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1
00:01:09,792 --> 00:01:13,792
All right. Who do I gotta screw to get
some health care around here?!
2
00:01:14,903 --> 00:01:17,292
- Well, honey!
- Why don't you try an intern?
3
00:01:17,293 --> 00:01:18,623
They're always hard up.
4
00:01:18,658 --> 00:01:19,916
Come on, Jeremy, I'll take you back.
5
00:01:20,151 --> 00:01:20,951
Where?
6
00:01:20,989 --> 00:01:22,144
To see the doctor.
7
00:01:22,787 --> 00:01:24,917
- My dad here yet?
- No. He's on his way.
8
00:01:25,453 --> 00:01:27,000
Can I give my ticket to you?
9
00:01:27,367 --> 00:01:28,708
Just a little longer, sir.
10
00:01:29,526 --> 00:01:31,971
D-D-Don't make me late.
My baggage already went through.
11
00:01:32,050 --> 00:01:32,760
Right.
12
00:01:32,760 --> 00:01:33,563
Come on, Jeremy.
13
00:01:36,683 --> 00:01:38,687
11-year-old boy with multiple lacs.
14
00:01:38,718 --> 00:01:39,876
Hey, how you doing, little man?
15
00:01:40,270 --> 00:01:42,027
TV fell on him. Kids were home alone.
16
00:01:42,137 --> 00:01:43,555
Okay, we'll get to him real soon.
17
00:01:44,187 --> 00:01:46,727
Standard of care is primary
closure within six hours.
18
00:01:46,762 --> 00:01:47,956
Standard of care is for rookies.
19
00:01:47,991 --> 00:01:49,978
Get him started, Jane.
Dr. Pratt will be right there.
20
00:01:50,437 --> 00:01:52,038
And, I got a real winner for you.
21
00:01:52,964 --> 00:01:54,614
Belly pain with combustible breath.
22
00:01:55,024 --> 00:01:56,707
You talking about
that creepy homeless guy?
23
00:01:56,742 --> 00:01:58,353
"Creepy" I'll give you, but
I don't think he's homeless.
24
00:01:58,388 --> 00:01:59,901
How 'bout we wait till he sobers up?
25
00:01:59,936 --> 00:02:01,358
I'll be home and in bed by then.
26
00:02:01,541 --> 00:02:03,150
He needs to be examined, Pratt.
27
00:02:03,151 --> 00:02:03,951
I'll take care of it.
28
00:02:04,534 --> 00:02:05,670
How long's he been here?
29
00:02:05,705 --> 00:02:07,298
Oh, about two hours.
30
00:02:07,333 --> 00:02:09,163
He thinks he's in an
airport or something.
31
00:02:09,310 --> 00:02:11,052
- He's altered?
- Yeah, a little.
32
00:02:11,100 --> 00:02:13,323
If you ask me, we need to have
one line for legitimate patients,
33
00:02:13,358 --> 00:02:14,702
another line for all the rest.
34
00:02:14,737 --> 00:02:15,999
Yeah, well, good thing
nobody asked you.
35
00:02:16,034 --> 00:02:18,150
Luka, our UTI, dislocated shoulder and
rapid hair loss,
36
00:02:18,185 --> 00:02:19,372
all need to be signed out.
37
00:02:19,407 --> 00:02:22,360
I haven't been this starved
since the last Burning Man festival.
38
00:02:22,395 --> 00:02:23,500
Who wants some 'za?
39
00:02:23,535 --> 00:02:25,084
You had a burger a couple of hours ago.
40
00:02:25,119 --> 00:02:26,140
Fast metabolism.
41
00:02:26,175 --> 00:02:28,550
Pratt, wheezing guy was
driving insomnia lady crazy
42
00:02:28,585 --> 00:02:30,236
so I moved him into Exam Three.
43
00:02:30,671 --> 00:02:31,642
Okay, beautiful.
44
00:02:31,677 --> 00:02:34,504
Okay, who's the lucky bastard
that gets to take my blood?
45
00:02:34,539 --> 00:02:36,272
I need CBC, LFTs and amylase.
46
00:02:36,307 --> 00:02:37,223
I'll do it.
47
00:02:37,258 --> 00:02:38,380
Is this about your needle stick?
48
00:02:39,311 --> 00:02:40,223
Yeah.
49
00:02:40,258 --> 00:02:41,590
You gotta do what
you gotta do, right?
50
00:02:42,941 --> 00:02:44,634
Hey, this is Dr. Barnett from County.
51
00:02:44,669 --> 00:02:46,595
I'll take six-- no, no, no,
make that seven.
52
00:02:46,630 --> 00:02:48,502
I'll take two pepperoni,
two sausage and pepper,
53
00:02:48,537 --> 00:02:50,419
two Hawaiian and one with the works.
54
00:02:50,454 --> 00:02:52,273
It's, let's see, 11:23 right now.
55
00:02:52,308 --> 00:02:53,944
So we'll get that at 12:03, right?
56
00:02:54,551 --> 00:02:55,718
All right, man. Cool.
57
00:02:55,753 --> 00:02:57,614
Seven pies. What
the hell was that about?
58
00:02:57,649 --> 00:03:00,530
Guaranteed delivery within
40 minutes or there's no charge,
59
00:03:00,565 --> 00:03:01,781
but what the guy doesn't know
60
00:03:01,816 --> 00:03:04,785
is that Wacker's closed
and the Loop is a parking lot.
61
00:03:04,820 --> 00:03:06,988
There is such a thing
as a free lunch, my friend.
62
00:03:07,023 --> 00:03:08,627
Luka. Belly-pain guy's going down.
63
00:03:14,167 --> 00:03:15,368
Somebody bring a gurney!
64
00:03:16,039 --> 00:03:17,908
Sir. Open your eyes, sir.
65
00:03:17,909 --> 00:03:20,580
Hey, doctor, no way. Uh-uh.
I was here before him.
66
00:03:20,615 --> 00:03:22,585
Vitals were normal when I
triaged him a couple of hours ago.
67
00:03:22,620 --> 00:03:24,227
That nurse told me I was next.
68
00:03:24,262 --> 00:03:26,135
Diaphoretic, carotid's
weak and thready.
69
00:03:26,170 --> 00:03:27,375
70 systolic.
70
00:03:27,410 --> 00:03:30,948
Hey, is that what it takes, huh? Flopping
around on the floor like I'm dying?
71
00:03:30,983 --> 00:03:32,216
Yeah, don't push me!
72
00:03:32,251 --> 00:03:33,487
Watch me! Hey!
73
00:03:33,487 --> 00:03:34,726
Get him on O2 right away.
74
00:03:34,761 --> 00:03:36,064
Here we go!
75
00:03:36,099 --> 00:03:38,341
Hey! Look at me! Look!
76
00:03:38,907 --> 00:03:41,254
My bag. My bag.
I want my bag.
77
00:03:41,626 --> 00:03:42,062
I got it!
78
00:03:42,063 --> 00:03:44,392
Stat EKG in case he's having an M.I.
79
00:03:44,427 --> 00:03:45,686
What about me, huh?
80
00:03:45,721 --> 00:03:47,131
I might have an M.I., too!
81
00:03:47,166 --> 00:03:48,488
Any history of hepatitis?
82
00:03:49,417 --> 00:03:51,046
Abby, can you give us a hand?
83
00:03:51,081 --> 00:03:52,101
What about my blood draw?
84
00:03:52,136 --> 00:03:53,330
I'll write you a note.
85
00:03:53,987 --> 00:03:55,486
Get a 12-lead going.
86
00:03:55,521 --> 00:03:56,275
Where am I?
87
00:03:56,276 --> 00:03:57,234
Sam, you've got the IV.
88
00:03:57,269 --> 00:03:58,381
Where am I? What are you doing?
89
00:03:58,759 --> 00:04:00,540
Okay. Hey, Pratt, can you spare Jane?
90
00:04:00,575 --> 00:04:01,375
Definitely.
91
00:04:02,582 --> 00:04:04,595
Document everything we do
at the time we do it.
92
00:04:04,630 --> 00:04:06,186
Isn't that usually a nurse's job?
93
00:04:06,221 --> 00:04:08,247
There's a nursing shortage,
Jane-- haven't you heard?
94
00:04:08,282 --> 00:04:09,008
What are you doing? Stop!
95
00:04:09,009 --> 00:04:10,066
Hey, hey, hey, now.
96
00:04:10,101 --> 00:04:12,097
Okay. I may not always
know what to write.
97
00:04:12,132 --> 00:04:12,920
We'll tell you.
98
00:04:12,921 --> 00:04:16,160
Start with two liters of
02 at 11:25. Pulse ox 98.
99
00:04:18,236 --> 00:04:18,951
That's my bag.
100
00:04:18,952 --> 00:04:20,002
Gimme my bag back.
101
00:04:20,037 --> 00:04:21,541
I'll give you your bag
back right down here.
102
00:04:21,576 --> 00:04:22,750
Get your hands off of me!
103
00:04:22,785 --> 00:04:24,039
Calm down.
104
00:04:24,074 --> 00:04:24,957
Knock it off.
105
00:04:25,152 --> 00:04:26,971
Okay? We're here to help you,
106
00:04:27,006 --> 00:04:29,547
and we can try this the nice way,
or we can try other options.
107
00:04:30,609 --> 00:04:31,615
This is how you help?
108
00:04:31,650 --> 00:04:32,955
- Yeah, that's right, sir.
- Okay.
109
00:04:32,990 --> 00:04:34,089
EEG is ten centimeters.
110
00:04:35,032 --> 00:04:36,224
EEG's printing.
111
00:04:37,046 --> 00:04:37,846
Chart it.
112
00:04:37,877 --> 00:04:39,105
11:26.
113
00:04:39,697 --> 00:04:41,616
Got your line.
What do you want sent?
114
00:04:41,651 --> 00:04:42,633
Abby?
115
00:04:42,668 --> 00:04:46,668
CBC, chem 20, PT/PTT,
troponin. Type and hold.
116
00:04:47,165 --> 00:04:48,710
And add a serum ammonia.
117
00:04:48,745 --> 00:04:50,972
EKG looks good.
No ischemic changes.
118
00:04:50,995 --> 00:04:52,770
Excuse me. Excuse me.
119
00:04:56,797 --> 00:04:58,237
My name is Charlie
120
00:04:58,272 --> 00:04:59,732
Metcalf, okay?
121
00:05:03,047 --> 00:05:04,229
Okay?
122
00:05:04,984 --> 00:05:05,784
Okay.
123
00:05:06,218 --> 00:05:07,075
Okay?
124
00:05:07,915 --> 00:05:08,781
Okay.
125
00:05:10,257 --> 00:05:11,390
Ouch! Don't.
126
00:05:11,425 --> 00:05:12,953
I'm not gonna hurt you, okay?
127
00:05:13,302 --> 00:05:14,360
Dr. Kovac.
128
00:05:14,395 --> 00:05:15,827
Okay, let's get him gowned.
129
00:05:15,862 --> 00:05:17,472
We need you to work
with us, Mr. Metcalf.
130
00:05:17,507 --> 00:05:18,819
This'll be much easier, okay?
131
00:05:21,776 --> 00:05:22,842
What's the trouble?
132
00:05:22,877 --> 00:05:24,161
Possible extensor tendon lac.
133
00:05:26,334 --> 00:05:28,209
Can you move your toes up and down?
134
00:05:29,598 --> 00:05:30,651
How'd that happen?
135
00:05:30,808 --> 00:05:33,117
My sister pulled
the television down on me.
136
00:05:33,152 --> 00:05:34,148
It was an accident.
137
00:05:34,939 --> 00:05:38,049
I guess it's true, then, huh?
TV really is bad for kids.
138
00:05:38,949 --> 00:05:40,238
Where were your parents?
139
00:05:40,273 --> 00:05:41,457
My dad was at work.
140
00:05:41,757 --> 00:05:42,908
Baby-sitter?
141
00:05:42,943 --> 00:05:45,585
We can't afford one.
I watch after Steffie.
142
00:05:45,586 --> 00:05:47,828
Can't afford a baby-sitter,
but they got one big-ass TV.
143
00:05:47,863 --> 00:05:48,667
Luka.
144
00:05:48,970 --> 00:05:50,252
Somebody called the dad?
145
00:05:50,280 --> 00:05:51,763
Yeah, the neighbor
who brought them in.
146
00:05:51,793 --> 00:05:53,717
Get him cleaned up
and send for X rays.
147
00:05:55,255 --> 00:05:57,033
We have three TVs.
148
00:05:58,382 --> 00:05:59,901
That IV making you feel better?
149
00:05:59,936 --> 00:06:03,897
Yeah. Yeah, look, before;
I-I'm sorry. I-I just...
150
00:06:03,932 --> 00:06:04,766
Shh.
151
00:06:04,801 --> 00:06:07,346
11:27. 300 cc bolus is in.
152
00:06:07,381 --> 00:06:08,837
Pulse down to 110.
153
00:06:08,872 --> 00:06:12,589
No murmur rubs or gallops. Multiple
spider angiomas on the chest wall.
154
00:06:12,624 --> 00:06:13,735
Watch my stomach. Watch my...
155
00:06:14,975 --> 00:06:16,422
You seen a doctor lately?
156
00:06:16,457 --> 00:06:18,397
Um, it's been a of couple years.
157
00:06:18,708 --> 00:06:20,142
Do you have a primary-care physician?
158
00:06:20,919 --> 00:06:22,264
No, not at the present time.
159
00:06:22,299 --> 00:06:23,371
Need a 5-O nylon.
160
00:06:25,759 --> 00:06:27,310
Who were you seeing
a couple of years ago?
161
00:06:27,345 --> 00:06:29,224
I don't remember the guy's name.
162
00:06:29,259 --> 00:06:30,990
Some doctor in Taylorville.
163
00:06:31,459 --> 00:06:33,784
Taylorville? You lived there?
164
00:06:34,423 --> 00:06:35,380
Yeah.
165
00:06:35,709 --> 00:06:36,926
There's a prison there, right?
166
00:06:37,203 --> 00:06:39,084
Yeah, it's a correctional facility.
167
00:06:39,119 --> 00:06:40,423
What's the big deal?
168
00:06:40,458 --> 00:06:42,145
I knew somebody
who spent time there once.
169
00:06:42,180 --> 00:06:43,192
Small world.
170
00:06:43,818 --> 00:06:46,021
Positive fluid wave. Liver's small.
171
00:06:46,046 --> 00:06:46,986
Ascites?
172
00:06:47,655 --> 00:06:48,555
Yeah.
173
00:06:48,590 --> 00:06:49,482
What's that?
174
00:06:49,822 --> 00:06:51,759
It means you have fluid in your belly.
175
00:06:52,370 --> 00:06:53,589
So, what were you in for?
176
00:06:53,624 --> 00:06:54,657
A mistake.
177
00:06:55,671 --> 00:06:57,162
What, you mean you weren't framed?
178
00:06:57,197 --> 00:06:58,396
Spleen is enlarged.
179
00:06:58,782 --> 00:07:02,498
Chart a BP. 100/70 at... 11:28.
180
00:07:02,533 --> 00:07:03,539
Caput medusa.
181
00:07:03,574 --> 00:07:04,640
What kind of mistake?
182
00:07:06,184 --> 00:07:07,438
I killed a guy.
183
00:07:08,302 --> 00:07:10,328
Palmar erythema and muscle atrophy.
184
00:07:10,363 --> 00:07:11,624
Oh, yeah? For what?
185
00:07:11,659 --> 00:07:14,347
For asking too many damn
questions, that's for what.
186
00:07:14,382 --> 00:07:15,344
Hemocue 7.2
187
00:07:18,127 --> 00:07:19,446
My dad here yet?
188
00:07:20,495 --> 00:07:21,440
No, not yet.
189
00:07:22,095 --> 00:07:22,927
Hey, kid!
190
00:07:22,962 --> 00:07:24,814
Don't look at him.
Just look this way, okay?
191
00:07:24,849 --> 00:07:25,755
Hey, pally.
192
00:07:25,790 --> 00:07:26,678
Don't worry about him.
193
00:07:26,713 --> 00:07:27,822
- Mr. Metcalf?
- What?
194
00:07:28,460 --> 00:07:29,260
Mr. Metcalf!
195
00:07:29,309 --> 00:07:32,436
You're very anemic and could be
losing blood from an ulcer.
196
00:07:32,989 --> 00:07:34,022
Are you a drinker?
197
00:07:35,812 --> 00:07:36,524
Y eah.
198
00:07:36,525 --> 00:07:37,523
Were you drinking in jail?
199
00:07:37,524 --> 00:07:39,903
Yeah, but you're not gonna rat me
to my parole board, are you darling?
200
00:07:39,938 --> 00:07:41,446
It's important we know
what you've been taking.
201
00:07:43,068 --> 00:07:45,388
Pruno, breakfast of felons.
202
00:07:45,423 --> 00:07:48,739
Now, I drink wine, beer,
anything I can get my hands on.
203
00:07:48,774 --> 00:07:49,864
P runo?
204
00:07:50,416 --> 00:07:52,682
Yeah, it's fruit... ow.
205
00:07:52,717 --> 00:07:54,865
fruit and bread from the cafeteria.
206
00:07:54,900 --> 00:07:58,469
You put it in a garbage bag with toilet
water and then you let it ferment.
207
00:07:59,819 --> 00:08:00,908
Ferment where?
208
00:08:00,943 --> 00:08:01,743
Under the bed.
209
00:08:02,149 --> 00:08:04,439
Strain it through your socks
and then you're ready to go.
210
00:08:05,194 --> 00:08:07,292
If you're desperate enough,
it tastes like a martini.
211
00:08:07,327 --> 00:08:08,356
Oh, yeah?
212
00:08:08,984 --> 00:08:11,341
Yeah. You don't know
what it's like to need a drink.
213
00:08:12,146 --> 00:08:13,157
I can imagine.
214
00:08:13,823 --> 00:08:16,234
Okay. To check for blood loss, we're
going to have to do a rectal exam.
215
00:08:17,169 --> 00:08:18,821
A what? No, no, no, no, no.
216
00:08:18,856 --> 00:08:21,779
I spent the last nine years
avoiding rectals. No.
217
00:08:21,814 --> 00:08:23,779
It's the only way for me to know
that there's any gastrointestinal...
218
00:08:23,814 --> 00:08:25,675
You're gonna stick
your finger up my ass?
219
00:08:25,710 --> 00:08:28,519
My gloved and lubricated finger, yeah.
220
00:08:28,554 --> 00:08:29,354
No.
221
00:08:30,491 --> 00:08:32,225
I'm sure it's smaller
than your bowel movements.
222
00:08:32,260 --> 00:08:34,808
Listen, boss-- exit
only. You understand?
223
00:08:35,053 --> 00:08:36,245
Exit only.
224
00:08:36,589 --> 00:08:39,024
If you're bleeding internally,
it could be life-threatening.
225
00:08:44,287 --> 00:08:45,185
Okay. fine.
226
00:08:46,046 --> 00:08:48,506
Can I...? Maybe we can
cover me up or something.
227
00:08:48,541 --> 00:08:49,435
I don't want it.
228
00:08:50,498 --> 00:08:51,219
Would I hurt you?
229
00:08:51,220 --> 00:08:52,592
No! I don't want it!
230
00:08:52,627 --> 00:08:54,399
Look at me, I'm not going
to hurt you, okay?
231
00:08:54,434 --> 00:08:55,448
I want my dad!
232
00:08:55,483 --> 00:08:56,498
You don't have to worry.
233
00:08:56,533 --> 00:08:57,333
Where's my dad?
234
00:08:57,356 --> 00:08:58,905
Look at me, I'm not
going to hurt you, okay?
235
00:08:58,940 --> 00:09:00,086
I want my dad!
236
00:09:00,121 --> 00:09:01,994
I don't want to get a shot!
237
00:09:02,029 --> 00:09:04,008
Look at me. I'm not gonna
hurt you, okay?
238
00:09:04,043 --> 00:09:04,969
Pally?
239
00:09:11,682 --> 00:09:12,705
What's your name?
240
00:09:13,226 --> 00:09:14,026
Jeremy.
241
00:09:16,328 --> 00:09:20,165
Jeremy, you know, the way
I see it, doctors are mean.
242
00:09:20,669 --> 00:09:22,563
They wanna make us cry,
but you know what?
243
00:09:23,948 --> 00:09:27,200
If you don't, I won't.
What do you say?
244
00:09:29,361 --> 00:09:30,964
Let's show 'em.
Let's both not cry.
245
00:09:32,323 --> 00:09:33,532
Okay, kid?
246
00:09:34,653 --> 00:09:35,932
Okay, Jeremy.
247
00:09:38,638 --> 00:09:40,783
It's okay. It's okay. It's all right.
248
00:09:40,818 --> 00:09:41,687
See?
249
00:09:45,844 --> 00:09:47,510
That's it. Don't worry It's okay.
250
00:09:47,865 --> 00:09:49,865
There it is. Get that. That's it.
251
00:09:50,412 --> 00:09:52,720
See? Hey, that wasn't bad, was it?
252
00:09:55,044 --> 00:09:58,366
We have to put a tube down
your nose into your stomach
253
00:09:58,401 --> 00:10:00,265
to figure out what's
causing the bleeding.
254
00:10:00,266 --> 00:10:03,356
No, the docs in the joint gave me
one of those for my pancreatitis.
255
00:10:03,959 --> 00:10:05,755
We're going to numb it up
so it won't be too bad.
256
00:10:05,790 --> 00:10:06,531
Great.
257
00:10:06,532 --> 00:10:09,165
We won't keep the tube in
any longer than necessary, okay?
258
00:10:09,631 --> 00:10:10,581
Sit him up.
259
00:10:14,598 --> 00:10:16,169
You know, I used to be an artist.
260
00:10:16,204 --> 00:10:17,004
Open.
261
00:10:17,761 --> 00:10:20,681
Pressure's up to 110/76.
262
00:10:20,716 --> 00:10:21,956
What kind of artist?
263
00:10:21,991 --> 00:10:23,788
I-I did some painting.
264
00:10:23,823 --> 00:10:25,877
A mural for my wife's church.
265
00:10:27,125 --> 00:10:31,125
You know, mostly I, uh, I earned
my living as a contractor,
266
00:10:31,191 --> 00:10:34,234
a carpenter-- that sort of
thing-- fixing old places up.
267
00:10:34,660 --> 00:10:36,699
You all could use my help around here.
268
00:10:36,734 --> 00:10:39,433
Okay, if you swallow it while
we pass it, it'll go down easier.
269
00:10:39,468 --> 00:10:40,736
All right, all right, all right.
270
00:10:45,601 --> 00:10:46,766
Okay.
271
00:10:48,002 --> 00:10:49,344
It's going down.
272
00:10:49,379 --> 00:10:51,355
Keep swallowing. It's
going down. That's good.
273
00:10:51,590 --> 00:10:52,482
Very good.
274
00:10:55,823 --> 00:10:56,985
All set.
275
00:10:57,390 --> 00:10:58,397
Relax.
276
00:10:58,432 --> 00:10:59,970
Okay. Hook it up to low suction.
277
00:11:00,005 --> 00:11:01,766
Yeah, I was mixed up before.
278
00:11:03,063 --> 00:11:06,329
I get confused in my head.
I-I-I'm better now.
279
00:11:06,770 --> 00:11:08,305
Like you think you're going on a trip?
280
00:11:10,045 --> 00:11:11,079
When you were in the waiting room,
281
00:11:11,114 --> 00:11:12,972
you kept asking me
what time your flight was.
282
00:11:13,007 --> 00:11:15,286
Sometimes it's a train or a bus.
283
00:11:15,321 --> 00:11:16,570
Sometimes it's a boat.
284
00:11:17,525 --> 00:11:19,624
One time, I was
getting ready to parachute.
285
00:11:20,004 --> 00:11:21,849
So is that what the
suitcase is all about?
286
00:11:21,884 --> 00:11:23,416
No, I always have that.
287
00:11:23,451 --> 00:11:26,828
You leave anything behind at the flop,
it won't be there when you get back.
288
00:11:26,863 --> 00:11:28,365
The scumbags steal it.
289
00:11:28,400 --> 00:11:32,400
NG output one liter at 11:32.
290
00:11:32,528 --> 00:11:34,335
Blood's too dark for an ulcer.
291
00:11:35,580 --> 00:11:36,656
Varices?
292
00:11:36,691 --> 00:11:37,351
What's that?
293
00:11:37,352 --> 00:11:40,857
That's when the elevated pressure
in your liver backs up.
294
00:11:41,291 --> 00:11:44,166
The veins of the esophagus
become engorged and fragile
295
00:11:44,201 --> 00:11:46,236
and can bleed a lot,
sometimes uncontrollably.
296
00:11:48,635 --> 00:11:49,802
Emesis basin!
297
00:11:56,545 --> 00:11:59,271
Oh, you made me worse. Get...
Get it out of me.
298
00:11:59,271 --> 00:12:00,215
Mr. Metcalf.
299
00:12:01,338 --> 00:12:02,675
- Get it out!
- Okay.
300
00:12:03,577 --> 00:12:05,528
- That has to stay in.
- Get it out of me!
301
00:12:05,529 --> 00:12:07,593
- Okay, soft restraints.
- Get the tube out.
302
00:12:07,726 --> 00:12:09,547
Pressure's dropping,
82/66, tachy at 130.
303
00:12:09,582 --> 00:12:11,945
Another liter and two units
of type-specific,
304
00:12:11,980 --> 00:12:13,376
and call G.I. down here now.
305
00:12:13,686 --> 00:12:14,617
He needs a room.
306
00:12:16,283 --> 00:12:17,211
Trauma One is open.
307
00:12:17,212 --> 00:12:20,073
Okay. Mr. Metcalf, is there anyone
we can call for you?
308
00:12:20,108 --> 00:12:21,276
You mentioned you had a wife.
309
00:12:21,311 --> 00:12:21,956
No.
310
00:12:21,957 --> 00:12:24,639
- Children, siblings?
- No. No. Nobody that'll come.
311
00:12:24,640 --> 00:12:25,560
Okay, let's get him up to X ray.
312
00:12:25,641 --> 00:12:27,643
Stef, you stay with him. Okay, sweetie?
I'll see you back here in an hour.
313
00:12:27,643 --> 00:12:28,843
Pratt, with us.
314
00:12:28,878 --> 00:12:30,479
Make it four units type-specific.
315
00:12:31,027 --> 00:12:33,387
Type-specific'll take too long.
Get O-neg out of the cooler!
316
00:12:33,714 --> 00:12:35,076
Get these things off me.
Don't tie me down!
317
00:12:35,111 --> 00:12:36,934
You can't keep tying me down!
318
00:12:37,191 --> 00:12:39,065
Let's go, people.
Prime the rapid infuser.
319
00:12:39,066 --> 00:12:41,139
- Subclavian on the right?
- Yeah. Prep the chest.
320
00:12:42,313 --> 00:12:43,989
Let's go, people.
Prime the rapid infuser.
321
00:12:44,024 --> 00:12:46,047
- Subclavian on the right?
- Ok, preping the chest.
322
00:12:46,102 --> 00:12:47,228
O-neg here.
323
00:12:47,263 --> 00:12:51,078
Squeeze in the first units.
Sam, second on the infuser. Pratt...
324
00:12:51,079 --> 00:12:52,205
Push the octreotide.
325
00:12:52,917 --> 00:12:53,999
You've been paying attention, huh?
326
00:12:54,034 --> 00:12:55,211
You need me to do something?
327
00:12:55,246 --> 00:12:56,848
Yes, cycle the dynamap
when it's ready.
328
00:12:57,643 --> 00:12:59,953
A little sandostatin's not going
to make his chances any better.
329
00:12:59,988 --> 00:13:02,335
Diminished blood flow
through the portal system.
330
00:13:02,370 --> 00:13:03,492
Yeah, but what's the point?
331
00:13:03,527 --> 00:13:05,300
The odds of him making it
are what, 30%?
332
00:13:05,335 --> 00:13:07,156
Another 200cc's out the NG tube.
333
00:13:07,191 --> 00:13:09,720
He's that sick, even though he was
just lucid and talking?
334
00:13:09,755 --> 00:13:11,995
He's right on the edge.
All he needs is a little push.
335
00:13:11,995 --> 00:13:13,991
You know what, Pratt?
We got a lot of hands in here.
336
00:13:13,992 --> 00:13:15,507
So you want attending now?
337
00:13:15,567 --> 00:13:17,341
What, no one wants
to be a nurse anymore?
338
00:13:17,342 --> 00:13:18,024
Is he taking any meds?
339
00:13:18,025 --> 00:13:20,218
Check his bag. He said
all his stuff is in there.
340
00:13:21,081 --> 00:13:21,942
First unit's up.
341
00:13:22,486 --> 00:13:23,412
11:35.
342
00:13:23,447 --> 00:13:25,255
Pushing 15 mikes of octreotide.
343
00:13:27,288 --> 00:13:28,094
All right.
344
00:13:28,950 --> 00:13:31,895
- The guide wire's passing.
- Yo, hair of the dog.
345
00:13:31,900 --> 00:13:32,659
151 proof.
346
00:13:32,660 --> 00:13:33,813
What is your problem, Pratt?
347
00:13:33,848 --> 00:13:36,669
We're killing ourselves for
a non-compliant alcoholic,
348
00:13:36,704 --> 00:13:39,357
ex-con drifter with
end-stage liver failure.
349
00:13:39,358 --> 00:13:40,668
You want to get out?!
Then get out!
350
00:13:42,965 --> 00:13:44,594
You know what? It's Friday.
351
00:13:45,340 --> 00:13:47,644
I don't do lost causes on Friday.
It's a religious thing.
352
00:13:51,166 --> 00:13:52,469
Second unit's going in.
353
00:13:52,933 --> 00:13:54,929
Is there anything else in that bag
we need to know about?
354
00:13:54,964 --> 00:13:58,714
No, but there's a picture. It looks like
him and his wife and a kid maybe.
355
00:13:59,110 --> 00:14:01,380
A bunch of letters and a journal.
356
00:14:02,142 --> 00:14:05,145
Pressure's 98 over 62 at 11:37.
357
00:14:05,180 --> 00:14:06,344
I don't know. Some kind of painting.
358
00:14:06,523 --> 00:14:09,487
- Where's my passport...?
- Where's your what?
359
00:14:09,522 --> 00:14:10,813
Give me my passport.
360
00:14:10,848 --> 00:14:12,953
I can't go without my shoes.
361
00:14:12,988 --> 00:14:14,633
Go where, Mr...?
Whoa, whoa, whoa.
362
00:14:15,215 --> 00:14:15,914
Let me go.
363
00:14:15,915 --> 00:14:17,202
Head up to 20 degrees.
364
00:14:18,111 --> 00:14:19,763
And check on G.I. again.
365
00:14:19,764 --> 00:14:21,236
- Let me go. Thank you.
- I'll be right back.
366
00:14:21,271 --> 00:14:22,716
Get 'em off. Get 'em off.
367
00:14:24,964 --> 00:14:26,134
Do you have a problem with me?
368
00:14:28,533 --> 00:14:30,144
- No.
- Sam?
369
00:14:31,627 --> 00:14:32,842
I was out of line.
370
00:14:33,326 --> 00:14:34,871
Okay, let's go.
371
00:14:35,265 --> 00:14:36,678
The guy's a waste.
372
00:14:38,085 --> 00:14:40,148
Dying from something
that he's doing to himself.
373
00:14:40,183 --> 00:14:42,592
Last time I checked,
alcoholism was still a disease.
374
00:14:42,627 --> 00:14:43,693
So is suicide.
375
00:14:43,728 --> 00:14:45,923
He should catch some of that
and save us the trouble.
376
00:14:47,239 --> 00:14:49,973
- We get ones like this every day.
- Then maybe I need a day off.
377
00:14:52,357 --> 00:14:53,442
This personal?
378
00:14:54,870 --> 00:14:55,811
I guess.
379
00:14:56,705 --> 00:14:58,727
Good. You and I have to talk about it.
380
00:14:59,676 --> 00:15:02,150
- You like riding me, don't you?
- I don't think I do.
381
00:15:02,307 --> 00:15:04,219
Ever since I was an intern
you've been on my back.
382
00:15:05,153 --> 00:15:06,568
- Maybe a couple of times.
- Why?
383
00:15:09,433 --> 00:15:12,227
You're good, Pratt,
but I think you could be better.
384
00:15:17,555 --> 00:15:19,251
There's a number you wrote
down here with a name.
385
00:15:19,286 --> 00:15:21,582
"Bobby?" Should we call him, Charlie?
386
00:15:21,617 --> 00:15:23,996
No. No, don't call him, please.
387
00:15:24,031 --> 00:15:26,188
I don't want anybody
to call him, okay?
388
00:15:26,223 --> 00:15:28,810
No calling. I-I don't want to see him.
389
00:15:30,287 --> 00:15:34,540
Mr. Metcalf, the veins at the end
of your esophagus are bleeding a lot.
390
00:15:34,541 --> 00:15:36,710
This is a result of your cirrhosis.
391
00:15:37,718 --> 00:15:42,469
That also means you have less than
50% chance of surviving.
392
00:15:47,843 --> 00:15:49,881
This is surviving for how long?
393
00:15:49,916 --> 00:15:51,190
A few months?
394
00:15:51,225 --> 00:15:52,813
Months? Months? What?
395
00:15:54,474 --> 00:15:55,357
Not that long.
396
00:15:55,791 --> 00:15:59,514
What we need to know is if you stop
breathing or your heart gives out,
397
00:15:59,549 --> 00:16:01,843
do you want us to use heroic measures?
398
00:16:08,103 --> 00:16:09,703
Heroic what?
399
00:16:09,738 --> 00:16:13,366
You want us to do CPR, shock your heart
or put you on a breathing machine?
400
00:16:13,401 --> 00:16:14,930
Wait, wait, wait, wait.
401
00:16:15,452 --> 00:16:16,773
You saying now?
402
00:16:18,259 --> 00:16:21,094
You're, you're saying now,
you mean like, today?
403
00:16:23,686 --> 00:16:24,660
No, no, no.
404
00:16:24,695 --> 00:16:27,300
Look, no, I have a lot
of things that I have to do.
405
00:16:27,335 --> 00:16:29,232
- I'm just not ready.
- Okay.
406
00:16:29,267 --> 00:16:31,068
I'm not ready. I'm, I'm...
407
00:16:31,103 --> 00:16:32,845
Okay, the man wants it all.
408
00:16:34,156 --> 00:16:35,123
Okay.
409
00:16:39,962 --> 00:16:42,572
I'm Adler from G.I. How bad?
410
00:16:43,765 --> 00:16:45,560
About 2� liters of output.
411
00:16:45,705 --> 00:16:47,945
Pre-load the scope
with a Saeed six-shooter.
412
00:16:48,888 --> 00:16:50,466
What? What's a six-shooter?
413
00:16:50,501 --> 00:16:52,160
We're going to look down your esophagus
414
00:16:52,605 --> 00:16:55,265
and try to band the veins
to stop the bleeding.
415
00:16:55,266 --> 00:16:56,528
What's the deal with your suction?
416
00:16:57,070 --> 00:16:58,617
- Turn it up.
- I did.
417
00:16:59,186 --> 00:17:00,853
Nothing's coming out, great.
418
00:17:00,888 --> 00:17:01,820
Check in two, Abby?
419
00:17:01,855 --> 00:17:03,998
Jane, get on the phone
about a portable unit.
420
00:17:04,033 --> 00:17:05,235
You guys have suction in here?
421
00:17:05,270 --> 00:17:06,330
Last time I checked.
422
00:17:06,365 --> 00:17:07,732
- What time is it?
- 11:40. Why?
423
00:17:08,257 --> 00:17:10,073
They got 23 minutes,
or we're eating for free.
424
00:17:10,108 --> 00:17:12,695
- Is your patient stable?
- Smoke inhalation with wheezing.
425
00:17:12,895 --> 00:17:13,894
Okay, we need the room.
426
00:17:14,424 --> 00:17:15,495
You into pepperoni, Abby?
427
00:17:15,711 --> 00:17:17,624
Do you have ADD?
Come on! Let's go.
428
00:17:17,659 --> 00:17:19,971
We need it now, Ray.
We're good in here.
429
00:17:19,972 --> 00:17:21,632
This guy may just need to be tubed.
430
00:17:21,667 --> 00:17:22,973
This guy might need to be pronounced.
431
00:17:23,008 --> 00:17:26,143
I hope you're not a veggie,
'cause I got meat on everything.
432
00:17:26,178 --> 00:17:26,899
See you later.
433
00:17:29,732 --> 00:17:31,656
Cetacaine and bite block.
434
00:17:31,691 --> 00:17:32,934
A little more numbing spray, Charlie.
435
00:17:32,969 --> 00:17:34,551
Push two of versed.
436
00:17:36,569 --> 00:17:39,501
All right, Charlie,
once we're ready to start,
437
00:17:39,536 --> 00:17:41,465
you're going to have to keep
this in between your teeth
438
00:17:41,500 --> 00:17:43,913
because it stops you from biting
down on the fiber-optic scope.
439
00:17:43,948 --> 00:17:46,844
- Check your monitor.
- Is this Bobby, Charlie?
440
00:17:48,300 --> 00:17:49,267
Is that your son?
441
00:17:50,102 --> 00:17:50,929
Yeah.
442
00:17:51,469 --> 00:17:53,690
- And your wife?
- Evelyn.
443
00:17:53,691 --> 00:17:54,684
Pretty.
444
00:17:55,256 --> 00:17:56,539
You want me to call her?
445
00:17:56,574 --> 00:17:58,368
No, she's gone.
446
00:17:58,403 --> 00:18:00,304
It's been a long time.
447
00:18:01,340 --> 00:18:03,778
What about Bobby?
Must be all grown up by now, huh?
448
00:18:03,919 --> 00:18:06,889
He's 19. He's going to be
20 next month. He's in college.
449
00:18:07,738 --> 00:18:09,135
Let's try to reach him, okay?
450
00:18:10,939 --> 00:18:13,066
I haven't talked to him
since he was little.
451
00:18:13,101 --> 00:18:15,835
His aunt gave me that number
when I got out of prison, but...
452
00:18:15,870 --> 00:18:18,350
Well, it's all the more
reason to use it now.
453
00:18:22,404 --> 00:18:23,493
Let's pull the NG.
454
00:18:24,861 --> 00:18:26,347
Okay, Charlie, here we go.
455
00:18:43,330 --> 00:18:46,435
- How's his pressure?
- 108 over 58.
456
00:18:46,470 --> 00:18:47,667
Okay, ready to go.
457
00:18:47,702 --> 00:18:50,046
Hi, I'm looking for Bobby Metcalf?
458
00:18:52,778 --> 00:18:56,026
Okay. You know what?
Can you actually wake him up for me?
459
00:19:03,657 --> 00:19:05,910
Hi, Bobby, my name is Samantha Taggart.
460
00:19:05,945 --> 00:19:08,072
I'm an ER nurse at the
County General in Chicago.
461
00:19:08,107 --> 00:19:10,252
- Grade-two varices?
- Grade three.
462
00:19:10,345 --> 00:19:14,178
Yeah, we have your father here,
and, uh... Yeah.
463
00:19:14,213 --> 00:19:15,259
And he's pretty sick.
464
00:19:15,294 --> 00:19:16,889
Four columns, two hemorrhagic.
465
00:19:16,890 --> 00:19:20,024
Two bands at each bleeding site,
one at the others.
466
00:19:20,507 --> 00:19:23,557
Uh, no, he's, well, he's out of jail.
467
00:19:24,649 --> 00:19:26,916
I don't know. For a while, I think.
468
00:19:26,916 --> 00:19:28,255
Systolic's down to 90.
469
00:19:29,476 --> 00:19:31,570
Is there any way you can come down
here and be with him?
470
00:19:31,605 --> 00:19:34,240
Probably the versed.
500cc saline bolus.
471
00:19:35,309 --> 00:19:38,677
Uh, no. You know what. He can't talk
right now because he's in a procedure.
472
00:19:40,592 --> 00:19:42,409
Sucking the varix into the cap.
473
00:19:44,136 --> 00:19:45,080
Okay, hold on.
474
00:19:47,638 --> 00:19:48,979
He wants to talk to you.
475
00:19:50,035 --> 00:19:51,596
Sorry. That needs to stay in.
476
00:19:52,878 --> 00:19:53,887
And...
477
00:19:56,294 --> 00:19:57,511
firing.
478
00:20:01,534 --> 00:20:04,294
Okay, let's talk.
479
00:20:07,500 --> 00:20:11,323
Okay, you guys, I'm gonna put Mr.
Metcalf's son on the phone for a minute, okay?
480
00:20:21,421 --> 00:20:22,687
Bobby?
481
00:20:24,272 --> 00:20:27,357
Dad? Is it you?
482
00:20:27,978 --> 00:20:30,945
Yeah... it's me.
483
00:20:32,041 --> 00:20:35,394
- So you're sick huh? You dying?
- No, no, no, no.
484
00:20:35,395 --> 00:20:36,804
Nurse, is he dying?
485
00:20:37,481 --> 00:20:38,784
He's very sick.
486
00:20:42,678 --> 00:20:46,680
What am I supposed to say...
huh, Dad?
487
00:20:48,894 --> 00:20:51,047
It's been a long time,
There's so many things I...
488
00:20:52,041 --> 00:20:53,112
Yeah?
489
00:20:53,159 --> 00:20:55,285
I don't know. I...
490
00:21:01,004 --> 00:21:02,660
- Hey, Dad?
- Yeah.
491
00:21:04,196 --> 00:21:05,528
Nice knowing you.
492
00:21:32,221 --> 00:21:34,037
I told you you shouldn't call him.
493
00:21:36,918 --> 00:21:38,271
Firing.
494
00:21:38,887 --> 00:21:40,094
Good.
495
00:21:40,129 --> 00:21:41,149
Turn up my section.
496
00:21:41,184 --> 00:21:43,270
- Can you band it?
- Not if I can't see it.
497
00:21:43,841 --> 00:21:47,109
- Mr. Metcalf? Mr. Metcalf?
- BP 68 over 32.
498
00:21:47,144 --> 00:21:48,230
I can't even feel a pulse.
499
00:21:48,265 --> 00:21:49,091
Bobby?
500
00:21:50,742 --> 00:21:51,852
Bobby?!
501
00:21:55,181 --> 00:21:56,101
Bobby?!
502
00:21:56,544 --> 00:21:57,697
He's bleeding out.
503
00:21:58,353 --> 00:21:59,639
Okay, turn him over.
504
00:21:59,674 --> 00:22:02,039
Another two units
on the infuser. Ambu-bag!
505
00:22:03,558 --> 00:22:05,430
Come on in. The water's warm.
506
00:22:07,872 --> 00:22:09,372
Try the femoral.
507
00:22:09,373 --> 00:22:11,379
- Get another four units up here.
- FFP after these two!
508
00:22:12,250 --> 00:22:14,937
Hey! Hey, you dumb son of a bitch!
509
00:22:16,895 --> 00:22:19,034
Hey, you dumb son of a bitch!
510
00:22:28,080 --> 00:22:29,839
Thought we lost you
there for a second.
511
00:22:33,691 --> 00:22:34,943
Bobby?
512
00:22:35,641 --> 00:22:37,119
Uh, we had him on the phone.
513
00:22:38,848 --> 00:22:40,216
Is he coming?
514
00:22:41,090 --> 00:22:44,112
No. No, he's not coming, man.
515
00:22:44,948 --> 00:22:47,435
BP's 86/42 at 11:44.
516
00:22:48,341 --> 00:22:49,496
You want the FFP?
517
00:22:49,531 --> 00:22:51,197
Yeah, and another unit
of packed cells.
518
00:22:51,232 --> 00:22:52,413
Dr. Kovac.
519
00:23:01,412 --> 00:23:03,466
How long have you been
out of touch with him?
520
00:23:04,270 --> 00:23:05,619
Your son.
521
00:23:05,654 --> 00:23:09,336
Long time. Since I went to prison.
522
00:23:10,381 --> 00:23:12,359
Well, even in prison,
he's still your kid.
523
00:23:14,887 --> 00:23:15,843
Blood's here.
524
00:23:15,878 --> 00:23:17,830
You don't know what it's like.
525
00:23:17,865 --> 00:23:21,112
I know if I had a kid, I'd want to do
everything I could to stay with him.
526
00:23:21,147 --> 00:23:24,230
I need a Linton tube,
Kelly and a 60cc syringe.
527
00:23:25,490 --> 00:23:27,723
You think you know, but you don't.
528
00:23:29,607 --> 00:23:31,678
How it could all switch on you.
529
00:23:34,431 --> 00:23:36,940
How life could turn on a dime.
530
00:23:39,047 --> 00:23:41,547
Gets broke and you can't s...
531
00:23:42,087 --> 00:23:44,361
you can't see a way to fix it.
532
00:23:44,396 --> 00:23:47,963
Mr. Metcalf, the specialist,
uh, here thinks
533
00:23:47,998 --> 00:23:49,766
we can control your
breathing with the scope.
534
00:23:49,801 --> 00:23:51,027
So you want a Linton tube?
535
00:23:51,062 --> 00:23:52,157
Wha... What?
536
00:23:52,192 --> 00:23:55,445
We pass a large balloon
into your stomach.
537
00:23:55,895 --> 00:23:58,450
So it helps us keep pressure
on your veins.
538
00:24:00,343 --> 00:24:01,988
All right, well, what's to lose?
539
00:24:03,481 --> 00:24:04,904
I'll test the balloon.
540
00:24:07,400 --> 00:24:11,162
It was April 10, 1992.
541
00:24:13,572 --> 00:24:15,592
Bobby was turning eight.
542
00:24:18,337 --> 00:24:24,132
My wife asked me to go get some
stuff for the party, but I... I-I st...
543
00:24:24,167 --> 00:24:27,844
I stayed so I could finish putting
together this robot for him.
544
00:24:27,879 --> 00:24:29,868
You know, so I made her go.
545
00:24:30,427 --> 00:24:35,775
From the street, I hear a thud...
and the scream.
546
00:24:38,535 --> 00:24:40,715
And I go to the window to look out.
547
00:24:42,677 --> 00:24:48,012
And... and she's... she's lying there
like she's asleep on the street.
548
00:24:48,651 --> 00:24:50,268
And the ice cream cake...
549
00:24:50,314 --> 00:24:53,291
the ice cream cake was
all around her on the pavement.
550
00:24:53,883 --> 00:24:55,141
Five syringes.
551
00:24:56,332 --> 00:24:58,731
So there I am,
there I am with this...
552
00:24:58,766 --> 00:25:01,348
with this little boy to raise.
553
00:25:01,383 --> 00:25:02,822
And what do I do?
554
00:25:05,644 --> 00:25:09,828
I start drinking...
and getting high.
555
00:25:13,294 --> 00:25:15,598
I couldn't keep it together.
556
00:25:17,498 --> 00:25:19,492
I couldn't keep it together.
557
00:25:21,175 --> 00:25:23,791
And then I stabbed some guy in a bar,
558
00:25:23,826 --> 00:25:27,840
Just for... just for... just for nothing.
559
00:25:29,473 --> 00:25:31,701
For nothing. 'Cause
he looked at me wrong.
560
00:25:34,267 --> 00:25:35,474
This one's good.
561
00:25:35,509 --> 00:25:37,847
We can go up to 750 for hemostasis.
562
00:25:39,674 --> 00:25:41,230
Okay, ready, Mr. Metcalf?
563
00:26:04,376 --> 00:26:06,706
So, where was your son after that?
564
00:26:07,960 --> 00:26:09,408
With my wife's folks.
565
00:26:09,443 --> 00:26:10,676
Listen for bowel sounds.
566
00:26:12,140 --> 00:26:15,301
At first, they would bring him
by on visiting days, but...
567
00:26:16,872 --> 00:26:19,180
after a while that stopped.
568
00:26:20,132 --> 00:26:22,956
And then the letters started
coming back unopened.
569
00:26:23,428 --> 00:26:24,623
You know what?
570
00:26:24,658 --> 00:26:26,760
I-I-I-I don't feel good.
Something's wrong.
571
00:26:26,795 --> 00:26:28,568
Something's wrong.
572
00:26:28,973 --> 00:26:31,611
BUN 74, creatinine 8.2.
573
00:26:31,646 --> 00:26:33,553
Okay, call renal and throw in a Foley.
574
00:26:34,439 --> 00:26:36,304
Hey, we should think about TIPS.
575
00:26:37,126 --> 00:26:37,917
What's that?
576
00:26:38,466 --> 00:26:42,156
TIPS stands for Trans-jugular
Inter-hepatic Porta-systemic Shunt.
577
00:26:43,523 --> 00:26:46,396
Uh, we put a catheter
from your neck to your belly.
578
00:26:46,431 --> 00:26:50,688
By bridging the two vessels, we can bypass
the liver and slow down the bleeding.
579
00:26:50,986 --> 00:26:52,865
And how much time would that give me?
580
00:26:53,132 --> 00:26:54,537
It's hard to say.
581
00:26:56,430 --> 00:26:58,911
- No urine output.
- Hepatorenal syndrome.
582
00:27:00,259 --> 00:27:03,439
- Your... your kidneys are not working.
- He needs dialysis.
583
00:27:04,011 --> 00:27:05,241
I'll make the call.
584
00:27:06,079 --> 00:27:07,572
GSW to the belly.
585
00:27:07,607 --> 00:27:09,302
- Not here, Chuny.
- There's nowhere else.
586
00:27:09,560 --> 00:27:11,825
'Kay, move him over, and keep
traction on the Linton.
587
00:27:11,860 --> 00:27:12,837
Hold on.
588
00:27:12,872 --> 00:27:13,938
'Kay, go ahead.
589
00:27:13,973 --> 00:27:16,875
Okay, let's transfer him.
One, two, three.
590
00:27:18,199 --> 00:27:20,818
There's no meds,
no allergies, no past history.
591
00:27:20,853 --> 00:27:22,574
NG, Foley and portable chest.
592
00:27:22,609 --> 00:27:24,579
Bastard shot me
for stealing my own spliff.
593
00:27:24,614 --> 00:27:25,982
I need another nurse in here.
594
00:27:26,017 --> 00:27:27,541
Said it was his, but it was mine.
595
00:27:29,338 --> 00:27:31,453
- What's going on?
- They just need to stabilize him.
596
00:27:31,453 --> 00:27:34,127
I want my own damn room!
Get the hell outta here, man!
597
00:27:34,128 --> 00:27:37,339
- Screw you, jerk-off.
- Okay, doctors only talking now.
598
00:27:37,374 --> 00:27:38,352
Damn, that's hard.
599
00:27:38,786 --> 00:27:41,683
Even a gunshot wound to the belly
don't buy a man some privacy.
600
00:27:43,867 --> 00:27:46,595
'Kay, two grams of
Cefoxitin I.V. piggyback.
601
00:27:47,456 --> 00:27:49,032
That's a house we rented one summer.
602
00:27:50,122 --> 00:27:53,089
There was a lake nearby.
I-I took Bobby fishing...
603
00:27:53,124 --> 00:27:56,200
Periumbilical GSW
with intestinal prolapse.
604
00:27:56,235 --> 00:27:57,885
Hey, what about the on-deck batter?
605
00:27:57,920 --> 00:28:00,477
- We're waiting for a TIPS and IR.
- That sounds bad.
606
00:28:00,572 --> 00:28:01,731
Let's get him up for an ex-lap.
607
00:28:01,766 --> 00:28:03,448
Portable monitor, let's go.
608
00:28:03,483 --> 00:28:05,536
- What about X rays?
- We'll get them upstairs.
609
00:28:05,689 --> 00:28:07,756
T minus eleven minutes
on those pizzas.
610
00:28:09,892 --> 00:28:12,910
IR's already on the floor,
and Renal's on the way.
611
00:28:14,028 --> 00:28:16,539
Luka, he's getting tremulous.
612
00:28:16,969 --> 00:28:19,151
Haven't had a drink since last night.
613
00:28:19,186 --> 00:28:20,677
It's alcohol withdrawal.
614
00:28:20,712 --> 00:28:23,599
- Dr. Pratt?
- Yeah, that'd be me.
615
00:28:23,634 --> 00:28:25,239
Hey. Ramirez, nephrology.
616
00:28:25,906 --> 00:28:27,139
All right, who's this guy?
617
00:28:27,140 --> 00:28:29,351
- We're gonna need central access.
- He's got a subclavian.
618
00:28:29,370 --> 00:28:31,647
That's great, let's consent him
and start the run.
619
00:28:31,682 --> 00:28:33,610
What? What is he talking about?
620
00:28:33,645 --> 00:28:35,608
He's here for the dialysis
that we discussed.
621
00:28:36,304 --> 00:28:37,667
I never discussed it.
622
00:28:38,585 --> 00:28:41,058
You discussed it.
I never... I never discussed it.
623
00:28:41,539 --> 00:28:42,928
Alfonso, how are you?
624
00:28:42,963 --> 00:28:46,119
- Is this a TIPS patient?
- Yeah, and we should go first.
625
00:28:47,299 --> 00:28:48,732
Uh, wha... wh-what
are you talking about?
626
00:28:48,767 --> 00:28:50,008
That's what's gonna prolong his life.
627
00:28:50,009 --> 00:28:52,896
Yeah, without the dialysis, he'll bleed out
the minute you spike through his liver.
628
00:28:52,931 --> 00:28:55,225
What? What? Spike my liver?
629
00:28:55,260 --> 00:28:58,396
Will his pressure even tolerate dialysis
if the varices keep bleeding?
630
00:28:58,431 --> 00:28:59,899
I-I don't understand.
631
00:28:59,934 --> 00:29:01,217
I can support his pressure.
632
00:29:01,252 --> 00:29:03,221
The Linton tube is supporting
his pressure, and only barely.
633
00:29:03,256 --> 00:29:04,692
Wh-What are you talking about?
634
00:29:04,727 --> 00:29:05,456
Dr. Kovac.
635
00:29:05,491 --> 00:29:07,765
Well, he's gonna need dialysis
three times a week.
636
00:29:07,800 --> 00:29:09,169
Yeah, for the rest of his life.
637
00:29:09,204 --> 00:29:10,512
Hey... hey...
638
00:29:10,547 --> 00:29:11,428
TIPS is not a cure.
639
00:29:11,463 --> 00:29:12,693
It's a bridge to a liver transplant.
640
00:29:12,728 --> 00:29:13,888
We all know that's not gonna happen.
641
00:29:13,923 --> 00:29:15,632
Hey, hey, hey, hey.
642
00:29:15,957 --> 00:29:17,272
I'm right here.
643
00:29:19,021 --> 00:29:20,039
- Yeah.
- Talk to me.
644
00:29:21,341 --> 00:29:22,063
Sorry.
645
00:29:26,766 --> 00:29:28,396
Now, you can't fix my kidneys?
646
00:29:28,431 --> 00:29:31,792
You're gonna need dialysis,
three times a week.
647
00:29:33,793 --> 00:29:36,833
And what about my liver problem
and the... and the bleeding?
648
00:29:36,868 --> 00:29:38,645
The TIPS is a temporary measure.
649
00:29:38,680 --> 00:29:40,517
Your best hope is for
a liver transplant.
650
00:29:41,851 --> 00:29:43,297
I-I-I don't understand.
651
00:29:43,332 --> 00:29:45,465
Wh-Wh-What are the odds of that?
652
00:29:46,444 --> 00:29:48,526
Based on your history
of drinking, not good.
653
00:29:51,822 --> 00:29:54,691
Is there... is there any chance
that I'm gonna be walking out of here?
654
00:29:55,632 --> 00:29:57,533
With the dialysis and the TIPS...
655
00:29:57,568 --> 00:29:58,600
I mean today.
656
00:29:59,919 --> 00:30:02,630
What are the chances that I'm
gonna walk out of here today?
657
00:30:04,585 --> 00:30:05,493
None.
658
00:30:15,400 --> 00:30:16,809
I-I-I don't want it.
659
00:30:20,019 --> 00:30:21,592
I don't want anything, then.
660
00:30:22,372 --> 00:30:25,448
If you don't have the TIPS procedure,
we can't control the bleeding--
661
00:30:25,483 --> 00:30:26,179
you'll die.
662
00:30:26,214 --> 00:30:27,202
Yeah, I get it. I get it.
663
00:30:30,691 --> 00:30:32,321
Just stop everything.
664
00:30:33,935 --> 00:30:36,298
No more blood transfusions?
No breathing machine?
665
00:30:36,299 --> 00:30:37,342
- No CPR?
- No.
666
00:30:37,377 --> 00:30:39,436
I need it to be very clear, Charlie--
667
00:30:39,471 --> 00:30:43,673
if we don't continue with the treatment,
do you understand what will happen?
668
00:30:47,283 --> 00:30:51,109
Yeah. Yeah.
669
00:31:01,744 --> 00:31:03,506
Okay, Mr. Metcalf is a DNR.
670
00:31:06,229 --> 00:31:07,583
11:57.
671
00:31:08,940 --> 00:31:10,671
Wait, wait a minute, wait a minute.
672
00:31:10,734 --> 00:31:13,669
- Hey, he's not competent. Come on.
- It's what he wants, Pratt.
673
00:31:15,118 --> 00:31:19,012
Can you, uh... can you
do something for this?
674
00:31:21,442 --> 00:31:23,131
Hey, could we put him
on an alcohol drip?
675
00:31:23,984 --> 00:31:25,242
You gonna get me drunk?
676
00:31:25,277 --> 00:31:27,339
Just enough to stop
the tremors, Charlie.
677
00:31:28,042 --> 00:31:30,605
Charlie, let us do the procedure.
You don't have to do this.
678
00:31:31,317 --> 00:31:34,974
Just call... could you,
um... try Bobby again.
679
00:31:36,104 --> 00:31:37,844
Try my boy, get him on the phone.
680
00:31:38,376 --> 00:31:41,210
If he knows it's really over,
he'll come.
681
00:31:41,838 --> 00:31:43,088
Okay? He'll come.
682
00:31:58,675 --> 00:32:00,193
Hey. Bobby Metcalf...?
683
00:32:02,775 --> 00:32:05,054
Oh, yeah. It's the hospital
calling again.
684
00:32:06,076 --> 00:32:07,561
Yeah, do you think you could do that?
685
00:32:07,864 --> 00:32:09,182
Okay, thank you.
686
00:32:10,694 --> 00:32:11,956
What happened?
687
00:32:11,991 --> 00:32:14,091
He went to class. His roommate's going
to see if he can find him.
688
00:32:16,343 --> 00:32:17,944
Can you take this out?
It's uncomfortable.
689
00:32:17,979 --> 00:32:20,373
- That tube's keeping you alive.
- It's uncomfortable. Please.
690
00:32:22,777 --> 00:32:23,747
Okay.
691
00:32:26,057 --> 00:32:28,250
Is there, um... is-is there a window?
692
00:32:28,251 --> 00:32:30,295
Can you open a window
and get some fresh air in here?
693
00:32:30,330 --> 00:32:31,406
Please?
694
00:32:32,179 --> 00:32:33,734
- Sam.
- Please.
695
00:32:37,005 --> 00:32:38,584
All right. Here we go.
696
00:32:41,509 --> 00:32:43,252
That's right, blow it out.
697
00:33:06,106 --> 00:33:09,340
- What is that, Lincoln Street?
- Harrison.
698
00:33:09,375 --> 00:33:10,408
I worked here over a year,
699
00:33:10,409 --> 00:33:12,542
and I never even thought about
what's outside that window.
700
00:33:13,042 --> 00:33:14,515
I've worked here six.
701
00:33:19,068 --> 00:33:20,802
It's from the tube.
I'll take care of it.
702
00:33:20,837 --> 00:33:23,119
Ten percent ethanol
at 100cc's an hour.
703
00:33:24,691 --> 00:33:26,733
You know, your booze works fast.
704
00:33:27,168 --> 00:33:28,950
Mad Dog IV, just for you.
705
00:33:31,330 --> 00:33:35,890
All this stuff, you know,
it's just blinders.
706
00:33:37,680 --> 00:33:39,173
It's just a screen.
707
00:33:40,768 --> 00:33:43,670
I don't want anything separating me
from what's happening.
708
00:33:46,400 --> 00:33:49,549
I'm not gonna run and hide from this.
709
00:33:50,165 --> 00:33:52,198
Pulse ox and dynamap
can come off.
710
00:33:53,111 --> 00:33:54,672
Last sat's 92.
711
00:33:58,197 --> 00:34:03,738
My brother Lou died...
when we were kids.
712
00:34:12,811 --> 00:34:15,418
My mom, she said...
713
00:34:25,266 --> 00:34:29,517
She said, "Charlie, Lou's
gone away on a long trip."
714
00:34:36,209 --> 00:34:40,911
Don't you just leave me here.
I want to see a doctor now.
715
00:34:50,714 --> 00:34:52,799
When is my turn, huh?!
716
00:34:53,426 --> 00:34:57,275
When's it going to
be my turn?! Huh?!
717
00:34:57,729 --> 00:34:58,897
People!
718
00:34:59,388 --> 00:35:03,642
When is it?! When is my turn?!
719
00:35:22,185 --> 00:35:24,713
170... 91...
720
00:35:26,240 --> 00:35:27,223
What are you saying?
721
00:35:28,003 --> 00:35:29,117
It's your vitals.
722
00:35:32,445 --> 00:35:34,844
- Is it starting?
- What, Charlie?
723
00:35:36,014 --> 00:35:37,355
Am I going?
724
00:35:40,484 --> 00:35:41,537
It's starting.
725
00:35:41,572 --> 00:35:44,110
Don't you people have a system?
726
00:35:44,145 --> 00:35:46,696
Isn't there any method at all?
727
00:35:48,784 --> 00:35:50,148
Don't worry, you won't be alone.
728
00:35:52,769 --> 00:35:55,371
Good. That's good.
729
00:35:56,289 --> 00:35:57,479
Someone will stay with you.
730
00:36:00,415 --> 00:36:02,729
Sam, you got this?
731
00:36:09,213 --> 00:36:12,394
Could you, um... touch me?
732
00:36:12,668 --> 00:36:13,852
Sorry?
733
00:36:16,139 --> 00:36:17,257
My face.
734
00:36:17,981 --> 00:36:19,327
Please?
735
00:36:56,156 --> 00:36:57,817
Maybe we should anchor.
736
00:36:58,578 --> 00:37:00,492
- What?
- Do you think we should keep going?
737
00:37:01,659 --> 00:37:02,953
I don't know Charlie.
738
00:37:04,769 --> 00:37:06,339
What about him?
739
00:37:06,833 --> 00:37:08,446
What do you think he wants?
740
00:37:09,082 --> 00:37:11,495
I don't know. I don't think he knows.
741
00:37:15,885 --> 00:37:17,414
Is it too late?
742
00:37:18,402 --> 00:37:20,330
Not if you don't
want it to be, Charlie.
743
00:37:22,877 --> 00:37:24,296
Watch it!
744
00:37:42,034 --> 00:37:44,293
I feel drunk again.
745
00:37:44,328 --> 00:37:46,199
- Yeah.
- Thank you.
746
00:37:48,964 --> 00:37:51,112
Okay, Mr. Metcalf, we're going to keep
747
00:37:51,147 --> 00:37:54,323
a heart monitor on and
the alcohol drip for comfort.
748
00:37:54,358 --> 00:37:55,182
Okay.
749
00:37:55,217 --> 00:37:59,061
But I'm going to take you off the octreotide
now which is the last support measure.
750
00:38:00,020 --> 00:38:01,151
Okay.
751
00:38:02,443 --> 00:38:04,423
- It shouldn't be long now.
- Okay.
752
00:38:16,356 --> 00:38:18,160
I never believed in God.
753
00:38:20,900 --> 00:38:23,411
That might bite me
in the ass now, huh?
754
00:38:24,771 --> 00:38:26,278
God will get over it.
755
00:38:58,257 --> 00:39:00,423
Do you need this? Can I take it?
756
00:39:01,017 --> 00:39:02,411
Take it.
757
00:39:06,506 --> 00:39:07,640
What?
758
00:39:10,686 --> 00:39:11,913
What can I take?
759
00:39:12,360 --> 00:39:14,031
No, never mind. Never mind.
760
00:39:19,215 --> 00:39:20,856
What's it going to be like there?
761
00:39:23,066 --> 00:39:24,394
Peaceful.
762
00:39:39,277 --> 00:39:41,434
- Come back.
- Charlie.
763
00:39:44,463 --> 00:39:45,614
Charlie...
764
00:39:47,951 --> 00:39:49,419
Get all my stuff?
765
00:39:50,499 --> 00:39:51,686
Oh, yeah.
766
00:39:52,343 --> 00:39:53,160
Yeah.
767
00:39:55,536 --> 00:39:57,279
Make sure he gets it.
768
00:39:58,232 --> 00:39:59,408
I will.
769
00:40:01,691 --> 00:40:03,149
Yeah, and give this to him.
770
00:40:13,023 --> 00:40:14,762
You never knew your dad.
771
00:40:19,249 --> 00:40:20,346
No.
772
00:40:22,961 --> 00:40:24,399
That's too bad.
773
00:40:28,536 --> 00:40:30,133
I don't let it bother me.
774
00:40:32,605 --> 00:40:34,402
I bet it bothers him.
775
00:41:15,236 --> 00:41:16,416
Bobby.
776
00:41:22,615 --> 00:41:24,106
Let me in.
777
00:41:33,815 --> 00:41:35,246
Open up.
778
00:41:39,562 --> 00:41:40,973
Let me in.
779
00:41:46,888 --> 00:41:48,845
Charlie, can you hear me?
780
00:41:55,358 --> 00:41:57,464
Charlie, can you hear me?
781
00:42:02,181 --> 00:42:03,814
Hey, pally.
782
00:42:05,233 --> 00:42:06,651
You made it.
783
00:42:11,065 --> 00:42:12,593
Uh, how do I look?
784
00:42:13,196 --> 00:42:14,583
You look okay.
785
00:42:18,420 --> 00:42:20,766
I'm so sorry.
786
00:42:30,989 --> 00:42:32,989
I'm so sorry.
787
00:42:37,838 --> 00:42:39,874
Oh, don't think about that.
788
00:42:39,909 --> 00:42:41,091
Okay?
789
00:42:41,584 --> 00:42:43,507
Just take it easy.
790
00:42:47,067 --> 00:42:50,395
It's okay... son.
791
00:42:53,188 --> 00:42:54,389
It's...
792
00:43:13,805 --> 00:43:15,028
12:04.
793
00:43:45,097 --> 00:43:46,477
I'll take that.
794
00:44:00,643 --> 00:44:02,774
Can someone just tell me that?
795
00:44:02,809 --> 00:44:04,780
How much longer?
796
00:44:04,815 --> 00:44:07,320
Ma'am, you need to wait in the room.
Let's go.
797
00:44:07,440 --> 00:44:08,600
Well, it's about time.
798
00:44:08,635 --> 00:44:10,689
You been with the same patient
for almost 45 minutes.
799
00:44:10,724 --> 00:44:13,117
Whatever happened to "treat 'em
and street 'em" Pratt?
800
00:44:13,152 --> 00:44:14,823
Do as I say, not as I do.
801
00:44:14,858 --> 00:44:17,212
All right, well, the TV
kid's back from X ray.
802
00:44:17,213 --> 00:44:18,876
He's in triage with his dad
and his sister.
803
00:44:19,388 --> 00:44:20,869
Things go south?
804
00:44:22,222 --> 00:44:23,252
He was a nice guy.
805
00:44:24,330 --> 00:44:25,530
Just a drunk.
806
00:44:26,132 --> 00:44:28,038
All right, well, there's pizzas
over here if you get hungry.
807
00:44:28,038 --> 00:44:29,701
Got you one with anchovies.
808
00:44:30,985 --> 00:44:34,101
Oh, and the delivery guy got here
at 12:04. You know what that means?
809
00:44:34,827 --> 00:44:36,400
It means he didn't make it on time.
810
00:44:36,435 --> 00:44:38,388
No, it means lunch is
on the house, my friend.
811
00:44:45,265 --> 00:44:48,188
Hey, Jeremy, little man, back so soon?
812
00:44:49,334 --> 00:44:53,405
Transcript: RaceMan
813
00:44:54,181 --> 00:44:57,958
Synchro: Bendef
814
00:44:58,310 --> 00:45:02,346
Trad: Bendef
815
00:45:02,767 --> 00:45:05,160
www.forom.com
9999
00:00:0,500 --> 00:00:2,00
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