1 00:01:38,056 --> 00:01:39,390 Is it true? 2 00:01:39,391 --> 00:01:41,392 Simi told Hector that Dr. Deranjian said 3 00:01:41,393 --> 00:01:43,102 the hospital was up for sale. 4 00:01:43,103 --> 00:01:45,604 They might turn it into an ortho center with no ER. 5 00:01:45,605 --> 00:01:47,523 Oh, they're always threatening to shut us down, 6 00:01:47,524 --> 00:01:49,483 but they never do. 7 00:01:49,484 --> 00:01:51,069 Do you believe him? 8 00:01:52,445 --> 00:01:54,823 I never trust the doctors. 9 00:01:56,032 --> 00:01:57,783 Gloria is looking for you. 10 00:01:57,784 --> 00:01:59,284 No guts, no Gloria. 11 00:01:59,285 --> 00:02:00,994 Must be time for my weekly spanking. 12 00:02:00,995 --> 00:02:03,247 Try to be nice, for all our sakes. 13 00:02:03,248 --> 00:02:05,958 You sure you're cool being here today? 14 00:02:05,959 --> 00:02:09,169 Yeah. Why wouldn't I be? 15 00:02:09,170 --> 00:02:10,546 Well, if you need to talk... 16 00:02:10,547 --> 00:02:13,757 Yeah, I won't, but thanks. 17 00:02:13,758 --> 00:02:16,885 Where's Abbot? 18 00:02:16,886 --> 00:02:18,596 Getting some air. 19 00:02:30,442 --> 00:02:32,526 Hey. 20 00:02:32,527 --> 00:02:35,112 You OK in there? 21 00:02:35,113 --> 00:02:37,699 Uh, awesome. 22 00:02:39,868 --> 00:02:42,286 I'd like to say it goes away, but I had morning sickness 23 00:02:42,287 --> 00:02:43,997 for six months with my second daughter. 24 00:02:44,831 --> 00:02:46,206 Hell, who am I kidding? 25 00:02:46,207 --> 00:02:48,209 That one still worries me sick. 26 00:02:49,878 --> 00:02:52,963 - Thanks. - But it's worth it. 27 00:02:52,964 --> 00:02:54,673 You tell anybody yet? 28 00:02:54,674 --> 00:02:57,468 Oh, no. 29 00:02:57,469 --> 00:03:00,304 Not until I pass 12 weeks. Not this time. 30 00:03:00,305 --> 00:03:02,514 Nothing but good vibes. 31 00:03:02,515 --> 00:03:05,392 But just so you know, Robby's working today. 32 00:03:05,393 --> 00:03:07,019 Today's the day Doc Adamson died. 33 00:03:07,020 --> 00:03:08,938 He hasn't worked it in four years. 34 00:03:11,524 --> 00:03:13,150 So why is he here? 35 00:03:13,151 --> 00:03:15,444 All I know is, he still blames himself 36 00:03:15,445 --> 00:03:18,322 for Adamson's death, so if he's a little prickly today, 37 00:03:18,323 --> 00:03:20,200 give him a pass, OK? 38 00:03:21,493 --> 00:03:23,619 - Right. - Thank you. 39 00:03:23,620 --> 00:03:25,497 Hang in there, kid. 40 00:03:36,174 --> 00:03:37,634 Good morning, Jack. 41 00:03:40,220 --> 00:03:42,680 What are you doing here? 42 00:03:42,681 --> 00:03:44,306 I'm working. 43 00:03:44,307 --> 00:03:47,601 And you? 44 00:03:47,602 --> 00:03:49,812 Oh, I don't know. 45 00:03:49,813 --> 00:03:52,147 Had a guy come in. 46 00:03:52,148 --> 00:03:54,733 Hit by a drunk driver in a crosswalk. 47 00:03:54,734 --> 00:03:57,319 39-year-old vet. 48 00:03:57,320 --> 00:04:00,115 Survived three tours without a scratch. 49 00:04:02,575 --> 00:04:05,578 I spent the last two hours coding him. 50 00:04:07,163 --> 00:04:09,498 That's always a rough way to end the night. 51 00:04:09,499 --> 00:04:10,874 I must have had a reason 52 00:04:10,875 --> 00:04:12,626 at one time to keep coming back, 53 00:04:12,627 --> 00:04:17,923 but I can't think of it right now. 54 00:04:17,924 --> 00:04:21,218 Because this is the job that keeps on giving. 55 00:04:21,219 --> 00:04:22,803 Nightmares. 56 00:04:22,804 --> 00:04:24,763 Ulcers. 57 00:04:24,764 --> 00:04:26,808 Suicidal tendencies. 58 00:04:29,728 --> 00:04:32,271 Besides, if you jump on my shift, 59 00:04:32,272 --> 00:04:36,151 that's just rude, man. 60 00:04:42,615 --> 00:04:45,659 I hope I'm never one of your patients. 61 00:04:45,660 --> 00:04:49,413 That makes two of us, my friend. 62 00:04:49,414 --> 00:04:52,916 I got a pregnant teen coming back today for mifepristone 63 00:04:52,917 --> 00:04:55,419 and a small bowel obstruction waiting on surgery 64 00:04:55,420 --> 00:04:57,546 for the last three hours. 65 00:04:57,547 --> 00:05:00,174 Oh, and unfortunately, 66 00:05:00,175 --> 00:05:02,551 the Kraken is still boarding in BH. 67 00:05:02,552 --> 00:05:04,178 Still? 68 00:05:04,179 --> 00:05:06,096 Guy's been here for a week waiting on a psych bed. 69 00:05:06,097 --> 00:05:08,599 Yep. He's only getting worse. 70 00:05:08,600 --> 00:05:11,018 He's catching some Zyprexa Z's at the moment. 71 00:05:11,019 --> 00:05:15,023 But when he wakes up, God help you all. 72 00:05:16,691 --> 00:05:18,609 I wrote a note for the family of my dead vet, 73 00:05:18,610 --> 00:05:21,236 if anyone shows. 74 00:05:21,237 --> 00:05:23,238 Oh, and you got the med students 75 00:05:23,239 --> 00:05:26,367 and new interns starting today, so good luck with that. 76 00:05:26,368 --> 00:05:28,202 Lucky, lucky me. 77 00:05:28,203 --> 00:05:30,746 - Sir, come back here! - No more needles! 78 00:05:30,747 --> 00:05:31,872 - Oh! - Sir! 79 00:05:31,873 --> 00:05:34,041 - No more needles! - Stop! 80 00:05:34,042 --> 00:05:35,542 Sure you want to work today, huh? 81 00:05:35,543 --> 00:05:36,960 Help me! They're gonna hurt me! 82 00:05:36,961 --> 00:05:40,964 Sir, I promise nobody is going to hurt you. 83 00:05:40,965 --> 00:05:42,967 Sir! 84 00:05:45,679 --> 00:05:47,846 Who left this mess? 85 00:05:47,847 --> 00:05:50,265 They had a rough night. 86 00:05:50,266 --> 00:05:52,309 Good morning, sunshine. 87 00:05:52,310 --> 00:05:54,186 You obviously haven't seen this board. 88 00:05:54,187 --> 00:05:55,896 Oh, we've seen worse. 89 00:05:55,897 --> 00:05:57,898 Nothing like a little challenge every now and then 90 00:05:57,899 --> 00:05:59,525 to keep everybody on their toes. 91 00:05:59,526 --> 00:06:01,151 - Dr. Robinavitch? - Yep. 92 00:06:01,152 --> 00:06:03,654 Melissa King. I will be joining you today. 93 00:06:03,655 --> 00:06:05,072 I just came from two months at the VA. 94 00:06:05,073 --> 00:06:06,448 Hey, welcome to the Pitt. 95 00:06:06,449 --> 00:06:08,075 This is Dr. Jack Abbot. 96 00:06:08,076 --> 00:06:09,910 Nice to meet you. 97 00:06:09,911 --> 00:06:12,705 I can't tell you how excited I am to be here today, so... 98 00:06:12,706 --> 00:06:15,290 Talk to me at the end of the day. 99 00:06:15,291 --> 00:06:17,710 Ignore him. He had a rough night 100 00:06:17,711 --> 00:06:20,629 and is having an ongoing existential crisis. 101 00:06:20,630 --> 00:06:23,424 Don't worry, you'll get there soon enough. 102 00:06:23,425 --> 00:06:27,553 I married my second husband, Everett, in 1964. 103 00:06:27,554 --> 00:06:31,849 He unfortunately passed in 1976 from a heart attack 104 00:06:31,850 --> 00:06:34,727 while we were vacationing in Kissimmee, Florida. 105 00:06:34,728 --> 00:06:36,603 - It was awful. - Good morning. 106 00:06:36,604 --> 00:06:39,815 We're gonna round, Dr. Mohan. 107 00:06:39,816 --> 00:06:42,360 Excuse me, Estelle. I'll be right back. 108 00:06:44,112 --> 00:06:45,946 So you know we track every resident's 109 00:06:45,947 --> 00:06:47,322 patients seen per hour. 110 00:06:47,323 --> 00:06:48,991 I was just taking her history. 111 00:06:48,992 --> 00:06:50,534 It's a brief backstory about what brought them in, 112 00:06:50,535 --> 00:06:51,994 - not an autobiography. - I was almost done. 113 00:06:51,995 --> 00:06:55,372 You hadn't even made it to this century. 114 00:06:55,373 --> 00:06:58,375 Patients, they check in for registration here. 115 00:06:58,376 --> 00:07:01,587 A nurse eyeballs them, makes sure they're not dying. 116 00:07:01,588 --> 00:07:04,048 If not, they're moved to one of two triage rooms for vitals 117 00:07:04,049 --> 00:07:05,632 and a quick chair exam where you can order 118 00:07:05,633 --> 00:07:07,384 your labs and your X-rays. 119 00:07:07,385 --> 00:07:08,969 And then they come back to... 120 00:07:08,970 --> 00:07:11,138 Waiting room, until a bed opens up. 121 00:07:11,139 --> 00:07:12,639 For how long? 122 00:07:12,640 --> 00:07:14,475 Eight hours, if they're lucky. 123 00:07:14,476 --> 00:07:15,934 A lot of times, 12. 124 00:07:15,935 --> 00:07:18,520 Uh, is it always this busy? 125 00:07:18,521 --> 00:07:20,105 Uh, no. 126 00:07:20,106 --> 00:07:22,609 It gets a lot busier. 127 00:07:25,070 --> 00:07:26,320 Take this. 128 00:07:26,321 --> 00:07:27,363 Hey, Mateo. 129 00:07:27,364 --> 00:07:28,530 Good morning, Cass. 130 00:07:28,531 --> 00:07:30,449 This is Sherry. 131 00:07:30,450 --> 00:07:31,825 Hi. 132 00:07:31,826 --> 00:07:33,702 Sherry, I'm Dr. McKay. 133 00:07:33,703 --> 00:07:35,454 I have some student doctors with me today. 134 00:07:35,455 --> 00:07:36,872 Do you mind if they observe? 135 00:07:36,873 --> 00:07:39,333 - Sure. - OK. 136 00:07:39,334 --> 00:07:40,918 What's going on, Sherry? 137 00:07:40,919 --> 00:07:43,462 I-- 138 00:07:43,463 --> 00:07:46,048 I burned my hand on a Sterno. 139 00:07:46,049 --> 00:07:47,800 What were you doing with a Sterno? 140 00:07:47,801 --> 00:07:49,134 Uh, cooking. 141 00:07:49,135 --> 00:07:51,011 You were cooking with a Sterno? 142 00:07:51,012 --> 00:07:54,473 Yeah, we were making s'mores. 143 00:07:54,474 --> 00:07:55,516 That's sweet. 144 00:07:55,517 --> 00:07:58,394 My son loves s'mores. 145 00:07:58,395 --> 00:08:01,188 Uh, we've-- we've been here for hours, 146 00:08:01,189 --> 00:08:02,773 and I have to get them to school. 147 00:08:02,774 --> 00:08:04,817 Do you know how much longer this will take? 148 00:08:04,818 --> 00:08:07,986 Uh, yeah, let's see. 149 00:08:07,987 --> 00:08:10,406 - You take anything for the pain? - Uh, not yet. 150 00:08:10,407 --> 00:08:11,699 1,000 of Tylenol, 151 00:08:11,700 --> 00:08:12,908 400 ibuprofen, and saline dressing? 152 00:08:12,909 --> 00:08:14,993 Yes, please. 153 00:08:14,994 --> 00:08:16,704 McKay, we're gonna round. 154 00:08:16,705 --> 00:08:18,872 And the fun begins. 155 00:08:18,873 --> 00:08:20,541 All right, Sherry, we're gonna patch you up 156 00:08:20,542 --> 00:08:23,127 and get you out of here as soon as possible, OK? 157 00:08:23,128 --> 00:08:24,921 - I'll be back. - OK. 158 00:08:28,049 --> 00:08:31,343 As you can see, we have some new faces with us this morning. 159 00:08:31,344 --> 00:08:33,178 Good morning, good morning. Come on over. 160 00:08:33,179 --> 00:08:36,098 Starting with second-year resident Dr. Melissa King, 161 00:08:36,099 --> 00:08:37,558 fresh from the VA. 162 00:08:37,559 --> 00:08:39,143 Everyone calls me Mel. 163 00:08:39,144 --> 00:08:41,103 I'm so happy to be here. 164 00:08:41,104 --> 00:08:43,105 Trinity Santos, intern. 165 00:08:43,106 --> 00:08:45,441 Victoria Javadi, MS3. 166 00:08:45,442 --> 00:08:47,943 Uh, Dennis Whitaker, MS4. 167 00:08:47,944 --> 00:08:49,361 Welcome to the Pitt. I'm-- 168 00:08:49,362 --> 00:08:50,779 We've got two traumas from the T. 169 00:08:50,780 --> 00:08:52,406 - Five minutes out. - OK, copy that. 170 00:08:52,407 --> 00:08:54,074 Actually, this is the most important person 171 00:08:54,075 --> 00:08:55,534 that you're gonna meet today. This is Dana. 172 00:08:55,535 --> 00:08:56,952 She's our charge nurse. 173 00:08:56,953 --> 00:08:59,329 She is the ringleader of our circus. 174 00:08:59,330 --> 00:09:01,415 Do what she says when she says it. 175 00:09:01,416 --> 00:09:04,793 As you can see, our house is always packed, 176 00:09:04,794 --> 00:09:07,129 and our department is mostly clogged up with boarders. 177 00:09:07,130 --> 00:09:09,381 Those are admitted patients waiting for a room upstairs, 178 00:09:09,382 --> 00:09:11,300 sometimes for days. 179 00:09:11,301 --> 00:09:13,510 Beds are a very precious commodity around here, 180 00:09:13,511 --> 00:09:14,803 so please be quick and efficient 181 00:09:14,804 --> 00:09:15,804 with your workups. 182 00:09:15,805 --> 00:09:17,264 What else? 183 00:09:17,265 --> 00:09:18,807 We treat the sicker patients back here, 184 00:09:18,808 --> 00:09:20,476 but please keep your eye on that waiting room. 185 00:09:20,477 --> 00:09:23,228 Make sure nobody's gonna die out there. 186 00:09:23,229 --> 00:09:25,731 Your senior residents are Dr. Collins 187 00:09:25,732 --> 00:09:27,399 and Dr. Langdon. 188 00:09:27,400 --> 00:09:30,110 You report to them, and they report to me. 189 00:09:30,111 --> 00:09:31,612 OK? Great. 190 00:09:31,613 --> 00:09:32,946 Senior residents, you got your sign-outs? 191 00:09:32,947 --> 00:09:34,281 - Yep. - Yep. 192 00:09:34,282 --> 00:09:37,326 OK. Let's do this. 193 00:09:37,327 --> 00:09:39,828 Virgil Straker. 194 00:09:39,829 --> 00:09:42,706 9mm GSW to the left shoulder. 195 00:09:42,707 --> 00:09:44,917 CT angiogram negative, surgery wants to admit 196 00:09:44,918 --> 00:09:46,627 for overnight observation. 197 00:09:46,628 --> 00:09:49,004 Good vitals. They repeat a crit? 198 00:09:49,005 --> 00:09:50,547 Stable crits every two hours times three. 199 00:09:50,548 --> 00:09:52,466 Discharge on Ceftin, recheck tomorrow. 200 00:09:52,467 --> 00:09:54,426 He'll get way more rest at home. 201 00:09:54,427 --> 00:09:56,428 Good morning, Mr. Straker. You want to go home? 202 00:09:56,429 --> 00:09:58,180 - Hell yeah. - OK. 203 00:09:58,181 --> 00:09:59,598 Hey. Hey, Ro. 204 00:09:59,599 --> 00:10:01,685 Hey, Ro, I'm finally getting out of here! 205 00:10:03,687 --> 00:10:05,562 All right, Murphy Rottenstein. 206 00:10:05,563 --> 00:10:07,398 48-year-old woman with cirrhosis 207 00:10:07,399 --> 00:10:08,816 and upper GI bleed. 208 00:10:08,817 --> 00:10:11,568 Intubated and stable after one unit. 209 00:10:11,569 --> 00:10:13,195 Awaiting ICU bed. 210 00:10:13,196 --> 00:10:15,072 Hey, Doc. 211 00:10:15,073 --> 00:10:17,825 And we all know Louie Cloverfield. 212 00:10:17,826 --> 00:10:21,620 Blood alcohol of .420 at 11:00 PM. 213 00:10:21,621 --> 00:10:23,580 - I've been cutting back. - How is he still breathing? 214 00:10:23,581 --> 00:10:25,165 That's a lethal dose for you and me. 215 00:10:25,166 --> 00:10:26,709 That's happy hour for Louie. 216 00:10:26,710 --> 00:10:28,460 Sobered up. Had two rounds of lorazepam. 217 00:10:28,461 --> 00:10:31,672 Hold out your hands for me, Louie. 218 00:10:31,673 --> 00:10:33,298 - Another two of lorazepam. - On it. 219 00:10:33,299 --> 00:10:34,425 And a script for Librium. 220 00:10:34,426 --> 00:10:35,551 It's good to see you, Louie. 221 00:10:35,552 --> 00:10:37,678 It's always a pleasure, Doc. 222 00:10:37,679 --> 00:10:39,763 Bar fight with complete avulsion 223 00:10:39,764 --> 00:10:41,765 of tooth number eight. 224 00:10:41,766 --> 00:10:43,434 Smile, Charlie. 225 00:10:43,435 --> 00:10:46,520 Oh! Where's your tooth, Charlie? 226 00:10:46,521 --> 00:10:48,439 Fuck if I know. 227 00:10:48,440 --> 00:10:50,983 Cancel the discharge. Order a chest X-ray. 228 00:10:50,984 --> 00:10:52,526 Got to rule out aspiration. 229 00:10:52,527 --> 00:10:55,195 Incoming! 230 00:10:55,196 --> 00:10:56,947 42-year-old male, Sam Wallace. 231 00:10:56,948 --> 00:10:58,782 Blunt head with agonal respirations. 232 00:10:58,783 --> 00:11:00,534 Dropped down on the T tracks. Couldn't tube him. 233 00:11:00,535 --> 00:11:02,036 - LMA in place. - Suicide attempt? 234 00:11:02,037 --> 00:11:04,038 Rescue. He's a good Samaritan. 235 00:11:04,039 --> 00:11:06,165 Took a spill helping a woman who fell off the track. 236 00:11:06,166 --> 00:11:08,042 - She's right behind us. - OK. Trauma one. Go ahead. 237 00:11:08,043 --> 00:11:09,251 Copy. 238 00:11:09,252 --> 00:11:11,420 Come on. 239 00:11:11,421 --> 00:11:12,838 Woman fell from T platform. 240 00:11:12,839 --> 00:11:14,715 Good vitals and no head injuries. 241 00:11:14,716 --> 00:11:16,300 Degloving injury, right lower leg 242 00:11:16,301 --> 00:11:18,635 with open fracture dislocation to the ankle. 243 00:11:18,636 --> 00:11:20,137 Whoa. OK. 244 00:11:20,138 --> 00:11:22,015 Trauma two. Trauma two. Let's go! 245 00:11:28,980 --> 00:11:30,981 How are we doing? We ready? 246 00:11:30,982 --> 00:11:32,524 OK, here we go. Ready? 247 00:11:32,525 --> 00:11:35,486 One, two, three. 248 00:11:35,487 --> 00:11:36,820 Good breath sounds bilaterally, 249 00:11:36,821 --> 00:11:38,364 but we need to protect... 250 00:11:38,365 --> 00:11:39,823 Apparently he jumped down to save the lady. 251 00:11:39,824 --> 00:11:41,367 When he climbed back up, he slipped, 252 00:11:41,368 --> 00:11:43,160 - fell back, and hit his head. - OK, thanks. 253 00:11:43,161 --> 00:11:44,661 Uh, Mel, right? 254 00:11:44,662 --> 00:11:46,372 I need you on the E-FAST. 255 00:11:46,373 --> 00:11:48,248 Pupils 4 millimeters and reactive. 256 00:11:48,249 --> 00:11:50,084 OK, that's encouraging. 257 00:11:50,085 --> 00:11:52,086 - What do you want for meds? - 120 ketamine, 80 of rock. 258 00:11:52,087 --> 00:11:54,505 - A-fib on a monitor. - Courses clear. 259 00:11:54,506 --> 00:11:56,507 That's a lot more blood than expected. 260 00:11:56,508 --> 00:11:59,802 Um, he's probably anticoagulated for A-fib. 261 00:11:59,803 --> 00:12:01,845 Check his medical records, see if he's on a DOAC. 262 00:12:01,846 --> 00:12:04,431 Stand by with four-factor PCC if there's a brain bleed. 263 00:12:04,432 --> 00:12:06,475 What's in the PCC, Mel? 264 00:12:06,476 --> 00:12:09,520 Uh, clotting factors two, seven, nine, and ten. 265 00:12:09,521 --> 00:12:11,355 OK. Be right back. 266 00:12:11,356 --> 00:12:12,981 50 of fent didn't touch her. 267 00:12:12,982 --> 00:12:14,566 Did she faint or did she trip off the platform? 268 00:12:14,567 --> 00:12:16,235 Nobody knows. 269 00:12:16,236 --> 00:12:17,569 The other guy jumped down, pulled her off the tracks 270 00:12:17,570 --> 00:12:18,654 just as the train was rolling in. 271 00:12:18,655 --> 00:12:19,947 Isolated injury to the foot. 272 00:12:19,948 --> 00:12:21,281 The train ran over her foot? 273 00:12:21,282 --> 00:12:22,282 Got caught between the platform 274 00:12:22,283 --> 00:12:23,450 and the incoming train. 275 00:12:23,451 --> 00:12:24,827 Ma'am? Ma'am, what's your name? 276 00:12:24,828 --> 00:12:26,161 All right, type 3 open fracture. 277 00:12:26,162 --> 00:12:27,955 Two grams Cefazolin, 400 of gent. 278 00:12:27,956 --> 00:12:29,790 Do you speak any English? 279 00:12:29,791 --> 00:12:31,709 Airway and breathing are perfect. 280 00:12:31,710 --> 00:12:33,252 As is circulation. 281 00:12:33,253 --> 00:12:35,629 BP 140 over 85. 282 00:12:35,630 --> 00:12:38,173 Students, what might have made her faint on the platform? 283 00:12:38,174 --> 00:12:39,591 - Uh, TIA, CVA. - Could be an arrhythmia, 284 00:12:39,592 --> 00:12:41,343 - cardiac event. - So she needs... 285 00:12:41,344 --> 00:12:42,928 - Hed CT. - EKG and troponin. 286 00:12:42,929 --> 00:12:44,430 - OK, good. - What do we got, party people? 287 00:12:44,431 --> 00:12:45,931 Subway train degloved her foot 288 00:12:45,932 --> 00:12:47,474 with an open fracture dislocation. 289 00:12:47,475 --> 00:12:48,976 Ooh, and I thought my heels were painful. 290 00:12:48,977 --> 00:12:50,728 - Hemodynamically stable. - E-FAST negative. 291 00:12:50,729 --> 00:12:52,271 Ma'am, I'm Dr. Yolanda Garcia. 292 00:12:52,272 --> 00:12:54,065 Any pain in your chest or belly? 293 00:12:56,860 --> 00:12:58,277 Can we please push the morphine? 294 00:12:58,278 --> 00:13:00,320 No, it could cloud her mental status. 295 00:13:00,321 --> 00:13:03,323 I can't do an exam like this. Push the damn morphine. 296 00:13:03,324 --> 00:13:04,908 We're doing a popliteal block. 297 00:13:04,909 --> 00:13:06,618 Numbs the lower leg, no side effects. 298 00:13:06,619 --> 00:13:07,953 Wonderful. Where's the other guy? 299 00:13:07,954 --> 00:13:09,455 Next door. He's a bit worse. 300 00:13:09,456 --> 00:13:10,831 Pan scan her. 301 00:13:10,832 --> 00:13:12,834 Let me know when she stops screaming. 302 00:13:16,004 --> 00:13:17,546 The cords are very anterior. 303 00:13:17,547 --> 00:13:19,340 Yeah, that's because we can't flex the neck. 304 00:13:19,341 --> 00:13:22,259 Keep the hockey stick straight up. 305 00:13:22,260 --> 00:13:24,136 - I'm in. - Good. Well done. 306 00:13:24,137 --> 00:13:25,471 Bring me up to speed. 307 00:13:25,472 --> 00:13:27,222 Intubated for agonal respirations. 308 00:13:27,223 --> 00:13:29,892 GCS 5. Probably anticoagulated. 309 00:13:29,893 --> 00:13:31,018 With what? 310 00:13:31,019 --> 00:13:32,144 First time here. 311 00:13:32,145 --> 00:13:33,771 There's no medical records. 312 00:13:33,772 --> 00:13:36,398 - Call for FFP? - No, we got four-factor PCC. 313 00:13:36,399 --> 00:13:38,192 80 of mannitol to reduce brain swelling, 314 00:13:38,193 --> 00:13:39,361 then right up to CT. 315 00:13:40,862 --> 00:13:42,237 Do me a favor. 316 00:13:42,238 --> 00:13:43,489 Swap out with Jesse for me, would you? 317 00:13:43,490 --> 00:13:44,907 Of course. 318 00:13:44,908 --> 00:13:46,450 Dr. Robinavitch, do you have a moment? 319 00:13:46,451 --> 00:13:48,077 I'm just a little busy right now, Gloria. 320 00:13:48,078 --> 00:13:49,537 One sec. 321 00:13:50,663 --> 00:13:52,414 Nerve block complete. 322 00:13:52,415 --> 00:13:53,957 Seems like it's starting to work. 323 00:13:53,958 --> 00:13:55,459 Swapping out, Jesse. 324 00:13:55,460 --> 00:13:56,960 Takes ten minutes for the full effect, 325 00:13:56,961 --> 00:13:58,671 and the Marcaine lasts a good four hours. 326 00:13:58,672 --> 00:14:00,422 She's next for CT. 327 00:14:00,423 --> 00:14:01,715 You have any idea what language that is? 328 00:14:01,716 --> 00:14:02,966 Definitely not Tagalog. 329 00:14:02,967 --> 00:14:04,760 Maybe Hindi or Urdu. 330 00:14:04,761 --> 00:14:06,303 I'm gonna go get language services. 331 00:14:06,304 --> 00:14:07,721 Don't you speak, like, five languages? 332 00:14:07,722 --> 00:14:09,306 Six, but that's not one of them. 333 00:14:09,307 --> 00:14:10,641 Six? 334 00:14:10,642 --> 00:14:11,642 And I thought Collins was smart. 335 00:14:11,643 --> 00:14:13,018 Oh, it's way too early 336 00:14:13,019 --> 00:14:14,561 for you to start being an ass, Langdon. 337 00:14:14,562 --> 00:14:16,105 Open hostility in front of the patient? 338 00:14:16,106 --> 00:14:17,648 She doesn't speak English. 339 00:14:17,649 --> 00:14:19,316 Judgmental and dismissive. 340 00:14:19,317 --> 00:14:20,776 How are we doing? 341 00:14:20,777 --> 00:14:22,945 - Vitals stable. - Unlike these two. 342 00:14:22,946 --> 00:14:25,280 Ooh, good for you. Princess made a joke. 343 00:14:25,281 --> 00:14:26,782 Why are you always an asshole? 344 00:14:26,783 --> 00:14:28,283 And I thank you for that beautiful blessing. 345 00:14:28,284 --> 00:14:30,536 - Namaste. - OK, do we have a phone 346 00:14:30,537 --> 00:14:31,870 or anything with a relative's name on it? 347 00:14:31,871 --> 00:14:33,956 EMT said the purse got obliterated 348 00:14:33,957 --> 00:14:36,625 when the subway ran over it. 349 00:14:36,626 --> 00:14:39,003 - Any way I can speak with her? - Highly doubt it. 350 00:14:39,004 --> 00:14:40,587 We don't know what language she speaks. 351 00:14:40,588 --> 00:14:44,550 Hey, um, any chance she jumped? 352 00:14:44,551 --> 00:14:46,260 She may have been pushed. 353 00:14:46,261 --> 00:14:47,678 - Jesus. - Yeah. 354 00:14:47,679 --> 00:14:49,346 Could be looking at a possible hate crime. 355 00:14:49,347 --> 00:14:50,682 I take it you're free now? 356 00:14:55,687 --> 00:14:57,187 We need to talk about your numbers. 357 00:14:57,188 --> 00:14:59,565 - Of people we've saved? - Metrics. 358 00:14:59,566 --> 00:15:01,900 Our door-to-balloon times beat federal standards. 359 00:15:01,901 --> 00:15:04,820 I'm talking about Press Ganey scores. 360 00:15:04,821 --> 00:15:06,613 Patient satisfaction. 361 00:15:06,614 --> 00:15:08,657 If they're still alive, they should be satisfied. 362 00:15:08,658 --> 00:15:11,952 Our goal is 36% very satisfied with their care. 363 00:15:11,953 --> 00:15:14,371 Your department is at 8. 364 00:15:14,372 --> 00:15:16,790 Do you know how likely patients are to recommend this hospital? 365 00:15:16,791 --> 00:15:18,208 This is an emergency department, 366 00:15:18,209 --> 00:15:19,918 not a Taco Bell. 367 00:15:19,919 --> 00:15:21,420 11%. 368 00:15:21,421 --> 00:15:22,796 Well, if you want people to be happier, 369 00:15:22,797 --> 00:15:24,465 don't make 'em wait for 12 hours. 370 00:15:24,466 --> 00:15:26,300 There's a nursing shortage across the country. 371 00:15:26,301 --> 00:15:28,344 Most of our patients are boarders 372 00:15:28,345 --> 00:15:31,096 who are waiting for a bed upstairs. 373 00:15:31,097 --> 00:15:32,723 We don't have the beds. 374 00:15:32,724 --> 00:15:34,350 That's bullshit. The beds are up there. 375 00:15:34,351 --> 00:15:35,642 You just don't want to hire the staff you need 376 00:15:35,643 --> 00:15:37,686 to care for them. 377 00:15:37,687 --> 00:15:40,272 Oh, Doc. Doc, it ain't working. 378 00:15:40,273 --> 00:15:42,441 Man, whatever they're giving me, it's not working. 379 00:15:42,442 --> 00:15:44,151 No response to mag citrate. 380 00:15:44,152 --> 00:15:46,528 Should I send in the Fleet? 381 00:15:46,529 --> 00:15:49,198 OK, sir, we're gonna try an enema. 382 00:15:49,199 --> 00:15:51,492 Like I said, there's a nursing shortage. 383 00:15:51,493 --> 00:15:52,868 Well, if you paid them a living wage, 384 00:15:52,869 --> 00:15:54,286 they'd be lining up to work here. 385 00:15:54,287 --> 00:15:55,788 Our budget can't support that. 386 00:15:55,789 --> 00:15:57,414 Here's a dirty little secret. 387 00:15:57,415 --> 00:15:58,874 The hospital saves money 388 00:15:58,875 --> 00:16:00,501 keeping patients down here in the Pitt. 389 00:16:00,502 --> 00:16:02,336 It's way cheaper than staffing upstairs. 390 00:16:02,337 --> 00:16:04,088 I have asked you repeatedly 391 00:16:04,089 --> 00:16:06,298 to stop referring to the emergency department 392 00:16:06,299 --> 00:16:08,592 as the Pitt--it is derogatory 393 00:16:08,593 --> 00:16:10,719 and incompatible to the institution's image. 394 00:16:10,720 --> 00:16:12,388 You know what's incompatible with the institution's image? 395 00:16:12,389 --> 00:16:14,056 Me speaking to the media 396 00:16:14,057 --> 00:16:15,849 about people who code in our waiting rooms 397 00:16:15,850 --> 00:16:17,601 and people who get shitty care in our hallways 398 00:16:17,602 --> 00:16:19,395 waiting for an ICU bed for days. 399 00:16:19,396 --> 00:16:21,397 I've heard about doctors who have tried that 400 00:16:21,398 --> 00:16:23,065 and find themselves out of work. 401 00:16:23,066 --> 00:16:24,441 Uh-huh. 402 00:16:24,442 --> 00:16:25,818 I know today is difficult for you. 403 00:16:25,819 --> 00:16:27,444 Every day is difficult down here. 404 00:16:27,445 --> 00:16:29,613 Boarding is a nationwide problem. 405 00:16:29,614 --> 00:16:32,074 Your predecessor, Adamson, sure as hell knew that. 406 00:16:32,075 --> 00:16:33,742 Or wasn't that something he taught you? 407 00:16:33,743 --> 00:16:36,161 Fuck. Wow. Really? 408 00:16:36,162 --> 00:16:37,955 Yes, really. 409 00:16:37,956 --> 00:16:39,873 Other hospitals are managing this crisis 410 00:16:39,874 --> 00:16:41,208 much more effectively. 411 00:16:41,209 --> 00:16:42,960 So you can either step up your game, 412 00:16:42,961 --> 00:16:44,629 or you can step aside. 413 00:16:55,849 --> 00:16:57,933 Good Samaritan dude has a small left temporal 414 00:16:57,934 --> 00:16:59,810 intraparenchymal bleed. 415 00:16:59,811 --> 00:17:01,937 No epidural, no subdural, no midline shift in the brain. 416 00:17:01,938 --> 00:17:03,480 Oh, that's good news. He could recover. 417 00:17:03,481 --> 00:17:04,898 CT can take her in five. 418 00:17:04,899 --> 00:17:06,650 Let's have a look. Bandage scissors? 419 00:17:06,651 --> 00:17:08,068 All right. 420 00:17:08,069 --> 00:17:10,070 If an artery is totally transected, 421 00:17:10,071 --> 00:17:12,031 the smooth muscle and the tunica media 422 00:17:12,032 --> 00:17:13,741 contracts with hemostasis. 423 00:17:13,742 --> 00:17:16,535 But if it's a partial cut, get out your umbrella. 424 00:17:16,536 --> 00:17:19,413 Grab a culture from the open fibula before you reduce. 425 00:17:19,414 --> 00:17:22,124 You're up. 426 00:17:22,125 --> 00:17:24,084 I'll stabilize the knee for the reduction. 427 00:17:24,085 --> 00:17:26,670 Dr. Langdon will be distracting distally 428 00:17:26,671 --> 00:17:29,548 before moving medially to clear the tibia. 429 00:17:29,549 --> 00:17:32,051 Good. 430 00:17:32,052 --> 00:17:33,345 Ready? 431 00:17:45,482 --> 00:17:47,776 Med student down. 432 00:17:48,860 --> 00:17:50,652 Good catch on Bar Fight Billy. 433 00:17:50,653 --> 00:17:52,654 There was an aspirated tooth on chest X-ray. 434 00:17:52,655 --> 00:17:54,365 Would have been dead in a week from a lung abscess 435 00:17:54,366 --> 00:17:55,532 had you let him be discharged. 436 00:17:55,533 --> 00:17:56,825 Good call on the pulmonary. 437 00:17:56,826 --> 00:17:58,660 Cardiac arrest, ETA 10 minutes. 438 00:17:58,661 --> 00:18:00,579 - Where should we put it? - Anywhere. 439 00:18:00,580 --> 00:18:02,748 We might have to put somebody in the hall. 440 00:18:02,749 --> 00:18:05,042 Dr. Robby? She, uh, took a fall. 441 00:18:05,043 --> 00:18:06,794 No, I-- I tripped on the gurney. 442 00:18:06,795 --> 00:18:08,088 I'm fine. 443 00:18:10,423 --> 00:18:12,341 Why don't you go get a cold drink 444 00:18:12,342 --> 00:18:14,885 in the staff lounge? 445 00:18:14,886 --> 00:18:16,303 I'm fine, really. I swear. 446 00:18:16,304 --> 00:18:18,180 Oh, I know, but it's hospital policy. 447 00:18:18,181 --> 00:18:19,932 Anytime someone gets a paper cut around here, 448 00:18:19,933 --> 00:18:21,726 we have to fill out a workers' comp report. 449 00:18:27,107 --> 00:18:28,817 Other way. 450 00:18:31,069 --> 00:18:33,112 I was fine until about two weeks ago, 451 00:18:33,113 --> 00:18:34,446 after the Rochester Marathon. 452 00:18:34,447 --> 00:18:36,824 OK. Any falls or injuries? 453 00:18:36,825 --> 00:18:38,784 Just tired. Sore muscles. 454 00:18:38,785 --> 00:18:40,911 Yeah, I'd be in bed for a month. 455 00:18:40,912 --> 00:18:42,496 Was this your first triathlon? 456 00:18:42,497 --> 00:18:43,622 God no. 457 00:18:43,623 --> 00:18:45,874 No, I do one every few months. 458 00:18:45,875 --> 00:18:47,793 Have you seen a doctor yet? 459 00:18:47,794 --> 00:18:49,878 Uh, no. 460 00:18:49,879 --> 00:18:51,672 I went for a run this morning. 461 00:18:51,673 --> 00:18:53,090 Had to quit after a minute. 462 00:18:53,091 --> 00:18:54,258 Pretty short of breath. 463 00:18:54,259 --> 00:18:56,844 This goes under your tongue. 464 00:18:56,845 --> 00:18:58,679 - No current meds, no allergies? - Mm-mm. 465 00:18:58,680 --> 00:19:00,806 We're gonna check a few labs and an EKG. 466 00:19:00,807 --> 00:19:03,018 - Draw a red and purple top. - Yep. 467 00:19:06,062 --> 00:19:08,564 Temp 98.2. 468 00:19:08,565 --> 00:19:10,275 Take a deep breath for me, Otis. 469 00:19:11,735 --> 00:19:13,570 Little pinprick now, OK? 470 00:19:17,198 --> 00:19:19,366 Otis? 471 00:19:19,367 --> 00:19:21,076 Otis. 472 00:19:21,077 --> 00:19:22,996 I didn't take him for a lightweight, huh? 473 00:19:25,749 --> 00:19:27,082 Oh, shit. No pulse. 474 00:19:27,083 --> 00:19:29,252 Crash cart! Lay him flat! 475 00:19:31,421 --> 00:19:33,214 - Let's check a rhythm. - Saline pads. 476 00:19:35,842 --> 00:19:37,635 Quick look paddles. 477 00:19:40,764 --> 00:19:42,181 V-tach. 478 00:19:42,182 --> 00:19:43,807 Charging at 200. 479 00:19:43,808 --> 00:19:45,059 Charged. 480 00:19:45,060 --> 00:19:46,394 Clear! 481 00:19:47,937 --> 00:19:49,772 All right, he's back to normal sinus. 482 00:19:49,773 --> 00:19:51,149 Need a gurney in here! 483 00:19:53,360 --> 00:19:55,152 So what's the plan? 484 00:19:55,153 --> 00:19:59,073 ICU when we can get a bed and admit for supportive care. 485 00:19:59,074 --> 00:20:02,284 Repeat head CT in three hours. 486 00:20:02,285 --> 00:20:04,453 Or sooner, if he blows a pupil. 487 00:20:04,454 --> 00:20:06,706 - Want a Keppra load? - Order's already in. 488 00:20:08,375 --> 00:20:09,584 Nice job. 489 00:20:11,878 --> 00:20:13,754 Do you think he'll wake up? 490 00:20:13,755 --> 00:20:15,839 Maybe. 491 00:20:15,840 --> 00:20:18,759 Maybe not. 492 00:20:18,760 --> 00:20:22,846 No good deed goes unpunished. 493 00:20:22,847 --> 00:20:25,850 Oh, has anyone, um, notified the family? 494 00:20:29,771 --> 00:20:31,438 I could try. 495 00:20:31,439 --> 00:20:33,899 Otis Williams. Healthy 31-year-old. 496 00:20:33,900 --> 00:20:36,485 V-tach arrest two weeks after triathlon. 497 00:20:36,486 --> 00:20:38,195 NSR with one shock. 498 00:20:38,196 --> 00:20:40,197 Pulse 98, BP 110 over 60. 499 00:20:40,198 --> 00:20:41,281 He's a little young for an MI. 500 00:20:41,282 --> 00:20:42,783 Exactly right, 501 00:20:42,784 --> 00:20:44,201 What's in the differential, Dr. Collins? 502 00:20:44,202 --> 00:20:46,912 Drug overdose, electrolytes, long QT-- 503 00:20:46,913 --> 00:20:48,872 ooh, Brugada syndrome, WPW... 504 00:20:48,873 --> 00:20:50,582 How you doing there, Otis? 505 00:20:50,583 --> 00:20:52,460 OK. What ha-- 506 00:20:53,128 --> 00:20:54,169 V-tach again. 507 00:20:54,170 --> 00:20:55,546 200 joules. 508 00:20:55,547 --> 00:20:58,799 Charged, and clear! 509 00:20:58,800 --> 00:21:00,718 Back in sinus. 510 00:21:00,719 --> 00:21:01,928 Otis? 511 00:21:04,514 --> 00:21:06,432 Otis? 512 00:21:06,433 --> 00:21:09,560 Oh, groaning's good. 5 of nasal O2, CBC, 513 00:21:09,561 --> 00:21:12,229 CMP, troponin, and D-dimer. 514 00:21:12,230 --> 00:21:13,605 What are you doing? 515 00:21:13,606 --> 00:21:15,357 One gram calcium gluconate, IV push. 516 00:21:15,358 --> 00:21:17,109 - We don't have the labs back. - Look at the monitor. 517 00:21:17,110 --> 00:21:18,485 Widened QRS and PT waves. 518 00:21:18,486 --> 00:21:20,029 - Hyperkalemia. - How'd he get that? 519 00:21:20,030 --> 00:21:21,739 Intense exercise caused muscle breakdown. 520 00:21:21,740 --> 00:21:23,073 Rhabdomyolysis knocked out his kidneys. 521 00:21:23,074 --> 00:21:24,199 Now he's not clearing potassium. 522 00:21:24,200 --> 00:21:25,576 I bet it's over 7.5. 523 00:21:25,577 --> 00:21:27,244 Wait two minutes for the i-STAT. 524 00:21:27,245 --> 00:21:28,746 If he arrests again, we might not get him back. 525 00:21:28,747 --> 00:21:30,205 If it's hypercalcemia, you could kill him. 526 00:21:30,206 --> 00:21:32,751 - Wait. - Oh, it's my ass, not yours. 527 00:21:43,386 --> 00:21:44,720 Pan scan is negative. 528 00:21:44,721 --> 00:21:46,388 That means you can admit to orthopedics. 529 00:21:46,389 --> 00:21:48,265 But there may have been a medical etiology 530 00:21:48,266 --> 00:21:50,100 - if she fainted. - That's not surgical. 531 00:21:50,101 --> 00:21:51,727 Get an internal medicine consult, 532 00:21:51,728 --> 00:21:53,979 or admit to medicine with ortho consulting. 533 00:21:53,980 --> 00:21:55,272 Either way, I'm off the case. 534 00:21:55,273 --> 00:21:57,524 OK. Thanks for nothing. 535 00:21:57,525 --> 00:22:00,444 Ancef's in. I'll grab the gent. 536 00:22:00,445 --> 00:22:02,237 Did we figure out what she's speaking? 537 00:22:02,238 --> 00:22:04,823 Last interpreter thought she might be from Pakistan. 538 00:22:04,824 --> 00:22:07,451 There are 77 languages in Pakistan. 539 00:22:07,452 --> 00:22:10,579 OK, well, I will buy lunch for whoever figures it out. 540 00:22:10,580 --> 00:22:12,039 Good luck. 541 00:22:12,040 --> 00:22:14,917 If you need me, I'll be saving lives. 542 00:22:14,918 --> 00:22:16,877 That was wicked. 543 00:22:16,878 --> 00:22:19,588 - That was gross. - Yeah. 544 00:22:19,589 --> 00:22:21,799 Too much for Little Miss Crash and Burn. 545 00:22:21,800 --> 00:22:23,342 - What'd you do with her? - Nothing. 546 00:22:23,343 --> 00:22:25,844 - I think she'll be fine. - Are you kidding? 547 00:22:25,845 --> 00:22:27,262 If that took her out, she'll be lucky to make it 548 00:22:27,263 --> 00:22:29,014 through this rotation. 549 00:22:29,015 --> 00:22:30,767 I got 50 bucks says she doesn't last through this shift. 550 00:22:32,602 --> 00:22:33,894 Come on. 551 00:22:33,895 --> 00:22:35,229 Put your money where your mouth is. 552 00:22:35,230 --> 00:22:37,815 Uh, no. I didn't say anything, OK? 553 00:22:37,816 --> 00:22:40,442 And I sure as hell don't have 50 bucks. 554 00:22:40,443 --> 00:22:41,860 I'll be this lady's age by the time 555 00:22:41,861 --> 00:22:43,112 I pay off my student loans. 556 00:22:43,113 --> 00:22:44,406 Not that you're-- 557 00:22:45,949 --> 00:22:47,700 Hey. 558 00:22:47,701 --> 00:22:50,244 You want to sell a kidney? 559 00:22:50,245 --> 00:22:53,497 I could get you 30K as soon as this weekend. 560 00:22:53,498 --> 00:22:56,583 That's just between you and me. 561 00:22:56,584 --> 00:22:57,877 Think about it. 562 00:23:02,590 --> 00:23:04,758 How you doing? 563 00:23:04,759 --> 00:23:06,468 Yeah. 564 00:23:06,469 --> 00:23:08,345 QRS has narrowed. 565 00:23:08,346 --> 00:23:09,388 Much better. 566 00:23:09,389 --> 00:23:11,265 Potassium is 7.7. 567 00:23:11,266 --> 00:23:13,517 Creatinine, 5.6. 568 00:23:13,518 --> 00:23:15,269 High potassium and renal failure. 569 00:23:15,270 --> 00:23:16,520 Just what you thought. 570 00:23:16,521 --> 00:23:18,272 It must be my lucky day. 571 00:23:18,273 --> 00:23:20,441 Ordering 10 units of regular insulin 572 00:23:20,442 --> 00:23:23,736 and 25 grams of glucose. 573 00:23:23,737 --> 00:23:25,612 Why insulin and glucose? 574 00:23:25,613 --> 00:23:27,364 Shift the potassium intracellularly. 575 00:23:27,365 --> 00:23:29,116 Exactly, but the definitive treatment is... 576 00:23:29,117 --> 00:23:30,617 Hemodialysis. I'll call renal 577 00:23:30,618 --> 00:23:32,536 and get a tech down with the machine. 578 00:23:32,537 --> 00:23:35,622 Have you ever seen a dialysis catheter inserted? 579 00:23:35,623 --> 00:23:37,416 Dr. Collins is gonna place a femoral Quinton 580 00:23:37,417 --> 00:23:38,584 under ultrasound guidance. 581 00:23:38,585 --> 00:23:39,752 It's an excellent way to learn. 582 00:23:39,753 --> 00:23:41,962 Oh, my chest. 583 00:23:41,963 --> 00:23:43,422 Yeah, we had to shock you. 584 00:23:43,423 --> 00:23:45,257 You're gonna be sore for a while. 585 00:23:45,258 --> 00:23:46,842 You shocked my heart? 586 00:23:46,843 --> 00:23:49,012 Long story. Dr. Collins will fill you in. 587 00:23:57,103 --> 00:23:59,356 You got a sec? 588 00:24:02,067 --> 00:24:03,650 You OK? 589 00:24:03,651 --> 00:24:05,569 Why wouldn't I be? Are you OK? 590 00:24:05,570 --> 00:24:07,405 Why wouldn't I be? 591 00:24:08,865 --> 00:24:10,407 You seem annoyed with me already, 592 00:24:10,408 --> 00:24:13,118 and I just got here. 593 00:24:13,119 --> 00:24:15,622 It's not always about you, Robby. 594 00:24:17,540 --> 00:24:19,375 Am I gonna be OK? 595 00:24:19,376 --> 00:24:20,918 Yeah. 596 00:24:20,919 --> 00:24:23,087 You just need to take it easy on yourself. 597 00:24:23,088 --> 00:24:26,590 Muscle breakdown and myoglobin damaged your kidneys. 598 00:24:26,591 --> 00:24:28,384 Why'd you shock my heart? 599 00:24:28,385 --> 00:24:31,011 When your kidneys don't work, potassium builds up 600 00:24:31,012 --> 00:24:35,516 and messes with the electrical activity in your heart. 601 00:24:35,517 --> 00:24:37,768 Can it happen again? 602 00:24:37,769 --> 00:24:39,728 We gave you medicine to lower your potassium, 603 00:24:39,729 --> 00:24:42,272 and you'll need dialysis to clear it all out. 604 00:24:42,273 --> 00:24:44,149 Then I'll be OK? 605 00:24:44,150 --> 00:24:45,401 Yeah. 606 00:24:45,402 --> 00:24:46,819 You might need a week or two 607 00:24:46,820 --> 00:24:49,446 for your kidneys to recover, but yeah. 608 00:24:49,447 --> 00:24:51,782 You really need to hydrate like crazy 609 00:24:51,783 --> 00:24:54,702 before and after a triathlon. 610 00:24:54,703 --> 00:24:58,372 Trust me, I won't let this happen again. 611 00:24:58,373 --> 00:25:01,000 Good. 612 00:25:01,001 --> 00:25:03,545 Be kind to yourself, OK? 613 00:25:13,763 --> 00:25:14,680 Oh, hey. 614 00:25:14,681 --> 00:25:16,515 Abbot's told me that he's got a pregnant teen 615 00:25:16,516 --> 00:25:17,975 coming back today for mifepristone. 616 00:25:17,976 --> 00:25:19,852 - Let me know when she gets here. - Yep. 617 00:25:19,853 --> 00:25:21,353 Bowel obstruction, still waiting 618 00:25:21,354 --> 00:25:23,105 on a surgery consult. What about Garcia? 619 00:25:23,106 --> 00:25:25,107 She was just here for the traumas. 620 00:25:25,108 --> 00:25:27,444 I think she was waiting for her attending to sign off. 621 00:25:29,571 --> 00:25:31,989 OK. 622 00:25:31,990 --> 00:25:34,658 Oh, one of the med students took a header. 623 00:25:34,659 --> 00:25:36,118 I parked her in the lounge under the guise 624 00:25:36,119 --> 00:25:37,578 of a work comp report. 625 00:25:37,579 --> 00:25:38,704 Will you just go in there, eyeball her, 626 00:25:38,705 --> 00:25:40,164 and make sure she's all right? 627 00:25:40,165 --> 00:25:41,248 She's gonna miss the morning arrival 628 00:25:41,249 --> 00:25:42,583 of the living dead. 629 00:25:42,584 --> 00:25:44,126 How many are we expecting? 630 00:25:44,127 --> 00:25:45,878 We were getting three, but one died en route. 631 00:25:45,879 --> 00:25:47,755 Don't know who's luckier, us or them. 632 00:25:47,756 --> 00:25:49,423 - What's open? - 14. 633 00:25:49,424 --> 00:25:51,050 89-year-old woman from a SNF. 634 00:25:51,051 --> 00:25:53,427 History of emphysema, CHF, MS. 635 00:25:53,428 --> 00:25:55,262 V-fib, unresponsive to three shocks. 636 00:25:55,263 --> 00:25:57,514 - Two rounds of epi. - What is that? 637 00:25:57,515 --> 00:25:59,058 LUCAS chest compression system. 638 00:25:59,059 --> 00:26:00,560 Robotic CPR. 639 00:26:03,188 --> 00:26:05,815 Everybody get a hold. One, two, three. 640 00:26:11,029 --> 00:26:12,821 Students are dropping like flies. 641 00:26:12,822 --> 00:26:14,531 Take a break. Ice the finger. 642 00:26:14,532 --> 00:26:16,909 You can count on getting a couple elderly patients 643 00:26:16,910 --> 00:26:19,536 every day around 7:30, after the nursing homes 644 00:26:19,537 --> 00:26:21,914 and assisted living facilities do their morning bed checks. 645 00:26:21,915 --> 00:26:24,083 You can practically set your watch. 646 00:26:24,084 --> 00:26:25,459 Was there an advanced directive? 647 00:26:25,460 --> 00:26:27,461 No, full code, per the nursing home. 648 00:26:27,462 --> 00:26:29,713 Seriously? 649 00:26:29,714 --> 00:26:32,257 LUCAS off. 650 00:26:32,258 --> 00:26:33,717 Still V-fib. 651 00:26:33,718 --> 00:26:35,260 LUCAS on. 652 00:26:35,261 --> 00:26:37,680 One more round of epi, one more shock, 653 00:26:37,681 --> 00:26:39,808 and then we call it? 654 00:26:43,353 --> 00:26:44,895 Joseph Spencer, 79. 655 00:26:44,896 --> 00:26:46,855 Fever and cough. From assisted living. 656 00:26:46,856 --> 00:26:49,608 He has a history of mild Alzheimer's. 657 00:26:49,609 --> 00:26:52,403 One, two, three. 658 00:26:52,404 --> 00:26:54,321 Heart rate 130. BP 90 over 60. 659 00:26:54,322 --> 00:26:56,490 Gave him 500 cc's normal saline. 660 00:26:56,491 --> 00:26:58,242 Hi, Mr. Spencer. I'm Dr. King. 661 00:26:58,243 --> 00:26:59,743 This is Dr. Collins. 662 00:26:59,744 --> 00:27:01,286 How are you feeling today? 663 00:27:01,287 --> 00:27:04,540 Is it dinnertime? I--I'm not really hungry. 664 00:27:04,541 --> 00:27:06,375 Do we have any paperwork from the facility? 665 00:27:06,376 --> 00:27:07,626 He has a POLST. 666 00:27:07,627 --> 00:27:09,128 IV fluids and medications are fine, 667 00:27:09,129 --> 00:27:11,171 but no intubation and no chest compressions. 668 00:27:11,172 --> 00:27:12,589 That's helpful. 669 00:27:12,590 --> 00:27:14,299 Coarse rhonchi here. 670 00:27:14,300 --> 00:27:16,635 Right middle lobe infiltrate. 671 00:27:16,636 --> 00:27:19,513 Temp 102. Call a code sepsis. 672 00:27:19,514 --> 00:27:21,015 - Mm-hmm. - Code? 673 00:27:21,016 --> 00:27:22,933 To make sure we check all of our boxes. 674 00:27:22,934 --> 00:27:25,102 The federal government audits our sepsis bundle performance 675 00:27:25,103 --> 00:27:26,812 and publishes the data online. 676 00:27:26,813 --> 00:27:28,689 Today, it better be perfect. 677 00:27:28,690 --> 00:27:31,650 Two sets of blood cultures, lactic acid, 678 00:27:31,651 --> 00:27:35,070 30 cc's per kilo NS, a gram of ceftriaxone, 679 00:27:35,071 --> 00:27:39,033 500 of azithromycin, repeat lactic in three hours. 680 00:27:39,034 --> 00:27:40,576 Nice. 681 00:27:40,577 --> 00:27:44,997 Charging, and... 682 00:27:44,998 --> 00:27:46,248 Stop. 683 00:27:46,249 --> 00:27:47,583 Call it. 684 00:27:47,584 --> 00:27:49,335 Nursing home just faxed us a DNR. 685 00:27:49,336 --> 00:27:51,128 Are you kidding me? 686 00:27:51,129 --> 00:27:52,921 Power off the defibrillator and the LUCAS. 687 00:27:52,922 --> 00:27:54,256 Complete waste of time and money. 688 00:27:54,257 --> 00:27:55,674 Who the hell works at that place? 689 00:27:55,675 --> 00:27:56,842 A nurse taking care of 60 patients 690 00:27:56,843 --> 00:27:58,552 who couldn't find the form. 691 00:27:58,553 --> 00:28:00,387 She called 911 so she could take care of the others. 692 00:28:00,388 --> 00:28:01,930 OK, let's move her to the viewing room 693 00:28:01,931 --> 00:28:04,433 - and notify the family. - Yep. 694 00:28:04,434 --> 00:28:07,895 One of the things we do here is to take a moment of silence 695 00:28:07,896 --> 00:28:11,482 when we lose a patient, to respect their humanity 696 00:28:11,483 --> 00:28:14,068 and also to remember that this was somebody's child 697 00:28:14,069 --> 00:28:18,239 or sibling or parent, friend. 698 00:28:28,583 --> 00:28:31,378 Oh. Ow, ow! 699 00:28:32,462 --> 00:28:34,129 I am so sorry. 700 00:28:34,130 --> 00:28:36,341 Maybe leave it on vibrate while you're working. 701 00:28:39,636 --> 00:28:41,887 - Later, Doc. - You behave yourself now. 702 00:28:41,888 --> 00:28:43,431 Always. 703 00:28:45,558 --> 00:28:48,143 Your med student's back on her feet. 704 00:28:48,144 --> 00:28:50,521 - How old's that kid? - I don't know. I didn't ask. 705 00:28:50,522 --> 00:28:51,897 What is she, some sort of savant? 706 00:28:51,898 --> 00:28:53,148 I don't know. Maybe. 707 00:28:53,149 --> 00:28:54,608 Dr. Robinavitch. 708 00:28:54,609 --> 00:28:56,026 I just wanted to apologize for any trouble 709 00:28:56,027 --> 00:28:57,403 my clumsiness might have caused. 710 00:28:57,404 --> 00:28:58,737 I feel ridiculous. 711 00:28:58,738 --> 00:29:00,072 Oh, I can't tell how many times 712 00:29:00,073 --> 00:29:01,365 I've hit my head on an overhead lamp. 713 00:29:01,366 --> 00:29:03,617 Twice I needed to get staples. 714 00:29:03,618 --> 00:29:05,744 Why don't you go work with Dr. McKay in triage? 715 00:29:05,745 --> 00:29:07,538 That would help both of us. 716 00:29:07,539 --> 00:29:10,040 Oh, I--I don't need special treatment. 717 00:29:10,041 --> 00:29:11,334 Good, because I don't give it. 718 00:29:14,212 --> 00:29:15,587 Look, I know I might look too young, 719 00:29:15,588 --> 00:29:17,756 but I studied my ass off to get here. 720 00:29:17,757 --> 00:29:19,883 Probably harder than the others. 721 00:29:19,884 --> 00:29:21,343 I earned this. 722 00:29:21,344 --> 00:29:23,512 OK, look, I respect your dedication 723 00:29:23,513 --> 00:29:25,389 and your determination, but while you're here, 724 00:29:25,390 --> 00:29:26,765 you're my responsibility. 725 00:29:26,766 --> 00:29:28,017 And when one of my responsibilities 726 00:29:28,018 --> 00:29:29,685 takes a header--wow! 727 00:29:29,686 --> 00:29:31,186 Abbot called for a surgical consult 728 00:29:31,187 --> 00:29:32,479 on the SBO three hours ago. 729 00:29:32,480 --> 00:29:33,731 You're very lucky they didn't perf. 730 00:29:33,732 --> 00:29:35,649 I'm here to see my daughter. 731 00:29:35,650 --> 00:29:37,109 I'm sorry, is that a patient? 732 00:29:37,110 --> 00:29:38,737 You're talking to her. 733 00:29:41,156 --> 00:29:42,573 Am I interrupting? 734 00:29:42,574 --> 00:29:44,158 No. 735 00:29:44,159 --> 00:29:46,326 No, we're done. We're good. 736 00:29:46,327 --> 00:29:48,162 Come find me when you're ready to present your next case. 737 00:29:48,163 --> 00:29:49,330 Thank you. 738 00:29:51,082 --> 00:29:53,083 So how's your first day going? 739 00:29:53,084 --> 00:29:54,376 - It's great. - Yeah? 740 00:29:54,377 --> 00:29:55,753 Yeah, really great. 741 00:29:55,754 --> 00:29:57,796 Hey, Crash, they're doing a dialysis 742 00:29:57,797 --> 00:29:59,590 catheter insertion in North One if you want to check it out. 743 00:29:59,591 --> 00:30:01,008 Mm-hmm. 744 00:30:01,009 --> 00:30:02,885 - That thing-- - Did she say Crash? 745 00:30:02,886 --> 00:30:04,136 No. 746 00:30:04,137 --> 00:30:05,846 No, no, it's not crash. 747 00:30:05,847 --> 00:30:08,433 Um, she said crush, 'cause I'm always crushing it. 748 00:30:11,061 --> 00:30:12,811 Um, thanks for coming down, Mom, but I've-- 749 00:30:12,812 --> 00:30:14,563 I've got a patient. 750 00:30:14,564 --> 00:30:15,648 Bye. 751 00:30:25,200 --> 00:30:26,825 What do you want? 752 00:30:26,826 --> 00:30:29,661 Um, I--I just wanted to make sure you're comfortable. 753 00:30:29,662 --> 00:30:34,249 I am taking a dump in a dustpan, 754 00:30:34,250 --> 00:30:36,210 so what's that fucking tell you? 755 00:30:36,211 --> 00:30:37,795 Um, I'm-- 756 00:30:37,796 --> 00:30:39,463 I'm clearly-- I'm clearly in the wrong room. 757 00:30:39,464 --> 00:30:40,464 - Yeah. - I'm sorry. 758 00:30:40,465 --> 00:30:41,966 Mm-hmm. 759 00:30:46,721 --> 00:30:49,515 So it would have been nice if someone had told me 760 00:30:49,516 --> 00:30:52,101 that Eileen Shamsi's daughter was one of our med students. 761 00:30:52,102 --> 00:30:54,436 What, and ruin the surprise? 762 00:30:54,437 --> 00:30:56,188 Was it as awkward as I hoped it would be? 763 00:30:56,189 --> 00:30:59,483 You--you have a mean streak in you, you know that? 764 00:30:59,484 --> 00:31:01,068 What's the deal with the body in 19? 765 00:31:01,069 --> 00:31:03,237 That's Abbot's MVC vet from last night. 766 00:31:03,238 --> 00:31:04,446 Still waiting on next of kin. 767 00:31:04,447 --> 00:31:06,073 - Supposedly on their way. - OK. 768 00:31:06,074 --> 00:31:07,533 Can we move him to the viewing room, at least? 769 00:31:07,534 --> 00:31:08,701 Nursing home DNR is heading there, 770 00:31:08,702 --> 00:31:09,993 joining last night's Jane Doe. 771 00:31:09,994 --> 00:31:11,578 Coroner's office is backed up. 772 00:31:11,579 --> 00:31:15,249 Well, then our morgue needs to take her, then. 773 00:31:15,250 --> 00:31:17,543 Perlah. 774 00:31:17,544 --> 00:31:19,128 Triathlete, Otis? 775 00:31:19,129 --> 00:31:20,212 Oh, he's stable. 776 00:31:20,213 --> 00:31:22,006 Repeat potassium is 6.1. 777 00:31:22,007 --> 00:31:24,008 Renal wrote the dialysis order. 778 00:31:24,009 --> 00:31:25,926 Tech should be down in 15 minutes. 779 00:31:25,927 --> 00:31:28,637 Good. Thank you. 780 00:31:28,638 --> 00:31:30,097 Language mystery solved yet? 781 00:31:30,098 --> 00:31:31,265 No. 782 00:31:31,266 --> 00:31:35,019 Hey, what's your take on dogs? 783 00:31:35,020 --> 00:31:36,478 In what context? 784 00:31:36,479 --> 00:31:38,188 For kids. 785 00:31:38,189 --> 00:31:40,816 Kids and puppies go together like fish and chips. 786 00:31:40,817 --> 00:31:42,192 Man's best friend, you know? 787 00:31:42,193 --> 00:31:43,485 Well, you don't have a dog. 788 00:31:43,486 --> 00:31:44,945 I don't have a best friend. 789 00:31:44,946 --> 00:31:46,613 - What am I? - You're my best resident. 790 00:31:46,614 --> 00:31:47,865 Big difference. 791 00:31:47,866 --> 00:31:49,658 Yeah, but we're still friends. 792 00:31:49,659 --> 00:31:52,494 Not if this conversation goes on much longer. 793 00:31:52,495 --> 00:31:54,538 I have a lethargic four-year-old, 794 00:31:54,539 --> 00:31:58,375 no PMH, no antecedent illness, no fever or vomiting. 795 00:31:58,376 --> 00:32:00,085 Parents just couldn't wake him up this morning. 796 00:32:00,086 --> 00:32:03,047 - What room? - Oh, South 15. 797 00:32:03,048 --> 00:32:05,090 There's no nuchal rigidity, 798 00:32:05,091 --> 00:32:09,678 no skin lesions, no focal neuro. 799 00:32:09,679 --> 00:32:12,681 He looks well fed and cared for. 800 00:32:12,682 --> 00:32:14,850 DKA from new-onset diabetes? 801 00:32:14,851 --> 00:32:16,477 No, BG 85. 802 00:32:16,478 --> 00:32:20,982 CBC, BMP, UA, and UDS ordered. 803 00:32:28,782 --> 00:32:31,784 Can you wake up for me, Tyler? 804 00:32:31,785 --> 00:32:33,494 He's not usually this sleepy? 805 00:32:33,495 --> 00:32:35,621 No, and he barely flinched for the blood test. 806 00:32:35,622 --> 00:32:37,122 He wakes up at 90 miles an hour 807 00:32:37,123 --> 00:32:38,791 and doesn't stop till he passes out at night. 808 00:32:38,792 --> 00:32:40,167 He passes out? 809 00:32:40,168 --> 00:32:42,127 No, he just means he goes all day. 810 00:32:42,128 --> 00:32:44,380 Any chance he could have ingested something? 811 00:32:44,381 --> 00:32:46,632 Any pills, vitamins, 812 00:32:46,633 --> 00:32:48,842 any prescriptions that may have been left around? 813 00:32:48,843 --> 00:32:51,220 No, that's all kept locked in the medicine cabinet. 814 00:32:51,221 --> 00:32:53,180 The whole house is childproof. 815 00:32:53,181 --> 00:32:55,933 Uh, what about alcohol? Anything left out? 816 00:32:55,934 --> 00:32:58,143 - No. - What about pets? 817 00:32:58,144 --> 00:32:59,645 No. 818 00:32:59,646 --> 00:33:01,605 So he's usually, like, quite active? 819 00:33:01,606 --> 00:33:04,441 - Very. - Um, any injuries lately? 820 00:33:04,442 --> 00:33:05,859 No. 821 00:33:05,860 --> 00:33:07,444 Hasn't bumped his head recently? 822 00:33:07,445 --> 00:33:09,113 Not that I'm aware of, but he does love 823 00:33:09,114 --> 00:33:10,364 roughhousing with Drew. 824 00:33:10,365 --> 00:33:11,699 But he never gets hurt. 825 00:33:11,700 --> 00:33:13,575 Oxygen level is normal. 826 00:33:13,576 --> 00:33:16,704 Good pulse and blood pressure. No signs of infection. 827 00:33:16,705 --> 00:33:18,664 We're gonna start with blood and urine tests, 828 00:33:18,665 --> 00:33:21,584 check for any metabolic abnormalities. 829 00:33:24,337 --> 00:33:26,922 It's really throbbing. 830 00:33:26,923 --> 00:33:28,173 Yeah, the blood's under pressure. 831 00:33:28,174 --> 00:33:30,676 Gotta drain it. 832 00:33:30,677 --> 00:33:32,261 No anesthesia, or-- 833 00:33:32,262 --> 00:33:35,180 I'll stop before I hit the nail bed. 834 00:33:35,181 --> 00:33:36,558 I hope. 835 00:33:39,853 --> 00:33:41,145 Hey, eyes down here. 836 00:33:41,146 --> 00:33:42,563 Watch and learn. 837 00:33:42,564 --> 00:33:44,356 I'm just looking who to see next. 838 00:33:44,357 --> 00:33:46,900 You're supposed to take them in the order they arrive. 839 00:33:46,901 --> 00:33:48,318 Yeah, I know how it works. 840 00:33:48,319 --> 00:33:50,404 OK. No need to cry about it. 841 00:33:50,405 --> 00:33:51,947 Do you want me to choose for you? 842 00:33:51,948 --> 00:33:53,283 No. 843 00:33:55,618 --> 00:33:57,619 Wow, pain's gone. 844 00:33:57,620 --> 00:33:58,871 - Thank you. - Yeah. 845 00:33:58,872 --> 00:34:00,289 All right. 846 00:34:00,290 --> 00:34:02,958 How about a 20-year-old cough in eight? 847 00:34:02,959 --> 00:34:05,085 Should be easy. Probably viral. 848 00:34:05,086 --> 00:34:06,920 I don't need an easy one. 849 00:34:06,921 --> 00:34:08,839 Suit yourself, Huckleberry. 850 00:34:08,840 --> 00:34:10,799 I'm gonna take the splitting headache. 851 00:34:10,800 --> 00:34:13,260 Maybe I'll catch a subarachnoid hemorrhage or something cool. 852 00:34:13,261 --> 00:34:15,095 Hey, why do you keep calling me that? 853 00:34:15,096 --> 00:34:16,221 Huckleberry? 854 00:34:16,222 --> 00:34:18,098 It's a term of endearment. 855 00:34:18,099 --> 00:34:19,433 It sounds like sarcasm. 856 00:34:19,434 --> 00:34:20,517 You think? 857 00:34:20,518 --> 00:34:23,354 Bordering on harassment. 858 00:34:23,355 --> 00:34:24,938 Where are you from? 859 00:34:24,939 --> 00:34:26,857 Broken Bow, Nebraska. 860 00:34:26,858 --> 00:34:28,776 Jesus, where the hell is that? 861 00:34:28,777 --> 00:34:31,278 It's about three and a half hours west of Omaha. 862 00:34:31,279 --> 00:34:33,739 Oh, yeah, just a little south of nowhere. 863 00:34:33,740 --> 00:34:35,074 What the hell do you do there? 864 00:34:35,075 --> 00:34:37,576 My parents have a farm, so... 865 00:34:37,577 --> 00:34:40,037 You're a farm boy? 866 00:34:40,038 --> 00:34:42,039 Yeah, I guess. 867 00:34:42,040 --> 00:34:44,876 I rest my case, Huckleberry. 868 00:34:50,924 --> 00:34:52,216 I'm so sorry, ma'am. 869 00:34:52,217 --> 00:34:54,386 We don't understand you. 870 00:34:58,807 --> 00:35:01,475 Oh. 871 00:35:01,476 --> 00:35:04,937 Me, I'm Dr. Heather Collins. 872 00:35:04,938 --> 00:35:07,856 I'm from here. 873 00:35:07,857 --> 00:35:09,441 Portland, Oregon. 874 00:35:09,442 --> 00:35:11,026 You. 875 00:35:11,027 --> 00:35:13,821 Where are you from? 876 00:35:13,822 --> 00:35:15,281 Uh-huh. 877 00:35:16,991 --> 00:35:19,159 Uh, China? India? 878 00:35:19,160 --> 00:35:20,285 I can't tell where you're pointing. 879 00:35:20,286 --> 00:35:21,579 Tajikistan? 880 00:35:23,748 --> 00:35:25,082 Nepal. 881 00:35:25,083 --> 00:35:26,500 Mm. 882 00:35:26,501 --> 00:35:28,920 - You're from Nepal. - Nepali. 883 00:35:34,259 --> 00:35:35,509 Mom's got a bad burn. 884 00:35:35,510 --> 00:35:37,219 Needs wound checks and hand therapy. 885 00:35:37,220 --> 00:35:40,139 And I got a sneaking suspicion she may be unhoused. 886 00:35:40,140 --> 00:35:42,141 I'll talk to her. We can offer some help. 887 00:35:42,142 --> 00:35:45,310 Thank you, I appreciate it. Ah, you're back. 888 00:35:45,311 --> 00:35:47,688 Dr. Robby suggested I might be of assistance. 889 00:35:47,689 --> 00:35:49,481 Yeah, I could use the company. 890 00:35:49,482 --> 00:35:52,026 Victoria Javadi, this is Kiara Alfaro. 891 00:35:52,027 --> 00:35:53,444 She's the department social worker, 892 00:35:53,445 --> 00:35:55,237 which pretty much makes her an angel. 893 00:35:55,238 --> 00:35:57,031 - Welcome. - Thanks. 894 00:35:57,032 --> 00:35:58,240 Thank you. 895 00:35:58,241 --> 00:36:00,117 So what rotation is this for you? 896 00:36:00,118 --> 00:36:01,201 Um, third. 897 00:36:01,202 --> 00:36:02,703 I've done OB-GYN and pedes. 898 00:36:02,704 --> 00:36:04,204 You have any favorites? 899 00:36:04,205 --> 00:36:05,581 Not really. 900 00:36:05,582 --> 00:36:07,374 Well, what are you leaning towards? 901 00:36:07,375 --> 00:36:09,251 I'm not really sure yet. 902 00:36:09,252 --> 00:36:11,045 OK, well, you have time. 903 00:36:11,046 --> 00:36:14,631 Uh, can I actually ask you a personal question? 904 00:36:14,632 --> 00:36:17,801 I'm 20, and I've earned the right to be here. 905 00:36:17,802 --> 00:36:19,428 Oh. 906 00:36:19,429 --> 00:36:21,430 Yeah, I don't--I don't doubt that for a minute. 907 00:36:21,431 --> 00:36:25,559 I--I was actually wondering if Dr. Eileen Shamsi from surgery 908 00:36:25,560 --> 00:36:27,686 is a friend or relative of yours. 909 00:36:27,687 --> 00:36:29,480 I saw you talking to her in the hall and I thought-- 910 00:36:29,481 --> 00:36:30,899 Yeah, she's my mother. 911 00:36:32,734 --> 00:36:33,734 Oh. 912 00:36:33,735 --> 00:36:35,444 Oh, wow. 913 00:36:35,445 --> 00:36:38,197 Oh, that's cool. 914 00:36:38,198 --> 00:36:40,824 - You're really only 20? - Yeah. 915 00:36:40,825 --> 00:36:43,202 And for the record, my-- my father also works here. 916 00:36:43,203 --> 00:36:44,661 He's an endocrinologist. 917 00:36:44,662 --> 00:36:46,039 Oh, so it's like a family business. 918 00:36:48,083 --> 00:36:50,125 I'm sorry. That was a joke. That was a joke. 919 00:36:50,126 --> 00:36:52,002 And I'm sure that comes with a lot of pressure. 920 00:36:52,003 --> 00:36:54,838 And as for the age thing, I'm a 42-year-old R2, 921 00:36:54,839 --> 00:36:58,467 so I have my own haters, trust me. 922 00:36:58,468 --> 00:36:59,718 OK. 923 00:36:59,719 --> 00:37:01,261 Um, sometimes when it gets busy, 924 00:37:01,262 --> 00:37:02,930 we'll help the nurses bring back patients. 925 00:37:02,931 --> 00:37:04,765 - OK. - Um, OK. 926 00:37:04,766 --> 00:37:06,475 Next to come back is Fred Saeta. 927 00:37:06,476 --> 00:37:08,268 - Knee pain after a fall. - Great. 928 00:37:08,269 --> 00:37:09,395 - Fred Sa-- - Doc. Hey, Doc. Hi. 929 00:37:09,396 --> 00:37:10,729 Hi. Doug Driscoll. 930 00:37:10,730 --> 00:37:12,147 Any chance someone could see me now? 931 00:37:12,148 --> 00:37:13,899 I've been here for, like, two hours. 932 00:37:13,900 --> 00:37:15,609 Unfortunately, Mr. Driscoll, there's a lot of patients 933 00:37:15,610 --> 00:37:17,236 still ahead of you, some of whom are severely ill. 934 00:37:17,237 --> 00:37:18,779 Yeah, and I got chest pains that woke me up 935 00:37:18,780 --> 00:37:20,072 - in the middle of the night. - Chest pain. 936 00:37:20,073 --> 00:37:21,699 - Yeah. - No, it's not plural. 937 00:37:21,700 --> 00:37:24,451 It's just chest pain, not chest pains. 938 00:37:24,452 --> 00:37:26,995 Yeah, and if I have more than one, it's chest pains. 939 00:37:26,996 --> 00:37:29,164 - Are you even a real doctor? - She's a student doctor. 940 00:37:29,165 --> 00:37:30,791 Yeah, well, keep her the hell away from me. 941 00:37:30,792 --> 00:37:33,168 I just need to see someone, OK? Not her. 942 00:37:33,169 --> 00:37:34,962 Isn't chest pain an emergency? I don't-- 943 00:37:34,963 --> 00:37:37,006 It looks here like you got an EKG 944 00:37:37,007 --> 00:37:39,216 five minutes after arrival, so it's not a heart attack. 945 00:37:39,217 --> 00:37:42,511 Yeah, but I'm supposed to get a chest X-ray and blood tests. 946 00:37:42,512 --> 00:37:45,055 Ah, and you are next in line for lab tech, OK? 947 00:37:45,056 --> 00:37:47,141 So listen for your name. Excuse me. 948 00:37:47,142 --> 00:37:49,143 Fred-- 949 00:37:49,144 --> 00:37:52,187 Actually, can you get me a wheelchair, please? 950 00:37:52,188 --> 00:37:53,981 Uh, hi. I'm--I'm Dr. McKay. 951 00:37:53,982 --> 00:37:55,649 What's going on? 952 00:37:55,650 --> 00:37:57,443 I, uh, found her on the floor in the bathroom. 953 00:37:57,444 --> 00:37:59,445 - She can't stop puking. - What's her name? 954 00:37:59,446 --> 00:38:01,447 Theresa. She's my mom. 955 00:38:01,448 --> 00:38:02,948 Theresa? 956 00:38:02,949 --> 00:38:03,991 Theresa, are you taking any medication? 957 00:38:03,992 --> 00:38:05,242 No. 958 00:38:05,243 --> 00:38:06,243 Any previous stomach problems? 959 00:38:06,244 --> 00:38:07,411 No. 960 00:38:07,412 --> 00:38:08,829 When did the vomiting begin? 961 00:38:08,830 --> 00:38:10,414 Um, last night. 962 00:38:10,415 --> 00:38:12,333 - Last night. - Oh, come on! 963 00:38:12,334 --> 00:38:15,085 Do you have any dizziness or fatigue? 964 00:38:15,086 --> 00:38:17,046 Mystery solved. 965 00:38:17,047 --> 00:38:19,757 Our lady with the degloved foot is Nepali. 966 00:38:19,758 --> 00:38:22,551 Oh, hey, congratulations. 967 00:38:22,552 --> 00:38:24,470 Otis's BP is crashing. 70 over 50. 968 00:38:24,471 --> 00:38:27,140 Still waiting for dialysis. 969 00:38:29,601 --> 00:38:31,643 How you doing there, Otis? 970 00:38:31,644 --> 00:38:33,020 - Not so good. - 50 liters. 971 00:38:33,021 --> 00:38:34,397 Non-rebreather, please. 972 00:38:39,819 --> 00:38:41,653 Oh, crap. 973 00:38:41,654 --> 00:38:43,781 Diastolic collapse of the right atrium and right ventricle. 974 00:38:43,782 --> 00:38:45,282 Tamponade from uremic effusion. 975 00:38:45,283 --> 00:38:46,658 - That's why his BP is low? - Yep. 976 00:38:46,659 --> 00:38:48,035 Too much fluid and pressure 977 00:38:48,036 --> 00:38:49,703 around the heart, chambers can't fill. 978 00:38:49,704 --> 00:38:51,121 Otis, you've got some fluid around your heart. 979 00:38:51,122 --> 00:38:52,289 We need to get it off. 980 00:38:52,290 --> 00:38:53,874 What's happening? 981 00:38:53,875 --> 00:38:55,959 25 of Propofol, 10 cc's of lidocaine with epi, 982 00:38:55,960 --> 00:38:57,336 pericardiocentesis tray. 983 00:38:57,337 --> 00:38:58,754 I have to get that from central. 984 00:38:58,755 --> 00:39:00,089 No, no. Just open a central line kit. 985 00:39:00,090 --> 00:39:01,674 Dr. Santos, take the head of the bed 986 00:39:01,675 --> 00:39:03,092 and bag him if he stops breathing, 987 00:39:03,093 --> 00:39:04,927 compressions if we lose the carotid. 988 00:39:04,928 --> 00:39:06,470 Prep and drape the subxiphoid, please. 989 00:39:06,471 --> 00:39:08,639 - 10 cc's of 1% with. - Chlorhexidine here. 990 00:39:08,640 --> 00:39:10,933 - 25 or 27-gauge? - Long 25, 25. 991 00:39:10,934 --> 00:39:13,894 Thank you. 992 00:39:13,895 --> 00:39:16,438 Injecting lidocaine. 993 00:39:16,439 --> 00:39:18,816 Pressure down. 60 over 40. 994 00:39:18,817 --> 00:39:20,985 Right. 995 00:39:22,779 --> 00:39:24,446 Wait, you can't ultrasound and place. 996 00:39:24,447 --> 00:39:26,031 I know, that's why I'm taking the probe. 997 00:39:26,032 --> 00:39:27,533 18-gauge thin wall 998 00:39:27,534 --> 00:39:29,410 on a 60 cc syringe, please, Dr. Collins. 999 00:39:29,411 --> 00:39:31,453 Let's go. 1000 00:39:31,454 --> 00:39:34,665 You're going in right over the center of my probe, 1001 00:39:34,666 --> 00:39:36,875 advancing very slowly. 1002 00:39:36,876 --> 00:39:39,712 We're looking for the hyperechoic tip. 1003 00:39:39,713 --> 00:39:42,256 Very, very slowly. Do not hit that heart. 1004 00:39:42,257 --> 00:39:43,674 Dr. Santos, do you see that sea of black? 1005 00:39:43,675 --> 00:39:45,175 That's the effusion. 1006 00:39:45,176 --> 00:39:46,802 We're looking for a little white dot. 1007 00:39:46,803 --> 00:39:48,554 There it is. 1008 00:39:48,555 --> 00:39:50,180 Got it. 1009 00:39:50,181 --> 00:39:51,515 Aspirating. 1010 00:39:51,516 --> 00:39:53,476 3 cc's should be enough. 1011 00:39:56,646 --> 00:39:57,855 Good. 1012 00:39:57,856 --> 00:39:59,148 Next, we'll place the guide wire, 1013 00:39:59,149 --> 00:40:01,108 and then the triple lumen catheter. 1014 00:40:01,109 --> 00:40:02,276 Pulse ox is 99. 1015 00:40:02,277 --> 00:40:05,571 Pressure is up. 124 over 78. 1016 00:40:05,572 --> 00:40:09,033 Looks like things are back to normal. 1017 00:40:09,034 --> 00:40:10,451 That was cool. 1018 00:40:10,452 --> 00:40:12,578 Four Zofrans on board. 1019 00:40:12,579 --> 00:40:15,414 That should stop the nausea. 1020 00:40:15,415 --> 00:40:17,458 David, have you had any vomiting? 1021 00:40:17,459 --> 00:40:21,462 - No. - Anyone else sick at home? 1022 00:40:21,463 --> 00:40:23,714 No, it's just us. 1023 00:40:23,715 --> 00:40:27,092 My husband passed away a few years ago, from COVID. 1024 00:40:27,093 --> 00:40:29,678 Oh, I'm so sorry. 1025 00:40:29,679 --> 00:40:31,181 Potassium, 3.1. 1026 00:40:32,974 --> 00:40:34,767 Is that bad? 1027 00:40:34,768 --> 00:40:36,101 It can cause heart problems. 1028 00:40:36,102 --> 00:40:37,436 But we're gonna correct it, OK? 1029 00:40:37,437 --> 00:40:40,064 10 in the bag, 20 PO. 1030 00:40:40,065 --> 00:40:42,775 Javadi, any questions? 1031 00:40:42,776 --> 00:40:44,401 Um... 1032 00:40:44,402 --> 00:40:46,236 uh, David, have you two traveled 1033 00:40:46,237 --> 00:40:47,780 out of the country recently? 1034 00:40:47,781 --> 00:40:50,157 We never go anywhere. 1035 00:40:50,158 --> 00:40:52,410 Is she gonna have to stay here? 1036 00:40:54,621 --> 00:40:56,163 If the rest of the tests are good, 1037 00:40:56,164 --> 00:40:59,501 and she responds to treatment, she can go home. 1038 00:41:06,508 --> 00:41:08,967 Mr. Milton, my name is Dennis Whitaker. 1039 00:41:08,968 --> 00:41:10,886 I'm one of the student doctors here. 1040 00:41:10,887 --> 00:41:12,221 I'll be seeing you first. 1041 00:41:12,222 --> 00:41:13,222 Nice to meet you. 1042 00:41:13,223 --> 00:41:15,599 BP's 150 over 90. 1043 00:41:15,600 --> 00:41:17,559 That's just a touch high. 1044 00:41:17,560 --> 00:41:19,478 I forgot to take my damn enalapril this morning. 1045 00:41:19,479 --> 00:41:20,979 Oh, we'll get that for you. 1046 00:41:20,980 --> 00:41:22,898 Tell me about this belly pain. 1047 00:41:22,899 --> 00:41:26,527 Uh, it started about here. 1048 00:41:26,528 --> 00:41:29,988 Um, woke me up at, like, 2:00 AM. 1049 00:41:29,989 --> 00:41:31,782 Pretty intense. 1050 00:41:31,783 --> 00:41:33,909 Lasted about an hour. 1051 00:41:33,910 --> 00:41:35,285 Now it's gone. 1052 00:41:35,286 --> 00:41:36,787 Any fever or vomiting? 1053 00:41:36,788 --> 00:41:38,789 Nah, I never get sick. 1054 00:41:38,790 --> 00:41:40,124 OK. 1055 00:41:40,125 --> 00:41:42,167 Uh, what did you eat last night? 1056 00:41:42,168 --> 00:41:43,961 Oh, it was my wife's birthday. 1057 00:41:43,962 --> 00:41:45,796 I took her out to Sullivan's for a steak. 1058 00:41:45,797 --> 00:41:47,172 Oh. 1059 00:41:47,173 --> 00:41:49,008 Well, the exam is pretty benign. 1060 00:41:49,009 --> 00:41:50,801 I'm gonna test for gallstones. 1061 00:41:50,802 --> 00:41:55,931 If there is a stone and you eat fatty food, 1062 00:41:55,932 --> 00:41:59,852 there can be pain when the gallbladder contracts. 1063 00:41:59,853 --> 00:42:01,103 Oh. 1064 00:42:01,104 --> 00:42:02,771 Uh, bingo. 1065 00:42:02,772 --> 00:42:05,649 One stone. There it is. 1066 00:42:05,650 --> 00:42:07,735 Do I need surgery? 1067 00:42:07,736 --> 00:42:10,320 Uh, you should be able to manage with a low-fat diet. 1068 00:42:10,321 --> 00:42:13,282 But we'll send off labs for liver and pancreas. 1069 00:42:13,283 --> 00:42:16,285 Just let us know if you have any more pain. 1070 00:42:16,286 --> 00:42:17,703 OK. 1071 00:42:17,704 --> 00:42:19,621 Thanks. 1072 00:42:19,622 --> 00:42:21,749 Yeah, you bet. 1073 00:42:21,750 --> 00:42:23,834 Great. 1074 00:42:23,835 --> 00:42:25,669 You want an EKG? 1075 00:42:25,670 --> 00:42:27,379 For? 1076 00:42:27,380 --> 00:42:30,132 Heart attacks can present as upper abdominal pain. 1077 00:42:30,133 --> 00:42:31,884 Um, yeah. 1078 00:42:31,885 --> 00:42:33,427 No, yeah, that's a great idea. 1079 00:42:33,428 --> 00:42:35,847 Thank you. 1080 00:42:48,651 --> 00:42:50,069 I'm going as fast as I can. 1081 00:42:50,070 --> 00:42:51,403 I'm picking up two more patients. 1082 00:42:51,404 --> 00:42:54,365 I didn't say anything. 1083 00:42:54,366 --> 00:42:56,450 I, uh--I need a fresh set of eyes. 1084 00:42:56,451 --> 00:42:58,327 On what? 1085 00:42:58,328 --> 00:43:00,245 54-year-old woman brought in with intractable vomiting 1086 00:43:00,246 --> 00:43:01,705 by her 18-year-old son. 1087 00:43:01,706 --> 00:43:04,292 I'm, um-- I'm getting a weird vibe. 1088 00:43:06,252 --> 00:43:07,920 How so? 1089 00:43:07,921 --> 00:43:09,880 Like, I don't know, maybe she was given something. 1090 00:43:09,881 --> 00:43:12,466 Some sort of elder abuse. 1091 00:43:12,467 --> 00:43:14,635 There's just a strange dynamic I can't quite figure out. 1092 00:43:14,636 --> 00:43:16,638 You're really good at sussing out that sort of thing. 1093 00:43:18,014 --> 00:43:19,349 I don't know about that. 1094 00:43:22,018 --> 00:43:25,145 Uh, excuse me, Dr. Langdon. 1095 00:43:25,146 --> 00:43:27,856 Almost all of our labs are back on sleeping boy Tyler. 1096 00:43:27,857 --> 00:43:30,567 All 100% normal. 1097 00:43:30,568 --> 00:43:32,070 What are we missing? 1098 00:43:35,907 --> 00:43:37,282 Is he waking up? 1099 00:43:37,283 --> 00:43:39,576 No, he's-- he's still fast asleep. 1100 00:43:39,577 --> 00:43:42,121 Most of the lab results are in, and they look great. 1101 00:43:42,122 --> 00:43:44,206 No abnormal blood count, no, uh, 1102 00:43:44,207 --> 00:43:46,917 electrolyte abnormalities, no diabetes, 1103 00:43:46,918 --> 00:43:49,753 no, um, kidney disease, so... 1104 00:43:49,754 --> 00:43:52,381 Good. So--so what's wrong with him? 1105 00:43:52,382 --> 00:43:54,675 We're still trying to figure that out. 1106 00:43:54,676 --> 00:43:57,386 Did he, uh, have a playdate yesterday, by chance? 1107 00:43:57,387 --> 00:43:58,846 No, he had preschool, 1108 00:43:58,847 --> 00:44:00,347 but he was fine when I picked him up. 1109 00:44:00,348 --> 00:44:02,141 Any kids in his class ill? 1110 00:44:02,142 --> 00:44:03,684 No, my phone tree would have lit up 1111 00:44:03,685 --> 00:44:05,185 if someone else was sick. 1112 00:44:05,186 --> 00:44:06,937 He eat anything this morning? 1113 00:44:06,938 --> 00:44:08,605 No. 1114 00:44:08,606 --> 00:44:10,441 Why? 1115 00:44:10,442 --> 00:44:13,402 It looks like some sort of gelatin. 1116 00:44:13,403 --> 00:44:14,862 Any chance he could have gotten 1117 00:44:14,863 --> 00:44:17,322 into some bath beads or laundry pods? 1118 00:44:17,323 --> 00:44:19,199 No, there's no such thing in our house. 1119 00:44:19,200 --> 00:44:20,617 What about gummies? 1120 00:44:20,618 --> 00:44:22,870 No, we're very strict about candy. 1121 00:44:22,871 --> 00:44:24,122 Right? 1122 00:44:26,750 --> 00:44:29,710 Oh, shit. 1123 00:44:29,711 --> 00:44:30,961 Danny. 1124 00:44:30,962 --> 00:44:32,171 What about Danny? 1125 00:44:32,172 --> 00:44:34,631 Your brother, he-- 1126 00:44:34,632 --> 00:44:36,675 he gave me some gummies he got in Cleveland. 1127 00:44:36,676 --> 00:44:39,511 They were in my coat pocket. 1128 00:44:39,512 --> 00:44:41,221 Are you fucking serious? 1129 00:44:41,222 --> 00:44:42,348 Pot gummies? 1130 00:44:42,349 --> 00:44:44,725 Yes. I'm so sorry. 1131 00:44:44,726 --> 00:44:46,852 Let me call the lab. Maybe the tox screen is back. 1132 00:44:46,853 --> 00:44:49,104 Hey, this is Dr. Langdon from the ED. 1133 00:44:49,105 --> 00:44:51,023 Can I fast-track a lab on a little boy, 1134 00:44:51,024 --> 00:44:52,983 last name Jones, first name Tyler, tox screen? 1135 00:44:52,984 --> 00:44:54,735 Get the fuck out! I mean it. 1136 00:44:54,736 --> 00:44:56,528 Why don't we step outside, and maybe you can help me 1137 00:44:56,529 --> 00:44:59,114 figure out how much he may have taken. 1138 00:44:59,115 --> 00:45:00,574 Thanks. 1139 00:45:00,575 --> 00:45:03,952 I appreciate that quick turnaround. 1140 00:45:03,953 --> 00:45:05,412 The labs confirm it. 1141 00:45:05,413 --> 00:45:07,956 Your son tested positive for cannabis. 1142 00:45:07,957 --> 00:45:09,334 This is a fucking nightmare. 1143 00:45:13,963 --> 00:45:17,841 Theresa, David, this is my attending, Dr. Robinavitch. 1144 00:45:17,842 --> 00:45:19,426 Hi, I'm Dr. Robby. 1145 00:45:19,427 --> 00:45:21,679 We need to do a pelvic exam. 1146 00:45:21,680 --> 00:45:24,306 And David, I don't think you want to be in here for that. 1147 00:45:24,307 --> 00:45:26,058 Definitely not. 1148 00:45:26,059 --> 00:45:28,977 Can you have Nurse Perlah come join me, please? 1149 00:45:28,978 --> 00:45:32,064 Do you want a coffee or a soda or something? 1150 00:45:32,065 --> 00:45:33,691 Why do I need a pelvic exam? 1151 00:45:33,692 --> 00:45:36,402 Uh, you don't. 1152 00:45:36,403 --> 00:45:38,028 Your son seems like a nice kid. 1153 00:45:38,029 --> 00:45:40,239 He's clearly worried about you. 1154 00:45:40,240 --> 00:45:42,783 But your exam and your labs are not matching 1155 00:45:42,784 --> 00:45:44,159 any of the usual diagnoses, 1156 00:45:44,160 --> 00:45:45,704 so I'm not really sure what's going on. 1157 00:45:47,580 --> 00:45:49,331 I'm not here for me. 1158 00:45:49,332 --> 00:45:51,667 - I'm here for David. - I don't understand. 1159 00:45:51,668 --> 00:45:53,168 He said that you've had persistent vomiting, 1160 00:45:53,169 --> 00:45:54,503 some--some dehydration. 1161 00:45:54,504 --> 00:45:57,339 I made myself sick with ipecac. 1162 00:45:57,340 --> 00:45:59,758 To induce vomiting? Why would you do that? 1163 00:45:59,759 --> 00:46:02,928 So David would bring me here. 1164 00:46:02,929 --> 00:46:05,097 My son has some problems. 1165 00:46:05,098 --> 00:46:07,224 He needs professional help. 1166 00:46:07,225 --> 00:46:08,684 OK. What kind of problems? 1167 00:46:08,685 --> 00:46:10,228 Drugs, alcohol? 1168 00:46:12,063 --> 00:46:15,524 I found some of his writing. 1169 00:46:15,525 --> 00:46:18,820 I thought it was schoolwork, but it wasn't. 1170 00:46:20,697 --> 00:46:23,992 It was lists of girls he wanted to hurt. 1171 00:46:37,213 --> 00:46:38,714 Hurt them how? 1172 00:46:38,715 --> 00:46:42,260 He said, "They should all be eliminated." 1173 00:46:44,804 --> 00:46:46,555 Has David seen a therapist? 1174 00:46:46,556 --> 00:46:48,891 No. 1175 00:46:48,892 --> 00:46:52,478 He's not a bad kid, but I'm afraid he's troubled, 1176 00:46:52,479 --> 00:46:53,896 and I didn't want to call the police 1177 00:46:53,897 --> 00:46:55,439 because I was afraid they'd overreact. 1178 00:46:55,440 --> 00:46:57,816 - He's just a kid. - How old is David? 1179 00:46:57,817 --> 00:47:01,320 He just turned 18 last month. 1180 00:47:01,321 --> 00:47:02,905 Then he's considered an adult 1181 00:47:02,906 --> 00:47:06,825 and he would have to consent to treatment. 1182 00:47:06,826 --> 00:47:08,410 Do you have any guns in the house? 1183 00:47:08,411 --> 00:47:09,703 No. 1184 00:47:09,704 --> 00:47:11,246 My husband did, 1185 00:47:11,247 --> 00:47:13,749 but I got rid of all of them after he passed. 1186 00:47:13,750 --> 00:47:15,709 He's a good soul. 1187 00:47:15,710 --> 00:47:18,797 I just don't want to see him hurt anyone or himself. 1188 00:47:21,549 --> 00:47:23,342 How are you feeling, Crash? 1189 00:47:23,343 --> 00:47:25,844 I'd really appreciate if you didn't call me that. 1190 00:47:25,845 --> 00:47:27,888 Why not? It's a cool nickname. 1191 00:47:27,889 --> 00:47:31,141 You earned it. You should own it. 1192 00:47:31,142 --> 00:47:33,519 I don't like it. 1193 00:47:33,520 --> 00:47:36,856 All right. It's just a joke. 1194 00:47:39,526 --> 00:47:43,070 You know, if it makes you feel any better, 1195 00:47:43,071 --> 00:47:46,950 I sharted the first time I saw an emergency C-section. 1196 00:47:48,451 --> 00:47:50,786 Really? 1197 00:47:50,787 --> 00:47:52,580 Of course not. 1198 00:48:02,007 --> 00:48:05,426 Excuse me. I'll be right back. 1199 00:48:05,427 --> 00:48:07,052 I got a situation. 1200 00:48:07,053 --> 00:48:09,596 18-year-old kid brings in his dehydrated mom. 1201 00:48:09,597 --> 00:48:11,306 Dad died during the pandemic. 1202 00:48:11,307 --> 00:48:13,600 Mom's vomiting is self-induced for the sole purpose 1203 00:48:13,601 --> 00:48:15,185 of getting him here after she finds 1204 00:48:15,186 --> 00:48:17,312 his death list for classmates. 1205 00:48:17,313 --> 00:48:20,691 I--OK. 1206 00:48:20,692 --> 00:48:22,609 What does she want us to do? 1207 00:48:22,610 --> 00:48:24,403 Help him, protect him, save him. 1208 00:48:24,404 --> 00:48:27,906 - Where is he now? - Talking to McKay. 1209 00:48:27,907 --> 00:48:29,366 How are you doing? 1210 00:48:29,367 --> 00:48:30,826 Me? I'm good. 1211 00:48:30,827 --> 00:48:32,411 I'm always good. You know that. 1212 00:48:32,412 --> 00:48:34,329 Do I? Does anybody? 1213 00:48:34,330 --> 00:48:37,249 - I'm an open book. - Not even close. 1214 00:48:37,250 --> 00:48:39,001 You do know you can always come talk to me, right? 1215 00:48:39,002 --> 00:48:40,795 Yep. 1216 00:48:43,214 --> 00:48:45,841 - How's it going over here? - Good, good. 1217 00:48:45,842 --> 00:48:48,135 We're just going over aftercare instructions, 1218 00:48:48,136 --> 00:48:49,720 prescription medications, special diet 1219 00:48:49,721 --> 00:48:51,347 for the next few days. 1220 00:48:51,348 --> 00:48:53,223 Dr. McKay, can you check orthostatics on Mom? 1221 00:48:53,224 --> 00:48:54,641 I can. 1222 00:48:54,642 --> 00:48:55,976 David, I wanted you to meet Kiara. 1223 00:48:55,977 --> 00:48:57,311 She's a social worker here who helps 1224 00:48:57,312 --> 00:48:59,104 in situations like this. 1225 00:48:59,105 --> 00:49:01,398 We heard about your father's passing. 1226 00:49:01,399 --> 00:49:02,941 We're really sorry. 1227 00:49:02,942 --> 00:49:05,069 And we know that it can put a lot of pressure 1228 00:49:05,070 --> 00:49:08,197 on somebody your age, which, combined with school 1229 00:49:08,198 --> 00:49:11,241 and now having to take care of your mom, that's a lot. 1230 00:49:11,242 --> 00:49:13,118 It's fine. 1231 00:49:13,119 --> 00:49:14,870 We just want to make sure that when your mom goes home, 1232 00:49:14,871 --> 00:49:16,205 you can handle it. 1233 00:49:16,206 --> 00:49:17,498 We want to make sure you have someone 1234 00:49:17,499 --> 00:49:19,041 you can talk to if you need to. 1235 00:49:19,042 --> 00:49:20,376 I'm OK. 1236 00:49:20,377 --> 00:49:23,253 I don't need to talk to anybody. 1237 00:49:23,254 --> 00:49:24,713 After a parent dies, 1238 00:49:24,714 --> 00:49:27,091 the sadness can last a long time. 1239 00:49:27,092 --> 00:49:29,093 How's that going for you? 1240 00:49:29,094 --> 00:49:31,053 It's not a problem. 1241 00:49:31,054 --> 00:49:32,471 What about school? 1242 00:49:32,472 --> 00:49:33,889 What about it? 1243 00:49:33,890 --> 00:49:36,183 Anything you enjoy there? 1244 00:49:36,184 --> 00:49:39,520 Not really. 1245 00:49:39,521 --> 00:49:42,606 A lot of people have thoughts that can disturb them. 1246 00:49:42,607 --> 00:49:44,817 If you've had any, it's OK to talk about it. 1247 00:49:44,818 --> 00:49:47,528 What's that have to do with my mom? 1248 00:49:47,529 --> 00:49:49,988 - Is she gonna be OK? - Yeah, she's gonna be fine. 1249 00:49:49,989 --> 00:49:51,365 She's probably got a stomach virus, 1250 00:49:51,366 --> 00:49:52,825 maybe food poisoning. 1251 00:49:52,826 --> 00:49:55,160 I think she's more worried about you. 1252 00:49:55,161 --> 00:49:57,079 She always worries about me. 1253 00:49:57,080 --> 00:50:00,249 - Does she have a reason to? - No. 1254 00:50:00,250 --> 00:50:02,168 It's almost 8:00. I gotta go. 1255 00:50:03,920 --> 00:50:05,963 Are you sure you wouldn't prefer to wait with your mom? 1256 00:50:05,964 --> 00:50:07,339 I'm late for school. 1257 00:50:07,340 --> 00:50:10,134 She can just call me when she's ready. 1258 00:50:10,135 --> 00:50:11,593 It would actually be kind of helpful 1259 00:50:11,594 --> 00:50:12,886 to talk to you some more. 1260 00:50:12,887 --> 00:50:15,514 Hey, David. 1261 00:50:15,515 --> 00:50:17,433 David. 1262 00:50:17,434 --> 00:50:18,517 Just give me five minutes. 1263 00:50:18,518 --> 00:50:19,728 Leave me alone! 1264 00:50:28,570 --> 00:50:30,988 Hey, David! 1265 00:50:30,989 --> 00:50:32,449 Shit. 1266 00:50:34,534 --> 00:50:36,410 Robby! 1267 00:50:36,411 --> 00:50:38,579 Robby. 1268 00:50:38,580 --> 00:50:40,289 Got a college kid, respiratory arrest, 1269 00:50:40,290 --> 00:50:41,458 coming in hot. 1270 00:51:12,447 --> 00:51:15,657 Robby, we need to intubate here. 1271 00:51:15,658 --> 00:51:18,578 Dr. Adamson just went down with a pulse ox of 65. 1272 00:51:26,878 --> 00:51:28,630 Robby!