:21,100 --> 00:24:22,600 - Stop talking. - She was giving unsupervised-- 662 00:24:22,690 --> 00:24:24,020 Knock it off. Shut the fuck up! 663 00:24:25,690 --> 00:24:28,440 Where does it say that shaming, belittling, and insulting 664 00:24:28,520 --> 00:24:29,650 are effective teaching tools? 665 00:24:29,730 --> 00:24:31,240 Let me just tell you, 666 00:24:31,320 --> 00:24:32,950 harassment has zero educational value. 667 00:24:33,030 --> 00:24:35,280 You're feeling upset? She's getting under your skin? 668 00:24:35,360 --> 00:24:36,780 Check yourself. Take a break. 669 00:24:36,870 --> 00:24:38,410 I've been watching you ride her. 670 00:24:38,490 --> 00:24:41,160 This kind of behavior will not be tolerated. 671 00:24:41,250 --> 00:24:43,080 I don't want to see it. 672 00:24:43,160 --> 00:24:45,000 I'm sorry. It won't happen again. 673 00:24:45,080 --> 00:24:47,210 Where's your other one? Where's Mel? 674 00:24:47,290 --> 00:24:48,590 - She's taking a breather. - Yeah. 675 00:24:48,670 --> 00:24:50,300 Well, maybe go find her, and see if you can 676 00:24:50,380 --> 00:24:53,930 get her back in the game. You are senior leadership here. 677 00:24:54,010 --> 00:24:55,970 Step up and act like it. 678 00:25:07,020 --> 00:25:09,440 Wow. You came prepared. 679 00:25:09,520 --> 00:25:12,570 Better safe than sorry. 680 00:25:12,650 --> 00:25:14,150 Sorry I took off like that. 681 00:25:14,240 --> 00:25:15,530 I have a thing about rats. 682 00:25:15,610 --> 00:25:17,820 And cows totally freak me out. 683 00:25:17,910 --> 00:25:19,450 Really? 684 00:25:19,530 --> 00:25:21,830 Oh, there's plenty of both where I come from. 685 00:25:21,910 --> 00:25:24,040 They're--you know, they're pretty harmless. 686 00:25:24,120 --> 00:25:25,920 Let's hope Mr. Krakozhia is now too. 687 00:25:26,000 --> 00:25:27,920 Yeah, no kidding. 688 00:25:28,000 --> 00:25:29,460 OK. 689 00:25:37,430 --> 00:25:38,550 Is this the guy? 690 00:25:38,640 --> 00:25:40,470 Yes. 691 00:25:40,560 --> 00:25:41,600 Hey, man. 692 00:25:41,680 --> 00:25:43,180 It's Dennis Whitaker. 693 00:25:43,270 --> 00:25:45,810 I just wanted to say sorry for earlier. 694 00:25:45,890 --> 00:25:48,440 Heard I got you pretty good. 695 00:25:48,520 --> 00:25:50,150 Yeah. 696 00:25:50,230 --> 00:25:53,440 I kind of go out of my head when I'm off my meds. 697 00:25:53,530 --> 00:25:56,200 Then I guess I piss on people. 698 00:25:56,280 --> 00:25:58,820 I'm pretty sure the meth doesn't help. 699 00:25:58,910 --> 00:26:01,030 I'm not using anymore. 700 00:26:01,120 --> 00:26:03,410 I take antipsychotics for the schizophrenia 701 00:26:03,490 --> 00:26:05,290 I got from doing meth. 702 00:26:05,370 --> 00:26:08,500 But I've been clean a year. 703 00:26:09,830 --> 00:26:11,500 Why aren't you taking your meds? 704 00:26:11,590 --> 00:26:13,130 Why don't I take my meds? 705 00:26:13,210 --> 00:26:15,760 Well, Doc, I'm kind of in between houses right now 706 00:26:15,840 --> 00:26:19,300 living in an encampment on Liberty Avenue. 707 00:26:19,390 --> 00:26:20,470 Meds cost money. 708 00:26:20,550 --> 00:26:22,850 I don't have insurance. 709 00:26:22,930 --> 00:26:24,350 - Should I go on? - No. No. 710 00:26:24,430 --> 00:26:26,640 That's fine. 711 00:26:26,730 --> 00:26:27,980 I'm sorry. 712 00:26:31,900 --> 00:26:34,940 Life isn't always easy. 713 00:26:37,240 --> 00:26:39,030 Have you talked to a social worker yet? 714 00:26:39,110 --> 00:26:40,570 - No. - OK. 715 00:26:40,660 --> 00:26:42,530 Do you think you could go grab-- 716 00:26:42,620 --> 00:26:43,830 - Kiara? - Kiara in here? 717 00:26:43,910 --> 00:26:45,120 Yeah. 718 00:26:47,620 --> 00:26:49,170 I really am sorry. 719 00:26:49,250 --> 00:26:50,750 It's OK, honestly. 720 00:26:50,830 --> 00:26:53,500 Really, it's OK. 721 00:26:53,590 --> 00:26:55,670 I appreciate the apology. 722 00:27:02,760 --> 00:27:04,390 This must be Crosby. 723 00:27:05,890 --> 00:27:08,730 I've heard a lot about you, buddy. 724 00:27:08,810 --> 00:27:10,980 How's my least problematic trainee? 725 00:27:11,060 --> 00:27:13,690 Well, technically, you're all pretty green, 726 00:27:13,770 --> 00:27:15,230 but you're growing on me. 727 00:27:15,320 --> 00:27:16,980 Thank you. 728 00:27:17,070 --> 00:27:19,150 So how you doing? 729 00:27:20,490 --> 00:27:22,490 Um, good. 730 00:27:22,570 --> 00:27:23,820 Better. 731 00:27:23,910 --> 00:27:25,580 Yeah? 732 00:27:25,660 --> 00:27:28,500 It's--I mean, it's just-- 733 00:27:28,580 --> 00:27:32,380 it's the--the little girl and the sister's 734 00:27:32,460 --> 00:27:33,920 too close to home. 735 00:27:34,000 --> 00:27:36,210 The things we do are hard. 736 00:27:36,300 --> 00:27:37,920 Yeah. 737 00:27:38,010 --> 00:27:43,680 You're sitting here feeling like-- 738 00:27:43,760 --> 00:27:46,470 like maybe you're not up to it? 739 00:27:46,560 --> 00:27:48,560 Yeah. 740 00:27:48,640 --> 00:27:50,520 Been there. 741 00:27:50,600 --> 00:27:53,400 We all been there. 742 00:27:53,480 --> 00:27:57,070 Mel, you're a sensitive person. 743 00:27:57,150 --> 00:28:02,530 This--this is a tough place for sensitive people. 744 00:28:02,610 --> 00:28:05,370 But we need them badly. 745 00:28:07,830 --> 00:28:12,830 Now, if you're ready, I need you. 746 00:28:12,920 --> 00:28:14,250 It's a perfect job. 747 00:28:14,330 --> 00:28:16,290 It's practically a zen exercise. 748 00:28:16,380 --> 00:28:19,420 I've got 1,000 pieces of gravel 749 00:28:19,510 --> 00:28:23,180 that need to be plucked out of a 2-foot-long road rash. 750 00:28:23,260 --> 00:28:25,340 - 1,000? - Yeah. 751 00:28:25,430 --> 00:28:27,680 Give or take 100. 752 00:28:27,760 --> 00:28:29,350 South 20. 753 00:28:29,430 --> 00:28:31,850 Make sure you close the door behind you. 754 00:28:31,930 --> 00:28:34,020 - Don't want Crosby getting out. - Yeah. 755 00:28:34,100 --> 00:28:37,480 Thank you. No problem. I'll be right there. 756 00:28:38,860 --> 00:28:40,860 That's a lot of gravel. 757 00:28:40,940 --> 00:28:42,820 It looks clean to me. You feel that, Earl? 758 00:28:42,900 --> 00:28:43,900 Feel what? 759 00:28:43,990 --> 00:28:45,360 That's a no. 760 00:28:45,450 --> 00:28:46,910 All right. Now just apply the Dermabond. 761 00:28:46,990 --> 00:28:49,870 Cool. 762 00:28:49,950 --> 00:28:52,160 Can I ask you something? 763 00:28:52,250 --> 00:28:53,830 That's why I'm here. 764 00:28:53,910 --> 00:28:55,210 Yeah, I was just wondering 765 00:28:55,290 --> 00:28:58,130 what the nurses do after their shifts. 766 00:28:58,210 --> 00:29:00,000 In terms of what? 767 00:29:00,090 --> 00:29:02,420 You know, do they ever, like, go out together, 768 00:29:02,510 --> 00:29:05,590 like, hang out to decompress after a shift or anything? 769 00:29:05,680 --> 00:29:07,140 Yeah, sometimes. 770 00:29:07,220 --> 00:29:08,300 I mean, most of us are just happy 771 00:29:08,390 --> 00:29:09,810 to get the hell out of here. 772 00:29:09,890 --> 00:29:14,890 Personally, I'm all about a long, long, hot shower, 773 00:29:14,980 --> 00:29:16,560 comfy sweats, 774 00:29:16,650 --> 00:29:18,270 eating some takeout in front of the TV, 775 00:29:18,360 --> 00:29:21,940 ideally watching something that makes me laugh, so... 776 00:29:22,030 --> 00:29:23,990 Yeah, I can see that. 777 00:29:24,070 --> 00:29:25,570 I'm not imagining it in my mind, of course. 778 00:29:25,650 --> 00:29:29,330 I just mean that I can-- I can see the appeal. 779 00:29:29,410 --> 00:29:31,040 I was just asking because-- 780 00:29:31,120 --> 00:29:32,620 you know, since we work together, 781 00:29:32,700 --> 00:29:36,750 maybe we could grab a coffee together sometime. 782 00:29:36,830 --> 00:29:39,710 And you could, like, help me get the lay of the land, 783 00:29:39,790 --> 00:29:41,550 so to speak? 784 00:29:41,630 --> 00:29:43,630 You asking him out? 785 00:29:43,710 --> 00:29:45,380 No. What? No. No. 786 00:29:45,470 --> 00:29:48,140 It's just--I'm--I'm new here, so I just thought-- 787 00:29:48,220 --> 00:29:50,640 I--I don't date people in the workplace. 788 00:29:50,720 --> 00:29:54,640 It's nothing personal. Just it's never a good idea. 789 00:29:54,730 --> 00:29:56,810 No. No, of course not. No. No. 790 00:29:56,890 --> 00:29:59,190 I just--no, it's not a good--no, of course. 791 00:29:59,270 --> 00:30:00,980 I just thought that since you know 792 00:30:01,070 --> 00:30:02,780 how everything operates here and you, like, have everything 793 00:30:02,860 --> 00:30:04,610 so dialed in, that you would be, like, a valuable resource. 794 00:30:04,690 --> 00:30:06,900 But no. No. 795 00:30:06,990 --> 00:30:09,950 I should probably just figure it out on my own. 796 00:30:10,030 --> 00:30:11,830 Mm-hmm. 797 00:30:11,910 --> 00:30:14,750 No shortcuts here. 798 00:30:14,830 --> 00:30:16,790 How are they treating you, Earl? 799 00:30:16,870 --> 00:30:18,250 Huh? 800 00:30:18,330 --> 00:30:19,920 I see you wrangled yourself another sandwich. 801 00:30:20,000 --> 00:30:22,000 I feel like I'm watching a rom-com. 802 00:30:23,670 --> 00:30:24,920 Just came by to see if I could take Dr. Javadi 803 00:30:25,010 --> 00:30:26,220 on a reconnaissance through chairs. 804 00:30:26,300 --> 00:30:27,550 Yes. 805 00:30:27,630 --> 00:30:28,840 I mean, sorry, if you think that's-- 806 00:30:28,930 --> 00:30:30,340 Of course. Of course. 807 00:30:30,430 --> 00:30:31,970 I can finish up my man here. 808 00:30:32,050 --> 00:30:33,100 Great. 809 00:30:40,730 --> 00:30:41,980 Are you OK? 810 00:30:42,060 --> 00:30:44,150 I feel ridiculous. 811 00:30:44,230 --> 00:30:47,780 I've spoken, like, two complete sentences 812 00:30:47,860 --> 00:30:49,070 in the last half hour. 813 00:30:49,150 --> 00:30:50,530 And both of them have made me sound 814 00:30:50,610 --> 00:30:53,700 even more imbecilic than the incomplete ones. 815 00:30:53,780 --> 00:30:56,250 And you attribute that to... 816 00:30:56,330 --> 00:30:58,370 It's like, my parents once took me skiing 817 00:30:58,460 --> 00:31:00,170 for Christmas in Utah, and from the moment 818 00:31:00,250 --> 00:31:03,130 I got off the plane, I could not catch my breath. 819 00:31:03,210 --> 00:31:05,630 No matter how hard I tried, the altitude made me feel, 820 00:31:05,710 --> 00:31:08,050 like, awkward and uncoordinated. 821 00:31:08,130 --> 00:31:09,800 I couldn't concentrate. I couldn't get my bearings. 822 00:31:09,880 --> 00:31:12,090 - Mm-hmm. - And I'm a very good skier, 823 00:31:12,180 --> 00:31:13,350 but I spent the whole vacation just, like, 824 00:31:13,430 --> 00:31:18,060 on my butt, dizzy and panting. 825 00:31:18,140 --> 00:31:20,230 Mateo is like a human Utah. 826 00:31:21,810 --> 00:31:23,520 Oh, honey. 827 00:31:23,610 --> 00:31:25,400 I've worked with a few Utahs. 828 00:31:25,480 --> 00:31:28,320 I wish you many, many Utahs in your life. 829 00:31:30,320 --> 00:31:31,700 Jesse, where are you going? 830 00:31:31,780 --> 00:31:33,200 - Trauma Two. - Stop. Stop. Stop. 831 00:31:33,280 --> 00:31:35,080 Stop. Not back in there. 832 00:31:35,160 --> 00:31:37,240 I'm not even gonna tell you why. 833 00:31:37,330 --> 00:31:38,450 How's she doing? 834 00:31:38,540 --> 00:31:39,710 Still with some pleuritic pain. 835 00:31:39,790 --> 00:31:42,040 Oh. Hey, Paula. I'm Dr. Collins. 836 00:31:42,120 --> 00:31:44,500 Your CT shows that you have a broken sternum. 837 00:31:44,590 --> 00:31:46,420 That's your breastbone right here. 838 00:31:46,500 --> 00:31:48,710 Probably from the shoulder belt when you crashed your car. 839 00:31:48,800 --> 00:31:49,970 I crashed my car? 840 00:31:50,050 --> 00:31:51,550 Mm-hmm, and hit your head. 841 00:31:51,630 --> 00:31:53,680 With a concussion, sometimes you don't remember. 842 00:31:53,760 --> 00:31:56,930 But your head CT doesn't show anything serious. 843 00:31:57,010 --> 00:32:00,560 So I saw in your chart you're a new mom. 844 00:32:00,640 --> 00:32:02,520 How's your baby doing? 845 00:32:02,600 --> 00:32:05,270 He's good. He's with my mom. 846 00:32:05,360 --> 00:32:07,690 South 15's open. Oh. Hey, Dr. McKay? 847 00:32:07,780 --> 00:32:08,940 Just get the bed out of 15. 848 00:32:09,030 --> 00:32:10,280 A patient you saw this morning 849 00:32:10,360 --> 00:32:11,950 came back as an MVC. 850 00:32:12,030 --> 00:32:13,910 Sternal fracture. Slightly concussed. 851 00:32:13,990 --> 00:32:15,570 Oh, no. Paula, do you remember me? 852 00:32:15,660 --> 00:32:16,830 You look familiar. 853 00:32:16,910 --> 00:32:18,240 I was your doctor this morning 854 00:32:18,330 --> 00:32:19,660 - for your bladder infection. - Oh, yeah. 855 00:32:19,750 --> 00:32:21,710 Sorry. I'm a little out of it. 856 00:32:21,790 --> 00:32:23,250 Still tachycardic, 115. 857 00:32:23,330 --> 00:32:25,500 BP's 124 over 78. 858 00:32:25,580 --> 00:32:27,290 There's no bleeding anywhere on the CT. 859 00:32:27,380 --> 00:32:29,920 Chest and abdomen clear apart from the sternal fracture. 860 00:32:30,010 --> 00:32:32,130 Well, probably still tachy from the fracture pain. 861 00:32:32,220 --> 00:32:33,550 It hurts when I breathe. 862 00:32:33,630 --> 00:32:35,140 Let's try four of morphine. 863 00:32:35,220 --> 00:32:37,300 Paula, we're gonna give you some pain meds. 864 00:32:37,390 --> 00:32:39,850 Let me know if it helps, OK? 865 00:32:39,930 --> 00:32:41,770 Mr. Pernell, you are in luck. 866 00:32:41,850 --> 00:32:44,140 If I had to have gravel meticulously picked out 867 00:32:44,230 --> 00:32:46,560 of my leg, this is the person I'd call, 868 00:32:46,650 --> 00:32:48,360 Dr. Mel King, detail specialist. 869 00:32:48,440 --> 00:32:49,400 - Hello. - Hi. 870 00:32:49,480 --> 00:32:50,820 - I love your dog. - Crosby? 871 00:32:50,900 --> 00:32:52,530 - How is he? - Oh, he's great. 872 00:32:52,610 --> 00:32:54,360 Here. Something to help see up close. 873 00:32:54,450 --> 00:32:56,780 Hey, I don't want to be one of those people 874 00:32:56,870 --> 00:32:59,370 who say they need an emotional support animal, 875 00:32:59,450 --> 00:33:01,450 but is it possible he could be with me? 876 00:33:01,540 --> 00:33:03,160 We could tie his leash to the bed. 877 00:33:03,250 --> 00:33:04,750 He wouldn't be in any trouble. I swear. 878 00:33:04,830 --> 00:33:06,920 - What do you think? - I'm happy to go get him. 879 00:33:07,000 --> 00:33:08,590 - Any pain here? - No. 880 00:33:08,670 --> 00:33:09,840 OK. 881 00:33:09,920 --> 00:33:12,010 You go get the dog. You get to work. 882 00:33:12,090 --> 00:33:14,130 I'm gonna get some more gauze from triage. 883 00:33:14,220 --> 00:33:15,970 And just in case, if anybody asks, 884 00:33:16,050 --> 00:33:18,260 just say you need him for anxiety. 885 00:33:18,350 --> 00:33:19,430 OK. 886 00:33:19,510 --> 00:33:21,020 Thanks. 887 00:33:21,100 --> 00:33:23,310 I know you hear me. 888 00:33:23,390 --> 00:33:27,150 You can pretend you don't, but I know you do. 889 00:33:27,230 --> 00:33:28,650 This glass might be bulletproof, 890 00:33:28,730 --> 00:33:29,900 but it ain't soundproof. 891 00:33:29,980 --> 00:33:31,070 Huh? 892 00:33:31,150 --> 00:33:32,230 Hello? 893 00:33:32,320 --> 00:33:33,820 Can you hear me now? Huh? 894 00:33:33,900 --> 00:33:35,900 - Hello! - Whoa. Whoa. Whoa, sir. 895 00:33:35,990 --> 00:33:37,360 Sir, what is the issue? 896 00:33:37,450 --> 00:33:38,410 Oh, same issue. 897 00:33:38,490 --> 00:33:40,030 I've been here all day, 898 00:33:40,120 --> 00:33:41,950 and you people have done nothing to fucking help me. 899 00:33:42,040 --> 00:33:43,620 We're still waiting on your second troponin. 900 00:33:43,700 --> 00:33:45,790 We can't clear you medically until it comes back. 901 00:33:45,870 --> 00:33:47,580 For instance, if it comes back elevated, 902 00:33:47,670 --> 00:33:49,630 that could indicate a silent heart attack. 903 00:33:49,710 --> 00:33:51,050 And you'd need to be admitted for monitoring 904 00:33:51,130 --> 00:33:52,420 in a cardiology consult. 905 00:33:52,500 --> 00:33:54,130 That's all I'm asking for. 906 00:33:54,210 --> 00:33:56,840 I'm afraid I've had a silent heart attack. 907 00:33:56,930 --> 00:33:59,140 I just want someone who knows something about hearts 908 00:33:59,220 --> 00:34:00,470 to tell me what's happening to me. 909 00:34:00,550 --> 00:34:02,470 You know, unlike most of these losers, 910 00:34:02,560 --> 00:34:04,640 I have insurance, good insurance. 911 00:34:04,730 --> 00:34:06,690 And I pay my taxes, which pays for them 912 00:34:06,770 --> 00:34:08,020 to not have any insurance. 913 00:34:08,100 --> 00:34:09,560 Sir, you've got about five seconds 914 00:34:09,650 --> 00:34:11,320 to change your whole attitude before security 915 00:34:11,400 --> 00:34:12,900 and the police get involved. 916 00:34:12,980 --> 00:34:14,570 Fuck it. 917 00:34:14,650 --> 00:34:17,030 I'm leaving. 918 00:34:17,110 --> 00:34:18,110 Hey. 919 00:34:18,200 --> 00:34:19,450 Hey! 920 00:34:19,530 --> 00:34:20,990 You are absolutely free to go. 921 00:34:21,080 --> 00:34:23,490 But if you do, you will be leaving AMA, 922 00:34:23,580 --> 00:34:25,080 against medical advice. 923 00:34:25,160 --> 00:34:27,710 This form states that I have advised you to stay 924 00:34:27,790 --> 00:34:30,790 and complete your evaluation, but you are choosing to leave, 925 00:34:30,880 --> 00:34:33,500 understanding and accepting all risks of heart attack, 926 00:34:33,590 --> 00:34:35,260 stroke, disability, and death. 927 00:34:40,640 --> 00:34:41,800 Sounds like a CYA form 928 00:34:41,890 --> 00:34:43,390 in case I drop dead on the curb. 929 00:34:43,470 --> 00:34:46,390 That's exactly what it is. 930 00:34:46,480 --> 00:34:49,440 I just want to be treated fairly. 931 00:34:49,520 --> 00:34:51,940 I assure you that is our intention. 932 00:34:52,020 --> 00:34:53,770 We are not back here playing Go Fish. 933 00:34:53,860 --> 00:34:56,150 We're doing our best to help some very sick people. 934 00:34:56,240 --> 00:34:57,860 You will be seen, OK? 935 00:35:03,870 --> 00:35:06,660 Robby's gonna love that patient satisfaction score. 936 00:35:06,750 --> 00:35:08,500 Crazy people. 937 00:35:12,920 --> 00:35:14,340 What's going on? 938 00:35:14,420 --> 00:35:15,880 Car crash victim Paula just went south. 939 00:35:15,960 --> 00:35:18,130 BP's crashing. 84 over 62. 940 00:35:18,220 --> 00:35:19,130 Much less responsive. 941 00:35:19,220 --> 00:35:20,470 Liter of LR wide open. 942 00:35:20,550 --> 00:35:21,800 Putting her in a 100% non-rebreather. 943 00:35:21,890 --> 00:35:23,180 Paula, open your eyes. 944 00:35:23,260 --> 00:35:24,510 Paula. 945 00:35:24,600 --> 00:35:25,810 Was it the morphine? 946 00:35:25,890 --> 00:35:26,850 She only got a small dose. 947 00:35:26,930 --> 00:35:28,770 Pulse ox is down to 89. 948 00:35:28,850 --> 00:35:29,940 Set up for intubation. 949 00:35:30,020 --> 00:35:33,360 And, McKay, get Robby in here. 950 00:35:33,440 --> 00:35:34,650 I'll call ICU and get her bumped 951 00:35:34,730 --> 00:35:36,610 ahead of Joyce, our sickler. 952 00:35:36,690 --> 00:35:38,150 She should get the next bed. 953 00:35:38,240 --> 00:35:39,860 Between the hyperthermia and the seizure, 954 00:35:39,950 --> 00:35:41,450 she's gonna be out of it for a while. 955 00:35:41,530 --> 00:35:43,620 A similar thing happened to a friend of mine. 956 00:35:43,700 --> 00:35:45,740 Is that what made you think of hyponatremia? 957 00:35:45,830 --> 00:35:47,790 Look, I know you value evidence-based medicine. 958 00:35:47,870 --> 00:35:51,120 But sometimes experience counts for something. 959 00:35:54,420 --> 00:35:57,670 - May I ask why you did that? - What? 960 00:35:57,750 --> 00:35:59,840 Took the blame for a delay in care 961 00:35:59,920 --> 00:36:02,010 which didn't belong to you 962 00:36:02,090 --> 00:36:04,800 and gave me credit for a save that did belong to you? 963 00:36:04,890 --> 00:36:08,270 You know, I've been on Langdon's shit list all day. 964 00:36:08,350 --> 00:36:10,100 It seemed like he was gonna be more upset about us 965 00:36:10,180 --> 00:36:12,730 not calling him in than glad that we stopped the seizure, 966 00:36:12,810 --> 00:36:16,230 so no reason for him to be pissed at both of us. 967 00:36:16,320 --> 00:36:18,610 Why have you been on his shit list? 968 00:36:18,690 --> 00:36:20,860 Well, I think he made it very clear 969 00:36:20,940 --> 00:36:23,910 that he thinks I don't have what it takes to make it here. 970 00:36:23,990 --> 00:36:26,410 Whether you do or do not, it was completely inappropriate 971 00:36:26,490 --> 00:36:28,160 for him to speak to you that way. 972 00:36:28,240 --> 00:36:29,950 Eh, I've heard worse. 973 00:36:30,040 --> 00:36:32,210 Well, for what it's worth, he's wrong. 974 00:36:33,540 --> 00:36:35,210 You're very good at this. 975 00:36:36,670 --> 00:36:38,630 Thank you. 976 00:36:38,710 --> 00:36:41,550 That's actually worth a lot. 977 00:36:41,630 --> 00:36:43,300 I thought the CTs were normal. 978 00:36:43,380 --> 00:36:44,680 They were. Systolic's down to 70. 979 00:36:44,760 --> 00:36:45,930 Heart rate's up to 130. 980 00:36:46,010 --> 00:36:47,140 100 of ketamine, 100 of rock. 981 00:36:47,220 --> 00:36:48,180 Could she have delayed bleeding? 982 00:36:48,260 --> 00:36:49,180 It's not the chest. 983 00:36:49,260 --> 00:36:50,310 Pericardium's still clear. 984 00:36:50,390 --> 00:36:51,520 No tamponade, good EF. 985 00:36:51,600 --> 00:36:52,560 Lungs are up. 986 00:36:52,640 --> 00:36:53,640 She feels warm. 987 00:36:53,730 --> 00:36:54,770 We'll check a temp. 988 00:36:54,850 --> 00:36:56,190 Meds are on board. 989 00:36:56,270 --> 00:36:57,810 Belly's clear. No bleeding here. 990 00:36:57,900 --> 00:36:59,900 - She's loose. - OK. Go for it. 991 00:37:03,280 --> 00:37:04,660 I see cords. 992 00:37:04,740 --> 00:37:05,860 Looks good. 993 00:37:05,950 --> 00:37:06,990 I'm in. 994 00:37:07,070 --> 00:37:10,040 - Connect the bag. - Nice. 995 00:37:10,120 --> 00:37:11,750 Good breath sounds bilaterally. 996 00:37:11,830 --> 00:37:13,120 Temp is 102.4. 997 00:37:13,210 --> 00:37:14,670 What? Is this septic shock? 998 00:37:14,750 --> 00:37:16,120 OK, we need to assume the worst here. 999 00:37:16,210 --> 00:37:17,880 Code sepsis. Two sets of blood cultures, 1000 00:37:17,960 --> 00:37:19,710 lactate, 30 per kilo of LR 1001 00:37:19,800 --> 00:37:21,510 and for antibiotics, ceftriaxone? 1002 00:37:21,590 --> 00:37:23,010 No, no, she was just in the hospital. 1003 00:37:23,090 --> 00:37:24,470 - Pip-tazo and vanco. - Got it. 1004 00:37:24,550 --> 00:37:26,840 If this is sepsis, where is it coming from? 1005 00:37:26,930 --> 00:37:28,430 - What's the source? - Her urinary tract infection. 1006 00:37:28,510 --> 00:37:30,010 - She doesn't have one. - She did when I saw her. 1007 00:37:30,100 --> 00:37:31,470 It's not a UTI. 1008 00:37:31,560 --> 00:37:32,720 We catheterized urine a half an hour ago. 1009 00:37:32,810 --> 00:37:35,390 There's no nitrates, zero WBCs. 1010 00:37:35,480 --> 00:37:37,560 Your specimen could have been contaminated this morning. 1011 00:37:37,650 --> 00:37:39,900 - Is it pneumonia? - Chest CT negative. 1012 00:37:39,980 --> 00:37:42,940 Abdominal CT negative for an infectious source. 1013 00:37:43,030 --> 00:37:44,490 She was altered. Meningitis? 1014 00:37:44,570 --> 00:37:45,530 She's postpartum. 1015 00:37:45,610 --> 00:37:47,740 Endometritis. 1016 00:37:47,820 --> 00:37:50,660 The CT of the uterus shows a thickened endometrium, 1017 00:37:50,740 --> 00:37:52,200 but that's normal postpartum. 1018 00:37:52,290 --> 00:37:53,290 No retained POCs. 1019 00:37:53,370 --> 00:37:54,580 It still could be the source. 1020 00:37:54,660 --> 00:37:57,580 We'll do a pelvic after she's stable. 1021 00:37:57,670 --> 00:38:00,210 Mr. Krakozhia, here's my obvious concern. 1022 00:38:00,290 --> 00:38:04,800 I write you a script for 30 days' worth of pills. 1023 00:38:04,880 --> 00:38:06,130 Then what? 1024 00:38:06,220 --> 00:38:07,840 What do you mean? I'll take them. 1025 00:38:07,930 --> 00:38:10,260 Well, you come back for 30 more, right? 1026 00:38:10,350 --> 00:38:11,720 I mean, that's the question. 1027 00:38:11,810 --> 00:38:13,850 Even if I could give you your dose 1028 00:38:13,930 --> 00:38:15,520 in a once-a-month shot, 1029 00:38:15,600 --> 00:38:18,400 you still have to come back when the month is over. 1030 00:38:18,480 --> 00:38:19,810 What if he didn't have to? 1031 00:38:19,900 --> 00:38:21,020 Oh, no. He has to. 1032 00:38:21,110 --> 00:38:22,690 If he doesn't, he-- 1033 00:38:22,770 --> 00:38:24,070 well, he pees. 1034 00:38:24,150 --> 00:38:25,860 We have a street team here. 1035 00:38:25,940 --> 00:38:27,200 Mr. Krakozhia, are you pretty much 1036 00:38:27,280 --> 00:38:28,910 in one spot these days? 1037 00:38:28,990 --> 00:38:31,580 Yeah, I'm over on Liberty near the Benedum. 1038 00:38:31,660 --> 00:38:32,620 The alley? 1039 00:38:32,700 --> 00:38:33,990 I know it well. 1040 00:38:34,080 --> 00:38:35,910 So we could bring the meds to him? 1041 00:38:36,000 --> 00:38:37,040 Absolutely. 1042 00:38:37,120 --> 00:38:38,460 The once-a-month injection 1043 00:38:38,540 --> 00:38:39,830 sounds like the easier option. 1044 00:38:39,920 --> 00:38:42,420 We could just put you on our schedule. 1045 00:38:42,500 --> 00:38:45,380 I'd be interested in joining that. 1046 00:38:45,460 --> 00:38:47,340 Maybe I can bring out the medicine myself. 1047 00:38:47,420 --> 00:38:48,590 That'd be amazing. 1048 00:38:48,680 --> 00:38:50,720 We could use all the help we can get. 1049 00:38:50,800 --> 00:38:52,390 Thanks, Doc. 1050 00:38:54,180 --> 00:38:58,020 Yeah, purulent drainage from the cervix. 1051 00:38:58,100 --> 00:38:59,980 Got the culture. Oof. 1052 00:39:00,060 --> 00:39:01,980 Looks like we have our source. 1053 00:39:02,060 --> 00:39:05,230 The positive urine this morning was contaminated. 1054 00:39:05,320 --> 00:39:06,440 Maybe. 1055 00:39:06,530 --> 00:39:08,530 Definitely. 1056 00:39:08,610 --> 00:39:11,410 Not-so-clean catch specimen. 1057 00:39:11,490 --> 00:39:13,780 This infection's been brewing for a while. 1058 00:39:13,870 --> 00:39:15,540 So the car crash was a coincidence. 1059 00:39:15,620 --> 00:39:17,330 Not necessarily. 1060 00:39:17,410 --> 00:39:19,620 She was probably already septic as the disease progressed, 1061 00:39:19,710 --> 00:39:21,250 dropped her BP, and passed out while driving. 1062 00:39:21,330 --> 00:39:22,790 She wasn't hypotensive when she arrived. 1063 00:39:22,880 --> 00:39:24,210 Adrenaline rush from the car crash 1064 00:39:24,290 --> 00:39:25,750 and the sternal fracture raised her BP 1065 00:39:25,840 --> 00:39:27,090 - but not for long. - Oh. 1066 00:39:27,170 --> 00:39:29,010 No history of fever. 1067 00:39:29,090 --> 00:39:31,180 Bet she was taking Tylenol for the pain. 1068 00:39:31,260 --> 00:39:32,590 Let's call ICU for an admit. 1069 00:39:32,680 --> 00:39:34,140 Also want gyn to see her. 1070 00:39:37,180 --> 00:39:39,850 She had mild lower abdominal pain 1071 00:39:39,940 --> 00:39:41,730 and a positive urine dip. 1072 00:39:41,810 --> 00:39:45,730 No fever, no back pain to indicate pyelonephritis. 1073 00:39:45,820 --> 00:39:47,900 She was alert, walking, talking. 1074 00:39:47,980 --> 00:39:50,110 It just seemed like a simple UTI. 1075 00:39:50,200 --> 00:39:51,950 I saw no reason to have her wait eight hours 1076 00:39:52,030 --> 00:39:54,240 for a bed for a pelvic exam. 1077 00:39:58,700 --> 00:39:59,960 McKay. 1078 00:40:04,000 --> 00:40:06,460 Every postpartum patient needs a pelvic exam 1079 00:40:06,550 --> 00:40:08,800 to rule out endometritis. 1080 00:40:08,880 --> 00:40:11,840 Wait, you're saying that with 20/20 hindsight. 1081 00:40:11,930 --> 00:40:15,350 Did you ask about Tylenol or ibuprofen use? 1082 00:40:15,430 --> 00:40:16,760 Because that can mask a fever. 1083 00:40:16,850 --> 00:40:18,180 There was no fever. 1084 00:40:18,270 --> 00:40:20,310 Did you do a careful abdominal exam? 1085 00:40:20,390 --> 00:40:21,980 It was a quick chair exam, 1086 00:40:22,060 --> 00:40:24,520 and there was only mild tenderness over the bladder. 1087 00:40:24,600 --> 00:40:27,650 Perhaps there was something about the patient 1088 00:40:27,730 --> 00:40:30,280 that made you overlook proper treatment. 1089 00:40:31,820 --> 00:40:34,570 Like what, 1090 00:40:34,660 --> 00:40:36,950 other than the obvious health risk factors? 1091 00:40:37,030 --> 00:40:40,160 Her size doesn't inherently make her unhealthy. 1092 00:40:40,250 --> 00:40:42,410 Are you saying I was biased against the patient 1093 00:40:42,500 --> 00:40:44,080 because of her weight? 1094 00:40:44,170 --> 00:40:47,090 I raise it as a possibility, not as an accusation. 1095 00:40:47,170 --> 00:40:49,090 Wow. 1096 00:40:49,170 --> 00:40:52,170 I mean, I really don't think that's the case here, 1097 00:40:52,260 --> 00:40:55,390 but I will look out for it. 1098 00:40:55,470 --> 00:40:57,390 Yeah. 1099 00:40:57,470 --> 00:40:59,140 You were good with him. 1100 00:40:59,220 --> 00:41:01,060 Do you get a lot of homeless in Pittsburgh? 1101 00:41:01,140 --> 00:41:02,350 We call them unhoused. 1102 00:41:02,430 --> 00:41:03,850 It's not as bad as Philly or D.C., 1103 00:41:03,940 --> 00:41:05,650 - but it's still pretty bad. - Yeah. 1104 00:41:05,730 --> 00:41:07,690 It really is great that you want to help out. 1105 00:41:07,770 --> 00:41:09,570 The street team get cool jackets. 1106 00:41:09,650 --> 00:41:11,570 - Yeah? - Come find me end of shift, 1107 00:41:11,650 --> 00:41:12,990 and I'll give you more information. 1108 00:41:13,070 --> 00:41:15,280 Will do. 1109 00:41:15,360 --> 00:41:17,120 You made it out unscathed this time. 1110 00:41:17,200 --> 00:41:18,240 Yeah. 1111 00:41:18,330 --> 00:41:20,200 I'm joining the street team. 1112 00:41:20,290 --> 00:41:22,450 Even get a jacket, so... 1113 00:41:22,540 --> 00:41:25,540 Cool. 1114 00:41:25,620 --> 00:41:27,540 Yeah. It is cool. 1115 00:41:27,630 --> 00:41:29,210 Very cool. 1116 00:41:33,590 --> 00:41:35,300 - Whose pooch? - South 20's. 1117 00:41:35,380 --> 00:41:36,840 I'm taking him for a visit. 1118 00:41:36,930 --> 00:41:38,300 This is Crosby. 1119 00:41:38,390 --> 00:41:39,680 Hello. 1120 00:41:39,760 --> 00:41:41,010 I'm going for a smoke. 1121 00:41:41,100 --> 00:41:42,180 If anyone asks, he's an emotional-- 1122 00:41:42,270 --> 00:41:44,100 Support animal. I know. 1123 00:41:44,180 --> 00:41:45,600 I got it. 1124 00:41:49,110 --> 00:41:50,480 Whoa! 1125 00:41:50,570 --> 00:41:52,440 Crosby! Hey, hey, heads up. 1126 00:41:52,530 --> 00:41:54,320 Crosby. Ow! 1127 00:41:54,400 --> 00:41:56,070 Drop it. Drop it. 1128 00:41:56,150 --> 00:41:58,280 - Ugh! - Whoa. 1129 00:42:05,710 --> 00:42:08,170 Got you. Come on. 1130 00:42:08,250 --> 00:42:10,290 Crosby. Crosby, come here, buddy. 1131 00:42:10,380 --> 00:42:12,090 Come here. There you go. 1132 00:42:12,170 --> 00:42:13,670 Yeah. 1133 00:42:16,050 --> 00:42:18,470 - Nice job! - Hey. 1134 00:42:18,550 --> 00:42:20,300 - Good work! - There you go. 1135 00:42:28,190 --> 00:42:29,980 You got a rat, didn't you? 1136 00:42:30,060 --> 00:42:31,520 Yeah. 1137 00:42:31,610 --> 00:42:33,980 - He does that. - Yeah. 1138 00:42:34,070 --> 00:42:36,990 - When did those cops get here? - I don't know. 1139 00:42:37,070 --> 00:42:38,610 - Who called them? - I don't know. 1140 00:42:38,700 --> 00:42:40,530 - Where's Dana? - Again, I don't know. 1141 00:42:40,620 --> 00:42:41,780 - Thank you. - Anytime. 1142 00:42:49,870 --> 00:42:51,130 Hard at work? 1143 00:42:54,250 --> 00:42:55,760 I'll take my chances.