1 00:00:00,950 --> 00:00:02,140 Previously on The Resident... 2 00:00:02,145 --> 00:00:03,795 Dr. Bell? Here's the clamp. 3 00:00:03,800 --> 00:00:06,400 Something's wrong with me, and I'm not quite sure what, 4 00:00:06,405 --> 00:00:08,905 - but I think it may be serious. - Want me to examine you? 5 00:00:08,910 --> 00:00:11,210 The results all under the radar. 6 00:00:11,215 --> 00:00:13,446 We're gonna need to set some rules. 7 00:00:13,451 --> 00:00:15,877 No one here needs to know that we're related, 8 00:00:15,882 --> 00:00:17,282 or that you're my biological son. 9 00:00:17,287 --> 00:00:19,119 - Agreed. It's none of their business. - Mm-hmm. 10 00:00:19,123 --> 00:00:20,453 I talked to your boy. 11 00:00:20,458 --> 00:00:22,988 He thinks I recommended him to Chastain. 12 00:00:22,993 --> 00:00:26,192 - I did no such thing. - I did. 13 00:00:26,197 --> 00:00:27,626 You didn't just break protocol. 14 00:00:27,631 --> 00:00:29,261 You broke every rule of medicine. 15 00:00:29,266 --> 00:00:31,864 Are your patients just pawns to prove how smart you are? 16 00:00:31,869 --> 00:00:33,432 Now that you're spending more time 17 00:00:33,437 --> 00:00:36,624 on research and clinical trials, we need a new ER doctor. 18 00:00:36,629 --> 00:00:39,160 All I know is that Nic wouldn't want you to be alone forever. 19 00:00:39,165 --> 00:00:42,263 For your sake and for Gigi's, you deserve to be happy. 20 00:00:42,268 --> 00:00:43,598 Hey, Marion! 21 00:00:43,603 --> 00:00:45,200 We are gonna go get some ice cream 22 00:00:45,205 --> 00:00:47,940 - if you would like to join us. - I would love to. 23 00:00:51,910 --> 00:00:54,175 Marion, I just want to say it again. 24 00:00:54,180 --> 00:00:56,044 I know. 25 00:00:56,049 --> 00:00:57,812 Boundaries clear. 26 00:00:57,817 --> 00:01:00,181 - We both had fun. - Yes, we did. 27 00:01:02,188 --> 00:01:06,554 Conrad, it's okay. Truth? 28 00:01:07,559 --> 00:01:09,624 You're not my type. 29 00:01:09,629 --> 00:01:12,727 Well, okay. 30 00:01:12,732 --> 00:01:17,332 Besides, I've got a mad crush on someone else. 31 00:01:17,337 --> 00:01:21,269 - Someone much younger. - Oh, ouch. 32 00:01:21,274 --> 00:01:23,404 And... 33 00:01:23,409 --> 00:01:25,239 shorter. 34 00:01:25,244 --> 00:01:27,041 Like your daughter. 35 00:01:27,046 --> 00:01:29,243 - Daddy? - And there she is. 36 00:01:29,248 --> 00:01:30,945 She never gets up this early. 37 00:01:30,950 --> 00:01:33,485 I'll be quiet. See you later. 38 00:01:36,723 --> 00:01:39,387 Daddy, you need a shirt. 39 00:01:39,392 --> 00:01:40,922 Yes, I do. 40 00:01:40,927 --> 00:01:42,724 You're up so early. 41 00:01:42,729 --> 00:01:45,293 I wanted to pick out the perfect outfit for my trip 42 00:01:45,298 --> 00:01:47,629 to the aquarium. 43 00:01:47,634 --> 00:01:50,331 Oh, look at that. 44 00:01:50,336 --> 00:01:52,534 - Yeah? - Yeah. Yeah, definitely thumbs up. 45 00:01:52,539 --> 00:01:55,069 Get this sucker on you, okay? 46 00:01:55,074 --> 00:01:57,238 What are you gonna color over here? 47 00:01:57,243 --> 00:01:59,574 - I don't know. - Huh? You don't know? 48 00:01:59,579 --> 00:02:01,309 Hmm. Let me think. 49 00:02:01,314 --> 00:02:03,044 What is that? What if I color that in there 50 00:02:03,049 --> 00:02:04,914 like that, with that blue? 51 00:02:04,919 --> 00:02:06,582 Oh, my gosh, who is that? 52 00:02:06,587 --> 00:02:09,418 My favorite babysitter! 53 00:02:16,396 --> 00:02:19,460 Hey, my love. Are you ready to go see the fish? 54 00:02:19,465 --> 00:02:21,066 Yes! 55 00:02:22,268 --> 00:02:25,066 I will bring her back tonight, Dr. Hawkins. 56 00:02:25,071 --> 00:02:28,073 Thanks for this. Your purse, sweetheart. 57 00:02:33,513 --> 00:02:37,212 There's some mad money in there for both of your tickets 58 00:02:37,217 --> 00:02:40,147 and a nice lunch. 59 00:02:40,152 --> 00:02:42,517 Make sure you pick up the check. 60 00:02:42,522 --> 00:02:44,723 Mwah. 61 00:02:46,125 --> 00:02:47,422 Have fun. 62 00:02:47,427 --> 00:02:49,324 Thanks. 63 00:02:49,329 --> 00:02:51,326 - Come on. - Bye-bye. 64 00:02:51,331 --> 00:02:53,628 Bye. 65 00:02:56,240 --> 00:03:03,740 - Synced and corrected by Firefly - - www.addic7ed.com - 66 00:03:08,081 --> 00:03:09,677 Your heart and lungs 67 00:03:09,682 --> 00:03:11,312 sound good, your blood pressure 68 00:03:11,317 --> 00:03:13,448 and cholesterol are both low. 69 00:03:13,453 --> 00:03:15,787 You're in good shape. 70 00:03:16,889 --> 00:03:18,553 But? 71 00:03:18,558 --> 00:03:20,455 I'll see you later, and we'll talk. 72 00:03:20,460 --> 00:03:22,857 No. Talk here. Let's go. 73 00:03:22,862 --> 00:03:26,093 Lots of the tests aren't in yet. I'm not gonna speculate. 74 00:03:26,098 --> 00:03:28,730 You have a differential. I know you do. 75 00:03:28,735 --> 00:03:31,566 Cancer? Stroke? 76 00:03:31,571 --> 00:03:33,701 ALS? I thought of that one, too. I just... 77 00:03:33,706 --> 00:03:36,606 And I'm reassured because the lack of muscle fasciculations, 78 00:03:36,611 --> 00:03:38,806 - but just perhaps? - No. 79 00:03:38,811 --> 00:03:41,008 Your exam isn't consistent with ALS. 80 00:03:41,013 --> 00:03:43,110 This could be something simple and treatable. 81 00:03:43,115 --> 00:03:45,647 - You know it's not. - I don't know anything yet. 82 00:03:45,652 --> 00:03:48,153 I'll have more information at the end of the day. 83 00:03:50,123 --> 00:03:52,953 - But in the meantime... - Yeah. No, I know. I know. 84 00:03:52,958 --> 00:03:54,556 Don't operate. Trust me, I don't want a repeat 85 00:03:54,560 --> 00:03:56,424 of what happened in the OR. 86 00:03:56,429 --> 00:04:00,061 Bolting mid-surgery, leaving Dr. Devi, 87 00:04:00,066 --> 00:04:02,831 who I'm supposed to be teaching, for God's sake. 88 00:04:06,272 --> 00:04:09,337 I got to go. Kit's new Flight Go Team 89 00:04:09,342 --> 00:04:11,939 just got activated for the first time. 90 00:04:11,944 --> 00:04:14,142 Yeah, that's a big step forward 91 00:04:14,147 --> 00:04:16,477 for any hospital with a level-1 trauma center. 92 00:04:16,482 --> 00:04:20,682 Doctors flying to emergencies EMTs can't handle. 93 00:04:20,687 --> 00:04:22,584 Okay, go. We're finished here. 94 00:04:22,589 --> 00:04:24,087 - Till later today, all right? - Yup. Yup. Yup. 95 00:04:24,091 --> 00:04:26,293 - I'll see you then. - Yup, yup. 96 00:04:57,123 --> 00:05:00,021 There's been an accident on I-20 involving a bus. 97 00:05:00,026 --> 00:05:02,423 Multiple victims are being transported here, 98 00:05:02,428 --> 00:05:04,092 but one is trapped, can't be moved, 99 00:05:04,097 --> 00:05:06,527 and is in need of the highest level of critical care. 100 00:05:06,532 --> 00:05:08,563 This is why you created the Flight Go Team, right? 101 00:05:08,567 --> 00:05:11,499 Listen to me. The situation is dangerous 102 00:05:11,504 --> 00:05:13,667 for the victims and the rescuers. 103 00:05:13,672 --> 00:05:17,305 - Save lives, but stay safe out there. - Copy you. 104 00:06:14,577 --> 00:06:17,575 Bus carrying a college women's softball team 105 00:06:17,580 --> 00:06:19,476 flipped over the guard rail, landed on that car. 106 00:06:19,481 --> 00:06:20,982 The passengers in the car died instantly. 107 00:06:20,986 --> 00:06:22,783 We got everyone out of the bus except one. 108 00:06:22,788 --> 00:06:24,954 She's critical, and if we tried to move her, she won't make it. 109 00:06:24,958 --> 00:06:27,188 She's pinned down with a penetrating abdominal injury. 110 00:06:27,193 --> 00:06:29,091 The firefighters are trying to cut her out, but 111 00:06:29,096 --> 00:06:31,195 - they're running out of time. - Top windows the only access? 112 00:06:31,199 --> 00:06:33,499 Yeah, it's the front of the bus. The door's jammed shut. 113 00:06:33,504 --> 00:06:34,935 We're working on opening something else up, 114 00:06:34,939 --> 00:06:36,174 but no luck yet. 115 00:06:44,741 --> 00:06:46,810 Ah, so it's like that, huh? 116 00:06:51,713 --> 00:06:53,181 Pass me the stuff. 117 00:07:08,698 --> 00:07:10,497 It's a good thing they called in the Go Team, 118 00:07:10,501 --> 00:07:13,032 'cause this is definitely something EMTs couldn't handle. 119 00:07:13,037 --> 00:07:14,534 I know what you're thinking, but the first rule 120 00:07:14,538 --> 00:07:16,235 of penetrating trauma... never pull it out. 121 00:07:16,240 --> 00:07:17,872 If we pulled that out of her, and it lacerated 122 00:07:17,876 --> 00:07:19,907 any vessels, she could bleed out in seconds. 123 00:07:19,912 --> 00:07:21,442 I'm well aware. 124 00:07:21,447 --> 00:07:25,016 Pulling it out is a risk, but we can manage that risk. 125 00:07:26,282 --> 00:07:28,178 Okay, what's your plan? Go on. 126 00:07:28,183 --> 00:07:31,615 You get the meds, I'll get ready to intubate. 127 00:07:31,620 --> 00:07:35,152 Let's push 100 of ketamine and 150 of roc. 128 00:07:35,157 --> 00:07:37,455 Keep her paralyzed and sedated so she doesn't move an inch. 129 00:07:37,459 --> 00:07:40,491 Then we get her unpinned. Okay, we got a good plan. 130 00:07:40,496 --> 00:07:43,094 Help me. 131 00:07:44,199 --> 00:07:45,663 We got you. 132 00:07:50,439 --> 00:07:52,507 Push the meds now. 133 00:08:03,419 --> 00:08:05,454 Now for the tough part. 134 00:08:11,160 --> 00:08:13,191 Let's pack that with wet gauze. 135 00:08:13,196 --> 00:08:14,763 And tape it. I'm on it. 136 00:08:27,476 --> 00:08:28,610 I'm here. 137 00:08:29,546 --> 00:08:31,880 Give me the bag. 138 00:08:34,183 --> 00:08:36,214 On my count. Three... 139 00:08:36,219 --> 00:08:38,383 Two, one. 140 00:08:38,388 --> 00:08:40,389 Okay. 141 00:08:44,259 --> 00:08:46,294 Perfect timing. 142 00:08:48,464 --> 00:08:50,794 Wait. 143 00:08:50,799 --> 00:08:52,330 There's someone else in here. 144 00:08:52,335 --> 00:08:53,965 There's a gas leak under this thing. 145 00:08:53,970 --> 00:08:56,370 Smoke means there's fire, too. It's gonna blow. 146 00:08:56,375 --> 00:08:58,505 Keep going. We'll catch up. 147 00:08:58,510 --> 00:09:00,007 Come on, guys. 148 00:09:00,012 --> 00:09:01,842 - What's your name? - Jill. 149 00:09:01,847 --> 00:09:03,612 Jill, you're gonna be okay, all right? 150 00:09:03,616 --> 00:09:05,884 Oh, God. Oh, God. 151 00:09:13,222 --> 00:09:15,286 Posterior elbow dislocation, 152 00:09:15,291 --> 00:09:17,789 possible fracture, with brachial artery compromise. 153 00:09:17,794 --> 00:09:19,090 This is gonna hurt. 154 00:09:19,095 --> 00:09:21,526 Take a deep breath. 155 00:09:21,531 --> 00:09:23,431 Got it. 156 00:09:46,789 --> 00:09:49,020 Hey, you, get out of the bus, now. 157 00:09:49,524 --> 00:09:51,155 I thought I heard a noise. 158 00:09:51,160 --> 00:09:53,591 It's a cat. It must be the team mascot. 159 00:09:53,596 --> 00:09:55,630 - Not exactly a bobcat. - Run! 160 00:10:06,943 --> 00:10:09,477 At least you saved the cat. 161 00:10:10,680 --> 00:10:13,010 Okay, that was kick-ass. 162 00:10:13,015 --> 00:10:15,849 Yeah, it was all right. 163 00:10:22,600 --> 00:10:24,700 Uh, Dr. Pravesh. Hey. 164 00:10:24,705 --> 00:10:25,961 Look, I know I gave you some trouble 165 00:10:25,965 --> 00:10:27,029 the last time I worked with you, 166 00:10:27,033 --> 00:10:28,165 and I just want to let you know that... 167 00:10:28,169 --> 00:10:29,933 Apology accepted, but you have one strike 168 00:10:29,938 --> 00:10:31,634 and a lot to prove, so don't forget it. 169 00:10:31,639 --> 00:10:33,271 Now, I hope you have your big boy pants on 170 00:10:33,275 --> 00:10:35,839 because we have a very difficult case. 171 00:10:36,370 --> 00:10:38,200 Hi, there. How we doing? 172 00:10:38,205 --> 00:10:41,302 Temp 102. BP 170/100. 173 00:10:41,307 --> 00:10:42,703 We gave Mr. Parker 174 00:10:42,708 --> 00:10:45,308 meds 40 minutes ago, and his fever hasn't budged. 175 00:10:45,313 --> 00:10:47,777 Mr. Parker is my dad. 176 00:10:47,782 --> 00:10:49,245 Call me Jerome. 177 00:10:49,250 --> 00:10:51,747 Uh, I've had the fever for ten days. 178 00:10:54,455 --> 00:10:55,685 Oh, um... 179 00:10:55,690 --> 00:10:58,721 That's the, that's the call bell. We're here. 180 00:11:00,661 --> 00:11:03,230 I wanted to make sure it works. 181 00:11:04,632 --> 00:11:07,363 Um, preliminary test results 182 00:11:07,368 --> 00:11:08,998 came back inconclusive. 183 00:11:09,003 --> 00:11:11,467 Your chest X-ray and urine tests 184 00:11:11,472 --> 00:11:13,836 did not show any sign of infection. 185 00:11:13,841 --> 00:11:15,538 No headache, diarrhea, 186 00:11:15,543 --> 00:11:17,940 stiff neck, nausea, sore throat. 187 00:11:17,945 --> 00:11:21,377 Which means we can consider this a fever of unknown origin. 188 00:11:21,382 --> 00:11:23,412 Unknown origin? 189 00:11:23,417 --> 00:11:25,150 Wait, so you have no idea what's wrong with me? 190 00:11:25,154 --> 00:11:28,018 Well, it's a mystery for now, but you have 191 00:11:28,023 --> 00:11:30,354 two motivated detectives on the case. 192 00:11:30,359 --> 00:11:32,689 What we need is more information, so we're gonna 193 00:11:32,694 --> 00:11:34,757 run some more tests and a thorough history, 194 00:11:34,762 --> 00:11:35,858 and that should be 195 00:11:35,863 --> 00:11:38,461 the key to figuring this out, okay? 196 00:11:38,466 --> 00:11:39,995 Oh, God. 197 00:11:40,000 --> 00:11:42,765 Where's BooBooBear? 198 00:11:42,770 --> 00:11:45,501 - That's his service dog. - I have panic attacks. 199 00:11:45,506 --> 00:11:48,070 Boo is the only thread that, um, 200 00:11:48,075 --> 00:11:49,606 keeps me from unraveling. 201 00:11:49,611 --> 00:11:52,508 Your dog is tied up outside. We don't allow 202 00:11:52,513 --> 00:11:53,776 animals in the ER. 203 00:11:53,781 --> 00:11:56,646 No, no, wait, no. Um, please, you don't understand. 204 00:11:56,651 --> 00:11:59,281 I-I need her. 205 00:11:59,286 --> 00:12:01,517 - I'm beginning to freak out. - O-Okay. 206 00:12:01,522 --> 00:12:02,618 Okay. Okay, um, 207 00:12:02,623 --> 00:12:05,221 I might be able to clear the dog through social work. 208 00:12:05,226 --> 00:12:07,861 I'll call Winston. 209 00:12:11,198 --> 00:12:12,795 Three, two, 210 00:12:12,800 --> 00:12:14,334 one, mark. 211 00:12:22,509 --> 00:12:24,139 Two patients. That's the limit. 212 00:12:24,144 --> 00:12:26,179 We'll hitch a ride on an ambulance. 213 00:12:31,452 --> 00:12:33,749 You okay? You got pretty cut up. 214 00:12:33,754 --> 00:12:36,323 - Let me take a look. - I'm fine. 215 00:12:39,994 --> 00:12:41,457 That needs to be cleaned up. 216 00:12:41,462 --> 00:12:43,697 Might need a stitch or two. 217 00:12:45,266 --> 00:12:47,296 Are you two headed back to Chastain? 218 00:12:47,301 --> 00:12:49,903 I got space in the back of my rig. 219 00:12:55,209 --> 00:12:57,039 Thank you for getting me off that bus. 220 00:12:57,044 --> 00:12:58,908 I almost went up in flames. 221 00:12:58,913 --> 00:13:00,447 I was worried about the cat. 222 00:13:01,916 --> 00:13:04,614 That you didn't know existed. 223 00:13:04,619 --> 00:13:06,315 Good point. 224 00:13:06,320 --> 00:13:08,351 Truth is, I'm more of a dog person. 225 00:13:08,356 --> 00:13:10,820 I'm a chicken guy. 226 00:13:10,825 --> 00:13:12,655 - No way. - Oh, yeah. 227 00:13:12,660 --> 00:13:14,394 I'll have to hit you up for some eggs. 228 00:13:29,977 --> 00:13:31,507 Oh, man. 229 00:13:31,512 --> 00:13:34,044 Is that little fluff nugget here to comfort stressed out doctors? 230 00:13:34,048 --> 00:13:35,811 Because I am in need. 231 00:13:35,816 --> 00:13:38,648 That little fluff nugget is an infection risk. 232 00:13:38,653 --> 00:13:41,016 Service dogs are allowed in hospitals, Nurse Hundley. 233 00:13:41,021 --> 00:13:43,619 Some areas are off-limits, but this isn't one. 234 00:13:43,624 --> 00:13:45,125 Hmm. 235 00:13:48,429 --> 00:13:50,893 - BooBooBear. - Hey, hold on. 236 00:13:50,898 --> 00:13:54,096 Lyme disease is on the differential. 237 00:13:54,101 --> 00:13:56,532 Uh, Boo has no parasites, ever. 238 00:13:56,537 --> 00:13:57,567 She's groomed, 239 00:13:57,572 --> 00:13:59,070 gets a monthly topical tick repellant, and her paws 240 00:13:59,074 --> 00:14:00,171 barely touch the ground. See? 241 00:14:00,175 --> 00:14:02,240 I-I carry her in this pup pack. 242 00:14:03,244 --> 00:14:05,478 We'll run a Lyme test anyway. 243 00:14:11,685 --> 00:14:13,449 Preliminary history is unremarkable. 244 00:14:13,454 --> 00:14:15,284 No contact with anyone else who was sick. 245 00:14:15,289 --> 00:14:18,654 No recent travel or relevant medical issues. 246 00:14:18,659 --> 00:14:21,757 Jerome is a computer programmer 247 00:14:21,762 --> 00:14:24,460 who works from home. 248 00:14:24,465 --> 00:14:27,329 - Okay. What next? - You build the differential 249 00:14:27,334 --> 00:14:30,199 using the latest test results, but be patient. 250 00:14:30,204 --> 00:14:31,767 Fever of unknown origin 251 00:14:31,772 --> 00:14:34,274 can stump the most experienced doctors. 252 00:14:49,256 --> 00:14:51,687 - What do we got? - Two adult females. 253 00:14:51,692 --> 00:14:54,556 Young 20s. Traumatic penetrating abdominal injury, 254 00:14:54,561 --> 00:14:56,225 evisceration. Intubated at the scene. 255 00:14:56,230 --> 00:14:57,260 And the other one? 256 00:14:57,265 --> 00:14:59,628 Posterior elbow dislocation with vascular compromise. 257 00:14:59,633 --> 00:15:01,463 Dr. Hawkins reduced in the field. 258 00:15:01,468 --> 00:15:02,865 She's C.S. 13. 259 00:15:02,870 --> 00:15:05,033 Repetitive questioning, possible head injury. 260 00:15:05,038 --> 00:15:06,769 Is Mindy going to be okay? 261 00:15:06,774 --> 00:15:08,071 Easy. We'll take care of her. 262 00:15:08,076 --> 00:15:10,444 We need to page Sutton and Voss now. 263 00:15:21,755 --> 00:15:24,119 Okay... 264 00:15:24,124 --> 00:15:25,392 Hey. 265 00:15:27,762 --> 00:15:29,592 Good work. 266 00:15:29,597 --> 00:15:30,860 I only have a few minutes. 267 00:15:30,865 --> 00:15:32,995 We have traumas from the crash site coming in. 268 00:15:33,000 --> 00:15:34,831 What can we rule out? 269 00:15:34,836 --> 00:15:37,900 Jerome took an HIV test a week ago. That came back negative. 270 00:15:37,905 --> 00:15:40,140 Plus, he has an elevated white blood count. 271 00:15:41,409 --> 00:15:42,772 So? 272 00:15:42,777 --> 00:15:44,609 That means we cross off all AIDS-defining illnesses, 273 00:15:44,613 --> 00:15:47,181 fungal infections like, uh, PJP. 274 00:15:52,019 --> 00:15:53,949 What else? 275 00:15:53,954 --> 00:15:56,389 Lupus, R.A., probably out. 276 00:16:00,561 --> 00:16:02,491 I mean, the list is brutally long. 277 00:16:02,496 --> 00:16:03,892 He could have almost anything. 278 00:16:03,897 --> 00:16:06,729 - Go talk to him again. - Okay. 279 00:16:06,734 --> 00:16:08,163 - About what? - Anything. 280 00:16:08,168 --> 00:16:10,566 What did he have for breakfast two days ago? 281 00:16:10,571 --> 00:16:12,034 Do his parents have heart trouble? 282 00:16:12,039 --> 00:16:14,170 - Does he kiss his pet salamander? - Wait. 283 00:16:14,175 --> 00:16:15,839 What does a salamander have to do with it? 284 00:16:15,844 --> 00:16:17,541 Well, salamanders carry salmonella, 285 00:16:17,546 --> 00:16:19,209 specifically osteomyelitis, 286 00:16:19,214 --> 00:16:20,909 which can cause a fever. 287 00:16:20,914 --> 00:16:23,445 My point is, the answer is almost always 288 00:16:23,450 --> 00:16:25,515 in the patient history. 289 00:16:25,520 --> 00:16:27,554 I'll tag in when I can. 290 00:16:37,064 --> 00:16:38,627 You aren't on the Go Team. 291 00:16:38,632 --> 00:16:41,830 Where'd the chopper pick you up? Atlanta General? 292 00:16:41,835 --> 00:16:43,799 Yeah. 293 00:16:43,804 --> 00:16:45,804 They're not level-1 trauma. 294 00:16:46,740 --> 00:16:48,775 Where'd you learn your field medicine? 295 00:16:51,378 --> 00:16:53,409 A lot of places. 296 00:16:53,414 --> 00:16:55,010 How about you? 297 00:16:55,015 --> 00:16:59,448 Afghanistan. Yeah, Navy corpsman. Two tours. 298 00:16:59,453 --> 00:17:01,684 Back to you. 299 00:17:01,689 --> 00:17:04,620 Are you an ER doc? 300 00:17:04,625 --> 00:17:05,921 Trauma surgeon? 301 00:17:05,926 --> 00:17:08,724 I'm double board certified. Emergency med and... 302 00:17:08,729 --> 00:17:10,393 We're picking up a patient en route. 303 00:17:10,398 --> 00:17:11,560 Female, 35, 304 00:17:11,565 --> 00:17:13,533 pregnant and in active labor. 305 00:17:16,137 --> 00:17:17,933 Who doesn't love babies? 306 00:17:17,938 --> 00:17:20,507 Looks like we're in for more fun. 307 00:17:22,876 --> 00:17:25,240 We're stacked up and more are incoming. 308 00:17:25,245 --> 00:17:27,343 Medivac just landed. 309 00:17:27,348 --> 00:17:29,311 We need a bay. Severe abdominal lac. 310 00:17:29,316 --> 00:17:31,514 She needs to be top of the list. 311 00:17:31,519 --> 00:17:33,954 I saved you a trauma bay. Follow me. 312 00:17:37,057 --> 00:17:40,323 Looks like Conrad repacked the bowel on-site. 313 00:17:40,328 --> 00:17:42,958 - Team did a good job. - Free fluid in the abdomen. 314 00:17:42,963 --> 00:17:45,861 Her intestines may have been lacerated by the impalement. 315 00:17:47,501 --> 00:17:50,099 Mindy. 316 00:17:50,104 --> 00:17:51,900 Mindy. My name 317 00:17:51,905 --> 00:17:53,636 is Dr. Devi. You've been in an accident, 318 00:17:53,641 --> 00:17:55,004 but we're gonna take care of you, okay? 319 00:17:55,008 --> 00:17:56,105 Hundley, start her 320 00:17:56,110 --> 00:17:58,611 on her propofol drip. I'll get someone to book an OR. 321 00:18:00,848 --> 00:18:03,082 Gonna get you down to X-ray. 322 00:18:04,819 --> 00:18:06,349 Ortho and neuro page? 323 00:18:06,354 --> 00:18:08,184 Uh, Bay Two. Jill Rhinehart. Dislocated elbow 324 00:18:08,189 --> 00:18:09,418 and an epidural hematoma. 325 00:18:09,423 --> 00:18:10,920 I thought you could use an extra hand. 326 00:18:10,924 --> 00:18:11,991 Nolan. 327 00:18:16,196 --> 00:18:18,227 Hi, Jill. I'm Dr. Voss. 328 00:18:18,232 --> 00:18:19,666 And I'm Dr. Sutton. 329 00:18:20,934 --> 00:18:22,931 I'm just gonna do a quick exam. 330 00:18:22,936 --> 00:18:24,500 How's the arm feel? 331 00:18:24,505 --> 00:18:27,035 It hurts bad, really bad. 332 00:18:27,040 --> 00:18:28,804 We'll get you something for the pain. 333 00:18:28,809 --> 00:18:30,843 Let's get her 25 mikes of fentanyl. 334 00:18:32,980 --> 00:18:34,814 Can you follow my finger? 335 00:18:39,152 --> 00:18:40,682 She needs an OR. 336 00:18:40,687 --> 00:18:43,185 I'll join you. Compartment syndrome. 337 00:18:43,190 --> 00:18:45,521 We'll likely need to take that down with a fasciotomy. 338 00:18:45,526 --> 00:18:47,790 - I'll prep her. - Thanks. 339 00:18:47,795 --> 00:18:51,894 Jill, I'm gonna need your consent for surgery. 340 00:18:54,001 --> 00:18:57,533 You're in good hands with Dr. Nolan. 341 00:18:57,538 --> 00:18:59,939 - What a mess. - And more coming. 342 00:19:01,642 --> 00:19:04,577 - Who are you operating on? - I'm not. 343 00:19:05,312 --> 00:19:06,709 It's-it's better if I stay here. 344 00:19:06,714 --> 00:19:08,554 If they need a trauma surgeon, they'll page me. 345 00:19:09,383 --> 00:19:10,613 All right. 346 00:19:10,618 --> 00:19:12,819 - I'll see you in a bit. - Mm-hmm. 347 00:19:24,300 --> 00:19:25,399 Ten times out of ten, 348 00:19:25,404 --> 00:19:27,904 a person with injuries like this dies in the field. 349 00:19:27,909 --> 00:19:29,438 Genius work by the Go Team. 350 00:19:29,443 --> 00:19:31,375 Well, she has gross contamination of her abdomen, 351 00:19:31,380 --> 00:19:32,577 and she's in septic shock. 352 00:19:32,582 --> 00:19:34,578 Okay, so we get in and out fast. What's first? 353 00:19:34,583 --> 00:19:36,795 Identify the ligament of Treitz, run the bowel, 354 00:19:36,800 --> 00:19:37,930 look for vascular injuries, 355 00:19:37,935 --> 00:19:39,233 and cut out anything that's not viable. 356 00:19:39,237 --> 00:19:41,033 Very good. We cannot miss anything. 357 00:19:41,038 --> 00:19:43,135 - If we leave contaminants... - She dies. 358 00:19:43,140 --> 00:19:45,642 So, we're fast, but we're meticulous. 359 00:19:47,845 --> 00:19:49,975 We need to avoid ICP elevating meds 360 00:19:49,980 --> 00:19:52,478 and prep her for a right-sided decompressive craniotomy. 361 00:19:52,483 --> 00:19:54,246 The arm looks terrible. 362 00:19:54,251 --> 00:19:56,248 Life and limb, literally. 363 00:20:05,362 --> 00:20:07,693 Thank you. 364 00:20:07,698 --> 00:20:09,098 Thank you. 365 00:20:11,101 --> 00:20:13,432 Ma'am, how far apart are your contractions? 366 00:20:32,055 --> 00:20:34,619 Creole. She's Haitian. 367 00:20:34,624 --> 00:20:36,655 Guess I know where you learned your field medicine. 368 00:20:37,961 --> 00:20:39,658 It's her third child. 369 00:20:39,663 --> 00:20:41,698 Which means it can come very quickly. 370 00:20:47,938 --> 00:20:50,135 Uh, no exotic foods? 371 00:20:50,140 --> 00:20:52,805 Raw fish? Wild mushrooms? 372 00:20:52,810 --> 00:20:54,406 I have a... 373 00:20:54,411 --> 00:20:56,675 a delicate stomach. 374 00:20:56,680 --> 00:20:59,349 Okay. Um... 375 00:21:01,051 --> 00:21:03,415 Any sexual encounters recently? 376 00:21:03,420 --> 00:21:05,717 I need my dog 377 00:21:05,722 --> 00:21:07,352 just to leave the apartment. 378 00:21:07,357 --> 00:21:08,987 Definitely not 379 00:21:08,992 --> 00:21:11,761 hooking up with some rando. 380 00:21:16,534 --> 00:21:19,235 Jerome? 381 00:21:21,705 --> 00:21:24,002 Uh... Uh... 382 00:21:24,007 --> 00:21:26,075 Hey, I-I need help in here. 383 00:21:29,980 --> 00:21:31,310 Here. 384 00:21:34,185 --> 00:21:36,849 He's burning up. 385 00:21:37,254 --> 00:21:39,551 Fever 104.2. 386 00:21:39,556 --> 00:21:42,424 We're heading into the red zone. Orders, doctor? 387 00:21:44,294 --> 00:21:45,724 Dr. Daniels. 388 00:21:47,298 --> 00:21:49,327 Uh, let's push 30 ketorolac, 389 00:21:49,332 --> 00:21:50,529 get a cooling blanket on him. 390 00:21:50,534 --> 00:21:52,535 - Okay. - I'll call Dr. Pravesh. 391 00:22:18,195 --> 00:22:20,859 Significant hemorrhage and ecchymosis, 392 00:22:20,864 --> 00:22:22,944 but the compression on the brain should be much less. 393 00:22:23,934 --> 00:22:25,564 Now, I have to find the source. 394 00:22:25,569 --> 00:22:28,500 100% compartment syndrome. 395 00:22:28,505 --> 00:22:30,706 Thank goodness Conrad reduced it on-site. 396 00:22:34,377 --> 00:22:36,542 Found the bleeders. 397 00:22:36,547 --> 00:22:38,644 Middle meningeal artery. 398 00:22:38,649 --> 00:22:41,146 Cauterizing now. 399 00:22:41,151 --> 00:22:44,182 Good job, Dr. Sutton. Now, if I 400 00:22:44,187 --> 00:22:47,786 can just try not to nick an artery. 401 00:22:47,791 --> 00:22:49,454 Won't be pretty, 402 00:22:49,459 --> 00:22:52,624 but when the swelling goes down, she'll have a functional arm. 403 00:22:52,629 --> 00:22:54,730 Banner day for the Go Team. 404 00:22:56,166 --> 00:22:59,402 Quick question. Is Bell okay? 405 00:23:01,405 --> 00:23:02,634 What do you mean? 406 00:23:02,639 --> 00:23:05,503 He's a surgeon, not emergency. 407 00:23:05,508 --> 00:23:09,041 Pulled himself from the board for the entire day. 408 00:23:09,046 --> 00:23:11,476 Austin's taking a case for him in OR One. 409 00:23:11,481 --> 00:23:14,546 I did not know that. 410 00:23:14,551 --> 00:23:17,583 I'm not one to tattle. 411 00:23:17,588 --> 00:23:19,655 Something's up. 412 00:23:40,310 --> 00:23:42,908 Uh, pink bowel is healthy. 413 00:23:42,913 --> 00:23:44,743 Gray we resect. 414 00:23:44,748 --> 00:23:47,045 BP's dropping to the 70s. Heart rate's 130. 415 00:23:47,050 --> 00:23:51,049 Cranking pressors. She's already had four liters of fluid. 416 00:23:51,054 --> 00:23:53,552 We got a bit of luck here. Looks like the blood vessels 417 00:23:53,557 --> 00:23:55,187 escaped getting torn apart. 418 00:23:55,192 --> 00:23:57,756 I've got eyes on the duodenum. 419 00:23:57,761 --> 00:23:59,858 First part of jejunum looks good. 420 00:23:59,863 --> 00:24:02,294 Oh, no. 421 00:24:02,299 --> 00:24:04,897 Bowels are leaking into the abdomen. 422 00:24:04,902 --> 00:24:06,599 All right, find the healthy margins 423 00:24:06,603 --> 00:24:09,034 and staple them, both sides. 424 00:24:09,039 --> 00:24:11,704 We're at 100 centimeters. 425 00:24:11,709 --> 00:24:14,006 Now 125. 150's the limit. 426 00:24:14,011 --> 00:24:15,941 She's gonna be at risk for short gut syndrome. 427 00:24:15,946 --> 00:24:18,676 I'm about to clip the next segment. 428 00:24:19,716 --> 00:24:21,547 Uh, s-slow down. 429 00:24:21,552 --> 00:24:23,215 You can adjust to make the 430 00:24:23,220 --> 00:24:25,351 viable tissue a little more visible in the field. 431 00:24:25,355 --> 00:24:28,287 Clip, and then you can staple, and... toss. 432 00:24:28,292 --> 00:24:31,189 This is my OR, thank you very much. 433 00:24:31,194 --> 00:24:35,627 However, good advice is good advice. 434 00:24:35,632 --> 00:24:37,901 Adjusting to get a better view. 435 00:24:40,337 --> 00:24:43,068 Just under 150 centimeters total. 436 00:24:43,073 --> 00:24:44,236 BP's coming up. 437 00:24:44,241 --> 00:24:45,437 Backing off pressors. 438 00:24:45,442 --> 00:24:47,072 Right. 439 00:24:47,077 --> 00:24:48,611 Good call, Bell. 440 00:25:14,020 --> 00:25:15,550 How far are we from Chastain? 441 00:25:15,555 --> 00:25:17,919 20 minutes. 442 00:25:17,924 --> 00:25:19,554 Ever delivered a baby before? 443 00:25:19,559 --> 00:25:20,856 A few. 444 00:25:20,861 --> 00:25:22,658 Ever delivered one in a moving ambulance? 445 00:25:22,662 --> 00:25:25,226 This day just keeps getting more and more interesting. 446 00:25:25,231 --> 00:25:26,628 It's one for the record books. 447 00:25:39,179 --> 00:25:41,176 Hey. That was good work with your 448 00:25:41,181 --> 00:25:43,044 hematoma and compartment syndrome patient. 449 00:25:43,049 --> 00:25:45,480 It'll be a tough recovery, but she should make it. 450 00:25:45,485 --> 00:25:47,816 You checked in on us during surgery? 451 00:25:47,821 --> 00:25:51,319 N-No. I-I got the report from Jessica. 452 00:25:51,324 --> 00:25:54,456 Oh, by the way, is Conrad back yet? 453 00:25:54,461 --> 00:25:55,824 No. 454 00:25:55,829 --> 00:25:59,231 - What do you want with Conrad? - He wanted to see me. 455 00:26:00,834 --> 00:26:02,464 AJ mentioned that you were 456 00:26:02,469 --> 00:26:05,037 in his bowel trauma in OR Two. 457 00:26:07,173 --> 00:26:08,770 It is my area of expertise. 458 00:26:08,775 --> 00:26:11,273 Thought I could be there if they ran into the weeds. 459 00:26:11,278 --> 00:26:13,475 He said you made a good call. 460 00:26:13,480 --> 00:26:16,177 Uh, it was nothing. 461 00:26:16,182 --> 00:26:18,481 Really. I was superfluous. 462 00:26:19,887 --> 00:26:23,289 No other procedures that need your experienced hands? 463 00:26:25,091 --> 00:26:27,860 I understand you've canceled your surgeries. 464 00:26:30,330 --> 00:26:32,760 Yeah, I felt some flu-like symptoms, 465 00:26:32,765 --> 00:26:36,298 just a touch... it's an abundance of caution. 466 00:26:36,303 --> 00:26:37,899 Of course. 467 00:26:44,010 --> 00:26:45,545 No fever. 468 00:26:50,250 --> 00:26:52,914 Perhaps, when you feel up to it, 469 00:26:52,919 --> 00:26:55,121 you'll tell me what's really going on. 470 00:27:11,171 --> 00:27:13,735 How's it going? 471 00:27:13,740 --> 00:27:16,237 Fever spiked to 105, and he's hypotensive. 472 00:27:16,242 --> 00:27:17,373 We broadened his antibiotics, 473 00:27:17,377 --> 00:27:20,510 got cool saline, ice packs, acetaminophen, ketorolac. 474 00:27:20,515 --> 00:27:22,113 We finally found a cooling blanket, but he's so... 475 00:27:22,117 --> 00:27:24,216 - It's not doing a thing. - Give me the service dog. 476 00:27:24,220 --> 00:27:25,350 I'll take care of her. 477 00:27:25,355 --> 00:27:27,486 - Come on. - I think this is beyond 478 00:27:27,491 --> 00:27:30,420 BooBooBear's expertise. 479 00:27:30,425 --> 00:27:34,591 Okay. Okay. Good girl. 480 00:27:34,596 --> 00:27:36,159 How'd he get this bad this quickly? 481 00:27:36,164 --> 00:27:38,262 Whatever it is has been building in his system for days. 482 00:27:38,266 --> 00:27:39,863 I don't like where it's going. 483 00:27:39,868 --> 00:27:41,800 He was just talking to me a bit ago, but he's so... 484 00:27:41,804 --> 00:27:43,067 altered. I... 485 00:27:43,072 --> 00:27:45,401 Well, he might need to be intubated. 486 00:27:45,406 --> 00:27:46,669 Let's get an ABG. 487 00:27:46,674 --> 00:27:47,708 Yeah. 488 00:27:58,553 --> 00:28:01,121 - Hold on, hold on. - Here. 489 00:28:02,123 --> 00:28:05,088 Your patient. You do it. 490 00:28:05,093 --> 00:28:06,560 Okay. 491 00:28:17,271 --> 00:28:19,002 Okay. 492 00:28:23,178 --> 00:28:25,010 Oh, come on. He-he won't settle. This is awful. 493 00:28:25,014 --> 00:28:26,343 - I can't do this. - I'll hold him. 494 00:28:26,347 --> 00:28:27,777 Got it. 495 00:28:30,752 --> 00:28:31,818 Okay. 496 00:28:35,289 --> 00:28:36,556 I'm in. 497 00:28:50,205 --> 00:28:52,502 Oh! Uh... 498 00:28:52,507 --> 00:28:54,605 - Hold pressure, quick. Come on. - Yeah, yeah, yeah. 499 00:28:54,610 --> 00:28:55,877 Hold pressure. 500 00:28:57,945 --> 00:29:00,710 - Did you check his platelets and INR? - Of course. 501 00:29:00,715 --> 00:29:03,479 160 and 1.8. Not normal, but not catastrophic. 502 00:29:03,484 --> 00:29:06,749 Well, they must be getting worse. He's not clotting. 503 00:29:06,754 --> 00:29:09,285 Possibly in DIC or liver failure. He's decompensating. 504 00:29:09,290 --> 00:29:11,021 I don't understand what's happening. Explain. 505 00:29:11,025 --> 00:29:13,122 I can't. 506 00:29:13,127 --> 00:29:15,391 We can't fix him if we don't know what's wrong, 507 00:29:15,396 --> 00:29:17,093 and we're running out of time. 508 00:29:17,098 --> 00:29:19,162 Wait. You mean he could die? 509 00:29:19,167 --> 00:29:20,563 - I... - Hundley. 510 00:29:20,568 --> 00:29:22,732 35-year-old woman, 511 00:29:22,737 --> 00:29:24,267 BP steady, pulse in the 70s, 512 00:29:24,272 --> 00:29:26,135 but also we have a newborn male, 513 00:29:26,140 --> 00:29:27,837 healthy, Apgar off the charts. 514 00:29:27,842 --> 00:29:30,339 Who could use labor and delivery and an OB-GYN. 515 00:29:30,344 --> 00:29:31,742 She gave birth in the ambulance. 516 00:29:31,746 --> 00:29:33,176 Peachtree and Seventh. 517 00:29:33,181 --> 00:29:34,678 Perfect corner to come into the world. 518 00:29:34,682 --> 00:29:36,913 Great deli there, too. 519 00:29:38,052 --> 00:29:41,284 Mèsi. 520 00:29:41,289 --> 00:29:42,752 Hey, Conrad, listen. 521 00:29:42,757 --> 00:29:45,822 We've got a 30-year-old male who came in with a week of fever. 522 00:29:45,827 --> 00:29:47,724 No clear source, and he's going downhill 523 00:29:47,729 --> 00:29:49,492 fast, and we're nowhere closer to a diagnosis 524 00:29:49,497 --> 00:29:50,727 than when he first came in. 525 00:29:50,732 --> 00:29:52,395 We need all the help we can get. 526 00:29:52,400 --> 00:29:53,997 The antipyretics, cooling blankets, 527 00:29:54,002 --> 00:29:55,898 antibiotics, none of it's making him better. 528 00:29:55,903 --> 00:29:57,299 He's going into shock. 529 00:29:57,304 --> 00:29:58,936 We're gonna get started on norepinephrine. 530 00:29:58,940 --> 00:30:00,270 Let's get him to the ICU. 531 00:30:00,275 --> 00:30:03,305 Still waiting on a bed. ICU is short-handed today. 532 00:30:03,310 --> 00:30:05,508 Well, we can't keep him down here indefinitely. 533 00:30:05,513 --> 00:30:07,043 I'm double board certified. 534 00:30:07,048 --> 00:30:09,012 Emergency med and intensive care. 535 00:30:09,017 --> 00:30:10,449 If there's anything I can do to help. 536 00:30:10,453 --> 00:30:11,583 This is my patient. 537 00:30:11,588 --> 00:30:12,816 I'm sorry, I don't know you. 538 00:30:12,820 --> 00:30:14,317 Do you have privileges here? 539 00:30:14,322 --> 00:30:16,553 He has a point. 540 00:30:16,558 --> 00:30:18,622 I'm vouching for her. 541 00:30:19,327 --> 00:30:21,457 I'll get Kit to meet us in the ICU. 542 00:30:21,462 --> 00:30:22,725 Sounds good. 543 00:30:22,730 --> 00:30:24,397 Let's grab you some scrubs. 544 00:30:46,400 --> 00:30:49,615 Hi. I'm Chastain's CEO, Kit Voss. 545 00:30:49,620 --> 00:30:52,419 Thanks for pitching in. I know we're desperately 546 00:30:52,424 --> 00:30:54,754 short-staffed here in the unit, but I have to clear you. 547 00:30:54,759 --> 00:30:57,224 Understood. My name is Kincaid Sullivan. 548 00:30:57,229 --> 00:30:58,229 I'm an ER doctor, 549 00:30:58,234 --> 00:31:00,198 and I also cover the ICU at Atlanta General. 550 00:31:00,203 --> 00:31:01,733 You can call them for recommendations. 551 00:31:01,738 --> 00:31:04,036 - And the state board, of course. - Hey, Go Team. 552 00:31:04,041 --> 00:31:05,942 You with us? 553 00:31:07,239 --> 00:31:10,337 I'm issuing you privileges on an emergency basis. 554 00:31:10,342 --> 00:31:11,906 Come to my office when you have a moment, 555 00:31:11,910 --> 00:31:13,477 and we'll do the paperwork. 556 00:31:15,600 --> 00:31:18,398 Ejection fraction's at 15%. 557 00:31:18,403 --> 00:31:21,101 His heart is failing, too. Damn it. 558 00:31:21,106 --> 00:31:23,904 She's the ICU doctor. She should run the room. 559 00:31:23,909 --> 00:31:26,644 Go. 560 00:31:27,612 --> 00:31:29,242 Okay, as far as I can tell, 561 00:31:29,247 --> 00:31:31,645 we've got a 30-year-old man, otherwise healthy, 562 00:31:31,650 --> 00:31:32,746 febrile, 563 00:31:32,751 --> 00:31:34,182 now in multisystem organ failure, 564 00:31:34,187 --> 00:31:35,849 with undifferentiated shock, 565 00:31:35,854 --> 00:31:38,452 respiratory failure, liver failure, 566 00:31:38,457 --> 00:31:40,153 all complicated by disseminated 567 00:31:40,158 --> 00:31:42,923 intravascular coagulopathy? 568 00:31:42,928 --> 00:31:44,024 That cover it? 569 00:31:44,029 --> 00:31:46,293 No urine output in the last three hours. 570 00:31:46,298 --> 00:31:48,995 Add renal failure to the list. 571 00:31:49,000 --> 00:31:51,898 He's nearly maxed out on norepi and vaso. 572 00:31:51,903 --> 00:31:53,733 I think we should start epi next. 573 00:31:53,738 --> 00:31:56,703 Agreed, but he needs more access. 574 00:31:56,708 --> 00:31:59,173 We'll need to place four lines, minimum, a central, 575 00:31:59,178 --> 00:32:02,213 - a dialysis catheter. - An arterial, and a PA-line. 576 00:32:05,350 --> 00:32:07,814 All right, team. Let's keep this man alive 577 00:32:07,819 --> 00:32:10,755 long enough to find out what's wrong with him. 578 00:32:12,090 --> 00:32:13,520 What should I do? 579 00:32:13,525 --> 00:32:15,055 Go back to the white board 580 00:32:15,060 --> 00:32:17,157 and go over every detail we know. 581 00:32:17,162 --> 00:32:18,325 Find answers, 582 00:32:18,330 --> 00:32:20,565 and be ready to report back. 583 00:32:29,074 --> 00:32:32,372 My sixth surgery of the day starts in ten minutes. 584 00:32:32,377 --> 00:32:34,374 Please tell me this coffee is hot. 585 00:32:34,379 --> 00:32:35,876 That's why God made microwaves. 586 00:32:35,881 --> 00:32:37,544 Oh, bless you. 587 00:32:39,218 --> 00:32:42,115 Ooh. I smell panic. 588 00:32:42,120 --> 00:32:44,050 I'd rather smell a warm muffin. 589 00:32:44,055 --> 00:32:45,452 What's going on? 590 00:32:45,457 --> 00:32:46,722 We have a patient who started out 591 00:32:46,726 --> 00:32:48,056 with a fever of unknown origin, 592 00:32:48,061 --> 00:32:50,056 and is now the sickest guy in the unit, 593 00:32:50,061 --> 00:32:53,593 and if we don't get a diagnosis soon, he's gonna die. 594 00:32:53,598 --> 00:32:55,963 - And this is the differential? - Uh-huh. 595 00:32:55,968 --> 00:32:57,602 Good luck. 596 00:33:00,906 --> 00:33:03,136 I mean, how do they expect me to figure this out? 597 00:33:03,141 --> 00:33:05,007 I'm supposed to see what Hawkins and Pravesh don't? 598 00:33:05,011 --> 00:33:07,373 Wild guess, they're teaching you to look. 599 00:33:07,378 --> 00:33:09,876 And you may never get an answer. 600 00:33:09,881 --> 00:33:11,411 You know, by some estimates, 601 00:33:11,416 --> 00:33:13,880 one in four patients who die in the ICU 602 00:33:13,885 --> 00:33:15,815 never get properly diagnosed. 603 00:33:15,820 --> 00:33:17,951 Despite our best efforts, the human body is a mystery 604 00:33:17,956 --> 00:33:19,855 that keeps its secrets more than a quarter of the time. 605 00:33:19,859 --> 00:33:22,389 - Okay, that's-that's so... - Imperfect. 606 00:33:22,394 --> 00:33:23,657 Remarkable. 607 00:33:23,662 --> 00:33:25,792 Human. 608 00:33:25,797 --> 00:33:27,160 What have you got? 609 00:33:27,165 --> 00:33:28,929 Well... 610 00:33:28,934 --> 00:33:30,797 everything on that board 611 00:33:30,802 --> 00:33:33,700 and nothing at all. 612 00:33:33,705 --> 00:33:35,769 It's okay. 613 00:33:35,774 --> 00:33:37,137 It happens. 614 00:33:37,142 --> 00:33:39,206 We'll keep looking. 615 00:33:39,211 --> 00:33:41,579 But there is something you can do for your patient. 616 00:33:43,682 --> 00:33:45,116 What? 617 00:33:52,924 --> 00:33:54,388 What's going on? 618 00:33:54,393 --> 00:33:56,623 A kid came in, drowning victim. 619 00:33:56,628 --> 00:33:59,025 They couldn't save her. They tried over an hour. 620 00:33:59,030 --> 00:34:01,595 Okay. I need BooBooBear. 621 00:34:01,600 --> 00:34:03,397 For Jerome. 622 00:34:03,402 --> 00:34:06,600 Aw. I was wrong about this little pup. 623 00:34:06,605 --> 00:34:08,902 She's really good at her job. 624 00:34:08,907 --> 00:34:10,537 Wait. 625 00:34:10,542 --> 00:34:13,711 - Don't forget this. - Thanks. 626 00:34:30,462 --> 00:34:33,326 His bacterial cultures all came back negative. 627 00:34:33,331 --> 00:34:35,229 We have him on broad-spectrum antibiotics 628 00:34:35,234 --> 00:34:36,597 and added antifungals. 629 00:34:36,602 --> 00:34:40,000 Looks like the labs are negative for vasculitis and autoimmune. 630 00:34:40,005 --> 00:34:42,602 What if it's something more insidious? 631 00:34:42,607 --> 00:34:45,305 Like an underlying malignancy leading to HLH? 632 00:34:45,310 --> 00:34:47,508 It's a good thought, but the ferritin isn't consistent. 633 00:34:47,513 --> 00:34:49,112 - Ingestions? - Tox screen, negative. 634 00:34:49,116 --> 00:34:50,312 Extended panel, negative. 635 00:34:50,317 --> 00:34:52,116 This was in the dog's backpack. 636 00:34:52,817 --> 00:34:54,448 - A map? - Uh-huh. 637 00:34:54,453 --> 00:34:56,750 A trail map to a state park. 638 00:34:56,755 --> 00:34:58,785 We've already established the dog's feet 639 00:34:58,790 --> 00:35:00,288 never touch the ground, and we've already 640 00:35:00,292 --> 00:35:01,621 - tested for Lyme. - No, no, no. 641 00:35:01,626 --> 00:35:03,723 Boo's feet didn't touch the ground, 642 00:35:03,728 --> 00:35:06,059 but Jerome's have. 643 00:35:06,064 --> 00:35:08,228 In a Georgia state park, where there are other 644 00:35:08,233 --> 00:35:09,863 tick-borne diseases, not just Lyme. 645 00:35:09,868 --> 00:35:11,131 I looked it up. 646 00:35:11,136 --> 00:35:13,437 It could be babesiosis. 647 00:35:16,675 --> 00:35:19,205 Babesiosis is rare. 648 00:35:19,210 --> 00:35:21,642 So rare we never considered it. 649 00:35:21,647 --> 00:35:23,109 But the symptoms fit. 650 00:35:23,114 --> 00:35:24,878 It's an incredible long shot. 651 00:35:24,883 --> 00:35:26,980 But possible. 652 00:35:26,985 --> 00:35:28,581 So we start him on clindamycin 653 00:35:28,586 --> 00:35:31,084 and quinine, stat, and if the smear is positive, 654 00:35:31,089 --> 00:35:32,624 we start pheresis. 655 00:35:36,027 --> 00:35:39,261 No matter if this is wrong or right, good work, Trevor. 656 00:35:55,400 --> 00:35:56,420 Hello. 657 00:35:56,425 --> 00:35:58,422 Hi. 658 00:35:58,427 --> 00:35:59,790 How's Jerome? 659 00:36:00,825 --> 00:36:04,328 Blood test confirmed babesiosis. 660 00:36:04,333 --> 00:36:07,531 - Wow. - Yeah, he's responding to the meds. 661 00:36:07,536 --> 00:36:10,167 His fever is still high, but it's coming down. 662 00:36:10,172 --> 00:36:12,636 Incredible save. 663 00:36:12,641 --> 00:36:14,705 Who was that kid? An intern? 664 00:36:14,710 --> 00:36:17,241 He's gonna be one of our best. 665 00:36:17,246 --> 00:36:18,943 All credit to him. 666 00:36:18,948 --> 00:36:20,815 And to the team. You... 667 00:36:22,151 --> 00:36:24,015 You ran the room. 668 00:36:24,020 --> 00:36:27,251 Does every day on the job with you go like this one? 669 00:36:27,256 --> 00:36:28,786 Just one surprise 670 00:36:28,791 --> 00:36:31,122 - after another? - No, thank God. 671 00:36:31,127 --> 00:36:33,457 Today was particularly intense. 672 00:36:33,462 --> 00:36:35,997 And I still don't know your name. 673 00:36:37,533 --> 00:36:39,163 I don't know yours, either. 674 00:36:39,168 --> 00:36:40,364 Although, "Hey, you" 675 00:36:40,369 --> 00:36:43,234 - worked surprisingly well. - Conrad Hawkins. 676 00:36:43,239 --> 00:36:45,636 Kincaid Sullivan. 677 00:36:45,641 --> 00:36:47,438 Cade to friend and foe alike. 678 00:36:47,443 --> 00:36:50,045 I'd like to have a word with your foes. 679 00:36:51,214 --> 00:36:53,415 No, you wouldn't. Believe me. 680 00:36:58,621 --> 00:37:02,420 I'm gonna guess you were in Haiti doing earthquake relief. 681 00:37:02,425 --> 00:37:04,088 Twice. 682 00:37:04,093 --> 00:37:05,661 How long you been at Atlanta General? 683 00:37:08,264 --> 00:37:09,827 Not long. 684 00:37:09,832 --> 00:37:11,599 What's with the third degree? 685 00:37:13,102 --> 00:37:15,833 Dr. Pravesh, Jerome's doctor, 686 00:37:15,838 --> 00:37:18,275 is gonna be spending more time doing clinical trials, 687 00:37:18,280 --> 00:37:21,244 and we need somebody to fill his slot in the ER, so... 688 00:37:21,249 --> 00:37:23,980 He's having a hard time finding good people. 689 00:37:23,985 --> 00:37:25,719 You seem like good people. 690 00:37:26,355 --> 00:37:28,818 - Is that a job offer? - No. 691 00:37:28,823 --> 00:37:31,454 That's up to Dr. Voss, our CEO. 692 00:37:31,459 --> 00:37:34,462 But Pravesh already talked to her. 693 00:37:36,164 --> 00:37:38,432 She's making a few calls. She'd like to talk to you. 694 00:37:43,805 --> 00:37:45,406 Thanks. 695 00:37:51,646 --> 00:37:53,414 I don't remember much. 696 00:37:54,883 --> 00:37:56,746 I guess it got bad. 697 00:37:56,751 --> 00:37:58,948 It did. 698 00:37:58,953 --> 00:38:00,417 Don't go hiking in the woods again 699 00:38:00,422 --> 00:38:02,719 without buttoning up your shirt, tucking your pants 700 00:38:02,724 --> 00:38:04,454 into your socks, and wearing a hat, okay? 701 00:38:04,459 --> 00:38:06,222 Trust me, I won't. 702 00:38:06,227 --> 00:38:08,658 I might not ever leave my apartment again. 703 00:38:14,469 --> 00:38:17,504 I'll be back to check on you later, okay? 704 00:38:22,510 --> 00:38:24,407 How does it feel? 705 00:38:24,412 --> 00:38:26,947 Making a diagnosis no one else could make? 706 00:38:28,350 --> 00:38:30,147 Feels good. 707 00:38:30,152 --> 00:38:33,216 It was one of the good days. We live for these. 708 00:38:33,221 --> 00:38:35,290 You were the hero. 709 00:38:38,226 --> 00:38:40,061 And I'm proud of what you did. 710 00:38:43,031 --> 00:38:44,799 Thanks. 711 00:38:47,135 --> 00:38:48,965 We have to care about our patients, Trevor, 712 00:38:48,970 --> 00:38:51,334 but this could've gone the other way. 713 00:38:51,339 --> 00:38:53,303 If it had, 714 00:38:53,308 --> 00:38:55,276 it would not have been your fault. 715 00:39:05,086 --> 00:39:07,117 That was odd. 716 00:39:07,122 --> 00:39:08,418 What's that? 717 00:39:08,423 --> 00:39:10,925 She keeps on being nice to me. 718 00:39:13,962 --> 00:39:15,964 Possible she has a heart? 719 00:39:19,167 --> 00:39:22,499 She does have a heart, Trevor. 720 00:39:22,504 --> 00:39:24,371 Bigger than you know. 721 00:39:25,574 --> 00:39:27,672 Fever's still high, but he's starting to feel better. 722 00:39:27,677 --> 00:39:29,540 Hey, guys. 723 00:39:29,545 --> 00:39:31,274 Dr. Sullivan checks out. 724 00:39:31,279 --> 00:39:33,910 The folks at Atlanta General sang her praises. 725 00:39:33,915 --> 00:39:36,112 Though, she's only been there a few months. 726 00:39:36,117 --> 00:39:37,781 Well, where was she before that? 727 00:39:37,786 --> 00:39:40,683 An ER in Chicago, also briefly. 728 00:39:40,688 --> 00:39:43,053 Before that, there's a two-year gap in her record. 729 00:39:43,058 --> 00:39:45,422 Yeah, she said she spent some time in Haiti 730 00:39:45,427 --> 00:39:47,991 - doing earthquake relief. - She told me that as well. 731 00:39:47,996 --> 00:39:49,593 Well, how'd she do on her interview? 732 00:39:49,598 --> 00:39:51,327 We didn't talk for long, 733 00:39:51,332 --> 00:39:53,797 but she's obviously smart and capable. 734 00:39:53,802 --> 00:39:57,334 I could see her ICU leadership was top notch. 735 00:39:57,739 --> 00:39:59,235 But? 736 00:39:59,240 --> 00:40:01,338 She was a bit evasive, frankly. 737 00:40:01,343 --> 00:40:03,173 Like she was hiding something. 738 00:40:03,178 --> 00:40:05,775 Did you hire her temporarily? We need someone now. 739 00:40:05,780 --> 00:40:06,910 Yes, 740 00:40:06,915 --> 00:40:09,379 but if we're going to make her a permanent hire, 741 00:40:09,384 --> 00:40:11,448 I'll need more information, 742 00:40:11,453 --> 00:40:13,354 considerably more. 743 00:40:16,758 --> 00:40:18,121 That's odd. 744 00:40:18,126 --> 00:40:19,756 Eh, she wasn't real talkative 745 00:40:19,761 --> 00:40:21,324 about her past with me, either, 746 00:40:21,329 --> 00:40:23,827 but she's a hell of a doctor. I'd hate to lose her. 747 00:40:23,832 --> 00:40:26,630 Well, you'd be amazed at what a five-minute Internet search 748 00:40:26,635 --> 00:40:28,431 can dig up on a person. 749 00:40:28,436 --> 00:40:30,967 That's worth a look. 750 00:40:31,372 --> 00:40:33,903 So, one in two people 751 00:40:33,908 --> 00:40:36,906 leave their social media open to the public. 752 00:40:36,911 --> 00:40:37,911 Pay attention 753 00:40:37,916 --> 00:40:39,577 and you can find out somebody's favorite color 754 00:40:39,581 --> 00:40:40,977 and who they dated in high school. 755 00:40:40,982 --> 00:40:43,046 All right. 756 00:40:43,051 --> 00:40:44,681 Kincaid. 757 00:40:44,686 --> 00:40:46,049 Sullivan. 758 00:40:46,054 --> 00:40:49,285 M.D. Atlanta, Georgia. 759 00:40:49,290 --> 00:40:50,754 Huh. 760 00:40:50,759 --> 00:40:53,357 No Facebook. No Insta. 761 00:40:54,462 --> 00:40:57,694 Okay, um, I'll try broadening the search. 762 00:40:57,699 --> 00:41:01,268 I'll add her work history and education. 763 00:41:04,806 --> 00:41:06,669 No results. 764 00:41:06,674 --> 00:41:10,211 Try changing the spelling of her name. 765 00:41:11,479 --> 00:41:13,347 Add that she's an ER doc. 766 00:41:16,951 --> 00:41:19,048 Nothing. 767 00:41:19,053 --> 00:41:21,088 Not a single hit. 768 00:41:25,059 --> 00:41:27,423 That's weird. 769 00:41:27,428 --> 00:41:28,958 Given that she's not an 80-year-old 770 00:41:28,963 --> 00:41:30,860 with a flip phone, yeah. 771 00:41:30,865 --> 00:41:33,897 It's like someone scrubbed her entire Internet presence. 772 00:41:38,873 --> 00:41:41,371 Test results. 773 00:41:41,376 --> 00:41:43,673 Patient's been waiting for them all day. 774 00:41:43,678 --> 00:41:45,442 Go. 775 00:41:45,447 --> 00:41:47,277 I'll keep digging. 776 00:41:47,282 --> 00:41:50,213 Yeah, thanks. 777 00:41:50,218 --> 00:41:52,019 Yeah. 778 00:42:05,633 --> 00:42:08,402 I've got what we need now. 779 00:42:10,205 --> 00:42:12,439 I think I know what's going on. 780 00:42:16,878 --> 00:42:19,079 Let's sit down. 781 00:43:19,000 --> 00:43:23,000 - Synced and corrected by Firefly - - www.addic7ed.com -