1 00:00:15,724 --> 00:00:18,852 Structural collapse at the water park-- two victims coming in via helicopter. 2 00:00:18,936 --> 00:00:21,438 - ETA, five minutes. - Time to rally the troops. 3 00:00:21,522 --> 00:00:23,732 I'll get environmental to clear and prep the trauma rooms. 4 00:00:23,815 --> 00:00:24,816 Emma, restock the crash carts. 5 00:00:24,900 --> 00:00:26,860 Makedah, take the latest scripts to the drug cage. 6 00:00:26,944 --> 00:00:29,238 - Should be a fun one. - "Fun one"? What's up? 7 00:00:29,321 --> 00:00:31,865 Slide broke at the water park-- two victims, five minutes to touchdown. 8 00:00:31,949 --> 00:00:34,451 - No information on extent of injuries. - I can jump in with-- 9 00:00:34,535 --> 00:00:38,664 Ogilvie, grab some goggles, gloves, gown. Go up to the roof. 10 00:00:38,747 --> 00:00:40,832 First patient that lands, bring 'em down. 11 00:00:40,916 --> 00:00:43,460 We got two choppers. You want to grab some bodies and meet me? 12 00:00:43,544 --> 00:00:46,880 - What injuries are we expecting? - Structural collapse. Could be anything. 13 00:00:46,964 --> 00:00:50,467 I can increase the morphine drip to manage the pain, 14 00:00:50,551 --> 00:00:53,136 but that could also slow down your breathing. 15 00:00:53,220 --> 00:00:56,974 You will likely feel very drowsy. You may lose consciousness. 16 00:00:58,100 --> 00:01:00,227 And it could cause you to stop breathing altogether. 17 00:01:10,362 --> 00:01:11,989 I'll be right back. 18 00:01:19,371 --> 00:01:22,499 - Hey, you okay? - Yeah. 19 00:01:22,583 --> 00:01:23,875 Yeah. Sorry. 20 00:01:23,959 --> 00:01:27,504 Look, it's hard seeing your patients die. 21 00:01:27,588 --> 00:01:31,508 But as professionals, we have to create emotional boundaries for ourselves. 22 00:01:31,592 --> 00:01:34,011 It's not about us. It's about them. 23 00:01:36,096 --> 00:01:38,098 She's so calm. I just... 24 00:01:39,015 --> 00:01:40,517 Yeah. 25 00:01:40,601 --> 00:01:42,769 She's had a long time to prepare for this moment. 26 00:01:44,062 --> 00:01:49,026 What she's doing for her sons-- managing this with so much grace-- 27 00:01:49,109 --> 00:01:50,735 it's a real gift of love. 28 00:01:50,819 --> 00:01:52,613 I feel like an asshole. 29 00:01:53,655 --> 00:01:55,699 All they want is more time with their mother. 30 00:01:55,782 --> 00:01:57,533 All I want is less time with mine. 31 00:01:57,618 --> 00:01:59,494 Don't feel guilty. 32 00:01:59,578 --> 00:02:03,749 I mean, you can be grateful and gracious from a distance. 33 00:02:03,832 --> 00:02:06,543 Just talk to her. Tell her what you want. She'll understand. 34 00:02:09,211 --> 00:02:10,422 I doubt that. 35 00:02:11,798 --> 00:02:14,926 Give her a chance, you know? She may surprise you. 36 00:02:17,387 --> 00:02:18,805 Hey. 37 00:02:18,889 --> 00:02:20,766 Two birds headed our way. Need a hand? 38 00:02:20,849 --> 00:02:22,559 That's the rumor. 39 00:02:22,643 --> 00:02:24,478 Santos, trauma incoming. 40 00:02:24,561 --> 00:02:27,064 Grab a gown. You can assist Dr. Langdon. 41 00:02:30,067 --> 00:02:31,360 Fuck me. 42 00:02:31,443 --> 00:02:33,987 Jesus, I got blood tubes growing moss over here. 43 00:02:34,071 --> 00:02:36,073 Ticktock, people. 44 00:02:36,156 --> 00:02:38,367 Hey, Olive, do me a solid-- run these to the lab. 45 00:02:38,450 --> 00:02:39,576 No problem. 46 00:02:39,660 --> 00:02:41,453 I got more lab results. 47 00:02:41,536 --> 00:02:43,579 Start putting them on the patient clipboards, 48 00:02:43,664 --> 00:02:45,791 PTMC Emergency. Go ahead, Medic Command. 49 00:02:45,874 --> 00:02:47,459 Do cyberattacks happen often? 50 00:02:47,542 --> 00:02:49,670 - More than you realize. - I blame the Russkies. 51 00:02:49,753 --> 00:02:52,756 Dr. Mohan, it's your mother? 52 00:02:52,839 --> 00:02:54,466 She sounds pretty upset. 53 00:02:54,549 --> 00:02:56,885 Says she really needs to talk to you. 54 00:02:57,886 --> 00:02:59,888 You're shitting me. Tell her I'm not available. 55 00:03:10,273 --> 00:03:11,566 How's your shift going? 56 00:03:12,484 --> 00:03:14,611 It's been a lot already. 57 00:03:15,696 --> 00:03:18,281 You know, I worked in an ER before, up in Vermont, 58 00:03:18,365 --> 00:03:22,035 and we had MVAs and ODs, MIs. 59 00:03:22,119 --> 00:03:23,286 But this place... 60 00:03:24,121 --> 00:03:25,579 ...this place is relentless. 61 00:03:26,289 --> 00:03:29,126 Holiday weekend. We're not normally offline. 62 00:03:30,127 --> 00:03:32,796 I think we have a very different idea of normal. 63 00:03:32,879 --> 00:03:34,256 It's not for everyone. 64 00:03:34,339 --> 00:03:37,426 - I'm not sure it's healthy for anybody. - Here's her leg. 65 00:03:38,510 --> 00:03:40,137 Jesus. 66 00:03:47,519 --> 00:03:50,063 - I need more runners. - Oh, you could shut down the gift shop. 67 00:03:50,147 --> 00:03:52,232 They always have a couple of volunteers there. 68 00:03:52,315 --> 00:03:54,234 Most of those volunteers use walkers. 69 00:03:54,317 --> 00:03:55,861 Beggars can't be choosers. 70 00:03:55,944 --> 00:03:57,279 Go get 'em. 71 00:03:57,362 --> 00:03:59,656 - Okay, I'm gonna grab a smoke first. - No time. 72 00:03:59,740 --> 00:04:01,241 Nicotine gum--take the edge off. 73 00:04:01,324 --> 00:04:03,869 You two, head to triage to help out the front of the house. 74 00:04:03,952 --> 00:04:06,663 They're running out of space, and there's a line out the door. 75 00:04:06,747 --> 00:04:09,332 - Okay, let's go. - Hang on, Mohan. 76 00:04:10,959 --> 00:04:12,210 Sign this. 77 00:04:14,546 --> 00:04:16,464 Nicotine patch, 21 milligrams. 78 00:04:16,548 --> 00:04:19,091 - Who's it for? - Monica. This nicotine gum's shit. 79 00:04:19,176 --> 00:04:22,220 She'll never survive the shift, and I need her so I don't lose my goddamn mind. 80 00:04:24,973 --> 00:04:26,183 Thanks. 81 00:04:26,266 --> 00:04:27,934 Is Dr. Abbot still around? 82 00:04:28,018 --> 00:04:30,687 He went to get some sleep before his night shift starts in a couple hours. 83 00:04:30,771 --> 00:04:33,482 Shit. Okay, I should have planned this better. 84 00:04:33,565 --> 00:04:36,276 I was hoping he'd write me a letter of rec for an elective 85 00:04:36,359 --> 00:04:38,653 so I could have a shot at a fellowship next year. 86 00:04:38,737 --> 00:04:39,780 Which one? 87 00:04:40,989 --> 00:04:42,282 Whichever will take me. 88 00:04:42,365 --> 00:04:44,493 Didn't the electives fill up a while ago? 89 00:04:44,576 --> 00:04:46,912 Don't remind me. I'm gonna throw myself at the mercy of the court, 90 00:04:46,995 --> 00:04:48,914 beg for them to take me anyway. 91 00:04:48,997 --> 00:04:51,707 Just kill me now. It'll be less painful. 92 00:04:51,792 --> 00:04:53,835 Dana, I can't read this handwriting. 93 00:04:53,919 --> 00:04:55,003 It says... 94 00:04:56,004 --> 00:05:00,509 ...1,000 milligrams acetaminophen orally, 4 milligrams ondansetron under the tongue, 95 00:05:00,592 --> 00:05:02,719 and trial of clear fluids. 96 00:05:02,803 --> 00:05:04,513 Seriously? It says all that? 97 00:05:04,596 --> 00:05:07,307 If it's not in a text with emojis, you kids can't read for shit. 98 00:05:10,602 --> 00:05:11,645 What do we have? 99 00:05:11,728 --> 00:05:13,647 A fall from 10 feet onto a metal fence. 100 00:05:13,730 --> 00:05:16,024 Right below the knee. Good vitals. 101 00:05:16,107 --> 00:05:17,776 Oh, it hurts. Oh, my God. 102 00:05:17,859 --> 00:05:20,153 - What's she had so far? - 50 of fent, repeated 25. 103 00:05:20,237 --> 00:05:21,530 No meds, no allergies. 104 00:05:21,613 --> 00:05:23,865 - Where should I put this? - Just hang on to it for now. 105 00:05:23,949 --> 00:05:27,744 On my count. One, two, three. 106 00:05:29,538 --> 00:05:32,666 Okay, Whitaker, E-FAST. Donnie, primary survey, please. 107 00:05:32,749 --> 00:05:34,835 Pupils equal and reactive. 108 00:05:35,544 --> 00:05:37,963 - What's your name? - My leg hurts really bad. 109 00:05:38,046 --> 00:05:39,756 Did I break it? 110 00:05:39,840 --> 00:05:41,299 I wouldn't say that it's broken exactly. 111 00:05:41,383 --> 00:05:43,552 We're gonna get an X-ray to determine that. 112 00:05:43,635 --> 00:05:45,554 Put that on the gurney, line it up for X-ray, 113 00:05:45,637 --> 00:05:46,972 keep your fucking mouth shut. 114 00:05:47,055 --> 00:05:48,849 Good lung sliding right and left. 115 00:05:48,932 --> 00:05:50,933 Airway patent, breath sounds bilaterally. 116 00:05:51,643 --> 00:05:54,020 - Please, it hurts. - BP 100 over 60. 117 00:05:54,104 --> 00:05:57,065 Pulse 118, pulse ox 98%. 118 00:05:57,148 --> 00:06:00,360 - Does your belly hurt? - No, asshole! It's my leg! 119 00:06:00,443 --> 00:06:03,488 - Okay, she's really moving here. - 100 of ketamine? 120 00:06:03,572 --> 00:06:05,407 Yeah, we can't evaluate like this. 121 00:06:06,449 --> 00:06:08,076 Hey, Ogilvie? 122 00:06:08,159 --> 00:06:10,245 - Deep breaths, yeah? - Yeah, okay. 123 00:06:10,328 --> 00:06:11,788 Whitaker, what's next? 124 00:06:11,872 --> 00:06:14,332 Once she's sedated, finish the E-FAST, 125 00:06:14,416 --> 00:06:16,251 plain X-ray, check her back, straight to CT. 126 00:06:16,334 --> 00:06:18,587 - What if the ketamine wears off? - Right. 127 00:06:18,670 --> 00:06:22,215 We should do a popliteal nerve block before the CT, 128 00:06:22,299 --> 00:06:24,134 anesthetize from the knee down. 129 00:06:24,217 --> 00:06:26,219 - Two view tib-fib. - Pushing ketamine now. 130 00:06:26,303 --> 00:06:29,014 - What's the bullet? - 42-year-old male with 20-foot fall. 131 00:06:29,097 --> 00:06:31,099 Blunt chest trauma with hand injury. 132 00:06:31,641 --> 00:06:33,560 Where's my son? Where's my son? 133 00:06:33,643 --> 00:06:35,937 He's tachy to 108, sats 98 on 2 liters, 134 00:06:36,021 --> 00:06:38,648 - BP 122 over 84. - We'll pan scan due to mechanism. 135 00:06:38,732 --> 00:06:40,609 - You? - Tib-fib amputation. 136 00:06:40,692 --> 00:06:43,570 Hoping ortho can give us a little hope for replantation. 137 00:06:43,653 --> 00:06:46,406 - Derek, where are you hurting? - Chest and my finger. 138 00:06:46,489 --> 00:06:47,532 Did they find my son? 139 00:06:47,616 --> 00:06:49,618 - Did you hit your head? - Don't think so. 140 00:06:49,701 --> 00:06:51,036 I need to find my son! 141 00:06:51,119 --> 00:06:53,413 We'll find him for you, but we need to take care of you first. 142 00:06:53,496 --> 00:06:56,416 Pericardium's clear. No fluid in Morrison's. 143 00:06:56,499 --> 00:06:58,084 Move both arms, wiggle your feet. 144 00:06:58,710 --> 00:07:01,046 - Good. Any pain in your neck? - No. 145 00:07:01,129 --> 00:07:02,839 - Spleen looks good. - Start with his chest. 146 00:07:02,923 --> 00:07:04,257 That's where he hurts. 147 00:07:04,341 --> 00:07:06,551 - No hemotympanum. - Normal sliding. 148 00:07:07,135 --> 00:07:09,095 Best to start with the side he's complaining about first. 149 00:07:10,722 --> 00:07:12,599 I don't see much sliding there. 150 00:07:12,682 --> 00:07:14,851 His name is Zack. He's seven. 151 00:07:14,935 --> 00:07:16,645 - Pneumothorax? - Set up for a chest tube. 152 00:07:16,728 --> 00:07:20,857 Not yet. Let's go posterolateral. Look for fluid first. 153 00:07:20,941 --> 00:07:22,901 Traumatic pneumothorax. We should prep the chest. 154 00:07:23,610 --> 00:07:25,528 Not necessarily. He's hemodynamically stable. 155 00:07:26,363 --> 00:07:27,656 Okay. 156 00:07:27,739 --> 00:07:29,407 Does that look like some fluid there? 157 00:07:29,491 --> 00:07:30,867 Hard to say for sure. 158 00:07:30,951 --> 00:07:33,662 Okay, he's tachycardic hemopneumothorax. He needs a chest tube. 159 00:07:33,745 --> 00:07:37,666 BP and sats are fine. We can wait for CT. If it's small, it'll resolve on its own. 160 00:07:37,749 --> 00:07:40,085 - We observe and reimage. - I agree. He's stable for now. 161 00:07:40,168 --> 00:07:41,544 Let's wait for the scan, Dr. Santos. 162 00:07:41,628 --> 00:07:43,880 - Okay, let's order... - Okay. 163 00:07:43,964 --> 00:07:46,383 ...a CT chest, abdomen, pelvis, and X-ray left hand. 164 00:07:48,176 --> 00:07:50,303 - Major degloving. - Focus on the primary. 165 00:07:50,387 --> 00:07:52,514 Dr. Langdon's correct. We need to logroll him. 166 00:07:54,307 --> 00:07:56,433 Oh, okay. How about another 4 of morphine? 167 00:07:56,518 --> 00:07:57,477 Put it in. 168 00:07:57,560 --> 00:07:59,562 Hang in there, Derek. We got you. 169 00:08:01,815 --> 00:08:03,692 Fuck off already. 170 00:08:03,775 --> 00:08:06,319 - Boyfriend? - Wish. My mom. 171 00:08:06,403 --> 00:08:08,279 Every time I get a second of service, 172 00:08:08,363 --> 00:08:11,116 - another dozen texts come in. - Hey! How much longer do I have to wait? 173 00:08:11,199 --> 00:08:12,826 I got a broken leg here. 174 00:08:12,909 --> 00:08:14,494 Someone will be with you shortly, sir. 175 00:08:14,577 --> 00:08:17,330 Am I allowed to use the bathroom? I really have to go. 176 00:08:17,414 --> 00:08:19,290 I don't know, ma'am. I am not your doctor. 177 00:08:19,374 --> 00:08:22,460 - It says right there "doctor." - Yes, but I'm not your doctor. 178 00:08:22,544 --> 00:08:24,796 But if you go back to your room, a nurse will come find you. 179 00:08:24,879 --> 00:08:26,548 I wasn't in a room. 180 00:08:26,631 --> 00:08:29,509 I'm sorry. Are either of you treating my mother? 181 00:08:29,592 --> 00:08:30,593 Nope! 182 00:08:37,726 --> 00:08:39,811 Take a seat. It's gonna be a while. 183 00:08:43,231 --> 00:08:45,275 Helen Torres, come on down. 184 00:08:46,943 --> 00:08:48,945 Helen Torres? 185 00:08:49,029 --> 00:08:50,447 Yes, I'm coming. 186 00:08:53,033 --> 00:08:56,244 - Go through the door on this side. - Thank you. 187 00:09:04,252 --> 00:09:05,253 Thank you. 188 00:09:10,425 --> 00:09:12,260 I'm Dr. Mohan. This is Student Doctor Kwon. 189 00:09:12,343 --> 00:09:13,344 Helen. 190 00:09:13,428 --> 00:09:15,597 How long has your leg been swollen, Helen? 191 00:09:15,680 --> 00:09:18,308 It's been getting worse over the past week. 192 00:09:19,017 --> 00:09:20,769 Dr. Mohan, your mom called again. 193 00:09:20,852 --> 00:09:22,479 - She said you need to call her back. - Not now! 194 00:09:23,438 --> 00:09:24,647 I'm with a patient. 195 00:09:27,358 --> 00:09:28,485 Sorry about that. 196 00:09:29,861 --> 00:09:31,780 Did you fall or hit your leg? 197 00:09:31,863 --> 00:09:32,989 No. 198 00:09:33,865 --> 00:09:36,785 Have you ever had a blood clot before? 199 00:09:36,868 --> 00:09:37,869 No. 200 00:09:41,498 --> 00:09:43,750 - Are you all right? - Excuse me? 201 00:09:43,833 --> 00:09:47,003 - Do you need to sit down? - Oh, no. I'm fine. 202 00:09:47,087 --> 00:09:48,254 You don't look too good. 203 00:09:48,880 --> 00:09:50,298 What? 204 00:09:50,381 --> 00:09:52,050 No, it's just... 205 00:09:52,133 --> 00:09:53,718 it's really hot in here. 206 00:09:53,802 --> 00:09:54,928 And... 207 00:09:56,262 --> 00:09:58,306 - You need to sit down. - I'm good. 208 00:10:00,100 --> 00:10:02,018 I just need some air. 209 00:10:02,102 --> 00:10:03,686 Excuse me one second. 210 00:10:21,329 --> 00:10:24,165 - You a doctor? - Sorry, Doctor, does this look infected? 211 00:10:24,249 --> 00:10:26,835 I've been waiting six hours, and people keep cutting in front of me. 212 00:10:26,918 --> 00:10:30,046 Doctor, can you just look at my throat just to see if it's strep? 213 00:10:30,130 --> 00:10:31,714 Look out! Make way! 214 00:10:32,924 --> 00:10:34,425 Get in. 215 00:10:34,509 --> 00:10:36,094 No, I'm okay. 216 00:10:36,177 --> 00:10:38,930 - I'm okay. - Get in the fucking chair. 217 00:10:42,142 --> 00:10:43,268 Excuse me, ma'am. 218 00:10:43,351 --> 00:10:45,478 Excuse me, coming through! 219 00:10:45,562 --> 00:10:47,063 Out of my way! 220 00:10:47,147 --> 00:10:50,441 We were going down the water slide, and the bottom just fell off. 221 00:10:50,525 --> 00:10:53,069 I grabbed Zack's arm, and I tried to hold on to the sides, 222 00:10:53,153 --> 00:10:55,280 but my hand slipped, and my ring got stuck. 223 00:10:55,363 --> 00:10:57,157 My finger was ripping off, and I just... 224 00:10:57,949 --> 00:10:59,534 ...and I lost him. 225 00:11:00,160 --> 00:11:03,580 We can numb up your finger as soon as we gauge the extent of the injury. 226 00:11:03,663 --> 00:11:05,498 You can cut the damn thing off for all I care. 227 00:11:05,582 --> 00:11:07,125 I just need to find Zack. 228 00:11:07,959 --> 00:11:10,587 - Okay, do you feel anything here? - Yeah, sharp. 229 00:11:10,670 --> 00:11:12,463 - How about here? - Sharp again. 230 00:11:12,547 --> 00:11:13,882 A little late for the show, Yoyo. 231 00:11:13,965 --> 00:11:16,092 I am the show, Dr. Langdon. You're the warm-up act. 232 00:11:16,176 --> 00:11:17,510 I knew somebody missed me. 233 00:11:18,219 --> 00:11:20,889 Mr. Foster suffered a degloving injury of the ring finger. 234 00:11:20,972 --> 00:11:23,099 Stable pneumothorax awaiting imaging. 235 00:11:23,183 --> 00:11:25,768 Hello, sir. I'm Dr. Garcia from the trauma service. 236 00:11:26,394 --> 00:11:27,520 I need the ring cutter. 237 00:11:27,604 --> 00:11:29,397 That's why they pay the surgeons the big bucks. 238 00:11:29,981 --> 00:11:31,983 Possible flexor tendon injury. 239 00:11:33,610 --> 00:11:36,196 Try to bend up your ring finger. 240 00:11:38,740 --> 00:11:40,241 Let's go with the block. 241 00:11:40,325 --> 00:11:43,328 You're gonna feel a pinprick and some burning. 242 00:11:43,411 --> 00:11:45,914 Which tendon did we test, Dr. Santos? 243 00:11:45,997 --> 00:11:47,832 Seriously? That's a med-student question. 244 00:11:48,625 --> 00:11:51,419 We're a teaching hospital. It's always good to review. 245 00:11:52,795 --> 00:11:55,715 Flexor digitorum superficialis is intact 246 00:11:55,798 --> 00:11:58,134 as it inserts on the middle phalanx. 247 00:11:58,218 --> 00:12:00,511 - Correct. - Gee, thanks. 248 00:12:01,221 --> 00:12:02,639 No sign of tension. 249 00:12:03,264 --> 00:12:04,974 At least no tension pneumo. 250 00:12:05,808 --> 00:12:07,727 Let's wait for the CT. I'll be next door. 251 00:12:07,810 --> 00:12:10,521 Langdon, Mel's sister's been asking for you. 252 00:12:10,605 --> 00:12:12,732 She's getting antsy, and we could really use the room. 253 00:12:12,815 --> 00:12:14,984 - CT's ready. - Okay. Let Becca know I'll be there soon. 254 00:12:15,068 --> 00:12:18,363 And Mr. Foster got separated from his son Zack 255 00:12:18,446 --> 00:12:19,739 at the water park. 256 00:12:19,822 --> 00:12:22,367 - Is there anyone we can call for you? - My wife, Angela. 257 00:12:22,450 --> 00:12:25,453 Dr. Santos, will you escort Mr. Foster to CT? 258 00:12:29,832 --> 00:12:30,917 Help! 259 00:12:31,000 --> 00:12:32,669 Need a hand here. 260 00:12:33,461 --> 00:12:36,297 - What the hell happened? - I think I'm having an MI. 261 00:12:36,381 --> 00:12:38,508 My chest is so tight, I can barely breathe. 262 00:12:38,591 --> 00:12:41,594 Okay, I got to get a 12 lead. Perlah, can I get an assist here? 263 00:12:41,678 --> 00:12:42,845 Yeah, I'm on it. 264 00:12:44,305 --> 00:12:45,306 CT's normal. 265 00:12:45,390 --> 00:12:47,183 Why do we take down the tourniquet, Whitaker? 266 00:12:47,267 --> 00:12:50,061 To give the residual limb blood flow. 267 00:12:50,144 --> 00:12:51,562 Just two little pumpers. 268 00:12:51,646 --> 00:12:53,690 A couple of figure eights ought to take care of those. 269 00:12:54,482 --> 00:12:55,942 Park. 270 00:12:56,025 --> 00:12:58,486 Park the Shark, orthopedic surgeon. 271 00:12:59,070 --> 00:13:01,197 - Is this a favorable amputation? - Pretty clean cut. 272 00:13:01,281 --> 00:13:02,991 Fence sliced through like a guillotine. 273 00:13:03,074 --> 00:13:04,242 X-ray? 274 00:13:06,786 --> 00:13:08,079 Not too bad. 275 00:13:10,290 --> 00:13:13,710 Just tying off a couple arterioles. 276 00:13:13,793 --> 00:13:15,295 I'm not blind. 277 00:13:16,004 --> 00:13:18,715 - Where's the amputated leg? - Double bagged on ice. 278 00:13:19,507 --> 00:13:21,676 Sterile saline on the inner bag. 279 00:13:21,759 --> 00:13:25,638 Ice water in the outer bag. No direct ice-on-skin contact. 280 00:13:25,722 --> 00:13:29,100 - We spent a lot of time prepping-- - He still needs to look. 281 00:13:33,521 --> 00:13:34,731 Get Robby. 282 00:13:43,948 --> 00:13:46,617 - Antibiotics? - Cefazolin and gent. 283 00:13:46,701 --> 00:13:49,078 We've cleared her chest, abdomen, and pelvis. 284 00:13:49,162 --> 00:13:53,333 Clean wound, no crush injury, rapid transport time. 285 00:13:53,875 --> 00:13:55,460 Replantation is a go. 286 00:13:55,543 --> 00:13:56,669 I'll book an OR. 287 00:13:56,753 --> 00:13:58,254 Irrigate the hell out of this with 3 liters. 288 00:13:58,338 --> 00:14:00,840 - 3 liters? - Of saline, genius. 289 00:14:02,717 --> 00:14:03,926 Thanks, Shark. 290 00:14:07,764 --> 00:14:09,432 I knew he meant saline. 291 00:14:10,558 --> 00:14:14,645 Dr. Robby, we need you in Central 6. Dr. Mohan may be having a heart attack. 292 00:14:14,729 --> 00:14:15,772 What? 293 00:14:17,732 --> 00:14:20,276 - EKG is normal. - You sure? 294 00:14:20,360 --> 00:14:22,487 Check it out. You can be your own second opinion. 295 00:14:22,570 --> 00:14:24,655 - What's going on? - It's okay. I'm okay. 296 00:14:24,739 --> 00:14:26,157 You don't look okay. 297 00:14:26,240 --> 00:14:28,284 - You look like shit. - I feel like shit. 298 00:14:28,368 --> 00:14:30,870 - What happened? - I don't know. 299 00:14:30,953 --> 00:14:34,749 I just got really hot, and I started having trouble breathing. 300 00:14:35,583 --> 00:14:37,794 We should send up some labs just to be safe. 301 00:14:38,795 --> 00:14:40,004 Any chance you're pregnant? 302 00:14:40,088 --> 00:14:42,799 I'm not sure I feel comfortable answering that. 303 00:14:44,550 --> 00:14:46,886 - No. - She was tachy, but it's resolved now. 304 00:14:46,969 --> 00:14:48,805 - Have you eaten anything? - Yeah. 305 00:14:49,389 --> 00:14:51,182 - You staying hydrated? - 100%. 306 00:14:51,808 --> 00:14:52,934 I'm doing everything right. 307 00:14:53,017 --> 00:14:55,228 It's everything around me that's all fucked up. 308 00:14:55,311 --> 00:14:58,189 It's just my mom moving and calling me over and over again 309 00:14:58,272 --> 00:15:00,108 and now me scrambling to find a job next year. 310 00:15:00,191 --> 00:15:02,902 I had it all planned out, and now everything's just out the window. 311 00:15:02,985 --> 00:15:05,863 Wait a minute. Is this a panic attack because of your mommy issues? 312 00:15:06,531 --> 00:15:08,032 - What? No. - Jesus. 313 00:15:08,116 --> 00:15:09,325 Do you need to go home? 314 00:15:09,409 --> 00:15:11,035 - You should go home. - No, I'm fine. 315 00:15:11,119 --> 00:15:12,662 I don't need the fucking liability. Go home. 316 00:15:13,204 --> 00:15:15,915 And the rest of you, the last time I checked, the ED is a shit show. 317 00:15:15,998 --> 00:15:18,000 So let's all get back to work, huh? 318 00:15:25,341 --> 00:15:27,802 Sorry for taking so long, Becca. 319 00:15:27,885 --> 00:15:29,887 Nurse Dana said you'd be back in a few minutes, 320 00:15:29,971 --> 00:15:32,140 but it's definitely been more than a few minutes. 321 00:15:32,223 --> 00:15:34,016 You're right. My apologies. 322 00:15:34,642 --> 00:15:36,769 - I brought some drink options. - Okay. 323 00:15:36,853 --> 00:15:40,606 We've got apple juice, cranberry juice, 324 00:15:40,690 --> 00:15:43,734 OJ, and Pittsburgh's finest. 325 00:15:43,818 --> 00:15:46,028 - What's that? - Water. 326 00:15:46,863 --> 00:15:48,656 - OJ, please. - Okay. 327 00:15:50,032 --> 00:15:51,451 Let's see. 328 00:15:54,620 --> 00:15:55,663 All right. 329 00:15:56,664 --> 00:15:59,459 Now, I am going to give you two pills. 330 00:16:00,042 --> 00:16:02,086 The first is an antibiotic. 331 00:16:02,170 --> 00:16:04,380 That will get rid of the infection. 332 00:16:04,464 --> 00:16:06,382 The second should take care of the burning. 333 00:16:06,466 --> 00:16:09,886 You want to take both pills for three days and drink lots of water. 334 00:16:09,969 --> 00:16:11,387 I'll write it all down. 335 00:16:11,471 --> 00:16:12,680 I hate pills. 336 00:16:13,347 --> 00:16:16,225 Could you mash those up and put them in the OJ for me? 337 00:16:16,309 --> 00:16:17,685 Coming right up. 338 00:16:19,604 --> 00:16:20,688 Okay. 339 00:16:21,898 --> 00:16:24,567 Mel's gonna be super worried when you tell her. 340 00:16:25,193 --> 00:16:26,736 You are gonna be just fine. 341 00:16:26,819 --> 00:16:30,198 But as far as telling your sister what's going on with you, 342 00:16:30,281 --> 00:16:32,450 that is your decision, not mine. 343 00:16:34,702 --> 00:16:37,705 So you're not going to tell Mel? 344 00:16:38,498 --> 00:16:42,460 I can't, not unless you, my patient, tell me to. 345 00:16:45,713 --> 00:16:49,300 Do you know when Mel's gonna be done with her important meeting? 346 00:16:50,092 --> 00:16:51,302 Hopefully soon. 347 00:16:52,720 --> 00:16:56,224 Dr. Langdon, they need you back in Trauma Two. 348 00:16:56,307 --> 00:16:57,308 Hi. 349 00:16:59,644 --> 00:17:01,187 Becca, I got to go. I'll be-- 350 00:17:01,270 --> 00:17:04,397 Don't say "in a few minutes" unless you actually mean in a few minutes. 351 00:17:05,107 --> 00:17:06,317 I would never. 352 00:17:11,239 --> 00:17:14,450 And I need you to be kind to each other. 353 00:17:14,534 --> 00:17:17,954 I am kind. Shane's just a butthead sometimes. 354 00:17:19,539 --> 00:17:23,125 He's your brother, and he loves you. 355 00:17:25,419 --> 00:17:26,546 Don't go. 356 00:17:27,338 --> 00:17:28,756 I don't want to go. 357 00:17:30,091 --> 00:17:32,843 But it's not up to me. 358 00:17:33,970 --> 00:17:35,054 Hey. 359 00:17:35,137 --> 00:17:37,139 We'll always be connected... 360 00:17:37,974 --> 00:17:39,350 ...no matter what. 361 00:17:42,353 --> 00:17:43,980 Invisible string. 362 00:17:47,567 --> 00:17:49,151 Invisible string. 363 00:18:01,372 --> 00:18:02,373 Hey. 364 00:18:04,792 --> 00:18:06,502 You gonna go in and see your mom? 365 00:18:08,004 --> 00:18:09,589 Cancer sucks. 366 00:18:10,590 --> 00:18:11,841 Yeah. 367 00:18:11,924 --> 00:18:13,384 Yeah, it does. 368 00:18:16,387 --> 00:18:19,599 - It's not fair. - No, it's not. 369 00:18:24,186 --> 00:18:25,771 I don't want to go in there. 370 00:18:27,815 --> 00:18:29,817 Nobody's gonna make you. 371 00:18:36,824 --> 00:18:38,826 She didn't used to look like that. 372 00:18:41,829 --> 00:18:43,414 Yeah, I get that. 373 00:18:47,084 --> 00:18:50,129 But if you don't go in there and say goodbye 374 00:18:50,212 --> 00:18:52,214 and tell your mom you love her... 375 00:18:53,841 --> 00:18:57,053 ...I think you might wish you had for a very long time. 376 00:19:01,223 --> 00:19:02,642 It's your call. 377 00:19:06,437 --> 00:19:10,650 D-5 half normal saline, 20 of K running at 125 an hour. 378 00:19:11,442 --> 00:19:12,777 One of the most common reasons 379 00:19:12,860 --> 00:19:15,196 for traumatic-replantation failure is infections. 380 00:19:15,279 --> 00:19:16,656 So we do what, Whitaker? 381 00:19:16,739 --> 00:19:18,824 Rinse and repeat until surgery calls for us. 382 00:19:21,077 --> 00:19:23,162 Is everything okay with Dr. Mohan? 383 00:19:23,245 --> 00:19:24,747 She's fine. Focus. 384 00:19:30,086 --> 00:19:31,253 Where am I? 385 00:19:32,463 --> 00:19:33,923 Ketamine's wearing off. 386 00:19:37,093 --> 00:19:39,095 I can't feel my leg. 387 00:19:39,178 --> 00:19:41,972 I'm Dr. Michael Robinavitch. You're at a hospital. 388 00:19:42,056 --> 00:19:44,642 And we gave you a nerve block so that you can't feel any pain. 389 00:19:44,725 --> 00:19:45,726 Why? 390 00:19:45,810 --> 00:19:49,772 You were on a water slide that collapsed and did serious injury to your leg. 391 00:19:53,901 --> 00:19:55,152 What the fuck? 392 00:19:55,236 --> 00:19:56,529 Is that my leg? 393 00:19:56,612 --> 00:19:57,613 Is that my... 394 00:19:57,697 --> 00:20:00,449 - Did you cut my fucking leg off? - Your leg was cut off in the accident. 395 00:20:00,533 --> 00:20:02,660 Our surgeons are going to try for replantation. 396 00:20:02,743 --> 00:20:04,203 No. 397 00:20:04,286 --> 00:20:05,621 - She needs more ketamine. - Just wrap up the leg. 398 00:20:05,705 --> 00:20:06,831 Emily, I know that this is really hard. 399 00:20:06,914 --> 00:20:08,332 I need you to focus on me right now, 400 00:20:08,416 --> 00:20:09,834 because we need to get your consent 401 00:20:09,917 --> 00:20:11,627 - to proceed with the surgery. - Why? 402 00:20:11,711 --> 00:20:13,045 There are risks with the surgery. 403 00:20:13,129 --> 00:20:15,423 There's anesthesia, and there's no guarantee-- 404 00:20:15,506 --> 00:20:17,049 Emily? 405 00:20:17,133 --> 00:20:19,844 Can you just put it back on? 406 00:20:19,927 --> 00:20:22,346 - Can you just put it back on? - Sounds like consent to me. 407 00:20:22,430 --> 00:20:24,849 - Now can she have sedation? - Okay, load her up. Ketamine and rock. 408 00:20:24,932 --> 00:20:26,225 It's gonna be okay. It's gonna be okay. 409 00:20:26,308 --> 00:20:28,102 We're gonna intubate before the OR. 410 00:20:28,185 --> 00:20:29,729 It's gonna be okay. 411 00:20:30,354 --> 00:20:33,441 - Finishing second cut. - Success. 412 00:20:33,524 --> 00:20:36,694 - Can that be saved? - The finger or the ring? 413 00:20:36,777 --> 00:20:38,362 - The wedding ring. - Yes, sir. 414 00:20:38,446 --> 00:20:40,740 A jeweler can weld it back together good as new. 415 00:20:41,490 --> 00:20:44,243 Stop. Irrigate the ring shavings off first. 416 00:20:46,162 --> 00:20:48,748 - What did I miss? - Finishing irrigation. 417 00:20:49,540 --> 00:20:50,666 Okay. 418 00:20:50,750 --> 00:20:52,460 Doesn't look like you lost any skin. 419 00:20:52,543 --> 00:20:54,628 It's a little dusky. Might not be viable. 420 00:20:54,712 --> 00:20:56,464 There's intact skin on the dorsum. 421 00:20:56,547 --> 00:20:58,841 More irrigation, then tack it down with one suture. 422 00:20:58,924 --> 00:21:00,342 Okay, thanks. 423 00:21:00,426 --> 00:21:04,263 - Radiologist reports a 25% pneumothorax. - Is that bad? 424 00:21:04,346 --> 00:21:07,099 That is a partially collapsed lung that needs treatment. 425 00:21:07,183 --> 00:21:09,769 - I can put in a chest tube. - He doesn't need a chest tube. 426 00:21:09,852 --> 00:21:11,937 Okay, what do you want, a pigtail catheter? 427 00:21:12,772 --> 00:21:14,398 I was thinking a ThoraVent. 428 00:21:14,482 --> 00:21:15,775 What? Why? 429 00:21:15,858 --> 00:21:18,068 It's not a bad idea. No need for wall suction. 430 00:21:18,152 --> 00:21:21,113 If Hand can operate today, he can go home tomorrow with the ThoraVent. 431 00:21:21,197 --> 00:21:23,491 You can learn a lot from your senior residents. 432 00:21:23,574 --> 00:21:25,785 I'm happy to teach Dr. Santos. 433 00:21:25,868 --> 00:21:27,787 Thank you, Dr. Langdon. 434 00:21:31,999 --> 00:21:35,127 Janelle, I need you to take the samples to the lab 435 00:21:35,211 --> 00:21:37,004 and come back with any results that are ready. 436 00:21:37,087 --> 00:21:40,925 Geoffrey, head to CT to see if any new results are printed and bring those back. 437 00:21:41,008 --> 00:21:43,844 Pam, check in with whoever's running the PDS 438 00:21:43,928 --> 00:21:46,138 to see if any orders need to go to the pharmacy 439 00:21:46,222 --> 00:21:48,224 and bring back any meds that are ready for pickup. 440 00:21:48,307 --> 00:21:50,684 Rinse and repeat every 15 minutes. 441 00:21:50,768 --> 00:21:52,686 Double-tie those shoelaces and hydrate. 442 00:21:52,770 --> 00:21:54,814 It's not a sprint. It's a marathon. 443 00:21:55,606 --> 00:21:57,233 Fly, my pretties. 444 00:21:58,025 --> 00:22:00,736 Okay, any word on finding our water slide dad's kid? 445 00:22:00,820 --> 00:22:04,406 Not yet. Called the wife, went straight to voicemail. 446 00:22:04,490 --> 00:22:07,159 Police dispatch said that there were a couple of fatalities on site-- 447 00:22:07,243 --> 00:22:09,745 - one adult, one kid. - Sweet Jesus. 448 00:22:09,829 --> 00:22:10,996 Who the fuck did this? 449 00:22:11,080 --> 00:22:15,334 No sign-off on orders for labs or X-rays, and it's in the wrong freaking rack? 450 00:22:15,417 --> 00:22:17,837 You guys trying to kill me and the patient? 451 00:22:17,920 --> 00:22:19,547 - I'll take care of it. - Thanks. 452 00:22:19,630 --> 00:22:22,967 - Dana, this gum is abso-- - Shit. I know. 453 00:22:23,050 --> 00:22:24,969 Pharmacy said you needed this right away. 454 00:22:25,052 --> 00:22:27,513 Just in time. Slap one on and give it an hour to kick in. 455 00:22:27,596 --> 00:22:28,597 You're welcome. 456 00:22:29,807 --> 00:22:32,601 - What? - The prescription is for you. 457 00:22:32,685 --> 00:22:34,520 My insurance will cover it. Hers won't. 458 00:22:35,271 --> 00:22:36,689 Isn't that insurance fraud? 459 00:22:37,648 --> 00:22:39,775 Throw me in jail. I could use a vacation. 460 00:22:43,237 --> 00:22:44,280 Mom. 461 00:22:49,869 --> 00:22:51,370 I'm really glad to see you, Mom. I-- 462 00:22:51,453 --> 00:22:53,873 Garcia told me about the sigmoid volvulus you missed. 463 00:22:53,956 --> 00:22:56,292 - It was an oversight. - That could have killed her. 464 00:22:56,876 --> 00:22:59,378 Without electronic records, it's been kind of a challenge to figure out-- 465 00:22:59,461 --> 00:23:02,381 Chaos is the status quo in the ED, even when the computers are working properly. 466 00:23:02,464 --> 00:23:04,633 You have to be hypervigilant and double-check everything. 467 00:23:04,717 --> 00:23:07,094 - I can handle it. - Why would you want to? 468 00:23:07,970 --> 00:23:11,223 Down here your learning street-level medicine, all seat of your pants. 469 00:23:11,307 --> 00:23:12,600 Oh, well, I made a mistake, 470 00:23:12,683 --> 00:23:15,686 but the more talented practitioners upstairs will fix it. 471 00:23:17,897 --> 00:23:19,356 You are better than this. 472 00:23:20,900 --> 00:23:23,903 I love you, too. 473 00:23:28,282 --> 00:23:32,244 - Well, that is one way to do a debrief. - You should talk to her. 474 00:23:32,328 --> 00:23:34,955 - Which one? - Honestly, both of them. 475 00:23:35,039 --> 00:23:37,666 - Can you call in some extra doctors? - Sure. 476 00:23:37,750 --> 00:23:39,376 Everyone's dying to work on the Fourth of July. 477 00:23:39,460 --> 00:23:41,545 - Why? - Dr. Mohan went down. 478 00:23:41,629 --> 00:23:43,797 Yeah. I saw your pep talk. 479 00:23:44,715 --> 00:23:47,426 She's taking a little break until her labs are back. 480 00:23:47,509 --> 00:23:50,846 She's going to be fine, but I'm not sure her head is in the game. 481 00:23:51,722 --> 00:23:53,140 I'm on it, Cap. 482 00:23:53,223 --> 00:23:55,059 Small stab incision with the 11 blade, 483 00:23:55,142 --> 00:23:58,437 midclavicular line, second intercostal space. 484 00:23:58,520 --> 00:24:01,315 - She's gonna stab me? - It's just a medical term. 485 00:24:01,398 --> 00:24:02,650 Stay superior to the rib. 486 00:24:07,738 --> 00:24:10,699 - Is there a problem? - Nope, everything's going well. 487 00:24:11,867 --> 00:24:13,160 Place the trocar. 488 00:24:13,953 --> 00:24:16,580 Hold back the adhesive wings 489 00:24:16,664 --> 00:24:20,084 and advance until you see the red diaphragm move. 490 00:24:20,167 --> 00:24:22,169 That means you're in the pleural space. 491 00:24:22,878 --> 00:24:25,214 Now remove the trocar. 492 00:24:28,717 --> 00:24:29,885 Perfect. 493 00:24:29,969 --> 00:24:33,639 Okay, now we can either hook up to wall suction, 494 00:24:33,722 --> 00:24:37,101 or we can use this one-way valve to repeatedly aspirate with a syringe. 495 00:24:37,184 --> 00:24:39,478 Well, with all your vast experience, Dr. Langdon, 496 00:24:39,561 --> 00:24:41,230 you should probably decide. 497 00:24:43,941 --> 00:24:46,694 We can avoid wall suction if I pump manually. 498 00:24:46,777 --> 00:24:48,487 - Have at it, Doc. - Enough. 499 00:24:48,570 --> 00:24:52,116 Apparently, decency and decorum need to be reintroduced to our R2 curriculum. 500 00:24:52,825 --> 00:24:54,535 Nice work, Dr. Langdon. 501 00:24:54,618 --> 00:24:56,787 I'll go check on an OR for Mr. Foster. 502 00:25:02,209 --> 00:25:04,586 Hey. I'm gonna need you to pick up the pace. 503 00:25:05,379 --> 00:25:08,507 Can I get a sec? Dr. Mohan just almost died on me. 504 00:25:08,590 --> 00:25:10,926 Not even close. She's tougher than she looks. 505 00:25:11,010 --> 00:25:12,803 Propane hero in North 4. 506 00:25:12,886 --> 00:25:14,388 Hey, any word from surgery 507 00:25:14,471 --> 00:25:17,516 on how our big patient Howard's perforated diverticulitis is doing? 508 00:25:17,599 --> 00:25:20,144 - Still in the OR. - What about our drunk firework kid? 509 00:25:20,227 --> 00:25:22,187 Waiting his turn in the surgical conga line. 510 00:25:22,813 --> 00:25:24,440 What about Social Services? 511 00:25:24,523 --> 00:25:26,525 Have they found a temporary foster home 512 00:25:26,608 --> 00:25:28,944 - for our baby Jane Doe? - Still working on it. 513 00:25:29,028 --> 00:25:31,905 Kid's gonna be old enough to drive by the time she gets out of here. 514 00:25:31,989 --> 00:25:33,449 You joke... 515 00:25:34,533 --> 00:25:36,160 Oh, for fuck's sake! 516 00:25:36,243 --> 00:25:39,371 Go, quickly, before I change my mind. 517 00:25:39,455 --> 00:25:42,166 Hey, did the county pick up Louie's body yet? 518 00:25:42,249 --> 00:25:45,169 - No. He's still in the viewing room. - Jesus. He's just laying in there? 519 00:25:45,252 --> 00:25:48,255 Yeah. Another couple minutes, I'm gonna wheel him down to the morgue myself. 520 00:25:49,965 --> 00:25:50,966 What's the bullet? 521 00:25:51,050 --> 00:25:52,968 Eight-year-old boy, part of the water park accident. 522 00:25:53,052 --> 00:25:54,970 - Thrown off the water slide. - How far did he fall? 523 00:25:55,054 --> 00:25:57,347 Maybe 6 or 7 feet, landed in a tree. 524 00:25:57,431 --> 00:25:59,141 Had to wait for a ladder truck to get him down. 525 00:25:59,224 --> 00:26:01,351 Major neck trauma. Must've taken all the impact there. 526 00:26:01,435 --> 00:26:02,770 Couldn't tube him, hard to bag. 527 00:26:02,853 --> 00:26:06,482 Sats in the 80s. BP 85 over 60. Pulse 50. 528 00:26:08,650 --> 00:26:11,070 Okay, one, two, and three. 529 00:26:12,321 --> 00:26:14,990 - Possible laryngeal fracture. - Hypoxic bradycardic. 530 00:26:15,074 --> 00:26:17,034 Kid needs an airway before he arrests. 531 00:26:17,117 --> 00:26:19,453 Broselow tape, pedes cart, set up suction. 532 00:26:19,536 --> 00:26:21,705 Oh, my God. Is that Zack? 533 00:26:22,414 --> 00:26:24,500 Hey. Hey, kid, can you look at me? 534 00:26:25,209 --> 00:26:27,878 No response, no purposeful movement to pain. 535 00:26:29,213 --> 00:26:30,255 Oh, my God. 536 00:26:30,339 --> 00:26:31,381 Is this your kid? 537 00:26:32,091 --> 00:26:33,592 - No. - Sir, go back to your room now. 538 00:26:33,675 --> 00:26:35,552 - Broselow says 25 kilograms. - Jesse? 539 00:26:35,636 --> 00:26:36,970 5 1/2 ET tube. 540 00:26:37,054 --> 00:26:40,682 - Okay, 30 of rock, 50 ketamine. - You're gonna paralyze? 541 00:26:40,766 --> 00:26:43,227 - Yep. - If we can't intubate, we crike? 542 00:26:43,310 --> 00:26:44,603 He's too young for a crike. 543 00:26:44,686 --> 00:26:46,688 - Needle crike? - Can't ventilate through that. 544 00:26:46,772 --> 00:26:49,733 - Sats down to 78. - 11 blade, Kelly, and a pedes bougie. 545 00:26:49,817 --> 00:26:51,068 One quick look, and then we cut. 546 00:26:51,777 --> 00:26:54,363 I can't tell if there's lung sliding. No movement, no air entry. 547 00:26:54,446 --> 00:26:56,448 Way too edematous. I can't see the cords. 548 00:26:56,532 --> 00:26:58,158 Better with cricoid pressure? 549 00:26:59,326 --> 00:27:00,410 Nothing. Fuck. 550 00:27:00,494 --> 00:27:02,246 Okay. Towel roll between the shoulder blades, please. 551 00:27:02,329 --> 00:27:04,456 Heart rate down to 49. Headed to cardiac arrest. 552 00:27:04,540 --> 00:27:06,625 Trake's going to take 20 minutes. This kid's not gonna last 60 seconds. 553 00:27:06,708 --> 00:27:08,043 That's why we're doing a slash trake. 554 00:27:08,127 --> 00:27:09,628 - Don't know it. - Me neither. 555 00:27:09,711 --> 00:27:11,630 - Boss? - Show me what you got. 556 00:27:20,931 --> 00:27:24,143 Pull up the trachea between your thumb and middle finger. 557 00:27:24,810 --> 00:27:27,729 Vertical incision right over the trachea. 558 00:27:28,564 --> 00:27:32,192 Vertical, not horizontal, or you transect the trachea and cut the jugular veins. 559 00:27:33,652 --> 00:27:34,987 That's a lot of blood. 560 00:27:35,571 --> 00:27:37,406 Now it's a tactile procedure. 561 00:27:37,489 --> 00:27:40,117 2-centimeter incision through the tracheal rings. 562 00:27:40,742 --> 00:27:42,369 Finger in the trachea. 563 00:27:43,954 --> 00:27:45,706 Bougie into the airway. 564 00:27:47,583 --> 00:27:51,128 - Thoughts on what's next, Dr. Whitaker? - Insert the ET tube into the trachea. 565 00:27:52,421 --> 00:27:54,423 Suction. Lots of blood in the airway. 566 00:28:01,221 --> 00:28:02,389 Okay, bag him. 567 00:28:03,473 --> 00:28:04,766 Check the CO2. 568 00:28:05,976 --> 00:28:07,895 Sats coming up, in the 80s. 569 00:28:07,978 --> 00:28:10,898 Bilateral breath sounds. End tidal CO2 is 70. 570 00:28:10,981 --> 00:28:12,691 - That's crazy high. - It'll come down. 571 00:28:12,774 --> 00:28:14,693 Tie down the tube, control all the bleeders. 572 00:28:14,776 --> 00:28:17,321 Spray an amp of epi on a stack of 4-by-4s. 573 00:28:17,404 --> 00:28:20,073 Okay. Sats are up to the 90s. 574 00:28:20,157 --> 00:28:22,326 Good. CO2's in the 50s. Good heart rate. 575 00:28:22,409 --> 00:28:24,036 You forgot the last step. 576 00:28:24,119 --> 00:28:25,913 Change your underwear. 577 00:28:25,996 --> 00:28:28,624 - How many of these you done? - First one. 578 00:28:28,707 --> 00:28:29,833 You serious? 579 00:28:29,917 --> 00:28:31,710 - How about you? - None. 580 00:28:31,793 --> 00:28:34,338 I practiced in the Sim Lab when I was at Stanford. 581 00:28:34,421 --> 00:28:35,714 - What'd I miss? - All the fun. 582 00:28:35,797 --> 00:28:37,049 - Slash trake. - Seriously? 583 00:28:38,008 --> 00:28:40,886 Fractured larynx. Couldn't oxygenate, couldn't ventilate. 584 00:28:40,969 --> 00:28:44,681 - You use a meat cleaver on this kid? - ENT can revise the trake in the OR. 585 00:28:45,390 --> 00:28:47,059 They'll be thrilled to clean up your mess. 586 00:28:48,018 --> 00:28:50,437 Or maybe they'll thank us for not letting him die. 587 00:28:56,109 --> 00:28:58,070 So we're still waiting on your prescription, 588 00:28:58,153 --> 00:28:59,947 and the pharmacy is a little backed up. 589 00:29:00,030 --> 00:29:02,491 But I'm glad to see you're doing good. 590 00:29:02,574 --> 00:29:03,533 Well. 591 00:29:04,159 --> 00:29:05,244 I'm well. 592 00:29:06,828 --> 00:29:08,163 Glad to see you're well. 593 00:29:08,247 --> 00:29:10,457 Can't you expedite my medication? 594 00:29:11,166 --> 00:29:13,377 Sure, but it may still be a little while 595 00:29:13,460 --> 00:29:17,547 before Dr. Mohan can sign off on the discharge, so sit tight. 596 00:29:19,466 --> 00:29:20,676 And do what? 597 00:29:24,846 --> 00:29:27,474 You just keep this handy for occasions like this? 598 00:29:28,475 --> 00:29:31,103 I thought that I might not have that much to do today. 599 00:29:31,186 --> 00:29:32,271 But... 600 00:29:33,063 --> 00:29:34,690 ...man, I was wrong. 601 00:29:41,405 --> 00:29:42,698 Thank you. 602 00:29:47,494 --> 00:29:50,789 - What brings you in today? - A friend made me come in. 603 00:29:50,872 --> 00:29:54,001 - Name's Robby. He said I should-- - You're Duke. 604 00:29:54,710 --> 00:29:56,211 - Donnie? - Yep? 605 00:29:56,295 --> 00:29:58,088 Robby's VIP is here. 606 00:30:01,717 --> 00:30:04,636 Hi. I'm Donnie, nurse practitioner. 607 00:30:04,720 --> 00:30:08,807 Robby's already put in orders for a numbing spray for your nostril. 608 00:30:08,890 --> 00:30:10,892 "Nostril"? It's my throat. 609 00:30:10,976 --> 00:30:12,811 - It's not my nose. - Okay. 610 00:30:12,894 --> 00:30:15,314 Let's get you set up in a room. 611 00:30:18,650 --> 00:30:22,321 That was the most unprofessional deposition I've ever witnessed. 612 00:30:22,404 --> 00:30:24,740 They were nowhere near that aggressive with Dr. Ellis. 613 00:30:25,907 --> 00:30:27,326 Oh, okay. 614 00:30:29,536 --> 00:30:31,538 It didn't go as badly as you think. 615 00:30:32,080 --> 00:30:33,915 They suggested I was incompetent. 616 00:30:33,999 --> 00:30:38,003 They're posturing to set the stage for a ridiculous settlement request. 617 00:30:38,086 --> 00:30:39,838 This isn't about those parents or that kid. 618 00:30:39,921 --> 00:30:42,090 It's only about trying to make a lot of money. 619 00:30:42,174 --> 00:30:45,344 Well, I don't have a lot of money. 620 00:30:45,427 --> 00:30:48,055 Not your money, Dr. King. It's an insurance game. 621 00:30:48,138 --> 00:30:51,350 You're protected by the hospital. This won't affect your career. 622 00:30:57,147 --> 00:30:59,483 Hey. How was your deposition? 623 00:30:59,566 --> 00:31:00,901 Have you seen Dr. Langdon? 624 00:31:01,485 --> 00:31:02,569 No. Why? 625 00:31:04,321 --> 00:31:06,156 Okay, okay. How's Becca? 626 00:31:06,239 --> 00:31:07,699 - Oh, she's fine. - Yeah? 627 00:31:07,783 --> 00:31:09,076 Okay, I should go see her, then. 628 00:31:09,159 --> 00:31:11,495 How was your deposition? I'm sure it was stressful. 629 00:31:15,165 --> 00:31:17,376 What's going on with Becca? What's her diagnosis? 630 00:31:17,459 --> 00:31:18,585 I can't tell you. 631 00:31:19,294 --> 00:31:20,545 Why? 632 00:31:20,629 --> 00:31:22,089 - HIPAA. - Seriously? 633 00:31:22,172 --> 00:31:23,715 If you want to know what's going on with Becca, 634 00:31:23,799 --> 00:31:25,300 you're gonna have to ask her yourself. 635 00:31:25,384 --> 00:31:27,135 Hey, you survived your deposition. 636 00:31:27,219 --> 00:31:29,304 Welcome back to the seventh circle of hell. 637 00:31:29,388 --> 00:31:30,389 What's this? 638 00:31:30,472 --> 00:31:32,891 You're welcome for covering your patients. They're yours again. 639 00:31:32,974 --> 00:31:35,519 Might want to check on the pancreatitis in North 3 first. 640 00:31:36,395 --> 00:31:37,437 Okay. 641 00:31:37,521 --> 00:31:40,107 Langdon, I got some intel on Louie. 642 00:31:40,190 --> 00:31:41,691 They move him out of the viewing room? 643 00:31:41,775 --> 00:31:44,319 No, but county's promised they're on the way to come get him. 644 00:31:44,403 --> 00:31:47,322 - Can I get the county coroner's number? - What for? 645 00:31:47,406 --> 00:31:49,282 I just want to make sure if no family shows up, 646 00:31:49,366 --> 00:31:51,535 - Louie gets a proper burial. - That's expensive. 647 00:31:51,618 --> 00:31:53,829 You may want to run it by the missus first. 648 00:31:54,413 --> 00:31:57,124 Maybe I'll start a GoFundMe. I bet people around here would pitch in. 649 00:31:57,207 --> 00:32:00,210 Hey, kid, you can't do this for every unhoused guy 650 00:32:00,293 --> 00:32:02,087 that dies around here. 651 00:32:02,170 --> 00:32:03,713 There but for the grace of God. 652 00:32:03,797 --> 00:32:07,926 No, the success of your sobriety is a testament to your support system. 653 00:32:08,009 --> 00:32:09,761 Louie didn't have that. 654 00:32:09,845 --> 00:32:11,888 Still, Louie was a good man. 655 00:32:11,972 --> 00:32:14,141 He deserves to be put to rest with dignity. 656 00:32:14,224 --> 00:32:16,560 Okay. I'll dig it up. 657 00:32:19,312 --> 00:32:20,647 You heard all that? 658 00:32:22,190 --> 00:32:25,444 Robby, your VIP's here. Got him in Central 11. 659 00:32:25,527 --> 00:32:26,862 Finally. 660 00:32:30,240 --> 00:32:31,491 About fucking time. 661 00:32:31,575 --> 00:32:34,953 If I knew you were gonna make me wear a dress, I wouldn't have come at all. 662 00:32:35,036 --> 00:32:38,290 - Dennis Whitaker, meet my buddy Duke. - Nice to meet you. 663 00:32:38,373 --> 00:32:40,500 Any friend of Dr. Robby's is a friend of mine. 664 00:32:40,584 --> 00:32:44,171 "Friend" is a vast overstatement. He's more just a pain in my ass. 665 00:32:44,254 --> 00:32:46,298 Don't let his surly exterior fool you. 666 00:32:46,381 --> 00:32:48,884 Deep down inside, he's just as grumpy. 667 00:32:48,967 --> 00:32:51,470 - How did you two meet? - Tinder. 668 00:32:52,679 --> 00:32:54,973 Duke is a motorcycle engineer. 669 00:32:55,056 --> 00:32:58,393 You should've seen his Bonneville when he first brought it in six months ago. 670 00:32:58,477 --> 00:33:00,187 Someone left it for dead. 671 00:33:00,270 --> 00:33:03,190 He helped me bring it back to life. Today we're going to return the favor. 672 00:33:03,273 --> 00:33:05,400 Dr. Whitaker's one of our most trusted physicians, 673 00:33:05,484 --> 00:33:07,611 and today he's going to help me oversee your care. 674 00:33:08,278 --> 00:33:10,071 what seems to be troubling you? 675 00:33:10,155 --> 00:33:12,199 Ask him. He's the one who made me come in. 676 00:33:12,282 --> 00:33:14,951 He's had some hoarseness on and off for a couple months. 677 00:33:15,035 --> 00:33:17,704 Okay, any history of tobacco or alcohol use? 678 00:33:18,914 --> 00:33:20,582 Two of my oldest and closest friends. 679 00:33:20,665 --> 00:33:23,627 Former two-pack-a-day smoker and lover of the drink. 680 00:33:23,710 --> 00:33:25,629 Okay. He on any medication? 681 00:33:25,712 --> 00:33:27,422 Blood-pressure meds. 682 00:33:27,506 --> 00:33:29,132 Which he forgets to take. 683 00:33:29,216 --> 00:33:30,842 He's all numbed up and ready to go. 684 00:33:30,926 --> 00:33:32,761 Okay. Thank you, Donnie. 685 00:33:33,720 --> 00:33:38,642 My man, I am gonna take this scope, and I'm gonna stick it in your nose, 686 00:33:38,725 --> 00:33:41,436 and we're going to check out your upper airway. 687 00:33:41,520 --> 00:33:43,855 That seems like a lot of fuss for a sore throat. 688 00:33:43,939 --> 00:33:45,232 Dr. Whitaker, you want to explain to Duke 689 00:33:45,315 --> 00:33:48,068 why this procedure is absolutely necessary? 690 00:33:48,151 --> 00:33:50,820 The scope is gonna give us a better view of your voice box 691 00:33:50,904 --> 00:33:52,531 and your vocal cords. 692 00:33:53,114 --> 00:33:54,407 Here we go. 693 00:33:59,329 --> 00:34:01,623 Gonna feel a little pressure between your eyes. 694 00:34:01,706 --> 00:34:03,124 I am sorry about that. 695 00:34:03,208 --> 00:34:05,377 Okay, just breathe through your nose. 696 00:34:05,460 --> 00:34:08,045 This is gonna help us see if there are any abnormalities 697 00:34:08,129 --> 00:34:11,132 like inflammation, tumors, nodules. 698 00:34:11,757 --> 00:34:13,467 That all looks pretty normal. 699 00:34:13,552 --> 00:34:16,012 I don't see too much drainage. Stick your tongue out for me, all the way. 700 00:34:16,929 --> 00:34:18,764 All the way out. Good. Now say... 701 00:34:20,559 --> 00:34:22,143 Good. Now again, say... 702 00:34:23,645 --> 00:34:25,355 Good. Removing the scope. 703 00:34:26,898 --> 00:34:28,942 Dr. Whitaker, what do you think? 704 00:34:29,025 --> 00:34:31,902 - Looks normal, no abnormalities. - Told you it was nothing. 705 00:34:31,987 --> 00:34:35,489 With your history of smoking, I'd like to do a chest X-ray. 706 00:34:35,574 --> 00:34:37,284 If there are growths, 707 00:34:37,367 --> 00:34:40,954 they can push against the recurrent laryngeal nerve intermittently. 708 00:34:41,036 --> 00:34:45,708 That can paralyze one of the vocal cords and cause the hoarseness. 709 00:34:45,792 --> 00:34:49,295 That sounds like a lot of bullshit doctor speak to charge me more. 710 00:34:49,379 --> 00:34:50,505 You've got Medicare. 711 00:34:50,589 --> 00:34:52,090 And, besides, I finally got you into my ED. 712 00:34:52,172 --> 00:34:55,719 You're gonna get the golden workup before I leave town tonight. 713 00:34:55,802 --> 00:34:59,389 Only an idiot would ride all night after working a 12-hour day. 714 00:34:59,472 --> 00:35:01,433 That does sound pretty dangerous. 715 00:35:01,516 --> 00:35:03,310 You gonna stay put, or do I have to tie you down? 716 00:35:03,393 --> 00:35:05,770 Fine, so long as you keep your hands where I can see 'em. 717 00:35:05,854 --> 00:35:07,314 No promises. 718 00:35:07,397 --> 00:35:08,940 Let me know when his chest X-ray is back. 719 00:35:09,024 --> 00:35:10,191 Yeah. 720 00:35:13,612 --> 00:35:14,821 - Hey. - Hey. 721 00:35:15,822 --> 00:35:17,032 Are we okay? 722 00:35:18,617 --> 00:35:21,745 - Yeah. Why? - I don't know. 723 00:35:21,828 --> 00:35:25,040 You kind of ripped me a new one in front of Langdon. 724 00:35:25,832 --> 00:35:28,335 - Whose side are you on? - This isn't middle school. 725 00:35:28,418 --> 00:35:30,337 Langdon made a mistake and owned up to it. 726 00:35:30,420 --> 00:35:32,213 - Let it go. - He should-- 727 00:35:34,841 --> 00:35:36,801 He should have been fired. 728 00:35:36,885 --> 00:35:39,596 But instead, he waltzes back in here, no big deal. 729 00:35:39,679 --> 00:35:41,890 Meanwhile, I've been a goddamn pariah for the last 10 months 730 00:35:41,973 --> 00:35:43,600 for doing the right thing. 731 00:35:43,683 --> 00:35:46,728 Or maybe you're a pariah because you don't play well with others. 732 00:35:48,229 --> 00:35:50,857 If you've still got beef with Langdon, go tell him. 733 00:35:50,940 --> 00:35:54,319 He's here to stay, so put on your big-girl panties and work it out. 734 00:35:54,402 --> 00:35:56,279 - He is no-- - Nope. 735 00:35:56,363 --> 00:35:58,990 You want to have sex and eat ramen in bed, I'm your girl. 736 00:35:59,074 --> 00:36:02,577 But if you want to talk about this Langdon shit, again, 737 00:36:02,661 --> 00:36:04,037 call a therapist. 738 00:36:13,505 --> 00:36:15,382 How's it hanging, Dr. J? 739 00:36:15,465 --> 00:36:18,968 - Never call me that again. - It was a joke. 740 00:36:19,052 --> 00:36:22,597 Relax. He's clueless about your TikToks. 741 00:36:22,681 --> 00:36:24,182 But you're not. 742 00:36:24,265 --> 00:36:26,601 - Props on the side hustle. - There is no hustle. 743 00:36:26,685 --> 00:36:27,811 They're just some stupid videos. 744 00:36:27,894 --> 00:36:29,813 - Wait, are you an influencer? - No! 745 00:36:29,896 --> 00:36:31,064 Yep. 746 00:36:32,315 --> 00:36:34,359 Yo, pre-docs, it's not happy hour yet. 747 00:36:34,442 --> 00:36:36,695 There's still a shit ton of patients to be seen. 748 00:36:41,282 --> 00:36:43,993 Ben, our slash-trake kid from the water park 749 00:36:44,077 --> 00:36:46,037 had some purposeful movement in pre-op. 750 00:36:46,121 --> 00:36:47,414 That's a good sign. 751 00:36:47,497 --> 00:36:48,707 Take the win. 752 00:36:51,292 --> 00:36:52,460 We need to talk. 753 00:36:54,504 --> 00:36:56,506 - We are talking. - In private. 754 00:37:05,515 --> 00:37:08,017 What the hell was that with Samira earlier? 755 00:37:08,727 --> 00:37:11,229 - That was tough love. - You are her superior. 756 00:37:11,312 --> 00:37:14,691 She was obviously struggling, and your advice was "go home"? 757 00:37:14,774 --> 00:37:16,192 Essentially, yeah. 758 00:37:16,276 --> 00:37:18,778 This is the ED. It's not for the faint of heart. 759 00:37:18,862 --> 00:37:20,739 It's not for the unempathetic either. 760 00:37:21,531 --> 00:37:23,867 Samira's not having a panic attack because of her patient. 761 00:37:23,950 --> 00:37:25,660 She's having one because of personal baggage. 762 00:37:25,744 --> 00:37:28,246 What she needs to do is pull her head out of her ass and focus on the work. 763 00:37:28,329 --> 00:37:29,372 What about you? 764 00:37:29,456 --> 00:37:32,208 What do you need to get some basic human empathy back? 765 00:37:34,753 --> 00:37:35,879 I don't know. 766 00:37:35,962 --> 00:37:38,965 Something that gives me a little hope this place won't fall to shit when I'm gone. 767 00:37:40,550 --> 00:37:42,802 - Found him! - Found who? 768 00:37:43,511 --> 00:37:45,889 - The water slide dad's kid. - How'd you manage that? 769 00:37:45,972 --> 00:37:47,891 I went outside, stalked the dad's IG, 770 00:37:47,974 --> 00:37:49,893 found a pic of his son, sent it to Pittsburgh PD. 771 00:37:49,976 --> 00:37:51,019 Now they're on their way over. 772 00:37:51,770 --> 00:37:53,980 Well, maybe Gen Z should be working for the FBI. 773 00:37:58,193 --> 00:37:59,778 - Hi, Becca. Hi. - Mel! 774 00:38:01,988 --> 00:38:04,699 - You doing all right? - I'm a little bored. 775 00:38:04,783 --> 00:38:05,784 Yeah? 776 00:38:06,993 --> 00:38:08,912 - How are you feeling? - A lot better. 777 00:38:08,995 --> 00:38:11,331 Dr. Langdon gave me some medicine and OJ. 778 00:38:11,414 --> 00:38:12,916 He's super nice. 779 00:38:12,999 --> 00:38:14,334 I see why you like him. 780 00:38:15,376 --> 00:38:18,046 Did he tell you what the medicine was for? 781 00:38:18,129 --> 00:38:19,297 Yes. 782 00:38:19,380 --> 00:38:20,924 Did you tell her? 783 00:38:21,007 --> 00:38:22,008 I did not. 784 00:38:22,801 --> 00:38:26,513 I explained to Becca that due to doctor-patient confidentiality, 785 00:38:26,596 --> 00:38:28,515 everything she told me was private 786 00:38:28,598 --> 00:38:30,308 and that it was her decision 787 00:38:30,391 --> 00:38:33,394 if she wanted to share anything with you or not. 788 00:38:35,230 --> 00:38:37,440 - Do you want to share? - Yes. 789 00:38:48,618 --> 00:38:51,120 I have a urinary-tract infection. 790 00:38:54,040 --> 00:38:55,166 Okay. 791 00:38:55,250 --> 00:38:59,963 Yeah, those can happen if you, you know, hold your pee in for too long 792 00:39:00,046 --> 00:39:01,965 or you accidentally wipe from back to front-- 793 00:39:02,048 --> 00:39:04,175 Mel, I know. I know, Mel. He told me. 794 00:39:04,259 --> 00:39:05,969 Oh, good. 795 00:39:06,052 --> 00:39:09,013 You know, he also told me it can happen from having sex. 796 00:39:10,640 --> 00:39:12,058 Yeah, it can. 797 00:39:12,851 --> 00:39:15,270 - It's not like you're having sex. - Yes, I am. 798 00:39:19,357 --> 00:39:20,608 I'm sorr--What? 799 00:39:20,692 --> 00:39:22,777 I'm having sex. 800 00:39:24,654 --> 00:39:26,865 - With who? - My boyfriend. 801 00:39:26,948 --> 00:39:29,033 - You have a boyfriend? - Yes. 802 00:39:29,117 --> 00:39:33,872 His name is Adam, and we're having sex, 803 00:39:33,955 --> 00:39:35,290 lots of sex. 804 00:39:37,458 --> 00:39:38,668 Okay. 805 00:39:42,463 --> 00:39:45,091 Mel, are you okay? 806 00:39:49,888 --> 00:39:51,848 - Got a sec? - Sure. 807 00:39:51,931 --> 00:39:54,392 - How you feeling? - I'm fine. 808 00:39:55,226 --> 00:39:56,728 - Are you sure? - Yeah. 809 00:39:56,811 --> 00:39:59,105 Troponin, D-dimer, and TSH all normal. 810 00:39:59,898 --> 00:40:01,232 Listen, I'm sorry about earlier. 811 00:40:01,316 --> 00:40:03,109 - I think I was being... - A dick? 812 00:40:04,694 --> 00:40:07,697 I was gonna say "unprofessional," but probably that, too. 813 00:40:08,615 --> 00:40:09,616 I'm sorry. 814 00:40:10,909 --> 00:40:11,910 Thanks. 815 00:40:12,952 --> 00:40:14,954 But now I kind of need you to stop feeling sorry for yourself 816 00:40:15,038 --> 00:40:16,623 and focus back on your patients. 817 00:40:16,706 --> 00:40:17,790 Think you can do that? 818 00:40:18,917 --> 00:40:20,501 - Sure. - Great. 819 00:40:24,088 --> 00:40:28,426 With this extra dose and increased morphine from the pump, 820 00:40:28,509 --> 00:40:30,053 your pain should subside. 821 00:40:30,136 --> 00:40:31,930 Your breathing will slow down. 822 00:40:32,972 --> 00:40:34,641 You may get very sleepy. 823 00:40:35,934 --> 00:40:38,353 Paul, go be with the boys. 824 00:40:39,729 --> 00:40:42,357 They need you more than I do now. 825 00:40:43,316 --> 00:40:44,525 Later. 826 00:40:45,234 --> 00:40:47,737 Right now I'm exactly where I'm supposed to be. 827 00:40:56,162 --> 00:40:57,163 Yeah. 828 00:40:58,122 --> 00:40:59,457 Okay. 829 00:40:59,540 --> 00:41:00,750 Here we go.