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Previously on The Resident...
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Hope it's okay that I'm here.
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- 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.
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00:03:23,062 --> 00:03:24,637
Okay, Pravesh almost
cut me, so...
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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.
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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
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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
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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.
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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.
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00:04:42,975 --> 00:04:43,973
He caused all of this.
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00:04:43,975 --> 00:04:44,975
There's something
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00:04:44,976 --> 00:04:46,494
definitely wrong with him.
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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
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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?
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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.
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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.
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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?
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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
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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
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841
00:43:11,039 --> 00:43:12,797
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842
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