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E. R.
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Previously on E. R.
3
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- And welcome back.
- How have you been?
4
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- Good.
5
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- I'm back in med school.
- Really?
6
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I know I'm supposed to feel
like I wanna carry a baby. But I don't.
7
00:00:16,029 --> 00:00:20,709
Once that baby's inside of you, it's-
I mean, it's incredible.
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- I mean, it's-
- Kerry, I don't want it.
9
00:00:22,265 --> 00:00:25,748
Abby, would you be interested
in studying together some time?
10
00:00:26,249 --> 00:00:29,929
- Sorry?
- I'm good at the academic stuff.
11
00:00:30,130 --> 00:00:33,565
But you're good with everything else.
Maybe we could help each other.
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00:00:34,831 --> 00:00:36,397
Okay.
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E. R. 10x12 "NICU"
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Four-day-old full-term male.
Mottled, lethargic, retractions.
15
00:00:43,539 --> 00:00:46,244
- NICU been called?
- They�re on the way. Pratt's intubating.
16
00:00:46,417 --> 00:00:49,916
- Suction. Tube's too big. Give me the 3-0.
- I'm Dr. Carter. What's his name?
17
00:00:50,087 --> 00:00:51,368
Jacob.
18
00:00:52,506 --> 00:00:54,214
It won't advance.
19
00:00:54,383 --> 00:00:56,376
Sats are good, try again.
20
00:00:56,552 --> 00:00:59,125
Anatomy's distorted. Here, go for it.
21
00:01:00,889 --> 00:01:03,012
- Just brought him home.
- He started gasping...
22
00:01:03,183 --> 00:01:05,057
...while I was feeding him.
23
00:01:12,359 --> 00:01:14,565
Okay, Pratt, bag him.
24
00:01:17,447 --> 00:01:20,116
- Equal breath sounds.
-200 of cefotax for presumed sepsis.
25
00:01:20,283 --> 00:01:23,070
- Where the hell is NICU?
- Is he gonna be okay?
26
00:01:23,328 --> 00:01:24,703
We�re taking care of him.
27
00:01:24,871 --> 00:01:27,907
Systolic murmur, weak femoral pulses,
distress while feeding.
28
00:01:28,166 --> 00:01:30,835
- What's your diagnosis?
- Ductal-dependent cardiac lesion.
29
00:01:31,002 --> 00:01:32,959
Matt Gillespie, R3, Pediatrics.
30
00:01:33,879 --> 00:01:37,414
Sam, PGE infusion
at. 05 mics, quickly.
31
00:01:38,050 --> 00:01:39,841
Oh, doing your NICU rotation, huh?
32
00:01:40,010 --> 00:01:42,252
Just when I was used to
my double life in the ER.
33
00:01:42,429 --> 00:01:43,840
What's happening?
34
00:01:44,014 --> 00:01:46,339
- We think Jacob has a heart problem.
- You think?
35
00:01:46,517 --> 00:01:48,924
ABG's back, metabolic acidosis,
minus 18.
36
00:01:49,102 --> 00:01:50,597
What does that mean?
37
00:01:50,771 --> 00:01:53,096
It means his body's
not getting enough oxygen...
38
00:01:53,273 --> 00:01:56,607
...but the breathing tube should help.
Sam, 10 of bicarb, 50 of saline.
39
00:01:56,776 --> 00:01:58,935
I only have two hands
and he only has one line.
40
00:01:59,738 --> 00:02:02,063
- Abby, bag him.
- Tell Cards to meet us in the NICU.
41
00:02:02,240 --> 00:02:04,696
- Start the Prostins on the way.
- We'll take it.
42
00:02:04,868 --> 00:02:06,944
- We don't need help.
- If he starts crashing...
43
00:02:07,120 --> 00:02:08,947
- ... you'll need extra hands.
- Push this.
44
00:02:09,122 --> 00:02:11,695
It can be difficult to diagnose
congenital heart disease.
45
00:02:11,874 --> 00:02:13,950
His doctor saw him yesterday.
She missed this?
46
00:02:14,127 --> 00:02:16,285
Sometimes symptoms
don't present right away.
47
00:02:16,462 --> 00:02:18,787
- How serious is this?
- We don't know yet.
48
00:02:18,965 --> 00:02:20,957
Cards will meet us just in case.
49
00:02:21,133 --> 00:02:23,375
- In case of what?
- Cardiology will talk to you.
50
00:02:23,552 --> 00:02:24,963
I want to know what's going on.
51
00:02:25,137 --> 00:02:27,972
- It's possible he may need a septostomy.
- What? A what?
52
00:02:28,140 --> 00:02:31,675
- Everybody off the elevator. Out!
- I can explain everything to you.
53
00:02:32,019 --> 00:02:34,307
- Mean's down to 34.
- He needs pressors.
54
00:02:34,479 --> 00:02:36,223
Aeration's good, sats are 93.
55
00:02:36,982 --> 00:02:39,817
He's in very good hands.
56
00:02:44,322 --> 00:02:46,992
Back off the FIO2.
We don't want to flood the lungs.
57
00:02:47,158 --> 00:02:49,115
He'll be okay
once he's got the Prostins.
58
00:02:49,285 --> 00:02:51,823
- When'd you two start your rotation?
- Five minutes ago.
59
00:02:51,996 --> 00:02:55,365
Well, the NICU's great: intubations,
chest tubes, umbilical lines.
60
00:02:55,541 --> 00:02:58,495
You'll get to do all sorts of teeny,
tiny, kick-ass procedures.
61
00:02:59,921 --> 00:03:01,747
Cards is waiting and Raab is pissed.
62
00:03:01,923 --> 00:03:03,381
You trying to give him a pneumo?
63
00:03:03,883 --> 00:03:05,543
- Good luck.
- You�re gonna love it.
64
00:03:05,718 --> 00:03:07,592
- Let's get out of here.
- I hate the NICU.
65
00:03:07,762 --> 00:03:09,172
Those guys are screwed.
66
00:04:00,521 --> 00:04:03,094
Humphrey Fowler,
ex-33-weeker, day of life: 58.
67
00:04:03,300 --> 00:04:07,936
Status: post-RDS, on vanco for MRSA,
day 19 of 21.
68
00:04:09,488 --> 00:04:11,730
- Who names their kid Humphrey?
- It's the last one.
69
00:04:11,907 --> 00:04:14,658
- Post-op, day 46 for CCAM repair.
- CCAM?
70
00:04:14,826 --> 00:04:16,866
Congenital cystic
adenomatoid malformation.
71
00:04:17,037 --> 00:04:19,610
Was on the oscillator,
weaning the map and amp.
72
00:04:19,789 --> 00:04:21,996
Born with one lung.
Other than that, he's great.
73
00:04:22,167 --> 00:04:25,370
- Okay.
- You didn't keep flow sheets, index cards?
74
00:04:25,545 --> 00:04:27,584
- It's all up in here.
- Tell me you�re joking.
75
00:04:27,755 --> 00:04:30,958
You don't need any paperwork for
this kid. Bad hypoxic encephalopathy.
76
00:04:31,134 --> 00:04:32,925
His brain's mush.
77
00:04:33,094 --> 00:04:35,715
But his vitals are good.
He can go on indefinitely.
78
00:04:35,888 --> 00:04:39,257
- Family won't withdraw support?
- Two months and about $2 million later...
79
00:04:39,433 --> 00:04:41,924
...Mom's still holding out
for a miracle.
80
00:04:43,896 --> 00:04:45,355
They�re here every day.
81
00:04:46,065 --> 00:04:49,184
He's a paperweight.
There's nothing to do.
82
00:04:49,818 --> 00:04:51,811
Come on, they�re waiting for us.
83
00:04:52,446 --> 00:04:54,273
Thank you so much for joining us.
84
00:04:54,448 --> 00:04:57,567
I'm Dr. Raab,
director of Neonatology.
85
00:04:57,743 --> 00:05:00,280
We round twice a day, 7 and 4.
You will come ready...
86
00:05:00,454 --> 00:05:03,704
...to present overnight data
and exams on your patients.
87
00:05:03,874 --> 00:05:07,325
Everyone scrubs for a full three minutes
before you enter the NICU.
88
00:05:07,502 --> 00:05:09,744
No jewelry on the hands,
spreads bacteria.
89
00:05:09,921 --> 00:05:12,756
- Not even my wedding band?
- No, and cut your fingernails.
90
00:05:12,924 --> 00:05:16,423
In 1993, two children
were abducted from this unit.
91
00:05:16,594 --> 00:05:18,752
Explains the little LoJacks
around their ankles.
92
00:05:18,930 --> 00:05:21,468
You will be issued a code for this door.
93
00:05:21,641 --> 00:05:24,926
- Do not give your code to anyone.
- I tattooed mine on my scrotum.
94
00:05:25,102 --> 00:05:26,680
No one will ever see it there.
95
00:05:26,854 --> 00:05:28,396
Dr. Gillespie, back already?
96
00:05:28,564 --> 00:05:30,224
Another month in the box.
97
00:05:30,399 --> 00:05:33,685
Your standup routine
might go over on other rotations...
98
00:05:33,861 --> 00:05:35,937
...but the NICU is a tough room.
99
00:05:36,113 --> 00:05:38,651
- Who do we have here?
- Lloyd Roberts, ex-38-weeker...
100
00:05:38,824 --> 00:05:40,900
- ... admitted for TTN and detox.
- What's TTN?
101
00:05:41,076 --> 00:05:42,784
Transient tachypnea of the newborn...
102
00:05:42,953 --> 00:05:45,444
...results from delayed clearance
of fetal lung fluid.
103
00:05:45,622 --> 00:05:48,457
Good. Continue, Kate.
104
00:05:48,792 --> 00:05:52,955
Born to 23-year-old G4P4 mom who used
meth and heroin during pregnancy.
105
00:05:53,338 --> 00:05:55,046
Do we need to keep our voices down?
106
00:05:55,215 --> 00:05:57,172
Confidentiality doesn't exist here.
107
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The quieter we talk,
the harder they listen.
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00:05:59,636 --> 00:06:02,471
- Kate, your plan?
- DC the O2, continue amp and gent...
109
00:06:02,639 --> 00:06:05,308
...advance the feeds, morphine taper.
110
00:06:05,475 --> 00:06:08,179
- Did you name him yet?
- Everyone, meet Virgie.
111
00:06:08,352 --> 00:06:11,852
Twenty-years-plus as a NICU nurse.
Her mission: to protect the babies...
112
00:06:12,023 --> 00:06:13,398
...from the likes of you.
113
00:06:13,566 --> 00:06:15,392
Haven't had a Thor in a while.
114
00:06:15,568 --> 00:06:18,355
We have a tradition of giving
the babies tough-guy nicknames.
115
00:06:18,529 --> 00:06:21,446
Hard to fight with a name like Lloyd.
116
00:06:22,991 --> 00:06:24,984
Latest gas on Jacob Kolber.
117
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Acidosis is worse.
118
00:06:26,954 --> 00:06:29,195
What was the final read on the echo?
119
00:06:29,373 --> 00:06:31,164
Come on, people, who picked him up?
120
00:06:31,333 --> 00:06:34,618
Lockhart, he's yours. Go.
Examine your patient.
121
00:06:34,795 --> 00:06:36,586
Cardiology confirmed a critical coarct.
122
00:06:36,755 --> 00:06:39,162
- Which is?
- A narrowing of the aorta...
123
00:06:39,341 --> 00:06:41,298
...usually at the ductus arteriosus.
124
00:06:41,468 --> 00:06:43,923
- And why do we care?
- Because blood can't get to...
125
00:06:44,095 --> 00:06:45,839
...the lower half of the body.
126
00:06:46,181 --> 00:06:47,805
Why is that bad?
127
00:06:48,516 --> 00:06:50,343
His legs need blood.
128
00:06:50,518 --> 00:06:53,969
If you don't know, don't guess.
Decreased perfusion means acidosis...
129
00:06:54,147 --> 00:06:55,605
...shock and heart failure.
130
00:06:55,773 --> 00:06:57,564
His means have been drifting down.
131
00:06:59,694 --> 00:07:02,647
Lungs are wet. I can barely
palpate the femorals.
132
00:07:03,405 --> 00:07:07,403
Ten of bicarb, start dopa at 12,
crank up the Prostins to 0. 1.
133
00:07:07,743 --> 00:07:10,697
- He needs the O. R.
- The cardiologist said to try medicine first.
134
00:07:10,871 --> 00:07:13,196
- Medicine isn't working.
- CT Surg said they'll...
135
00:07:13,373 --> 00:07:16,540
- ... get to him in the next 48 hours.
- This boy can't wait 48 hours.
136
00:07:16,710 --> 00:07:20,494
If not to the O. R., they can take him
to the cath lab for dilation and stenting.
137
00:07:20,672 --> 00:07:22,914
- Stenting?
- Another way to open a blockage.
138
00:07:23,091 --> 00:07:27,041
- Blocked? You said it was too narrow.
- So narrow, blood isn't getting through.
139
00:07:27,220 --> 00:07:31,846
Tom, send off LFTs and creatinine.
Check for end-organ damage.
140
00:07:32,225 --> 00:07:33,470
You got it.
141
00:07:33,643 --> 00:07:36,478
I want to talk to that
cardiologist again, all right?
142
00:07:36,646 --> 00:07:39,600
Mr. and Mrs. Kolber, Jacob is very sick...
143
00:07:39,774 --> 00:07:41,850
...but all this is really
a plumbing problem.
144
00:07:42,026 --> 00:07:43,983
Nothing that a CT surgeon can't fix.
145
00:07:44,153 --> 00:07:46,726
- Surgery will cure him?
- It should, yes.
146
00:07:48,407 --> 00:07:51,574
Dr. Lockhart, he needs a nickname.
147
00:07:52,578 --> 00:07:55,069
How about Jake? Sounds tough to me.
148
00:07:55,247 --> 00:07:58,746
Jacob to Jake. Very creative.
149
00:08:00,919 --> 00:08:02,912
Thin mec, Delivery Room 3.
150
00:08:05,424 --> 00:08:07,582
What are you waiting for? Go.
151
00:08:07,759 --> 00:08:11,923
Fifty cc saline bolus. Push it, Tom.
152
00:08:14,057 --> 00:08:18,185
Dr. Lockhart, what are you waiting for?
Go. You could learn something.
153
00:08:18,353 --> 00:08:20,179
I'd like to stay here, if that's okay.
154
00:08:20,355 --> 00:08:23,225
Covering deliveries
is part of your job. Go.
155
00:08:23,816 --> 00:08:26,188
Tom, we need another
i-STAT to see where we are.
156
00:08:26,360 --> 00:08:30,061
- Dr. Raab-
- And he needs a Foley and another PIV.
157
00:08:30,239 --> 00:08:32,113
I can do that. He's my patient.
158
00:08:35,494 --> 00:08:40,203
Get CT Surg on the phone and tell them
your patient needs the O. R. right now.
159
00:08:40,374 --> 00:08:41,405
Not in 48 hours...
160
00:08:41,583 --> 00:08:43,956
- ... not sometime today, now.
- I'll be right back.
161
00:08:44,128 --> 00:08:46,749
So when the DR phone rings
we drop everything and run?
162
00:08:46,922 --> 00:08:49,958
Yep, 24/7. It means some potentially
sick-ass baby's being born.
163
00:08:50,133 --> 00:08:54,261
- Kid ends up fine, but you never know.
- Can I do the intubation? If it's indicated.
164
00:08:54,429 --> 00:08:55,804
Oh, you like this stuff.
165
00:08:55,972 --> 00:08:58,380
- The technology's fascinating.
- What's wrong with us?
166
00:08:58,558 --> 00:09:01,512
We should be in the easy, lucrative
specialties: Derm, Radiology.
167
00:09:01,686 --> 00:09:04,640
Okay, little gunner, welcome to
your very first delivery.
168
00:09:07,317 --> 00:09:09,772
Matt, just in time.
Six weeks early, no prenatal care.
169
00:09:09,944 --> 00:09:11,937
- You have a boy.
- First get rid of the gunk.
170
00:09:12,113 --> 00:09:15,564
And dry him like crazy. Warms the
baby up and reminds him to breathe.
171
00:09:16,867 --> 00:09:19,655
- Good pulse but the cry's weak.
- It's all about ventilation.
172
00:09:19,829 --> 00:09:22,995
- Get them to breathe, the rest follows.
- Decel down to the 20s.
173
00:09:23,165 --> 00:09:25,241
- Got it. One more big push.
- Hand me the bag.
174
00:09:25,918 --> 00:09:28,124
- You can do better than that. Wake up.
- Matt.
175
00:09:28,295 --> 00:09:30,667
- Head's out, here we go.
- We were visiting my cousin.
176
00:09:30,839 --> 00:09:32,381
- Baby come too soon.
- Don't worry.
177
00:09:32,549 --> 00:09:34,174
Just needs help getting started.
178
00:09:34,343 --> 00:09:37,012
- Thirty-two-weekers usually do fine.
- Matt, it's twins.
179
00:09:37,179 --> 00:09:40,678
Dude, thanks for the heads-up. We would
have brought down a second team.
180
00:09:40,849 --> 00:09:43,138
Neela, second setup.
You know what to do.
181
00:09:43,310 --> 00:09:46,227
Okay, buddy, you just bought
yourself a tube.
182
00:09:46,396 --> 00:09:48,223
Call the NICU for backup.
183
00:09:49,315 --> 00:09:51,023
It's a girl.
184
00:09:51,693 --> 00:09:54,065
This baby's not breathing.
185
00:09:56,197 --> 00:10:00,374
A NICU admission is like running
a marathon without training.
186
00:10:00,443 --> 00:10:04,823
It's an endurance test for patients,
for families, and for you.
187
00:10:04,997 --> 00:10:08,331
Eat when you can, sleep when you can,
and when it's time to go home...
188
00:10:08,501 --> 00:10:10,826
...get the hell out of here.
189
00:10:11,170 --> 00:10:12,997
Let's round.
190
00:10:14,214 --> 00:10:18,544
Jiang Han's up to 1830 grams.
Room air, q. 3 feeds.
191
00:10:21,680 --> 00:10:25,464
Feeder and grower,
behaving himself nicely.
192
00:10:25,642 --> 00:10:27,184
Inga's ABG.
193
00:10:27,644 --> 00:10:29,553
Sister's a mess.
194
00:10:30,772 --> 00:10:32,266
Inga?
195
00:10:34,025 --> 00:10:36,184
- Inga?
- You had to come up with nicknames...
196
00:10:36,361 --> 00:10:38,188
...and you failed to. Dirk and Inga.
197
00:10:38,363 --> 00:10:41,150
I was going to call her Surinder.
It's Punjabi for "warrior. "
198
00:10:41,324 --> 00:10:43,696
- You're thinking too much.
- Inga doesn't sound tough.
199
00:10:43,868 --> 00:10:46,703
Neela, present your patient.
200
00:10:47,330 --> 00:10:48,788
Her pneumonia is worse.
201
00:10:48,956 --> 00:10:51,245
Acidotic. Ventilation's crap.
202
00:10:51,667 --> 00:10:53,375
Pa02 in the 40s all day.
203
00:10:53,544 --> 00:10:55,038
I think we should consider ECMO.
204
00:10:57,506 --> 00:10:58,835
Cardiopulmonary bypass?
205
00:11:00,092 --> 00:11:02,547
Isn't that incredibly dangerous
on a 2-kilo kid?
206
00:11:02,720 --> 00:11:06,088
We need to do something before the
prolonged hypoxia causes brain damage.
207
00:11:06,473 --> 00:11:09,676
- Who can tell me the risk of ECMO?
- Overwhelming infection.
208
00:11:09,851 --> 00:11:11,559
Could happen anyway, ECMO or not.
209
00:11:11,728 --> 00:11:14,397
- Head bleed.
- Parents could end up with a little potato.
210
00:11:14,564 --> 00:11:17,269
- We'll get daily head ultrasounds.
- Won't prevent a bleed...
211
00:11:17,442 --> 00:11:20,478
- ... just detect it after.
- She was well till she became bacteremic.
212
00:11:20,653 --> 00:11:23,061
It's risky, but ECMO
could get her through.
213
00:11:23,239 --> 00:11:25,564
She's not getting enough oxygen.
214
00:11:25,742 --> 00:11:28,233
- If we do nothing, she'll die.
- Are you sure?
215
00:11:28,411 --> 00:11:31,198
How can anyone be sure
about something like that?
216
00:11:32,623 --> 00:11:36,241
Neela, call the profusion team
to start ECMO. Rounds are over.
217
00:11:38,045 --> 00:11:39,539
Thanks.
218
00:11:40,089 --> 00:11:43,422
She already thinks I'm an idiot,
so there's really nothing to lose.
219
00:11:43,592 --> 00:11:46,048
I have your sign-out.
You should get out of here.
220
00:11:46,220 --> 00:11:48,296
I need to talk to Inga's
parents about ECMO.
221
00:11:48,472 --> 00:11:51,639
I'm gonna be here all night anyway.
Go. I'll talk to them.
222
00:11:51,809 --> 00:11:54,382
No. I'll do it.
223
00:11:54,686 --> 00:11:57,094
- Did you change Rocky's diaper?
- Yeah.
224
00:11:57,272 --> 00:11:59,763
- Why did you do that?
- Because it was dirty.
225
00:11:59,941 --> 00:12:02,859
My ins and outs are all off now.
226
00:12:03,320 --> 00:12:04,600
All right. I'm sorry.
227
00:12:04,779 --> 00:12:06,273
Not good enough. Go find it.
228
00:12:06,448 --> 00:12:08,939
- It's in the trash.
- Find it, weigh it, and I might...
229
00:12:09,117 --> 00:12:10,777
...let you get some sleep tonight.
230
00:12:14,455 --> 00:12:15,914
Mr. and Mrs. Tseng.
231
00:12:17,375 --> 00:12:20,292
Sorry. Do you have the results
back on the cardiac cath?
232
00:12:20,461 --> 00:12:23,415
Cards will talk to you as soon
as they have an official report.
233
00:12:23,589 --> 00:12:26,080
I've been waiting.
I'll take an unofficial report.
234
00:12:26,258 --> 00:12:28,050
I'll ask Abby if she's heard.
235
00:12:28,219 --> 00:12:30,626
- I need to talk to you.
- Waiting's driving me crazy.
236
00:12:30,804 --> 00:12:32,215
The waiting is hard.
237
00:12:32,389 --> 00:12:35,307
You know how long it takes
to recover from something like this?
238
00:12:35,476 --> 00:12:37,433
- A rough estimate?
- It's too soon to say.
239
00:12:37,603 --> 00:12:39,429
Would you two come with me?
240
00:12:41,273 --> 00:12:43,064
How long you been here?
241
00:12:43,525 --> 00:12:46,810
Eight days. We were visiting from
Suzhou in China when the babies come.
242
00:12:47,404 --> 00:12:48,649
Are they doing okay?
243
00:12:49,030 --> 00:12:51,817
- Our son is very strong.
- Mr. Tseng?
244
00:13:00,458 --> 00:13:03,578
ECMO stands for Extracorporeal
Membrane Oxygenation.
245
00:13:03,753 --> 00:13:06,670
- Ready for circuit.
- The machine puts oxygen in the blood...
246
00:13:06,839 --> 00:13:08,879
...and sends it back to Inga's body.
247
00:13:09,550 --> 00:13:12,919
- It does the work of her heart and lungs.
- Let's go. I'm clamped on high.
248
00:13:13,095 --> 00:13:15,669
I know it looks scary,
but it's her best chance.
249
00:13:15,848 --> 00:13:18,303
- Chance of what?
- A good outcome.
250
00:13:18,726 --> 00:13:20,434
She be healthy?
251
00:13:20,602 --> 00:13:22,476
- I hope so.
- Chow time for Dirk.
252
00:13:22,646 --> 00:13:24,473
One of you want to feed him?
253
00:13:24,857 --> 00:13:27,561
- I go.
- I've got control down low.
254
00:13:27,734 --> 00:13:31,103
- Releasing arterial.
- Releasing venous.
255
00:13:31,279 --> 00:13:33,237
Clamping bridge.
256
00:13:33,406 --> 00:13:36,526
ECMO on, 20-25.
257
00:13:37,535 --> 00:13:40,702
It'll be a while before we know
how she's going to respond.
258
00:13:40,872 --> 00:13:42,580
I'll let you know.
259
00:13:51,090 --> 00:13:55,218
If she was born in China,
she'd already be dead.
260
00:13:55,761 --> 00:13:57,837
You don't know that.
261
00:13:58,389 --> 00:14:00,595
My husband and I are lucky.
262
00:14:00,766 --> 00:14:03,886
We went to school,
we have jobs as teachers.
263
00:14:05,396 --> 00:14:07,554
But it's not like here.
264
00:14:07,981 --> 00:14:10,935
We wanted our daughter
to be born in America...
265
00:14:11,109 --> 00:14:13,482
...so she'd have more options.
266
00:14:14,112 --> 00:14:16,520
And she already does.
267
00:14:19,075 --> 00:14:21,745
We don't have hospitals like this.
268
00:14:23,079 --> 00:14:25,914
It wasn't an accident, then.
You meant to deliver here.
269
00:14:28,543 --> 00:14:31,710
We sold everything
to come stay with my aunt...
270
00:14:31,880 --> 00:14:34,370
...have the babies in Chicago.
271
00:14:34,549 --> 00:14:37,253
You're just going to start over,
with nothing?
272
00:14:39,554 --> 00:14:41,676
Her life will be better.
273
00:14:43,724 --> 00:14:47,058
Isn't that why your parents
sent you to this country too?
274
00:14:53,692 --> 00:14:57,227
- Tom, can you help me out?
- Not now. Gotta hang vanco.
275
00:14:58,280 --> 00:15:01,649
Transducers, art lines, no butterflies.
276
00:15:01,825 --> 00:15:04,826
They're in the cabinet
by the sinks on the left.
277
00:15:05,787 --> 00:15:07,281
Been here for nine weeks.
278
00:15:08,248 --> 00:15:09,742
Thanks.
279
00:15:12,460 --> 00:15:14,785
- Hi.
- Hi.
280
00:15:14,963 --> 00:15:17,086
Just came to check on Jacob.
281
00:15:17,257 --> 00:15:18,964
He looks great.
282
00:15:19,133 --> 00:15:21,885
His suck is still weak,
but Abby tells me to keep trying.
283
00:15:22,053 --> 00:15:23,844
- He'll get there.
- You keep trying.
284
00:15:24,013 --> 00:15:28,011
It says here that he may need surgery
again in a few years. Is that true?
285
00:15:28,184 --> 00:15:30,426
That sounds like a question
for Cardiology.
286
00:15:30,603 --> 00:15:34,552
Occasionally the area where the aorta
was repaired gets blocked from scarring...
287
00:15:34,732 --> 00:15:37,768
...but usually they can take care of it
and avoid another surgery.
288
00:15:37,943 --> 00:15:39,603
That's good to know. Thanks, Abby.
289
00:15:41,905 --> 00:15:44,823
I better get back to work.
But I'll be by later.
290
00:15:46,451 --> 00:15:48,989
It was nice to see you, Mrs. Kolber.
291
00:15:51,206 --> 00:15:53,495
Looks like you're doing well here.
292
00:15:54,000 --> 00:15:57,998
- Right.
- Abby, take a look at the CO2.
293
00:15:58,171 --> 00:16:01,754
- Back off on the rate, check it in an hour.
- You got it.
294
00:16:03,968 --> 00:16:06,755
Parents love you. Nurses wouldn't
give you the time of day...
295
00:16:06,929 --> 00:16:09,681
- ... unless you knew what you were doing.
- Yeah?
296
00:16:09,849 --> 00:16:12,684
Tell that to my Attending.
You should see me on rounds.
297
00:16:14,937 --> 00:16:18,851
So Kem and I had our first official tour
of the labor and delivery suites today.
298
00:16:19,525 --> 00:16:21,731
How can you call one room a suite?
299
00:16:22,403 --> 00:16:24,395
They're counting the bathroom.
300
00:16:29,201 --> 00:16:31,739
- You're gonna be a dad.
- Yeah.
301
00:16:33,705 --> 00:16:36,540
- How's it feel?
- Scary.
302
00:16:38,585 --> 00:16:40,542
Especially in this room.
303
00:16:41,379 --> 00:16:44,131
I start thinking about all the things
that can go wrong...
304
00:16:44,299 --> 00:16:46,375
...all the mistakes you can make.
305
00:16:48,261 --> 00:16:49,839
You're gonna be a great father.
306
00:16:50,638 --> 00:16:53,176
Full-term forceps in 2.
307
00:16:54,559 --> 00:16:56,101
That's my cue.
308
00:16:57,603 --> 00:16:59,263
Hey, Abby.
309
00:17:00,731 --> 00:17:02,688
You're gonna be a great doctor.
310
00:17:05,903 --> 00:17:07,730
Okay. Let's go. Baby time.
311
00:17:07,905 --> 00:17:10,526
Can't. Got a finger in this
kid's pleural cavity. You go.
312
00:17:10,699 --> 00:17:13,985
- Alone? Is that even legal?
- I'm right behind you.
313
00:17:14,161 --> 00:17:16,569
- Get set up, I'll meet you there.
- I'll go with you.
314
00:17:16,747 --> 00:17:20,412
- Are you kidding? You have to go home.
- You can't go to a delivery on your own.
315
00:17:20,584 --> 00:17:25,744
I dream about blood sugars, TPN orders,
gent doses, boxed kidneys.
316
00:17:25,922 --> 00:17:28,211
Get used to it if you're
going into neonatology.
317
00:17:28,383 --> 00:17:29,961
I haven't slept well for days.
318
00:17:30,135 --> 00:17:34,298
You know, all this whining about how
tired you are, but you never leave.
319
00:17:34,472 --> 00:17:37,971
I hate to break it to you, but we'll
make it through this night without you.
320
00:17:38,142 --> 00:17:39,767
Just trying to help.
321
00:17:43,022 --> 00:17:44,267
NICU's here.
322
00:17:44,440 --> 00:17:47,774
Thirty-five-weeker, maternal diabetes,
failure to progress.
323
00:17:47,944 --> 00:17:49,901
I thought this was just
a forceps delivery.
324
00:17:50,071 --> 00:17:52,608
- That too.
- Here comes a contraction, Sarah.
325
00:17:53,073 --> 00:17:55,232
That's it, baby. Big push.
We're almost there.
326
00:17:55,409 --> 00:17:56,572
What do you mean "we"?
327
00:17:56,744 --> 00:17:58,950
Hi, I'm Abby from the NICU team.
328
00:17:59,121 --> 00:18:01,790
- Something wrong?
- We're called for forceps deliveries.
329
00:18:01,957 --> 00:18:04,495
- It's standard procedure.
- Baby's heart rate's dropping.
330
00:18:04,668 --> 00:18:06,292
Let's go. Baby's getting tired!
331
00:18:06,461 --> 00:18:08,537
She's not the only one.
332
00:18:09,256 --> 00:18:11,295
Nuchal cord. Bad decel, 54.
333
00:18:11,466 --> 00:18:13,293
Okay, Sarah, one more.
334
00:18:13,802 --> 00:18:15,082
That's it.
335
00:18:15,470 --> 00:18:17,012
Here she comes.
336
00:18:17,847 --> 00:18:19,804
Okay, Sarah, one more.
337
00:18:19,974 --> 00:18:22,133
That's it.
338
00:18:22,310 --> 00:18:23,934
Here she comes.
339
00:18:24,145 --> 00:18:26,636
A girl? It's a girl?
340
00:18:26,814 --> 00:18:28,273
It's a girl!
341
00:18:28,441 --> 00:18:31,062
- It's a girl!
- Good work, baby.
342
00:18:31,235 --> 00:18:32,777
Good work.
343
00:18:33,279 --> 00:18:36,482
Poor tone. Check the heart rate.
344
00:18:37,199 --> 00:18:40,153
- I can't feel it.
- Well, listen, then. Shallow resps.
345
00:18:40,327 --> 00:18:41,987
How is she? How's my girl?
346
00:18:42,162 --> 00:18:44,120
Come on, baby. Wake up.
347
00:18:44,707 --> 00:18:46,331
Wake up.
348
00:18:46,500 --> 00:18:47,994
Hold on, I'm gonna get a picture.
349
00:18:48,168 --> 00:18:49,995
- Neela, what's the pulse?
- I'm counting.
350
00:18:50,170 --> 00:18:52,127
It's not that hard. Tap it out.
351
00:18:54,007 --> 00:18:55,383
Where the hell is Matt?
352
00:18:55,550 --> 00:18:57,093
Oh, look at all that hair.
353
00:18:57,260 --> 00:18:59,549
I'm sorry, I'm going to need
some room, okay?
354
00:18:59,721 --> 00:19:01,299
Okay.
355
00:19:04,934 --> 00:19:06,393
She's okay.
356
00:19:06,561 --> 00:19:08,969
You hear that baby?
She got some lungs.
357
00:19:09,147 --> 00:19:11,389
- Everything cool?
- Yeah.
358
00:19:11,566 --> 00:19:14,235
She's gonna have to come upstairs
to monitor her sugars...
359
00:19:14,402 --> 00:19:17,154
...but, yeah, she looks good.
360
00:19:18,030 --> 00:19:21,031
- Congratulations.
- Thank you. Thank you.
361
00:19:22,159 --> 00:19:25,113
Girl, you look just like your daddy.
Except three shades lighter.
362
00:19:25,287 --> 00:19:28,490
Babies are supposed to be light
when they're born, I told you.
363
00:19:29,500 --> 00:19:31,658
Don't listen to your daddy, Daphne.
364
00:19:31,835 --> 00:19:33,246
You're perfect.
365
00:19:36,381 --> 00:19:37,924
It's Matt.
366
00:19:38,675 --> 00:19:40,253
He's a little late.
367
00:19:40,802 --> 00:19:42,629
It's Inga.
368
00:19:46,850 --> 00:19:49,601
- What happened?
- Hypertensive. Crit bottomed out.
369
00:19:49,769 --> 00:19:52,058
- Ultrasound shows huge brain bleed.
- Are you sure?
370
00:19:52,230 --> 00:19:54,436
Yeah, like we said,
it's always a risk with ECMO.
371
00:19:54,607 --> 00:19:56,399
- She's got to come off.
- She'll die.
372
00:19:56,568 --> 00:19:58,726
We can't leave her on,
the bleed will get worse.
373
00:19:58,903 --> 00:20:02,568
- Hey, Matt, they need you in L&D.
- There's a C-section. I gotta go.
374
00:20:02,740 --> 00:20:05,943
Order 20 per kilo of packed cells.
I'll be back soon.
375
00:20:06,369 --> 00:20:08,077
Surgery's on their way
to decannulate.
376
00:20:08,245 --> 00:20:10,736
- I talked everyone into this.
- Nobody, not even you...
377
00:20:10,915 --> 00:20:14,248
...could talk Raab into ECMO
if she didn't think it was the right thing.
378
00:20:14,752 --> 00:20:16,294
She's seizing. 0.5 of Ativan.
379
00:20:16,462 --> 00:20:18,039
I can't take a verbal from a student.
380
00:20:18,213 --> 00:20:19,873
Raab's gone, Matt's in a delivery.
381
00:20:20,049 --> 00:20:22,255
- I could lose my job.
- She's seizing.
382
00:20:22,426 --> 00:20:25,759
That's the least of her worries.
Let's see what Matt says.
383
00:20:25,929 --> 00:20:28,847
- Versed will do the same.
- You can't without a cosigned order.
384
00:20:29,016 --> 00:20:30,925
- Watch me.
- I'm telling Dr. Raab.
385
00:20:31,101 --> 00:20:32,381
You do that.
386
00:20:32,561 --> 00:20:34,933
- She'll kick you guys off the rotation.
- Kick me off.
387
00:20:35,105 --> 00:20:38,604
- Neela has nothing to do with it.
- What am I going to tell her parents?
388
00:20:41,069 --> 00:20:42,729
Versed's in.
389
00:20:44,781 --> 00:20:46,654
- Go home.
- "Mr. and Mrs. Tseng, I'm sorry.
390
00:20:46,824 --> 00:20:50,158
- I screwed up. Inga's brain is toast. "
- Stop it. You didn't do this.
391
00:20:50,328 --> 00:20:52,569
- I've gotta call them.
- Just go. Raab will do it.
392
00:20:52,747 --> 00:20:55,119
- They should hear it from me.
- You're a med student.
393
00:20:55,291 --> 00:20:57,248
The Attending can handle it. Just go.
394
00:21:03,799 --> 00:21:05,507
Good night, Neela.
395
00:21:18,605 --> 00:21:21,440
Excuse me, can someone
get the door, please?
396
00:21:21,608 --> 00:21:23,482
Hello? Anyone?
397
00:21:27,238 --> 00:21:29,231
Get me the hell out of here!
398
00:21:36,914 --> 00:21:39,785
Oxygen is perfect the whole time.
When can we take Dirk home?
399
00:21:39,959 --> 00:21:43,624
- As soon as Dr. Raab writes her a note.
- Thank you, Neela.
400
00:21:44,547 --> 00:21:47,334
Inga's not breathing over
her ventilator at all.
401
00:21:47,508 --> 00:21:49,216
That's not a good sign, is it?
402
00:21:49,385 --> 00:21:53,133
It'll take time before we know how much
neurological function she'll get back...
403
00:21:53,305 --> 00:21:54,965
...but her lungs are much better.
404
00:21:55,140 --> 00:21:57,014
- She's a strong girl.
- Yes, she is.
405
00:21:57,184 --> 00:22:00,138
- I'm waiting for Dirk's discharge summary.
- I'll get on that.
406
00:22:00,312 --> 00:22:04,606
Cher's a lovely name,
it's just how you spelled it.
407
00:22:04,816 --> 00:22:06,809
I just wanted it to be different.
408
00:22:08,194 --> 00:22:11,279
Okay. As long as you're aware.
409
00:22:12,157 --> 00:22:13,651
Poor Chair, she's doomed.
410
00:22:13,825 --> 00:22:15,901
Hopefully she'll meet a
nice Ottoman someday.
411
00:22:16,077 --> 00:22:17,986
Heard any funny
dead-baby stories lately?
412
00:22:18,162 --> 00:22:20,997
Here's a good one:
Inga's hydrocephalus is worsening.
413
00:22:21,165 --> 00:22:23,490
EEG shows continued seizure activity.
414
00:22:23,668 --> 00:22:27,500
She's not dead, but she might
never wake up. It's a real laugh.
415
00:22:29,215 --> 00:22:31,006
Bad day, Neela?
416
00:22:31,675 --> 00:22:35,969
Millions of dollars keeping these babies
alive. Half die anyway. Why bother?
417
00:22:36,847 --> 00:22:38,341
Time for rounds.
418
00:22:39,516 --> 00:22:44,344
Forty years ago, Inga was considered
a micro-preemie, borderline viable.
419
00:22:44,521 --> 00:22:47,190
In many parts of the world,
that's still the case.
420
00:22:47,357 --> 00:22:52,696
We saved her so she can endure a lifetime
of seizures, lung disease, cerebral palsy.
421
00:22:52,863 --> 00:22:57,524
We gave Inga a chance. Her brother's
going home today, a normal kid.
422
00:22:57,701 --> 00:23:00,867
But Inga's here now, gorked out
in a level-three nursery.
423
00:23:01,037 --> 00:23:02,579
Look, we do our best.
424
00:23:02,747 --> 00:23:08,334
Some kids will end up hospitalized
for life, and some will go to the prom.
425
00:23:08,503 --> 00:23:10,958
Neela, there are no guarantees
in this work.
426
00:23:11,130 --> 00:23:14,581
If you can't live with that,
I suggest you become a bank teller.
427
00:23:14,759 --> 00:23:16,502
We'll pick up again when I get back.
428
00:23:17,094 --> 00:23:21,756
Don't listen. My cousin's a bank teller.
Got held up at gunpoint last year.
429
00:23:25,394 --> 00:23:28,395
Still here? I discharged
Daphne an hour ago.
430
00:23:28,564 --> 00:23:30,889
I'm just waiting for
the nurse to take out that IV.
431
00:23:31,066 --> 00:23:33,735
- I can do it.
- You're letting a student touch your IV?
432
00:23:33,902 --> 00:23:35,361
That's brave.
433
00:23:36,196 --> 00:23:38,734
She's territorial. They teach that
in nursing school.
434
00:23:38,907 --> 00:23:42,821
Abby, we need you over here.
435
00:23:43,161 --> 00:23:45,913
- Just keep some pressure there.
- Okay.
436
00:23:46,206 --> 00:23:47,748
Come on, come on.
437
00:23:47,916 --> 00:23:51,616
- She's gonna miss you guys.
- No, she won't. She'll be home.
438
00:23:51,794 --> 00:23:54,748
He's been tachypneic, sats dropping.
He's tiring out.
439
00:23:54,922 --> 00:23:57,592
- Put him back on O2?
- He's going to need more than that.
440
00:23:58,467 --> 00:24:01,089
- Diastolic is in the teens.
- Widening pulse pressure.
441
00:24:01,262 --> 00:24:05,094
Okay, 50 cc's of saline cultures,
start him on amp and cefotax.
442
00:24:05,266 --> 00:24:06,594
What's happening, Abby?
443
00:24:07,142 --> 00:24:10,392
- He's apneic. Pulse down to 105.
- Bag him.
444
00:24:10,562 --> 00:24:13,433
- Five As and Bs in the last hour.
- Did anybody page Raab?
445
00:24:13,607 --> 00:24:16,561
-911.
- Okay, Mrs. Kolber- Kyle?
446
00:24:16,735 --> 00:24:20,483
Jacob's having trouble breathing
likely due to blood infection.
447
00:24:20,656 --> 00:24:23,229
- From what?
- We sent out cultures.
448
00:24:23,408 --> 00:24:25,401
- He was okay.
- Sepsis can come on quickly.
449
00:24:25,577 --> 00:24:28,910
We're starting antibiotics, but we
have to put the breathing tube back.
450
00:24:29,080 --> 00:24:32,948
- We were talking about going home.
- He's tough. He'll get through this.
451
00:24:33,501 --> 00:24:35,957
Get together. Photo for the wall.
452
00:24:36,337 --> 00:24:37,713
Smile.
453
00:24:38,673 --> 00:24:40,297
Fentanyl's in.
454
00:24:41,300 --> 00:24:43,044
Go ahead, Abby.
455
00:24:48,891 --> 00:24:50,171
One more with Dr. Neela.
456
00:24:50,351 --> 00:24:52,343
- Oh, it's okay.
- We insist.
457
00:24:54,772 --> 00:24:57,642
- Suction.
- Take your time.
458
00:24:57,816 --> 00:24:59,856
- Heart rate's good.
- Smile.
459
00:25:08,118 --> 00:25:10,324
I see the cords. Tube.
460
00:25:10,829 --> 00:25:12,109
Goodbye, Jiang Han.
461
00:25:12,289 --> 00:25:15,159
Ready to see the outside world?
462
00:25:15,625 --> 00:25:19,837
We're going to keep calling him Dirk
since the name has bring him luck.
463
00:25:20,672 --> 00:25:22,380
Thank you, Dr. Neela.
464
00:25:23,716 --> 00:25:24,997
Mei Fan.
465
00:25:42,151 --> 00:25:43,561
Mei Fan?
466
00:25:52,995 --> 00:25:54,952
I want you to have this.
467
00:25:55,122 --> 00:25:57,695
- Thanks.
- It's strange to be going.
468
00:25:58,416 --> 00:26:01,370
Lots of parents are nervous when
their babies are discharged.
469
00:26:02,128 --> 00:26:05,462
It'll be great. You'll love
having him home.
470
00:26:06,716 --> 00:26:08,376
I know you're right.
471
00:26:08,551 --> 00:26:10,045
Bye, Neela.
472
00:26:10,219 --> 00:26:12,212
See you tomorrow.
473
00:26:23,733 --> 00:26:27,018
- What are my vent settings?
-24 over eight. We'll adjust from there.
474
00:26:27,194 --> 00:26:30,278
Order a Versed drip and a chest film.
475
00:26:30,447 --> 00:26:32,072
You wanna call the tech?
476
00:26:32,241 --> 00:26:36,570
Okay, nothing to do now but wait
for the antibiotics to kick in.
477
00:26:37,329 --> 00:26:40,413
I don't know if I can take
another round of this.
478
00:26:47,672 --> 00:26:49,166
Sit.
479
00:26:59,934 --> 00:27:02,259
One of those better be for me.
480
00:27:02,520 --> 00:27:05,225
I just needed to get outside for a minute.
481
00:27:05,398 --> 00:27:09,146
The NICU's so confining,
claustrophobic.
482
00:27:09,318 --> 00:27:12,105
There's a reason why Matt
calls it the "the box. "
483
00:27:12,279 --> 00:27:15,779
- Raab's right, you know.
- Did you eat anything?
484
00:27:16,659 --> 00:27:19,944
I like science, complete answers,
a plan for everything.
485
00:27:20,120 --> 00:27:22,872
I can't deal with uncertainty.
486
00:27:23,373 --> 00:27:24,618
It gets easier.
487
00:27:24,791 --> 00:27:27,282
I planned neonatology since
I started medical school.
488
00:27:27,461 --> 00:27:29,334
I'm supposed to be loving this.
489
00:27:29,504 --> 00:27:34,083
Well, the whole purpose of rotation
is to try on different specialties.
490
00:27:34,259 --> 00:27:37,129
- I mean, it's okay if you don't-
- I had a baby brother.
491
00:27:37,303 --> 00:27:39,973
He died when he was 6 days old.
492
00:27:40,807 --> 00:27:42,349
I was only 3.
493
00:27:45,812 --> 00:27:49,940
I remember sitting in my mom's
hospital room eating ice cream.
494
00:27:50,399 --> 00:27:51,977
But I don't actually remember him.
495
00:27:55,321 --> 00:27:58,322
The NICU's just so sad all the time.
How can you stand it?
496
00:28:00,534 --> 00:28:02,443
I don't know.
497
00:28:03,120 --> 00:28:05,445
When I was an OB nurse,
preemies freaked me out.
498
00:28:05,622 --> 00:28:08,826
I thought they looked like frogs. I was
pretty sure I was gonna hate the NICU.
499
00:28:09,168 --> 00:28:10,496
But you don't.
500
00:28:12,963 --> 00:28:14,671
No, I don't.
501
00:28:18,677 --> 00:28:20,171
It's not just about the babies.
502
00:28:20,345 --> 00:28:23,132
You know, so much of it is
about taking care of the parents.
503
00:28:24,599 --> 00:28:29,261
And it turns out tragic family dynamics
are my specialty.
504
00:28:30,271 --> 00:28:33,438
It's Matt. There's a delivery.
505
00:28:33,608 --> 00:28:36,811
Full-term, mom's febrile,
PPROM, suspected chorio.
506
00:28:36,986 --> 00:28:39,987
- Good work, Sandy.
- Oh, my God.
507
00:28:40,156 --> 00:28:42,694
We're almost there.
Honey, we're almost there.
508
00:28:43,409 --> 00:28:46,860
The little boy is officially here.
509
00:28:49,164 --> 00:28:51,869
- You did it.
- We have a baby.
510
00:28:52,042 --> 00:28:55,874
Amniotic fluid's clouding.
Kid's had late variables.
511
00:28:59,966 --> 00:29:01,626
Abby?
512
00:29:03,053 --> 00:29:06,137
- Wait, you're bagging him?
- You need to wait over there.
513
00:29:06,348 --> 00:29:07,890
No, that's my son. I'm a doctor.
514
00:29:08,058 --> 00:29:10,383
- It's okay, Matt. It's okay.
- Honey, what's wrong?
515
00:29:10,560 --> 00:29:12,718
Just a little blow-by.
Let them work.
516
00:29:13,146 --> 00:29:14,937
What's wrong?
517
00:29:18,651 --> 00:29:20,193
He's too quiet.
518
00:29:20,361 --> 00:29:21,606
Give him a minute.
519
00:29:23,364 --> 00:29:25,440
Good chest excursion.
520
00:29:26,617 --> 00:29:29,737
Thank you very much.
That's what we like to hear.
521
00:29:29,912 --> 00:29:32,320
Congratulations, Mom.
522
00:29:33,249 --> 00:29:34,791
And Mom.
523
00:29:37,544 --> 00:29:39,418
He's beautiful.
524
00:29:39,713 --> 00:29:42,797
- Is he really all right?
- He'll go upstairs for antibiotics...
525
00:29:42,966 --> 00:29:46,465
...because of the chorio.
But right now, he looks great.
526
00:29:47,471 --> 00:29:48,929
I love you.
527
00:29:55,103 --> 00:29:56,431
I had no idea.
528
00:29:57,272 --> 00:29:59,311
Nobody did.
529
00:29:59,482 --> 00:30:01,605
Would you like to cut
the cord, Dr. Weaver?
530
00:30:14,789 --> 00:30:16,947
Hello, Henry.
531
00:30:51,324 --> 00:30:53,316
Hey.
532
00:30:53,493 --> 00:30:55,284
- Your usual.
- Thank you.
533
00:30:55,453 --> 00:30:57,113
Bad night?
534
00:30:58,122 --> 00:31:01,657
Jake is maxed out on dopa and epi,
third-spacing like mad.
535
00:31:01,834 --> 00:31:04,372
In the past two hours, his belly
blew up in front of our eyes.
536
00:31:04,545 --> 00:31:06,870
I think it's NEC. Surgery's on their way.
537
00:31:07,006 --> 00:31:09,164
God. His parents here?
538
00:31:09,341 --> 00:31:12,627
No, they're on their way.
I finally convinced them to go home...
539
00:31:12,803 --> 00:31:14,712
...and then I had to call them back.
540
00:31:14,888 --> 00:31:17,177
- Any word from Inga's parents?
- No.
541
00:31:17,349 --> 00:31:19,804
Three days and not a single phone call.
542
00:31:19,976 --> 00:31:22,930
KUB on Jake Kolber. Free air under
the diaphragm and pneumatosis.
543
00:31:23,104 --> 00:31:25,014
Oh, damn it. He's perfed.
544
00:31:25,190 --> 00:31:28,523
Pedes surgery's gonna meet us
in the O. R. Come on, let's go.
545
00:31:30,153 --> 00:31:34,233
- Can we wait for his parents to see him?
- His bowel's dying, there isn't time.
546
00:31:34,407 --> 00:31:38,357
We need to save the viable tissue
before there's nothing left to save.
547
00:31:39,287 --> 00:31:40,567
He's thrombocytopenic.
548
00:31:40,747 --> 00:31:44,115
Platelets and FFP are on hold in the O. R.
549
00:31:44,375 --> 00:31:47,210
- Abby, where are you going?
- To surgery.
550
00:31:47,378 --> 00:31:51,672
His intestines were injured and they
need to cut out the injured part.
551
00:31:51,841 --> 00:31:55,921
I'm Dr. Corday. The injury's compromised
your son's already tenuous condition.
552
00:31:56,095 --> 00:31:58,171
The sooner we get him
to the O. R., the better.
553
00:31:58,347 --> 00:31:59,627
Okay.
554
00:31:59,807 --> 00:32:04,053
Hey. Would you like to see
your little brother up close?
555
00:32:05,228 --> 00:32:06,604
Abby.
556
00:32:06,772 --> 00:32:09,013
Kids aren't allowed in NICU.
Just five seconds.
557
00:32:12,819 --> 00:32:14,361
There he is.
558
00:32:17,824 --> 00:32:20,066
- Can he hear me?
- Yes, he can.
559
00:32:24,914 --> 00:32:26,871
It's okay. You won't hurt him.
560
00:32:31,921 --> 00:32:35,420
I'm Miranda, your big sister.
561
00:32:41,263 --> 00:32:42,757
Come on, honey.
562
00:32:50,480 --> 00:32:52,888
- Thank you, Abby.
- Thank you.
563
00:33:13,211 --> 00:33:14,871
Good morning.
564
00:33:15,046 --> 00:33:16,789
Morning.
565
00:33:18,215 --> 00:33:20,291
Where is your prayer group?
566
00:33:20,760 --> 00:33:22,633
I told them not to come.
567
00:33:27,808 --> 00:33:29,682
I think he's getting a diaper rash.
568
00:33:31,478 --> 00:33:33,352
I'll order some nystatin.
569
00:33:42,322 --> 00:33:44,528
He's 3 months old today.
570
00:33:45,909 --> 00:33:47,985
You should go home.
571
00:33:54,292 --> 00:33:56,450
I thought that...
572
00:33:57,920 --> 00:34:00,411
...if I prayed hard enough...
573
00:34:01,966 --> 00:34:03,959
...if I showed God
how much I believed...
574
00:34:04,135 --> 00:34:06,092
You must be exhausted.
575
00:34:11,559 --> 00:34:14,310
I don't want him to suffer anymore.
576
00:34:18,899 --> 00:34:21,900
My patient has been bumped three times
for so-called emergencies.
577
00:34:22,069 --> 00:34:25,105
Been waiting over 24 hours
for ORIF, happened again.
578
00:34:25,322 --> 00:34:28,857
- Came up to see what's so important.
- Jake Kolber.
579
00:34:30,410 --> 00:34:33,577
It's the congenital-heart-disease baby
you guys admitted to us.
580
00:34:33,747 --> 00:34:35,407
Do you remember?
581
00:34:36,499 --> 00:34:37,875
No.
582
00:34:38,042 --> 00:34:40,913
Circumferential necrosis
to the jejunum.
583
00:34:41,087 --> 00:34:44,835
- There's really nothing viable here.
- Damn.
584
00:34:46,592 --> 00:34:49,130
Abby? The bowel's completely infarcted.
585
00:34:49,929 --> 00:34:52,052
I'm sorry. We're closing.
586
00:35:02,858 --> 00:35:04,352
So that's it.
587
00:35:06,445 --> 00:35:08,900
Can't live without a gut.
588
00:35:11,700 --> 00:35:13,491
I'm sorry.
589
00:35:21,167 --> 00:35:23,575
- Where you going?
- I'm gonna go tell the family.
590
00:35:23,753 --> 00:35:26,754
Give yourself a minute. They don't
need to hear this immediately.
591
00:35:26,923 --> 00:35:30,422
What am I to do, go out and get a latte
while they wonder what's going on?
592
00:35:30,593 --> 00:35:34,425
All right, listen. Maybe you would want
to wait for the Attending to tell them.
593
00:35:35,598 --> 00:35:37,425
Is that what you would do?
594
00:35:50,446 --> 00:35:51,940
Kyle.
595
00:35:55,784 --> 00:35:57,444
Oh, God.
596
00:35:58,120 --> 00:36:00,527
Oh, my God.
597
00:36:14,969 --> 00:36:17,804
Is this the Chinese interpreter?
598
00:36:19,891 --> 00:36:21,551
Excuse me.
599
00:36:21,976 --> 00:36:24,348
No, I don't understand
what you're saying.
600
00:36:24,812 --> 00:36:28,679
I've already called them.
I was connected to you.
601
00:36:29,233 --> 00:36:31,771
Please don't put me on hold again.
602
00:36:52,505 --> 00:36:53,964
Hello?
603
00:36:54,132 --> 00:36:56,208
Yes, I'm still here.
604
00:36:57,260 --> 00:36:59,668
I'm not sure if I need
Mandarin or Cantonese.
605
00:37:53,898 --> 00:37:55,273
How long will it take?
606
00:37:55,441 --> 00:37:57,897
An hour, maybe longer.
607
00:38:03,240 --> 00:38:04,651
You helped this family, Abby.
608
00:38:04,825 --> 00:38:08,075
They will remember you
for the rest of their lives.
609
00:38:09,413 --> 00:38:10,658
Yeah.
610
00:38:10,831 --> 00:38:15,291
I'm hoping you'll give neonatology
serious consideration.
611
00:38:17,004 --> 00:38:20,337
Are you mocking me? Because
it's really, really not a good time.
612
00:38:22,300 --> 00:38:23,676
No.
613
00:38:23,843 --> 00:38:26,216
You're one of the best students
I've ever had.
614
00:38:33,228 --> 00:38:35,979
Thank you. Bye.
615
00:38:38,441 --> 00:38:41,358
- What?
- The Tsengs have gone to China with Dirk.
616
00:38:41,527 --> 00:38:43,899
- What?
- That was Mrs. Tseng's cousin.
617
00:38:44,071 --> 00:38:46,906
They went back yesterday.
She doesn't know how to reach them.
618
00:38:47,074 --> 00:38:48,983
Come on. We've got work to do.
619
00:38:50,786 --> 00:38:52,577
Tell me this is our last day.
620
00:38:58,794 --> 00:39:00,917
- Good morning. How's Henry today?
- He's great.
621
00:39:01,088 --> 00:39:02,630
He's raring to get out of here.
622
00:39:02,798 --> 00:39:06,380
All cultures came back negative, but we
need to treat for another seven days.
623
00:39:06,551 --> 00:39:08,876
Unless you two allow us to do the LP.
624
00:39:09,304 --> 00:39:11,925
I do taps on babies all day in the ER...
625
00:39:12,015 --> 00:39:13,972
...and never think twice about it.
626
00:39:14,142 --> 00:39:16,633
Just do the spinal tap.
We wanna take our baby home.
627
00:39:16,811 --> 00:39:19,100
- Okay. Abby, you're on.
- Okay.
628
00:39:19,647 --> 00:39:24,807
Dr. Raab, I would be more comfortable if
you did the procedure, if you don't mind.
629
00:39:25,111 --> 00:39:27,780
No problem. I'll be back after rounds.
630
00:39:27,947 --> 00:39:29,406
Okay, thanks.
631
00:39:29,907 --> 00:39:31,401
Let Abby do it.
632
00:39:31,575 --> 00:39:32,951
Kerry.
633
00:39:33,119 --> 00:39:34,613
It's okay, Sandy.
634
00:39:44,630 --> 00:39:46,207
What's going to happen to Inga?
635
00:39:46,381 --> 00:39:48,753
If she survives,
she'll either be adopted...
636
00:39:48,926 --> 00:39:52,176
- ...or put in a long-term care facility.
- Should I call Social Work?
637
00:39:52,387 --> 00:39:54,961
Go ahead, but nobody's going
to China to look for them.
638
00:39:55,140 --> 00:39:57,179
Her mother wouldn't leave her here.
639
00:39:57,350 --> 00:40:00,802
They're young, scared. Maybe they
think Inga would be better off this way.
640
00:40:00,979 --> 00:40:03,766
- In a hospital, alone?
- If you were in a foreign country...
641
00:40:03,940 --> 00:40:07,060
...with no money, no job,
and no place to live, who knows?
642
00:40:07,235 --> 00:40:11,315
- You might do the same thing.
- No, I wouldn't, and neither would you.
643
00:40:11,489 --> 00:40:14,359
You can't begin to know
what you would do...
644
00:40:14,534 --> 00:40:18,199
...and you don't know the first thing
about me. People are complicated.
645
00:40:18,371 --> 00:40:20,659
That's not an excuse
for abandoning a baby.
646
00:40:20,831 --> 00:40:24,283
Neela, if you stay that judgmental,
you're gonna hate this job.
647
00:40:30,466 --> 00:40:34,795
CSF on the first attempt with
Dr. Mom breathing down your neck.
648
00:40:34,970 --> 00:40:36,594
I'm impressed.
649
00:40:36,763 --> 00:40:39,385
You should see how good I am
when I'm not post-call.
650
00:40:39,558 --> 00:40:41,965
Wait a minute.
You stuck a needle in my kid's back...
651
00:40:42,144 --> 00:40:44,219
...and you've been working for 36 hours?
652
00:40:44,396 --> 00:40:46,768
Actually, it's only been 31 hours.
653
00:40:46,940 --> 00:40:49,347
Tube four, crystal clear.
654
00:40:50,360 --> 00:40:52,620
Owen Miller. Bad hypoxic brain injury.
655
00:40:52,671 --> 00:40:56,525
Mom's your real patient.
She's letting go, needs help.
656
00:40:56,699 --> 00:40:59,653
- Mrs. Miller, this is David.
- Hi. I'm your new medical student.
657
00:40:59,827 --> 00:41:02,911
Ex-34-weeker with mec asp
and pneumomediastinum.
658
00:41:03,080 --> 00:41:05,322
Got him off high frequency last night.
659
00:41:05,499 --> 00:41:07,907
- "Mec asp"?
- Meconium aspiration.
660
00:41:08,085 --> 00:41:10,541
It's a foreign language,
but you'll pick it up fast.
661
00:41:10,713 --> 00:41:13,583
Zero red blood cells.
Champagne tap.
662
00:41:13,757 --> 00:41:17,541
Hey, before we go,
do you mind taking a picture?
663
00:41:25,477 --> 00:41:28,050
- Thanks.
- Get your butt back down to the ER...
664
00:41:28,230 --> 00:41:29,261
...where you belong.
665
00:41:29,439 --> 00:41:30,602
- Bye.
- Bye.
666
00:41:30,774 --> 00:41:32,980
- Congratulations.
- Thanks.
667
00:42:07,434 --> 00:42:11,182
- You all signed out?
- Yeah.
668
00:42:12,022 --> 00:42:13,813
Ever been to the Sky Bar?
669
00:42:15,775 --> 00:42:18,017
This is disgusting.
670
00:42:18,194 --> 00:42:19,653
I told you.
671
00:42:19,821 --> 00:42:21,730
Why are cigars
associated with babies?
672
00:42:21,906 --> 00:42:24,065
This stinky thing has
no place in a nursery.
673
00:42:24,242 --> 00:42:25,617
It's Freudian.
674
00:42:25,785 --> 00:42:28,490
Something about men wanting
to have sex with their mothers.
675
00:42:28,663 --> 00:42:31,866
Thank you. You know what else I
don't get? Why we're drinking cider...
676
00:42:32,041 --> 00:42:35,576
...instead of champagne. You're supposed
to get champagne for a champagne tap.
677
00:42:35,753 --> 00:42:39,003
- Is Weaver that cheap?
- Weaver knows I don't drink champagne.
678
00:42:39,382 --> 00:42:42,299
So you still thinking
about neonatology?
679
00:42:42,468 --> 00:42:44,342
Not in a million years.
680
00:42:45,387 --> 00:42:47,344
I hope you didn't let Raab
discourage you.
681
00:42:48,015 --> 00:42:50,007
It's more than that.
682
00:42:51,185 --> 00:42:53,854
She thinks you should go
into NICU, you know.
683
00:42:54,771 --> 00:42:56,182
Yeah.
684
00:42:57,024 --> 00:42:58,683
You should.
685
00:43:01,778 --> 00:43:03,854
No, thanks.
686
00:43:04,948 --> 00:43:08,399
- I bet every Attending tries to recruit you.
- Oh, please.
687
00:43:08,576 --> 00:43:10,616
Look who's talking.
Your mind is a sponge.
688
00:43:10,787 --> 00:43:12,863
Maybe, but...
689
00:43:13,539 --> 00:43:15,532
...you've got that thing.
690
00:43:19,212 --> 00:43:21,999
I don't know what it is,
but it's much harder to learn.
691
00:43:25,843 --> 00:43:28,595
I think all that cider's
going to your head.
692
00:44:17,685 --> 00:44:19,761
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