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1
00:00:14,229 --> 00:00:16,769
I asked you to plant one
bug then walk away.
2
00:00:16,794 --> 00:00:18,110
But no, you couldn't do that.
3
00:00:18,135 --> 00:00:19,437
Hell, you don't seem to get it.
4
00:00:19,462 --> 00:00:21,179
As a physician, I have
a responsibility...
5
00:00:21,204 --> 00:00:22,801
I'm so tired of hearing that.
6
00:00:23,137 --> 00:00:24,973
After the MRI fiasco, Ray Burke said
7
00:00:24,998 --> 00:00:27,536
he was done with you and
still you called him.
8
00:00:27,562 --> 00:00:29,830
Well, I need to speak to
him about his MRI results.
9
00:00:29,952 --> 00:00:31,398
I'm concerned.
10
00:00:31,423 --> 00:00:32,825
Concerned how?
11
00:00:33,434 --> 00:00:35,243
There are some old
subdural hematomas
12
00:00:35,268 --> 00:00:36,993
and plaques in both his carotids.
13
00:00:37,423 --> 00:00:39,101
It could mean he's at
risk for a stroke.
14
00:00:39,285 --> 00:00:39,947
Could?
15
00:00:39,972 --> 00:00:41,319
I can't make a diagnosis
16
00:00:41,344 --> 00:00:42,350
without more of a work-up.
17
00:00:42,375 --> 00:00:45,002
That case, there's nothing
to report to Ray about.
18
00:00:45,199 --> 00:00:47,158
We could have nailed
that scumbag a week ago
19
00:00:47,183 --> 00:00:48,811
if you hadn't screwed things up.
20
00:00:48,836 --> 00:00:50,018
No more calls.
21
00:00:50,043 --> 00:00:51,615
I can't just walk away.
22
00:00:52,030 --> 00:00:54,522
You can and you will.
23
00:00:54,547 --> 00:00:56,596
It's over, Dr. Halstead.
24
00:00:57,171 --> 00:01:00,421
Hey, you made this mess when
you took Ray's kickback.
25
00:01:00,680 --> 00:01:02,388
This is on you.
26
00:01:06,688 --> 00:01:09,295
Will, who was that woman?
27
00:01:09,482 --> 00:01:11,008
Oh, just a drug rep.
28
00:01:11,033 --> 00:01:12,675
They just won't leave me alone.
29
00:01:12,836 --> 00:01:14,440
Really? I've never seen her before.
30
00:01:14,465 --> 00:01:16,331
So, listen, the DJ texted me.
31
00:01:16,518 --> 00:01:17,713
The wedding's only three weeks away.
32
00:01:17,738 --> 00:01:19,129
We haven't given him a song list.
33
00:01:19,155 --> 00:01:20,736
What was she pushing?
34
00:01:20,824 --> 00:01:22,060
The drug rep.
35
00:01:22,254 --> 00:01:24,975
Oh, just some calcium channel blocker.
36
00:01:25,181 --> 00:01:26,886
Uh, so about the DJ...
37
00:01:26,952 --> 00:01:29,127
- It's Maggie.
- Yeah, me too.
38
00:01:33,375 --> 00:01:35,029
Father and daughter
hit and run victims.
39
00:01:35,054 --> 00:01:37,064
This is Abigail Jones, two years old.
40
00:01:37,089 --> 00:01:39,653
GCS nine, blunt head
trauma with lacerations.
41
00:01:39,678 --> 00:01:41,266
IO line in the left leg.
42
00:01:41,291 --> 00:01:43,308
Abigail, it's gonna be okay.
43
00:01:43,333 --> 00:01:45,211
- Where's the father?
- En route.
44
00:01:45,236 --> 00:01:46,696
Other ambo was trying to get an airway
45
00:01:46,721 --> 00:01:48,047
when we rolled away from the scene.
46
00:01:48,072 --> 00:01:50,149
They were in crosswalk.
They had the signal.
47
00:01:50,174 --> 00:01:51,730
Car plowed right through them.
48
00:01:52,649 --> 00:01:55,159
Let's transfer on my
count: One, two, three.
49
00:02:00,049 --> 00:02:02,091
Abigail? Abigail?
50
00:02:02,116 --> 00:02:03,745
She's unresponsive. I need to intubate.
51
00:02:03,770 --> 00:02:04,799
Broselow tape.
52
00:02:04,825 --> 00:02:06,012
And a chest X-ray.
53
00:02:08,014 --> 00:02:10,512
Just about 12 to 14 kilos.
54
00:02:10,537 --> 00:02:11,712
Yellow drawer.
55
00:02:11,737 --> 00:02:13,716
Four etomidate. 20 of sux.
56
00:02:13,741 --> 00:02:15,286
BP 100 over 70.
57
00:02:15,311 --> 00:02:16,869
Heart rate 136.
58
00:02:16,894 --> 00:02:18,229
Sats 88.
59
00:02:21,633 --> 00:02:24,068
X-rays in place. Nat, tell us when.
60
00:02:24,399 --> 00:02:26,028
All right, I'm in.
61
00:02:26,981 --> 00:02:28,313
Go.
62
00:02:32,057 --> 00:02:33,854
Clear.
63
00:02:33,879 --> 00:02:35,157
Right side's whited out.
64
00:02:35,182 --> 00:02:36,404
Chest tube.
65
00:02:36,616 --> 00:02:37,969
Ultrasound.
66
00:02:39,051 --> 00:02:40,540
Sats down to 80.
67
00:02:46,764 --> 00:02:48,947
Fastscan's negative.
No blood in the belly.
68
00:02:52,043 --> 00:02:53,515
Tubes in.
69
00:02:53,540 --> 00:02:55,809
Sats coming back up. 100%.
70
00:02:55,834 --> 00:02:57,660
BP and heart rate's
stabilizing, as well.
71
00:02:59,197 --> 00:03:01,665
Pupils are reactive but sluggish.
72
00:03:01,690 --> 00:03:03,197
Heads up, paramedics are coming in
73
00:03:03,222 --> 00:03:04,527
with the father right now.
74
00:03:04,795 --> 00:03:06,844
You go take him. I'll finish this.
75
00:03:08,244 --> 00:03:09,656
Marc Jones, 32.
76
00:03:09,681 --> 00:03:11,791
GCS 3, intubated in the field.
77
00:03:11,816 --> 00:03:13,265
Suspect a C-spine injury.
78
00:03:13,290 --> 00:03:14,926
There's a step off on
the back of his neck.
79
00:03:14,951 --> 00:03:16,990
All right. Let's transfer him.
80
00:03:17,087 --> 00:03:19,105
One... two... three.
81
00:03:21,755 --> 00:03:23,271
- Thank you, Cesar.
- Yep.
82
00:03:30,556 --> 00:03:32,901
Good breath sounds bilaterally.
83
00:03:33,932 --> 00:03:37,067
BP 88 over 58. Heart rate 120.
84
00:03:37,092 --> 00:03:38,134
Should we start a neo bag?
85
00:03:38,159 --> 00:03:39,806
Yes, titrate to a pressure of 110.
86
00:03:39,831 --> 00:03:41,185
Need a chest X-ray and an ultrasound.
87
00:03:41,210 --> 00:03:42,116
Yep.
88
00:03:45,804 --> 00:03:47,870
Oh, my God.
89
00:03:47,895 --> 00:03:49,435
Dr. Halstead.
90
00:03:50,786 --> 00:03:52,208
Hold on.
91
00:03:53,971 --> 00:03:58,034
_
92
00:04:03,576 --> 00:04:09,088
- Synced and corrected by martythecrazy -
- www.addic7ed.com -
93
00:04:17,492 --> 00:04:19,062
How's the little girl?
94
00:04:19,132 --> 00:04:21,471
Her vitals are stable and
no long bone fractures.
95
00:04:21,540 --> 00:04:24,633
But CT Head shows diffuse
intraparenchymal bleeding.
96
00:04:24,658 --> 00:04:26,433
And what did neuro say?
97
00:04:26,458 --> 00:04:27,673
I just got off the phone with them.
98
00:04:27,698 --> 00:04:29,754
They put in a pressure monitor,
and they agreed with me
99
00:04:29,779 --> 00:04:31,556
to treat with
hyperventilation and mannitol
100
00:04:31,581 --> 00:04:33,123
to reduce the intracranial pressure.
101
00:04:33,192 --> 00:04:34,802
And what about the father?
102
00:04:34,827 --> 00:04:37,376
Intubated but unresponsive
without sedation.
103
00:04:37,511 --> 00:04:39,919
- So, a brain injury?
- I'm not sure.
104
00:04:39,944 --> 00:04:42,042
Pupils are equal and reactive,
so that's a good sign.
105
00:04:42,067 --> 00:04:43,601
We're just waiting on
scan results to see
106
00:04:43,626 --> 00:04:45,088
how bad the injuries are.
107
00:04:45,113 --> 00:04:47,879
Look, Marc's stable now, but
what if he goes downhill?
108
00:04:48,010 --> 00:04:49,444
He's wearing a lot of ink.
109
00:04:49,469 --> 00:04:51,596
Is this "Do No Resuscitate"
a legit advanced directive?
110
00:04:51,699 --> 00:04:53,690
The hospital's got a team of lawyers
111
00:04:53,715 --> 00:04:55,177
trying to figure that out.
112
00:04:55,202 --> 00:04:56,456
What about his family?
113
00:04:56,481 --> 00:04:57,937
Do they know if he meant it or not?
114
00:04:57,962 --> 00:04:58,892
We're looking for them too.
115
00:04:58,917 --> 00:05:00,776
It seems it's just Mr. Jones
116
00:05:00,801 --> 00:05:02,791
and his daughter,
Abigail, in the world.
117
00:05:02,816 --> 00:05:04,468
He had on a wedding ring.
There's no wife?
118
00:05:04,493 --> 00:05:07,302
There was, Melinda. Legal
found an obituary.
119
00:05:07,327 --> 00:05:10,169
She died last year. Ovarian cancer.
120
00:05:10,282 --> 00:05:11,823
If his wife had to be intubated
121
00:05:11,848 --> 00:05:13,527
and wasn't able to get off the vent,
122
00:05:13,552 --> 00:05:16,497
seeing her like that could
be why he got that tattoo.
123
00:05:17,201 --> 00:05:18,802
Yeah, maybe that's what
he was feeling then,
124
00:05:18,827 --> 00:05:19,994
but what about now?
125
00:05:20,019 --> 00:05:21,220
He's all Abigail has.
126
00:05:21,245 --> 00:05:23,167
I can't see him not wanting
us to do everything
127
00:05:23,192 --> 00:05:24,884
in our power to keep him alive for her.
128
00:05:24,909 --> 00:05:26,418
Well, the truth is, we don't know why
129
00:05:26,443 --> 00:05:29,614
Mr. Jones got the tattoo or
how he feels about it now.
130
00:05:29,639 --> 00:05:31,564
So, let's not jump to conclusions
131
00:05:31,590 --> 00:05:33,668
until we have real facts.
132
00:05:33,843 --> 00:05:35,346
And in the meantime?
133
00:05:35,371 --> 00:05:38,054
While the hospital does
their due diligence,
134
00:05:38,079 --> 00:05:39,630
err on the side of life.
135
00:05:39,715 --> 00:05:41,068
Thank you.
136
00:05:46,823 --> 00:05:49,422
Keegan and I have been
neighbors for a few months.
137
00:05:49,447 --> 00:05:50,648
Since I moved back.
138
00:05:50,673 --> 00:05:52,912
I'm only here 'cause
Vicki talked me into it.
139
00:05:52,937 --> 00:05:55,295
At this point, I've
given up on doctors.
140
00:05:55,763 --> 00:05:58,452
Whoa, no, no, no. No more scratching.
141
00:05:58,477 --> 00:06:01,336
I can't help it. It's been three years.
142
00:06:01,393 --> 00:06:03,124
Three years. Never stops.
143
00:06:03,149 --> 00:06:04,484
And it started with a MRSA infection?
144
00:06:04,509 --> 00:06:06,064
The antibiotics to treat it.
145
00:06:06,089 --> 00:06:08,644
Linezolid. Side effect was pruritus.
146
00:06:08,669 --> 00:06:10,626
- Bad itch, huh?
- Mm, the worst.
147
00:06:10,651 --> 00:06:13,993
Everywhere. And I mean everywhere.
148
00:06:14,018 --> 00:06:15,496
But the reaction went away
149
00:06:15,521 --> 00:06:17,093
when she stopped taking the pills.
150
00:06:17,118 --> 00:06:18,723
Except for right here,
and it is killing me
151
00:06:18,748 --> 00:06:20,270
not to scratch it right now.
152
00:06:20,295 --> 00:06:21,952
The itch never lets up?
153
00:06:22,082 --> 00:06:23,787
In the shower? When you're sleeping?
154
00:06:23,812 --> 00:06:24,746
Never.
155
00:06:24,771 --> 00:06:26,413
I've used toothbrushes,
156
00:06:26,438 --> 00:06:29,225
pencils, even steel wool once.
157
00:06:29,346 --> 00:06:31,459
Nothing stops the itch.
158
00:06:31,569 --> 00:06:33,525
- Easy, Keegan. Keegan.
- Stop. Stop-
159
00:06:33,564 --> 00:06:35,076
- Stop.
- I know it's hard.
160
00:06:35,101 --> 00:06:37,074
Just try not to scratch.
161
00:06:37,321 --> 00:06:38,824
All right, I'm gonna clean it out
162
00:06:38,849 --> 00:06:40,551
and apply some steroid cream.
163
00:06:40,576 --> 00:06:42,315
Should help calm it down.
164
00:06:42,802 --> 00:06:44,539
That won't do anything.
165
00:06:44,608 --> 00:06:47,648
I've tried creams and
antihistamines, acupuncture.
166
00:06:47,673 --> 00:06:51,500
I've seen dozens of doctors,
dermatologists, allergists.
167
00:06:51,526 --> 00:06:53,010
Nothing helps.
168
00:06:53,518 --> 00:06:55,357
I... I just can't stop.
169
00:06:56,348 --> 00:06:57,398
D... don't. Don't. Don't. Don't.
170
00:06:57,424 --> 00:06:59,804
- Doesn't that hurt?
- All I feel is the itch.
171
00:06:59,829 --> 00:07:01,632
It's all day, every day.
172
00:07:01,658 --> 00:07:03,708
Please just find it and cut it out.
173
00:07:03,959 --> 00:07:05,525
Okay.
174
00:07:05,550 --> 00:07:08,280
Let's get a full set of
labs and go from there.
175
00:07:10,505 --> 00:07:12,185
I'll be back with the results.
176
00:07:13,475 --> 00:07:15,180
No more scratching.
177
00:07:15,206 --> 00:07:16,693
Thank you.
178
00:07:21,234 --> 00:07:23,215
I've never seen anything like this.
179
00:07:23,241 --> 00:07:24,514
She's down to the muscle.
180
00:07:24,539 --> 00:07:26,319
And she was serious about
trying everything.
181
00:07:26,344 --> 00:07:27,906
I looked inside her medicine cabinet,
182
00:07:27,931 --> 00:07:29,417
it's like a pharmacy.
183
00:07:29,562 --> 00:07:31,634
I tried to help her,
but she didn't serve,
184
00:07:31,659 --> 00:07:33,109
so I can't bring her to the VA.
185
00:07:33,341 --> 00:07:36,150
How much do you know about
Keegan outside of the itch?
186
00:07:36,175 --> 00:07:37,654
Is she...
187
00:07:37,679 --> 00:07:38,972
Crazy?
188
00:07:39,581 --> 00:07:42,855
I don't think so, but an
itch for three years...
189
00:07:42,880 --> 00:07:43,786
Yeah.
190
00:07:44,440 --> 00:07:46,071
I'm gonna get psych involved.
191
00:07:46,096 --> 00:07:47,398
Thanks for bringing her in.
192
00:07:47,423 --> 00:07:48,509
Thanks.
193
00:07:48,534 --> 00:07:49,536
Yeah.
194
00:07:53,339 --> 00:07:55,891
So, Vicki's here.
195
00:07:56,574 --> 00:07:58,459
She just brought in a patient.
196
00:07:59,924 --> 00:08:02,431
This is the only hospital in Chicago?
197
00:08:03,875 --> 00:08:06,677
You trying to tell me something?
198
00:08:08,573 --> 00:08:10,218
No.
199
00:08:11,541 --> 00:08:13,278
Okay.
200
00:08:15,087 --> 00:08:18,130
April, I appreciate you covering for me
201
00:08:18,155 --> 00:08:20,021
every time I'm in the Hybrid OR.
202
00:08:20,046 --> 00:08:21,772
Of course I don't expect you to know
203
00:08:21,797 --> 00:08:22,809
everything that I've learned,
204
00:08:22,834 --> 00:08:25,500
so I made a reference guide for you.
205
00:08:25,537 --> 00:08:27,235
Well, I haven't had any problems.
206
00:08:27,451 --> 00:08:30,449
Well, not yet, but it's
good to be prepared.
207
00:08:30,589 --> 00:08:32,338
"Obligations and Proficiencies
208
00:08:32,363 --> 00:08:34,192
of the Charge Nurse."
209
00:08:34,411 --> 00:08:37,275
People don't realize how
complex the job can be.
210
00:08:37,586 --> 00:08:39,526
How many pages is this thing?
211
00:08:39,854 --> 00:08:42,533
Is there a PowerPoint
presentation to go with it?
212
00:08:42,756 --> 00:08:44,259
Is that gonna be a problem?
213
00:08:44,846 --> 00:08:46,650
No problem.
214
00:08:48,790 --> 00:08:50,493
Vicki brought in the patient.
215
00:08:50,562 --> 00:08:53,002
Vicki. Your... uh...
your friend, Vicki?
216
00:08:53,070 --> 00:08:54,681
Former friend. Yeah.
217
00:08:54,878 --> 00:08:56,548
Keegan. I'm Dr. Charles.
218
00:08:56,573 --> 00:08:57,776
How you doing?
219
00:09:00,255 --> 00:09:02,446
Of course. The shrink.
220
00:09:02,623 --> 00:09:05,572
Look, this isn't because of feelings,
221
00:09:05,597 --> 00:09:06,682
and it's not OCD.
222
00:09:06,707 --> 00:09:08,780
I don't have delusional parasitosis
223
00:09:08,805 --> 00:09:10,437
or a conversion disorder.
224
00:09:10,462 --> 00:09:11,943
And the itching didn't
start after my dad died
225
00:09:11,968 --> 00:09:13,739
or my boyfriend left me.
226
00:09:14,293 --> 00:09:15,950
Look, I'm not insane.
227
00:09:16,061 --> 00:09:18,853
My head just itches and
I want it to stop.
228
00:09:18,930 --> 00:09:20,123
Okay.
229
00:09:20,148 --> 00:09:22,463
Well, let's try to make that happen.
230
00:09:22,808 --> 00:09:24,034
Really?
231
00:09:24,059 --> 00:09:27,168
Usually docs are writing me
a referral so I'll leave.
232
00:09:27,193 --> 00:09:28,438
Well, you came to us for help,
233
00:09:28,463 --> 00:09:29,933
so we're gonna help ya.
234
00:09:30,017 --> 00:09:31,354
Just for now though,
do you think you can
235
00:09:31,379 --> 00:09:32,716
keep your hand away from the wound?
236
00:09:33,275 --> 00:09:34,697
I can't help it.
237
00:09:34,722 --> 00:09:36,039
Okay.
238
00:09:36,064 --> 00:09:39,411
So Dr. Choi told me that
you've tried OTC's,
239
00:09:39,483 --> 00:09:42,040
prescriptions, host of home remedies.
240
00:09:42,065 --> 00:09:43,817
How 'bout bupivacaine?
241
00:09:43,956 --> 00:09:45,143
What's that?
242
00:09:45,168 --> 00:09:46,801
A local anesthetic.
243
00:09:46,826 --> 00:09:48,400
Five mil should do it.
244
00:09:48,425 --> 00:09:50,788
I'd like to apply a
little bit to the area.
245
00:09:50,814 --> 00:09:52,805
If it provides relief,
it would suggest that
246
00:09:52,830 --> 00:09:55,452
the problem might lie in your
cutaneous nerve endings.
247
00:09:55,477 --> 00:09:58,033
And that would help suggest a
treatment plan going forward.
248
00:09:58,613 --> 00:10:00,549
Then stop talking and get to it.
249
00:10:00,574 --> 00:10:01,941
You're gonna feel a pinch.
250
00:10:02,158 --> 00:10:03,821
Do it.
251
00:10:04,561 --> 00:10:05,956
Whoa.
252
00:10:06,749 --> 00:10:08,195
Okay.
253
00:10:10,078 --> 00:10:11,581
It feels different.
254
00:10:11,606 --> 00:10:12,841
Different how?
255
00:10:13,149 --> 00:10:14,263
Better.
256
00:10:14,288 --> 00:10:17,308
I mean, it tingles a little,
but it itches less.
257
00:10:17,691 --> 00:10:20,190
Hmm. That's a good start.
258
00:10:20,226 --> 00:10:21,494
Yeah.
259
00:10:21,547 --> 00:10:23,148
We'll check on you in a bit.
260
00:10:28,847 --> 00:10:30,817
So, anesthetic should provide relief
261
00:10:30,842 --> 00:10:32,427
for like, three or four hours.
262
00:10:32,452 --> 00:10:34,319
Itch doesn't come back, then set her up
263
00:10:34,344 --> 00:10:36,074
with some topical patches to take home.
264
00:10:36,099 --> 00:10:37,435
Sounds good.
265
00:10:38,226 --> 00:10:39,729
Mannequins?
266
00:10:39,754 --> 00:10:41,667
Look, I was a department
store latchkey kid.
267
00:10:41,692 --> 00:10:43,474
So, I took what I could get.
268
00:10:43,499 --> 00:10:44,947
Jenny was basically
my first girlfriend.
269
00:10:44,972 --> 00:10:47,453
Which is why I am such a good kisser.
270
00:10:47,700 --> 00:10:49,772
I don't think I know how
to feel about this.
271
00:10:49,797 --> 00:10:51,348
On the one hand, it's very disturbing.
272
00:10:51,373 --> 00:10:54,056
On the other, I should
probably be thanking Jenny
273
00:10:54,081 --> 00:10:56,027
for those years of practice.
274
00:10:56,052 --> 00:10:58,166
Hold on. It wasn't years, okay?
275
00:10:58,191 --> 00:11:00,964
Dr. Rhodes... was looking for you.
276
00:11:01,160 --> 00:11:03,612
I wanted to tell you
before you got the memo.
277
00:11:03,838 --> 00:11:05,516
The Hybrid Room will be used
278
00:11:05,541 --> 00:11:07,722
for general surgeries when needed.
279
00:11:07,935 --> 00:11:09,171
General surgeries?
280
00:11:09,196 --> 00:11:10,823
Appendectomies, gall bladders...
281
00:11:10,848 --> 00:11:12,895
So, everything but trauma, which is why
282
00:11:12,920 --> 00:11:14,144
we built it in the first place.
283
00:11:14,169 --> 00:11:16,669
Look, the Hybrid Room was expensive.
284
00:11:16,694 --> 00:11:18,163
It came in over budget.
285
00:11:18,306 --> 00:11:20,877
Using it when we can will
help balance the books.
286
00:11:20,902 --> 00:11:22,091
You mean, pad them?
287
00:11:22,116 --> 00:11:23,947
Well, profit's not a bad thing.
288
00:11:23,972 --> 00:11:25,208
Ms. Goodwin, this is Chicago.
289
00:11:25,233 --> 00:11:27,077
We get six traumas before lunch.
290
00:11:27,102 --> 00:11:28,219
What are those patients supposed to do?
291
00:11:28,244 --> 00:11:29,886
I don't know, take a number?
292
00:11:29,911 --> 00:11:34,267
Well, your displeasure is noted, Dr.
Rhodes.
293
00:11:34,656 --> 00:11:36,161
And overruled.
294
00:11:38,048 --> 00:11:39,773
When does all this start?
295
00:11:40,324 --> 00:11:41,729
Today.
296
00:11:41,860 --> 00:11:45,051
In fact, Dr. Lanik will take the lead.
297
00:11:49,019 --> 00:11:50,935
This is a terrible idea.
298
00:11:51,496 --> 00:11:53,501
It's gotta be Gwen Garrett.
299
00:11:56,251 --> 00:11:57,379
Let it go.
300
00:11:57,568 --> 00:11:59,350
This isn't a hill to die on.
301
00:12:05,641 --> 00:12:07,557
Damn it!
302
00:12:07,589 --> 00:12:09,017
Call Dr. Charles.
303
00:12:10,053 --> 00:12:11,255
Keegan, stop. Don't scratch.
304
00:12:11,280 --> 00:12:13,104
Oh, the itch is back and
it's worse than before.
305
00:12:13,129 --> 00:12:14,186
You have to stop scratching.
306
00:12:14,211 --> 00:12:16,603
Oh, then you have to tie me down.
307
00:12:16,628 --> 00:12:18,478
- Five milligrams of diazepam.
- On it.
308
00:12:18,503 --> 00:12:21,056
I can't live like this anymore.
309
00:12:21,081 --> 00:12:22,734
I'd rather be dead.
310
00:12:22,759 --> 00:12:24,101
What happened?
311
00:12:26,067 --> 00:12:28,144
Oh, God.
312
00:12:28,844 --> 00:12:30,918
She scratched through to her skull.
313
00:12:43,746 --> 00:12:44,914
How's Abigail?
314
00:12:44,983 --> 00:12:47,389
Fighting. How's the dad?
315
00:12:48,106 --> 00:12:49,542
Scans are back.
316
00:12:49,567 --> 00:12:51,858
CT brain revealed no
bleeding, and there's no
317
00:12:51,883 --> 00:12:53,285
obvious brain trauma.
318
00:12:53,310 --> 00:12:54,847
Well, that's good news.
319
00:12:54,916 --> 00:12:57,805
Yeah, except the CT C-spine
320
00:12:57,830 --> 00:13:00,254
revealed a subluxation at C3 on 4.
321
00:13:00,496 --> 00:13:01,966
MRI confirmed?
322
00:13:01,991 --> 00:13:03,988
Complete spinal cord transection.
323
00:13:04,199 --> 00:13:06,174
He's paralyzed from the neck down.
324
00:13:06,918 --> 00:13:08,638
I'm sorry.
325
00:13:09,044 --> 00:13:10,131
I just spoke with Jay.
326
00:13:10,156 --> 00:13:11,987
PD caught the driver who hit them.
327
00:13:13,221 --> 00:13:15,304
He blew through a red light
because he was texting.
328
00:13:16,643 --> 00:13:20,487
BP's spiked, 146 over 94.
Heart rate's down, 54.
329
00:13:21,709 --> 00:13:23,341
Cushing's Reflex.
330
00:13:23,366 --> 00:13:25,438
Her intracranial pressure is worsening.
331
00:13:25,463 --> 00:13:26,473
She needs more hyperventilation.
332
00:13:26,498 --> 00:13:27,666
Get her off the vent.
333
00:13:29,622 --> 00:13:31,091
Heart rate's still dropping.
334
00:13:31,117 --> 00:13:32,285
47.
335
00:13:32,310 --> 00:13:33,754
Two milligrams of atropine.
336
00:13:37,826 --> 00:13:39,212
It's in.
337
00:13:39,545 --> 00:13:41,949
Come on. Come on.
338
00:13:42,139 --> 00:13:45,129
Heart rate's coming back up. 49...
339
00:13:45,272 --> 00:13:46,531
51...
340
00:13:46,556 --> 00:13:49,207
Come on. Come on.
341
00:13:49,327 --> 00:13:50,921
Come on, Abigail.
342
00:13:55,988 --> 00:13:57,459
Dr. Rhodes, you're going to Baghdad.
343
00:13:57,484 --> 00:13:59,011
Yep. Talk to me.
344
00:13:59,037 --> 00:14:00,241
James Brice, 24.
345
00:14:00,266 --> 00:14:02,284
GCS 7. Hypotensive.
346
00:14:02,316 --> 00:14:04,382
Intubated en route. Belly's distended.
347
00:14:04,407 --> 00:14:05,173
What happened?
348
00:14:05,198 --> 00:14:06,868
He was putting in storm
windows for the nursery.
349
00:14:06,893 --> 00:14:08,261
He fell off the ladder.
350
00:14:08,286 --> 00:14:09,455
At least 20 feet.
351
00:14:09,480 --> 00:14:11,232
I was worried the baby
would be cold this winter.
352
00:14:11,257 --> 00:14:12,745
It's okay. Don't worry.
353
00:14:12,770 --> 00:14:13,966
It's not your fault. Maggie?
354
00:14:13,991 --> 00:14:14,815
I got her.
355
00:14:14,840 --> 00:14:15,894
Mrs. Brice, why don't you come with me,
356
00:14:15,919 --> 00:14:17,430
and let the doctors work, okay?
357
00:14:17,455 --> 00:14:18,884
He keeps trying to die on us.
358
00:14:18,910 --> 00:14:20,346
All right. On my count.
359
00:14:20,371 --> 00:14:22,021
One, two, three.
360
00:14:28,481 --> 00:14:30,248
Good breath sounds on
the left and the right.
361
00:14:30,273 --> 00:14:31,664
Let's get a chest X-ray.
362
00:14:31,689 --> 00:14:33,740
Field IV is blown. We
don't have access.
363
00:14:33,765 --> 00:14:34,961
All right.
364
00:14:34,986 --> 00:14:36,934
Ava, can you get a line in?
365
00:14:36,959 --> 00:14:38,481
Give me a kit.
366
00:14:39,918 --> 00:14:41,423
X-ray's up.
367
00:14:41,448 --> 00:14:42,725
Everybody clear.
368
00:14:44,486 --> 00:14:45,727
Looks good.
369
00:14:47,713 --> 00:14:50,685
Belly's hard as a rock.
Give me a Fastscan.
370
00:14:57,373 --> 00:14:58,792
It's full of blood.
371
00:14:58,817 --> 00:15:00,554
I need to get in there
and find the bleed.
372
00:15:02,912 --> 00:15:04,570
We'll use the Hybrid OR.
373
00:15:04,750 --> 00:15:05,915
We can make it upstairs.
374
00:15:05,940 --> 00:15:07,002
There are operating rooms available.
375
00:15:07,027 --> 00:15:08,560
There's also one right across the ED.
376
00:15:08,585 --> 00:15:10,239
- Much closer.
- Connor, Goodwin just to you...
377
00:15:10,264 --> 00:15:11,356
I know what she said.
378
00:15:11,381 --> 00:15:13,229
Find Maggie. Have her page my team.
379
00:15:14,289 --> 00:15:15,695
It's probably CT looking for you.
380
00:15:15,720 --> 00:15:16,765
I got this.
381
00:15:16,790 --> 00:15:18,251
You're going to get
yourself into trouble.
382
00:15:18,276 --> 00:15:19,510
I can't worry about that now.
383
00:15:19,535 --> 00:15:21,137
Get James ready to go.
384
00:15:23,414 --> 00:15:25,658
Lanik. I'm taking the Hybrid OR.
385
00:15:25,683 --> 00:15:27,622
My patient is on the table.
386
00:15:27,647 --> 00:15:30,070
His gall bladder can wait.
Bring him back next week.
387
00:15:30,095 --> 00:15:31,336
I'm not your resident, Connor.
388
00:15:31,361 --> 00:15:32,833
You can't order me around.
389
00:15:33,306 --> 00:15:36,303
Is your patient about to die?
Because mine sure is.
390
00:15:39,915 --> 00:15:42,800
Get Dr. Lanik's patient out and
re-prep the room for mine.
391
00:16:01,470 --> 00:16:02,706
Natalie.
392
00:16:02,821 --> 00:16:04,257
I just need a moment.
393
00:16:04,450 --> 00:16:06,198
Yeah, of course.
394
00:16:09,616 --> 00:16:11,815
All right. Thank you.
395
00:16:12,046 --> 00:16:14,331
April, I'm getting pulled into surgery.
396
00:16:14,356 --> 00:16:16,183
Okay, I'll hold it down out here.
397
00:16:16,208 --> 00:16:18,480
Oh, and I've got a delivery
of NG Tubes, Hep Locks,
398
00:16:18,505 --> 00:16:19,769
and ABD Pads coming in.
399
00:16:19,794 --> 00:16:21,181
I called it in late last night.
400
00:16:21,206 --> 00:16:22,575
I'll double check the order
against the invoice,
401
00:16:22,600 --> 00:16:23,626
make sure it's all there.
402
00:16:23,652 --> 00:16:24,818
All right. Oh.
403
00:16:24,843 --> 00:16:27,485
And it's payroll week, so
it means that you have...
404
00:16:27,510 --> 00:16:30,063
All the nurses need to sign
off on their timecards.
405
00:16:30,088 --> 00:16:32,201
Maggie, you're driving me crazy.
406
00:16:32,313 --> 00:16:34,067
If anything happens, I'll handle it.
407
00:16:34,250 --> 00:16:35,651
Okay, and you've got
the reference guide
408
00:16:35,676 --> 00:16:38,289
that I wrote, so we're all good.
409
00:16:38,314 --> 00:16:40,617
All good. Good, good, good.
410
00:16:44,782 --> 00:16:46,130
You want some company?
411
00:16:46,155 --> 00:16:47,869
I get it if you'd rather be alone.
412
00:16:47,894 --> 00:16:49,765
No, I'm glad to see you.
413
00:16:49,833 --> 00:16:51,537
How's Marc?
414
00:16:51,607 --> 00:16:54,282
No change. Still unconscious.
415
00:16:55,933 --> 00:16:58,063
Abigail was only two.
416
00:16:58,504 --> 00:17:00,877
And now she's gone.
417
00:17:00,902 --> 00:17:04,177
All because some guy couldn't
look away from his phone.
418
00:17:06,086 --> 00:17:08,805
But maybe something good
could come from all of this.
419
00:17:08,830 --> 00:17:12,688
I mean, all these kids
waiting for transplants.
420
00:17:12,713 --> 00:17:14,885
There are so few pediatric donors
421
00:17:14,910 --> 00:17:18,110
in comparison to the thousands
of children in need.
422
00:17:18,186 --> 00:17:20,528
Abigail could be an organ donor.
423
00:17:21,653 --> 00:17:23,323
As a minor, you know, she's gotta get
424
00:17:23,348 --> 00:17:24,822
a parent or guardian to sign off
425
00:17:24,847 --> 00:17:25,816
before she can donate.
426
00:17:25,841 --> 00:17:27,259
Yeah, I know that.
427
00:17:27,284 --> 00:17:29,460
And if Goodwin can't track
down any of her other family,
428
00:17:29,485 --> 00:17:33,397
then all that's left is her father.
429
00:17:34,882 --> 00:17:36,553
Do you think Marc will wake up?
430
00:17:38,352 --> 00:17:40,753
I've seen patients in
worse shape turn around.
431
00:17:51,129 --> 00:17:52,388
Well, that's a new one.
432
00:17:52,413 --> 00:17:54,465
Usually I have to cut them open
myself to get to the brain.
433
00:17:54,490 --> 00:17:55,708
So, what do you think?
434
00:17:55,733 --> 00:17:57,626
Well, for whatever reason,
the cutaneous nerves
435
00:17:57,651 --> 00:17:59,596
in that part of her scalp went haywire.
436
00:17:59,653 --> 00:18:01,863
Makes them always feel itchy,
so she keep scratching.
437
00:18:01,888 --> 00:18:02,941
There a fix?
438
00:18:02,966 --> 00:18:04,113
Yeah, surgery.
439
00:18:04,138 --> 00:18:05,207
Sever the nerve.
440
00:18:05,232 --> 00:18:06,805
No more feeling, no more itching.
441
00:18:06,831 --> 00:18:07,970
And no more scratching.
442
00:18:07,995 --> 00:18:11,196
Yeah, and possible serious,
irreversible side effects.
443
00:18:11,292 --> 00:18:12,932
Facial paralysis, blurred vision.
444
00:18:12,957 --> 00:18:14,436
Worst case, she ends
up in a wheelchair.
445
00:18:14,461 --> 00:18:17,103
I'm not cutting her open
in an alley, Daniel.
446
00:18:17,128 --> 00:18:19,167
The risks you're describing
are dwarfed by the reward.
447
00:18:19,192 --> 00:18:20,766
- Yeah, we hope.
- What do you suggest?
448
00:18:20,791 --> 00:18:22,604
Twice a week counseling sessions?
449
00:18:22,629 --> 00:18:23,914
Of course, we'd have to put
a cone around her neck
450
00:18:23,939 --> 00:18:25,272
to keep her from scratching.
451
00:18:25,297 --> 00:18:26,872
Sam, all those years of scratching,
452
00:18:26,897 --> 00:18:28,312
those nerves are shot.
453
00:18:28,337 --> 00:18:29,561
There's nothing left to go haywire.
454
00:18:29,586 --> 00:18:30,868
Dr. Charles, if that were the case,
455
00:18:30,893 --> 00:18:32,139
Keegan shouldn't feel anything.
456
00:18:32,164 --> 00:18:33,294
Let alone an itch.
457
00:18:33,319 --> 00:18:35,960
If those nerves were active,
that anesthetic would have
458
00:18:35,986 --> 00:18:37,312
provided relief for hours.
459
00:18:37,344 --> 00:18:38,654
- It didn't.
- You only used 5 mil.
460
00:18:38,679 --> 00:18:40,135
- It wasn't enough.
- I agree.
461
00:18:40,160 --> 00:18:42,026
The anesthetic didn't work
for long, but it did work.
462
00:18:42,051 --> 00:18:43,406
Proves the nerves are involved.
463
00:18:43,431 --> 00:18:45,302
Great, we have a majority.
Not that I care.
464
00:18:45,327 --> 00:18:47,238
- We done?
- Sam?
465
00:18:47,311 --> 00:18:49,262
All I'm saying, I don't think operating
466
00:18:49,287 --> 00:18:50,645
is gonna do a damn thing.
467
00:18:50,677 --> 00:18:52,130
Thanks for you input.
468
00:18:52,155 --> 00:18:54,574
But the last time I checked,
I was the neurosurgeon.
469
00:18:54,722 --> 00:18:56,593
Put her on the schedule.
470
00:18:58,057 --> 00:19:00,781
Isn't surgery supposed
to be the last option?
471
00:19:02,320 --> 00:19:05,418
Dr. Charles, she scratched
into her skull.
472
00:19:11,354 --> 00:19:13,091
What happened?
473
00:19:13,383 --> 00:19:15,060
He suddenly went into V-fib.
474
00:19:15,085 --> 00:19:17,043
Shocked him multiple times
and then he went asystolic.
475
00:19:17,068 --> 00:19:18,354
Another round of epi.
476
00:19:23,044 --> 00:19:24,511
It's in.
477
00:19:25,289 --> 00:19:26,520
Check for a pulse.
478
00:19:29,229 --> 00:19:30,768
Nothing.
479
00:19:30,793 --> 00:19:32,388
Come on, Marc.
480
00:19:34,302 --> 00:19:36,477
Don't you give up.
481
00:19:39,070 --> 00:19:41,242
Pulse is back. Sinus tach.
482
00:19:41,532 --> 00:19:42,733
He's back.
483
00:19:42,758 --> 00:19:44,338
All right.
484
00:19:44,531 --> 00:19:45,910
Prep him to move.
485
00:19:45,935 --> 00:19:48,361
I'll call ICU, tell them we're
sending him up for cooling.
486
00:19:51,229 --> 00:19:53,018
How long was he asystole?
487
00:19:53,043 --> 00:19:55,022
Almost ten minutes.
488
00:19:55,372 --> 00:19:57,145
What's your boyfriend thinking?
489
00:19:57,170 --> 00:19:58,772
This guy's not waking up.
490
00:20:14,116 --> 00:20:16,933
Hey, is your ulcer getting worse?
491
00:20:16,982 --> 00:20:18,519
Today's not helping.
492
00:20:18,544 --> 00:20:19,904
Yeah.
493
00:20:20,306 --> 00:20:22,522
So, I looked at the Paramedic's report
494
00:20:22,548 --> 00:20:24,319
from the accident scene.
495
00:20:24,501 --> 00:20:26,274
Marc was down at least five minutes
496
00:20:26,299 --> 00:20:27,635
before help arrived.
497
00:20:27,659 --> 00:20:30,279
And after this last
code it was almost ten.
498
00:20:30,304 --> 00:20:32,926
I mean, that's almost 15
minutes with no oxygen.
499
00:20:32,951 --> 00:20:33,819
I know.
500
00:20:33,878 --> 00:20:35,191
Increases the chances
the brain function
501
00:20:35,216 --> 00:20:36,883
he has is now compromised.
502
00:20:36,908 --> 00:20:38,265
But we won't know if that's the case
503
00:20:38,290 --> 00:20:39,704
until he wakes up.
504
00:20:39,729 --> 00:20:41,148
You think he really will?
505
00:20:41,174 --> 00:20:42,275
After he coded?
506
00:20:42,300 --> 00:20:43,536
I don't know.
507
00:20:45,339 --> 00:20:47,639
Maybe it's time to start thinking about
508
00:20:47,664 --> 00:20:49,869
honoring his advanced directive.
509
00:20:50,226 --> 00:20:51,595
Advanced directive?
510
00:20:51,620 --> 00:20:54,536
Nat, it is a tattoo,
not a legal document.
511
00:20:54,642 --> 00:20:56,647
It might be a proxy to one.
512
00:20:56,819 --> 00:20:59,078
And what if Marc does have
the paperwork to back it up?
513
00:20:59,103 --> 00:21:01,000
I mean, it could be at home in a file
514
00:21:01,026 --> 00:21:02,321
or in a safety deposit box.
515
00:21:02,346 --> 00:21:03,943
If something binding exists,
516
00:21:03,968 --> 00:21:05,485
the hospital's lawyers will find it,
517
00:21:05,510 --> 00:21:06,894
and I'll obey whatever it says.
518
00:21:06,919 --> 00:21:08,179
But until then, it's just a tattoo,
519
00:21:08,204 --> 00:21:09,350
and one of many.
520
00:21:09,375 --> 00:21:13,055
Will, Abigail's organs
are still healthy.
521
00:21:13,166 --> 00:21:14,827
But they won't be viable for long.
522
00:21:15,040 --> 00:21:16,796
Without Marc or any family to consent,
523
00:21:16,821 --> 00:21:18,492
we can't donate them.
524
00:21:18,958 --> 00:21:22,099
But if we honor his
tattoo and we let him go,
525
00:21:22,232 --> 00:21:23,725
then the hospital can
petition to become
526
00:21:23,750 --> 00:21:26,435
Abigail's legal guardian, and
we can make the decision
527
00:21:26,460 --> 00:21:29,366
to donate her organs
before they go to waste.
528
00:21:29,391 --> 00:21:31,815
Natalie, you are asking
me to let Marc die.
529
00:21:31,840 --> 00:21:33,330
I can't do that.
530
00:21:33,635 --> 00:21:36,801
Well, if by some miracle
he does wake up,
531
00:21:36,826 --> 00:21:38,879
it'll be to brain damage, paralysis,
532
00:21:38,904 --> 00:21:40,605
and the loss of his daughter.
533
00:21:40,630 --> 00:21:43,615
So, please help me understand
534
00:21:43,640 --> 00:21:45,078
why you won't even consider this.
535
00:21:45,103 --> 00:21:47,141
I have a responsibility to my patients
536
00:21:47,166 --> 00:21:49,300
to do everything I can
to save their lives.
537
00:21:49,325 --> 00:21:51,568
Anything less, then I am failing them.
538
00:21:54,988 --> 00:21:56,323
Okay.
539
00:22:04,467 --> 00:22:06,654
He's losing blood faster
than I can replace it.
540
00:22:06,679 --> 00:22:09,530
Massive bleed from behind the liver.
541
00:22:09,555 --> 00:22:12,336
There must be a hole in the vena cava.
542
00:22:13,653 --> 00:22:15,531
Long Allis clamps.
543
00:22:20,379 --> 00:22:21,921
Damn it, this isn't working.
544
00:22:22,387 --> 00:22:25,429
I can't reach the tear
without making it worse.
545
00:22:25,454 --> 00:22:27,454
All right, Maggie, get
your hands in here.
546
00:22:28,641 --> 00:22:30,425
Push on these packs. Press hard.
547
00:22:30,450 --> 00:22:31,552
All right.
548
00:22:31,577 --> 00:22:33,133
That'll buy us some time.
549
00:22:33,158 --> 00:22:35,282
Call Dr. Lanik, get him in here.
550
00:22:35,307 --> 00:22:37,220
I don't care what he's doing.
Just make sure he's scrubbed up
551
00:22:37,245 --> 00:22:38,448
and ready to work.
552
00:22:38,473 --> 00:22:40,874
Give me an 8 ET tube and a sternal saw.
553
00:22:40,899 --> 00:22:42,505
Sternotomy?
554
00:22:42,531 --> 00:22:43,727
You're gonna open up his chest?
555
00:22:43,752 --> 00:22:45,673
I gotta get to the bleed somehow.
556
00:22:46,434 --> 00:22:48,131
Hey, got your page.
557
00:22:48,156 --> 00:22:49,558
Come on in.
558
00:22:49,583 --> 00:22:51,332
Dr. Abrams is in surgery right now.
559
00:22:51,357 --> 00:22:53,663
As soon as he's done, Keegan's next.
560
00:22:53,688 --> 00:22:54,627
Uh-huh.
561
00:22:54,652 --> 00:22:56,910
- What's all this?
- It's an experiment.
562
00:22:57,831 --> 00:22:58,974
For what?
563
00:22:58,999 --> 00:23:00,949
Well, you don't think that
564
00:23:00,974 --> 00:23:03,796
Keegan can experience her itch
without cutaneous nerves.
565
00:23:03,821 --> 00:23:06,285
And I do. I think I can prove it.
566
00:23:09,553 --> 00:23:11,044
Have a seat.
567
00:23:12,978 --> 00:23:14,803
Okay.
568
00:23:14,828 --> 00:23:17,446
So, can you take your left arm
569
00:23:17,471 --> 00:23:20,027
and put it on the other
side of the partition here?
570
00:23:22,544 --> 00:23:23,988
Thank you.
571
00:23:24,433 --> 00:23:26,136
So, is this like a magic trick?
572
00:23:26,279 --> 00:23:27,985
Yeah, kinda.
573
00:23:30,340 --> 00:23:35,712
Okay, so I'm gonna start
to brush your real hand
574
00:23:35,753 --> 00:23:37,563
and the fake hand simultaneously.
575
00:23:37,588 --> 00:23:39,437
But I just want you to
look at the fake hand.
576
00:23:39,462 --> 00:23:40,664
Okay?
577
00:23:40,689 --> 00:23:42,426
Whatever you say.
578
00:23:42,451 --> 00:23:46,181
So, amputees sometimes still feel
579
00:23:46,206 --> 00:23:47,564
the missing limb, right?
580
00:23:47,711 --> 00:23:49,578
Yeah. A phantom limb.
581
00:23:49,603 --> 00:23:52,289
The nerves are transmitting
confusing signals.
582
00:23:52,462 --> 00:23:55,357
Or do amputees still feel
missing limbs because
583
00:23:55,382 --> 00:23:58,270
the brain is just assuming
that it's still there?
584
00:23:58,567 --> 00:24:01,508
'Cause if that were the case,
the nerves would be irrelevant.
585
00:24:01,533 --> 00:24:02,725
Right?
586
00:24:02,882 --> 00:24:06,259
So, you're suggesting
Keegan's got a phantom itch?
587
00:24:06,284 --> 00:24:07,539
Her brain is telling her it's there,
588
00:24:07,564 --> 00:24:08,632
even though it isn't?
589
00:24:08,657 --> 00:24:09,757
Yeah.
590
00:24:10,057 --> 00:24:14,255
Just like amputees perceive a
limb that used to be there.
591
00:24:14,281 --> 00:24:17,211
Keegan still perceives an itch
that she got three years ago
592
00:24:17,237 --> 00:24:18,627
from a drug reaction.
593
00:24:18,652 --> 00:24:20,489
I mean, the brain's basically
playing a trick on her.
594
00:24:21,754 --> 00:24:23,524
Interesting theory.
595
00:24:23,892 --> 00:24:25,329
Where are you going with all this?
596
00:24:25,354 --> 00:24:27,526
That's not your hand. Right?
597
00:24:27,551 --> 00:24:29,295
But the more you stare at it,
598
00:24:29,320 --> 00:24:31,812
while feeling me brush your real hand,
599
00:24:31,837 --> 00:24:34,695
the more your brain might
start to blend them together.
600
00:24:34,720 --> 00:24:36,418
Well, I guess I can buy that.
601
00:24:36,443 --> 00:24:37,478
Yeah.
602
00:24:37,969 --> 00:24:40,784
Very powerful, the connection
between what we see
603
00:24:40,837 --> 00:24:42,340
and what we feel.
604
00:24:43,827 --> 00:24:46,435
But Dr. Charles, I still
know which one's my arm.
605
00:24:46,504 --> 00:24:49,379
Huh. Do ya?
606
00:24:51,986 --> 00:24:53,521
Ah.
607
00:24:56,907 --> 00:24:58,440
Uh, for a second there...
608
00:24:58,465 --> 00:25:00,014
You felt the hammer.
609
00:25:00,607 --> 00:25:02,167
Yeah, I did.
610
00:25:02,832 --> 00:25:04,341
Yeah.
611
00:25:04,366 --> 00:25:06,739
Well, and we both know there aren't
612
00:25:06,770 --> 00:25:09,308
any nerve endings in this thing, right?
613
00:25:10,455 --> 00:25:13,356
Amazing the tricks the
brain can play on us.
614
00:25:15,876 --> 00:25:17,643
Keegan. Keegan, wait.
615
00:25:17,792 --> 00:25:18,857
I've changed my mind.
616
00:25:18,882 --> 00:25:20,467
I don't think you should
have surgery just yet.
617
00:25:20,492 --> 00:25:21,886
Oh, here we go.
618
00:25:21,911 --> 00:25:24,134
What crazy idea has Dr.
Charles talked you into?
619
00:25:24,159 --> 00:25:26,063
It may not be a nerve problem.
620
00:25:26,128 --> 00:25:27,727
It could be a perception problem.
621
00:25:28,119 --> 00:25:30,711
In fact, I'm not sure
your itch is real.
622
00:25:30,736 --> 00:25:32,296
Not real? Are you two serious?
623
00:25:32,321 --> 00:25:33,418
Look at me.
624
00:25:33,443 --> 00:25:34,877
I have to be tied to the bed
625
00:25:34,902 --> 00:25:37,017
so I don't scratch a
bigger hole in my head.
626
00:25:37,042 --> 00:25:39,084
If surgery will work, I have to do it.
627
00:25:39,109 --> 00:25:40,545
But what if it doesn't?
628
00:25:40,611 --> 00:25:42,287
What if you wake up and
nothing's changed?
629
00:25:42,312 --> 00:25:43,866
It has to work.
630
00:25:43,891 --> 00:25:45,719
Because I can't live like this anymore.
631
00:25:45,744 --> 00:25:47,193
I want my life back.
632
00:25:47,218 --> 00:25:48,979
Surgery will give it to you.
633
00:25:49,314 --> 00:25:50,649
All right, let's go.
634
00:25:50,860 --> 00:25:53,132
Wait, Keegan. Wait, wait.
635
00:25:53,181 --> 00:25:55,978
The brain can change. It
responds to experience.
636
00:25:56,003 --> 00:25:57,717
It's called neuroplasticity.
637
00:25:57,742 --> 00:26:00,333
Three years ago, a
drug reaction created
638
00:26:00,358 --> 00:26:02,116
a chronic itch that you
can't seem to satisfy,
639
00:26:02,141 --> 00:26:04,046
because it rewired your brain.
640
00:26:04,249 --> 00:26:06,480
No surgery is gonna fix that. Trust me.
641
00:26:06,505 --> 00:26:07,717
Daniel.
642
00:26:07,742 --> 00:26:09,414
Please. Please, Keegan.
643
00:26:09,439 --> 00:26:11,764
Let me try something before
you go under the knife.
644
00:26:12,571 --> 00:26:14,308
It's been three years.
645
00:26:14,670 --> 00:26:17,624
What can you do for me that
no other doctor has tried?
646
00:26:17,827 --> 00:26:19,787
A trick.
647
00:26:25,536 --> 00:26:26,957
What the hell is going on?
648
00:26:26,982 --> 00:26:29,014
I was told you needed
help with a liver bleed.
649
00:26:29,039 --> 00:26:30,947
Retro-hepatic cava tear.
650
00:26:30,972 --> 00:26:32,717
Can't fix anything until
I control the bleed.
651
00:26:32,742 --> 00:26:34,972
I'm gonna do that with
an atrial caval shunt.
652
00:26:34,997 --> 00:26:36,237
You gotta be kidding.
653
00:26:36,262 --> 00:26:38,230
Nope, I'm gonna snake an ET tube
654
00:26:38,255 --> 00:26:40,811
down his heart and bypass the tear.
655
00:26:40,836 --> 00:26:42,853
What, you couldn't think
of a riskier move?
656
00:26:42,878 --> 00:26:45,800
Atrial caval shunts have
an abysmal success rate.
657
00:26:45,825 --> 00:26:47,424
Yep, I'm aware.
658
00:26:47,449 --> 00:26:50,056
Then you also know that he's
cold and coagulopathic.
659
00:26:50,081 --> 00:26:52,397
So, if you don't pack him up,
and get him up to the ICU
660
00:26:52,423 --> 00:26:54,857
to be warmed, he's gonna
die here on this table.
661
00:26:54,882 --> 00:26:56,426
At least this gives him a shot.
662
00:26:56,451 --> 00:26:57,842
If we send him up to the ICU,
663
00:26:57,867 --> 00:26:59,672
he bleeds out and dies for sure.
664
00:26:59,963 --> 00:27:01,636
Scissors and ET tube.
665
00:27:02,188 --> 00:27:04,661
If you cut into that heart,
there is no going back.
666
00:27:04,687 --> 00:27:06,358
Yeah, I know.
667
00:27:06,978 --> 00:27:08,582
Don't do it.
668
00:27:13,556 --> 00:27:15,517
God damn it.
669
00:27:16,086 --> 00:27:17,924
You kick me out of
here only to force me
670
00:27:17,949 --> 00:27:18,931
to help you kill this guy.
671
00:27:18,956 --> 00:27:21,056
You're a prick, Rhodes.
672
00:27:21,081 --> 00:27:22,629
Yeah, maybe.
673
00:27:32,505 --> 00:27:34,578
If her father doesn't wake up,
674
00:27:34,747 --> 00:27:36,900
what happens to Abigail's organs?
675
00:27:37,390 --> 00:27:39,454
They're no good to anyone.
676
00:27:46,994 --> 00:27:49,634
Ms. Goodwin, can I speak
to you about something?
677
00:27:54,237 --> 00:27:55,574
Could've driven a truck
through this hole.
678
00:27:55,599 --> 00:27:57,823
He never would have
survived in the ICU.
679
00:27:58,004 --> 00:27:59,440
This is the right call.
680
00:27:59,603 --> 00:28:02,373
Don't act like you didn't
get lucky as hell.
681
00:28:03,240 --> 00:28:05,104
Let's finish this up.
682
00:28:10,260 --> 00:28:11,559
What do I do?
683
00:28:11,584 --> 00:28:13,225
I don't know how long I can
go without scratching.
684
00:28:13,250 --> 00:28:14,093
Okay.
685
00:28:14,118 --> 00:28:15,491
I want you to look at your reflection
686
00:28:15,516 --> 00:28:18,685
and scratch the non-itchy
side of your head.
687
00:28:20,349 --> 00:28:23,243
In the mirror, the image
is gonna be reversed.
688
00:28:23,268 --> 00:28:24,086
It's gonna look like you're actually
689
00:28:24,111 --> 00:28:25,456
scratching the itchy side.
690
00:28:25,481 --> 00:28:27,704
Oh, I see it.
691
00:28:28,286 --> 00:28:30,014
But how is scratching
this side of my head
692
00:28:30,039 --> 00:28:31,965
gonna make the itch go
away on the other side?
693
00:28:31,990 --> 00:28:33,097
Keegan, trust me.
694
00:28:33,122 --> 00:28:35,259
We know that you've been
feeling this thing.
695
00:28:35,284 --> 00:28:38,517
But I just want you to consider
the possibility that maybe,
696
00:28:38,542 --> 00:28:40,849
just maybe that this itch isn't real.
697
00:28:40,874 --> 00:28:43,394
And no amount of scratching
is gonna satisfy it.
698
00:28:43,419 --> 00:28:45,189
Well, then what the hell am I doing?
699
00:28:45,214 --> 00:28:47,386
Giving your brain new visual input
700
00:28:47,411 --> 00:28:49,975
to the override the experience
you had three years ago,
701
00:28:50,000 --> 00:28:51,992
so it can begin to rewire itself.
702
00:28:52,384 --> 00:28:54,416
Okay, you're losing me.
703
00:28:54,441 --> 00:28:56,505
By feeling yourself scratch
one side of your head
704
00:28:56,530 --> 00:28:58,903
while you're seeing
yourself scratch the other,
705
00:28:59,333 --> 00:29:01,084
your brain will be tricked.
706
00:29:01,109 --> 00:29:02,814
And realize something's not right.
707
00:29:03,137 --> 00:29:06,080
Now, hopefully, that
experience will force you
708
00:29:06,105 --> 00:29:07,595
to perceive a new reality.
709
00:29:07,620 --> 00:29:11,044
A reality in which the
itch doesn't exist.
710
00:29:11,848 --> 00:29:14,821
So you say, but nothing's changing.
711
00:29:15,026 --> 00:29:16,433
And I feel stupid.
712
00:29:16,713 --> 00:29:19,207
The exercise is designed
to confuse your brain,
713
00:29:19,232 --> 00:29:20,330
so don't worry about that.
714
00:29:20,355 --> 00:29:22,264
Just keep scratching.
715
00:29:22,814 --> 00:29:26,041
Like this? Harder? Softer?
716
00:29:26,066 --> 00:29:27,587
- Just like you're doing.
- Yes.
717
00:29:27,613 --> 00:29:29,172
Be patient.
718
00:29:30,660 --> 00:29:32,322
Give it a chance.
719
00:29:34,594 --> 00:29:36,268
Keegan, we'll be just outside.
720
00:29:37,622 --> 00:29:39,126
You're doing great.
721
00:29:45,032 --> 00:29:47,322
How long are we gonna let
her keep scratching?
722
00:29:47,347 --> 00:29:50,571
She's been dealing with
this for what, three years?
723
00:29:50,596 --> 00:29:53,257
I mean, honestly Ethan,
724
00:29:53,282 --> 00:29:54,632
I don't know how long it might take.
725
00:29:54,657 --> 00:29:55,755
If it takes.
726
00:29:56,140 --> 00:29:58,341
The phantom itch theory makes sense,
727
00:29:58,451 --> 00:30:00,059
but it's still just a theory.
728
00:30:00,084 --> 00:30:03,412
I just really don't wanna
give her any false hope.
729
00:30:04,083 --> 00:30:05,539
Dr. Charles.
730
00:30:05,564 --> 00:30:08,067
Something's definitely happening.
731
00:30:08,435 --> 00:30:11,790
The itch, it's less.
732
00:30:16,076 --> 00:30:17,761
Okay.
733
00:30:19,600 --> 00:30:21,238
All right, I'll be back in five.
734
00:30:21,263 --> 00:30:24,029
I'm gonna run these over
to sterile processing.
735
00:30:29,680 --> 00:30:31,986
Hey. Have you seen April?
736
00:30:32,011 --> 00:30:34,021
- I wanted to check in on her.
- Nope.
737
00:30:34,069 --> 00:30:35,843
She's probably putting
out a fire somewhere.
738
00:30:35,868 --> 00:30:37,418
That girl is on it.
739
00:30:37,703 --> 00:30:39,840
So, things went well
while I was in surgery?
740
00:30:40,031 --> 00:30:42,355
Yeah, didn't even
realize you were gone.
741
00:30:43,296 --> 00:30:44,872
Oh.
742
00:30:44,897 --> 00:30:46,446
That's great.
743
00:30:46,471 --> 00:30:48,255
Yeah.
744
00:30:51,883 --> 00:30:54,861
Dr. Halstead, could I have a moment?
745
00:30:54,886 --> 00:30:55,988
Of course.
746
00:30:56,013 --> 00:30:59,184
An emergency ethics committee
was formed to evaluate
747
00:30:59,209 --> 00:31:02,720
Marc Jones's current condition
and future prognosis.
748
00:31:02,745 --> 00:31:05,356
Wait, was formed? Who asked for that?
749
00:31:05,381 --> 00:31:09,241
Between his spinal cord injury
and the high probability
750
00:31:09,266 --> 00:31:12,005
for irreparable brain damage,
the committee concluded
751
00:31:12,030 --> 00:31:14,405
with reasonable medical certainty
752
00:31:14,430 --> 00:31:17,047
that he has no quality of life.
753
00:31:17,072 --> 00:31:17,952
No.
754
00:31:17,978 --> 00:31:21,725
Listen, the hospital will honor
755
00:31:21,750 --> 00:31:25,381
Mr. Jones's tattoo as
an advanced directive.
756
00:31:25,406 --> 00:31:29,481
If he codes again, you
will not resuscitate.
757
00:31:29,506 --> 00:31:31,488
I cannot just walk away.
758
00:31:31,514 --> 00:31:35,570
I'm sorry, but it's over, Dr. Halstead.
759
00:31:40,458 --> 00:31:42,129
I wanna talk to you.
760
00:31:47,984 --> 00:31:50,493
An emergency ethics committee?
761
00:31:50,518 --> 00:31:53,048
What, I don't bow down to
your decision on my patient,
762
00:31:53,074 --> 00:31:54,845
so you go over me to
Goodwin and bench me?
763
00:31:54,870 --> 00:31:55,997
You forced my hand.
764
00:31:56,022 --> 00:31:58,434
I tried talking to you.
You shut me down.
765
00:31:58,459 --> 00:32:00,784
Because you'd already
decided Marc should die.
766
00:32:00,809 --> 00:32:03,058
He has a tattoo across
his chest that says,
767
00:32:03,083 --> 00:32:04,497
"Do Not Resuscitate."
768
00:32:04,522 --> 00:32:06,458
We don't know that's how he feels.
769
00:32:06,483 --> 00:32:07,840
We don't know he doesn't.
770
00:32:07,865 --> 00:32:10,466
But what I do know is
that if we don't act now,
771
00:32:10,491 --> 00:32:12,262
we will lose Abigail's organs.
772
00:32:12,287 --> 00:32:14,824
Those are children's
lives in our hands.
773
00:32:14,849 --> 00:32:16,201
No, don't turn this on me.
774
00:32:16,226 --> 00:32:18,067
Don't guilt me into thinking
that I'm the bad guy.
775
00:32:18,092 --> 00:32:20,039
You don't think I know
the stakes of this case?
776
00:32:20,064 --> 00:32:22,960
I am sick of everyone
telling me what I can
777
00:32:22,985 --> 00:32:24,057
and what I cannot do.
778
00:32:24,082 --> 00:32:26,902
I am just trying to save my patients.
779
00:32:26,927 --> 00:32:28,417
What are you talking about?
780
00:32:28,442 --> 00:32:29,754
Who is everyone?
781
00:32:31,935 --> 00:32:33,509
You betrayed me.
782
00:32:33,957 --> 00:32:35,657
How can I ever trust you?
783
00:32:36,606 --> 00:32:38,580
How can I trust you?
784
00:32:38,605 --> 00:32:40,941
In the past, you have let patients go
785
00:32:40,966 --> 00:32:42,683
who you knew were hopeless.
786
00:32:42,871 --> 00:32:44,399
But you know what? It
is more than that.
787
00:32:44,424 --> 00:32:45,618
No, look at me.
788
00:32:45,643 --> 00:32:47,029
It is more than that.
789
00:32:47,054 --> 00:32:49,380
You have been acting strange for weeks.
790
00:32:49,405 --> 00:32:51,325
And this morning, that ridiculous story
791
00:32:51,350 --> 00:32:53,467
about a drug rep, really?
792
00:32:56,640 --> 00:32:58,136
Well then, here we are.
793
00:32:58,161 --> 00:32:59,808
And about to get married.
794
00:33:05,732 --> 00:33:07,356
- Maggie.
- Yep.
795
00:33:07,381 --> 00:33:10,462
Thanks for approving
my PTO for next month.
796
00:33:10,841 --> 00:33:13,143
I didn't think there was
a way to make it happen.
797
00:33:13,339 --> 00:33:16,082
Oh, yeah. Sure.
798
00:33:17,047 --> 00:33:18,718
April.
799
00:33:19,070 --> 00:33:22,271
Did you sign off on Monique's
paid time off for next month?
800
00:33:22,297 --> 00:33:23,060
Yeah.
801
00:33:23,085 --> 00:33:24,974
Saw her request had been
siting there for three weeks.
802
00:33:24,999 --> 00:33:25,954
I hate it when I put in
803
00:33:25,979 --> 00:33:27,650
for vacation times and nothing happens.
804
00:33:27,675 --> 00:33:28,704
It takes a long time
805
00:33:28,729 --> 00:33:31,194
because someone's
always asking for PTO.
806
00:33:31,219 --> 00:33:32,616
Especially Monique.
807
00:33:32,641 --> 00:33:35,053
She took eight days off last month.
808
00:33:35,174 --> 00:33:38,397
Well, her sister is pregnant,
on bed rest and needs help.
809
00:33:38,422 --> 00:33:40,104
So, how could I say no?
810
00:33:40,129 --> 00:33:41,631
- What?
- Lisa.
811
00:33:41,926 --> 00:33:43,409
I'm talking to you.
812
00:33:43,434 --> 00:33:45,363
I have a system for handling PTO's.
813
00:33:45,388 --> 00:33:47,518
You can't take time off if
you're out of vacation.
814
00:33:47,543 --> 00:33:49,482
Monique was out.
815
00:33:49,565 --> 00:33:51,422
Doris gave her some of hers.
816
00:33:51,740 --> 00:33:54,048
Oh, my God. You let them swap?
817
00:33:54,073 --> 00:33:55,873
Doris said she wasn't gonna use them.
818
00:33:55,898 --> 00:33:57,520
No sense letting them gather dust.
819
00:33:57,545 --> 00:33:58,773
You know what's gonna happen now?
820
00:33:58,798 --> 00:34:00,902
I'm gonna get hammered
with requests from nurses
821
00:34:00,927 --> 00:34:02,414
who wanna swap days.
822
00:34:02,504 --> 00:34:04,574
- Thanks a lot.
- You know what?
823
00:34:04,600 --> 00:34:05,970
You don't like the way I handle things
824
00:34:05,995 --> 00:34:07,762
when I'm doing you a favor...
825
00:34:07,787 --> 00:34:09,257
A favor?
826
00:34:09,326 --> 00:34:11,932
This is a privilege.
827
00:34:12,836 --> 00:34:15,926
Give your privilege to someone else.
828
00:34:43,137 --> 00:34:45,176
Time of death, 19:22.
829
00:34:55,299 --> 00:34:57,304
There, he's gone.
830
00:34:57,654 --> 00:34:59,141
You won.
831
00:35:05,554 --> 00:35:07,093
I was about to give up,
832
00:35:07,118 --> 00:35:08,869
but then there was this moment.
833
00:35:08,897 --> 00:35:11,269
Look at me, I'm not scratching.
834
00:35:12,147 --> 00:35:14,630
I am so happy for you.
835
00:35:14,655 --> 00:35:17,390
Dr. Choi, I can keep
these mirrors, right?
836
00:35:17,691 --> 00:35:19,256
It's so much better.
837
00:35:19,281 --> 00:35:21,106
Of course. And keep it up.
838
00:35:21,132 --> 00:35:23,424
Over time, they should
fade away completely.
839
00:35:24,643 --> 00:35:26,001
Excuse me.
840
00:35:26,026 --> 00:35:29,006
Dr. Charles, surgery would
have been a mistake.
841
00:35:29,179 --> 00:35:30,825
Good call steering her away.
842
00:35:30,851 --> 00:35:32,548
Yeah, but, you know, I
certainly understood
843
00:35:32,573 --> 00:35:34,538
her desperation for relief.
844
00:35:35,794 --> 00:35:37,289
Do you know that scientifically,
845
00:35:37,314 --> 00:35:39,461
itching is ranked as one of the most
846
00:35:39,486 --> 00:35:42,322
distressing sensations a
human being can experience?
847
00:35:42,347 --> 00:35:43,949
Really?
848
00:35:46,308 --> 00:35:49,969
You know what, Dr. Charles,
maybe it's not a good idea,
849
00:35:49,994 --> 00:35:53,717
but some itches you
just have to scratch.
850
00:35:56,721 --> 00:35:59,917
Vicki. Hey.
851
00:36:03,200 --> 00:36:05,134
What do you say we go for a run?
852
00:36:05,644 --> 00:36:07,300
Like old times?
853
00:36:07,725 --> 00:36:09,108
Sure.
854
00:36:09,133 --> 00:36:10,525
Call me sometime.
855
00:36:10,581 --> 00:36:13,191
My shift's over.
856
00:36:14,505 --> 00:36:15,731
How 'bout now?
857
00:36:18,319 --> 00:36:20,725
Okay. Let's do it.
858
00:36:27,676 --> 00:36:31,453
Okay, look, my way isn't the only way.
859
00:36:31,478 --> 00:36:33,095
You're doing a good job.
860
00:36:33,230 --> 00:36:34,879
Thanks.
861
00:36:35,107 --> 00:36:37,413
And I confess, it sucks
when you realize
862
00:36:37,438 --> 00:36:39,738
that you can be replaced.
863
00:36:40,104 --> 00:36:42,577
Yeah, I know.
864
00:36:46,687 --> 00:36:47,755
Oh.
865
00:36:51,696 --> 00:36:53,447
Wanna get a drink?
866
00:36:54,088 --> 00:36:55,582
Maybe two?
867
00:36:58,650 --> 00:37:00,308
Yeah.
868
00:37:08,372 --> 00:37:09,908
Oh, Sam.
869
00:37:09,933 --> 00:37:12,671
You'll be happy to hear that
Keegan's feeling much better.
870
00:37:12,720 --> 00:37:14,458
Oh, your smoke and mirrors?
871
00:37:14,483 --> 00:37:16,086
Temporary fix.
872
00:37:16,403 --> 00:37:17,944
She'll be back here in six weeks
873
00:37:17,969 --> 00:37:19,219
to get that surgery.
874
00:37:19,244 --> 00:37:21,225
Well, that's the way you see it,
875
00:37:21,250 --> 00:37:23,818
I, uh, I guess I see it
a little differently.
876
00:37:25,033 --> 00:37:26,661
Until next time, Daniel.
877
00:37:26,686 --> 00:37:28,389
Good night.
878
00:37:36,249 --> 00:37:38,872
An atrial caval shunt.
879
00:37:39,583 --> 00:37:41,220
My cowboy.
880
00:37:42,806 --> 00:37:44,409
Dr. Rhodes.
881
00:37:45,210 --> 00:37:48,335
Three operating rooms
upstairs were open.
882
00:37:48,360 --> 00:37:50,032
You could have treated your patient
883
00:37:50,065 --> 00:37:51,349
in any one of them.
884
00:37:51,374 --> 00:37:53,474
Maybe, but I didn't want to
risk him dying in transit.
885
00:37:53,499 --> 00:37:55,370
That is why we have a Hybrid OR.
886
00:37:57,202 --> 00:37:59,173
The gall bladder surgery
you interrupted,
887
00:37:59,198 --> 00:38:01,428
I'm rescheduling it for tomorrow.
888
00:38:01,453 --> 00:38:02,987
In the Hybrid OR.
889
00:38:03,012 --> 00:38:05,249
Ms. Goodwin, this idea
to repurpose my room
890
00:38:05,274 --> 00:38:07,679
is misguided and reckless.
891
00:38:07,704 --> 00:38:09,097
Your room?
892
00:38:09,294 --> 00:38:12,770
Well, the board is considering
closing your room
893
00:38:12,795 --> 00:38:15,034
unless it starts proving its worth.
894
00:38:15,147 --> 00:38:18,752
That's why I'm gonna make sure
it is always earning money.
895
00:38:18,890 --> 00:38:21,244
Great. Then I'm gonna
keep fighting back,
896
00:38:21,270 --> 00:38:23,039
because I'm not gonna let Gwen Garrett
897
00:38:23,064 --> 00:38:24,929
turn the Hybrid OR into an ATM.
898
00:38:24,954 --> 00:38:27,187
Gwen Garrett has nothing
to do with this.
899
00:38:27,212 --> 00:38:30,315
I decided to put general
surgeries in there.
900
00:38:30,485 --> 00:38:33,130
So you pull this little stunt again,
901
00:38:33,249 --> 00:38:35,328
and I'll show you the door.
902
00:38:39,101 --> 00:38:40,661
I don't care what she says.
903
00:38:41,058 --> 00:38:43,783
I saved his life. I'd do it again.
904
00:38:43,889 --> 00:38:45,749
Come here.
905
00:39:01,478 --> 00:39:03,553
We're a lot alike, you know.
906
00:39:03,760 --> 00:39:06,168
You'd do anything to get what you want.
907
00:39:10,823 --> 00:39:12,713
You're that bad, huh?
908
00:39:13,375 --> 00:39:15,226
I'm that bad.
909
00:39:38,582 --> 00:39:41,056
Abigail's organs are off to recipients.
910
00:39:43,745 --> 00:39:45,374
That's good.
911
00:39:59,240 --> 00:40:01,314
Maybe you want this back?
912
00:40:15,528 --> 00:40:17,616
No, I don't.
913
00:40:23,249 --> 00:40:25,734
Natalie, I wanna marry you.
914
00:40:33,029 --> 00:40:40,617
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