1 00:01:38,006 --> 00:01:39,341 Is it true? 2 00:01:39,424 --> 00:01:41,343 Simi told Hector that Dr. Deranjian said 3 00:01:41,426 --> 00:01:43,053 the hospital was up for sale. 4 00:01:43,136 --> 00:01:45,555 They might turn it into an ortho center with no ER. 5 00:01:45,639 --> 00:01:47,474 Oh, they're always threatening to shut us down, 6 00:01:47,557 --> 00:01:49,434 but they never do. 7 00:01:49,517 --> 00:01:51,019 Do you believe him? 8 00:01:52,395 --> 00:01:54,773 I never trust the doctors. 9 00:01:55,982 --> 00:01:57,734 Gloria is looking for you. 10 00:01:57,817 --> 00:01:59,235 No guts, no Gloria. 11 00:01:59,319 --> 00:02:00,945 Must be time for my weekly spanking. 12 00:02:01,029 --> 00:02:03,198 Try to be nice, for all our sakes. 13 00:02:03,281 --> 00:02:05,909 You sure you're cool being here today? 14 00:02:05,992 --> 00:02:09,120 Yeah. Why wouldn't I be? 15 00:02:09,204 --> 00:02:10,497 Well, if you need to talk… 16 00:02:10,580 --> 00:02:13,708 Yeah, I won't, but thanks. 17 00:02:13,792 --> 00:02:16,836 Where's Abbot? 18 00:02:16,920 --> 00:02:18,546 Getting some air. 19 00:02:30,392 --> 00:02:32,477 Hey. 20 00:02:32,560 --> 00:02:35,063 You OK in there? 21 00:02:35,146 --> 00:02:37,649 Uh, awesome. 22 00:02:39,818 --> 00:02:42,237 I'd like to say it goes away, but I had morning sickness 23 00:02:42,320 --> 00:02:43,947 for six months with my second daughter. 24 00:02:44,781 --> 00:02:46,157 Hell, who am I kidding? 25 00:02:46,241 --> 00:02:48,159 That one still worries me sick. 26 00:02:49,828 --> 00:02:52,914 - Thanks. - But it's worth it. 27 00:02:52,998 --> 00:02:54,624 You tell anybody yet? 28 00:02:54,708 --> 00:02:57,419 Oh, no. 29 00:02:57,502 --> 00:03:00,255 Not until I pass 12 weeks. Not this time. 30 00:03:00,338 --> 00:03:02,465 Nothing but good vibes. 31 00:03:02,549 --> 00:03:05,343 But just so you know, Robby's working today. 32 00:03:05,427 --> 00:03:06,970 Today's the day Doc Adamson died. 33 00:03:07,053 --> 00:03:08,888 He hasn't worked it in four years. 34 00:03:11,474 --> 00:03:13,101 So why is he here? 35 00:03:13,184 --> 00:03:15,395 All I know is, he still blames himself 36 00:03:15,478 --> 00:03:18,273 for Adamson's death, so if he's a little prickly today, 37 00:03:18,356 --> 00:03:20,150 give him a pass, OK? 38 00:03:21,443 --> 00:03:23,570 - Right. - Thank you. 39 00:03:23,653 --> 00:03:25,447 Hang in there, kid. 40 00:03:36,124 --> 00:03:37,584 Good morning, Jack. 41 00:03:40,170 --> 00:03:42,631 What are you doing here? 42 00:03:42,714 --> 00:03:44,257 I'm working. 43 00:03:44,341 --> 00:03:47,552 And you? 44 00:03:47,636 --> 00:03:49,763 Oh, I don't know. 45 00:03:49,846 --> 00:03:52,098 Had a guy come in. 46 00:03:52,182 --> 00:03:54,684 Hit by a drunk driver in a crosswalk. 47 00:03:54,768 --> 00:03:57,270 39-year-old vet. 48 00:03:57,354 --> 00:04:00,065 Survived three tours without a scratch. 49 00:04:02,525 --> 00:04:05,528 I spent the last two hours coding him. 50 00:04:07,113 --> 00:04:09,449 That's always a rough way to end the night. 51 00:04:09,532 --> 00:04:10,825 I must have had a reason 52 00:04:10,909 --> 00:04:12,577 at one time to keep coming back, 53 00:04:12,661 --> 00:04:17,874 but I can't think of it right now. 54 00:04:17,958 --> 00:04:21,169 Because this is the job that keeps on giving. 55 00:04:21,252 --> 00:04:22,754 Nightmares. 56 00:04:22,837 --> 00:04:24,714 Ulcers. 57 00:04:24,798 --> 00:04:26,758 Suicidal tendencies. 58 00:04:29,678 --> 00:04:32,222 Besides, if you jump on my shift, 59 00:04:32,305 --> 00:04:36,101 that's just rude, man. 60 00:04:42,565 --> 00:04:45,610 I hope I'm never one of your patients. 61 00:04:45,694 --> 00:04:49,364 That makes two of us, my friend. 62 00:04:49,447 --> 00:04:52,867 I got a pregnant teen coming back today for mifepristone 63 00:04:52,951 --> 00:04:55,370 and a small bowel obstruction waiting on surgery 64 00:04:55,453 --> 00:04:57,497 for the last three hours. 65 00:04:57,580 --> 00:05:00,125 Oh, and unfortunately, 66 00:05:00,208 --> 00:05:02,502 the Kraken is still boarding in BH. 67 00:05:02,585 --> 00:05:04,129 Still? 68 00:05:04,212 --> 00:05:06,047 Guy's been here for a week waiting on a psych bed. 69 00:05:06,131 --> 00:05:08,550 Yep. He's only getting worse. 70 00:05:08,633 --> 00:05:10,969 He's catching some Zyprexa Z's at the moment. 71 00:05:11,052 --> 00:05:14,973 But when he wakes up, God help you all. 72 00:05:16,641 --> 00:05:18,560 I wrote a note for the family of my dead vet, 73 00:05:18,643 --> 00:05:21,187 if anyone shows. 74 00:05:21,271 --> 00:05:23,189 Oh, and you got the med students 75 00:05:23,273 --> 00:05:26,318 and new interns starting today, so good luck with that. 76 00:05:26,401 --> 00:05:28,153 Lucky, lucky me. 77 00:05:28,236 --> 00:05:30,697 - Sir, come back here! - No more needles! 78 00:05:30,780 --> 00:05:31,823 - Oh! - Sir! 79 00:05:31,906 --> 00:05:33,992 - No more needles! - Stop! 80 00:05:34,075 --> 00:05:35,493 Sure you want to work today, huh? 81 00:05:35,577 --> 00:05:36,911 Help me! They're gonna hurt me! 82 00:05:36,995 --> 00:05:40,915 Sir, I promise nobody is going to hurt you. 83 00:05:40,999 --> 00:05:42,917 Sir! 84 00:05:45,629 --> 00:05:47,797 Who left this mess? 85 00:05:47,881 --> 00:05:50,216 They had a rough night. 86 00:05:50,300 --> 00:05:52,260 Good morning, sunshine. 87 00:05:52,344 --> 00:05:54,137 You obviously haven't seen this board. 88 00:05:54,220 --> 00:05:55,847 Oh, we've seen worse. 89 00:05:55,930 --> 00:05:57,849 Nothing like a little challenge every now and then 90 00:05:57,932 --> 00:05:59,476 to keep everybody on their toes. 91 00:05:59,559 --> 00:06:01,102 - Dr. Robinavitch? - Yep. 92 00:06:01,186 --> 00:06:03,605 Melissa King. I will be joining you today. 93 00:06:03,688 --> 00:06:05,023 I just came from two months at the VA. 94 00:06:05,106 --> 00:06:06,399 Hey, welcome to the Pitt. 95 00:06:06,483 --> 00:06:08,026 This is Dr. Jack Abbot. 96 00:06:08,109 --> 00:06:09,861 Nice to meet you. 97 00:06:09,944 --> 00:06:12,656 I can't tell you how excited I am to be here today, so… 98 00:06:12,739 --> 00:06:15,241 Talk to me at the end of the day. 99 00:06:15,325 --> 00:06:17,661 Ignore him. He had a rough night 100 00:06:17,744 --> 00:06:20,580 and is having an ongoing existential crisis. 101 00:06:20,664 --> 00:06:23,375 Don't worry, you'll get there soon enough. 102 00:06:23,458 --> 00:06:27,504 I married my second husband, Everett, in 1964. 103 00:06:27,587 --> 00:06:31,800 He unfortunately passed in 1976 from a heart attack 104 00:06:31,883 --> 00:06:34,678 while we were vacationing in Kissimmee, Florida. 105 00:06:34,761 --> 00:06:36,554 - It was awful. - Good morning. 106 00:06:36,638 --> 00:06:39,766 We're gonna round, Dr. Mohan. 107 00:06:39,849 --> 00:06:42,310 Excuse me, Estelle. I'll be right back. 108 00:06:44,062 --> 00:06:45,897 So you know we track every resident's 109 00:06:45,981 --> 00:06:47,273 patients seen per hour. 110 00:06:47,357 --> 00:06:48,942 I was just taking her history. 111 00:06:49,025 --> 00:06:50,485 It's a brief backstory about what brought them in, 112 00:06:50,568 --> 00:06:51,945 - not an autobiography. - I was almost done. 113 00:06:52,028 --> 00:06:55,323 You hadn't even made it to this century. 114 00:06:55,407 --> 00:06:58,326 Patients, they check in for registration here. 115 00:06:58,410 --> 00:07:01,538 A nurse eyeballs them, makes sure they're not dying. 116 00:07:01,621 --> 00:07:03,999 If not, they're moved to one of two triage rooms for vitals 117 00:07:04,082 --> 00:07:05,583 and a quick chair exam where you can order 118 00:07:05,667 --> 00:07:07,335 your labs and your X-rays. 119 00:07:07,419 --> 00:07:08,920 And then they come back to… 120 00:07:09,004 --> 00:07:11,089 Waiting room, until a bed opens up. 121 00:07:11,172 --> 00:07:12,590 For how long? 122 00:07:12,674 --> 00:07:14,426 Eight hours, if they're lucky. 123 00:07:14,509 --> 00:07:15,885 A lot of times, 12. 124 00:07:15,969 --> 00:07:18,471 Uh, is it always this busy? 125 00:07:18,555 --> 00:07:20,056 Uh, no. 126 00:07:20,140 --> 00:07:22,559 It gets a lot busier. 127 00:07:25,020 --> 00:07:26,271 Take this. 128 00:07:26,354 --> 00:07:27,354 Hey, Mateo. 129 00:07:27,397 --> 00:07:28,481 Good morning, Cass. 130 00:07:28,565 --> 00:07:30,400 This is Sherry. 131 00:07:30,483 --> 00:07:31,776 Hi. 132 00:07:31,860 --> 00:07:33,653 Sherry, I'm Dr. McKay. 133 00:07:33,737 --> 00:07:35,405 I have some student doctors with me today. 134 00:07:35,488 --> 00:07:36,823 Do you mind if they observe? 135 00:07:36,906 --> 00:07:39,284 - Sure. - OK. 136 00:07:39,367 --> 00:07:40,869 What's going on, Sherry? 137 00:07:40,952 --> 00:07:43,413 I… 138 00:07:43,496 --> 00:07:45,999 I burned my hand on a Sterno. 139 00:07:46,082 --> 00:07:47,751 What were you doing with a Sterno? 140 00:07:47,834 --> 00:07:49,085 Uh, cooking. 141 00:07:49,169 --> 00:07:50,962 You were cooking with a Sterno? 142 00:07:51,046 --> 00:07:54,424 Yeah, we were making s'mores. 143 00:07:54,507 --> 00:07:55,507 That's sweet. 144 00:07:55,550 --> 00:07:58,345 My son loves s'mores. 145 00:07:58,428 --> 00:08:01,139 Uh, we've… we've been here for hours, 146 00:08:01,222 --> 00:08:02,724 and I have to get them to school. 147 00:08:02,807 --> 00:08:04,768 Do you know how much longer this will take? 148 00:08:04,851 --> 00:08:07,937 Uh, yeah, let's see. 149 00:08:08,021 --> 00:08:10,357 - You take anything for the pain? - Uh, not yet. 150 00:08:10,440 --> 00:08:11,650 1,000 of Tylenol, 151 00:08:11,733 --> 00:08:12,859 400 ibuprofen, and saline dressing? 152 00:08:12,942 --> 00:08:14,944 Yes, please. 153 00:08:15,028 --> 00:08:16,655 McKay, we're gonna round. 154 00:08:16,738 --> 00:08:18,823 And the fun begins. 155 00:08:18,907 --> 00:08:20,492 All right, Sherry, we're gonna patch you up 156 00:08:20,575 --> 00:08:23,078 and get you out of here as soon as possible, OK? 157 00:08:23,161 --> 00:08:24,871 - I'll be back. - OK. 158 00:08:27,999 --> 00:08:31,294 As you can see, we have some new faces with us this morning. 159 00:08:31,378 --> 00:08:33,129 Good morning, good morning. Come on over. 160 00:08:33,213 --> 00:08:36,049 Starting with second-year resident Dr. Melissa King, 161 00:08:36,132 --> 00:08:37,509 fresh from the VA. 162 00:08:37,592 --> 00:08:39,094 Everyone calls me Mel. 163 00:08:39,177 --> 00:08:41,054 I'm so happy to be here. 164 00:08:41,137 --> 00:08:43,056 Trinity Santos, intern. 165 00:08:43,139 --> 00:08:45,392 Victoria Javadi, MS3. 166 00:08:45,475 --> 00:08:47,894 Uh, Dennis Whitaker, MS4. 167 00:08:47,978 --> 00:08:49,312 Welcome to the Pitt. I'm… 168 00:08:49,396 --> 00:08:50,730 We've got two traumas from the T. 169 00:08:50,814 --> 00:08:52,357 - Five minutes out. - OK, copy that. 170 00:08:52,440 --> 00:08:54,025 Actually, this is the most important person 171 00:08:54,109 --> 00:08:55,485 that you're gonna meet today. This is Dana. 172 00:08:55,568 --> 00:08:56,903 She's our charge nurse. 173 00:08:56,987 --> 00:08:59,280 She is the ringleader of our circus. 174 00:08:59,364 --> 00:09:01,366 Do what she says when she says it. 175 00:09:01,449 --> 00:09:04,744 As you can see, our house is always packed, 176 00:09:04,828 --> 00:09:07,080 and our department is mostly clogged up with boarders. 177 00:09:07,163 --> 00:09:09,332 Those are admitted patients waiting for a room upstairs, 178 00:09:09,416 --> 00:09:11,251 sometimes for days. 179 00:09:11,334 --> 00:09:13,461 Beds are a very precious commodity around here, 180 00:09:13,545 --> 00:09:14,754 so please be quick and efficient 181 00:09:14,838 --> 00:09:15,824 with your workups. 182 00:09:15,839 --> 00:09:17,215 What else? 183 00:09:17,299 --> 00:09:18,758 We treat the sicker patients back here, 184 00:09:18,842 --> 00:09:20,427 but please keep your eye on that waiting room. 185 00:09:20,510 --> 00:09:23,179 Make sure nobody's gonna die out there. 186 00:09:23,263 --> 00:09:25,682 Your senior residents are Dr. Collins 187 00:09:25,765 --> 00:09:27,350 and Dr. Langdon. 188 00:09:27,434 --> 00:09:30,061 You report to them, and they report to me. 189 00:09:30,145 --> 00:09:31,563 OK? Great. 190 00:09:31,646 --> 00:09:32,897 Senior residents, you got your sign-outs? 191 00:09:32,981 --> 00:09:34,232 - Yep. - Yep. 192 00:09:34,316 --> 00:09:37,277 OK. Let's do this. 193 00:09:37,360 --> 00:09:39,779 Virgil Straker. 194 00:09:39,863 --> 00:09:42,657 9mm GSW to the left shoulder. 195 00:09:42,741 --> 00:09:44,868 CT angiogram negative, surgery wants to admit 196 00:09:44,951 --> 00:09:46,578 for overnight observation. 197 00:09:46,661 --> 00:09:48,955 Good vitals. They repeat a crit? 198 00:09:49,039 --> 00:09:50,498 Stable crits every two hours times three. 199 00:09:50,582 --> 00:09:52,417 Discharge on Ceftin, recheck tomorrow. 200 00:09:52,500 --> 00:09:54,377 He'll get way more rest at home. 201 00:09:54,461 --> 00:09:56,379 Good morning, Mr. Straker. You want to go home? 202 00:09:56,463 --> 00:09:58,131 - Hell yeah. - OK. 203 00:09:58,214 --> 00:09:59,549 Hey. Hey, Ro. 204 00:09:59,633 --> 00:10:01,635 Hey, Ro, I'm finally getting out of here! 205 00:10:03,637 --> 00:10:05,513 All right, Murphy Rottenstein. 206 00:10:05,597 --> 00:10:07,349 48-year-old woman with cirrhosis 207 00:10:07,432 --> 00:10:08,767 and upper GI bleed. 208 00:10:08,850 --> 00:10:11,519 Intubated and stable after one unit. 209 00:10:11,603 --> 00:10:13,146 Awaiting ICU bed. 210 00:10:13,229 --> 00:10:15,023 Hey, Doc. 211 00:10:15,106 --> 00:10:17,776 And we all know Louie Cloverfield. 212 00:10:17,859 --> 00:10:21,571 Blood alcohol of.420 at 11:00 PM. 213 00:10:21,655 --> 00:10:23,531 - I've been cutting back. - How is he still breathing? 214 00:10:23,615 --> 00:10:25,116 That's a lethal dose for you and me. 215 00:10:25,200 --> 00:10:26,660 That's happy hour for Louie. 216 00:10:26,743 --> 00:10:28,411 Sobered up. Had two rounds of lorazepam. 217 00:10:28,495 --> 00:10:31,623 Hold out your hands for me, Louie. 218 00:10:31,706 --> 00:10:33,249 - Another two of lorazepam. - On it. 219 00:10:33,333 --> 00:10:34,376 And a script for Librium. 220 00:10:34,459 --> 00:10:35,502 It's good to see you, Louie. 221 00:10:35,585 --> 00:10:37,629 It's always a pleasure, Doc. 222 00:10:37,712 --> 00:10:39,714 Bar fight with complete avulsion 223 00:10:39,798 --> 00:10:41,716 of tooth number eight. 224 00:10:41,800 --> 00:10:43,385 Smile, Charlie. 225 00:10:43,468 --> 00:10:46,471 Oh! Where's your tooth, Charlie? 226 00:10:46,554 --> 00:10:48,390 Fuck if I know. 227 00:10:48,473 --> 00:10:50,934 Cancel the discharge. Order a chest X-ray. 228 00:10:51,017 --> 00:10:52,477 Got to rule out aspiration. 229 00:10:52,560 --> 00:10:55,146 Incoming! 230 00:10:55,230 --> 00:10:56,898 42-year-old male, Sam Wallace. 231 00:10:56,982 --> 00:10:58,733 Blunt head with agonal respirations. 232 00:10:58,817 --> 00:11:00,485 Dropped down on the T tracks. Couldn't tube him. 233 00:11:00,568 --> 00:11:01,987 - LMA in place. - Suicide attempt? 234 00:11:02,070 --> 00:11:03,989 Rescue. He's a good Samaritan. 235 00:11:04,072 --> 00:11:06,116 Took a spill helping a woman who fell off the track. 236 00:11:06,199 --> 00:11:07,993 - She's right behind us. - OK. Trauma one. Go ahead. 237 00:11:08,076 --> 00:11:09,202 Copy. 238 00:11:09,286 --> 00:11:11,371 Come on. 239 00:11:11,454 --> 00:11:12,789 Woman fell from T platform. 240 00:11:12,872 --> 00:11:14,666 Good vitals and no head injuries. 241 00:11:14,749 --> 00:11:16,251 Degloving injury, right lower leg 242 00:11:16,334 --> 00:11:18,586 with open fracture dislocation to the ankle. 243 00:11:18,670 --> 00:11:20,088 Whoa. OK. 244 00:11:20,171 --> 00:11:21,965 Trauma two. Trauma two. Let's go! 245 00:11:28,930 --> 00:11:30,932 How are we doing? We ready? 246 00:11:31,016 --> 00:11:32,475 OK, here we go. Ready? 247 00:11:32,559 --> 00:11:35,437 One, two, three. 248 00:11:35,520 --> 00:11:36,771 Good breath sounds bilaterally, 249 00:11:36,855 --> 00:11:38,315 but we need to protect… 250 00:11:38,398 --> 00:11:39,774 Apparently he jumped down to save the lady. 251 00:11:39,858 --> 00:11:41,318 When he climbed back up, he slipped, 252 00:11:41,401 --> 00:11:43,111 - fell back, and hit his head. - OK, thanks. 253 00:11:43,194 --> 00:11:44,612 Uh, Mel, right? 254 00:11:44,696 --> 00:11:46,323 I need you on the E-FAST. 255 00:11:46,406 --> 00:11:48,199 Pupils 4 millimeters and reactive. 256 00:11:48,283 --> 00:11:50,035 OK, that's encouraging. 257 00:11:50,118 --> 00:11:52,037 - What do you want for meds? - 120 ketamine, 80 of rock. 258 00:11:52,120 --> 00:11:54,456 - A-fib on a monitor. - Courses clear. 259 00:11:54,539 --> 00:11:56,458 That's a lot more blood than expected. 260 00:11:56,541 --> 00:11:59,753 Um, he's probably anticoagulated for A-fib. 261 00:11:59,836 --> 00:12:01,796 Check his medical records, see if he's on a DOAC. 262 00:12:01,880 --> 00:12:04,382 Stand by with four-factor PCC if there's a brain bleed. 263 00:12:04,466 --> 00:12:06,426 What's in the PCC, Mel? 264 00:12:06,509 --> 00:12:09,471 Uh, clotting factors two, seven, nine, and ten. 265 00:12:09,554 --> 00:12:11,306 OK. Be right back. 266 00:12:11,389 --> 00:12:12,932 50 of fent didn't touch her. 267 00:12:13,016 --> 00:12:14,517 Did she faint or did she trip off the platform? 268 00:12:14,601 --> 00:12:16,186 Nobody knows. 269 00:12:16,269 --> 00:12:17,520 The other guy jumped down, pulled her off the tracks 270 00:12:17,604 --> 00:12:18,605 just as the train was rolling in. 271 00:12:18,688 --> 00:12:19,898 Isolated injury to the foot. 272 00:12:19,981 --> 00:12:21,232 The train ran over her foot? 273 00:12:21,316 --> 00:12:22,302 Got caught between the platform 274 00:12:22,317 --> 00:12:23,401 and the incoming train. 275 00:12:23,485 --> 00:12:24,778 Ma'am? Ma'am, what's your name? 276 00:12:24,861 --> 00:12:26,112 All right, type 3 open fracture. 277 00:12:26,196 --> 00:12:27,906 Two grams Cefazolin, 400 of gent. 278 00:12:27,989 --> 00:12:29,741 Do you speak any English? 279 00:12:29,824 --> 00:12:31,660 Airway and breathing are perfect. 280 00:12:31,743 --> 00:12:33,203 As is circulation. 281 00:12:33,286 --> 00:12:35,580 BP 140 over 85. 282 00:12:35,664 --> 00:12:38,124 Students, what might have made her faint on the platform? 283 00:12:38,208 --> 00:12:39,542 - Uh, TIA, CVA. - Could be an arrhythmia, 284 00:12:39,626 --> 00:12:41,294 - cardiac event. - So she needs… 285 00:12:41,378 --> 00:12:42,879 - Hed CT. - EKG and troponin. 286 00:12:42,963 --> 00:12:44,381 - OK, good. - What do we got, party people? 287 00:12:44,464 --> 00:12:45,882 Subway train degloved her foot 288 00:12:45,966 --> 00:12:47,425 with an open fracture dislocation. 289 00:12:47,509 --> 00:12:48,927 Ooh, and I thought my heels were painful. 290 00:12:49,010 --> 00:12:50,679 - Hemodynamically stable. - E-FAST negative. 291 00:12:50,762 --> 00:12:52,222 Ma'am, I'm Dr. Yolanda Garcia. 292 00:12:52,305 --> 00:12:54,015 Any pain in your chest or belly? 293 00:12:56,810 --> 00:12:58,228 Can we please push the morphine? 294 00:12:58,311 --> 00:13:00,271 No, it could cloud her mental status. 295 00:13:00,355 --> 00:13:03,274 I can't do an exam like this. Push the damn morphine. 296 00:13:03,358 --> 00:13:04,859 We're doing a popliteal block. 297 00:13:04,943 --> 00:13:06,569 Numbs the lower leg, no side effects. 298 00:13:06,653 --> 00:13:07,904 Wonderful. Where's the other guy? 299 00:13:07,988 --> 00:13:09,406 Next door. He's a bit worse. 300 00:13:09,489 --> 00:13:10,782 Pan scan her. 301 00:13:10,865 --> 00:13:12,784 Let me know when she stops screaming. 302 00:13:15,954 --> 00:13:17,497 The cords are very anterior. 303 00:13:17,580 --> 00:13:19,291 Yeah, that's because we can't flex the neck. 304 00:13:19,374 --> 00:13:22,210 Keep the hockey stick straight up. 305 00:13:22,294 --> 00:13:24,087 - I'm in. - Good. Well done. 306 00:13:24,170 --> 00:13:25,422 Bring me up to speed. 307 00:13:25,505 --> 00:13:27,173 Intubated for agonal respirations. 308 00:13:27,257 --> 00:13:29,843 GCS 5. Probably anticoagulated. 309 00:13:29,926 --> 00:13:30,969 With what? 310 00:13:31,052 --> 00:13:32,095 First time here. 311 00:13:32,178 --> 00:13:33,722 There's no medical records. 312 00:13:33,805 --> 00:13:36,349 - Call for FFP? - No, we got four-factor PCC. 313 00:13:36,433 --> 00:13:38,143 80 of mannitol to reduce brain swelling, 314 00:13:38,226 --> 00:13:39,311 then right up to CT. 315 00:13:40,812 --> 00:13:42,188 Do me a favor. 316 00:13:42,272 --> 00:13:43,440 Swap out with Jesse for me, would you? 317 00:13:43,523 --> 00:13:44,858 Of course. 318 00:13:44,941 --> 00:13:46,401 Dr. Robinavitch, do you have a moment? 319 00:13:46,484 --> 00:13:48,028 I'm just a little busy right now, Gloria. 320 00:13:48,111 --> 00:13:49,487 One sec. 321 00:13:50,613 --> 00:13:52,365 Nerve block complete. 322 00:13:52,449 --> 00:13:53,908 Seems like it's starting to work. 323 00:13:53,992 --> 00:13:55,410 Swapping out, Jesse. 324 00:13:55,493 --> 00:13:56,911 Takes ten minutes for the full effect, 325 00:13:56,995 --> 00:13:58,622 and the Marcaine lasts a good four hours. 326 00:13:58,705 --> 00:14:00,373 She's next for CT. 327 00:14:00,457 --> 00:14:01,666 You have any idea what language that is? 328 00:14:01,750 --> 00:14:02,917 Definitely not Tagalog. 329 00:14:03,001 --> 00:14:04,711 Maybe Hindi or Urdu. 330 00:14:04,794 --> 00:14:06,254 I'm gonna go get language services. 331 00:14:06,338 --> 00:14:07,672 Don't you speak, like, five languages? 332 00:14:07,756 --> 00:14:09,257 Six, but that's not one of them. 333 00:14:09,341 --> 00:14:10,592 Six? 334 00:14:10,675 --> 00:14:11,661 And I thought Collins was smart. 335 00:14:11,676 --> 00:14:12,969 Oh, it's way too early 336 00:14:13,053 --> 00:14:14,512 for you to start being an ass, Langdon. 337 00:14:14,596 --> 00:14:16,056 Open hostility in front of the patient? 338 00:14:16,139 --> 00:14:17,599 She doesn't speak English. 339 00:14:17,682 --> 00:14:19,267 Judgmental and dismissive. 340 00:14:19,351 --> 00:14:20,727 How are we doing? 341 00:14:20,810 --> 00:14:22,896 - Vitals stable. - Unlike these two. 342 00:14:22,979 --> 00:14:25,231 Ooh, good for you. Princess made a joke. 343 00:14:25,315 --> 00:14:26,733 Why are you always an asshole? 344 00:14:26,816 --> 00:14:28,234 And I thank you for that beautiful blessing. 345 00:14:28,318 --> 00:14:30,487 - Namaste. - OK, do we have a phone 346 00:14:30,570 --> 00:14:31,821 or anything with a relative's name on it? 347 00:14:31,905 --> 00:14:33,907 EMT said the purse got obliterated 348 00:14:33,990 --> 00:14:36,576 when the subway ran over it. 349 00:14:36,660 --> 00:14:38,954 - Any way I can speak with her? - Highly doubt it. 350 00:14:39,037 --> 00:14:40,538 We don't know what language she speaks. 351 00:14:40,622 --> 00:14:44,501 Hey, um, any chance she jumped? 352 00:14:44,584 --> 00:14:46,211 She may have been pushed. 353 00:14:46,294 --> 00:14:47,629 - Jesus. - Yeah. 354 00:14:47,712 --> 00:14:49,297 Could be looking at a possible hate crime. 355 00:14:49,381 --> 00:14:50,632 I take it you're free now? 356 00:14:55,637 --> 00:14:57,138 We need to talk about your numbers. 357 00:14:57,222 --> 00:14:59,516 - Of people we've saved? - Metrics. 358 00:14:59,599 --> 00:15:01,851 Our door-to-balloon times beat federal standards. 359 00:15:01,935 --> 00:15:04,771 I'm talking about Press Ganey scores. 360 00:15:04,854 --> 00:15:06,564 Patient satisfaction. 361 00:15:06,648 --> 00:15:08,608 If they're still alive, they should be satisfied. 362 00:15:08,692 --> 00:15:11,903 Our goal is 36% very satisfied with their care. 363 00:15:11,987 --> 00:15:14,322 Your department is at 8. 364 00:15:14,406 --> 00:15:16,741 Do you know how likely patients are to recommend this hospital? 365 00:15:16,825 --> 00:15:18,159 This is an emergency department, 366 00:15:18,243 --> 00:15:19,869 not a Taco Bell. 367 00:15:19,953 --> 00:15:21,371 11%. 368 00:15:21,454 --> 00:15:22,747 Well, if you want people to be happier, 369 00:15:22,831 --> 00:15:24,416 don't make 'em wait for 12 hours. 370 00:15:24,499 --> 00:15:26,251 There's a nursing shortage across the country. 371 00:15:26,334 --> 00:15:28,295 Most of our patients are boarders 372 00:15:28,378 --> 00:15:31,047 who are waiting for a bed upstairs. 373 00:15:31,131 --> 00:15:32,674 We don't have the beds. 374 00:15:32,757 --> 00:15:34,301 That's bullshit. The beds are up there. 375 00:15:34,384 --> 00:15:35,593 You just don't want to hire the staff you need 376 00:15:35,677 --> 00:15:37,637 to care for them. 377 00:15:37,721 --> 00:15:40,223 Oh, Doc. Doc, it ain't working. 378 00:15:40,307 --> 00:15:42,392 Man, whatever they're giving me, it's not working. 379 00:15:42,475 --> 00:15:44,102 No response to mag citrate. 380 00:15:44,185 --> 00:15:46,479 Should I send in the Fleet? 381 00:15:46,563 --> 00:15:49,149 OK, sir, we're gonna try an enema. 382 00:15:49,232 --> 00:15:51,443 Like I said, there's a nursing shortage. 383 00:15:51,526 --> 00:15:52,819 Well, if you paid them a living wage, 384 00:15:52,902 --> 00:15:54,237 they'd be lining up to work here. 385 00:15:54,321 --> 00:15:55,739 Our budget can't support that. 386 00:15:55,822 --> 00:15:57,365 Here's a dirty little secret. 387 00:15:57,449 --> 00:15:58,825 The hospital saves money 388 00:15:58,908 --> 00:16:00,452 keeping patients down here in the Pitt. 389 00:16:00,535 --> 00:16:02,287 It's way cheaper than staffing upstairs. 390 00:16:02,370 --> 00:16:04,039 I have asked you repeatedly 391 00:16:04,122 --> 00:16:06,249 to stop referring to the emergency department 392 00:16:06,333 --> 00:16:08,543 as the Pitt…it is derogatory 393 00:16:08,627 --> 00:16:10,670 and incompatible to the institution's image. 394 00:16:10,754 --> 00:16:12,339 You know what's incompatible with the institution's image? 395 00:16:12,422 --> 00:16:14,007 Me speaking to the media 396 00:16:14,090 --> 00:16:15,800 about people who code in our waiting rooms 397 00:16:15,884 --> 00:16:17,552 and people who get shitty care in our hallways 398 00:16:17,636 --> 00:16:19,346 waiting for an ICU bed for days. 399 00:16:19,429 --> 00:16:21,348 I've heard about doctors who have tried that 400 00:16:21,431 --> 00:16:23,016 and find themselves out of work. 401 00:16:23,099 --> 00:16:24,392 Uh-huh. 402 00:16:24,476 --> 00:16:25,769 I know today is difficult for you. 403 00:16:25,852 --> 00:16:27,395 Every day is difficult down here. 404 00:16:27,479 --> 00:16:29,564 Boarding is a nationwide problem. 405 00:16:29,648 --> 00:16:32,025 Your predecessor, Adamson, sure as hell knew that. 406 00:16:32,108 --> 00:16:33,693 Or wasn't that something he taught you? 407 00:16:33,777 --> 00:16:36,112 Fuck. Wow. Really? 408 00:16:36,196 --> 00:16:37,906 Yes, really. 409 00:16:37,989 --> 00:16:39,824 Other hospitals are managing this crisis 410 00:16:39,908 --> 00:16:41,159 much more effectively. 411 00:16:41,242 --> 00:16:42,911 So you can either step up your game, 412 00:16:42,994 --> 00:16:44,579 or you can step aside. 413 00:16:55,799 --> 00:16:57,884 Good Samaritan dude has a small left temporal 414 00:16:57,968 --> 00:16:59,761 intraparenchymal bleed. 415 00:16:59,844 --> 00:17:01,888 No epidural, no subdural, no midline shift in the brain. 416 00:17:01,972 --> 00:17:03,431 Oh, that's good news. He could recover. 417 00:17:03,515 --> 00:17:04,849 CT can take her in five. 418 00:17:04,933 --> 00:17:06,601 Let's have a look. Bandage scissors? 419 00:17:06,685 --> 00:17:08,019 All right. 420 00:17:08,103 --> 00:17:10,021 If an artery is totally transected, 421 00:17:10,105 --> 00:17:11,982 the smooth muscle and the tunica media 422 00:17:12,065 --> 00:17:13,692 contracts with hemostasis. 423 00:17:13,775 --> 00:17:16,486 But if it's a partial cut, get out your umbrella. 424 00:17:16,569 --> 00:17:19,364 Grab a culture from the open fibula before you reduce. 425 00:17:19,447 --> 00:17:22,075 You're up. 426 00:17:22,158 --> 00:17:24,035 I'll stabilize the knee for the reduction. 427 00:17:24,119 --> 00:17:26,621 Dr. Langdon will be distracting distally 428 00:17:26,705 --> 00:17:29,499 before moving medially to clear the tibia. 429 00:17:29,582 --> 00:17:32,002 Good. 430 00:17:32,085 --> 00:17:33,295 Ready? 431 00:17:45,432 --> 00:17:47,726 Med student down. 432 00:17:48,810 --> 00:17:50,603 Good catch on Bar Fight Billy. 433 00:17:50,687 --> 00:17:52,605 There was an aspirated tooth on chest X-ray. 434 00:17:52,689 --> 00:17:54,316 Would have been dead in a week from a lung abscess 435 00:17:54,399 --> 00:17:55,483 had you let him be discharged. 436 00:17:55,567 --> 00:17:56,776 Good call on the pulmonary. 437 00:17:56,860 --> 00:17:58,611 Cardiac arrest, ETA 10 minutes. 438 00:17:58,695 --> 00:18:00,530 - Where should we put it? - Anywhere. 439 00:18:00,613 --> 00:18:02,699 We might have to put somebody in the hall. 440 00:18:02,782 --> 00:18:04,993 Dr. Robby? She, uh, took a fall. 441 00:18:05,076 --> 00:18:06,745 No, I… I tripped on the gurney. 442 00:18:06,828 --> 00:18:08,038 I'm fine. 443 00:18:10,373 --> 00:18:12,292 Why don't you go get a cold drink 444 00:18:12,375 --> 00:18:14,836 in the staff lounge? 445 00:18:14,919 --> 00:18:16,254 I'm fine, really. I swear. 446 00:18:16,338 --> 00:18:18,131 Oh, I know, but it's hospital policy. 447 00:18:18,214 --> 00:18:19,883 Anytime someone gets a paper cut around here, 448 00:18:19,966 --> 00:18:21,676 we have to fill out a workers' comp report. 449 00:18:27,057 --> 00:18:28,767 Other way. 450 00:18:31,019 --> 00:18:33,063 I was fine until about two weeks ago, 451 00:18:33,146 --> 00:18:34,397 after the Rochester Marathon. 452 00:18:34,481 --> 00:18:36,775 OK. Any falls or injuries? 453 00:18:36,858 --> 00:18:38,735 Just tired. Sore muscles. 454 00:18:38,818 --> 00:18:40,862 Yeah, I'd be in bed for a month. 455 00:18:40,945 --> 00:18:42,447 Was this your first triathlon? 456 00:18:42,530 --> 00:18:43,573 God no. 457 00:18:43,657 --> 00:18:45,825 No, I do one every few months. 458 00:18:45,909 --> 00:18:47,744 Have you seen a doctor yet? 459 00:18:47,827 --> 00:18:49,829 Uh, no. 460 00:18:49,913 --> 00:18:51,623 I went for a run this morning. 461 00:18:51,706 --> 00:18:53,041 Had to quit after a minute. 462 00:18:53,124 --> 00:18:54,209 Pretty short of breath. 463 00:18:54,292 --> 00:18:56,795 This goes under your tongue. 464 00:18:56,878 --> 00:18:58,630 - No current meds, no allergies? - Mm-mm. 465 00:18:58,713 --> 00:19:00,757 We're gonna check a few labs and an EKG. 466 00:19:00,840 --> 00:19:02,968 - Draw a red and purple top. - Yep. 467 00:19:06,012 --> 00:19:08,515 Temp 98.2. 468 00:19:08,598 --> 00:19:10,225 Take a deep breath for me, Otis. 469 00:19:11,685 --> 00:19:13,520 Little pinprick now, OK? 470 00:19:17,148 --> 00:19:19,317 Otis? 471 00:19:19,401 --> 00:19:21,027 Otis. 472 00:19:21,111 --> 00:19:22,946 I didn't take him for a lightweight, huh? 473 00:19:25,699 --> 00:19:27,033 Oh, shit. No pulse. 474 00:19:27,117 --> 00:19:29,202 Crash cart! Lay him flat! 475 00:19:31,371 --> 00:19:33,164 - Let's check a rhythm. - Saline pads. 476 00:19:35,792 --> 00:19:37,585 Quick look paddles. 477 00:19:40,714 --> 00:19:42,132 V-tach. 478 00:19:42,215 --> 00:19:43,758 Charging at 200. 479 00:19:43,842 --> 00:19:45,010 Charged. 480 00:19:45,093 --> 00:19:46,344 Clear! 481 00:19:47,887 --> 00:19:49,723 All right, he's back to normal sinus. 482 00:19:49,806 --> 00:19:51,099 Need a gurney in here! 483 00:19:53,310 --> 00:19:55,103 So what's the plan? 484 00:19:55,186 --> 00:19:59,024 ICU when we can get a bed and admit for supportive care. 485 00:19:59,107 --> 00:20:02,235 Repeat head CT in three hours. 486 00:20:02,319 --> 00:20:04,404 Or sooner, if he blows a pupil. 487 00:20:04,487 --> 00:20:06,656 - Want a Keppra load? - Order's already in. 488 00:20:08,325 --> 00:20:09,534 Nice job. 489 00:20:11,828 --> 00:20:13,705 Do you think he'll wake up? 490 00:20:13,788 --> 00:20:15,790 Maybe. 491 00:20:15,874 --> 00:20:18,710 Maybe not. 492 00:20:18,793 --> 00:20:22,797 No good deed goes unpunished. 493 00:20:22,881 --> 00:20:25,800 Oh, has anyone, um, notified the family? 494 00:20:29,721 --> 00:20:31,389 I could try. 495 00:20:31,473 --> 00:20:33,850 Otis Williams. Healthy 31-year-old. 496 00:20:33,933 --> 00:20:36,436 V-tach arrest two weeks after triathlon. 497 00:20:36,519 --> 00:20:38,146 NSR with one shock. 498 00:20:38,229 --> 00:20:40,148 Pulse 98, BP 110 over 60. 499 00:20:40,231 --> 00:20:41,232 He's a little young for an MI. 500 00:20:41,316 --> 00:20:42,734 Exactly right, 501 00:20:42,817 --> 00:20:44,152 What's in the differential, Dr. Collins? 502 00:20:44,235 --> 00:20:46,863 Drug overdose, electrolytes, long QT… 503 00:20:46,946 --> 00:20:48,823 ooh, Brugada syndrome, WPW… 504 00:20:48,907 --> 00:20:50,533 How you doing there, Otis? 505 00:20:50,617 --> 00:20:52,410 OK. What ha… 506 00:20:53,078 --> 00:20:54,120 V-tach again. 507 00:20:54,204 --> 00:20:55,497 200 joules. 508 00:20:55,580 --> 00:20:58,750 Charged, and clear! 509 00:20:58,833 --> 00:21:00,669 Back in sinus. 510 00:21:00,752 --> 00:21:01,878 Otis? 511 00:21:04,464 --> 00:21:06,383 Otis? 512 00:21:06,466 --> 00:21:09,511 Oh, groaning's good. 5 of nasal O2, CBC, 513 00:21:09,594 --> 00:21:12,180 CMP, troponin, and D-dimer. 514 00:21:12,263 --> 00:21:13,556 What are you doing? 515 00:21:13,640 --> 00:21:15,308 One gram calcium gluconate, IV push. 516 00:21:15,392 --> 00:21:17,060 - We don't have the labs back. - Look at the monitor. 517 00:21:17,143 --> 00:21:18,436 Widened QRS and PT waves. 518 00:21:18,520 --> 00:21:19,980 - Hyperkalemia. - How'd he get that? 519 00:21:20,063 --> 00:21:21,690 Intense exercise caused muscle breakdown. 520 00:21:21,773 --> 00:21:23,024 Rhabdomyolysis knocked out his kidneys. 521 00:21:23,108 --> 00:21:24,150 Now he's not clearing potassium. 522 00:21:24,234 --> 00:21:25,527 I bet it's over 7.5. 523 00:21:25,610 --> 00:21:27,195 Wait two minutes for the I-STAT. 524 00:21:27,278 --> 00:21:28,697 If he arrests again, we might not get him back. 525 00:21:28,780 --> 00:21:30,156 If it's hypercalcemia, you could kill him. 526 00:21:30,240 --> 00:21:32,701 - Wait. - Oh, it's my ass, not yours. 527 00:21:43,336 --> 00:21:44,671 Pan scan is negative. 528 00:21:44,754 --> 00:21:46,339 That means you can admit to orthopedics. 529 00:21:46,423 --> 00:21:48,216 But there may have been a medical etiology 530 00:21:48,300 --> 00:21:50,051 - if she fainted. - That's not surgical. 531 00:21:50,135 --> 00:21:51,678 Get an internal medicine consult, 532 00:21:51,761 --> 00:21:53,930 or admit to medicine with ortho consulting. 533 00:21:54,014 --> 00:21:55,223 Either way, I'm off the case. 534 00:21:55,307 --> 00:21:57,475 OK. Thanks for nothing. 535 00:21:57,559 --> 00:22:00,395 Ancef's in. I'll grab the gent. 536 00:22:00,478 --> 00:22:02,188 Did we figure out what she's speaking? 537 00:22:02,272 --> 00:22:04,774 Last interpreter thought she might be from Pakistan. 538 00:22:04,858 --> 00:22:07,402 There are 77 languages in Pakistan. 539 00:22:07,485 --> 00:22:10,530 OK, well, I will buy lunch for whoever figures it out. 540 00:22:10,613 --> 00:22:11,990 Good luck. 541 00:22:12,073 --> 00:22:14,868 If you need me, I'll be saving lives. 542 00:22:14,951 --> 00:22:16,828 That was wicked. 543 00:22:16,911 --> 00:22:19,539 - That was gross. - Yeah. 544 00:22:19,623 --> 00:22:21,750 Too much for Little Miss Crash and Burn. 545 00:22:21,833 --> 00:22:23,293 - What'd you do with her? - Nothing. 546 00:22:23,376 --> 00:22:25,795 - I think she'll be fine. - Are you kidding? 547 00:22:25,879 --> 00:22:27,213 If that took her out, she'll be lucky to make it 548 00:22:27,297 --> 00:22:28,965 through this rotation. 549 00:22:29,049 --> 00:22:30,717 I got 50 bucks says she doesn't last through this shift. 550 00:22:32,552 --> 00:22:33,845 Come on. 551 00:22:33,928 --> 00:22:35,180 Put your money where your mouth is. 552 00:22:35,263 --> 00:22:37,766 Uh, no. I didn't say anything, OK? 553 00:22:37,849 --> 00:22:40,393 And I sure as hell don't have 50 bucks. 554 00:22:40,477 --> 00:22:41,811 I'll be this lady's age by the time 555 00:22:41,895 --> 00:22:43,063 I pay off my student loans. 556 00:22:43,146 --> 00:22:44,356 Not that you're… 557 00:22:45,899 --> 00:22:47,651 Hey. 558 00:22:47,734 --> 00:22:50,195 You want to sell a kidney? 559 00:22:50,278 --> 00:22:53,448 I could get you 30K as soon as this weekend. 560 00:22:53,531 --> 00:22:56,534 That's just between you and me. 561 00:22:56,618 --> 00:22:57,827 Think about it. 562 00:23:02,540 --> 00:23:04,709 How you doing? 563 00:23:04,793 --> 00:23:06,419 Yeah. 564 00:23:06,503 --> 00:23:08,296 QRS has narrowed. 565 00:23:08,380 --> 00:23:09,380 Much better. 566 00:23:09,422 --> 00:23:11,216 Potassium is 7.7. 567 00:23:11,299 --> 00:23:13,468 Creatinine, 5.6. 568 00:23:13,551 --> 00:23:15,220 High potassium and renal failure. 569 00:23:15,303 --> 00:23:16,471 Just what you thought. 570 00:23:16,554 --> 00:23:18,223 It must be my lucky day. 571 00:23:18,306 --> 00:23:20,392 Ordering 10 units of regular insulin 572 00:23:20,475 --> 00:23:23,687 and 25 grams of glucose. 573 00:23:23,770 --> 00:23:25,563 Why insulin and glucose? 574 00:23:25,647 --> 00:23:27,315 Shift the potassium intracellularly. 575 00:23:27,399 --> 00:23:29,067 Exactly, but the definitive treatment is… 576 00:23:29,150 --> 00:23:30,568 Hemodialysis. I'll call renal 577 00:23:30,652 --> 00:23:32,487 and get a tech down with the machine. 578 00:23:32,570 --> 00:23:35,573 Have you ever seen a dialysis catheter inserted? 579 00:23:35,657 --> 00:23:37,367 Dr. Collins is gonna place a femoral Quinton 580 00:23:37,450 --> 00:23:38,535 under ultrasound guidance. 581 00:23:38,618 --> 00:23:39,703 It's an excellent way to learn. 582 00:23:39,786 --> 00:23:41,913 Oh, my chest. 583 00:23:41,997 --> 00:23:43,373 Yeah, we had to shock you. 584 00:23:43,456 --> 00:23:45,208 You're gonna be sore for a while. 585 00:23:45,292 --> 00:23:46,793 You shocked my heart? 586 00:23:46,876 --> 00:23:48,962 Long story. Dr. Collins will fill you in. 587 00:23:57,053 --> 00:23:59,306 You got a sec? 588 00:24:02,017 --> 00:24:03,601 You OK? 589 00:24:03,685 --> 00:24:05,520 Why wouldn't I be? Are you OK? 590 00:24:05,603 --> 00:24:07,355 Why wouldn't I be? 591 00:24:08,815 --> 00:24:10,358 You seem annoyed with me already, 592 00:24:10,442 --> 00:24:13,069 and I just got here. 593 00:24:13,153 --> 00:24:15,572 It's not always about you, Robby. 594 00:24:17,490 --> 00:24:19,326 Am I gonna be OK? 595 00:24:19,409 --> 00:24:20,869 Yeah. 596 00:24:20,952 --> 00:24:23,038 You just need to take it easy on yourself. 597 00:24:23,121 --> 00:24:26,541 Muscle breakdown and myoglobin damaged your kidneys. 598 00:24:26,625 --> 00:24:28,335 Why'd you shock my heart? 599 00:24:28,418 --> 00:24:30,962 When your kidneys don't work, potassium builds up 600 00:24:31,046 --> 00:24:35,467 and messes with the electrical activity in your heart. 601 00:24:35,550 --> 00:24:37,719 Can it happen again? 602 00:24:37,802 --> 00:24:39,679 We gave you medicine to lower your potassium, 603 00:24:39,763 --> 00:24:42,223 and you'll need dialysis to clear it all out. 604 00:24:42,307 --> 00:24:44,100 Then I'll be OK? 605 00:24:44,184 --> 00:24:45,352 Yeah. 606 00:24:45,435 --> 00:24:46,770 You might need a week or two 607 00:24:46,853 --> 00:24:49,397 for your kidneys to recover, but yeah. 608 00:24:49,481 --> 00:24:51,733 You really need to hydrate like crazy 609 00:24:51,816 --> 00:24:54,653 before and after a triathlon. 610 00:24:54,736 --> 00:24:58,323 Trust me, I won't let this happen again. 611 00:24:58,406 --> 00:25:00,951 Good. 612 00:25:01,034 --> 00:25:03,495 Be kind to yourself, OK? 613 00:25:13,713 --> 00:25:14,699 Oh, hey. 614 00:25:14,714 --> 00:25:16,466 Abbot's told me that he's got a pregnant teen 615 00:25:16,549 --> 00:25:17,926 coming back today for mifepristone. 616 00:25:18,009 --> 00:25:19,803 - Let me know when she gets here. - Yep. 617 00:25:19,886 --> 00:25:21,304 Bowel obstruction, still waiting 618 00:25:21,388 --> 00:25:23,056 on a surgery consult. What about Garcia? 619 00:25:23,139 --> 00:25:25,058 She was just here for the traumas. 620 00:25:25,141 --> 00:25:27,394 I think she was waiting for her attending to sign off. 621 00:25:29,521 --> 00:25:31,940 OK. 622 00:25:32,023 --> 00:25:34,609 Oh, one of the med students took a header. 623 00:25:34,693 --> 00:25:36,069 I parked her in the lounge under the guise 624 00:25:36,152 --> 00:25:37,529 of a work comp report. 625 00:25:37,612 --> 00:25:38,655 Will you just go in there, eyeball her, 626 00:25:38,738 --> 00:25:40,115 and make sure she's all right? 627 00:25:40,198 --> 00:25:41,199 She's gonna miss the morning arrival 628 00:25:41,282 --> 00:25:42,534 of the living dead. 629 00:25:42,617 --> 00:25:44,077 How many are we expecting? 630 00:25:44,160 --> 00:25:45,829 We were getting three, but one died en route. 631 00:25:45,912 --> 00:25:47,706 Don't know who's luckier, us or them. 632 00:25:47,789 --> 00:25:49,374 - What's open? - 14. 633 00:25:49,457 --> 00:25:51,001 89-year-old woman from a SNF. 634 00:25:51,084 --> 00:25:53,378 History of emphysema, CHF, MS. 635 00:25:53,461 --> 00:25:55,213 V-fib, unresponsive to three shocks. 636 00:25:55,297 --> 00:25:57,465 - Two rounds of epi. - What is that? 637 00:25:57,549 --> 00:25:59,009 LUCAS chest compression system. 638 00:25:59,092 --> 00:26:00,510 Robotic CPR. 639 00:26:03,138 --> 00:26:05,765 Everybody get a hold. One, two, three. 640 00:26:10,979 --> 00:26:12,772 Students are dropping like flies. 641 00:26:12,856 --> 00:26:14,482 Take a break. Ice the finger. 642 00:26:14,566 --> 00:26:16,860 You can count on getting a couple elderly patients 643 00:26:16,943 --> 00:26:19,487 every day around 7:30, after the nursing homes 644 00:26:19,571 --> 00:26:21,865 and assisted living facilities do their morning bed checks. 645 00:26:21,948 --> 00:26:24,034 You can practically set your watch. 646 00:26:24,117 --> 00:26:25,410 Was there an advanced directive? 647 00:26:25,493 --> 00:26:27,412 No, full code, per the nursing home. 648 00:26:27,495 --> 00:26:29,664 Seriously? 649 00:26:29,748 --> 00:26:32,208 LUCAS off. 650 00:26:32,292 --> 00:26:33,668 Still V-fib. 651 00:26:33,752 --> 00:26:35,211 LUCAS on. 652 00:26:35,295 --> 00:26:37,631 One more round of epi, one more shock, 653 00:26:37,714 --> 00:26:39,758 and then we call it? 654 00:26:43,303 --> 00:26:44,846 Joseph Spencer, 79. 655 00:26:44,929 --> 00:26:46,806 Fever and cough. From assisted living. 656 00:26:46,890 --> 00:26:49,559 He has a history of mild Alzheimer's. 657 00:26:49,643 --> 00:26:52,354 One, two, three. 658 00:26:52,437 --> 00:26:54,272 Heart rate 130. BP 90 over 60. 659 00:26:54,356 --> 00:26:56,441 Gave him 500 cc's normal saline. 660 00:26:56,524 --> 00:26:58,193 Hi, Mr. Spencer. I'm Dr. King. 661 00:26:58,276 --> 00:26:59,694 This is Dr. Collins. 662 00:26:59,778 --> 00:27:01,237 How are you feeling today? 663 00:27:01,321 --> 00:27:04,491 Is it dinnertime? I…I'm not really hungry. 664 00:27:04,574 --> 00:27:06,326 Do we have any paperwork from the facility? 665 00:27:06,409 --> 00:27:07,577 He has a POLST. 666 00:27:07,661 --> 00:27:09,079 IV fluids and medications are fine, 667 00:27:09,162 --> 00:27:11,122 but no intubation and no chest compressions. 668 00:27:11,206 --> 00:27:12,540 That's helpful. 669 00:27:12,624 --> 00:27:14,250 Coarse rhonchi here. 670 00:27:14,334 --> 00:27:16,586 Right middle lobe infiltrate. 671 00:27:16,670 --> 00:27:19,464 Temp 102. Call a code sepsis. 672 00:27:19,547 --> 00:27:20,966 - Mm-hmm. - Code? 673 00:27:21,049 --> 00:27:22,884 To make sure we check all of our boxes. 674 00:27:22,968 --> 00:27:25,053 The federal government audits our sepsis bundle performance 675 00:27:25,136 --> 00:27:26,763 and publishes the data online. 676 00:27:26,846 --> 00:27:28,640 Today, it better be perfect. 677 00:27:28,723 --> 00:27:31,601 Two sets of blood cultures, lactic acid, 678 00:27:31,685 --> 00:27:35,021 30 cc's per kilo NS, a gram of ceftriaxone, 679 00:27:35,105 --> 00:27:38,984 500 of azithromycin, repeat lactic in three hours. 680 00:27:39,067 --> 00:27:40,527 Nice. 681 00:27:40,610 --> 00:27:44,948 Charging, and… 682 00:27:45,031 --> 00:27:46,199 Stop. 683 00:27:46,282 --> 00:27:47,534 Call it. 684 00:27:47,617 --> 00:27:49,286 Nursing home just faxed us a DNR. 685 00:27:49,369 --> 00:27:51,079 Are you kidding me? 686 00:27:51,162 --> 00:27:52,872 Power off the defibrillator and the LUCAS. 687 00:27:52,956 --> 00:27:54,207 Complete waste of time and money. 688 00:27:54,291 --> 00:27:55,625 Who the hell works at that place? 689 00:27:55,709 --> 00:27:56,793 A nurse taking care of 60 patients 690 00:27:56,876 --> 00:27:58,503 who couldn't find the form. 691 00:27:58,586 --> 00:28:00,338 She called 911 so she could take care of the others. 692 00:28:00,422 --> 00:28:01,881 OK, let's move her to the viewing room 693 00:28:01,965 --> 00:28:04,384 - and notify the family. - Yep. 694 00:28:04,467 --> 00:28:07,846 One of the things we do here is to take a moment of silence 695 00:28:07,929 --> 00:28:11,433 when we lose a patient, to respect their humanity 696 00:28:11,516 --> 00:28:14,019 and also to remember that this was somebody's child 697 00:28:14,102 --> 00:28:18,189 or sibling or parent, friend. 698 00:28:28,533 --> 00:28:31,328 Oh. Ow, ow! 699 00:28:32,412 --> 00:28:34,080 I am so sorry. 700 00:28:34,164 --> 00:28:36,291 Maybe leave it on vibrate while you're working. 701 00:28:39,586 --> 00:28:41,838 - Later, Doc. - You behave yourself now. 702 00:28:41,921 --> 00:28:43,381 Always. 703 00:28:45,508 --> 00:28:48,094 Your med student's back on her feet. 704 00:28:48,178 --> 00:28:50,472 - How old's that kid? - I don't know. I didn't ask. 705 00:28:50,555 --> 00:28:51,848 What is she, some sort of savant? 706 00:28:51,931 --> 00:28:53,099 I don't know. Maybe. 707 00:28:53,183 --> 00:28:54,559 Dr. Robinavitch. 708 00:28:54,643 --> 00:28:55,977 I just wanted to apologize for any trouble 709 00:28:56,061 --> 00:28:57,354 my clumsiness might have caused. 710 00:28:57,437 --> 00:28:58,688 I feel ridiculous. 711 00:28:58,772 --> 00:29:00,023 Oh, I can't tell how many times 712 00:29:00,106 --> 00:29:01,316 I've hit my head on an overhead lamp. 713 00:29:01,399 --> 00:29:03,568 Twice I needed to get staples. 714 00:29:03,652 --> 00:29:05,695 Why don't you go work with Dr. McKay in triage? 715 00:29:05,779 --> 00:29:07,489 That would help both of us. 716 00:29:07,572 --> 00:29:09,991 Oh, I…I don't need special treatment. 717 00:29:10,075 --> 00:29:11,284 Good, because I don't give it. 718 00:29:14,162 --> 00:29:15,538 Look, I know I might look too young, 719 00:29:15,622 --> 00:29:17,707 but I studied my ass off to get here. 720 00:29:17,791 --> 00:29:19,834 Probably harder than the others. 721 00:29:19,918 --> 00:29:21,294 I earned this. 722 00:29:21,378 --> 00:29:23,463 OK, look, I respect your dedication 723 00:29:23,546 --> 00:29:25,340 and your determination, but while you're here, 724 00:29:25,423 --> 00:29:26,716 you're my responsibility. 725 00:29:26,800 --> 00:29:27,968 And when one of my responsibilities 726 00:29:28,051 --> 00:29:29,636 takes a header…wow! 727 00:29:29,719 --> 00:29:31,137 Abbot called for a surgical consult 728 00:29:31,221 --> 00:29:32,430 on the SBO three hours ago. 729 00:29:32,514 --> 00:29:33,682 You're very lucky they didn't perf. 730 00:29:33,765 --> 00:29:35,600 I'm here to see my daughter. 731 00:29:35,684 --> 00:29:37,060 I'm sorry, is that a patient? 732 00:29:37,143 --> 00:29:38,687 You're talking to her. 733 00:29:41,106 --> 00:29:42,524 Am I interrupting? 734 00:29:42,607 --> 00:29:44,109 No. 735 00:29:44,192 --> 00:29:46,277 No, we're done. We're good. 736 00:29:46,361 --> 00:29:48,113 Come find me when you're ready to present your next case. 737 00:29:48,196 --> 00:29:49,280 Thank you. 738 00:29:51,032 --> 00:29:53,034 So how's your first day going? 739 00:29:53,118 --> 00:29:54,327 - It's great. - Yeah? 740 00:29:54,411 --> 00:29:55,704 Yeah, really great. 741 00:29:55,787 --> 00:29:57,747 Hey, Crash, they're doing a dialysis 742 00:29:57,831 --> 00:29:59,541 catheter insertion in North One if you want to check it out. 743 00:29:59,624 --> 00:30:00,959 Mm-hmm. 744 00:30:01,042 --> 00:30:02,836 - That thing… - Did she say Crash? 745 00:30:02,919 --> 00:30:04,087 No. 746 00:30:04,170 --> 00:30:05,797 No, no, it's not crash. 747 00:30:05,880 --> 00:30:08,383 Um, she said crush, 'cause I'm always crushing it. 748 00:30:11,011 --> 00:30:12,762 Um, thanks for coming down, Mom, but I've… 749 00:30:12,846 --> 00:30:14,514 I've got a patient. 750 00:30:14,597 --> 00:30:15,598 Bye. 751 00:30:25,150 --> 00:30:26,776 What do you want? 752 00:30:26,860 --> 00:30:29,612 Um, I…I just wanted to make sure you're comfortable. 753 00:30:29,696 --> 00:30:34,200 I am taking a dump in a dustpan, 754 00:30:34,284 --> 00:30:36,161 so what's that fucking tell you? 755 00:30:36,244 --> 00:30:37,746 Um, I'm… 756 00:30:37,829 --> 00:30:39,414 I'm clearly… I'm clearly in the wrong room. 757 00:30:39,497 --> 00:30:40,483 - Yeah. - I'm sorry. 758 00:30:40,498 --> 00:30:41,916 Mm-hmm. 759 00:30:46,671 --> 00:30:49,466 So it would have been nice if someone had told me 760 00:30:49,549 --> 00:30:52,052 that Eileen Shamsi's daughter was one of our med students. 761 00:30:52,135 --> 00:30:54,387 What, and ruin the surprise? 762 00:30:54,471 --> 00:30:56,139 Was it as awkward as I hoped it would be? 763 00:30:56,222 --> 00:30:59,434 You…you have a mean streak in you, you know that? 764 00:30:59,517 --> 00:31:01,019 What's the deal with the body in 19? 765 00:31:01,102 --> 00:31:03,188 That's Abbot's MVC vet from last night. 766 00:31:03,271 --> 00:31:04,397 Still waiting on next of kin. 767 00:31:04,481 --> 00:31:06,024 - Supposedly on their way. - OK. 768 00:31:06,107 --> 00:31:07,484 Can we move him to the viewing room, at least? 769 00:31:07,567 --> 00:31:08,652 Nursing home DNR is heading there, 770 00:31:08,735 --> 00:31:09,944 joining last night's Jane Doe. 771 00:31:10,028 --> 00:31:11,529 Coroner's office is backed up. 772 00:31:11,613 --> 00:31:15,200 Well, then our morgue needs to take her, then. 773 00:31:15,283 --> 00:31:17,494 Perlah. 774 00:31:17,577 --> 00:31:19,079 Triathlete, Otis? 775 00:31:19,162 --> 00:31:20,163 Oh, he's stable. 776 00:31:20,246 --> 00:31:21,957 Repeat potassium is 6.1. 777 00:31:22,040 --> 00:31:23,959 Renal wrote the dialysis order. 778 00:31:24,042 --> 00:31:25,877 Tech should be down in 15 minutes. 779 00:31:25,961 --> 00:31:28,588 Good. Thank you. 780 00:31:28,672 --> 00:31:30,048 Language mystery solved yet? 781 00:31:30,131 --> 00:31:31,216 No. 782 00:31:31,299 --> 00:31:34,970 Hey, what's your take on dogs? 783 00:31:35,053 --> 00:31:36,429 In what context? 784 00:31:36,513 --> 00:31:38,139 For kids. 785 00:31:38,223 --> 00:31:40,767 Kids and puppies go together like fish and chips. 786 00:31:40,850 --> 00:31:42,143 Man's best friend, you know? 787 00:31:42,227 --> 00:31:43,436 Well, you don't have a dog. 788 00:31:43,520 --> 00:31:44,896 I don't have a best friend. 789 00:31:44,980 --> 00:31:46,564 - What am I? - You're my best resident. 790 00:31:46,648 --> 00:31:47,816 Big difference. 791 00:31:47,899 --> 00:31:49,609 Yeah, but we're still friends. 792 00:31:49,693 --> 00:31:52,445 Not if this conversation goes on much longer. 793 00:31:52,529 --> 00:31:54,489 I have a lethargic four-year-old, 794 00:31:54,572 --> 00:31:58,326 no PMH, no antecedent illness, no fever or vomiting. 795 00:31:58,410 --> 00:32:00,036 Parents just couldn't wake him up this morning. 796 00:32:00,120 --> 00:32:02,998 - What room? - Oh, South 15. 797 00:32:03,081 --> 00:32:05,041 There's no nuchal rigidity, 798 00:32:05,125 --> 00:32:09,629 no skin lesions, no focal neuro. 799 00:32:09,713 --> 00:32:12,632 He looks well fed and cared for. 800 00:32:12,716 --> 00:32:14,801 DKA from new-onset diabetes? 801 00:32:14,884 --> 00:32:16,428 No, BG 85. 802 00:32:16,511 --> 00:32:20,932 CBC, BMP, UA, and UDS ordered. 803 00:32:28,732 --> 00:32:31,735 Can you wake up for me, Tyler? 804 00:32:31,818 --> 00:32:33,445 He's not usually this sleepy? 805 00:32:33,528 --> 00:32:35,572 No, and he barely flinched for the blood test. 806 00:32:35,655 --> 00:32:37,073 He wakes up at 90 miles an hour 807 00:32:37,157 --> 00:32:38,742 and doesn't stop till he passes out at night. 808 00:32:38,825 --> 00:32:40,118 He passes out? 809 00:32:40,201 --> 00:32:42,078 No, he just means he goes all day. 810 00:32:42,162 --> 00:32:44,331 Any chance he could have ingested something? 811 00:32:44,414 --> 00:32:46,583 Any pills, vitamins, 812 00:32:46,666 --> 00:32:48,793 any prescriptions that may have been left around? 813 00:32:48,877 --> 00:32:51,171 No, that's all kept locked in the medicine cabinet. 814 00:32:51,254 --> 00:32:53,131 The whole house is childproof. 815 00:32:53,214 --> 00:32:55,884 Uh, what about alcohol? Anything left out? 816 00:32:55,967 --> 00:32:58,094 - No. - What about pets? 817 00:32:58,178 --> 00:32:59,596 No. 818 00:32:59,679 --> 00:33:01,556 So he's usually, like, quite active? 819 00:33:01,640 --> 00:33:04,392 - Very. - Um, any injuries lately? 820 00:33:04,476 --> 00:33:05,810 No. 821 00:33:05,894 --> 00:33:07,395 Hasn't bumped his head recently? 822 00:33:07,479 --> 00:33:09,064 Not that I'm aware of, but he does love 823 00:33:09,147 --> 00:33:10,315 roughhousing with Drew. 824 00:33:10,398 --> 00:33:11,650 But he never gets hurt. 825 00:33:11,733 --> 00:33:13,526 Oxygen level is normal. 826 00:33:13,610 --> 00:33:16,655 Good pulse and blood pressure. No signs of infection. 827 00:33:16,738 --> 00:33:18,615 We're gonna start with blood and urine tests, 828 00:33:18,698 --> 00:33:21,534 check for any metabolic abnormalities. 829 00:33:24,287 --> 00:33:26,873 It's really throbbing. 830 00:33:26,957 --> 00:33:28,124 Yeah, the blood's under pressure. 831 00:33:28,208 --> 00:33:30,627 Gotta drain it. 832 00:33:30,710 --> 00:33:32,212 No anesthesia, or… 833 00:33:32,295 --> 00:33:35,131 I'll stop before I hit the nail bed. 834 00:33:35,215 --> 00:33:36,508 I hope. 835 00:33:39,803 --> 00:33:41,096 Hey, eyes down here. 836 00:33:41,179 --> 00:33:42,514 Watch and learn. 837 00:33:42,597 --> 00:33:44,307 I'm just looking who to see next. 838 00:33:44,391 --> 00:33:46,851 You're supposed to take them in the order they arrive. 839 00:33:46,935 --> 00:33:48,269 Yeah, I know how it works. 840 00:33:48,353 --> 00:33:50,355 OK. No need to cry about it. 841 00:33:50,438 --> 00:33:51,898 Do you want me to choose for you? 842 00:33:51,982 --> 00:33:53,233 No. 843 00:33:55,568 --> 00:33:57,570 Wow, pain's gone. 844 00:33:57,654 --> 00:33:58,822 - Thank you. - Yeah. 845 00:33:58,905 --> 00:34:00,240 All right. 846 00:34:00,323 --> 00:34:02,909 How about a 20-year-old cough in eight? 847 00:34:02,993 --> 00:34:05,036 Should be easy. Probably viral. 848 00:34:05,120 --> 00:34:06,871 I don't need an easy one. 849 00:34:06,955 --> 00:34:08,790 Suit yourself, Huckleberry. 850 00:34:08,873 --> 00:34:10,750 I'm gonna take the splitting headache. 851 00:34:10,834 --> 00:34:13,211 Maybe I'll catch a subarachnoid hemorrhage or something cool. 852 00:34:13,295 --> 00:34:15,046 Hey, why do you keep calling me that? 853 00:34:15,130 --> 00:34:16,172 Huckleberry? 854 00:34:16,256 --> 00:34:18,049 It's a term of endearment. 855 00:34:18,133 --> 00:34:19,384 It sounds like sarcasm. 856 00:34:19,467 --> 00:34:20,468 You think? 857 00:34:20,552 --> 00:34:23,305 Bordering on harassment. 858 00:34:23,388 --> 00:34:24,889 Where are you from? 859 00:34:24,973 --> 00:34:26,808 Broken Bow, Nebraska. 860 00:34:26,891 --> 00:34:28,727 Jesus, where the hell is that? 861 00:34:28,810 --> 00:34:31,229 It's about three and a half hours west of Omaha. 862 00:34:31,313 --> 00:34:33,690 Oh, yeah, just a little south of nowhere. 863 00:34:33,773 --> 00:34:35,025 What the hell do you do there? 864 00:34:35,108 --> 00:34:37,527 My parents have a farm, so… 865 00:34:37,610 --> 00:34:39,988 You're a farm boy? 866 00:34:40,071 --> 00:34:41,990 Yeah, I guess. 867 00:34:42,073 --> 00:34:44,826 I rest my case, Huckleberry. 868 00:34:50,874 --> 00:34:52,167 I'm so sorry, ma'am. 869 00:34:52,250 --> 00:34:54,336 We don't understand you. 870 00:34:58,757 --> 00:35:01,426 Oh. 871 00:35:01,509 --> 00:35:04,888 Me, I'm Dr. Heather Collins. 872 00:35:04,971 --> 00:35:07,807 I'm from here. 873 00:35:07,891 --> 00:35:09,392 Portland, Oregon. 874 00:35:09,476 --> 00:35:10,977 You. 875 00:35:11,061 --> 00:35:13,772 Where are you from? 876 00:35:13,855 --> 00:35:15,231 Uh-huh. 877 00:35:16,941 --> 00:35:19,110 Uh, China? India? 878 00:35:19,194 --> 00:35:20,236 I can't tell where you're pointing. 879 00:35:20,320 --> 00:35:21,529 Tajikistan? 880 00:35:23,698 --> 00:35:25,033 Nepal. 881 00:35:25,116 --> 00:35:26,451 Mm. 882 00:35:26,534 --> 00:35:28,870 - You're from Nepal. - Nepali. 883 00:35:34,209 --> 00:35:35,460 Mom's got a bad burn. 884 00:35:35,543 --> 00:35:37,170 Needs wound checks and hand therapy. 885 00:35:37,253 --> 00:35:40,090 And I got a sneaking suspicion she may be unhoused. 886 00:35:40,173 --> 00:35:42,092 I'll talk to her. We can offer some help. 887 00:35:42,175 --> 00:35:45,261 Thank you, I appreciate it. Ah, you're back. 888 00:35:45,345 --> 00:35:47,639 Dr. Robby suggested I might be of assistance. 889 00:35:47,722 --> 00:35:49,432 Yeah, I could use the company. 890 00:35:49,516 --> 00:35:51,977 Victoria Javadi, this is Kiara Alfaro. 891 00:35:52,060 --> 00:35:53,395 She's the department social worker, 892 00:35:53,478 --> 00:35:55,188 which pretty much makes her an angel. 893 00:35:55,271 --> 00:35:56,982 - Welcome. - Thanks. 894 00:35:57,065 --> 00:35:58,191 Thank you. 895 00:35:58,274 --> 00:36:00,068 So what rotation is this for you? 896 00:36:00,151 --> 00:36:01,152 Um, third. 897 00:36:01,236 --> 00:36:02,654 I've done OB-GYN and pedes. 898 00:36:02,737 --> 00:36:04,155 You have any favorites? 899 00:36:04,239 --> 00:36:05,532 Not really. 900 00:36:05,615 --> 00:36:07,325 Well, what are you leaning towards? 901 00:36:07,409 --> 00:36:09,202 I'm not really sure yet. 902 00:36:09,286 --> 00:36:10,996 OK, well, you have time. 903 00:36:11,079 --> 00:36:14,582 Uh, can I actually ask you a personal question? 904 00:36:14,666 --> 00:36:17,752 I'm 20, and I've earned the right to be here. 905 00:36:17,836 --> 00:36:19,379 Oh. 906 00:36:19,462 --> 00:36:21,381 Yeah, I don't…I don't doubt that for a minute. 907 00:36:21,464 --> 00:36:25,510 I…I was actually wondering if Dr. Eileen Shamsi from surgery 908 00:36:25,593 --> 00:36:27,637 is a friend or relative of yours. 909 00:36:27,721 --> 00:36:29,431 I saw you talking to her in the hall and I thought… 910 00:36:29,514 --> 00:36:30,849 Yeah, she's my mother. 911 00:36:32,684 --> 00:36:33,685 Oh. 912 00:36:33,768 --> 00:36:35,395 Oh, wow. 913 00:36:35,478 --> 00:36:38,148 Oh, that's cool. 914 00:36:38,231 --> 00:36:40,775 - You're really only 20? - Yeah. 915 00:36:40,859 --> 00:36:43,153 And for the record, my… my father also works here. 916 00:36:43,236 --> 00:36:44,612 He's an endocrinologist. 917 00:36:44,696 --> 00:36:45,989 Oh, so it's like a family business. 918 00:36:48,033 --> 00:36:50,076 I'm sorry. That was a joke. That was a joke. 919 00:36:50,160 --> 00:36:51,953 And I'm sure that comes with a lot of pressure. 920 00:36:52,037 --> 00:36:54,789 And as for the age thing, I'm a 42-year-old R2, 921 00:36:54,873 --> 00:36:58,418 so I have my own haters, trust me. 922 00:36:58,501 --> 00:36:59,669 OK. 923 00:36:59,753 --> 00:37:01,212 Um, sometimes when it gets busy, 924 00:37:01,296 --> 00:37:02,881 we'll help the nurses bring back patients. 925 00:37:02,964 --> 00:37:04,716 - OK. - Um, OK. 926 00:37:04,799 --> 00:37:06,426 Next to come back is Fred Saeta. 927 00:37:06,509 --> 00:37:08,219 - Knee pain after a fall. - Great. 928 00:37:08,303 --> 00:37:09,346 - Fred Sa… - Doc. Hey, Doc. Hi. 929 00:37:09,429 --> 00:37:10,680 Hi. Doug Driscoll. 930 00:37:10,764 --> 00:37:12,098 Any chance someone could see me now? 931 00:37:12,182 --> 00:37:13,850 I've been here for, like, two hours. 932 00:37:13,933 --> 00:37:15,560 Unfortunately, Mr. Driscoll, there's a lot of patients 933 00:37:15,644 --> 00:37:17,187 still ahead of you, some of whom are severely ill. 934 00:37:17,270 --> 00:37:18,730 Yeah, and I got chest pains that woke me up 935 00:37:18,813 --> 00:37:20,023 - in the middle of the night. - Chest pain. 936 00:37:20,106 --> 00:37:21,650 - Yeah. - No, it's not plural. 937 00:37:21,733 --> 00:37:24,402 It's just chest pain, not chest pains. 938 00:37:24,486 --> 00:37:26,946 Yeah, and if I have more than one, it's chest pains. 939 00:37:27,030 --> 00:37:29,115 - Are you even a real doctor? - She's a student doctor. 940 00:37:29,199 --> 00:37:30,742 Yeah, well, keep her the hell away from me. 941 00:37:30,825 --> 00:37:33,119 I just need to see someone, OK? Not her. 942 00:37:33,203 --> 00:37:34,913 Isn't chest pain an emergency? I don't… 943 00:37:34,996 --> 00:37:36,957 It looks here like you got an EKG 944 00:37:37,040 --> 00:37:39,167 five minutes after arrival, so it's not a heart attack. 945 00:37:39,250 --> 00:37:42,462 Yeah, but I'm supposed to get a chest X-ray and blood tests. 946 00:37:42,545 --> 00:37:45,006 Ah, and you are next in line for lab tech, OK? 947 00:37:45,090 --> 00:37:47,092 So listen for your name. Excuse me. 948 00:37:47,175 --> 00:37:49,094 Fred… 949 00:37:49,177 --> 00:37:52,138 Actually, can you get me a wheelchair, please? 950 00:37:52,222 --> 00:37:53,932 Uh, hi. I'm…I'm Dr. McKay. 951 00:37:54,015 --> 00:37:55,600 What's going on? 952 00:37:55,684 --> 00:37:57,394 I, uh, found her on the floor in the bathroom. 953 00:37:57,477 --> 00:37:59,396 - She can't stop puking. - What's her name? 954 00:37:59,479 --> 00:38:01,398 Theresa. She's my mom. 955 00:38:01,481 --> 00:38:02,899 Theresa? 956 00:38:02,983 --> 00:38:03,983 Theresa, are you taking any medication? 957 00:38:04,025 --> 00:38:05,193 No. 958 00:38:05,276 --> 00:38:06,262 Any previous stomach problems? 959 00:38:06,277 --> 00:38:07,362 No. 960 00:38:07,445 --> 00:38:08,780 When did the vomiting begin? 961 00:38:08,863 --> 00:38:10,365 Um, last night. 962 00:38:10,448 --> 00:38:12,284 - Last night. - Oh, come on! 963 00:38:12,367 --> 00:38:15,036 Do you have any dizziness or fatigue? 964 00:38:15,120 --> 00:38:16,997 Mystery solved. 965 00:38:17,080 --> 00:38:19,708 Our lady with the degloved foot is Nepali. 966 00:38:19,791 --> 00:38:22,502 Oh, hey, congratulations. 967 00:38:22,585 --> 00:38:24,421 Otis's BP is crashing. 70 over 50. 968 00:38:24,504 --> 00:38:27,090 Still waiting for dialysis. 969 00:38:29,551 --> 00:38:31,594 How you doing there, Otis? 970 00:38:31,678 --> 00:38:32,971 - Not so good. - 50 liters. 971 00:38:33,054 --> 00:38:34,347 Non-rebreather, please. 972 00:38:39,769 --> 00:38:41,604 Oh, crap. 973 00:38:41,688 --> 00:38:43,732 Diastolic collapse of the right atrium and right ventricle. 974 00:38:43,815 --> 00:38:45,233 Tamponade from uremic effusion. 975 00:38:45,317 --> 00:38:46,609 - That's why his BP is low? - Yep. 976 00:38:46,693 --> 00:38:47,986 Too much fluid and pressure 977 00:38:48,069 --> 00:38:49,654 around the heart, chambers can't fill. 978 00:38:49,738 --> 00:38:51,072 Otis, you've got some fluid around your heart. 979 00:38:51,156 --> 00:38:52,240 We need to get it off. 980 00:38:52,324 --> 00:38:53,825 What's happening? 981 00:38:53,908 --> 00:38:55,910 25 of Propofol, 10 cc's of lidocaine with epi, 982 00:38:55,994 --> 00:38:57,287 pericardiocentesis tray. 983 00:38:57,370 --> 00:38:58,705 I have to get that from central. 984 00:38:58,788 --> 00:39:00,040 No, no. Just open a central line kit. 985 00:39:00,123 --> 00:39:01,625 Dr. Santos, take the head of the bed 986 00:39:01,708 --> 00:39:03,043 and bag him if he stops breathing, 987 00:39:03,126 --> 00:39:04,878 compressions if we lose the carotid. 988 00:39:04,961 --> 00:39:06,421 Prep and drape the subxiphoid, please. 989 00:39:06,504 --> 00:39:08,590 - 10 cc's of 1% with. - Chlorhexidine here. 990 00:39:08,673 --> 00:39:10,884 - 25 or 27-gauge? - Long 25, 25. 991 00:39:10,967 --> 00:39:13,845 Thank you. 992 00:39:13,928 --> 00:39:16,389 Injecting lidocaine. 993 00:39:16,473 --> 00:39:18,767 Pressure down. 60 over 40. 994 00:39:18,850 --> 00:39:20,935 Right. 995 00:39:22,729 --> 00:39:24,397 Wait, you can't ultrasound and place. 996 00:39:24,481 --> 00:39:25,982 I know, that's why I'm taking the probe. 997 00:39:26,066 --> 00:39:27,484 18-gauge thin wall 998 00:39:27,567 --> 00:39:29,361 on a 60 cc syringe, please, Dr. Collins. 999 00:39:29,444 --> 00:39:31,404 Let's go. 1000 00:39:31,488 --> 00:39:34,616 You're going in right over the center of my probe, 1001 00:39:34,699 --> 00:39:36,826 advancing very slowly. 1002 00:39:36,910 --> 00:39:39,663 We're looking for the hyperechoic tip. 1003 00:39:39,746 --> 00:39:42,207 Very, very slowly. Do not hit that heart. 1004 00:39:42,290 --> 00:39:43,625 Dr. Santos, do you see that sea of black? 1005 00:39:43,708 --> 00:39:45,126 That's the effusion. 1006 00:39:45,210 --> 00:39:46,753 We're looking for a little white dot. 1007 00:39:46,836 --> 00:39:48,505 There it is. 1008 00:39:48,588 --> 00:39:50,131 Got it. 1009 00:39:50,215 --> 00:39:51,466 Aspirating. 1010 00:39:51,549 --> 00:39:53,426 3 cc's should be enough. 1011 00:39:56,596 --> 00:39:57,806 Good. 1012 00:39:57,889 --> 00:39:59,099 Next, we'll place the guide wire, 1013 00:39:59,182 --> 00:40:01,059 and then the triple lumen catheter. 1014 00:40:01,142 --> 00:40:02,227 Pulse ox is 99. 1015 00:40:02,310 --> 00:40:05,522 Pressure is up. 124 over 78. 1016 00:40:05,605 --> 00:40:08,984 Looks like things are back to normal. 1017 00:40:09,067 --> 00:40:10,402 That was cool. 1018 00:40:10,485 --> 00:40:12,529 Four Zofrans on board. 1019 00:40:12,612 --> 00:40:15,365 That should stop the nausea. 1020 00:40:15,448 --> 00:40:17,409 David, have you had any vomiting? 1021 00:40:17,492 --> 00:40:21,413 - No. - Anyone else sick at home? 1022 00:40:21,496 --> 00:40:23,665 No, it's just us. 1023 00:40:23,748 --> 00:40:27,043 My husband passed away a few years ago, from COVID. 1024 00:40:27,127 --> 00:40:29,629 Oh, I'm so sorry. 1025 00:40:29,713 --> 00:40:31,131 Potassium, 3.1. 1026 00:40:32,924 --> 00:40:34,718 Is that bad? 1027 00:40:34,801 --> 00:40:36,052 It can cause heart problems. 1028 00:40:36,136 --> 00:40:37,387 But we're gonna correct it, OK? 1029 00:40:37,470 --> 00:40:40,015 10 in the bag, 20 PO. 1030 00:40:40,098 --> 00:40:42,726 Javadi, any questions? 1031 00:40:42,809 --> 00:40:44,352 Um… 1032 00:40:44,436 --> 00:40:46,187 uh, David, have you two traveled 1033 00:40:46,271 --> 00:40:47,731 out of the country recently? 1034 00:40:47,814 --> 00:40:50,108 We never go anywhere. 1035 00:40:50,191 --> 00:40:52,360 Is she gonna have to stay here? 1036 00:40:54,571 --> 00:40:56,114 If the rest of the tests are good, 1037 00:40:56,197 --> 00:40:59,451 and she responds to treatment, she can go home. 1038 00:41:06,458 --> 00:41:08,918 Mr. Milton, my name is Dennis Whitaker. 1039 00:41:09,002 --> 00:41:10,837 I'm one of the student doctors here. 1040 00:41:10,920 --> 00:41:12,172 I'll be seeing you first. 1041 00:41:12,255 --> 00:41:13,241 Nice to meet you. 1042 00:41:13,256 --> 00:41:15,550 BP's 150 over 90. 1043 00:41:15,634 --> 00:41:17,510 That's just a touch high. 1044 00:41:17,594 --> 00:41:19,429 I forgot to take my damn enalapril this morning. 1045 00:41:19,512 --> 00:41:20,930 Oh, we'll get that for you. 1046 00:41:21,014 --> 00:41:22,849 Tell me about this belly pain. 1047 00:41:22,932 --> 00:41:26,478 Uh, it started about here. 1048 00:41:26,561 --> 00:41:29,939 Um, woke me up at, like, 2:00 AM. 1049 00:41:30,023 --> 00:41:31,733 Pretty intense. 1050 00:41:31,816 --> 00:41:33,860 Lasted about an hour. 1051 00:41:33,943 --> 00:41:35,236 Now it's gone. 1052 00:41:35,320 --> 00:41:36,738 Any fever or vomiting? 1053 00:41:36,821 --> 00:41:38,740 Nah, I never get sick. 1054 00:41:38,823 --> 00:41:40,075 OK. 1055 00:41:40,158 --> 00:41:42,118 Uh, what did you eat last night? 1056 00:41:42,202 --> 00:41:43,912 Oh, it was my wife's birthday. 1057 00:41:43,995 --> 00:41:45,747 I took her out to Sullivan's for a steak. 1058 00:41:45,830 --> 00:41:47,123 Oh. 1059 00:41:47,207 --> 00:41:48,959 Well, the exam is pretty benign. 1060 00:41:49,042 --> 00:41:50,752 I'm gonna test for gallstones. 1061 00:41:50,835 --> 00:41:55,882 If there is a stone and you eat fatty food, 1062 00:41:55,966 --> 00:41:59,803 there can be pain when the gallbladder contracts. 1063 00:41:59,886 --> 00:42:01,054 Oh. 1064 00:42:01,137 --> 00:42:02,722 Uh, bingo. 1065 00:42:02,806 --> 00:42:05,600 One stone. There it is. 1066 00:42:05,684 --> 00:42:07,686 Do I need surgery? 1067 00:42:07,769 --> 00:42:10,271 Uh, you should be able to manage with a low-fat diet. 1068 00:42:10,355 --> 00:42:13,233 But we'll send off labs for liver and pancreas. 1069 00:42:13,316 --> 00:42:16,236 Just let us know if you have any more pain. 1070 00:42:16,319 --> 00:42:17,654 OK. 1071 00:42:17,737 --> 00:42:19,572 Thanks. 1072 00:42:19,656 --> 00:42:21,700 Yeah, you bet. 1073 00:42:21,783 --> 00:42:23,785 Great. 1074 00:42:23,868 --> 00:42:25,620 You want an EKG? 1075 00:42:25,704 --> 00:42:27,330 For? 1076 00:42:27,414 --> 00:42:30,083 Heart attacks can present as upper abdominal pain. 1077 00:42:30,166 --> 00:42:31,835 Um, yeah. 1078 00:42:31,918 --> 00:42:33,378 No, yeah, that's a great idea. 1079 00:42:33,461 --> 00:42:35,797 Thank you. 1080 00:42:48,601 --> 00:42:50,020 I'm going as fast as I can. 1081 00:42:50,103 --> 00:42:51,354 I'm picking up two more patients. 1082 00:42:51,438 --> 00:42:54,316 I didn't say anything. 1083 00:42:54,399 --> 00:42:56,401 I, uh…I need a fresh set of eyes. 1084 00:42:56,484 --> 00:42:58,278 On what? 1085 00:42:58,361 --> 00:43:00,196 54-year-old woman brought in with intractable vomiting 1086 00:43:00,280 --> 00:43:01,656 by her 18-year-old son. 1087 00:43:01,740 --> 00:43:04,242 I'm, um… I'm getting a weird vibe. 1088 00:43:06,202 --> 00:43:07,871 How so? 1089 00:43:07,954 --> 00:43:09,831 Like, I don't know, maybe she was given something. 1090 00:43:09,914 --> 00:43:12,417 Some sort of elder abuse. 1091 00:43:12,500 --> 00:43:14,586 There's just a strange dynamic I can't quite figure out. 1092 00:43:14,669 --> 00:43:16,588 You're really good at sussing out that sort of thing. 1093 00:43:17,964 --> 00:43:19,299 I don't know about that. 1094 00:43:21,968 --> 00:43:25,096 Uh, excuse me, Dr. Langdon. 1095 00:43:25,180 --> 00:43:27,807 Almost all of our labs are back on sleeping boy Tyler. 1096 00:43:27,891 --> 00:43:30,518 All 100% normal. 1097 00:43:30,602 --> 00:43:32,020 What are we missing? 1098 00:43:35,857 --> 00:43:37,233 Is he waking up? 1099 00:43:37,317 --> 00:43:39,527 No, he's… he's still fast asleep. 1100 00:43:39,611 --> 00:43:42,072 Most of the lab results are in, and they look great. 1101 00:43:42,155 --> 00:43:44,157 No abnormal blood count, no, uh, 1102 00:43:44,240 --> 00:43:46,868 electrolyte abnormalities, no diabetes, 1103 00:43:46,952 --> 00:43:49,704 no, um, kidney disease, so… 1104 00:43:49,788 --> 00:43:52,332 Good. So…so what's wrong with him? 1105 00:43:52,415 --> 00:43:54,626 We're still trying to figure that out. 1106 00:43:54,709 --> 00:43:57,337 Did he, uh, have a playdate yesterday, by chance? 1107 00:43:57,420 --> 00:43:58,797 No, he had preschool, 1108 00:43:58,880 --> 00:44:00,298 but he was fine when I picked him up. 1109 00:44:00,382 --> 00:44:02,092 Any kids in his class ill? 1110 00:44:02,175 --> 00:44:03,635 No, my phone tree would have lit up 1111 00:44:03,718 --> 00:44:05,136 if someone else was sick. 1112 00:44:05,220 --> 00:44:06,888 He eat anything this morning? 1113 00:44:06,972 --> 00:44:08,556 No. 1114 00:44:08,640 --> 00:44:10,392 Why? 1115 00:44:10,475 --> 00:44:13,353 It looks like some sort of gelatin. 1116 00:44:13,436 --> 00:44:14,813 Any chance he could have gotten 1117 00:44:14,896 --> 00:44:17,273 into some bath beads or laundry pods? 1118 00:44:17,357 --> 00:44:19,150 No, there's no such thing in our house. 1119 00:44:19,234 --> 00:44:20,568 What about gummies? 1120 00:44:20,652 --> 00:44:22,821 No, we're very strict about candy. 1121 00:44:22,904 --> 00:44:24,072 Right? 1122 00:44:26,700 --> 00:44:29,661 Oh, shit. 1123 00:44:29,744 --> 00:44:30,912 Danny. 1124 00:44:30,996 --> 00:44:32,122 What about Danny? 1125 00:44:32,205 --> 00:44:34,582 Your brother, he… 1126 00:44:34,666 --> 00:44:36,626 he gave me some gummies he got in Cleveland. 1127 00:44:36,710 --> 00:44:39,462 They were in my coat pocket. 1128 00:44:39,546 --> 00:44:41,172 Are you fucking serious? 1129 00:44:41,256 --> 00:44:42,299 Pot gummies? 1130 00:44:42,382 --> 00:44:44,676 Yes. I'm so sorry. 1131 00:44:44,759 --> 00:44:46,803 Let me call the lab. Maybe the tox screen is back. 1132 00:44:46,886 --> 00:44:49,055 Hey, this is Dr. Langdon from the ED. 1133 00:44:49,139 --> 00:44:50,974 Can I fast-track a lab on a little boy, 1134 00:44:51,057 --> 00:44:52,934 last name Jones, first name Tyler, tox screen? 1135 00:44:53,018 --> 00:44:54,686 Get the fuck out! I mean it. 1136 00:44:54,769 --> 00:44:56,479 Why don't we step outside, and maybe you can help me 1137 00:44:56,563 --> 00:44:59,065 figure out how much he may have taken. 1138 00:44:59,149 --> 00:45:00,525 Thanks. 1139 00:45:00,608 --> 00:45:03,903 I appreciate that quick turnaround. 1140 00:45:03,987 --> 00:45:05,363 The labs confirm it. 1141 00:45:05,447 --> 00:45:07,907 Your son tested positive for cannabis. 1142 00:45:07,991 --> 00:45:09,284 This is a fucking nightmare. 1143 00:45:13,913 --> 00:45:17,792 Theresa, David, this is my attending, Dr. Robinavitch. 1144 00:45:17,876 --> 00:45:19,377 Hi, I'm Dr. Robby. 1145 00:45:19,461 --> 00:45:21,630 We need to do a pelvic exam. 1146 00:45:21,713 --> 00:45:24,257 And David, I don't think you want to be in here for that. 1147 00:45:24,341 --> 00:45:26,009 Definitely not. 1148 00:45:26,092 --> 00:45:28,928 Can you have Nurse Perlah come join me, please? 1149 00:45:29,012 --> 00:45:32,015 Do you want a coffee or a soda or something? 1150 00:45:32,098 --> 00:45:33,642 Why do I need a pelvic exam? 1151 00:45:33,725 --> 00:45:36,353 Uh, you don't. 1152 00:45:36,436 --> 00:45:37,979 Your son seems like a nice kid. 1153 00:45:38,063 --> 00:45:40,190 He's clearly worried about you. 1154 00:45:40,273 --> 00:45:42,734 But your exam and your labs are not matching 1155 00:45:42,817 --> 00:45:44,110 any of the usual diagnoses, 1156 00:45:44,194 --> 00:45:45,654 so I'm not really sure what's going on. 1157 00:45:47,530 --> 00:45:49,282 I'm not here for me. 1158 00:45:49,366 --> 00:45:51,618 - I'm here for David. - I don't understand. 1159 00:45:51,701 --> 00:45:53,119 He said that you've had persistent vomiting, 1160 00:45:53,203 --> 00:45:54,454 some…some dehydration. 1161 00:45:54,537 --> 00:45:57,290 I made myself sick with ipecac. 1162 00:45:57,374 --> 00:45:59,709 To induce vomiting? Why would you do that? 1163 00:45:59,793 --> 00:46:02,879 So David would bring me here. 1164 00:46:02,963 --> 00:46:05,048 My son has some problems. 1165 00:46:05,131 --> 00:46:07,175 He needs professional help. 1166 00:46:07,258 --> 00:46:08,635 OK. What kind of problems? 1167 00:46:08,718 --> 00:46:10,178 Drugs, alcohol? 1168 00:46:12,013 --> 00:46:15,475 I found some of his writing. 1169 00:46:15,558 --> 00:46:18,770 I thought it was schoolwork, but it wasn't. 1170 00:46:20,647 --> 00:46:23,942 It was lists of girls he wanted to hurt. 1171 00:46:37,163 --> 00:46:38,665 Hurt them how? 1172 00:46:38,748 --> 00:46:42,210 He said, "They should all be eliminated." 1173 00:46:44,754 --> 00:46:46,506 Has David seen a therapist? 1174 00:46:46,589 --> 00:46:48,842 No. 1175 00:46:48,925 --> 00:46:52,429 He's not a bad kid, but I'm afraid he's troubled, 1176 00:46:52,512 --> 00:46:53,847 and I didn't want to call the police 1177 00:46:53,930 --> 00:46:55,390 because I was afraid they'd overreact. 1178 00:46:55,473 --> 00:46:57,767 - He's just a kid. - How old is David? 1179 00:46:57,851 --> 00:47:01,271 He just turned 18 last month. 1180 00:47:01,354 --> 00:47:02,856 Then he's considered an adult 1181 00:47:02,939 --> 00:47:06,776 and he would have to consent to treatment. 1182 00:47:06,860 --> 00:47:08,361 Do you have any guns in the house? 1183 00:47:08,445 --> 00:47:09,654 No. 1184 00:47:09,738 --> 00:47:11,197 My husband did, 1185 00:47:11,281 --> 00:47:13,700 but I got rid of all of them after he passed. 1186 00:47:13,783 --> 00:47:15,660 He's a good soul. 1187 00:47:15,744 --> 00:47:18,747 I just don't want to see him hurt anyone or himself. 1188 00:47:21,499 --> 00:47:23,293 How are you feeling, Crash? 1189 00:47:23,376 --> 00:47:25,795 I'd really appreciate if you didn't call me that. 1190 00:47:25,879 --> 00:47:27,839 Why not? It's a cool nickname. 1191 00:47:27,922 --> 00:47:31,092 You earned it. You should own it. 1192 00:47:31,176 --> 00:47:33,470 I don't like it. 1193 00:47:33,553 --> 00:47:36,806 All right. It's just a joke. 1194 00:47:39,476 --> 00:47:43,021 You know, if it makes you feel any better, 1195 00:47:43,104 --> 00:47:46,900 I sharted the first time I saw an emergency C-section. 1196 00:47:48,401 --> 00:47:50,737 Really? 1197 00:47:50,820 --> 00:47:52,530 Of course not. 1198 00:48:01,957 --> 00:48:05,377 Excuse me. I'll be right back. 1199 00:48:05,460 --> 00:48:07,003 I got a situation. 1200 00:48:07,087 --> 00:48:09,547 18-year-old kid brings in his dehydrated mom. 1201 00:48:09,631 --> 00:48:11,257 Dad died during the pandemic. 1202 00:48:11,341 --> 00:48:13,551 Mom's vomiting is self-induced for the sole purpose 1203 00:48:13,635 --> 00:48:15,136 of getting him here after she finds 1204 00:48:15,220 --> 00:48:17,263 his death list for classmates. 1205 00:48:17,347 --> 00:48:20,642 I…OK. 1206 00:48:20,725 --> 00:48:22,560 What does she want us to do? 1207 00:48:22,644 --> 00:48:24,354 Help him, protect him, save him. 1208 00:48:24,437 --> 00:48:27,857 - Where is he now? - Talking to McKay. 1209 00:48:27,941 --> 00:48:29,317 How are you doing? 1210 00:48:29,401 --> 00:48:30,777 Me? I'm good. 1211 00:48:30,860 --> 00:48:32,362 I'm always good. You know that. 1212 00:48:32,445 --> 00:48:34,280 Do I? Does anybody? 1213 00:48:34,364 --> 00:48:37,200 - I'm an open book. - Not even close. 1214 00:48:37,284 --> 00:48:38,952 You do know you can always come talk to me, right? 1215 00:48:39,035 --> 00:48:40,745 Yep. 1216 00:48:43,164 --> 00:48:45,792 - How's it going over here? - Good, good. 1217 00:48:45,875 --> 00:48:48,086 We're just going over aftercare instructions, 1218 00:48:48,169 --> 00:48:49,671 prescription medications, special diet 1219 00:48:49,754 --> 00:48:51,298 for the next few days. 1220 00:48:51,381 --> 00:48:53,174 Dr. McKay, can you check orthostatics on Mom? 1221 00:48:53,258 --> 00:48:54,592 I can. 1222 00:48:54,676 --> 00:48:55,927 David, I wanted you to meet Kiara. 1223 00:48:56,011 --> 00:48:57,262 She's a social worker here who helps 1224 00:48:57,345 --> 00:48:59,055 in situations like this. 1225 00:48:59,139 --> 00:49:01,349 We heard about your father's passing. 1226 00:49:01,433 --> 00:49:02,892 We're really sorry. 1227 00:49:02,976 --> 00:49:05,020 And we know that it can put a lot of pressure 1228 00:49:05,103 --> 00:49:08,148 on somebody your age, which, combined with school 1229 00:49:08,231 --> 00:49:11,192 and now having to take care of your mom, that's a lot. 1230 00:49:11,276 --> 00:49:13,069 It's fine. 1231 00:49:13,153 --> 00:49:14,821 We just want to make sure that when your mom goes home, 1232 00:49:14,904 --> 00:49:16,156 you can handle it. 1233 00:49:16,239 --> 00:49:17,449 We want to make sure you have someone 1234 00:49:17,532 --> 00:49:18,992 you can talk to if you need to. 1235 00:49:19,075 --> 00:49:20,327 I'm OK. 1236 00:49:20,410 --> 00:49:23,204 I don't need to talk to anybody. 1237 00:49:23,288 --> 00:49:24,664 After a parent dies, 1238 00:49:24,748 --> 00:49:27,042 the sadness can last a long time. 1239 00:49:27,125 --> 00:49:29,044 How's that going for you? 1240 00:49:29,127 --> 00:49:31,004 It's not a problem. 1241 00:49:31,087 --> 00:49:32,422 What about school? 1242 00:49:32,505 --> 00:49:33,840 What about it? 1243 00:49:33,923 --> 00:49:36,134 Anything you enjoy there? 1244 00:49:36,217 --> 00:49:39,471 Not really. 1245 00:49:39,554 --> 00:49:42,557 A lot of people have thoughts that can disturb them. 1246 00:49:42,641 --> 00:49:44,768 If you've had any, it's OK to talk about it. 1247 00:49:44,851 --> 00:49:47,479 What's that have to do with my mom? 1248 00:49:47,562 --> 00:49:49,939 - Is she gonna be OK? - Yeah, she's gonna be fine. 1249 00:49:50,023 --> 00:49:51,316 She's probably got a stomach virus, 1250 00:49:51,399 --> 00:49:52,776 maybe food poisoning. 1251 00:49:52,859 --> 00:49:55,111 I think she's more worried about you. 1252 00:49:55,195 --> 00:49:57,030 She always worries about me. 1253 00:49:57,113 --> 00:50:00,200 - Does she have a reason to? - No. 1254 00:50:00,283 --> 00:50:02,118 It's almost 8:00. I gotta go. 1255 00:50:03,870 --> 00:50:05,914 Are you sure you wouldn't prefer to wait with your mom? 1256 00:50:05,997 --> 00:50:07,290 I'm late for school. 1257 00:50:07,374 --> 00:50:10,085 She can just call me when she's ready. 1258 00:50:10,168 --> 00:50:11,544 It would actually be kind of helpful 1259 00:50:11,628 --> 00:50:12,837 to talk to you some more. 1260 00:50:12,921 --> 00:50:15,465 Hey, David. 1261 00:50:15,548 --> 00:50:17,384 David. 1262 00:50:17,467 --> 00:50:18,468 Just give me five minutes. 1263 00:50:18,551 --> 00:50:19,678 Leave me alone! 1264 00:50:28,520 --> 00:50:30,939 Hey, David! 1265 00:50:31,022 --> 00:50:32,399 Shit. 1266 00:50:34,484 --> 00:50:36,361 Robby! 1267 00:50:36,444 --> 00:50:38,530 Robby. 1268 00:50:38,613 --> 00:50:40,240 Got a college kid, respiratory arrest, 1269 00:50:40,323 --> 00:50:41,408 coming in hot. 1270 00:51:12,397 --> 00:51:15,608 Robby, we need to intubate here. 1271 00:51:15,692 --> 00:51:18,528 Dr. Adamson just went down with a pulse ox of 65. 1272 00:51:26,828 --> 00:51:28,580 Robby!