1 00:00:10,797 --> 00:00:14,141 Sync and corrections by btsix www.addic7ed.com 2 00:00:16,352 --> 00:00:18,478 I'm in. 3 00:00:18,479 --> 00:00:19,772 Bag him. 4 00:00:23,026 --> 00:00:25,819 Defib pads are in place. 5 00:00:25,820 --> 00:00:27,779 OK, holding compressions. 6 00:00:27,780 --> 00:00:29,823 Good square line on the End-Tidal CO2. 7 00:00:29,824 --> 00:00:32,451 V-fib, charge to 200. 8 00:00:33,786 --> 00:00:35,120 Charged. 9 00:00:35,121 --> 00:00:38,457 Clear. 10 00:00:38,458 --> 00:00:40,752 Stand by with epi. 11 00:00:44,255 --> 00:00:46,174 Suction that tube. 12 00:00:48,092 --> 00:00:49,384 You're not in the esophagus, are you? 13 00:00:49,385 --> 00:00:50,677 Definitely not. 14 00:00:50,678 --> 00:00:52,095 I passed right through the cords. 15 00:00:52,096 --> 00:00:54,848 Good breath sounds. End-Tidal CO2 confirmed. 16 00:00:54,849 --> 00:00:56,183 His lungs are filling up with blood. 17 00:00:56,184 --> 00:00:57,351 I know. 18 00:01:02,982 --> 00:01:04,358 OK, rhythm check. 19 00:01:06,027 --> 00:01:07,527 Asystole. Push the epi. 20 00:01:07,528 --> 00:01:09,238 Fuck. 21 00:01:12,700 --> 00:01:14,534 Patients with lunch trays have been admitted. 22 00:01:14,535 --> 00:01:15,911 They're boarders. 23 00:01:15,912 --> 00:01:17,746 They're waiting for a bed to open upstairs. 24 00:01:17,747 --> 00:01:19,915 - And what about the others? - Non-admitted patients. 25 00:01:19,916 --> 00:01:21,708 They can have sandwiches or juice boxes. 26 00:01:21,709 --> 00:01:24,086 Just make sure they're not NPO. 27 00:01:24,087 --> 00:01:25,379 That's "nil per os." 28 00:01:25,380 --> 00:01:26,588 It's Latin for "nothing by mouth." 29 00:01:26,589 --> 00:01:28,382 NPOs are waiting for surgery. 30 00:01:28,383 --> 00:01:30,217 They'll beg, spit, and curse for food, 31 00:01:30,218 --> 00:01:31,551 but you got to stay strong. 32 00:01:31,552 --> 00:01:33,053 Hey, I've been waiting for an hour. 33 00:01:33,054 --> 00:01:34,888 When am I gonna see a fucking doctor? 34 00:01:34,889 --> 00:01:37,057 Excuse me! 35 00:01:37,058 --> 00:01:39,101 Perhaps you didn't see this, which is strange, 36 00:01:39,102 --> 00:01:40,894 because they're all over the place. 37 00:01:40,895 --> 00:01:43,397 Aggressive behavior toward healthcare workers is a felony. 38 00:01:43,398 --> 00:01:45,232 $2,000 fine, possible jail time. 39 00:01:45,233 --> 00:01:46,566 Got it? 40 00:01:46,567 --> 00:01:49,152 OK. I was just asking. 41 00:01:49,153 --> 00:01:50,821 We're busy today. 42 00:01:50,822 --> 00:01:52,114 It's a holiday weekend. 43 00:01:52,115 --> 00:01:53,407 We see the sickest patients first, 44 00:01:53,408 --> 00:01:55,951 so be happy you're still waiting. 45 00:01:55,952 --> 00:02:00,080 Jag-off. 46 00:02:00,081 --> 00:02:01,707 PTMC charge nurse. 47 00:02:01,708 --> 00:02:04,459 Go ahead, Medic Command. 48 00:02:04,460 --> 00:02:07,212 OK. Got it. 49 00:02:07,213 --> 00:02:08,422 Incoming trauma. 50 00:02:08,423 --> 00:02:10,924 Come on. 51 00:02:10,925 --> 00:02:12,300 Three minutes since the last epi. 52 00:02:12,301 --> 00:02:14,803 Hold compressions. 53 00:02:14,804 --> 00:02:16,138 Asystole. 54 00:02:16,139 --> 00:02:18,432 Resume CPR. Another amp of epi. 55 00:02:18,433 --> 00:02:20,767 Needs more suction. 56 00:02:26,482 --> 00:02:28,608 Pulmonary hemorrhage from liver failure. 57 00:02:28,609 --> 00:02:30,486 Is he going to make it? 58 00:02:35,742 --> 00:02:37,826 Should we give PCC? 59 00:02:37,827 --> 00:02:40,120 Too late for that. 60 00:02:40,121 --> 00:02:41,997 And he's not an ECMO candidate. 61 00:02:41,998 --> 00:02:44,082 Nothing else we can do? 62 00:02:48,963 --> 00:02:51,298 No, I think we're done. 63 00:02:55,845 --> 00:02:58,473 Louie. 64 00:03:02,477 --> 00:03:04,687 12:07. 65 00:03:11,486 --> 00:03:13,987 Should we do a debrief? 66 00:03:13,988 --> 00:03:15,947 We've got another motorcycle injury coming in, 67 00:03:15,948 --> 00:03:17,199 ETA 10 minutes. 68 00:03:17,200 --> 00:03:18,700 Why don't we get Louie cleaned up, 69 00:03:18,701 --> 00:03:20,744 - move him to the viewing room? - Yeah. 70 00:03:20,745 --> 00:03:23,664 Anybody that wants to pay their respects can join us in there. 71 00:03:25,917 --> 00:03:27,668 Thank you, everyone. 72 00:03:34,967 --> 00:03:36,384 I'll clean him up. 73 00:03:36,385 --> 00:03:38,553 Why don't you take five first? 74 00:03:38,554 --> 00:03:41,181 Or ten. Yeah? 75 00:03:41,182 --> 00:03:42,600 Yep. 76 00:03:52,360 --> 00:03:54,569 This is Dr. Jefferson from psychiatry. 77 00:03:54,570 --> 00:03:57,322 Why do I need to see a psychiatrist? 78 00:03:57,323 --> 00:03:59,699 Jada, why do I need to see a psychiatrist? 79 00:03:59,700 --> 00:04:01,368 It's gonna be OK, Jackson. 80 00:04:01,369 --> 00:04:03,870 Dr. Jefferson says he can help. 81 00:04:03,871 --> 00:04:06,665 Do you know how you got here? 82 00:04:06,666 --> 00:04:09,042 The medics brought me. 83 00:04:09,043 --> 00:04:11,878 I don't really remember. I... I was in the library. 84 00:04:11,879 --> 00:04:14,840 What were you doing there? 85 00:04:14,841 --> 00:04:17,717 I was... I was studying. 86 00:04:17,718 --> 00:04:20,387 I was trying to study. 87 00:04:20,388 --> 00:04:22,097 But then they wouldn't stop talking. 88 00:04:22,098 --> 00:04:24,307 Who wouldn't stop talking? 89 00:04:24,308 --> 00:04:25,976 They don't want me to pass the bar. 90 00:04:25,977 --> 00:04:27,561 Who doesn't want you to pass the bar? 91 00:04:27,562 --> 00:04:29,646 - That's what they told me. - Hey, hey. 92 00:04:29,647 --> 00:04:30,897 Hey, look at me. Look at me. 93 00:04:30,898 --> 00:04:32,232 Who doesn't want you to pass the bar? 94 00:04:32,233 --> 00:04:34,025 Let's give them some privacy. 95 00:04:34,026 --> 00:04:37,362 Dr. Jefferson will let us know when he's done. 96 00:04:37,363 --> 00:04:38,738 They don't want me to pass the bar. 97 00:04:38,739 --> 00:04:40,574 I'll be right outside, OK? 98 00:04:40,575 --> 00:04:44,077 I'll be right outside, Jackson. 99 00:04:44,078 --> 00:04:47,038 Why don't they want you to pass the bar, Jackson? 100 00:04:47,039 --> 00:04:49,040 They're afraid of me becoming a lawyer. 101 00:04:49,041 --> 00:04:52,043 They're afraid of you becoming a lawyer? 102 00:04:52,044 --> 00:04:56,256 He must have been studying with his law school friends. 103 00:04:56,257 --> 00:04:57,924 They... they should know what happened. 104 00:04:57,925 --> 00:05:00,594 I'm gonna call them. 105 00:05:00,595 --> 00:05:02,470 If you need anything, let me know. 106 00:05:02,471 --> 00:05:04,932 - OK, thank you. - Mm-hmm. 107 00:05:14,317 --> 00:05:15,610 Louie. 108 00:05:17,069 --> 00:05:20,280 Pulmonary hemorrhage. 109 00:05:20,281 --> 00:05:22,657 That was quick. 110 00:05:22,658 --> 00:05:25,160 I'm gonna go clean him up. 111 00:05:25,161 --> 00:05:26,536 I'll help. 112 00:05:29,790 --> 00:05:31,041 Go, go. 113 00:05:34,712 --> 00:05:38,006 Everything OK, Roxie? 114 00:05:38,007 --> 00:05:39,841 I can't get off the bedpan. 115 00:05:39,842 --> 00:05:41,969 Oh, that's what I'm here for. 116 00:05:47,975 --> 00:05:50,477 Your husband seems like a saint. 117 00:05:50,478 --> 00:05:53,772 How long you been married? 118 00:05:53,773 --> 00:05:56,233 Too long. 119 00:05:57,693 --> 00:06:00,654 Almost 20 years. 120 00:06:00,655 --> 00:06:02,489 - OK, put your arm around me. - Mm-hmm. 121 00:06:02,490 --> 00:06:04,324 And I'll pull the bedpan on three. 122 00:06:04,325 --> 00:06:05,492 OK. 123 00:06:05,493 --> 00:06:08,995 One, two, three. 124 00:06:08,996 --> 00:06:10,664 One more. 125 00:06:10,665 --> 00:06:12,874 - Great. - Mm. 126 00:06:12,875 --> 00:06:16,628 20? Wow. 127 00:06:16,629 --> 00:06:18,630 Yeah. 128 00:06:18,631 --> 00:06:22,677 He's been by my side through all of this. 129 00:06:24,553 --> 00:06:28,556 I've watched the light go out of him. 130 00:06:28,557 --> 00:06:31,017 So have the kids. 131 00:06:31,018 --> 00:06:32,435 That's what happened to my auntie 132 00:06:32,436 --> 00:06:35,772 when my Uncle Gerald got sick. 133 00:06:35,773 --> 00:06:38,358 But your husband does it because he loves you. 134 00:06:38,359 --> 00:06:39,859 Mm. 135 00:06:39,860 --> 00:06:42,070 I don't know how you do it, 136 00:06:42,071 --> 00:06:44,698 care for people day after day. 137 00:06:44,699 --> 00:06:47,158 I'll tell you my secret. 138 00:06:47,159 --> 00:06:50,036 I go home at the end of every shift, 139 00:06:50,037 --> 00:06:52,664 leave this all behind, 140 00:06:52,665 --> 00:06:54,582 and escape to "Love Island." 141 00:06:56,377 --> 00:06:57,919 How's it going in here? 142 00:06:57,920 --> 00:06:59,796 The higher-demand dose of morphine helped a little, 143 00:06:59,797 --> 00:07:01,881 - but she's still in pain. - OK. 144 00:07:01,882 --> 00:07:04,718 I got your order. 0.1 per kilo. 145 00:07:04,719 --> 00:07:06,386 - Thanks. - Mm-hmm. 146 00:07:06,387 --> 00:07:08,930 This is a very low sub-dissociative dose 147 00:07:08,931 --> 00:07:10,140 of ketamine. 148 00:07:10,141 --> 00:07:11,641 You might feel a little weird, 149 00:07:11,642 --> 00:07:14,228 but I think it's gonna help with the pain. 150 00:07:16,731 --> 00:07:18,773 Is my husband still in the cafeteria? 151 00:07:18,774 --> 00:07:20,859 I think so. Want me to get him? 152 00:07:20,860 --> 00:07:23,528 No, no. 153 00:07:23,529 --> 00:07:26,907 It's good for us to have a little time apart. 154 00:07:29,160 --> 00:07:31,495 I'll get you another blanket. 155 00:07:35,583 --> 00:07:37,250 Here. I'm headed that way. 156 00:07:37,251 --> 00:07:39,127 Thank you. 157 00:07:39,128 --> 00:07:40,795 Back here for good? 158 00:07:40,796 --> 00:07:42,589 Officially out of triage. 159 00:07:42,590 --> 00:07:45,759 They need extra hands with all the Westbridge hullabaloo. 160 00:07:45,760 --> 00:07:47,761 How many cups have you had today? 161 00:07:47,762 --> 00:07:49,262 - Don't judge me. - Just asking. 162 00:07:49,263 --> 00:07:50,598 You're judging. 163 00:07:52,475 --> 00:07:53,808 Did you hear about Louie? 164 00:07:53,809 --> 00:07:55,226 No. 165 00:07:55,227 --> 00:07:57,228 Pulmonary hemorrhage. Didn't make it. 166 00:07:57,229 --> 00:07:59,773 - Shit. - Mm. 167 00:07:59,774 --> 00:08:01,441 He's been here a hundred times. 168 00:08:01,442 --> 00:08:03,026 I know. 169 00:08:03,027 --> 00:08:06,279 Debrief in the viewing room later. 170 00:08:06,280 --> 00:08:07,947 On a happier note, Perlah and I are planning 171 00:08:07,948 --> 00:08:09,532 a birthday party for Javadi. 172 00:08:09,533 --> 00:08:11,284 She's turning 21. 173 00:08:11,285 --> 00:08:14,120 You two are thick as thieves. 174 00:08:14,121 --> 00:08:16,623 I don't have much of a social life these days, 175 00:08:16,624 --> 00:08:19,459 but I'll be sure to keep an eye out for the Partiful. 176 00:08:19,460 --> 00:08:22,462 Let's discuss our incarcerated patient Gus. 177 00:08:22,463 --> 00:08:24,255 Prison infirmaries tend to be short-staffed, 178 00:08:24,256 --> 00:08:26,591 so we need to be thorough. 179 00:08:26,592 --> 00:08:29,803 What's in the differential diagnosis for malnutrition? 180 00:08:29,804 --> 00:08:32,972 Inadequate intake, methamphetamine use, 181 00:08:32,973 --> 00:08:36,017 severe alcoholism, ADHD medication. 182 00:08:36,018 --> 00:08:37,644 What else? 183 00:08:37,645 --> 00:08:39,979 Cancer of the oropharynx, esophageal strictures, 184 00:08:39,980 --> 00:08:43,024 prior strokes, malabsorption, inflammatory bowel disease, 185 00:08:43,025 --> 00:08:44,984 none of which were in his medical record. 186 00:08:44,985 --> 00:08:47,403 What about psychosocial causes? 187 00:08:47,404 --> 00:08:49,739 Could be an intentional hunger strike. 188 00:08:49,740 --> 00:08:51,866 Or refusing food to get to the infirmary. 189 00:08:51,867 --> 00:08:53,701 Could also be abuse or neglect. 190 00:08:53,702 --> 00:08:55,995 Let's start with a nutrition history once he's back from CT. 191 00:08:55,996 --> 00:08:57,413 Do you have a second to talk about Westbridge? 192 00:08:57,414 --> 00:08:59,165 Mm-hmm. 193 00:08:59,166 --> 00:09:00,583 Hey, we need to start moving some patients out of here. 194 00:09:00,584 --> 00:09:01,876 These walls are starting to fill up with gurneys. 195 00:09:01,877 --> 00:09:03,336 Santos, Ogilvie, and King 196 00:09:03,337 --> 00:09:04,838 all have patients on the launching pad. 197 00:09:04,839 --> 00:09:06,673 I'll check in with them. 198 00:09:06,674 --> 00:09:08,341 How many patients have we had rerouted from Westbridge? 199 00:09:08,342 --> 00:09:09,676 Ten, and God knows how many more in the waiting room. 200 00:09:09,677 --> 00:09:11,344 Ambulance will be here in a few minutes 201 00:09:11,345 --> 00:09:13,138 with the accident victim; I'll stick him in Trauma Two. 202 00:09:13,139 --> 00:09:15,557 What is the story with your incarcerated patient? 203 00:09:15,558 --> 00:09:17,517 Gus Varney, three rib fractures 204 00:09:17,518 --> 00:09:20,145 with normal O2 sats currently, waiting on CT results. 205 00:09:20,146 --> 00:09:21,187 OK, if he's stable at the two-hour mark, 206 00:09:21,188 --> 00:09:22,647 I'd say he's good to go. 207 00:09:22,648 --> 00:09:23,815 Let's get the ball rolling on discharge. 208 00:09:23,816 --> 00:09:25,233 Let's wait on the CT results. 209 00:09:25,234 --> 00:09:26,693 We can move him out of Trauma One, at least. 210 00:09:26,694 --> 00:09:28,027 Yes, we can. What's open? 211 00:09:28,028 --> 00:09:29,696 13 and 14 will be discharged soon, 212 00:09:29,697 --> 00:09:31,489 15 once we move Louie to the viewing room 213 00:09:31,490 --> 00:09:32,907 and get it cleaned up. 214 00:09:32,908 --> 00:09:34,784 Our paracentesis patient, Mr. Cloverfield? 215 00:09:34,785 --> 00:09:36,369 V-fib arrest. 216 00:09:36,370 --> 00:09:37,579 We'll do a debrief when we know how many patients 217 00:09:37,580 --> 00:09:39,038 we're getting from Westbridge. 218 00:09:39,039 --> 00:09:42,083 So Gus goes to 13, 14, or 15? 219 00:09:42,084 --> 00:09:43,710 I kind of want to keep him in plain sight. 220 00:09:43,711 --> 00:09:45,712 - What about BH-2? - Sold. 221 00:09:45,713 --> 00:09:47,547 Why not give him some privacy? 222 00:09:47,548 --> 00:09:50,717 Everyone can see him in BH-2 like he's a monkey at the zoo. 223 00:09:50,718 --> 00:09:52,635 Because he came in with an orange jumpsuit, 224 00:09:52,636 --> 00:09:54,554 and we need to think about patient and staff safety. 225 00:09:54,555 --> 00:09:56,598 Safety first. BH-2 beats a prison cell. 226 00:09:56,599 --> 00:09:58,057 Not by much. 227 00:09:58,058 --> 00:09:59,726 Did you guys hear about Louie? 228 00:09:59,727 --> 00:10:02,395 - Yeah. - Yeah, chronic alcoholic. 229 00:10:02,396 --> 00:10:03,980 Go figure. 230 00:10:03,981 --> 00:10:06,566 Hey, fent OD in South 20 is ready for discharge, 231 00:10:06,567 --> 00:10:08,568 but could you get Lupe to call him a ride? 232 00:10:08,569 --> 00:10:09,944 I need to check on Louie. 233 00:10:09,945 --> 00:10:13,031 - Uh, actually, Whitaker... - He croaked. 234 00:10:13,032 --> 00:10:14,866 - What? - Five minutes ago. 235 00:10:14,867 --> 00:10:16,327 Robby called it. 236 00:10:26,420 --> 00:10:27,712 I'm sorry, man. 237 00:10:27,713 --> 00:10:30,548 We didn't have time to find you. 238 00:10:30,549 --> 00:10:32,800 What happened? 239 00:10:32,801 --> 00:10:35,428 He was apneic and pulseless. 240 00:10:35,429 --> 00:10:38,097 We started CPR and intubated him. 241 00:10:38,098 --> 00:10:39,766 He had a massive pulmonary hemorrhage. 242 00:10:39,767 --> 00:10:42,602 Robby called it. 243 00:10:43,771 --> 00:10:45,772 Found this with his stuff. 244 00:10:45,773 --> 00:10:48,107 Guess he was married at some point. 245 00:10:48,108 --> 00:10:49,860 Never knew that. 246 00:10:53,113 --> 00:10:55,823 Oh, didn't miss this part of the job. 247 00:10:55,824 --> 00:10:57,825 Yeah. 248 00:10:57,826 --> 00:11:03,289 Perlah, did Louie ever mention anything about a wife and kids? 249 00:11:03,290 --> 00:11:04,958 Not as far as I know. 250 00:11:04,959 --> 00:11:07,001 He only had eyes for Rita Moreno. 251 00:11:07,002 --> 00:11:10,755 Well, this is not Rita Moreno. 252 00:11:10,756 --> 00:11:12,590 No, it's not. 253 00:11:12,591 --> 00:11:16,678 Can we check to see if there's an emergency contact? 254 00:11:16,679 --> 00:11:19,556 Yeah, there's a number listed. 255 00:11:26,021 --> 00:11:30,149 You were his primary. Do you want to... 256 00:11:30,150 --> 00:11:31,819 No. 257 00:11:41,328 --> 00:11:43,830 PTMC charge nurse. 258 00:11:43,831 --> 00:11:48,001 Langdon? Where are you? 259 00:11:48,002 --> 00:11:50,086 Makes sense that we'd be his emergency contact. 260 00:11:50,087 --> 00:11:53,673 Sorry to get your hopes up. 261 00:11:53,674 --> 00:11:55,591 Our social worker's gonna do their thing. 262 00:11:55,592 --> 00:11:59,387 If Louie had any family left, they'll find them. 263 00:11:59,388 --> 00:12:01,347 OK? 264 00:12:03,058 --> 00:12:05,935 Guess it's good it happened here, not out on the street. 265 00:12:05,936 --> 00:12:07,395 You're off the hook with Louie. 266 00:12:07,396 --> 00:12:10,107 I'ma teach Emma here how to clean a dead body. 267 00:12:12,192 --> 00:12:14,027 I'm sorry, but they need me in L&D. 268 00:12:14,028 --> 00:12:15,695 You might want to call for another interpreter. 269 00:12:15,696 --> 00:12:17,071 Busy day. 270 00:12:17,072 --> 00:12:18,531 Shit, that's the girl in 12? 271 00:12:18,532 --> 00:12:20,241 Yeah, she's been waiting for five hours. 272 00:12:20,242 --> 00:12:21,993 Didn't hear her name called the first time. 273 00:12:21,994 --> 00:12:23,536 You check on her? 274 00:12:23,537 --> 00:12:24,871 Need to brush up on my ASL. 275 00:12:24,872 --> 00:12:26,372 You know sign language too? 276 00:12:26,373 --> 00:12:28,082 Princess here knows six languages. 277 00:12:28,083 --> 00:12:30,668 - I know French. - OK, it's not a contest. 278 00:12:30,669 --> 00:12:32,587 Ah! 279 00:12:32,588 --> 00:12:34,213 No shit talking in front of me. 280 00:12:34,214 --> 00:12:36,549 I get enough of that from her and Perlah. 281 00:12:36,550 --> 00:12:39,344 Guess I'll call for backup. 282 00:12:39,345 --> 00:12:41,387 Yo, Donnie, did you discharge your butt abscess? 283 00:12:41,388 --> 00:12:43,765 Not yet! 284 00:12:43,766 --> 00:12:45,266 What the hell? 285 00:12:45,267 --> 00:12:46,559 Your good friends upstairs sent doughnuts. 286 00:12:46,560 --> 00:12:47,977 Special thank-you for working the holiday. 287 00:12:47,978 --> 00:12:49,771 You got to be kidding me. 288 00:12:49,772 --> 00:12:51,606 What were you expecting, tacos and tequila? 289 00:12:51,607 --> 00:12:53,483 Every single one of them can forget about extra shifts. 290 00:12:53,484 --> 00:12:55,651 - Won't hire more nurses. - Won't pay us a decent wage. 291 00:12:55,652 --> 00:12:57,153 Won't hire security that can actually 292 00:12:57,154 --> 00:12:58,237 protect us from patients. 293 00:12:58,238 --> 00:12:59,906 But absolutely, send doughnuts. 294 00:12:59,907 --> 00:13:01,407 Sure you want to go into this line of work? 295 00:13:01,408 --> 00:13:03,242 Want me get you one? 296 00:13:03,243 --> 00:13:04,744 Of course I do, but I'm not taking admin's blood pastries. 297 00:13:04,745 --> 00:13:07,580 Et tu, Donnie? 298 00:13:07,581 --> 00:13:09,582 OK, move it or lose it. 299 00:13:09,583 --> 00:13:12,043 Meet me in South 15 with gowns and gloves. 300 00:13:12,044 --> 00:13:13,753 Looks like happy hour in here. 301 00:13:13,754 --> 00:13:15,463 Don't ask. What's up with Evel Knievel? 302 00:13:15,464 --> 00:13:17,924 Brandon Li, 52, fell off a motorcycle pyramid 303 00:13:17,925 --> 00:13:19,550 at 25 miles per hour. 304 00:13:19,551 --> 00:13:21,469 Motorcycle pyramid? You recruiting? 305 00:13:21,470 --> 00:13:22,887 Got a fellow rider in your midst. 306 00:13:22,888 --> 00:13:24,138 - No kidding. - How high up were you? 307 00:13:24,139 --> 00:13:25,932 On top of a three, two, one. 308 00:13:25,933 --> 00:13:27,892 But the bottom guys are sitting down driving the choppers. 309 00:13:27,893 --> 00:13:29,560 I'm fine. I don't need all this. 310 00:13:29,561 --> 00:13:31,270 - Were you wearing a helmet? - Of course. 311 00:13:31,271 --> 00:13:33,564 Oh, what do you know? They're still in style. 312 00:13:33,565 --> 00:13:36,150 Good vitals, tender right wrist, and big left knee lac. 313 00:13:36,151 --> 00:13:38,486 Hey, Joy, Perlah, Trauma Two. 314 00:13:38,487 --> 00:13:39,946 Who else can I have? 315 00:13:39,947 --> 00:13:41,572 Santos and Whitaker are in with Louie. 316 00:13:41,573 --> 00:13:43,366 Yeah, give me Whitaker. He could use a distraction. 317 00:13:43,367 --> 00:13:45,118 And Santos has been ducking traumas all day. 318 00:13:45,119 --> 00:13:46,536 Well, she's behind in her charting. 319 00:13:46,537 --> 00:13:47,830 Who isn't? 320 00:13:50,958 --> 00:13:54,502 OK, even when it's not your fault, 321 00:13:54,503 --> 00:13:56,129 sometimes it's worse knowing 322 00:13:56,130 --> 00:13:58,297 that there was nothing you could do. 323 00:13:58,298 --> 00:14:00,633 Uh-huh. 324 00:14:00,634 --> 00:14:02,468 Are you... 325 00:14:02,469 --> 00:14:03,886 Robby needs you both in Trauma Two, 326 00:14:03,887 --> 00:14:05,680 and I need you to discharge sweet Patty in 13 327 00:14:05,681 --> 00:14:07,056 as soon as you're done. 328 00:14:07,057 --> 00:14:08,558 Can't catch a break. 329 00:14:08,559 --> 00:14:10,477 I push you 'cause I know you can take it. 330 00:14:22,823 --> 00:14:25,950 You ever clean a dead body? 331 00:14:25,951 --> 00:14:29,662 Probably never seen one either. 332 00:14:29,663 --> 00:14:32,665 No one tells you what it looks, feels, or smells like, 333 00:14:32,666 --> 00:14:36,836 but you get used to it over time. 334 00:14:36,837 --> 00:14:40,006 You pull off the gown. You wipe him down with towels. 335 00:14:40,007 --> 00:14:42,216 Then we'll roll him on his side, 336 00:14:42,217 --> 00:14:45,511 clean his back, stuff the sheet under him, 337 00:14:45,512 --> 00:14:48,097 wipe down the bed, roll him the other way, 338 00:14:48,098 --> 00:14:49,849 pull out the sheet, and repeat. 339 00:14:49,850 --> 00:14:52,518 Just follow my lead. 340 00:14:52,519 --> 00:14:56,481 Usually, you leave the ET tube in for the coroner, 341 00:14:56,482 --> 00:15:00,359 but Louie's a chronic alcoholic with end-stage liver disease. 342 00:15:00,360 --> 00:15:04,238 Not a coroner's case. 343 00:15:04,239 --> 00:15:07,533 - Did he have family? - Everyone has family. 344 00:15:07,534 --> 00:15:10,703 The social worker always tries to find them. 345 00:15:10,704 --> 00:15:13,039 Sometimes the family loved them, 346 00:15:13,040 --> 00:15:14,665 tried to get them to come home. 347 00:15:14,666 --> 00:15:17,376 Other times, the family wants nothing to do with them. 348 00:15:17,377 --> 00:15:21,214 - That's sad. - That's life. 349 00:15:21,215 --> 00:15:22,924 What happens if no one claims his body? 350 00:15:22,925 --> 00:15:24,550 He'll be cremated. 351 00:15:24,551 --> 00:15:26,093 Where would his ashes go? 352 00:15:26,094 --> 00:15:27,553 They'll keep him for a few months. 353 00:15:27,554 --> 00:15:28,930 Then he gets buried in a mass grave 354 00:15:28,931 --> 00:15:32,892 with all the other unclaimed bodies. 355 00:15:32,893 --> 00:15:35,812 OK, now we roll him. 356 00:15:38,857 --> 00:15:40,691 Ready. 357 00:15:40,692 --> 00:15:42,276 Go. 358 00:15:42,277 --> 00:15:43,694 Oh, my God, is he still alive? 359 00:15:43,695 --> 00:15:45,404 No, that happens. 360 00:15:45,405 --> 00:15:48,241 These frequent fliers. 361 00:15:48,242 --> 00:15:52,078 They can be a real pain in the ass, but... 362 00:15:52,079 --> 00:15:55,165 you miss them when they're gone. 363 00:16:01,838 --> 00:16:04,006 I've been at every Millvale Fourth of July parade 364 00:16:04,007 --> 00:16:05,508 since '08. 365 00:16:05,509 --> 00:16:07,927 World record is 40 men on seven motorcycles. 366 00:16:07,928 --> 00:16:09,512 I plan to beat that someday. 367 00:16:09,513 --> 00:16:11,514 Good lung sliding bilaterally. 368 00:16:11,515 --> 00:16:13,099 Pupils equal and reactive. 369 00:16:13,100 --> 00:16:14,934 - What do you ride? - The Bullet. 370 00:16:14,935 --> 00:16:16,811 Oh, Royal Enfield. Ankle breaker. 371 00:16:16,812 --> 00:16:19,146 - Thumper. - BP 138 over 80. 372 00:16:19,147 --> 00:16:21,315 Pulse 94. Pulse ox 98. 373 00:16:21,316 --> 00:16:23,609 All your vitals sound really good, Brandon. 374 00:16:23,610 --> 00:16:25,236 They call it an ankle breaker 'cause 375 00:16:25,237 --> 00:16:26,904 you got to kick over a big, fat single cylinder 376 00:16:26,905 --> 00:16:29,115 to get it started, sometimes five or six kicks. 377 00:16:29,116 --> 00:16:31,325 Yeah, especially on a cold day. 378 00:16:31,326 --> 00:16:33,619 Um, does anyone have any trauma scissors? 379 00:16:33,620 --> 00:16:35,496 - I'll check the knee. - Uh, not yet. 380 00:16:35,497 --> 00:16:37,331 - Why not? - Dr. Santos. 381 00:16:37,332 --> 00:16:39,792 Primary survey means rule out the life threats. 382 00:16:39,793 --> 00:16:41,919 Don't get distracted by lacerations or fractures. 383 00:16:41,920 --> 00:16:43,629 No free fluid in the belly. 384 00:16:43,630 --> 00:16:46,132 Airway, breathing, circulation are fine. 385 00:16:46,133 --> 00:16:48,342 OK, that's ABC. That just leaves two letters. 386 00:16:48,343 --> 00:16:50,553 Tell her about D, Dr. Santos. 387 00:16:50,554 --> 00:16:52,555 Disability. Wiggle your toes, sir. 388 00:16:52,556 --> 00:16:54,807 Any pain in your arms or legs? 389 00:16:54,808 --> 00:16:56,350 Not really. 390 00:16:56,351 --> 00:16:57,643 Does it hurt when I push here? 391 00:16:57,644 --> 00:16:59,562 - No. - OK, no midline tenderness. 392 00:16:59,563 --> 00:17:01,230 Nexus negative. 393 00:17:01,231 --> 00:17:03,399 With no obvious brain injury or spinal cord injury. 394 00:17:03,400 --> 00:17:06,569 That just leaves E. Joy. 395 00:17:06,570 --> 00:17:08,321 Can I buy another vowel? 396 00:17:08,322 --> 00:17:10,531 - Dr. Whitaker. - Exposure. 397 00:17:10,532 --> 00:17:12,033 AKA strip and flip. 398 00:17:12,034 --> 00:17:14,160 Cut off his clothes, and we'll log roll him. 399 00:17:14,161 --> 00:17:16,203 What do we have? 400 00:17:16,204 --> 00:17:18,122 Helmeted motorcycle acrobat. 401 00:17:18,123 --> 00:17:20,708 8-foot fall standing on top of five riders. 402 00:17:20,709 --> 00:17:22,376 Primary survey normal, E-FAST negative. 403 00:17:22,377 --> 00:17:24,295 Another motorcycle accident. 404 00:17:24,296 --> 00:17:26,505 Hello, sir. I'm Dr. Garcia from surgery. 405 00:17:26,506 --> 00:17:28,007 Hello. 406 00:17:28,008 --> 00:17:33,180 OK, we will roll him in three, two, one. 407 00:17:37,184 --> 00:17:39,644 Well, I grew up a block from Carrick, 408 00:17:39,645 --> 00:17:42,521 but my mom was a teacher at Brashear, so I had to go there. 409 00:17:42,522 --> 00:17:45,024 - The Bullets? - That's right. 410 00:17:45,025 --> 00:17:46,400 They were the Bullets when I was there. 411 00:17:46,401 --> 00:17:48,194 They changed to the Bulls when I left. 412 00:17:48,195 --> 00:17:49,695 Oh. 413 00:17:49,696 --> 00:17:54,200 Hey, you think I could get something to eat? 414 00:17:54,201 --> 00:17:56,786 Gus here is wondering if he's clear to eat. 415 00:17:56,787 --> 00:17:58,746 As long as it's a liquid diet. 416 00:17:58,747 --> 00:18:01,624 We have the results of your CT scan. 417 00:18:01,625 --> 00:18:04,543 Your jaw should heal without surgery, which is good news, 418 00:18:04,544 --> 00:18:07,129 but it will be a few weeks. 419 00:18:07,130 --> 00:18:08,631 Before I can eat? 420 00:18:08,632 --> 00:18:10,424 Solid foods, yes. 421 00:18:10,425 --> 00:18:14,220 Or you can have food pureed with liquid in a blender. 422 00:18:14,221 --> 00:18:16,889 I don't have a blender. 423 00:18:16,890 --> 00:18:18,307 Right. 424 00:18:18,308 --> 00:18:20,226 Sorry. 425 00:18:20,227 --> 00:18:23,604 We have a calorie-rich supplement drink called Ensure. 426 00:18:23,605 --> 00:18:27,066 Comes in chocolate, vanilla, or strawberry. 427 00:18:27,067 --> 00:18:28,901 Chocolate, please. 428 00:18:28,902 --> 00:18:30,569 - Good choice. - How many can I have? 429 00:18:30,570 --> 00:18:32,071 Two a day is recommended. 430 00:18:32,072 --> 00:18:34,198 I'll get it for you. 431 00:18:34,199 --> 00:18:37,576 You have an appetite. That's good. 432 00:18:37,577 --> 00:18:39,745 Mr. Varney, your blood tests indicate 433 00:18:39,746 --> 00:18:42,289 low levels of protein and vitamins. 434 00:18:42,290 --> 00:18:46,252 Can we ask you a few questions about your diet? 435 00:18:46,253 --> 00:18:49,588 How many meals or snacks do you have in a 24-hour period? 436 00:18:49,589 --> 00:18:50,923 I don't know. 437 00:18:50,924 --> 00:18:52,925 Don't count. 438 00:18:52,926 --> 00:18:55,511 Pretty sure it's three trays a day. 439 00:18:55,512 --> 00:18:57,179 OK. 440 00:18:57,180 --> 00:19:00,391 How often do you eat cereals, fruits, or vegetables? 441 00:19:00,392 --> 00:19:03,644 Not many fruits and vegetables in prison. 442 00:19:03,645 --> 00:19:05,313 Slow and steady. 443 00:19:07,315 --> 00:19:09,442 What year is your Bonneville? 444 00:19:09,443 --> 00:19:10,776 '69. 445 00:19:10,777 --> 00:19:13,112 Rescued it from a motor graveyard. 446 00:19:13,113 --> 00:19:14,655 Brought it back to life with a buddy of mine, 447 00:19:14,656 --> 00:19:16,449 who's supposed to be coming in today. 448 00:19:16,450 --> 00:19:17,867 How often do you ride? 449 00:19:17,868 --> 00:19:19,702 I ride it in to work every day. 450 00:19:19,703 --> 00:19:20,953 Good for you. 451 00:19:20,954 --> 00:19:22,621 Don't encourage him. 452 00:19:22,622 --> 00:19:24,331 CT's ready for Brandon. 453 00:19:24,332 --> 00:19:28,335 As soon as we take a look at this knee. 454 00:19:28,336 --> 00:19:30,671 - Whoa. - Through the deep fascia. 455 00:19:30,672 --> 00:19:31,964 How's it look? 456 00:19:31,965 --> 00:19:32,965 Definitely gonna need stitches. 457 00:19:32,966 --> 00:19:34,300 - How many? - A lot. 458 00:19:34,301 --> 00:19:35,843 It could be an open joint. 459 00:19:35,844 --> 00:19:37,762 We'll do a saline load after CT. 460 00:19:37,763 --> 00:19:39,305 OK. 461 00:19:39,306 --> 00:19:41,182 Lever sign negative. ACL intact. 462 00:19:41,183 --> 00:19:42,559 OK, ready to roll. 463 00:19:47,606 --> 00:19:49,440 Are you still coming over tonight? 464 00:19:49,441 --> 00:19:51,192 I think Whitaker is gonna be playing 465 00:19:51,193 --> 00:19:53,277 farm boy again this weekend, so he's not gonna be around. 466 00:19:53,278 --> 00:19:54,945 I may need a rain check. 467 00:19:54,946 --> 00:19:56,655 Hey, do you have an update on that nec fasc patient? 468 00:19:56,656 --> 00:19:58,073 Last I heard, Miller was doing 469 00:19:58,074 --> 00:20:00,243 an above-the-knee amputation with ortho. 470 00:20:02,204 --> 00:20:04,663 Langdon's waitress with the cellulitis? 471 00:20:04,664 --> 00:20:05,956 Yeah. 472 00:20:05,957 --> 00:20:08,584 - Man, that took a turn. - Sure did. 473 00:20:08,585 --> 00:20:12,505 Hey, did you hear about Louie? 474 00:20:12,506 --> 00:20:15,007 - Yeah. - You OK? 475 00:20:15,008 --> 00:20:16,509 Um, 476 00:20:16,510 --> 00:20:20,054 one of my uncles drank himself to death. 477 00:20:20,055 --> 00:20:22,932 I barely recognized him at the end. 478 00:20:22,933 --> 00:20:26,227 At least Louie always seemed happy. 479 00:20:26,228 --> 00:20:27,896 I'm here if you want to talk. 480 00:20:33,485 --> 00:20:36,362 Should've known I'd find you in here. 481 00:20:36,363 --> 00:20:40,199 You steal anyone's lunch, it's a $20 fine. 482 00:20:40,200 --> 00:20:41,867 Made a lot of changes while you were gone. 483 00:20:41,868 --> 00:20:43,536 I can see that. 484 00:20:43,537 --> 00:20:44,995 Look, I'll let you hide out a little bit longer, 485 00:20:44,996 --> 00:20:46,664 but then I need you to pick up more patients. 486 00:20:46,665 --> 00:20:48,207 You're not as fast as you used to be. 487 00:20:48,208 --> 00:20:50,376 Damn doughnuts! 488 00:20:50,377 --> 00:20:52,711 Ouch. 489 00:20:52,712 --> 00:20:55,673 First day back, I get kicked in the nuts. 490 00:20:55,674 --> 00:20:57,842 One dead, one septic bounce-back. 491 00:20:57,843 --> 00:21:00,136 Both of those not your fault. 492 00:21:02,722 --> 00:21:04,431 You expecting a party? 493 00:21:04,432 --> 00:21:06,141 No, not really. 494 00:21:06,142 --> 00:21:08,603 Didn't hear from anyone while I was gone. 495 00:21:11,064 --> 00:21:12,857 Sorry. 496 00:21:12,858 --> 00:21:16,527 They ever, uh, arrest that guy who punched you? 497 00:21:16,528 --> 00:21:18,362 Yeah. 498 00:21:18,363 --> 00:21:20,281 Wanted to know if I wanted to press charges, 499 00:21:20,282 --> 00:21:23,617 but didn't want to go through all that. 500 00:21:23,618 --> 00:21:26,245 Thought I was done, really did, but... 501 00:21:26,246 --> 00:21:29,915 I got bored at home, so only lasted a few weeks. 502 00:21:29,916 --> 00:21:31,709 You? 503 00:21:31,710 --> 00:21:34,420 10 months is a long time to be alone with your thoughts. 504 00:21:34,421 --> 00:21:36,964 I almost lost everything. 505 00:21:36,965 --> 00:21:39,133 I know a lot of women who would have taken the kids and left, 506 00:21:39,134 --> 00:21:42,428 - but Abby stayed. - 'Cause she's a good woman. 507 00:21:42,429 --> 00:21:44,263 'Cause you deserve a second chance. 508 00:21:44,264 --> 00:21:45,890 I'm not sure everyone agrees with you. 509 00:21:45,891 --> 00:21:47,308 Give it time. 510 00:21:47,309 --> 00:21:49,436 Look, I... 511 00:21:53,565 --> 00:21:56,108 I, um... 512 00:21:56,109 --> 00:21:59,987 I've been working the 12 steps, trying to make amends. 513 00:21:59,988 --> 00:22:01,780 I was really selfish. 514 00:22:01,781 --> 00:22:03,616 I lied to myself, and I lied to you. 515 00:22:03,617 --> 00:22:04,992 I'm really sorry. 516 00:22:04,993 --> 00:22:06,452 You can check me off your list, kid. 517 00:22:06,453 --> 00:22:08,329 We're good. 518 00:22:08,330 --> 00:22:10,497 - OK. - Yeah. 519 00:22:10,498 --> 00:22:12,166 Got a lovely patient for you in Two. 520 00:22:12,167 --> 00:22:14,127 Let's get you back on the horse. 521 00:22:17,130 --> 00:22:18,631 Really need to talk with Robby. 522 00:22:18,632 --> 00:22:20,049 I don't know if today's the best day for that. 523 00:22:20,050 --> 00:22:21,342 He leaves on vacation tomorrow. 524 00:22:21,343 --> 00:22:22,843 Let him get through the day in peace. 525 00:22:22,844 --> 00:22:24,345 He's supposed to be gone for three months? 526 00:22:24,346 --> 00:22:26,347 So he says. I give him one. 527 00:22:26,348 --> 00:22:27,766 Go get 'em, kid. 528 00:22:29,976 --> 00:22:33,312 Dr. Langdon, this is Rocky. 529 00:22:33,313 --> 00:22:34,688 Great name. 530 00:22:34,689 --> 00:22:38,317 What brings you in, Rocky? 531 00:22:38,318 --> 00:22:40,027 Very sick. 532 00:22:40,028 --> 00:22:42,321 When did it start? 533 00:22:42,322 --> 00:22:43,864 An hour ago. 534 00:22:43,865 --> 00:22:46,492 After he won a hot dog eating contest. 535 00:22:46,493 --> 00:22:48,995 A hot dog eating contest? How many you eat? 536 00:22:51,831 --> 00:22:53,917 351 hot dogs? 537 00:22:58,046 --> 00:22:59,546 36. 538 00:22:59,547 --> 00:23:02,049 Still a lot. 539 00:23:02,050 --> 00:23:04,051 - I pulled eight of Zofran. - Go for it. 540 00:23:04,052 --> 00:23:05,469 All right, this should help. 541 00:23:05,470 --> 00:23:07,179 Stick it under your tongue. Let it dissolve. 542 00:23:07,180 --> 00:23:08,700 OK, are you taking any prescription... 543 00:23:13,728 --> 00:23:16,105 Oh, thank you. 544 00:23:16,106 --> 00:23:18,691 Thanks. 545 00:23:18,692 --> 00:23:20,943 Santos, what's up with your ileus patient? 546 00:23:20,944 --> 00:23:22,945 Admitted to medicine, and before you ask, 547 00:23:22,946 --> 00:23:24,697 13 has been discharged. 548 00:23:24,698 --> 00:23:27,032 Great. 12 needs a doctor. 549 00:23:27,033 --> 00:23:28,867 No, don't make me go back there. 550 00:23:28,868 --> 00:23:32,037 That disimpaction left a smell and stunk up the whole hallway. 551 00:23:32,038 --> 00:23:34,081 So grab some coffee grounds from the lounge. 552 00:23:34,082 --> 00:23:36,709 We need to admit our incarcerated patient, Gus. 553 00:23:36,710 --> 00:23:38,585 What did the CT show? 554 00:23:38,586 --> 00:23:41,046 Moderate pulmonary contusion, three rib fractures, 555 00:23:41,047 --> 00:23:43,841 no intra-abdominal bleeding, and oblique fracture 556 00:23:43,842 --> 00:23:46,510 in the body of the mandible anterior to the angle. 557 00:23:46,511 --> 00:23:48,721 All favorable for healing. What's the treatment plan? 558 00:23:48,722 --> 00:23:50,556 - A pain med... - Security. 559 00:23:50,557 --> 00:23:51,932 People are trying to sleep. 560 00:23:51,933 --> 00:23:55,436 Pain medication, antibiotics, liquid diet, 561 00:23:55,437 --> 00:23:57,396 um, a pulse ox a few times a day, 562 00:23:57,397 --> 00:24:00,232 and then also dressing changes for the laceration. 563 00:24:00,233 --> 00:24:02,735 Which he can get at his correctional facility. 564 00:24:02,736 --> 00:24:05,029 Or he stays here for a few days, 565 00:24:05,030 --> 00:24:07,906 and we get him on the right track to healing. 566 00:24:07,907 --> 00:24:09,992 Why don't you two go check on your patients? 567 00:24:09,993 --> 00:24:12,745 - Got it. - Sure thing. 568 00:24:12,746 --> 00:24:14,580 What am I missing? 569 00:24:14,581 --> 00:24:15,956 He's not getting enough to eat 570 00:24:15,957 --> 00:24:17,458 at his correctional facility. 571 00:24:17,459 --> 00:24:19,043 The portions are tiny. 572 00:24:19,044 --> 00:24:21,003 Too many carbs, not enough fruits or vegetables. 573 00:24:21,004 --> 00:24:24,465 He's lucky he hasn't developed a chronic illness. 574 00:24:24,466 --> 00:24:26,258 We don't have any inpatient beds. 575 00:24:26,259 --> 00:24:27,801 He would board down here for three days. 576 00:24:27,802 --> 00:24:29,344 We're still getting runs from Westbridge, 577 00:24:29,345 --> 00:24:31,680 and we cannot tie up Behavioral for that long. 578 00:24:31,681 --> 00:24:33,515 Dr. Al-Hashimi, Dr. Jefferson wants to talk 579 00:24:33,516 --> 00:24:35,226 to you about our tasered kid. 580 00:24:39,105 --> 00:24:40,606 Why don't I call the prison doctor 581 00:24:40,607 --> 00:24:42,274 and find out what they're working with over there? 582 00:24:42,275 --> 00:24:44,110 - Thank you. - My pleasure. 583 00:24:46,154 --> 00:24:48,572 Dr. Jefferson seems to have a good rapport with Jackson. 584 00:24:48,573 --> 00:24:49,948 That's excellent. 585 00:24:49,949 --> 00:24:51,283 How's the sister doing? 586 00:24:51,284 --> 00:24:52,618 Still pretty upset. 587 00:24:52,619 --> 00:24:54,119 She's never seen him like this. 588 00:24:54,120 --> 00:24:55,788 It's a lot to process. 589 00:24:55,789 --> 00:24:57,998 - How's he doing? - He's scared. 590 00:24:57,999 --> 00:24:59,583 Droperidol had a positive effect, 591 00:24:59,584 --> 00:25:01,960 but he doesn't understand what's going on. 592 00:25:01,961 --> 00:25:03,962 He's been experiencing auditory hallucinations 593 00:25:03,963 --> 00:25:05,589 and paranoid delusions. 594 00:25:05,590 --> 00:25:08,801 Voices are telling him he isn't safe. 595 00:25:08,802 --> 00:25:10,052 This has been going on for months. 596 00:25:10,053 --> 00:25:11,678 - Months? - Yeah. 597 00:25:11,679 --> 00:25:13,305 Turns out, his sister hasn't seen him in a while. 598 00:25:13,306 --> 00:25:15,307 Family history of mental illness? 599 00:25:15,308 --> 00:25:17,518 Not that we know of. 600 00:25:17,519 --> 00:25:21,355 I'm gonna give him a break and then continue the conversation. 601 00:25:21,356 --> 00:25:22,731 Parents are on their way. 602 00:25:22,732 --> 00:25:23,732 We'll let you know when they get here. 603 00:25:23,733 --> 00:25:25,192 Yes. Do. 604 00:25:25,193 --> 00:25:27,027 OK, hospital bed, wheelchair, 605 00:25:27,028 --> 00:25:30,030 and shower chair have all been ordered. 606 00:25:30,031 --> 00:25:31,740 What do you say, kid? 607 00:25:31,741 --> 00:25:33,701 Ready to go home? 608 00:25:35,995 --> 00:25:38,872 How's your pain, Mrs. Hamler? 609 00:25:38,873 --> 00:25:40,374 The same. 610 00:25:40,375 --> 00:25:42,709 We're gonna write you a script for Keppra. 611 00:25:42,710 --> 00:25:44,044 You'll take that to prevent seizures 612 00:25:44,045 --> 00:25:45,879 once a day, starting tomorrow. 613 00:25:45,880 --> 00:25:47,840 Between your broken leg and the bruises from your seizure, 614 00:25:47,841 --> 00:25:49,883 the pain will probably get a little worse. 615 00:25:49,884 --> 00:25:51,176 Yeah, the most important thing is 616 00:25:51,177 --> 00:25:52,344 to let others help you. 617 00:25:52,345 --> 00:25:53,971 You'll need assistance showering 618 00:25:53,972 --> 00:25:55,472 and getting to the bathroom. 619 00:25:55,473 --> 00:25:57,349 Yeah, no problem. I won't leave her side. 620 00:25:57,350 --> 00:25:59,726 Paul, you need a break. 621 00:25:59,727 --> 00:26:04,189 You're... you're taking care of me, the kids, the house. 622 00:26:04,190 --> 00:26:07,484 It's too much for one person. 623 00:26:07,485 --> 00:26:09,736 I'm not the one battling cancer. 624 00:26:09,737 --> 00:26:11,029 Paul. 625 00:26:11,030 --> 00:26:14,533 Hey, you're in pain every day, 626 00:26:14,534 --> 00:26:16,201 fighting for your life. 627 00:26:16,202 --> 00:26:18,871 I'm happy to do this for you. 628 00:26:18,872 --> 00:26:21,415 You're my wife. 629 00:26:21,416 --> 00:26:24,543 Now, let's go home and forget this day ever happened. 630 00:26:24,544 --> 00:26:26,044 I'll call the transpo ambulance. 631 00:26:26,045 --> 00:26:27,338 Thanks, Princess. 632 00:26:33,887 --> 00:26:35,429 Hey. 633 00:26:35,430 --> 00:26:36,889 Hmm? 634 00:26:36,890 --> 00:26:39,057 Why don't you go ahead? 635 00:26:39,058 --> 00:26:40,142 - What? - Yeah. 636 00:26:40,143 --> 00:26:41,435 You can get the house ready. 637 00:26:41,436 --> 00:26:43,604 I'll be right behind you. 638 00:26:43,605 --> 00:26:45,272 - No. - Mm-hmm. 639 00:26:45,273 --> 00:26:49,401 No, I'm... I'm riding in the back with you. 640 00:26:49,402 --> 00:26:52,322 You know what? I'll stay with her. 641 00:26:53,865 --> 00:26:55,616 Are you sure? 642 00:26:55,617 --> 00:26:57,910 - Mm-hmm. - Yeah. 643 00:26:57,911 --> 00:27:01,079 OK. 644 00:27:01,080 --> 00:27:04,082 Um, call me if you need me to come back. 645 00:27:04,083 --> 00:27:05,918 Mm-hmm. 646 00:27:11,090 --> 00:27:12,549 When will the ambulance get here? 647 00:27:12,550 --> 00:27:13,592 It shouldn't be long. 648 00:27:13,593 --> 00:27:15,677 Mr. Francis, short of breath? 649 00:27:15,678 --> 00:27:17,137 Yeah, I was worried the clot in my leg 650 00:27:17,138 --> 00:27:19,181 could have gone up to my lungs, so... 651 00:27:19,182 --> 00:27:21,016 You're on Eliquis. That shouldn't happen. 652 00:27:21,017 --> 00:27:22,851 - Yeah, I know, but... - Hey, Donnie, I got this. 653 00:27:22,852 --> 00:27:24,353 Don't worry, Mr. Francis. 654 00:27:24,354 --> 00:27:26,021 I'll order the D-dimer. I'll be back to see you. 655 00:27:26,022 --> 00:27:28,607 Thank you, Dr. Mohan. 656 00:27:28,608 --> 00:27:30,609 You know I'm an NP now. 657 00:27:30,610 --> 00:27:32,110 I can pick up a patient with dyspnea. 658 00:27:32,111 --> 00:27:33,612 I'm sorry. 659 00:27:33,613 --> 00:27:36,031 I've seen him before, and he's asked for me. 660 00:27:36,032 --> 00:27:38,158 Why even order the test? He's on Eliquis. 661 00:27:38,159 --> 00:27:39,493 Mr. Francis comes in every month 662 00:27:39,494 --> 00:27:41,495 and always asks for a D-dimer. 663 00:27:41,496 --> 00:27:43,956 Just... he's worried, and it puts his mind at ease. 664 00:27:43,957 --> 00:27:46,625 - Why not? - Yeah, OK. 665 00:27:46,626 --> 00:27:49,461 Donnie's the best. You'll learn a lot from him. 666 00:27:49,462 --> 00:27:51,464 That's right. 667 00:28:18,074 --> 00:28:20,200 All right, fill me in. 668 00:28:20,201 --> 00:28:22,911 This is Harlow Graham. She was seen in triage. 669 00:28:22,912 --> 00:28:25,330 CBC and CMP came back normal. 670 00:28:25,331 --> 00:28:27,833 IT was supposed to bring the VRI down, but they're slammed. 671 00:28:27,834 --> 00:28:29,501 I know a bit of sign language. 672 00:28:29,502 --> 00:28:35,007 Harlow, this is Dr. Santos. 673 00:28:35,008 --> 00:28:36,718 Hi, Harlow. How are you feeling? 674 00:28:39,554 --> 00:28:40,887 She has a headache. 675 00:28:40,888 --> 00:28:42,724 OK. What else? 676 00:28:48,187 --> 00:28:49,855 What is she saying? 677 00:28:49,856 --> 00:28:51,982 I think she had a stomachache, 678 00:28:51,983 --> 00:28:54,777 and she might have passed out. 679 00:28:57,864 --> 00:28:59,656 I'm not 100% sure. 680 00:28:59,657 --> 00:29:02,200 OK, we're just gonna need to wait for an interpreter, 681 00:29:02,201 --> 00:29:03,869 'cause I need to ask a million questions, 682 00:29:03,870 --> 00:29:05,537 and I can't do it this way. 683 00:29:05,538 --> 00:29:07,623 So just call me when IT comes down. 684 00:29:18,926 --> 00:29:21,887 CT head, neck, chest, abdomen, pelvis all negative. 685 00:29:21,888 --> 00:29:24,931 It means we can get this collar off. 686 00:29:24,932 --> 00:29:27,059 Thank you. 687 00:29:27,060 --> 00:29:28,477 Roll to your side. 688 00:29:28,478 --> 00:29:30,729 We'll get you off this board. 689 00:29:30,730 --> 00:29:32,314 How long is your trip? 690 00:29:32,315 --> 00:29:35,233 2,000 miles, all the way from here to Alberta. 691 00:29:35,234 --> 00:29:36,902 Couple stops along the way. 692 00:29:36,903 --> 00:29:38,403 Got the whole thing mapped out. 693 00:29:38,404 --> 00:29:40,614 - Sounds like heaven. - Let's sit you up. 694 00:29:40,615 --> 00:29:42,324 Sorry, I got stuck with a patient. 695 00:29:42,325 --> 00:29:44,409 You know the old saying, four wheels move the body, 696 00:29:44,410 --> 00:29:45,994 two wheels move the soul. 697 00:29:45,995 --> 00:29:47,496 You're gonna be living the dream. 698 00:29:47,497 --> 00:29:48,914 Thank you, Brandon. 699 00:29:48,915 --> 00:29:50,457 Not everybody down here feels that way. 700 00:29:50,458 --> 00:29:52,751 - OK, Whitaker, what's next? - Ortho assessment. 701 00:29:52,752 --> 00:29:55,962 Palpate all long bones, starting with the clavicle. 702 00:29:55,963 --> 00:29:57,255 Got it. 703 00:29:57,256 --> 00:29:59,801 I'll take the lower extremities. 704 00:30:04,389 --> 00:30:05,597 Distal radius tender. No deformities. 705 00:30:05,598 --> 00:30:06,807 Needs an X-ray. 706 00:30:06,808 --> 00:30:08,225 No bony tenderness down here. 707 00:30:08,226 --> 00:30:09,601 No laxity of the knee. 708 00:30:09,602 --> 00:30:12,312 Are you concerned about that knee lac? 709 00:30:12,313 --> 00:30:14,481 If it's an open joint, he'll need a washout in the OR. 710 00:30:14,482 --> 00:30:16,441 We could try a fluorescein injection. 711 00:30:16,442 --> 00:30:17,943 OK, we'll need a... 712 00:30:17,944 --> 00:30:19,611 Wood's lamp, 1% lido with epi, 713 00:30:19,612 --> 00:30:22,030 sterile saline, sterile basin, sterile fluoro-strip, 714 00:30:22,031 --> 00:30:26,159 18- and 27-gauge needles, 5- and 60-cc syringes. 715 00:30:26,160 --> 00:30:28,620 How does she know all that? 716 00:30:28,621 --> 00:30:31,373 She just does. 717 00:30:31,374 --> 00:30:32,791 How are you feeling, Rocky? 718 00:30:32,792 --> 00:30:34,543 Oh, much better. 719 00:30:34,544 --> 00:30:36,294 He's had eight migs of ondansetron. 720 00:30:36,295 --> 00:30:37,796 Any pain in the belly? 721 00:30:37,797 --> 00:30:40,048 No, but my mouth is really dry. 722 00:30:40,049 --> 00:30:43,176 No doubt from consuming mass quantities of salty hot dogs. 723 00:30:43,177 --> 00:30:45,053 Could I have another sip of water? 724 00:30:45,054 --> 00:30:46,638 Sure. A little sip. 725 00:30:46,639 --> 00:30:48,682 Take it slow. 726 00:30:48,683 --> 00:30:50,183 - Here you go. - Thank you. 727 00:30:50,184 --> 00:30:53,937 Just enough to wet your whistle. 728 00:30:53,938 --> 00:30:56,690 So how'd you get your start as a competitive eater? 729 00:31:05,491 --> 00:31:07,951 Any pain here, Mr. Li? 730 00:31:07,952 --> 00:31:09,619 - Can't feel a thing. - Great. 731 00:31:09,620 --> 00:31:10,954 Where is Santos? 732 00:31:10,955 --> 00:31:13,623 Probably catching up on her charting. 733 00:31:13,624 --> 00:31:15,000 - Right. - Lights out. 734 00:31:15,001 --> 00:31:16,878 Wood's lamp on. 735 00:31:18,713 --> 00:31:20,548 OK. 736 00:31:22,175 --> 00:31:24,050 I might want to use some of that on Halloween. 737 00:31:24,051 --> 00:31:26,887 That is 250 ccs of sterile saline 738 00:31:26,888 --> 00:31:29,681 with one small touch of a sterile fluoro-strip. 739 00:31:29,682 --> 00:31:31,433 OK. 740 00:31:31,434 --> 00:31:34,227 We're going to inject this fluid into your knee, Brandon, 741 00:31:34,228 --> 00:31:37,856 and if there's anything glowing in your wound, 742 00:31:37,857 --> 00:31:39,858 we know we have a leak. 743 00:31:39,859 --> 00:31:42,360 - Feeling some pressure. - Yeah, it's normal. 744 00:31:42,361 --> 00:31:45,238 As soon as I finish the test, I'll pull off the fluid. 745 00:31:47,533 --> 00:31:49,117 That looks good. 746 00:31:49,118 --> 00:31:51,203 Laceration did not enter into the joint space. 747 00:31:51,204 --> 00:31:52,704 Surgery not needed. 748 00:31:52,705 --> 00:31:54,372 Excellent. I can get back to the parade. 749 00:31:54,373 --> 00:31:55,832 No, we'll still need to 750 00:31:55,833 --> 00:31:57,209 stitch you up and splint your wrist. 751 00:31:57,210 --> 00:31:58,543 Hanging a gram of Ancef. 752 00:31:58,544 --> 00:32:00,378 Wait, he has a penicillin allergy. 753 00:32:00,379 --> 00:32:03,006 No, PEN-FAST was negative. We're OK. 754 00:32:03,007 --> 00:32:05,759 My mom said I got a rash with amoxicillin when I was two. 755 00:32:05,760 --> 00:32:07,719 Yeah, probably not a true allergy. 756 00:32:07,720 --> 00:32:09,262 Go ahead and give it, Kim. 757 00:32:09,263 --> 00:32:11,264 But have epi and Benadryl standing by, right? 758 00:32:11,265 --> 00:32:13,266 Yes, to be on the safe side. 759 00:32:13,267 --> 00:32:15,560 Most people who think they have a penicillin allergy 760 00:32:15,561 --> 00:32:17,521 actually don't. 761 00:32:17,522 --> 00:32:20,065 Always listen to the nurses. They run the ER. 762 00:32:20,066 --> 00:32:22,109 We just try and stay out of their way. 763 00:32:28,991 --> 00:32:31,076 Now we can really clean him up. 764 00:32:31,077 --> 00:32:32,744 Didn't we already do that? 765 00:32:32,745 --> 00:32:34,913 Dried blood on the face, neck, hands. 766 00:32:34,914 --> 00:32:37,832 If anyone comes, they shouldn't have to see that. 767 00:32:37,833 --> 00:32:39,960 Sometimes the local unhoused folks will pay a visit, 768 00:32:39,961 --> 00:32:41,586 but we always make them presentable 769 00:32:41,587 --> 00:32:44,089 in case anyone comes. 770 00:32:44,090 --> 00:32:47,259 That's the last thing we can do for them. 771 00:32:47,260 --> 00:32:50,929 Didn't get to do that during COVID. 772 00:32:50,930 --> 00:32:53,265 Once he's spotless, we'll tuck him in nice and tight, 773 00:32:53,266 --> 00:32:55,600 but we always leave one arm outside the sheet. 774 00:32:55,601 --> 00:32:57,894 Because? 775 00:32:57,895 --> 00:33:00,480 So loved ones can hold their hand. 776 00:33:00,481 --> 00:33:02,566 - Here you go. - Thanks. 777 00:33:02,567 --> 00:33:04,110 Yeah. 778 00:33:06,153 --> 00:33:08,446 We're ready to discharge our cancer mom, Roxie. 779 00:33:08,447 --> 00:33:09,948 Ambulance is on the way; we just need 780 00:33:09,949 --> 00:33:11,783 - to reconcile her home meds. - Sounds good. 781 00:33:11,784 --> 00:33:13,743 Hey, I thought I saw another charge nurse around here. 782 00:33:13,744 --> 00:33:15,495 Oh, yeah. We travel in packs. 783 00:33:15,496 --> 00:33:16,955 Aren't you sick of this place yet? 784 00:33:16,956 --> 00:33:19,082 Oh, someone is ready for his sabbatical. 785 00:33:19,083 --> 00:33:20,750 Guilty as charged. 786 00:33:20,751 --> 00:33:22,669 Hey, I just got word that the at-home morphine pump 787 00:33:22,670 --> 00:33:23,837 is gonna be delayed. 788 00:33:23,838 --> 00:33:25,505 Hospital pharmacy has to mix it 789 00:33:25,506 --> 00:33:27,048 and then deliver it later today. 790 00:33:27,049 --> 00:33:28,800 Well, should we keep her here until it's ready? 791 00:33:28,801 --> 00:33:30,135 No, you can give her 792 00:33:30,136 --> 00:33:31,803 a 200-milligram tablet of MS Contin. 793 00:33:31,804 --> 00:33:33,972 - 200 milligrams? - Biggest pill they make. 794 00:33:33,973 --> 00:33:37,392 Releases over 12 hours for patients with opiate tolerance. 795 00:33:37,393 --> 00:33:38,977 Got it. 796 00:33:38,978 --> 00:33:40,478 Hey, do you want to stick around a little bit? 797 00:33:40,479 --> 00:33:41,896 Westbridge is closed to internal disaster. 798 00:33:41,897 --> 00:33:43,189 - We're getting all their runs. - Yeah, I heard. 799 00:33:43,190 --> 00:33:44,733 I put 20 bucks on a plumbing issue. 800 00:33:44,734 --> 00:33:46,651 I just watched that poop cruise documentary. 801 00:33:46,652 --> 00:33:48,403 Oh, I cannot stop thinking about it. 802 00:33:48,404 --> 00:33:50,530 That sounds like something I will absolutely never watch. 803 00:33:50,531 --> 00:33:52,115 Dr. Robby, 804 00:33:52,116 --> 00:33:54,701 you gave us a clozapine ileus about an hour ago. 805 00:33:54,702 --> 00:33:56,328 Your resident reported no surgical history, 806 00:33:56,329 --> 00:33:58,622 but the chart says they've had an appendectomy. 807 00:33:58,623 --> 00:34:00,665 We're not admitting the patient without a surgery consult. 808 00:34:00,666 --> 00:34:03,001 - Who called it in? - A Dr. Trinity Santos. 809 00:34:03,002 --> 00:34:06,338 Dr. Santos, you had an ileus patient. 810 00:34:06,339 --> 00:34:08,798 You neglected to mention a history of appendectomy. 811 00:34:08,799 --> 00:34:10,842 There was no history of appendectomy. 812 00:34:10,843 --> 00:34:12,302 It was in your note. 813 00:34:12,303 --> 00:34:15,055 I may have forgotten to proof check it. 814 00:34:15,056 --> 00:34:17,182 I was using the app that Dr. Al-Hashimi suggested 815 00:34:17,183 --> 00:34:18,652 to catch up on my charting. 816 00:34:18,653 --> 00:34:19,851 Wonderful. 817 00:34:19,852 --> 00:34:21,811 - Ah, Dr. Al-Hashimi. - Yes? 818 00:34:21,812 --> 00:34:25,398 Dr. Santos was just using your AI tool for her charting, 819 00:34:25,399 --> 00:34:28,693 and it hallucinated a history of appendicitis. 820 00:34:28,694 --> 00:34:31,988 As I mentioned to Dr. Santos, generative AI is not perfect. 821 00:34:31,989 --> 00:34:34,407 We still need to proofread every chart it creates. 822 00:34:34,408 --> 00:34:37,035 Mm-hmm, the patient also has a history of headache, 823 00:34:37,036 --> 00:34:39,204 followed by Dr. Park from Urology. 824 00:34:39,205 --> 00:34:41,873 That should probably be Neurology. 825 00:34:41,874 --> 00:34:44,125 Unless urologists are now treating migraines. 826 00:34:44,126 --> 00:34:45,543 Another example that should have been caught 827 00:34:45,544 --> 00:34:47,212 by proofreading. 828 00:34:47,213 --> 00:34:49,547 AI's 2% error rate is still better than dictation. 829 00:34:49,548 --> 00:34:51,049 Yeah, I don't really give a shit whether or not 830 00:34:51,050 --> 00:34:53,051 you want to use robots down here. 831 00:34:53,052 --> 00:34:55,553 I need accurate information in the medical record. 832 00:34:55,554 --> 00:34:56,971 - Understood. - OK. 833 00:34:56,972 --> 00:34:59,641 Dr. Santos. 834 00:34:59,642 --> 00:35:01,726 Dr. Santos! 835 00:35:01,727 --> 00:35:03,562 Yup. Won't happen again. 836 00:35:06,232 --> 00:35:07,274 Hoy. 837 00:35:08,943 --> 00:35:10,402 Thanks, Perlah. 838 00:35:10,403 --> 00:35:12,738 Six hours to go. You got this. 839 00:35:14,573 --> 00:35:17,617 When a wound is gaping like this, 840 00:35:17,618 --> 00:35:20,078 you want to use sub-Q to bring the edges together. 841 00:35:20,079 --> 00:35:21,871 A lot of meat to close. 842 00:35:21,872 --> 00:35:25,291 What would happen if we just did a simple wound closure? 843 00:35:25,292 --> 00:35:27,085 You take the stitches out in ten days, 844 00:35:27,086 --> 00:35:28,962 the wound opens, dehisces. 845 00:35:28,963 --> 00:35:30,296 Exactly. 846 00:35:30,297 --> 00:35:32,340 So what suture do we use under the skin? 847 00:35:32,341 --> 00:35:33,925 Vicryl provides support for a month. 848 00:35:33,926 --> 00:35:35,427 It takes two months to dissolve. 849 00:35:35,428 --> 00:35:38,763 Mm-hmm. So 5-0 nylon on the skin. 850 00:35:38,764 --> 00:35:40,849 4-0 vicryl under the skin. 851 00:35:40,850 --> 00:35:42,976 I'd go with a 3-0 vicryl. 852 00:35:42,977 --> 00:35:45,603 - You think? - Most definitely. 853 00:35:45,604 --> 00:35:47,981 Donnie is the master of wound closure. 854 00:35:47,982 --> 00:35:51,359 I do at least ten lacs a day out at triage, so... 855 00:35:51,360 --> 00:35:55,321 Can we see your sub-Q? 856 00:35:55,322 --> 00:35:56,948 Be my guest. 857 00:35:56,949 --> 00:35:58,993 If you insist. 858 00:36:03,456 --> 00:36:05,790 So... 859 00:36:05,791 --> 00:36:09,252 The secret is to be sure your entry point 860 00:36:09,253 --> 00:36:12,005 and exit point on both sides of the wound 861 00:36:12,006 --> 00:36:14,966 matches the depth on the other side. 862 00:36:14,967 --> 00:36:16,218 S... 863 00:36:19,680 --> 00:36:21,473 Start deep. 864 00:36:21,474 --> 00:36:25,435 Come up at the dermis. 865 00:36:25,436 --> 00:36:28,230 Big bites help the tissue close. 866 00:36:30,941 --> 00:36:34,152 It's a mirror image on the other side. 867 00:36:34,153 --> 00:36:36,822 Superficial to deep. 868 00:36:38,657 --> 00:36:41,367 - So you bury the knot. - Bingo. 869 00:36:41,368 --> 00:36:44,204 Avoids bumps on the scar line. 870 00:36:44,205 --> 00:36:47,999 Three ties, not four. 871 00:36:48,000 --> 00:36:50,376 Yeah, that's beautiful. 872 00:36:50,377 --> 00:36:53,546 And then you cut it short. 873 00:36:53,547 --> 00:36:55,173 Not too short. 874 00:36:55,174 --> 00:36:58,843 I like to slide my scissors 875 00:36:58,844 --> 00:37:02,013 down on the knot, 876 00:37:02,014 --> 00:37:07,227 then rotate up 45 degrees before I cut. 877 00:37:07,228 --> 00:37:09,395 Could use two more sub-Qs, 878 00:37:09,396 --> 00:37:12,649 one above, one below. 879 00:37:12,650 --> 00:37:13,776 Have at it. 880 00:37:16,153 --> 00:37:19,198 Interesting ink. Do they mean anything? 881 00:37:21,158 --> 00:37:24,828 This, this is "death and chaos," 882 00:37:24,829 --> 00:37:27,247 and this is "miracles and blessings." 883 00:37:27,248 --> 00:37:31,042 Got this one after the PittFest shooting, 884 00:37:31,043 --> 00:37:35,381 and I got this after my daughter was born. 885 00:37:37,883 --> 00:37:39,217 Put the head of the gurney up 886 00:37:39,218 --> 00:37:41,219 so people can see him, but not so high 887 00:37:41,220 --> 00:37:43,264 that his head flops to the side. 888 00:37:47,476 --> 00:37:48,810 What do you think? 889 00:37:48,811 --> 00:37:51,396 He looks peaceful. 890 00:37:51,397 --> 00:37:53,982 What's the hardest part of this job? 891 00:37:53,983 --> 00:37:55,817 It's pretty thankless, and that can be tough. 892 00:37:55,818 --> 00:37:57,235 You've seen burnout rates. 893 00:37:57,236 --> 00:37:59,070 I'm sure they teach you that in school. 894 00:37:59,071 --> 00:38:02,115 All my closest friends left after COVID. 895 00:38:02,116 --> 00:38:04,158 Some during. 896 00:38:04,159 --> 00:38:05,952 But I don't blame them. 897 00:38:05,953 --> 00:38:08,955 They needed to do what was best for their mental health. 898 00:38:08,956 --> 00:38:11,416 A lot of people broke. 899 00:38:11,417 --> 00:38:13,335 Why do you keep coming back? 900 00:38:15,796 --> 00:38:18,089 Why don't you, um, 901 00:38:18,090 --> 00:38:21,427 just finish up here and then go help Perlah for a bit? 902 00:38:25,598 --> 00:38:27,098 Great. Thank you. 903 00:38:27,099 --> 00:38:28,433 No, that is exactly what I needed to know. 904 00:38:28,434 --> 00:38:29,976 OK. 905 00:38:29,977 --> 00:38:32,604 I just got off the phone with the physician assistant 906 00:38:32,605 --> 00:38:35,106 at the prison; they've got a 16-hour-a-day infirmary 907 00:38:35,107 --> 00:38:37,400 with NP and PA coverage giving everything that we need, 908 00:38:37,401 --> 00:38:39,193 and they've got an RN for overnights. 909 00:38:39,194 --> 00:38:40,820 Even so, he's here because 910 00:38:40,821 --> 00:38:43,448 they're ignoring his basic needs. 911 00:38:43,449 --> 00:38:45,617 He's here because somebody kicked the shit out of him. 912 00:38:45,618 --> 00:38:47,118 I think you're missing the point. 913 00:38:47,119 --> 00:38:48,703 We have more to offer. 914 00:38:48,704 --> 00:38:50,830 Robby, we've got four more coming our way. 915 00:38:50,831 --> 00:38:52,457 OK, got it. 916 00:38:52,458 --> 00:38:53,958 What you're trying to do is very noble. 917 00:38:53,959 --> 00:38:55,335 We don't have the resources to spare. 918 00:38:55,336 --> 00:38:57,629 OK, then why admit the unhoused man, Digby? 919 00:38:57,630 --> 00:38:59,213 Why not send him back to the street 920 00:38:59,214 --> 00:39:00,882 with antibiotics and a roll of gauze? 921 00:39:00,883 --> 00:39:02,508 Because Digby lives on the street, 922 00:39:02,509 --> 00:39:05,136 and your incarcerated patient has a mid-level provider 923 00:39:05,137 --> 00:39:06,679 and a nurse looking after him. 924 00:39:06,680 --> 00:39:08,973 We both know the quality of care is not the same. 925 00:39:08,974 --> 00:39:09,974 Sorry, are you waiting for me? 926 00:39:09,975 --> 00:39:11,309 No. 927 00:39:11,310 --> 00:39:12,977 Dr. Al-Hashimi, for the patient in Seven. 928 00:39:12,978 --> 00:39:14,270 A few days here could make a world of difference 929 00:39:14,271 --> 00:39:15,688 for Gus' health. 930 00:39:15,689 --> 00:39:17,941 We are a safety net, but nets have holes. 931 00:39:17,942 --> 00:39:19,359 We are not admitting him 932 00:39:19,360 --> 00:39:21,194 'cause this is not about social justice. 933 00:39:23,322 --> 00:39:24,864 Everything I've done in my career 934 00:39:24,865 --> 00:39:27,325 is an effort to improve the system. 935 00:39:27,326 --> 00:39:29,035 Just because you know it's broken 936 00:39:29,036 --> 00:39:31,621 doesn't mean you stop trying. 937 00:39:31,622 --> 00:39:33,040 Excuse me. 938 00:39:37,503 --> 00:39:39,629 I talked to Jackson's girlfriend. 939 00:39:39,630 --> 00:39:40,755 OK. 940 00:39:40,756 --> 00:39:42,757 She told me a lot of stuff. 941 00:39:42,758 --> 00:39:45,176 Um, she wants to come see him, 942 00:39:45,177 --> 00:39:48,012 but I just don't think that's a good idea. 943 00:39:48,013 --> 00:39:50,431 And my... my parents are asking a lot of questions. 944 00:39:50,432 --> 00:39:52,350 Can I just take him home? 945 00:39:52,351 --> 00:39:53,893 I'm so sorry. 946 00:39:53,894 --> 00:39:56,062 Your... your brother is on an involuntary psych hold. 947 00:39:56,063 --> 00:39:57,397 He can't leave. 948 00:39:57,398 --> 00:39:58,523 It could take us weeks to figure out 949 00:39:58,524 --> 00:39:59,857 what's wrong with him. 950 00:39:59,858 --> 00:40:01,776 What's wrong with him? 951 00:40:01,777 --> 00:40:03,611 I'm so sorry. I did not mean it like that. 952 00:40:03,612 --> 00:40:04,946 What's... 953 00:40:04,947 --> 00:40:06,280 Why don't we go somewhere quiet, yeah? 954 00:40:06,281 --> 00:40:08,449 What's wrong with him? 955 00:40:08,450 --> 00:40:11,786 - Let's go over here. - What's wrong with him? 956 00:40:11,787 --> 00:40:13,705 What's wrong with him? 957 00:40:15,374 --> 00:40:17,418 What's wrong with him? 958 00:40:27,553 --> 00:40:29,220 How's she doing? 959 00:40:29,221 --> 00:40:31,431 She took three ounces of formula 960 00:40:31,432 --> 00:40:32,890 without vomiting or distress. 961 00:40:32,891 --> 00:40:34,350 Excellent. 962 00:40:34,351 --> 00:40:37,270 Dr. Wolke from Pedes should be down shortly. 963 00:40:37,271 --> 00:40:40,231 Yeah. I think I saw her smile. 964 00:40:40,232 --> 00:40:43,401 A true social smile where the baby is awake, alert, 965 00:40:43,402 --> 00:40:45,194 and responding to facial expressions 966 00:40:45,195 --> 00:40:47,739 usually doesn't happen until six weeks or older. 967 00:40:47,740 --> 00:40:49,449 It was likely a reflex smile that happens 968 00:40:49,450 --> 00:40:52,577 while they're sleeping. 969 00:40:52,578 --> 00:40:56,164 But some parents have reported their babies 970 00:40:56,165 --> 00:40:58,666 smiled socially as early as four weeks, 971 00:40:58,667 --> 00:41:01,627 so who knows? 972 00:41:01,628 --> 00:41:03,254 - Jesse. - Hmm? 973 00:41:03,255 --> 00:41:04,922 North 4 needs a blood draw when you have a sec. 974 00:41:04,923 --> 00:41:06,007 Got it. 975 00:41:06,008 --> 00:41:07,258 How we doing in here? 976 00:41:07,259 --> 00:41:08,426 Almost ready to head out. 977 00:41:08,427 --> 00:41:09,594 Looking good. 978 00:41:09,595 --> 00:41:10,636 Heart rate 91. 979 00:41:10,637 --> 00:41:12,305 BP is 115 over 82. 980 00:41:12,306 --> 00:41:14,265 Oxygen sat's 95%. 981 00:41:14,266 --> 00:41:15,892 Great. 982 00:41:15,893 --> 00:41:17,393 I'm sending him home with some nonstick dressing 983 00:41:17,394 --> 00:41:18,811 in case they don't stock them. 984 00:41:18,812 --> 00:41:20,605 Grab some burn net too. 985 00:41:20,606 --> 00:41:23,232 He's a good guy. He's a local. 986 00:41:23,233 --> 00:41:25,610 Yeah? You're from Pittsburgh? 987 00:41:25,611 --> 00:41:27,236 Yes, ma'am. Born and raised. 988 00:41:27,237 --> 00:41:28,404 Whereabouts? 989 00:41:28,405 --> 00:41:30,656 Bloomfield, Liberty Ave. 990 00:41:30,657 --> 00:41:33,284 Bloomfield? 991 00:41:33,285 --> 00:41:34,952 You know Sonny's Tavern? 992 00:41:34,953 --> 00:41:36,579 Worked there through high school. 993 00:41:36,580 --> 00:41:38,457 - No kidding. - You know Sonny's? 994 00:41:39,958 --> 00:41:43,252 Had my first kiss there. 995 00:41:43,253 --> 00:41:45,671 Hey, Donnie, my buddy Duke hasn't checked in yet? 996 00:41:45,672 --> 00:41:47,381 Nah, I told Lupe to keep an eye out. 997 00:41:47,382 --> 00:41:48,883 - Thank you. - Yep. 998 00:41:48,884 --> 00:41:51,220 Right, left. Right, left. Yeah. That's it. 999 00:41:54,848 --> 00:41:56,307 You back to check our work? 1000 00:41:56,308 --> 00:41:58,476 Nope. I need a silastic loop drain. 1001 00:41:58,477 --> 00:42:00,561 That looks great. 1002 00:42:00,562 --> 00:42:02,355 It's thanks to your fine instruction. 1003 00:42:02,356 --> 00:42:06,359 OK, he's going to need Kerlix and Xeroform. 1004 00:42:06,360 --> 00:42:08,236 You should throw a neoprene sleeve on him. 1005 00:42:08,237 --> 00:42:09,987 Limits the range of motion at the knee 1006 00:42:09,988 --> 00:42:11,823 - so the sutures don't pull out. - That's a good idea. 1007 00:42:11,824 --> 00:42:13,157 Must be fun to work here. 1008 00:42:13,158 --> 00:42:15,910 Oh, sure is. First week for these two. 1009 00:42:15,911 --> 00:42:17,370 How are you guys liking the Pitt? 1010 00:42:17,371 --> 00:42:18,830 I feel like I was born to do this. 1011 00:42:18,831 --> 00:42:21,332 Hard pass. 1012 00:42:21,333 --> 00:42:23,334 I'm shooting for pathology. 1013 00:42:23,335 --> 00:42:24,710 I like medical mysteries, 1014 00:42:24,711 --> 00:42:26,879 but I don't really deal well with people. 1015 00:42:26,880 --> 00:42:28,798 You have an interesting energy. 1016 00:42:28,799 --> 00:42:30,633 What's that for? 1017 00:42:30,634 --> 00:42:32,802 Splint starts at the knuckles, 1018 00:42:32,803 --> 00:42:36,347 comes up and around the elbow, 1019 00:42:36,348 --> 00:42:38,683 and back down to the palm. 1020 00:42:38,684 --> 00:42:41,519 It needs to be smaller. I can't ride with a splint. 1021 00:42:41,520 --> 00:42:43,020 Well, no, you shouldn't be riding at all. 1022 00:42:43,021 --> 00:42:44,981 Right now, that's a non-displaced fracture. 1023 00:42:44,982 --> 00:42:48,025 If you fall on it again, you're gonna need to go to the OR. 1024 00:42:48,026 --> 00:42:51,195 No worries, Doc. I won't fall again. 1025 00:42:51,196 --> 00:42:52,446 Uh-huh. 1026 00:42:54,366 --> 00:42:56,367 Robby, pulse ox just dropped. 1027 00:42:56,368 --> 00:42:57,869 What happened? 1028 00:42:57,870 --> 00:42:59,287 I don't know. I stepped out for a minute. 1029 00:42:59,288 --> 00:43:01,122 It's down to 85%. 1030 00:43:01,123 --> 00:43:02,540 Are you having some trouble breathing? 1031 00:43:02,541 --> 00:43:04,083 A little. 1032 00:43:04,084 --> 00:43:05,751 Start him on 2 liters oxygen, nasal cannula. 1033 00:43:05,752 --> 00:43:07,378 Titrate to 5. 1034 00:43:07,379 --> 00:43:08,963 Keep the pulse ox at 92 or higher 1035 00:43:08,964 --> 00:43:12,383 and have a rebreather standing by just in case. 1036 00:43:12,384 --> 00:43:14,218 He's gonna have to stay. 1037 00:43:14,219 --> 00:43:15,970 For how long? 1038 00:43:15,971 --> 00:43:18,764 Not sure. 1039 00:43:18,765 --> 00:43:20,683 Sorry, boss, I only stepped out for a second. 1040 00:43:20,684 --> 00:43:22,226 Let me know if anything changes. 1041 00:43:22,227 --> 00:43:23,769 You were in the room when his pulse ox dropped? 1042 00:43:23,770 --> 00:43:25,062 - I was. - What were you doing? 1043 00:43:25,063 --> 00:43:26,772 D, still can't get a hold of Ortho. 1044 00:43:26,773 --> 00:43:30,067 Leave them to me. 1045 00:43:30,068 --> 00:43:32,361 - Feeling better? - Oh, so much better. 1046 00:43:32,362 --> 00:43:35,573 Well, I wrote you a script for Zofran, just in case. 1047 00:43:35,574 --> 00:43:38,034 Thanks. I think I cleared it all out. 1048 00:43:38,035 --> 00:43:40,703 - So no more hot dogs, right? - Oh, not today. 1049 00:43:40,704 --> 00:43:42,205 But I'll be back next year. 1050 00:43:42,206 --> 00:43:43,539 - Got to defend my title! - Yo. 1051 00:43:43,540 --> 00:43:44,916 OK, well, best of luck to you. 1052 00:43:44,917 --> 00:43:46,459 They got a Wiener World truck outside. 1053 00:43:46,460 --> 00:43:48,085 You want one? 1054 00:43:48,086 --> 00:43:49,795 I think I'm good on hot dogs for the rest of my life. 1055 00:43:49,796 --> 00:43:51,672 Wait, didn't I just see you eating a doughnut? 1056 00:43:51,673 --> 00:43:53,341 Don't judge. 1057 00:43:53,342 --> 00:43:54,885 Stay here for a sec. 1058 00:44:00,933 --> 00:44:03,309 - Transport ambulance is here. - Thanks, Princess. 1059 00:44:03,310 --> 00:44:05,770 This is a 200-milligram MS Contin. 1060 00:44:05,771 --> 00:44:09,106 This will give you 12 hours of relief. 1061 00:44:09,107 --> 00:44:10,983 - OK. - Mm. 1062 00:44:10,984 --> 00:44:12,402 Yes. 1063 00:44:14,279 --> 00:44:16,113 Whenever you're ready, Rox. 1064 00:44:16,114 --> 00:44:17,990 Hey, guys, this is Roxie Hamler. 1065 00:44:17,991 --> 00:44:19,784 Hello, ma'am. 1066 00:44:19,785 --> 00:44:21,828 - Easy on the transfer, guys. - Yeah. 1067 00:44:28,460 --> 00:44:30,670 OK, on my count. 1068 00:44:30,671 --> 00:44:33,589 No, no, no. This isn't gonna work out. 1069 00:44:33,590 --> 00:44:36,759 I'm sorry. 1070 00:44:36,760 --> 00:44:38,427 I can't... I can't... 1071 00:44:38,428 --> 00:44:42,014 I can't... I can't do this. 1072 00:44:42,015 --> 00:44:45,101 - It's OK. - I want to stay. 1073 00:44:45,102 --> 00:44:48,813 Please. 1074 00:44:48,814 --> 00:44:51,983 It's OK. 1075 00:44:51,984 --> 00:44:53,859 Can I assume that you've already called upstairs 1076 00:44:53,860 --> 00:44:55,736 to get Gus Varney a bed? 1077 00:44:55,737 --> 00:44:58,030 Do you want to tell me what you did? 1078 00:44:58,031 --> 00:45:00,533 I don't know what you're talking about. 1079 00:45:00,534 --> 00:45:03,494 His pulse ox was steady. We were about to discharge him. 1080 00:45:03,495 --> 00:45:05,246 Did Dr. Al-Hashimi put you up to that? 1081 00:45:05,247 --> 00:45:07,581 Al-Hashimi? No. 1082 00:45:07,582 --> 00:45:09,083 You know he's gonna go back to prison 1083 00:45:09,084 --> 00:45:12,878 after they discharge him upstairs. 1084 00:45:12,879 --> 00:45:14,672 I thought you didn't go the extra distance 1085 00:45:14,673 --> 00:45:16,049 for your patients anymore. 1086 00:45:22,681 --> 00:45:25,224 - It's Emma, right? - Yeah. 1087 00:45:25,225 --> 00:45:26,851 How's your first day going? 1088 00:45:26,852 --> 00:45:28,644 Good, I think. 1089 00:45:28,645 --> 00:45:32,023 Haven't killed anyone yet. 1090 00:45:32,024 --> 00:45:35,359 - I'm sorry. I... - It's OK. 1091 00:45:35,360 --> 00:45:38,904 I guess time will tell if I'm cut out for this. 1092 00:45:38,905 --> 00:45:42,658 Well, when in doubt, stick with her, kid. 1093 00:45:42,659 --> 00:45:44,160 She scares me. 1094 00:45:44,161 --> 00:45:46,829 No, that's just a... it's a tough exterior. 1095 00:45:46,830 --> 00:45:50,583 She's warm and gooey on the inside. 1096 00:45:50,584 --> 00:45:53,502 Looks like they're doing the debrief for Louie. 1097 00:45:53,503 --> 00:45:55,504 - You coming? - I paid my respects. 1098 00:45:55,505 --> 00:45:57,716 Besides, who's gonna hold down the fort? 1099 00:46:09,770 --> 00:46:12,271 Remember the day you found him passed out in the park? 1100 00:46:12,272 --> 00:46:13,564 Sure do. 1101 00:46:13,565 --> 00:46:15,066 I had to drag his ass over here. 1102 00:46:15,067 --> 00:46:16,442 Came in soaked to the bone. 1103 00:46:16,443 --> 00:46:18,235 You saved his life. 1104 00:46:18,236 --> 00:46:20,279 How about last summer when we didn't see him for months? 1105 00:46:20,280 --> 00:46:21,739 He said he finally quit drinking, 1106 00:46:21,740 --> 00:46:23,574 - so he didn't need to come in. - Mm-hmm. 1107 00:46:23,575 --> 00:46:25,951 How many times did he say he was gonna quit drinking? 1108 00:46:25,952 --> 00:46:28,079 Mm-hmm. 1109 00:46:28,080 --> 00:46:30,706 He always asked about Harrison. 1110 00:46:30,707 --> 00:46:33,084 - Always said thank you. - Mm-hmm. 1111 00:46:33,085 --> 00:46:36,545 Found this with his stuff. 1112 00:46:36,546 --> 00:46:38,089 Who knew he was married? 1113 00:46:38,090 --> 00:46:40,758 Hmm. 1114 00:46:40,759 --> 00:46:43,302 That's Rhonda, Louie's wife. 1115 00:46:43,303 --> 00:46:45,262 High school sweetheart. 1116 00:46:45,263 --> 00:46:48,391 About five years ago, I was covering a night shift. 1117 00:46:48,392 --> 00:46:51,602 He came in feeling talkative. 1118 00:46:51,603 --> 00:46:53,270 Born and raised in Pittsburgh. 1119 00:46:53,271 --> 00:46:55,606 Lifelong Steelers fan. 1120 00:46:55,607 --> 00:46:57,358 Groundskeeper at Three Rivers Stadium 1121 00:46:57,359 --> 00:46:58,777 until 1998. 1122 00:47:01,530 --> 00:47:04,448 He never really wanted kids, 1123 00:47:04,449 --> 00:47:06,826 but Rhonda wore him down, 1124 00:47:06,827 --> 00:47:08,452 and when she finally got pregnant, 1125 00:47:08,453 --> 00:47:11,205 he changed his tune, he got excited. 1126 00:47:14,543 --> 00:47:16,877 And then about a month before the baby was due, 1127 00:47:16,878 --> 00:47:19,965 Rhonda and the baby were killed in a car crash. 1128 00:47:23,176 --> 00:47:25,679 Louie never really came back from that. 1129 00:47:29,683 --> 00:47:32,143 May his memory be a blessing. 1130 00:47:32,144 --> 00:47:34,479 - Amen. - May his memory be a blessing. 1131 00:47:36,481 --> 00:47:37,815 Yep. 1132 00:47:37,816 --> 00:47:40,818 Sync and corrections by btsix www.addic7ed.com