1 00:00:15,662 --> 00:00:17,080 - You know this guy? - Orlando Diaz. 2 00:00:17,163 --> 00:00:18,831 We were treating him for DKA when he eloped. 3 00:00:18,915 --> 00:00:20,416 - How far did he fall? - 20 feet or so. 4 00:00:20,500 --> 00:00:22,252 - Anyone see him pass out? - No. 5 00:00:22,335 --> 00:00:24,379 They went looking for him after he didn't answer his radio. 6 00:00:24,462 --> 00:00:25,588 Pupils equal but sluggish. 7 00:00:25,672 --> 00:00:26,965 He left against medical advice. 8 00:00:27,048 --> 00:00:29,676 On my count, three, two, one. 9 00:00:30,927 --> 00:00:33,137 Dr. Ellis on the case. Day shift, we got this. 10 00:00:33,221 --> 00:00:35,515 - I'm staying. - Continuity of care. 11 00:00:35,598 --> 00:00:36,891 Dr. Al-Hashimi, why don't you go cover 12 00:00:36,975 --> 00:00:38,184 sign-out rounds with Dr. Abbot? 13 00:00:38,268 --> 00:00:39,519 - Shen, you too. - Got it. 14 00:00:39,602 --> 00:00:41,604 OK, let me know if you need anything. 15 00:00:41,688 --> 00:00:44,190 - Lungs are up bilaterally. - Pelvis is stable. 16 00:00:44,274 --> 00:00:48,069 Right tib-fib hematoma, deformed right forearm. 17 00:00:48,152 --> 00:00:50,071 Ruptured TM on the left with sero-sanguinous fluid. 18 00:00:50,154 --> 00:00:51,864 That means basilar skull fracture. 19 00:00:51,948 --> 00:00:53,658 We've got a diabetic patient, 20-foot fall. 20 00:00:53,741 --> 00:00:55,994 BP 204 over 98, pulse 56. 21 00:00:56,077 --> 00:00:57,662 Dr. Mohan, what do those numbers indicate? 22 00:00:57,745 --> 00:00:59,455 I'm trying to treat the patient. 23 00:00:59,539 --> 00:01:00,748 It's the Cushing's reflex. 24 00:01:00,832 --> 00:01:02,875 From increased intracranial pressure. 25 00:01:02,959 --> 00:01:05,211 Yeah, we need to get him to CT right away. 26 00:01:05,295 --> 00:01:06,879 No free fluid in the belly. 27 00:01:06,963 --> 00:01:10,216 - Any family to notify? - Wife and three kids. 28 00:01:10,300 --> 00:01:12,302 Is there a card to sign for Robby? 29 00:01:12,385 --> 00:01:14,345 No, he said no card, no presents. 30 00:01:14,429 --> 00:01:15,763 Oh. Was there a cake? 31 00:01:15,847 --> 00:01:17,348 Oh, he didn't want that either. 32 00:01:17,432 --> 00:01:19,309 That sucks. I need some cake. 33 00:01:19,392 --> 00:01:21,519 Patient was injured when they raided a restaurant. 34 00:01:21,603 --> 00:01:23,313 And they actually arrested the nurse? 35 00:01:23,396 --> 00:01:25,857 - With a takedown and zip ties. - Damn. 36 00:01:25,940 --> 00:01:27,984 Crus, you, uh, know the computer downtime drill? 37 00:01:28,066 --> 00:01:29,444 Yeah, no biggie. 38 00:01:29,527 --> 00:01:31,112 I prefer to treat 'em without labs and X-rays. 39 00:01:31,195 --> 00:01:32,614 Welcome back. 40 00:01:32,697 --> 00:01:34,490 If you do have orders for labs and X-rays, 41 00:01:34,574 --> 00:01:36,576 clipboards go here. 42 00:01:36,659 --> 00:01:39,329 If it's just nursing orders, here. 43 00:01:39,411 --> 00:01:41,122 Please write neatly, for God's sake. 44 00:01:41,205 --> 00:01:43,666 Oh, Monica, this is Nazely, new intern. 45 00:01:43,750 --> 00:01:46,544 - I don't need to know that. - So nice to meet you. 46 00:01:47,712 --> 00:01:49,339 Looks like you and me, Jack. 47 00:01:49,422 --> 00:01:50,798 Yeah, who's our senior? 48 00:01:50,881 --> 00:01:53,926 - Dr. Henderson. - Excellent. 49 00:01:54,010 --> 00:01:55,803 Night shift's on Crus control. 50 00:01:55,887 --> 00:01:57,929 You hear ICE brought us a patient? 51 00:01:58,014 --> 00:01:59,724 Oh, yeah? How'd that go? 52 00:01:59,807 --> 00:02:00,850 There was some collateral damage. 53 00:02:00,933 --> 00:02:02,352 They arrested Jesse. 54 00:02:02,435 --> 00:02:04,354 - For what? - Assaulting a federal officer. 55 00:02:04,437 --> 00:02:05,897 Are you fucking kidding me? 56 00:02:05,980 --> 00:02:07,273 Oh, Dr. Al-Hashimi, 57 00:02:07,357 --> 00:02:09,566 this is Nazely Toomarian-- new intern. 58 00:02:16,366 --> 00:02:18,201 OK, everybody, let's huddle up. 59 00:02:18,284 --> 00:02:19,535 Before we start, 60 00:02:19,619 --> 00:02:21,162 let me address the elephant in the room. 61 00:02:21,245 --> 00:02:22,955 For those of you who don't know, 62 00:02:23,039 --> 00:02:24,415 Jesse tried to intervene 63 00:02:24,499 --> 00:02:26,209 when a federal agent was handling his patient, 64 00:02:26,292 --> 00:02:28,586 and both he and the patient were taken away by ICE. 65 00:02:28,670 --> 00:02:30,254 - Did he punch the guy? - No. 66 00:02:30,338 --> 00:02:32,674 He put out a hand to stop him, made physical contact. 67 00:02:32,757 --> 00:02:34,258 It was a little bit more than that. 68 00:02:34,342 --> 00:02:35,843 The hospital lawyers are on the case, 69 00:02:35,927 --> 00:02:38,179 and we will brief the staff every 12 hours 70 00:02:38,262 --> 00:02:39,931 at sign-out rounds with an official update. 71 00:02:40,014 --> 00:02:42,433 In the meantime, don't feed the rumor mill. 72 00:02:42,517 --> 00:02:44,769 You may have also heard that new grad nurse Emma here 73 00:02:44,852 --> 00:02:47,271 - was assaulted by a patient. - I--I'm fine. 74 00:02:47,355 --> 00:02:48,898 Please don't forget "code hula hoop," 75 00:02:48,981 --> 00:02:50,233 and with risky patients, 76 00:02:50,316 --> 00:02:52,568 always keep a path to the door clear. 77 00:02:52,652 --> 00:02:54,237 Sounds like one hell of a day. 78 00:02:54,320 --> 00:02:56,072 And we're still dealing with downtime, 79 00:02:56,155 --> 00:02:58,241 so day shift should brief night residents 80 00:02:58,324 --> 00:02:59,575 about the protocol-- 81 00:02:59,659 --> 00:03:00,535 Hey! 82 00:03:00,618 --> 00:03:02,203 Oh, all right! 83 00:03:02,286 --> 00:03:04,414 Oh, thank God. 84 00:03:04,497 --> 00:03:05,790 Yeah, not so fast. 85 00:03:05,873 --> 00:03:07,667 Every chart from the last five hours 86 00:03:07,750 --> 00:03:10,002 needs to be scanned into the Electronic Health Record 87 00:03:10,086 --> 00:03:12,046 and checked for accuracy... 88 00:03:12,130 --> 00:03:14,215 - Um, whose job is that? - Day shift. 89 00:03:14,298 --> 00:03:16,175 With a completed and signed T-sheet. 90 00:03:16,259 --> 00:03:17,885 - Are you kidding me? - That's gonna take forever. 91 00:03:17,969 --> 00:03:19,637 We will set up stations for scanning. 92 00:03:19,721 --> 00:03:21,431 OK, everybody, let's get moving. 93 00:03:21,514 --> 00:03:23,599 Triage is 20 behind. Gotta help 'em clean up. 94 00:03:23,683 --> 00:03:24,850 I'm skipping rounds. 95 00:03:24,934 --> 00:03:26,686 Consider yourself lucky. 96 00:03:26,769 --> 00:03:27,937 Should we join them? 97 00:03:29,355 --> 00:03:30,982 Might as well witness the magic. 98 00:03:31,065 --> 00:03:33,234 It's like changing of the guard at Buckingham Palace. 99 00:03:33,317 --> 00:03:35,111 Except we're allowed to smile. 100 00:03:35,194 --> 00:03:37,405 "Smile though your heart is aching." 101 00:03:38,573 --> 00:03:39,574 Plain films, right tib-fib 102 00:03:39,657 --> 00:03:41,534 and right forearm after CT. 103 00:03:41,617 --> 00:03:43,536 Got the chem-8. Blood sugar's 284. 104 00:03:43,619 --> 00:03:46,164 That's not too bad. Potassium looks good. 105 00:03:46,247 --> 00:03:48,416 Mm-hmm. Anion gap's up at 14. 106 00:03:48,499 --> 00:03:49,667 It was 24 this morning. 107 00:03:49,751 --> 00:03:51,335 He's definitely improving. 108 00:03:51,419 --> 00:03:52,712 The DKA is resolving. 109 00:03:52,795 --> 00:03:54,338 So what made him pass out? 110 00:03:54,422 --> 00:03:56,174 It's hot as hell out there. 111 00:03:56,257 --> 00:03:58,342 He could have been dehydrated from sweating. 112 00:03:58,426 --> 00:04:01,804 Or he could have had an N-STEMI or a posterior CVA. 113 00:04:01,888 --> 00:04:03,347 Ready to roll. 114 00:04:05,099 --> 00:04:07,727 - I can babysit him at CT. - Thank you. 115 00:04:07,810 --> 00:04:10,021 I'll stay in case he needs the OR. 116 00:04:11,856 --> 00:04:13,733 Hey, we're back up. 117 00:04:13,816 --> 00:04:15,735 It's about time. 118 00:04:15,818 --> 00:04:17,194 - Ooh, Robby. - Yeah. 119 00:04:17,278 --> 00:04:19,405 I got intel on where ICE has taken Jesse. 120 00:04:19,489 --> 00:04:20,656 Intel from who? 121 00:04:20,740 --> 00:04:22,533 Uh, my brother-in-law's a cop. 122 00:04:22,617 --> 00:04:24,869 So he'll be processed at DHS Southside 123 00:04:24,952 --> 00:04:27,371 and then transferred to ICE detention in Clearfield. 124 00:04:27,455 --> 00:04:28,664 Clearfield? That's two hours away. 125 00:04:28,748 --> 00:04:30,166 Mm-hmm. 126 00:04:30,249 --> 00:04:32,293 OK, I'll let the hospital attorneys know. 127 00:04:32,376 --> 00:04:34,212 - How are you doing, Oliver? - Alive and kicking. 128 00:04:34,295 --> 00:04:35,588 Uh, Mr. Haas. 129 00:04:35,671 --> 00:04:37,882 Pulmonary edema after missed dialysis, 130 00:04:37,965 --> 00:04:40,468 now stable with his son Mason at the bedside. 131 00:04:40,551 --> 00:04:42,094 - Hello. - I'm Dr. Shen. 132 00:04:42,178 --> 00:04:43,304 I'll be back. 133 00:04:43,387 --> 00:04:44,347 Dialysis tech says 134 00:04:44,430 --> 00:04:46,140 I'm off the machine at 10:42. 135 00:04:46,224 --> 00:04:48,267 Hit the call light, and I'll come running. 136 00:04:48,351 --> 00:04:50,436 South 21 next... 137 00:04:52,396 --> 00:04:54,148 Mr. Digby. 138 00:04:54,232 --> 00:04:55,733 J-just Digby. 139 00:04:55,817 --> 00:04:57,401 Dr. Mohan's patient. 140 00:04:57,485 --> 00:04:59,612 Forearm cellulitis, admit med-surge. 141 00:04:59,695 --> 00:05:01,197 - Awaiting a bed. - I can take him. 142 00:05:01,280 --> 00:05:03,032 Sold to Dr. Toomarian. 143 00:05:03,115 --> 00:05:05,451 Moving right along. 144 00:05:05,535 --> 00:05:07,245 Get enough to eat? 145 00:05:07,328 --> 00:05:09,580 We'll be back. 146 00:05:09,664 --> 00:05:13,000 Lillian Stegman. Tweaked her knee water-skiing. 147 00:05:13,084 --> 00:05:15,044 Doing a 360 off a 5-foot ramp. 148 00:05:15,127 --> 00:05:16,504 Ooh, respect. 149 00:05:16,587 --> 00:05:17,839 X-rays ordered in triage. 150 00:05:17,922 --> 00:05:19,131 That was hours ago. 151 00:05:19,215 --> 00:05:21,342 Ma'am, I'm Dr. Crus Henderson. 152 00:05:21,425 --> 00:05:23,594 Let's get you home real fast. 153 00:05:23,678 --> 00:05:25,346 - That would be wonderful. - OK, heading to North. 154 00:05:25,429 --> 00:05:27,056 Thank you. 155 00:05:27,139 --> 00:05:29,600 Looks like our first scanning station is almost ready. 156 00:05:29,684 --> 00:05:32,353 Whitaker, Santos, after rounds, this will be your post. 157 00:05:32,436 --> 00:05:35,022 - Seriously? - For...how long? 158 00:05:35,106 --> 00:05:37,149 Till we mop up this mess. 159 00:05:37,233 --> 00:05:38,818 And away we go. 160 00:05:38,901 --> 00:05:40,987 All right, now you know everything 161 00:05:41,070 --> 00:05:42,196 there is to know about rounds. 162 00:05:42,280 --> 00:05:43,364 Fascinating, right? 163 00:05:43,447 --> 00:05:45,533 Uh...yeah. 164 00:05:45,616 --> 00:05:47,827 Here, I got something better for you. 165 00:05:49,620 --> 00:05:52,415 So, Digby, we're gonna find you some new clothes, 166 00:05:52,498 --> 00:05:54,208 but my friend Emma and I wondered if you'd like 167 00:05:54,292 --> 00:05:56,836 to get cleaned up a bit first. 168 00:05:56,919 --> 00:05:58,588 I already had a shower. 169 00:05:58,671 --> 00:06:00,214 I know, and you look good. 170 00:06:00,298 --> 00:06:02,300 But the offer also comes with a shave and a haircut, 171 00:06:02,383 --> 00:06:03,551 if you're interested. 172 00:06:03,634 --> 00:06:04,760 No pressure--like I said, 173 00:06:04,844 --> 00:06:06,012 you already look great. 174 00:06:07,430 --> 00:06:10,349 - Sure, I guess. - Fantastic. 175 00:06:10,433 --> 00:06:12,351 All right, kid, fill that basin with some warm water 176 00:06:12,435 --> 00:06:14,061 and lather him up. 177 00:06:16,981 --> 00:06:19,400 - Hey, stay safe out there. - Back at you in here. 178 00:06:19,483 --> 00:06:21,402 Hey, Cary. 179 00:06:21,485 --> 00:06:23,529 You were on scene with Orlando, right? 180 00:06:23,613 --> 00:06:25,948 Did you notice anything about his fall? 181 00:06:26,032 --> 00:06:27,450 Like what? 182 00:06:27,533 --> 00:06:30,620 Like, um, if there was a break in the railing 183 00:06:30,703 --> 00:06:33,623 or if there were security cameras? 184 00:06:33,706 --> 00:06:35,207 Too busy working on the guy-- 185 00:06:35,291 --> 00:06:37,668 IV, intubation, backboard, splint. 186 00:06:37,752 --> 00:06:38,836 Thanks. 187 00:06:38,920 --> 00:06:40,463 Oh, two names is a start. 188 00:06:40,546 --> 00:06:42,214 Pretty soon, we'll retire the clipboards. 189 00:06:42,298 --> 00:06:43,549 Baby Jane Doe in Pedes? 190 00:06:43,633 --> 00:06:45,426 Uh, yeah, abandoned 191 00:06:45,509 --> 00:06:48,179 in the waiting room bathroom at 7:30 a.m. 192 00:06:48,262 --> 00:06:50,640 - Safe haven drop-off? - No, she's too old for that. 193 00:06:50,723 --> 00:06:52,475 - At least two months. - I'll take her. 194 00:06:52,558 --> 00:06:54,644 Awaiting foster placement by CYF. 195 00:06:54,727 --> 00:06:56,978 - What if the mom comes back? - Call the cops. 196 00:06:57,063 --> 00:06:58,439 Day shift, get to work scanning. 197 00:06:58,522 --> 00:06:59,982 Night shift, the room numbers 198 00:07:00,066 --> 00:07:02,151 on top of the dry-erase board need a doctor. 199 00:07:02,234 --> 00:07:05,071 - Who's in BH-1? - Psych hold, danger to self. 200 00:07:05,154 --> 00:07:06,530 What's the story? 201 00:07:06,614 --> 00:07:08,407 Doctors King and Langdon were on the case. 202 00:07:08,491 --> 00:07:10,660 It's a sad story-- she says her 5-year-old 203 00:07:10,743 --> 00:07:12,536 snuck into the back seat of the car to take a nap. 204 00:07:12,620 --> 00:07:14,205 Heat stroke. 205 00:07:14,288 --> 00:07:16,582 Mom was extremely distraught. Walked out into traffic. 206 00:07:16,666 --> 00:07:18,125 Grady Barnhill, wheezing 207 00:07:18,209 --> 00:07:19,752 and not responding to albuterol. 208 00:07:19,835 --> 00:07:21,629 Pulse ox 87. His mother, Naomi. 209 00:07:21,712 --> 00:07:23,839 - OK, Trauma Two's open. - On our way. 210 00:07:23,923 --> 00:07:26,342 - Uh, Mom, history of asthma? - His whole life. 211 00:07:26,425 --> 00:07:28,469 - Never this bad. - Barely moving air. 212 00:07:28,552 --> 00:07:31,097 Using all his accessory muscles. 213 00:07:31,180 --> 00:07:32,555 Call RT! 214 00:07:32,640 --> 00:07:35,309 Uh, continuous nebs, 20 milligrams an hour. 215 00:07:35,393 --> 00:07:36,811 We have a home nebulizer. 216 00:07:36,894 --> 00:07:39,689 I've been giving him albuterol every hour. 217 00:07:39,772 --> 00:07:40,815 Ready? 218 00:07:40,898 --> 00:07:43,734 On my count, one, two, three. 219 00:07:43,818 --> 00:07:45,194 Does he take any other medications? 220 00:07:45,277 --> 00:07:46,696 Just the albuterol. 221 00:07:46,779 --> 00:07:48,239 He used to be on montelukast and Symbicort. 222 00:07:48,322 --> 00:07:49,824 Why did you stop that? 223 00:07:49,907 --> 00:07:51,867 Because he lost his Medicaid two months ago. 224 00:07:51,951 --> 00:07:53,703 He's so tight, nothing's getting through. 225 00:07:53,786 --> 00:07:55,287 - Mel, EpiPen. - On it. 226 00:07:55,371 --> 00:07:56,789 0.3 milligrams. 227 00:07:56,872 --> 00:07:59,917 That may open his lungs so the nebs can work. 228 00:08:00,001 --> 00:08:02,003 All right, Grady, shot in the thigh. 229 00:08:07,049 --> 00:08:08,801 Hey. 230 00:08:08,884 --> 00:08:10,261 Something to scan? 231 00:08:10,344 --> 00:08:11,804 Critical labs on North Three. 232 00:08:11,887 --> 00:08:13,389 Oh, it's, uh-- it's not my patient. 233 00:08:13,472 --> 00:08:14,724 She's about to be. 234 00:08:16,642 --> 00:08:18,894 I'm, uh-- I'm off the clock, so... 235 00:08:18,978 --> 00:08:21,564 These were ordered three hours ago from triage, 236 00:08:21,647 --> 00:08:24,025 so, technically, she is a day-shift patient. 237 00:08:24,108 --> 00:08:25,317 Just get the intern started. 238 00:08:25,401 --> 00:08:26,861 I got a meeting upstairs with admin 239 00:08:26,944 --> 00:08:28,863 to get things back on track. 240 00:08:28,946 --> 00:08:30,614 Sorry. Everyone else is tied up. 241 00:08:30,698 --> 00:08:31,991 That's OK. 242 00:08:32,074 --> 00:08:33,200 How'd you get stuck on night shift 243 00:08:33,284 --> 00:08:34,368 for your first rotation? 244 00:08:34,452 --> 00:08:35,828 Just lucky, I guess. 245 00:08:35,911 --> 00:08:37,371 Yeah, if you like a good horror movie. 246 00:08:38,789 --> 00:08:40,666 - Where was med school? - Uh, UC Irvine. 247 00:08:40,750 --> 00:08:42,459 - California, right? - Yep. 248 00:08:42,543 --> 00:08:43,711 Pittsburgh's a little different. 249 00:08:43,794 --> 00:08:44,920 Yeah, a lot more humidity. 250 00:08:45,004 --> 00:08:46,005 Yeah, that'll go away 251 00:08:46,088 --> 00:08:47,923 with your first foot of snow. 252 00:08:48,007 --> 00:08:50,718 Uh, hi, Mrs. Davis. 253 00:08:50,801 --> 00:08:52,762 I am Dr. McKay. This is Doctor... 254 00:08:52,845 --> 00:08:55,014 - Toomarian. - Hello. 255 00:08:55,097 --> 00:08:58,142 Uh, your labs show a lot of inflammation in your liver. 256 00:08:58,225 --> 00:09:01,520 - Is that why I'm so nauseated? - Definitely, yeah. 257 00:09:01,604 --> 00:09:04,607 Have you, um, noticed a change in your skin coloration? 258 00:09:04,690 --> 00:09:06,650 I've been using this bronzing cream 259 00:09:06,734 --> 00:09:09,320 so I don't look like a ghost in my bathing suit. 260 00:09:09,403 --> 00:09:11,280 Do you remember the name of the bronzer? 261 00:09:11,363 --> 00:09:12,823 It could have a chemical that can cause-- 262 00:09:12,907 --> 00:09:14,867 Oh, no, no, it's 100% natural. 263 00:09:14,950 --> 00:09:18,120 - It's DHA from sugar beets. - OK. 264 00:09:18,204 --> 00:09:20,289 Why would my liver be inflamed? 265 00:09:20,372 --> 00:09:22,249 Uh, there's a lot of possibilities. 266 00:09:22,333 --> 00:09:24,085 Are you taking any prescription medications? 267 00:09:24,168 --> 00:09:25,086 Not a single one. 268 00:09:25,169 --> 00:09:26,670 - Tylenol? - God, no. 269 00:09:26,754 --> 00:09:28,881 We have to ask everybody about injection drug use. 270 00:09:28,964 --> 00:09:30,007 Never. 271 00:09:30,091 --> 00:09:31,675 Raw clams or oysters? 272 00:09:31,759 --> 00:09:33,511 I'm a vegan. 273 00:09:33,594 --> 00:09:35,721 One step at a time, OK? 274 00:09:35,805 --> 00:09:36,889 We'll be back. 275 00:09:38,307 --> 00:09:40,142 Digby, Haas, now on the big board. 276 00:09:40,226 --> 00:09:41,143 Progress. 277 00:09:41,227 --> 00:09:42,144 So he's just been waiting 278 00:09:42,228 --> 00:09:43,813 in the hall the whole time? 279 00:09:43,896 --> 00:09:46,774 OK, well, can you maybe get to him next? 280 00:09:48,067 --> 00:09:49,110 Thank you. 281 00:09:50,236 --> 00:09:51,821 Duke goes to CT, and they bump him. 282 00:09:51,904 --> 00:09:54,323 Yeah, he may end up waiting for hours over there. 283 00:09:54,406 --> 00:09:56,826 Oh, look at that. 7:15 already. 284 00:09:56,909 --> 00:09:58,786 Just a few more loose ends to tie up. 285 00:09:58,869 --> 00:10:01,997 You got more loose ends than a macramé wall hanging. 286 00:10:02,081 --> 00:10:04,291 My mom had one. Took up the whole goddamn wall. 287 00:10:04,375 --> 00:10:06,001 Seriously, you should think about signing out 288 00:10:06,085 --> 00:10:07,795 - and hitting the road. - Yeah, maybe you should too. 289 00:10:07,878 --> 00:10:09,547 Oh, that's right, you sent Lena home. 290 00:10:09,630 --> 00:10:11,423 Are you planning on calling in a replacement, 291 00:10:11,507 --> 00:10:13,217 or are you just gonna work till sunrise? 292 00:10:13,300 --> 00:10:14,635 If I have to. 293 00:10:14,718 --> 00:10:16,720 Oh, so you get to go the extra mile, 294 00:10:16,804 --> 00:10:19,223 and the rest of us just get accused of being martyrs. 295 00:10:19,306 --> 00:10:20,599 - Robby. - Excuse me. 296 00:10:22,643 --> 00:10:24,520 - What's the word? - No subdural, no epidural. 297 00:10:24,603 --> 00:10:26,522 Diffuse brain swelling with effacement 298 00:10:26,605 --> 00:10:28,232 and compression of the ventricles. 299 00:10:28,315 --> 00:10:30,442 C-spine? Chest-abdomen-pelvis? 300 00:10:30,526 --> 00:10:32,736 Uh, left pulmonary contusion, no intra-abdominal hemorrhage. 301 00:10:32,820 --> 00:10:33,904 Which means I'm off the hook. 302 00:10:33,988 --> 00:10:35,364 I'll send Neurosurgery down. 303 00:10:35,447 --> 00:10:37,908 If he doesn't need the OR, why Neurosurgery? 304 00:10:37,992 --> 00:10:39,326 - Wait and see. - Let's get busy. 305 00:10:39,410 --> 00:10:40,578 CVP and an art line. 306 00:10:40,661 --> 00:10:43,747 Orlando. Orlando, squeeze my hand. 307 00:10:44,915 --> 00:10:46,125 Open your eyes. 308 00:10:46,208 --> 00:10:48,669 We already know his GCS is going to be three. 309 00:10:48,752 --> 00:10:50,671 Hey, Javadi, anti-seizure prophylaxis? 310 00:10:50,754 --> 00:10:52,673 - Keppra, 20 migs per kilo. - Mixing it now. 311 00:10:52,756 --> 00:10:54,341 Gotta get this brain swelling down, Samira. 312 00:10:54,425 --> 00:10:55,509 How we gonna do that? 313 00:10:56,802 --> 00:10:58,304 - Samira? - What? 314 00:10:58,387 --> 00:11:01,515 We have to lower the intracranial pressure. 315 00:11:01,599 --> 00:11:03,225 - Mannitol. - Not the best. 316 00:11:03,309 --> 00:11:04,560 Can cause diuresis and hypotension. 317 00:11:04,643 --> 00:11:05,936 Then hypertonic saline. 318 00:11:06,020 --> 00:11:08,439 23%. 50 cc's through a central line. 319 00:11:10,357 --> 00:11:11,859 Still tight as a drum. 320 00:11:11,942 --> 00:11:12,985 Five minutes since the epi. 321 00:11:13,068 --> 00:11:14,361 He can have one more EpiPen. 322 00:11:14,445 --> 00:11:16,113 Sats are borderline, 87. 323 00:11:16,197 --> 00:11:17,531 How about BiPap? 10 over 5. 324 00:11:17,615 --> 00:11:19,700 Yes, with in-line nebs. 325 00:11:19,783 --> 00:11:21,535 All right, Grady, shot number two. 326 00:11:21,619 --> 00:11:23,746 Might as well throw in some magnesium, 50 per kilo. 327 00:11:23,829 --> 00:11:25,080 I'm sorry. He's not ventilating. 328 00:11:25,164 --> 00:11:26,457 We should be ready to intubate. 329 00:11:26,540 --> 00:11:27,833 With an asthma patient? 330 00:11:27,917 --> 00:11:29,752 There's a high risk of cardiac arrest. 331 00:11:29,835 --> 00:11:32,004 Naomi, has he ever been put on a breathing machine before? 332 00:11:32,087 --> 00:11:33,672 - Never. - Hospitalized? 333 00:11:33,756 --> 00:11:35,591 No, we could always break him with the Symbicort. 334 00:11:35,674 --> 00:11:37,051 We're gonna give the current treatment 335 00:11:37,134 --> 00:11:39,178 a few more minutes to help him turn the corner. 336 00:11:42,348 --> 00:11:44,183 I could probably do this myself 337 00:11:44,266 --> 00:11:45,601 now that my cast is off. 338 00:11:45,684 --> 00:11:47,519 Oh, that's OK. 339 00:11:47,603 --> 00:11:49,230 I don't mind. 340 00:11:53,150 --> 00:11:55,027 How long have you been a nurse? 341 00:11:56,445 --> 00:11:58,113 This is my first day. 342 00:12:00,824 --> 00:12:02,826 You're doing really good. 343 00:12:04,787 --> 00:12:06,330 Thank you. 344 00:12:10,334 --> 00:12:12,044 - Oh, shit, you OK? - Yeah. 345 00:12:12,127 --> 00:12:13,545 There's water on the floor. 346 00:12:13,629 --> 00:12:15,047 Sorry! I--I might have spilled. 347 00:12:15,130 --> 00:12:16,465 Yeah, no worries. 348 00:12:16,548 --> 00:12:18,509 We're gonna have to sort these all by patient 349 00:12:18,592 --> 00:12:20,302 before we scan them. 350 00:12:20,386 --> 00:12:22,972 Is, uh, Joy still around? 351 00:12:23,055 --> 00:12:25,641 I heard she left at 6:59. 352 00:12:25,724 --> 00:12:27,643 - Smart girl. - Mm-hmm. 353 00:12:27,726 --> 00:12:29,812 You know what? Find Ogilvie. He's such an ass-kisser. 354 00:12:29,895 --> 00:12:31,480 He might stay and scan all the charts himself. 355 00:12:31,563 --> 00:12:33,649 Oh, he, uh, scrubbed in in the OR, 356 00:12:33,732 --> 00:12:35,567 scrubbed in on the ruptured triple-A. 357 00:12:35,651 --> 00:12:37,278 Oh, the kidney stone that wasn't. 358 00:12:37,361 --> 00:12:39,154 That'll be four hours at least. 359 00:12:41,115 --> 00:12:44,451 So are you still going to Amy's after work? 360 00:12:44,535 --> 00:12:46,370 Yeah, maybe just for tonight, 361 00:12:46,453 --> 00:12:48,747 after Robby briefs me on all the house stuff. 362 00:12:49,873 --> 00:12:51,292 Sounds fun. 363 00:12:52,710 --> 00:12:54,628 When he asked, it was hard to say no. 364 00:12:54,712 --> 00:12:56,046 Sure. 365 00:12:58,299 --> 00:13:00,467 It's gonna be very weird without him here. 366 00:13:00,551 --> 00:13:01,885 Yeah. 367 00:13:01,969 --> 00:13:04,430 You think Dr. Al-Hashimi can handle it? 368 00:13:04,513 --> 00:13:05,973 In a word, no. 369 00:13:06,056 --> 00:13:07,391 She's smart. 370 00:13:07,474 --> 00:13:08,684 It takes more than that. 371 00:13:08,767 --> 00:13:10,311 Yeah, well, at least 372 00:13:10,394 --> 00:13:11,687 it's only three months. 373 00:13:11,770 --> 00:13:13,814 Yeah, three long months. 374 00:13:13,897 --> 00:13:15,524 Then you need to find a new home. 375 00:13:16,483 --> 00:13:17,860 Not necessarily. 376 00:13:17,943 --> 00:13:19,945 I mean, if I wanted, I could just check on 377 00:13:20,029 --> 00:13:23,032 Robby's house once or twice a day, you know. 378 00:13:23,115 --> 00:13:24,783 Why would you do that? 379 00:13:26,160 --> 00:13:28,287 I don't know. Why not? 380 00:13:31,373 --> 00:13:32,750 Hypertonic's in. 381 00:13:32,833 --> 00:13:34,877 Maintenance LR in the AC. 382 00:13:34,960 --> 00:13:36,670 Looks like a halo sign. 383 00:13:36,754 --> 00:13:39,256 Cerebrospinal fluid from a basilar skull fracture. 384 00:13:39,340 --> 00:13:43,260 The halo sign is neither sensitive nor specific for CSF. 385 00:13:43,344 --> 00:13:45,554 Saline, tap water, and runny noses 386 00:13:45,637 --> 00:13:46,764 all separate from blood. 387 00:13:46,847 --> 00:13:48,265 - Hello, Linda. - Robby. 388 00:13:48,349 --> 00:13:50,726 Division chief working on a holiday weekend. 389 00:13:50,809 --> 00:13:52,853 Well, somebody's got to. 390 00:13:52,936 --> 00:13:55,647 Saw the scans. This guy needs an EVD. 391 00:13:55,731 --> 00:13:57,941 External ventricular drain to take down the pressure. 392 00:13:58,025 --> 00:14:01,195 Because CPP equals "MAP" minus ICP. 393 00:14:01,278 --> 00:14:03,864 Cerebral perfusion pressure in the brain 394 00:14:03,947 --> 00:14:05,783 equals mean arterial blood pressure 395 00:14:05,866 --> 00:14:07,284 minus the pressure in the skull. 396 00:14:07,368 --> 00:14:08,994 ICP less than 22 397 00:14:09,078 --> 00:14:11,538 predicts survival and favorable outcome. 398 00:14:11,622 --> 00:14:15,918 CPP from 60 to 70 reduces morbidity and mortality. 399 00:14:16,001 --> 00:14:17,336 Can somebody assist? 400 00:14:17,419 --> 00:14:18,504 Dr. Mohan? 401 00:14:18,587 --> 00:14:19,671 I'm good. 402 00:14:20,798 --> 00:14:22,299 Samira, you should lend a hand. 403 00:14:22,383 --> 00:14:24,051 I said I'm good. 404 00:14:24,134 --> 00:14:26,929 - Javadi? - I don't think so. 405 00:14:27,012 --> 00:14:28,472 Javadi? 406 00:14:28,555 --> 00:14:31,892 As in, daughter of Raymond and Eileen? 407 00:14:31,975 --> 00:14:34,353 I was at your mother's baby shower. 408 00:14:34,436 --> 00:14:35,311 She was a resident. 409 00:14:35,396 --> 00:14:36,772 You were in utero. 410 00:14:38,273 --> 00:14:39,316 I don't know how she got through 411 00:14:39,400 --> 00:14:41,110 motherhood and training. 412 00:14:41,193 --> 00:14:42,694 Feel free to join me. 413 00:14:42,778 --> 00:14:44,571 Oh, my--my shift was over a while ago. 414 00:14:44,655 --> 00:14:46,031 OK. 415 00:14:46,115 --> 00:14:48,075 Masks all around. Two sterile gowns. 416 00:14:48,158 --> 00:14:50,702 We brought the surgical towels. Just need some Betadine. 417 00:14:50,786 --> 00:14:52,371 This is kind of an amazing opportunity. 418 00:14:53,539 --> 00:14:54,748 I'm exhausted. 419 00:14:54,832 --> 00:14:56,708 The Chief of Neurosurgery is here. 420 00:14:56,792 --> 00:14:58,168 She's kind of a legend. 421 00:14:58,252 --> 00:15:00,212 Maybe one of the night residents can do it. 422 00:15:00,295 --> 00:15:02,464 Is this about the volvulus case from earlier? 423 00:15:02,548 --> 00:15:04,049 'Cause if it is, you made a mistake. 424 00:15:04,133 --> 00:15:05,968 You need to move on. 425 00:15:06,051 --> 00:15:07,636 I do not want to come back here and find that 426 00:15:07,719 --> 00:15:10,848 you've applied for a residency in derm. 427 00:15:10,931 --> 00:15:13,517 Step up to the plate. Do it. 428 00:15:13,600 --> 00:15:14,726 Javadi will assist. 429 00:15:14,810 --> 00:15:16,395 Excellent. 430 00:15:16,478 --> 00:15:18,147 You know, I think Eileen did her first EVD with me 431 00:15:18,230 --> 00:15:20,691 back when I was a brand-new assistant professor. 432 00:15:22,109 --> 00:15:23,527 Time flies. 433 00:15:26,488 --> 00:15:27,531 How you doing, Grady? 434 00:15:27,614 --> 00:15:28,991 Still retracting. 435 00:15:29,074 --> 00:15:30,701 - Any improvement? - Not really. 436 00:15:30,784 --> 00:15:31,827 You feeling tired? 437 00:15:33,704 --> 00:15:36,206 - Do we have Aerogen in the ED? - Just in the unit. 438 00:15:36,290 --> 00:15:37,833 How fast can you get back? 439 00:15:37,916 --> 00:15:39,001 Two minutes if I take the stairs. 440 00:15:39,084 --> 00:15:40,043 Go. 441 00:15:40,127 --> 00:15:41,378 Uh, Aerogen? 442 00:15:41,462 --> 00:15:43,338 It has a 5-millimeter mesh 443 00:15:43,422 --> 00:15:46,592 that vibrates over 120,000 times per second. 444 00:15:51,763 --> 00:15:53,098 Dr. Al-Hashimi? 445 00:15:57,436 --> 00:15:58,854 You OK? 446 00:16:01,315 --> 00:16:03,317 Uh, you were telling us about Aerogen. 447 00:16:04,485 --> 00:16:05,819 Dr. Shen can explain. 448 00:16:07,237 --> 00:16:10,115 It produces droplets in the 2- to 5-micron range 449 00:16:10,199 --> 00:16:12,117 for medication delivery. 450 00:16:19,416 --> 00:16:21,877 - How's it going? - Just about to start. 451 00:16:21,960 --> 00:16:23,086 Securing the art line here. 452 00:16:23,170 --> 00:16:25,339 Measure twice, cut once. 453 00:16:25,422 --> 00:16:29,134 We enter 11 centimeters back from the nasion, 454 00:16:29,218 --> 00:16:30,761 3 centimeters lateral. 455 00:16:30,844 --> 00:16:32,346 Without any direct imaging? 456 00:16:32,429 --> 00:16:35,390 No, straight shot into the lateral ventricle-- 457 00:16:35,474 --> 00:16:38,977 tried and true since 1890. 458 00:16:39,061 --> 00:16:41,355 OK, go ahead with the incision. 459 00:16:42,898 --> 00:16:45,025 Hey, you worked with Dr. Al-Hashimi at the VA. 460 00:16:45,108 --> 00:16:46,151 I did. 461 00:16:46,235 --> 00:16:47,653 For how long? 462 00:16:47,736 --> 00:16:49,613 During my R2 rotation 463 00:16:49,696 --> 00:16:51,823 and then one again last year. 464 00:16:55,244 --> 00:16:58,330 OK. Hand drill's all set. 465 00:16:58,413 --> 00:16:59,748 Maybe you should do this part. 466 00:16:59,831 --> 00:17:01,124 No, no, there's a safety stop here. 467 00:17:01,208 --> 00:17:02,626 You can't go too deep. 468 00:17:02,709 --> 00:17:04,669 It's not brain surgery. 469 00:17:06,922 --> 00:17:08,130 OK. 470 00:17:11,342 --> 00:17:13,095 - Stay perpendicular. - OK. 471 00:17:13,177 --> 00:17:15,055 Good. 472 00:17:15,138 --> 00:17:16,807 All right, now, four turns 473 00:17:16,889 --> 00:17:18,015 to get through the outer table... 474 00:17:18,100 --> 00:17:19,309 - Yep. - Then half turns 475 00:17:19,393 --> 00:17:20,978 till you penetrate the skull. 476 00:17:31,822 --> 00:17:35,409 Three, four. 477 00:17:35,492 --> 00:17:36,743 One... 478 00:17:38,745 --> 00:17:40,330 Holy smoke! 479 00:17:40,414 --> 00:17:43,750 I thought it was Tom Cruise for a second over here. 480 00:17:43,834 --> 00:17:46,795 Nice job. How's that feel, Digby? 481 00:17:46,878 --> 00:17:48,380 - Pretty good. - I bet. 482 00:17:48,463 --> 00:17:49,673 What do you say we trim up 483 00:17:49,756 --> 00:17:51,466 those gorgeous locks of yours now? 484 00:17:53,176 --> 00:17:55,137 I don't like having my hair cut. 485 00:17:55,220 --> 00:17:58,473 I get it, Rapunzel, but you need your ears lowered. 486 00:17:58,557 --> 00:18:00,601 You'll feel better with a fresh summer look 487 00:18:00,684 --> 00:18:02,686 that won't go unnoticed by the ladies. 488 00:18:04,605 --> 00:18:06,898 - Maybe just a trim? - Great. 489 00:18:06,982 --> 00:18:09,109 I'm thinking a pixie cut. 490 00:18:09,192 --> 00:18:10,902 - What? - I'm kidding. 491 00:18:10,986 --> 00:18:12,696 I cut my husband Benji's hair all the time. 492 00:18:12,779 --> 00:18:14,197 Trust me, you're gonna look fabulous. 493 00:18:14,281 --> 00:18:15,866 When's the last time you had a haircut? 494 00:18:17,492 --> 00:18:20,704 Maybe my daughter's wedding a few years ago. 495 00:18:20,787 --> 00:18:22,039 Where? 496 00:18:22,122 --> 00:18:23,248 St. Sebastian, 497 00:18:23,332 --> 00:18:25,250 Our Lady of Mount Carmel Parish. 498 00:18:25,334 --> 00:18:27,878 Does your daughter know where you are? 499 00:18:27,961 --> 00:18:31,048 Of course. We all live in Pittsburgh. 500 00:18:31,131 --> 00:18:33,342 In fact, they live in my old house. 501 00:18:35,969 --> 00:18:38,221 Your daughter lives in your house? 502 00:18:38,305 --> 00:18:40,098 Yep. 503 00:18:40,182 --> 00:18:42,643 Where do you live? 504 00:18:42,726 --> 00:18:44,895 Wherever I want. 505 00:18:46,688 --> 00:18:48,732 You're gonna pass it 5 to 6 centimeters 506 00:18:48,815 --> 00:18:51,318 from the inner table of the skull, OK? 507 00:18:53,278 --> 00:18:55,364 Centered... 508 00:18:55,447 --> 00:18:57,199 perpendicular... 509 00:18:57,282 --> 00:18:59,076 aiming for the medial canthus. 510 00:19:00,243 --> 00:19:01,828 All yours. 511 00:19:01,912 --> 00:19:03,163 A-and just keep going? 512 00:19:03,246 --> 00:19:04,623 You'll feel a pop when you pass 513 00:19:04,706 --> 00:19:07,209 the ependymal lining. 514 00:19:07,292 --> 00:19:09,002 Art line is calibrated. Good to go. 515 00:19:09,086 --> 00:19:12,923 Titrate the nicardipine to a MAP of 85, please. 516 00:19:13,006 --> 00:19:14,341 And if we can get the intracranial pressure 517 00:19:14,424 --> 00:19:16,176 down to 20? 518 00:19:17,636 --> 00:19:19,012 Dr. Mohan? 519 00:19:19,096 --> 00:19:20,472 I'm sorry. 520 00:19:20,555 --> 00:19:22,766 MAP of 85, ICP of 20? 521 00:19:22,849 --> 00:19:25,769 Um, cerebral perfusion pressure 65. 522 00:19:25,852 --> 00:19:28,522 Which gives him the best shot at survival. 523 00:19:28,605 --> 00:19:30,023 A third of patients like this die. 524 00:19:30,107 --> 00:19:32,609 Half have long-term disability. 525 00:19:32,693 --> 00:19:34,569 We'll know in two weeks if there's a possibility 526 00:19:34,653 --> 00:19:36,905 for a good prognosis. 527 00:19:36,988 --> 00:19:38,115 Felt a pop. 528 00:19:38,198 --> 00:19:39,783 Remove the stylet. 529 00:19:42,327 --> 00:19:45,080 OK, let it drain a bit. 530 00:19:47,040 --> 00:19:49,251 And now pinch it shut. 531 00:19:50,752 --> 00:19:51,670 Perfect. 532 00:19:51,753 --> 00:19:53,547 BP is down, 190 over 88. 533 00:19:53,630 --> 00:19:54,965 Heart rate's 67. 534 00:19:59,094 --> 00:20:00,971 How are you guys doing? 535 00:20:01,054 --> 00:20:02,889 Yeah, making some progress. 536 00:20:02,973 --> 00:20:04,224 You seen Abbot? 537 00:20:04,307 --> 00:20:06,017 Not since rounds. 538 00:20:06,101 --> 00:20:08,729 He asked me to see a patient with the night intern. 539 00:20:08,812 --> 00:20:10,355 And you said yes? 540 00:20:10,439 --> 00:20:13,233 48-year-old woman, new onset jaundice, 541 00:20:13,316 --> 00:20:16,319 elevated liver enzymes, no history of alcohol use. 542 00:20:16,403 --> 00:20:17,654 Take your pick-- 543 00:20:17,738 --> 00:20:20,365 hepatitis A, B, C, D, or E. 544 00:20:20,449 --> 00:20:23,243 - No risk factors, no fever. - Tylenol? 545 00:20:23,326 --> 00:20:25,120 Never, and no prescription meds. 546 00:20:25,203 --> 00:20:27,414 Does she eat polar bear liver? 547 00:20:28,623 --> 00:20:30,834 It can cause vitamin A toxicity. 548 00:20:31,793 --> 00:20:32,794 - No. - Yeah. 549 00:20:32,878 --> 00:20:34,045 She, uh, doesn't eat meat, 550 00:20:34,129 --> 00:20:35,672 kind of a health nut. 551 00:20:35,756 --> 00:20:37,090 Well, maybe she's gulping down 552 00:20:37,174 --> 00:20:38,717 cod liver oil to prevent measles. 553 00:20:38,800 --> 00:20:40,927 No. Vegan, no fish. 554 00:20:41,011 --> 00:20:43,054 Would you, uh, mind laying eyes on her? 555 00:20:43,847 --> 00:20:44,765 Seriously? 556 00:20:44,848 --> 00:20:46,933 You have a way of figuring out the weird stuff. 557 00:20:47,017 --> 00:20:48,477 Take the compliment. 558 00:20:49,895 --> 00:20:51,229 OK, fine. 559 00:20:51,313 --> 00:20:53,523 Five minutes at the bedside-- that's it. 560 00:20:53,607 --> 00:20:55,484 I'm already gonna be here for hours as it is. 561 00:20:55,567 --> 00:20:57,736 Thank you. 562 00:20:57,819 --> 00:20:59,362 What am I doing-- 563 00:21:02,574 --> 00:21:04,868 - Definitely improving. - Tidal volume's up. 564 00:21:04,951 --> 00:21:07,370 Wheezes now expiratory only. 565 00:21:07,454 --> 00:21:08,955 Oh, making some progress. 566 00:21:09,039 --> 00:21:11,082 You feeling better, baby? 567 00:21:11,166 --> 00:21:14,336 - You scared the shit out of me. - Language! 568 00:21:14,419 --> 00:21:16,713 Does he have a primary-care doctor? 569 00:21:16,797 --> 00:21:18,089 Not anymore. 570 00:21:18,173 --> 00:21:20,675 How do you get his prescriptions renewed? 571 00:21:20,759 --> 00:21:22,886 Neighborhood clinic. We pay cash. 572 00:21:22,969 --> 00:21:24,679 - Albuterol's cheap. - Symbicort? 573 00:21:24,763 --> 00:21:27,641 Without Medicaid, 400 bucks a month. 574 00:21:27,724 --> 00:21:29,142 Just for a little inhaler? 575 00:21:31,311 --> 00:21:32,813 Trocar is on the tube. 576 00:21:33,897 --> 00:21:37,108 I tunnel underneath the scalp about 5 centimeters 577 00:21:37,192 --> 00:21:38,610 and poke through. 578 00:21:38,693 --> 00:21:40,362 - To prevent infection? - Mm-hmm, exactly. 579 00:21:41,947 --> 00:21:44,491 Now you hold the knuckle steady while I pull it through. 580 00:21:47,869 --> 00:21:49,996 And you can staple the wound shut. 581 00:21:51,498 --> 00:21:53,542 That looks like something from Home Depot. 582 00:21:53,625 --> 00:21:55,377 Yeah, big Fourth of July sale. 583 00:21:55,460 --> 00:21:56,711 The brain pressure is measured by 584 00:21:56,795 --> 00:21:58,588 the height of the fluid column. 585 00:21:58,672 --> 00:22:01,132 We need to calibrate it to zero at the level of the tragus. 586 00:22:01,216 --> 00:22:03,176 Stopcock's on, ready to attach. 587 00:22:03,260 --> 00:22:04,553 First troponin's normal, 588 00:22:04,636 --> 00:22:07,013 but you need a second to rule out MI. 589 00:22:07,097 --> 00:22:08,890 Hey, can you step out for a second? 590 00:22:15,063 --> 00:22:16,439 I really did do everything I could 591 00:22:16,523 --> 00:22:18,024 to try to make Orlando stay. 592 00:22:18,108 --> 00:22:19,025 Yeah, I don't doubt it. 593 00:22:19,109 --> 00:22:20,026 I wanted to ask you about 594 00:22:20,110 --> 00:22:22,237 Dr. Al-Hashimi at the VA. 595 00:22:22,320 --> 00:22:24,948 Did you ever notice anything unusual about her behavior? 596 00:22:25,031 --> 00:22:26,950 Um, like what? 597 00:22:27,033 --> 00:22:29,578 Lapses in focus, attention? 598 00:22:29,661 --> 00:22:32,163 No, she was always on top of her game. 599 00:22:35,166 --> 00:22:38,795 But this morning when she was checking labs on Baby Jane Doe, 600 00:22:38,879 --> 00:22:41,214 it was like she zoned out for a few seconds. 601 00:22:42,716 --> 00:22:44,467 Maybe she was just tired. 602 00:22:51,516 --> 00:22:53,768 No congestion, nodules, 603 00:22:53,852 --> 00:22:55,228 or cirrhosis. 604 00:22:55,312 --> 00:22:56,897 Good-looking liver. 605 00:22:56,980 --> 00:22:58,773 I should not be sick. 606 00:22:58,857 --> 00:23:01,401 I work so hard to stay healthy-- 607 00:23:01,484 --> 00:23:04,321 diet, exercise, eight hours of sleep. 608 00:23:04,404 --> 00:23:08,158 I can't remember the last time I got eight hours. 609 00:23:08,241 --> 00:23:10,160 Maybe you should try sleepmaxxing. 610 00:23:10,243 --> 00:23:12,078 Oh, you definitely should. 611 00:23:12,162 --> 00:23:14,998 Yeah, cold room, white noise, eye shades. 612 00:23:15,081 --> 00:23:18,835 Kiwis before bedtime, lettuce water, mouth taping. 613 00:23:18,919 --> 00:23:20,503 Who do you follow for health? 614 00:23:20,587 --> 00:23:22,839 A few naturopaths and some functional healers. 615 00:23:22,923 --> 00:23:24,799 Do you--do you buy vitamins from them? 616 00:23:24,883 --> 00:23:26,635 Oh, no, no, I don't take vitamins. 617 00:23:26,718 --> 00:23:29,429 Food is the best medicine-- kale, blueberries, 618 00:23:29,512 --> 00:23:32,015 - kidney beans, turmeric. - Turmeric? 619 00:23:32,098 --> 00:23:33,725 Uh, how long have you been taking that? 620 00:23:33,808 --> 00:23:36,269 For a few months. It's an anti-inflammatory. 621 00:23:36,353 --> 00:23:38,813 It detoxes the body, and it can prevent Alzheimer's. 622 00:23:38,897 --> 00:23:40,273 How much do you take? 623 00:23:40,357 --> 00:23:42,275 500 milligram capsules, 624 00:23:42,359 --> 00:23:43,568 but I take five a day. 625 00:23:45,320 --> 00:23:46,821 What? 626 00:23:46,905 --> 00:23:48,657 With doses that large of turmeric, 627 00:23:48,740 --> 00:23:51,284 there have been cases of liver failure. 628 00:23:51,368 --> 00:23:52,994 From eating a spice? 629 00:23:53,078 --> 00:23:55,664 All right, Digby, I think you're good to go. 630 00:23:55,747 --> 00:23:57,832 Mm-hmm. Would you like to see? 631 00:24:10,470 --> 00:24:12,847 I haven't looked like this in a long time. 632 00:24:12,931 --> 00:24:15,350 Your family won't recognize you. 633 00:24:17,268 --> 00:24:19,354 Then how will they find me? 634 00:24:19,437 --> 00:24:21,356 They--they won't know what I look like. 635 00:24:21,439 --> 00:24:22,440 They won't know this is me. 636 00:24:22,524 --> 00:24:23,566 Of course they will. 637 00:24:23,650 --> 00:24:24,818 They know your voice. 638 00:24:24,901 --> 00:24:26,653 They know where you hang out. 639 00:24:26,736 --> 00:24:30,490 They even remember that you used to look like this. 640 00:24:30,573 --> 00:24:32,575 They remember the wedding. 641 00:24:35,537 --> 00:24:37,706 Did you dance with your daughter 642 00:24:37,789 --> 00:24:39,207 at her wedding? 643 00:24:40,625 --> 00:24:42,752 I did. 644 00:24:42,836 --> 00:24:45,839 Then she will always remember you. 645 00:24:48,591 --> 00:24:50,135 - Yeah. - OK. 646 00:24:51,636 --> 00:24:53,179 Hey, I was just looking for you. 647 00:24:53,263 --> 00:24:54,514 - What's up? - You tell me. 648 00:24:54,597 --> 00:24:56,850 - The, uh, asthma patient. - What about him? 649 00:24:56,933 --> 00:24:58,226 Seemed like you were hesitating 650 00:24:58,309 --> 00:24:59,894 talking about using Aerogen. 651 00:24:59,978 --> 00:25:01,604 I was wondering if you were having second thoughts. 652 00:25:01,688 --> 00:25:03,356 No. Just thinking. 653 00:25:03,440 --> 00:25:04,649 About? 654 00:25:04,733 --> 00:25:06,651 The best treatment plan for the patient. 655 00:25:06,735 --> 00:25:08,737 And I think he's on it. 656 00:25:08,820 --> 00:25:10,238 - Anything else? - I don't know. 657 00:25:10,321 --> 00:25:12,824 You tell me. Anything else I need to know? 658 00:25:12,907 --> 00:25:14,159 I don't think so. 659 00:25:15,827 --> 00:25:17,287 This is Dr. Robby in the ED. 660 00:25:17,370 --> 00:25:18,997 I'm checking on a patient, Ekins. 661 00:25:19,080 --> 00:25:21,541 We can take Larson and Stevens off the dry-erase. 662 00:25:21,624 --> 00:25:22,584 Consider it done. 663 00:25:22,667 --> 00:25:23,793 He's in the scanner now? 664 00:25:23,877 --> 00:25:25,253 Oh, great. 665 00:25:25,336 --> 00:25:26,337 No, I was just calling to confirm. 666 00:25:26,421 --> 00:25:27,630 Thank you. 667 00:25:27,714 --> 00:25:29,424 Any new information from upstairs? 668 00:25:29,507 --> 00:25:30,884 Nothing we don't already know. 669 00:25:30,967 --> 00:25:32,552 Same old story, huh? 670 00:25:32,635 --> 00:25:33,970 You think we should take up a collection 671 00:25:34,054 --> 00:25:35,764 for Jesse for--for bail money? 672 00:25:35,847 --> 00:25:37,348 They don't usually set bail 673 00:25:37,432 --> 00:25:39,142 until after you've appeared in front of a judge. 674 00:25:39,225 --> 00:25:41,019 With the holiday, it's not likely to happen till Monday. 675 00:25:41,102 --> 00:25:43,188 So he's gonna be locked up all weekend? 676 00:25:43,271 --> 00:25:44,898 That sucks. 677 00:25:44,981 --> 00:25:46,900 It does suck. 678 00:25:46,983 --> 00:25:49,944 Dr. Langdon, Grady's worse-- much worse. 679 00:25:50,028 --> 00:25:52,739 - Need an attending? - Uh, no, we have Shen. 680 00:25:52,822 --> 00:25:54,157 Sat's down to 83. 681 00:25:54,240 --> 00:25:56,242 - What's happening? - Give us a minute. 682 00:25:56,326 --> 00:25:57,744 He's tiring out. 683 00:25:57,827 --> 00:25:59,788 Ketamine and rock. It's time to intubate. 684 00:25:59,871 --> 00:26:00,997 I'll call Volk. 685 00:26:01,081 --> 00:26:02,749 Ma'am, we have to put a tube 686 00:26:02,832 --> 00:26:04,000 down your son's windpipe 687 00:26:04,084 --> 00:26:05,460 so a machine can breathe for him. 688 00:26:05,543 --> 00:26:06,795 Oh, my God. 689 00:26:06,878 --> 00:26:08,338 Hold on, hold on. 690 00:26:08,421 --> 00:26:09,547 No lung sliding on the right. 691 00:26:09,631 --> 00:26:11,049 Pneumothorax. 692 00:26:11,132 --> 00:26:13,093 No need to intubate. 693 00:26:13,176 --> 00:26:14,385 What's going on? 694 00:26:14,469 --> 00:26:16,346 He has a collapsed lung. 695 00:26:16,429 --> 00:26:18,264 There was no history of trauma 696 00:26:18,348 --> 00:26:19,766 that would have caused pneumothorax. 697 00:26:19,849 --> 00:26:21,810 Glove up, Dr. King. 698 00:26:21,893 --> 00:26:24,145 In asthma, you can get "air trapping." 699 00:26:24,229 --> 00:26:25,897 When the lungs can't fully exhale, 700 00:26:25,980 --> 00:26:27,273 eventually they overinflate, 701 00:26:27,357 --> 00:26:29,192 causing some of the tiny air sacs to burst. 702 00:26:29,275 --> 00:26:30,443 How do you fix it? 703 00:26:36,366 --> 00:26:37,283 Like that. 704 00:26:42,997 --> 00:26:45,542 It's a good thing Dr. Conley was here. 705 00:26:45,625 --> 00:26:46,835 - Yeah. - We should probably try 706 00:26:46,918 --> 00:26:48,378 to find him a Neuro-Critical ICU bed. 707 00:26:48,461 --> 00:26:49,963 We don't want to board a patient like this. 708 00:26:50,046 --> 00:26:51,631 - Mm-hmm. - Hey, Robby. 709 00:26:51,714 --> 00:26:54,217 - Hey, how did the scan go? - Fine. 710 00:26:54,300 --> 00:26:55,677 It is probably gonna take a little while 711 00:26:55,760 --> 00:26:57,137 to get the results from the radiologist. 712 00:26:57,220 --> 00:26:58,596 Well, that's not a problem. 713 00:26:58,680 --> 00:27:00,807 Nurse Vivi and I need a little time 714 00:27:00,890 --> 00:27:03,393 to coordinate our schedules over the next few months. 715 00:27:03,476 --> 00:27:04,394 - Really? - Yeah. 716 00:27:04,477 --> 00:27:05,395 I've always wanted to learn 717 00:27:05,478 --> 00:27:06,437 how to ride a motorcycle, 718 00:27:06,521 --> 00:27:07,939 and Duke offered to teach me. 719 00:27:08,022 --> 00:27:10,233 Well, nobody knows motorcycles like Duke. 720 00:27:10,316 --> 00:27:12,652 He's giving me the health care worker discount. 721 00:27:12,735 --> 00:27:13,987 He's quite the gentleman. 722 00:27:14,070 --> 00:27:15,780 Let's get him back to his room. 723 00:27:15,864 --> 00:27:18,575 How would next Saturday be for you, Vivi? 724 00:27:18,658 --> 00:27:21,911 Uh, maybe we could have some dinner after. 725 00:27:21,995 --> 00:27:23,538 Dr. Mohan, Lorrie Diaz is here. 726 00:27:23,621 --> 00:27:25,290 She wants to see her husband. She's heading back. 727 00:27:25,373 --> 00:27:26,875 OK, I'm on my way. 728 00:27:29,043 --> 00:27:30,962 - Mrs. Diaz? - Hi. 729 00:27:31,045 --> 00:27:33,840 Did Orlando go up to his room yet? 730 00:27:33,923 --> 00:27:35,341 No. Um-- 731 00:27:35,425 --> 00:27:37,468 I brought him some dinner from Burgatory. 732 00:27:37,552 --> 00:27:38,845 It's a chicken burger-- 733 00:27:38,928 --> 00:27:40,471 no bun, just lettuce. 734 00:27:40,555 --> 00:27:43,183 Figured it would be better than hospital food. 735 00:27:46,519 --> 00:27:50,690 He's being treated by our top brain-injury specialists. 736 00:27:50,773 --> 00:27:52,192 Will he wake up? 737 00:27:52,275 --> 00:27:54,110 We won't know for several weeks. 738 00:27:54,194 --> 00:27:56,696 And then he could be back to normal? 739 00:27:56,779 --> 00:27:59,824 Best-case scenario, it would take about a year 740 00:27:59,908 --> 00:28:02,452 before he could be independent at home. 741 00:28:02,535 --> 00:28:04,120 And the worst case? 742 00:28:04,204 --> 00:28:07,624 Round-the-clock nursing care for severe disability. 743 00:28:11,252 --> 00:28:13,379 You let him leave? 744 00:28:13,463 --> 00:28:17,383 He insisted on leaving to work at his second job. 745 00:28:17,467 --> 00:28:19,594 You couldn't make him stay? 746 00:28:19,677 --> 00:28:22,597 He was competent. He knew the risks. 747 00:28:22,680 --> 00:28:24,599 We honored his decision to leave. 748 00:28:24,682 --> 00:28:26,392 Even if it was a stupid one? 749 00:28:26,476 --> 00:28:27,894 I tried to stop him. 750 00:28:27,977 --> 00:28:29,520 Offered to get him all the supplies he'd need 751 00:28:29,604 --> 00:28:31,022 to take care of himself at home. 752 00:28:31,105 --> 00:28:33,566 But he left before I could give them to him. 753 00:28:33,650 --> 00:28:36,069 He said he couldn't afford to lose a paycheck. 754 00:28:43,618 --> 00:28:45,787 Dr. Langdon. 755 00:28:48,039 --> 00:28:49,707 Are you OK? 756 00:28:49,791 --> 00:28:52,835 Yeah. I'm just kind of, uh... 757 00:28:52,919 --> 00:28:55,296 wondering if I'm really ready to be back here. 758 00:28:55,380 --> 00:28:57,590 Well, of course you are. 759 00:28:57,674 --> 00:28:59,717 Ten months is a long time. 760 00:28:59,801 --> 00:29:02,971 I almost killed that kid with an intubation. 761 00:29:03,054 --> 00:29:06,266 Didn't even occur to me to check for pneumothorax. 762 00:29:06,349 --> 00:29:07,976 There wasn't any trauma to indicate-- 763 00:29:08,059 --> 00:29:09,185 - I should have caught it. - OK. 764 00:29:15,942 --> 00:29:17,235 You know, I, um... 765 00:29:19,153 --> 00:29:21,990 I had a deposition today, 766 00:29:22,073 --> 00:29:25,451 and all the lawyer's questions made me feel like 767 00:29:25,535 --> 00:29:27,829 I was a really, really bad doctor. 768 00:29:30,206 --> 00:29:33,668 We don't always get everything right the first time. 769 00:29:34,836 --> 00:29:37,297 You would have caught the collapsed lung. 770 00:29:37,380 --> 00:29:40,008 And it may have taken a minute, but you would have saved him. 771 00:29:41,259 --> 00:29:43,594 I'm not sure Robby would agree with you. 772 00:29:43,678 --> 00:29:46,306 He's been riding me all day. 773 00:29:46,389 --> 00:29:48,182 Well, Robby's leaving for three months. 774 00:29:48,266 --> 00:29:51,019 And, you know, with Robby gone... 775 00:29:51,102 --> 00:29:53,062 I really don't want you to leave either. 776 00:29:56,649 --> 00:29:59,193 That which does not kill me makes me stronger. 777 00:29:59,277 --> 00:30:02,488 Wow, Friedrich Nietzsche. 778 00:30:02,572 --> 00:30:05,700 Yeah, Nietzsche, yeah... 779 00:30:05,783 --> 00:30:08,077 not Kelly Clarkson. 780 00:30:10,079 --> 00:30:11,998 Hey, that's a thick one. 781 00:30:12,081 --> 00:30:14,917 Yeah, Austin Green. Ogilvie's triple-A. 782 00:30:17,962 --> 00:30:20,506 Uh, G-R-E-E-N? 783 00:30:20,590 --> 00:30:21,924 Yeah. Why? What are you doing? 784 00:30:22,008 --> 00:30:23,384 Checking to see when we'll get Ogilvie 785 00:30:23,468 --> 00:30:25,303 back from the OR. 786 00:30:25,386 --> 00:30:27,347 - Oh, shit. - What? 787 00:30:27,430 --> 00:30:29,098 The guy didn't make it. 788 00:30:29,182 --> 00:30:31,392 He died on the table about 40 minutes ago. 789 00:30:31,476 --> 00:30:33,561 Then where's Ogilvie? 790 00:30:33,644 --> 00:30:35,521 Oh, man. 791 00:30:35,605 --> 00:30:38,149 His patient had a CT a year and a half ago 792 00:30:38,232 --> 00:30:40,443 that showed a 4-centimeter triple-A. 793 00:30:40,526 --> 00:30:42,111 That's too small for surgery. 794 00:30:42,195 --> 00:30:43,446 He was supposed to come back 795 00:30:43,529 --> 00:30:45,198 every six months for a repeat ultrasound, 796 00:30:45,281 --> 00:30:46,908 but looks like he didn't. 797 00:30:46,991 --> 00:30:49,577 We would've seen that if the computers were working. 798 00:30:49,660 --> 00:30:51,245 Why wouldn't he tell Ogilvie? 799 00:30:51,329 --> 00:30:53,122 I don't know. Maybe he forgot all about it. 800 00:30:53,206 --> 00:30:55,166 Or Ogilvie didn't ask the right questions. 801 00:30:56,292 --> 00:30:58,252 Dennis, hey, got a minute? 802 00:30:58,336 --> 00:31:00,797 Uh, sure. What do you need? 803 00:31:00,880 --> 00:31:02,465 Teenager with jewelry magnets 804 00:31:02,548 --> 00:31:04,467 stuck to both sides of her nasal septum. 805 00:31:04,550 --> 00:31:06,469 I tried to move them with a plastic curette. 806 00:31:06,552 --> 00:31:08,304 Too much pain, and then there was bleeding. 807 00:31:08,388 --> 00:31:10,598 Those need to come off before they cause permanent damage. 808 00:31:10,681 --> 00:31:12,183 Yeah, you think, uh, you could find, like, 809 00:31:12,266 --> 00:31:14,102 a senior or an attending? 810 00:31:14,185 --> 00:31:15,978 We're really trying to get off the clock here. 811 00:31:16,062 --> 00:31:17,146 They're all busy. 812 00:31:19,899 --> 00:31:21,442 I already took one for the team. 813 00:31:21,526 --> 00:31:23,403 Yeah, fine. 814 00:31:23,486 --> 00:31:26,948 Uh, labs on your yellow lady. 815 00:31:27,031 --> 00:31:29,409 INR is elevated, 2.2. 816 00:31:29,492 --> 00:31:31,369 Liver's in trouble but not dead yet. 817 00:31:31,452 --> 00:31:32,954 Tell her to skip the turmeric. 818 00:31:33,037 --> 00:31:35,123 Admit for monitoring, and follow the LFTs. 819 00:31:35,206 --> 00:31:36,332 - Got it. - Mm-hmm. 820 00:31:36,416 --> 00:31:37,834 - Central 10? - Yeah. 821 00:31:42,213 --> 00:31:44,298 "Sleepmaxxing"? Really? 822 00:31:44,382 --> 00:31:45,883 I track the online trends. 823 00:31:45,967 --> 00:31:48,261 Is that your secret for the tough ones? 824 00:31:48,344 --> 00:31:49,971 I just think, 825 00:31:50,054 --> 00:31:52,348 what's the stupidest thing this person could have done? 826 00:31:52,432 --> 00:31:53,599 Then assume they did it. 827 00:31:55,059 --> 00:31:57,186 Well, I mean, she was trying to be healthy. 828 00:31:57,270 --> 00:31:59,522 Yeah, by taking advice from fools. 829 00:31:59,605 --> 00:32:01,732 Turmeric is recommended by a lot of doctors. 830 00:32:01,816 --> 00:32:03,734 Yeah, then ask your doctor for the dose 831 00:32:03,818 --> 00:32:06,320 or check someplace reputable, like the CDC. 832 00:32:06,404 --> 00:32:09,615 Oh, right, I forgot, it's now a medical toxic waste site. 833 00:32:09,699 --> 00:32:12,660 I mean, she's in pretty bad shape. 834 00:32:12,743 --> 00:32:14,954 If things get worse, she could need a liver transplant. 835 00:32:15,037 --> 00:32:17,081 Yeah, 'cause she's a big fucking idiot. 836 00:32:18,666 --> 00:32:20,418 Wow. 837 00:32:20,501 --> 00:32:22,670 No, I actually appreciate her. 838 00:32:22,753 --> 00:32:25,423 Our job security depends on all these big fucking idiots. 839 00:32:27,884 --> 00:32:29,093 OK. 840 00:32:31,429 --> 00:32:34,807 Uh, good night, Perlah, Monica. 841 00:32:34,891 --> 00:32:37,560 - Good night, Dr. Robby. - Good night. 842 00:32:37,643 --> 00:32:39,145 Bye, Emma. 843 00:32:39,228 --> 00:32:40,605 You could stay to pitch in. 844 00:32:40,688 --> 00:32:42,565 Mm, Dana told me to go and get some rest 845 00:32:42,648 --> 00:32:43,983 before tomorrow's shift. 846 00:32:44,066 --> 00:32:45,651 Yeah, you had quite a day. 847 00:32:45,735 --> 00:32:47,028 Wasn't so bad. 848 00:32:49,071 --> 00:32:50,823 Why can't I find Duke's results? 849 00:32:50,907 --> 00:32:53,576 Oh, new patient, no EHR yet. 850 00:32:53,659 --> 00:32:56,370 I can run over to Radiology, get a printout. 851 00:32:56,454 --> 00:32:57,830 Thank you, Monica. 852 00:33:00,374 --> 00:33:02,293 Ready to pick up a few more. 853 00:33:02,376 --> 00:33:03,711 Orlando's all tucked in for now. 854 00:33:03,794 --> 00:33:05,338 - How's he doing? - Numbers are good. 855 00:33:05,421 --> 00:33:07,173 CPP 22. 856 00:33:07,256 --> 00:33:09,800 OK, so he's got a shot at a decent outcome at least. 857 00:33:09,884 --> 00:33:11,427 You think he has a chance? 858 00:33:11,511 --> 00:33:13,638 Oh, I don't know that survival was 859 00:33:13,721 --> 00:33:15,640 the outcome he was hoping for. 860 00:33:15,723 --> 00:33:17,266 What? 861 00:33:17,350 --> 00:33:19,477 He told Samira he's got $100,000 in medical debt, 862 00:33:19,560 --> 00:33:21,979 - that his life is probably-- - Mrs. Diaz! 863 00:33:24,315 --> 00:33:26,734 - How can we help you? - The bathroom? 864 00:33:26,817 --> 00:33:29,445 Uh, yeah. Perlah can show you the way. 865 00:33:31,239 --> 00:33:33,574 Not a great idea to have a private conversation 866 00:33:33,658 --> 00:33:34,825 about a patient in a public area. 867 00:33:34,909 --> 00:33:36,827 I know. I know. 868 00:33:36,911 --> 00:33:38,204 You were about to start yapping-- 869 00:33:38,287 --> 00:33:39,789 But I didn't! 870 00:33:42,333 --> 00:33:45,211 OK. 871 00:33:45,294 --> 00:33:47,547 And how long have they been in there? 872 00:33:47,630 --> 00:33:49,006 At least two hours. 873 00:33:49,090 --> 00:33:51,425 - How did it happen? - With my earring. 874 00:33:51,509 --> 00:33:54,345 It was supposed to be, uh, red, white, and blue 875 00:33:54,428 --> 00:33:56,138 to look cool at the fireworks. 876 00:33:56,222 --> 00:33:57,848 I told her for the nose, one side only, 877 00:33:57,932 --> 00:33:59,100 but she never listens. 878 00:33:59,183 --> 00:34:00,351 This can be pretty serious. 879 00:34:00,434 --> 00:34:01,644 If we don't get them out quickly, 880 00:34:01,727 --> 00:34:03,062 it can cut off the blood supply 881 00:34:03,145 --> 00:34:04,981 and cause the septum to collapse. 882 00:34:05,064 --> 00:34:08,568 Like, my nose could be deformed? 883 00:34:10,861 --> 00:34:13,363 - Oh, my God, get them off. - Yeah, that's the plan. 884 00:34:13,447 --> 00:34:15,074 Yeah, she tried already. It hurt like crazy. 885 00:34:15,157 --> 00:34:16,242 Because they're stuck together 886 00:34:16,325 --> 00:34:18,369 by a very strong magnetic force. 887 00:34:18,452 --> 00:34:20,287 - Yeah. - No, no, no. 888 00:34:20,371 --> 00:34:22,039 Oh, uh, I'm not gonna use the tips. 889 00:34:22,122 --> 00:34:25,084 I'm gonna flip it around and use the handle. 890 00:34:25,167 --> 00:34:26,711 It's still gonna hurt. 891 00:34:26,794 --> 00:34:27,920 Probably not. 892 00:34:28,004 --> 00:34:29,338 Just, uh, hold still. 893 00:34:31,881 --> 00:34:33,301 OK. 894 00:34:37,555 --> 00:34:38,764 Voilà. 895 00:34:38,848 --> 00:34:41,475 - Really? - That was amazing. 896 00:34:41,559 --> 00:34:43,311 I think another half hour, 897 00:34:43,394 --> 00:34:45,021 we can send this dry-erase board back to storage. 898 00:34:45,104 --> 00:34:46,229 With pleasure. 899 00:34:46,314 --> 00:34:47,606 - Dr. Robinavitch? - Yep. 900 00:34:47,689 --> 00:34:49,108 Results on your friend. 901 00:34:53,778 --> 00:34:55,906 - Fuck. - Duke? 902 00:34:59,910 --> 00:35:01,537 Are you gonna tell him? 903 00:35:01,621 --> 00:35:03,164 I want to talk to a surgeon first. 904 00:35:03,247 --> 00:35:05,207 Uh, Dr. Robby, I have an update on the patient. 905 00:35:05,291 --> 00:35:06,626 Now is not a great time. 906 00:35:06,709 --> 00:35:08,044 Oh, I thought you were going home. 907 00:35:08,127 --> 00:35:09,253 Uh, I was. 908 00:35:09,337 --> 00:35:11,005 Dr. Ogilvie is just sitting 909 00:35:11,088 --> 00:35:12,757 out in the ambulance bay covered in blood. 910 00:35:12,840 --> 00:35:14,383 Sorry, what-- what's he doing out there? 911 00:35:14,467 --> 00:35:16,344 Kind of, uh, staring off into space. 912 00:35:16,427 --> 00:35:17,637 I tried to talk to him, but it was like 913 00:35:17,720 --> 00:35:19,096 - he couldn't hear me. - Monica, 914 00:35:19,180 --> 00:35:20,681 can you stat page CardioThoracic? 915 00:35:20,765 --> 00:35:22,892 - I'll go check on Ogilvie. - Please. 916 00:35:25,227 --> 00:35:26,437 Oh. 917 00:35:37,865 --> 00:35:39,992 Hey, Ogilvie. 918 00:35:42,620 --> 00:35:44,538 Ogilvie... 919 00:35:44,622 --> 00:35:46,457 y-you OK, man? 920 00:35:51,545 --> 00:35:53,589 99 on 2 liters. 921 00:35:53,673 --> 00:35:55,925 Scattered end expiratory wheezes. 922 00:35:56,008 --> 00:35:58,135 He is so much better. 923 00:35:58,219 --> 00:36:00,179 The steroids should kick in soon. 924 00:36:00,262 --> 00:36:02,556 So he'll keep improving. 925 00:36:02,640 --> 00:36:04,892 Um, when can I go home? 926 00:36:04,975 --> 00:36:06,560 In a day or two. 927 00:36:06,644 --> 00:36:09,855 And we will, uh, discharge you with a Symbicort inhaler. 928 00:36:09,939 --> 00:36:12,024 That should last about a month. 929 00:36:12,108 --> 00:36:14,568 Hopefully we'll be back on Medicaid by then. 930 00:36:14,652 --> 00:36:16,612 How'd you lose it? 931 00:36:16,696 --> 00:36:20,116 They sent a redetermination letter to our old apartment. 932 00:36:20,199 --> 00:36:22,660 It didn't get forwarded. 933 00:36:22,743 --> 00:36:24,704 When I went to pick up his prescription, 934 00:36:24,787 --> 00:36:28,541 pharmacist told me we were no longer covered. 935 00:36:28,624 --> 00:36:30,793 And you haven't been able to get it back since? 936 00:36:30,876 --> 00:36:33,129 I've been trying for months. 937 00:36:33,212 --> 00:36:35,589 To get re-enrolled, you need tax returns, 938 00:36:35,673 --> 00:36:37,007 pay stubs. 939 00:36:37,091 --> 00:36:39,927 I cut hair. My income fluctuates. 940 00:36:40,010 --> 00:36:42,388 A lot of my regulars are struggling, 941 00:36:42,471 --> 00:36:45,516 so it's been tough. 942 00:36:45,599 --> 00:36:47,435 Well, if you run out of Symbicort 943 00:36:47,518 --> 00:36:49,812 before your Medicaid kicks in, you can come back, 944 00:36:49,895 --> 00:36:52,732 and we'll, uh, set you up with another one. 945 00:36:52,815 --> 00:36:54,734 Oh, is there a patient in here? 946 00:36:54,817 --> 00:36:57,820 'Cause everyone in this room looks extremely healthy to me. 947 00:36:57,903 --> 00:37:00,281 Dr. Shen and I will be with Grady all night long. 948 00:37:00,364 --> 00:37:02,241 Yeah. Day shift, we got this. 949 00:37:02,324 --> 00:37:04,201 We're leaving you in good hands. 950 00:37:04,285 --> 00:37:06,036 Um... 951 00:37:06,120 --> 00:37:08,456 I was really scared. 952 00:37:08,539 --> 00:37:09,665 Thank you. 953 00:37:11,375 --> 00:37:13,377 You're very welcome. 954 00:37:17,298 --> 00:37:19,884 Due to his injury, things have changed. 955 00:37:21,343 --> 00:37:23,554 I was looking for Dr. Abbot. 956 00:37:23,637 --> 00:37:26,390 I haven't seen him for a while. 957 00:37:26,474 --> 00:37:27,725 Excuse me. 958 00:37:30,770 --> 00:37:32,688 So now, with a long-term disability, 959 00:37:32,772 --> 00:37:35,399 things may be easier. 960 00:37:35,483 --> 00:37:36,567 "Easier"? 961 00:37:36,650 --> 00:37:38,068 His condition will qualify him 962 00:37:38,152 --> 00:37:39,570 for Medicare and Medicaid. 963 00:37:39,653 --> 00:37:42,072 So, moving forward, costs should be covered, 964 00:37:42,156 --> 00:37:43,866 including home health care. 965 00:37:43,949 --> 00:37:45,201 OK. 966 00:37:45,284 --> 00:37:46,660 Perhaps this isn't the best time-- 967 00:37:46,744 --> 00:37:48,037 I just wanted to reassure you 968 00:37:48,120 --> 00:37:49,914 about future costs. 969 00:37:58,172 --> 00:37:59,507 Robby. 970 00:37:59,590 --> 00:38:01,675 Noelle. 971 00:38:01,759 --> 00:38:03,302 You're still here. 972 00:38:03,385 --> 00:38:05,638 It's not the best day to try to get out on time. 973 00:38:05,721 --> 00:38:07,306 Mm. 974 00:38:07,389 --> 00:38:08,766 So I guess this is it for a while. 975 00:38:08,849 --> 00:38:10,267 Unless you want to come with me. 976 00:38:10,351 --> 00:38:12,645 No, but thank you, 977 00:38:12,728 --> 00:38:14,688 even if it isn't a legitimate offer. 978 00:38:14,772 --> 00:38:16,190 - What do you mean? - Oh, please. 979 00:38:16,273 --> 00:38:18,067 I know well enough not to get in between 980 00:38:18,150 --> 00:38:20,194 a man and his vision quest. 981 00:38:21,612 --> 00:38:22,863 "Vision quest." 982 00:38:22,947 --> 00:38:26,033 That is my nice way of putting it. 983 00:38:27,284 --> 00:38:28,577 I probably don't want to hear 984 00:38:28,661 --> 00:38:30,454 your not-so-nice way of putting it. 985 00:38:30,538 --> 00:38:31,872 No, probably not. 986 00:38:33,624 --> 00:38:37,169 I-I hope that this is not, um... 987 00:38:37,253 --> 00:38:38,546 about you running away from me. 988 00:38:38,629 --> 00:38:39,797 I'm a big girl. 989 00:38:39,880 --> 00:38:41,465 You can tell me just to get lost. 990 00:38:41,549 --> 00:38:43,300 This has nothing to do with you. 991 00:38:43,384 --> 00:38:44,593 Oh, right. 992 00:38:44,677 --> 00:38:47,388 It's the old, uh, "it's not you, it's me"? 993 00:38:48,889 --> 00:38:51,058 In this case, it's actually true. 994 00:38:57,273 --> 00:38:58,899 Excuse me. 995 00:39:04,989 --> 00:39:06,282 I'll see you next week? 996 00:39:06,365 --> 00:39:07,616 It's a three-month sabbatical. 997 00:39:07,700 --> 00:39:09,660 Like I said, I will see you next week. 998 00:39:16,333 --> 00:39:19,545 My first day here as a med student... 999 00:39:19,628 --> 00:39:21,255 there was a patient. 1000 00:39:23,090 --> 00:39:24,758 He was a real nice guy, 1001 00:39:24,842 --> 00:39:27,595 came in with belly pain. 1002 00:39:27,678 --> 00:39:31,223 I saw a gall stone on the ultrasound, 1003 00:39:31,307 --> 00:39:33,392 normal EKG, troponin. 1004 00:39:33,475 --> 00:39:36,770 The pain resolved, and he was in the hall 1005 00:39:36,854 --> 00:39:38,731 when he had a cardiac arrest. 1006 00:39:41,525 --> 00:39:42,860 I couldn't save him. 1007 00:39:44,486 --> 00:39:45,905 People die. 1008 00:39:47,364 --> 00:39:50,826 And we do the best we can... 1009 00:39:50,910 --> 00:39:53,245 but people die. 1010 00:39:54,496 --> 00:39:56,457 You ever get used to it? 1011 00:39:58,250 --> 00:39:59,335 No. 1012 00:40:01,003 --> 00:40:03,756 No, you... 1013 00:40:03,839 --> 00:40:05,716 you try to accept it. 1014 00:40:07,718 --> 00:40:09,470 You try to find balance. 1015 00:40:14,934 --> 00:40:17,811 I don't know if I can take another day like today. 1016 00:40:19,355 --> 00:40:22,650 Primary care specialty sounds way better. 1017 00:40:22,733 --> 00:40:24,443 Pedes, maybe. 1018 00:40:24,526 --> 00:40:26,070 Yeah, maybe. 1019 00:40:27,613 --> 00:40:30,699 I know I'd be bored out of my fucking mind. 1020 00:40:32,034 --> 00:40:36,038 Seriously, I like the challenge of undiagnosed illness, 1021 00:40:36,121 --> 00:40:41,043 of quick decisions, of life-saving procedures. 1022 00:40:41,126 --> 00:40:43,462 And I like being here for people 1023 00:40:43,545 --> 00:40:45,923 on the worst days of their lives. 1024 00:40:54,098 --> 00:40:56,058 You know what I think? 1025 00:40:56,141 --> 00:40:57,768 What? 1026 00:40:57,851 --> 00:41:00,104 I think you should go home. 1027 00:41:00,187 --> 00:41:01,522 I think you should sleep on it. 1028 00:41:01,605 --> 00:41:03,023 And I think you should at least wait 1029 00:41:03,107 --> 00:41:04,274 till the morning to decide 1030 00:41:04,358 --> 00:41:05,776 if you want to come back. 1031 00:41:08,779 --> 00:41:11,073 I don't really want to... 1032 00:41:11,156 --> 00:41:13,701 go back in there and see anybody. 1033 00:41:13,784 --> 00:41:14,910 Yeah. 1034 00:41:16,453 --> 00:41:18,956 OK, pull off your gown. I'll take it in. 1035 00:41:19,039 --> 00:41:21,417 Shift is over. 1036 00:41:21,500 --> 00:41:22,960 Go home. 1037 00:41:35,848 --> 00:41:37,057 - Oh! - Oh, God. 1038 00:41:37,141 --> 00:41:38,142 - No, I'm--I'm-- - Sorry. 1039 00:41:38,225 --> 00:41:39,560 I'm good. I'm good. I'm good. 1040 00:41:39,643 --> 00:41:41,270 There's a dummy in a wheelchair. 1041 00:41:41,353 --> 00:41:43,230 Uh, yeah, he moves around. 1042 00:41:46,316 --> 00:41:48,444 I see I've been replaced. 1043 00:41:48,527 --> 00:41:49,987 Oh, did I take your spot? 1044 00:41:50,070 --> 00:41:51,655 - Not really, no. - Are you sure? 1045 00:41:51,739 --> 00:41:53,115 Where the hell have you been? 1046 00:41:53,198 --> 00:41:54,742 I found Ogilvie. 1047 00:41:54,825 --> 00:41:56,035 And? 1048 00:41:56,118 --> 00:41:58,370 And he's going home. 1049 00:41:58,454 --> 00:41:59,580 That's it? 1050 00:41:59,663 --> 00:42:00,914 It's a long story. 1051 00:42:00,998 --> 00:42:02,374 Well, I got nothing but time. 1052 00:42:02,458 --> 00:42:04,543 I need to respect his privacy. 1053 00:42:04,626 --> 00:42:06,128 Where's the fun in that? 1054 00:42:06,211 --> 00:42:08,172 - Beep. Beep, beep. - Sorry. 1055 00:42:16,764 --> 00:42:18,098 Um, the shredder jammed. 1056 00:42:18,182 --> 00:42:21,143 Yeah, uh, try putting it in reverse. 1057 00:42:23,520 --> 00:42:24,688 Perfect. 1058 00:42:24,772 --> 00:42:26,774 Just give it a little love tap. 1059 00:42:26,857 --> 00:42:28,358 - OK. - Kick it. 1060 00:42:29,526 --> 00:42:31,070 Jesus Christ. 1061 00:42:33,072 --> 00:42:35,157 Guess Mr. Digby got a room upstairs. 1062 00:42:35,240 --> 00:42:36,617 In your dreams. 1063 00:42:36,700 --> 00:42:38,619 He's not in South 21. 1064 00:42:38,702 --> 00:42:40,037 Yeah, he is. 1065 00:42:40,120 --> 00:42:42,372 There's a new guy in the bed. 1066 00:42:42,456 --> 00:42:44,374 Short hair, clean-shaved? 1067 00:42:44,458 --> 00:42:46,794 I'll take care of it. 1068 00:42:46,877 --> 00:42:48,504 Scout film showed obvious pathology, 1069 00:42:48,587 --> 00:42:50,047 so we ordered the CT angiogram. 1070 00:42:50,130 --> 00:42:51,715 Textbook ascending aortic aneurysm. 1071 00:42:51,799 --> 00:42:53,550 Eight centimeters. 1072 00:42:53,634 --> 00:42:55,427 50% one-year mortality. 1073 00:42:55,511 --> 00:42:56,720 So he definitely needs surgery. 1074 00:42:56,804 --> 00:42:57,721 If he wants to live. 1075 00:42:57,805 --> 00:42:58,764 OK, well, he's a friend, 1076 00:42:58,847 --> 00:43:00,057 so I will talk to him. 1077 00:43:00,140 --> 00:43:01,225 I'll get him admitted to your service. 1078 00:43:01,308 --> 00:43:03,352 - Not today. - Why not? 1079 00:43:03,435 --> 00:43:05,187 He needs to see Cardiology and Pulmonary first 1080 00:43:05,270 --> 00:43:06,438 to be cleared for the OR. 1081 00:43:06,522 --> 00:43:08,357 They can do a stress echo, PFTs. 1082 00:43:08,440 --> 00:43:10,609 He needs to be admitted and evaluated as an inpatient. 1083 00:43:10,692 --> 00:43:12,277 Nothing ever gets done over a holiday weekend. 1084 00:43:12,361 --> 00:43:13,362 He can take it easy at home. 1085 00:43:13,445 --> 00:43:14,780 He's a ticking time bomb. 1086 00:43:14,863 --> 00:43:16,115 He's probably been that way for years. 1087 00:43:16,198 --> 00:43:17,407 We can get him in early next week 1088 00:43:17,491 --> 00:43:18,992 with a specialist to get his testing done. 1089 00:43:19,076 --> 00:43:20,953 All goes well, he's on the OR schedule in a week. 1090 00:43:21,036 --> 00:43:22,579 What happens if it ruptures before then? 1091 00:43:22,663 --> 00:43:24,414 Call 911. 1092 00:43:24,498 --> 00:43:26,083 Sorry, Robby. Best we can do. 1093 00:43:26,166 --> 00:43:28,085 Text me his number. I'll have my office coordinate. 1094 00:43:30,295 --> 00:43:31,839 - Fuck! - Hey! 1095 00:43:31,922 --> 00:43:33,590 Take a walk. Come on! 1096 00:43:37,928 --> 00:43:38,846 Two for discharge. 1097 00:43:38,929 --> 00:43:40,347 Yeah, please don't ring the bell. 1098 00:43:40,430 --> 00:43:41,974 The computers are back up and running. 1099 00:43:42,057 --> 00:43:43,517 Not for these two. 1100 00:43:43,600 --> 00:43:44,935 They don't have electronic health records yet. 1101 00:43:45,018 --> 00:43:46,311 Wait, hold up. 1102 00:43:46,395 --> 00:43:48,564 This kid had a wrist X-ray ordered. 1103 00:43:48,647 --> 00:43:49,815 Ugh, it never happened. 1104 00:43:49,898 --> 00:43:51,150 And water-skiing lady's 1105 00:43:51,233 --> 00:43:52,484 still waiting on a knee series. 1106 00:43:52,568 --> 00:43:53,735 I canceled the X-rays. 1107 00:43:53,819 --> 00:43:56,071 Diagnosed them both with ultrasound. 1108 00:43:56,155 --> 00:43:57,322 Really? 1109 00:43:57,406 --> 00:43:59,074 Yeah. 1110 00:43:59,158 --> 00:44:01,535 The, uh, little boy had a simple buckle fracture. 1111 00:44:01,618 --> 00:44:04,163 Distal radius. He got a Velcro splint. 1112 00:44:04,246 --> 00:44:06,874 And Mrs. Stegman had a small medial meniscus tear. 1113 00:44:06,957 --> 00:44:09,293 Knee immobilizer, crutches, and a follow up with ortho. 1114 00:44:09,376 --> 00:44:11,628 Could have used you on the day shift today. 1115 00:44:11,712 --> 00:44:14,047 They don't teach us a lot of musculoskeletal ultrasound. 1116 00:44:14,131 --> 00:44:15,591 I know. 1117 00:44:15,674 --> 00:44:18,218 That's why I did electives at Harvard and Highland. 1118 00:44:18,302 --> 00:44:21,054 Are you applying for an ultrasound fellowship here? 1119 00:44:21,138 --> 00:44:23,849 I am, but it is so competitive. 1120 00:44:23,932 --> 00:44:26,101 - That's what I hear. - Kind of a long shot. 1121 00:44:26,185 --> 00:44:27,519 I only have one publication, 1122 00:44:27,603 --> 00:44:29,438 but it's a series of case reports diagnosing 1123 00:44:29,521 --> 00:44:31,982 shoulder dislocations with ultrasound only. 1124 00:44:32,065 --> 00:44:33,984 If you want to learn some MSK, you can tag along. 1125 00:44:34,067 --> 00:44:35,485 I got three more to scan. 1126 00:44:35,569 --> 00:44:37,487 Maybe some other time. 1127 00:44:37,571 --> 00:44:39,907 Cool. 1128 00:44:42,326 --> 00:44:44,244 Hey, don't jam the shredder. 1129 00:44:44,328 --> 00:44:45,787 What is that, two charts? 1130 00:44:45,871 --> 00:44:48,373 No, it's my ultrasound fellowship application. 1131 00:44:50,209 --> 00:44:51,752 Hey. 1132 00:44:51,835 --> 00:44:54,755 Uh, sorry about your patient. 1133 00:44:54,838 --> 00:44:57,758 Yeah, Orlando's in pretty bad shape. 1134 00:44:57,841 --> 00:44:59,676 Oh, no, I--I was talking about 1135 00:44:59,760 --> 00:45:03,347 the triple-A guy you worked on with Ogilvie. 1136 00:45:05,974 --> 00:45:08,518 He didn't make it through surgery. 1137 00:45:08,602 --> 00:45:10,062 I tried to talk to Robby about it, 1138 00:45:10,145 --> 00:45:12,064 but I think he's busy. 1139 00:45:12,147 --> 00:45:13,774 Excuse me. 1140 00:45:16,151 --> 00:45:17,903 Oh, shit. 1141 00:45:22,157 --> 00:45:23,575 You think I'm on edge? 1142 00:45:23,659 --> 00:45:25,369 First you're shaming Samira, then McKay-- 1143 00:45:25,452 --> 00:45:26,703 They both needed to be called out 1144 00:45:26,787 --> 00:45:28,038 - for unacceptable behavior. - Yeah? 1145 00:45:28,121 --> 00:45:29,331 Yeah, well, you do that in private. 1146 00:45:29,414 --> 00:45:30,749 Same place you share your thoughts 1147 00:45:30,832 --> 00:45:31,959 about a patient's possible suicide. 1148 00:45:32,042 --> 00:45:33,418 And slamming stuff? Please. 1149 00:45:33,502 --> 00:45:34,628 Sign out all the shit that's bugging you 1150 00:45:34,711 --> 00:45:35,796 and get out of here. 1151 00:45:35,879 --> 00:45:37,631 - I can't. - Yes, you can. 1152 00:45:37,714 --> 00:45:38,966 When either of my kids was acting like this, 1153 00:45:39,049 --> 00:45:40,425 I gave them a time-out in their room. 1154 00:45:40,509 --> 00:45:41,593 Whoa, whoa, whoa, you're not my mother. 1155 00:45:41,677 --> 00:45:42,803 Yeah? Well, too bad. 1156 00:45:42,886 --> 00:45:44,012 - You need one. - No, I had one. 1157 00:45:44,096 --> 00:45:45,722 She left. I don't need another one. 1158 00:45:45,806 --> 00:45:47,057 What I need is someone who can actually run this place 1159 00:45:47,140 --> 00:45:48,976 - while I'm gone. - OK, I'm sorry. 1160 00:45:49,059 --> 00:45:50,310 - I didn't know. - Nobody knows. 1161 00:45:50,394 --> 00:45:52,604 Who needs to know? Who gives a fuck? 1162 00:45:52,688 --> 00:45:53,939 I think you need a break. 1163 00:45:54,022 --> 00:45:55,524 That is what the sabbatical is for. 1164 00:45:55,607 --> 00:45:57,067 Then start it now. Walk away. 1165 00:45:57,150 --> 00:45:58,318 I have too much to do. 1166 00:45:58,402 --> 00:46:00,028 Let someone else talk to Duke. 1167 00:46:00,112 --> 00:46:01,780 No, that needs to come from me. 1168 00:46:01,863 --> 00:46:03,115 Why? 1169 00:46:03,198 --> 00:46:04,700 Because I owe him that. 1170 00:46:04,783 --> 00:46:06,535 It needs to come from a friend, not a stranger, 1171 00:46:06,618 --> 00:46:08,578 otherwise he's gonna bail and drop dead while I'm gone. 1172 00:46:08,662 --> 00:46:11,456 OK, wrap that up and then leave. 1173 00:46:11,540 --> 00:46:13,083 It's not just Duke. 1174 00:46:13,166 --> 00:46:14,835 I'm not sure that Al-Hashimi is fit to run this place. 1175 00:46:14,918 --> 00:46:16,044 - What's that supposed to mean? - I'm not sure. 1176 00:46:16,128 --> 00:46:17,671 I'm trying to figure that out. 1177 00:46:17,754 --> 00:46:18,922 Did you know that she wants to have two attendings 1178 00:46:19,006 --> 00:46:20,549 - on at all times? - No. 1179 00:46:20,632 --> 00:46:22,050 Is that something she's worked out with Gloria? 1180 00:46:22,134 --> 00:46:23,593 - I don't know. - I also don't know 1181 00:46:23,677 --> 00:46:24,928 if Langdon is going to relapse. 1182 00:46:25,012 --> 00:46:25,929 I don't know if Whitaker's gonna be able 1183 00:46:26,013 --> 00:46:27,306 to take care of my shit. 1184 00:46:27,389 --> 00:46:28,890 I don't know if Javadi's gonna give up on 1185 00:46:28,974 --> 00:46:30,767 what she's good at or if Samira's gonna flame out 1186 00:46:30,851 --> 00:46:32,185 because of some bullshit with her mother. 1187 00:46:32,269 --> 00:46:34,604 - Is there anything else? - Yeah, you. 1188 00:46:34,688 --> 00:46:36,815 I don't know about you running around 1189 00:46:36,898 --> 00:46:38,608 with a full syringe of Versed in your pocket. 1190 00:46:38,692 --> 00:46:40,986 I'm worried about the people that I care about. 1191 00:46:41,069 --> 00:46:43,405 We'll all manage until you come back. 1192 00:46:43,488 --> 00:46:44,573 We always do. 1193 00:46:44,656 --> 00:46:46,408 Yeah? What if I don't come back?