1 00:01:14,657 --> 00:01:16,576 Hey, I need my cast off. 2 00:01:16,658 --> 00:01:17,869 As soon as you park that outside. 3 00:01:17,952 --> 00:01:19,579 - Morning, Doc. - Olsen. 4 00:01:19,662 --> 00:01:20,997 Happy Fourth. 5 00:01:21,081 --> 00:01:22,664 Excuse me, guys. 6 00:01:22,749 --> 00:01:25,668 Sorry. 7 00:01:50,318 --> 00:01:52,027 Hey, how's it going, Dad? 8 00:01:52,112 --> 00:01:53,488 I'm so sleep-deprived. 9 00:01:53,571 --> 00:01:55,532 My house is starting to feel like a CIA black site. 10 00:01:55,615 --> 00:01:57,491 Have you considered hiring a night nurse? 11 00:01:57,575 --> 00:01:59,244 - You're looking at him. - You got a ripe one coming in 12 00:01:59,327 --> 00:02:00,912 you're gonna have to deal with before everybody out there 13 00:02:00,995 --> 00:02:02,330 - starts puking. - Lovely. 14 00:02:02,413 --> 00:02:03,915 Your replacement came in early. 15 00:02:03,998 --> 00:02:05,708 She brought in a full bagel spread. 16 00:02:05,792 --> 00:02:07,502 - I'm just saying. - She's not my replacement. 17 00:02:07,585 --> 00:02:09,044 She's just covering as chief while I go 18 00:02:09,128 --> 00:02:10,420 - on my little sabbatical. - Three months? 19 00:02:10,505 --> 00:02:11,965 I'll be back before your daughter 20 00:02:12,048 --> 00:02:13,800 - sleeps through the night. - Hey, dude, that's cold. 21 00:02:13,883 --> 00:02:15,552 - Morning. - Good morning. 22 00:02:30,191 --> 00:02:31,734 Good morning, John. 23 00:02:31,818 --> 00:02:33,736 I could have sworn it was still around 4:00 a.m.. 24 00:02:33,820 --> 00:02:35,488 Did you guys have an easy night last night? 25 00:02:35,572 --> 00:02:37,198 The waiting room actually looks manageable. 26 00:02:37,281 --> 00:02:39,117 I wouldn't call it easy, but not too bad. 27 00:02:39,200 --> 00:02:41,286 I figured we'd have hands and burns down here a bunch, 28 00:02:41,369 --> 00:02:43,371 but so far nobody's blown off any fingers. 29 00:02:43,454 --> 00:02:45,248 Oh, you know you just jinxed it. 30 00:02:45,331 --> 00:02:46,624 You guys and your jinxes. 31 00:02:46,708 --> 00:02:49,335 - Please, Jesus, please. - Hail Mary again. 32 00:02:49,418 --> 00:02:51,337 - In the sanctified flesh. - Don't let me die alone. 33 00:02:51,421 --> 00:02:54,591 - Just try to relax, Margaret. - I need a priest. 34 00:02:54,674 --> 00:02:57,260 - Hey, hey, Dr. Robby. - What's the good word, Perlah? 35 00:02:57,343 --> 00:02:59,179 All your results came back normal, Mrs. Walker. 36 00:02:59,262 --> 00:03:00,180 I'm dying. 37 00:03:00,263 --> 00:03:01,598 You're not dying, Mrs. Walker, I promise. 38 00:03:01,681 --> 00:03:03,016 Jesus is coming for me. 39 00:03:03,099 --> 00:03:05,310 If He is, He hasn't checked in at registration yet. 40 00:03:05,393 --> 00:03:06,644 Please don't let me die a sinner. 41 00:03:06,728 --> 00:03:08,228 Don't worry, Margaret-- we're going to have 42 00:03:08,313 --> 00:03:10,190 the hospital chaplain come and see you in a moment. 43 00:03:10,273 --> 00:03:11,691 I'm not going to last that long. 44 00:03:11,774 --> 00:03:13,526 Yes, you will, because we're going to give you a shot 45 00:03:13,610 --> 00:03:14,986 to keep you alive until they get here. 46 00:03:15,069 --> 00:03:16,613 What are you thinking, Dr. Robinavitch? 47 00:03:16,696 --> 00:03:18,489 500 mikes of cyanocobalamin? 48 00:03:18,573 --> 00:03:20,658 In her condition, I'd push a full 1,000. 49 00:03:20,742 --> 00:03:23,703 Whoo. You heard the man, Perlah. 50 00:03:23,786 --> 00:03:25,997 God bless you. God bless all of you. 51 00:03:26,079 --> 00:03:27,582 Amen to that. 52 00:03:27,665 --> 00:03:29,584 Hail Mary, full of grace, the Lord is with thee... 53 00:03:29,667 --> 00:03:31,419 Ooh, nothing like the miracle healing powers 54 00:03:31,502 --> 00:03:32,921 of a good old B12 shot. 55 00:03:33,004 --> 00:03:36,049 - How does she hold down a job? - She doesn't. 56 00:03:36,132 --> 00:03:37,716 She's wearing a waitress uniform. 57 00:03:37,800 --> 00:03:39,302 Yeah, from a diner that closed 20 years ago. 58 00:03:39,385 --> 00:03:41,596 Tier One Trauma, ETA six minutes. 59 00:03:41,679 --> 00:03:43,430 And so it begins. 60 00:03:43,514 --> 00:03:45,892 My husband is still waiting to see a doctor. 61 00:03:45,975 --> 00:03:47,185 I apologize for the wait, 62 00:03:47,268 --> 00:03:48,978 but here are two doctors just for you. 63 00:03:49,062 --> 00:03:51,147 Mr. Burgess has been complaining 64 00:03:51,231 --> 00:03:52,649 of leg cramps for a day. 65 00:03:52,732 --> 00:03:56,236 Slightly tachy at 110, BP 128 over 75. 66 00:03:56,319 --> 00:03:58,196 Afebrile, good sats. 67 00:03:58,279 --> 00:04:00,156 I'm Dr. Shen, but I'm going off shift. 68 00:04:00,240 --> 00:04:02,408 Dr. Robinavitch will be one of the doctors looking after you. 69 00:04:02,492 --> 00:04:03,701 What other medications 70 00:04:03,785 --> 00:04:05,662 are you currently taking, Mr. Burgess? 71 00:04:05,745 --> 00:04:07,747 I brought his meds. 72 00:04:07,830 --> 00:04:09,791 Thank you. 73 00:04:09,874 --> 00:04:11,334 These are his supplements, 74 00:04:11,417 --> 00:04:13,503 mostly all-natural and organic where possible. 75 00:04:13,586 --> 00:04:16,255 And these are his homeopathic prescriptions. 76 00:04:16,339 --> 00:04:20,343 I also have a list of his refrigerated probiotics. 77 00:04:23,137 --> 00:04:25,014 Where the hell is everybody? 78 00:04:25,098 --> 00:04:27,267 Our new attending is torturing 79 00:04:27,350 --> 00:04:29,519 our intern and med students in Trauma One. 80 00:04:29,602 --> 00:04:31,813 She came in early to meet the night shift 81 00:04:31,896 --> 00:04:33,398 and took things over. 82 00:04:33,481 --> 00:04:36,317 Okay, that takes giant balls of disrespect. 83 00:04:36,401 --> 00:04:37,694 Giant Balls of Disrespect 84 00:04:37,777 --> 00:04:39,487 was the name of my band in high school. 85 00:04:39,570 --> 00:04:41,698 And my nickname for my ex-husband. 86 00:04:41,781 --> 00:04:43,866 Hey, uh, is this your last shift? 87 00:04:43,950 --> 00:04:47,829 - For a while, yeah. - Oh, I am so jealous. 88 00:04:47,912 --> 00:04:50,498 Hey, I'll pay you a grand if you take my second husband. 89 00:04:50,581 --> 00:04:51,749 Tempting. 90 00:04:51,832 --> 00:04:53,710 So tell me about this new attending. 91 00:04:53,793 --> 00:04:56,838 Uh, she's pretty, divorced, one kid. 92 00:04:56,921 --> 00:04:59,382 Can already tell she is a strict rule follower. 93 00:04:59,465 --> 00:05:01,301 I'm probably going to grow to hate her. 94 00:05:01,384 --> 00:05:05,054 - What's her name, again? - Dr. Baran Al-Hashimi. 95 00:05:05,138 --> 00:05:07,724 Al-Hashimi? What is that? 96 00:05:07,807 --> 00:05:10,101 Irish? 97 00:05:10,184 --> 00:05:13,062 She's some sort of clinical informatics expert. 98 00:05:13,146 --> 00:05:14,939 Once she started talking about AI, 99 00:05:15,023 --> 00:05:18,318 I started thinking about robots and kind of stopped listening. 100 00:05:18,401 --> 00:05:20,820 Clear. Off the chest, Ogilvie. 101 00:05:20,903 --> 00:05:22,405 Get ready to step up here, Joy. 102 00:05:22,488 --> 00:05:24,657 Ogilvie, off the chest! 103 00:05:24,741 --> 00:05:26,117 Clear! 104 00:05:26,200 --> 00:05:27,952 Still V-tach, but it looks weird. 105 00:05:28,036 --> 00:05:29,704 - Agreed. - No pulse. 106 00:05:29,787 --> 00:05:31,831 No effusion, good lung sliding. 107 00:05:31,914 --> 00:05:32,874 Start compressions, Joy. 108 00:05:32,957 --> 00:05:34,000 We haven't considered all the Ts. 109 00:05:34,082 --> 00:05:36,002 I checked for tamponade and tension pneumo. 110 00:05:36,085 --> 00:05:37,211 What if it's thrombosis? 111 00:05:37,295 --> 00:05:39,422 If it's a pulmonary or cardiac clot, TNK could save him. 112 00:05:39,505 --> 00:05:41,507 We are sticking with the algorithm for now. 113 00:05:41,591 --> 00:05:43,551 - Algorithm's not working. - Faster and deeper, please. 114 00:05:43,634 --> 00:05:46,429 - Uh, you need a break, Joy? - No, I need an attending. 115 00:05:46,512 --> 00:05:48,806 I'm right here. 116 00:05:48,890 --> 00:05:50,725 Stop compressions. We're calling it. 117 00:05:52,268 --> 00:05:54,062 Sorry, the patient's dead. 118 00:05:56,939 --> 00:05:59,400 All right. Who can tell me what went well? 119 00:05:59,484 --> 00:06:01,110 We followed the V-tach algorithm. 120 00:06:01,194 --> 00:06:02,862 We checked for reversible causes. 121 00:06:02,945 --> 00:06:04,614 We limited our rhythm and pulse checks to 10 seconds. 122 00:06:04,697 --> 00:06:05,990 Excellent. 123 00:06:06,074 --> 00:06:07,283 Should we have given thrombolytics? 124 00:06:07,367 --> 00:06:08,659 No, you should have recognized 125 00:06:08,743 --> 00:06:10,787 that the cardiac rhythm on the monitor was polymorphic, 126 00:06:10,870 --> 00:06:12,622 not just V-tach. 127 00:06:12,705 --> 00:06:14,540 It was torsades de pointes. 128 00:06:14,624 --> 00:06:16,793 That's French-- "twisting of the points." 129 00:06:16,876 --> 00:06:18,669 From prolonged QT, antiarrhythmics, 130 00:06:18,753 --> 00:06:20,004 electrolyte disorders. 131 00:06:20,088 --> 00:06:21,255 Your patient would have lived 132 00:06:21,339 --> 00:06:22,965 if you had pushed magnesium sulfate. 133 00:06:23,049 --> 00:06:24,842 Good news is he's an organ donor. 134 00:06:24,926 --> 00:06:26,594 Parts of him are going to get used to make Frisbees 135 00:06:26,677 --> 00:06:28,805 and water bottles and end up as microplastics 136 00:06:28,888 --> 00:06:30,515 in our brains and reproductive organs. 137 00:06:30,598 --> 00:06:32,183 Thank you for the words of encouragement, boss. 138 00:06:32,266 --> 00:06:33,810 Dr. Al-Hashimi, Dr. Michael Robinavitch. 139 00:06:33,893 --> 00:06:35,770 - Everybody calls me Robby. - Baran, please. 140 00:06:35,853 --> 00:06:37,397 - Welcome to the Pitt. - Yeah, about that-- 141 00:06:37,480 --> 00:06:38,773 Trauma's a minute out. 142 00:06:38,856 --> 00:06:40,733 Ooh, who wants to treat a real patient? 143 00:06:40,817 --> 00:06:42,151 Yes, please. 144 00:06:42,235 --> 00:06:44,070 This thing's going to give me nightmares. 145 00:06:45,822 --> 00:06:47,782 I hope you don't mind me jumping right into things. 146 00:06:47,865 --> 00:06:49,534 I find that a mock code is a great way 147 00:06:49,617 --> 00:06:51,284 to assess the students' capabilities. 148 00:06:51,369 --> 00:06:53,871 Well, it might have been nice if we'd had a little time 149 00:06:53,955 --> 00:06:55,623 to go over how we do things. 150 00:06:55,706 --> 00:06:58,626 Did you not get a packet from Dr. Underwood? Gloria? 151 00:06:58,709 --> 00:07:00,711 It outlined the quality-improvement changes 152 00:07:00,795 --> 00:07:02,547 I instituted at the VA. 153 00:07:02,630 --> 00:07:03,840 We're adopting the program 154 00:07:03,923 --> 00:07:05,633 at all of the university hospitals. 155 00:07:05,716 --> 00:07:08,010 - You didn't read it? - No, I did. I mean, I will. 156 00:07:08,094 --> 00:07:09,554 I'm going to. I want to. 157 00:07:09,637 --> 00:07:11,222 I thought I had a little bit more time 158 00:07:11,305 --> 00:07:13,182 - before you came in today. - We've already distributed 159 00:07:13,266 --> 00:07:15,685 patient passports to everyone at registration. 160 00:07:15,768 --> 00:07:18,229 What is a patient passport? 161 00:07:18,312 --> 00:07:20,773 So glad you asked. 162 00:07:20,857 --> 00:07:22,650 - Samira? - Dr. Al. 163 00:07:22,733 --> 00:07:25,278 We worked together at the VA a few years ago. 164 00:07:25,361 --> 00:07:27,238 - And now you're an R4. - Yes. 165 00:07:27,321 --> 00:07:29,323 And I'm so excited you're joining us. 166 00:07:29,407 --> 00:07:30,783 Dr. Mel King is here, too. 167 00:07:30,867 --> 00:07:32,201 I think you worked with her as well. 168 00:07:32,284 --> 00:07:33,911 - Incoming! - I did indeed. 169 00:07:33,995 --> 00:07:35,872 John Doe--dishwasher, penetrating trauma 170 00:07:35,955 --> 00:07:37,874 from a kitchen knife to the right chest. 171 00:07:37,957 --> 00:07:39,332 - Assault or accident? - Unclear. 172 00:07:39,417 --> 00:07:42,044 Initially had a pulse, lost it two blocks away. 173 00:07:44,505 --> 00:07:46,466 What do we got, party people? 174 00:07:46,549 --> 00:07:49,677 Dr. Yolanda Garcia, trauma surgery fellow, 175 00:07:49,760 --> 00:07:52,555 meet Dr. Baran Al-Hashimi, new E.D. attending. 176 00:07:52,638 --> 00:07:54,432 She's gonna be covering for me while I'm gone. 177 00:07:54,515 --> 00:07:55,975 So nice to meet you. 178 00:07:56,058 --> 00:07:57,477 About time they replaced you, Rabbit-bitch. 179 00:07:57,560 --> 00:07:59,270 I'm gonna miss you, too, Yolo. 180 00:07:59,353 --> 00:08:01,606 Dr. Garcia has a hard time expressing her feelings. 181 00:08:01,689 --> 00:08:02,648 Not all of them. 182 00:08:02,732 --> 00:08:06,152 One, two, three. 183 00:08:06,235 --> 00:08:09,489 - Prep for a left thoracotomy. - I'm on it. 184 00:08:09,572 --> 00:08:11,699 What's up, White Chocolate? 185 00:08:11,782 --> 00:08:15,536 Did you know our farm boy here is a vintage-funk freak? 186 00:08:15,620 --> 00:08:17,914 Unfortunately, he also likes to use 187 00:08:17,997 --> 00:08:20,457 - other people's toothbrushes. - It was one time. 188 00:08:20,541 --> 00:08:22,084 They were the same color. 189 00:08:22,168 --> 00:08:24,086 - What's your plan, Samira? - Dr. Mohan, next steps? 190 00:08:24,170 --> 00:08:25,421 Chest tube to the right. 191 00:08:25,505 --> 00:08:27,173 Stand by with massive transfusion protocol. 192 00:08:27,256 --> 00:08:28,466 I put two units on the infuser. 193 00:08:28,549 --> 00:08:29,800 Sterile gloves, 6 1/2. 194 00:08:29,884 --> 00:08:30,885 Here, we let the fellows 195 00:08:30,968 --> 00:08:32,303 and the residents kind of take charge. 196 00:08:32,385 --> 00:08:34,472 I'll hold on to them just in case. 197 00:08:34,554 --> 00:08:37,475 Is the VA even a trauma center? 198 00:08:37,558 --> 00:08:41,062 Not for medic runs, but they walk in-- 199 00:08:41,145 --> 00:08:45,107 falls, major MVCs, GSWs. 200 00:08:45,191 --> 00:08:46,609 Stab wound's on the right. 201 00:08:46,692 --> 00:08:48,194 Why are we opening the left chest? 202 00:08:48,277 --> 00:08:50,112 Better access if it's tamponade, 203 00:08:50,196 --> 00:08:52,031 and you can cross-clamp the aorta. 204 00:08:52,114 --> 00:08:53,658 Javadi, Whitaker, sterile gloves. 205 00:08:53,741 --> 00:08:54,742 Can I glove up? 206 00:08:54,825 --> 00:08:57,328 It's best if you watch the first one. 207 00:08:57,411 --> 00:08:59,080 This guy's dead anyway. 208 00:09:01,082 --> 00:09:04,126 - 10 blade. - 28 French on a long Kelly. 209 00:09:05,336 --> 00:09:06,796 Javadi, you're on suction, 210 00:09:06,879 --> 00:09:09,715 Whitaker, get ready for internal compressions. 211 00:09:11,592 --> 00:09:13,469 Sorry, that's my phone. 212 00:09:15,096 --> 00:09:16,556 Finochietto retractor. 213 00:09:16,639 --> 00:09:17,890 Whitaker, give me a little room. 214 00:09:17,974 --> 00:09:19,141 I need to get to his heart. 215 00:09:19,225 --> 00:09:20,768 I'm in. Hook up the Thora-Seal. 216 00:09:22,270 --> 00:09:23,479 You want me to get that for you? 217 00:09:23,563 --> 00:09:25,648 Not right now. 218 00:09:34,031 --> 00:09:36,075 No tamponade, pretty dry in here. 219 00:09:37,702 --> 00:09:39,203 Heart's empty. 220 00:09:39,287 --> 00:09:40,830 Somebody start cardiac massage, I'll cross-clamp. 221 00:09:40,913 --> 00:09:41,998 Yeah, I got it. 222 00:09:42,081 --> 00:09:43,415 You do these one-handed, 223 00:09:43,499 --> 00:09:45,459 pushing up against the breastbone with four fingers. 224 00:09:45,543 --> 00:09:47,420 - Very good. - Not much blood to suction. 225 00:09:47,503 --> 00:09:50,006 - Okay, team, I think we need-- - Samira, next steps? 226 00:09:50,089 --> 00:09:51,090 Keep transfusing. 227 00:09:51,173 --> 00:09:52,592 - Open the right chest. - That is correct. 228 00:09:52,675 --> 00:09:54,385 Booties on, kids. There will be blood. 229 00:09:56,846 --> 00:09:58,681 Frank? 230 00:10:00,224 --> 00:10:03,269 Langdon. 231 00:10:03,352 --> 00:10:05,438 Frank? 232 00:10:12,570 --> 00:10:14,614 You should be good to go now, hon. 233 00:10:14,697 --> 00:10:16,741 - Thanks, Lupe. - Of course. 234 00:10:16,824 --> 00:10:18,659 Hey, go get 'em. 235 00:10:21,662 --> 00:10:23,998 Hey, Doc. 236 00:10:24,081 --> 00:10:27,001 It's been a while. 237 00:10:27,084 --> 00:10:30,630 I got a-a bad toothache today. 238 00:10:30,713 --> 00:10:33,299 We'll take care of that, Louie. 239 00:10:33,382 --> 00:10:34,717 All right. 240 00:11:08,084 --> 00:11:10,252 There's too much blood to suction. 241 00:11:10,336 --> 00:11:12,254 Uh, retracting the lung. 242 00:11:12,338 --> 00:11:14,632 - Try to identify the source. - Could be the right ventricle. 243 00:11:14,715 --> 00:11:16,592 Or more likely, the hilum. 244 00:11:16,676 --> 00:11:18,344 Fresh lap pads. 245 00:11:19,720 --> 00:11:23,015 Siri, turn on silent mode! 246 00:12:13,607 --> 00:12:15,109 Good morning. 247 00:12:15,192 --> 00:12:16,861 If it was a good morning, I'd still be in bed. 248 00:12:16,944 --> 00:12:18,529 So what are you doing here? 249 00:12:18,612 --> 00:12:20,531 Benji's mom is visiting for the holiday. 250 00:12:20,614 --> 00:12:22,533 - She's still alive? - That woman's too mean to die. 251 00:12:22,616 --> 00:12:24,160 Plus, who else is going to get this place 252 00:12:24,243 --> 00:12:25,953 through the Fourth of July weekend? 253 00:12:26,036 --> 00:12:27,747 Sure as hell ain't going to be me. 254 00:12:27,830 --> 00:12:30,082 I rest my case. What am I walking into? 255 00:12:30,166 --> 00:12:31,667 Nothing too bad, yet. 256 00:12:31,751 --> 00:12:33,878 Uh, these are the ones I'd keep an eye on. 257 00:12:35,796 --> 00:12:38,674 The prodigal son returns. 258 00:12:38,758 --> 00:12:39,842 Too soon? 259 00:12:39,925 --> 00:12:42,303 No, I guess not. 260 00:12:42,386 --> 00:12:44,972 - You're back. - I took some time. 261 00:12:45,055 --> 00:12:48,184 I'm like an old trail horse-- I always find my way back home. 262 00:12:48,267 --> 00:12:49,935 You look good, kid. How you feeling? 263 00:12:50,019 --> 00:12:51,896 Uh, yeah, great. 264 00:12:51,979 --> 00:12:54,482 You know, it's been a... 265 00:12:54,565 --> 00:12:56,984 - it's been a journey. - I bet. 266 00:12:57,067 --> 00:12:58,652 Thanks. Robby around? 267 00:12:58,736 --> 00:13:00,571 Uh, he's in with a trauma. 268 00:13:00,654 --> 00:13:02,990 But if you hurry back, you can catch some of the pass-ons. 269 00:13:03,073 --> 00:13:05,284 - They're in North. - Uh, thanks. 270 00:13:07,077 --> 00:13:09,079 I'll keep an eye on him. 271 00:13:11,207 --> 00:13:13,417 I think we have a lost little lamb. 272 00:13:13,501 --> 00:13:16,045 Uh, excuse me, hon. Can we help you? 273 00:13:16,128 --> 00:13:18,005 I'm looking for the charge nurse. 274 00:13:18,088 --> 00:13:20,090 Oh, well, you found two of 'em. 275 00:13:20,174 --> 00:13:21,509 I'm Lena. This is Dana. 276 00:13:21,592 --> 00:13:22,802 I'm night shift, going home, 277 00:13:22,885 --> 00:13:25,137 but Dana is queen of the day shift. 278 00:13:25,221 --> 00:13:27,223 Emma Nolan. Nice to meet you both. 279 00:13:27,306 --> 00:13:29,683 Uh, I'm a new grad RN here to shadow. 280 00:13:29,767 --> 00:13:31,227 Welcome to the Pitt, Emma Nolan. 281 00:13:31,310 --> 00:13:32,937 Here, let me put some of your stuff behind the desk, 282 00:13:33,020 --> 00:13:35,731 - and I'll give you a quick tour. - Okay. 283 00:13:35,815 --> 00:13:38,234 - Where you from, sweetheart? - Sault Ste. Marie. 284 00:13:38,317 --> 00:13:39,693 Oh. 285 00:13:39,777 --> 00:13:42,238 It's in Upper Michigan, practically Canada. 286 00:13:42,321 --> 00:13:45,074 My great-grandmother was from up that way-- 287 00:13:45,157 --> 00:13:48,244 nice area, a lot of bugs. 288 00:13:48,327 --> 00:13:50,079 How about a cup of coffee? 289 00:13:51,539 --> 00:13:53,040 Can't locate the source. 290 00:13:53,123 --> 00:13:54,834 Proximal hilum is under the sternum. 291 00:13:54,917 --> 00:13:56,836 Along with most of the right ventricle. 292 00:13:56,919 --> 00:13:59,630 - You need better exposure. - Convert to a clamshell. 293 00:13:59,713 --> 00:14:02,049 - Exactly. - Trauma shears. 294 00:14:02,132 --> 00:14:04,677 Would've been nice to let them come up with that plan. 295 00:14:04,760 --> 00:14:06,762 Heart's going to need double compressions just like this. 296 00:14:08,222 --> 00:14:10,599 Squeeze from the apex to the aorta. 297 00:14:12,226 --> 00:14:13,769 Right ventricle looks good. 298 00:14:13,853 --> 00:14:15,187 Massive hemorrhage from the hilum. 299 00:14:15,271 --> 00:14:18,732 Second MTP pack is going, additional four units. 300 00:14:18,816 --> 00:14:21,151 Hilar injury looks very proximal-- 301 00:14:21,235 --> 00:14:23,362 may be pulmonary artery and vein. 302 00:14:23,445 --> 00:14:26,073 Clamp's on. Nope, no good. 303 00:14:26,156 --> 00:14:27,575 Still bleeding like a stuck pig. 304 00:14:27,658 --> 00:14:28,576 I can give it a try. 305 00:14:28,659 --> 00:14:29,952 Dr. Garcia is a very skilled surgeon. 306 00:14:30,035 --> 00:14:31,620 If she can't get it, we need to think of something else. 307 00:14:31,704 --> 00:14:32,872 Like what? 308 00:14:36,375 --> 00:14:37,793 Hilar flip. 309 00:14:37,877 --> 00:14:39,461 We're going to rotate the lung 180 degrees, 310 00:14:39,545 --> 00:14:41,088 like putting a kink in the garden hose. 311 00:14:41,171 --> 00:14:43,841 - It'll stop the bleeding. - That could possibly work. 312 00:14:43,924 --> 00:14:47,595 Or he'll die when you rip the entire lung off the hilum. 313 00:14:47,678 --> 00:14:50,431 Gently, very, very gently, very, very slowly. 314 00:15:06,155 --> 00:15:07,907 - Blood loss is slowing down. - That's a good sign. 315 00:15:07,990 --> 00:15:09,199 Hilum looks dry. 316 00:15:09,283 --> 00:15:11,035 Yeah, but the heart feels empty. 317 00:15:11,118 --> 00:15:13,579 Okay, we fixed the leak. Now let's fill the tank. 318 00:15:15,831 --> 00:15:17,833 You are very popular today. 319 00:15:17,917 --> 00:15:20,669 Sorry, I'll turn it off when I can. 320 00:15:24,882 --> 00:15:26,508 Nine-year-old Kylie Connors-- 321 00:15:26,592 --> 00:15:28,719 brought in by her dad's girlfriend, Gina. 322 00:15:28,802 --> 00:15:31,138 Kylie took a tumble on the stairs this morning. 323 00:15:31,221 --> 00:15:34,099 3-centimeter chin lac and a chipped front incisor. 324 00:15:34,183 --> 00:15:36,060 She's got LET on a pressure dressing. 325 00:15:36,143 --> 00:15:37,895 Bleeding pretty good on arrival. 326 00:15:37,978 --> 00:15:40,064 Dermabond should do the trick. 327 00:15:40,147 --> 00:15:42,107 Any questions? 328 00:15:42,191 --> 00:15:44,526 Dr. King? 329 00:15:44,610 --> 00:15:45,945 Mel? 330 00:15:46,028 --> 00:15:48,614 Oh, um, I didn't say anything. 331 00:15:51,450 --> 00:15:54,161 - Uh, how you feeling, Kylie? - Tired. 332 00:15:54,244 --> 00:15:56,956 - We've been here since 5:30. - Oh, that makes two of us. 333 00:15:57,039 --> 00:15:59,333 But don't worry. We'll patch you up good as new. 334 00:15:59,415 --> 00:16:01,961 And we will get you out of here as soon as we can. 335 00:16:02,044 --> 00:16:03,379 - Any questions? - Can you raise your chin? 336 00:16:03,462 --> 00:16:05,255 No, I'm just her dad's girlfriend, 337 00:16:05,339 --> 00:16:07,299 - so I'm new to all this. - No worries. We got you. 338 00:16:07,383 --> 00:16:08,634 Next. 339 00:16:10,260 --> 00:16:14,056 26-year-old Liam Sanders-- took a fall from his bicycle. 340 00:16:14,139 --> 00:16:16,183 No LOC, nonfocal neuro, 341 00:16:16,266 --> 00:16:18,477 lower-leg lac with no bony tenderness. 342 00:16:18,560 --> 00:16:20,312 Were you wearing a helmet, Liam? 343 00:16:20,396 --> 00:16:22,231 No, I was just riding in my neighborhood. 344 00:16:22,314 --> 00:16:23,983 You should always wear a helmet. 345 00:16:24,066 --> 00:16:25,484 Hey, nice of you to join us. 346 00:16:25,567 --> 00:16:27,653 - Hey. - Dr. Langdon! 347 00:16:30,114 --> 00:16:32,825 Sold to Dr. Langdon. 348 00:16:32,908 --> 00:16:35,160 Candace O'Grady, 82... 349 00:16:35,244 --> 00:16:39,415 Brought in by her son Richard for intractable vomiting. 350 00:16:41,290 --> 00:16:43,002 Hardly any hemorrhage on the right. 351 00:16:43,085 --> 00:16:44,461 - Looks like the flip worked. - How's the heart, Whitaker? 352 00:16:44,545 --> 00:16:46,422 Feels full of blood. First time since we started. 353 00:16:46,505 --> 00:16:50,342 Hold compressions. 354 00:16:50,426 --> 00:16:53,012 - Quivering bag of worms. - Resume compressions. 355 00:16:53,095 --> 00:16:55,514 When the heart quivers like that, it's obvious V-fib. 356 00:16:55,597 --> 00:16:58,809 - Okay, internal paddles ready. - Mm-hmm. Charge to...? 357 00:16:58,892 --> 00:17:00,602 - 25 joules. - 50 joules. 358 00:17:00,686 --> 00:17:02,521 50 gets it right the first time. 359 00:17:02,604 --> 00:17:04,690 Charged. 360 00:17:04,772 --> 00:17:05,983 Okay, Whitaker, when you're ready. 361 00:17:06,066 --> 00:17:08,068 Clear. 362 00:17:10,695 --> 00:17:12,781 That's what normal sinus looks like. 363 00:17:14,616 --> 00:17:15,617 Strong carotid. 364 00:17:15,701 --> 00:17:18,746 Saline lap pads and up to the OR. 365 00:17:18,829 --> 00:17:21,040 That's a hell of a way to start the day. 366 00:17:21,123 --> 00:17:24,877 Unconventional, but a decent outcome. 367 00:17:24,960 --> 00:17:27,212 Why don't we split up for efficiency? 368 00:17:27,296 --> 00:17:29,631 Residents present to either one of us but not both. 369 00:17:31,133 --> 00:17:33,093 We can certainly discuss that. 370 00:17:37,598 --> 00:17:39,475 Were you feeling weak or dizzy? 371 00:17:39,558 --> 00:17:40,851 No. 372 00:17:40,934 --> 00:17:42,561 I-I got up to pee, and I tripped over 373 00:17:42,644 --> 00:17:44,605 a laundry basket that I couldn't see in the dark. 374 00:17:44,688 --> 00:17:46,148 Did you hit your head? 375 00:17:46,231 --> 00:17:48,067 Does my chart say that I hit my head? 376 00:17:48,150 --> 00:17:50,277 No, we just want to be thorough 377 00:17:50,360 --> 00:17:52,529 to make sure you don't miss anything. 378 00:17:52,613 --> 00:17:54,865 How about we focus on patching me up? 379 00:17:54,948 --> 00:17:56,492 Ah! 380 00:17:56,575 --> 00:17:58,494 All right, Mr. Williams, 381 00:17:58,577 --> 00:18:00,287 we're going to check an X-ray of your wrist 382 00:18:00,370 --> 00:18:02,498 and try to get you out of here as quickly as possible. 383 00:18:02,581 --> 00:18:05,000 Great. And let's keep the bullshit extra charges 384 00:18:05,084 --> 00:18:06,502 to a minimum, huh? 385 00:18:06,585 --> 00:18:08,796 My deductible is already a bitch. 386 00:18:11,381 --> 00:18:13,175 Sure. 387 00:18:34,905 --> 00:18:36,240 Bye. 388 00:18:36,323 --> 00:18:38,700 My mother is trying to destroy my life. 389 00:18:38,784 --> 00:18:40,869 Yeah, they seem to take pleasure in that. 390 00:18:40,953 --> 00:18:42,704 I committed to a partnership-track position 391 00:18:42,788 --> 00:18:44,540 next year at a hospital back in Jersey 392 00:18:44,623 --> 00:18:46,542 so I could be close and support her. 393 00:18:46,625 --> 00:18:49,545 But now she's getting married and selling our house 394 00:18:49,628 --> 00:18:52,089 to go on a year-long cruise around the world. 395 00:18:52,172 --> 00:18:54,675 Wow. I mean, that's a-- 396 00:18:54,758 --> 00:18:56,635 Pretty fucking stupid idea, if you ask me. 397 00:18:56,718 --> 00:18:58,720 She's known this guy less than a year. 398 00:18:58,804 --> 00:19:02,099 What if he's a player? What if she disappears at sea? 399 00:19:02,182 --> 00:19:03,851 I mean, what if they're in love? 400 00:19:03,934 --> 00:19:05,519 Lust is more like it. 401 00:19:05,602 --> 00:19:08,647 That is even better. 402 00:19:08,730 --> 00:19:11,942 Man, it has been a while, 403 00:19:12,025 --> 00:19:15,362 and I'm solo this weekend. 404 00:19:15,445 --> 00:19:17,656 I need to get laid. 405 00:19:21,577 --> 00:19:23,620 It's a little much before 8:00 a.m., right? 406 00:19:23,704 --> 00:19:25,497 Yeah. 407 00:19:27,040 --> 00:19:28,792 Or ever. 408 00:19:34,256 --> 00:19:35,757 How's it going, Esme? 409 00:19:35,841 --> 00:19:38,051 Oh, just another day in paradise. 410 00:19:55,277 --> 00:19:57,946 Heard you're going on a trip. 411 00:19:58,030 --> 00:20:00,199 Taking a sabbatical. Leave tonight. 412 00:20:00,282 --> 00:20:02,034 Where you going? 413 00:20:02,117 --> 00:20:05,871 Um, Head-Smashed-In Buffalo Jump. 414 00:20:05,954 --> 00:20:08,665 Captain Crunch flying squirrel socks. 415 00:20:08,749 --> 00:20:11,960 What, are we talking in code, or are you having a stroke? 416 00:20:12,044 --> 00:20:15,422 It's an Aboriginal UNESCO Heritage Site in Alberta. 417 00:20:15,505 --> 00:20:17,424 I've never seen the Badlands. 418 00:20:17,507 --> 00:20:20,636 What is this, like, uh, some sort of spirit quest? 419 00:20:20,719 --> 00:20:23,931 Uh, yeah, something like that. 420 00:20:24,014 --> 00:20:26,558 Look, I, uh-- I guess we should talk. 421 00:20:26,642 --> 00:20:28,894 - Got a lot of things I need to-- - At some point, not right now. 422 00:20:28,977 --> 00:20:30,562 Right now I got to hit the head, 423 00:20:30,646 --> 00:20:32,564 and I would like you to go help Donnie out in Triage. 424 00:20:32,648 --> 00:20:33,941 Triage? 425 00:20:34,024 --> 00:20:35,484 N-no. 426 00:20:35,567 --> 00:20:37,194 No, I already picked up a patient in North 2, 427 00:20:37,277 --> 00:20:38,612 a bicycle fall leg lac, so maybe-- 428 00:20:38,695 --> 00:20:39,738 Pretty sure we can cover for you. 429 00:20:39,821 --> 00:20:43,033 We've been doing it for months. 430 00:20:43,116 --> 00:20:44,618 Right. 431 00:20:44,701 --> 00:20:47,204 No, and I--and I am-- I am very, uh-- 432 00:20:47,287 --> 00:20:48,914 both very sorry and appreciative of that. 433 00:20:48,997 --> 00:20:50,415 I just would hate to think 434 00:20:50,499 --> 00:20:53,085 that this is some kind of a punishment for... 435 00:20:53,168 --> 00:20:55,045 but, uh, yeah. Yeah. No, for sure. 436 00:20:55,128 --> 00:20:58,674 We'll--we'll talk later, before you go. 437 00:20:58,757 --> 00:21:01,134 Like I said, not right now. 438 00:21:01,218 --> 00:21:03,512 Donnie just passed his NP certification. 439 00:21:03,595 --> 00:21:05,472 He can help if you get in over your head. 440 00:21:08,976 --> 00:21:10,852 Hey, Mel... 441 00:21:10,936 --> 00:21:13,730 can you take over a bike fall leg lac in North 2 442 00:21:13,814 --> 00:21:15,607 for Langdon while he's out in Triage? 443 00:21:15,691 --> 00:21:17,401 Um, you know, I-I can work in Triage if you want-- 444 00:21:17,484 --> 00:21:19,278 No, I want to keep Langdon out in Triage, 445 00:21:19,361 --> 00:21:20,988 and I want to keep you back here. 446 00:21:21,071 --> 00:21:23,490 - You okay with that? - Sure. 447 00:21:23,573 --> 00:21:25,534 - Great. - Absolutely. 448 00:21:31,581 --> 00:21:33,208 So... 449 00:21:33,292 --> 00:21:35,460 who should I pick up? 450 00:21:35,544 --> 00:21:37,504 We're about to get the morning rush. 451 00:21:37,587 --> 00:21:38,714 What do you mean? 452 00:21:38,797 --> 00:21:40,215 Every morning around this time, 453 00:21:40,299 --> 00:21:42,634 the nursing homes and assisted-living facilities 454 00:21:42,718 --> 00:21:45,387 - do their morning bed checks. - Uh-huh. 455 00:21:48,181 --> 00:21:50,684 It looks pretty quiet to me. 456 00:21:53,979 --> 00:21:56,106 Huh. 457 00:21:56,189 --> 00:21:57,816 Incoming. 458 00:21:57,899 --> 00:21:59,526 Oh, like I said. 459 00:21:59,609 --> 00:22:01,069 Come on. 460 00:22:01,153 --> 00:22:02,612 Ethan Bostick, 79-- 461 00:22:02,696 --> 00:22:04,698 found altered this morning at assisted living. 462 00:22:04,781 --> 00:22:06,033 No history of dementia. 463 00:22:06,116 --> 00:22:07,909 - Has a POLST. - What's a POLST? 464 00:22:07,993 --> 00:22:10,537 Physician Orders for Life-Sustaining Treatment-- 465 00:22:10,620 --> 00:22:12,998 no CPR, no intubation. 466 00:22:13,081 --> 00:22:15,083 Then there's-- there's nothing for us to do. 467 00:22:15,167 --> 00:22:16,918 South 15 is open. 468 00:22:17,002 --> 00:22:19,921 Uh, well, "do not resuscitate" does not mean "do not treat." 469 00:22:20,005 --> 00:22:24,092 He may perk up with fluids, IV antibiotics. 470 00:22:28,638 --> 00:22:29,848 What's the good word, Crash? 471 00:22:29,931 --> 00:22:32,184 You save that ventriloquist dummy? 472 00:22:32,267 --> 00:22:33,935 - Yeah. - Really? 473 00:22:34,019 --> 00:22:36,355 No. 474 00:22:36,438 --> 00:22:38,357 Wait, tell me you're not actually charting 475 00:22:38,440 --> 00:22:40,567 - about losing a mannequin. - It's part of the exercise. 476 00:22:40,650 --> 00:22:42,361 Dr. Al-Hashimi asked us to do it. 477 00:22:42,444 --> 00:22:44,363 Who's his next of kin-- Barbie? 478 00:22:46,031 --> 00:22:49,951 What's your, uh, take on the new attending? 479 00:22:50,035 --> 00:22:51,661 Too soon to tell. 480 00:22:53,622 --> 00:22:54,873 You? 481 00:22:54,956 --> 00:22:56,166 She's already bugging me 482 00:22:56,249 --> 00:22:57,793 about being behind on my charting. 483 00:22:57,876 --> 00:22:59,461 Now I know why everyone says 484 00:22:59,544 --> 00:23:01,713 being a second-year resident sucks--because it does. 485 00:23:01,797 --> 00:23:03,548 I must've slept through the part of med school 486 00:23:03,632 --> 00:23:06,385 where they tell you 90% of your time will be spent typing. 487 00:23:06,468 --> 00:23:07,969 Which is just one more reason 488 00:23:08,053 --> 00:23:10,180 surgery is a better lifestyle choice. 489 00:23:10,263 --> 00:23:13,183 Hey, Dr. Shamsi. Dr. Trinity Santos. 490 00:23:13,266 --> 00:23:15,394 Ah, yes, the ER intern who's interested 491 00:23:15,477 --> 00:23:17,396 - in my surgery program. - That's me. 492 00:23:17,479 --> 00:23:19,981 But I'm an R2 now and thinking of double boarding 493 00:23:20,065 --> 00:23:21,817 in surgery and emergency medicine, 494 00:23:21,900 --> 00:23:24,319 which I know would sound ridiculously ambitious 495 00:23:24,403 --> 00:23:26,655 if I didn't have the talent to back it up. 496 00:23:26,738 --> 00:23:28,281 And the required attitude. 497 00:23:29,950 --> 00:23:31,618 Are you here to see a patient? 498 00:23:31,701 --> 00:23:33,412 I was. I did. 499 00:23:33,495 --> 00:23:34,788 And now I'm here to learn 500 00:23:34,871 --> 00:23:37,416 why you aren't returning my calls or texts. 501 00:23:37,499 --> 00:23:39,000 Okay, I'm out. 502 00:23:39,084 --> 00:23:41,086 Nice seeing you again, Dr. Shamsi. 503 00:23:41,169 --> 00:23:42,671 As soon as I get a little free time, 504 00:23:42,754 --> 00:23:44,756 I will make plans for all of us to do something together. 505 00:23:44,840 --> 00:23:46,633 - What about Tuesday? - I'm working. 506 00:23:46,716 --> 00:23:48,510 On your birthday? 507 00:23:48,593 --> 00:23:50,262 I will call you and Dad tomorrow, 508 00:23:50,345 --> 00:23:52,013 and we'll come up with something to do together, I promise. 509 00:23:52,097 --> 00:23:54,015 But right now I actually have 510 00:23:54,099 --> 00:23:56,309 a bunch of night-shift hand-offs. 511 00:24:03,442 --> 00:24:07,112 We have schedules. You have chaos. 512 00:24:07,195 --> 00:24:09,239 You know she's wasting her talents down here. 513 00:24:09,322 --> 00:24:12,242 Victoria is a big girl. She can make her own decisions. 514 00:24:12,325 --> 00:24:15,829 She's also a young girl who's still very impressionable. 515 00:24:15,912 --> 00:24:18,874 - And you can be very... - "Pressionable"? 516 00:24:21,543 --> 00:24:22,836 Yes? 517 00:24:22,919 --> 00:24:24,212 Who? 518 00:24:24,296 --> 00:24:25,672 Who? 519 00:24:25,755 --> 00:24:28,467 Oh, for God's sake. I'll be right there. 520 00:24:28,550 --> 00:24:30,969 We need to talk. 521 00:24:31,052 --> 00:24:33,346 How about same time tomorrow? 522 00:24:35,974 --> 00:24:37,726 Next Tuesday's your birthday? 523 00:24:37,809 --> 00:24:39,978 No. 524 00:24:40,061 --> 00:24:42,272 - Yes. - Your 21st birthday? 525 00:24:42,355 --> 00:24:43,690 Please don't say anything, okay? 526 00:24:43,773 --> 00:24:45,066 I-I get a little anxious about-- 527 00:24:45,150 --> 00:24:46,568 Dr. Santos, little girl with the chin lac 528 00:24:46,651 --> 00:24:48,069 is getting into a gown. 529 00:24:48,153 --> 00:24:50,697 Don't want anyone to know what? 530 00:24:50,780 --> 00:24:52,991 Nothing. 531 00:24:53,074 --> 00:24:55,202 - Have a good day. - You too. 532 00:24:56,953 --> 00:24:57,996 Oh. 533 00:24:59,414 --> 00:25:02,083 Hey, Duke, I'm just calling to remind you 534 00:25:02,167 --> 00:25:05,086 that this is my last shift for a while. 535 00:25:05,170 --> 00:25:07,631 So I need you to come in before 3:00 536 00:25:07,714 --> 00:25:11,092 in case we need to run some tests. 537 00:25:11,176 --> 00:25:13,803 Okay? We had a deal, brother. 538 00:25:15,889 --> 00:25:17,933 - Oh. Hello. - Hi. 539 00:25:18,016 --> 00:25:20,101 - I know you're crazy busy. - Always. 540 00:25:20,185 --> 00:25:22,187 But I figured we should really go over a few things 541 00:25:22,270 --> 00:25:23,730 - before you're gone. - Sure. 542 00:25:23,813 --> 00:25:25,815 Where would you like to start? 543 00:25:25,899 --> 00:25:27,526 Well, one little thing that I think 544 00:25:27,609 --> 00:25:30,111 would have a big impact with staff and patients alike 545 00:25:30,195 --> 00:25:31,947 is if we launched a campaign 546 00:25:32,030 --> 00:25:35,116 to eradicate referring to this wonderful department 547 00:25:35,200 --> 00:25:37,744 - as the Pitt. - Really? 548 00:25:37,827 --> 00:25:39,746 I know you think it's silly and petty. 549 00:25:39,829 --> 00:25:41,748 No, I think it's just kind of endearing, 550 00:25:41,831 --> 00:25:45,627 - pretty damn accurate. - I would argue the opposite. 551 00:25:45,710 --> 00:25:48,129 I think subconsciously it affects those who work here. 552 00:25:48,213 --> 00:25:49,756 It also lowers expectations, 553 00:25:49,839 --> 00:25:52,133 which in turn lowers patient-satisfaction scores. 554 00:25:52,217 --> 00:25:53,969 You have been talking to Gloria. 555 00:25:54,052 --> 00:25:57,389 - Yes, and she agrees with me. - Don't doubt that for a moment. 556 00:25:57,472 --> 00:25:59,266 You have to see the man over there right now! 557 00:25:59,349 --> 00:26:01,851 We see people in order of severity, ma'am. 558 00:26:05,313 --> 00:26:06,731 I don't know what you're saying. 559 00:26:06,815 --> 00:26:09,067 I can taste the shit in the back of my throat. 560 00:26:09,150 --> 00:26:10,360 Actually, the lady's right. 561 00:26:10,443 --> 00:26:11,987 He's going to make all of us sick. 562 00:26:12,070 --> 00:26:13,071 Yes, please. 563 00:26:19,953 --> 00:26:21,454 All right. 564 00:26:21,538 --> 00:26:22,998 We'll get him back. 565 00:26:23,081 --> 00:26:25,417 Tell Dana we're bringing the funk. 566 00:26:25,500 --> 00:26:27,502 - Oh, my God. - Whew! 567 00:26:28,378 --> 00:26:30,797 So when did your eye start bothering you, Ms. Mathews? 568 00:26:30,880 --> 00:26:32,841 Sister Grace, please. 569 00:26:32,924 --> 00:26:34,884 I'm only married to God. 570 00:26:34,968 --> 00:26:36,595 Of course, I'm sorry. 571 00:26:36,678 --> 00:26:40,181 A few days ago. I thought it was pink eye 572 00:26:40,265 --> 00:26:42,392 or maybe I scratched it while gardening. 573 00:26:42,475 --> 00:26:44,603 It's a very bad case of conjunctivitis. 574 00:26:44,686 --> 00:26:46,396 We should send a sample to the lab 575 00:26:46,479 --> 00:26:47,856 to direct our treatment. 576 00:26:47,939 --> 00:26:49,774 Look up for me. Thank you. 577 00:26:53,028 --> 00:26:55,822 Okay, I'll put a numbing drop in your eye 578 00:26:55,905 --> 00:26:58,908 and check for a scratch with a special lamp. 579 00:27:01,911 --> 00:27:03,830 And I'll get you to look up for me again. 580 00:27:03,913 --> 00:27:05,624 Thank you. 581 00:27:05,707 --> 00:27:08,126 Have you ever considered serving God? 582 00:27:08,209 --> 00:27:09,294 Which one? 583 00:27:09,377 --> 00:27:11,630 Excuse me? 584 00:27:11,713 --> 00:27:13,423 My family is Hindu, 585 00:27:13,506 --> 00:27:16,217 so we have, like, 33 different kinds of deities. 586 00:27:16,301 --> 00:27:18,470 Oh, we have the one. 587 00:27:18,553 --> 00:27:21,514 Some people only need one, right? 588 00:27:21,598 --> 00:27:23,016 Okay. 589 00:27:25,226 --> 00:27:28,021 Most important rule around here--be smart, be safe. 590 00:27:28,104 --> 00:27:30,065 I can't warn you enough about protecting yourself 591 00:27:30,148 --> 00:27:31,483 and your fellow nurses. 592 00:27:31,566 --> 00:27:33,943 We use the STAMP acronym to assess patients. 593 00:27:34,027 --> 00:27:35,362 You know it? 594 00:27:35,445 --> 00:27:37,906 Uh, S is for staring or refusal to make eye contact. 595 00:27:37,989 --> 00:27:39,574 If they're staring, they're scaring. 596 00:27:39,658 --> 00:27:41,117 - T? - Tone of voice. 597 00:27:41,201 --> 00:27:43,495 Often the threat level rises with their voice. 598 00:27:43,578 --> 00:27:44,954 A is for anxiety. 599 00:27:45,038 --> 00:27:46,623 You can also think "aggression." 600 00:27:46,706 --> 00:27:47,999 M is mumbling. 601 00:27:48,083 --> 00:27:49,250 Which, if you listen closely enough, 602 00:27:49,334 --> 00:27:50,919 is often them saying what they're thinking of doing 603 00:27:51,002 --> 00:27:52,587 as they talk themselves up to it. 604 00:27:52,671 --> 00:27:54,130 - And P? - Pacing. 605 00:27:54,214 --> 00:27:55,507 Good. 606 00:27:55,590 --> 00:27:57,467 We also have a safe word-- "hula hoop." 607 00:27:57,550 --> 00:27:59,260 I guess technically it's two words, but whatever. 608 00:27:59,344 --> 00:28:01,262 If there's a threat, say "hula hoop," 609 00:28:01,346 --> 00:28:04,683 and we'll all respond. 610 00:28:04,766 --> 00:28:06,267 Yeah? 611 00:28:06,351 --> 00:28:07,727 Lovely. 612 00:28:07,811 --> 00:28:11,898 Okay, I'll be right there with reinforcements. 613 00:28:11,981 --> 00:28:14,776 Duty calls. We're headed for Triage. 614 00:28:20,573 --> 00:28:22,450 We're going to get your cast off-- 615 00:28:41,594 --> 00:28:44,222 The antibiotics should clear everything up, 616 00:28:44,305 --> 00:28:47,142 but you should try to stay off it for a few days. 617 00:28:47,225 --> 00:28:50,520 Uh, I have to work. I'm late as it is. 618 00:28:50,603 --> 00:28:54,524 Well, um, take breaks and elevate when you can. 619 00:28:54,607 --> 00:28:56,359 Tylenol and Advil for the pain. 620 00:28:56,443 --> 00:28:59,112 If the pain persists or feel like it's getting worse, 621 00:28:59,195 --> 00:29:00,321 come on back. 622 00:29:00,405 --> 00:29:02,657 - We'll get you fixed up. - Thanks. 623 00:29:02,741 --> 00:29:05,702 They said give this to the doctor. 624 00:29:05,785 --> 00:29:08,747 - What the hell is it? - Patient passport. 625 00:29:08,830 --> 00:29:10,749 Lets patients know what they're waiting for 626 00:29:10,832 --> 00:29:12,250 and how long it'll take. 627 00:29:12,333 --> 00:29:14,544 You check off if he needs labs, X-rays, CT. 628 00:29:14,627 --> 00:29:16,504 None of the above. When did we start this? 629 00:29:16,588 --> 00:29:18,548 Today, the new attending. 630 00:29:20,383 --> 00:29:22,635 What's up with your tooth, Louie? 631 00:29:22,719 --> 00:29:25,346 It's been going on for a while, 632 00:29:25,430 --> 00:29:27,348 but it got bad last night. 633 00:29:27,432 --> 00:29:29,976 Lower-left side. 634 00:29:30,059 --> 00:29:32,145 Okay. 635 00:29:32,228 --> 00:29:35,607 Oh, yeah. 636 00:29:35,690 --> 00:29:37,484 It could be an infection at the root. 637 00:29:37,567 --> 00:29:40,653 We can drain it, but then... 638 00:29:40,737 --> 00:29:42,822 you're, uh--you're breathing kind of fast. 639 00:29:42,906 --> 00:29:44,741 Yeah, I've been-- 640 00:29:44,824 --> 00:29:48,203 well, I've been, uh, walking more, 641 00:29:48,286 --> 00:29:49,871 trying to get in shape. 642 00:29:49,954 --> 00:29:52,707 But sometimes I get a little short of breath. 643 00:29:52,791 --> 00:29:55,752 Yeah, you need to walk past the liquor store, not into it. 644 00:29:55,835 --> 00:29:58,379 Only shape you're getting in is for a liver transplant. 645 00:29:58,463 --> 00:30:01,382 I don't need a new liver. Just get rid of this toothache. 646 00:30:01,466 --> 00:30:02,801 Deep breath. 647 00:30:06,679 --> 00:30:08,223 One more. 648 00:30:08,306 --> 00:30:10,809 - Is my heart still ticking? - Like a jackrabbit. 649 00:30:10,892 --> 00:30:14,062 - How long you been sitting down? - Oh, just for a few minutes. 650 00:30:14,145 --> 00:30:15,605 Not that long. 651 00:30:15,688 --> 00:30:17,482 Um, Louie... 652 00:30:19,317 --> 00:30:21,486 There's something I need to tell you. 653 00:30:23,863 --> 00:30:27,033 Last time I saw you, about ten months ago, 654 00:30:27,116 --> 00:30:31,830 I treated you, and I took some of your medicine. 655 00:30:31,913 --> 00:30:34,916 I'm not sure I follow. 656 00:30:34,999 --> 00:30:37,585 I have an addiction to benzos, 657 00:30:37,669 --> 00:30:41,256 and I helped myself to some of the Librium I prescribed you 658 00:30:41,339 --> 00:30:42,882 for your withdrawal. 659 00:30:42,966 --> 00:30:44,843 You stole my pills? 660 00:30:46,594 --> 00:30:48,012 Yeah. 661 00:30:48,096 --> 00:30:50,515 Yes, um... 662 00:30:50,598 --> 00:30:53,142 I'm sorry. It was, uh... 663 00:30:53,226 --> 00:30:56,062 it was not only wrong and utterly unprofessional, 664 00:30:56,145 --> 00:30:58,815 but it was a betrayal of my Hippocratic Oath, 665 00:30:58,898 --> 00:31:02,068 and it was a fucking crime. 666 00:31:02,151 --> 00:31:06,531 That's where I've been-- rehab and counseling. 667 00:31:08,366 --> 00:31:10,869 - Huh. - I'm sorry. 668 00:31:10,952 --> 00:31:13,788 I-I understand if you'd prefer a different doctor. 669 00:31:13,872 --> 00:31:17,208 Hey, Doc, we have a situation. 670 00:31:17,292 --> 00:31:19,669 Excuse me. 671 00:31:19,752 --> 00:31:21,087 What kind of situation? 672 00:31:21,170 --> 00:31:23,673 Someone left a little baby in the restroom. 673 00:31:31,931 --> 00:31:33,766 Okay, let's think 674 00:31:33,850 --> 00:31:36,686 about reversible causes of confusion in the elderly. 675 00:31:36,769 --> 00:31:40,315 Uh, hypo or hypernatremia, infection, but he's afebrile, 676 00:31:40,398 --> 00:31:42,233 good O2 sats, and urine dip is negative. 677 00:31:42,317 --> 00:31:46,321 Yeah, great. Joy, anything to add? 678 00:31:46,404 --> 00:31:48,907 Nah. 679 00:31:48,990 --> 00:31:51,409 - V-tach. Can I-- - Yeah. 680 00:31:53,202 --> 00:31:55,038 No pulse. Should we call for a code blue? 681 00:31:55,121 --> 00:31:59,042 No CPR, no shock, we honor his POLST and his wishes. 682 00:31:59,125 --> 00:32:02,629 So what does that leave us? 683 00:32:02,712 --> 00:32:05,256 Making sure he's comfortable. 684 00:32:05,340 --> 00:32:06,799 I'll suction. 685 00:32:06,883 --> 00:32:09,010 Altered mental in the elderly can also be 686 00:32:09,093 --> 00:32:13,473 toxicity from anticholinergics, sedative-hypnotics, opioids. 687 00:32:14,974 --> 00:32:17,143 A-am I missing something? 688 00:32:17,226 --> 00:32:19,228 Social skills? 689 00:32:19,312 --> 00:32:21,522 What? 690 00:32:24,150 --> 00:32:25,401 He looks so peaceful. 691 00:32:25,485 --> 00:32:26,611 Shouldn't we go find a new patient? 692 00:32:26,694 --> 00:32:29,238 No, stay here. 693 00:32:31,115 --> 00:32:33,117 Asystole. 694 00:32:42,085 --> 00:32:44,295 Quick and painless. 695 00:32:44,379 --> 00:32:46,089 We should all be so lucky. 696 00:32:46,172 --> 00:32:48,174 I'll try to contact some family. 697 00:32:49,842 --> 00:32:53,262 Yeah, one of the things we like to do here... 698 00:32:56,182 --> 00:32:58,142 When we have the time... 699 00:32:58,226 --> 00:33:00,979 is to take a moment of silence when we lose a patient 700 00:33:01,062 --> 00:33:03,398 to respect their humanity. 701 00:33:03,481 --> 00:33:07,527 He was someone's son, perhaps a father himself, 702 00:33:07,610 --> 00:33:10,071 a brother or a friend. 703 00:33:12,865 --> 00:33:16,244 Oh, uh, make sure your phones are on silent. 704 00:33:20,415 --> 00:33:23,001 Great, great, great. Okay. Uh... 705 00:33:23,084 --> 00:33:26,421 Is anyone missing a baby? 706 00:33:26,504 --> 00:33:30,758 Did anyone leave their child in the restroom? 707 00:33:30,842 --> 00:33:34,262 Do you, uh, remember seeing a woman enter with a baby 708 00:33:34,345 --> 00:33:36,139 but leave without one? 709 00:33:36,222 --> 00:33:38,433 No, sorry. 710 00:33:38,516 --> 00:33:40,435 Might be on the security tapes. 711 00:33:40,518 --> 00:33:42,687 - I'll have Ahmad check it out. - Please. 712 00:33:42,770 --> 00:33:43,855 Yeah. 713 00:33:43,938 --> 00:33:46,190 Harlow Graham to window one. 714 00:33:46,274 --> 00:33:49,527 Harlow Graham to window one. 715 00:33:49,610 --> 00:33:53,531 Harlow Graham to window one, please. 716 00:33:58,369 --> 00:34:00,038 Donnie Donahue, nurse practitioner. 717 00:34:00,121 --> 00:34:01,456 This is Emma, new grad nurse. 718 00:34:01,539 --> 00:34:02,999 - Hey. - Nice to meet you. 719 00:34:03,082 --> 00:34:04,834 - What's going on? - Somebody dumped their kid. 720 00:34:04,917 --> 00:34:07,462 Maybe Mom just stepped out for a smoke or something. 721 00:34:07,545 --> 00:34:09,255 What? I'm being helpful. 722 00:34:09,338 --> 00:34:10,797 Sometimes they just need a little break, 723 00:34:10,882 --> 00:34:13,259 and then they come back. 724 00:34:13,342 --> 00:34:14,886 At least they didn't leave her in a suitcase 725 00:34:14,969 --> 00:34:17,263 - at the bus station. - Does that happen? 726 00:34:17,346 --> 00:34:19,139 If that's a true story, I don't want to know about it. 727 00:34:19,223 --> 00:34:21,266 - It ain't the worst I've seen. - Please, don't tell me. 728 00:34:21,350 --> 00:34:23,728 - I'm a new dad, remember? - Okay. 729 00:34:30,735 --> 00:34:32,652 There you go. I'll get Robby. 730 00:34:32,737 --> 00:34:34,362 - Should I come with? - No, stay here. 731 00:34:34,447 --> 00:34:36,699 Donnie, Jesse, teach her something. 732 00:34:39,452 --> 00:34:43,121 You know how to check a rectal temp on an infant? 733 00:34:43,206 --> 00:34:44,748 Uh... 734 00:34:44,831 --> 00:34:46,708 theoretically. 735 00:34:52,255 --> 00:34:55,051 Mr. Williams, how's the pain? 736 00:34:55,134 --> 00:34:56,677 Nothing I can't manage 737 00:34:56,761 --> 00:34:58,679 with some Vicodin and a little scotch. 738 00:34:58,763 --> 00:35:01,265 Well, it's best not to mix the two. 739 00:35:01,349 --> 00:35:03,601 James here is going to take you to get an X-ray of your wrist. 740 00:35:03,684 --> 00:35:05,520 I'm going to be fine. 741 00:35:05,603 --> 00:35:07,980 Well, it'll tell us if you need a cast. 742 00:35:08,064 --> 00:35:09,649 Oh, I doubt it. 743 00:35:09,732 --> 00:35:11,901 I should probably go home, keep some ice on it. 744 00:35:11,984 --> 00:35:14,695 I know you guys always need the beds. 745 00:35:14,779 --> 00:35:17,073 Well, uh, it'll only take a minute, 746 00:35:17,156 --> 00:35:18,783 and then we'll know for sure. 747 00:35:18,866 --> 00:35:20,910 Yeah, I-I really don't think it's necessary. 748 00:35:20,993 --> 00:35:23,496 And I have a busy day, but I appreciate your concern. 749 00:35:26,791 --> 00:35:29,252 I'd really like to observe you for a little bit, 750 00:35:29,335 --> 00:35:31,838 in case you did hit your head. 751 00:35:31,921 --> 00:35:33,422 My head? 752 00:35:33,506 --> 00:35:35,883 I hit my schnoz on my arm, I think, nothing more. 753 00:35:35,967 --> 00:35:38,177 You think? You don't remember? 754 00:35:38,261 --> 00:35:39,637 No. 755 00:35:39,720 --> 00:35:41,472 Or, yes. 756 00:35:41,556 --> 00:35:44,517 I'm going to be fine, really. 757 00:35:44,600 --> 00:35:46,811 But thank you for your concern. 758 00:35:50,565 --> 00:35:52,275 Okay. 759 00:35:54,652 --> 00:35:58,239 How about we take that X-ray just to be safe? 760 00:35:58,322 --> 00:36:00,741 - Yeah. Yeah, okay. - Yeah? 761 00:36:00,825 --> 00:36:02,952 - Okay. - Okay, good idea. 762 00:36:04,954 --> 00:36:06,956 - Somebody found a baby? - Yeah. 763 00:36:07,039 --> 00:36:09,333 Not the first time it's happened. 764 00:36:09,417 --> 00:36:11,210 So, about those pills I took-- 765 00:36:11,294 --> 00:36:14,255 Oh, don't worry about it, Doc. 766 00:36:14,338 --> 00:36:17,633 If the pills helped you, great. 767 00:36:17,717 --> 00:36:19,844 I never really liked taking 'em. 768 00:36:21,888 --> 00:36:23,389 I appreciate that, Louie. 769 00:36:23,472 --> 00:36:25,391 That's not really the point, but... 770 00:36:25,474 --> 00:36:27,810 I need to lift up your shirt for a second. 771 00:36:33,858 --> 00:36:36,152 How long has your belly been hard like that? 772 00:36:36,235 --> 00:36:37,612 I don't know. 773 00:36:37,695 --> 00:36:39,739 I figured I could wait another week. 774 00:36:39,822 --> 00:36:41,782 You need, uh, some lab tests 775 00:36:41,866 --> 00:36:44,619 and a procedure to drain off some of this fluid. 776 00:36:44,702 --> 00:36:46,621 Yeah, I know the drill. 777 00:36:46,704 --> 00:36:48,998 I've been tapped a few times before. 778 00:36:49,081 --> 00:36:52,210 Three times in the last six months. 779 00:36:52,293 --> 00:36:55,004 You need to give your liver a break, Louie. 780 00:36:55,087 --> 00:36:56,464 Yeah, I know. 781 00:37:01,093 --> 00:37:03,012 I just heard somebody dumped a baby 782 00:37:03,095 --> 00:37:04,430 in the waiting-room bathroom. 783 00:37:04,513 --> 00:37:07,642 - How sad is that? - Huh? 784 00:37:07,725 --> 00:37:10,728 What's up with you today, Mel...ancholia? 785 00:37:10,811 --> 00:37:13,189 What makes you think there's something up with me? 786 00:37:13,272 --> 00:37:14,982 You're moping around here all day 787 00:37:15,066 --> 00:37:17,443 like somebody gunned down your favorite K-Pop band. 788 00:37:17,526 --> 00:37:19,445 I don't really have a favorite K-Pop band. 789 00:37:19,528 --> 00:37:21,280 It's not that I don't like the genre. 790 00:37:21,364 --> 00:37:23,032 - It's just kinda-- - Okay, forget K-Pop. 791 00:37:23,115 --> 00:37:24,659 What's going on with you? 792 00:37:24,742 --> 00:37:26,035 You usually ride in here 793 00:37:26,118 --> 00:37:27,828 on your unicorn tossing wildflowers. 794 00:37:27,912 --> 00:37:30,539 - "Unicorn"? - Never mind. 795 00:37:30,623 --> 00:37:33,042 Is everything okay with your sister? 796 00:37:33,125 --> 00:37:34,752 Oh, yeah, she's great. 797 00:37:34,835 --> 00:37:36,837 It's just this... 798 00:37:38,589 --> 00:37:40,675 Spill, girl. 799 00:37:40,758 --> 00:37:42,301 Um... 800 00:37:42,385 --> 00:37:45,680 well, a-a couple months ago, I got named in a... 801 00:37:45,763 --> 00:37:47,848 Malpractice lawsuit. 802 00:37:47,932 --> 00:37:51,727 And so, um, today is the--the deposition. 803 00:37:51,811 --> 00:37:53,437 That's it? 804 00:37:53,521 --> 00:37:56,607 Every emergency-medicine doc gets sued sooner or later. 805 00:37:56,691 --> 00:37:59,026 Seriously, don't sweat it. You're still a resident. 806 00:37:59,110 --> 00:38:00,695 We're protected by the hospital. 807 00:38:00,778 --> 00:38:04,532 You could cut somebody's head off and get away with it. 808 00:38:04,615 --> 00:38:06,951 But, you know, like, don't. 809 00:38:07,034 --> 00:38:09,412 You don't want to become known as the one 810 00:38:09,495 --> 00:38:11,998 who put Mel in mel-practice. 811 00:38:12,081 --> 00:38:14,792 Hey, Santos, our little girl, Kylie, has been 812 00:38:14,875 --> 00:38:18,087 in the West Penn Emergency Department a couple times. 813 00:38:18,170 --> 00:38:20,715 I'm not saying this is necessarily the case here, 814 00:38:20,798 --> 00:38:23,509 but recent studies have linked bullying behavior 815 00:38:23,592 --> 00:38:26,429 to different personality disorders. 816 00:38:26,512 --> 00:38:29,098 On the other hand, though, I-I am known to be a bit 817 00:38:29,181 --> 00:38:30,558 overly sensitive sometimes-- 818 00:38:30,641 --> 00:38:31,767 - Mel. - Yes? 819 00:38:31,851 --> 00:38:33,102 You're talking to yourself again. 820 00:38:33,185 --> 00:38:34,937 - You need something? - Uh, yeah, a good lawyer. 821 00:38:35,021 --> 00:38:36,731 I don't know. I'm kidding. 822 00:38:36,814 --> 00:38:38,065 I'm-- 823 00:38:40,026 --> 00:38:42,153 Yo, Robinavitch, somebody ditched a bundle of joy 824 00:38:42,236 --> 00:38:43,446 in chairs. 825 00:38:43,529 --> 00:38:44,905 - How old? - Couple months maybe. 826 00:38:44,989 --> 00:38:46,324 Donahue's got her in Pedes. 827 00:38:46,407 --> 00:38:48,784 - No one saw who left her? - Apparently not. 828 00:38:48,868 --> 00:38:50,536 - That's so sad. - Tell me about it. 829 00:38:50,619 --> 00:38:52,079 Who throws away a perfectly good baby? 830 00:38:53,331 --> 00:38:54,623 Make a lane! 831 00:38:54,707 --> 00:38:57,126 Ah, sweet baby Jesus, Antoine! 832 00:38:57,209 --> 00:38:59,253 - Right to the outdoor shower! - I just drive 'em. 833 00:38:59,337 --> 00:39:00,713 I'm not a wash and detail service. 834 00:39:00,796 --> 00:39:03,090 Yeah, yeah, God forbid you prove useful. 835 00:39:03,174 --> 00:39:04,675 Ah, good timing, Ms. Emma. 836 00:39:04,759 --> 00:39:07,386 Time for you and me to do the Lord's work. This way. 837 00:39:07,470 --> 00:39:09,305 Ooh, God, what is that? 838 00:39:09,388 --> 00:39:13,059 Okay, big breath. 839 00:39:13,142 --> 00:39:17,063 All right, lungs sound great. Can you lean forward for me? 840 00:39:22,651 --> 00:39:26,322 Uh, did you hit your back when you fell down the stairs? 841 00:39:26,405 --> 00:39:27,448 No. 842 00:39:27,531 --> 00:39:29,325 Okay, there's a pretty good bruise here. 843 00:39:29,408 --> 00:39:31,243 I got knocked down in soccer. 844 00:39:33,287 --> 00:39:36,082 Oh, no, you broke your wrist last year, too, huh? 845 00:39:36,165 --> 00:39:38,876 Fell off my skateboard. Got a purple cast. 846 00:39:38,959 --> 00:39:40,503 Cool color. 847 00:39:40,586 --> 00:39:42,463 And you were treated at West Penn? 848 00:39:42,546 --> 00:39:44,924 Is that your closest hospital? 849 00:39:45,007 --> 00:39:46,675 Uh, I guess that would make sense. 850 00:39:46,759 --> 00:39:48,677 I've only been dating her dad a few months. 851 00:39:48,761 --> 00:39:51,430 Uh, he lived in Garfield before the divorce. 852 00:39:51,514 --> 00:39:53,933 - And, uh, what about these? - Soccer. 853 00:39:54,016 --> 00:39:55,643 Do you wear shin guards? 854 00:39:55,726 --> 00:39:57,311 My dad ordered them. 855 00:39:57,395 --> 00:40:00,689 Okay. What does your dad do for work? 856 00:40:00,773 --> 00:40:03,567 He draws buildings, but he's not an architect. 857 00:40:03,651 --> 00:40:05,986 He's a draftsman for a firm in Newcastle. 858 00:40:06,070 --> 00:40:10,408 Okay. Um, Kylie, any chance you can pee? 859 00:40:10,491 --> 00:40:12,827 - Mm, maybe. - Okay. 860 00:40:12,910 --> 00:40:14,870 Well, with the bruise on your back, 861 00:40:14,954 --> 00:40:16,414 we need to check your urine. 862 00:40:16,497 --> 00:40:18,082 - Okay. - Okay. 863 00:40:21,001 --> 00:40:23,337 Did you eat anything out of the ordinary recently? 864 00:40:23,421 --> 00:40:24,755 No. 865 00:40:24,839 --> 00:40:27,216 Sorry, but we went through this a bunch. 866 00:40:27,299 --> 00:40:28,884 Don't you people communicate? 867 00:40:28,968 --> 00:40:30,761 You're the third nurse we've told her story to. 868 00:40:30,845 --> 00:40:32,096 I'm a doctor. 869 00:40:32,179 --> 00:40:35,141 Richard, would you go to the cafeteria 870 00:40:35,224 --> 00:40:37,560 and get me a large chamomile tea? 871 00:40:37,643 --> 00:40:39,728 What can we get you, my dear? 872 00:40:39,812 --> 00:40:42,106 I'm fine, thank you. 873 00:40:44,108 --> 00:40:45,901 Yeah, I'll be right back. 874 00:40:49,780 --> 00:40:52,116 Please excuse my son. 875 00:40:52,199 --> 00:40:54,034 Ever since my husband died, 876 00:40:54,118 --> 00:40:56,454 he's been a little overprotective. 877 00:40:56,537 --> 00:40:58,497 I think it's sweet. 878 00:40:58,581 --> 00:41:01,417 - You're very lucky to have him. - I am. 879 00:41:03,043 --> 00:41:06,881 Are you still taking your loperamide and cholestyramine? 880 00:41:06,964 --> 00:41:09,675 Um, mm, not so much. 881 00:41:09,758 --> 00:41:11,385 No? 882 00:41:11,469 --> 00:41:13,804 That may be why you're experiencing the abdominal pain 883 00:41:13,888 --> 00:41:15,431 and vomiting. 884 00:41:15,514 --> 00:41:17,641 When did you stop taking your meds? 885 00:41:17,725 --> 00:41:19,894 Last winter or so. 886 00:41:21,937 --> 00:41:25,483 My neighbor Helen and I bingo in Wintersville. 887 00:41:25,566 --> 00:41:28,194 There's a dispensary next door. 888 00:41:28,277 --> 00:41:30,237 And we got some marijuana. 889 00:41:30,321 --> 00:41:34,492 And I swear it cleared everything up. 890 00:41:34,575 --> 00:41:38,078 A few cookies every few hours... 891 00:41:38,162 --> 00:41:40,748 and no more pain. 892 00:41:40,831 --> 00:41:43,292 "A few cookies"? 893 00:41:43,375 --> 00:41:45,419 How many are you eating in a day? 894 00:41:45,503 --> 00:41:47,505 Oh, uh... 895 00:41:47,588 --> 00:41:50,174 I don't know. 896 00:41:50,257 --> 00:41:55,095 Probably a dozen or so, but they're not very big. 897 00:41:55,179 --> 00:41:57,097 There have been some studies 898 00:41:57,181 --> 00:41:59,308 that show an added dementia risk 899 00:41:59,391 --> 00:42:02,353 with marijuana use in older adults. 900 00:42:03,771 --> 00:42:06,398 Well, that sucks for old people. 901 00:42:07,816 --> 00:42:09,693 Kylie, there are some questions 902 00:42:09,777 --> 00:42:13,739 that we ask every kid who comes in with an injury. 903 00:42:13,822 --> 00:42:15,282 Like what? 904 00:42:15,366 --> 00:42:18,744 Like, sometimes the people that you live with 905 00:42:18,827 --> 00:42:23,749 can get so mad that they hit you or hurt you, 906 00:42:23,832 --> 00:42:25,960 maybe without even meaning to. 907 00:42:26,043 --> 00:42:27,419 Does that ever happen? 908 00:42:27,503 --> 00:42:29,880 No, not to me. 909 00:42:29,964 --> 00:42:32,132 Or sometimes kids can get punished 910 00:42:32,216 --> 00:42:33,759 for doing something wrong 911 00:42:33,842 --> 00:42:37,304 with maybe a spanking or a belt. 912 00:42:37,388 --> 00:42:39,974 I get time-outs. 913 00:42:40,057 --> 00:42:42,101 How about at school, Kylie? 914 00:42:42,184 --> 00:42:45,563 You know, is anybody being, you know, mean or bullying you? 915 00:42:45,646 --> 00:42:48,232 No, I have lots of friends. 916 00:43:09,086 --> 00:43:11,171 Yo, Whitaker. 917 00:43:11,255 --> 00:43:14,008 Dr. Langdon. 918 00:43:14,091 --> 00:43:17,803 - You, uh, meet Louie here? - Uh, yeah, yeah, many times. 919 00:43:17,886 --> 00:43:20,180 - Good morning, Mr. Cloverfield. - What's up, Doc? 920 00:43:20,264 --> 00:43:22,391 Where's your new resident badge buddy, buddy? 921 00:43:22,474 --> 00:43:26,729 Oh, uh, yeah, they--they didn't give me a new one yet. 922 00:43:26,812 --> 00:43:28,063 Bummer. 923 00:43:28,147 --> 00:43:29,607 You and, uh, your ducklings got time 924 00:43:29,690 --> 00:43:31,317 to tap a six-pack off our friend here? 925 00:43:31,400 --> 00:43:33,861 - Louie needs a paracentesis. - Yeah, sure. 926 00:43:33,944 --> 00:43:35,821 It's good to see you again, Louie-- 927 00:43:35,904 --> 00:43:37,573 not in this condition, of course. 928 00:43:37,656 --> 00:43:38,616 How you feeling? 929 00:43:38,699 --> 00:43:41,994 Feeling like I need a drink pretty soon. 930 00:43:42,077 --> 00:43:43,829 Okay, well, first things first-- 931 00:43:43,912 --> 00:43:46,081 we are going to make you more comfortable 932 00:43:46,165 --> 00:43:47,708 by draining some fluid. 933 00:43:47,791 --> 00:43:49,418 You're gonna take off a big volume, 934 00:43:49,501 --> 00:43:52,546 so start with 60 grams of 25% albumin IV. 935 00:43:52,630 --> 00:43:55,132 - You tapped him before? - No. 936 00:43:55,215 --> 00:43:57,635 That's okay, Doc. I'll talk him through it. 937 00:43:57,718 --> 00:43:59,428 Okay. 938 00:44:01,096 --> 00:44:04,475 Sats 99 on room air, normal BP, normal pulse. 939 00:44:07,311 --> 00:44:08,896 Oh, well hydrated. 940 00:44:08,979 --> 00:44:10,648 No obvious source of infection. 941 00:44:10,731 --> 00:44:13,651 Could be a benign virus, but can't assume that. 942 00:44:13,734 --> 00:44:16,278 - Is this the abandoned baby? - Mm-hmm. 943 00:44:16,362 --> 00:44:18,656 - How old? - How old do you think she is? 944 00:44:18,739 --> 00:44:22,076 - Month, month and a half? - It's tricky. 945 00:44:22,159 --> 00:44:25,454 Under 28 days is a Safe Haven drop-off, no questions asked. 946 00:44:25,537 --> 00:44:28,916 But over 28 days is a crime, child abandonment. 947 00:44:28,999 --> 00:44:31,085 How should we assess? 948 00:44:31,168 --> 00:44:34,171 Under 28 days gets everything, including an LP. 949 00:44:34,254 --> 00:44:36,507 But over 28 days, 950 00:44:36,590 --> 00:44:38,676 you can follow PECARN or Step-by-step 951 00:44:38,759 --> 00:44:41,428 to determine risk of invasive bacterial infection. 952 00:44:41,512 --> 00:44:42,930 This baby looks great. 953 00:44:43,013 --> 00:44:44,890 But we know nothing about the birth history. 954 00:44:44,973 --> 00:44:48,686 Did Mom have group B strep, active HSV lesions? 955 00:44:48,769 --> 00:44:52,773 We should assume the worst. Put in your orders, Dr. Mohan. 956 00:44:52,856 --> 00:44:54,817 CBC... 957 00:44:54,900 --> 00:44:57,319 Blood culture, chem panel, 958 00:44:57,403 --> 00:45:00,197 chest X-ray, UA and culture, 959 00:45:00,280 --> 00:45:02,408 respiratory virus panel. 960 00:45:02,491 --> 00:45:06,704 Check inflammatory markers-- procalcitonin and CRP-- 961 00:45:06,787 --> 00:45:08,789 then take it from there. 962 00:45:08,872 --> 00:45:10,999 That sounds like a plan. 963 00:45:11,083 --> 00:45:13,168 Dr. Robby, Santos needs you in North 1. 964 00:45:13,252 --> 00:45:14,712 Okay, I'll be right there. 965 00:45:14,795 --> 00:45:17,214 If you'll excuse me, if you'll excuse me. 966 00:45:19,591 --> 00:45:23,762 - Mind if I join with? - Uh, no, I got this. 967 00:45:23,846 --> 00:45:25,514 It will help me get a better sense 968 00:45:25,597 --> 00:45:27,725 of how you like to do things by seeing you in action 969 00:45:27,808 --> 00:45:29,268 with the residents. 970 00:45:29,351 --> 00:45:31,019 Be my guest. 971 00:45:33,772 --> 00:45:35,941 I will be right back. 972 00:45:41,071 --> 00:45:43,741 Um, nine-year-old Kylie Connors-- 973 00:45:43,824 --> 00:45:45,826 took a tumble running up the stairs this morning. 974 00:45:45,909 --> 00:45:47,578 Chin lac and fractured tooth. 975 00:45:47,661 --> 00:45:49,830 Brought in by her dad's girlfriend, Gina. 976 00:45:49,913 --> 00:45:52,958 Supposedly, the dad had to leave early for work. 977 00:45:53,041 --> 00:45:55,753 Kylie has a lot of bruising on her body-- 978 00:45:55,836 --> 00:45:57,337 some old, some new. 979 00:45:57,421 --> 00:46:00,924 Are you concerned about non-accidental trauma? 980 00:46:01,008 --> 00:46:02,551 Or worse. 981 00:46:02,634 --> 00:46:05,012 Her urine sample shows gross hematuria, 982 00:46:05,095 --> 00:46:08,223 which could be renal injury, or vaginal bleeding from trauma 983 00:46:08,307 --> 00:46:10,476 could have contaminated the specimen. 984 00:46:10,559 --> 00:46:13,395 Lots to consider. What's your plan? 985 00:46:13,479 --> 00:46:16,064 Labs, ultrasound, social-work consult, 986 00:46:16,148 --> 00:46:18,108 then decide if this is reportable. 987 00:46:18,192 --> 00:46:19,568 Mm-hmm. 988 00:46:22,821 --> 00:46:24,573 Let me know if you can feel this. 989 00:46:24,656 --> 00:46:26,408 No. Am I supposed to? 990 00:46:26,492 --> 00:46:27,659 No. 991 00:46:31,914 --> 00:46:33,999 Your hair's such a pretty color. 992 00:46:34,082 --> 00:46:35,209 Thank you. 993 00:46:35,292 --> 00:46:37,711 Reminds me of my mom. 994 00:46:37,795 --> 00:46:41,006 - She died when I was nine. - Oh, I'm sorry about that. 995 00:46:41,089 --> 00:46:43,592 She wore glasses like you, too. 996 00:46:43,675 --> 00:46:45,594 Weird. 997 00:46:45,677 --> 00:46:48,972 What do you like to do when you're not working? 998 00:46:49,056 --> 00:46:51,433 Um, spend some time with my sister, 999 00:46:51,517 --> 00:46:53,227 read. 1000 00:46:53,310 --> 00:46:54,812 Do you drink coffee? 1001 00:46:54,895 --> 00:46:58,482 Uh, no, I avoid caffeine. 1002 00:46:58,565 --> 00:46:59,608 Me too. 1003 00:46:59,691 --> 00:47:01,276 Um... 1004 00:47:01,360 --> 00:47:03,320 what about boba? 1005 00:47:04,905 --> 00:47:08,367 I love boba. 1006 00:47:11,036 --> 00:47:12,955 I'd offer you some gum, but it's laced with nicotine. 1007 00:47:13,038 --> 00:47:14,832 Trying to quit smoking. 1008 00:47:14,915 --> 00:47:17,417 That's good. 1009 00:47:17,501 --> 00:47:19,169 Verdict's still out. 1010 00:47:19,253 --> 00:47:21,547 Get in all those nooks and crannies, Mr. Digby. 1011 00:47:21,630 --> 00:47:23,423 Your skin will thank you. 1012 00:47:23,507 --> 00:47:25,342 We all will. 1013 00:47:25,425 --> 00:47:29,346 Oh, I could stay in here all day. 1014 00:47:29,429 --> 00:47:31,640 It's a miracle what little soap, water, and human decency 1015 00:47:31,723 --> 00:47:33,642 can do sometimes. 1016 00:47:33,725 --> 00:47:35,060 Don't forget the ears, pal. 1017 00:47:35,143 --> 00:47:37,020 Don't want anything growing in there either. 1018 00:47:37,104 --> 00:47:38,647 Okay. Okay. 1019 00:47:38,730 --> 00:47:40,566 What's your story, Emma? 1020 00:47:40,649 --> 00:47:43,443 What'd your parents do? Got siblings? Boyfriend? 1021 00:47:43,527 --> 00:47:46,363 Ever kill a man in a bar fight? 1022 00:47:46,446 --> 00:47:47,739 Uh... 1023 00:47:57,207 --> 00:47:59,459 So, Mr. Williams, 1024 00:47:59,543 --> 00:48:01,879 sometimes a fracture of the scaphoid bone 1025 00:48:01,962 --> 00:48:03,755 doesn't show up on day one. 1026 00:48:03,839 --> 00:48:07,467 So my advice to be safe is wear a splint for two weeks 1027 00:48:07,551 --> 00:48:09,678 and then come back for a repeat X-ray, 1028 00:48:09,761 --> 00:48:11,471 and we'll see if it's really there. 1029 00:48:13,849 --> 00:48:16,393 My knee hurts. 1030 00:48:16,476 --> 00:48:19,730 Oh, did you hurt your knee? 1031 00:48:19,813 --> 00:48:21,523 I must have. 1032 00:48:28,113 --> 00:48:30,115 What is this? 1033 00:48:30,198 --> 00:48:33,035 That's, um, for your wrist. 1034 00:48:33,118 --> 00:48:35,954 And I need this? 1035 00:48:36,038 --> 00:48:38,707 Well, um, if it's a, uh-- 1036 00:48:38,790 --> 00:48:40,751 John, can you? 1037 00:48:40,834 --> 00:48:43,337 If it's a fracture and we don't immobilize, 1038 00:48:43,420 --> 00:48:45,589 the bone might not heal properly. 1039 00:48:47,591 --> 00:48:51,345 How long is this gonna take? 1040 00:48:51,428 --> 00:48:53,805 Just a few minutes to fit you. 1041 00:48:56,725 --> 00:48:59,186 Is this place new? 1042 00:49:01,939 --> 00:49:05,901 Mr. Williams, do you know what day it is? 1043 00:49:09,488 --> 00:49:11,949 It's Taco Tuesday. 1044 00:49:12,032 --> 00:49:14,242 Do you know where you are? 1045 00:49:15,786 --> 00:49:18,956 Yeah, I'm in the slowest medical clinic in the West. 1046 00:49:19,039 --> 00:49:21,416 Do you know what year it is? 1047 00:49:21,500 --> 00:49:23,543 How about you just fix my wrist 1048 00:49:23,627 --> 00:49:27,756 and you stop with all the questions? 1049 00:49:27,839 --> 00:49:30,884 I am not here to be profiled. 1050 00:49:35,097 --> 00:49:37,933 Yeah, of course. 1051 00:49:38,016 --> 00:49:40,102 I'll be back, okay? 1052 00:49:50,862 --> 00:49:53,490 All right, Mr. Digby, looking better already. 1053 00:49:53,573 --> 00:49:55,450 Certainly smell a little better. 1054 00:49:55,534 --> 00:49:56,952 Do you have any conditioner? 1055 00:49:57,035 --> 00:49:59,079 Let's get you dried off and back inside. 1056 00:49:59,162 --> 00:50:00,747 Get him gowned up and put him in South 21, 1057 00:50:00,831 --> 00:50:01,915 across from the old nun. 1058 00:50:01,999 --> 00:50:05,210 Maybe some of her divine grace will wear off on him. 1059 00:50:05,293 --> 00:50:06,545 Who do we have here? 1060 00:50:06,628 --> 00:50:09,464 Evelyn Bostick, 81, with Alzheimer's. 1061 00:50:09,548 --> 00:50:11,717 We brought her husband in about 30 minutes ago. 1062 00:50:11,800 --> 00:50:13,343 She was supposed to get a ride in, 1063 00:50:13,427 --> 00:50:15,012 but they found her wandering in traffic. 1064 00:50:15,095 --> 00:50:17,055 - Where are we? - You're at the hospital, dear. 1065 00:50:17,139 --> 00:50:18,432 I'm not sick. 1066 00:50:18,515 --> 00:50:20,434 We brought you to see your husband. 1067 00:50:20,517 --> 00:50:22,436 Oh, no. Is Ethan okay? 1068 00:50:22,519 --> 00:50:25,022 I'll be in to chat with you, Mrs. Bostick. 1069 00:50:25,105 --> 00:50:27,566 He died. 1070 00:50:27,649 --> 00:50:29,443 What you got, Amboy? 1071 00:50:29,526 --> 00:50:32,654 Allen Billings--had a pallet fall onto his outstretched arm. 1072 00:50:32,738 --> 00:50:35,073 - Looks like an open dislocation. - Yeah, that's got to hurt. 1073 00:50:35,157 --> 00:50:36,783 Don't worry, sir. We got you. 1074 00:50:42,914 --> 00:50:46,043 - How's she doing? - Seems happy enough. 1075 00:50:46,126 --> 00:50:48,045 - Yeah. Hi. - Hi. 1076 00:50:48,128 --> 00:50:50,839 Just got a quick point-of-care CBC. 1077 00:50:57,345 --> 00:50:59,306 Is there a problem? 1078 00:51:02,851 --> 00:51:04,603 Did I miss something? 1079 00:51:04,686 --> 00:51:07,647 Dr. Al? Dr. Al?