1 00:00:17,226 --> 00:00:18,518 I'm in. 2 00:00:18,519 --> 00:00:19,770 Bag him. 3 00:00:23,065 --> 00:00:25,816 Defib pads are in place. 4 00:00:25,817 --> 00:00:27,777 OK, holding compressions. 5 00:00:27,778 --> 00:00:29,820 Good square line on the End-Tidal CO2. 6 00:00:29,821 --> 00:00:32,407 V-fib, charge to 200. 7 00:00:33,784 --> 00:00:35,117 Charged. 8 00:00:35,118 --> 00:00:36,662 Clear. 9 00:00:38,455 --> 00:00:40,707 Stand by with epi. 10 00:00:44,294 --> 00:00:46,129 Suction that tube. 11 00:00:48,131 --> 00:00:49,423 You're not in the esophagus, are you? 12 00:00:49,424 --> 00:00:50,675 Definitely not. 13 00:00:50,676 --> 00:00:52,134 I passed right through the cords. 14 00:00:52,135 --> 00:00:54,845 Good breath sounds. End-Tidal CO2 confirmed. 15 00:00:54,846 --> 00:00:56,222 His lungs are filling up with blood. 16 00:00:56,223 --> 00:00:57,349 I know. 17 00:01:02,980 --> 00:01:04,273 OK, rhythm check. 18 00:01:06,024 --> 00:01:07,567 Asystole. Push the epi. 19 00:01:07,568 --> 00:01:09,194 Fuck. 20 00:01:12,739 --> 00:01:14,574 Patients with lunch trays have been admitted. 21 00:01:14,575 --> 00:01:15,950 They're boarders. 22 00:01:15,951 --> 00:01:17,785 They're waiting for a bed to open upstairs. 23 00:01:17,786 --> 00:01:19,954 - And what about the others? - Non-admitted patients. 24 00:01:19,955 --> 00:01:21,706 They can have sandwiches or juice boxes. 25 00:01:21,707 --> 00:01:24,125 Just make sure they're not NPO. 26 00:01:24,126 --> 00:01:25,418 That's "nil per os." 27 00:01:25,419 --> 00:01:26,627 It's Latin for "nothing by mouth." 28 00:01:26,628 --> 00:01:28,421 NPOs are waiting for surgery. 29 00:01:28,422 --> 00:01:30,256 They'll beg, spit, and curse for food, 30 00:01:30,257 --> 00:01:31,591 but you got to stay strong. 31 00:01:31,592 --> 00:01:33,050 Hey, I've been waiting for an hour. 32 00:01:33,051 --> 00:01:34,885 When am I gonna see a fucking doctor? 33 00:01:34,886 --> 00:01:37,096 Excuse me! 34 00:01:37,097 --> 00:01:39,140 Perhaps you didn't see this, which is strange, 35 00:01:39,141 --> 00:01:41,183 because they're all over the place. 36 00:01:41,184 --> 00:01:43,394 Aggressive behavior toward healthcare workers is a felony. 37 00:01:43,395 --> 00:01:45,271 $2,000 fine, possible jail time. 38 00:01:45,272 --> 00:01:46,606 Got it? 39 00:01:46,607 --> 00:01:49,191 OK. I was just asking. 40 00:01:49,192 --> 00:01:50,860 We're busy today. 41 00:01:50,861 --> 00:01:52,153 It's a holiday weekend. 42 00:01:52,154 --> 00:01:53,446 We see the sickest patients first, 43 00:01:53,447 --> 00:01:55,115 so be happy you're still waiting. 44 00:01:56,700 --> 00:01:57,909 Jag-off. 45 00:02:00,078 --> 00:02:01,704 PTMC charge nurse. 46 00:02:01,705 --> 00:02:04,498 Go ahead, Medic Command. 47 00:02:04,499 --> 00:02:07,209 OK. Got it. 48 00:02:07,210 --> 00:02:08,419 Incoming trauma. 49 00:02:08,420 --> 00:02:10,921 Come on. 50 00:02:10,922 --> 00:02:12,340 Three minutes since the last epi. 51 00:02:12,341 --> 00:02:13,634 Hold compressions. 52 00:02:14,843 --> 00:02:16,177 Asystole. 53 00:02:16,178 --> 00:02:18,429 Resume CPR. Another amp of epi. 54 00:02:18,430 --> 00:02:20,724 Needs more suction. 55 00:02:26,521 --> 00:02:28,648 Pulmonary hemorrhage from liver failure. 56 00:02:28,649 --> 00:02:30,442 Is he going to make it? 57 00:02:35,739 --> 00:02:37,865 Should we give PCC? 58 00:02:37,866 --> 00:02:40,117 Too late for that. 59 00:02:40,118 --> 00:02:42,036 And he's not an ECMO candidate. 60 00:02:42,037 --> 00:02:44,039 Nothing else we can do? 61 00:02:49,002 --> 00:02:51,296 No, I think we're done. 62 00:02:56,301 --> 00:02:58,428 Louie. 63 00:03:02,474 --> 00:03:04,685 12:07. 64 00:03:11,525 --> 00:03:13,984 Should we do a debrief? 65 00:03:13,985 --> 00:03:15,945 We've got another motorcycle injury coming in, 66 00:03:15,946 --> 00:03:17,238 ETA 10 minutes. 67 00:03:17,239 --> 00:03:18,739 Why don't we get Louie cleaned up, 68 00:03:18,740 --> 00:03:20,783 - move him to the viewing room? - Yeah. 69 00:03:20,784 --> 00:03:23,620 Anybody that wants to pay their respects can join us in there. 70 00:03:25,956 --> 00:03:27,666 Thank you, everyone. 71 00:03:34,965 --> 00:03:36,424 I'll clean him up. 72 00:03:36,425 --> 00:03:38,592 Why don't you take five first? 73 00:03:38,593 --> 00:03:41,178 Or ten. Yeah? 74 00:03:41,179 --> 00:03:42,556 Yep. 75 00:03:52,357 --> 00:03:54,608 This is Dr. Jefferson from psychiatry. 76 00:03:54,609 --> 00:03:57,361 Why do I need to see a psychiatrist? 77 00:03:57,362 --> 00:03:59,697 Jada, why do I need to see a psychiatrist? 78 00:03:59,698 --> 00:04:01,365 It's gonna be OK, Jackson. 79 00:04:01,366 --> 00:04:03,909 Dr. Jefferson says he can help. 80 00:04:03,910 --> 00:04:06,662 Do you know how you got here? 81 00:04:06,663 --> 00:04:09,081 The medics brought me. 82 00:04:09,082 --> 00:04:11,917 I don't really remember. I--I was in the library. 83 00:04:11,918 --> 00:04:14,837 What were you doing there? 84 00:04:14,838 --> 00:04:17,715 I was--I was studying. 85 00:04:17,716 --> 00:04:20,384 I was trying to study. 86 00:04:20,385 --> 00:04:22,136 But then they wouldn't stop talking. 87 00:04:22,137 --> 00:04:24,346 Who wouldn't stop talking? 88 00:04:24,347 --> 00:04:26,015 They don't want me to pass the bar. 89 00:04:26,016 --> 00:04:27,600 Who doesn't want you to pass the bar? 90 00:04:27,601 --> 00:04:29,685 - That's what they told me. - Hey, hey. 91 00:04:29,686 --> 00:04:30,936 Hey, look at me. Look at me. 92 00:04:30,937 --> 00:04:32,229 Who doesn't want you to pass the bar? 93 00:04:32,230 --> 00:04:34,064 Let's give them some privacy. 94 00:04:34,065 --> 00:04:37,359 Dr. Jefferson will let us know when he's done. 95 00:04:37,360 --> 00:04:38,736 They don't want me to pass the bar. 96 00:04:38,737 --> 00:04:40,571 I'll be right outside, OK? 97 00:04:40,572 --> 00:04:44,116 I'll be right outside, Jackson. 98 00:04:44,117 --> 00:04:47,077 Why don't they want you to pass the bar, Jackson? 99 00:04:47,078 --> 00:04:49,038 They're afraid of me becoming a lawyer. 100 00:04:49,039 --> 00:04:52,041 They're afraid of you becoming a lawyer? 101 00:04:52,042 --> 00:04:56,295 He must have been studying with his law school friends. 102 00:04:56,296 --> 00:04:57,963 They--they should know what happened. 103 00:04:57,964 --> 00:05:00,633 I'm gonna call them. 104 00:05:00,634 --> 00:05:02,510 If you need anything, let me know. 105 00:05:02,511 --> 00:05:04,888 - OK, thank you. - Mm-hmm. 106 00:05:14,356 --> 00:05:15,524 Louie. 107 00:05:17,067 --> 00:05:20,277 Pulmonary hemorrhage. 108 00:05:20,278 --> 00:05:22,696 That was quick. 109 00:05:22,697 --> 00:05:25,199 I'm gonna go clean him up. 110 00:05:25,200 --> 00:05:26,493 I'll help. 111 00:05:29,788 --> 00:05:30,997 Go, go. 112 00:05:34,751 --> 00:05:38,045 Everything OK, Roxie? 113 00:05:38,046 --> 00:05:39,880 I can't get off the bedpan. 114 00:05:39,881 --> 00:05:41,967 Oh, that's what I'm here for. 115 00:05:48,014 --> 00:05:50,474 Your husband seems like a saint. 116 00:05:50,475 --> 00:05:53,769 How long you been married? 117 00:05:53,770 --> 00:05:55,313 Too long. 118 00:05:57,732 --> 00:06:00,693 Almost 20 years. 119 00:06:00,694 --> 00:06:02,486 - OK, put your arm around me. - Mm-hmm. 120 00:06:02,487 --> 00:06:04,321 And I'll pull the bedpan on three. 121 00:06:04,322 --> 00:06:05,531 OK. 122 00:06:05,532 --> 00:06:09,034 One, two, three. 123 00:06:09,035 --> 00:06:10,703 One more. 124 00:06:10,704 --> 00:06:12,913 - Great. - Mm. 125 00:06:12,914 --> 00:06:16,625 20? Wow. 126 00:06:16,626 --> 00:06:18,669 Yeah. 127 00:06:18,670 --> 00:06:22,674 He's been by my side through all of this. 128 00:06:24,593 --> 00:06:28,596 I've watched the light go out of him. 129 00:06:28,597 --> 00:06:31,056 So have the kids. 130 00:06:31,057 --> 00:06:32,474 That's what happened to my auntie 131 00:06:32,475 --> 00:06:35,811 when my Uncle Gerald got sick. 132 00:06:35,812 --> 00:06:38,397 But your husband does it because he loves you. 133 00:06:38,398 --> 00:06:39,857 Mm. 134 00:06:39,858 --> 00:06:42,109 I don't know how you do it, 135 00:06:42,110 --> 00:06:44,695 care for people day after day. 136 00:06:44,696 --> 00:06:47,156 I'll tell you my secret. 137 00:06:47,157 --> 00:06:50,075 I go home at the end of every shift, 138 00:06:50,076 --> 00:06:52,661 leave this all behind, 139 00:06:52,662 --> 00:06:54,581 and escape to "Love Island." 140 00:06:56,374 --> 00:06:57,958 How's it going in here? 141 00:06:57,959 --> 00:06:59,835 The higher-demand dose of morphine helped a little, 142 00:06:59,836 --> 00:07:01,879 - but she's still in pain. - OK. 143 00:07:01,880 --> 00:07:04,715 I got your order. 0.1 per kilo. 144 00:07:04,716 --> 00:07:06,383 - Thanks. - Mm-hmm. 145 00:07:06,384 --> 00:07:08,969 This is a very low sub-dissociative dose 146 00:07:08,970 --> 00:07:10,179 of ketamine. 147 00:07:10,180 --> 00:07:11,680 You might feel a little weird, 148 00:07:11,681 --> 00:07:14,142 but I think it's gonna help with the pain. 149 00:07:16,770 --> 00:07:18,812 Is my husband still in the cafeteria? 150 00:07:18,813 --> 00:07:20,856 I think so. Want me to get him? 151 00:07:20,857 --> 00:07:23,525 No, no. 152 00:07:23,526 --> 00:07:26,863 It's good for us to have a little time apart. 153 00:07:29,199 --> 00:07:31,493 I'll get you another blanket. 154 00:07:35,622 --> 00:07:37,247 Here. I'm headed that way. 155 00:07:37,248 --> 00:07:39,166 Thank you. 156 00:07:39,167 --> 00:07:40,834 Back here for good? 157 00:07:40,835 --> 00:07:42,586 Officially out of triage. 158 00:07:42,587 --> 00:07:45,798 They need extra hands with all the Westbridge hullabaloo. 159 00:07:45,799 --> 00:07:47,758 How many cups have you had today? 160 00:07:47,759 --> 00:07:49,259 - Don't judge me. - Just asking. 161 00:07:49,260 --> 00:07:50,553 You're judging. 162 00:07:52,514 --> 00:07:53,847 Did you hear about Louie? 163 00:07:53,848 --> 00:07:55,265 No. 164 00:07:55,266 --> 00:07:57,226 Pulmonary hemorrhage. Didn't make it. 165 00:07:57,227 --> 00:07:59,812 - Shit. - Mm. 166 00:07:59,813 --> 00:08:01,480 He's been here a hundred times. 167 00:08:01,481 --> 00:08:03,065 I know. 168 00:08:03,066 --> 00:08:06,318 Debrief in the viewing room later. 169 00:08:06,319 --> 00:08:07,945 On a happier note, Perlah and I are planning 170 00:08:07,946 --> 00:08:09,571 a birthday party for Javadi. 171 00:08:09,572 --> 00:08:11,323 She's turning 21. 172 00:08:11,324 --> 00:08:14,118 You two are thick as thieves. 173 00:08:14,119 --> 00:08:16,620 I don't have much of a social life these days, 174 00:08:16,621 --> 00:08:19,498 but I'll be sure to keep an eye out for the Partiful. 175 00:08:19,499 --> 00:08:22,459 Let's discuss our incarcerated patient Gus. 176 00:08:22,460 --> 00:08:24,253 Prison infirmaries tend to be short-staffed, 177 00:08:24,254 --> 00:08:26,630 so we need to be thorough. 178 00:08:26,631 --> 00:08:29,842 What's in the differential diagnosis for malnutrition? 179 00:08:29,843 --> 00:08:33,012 Inadequate intake, methamphetamine use, 180 00:08:33,013 --> 00:08:36,056 severe alcoholism, ADHD medication. 181 00:08:36,057 --> 00:08:37,683 What else? 182 00:08:37,684 --> 00:08:40,019 Cancer of the oropharynx, esophageal strictures, 183 00:08:40,020 --> 00:08:43,063 prior strokes, malabsorption, inflammatory bowel disease, 184 00:08:43,064 --> 00:08:45,024 none of which were in his medical record. 185 00:08:45,025 --> 00:08:47,443 What about psychosocial causes? 186 00:08:47,444 --> 00:08:49,778 Could be an intentional hunger strike. 187 00:08:49,779 --> 00:08:51,905 Or refusing food to get to the infirmary. 188 00:08:51,906 --> 00:08:53,741 Could also be abuse or neglect. 189 00:08:53,742 --> 00:08:56,035 Let's start with a nutrition history once he's back from CT. 190 00:08:56,036 --> 00:08:57,327 Do you have a second to talk about Westbridge? 191 00:08:57,328 --> 00:08:58,412 Mm-hmm. 192 00:08:58,413 --> 00:09:00,164 Hey, we need to start moving some patients out of here. 193 00:09:00,165 --> 00:09:01,915 These walls are starting to fill up with gurneys. 194 00:09:01,916 --> 00:09:03,375 Santos, Ogilvie, and King 195 00:09:03,376 --> 00:09:04,877 all have patients on the launching pad. 196 00:09:04,878 --> 00:09:05,961 I'll check in with them. 197 00:09:05,962 --> 00:09:07,713 How many patients have we had rerouted from Westbridge? 198 00:09:07,714 --> 00:09:09,673 Ten, and God knows how many more in the waiting room. 199 00:09:09,674 --> 00:09:10,924 Ambulance will be here in a few minutes 200 00:09:10,925 --> 00:09:13,177 with the accident victim; I'll stick him in Trauma Two. 201 00:09:13,178 --> 00:09:15,596 What is the story with your incarcerated patient? 202 00:09:15,597 --> 00:09:17,514 Gus Varney, three rib fractures 203 00:09:17,515 --> 00:09:20,184 with normal O2 sats currently, waiting on CT results. 204 00:09:20,185 --> 00:09:21,226 OK, if he's stable at the two-hour mark, 205 00:09:21,227 --> 00:09:22,644 I'd say he's good to go. 206 00:09:22,645 --> 00:09:23,812 Let's get the ball rolling on discharge. 207 00:09:23,813 --> 00:09:25,272 Let's wait on the CT results. 208 00:09:25,273 --> 00:09:26,732 We can move him out of Trauma One, at least. 209 00:09:26,733 --> 00:09:28,025 Yes, we can. What's open? 210 00:09:28,026 --> 00:09:29,735 13 and 14 will be discharged soon, 211 00:09:29,736 --> 00:09:31,487 15 once we move Louie to the viewing room 212 00:09:31,488 --> 00:09:32,946 and get it cleaned up. 213 00:09:32,947 --> 00:09:34,823 Our paracentesis patient, Mr. Cloverfield? 214 00:09:34,824 --> 00:09:36,366 V-fib arrest. 215 00:09:36,367 --> 00:09:37,618 We'll do a debrief when we know how many patients 216 00:09:37,619 --> 00:09:39,036 we're getting from Westbridge. 217 00:09:39,037 --> 00:09:42,122 So Gus goes to 13, 14, or 15? 218 00:09:42,123 --> 00:09:43,749 I kind of want to keep him in plain sight. 219 00:09:43,750 --> 00:09:45,751 - What about BH-2? - Sold. 220 00:09:45,752 --> 00:09:47,544 Why not give him some privacy? 221 00:09:47,545 --> 00:09:50,756 Everyone can see him in BH-2 like he's a monkey at the zoo. 222 00:09:50,757 --> 00:09:52,674 Because he came in with an orange jumpsuit, 223 00:09:52,675 --> 00:09:54,551 and we need to think about patient and staff safety. 224 00:09:54,552 --> 00:09:56,637 Safety first. BH-2 beats a prison cell. 225 00:09:56,638 --> 00:09:58,055 Not by much. 226 00:09:58,056 --> 00:09:59,723 Did you guys hear about Louie? 227 00:09:59,724 --> 00:10:02,392 - Yeah. - Yeah, chronic alcoholic. 228 00:10:02,393 --> 00:10:04,019 Go figure. 229 00:10:04,020 --> 00:10:06,563 Hey, fent OD in South 20 is ready for discharge, 230 00:10:06,564 --> 00:10:08,565 but could you get Lupe to call him a ride? 231 00:10:08,566 --> 00:10:09,983 I need to check on Louie. 232 00:10:09,984 --> 00:10:13,028 - Uh, actually, Whitaker-- - He croaked. 233 00:10:13,029 --> 00:10:14,863 - What? - Five minutes ago. 234 00:10:14,864 --> 00:10:16,324 Robby called it. 235 00:10:26,459 --> 00:10:27,709 I'm sorry, man. 236 00:10:27,710 --> 00:10:30,546 We didn't have time to find you. 237 00:10:30,547 --> 00:10:32,840 What happened? 238 00:10:32,841 --> 00:10:35,425 He was apneic and pulseless. 239 00:10:35,426 --> 00:10:38,095 We started CPR and intubated him. 240 00:10:38,096 --> 00:10:39,805 He had a massive pulmonary hemorrhage. 241 00:10:39,806 --> 00:10:41,057 Robby called it. 242 00:10:43,810 --> 00:10:45,811 Found this with his stuff. 243 00:10:45,812 --> 00:10:48,105 Guess he was married at some point. 244 00:10:48,106 --> 00:10:49,816 Never knew that. 245 00:10:53,111 --> 00:10:55,863 Oh, didn't miss this part of the job. 246 00:10:55,864 --> 00:10:57,865 Yeah. 247 00:10:57,866 --> 00:11:03,328 Perlah, did Louie ever mention anything about a wife and kids? 248 00:11:03,329 --> 00:11:04,955 Not as far as I know. 249 00:11:04,956 --> 00:11:07,040 He only had eyes for Rita Moreno. 250 00:11:07,041 --> 00:11:10,752 Well, this is not Rita Moreno. 251 00:11:10,753 --> 00:11:12,588 No, it's not. 252 00:11:12,589 --> 00:11:14,549 Can we check to see if there's an emergency contact? 253 00:11:16,718 --> 00:11:19,554 Yeah, there's a number listed. 254 00:11:26,060 --> 00:11:27,645 You were his primary. Do you want to... 255 00:11:30,148 --> 00:11:31,774 No. 256 00:11:41,326 --> 00:11:43,827 PTMC charge nurse. 257 00:11:43,828 --> 00:11:48,040 Langdon? Where are you? 258 00:11:48,041 --> 00:11:50,125 Makes sense that we'd be his emergency contact. 259 00:11:50,126 --> 00:11:53,712 Sorry to get your hopes up. 260 00:11:53,713 --> 00:11:55,631 Our social worker's gonna do their thing. 261 00:11:55,632 --> 00:11:59,426 If Louie had any family left, they'll find them. 262 00:11:59,427 --> 00:12:01,054 You OK? 263 00:12:02,388 --> 00:12:05,974 Guess it's good it happened here, not out on the street. 264 00:12:05,975 --> 00:12:07,434 You're off the hook with Louie. 265 00:12:07,435 --> 00:12:10,063 I'ma teach Emma here how to clean a dead body. 266 00:12:12,190 --> 00:12:14,024 I'm sorry, but they need me in L&D. 267 00:12:14,025 --> 00:12:15,692 You might want to call for another interpreter. 268 00:12:15,693 --> 00:12:17,110 Busy day. 269 00:12:17,111 --> 00:12:18,570 Shit, that's the girl in 12? 270 00:12:18,571 --> 00:12:20,280 Yeah, she's been waiting for five hours. 271 00:12:20,281 --> 00:12:21,990 Didn't hear her name called the first time. 272 00:12:21,991 --> 00:12:23,533 You check on her? 273 00:12:23,534 --> 00:12:24,910 Need to brush up on my ASL. 274 00:12:24,911 --> 00:12:26,370 You know sign language too? 275 00:12:26,371 --> 00:12:28,121 Princess here knows six languages. 276 00:12:28,122 --> 00:12:30,625 - I know French. - OK, it's not a contest. 277 00:12:31,542 --> 00:12:32,626 Ah! 278 00:12:32,627 --> 00:12:34,211 No shit talking in front of me. 279 00:12:34,212 --> 00:12:36,588 I get enough of that from her and Perlah. 280 00:12:36,589 --> 00:12:39,341 Guess I'll call for backup. 281 00:12:39,342 --> 00:12:41,385 Yo, Donnie, did you discharge your butt abscess? 282 00:12:41,386 --> 00:12:43,804 Not yet! 283 00:12:43,805 --> 00:12:45,430 What the hell? 284 00:12:45,431 --> 00:12:46,598 Your good friends upstairs sent doughnuts. 285 00:12:46,599 --> 00:12:48,016 Special thank-you for working the holiday. 286 00:12:48,017 --> 00:12:49,810 You got to be kidding me. 287 00:12:49,811 --> 00:12:51,645 What were you expecting, tacos and tequila? 288 00:12:51,646 --> 00:12:53,522 Every single one of them can forget about extra shifts. 289 00:12:53,523 --> 00:12:55,691 - Won't hire more nurses. - Won't pay us a decent wage. 290 00:12:55,692 --> 00:12:57,192 Won't hire security that can actually 291 00:12:57,193 --> 00:12:58,277 protect us from patients. 292 00:12:58,278 --> 00:12:59,903 But absolutely, send doughnuts. 293 00:12:59,904 --> 00:13:01,405 Sure you want to go into this line of work? 294 00:13:01,406 --> 00:13:02,489 Want me get you one? 295 00:13:02,490 --> 00:13:04,701 Of course I do, but I'm not taking admin's blood pastries. 296 00:13:05,410 --> 00:13:07,619 Et tu, Donnie? 297 00:13:07,620 --> 00:13:09,579 OK, move it or lose it. 298 00:13:09,580 --> 00:13:12,040 Meet me in South 15 with gowns and gloves. 299 00:13:12,041 --> 00:13:13,750 Looks like happy hour in here. 300 00:13:13,751 --> 00:13:15,502 Don't ask. What's up with Evel Knievel? 301 00:13:15,503 --> 00:13:17,921 Brandon Li, 52, fell off a motorcycle pyramid 302 00:13:17,922 --> 00:13:19,548 at 25 miles per hour. 303 00:13:19,549 --> 00:13:21,508 Motorcycle pyramid? You recruiting? 304 00:13:21,509 --> 00:13:22,884 Got a fellow rider in your midst. 305 00:13:22,885 --> 00:13:24,177 - No kidding. - How high up were you? 306 00:13:24,178 --> 00:13:25,971 On top of a three, two, one. 307 00:13:25,972 --> 00:13:27,889 But the bottom guys are sitting down driving the choppers. 308 00:13:27,890 --> 00:13:29,599 I'm fine. I don't need all this. 309 00:13:29,600 --> 00:13:31,310 - Were you wearing a helmet? - Of course. 310 00:13:31,311 --> 00:13:33,603 Oh, what do you know? They're still in style. 311 00:13:33,604 --> 00:13:36,189 Good vitals, tender right wrist, and big left knee lac. 312 00:13:36,190 --> 00:13:38,525 Hey, Joy, Perlah, Trauma Two. 313 00:13:38,526 --> 00:13:39,943 Who else can I have? 314 00:13:39,944 --> 00:13:41,570 Santos and Whitaker are in with Louie. 315 00:13:41,571 --> 00:13:43,405 Yeah, give me Whitaker. He could use a distraction. 316 00:13:43,406 --> 00:13:45,115 And Santos has been ducking traumas all day. 317 00:13:45,116 --> 00:13:46,575 Well, she's behind in her charting. 318 00:13:46,576 --> 00:13:47,827 Who isn't? 319 00:13:50,955 --> 00:13:54,541 OK, even when it's not your fault, 320 00:13:54,542 --> 00:13:56,126 sometimes it's worse knowing 321 00:13:56,127 --> 00:13:58,295 that there was nothing you could do. 322 00:13:58,296 --> 00:14:00,672 Uh-huh. 323 00:14:00,673 --> 00:14:02,466 Are you-- 324 00:14:02,467 --> 00:14:03,925 Robby needs you both in Trauma Two, 325 00:14:03,926 --> 00:14:05,719 and I need you to discharge sweet Patty in 13 326 00:14:05,720 --> 00:14:07,095 as soon as you're done. 327 00:14:07,096 --> 00:14:08,597 Can't catch a break. 328 00:14:08,598 --> 00:14:10,433 I push you 'cause I know you can take it. 329 00:14:22,820 --> 00:14:25,947 You ever clean a dead body? 330 00:14:25,948 --> 00:14:29,701 Probably never seen one either. 331 00:14:29,702 --> 00:14:32,662 No one tells you what it looks, feels, or smells like, 332 00:14:32,663 --> 00:14:35,249 but you get used to it over time. 333 00:14:36,876 --> 00:14:40,003 You pull off the gown. You wipe him down with towels. 334 00:14:40,004 --> 00:14:42,255 Then we'll roll him on his side, 335 00:14:42,256 --> 00:14:45,550 clean his back, stuff the sheet under him, 336 00:14:45,551 --> 00:14:48,136 wipe down the bed, roll him the other way, 337 00:14:48,137 --> 00:14:49,846 pull out the sheet, and repeat. 338 00:14:49,847 --> 00:14:52,516 Just follow my lead. 339 00:14:52,517 --> 00:14:56,520 Usually, you leave the ET tube in for the coroner, 340 00:14:56,521 --> 00:15:00,399 but Louie's a chronic alcoholic with end-stage liver disease. 341 00:15:00,400 --> 00:15:02,151 Not a coroner's case. 342 00:15:04,278 --> 00:15:07,572 - Did he have family? - Everyone has family. 343 00:15:07,573 --> 00:15:10,700 The social worker always tries to find them. 344 00:15:10,701 --> 00:15:13,078 Sometimes the family loved them, 345 00:15:13,079 --> 00:15:14,287 tried to get them to come home. 346 00:15:14,288 --> 00:15:17,374 Other times, the family wants nothing to do with them. 347 00:15:17,375 --> 00:15:19,377 - That's sad. - That's life. 348 00:15:21,212 --> 00:15:22,963 What happens if no one claims his body? 349 00:15:22,964 --> 00:15:24,589 He'll be cremated. 350 00:15:24,590 --> 00:15:26,133 Where would his ashes go? 351 00:15:26,134 --> 00:15:27,551 They'll keep him for a few months. 352 00:15:27,552 --> 00:15:28,969 Then he gets buried in a mass grave 353 00:15:28,970 --> 00:15:31,013 with all the other unclaimed bodies. 354 00:15:32,932 --> 00:15:35,810 OK, now we roll him. 355 00:15:38,855 --> 00:15:40,689 Ready. 356 00:15:40,690 --> 00:15:42,315 Go. 357 00:15:42,316 --> 00:15:43,692 Oh, my God, is he still alive? 358 00:15:43,693 --> 00:15:45,403 No, that happens. 359 00:15:46,362 --> 00:15:48,280 These frequent fliers. 360 00:15:48,281 --> 00:15:52,075 They can be a real pain in the ass, but... 361 00:15:52,076 --> 00:15:55,121 you miss them when they're gone. 362 00:16:01,878 --> 00:16:04,045 I've been at every Millvale Fourth of July parade 363 00:16:04,046 --> 00:16:05,547 since '08. 364 00:16:05,548 --> 00:16:07,966 World record is 40 men on seven motorcycles. 365 00:16:07,967 --> 00:16:09,551 I plan to beat that someday. 366 00:16:09,552 --> 00:16:11,553 Good lung sliding bilaterally. 367 00:16:11,554 --> 00:16:13,138 Pupils equal and reactive. 368 00:16:13,139 --> 00:16:14,973 - What do you ride? - The Bullet. 369 00:16:14,974 --> 00:16:16,850 Oh, Royal Enfield. Ankle breaker. 370 00:16:16,851 --> 00:16:19,186 - Thumper. - BP 138 over 80. 371 00:16:19,187 --> 00:16:21,354 Pulse 94. Pulse ox 98. 372 00:16:21,355 --> 00:16:23,607 All your vitals sound really good, Brandon. 373 00:16:23,608 --> 00:16:25,233 They call it an ankle breaker 'cause 374 00:16:25,234 --> 00:16:26,902 you got to kick over a big, fat single cylinder 375 00:16:26,903 --> 00:16:29,154 to get it started, sometimes five or six kicks. 376 00:16:29,155 --> 00:16:31,364 Yeah, especially on a cold day. 377 00:16:31,365 --> 00:16:33,658 Um, does anyone have any trauma scissors? 378 00:16:33,659 --> 00:16:35,535 - I'll check the knee. - Uh, not yet. 379 00:16:35,536 --> 00:16:37,370 - Why not? - Dr. Santos. 380 00:16:37,371 --> 00:16:39,831 Primary survey means rule out the life threats. 381 00:16:39,832 --> 00:16:41,917 Don't get distracted by lacerations or fractures. 382 00:16:41,918 --> 00:16:43,668 No free fluid in the belly. 383 00:16:43,669 --> 00:16:46,129 Airway, breathing, circulation are fine. 384 00:16:46,130 --> 00:16:48,381 OK, that's ABC. That just leaves two letters. 385 00:16:48,382 --> 00:16:50,592 Tell her about D, Dr. Santos. 386 00:16:50,593 --> 00:16:52,594 Disability. Wiggle your toes, sir. 387 00:16:52,595 --> 00:16:54,804 Any pain in your arms or legs? 388 00:16:54,805 --> 00:16:56,389 Not really. 389 00:16:56,390 --> 00:16:57,682 Does it hurt when I push here? 390 00:16:57,683 --> 00:16:59,601 - No. - OK, no midline tenderness. 391 00:16:59,602 --> 00:17:01,269 Nexus negative. 392 00:17:01,270 --> 00:17:03,438 With no obvious brain injury or spinal cord injury. 393 00:17:03,439 --> 00:17:06,608 That just leaves E. Joy. 394 00:17:06,609 --> 00:17:08,360 Can I buy another vowel? 395 00:17:08,361 --> 00:17:10,570 - Dr. Whitaker. - Exposure. 396 00:17:10,571 --> 00:17:12,072 AKA strip and flip. 397 00:17:12,073 --> 00:17:14,199 Cut off his clothes, and we'll log roll him. 398 00:17:14,200 --> 00:17:16,243 What do we have? 399 00:17:16,244 --> 00:17:18,161 Helmeted motorcycle acrobat. 400 00:17:18,162 --> 00:17:20,747 8-foot fall standing on top of five riders. 401 00:17:20,748 --> 00:17:22,415 Primary survey normal, E-FAST negative. 402 00:17:22,416 --> 00:17:24,334 Another motorcycle accident. 403 00:17:24,335 --> 00:17:26,545 Hello, sir. I'm Dr. Garcia from surgery. 404 00:17:26,546 --> 00:17:28,004 Hello. 405 00:17:28,005 --> 00:17:33,135 OK, we will roll him in three, two, one. 406 00:17:37,181 --> 00:17:39,641 Well, I grew up a block from Carrick, 407 00:17:39,642 --> 00:17:42,561 but my mom was a teacher at Brashear, so I had to go there. 408 00:17:42,562 --> 00:17:45,063 - The Bullets? - That's right. 409 00:17:45,064 --> 00:17:46,439 They were the Bullets when I was there. 410 00:17:46,440 --> 00:17:48,233 They changed to the Bulls when I left. 411 00:17:48,234 --> 00:17:49,734 Oh. 412 00:17:49,735 --> 00:17:52,697 Hey, you think I could get something to eat? 413 00:17:54,198 --> 00:17:56,825 Gus here is wondering if he's clear to eat. 414 00:17:56,826 --> 00:17:58,785 As long as it's a liquid diet. 415 00:17:58,786 --> 00:18:01,663 We have the results of your CT scan. 416 00:18:01,664 --> 00:18:04,583 Your jaw should heal without surgery, which is good news, 417 00:18:04,584 --> 00:18:07,168 but it will be a few weeks. 418 00:18:07,169 --> 00:18:08,670 Before I can eat? 419 00:18:08,671 --> 00:18:10,463 Solid foods, yes. 420 00:18:10,464 --> 00:18:14,259 Or you can have food pureed with liquid in a blender. 421 00:18:14,260 --> 00:18:16,928 I don't have a blender. 422 00:18:16,929 --> 00:18:18,346 Right. 423 00:18:18,347 --> 00:18:20,265 Sorry. 424 00:18:20,266 --> 00:18:23,643 We have a calorie-rich supplement drink called Ensure. 425 00:18:23,644 --> 00:18:27,063 Comes in chocolate, vanilla, or strawberry. 426 00:18:27,064 --> 00:18:28,940 Chocolate, please. 427 00:18:28,941 --> 00:18:30,609 - Good choice. - How many can I have? 428 00:18:30,610 --> 00:18:32,110 Two a day is recommended. 429 00:18:32,111 --> 00:18:34,195 I'll get it for you. 430 00:18:34,196 --> 00:18:37,616 You have an appetite. That's good. 431 00:18:37,617 --> 00:18:39,743 Mr. Varney, your blood tests indicate 432 00:18:39,744 --> 00:18:42,329 low levels of protein and vitamins. 433 00:18:42,330 --> 00:18:44,498 Can we ask you a few questions about your diet? 434 00:18:46,292 --> 00:18:49,586 How many meals or snacks do you have in a 24-hour period? 435 00:18:49,587 --> 00:18:50,962 I don't know. 436 00:18:50,963 --> 00:18:52,922 Don't count. 437 00:18:52,923 --> 00:18:55,550 Pretty sure it's three trays a day. 438 00:18:55,551 --> 00:18:57,218 OK. 439 00:18:57,219 --> 00:19:00,430 How often do you eat cereals, fruits, or vegetables? 440 00:19:00,431 --> 00:19:03,683 Not many fruits and vegetables in prison. 441 00:19:03,684 --> 00:19:05,311 Slow and steady. 442 00:19:07,355 --> 00:19:09,481 What year is your Bonneville? 443 00:19:09,482 --> 00:19:10,774 '69. 444 00:19:10,775 --> 00:19:13,151 Rescued it from a motor graveyard. 445 00:19:13,152 --> 00:19:14,694 Brought it back to life with a buddy of mine, 446 00:19:14,695 --> 00:19:16,446 who's supposed to be coming in today. 447 00:19:16,447 --> 00:19:17,906 How often do you ride? 448 00:19:17,907 --> 00:19:19,741 I ride it in to work every day. 449 00:19:19,742 --> 00:19:20,950 Good for you. 450 00:19:20,951 --> 00:19:22,619 Don't encourage him. 451 00:19:22,620 --> 00:19:24,371 CT's ready for Brandon. 452 00:19:24,372 --> 00:19:26,957 As soon as we take a look at this knee. 453 00:19:28,376 --> 00:19:30,710 - Whoa. - Through the deep fascia. 454 00:19:30,711 --> 00:19:31,836 How's it look? 455 00:19:31,837 --> 00:19:33,004 Definitely gonna need stitches. 456 00:19:33,005 --> 00:19:34,339 - How many? - A lot. 457 00:19:34,340 --> 00:19:35,882 It could be an open joint. 458 00:19:35,883 --> 00:19:37,759 We'll do a saline load after CT. 459 00:19:37,760 --> 00:19:39,302 OK. 460 00:19:39,303 --> 00:19:41,221 Lever sign negative. ACL intact. 461 00:19:41,222 --> 00:19:42,556 OK, ready to roll. 462 00:19:47,603 --> 00:19:49,437 Are you still coming over tonight? 463 00:19:49,438 --> 00:19:51,231 I think Whitaker is gonna be playing 464 00:19:51,232 --> 00:19:53,274 farm boy again this weekend, so he's not gonna be around. 465 00:19:53,275 --> 00:19:54,984 I may need a rain check. 466 00:19:54,985 --> 00:19:56,653 Hey, do you have an update on that nec fasc patient? 467 00:19:56,654 --> 00:19:58,113 Last I heard, Miller was doing 468 00:19:58,114 --> 00:20:00,199 an above-the-knee amputation with ortho. 469 00:20:02,243 --> 00:20:04,661 Langdon's waitress with the cellulitis? 470 00:20:04,662 --> 00:20:05,995 Yeah. 471 00:20:05,996 --> 00:20:08,623 - Man, that took a turn. - Sure did. 472 00:20:08,624 --> 00:20:11,252 Hey, did you hear about Louie? 473 00:20:12,545 --> 00:20:15,046 - Yeah. - You OK? 474 00:20:15,047 --> 00:20:16,548 Um, 475 00:20:16,549 --> 00:20:20,093 one of my uncles drank himself to death. 476 00:20:20,094 --> 00:20:22,971 I barely recognized him at the end. 477 00:20:22,972 --> 00:20:26,266 At least Louie always seemed happy. 478 00:20:26,267 --> 00:20:27,852 I'm here if you want to talk. 479 00:20:33,482 --> 00:20:36,401 Should've known I'd find you in here. 480 00:20:36,402 --> 00:20:40,238 You steal anyone's lunch, it's a $20 fine. 481 00:20:40,239 --> 00:20:41,906 Made a lot of changes while you were gone. 482 00:20:41,907 --> 00:20:43,533 I can see that. 483 00:20:43,534 --> 00:20:44,993 Look, I'll let you hide out a little bit longer, 484 00:20:44,994 --> 00:20:46,661 but then I need you to pick up more patients. 485 00:20:46,662 --> 00:20:48,246 You're not as fast as you used to be. 486 00:20:48,247 --> 00:20:50,373 Damn doughnuts! 487 00:20:50,374 --> 00:20:52,709 Ouch. 488 00:20:52,710 --> 00:20:55,670 First day back, I get kicked in the nuts. 489 00:20:55,671 --> 00:20:57,839 One dead, one septic bounce-back. 490 00:20:57,840 --> 00:21:00,092 Both of those not your fault. 491 00:21:02,720 --> 00:21:04,471 You expecting a party? 492 00:21:04,472 --> 00:21:06,181 No, not really. 493 00:21:06,182 --> 00:21:08,559 Didn't hear from anyone while I was gone. 494 00:21:11,061 --> 00:21:12,896 Sorry. 495 00:21:12,897 --> 00:21:16,566 They ever, uh, arrest that guy who punched you? 496 00:21:16,567 --> 00:21:18,401 Yeah. 497 00:21:18,402 --> 00:21:20,320 Wanted to know if I wanted to press charges, 498 00:21:20,321 --> 00:21:23,656 but didn't want to go through all that. 499 00:21:23,657 --> 00:21:26,242 Thought I was done, really did, but... 500 00:21:26,243 --> 00:21:29,913 I got bored at home, so only lasted a few weeks. 501 00:21:29,914 --> 00:21:31,706 You? 502 00:21:31,707 --> 00:21:34,417 10 months is a long time to be alone with your thoughts. 503 00:21:34,418 --> 00:21:37,003 I almost lost everything. 504 00:21:37,004 --> 00:21:39,172 I know a lot of women who would have taken the kids and left, 505 00:21:39,173 --> 00:21:42,425 - but Abby stayed. - 'Cause she's a good woman. 506 00:21:42,426 --> 00:21:44,260 'Cause you deserve a second chance. 507 00:21:44,261 --> 00:21:46,054 I'm not sure everyone agrees with you. 508 00:21:46,055 --> 00:21:47,347 Give it time. 509 00:21:47,348 --> 00:21:49,391 Look, I-- 510 00:21:53,604 --> 00:21:56,147 I, um-- 511 00:21:56,148 --> 00:22:00,026 I've been working the 12 steps, trying to make amends. 512 00:22:00,027 --> 00:22:01,778 I was really selfish. 513 00:22:01,779 --> 00:22:03,655 I lied to myself, and I lied to you. 514 00:22:03,656 --> 00:22:05,031 I'm really sorry. 515 00:22:05,032 --> 00:22:06,449 You can check me off your list, kid. 516 00:22:06,450 --> 00:22:08,368 We're good. 517 00:22:08,369 --> 00:22:10,537 - OK. - Yeah. 518 00:22:10,538 --> 00:22:12,205 Got a lovely patient for you in Two. 519 00:22:12,206 --> 00:22:14,124 Let's get you back on the horse. 520 00:22:17,169 --> 00:22:18,670 Really need to talk with Robby. 521 00:22:18,671 --> 00:22:20,088 I don't know if today's the best day for that. 522 00:22:20,089 --> 00:22:21,381 He leaves on vacation tomorrow. 523 00:22:21,382 --> 00:22:22,882 Let him get through the day in peace. 524 00:22:22,883 --> 00:22:24,384 He's supposed to be gone for three months? 525 00:22:24,385 --> 00:22:26,386 So he says. I give him one. 526 00:22:26,387 --> 00:22:27,763 Go get 'em, kid. 527 00:22:30,558 --> 00:22:33,351 Dr. Langdon, this is Rocky. 528 00:22:33,352 --> 00:22:34,727 Great name. 529 00:22:34,728 --> 00:22:38,356 What brings you in, Rocky? 530 00:22:38,357 --> 00:22:40,066 Very sick. 531 00:22:40,067 --> 00:22:42,318 When did it start? 532 00:22:42,319 --> 00:22:43,903 An hour ago. 533 00:22:43,904 --> 00:22:46,531 After he won a hot dog eating contest. 534 00:22:46,532 --> 00:22:48,951 A hot dog eating contest? How many you eat? 535 00:22:51,871 --> 00:22:53,914 351 hot dogs? 536 00:22:58,085 --> 00:22:59,586 36. 537 00:22:59,587 --> 00:23:02,088 Still a lot. 538 00:23:02,089 --> 00:23:04,090 - I pulled eight of Zofran. - Go for it. 539 00:23:04,091 --> 00:23:05,508 All right, this should help. 540 00:23:05,509 --> 00:23:07,176 Stick it under your tongue. Let it dissolve. 541 00:23:07,177 --> 00:23:08,345 OK, are you taking any prescription-- 542 00:23:13,767 --> 00:23:16,144 Oh, thank you. 543 00:23:16,145 --> 00:23:18,688 Thanks. 544 00:23:18,689 --> 00:23:20,982 Santos, what's up with your ileus patient? 545 00:23:20,983 --> 00:23:22,984 Admitted to medicine, and before you ask, 546 00:23:22,985 --> 00:23:24,736 13 has been discharged. 547 00:23:24,737 --> 00:23:27,030 Great. 12 needs a doctor. 548 00:23:27,031 --> 00:23:28,907 No, don't make me go back there. 549 00:23:28,908 --> 00:23:32,076 That disimpaction left a smell and stunk up the whole hallway. 550 00:23:32,077 --> 00:23:34,120 So grab some coffee grounds from the lounge. 551 00:23:34,121 --> 00:23:36,748 We need to admit our incarcerated patient, Gus. 552 00:23:36,749 --> 00:23:38,625 What did the CT show? 553 00:23:38,626 --> 00:23:41,085 Moderate pulmonary contusion, three rib fractures, 554 00:23:41,086 --> 00:23:43,880 no intra-abdominal bleeding, and oblique fracture 555 00:23:43,881 --> 00:23:46,507 in the body of the mandible anterior to the angle. 556 00:23:46,508 --> 00:23:48,718 All favorable for healing. What's the treatment plan? 557 00:23:48,719 --> 00:23:50,553 - A pain med-- - Security. 558 00:23:50,554 --> 00:23:51,971 People are trying to sleep. 559 00:23:51,972 --> 00:23:55,475 Pain medication, antibiotics, liquid diet, 560 00:23:55,476 --> 00:23:57,435 um, a pulse ox a few times a day, 561 00:23:57,436 --> 00:24:00,271 and then also dressing changes for the laceration. 562 00:24:00,272 --> 00:24:02,774 Which he can get at his correctional facility. 563 00:24:02,775 --> 00:24:05,026 Or he stays here for a few days, 564 00:24:05,027 --> 00:24:07,946 and we get him on the right track to healing. 565 00:24:07,947 --> 00:24:10,031 Why don't you two go check on your patients? 566 00:24:10,032 --> 00:24:12,742 - Got it. - Sure thing. 567 00:24:12,743 --> 00:24:14,577 What am I missing? 568 00:24:14,578 --> 00:24:15,995 He's not getting enough to eat 569 00:24:15,996 --> 00:24:17,497 at his correctional facility. 570 00:24:17,498 --> 00:24:19,082 The portions are tiny. 571 00:24:19,083 --> 00:24:21,042 Too many carbs, not enough fruits or vegetables. 572 00:24:21,043 --> 00:24:24,504 He's lucky he hasn't developed a chronic illness. 573 00:24:24,505 --> 00:24:26,297 We don't have any inpatient beds. 574 00:24:26,298 --> 00:24:27,840 He would board down here for three days. 575 00:24:27,841 --> 00:24:29,384 We're still getting runs from Westbridge, 576 00:24:29,385 --> 00:24:31,719 and we cannot tie up Behavioral for that long. 577 00:24:31,720 --> 00:24:33,554 Dr. Al-Hashimi, Dr. Jefferson wants to talk 578 00:24:33,555 --> 00:24:35,224 to you about our tasered kid. 579 00:24:39,144 --> 00:24:40,603 Why don't I call the prison doctor 580 00:24:40,604 --> 00:24:42,313 and find out what they're working with over there? 581 00:24:42,314 --> 00:24:44,066 - Thank you. - My pleasure. 582 00:24:46,193 --> 00:24:48,569 Dr. Jefferson seems to have a good rapport with Jackson. 583 00:24:48,570 --> 00:24:49,946 That's excellent. 584 00:24:49,947 --> 00:24:51,280 How's the sister doing? 585 00:24:51,281 --> 00:24:52,657 Still pretty upset. 586 00:24:52,658 --> 00:24:54,158 She's never seen him like this. 587 00:24:54,159 --> 00:24:55,785 It's a lot to process. 588 00:24:55,786 --> 00:24:58,037 - How's he doing? - He's scared. 589 00:24:58,038 --> 00:24:59,580 Droperidol had a positive effect, 590 00:24:59,581 --> 00:25:01,958 but he doesn't understand what's going on. 591 00:25:01,959 --> 00:25:04,002 He's been experiencing auditory hallucinations 592 00:25:04,003 --> 00:25:05,586 and paranoid delusions. 593 00:25:05,587 --> 00:25:08,798 Voices are telling him he isn't safe. 594 00:25:08,799 --> 00:25:10,091 This has been going on for months. 595 00:25:10,092 --> 00:25:11,718 - Months? - Yeah. 596 00:25:11,719 --> 00:25:13,302 Turns out, his sister hasn't seen him in a while. 597 00:25:13,303 --> 00:25:15,346 Family history of mental illness? 598 00:25:15,347 --> 00:25:17,557 Not that we know of. 599 00:25:17,558 --> 00:25:21,394 I'm gonna give him a break and then continue the conversation. 600 00:25:21,395 --> 00:25:22,770 Parents are on their way. 601 00:25:22,771 --> 00:25:23,771 We'll let you know when they get here. 602 00:25:23,772 --> 00:25:25,231 Yes. Do. 603 00:25:25,232 --> 00:25:27,066 OK, hospital bed, wheelchair, 604 00:25:27,067 --> 00:25:30,069 and shower chair have all been ordered. 605 00:25:30,070 --> 00:25:31,779 What do you say, kid? 606 00:25:31,780 --> 00:25:33,657 Ready to go home? 607 00:25:36,035 --> 00:25:38,911 How's your pain, Mrs. Hamler? 608 00:25:38,912 --> 00:25:40,413 The same. 609 00:25:40,414 --> 00:25:42,749 We're gonna write you a script for Keppra. 610 00:25:42,750 --> 00:25:44,083 You'll take that to prevent seizures 611 00:25:44,084 --> 00:25:45,918 once a day, starting tomorrow. 612 00:25:45,919 --> 00:25:47,879 Between your broken leg and the bruises from your seizure, 613 00:25:47,880 --> 00:25:49,922 the pain will probably get a little worse. 614 00:25:49,923 --> 00:25:51,174 Yeah, the most important thing is 615 00:25:51,175 --> 00:25:52,383 to let others help you. 616 00:25:52,384 --> 00:25:53,968 You'll need assistance showering 617 00:25:53,969 --> 00:25:55,470 and getting to the bathroom. 618 00:25:55,471 --> 00:25:57,388 Yeah, no problem. I won't leave her side. 619 00:25:57,389 --> 00:25:59,766 Paul, you need a break. 620 00:25:59,767 --> 00:26:04,228 You're--you're taking care of me, the kids, the house. 621 00:26:04,229 --> 00:26:07,482 It's too much for one person. 622 00:26:07,483 --> 00:26:09,776 I'm not the one battling cancer. 623 00:26:09,777 --> 00:26:11,069 Paul. 624 00:26:11,070 --> 00:26:14,530 Hey, you're in pain every day, 625 00:26:14,531 --> 00:26:16,240 fighting for your life. 626 00:26:16,241 --> 00:26:18,910 I'm happy to do this for you. 627 00:26:18,911 --> 00:26:21,454 You're my wife. 628 00:26:21,455 --> 00:26:24,582 Now, let's go home and forget this day ever happened. 629 00:26:24,583 --> 00:26:26,042 I'll call the transpo ambulance. 630 00:26:26,043 --> 00:26:27,294 Thanks, Princess. 631 00:26:33,884 --> 00:26:35,468 Hey. 632 00:26:35,469 --> 00:26:36,928 Hmm? 633 00:26:36,929 --> 00:26:39,097 Why don't you go ahead? 634 00:26:39,098 --> 00:26:40,181 - What? - Yeah. 635 00:26:40,182 --> 00:26:41,474 You can get the house ready. 636 00:26:41,475 --> 00:26:43,643 I'll be right behind you. 637 00:26:43,644 --> 00:26:45,311 - No. - Mm-hmm. 638 00:26:45,312 --> 00:26:49,440 No, I'm--I'm riding in the back with you. 639 00:26:49,441 --> 00:26:52,277 You know what? I'll stay with her. 640 00:26:53,862 --> 00:26:55,655 Are you sure? 641 00:26:55,656 --> 00:26:57,907 - Mm-hmm. - Yeah. 642 00:26:57,908 --> 00:27:01,119 OK. 643 00:27:01,120 --> 00:27:04,080 Um, call me if you need me to come back. 644 00:27:04,081 --> 00:27:05,833 Mm-hmm. 645 00:27:11,130 --> 00:27:12,547 When will the ambulance get here? 646 00:27:12,548 --> 00:27:13,631 It shouldn't be long. 647 00:27:13,632 --> 00:27:15,716 Mr. Francis, short of breath? 648 00:27:15,717 --> 00:27:17,176 Yeah, I was worried the clot in my leg 649 00:27:17,177 --> 00:27:19,220 could have gone up to my lungs, so... 650 00:27:19,221 --> 00:27:21,055 You're on Eliquis. That shouldn't happen. 651 00:27:21,056 --> 00:27:22,890 - Yeah, I know, but-- - Hey, Donnie, I got this. 652 00:27:22,891 --> 00:27:24,392 Don't worry, Mr. Francis. 653 00:27:24,393 --> 00:27:26,060 I'll order the D-dimer. I'll be back to see you. 654 00:27:26,061 --> 00:27:28,646 Thank you, Dr. Mohan. 655 00:27:28,647 --> 00:27:30,648 You know I'm an NP now. 656 00:27:30,649 --> 00:27:32,150 I can pick up a patient with dyspnea. 657 00:27:32,151 --> 00:27:33,651 I'm sorry. 658 00:27:33,652 --> 00:27:36,070 I've seen him before, and he's asked for me. 659 00:27:36,071 --> 00:27:38,197 Why even order the test? He's on Eliquis. 660 00:27:38,198 --> 00:27:39,532 Mr. Francis comes in every month 661 00:27:39,533 --> 00:27:41,534 and always asks for a D-dimer. 662 00:27:41,535 --> 00:27:43,995 Just--he's worried, and it puts his mind at ease. 663 00:27:43,996 --> 00:27:46,622 - Why not? - Yeah, OK. 664 00:27:46,623 --> 00:27:49,458 Donnie's the best. You'll learn a lot from him. 665 00:27:49,459 --> 00:27:51,420 That's right. 666 00:28:18,113 --> 00:28:20,239 All right, fill me in. 667 00:28:20,240 --> 00:28:22,950 This is Harlow Graham. She was seen in triage. 668 00:28:22,951 --> 00:28:25,328 CBC and CMP came back normal. 669 00:28:25,329 --> 00:28:27,830 IT was supposed to bring the VRI down, but they're slammed. 670 00:28:27,831 --> 00:28:29,540 I know a bit of sign language. 671 00:28:29,541 --> 00:28:35,046 Harlow, this is Dr. Santos. 672 00:28:35,047 --> 00:28:36,715 Hi, Harlow. How are you feeling? 673 00:28:39,593 --> 00:28:40,927 She has a headache. 674 00:28:40,928 --> 00:28:42,721 OK. What else? 675 00:28:48,227 --> 00:28:49,852 What is she saying? 676 00:28:49,853 --> 00:28:51,979 I think she had a stomachache, 677 00:28:51,980 --> 00:28:54,775 and she might have passed out. 678 00:28:57,903 --> 00:28:59,654 I'm not 100% sure. 679 00:28:59,655 --> 00:29:02,240 OK, we're just gonna need to wait for an interpreter, 680 00:29:02,241 --> 00:29:03,908 'cause I need to ask a million questions, 681 00:29:03,909 --> 00:29:05,534 and I can't do it this way. 682 00:29:05,535 --> 00:29:07,579 So just call me when IT comes down. 683 00:29:18,966 --> 00:29:21,884 CT head, neck, chest, abdomen, pelvis all negative. 684 00:29:21,885 --> 00:29:24,971 It means we can get this collar off. 685 00:29:24,972 --> 00:29:27,098 Thank you. 686 00:29:27,099 --> 00:29:28,516 Roll to your side. 687 00:29:28,517 --> 00:29:30,768 We'll get you off this board. 688 00:29:30,769 --> 00:29:32,353 How long is your trip? 689 00:29:32,354 --> 00:29:35,231 2,000 miles, all the way from here to Alberta. 690 00:29:35,232 --> 00:29:36,899 Couple stops along the way. 691 00:29:36,900 --> 00:29:38,442 Got the whole thing mapped out. 692 00:29:38,443 --> 00:29:40,653 - Sounds like heaven. - Let's sit you up. 693 00:29:40,654 --> 00:29:42,363 Sorry, I got stuck with a patient. 694 00:29:42,364 --> 00:29:44,448 You know the old saying, four wheels move the body, 695 00:29:44,449 --> 00:29:46,033 two wheels move the soul. 696 00:29:46,034 --> 00:29:47,535 You're gonna be living the dream. 697 00:29:47,536 --> 00:29:48,953 Thank you, Brandon. 698 00:29:48,954 --> 00:29:50,496 Not everybody down here feels that way. 699 00:29:50,497 --> 00:29:52,790 - OK, Whitaker, what's next? - Ortho assessment. 700 00:29:52,791 --> 00:29:56,002 Palpate all long bones, starting with the clavicle. 701 00:29:56,003 --> 00:29:57,295 Got it. 702 00:29:57,296 --> 00:29:59,756 I'll take the lower extremities. 703 00:30:04,386 --> 00:30:05,636 Distal radius tender. No deformities. 704 00:30:05,637 --> 00:30:06,846 Needs an X-ray. 705 00:30:06,847 --> 00:30:08,222 No bony tenderness down here. 706 00:30:08,223 --> 00:30:09,640 No laxity of the knee. 707 00:30:09,641 --> 00:30:12,351 Are you concerned about that knee lac? 708 00:30:12,352 --> 00:30:14,520 If it's an open joint, he'll need a washout in the OR. 709 00:30:14,521 --> 00:30:16,480 We could try a fluorescein injection. 710 00:30:16,481 --> 00:30:17,982 OK, we'll need a-- 711 00:30:17,983 --> 00:30:19,650 Wood's lamp, 1% lido with epi, 712 00:30:19,651 --> 00:30:22,069 sterile saline, sterile basin, sterile fluoro-strip, 713 00:30:22,070 --> 00:30:26,198 18- and 27-gauge needles, 5- and 60-cc syringes. 714 00:30:26,199 --> 00:30:28,659 How does she know all that? 715 00:30:28,660 --> 00:30:29,953 She just does. 716 00:30:31,413 --> 00:30:32,788 How are you feeling, Rocky? 717 00:30:32,789 --> 00:30:34,582 Oh, much better. 718 00:30:34,583 --> 00:30:36,334 He's had eight migs of ondansetron. 719 00:30:36,335 --> 00:30:37,793 Any pain in the belly? 720 00:30:37,794 --> 00:30:40,087 No, but my mouth is really dry. 721 00:30:40,088 --> 00:30:43,549 No doubt from consuming mass quantities of salty hot dogs. 722 00:30:43,550 --> 00:30:45,092 Could I have another sip of water? 723 00:30:45,093 --> 00:30:46,677 Sure. A little sip. 724 00:30:46,678 --> 00:30:48,721 Take it slow. 725 00:30:48,722 --> 00:30:50,222 - Here you go. - Thank you. 726 00:30:50,223 --> 00:30:53,934 Just enough to wet your whistle. 727 00:30:53,935 --> 00:30:56,688 So how'd you get your start as a competitive eater? 728 00:31:05,489 --> 00:31:07,948 Any pain here, Mr. Li? 729 00:31:07,949 --> 00:31:09,617 - Can't feel a thing. - Great. 730 00:31:09,618 --> 00:31:10,951 Where is Santos? 731 00:31:10,952 --> 00:31:13,621 Probably catching up on her charting. 732 00:31:13,622 --> 00:31:15,039 - Right. - Lights out. 733 00:31:15,040 --> 00:31:16,833 Wood's lamp on. 734 00:31:18,752 --> 00:31:20,545 OK. 735 00:31:22,172 --> 00:31:24,090 I might want to use some of that on Halloween. 736 00:31:24,091 --> 00:31:26,926 That is 250 ccs of sterile saline 737 00:31:26,927 --> 00:31:29,720 with one small touch of a sterile fluoro-strip. 738 00:31:29,721 --> 00:31:31,472 OK. 739 00:31:31,473 --> 00:31:34,266 We're going to inject this fluid into your knee, Brandon, 740 00:31:34,267 --> 00:31:37,895 and if there's anything glowing in your wound, 741 00:31:37,896 --> 00:31:39,855 we know we have a leak. 742 00:31:39,856 --> 00:31:42,358 - Feeling some pressure. - Yeah, it's normal. 743 00:31:42,359 --> 00:31:45,237 As soon as I finish the test, I'll pull off the fluid. 744 00:31:47,531 --> 00:31:49,156 That looks good. 745 00:31:49,157 --> 00:31:51,200 Laceration did not enter into the joint space. 746 00:31:51,201 --> 00:31:52,743 Surgery not needed. 747 00:31:52,744 --> 00:31:54,412 Excellent. I can get back to the parade. 748 00:31:54,413 --> 00:31:55,830 No, we'll still need to 749 00:31:55,831 --> 00:31:57,248 stitch you up and splint your wrist. 750 00:31:57,249 --> 00:31:58,582 Hanging a gram of Ancef. 751 00:31:58,583 --> 00:32:00,376 Wait, he has a penicillin allergy. 752 00:32:00,377 --> 00:32:03,003 No, PEN-FAST was negative. We're OK. 753 00:32:03,004 --> 00:32:05,798 My mom said I got a rash with amoxicillin when I was two. 754 00:32:05,799 --> 00:32:07,716 Yeah, probably not a true allergy. 755 00:32:07,717 --> 00:32:09,301 Go ahead and give it, Kim. 756 00:32:09,302 --> 00:32:11,303 But have epi and Benadryl standing by, right? 757 00:32:11,304 --> 00:32:13,305 Yes, to be on the safe side. 758 00:32:13,306 --> 00:32:15,558 Most people who think they have a penicillin allergy 759 00:32:15,559 --> 00:32:17,518 actually don't. 760 00:32:17,519 --> 00:32:20,104 Always listen to the nurses. They run the ER. 761 00:32:20,105 --> 00:32:22,065 We just try and stay out of their way. 762 00:32:29,030 --> 00:32:31,073 Now we can really clean him up. 763 00:32:31,074 --> 00:32:32,741 Didn't we already do that? 764 00:32:32,742 --> 00:32:34,952 Dried blood on the face, neck, hands. 765 00:32:34,953 --> 00:32:37,872 If anyone comes, they shouldn't have to see that. 766 00:32:37,873 --> 00:32:39,999 Sometimes the local unhoused folks will pay a visit, 767 00:32:40,000 --> 00:32:41,625 but we always make them presentable 768 00:32:41,626 --> 00:32:44,128 in case anyone comes. 769 00:32:44,129 --> 00:32:47,256 That's the last thing we can do for them. 770 00:32:47,257 --> 00:32:50,926 Didn't get to do that during COVID. 771 00:32:50,927 --> 00:32:53,304 Once he's spotless, we'll tuck him in nice and tight, 772 00:32:53,305 --> 00:32:55,598 but we always leave one arm outside the sheet. 773 00:32:55,599 --> 00:32:57,892 Because? 774 00:32:57,893 --> 00:33:00,519 So loved ones can hold their hand. 775 00:33:00,520 --> 00:33:02,563 - Here you go. - Thanks. 776 00:33:02,564 --> 00:33:04,065 Yeah. 777 00:33:06,193 --> 00:33:08,444 We're ready to discharge our cancer mom, Roxie. 778 00:33:08,445 --> 00:33:09,945 Ambulance is on the way; we just need 779 00:33:09,946 --> 00:33:11,822 - to reconcile her home meds. - Sounds good. 780 00:33:11,823 --> 00:33:13,741 Hey, I thought I saw another charge nurse around here. 781 00:33:13,742 --> 00:33:15,534 Oh, yeah. We travel in packs. 782 00:33:15,535 --> 00:33:16,911 Aren't you sick of this place yet? 783 00:33:16,912 --> 00:33:19,079 Oh, someone is ready for his sabbatical. 784 00:33:19,080 --> 00:33:20,748 Guilty as charged. 785 00:33:20,749 --> 00:33:22,708 Hey, I just got word that the at-home morphine pump 786 00:33:22,709 --> 00:33:23,876 is gonna be delayed. 787 00:33:23,877 --> 00:33:25,544 Hospital pharmacy has to mix it 788 00:33:25,545 --> 00:33:27,087 and then deliver it later today. 789 00:33:27,088 --> 00:33:28,839 Well, should we keep her here until it's ready? 790 00:33:28,840 --> 00:33:30,174 No, you can give her 791 00:33:30,175 --> 00:33:31,842 a 200-milligram tablet of MS Contin. 792 00:33:31,843 --> 00:33:34,011 - 200 milligrams? - Biggest pill they make. 793 00:33:34,012 --> 00:33:37,431 Releases over 12 hours for patients with opiate tolerance. 794 00:33:37,432 --> 00:33:39,016 Got it. 795 00:33:39,017 --> 00:33:40,476 Hey, do you want to stick around a little bit? 796 00:33:40,477 --> 00:33:41,936 Westbridge is closed to internal disaster. 797 00:33:41,937 --> 00:33:43,229 - We're getting all their runs. - Yeah, I heard. 798 00:33:43,230 --> 00:33:44,772 I put 20 bucks on a plumbing issue. 799 00:33:44,773 --> 00:33:46,649 I just watched that poop cruise documentary. 800 00:33:46,650 --> 00:33:48,442 Oh, I cannot stop thinking about it. 801 00:33:48,443 --> 00:33:50,569 That sounds like something I will absolutely never watch. 802 00:33:50,570 --> 00:33:52,154 Dr. Robby, 803 00:33:52,155 --> 00:33:54,740 you gave us a clozapine ileus about an hour ago. 804 00:33:54,741 --> 00:33:56,367 Your resident reported no surgical history, 805 00:33:56,368 --> 00:33:58,619 but the chart says they've had an appendectomy. 806 00:33:58,620 --> 00:34:00,704 We're not admitting the patient without a surgery consult. 807 00:34:00,705 --> 00:34:03,040 - Who called it in? - A Dr. Trinity Santos. 808 00:34:03,041 --> 00:34:06,377 Dr. Santos, you had an ileus patient. 809 00:34:06,378 --> 00:34:08,796 You neglected to mention a history of appendectomy. 810 00:34:08,797 --> 00:34:10,881 There was no history of appendectomy. 811 00:34:10,882 --> 00:34:12,299 It was in your note. 812 00:34:12,300 --> 00:34:15,094 I may have forgotten to proof check it. 813 00:34:15,095 --> 00:34:17,221 I was using the app that Dr. Al-Hashimi suggested 814 00:34:17,222 --> 00:34:18,347 to catch up on my charting. 815 00:34:18,348 --> 00:34:19,848 Wonderful. 816 00:34:19,849 --> 00:34:21,850 - Ah, Dr. Al-Hashimi. - Yes? 817 00:34:21,851 --> 00:34:25,437 Dr. Santos was just using your AI tool for her charting, 818 00:34:25,438 --> 00:34:28,732 and it hallucinated a history of appendicitis. 819 00:34:28,733 --> 00:34:32,027 As I mentioned to Dr. Santos, generative AI is not perfect. 820 00:34:32,028 --> 00:34:34,446 We still need to proofread every chart it creates. 821 00:34:34,447 --> 00:34:37,074 Mm-hmm, the patient also has a history of headache, 822 00:34:37,075 --> 00:34:39,201 followed by Dr. Park from Urology. 823 00:34:39,202 --> 00:34:41,912 That should probably be Neurology. 824 00:34:41,913 --> 00:34:44,164 Unless urologists are now treating migraines. 825 00:34:44,165 --> 00:34:45,583 Another example that should have been caught 826 00:34:45,584 --> 00:34:47,209 by proofreading. 827 00:34:47,210 --> 00:34:49,545 AI's 2% error rate is still better than dictation. 828 00:34:49,546 --> 00:34:51,046 Yeah, I don't really give a shit whether or not 829 00:34:51,047 --> 00:34:53,090 you want to use robots down here. 830 00:34:53,091 --> 00:34:55,551 I need accurate information in the medical record. 831 00:34:55,552 --> 00:34:57,011 - Understood. - OK. 832 00:34:57,012 --> 00:34:59,680 Dr. Santos. 833 00:34:59,681 --> 00:35:01,724 Dr. Santos! 834 00:35:01,725 --> 00:35:03,518 Yup. Won't happen again. 835 00:35:06,271 --> 00:35:07,272 Hoy. 836 00:35:08,982 --> 00:35:10,441 Thanks, Perlah. 837 00:35:10,442 --> 00:35:12,736 Six hours to go. You got this. 838 00:35:14,571 --> 00:35:17,656 When a wound is gaping like this, 839 00:35:17,657 --> 00:35:20,075 you want to use sub-Q to bring the edges together. 840 00:35:20,076 --> 00:35:21,869 A lot of meat to close. 841 00:35:21,870 --> 00:35:25,331 What would happen if we just did a simple wound closure? 842 00:35:25,332 --> 00:35:27,082 You take the stitches out in ten days, 843 00:35:27,083 --> 00:35:29,001 the wound opens, dehisces. 844 00:35:29,002 --> 00:35:30,336 Exactly. 845 00:35:30,337 --> 00:35:32,379 So what suture do we use under the skin? 846 00:35:32,380 --> 00:35:33,922 Vicryl provides support for a month. 847 00:35:33,923 --> 00:35:35,466 It takes two months to dissolve. 848 00:35:35,467 --> 00:35:38,802 Mm-hmm. So 5-0 nylon on the skin. 849 00:35:38,803 --> 00:35:40,888 4-0 vicryl under the skin. 850 00:35:40,889 --> 00:35:43,015 I'd go with a 3-0 vicryl. 851 00:35:43,016 --> 00:35:45,643 - You think? - Most definitely. 852 00:35:45,644 --> 00:35:48,020 Donnie is the master of wound closure. 853 00:35:48,021 --> 00:35:51,398 I do at least ten lacs a day out at triage, so... 854 00:35:51,399 --> 00:35:55,361 Can we see your sub-Q? 855 00:35:55,362 --> 00:35:56,987 Be my guest. 856 00:35:56,988 --> 00:35:58,990 If you insist. 857 00:36:03,495 --> 00:36:05,788 So... 858 00:36:05,789 --> 00:36:09,249 the secret is to be sure your entry point 859 00:36:09,250 --> 00:36:12,044 and exit point on both sides of the wound 860 00:36:12,045 --> 00:36:14,963 matches the depth on the other side. 861 00:36:14,964 --> 00:36:16,216 S-- 862 00:36:19,719 --> 00:36:21,470 Start deep. 863 00:36:21,471 --> 00:36:25,432 Come up at the dermis. 864 00:36:25,433 --> 00:36:28,186 Big bites help the tissue close. 865 00:36:30,939 --> 00:36:34,191 It's a mirror image on the other side. 866 00:36:34,192 --> 00:36:36,778 Superficial to deep. 867 00:36:38,655 --> 00:36:41,407 - So you bury the knot. - Bingo. 868 00:36:41,408 --> 00:36:44,243 Avoids bumps on the scar line. 869 00:36:44,244 --> 00:36:47,996 Three ties, not four. 870 00:36:47,997 --> 00:36:50,416 Yeah, that's beautiful. 871 00:36:50,417 --> 00:36:53,585 And then you cut it short. 872 00:36:53,586 --> 00:36:55,212 Not too short. 873 00:36:55,213 --> 00:36:58,882 I like to slide my scissors 874 00:36:58,883 --> 00:37:02,010 down on the knot, 875 00:37:02,011 --> 00:37:07,266 then rotate up 45 degrees before I cut. 876 00:37:07,267 --> 00:37:09,435 Could use two more sub-Qs, 877 00:37:09,436 --> 00:37:12,646 one above, one below. 878 00:37:12,647 --> 00:37:13,732 Have at it. 879 00:37:16,151 --> 00:37:19,154 Interesting ink. Do they mean anything? 880 00:37:21,156 --> 00:37:24,825 This, this is "death and chaos," 881 00:37:24,826 --> 00:37:27,286 and this is "miracles and blessings." 882 00:37:27,287 --> 00:37:31,039 Got this one after the PittFest shooting, 883 00:37:31,040 --> 00:37:35,295 and I got this after my daughter was born. 884 00:37:37,881 --> 00:37:39,256 Put the head of the gurney up 885 00:37:39,257 --> 00:37:41,216 so people can see him, but not so high 886 00:37:41,217 --> 00:37:43,261 that his head flops to the side. 887 00:37:47,515 --> 00:37:48,849 What do you think? 888 00:37:48,850 --> 00:37:51,435 He looks peaceful. 889 00:37:51,436 --> 00:37:54,021 What's the hardest part of this job? 890 00:37:54,022 --> 00:37:55,856 It's pretty thankless, and that can be tough. 891 00:37:55,857 --> 00:37:57,274 You've seen burnout rates. 892 00:37:57,275 --> 00:37:59,067 I'm sure they teach you that in school. 893 00:37:59,068 --> 00:38:02,154 All my closest friends left after COVID. 894 00:38:02,155 --> 00:38:04,198 Some during. 895 00:38:04,199 --> 00:38:05,991 But I don't blame them. 896 00:38:05,992 --> 00:38:08,994 They needed to do what was best for their mental health. 897 00:38:08,995 --> 00:38:11,413 A lot of people broke. 898 00:38:11,414 --> 00:38:13,291 Why do you keep coming back? 899 00:38:15,835 --> 00:38:18,128 Why don't you, um, 900 00:38:18,129 --> 00:38:21,424 just finish up here and then go help Perlah for a bit? 901 00:38:25,637 --> 00:38:27,054 Great. Thank you. 902 00:38:27,055 --> 00:38:28,430 No, that is exactly what I needed to know. 903 00:38:28,431 --> 00:38:30,015 OK. 904 00:38:30,016 --> 00:38:32,643 I just got off the phone with the physician assistant 905 00:38:32,644 --> 00:38:35,145 at the prison; they've got a 16-hour-a-day infirmary 906 00:38:35,146 --> 00:38:37,397 with NP and PA coverage giving everything that we need, 907 00:38:37,398 --> 00:38:39,233 and they've got an RN for overnights. 908 00:38:39,234 --> 00:38:40,859 Even so, he's here because 909 00:38:40,860 --> 00:38:43,487 they're ignoring his basic needs. 910 00:38:43,488 --> 00:38:45,656 He's here because somebody kicked the shit out of him. 911 00:38:45,657 --> 00:38:47,157 I think you're missing the point. 912 00:38:47,158 --> 00:38:48,742 We have more to offer. 913 00:38:48,743 --> 00:38:50,869 Robby, we've got four more coming our way. 914 00:38:50,870 --> 00:38:52,496 OK, got it. 915 00:38:52,497 --> 00:38:53,956 What you're trying to do is very noble. 916 00:38:53,957 --> 00:38:55,374 We don't have the resources to spare. 917 00:38:55,375 --> 00:38:57,668 OK, then why admit the unhoused man, Digby? 918 00:38:57,669 --> 00:38:59,253 Why not send him back to the street 919 00:38:59,254 --> 00:39:00,921 with antibiotics and a roll of gauze? 920 00:39:00,922 --> 00:39:02,548 Because Digby lives on the street, 921 00:39:02,549 --> 00:39:05,175 and your incarcerated patient has a mid-level provider 922 00:39:05,176 --> 00:39:06,718 and a nurse looking after him. 923 00:39:06,719 --> 00:39:08,971 We both know the quality of care is not the same. 924 00:39:08,972 --> 00:39:09,972 Sorry, are you waiting for me? 925 00:39:09,973 --> 00:39:11,348 No. 926 00:39:11,349 --> 00:39:12,975 Dr. Al-Hashimi, for the patient in Seven. 927 00:39:12,976 --> 00:39:14,268 A few days here could make a world of difference 928 00:39:14,269 --> 00:39:15,727 for Gus' health. 929 00:39:15,728 --> 00:39:17,938 We are a safety net, but nets have holes. 930 00:39:17,939 --> 00:39:19,398 We are not admitting him 931 00:39:19,399 --> 00:39:21,150 'cause this is not about social justice. 932 00:39:23,361 --> 00:39:24,903 Everything I've done in my career 933 00:39:24,904 --> 00:39:27,364 is an effort to improve the system. 934 00:39:27,365 --> 00:39:29,074 Just because you know it's broken 935 00:39:29,075 --> 00:39:31,618 doesn't mean you stop trying. 936 00:39:31,619 --> 00:39:33,037 Excuse me. 937 00:39:37,500 --> 00:39:39,626 I talked to Jackson's girlfriend. 938 00:39:39,627 --> 00:39:40,794 OK. 939 00:39:40,795 --> 00:39:42,796 She told me a lot of stuff. 940 00:39:42,797 --> 00:39:45,215 Um, she wants to come see him, 941 00:39:45,216 --> 00:39:48,010 but I just don't think that's a good idea. 942 00:39:48,011 --> 00:39:50,470 And my--my parents are asking a lot of questions. 943 00:39:50,471 --> 00:39:52,389 Can I just take him home? 944 00:39:52,390 --> 00:39:53,932 I'm so sorry. 945 00:39:53,933 --> 00:39:56,101 Your--your brother is on an involuntary psych hold. 946 00:39:56,102 --> 00:39:57,436 He can't leave. 947 00:39:57,437 --> 00:39:58,562 It could take us weeks to figure out 948 00:39:58,563 --> 00:39:59,897 what's wrong with him. 949 00:39:59,898 --> 00:40:01,815 What's wrong with him? 950 00:40:01,816 --> 00:40:03,650 I'm so sorry. I did not mean it like that. 951 00:40:03,651 --> 00:40:04,985 What's-- 952 00:40:04,986 --> 00:40:06,320 Why don't we go somewhere quiet, yeah? 953 00:40:06,321 --> 00:40:08,488 What's wrong with him? 954 00:40:08,489 --> 00:40:11,825 - Let's go over here. - What's wrong with him? 955 00:40:11,826 --> 00:40:13,703 What's wrong with him? 956 00:40:15,413 --> 00:40:17,373 What's wrong with him? 957 00:40:27,550 --> 00:40:29,259 How's she doing? 958 00:40:29,260 --> 00:40:31,470 She took three ounces of formula 959 00:40:31,471 --> 00:40:32,888 without vomiting or distress. 960 00:40:32,889 --> 00:40:34,389 Excellent. 961 00:40:34,390 --> 00:40:37,309 Dr. Wolke from Pedes should be down shortly. 962 00:40:37,310 --> 00:40:40,228 Yeah. I think I saw her smile. 963 00:40:40,229 --> 00:40:43,440 A true social smile where the baby is awake, alert, 964 00:40:43,441 --> 00:40:45,233 and responding to facial expressions 965 00:40:45,234 --> 00:40:47,778 usually doesn't happen until six weeks or older. 966 00:40:47,779 --> 00:40:49,488 It was likely a reflex smile that happens 967 00:40:49,489 --> 00:40:52,574 while they're sleeping. 968 00:40:52,575 --> 00:40:56,203 But some parents have reported their babies 969 00:40:56,204 --> 00:40:58,705 smiled socially as early as four weeks, 970 00:40:58,706 --> 00:41:01,667 so who knows? 971 00:41:01,668 --> 00:41:03,251 - Jesse. - Hmm? 972 00:41:03,252 --> 00:41:04,920 North 4 needs a blood draw when you have a sec. 973 00:41:04,921 --> 00:41:06,046 Got it. 974 00:41:06,047 --> 00:41:07,255 How we doing in here? 975 00:41:07,256 --> 00:41:08,465 Almost ready to head out. 976 00:41:08,466 --> 00:41:09,633 Looking good. 977 00:41:09,634 --> 00:41:10,676 Heart rate 91. 978 00:41:10,677 --> 00:41:12,344 BP is 115 over 82. 979 00:41:12,345 --> 00:41:14,262 Oxygen sat's 95%. 980 00:41:14,263 --> 00:41:15,889 Great. 981 00:41:15,890 --> 00:41:17,391 I'm sending him home with some nonstick dressing 982 00:41:17,392 --> 00:41:18,850 in case they don't stock them. 983 00:41:18,851 --> 00:41:20,602 Grab some burn net too. 984 00:41:20,603 --> 00:41:23,230 He's a good guy. He's a local. 985 00:41:23,231 --> 00:41:25,607 Yeah? You're from Pittsburgh? 986 00:41:25,608 --> 00:41:27,234 Yes, ma'am. Born and raised. 987 00:41:27,235 --> 00:41:28,402 Whereabouts? 988 00:41:28,403 --> 00:41:30,696 Bloomfield, Liberty Ave. 989 00:41:30,697 --> 00:41:33,281 Bloomfield? 990 00:41:33,282 --> 00:41:34,950 You know Sonny's Tavern? 991 00:41:34,951 --> 00:41:36,576 Worked there through high school. 992 00:41:36,577 --> 00:41:38,413 - No kidding. - You know Sonny's? 993 00:41:39,998 --> 00:41:43,250 Had my first kiss there. 994 00:41:43,251 --> 00:41:45,711 Hey, Donnie, my buddy Duke hasn't checked in yet? 995 00:41:45,712 --> 00:41:47,421 Nah, I told Lupe to keep an eye out. 996 00:41:47,422 --> 00:41:48,922 - Thank you. - Yep. 997 00:41:48,923 --> 00:41:51,217 Right, left. Right, left. Yeah. That's it. 998 00:41:54,887 --> 00:41:56,346 You back to check our work? 999 00:41:56,347 --> 00:41:58,515 Nope. I need a silastic loop drain. 1000 00:41:58,516 --> 00:42:00,600 That looks great. 1001 00:42:00,601 --> 00:42:02,394 It's thanks to your fine instruction. 1002 00:42:02,395 --> 00:42:06,398 OK, he's going to need Kerlix and Xeroform. 1003 00:42:06,399 --> 00:42:08,275 You should throw a neoprene sleeve on him. 1004 00:42:08,276 --> 00:42:10,027 Limits the range of motion at the knee 1005 00:42:10,028 --> 00:42:11,820 - so the sutures don't pull out. - That's a good idea. 1006 00:42:11,821 --> 00:42:13,113 Must be fun to work here. 1007 00:42:13,114 --> 00:42:15,949 Oh, sure is. First week for these two. 1008 00:42:15,950 --> 00:42:17,409 How are you guys liking the Pitt? 1009 00:42:17,410 --> 00:42:18,828 I feel like I was born to do this. 1010 00:42:20,079 --> 00:42:21,371 Hard pass. 1011 00:42:21,372 --> 00:42:23,331 I'm shooting for pathology. 1012 00:42:23,332 --> 00:42:24,750 I like medical mysteries, 1013 00:42:24,751 --> 00:42:26,918 but I don't really deal well with people. 1014 00:42:26,919 --> 00:42:28,795 You have an interesting energy. 1015 00:42:28,796 --> 00:42:30,630 What's that for? 1016 00:42:30,631 --> 00:42:32,799 Splint starts at the knuckles, 1017 00:42:32,800 --> 00:42:36,344 comes up and around the elbow, 1018 00:42:36,345 --> 00:42:38,722 and back down to the palm. 1019 00:42:38,723 --> 00:42:41,558 It needs to be smaller. I can't ride with a splint. 1020 00:42:41,559 --> 00:42:43,018 Well, no, you shouldn't be riding at all. 1021 00:42:43,019 --> 00:42:44,978 Right now, that's a non-displaced fracture. 1022 00:42:44,979 --> 00:42:48,023 If you fall on it again, you're gonna need to go to the OR. 1023 00:42:48,024 --> 00:42:51,234 No worries, Doc. I won't fall again. 1024 00:42:51,235 --> 00:42:52,445 Uh-huh. 1025 00:42:54,405 --> 00:42:56,364 Robby, pulse ox just dropped. 1026 00:42:56,365 --> 00:42:57,866 What happened? 1027 00:42:57,867 --> 00:42:59,326 I don't know. I stepped out for a minute. 1028 00:42:59,327 --> 00:43:01,161 It's down to 85%. 1029 00:43:01,162 --> 00:43:02,579 Are you having some trouble breathing? 1030 00:43:02,580 --> 00:43:04,122 A little. 1031 00:43:04,123 --> 00:43:05,791 Start him on 2 liters oxygen, nasal cannula. 1032 00:43:05,792 --> 00:43:07,375 Titrate to 5. 1033 00:43:07,376 --> 00:43:09,002 Keep the pulse ox at 92 or higher 1034 00:43:09,003 --> 00:43:12,422 and have a rebreather standing by just in case. 1035 00:43:12,423 --> 00:43:14,257 He's gonna have to stay. 1036 00:43:14,258 --> 00:43:16,009 For how long? 1037 00:43:16,010 --> 00:43:18,804 Not sure. 1038 00:43:18,805 --> 00:43:20,680 Sorry, boss, I only stepped out for a second. 1039 00:43:20,681 --> 00:43:22,224 Let me know if anything changes. 1040 00:43:22,225 --> 00:43:23,809 You were in the room when his pulse ox dropped? 1041 00:43:23,810 --> 00:43:25,060 - I was. - What were you doing? 1042 00:43:25,061 --> 00:43:26,812 D, still can't get a hold of Ortho. 1043 00:43:26,813 --> 00:43:30,107 Leave them to me. 1044 00:43:30,108 --> 00:43:32,400 - Feeling better? - Oh, so much better. 1045 00:43:32,401 --> 00:43:35,570 Well, I wrote you a script for Zofran, just in case. 1046 00:43:35,571 --> 00:43:38,031 Thanks. I think I cleared it all out. 1047 00:43:38,032 --> 00:43:40,700 - So no more hot dogs, right? - Oh, not today. 1048 00:43:40,701 --> 00:43:42,202 But I'll be back next year. 1049 00:43:42,203 --> 00:43:43,537 - Got to defend my title! - Yo. 1050 00:43:43,538 --> 00:43:44,955 OK, well, best of luck to you. 1051 00:43:44,956 --> 00:43:46,498 They got a Wiener World truck outside. 1052 00:43:46,499 --> 00:43:48,125 You want one? 1053 00:43:48,126 --> 00:43:49,835 I think I'm good on hot dogs for the rest of my life. 1054 00:43:49,836 --> 00:43:51,711 Wait, didn't I just see you eating a doughnut? 1055 00:43:51,712 --> 00:43:53,380 Don't judge. 1056 00:43:53,381 --> 00:43:54,882 Stay here for a sec. 1057 00:44:00,930 --> 00:44:03,348 - Transport ambulance is here. - Thanks, Princess. 1058 00:44:03,349 --> 00:44:05,809 This is a 200-milligram MS Contin. 1059 00:44:05,810 --> 00:44:09,146 This will give you 12 hours of relief. 1060 00:44:09,147 --> 00:44:11,022 - OK. - Mm. 1061 00:44:11,023 --> 00:44:12,400 Yes. 1062 00:44:14,318 --> 00:44:16,111 Whenever you're ready, Rox. 1063 00:44:16,112 --> 00:44:18,029 Hey, guys, this is Roxie Hamler. 1064 00:44:18,030 --> 00:44:19,823 Hello, ma'am. 1065 00:44:19,824 --> 00:44:21,826 - Easy on the transfer, guys. - Yeah. 1066 00:44:28,499 --> 00:44:30,709 OK, on my count. 1067 00:44:30,710 --> 00:44:33,504 No, no, no. This isn't gonna work out. 1068 00:44:35,089 --> 00:44:36,756 I'm sorry. 1069 00:44:36,757 --> 00:44:38,425 I can't--I can't-- 1070 00:44:38,426 --> 00:44:42,053 I can't--I can't do this. 1071 00:44:42,054 --> 00:44:45,098 - It's OK. - I want to stay. 1072 00:44:45,099 --> 00:44:48,852 Please. 1073 00:44:48,853 --> 00:44:51,980 It's OK. 1074 00:44:51,981 --> 00:44:53,899 Can I assume that you've already called upstairs 1075 00:44:53,900 --> 00:44:55,775 to get Gus Varney a bed? 1076 00:44:55,776 --> 00:44:58,069 Do you want to tell me what you did? 1077 00:44:58,070 --> 00:45:00,572 I don't know what you're talking about. 1078 00:45:00,573 --> 00:45:03,491 His pulse ox was steady. We were about to discharge him. 1079 00:45:03,492 --> 00:45:05,285 Did Dr. Al-Hashimi put you up to that? 1080 00:45:05,286 --> 00:45:07,621 Al-Hashimi? No. 1081 00:45:07,622 --> 00:45:09,122 You know he's gonna go back to prison 1082 00:45:09,123 --> 00:45:12,918 after they discharge him upstairs. 1083 00:45:12,919 --> 00:45:14,669 I thought you didn't go the extra distance 1084 00:45:14,670 --> 00:45:16,005 for your patients anymore. 1085 00:45:22,678 --> 00:45:25,263 - It's Emma, right? - Yeah. 1086 00:45:25,264 --> 00:45:26,890 How's your first day going? 1087 00:45:26,891 --> 00:45:28,642 Good, I think. 1088 00:45:28,643 --> 00:45:32,020 Haven't killed anyone yet. 1089 00:45:32,021 --> 00:45:35,398 - I'm sorry. I-- - It's OK. 1090 00:45:35,399 --> 00:45:38,944 I guess time will tell if I'm cut out for this. 1091 00:45:38,945 --> 00:45:42,656 Well, when in doubt, stick with her, kid. 1092 00:45:42,657 --> 00:45:44,157 She scares me. 1093 00:45:44,158 --> 00:45:46,826 No, that's just a-- it's a tough exterior. 1094 00:45:46,827 --> 00:45:50,622 She's warm and gooey on the inside. 1095 00:45:50,623 --> 00:45:53,500 Looks like they're doing the debrief for Louie. 1096 00:45:53,501 --> 00:45:55,543 - You coming? - I paid my respects. 1097 00:45:55,544 --> 00:45:57,672 Besides, who's gonna hold down the fort? 1098 00:46:09,809 --> 00:46:12,310 Remember the day you found him passed out in the park? 1099 00:46:12,311 --> 00:46:13,561 Sure do. 1100 00:46:13,562 --> 00:46:15,063 I had to drag his ass over here. 1101 00:46:15,064 --> 00:46:16,481 Came in soaked to the bone. 1102 00:46:16,482 --> 00:46:18,275 You saved his life. 1103 00:46:18,276 --> 00:46:20,318 How about last summer when we didn't see him for months? 1104 00:46:20,319 --> 00:46:21,778 He said he finally quit drinking, 1105 00:46:21,779 --> 00:46:23,571 - so he didn't need to come in. - Mm-hmm. 1106 00:46:23,572 --> 00:46:25,991 How many times did he say he was gonna quit drinking? 1107 00:46:25,992 --> 00:46:28,076 Mm-hmm. 1108 00:46:28,077 --> 00:46:30,704 He always asked about Harrison. 1109 00:46:30,705 --> 00:46:33,123 - Always said thank you. - Mm-hmm. 1110 00:46:33,124 --> 00:46:36,543 Found this with his stuff. 1111 00:46:36,544 --> 00:46:38,128 Who knew he was married? 1112 00:46:38,129 --> 00:46:40,797 Hmm. 1113 00:46:40,798 --> 00:46:43,341 That's Rhonda, Louie's wife. 1114 00:46:43,342 --> 00:46:45,260 High school sweetheart. 1115 00:46:45,261 --> 00:46:48,388 About five years ago, I was covering a night shift. 1116 00:46:48,389 --> 00:46:51,641 He came in feeling talkative. 1117 00:46:51,642 --> 00:46:53,268 Born and raised in Pittsburgh. 1118 00:46:53,269 --> 00:46:55,645 Lifelong Steelers fan. 1119 00:46:55,646 --> 00:46:57,397 Groundskeeper at Three Rivers Stadium 1120 00:46:57,398 --> 00:46:58,733 until 1998. 1121 00:47:01,569 --> 00:47:04,446 He never really wanted kids, 1122 00:47:04,447 --> 00:47:06,865 but Rhonda wore him down, 1123 00:47:06,866 --> 00:47:08,491 and when she finally got pregnant, 1124 00:47:08,492 --> 00:47:11,162 he changed his tune, he got excited. 1125 00:47:14,582 --> 00:47:16,916 And then about a month before the baby was due, 1126 00:47:16,917 --> 00:47:19,920 Rhonda and the baby were killed in a car crash. 1127 00:47:23,215 --> 00:47:25,676 Louie never really came back from that. 1128 00:47:29,722 --> 00:47:32,182 May his memory be a blessing. 1129 00:47:32,183 --> 00:47:34,435 - Amen. - May his memory be a blessing. 1130 00:47:36,520 --> 00:47:37,772 Yep.