1 00:00:25,567 --> 00:00:30,321 Can you…can you just put him on the phone for a second? 2 00:00:30,405 --> 00:00:33,575 I just want to hear his voice. 3 00:00:33,658 --> 00:00:36,703 There's my guy. 4 00:00:36,786 --> 00:00:39,497 How you doing, buddy? 5 00:00:39,581 --> 00:00:42,459 I would love to hear your…your song. 6 00:01:00,143 --> 00:01:02,479 You should go home. 7 00:01:02,562 --> 00:01:04,689 Oh, that is the last place I want to be. 8 00:01:04,773 --> 00:01:07,067 Are you sure you shouldn't see your OB? 9 00:01:07,150 --> 00:01:09,694 I checked myself. 10 00:01:09,778 --> 00:01:11,780 Uterus is empty, barely spotting now. 11 00:01:11,863 --> 00:01:13,239 I'm fine. 12 00:01:14,199 --> 00:01:15,492 Oh, honey. 13 00:01:15,575 --> 00:01:17,786 I'm so sorry. 14 00:01:17,869 --> 00:01:20,789 Oh, I shouldn't have bought that fucking stroller. 15 00:01:20,872 --> 00:01:22,165 Oh. 16 00:01:22,248 --> 00:01:24,000 Fuck that fucking stroller. 17 00:01:30,090 --> 00:01:33,718 Losing a kid is hard on everybody. 18 00:01:45,647 --> 00:01:47,357 That's as hard as it gets. 19 00:01:47,440 --> 00:01:49,484 We do these debriefs 20 00:01:49,567 --> 00:01:53,696 to try to give a sense of closure, meaning, 21 00:01:53,780 --> 00:01:56,533 to difficult cases so that they won't linger. 22 00:01:56,616 --> 00:02:01,329 But trust me, the kids you'll lose will linger. 23 00:02:01,412 --> 00:02:04,082 So what do you do? 24 00:02:04,165 --> 00:02:07,127 I did my residency at Big Charity in New Orleans. 25 00:02:07,210 --> 00:02:11,172 And day one, I got a kid, five-year-old boy, 26 00:02:11,256 --> 00:02:12,674 accidentally shot by his brother 27 00:02:12,757 --> 00:02:14,926 playing with Dad's gun, 28 00:02:15,009 --> 00:02:17,679 worried he was gonna get in trouble 29 00:02:17,762 --> 00:02:19,639 right up until he coded and died. 30 00:02:23,434 --> 00:02:26,646 That night, I asked myself, like, 31 00:02:26,729 --> 00:02:29,065 what do I do with this kid? 32 00:02:29,149 --> 00:02:31,151 Where do I put this feeling? 33 00:02:31,234 --> 00:02:32,944 And I found myself walking all night. 34 00:02:33,027 --> 00:02:34,320 I was walking and walking and walking. 35 00:02:34,404 --> 00:02:35,738 Then I found myself back at the gates 36 00:02:35,822 --> 00:02:37,198 of Big Charity Cemetery, and I'm looking 37 00:02:37,282 --> 00:02:38,950 at all those mausoleums and those crypts 38 00:02:39,033 --> 00:02:40,785 and I'm thinking to myself, OK, that's what I need. 39 00:02:40,869 --> 00:02:42,871 I just need a safe place where I can put these feelings… 40 00:02:42,954 --> 00:02:44,747 Yo, we got patients throwing punches in chairs. 41 00:02:46,791 --> 00:02:48,793 Uh, OK, everybody. Let's get back to it. 42 00:02:48,877 --> 00:02:50,753 Just remember, the Employee Assistance Program 43 00:02:50,837 --> 00:02:52,630 is available, as are Kiara and myself, 44 00:02:52,714 --> 00:02:54,632 if anybody needs to talk. 45 00:02:54,716 --> 00:02:56,176 - Where's McKay? - In Central 11 46 00:02:56,259 --> 00:02:58,052 with our UTI accounting assistant 47 00:02:58,136 --> 00:03:00,388 while we keep her boss on ice in North 2. 48 00:03:00,471 --> 00:03:02,182 Robby, critical case flying in… 49 00:03:02,265 --> 00:03:04,184 possible MDMA overdose, high temp, 50 00:03:04,267 --> 00:03:05,894 en route from PittFest. Five minutes out. 51 00:03:05,977 --> 00:03:07,312 Stay here. Set up for that. 52 00:03:07,395 --> 00:03:08,730 - Ahmad and I got chairs. - Hey, hey. 53 00:03:08,813 --> 00:03:10,315 Is everything all right with Collins? 54 00:03:10,398 --> 00:03:11,858 Something's bothering her. I asked her about it. 55 00:03:11,941 --> 00:03:13,193 She said she doesn't want to talk to me about it. 56 00:03:13,276 --> 00:03:14,527 Oh. Imagine that. 57 00:03:14,611 --> 00:03:16,154 She probably learned it from you. 58 00:03:16,237 --> 00:03:18,448 Seriously? You just gave a speech titled 59 00:03:18,531 --> 00:03:20,116 "How to Literally Bury your Feelings." 60 00:03:20,200 --> 00:03:23,244 Now, if you'll excuse me, I gotta break up a fight. 61 00:03:24,787 --> 00:03:25,914 Yo, you need to control your wife, man! 62 00:03:25,997 --> 00:03:27,123 Shut it, man! 63 00:03:28,374 --> 00:03:30,168 Hey, hey, Olsen! 64 00:03:30,251 --> 00:03:32,003 - Olsen, what the fuck, man? - Took you long enough! 65 00:03:32,086 --> 00:03:33,087 - Calm down. - No. 66 00:03:33,171 --> 00:03:34,589 Don't tell me to calm down. 67 00:03:34,672 --> 00:03:36,174 How hard is it to put a mask on your kid? 68 00:03:36,257 --> 00:03:38,593 He has allergies, you fucking Fauci zombie. 69 00:03:38,676 --> 00:03:40,762 - What? - Allergies! Fuck you. 70 00:03:42,263 --> 00:03:43,263 - You fucking bitch! - Hey! 71 00:03:43,306 --> 00:03:45,016 Hey! That's enough! 72 00:03:45,099 --> 00:03:47,518 Jesus almighty, I don't believe what I'm seeing. 73 00:03:47,602 --> 00:03:50,021 Where do you people think you are, huh? 74 00:03:50,104 --> 00:03:51,522 This ain't Philly. 75 00:03:51,606 --> 00:03:53,316 This is a hospital, for Christ's sakes. 76 00:03:53,399 --> 00:03:55,985 What's the matter with you? 77 00:03:56,069 --> 00:03:58,488 You call yourselves adults? Huh? 78 00:03:58,571 --> 00:04:00,323 There are children in here. 79 00:04:00,406 --> 00:04:03,368 You should be ashamed of yourselves. 80 00:04:03,451 --> 00:04:05,870 Olsen, you catch any shrapnel? 81 00:04:05,954 --> 00:04:08,831 Craziest shit I've seen since I've been here, but I'm good. 82 00:04:08,915 --> 00:04:10,708 - I'm good, seriously. - Jack-offs. 83 00:04:10,792 --> 00:04:14,712 Ladies, are we finished with the craziness? 84 00:04:14,796 --> 00:04:16,256 This is fucking ridiculous. 85 00:04:16,339 --> 00:04:18,258 All I did was offer to put a mask on her child 86 00:04:18,341 --> 00:04:19,968 who's been coughing for over an hour. 87 00:04:20,051 --> 00:04:21,719 And…and now I'm missing half my goddamn tooth 88 00:04:21,803 --> 00:04:23,137 and talking like this. 89 00:04:23,221 --> 00:04:24,555 First of all, masks are bullshit. 90 00:04:24,639 --> 00:04:26,307 - Oh, my God. - And B, it's an allergy. 91 00:04:26,391 --> 00:04:28,726 He's allergic to cat dander, like I fucking told you. 92 00:04:28,810 --> 00:04:30,270 My sister brought her two Persians… 93 00:04:30,353 --> 00:04:32,313 Shut up. Shut up right now, please. 94 00:04:32,397 --> 00:04:34,565 And only answer the questions I ask. 95 00:04:34,649 --> 00:04:37,652 What happened to the tooth? Did you swallow it? 96 00:04:37,735 --> 00:04:38,903 I don't think so. 97 00:04:38,987 --> 00:04:39,988 I think it's still in my hand. 98 00:04:40,071 --> 00:04:41,406 It sure is. 99 00:04:41,489 --> 00:04:42,949 I hope you both have all your shots. 100 00:04:43,032 --> 00:04:44,492 What do you mean, like, vaccines? 101 00:04:44,575 --> 00:04:46,119 Jesus, please don't stir this pot. 102 00:04:46,202 --> 00:04:47,412 Let's take these ladies back 103 00:04:47,495 --> 00:04:48,871 and get them treated, separately. 104 00:04:48,955 --> 00:04:50,665 - Stick with me. - Come on. 105 00:04:50,748 --> 00:04:51,833 Ma'am, it's time to go. 106 00:04:51,916 --> 00:04:54,210 Guess that makes us a team. 107 00:04:54,294 --> 00:04:55,878 I guess it does. 108 00:04:55,962 --> 00:04:58,589 Ma'am, come with Mateo and I… 109 00:04:58,673 --> 00:05:00,008 Mateo and me. 110 00:05:00,091 --> 00:05:01,759 Yes, with us both. 111 00:05:01,843 --> 00:05:03,469 OK, Earl, let's take a look at you. 112 00:05:03,553 --> 00:05:04,929 Oof, she really tagged you. 113 00:05:05,013 --> 00:05:07,515 Red's got a left hook like Billy Conn. 114 00:05:07,598 --> 00:05:08,725 Well, let's get you cleaned up. 115 00:05:08,808 --> 00:05:11,686 Come on, baby. 116 00:05:11,769 --> 00:05:12,854 Excuse me, sir. 117 00:05:12,937 --> 00:05:15,148 You're not allowed back there. 118 00:05:15,231 --> 00:05:17,442 Unless, what, I start a fight? 119 00:05:17,525 --> 00:05:18,818 Become homeless? 120 00:05:18,901 --> 00:05:19,986 Apparently, that's what it takes. 121 00:05:20,069 --> 00:05:21,070 I understand your frustration. 122 00:05:21,154 --> 00:05:22,405 I promise you'll be seen 123 00:05:22,488 --> 00:05:23,948 as soon as a provider is available. 124 00:05:24,032 --> 00:05:25,658 But how can they become available 125 00:05:25,742 --> 00:05:27,368 if new people keep cutting the fucking line? 126 00:05:27,452 --> 00:05:28,703 There's no line. 127 00:05:28,786 --> 00:05:30,496 We see patients by severity of need. 128 00:05:30,580 --> 00:05:33,416 As soon as we have your tests and labs, you will be seen. 129 00:05:33,499 --> 00:05:35,626 This place is fucking unbelievable. 130 00:05:35,710 --> 00:05:38,212 Runaround after runaround. 131 00:05:38,296 --> 00:05:40,381 Hey. What's up, Erik Estrada? 132 00:05:40,465 --> 00:05:41,799 Still keeping your eye on me? 133 00:05:41,883 --> 00:05:43,718 Always, my friend. 134 00:05:43,801 --> 00:05:45,386 Always. 135 00:05:45,470 --> 00:05:48,056 - Who's Erik Estrada? - Shame on you. "CHiPs." 136 00:05:48,139 --> 00:05:49,349 Know your television history. 137 00:05:49,432 --> 00:05:50,933 - And thank you. - Yeah. 138 00:05:53,102 --> 00:05:54,979 Crazy people. 139 00:05:55,063 --> 00:05:56,647 If you do get my tooth out, I don't want it 140 00:05:56,731 --> 00:05:58,691 after it's been inside that woman. 141 00:05:58,775 --> 00:06:00,526 Reattachment wouldn't be possible. 142 00:06:00,610 --> 00:06:02,236 A type two fracture into the dentin. 143 00:06:02,320 --> 00:06:03,529 Seal with dental cement. 144 00:06:03,613 --> 00:06:05,448 Prescription for Pen VK, soft diet. 145 00:06:05,531 --> 00:06:07,575 Follow up with the dentist in one to three days for a crown. 146 00:06:07,658 --> 00:06:10,912 You handle Spinks while I check on Ali. 147 00:06:10,995 --> 00:06:11,995 You got this. 148 00:06:12,038 --> 00:06:13,873 Don't worry, partner. 149 00:06:13,956 --> 00:06:15,416 Yes. 150 00:06:15,500 --> 00:06:16,918 I totally got this. 151 00:06:20,254 --> 00:06:21,881 How are we doing in here? 152 00:06:21,964 --> 00:06:23,674 You should write that bitch a script for calcium 153 00:06:23,758 --> 00:06:25,551 because I didn't even hit her that hard. 154 00:06:25,635 --> 00:06:28,971 Too much almond milk in your soy lattes. 155 00:06:29,055 --> 00:06:30,807 That doesn't even make sense. 156 00:06:30,890 --> 00:06:33,142 You know, most commercial almond and soy milks 157 00:06:33,226 --> 00:06:35,228 are fortified with calcium, so they end up having 158 00:06:35,311 --> 00:06:37,814 a higher percentage of calcium than cows' milk. 159 00:06:37,897 --> 00:06:39,690 Prepped with Betadine and draped. 160 00:06:39,774 --> 00:06:40,817 Very nice. 161 00:06:40,900 --> 00:06:42,193 Let's have a closer look. 162 00:06:42,276 --> 00:06:44,070 Dr. King, can you please grab me 163 00:06:44,153 --> 00:06:46,656 a 10 cc syringe, a 20 gauge needle, 164 00:06:46,739 --> 00:06:48,241 and some sterile saline, please? 165 00:06:48,324 --> 00:06:50,201 Pluck it out, stitch me up, and send me home. 166 00:06:50,284 --> 00:06:51,786 I've got to get back out there to my kid, 167 00:06:51,869 --> 00:06:53,663 who is still waiting to be seen, by the way. 168 00:06:53,746 --> 00:06:55,540 Afraid it's a little more complicated than that. 169 00:06:55,623 --> 00:06:58,209 You got yourself a fight bite, which means a couple things. 170 00:06:58,292 --> 00:06:59,752 First, we need to determine 171 00:06:59,836 --> 00:07:01,671 if the bite extended into the joint space. 172 00:07:01,754 --> 00:07:03,589 If it did, you're gonna need IV antibiotics 173 00:07:03,673 --> 00:07:05,633 and a trip to the OR to see a hand surgeon. 174 00:07:05,716 --> 00:07:08,511 - Pinprick and a little burning. - An operation? 175 00:07:08,594 --> 00:07:11,139 Well, you were just shouting a minute ago about infection, 176 00:07:11,222 --> 00:07:13,015 and with good reason. 177 00:07:13,099 --> 00:07:16,769 While I am sure you are in the clear for rabies and HIV, 178 00:07:16,853 --> 00:07:19,522 human mouths are filthy, some more than others. 179 00:07:19,605 --> 00:07:20,898 How can you tell if it's bad? 180 00:07:20,982 --> 00:07:22,608 Good question. Dr. K? 181 00:07:24,152 --> 00:07:25,611 I'm sorry? 182 00:07:25,695 --> 00:07:28,573 I am going to inject some sterile saline 183 00:07:28,656 --> 00:07:30,074 into your knuckle joint, which you won't feel 184 00:07:30,158 --> 00:07:31,284 'cause of the anesthetic. 185 00:07:31,367 --> 00:07:33,703 If it comes spraying back out of the bite wound, we'll know. 186 00:07:33,786 --> 00:07:35,121 - Ready? - I guess. 187 00:07:37,498 --> 00:07:38,833 There she blows. 188 00:07:38,916 --> 00:07:40,376 Ah, shit. 189 00:07:40,460 --> 00:07:41,752 Are you serious? 190 00:07:41,836 --> 00:07:43,838 You hear that, you fucking bitch? 191 00:07:43,921 --> 00:07:46,090 I've got to have surgery, thanks to you. 192 00:07:46,174 --> 00:07:49,886 - Good. You assaulted me! - Damn right. 193 00:07:49,969 --> 00:07:51,804 And I'll bet next time, you keep your masks 194 00:07:51,888 --> 00:07:54,015 and opinions to yourself. 195 00:07:54,098 --> 00:07:55,349 You OK? 196 00:07:55,433 --> 00:07:56,767 Yes. 197 00:07:56,851 --> 00:08:00,021 3 grams Unasyn IV. Call the OR. 198 00:08:00,104 --> 00:08:02,440 Tell them we have a fight bite that needs to be washed out. 199 00:08:02,523 --> 00:08:03,774 Then go take 20 minutes in the lounge. 200 00:08:03,858 --> 00:08:05,234 I'll come find you if I need you. 201 00:08:05,318 --> 00:08:07,153 - I don't need a break. - Yes, you do. 202 00:08:09,572 --> 00:08:10,990 OK. 203 00:08:11,073 --> 00:08:13,993 Oh, did you want me to tell the surgeons 204 00:08:14,076 --> 00:08:16,829 - to go no masks for surgery? - What? 205 00:08:16,913 --> 00:08:19,040 Well, those of us who save lives for a living 206 00:08:19,123 --> 00:08:21,417 believe strongly that masks minimize risk 207 00:08:21,501 --> 00:08:23,169 when it comes to spreading disease and infection. 208 00:08:23,252 --> 00:08:25,338 But I…I want to respect your beliefs, 209 00:08:25,421 --> 00:08:27,215 so what do you think? 210 00:08:27,298 --> 00:08:28,799 With or without for surgery? Without? 211 00:08:28,883 --> 00:08:32,637 Um…I want with. 212 00:08:32,720 --> 00:08:35,681 Good call. 213 00:08:35,765 --> 00:08:37,558 Helicopter's here. Cafeteria send the ice? 214 00:08:37,642 --> 00:08:39,268 - Yeah, everything they got. - Hey. 215 00:08:39,352 --> 00:08:40,728 I hear they're gonna start you 216 00:08:40,811 --> 00:08:42,104 working on the Middle East peace plan. 217 00:08:42,188 --> 00:08:43,898 Not since the Dalai Lama or Gandhi. 218 00:08:43,981 --> 00:08:45,066 They'd be fucking-A right to. 219 00:08:45,149 --> 00:08:46,275 You should have seen me. 220 00:08:46,359 --> 00:08:48,027 I was inspiring, also terrifying, 221 00:08:48,110 --> 00:08:49,278 and a little bit shaming. 222 00:08:49,362 --> 00:08:50,905 Holy Trinity of crowd control. 223 00:08:50,988 --> 00:08:52,240 Hey, can we pick it up in here, please? 224 00:08:52,323 --> 00:08:55,159 Overdose is here. 225 00:08:55,243 --> 00:08:56,744 PittFest OD. 226 00:08:56,827 --> 00:08:58,329 Keely Ralston, brought to the first aid tent 227 00:08:58,412 --> 00:09:00,581 at PittFest with altered mental status and fever. 228 00:09:00,665 --> 00:09:02,166 Temp too high for a field thermometer. 229 00:09:02,250 --> 00:09:03,417 Intubated en route. 230 00:09:03,501 --> 00:09:04,919 We got to cool this lady down. 231 00:09:05,002 --> 00:09:06,420 Get some ice packs, head, neck, groin. 232 00:09:06,504 --> 00:09:08,881 - Send off for a rainbow. - On it. 233 00:09:08,965 --> 00:09:11,467 Heart rate 132, BP 210 over 120. 234 00:09:11,551 --> 00:09:14,053 - Jesus, that's high. - Four of Ativan in the field. 235 00:09:14,136 --> 00:09:16,222 Pupils are dilated. Definitely MDMA overdose. 236 00:09:16,305 --> 00:09:18,015 Dr. Mohan, how do you want to treat the BP? 237 00:09:18,099 --> 00:09:19,392 - Beta blockers? - No. 238 00:09:19,475 --> 00:09:20,476 Unopposed alpha could kill her. 239 00:09:20,560 --> 00:09:21,560 Four more of Ativan, please. 240 00:09:21,602 --> 00:09:22,895 Seriously? 241 00:09:22,979 --> 00:09:24,522 She might need another 40. 242 00:09:24,605 --> 00:09:26,399 Hypertension and tachycardia from MDMA 243 00:09:26,482 --> 00:09:28,025 is centrally mediated. 244 00:09:28,109 --> 00:09:29,110 Ativan is the drug of choice. 245 00:09:29,193 --> 00:09:31,195 Damn. Core temp, 107.3. 246 00:09:31,279 --> 00:09:32,613 OK, can we get another hose in here 247 00:09:32,697 --> 00:09:33,948 before she fries her brain, please? 248 00:09:34,031 --> 00:09:36,158 Let's go. Come on. 249 00:09:39,161 --> 00:09:41,038 I'll be right back. 250 00:09:41,122 --> 00:09:43,541 Hi. You look lost. 251 00:09:43,624 --> 00:09:45,001 No, it's my assistant 252 00:09:45,084 --> 00:09:46,502 who actually seems to have been misplaced. 253 00:09:46,586 --> 00:09:48,379 I mean, how long does a CT take? 254 00:09:48,462 --> 00:09:49,630 Certainly not this long. 255 00:09:49,714 --> 00:09:51,007 They can get pretty backed up. 256 00:09:51,090 --> 00:09:52,216 Can I get you a cup of bad coffee? 257 00:09:52,300 --> 00:09:54,176 - Dry sandwich? - No, thank you. 258 00:09:54,260 --> 00:09:55,886 How about a cold LaCroix from my secret stash in the lounge? 259 00:09:55,970 --> 00:09:57,638 I'm going for one myself. I'm freaking addicted. 260 00:09:57,722 --> 00:09:59,890 I'm good on drinks. Can you take me to radiology? 261 00:09:59,974 --> 00:10:02,268 Yeah, right this way. Right this way. 262 00:10:07,064 --> 00:10:09,108 Piper, while we still have a few minutes, 263 00:10:09,191 --> 00:10:10,568 there are some things I want to say. 264 00:10:10,651 --> 00:10:12,278 Yeah, use protection. 265 00:10:12,361 --> 00:10:14,405 - I know. I'm sorry. - Totally. 266 00:10:14,488 --> 00:10:17,116 - It was a mistake. - Totally. 267 00:10:17,199 --> 00:10:19,410 I'm a part of the street team here. 268 00:10:19,493 --> 00:10:21,370 It's a group of doctors and nurses 269 00:10:21,454 --> 00:10:24,081 who go out into the community and help people 270 00:10:24,165 --> 00:10:27,001 who can't or won't ask for help… 271 00:10:27,084 --> 00:10:30,755 addicts, unhoused, runaways. 272 00:10:30,838 --> 00:10:32,923 And I'll be honest with you, Piper. 273 00:10:33,007 --> 00:10:35,843 I think you need some help. 274 00:10:35,926 --> 00:10:37,762 What are you talking about? 275 00:10:37,845 --> 00:10:40,264 If you're in trouble, we can help you. 276 00:10:40,348 --> 00:10:43,100 I'm not. OK? 277 00:10:43,184 --> 00:10:46,771 And if we're done here, I think I'd like to go. 278 00:10:46,854 --> 00:10:51,317 Will you at least take a look at this? 279 00:10:51,400 --> 00:10:53,152 There's a list of resources on the back. 280 00:10:53,235 --> 00:10:55,446 I don't need that. 281 00:10:55,529 --> 00:10:57,907 I know you don't have a phone, 282 00:10:57,990 --> 00:11:02,203 but if you could just take my number, OK? 283 00:11:02,286 --> 00:11:04,121 You never know. 284 00:11:04,205 --> 00:11:06,332 Where's Laura? 285 00:11:06,415 --> 00:11:08,167 How about taking the pen? 286 00:11:08,250 --> 00:11:11,212 If you ever feel unsafe or in danger, call this number. 287 00:11:11,295 --> 00:11:12,755 It's a national hotline. 288 00:11:12,838 --> 00:11:15,174 There's somebody on the other end 24/7, 289 00:11:15,257 --> 00:11:17,134 a trained professional who can help with anything. 290 00:11:17,218 --> 00:11:18,427 I have all the help I need. 291 00:11:18,511 --> 00:11:20,805 I want to go. Now. 292 00:11:20,888 --> 00:11:23,057 OK, on my count. One, two, three. 293 00:11:23,140 --> 00:11:24,809 Gentle, gentle, gentle. 294 00:11:24,892 --> 00:11:26,936 Houston, we have splashdown. 295 00:11:27,019 --> 00:11:28,229 Good luck. See you on the next one. 296 00:11:28,312 --> 00:11:30,272 - Yep. - Temp's down to 107.1. 297 00:11:30,356 --> 00:11:32,066 How long does she need to stay in the ice, Dr. Santos? 298 00:11:32,149 --> 00:11:33,609 My PB in the ice is 13 minutes. 299 00:11:33,693 --> 00:11:35,569 - Dr. Santos. - Until her temp is normal. 300 00:11:35,653 --> 00:11:37,196 Wrong. You pull her out at 102. 301 00:11:37,279 --> 00:11:39,281 Otherwise we could overshoot and cause hypothermia. 302 00:11:39,365 --> 00:11:42,034 Heart rate 120. Pressure 198 over 116. 303 00:11:42,118 --> 00:11:44,161 More Ativan? Another four, please. 304 00:11:44,245 --> 00:11:45,788 Why is she on the ice, Dr. Santos? 305 00:11:45,871 --> 00:11:47,456 - To bring her temp down. - Wow, state the obvious, 306 00:11:47,540 --> 00:11:49,208 yet still don't answer the question. 307 00:11:49,291 --> 00:11:50,710 The quicker we bring it down, the less of a chance 308 00:11:50,793 --> 00:11:52,002 for permanent damage to the brain, 309 00:11:52,086 --> 00:11:53,504 - liver, or kidneys. - Exactly. 310 00:11:53,587 --> 00:11:55,423 - Was she sweating? - Profusely. 311 00:11:55,506 --> 00:11:56,674 What if she wasn't, Dr. Santos? 312 00:11:56,757 --> 00:11:58,259 What if she was dry as a bone? 313 00:11:58,342 --> 00:11:59,885 Then we'd have to think anticholinergic overdose, 314 00:11:59,969 --> 00:12:01,011 not sympathetic. 315 00:12:04,265 --> 00:12:05,433 Very good. 316 00:12:12,732 --> 00:12:14,734 Hey. 317 00:12:14,817 --> 00:12:17,153 I found you scrubs that should fit. 318 00:12:17,236 --> 00:12:18,487 Oh. 319 00:12:18,571 --> 00:12:20,197 Thank you. That's great. 320 00:12:20,281 --> 00:12:23,534 - I appreciate that. - But they come with a catch. 321 00:12:23,617 --> 00:12:25,578 Mr. Krakozhia is asking to see you. 322 00:12:25,661 --> 00:12:27,621 The guy who peed on me? 323 00:12:27,705 --> 00:12:29,665 - Why me? - I didn't ask. 324 00:12:29,749 --> 00:12:31,917 But maybe you should wait to put these scrubs on 325 00:12:32,001 --> 00:12:33,794 until after you've… 326 00:12:33,878 --> 00:12:34,920 That's a good idea. 327 00:12:35,004 --> 00:12:36,380 Oh, God. 328 00:12:38,466 --> 00:12:40,301 Oh, man. We got a load of the… 329 00:12:40,384 --> 00:12:42,344 Oh, my God. 330 00:12:42,428 --> 00:12:43,512 Whoa! Hey! 331 00:12:48,058 --> 00:12:49,685 Yeah, I see you. 332 00:12:52,188 --> 00:12:53,606 Your days are numbered, buddy. 333 00:12:53,689 --> 00:12:55,065 Trauma to ER Two. ETA now. 334 00:12:55,149 --> 00:12:56,609 That's another four of Ativan. 335 00:12:56,692 --> 00:12:58,194 Rectal temp's down to 105. 336 00:12:58,277 --> 00:12:59,361 OK, moving in the right direction. 337 00:12:59,445 --> 00:13:00,696 We might get lucky here. 338 00:13:00,780 --> 00:13:02,364 Double trauma at the back door. 339 00:13:02,448 --> 00:13:04,366 Auto versus pedestrian before hitting a telephone pole. 340 00:13:04,450 --> 00:13:06,410 - You got this? - Yep. 341 00:13:06,494 --> 00:13:08,454 Dr. Robby, I finished with Dr. Ozeki, 342 00:13:08,537 --> 00:13:09,538 the therapist upstairs. 343 00:13:09,622 --> 00:13:11,165 Yes, yes, yes. How did that go? 344 00:13:11,248 --> 00:13:13,000 - Well. - Excellent. 345 00:13:16,086 --> 00:13:17,379 Have you heard from David? 346 00:13:17,463 --> 00:13:18,714 No. 347 00:13:18,798 --> 00:13:20,216 Has David seen the therapist? 348 00:13:26,222 --> 00:13:27,973 Do you think that he's still gonna pick you up today? 349 00:13:28,057 --> 00:13:29,600 - I think so. - OK, well… 350 00:13:29,683 --> 00:13:31,644 - Robby, here they come. - OK. 351 00:13:31,727 --> 00:13:33,687 Well, you're medically cleared, so why don't you stay here 352 00:13:33,771 --> 00:13:36,190 for a little while longer in the hopes that he does? 353 00:13:36,273 --> 00:13:37,733 I still would like him to talk to somebody. 354 00:13:37,817 --> 00:13:39,568 Perlah, this is Theresa. She's a friend of mine, 355 00:13:39,652 --> 00:13:41,570 so I expect concierge service, yes? 356 00:13:41,654 --> 00:13:42,822 - VIP treatment. - Thank you. 357 00:13:42,905 --> 00:13:44,281 You're in good hands. 358 00:13:44,365 --> 00:13:46,367 Just let me know if David shows up or if he calls. 359 00:13:46,450 --> 00:13:48,536 Good boy. Good boy. 360 00:13:48,619 --> 00:13:50,162 Walter Pernell, 52, 361 00:13:50,246 --> 00:13:51,664 walking his dog in the crosswalk, 362 00:13:51,747 --> 00:13:53,791 got struck by a Chevy Impala at low velocity. 363 00:13:53,874 --> 00:13:57,127 Ambulatory on scene, no KO, no neck, chest, or belly pain. 364 00:13:57,211 --> 00:13:59,672 - Good vitals. - Whoa. Major road rash. 365 00:13:59,755 --> 00:14:02,341 Yeah, the car didn't hit me so much as throw me. 366 00:14:02,424 --> 00:14:04,426 But I slid for a good 10 feet. 367 00:14:04,510 --> 00:14:05,678 Of course, this is the first day 368 00:14:05,761 --> 00:14:07,263 I've worn shorts all effin' year. 369 00:14:07,346 --> 00:14:09,181 No deformity at the knee or ankle. 370 00:14:09,265 --> 00:14:10,599 Distal pulse is intact. 371 00:14:10,683 --> 00:14:11,934 Four of morphine so far. 372 00:14:12,017 --> 00:14:13,352 Yeah, feel free to be more generous. 373 00:14:13,435 --> 00:14:14,770 Don't worry. We will patch you up. 374 00:14:14,854 --> 00:14:16,230 We will get you right. Who's your friend? 375 00:14:16,313 --> 00:14:17,565 Oh, this is Crosby, 376 00:14:17,648 --> 00:14:19,483 who thankfully barked and warned me 377 00:14:19,567 --> 00:14:21,402 so I had half a second to try to move out of the way. 378 00:14:21,485 --> 00:14:22,945 Crosby, you're a hero. 379 00:14:23,028 --> 00:14:24,655 Donahue, you think you could find a Milk-Bone 380 00:14:24,738 --> 00:14:26,532 for our little lifesaver here in the doctor's lounge? 381 00:14:26,615 --> 00:14:28,242 Absolutely. I'll take good care of him. 382 00:14:28,325 --> 00:14:29,952 Can't he stay with me? He's a very good boy. 383 00:14:30,035 --> 00:14:31,412 No doubt. Let's get you settled first. 384 00:14:31,495 --> 00:14:32,830 - You're going to South 20. - Got it. 385 00:14:32,913 --> 00:14:34,290 Is that the driver? 386 00:14:34,373 --> 00:14:35,833 28-year-old lady, had her seat belt on. 387 00:14:35,916 --> 00:14:37,084 Clipped the guy with the dog and went 388 00:14:37,167 --> 00:14:38,586 straight into a telephone pole. 389 00:14:38,669 --> 00:14:39,879 Blood's from a scalp lac. 390 00:14:39,962 --> 00:14:41,088 Also complained of chest pain. 391 00:14:41,171 --> 00:14:42,339 Sleepy but arousable. 392 00:14:42,423 --> 00:14:44,049 - What's your name? - Paula. 393 00:14:44,133 --> 00:14:46,719 Heart rate's a bit tachy. 112. BP's fine. 394 00:14:46,802 --> 00:14:48,387 Paula, are you in any pain right now? 395 00:14:48,470 --> 00:14:50,264 Yeah, I got hurt. 396 00:14:50,347 --> 00:14:52,683 Witnesses say she was driving erratically before the crash. 397 00:14:52,766 --> 00:14:55,644 No ETOH on her breath. Maybe drugs? 398 00:14:55,728 --> 00:14:58,355 - Core temp's 104.2. - Heart rate 116. 399 00:14:58,439 --> 00:15:00,316 BP 180 over 110. 400 00:15:00,399 --> 00:15:01,734 Better, but still too high. 401 00:15:01,817 --> 00:15:02,985 Another four of Ativan. 402 00:15:03,068 --> 00:15:04,069 That'll make 20. 403 00:15:04,153 --> 00:15:05,404 Good counting. 404 00:15:05,487 --> 00:15:06,822 Pedestrian in South 20 needs a doctor. 405 00:15:06,906 --> 00:15:08,949 - You got this? - Yep. Keep chilling. 406 00:15:09,033 --> 00:15:10,993 - All hands on deck. You ready? - Ready. 407 00:15:11,076 --> 00:15:13,287 OK, here we go. One, two, three. 408 00:15:17,791 --> 00:15:19,585 I heard motor vehicle collision with chest pain 409 00:15:19,668 --> 00:15:20,711 and altered mental status. 410 00:15:20,794 --> 00:15:22,046 - Qué más? - Meet Paula. 411 00:15:22,129 --> 00:15:24,381 Restrained driver versus telephone pole. 412 00:15:24,465 --> 00:15:26,800 Altered before the crash. Good BP, but tachy. 413 00:15:26,884 --> 00:15:28,761 Second line and run a liter of LR wide open. 414 00:15:28,844 --> 00:15:31,555 Still tachy at 115. BP's 180 over 72. 415 00:15:31,639 --> 00:15:32,806 Airway's patent. 416 00:15:32,890 --> 00:15:34,099 Good breath sounds bilaterally. 417 00:15:34,183 --> 00:15:35,768 Pupils are equal and reactive. 418 00:15:35,851 --> 00:15:37,561 Paula, do you know what today's date is? 419 00:15:37,645 --> 00:15:39,438 It's, uh… 420 00:15:39,521 --> 00:15:40,814 Sats 94%. 421 00:15:40,898 --> 00:15:42,107 How about the city we're in? 422 00:15:42,191 --> 00:15:43,317 Pittsburgh? 423 00:15:43,400 --> 00:15:44,860 Bruising on the chest. 424 00:15:44,944 --> 00:15:47,112 Possible sternal fracture. 425 00:15:47,196 --> 00:15:48,822 - Pericardium's clear. - Good. Good. 426 00:15:48,906 --> 00:15:50,616 No marked tenderness. 427 00:15:50,699 --> 00:15:52,868 Nothing in Morrison's pouch. 428 00:15:52,952 --> 00:15:54,370 She's a little tachypneic. 429 00:15:54,453 --> 00:15:55,788 I don't think she needs intubation. 430 00:15:55,871 --> 00:15:57,289 Might just be concussed. 431 00:15:57,373 --> 00:15:58,916 I worry about her crumping in the scanner. 432 00:15:58,999 --> 00:16:00,876 She's protecting her airway. I see lung sliding. 433 00:16:00,960 --> 00:16:02,503 - No pneumo. - With a head injury? 434 00:16:02,586 --> 00:16:04,129 You guys are supposed to be the airway experts. 435 00:16:04,213 --> 00:16:05,965 Stop fighting. Make a decision. 436 00:16:06,048 --> 00:16:07,591 Call me when she goes to CT. 437 00:16:07,675 --> 00:16:10,219 Paula, can you raise your right arm for me? 438 00:16:10,302 --> 00:16:12,471 Good sign. Follows commands. 439 00:16:12,554 --> 00:16:14,431 You want to intubate with a GCS of 13? 440 00:16:14,515 --> 00:16:15,891 OK. We can hold off and monitor. 441 00:16:15,975 --> 00:16:18,060 - What's your plan? - Pan scan, head to pelvis. 442 00:16:18,143 --> 00:16:19,770 EKG, troponin. 443 00:16:19,853 --> 00:16:21,897 Straight cath urine for UA and tox screen. 444 00:16:21,981 --> 00:16:24,608 - Agreed. - I'm on it. 445 00:16:24,692 --> 00:16:26,902 - Gotta bend those knees. - I gotta quit showing off. 446 00:16:26,986 --> 00:16:29,571 - Is that what you were doing? - Always. 447 00:16:31,031 --> 00:16:33,158 It's a ten-day course of doxycycline, 448 00:16:33,242 --> 00:16:35,035 one pill twice a day. 449 00:16:35,119 --> 00:16:38,664 I'll make sure she takes it on a full stomach. 450 00:16:38,747 --> 00:16:41,417 I can give you your first dose now, Piper, if you like. 451 00:16:41,500 --> 00:16:42,876 - Get you started. - That'd be great. 452 00:16:42,960 --> 00:16:46,088 Actually, I need Piper to answer that one. 453 00:16:46,171 --> 00:16:47,881 Sure. That'd be great. 454 00:16:47,965 --> 00:16:49,758 OK. 455 00:16:50,801 --> 00:16:51,927 Hello, everyone. 456 00:16:52,011 --> 00:16:53,679 Looks like we're finishing up here. 457 00:16:53,762 --> 00:16:55,180 I come bearing gifts. 458 00:16:55,264 --> 00:16:56,807 Everything you always wanted to know about STIs 459 00:16:56,890 --> 00:16:58,100 but never wanted to read. 460 00:16:58,183 --> 00:17:00,102 No gross pictures, I promise. 461 00:17:00,185 --> 00:17:01,353 I think we're good. 462 00:17:01,437 --> 00:17:03,522 - You sure? - Mm-hmm. 463 00:17:03,605 --> 00:17:05,315 Yeah. I learned my lesson. 464 00:17:05,399 --> 00:17:06,900 It won't happen again. 465 00:17:09,445 --> 00:17:12,990 I guess that's it, then. 466 00:17:13,073 --> 00:17:14,992 Well, if you change your mind, 467 00:17:15,075 --> 00:17:17,578 it comes with a free pen. 468 00:17:17,661 --> 00:17:19,538 Thank you both so much for your help. 469 00:17:19,621 --> 00:17:21,331 - Yeah. - Thanks. 470 00:17:23,959 --> 00:17:25,294 OK. 471 00:17:25,377 --> 00:17:27,046 Good luck to you both. 472 00:17:31,592 --> 00:17:32,676 Fuck. 473 00:17:34,720 --> 00:17:35,721 Fuck. 474 00:17:35,804 --> 00:17:38,182 That sums it up. 475 00:17:38,265 --> 00:17:39,683 She'll be back. 476 00:17:39,767 --> 00:17:41,435 Only she'll have slipped a little further. 477 00:17:41,518 --> 00:17:44,188 Sometimes it takes a few visits. 478 00:17:44,271 --> 00:17:45,564 How can I keep her here? 479 00:17:45,647 --> 00:17:47,107 You got anything? 480 00:17:47,191 --> 00:17:49,735 Maybe Kiara has a social services card to play. 481 00:17:49,818 --> 00:17:51,487 She was by Trauma One last I saw her. 482 00:17:51,570 --> 00:17:53,697 Brilliant. Brilliant. Thank you. 483 00:17:53,781 --> 00:17:56,784 That's why I'm here, to be brilliant 484 00:17:56,867 --> 00:17:58,660 and bring peace. 485 00:17:58,744 --> 00:17:59,828 Heart rate's 84. 486 00:17:59,912 --> 00:18:01,789 BP 126 over 78. 487 00:18:01,872 --> 00:18:03,791 Pulse ox, 99 on room air. 488 00:18:03,874 --> 00:18:05,209 Good news, Mr. Pernell. 489 00:18:05,292 --> 00:18:07,586 Your heart, lungs, and belly all look good. 490 00:18:07,669 --> 00:18:09,838 Yeah, just the leg. 491 00:18:09,922 --> 00:18:11,673 Whoo, this might be a road rash record. 492 00:18:11,757 --> 00:18:13,175 We might have to bust out the tape. 493 00:18:13,258 --> 00:18:14,968 I'm getting a little worried about Crosby. 494 00:18:15,052 --> 00:18:16,053 Who's Crosby? 495 00:18:16,136 --> 00:18:17,221 - His dog. - My dog. 496 00:18:17,304 --> 00:18:18,847 Where is Crosby? 497 00:18:18,931 --> 00:18:21,016 - He's in the break room. - Your break room, I think. 498 00:18:21,100 --> 00:18:22,392 I'm sure he's fine. 499 00:18:22,476 --> 00:18:24,311 We got a lot of dog lovers around here. 500 00:18:24,394 --> 00:18:26,313 I'm the new owner of a nine-week-old Goldendoodle. 501 00:18:26,396 --> 00:18:27,731 Oh, nice. 502 00:18:27,815 --> 00:18:28,941 Crosby's a terrier. 503 00:18:29,942 --> 00:18:31,151 Great dogs. 504 00:18:31,235 --> 00:18:33,278 Determined, courageous, love to dig. 505 00:18:33,362 --> 00:18:35,072 Who's he named for, Sidney or David? 506 00:18:35,155 --> 00:18:36,365 David. 507 00:18:36,448 --> 00:18:37,448 Still my Sunday morning soundtrack. 508 00:18:37,491 --> 00:18:39,368 - Ow. Ow. - Oh. Sorry. 509 00:18:39,451 --> 00:18:41,078 Yeah, anyways, great name. 510 00:18:41,161 --> 00:18:42,830 So the knee looks stable. 511 00:18:42,913 --> 00:18:45,415 There's no laxity to suggest a torn ligament. 512 00:18:45,499 --> 00:18:47,626 I think the pain's probably just from the road rash, 513 00:18:47,709 --> 00:18:49,002 but let's get an X-ray just to be sure. 514 00:18:49,086 --> 00:18:50,420 Some more morphine? 515 00:18:50,504 --> 00:18:52,005 You're a wonderful human being. 516 00:18:52,089 --> 00:18:53,590 Let's start with LET, no more than 30 cc's. 517 00:18:53,674 --> 00:18:56,135 We're gonna try a topical anesthetic 518 00:18:56,218 --> 00:18:57,845 to numb the raw skin 519 00:18:57,928 --> 00:18:59,721 before we start picking out all the gravel. 520 00:18:59,805 --> 00:19:02,266 Well, my morning horoscope didn't mention any of this. 521 00:19:02,349 --> 00:19:04,017 Well, hey, look on the bright side. 522 00:19:04,101 --> 00:19:05,602 Now you can tell people that you got hit by a car. 523 00:19:05,686 --> 00:19:07,271 Not a lot of people can live to say that. 524 00:19:07,354 --> 00:19:11,483 Yeah, I hope whoever hit me is rich and well insured. 525 00:19:11,567 --> 00:19:14,570 I'll let him know. OK. Thanks. 526 00:19:14,653 --> 00:19:15,904 Flag on the play. 527 00:19:15,988 --> 00:19:17,823 Positive pregnancy test. 528 00:19:17,906 --> 00:19:19,241 You still want a scan? 529 00:19:19,324 --> 00:19:21,535 Maybe she's bleeding from an ectopic. 530 00:19:21,618 --> 00:19:23,453 No, she delivered a healthy baby here 531 00:19:23,537 --> 00:19:24,746 ten days ago. 532 00:19:24,830 --> 00:19:28,333 Normal vaginal delivery, no complications. 533 00:19:28,417 --> 00:19:30,335 Pregnancy tests stay positive for a few weeks. 534 00:19:30,419 --> 00:19:31,920 - So are we good to go? - Good to go. 535 00:19:32,004 --> 00:19:33,213 We'll let the tech know. 536 00:19:38,594 --> 00:19:40,137 Oh, man. 537 00:19:40,220 --> 00:19:42,306 She was seen here this morning by Dr. McKay. 538 00:19:42,389 --> 00:19:44,683 - For what? - Urinary tract infection. 539 00:19:44,766 --> 00:19:47,769 Discharged with oral antibiotics. 540 00:19:47,853 --> 00:19:49,646 You think it has something to do with the crash? 541 00:19:49,730 --> 00:19:51,023 Yes. No. Maybe. 542 00:19:51,106 --> 00:19:52,816 Ask me again after I've had 543 00:19:52,900 --> 00:19:55,777 the scans, labs, and tox screen. 544 00:19:57,613 --> 00:19:58,614 No. 545 00:19:58,697 --> 00:20:00,157 OK. 546 00:20:00,240 --> 00:20:03,327 So I need to talk to you about something. 547 00:20:03,410 --> 00:20:05,120 - About what? - Do me a favor. 548 00:20:05,204 --> 00:20:07,539 Look at me, and don't turn around 549 00:20:07,623 --> 00:20:09,041 - and just watch… - Oh, hell no! 550 00:20:09,124 --> 00:20:11,877 I told you not to turn around. 551 00:20:15,172 --> 00:20:16,673 I wish there was a way to keep her, 552 00:20:16,757 --> 00:20:18,342 but there just isn't. 553 00:20:18,425 --> 00:20:19,968 Well…well, then fuck it. 554 00:20:20,052 --> 00:20:21,678 We'll just say that we need another urine sample, 555 00:20:21,762 --> 00:20:23,222 that the lab left the last one out too long 556 00:20:23,305 --> 00:20:24,556 and couldn't culture it. 557 00:20:24,640 --> 00:20:26,058 OK. Then what? 558 00:20:26,141 --> 00:20:27,517 I'll give Piper the sample cup 559 00:20:27,601 --> 00:20:29,436 and send her down the hall to the bathroom. 560 00:20:29,519 --> 00:20:31,355 I'll stay with Laura in the room with some bullshit. 561 00:20:31,438 --> 00:20:32,773 You wait for Piper by the bathroom. 562 00:20:32,856 --> 00:20:34,733 To say what exactly? 563 00:20:34,816 --> 00:20:36,485 I don't know. 564 00:20:36,568 --> 00:20:39,363 Just be another voice saying, I see you in danger. 565 00:20:39,446 --> 00:20:41,740 There are limits to what we can legally do, 566 00:20:41,823 --> 00:20:43,700 but I can try to talk to her. 567 00:20:43,784 --> 00:20:45,994 Thank you. 568 00:20:46,078 --> 00:20:48,163 Hi. It's Dr. McKay again. 569 00:20:48,247 --> 00:20:49,331 Can I come in? 570 00:20:51,792 --> 00:20:54,461 Sorry. 571 00:20:54,544 --> 00:20:56,755 Yeah. 572 00:20:56,838 --> 00:21:00,050 Well, it was a long shot anyway. 573 00:21:00,133 --> 00:21:01,510 Hey. 574 00:21:01,593 --> 00:21:03,762 I think Piper took a pen. 575 00:21:03,845 --> 00:21:05,055 Yeah. 576 00:21:11,520 --> 00:21:12,896 Temp is 103.2. 577 00:21:12,980 --> 00:21:15,774 Nice. Almost there. 578 00:21:15,857 --> 00:21:17,693 My God, there are literally hundreds 579 00:21:17,776 --> 00:21:19,861 of different MDMA pills. 580 00:21:19,945 --> 00:21:22,531 And the milligram dosage range is all over the place. 581 00:21:22,614 --> 00:21:26,618 These names…BMW5, Jurassic Park, Red Superman. 582 00:21:27,869 --> 00:21:29,246 Whoa. Why is she seizing? 583 00:21:29,329 --> 00:21:30,414 Febrile seizure? 584 00:21:30,497 --> 00:21:31,665 No, her temp is down. 585 00:21:31,748 --> 00:21:32,734 Maybe she needs more Ativan. 586 00:21:32,749 --> 00:21:33,750 No, she's had 20 already. 587 00:21:33,834 --> 00:21:34,820 And her vitals are stabilizing. 588 00:21:34,835 --> 00:21:35,877 Another four of Ativan. 589 00:21:35,961 --> 00:21:37,254 And prep a gram of Keppra. 590 00:21:37,337 --> 00:21:40,132 I don't think this is a CNS problem. 591 00:21:40,215 --> 00:21:42,092 She needs saline. 592 00:21:42,175 --> 00:21:43,552 We don't have her labs back yet. 593 00:21:43,635 --> 00:21:45,137 At festivals, you dance for hours. 594 00:21:45,220 --> 00:21:47,347 You sweat, you drink gallons of water, 595 00:21:47,431 --> 00:21:49,182 but nobody thinks to replenish their salts. 596 00:21:49,266 --> 00:21:50,934 It's low sodium. Hyponatremia. 597 00:21:51,018 --> 00:21:52,644 She needs 100 cc's of hot saline. 598 00:21:52,728 --> 00:21:54,479 We don't know her sodium levels. 599 00:21:54,563 --> 00:21:56,690 Drop 100 cc's of 3% and have it ready. 600 00:21:56,773 --> 00:21:57,983 OK? 601 00:21:58,066 --> 00:22:00,319 Do it. And prep a gram of Keppra now. 602 00:22:14,124 --> 00:22:15,459 Start the Keppra, please. 603 00:22:15,542 --> 00:22:16,960 It's not gonna help. 604 00:22:17,044 --> 00:22:18,170 Trauma One. 605 00:22:18,253 --> 00:22:20,547 What are you doing? 606 00:22:20,630 --> 00:22:22,007 Got it. Thanks. 607 00:22:22,090 --> 00:22:23,175 It's hyponatremia. 608 00:22:23,258 --> 00:22:24,301 Serum sodium is critical. 609 00:22:24,384 --> 00:22:25,370 Only 112. 610 00:22:25,385 --> 00:22:26,595 Knew it. 611 00:22:26,678 --> 00:22:28,722 OK, I'll push the other 50 cc's. 612 00:22:28,805 --> 00:22:30,807 - What the hell? - She's seizing. 613 00:22:30,891 --> 00:22:32,142 You think? How long? 614 00:22:32,225 --> 00:22:33,477 About three minutes. 615 00:22:33,560 --> 00:22:34,811 Why did you not come get me? 616 00:22:34,895 --> 00:22:36,730 Hello? I was…I was across the hall. 617 00:22:36,813 --> 00:22:38,523 I was 30 feet away. What has she had already? 618 00:22:40,359 --> 00:22:41,818 It's hyponatremia. 619 00:22:41,902 --> 00:22:43,528 We pushed 100 cc's of 3% saline. 620 00:22:43,612 --> 00:22:44,863 That did the trick. 621 00:22:44,946 --> 00:22:47,657 Again, why did you not come get me? 622 00:22:47,741 --> 00:22:49,618 It was my fault. Yeah, I want… 623 00:22:49,701 --> 00:22:52,120 I wanted to keep going with Ativan and Keppra, 624 00:22:52,204 --> 00:22:54,331 but Dr. Mohan had an excellent idea 625 00:22:54,414 --> 00:22:58,335 to treat for hyponatremia even before her labs came back. 626 00:22:58,418 --> 00:23:00,837 Temp's down to 102.4. 627 00:23:00,921 --> 00:23:02,255 Good call, Dr. Mohan. 628 00:23:02,339 --> 00:23:04,132 Another minute, and we'll de-ice her. 629 00:23:04,216 --> 00:23:08,428 I am going to take that minute to try to instill in Dr. Santos 630 00:23:08,512 --> 00:23:11,515 a very clear understanding of what her role is here 631 00:23:11,598 --> 00:23:13,308 and how she is expected to function. 632 00:23:13,392 --> 00:23:15,977 - Dr. Langdon… - Dr. Santos… 633 00:23:16,061 --> 00:23:18,313 and I say doctor in such a fashion 634 00:23:18,397 --> 00:23:21,024 to draw attention to the ridiculous fact 635 00:23:21,108 --> 00:23:24,486 that you have enjoyed that title for, what, 90 days? 636 00:23:24,569 --> 00:23:26,446 So yeah, I'm confused. 637 00:23:26,530 --> 00:23:28,949 Is it…is it hubris or ignorance 638 00:23:29,032 --> 00:23:31,743 that makes you think that you know more than other residents 639 00:23:31,827 --> 00:23:33,995 that have two to three years more experience 640 00:23:34,079 --> 00:23:36,123 and have helped thousands more patients 641 00:23:36,206 --> 00:23:37,749 in the emergency department than you have? 642 00:23:37,833 --> 00:23:40,752 Not to mention the over 500 hours 643 00:23:40,836 --> 00:23:42,087 of advanced training 644 00:23:42,170 --> 00:23:44,256 with lectures and simulation labs 645 00:23:44,339 --> 00:23:45,674 with senior faculty instruction. 646 00:23:45,757 --> 00:23:47,342 It doesn't matter! 647 00:23:47,426 --> 00:23:49,469 Stupid or arrogant, you need to realize 648 00:23:49,553 --> 00:23:52,055 that you are a beginner, which means your job 649 00:23:52,139 --> 00:23:53,682 is to shut up, listen, and learn 650 00:23:53,765 --> 00:23:55,308 because so far today, the only thing you have been 651 00:23:55,392 --> 00:23:57,394 successful at is proving repeatedly 652 00:23:57,477 --> 00:23:58,562 that you know nothing. 653 00:23:58,645 --> 00:23:59,688 Dr. Langdon. 654 00:24:01,690 --> 00:24:04,484 Is the patient stable? 655 00:24:04,568 --> 00:24:05,861 Temp's 102. 656 00:24:05,944 --> 00:24:07,237 Just about to take her out of the ice. 657 00:24:07,320 --> 00:24:09,823 Proceed. Dr. Langdon, a word, please. 658 00:24:16,621 --> 00:24:18,081 Look, I know that sounded rough, 659 00:24:18,165 --> 00:24:19,416 - but you only caught the tail. - Stop talking. 660 00:24:19,499 --> 00:24:21,001 I can give you a list a mile… 661 00:24:21,084 --> 00:24:22,586 - Stop talking. - She was giving unsupervised… 662 00:24:22,669 --> 00:24:24,004 Knock it off. Shut the fuck up! 663 00:24:25,672 --> 00:24:28,425 Where does it say that shaming, belittling, and insulting 664 00:24:28,508 --> 00:24:29,634 are effective teaching tools? 665 00:24:29,718 --> 00:24:31,219 Let me just tell you, 666 00:24:31,303 --> 00:24:32,929 harassment has zero educational value. 667 00:24:33,013 --> 00:24:35,265 You're feeling upset? She's getting under your skin? 668 00:24:35,348 --> 00:24:36,766 Check yourself. Take a break. 669 00:24:36,850 --> 00:24:38,393 I've been watching you ride her. 670 00:24:38,477 --> 00:24:41,146 This kind of behavior will not be tolerated. 671 00:24:41,229 --> 00:24:43,064 I don't want to see it. 672 00:24:43,148 --> 00:24:44,983 I'm sorry. It won't happen again. 673 00:24:45,066 --> 00:24:47,194 Where's your other one? Where's Mel? 674 00:24:47,277 --> 00:24:48,570 - She's taking a breather. - Yeah. 675 00:24:48,653 --> 00:24:50,280 Well, maybe go find her, and see if you can 676 00:24:50,363 --> 00:24:53,909 get her back in the game. You are senior leadership here. 677 00:24:53,992 --> 00:24:55,952 Step up and act like it. 678 00:25:07,005 --> 00:25:09,424 Wow. You came prepared. 679 00:25:09,508 --> 00:25:12,552 Better safe than sorry. 680 00:25:12,636 --> 00:25:14,137 Sorry I took off like that. 681 00:25:14,221 --> 00:25:15,514 I have a thing about rats. 682 00:25:15,597 --> 00:25:17,807 And cows totally freak me out. 683 00:25:17,891 --> 00:25:19,434 Really? 684 00:25:19,518 --> 00:25:21,811 Oh, there's plenty of both where I come from. 685 00:25:21,895 --> 00:25:24,022 They're…you know, they're pretty harmless. 686 00:25:24,105 --> 00:25:25,899 Let's hope Mr. Krakozhia is now too. 687 00:25:25,982 --> 00:25:27,901 Yeah, no kidding. 688 00:25:27,984 --> 00:25:29,444 OK. 689 00:25:37,410 --> 00:25:38,537 Is this the guy? 690 00:25:38,620 --> 00:25:40,455 Yes. 691 00:25:40,539 --> 00:25:41,581 Hey, man. 692 00:25:41,665 --> 00:25:43,166 It's Dennis Whitaker. 693 00:25:43,250 --> 00:25:45,794 I just wanted to say sorry for earlier. 694 00:25:45,877 --> 00:25:48,421 Heard I got you pretty good. 695 00:25:48,505 --> 00:25:50,131 Yeah. 696 00:25:50,215 --> 00:25:53,426 I kind of go out of my head when I'm off my meds. 697 00:25:53,510 --> 00:25:56,179 Then I guess I piss on people. 698 00:25:56,263 --> 00:25:58,807 I'm pretty sure the meth doesn't help. 699 00:25:58,890 --> 00:26:01,017 I'm not using anymore. 700 00:26:01,101 --> 00:26:03,395 I take antipsychotics for the schizophrenia 701 00:26:03,478 --> 00:26:05,272 I got from doing meth. 702 00:26:05,355 --> 00:26:08,483 But I've been clean a year. 703 00:26:09,818 --> 00:26:11,486 Why aren't you taking your meds? 704 00:26:11,570 --> 00:26:13,113 Why don't I take my meds? 705 00:26:13,196 --> 00:26:15,740 Well, Doc, I'm kind of in between houses right now 706 00:26:15,824 --> 00:26:19,286 living in an encampment on Liberty Avenue. 707 00:26:19,369 --> 00:26:20,453 Meds cost money. 708 00:26:20,537 --> 00:26:22,831 I don't have insurance. 709 00:26:22,914 --> 00:26:24,332 - Should I go on? - No. No. 710 00:26:24,416 --> 00:26:26,626 That's fine. 711 00:26:26,710 --> 00:26:27,961 I'm sorry. 712 00:26:31,881 --> 00:26:34,926 Life isn't always easy. 713 00:26:37,220 --> 00:26:39,014 Have you talked to a social worker yet? 714 00:26:39,097 --> 00:26:40,557 - No. - OK. 715 00:26:40,640 --> 00:26:42,517 Do you think you could go grab… 716 00:26:42,601 --> 00:26:43,810 - Kiara? - Kiara in here? 717 00:26:43,893 --> 00:26:45,103 Yeah. 718 00:26:47,606 --> 00:26:49,149 I really am sorry. 719 00:26:49,232 --> 00:26:50,734 It's OK, honestly. 720 00:26:50,817 --> 00:26:53,486 Really, it's OK. 721 00:26:53,570 --> 00:26:55,655 I appreciate the apology. 722 00:27:02,746 --> 00:27:04,372 This must be Crosby. 723 00:27:05,874 --> 00:27:08,710 I've heard a lot about you, buddy. 724 00:27:08,793 --> 00:27:10,962 How's my least problematic trainee? 725 00:27:11,046 --> 00:27:13,673 Well, technically, you're all pretty green, 726 00:27:13,757 --> 00:27:15,216 but you're growing on me. 727 00:27:15,300 --> 00:27:16,968 Thank you. 728 00:27:17,052 --> 00:27:19,137 So how you doing? 729 00:27:20,472 --> 00:27:22,474 Um, good. 730 00:27:22,557 --> 00:27:23,808 Better. 731 00:27:23,892 --> 00:27:25,560 Yeah? 732 00:27:25,644 --> 00:27:28,480 It's…I mean, it's just… 733 00:27:28,563 --> 00:27:32,359 it's the…the little girl and the sister's 734 00:27:32,442 --> 00:27:33,902 too close to home. 735 00:27:33,985 --> 00:27:36,196 The things we do are hard. 736 00:27:36,279 --> 00:27:37,906 Yeah. 737 00:27:37,989 --> 00:27:43,662 You're sitting here feeling like… 738 00:27:43,745 --> 00:27:46,456 like maybe you're not up to it? 739 00:27:46,539 --> 00:27:48,541 Yeah. 740 00:27:48,625 --> 00:27:50,502 Been there. 741 00:27:50,585 --> 00:27:53,380 We all been there. 742 00:27:53,463 --> 00:27:57,050 Mel, you're a sensitive person. 743 00:27:57,133 --> 00:28:02,514 This…this is a tough place for sensitive people. 744 00:28:02,597 --> 00:28:05,350 But we need them badly. 745 00:28:07,811 --> 00:28:12,816 Now, if you're ready, I need you. 746 00:28:12,899 --> 00:28:14,234 It's a perfect job. 747 00:28:14,317 --> 00:28:16,277 It's practically a zen exercise. 748 00:28:16,361 --> 00:28:19,406 I've got 1,000 pieces of gravel 749 00:28:19,489 --> 00:28:23,159 that need to be plucked out of a 2-foot-long road rash. 750 00:28:23,243 --> 00:28:25,328 - 1,000? - Yeah. 751 00:28:25,412 --> 00:28:27,664 Give or take 100. 752 00:28:27,747 --> 00:28:29,332 South 20. 753 00:28:29,416 --> 00:28:31,835 Make sure you close the door behind you. 754 00:28:31,918 --> 00:28:34,003 - Don't want Crosby getting out. - Yeah. 755 00:28:34,087 --> 00:28:37,465 Thank you. No problem. I'll be right there. 756 00:28:38,842 --> 00:28:40,844 That's a lot of gravel. 757 00:28:40,927 --> 00:28:42,804 It looks clean to me. You feel that, Earl? 758 00:28:42,887 --> 00:28:43,888 Feel what? 759 00:28:43,972 --> 00:28:45,348 That's a no. 760 00:28:45,432 --> 00:28:46,891 All right. Now just apply the Dermabond. 761 00:28:46,975 --> 00:28:49,853 Cool. 762 00:28:49,936 --> 00:28:52,147 Can I ask you something? 763 00:28:52,230 --> 00:28:53,815 That's why I'm here. 764 00:28:53,898 --> 00:28:55,191 Yeah, I was just wondering 765 00:28:55,275 --> 00:28:58,111 what the nurses do after their shifts. 766 00:28:58,194 --> 00:28:59,988 In terms of what? 767 00:29:00,071 --> 00:29:02,407 You know, do they ever, like, go out together, 768 00:29:02,490 --> 00:29:05,577 like, hang out to decompress after a shift or anything? 769 00:29:05,660 --> 00:29:07,120 Yeah, sometimes. 770 00:29:07,203 --> 00:29:08,288 I mean, most of us are just happy 771 00:29:08,371 --> 00:29:09,789 to get the hell out of here. 772 00:29:09,873 --> 00:29:14,878 Personally, I'm all about a long, long, hot shower, 773 00:29:14,961 --> 00:29:16,546 comfy sweats, 774 00:29:16,629 --> 00:29:18,256 eating some takeout in front of the TV, 775 00:29:18,339 --> 00:29:21,926 ideally watching something that makes me laugh, so… 776 00:29:22,010 --> 00:29:23,970 Yeah, I can see that. 777 00:29:24,053 --> 00:29:25,555 I'm not imagining it in my mind, of course. 778 00:29:25,638 --> 00:29:29,309 I just mean that I can… I can see the appeal. 779 00:29:29,392 --> 00:29:31,019 I was just asking because… 780 00:29:31,102 --> 00:29:32,604 you know, since we work together, 781 00:29:32,687 --> 00:29:36,733 maybe we could grab a coffee together sometime. 782 00:29:36,816 --> 00:29:39,694 And you could, like, help me get the lay of the land, 783 00:29:39,778 --> 00:29:41,529 so to speak? 784 00:29:41,613 --> 00:29:43,615 You asking him out? 785 00:29:43,698 --> 00:29:45,366 No. What? No. No. 786 00:29:45,450 --> 00:29:48,119 It's just…I'm…I'm new here, so I just thought… 787 00:29:48,203 --> 00:29:50,622 I…I don't date people in the workplace. 788 00:29:50,705 --> 00:29:54,626 It's nothing personal. Just it's never a good idea. 789 00:29:54,709 --> 00:29:56,795 No. No, of course not. No. No. 790 00:29:56,878 --> 00:29:59,172 I just…no, it's not a good…no, of course. 791 00:29:59,255 --> 00:30:00,965 I just thought that since you know 792 00:30:01,049 --> 00:30:02,759 how everything operates here and you, like, have everything 793 00:30:02,842 --> 00:30:04,594 so dialed in, that you would be, like, a valuable resource. 794 00:30:04,677 --> 00:30:06,888 But no. No. 795 00:30:06,971 --> 00:30:09,933 I should probably just figure it out on my own. 796 00:30:10,016 --> 00:30:11,810 Mm-hmm. 797 00:30:11,893 --> 00:30:14,729 No shortcuts here. 798 00:30:14,813 --> 00:30:16,773 How are they treating you, Earl? 799 00:30:16,856 --> 00:30:18,233 Huh? 800 00:30:18,316 --> 00:30:19,901 I see you wrangled yourself another sandwich. 801 00:30:19,984 --> 00:30:21,986 I feel like I'm watching a rom-com. 802 00:30:23,655 --> 00:30:24,906 Just came by to see if I could take Dr. Javadi 803 00:30:24,989 --> 00:30:26,199 on a reconnaissance through chairs. 804 00:30:26,282 --> 00:30:27,534 Yes. 805 00:30:27,617 --> 00:30:28,827 I mean, sorry, if you think that's… 806 00:30:28,910 --> 00:30:30,328 Of course. Of course. 807 00:30:30,411 --> 00:30:31,955 I can finish up my man here. 808 00:30:32,038 --> 00:30:33,081 Great. 809 00:30:40,713 --> 00:30:41,965 Are you OK? 810 00:30:42,048 --> 00:30:44,133 I feel ridiculous. 811 00:30:44,217 --> 00:30:47,762 I've spoken, like, two complete sentences 812 00:30:47,846 --> 00:30:49,055 in the last half hour. 813 00:30:49,138 --> 00:30:50,515 And both of them have made me sound 814 00:30:50,598 --> 00:30:53,685 even more imbecilic than the incomplete ones. 815 00:30:53,768 --> 00:30:56,229 And you attribute that to… 816 00:30:56,312 --> 00:30:58,356 It's like, my parents once took me skiing 817 00:30:58,439 --> 00:31:00,149 for Christmas in Utah, and from the moment 818 00:31:00,233 --> 00:31:03,111 I got off the plane, I could not catch my breath. 819 00:31:03,194 --> 00:31:05,613 No matter how hard I tried, the altitude made me feel, 820 00:31:05,697 --> 00:31:08,032 like, awkward and uncoordinated. 821 00:31:08,116 --> 00:31:09,784 I couldn't concentrate. I couldn't get my bearings. 822 00:31:09,868 --> 00:31:12,078 - Mm-hmm. - And I'm a very good skier, 823 00:31:12,161 --> 00:31:13,329 but I spent the whole vacation just, like, 824 00:31:13,413 --> 00:31:18,042 on my butt, dizzy and panting. 825 00:31:18,126 --> 00:31:20,211 Mateo is like a human Utah. 826 00:31:21,796 --> 00:31:23,506 Oh, honey. 827 00:31:23,590 --> 00:31:25,383 I've worked with a few Utahs. 828 00:31:25,466 --> 00:31:28,303 I wish you many, many Utahs in your life. 829 00:31:30,305 --> 00:31:31,681 Jesse, where are you going? 830 00:31:31,764 --> 00:31:33,182 - Trauma Two. - Stop. Stop. Stop. 831 00:31:33,266 --> 00:31:35,059 Stop. Not back in there. 832 00:31:35,143 --> 00:31:37,228 I'm not even gonna tell you why. 833 00:31:37,312 --> 00:31:38,438 How's she doing? 834 00:31:38,521 --> 00:31:39,689 Still with some pleuritic pain. 835 00:31:39,772 --> 00:31:42,025 Oh. Hey, Paula. I'm Dr. Collins. 836 00:31:42,108 --> 00:31:44,485 Your CT shows that you have a broken sternum. 837 00:31:44,569 --> 00:31:46,404 That's your breastbone right here. 838 00:31:46,487 --> 00:31:48,698 Probably from the shoulder belt when you crashed your car. 839 00:31:48,781 --> 00:31:49,949 I crashed my car? 840 00:31:50,033 --> 00:31:51,534 Mm-hmm, and hit your head. 841 00:31:51,618 --> 00:31:53,661 With a concussion, sometimes you don't remember. 842 00:31:53,745 --> 00:31:56,915 But your head CT doesn't show anything serious. 843 00:31:56,998 --> 00:32:00,543 So I saw in your chart you're a new mom. 844 00:32:00,627 --> 00:32:02,503 How's your baby doing? 845 00:32:02,587 --> 00:32:05,256 He's good. He's with my mom. 846 00:32:05,340 --> 00:32:07,675 South 15's open. Oh. Hey, Dr. McKay? 847 00:32:07,759 --> 00:32:08,927 Just get the bed out of 15. 848 00:32:09,010 --> 00:32:10,261 A patient you saw this morning 849 00:32:10,345 --> 00:32:11,930 came back as an MVC. 850 00:32:12,013 --> 00:32:13,890 Sternal fracture. Slightly concussed. 851 00:32:13,973 --> 00:32:15,558 Oh, no. Paula, do you remember me? 852 00:32:15,642 --> 00:32:16,809 You look familiar. 853 00:32:16,893 --> 00:32:18,227 I was your doctor this morning 854 00:32:18,311 --> 00:32:19,646 - for your bladder infection. - Oh, yeah. 855 00:32:19,729 --> 00:32:21,689 Sorry. I'm a little out of it. 856 00:32:21,773 --> 00:32:23,232 Still tachycardic, 115. 857 00:32:23,316 --> 00:32:25,485 BP's 124 over 78. 858 00:32:25,568 --> 00:32:27,278 There's no bleeding anywhere on the CT. 859 00:32:27,362 --> 00:32:29,906 Chest and abdomen clear apart from the sternal fracture. 860 00:32:29,989 --> 00:32:32,116 Well, probably still tachy from the fracture pain. 861 00:32:32,200 --> 00:32:33,534 It hurts when I breathe. 862 00:32:33,618 --> 00:32:35,119 Let's try four of morphine. 863 00:32:35,203 --> 00:32:37,288 Paula, we're gonna give you some pain meds. 864 00:32:37,372 --> 00:32:39,832 Let me know if it helps, OK? 865 00:32:39,916 --> 00:32:41,751 Mr. Pernell, you are in luck. 866 00:32:41,834 --> 00:32:44,128 If I had to have gravel meticulously picked out 867 00:32:44,212 --> 00:32:46,547 of my leg, this is the person I'd call, 868 00:32:46,631 --> 00:32:48,341 Dr. Mel King, detail specialist. 869 00:32:48,424 --> 00:32:49,424 - Hello. - Hi. 870 00:32:49,467 --> 00:32:50,802 - I love your dog. - Crosby? 871 00:32:50,885 --> 00:32:52,512 - How is he? - Oh, he's great. 872 00:32:52,595 --> 00:32:54,347 Here. Something to help see up close. 873 00:32:54,430 --> 00:32:56,766 Hey, I don't want to be one of those people 874 00:32:56,849 --> 00:32:59,352 who say they need an emotional support animal, 875 00:32:59,435 --> 00:33:01,437 but is it possible he could be with me? 876 00:33:01,521 --> 00:33:03,147 We could tie his leash to the bed. 877 00:33:03,231 --> 00:33:04,732 He wouldn't be in any trouble. I swear. 878 00:33:04,816 --> 00:33:06,901 - What do you think? - I'm happy to go get him. 879 00:33:06,985 --> 00:33:08,569 - Any pain here? - No. 880 00:33:08,653 --> 00:33:09,821 OK. 881 00:33:09,904 --> 00:33:11,990 You go get the dog. You get to work. 882 00:33:12,073 --> 00:33:14,117 I'm gonna get some more gauze from triage. 883 00:33:14,200 --> 00:33:15,952 And just in case, if anybody asks, 884 00:33:16,035 --> 00:33:18,246 just say you need him for anxiety. 885 00:33:18,329 --> 00:33:19,414 OK. 886 00:33:19,497 --> 00:33:20,999 Thanks. 887 00:33:21,082 --> 00:33:23,292 I know you hear me. 888 00:33:23,376 --> 00:33:27,130 You can pretend you don't, but I know you do. 889 00:33:27,213 --> 00:33:28,631 This glass might be bulletproof, 890 00:33:28,715 --> 00:33:29,882 but it ain't soundproof. 891 00:33:29,966 --> 00:33:31,050 Huh? 892 00:33:31,134 --> 00:33:32,218 Hello? 893 00:33:32,301 --> 00:33:33,803 Can you hear me now? Huh? 894 00:33:33,886 --> 00:33:35,888 - Hello! - Whoa. Whoa. Whoa, sir. 895 00:33:35,972 --> 00:33:37,348 Sir, what is the issue? 896 00:33:37,432 --> 00:33:38,432 Oh, same issue. 897 00:33:38,474 --> 00:33:40,018 I've been here all day, 898 00:33:40,101 --> 00:33:41,936 and you people have done nothing to fucking help me. 899 00:33:42,020 --> 00:33:43,604 We're still waiting on your second troponin. 900 00:33:43,688 --> 00:33:45,773 We can't clear you medically until it comes back. 901 00:33:45,857 --> 00:33:47,567 For instance, if it comes back elevated, 902 00:33:47,650 --> 00:33:49,610 that could indicate a silent heart attack. 903 00:33:49,694 --> 00:33:51,029 And you'd need to be admitted for monitoring 904 00:33:51,112 --> 00:33:52,405 in a cardiology consult. 905 00:33:52,488 --> 00:33:54,115 That's all I'm asking for. 906 00:33:54,198 --> 00:33:56,826 I'm afraid I've had a silent heart attack. 907 00:33:56,909 --> 00:33:59,120 I just want someone who knows something about hearts 908 00:33:59,203 --> 00:34:00,455 to tell me what's happening to me. 909 00:34:00,538 --> 00:34:02,457 You know, unlike most of these losers, 910 00:34:02,540 --> 00:34:04,625 I have insurance, good insurance. 911 00:34:04,709 --> 00:34:06,669 And I pay my taxes, which pays for them 912 00:34:06,753 --> 00:34:08,004 to not have any insurance. 913 00:34:08,087 --> 00:34:09,547 Sir, you've got about five seconds 914 00:34:09,630 --> 00:34:11,299 to change your whole attitude before security 915 00:34:11,382 --> 00:34:12,884 and the police get involved. 916 00:34:12,967 --> 00:34:14,552 Fuck it. 917 00:34:14,635 --> 00:34:17,013 I'm leaving. 918 00:34:17,096 --> 00:34:18,097 Hey. 919 00:34:18,181 --> 00:34:19,432 Hey! 920 00:34:19,515 --> 00:34:20,975 You are absolutely free to go. 921 00:34:21,059 --> 00:34:23,478 But if you do, you will be leaving AMA, 922 00:34:23,561 --> 00:34:25,063 against medical advice. 923 00:34:25,146 --> 00:34:27,690 This form states that I have advised you to stay 924 00:34:27,774 --> 00:34:30,777 and complete your evaluation, but you are choosing to leave, 925 00:34:30,860 --> 00:34:33,488 understanding and accepting all risks of heart attack, 926 00:34:33,571 --> 00:34:35,239 stroke, disability, and death. 927 00:34:40,620 --> 00:34:41,788 Sounds like a CYA form 928 00:34:41,871 --> 00:34:43,372 in case I drop dead on the curb. 929 00:34:43,456 --> 00:34:46,375 That's exactly what it is. 930 00:34:46,459 --> 00:34:49,420 I just want to be treated fairly. 931 00:34:49,504 --> 00:34:51,923 I assure you that is our intention. 932 00:34:52,006 --> 00:34:53,758 We are not back here playing Go Fish. 933 00:34:53,841 --> 00:34:56,135 We're doing our best to help some very sick people. 934 00:34:56,219 --> 00:34:57,845 You will be seen, OK? 935 00:35:03,851 --> 00:35:06,646 Robby's gonna love that patient satisfaction score. 936 00:35:06,729 --> 00:35:08,481 Crazy people. 937 00:35:12,902 --> 00:35:14,320 What's going on? 938 00:35:14,403 --> 00:35:15,863 Car crash victim Paula just went south. 939 00:35:15,947 --> 00:35:18,116 BP's crashing. 84 over 62. 940 00:35:18,199 --> 00:35:19,185 Much less responsive. 941 00:35:19,200 --> 00:35:20,451 Liter of LR wide open. 942 00:35:20,535 --> 00:35:21,786 Putting her in a 100% non-rebreather. 943 00:35:21,869 --> 00:35:23,162 Paula, open your eyes. 944 00:35:23,246 --> 00:35:24,497 Paula. 945 00:35:24,580 --> 00:35:25,790 Was it the morphine? 946 00:35:25,873 --> 00:35:26,873 She only got a small dose. 947 00:35:26,916 --> 00:35:28,751 Pulse ox is down to 89. 948 00:35:28,835 --> 00:35:29,919 Set up for intubation. 949 00:35:30,002 --> 00:35:33,339 And, McKay, get Robby in here. 950 00:35:33,422 --> 00:35:34,632 I'll call ICU and get her bumped 951 00:35:34,715 --> 00:35:36,592 ahead of Joyce, our sickler. 952 00:35:36,676 --> 00:35:38,136 She should get the next bed. 953 00:35:38,219 --> 00:35:39,846 Between the hyperthermia and the seizure, 954 00:35:39,929 --> 00:35:41,430 she's gonna be out of it for a while. 955 00:35:41,514 --> 00:35:43,599 A similar thing happened to a friend of mine. 956 00:35:43,683 --> 00:35:45,726 Is that what made you think of hyponatremia? 957 00:35:45,810 --> 00:35:47,770 Look, I know you value evidence-based medicine. 958 00:35:47,854 --> 00:35:51,107 But sometimes experience counts for something. 959 00:35:54,402 --> 00:35:57,655 - May I ask why you did that? - What? 960 00:35:57,738 --> 00:35:59,824 Took the blame for a delay in care 961 00:35:59,907 --> 00:36:01,993 which didn't belong to you 962 00:36:02,076 --> 00:36:04,787 and gave me credit for a save that did belong to you? 963 00:36:04,871 --> 00:36:08,249 You know, I've been on Langdon's shit list all day. 964 00:36:08,332 --> 00:36:10,084 It seemed like he was gonna be more upset about us 965 00:36:10,168 --> 00:36:12,712 not calling him in than glad that we stopped the seizure, 966 00:36:12,795 --> 00:36:16,215 so no reason for him to be pissed at both of us. 967 00:36:16,299 --> 00:36:18,593 Why have you been on his shit list? 968 00:36:18,676 --> 00:36:20,845 Well, I think he made it very clear 969 00:36:20,928 --> 00:36:23,890 that he thinks I don't have what it takes to make it here. 970 00:36:23,973 --> 00:36:26,392 Whether you do or do not, it was completely inappropriate 971 00:36:26,475 --> 00:36:28,144 for him to speak to you that way. 972 00:36:28,227 --> 00:36:29,937 Eh, I've heard worse. 973 00:36:30,021 --> 00:36:32,190 Well, for what it's worth, he's wrong. 974 00:36:33,524 --> 00:36:35,193 You're very good at this. 975 00:36:36,652 --> 00:36:38,613 Thank you. 976 00:36:38,696 --> 00:36:41,532 That's actually worth a lot. 977 00:36:41,616 --> 00:36:43,284 I thought the CTs were normal. 978 00:36:43,367 --> 00:36:44,660 They were. Systolic's down to 70. 979 00:36:44,744 --> 00:36:45,912 Heart rate's up to 130. 980 00:36:45,995 --> 00:36:47,121 100 of ketamine, 100 of rock. 981 00:36:47,205 --> 00:36:48,205 Could she have delayed bleeding? 982 00:36:48,247 --> 00:36:49,233 It's not the chest. 983 00:36:49,248 --> 00:36:50,291 Pericardium's still clear. 984 00:36:50,374 --> 00:36:51,500 No tamponade, good EF. 985 00:36:51,584 --> 00:36:52,584 Lungs are up. 986 00:36:52,627 --> 00:36:53,628 She feels warm. 987 00:36:53,711 --> 00:36:54,754 We'll check a temp. 988 00:36:54,837 --> 00:36:56,172 Meds are on board. 989 00:36:56,255 --> 00:36:57,798 Belly's clear. No bleeding here. 990 00:36:57,882 --> 00:36:59,884 - She's loose. - OK. Go for it. 991 00:37:03,262 --> 00:37:04,639 I see cords. 992 00:37:04,722 --> 00:37:05,848 Looks good. 993 00:37:05,932 --> 00:37:06,974 I'm in. 994 00:37:07,058 --> 00:37:10,019 - Connect the bag. - Nice. 995 00:37:10,102 --> 00:37:11,729 Good breath sounds bilaterally. 996 00:37:11,812 --> 00:37:13,105 Temp is 102.4. 997 00:37:13,189 --> 00:37:14,649 What? Is this septic shock? 998 00:37:14,732 --> 00:37:16,108 OK, we need to assume the worst here. 999 00:37:16,192 --> 00:37:17,860 Code sepsis. Two sets of blood cultures, 1000 00:37:17,944 --> 00:37:19,695 lactate, 30 per kilo of LR 1001 00:37:19,779 --> 00:37:21,489 and for antibiotics, ceftriaxone? 1002 00:37:21,572 --> 00:37:22,990 No, no, she was just in the hospital. 1003 00:37:23,074 --> 00:37:24,450 - Pip-tazo and vanco. - Got it. 1004 00:37:24,533 --> 00:37:26,827 If this is sepsis, where is it coming from? 1005 00:37:26,911 --> 00:37:28,412 - What's the source? - Her urinary tract infection. 1006 00:37:28,496 --> 00:37:29,997 - She doesn't have one. - She did when I saw her. 1007 00:37:30,081 --> 00:37:31,457 It's not a UTI. 1008 00:37:31,540 --> 00:37:32,708 We catheterized urine a half an hour ago. 1009 00:37:32,792 --> 00:37:35,378 There's no nitrates, zero WBCs. 1010 00:37:35,461 --> 00:37:37,546 Your specimen could have been contaminated this morning. 1011 00:37:37,630 --> 00:37:39,882 - Is it pneumonia? - Chest CT negative. 1012 00:37:39,966 --> 00:37:42,927 Abdominal CT negative for an infectious source. 1013 00:37:43,010 --> 00:37:44,470 She was altered. Meningitis? 1014 00:37:44,553 --> 00:37:45,553 She's postpartum. 1015 00:37:45,596 --> 00:37:47,723 Endometritis. 1016 00:37:47,807 --> 00:37:50,643 The CT of the uterus shows a thickened endometrium, 1017 00:37:50,726 --> 00:37:52,186 but that's normal postpartum. 1018 00:37:52,270 --> 00:37:53,271 No retained POCs. 1019 00:37:53,354 --> 00:37:54,563 It still could be the source. 1020 00:37:54,647 --> 00:37:57,566 We'll do a pelvic after she's stable. 1021 00:37:57,650 --> 00:38:00,194 Mr. Krakozhia, here's my obvious concern. 1022 00:38:00,278 --> 00:38:04,782 I write you a script for 30 days' worth of pills. 1023 00:38:04,865 --> 00:38:06,117 Then what? 1024 00:38:06,200 --> 00:38:07,827 What do you mean? I'll take them. 1025 00:38:07,910 --> 00:38:10,246 Well, you come back for 30 more, right? 1026 00:38:10,329 --> 00:38:11,706 I mean, that's the question. 1027 00:38:11,789 --> 00:38:13,833 Even if I could give you your dose 1028 00:38:13,916 --> 00:38:15,501 in a once-a-month shot, 1029 00:38:15,584 --> 00:38:18,379 you still have to come back when the month is over. 1030 00:38:18,462 --> 00:38:19,797 What if he didn't have to? 1031 00:38:19,880 --> 00:38:21,007 Oh, no. He has to. 1032 00:38:21,090 --> 00:38:22,675 If he doesn't, he… 1033 00:38:22,758 --> 00:38:24,051 well, he pees. 1034 00:38:24,135 --> 00:38:25,845 We have a street team here. 1035 00:38:25,928 --> 00:38:27,179 Mr. Krakozhia, are you pretty much 1036 00:38:27,263 --> 00:38:28,889 in one spot these days? 1037 00:38:28,973 --> 00:38:31,559 Yeah, I'm over on Liberty near the Benedum. 1038 00:38:31,642 --> 00:38:32,642 The alley? 1039 00:38:32,685 --> 00:38:33,978 I know it well. 1040 00:38:34,061 --> 00:38:35,896 So we could bring the meds to him? 1041 00:38:35,980 --> 00:38:37,023 Absolutely. 1042 00:38:37,106 --> 00:38:38,441 The once-a-month injection 1043 00:38:38,524 --> 00:38:39,817 sounds like the easier option. 1044 00:38:39,900 --> 00:38:42,403 We could just put you on our schedule. 1045 00:38:42,486 --> 00:38:45,364 I'd be interested in joining that. 1046 00:38:45,448 --> 00:38:47,325 Maybe I can bring out the medicine myself. 1047 00:38:47,408 --> 00:38:48,576 That'd be amazing. 1048 00:38:48,659 --> 00:38:50,703 We could use all the help we can get. 1049 00:38:50,786 --> 00:38:52,371 Thanks, Doc. 1050 00:38:54,165 --> 00:38:58,002 Yeah, purulent drainage from the cervix. 1051 00:38:58,085 --> 00:38:59,962 Got the culture. Oof. 1052 00:39:00,046 --> 00:39:01,964 Looks like we have our source. 1053 00:39:02,048 --> 00:39:05,217 The positive urine this morning was contaminated. 1054 00:39:05,301 --> 00:39:06,427 Maybe. 1055 00:39:06,510 --> 00:39:08,512 Definitely. 1056 00:39:08,596 --> 00:39:11,390 Not-so-clean catch specimen. 1057 00:39:11,474 --> 00:39:13,768 This infection's been brewing for a while. 1058 00:39:13,851 --> 00:39:15,519 So the car crash was a coincidence. 1059 00:39:15,603 --> 00:39:17,313 Not necessarily. 1060 00:39:17,396 --> 00:39:19,607 She was probably already septic as the disease progressed, 1061 00:39:19,690 --> 00:39:21,233 dropped her BP, and passed out while driving. 1062 00:39:21,317 --> 00:39:22,777 She wasn't hypotensive when she arrived. 1063 00:39:22,860 --> 00:39:24,195 Adrenaline rush from the car crash 1064 00:39:24,278 --> 00:39:25,738 and the sternal fracture raised her BP 1065 00:39:25,821 --> 00:39:27,073 - but not for long. - Oh. 1066 00:39:27,156 --> 00:39:28,991 No history of fever. 1067 00:39:29,075 --> 00:39:31,160 Bet she was taking Tylenol for the pain. 1068 00:39:31,243 --> 00:39:32,578 Let's call ICU for an admit. 1069 00:39:32,661 --> 00:39:34,121 Also want gyn to see her. 1070 00:39:37,166 --> 00:39:39,835 She had mild lower abdominal pain 1071 00:39:39,919 --> 00:39:41,712 and a positive urine dip. 1072 00:39:41,796 --> 00:39:45,716 No fever, no back pain to indicate pyelonephritis. 1073 00:39:45,800 --> 00:39:47,885 She was alert, walking, talking. 1074 00:39:47,968 --> 00:39:50,096 It just seemed like a simple UTI. 1075 00:39:50,179 --> 00:39:51,931 I saw no reason to have her wait eight hours 1076 00:39:52,014 --> 00:39:54,225 for a bed for a pelvic exam. 1077 00:39:58,687 --> 00:39:59,939 McKay. 1078 00:40:03,984 --> 00:40:06,445 Every postpartum patient needs a pelvic exam 1079 00:40:06,529 --> 00:40:08,781 to rule out endometritis. 1080 00:40:08,864 --> 00:40:11,826 Wait, you're saying that with 20/20 hindsight. 1081 00:40:11,909 --> 00:40:15,329 Did you ask about Tylenol or ibuprofen use? 1082 00:40:15,413 --> 00:40:16,747 Because that can mask a fever. 1083 00:40:16,831 --> 00:40:18,165 There was no fever. 1084 00:40:18,249 --> 00:40:20,292 Did you do a careful abdominal exam? 1085 00:40:20,376 --> 00:40:21,961 It was a quick chair exam, 1086 00:40:22,044 --> 00:40:24,505 and there was only mild tenderness over the bladder. 1087 00:40:24,588 --> 00:40:27,633 Perhaps there was something about the patient 1088 00:40:27,716 --> 00:40:30,261 that made you overlook proper treatment. 1089 00:40:31,804 --> 00:40:34,557 Like what, 1090 00:40:34,640 --> 00:40:36,934 other than the obvious health risk factors? 1091 00:40:37,017 --> 00:40:40,146 Her size doesn't inherently make her unhealthy. 1092 00:40:40,229 --> 00:40:42,398 Are you saying I was biased against the patient 1093 00:40:42,481 --> 00:40:44,066 because of her weight? 1094 00:40:44,150 --> 00:40:47,069 I raise it as a possibility, not as an accusation. 1095 00:40:47,153 --> 00:40:49,071 Wow. 1096 00:40:49,155 --> 00:40:52,158 I mean, I really don't think that's the case here, 1097 00:40:52,241 --> 00:40:55,369 but I will look out for it. 1098 00:40:55,453 --> 00:40:57,371 Yeah. 1099 00:40:57,455 --> 00:40:59,123 You were good with him. 1100 00:40:59,206 --> 00:41:01,041 Do you get a lot of homeless in Pittsburgh? 1101 00:41:01,125 --> 00:41:02,334 We call them unhoused. 1102 00:41:02,418 --> 00:41:03,836 It's not as bad as Philly or D.C., 1103 00:41:03,919 --> 00:41:05,629 - but it's still pretty bad. - Yeah. 1104 00:41:05,713 --> 00:41:07,673 It really is great that you want to help out. 1105 00:41:07,756 --> 00:41:09,550 The street team get cool jackets. 1106 00:41:09,633 --> 00:41:11,552 - Yeah? - Come find me end of shift, 1107 00:41:11,635 --> 00:41:12,970 and I'll give you more information. 1108 00:41:13,053 --> 00:41:15,264 Will do. 1109 00:41:15,347 --> 00:41:17,099 You made it out unscathed this time. 1110 00:41:17,183 --> 00:41:18,225 Yeah. 1111 00:41:18,309 --> 00:41:20,186 I'm joining the street team. 1112 00:41:20,269 --> 00:41:22,438 Even get a jacket, so… 1113 00:41:22,521 --> 00:41:25,524 Cool. 1114 00:41:25,608 --> 00:41:27,526 Yeah. It is cool. 1115 00:41:27,610 --> 00:41:29,195 Very cool. 1116 00:41:33,574 --> 00:41:35,284 - Whose pooch? - South 20's. 1117 00:41:35,367 --> 00:41:36,827 I'm taking him for a visit. 1118 00:41:36,911 --> 00:41:38,287 This is Crosby. 1119 00:41:38,370 --> 00:41:39,663 Hello. 1120 00:41:39,747 --> 00:41:40,998 I'm going for a smoke. 1121 00:41:41,081 --> 00:41:42,166 If anyone asks, he's an emotional… 1122 00:41:42,249 --> 00:41:44,084 Support animal. I know. 1123 00:41:44,168 --> 00:41:45,586 I got it. 1124 00:41:49,089 --> 00:41:50,466 Whoa! 1125 00:41:50,549 --> 00:41:52,426 Crosby! Hey, hey, heads up. 1126 00:41:52,510 --> 00:41:54,303 Crosby. Ow! 1127 00:41:54,386 --> 00:41:56,055 Drop it. Drop it. 1128 00:41:56,138 --> 00:41:58,265 - Ugh! - Whoa. 1129 00:42:05,689 --> 00:42:08,150 Got you. Come on. 1130 00:42:08,234 --> 00:42:10,277 Crosby. Crosby, come here, buddy. 1131 00:42:10,361 --> 00:42:12,071 Come here. There you go. 1132 00:42:12,154 --> 00:42:13,656 Yeah. 1133 00:42:16,033 --> 00:42:18,452 - Nice job! - Hey. 1134 00:42:18,536 --> 00:42:20,287 - Good work! - There you go. 1135 00:42:28,170 --> 00:42:29,964 You got a rat, didn't you? 1136 00:42:30,047 --> 00:42:31,507 Yeah. 1137 00:42:31,590 --> 00:42:33,968 - He does that. - Yeah. 1138 00:42:34,051 --> 00:42:36,971 - When did those cops get here? - I don't know. 1139 00:42:37,054 --> 00:42:38,597 - Who called them? - I don't know. 1140 00:42:38,681 --> 00:42:40,516 - Where's Dana? - Again, I don't know. 1141 00:42:40,599 --> 00:42:41,767 - Thank you. - Anytime. 1142 00:42:49,858 --> 00:42:51,110 Hard at work? 1143 00:42:54,238 --> 00:42:55,739 I'll take my chances.