1 00:00:09,982 --> 00:00:15,982 Sync and corrections by btsix www.addic7ed.com 2 00:00:25,883 --> 00:00:27,801 Oh, okay. 3 00:00:27,802 --> 00:00:29,636 Where are we now? 4 00:00:29,637 --> 00:00:31,638 Got the VRI for our deaf patient in Central 12. 5 00:00:31,639 --> 00:00:33,640 Still waiting on Pedes for Baby Jane Doe. 6 00:00:33,641 --> 00:00:35,601 Central 6 is sitting pretty with his insulin drip. 7 00:00:35,602 --> 00:00:37,144 And the Westbridge diversions are 8 00:00:37,145 --> 00:00:38,478 kindly waiting their turn to sit 9 00:00:38,479 --> 00:00:40,022 for hours in our lovely halls. 10 00:00:40,023 --> 00:00:41,982 You are some kind of savant. 11 00:00:41,983 --> 00:00:43,025 Worthy of a raise? 12 00:00:43,026 --> 00:00:44,901 Just more of my love. 13 00:00:44,902 --> 00:00:46,361 I got enough of that. 14 00:00:46,362 --> 00:00:48,697 I have a sexual assault victim in triage. 15 00:00:48,698 --> 00:00:50,991 I called PAAR, so an advocate is on the way. 16 00:00:50,992 --> 00:00:53,327 Okay. We'll take care of it. 17 00:00:53,328 --> 00:00:56,163 Uh, Dr. McKay, what's going on with your patient in Central 9? 18 00:00:56,164 --> 00:00:57,539 Isn't she good to go? 19 00:00:57,540 --> 00:00:59,333 Oh, she was, but she decided 20 00:00:59,334 --> 00:01:00,834 she wanted to stay in the hospital now 21 00:01:00,835 --> 00:01:02,169 because she's in too much pain. 22 00:01:02,170 --> 00:01:04,129 In our loud and overcrowded ED 23 00:01:04,130 --> 00:01:06,340 with more Westbridge cases arriving every moment? 24 00:01:06,341 --> 00:01:08,300 She would be more comfortable at home. 25 00:01:08,301 --> 00:01:11,678 The debrief was lovely. 26 00:01:11,679 --> 00:01:13,472 Thank you. 27 00:01:13,473 --> 00:01:15,349 Would you mind helping Dana with a sexual assault victim 28 00:01:15,350 --> 00:01:17,351 - who just came in? - Of course. Sure. 29 00:01:17,352 --> 00:01:19,186 Why don't you and I go see if we can't convince 30 00:01:19,187 --> 00:01:20,937 - your patient to leave? - All right. 31 00:01:20,938 --> 00:01:23,565 I need to take care of a sexual assault victim in triage. 32 00:01:23,566 --> 00:01:25,359 One of you needs to hold down the fort. 33 00:01:25,360 --> 00:01:28,028 - We can call for a SANE. - On a holiday? Could be hours. 34 00:01:28,029 --> 00:01:29,738 We're not gonna make this patient wait. 35 00:01:29,739 --> 00:01:30,864 And since I'm the only SANE on staff... 36 00:01:30,865 --> 00:01:32,240 Princess will cover. 37 00:01:34,035 --> 00:01:35,869 Hey! Hey! 38 00:01:35,870 --> 00:01:37,371 You two better not be teaching her any bad habits. 39 00:01:37,372 --> 00:01:39,998 - Come on. You ready, Doc? - Sure. 40 00:01:39,999 --> 00:01:42,876 A SANE is a Sexual Assault Nurse Examiner. 41 00:01:42,877 --> 00:01:45,087 We do forensic exams, collect evidence, 42 00:01:45,088 --> 00:01:47,756 and hand it over to the police if a report is made. 43 00:01:47,757 --> 00:01:49,758 We also provide resources, support, 44 00:01:49,759 --> 00:01:52,135 - sometimes even testimony. - You go to court? 45 00:01:52,136 --> 00:01:55,055 SANEs are very valuable in a hospital, especially an ED. 46 00:01:55,056 --> 00:01:56,932 More nurses should train for it. 47 00:01:56,933 --> 00:01:58,935 That's a not so subtle hint. 48 00:02:07,235 --> 00:02:09,361 Looks like this is the new hot spot, huh? 49 00:02:09,362 --> 00:02:10,904 And only getting hotter. 50 00:02:10,905 --> 00:02:12,739 Any word on what's going on with Westbridge? 51 00:02:12,740 --> 00:02:14,074 I got 20 on lantern flies. 52 00:02:14,075 --> 00:02:16,368 Nope, nothing. 53 00:02:16,369 --> 00:02:19,621 These patient passports have an interesting alternative use. 54 00:02:19,622 --> 00:02:21,081 Where's the sexual assault victim? 55 00:02:21,082 --> 00:02:22,582 She's in Triage, Chair 2. 56 00:02:22,583 --> 00:02:24,584 Thanks, Lupe. 57 00:02:24,585 --> 00:02:25,585 Here's her intake. 58 00:02:25,586 --> 00:02:27,587 Got it. 59 00:02:33,928 --> 00:02:35,929 Hi, Ms. Miller. 60 00:02:35,930 --> 00:02:37,264 I'm Dana. 61 00:02:37,265 --> 00:02:38,932 How are you doing? 62 00:02:38,933 --> 00:02:41,476 - I've been better. - Yeah. 63 00:02:41,477 --> 00:02:42,936 You're in a safe place now. 64 00:02:42,937 --> 00:02:44,771 I'm the charge nurse in the ED 65 00:02:44,772 --> 00:02:46,982 and a sexual assault nurse examiner. 66 00:02:46,983 --> 00:02:48,608 This is Emma, who will be assisting. 67 00:02:48,609 --> 00:02:50,152 And I'm Dr. Al-Hashimi. 68 00:02:50,153 --> 00:02:51,528 I'll be checking you for any injuries 69 00:02:51,529 --> 00:02:54,197 that need immediate attention. 70 00:02:54,198 --> 00:02:56,116 You can just call me Ilana. 71 00:02:56,117 --> 00:02:57,451 I don't have any injuries. 72 00:02:57,452 --> 00:02:59,161 Okay, that's good. 73 00:02:59,162 --> 00:03:01,037 We're gonna get a room ready for you. 74 00:03:01,038 --> 00:03:02,998 Meanwhile, Dr. Al-Hashimi is gonna ask you a few questions. 75 00:03:02,999 --> 00:03:05,125 How long is this gonna take? 76 00:03:05,126 --> 00:03:06,793 I can't promise an exact time, 77 00:03:06,794 --> 00:03:09,671 but we'll try to be as fast as you need. 78 00:03:09,672 --> 00:03:11,007 - Thank you. - Yeah. 79 00:03:15,261 --> 00:03:18,472 Okay, Ilana, do you take any prescription medications? 80 00:03:18,473 --> 00:03:20,515 Just Synthroid, one tab a day. 81 00:03:20,516 --> 00:03:22,350 Okay, and any allergies to medications? 82 00:03:22,351 --> 00:03:24,561 - No. No. - Okay. 83 00:03:24,562 --> 00:03:26,563 Dana will come get you when the room is ready, 84 00:03:26,564 --> 00:03:28,691 and I'll be back to finish your exam. 85 00:03:35,823 --> 00:03:37,199 Come find me when she's in a gown. 86 00:03:37,200 --> 00:03:38,950 Will do. 87 00:03:38,951 --> 00:03:40,827 We're gonna use Triage Exam Rooms 1 and 2 for this. 88 00:03:40,828 --> 00:03:43,705 It's the most private space we have away from the ED. 89 00:03:43,706 --> 00:03:45,457 All right, this can be a lot. 90 00:03:45,458 --> 00:03:47,334 You up for it? 91 00:03:47,335 --> 00:03:48,543 Yeah. 92 00:03:48,544 --> 00:03:50,378 Yes. I'm good. 93 00:03:50,379 --> 00:03:52,590 Let me know if you need to step out. 94 00:03:59,013 --> 00:04:01,432 Yes. 95 00:04:03,684 --> 00:04:05,393 Dr. Ellis. 96 00:04:05,394 --> 00:04:07,521 - Oh, no. - Oh, yes. 97 00:04:07,522 --> 00:04:08,855 Need the room. 98 00:04:08,856 --> 00:04:10,857 Find another place to lay your head. 99 00:04:10,858 --> 00:04:13,527 Not even a 20-minute power nap? 100 00:04:13,528 --> 00:04:15,153 You know, my double is at 1:30. I'm... 101 00:04:15,154 --> 00:04:17,030 Nope, we're getting Westbridge diversions. 102 00:04:17,031 --> 00:04:18,323 And chairs is insane. 103 00:04:18,324 --> 00:04:19,825 - Did you see out there? - No. 104 00:04:19,826 --> 00:04:21,409 I do not come in through that mess. 105 00:04:21,410 --> 00:04:23,119 Okay. 106 00:04:23,120 --> 00:04:24,412 Yeah. 107 00:04:24,413 --> 00:04:26,039 People sleep in here? 108 00:04:26,040 --> 00:04:28,208 Yeah, the night shift docs just need rest, 109 00:04:28,209 --> 00:04:30,043 especially if they have to come in during the day. 110 00:04:30,044 --> 00:04:32,295 But today, we can't waste the space. 111 00:04:32,296 --> 00:04:37,301 I need you to get me a stool on wheels and Esme for a turnover. 112 00:04:40,429 --> 00:04:43,724 So you're having a headache and abdominal pain? 113 00:04:47,395 --> 00:04:49,271 Yeah, that's right. 114 00:04:49,272 --> 00:04:51,816 Okay, and which would you say is worse? 115 00:04:55,403 --> 00:04:57,279 My headache was terrible last week... 116 00:04:57,280 --> 00:05:00,240 But now... 117 00:05:00,241 --> 00:05:01,660 Hey, you're... you're breaking up. 118 00:05:01,661 --> 00:05:02,951 Can you run that back again? 119 00:05:02,952 --> 00:05:04,578 Sure. 120 00:05:07,582 --> 00:05:09,916 My headache was terrible last week... 121 00:05:09,917 --> 00:05:13,253 But now my abdominal pain... 122 00:05:13,254 --> 00:05:14,421 Oh, my God. 123 00:05:14,422 --> 00:05:16,381 Come on, you piece of... 124 00:05:16,382 --> 00:05:17,924 fuck. 125 00:05:17,925 --> 00:05:19,302 Um... 126 00:05:45,161 --> 00:05:47,621 I'll... I'll be right back. 127 00:05:47,622 --> 00:05:49,373 Sorry. 128 00:05:55,630 --> 00:05:57,130 Um, Dr. Al-Hashimi? 129 00:05:57,131 --> 00:05:58,840 Jackson's parents are here. 130 00:05:58,841 --> 00:06:01,551 Okay. I'll take that. 131 00:06:01,552 --> 00:06:04,387 Um, Mr. and Mrs. Davis, this is one of my attendings, 132 00:06:04,388 --> 00:06:06,556 - Dr. Al-Hashimi. - Hi. Nice to meet you. 133 00:06:06,557 --> 00:06:08,683 - Demi. - Charles. 134 00:06:08,684 --> 00:06:10,518 What the hell's going on? 135 00:06:10,519 --> 00:06:12,141 He's barely conscious. 136 00:06:12,142 --> 00:06:14,272 Jackson's just a little tired due to the sedative 137 00:06:14,273 --> 00:06:16,358 - he was given. - You sedated him? 138 00:06:16,359 --> 00:06:18,652 Oh, your son was brought in extremely agitated. 139 00:06:18,653 --> 00:06:19,986 You'd be, too, if you were tased. 140 00:06:19,987 --> 00:06:22,322 And why the fuck did they do that? 141 00:06:22,323 --> 00:06:25,033 This is bullshit. We're taking him home. 142 00:06:25,034 --> 00:06:26,869 Why don't we step out for a second? 143 00:06:35,544 --> 00:06:38,880 Right now, Jackson is on an involuntary psych hold. 144 00:06:38,881 --> 00:06:40,757 What? That's not necessary. 145 00:06:40,758 --> 00:06:42,217 He just needs some rest. 146 00:06:42,218 --> 00:06:44,135 He's been studying for the bar exam. 147 00:06:44,136 --> 00:06:45,637 We can watch him at home. 148 00:06:45,638 --> 00:06:47,180 So far, all of his tests look good, 149 00:06:47,181 --> 00:06:50,183 but Jackson has reported hearing voices. 150 00:06:50,184 --> 00:06:51,893 This could be serious. 151 00:06:51,894 --> 00:06:54,020 Dr. Jefferson will come back and speak with you. 152 00:06:54,021 --> 00:06:57,023 He can explain more of what may be going on with Jackson. 153 00:06:57,024 --> 00:06:58,300 And who is Dr. Jefferson? 154 00:06:58,301 --> 00:07:00,475 He's from Psychiatry, and he's excellent. 155 00:07:00,476 --> 00:07:02,862 He can explain next steps and answer all of your questions. 156 00:07:02,863 --> 00:07:05,198 Javadi, why don't you take the Davises to the family room? 157 00:07:05,199 --> 00:07:06,574 - Sure. - Excuse me. 158 00:07:06,575 --> 00:07:08,034 It's just this way. 159 00:07:29,724 --> 00:07:32,308 You have reached the Pittsburgh Neuroscience Group. 160 00:07:32,309 --> 00:07:34,269 If this is a medical emergency, 161 00:07:34,270 --> 00:07:37,397 please hang up and dial 911. 162 00:07:37,398 --> 00:07:40,400 For our address and office hours, press 1. 163 00:07:40,401 --> 00:07:43,194 To refill a prescription, press 2. 164 00:07:43,195 --> 00:07:47,741 To leave a message for the doctor on call... 165 00:07:47,742 --> 00:07:49,909 Hi, this is Dr. Baran al-Hashimi. 166 00:07:49,910 --> 00:07:51,870 I'm a patient of Dr. Fairgraves. 167 00:07:51,871 --> 00:07:55,790 I need to speak to him if he's on call. 168 00:07:55,791 --> 00:07:59,044 If he's not, I'll take his next available appointment. 169 00:07:59,045 --> 00:08:02,255 And please call me if he has a cancellation. 170 00:08:02,256 --> 00:08:04,340 Thank you. 171 00:08:04,341 --> 00:08:06,801 Like I said, you're more than welcome to stay down here 172 00:08:06,802 --> 00:08:08,636 until an inpatient bed opens up upstairs. 173 00:08:08,637 --> 00:08:11,931 But that can take a while, sometimes days, 174 00:08:11,932 --> 00:08:14,392 even longer. 175 00:08:14,393 --> 00:08:15,894 It's gonna be really noisy here, 176 00:08:15,895 --> 00:08:17,437 and you won't get any rest. 177 00:08:17,438 --> 00:08:19,430 At home, you'll be surrounded by your family 178 00:08:19,431 --> 00:08:22,650 and be more comfortable. 179 00:08:22,651 --> 00:08:24,779 It's your choice, Roxie. 180 00:08:27,073 --> 00:08:29,908 It's not that I don't wanna go home, but... 181 00:08:29,909 --> 00:08:32,118 - Hi, Mom. - Mom. 182 00:08:32,119 --> 00:08:35,789 Lena texted me to come back. I figured I'd bring the boys. 183 00:08:35,790 --> 00:08:38,291 What's going on? Is everything okay? 184 00:08:38,292 --> 00:08:41,961 Robby, police officer, incoming trauma. 185 00:08:41,962 --> 00:08:43,171 Coming. 186 00:08:43,172 --> 00:08:44,547 I'll be right back. 187 00:08:44,548 --> 00:08:46,050 We'll give you a chance to talk. 188 00:08:48,636 --> 00:08:51,138 Okay, why don't you have a seat? 189 00:08:59,021 --> 00:09:01,315 Do you need anything before we begin? 190 00:09:06,278 --> 00:09:08,988 You're in control now, Ilana. 191 00:09:08,989 --> 00:09:11,783 We're here to help and support you. 192 00:09:11,784 --> 00:09:15,203 Once I open this kit, I cannot leave the room. 193 00:09:15,204 --> 00:09:18,289 But if you need a break or some air, just let us know. 194 00:09:18,290 --> 00:09:21,543 Okay? Emma can go with you if you like. 195 00:09:21,544 --> 00:09:24,429 An advocate from Pittsburgh Action Against Rape 196 00:09:24,430 --> 00:09:26,203 has been called, and they should arrive soon. 197 00:09:26,204 --> 00:09:28,341 - Can we start? - Sure. 198 00:09:28,342 --> 00:09:29,801 I'm gonna put my face shield on 199 00:09:29,802 --> 00:09:32,011 so I don't contaminate anything. 200 00:09:32,012 --> 00:09:34,973 Emma has already done the same. 201 00:09:34,974 --> 00:09:38,935 Now, in order for the doctor to do her exam, 202 00:09:38,936 --> 00:09:40,068 I need you in a gown, 203 00:09:40,069 --> 00:09:41,729 but I need to collect your clothing first. 204 00:09:41,730 --> 00:09:43,649 Is that okay? 205 00:09:47,736 --> 00:09:50,738 I'm gonna need you to undress on top of these pads. 206 00:09:50,739 --> 00:09:53,700 Put each item of clothing on the pads, okay? 207 00:09:53,701 --> 00:09:57,245 Then we'll package each piece in a separate bag. 208 00:09:57,246 --> 00:09:58,413 We'll get you new clothes. 209 00:09:58,414 --> 00:09:59,789 - Don't worry. - All right. 210 00:09:59,790 --> 00:10:01,541 Emma's gonna be behind this curtain, 211 00:10:01,542 --> 00:10:04,544 and I'll be in here with you. 212 00:10:04,545 --> 00:10:07,714 And take off your shoes first. 213 00:10:07,715 --> 00:10:12,051 When you're done, I want you to put on your gown 214 00:10:12,052 --> 00:10:15,180 open in the back. 215 00:10:39,455 --> 00:10:41,748 What if the mom doesn't wanna leave? 216 00:10:41,749 --> 00:10:44,000 Well, then she's gonna have to put up with us. 217 00:10:45,920 --> 00:10:48,755 I can't imagine... her boys. 218 00:10:48,756 --> 00:10:50,590 Oh, don't go there. 219 00:10:50,591 --> 00:10:52,258 I'm gonna see if I can grease the wheels, 220 00:10:52,259 --> 00:10:53,468 get her a room upstairs soon. 221 00:10:53,469 --> 00:10:55,428 Good luck. What was that? 222 00:10:55,429 --> 00:10:56,846 Battle plan for our hall space. 223 00:10:56,847 --> 00:10:58,431 It's filling up fast. 224 00:10:58,432 --> 00:11:00,141 Police officer should be here any minute. 225 00:11:00,142 --> 00:11:01,935 Yeah, well, as soon as you can, please, 226 00:11:01,936 --> 00:11:03,269 I need you to fix the VRI. 227 00:11:03,270 --> 00:11:04,442 All right. Thanks. 228 00:11:04,443 --> 00:11:06,023 Santos, I need you to pick up some more 229 00:11:06,024 --> 00:11:07,732 - of these Westbridge diversions. - Sure. 230 00:11:07,733 --> 00:11:09,234 You want my firstborn too? 231 00:11:09,235 --> 00:11:11,402 Maybe. Will they know how to suture? 232 00:11:11,403 --> 00:11:13,071 Intubated neck wound, sats not great. 233 00:11:13,072 --> 00:11:15,073 We were diverted here. Is there a trauma room open? 234 00:11:15,074 --> 00:11:16,824 - Trauma 1! - What's the story? 235 00:11:16,825 --> 00:11:19,410 My buddy, Officer Hiro, high-velocity GSW. 236 00:11:19,411 --> 00:11:20,787 He's getting harder to bag. 237 00:11:20,788 --> 00:11:23,581 Warehouse robbery gone sideways. 238 00:11:23,582 --> 00:11:24,818 One, two, three. 239 00:11:24,819 --> 00:11:26,106 You guys wait here. 240 00:11:26,107 --> 00:11:27,856 We'll take care of him, I promise. 241 00:11:27,857 --> 00:11:29,671 I thought you left us already for the open road? 242 00:11:29,672 --> 00:11:31,297 And miss seeing you in uniform? 243 00:11:31,298 --> 00:11:32,941 You should see me as a flight attendant. 244 00:11:32,942 --> 00:11:35,176 - Did you do this intubation? - Under active fire, yeah. 245 00:11:35,177 --> 00:11:36,656 Are you serious? 246 00:11:36,657 --> 00:11:38,388 I go in with the team in case there's an injury. 247 00:11:38,389 --> 00:11:39,495 That's badass. 248 00:11:39,496 --> 00:11:41,302 Dr. Santos, let's make sure these lungs are up. 249 00:11:41,303 --> 00:11:43,434 - Could you see the cords? - Yeah, there was a great view, 250 00:11:43,435 --> 00:11:45,061 but it was hard to pass after I cleared them. 251 00:11:45,062 --> 00:11:47,021 Yeah, sats down to 85. 252 00:11:47,022 --> 00:11:48,982 Dr. Santos, what could cause respiratory failure 253 00:11:48,983 --> 00:11:50,650 in an intubated patient? 254 00:11:50,651 --> 00:11:51,859 There are a lot of possibilities. 255 00:11:51,860 --> 00:11:53,136 Think DOPE. 256 00:11:53,137 --> 00:11:55,655 Displacement, Obstruction, Pneumothorax, 257 00:11:55,656 --> 00:11:57,031 Equipment failure. 258 00:11:57,032 --> 00:11:59,534 Good lung sliding, no pneumo. 259 00:11:59,535 --> 00:12:01,160 It is displacement. 260 00:12:01,161 --> 00:12:03,579 Okay, that is a transected trachea. 261 00:12:05,499 --> 00:12:07,542 Pulling out. 262 00:12:07,543 --> 00:12:08,632 Bag. 263 00:12:08,633 --> 00:12:10,712 But if you intubate again, won't it just come straight 264 00:12:10,713 --> 00:12:12,171 - out the wound? - Yep, exactly. 265 00:12:12,172 --> 00:12:13,506 So we're gonna need another plan. 266 00:12:13,507 --> 00:12:15,341 Okay. Sats down to 83. 267 00:12:15,342 --> 00:12:16,801 Yeah, he's not moving any air. 268 00:12:16,802 --> 00:12:18,678 Okay, I need a neonatal mask. 269 00:12:18,679 --> 00:12:21,306 - Neonatal? - Yep. 270 00:12:21,307 --> 00:12:23,808 I'm just going to finish my initial exam. 271 00:12:23,809 --> 00:12:25,728 Let me know if you feel any pain, okay? 272 00:12:29,690 --> 00:12:32,358 My legs are fine. 273 00:12:32,359 --> 00:12:34,068 All looks good. 274 00:12:34,069 --> 00:12:36,487 No need for X-rays or advanced imaging. 275 00:12:36,488 --> 00:12:38,072 Got it. 276 00:12:38,073 --> 00:12:40,533 - Two areas of ecchymosis... - That means bruising. 277 00:12:40,534 --> 00:12:42,243 Over the shoulders bilaterally. 278 00:12:42,244 --> 00:12:44,037 - I'll document with photos. - Okay. 279 00:12:44,038 --> 00:12:46,039 Dana will finish up her work, and I will be in the ER 280 00:12:46,040 --> 00:12:47,707 if you have any questions. 281 00:12:47,708 --> 00:12:49,250 You're in great hands. 282 00:12:49,251 --> 00:12:51,878 Thank you. 283 00:12:51,879 --> 00:12:54,213 All right, Ilana. 284 00:12:54,214 --> 00:12:56,215 I read your intake. 285 00:12:56,216 --> 00:12:57,550 Why don't you give me your description 286 00:12:57,551 --> 00:12:58,969 of exactly what happened? 287 00:13:02,056 --> 00:13:06,100 I was at a 4th of July barbecue 288 00:13:06,101 --> 00:13:08,895 with a bunch of friends. 289 00:13:08,896 --> 00:13:11,689 I helped set up. 290 00:13:19,073 --> 00:13:20,698 Where does it hurt? 291 00:13:20,699 --> 00:13:24,202 Like here, under my belly button. 292 00:13:24,203 --> 00:13:27,580 Okay, do you have any fever, vomiting, diarrhea? 293 00:13:27,581 --> 00:13:31,042 Oh, no. It's... it's just a stomachache. 294 00:13:31,043 --> 00:13:33,044 Okay, well, still, go see the nurse and have her call me. 295 00:13:33,045 --> 00:13:34,754 Okay. 296 00:13:34,755 --> 00:13:37,215 But I'm still having ice cream tonight. 297 00:13:37,216 --> 00:13:39,384 Why don't you see how you feel later? 298 00:13:39,385 --> 00:13:42,804 It... it's not bad. You don't have to get so sad. 299 00:13:42,805 --> 00:13:45,181 I'm not sad. I'm... I'm good. 300 00:13:45,182 --> 00:13:47,433 Your face doesn't look good. 301 00:13:47,434 --> 00:13:49,018 Oh. 302 00:13:49,019 --> 00:13:51,104 Well, you still wanna watch the fireworks tonight? 303 00:13:51,105 --> 00:13:52,313 I have our headphones... 304 00:13:54,024 --> 00:13:56,527 - I'm not being rude. - Sorry, Becca. I gotta go. 305 00:14:02,574 --> 00:14:05,785 Elliot Green, 17, syncopal episode at football practice. 306 00:14:05,786 --> 00:14:07,703 Look, I just got dizzy, okay? 307 00:14:07,704 --> 00:14:09,163 It's hell week. I need to get back. 308 00:14:09,164 --> 00:14:11,124 Yeah, okay, tough guy. 309 00:14:11,125 --> 00:14:15,002 A and O, systolic of 95, tachy at 122, no meds, no allergies. 310 00:14:15,003 --> 00:14:16,629 How long were you at practice? 311 00:14:16,630 --> 00:14:19,090 I started at 9:00, so, like, four hours. 312 00:14:19,091 --> 00:14:21,467 Four hours in this heat with all that gear? 313 00:14:21,468 --> 00:14:23,470 No pain, no game. 314 00:14:25,514 --> 00:14:27,975 God, I'm hungry. 315 00:14:29,810 --> 00:14:33,146 - Hey. When's our break? - There's no breaks down here. 316 00:14:33,147 --> 00:14:36,107 Always make sure you pack a protein bar, something quick. 317 00:14:36,108 --> 00:14:39,986 Ogilvie, Joy, jump in on this. 318 00:14:39,987 --> 00:14:41,529 Syncope at football practice. 319 00:14:41,530 --> 00:14:44,657 No, I just... I just needed to hydrate. 320 00:14:44,658 --> 00:14:46,075 Possible heatstroke? 321 00:14:46,076 --> 00:14:47,243 Well, with heatstroke, you would have 322 00:14:47,244 --> 00:14:48,703 an altered mental status. 323 00:14:48,704 --> 00:14:50,204 And they're usually dry, not sweaty. 324 00:14:50,205 --> 00:14:52,039 Mortality is 50%, especially in the elderly. 325 00:14:52,040 --> 00:14:54,126 In extreme heat like this... 326 00:14:55,335 --> 00:14:56,836 Langdon, can you cover this? 327 00:14:56,837 --> 00:14:59,255 - No problem. - Mr. Diaz. Orlando. 328 00:14:59,256 --> 00:15:01,215 Orlando, where are you going? 329 00:15:01,216 --> 00:15:03,092 - Home. Can you take these out? - Uh, no. 330 00:15:03,093 --> 00:15:05,178 It takes 48 hours for you to get out of DKA. 331 00:15:05,179 --> 00:15:06,662 Your blood is still full of acid. 332 00:15:06,663 --> 00:15:08,514 Look, I can't add thousands of dollars 333 00:15:08,515 --> 00:15:09,849 to the 100 grand I already owe. 334 00:15:09,850 --> 00:15:11,767 I'm... I'm sorry. 100 grand? 335 00:15:11,768 --> 00:15:14,020 In medical debt. My wife doesn't even know. 336 00:15:14,021 --> 00:15:16,022 I'll never be able to pay it off as it is. 337 00:15:16,023 --> 00:15:17,190 Where are your wife and daughter? 338 00:15:17,191 --> 00:15:18,289 Maybe we can all talk. 339 00:15:18,290 --> 00:15:20,003 I told them to go back to work a couple hours ago. 340 00:15:20,004 --> 00:15:21,877 But the hospital is giving you a big discount. 341 00:15:21,878 --> 00:15:23,738 And, Mr. Diaz, I know it's not ideal, 342 00:15:23,739 --> 00:15:25,531 but can you stay for at least 12 hours? 343 00:15:25,532 --> 00:15:27,158 It would get you out of the danger zone. 344 00:15:27,159 --> 00:15:29,869 No. I really can't. 345 00:15:29,870 --> 00:15:33,247 Every minute I stay is a meal, shoes, school supplies. 346 00:15:33,248 --> 00:15:35,750 Plus, I have a second job I have to get to by 4:00. 347 00:15:35,751 --> 00:15:38,753 - You need fluids! - I drink plenty of water. 348 00:15:38,754 --> 00:15:41,172 And potassium and insulin. Okay, how about this? 349 00:15:41,173 --> 00:15:43,883 You stay and I'll get together everything you'll need at home. 350 00:15:43,884 --> 00:15:48,095 Also, a referral to Northside Christian Health Center. 351 00:15:48,096 --> 00:15:50,556 Come on. You don't work until 4:00. 352 00:15:50,557 --> 00:15:53,059 It'll keep you from passing out on the job again... 353 00:15:53,060 --> 00:15:54,269 or worse. 354 00:15:58,315 --> 00:15:59,815 Okay, I guess. 355 00:15:59,816 --> 00:16:01,067 Great. 356 00:16:01,068 --> 00:16:02,902 Thank you. Please. 357 00:16:06,240 --> 00:16:08,032 Sats up to 98. 358 00:16:08,033 --> 00:16:10,618 - Neonatal mask is working. - Santos, finish the FAST. 359 00:16:10,619 --> 00:16:11,971 What... what are you injecting? 360 00:16:11,972 --> 00:16:13,246 Lido with epi. 361 00:16:13,247 --> 00:16:14,705 It'll clamp off any little bleeders. 362 00:16:14,706 --> 00:16:16,290 We need some skin hooks. 4 Shiley? 363 00:16:16,291 --> 00:16:18,626 Mm, I don't like the curve of a Shiley. 364 00:16:18,627 --> 00:16:20,211 I didn't know you were so picky. 365 00:16:20,212 --> 00:16:21,379 Santos, take a break. 366 00:16:21,380 --> 00:16:23,422 Help me cut down a 6-0 ET tube. 367 00:16:23,423 --> 00:16:24,924 What is going on here? 368 00:16:24,925 --> 00:16:26,551 You have a field medic assisting you? 369 00:16:26,552 --> 00:16:27,927 Dr. Abbot is an attending, 370 00:16:27,928 --> 00:16:29,595 and he's also a SWAT physician. 371 00:16:29,596 --> 00:16:32,182 My buddy Hiro here is in bad need of an airway. 372 00:16:32,183 --> 00:16:33,975 - Cut it right here. - We can do this. 373 00:16:33,976 --> 00:16:35,309 No, no, I got it. 374 00:16:35,310 --> 00:16:36,435 You must be Gloria's new hire. 375 00:16:36,436 --> 00:16:37,739 Yes. Dr. Al-Hashimi. 376 00:16:37,740 --> 00:16:40,147 Well, I'd shake your hand, but my tube is ready. 377 00:16:40,148 --> 00:16:41,687 And if I could find and secure the distal trachea, 378 00:16:41,688 --> 00:16:42,741 we have a shot at this. 379 00:16:42,742 --> 00:16:45,653 Okay, keeping an eye on the sats. 380 00:16:45,654 --> 00:16:47,905 Slow is smooth. Smooth is fast. 381 00:16:47,906 --> 00:16:50,116 You know, you can call me just to say hi sometimes. 382 00:16:50,117 --> 00:16:51,222 What's up now? 383 00:16:51,223 --> 00:16:53,035 GSW with tracheal transection. 384 00:16:53,036 --> 00:16:56,455 Very retracted, but I think I can get it. 385 00:16:56,456 --> 00:16:58,165 Both lungs are up? 386 00:16:58,166 --> 00:17:00,376 - Sats down to 91. - Scanning the belly now. 387 00:17:00,377 --> 00:17:01,837 Okay. 388 00:17:03,505 --> 00:17:05,132 I got it. I got it. 389 00:17:08,260 --> 00:17:10,136 Gently, gently, or we're gonna lose it. 390 00:17:10,137 --> 00:17:11,971 Down to 89. 391 00:17:11,972 --> 00:17:13,139 Oh, no. 392 00:17:13,140 --> 00:17:15,017 I'm in. Balloon up. 393 00:17:17,144 --> 00:17:19,812 End tidal, excellent wave form. 394 00:17:19,813 --> 00:17:22,106 Good breath sounds. 395 00:17:22,107 --> 00:17:25,484 I'll sew the tracheal to the skin, 2-0 silk. 396 00:17:25,485 --> 00:17:27,194 - Sats are coming up. - Whoo. 397 00:17:27,195 --> 00:17:29,780 Not bad, Abbot. 398 00:17:29,781 --> 00:17:31,866 Mm, while you were playing with that airway, 399 00:17:31,867 --> 00:17:33,868 you missed a big bruise in the left upper quadrant. 400 00:17:33,869 --> 00:17:35,248 He was wearing body armor. 401 00:17:35,249 --> 00:17:36,495 High-velocity projectile doesn't have 402 00:17:36,496 --> 00:17:38,664 to penetrate to damage. 403 00:17:38,665 --> 00:17:41,000 There's no fluid in the suprasplenic space. 404 00:17:41,001 --> 00:17:43,169 Let me look. 405 00:17:43,170 --> 00:17:44,338 Okay, right there. 406 00:17:46,840 --> 00:17:49,175 Looks like a subcapsular hematoma of his spleen. 407 00:17:49,176 --> 00:17:50,801 Must have been a big impact. 408 00:17:50,802 --> 00:17:53,554 AR-15 muzzle velocity is 3,000 feet per second. 409 00:17:53,555 --> 00:17:55,181 CT angio of the neck ASAP, 410 00:17:55,182 --> 00:17:57,767 along with CT chest, abdomen, pelvis. 411 00:17:57,768 --> 00:18:00,729 Yep, just as soon as we secure this tube. 412 00:18:04,524 --> 00:18:07,026 - First liter's in. - Mucous membranes dry. 413 00:18:07,027 --> 00:18:09,195 Pupils 4 millimeters reactive. 414 00:18:09,196 --> 00:18:10,571 Did you get tackled today? 415 00:18:10,572 --> 00:18:12,031 No, just running drills. 416 00:18:12,032 --> 00:18:13,866 Any chest pain? Palpitations? 417 00:18:13,867 --> 00:18:14,929 No. 418 00:18:14,930 --> 00:18:16,950 Hands off, please, running the 12 lead. 419 00:18:16,951 --> 00:18:18,120 How are we looking? 420 00:18:18,121 --> 00:18:19,747 Good. Healthy kid. 421 00:18:19,748 --> 00:18:21,374 No history, no trauma. 422 00:18:21,375 --> 00:18:24,251 Differential for syncope in an adolescent? 423 00:18:24,252 --> 00:18:25,923 Cardiac arrhythmia from drugs... 424 00:18:25,924 --> 00:18:27,588 - Hypovolemia, seizure... - Long QT, WPW... 425 00:18:27,589 --> 00:18:29,340 - Sepsis. - Or Brugada. 426 00:18:29,341 --> 00:18:31,550 Uh, Brugada is more common in Asian males. 427 00:18:31,551 --> 00:18:33,010 But still should be considered. 428 00:18:33,011 --> 00:18:34,679 Long odds, though. 429 00:18:34,680 --> 00:18:36,555 Brugada prevalence is 1 in 20,000 in North America, 430 00:18:36,556 --> 00:18:39,225 as high as 1 in 300 in Asia and the Middle East. 431 00:18:39,226 --> 00:18:40,407 And? 432 00:18:40,408 --> 00:18:42,937 First described in 1992, has a high incidence 433 00:18:42,938 --> 00:18:44,730 of sudden death among young patients with otherwise 434 00:18:44,731 --> 00:18:47,233 - structurally normal hearts... - Oof, oof, wait. 435 00:18:47,234 --> 00:18:48,734 Did you just say "sudden death"? 436 00:18:48,735 --> 00:18:50,000 Temp is 102.5. 437 00:18:50,001 --> 00:18:51,737 Sorry, our student doctors are discussing 438 00:18:51,738 --> 00:18:54,240 a rare condition you don't have. 439 00:18:54,241 --> 00:18:57,326 I... I just didn't drink enough water. 440 00:18:57,327 --> 00:19:00,329 I overheated. 441 00:19:00,330 --> 00:19:02,081 Not my type, bud. 442 00:19:02,082 --> 00:19:04,960 Other than standard labs, what else to order? 443 00:19:08,588 --> 00:19:10,464 CK to rule out rhabdo. 444 00:19:10,465 --> 00:19:11,757 To make sure you don't have 445 00:19:11,758 --> 00:19:13,182 any muscle breakdown from the heat. 446 00:19:13,183 --> 00:19:15,469 Let's set up a cooling room for Elliot here 447 00:19:15,470 --> 00:19:18,473 and the other heat exhaustions we'll inevitably get today. 448 00:19:22,269 --> 00:19:24,019 Last photo. 449 00:19:27,941 --> 00:19:29,233 Okay. 450 00:19:29,234 --> 00:19:31,485 We'll take the SD card and seal it 451 00:19:31,486 --> 00:19:34,613 in an evidence envelope with everything else. 452 00:19:34,614 --> 00:19:36,115 Okay. 453 00:19:36,116 --> 00:19:40,119 Next, Emma's gonna turn off the light, 454 00:19:40,120 --> 00:19:42,663 and I'll run a blue light over your skin. 455 00:19:42,664 --> 00:19:48,127 Anything glows, I'll swab it with a wet, then dry Q-tip. 456 00:19:48,128 --> 00:19:49,336 Is that okay? 457 00:19:49,337 --> 00:19:50,380 Yeah, sure. 458 00:19:52,966 --> 00:19:54,300 All right. 459 00:19:54,301 --> 00:19:56,510 Take off your gown on the left side 460 00:19:56,511 --> 00:19:58,889 and turn a little bit towards me, just to the left. 461 00:20:00,891 --> 00:20:02,267 There. 462 00:20:27,000 --> 00:20:28,626 Something on the left wrist. 463 00:20:28,627 --> 00:20:29,711 Swab. 464 00:20:37,177 --> 00:20:38,219 Sorry. 465 00:20:38,220 --> 00:20:39,637 Don't be. 466 00:20:39,638 --> 00:20:41,347 - It's just cold. - Yeah. 467 00:20:41,348 --> 00:20:43,016 Almost done. 468 00:20:49,523 --> 00:20:51,816 - Thanks, Antoine. - No problem. 469 00:20:51,817 --> 00:20:53,359 Keep your head down out there. 470 00:20:53,360 --> 00:20:54,487 What's the story? 471 00:20:54,488 --> 00:20:56,880 Neck angio is negative, missed the carotids. 472 00:20:56,881 --> 00:20:58,489 - He's lucky. - What about the belly? 473 00:20:58,490 --> 00:21:00,957 Small splenic injury, no free fluid in the abdomen. 474 00:21:00,958 --> 00:21:03,118 - That should heal on its own. - What's the plan? 475 00:21:03,119 --> 00:21:04,537 Head and Neck will have an OR ready 476 00:21:04,538 --> 00:21:05,785 with thoracic standing by. 477 00:21:05,786 --> 00:21:07,224 How soon can they take him? 478 00:21:07,225 --> 00:21:08,881 We're a little backed up with Westbridge patients, 479 00:21:08,882 --> 00:21:09,981 but let's bring him up. 480 00:21:09,982 --> 00:21:11,468 I'll get him taken care of for you. 481 00:21:12,754 --> 00:21:14,630 Hey. 482 00:21:14,631 --> 00:21:16,871 You're gonna be okay, Hiro. We're getting you to surgery. 483 00:21:17,457 --> 00:21:18,458 I'll write the procedure note. 484 00:21:18,459 --> 00:21:19,502 Thank you. 485 00:21:24,891 --> 00:21:25,975 SWAT? Really? 486 00:21:25,976 --> 00:21:28,102 I suck at golf. 487 00:21:28,103 --> 00:21:30,396 You spend time in the Middle East? 488 00:21:30,397 --> 00:21:32,106 More than I would have liked. 489 00:21:32,107 --> 00:21:34,900 I worked in Kabul with Médecins Sans Frontières 490 00:21:34,901 --> 00:21:37,695 and in 2020, at the maternity hospital. 491 00:21:37,696 --> 00:21:41,282 I met the most incredible, bravest doctors there. 492 00:21:41,283 --> 00:21:43,576 Dasht-e-Barchi. 493 00:21:43,577 --> 00:21:46,370 Tragedy. 494 00:21:46,371 --> 00:21:49,415 We should grab a beer sometime, share war stories. 495 00:21:49,416 --> 00:21:51,418 I'd like that. 496 00:21:54,546 --> 00:21:55,546 She seems cool. 497 00:21:55,547 --> 00:21:57,256 Yep, maybe. 498 00:21:57,257 --> 00:22:00,885 I'm not gonna be around long enough to find out. 499 00:22:00,886 --> 00:22:03,012 Oh, there she is! Vic! 500 00:22:03,013 --> 00:22:04,305 Dad! 501 00:22:04,306 --> 00:22:07,600 Victoria, this is Dr. Amy Joon. 502 00:22:07,601 --> 00:22:09,476 Dr. Joon is the smartest person I know. 503 00:22:09,477 --> 00:22:10,957 Don't tell your mother. Just kidding. 504 00:22:11,984 --> 00:22:13,188 But seriously, don't. 505 00:22:13,189 --> 00:22:14,607 - Hi. - Hello. 506 00:22:14,608 --> 00:22:16,409 Are... are you here to see a patient? 507 00:22:16,410 --> 00:22:18,089 No. We're here to see you. 508 00:22:18,090 --> 00:22:19,778 Dr. Joon is Chief of Dermatology. 509 00:22:19,779 --> 00:22:21,363 And Victoria's first shift in the ER 510 00:22:21,364 --> 00:22:24,283 was on the day of the PittFest shooting. 511 00:22:24,284 --> 00:22:26,368 I heard all the incredible stories, 512 00:22:26,369 --> 00:22:30,205 including your own acts of med student prowess. 513 00:22:30,206 --> 00:22:31,957 Wow, med student prowess. 514 00:22:31,958 --> 00:22:34,126 That's... I'm... I'm pretty sure 515 00:22:34,127 --> 00:22:35,753 I was just trying to stay out of the way. 516 00:22:35,754 --> 00:22:37,004 Ah, she's modest, like her dad. 517 00:22:37,005 --> 00:22:38,756 And her mother? 518 00:22:38,757 --> 00:22:40,966 Oh. Sorry. 519 00:22:40,967 --> 00:22:42,801 Dr. Joon. 520 00:22:42,802 --> 00:22:44,845 Yep, coming. 521 00:22:44,846 --> 00:22:46,931 I'm doing a favor for someone at the mayor's office 522 00:22:46,932 --> 00:22:49,808 who needs Mohs surgery on a basal cell carcinoma. 523 00:22:49,809 --> 00:22:51,810 And then I am grilling for 30. 524 00:22:51,811 --> 00:22:53,812 - Oh, wow. - Happy 4th, all. 525 00:22:53,813 --> 00:22:55,147 - Happy 4th. - Yeah. 526 00:22:55,148 --> 00:22:57,358 - Thanks for coming down. - My pleasure. 527 00:22:57,359 --> 00:22:59,443 - Let's grab a coffee sometime. - Absolutely. Yes. 528 00:22:59,444 --> 00:23:01,946 Thank you. 529 00:23:01,947 --> 00:23:04,365 You know Mom really wants me to go into surgery. 530 00:23:04,366 --> 00:23:06,325 Ah, your mom wants me to stop drinking 531 00:23:06,326 --> 00:23:08,661 - and join a pickleball league. - Oh, that's the same. 532 00:23:08,662 --> 00:23:10,371 - Yeah, well... - Exact same. 533 00:23:10,372 --> 00:23:12,831 I will risk an Achilles tear before I give up scotch. 534 00:23:12,832 --> 00:23:15,205 Hey, I hope I didn't embarrass you coming down here. 535 00:23:15,206 --> 00:23:16,251 No. 536 00:23:16,252 --> 00:23:18,121 I'm just trying to present you with some options 537 00:23:18,122 --> 00:23:19,505 for your residency. 538 00:23:19,506 --> 00:23:21,423 I... I really appreciate it, Dad. 539 00:23:21,424 --> 00:23:23,676 I do. I just... 540 00:23:23,677 --> 00:23:25,844 I'm still not sure. 541 00:23:25,845 --> 00:23:27,513 Well, either way, you'll do what's right. 542 00:23:27,514 --> 00:23:28,847 You always do. 543 00:23:28,848 --> 00:23:30,849 - Proud of ya. - Okay. 544 00:23:30,850 --> 00:23:33,435 Dr. Javadi, you are a man of many talents. 545 00:23:33,436 --> 00:23:35,187 You don't know the half of it. 546 00:23:35,188 --> 00:23:36,355 Your daughter has some 547 00:23:36,356 --> 00:23:37,982 high standards to live up to. 548 00:23:37,983 --> 00:23:40,527 Oh, you don't know the half of it. 549 00:23:43,697 --> 00:23:46,907 Mr. and Mrs. Davis, this is Dr. Jefferson from Psychiatry. 550 00:23:46,908 --> 00:23:48,909 Please call me Caleb. 551 00:23:48,910 --> 00:23:51,370 Can you tell us what's going on with our son? 552 00:23:51,371 --> 00:23:55,207 All of his labs and X-rays came back normal. 553 00:23:55,208 --> 00:23:58,919 Given his age and his hearing voices, 554 00:23:58,920 --> 00:24:03,424 do either of you have a family history of mental illness? 555 00:24:03,425 --> 00:24:04,759 Not mine. 556 00:24:11,725 --> 00:24:13,392 My brother took his own life. 557 00:24:13,393 --> 00:24:15,728 Wait, what? 558 00:24:15,729 --> 00:24:18,063 Uncle Ken? 559 00:24:18,064 --> 00:24:19,898 You said he drank himself to death. 560 00:24:19,899 --> 00:24:21,734 - Ma. - He did that too. 561 00:24:21,735 --> 00:24:23,027 Was he ever formally diagnosed 562 00:24:23,028 --> 00:24:24,111 with a mental health issue? 563 00:24:24,112 --> 00:24:25,571 No. 564 00:24:25,572 --> 00:24:28,699 He was depressed, had mood swings. 565 00:24:28,700 --> 00:24:30,451 - But he didn't wanna see anyone. - Oh, my God. 566 00:24:30,452 --> 00:24:32,366 Okay, why am I just now hearing about this? 567 00:24:32,367 --> 00:24:34,753 - Jada, please. - Please what, Mom? 568 00:24:34,754 --> 00:24:37,916 Why would you not tell Jackson or me? 569 00:24:37,917 --> 00:24:39,376 I can't believe this. 570 00:24:39,377 --> 00:24:41,045 - Jada. - Excuse me. 571 00:24:41,046 --> 00:24:42,088 Jada. 572 00:24:49,763 --> 00:24:51,764 What happens next? 573 00:24:51,765 --> 00:24:54,058 We keep your son here for the next three days 574 00:24:54,059 --> 00:24:56,143 for observation and therapy. 575 00:24:56,144 --> 00:24:58,645 And that will help us to understand what is going on. 576 00:24:58,646 --> 00:25:00,272 Jada should really hear this. 577 00:25:00,273 --> 00:25:02,817 Let me see if I can find her, bring her back. 578 00:25:05,779 --> 00:25:08,113 Okay. I'm gonna swab your mouth now. 579 00:25:08,114 --> 00:25:09,948 My mouth? 580 00:25:09,949 --> 00:25:13,827 Two dry swabs along the inside of your cheek 581 00:25:13,828 --> 00:25:15,747 and then along the gum line. 582 00:25:19,542 --> 00:25:21,419 How you feeling? 583 00:25:23,296 --> 00:25:25,339 I wish this day never happened. 584 00:25:25,340 --> 00:25:27,341 Would you like some medicine to help you relax? 585 00:25:27,342 --> 00:25:29,302 You've experienced a horrific trauma. 586 00:25:32,013 --> 00:25:33,972 You've been doing this a while? 587 00:25:33,973 --> 00:25:35,307 Let's just say Florence Nightingale 588 00:25:35,308 --> 00:25:37,351 and I were roommates. 589 00:25:37,352 --> 00:25:39,853 Who? 590 00:25:39,854 --> 00:25:41,522 I rest my case. 591 00:25:41,523 --> 00:25:43,566 She was the founder of modern nursing. 592 00:25:45,777 --> 00:25:48,028 Okay, you can have something to eat or drink now. 593 00:25:48,029 --> 00:25:50,030 - I'm fine. - Are you sure? 594 00:25:50,031 --> 00:25:51,782 I'll just keep going. 595 00:25:51,783 --> 00:25:53,660 Okay. 596 00:26:00,667 --> 00:26:05,337 We now have a heat exhaustion treatment area in North 5. 597 00:26:05,338 --> 00:26:07,840 Evaporated cooling. Great plan. 598 00:26:07,841 --> 00:26:12,719 Yeah, it was Dr. Langdon's idea. 599 00:26:12,720 --> 00:26:16,390 He figured we'd be seeing a lot more patients in this heat. 600 00:26:16,391 --> 00:26:18,183 He's right. 601 00:26:18,184 --> 00:26:19,434 How are you feeling? 602 00:26:19,435 --> 00:26:21,895 That's a loaded question. 603 00:26:21,896 --> 00:26:24,064 It wasn't meant to be. 604 00:26:24,065 --> 00:26:26,275 You have a deposition in a couple of hours? 605 00:26:26,276 --> 00:26:28,527 - Yes. - How are you feeling about it? 606 00:26:28,528 --> 00:26:30,529 Um, trying to think positively 607 00:26:30,530 --> 00:26:33,740 but feeling, um, less so. 608 00:26:33,741 --> 00:26:35,951 This job's really important to me and my sister. 609 00:26:35,952 --> 00:26:37,452 You know, I support both of us. 610 00:26:37,453 --> 00:26:38,579 It's gonna go great. 611 00:26:38,580 --> 00:26:40,372 Just tell them what happened. 612 00:26:40,373 --> 00:26:41,915 You're not at fault. Your job's not in jeopardy. 613 00:26:41,916 --> 00:26:44,042 I mean, the lawyers said that I could... 614 00:26:44,043 --> 00:26:46,211 The lawyers' job is to try and shake your confidence. 615 00:26:46,212 --> 00:26:48,589 So don't let them. You're a very good doctor. 616 00:26:48,590 --> 00:26:50,716 I have been training residents for years. 617 00:26:50,717 --> 00:26:53,260 You are one of the very best. 618 00:26:53,261 --> 00:26:54,720 I am? 619 00:26:54,721 --> 00:26:55,846 No, we need to stick to the plan. 620 00:26:55,847 --> 00:26:56,889 - I promise. - Look. 621 00:26:56,890 --> 00:26:58,265 Thanks. 622 00:26:58,266 --> 00:26:59,558 She's not thinking clearly, okay? 623 00:26:59,559 --> 00:27:00,726 It's gonna be great. 624 00:27:00,727 --> 00:27:02,060 This is not what she wants. 625 00:27:02,061 --> 00:27:03,896 Then I'm taking her home. That's it. 626 00:27:03,897 --> 00:27:05,898 We have to honor your wife's wishes. 627 00:27:05,899 --> 00:27:07,399 Even if she's loaded up on morphine 628 00:27:07,400 --> 00:27:09,067 - and can't think straight? - Especially then. 629 00:27:09,068 --> 00:27:10,316 Hello. 630 00:27:10,317 --> 00:27:12,779 Paul Hamler, this is my attending, Dr. Robinavitch. 631 00:27:12,780 --> 00:27:14,239 - Hi. - Hi. 632 00:27:14,240 --> 00:27:16,742 Uh, my wife is not thinking clearly. 633 00:27:16,743 --> 00:27:19,244 What is it that she's asking for? 634 00:27:19,245 --> 00:27:21,496 Said she wants to stay here. 635 00:27:21,497 --> 00:27:23,291 Why don't we all go in and talk? 636 00:27:24,751 --> 00:27:26,752 Brian Jenkins is allowed to hunt with a.22 637 00:27:26,753 --> 00:27:28,337 on his grandpa's farm. 638 00:27:28,338 --> 00:27:30,339 Sounds like an accident just waiting to happen. 639 00:27:30,340 --> 00:27:32,925 Mm-hmm. And you're not Brian Jenkins. 640 00:27:32,926 --> 00:27:35,510 How are we doing in here, Roxie? 641 00:27:35,511 --> 00:27:37,262 Been better. 642 00:27:37,263 --> 00:27:38,805 Rumor has it you're still interested 643 00:27:38,806 --> 00:27:41,266 in booking a room with us? 644 00:27:41,267 --> 00:27:43,435 I don't wanna go back home yet. 645 00:27:43,436 --> 00:27:44,895 It's all set up, Rox. 646 00:27:44,896 --> 00:27:47,064 You're gonna be more comfortable at home. 647 00:27:47,065 --> 00:27:49,274 Paul, I changed my mind. 648 00:27:49,275 --> 00:27:50,526 It is our home. 649 00:27:52,570 --> 00:27:54,571 I don't... 650 00:27:54,572 --> 00:27:56,406 I don't want you living with my ghost. 651 00:27:56,407 --> 00:27:58,408 I will happily live with your ghost. 652 00:27:58,409 --> 00:28:01,787 Can we just all stop talking about ghosts, please? 653 00:28:01,788 --> 00:28:03,121 Yes. I'm sorry. 654 00:28:03,122 --> 00:28:05,916 I'm sorry, sweetie. You're right. 655 00:28:05,917 --> 00:28:07,834 Got trauma flying in. ETA, five minutes. 656 00:28:07,835 --> 00:28:10,003 Okay. Um, I'm very sorry. 657 00:28:10,004 --> 00:28:11,463 I will be right back. 658 00:28:11,464 --> 00:28:14,007 Excuse me. 659 00:28:14,008 --> 00:28:16,373 It's a boating accident, swimmer versus propeller. 660 00:28:16,374 --> 00:28:17,380 Ouch. 661 00:28:17,381 --> 00:28:19,304 - What body parts involved? - They didn't say. 662 00:28:19,305 --> 00:28:20,806 - How old? - Nope. 663 00:28:20,807 --> 00:28:22,140 Anything? 664 00:28:22,141 --> 00:28:23,642 All I got was boating accident, 665 00:28:23,643 --> 00:28:25,560 - swimmer versus propeller. - Propeller. Got it. 666 00:28:56,467 --> 00:28:59,678 Picked a hell of a day to come back, huh? 667 00:28:59,679 --> 00:29:02,681 How's Jake? 668 00:29:02,682 --> 00:29:04,474 He's good. 669 00:29:04,475 --> 00:29:06,685 He's better. He's coping. 670 00:29:06,686 --> 00:29:08,687 He's gonna be a senior this fall. 671 00:29:08,688 --> 00:29:11,231 That's great. 672 00:29:11,232 --> 00:29:14,401 That was a lot for him to go through. 673 00:29:14,402 --> 00:29:16,361 A lot for all of us to go through. 674 00:29:16,362 --> 00:29:17,697 Yeah. 675 00:29:19,449 --> 00:29:21,450 Okay, I'm just gonna say it! 676 00:29:21,451 --> 00:29:22,951 I'm sorry. 677 00:29:22,952 --> 00:29:24,619 I betrayed your trust. 678 00:29:24,620 --> 00:29:26,580 I betrayed our patients' trust. 679 00:29:26,581 --> 00:29:27,956 And I'm really fucking sorry. 680 00:29:27,957 --> 00:29:30,168 It'll never happen again, I swear. 681 00:29:34,589 --> 00:29:38,092 I'm really glad that you got the help that you need. 682 00:29:40,845 --> 00:29:44,515 But I don't know if I want you working in my ER. 683 00:29:52,607 --> 00:29:53,790 Why'd you intubate him? 684 00:29:53,791 --> 00:29:55,116 He was splinting from the pain, 685 00:29:55,117 --> 00:29:56,785 barely moving air with sats in the 80s. 686 00:29:56,786 --> 00:29:58,236 How'd he get sliced up in the propeller? 687 00:29:58,237 --> 00:29:59,527 He was in the Allegheny 688 00:29:59,528 --> 00:30:01,114 trying to untangle a water ski tow line 689 00:30:01,115 --> 00:30:02,115 when his buddy started the engine. 690 00:30:02,116 --> 00:30:03,408 Drunk buddy, I assume? 691 00:30:03,409 --> 00:30:04,868 Well, it's 4th of July. You tell me. 692 00:30:04,869 --> 00:30:06,203 Focus on the patient, please. 693 00:30:06,204 --> 00:30:08,081 Sofie, take over bagging. 694 00:30:10,249 --> 00:30:12,417 Okay. One, two, three. 695 00:30:12,418 --> 00:30:13,419 Watch that buckle. 696 00:30:14,921 --> 00:30:16,296 - Do you need me in here? - Nope. 697 00:30:16,297 --> 00:30:18,924 We have a senior resident and an attending. 698 00:30:18,925 --> 00:30:20,258 Mel, can we start with a... 699 00:30:20,259 --> 00:30:22,761 - An EFAST? Sure. - Yes, please. 700 00:30:22,762 --> 00:30:23,771 Why? 701 00:30:23,772 --> 00:30:25,806 To check and make sure there's no pneumothorax. 702 00:30:25,807 --> 00:30:27,432 Otherwise, it could become a tension. 703 00:30:27,433 --> 00:30:29,877 Exactly. Oh, wow. 704 00:30:29,878 --> 00:30:32,312 - You want O-neg? - Not without a BP first. 705 00:30:32,313 --> 00:30:35,524 108/64, pulse is 102. 706 00:30:35,525 --> 00:30:37,776 - Sats are good. - Okay, let's have O-neg ready, 707 00:30:37,777 --> 00:30:40,779 - but don't give it just yet. - Anything else? 708 00:30:42,990 --> 00:30:44,574 How about a hemocue? 709 00:30:44,575 --> 00:30:46,619 Uh, yeah. Yeah, yeah, of course. 710 00:30:54,752 --> 00:30:56,379 Next step is fingernails. 711 00:30:58,297 --> 00:31:00,674 We'll go under each nail, 712 00:31:00,675 --> 00:31:05,011 first with the wet swab and then with the dry one. 713 00:31:05,012 --> 00:31:07,472 Do you wanna take a break, hon? 714 00:31:07,473 --> 00:31:09,225 No. 715 00:31:12,311 --> 00:31:15,480 How much longer? 716 00:31:15,481 --> 00:31:17,149 After these, we'll get to external... 717 00:31:18,484 --> 00:31:20,194 And internal vaginal collection. 718 00:31:23,823 --> 00:31:27,576 It's the advocate from PAAR. 719 00:31:27,577 --> 00:31:29,327 They've been doing this longer than I have. 720 00:31:29,328 --> 00:31:31,580 They provide resources, assistance, and support 721 00:31:31,581 --> 00:31:33,291 for sexual assault survivors. 722 00:31:35,501 --> 00:31:38,378 Hey. 723 00:31:38,379 --> 00:31:40,839 This will not define you, okay? 724 00:31:40,840 --> 00:31:44,509 You don't have to talk to them, but I recommend you do. 725 00:31:44,510 --> 00:31:46,387 They're available 24/7. 726 00:31:48,264 --> 00:31:50,475 - Okay. - Okay. 727 00:31:56,564 --> 00:31:57,870 Hi. 728 00:31:57,871 --> 00:32:00,692 I'm Paulette Sanderson from Pittsburgh Action Against Rape. 729 00:32:00,693 --> 00:32:02,819 Hi, Paulette. I'm the SANE, Dana. 730 00:32:02,820 --> 00:32:04,905 - And this is Ilana. - Hello. 731 00:32:04,906 --> 00:32:07,212 I'm sorry to meet you under these circumstances, 732 00:32:07,213 --> 00:32:09,493 but I and my organization are here to help you navigate 733 00:32:09,494 --> 00:32:11,536 everything that comes next. 734 00:32:11,537 --> 00:32:14,581 I brought you some clothes and basic necessities. 735 00:32:14,582 --> 00:32:16,208 I can even stay with you through the rest 736 00:32:16,209 --> 00:32:18,294 of your examination if you'd like. 737 00:32:20,588 --> 00:32:22,172 I don't think that's necessary. 738 00:32:22,173 --> 00:32:24,758 - Okay. - That's fine. 739 00:32:24,759 --> 00:32:27,303 Would it be okay if I asked you a few questions? 740 00:32:37,772 --> 00:32:39,147 Sure. 741 00:32:41,400 --> 00:32:44,903 Mm, our VRI isn't working. 742 00:32:44,904 --> 00:32:47,739 Video Relay Interpreter? 743 00:32:47,740 --> 00:32:49,282 Yeah, of course I rebooted it. 744 00:32:49,283 --> 00:32:50,909 Wait, how are you gonna fix it if you don't know 745 00:32:50,910 --> 00:32:52,994 what the hell it is? 746 00:32:52,995 --> 00:32:55,247 Yeah, okay. Whatever. 747 00:32:55,248 --> 00:32:57,249 I wanna do a head and belly scan on Harlow. 748 00:32:57,250 --> 00:32:58,458 Can you try telling her why? 749 00:32:58,459 --> 00:32:59,709 What about the VRI? 750 00:32:59,710 --> 00:33:01,711 It's DOA. 751 00:33:01,712 --> 00:33:04,631 I'm charting every free minute I get. 752 00:33:04,632 --> 00:33:06,466 I wasn't coming over for that. 753 00:33:06,467 --> 00:33:08,135 Good job in the Trauma earlier. 754 00:33:11,389 --> 00:33:12,472 What's this? 755 00:33:12,473 --> 00:33:13,807 Daniel Scott, 32, 756 00:33:13,808 --> 00:33:15,559 weak and dizzy while washing his car. 757 00:33:15,560 --> 00:33:18,061 Tachy at 106, BP 90/60. 758 00:33:18,062 --> 00:33:19,604 Temp's too high to register. 759 00:33:19,605 --> 00:33:21,231 We have a cooling room set up in North 5. 760 00:33:21,232 --> 00:33:22,568 Okay, how are you feeling, Mr. Scott? 761 00:33:22,569 --> 00:33:23,608 Thirsty. 762 00:33:23,609 --> 00:33:25,068 Let's see if we can't fix that. 763 00:33:25,069 --> 00:33:26,945 He's gonna need a core temp, a CMP... whoa. 764 00:33:26,946 --> 00:33:28,446 Oh, hey, we need a trauma room. 765 00:33:28,447 --> 00:33:29,656 - What's open? - 2. 766 00:33:29,657 --> 00:33:31,007 I'll grab the Ativan. 767 00:33:31,008 --> 00:33:32,807 - Any past medical history? - No. 768 00:33:32,808 --> 00:33:34,703 Wife says he's healthy. No meds, no allergies. 769 00:33:34,704 --> 00:33:37,331 He needs a core temp. 770 00:33:41,460 --> 00:33:43,044 Ready to transfer. 771 00:33:43,045 --> 00:33:44,337 Let's give 2 of Ativan. 772 00:33:44,338 --> 00:33:45,839 Don't want him seizing again. 773 00:33:45,840 --> 00:33:47,048 I gotta get back to my patients. 774 00:33:47,049 --> 00:33:48,049 Okay. 775 00:33:48,050 --> 00:33:50,802 One, two, three. 776 00:33:50,803 --> 00:33:51,970 Orders? 777 00:33:51,971 --> 00:33:54,139 Second IV with saline open. 778 00:33:54,140 --> 00:33:57,475 Sepsis panel, UA, urine drug screen, EKG, and CK. 779 00:33:57,476 --> 00:33:59,477 I don't see any apparent trauma. 780 00:34:00,980 --> 00:34:03,690 - Pupils reactive. - Mr. Scott? Daniel? 781 00:34:03,691 --> 00:34:05,358 Can you talk to me? 782 00:34:05,359 --> 00:34:07,027 Post-ictal, but moving all extremities. 783 00:34:07,028 --> 00:34:09,029 Pulse 137, BP 88/60. 784 00:34:09,030 --> 00:34:10,697 What are you thinking, Dr. Santos? 785 00:34:10,698 --> 00:34:13,534 Uh, heat stroke, but consider sepsis or drugs. 786 00:34:17,121 --> 00:34:20,624 Rectal temp is 104.6. 787 00:34:20,625 --> 00:34:22,626 All right, let's start with four ice packs 788 00:34:22,627 --> 00:34:24,461 on the groin and axilla. 789 00:34:24,462 --> 00:34:26,133 Should we do a full body ice bath? 790 00:34:26,134 --> 00:34:27,568 That'll take too long. Do you have an Arctic Sun? 791 00:34:27,569 --> 00:34:28,569 Yeah, we do. 792 00:34:28,570 --> 00:34:30,442 Get pads on the chest, abdomen, and both legs. 793 00:34:30,444 --> 00:34:31,945 I'll check back in. 794 00:34:34,055 --> 00:34:37,515 Ceftazidime is up, and first hemoglobin, 8.2. 795 00:34:37,516 --> 00:34:40,268 8 is pretty low. He must have bled down from 14. 796 00:34:40,269 --> 00:34:42,020 Anything you wanna do about that? 797 00:34:42,021 --> 00:34:44,773 Um, young, healthy guy. We transfuse at 7. 798 00:34:44,774 --> 00:34:46,441 Do we? 799 00:34:46,442 --> 00:34:48,193 We'd be in real trouble if he equilibrates 800 00:34:48,194 --> 00:34:50,362 - from acute blood loss. - Am I interrupting something? 801 00:34:50,363 --> 00:34:52,615 - Multiple deep lacerations... - Motorboat versus... 802 00:34:55,368 --> 00:34:56,951 Jesus. 803 00:34:56,952 --> 00:34:58,620 This looks like some "Jurassic Park" shit. 804 00:34:58,621 --> 00:35:00,705 Is that your official surgical diagnosis? 805 00:35:00,706 --> 00:35:02,207 He is hemodynamically stable. 806 00:35:02,208 --> 00:35:04,709 What else do we know? 807 00:35:04,710 --> 00:35:08,380 Uh, intubated in the field due to poor tidal volume. 808 00:35:08,381 --> 00:35:10,590 EFAST was negative for pneumothorax, 809 00:35:10,591 --> 00:35:13,093 so no need to do a chest tube. 810 00:35:13,094 --> 00:35:15,845 And no free fluid in the abdomen, 811 00:35:15,846 --> 00:35:17,555 good hemostasis inside the wounds. 812 00:35:17,556 --> 00:35:19,057 Nothing arterial. 813 00:35:19,058 --> 00:35:20,684 At first, he had a hemoglobin of 8.2. 814 00:35:20,685 --> 00:35:22,352 We'll follow that closely. 815 00:35:22,353 --> 00:35:24,814 With no active bleeding, I wouldn't transfuse just yet. 816 00:35:27,233 --> 00:35:29,067 Dr. Langdon agrees with you. 817 00:35:29,068 --> 00:35:31,403 Let's get him to CT. 818 00:35:31,404 --> 00:35:33,822 Jason Stills, 62, was gathering the makings 819 00:35:33,823 --> 00:35:36,408 of a salad when he started feeling dizzy and nauseated. 820 00:35:36,409 --> 00:35:37,742 Vomited once. 821 00:35:37,743 --> 00:35:38,910 How are you feeling, Mr. Stills? 822 00:35:38,911 --> 00:35:40,555 Like I'm gonna die. 823 00:35:40,556 --> 00:35:42,747 Well, you came to the right place to prevent that. 824 00:35:42,748 --> 00:35:44,749 Do you mind if I touch your abdomen? 825 00:35:44,750 --> 00:35:46,918 - Yeah, sure. - Okay. 826 00:35:46,919 --> 00:35:49,337 - Does this hurt at all? - No. 827 00:35:49,338 --> 00:35:52,590 He's tachycardic at 124 with a temp of 102.4. 828 00:35:52,591 --> 00:35:54,592 Hey, Joy, what's your suggestion? 829 00:35:54,593 --> 00:35:56,261 Keep hydrating, check electrolytes, 830 00:35:56,262 --> 00:35:57,481 and move him to the cooling room. 831 00:35:57,482 --> 00:35:58,495 Precisely. 832 00:35:58,496 --> 00:35:59,806 Good luck finding a parking spot. 833 00:35:59,807 --> 00:36:02,767 - North 5. - What? No valet? 834 00:36:06,772 --> 00:36:08,648 Jada. Hey. 835 00:36:08,649 --> 00:36:10,775 I... I've been looking all over for you. 836 00:36:10,776 --> 00:36:12,444 I just went for a walk. 837 00:36:12,445 --> 00:36:15,281 I wanted to talk to you, if that's okay. 838 00:36:17,283 --> 00:36:19,284 So does Dr. Jefferson. 839 00:36:19,285 --> 00:36:21,453 It's important that you get to hear what he has to say. 840 00:36:21,454 --> 00:36:22,912 Why? 841 00:36:22,913 --> 00:36:24,914 He doesn't want me to go crazy like my brother? 842 00:36:24,915 --> 00:36:27,667 Or kill myself like my uncle? 843 00:36:27,668 --> 00:36:29,961 Of course not. 844 00:36:29,962 --> 00:36:32,756 We... we still have no idea what caused Jackson's episode. 845 00:36:32,757 --> 00:36:35,341 Episode. 846 00:36:35,342 --> 00:36:37,635 Right. 847 00:36:37,636 --> 00:36:41,931 Look, I... I know this must be so scary for you. 848 00:36:41,932 --> 00:36:45,477 And you probably feel betrayed by your parents. 849 00:36:45,478 --> 00:36:48,396 But they had no way of knowing about Jackson. 850 00:36:48,397 --> 00:36:50,648 You know, and some families just have a difficult time 851 00:36:50,649 --> 00:36:54,152 talking about mental health. 852 00:36:54,153 --> 00:36:56,196 Now you can help us take the first steps 853 00:36:56,197 --> 00:36:59,325 to finding out what we can do to help your brother. 854 00:37:04,663 --> 00:37:09,876 Mr. Diaz, I have a surprise for you. 855 00:37:09,877 --> 00:37:11,711 Oh. 856 00:37:11,712 --> 00:37:13,004 Sorry. 857 00:37:13,005 --> 00:37:14,506 It's okay. 858 00:37:14,507 --> 00:37:16,341 Have you... have you seen my patient? 859 00:37:16,342 --> 00:37:19,010 Orlando? Mr. Diaz? 860 00:37:19,011 --> 00:37:21,387 Room was empty. 861 00:37:21,388 --> 00:37:24,349 - Seriously? - Yeah. 862 00:37:28,854 --> 00:37:30,522 What happened to you? 863 00:37:30,523 --> 00:37:32,482 Oh. 864 00:37:32,483 --> 00:37:33,858 Bullet grazed my vest. 865 00:37:33,859 --> 00:37:35,026 You were shot? 866 00:37:35,027 --> 00:37:36,903 Shot at. 867 00:37:36,904 --> 00:37:40,073 Geniuses thought today was the day to rob a goods warehouse. 868 00:37:40,074 --> 00:37:41,241 Didn't think about how long it would take 869 00:37:41,242 --> 00:37:42,575 to load the appliances. 870 00:37:42,576 --> 00:37:43,910 They panicked. 871 00:37:43,911 --> 00:37:45,119 All hell broke loose. 872 00:37:45,120 --> 00:37:46,789 Jesus. 873 00:37:49,250 --> 00:37:51,251 Why do you do this? 874 00:37:51,252 --> 00:37:53,294 My therapist said I needed a hobby. 875 00:37:53,295 --> 00:37:54,963 Funny. 876 00:37:54,964 --> 00:37:57,048 Shit. 877 00:37:57,049 --> 00:37:59,259 This... this sucks. 878 00:37:59,260 --> 00:38:01,052 - Oh, it's nothing. - No. 879 00:38:01,053 --> 00:38:03,263 No, don't worry about me. I'm fine. Seriously. 880 00:38:03,264 --> 00:38:04,556 No, my patient. 881 00:38:04,557 --> 00:38:06,349 He didn't have any insurance, 882 00:38:06,350 --> 00:38:10,603 and he was already in a mountain of medical debt. 883 00:38:10,604 --> 00:38:12,438 He couldn't afford any of his meds. 884 00:38:12,439 --> 00:38:14,858 Hmm. 885 00:38:14,859 --> 00:38:16,401 What's in the bag? 886 00:38:16,402 --> 00:38:21,364 Insulin, test strips, electrolyte powder. 887 00:38:21,365 --> 00:38:24,075 I... I got him everything he needed for home care. 888 00:38:24,076 --> 00:38:26,286 So Uber it to his house. 889 00:38:26,287 --> 00:38:28,621 Is the hospital gonna pay for that? 890 00:38:28,622 --> 00:38:30,666 I'll pay for it. 891 00:38:40,843 --> 00:38:42,927 What are you doing? 892 00:38:42,928 --> 00:38:45,597 What you clearly can't. 893 00:38:45,598 --> 00:38:47,265 Did you make a chart? 894 00:38:47,266 --> 00:38:48,683 No. 895 00:38:48,684 --> 00:38:50,268 This can stay off the books. 896 00:38:50,269 --> 00:38:52,186 Don't need the paperwork from the hospital 897 00:38:52,187 --> 00:38:53,980 or the police department. 898 00:38:53,981 --> 00:38:56,107 Okay. 899 00:38:56,108 --> 00:38:57,651 Our little secret. 900 00:39:01,280 --> 00:39:03,615 How's he doing? Any more seizures? 901 00:39:03,616 --> 00:39:04,782 Nope. 902 00:39:04,783 --> 00:39:06,117 Temp 102.9. 903 00:39:06,118 --> 00:39:07,452 Labs back? 904 00:39:07,453 --> 00:39:09,162 Mostly signs of dehydration. 905 00:39:09,163 --> 00:39:12,916 A tad hypernatremic, mild BUN and creatinine bump. 906 00:39:12,917 --> 00:39:15,335 CK 400 something... nothing worrisome yet. 907 00:39:15,336 --> 00:39:16,961 Okay, good. Keep cooling. 908 00:39:16,962 --> 00:39:19,005 - I'll monitor him. - Great. 909 00:39:19,006 --> 00:39:21,842 That'll give Dr. Santos a chance to get caught up. 910 00:39:25,429 --> 00:39:28,014 Your R2 year can be challenging. 911 00:39:28,015 --> 00:39:30,975 You just have to keep grinding. 912 00:39:30,976 --> 00:39:32,977 What's your dispo plan for Mr. Scott? 913 00:39:32,978 --> 00:39:34,979 Uh, ICU admission. 914 00:39:34,980 --> 00:39:36,981 You should call Neurology to consult. 915 00:39:36,982 --> 00:39:38,775 Yeah, done. 916 00:39:38,776 --> 00:39:40,985 Since it was exertional heat illness in a young person, 917 00:39:40,986 --> 00:39:42,862 the mortality is low. 918 00:39:42,863 --> 00:39:45,740 But non-exertional heatstroke in an elderly person, 919 00:39:45,741 --> 00:39:47,825 - you need to worry. - Okay. 920 00:39:47,826 --> 00:39:50,828 I'll put in orders for repeat labs. 921 00:39:50,829 --> 00:39:52,665 Good work in there. 922 00:40:05,886 --> 00:40:09,722 This 49-year-old woman presents to the emergency department... 923 00:40:13,018 --> 00:40:17,689 Uh, with the chief complaint of right ear pain. 924 00:40:17,690 --> 00:40:20,358 Hey, Donnie, can you do something about that? 925 00:40:20,359 --> 00:40:21,818 What? 926 00:40:21,819 --> 00:40:23,361 Seriously? 927 00:40:23,362 --> 00:40:25,196 That... that's not driving you nuts? 928 00:40:25,197 --> 00:40:27,323 The baby, it won't stop crying. 929 00:40:27,324 --> 00:40:29,325 Oh, that? It's music to my ears now. 930 00:40:29,326 --> 00:40:30,702 I think Jesse's the nurse. 931 00:40:30,703 --> 00:40:33,371 Well, can't you... ugh. 932 00:40:39,378 --> 00:40:40,546 Fuck. 933 00:40:45,718 --> 00:40:48,094 What the hell is going on? 934 00:40:48,095 --> 00:40:50,555 With what? 935 00:40:50,556 --> 00:40:53,599 With her. Can't you make her stop crying? 936 00:40:53,600 --> 00:40:56,561 She's been fed and changed. She's cranky from rhinovirus. 937 00:40:58,230 --> 00:41:00,565 Isn't there something that you can do? 938 00:41:00,566 --> 00:41:03,151 She's due for her next Tylenol. 939 00:41:03,152 --> 00:41:04,569 Give me a minute. I'll be right back. 940 00:41:04,570 --> 00:41:06,738 Wait, no, no, no, I'm not gonna stay here. 941 00:41:09,450 --> 00:41:11,326 What is your problem? 942 00:41:14,288 --> 00:41:18,541 This is precisely why I didn't go into Pedes. 943 00:41:18,542 --> 00:41:19,709 Okay. 944 00:41:19,710 --> 00:41:21,627 Hey, hey. 945 00:41:21,628 --> 00:41:24,590 Hey, little Miss Sunshine. 946 00:41:26,258 --> 00:41:28,593 Is it time for you to take a little nap? 947 00:41:28,594 --> 00:41:30,720 That would be so fucking nice. 948 00:41:30,721 --> 00:41:32,096 Yes, it would. 949 00:41:35,392 --> 00:41:38,436 I'm starting to understand why you got left here. 950 00:41:38,437 --> 00:41:40,522 Hey, shh. 951 00:42:26,944 --> 00:42:28,653 What's the word from CT? 952 00:42:28,654 --> 00:42:31,656 Nothing intrathoracic, nothing intra-abdominal. 953 00:42:31,657 --> 00:42:32,990 Propeller just missed gutting him. 954 00:42:32,991 --> 00:42:34,450 - Very fortunate. - Okay. 955 00:42:34,451 --> 00:42:36,369 Repeat hemoglobin is 8. 956 00:42:36,370 --> 00:42:38,996 We're holding off on transfusing. 957 00:42:38,997 --> 00:42:40,832 Plan? 958 00:42:40,833 --> 00:42:42,875 I'll have Mel and Langdon suture up the lacerations. 959 00:42:42,876 --> 00:42:45,002 Wait, what? That could take days. 960 00:42:45,003 --> 00:42:46,462 I... I can't... 961 00:42:46,463 --> 00:42:48,422 Calm down, Sadness. I'm kidding. 962 00:42:48,423 --> 00:42:50,883 This is one for my skilled surgical residents upstairs, 963 00:42:50,884 --> 00:42:52,385 not you Boy Scout butchers. 964 00:42:52,386 --> 00:42:53,761 Boy, I missed you, Yoyo. 965 00:42:53,762 --> 00:42:56,097 Mm. Can't say the same. 966 00:42:56,098 --> 00:42:59,517 Okay, let's take up this art project. 967 00:42:59,518 --> 00:43:00,852 So about before... 968 00:43:00,853 --> 00:43:02,895 Back to it. 969 00:43:02,896 --> 00:43:04,355 Good talk. 970 00:43:04,356 --> 00:43:05,898 How we doing, Princess? 971 00:43:05,899 --> 00:43:07,567 All right. A little bloated. 972 00:43:07,568 --> 00:43:10,903 I had one too many hot dogs from the truck. 973 00:43:10,904 --> 00:43:13,072 You meant the board, huh? 974 00:43:13,073 --> 00:43:16,200 Gus, our incarcerated patient, got a spot upstairs. 975 00:43:16,201 --> 00:43:19,829 Looking for our unhoused patient, Digby, and, of course, 976 00:43:19,830 --> 00:43:22,748 we have Whitaker, Donahue, and the med students 977 00:43:22,749 --> 00:43:25,418 on these diversion intakes, but they just keep coming. 978 00:43:25,419 --> 00:43:27,336 Yeah, we may need to start just sending people up 979 00:43:27,337 --> 00:43:29,547 and ask for forgiveness instead of permission. 980 00:43:29,548 --> 00:43:32,008 Hello? 981 00:43:32,009 --> 00:43:34,385 Oh, okay. 982 00:43:34,386 --> 00:43:36,721 Yes, I will be right there. 983 00:43:36,722 --> 00:43:38,264 C-suite wants to see me upstairs. 984 00:43:38,265 --> 00:43:39,682 Ooh, called to the principal's office 985 00:43:39,683 --> 00:43:42,935 on your first day... not a good sign. 986 00:43:42,936 --> 00:43:45,563 - I think I'm a baby whisperer. - Hey, great. 987 00:43:45,564 --> 00:43:47,607 We'll add Baby Jane Doe to your patient load. 988 00:43:47,608 --> 00:43:49,192 Forget I said anything. 989 00:43:49,193 --> 00:43:51,110 Where are we with your deaf patient, Harlow? 990 00:43:51,111 --> 00:43:54,739 Uh, the VRI was a bust, but the interpreter's on the way. 991 00:43:54,740 --> 00:43:56,741 Figured I'd just give her a head and belly scan 992 00:43:56,742 --> 00:43:58,910 - and go from there. - No, wait for the interpreter. 993 00:43:58,911 --> 00:44:01,245 No need to give the patient unnecessary radiation. 994 00:44:01,246 --> 00:44:03,748 And your charting? 995 00:44:03,749 --> 00:44:05,265 Catching up and checking it twice. 996 00:44:05,266 --> 00:44:06,278 Good. 997 00:44:06,279 --> 00:44:08,878 Hey, have you had a chance to speak to Langdon today? 998 00:44:08,879 --> 00:44:10,755 Uh, no. 999 00:44:10,756 --> 00:44:12,006 Why? Did he say something? 1000 00:44:12,007 --> 00:44:13,758 No, just curious. 1001 00:44:13,759 --> 00:44:17,136 How is everything at home with you and Whitaker? 1002 00:44:17,137 --> 00:44:19,430 He's weirder than you'd expect. 1003 00:44:19,431 --> 00:44:21,307 - Hmm. - Yeah. 1004 00:44:21,308 --> 00:44:23,392 But I don't see him all that much. 1005 00:44:23,393 --> 00:44:24,936 He spends a lot of time at Amy's. 1006 00:44:24,937 --> 00:44:27,396 He has a girlfriend? 1007 00:44:27,397 --> 00:44:31,234 I don't know what to call it. 1008 00:44:31,235 --> 00:44:33,778 The... the farmer who got burned last year 1009 00:44:33,779 --> 00:44:36,239 the day of the mass cas, his widow, Amy. 1010 00:44:36,240 --> 00:44:37,615 Oh, he died? 1011 00:44:37,616 --> 00:44:39,659 Yeah, he had burns on 90% of his body. 1012 00:44:39,660 --> 00:44:41,452 His chance of survival was very slim. 1013 00:44:41,453 --> 00:44:43,120 Okay, so I'm an optimist. 1014 00:44:43,121 --> 00:44:45,623 The sun doesn't always come out tomorrow, Annie. 1015 00:44:45,624 --> 00:44:47,500 Wait, wasn't she pregnant? 1016 00:44:47,501 --> 00:44:50,169 No, she was a young orphan. 1017 00:44:50,170 --> 00:44:52,546 No, not Annie. Amy. 1018 00:44:52,547 --> 00:44:56,300 Yes. Yes, very pregnant and young. 1019 00:44:56,301 --> 00:44:58,135 Whitaker is now seeing this Amy? 1020 00:44:58,136 --> 00:45:00,106 And her baby. 1021 00:45:00,107 --> 00:45:02,056 He got really close to the family 1022 00:45:02,057 --> 00:45:04,058 when the husband was dying. 1023 00:45:04,059 --> 00:45:06,185 He really believed that the guy would pull through. 1024 00:45:06,186 --> 00:45:08,646 He helped her through the loss of her husband, 1025 00:45:08,647 --> 00:45:10,314 and then again when she had the kid, 1026 00:45:10,315 --> 00:45:13,484 and now he spends almost every weekend at the farm. 1027 00:45:13,485 --> 00:45:14,819 Huh. 1028 00:45:14,820 --> 00:45:16,320 Plus, he's on the street team, 1029 00:45:16,321 --> 00:45:18,239 and he just wants to help everybody. 1030 00:45:18,240 --> 00:45:21,200 And I just don't wanna see him taken advantage of, you know? 1031 00:45:21,201 --> 00:45:23,452 He's just a fucking Huckleberry. 1032 00:45:23,453 --> 00:45:26,038 Yeah, but he's our fucking Huckleberry. 1033 00:45:26,039 --> 00:45:27,540 I'll talk to him. 1034 00:45:27,541 --> 00:45:28,874 Hey, your call. 1035 00:45:28,875 --> 00:45:30,668 Strong deflection. Well played. 1036 00:45:30,669 --> 00:45:32,128 You're the boss. 1037 00:45:32,129 --> 00:45:33,713 Or you are until end of shift today. 1038 00:45:33,714 --> 00:45:35,047 Still the boss. 1039 00:45:35,048 --> 00:45:37,300 When you see me in here, still the boss. 1040 00:45:37,301 --> 00:45:39,844 Copy that, Boss. 1041 00:45:39,845 --> 00:45:43,180 Dr. Robby, can... can I grab you for a second? 1042 00:45:43,181 --> 00:45:46,183 Yeah. Sure. What's up? 1043 00:45:46,184 --> 00:45:51,063 Um, can't you order my wife to go home? 1044 00:45:51,064 --> 00:45:52,815 I'm sorry. 1045 00:45:54,943 --> 00:45:56,861 My wife's dying, 1046 00:45:56,862 --> 00:45:59,613 and you're telling me there's nothing I can do? 1047 00:45:59,614 --> 00:46:01,115 Mr. Hamler, that's not... 1048 00:46:01,116 --> 00:46:02,700 No, no. 1049 00:46:02,701 --> 00:46:05,411 There's gotta be something. 1050 00:46:05,412 --> 00:46:07,371 Please. 1051 00:46:07,372 --> 00:46:09,540 It may not seem like much, but right now, 1052 00:46:09,541 --> 00:46:12,084 you being here for her and respecting her wishes 1053 00:46:12,085 --> 00:46:14,962 is the best thing that you can do for her. 1054 00:46:14,963 --> 00:46:18,883 Supporting her and her choices is the most remarkable gift 1055 00:46:18,884 --> 00:46:22,178 that you can give her at this time. 1056 00:46:22,179 --> 00:46:24,889 And the meds we have her on will help her pain. 1057 00:46:24,890 --> 00:46:26,891 And she may get to a point where 1058 00:46:26,892 --> 00:46:29,394 she feels well enough to go home. 1059 00:46:45,577 --> 00:46:47,621 Give me one second. 1060 00:46:52,959 --> 00:46:54,960 Okay, I'm gonna let you guys get acquainted. 1061 00:46:54,961 --> 00:46:56,379 I will be right back. 1062 00:46:56,380 --> 00:46:57,922 Oh, oh, oh, excuse me! 1063 00:46:57,923 --> 00:47:00,800 I... I'm waiting for Dr. Mohan. Is she available? 1064 00:47:00,801 --> 00:47:03,220 I will try and find her for you, sir. 1065 00:47:07,432 --> 00:47:10,309 Whether you choose to report or not, we're here for you. 1066 00:47:10,310 --> 00:47:11,811 Call me any time. 1067 00:47:11,812 --> 00:47:15,272 It could be a month or a year from now. 1068 00:47:15,273 --> 00:47:16,607 I'll follow up with you too. 1069 00:47:16,608 --> 00:47:18,317 Thank you. 1070 00:47:18,318 --> 00:47:20,028 Thanks. 1071 00:47:23,615 --> 00:47:25,116 You've had a pap smear before? 1072 00:47:25,117 --> 00:47:27,284 Yeah, every few years. 1073 00:47:27,285 --> 00:47:28,786 Good. 1074 00:47:28,787 --> 00:47:31,288 Same position, but I'll start with swabs 1075 00:47:31,289 --> 00:47:34,166 on the outside, external genitalia. 1076 00:47:34,167 --> 00:47:36,460 Then I'll use a speculum to get internal swabs. 1077 00:47:36,461 --> 00:47:38,587 You ready? Okay. 1078 00:47:38,588 --> 00:47:40,965 I'll help you get your feet in the stirrups. 1079 00:47:40,966 --> 00:47:43,968 Good. 1080 00:47:43,969 --> 00:47:46,429 Okay. All right. 1081 00:47:46,430 --> 00:47:49,432 Now, slide your bottom down. 1082 00:47:49,433 --> 00:47:52,017 Oh. Yeah, a little bit more. 1083 00:47:52,018 --> 00:47:53,811 A little more. 1084 00:47:53,812 --> 00:47:56,439 - Sorry. I... I can't. - Okay. It's okay. 1085 00:47:56,440 --> 00:47:58,023 We can take a break. No problem. 1086 00:47:58,024 --> 00:48:00,526 I don't want a break. I wanna stop. 1087 00:48:00,527 --> 00:48:03,404 Okay. Is this about reporting? 1088 00:48:03,405 --> 00:48:04,989 Because you can do this collection 1089 00:48:04,990 --> 00:48:06,699 without a police report for now. 1090 00:48:06,700 --> 00:48:09,243 And none of it goes in your permanent medical record. 1091 00:48:09,244 --> 00:48:11,162 I don't wanna do this anymore. 1092 00:48:11,163 --> 00:48:13,330 Tell me why you wanna stop. 1093 00:48:16,001 --> 00:48:18,836 He's my friend. 1094 00:48:18,837 --> 00:48:22,715 He knows all my friends. 1095 00:48:22,716 --> 00:48:26,218 It was just a dumb... 1096 00:48:26,219 --> 00:48:28,554 he was drunk, he didn't mean it. 1097 00:48:28,555 --> 00:48:31,140 - It didn't mean anything. - Okay. 1098 00:48:31,141 --> 00:48:33,476 Okay. 1099 00:48:33,477 --> 00:48:36,479 It's okay. I understand. 1100 00:48:36,480 --> 00:48:39,148 I do. 1101 00:48:39,149 --> 00:48:43,986 Ilana, this is a difficult process, to say the least. 1102 00:48:43,987 --> 00:48:45,905 Why don't you take a breather and come back? 1103 00:48:45,906 --> 00:48:48,533 And whatever you wanna do, we'll do. 1104 00:48:56,416 --> 00:48:59,252 Let's go find the good snacks. 1105 00:49:22,234 --> 00:49:23,609 Jesus Christ. 1106 00:49:23,610 --> 00:49:25,402 Sorry. 1107 00:49:25,403 --> 00:49:27,905 Giving new meaning to the nickname Crash, huh? 1108 00:49:27,906 --> 00:49:29,323 I've been trying to get to the bathroom 1109 00:49:29,324 --> 00:49:30,908 for over an hour now. 1110 00:49:30,909 --> 00:49:33,744 Yeah, you and me both, sister. 1111 00:49:43,797 --> 00:49:46,423 Uh-oh, this can't be good. 1112 00:49:46,424 --> 00:49:47,883 Who's this? 1113 00:49:47,884 --> 00:49:49,093 That is hospital CEO Trent Norris. 1114 00:49:49,094 --> 00:49:51,595 He's the big boss. 1115 00:49:51,596 --> 00:49:53,097 Hmm. Nice outfit. 1116 00:49:53,098 --> 00:49:55,057 Hey, Rockstar. Gather your staff, please. 1117 00:49:55,058 --> 00:49:57,226 Sure, anything you wanna tell me first? 1118 00:49:57,227 --> 00:49:59,395 - No. - Okay. 1119 00:49:59,396 --> 00:50:01,730 Hey, everybody, can you, uh, gather 'round 1120 00:50:01,731 --> 00:50:04,191 and listen up for a moment, please? 1121 00:50:04,192 --> 00:50:07,653 Can I have your attention, everyone? 1122 00:50:07,654 --> 00:50:10,322 Internal disaster at Westbridge 1123 00:50:10,323 --> 00:50:12,449 has been identified as a cyberattack. 1124 00:50:15,161 --> 00:50:18,372 And now Good Dominion Hospital has been hit as well. 1125 00:50:18,373 --> 00:50:20,791 Their ambulances are being diverted over to St. Mary's, 1126 00:50:20,792 --> 00:50:24,128 but we can expect more walk-ins and Westbridge diversions. 1127 00:50:24,129 --> 00:50:26,005 Uh, for how long? 1128 00:50:26,006 --> 00:50:29,174 We don't know how long. If the ransom is paid... 1129 00:50:29,175 --> 00:50:30,884 Ransom? 1130 00:50:30,885 --> 00:50:32,720 Are we next? 1131 00:50:32,721 --> 00:50:35,347 Our IT protection system has blocked thousands 1132 00:50:35,348 --> 00:50:36,974 of intrusion attempts in the hours 1133 00:50:36,975 --> 00:50:39,184 since Westbridge was hit this morning. 1134 00:50:39,185 --> 00:50:43,188 But IT believes we're still vulnerable. 1135 00:50:43,189 --> 00:50:45,816 So we're gonna preemptively shut down 1136 00:50:45,817 --> 00:50:47,443 all the computer systems. 1137 00:50:47,444 --> 00:50:50,195 - Oh, my God. - Jesus. 1138 00:50:50,196 --> 00:50:52,948 Patient registration, electronic health records, 1139 00:50:52,949 --> 00:50:56,035 lab and radiology interfaces, email, internet. 1140 00:50:56,036 --> 00:50:57,328 You didn't wanna talk to me first? 1141 00:50:57,329 --> 00:50:58,704 You didn't wanna consult my department? 1142 00:50:58,705 --> 00:51:01,249 I consulted your fellow attending. 1143 00:51:03,168 --> 00:51:06,003 When are we going down? 1144 00:51:06,004 --> 00:51:08,922 Soon. Very soon. 1145 00:51:08,923 --> 00:51:11,300 Okay, hey, somebody get a picture of the board. 1146 00:51:11,301 --> 00:51:14,511 Quickly, quickly! We're about to go analog. 1147 00:51:16,556 --> 00:51:18,182 - No! - Oh, my gosh. 1148 00:51:21,227 --> 00:51:23,604 - Phones work? - They don't work. 1149 00:51:23,605 --> 00:51:25,356 - Oh, my gosh. - Did you get the photo? 1150 00:51:25,357 --> 00:51:28,067 Yeah, yeah, I got it. 1151 00:51:28,068 --> 00:51:29,611 This is gonna be fun. 1152 00:51:29,613 --> 00:51:32,588 Sync and corrections by btsix www.addic7ed.com