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Would you like to inspect the original subtitles? These are the user uploaded subtitles that are being translated: 1 00:00:00,945 --> 00:00:02,311 Previously on The Resident... 2 00:00:02,315 --> 00:00:03,630 Hope it's okay that I'm here. 3 00:00:04,348 --> 00:00:06,245 - How dare you? - What happened here? 4 00:00:06,250 --> 00:00:07,614 If you stepped out of line, 5 00:00:07,618 --> 00:00:09,579 then it won't just be Pravesh who comes for you. 6 00:00:09,584 --> 00:00:12,418 Surgery is a dangerous place. 7 00:00:12,423 --> 00:00:14,320 Especially considering your condition. 8 00:00:14,325 --> 00:00:15,989 You mean my dyslexia? 9 00:00:15,994 --> 00:00:17,826 Tell me why you aren't a scientist yet. 10 00:00:17,830 --> 00:00:20,094 This is obviously your future. You just got to go for it. 11 00:00:20,099 --> 00:00:22,098 I would like to start shifting my professional focus 12 00:00:22,102 --> 00:00:23,198 to clinical trials. 13 00:00:23,203 --> 00:00:25,736 Have a proposal on my desk by Monday. 14 00:00:36,447 --> 00:00:39,211 No eggs, Daddy, please, no eggs. 15 00:00:39,216 --> 00:00:42,448 I want cereal. And a banana. 16 00:00:42,453 --> 00:00:45,017 Whoa, whoa, excuse me. 17 00:00:45,022 --> 00:00:46,723 Coming right up. 18 00:00:56,901 --> 00:01:00,900 Daddy, did you forget to go to the market again? 19 00:01:02,773 --> 00:01:04,070 I did. 20 00:01:04,075 --> 00:01:06,105 I am a bad daddy. 21 00:01:06,110 --> 00:01:07,940 No, you're not. 22 00:01:10,247 --> 00:01:11,744 Let's grab your backpack. 23 00:01:11,749 --> 00:01:14,480 We'll get something great for you... 24 00:01:14,485 --> 00:01:16,616 takeout on the way to school. 25 00:01:36,707 --> 00:01:38,971 That's another all-nighter. This has got to stop. 26 00:01:38,976 --> 00:01:41,207 - I know. - You're wearing yourself out. 27 00:01:41,212 --> 00:01:42,612 I know. 28 00:01:43,314 --> 00:01:45,077 But I don't know how to stop. 29 00:01:57,028 --> 00:02:00,326 _ 30 00:02:13,411 --> 00:02:15,508 _ 31 00:02:22,687 --> 00:02:25,885 _ 32 00:02:29,060 --> 00:02:33,426 _ 33 00:02:38,202 --> 00:02:43,269 _ 34 00:03:06,063 --> 00:03:08,661 Dude, I lanced this massive abscess, 35 00:03:08,666 --> 00:03:10,529 and the pus exploded all over Dr. Feldman. 36 00:03:10,534 --> 00:03:12,331 - Ah. - He was pissed. 37 00:03:12,336 --> 00:03:14,666 - Pus-wise, better him than you. - Definitely. 38 00:03:14,671 --> 00:03:16,702 Trevor, we know you made the highlight reel. 39 00:03:16,707 --> 00:03:17,770 Yeah, yeah. 40 00:03:17,775 --> 00:03:19,538 No eruptions of bodily fluids, though. 41 00:03:19,543 --> 00:03:21,040 You had that awesome spinal tap. 42 00:03:21,045 --> 00:03:23,075 Hello. Beer-gate? Legendary. 43 00:03:23,080 --> 00:03:25,210 Okay, Pravesh almost cut me, so... 44 00:03:25,215 --> 00:03:27,279 Sure, but then Hawkins swooped in 45 00:03:27,284 --> 00:03:29,914 and took you under his wing. Please, golden boy. 46 00:03:29,919 --> 00:03:32,118 - "Golden boy". - I don't think anyone has any strong feelings 47 00:03:32,122 --> 00:03:33,152 about me either way. 48 00:03:33,157 --> 00:03:35,088 All right, well, I'd really like to put in a central line. 49 00:03:35,092 --> 00:03:37,623 Hey. Five-car pileup on Peachtree, 50 00:03:37,628 --> 00:03:39,424 multiple injuries headed our way. 51 00:03:39,429 --> 00:03:41,865 All hands on deck. It's game time. 52 00:03:46,274 --> 00:03:53,774 - Synced and corrected by Firefly - - www.addic7ed.com - 53 00:03:59,250 --> 00:04:00,946 Dr. Hawkins, Bay 2. 54 00:04:00,951 --> 00:04:03,216 - On it. - All right, let's get him to Bay 4. 55 00:04:03,221 --> 00:04:05,217 - Zach, with me. - Gemma, Bay 9. 56 00:04:05,222 --> 00:04:07,286 Pravesh, Bay 10. We're gonna need 57 00:04:07,291 --> 00:04:08,888 - another set of hands in there. - Okay, 58 00:04:08,893 --> 00:04:10,426 Janice, Trevor, you come with me. 59 00:04:11,696 --> 00:04:12,858 Pravesh! 60 00:04:12,863 --> 00:04:15,632 - Give me Trevor. - Go see what he needs. 61 00:04:21,572 --> 00:04:23,369 Grab the ultrasound. 62 00:04:23,374 --> 00:04:25,008 Right. 63 00:04:27,011 --> 00:04:28,741 Assess her for internal injuries, 64 00:04:28,746 --> 00:04:30,826 then we'll deal with the lower-extremity lacerations. 65 00:04:31,882 --> 00:04:33,179 Got it. 66 00:04:33,184 --> 00:04:35,080 Whoa. 67 00:04:35,085 --> 00:04:37,616 - Ma'am, what's wrong? - It's not my stomach. I'm okay. 68 00:04:37,621 --> 00:04:39,451 But he's not. 69 00:04:39,456 --> 00:04:42,922 I watched him turn his bike and drive right into traffic. 70 00:04:42,927 --> 00:04:44,056 He caused all of this. 71 00:04:44,061 --> 00:04:46,363 There's something definitely wrong with him. 72 00:04:48,299 --> 00:04:51,063 Hey, Zach. I need you to do a quick FAST exam 73 00:04:51,068 --> 00:04:53,736 and suture up some lacs. Trevor, come with me. 74 00:05:00,077 --> 00:05:02,141 The X-rays showed a fractured rib 75 00:05:02,146 --> 00:05:04,276 but fortunately no broken ankle. 76 00:05:04,281 --> 00:05:05,778 You're gonna be fine. 77 00:05:05,783 --> 00:05:08,547 - You're in good hands here. - Thank you. 78 00:05:08,552 --> 00:05:10,053 You're welcome. 79 00:05:11,355 --> 00:05:13,118 I-I really don't know what happened. 80 00:05:13,123 --> 00:05:16,221 One minute I'm riding my bike, next I'm on the ground 81 00:05:16,226 --> 00:05:18,290 and cars are skidding and crashing. 82 00:05:18,295 --> 00:05:19,758 I feel terrible. 83 00:05:19,763 --> 00:05:21,261 Sounds like you might have passed out? 84 00:05:21,265 --> 00:05:23,295 You got lucky. You could've been killed. 85 00:05:23,300 --> 00:05:25,598 Getting lucky is kind of my thing. 86 00:05:25,603 --> 00:05:27,467 Yeah? How's that? 87 00:05:27,472 --> 00:05:30,335 I was on a charter boat once, it sunk. 88 00:05:30,340 --> 00:05:32,642 Everyone drowned except me. 89 00:05:33,510 --> 00:05:36,108 - I won the lottery twice. - Cool. 90 00:05:36,113 --> 00:05:38,378 Maybe you take a look at the numbers I've been playing. 91 00:05:38,383 --> 00:05:40,079 Happy to, Doc. 92 00:05:40,084 --> 00:05:43,248 Wow, you got the odds of the gods on your side. 93 00:05:43,253 --> 00:05:46,251 I have always felt protected in an otherworldly way. 94 00:05:46,256 --> 00:05:47,786 A-And those are just the highlights. 95 00:05:47,791 --> 00:05:50,930 I also got diagnosed with this thing, sarcoid? 96 00:05:50,935 --> 00:05:52,310 - Mm-hmm. - Supposed to be bad, 97 00:05:52,314 --> 00:05:54,133 but it's never been a problem. 98 00:05:54,138 --> 00:05:55,467 Sarcoid? 99 00:05:55,472 --> 00:05:57,870 What medications are you taking for that? 100 00:05:57,875 --> 00:06:01,073 None. I'm not one to take meds I don't need. 101 00:06:01,078 --> 00:06:02,775 Too many side effects. 102 00:06:02,780 --> 00:06:05,177 - Whoa, whoa. - Oh, Wyatt. 103 00:06:05,182 --> 00:06:06,612 Wyatt? 104 00:06:06,617 --> 00:06:09,281 We need to get him on the monitor now. 105 00:06:09,286 --> 00:06:10,983 - Hey. - Hey. 106 00:06:10,988 --> 00:06:12,651 Sorry you had to come in on your day off. 107 00:06:12,656 --> 00:06:15,521 It's killing me. I've got to get my grant proposal done. 108 00:06:15,526 --> 00:06:18,757 - How are you? - Surgery went long. Don't ask. 109 00:06:18,762 --> 00:06:20,793 Man, it's crazy in here today. 110 00:06:20,798 --> 00:06:22,594 I know. Hi, Brit. 111 00:06:22,599 --> 00:06:24,930 This is Dr. Devi. 112 00:06:24,935 --> 00:06:27,933 She's the surgical consultant I told you about. 113 00:06:27,938 --> 00:06:30,236 Uh, I'm so sorry. Hi, Brit. 114 00:06:30,241 --> 00:06:32,238 I probably shouldn't have come. 115 00:06:32,243 --> 00:06:34,339 I've had this pain on and off for months. 116 00:06:34,344 --> 00:06:36,575 But I realized I'd lost ten pounds. 117 00:06:36,580 --> 00:06:39,945 Without trying, really, so I'm a little spooked. 118 00:06:39,950 --> 00:06:41,681 I'm probably overreacting, right? 119 00:06:41,686 --> 00:06:43,620 Let's just start with an exam. 120 00:06:45,089 --> 00:06:46,753 Ow! Right there. 121 00:06:46,758 --> 00:06:48,521 Can you describe your pain for me? 122 00:06:48,525 --> 00:06:49,789 Throbbing. 123 00:06:49,794 --> 00:06:51,691 Or maybe stabbing. 124 00:06:51,696 --> 00:06:53,559 Are you having any nausea or vomiting? 125 00:06:53,564 --> 00:06:55,261 I thought I was just nervous at first, 126 00:06:55,266 --> 00:06:58,630 you know, existential angst, which I am prone to, 127 00:06:58,635 --> 00:07:00,799 and it is kind of my occupational wheelhouse. 128 00:07:00,804 --> 00:07:02,868 I'm a cartoonist. 129 00:07:02,873 --> 00:07:04,403 Life's a Joke. 130 00:07:04,408 --> 00:07:06,472 - That's my strip. - Hmm. 131 00:07:06,477 --> 00:07:08,340 So, yes to the nausea and vomiting? 132 00:07:08,345 --> 00:07:11,477 Oh, right, yes. Krakatoa, east of Java, man. 133 00:07:11,482 --> 00:07:13,679 Just keeps on coming up. 134 00:07:13,684 --> 00:07:15,548 We'll start with a CT scan to take a closer look, 135 00:07:15,552 --> 00:07:17,750 and we can admit you to get control over your pain 136 00:07:17,755 --> 00:07:18,984 and we'll go from there. 137 00:07:18,989 --> 00:07:20,720 - Okay? - Cool. 138 00:07:20,725 --> 00:07:22,692 All right, we'll be back. 139 00:07:27,431 --> 00:07:29,228 It's a large hepatic hemangioma. 140 00:07:29,233 --> 00:07:30,763 That's a good catch, Dr. Devi. 141 00:07:30,768 --> 00:07:32,698 I haven't seen one of these before. 142 00:07:32,703 --> 00:07:34,433 Well, they're more common than you'd think. 143 00:07:34,438 --> 00:07:36,101 They're benign tumors made up of clusters 144 00:07:36,106 --> 00:07:37,436 of blood-filled cavities. 145 00:07:37,441 --> 00:07:39,071 And usually they don't cause symptoms. 146 00:07:39,076 --> 00:07:41,540 Well, I'm relieved it's benign. 147 00:07:41,545 --> 00:07:44,643 My patient will be, too. She's a little kooky. 148 00:07:44,648 --> 00:07:46,845 Sweet, though. 149 00:07:46,850 --> 00:07:48,680 Should I book an OR for us this afternoon? 150 00:07:48,685 --> 00:07:51,221 Oh, not so fast. Surgery's not a slam dunk here. 151 00:07:52,056 --> 00:07:53,786 A benign tumor causing pain? 152 00:07:53,791 --> 00:07:55,888 Well, surgery on the liver is always high-risk, 153 00:07:55,893 --> 00:07:58,157 even in the best hands, and pain can be managed. 154 00:07:58,162 --> 00:08:00,225 Okay, so I tell her we're not operating, 155 00:08:00,230 --> 00:08:02,695 and I need a repeat scan in two months. 156 00:08:02,700 --> 00:08:04,363 And that's not the answer, either. 157 00:08:04,368 --> 00:08:06,899 This is not something we can decide here. 158 00:08:06,904 --> 00:08:08,234 You need to talk to your patient 159 00:08:08,239 --> 00:08:09,669 and get a sense of her risk tolerance 160 00:08:09,673 --> 00:08:11,370 and the seriousness of her symptoms, 161 00:08:11,375 --> 00:08:14,444 and then you tell me what path you think makes sense. 162 00:08:16,213 --> 00:08:18,210 All right. Can you come with? 163 00:08:18,215 --> 00:08:20,145 Nope. She's your patient, you handle it. 164 00:08:20,150 --> 00:08:25,184 Then meet me in OR 3... an, uh, emergent splenectomy. 165 00:08:25,189 --> 00:08:26,589 Uh, 15 minutes. 166 00:08:28,025 --> 00:08:29,388 So, you have two options. 167 00:08:29,393 --> 00:08:31,091 If you go with the surgery and it goes well, 168 00:08:31,095 --> 00:08:33,092 - your symptoms go away. - Awesome. 169 00:08:33,097 --> 00:08:35,494 But surgery on the liver is never an easy call to make. 170 00:08:35,499 --> 00:08:37,396 It's an organ with many large blood vessels, 171 00:08:37,401 --> 00:08:39,465 which means we could run into significant bleeding. 172 00:08:39,470 --> 00:08:40,766 Oh. Not awesome. 173 00:08:40,771 --> 00:08:42,301 And that circumstance would require 174 00:08:42,306 --> 00:08:44,404 a much larger abdominal surgery with complications 175 00:08:44,408 --> 00:08:46,442 and a long recovery. 176 00:08:48,011 --> 00:08:49,074 Are you with me? 177 00:08:49,079 --> 00:08:50,442 Uh, sort of. 178 00:08:50,447 --> 00:08:53,012 Uh, you understand, right? I'm not a doctor. 179 00:08:53,017 --> 00:08:54,947 I'm a cartoonist. 180 00:08:54,952 --> 00:08:56,715 Right. 181 00:08:56,720 --> 00:08:58,721 Um... 182 00:08:59,823 --> 00:09:00,953 Do you take risks? 183 00:09:00,958 --> 00:09:03,355 If you do, then we go with the surgery. 184 00:09:03,360 --> 00:09:05,824 Are you cautious? Then we hold off for now, 185 00:09:05,829 --> 00:09:07,826 so long as your pain is tolerable. 186 00:09:09,233 --> 00:09:11,163 I don't know, Dr. Devi. 187 00:09:11,168 --> 00:09:13,365 Okay, you know what? Look. 188 00:09:13,370 --> 00:09:15,768 It's okay. Big decision. 189 00:09:15,773 --> 00:09:17,636 Think about it, and I will check in 190 00:09:17,641 --> 00:09:19,238 as soon as I'm back from surgery, okay? 191 00:09:19,243 --> 00:09:20,744 Okay. 192 00:09:24,548 --> 00:09:27,079 Heart block. What is that? 193 00:09:27,084 --> 00:09:29,648 Because of the sarcoid, your heart's electric circuit 194 00:09:29,653 --> 00:09:31,550 isn't working correctly, so your heartbeat 195 00:09:31,555 --> 00:09:33,219 slows to a dangerously low rate. 196 00:09:33,224 --> 00:09:35,254 In some cases, it can stop completely. 197 00:09:35,259 --> 00:09:37,289 Which, to state the obvious, is fatal. 198 00:09:37,294 --> 00:09:39,958 This morning, your heartbeat slowed so much 199 00:09:39,963 --> 00:09:41,960 that you fainted and you crashed your bike. 200 00:09:41,965 --> 00:09:43,962 But there is some good news. 201 00:09:43,967 --> 00:09:45,197 Told you guys. 202 00:09:45,202 --> 00:09:46,766 The solution to your problem 203 00:09:46,771 --> 00:09:48,267 is safe and simple. 204 00:09:48,272 --> 00:09:49,736 We put in a pacemaker, 205 00:09:49,741 --> 00:09:52,072 and your heart goes back to beating normally again. 206 00:09:52,077 --> 00:09:53,573 So you're saying I need a surgery? 207 00:09:53,578 --> 00:09:55,607 Yeah, and it's just an outpatient procedure. 208 00:09:55,612 --> 00:09:57,843 No general anesthesia, no operating room. 209 00:09:57,848 --> 00:09:58,945 It's super simple. 210 00:09:58,950 --> 00:10:01,014 Another narrow escape from death. 211 00:10:01,018 --> 00:10:03,182 The Wyatt Barnes legend grows. 212 00:10:03,187 --> 00:10:05,451 Hey. 213 00:10:05,456 --> 00:10:07,686 I'd like to admit you for observation, and then 214 00:10:07,691 --> 00:10:09,755 we'll schedule the procedure as soon as possible. 215 00:10:09,760 --> 00:10:11,461 Oh, I don't want the pacemaker. 216 00:10:12,129 --> 00:10:14,260 A-Admit me, fine, but, you know, finish 217 00:10:14,265 --> 00:10:16,529 - fixing me up and... - send me home. 218 00:10:16,534 --> 00:10:17,930 No, you don't understand. 219 00:10:17,935 --> 00:10:19,432 If we don't put the pacemaker in, 220 00:10:19,436 --> 00:10:21,133 you will almost certainly die. 221 00:10:21,138 --> 00:10:22,338 Almost? 222 00:10:23,407 --> 00:10:25,704 I'll take those odds. 223 00:10:25,709 --> 00:10:27,239 We are doctors, 224 00:10:27,244 --> 00:10:30,342 advising you on a procedure that will save your life. 225 00:10:30,347 --> 00:10:34,813 Sorry, but it's my body, my decision. 226 00:10:34,818 --> 00:10:36,819 No pacemaker. 227 00:10:37,621 --> 00:10:39,120 No, thanks. 228 00:10:44,200 --> 00:10:46,200 - Hey, we need a cart over here! - Now that you're spending 229 00:10:46,204 --> 00:10:48,300 more time on research and clinical trials, 230 00:10:48,305 --> 00:10:49,935 we need a new ER doctor. 231 00:10:49,940 --> 00:10:51,971 And I'd like you to do the interviews today. 232 00:10:51,976 --> 00:10:54,007 I would, of course, but I'm only filling in 233 00:10:54,012 --> 00:10:55,341 for a few hours today. 234 00:10:55,346 --> 00:10:57,443 And I didn't set aside time for that. 235 00:10:57,448 --> 00:10:58,813 There must be someone else who can help. 236 00:10:58,817 --> 00:11:00,948 There's no one. And I worked here all night. 237 00:11:00,953 --> 00:11:03,651 I'm sorry. Here are the candidates. 238 00:11:04,553 --> 00:11:07,251 Dr. Voss, I have to get my grant proposal in by 6:00 p.m. 239 00:11:07,256 --> 00:11:08,887 Your proposal will have to wait. 240 00:11:08,892 --> 00:11:10,455 And I don't need to remind you why 241 00:11:10,460 --> 00:11:12,128 we're short-staffed in the ER. 242 00:11:13,963 --> 00:11:15,326 Yeah. I get it. 243 00:11:15,331 --> 00:11:16,794 Thank you. 244 00:11:16,799 --> 00:11:18,863 I'm counting on you. 245 00:11:18,868 --> 00:11:20,365 Happy to help. 246 00:11:43,092 --> 00:11:45,956 So, our Mr. Lucky has complete AV block 247 00:11:45,961 --> 00:11:47,758 with wide ventricular escape. 248 00:11:47,763 --> 00:11:49,560 He's not gonna live long enough to cash in 249 00:11:49,565 --> 00:11:51,562 his third lotto ticket without a pacemaker. 250 00:11:52,701 --> 00:11:54,632 I mean, you think he wants to die? 251 00:11:55,805 --> 00:11:59,604 Yeah, the guy's super cheerful. It's bizarre. 252 00:11:59,609 --> 00:12:02,244 Mom, listen, I'm in the middle of... 253 00:12:04,213 --> 00:12:06,310 Well, is-is the cough getting any better? 254 00:12:06,315 --> 00:12:08,546 Did you call the oncologist? 255 00:12:08,551 --> 00:12:11,749 Mom, just do it now, please. 256 00:12:11,754 --> 00:12:14,489 Yes, I will see you before I go to the airport. 257 00:12:16,459 --> 00:12:18,289 Tell Carol I'll call her, 258 00:12:18,294 --> 00:12:22,360 talk her through some options for her respiratory symptoms. 259 00:12:22,365 --> 00:12:23,999 Appreciate it, man. 260 00:12:25,168 --> 00:12:27,331 Look, I-I wish I could engage. 261 00:12:27,336 --> 00:12:29,800 All right? I-If there were 28 hours in the day, 262 00:12:29,805 --> 00:12:31,902 I would gladly wax poetic with the patient 263 00:12:31,907 --> 00:12:33,404 about the benefits of a pacemaker, 264 00:12:33,409 --> 00:12:35,272 but I do not have the time. 265 00:12:35,277 --> 00:12:38,776 I have way too many patients who would kill for an easy cure. 266 00:12:38,781 --> 00:12:41,579 I got too many, too many obligations. 267 00:12:41,584 --> 00:12:43,114 All right, you get him to see reason, 268 00:12:43,119 --> 00:12:44,615 I have no doubt that you will, 269 00:12:44,620 --> 00:12:47,122 then I will come back, I'll put in the pacer. 270 00:12:51,568 --> 00:12:53,631 Okay. Have you, uh... 271 00:12:53,636 --> 00:12:54,933 you seen this problem before? 272 00:12:54,938 --> 00:12:58,236 All the time during the pandemic. 273 00:12:58,241 --> 00:13:01,473 We had a lot of patients who died claiming COVID was made up. 274 00:13:01,478 --> 00:13:03,208 Well, what do we do next? 275 00:13:03,213 --> 00:13:07,311 He agreed to a brief admission, so we bring him up to the ICU, 276 00:13:07,316 --> 00:13:09,814 start him on isoproterenol to raise his heart rate 277 00:13:09,819 --> 00:13:11,117 while I figure out a way to respectfully 278 00:13:11,121 --> 00:13:12,217 get him to see reason. 279 00:13:12,222 --> 00:13:14,290 I will watch and learn. 280 00:13:15,725 --> 00:13:17,489 Hey, Brit, have you had some time 281 00:13:17,494 --> 00:13:19,461 to review your options? 282 00:13:22,499 --> 00:13:25,201 She was here a minute ago. She should be back soon. 283 00:13:34,110 --> 00:13:38,543 And if you had to change one thing about emergency medicine, 284 00:13:38,548 --> 00:13:39,611 what would it be? 285 00:13:39,616 --> 00:13:41,313 Well, we're letting money walk out the door. 286 00:13:41,317 --> 00:13:42,347 That's for sure. 287 00:13:42,352 --> 00:13:45,316 Uh, I personally would deploy a-a number of strategies 288 00:13:45,321 --> 00:13:47,419 that would be more lucrative for the hospital. 289 00:13:47,424 --> 00:13:48,553 Uh, I mean, you can't fix 290 00:13:48,558 --> 00:13:50,356 all the inefficiencies at once, you know? 291 00:13:50,360 --> 00:13:53,858 You got to let this, uh, this pig work its way through 292 00:13:53,863 --> 00:13:56,094 the-the boa constrictor, so to speak. 293 00:13:56,099 --> 00:13:59,397 So, I created some slides here, uh, with ideas 294 00:13:59,402 --> 00:14:02,166 for how to capitalize on low-hanging fruit. 295 00:14:02,171 --> 00:14:03,201 I'll talk you through it. 296 00:14:03,206 --> 00:14:05,508 Uh, shouldn't be more than, uh, an hour. 297 00:14:06,576 --> 00:14:08,010 Or two. 298 00:14:10,580 --> 00:14:12,744 Brit? 299 00:14:12,749 --> 00:14:15,318 I've been looking everywhere for you. 300 00:14:16,553 --> 00:14:18,950 Has your abdominal pain gotten worse? 301 00:14:18,955 --> 00:14:21,653 You shouldn't be out here. We should get you back inside. 302 00:14:21,658 --> 00:14:23,655 It's not that, Dr. Devi. 303 00:14:23,660 --> 00:14:26,358 I had to get some air so I could think. 304 00:14:26,363 --> 00:14:27,763 Okay. 305 00:14:29,800 --> 00:14:32,097 I can't decide about the surgery. 306 00:14:32,102 --> 00:14:34,466 I tell myself, "Go for it". 307 00:14:34,471 --> 00:14:37,069 Then I think it's too dangerous. 308 00:14:37,074 --> 00:14:40,906 What if I bleed to death in the OR and my cat dies alone? 309 00:14:40,911 --> 00:14:44,876 Or I go home and die and no one finds me and Tinkerbell eats me. 310 00:14:44,881 --> 00:14:47,078 - You have to take it easy, Brit. - Sometimes I wake up 311 00:14:47,083 --> 00:14:49,181 and she's staring at me like I'm a goldfish. 312 00:14:49,186 --> 00:14:50,849 There's a darkness in her. 313 00:14:50,854 --> 00:14:53,318 I'm indecisive. 314 00:14:53,323 --> 00:14:55,754 Even about things that don't matter. 315 00:14:55,759 --> 00:14:58,894 My cartoons poke fun at people like me. 316 00:15:00,864 --> 00:15:02,264 Brit. 317 00:15:03,800 --> 00:15:06,769 What can I do to help you make this decision? 318 00:15:08,405 --> 00:15:10,006 Make it for me? 319 00:15:11,108 --> 00:15:12,738 Just be my doctor. 320 00:15:12,743 --> 00:15:14,777 I'll do whatever you say. 321 00:15:22,052 --> 00:15:24,850 How am I doing? 322 00:15:24,855 --> 00:15:27,386 Your heart rate is dangerously slow. 323 00:15:27,391 --> 00:15:29,221 38. 324 00:15:29,226 --> 00:15:32,091 Meds helped transiently, but they can't fix this, 325 00:15:32,096 --> 00:15:33,292 and it's getting worse. 326 00:15:33,297 --> 00:15:34,460 I feel fine. 327 00:15:34,465 --> 00:15:36,128 That's impossible, okay? 328 00:15:36,133 --> 00:15:37,996 You have to be tired, light-headed... 329 00:15:38,001 --> 00:15:39,068 Not really. 330 00:15:39,937 --> 00:15:41,100 I'm hungry. 331 00:15:41,105 --> 00:15:42,905 This place have ice cream? 332 00:15:44,341 --> 00:15:46,538 Yes... 333 00:15:46,543 --> 00:15:48,874 ... but let's finish talking first. 334 00:15:48,879 --> 00:15:50,976 A pacemaker is a simple device. 335 00:15:50,981 --> 00:15:53,378 It is not dangerous to put in, 336 00:15:53,383 --> 00:15:55,247 and it will keep you from falling off your bike 337 00:15:55,252 --> 00:15:56,415 in the middle of traffic. 338 00:15:56,420 --> 00:15:58,283 Or dying today. 339 00:15:58,288 --> 00:16:01,453 Which could happen. 340 00:16:01,458 --> 00:16:02,955 It's not gonna happen. 341 00:16:02,960 --> 00:16:05,290 What are you afraid of, Wyatt? 342 00:16:05,295 --> 00:16:07,326 I'm not afraid. I just don't like the idea 343 00:16:07,331 --> 00:16:09,595 of having a foreign object put into my body. 344 00:16:09,600 --> 00:16:11,730 Do you know anyone with type 1 diabetes? 345 00:16:11,735 --> 00:16:13,498 Yeah. My old boss. 346 00:16:13,503 --> 00:16:15,100 Did your boss use an insulin pump? 347 00:16:15,105 --> 00:16:17,803 She does, but what you're talking about 348 00:16:17,808 --> 00:16:19,671 is putting something in to control my heart. 349 00:16:19,676 --> 00:16:20,739 That's different. 350 00:16:20,744 --> 00:16:21,774 No. Not really. 351 00:16:21,779 --> 00:16:24,043 Uh, complications from pacemakers are rare. 352 00:16:24,047 --> 00:16:26,244 I'm sorry, but I do my own research. 353 00:16:26,249 --> 00:16:27,746 I'm part of this Facebook group. 354 00:16:27,751 --> 00:16:29,981 - Oh, here we go. - And they just published a list 355 00:16:29,986 --> 00:16:31,683 of unsafe products from China. 356 00:16:31,688 --> 00:16:34,720 Know what's on top? Pacemakers. 357 00:16:34,725 --> 00:16:36,521 Now, they're assembled here, 358 00:16:36,526 --> 00:16:38,323 but guess where the parts come from. 359 00:16:38,328 --> 00:16:41,794 Yep. Guy in the group got poisoned by some bad metals. 360 00:16:41,799 --> 00:16:44,863 Those posts aren't truthful, Wyatt. 361 00:16:44,868 --> 00:16:48,200 They are propaganda from unqualified people 362 00:16:48,205 --> 00:16:50,368 who have politicized health and medicine. 363 00:16:50,373 --> 00:16:52,532 They either want to sow distrust in science 364 00:16:52,537 --> 00:16:53,537 or sell you snake oil. 365 00:16:53,542 --> 00:16:54,641 The real truth, Wyatt? 366 00:16:54,645 --> 00:16:56,275 Bad metal is not a thing. 367 00:16:56,280 --> 00:16:58,743 Dr. Hawkins is who you want giving you advice. 368 00:16:58,748 --> 00:16:59,778 He's an actual expert. 369 00:16:59,783 --> 00:17:01,613 I form my own opinions, okay? 370 00:17:01,618 --> 00:17:04,583 - You have yours. - Okay, this isn't an opinion. 371 00:17:04,588 --> 00:17:06,018 It's fact versus fiction. 372 00:17:06,023 --> 00:17:07,823 - Do you understand? - All right. 373 00:17:08,659 --> 00:17:10,455 We hear you, Wyatt. 374 00:17:10,460 --> 00:17:11,994 Okay? 375 00:17:14,131 --> 00:17:15,795 Be back to check on you in a bit. 376 00:17:15,800 --> 00:17:17,701 Thanks, Doc. 377 00:17:19,770 --> 00:17:21,734 He was getting more and more dug in. 378 00:17:21,739 --> 00:17:23,770 - You have to know how to take a step back. - Okay, but if Wyatt dies, 379 00:17:23,774 --> 00:17:25,138 it won't be sarcoid that kills him, 380 00:17:25,142 --> 00:17:27,739 it'll be i-irrational fear and misinformation. 381 00:17:27,744 --> 00:17:30,008 And those are difficult conditions to cure. 382 00:17:30,013 --> 00:17:31,943 - I... - Some people only accept information 383 00:17:31,948 --> 00:17:33,378 that confirms their beliefs. 384 00:17:33,383 --> 00:17:35,347 You have to give them the facts, 385 00:17:35,352 --> 00:17:37,215 tell them how important the science is, 386 00:17:37,220 --> 00:17:39,951 - but then if you push too hard... - I get that, but if... 387 00:17:39,956 --> 00:17:43,355 ... we lose what little trust we may have earned. 388 00:17:43,360 --> 00:17:45,757 Even when you're 1,000% right. 389 00:17:45,762 --> 00:17:48,460 - Uh... He's gonna... - Gentlemen. 390 00:17:48,465 --> 00:17:51,396 So I don't see your patient on my cath lab schedule. 391 00:17:51,401 --> 00:17:54,066 - What happened? No pacemaker? - Uh, not yet. 392 00:17:54,071 --> 00:17:56,167 We were just getting ready to discuss next steps. 393 00:17:56,172 --> 00:17:58,070 The guy actually believes in luck. 394 00:17:58,075 --> 00:17:59,771 As in, he's too lucky to die. 395 00:17:59,776 --> 00:18:02,707 He did tell us he's always felt protected 396 00:18:02,712 --> 00:18:04,576 in an "otherworldly" way. 397 00:18:04,581 --> 00:18:07,045 An argument could be made that he doesn't have the capacity 398 00:18:07,050 --> 00:18:08,681 to make medical decisions for himself. 399 00:18:08,686 --> 00:18:10,483 Well, if he's making his decision based on 400 00:18:10,488 --> 00:18:12,284 otherworldly information, you may be right. 401 00:18:12,289 --> 00:18:14,386 I'll call Dr. Malco in the psych department. 402 00:18:14,391 --> 00:18:17,960 Let's hope this works. Wyatt's running out of time. 403 00:18:27,300 --> 00:18:29,730 Wyatt, why don't you tell me in your own words 404 00:18:29,735 --> 00:18:31,595 what's going on with your health right now? 405 00:18:31,600 --> 00:18:32,930 It's pretty simple. 406 00:18:32,935 --> 00:18:35,299 I've never liked hospitals, 407 00:18:35,304 --> 00:18:38,002 but I came here because of a bike accident. 408 00:18:38,007 --> 00:18:40,271 They escalated the whole thing by threatening 409 00:18:40,276 --> 00:18:41,973 to put in a pacemaker. 410 00:18:42,378 --> 00:18:45,042 Do you know how many people get a pacemaker? 411 00:18:45,047 --> 00:18:47,311 They're slapping them into everybody these days. 412 00:18:47,316 --> 00:18:49,413 Why don't you trust your doctors? 413 00:18:49,418 --> 00:18:51,549 I make up my own mind. 414 00:18:51,554 --> 00:18:53,317 And, look, I'm not crazy. 415 00:18:53,322 --> 00:18:55,319 You know, agreeing to have doctors I just met 416 00:18:55,324 --> 00:18:58,822 implant something into my body is what's crazy. 417 00:18:58,827 --> 00:19:01,726 We just need to make sure that you understand the consequences 418 00:19:01,731 --> 00:19:03,828 of the decision you're making here. 419 00:19:03,833 --> 00:19:06,497 I've been listening to those two all day. 420 00:19:06,502 --> 00:19:08,099 Of course I understand. 421 00:19:08,504 --> 00:19:12,569 And there's something you need to understand about me. 422 00:19:12,574 --> 00:19:14,271 And what is that? 423 00:19:14,276 --> 00:19:16,373 You're not gonna change my mind. 424 00:19:16,378 --> 00:19:19,143 And if I do die, I don't want anyone 425 00:19:19,148 --> 00:19:22,413 going wild and pounding on my chest, okay? 426 00:19:22,418 --> 00:19:25,849 Write that down in your little notepad. 427 00:19:25,854 --> 00:19:28,056 We all have to die someday. 428 00:19:28,061 --> 00:19:30,396 And I am not going out like that. 429 00:19:36,699 --> 00:19:38,429 - Dr. Bell? - Yeah. 430 00:19:38,434 --> 00:19:41,332 - Do you have a second? - Mm-hmm. 431 00:19:44,006 --> 00:19:46,203 Please tell me this gets easier. 432 00:19:46,208 --> 00:19:48,205 Is this about making a life-or-death decision 433 00:19:48,210 --> 00:19:50,878 - for a person you just met? - Yes. 434 00:19:50,883 --> 00:19:53,914 It should never be easy. This is the job. 435 00:19:53,919 --> 00:19:55,647 It's not irrational for a patient to think 436 00:19:55,651 --> 00:19:57,915 we know more and should decide for them. 437 00:19:57,920 --> 00:19:59,684 What if I can't figure out what's the best way to go? 438 00:19:59,688 --> 00:20:01,756 You will, because you have to. 439 00:20:02,491 --> 00:20:04,355 That's what your patient needs. 440 00:20:04,360 --> 00:20:06,523 So go with your gut, Dr. Devi, 441 00:20:06,528 --> 00:20:10,094 informed by your experience and your schooling. 442 00:20:10,099 --> 00:20:13,168 - Okay? - Okay. 443 00:20:18,207 --> 00:20:19,503 Dr. Voss. 444 00:20:19,508 --> 00:20:21,405 Tell me what you need. I'm here to help. 445 00:20:21,410 --> 00:20:24,775 Well, I'm realizing that all our doctors 446 00:20:24,780 --> 00:20:26,877 are in danger of burnout. 447 00:20:26,882 --> 00:20:29,947 The stress at times can be unrelenting. 448 00:20:29,952 --> 00:20:32,750 Maybe your program can help. 449 00:20:32,755 --> 00:20:34,151 I would love that. 450 00:20:34,156 --> 00:20:36,654 I offer yoga sessions, meditation, 451 00:20:36,659 --> 00:20:39,156 sleep counseling and positive affirmations. 452 00:20:39,161 --> 00:20:43,594 Plus, fresh-baked resiliency cookies. Gluten-free. 453 00:20:43,599 --> 00:20:48,532 I think I could make everybody ten percent happier, at least. 454 00:20:48,537 --> 00:20:51,202 I would invest in ten percent happier. 455 00:20:51,207 --> 00:20:52,736 When can you start? 456 00:20:52,741 --> 00:20:54,371 Shall we start now? 457 00:20:54,376 --> 00:20:57,040 Yes. Sign me up. 458 00:20:57,045 --> 00:20:58,776 - Come sit down. - Oh. 459 00:20:58,781 --> 00:21:00,816 Just five minutes. 460 00:21:03,919 --> 00:21:06,817 - Lie down, put your feet up. - Oh, wait, I can't. I'd be... 461 00:21:06,822 --> 00:21:09,386 All right. Okay. 462 00:21:11,427 --> 00:21:12,994 Close your eyes. 463 00:21:14,196 --> 00:21:19,029 And now just take a deep, cleansing breath. 464 00:21:20,536 --> 00:21:22,036 Ooh, sorry. 465 00:21:23,839 --> 00:21:25,673 - Later. I promise. - Okay. 466 00:21:38,887 --> 00:21:41,218 - Do you speak Spanish? - No. 467 00:21:41,223 --> 00:21:43,120 I don't think there's room in my head 468 00:21:43,125 --> 00:21:45,622 for any more words I'm supposed to understand. 469 00:21:45,627 --> 00:21:49,126 Do you mind turning it down? I promise to keep this simple. 470 00:21:51,900 --> 00:21:55,165 Based on the size of your hemangioma and your symptoms, 471 00:21:55,170 --> 00:21:58,001 if it were me, I would go with the surgery. 472 00:21:59,675 --> 00:22:02,039 Surgery it is. When? 473 00:22:02,044 --> 00:22:03,740 Well, we can operate later today. 474 00:22:03,745 --> 00:22:06,547 But I would like to take you through the consent. 475 00:22:08,984 --> 00:22:10,747 There are risks. 476 00:22:10,752 --> 00:22:14,618 Bleeding, infection, damage to your liver. 477 00:22:14,623 --> 00:22:17,221 It's possible but unlikely that we'll have trouble 478 00:22:17,226 --> 00:22:19,223 getting you off the ventilator. 479 00:22:19,228 --> 00:22:21,492 And as with any surgery, there is a risk of death. 480 00:22:21,497 --> 00:22:23,727 Have you done this operation often? 481 00:22:23,732 --> 00:22:26,230 Uh, no, I haven't, but the senior surgeon 482 00:22:26,235 --> 00:22:29,132 I work with has, and he'll be there. 483 00:22:31,440 --> 00:22:32,936 Pen. 484 00:22:32,941 --> 00:22:35,176 All right. 485 00:22:36,411 --> 00:22:38,412 Thank you. 486 00:22:49,992 --> 00:22:51,655 He's clear and consistent. 487 00:22:51,660 --> 00:22:53,490 I don't find him to be influenced 488 00:22:53,495 --> 00:22:55,959 by untreated depression, and he's not suicidal. 489 00:22:55,964 --> 00:22:57,928 His choice isn't one that I would make for myself 490 00:22:57,933 --> 00:23:01,164 or someone I love, but it's one he has a right to make. 491 00:23:01,169 --> 00:23:04,368 What do you make of his belief that he's cosmically protected? 492 00:23:04,373 --> 00:23:07,004 Hearing celestial voices is one thing, 493 00:23:07,009 --> 00:23:09,406 but it's human nature to search 494 00:23:09,411 --> 00:23:11,575 for explanations for our experiences. 495 00:23:11,580 --> 00:23:14,010 Just describing them in ways that are fantastical 496 00:23:14,015 --> 00:23:16,046 doesn't signify a lack of capacity. 497 00:23:16,051 --> 00:23:17,915 Um, I'm sorry, it makes no sense. 498 00:23:17,920 --> 00:23:21,085 I mean, look how young he is, and he even requested a DNR? 499 00:23:21,090 --> 00:23:24,889 Which is a sign that he's-he's clear and coherent. 500 00:23:24,894 --> 00:23:27,024 Look, lack of capacity is a high bar, 501 00:23:27,029 --> 00:23:28,926 and Wyatt doesn't reach it. 502 00:23:28,931 --> 00:23:30,661 I'm sorry. 503 00:23:30,666 --> 00:23:33,968 - You have to respect his wishes. - All right, thank you, Leslie. 504 00:23:37,273 --> 00:23:38,669 Uh... 505 00:23:38,674 --> 00:23:40,371 Is that really it? 506 00:23:40,376 --> 00:23:42,106 If he's determined to have capacity, 507 00:23:42,110 --> 00:23:43,408 we can't force him to be treated. 508 00:23:43,412 --> 00:23:44,776 Wait, hold on, I thought you were the renegade. 509 00:23:44,780 --> 00:23:46,643 I heard you drilled into a guy's head 510 00:23:46,648 --> 00:23:48,111 and you're not even a surgeon. 511 00:23:48,116 --> 00:23:50,080 But you're gonna sit here and let this man die? 512 00:23:50,085 --> 00:23:51,750 If the guy would've said, "Whatever you do, 513 00:23:51,754 --> 00:23:56,024 don't drill into my head", I wouldn't have. 514 00:23:56,029 --> 00:23:58,159 It's pretty simple. 515 00:23:59,194 --> 00:24:02,125 You can't do what the patient doesn't want. 516 00:24:02,130 --> 00:24:04,761 Okay, this is what we're gonna do. 517 00:24:04,766 --> 00:24:07,064 I did a deep dive into temporary pacers. 518 00:24:07,069 --> 00:24:09,566 Wyatt passes out, we get the pads on him, 519 00:24:09,571 --> 00:24:11,535 shock him if we need to, slip it in 520 00:24:11,540 --> 00:24:12,936 - at his bedside. - Hey. 521 00:24:19,381 --> 00:24:20,911 Let's get him some O2. 522 00:24:20,916 --> 00:24:22,946 I'm nauseous. My stomach hurts. 523 00:24:22,951 --> 00:24:24,548 What's going on? 524 00:24:24,553 --> 00:24:27,317 Gut ischemia from poor perfusion. 525 00:24:27,322 --> 00:24:29,219 Your heart rate's too low. 526 00:24:29,224 --> 00:24:30,854 Let's get him some pain meds. 527 00:24:30,859 --> 00:24:31,955 Page Bell. 528 00:24:31,960 --> 00:24:33,561 Okay. 529 00:24:40,599 --> 00:24:42,134 Okay. 530 00:24:47,238 --> 00:24:50,303 Yeah, he's-he's calmer now with the pain meds on board. 531 00:24:50,308 --> 00:24:52,906 It's highly likely he has dying bowel, 532 00:24:52,911 --> 00:24:55,942 but he's not a viable candidate for surgery. 533 00:24:55,947 --> 00:24:57,944 Unless we get him to agree to a pacer. 534 00:24:57,949 --> 00:25:01,147 And, yeah, if you do, tell me, and I'll take him to the OR. 535 00:25:01,152 --> 00:25:03,216 As of now, all the complications 536 00:25:03,221 --> 00:25:05,618 from his untreated heart condition are fixable, 537 00:25:05,623 --> 00:25:08,325 but I don't know for how long. 538 00:25:10,228 --> 00:25:12,396 He's refusing all intervention. 539 00:25:13,698 --> 00:25:15,662 Is there anything else I can do for you? 540 00:25:15,667 --> 00:25:17,234 I wish there were. 541 00:25:22,574 --> 00:25:24,904 Okay, just... just hear me out. 542 00:25:24,909 --> 00:25:27,740 All right, you know the Dax Cowart case, right? 543 00:25:27,745 --> 00:25:30,443 He wanted to die after suffering catastrophic burns. 544 00:25:30,448 --> 00:25:32,946 He was in pain, terribly disfigured, went blind. 545 00:25:32,951 --> 00:25:34,981 And he was ruled to have capacity, too, 546 00:25:34,986 --> 00:25:39,423 but his doctors disregarded his wishes and saved his life. 547 00:25:40,258 --> 00:25:41,788 Mm-hmm. 548 00:25:41,793 --> 00:25:44,858 Yeah, he had a career, he had a family, 549 00:25:44,863 --> 00:25:47,660 I mean, he lived until he was 71. 550 00:25:47,665 --> 00:25:49,597 Wyatt can have the same thing. 551 00:25:49,602 --> 00:25:52,732 Dax Cowart became a lawyer and built a career 552 00:25:52,737 --> 00:25:54,467 on fighting for patients' rights. 553 00:25:54,472 --> 00:25:57,403 He used his own case to show what the doctors did, 554 00:25:57,408 --> 00:26:00,541 what you want to do to Wyatt, was a betrayal of those rights. 555 00:26:00,546 --> 00:26:01,811 It's not a betrayal of his rights. 556 00:26:01,815 --> 00:26:03,575 Hey, I'm as frustrated as you are. 557 00:26:04,716 --> 00:26:06,780 As doctors, our purpose is to help. 558 00:26:06,785 --> 00:26:08,514 And you got that part right. 559 00:26:08,519 --> 00:26:10,617 But Wyatt needs to want to be helped. 560 00:26:10,622 --> 00:26:12,456 No, until he's dead, I'm not giving up. 561 00:26:18,429 --> 00:26:20,530 Then neither am I. 562 00:26:23,768 --> 00:26:25,502 Sorry I'm late. 563 00:26:26,504 --> 00:26:29,202 Had a rough consult with Conrad's patient. 564 00:26:29,207 --> 00:26:31,037 The exact opposite of Brit. 565 00:26:31,042 --> 00:26:33,539 He doesn't trust Conrad, for all the wrong reasons. 566 00:26:33,544 --> 00:26:35,608 And here I am tied up in knots 567 00:26:35,613 --> 00:26:37,644 over a patient who trusts me too much. 568 00:26:37,649 --> 00:26:39,747 You made the best decision you could 569 00:26:39,751 --> 00:26:41,581 with the information you have. 570 00:26:46,458 --> 00:26:48,655 You have a very unusual career path. 571 00:26:48,660 --> 00:26:51,591 What brought you from oncology to emergency medicine? 572 00:26:51,596 --> 00:26:53,226 So much suffering and death. 573 00:26:53,231 --> 00:26:55,695 The patients call you weeping at all hours 574 00:26:55,700 --> 00:26:57,964 of the day and night. 575 00:26:58,469 --> 00:27:01,301 I-I was worn out from the stress. 576 00:27:01,306 --> 00:27:04,170 Those days ruined me. And now? 577 00:27:04,175 --> 00:27:06,873 Just off a shift, look at me... I'm still fresh. 578 00:27:06,878 --> 00:27:08,908 Well, it must have been a challenge to go back 579 00:27:08,913 --> 00:27:11,477 to residency and learn all the ER procedures. 580 00:27:11,482 --> 00:27:13,780 Hmm, I'm not one for new techniques. 581 00:27:13,785 --> 00:27:16,316 I pretty much slept through that residency. 582 00:27:16,321 --> 00:27:19,252 - It was no big deal. - I see. 583 00:27:20,959 --> 00:27:22,288 I told you, Doc. 584 00:27:22,293 --> 00:27:26,297 If God wants me to live, I'll live. 585 00:27:27,699 --> 00:27:30,768 He'll reach His hand down to me. 586 00:27:32,437 --> 00:27:34,667 He's always been so good to me. 587 00:27:34,672 --> 00:27:37,003 Is this about luck now, Wyatt? 588 00:27:37,008 --> 00:27:38,208 Or God? 589 00:27:40,044 --> 00:27:44,077 He can't save you right now. We can. 590 00:27:44,082 --> 00:27:46,116 Leave me alone, Doc. 591 00:27:48,319 --> 00:27:51,184 No. Wyatt... 592 00:27:51,189 --> 00:27:53,987 - Trevor. - You just, you got to listen to what I'm... 593 00:27:53,992 --> 00:27:56,093 Trevor. Trevor, take a walk now. 594 00:28:08,606 --> 00:28:10,006 He's young. 595 00:28:11,442 --> 00:28:14,144 But he cares deeply. 596 00:28:15,981 --> 00:28:18,979 And I respect your faith in God's will. 597 00:28:19,584 --> 00:28:21,948 I'm in His hands now. 598 00:28:21,953 --> 00:28:25,189 And you always have been, right? 599 00:28:26,958 --> 00:28:31,162 How do you know He is not using us to save you? 600 00:28:33,531 --> 00:28:36,329 You think he wasn't sitting beside Rune Elmqvist in Sweden 601 00:28:36,334 --> 00:28:39,065 half a century ago when he invented the pacemaker? 602 00:28:39,070 --> 00:28:42,072 He is sending you one lifeline after another. 603 00:28:45,810 --> 00:28:47,211 Hey. 604 00:28:50,281 --> 00:28:52,983 I'll ask Him. 605 00:28:54,185 --> 00:28:56,019 Wyatt? 606 00:29:11,136 --> 00:29:13,833 Wyatt. 607 00:29:29,253 --> 00:29:31,284 Yeah, the liver is exposed. 608 00:29:31,289 --> 00:29:32,753 Ready to begin the enucleation. 609 00:29:32,757 --> 00:29:35,088 Remember, the beauty of this technique is that we, 610 00:29:35,092 --> 00:29:37,857 we work along existing planes to pop the mass out 611 00:29:37,862 --> 00:29:39,625 and we leave the liver intact. 612 00:29:39,630 --> 00:29:41,160 That's how we avoid massive bleeding. 613 00:29:41,165 --> 00:29:44,564 And note the vessels extending into the liver. 614 00:29:44,569 --> 00:29:46,833 Divide and ligate. 615 00:29:46,838 --> 00:29:48,906 Be careful. 616 00:29:50,175 --> 00:29:52,038 Ugh, I have a tiny bleeder. 617 00:29:52,043 --> 00:29:53,577 Cautery. 618 00:29:56,047 --> 00:29:57,711 And another one. 619 00:29:57,716 --> 00:29:59,150 Okay, suction. 620 00:30:04,622 --> 00:30:06,356 Okay, that's arterial. Clamp. 621 00:30:08,426 --> 00:30:10,928 Dr. Bell? Here's the clamp. 622 00:30:15,900 --> 00:30:17,234 Are you okay? 623 00:30:18,503 --> 00:30:20,066 Uh, no. 624 00:30:20,071 --> 00:30:21,838 Jessica, I'll take it. 625 00:30:22,506 --> 00:30:24,704 Uh, Dr. Devi, I have to leave. 626 00:30:24,709 --> 00:30:26,239 What? 627 00:30:26,244 --> 00:30:28,308 I-I'll find someone to cover as soon as possible. 628 00:30:28,312 --> 00:30:29,546 Uh, as soon as possible. 629 00:30:33,618 --> 00:30:35,018 Dr. Bell. 630 00:30:40,925 --> 00:30:42,491 You can do this. 631 00:30:51,130 --> 00:30:53,630 I've got the mass on the last vascular pedicle. 632 00:30:53,635 --> 00:30:54,865 Any word from Bell? 633 00:30:54,870 --> 00:30:56,999 Nothing yet. You'll probably get this sucker out of here 634 00:30:57,003 --> 00:30:58,571 before anyone comes. 635 00:31:01,107 --> 00:31:03,605 Pressure's drifting down, Dr. Devi. 636 00:31:03,610 --> 00:31:06,575 She's losing blood. Let's get some blood products in her. 637 00:31:06,580 --> 00:31:07,943 Tell me what you need. 638 00:31:07,948 --> 00:31:10,277 Lap pads and suction. I'm operating underwater here. 639 00:31:10,282 --> 00:31:12,381 If I can't find the source for the bleeding, I can't fix it. 640 00:31:12,385 --> 00:31:13,550 Two units are in, and I activated 641 00:31:13,554 --> 00:31:15,785 massive transfusion protocol. We're maxed on norepi. 642 00:31:15,790 --> 00:31:17,453 Found it. 643 00:31:17,458 --> 00:31:18,824 You've got to get control. She won't tolerate 644 00:31:18,828 --> 00:31:20,655 this blood loss much longer. 645 00:31:20,660 --> 00:31:22,526 I need to remove the portion of the liver 646 00:31:22,530 --> 00:31:24,659 the vessel is feeding. Prepare for a hepatectomy. 647 00:31:24,664 --> 00:31:26,561 That's a serious change in plans. 648 00:31:26,566 --> 00:31:27,796 We should call Dr. Bell first. 649 00:31:27,801 --> 00:31:29,464 No time. Clamp, now. 650 00:31:29,469 --> 00:31:32,001 Chu, give her 1:1:1 resuscitation to keep up. 651 00:31:32,006 --> 00:31:34,466 - Jessica, do not stop that suction. - Got it. 652 00:31:40,413 --> 00:31:41,847 Got it. 653 00:31:43,183 --> 00:31:45,080 We've got a stable pressure. 654 00:31:45,085 --> 00:31:47,582 Strong work, Dr. Devi. 655 00:31:49,990 --> 00:31:51,219 You did it. 656 00:31:51,224 --> 00:31:53,755 Let's get her closed up 657 00:31:53,760 --> 00:31:54,961 and off this table. 658 00:32:02,002 --> 00:32:04,332 What do you think the evidence is 659 00:32:04,337 --> 00:32:06,233 behind cookies for stress relief? 660 00:32:06,238 --> 00:32:08,970 - Anecdotal but robust. - I'm really feeling 661 00:32:08,975 --> 00:32:11,172 - the chocolate chip. - Dr. Austin? 662 00:32:11,177 --> 00:32:12,507 Of all people. 663 00:32:12,512 --> 00:32:14,309 Do raptors do yoga? 664 00:32:14,314 --> 00:32:17,913 I'm only here because my CEO told me I had to be here. 665 00:32:17,918 --> 00:32:19,447 But I won't be here for long. 666 00:32:19,452 --> 00:32:20,982 I have to round on the post-ops again 667 00:32:20,987 --> 00:32:22,717 before I fly to Manhattan tonight 668 00:32:22,722 --> 00:32:24,587 - for talk shows tomorrow. - Well, I'm stiff, 669 00:32:24,591 --> 00:32:25,687 my back is in knots. 670 00:32:25,692 --> 00:32:27,422 I've been in interviews all day, 671 00:32:27,427 --> 00:32:30,458 looking for an actual doctor who likes actual doctoring. 672 00:32:30,463 --> 00:32:32,397 Welcome, health care heroes. 673 00:32:32,866 --> 00:32:34,896 Uh, listen, I am not a man 674 00:32:34,901 --> 00:32:36,631 that you will find in Child's Pose. 675 00:32:36,636 --> 00:32:38,500 So I'm just gonna be on my way to... 676 00:32:38,505 --> 00:32:40,268 AJ, I happen to know from personal experience 677 00:32:40,273 --> 00:32:42,971 that you could really benefit from a little extra flexibility. 678 00:32:42,976 --> 00:32:46,812 All right, come lie down and grab a mat. 679 00:32:48,214 --> 00:32:50,979 Close your eyes. 680 00:32:50,984 --> 00:32:55,517 Let the world fade away and just relax. 681 00:32:55,522 --> 00:32:57,152 It's the ER. 682 00:32:58,162 --> 00:32:59,587 Oh, that's my next interview. 683 00:32:59,592 --> 00:33:01,156 Med-surg floor. 684 00:33:01,161 --> 00:33:03,995 My mother's having another complication. 685 00:33:06,333 --> 00:33:08,163 I mean, I feel 686 00:33:08,168 --> 00:33:09,597 so blissed out right now. 687 00:33:09,602 --> 00:33:11,599 I feel like I'm back to zero. I feel great. 688 00:33:11,604 --> 00:33:14,202 You know, after this is all done, 689 00:33:14,207 --> 00:33:17,638 I think that you and I should go to this great little vegan place 690 00:33:17,643 --> 00:33:18,874 that I know about in Inman Park. 691 00:33:18,878 --> 00:33:20,075 It-It's wonderful. 692 00:33:20,080 --> 00:33:22,643 It's the best tempeh à la King you will ever have. 693 00:33:22,648 --> 00:33:25,684 You're cute. Not a chance. 694 00:33:29,355 --> 00:33:32,057 That's a, that's a no, then? 695 00:33:35,028 --> 00:33:37,392 Okay, Wyatt Barnes' heart rate is in the 20s. 696 00:33:37,397 --> 00:33:39,660 He has gut ischemia, his kidneys are failing. 697 00:33:39,665 --> 00:33:40,995 Without a pacer, he's dying. 698 00:33:41,000 --> 00:33:42,464 We're running out of time, and he's waiting 699 00:33:42,468 --> 00:33:43,632 for the hand of God to reach down 700 00:33:43,636 --> 00:33:45,001 - and-and save him from... - First of all, back up. 701 00:33:45,005 --> 00:33:46,302 You're in my personal space. 702 00:33:46,307 --> 00:33:49,136 And you have intern coffee breath, which I do not like. 703 00:33:49,141 --> 00:33:50,806 Okay, look, look, look, with all due respect, 704 00:33:50,810 --> 00:33:52,773 Dr. Hawkins seems to have lost his edge, 705 00:33:52,778 --> 00:33:54,342 it's gonna cost a young dude his life. 706 00:33:54,347 --> 00:33:55,979 Can you please just put in a pacer, please? 707 00:33:55,983 --> 00:33:58,013 - I have one right here, come on. - Put that away. 708 00:33:58,017 --> 00:33:59,480 You are a green recruit 709 00:33:59,485 --> 00:34:01,549 questioning the general on the field. 710 00:34:01,554 --> 00:34:03,318 W-Wait, hold up. If someone came into this hospital 711 00:34:03,322 --> 00:34:04,987 after slitting their wrists or-or taking pills, 712 00:34:04,991 --> 00:34:06,021 we'd save them, right? 713 00:34:06,026 --> 00:34:07,523 Wyatt Barnes is doing the same thing. 714 00:34:07,528 --> 00:34:09,124 This is not a suicide. 715 00:34:09,528 --> 00:34:12,493 This is a man with capacity refusing intervention. 716 00:34:12,498 --> 00:34:14,295 That's a right we cannot abridge. 717 00:34:14,300 --> 00:34:16,296 His recalcitrance is not jeopardizing 718 00:34:16,301 --> 00:34:17,398 anyone else's health. 719 00:34:17,403 --> 00:34:19,536 - He's only hurting himself. - Okay, but he is hurting himself... 720 00:34:19,540 --> 00:34:20,903 Trevor, stop. 721 00:34:20,908 --> 00:34:24,106 Now you go back to your patient's room. 722 00:34:24,111 --> 00:34:28,642 You watch Dr. Hawkins and you do what he says. 723 00:34:28,647 --> 00:34:30,878 Stop second-guessing him. 724 00:34:30,883 --> 00:34:32,818 You might learn something. 725 00:34:41,260 --> 00:34:44,262 Please let me save you, Wyatt. 726 00:34:46,766 --> 00:34:49,601 I have everything we need. You just say the word. 727 00:34:53,005 --> 00:34:54,869 Think of all the beautiful things 728 00:34:54,874 --> 00:34:57,972 you'll never be able to experience again. 729 00:34:57,977 --> 00:35:01,609 I don't know what happens when you die, 730 00:35:02,014 --> 00:35:04,282 but I bet you don't get to kiss a woman... 731 00:35:05,618 --> 00:35:09,087 ... and know you want to be with her for the rest of your life. 732 00:35:10,489 --> 00:35:14,088 Don't you want to wake up on the first day of fall? 733 00:35:14,093 --> 00:35:16,090 Eat a peach? 734 00:35:17,696 --> 00:35:20,161 Laugh your ass off with your best friends? 735 00:35:20,166 --> 00:35:22,296 You don't have to give up any of that. 736 00:35:22,301 --> 00:35:24,999 Think of how lucky that makes you. 737 00:35:44,924 --> 00:35:47,158 Is he still saying no? 738 00:36:00,239 --> 00:36:01,439 Do it. 739 00:36:02,575 --> 00:36:04,309 Please. 740 00:36:18,257 --> 00:36:21,255 What are we here for, anyway, huh? 741 00:36:21,260 --> 00:36:26,494 To watch people we could save just... just die? 742 00:36:26,499 --> 00:36:28,734 I was here to save him. 743 00:36:31,503 --> 00:36:35,507 Now we're just here to make sure he doesn't die alone. 744 00:37:15,414 --> 00:37:17,482 He's your first death. 745 00:37:21,854 --> 00:37:24,184 Yeah. 746 00:37:24,189 --> 00:37:26,487 Not how I imagined it would go down. 747 00:37:26,492 --> 00:37:30,524 You pictured a different kind of heroism, 748 00:37:30,529 --> 00:37:34,432 blood spattered all over your white coat. 749 00:37:39,138 --> 00:37:41,572 Do you ever get used to it? 750 00:37:42,474 --> 00:37:45,806 It never gets easier. It just... 751 00:37:45,811 --> 00:37:47,678 It just gets different. 752 00:37:49,381 --> 00:37:55,186 But today was no small accomplishment. Dr. Daniels. 753 00:38:00,359 --> 00:38:03,424 We allowed him to live and die according to his principles, 754 00:38:03,429 --> 00:38:06,262 and because of that, we managed to keep ours. 755 00:38:14,800 --> 00:38:17,880 Look, again, I'm-I'm sorry about what happened in there. 756 00:38:17,885 --> 00:38:19,749 Well, I'm relieved you're okay. 757 00:38:19,754 --> 00:38:21,518 No, I-I'll be fine, it's just... 758 00:38:21,523 --> 00:38:23,887 It's a pinched nerve and... 759 00:38:24,292 --> 00:38:26,155 little bit of vertigo that came on suddenly. 760 00:38:26,160 --> 00:38:28,758 I think, you know, I-I overreacted, 761 00:38:28,763 --> 00:38:32,161 but in the moment, I-I thought if I stayed in the OR, 762 00:38:32,166 --> 00:38:34,797 you'd have two patients to deal with, so... 763 00:38:34,802 --> 00:38:37,000 Well, then, you did the right thing. 764 00:38:37,005 --> 00:38:39,569 So did you. 765 00:38:39,574 --> 00:38:40,870 This time. 766 00:38:40,875 --> 00:38:43,944 But, to be honest, it could have gone either way. 767 00:38:51,719 --> 00:38:54,083 - Hi. - So? 768 00:38:54,088 --> 00:38:56,719 Did you find anything else horrible inside me? 769 00:38:56,724 --> 00:38:58,888 I'm vaguely optimistic 770 00:38:58,893 --> 00:39:02,325 because I have a familiar sense of existential dread, 771 00:39:02,330 --> 00:39:05,094 and I'm pretty sure that can't be removed surgically. 772 00:39:05,099 --> 00:39:06,963 The surgery went great. 773 00:39:06,968 --> 00:39:08,231 You're going to be fine. 774 00:39:08,236 --> 00:39:10,066 Thanks to Dr. Devi. 775 00:39:10,071 --> 00:39:12,502 There was a complication during surgery. 776 00:39:12,507 --> 00:39:14,270 We had to remove a small piece of your liver. 777 00:39:14,275 --> 00:39:16,339 But it will grow back. 778 00:39:16,344 --> 00:39:18,074 And the hemangioma is gone for good. 779 00:39:18,079 --> 00:39:21,244 Thank you. I mean, really, thank you. 780 00:39:21,249 --> 00:39:24,247 And you made the right decision for me, too. 781 00:39:24,252 --> 00:39:26,950 Can I call you next time I'm buying a new car? 782 00:39:26,955 --> 00:39:28,419 Or don't know what to do 783 00:39:28,424 --> 00:39:30,121 when I get in a fight with my mom? 784 00:39:30,126 --> 00:39:32,088 I actually am a triple board-certified 785 00:39:32,093 --> 00:39:33,389 mother vanquisher. 786 00:39:38,866 --> 00:39:40,997 So... 787 00:39:41,002 --> 00:39:43,270 it's a no. 788 00:39:45,006 --> 00:39:46,836 Even the former oncologist? 789 00:39:46,841 --> 00:39:48,337 He's burnt out. 790 00:39:48,342 --> 00:39:50,373 He's not interested in learning anything new. 791 00:39:50,378 --> 00:39:53,142 H-He doesn't love medicine. 792 00:39:53,147 --> 00:39:54,344 None of them do. 793 00:39:54,349 --> 00:39:56,446 Keep looking. It's just the first round. 794 00:39:56,451 --> 00:39:58,214 No need to be discouraged. 795 00:39:58,219 --> 00:39:59,749 And the thing is, Dr. Voss, 796 00:39:59,754 --> 00:40:02,485 when I was talking to them, I realized 797 00:40:02,490 --> 00:40:04,424 I might not be so different. 798 00:40:05,259 --> 00:40:06,827 Of course you are, Dr. Pravesh. 799 00:40:07,962 --> 00:40:11,360 I am judging people for not loving medicine enough 800 00:40:11,365 --> 00:40:13,663 while trying to cut down on clinical time 801 00:40:13,668 --> 00:40:15,264 to go do research. 802 00:40:15,269 --> 00:40:17,100 I think about being in the ER 803 00:40:17,105 --> 00:40:21,738 year after year after year, with no outlet for research, 804 00:40:21,743 --> 00:40:24,941 and I don't know how we don't drown in the sickness, 805 00:40:24,946 --> 00:40:28,611 the sadness, the pressure, the paperwork. 806 00:40:30,084 --> 00:40:33,587 Half of my med school class isn't doing medicine anymore. 807 00:40:35,857 --> 00:40:38,091 That means something. 808 00:40:38,726 --> 00:40:42,730 Yes, I think it does. 809 00:40:59,414 --> 00:41:00,814 Hey. 810 00:41:05,653 --> 00:41:07,183 Hell of a day. 811 00:41:07,188 --> 00:41:09,819 Yeah, I heard. 812 00:41:09,824 --> 00:41:12,021 So, how tempted were you to put in the pacer 813 00:41:12,026 --> 00:41:15,525 - against the patient's wishes? - More than I'd like to admit. 814 00:41:15,530 --> 00:41:18,361 But there are some rules we can't break. 815 00:41:18,366 --> 00:41:21,130 Do I know I made the right choice? Yeah. 816 00:41:21,135 --> 00:41:24,133 Do I wish I'd made the wrong one? Maybe. 817 00:41:24,138 --> 00:41:25,701 I know my intern thinks so. 818 00:41:25,706 --> 00:41:30,106 I heard Dr. Daniels has a hard time with the rules. 819 00:41:30,111 --> 00:41:32,875 But maybe the example you set saved his medical career. 820 00:41:32,880 --> 00:41:35,278 To say nothing of your responsibility to your patient. 821 00:41:35,283 --> 00:41:37,146 Yeah, he's a bright kid, that Trevor, 822 00:41:37,151 --> 00:41:39,448 but too much confidence and passion, 823 00:41:39,453 --> 00:41:41,521 not nearly enough restraint. 824 00:41:46,828 --> 00:41:49,196 He learned something today. 825 00:41:55,369 --> 00:41:56,866 If I'd have saved Wyatt, 826 00:41:56,871 --> 00:41:59,802 would he have come back in ten years 827 00:41:59,807 --> 00:42:01,771 with an armload of kids, 828 00:42:01,776 --> 00:42:04,845 grateful that we didn't listen to him? 829 00:42:12,353 --> 00:42:15,054 And now I realize none of this is why you are here. 830 00:42:17,892 --> 00:42:19,459 Nope. 831 00:42:20,295 --> 00:42:22,196 I got a favor to ask you. 832 00:42:27,668 --> 00:42:28,831 What? 833 00:42:28,836 --> 00:42:31,667 But, look, before I even-even spell it out, 834 00:42:31,672 --> 00:42:35,271 can I count on you for full confidentiality? 835 00:42:35,276 --> 00:42:37,244 Go on. 836 00:42:39,480 --> 00:42:42,749 Something's wrong with me, a-and I'm not quite sure what. 837 00:42:44,518 --> 00:42:46,620 But I think it may be serious. 838 00:42:47,355 --> 00:42:49,152 You want me to examine you? 839 00:42:49,157 --> 00:42:50,887 Yeah, I'll clear my schedule tomorrow. 840 00:42:50,892 --> 00:42:52,722 Let's come in early. 841 00:42:52,727 --> 00:42:56,292 And the fact that I'm being tested at all, 842 00:42:56,297 --> 00:42:59,696 the results, all under the radar. 843 00:42:59,701 --> 00:43:02,031 So, is that something you can do? 844 00:43:06,340 --> 00:43:09,772 Okay. Great, thanks. 845 00:43:55,000 --> 00:43:58,500 - Synced and corrected by Firefly - - www.addic7ed.com - 62251

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