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Previously on
"The Resident"...
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00:00:02,346 --> 00:00:04,152
Hope it's okay
that I'm here.
3
00:00:04,236 --> 00:00:06,257
- How dare you?
- What happened here?
4
00:00:06,341 --> 00:00:07,647
If you stepped out of line,
5
00:00:07,731 --> 00:00:09,528
then it won't just be Pravesh
who comes for you.
6
00:00:09,613 --> 00:00:12,342
Surgery is a dangerous place.
7
00:00:12,426 --> 00:00:14,345
Especially considering
your condition.
8
00:00:14,429 --> 00:00:16,085
You mean my dyslexia?
9
00:00:16,169 --> 00:00:17,608
Tell me why you aren't
a scientist yet.
10
00:00:17,692 --> 00:00:19,923
This is obviously your future.
You just got to go for it.
11
00:00:20,007 --> 00:00:21,982
I would like to start
shifting my professional focus
12
00:00:22,066 --> 00:00:23,055
to clinical trials.
13
00:00:23,139 --> 00:00:25,673
Have a proposal on my desk
by Monday.
14
00:00:26,166 --> 00:00:28,988
"The Weight" by The Band
playing...
15
00:00:35,277 --> 00:00:39,247
- ♪ I pulled into Nazareth... ♪
- No eggs, Daddy, please, no eggs.
16
00:00:39,331 --> 00:00:42,426
I want cereal.
And a banana.
17
00:00:42,510 --> 00:00:44,911
Whoa, whoa, excuse me.
18
00:00:44,995 --> 00:00:46,758
Coming right up.
19
00:00:47,926 --> 00:00:50,677
♪ Hey, mister, can you tell me ♪
20
00:00:50,761 --> 00:00:53,736
♪ Where a man
might find a bed? ♪
21
00:00:54,783 --> 00:00:57,103
♪ He just grinned
and shook my hand... ♪
22
00:00:57,345 --> 00:01:01,004
Daddy, did you forget
to go to the market again?
23
00:01:01,088 --> 00:01:02,786
♪ Take a load off... ♪
24
00:01:02,870 --> 00:01:04,340
I did.
25
00:01:04,589 --> 00:01:06,464
I am a bad daddy.
26
00:01:06,565 --> 00:01:08,043
No, you're not.
27
00:01:08,127 --> 00:01:10,153
♪ Take a load off, Fanny... ♪
28
00:01:10,237 --> 00:01:11,900
Let's grab your backpack.
29
00:01:12,126 --> 00:01:14,550
We'll get something great
for you...
30
00:01:14,634 --> 00:01:17,037
Takeout on the way to school.
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00:01:17,121 --> 00:01:19,625
♪ You put the load right on me ♪
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00:01:19,798 --> 00:01:22,991
♪ Ooh-ooh-ooh-ooh ♪
33
00:01:24,221 --> 00:01:26,468
♪ I picked up my bag ♪
34
00:01:26,554 --> 00:01:30,827
♪ I went looking
for a place to hide ♪
35
00:01:30,911 --> 00:01:33,236
♪ When I saw Carmen ♪
36
00:01:33,320 --> 00:01:36,833
♪ And the devil
walking side by side... ♪
37
00:01:36,917 --> 00:01:38,801
That's another all-nighter.
This has got to stop.
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00:01:38,885 --> 00:01:41,311
- I know.
- You're wearing yourself out.
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00:01:41,395 --> 00:01:42,973
I know.
40
00:01:43,241 --> 00:01:45,160
But I don't know how to stop.
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00:01:45,244 --> 00:01:50,476
♪ I got to go, but my friend
can stick around ♪
42
00:01:51,407 --> 00:01:53,858
♪ Take a load off, Fanny ♪
43
00:01:53,942 --> 00:01:57,023
♪ Take a load for free ♪
44
00:01:57,351 --> 00:02:00,684
♪ Take a load off, Fanny ♪
45
00:02:00,768 --> 00:02:02,858
♪ And, and ♪
46
00:02:02,942 --> 00:02:05,602
♪ And you put the load
right on me ♪
47
00:02:05,686 --> 00:02:08,107
♪ You put the load right on me ♪
48
00:02:13,619 --> 00:02:15,850
♪ Crazy Chester followed me ♪
49
00:02:15,994 --> 00:02:18,859
♪ And he caught me in the fog ♪
50
00:02:19,978 --> 00:02:22,712
♪ He said,
"I will fix your rack ♪
51
00:02:22,796 --> 00:02:26,364
♪ If you'll take Jack my dog" ♪
52
00:02:26,448 --> 00:02:29,444
♪ I said,
"Wait a minute, Chester ♪
53
00:02:29,528 --> 00:02:33,539
♪ You know I'm a peaceful man" ♪
54
00:02:33,623 --> 00:02:35,220
♪ He said, "That's okay, boy ♪
55
00:02:36,551 --> 00:02:38,209
♪ Won't you feed him
when you can?" ♪
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00:02:38,293 --> 00:02:43,399
♪ Yeah, take a load off, Fanny ♪
57
00:02:43,483 --> 00:02:46,569
♪ Take a load for free ♪
58
00:02:46,653 --> 00:02:50,239
♪ Take a load off, Fanny ♪
59
00:02:50,323 --> 00:02:52,575
♪ And, and ♪
60
00:02:52,659 --> 00:02:54,802
♪ And you put the load
right on me ♪
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00:02:54,886 --> 00:02:57,573
♪ Put the load right on me... ♪
62
00:03:06,506 --> 00:03:08,757
Dude, I lanced
this massive abscess,
63
00:03:08,841 --> 00:03:10,818
and the pus exploded
all over Dr. Feldman.
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00:03:10,902 --> 00:03:12,428
- Ah.
- He was pissed.
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00:03:12,512 --> 00:03:14,505
- Pus-wise, better him than you.
- Definitely.
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00:03:14,589 --> 00:03:16,766
Trevor, we know you made
the highlight reel.
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00:03:16,850 --> 00:03:17,916
Yeah, yeah.
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00:03:18,000 --> 00:03:19,601
No eruptions
of bodily fluids, though.
69
00:03:19,685 --> 00:03:20,920
You had that awesome spinal tap.
70
00:03:21,004 --> 00:03:23,255
Hello. Beer-gate? Legendary.
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00:03:23,339 --> 00:03:24,832
Okay, Pravesh almost
cut me, so...
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00:03:24,916 --> 00:03:27,668
Sure, but then Hawkins
swooped in
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00:03:27,752 --> 00:03:29,854
and took you under his wing.
Please, golden boy.
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00:03:29,938 --> 00:03:31,329
- "Golden boy."
- I don't think anyone has any
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00:03:31,414 --> 00:03:33,116
strong feelings
about me either way.
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00:03:33,200 --> 00:03:34,956
All right, well, I'd really like
to put in a central line.
77
00:03:35,040 --> 00:03:37,691
Hey. Five-car pileup
on Peachtree,
78
00:03:37,775 --> 00:03:39,363
multiple injuries
headed our way.
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00:03:39,447 --> 00:03:42,244
All hands on deck.
It's game time.
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00:03:54,661 --> 00:03:56,354
*THE RESIDENT*
Season 05 Episode 09
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Episode Title:
"He'd Really Like to Put in a Central Lineo"
82
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Aired on:
November 30, 2021.
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Dr. Hawkins, Bay 2.
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00:04:00,893 --> 00:04:03,075
- On it.
- All right, let's get him to Bay 4.
85
00:04:03,159 --> 00:04:05,412
- Zach, with me.
- Gemma, Bay 9.
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00:04:05,496 --> 00:04:07,271
Pravesh, Bay 10.
We're gonna need
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00:04:07,355 --> 00:04:08,716
- another set of hands in there.
- Okay,
88
00:04:08,800 --> 00:04:10,673
Janice, Trevor,
you come with me.
89
00:04:11,396 --> 00:04:12,825
Pravesh!
90
00:04:13,232 --> 00:04:15,819
- Give me Trevor.
- Go see what he needs.
91
00:04:21,597 --> 00:04:23,203
Grab the ultrasound.
92
00:04:23,287 --> 00:04:24,947
Right.
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00:04:27,057 --> 00:04:28,400
Assess her
for internal injuries,
94
00:04:28,484 --> 00:04:30,727
then we'll deal with
the lower-extremity lacerations.
95
00:04:31,654 --> 00:04:32,796
Got it.
96
00:04:32,880 --> 00:04:34,649
Whoa.
97
00:04:34,733 --> 00:04:37,484
- Ma'am, what's wrong?
- It's not my stomach. I'm okay.
98
00:04:37,568 --> 00:04:39,486
But he's not.
99
00:04:39,570 --> 00:04:42,732
I watched him turn his bike
and drive right into traffic.
100
00:04:42,816 --> 00:04:44,097
He caused all of this.
101
00:04:44,181 --> 00:04:46,863
There's something
definitely wrong with him.
102
00:04:47,945 --> 00:04:50,872
Hey, Zach. I need you
to do a quick FAST exam
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00:04:50,956 --> 00:04:53,502
and suture up some lacs.
Trevor, come with me.
104
00:05:00,050 --> 00:05:02,044
The X-rays showed
a fractured rib
105
00:05:02,128 --> 00:05:04,006
but fortunately no broken ankle.
106
00:05:04,303 --> 00:05:05,807
You're gonna be fine.
107
00:05:06,019 --> 00:05:08,672
- You're in good hands here.
- Thank you.
108
00:05:08,756 --> 00:05:10,386
You're welcome.
109
00:05:11,597 --> 00:05:13,083
I-I really don't know
what happened.
110
00:05:13,167 --> 00:05:16,076
One minute I'm riding my bike,
next I'm on the ground
111
00:05:16,160 --> 00:05:18,388
and cars are skidding
and crashing.
112
00:05:18,472 --> 00:05:19,646
I feel terrible.
113
00:05:19,730 --> 00:05:21,396
Sounds like you might
have passed out?
114
00:05:21,480 --> 00:05:23,266
You got lucky.
You could've been killed.
115
00:05:23,394 --> 00:05:25,732
Getting lucky
is kind of my thing.
116
00:05:25,816 --> 00:05:27,404
Yeah? How's that?
117
00:05:27,488 --> 00:05:30,443
I was on a charter boat once,
it sunk.
118
00:05:30,527 --> 00:05:33,191
Everyone drowned except me.
119
00:05:33,275 --> 00:05:36,037
- I won the lottery twice.
- Cool.
120
00:05:36,121 --> 00:05:38,145
Maybe you take a look at
the numbers I've been playing.
121
00:05:38,229 --> 00:05:39,706
Happy to, Doc.
122
00:05:40,253 --> 00:05:43,365
Wow, you got the odds
of the gods on your side.
123
00:05:43,449 --> 00:05:46,209
I have always felt protected
in an otherworldly way.
124
00:05:46,293 --> 00:05:47,692
A-And those
are just the highlights.
125
00:05:47,776 --> 00:05:50,708
I also got diagnosed
with this thing, sarcoid?
126
00:05:50,792 --> 00:05:53,997
- Mm-hmm.
- Supposed to be bad, but it's never been a problem.
127
00:05:54,081 --> 00:05:55,419
Sarcoid?
128
00:05:55,855 --> 00:05:57,848
What medications
are you taking for that?
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00:05:57,932 --> 00:06:00,944
None. I'm not one to take meds
I don't need.
130
00:06:01,028 --> 00:06:02,649
Too many side effects.
131
00:06:02,733 --> 00:06:05,098
- Whoa, whoa.
- Oh, Wyatt.
132
00:06:05,182 --> 00:06:06,579
Wyatt?
133
00:06:06,663 --> 00:06:09,248
We need to get him
on the monitor now.
134
00:06:09,332 --> 00:06:10,808
- Hey.
- Hey.
135
00:06:10,892 --> 00:06:12,645
Sorry you had to come in
on your day off.
136
00:06:12,729 --> 00:06:15,214
It's killing me. I've got to get
my grant proposal done.
137
00:06:15,496 --> 00:06:18,501
- How are you?
- Surgery went long. Don't ask.
138
00:06:18,658 --> 00:06:20,575
Man, it's crazy in here today.
139
00:06:20,659 --> 00:06:22,504
I know. Hi, Brit.
140
00:06:22,588 --> 00:06:24,764
This is Dr. Devi.
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00:06:24,848 --> 00:06:27,750
She's the surgical consultant
I told you about.
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00:06:27,834 --> 00:06:30,327
Uh, I'm so sorry. Hi, Brit.
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00:06:30,411 --> 00:06:31,937
I probably shouldn't have come.
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00:06:32,021 --> 00:06:33,774
I've had this pain
on and off for months.
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00:06:33,858 --> 00:06:36,591
But I realized
I'd lost ten pounds.
146
00:06:36,675 --> 00:06:39,687
Without trying, really,
so I'm a little spooked.
147
00:06:39,771 --> 00:06:41,676
I'm probably overreacting,
right?
148
00:06:41,760 --> 00:06:43,857
Let's just start with an exam.
149
00:06:45,003 --> 00:06:46,631
Ow! Right there.
150
00:06:46,715 --> 00:06:48,042
Can you describe
your pain for me?
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00:06:48,126 --> 00:06:49,559
Throbbing.
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00:06:49,643 --> 00:06:51,470
Or maybe stabbing.
153
00:06:51,554 --> 00:06:53,304
Are you having any nausea
or vomiting?
154
00:06:53,388 --> 00:06:54,732
I thought I was
just nervous at first,
155
00:06:54,816 --> 00:06:57,809
you know, existential angst,
which I am prone to,
156
00:06:57,893 --> 00:07:00,829
and it is kind of
my occupational wheelhouse.
157
00:07:01,308 --> 00:07:02,739
I'm a cartoonist.
158
00:07:02,823 --> 00:07:04,316
Life's a Joke.
159
00:07:04,400 --> 00:07:06,389
- That's my strip.
- Hmm.
160
00:07:06,848 --> 00:07:08,208
So, yes to the nausea
and vomiting?
161
00:07:08,292 --> 00:07:11,341
Oh, right, yes.
Krakatoa, east of Java, man.
162
00:07:11,425 --> 00:07:13,400
Just keeps on coming up.
163
00:07:13,484 --> 00:07:14,994
We'll start with a CT scan
to take a closer look,
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00:07:15,078 --> 00:07:17,506
and we can admit you
to get control over your pain
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00:07:17,590 --> 00:07:18,692
and we'll go from there.
166
00:07:18,776 --> 00:07:20,521
- Okay?
- Cool.
167
00:07:20,605 --> 00:07:22,623
All right, we'll be back.
168
00:07:27,209 --> 00:07:28,998
It's a large hepatic hemangioma.
169
00:07:29,082 --> 00:07:30,744
That's a good catch, Dr. Devi.
170
00:07:30,934 --> 00:07:32,599
I haven't seen one
of these before.
171
00:07:32,683 --> 00:07:34,255
Well, they're more common
than you'd think.
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00:07:34,339 --> 00:07:36,046
They're benign tumors
made up of clusters
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00:07:36,130 --> 00:07:37,247
of blood-filled cavities.
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00:07:37,331 --> 00:07:39,372
And usually
they don't cause symptoms.
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00:07:39,456 --> 00:07:41,193
Well, I'm relieved it's benign.
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00:07:41,277 --> 00:07:44,770
My patient will be, too.
She's a little kooky.
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00:07:44,854 --> 00:07:46,363
Sweet, though.
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00:07:46,863 --> 00:07:48,564
Should I book an OR for us
this afternoon?
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00:07:48,648 --> 00:07:51,235
Oh, not so fast.
Surgery's not a slam dunk here.
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00:07:51,938 --> 00:07:53,607
A benign tumor causing pain?
181
00:07:53,691 --> 00:07:55,708
Well, surgery on the liver
is always high-risk,
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00:07:55,792 --> 00:07:58,130
even in the best hands,
and pain can be managed.
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00:07:58,214 --> 00:08:00,193
Okay, so I tell her
we're not operating,
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00:08:00,277 --> 00:08:02,685
and I need a repeat scan
in two months.
185
00:08:02,769 --> 00:08:04,677
And that's not
the answer, either.
186
00:08:04,761 --> 00:08:06,717
This is not something
we can decide here.
187
00:08:06,801 --> 00:08:07,960
You need to talk to your patient
188
00:08:08,044 --> 00:08:09,537
and get a sense
of her risk tolerance
189
00:08:09,621 --> 00:08:11,294
and the seriousness
of her symptoms,
190
00:08:11,378 --> 00:08:14,759
and then you tell me
what path you think makes sense.
191
00:08:16,115 --> 00:08:18,068
All right. Can you come with?
192
00:08:18,152 --> 00:08:20,114
Nope. She's your patient,
you handle it.
193
00:08:20,198 --> 00:08:24,454
Then meet me in OR 3...
An, uh, emergent splenectomy.
194
00:08:25,224 --> 00:08:26,535
Uh, 15 minutes.
195
00:08:27,913 --> 00:08:29,407
So, you have two options.
196
00:08:29,491 --> 00:08:30,849
If you go with the surgery
and it goes well,
197
00:08:30,933 --> 00:08:33,001
- your symptoms go away.
- Awesome.
198
00:08:33,085 --> 00:08:35,255
But surgery on the liver
is never an easy call to make.
199
00:08:35,339 --> 00:08:37,388
It's an organ
with many large blood vessels,
200
00:08:37,472 --> 00:08:39,324
which means we could run
into significant bleeding.
201
00:08:39,408 --> 00:08:40,552
Oh. Not awesome.
202
00:08:40,636 --> 00:08:42,372
And that circumstance
would require
203
00:08:42,456 --> 00:08:44,420
a much larger abdominal surgery
with complications
204
00:08:44,504 --> 00:08:46,541
and a long recovery.
205
00:08:47,767 --> 00:08:48,759
Are you with me?
206
00:08:48,843 --> 00:08:50,001
Uh, sort of.
207
00:08:50,085 --> 00:08:53,396
Uh, you understand, right?
I'm not a doctor.
208
00:08:53,480 --> 00:08:54,835
I'm a cartoonist.
209
00:08:55,044 --> 00:08:56,480
Right.
210
00:08:56,564 --> 00:08:58,892
Um...
211
00:08:59,503 --> 00:09:00,849
Do you take risks?
212
00:09:00,933 --> 00:09:03,052
If you do,
then we go with the surgery.
213
00:09:03,136 --> 00:09:05,849
Are you cautious?
Then we hold off for now,
214
00:09:05,933 --> 00:09:07,698
so long as your pain
is tolerable.
215
00:09:09,495 --> 00:09:10,948
I don't know, Dr. Devi.
216
00:09:11,032 --> 00:09:13,208
Okay, you know what?
Look.
217
00:09:13,292 --> 00:09:15,599
It's okay. Big decision.
218
00:09:15,683 --> 00:09:17,505
Think about it,
and I will check in
219
00:09:17,589 --> 00:09:19,122
as soon as I'm back
from surgery, okay?
220
00:09:19,206 --> 00:09:20,861
Okay.
221
00:09:24,542 --> 00:09:26,890
Heart block. What is that?
222
00:09:26,974 --> 00:09:29,464
Because of the sarcoid,
your heart's electric circuit
223
00:09:29,548 --> 00:09:31,496
isn't working correctly,
so your heartbeat
224
00:09:31,580 --> 00:09:33,002
slows to a dangerously low rate.
225
00:09:33,086 --> 00:09:35,096
In some cases,
it can stop completely.
226
00:09:35,180 --> 00:09:37,341
Which, to state the obvious,
is fatal.
227
00:09:37,425 --> 00:09:39,935
This morning,
your heartbeat slowed so much
228
00:09:40,019 --> 00:09:41,822
that you fainted
and you crashed your bike.
229
00:09:41,906 --> 00:09:43,744
But there is some good news.
230
00:09:43,880 --> 00:09:45,102
Told you guys.
231
00:09:45,186 --> 00:09:46,658
The solution to your problem
232
00:09:46,742 --> 00:09:48,182
is safe and simple.
233
00:09:48,266 --> 00:09:49,592
We put in a pacemaker,
234
00:09:49,676 --> 00:09:51,963
and your heart goes back
to beating normally again.
235
00:09:52,047 --> 00:09:53,424
So you're saying
I need a surgery?
236
00:09:53,508 --> 00:09:55,268
Yeah, and it's just
an outpatient procedure.
237
00:09:55,352 --> 00:09:57,651
No general anesthesia,
no operating room.
238
00:09:57,735 --> 00:09:58,862
It's super simple.
239
00:09:58,946 --> 00:10:00,866
Another narrow escape
from death.
240
00:10:01,186 --> 00:10:03,276
The Wyatt Barnes legend grows.
241
00:10:03,360 --> 00:10:05,364
Hey.
242
00:10:05,477 --> 00:10:07,655
I'd like to admit you
for observation, and then
243
00:10:07,739 --> 00:10:09,518
we'll schedule the procedure
as soon as possible.
244
00:10:09,602 --> 00:10:11,179
Oh, I don't want the pacemaker.
245
00:10:11,910 --> 00:10:14,132
A-Admit me, fine,
but, you know, finish
246
00:10:14,216 --> 00:10:16,393
- fixing me up and...
- send me home.
247
00:10:16,477 --> 00:10:17,838
No, you don't understand.
248
00:10:17,922 --> 00:10:19,266
If we don't put
the pacemaker in,
249
00:10:19,350 --> 00:10:21,049
you will almost certainly die.
250
00:10:21,133 --> 00:10:22,733
Almost?
251
00:10:23,497 --> 00:10:25,390
I'll take those odds.
252
00:10:25,638 --> 00:10:27,112
We are doctors,
253
00:10:27,196 --> 00:10:30,261
advising you on a procedure
that will save your life.
254
00:10:30,388 --> 00:10:34,749
Sorry, but it's my body,
my decision.
255
00:10:35,006 --> 00:10:36,710
No pacemaker.
256
00:10:37,589 --> 00:10:39,291
No, thanks.
257
00:10:44,173 --> 00:10:46,166
- Hey, we need a cart over here!
- Now that you're spending
258
00:10:46,250 --> 00:10:48,229
more time on research
and clinical trials,
259
00:10:48,313 --> 00:10:49,921
we need a new ER doctor.
260
00:10:50,017 --> 00:10:52,049
And I'd like you to do
the interviews today.
261
00:10:52,133 --> 00:10:54,188
I would, of course,
but I'm only filling in
262
00:10:54,272 --> 00:10:55,522
for a few hours today.
263
00:10:55,606 --> 00:10:57,307
And I didn't set aside time
for that.
264
00:10:57,391 --> 00:10:59,477
There must be someone else
who can help.
265
00:10:59,561 --> 00:11:00,869
There's no one.
And I worked here all night.
266
00:11:00,953 --> 00:11:04,202
I'm sorry.
Here are the candidates.
267
00:11:04,503 --> 00:11:07,153
Dr. Voss, I have to get my
grant proposal in by 6:00 p.m.
268
00:11:07,237 --> 00:11:08,786
Your proposal will have to wait.
269
00:11:08,870 --> 00:11:10,387
And I don't need
to remind you why
270
00:11:10,471 --> 00:11:12,284
we're short-staffed in the ER.
271
00:11:13,758 --> 00:11:15,087
Yeah. I get it.
272
00:11:15,171 --> 00:11:16,665
Thank you.
273
00:11:16,749 --> 00:11:18,676
I'm counting on you.
274
00:11:18,760 --> 00:11:20,488
Happy to help.
275
00:11:43,203 --> 00:11:46,030
So, our Mr. Lucky
has complete AV block
276
00:11:46,114 --> 00:11:47,520
with wide ventricular escape.
277
00:11:47,604 --> 00:11:49,503
He's not gonna live
long enough to cash in
278
00:11:49,587 --> 00:11:51,442
his third lotto ticket
without a pacemaker.
279
00:11:52,459 --> 00:11:54,855
I mean, you think
he wants to die?
280
00:11:55,807 --> 00:11:59,521
Yeah, the guy's super cheerful.
It's bizarre.
281
00:11:59,678 --> 00:12:02,256
Mom, listen,
I'm in the middle of...
282
00:12:04,255 --> 00:12:06,187
Well, is-is the cough
getting any better?
283
00:12:06,566 --> 00:12:08,236
Did you call the oncologist?
284
00:12:09,027 --> 00:12:11,661
Mom, just do it now, please.
285
00:12:11,745 --> 00:12:14,424
Yes, I will see you
before I go to the airport.
286
00:12:16,435 --> 00:12:18,338
Tell Carol I'll call her,
287
00:12:18,422 --> 00:12:20,905
talk her through some options
for her respiratory symptoms.
288
00:12:22,367 --> 00:12:23,946
Appreciate it, man.
289
00:12:25,108 --> 00:12:27,205
Look, I-I wish I could engage.
290
00:12:27,289 --> 00:12:29,661
All right? I-If there were
28 hours in the day,
291
00:12:29,745 --> 00:12:31,804
I would gladly wax poetic
with the patient
292
00:12:31,888 --> 00:12:33,247
about the benefits
of a pacemaker,
293
00:12:33,331 --> 00:12:35,084
but I do not have the time.
294
00:12:35,168 --> 00:12:38,713
I have way too many patients
who would kill for an easy cure.
295
00:12:38,797 --> 00:12:41,367
I got too many,
too many obligations.
296
00:12:41,451 --> 00:12:42,961
All right, you get him
to see reason,
297
00:12:43,045 --> 00:12:44,313
I have no doubt that you will,
298
00:12:44,397 --> 00:12:46,939
then I will come back,
I'll put in the pacer.
299
00:12:51,357 --> 00:12:53,426
Okay. Have you, uh...
300
00:12:53,510 --> 00:12:54,848
you seen this problem before?
301
00:12:55,081 --> 00:12:58,169
All the time
during the pandemic.
302
00:12:58,253 --> 00:13:01,474
We had a lot of patients who
died claiming COVID was made up.
303
00:13:01,558 --> 00:13:03,306
Well, what do we do next?
304
00:13:03,734 --> 00:13:07,076
He agreed to a brief admission,
so we bring him up to the ICU,
305
00:13:07,160 --> 00:13:09,864
start him on isoproterenol
to raise his heart rate
306
00:13:09,948 --> 00:13:11,017
while I figure out
a way to respectfully
307
00:13:11,101 --> 00:13:12,459
get him to see reason.
308
00:13:12,543 --> 00:13:14,806
I will watch and learn.
309
00:13:16,137 --> 00:13:17,450
Hey, Brit,
have you had some time
310
00:13:17,534 --> 00:13:19,275
to review your options?
311
00:13:22,599 --> 00:13:25,291
She was here a minute ago.
She should be back soon.
312
00:13:33,903 --> 00:13:38,309
And if you had to change one
thing about emergency medicine,
313
00:13:38,393 --> 00:13:39,495
what would it be?
314
00:13:39,579 --> 00:13:41,188
Well, we're letting money
walk out the door.
315
00:13:41,272 --> 00:13:42,364
That's for sure.
316
00:13:42,448 --> 00:13:45,232
Uh, I personally would deploy
a-a number of strategies
317
00:13:45,316 --> 00:13:47,268
that would be more lucrative
for the hospital.
318
00:13:47,352 --> 00:13:48,421
Uh, I mean, you can't fix
319
00:13:48,505 --> 00:13:50,423
all the inefficiencies at once,
you know?
320
00:13:50,507 --> 00:13:53,864
You got to let this, uh,
this pig work its way through
321
00:13:53,948 --> 00:13:56,059
the-the boa constrictor,
so to speak.
322
00:13:56,143 --> 00:13:59,430
So, I created some slides here,
uh, with ideas
323
00:13:59,514 --> 00:14:02,044
for how to capitalize
on low-hanging fruit.
324
00:14:02,128 --> 00:14:03,247
I'll talk you through it.
325
00:14:03,331 --> 00:14:05,679
Uh, shouldn't be more than,
uh, an hour.
326
00:14:06,598 --> 00:14:08,017
Or two.
327
00:14:10,554 --> 00:14:11,962
Brit?
328
00:14:12,883 --> 00:14:15,079
I've been looking everywhere
for you.
329
00:14:16,362 --> 00:14:18,533
Has your abdominal pain
gotten worse?
330
00:14:19,246 --> 00:14:21,645
You shouldn't be out here.
We should get you back inside.
331
00:14:21,729 --> 00:14:23,476
It's not that, Dr. Devi.
332
00:14:23,648 --> 00:14:26,192
I had to get some air
so I could think.
333
00:14:26,276 --> 00:14:27,603
Okay.
334
00:14:30,107 --> 00:14:31,972
I can't decide
about the surgery.
335
00:14:32,056 --> 00:14:34,079
I tell myself, "Go for it."
336
00:14:34,507 --> 00:14:37,002
Then I think it's too dangerous.
337
00:14:37,325 --> 00:14:40,976
What if I bleed to death
in the OR and my cat dies alone?
338
00:14:41,060 --> 00:14:44,614
Or I go home and die and no one
finds me and Tinkerbell eats me.
339
00:14:44,698 --> 00:14:47,067
- You have to take it easy, Brit.
- Sometimes I wake up
340
00:14:47,151 --> 00:14:49,066
and she's staring at me
like I'm a goldfish.
341
00:14:49,150 --> 00:14:50,729
There's a darkness in her.
342
00:14:51,214 --> 00:14:53,056
I'm indecisive.
343
00:14:53,350 --> 00:14:55,627
Even about things
that don't matter.
344
00:14:55,859 --> 00:14:59,022
My cartoons poke fun
at people like me.
345
00:15:00,725 --> 00:15:02,179
Brit.
346
00:15:03,771 --> 00:15:06,835
What can I do to help you
make this decision?
347
00:15:08,333 --> 00:15:10,086
Make it for me?
348
00:15:10,746 --> 00:15:12,678
Just be my doctor.
349
00:15:12,801 --> 00:15:14,711
I'll do whatever you say.
350
00:15:22,410 --> 00:15:24,706
How am I doing?
351
00:15:25,175 --> 00:15:27,443
Your heart rate
is dangerously slow.
352
00:15:27,527 --> 00:15:29,290
38.
353
00:15:29,374 --> 00:15:31,901
Meds helped transiently,
but they can't fix this,
354
00:15:31,985 --> 00:15:33,239
and it's getting worse.
355
00:15:33,323 --> 00:15:34,317
I feel fine.
356
00:15:34,401 --> 00:15:35,999
That's impossible, okay?
357
00:15:36,083 --> 00:15:37,812
You have to be tired,
light-headed...
358
00:15:37,896 --> 00:15:39,182
Not really.
359
00:15:39,827 --> 00:15:41,073
I'm hungry.
360
00:15:41,214 --> 00:15:42,853
This place have ice cream?
361
00:15:44,147 --> 00:15:46,308
Yes...
362
00:15:46,392 --> 00:15:48,494
but let's finish talking first.
363
00:15:49,261 --> 00:15:51,141
A pacemaker is a simple device.
364
00:15:51,300 --> 00:15:53,584
It is not dangerous to put in,
365
00:15:53,668 --> 00:15:55,388
and it will keep you
from falling off your bike
366
00:15:55,472 --> 00:15:56,318
in the middle of traffic.
367
00:15:56,402 --> 00:15:58,369
Or dying today.
368
00:15:58,613 --> 00:16:00,236
Which could happen.
369
00:16:01,526 --> 00:16:03,083
It's not gonna happen.
370
00:16:03,167 --> 00:16:05,130
What are you afraid of, Wyatt?
371
00:16:05,214 --> 00:16:07,247
I'm not afraid.
I just don't like the idea
372
00:16:07,331 --> 00:16:09,736
of having a foreign object
put into my body.
373
00:16:09,832 --> 00:16:11,683
Do you know anyone
with type 1 diabetes?
374
00:16:11,767 --> 00:16:13,357
Yeah. My old boss.
375
00:16:13,441 --> 00:16:15,112
Did your boss use
an insulin pump?
376
00:16:15,196 --> 00:16:17,873
She does, but what
you're talking about
377
00:16:17,957 --> 00:16:19,525
is putting something in
to control my heart.
378
00:16:19,609 --> 00:16:20,505
That's different.
379
00:16:20,589 --> 00:16:21,676
No. Not really.
380
00:16:21,760 --> 00:16:24,240
Uh, complications
from pacemakers are rare.
381
00:16:24,324 --> 00:16:25,989
I'm sorry, but I do
my own research.
382
00:16:26,073 --> 00:16:28,183
I'm part of this Facebook group.
383
00:16:28,267 --> 00:16:29,998
- Oh, here we go.
- And they just published a list
384
00:16:30,082 --> 00:16:31,528
of unsafe products from China.
385
00:16:31,612 --> 00:16:34,767
Know what's on top?
Pacemakers.
386
00:16:34,886 --> 00:16:36,435
Now, they're assembled here,
387
00:16:36,519 --> 00:16:38,447
but guess where the parts
come from.
388
00:16:38,543 --> 00:16:41,583
Yep. Guy in the group
got poisoned by some bad metals.
389
00:16:41,667 --> 00:16:44,397
Those posts aren't truthful,
Wyatt.
390
00:16:45,019 --> 00:16:48,369
They are propaganda
from unqualified people
391
00:16:48,453 --> 00:16:50,521
who have politicized health
and medicine.
392
00:16:50,605 --> 00:16:52,545
They either want to sow distrust
in science
393
00:16:52,629 --> 00:16:53,482
or sell you snake oil.
394
00:16:53,566 --> 00:16:54,633
The real truth, Wyatt?
395
00:16:54,717 --> 00:16:56,302
Bad metal is not a thing.
396
00:16:56,386 --> 00:16:58,560
Dr. Hawkins is who you want
giving you advice.
397
00:16:58,644 --> 00:16:59,731
He's an actual expert.
398
00:16:59,815 --> 00:17:01,709
I form my own opinions, okay?
399
00:17:01,793 --> 00:17:04,398
- You have yours.
- Okay, this isn't an opinion.
400
00:17:04,488 --> 00:17:05,904
It's fact versus fiction.
401
00:17:05,988 --> 00:17:08,150
- Do you understand?
- All right.
402
00:17:09,096 --> 00:17:10,333
We hear you, Wyatt.
403
00:17:10,417 --> 00:17:11,947
Okay?
404
00:17:14,199 --> 00:17:15,946
Be back to check on you
in a bit.
405
00:17:16,484 --> 00:17:18,211
Thanks, Doc.
406
00:17:19,803 --> 00:17:21,736
He was getting
more and more dug in.
407
00:17:21,820 --> 00:17:23,670
- You have to know how to take a step back.
- Okay, but if Wyatt dies,
408
00:17:23,754 --> 00:17:25,037
it won't be sarcoid
that kills him,
409
00:17:25,121 --> 00:17:27,638
it'll be i-irrational fear
and misinformation.
410
00:17:27,722 --> 00:17:30,002
And those are difficult
conditions to cure.
411
00:17:30,086 --> 00:17:31,990
- I...
- Some people only accept information
412
00:17:32,074 --> 00:17:33,435
that confirms their beliefs.
413
00:17:33,519 --> 00:17:35,248
You have to give them the facts,
414
00:17:35,332 --> 00:17:37,068
tell them how important
the science is,
415
00:17:37,152 --> 00:17:39,750
- but then if you push too hard...
- I get that, but if...
416
00:17:40,113 --> 00:17:43,103
we lose what little trust
we may have earned.
417
00:17:43,488 --> 00:17:45,530
Even when you're 1,000% right.
418
00:17:45,754 --> 00:17:48,442
- Uh... He's gonna...
- Gentlemen.
419
00:17:48,543 --> 00:17:51,490
So I don't see your patient
on my cath lab schedule.
420
00:17:51,574 --> 00:17:54,216
- What happened? No pacemaker?
- Uh, not yet.
421
00:17:54,300 --> 00:17:56,435
We were just getting ready
to discuss next steps.
422
00:17:56,519 --> 00:17:58,193
The guy actually
believes in luck.
423
00:17:58,277 --> 00:17:59,888
As in, he's too lucky to die.
424
00:17:59,972 --> 00:18:02,051
He did tell us
he's always felt protected
425
00:18:02,135 --> 00:18:04,575
in an "otherworldly" way.
426
00:18:04,659 --> 00:18:06,904
An argument could be made that
he doesn't have the capacity
427
00:18:06,988 --> 00:18:08,640
to make medical decisions
for himself.
428
00:18:08,724 --> 00:18:10,357
Well, if he's making
his decision based on
429
00:18:10,441 --> 00:18:12,216
otherworldly information,
you may be right.
430
00:18:12,300 --> 00:18:14,289
I'll call Dr. Malco
in the psych department.
431
00:18:14,373 --> 00:18:17,923
Let's hope this works.
Wyatt's running out of time.
432
00:18:27,053 --> 00:18:29,396
Wyatt, why don't you tell me
in your own words
433
00:18:29,480 --> 00:18:31,250
what's going on
with your health right now?
434
00:18:31,334 --> 00:18:33,137
It's pretty simple.
435
00:18:33,417 --> 00:18:35,200
I've never liked hospitals,
436
00:18:35,284 --> 00:18:37,887
but I came here
because of a bike accident.
437
00:18:37,971 --> 00:18:40,279
They escalated the whole thing
by threatening
438
00:18:40,363 --> 00:18:42,000
to put in a pacemaker.
439
00:18:42,084 --> 00:18:44,485
Do you know how many people
get a pacemaker?
440
00:18:44,569 --> 00:18:47,097
They're slapping them
into everybody these days.
441
00:18:47,181 --> 00:18:49,081
Why don't you trust
your doctors?
442
00:18:49,165 --> 00:18:51,100
I make up my own mind.
443
00:18:51,184 --> 00:18:53,162
And, look, I'm not crazy.
444
00:18:53,246 --> 00:18:55,208
You know, agreeing to have
doctors I just met
445
00:18:55,292 --> 00:18:58,425
implant something into my body
is what's crazy.
446
00:18:58,509 --> 00:19:01,841
We just need to make sure that
you understand the consequences
447
00:19:01,925 --> 00:19:04,005
of the decision
you're making here.
448
00:19:04,089 --> 00:19:06,433
I've been listening
to those two all day.
449
00:19:06,517 --> 00:19:08,100
Of course I understand.
450
00:19:08,184 --> 00:19:11,937
And there's something you need
to understand about me.
451
00:19:12,021 --> 00:19:13,865
And what is that?
452
00:19:13,949 --> 00:19:16,018
You're not gonna change my mind.
453
00:19:16,102 --> 00:19:19,068
And if I do die,
I don't want anyone
454
00:19:19,152 --> 00:19:22,292
going wild and
pounding on my chest, okay?
455
00:19:22,855 --> 00:19:25,095
Write that down
in your little notepad.
456
00:19:26,066 --> 00:19:27,962
We all have to die someday.
457
00:19:28,361 --> 00:19:30,590
And I am not going out
like that.
458
00:19:36,488 --> 00:19:38,193
- Dr. Bell?
- Yeah.
459
00:19:38,277 --> 00:19:40,980
- Do you have a second?
- Mm-hmm.
460
00:19:43,849 --> 00:19:45,654
Please tell me this gets easier.
461
00:19:45,972 --> 00:19:48,130
Is this about making
a life-or-death decision
462
00:19:48,214 --> 00:19:50,603
- for a person you just met?
- Yes.
463
00:19:50,913 --> 00:19:53,905
It should never be easy.
This is the job.
464
00:19:53,989 --> 00:19:55,615
It's not irrational
for a patient to think
465
00:19:55,699 --> 00:19:57,904
we know more
and should decide for them.
466
00:19:57,988 --> 00:19:59,638
What if I can't figure out
what's the best way to go?
467
00:19:59,722 --> 00:20:01,767
You will, because you have to.
468
00:20:02,256 --> 00:20:04,243
That's what your patient needs.
469
00:20:04,659 --> 00:20:06,435
So go with your gut, Dr. Devi,
470
00:20:06,519 --> 00:20:09,673
informed by your experience
and your schooling.
471
00:20:10,449 --> 00:20:13,329
- Okay?
- Okay.
472
00:20:18,150 --> 00:20:19,443
Dr. Voss.
473
00:20:19,527 --> 00:20:21,426
Tell me what you need.
I'm here to help.
474
00:20:21,510 --> 00:20:24,575
Well, I'm realizing
that all our doctors
475
00:20:24,659 --> 00:20:26,615
are in danger of burnout.
476
00:20:26,699 --> 00:20:29,677
The stress at times
can be unrelenting.
477
00:20:29,894 --> 00:20:32,364
Maybe your program can help.
478
00:20:32,714 --> 00:20:33,996
I would love that.
479
00:20:34,080 --> 00:20:36,482
I offer yoga sessions,
meditation,
480
00:20:36,566 --> 00:20:39,208
sleep counseling
and positive affirmations.
481
00:20:39,292 --> 00:20:43,779
Plus, fresh-baked
resiliency cookies. Gluten-free.
482
00:20:43,863 --> 00:20:48,607
I think I could make everybody
ten percent happier, at least.
483
00:20:48,691 --> 00:20:51,091
I would invest
in ten percent happier.
484
00:20:51,175 --> 00:20:52,771
When can you start?
485
00:20:52,855 --> 00:20:54,216
Shall we start now?
486
00:20:54,300 --> 00:20:56,841
Yes. Sign me up.
487
00:20:56,925 --> 00:20:58,751
- Come sit down.
- Oh.
488
00:20:58,878 --> 00:21:00,907
Just five minutes.
489
00:21:03,870 --> 00:21:06,411
- Lie down, put your feet up.
- Oh, wait, I can't. I'd be...
490
00:21:06,495 --> 00:21:08,901
All right. Okay.
491
00:21:10,825 --> 00:21:12,517
Close your eyes.
492
00:21:13,949 --> 00:21:18,727
And now just take
a deep, cleansing breath.
493
00:21:20,034 --> 00:21:21,703
Ooh, sorry.
494
00:21:23,701 --> 00:21:25,642
- Later. I promise.
- Okay.
495
00:21:32,530 --> 00:21:34,541
Speaking Spanish...
496
00:21:37,949 --> 00:21:39,884
- Do you speak Spanish?
- No.
497
00:21:39,968 --> 00:21:42,958
I don't think there's room
in my head
498
00:21:43,042 --> 00:21:45,993
for any more words
I'm supposed to understand.
499
00:21:46,386 --> 00:21:49,174
Do you mind turning it down?
I promise to keep this simple.
500
00:21:52,034 --> 00:21:54,950
Based on the size of your
hemangioma and your symptoms,
501
00:21:55,034 --> 00:21:57,616
if it were me,
I would go with the surgery.
502
00:21:59,550 --> 00:22:01,957
Surgery it is. When?
503
00:22:02,041 --> 00:22:03,575
Well, we can operate
later today.
504
00:22:03,659 --> 00:22:06,571
But I would like to take you
through the consent.
505
00:22:08,941 --> 00:22:10,282
There are risks.
506
00:22:10,366 --> 00:22:14,363
Bleeding, infection,
damage to your liver.
507
00:22:14,447 --> 00:22:17,255
It's possible but unlikely
that we'll have trouble
508
00:22:17,339 --> 00:22:18,742
getting you off the ventilator.
509
00:22:18,956 --> 00:22:21,197
And as with any surgery,
there is a risk of death.
510
00:22:21,878 --> 00:22:23,458
Have you done
this operation often?
511
00:22:23,542 --> 00:22:26,333
Uh, no, I haven't,
but the senior surgeon
512
00:22:26,417 --> 00:22:28,797
I work with has,
and he'll be there.
513
00:22:31,261 --> 00:22:32,423
Pen.
514
00:22:33,120 --> 00:22:34,567
All right.
515
00:22:36,188 --> 00:22:38,075
Thank you.
516
00:22:50,029 --> 00:22:51,380
He's clear and consistent.
517
00:22:51,464 --> 00:22:53,443
I don't find him
to be influenced
518
00:22:53,527 --> 00:22:55,645
by untreated depression,
and he's not suicidal.
519
00:22:55,729 --> 00:22:57,927
His choice isn't one
that I would make for myself
520
00:22:58,011 --> 00:23:01,122
or someone I love, but it's one
he has a right to make.
521
00:23:01,206 --> 00:23:04,240
What do you make of his belief
that he's cosmically protected?
522
00:23:04,324 --> 00:23:06,646
Hearing celestial voices
is one thing,
523
00:23:06,730 --> 00:23:09,099
but it's human nature to search
524
00:23:09,183 --> 00:23:11,248
for explanations
for our experiences.
525
00:23:11,386 --> 00:23:14,060
Just describing them
in ways that are fantastical
526
00:23:14,144 --> 00:23:15,950
doesn't signify
a lack of capacity.
527
00:23:16,034 --> 00:23:17,701
Um, I'm sorry,
it makes no sense.
528
00:23:17,785 --> 00:23:20,887
I mean, look how young he is,
and he even requested a DNR?
529
00:23:20,971 --> 00:23:24,676
Which is a sign that
he's-he's clear and coherent.
530
00:23:24,760 --> 00:23:26,952
Look, lack of capacity
is a high bar,
531
00:23:27,036 --> 00:23:28,575
and Wyatt doesn't reach it.
532
00:23:28,659 --> 00:23:30,480
I'm sorry.
533
00:23:30,625 --> 00:23:33,798
- You have to respect his wishes.
- All right, thank you, Leslie.
534
00:23:37,023 --> 00:23:38,545
Uh...
535
00:23:38,733 --> 00:23:40,325
Is that really it?
536
00:23:40,409 --> 00:23:41,849
If he's determined
to have capacity,
537
00:23:41,933 --> 00:23:43,130
we can't force him
to be treated.
538
00:23:43,214 --> 00:23:45,161
Wait, hold on, I thought
you were the renegade.
539
00:23:45,245 --> 00:23:46,684
I heard you drilled
into a guy's head
540
00:23:46,768 --> 00:23:48,028
and you're not
even a surgeon.
541
00:23:48,112 --> 00:23:50,013
But you're gonna sit here
and let this man die?
542
00:23:50,097 --> 00:23:51,653
If the guy would've said,
"Whatever you do,
543
00:23:51,737 --> 00:23:55,867
don't drill into my head,"
I wouldn't have.
544
00:23:56,652 --> 00:23:58,458
It's pretty simple.
545
00:23:59,136 --> 00:24:01,934
You can't do
what the patient doesn't want.
546
00:24:02,018 --> 00:24:04,582
Okay, this is what
we're gonna do.
547
00:24:04,666 --> 00:24:06,778
I did a deep dive
into temporary pacers.
548
00:24:06,862 --> 00:24:09,327
Wyatt passes out,
we get the pads on him,
549
00:24:09,411 --> 00:24:11,163
shock him if we need to,
slip it in
550
00:24:11,247 --> 00:24:12,511
- at his bedside.
- Hey.
551
00:24:19,421 --> 00:24:20,773
Let's get him some O2.
552
00:24:20,857 --> 00:24:23,157
I'm nauseous.
My stomach hurts.
553
00:24:23,464 --> 00:24:24,342
What's going on?
554
00:24:24,426 --> 00:24:26,966
Gut ischemia
from poor perfusion.
555
00:24:27,050 --> 00:24:28,618
Your heart rate's too low.
556
00:24:28,702 --> 00:24:30,214
Let's get him some pain meds.
557
00:24:30,298 --> 00:24:31,641
Page Bell.
558
00:24:31,725 --> 00:24:33,511
Okay.
559
00:24:40,392 --> 00:24:42,155
Okay.
560
00:24:47,308 --> 00:24:50,114
Yeah, he's-he's calmer now
with the pain meds on board.
561
00:24:50,198 --> 00:24:52,781
It's highly likely
he has dying bowel,
562
00:24:52,865 --> 00:24:55,188
but he's not a viable candidate
for surgery.
563
00:24:55,832 --> 00:24:57,833
Unless we get him
to agree to a pacer.
564
00:24:57,917 --> 00:25:01,074
And, yeah, if you do, tell me,
and I'll take him to the OR.
565
00:25:01,158 --> 00:25:03,005
As of now, all the complications
566
00:25:03,089 --> 00:25:05,333
from his untreated
heart condition are fixable,
567
00:25:05,417 --> 00:25:08,134
but I don't know for how long.
568
00:25:10,020 --> 00:25:12,284
He's refusing all intervention.
569
00:25:13,753 --> 00:25:15,484
Is there anything else
I can do for you?
570
00:25:15,568 --> 00:25:17,248
I wish there were.
571
00:25:22,244 --> 00:25:24,840
Okay, just... just hear me out.
572
00:25:24,924 --> 00:25:27,466
All right, you know
the Dax Cowart case, right?
573
00:25:27,550 --> 00:25:30,168
He wanted to die after suffering
catastrophic burns.
574
00:25:30,252 --> 00:25:32,653
He was in pain,
terribly disfigured, went blind.
575
00:25:32,737 --> 00:25:34,580
And he was ruled
to have capacity, too,
576
00:25:34,664 --> 00:25:38,928
but his doctors disregarded
his wishes and saved his life.
577
00:25:39,987 --> 00:25:41,586
Mm-hmm.
578
00:25:41,670 --> 00:25:44,700
Yeah, he had a career,
he had a family,
579
00:25:44,784 --> 00:25:47,421
I mean, he lived
until he was 71.
580
00:25:47,690 --> 00:25:49,410
Wyatt can have the same thing.
581
00:25:49,494 --> 00:25:52,559
Dax Cowart became a lawyer
and built a career
582
00:25:52,643 --> 00:25:54,175
on fighting
for patients' rights.
583
00:25:54,259 --> 00:25:57,247
He used his own case to show
what the doctors did,
584
00:25:57,331 --> 00:26:00,623
what you want to do to Wyatt,
was a betrayal of those rights.
585
00:26:00,707 --> 00:26:01,850
It's not a betrayal
of his rights.
586
00:26:01,934 --> 00:26:03,576
Hey, I'm as frustrated
as you are.
587
00:26:04,544 --> 00:26:06,653
As doctors,
our purpose is to help.
588
00:26:06,737 --> 00:26:08,688
And you got that part right.
589
00:26:09,143 --> 00:26:10,543
But Wyatt needs
to want to be helped.
590
00:26:10,627 --> 00:26:12,657
No, until he's dead,
I'm not giving up.
591
00:26:18,456 --> 00:26:20,368
Then neither am I.
592
00:26:23,580 --> 00:26:25,381
Sorry I'm late.
593
00:26:26,386 --> 00:26:29,122
Had a rough consult
with Conrad's patient.
594
00:26:29,206 --> 00:26:30,794
The exact opposite of Brit.
595
00:26:30,878 --> 00:26:33,595
He doesn't trust Conrad,
for all the wrong reasons.
596
00:26:33,713 --> 00:26:35,567
And here I am tied up in knots
597
00:26:35,651 --> 00:26:37,293
over a patient who trusts me
too much.
598
00:26:37,452 --> 00:26:39,606
You made
the best decision you could
599
00:26:39,690 --> 00:26:41,158
with the information you have.
600
00:26:46,145 --> 00:26:48,395
You have a very unusual
career path.
601
00:26:48,479 --> 00:26:51,388
What brought you from oncology
to emergency medicine?
602
00:26:51,472 --> 00:26:53,294
So much suffering and death.
603
00:26:53,378 --> 00:26:55,419
The patients call you
weeping at all hours
604
00:26:55,503 --> 00:26:57,824
of the day and night.
605
00:26:58,180 --> 00:27:01,183
I-I was worn out
from the stress.
606
00:27:01,267 --> 00:27:03,911
Those days ruined me. And now?
607
00:27:03,995 --> 00:27:06,651
Just off a shift, look at me...
I'm still fresh.
608
00:27:06,735 --> 00:27:08,651
Well, it must have been
a challenge to go back
609
00:27:08,735 --> 00:27:11,190
to residency and learn
all the ER procedures.
610
00:27:11,274 --> 00:27:13,869
Hmm, I'm not one
for new techniques.
611
00:27:13,953 --> 00:27:16,015
I pretty much slept
through that residency.
612
00:27:16,099 --> 00:27:19,100
- It was no big deal.
- I see.
613
00:27:20,632 --> 00:27:22,311
I told you, Doc.
614
00:27:22,735 --> 00:27:26,100
If God wants me to live,
I'll live.
615
00:27:27,461 --> 00:27:30,037
He'll reach His hand down to me.
616
00:27:32,196 --> 00:27:34,528
He's always been so good to me.
617
00:27:34,696 --> 00:27:36,715
Is this about luck now, Wyatt?
618
00:27:36,941 --> 00:27:38,334
Or God?
619
00:27:39,906 --> 00:27:43,388
He can't save you right now.
We can.
620
00:27:44,274 --> 00:27:46,154
Leave me alone, Doc.
621
00:27:48,017 --> 00:27:51,049
No. Wyatt...
622
00:27:51,133 --> 00:27:53,885
- Trevor.
- You just, you got to listen to what I'm...
623
00:27:53,969 --> 00:27:56,240
Trevor, take a walk now.
624
00:28:08,614 --> 00:28:10,256
He's young.
625
00:28:12,177 --> 00:28:13,959
But he cares deeply.
626
00:28:15,751 --> 00:28:18,358
And I respect your faith
in God's will.
627
00:28:20,055 --> 00:28:21,697
I'm in His hands now.
628
00:28:21,781 --> 00:28:25,201
And you always have been, right?
629
00:28:27,399 --> 00:28:31,412
How do you know He is not
using us to save you?
630
00:28:33,313 --> 00:28:36,322
You think he wasn't sitting
beside Rune Elmqvist in Sweden
631
00:28:36,406 --> 00:28:38,668
half a century ago
when he invented the pacemaker?
632
00:28:38,766 --> 00:28:41,818
He is sending you one lifeline
after another.
633
00:28:45,597 --> 00:28:46,950
Hey.
634
00:28:49,525 --> 00:28:52,205
I'll ask Him.
635
00:28:54,109 --> 00:28:55,837
Wyatt?
636
00:29:11,046 --> 00:29:13,084
Wyatt.
637
00:29:29,547 --> 00:29:31,072
Yeah, the liver is exposed.
638
00:29:31,156 --> 00:29:32,572
Ready to begin the enucleation.
639
00:29:32,656 --> 00:29:34,916
Remember, the beauty
of this technique is that we,
640
00:29:35,000 --> 00:29:37,463
we work along existing planes
to pop the mass out
641
00:29:37,547 --> 00:29:39,229
and we leave the liver intact.
642
00:29:39,313 --> 00:29:41,529
That's how we avoid
massive bleeding.
643
00:29:41,640 --> 00:29:44,654
And note the vessels
extending into the liver.
644
00:29:44,774 --> 00:29:46,717
Divide and ligate.
645
00:29:47,203 --> 00:29:48,725
Be careful.
646
00:29:50,133 --> 00:29:51,924
Ugh, I have a tiny bleeder.
647
00:29:52,088 --> 00:29:53,465
Cautery.
648
00:29:56,117 --> 00:29:57,602
And another one.
649
00:29:57,686 --> 00:29:59,248
Okay, suction.
650
00:30:04,460 --> 00:30:06,303
Okay, that's arterial. Clamp.
651
00:30:08,513 --> 00:30:10,990
Dr. Bell? Here's the clamp.
652
00:30:15,846 --> 00:30:17,649
Are you okay?
653
00:30:18,281 --> 00:30:19,837
Uh, no.
654
00:30:19,921 --> 00:30:21,441
Jessica, I'll take it.
655
00:30:22,407 --> 00:30:24,035
Uh, Dr. Devi, I have to leave.
656
00:30:24,119 --> 00:30:25,904
What?
657
00:30:26,100 --> 00:30:28,030
I-I'll find someone to cover
as soon as possible.
658
00:30:28,114 --> 00:30:29,534
Uh, as soon as possible.
659
00:30:33,452 --> 00:30:35,162
Dr. Bell.
660
00:30:40,873 --> 00:30:42,502
You can do this.
661
00:30:50,985 --> 00:30:53,548
I've got the mass
on the last vascular pedicle.
662
00:30:53,632 --> 00:30:54,822
Any word from Bell?
663
00:30:54,906 --> 00:30:56,658
Nothing yet. You'll probably
get this sucker out of here
664
00:30:56,742 --> 00:30:58,205
before anyone comes.
665
00:31:01,555 --> 00:31:03,725
Pressure's drifting down,
Dr. Devi.
666
00:31:03,977 --> 00:31:06,660
She's losing blood. Let's get
some blood products in her.
667
00:31:06,809 --> 00:31:07,784
Tell me what you need.
668
00:31:07,868 --> 00:31:10,276
Lap pads and suction.
I'm operating underwater here.
669
00:31:10,360 --> 00:31:12,268
If I can't find the source for
the bleeding, I can't fix it.
670
00:31:12,352 --> 00:31:13,347
Two units are in,
and I activated
671
00:31:13,431 --> 00:31:15,851
massive transfusion protocol.
We're maxed on norepi.
672
00:31:15,935 --> 00:31:17,369
Found it.
673
00:31:17,453 --> 00:31:19,112
You've got to get control.
She won't tolerate
674
00:31:19,196 --> 00:31:20,947
this blood loss much longer.
675
00:31:21,031 --> 00:31:22,633
I need to remove the portion
of the liver
676
00:31:22,717 --> 00:31:24,209
the vessel is feeding.
Prepare for a hepatectomy.
677
00:31:24,293 --> 00:31:26,694
That's a serious change
in plans.
678
00:31:26,778 --> 00:31:27,696
We should call Dr. Bell first.
679
00:31:27,780 --> 00:31:29,213
No time. Clamp, now.
680
00:31:29,297 --> 00:31:32,534
Chu, give her 1:1:1
resuscitation to keep up.
681
00:31:32,618 --> 00:31:35,659
- Jessica, do not stop that suction.
- Got it.
682
00:31:40,626 --> 00:31:42,308
Got it.
683
00:31:43,887 --> 00:31:45,063
We've got a stable pressure.
684
00:31:45,147 --> 00:31:47,878
Strong work, Dr. Devi.
685
00:31:49,968 --> 00:31:51,327
You did it.
686
00:31:51,411 --> 00:31:53,645
Let's get her closed up
687
00:31:53,729 --> 00:31:55,575
and off this table.
688
00:32:02,089 --> 00:32:04,156
What do you think
the evidence is
689
00:32:04,240 --> 00:32:05,583
behind cookies
for stress relief?
690
00:32:05,667 --> 00:32:06,992
Anecdotal
691
00:32:07,076 --> 00:32:09,086
- but robust.
- I'm really feeling
692
00:32:09,170 --> 00:32:11,238
- the chocolate chip.
- Dr. Austin?
693
00:32:11,322 --> 00:32:12,621
Of all people.
694
00:32:12,705 --> 00:32:14,333
Do raptors do yoga?
695
00:32:14,417 --> 00:32:17,929
I'm only here because my CEO
told me I had to be here.
696
00:32:18,013 --> 00:32:19,096
But I won't be here for long.
697
00:32:19,180 --> 00:32:21,098
I have to round
on the post-ops again
698
00:32:21,182 --> 00:32:22,558
before I fly
to Manhattan tonight
699
00:32:22,642 --> 00:32:24,677
- for talk shows tomorrow.
- Well, I'm stiff,
700
00:32:24,761 --> 00:32:25,754
my back is in knots.
701
00:32:25,838 --> 00:32:27,180
I've been in interviews all day,
702
00:32:27,264 --> 00:32:30,390
looking for an actual doctor
who likes actual doctoring.
703
00:32:30,474 --> 00:32:32,328
Welcome, health care heroes.
704
00:32:32,838 --> 00:32:34,481
Uh, listen, I am not a man
705
00:32:34,565 --> 00:32:36,213
that you will find
in Child's Pose.
706
00:32:36,297 --> 00:32:38,160
So I'm just gonna be
on my way to...
707
00:32:38,244 --> 00:32:40,183
AJ, I happen to know
from personal experience
708
00:32:40,267 --> 00:32:42,973
that you could really benefit
from a little extra flexibility.
709
00:32:43,057 --> 00:32:46,140
All right, come lie down and grab a mat.
710
00:32:48,192 --> 00:32:51,123
Close your eyes.
711
00:32:51,698 --> 00:32:55,208
Let the world fade away
and just relax.
712
00:32:55,292 --> 00:32:57,372
It's the ER.
713
00:32:58,203 --> 00:32:59,707
Oh, that's my next interview.
714
00:32:59,954 --> 00:33:01,284
Med-surg floor.
715
00:33:01,455 --> 00:33:03,944
My mother's having
another complication.
716
00:33:05,027 --> 00:33:06,509
I mean, I feel
717
00:33:07,430 --> 00:33:09,448
so blissed out right now.
718
00:33:09,532 --> 00:33:11,718
I feel like I'm back to zero.
I feel great.
719
00:33:12,048 --> 00:33:14,302
You know,
after this is all done,
720
00:33:14,386 --> 00:33:17,503
I think that you and I should go
to this great little vegan place
721
00:33:17,587 --> 00:33:18,995
that I know about in Inman Park.
722
00:33:19,079 --> 00:33:19,854
It-It's wonderful.
723
00:33:19,938 --> 00:33:22,596
It's the best tempeh à la King
you will ever have.
724
00:33:22,680 --> 00:33:25,600
You're cute. Not a chance.
725
00:33:29,574 --> 00:33:32,147
That's a, that's a no, then?
726
00:33:35,118 --> 00:33:37,323
Okay, Wyatt Barnes' heart rate
is in the 20s.
727
00:33:37,407 --> 00:33:39,510
He has gut ischemia,
his kidneys are failing.
728
00:33:39,594 --> 00:33:40,854
Without a pacer, he's dying.
729
00:33:40,938 --> 00:33:42,276
We're running out of time,
and he's waiting
730
00:33:42,360 --> 00:33:43,651
for the hand of God
to reach down
731
00:33:43,735 --> 00:33:45,042
- and-and save him from...
- First of all, back up.
732
00:33:45,126 --> 00:33:46,342
You're in my personal space.
733
00:33:46,426 --> 00:33:48,282
And you have intern coffee
breath,
734
00:33:48,366 --> 00:33:49,675
- which I do not like.
- Okay, look, look, look,
735
00:33:49,759 --> 00:33:50,706
with all due respect,
736
00:33:50,790 --> 00:33:52,690
Dr. Hawkins seems
to have lost his edge,
737
00:33:52,774 --> 00:33:54,267
it's gonna cost
a young dude his life.
738
00:33:54,351 --> 00:33:55,760
Can you please
just put in a pacer, please?
739
00:33:55,844 --> 00:33:57,694
- I have one right here, come on.
- Put that away.
740
00:33:57,778 --> 00:33:59,315
You are a green recruit
741
00:33:59,399 --> 00:34:01,181
questioning the general
on the field.
742
00:34:01,265 --> 00:34:03,042
W-Wait, hold up. If someone came
into this hospital
743
00:34:03,126 --> 00:34:04,846
after slitting their wrists
or-or taking pills,
744
00:34:04,930 --> 00:34:05,870
we'd save them, right?
745
00:34:05,954 --> 00:34:07,372
Wyatt Barnes is doing
the same thing.
746
00:34:07,456 --> 00:34:09,276
This is not a suicide.
747
00:34:09,531 --> 00:34:12,315
This is a man with capacity
refusing intervention.
748
00:34:12,399 --> 00:34:14,195
That's a right
we cannot abridge.
749
00:34:14,279 --> 00:34:16,182
His recalcitrance
is not jeopardizing
750
00:34:16,266 --> 00:34:17,215
anyone else's health.
751
00:34:17,299 --> 00:34:19,383
- He's only hurting himself.
- Okay, but he is hurting himself...
752
00:34:19,467 --> 00:34:20,864
Trevor, stop.
753
00:34:21,141 --> 00:34:23,960
Now you go back
to your patient's room.
754
00:34:24,227 --> 00:34:28,053
You watch Dr. Hawkins
and you do what he says.
755
00:34:28,703 --> 00:34:30,577
Stop second-guessing him.
756
00:34:30,886 --> 00:34:32,616
You might learn something.
757
00:34:41,165 --> 00:34:43,546
Please let me save you, Wyatt.
758
00:34:46,680 --> 00:34:49,749
I have everything we need.
You just say the word.
759
00:34:53,391 --> 00:34:54,845
Think of all
the beautiful things
760
00:34:54,929 --> 00:34:57,600
you'll never be able
to experience again.
761
00:34:58,376 --> 00:35:01,346
I don't know what happens
when you die,
762
00:35:01,813 --> 00:35:04,030
but I bet you don't get
to kiss a woman...
763
00:35:05,657 --> 00:35:08,780
and know you want to be with
her for the rest of your life.
764
00:35:10,384 --> 00:35:13,692
Don't you want to wake up
on the first day of fall?
765
00:35:13,946 --> 00:35:15,389
Eat a peach?
766
00:35:17,626 --> 00:35:19,869
Laugh your ass off
with your best friends?
767
00:35:19,953 --> 00:35:22,475
You don't have to give up
any of that.
768
00:35:22,837 --> 00:35:24,947
Think of how lucky
that makes you.
769
00:35:45,061 --> 00:35:47,241
Is he still saying no?
770
00:36:00,179 --> 00:36:01,558
Do it.
771
00:36:02,478 --> 00:36:04,073
Please.
772
00:36:18,040 --> 00:36:20,649
What are we here for,
anyway, huh?
773
00:36:21,712 --> 00:36:26,489
To watch people
we could save just... just die?
774
00:36:26,938 --> 00:36:29,390
I was here to save him.
775
00:36:32,258 --> 00:36:35,485
Now we're just here to make sure
he doesn't die alone.
776
00:37:15,333 --> 00:37:17,272
He's your first death.
777
00:37:21,626 --> 00:37:23,309
Yeah.
778
00:37:23,393 --> 00:37:26,335
Not how I imagined
it would go down.
779
00:37:27,454 --> 00:37:30,069
You pictured a different
kind of heroism,
780
00:37:30,813 --> 00:37:33,772
blood spattered
all over your white coat.
781
00:37:38,954 --> 00:37:41,003
Do you ever get used to it?
782
00:37:42,516 --> 00:37:45,009
It never gets easier. It just...
783
00:37:45,852 --> 00:37:47,608
It just gets different.
784
00:37:49,204 --> 00:37:54,522
But today was no small
accomplishment. Dr. Daniels.
785
00:38:00,085 --> 00:38:03,469
We allowed him to live and die
according to his principles,
786
00:38:03,553 --> 00:38:05,989
and because of that,
we managed to keep ours.
787
00:38:13,351 --> 00:38:17,676
Look, again, I'm-I'm sorry
about what happened in there.
788
00:38:17,866 --> 00:38:19,540
Well, I'm relieved you're okay.
789
00:38:19,624 --> 00:38:21,344
No, I-I'll be fine, it's just...
790
00:38:21,428 --> 00:38:23,623
It's a pinched nerve and...
791
00:38:24,139 --> 00:38:25,954
little bit of vertigo
that came on suddenly.
792
00:38:26,038 --> 00:38:28,743
I think, you know,
I-I overreacted,
793
00:38:28,827 --> 00:38:32,134
but in the moment, I-I thought
if I stayed in the OR,
794
00:38:32,218 --> 00:38:34,299
you'd have two patients
to deal with, so...
795
00:38:34,663 --> 00:38:36,728
Well, then,
you did the right thing.
796
00:38:36,944 --> 00:38:38,897
So did you.
797
00:38:39,522 --> 00:38:41,084
This time.
798
00:38:41,178 --> 00:38:43,669
But, to be honest,
it could have gone either way.
799
00:38:51,671 --> 00:38:54,137
- Hi.
- So?
800
00:38:54,225 --> 00:38:56,938
Did you find anything else
horrible inside me?
801
00:38:57,022 --> 00:38:58,837
I'm vaguely optimistic
802
00:38:58,921 --> 00:39:02,462
because I have a familiar sense
of existential dread,
803
00:39:02,546 --> 00:39:05,259
and I'm pretty sure that can't
be removed surgically.
804
00:39:05,343 --> 00:39:06,760
The surgery went great.
805
00:39:06,844 --> 00:39:08,278
You're going to be fine.
806
00:39:08,362 --> 00:39:10,093
Thanks to Dr. Devi.
807
00:39:10,685 --> 00:39:12,437
There was a complication
during surgery.
808
00:39:12,521 --> 00:39:14,376
We had to remove
a small piece of your liver.
809
00:39:14,460 --> 00:39:16,040
But it will grow back.
810
00:39:16,124 --> 00:39:17,765
And the hemangioma
is gone for good.
811
00:39:17,849 --> 00:39:21,333
Thank you.
I mean, really, thank you.
812
00:39:21,421 --> 00:39:24,122
And you made the right decision
for me, too.
813
00:39:24,233 --> 00:39:27,297
Can I call you next time
I'm buying a new car?
814
00:39:27,381 --> 00:39:28,719
Or don't know what to do
815
00:39:28,803 --> 00:39:29,883
when I get in a fight
with my mom?
816
00:39:29,967 --> 00:39:32,000
I actually am
a triple board-certified
817
00:39:32,084 --> 00:39:33,312
mother vanquisher.
818
00:39:39,223 --> 00:39:40,644
So...
819
00:39:41,663 --> 00:39:43,191
it's a no.
820
00:39:44,806 --> 00:39:46,679
Even the former oncologist?
821
00:39:46,763 --> 00:39:48,067
He's burnt out.
822
00:39:48,280 --> 00:39:50,304
He's not interested
in learning anything new.
823
00:39:50,388 --> 00:39:53,157
H-He doesn't love medicine.
824
00:39:53,241 --> 00:39:54,039
None of them do.
825
00:39:54,123 --> 00:39:56,400
Keep looking.
It's just the first round.
826
00:39:56,484 --> 00:39:58,156
No need to be discouraged.
827
00:39:58,240 --> 00:39:59,751
And the thing is, Dr. Voss,
828
00:39:59,835 --> 00:40:01,676
when I was talking to them,
I realized
829
00:40:02,567 --> 00:40:04,336
I might not be so different.
830
00:40:04,987 --> 00:40:07,090
Of course you are, Dr. Pravesh.
831
00:40:07,935 --> 00:40:11,434
I am judging people
for not loving medicine enough
832
00:40:11,518 --> 00:40:13,679
while trying to cut down
on clinical time
833
00:40:13,763 --> 00:40:15,104
to go do research.
834
00:40:15,188 --> 00:40:16,866
I think about being in the ER
835
00:40:16,950 --> 00:40:21,845
year after year after year,
with no outlet for research,
836
00:40:21,952 --> 00:40:24,946
and I don't know how we don't
drown in the sickness,
837
00:40:25,030 --> 00:40:28,520
the sadness, the pressure,
the paperwork.
838
00:40:30,460 --> 00:40:33,520
Half of my med school class
isn't doing medicine anymore.
839
00:40:35,944 --> 00:40:37,489
That means something.
840
00:40:38,506 --> 00:40:42,715
Yes, I think it does.
841
00:40:59,332 --> 00:41:00,934
Hey.
842
00:41:05,404 --> 00:41:06,848
Hell of a day.
843
00:41:07,694 --> 00:41:09,364
Yeah, I heard.
844
00:41:09,952 --> 00:41:11,672
So, how tempted were you
to put in the pacer
845
00:41:11,756 --> 00:41:15,338
- against the patient's wishes?
- More than I'd like to admit.
846
00:41:16,139 --> 00:41:18,786
But there are some rules
we can't break.
847
00:41:19,108 --> 00:41:21,141
Do I know I made
the right choice? Yeah.
848
00:41:21,225 --> 00:41:23,770
Do I wish I'd made
the wrong one? Maybe.
849
00:41:24,002 --> 00:41:25,915
I know my intern thinks so.
850
00:41:26,311 --> 00:41:29,723
I heard Dr. Daniels has
a hard time with the rules.
851
00:41:30,042 --> 00:41:32,755
But maybe the example you set
saved his medical career.
852
00:41:32,839 --> 00:41:35,134
To say nothing of your
responsibility to your patient.
853
00:41:35,218 --> 00:41:37,070
Yeah, he's a bright kid,
that Trevor,
854
00:41:37,154 --> 00:41:39,540
but... too much confidence
and passion,
855
00:41:39,624 --> 00:41:41,755
not nearly enough restraint.
856
00:41:46,805 --> 00:41:48,872
He learned something today.
857
00:41:55,479 --> 00:41:57,001
If I'd have saved Wyatt,
858
00:41:57,085 --> 00:41:59,014
would he have come back
in ten years
859
00:41:59,098 --> 00:42:01,942
with an armload of kids,
860
00:42:02,757 --> 00:42:05,082
grateful that we didn't
listen to him?
861
00:42:12,232 --> 00:42:15,434
And now I realize none of this
is why you are here.
862
00:42:17,792 --> 00:42:19,222
Nope.
863
00:42:20,318 --> 00:42:22,422
I got a favor to ask you.
864
00:42:27,485 --> 00:42:28,813
What?
865
00:42:28,897 --> 00:42:31,736
But, look, before
I even-even spell it out,
866
00:42:32,085 --> 00:42:35,215
can I count on you
for full confidentiality?
867
00:42:35,868 --> 00:42:37,662
Go on.
868
00:42:39,046 --> 00:42:42,543
Something's wrong with me,
a-and I'm not quite sure what.
869
00:42:44,473 --> 00:42:46,393
But I think
it may be serious.
870
00:42:47,208 --> 00:42:48,754
You want me to examine you?
871
00:42:49,389 --> 00:42:50,837
Yeah, I'll clear
my schedule tomorrow.
872
00:42:50,921 --> 00:42:52,442
Let's come in early.
873
00:42:53,233 --> 00:42:56,086
And the fact that I'm being
tested at all,
874
00:42:56,170 --> 00:42:58,926
the results,
all under the radar.
875
00:42:59,911 --> 00:43:02,005
So, is that something
you can do?
876
00:43:06,609 --> 00:43:08,724
Okay.
Great, thanks.
877
00:43:11,217 --> 00:43:13,009
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878
00:43:13,093 --> 00:43:14,501
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879
00:43:14,585 --> 00:43:16,307
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880
00:43:16,391 --> 00:43:17,889
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