1 00:00:08,670 --> 00:00:12,671 Sync and corrections by btsix www.addic7ed.com 2 00:00:12,672 --> 00:00:15,008 Baran, is this you? 3 00:00:20,513 --> 00:00:23,307 It began after a bad case of viral meningitis 4 00:00:23,308 --> 00:00:25,058 when I was five. 5 00:00:25,059 --> 00:00:27,394 They tried every anti-seizure medication, 6 00:00:27,395 --> 00:00:31,356 but I still had episodes every few months or so. 7 00:00:31,357 --> 00:00:32,608 No one's ever noticed before. 8 00:00:32,609 --> 00:00:34,068 They just think I'm thoughtful. 9 00:00:36,112 --> 00:00:37,529 Are you driving? 10 00:00:37,530 --> 00:00:40,657 I couldn't until laser ablation 11 00:00:40,658 --> 00:00:43,994 to my left temporal lobe 12 years ago. 12 00:00:43,995 --> 00:00:46,788 Between that and the Keppra, I've been seizure-free, 13 00:00:46,789 --> 00:00:50,460 cleared by Neurology to drive and to work as an attending. 14 00:00:52,253 --> 00:00:54,546 How long, uh, between the seizure 15 00:00:54,547 --> 00:00:56,423 you had today and the last one? 16 00:00:56,424 --> 00:00:59,677 It's been well over a year. 17 00:01:01,846 --> 00:01:03,348 But I had two today. 18 00:01:07,977 --> 00:01:09,519 I don't know why. 19 00:01:09,520 --> 00:01:12,731 It could be sleep deprivation, new job stress. 20 00:01:12,732 --> 00:01:16,026 I... I haven't had to deal with Peds cases 21 00:01:16,027 --> 00:01:17,527 since Afghanistan. 22 00:01:17,528 --> 00:01:19,279 What are your options now? 23 00:01:19,280 --> 00:01:21,406 Um... 24 00:01:21,407 --> 00:01:24,951 up my Keppra or maybe try 25 00:01:24,952 --> 00:01:26,578 one of the newer anti-seizure meds. 26 00:01:26,579 --> 00:01:29,414 But if that doesn't work, I'm left with two choices... 27 00:01:29,415 --> 00:01:33,877 um, a temporal lobectomy, which could impair my speech, 28 00:01:33,878 --> 00:01:36,338 or get a neuromodulation device, 29 00:01:36,339 --> 00:01:38,048 which can sense and stop the seizures 30 00:01:38,049 --> 00:01:39,883 almost immediately. 31 00:01:39,884 --> 00:01:41,718 You need to disclose this. 32 00:01:41,719 --> 00:01:43,762 I know. I have a plan. 33 00:01:43,763 --> 00:01:44,888 Hey, Robby, Dana's looking for you. 34 00:01:44,889 --> 00:01:46,098 She's in Peds. 35 00:01:46,099 --> 00:01:47,432 Yeah, OK, I'll be right there. 36 00:01:48,810 --> 00:01:50,060 Sounds like you're needed in Peds, 37 00:01:50,061 --> 00:01:52,145 and I have patients to see. 38 00:01:52,146 --> 00:01:54,064 Robby, pregnant woman with severe headache 39 00:01:54,065 --> 00:01:55,774 on her way in by ambulance. 40 00:01:55,775 --> 00:01:58,277 Find Abbot or a night shift resident. 41 00:02:13,292 --> 00:02:15,169 Need you to turn out your pockets. 42 00:02:21,426 --> 00:02:23,302 OK. Show me your hands. 43 00:02:51,289 --> 00:02:52,623 Come here often? 44 00:03:01,382 --> 00:03:02,883 What's going on? 45 00:03:02,884 --> 00:03:04,634 Oh, sorry... false alarm. 46 00:03:04,635 --> 00:03:07,076 We thought she spiked a fever, but it was the wrong chart 47 00:03:07,077 --> 00:03:09,306 from our analog hell. 48 00:03:09,307 --> 00:03:11,850 You know anybody who might consider kinship adoption? 49 00:03:11,851 --> 00:03:13,643 Doctors and nurses qualify. 50 00:03:13,644 --> 00:03:15,270 Don't look at me. 51 00:03:15,271 --> 00:03:17,355 Hey, can your staff keep an eye on Dr. Al-Hashimi 52 00:03:17,356 --> 00:03:18,440 until she leaves? 53 00:03:18,441 --> 00:03:20,859 Why? 54 00:03:20,860 --> 00:03:23,028 Uh, because I think she's tired, 55 00:03:23,029 --> 00:03:24,613 and I don't want her to make any mistakes. 56 00:03:24,614 --> 00:03:27,076 Oh, great advice. Maybe you should take it. 57 00:03:27,077 --> 00:03:28,996 Yeah. I'm gonna go get some fresh air. 58 00:03:28,997 --> 00:03:30,631 Grab some for me while you're out there. 59 00:03:30,632 --> 00:03:32,078 Your lungs wouldn't know what to do with it. 60 00:03:32,079 --> 00:03:33,163 Screw you! 61 00:03:33,164 --> 00:03:34,790 In front of the baby? Nice. 62 00:03:37,668 --> 00:03:39,294 Yeah. 63 00:03:39,295 --> 00:03:41,129 We are the night crawlers. 64 00:03:41,130 --> 00:03:44,132 We deal with the weirdest and the wildest because... 65 00:03:44,133 --> 00:03:46,676 We are the weirdest and the wildest of them all. 66 00:03:46,677 --> 00:03:47,803 That is right, and tonight, 67 00:03:47,804 --> 00:03:49,137 they are really gonna be crawling. 68 00:03:49,138 --> 00:03:50,514 Now go get some! 69 00:03:50,515 --> 00:03:51,515 Hooah! 70 00:03:55,937 --> 00:03:57,521 Sorry to wake you. 71 00:03:57,522 --> 00:03:59,023 I... I was thinking. 72 00:04:02,401 --> 00:04:04,194 Doubt PTX. 73 00:04:04,195 --> 00:04:06,404 You're supposed to be leaving. 74 00:04:06,405 --> 00:04:07,532 I am. 75 00:04:09,826 --> 00:04:11,368 You know, this spirit quest of yours 76 00:04:11,369 --> 00:04:13,245 has a lot of people up in arms around here. 77 00:04:13,246 --> 00:04:14,704 Everyone's gonna be fine without me, 78 00:04:14,705 --> 00:04:16,373 and it's hardly a spirit quest. 79 00:04:16,374 --> 00:04:18,203 Whatever it is, it seems you've given people 80 00:04:18,204 --> 00:04:19,690 the impression you might not be coming back. 81 00:04:19,691 --> 00:04:22,212 Well, who knows what the future has in store for any of us? 82 00:04:22,213 --> 00:04:24,631 Yeah, saying shit like that right there isn't helping. 83 00:04:24,632 --> 00:04:26,049 People are worried about you. 84 00:04:26,050 --> 00:04:27,968 Dr. Abbot, the patient in South 21, 85 00:04:27,969 --> 00:04:29,427 Digby, he's missing again. 86 00:04:29,428 --> 00:04:30,804 Sounds like a day shift problem. 87 00:04:30,805 --> 00:04:33,057 Not if he was handed off already. 88 00:04:37,228 --> 00:04:38,895 Best I can do under the circumstances. 89 00:04:38,896 --> 00:04:40,188 Thank you. 90 00:04:40,189 --> 00:04:41,690 Hey, don't leave before I get back, yeah? 91 00:04:41,691 --> 00:04:43,442 Hell, I feel like I live here now. 92 00:04:46,863 --> 00:04:48,196 Your friend fixing your bike? 93 00:04:48,197 --> 00:04:49,406 Ambulance clipped it 94 00:04:49,407 --> 00:04:51,283 while it was just parked here today. 95 00:04:51,284 --> 00:04:53,493 Jesus Christ. 96 00:04:53,494 --> 00:04:55,078 That's a sign if I've ever seen one. 97 00:04:56,664 --> 00:04:58,498 Yeah, here's the thing... when people worry about you, 98 00:04:58,499 --> 00:05:00,250 it makes me think that I should be worried about you, 99 00:05:00,251 --> 00:05:01,918 and I don't like worrying about things. 100 00:05:01,919 --> 00:05:03,128 Ooh. Now you're a shrink? 101 00:05:03,129 --> 00:05:04,254 No, I'm trying to be your friend. 102 00:05:04,255 --> 00:05:05,422 You got... you got Dana convinced 103 00:05:05,423 --> 00:05:06,749 that you're gonna hurt yourself. 104 00:05:06,750 --> 00:05:08,356 - Dana's got her own issues. - That sounds like projection. 105 00:05:08,357 --> 00:05:10,093 Are you seriously trying to have this fucking 106 00:05:10,094 --> 00:05:11,636 conversation with me right now, man? 107 00:05:11,637 --> 00:05:13,263 I... I'm not the one 108 00:05:13,264 --> 00:05:15,599 who spends his free time getting shot at. 109 00:05:15,600 --> 00:05:17,225 Hooah! 110 00:05:17,226 --> 00:05:19,561 Hey, Dr. Robby, this is Judith Lastrade... 111 00:05:19,562 --> 00:05:21,771 36 weeks pregnant with two days of headache, 112 00:05:21,772 --> 00:05:24,274 now a 10 out of 10 with blurred vision. 113 00:05:24,275 --> 00:05:27,485 BP 174/120, heart rate 92. 114 00:05:27,486 --> 00:05:29,613 - No relief with fentanyl. - Judith, I'm Dr. Abbot. 115 00:05:29,614 --> 00:05:30,989 Any weakness in your arms or legs? 116 00:05:30,990 --> 00:05:32,532 No, no. Is this a stroke? 117 00:05:32,533 --> 00:05:33,950 We need to check for everything. 118 00:05:33,951 --> 00:05:36,661 Pitting edema with severe preeclampsia. 119 00:05:36,662 --> 00:05:38,622 Where are you doing your prenatal care? 120 00:05:38,623 --> 00:05:39,831 Nowhere. 121 00:05:39,832 --> 00:05:41,333 It's a wild pregnancy. 122 00:05:41,334 --> 00:05:43,294 I want a free birth. 123 00:05:45,421 --> 00:05:48,798 This 81-year-old nun presents with red, itchy eyes 124 00:05:48,799 --> 00:05:51,968 with secretions for the past two days. 125 00:05:51,969 --> 00:05:54,471 Patient complains of no URI symptoms, 126 00:05:54,472 --> 00:05:56,056 - no contact with any chemical... - Hey. 127 00:05:56,057 --> 00:05:57,474 Agents, no known exposures... 128 00:05:57,475 --> 00:05:58,975 Want half a Monster? 129 00:05:58,976 --> 00:06:00,644 Oh, no, thanks. 130 00:06:00,645 --> 00:06:02,145 I... I don't really want to stay awake 131 00:06:02,146 --> 00:06:04,314 any longer than I have to. 132 00:06:04,315 --> 00:06:05,775 Yeah, I hear you. 133 00:06:07,318 --> 00:06:09,361 Did you find your ID badge? 134 00:06:09,362 --> 00:06:10,946 Uh, no. 135 00:06:10,947 --> 00:06:13,198 You any closer to deciding what's next for you? 136 00:06:13,199 --> 00:06:15,158 Uh, yeah, I'm seriously considering law school. 137 00:06:15,159 --> 00:06:16,660 What? What are you talking about? 138 00:06:16,661 --> 00:06:18,537 You're gonna be a great doctor. 139 00:06:19,997 --> 00:06:23,291 I mean, no offense, but look what this place does to you. 140 00:06:23,292 --> 00:06:24,960 Langdon's an addict. 141 00:06:24,961 --> 00:06:27,671 Is a person with a substance use disorder. 142 00:06:27,672 --> 00:06:29,589 McKay was on house arrest. 143 00:06:29,590 --> 00:06:31,091 Dana's a time bomb. 144 00:06:31,092 --> 00:06:32,842 Santos is one of the angriest people 145 00:06:32,843 --> 00:06:34,344 you are ever going to meet. 146 00:06:34,345 --> 00:06:35,845 Sarcastic, yes. Cynical, definitely. 147 00:06:35,846 --> 00:06:37,347 I don't know if she's, you know... 148 00:06:37,348 --> 00:06:38,724 Mel? 149 00:06:39,767 --> 00:06:42,811 Samira has no life. 150 00:06:42,812 --> 00:06:46,022 Abbot's an adrenaline junkie who gets shot at for fun. 151 00:06:46,023 --> 00:06:48,858 Robby's got, like, PTSD or something way fucking worse. 152 00:06:48,859 --> 00:06:50,151 OK, well, I... I mean, 153 00:06:50,152 --> 00:06:52,196 I'd hate to know what you think about me. 154 00:06:53,739 --> 00:06:55,407 I don't know, I just... 155 00:06:55,408 --> 00:06:58,034 the more time I spend here, 156 00:06:58,035 --> 00:06:59,285 the more I realize the importance 157 00:06:59,286 --> 00:07:01,956 of my mental health. 158 00:07:03,040 --> 00:07:04,124 Mm. 159 00:07:04,125 --> 00:07:05,417 For patients and for us. 160 00:07:05,418 --> 00:07:08,044 And this is... 161 00:07:08,045 --> 00:07:09,212 Yeah. 162 00:07:09,213 --> 00:07:10,463 Well, you know, 163 00:07:10,464 --> 00:07:13,300 maybe that's what you should focus on. 164 00:07:14,385 --> 00:07:16,678 - What? - Mental health. 165 00:07:16,679 --> 00:07:18,930 Clearly, you have a passion for it, right? 166 00:07:18,931 --> 00:07:20,515 I mean, that's... that's great. 167 00:07:20,516 --> 00:07:21,558 I don't know if I'd call it a passion. 168 00:07:21,559 --> 00:07:23,728 I would call it, like, a... 169 00:07:26,605 --> 00:07:28,232 Oh, my God. 170 00:07:30,109 --> 00:07:32,278 You might be right. 171 00:07:33,821 --> 00:07:35,447 Oh, you're a genius, Whitaker. 172 00:07:35,448 --> 00:07:36,656 Oh, OK. 173 00:07:38,284 --> 00:07:40,285 CTG is on. 174 00:07:40,286 --> 00:07:42,579 - CTG? - Cardiotocography. 175 00:07:42,580 --> 00:07:46,041 Measures the baby's heart rate and checks for contractions. 176 00:07:46,042 --> 00:07:47,584 Fetal heart rate 128. 177 00:07:47,585 --> 00:07:49,127 Normal range, Nazely? 178 00:07:49,128 --> 00:07:51,046 110 to 160. 179 00:07:51,047 --> 00:07:52,922 So the baby's OK? 180 00:07:52,923 --> 00:07:54,090 Right now, yes. 181 00:07:54,091 --> 00:07:55,550 128 is reassuring. 182 00:07:55,551 --> 00:07:57,761 BP's 170/119. 183 00:07:57,762 --> 00:07:59,512 6 grams of magnesium running in. 184 00:07:59,513 --> 00:08:01,097 Your next move, Crus? 185 00:08:01,098 --> 00:08:03,767 20 of labetalol, IV push over two minutes. 186 00:08:03,768 --> 00:08:05,268 Uh, what's happening? 187 00:08:05,269 --> 00:08:07,312 Uh, you have a condition called preeclampsia. 188 00:08:07,313 --> 00:08:08,605 And how did it happen? 189 00:08:08,606 --> 00:08:10,815 Uh, nobody really knows, actually. 190 00:08:10,816 --> 00:08:13,151 It affects about 10% of the pregnancies. 191 00:08:13,152 --> 00:08:14,611 High blood pressure, headaches, 192 00:08:14,612 --> 00:08:17,113 protein in the urine, and swollen ankles. 193 00:08:17,114 --> 00:08:19,407 OK, well, it's a wild pregnancy, 194 00:08:19,408 --> 00:08:21,618 so that means no medical care. 195 00:08:21,619 --> 00:08:23,620 Then why are you here? 196 00:08:25,122 --> 00:08:27,374 I just need to get rid of this headache. 197 00:08:29,502 --> 00:08:32,545 Well, if we don't lower your blood pressure 198 00:08:32,546 --> 00:08:35,465 and treat with magnesium, there can be problems. 199 00:08:35,466 --> 00:08:36,716 Like what? 200 00:08:36,717 --> 00:08:38,343 Seizures, bleeding, 201 00:08:38,344 --> 00:08:40,470 even death, for you and the baby. 202 00:08:40,471 --> 00:08:42,305 Oh, my God. 203 00:08:42,306 --> 00:08:43,973 Robby, your VIP's ready to go. 204 00:08:43,974 --> 00:08:46,059 OK, I'll be right there. 205 00:08:46,060 --> 00:08:47,685 - You good? - Yeah, I'm good. 206 00:08:47,686 --> 00:08:50,396 I got it. With my eyes closed. 207 00:08:50,397 --> 00:08:51,731 But I won't. Maybe one eye. 208 00:08:53,067 --> 00:08:54,150 Hey... 209 00:08:57,530 --> 00:08:58,988 Hey, Becca. How you feeling? 210 00:08:58,989 --> 00:09:01,200 I'm better. Thanks. 211 00:09:02,701 --> 00:09:04,119 Where are you? 212 00:09:04,120 --> 00:09:05,995 I'm at Adam's house. 213 00:09:05,996 --> 00:09:07,789 Can I call you later? We're watching a movie. 214 00:09:07,790 --> 00:09:08,998 Oh, sure. I just... I thought 215 00:09:08,999 --> 00:09:10,542 you were gonna see the fireworks. 216 00:09:10,543 --> 00:09:13,169 Nope, we decided to watch "Elf" instead. 217 00:09:13,170 --> 00:09:14,504 Ah. 218 00:09:14,505 --> 00:09:16,506 - Of course you did. - OK. 219 00:09:16,507 --> 00:09:18,174 - I'll call you tomorrow! - Tomorrow? Wait. 220 00:09:18,175 --> 00:09:20,510 Uh, are... are you spending the night? 221 00:09:20,511 --> 00:09:22,345 Um, uh, yes. 222 00:09:22,346 --> 00:09:24,139 His parents invited me. 223 00:09:24,140 --> 00:09:25,640 They... they need to ask me that. 224 00:09:25,641 --> 00:09:28,059 Are... are you staying here too? 225 00:09:28,060 --> 00:09:32,147 No, they... they needed to ask if it was OK if you stayed. 226 00:09:32,148 --> 00:09:33,523 Why? 227 00:09:33,524 --> 00:09:38,153 Be... because, uh, it's polite. 228 00:09:38,154 --> 00:09:40,446 It's the right... it's the right thing to do. 229 00:09:40,447 --> 00:09:43,533 Um, I need to talk to them. 230 00:09:43,534 --> 00:09:46,244 Um, they're not here. They're at a barbecue. 231 00:09:46,245 --> 00:09:48,371 OK, um, can you have them call me 232 00:09:48,372 --> 00:09:49,706 as soon as they get home? 233 00:09:49,707 --> 00:09:51,583 - Yes. - Can you promise? 234 00:09:51,584 --> 00:09:53,459 I promise. OK, bye, Mel! 235 00:09:53,460 --> 00:09:54,879 Bye. Have fun... 236 00:09:56,255 --> 00:09:57,881 Thanks for fixing my bike. 237 00:09:57,882 --> 00:10:00,050 Well, you keep me running, I'll keep her going. 238 00:10:01,927 --> 00:10:05,513 You know, the Cree don't have a word for goodbye. 239 00:10:05,514 --> 00:10:06,681 You know a lot of Cree? 240 00:10:06,682 --> 00:10:08,433 A bit. 241 00:10:08,434 --> 00:10:09,559 I got around, man. 242 00:10:09,560 --> 00:10:10,895 I don't doubt it. 243 00:10:13,397 --> 00:10:15,899 Look, I'll come back for all this other shit... 244 00:10:15,900 --> 00:10:17,233 Great. 245 00:10:17,234 --> 00:10:18,735 If you promise to come back 246 00:10:18,736 --> 00:10:20,570 and let me take the Bonnie for a ride. 247 00:10:20,571 --> 00:10:21,779 Uh, I don't know. 248 00:10:21,780 --> 00:10:23,198 I've seen you ride, old man. 249 00:10:23,199 --> 00:10:24,616 Fuck you. 250 00:10:24,617 --> 00:10:26,576 I mean it. 251 00:10:26,577 --> 00:10:27,786 We got a deal? 252 00:10:30,873 --> 00:10:32,750 I'll think about it. 253 00:10:45,846 --> 00:10:47,931 This looks like an ambush. 254 00:10:47,932 --> 00:10:49,599 We got a slight hiccup in chairs. 255 00:10:49,600 --> 00:10:50,642 ICE is back? 256 00:10:50,643 --> 00:10:52,644 No, we got a dead body. 257 00:10:52,645 --> 00:10:54,270 - Somebody died out there? - Yeah. 258 00:10:54,271 --> 00:10:56,105 Poor devil checked in at 5:00 this morning. 259 00:10:56,106 --> 00:10:57,565 He was a DNR. 260 00:10:57,566 --> 00:10:58,775 - What was his chief complaint? - Hemorrhoids 261 00:10:58,776 --> 00:11:00,276 - and constipation. - No shit. 262 00:11:00,277 --> 00:11:02,612 Hence the constipation. 263 00:11:02,613 --> 00:11:04,364 Throw me a slow one, I'm gonna hit it. 264 00:11:04,365 --> 00:11:06,032 Tell the night shift. I'm saying that's when he died. 265 00:11:06,033 --> 00:11:07,283 We all in agreement on that? 266 00:11:07,284 --> 00:11:08,660 To the grave. 267 00:11:08,661 --> 00:11:10,453 Just like poor Jasper. 268 00:11:10,454 --> 00:11:11,955 You're on fire. 269 00:11:11,956 --> 00:11:13,374 Just getting my second wind. 270 00:11:14,667 --> 00:11:15,959 How's the headache? 271 00:11:15,960 --> 00:11:17,293 Still a 10. 272 00:11:17,294 --> 00:11:18,795 More fentanyl? 273 00:11:18,796 --> 00:11:21,172 - Yep. - BP's good. Another 50. 274 00:11:21,173 --> 00:11:22,632 Hey, Abbot. 275 00:11:22,633 --> 00:11:24,634 Attending and resident are stuck in the OR. 276 00:11:24,635 --> 00:11:26,469 Oh, you're the next best thing. 277 00:11:26,470 --> 00:11:27,804 Better, some would say. 278 00:11:27,805 --> 00:11:29,138 Mm. 279 00:11:29,139 --> 00:11:30,682 - What do you got? - This is Judith. 280 00:11:30,683 --> 00:11:33,142 G1, P0 with no prenatal care. 281 00:11:33,143 --> 00:11:35,270 Preeclampsia with severe hypertension. 282 00:11:35,271 --> 00:11:37,689 Hi, Judith. Nurse Garvin from OB. 283 00:11:37,690 --> 00:11:39,148 Some jelly on the belly. 284 00:11:39,149 --> 00:11:40,692 Gonna take a quick look with ultrasound. 285 00:11:40,693 --> 00:11:42,652 No, no, no. Ultrasound can harm the baby. 286 00:11:42,653 --> 00:11:44,654 - Not true. - Not doing the ultrasound 287 00:11:44,655 --> 00:11:46,740 could end up harming you and the baby. 288 00:11:47,992 --> 00:11:49,158 OK. 289 00:11:49,159 --> 00:11:51,703 Just do it as fast as you can. 290 00:11:51,704 --> 00:11:54,164 Why no prenatal care, Judith? 291 00:11:55,207 --> 00:11:57,667 I wanted a free birth... 292 00:11:57,668 --> 00:11:59,836 no doctors, no hospital, no medicine. 293 00:11:59,837 --> 00:12:02,672 Mm. You have a midwife? 294 00:12:02,673 --> 00:12:03,715 A birth doula? 295 00:12:03,716 --> 00:12:06,134 No, I don't need one. 296 00:12:06,135 --> 00:12:07,427 Women have been having children on their own 297 00:12:07,428 --> 00:12:08,678 for thousands of years. 298 00:12:08,679 --> 00:12:10,221 Yeah, with an infant mortality rate 299 00:12:10,222 --> 00:12:13,141 of 30% for most of those thousands of years. 300 00:12:13,142 --> 00:12:15,393 - Femur length 7 centimeters. - 37 weeks. 301 00:12:15,394 --> 00:12:17,353 They'll probably induce. 302 00:12:17,354 --> 00:12:19,314 What? No. 303 00:12:19,315 --> 00:12:20,690 No, no, no, no. Absolutely not. 304 00:12:20,691 --> 00:12:22,191 At 37 weeks, 305 00:12:22,192 --> 00:12:24,402 the cure for preeclampsia is to deliver the baby. 306 00:12:24,403 --> 00:12:26,195 We need to get you upstairs so the OB doctors 307 00:12:26,196 --> 00:12:28,990 can induce labor to save you and your baby. 308 00:12:28,991 --> 00:12:31,410 No. No, no, no, no. Mm-mm. 309 00:12:33,746 --> 00:12:35,496 Yep, that's definitely Jasper. 310 00:12:35,497 --> 00:12:36,748 He was alive and kicking 311 00:12:36,749 --> 00:12:38,166 when my shift ended this morning. 312 00:12:38,167 --> 00:12:39,542 This is definitely a day shift patient. 313 00:12:39,543 --> 00:12:40,877 Now he's not a patient. 314 00:12:40,878 --> 00:12:42,378 He's a DB that we gotta deal with. 315 00:12:44,882 --> 00:12:46,132 Is this dude dead? 316 00:12:46,133 --> 00:12:47,633 Nope. 317 00:12:47,634 --> 00:12:49,469 All right, Mr. Reed, time to take you back 318 00:12:49,470 --> 00:12:50,928 and get you checked out, OK? 319 00:12:50,929 --> 00:12:52,388 - He sure looks dead. - Are you a doctor? 320 00:12:52,389 --> 00:12:54,724 - No, but he... - Has hypernarcolepsy. 321 00:12:54,725 --> 00:12:56,434 - It's no joke. - Mm-hmm. 322 00:12:56,435 --> 00:12:58,728 Excuse me. 323 00:12:58,729 --> 00:13:00,646 Oh, sometimes I hate nights. 324 00:13:00,647 --> 00:13:01,898 - Yep. - Oof. 325 00:13:12,785 --> 00:13:14,202 Wow. 326 00:13:14,203 --> 00:13:17,413 Crazy how muggy it still is out here. 327 00:13:17,414 --> 00:13:20,083 You, uh... you seen Robby? 328 00:13:20,084 --> 00:13:22,251 Uh, not for a bit. 329 00:13:22,252 --> 00:13:23,586 You catch up on your charts 330 00:13:23,587 --> 00:13:25,088 from the beginning of the shift? 331 00:13:25,089 --> 00:13:26,381 Yeah. 332 00:13:26,382 --> 00:13:27,423 What are you still doing here? 333 00:13:27,424 --> 00:13:29,258 Uh, just gonna... 334 00:13:29,259 --> 00:13:31,636 You staying for the fireworks? 335 00:13:31,637 --> 00:13:33,054 Yeah. 336 00:13:33,055 --> 00:13:34,430 I was supposed to see them with Becca, 337 00:13:34,431 --> 00:13:38,434 but she is at her boyfriend Adam's 338 00:13:38,435 --> 00:13:40,312 family's house instead. 339 00:13:44,608 --> 00:13:50,822 Your sister seems like she's, uh, pretty put-together. 340 00:13:50,823 --> 00:13:52,115 Yeah. 341 00:13:52,116 --> 00:13:54,868 Uh, a lot more than I realized. 342 00:13:56,787 --> 00:13:58,205 How was your day? 343 00:14:00,040 --> 00:14:02,542 I've had better. 344 00:14:02,543 --> 00:14:03,669 You? 345 00:14:06,547 --> 00:14:08,965 Yeah. 346 00:14:08,966 --> 00:14:12,301 But then again, I've had a lot worse. 347 00:14:12,302 --> 00:14:14,804 Hell, I did a closed cervical reduction, like, an hour ago. 348 00:14:14,805 --> 00:14:17,057 Oh, I heard. That must have been so intense. 349 00:14:18,767 --> 00:14:20,935 My hands are still shaking. 350 00:14:20,936 --> 00:14:22,979 Hey, um, do you think you could teach me 351 00:14:22,980 --> 00:14:25,148 how to do that sometime? 352 00:14:25,149 --> 00:14:26,607 Uh, yeah. 353 00:14:26,608 --> 00:14:27,817 - Yeah? - Yeah, sure. I mean, 354 00:14:27,818 --> 00:14:29,360 I hope you never have to use it. 355 00:14:29,361 --> 00:14:31,320 I could have paralyzed that guy. 356 00:14:31,321 --> 00:14:34,031 Yeah, but you didn't. 357 00:14:34,032 --> 00:14:37,326 No, I didn't. 358 00:14:37,327 --> 00:14:39,787 Thank you... 359 00:14:39,788 --> 00:14:41,873 by the way, for... 360 00:14:41,874 --> 00:14:44,625 talking me down earlier. 361 00:14:44,626 --> 00:14:46,503 I'm sorry I snapped. 362 00:14:48,005 --> 00:14:49,339 It's OK. 363 00:14:57,514 --> 00:15:00,183 Dr. Mohan, you ever heard of kinship fostering? 364 00:15:00,184 --> 00:15:01,893 It's where a nurse or doctor can 365 00:15:01,894 --> 00:15:03,394 - become an emergency foster... - Oh, no. 366 00:15:03,395 --> 00:15:04,896 I don't need any kids. 367 00:15:04,897 --> 00:15:07,064 I need to find a job first. 368 00:15:07,065 --> 00:15:09,525 Candice O'Grady is an 82-year-old female 369 00:15:09,526 --> 00:15:12,028 brought in by her son for intractable vomiting. 370 00:15:12,029 --> 00:15:14,990 No fever, no chills, no abdominal pain, no rash. 371 00:15:16,074 --> 00:15:18,075 Beep. 372 00:15:18,076 --> 00:15:21,496 Oh, I've already got one I can barely keep up with. 373 00:15:21,497 --> 00:15:23,372 What about Sleeping Beauty over here? 374 00:15:23,373 --> 00:15:25,416 She's already babysitting Whitaker. 375 00:15:25,417 --> 00:15:27,502 Well, if you know anyone who'd like to help us out 376 00:15:27,503 --> 00:15:29,420 with Baby Jane Doe, have them call the main desk. 377 00:15:29,421 --> 00:15:31,047 Sure thing. 378 00:15:31,048 --> 00:15:34,218 I'd take her myself, but Benji'd kill me. 379 00:15:35,594 --> 00:15:37,386 BP's 164/114. 380 00:15:37,387 --> 00:15:38,763 Another 40 of labetalol. 381 00:15:38,764 --> 00:15:39,889 Mag bolus is in. 382 00:15:39,890 --> 00:15:41,557 Now infusing 2 grams an hour. 383 00:15:41,558 --> 00:15:42,850 Labs are coming back. 384 00:15:42,851 --> 00:15:45,102 Hemoglobin 7.5, platelets 40. 385 00:15:45,103 --> 00:15:47,104 LFTs are sky high. 386 00:15:47,105 --> 00:15:48,898 - HELLP syndrome. - Hemolytic anemia, 387 00:15:48,899 --> 00:15:51,234 elevated liver enzymes, and low platelets. 388 00:15:51,235 --> 00:15:52,610 They're cleaning a room. 389 00:15:52,611 --> 00:15:54,570 We can bring her up in ten minutes. 390 00:15:54,571 --> 00:15:55,781 How you doing, Judith? 391 00:15:57,783 --> 00:16:00,326 I... I... 392 00:16:00,327 --> 00:16:01,994 Oh, she's seizing. 393 00:16:01,995 --> 00:16:03,663 Oh, shit. 394 00:16:03,664 --> 00:16:06,249 10 of IV diazepam. Have another 10 ready. 395 00:16:06,250 --> 00:16:08,209 With all the movement, we can't get a fetal heartbeat. 396 00:16:08,210 --> 00:16:10,503 Putting on 15 liters by mask. Should we intubate? 397 00:16:10,504 --> 00:16:12,505 Hold intubation. Let's try to break this. 398 00:16:12,506 --> 00:16:14,423 We don't want to mask seizures with paralysis 399 00:16:14,424 --> 00:16:16,008 unless we have to. 400 00:16:16,009 --> 00:16:17,593 OK, um... 401 00:16:20,055 --> 00:16:21,806 Crus, CTG isn't reading. 402 00:16:21,807 --> 00:16:23,266 - Check with ultrasound. - On it. 403 00:16:23,267 --> 00:16:24,892 Nazely, what's the diagnosis? 404 00:16:24,893 --> 00:16:27,938 Um, with the seizure, now it's eclampsia. 405 00:16:29,106 --> 00:16:31,148 - Fetal heart rate is about 90. - Way too low. 406 00:16:31,149 --> 00:16:32,441 Mom's sats are going down. 407 00:16:32,442 --> 00:16:33,901 Time to tube her? 408 00:16:33,902 --> 00:16:35,570 Set up for it, but wait. 409 00:16:35,571 --> 00:16:36,904 Another 10 of diazepam. 410 00:16:36,905 --> 00:16:39,366 Push 4 grams of Keppra. 411 00:16:42,119 --> 00:16:43,619 History of hypertension 412 00:16:43,620 --> 00:16:44,954 presents to the emergency department 413 00:16:44,955 --> 00:16:47,290 with a chief complaint of dizziness 414 00:16:47,291 --> 00:16:49,500 after inadvertently ingesting 80 milligrams... 415 00:16:49,501 --> 00:16:50,793 Hey, how are you guys making out? 416 00:16:50,794 --> 00:16:51,877 Yeah, we're getting there. 417 00:16:51,878 --> 00:16:53,629 Have you seen Dr. Al-Hashimi? 418 00:16:53,630 --> 00:16:55,465 - No. - Can I talk to you for a sec? 419 00:17:01,013 --> 00:17:02,346 So I just wanted to let you know that I've been 420 00:17:02,347 --> 00:17:03,639 checking out some of your online posts... 421 00:17:03,640 --> 00:17:04,807 Look, I was just trying to help 422 00:17:04,808 --> 00:17:06,392 get some health messages out there, 423 00:17:06,393 --> 00:17:07,977 - especially for young people. - I think they're great. 424 00:17:07,978 --> 00:17:09,979 Really good. 425 00:17:09,980 --> 00:17:11,981 - You do? - Yeah. 426 00:17:11,982 --> 00:17:14,191 Yeah, um, keep it up. 427 00:17:14,192 --> 00:17:15,651 OK. 428 00:17:15,652 --> 00:17:17,987 As long as you follow the HIPAA laws. 429 00:17:17,988 --> 00:17:19,363 I do. 430 00:17:19,364 --> 00:17:20,948 And wait until you're done charting. 431 00:17:20,949 --> 00:17:22,576 Sure. 432 00:17:24,786 --> 00:17:29,123 Actually, Dr. Robby... sorry, um, can I ask you a question? 433 00:17:29,124 --> 00:17:30,333 Shoot. 434 00:17:30,334 --> 00:17:31,792 Um, I... I may be 435 00:17:31,793 --> 00:17:34,588 considering emergency psychiatry. 436 00:17:35,839 --> 00:17:38,049 Very cool. 437 00:17:38,050 --> 00:17:39,843 Think I could do it? 438 00:17:42,012 --> 00:17:43,512 I think that you could do 439 00:17:43,513 --> 00:17:46,099 anything that you put your mind to, Victoria. 440 00:17:50,187 --> 00:17:51,646 OK. 441 00:17:51,647 --> 00:17:53,356 Pulse ox is 88. 442 00:17:54,524 --> 00:17:56,567 Dr. Abbot? 443 00:17:56,568 --> 00:17:58,736 - Intubate? - Let's do it. 444 00:17:58,737 --> 00:18:02,073 Nazely, what do you suggest for rapid sequence induction? 445 00:18:02,074 --> 00:18:03,282 Etomidate and roc. 446 00:18:03,283 --> 00:18:04,450 Mm, not quite. 447 00:18:04,451 --> 00:18:05,576 120 of propofol, 448 00:18:05,577 --> 00:18:06,577 60 of succinylcholine. 449 00:18:06,578 --> 00:18:08,037 Why is that, Crus? 450 00:18:08,038 --> 00:18:09,747 Propofol for the anti-seizure effect, 451 00:18:09,748 --> 00:18:11,374 sux to avoid prolonged paralysis 452 00:18:11,375 --> 00:18:13,459 - so we can check her neuro exam. - Exactly. 453 00:18:13,460 --> 00:18:14,794 Pushing the propofol. 454 00:18:14,795 --> 00:18:16,295 Once she's flat for intubation, 455 00:18:16,296 --> 00:18:17,880 we need to displace the uterus to the left. 456 00:18:17,881 --> 00:18:19,507 Nazely, that's you. Big hug, both arms. 457 00:18:19,508 --> 00:18:21,842 - Get the baby off the vena cava. - Sux is on board. 458 00:18:21,843 --> 00:18:24,595 But after she's paralyzed, the seizing stops, right? 459 00:18:24,596 --> 00:18:26,097 It might look like that, 460 00:18:26,098 --> 00:18:28,182 but an ongoing seizure will still fry the brain. 461 00:18:28,183 --> 00:18:30,017 We monitor with EEG. 462 00:18:30,018 --> 00:18:31,895 - Is there time for that? - Wait and see. 463 00:18:33,021 --> 00:18:34,271 Paralytics kicked in. 464 00:18:34,272 --> 00:18:35,816 Let's go. Roll her to her back. 465 00:18:36,858 --> 00:18:38,567 Intubate, then EEG 466 00:18:38,568 --> 00:18:41,070 to see if her brain is still seizing. 467 00:18:41,071 --> 00:18:42,613 I need first pass success. 468 00:18:42,614 --> 00:18:43,864 You and me both. 469 00:18:51,581 --> 00:18:54,125 Have you seen Dr. Al-Hashimi? 470 00:18:54,126 --> 00:18:55,334 No. 471 00:18:55,335 --> 00:18:57,753 Have you seen Dr. Al-Hashimi? 472 00:18:57,754 --> 00:18:59,505 Al-Hashimi? 473 00:18:59,506 --> 00:19:02,091 With how this day's going, she probably quit. 474 00:19:02,092 --> 00:19:05,344 Last I saw her, she was in Peds with Baby Jane Doe. 475 00:19:05,345 --> 00:19:07,763 Nope, I was just in there. 476 00:19:07,764 --> 00:19:08,764 Want me to page her? 477 00:19:08,765 --> 00:19:10,599 Uh, no, that's OK. 478 00:19:10,600 --> 00:19:11,893 I will find her. 479 00:19:16,481 --> 00:19:17,733 Hello. 480 00:19:20,527 --> 00:19:22,945 Hey, how did our people do at the deposition? 481 00:19:22,946 --> 00:19:25,489 Oh, well, Dr. Ellis is a pit bull. 482 00:19:25,490 --> 00:19:27,616 Dr. King is a petunia. 483 00:19:27,617 --> 00:19:28,951 They were pretty brutal with her. 484 00:19:28,952 --> 00:19:30,786 - She's sensitive. - Very. 485 00:19:30,787 --> 00:19:32,413 And I'm afraid it isn't over. 486 00:19:32,414 --> 00:19:33,581 They want to call her back. 487 00:19:33,582 --> 00:19:35,416 Oh, that's unfortunate. 488 00:19:35,417 --> 00:19:36,625 Maybe I should go with you 489 00:19:36,626 --> 00:19:38,294 to break that news to her, actually. 490 00:19:38,295 --> 00:19:40,129 - Misery loves company. - Um, hey, while I have you, 491 00:19:40,130 --> 00:19:42,923 can I pose a hypothetical to you? 492 00:19:42,924 --> 00:19:44,925 If a doctor suspects another physician 493 00:19:44,926 --> 00:19:47,178 of having a medical condition that could negatively 494 00:19:47,179 --> 00:19:49,305 affect the way they would treat a patient, 495 00:19:49,306 --> 00:19:51,015 where would disclosing that fall 496 00:19:51,016 --> 00:19:53,018 on the HIPAA violation scale? 497 00:19:54,019 --> 00:19:56,021 First, do no harm. 498 00:19:58,482 --> 00:20:00,901 Dr. King, do you have a second? 499 00:20:03,487 --> 00:20:06,281 Mm... 500 00:20:08,074 --> 00:20:10,159 Good lung sliding bilaterally. 501 00:20:10,160 --> 00:20:12,162 Fetal heart rate borderline at 98. 502 00:20:13,663 --> 00:20:15,831 Roll her to the left again. That can help. 503 00:20:15,832 --> 00:20:19,001 One, two, three. 504 00:20:19,002 --> 00:20:22,505 OK, all set here. 505 00:20:22,506 --> 00:20:24,006 EEG monitor's good to go. 506 00:20:24,007 --> 00:20:25,758 That was fast. 507 00:20:25,759 --> 00:20:27,218 Still seizing while paralyzed. 508 00:20:27,219 --> 00:20:29,804 It's nonconvulsive status. 509 00:20:29,805 --> 00:20:31,180 What's she had so far? 510 00:20:31,181 --> 00:20:32,848 30 of diazepam, a full load of mag, 511 00:20:32,849 --> 00:20:34,016 Keppra, and propofol. 512 00:20:34,017 --> 00:20:35,392 Damn. What's your next step? 513 00:20:35,393 --> 00:20:36,644 Any ideas? 514 00:20:36,645 --> 00:20:38,854 Hmm? Nazely? 515 00:20:38,855 --> 00:20:40,815 Dilantin? Valproate? 516 00:20:40,816 --> 00:20:42,149 Mm, infusion is too long. 517 00:20:42,150 --> 00:20:43,692 So is onset of action. 518 00:20:43,693 --> 00:20:45,152 Push 100 of ketamine. 519 00:20:45,153 --> 00:20:47,363 That's had results with refractory status. 520 00:20:47,364 --> 00:20:49,657 She also has HELLP syndrome... hemoglobin only 7, 521 00:20:49,658 --> 00:20:52,576 - platelets down to 30. - Two units whole blood? 522 00:20:52,577 --> 00:20:55,037 O-neg is going up on the rapid infuser as we speak. 523 00:20:55,038 --> 00:20:57,081 Uh, put the AP pads on, just in case. 524 00:20:57,082 --> 00:20:59,875 And 10 of Decadron IV push for the inflammatory storm. 525 00:20:59,876 --> 00:21:02,044 - Fetal heart rate up to 104. - Hmm. 526 00:21:02,045 --> 00:21:03,379 - Little better. - Yeah. 527 00:21:03,380 --> 00:21:05,714 She should be upstairs with OB. 528 00:21:05,715 --> 00:21:09,468 She will be after we break this seizure. 529 00:21:09,469 --> 00:21:12,680 There was a delay in history-taking 530 00:21:12,681 --> 00:21:15,808 due to a malfunctioning VRI interpretation device. 531 00:21:15,809 --> 00:21:18,394 During this time, there was a normal CBC 532 00:21:18,395 --> 00:21:20,062 and comprehensive metabolic panel 533 00:21:20,063 --> 00:21:21,773 that came back from the lab. 534 00:21:23,233 --> 00:21:25,150 What's wrong with you, Malfeasance? 535 00:21:25,151 --> 00:21:28,153 I have to do another deposition. 536 00:21:28,154 --> 00:21:30,114 Oh, that sucks. 537 00:21:30,115 --> 00:21:32,075 You must have really messed up. 538 00:21:33,118 --> 00:21:34,869 Dude, I'm joking. 539 00:21:34,870 --> 00:21:35,911 You gotta lighten up. 540 00:21:35,912 --> 00:21:37,581 It's all just bullshit. 541 00:21:39,082 --> 00:21:41,542 God, you know what? Fuck all this. 542 00:21:41,543 --> 00:21:42,919 Do you want to go get a drink? 543 00:21:44,045 --> 00:21:45,087 Me? 544 00:21:45,088 --> 00:21:46,755 Yes, you. 545 00:21:46,756 --> 00:21:49,091 You... you do go out, don't you? 546 00:21:49,092 --> 00:21:51,260 Well, I'm usually with Becca. 547 00:21:51,261 --> 00:21:52,595 Well, bring her along. 548 00:21:52,596 --> 00:21:53,929 Can she drive? 549 00:21:53,930 --> 00:21:56,182 No, and she's with her boyfriend. 550 00:21:57,142 --> 00:21:58,602 OK, Becca. 551 00:22:00,270 --> 00:22:02,230 So it's just you and me. 552 00:22:04,357 --> 00:22:06,775 Do you like karaoke? 553 00:22:06,776 --> 00:22:08,652 You do karaoke? 554 00:22:08,653 --> 00:22:13,032 Well, what I do is more like primal scream therapy. 555 00:22:13,033 --> 00:22:14,783 There's nothing like getting wasted 556 00:22:14,784 --> 00:22:16,285 and just absolutely wailing 557 00:22:16,286 --> 00:22:19,038 to shake off a shit show like today. 558 00:22:19,039 --> 00:22:20,916 I could use a fun night. 559 00:22:22,292 --> 00:22:24,168 You and me both, sister. 560 00:22:24,169 --> 00:22:25,961 There's been no improvement. 561 00:22:25,962 --> 00:22:27,504 Still seizing on the EEG. 562 00:22:27,505 --> 00:22:29,214 - Neurology has been called. - OK. Got it. 563 00:22:29,215 --> 00:22:31,175 OB says send her up. They have an OR ready. 564 00:22:31,176 --> 00:22:32,635 About time. 565 00:22:32,636 --> 00:22:34,345 Baby's been bradying down a bit more. 566 00:22:34,346 --> 00:22:35,930 This one looks like it took a turn for the worse. 567 00:22:35,931 --> 00:22:37,765 Eclampsia, refractory seizures, 568 00:22:37,766 --> 00:22:40,017 HELLP syndrome with anemia and thrombocytopenia. 569 00:22:40,018 --> 00:22:41,477 Yeah, about as bad as it gets. 570 00:22:41,478 --> 00:22:43,979 V-fib! 571 00:22:43,980 --> 00:22:45,981 Chest compressions, Nazely. 572 00:22:45,982 --> 00:22:48,776 Charge to 200. 573 00:22:48,777 --> 00:22:50,194 Prep the belly. 574 00:22:50,195 --> 00:22:51,528 Get a baby warmer. 575 00:22:51,529 --> 00:22:53,197 Call the NICU. Start a timer. 576 00:22:53,198 --> 00:22:55,032 Charged. 577 00:22:55,033 --> 00:22:56,325 Clear. 578 00:22:58,161 --> 00:22:59,495 Continue compressions. 579 00:22:59,496 --> 00:23:01,872 We'll check a rhythm in a minute. 580 00:23:01,873 --> 00:23:03,165 Gown up. 581 00:23:03,166 --> 00:23:04,500 Robby, it's you and me. 582 00:23:04,501 --> 00:23:06,502 Nazely, what's the four-minute rule? 583 00:23:06,503 --> 00:23:08,754 Uh, not sure. 584 00:23:08,755 --> 00:23:10,547 Pregnant patient with a viable fetus, 585 00:23:10,548 --> 00:23:12,174 you have four minutes after cardiac arrest 586 00:23:12,175 --> 00:23:14,468 - to save the baby. - And the mom. 587 00:23:14,469 --> 00:23:16,762 We don't call it a postmortem C-section anymore. 588 00:23:16,763 --> 00:23:18,013 It's a resuscitative hysterotomy 589 00:23:18,014 --> 00:23:19,515 to try to save them both. 590 00:23:19,516 --> 00:23:20,849 But she doesn't want any medical intervention. 591 00:23:20,850 --> 00:23:22,226 That doesn't matter. 592 00:23:22,227 --> 00:23:23,727 Mom and baby are both dead if we do nothing. 593 00:23:23,728 --> 00:23:25,521 OK, charge to 200. 594 00:23:25,522 --> 00:23:27,565 One more rhythm check and then Abbot and I are gonna cut. 595 00:23:28,858 --> 00:23:31,443 Ellis, you and Crus on Mom resuscitation. 596 00:23:31,444 --> 00:23:32,903 Shen, you and Nazely take the baby. 597 00:23:32,904 --> 00:23:34,405 OK, hold compressions. 598 00:23:36,074 --> 00:23:37,700 Still V-fib. 599 00:23:37,701 --> 00:23:38,867 Clear. 600 00:23:38,868 --> 00:23:40,703 No change. 601 00:23:40,704 --> 00:23:42,746 - Resume compression, amp of epi. - OK, showtime. 602 00:23:42,747 --> 00:23:44,415 We need to get this baby out right now. 603 00:23:44,416 --> 00:23:45,542 OK, take a break. 604 00:23:48,086 --> 00:23:51,588 OK, 10 blade. Good. 605 00:23:51,589 --> 00:23:53,841 First incision is from the xiphoid 606 00:23:53,842 --> 00:23:55,551 to the pubic symphysis 607 00:23:55,552 --> 00:23:58,554 through the skin to the linea alba. 608 00:23:58,555 --> 00:24:00,681 Units three and four on the infuser. 609 00:24:00,682 --> 00:24:03,559 Second incision goes through the peritoneum, 610 00:24:03,560 --> 00:24:05,352 exposing the uterus. 611 00:24:05,353 --> 00:24:07,062 Where do you need me? 612 00:24:07,063 --> 00:24:09,273 You're with the baby. Nazely's got the bag mask. 613 00:24:09,274 --> 00:24:11,483 You're on suction. Stand by for intubation. 614 00:24:11,484 --> 00:24:12,985 Bladder retractors. 615 00:24:12,986 --> 00:24:14,653 Neonatal monitor and pulse ox ready to go. 616 00:24:14,654 --> 00:24:17,072 Ellis, gentle traction. 617 00:24:17,073 --> 00:24:19,158 OK, making a small vertical incision 618 00:24:19,159 --> 00:24:22,786 through the lower uterus so as not to cut the baby. 619 00:24:22,787 --> 00:24:24,580 Mm-hmm. 620 00:24:24,581 --> 00:24:26,123 - Got it? - Yep, I got it. 621 00:24:26,124 --> 00:24:27,583 - OK. - OK. 622 00:24:27,584 --> 00:24:30,711 Using scissors to extend superiorly. 623 00:24:32,172 --> 00:24:34,256 Ellis, hand retract the uterus with me. 624 00:24:34,257 --> 00:24:36,175 Amniotic fluid looks good. 625 00:24:37,802 --> 00:24:39,553 Give me some fundal pressure. 626 00:24:39,554 --> 00:24:40,971 Breech position. 627 00:24:43,391 --> 00:24:46,560 OK, baby's out. 628 00:24:46,561 --> 00:24:48,395 - It's a girl. - All right. 629 00:24:50,065 --> 00:24:53,067 Milking the cord. 630 00:24:53,068 --> 00:24:55,569 Clamping. 631 00:24:55,570 --> 00:24:57,571 Cutting. 632 00:24:57,572 --> 00:24:59,156 OK, blue and flaccid. Coming to you, Shen. 633 00:24:59,157 --> 00:25:00,282 - You ready? - Yeah, you got her. 634 00:25:00,283 --> 00:25:02,326 I got it, yep. 635 00:25:02,327 --> 00:25:03,744 OK. 636 00:25:07,332 --> 00:25:09,792 Poor tone, no movement. 637 00:25:09,793 --> 00:25:12,461 Keep the blow-by closer. 638 00:25:12,462 --> 00:25:13,837 She's really blue. 639 00:25:13,838 --> 00:25:16,673 Some blue is normal, but not this much. 640 00:25:16,674 --> 00:25:18,634 - Do we need to intubate? - Not yet, no. 641 00:25:18,635 --> 00:25:21,345 They usually pink up with stimulation and blow-by. 642 00:25:21,346 --> 00:25:23,138 OK, removing the placenta. 643 00:25:23,139 --> 00:25:25,516 Sweeping to the left, trying to get it in one piece. 644 00:25:27,352 --> 00:25:28,644 - Looks intact. - Yeah. 645 00:25:28,645 --> 00:25:30,813 Nicely done. 646 00:25:30,814 --> 00:25:32,815 10 of IV Pitocin to contract the uterus. 647 00:25:32,816 --> 00:25:34,983 And lots of massage. 648 00:25:34,984 --> 00:25:36,652 Heart rate 76. 649 00:25:36,653 --> 00:25:38,237 Less than 100 means we need to bag. 650 00:25:38,238 --> 00:25:39,446 Suction first. 651 00:25:39,447 --> 00:25:40,614 OK. 652 00:25:42,534 --> 00:25:43,992 Hey, Jord, charge to 200. 653 00:25:43,993 --> 00:25:46,829 Stand by for the next rhythm check. 654 00:25:46,830 --> 00:25:48,539 She grimaced. Good sign. 655 00:25:48,540 --> 00:25:49,623 Bagging. 656 00:25:49,624 --> 00:25:51,625 Pulse ox 45%. 657 00:25:51,626 --> 00:25:53,210 Oh, I've never seen it that low. 658 00:25:53,211 --> 00:25:55,003 It's not as bad as it sounds. 659 00:25:55,004 --> 00:25:57,047 I'm more worried about the heart rate. 660 00:25:57,048 --> 00:25:59,216 McKay, get ready with an IO in case we need epi. 661 00:25:59,217 --> 00:26:00,676 OK. 662 00:26:02,512 --> 00:26:05,013 Rhythm check. Hold compressions. 663 00:26:05,014 --> 00:26:06,056 Still V-fib. 664 00:26:06,057 --> 00:26:07,558 - OK, shock it. - Clear. 665 00:26:08,560 --> 00:26:10,060 Resume compressions. 666 00:26:10,061 --> 00:26:11,562 Shen, how's she doing over there? 667 00:26:11,563 --> 00:26:12,855 Heart rate's up to 104. 668 00:26:12,856 --> 00:26:14,106 Uh, at one minute, 669 00:26:14,107 --> 00:26:16,441 she's 0 for color, 2 for heart rate, 670 00:26:16,442 --> 00:26:17,776 1 for reflex, tone, breathing. 671 00:26:17,777 --> 00:26:19,403 APGAR of 5. 672 00:26:19,404 --> 00:26:21,363 5 out of 10. Not great. 673 00:26:21,364 --> 00:26:23,031 Pulse ox 58%. 674 00:26:23,032 --> 00:26:24,950 - Intubation? - Uh, not yet. 675 00:26:24,951 --> 00:26:27,035 O2 sat in the 60s is normal at one minute. 676 00:26:27,036 --> 00:26:29,913 Her heart rate and pulse ox are trending higher. 677 00:26:29,914 --> 00:26:31,373 Let's keep doing what we're doing. 678 00:26:31,374 --> 00:26:32,875 A little tincture of time. 679 00:26:32,876 --> 00:26:34,543 Hold compressions. 680 00:26:34,544 --> 00:26:36,628 Looks like sinus. 681 00:26:36,629 --> 00:26:38,297 Can't feel a carotid. 682 00:26:38,298 --> 00:26:39,715 No. 683 00:26:39,716 --> 00:26:41,717 Heart's barely pumping. It's PEA. 684 00:26:41,718 --> 00:26:43,010 Back on compressions. 685 00:26:43,011 --> 00:26:44,511 Transfuse two more units. 686 00:26:44,512 --> 00:26:45,888 She needs more red cells and platelets. 687 00:26:45,889 --> 00:26:47,598 Ongoing blood loss from the uterus. 688 00:26:47,599 --> 00:26:49,183 Give me all the lap pads we got, please. 689 00:26:56,608 --> 00:26:57,941 Yeah. 690 00:26:57,942 --> 00:26:59,067 OK, yeah, thanks. 691 00:26:59,068 --> 00:27:00,527 I appreciate it, honey. 692 00:27:00,528 --> 00:27:02,404 Oh, gotta go. 693 00:27:02,405 --> 00:27:03,739 Whoa, whoa, whoa! 694 00:27:03,740 --> 00:27:04,740 Hold up. 695 00:27:04,741 --> 00:27:06,241 Is there a problem here? 696 00:27:06,242 --> 00:27:08,368 Yeah, you two aren't leaving empty-handed. 697 00:27:08,369 --> 00:27:09,412 What? 698 00:27:10,580 --> 00:27:12,123 One of you follow me. 699 00:27:13,791 --> 00:27:15,626 Rape kits are supposed to be picked up 700 00:27:15,627 --> 00:27:18,587 within 72 hours of collecting 'em. 701 00:27:18,588 --> 00:27:21,298 This one's been here for over two weeks. 702 00:27:21,299 --> 00:27:23,008 That's not on us. 703 00:27:23,009 --> 00:27:24,593 Well, it's on somebody. 704 00:27:24,594 --> 00:27:26,094 It's not bad enough these poor women 705 00:27:26,095 --> 00:27:27,679 go through an assault, plus the indignity 706 00:27:27,680 --> 00:27:29,348 of the whole collection process, 707 00:27:29,349 --> 00:27:31,099 but nobody from the police department 708 00:27:31,100 --> 00:27:33,685 even has the human decency to come get these things? 709 00:27:33,686 --> 00:27:34,811 Like nobody there gives a flying fuck? 710 00:27:34,812 --> 00:27:36,438 OK, we got it. 711 00:27:36,439 --> 00:27:38,357 We'll see that these get put into evidence properly. 712 00:27:38,358 --> 00:27:39,567 Thank you. 713 00:27:41,694 --> 00:27:42,946 How hard was that? 714 00:27:46,783 --> 00:27:47,950 Units five and six are in. 715 00:27:47,951 --> 00:27:49,409 Down to a slow ooze here. 716 00:27:49,410 --> 00:27:50,786 Hold compressions. 717 00:27:54,332 --> 00:27:56,416 Looks like sinus. 718 00:27:56,417 --> 00:27:57,793 - And I got a weak carotid. - OK. 719 00:27:57,794 --> 00:27:59,294 Cycle the BP. 720 00:27:59,295 --> 00:28:01,421 Better filling, better squeeze. 721 00:28:01,422 --> 00:28:03,006 No seizure activity on the EEG. 722 00:28:03,007 --> 00:28:04,508 That's progress. That's progress. 723 00:28:04,509 --> 00:28:05,592 We're at five minutes. 724 00:28:05,593 --> 00:28:07,511 Uh, heart rate is 132. 725 00:28:07,512 --> 00:28:09,179 Uh, pulse ox 79%. 726 00:28:09,180 --> 00:28:11,098 Nazely, the APGAR? 727 00:28:11,099 --> 00:28:12,641 Um... 728 00:28:12,642 --> 00:28:14,810 1 off for color, 1 off for tone, 729 00:28:14,811 --> 00:28:17,354 1 off for respiration with hypoxia, total of 7. 730 00:28:17,355 --> 00:28:18,730 Respiration score is for observed breathing, 731 00:28:18,731 --> 00:28:20,148 not pulse ox. 732 00:28:20,149 --> 00:28:21,692 Sat of 80 is normal at five minutes. 733 00:28:21,693 --> 00:28:23,151 With no crying, she still gets 1 off. 734 00:28:23,152 --> 00:28:24,195 Yeah. 735 00:28:26,572 --> 00:28:28,073 Ah! 736 00:28:28,074 --> 00:28:30,033 She just scored the winning point! 737 00:28:30,034 --> 00:28:32,370 APGAR of 8 is pretty normal. 738 00:28:35,665 --> 00:28:38,000 Holy shit. What did I miss? 739 00:28:38,001 --> 00:28:40,711 Eclampsia with status, HELLP syndrome, 740 00:28:40,712 --> 00:28:43,880 cardiac arrest, resuscitative hysterotomy. 741 00:28:43,881 --> 00:28:46,216 I was in the OR with a septic twin C-section. 742 00:28:46,217 --> 00:28:47,509 Got your text 12 minutes ago. 743 00:28:47,510 --> 00:28:49,011 Shit happens fast down here. 744 00:28:49,012 --> 00:28:51,555 Resuscitative hysterotomy in 36 seconds. 745 00:28:51,556 --> 00:28:53,849 - Impressive. - BP's 102/64. 746 00:28:53,850 --> 00:28:55,058 Hemoglobin is up to 9. 747 00:28:55,059 --> 00:28:57,144 That'll do. 748 00:28:57,145 --> 00:28:58,520 NICU's sending a team down. 749 00:28:58,521 --> 00:29:00,856 We can take Mom. You guys are rock stars. 750 00:29:00,857 --> 00:29:03,359 We like to be referred to as crawlers of the night. 751 00:29:06,529 --> 00:29:07,904 If you're not careful, 752 00:29:07,905 --> 00:29:09,489 you're gonna get stuck here all night. 753 00:29:09,490 --> 00:29:11,992 Nah, Henny said she'd be here in 30 minutes. 754 00:29:11,993 --> 00:29:14,536 - How's Mom and baby? - Whew. 755 00:29:14,537 --> 00:29:16,538 They're both gonna go upstairs. 756 00:29:16,539 --> 00:29:18,707 Good. You leaving now? 757 00:29:18,708 --> 00:29:20,375 Yeah, pretty soon. 758 00:29:20,376 --> 00:29:23,462 I gotta find Whitaker, I gotta find Al-Hashimi, 759 00:29:23,463 --> 00:29:25,714 and I gotta find Langdon before I leave. 760 00:29:25,715 --> 00:29:28,217 You missed Langdon. He just checked out. 761 00:29:30,636 --> 00:29:32,680 Shit. 762 00:29:56,120 --> 00:29:57,537 Can I help you? 763 00:29:57,538 --> 00:30:01,083 Uh, yeah, I'm Dr. Langdon from the ED. 764 00:30:01,084 --> 00:30:04,044 I was just, uh, checking in on the status 765 00:30:04,045 --> 00:30:06,713 of someone we sent up here earlier. 766 00:30:06,714 --> 00:30:09,299 Patient's name is, uh, Cohen. 767 00:30:09,300 --> 00:30:10,592 Let me check. 768 00:30:10,593 --> 00:30:11,885 What was she up here for? 769 00:30:11,886 --> 00:30:13,720 Uh, clean out a nasty neck fash. 770 00:30:16,391 --> 00:30:18,058 Oh, yeah, she's good. 771 00:30:18,059 --> 00:30:21,144 She's in 4202, recovering nicely. 772 00:30:21,145 --> 00:30:23,730 Great, great. 773 00:30:23,731 --> 00:30:26,650 I mean, she was... she was in not-great shape earlier. 774 00:30:26,651 --> 00:30:28,777 It was a good catch. 775 00:30:28,778 --> 00:30:32,781 Saved her life, even if we couldn't save her leg. 776 00:30:32,782 --> 00:30:35,784 Uh, was it below the knee? 777 00:30:35,785 --> 00:30:37,620 Unfortunately, it was above. 778 00:30:54,512 --> 00:30:57,639 My cell phone and the building manager's. 779 00:30:57,640 --> 00:30:59,599 He can help if there's any emergencies. 780 00:30:59,600 --> 00:31:01,685 Yeah, what kind of emergencies? 781 00:31:01,686 --> 00:31:03,103 Whatever. 782 00:31:03,104 --> 00:31:04,104 And follow up with Duke 783 00:31:04,105 --> 00:31:05,105 in a couple days, yeah? 784 00:31:05,106 --> 00:31:06,148 Yeah. 785 00:31:06,149 --> 00:31:08,525 You, um... you sure about this? 786 00:31:08,526 --> 00:31:10,360 I trust you, Whitaker. 787 00:31:10,361 --> 00:31:12,154 Great. 788 00:31:12,155 --> 00:31:13,613 Any questions? 789 00:31:13,614 --> 00:31:16,658 Uh, when are you back, exactly? 790 00:31:16,659 --> 00:31:18,160 You know, I'll text you. 791 00:31:18,161 --> 00:31:19,996 I'm trying to keep my dates kind of fluid. 792 00:31:21,372 --> 00:31:23,498 I think this is your ride. 793 00:31:23,499 --> 00:31:25,542 Yeah, uh, yes. 794 00:31:25,543 --> 00:31:28,086 I... I promise I'll check in on your house tomorrow. 795 00:31:28,087 --> 00:31:29,589 Sounds good. 796 00:31:30,715 --> 00:31:32,424 - Hey. - Hey. 797 00:31:32,425 --> 00:31:35,510 OK. Hey, Theo. 798 00:31:35,511 --> 00:31:37,345 You're up late, huh? 799 00:31:37,346 --> 00:31:40,016 What you got there? 800 00:31:41,559 --> 00:31:44,019 OK. 801 00:31:44,020 --> 00:31:45,687 He's been fussy all day. 802 00:31:45,688 --> 00:31:47,856 I think he's got another tooth coming in. 803 00:31:47,857 --> 00:31:49,524 Aw, right on, big guy. 804 00:31:49,525 --> 00:31:52,944 Are you ready to get funky? 805 00:31:52,945 --> 00:31:54,738 Yeah? 806 00:32:13,841 --> 00:32:15,217 Hey. 807 00:32:15,218 --> 00:32:17,220 Any luck picking an elective? 808 00:32:18,679 --> 00:32:21,515 Don't know. 809 00:32:21,516 --> 00:32:23,726 Maybe I will go into geriatrics. 810 00:32:25,228 --> 00:32:27,188 It's a smart choice. 811 00:32:30,900 --> 00:32:32,567 I know that life can be challenging, 812 00:32:32,568 --> 00:32:33,902 especially when it doesn't work out 813 00:32:33,903 --> 00:32:35,237 the way you expected. 814 00:32:35,238 --> 00:32:36,447 OK. 815 00:32:41,285 --> 00:32:42,744 I thought I would be married 816 00:32:42,745 --> 00:32:44,830 with two kids in college by now. 817 00:32:46,123 --> 00:32:48,917 Maybe have some property with a pond, 818 00:32:48,918 --> 00:32:51,127 and we could play hockey on it in the wintertime. 819 00:32:53,256 --> 00:32:54,464 And yet look at me now. 820 00:32:54,465 --> 00:32:58,594 No wife, no kids, no pond. 821 00:33:02,056 --> 00:33:04,266 It's never too late. 822 00:33:04,267 --> 00:33:06,768 Do you really believe that? 823 00:33:06,769 --> 00:33:08,103 Yeah. 824 00:33:08,104 --> 00:33:09,813 Only for me, or for you too? 825 00:33:09,814 --> 00:33:11,439 OK. 826 00:33:11,440 --> 00:33:13,025 I see what you did there. 827 00:33:14,235 --> 00:33:16,945 Was that true, or something you just said to make a point? 828 00:33:23,077 --> 00:33:25,830 Have you worked things out with your mom? 829 00:33:28,040 --> 00:33:29,625 We're not talking. 830 00:33:32,878 --> 00:33:37,216 I am sorry that, um, I let it distract me. 831 00:33:38,718 --> 00:33:40,385 She was treating me like a child, 832 00:33:40,386 --> 00:33:41,804 and I was letting her. 833 00:33:46,976 --> 00:33:48,477 Have a good trip. 834 00:33:49,645 --> 00:33:50,813 Please be safe. 835 00:33:52,732 --> 00:33:55,150 We need you here. 836 00:33:55,151 --> 00:33:57,320 Even if you can be a dick sometimes. 837 00:34:00,156 --> 00:34:01,365 Good luck. 838 00:34:02,700 --> 00:34:04,076 You too. 839 00:34:13,169 --> 00:34:15,337 Hey, I didn't think you were still here. 840 00:34:15,338 --> 00:34:17,757 I was just talking to the neurologist on call. 841 00:34:19,175 --> 00:34:20,967 And? 842 00:34:20,968 --> 00:34:24,304 We had a nice chat. 843 00:34:24,305 --> 00:34:26,973 She agrees I can work with double coverage. 844 00:34:26,974 --> 00:34:29,351 That's not her call to make. 845 00:34:29,352 --> 00:34:30,727 You can't do anything critical 846 00:34:30,728 --> 00:34:32,228 where a five-second lapse in consciousness 847 00:34:32,229 --> 00:34:34,023 could potentially kill a patient. 848 00:34:35,858 --> 00:34:37,068 I agree. 849 00:34:40,529 --> 00:34:41,821 But 90% of our patients 850 00:34:41,822 --> 00:34:43,114 don't require critical procedures. 851 00:34:43,115 --> 00:34:45,283 And the ones that do? 852 00:34:45,284 --> 00:34:47,702 Will be handled by whomever is working with me. 853 00:34:47,703 --> 00:34:49,579 Unless they're also tied up with a critical patient. 854 00:34:49,580 --> 00:34:50,955 What if it's a double or triple trauma? 855 00:34:50,956 --> 00:34:52,957 - Robby, I can handle it. - No, you can't. 856 00:34:52,958 --> 00:34:54,376 And I can't let you. 857 00:34:54,377 --> 00:34:55,794 I am fully capable of handling... 858 00:34:55,795 --> 00:34:57,379 No, you are not fully capable, 859 00:34:57,380 --> 00:34:58,839 and you know it. 860 00:35:02,551 --> 00:35:04,052 What do you want from me? 861 00:35:04,053 --> 00:35:05,178 I want what's best for this department... 862 00:35:05,179 --> 00:35:06,596 patients and staff. 863 00:35:06,597 --> 00:35:08,890 Best-case scenario, you get a handle on this, 864 00:35:08,891 --> 00:35:10,433 you're seizure-free for six months, 865 00:35:10,434 --> 00:35:11,685 you get your driver's license back, 866 00:35:11,686 --> 00:35:12,936 you are cleared to work. 867 00:35:12,937 --> 00:35:15,271 I am cleared for my driver's license. 868 00:35:15,272 --> 00:35:17,440 You shouldn't be driving at all like this. 869 00:35:17,441 --> 00:35:19,901 If you were a patient, we would have to report you. 870 00:35:19,902 --> 00:35:21,528 I am not your fucking patient. 871 00:35:21,529 --> 00:35:22,612 No, but I cannot let you work 872 00:35:22,613 --> 00:35:24,030 in my emergency department 873 00:35:24,031 --> 00:35:25,865 until you're fully capable of doing so. 874 00:35:25,866 --> 00:35:27,575 That is not your fucking call! 875 00:35:27,576 --> 00:35:29,077 You're fucking-A right, that's my call! 876 00:35:29,078 --> 00:35:31,079 I'm trying to protect you and my patients, 877 00:35:31,080 --> 00:35:32,414 and you know I'm right about this. 878 00:35:32,415 --> 00:35:34,124 Oh, "my department,"my patients." 879 00:35:34,125 --> 00:35:35,625 All you fucking think about is yourself! 880 00:35:35,626 --> 00:35:36,918 Do you hear yourself? 881 00:35:36,919 --> 00:35:37,961 You didn't rat out Langdon 882 00:35:37,962 --> 00:35:39,504 for stealing fucking drugs. 883 00:35:39,505 --> 00:35:41,089 No, but I kicked him out of this department 884 00:35:41,090 --> 00:35:43,007 until he got the appropriate help that he needs, 885 00:35:43,008 --> 00:35:44,926 and the same goes for you. 886 00:35:44,927 --> 00:35:46,511 You've got until Monday to let the administration know, 887 00:35:46,512 --> 00:35:47,680 or I will. 888 00:35:54,770 --> 00:35:56,604 I am finished. 889 00:35:56,605 --> 00:35:58,440 Last chart. 890 00:35:59,525 --> 00:36:01,025 - You and me both. - Really? 891 00:36:01,026 --> 00:36:02,610 Is this a thing? I finished a while ago. 892 00:36:04,071 --> 00:36:05,865 I never want to hear that fucking bell again. 893 00:36:10,453 --> 00:36:11,953 - Where's Dana? - Not sure. 894 00:36:11,954 --> 00:36:13,455 A bunch of day shift just headed to the roof 895 00:36:13,456 --> 00:36:14,664 to watch the fireworks. 896 00:36:14,665 --> 00:36:15,957 You want me to call her? 897 00:36:15,958 --> 00:36:17,460 No, that's OK. 898 00:36:19,336 --> 00:36:20,837 Yo. 899 00:36:20,838 --> 00:36:22,548 Thanks for your help in there. 900 00:36:24,467 --> 00:36:26,677 - Almost out? - Yep, just about. 901 00:36:28,971 --> 00:36:30,680 Is this where you try to talk me out of going? 902 00:36:30,681 --> 00:36:31,681 Me? 903 00:36:31,682 --> 00:36:33,475 No, not a chance. 904 00:36:33,476 --> 00:36:34,684 Why, are you having second thoughts? 905 00:36:34,685 --> 00:36:35,685 - Nope. - No? 906 00:36:35,686 --> 00:36:37,312 Nope. 907 00:36:37,313 --> 00:36:39,314 Don't have to convince me. 908 00:36:39,315 --> 00:36:40,648 I mean, it is a little strange the only place 909 00:36:40,649 --> 00:36:42,192 you talked about going is somewhere 910 00:36:42,193 --> 00:36:43,485 they used to drive buffalo off a cliff to die. 911 00:36:43,486 --> 00:36:44,819 - Here it comes. - I looked it up, 912 00:36:44,820 --> 00:36:46,488 and as far as summer vacations go, 913 00:36:46,489 --> 00:36:48,239 it's not exactly a holiday hotspot. 914 00:36:48,240 --> 00:36:51,367 I mean, what's in the fucking gift shop, man? 915 00:36:51,368 --> 00:36:52,577 It's just one place I'm going. 916 00:36:52,578 --> 00:36:54,162 As long as it's not the last. 917 00:36:54,163 --> 00:36:56,331 Don't be pulling a "Thelma and Louise" out there. 918 00:36:56,332 --> 00:36:58,541 I am minutes from taking a three-month vacation. 919 00:36:58,542 --> 00:37:00,084 When's the last time you took any time off, Jack? 920 00:37:00,085 --> 00:37:01,962 Yeah, but I've dealt with my demons. 921 00:37:03,255 --> 00:37:05,882 It's a process. 922 00:37:05,883 --> 00:37:08,635 You want to know why I never killed myself? 923 00:37:08,636 --> 00:37:12,013 After what I saw, lived through? 924 00:37:12,014 --> 00:37:15,601 Losing my leg, losing my wife? 925 00:37:16,852 --> 00:37:19,020 Because it comes for all of us, man. 926 00:37:19,021 --> 00:37:20,230 You and I know it more than most. 927 00:37:20,231 --> 00:37:21,981 We see it every shift, 928 00:37:21,982 --> 00:37:24,109 but we can't let ourselves succumb to it. 929 00:37:25,194 --> 00:37:27,029 Yes, life can suck. 930 00:37:28,364 --> 00:37:30,365 It can be unbearable 931 00:37:30,366 --> 00:37:32,200 and... and brutal 932 00:37:32,201 --> 00:37:34,911 and ugly and heartbreaking. 933 00:37:34,912 --> 00:37:39,082 But it's also beautiful... and hilarious. 934 00:37:39,083 --> 00:37:41,335 And that woman today... 935 00:37:44,380 --> 00:37:45,964 Her baby, they'd both be in the morgue 936 00:37:45,965 --> 00:37:47,882 if you hadn't been here. 937 00:37:47,883 --> 00:37:49,717 That's us. That's you and me. 938 00:37:49,718 --> 00:37:52,720 That's what we're here for. 939 00:37:52,721 --> 00:37:55,306 The most important things I've ever done in my life 940 00:37:55,307 --> 00:37:57,976 have been in this hospital. 941 00:37:57,977 --> 00:38:00,436 Nothing will ever matter more than what I've done 942 00:38:00,437 --> 00:38:03,399 in this hospital, but it is killing me. 943 00:38:05,025 --> 00:38:07,151 You know how they say that a part of you dies 944 00:38:07,152 --> 00:38:08,778 when you lose someone you love? 945 00:38:08,779 --> 00:38:11,197 I'm not convinced that a part of you doesn't die 946 00:38:11,198 --> 00:38:13,366 every time you see a fellow human pass. 947 00:38:13,367 --> 00:38:17,871 And I've seen so many people die 948 00:38:17,872 --> 00:38:20,916 that I feel like it's leaching something from my soul. 949 00:38:22,585 --> 00:38:24,587 Go on a cruise, man. 950 00:38:26,964 --> 00:38:29,799 Knock off this helmetless motorcycle shit. 951 00:38:29,800 --> 00:38:31,885 Yeah, people talk. 952 00:38:31,886 --> 00:38:33,261 That's death-wish behavior. 953 00:38:33,262 --> 00:38:34,721 I'm tired of being a role model. 954 00:38:34,722 --> 00:38:36,639 I'm tired of feeling like you can't get ahead. 955 00:38:36,640 --> 00:38:38,433 I'm tired of feeling like I'm drowning every day. 956 00:38:38,434 --> 00:38:39,684 I'm tired of all of it. 957 00:38:39,685 --> 00:38:40,935 You need to get away for a while, 958 00:38:40,936 --> 00:38:42,312 and you need to get some help. 959 00:38:42,313 --> 00:38:45,774 You need this place as much as it needs you. 960 00:38:50,154 --> 00:38:52,280 Am I fucked up? 961 00:38:52,281 --> 00:38:53,866 100%. 962 00:38:57,369 --> 00:38:59,621 But nobody works here as long as you and me 963 00:38:59,622 --> 00:39:00,788 and doesn't get screwed up. 964 00:39:00,789 --> 00:39:03,958 You... you gotta find somebody 965 00:39:03,959 --> 00:39:06,669 to help you dance through the darkness. 966 00:39:10,674 --> 00:39:12,384 Did you just make that up? 967 00:39:14,595 --> 00:39:15,970 Maybe it's a song lyric. 968 00:39:15,971 --> 00:39:17,764 I don't... maybe my therapist said it. 969 00:39:17,765 --> 00:39:19,766 I don't know. 970 00:39:22,478 --> 00:39:23,937 Some dude just pulled up. 971 00:39:23,938 --> 00:39:25,981 Looks like he blew half his face off. 972 00:39:28,817 --> 00:39:30,653 How can you not love this place? 973 00:39:33,030 --> 00:39:36,491 Look, don't make me look stupid. 974 00:39:36,492 --> 00:39:38,911 You come back to us in one piece. 975 00:39:42,247 --> 00:39:43,706 I'm still your emergency contact, 976 00:39:43,707 --> 00:39:46,085 and I do not want to be contacted. 977 00:39:48,420 --> 00:39:49,671 All right, night crawlers, 978 00:39:49,672 --> 00:39:50,880 what the hell's going on out here? 979 00:39:56,428 --> 00:39:57,762 25-year-old man... 980 00:39:57,763 --> 00:39:59,055 history, 981 00:39:59,056 --> 00:40:00,390 no meds, no allergies. 982 00:41:26,769 --> 00:41:28,728 More than 2,000 years ago, 983 00:41:28,729 --> 00:41:30,897 the Chinese were throwing bamboo into fire 984 00:41:30,898 --> 00:41:32,899 to make explosions. 985 00:41:32,900 --> 00:41:34,442 They went on to invent gunpowder. 986 00:41:34,443 --> 00:41:36,612 And boom! The rest is history. 987 00:41:38,238 --> 00:41:41,324 They had chemicals to get the different colors, you know? 988 00:41:41,325 --> 00:41:44,118 Sodium gives you yellow, strontium gives you red, 989 00:41:44,119 --> 00:41:47,163 and barium is green. 990 00:41:47,164 --> 00:41:50,750 Who knew chemistry could be so damn pretty? 991 00:42:59,695 --> 00:43:01,445 - Hey. - Hey. 992 00:43:01,446 --> 00:43:03,865 - I thought you'd left already. - On my way out. 993 00:43:03,866 --> 00:43:07,869 Hey, I'm sorry that I didn't find the time today 994 00:43:07,870 --> 00:43:09,036 to have that conversation. 995 00:43:09,037 --> 00:43:10,371 Yeah, that's all right. 996 00:43:10,372 --> 00:43:12,248 Seems like you didn't really want to. 997 00:43:12,249 --> 00:43:14,376 I didn't. 998 00:43:16,545 --> 00:43:17,962 Did you? 999 00:43:17,963 --> 00:43:20,339 Uh... 1000 00:43:20,340 --> 00:43:23,092 yeah, actually. 1001 00:43:23,093 --> 00:43:26,220 Look, I'm doing the work. 1002 00:43:26,221 --> 00:43:28,681 I'm... I've been sober 186 days. 1003 00:43:28,682 --> 00:43:30,892 I'm going to meetings. I'm taking the drug tests. 1004 00:43:30,893 --> 00:43:33,145 - That's good. - And you're still riding me. 1005 00:43:36,190 --> 00:43:39,567 What would have happened if I'd paralyzed that guy? 1006 00:43:39,568 --> 00:43:41,235 I don't know. 1007 00:43:41,236 --> 00:43:42,862 What would have happened if I hadn't been here today? 1008 00:43:42,863 --> 00:43:44,530 You'd still be questioning yourself. 1009 00:43:44,531 --> 00:43:46,282 Now you know you can do it. You're welcome. 1010 00:43:46,283 --> 00:43:47,909 Oh, so that's... that's how you teach now? 1011 00:43:47,910 --> 00:43:49,869 Sometimes. 1012 00:43:49,870 --> 00:43:52,163 You know who I saw in rehab? 1013 00:43:52,164 --> 00:43:54,832 I saw a bunch of guys just like you. 1014 00:43:54,833 --> 00:43:56,125 The only difference is, 1015 00:43:56,126 --> 00:43:59,253 they've accepted that they need help. 1016 00:43:59,254 --> 00:44:01,297 I think you're afraid to admit that 1017 00:44:01,298 --> 00:44:03,966 the mighty Dr. Robinavitch isn't perfect. 1018 00:44:03,967 --> 00:44:06,010 Oh, I never claimed to be perfect. 1019 00:44:06,011 --> 00:44:09,263 No, but you expect it of yourself, 1020 00:44:09,264 --> 00:44:11,766 and it's not realistic, man. 1021 00:44:11,767 --> 00:44:14,101 How can any of us live up to your standards 1022 00:44:14,102 --> 00:44:15,812 if you can't even do it? 1023 00:44:17,189 --> 00:44:20,149 You need help, Robby. 1024 00:44:20,150 --> 00:44:21,943 You need help. 1025 00:44:24,780 --> 00:44:25,948 Finished? 1026 00:44:27,115 --> 00:44:29,492 You don't gotta be honest with me, man. 1027 00:44:29,493 --> 00:44:31,577 At least be honest with yourself. 1028 00:44:47,010 --> 00:44:49,428 She is due for a new bottle. 1029 00:44:49,429 --> 00:44:52,182 I was hoping to get her some formula before I clocked out. 1030 00:44:53,850 --> 00:44:56,227 I'll stay with her. 1031 00:44:56,228 --> 00:44:57,479 Thanks. 1032 00:44:59,731 --> 00:45:01,983 Why are you... will you hit those lights on your way out? 1033 00:45:01,984 --> 00:45:04,986 - Yep. - Why are you crying? 1034 00:45:04,987 --> 00:45:07,571 Why are you crying, little one? 1035 00:45:07,572 --> 00:45:10,157 You're OK. You're safe. 1036 00:45:10,158 --> 00:45:12,493 Yeah, you're not alone. 1037 00:45:19,334 --> 00:45:21,877 Yeah, you're OK. 1038 00:45:21,878 --> 00:45:25,172 Do you need to be swaddled again? 1039 00:45:25,173 --> 00:45:26,966 Is that it? 1040 00:45:26,967 --> 00:45:28,884 I can do that. Look. 1041 00:45:28,885 --> 00:45:31,512 Aww. 1042 00:45:31,513 --> 00:45:35,224 I wish somebody would swaddle me. 1043 00:45:35,225 --> 00:45:37,685 Yes, I do. 1044 00:45:37,686 --> 00:45:39,729 Oh. 1045 00:45:42,149 --> 00:45:45,192 You got off to kind of a rough start, 1046 00:45:45,193 --> 00:45:48,321 didn't you, little one? 1047 00:45:48,322 --> 00:45:50,406 Yeah, you did. 1048 00:45:52,701 --> 00:45:55,369 Well, that makes two of us. 1049 00:45:58,957 --> 00:46:01,042 I got abandoned too. 1050 00:46:04,379 --> 00:46:06,714 When I was eight. 1051 00:46:10,260 --> 00:46:15,723 But I got through all of that, and so will you. 1052 00:46:15,724 --> 00:46:19,727 I got a good feeling that you're gonna be just fine. 1053 00:46:19,728 --> 00:46:23,230 Everything's gonna be just fine. 1054 00:46:23,231 --> 00:46:26,192 You got so many wonderful things to see 1055 00:46:26,193 --> 00:46:29,403 and so many people to love ahead of you. 1056 00:46:31,573 --> 00:46:36,577 So many wonderful things to see, 1057 00:46:36,578 --> 00:46:38,746 people to love ahead of you. 1058 00:46:44,252 --> 00:46:47,213 Shh. 1059 00:46:47,214 --> 00:46:51,967 It's OK. It's gonna be OK. 1060 00:46:51,968 --> 00:46:54,553 It's OK. 1061 00:48:35,230 --> 00:48:38,776 Sync and corrections by btsix www.addic7ed.com