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Would you like to inspect the original subtitles? These are the user uploaded subtitles that are being translated: 1 00:00:00,952 --> 00:00:02,117 Previously on The Resident... 2 00:00:02,120 --> 00:00:04,270 Hope it's okay that I'm here. 3 00:00:04,272 --> 00:00:06,214 - How dare you? - What happened here? 4 00:00:06,216 --> 00:00:07,607 If you stepped out of line, 5 00:00:07,609 --> 00:00:09,291 then it won't just be Pravesh who comes for you. 6 00:00:09,294 --> 00:00:12,294 Surgery is a dangerous place. 7 00:00:12,297 --> 00:00:14,464 Especially considering your condition. 8 00:00:14,465 --> 00:00:15,798 You mean my dyslexia? 9 00:00:15,801 --> 00:00:17,725 Tell me why you aren't a scientist yet. 10 00:00:17,728 --> 00:00:19,728 This is obviously your future. You just got to go for it. 11 00:00:19,730 --> 00:00:21,788 I would like to start shifting my professional focus 12 00:00:21,789 --> 00:00:22,731 to clinical trials. 13 00:00:22,733 --> 00:00:25,233 Have a proposal on my desk by Monday. 14 00:00:36,304 --> 00:00:38,079 No eggs, Daddy, please, no eggs. 15 00:00:38,082 --> 00:00:42,308 I want cereal. And a banana. 16 00:00:42,310 --> 00:00:44,902 Whoa, whoa, excuse me. 17 00:00:44,904 --> 00:00:46,505 Coming right up. 18 00:00:57,250 --> 00:01:00,993 Daddy, did you forget to go to the market again? 19 00:01:02,773 --> 00:01:04,164 I did. 20 00:01:04,165 --> 00:01:06,108 I am a bad daddy. 21 00:01:06,109 --> 00:01:08,183 No, you're not. 22 00:01:10,430 --> 00:01:12,021 Let's grab your backpack. 23 00:01:12,022 --> 00:01:14,691 We'll get something great for you... 24 00:01:14,692 --> 00:01:16,843 Takeout on the way to school. 25 00:01:36,640 --> 00:01:38,472 That's another all-nighter. This has got to stop. 26 00:01:38,474 --> 00:01:40,975 - I know. - You're wearing yourself out. 27 00:01:40,978 --> 00:01:42,394 I know. 28 00:01:43,371 --> 00:01:45,371 But I don't know how to stop. 29 00:03:06,229 --> 00:03:08,562 Dude, I lanced this massive abscess, 30 00:03:08,564 --> 00:03:10,622 and the pus exploded all over Dr. Feldman. 31 00:03:10,625 --> 00:03:12,234 - Ah. - He was pissed. 32 00:03:12,235 --> 00:03:14,310 - Pus-wise, better him than you. - Definitely. 33 00:03:14,312 --> 00:03:16,570 Trevor, we know you made the highlight reel. 34 00:03:16,573 --> 00:03:17,722 Yeah, yeah. 35 00:03:17,723 --> 00:03:19,407 No eruptions of bodily fluids, though. 36 00:03:19,408 --> 00:03:20,724 You had that awesome spinal tap. 37 00:03:20,727 --> 00:03:23,060 Hello. Beer-gate? Legendary. 38 00:03:23,062 --> 00:03:24,637 Okay, Pravesh almost cut me, so... 39 00:03:24,639 --> 00:03:27,473 Sure, but then Hawkins swooped in 40 00:03:27,475 --> 00:03:29,658 and took you under his wing. Please, golden boy. 41 00:03:29,661 --> 00:03:31,493 - "Golden boy." - I don't think anyone has any strong feelings 42 00:03:31,496 --> 00:03:32,753 about me either way. 43 00:03:32,923 --> 00:03:35,072 All right, well, I'd really like to put in a central line. 44 00:03:35,074 --> 00:03:37,240 Hey. Five-car pileup on Peachtree, 45 00:03:37,242 --> 00:03:39,168 multiple injuries headed our way. 46 00:03:39,170 --> 00:03:41,805 All hands on deck. It's game time. 47 00:03:59,024 --> 00:04:00,615 Dr. Hawkins, Bay 2. 48 00:04:00,616 --> 00:04:03,359 - On it. - All right, let's get him to Bay 4. 49 00:04:03,360 --> 00:04:05,027 - Zach, with me. - Gemma, Bay 9. 50 00:04:05,030 --> 00:04:07,514 Pravesh, Bay 10. We're gonna need 51 00:04:07,515 --> 00:04:08,514 - another set of hands in there. - Okay, 52 00:04:08,516 --> 00:04:10,396 Janice, Trevor, you come with me. 53 00:04:11,853 --> 00:04:13,201 Pravesh! 54 00:04:13,204 --> 00:04:15,629 - Give me Trevor. - Go see what he needs. 55 00:04:21,305 --> 00:04:23,305 Grab the ultrasound. 56 00:04:23,307 --> 00:04:24,805 Right. 57 00:04:27,218 --> 00:04:28,643 Assess her for internal injuries, 58 00:04:28,644 --> 00:04:30,725 then we'll deal with the lower-extremity lacerations. 59 00:04:31,814 --> 00:04:33,038 Got it. 60 00:04:33,040 --> 00:04:34,891 Whoa. 61 00:04:34,893 --> 00:04:37,726 - Ma'am, what's wrong? - It's not my stomach. I'm okay. 62 00:04:37,728 --> 00:04:39,728 But he's not. 63 00:04:39,730 --> 00:04:42,973 I watched him turn his bike and drive right into traffic. 64 00:04:42,975 --> 00:04:43,973 He caused all of this. 65 00:04:43,975 --> 00:04:44,975 There's something 66 00:04:44,976 --> 00:04:46,494 definitely wrong with him. 67 00:04:48,480 --> 00:04:50,648 Hey, Zach. I need you to do a quick FAST exam 68 00:04:50,649 --> 00:04:53,500 and suture up some lacs. Trevor, come with me. 69 00:05:00,009 --> 00:05:02,084 The X-rays showed a fractured rib 70 00:05:02,086 --> 00:05:04,086 but fortunately no broken ankle. 71 00:05:04,088 --> 00:05:05,512 You're gonna be fine. 72 00:05:05,514 --> 00:05:08,165 - You're in good hands here. - Thank you. 73 00:05:08,166 --> 00:05:09,634 You're welcome. 74 00:05:10,670 --> 00:05:12,745 I-I really don't know what happened. 75 00:05:12,747 --> 00:05:15,932 One minute I'm riding my bike, next I'm on the ground 76 00:05:15,934 --> 00:05:18,026 and cars are skidding and crashing. 77 00:05:18,028 --> 00:05:19,586 I feel terrible. 78 00:05:19,588 --> 00:05:20,752 Sounds like you might have passed out? 79 00:05:20,754 --> 00:05:23,346 You got lucky. You could've been killed. 80 00:05:23,348 --> 00:05:25,850 Getting lucky is kind of my thing. 81 00:05:25,851 --> 00:05:27,535 Yeah? How's that? 82 00:05:27,536 --> 00:05:30,112 I was on a charter boat once, it sunk. 83 00:05:30,115 --> 00:05:32,447 Everyone drowned except me. 84 00:05:33,435 --> 00:05:35,692 - I won the lottery twice. - Cool. 85 00:05:35,694 --> 00:05:37,879 Maybe you take a look at the numbers I've been playing. 86 00:05:37,880 --> 00:05:38,880 Happy to, Doc. 87 00:05:39,790 --> 00:05:42,774 Wow, you got the odds of the gods on your side. 88 00:05:42,776 --> 00:05:45,870 I have always felt protected in an otherworldly way. 89 00:05:45,872 --> 00:05:47,613 A-And those are just the highlights. 90 00:05:47,615 --> 00:05:50,632 I also got diagnosed with this thing, sarcoid? 91 00:05:50,634 --> 00:05:53,877 - Mm-hmm. - Supposed to be bad, but it's never been a problem. 92 00:05:53,879 --> 00:05:55,137 Sarcoid? 93 00:05:55,139 --> 00:05:57,624 What medications are you taking for that? 94 00:05:57,625 --> 00:06:00,718 None. I'm not one to take meds I don't need. 95 00:06:00,720 --> 00:06:02,310 Too many side effects. 96 00:06:02,312 --> 00:06:04,906 - Whoa, whoa. - Oh, Wyatt. 97 00:06:04,908 --> 00:06:06,240 Wyatt? 98 00:06:06,242 --> 00:06:08,910 We need to get him on the monitor now. 99 00:06:08,911 --> 00:06:10,470 - Hey. - Hey. 100 00:06:10,471 --> 00:06:11,821 Sorry you had to come in on your day off. 101 00:06:11,822 --> 00:06:15,307 It's killing me. I've got to get my grant proposal done. 102 00:06:15,310 --> 00:06:18,235 - How are you? - Surgery went long. Don't ask. 103 00:06:18,237 --> 00:06:20,237 Man, it's crazy in here today. 104 00:06:20,238 --> 00:06:22,165 I know. Hi, Brit. 105 00:06:22,167 --> 00:06:24,425 This is Dr. Devi. 106 00:06:24,427 --> 00:06:27,411 She's the surgical consultant I told you about. 107 00:06:27,413 --> 00:06:29,988 Uh, I'm so sorry. Hi, Brit. 108 00:06:29,990 --> 00:06:31,598 I probably shouldn't have come. 109 00:06:31,600 --> 00:06:33,435 I've had this pain on and off for months. 110 00:06:33,437 --> 00:06:36,252 But I realized I'd lost ten pounds. 111 00:06:36,254 --> 00:06:39,348 Without trying, really, so I'm a little spooked. 112 00:06:39,350 --> 00:06:41,591 I'm probably overreacting, right? 113 00:06:41,593 --> 00:06:43,528 Let's just start with an exam. 114 00:06:45,005 --> 00:06:46,596 Ow! Right there. 115 00:06:46,598 --> 00:06:48,007 Can you describe your pain for me? 116 00:06:48,009 --> 00:06:49,524 Throbbing. 117 00:06:49,526 --> 00:06:51,435 Or maybe stabbing. 118 00:06:51,437 --> 00:06:53,269 Are you having any nausea or vomiting? 119 00:06:53,271 --> 00:06:54,697 I thought I was just nervous at first, 120 00:06:54,699 --> 00:06:57,774 you know, existential angst, which I am prone to, 121 00:06:57,776 --> 00:07:00,202 and it is kind of my occupational wheelhouse. 122 00:07:00,204 --> 00:07:02,704 I'm a cartoonist. 123 00:07:02,706 --> 00:07:04,281 Life's a Joke. 124 00:07:04,283 --> 00:07:06,192 - That's my strip. - Hmm. 125 00:07:06,194 --> 00:07:07,634 So, yes to the nausea and vomiting? 126 00:07:07,637 --> 00:07:11,047 Oh, right, yes. Krakatoa, east of Java, man. 127 00:07:11,048 --> 00:07:13,365 Just keeps on coming up. 128 00:07:13,367 --> 00:07:14,959 We'll start with a CT scan to take a closer look, 129 00:07:14,961 --> 00:07:17,293 and we can admit you to get control over your pain 130 00:07:17,295 --> 00:07:18,480 and we'll go from there. 131 00:07:18,481 --> 00:07:20,540 - Okay? - Cool. 132 00:07:20,542 --> 00:07:22,108 All right, we'll be back. 133 00:07:27,305 --> 00:07:28,973 It's a large hepatic hemangioma. 134 00:07:28,975 --> 00:07:30,307 That's a good catch, Dr. Devi. 135 00:07:30,309 --> 00:07:32,308 I haven't seen one of these before. 136 00:07:32,310 --> 00:07:33,644 Well, they're more common than you'd think. 137 00:07:33,646 --> 00:07:35,403 They're benign tumors made up of clusters 138 00:07:35,406 --> 00:07:36,572 of blood-filled cavities. 139 00:07:36,574 --> 00:07:38,332 And usually they don't cause symptoms. 140 00:07:38,334 --> 00:07:41,168 Well, I'm relieved it's benign. 141 00:07:41,170 --> 00:07:44,062 My patient will be, too. She's a little kooky. 142 00:07:44,064 --> 00:07:46,341 Sweet, though. 143 00:07:46,343 --> 00:07:48,250 Should I book an OR for us this afternoon? 144 00:07:48,252 --> 00:07:50,677 Oh, not so fast. Surgery's not a slam dunk here. 145 00:07:51,831 --> 00:07:53,406 A benign tumor causing pain? 146 00:07:53,408 --> 00:07:55,499 Well, surgery on the liver is always high-risk, 147 00:07:55,500 --> 00:07:57,500 even in the best hands, and pain can be managed. 148 00:07:57,502 --> 00:07:59,595 Okay, so I tell her we're not operating, 149 00:07:59,596 --> 00:08:02,264 and I need a repeat scan in two months. 150 00:08:02,266 --> 00:08:03,750 And that's not the answer, either. 151 00:08:03,752 --> 00:08:06,435 This is not something we can decide here. 152 00:08:06,437 --> 00:08:07,677 You need to talk to your patient 153 00:08:07,680 --> 00:08:09,254 and get a sense of her risk tolerance 154 00:08:09,257 --> 00:08:10,514 and the seriousness of her symptoms, 155 00:08:10,516 --> 00:08:14,035 and then you tell me what path you think makes sense. 156 00:08:16,096 --> 00:08:17,612 All right. Can you come with? 157 00:08:17,615 --> 00:08:19,540 Nope. She's your patient, you handle it. 158 00:08:19,543 --> 00:08:24,937 Then meet me in OR 3... An, uh, emergent splenectomy. 159 00:08:24,939 --> 00:08:26,088 Uh, 15 minutes. 160 00:08:27,550 --> 00:08:29,125 So, you have two options. 161 00:08:29,127 --> 00:08:30,367 If you go with the surgery and it goes well, 162 00:08:30,369 --> 00:08:32,720 - your symptoms go away. - Awesome. 163 00:08:32,721 --> 00:08:34,780 But surgery on the liver is never an easy call to make. 164 00:08:34,783 --> 00:08:36,724 It's an organ with many large blood vessels, 165 00:08:36,725 --> 00:08:39,043 which means we could run into significant bleeding. 166 00:08:39,044 --> 00:08:40,269 Oh. Not awesome. 167 00:08:40,272 --> 00:08:41,711 And that circumstance would require 168 00:08:41,713 --> 00:08:43,898 a much larger abdominal surgery with complications 169 00:08:43,899 --> 00:08:45,774 and a long recovery. 170 00:08:47,403 --> 00:08:48,476 Are you with me? 171 00:08:48,479 --> 00:08:49,720 Uh, sort of. 172 00:08:49,721 --> 00:08:52,798 Uh, you understand, right? I'm not a doctor. 173 00:08:52,801 --> 00:08:54,390 I'm a cartoonist. 174 00:08:54,393 --> 00:08:55,909 Right. 175 00:08:55,912 --> 00:08:58,078 Um... 176 00:08:59,139 --> 00:09:00,306 Do you take risks? 177 00:09:00,307 --> 00:09:02,642 If you do, then we go with the surgery. 178 00:09:02,644 --> 00:09:05,402 Are you cautious? Then we hold off for now, 179 00:09:05,403 --> 00:09:07,254 so long as your pain is tolerable. 180 00:09:09,240 --> 00:09:10,666 I don't know, Dr. Devi. 181 00:09:10,668 --> 00:09:12,927 Okay, you know what? Look. 182 00:09:12,928 --> 00:09:15,245 It's okay. Big decision. 183 00:09:15,246 --> 00:09:17,097 Think about it, and I will check in 184 00:09:17,100 --> 00:09:18,841 as soon as I'm back from surgery, okay? 185 00:09:18,842 --> 00:09:20,475 Okay. 186 00:09:23,940 --> 00:09:26,607 Heart block. What is that? 187 00:09:26,610 --> 00:09:28,533 Because of the sarcoid, your heart's electric circuit 188 00:09:28,536 --> 00:09:30,503 isn't working correctly, so your heartbeat 189 00:09:30,504 --> 00:09:33,172 slows to a dangerously low rate. 190 00:09:33,173 --> 00:09:34,523 In some cases, it can stop completely. 191 00:09:34,524 --> 00:09:36,676 Which, to state the obvious, is fatal. 192 00:09:36,677 --> 00:09:39,269 This morning, your heartbeat slowed so much 193 00:09:39,270 --> 00:09:41,364 that you fainted and you crashed your bike. 194 00:09:41,365 --> 00:09:43,124 But there is some good news. 195 00:09:43,125 --> 00:09:44,366 Told you guys. 196 00:09:44,369 --> 00:09:47,019 The solution to your problem 197 00:09:47,020 --> 00:09:48,129 is safe and simple. 198 00:09:48,130 --> 00:09:49,538 We put in a pacemaker, 199 00:09:49,539 --> 00:09:51,539 and your heart goes back to beating normally again. 200 00:09:51,542 --> 00:09:53,301 So you're saying I need a surgery? 201 00:09:53,302 --> 00:09:55,119 Yeah, and it's just an outpatient procedure. 202 00:09:55,120 --> 00:09:57,028 No general anesthesia, no operating room. 203 00:09:57,030 --> 00:09:58,806 It's super simple. 204 00:09:58,807 --> 00:10:00,140 Another narrow escape from death. 205 00:10:00,143 --> 00:10:02,701 The Wyatt Barnes legend grows. 206 00:10:02,703 --> 00:10:04,628 Hey. 207 00:10:04,629 --> 00:10:06,889 I'd like to admit you for observation, and then 208 00:10:06,890 --> 00:10:09,149 we'll schedule the procedure as soon as possible. 209 00:10:09,152 --> 00:10:10,432 Oh, I don't want the pacemaker. 210 00:10:11,562 --> 00:10:13,654 A-Admit me, fine, but, you know, finish 211 00:10:13,657 --> 00:10:16,306 - fixing me up and... - send me home. 212 00:10:16,307 --> 00:10:17,383 No, you don't understand. 213 00:10:17,384 --> 00:10:18,808 If we don't put the pacemaker in, 214 00:10:18,811 --> 00:10:20,735 you will almost certainly die. 215 00:10:20,738 --> 00:10:21,738 Almost? 216 00:10:22,907 --> 00:10:25,149 I'll take those odds. 217 00:10:25,150 --> 00:10:26,575 We are doctors, 218 00:10:26,576 --> 00:10:29,562 advising you on a procedure that will save your life. 219 00:10:29,563 --> 00:10:33,990 Sorry, but it's my body, my decision. 220 00:10:33,993 --> 00:10:36,094 No pacemaker. 221 00:10:37,013 --> 00:10:38,553 No, thanks. 222 00:10:44,595 --> 00:10:47,504 - Hey, we need a cart over here! - Now that you're spending 223 00:10:47,505 --> 00:10:48,431 more time on research and clinical trials, 224 00:10:48,432 --> 00:10:49,673 we need a new ER doctor. 225 00:10:49,674 --> 00:10:51,433 And I'd like you to do the interviews today. 226 00:10:51,436 --> 00:10:53,193 I would, of course, but I'm only filling in 227 00:10:53,196 --> 00:10:54,528 for a few hours today. 228 00:10:54,530 --> 00:10:56,605 And I didn't set aside time for that. 229 00:10:56,606 --> 00:10:58,774 There must be someone else who can help. 230 00:10:58,775 --> 00:11:00,350 There's no one. And I worked here all night. 231 00:11:00,351 --> 00:11:03,519 I'm sorry. Here are the candidates. 232 00:11:03,522 --> 00:11:06,374 Dr. Voss, I have to get my grant proposal in by 6:00 p.m. 233 00:11:06,375 --> 00:11:08,524 Your proposal will have to wait. 234 00:11:08,527 --> 00:11:09,769 And I don't need to remind you why 235 00:11:09,770 --> 00:11:11,421 we're short-staffed in the ER. 236 00:11:13,198 --> 00:11:14,530 Yeah. I get it. 237 00:11:14,533 --> 00:11:16,107 Thank you. 238 00:11:16,110 --> 00:11:18,385 I'm counting on you. 239 00:11:18,388 --> 00:11:20,037 Happy to help. 240 00:11:42,245 --> 00:11:45,153 So, our Mr. Lucky has complete AV block 241 00:11:45,155 --> 00:11:47,230 with wide ventricular escape. 242 00:11:47,232 --> 00:11:48,807 He's not gonna live long enough to cash in 243 00:11:48,809 --> 00:11:50,649 his third lotto ticket without a pacemaker. 244 00:11:51,587 --> 00:11:53,903 I mean, you think he wants to die? 245 00:11:55,240 --> 00:11:59,092 Yeah, the guy's super cheerful. It's bizarre. 246 00:11:59,095 --> 00:12:01,511 Mom, listen, I'm in the middle of... 247 00:12:03,414 --> 00:12:05,265 Well, is-is the cough getting any better? 248 00:12:05,268 --> 00:12:07,601 Did you call the oncologist? 249 00:12:07,604 --> 00:12:11,087 Mom, just do it now, please. 250 00:12:11,090 --> 00:12:13,607 Yes, I will see you before I go to the airport. 251 00:12:15,852 --> 00:12:17,836 Tell Carol I'll call her, 252 00:12:17,838 --> 00:12:21,783 talk her through some options for her respiratory symptoms. 253 00:12:21,784 --> 00:12:23,201 Appreciate it, man. 254 00:12:24,361 --> 00:12:26,602 Look, I-I wish I could engage. 255 00:12:26,605 --> 00:12:29,197 All right? I-If there were 28 hours in the day, 256 00:12:29,200 --> 00:12:31,107 I would gladly wax poetic with the patient 257 00:12:31,110 --> 00:12:32,701 about the benefits of a pacemaker, 258 00:12:32,702 --> 00:12:34,537 but I do not have the time. 259 00:12:34,538 --> 00:12:38,039 I have way too many patients who would kill for an easy cure. 260 00:12:38,042 --> 00:12:40,692 I got too many, too many obligations. 261 00:12:40,695 --> 00:12:42,286 All right, you get him to see reason, 262 00:12:42,288 --> 00:12:43,638 I have no doubt that you will, 263 00:12:43,639 --> 00:12:46,640 then I will come back, I'll put in the pacer. 264 00:12:50,813 --> 00:12:52,962 Okay. Have you, uh... 265 00:12:52,965 --> 00:12:54,222 you seen this problem before? 266 00:12:54,225 --> 00:12:57,485 All the time during the pandemic. 267 00:12:57,486 --> 00:13:00,636 We had a lot of patients who died claiming COVID was made up. 268 00:13:00,639 --> 00:13:02,657 Well, what do we do next? 269 00:13:02,658 --> 00:13:05,808 He agreed to a brief admission, so we bring him up to the ICU, 270 00:13:05,811 --> 00:13:09,071 start him on isoproterenol to raise his heart rate 271 00:13:09,072 --> 00:13:10,221 while I figure out a way to respectfully 272 00:13:10,224 --> 00:13:11,164 get him to see reason. 273 00:13:11,167 --> 00:13:13,668 I will watch and learn. 274 00:13:15,062 --> 00:13:16,912 Hey, Brit, have you had some time 275 00:13:16,913 --> 00:13:18,673 to review your options? 276 00:13:21,735 --> 00:13:24,427 She was here a minute ago. She should be back soon. 277 00:13:33,413 --> 00:13:37,750 And if you had to change one thing about emergency medicine, 278 00:13:37,751 --> 00:13:38,841 what would it be? 279 00:13:38,936 --> 00:13:40,193 Well, we're letting money walk out the door. 280 00:13:40,196 --> 00:13:41,604 That's for sure. 281 00:13:41,605 --> 00:13:44,347 Uh, I personally would deploy a-a number of strategies 282 00:13:44,350 --> 00:13:46,384 that would be more lucrative for the hospital. 283 00:13:46,385 --> 00:13:47,534 Uh, I mean, you can't fix 284 00:13:47,537 --> 00:13:49,537 all the inefficiencies at once, you know? 285 00:13:49,538 --> 00:13:53,206 You got to let this, uh, this pig work its way through 286 00:13:53,209 --> 00:13:55,768 the-the boa constrictor, so to speak. 287 00:13:55,769 --> 00:13:58,437 So, I created some slides here, uh, with ideas 288 00:13:58,438 --> 00:14:00,197 for how to capitalize on low-hanging fruit. 289 00:14:00,198 --> 00:14:02,532 I'll talk you through it. 290 00:14:02,533 --> 00:14:04,719 Uh, shouldn't be more than, uh, an hour. 291 00:14:05,796 --> 00:14:07,053 Or two. 292 00:14:09,799 --> 00:14:11,783 Brit? 293 00:14:11,785 --> 00:14:14,562 I've been looking everywhere for you. 294 00:14:15,639 --> 00:14:17,899 Has your abdominal pain gotten worse? 295 00:14:17,900 --> 00:14:20,902 You shouldn't be out here. We should get you back inside. 296 00:14:20,903 --> 00:14:22,570 It's not that, Dr. Devi. 297 00:14:22,572 --> 00:14:25,572 I had to get some air so I could think. 298 00:14:25,575 --> 00:14:26,740 Okay. 299 00:14:29,227 --> 00:14:31,245 I can't decide about the surgery. 300 00:14:31,246 --> 00:14:33,822 I tell myself, "Go for it." 301 00:14:33,823 --> 00:14:36,732 Then I think it's too dangerous. 302 00:14:36,735 --> 00:14:40,645 What if I bleed to death in the OR and my cat dies alone? 303 00:14:40,648 --> 00:14:43,758 Or I go home and die and no one finds me and Tinkerbell eats me. 304 00:14:43,759 --> 00:14:46,335 - You have to take it easy, Brit. - Sometimes I wake up 305 00:14:46,336 --> 00:14:48,486 and she's staring at me like I'm a goldfish. 306 00:14:48,489 --> 00:14:49,989 There's a darkness in her. 307 00:14:49,990 --> 00:14:52,508 I'm indecisive. 308 00:14:52,509 --> 00:14:55,101 Even about things that don't matter. 309 00:14:55,104 --> 00:14:58,105 My cartoons poke fun at people like me. 310 00:14:59,775 --> 00:15:01,067 Brit. 311 00:15:02,836 --> 00:15:05,738 What can I do to help you make this decision? 312 00:15:07,524 --> 00:15:09,115 Make it for me? 313 00:15:10,101 --> 00:15:11,952 Just be my doctor. 314 00:15:11,955 --> 00:15:13,703 I'll do whatever you say. 315 00:15:21,038 --> 00:15:23,779 How am I doing? 316 00:15:23,782 --> 00:15:26,634 Your heart rate is dangerously slow. 317 00:15:26,635 --> 00:15:28,527 38. 318 00:15:28,528 --> 00:15:31,138 Meds helped transiently, but they can't fix this, 319 00:15:31,139 --> 00:15:32,472 and it's getting worse. 320 00:15:32,475 --> 00:15:33,881 I feel fine. 321 00:15:33,884 --> 00:15:35,292 That's impossible, okay? 322 00:15:35,293 --> 00:15:36,977 You have to be tired, light-headed... 323 00:15:36,980 --> 00:15:38,104 Not really. 324 00:15:39,130 --> 00:15:40,297 I'm hungry. 325 00:15:40,298 --> 00:15:42,149 This place have ice cream? 326 00:15:43,302 --> 00:15:45,543 Yes... 327 00:15:45,546 --> 00:15:48,138 but let's finish talking first. 328 00:15:48,139 --> 00:15:50,216 A pacemaker is a simple device. 329 00:15:50,217 --> 00:15:52,551 It is not dangerous to put in, 330 00:15:52,552 --> 00:15:54,161 and it will keep you from falling off your bike 331 00:15:54,163 --> 00:15:55,553 in the middle of traffic. 332 00:15:55,556 --> 00:15:57,163 Or dying today. 333 00:15:57,165 --> 00:16:00,500 Which could happen. 334 00:16:00,503 --> 00:16:02,318 It's not gonna happen. 335 00:16:02,321 --> 00:16:04,562 What are you afraid of, Wyatt? 336 00:16:04,565 --> 00:16:06,731 I'm not afraid. I just don't like the idea 337 00:16:06,734 --> 00:16:08,509 of having a foreign object put into my body. 338 00:16:08,510 --> 00:16:10,918 Do you know anyone with type 1 diabetes? 339 00:16:10,921 --> 00:16:12,346 Yeah. My old boss. 340 00:16:12,347 --> 00:16:14,347 Did your boss use an insulin pump? 341 00:16:14,350 --> 00:16:16,683 She does, but what you're talking about 342 00:16:16,686 --> 00:16:18,760 is putting something in to control my heart. 343 00:16:18,763 --> 00:16:20,003 That's different. 344 00:16:20,004 --> 00:16:21,504 No. Not really. 345 00:16:21,506 --> 00:16:22,856 Uh, complications from pacemakers are rare. 346 00:16:22,859 --> 00:16:24,750 I'm sorry, but I do my own research. 347 00:16:24,751 --> 00:16:27,418 I'm part of this Facebook group. 348 00:16:27,421 --> 00:16:29,011 - Oh, here we go. - And they just published a list 349 00:16:29,014 --> 00:16:30,865 of unsafe products from China. 350 00:16:30,866 --> 00:16:33,942 Know what's on top? Pacemakers. 351 00:16:33,943 --> 00:16:35,443 Now, they're assembled here, 352 00:16:35,446 --> 00:16:37,520 but guess where the parts come from. 353 00:16:37,523 --> 00:16:41,115 Yep. Guy in the group got poisoned by some bad metals. 354 00:16:41,118 --> 00:16:43,769 Those posts aren't truthful, Wyatt. 355 00:16:43,770 --> 00:16:47,605 They are propaganda from unqualified people 356 00:16:47,607 --> 00:16:49,274 who have politicized health and medicine. 357 00:16:49,277 --> 00:16:51,217 They either want to sow distrust in science 358 00:16:51,220 --> 00:16:52,369 or sell you snake oil. 359 00:16:52,370 --> 00:16:53,870 The real truth, Wyatt? 360 00:16:53,871 --> 00:16:55,538 Bad metal is not a thing. 361 00:16:55,540 --> 00:16:57,283 Dr. Hawkins is who you want giving you advice. 362 00:16:57,284 --> 00:16:58,966 He's an actual expert. 363 00:16:58,969 --> 00:17:00,469 I form my own opinions, okay? 364 00:17:00,471 --> 00:17:03,471 - You have yours. - Okay, this isn't an opinion. 365 00:17:03,474 --> 00:17:05,140 It's fact versus fiction. 366 00:17:05,142 --> 00:17:06,608 - Do you understand? - All right. 367 00:17:07,811 --> 00:17:09,569 We hear you, Wyatt. 368 00:17:09,571 --> 00:17:11,196 Okay? 369 00:17:14,134 --> 00:17:15,800 Be back to check on you in a bit. 370 00:17:15,803 --> 00:17:17,368 Thanks, Doc. 371 00:17:19,082 --> 00:17:20,951 He was getting more and more dug in. 372 00:17:20,974 --> 00:17:22,307 - You have to know how to take a step back. - Okay, but if Wyatt dies, 373 00:17:22,309 --> 00:17:23,534 it won't be sarcoid that kills him, 374 00:17:23,536 --> 00:17:26,644 it'll be i-irrational fear and misinformation. 375 00:17:26,646 --> 00:17:29,239 And those are difficult conditions to cure. 376 00:17:29,240 --> 00:17:30,924 - I... - Some people only accept information 377 00:17:30,926 --> 00:17:32,409 that confirms their beliefs. 378 00:17:32,411 --> 00:17:34,336 You have to give them the facts, 379 00:17:34,337 --> 00:17:35,930 tell them how important the science is, 380 00:17:35,932 --> 00:17:38,824 - but then if you push too hard... - I get that, but if... 381 00:17:38,826 --> 00:17:42,176 we lose what little trust we may have earned. 382 00:17:42,179 --> 00:17:44,605 Even when you're 1,000% right. 383 00:17:44,606 --> 00:17:47,516 - Uh... He's gonna... - Gentlemen. 384 00:17:47,518 --> 00:17:50,443 So I don't see your patient on my cath lab schedule. 385 00:17:50,445 --> 00:17:52,947 - What happened? No pacemaker? - Uh, not yet. 386 00:17:52,949 --> 00:17:55,097 We were just getting ready to discuss next steps. 387 00:17:55,099 --> 00:17:57,175 The guy actually believes in luck. 388 00:17:57,177 --> 00:17:58,602 As in, he's too lucky to die. 389 00:17:58,604 --> 00:18:01,288 He did tell us he's always felt protected 390 00:18:01,289 --> 00:18:03,457 in an "otherworldly" way. 391 00:18:03,459 --> 00:18:05,608 An argument could be made that he doesn't have the capacity 392 00:18:05,611 --> 00:18:08,111 to make medical decisions for himself. 393 00:18:08,113 --> 00:18:09,355 Well, if he's making his decision based on 394 00:18:09,356 --> 00:18:11,373 otherworldly information, you may be right. 395 00:18:11,375 --> 00:18:13,525 I'll call Dr. Malco in the psych department. 396 00:18:13,527 --> 00:18:16,511 Let's hope this works. Wyatt's running out of time. 397 00:18:26,207 --> 00:18:28,632 Wyatt, why don't you tell me in your own words 398 00:18:28,634 --> 00:18:30,151 what's going on with your health right now? 399 00:18:30,153 --> 00:18:31,876 It's pretty simple. 400 00:18:31,878 --> 00:18:34,154 I've never liked hospitals, 401 00:18:34,156 --> 00:18:36,640 but I came here because of a bike accident. 402 00:18:36,642 --> 00:18:39,308 They escalated the whole thing by threatening 403 00:18:39,310 --> 00:18:41,236 to put in a pacemaker. 404 00:18:41,238 --> 00:18:43,721 Do you know how many people get a pacemaker? 405 00:18:43,723 --> 00:18:46,333 They're slapping them into everybody these days. 406 00:18:46,335 --> 00:18:48,317 Why don't you trust your doctors? 407 00:18:48,319 --> 00:18:50,336 I make up my own mind. 408 00:18:50,338 --> 00:18:52,397 And, look, I'm not crazy. 409 00:18:52,400 --> 00:18:54,174 You know, agreeing to have doctors I just met 410 00:18:54,176 --> 00:18:57,661 implant something into my body is what's crazy. 411 00:18:57,663 --> 00:19:00,847 We just need to make sure that you understand the consequences 412 00:19:00,849 --> 00:19:03,241 of the decision you're making here. 413 00:19:03,243 --> 00:19:05,669 I've been listening to those two all day. 414 00:19:05,671 --> 00:19:07,336 Of course I understand. 415 00:19:07,338 --> 00:19:11,173 And there's something you need to understand about me. 416 00:19:11,175 --> 00:19:13,101 And what is that? 417 00:19:13,103 --> 00:19:15,253 You're not gonna change my mind. 418 00:19:15,256 --> 00:19:17,756 And if I do die, I don't want anyone 419 00:19:17,758 --> 00:19:21,367 going wild and pounding on my chest, okay? 420 00:19:21,369 --> 00:19:24,371 Write that down in your little notepad. 421 00:19:24,373 --> 00:19:26,624 We all have to die someday. 422 00:19:28,102 --> 00:19:30,169 And I am not going out like that. 423 00:19:35,218 --> 00:19:37,291 - Dr. Bell? - Yeah. 424 00:19:37,294 --> 00:19:40,054 - Do you have a second? - Mm-hmm. 425 00:19:43,058 --> 00:19:44,782 Please tell me this gets easier. 426 00:19:44,785 --> 00:19:46,617 Is this about making a life-or-death decision 427 00:19:46,619 --> 00:19:49,230 - for a person you just met? - Yes. 428 00:19:50,458 --> 00:19:53,141 It should never be easy. This is the job. 429 00:19:53,143 --> 00:19:54,308 It's not irrational for a patient to think 430 00:19:54,310 --> 00:19:56,720 we know more and should decide for them. 431 00:19:56,721 --> 00:19:58,297 What if I can't figure out what's the best way to go? 432 00:19:58,298 --> 00:20:00,490 You will, because you have to. 433 00:20:01,410 --> 00:20:03,317 That's what your patient needs. 434 00:20:03,319 --> 00:20:05,394 So go with your gut, Dr. Devi, 435 00:20:05,396 --> 00:20:08,897 informed by your experience and your schooling. 436 00:20:08,900 --> 00:20:12,086 - Okay? - Okay. 437 00:20:17,000 --> 00:20:18,259 Dr. Voss. 438 00:20:18,260 --> 00:20:20,242 Tell me what you need. I'm here to help. 439 00:20:20,244 --> 00:20:23,321 Well, I'm realizing that all our doctors 440 00:20:23,324 --> 00:20:25,432 are in danger of burnout. 441 00:20:25,433 --> 00:20:28,751 The stress at times can be unrelenting. 442 00:20:28,753 --> 00:20:31,438 Maybe your program can help. 443 00:20:31,440 --> 00:20:33,015 I would love that. 444 00:20:33,017 --> 00:20:35,442 I offer yoga sessions, meditation, 445 00:20:35,443 --> 00:20:37,443 sleep counseling and positive affirmations. 446 00:20:37,445 --> 00:20:42,398 Plus, fresh-baked resiliency cookies. Gluten-free. 447 00:20:42,401 --> 00:20:47,346 I think I could make everybody ten percent happier, at least. 448 00:20:47,347 --> 00:20:50,105 I would invest in ten percent happier. 449 00:20:50,107 --> 00:20:51,273 When can you start? 450 00:20:51,276 --> 00:20:53,108 Shall we start now? 451 00:20:53,111 --> 00:20:55,796 Yes. Sign me up. 452 00:20:55,798 --> 00:20:57,279 - Come sit down. - Oh. 453 00:20:57,281 --> 00:21:00,174 Just five minutes. 454 00:21:02,695 --> 00:21:05,364 - Lie down, put your feet up. - Oh, wait, I can't. I'd be... 455 00:21:05,365 --> 00:21:07,974 All right. Okay. 456 00:21:09,979 --> 00:21:11,394 Close your eyes. 457 00:21:12,705 --> 00:21:17,800 And now just take a deep, cleansing breath. 458 00:21:19,063 --> 00:21:20,570 Ooh, sorry. 459 00:21:23,067 --> 00:21:24,532 - Later. I promise. - Okay. 460 00:21:37,565 --> 00:21:39,580 - Do you speak Spanish? - No. 461 00:21:39,583 --> 00:21:41,750 I don't think there's room in my head 462 00:21:41,751 --> 00:21:44,493 for any more words I'm supposed to understand. 463 00:21:44,496 --> 00:21:47,905 Do you mind turning it down? I promise to keep this simple. 464 00:21:50,594 --> 00:21:53,595 Based on the size of your hemangioma and your symptoms, 465 00:21:53,596 --> 00:21:56,690 if it were me, I would go with the surgery. 466 00:21:58,343 --> 00:22:00,935 Surgery it is. When? 467 00:22:00,938 --> 00:22:02,363 Well, we can operate later today. 468 00:22:02,365 --> 00:22:05,074 But I would like to take you through the consent. 469 00:22:07,760 --> 00:22:09,519 There are risks. 470 00:22:09,520 --> 00:22:13,598 Bleeding, infection, damage to your liver. 471 00:22:13,601 --> 00:22:15,709 It's possible but unlikely that we'll have trouble 472 00:22:15,711 --> 00:22:17,786 getting you off the ventilator. 473 00:22:17,788 --> 00:22:20,271 And as with any surgery, there is a risk of death. 474 00:22:20,273 --> 00:22:22,383 Have you done this operation often? 475 00:22:22,384 --> 00:22:25,126 Uh, no, I haven't, but the senior surgeon 476 00:22:25,128 --> 00:22:27,871 I work with has, and he'll be there. 477 00:22:29,875 --> 00:22:31,465 Pen. 478 00:22:31,468 --> 00:22:33,559 All right. 479 00:22:35,046 --> 00:22:36,771 Thank you. 480 00:22:48,894 --> 00:22:50,301 He's clear and consistent. 481 00:22:50,304 --> 00:22:51,728 I don't find him to be influenced 482 00:22:51,730 --> 00:22:54,655 by untreated depression, and he's not suicidal. 483 00:22:54,657 --> 00:22:56,566 His choice isn't one that I would make for myself 484 00:22:56,567 --> 00:22:59,810 or someone I love, but it's one he has a right to make. 485 00:22:59,813 --> 00:23:02,905 What do you make of his belief that he's cosmically protected? 486 00:23:02,907 --> 00:23:05,333 Hearing celestial voices is one thing, 487 00:23:05,335 --> 00:23:08,076 but it's human nature to search 488 00:23:08,078 --> 00:23:10,321 for explanations for our experiences. 489 00:23:10,324 --> 00:23:12,266 Just describing them in ways that are fantastical 490 00:23:12,268 --> 00:23:14,675 doesn't signify a lack of capacity. 491 00:23:14,678 --> 00:23:16,510 Um, I'm sorry, it makes no sense. 492 00:23:16,512 --> 00:23:20,332 I mean, look how young he is, and he even requested a DNR? 493 00:23:20,334 --> 00:23:24,259 Which is a sign that he's-he's clear and coherent. 494 00:23:24,261 --> 00:23:25,761 Look, lack of capacity is a high bar, 495 00:23:25,763 --> 00:23:27,763 and Wyatt doesn't reach it. 496 00:23:27,766 --> 00:23:29,508 I'm sorry. 497 00:23:29,509 --> 00:23:32,536 - You have to respect his wishes. - All right, thank you, Leslie. 498 00:23:36,016 --> 00:23:37,458 Uh... 499 00:23:37,460 --> 00:23:39,442 Is that really it? 500 00:23:39,443 --> 00:23:40,367 If he's determined to have capacity, 501 00:23:40,369 --> 00:23:41,702 we can't force him to be treated. 502 00:23:41,704 --> 00:23:43,463 Wait, hold on, I thought you were the renegade. 503 00:23:43,465 --> 00:23:45,039 I heard you drilled into a guy's head 504 00:23:45,041 --> 00:23:46,540 and you're not even a surgeon. 505 00:23:46,542 --> 00:23:48,617 But you're gonna sit here and let this man die? 506 00:23:48,619 --> 00:23:50,304 If the guy would've said, "Whatever you do, 507 00:23:50,306 --> 00:23:54,432 don't drill into my head," I wouldn't have. 508 00:23:55,810 --> 00:23:57,536 It's pretty simple. 509 00:23:57,538 --> 00:24:00,538 You can't do what the patient doesn't want. 510 00:24:00,540 --> 00:24:03,391 Okay, this is what we're gonna do. 511 00:24:03,393 --> 00:24:05,544 I did a deep dive into temporary pacers. 512 00:24:05,546 --> 00:24:08,136 Wyatt passes out, we get the pads on him, 513 00:24:08,138 --> 00:24:09,972 shock him if we need to, slip it in 514 00:24:09,974 --> 00:24:11,157 - at his bedside. - Hey. 515 00:24:18,148 --> 00:24:19,333 Let's get him some O2. 516 00:24:19,335 --> 00:24:21,201 I'm nauseous. My stomach hurts. 517 00:24:21,202 --> 00:24:23,152 What's going on? 518 00:24:23,153 --> 00:24:25,838 Gut ischemia from poor perfusion. 519 00:24:25,840 --> 00:24:27,490 Your heart rate's too low. 520 00:24:27,491 --> 00:24:29,084 Let's get him some pain meds. 521 00:24:29,086 --> 00:24:30,510 Page Bell. 522 00:24:30,512 --> 00:24:32,136 Okay. 523 00:24:40,838 --> 00:24:42,439 Okay. 524 00:24:45,602 --> 00:24:48,435 Yeah, he's-he's calmer now with the pain meds on board. 525 00:24:48,438 --> 00:24:51,589 It's highly likely he has dying bowel, 526 00:24:51,592 --> 00:24:54,425 but he's not a viable candidate for surgery. 527 00:24:54,427 --> 00:24:55,943 Unless we get him to agree to a pacer. 528 00:24:55,945 --> 00:24:59,447 And, yeah, if you do, tell me, and I'll take him to the OR. 529 00:24:59,449 --> 00:25:01,375 As of now, all the complications 530 00:25:01,376 --> 00:25:03,876 from his untreated heart condition are fixable, 531 00:25:03,878 --> 00:25:06,462 but I don't know for how long. 532 00:25:08,365 --> 00:25:10,467 He's refusing all intervention. 533 00:25:12,221 --> 00:25:14,037 Is there anything else I can do for you? 534 00:25:14,038 --> 00:25:15,556 I wish there were. 535 00:25:20,971 --> 00:25:23,378 Okay, just... just hear me out. 536 00:25:23,381 --> 00:25:25,807 All right, you know the Dax Cowart case, right? 537 00:25:25,808 --> 00:25:28,977 He wanted to die after suffering catastrophic burns. 538 00:25:28,979 --> 00:25:31,462 He was in pain, terribly disfigured, went blind. 539 00:25:31,464 --> 00:25:33,388 And he was ruled to have capacity, too, 540 00:25:33,391 --> 00:25:37,493 but his doctors disregarded his wishes and saved his life. 541 00:25:38,580 --> 00:25:40,395 Mm-hmm. 542 00:25:40,397 --> 00:25:43,307 Yeah, he had a career, he had a family, 543 00:25:43,309 --> 00:25:46,068 I mean, he lived until he was 71. 544 00:25:46,070 --> 00:25:48,904 Wyatt can have the same thing. 545 00:25:48,906 --> 00:25:51,240 Dax Cowart became a lawyer and built a career 546 00:25:51,241 --> 00:25:52,983 on fighting for patients' rights. 547 00:25:52,986 --> 00:25:55,596 He used his own case to show what the doctors did, 548 00:25:55,597 --> 00:25:59,432 what you want to do to Wyatt, was a betrayal of those rights. 549 00:25:59,434 --> 00:26:00,659 It's not a betrayal of his rights. 550 00:26:00,661 --> 00:26:02,141 Hey, I'm as frustrated as you are. 551 00:26:03,271 --> 00:26:05,253 As doctors, our purpose is to help. 552 00:26:05,256 --> 00:26:06,588 And you got that part right. 553 00:26:06,590 --> 00:26:09,351 But Wyatt needs to want to be helped. 554 00:26:09,353 --> 00:26:11,032 No, until he's dead, I'm not giving up. 555 00:26:16,785 --> 00:26:18,535 Then neither am I. 556 00:26:22,199 --> 00:26:23,772 Sorry I'm late. 557 00:26:24,776 --> 00:26:27,442 Had a rough consult with Conrad's patient. 558 00:26:27,444 --> 00:26:29,520 The exact opposite of Brit. 559 00:26:29,522 --> 00:26:31,780 He doesn't trust Conrad, for all the wrong reasons. 560 00:26:31,782 --> 00:26:33,858 And here I am tied up in knots 561 00:26:33,861 --> 00:26:36,451 over a patient who trusts me too much. 562 00:26:36,453 --> 00:26:38,046 You made the best decision you could 563 00:26:38,048 --> 00:26:39,806 with the information you have. 564 00:26:44,872 --> 00:26:46,872 You have a very unusual career path. 565 00:26:46,874 --> 00:26:49,891 What brought you from oncology to emergency medicine? 566 00:26:49,893 --> 00:26:51,467 So much suffering and death. 567 00:26:51,469 --> 00:26:54,229 The patients call you weeping at all hours 568 00:26:54,230 --> 00:26:56,471 of the day and night. 569 00:26:56,473 --> 00:26:59,992 I-I was worn out from the stress. 570 00:26:59,994 --> 00:27:02,721 Those days ruined me. And now? 571 00:27:02,722 --> 00:27:05,164 Just off a shift, look at me... I'm still fresh. 572 00:27:05,166 --> 00:27:07,166 Well, it must have been a challenge to go back 573 00:27:07,169 --> 00:27:09,576 to residency and learn all the ER procedures. 574 00:27:09,578 --> 00:27:12,230 Hmm, I'm not one for new techniques. 575 00:27:12,231 --> 00:27:14,824 I pretty much slept through that residency. 576 00:27:14,826 --> 00:27:17,844 - It was no big deal. - I see. 577 00:27:19,329 --> 00:27:20,513 I told you, Doc. 578 00:27:20,516 --> 00:27:24,726 If God wants me to live, I'll live. 579 00:27:26,054 --> 00:27:29,480 He'll reach His hand down to me. 580 00:27:30,508 --> 00:27:33,175 He's always been so good to me. 581 00:27:33,177 --> 00:27:35,362 Is this about luck now, Wyatt? 582 00:27:35,364 --> 00:27:36,364 Or God? 583 00:27:38,275 --> 00:27:42,035 He can't save you right now. We can. 584 00:27:42,037 --> 00:27:44,203 Leave me alone, Doc. 585 00:27:46,933 --> 00:27:49,616 No. Wyatt... 586 00:27:49,618 --> 00:27:52,361 - Trevor. - You just, you got to listen to what I'm... 587 00:27:52,363 --> 00:27:54,131 Trevor. Trevor, take a walk now. 588 00:28:06,803 --> 00:28:08,060 He's young. 589 00:28:09,623 --> 00:28:12,190 But he cares deeply. 590 00:28:14,478 --> 00:28:17,738 And I respect your faith in God's will. 591 00:28:17,740 --> 00:28:20,147 I'm in His hands now. 592 00:28:20,150 --> 00:28:24,301 And you always have been, right? 593 00:28:25,305 --> 00:28:29,665 How do you know He is not using us to save you? 594 00:28:31,753 --> 00:28:34,496 You think he wasn't sitting beside Rune Elmqvist in Sweden 595 00:28:34,498 --> 00:28:37,315 half a century ago when he invented the pacemaker? 596 00:28:37,317 --> 00:28:40,594 He is sending you one lifeline after another. 597 00:28:44,324 --> 00:28:45,515 Hey. 598 00:28:48,252 --> 00:28:50,770 I'll ask Him. 599 00:28:52,665 --> 00:28:54,231 Wyatt? 600 00:29:09,773 --> 00:29:12,107 Wyatt. 601 00:29:27,308 --> 00:29:29,476 Yeah, the liver is exposed. 602 00:29:29,478 --> 00:29:31,051 Ready to begin the enucleation. 603 00:29:31,054 --> 00:29:33,371 Remember, the beauty of this technique is that we, 604 00:29:33,373 --> 00:29:35,981 we work along existing planes to pop the mass out 605 00:29:35,983 --> 00:29:37,483 and we leave the liver intact. 606 00:29:37,486 --> 00:29:39,301 That's how we avoid massive bleeding. 607 00:29:39,304 --> 00:29:42,564 And note the vessels extending into the liver. 608 00:29:42,566 --> 00:29:45,141 Divide and ligate. 609 00:29:45,143 --> 00:29:47,786 Be careful. 610 00:29:49,072 --> 00:29:50,572 Ugh, I have a tiny bleeder. 611 00:29:50,574 --> 00:29:51,789 Cautery. 612 00:29:54,227 --> 00:29:56,411 And another one. 613 00:29:56,413 --> 00:29:57,671 Okay, suction. 614 00:30:03,086 --> 00:30:04,594 Okay, that's arterial. Clamp. 615 00:30:07,240 --> 00:30:09,391 Dr. Bell? Here's the clamp. 616 00:30:14,355 --> 00:30:15,605 Are you okay? 617 00:30:17,008 --> 00:30:18,249 Uh, no. 618 00:30:18,250 --> 00:30:19,608 Jessica, I'll take it. 619 00:30:21,346 --> 00:30:22,845 Uh, Dr. Devi, I have to leave. 620 00:30:22,846 --> 00:30:24,771 What? 621 00:30:24,773 --> 00:30:26,106 I-I'll find someone to cover as soon as possible. 622 00:30:26,108 --> 00:30:27,366 Uh, as soon as possible. 623 00:30:31,539 --> 00:30:32,788 Dr. Bell. 624 00:30:39,288 --> 00:30:40,755 You can do this. 625 00:30:49,557 --> 00:30:51,965 I've got the mass on the last vascular pedicle. 626 00:30:51,968 --> 00:30:53,709 Any word from Bell? 627 00:30:53,711 --> 00:30:55,135 Nothing yet. You'll probably get this sucker out of here 628 00:30:55,137 --> 00:30:56,770 before anyone comes. 629 00:30:59,401 --> 00:31:01,902 Pressure's drifting down, Dr. Devi. 630 00:31:01,903 --> 00:31:04,796 She's losing blood. Let's get some blood products in her. 631 00:31:04,798 --> 00:31:06,071 Tell me what you need. 632 00:31:06,074 --> 00:31:08,799 Lap pads and suction. I'm operating underwater here. 633 00:31:08,801 --> 00:31:10,300 If I can't find the source for the bleeding, I can't fix it. 634 00:31:10,303 --> 00:31:11,635 Two units are in, and I activated 635 00:31:11,637 --> 00:31:14,138 massive transfusion protocol. We're maxed on norepi. 636 00:31:14,141 --> 00:31:16,398 Found it. 637 00:31:16,401 --> 00:31:17,400 - You've got to get control. - She won't tolerate 638 00:31:17,402 --> 00:31:19,234 this blood loss much longer. 639 00:31:19,237 --> 00:31:20,921 I need to remove the portion of the liver 640 00:31:20,923 --> 00:31:22,497 the vessel is feeding. Prepare for a hepatectomy. 641 00:31:22,499 --> 00:31:24,982 That's a serious change in plans. 642 00:31:24,984 --> 00:31:25,983 We should call Dr. Bell first. 643 00:31:25,986 --> 00:31:27,501 No time. Clamp, now. 644 00:31:27,503 --> 00:31:30,821 Chu, give her 1:1:1 resuscitation to keep up. 645 00:31:30,824 --> 00:31:32,703 - Jessica, do not stop that suction. - Got it. 646 00:31:38,832 --> 00:31:40,065 Got it. 647 00:31:42,093 --> 00:31:43,351 We've got a stable pressure. 648 00:31:43,353 --> 00:31:46,003 Strong work, Dr. Devi. 649 00:31:48,174 --> 00:31:49,615 You did it. 650 00:31:49,617 --> 00:31:51,933 Let's get her closed up 651 00:31:51,935 --> 00:31:53,619 and off this table. 652 00:32:00,295 --> 00:32:02,444 What do you think the evidence is 653 00:32:02,446 --> 00:32:03,871 behind cookies for stress relief? 654 00:32:03,873 --> 00:32:05,280 Anecdotal 655 00:32:05,282 --> 00:32:07,375 - but robust. - I'm really feeling 656 00:32:07,376 --> 00:32:09,527 - the chocolate chip. - Dr. Austin? 657 00:32:09,528 --> 00:32:10,804 Of all people. 658 00:32:10,806 --> 00:32:12,621 Do raptors do yoga? 659 00:32:12,623 --> 00:32:16,217 I'm only here because my CEO told me I had to be here. 660 00:32:16,219 --> 00:32:17,384 But I won't be here for long. 661 00:32:17,386 --> 00:32:19,203 I have to round on the post-ops again 662 00:32:19,205 --> 00:32:20,555 before I fly to Manhattan tonight 663 00:32:20,557 --> 00:32:22,964 - for talk shows tomorrow. - Well, I'm stiff, 664 00:32:22,967 --> 00:32:24,041 my back is in knots. 665 00:32:24,044 --> 00:32:25,468 I've been in interviews all day, 666 00:32:25,470 --> 00:32:28,546 looking for an actual doctor who likes actual doctoring. 667 00:32:28,548 --> 00:32:30,073 Welcome, health care heroes. 668 00:32:31,326 --> 00:32:33,050 Uh, listen, I am not a man 669 00:32:33,052 --> 00:32:34,643 that you will find in Child's Pose. 670 00:32:34,644 --> 00:32:36,237 So I'm just gonna be on my way to... 671 00:32:36,239 --> 00:32:37,771 AJ, I happen to know from personal experience 672 00:32:37,773 --> 00:32:40,741 that you could really benefit from a little extra flexibility. 673 00:32:40,743 --> 00:32:44,628 All right, come lie down and grab a mat. 674 00:32:46,398 --> 00:32:49,250 Close your eyes. 675 00:32:49,251 --> 00:32:53,496 Let the world fade away and just relax. 676 00:32:53,498 --> 00:32:55,498 It's the ER. 677 00:32:56,409 --> 00:32:57,833 Oh, that's my next interview. 678 00:32:57,835 --> 00:32:59,410 Med-surg floor. 679 00:32:59,412 --> 00:33:01,479 My mother's having another complication. 680 00:33:04,358 --> 00:33:06,250 I mean, I feel 681 00:33:06,252 --> 00:33:07,509 so blissed out right now. 682 00:33:07,511 --> 00:33:09,845 I feel like I'm back to zero. I feel great. 683 00:33:09,846 --> 00:33:12,589 You know, after this is all done, 684 00:33:12,592 --> 00:33:15,367 I think that you and I should go to this great little vegan place 685 00:33:15,369 --> 00:33:16,594 that I know about in Inman Park. 686 00:33:16,596 --> 00:33:17,778 It-It's wonderful. 687 00:33:17,946 --> 00:33:20,265 It's the best tempeh à la King you will ever have. 688 00:33:20,267 --> 00:33:23,625 You're cute. Not a chance. 689 00:33:27,531 --> 00:33:29,715 That's a, that's a no, then? 690 00:33:32,702 --> 00:33:35,445 Okay, Wyatt Barnes' heart rate is in the 20s. 691 00:33:35,448 --> 00:33:37,115 He has gut ischemia, his kidneys are failing. 692 00:33:37,116 --> 00:33:38,282 Without a pacer, he's dying. 693 00:33:38,285 --> 00:33:40,117 We're running out of time, and he's waiting 694 00:33:40,119 --> 00:33:41,430 for the hand of God to reach down 695 00:33:41,453 --> 00:33:43,063 - and-and save him from... - First of all, back up. 696 00:33:43,065 --> 00:33:44,622 You're in my personal space. 697 00:33:44,624 --> 00:33:46,790 And you have intern coffee breath, which I do not like. 698 00:33:46,792 --> 00:33:48,459 Okay, look, look, look, with all due respect, 699 00:33:48,461 --> 00:33:50,627 Dr. Hawkins seems to have lost his edge, 700 00:33:50,630 --> 00:33:52,555 it's gonna cost a young dude his life. 701 00:33:52,557 --> 00:33:53,798 Can you please just put in a pacer, please? 702 00:33:53,799 --> 00:33:55,982 - I have one right here, come on. - Put that away. 703 00:33:55,984 --> 00:33:57,317 You are a green recruit 704 00:33:57,319 --> 00:33:59,470 questioning the general on the field. 705 00:33:59,471 --> 00:34:00,821 W-Wait, hold up. If someone came into this hospital 706 00:34:00,824 --> 00:34:02,973 after slitting their wrists or-or taking pills, 707 00:34:02,976 --> 00:34:04,157 we'd save them, right? 708 00:34:04,160 --> 00:34:05,660 Wyatt Barnes is doing the same thing. 709 00:34:05,662 --> 00:34:07,403 This is not a suicide. 710 00:34:07,404 --> 00:34:10,481 This is a man with capacity refusing intervention. 711 00:34:10,483 --> 00:34:12,483 That's a right we cannot abridge. 712 00:34:12,485 --> 00:34:13,909 His recalcitrance is not jeopardizing 713 00:34:13,911 --> 00:34:15,503 anyone else's health. 714 00:34:15,505 --> 00:34:17,672 - He's only hurting himself. - Okay, but he is hurting himself... 715 00:34:17,673 --> 00:34:18,989 Trevor, stop. 716 00:34:18,992 --> 00:34:22,251 Now you go back to your patient's room. 717 00:34:22,253 --> 00:34:26,179 You watch Dr. Hawkins and you do what he says. 718 00:34:26,181 --> 00:34:29,090 Stop second-guessing him. 719 00:34:29,092 --> 00:34:30,735 You might learn something. 720 00:34:39,103 --> 00:34:41,788 Please let me save you, Wyatt. 721 00:34:44,626 --> 00:34:47,501 I have everything we need. You just say the word. 722 00:34:51,206 --> 00:34:53,132 Think of all the beautiful things 723 00:34:53,135 --> 00:34:56,135 you'll never be able to experience again. 724 00:34:56,137 --> 00:34:59,472 I don't know what happens when you die, 725 00:34:59,474 --> 00:35:01,724 but I bet you don't get to kiss a woman... 726 00:35:03,385 --> 00:35:06,563 and know you want to be with her for the rest of your life. 727 00:35:08,298 --> 00:35:11,818 Don't you want to wake up on the first day of fall? 728 00:35:11,820 --> 00:35:13,878 Eat a peach? 729 00:35:15,472 --> 00:35:18,157 Laugh your ass off with your best friends? 730 00:35:18,159 --> 00:35:20,141 You don't have to give up any of that. 731 00:35:20,143 --> 00:35:22,887 Think of how lucky that makes you. 732 00:35:43,018 --> 00:35:45,101 Is he still saying no? 733 00:35:57,940 --> 00:35:59,157 Do it. 734 00:36:00,684 --> 00:36:02,117 Please. 735 00:36:15,865 --> 00:36:18,775 What are we here for, anyway, huh? 736 00:36:18,777 --> 00:36:24,614 To watch people we could save just... just die? 737 00:36:24,617 --> 00:36:27,434 I was here to save him. 738 00:36:28,878 --> 00:36:33,483 Now we're just here to make sure he doesn't die alone. 739 00:37:13,016 --> 00:37:15,565 He's your first death. 740 00:37:19,355 --> 00:37:21,597 Yeah. 741 00:37:21,599 --> 00:37:24,175 Not how I imagined it would go down. 742 00:37:24,177 --> 00:37:28,195 You pictured a different kind of heroism, 743 00:37:28,197 --> 00:37:31,708 blood spattered all over your white coat. 744 00:37:36,447 --> 00:37:39,047 Do you ever get used to it? 745 00:37:40,117 --> 00:37:43,135 It never gets easier. It just... 746 00:37:43,137 --> 00:37:45,137 It just gets different. 747 00:37:46,715 --> 00:37:52,478 But today was no small accomplishment. Dr. Daniels. 748 00:37:57,985 --> 00:38:00,652 We allowed him to live and die according to his principles, 749 00:38:00,655 --> 00:38:03,572 and because of that, we managed to keep ours. 750 00:38:11,557 --> 00:38:15,335 Look, again, I'm-I'm sorry about what happened in there. 751 00:38:15,336 --> 00:38:17,318 Well, I'm relieved you're okay. 752 00:38:17,320 --> 00:38:19,338 No, I-I'll be fine, it's just... 753 00:38:19,340 --> 00:38:21,748 It's a pinched nerve and... 754 00:38:21,751 --> 00:38:23,900 little bit of vertigo that came on suddenly. 755 00:38:23,902 --> 00:38:26,536 I think, you know, I-I overreacted, 756 00:38:26,539 --> 00:38:29,739 but in the moment, I-I thought if I stayed in the OR, 757 00:38:29,742 --> 00:38:32,425 you'd have two patients to deal with, so... 758 00:38:32,427 --> 00:38:34,853 Well, then, you did the right thing. 759 00:38:34,856 --> 00:38:37,023 So did you. 760 00:38:37,025 --> 00:38:38,507 This time. 761 00:38:38,509 --> 00:38:41,443 But, to be honest, it could have gone either way. 762 00:38:49,371 --> 00:38:51,762 - Hi. - So? 763 00:38:51,764 --> 00:38:54,206 Did you find anything else horrible inside me? 764 00:38:54,208 --> 00:38:56,525 I'm vaguely optimistic 765 00:38:56,527 --> 00:38:59,878 because I have a familiar sense of existential dread, 766 00:38:59,880 --> 00:39:02,940 and I'm pretty sure that can't be removed surgically. 767 00:39:02,942 --> 00:39:04,442 The surgery went great. 768 00:39:04,443 --> 00:39:05,960 You're going to be fine. 769 00:39:05,961 --> 00:39:07,612 Thanks to Dr. Devi. 770 00:39:07,614 --> 00:39:10,280 There was a complication during surgery. 771 00:39:10,282 --> 00:39:12,057 We had to remove a small piece of your liver. 772 00:39:12,059 --> 00:39:14,117 But it will grow back. 773 00:39:14,119 --> 00:39:15,543 And the hemangioma is gone for good. 774 00:39:15,545 --> 00:39:18,639 Thank you. I mean, really, thank you. 775 00:39:18,641 --> 00:39:21,641 And you made the right decision for me, too. 776 00:39:21,643 --> 00:39:25,128 Can I call you next time I'm buying a new car? 777 00:39:25,130 --> 00:39:26,297 Or don't know what to do 778 00:39:26,298 --> 00:39:28,298 when I get in a fight with my mom? 779 00:39:28,300 --> 00:39:29,742 I actually am a triple board-certified 780 00:39:29,744 --> 00:39:30,893 mother vanquisher. 781 00:39:36,643 --> 00:39:38,733 So... 782 00:39:38,735 --> 00:39:40,628 it's a no. 783 00:39:42,405 --> 00:39:44,514 Even the former oncologist? 784 00:39:44,516 --> 00:39:45,740 He's burnt out. 785 00:39:45,742 --> 00:39:47,985 He's not interested in learning anything new. 786 00:39:47,987 --> 00:39:50,838 H-He doesn't love medicine. 787 00:39:50,840 --> 00:39:52,338 None of them do. 788 00:39:52,340 --> 00:39:54,081 Keep looking. It's just the first round. 789 00:39:54,083 --> 00:39:55,992 No need to be discouraged. 790 00:39:55,994 --> 00:39:57,585 And the thing is, Dr. Voss, 791 00:39:57,588 --> 00:40:00,164 when I was talking to them, I realized 792 00:40:00,166 --> 00:40:01,773 I might not be so different. 793 00:40:03,001 --> 00:40:04,360 Of course you are, Dr. Pravesh. 794 00:40:05,762 --> 00:40:09,114 I am judging people for not loving medicine enough 795 00:40:09,117 --> 00:40:11,842 while trying to cut down on clinical time 796 00:40:11,844 --> 00:40:12,934 to go do research. 797 00:40:12,936 --> 00:40:14,695 I think about being in the ER 798 00:40:14,697 --> 00:40:19,365 year after year after year, with no outlet for research, 799 00:40:19,367 --> 00:40:22,443 and I don't know how we don't drown in the sickness, 800 00:40:22,445 --> 00:40:26,039 the sadness, the pressure, the paperwork. 801 00:40:27,635 --> 00:40:31,471 Half of my med school class isn't doing medicine anymore. 802 00:40:33,141 --> 00:40:35,474 That means something. 803 00:40:36,293 --> 00:40:40,771 Yes, I think it does. 804 00:40:57,072 --> 00:40:58,456 Hey. 805 00:41:03,003 --> 00:41:04,894 Hell of a day. 806 00:41:04,896 --> 00:41:07,340 Yeah, I heard. 807 00:41:07,342 --> 00:41:09,657 So, how tempted were you to put in the pacer 808 00:41:09,659 --> 00:41:13,161 - against the patient's wishes? - More than I'd like to admit. 809 00:41:13,163 --> 00:41:15,905 But there are some rules we can't break. 810 00:41:15,907 --> 00:41:18,541 Do I know I made the right choice? Yeah. 811 00:41:18,543 --> 00:41:21,670 Do I wish I'd made the wrong one? Maybe. 812 00:41:21,672 --> 00:41:23,505 I know my intern thinks so. 813 00:41:23,507 --> 00:41:27,842 I heard Dr. Daniels has a hard time with the rules. 814 00:41:27,844 --> 00:41:30,436 But maybe the example you set saved his medical career. 815 00:41:30,438 --> 00:41:32,532 To say nothing of your responsibility to your patient. 816 00:41:32,534 --> 00:41:34,440 Yeah, he's a bright kid, that Trevor, 817 00:41:34,443 --> 00:41:36,369 but too much confidence and passion, 818 00:41:36,371 --> 00:41:38,746 not nearly enough restraint. 819 00:41:44,193 --> 00:41:46,503 He learned something today. 820 00:41:52,961 --> 00:41:54,445 If I'd have saved Wyatt, 821 00:41:54,447 --> 00:41:57,056 would he have come back in ten years 822 00:41:57,057 --> 00:41:59,373 with an armload of kids, 823 00:41:59,376 --> 00:42:02,519 grateful that we didn't listen to him? 824 00:42:09,628 --> 00:42:12,070 And now I realize none of this is why you are here. 825 00:42:15,391 --> 00:42:16,659 Nope. 826 00:42:18,137 --> 00:42:20,079 I got a favor to ask you. 827 00:42:24,918 --> 00:42:26,327 What? 828 00:42:26,329 --> 00:42:29,255 But, look, before I even-even spell it out, 829 00:42:29,257 --> 00:42:32,833 can I count on you for full confidentiality? 830 00:42:32,835 --> 00:42:34,467 Go on. 831 00:42:36,764 --> 00:42:40,099 Something's wrong with me, a-and I'm not quite sure what. 832 00:42:42,010 --> 00:42:43,768 But I think it may be serious. 833 00:42:44,972 --> 00:42:46,438 You want me to examine you? 834 00:42:46,440 --> 00:42:48,106 Yeah, I'll clear my schedule tomorrow. 835 00:42:48,108 --> 00:42:50,333 Let's come in early. 836 00:42:50,335 --> 00:42:54,021 And the fact that I'm being tested at all, 837 00:42:54,023 --> 00:42:57,507 the results, all under the radar. 838 00:42:57,510 --> 00:42:59,768 So, is that something you can do? 839 00:43:03,865 --> 00:43:07,067 Okay. Great, thanks. 840 00:43:08,855 --> 00:43:11,038 Captioning sponsored by 20th CENTURY FOX TELEVISION 841 00:43:11,039 --> 00:43:12,797 and TOYOTA. 842 00:43:12,800 --> 00:43:15,760 Captioned by Media Access Group at WGBH access.wgbh.org 62350

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