1 00:00:35,326 --> 00:00:37,202 - Oh, shit. - What? 2 00:00:37,203 --> 00:00:39,288 I think I just broke some ribs. 3 00:00:39,289 --> 00:00:40,789 It means you're doing it right. 4 00:00:40,790 --> 00:00:43,292 Third amp of epi is on board. 5 00:00:43,293 --> 00:00:45,128 Oh, come on. 6 00:00:49,883 --> 00:00:52,093 Call me if there's a resurrection. 7 00:00:54,554 --> 00:00:56,722 - Hey, Perlah. - Doctor? 8 00:00:56,723 --> 00:00:58,724 Your kids have any pets? 9 00:00:58,725 --> 00:01:01,894 - Ugh, my house is like a zoo. - You have a dog? 10 00:01:01,895 --> 00:01:05,439 Ugh, no dogs, no cats. I followed my mother's rule. 11 00:01:05,440 --> 00:01:08,150 No pets that can't be buried at sea. 12 00:01:08,151 --> 00:01:09,610 I'm not sure I follow. 13 00:01:09,611 --> 00:01:12,112 You ever try to flush a guinea pig? 14 00:01:12,113 --> 00:01:14,364 Try explaining that to your plumber. 15 00:01:14,365 --> 00:01:16,117 Good to know. 16 00:01:22,373 --> 00:01:23,999 Hey, what's up with your asthma guy? 17 00:01:24,000 --> 00:01:25,542 Responding to albuterol. 18 00:01:25,543 --> 00:01:27,252 One more neb, and we'll discharge on prednisone. 19 00:01:27,253 --> 00:01:29,004 How's it going out in Chairs? 20 00:01:29,005 --> 00:01:31,006 Oh, it's fine, I guess. 21 00:01:31,007 --> 00:01:33,175 - Dr. McKay seems nice. - Cassie? 22 00:01:33,176 --> 00:01:34,802 Oh, yeah, she's great. 23 00:01:34,803 --> 00:01:37,012 - She been here long? - A little while. Why? 24 00:01:37,013 --> 00:01:38,555 I'm just curious. 25 00:01:38,556 --> 00:01:40,265 Do you know what she did before she came here? 26 00:01:40,266 --> 00:01:42,768 What she did? What do you mean, like, school? 27 00:01:42,769 --> 00:01:46,231 Oh, like school, work, personal life. 28 00:01:48,274 --> 00:01:49,608 I'm just trying to get to know her better. 29 00:01:49,609 --> 00:01:51,819 Um, yeah, I don't-- I don't know. 30 00:01:51,820 --> 00:01:53,112 I don't know that much about her. 31 00:01:53,113 --> 00:01:54,655 She has a son. I know that. 32 00:01:54,656 --> 00:01:57,908 She's a pretty private person. 33 00:01:57,909 --> 00:01:59,910 - Anything else? - No, sorry, I'm good. 34 00:01:59,911 --> 00:02:01,412 Thank you. 35 00:02:03,832 --> 00:02:06,375 Hey, where are we at with opening up some beds? 36 00:02:06,376 --> 00:02:09,002 Our Nepali lady with the crushed foot, 37 00:02:09,003 --> 00:02:10,879 Minu, she still in line for the OR? 38 00:02:10,880 --> 00:02:12,381 Yeah, she got bumped by your Le Fort 39 00:02:12,382 --> 00:02:13,590 three fracture, Ben Kemper. 40 00:02:13,591 --> 00:02:15,050 - He just went up. - Mm. 41 00:02:15,051 --> 00:02:16,176 Still waiting for them to take 42 00:02:16,177 --> 00:02:17,803 the electrocution fasciotomy. 43 00:02:17,804 --> 00:02:19,763 What about our OD in Central 7? 44 00:02:19,764 --> 00:02:22,516 Robby wants a few more tests. He's stable and on a vent. 45 00:02:22,517 --> 00:02:24,434 Is he a candidate for organ donation? 46 00:02:24,435 --> 00:02:25,811 Not sure. 47 00:02:25,812 --> 00:02:27,104 Then why is Robby keeping him here? 48 00:02:27,105 --> 00:02:28,397 I don't know. 49 00:02:28,398 --> 00:02:30,190 Maybe he sees something we don't. 50 00:02:30,191 --> 00:02:32,234 Or maybe he's hoping for something that isn't there. 51 00:02:32,235 --> 00:02:34,027 What's there is an 18-year-old kid 52 00:02:34,028 --> 00:02:35,988 - named Nick Bradley. - Yeah, is he though? 53 00:02:35,989 --> 00:02:37,114 I don't mean to be a dick, but-- 54 00:02:37,115 --> 00:02:38,532 You just can't help it? 55 00:02:38,533 --> 00:02:40,200 No, as sad as it is, that kid is gone. 56 00:02:40,201 --> 00:02:41,827 and if we get him upstairs to the ICU, 57 00:02:41,828 --> 00:02:43,287 we can use that bed to actually help somebody. 58 00:02:43,288 --> 00:02:44,997 Robby is helping somebody. 59 00:02:44,998 --> 00:02:46,790 He's helping two people, in fact. 60 00:02:46,791 --> 00:02:49,793 They're in there right now praying over their dead son. 61 00:02:49,794 --> 00:02:51,670 They just haven't let their hearts accept it yet. 62 00:02:51,671 --> 00:02:55,132 Jesus, 9:00, you're already bumming me out. 63 00:02:55,133 --> 00:02:56,550 OK, let's see. 64 00:02:56,551 --> 00:02:58,177 Who's up next at the deli of death? 65 00:02:58,178 --> 00:03:00,220 Weak and dizzy. No, thanks. 66 00:03:00,221 --> 00:03:02,472 Flank pain. Need a UA first. 67 00:03:02,473 --> 00:03:03,849 And buttock abscess. 68 00:03:03,850 --> 00:03:05,517 Great teaching case for a student. 69 00:03:05,518 --> 00:03:07,311 Don't make me tell Robby you're cherry picking. 70 00:03:07,312 --> 00:03:12,524 I'll take projectile vomiting in North 5 for 200, Alex. 71 00:03:12,525 --> 00:03:14,818 What do you think the chances are it's a demonic possession? 72 00:03:14,819 --> 00:03:16,069 About the same as you going a whole hour 73 00:03:16,070 --> 00:03:18,280 without saying something stupid. 74 00:03:18,281 --> 00:03:19,990 For Christ's sakes, go already. 75 00:03:19,991 --> 00:03:23,076 You're like having a kid I never wanted. 76 00:03:23,077 --> 00:03:25,205 How are you feeling? Any pain, Minu? 77 00:03:32,670 --> 00:03:35,005 No pain, but I'm thirsty. 78 00:03:35,006 --> 00:03:37,132 Oh, nothing to drink before your surgery, 79 00:03:37,133 --> 00:03:39,928 but we can get you some lemon swabs. 80 00:03:47,602 --> 00:03:49,646 Thank you. 81 00:03:52,440 --> 00:03:53,982 Excuse me? 82 00:03:53,983 --> 00:03:57,111 When are you due? 83 00:03:58,988 --> 00:04:00,156 You can always tell. 84 00:04:01,241 --> 00:04:02,741 Congratulations. 85 00:04:02,742 --> 00:04:04,244 Thanks. 86 00:04:13,711 --> 00:04:16,672 How long before we might expect to see some improvement? 87 00:04:16,673 --> 00:04:18,632 It could be hours. It could be days. 88 00:04:18,633 --> 00:04:20,300 It could be never. 89 00:04:20,301 --> 00:04:23,011 I don't expect anything for a little while. 90 00:04:23,012 --> 00:04:24,471 Why don't you guys go get a cup of coffee 91 00:04:24,472 --> 00:04:26,098 in the cafeteria, maybe something to eat? 92 00:04:26,099 --> 00:04:27,432 I'll have a nurse call you if anything changes 93 00:04:27,433 --> 00:04:29,518 - while you're out. - Thank you. 94 00:04:29,519 --> 00:04:31,103 We appreciate that. 95 00:04:31,104 --> 00:04:32,521 - I'm not leaving. - Suit yourself. 96 00:04:32,522 --> 00:04:33,897 I'm gonna get a cup of coffee. 97 00:04:33,898 --> 00:04:35,107 I got to call Sarah and the kids. 98 00:04:35,108 --> 00:04:36,233 Cafeteria? 99 00:04:36,234 --> 00:04:37,651 Straight down that hallway, 100 00:04:37,652 --> 00:04:39,152 through the corridor, and to the right. 101 00:04:39,153 --> 00:04:41,446 Thanks, and I'm-- I'm sorry 102 00:04:41,447 --> 00:04:43,949 if my sister comes across a little strident. 103 00:04:43,950 --> 00:04:47,328 It's OK. This isn't easy. 104 00:04:51,624 --> 00:04:54,209 The parents of teen overdose, Lily and John Bradley, 105 00:04:54,210 --> 00:04:56,628 are asking about the tests you told them about. 106 00:04:56,629 --> 00:04:58,797 - OK, I'll be right there. - What about the rats? 107 00:04:58,798 --> 00:05:00,424 What about them? 108 00:05:00,425 --> 00:05:02,092 - Have they been caught? - I have no idea. 109 00:05:02,093 --> 00:05:04,428 - Well, find out. - Not sure that's my job. 110 00:05:04,429 --> 00:05:07,306 You're in charge of the ER. The rats are in the ER. 111 00:05:07,307 --> 00:05:09,224 That makes you in charge of the rats, 112 00:05:09,225 --> 00:05:11,560 and I have a strict rule about vermin in the workplace. 113 00:05:11,561 --> 00:05:12,979 Good to know. 114 00:05:16,316 --> 00:05:18,275 Could I get your eyes on a sickle cell crisis in South 20? 115 00:05:18,276 --> 00:05:20,152 Headed that way right now. 116 00:05:20,153 --> 00:05:22,154 ICU is insisting they still don't have rooms available. 117 00:05:22,155 --> 00:05:24,865 Bullshit. Esme recon'd for me. 118 00:05:24,866 --> 00:05:26,366 Send our electrocution, Victor Hunt, up there 119 00:05:26,367 --> 00:05:28,453 until the OR is ready please. Thank you. 120 00:05:32,707 --> 00:05:34,833 - Third epi on board? - Three minutes ago. 121 00:05:34,834 --> 00:05:36,752 How long has he been going at it? 122 00:05:36,753 --> 00:05:39,629 10 minutes in here, possibly 30 minutes of prior downtime. 123 00:05:39,630 --> 00:05:42,382 Don't suppose you'd let me try a pericardiocentesis? 124 00:05:42,383 --> 00:05:45,135 - For what? - For practice. 125 00:05:45,136 --> 00:05:48,055 - In case it's tamponade. - None seen on ultrasound. 126 00:05:48,056 --> 00:05:50,557 - This is a teaching hospital. - It's not a cadaver lab. 127 00:05:50,558 --> 00:05:52,310 What do you call this? 128 00:05:54,312 --> 00:05:57,022 - Do you need a break? - I'm fine. 129 00:05:57,023 --> 00:05:59,566 You don't look fine. 130 00:05:59,567 --> 00:06:02,070 Hold compressions. 131 00:06:03,613 --> 00:06:05,906 Still no rhythm. 132 00:06:05,907 --> 00:06:08,158 OK, Whitaker, I think that's enough. 133 00:06:08,159 --> 00:06:10,827 It's been four minutes since the last epi. 134 00:06:10,828 --> 00:06:12,455 One more minute, please. 135 00:06:18,586 --> 00:06:21,463 Help me, please help! Somebody help! 136 00:06:21,464 --> 00:06:23,131 - Please, my friend needs help. - What happened? 137 00:06:23,132 --> 00:06:25,175 - My friend. - Hey, where is she? 138 00:06:25,176 --> 00:06:26,343 My friend, she's in my car. 139 00:06:26,344 --> 00:06:27,886 - She won't wake up. - OK. 140 00:06:27,887 --> 00:06:29,722 OK, Mateo, gurney! 141 00:06:35,853 --> 00:06:37,813 - What's her name? - Jenna. 142 00:06:37,814 --> 00:06:39,439 Come on, Jenna. 143 00:06:39,440 --> 00:06:42,318 Wake up for me, baby. 144 00:06:44,404 --> 00:06:46,196 Pupils pinpoint. I need-- 145 00:06:46,197 --> 00:06:48,240 - Narcan. - Yeah. 146 00:06:48,241 --> 00:06:52,078 Hold her head back, Javadi. OK. 147 00:07:02,046 --> 00:07:04,423 Not responding to Narcan. We might need to intubate. 148 00:07:04,424 --> 00:07:06,758 Find a room and open a crash cart. 149 00:07:06,759 --> 00:07:09,845 I can't find a carotid pulse. 150 00:07:09,846 --> 00:07:12,764 Five minutes since the last epi. 151 00:07:12,765 --> 00:07:15,517 OK, that's it. 152 00:07:15,518 --> 00:07:16,894 Hold compressions. 153 00:07:34,954 --> 00:07:39,250 Welcome back. She's OK. 154 00:07:41,878 --> 00:07:46,631 He took his wife out for dinner last night, 155 00:07:46,632 --> 00:07:48,467 for her birthday. 156 00:07:48,468 --> 00:07:50,010 OK, why doesn't everybody take a minute? 157 00:07:50,011 --> 00:07:51,553 Go check on your other patients. 158 00:07:51,554 --> 00:07:54,848 We'll meet back here to debrief with Kiara. 159 00:07:54,849 --> 00:07:56,766 - Bed four. - Where the hell am I? 160 00:07:56,767 --> 00:07:57,851 Pittsburgh Trauma Medical Center. 161 00:07:57,852 --> 00:07:59,186 Why? 162 00:07:59,187 --> 00:08:00,604 Your friend couldn't wake you. 163 00:08:00,605 --> 00:08:01,897 I'm right here, Jenna. 164 00:08:01,898 --> 00:08:03,231 Came to with one spray of Narcan. 165 00:08:03,232 --> 00:08:05,358 - What'd you take, Jenna? - Nothing. 166 00:08:05,359 --> 00:08:07,527 You had to have taken something to cause this. 167 00:08:07,528 --> 00:08:09,529 No, I was just up late studying, 168 00:08:09,530 --> 00:08:11,072 and I just couldn't fall asleep. 169 00:08:11,073 --> 00:08:12,949 So you took something to help you sleep? 170 00:08:12,950 --> 00:08:16,077 We need to know in order to treat you properly, OK? 171 00:08:16,078 --> 00:08:18,830 - Do you know what she took? - No. 172 00:08:18,831 --> 00:08:20,665 This could be a sign of something really serious, 173 00:08:20,666 --> 00:08:22,125 and we're gonna have to do a lot of tests that you-- 174 00:08:22,126 --> 00:08:23,502 OK, I took, like, half a Xanax. 175 00:08:23,503 --> 00:08:25,795 That's not nothing. 176 00:08:25,796 --> 00:08:28,423 It's OK. OK? 177 00:08:28,424 --> 00:08:31,426 - Have you taken Xanax before? - First time. 178 00:08:31,427 --> 00:08:34,095 OK. 179 00:08:34,096 --> 00:08:36,641 Take a deep breath for me. 180 00:08:40,102 --> 00:08:41,978 Come on, man. You heard Dr. Robby. 181 00:08:41,979 --> 00:08:44,231 Let's take a break. Grab a coffee. 182 00:08:44,232 --> 00:08:46,734 No, I'm fine, thank you. 183 00:09:03,668 --> 00:09:06,044 Did you know him? 184 00:09:06,045 --> 00:09:08,838 No, I didn't. Did you? 185 00:09:08,839 --> 00:09:11,091 I just met him. 186 00:09:11,092 --> 00:09:13,760 He was my first patient to die. 187 00:09:13,761 --> 00:09:17,014 I'm sorry. 188 00:09:22,478 --> 00:09:24,604 - Are you OK? - Mm-hmm, yeah. 189 00:09:24,605 --> 00:09:27,649 - You sure? - Yeah. Just I-- 190 00:09:27,650 --> 00:09:32,571 I just remember the first time that-- 191 00:09:32,572 --> 00:09:35,574 on occasion, I have an emotional response to death. 192 00:09:35,575 --> 00:09:37,075 It's-- 193 00:09:37,076 --> 00:09:39,369 Got to be kind of tough for a doctor. 194 00:09:39,370 --> 00:09:42,081 At times, it can be. 195 00:09:44,875 --> 00:09:48,045 At least I'm not a pathologist. 196 00:09:49,005 --> 00:09:50,672 I was joking. I-- 197 00:09:50,673 --> 00:09:52,048 Oh. 198 00:09:52,049 --> 00:09:55,218 I have nothing against pathologists. 199 00:09:55,219 --> 00:09:58,847 Yeah, no. 200 00:09:58,848 --> 00:10:01,391 New radiodensity in the right middle lobe. 201 00:10:01,392 --> 00:10:03,059 Is it pneumonia? 202 00:10:03,060 --> 00:10:04,894 Possibly, or just changes from vaso-occlusion 203 00:10:04,895 --> 00:10:06,313 of the sickle cells. 204 00:10:06,314 --> 00:10:07,689 It's called acute chest syndrome. 205 00:10:07,690 --> 00:10:09,190 We're gonna cover you with antibiotics 206 00:10:09,191 --> 00:10:10,525 just to be on the safe side. 207 00:10:10,526 --> 00:10:12,193 We've been through this before. 208 00:10:12,194 --> 00:10:15,030 Third generation cephalosporin and a macrolide. 209 00:10:15,031 --> 00:10:18,408 Perfect. You're in good hands. 210 00:10:18,409 --> 00:10:21,286 - Can I do a chest tube? - Which patient? 211 00:10:21,287 --> 00:10:22,787 Any. 212 00:10:22,788 --> 00:10:24,414 I've just never done a chest tube before. 213 00:10:24,415 --> 00:10:26,625 Are you really asking me to reserve 214 00:10:26,626 --> 00:10:30,253 any incoming injury requiring a chest tube for you? 215 00:10:30,254 --> 00:10:31,713 Not all of them. 216 00:10:31,714 --> 00:10:33,715 I'd be more than happy just doing one, 217 00:10:33,716 --> 00:10:35,425 but, hey, if you wanted to give me more, 218 00:10:35,426 --> 00:10:37,510 I'd be fine with that, too, but that's up to you. 219 00:10:37,511 --> 00:10:39,095 I'm down for anything. 220 00:10:39,096 --> 00:10:42,140 Confidence and ambition are great attributes, 221 00:10:42,141 --> 00:10:46,394 especially when paired with respect and humility. 222 00:10:46,395 --> 00:10:50,106 OK, what else? What else went well? 223 00:10:50,107 --> 00:10:52,442 We checked for reversible causes 224 00:10:52,443 --> 00:10:53,985 of cardiac arrest on ultrasound. 225 00:10:53,986 --> 00:10:55,987 OK, good. 226 00:10:55,988 --> 00:10:57,947 Does anybody have anything that they wish had gone differently? 227 00:10:57,948 --> 00:11:00,325 In the hall, he should have been on a cardiac monitor. 228 00:11:00,326 --> 00:11:01,826 We would have caught the arrest right away. 229 00:11:01,827 --> 00:11:03,411 That's true, 230 00:11:03,412 --> 00:11:05,246 but there was no indication for monitoring. 231 00:11:05,247 --> 00:11:07,290 And we now know that his abdominal pain 232 00:11:07,291 --> 00:11:09,668 was not from his gallstones but from unstable angina 233 00:11:09,669 --> 00:11:11,586 due to coronary artery disease. 234 00:11:11,587 --> 00:11:13,463 Then we should have admitted to cardiology. 235 00:11:13,464 --> 00:11:16,424 Mm, we did an EKG. We did a troponin. 236 00:11:16,425 --> 00:11:18,301 He had a HEART score of three. 237 00:11:18,302 --> 00:11:19,719 Who can tell me what that means? 238 00:11:19,720 --> 00:11:21,805 1% chance of an adverse cardiac event 239 00:11:21,806 --> 00:11:23,223 in the next 30 days. 240 00:11:23,224 --> 00:11:25,183 Standard of care is to discharge 241 00:11:25,184 --> 00:11:26,894 with outpatient follow-up. 242 00:11:28,479 --> 00:11:29,854 He was your patient, Dr. Whitaker. 243 00:11:29,855 --> 00:11:31,564 Would you like to say something before 244 00:11:31,565 --> 00:11:35,318 we all take a brief moment of silent reflection? 245 00:11:35,319 --> 00:11:38,029 Um... 246 00:11:38,030 --> 00:11:40,365 He liked Kentucky bourbon. 247 00:11:40,366 --> 00:11:42,158 OK, good. 248 00:11:42,159 --> 00:11:43,660 Me too. 249 00:11:43,661 --> 00:11:45,620 - Anything else? - I don't know. 250 00:11:45,621 --> 00:11:48,331 I just met him. 251 00:11:48,332 --> 00:11:50,583 No, he seemed nice. 252 00:11:50,584 --> 00:11:52,877 He was married. 253 00:11:52,878 --> 00:11:56,090 Um, that's it. That's all I got. I-- 254 00:11:57,758 --> 00:11:59,135 Mm. 255 00:12:00,386 --> 00:12:03,012 I spoke with his wife. She's on her way here. 256 00:12:03,013 --> 00:12:05,515 If anyone needs to talk about this some more, 257 00:12:05,516 --> 00:12:07,767 I'm available. 258 00:12:07,768 --> 00:12:09,686 For now, let's harness some good thoughts 259 00:12:09,687 --> 00:12:11,522 here for Mr. Milton. 260 00:12:22,450 --> 00:12:24,784 OK, that's it. 261 00:12:24,785 --> 00:12:26,370 Let's go save some lives. 262 00:12:28,998 --> 00:12:32,001 Hey, Whitaker. 263 00:12:34,670 --> 00:12:37,672 How are you feeling on this? 264 00:12:37,673 --> 00:12:40,383 I mean, not good. I was just talking to him. 265 00:12:40,384 --> 00:12:41,843 Now he's dead. 266 00:12:41,844 --> 00:12:43,219 That's the hardest way to lose a patient. 267 00:12:43,220 --> 00:12:44,429 It always hurts. 268 00:12:44,430 --> 00:12:46,055 Especially when it's your fault. 269 00:12:46,056 --> 00:12:48,433 This was not your fault. This was nobody's fault. 270 00:12:48,434 --> 00:12:50,643 No doctor on the planet could have caught this. 271 00:12:50,644 --> 00:12:52,604 Listen, it sucks, 272 00:12:52,605 --> 00:12:56,941 but today, today was this guy's day to leave this mortal coil. 273 00:12:56,942 --> 00:12:59,152 150,000 people die every day in the world, 274 00:12:59,153 --> 00:13:02,155 and you got one of them, but you learn to live with it, 275 00:13:02,156 --> 00:13:04,240 and you learn to accept it as much as your own mortality 276 00:13:04,241 --> 00:13:05,867 and find balance if you can. 277 00:13:05,868 --> 00:13:07,702 You've found balance? 278 00:13:07,703 --> 00:13:09,579 No, not even close. 279 00:13:09,580 --> 00:13:14,918 But, you know, you keep trying, which is all you can do. 280 00:13:14,919 --> 00:13:17,670 You're doing great, Whitaker. 281 00:13:17,671 --> 00:13:20,381 - Just, you know, hang in there. - Yeah, thanks. 282 00:13:20,382 --> 00:13:21,591 OK. 283 00:13:21,592 --> 00:13:23,343 - I'm just gonna go. - Yeah. 284 00:13:23,344 --> 00:13:25,386 But, you know, our social worker, Kiara, 285 00:13:25,387 --> 00:13:28,598 is here if you want to talk. 286 00:13:28,599 --> 00:13:30,476 OK, yeah. 287 00:13:33,229 --> 00:13:34,687 OK. 288 00:13:34,688 --> 00:13:37,190 You're gonna recover, OK? 289 00:13:37,191 --> 00:13:38,817 Good luck. 290 00:13:38,818 --> 00:13:41,027 Wait, what happens now? 291 00:13:41,028 --> 00:13:42,403 We monitor her heart and breathing 292 00:13:42,404 --> 00:13:43,571 for the next few hours to make sure 293 00:13:43,572 --> 00:13:44,781 she doesn't need more Narcan. 294 00:13:44,782 --> 00:13:46,866 - That's it? - Yeah. 295 00:13:46,867 --> 00:13:49,077 You should text your friends. 296 00:13:49,078 --> 00:13:51,454 Hell, you should text your whole college. 297 00:13:51,455 --> 00:13:52,997 Tell anyone who will listen 298 00:13:52,998 --> 00:13:54,582 to not take pills without a real prescription 299 00:13:54,583 --> 00:13:56,544 unless they want to end up here. 300 00:13:57,962 --> 00:13:59,796 Seriously, fentanyl is everywhere. 301 00:13:59,797 --> 00:14:01,298 It's in everything on the street these days. 302 00:14:03,634 --> 00:14:05,385 How long would I monitor her pupils for? 303 00:14:05,386 --> 00:14:06,761 You know what, actually, I should go to the bathroom. 304 00:14:06,762 --> 00:14:08,263 Are you OK on your own till I get back? 305 00:14:08,264 --> 00:14:09,347 Absolutely. Take your time. 306 00:14:09,348 --> 00:14:10,683 OK, great. Thanks. 307 00:14:13,561 --> 00:14:15,353 Sometimes I come on too strong. 308 00:14:15,354 --> 00:14:16,980 Excuse me? 309 00:14:16,981 --> 00:14:20,233 It's a defense mechanism against insecurity. 310 00:14:20,234 --> 00:14:23,361 - You're kidding, right? - Yeah. 311 00:14:23,362 --> 00:14:25,113 But I am sorry if I hurt your feelings. 312 00:14:25,114 --> 00:14:26,990 I really-- I want us to get along. 313 00:14:26,991 --> 00:14:29,367 I want us to be friends. 314 00:14:29,368 --> 00:14:30,702 And if I'm really being honest, 315 00:14:30,703 --> 00:14:32,328 I want your mother to write me 316 00:14:32,329 --> 00:14:33,788 a kickass recommendation letter. 317 00:14:33,789 --> 00:14:35,456 You're going into general surgery. 318 00:14:35,457 --> 00:14:39,377 I might. I'm keeping my options open. 319 00:14:39,378 --> 00:14:40,879 You want me to pimp out my mother 320 00:14:40,880 --> 00:14:43,381 for something you might do? 321 00:14:43,382 --> 00:14:46,551 OK, well, when you put it like that, it sounds dirty, 322 00:14:46,552 --> 00:14:49,053 and a little hot, but yes. 323 00:14:49,054 --> 00:14:52,181 In full disclosure, so we can be friends. 324 00:14:52,182 --> 00:14:55,018 - Friends? - You've heard of the concept? 325 00:14:55,019 --> 00:14:58,146 Buddies, compatriots, confidants, pals. 326 00:14:58,147 --> 00:15:00,690 - They even made a show about it. - Yeah. 327 00:15:00,691 --> 00:15:04,193 Boom. Come on. 328 00:15:04,194 --> 00:15:06,821 Don't leave me hanging, Crash. Pound that shit. 329 00:15:06,822 --> 00:15:10,492 I can call you that now that we're friends, right? 330 00:15:12,411 --> 00:15:14,622 - OK. - We'll work on that. 331 00:15:16,457 --> 00:15:20,084 So for the apnea test, we keep him on 100% oxygen, 332 00:15:20,085 --> 00:15:22,211 but the ventilator won't be giving him breaths. 333 00:15:22,212 --> 00:15:24,464 - For how long? - For 10 minutes. 334 00:15:24,465 --> 00:15:26,549 We'll monitor his carbon dioxide levels, 335 00:15:26,550 --> 00:15:28,343 and if they come back way too high, 336 00:15:28,344 --> 00:15:29,928 then we'll know that his brain stem 337 00:15:29,929 --> 00:15:33,264 - is not telling him to breathe. - And that means? 338 00:15:33,265 --> 00:15:36,142 That would mean that there's no brain function 339 00:15:36,143 --> 00:15:38,103 at the most fundamental level. 340 00:15:39,521 --> 00:15:42,565 Princess will monitor him, and I will come back as soon 341 00:15:42,566 --> 00:15:44,567 as we know the test results. 342 00:15:44,568 --> 00:15:46,486 - OK. - Yeah. 343 00:15:46,487 --> 00:15:49,198 OK. 344 00:15:55,079 --> 00:15:56,537 I hate this fucking hospital. 345 00:15:56,538 --> 00:15:57,956 This is Hank. 346 00:15:57,957 --> 00:16:00,124 - What happened? - Nothing. 347 00:16:00,125 --> 00:16:03,544 We were just framing, and then my buddy Joey comes in. 348 00:16:03,545 --> 00:16:06,381 He says, "A guy walks into a bar with a nail in his head," 349 00:16:06,382 --> 00:16:08,800 and then he points his fucking nail gun at my head. 350 00:16:08,801 --> 00:16:10,385 So what would you do? 351 00:16:10,386 --> 00:16:13,638 So I freaked out, and then in the ensuing melee, 352 00:16:13,639 --> 00:16:16,975 - he fucking shoots me. - Melee? 353 00:16:16,976 --> 00:16:19,978 Yeah, you know, like a scuffle, like a donnybrook. 354 00:16:19,979 --> 00:16:21,688 What, you think because I work construction, 355 00:16:21,689 --> 00:16:23,898 not a hospital, I don't have a fucking vocabulary? 356 00:16:23,899 --> 00:16:25,525 Tier one trauma now. 357 00:16:25,526 --> 00:16:26,609 - No, sir, I-- - Whoa. 358 00:16:26,610 --> 00:16:28,319 Definitely intracardiac. 359 00:16:28,320 --> 00:16:30,279 And I got to tell you, this fucking hurts. 360 00:16:30,280 --> 00:16:32,615 Let's just try and relax and dial down the F bombs. 361 00:16:32,616 --> 00:16:34,951 - We have children in here. - You want me to stop swearing? 362 00:16:34,952 --> 00:16:36,786 Take the fucking nail out of my heart. 363 00:16:36,787 --> 00:16:38,329 And, please, something for the pain! 364 00:16:38,330 --> 00:16:39,872 Stabilize the nail. 365 00:16:39,873 --> 00:16:40,915 Hank, we need to cut your shirt off. 366 00:16:40,916 --> 00:16:42,583 Fuck that. 367 00:16:42,584 --> 00:16:44,210 You cut the shirt, you're gonna buy me a new one. 368 00:16:44,211 --> 00:16:46,629 You can have your pick out of our lost and found. 369 00:16:46,630 --> 00:16:48,464 Whew, how did this happen? 370 00:16:48,465 --> 00:16:50,466 Framing nail incident with deep penetration 371 00:16:50,467 --> 00:16:52,635 - of the left chest. - The fuck does it look like? 372 00:16:52,636 --> 00:16:54,137 Hank, do you take medicine every day? 373 00:16:54,138 --> 00:16:56,097 Any allergies to medication? 374 00:16:56,098 --> 00:16:58,016 No. Can you give me something for the fucking pain already? 375 00:16:58,017 --> 00:16:59,851 Is this a hospital or a vet clinic? 376 00:16:59,852 --> 00:17:01,436 Very soon, Hank. Very soon. 377 00:17:01,437 --> 00:17:03,354 I bet you say that to the beagles too. 378 00:17:03,355 --> 00:17:06,315 Pulse 120. BP 100 over 65. 379 00:17:06,316 --> 00:17:08,109 Two milligrams of morphine. 380 00:17:08,110 --> 00:17:10,361 Liver GSW is in recovery. He's good as new. 381 00:17:10,362 --> 00:17:11,821 Whoa, that looks intracardiac. 382 00:17:11,822 --> 00:17:14,365 - Nailed it. - Whoa, you got jokes now. 383 00:17:14,366 --> 00:17:16,367 No jokes, just pushing your pain meds, buddy. 384 00:17:16,368 --> 00:17:19,495 Small pericardial effusion, but no evidence of tamponade. 385 00:17:19,496 --> 00:17:21,330 - Not yet. - Somebody talk to me. 386 00:17:21,331 --> 00:17:22,874 Do I need a priest here? 387 00:17:22,875 --> 00:17:24,333 He's tachycardic with borderline BP. 388 00:17:24,334 --> 00:17:25,668 He could decompensate. 389 00:17:25,669 --> 00:17:27,086 Standby with two units whole blood. 390 00:17:27,087 --> 00:17:29,255 Garcia here. Stat cardiac case. 391 00:17:29,256 --> 00:17:31,382 Am I dying here and nobody's telling me? 392 00:17:31,383 --> 00:17:33,468 Hank, there is blood collecting 393 00:17:33,469 --> 00:17:34,886 in the sac around your heart. 394 00:17:34,887 --> 00:17:36,679 You need surgery before your heart stops 395 00:17:36,680 --> 00:17:38,056 from the pressure around it. 396 00:17:38,057 --> 00:17:39,599 Just pull the fucking nail out! 397 00:17:39,600 --> 00:17:41,267 That would definitely kill you. 398 00:17:41,268 --> 00:17:44,520 I want a second opinion. Where's my fucking phone? 399 00:17:44,521 --> 00:17:47,065 I can Uber to Presby and find a real hospital. 400 00:17:47,066 --> 00:17:48,483 OR can take him in 10 minutes. 401 00:17:48,484 --> 00:17:50,318 Mind if we intubate him first? 402 00:17:50,319 --> 00:17:52,070 The sooner the better for all of us. 403 00:17:52,071 --> 00:17:54,822 Great. 120 of sux, 100 of ketamine. 404 00:17:54,823 --> 00:17:57,158 - Javadi, you're up for this one. - Really? 405 00:17:57,159 --> 00:17:58,910 Now. Let's go. Move. 406 00:17:58,911 --> 00:18:00,995 Code STEMI, ETA five minutes. 407 00:18:00,996 --> 00:18:03,915 Code STEMI, ETA five minutes. 408 00:18:03,916 --> 00:18:05,583 I can start the STEMI with Mel. 409 00:18:05,584 --> 00:18:07,502 - Sounds good. - This place sucks. 410 00:18:07,503 --> 00:18:09,712 I will destroy you on Yelp. 411 00:18:09,713 --> 00:18:11,839 Nobody's ever coming to this shithole again. 412 00:18:11,840 --> 00:18:13,174 I swear to God. 413 00:18:13,175 --> 00:18:15,593 From your mouth to God's ear. 414 00:18:15,594 --> 00:18:17,970 Kiara? Hi. I'm Dr. Melissa King. 415 00:18:17,971 --> 00:18:21,600 - Everyone calls me Mel. - Yes, we met. 416 00:18:22,768 --> 00:18:26,687 Right, um, I wanted to ask you 417 00:18:26,688 --> 00:18:30,274 about Tyler, the little boy who ate the marijuana gummy. 418 00:18:30,275 --> 00:18:32,693 He's been admitted to pediatrics for observation. 419 00:18:32,694 --> 00:18:35,530 - And his parents? - They're upstairs with him. 420 00:18:35,531 --> 00:18:38,324 CYF is going to follow up with a home visit just to be safe, 421 00:18:38,325 --> 00:18:40,785 but no police were involved. Don't worry. 422 00:18:40,786 --> 00:18:42,537 No one is taking their child away from them. 423 00:18:42,538 --> 00:18:43,996 Good. That's a relief. 424 00:18:43,997 --> 00:18:45,498 Yeah, the parents, on the other hand, 425 00:18:45,499 --> 00:18:47,583 may need couples counseling after this, 426 00:18:47,584 --> 00:18:50,044 but I think little Tyler's going to be fine. 427 00:18:50,045 --> 00:18:52,713 - STEMI with me, Mel. - Right behind you. 428 00:18:52,714 --> 00:18:55,716 - Dana, what's open? - Trauma two. 429 00:18:55,717 --> 00:18:57,510 All right, keep it that way. 430 00:18:57,511 --> 00:19:01,097 Our target door to balloon time for STEMIs is 51 minutes. 431 00:19:01,098 --> 00:19:02,640 Ambitious. 432 00:19:02,641 --> 00:19:05,476 But doable, as you're about to find out. 433 00:19:05,477 --> 00:19:07,563 Let's go. 434 00:19:10,232 --> 00:19:12,358 Good view of the glottis. 435 00:19:12,359 --> 00:19:14,902 Eyes off the screen. 436 00:19:14,903 --> 00:19:18,406 Now look down the mouth and insert 437 00:19:18,407 --> 00:19:21,492 the tube around the bend. 438 00:19:21,493 --> 00:19:24,203 You stole my med student from triage? 439 00:19:24,204 --> 00:19:26,455 - How's she doing over here? - She's doing pretty good. 440 00:19:26,456 --> 00:19:29,208 Now look back at the screen. 441 00:19:29,209 --> 00:19:31,962 And advance through the cords. 442 00:19:34,089 --> 00:19:36,757 Good. Good job. 443 00:19:36,758 --> 00:19:38,719 Thanks. 444 00:19:40,262 --> 00:19:42,848 Pressure's down. 72/38. 445 00:19:45,225 --> 00:19:48,352 Effusion has grown, now with the RV collapse. 446 00:19:48,353 --> 00:19:50,021 Pericardiocentesis? 447 00:19:50,022 --> 00:19:51,898 Let's get another unit on that infuser. 448 00:19:51,899 --> 00:19:54,025 Prep for thoracotomy. Coming through. 449 00:19:54,026 --> 00:19:55,401 We should get back to triage. 450 00:19:55,402 --> 00:19:56,944 You don't want to stay for this? 451 00:19:56,945 --> 00:19:58,321 There are like 30 patients still waiting 452 00:19:58,322 --> 00:20:02,116 - to be assessed out there. - OK. 453 00:20:02,117 --> 00:20:04,660 - Did someone say thoracotomy? - Crashing from tamponade. 454 00:20:04,661 --> 00:20:06,245 Dr. Garcia, do you think I-- 455 00:20:06,246 --> 00:20:08,497 Trauma Surgery gets left sided thoracotomies. 456 00:20:08,498 --> 00:20:11,501 ED gets the right if we need to extend. 457 00:20:13,003 --> 00:20:15,046 Glove up, girl. You're on suction. 458 00:20:15,047 --> 00:20:17,965 Let's advance that ET tube to the right main stem please. 459 00:20:17,966 --> 00:20:19,801 Ten blade. 460 00:20:28,143 --> 00:20:29,769 Metz. 461 00:20:29,770 --> 00:20:31,854 Dr. Santos, how do we cut through the intercostals? 462 00:20:31,855 --> 00:20:34,774 Through the superior rib to avoid the neurovascular bundle. 463 00:20:34,775 --> 00:20:37,444 - That is correct. - Finochietto retractor. 464 00:20:41,448 --> 00:20:42,865 Full suction. 465 00:20:42,866 --> 00:20:45,201 And get rid of this nail before I get poked. 466 00:20:45,202 --> 00:20:47,579 On it. 467 00:20:50,958 --> 00:20:54,168 Nail's intact in one piece. 468 00:20:54,169 --> 00:20:57,964 Toothed forceps. Opening the pericardium. 469 00:20:57,965 --> 00:20:59,632 This is so fucking cool. 470 00:20:59,633 --> 00:21:01,717 Dr. Santos, you and this patient 471 00:21:01,718 --> 00:21:03,719 share a common vocabulary. 472 00:21:03,720 --> 00:21:05,721 Yeah, I swear a lot. I know. I'm sorry. 473 00:21:05,722 --> 00:21:07,723 They say it's a sign of intelligence. 474 00:21:07,724 --> 00:21:10,351 I think it shows a lack of self-control. 475 00:21:10,352 --> 00:21:11,978 But what the fuck do I know? 476 00:21:11,979 --> 00:21:13,980 Single puncture wound to the left ventricle. 477 00:21:13,981 --> 00:21:16,399 We've got a finger on it. 478 00:21:16,400 --> 00:21:18,985 First unit is in. Pressure's up. 479 00:21:18,986 --> 00:21:20,861 Heart is filling well. 480 00:21:20,862 --> 00:21:22,780 Throw in a horizontal mattress, and we're out of here. 481 00:21:22,781 --> 00:21:25,533 - Stop the bleed while I sew. - STEMI's arrived. 482 00:21:25,534 --> 00:21:27,034 You got this? 483 00:21:27,035 --> 00:21:28,786 Just wrapping him up for OR delivery. 484 00:21:28,787 --> 00:21:30,496 2-0 Prolene on a tapered needle. 485 00:21:30,497 --> 00:21:33,291 Mr. Ed Gellin is 52 years young 486 00:21:33,292 --> 00:21:35,418 with a history of hypertension and hyperlipidemia. 487 00:21:35,419 --> 00:21:37,461 20 minutes of substernal chest pain. 488 00:21:37,462 --> 00:21:39,630 10 out of 10 with dyspnea and diaphoresis. 489 00:21:39,631 --> 00:21:42,008 BP is 152 over 95. 490 00:21:42,009 --> 00:21:44,051 Currently chewing 324 mgs of baby aspirin. 491 00:21:44,052 --> 00:21:45,344 OK. 492 00:21:45,345 --> 00:21:46,804 Blood's drawn. Second IV started. 493 00:21:46,805 --> 00:21:48,264 BP stable. 494 00:21:48,265 --> 00:21:49,974 Seven millimeters ST elevation... 495 00:21:49,975 --> 00:21:51,642 - One nitro spray, sublingual. - In the anterior leads. 496 00:21:51,643 --> 00:21:53,227 Those are sometimes called tombstones. 497 00:21:53,228 --> 00:21:54,312 - Open up, sir. - Tombstones? 498 00:21:54,313 --> 00:21:55,396 Lift your tongue. 499 00:21:55,397 --> 00:21:56,772 Mr. Gellin, you're having 500 00:21:56,773 --> 00:21:58,316 a very big heart attack right now. 501 00:21:58,317 --> 00:22:00,151 Major artery that carries oxygen to your heart 502 00:22:00,152 --> 00:22:02,153 - is almost totally blocked. - That doesn't sound too good. 503 00:22:02,154 --> 00:22:03,571 No, it's not very good. 504 00:22:03,572 --> 00:22:05,323 We're gonna send you up to the cath lab. 505 00:22:05,324 --> 00:22:06,657 A cardiologist is gonna unblock that with a balloon 506 00:22:06,658 --> 00:22:08,117 and leave it open with a stent. 507 00:22:08,118 --> 00:22:09,452 But I'm still having a heart attack? 508 00:22:09,453 --> 00:22:11,078 If everything goes as planned, 509 00:22:11,079 --> 00:22:12,830 it'll be like you never had a heart attack. 510 00:22:12,831 --> 00:22:14,206 We're gonna put a catheter in this artery right here. 511 00:22:14,207 --> 00:22:15,624 We're gonna shave the hair with a clipper. 512 00:22:15,625 --> 00:22:17,335 Long as you stop short of a Brazilian. 513 00:22:17,336 --> 00:22:19,712 It's an option we offer. Costs a little bit more. 514 00:22:19,713 --> 00:22:21,422 A lot of people's insurance won't cover it. 515 00:22:21,423 --> 00:22:22,423 Don't make me laugh. 516 00:22:22,424 --> 00:22:23,424 - It hurts. - Deal. 517 00:22:23,425 --> 00:22:24,842 Anybody we can call? 518 00:22:24,843 --> 00:22:26,927 - My wife. - Already have her number. 519 00:22:26,928 --> 00:22:28,804 OK, we'll call her. You hang in there. 520 00:22:28,805 --> 00:22:30,891 I'll be right back. 521 00:22:34,811 --> 00:22:37,146 I think they finished the apnea test on Nick. 522 00:22:37,147 --> 00:22:38,981 - Can you check the results? - Not just yet. 523 00:22:38,982 --> 00:22:40,399 The blood test needs to go to the lab. 524 00:22:40,400 --> 00:22:42,193 It takes a few minutes to run the test. 525 00:22:42,194 --> 00:22:44,279 I'll come find you in the room as soon as it's done. 526 00:22:47,115 --> 00:22:49,867 Horizontal mattress in place with excellent hemostasis. 527 00:22:49,868 --> 00:22:51,244 Cut here. 528 00:22:53,747 --> 00:22:56,540 Moist, sterile towel. And away we go. 529 00:22:56,541 --> 00:22:59,377 I spoke to cardiothoracic. They can meet you in the OR. 530 00:22:59,378 --> 00:23:02,171 Good job. 531 00:23:02,172 --> 00:23:04,007 Coming through. 532 00:23:05,717 --> 00:23:08,135 Well done. Well done. 533 00:23:08,136 --> 00:23:10,679 - Good luck, Mr. Gellin. - Thank you so much. 534 00:23:10,680 --> 00:23:12,391 You're very welcome. 535 00:23:15,852 --> 00:23:19,522 Two saves. Totally awesome. 536 00:23:19,523 --> 00:23:21,816 I just held a beating human heart in my hands. 537 00:23:21,817 --> 00:23:23,484 We should celebrate. 538 00:23:23,485 --> 00:23:24,860 We should clean these rooms 539 00:23:24,861 --> 00:23:26,445 and bring some more patients back. 540 00:23:26,446 --> 00:23:28,364 - Sounds like a plan. - No rest for the wicked. 541 00:23:28,365 --> 00:23:31,617 - Code STEMI was fast. - Time is myocardium. 542 00:23:31,618 --> 00:23:34,453 And our statistics for door to balloon time 543 00:23:34,454 --> 00:23:36,205 get reviewed, critiqued, and published online. 544 00:23:36,206 --> 00:23:37,790 Door to balloon time? 545 00:23:37,791 --> 00:23:39,750 That's the time from when they hit our door 546 00:23:39,751 --> 00:23:42,044 to when the angioplasty balloon gets inflated in the cath lab. 547 00:23:42,045 --> 00:23:44,296 We keep it to under 51 minutes, we can reverse a heart attack 548 00:23:44,297 --> 00:23:45,756 and save a life. 549 00:23:45,757 --> 00:23:48,843 Kind of wish Mr. Milton had a STEMI. 550 00:23:48,844 --> 00:23:51,512 Thank you for letting me go the distance on him. 551 00:23:51,513 --> 00:23:53,639 I really thought we'd get him back, you know? 552 00:23:53,640 --> 00:23:55,266 Yeah, well, you know, even though 553 00:23:55,267 --> 00:23:56,517 you do everything right, you don't always 554 00:23:56,518 --> 00:23:58,603 get what you hope for. 555 00:24:00,856 --> 00:24:03,190 My parents both had sickle cell trait, 556 00:24:03,191 --> 00:24:06,444 and I was screened as a newborn with the hemoglobin FS pattern. 557 00:24:06,445 --> 00:24:09,071 - Did you take penicillin? - Mm-hmm, until I was five. 558 00:24:09,072 --> 00:24:10,948 Then the vaccines kicked in. 559 00:24:10,949 --> 00:24:13,325 She has her entire medical history on her phone. 560 00:24:13,326 --> 00:24:14,869 It's extremely long. 561 00:24:14,870 --> 00:24:16,203 Dr. Mohan, do you have a minute? 562 00:24:16,204 --> 00:24:18,290 Yep. Excuse me. 563 00:24:23,545 --> 00:24:24,879 Is there a problem over there? 564 00:24:24,880 --> 00:24:26,547 No, her pain is well controlled. 565 00:24:26,548 --> 00:24:28,257 You understand that's my polite way of asking 566 00:24:28,258 --> 00:24:30,050 why are you spending so much time with one patient? 567 00:24:30,051 --> 00:24:31,969 You're an R3. 568 00:24:31,970 --> 00:24:33,971 As an R3, you should be seeing at least two patients an hour. 569 00:24:33,972 --> 00:24:36,140 I have two, Joyce and Mr. Wallace, 570 00:24:36,141 --> 00:24:38,267 - our Good Samaritan. - Who's comatose and stable. 571 00:24:38,268 --> 00:24:40,019 You should have four by now. 572 00:24:40,020 --> 00:24:41,854 I have the highest patient satisfaction of anyone. 573 00:24:41,855 --> 00:24:43,147 I don't doubt it, 574 00:24:43,148 --> 00:24:44,523 but we just had this conversation 575 00:24:44,524 --> 00:24:45,774 a couple of hours ago. 576 00:24:45,775 --> 00:24:47,401 I know people call me Slow-Mo. 577 00:24:47,402 --> 00:24:49,236 You don't have to confirm or deny. 578 00:24:49,237 --> 00:24:52,531 It used to hurt my feelings a lot, but I can't help it. 579 00:24:52,532 --> 00:24:54,992 I work at the speed I'm comfortable at. 580 00:24:54,993 --> 00:24:58,120 Because you're afraid of making a mistake? 581 00:24:58,121 --> 00:24:59,538 I'm always afraid of making a mistake. 582 00:24:59,539 --> 00:25:00,539 - Aren't you? - Yeah, of course I am. 583 00:25:00,540 --> 00:25:01,999 But you know what I mean. 584 00:25:02,000 --> 00:25:03,626 You make a mistake once, and somebody dies, 585 00:25:03,627 --> 00:25:05,002 and you feel so badly about it, 586 00:25:05,003 --> 00:25:06,003 you'll never let it happen again-- 587 00:25:06,004 --> 00:25:07,213 How is that wrong? 588 00:25:07,214 --> 00:25:09,673 Because you waste time and money 589 00:25:09,674 --> 00:25:11,509 on unnecessary tests. 590 00:25:11,510 --> 00:25:14,136 You keep sick patients waiting too long. 591 00:25:14,137 --> 00:25:15,971 You miss out on cases you could be learning from. 592 00:25:15,972 --> 00:25:17,681 You shortchange your own education. 593 00:25:17,682 --> 00:25:19,350 I'm not saying this to be a hard-ass. 594 00:25:19,351 --> 00:25:20,851 I'm saying this because I know you could do this, 595 00:25:20,852 --> 00:25:22,603 but you need to do it at a level 596 00:25:22,604 --> 00:25:25,648 - I also know you're capable of. - And what if I'm not? 597 00:25:25,649 --> 00:25:26,857 Then you should look into a specialty 598 00:25:26,858 --> 00:25:28,067 that better suits you. 599 00:25:28,068 --> 00:25:29,902 Have you thought about psychiatry? 600 00:25:29,903 --> 00:25:31,028 I don't want to go into psychiatry. 601 00:25:31,029 --> 00:25:32,029 I want to be here. 602 00:25:32,030 --> 00:25:34,114 Being here means 603 00:25:34,115 --> 00:25:36,033 no matter how good you are or how hard you try, 604 00:25:36,034 --> 00:25:37,368 you're gonna make another mistake, 605 00:25:37,369 --> 00:25:39,078 and someone else might even die. 606 00:25:39,079 --> 00:25:42,998 That's called being an emergency medicine doctor. 607 00:25:42,999 --> 00:25:44,500 And if you can't accept that, 608 00:25:44,501 --> 00:25:45,834 then maybe this isn't the place for you. 609 00:25:45,835 --> 00:25:48,379 - I can accept that. - You sure? 610 00:25:48,380 --> 00:25:51,090 - Yes. - OK, good. 611 00:25:51,091 --> 00:25:53,425 Go save some lives. 612 00:25:53,426 --> 00:25:57,263 Clear some beds while you're at it. 613 00:25:57,264 --> 00:26:01,058 I would fancy a spot of tea at some point. 614 00:26:01,059 --> 00:26:03,519 You want some tea, darling? I'll get you some tea. 615 00:26:03,520 --> 00:26:07,106 - Oh, thank you, sweetheart. - Is Dr. Robby available? 616 00:26:07,107 --> 00:26:08,857 He's with a patient. Can I help? 617 00:26:08,858 --> 00:26:11,652 - My father's starting to move. - OK, I'll let him know. 618 00:26:11,653 --> 00:26:13,946 - Thanks. - Yeah. 619 00:26:13,947 --> 00:26:15,406 Is it good or bad? 620 00:26:15,407 --> 00:26:17,366 If there's no spontaneous breathing, 621 00:26:17,367 --> 00:26:20,494 then carbon dioxide levels rise above 60. 622 00:26:20,495 --> 00:26:23,914 So 82 definitely means that Nick's brainstem 623 00:26:23,915 --> 00:26:25,374 is not triggering him to breathe. 624 00:26:25,375 --> 00:26:26,917 Well, how can you fix that? 625 00:26:26,918 --> 00:26:29,044 We can't. I'm sorry. 626 00:26:29,045 --> 00:26:30,963 But with rest and time... 627 00:26:30,964 --> 00:26:33,632 This is not something that heals on its own. 628 00:26:33,633 --> 00:26:36,302 There's got to be something else that we can do. 629 00:26:36,303 --> 00:26:38,053 Nick is our only child. 630 00:26:38,054 --> 00:26:41,140 - Is that test 100% accurate? - It is. 631 00:26:41,141 --> 00:26:43,809 Isn't there anything else? 632 00:26:43,810 --> 00:26:45,978 We can do an imaging test called 633 00:26:45,979 --> 00:26:48,063 - a cerebral perfusion study. - Then let's do it. 634 00:26:48,064 --> 00:26:49,648 But you have to understand that will be the last test 635 00:26:49,649 --> 00:26:51,609 that we would do. 636 00:26:51,610 --> 00:26:54,153 If it comes back that there's no blood flow to Nick's brain, 637 00:26:54,154 --> 00:26:58,240 it would confirm beyond a shadow of a doubt 638 00:26:58,241 --> 00:27:01,619 that there's been brain death, 639 00:27:01,620 --> 00:27:04,831 which would mean that he's gone. 640 00:27:07,334 --> 00:27:10,879 Then we wait and see. 641 00:27:12,547 --> 00:27:14,381 Call Nuclear Medicine. See how soon they can take him. 642 00:27:14,382 --> 00:27:15,758 You got it. 643 00:27:15,759 --> 00:27:17,009 I'll be back in a few minutes. 644 00:27:17,010 --> 00:27:19,095 Thank you. 645 00:27:24,934 --> 00:27:28,145 Hey, Mr. Spencer in Central 9 tried to pull out his ET tube 646 00:27:28,146 --> 00:27:30,814 - and is now in soft restraints. - No surprise there. 647 00:27:30,815 --> 00:27:32,650 We need to up the propofol. 648 00:27:32,651 --> 00:27:35,152 And the sister of the dead MVC vet in the viewing room 649 00:27:35,153 --> 00:27:37,321 - just arrived in Chairs. - Can you, um-- 650 00:27:37,322 --> 00:27:39,531 - Park her in the family room? - Please. 651 00:27:39,532 --> 00:27:42,034 No problem, I'll have Perlah and Princess prep the body 652 00:27:42,035 --> 00:27:43,911 as best they can for viewing. 653 00:27:43,912 --> 00:27:45,162 Any progress in there? 654 00:27:45,163 --> 00:27:46,830 No. 655 00:27:46,831 --> 00:27:50,084 Can you also keep an extra eye on Whitaker today? 656 00:27:50,085 --> 00:27:51,418 Oh, I'm already on it. 657 00:27:51,419 --> 00:27:53,212 I know he lost his first patient. 658 00:27:53,213 --> 00:27:54,838 Yeah, I just don't want it to throw him off his game. 659 00:27:54,839 --> 00:27:58,258 - You think this kid has game? - Not sure yet. 660 00:27:58,259 --> 00:27:59,677 I want to give him a chance to find out. 661 00:27:59,678 --> 00:28:02,221 Copy that. 662 00:28:02,222 --> 00:28:05,307 - Hey, fruitcake. - Myrna. 663 00:28:05,308 --> 00:28:07,518 What brings you in here today, anyway? 664 00:28:07,519 --> 00:28:10,104 - I murdered my husband. - Ah. 665 00:28:10,105 --> 00:28:11,689 How did you do it this time? 666 00:28:11,690 --> 00:28:14,983 I put him through a meat grinder. 667 00:28:14,984 --> 00:28:18,028 Best just to grab one and jump back in. 668 00:28:18,029 --> 00:28:19,822 Yeah, right. 669 00:28:19,823 --> 00:28:24,243 Mr. Fulton in Central 14 just needs a shot of Mylanta 670 00:28:24,244 --> 00:28:26,620 for his GERD, and to avoid eating foods 671 00:28:26,621 --> 00:28:28,247 with the words "flaming hot" in their title 672 00:28:28,248 --> 00:28:29,498 for at least a few days. 673 00:28:29,499 --> 00:28:33,085 - OK, thanks. - Central 14. 674 00:28:33,086 --> 00:28:35,212 Yeah. 675 00:28:35,213 --> 00:28:39,591 Could I get some Mylanta for Mr. Fulton in Central 14? 676 00:28:39,592 --> 00:28:41,135 It'll be a while. 677 00:28:41,136 --> 00:28:42,886 If you want it fast, go check out the employee 678 00:28:42,887 --> 00:28:45,222 - first aid cabinet. - Where is that? 679 00:28:45,223 --> 00:28:47,766 In the lounge. I'll show you. 680 00:28:47,767 --> 00:28:51,145 - How's it going? - Not so great. 681 00:28:51,146 --> 00:28:53,397 - I lost a patient. - So I heard. 682 00:28:53,398 --> 00:28:55,065 I also heard it wasn't your fault. 683 00:28:55,066 --> 00:28:56,567 Doesn't make it feel any better. 684 00:28:56,568 --> 00:28:58,110 Yeah, it doesn't. I'm sorry. 685 00:28:58,111 --> 00:29:00,112 Unfortunately, it comes with the job. 686 00:29:00,113 --> 00:29:03,532 If it's any consolation, I just got scolded for going too slow. 687 00:29:03,533 --> 00:29:05,617 If you hear someone talking about a Slow-Mo, that's me. 688 00:29:05,618 --> 00:29:07,870 Guaranteed you're going faster than me. 689 00:29:07,871 --> 00:29:10,497 I like to say it gets easier. Some days it does. 690 00:29:10,498 --> 00:29:12,124 I'm sure the rest of your shift will be better. 691 00:29:12,125 --> 00:29:13,667 - Shake it first. - Mm-hmm. 692 00:29:13,668 --> 00:29:16,086 Oh, but make sure the lid is... 693 00:29:16,087 --> 00:29:18,672 Screwed down tight. 694 00:29:18,673 --> 00:29:22,927 - OK. - Oh. 695 00:29:24,179 --> 00:29:27,431 Everyone seems to get along like family. 696 00:29:27,432 --> 00:29:31,268 You see a family, I see every man for himself. 697 00:29:31,269 --> 00:29:32,644 Actually, that's not entirely true. 698 00:29:32,645 --> 00:29:34,062 There is some family here. 699 00:29:34,063 --> 00:29:35,939 Javadi's mom is a surgeon upstairs. 700 00:29:35,940 --> 00:29:37,566 - Really? - Yeah. 701 00:29:37,567 --> 00:29:40,277 - Oh, that must be so nice. - Are you kidding? 702 00:29:40,278 --> 00:29:42,070 I don't know about your mom, 703 00:29:42,071 --> 00:29:44,823 but I would not want mine working within 100 miles of me. 704 00:29:44,824 --> 00:29:48,327 - No way. - My mother passed. 705 00:29:48,328 --> 00:29:53,415 She had a very aggressive, malignant pheochromocytoma, 706 00:29:53,416 --> 00:29:56,502 - so... - Sorry. 707 00:29:56,503 --> 00:30:00,131 Unfortunately, my mother is gonna live forever. 708 00:30:01,174 --> 00:30:04,134 No, she was definitely dead. Like, I'm still shaking. 709 00:30:04,135 --> 00:30:06,970 No, she was, like, dead. Like dead-dead. 710 00:30:06,971 --> 00:30:08,555 I mean, I think her heart stopped. 711 00:30:08,556 --> 00:30:10,140 No, she was, like, literally dead. 712 00:30:10,141 --> 00:30:12,768 - Think she was dead? - Who? 713 00:30:12,769 --> 00:30:14,812 Who she was just talking about. 714 00:30:14,813 --> 00:30:16,396 Oh. 715 00:30:16,397 --> 00:30:18,023 In case you didn't realize, I use sarcasm 716 00:30:18,024 --> 00:30:21,068 and comedy as a shield. Or so I've been told. 717 00:30:21,069 --> 00:30:23,111 Thank you for opening up to me. 718 00:30:23,112 --> 00:30:25,280 - Mel, right? - Yes. 719 00:30:25,281 --> 00:30:26,907 Well, it was nice talking to you, Mel. 720 00:30:26,908 --> 00:30:28,742 It was nice talking to you too. 721 00:30:28,743 --> 00:30:30,410 You know, I really hope we can be fri-- 722 00:30:30,411 --> 00:30:32,497 friends. 723 00:30:40,547 --> 00:30:42,923 Is there anything I can assist you with, Dr. Robby? 724 00:30:42,924 --> 00:30:44,716 I think we're best on our own right now, thank you. 725 00:30:44,717 --> 00:30:46,635 He keeps trying to pull away. 726 00:30:46,636 --> 00:30:48,345 We're giving him some more sedation. 727 00:30:48,346 --> 00:30:50,180 Why is he so agitated? 728 00:30:50,181 --> 00:30:52,307 He could have some awareness of the tube in his throat 729 00:30:52,308 --> 00:30:54,643 or that he's in a strange place, 730 00:30:54,644 --> 00:30:57,479 or it could be lack of oxygen to his brain. 731 00:30:57,480 --> 00:30:59,648 - Does he need more oxygen? - He's on 100%. 732 00:30:59,649 --> 00:31:00,942 That's as high as it goes. 733 00:31:02,402 --> 00:31:04,444 That is his blood pressure dropping. 734 00:31:04,445 --> 00:31:06,738 Oh, is that even fixable? 735 00:31:06,739 --> 00:31:09,449 Normally, yes, with IV fluids, 736 00:31:09,450 --> 00:31:11,869 but we now know that that will just fill up his lungs, 737 00:31:11,870 --> 00:31:13,453 drop his oxygen even more. 738 00:31:13,454 --> 00:31:15,414 Well, isn't there something else we can do? 739 00:31:15,415 --> 00:31:19,877 We can place a long, large IV catheter in his jugular vein 740 00:31:19,878 --> 00:31:23,422 down into his heart and administer Levophed, 741 00:31:23,423 --> 00:31:25,173 which is a very powerful medicine 742 00:31:25,174 --> 00:31:28,051 to constrict his arteries, raise his blood pressure. 743 00:31:28,052 --> 00:31:34,016 But that could cause other organ damage, organ failure. 744 00:31:34,017 --> 00:31:39,062 I'm really sorry, but each new step is even more invasive, 745 00:31:39,063 --> 00:31:43,985 could cause more suffering with minimal benefit. 746 00:31:50,992 --> 00:31:53,327 Uh, hi. 747 00:31:53,328 --> 00:31:55,579 Dr. Robby said he'd be back in a few minutes. 748 00:31:55,580 --> 00:31:58,583 Yeah, he's with a patient, but I'll let him know. 749 00:32:00,501 --> 00:32:02,127 My son is dead, isn't he? 750 00:32:02,128 --> 00:32:04,796 I'm not a doctor, Mr. Bradley, 751 00:32:04,797 --> 00:32:08,383 but I do believe in God, and I am praying for your boy 752 00:32:08,384 --> 00:32:10,177 with every beat of my heart. 753 00:32:10,178 --> 00:32:12,346 Thought she'd taken Xanax, but it was actually fent. 754 00:32:12,347 --> 00:32:14,264 - Thank you. - Yeah. 755 00:32:14,265 --> 00:32:16,308 Oh, one second. Yeah? 756 00:32:16,309 --> 00:32:18,435 - She was legitimately dead? - Yeah, like, 100%. 757 00:32:18,436 --> 00:32:22,898 - Mr. Bradley? - Vince? 758 00:32:22,899 --> 00:32:25,609 No, my dad's gonna freak out. 759 00:32:25,610 --> 00:32:27,611 No, I know. I know. 760 00:32:27,612 --> 00:32:31,156 I just needed to sleep. I thought I was. 761 00:32:31,157 --> 00:32:33,200 Where did you get the fucking drugs? 762 00:32:33,201 --> 00:32:35,619 - Who are you? - Did you give them to my son? 763 00:32:35,620 --> 00:32:37,496 Did you give my son drugs? 764 00:32:37,497 --> 00:32:39,039 Mr. Bradley, you can't come in here. 765 00:32:39,040 --> 00:32:40,791 - Mr. Bradley, please. - Who is this? 766 00:32:40,792 --> 00:32:42,334 - Tell me the fucking truth. - Security! 767 00:32:42,335 --> 00:32:44,044 It's Nick's dad. 768 00:32:44,045 --> 00:32:45,921 - Did you drug my son? - Where the hell's security? 769 00:32:45,922 --> 00:32:47,589 Your son gave me the drugs, asshole. 770 00:32:47,590 --> 00:32:49,633 - Ask him. - He's dead. 771 00:32:49,634 --> 00:32:51,969 And you are a fucking liar! 772 00:32:51,970 --> 00:32:56,140 You killed my son! You killed my fucking son! 773 00:33:07,276 --> 00:33:08,986 Hey, there's no scrubs in here. 774 00:33:08,987 --> 00:33:11,154 Yeah, you have to put your old ones in before 775 00:33:11,155 --> 00:33:13,115 it'll give you a new pair. 776 00:33:13,116 --> 00:33:16,327 What? 777 00:33:35,096 --> 00:33:37,682 Forgive me, Mr. Milton. 778 00:33:42,103 --> 00:33:44,604 Hey, you missed the best action of the day. 779 00:33:44,605 --> 00:33:46,481 I heard. What happened? 780 00:33:46,482 --> 00:33:48,150 Father of the brain-dead son 781 00:33:48,151 --> 00:33:50,277 goes after another patient he thinks gave his son 782 00:33:50,278 --> 00:33:52,154 - the drugs that killed him. - Jesus. 783 00:33:52,155 --> 00:33:55,866 - How do you deal with that? - No fucking idea. 784 00:33:55,867 --> 00:33:58,744 Whoa, what happened here? Did we have an accident? 785 00:33:58,745 --> 00:34:00,120 Do you think I'm wearing this by choice? 786 00:34:00,121 --> 00:34:01,872 Was it number one or number two? 787 00:34:01,873 --> 00:34:03,707 I just got some stuff spilled on me. 788 00:34:03,708 --> 00:34:05,375 Was it a bodily fluid, and was it yours? 789 00:34:05,376 --> 00:34:06,918 No and no. 790 00:34:06,919 --> 00:34:08,420 Oh, is it from when you killed that guy? 791 00:34:08,421 --> 00:34:09,838 I did not-- 792 00:34:09,839 --> 00:34:11,840 that guy had a massive MI in his sleep. 793 00:34:11,841 --> 00:34:13,759 Relax, Huckleberry, I'm just fucking with you. 794 00:34:13,760 --> 00:34:16,094 Truth is, you're not a real doctor until 795 00:34:16,095 --> 00:34:18,263 you've lost at least one patient. 796 00:34:18,264 --> 00:34:20,682 You got off easy. It wasn't your fault. 797 00:34:20,683 --> 00:34:24,519 Not all of us can take comfort in saying that. 798 00:34:24,520 --> 00:34:27,856 But try not to kill anybody else. 799 00:34:27,857 --> 00:34:31,401 - What am I looking at? - Mr. Bill Philbin, 46. 800 00:34:31,402 --> 00:34:33,278 He tripped while walking his dog. 801 00:34:33,279 --> 00:34:36,156 He saw a squirrel. And it's my wife's dog. 802 00:34:36,157 --> 00:34:37,824 Damn thing doesn't even like me. 803 00:34:37,825 --> 00:34:39,785 Clearly. Where's the dog now? 804 00:34:39,786 --> 00:34:41,537 Hopefully in a kill shelter. 805 00:34:56,010 --> 00:34:57,136 Come on, baby. 806 00:35:07,230 --> 00:35:10,566 Oh, yes. 807 00:35:12,068 --> 00:35:14,111 I'm sorry. 808 00:35:14,112 --> 00:35:18,281 I just want to understand how this could happen to our son. 809 00:35:18,282 --> 00:35:23,203 I can't stop wondering, why Nick and not her? 810 00:35:23,204 --> 00:35:25,080 I can't help it. 811 00:35:25,081 --> 00:35:26,498 I think it would be helpful for you 812 00:35:26,499 --> 00:35:28,750 to speak with our department social worker. 813 00:35:28,751 --> 00:35:30,669 Would you two be open to that? 814 00:35:30,670 --> 00:35:34,256 - None of this is fair. - No. 815 00:35:34,257 --> 00:35:38,093 - No, it's not. - But he's still breathing. 816 00:35:38,094 --> 00:35:40,053 The ventilator is breathing for him. 817 00:35:40,054 --> 00:35:42,472 Brain death is the same as death. 818 00:35:42,473 --> 00:35:44,349 What about that last test that we're waiting for? 819 00:35:44,350 --> 00:35:47,269 I can almost guarantee it'll stay the same. 820 00:35:47,270 --> 00:35:48,980 I'm so sorry. 821 00:35:50,439 --> 00:35:53,359 I wish I could have done more to save your son. 822 00:35:55,653 --> 00:35:57,320 Our social worker, Kiara, is here to help you 823 00:35:57,321 --> 00:35:59,030 with anything you might need. She's amazing. 824 00:35:59,031 --> 00:36:01,117 I'm gonna go find her and have her come see you. 825 00:36:03,578 --> 00:36:05,078 Go back to the dorm, 826 00:36:05,079 --> 00:36:08,332 and within a couple of minutes... 827 00:36:12,128 --> 00:36:13,837 Get dad sorted out? 828 00:36:13,838 --> 00:36:15,755 I think so. 829 00:36:15,756 --> 00:36:17,382 He and his wife are dealing with a lot right now. 830 00:36:17,383 --> 00:36:20,385 No shit. That's a tough one. 831 00:36:20,386 --> 00:36:22,429 Yeah. Do you know where Kiara is? 832 00:36:22,430 --> 00:36:24,055 Not offhand, but I can page her. 833 00:36:24,056 --> 00:36:25,724 No, it's OK. I'll find her. 834 00:36:25,725 --> 00:36:27,642 I got to hit the restroom anyway. 835 00:36:27,643 --> 00:36:29,186 I'll tell her you're looking for her if she comes this way. 836 00:36:29,187 --> 00:36:30,562 - Thank you. - Yep. 837 00:36:30,563 --> 00:36:32,230 Now I got to pee. 838 00:36:32,231 --> 00:36:35,817 Kevin, take Myrna to pee. 839 00:36:35,818 --> 00:36:38,486 Ask Dana what's open, four of morphine, 840 00:36:38,487 --> 00:36:41,323 - and order an X-ray, OK? - Copy. 841 00:36:41,324 --> 00:36:43,575 Hey, closed injury, forklift versus foot. 842 00:36:43,576 --> 00:36:45,452 - Forklift won. - Got it. 843 00:36:45,453 --> 00:36:47,537 Hey, any news on our incel kid, David? 844 00:36:47,538 --> 00:36:49,289 Uh, I don't think we've heard from him yet, 845 00:36:49,290 --> 00:36:51,249 and I don't know that you should refer to him that way. 846 00:36:51,250 --> 00:36:54,294 Well, he did have a list of girls' names he wanted to hurt. 847 00:36:54,295 --> 00:36:57,088 They could be at risk. Are the cops looking for him? 848 00:36:57,089 --> 00:36:59,132 - Not sure we're there yet. - OK. 849 00:36:59,133 --> 00:37:00,759 I trust your judgment, 850 00:37:00,760 --> 00:37:02,302 and I'm the last person who wants to involve 851 00:37:02,303 --> 00:37:03,845 the police in anything, 852 00:37:03,846 --> 00:37:05,597 but you don't want to be wrong about this one. 853 00:37:05,598 --> 00:37:07,474 I know. I know. 854 00:37:07,475 --> 00:37:09,059 So what's the issue? 855 00:37:09,060 --> 00:37:12,020 Maybe I don't want to ruin this kid's life. 856 00:37:12,021 --> 00:37:13,480 Well, you don't want him ruining 857 00:37:13,481 --> 00:37:15,024 anyone else's life either. 858 00:37:18,694 --> 00:37:21,279 Look, I've personally been on the wrong side 859 00:37:21,280 --> 00:37:23,365 of someone who hates women. 860 00:37:23,366 --> 00:37:26,117 It's not a safe place to be. 861 00:37:26,118 --> 00:37:28,371 OK? 862 00:37:34,085 --> 00:37:36,711 - Any luck reaching David? - Not yet. 863 00:37:36,712 --> 00:37:38,046 Did you try calling the school? 864 00:37:38,047 --> 00:37:41,716 He didn't show up for class. 865 00:37:41,717 --> 00:37:43,760 Any idea where he might have gone? 866 00:37:43,761 --> 00:37:45,303 Friends, relatives. 867 00:37:45,304 --> 00:37:47,472 We don't have any family in state. 868 00:37:47,473 --> 00:37:52,395 And David, he doesn't associate with anyone. 869 00:37:55,856 --> 00:37:58,024 Theresa, do you think that David 870 00:37:58,025 --> 00:38:00,361 would try to hurt any of the girls that are on that list? 871 00:38:01,362 --> 00:38:02,946 No. 872 00:38:02,947 --> 00:38:05,991 Do you remember some of the names on that list? 873 00:38:05,992 --> 00:38:07,701 Not really. 874 00:38:07,702 --> 00:38:09,662 Maybe you could try. 875 00:38:17,044 --> 00:38:18,336 How's she doing? 876 00:38:18,337 --> 00:38:20,463 She's worried sick about her son. 877 00:38:20,464 --> 00:38:22,215 What are you going to do? 878 00:38:22,216 --> 00:38:24,676 I thought he would come back after mom called him. 879 00:38:24,677 --> 00:38:26,094 Hey, what are the ethics about me reaching out 880 00:38:26,095 --> 00:38:27,345 to him under the guise 881 00:38:27,346 --> 00:38:28,847 of a medical emergency with mom? 882 00:38:28,848 --> 00:38:30,682 If he's a danger to himself or others, 883 00:38:30,683 --> 00:38:33,184 I'd argue you have a professional responsibility 884 00:38:33,185 --> 00:38:36,187 to do whatever is necessary. 885 00:38:36,188 --> 00:38:38,356 Right. OK. 886 00:38:38,357 --> 00:38:40,442 Hey, can you come talk to the parents of the OD'd kid 887 00:38:40,443 --> 00:38:42,027 that we brought in earlier? 888 00:38:42,028 --> 00:38:44,279 18-year-old brain-dead from a fentanyl overdose. 889 00:38:44,280 --> 00:38:46,406 - Oh, jeez. - Yeah, only child. 890 00:38:46,407 --> 00:38:47,782 And I just think that the parents 891 00:38:47,783 --> 00:38:48,908 could use a little help processing 892 00:38:48,909 --> 00:38:50,493 what they're going through. 893 00:38:50,494 --> 00:38:52,245 What about donation? Is he a candidate? 894 00:38:52,246 --> 00:38:53,997 If the transplant counselor could get him there, 895 00:38:53,998 --> 00:38:55,540 but I think we're a ways away from calling them in. 896 00:38:55,541 --> 00:38:57,584 - I'll see what I can do. - Thank you. 897 00:38:57,585 --> 00:38:59,169 They're in Central 7. 898 00:38:59,170 --> 00:39:00,378 I would introduce you, but I really have to pee. 899 00:39:00,379 --> 00:39:02,923 - No worries. - Thank you. 900 00:39:08,429 --> 00:39:09,971 What the hell? 901 00:39:09,972 --> 00:39:11,473 I just saw one of those rats. 902 00:39:11,474 --> 00:39:13,266 And you thought you'd start an IV? 903 00:39:13,267 --> 00:39:14,893 It's not funny. 904 00:39:14,894 --> 00:39:16,811 You're not the one who's gonna have nightmares. 905 00:39:16,812 --> 00:39:19,564 I forgot about your phobia with rats. 906 00:39:19,565 --> 00:39:21,816 It is not a phobia. Nobody likes rats. 907 00:39:21,817 --> 00:39:23,610 Some people keep them as pets. 908 00:39:23,611 --> 00:39:27,280 If you are purposely keeping a rat in your house, 909 00:39:27,281 --> 00:39:29,074 that is not a pet. 910 00:39:29,075 --> 00:39:31,076 That is a sign of an underlying mental health problem. 911 00:39:31,077 --> 00:39:32,660 OK, if it makes you feel any better, 912 00:39:32,661 --> 00:39:34,204 just think of them as cute little Disney mice 913 00:39:34,205 --> 00:39:35,580 with a pituitary condition. 914 00:39:35,581 --> 00:39:37,415 Mm-hmm, joke all you want, 915 00:39:37,416 --> 00:39:40,919 but if one of those disgusting things bites a patient 916 00:39:40,920 --> 00:39:42,796 and we get a case of hantavirus, 917 00:39:42,797 --> 00:39:45,548 guess who's gonna have to answer for that one, Chief. 918 00:39:45,549 --> 00:39:47,425 Point taken. 919 00:39:47,426 --> 00:39:49,094 What was the name of that cop you were talking to earlier? 920 00:39:49,095 --> 00:39:50,929 What cop? 921 00:39:50,930 --> 00:39:52,680 The good-looking one that you were talking to earlier. 922 00:39:52,681 --> 00:39:54,766 - How would I know? - It seemed like you guys had-- 923 00:39:54,767 --> 00:39:57,727 - Stay in your own lane. - What? 924 00:39:57,728 --> 00:39:59,479 I'm not even asking like that. 925 00:39:59,480 --> 00:40:01,981 I really did want to talk to him about something. 926 00:40:01,982 --> 00:40:04,651 Uh-huh. 927 00:40:04,652 --> 00:40:06,820 Hey, did the exterminator come yet? 928 00:40:06,821 --> 00:40:08,905 Yeah. Right. Sometimes you can be so cute. 929 00:40:08,906 --> 00:40:10,865 Anything like that has to go through facilities. 930 00:40:10,866 --> 00:40:13,952 - They said they'd handle it. - What does that mean? 931 00:40:13,953 --> 00:40:16,037 It means nothing's gonna happen until next week 932 00:40:16,038 --> 00:40:18,331 at the earliest unless we get a patient in here 933 00:40:18,332 --> 00:40:20,667 with a service cat. 934 00:40:20,668 --> 00:40:22,752 Oh, don't forget, you still have the sister 935 00:40:22,753 --> 00:40:24,462 of Abbot's deceased veteran waiting for you. 936 00:40:24,463 --> 00:40:25,713 Oh, shit, yes, yes, yes. I'll be there. 937 00:40:25,714 --> 00:40:27,800 - I'll be there. - Yeah, go. 938 00:40:29,635 --> 00:40:31,469 Hey, I've been looking all over for you. 939 00:40:31,470 --> 00:40:33,763 We need a cardiovert unstable AFib in North 1. 940 00:40:33,764 --> 00:40:36,224 - OK, just give me a sec. - Systolic's 90. 941 00:40:36,225 --> 00:40:38,018 Fuck me. 942 00:40:39,728 --> 00:40:42,313 35-year-old architect working on a deadline, 943 00:40:42,314 --> 00:40:45,316 vaping nicotine all night. Palpitations this morning. 944 00:40:45,317 --> 00:40:48,611 AFib at 147. Mr. Quinn, this is Dr. Robby. 945 00:40:48,612 --> 00:40:49,779 Hello, sir. How are you feeling? 946 00:40:49,780 --> 00:40:51,197 Like crap. 947 00:40:51,198 --> 00:40:52,740 When did your palpitations start? 948 00:40:52,741 --> 00:40:54,033 A little while ago. 949 00:40:54,034 --> 00:40:55,702 We interrogated his smartwatch. 950 00:40:55,703 --> 00:40:57,036 His heart rate has only been up for 92 minutes. 951 00:40:57,037 --> 00:40:58,663 You understand we need to shock 952 00:40:58,664 --> 00:41:00,331 - your heart back to normal? - Is it gonna hurt? 953 00:41:00,332 --> 00:41:03,209 - You'll be sedated. - So it's really gonna hurt. 954 00:41:03,210 --> 00:41:04,794 Mel, 75 of propofol, slow IV push. 955 00:41:04,795 --> 00:41:06,337 How much did you vape last night? 956 00:41:06,338 --> 00:41:08,756 - A couple of pods. - You vape every day? 957 00:41:08,757 --> 00:41:10,800 I do, but not that much. 958 00:41:10,801 --> 00:41:12,886 - You want to cut back? - I've tried. 959 00:41:12,887 --> 00:41:14,512 It's just really fucking hard. 960 00:41:14,513 --> 00:41:16,014 How much nicotine is in a pod? 961 00:41:16,015 --> 00:41:17,807 - Anybody know? - No idea. 962 00:41:17,808 --> 00:41:19,559 40 milligrams, same as a pack of cigarettes. 963 00:41:19,560 --> 00:41:21,227 Wow, two packs in one night. 964 00:41:21,228 --> 00:41:23,354 Mel, what's the safe window for cardioversion? 965 00:41:23,355 --> 00:41:25,815 - 12 hours. - What happens after that? 966 00:41:25,816 --> 00:41:27,901 Increased risk of embolic stroke 967 00:41:27,902 --> 00:41:29,444 from left atrial blood clot. 968 00:41:29,445 --> 00:41:31,821 Which he does not have. 969 00:41:31,822 --> 00:41:34,073 Mr. Quinn. Mr. Quinn. 970 00:41:34,074 --> 00:41:35,450 OK, he's out. 971 00:41:35,451 --> 00:41:37,160 Sync cardioversion at 200 joules. 972 00:41:37,161 --> 00:41:39,705 - Charged. - Clear. 973 00:41:43,375 --> 00:41:45,418 - Bingo. - Sinus rhythm. 974 00:41:45,419 --> 00:41:46,669 Cycle BP. 975 00:41:46,670 --> 00:41:48,379 We'll monitor for a few hours. 976 00:41:48,380 --> 00:41:50,089 Yeah, let's get addiction services on the case too. 977 00:41:50,090 --> 00:41:51,549 He's gonna need a daily patch 978 00:41:51,550 --> 00:41:53,343 and nicotine gum for breakthrough cravings. 979 00:41:53,344 --> 00:41:54,886 This one's a bitch to kick. 980 00:41:54,887 --> 00:41:56,679 Hey, the sister of Abbot-- 981 00:41:56,680 --> 00:41:59,432 Shit, yes. Shit, yes, yes. 982 00:41:59,433 --> 00:42:02,311 Go get 'em, tiger. 983 00:42:08,025 --> 00:42:10,485 Are you Mr. Orser's sister? 984 00:42:10,486 --> 00:42:12,987 - Fiona. - Hi, Fiona. 985 00:42:12,988 --> 00:42:14,239 I'm Dr. Robinavitch. 986 00:42:14,240 --> 00:42:15,823 Everybody calls me Dr. Robby. 987 00:42:15,824 --> 00:42:18,243 Have a seat, please, and I will tell you 988 00:42:18,244 --> 00:42:19,912 everything that's happened. 989 00:42:23,082 --> 00:42:25,166 Are you looking for something in particular? 990 00:42:25,167 --> 00:42:28,336 Anything with a very low potential for mortality. 991 00:42:28,337 --> 00:42:30,463 Mm-mm. You're not playing that game. 992 00:42:30,464 --> 00:42:32,382 Only thing I'm playing is let's keep the patients alive. 993 00:42:32,383 --> 00:42:36,803 Uh-huh, well, now we're playing face your fears. 994 00:42:36,804 --> 00:42:38,513 That sounds like a terrible game. 995 00:42:38,514 --> 00:42:40,098 What up there scares you the most? 996 00:42:40,099 --> 00:42:43,935 - All of it. - Pick the worst. 997 00:42:43,936 --> 00:42:45,270 South 20. 998 00:42:45,271 --> 00:42:47,230 82-year-old woman, low back pain. 999 00:42:47,231 --> 00:42:49,983 I mean, that's potential leaking AAA, 1000 00:42:49,984 --> 00:42:52,819 cauda equina syndrome, spinal epidural abscess. 1001 00:42:52,820 --> 00:42:54,362 That could go wrong in so many ways. 1002 00:42:54,363 --> 00:42:55,905 Not today, amigo. 1003 00:42:55,906 --> 00:42:57,115 We're gonna work this lady up like a race car. 1004 00:42:57,116 --> 00:42:58,491 What does that mean? 1005 00:42:58,492 --> 00:42:59,867 It means you're on the pit crew now. 1006 00:42:59,868 --> 00:43:01,954 Come on. 1007 00:43:03,789 --> 00:43:06,874 Are you ready to go inside? 1008 00:43:06,875 --> 00:43:09,544 No, not really. 1009 00:43:09,545 --> 00:43:11,212 I'll be with you. 1010 00:43:11,213 --> 00:43:13,924 You can decide when you want to leave. 1011 00:43:31,317 --> 00:43:35,695 You're so cold. 1012 00:43:35,696 --> 00:43:38,072 I'm sorry. 1013 00:43:38,073 --> 00:43:41,909 I'm sorry I wasn't here with you. 1014 00:43:41,910 --> 00:43:45,747 But I'm here now. 1015 00:43:45,748 --> 00:43:48,667 Wherever you are. 1016 00:43:51,045 --> 00:43:54,131 I don't know what the world is without you. 1017 00:44:06,143 --> 00:44:07,727 I really can't look at this letter. 1018 00:44:07,728 --> 00:44:10,855 Would it be too much to ask you to read it to me? 1019 00:44:10,856 --> 00:44:12,106 Oh, I'm sorry. 1020 00:44:12,107 --> 00:44:13,399 That's an inappropriate request. 1021 00:44:13,400 --> 00:44:15,443 No, not at all, not at all. 1022 00:44:15,444 --> 00:44:17,321 I'd be honored by the request. 1023 00:44:28,540 --> 00:44:32,043 "To the family of Raymond Orser, 1024 00:44:32,044 --> 00:44:35,296 "my name is Dr. Jack Abbot. 1025 00:44:35,297 --> 00:44:40,760 "I am the emergency department physician who treated Raymond. 1026 00:44:40,761 --> 00:44:44,972 "I, like Ray, am also a veteran. 1027 00:44:44,973 --> 00:44:48,559 "And though I never met Raymond before today, 1028 00:44:48,560 --> 00:44:51,521 "I served with men like him. 1029 00:44:51,522 --> 00:44:53,981 "So I can only imagine what an outstanding person 1030 00:44:53,982 --> 00:44:56,068 he must have been." 1031 00:45:00,656 --> 00:45:04,200 "I'm sorry I could not save Ray's life. 1032 00:45:04,201 --> 00:45:06,160 "We worked on him for several hours, 1033 00:45:06,161 --> 00:45:09,122 "but his injuries were too severe, 1034 00:45:09,123 --> 00:45:14,460 "even for someone as tough and battle-tested as Raymond. 1035 00:45:14,461 --> 00:45:19,215 "Please take some comfort in knowing he did not suffer. 1036 00:45:19,216 --> 00:45:21,300 "You have my heartfelt condolences. 1037 00:45:21,301 --> 00:45:24,805 Jack Abbot." 1038 00:45:27,766 --> 00:45:31,687 - Thank you. - You're very welcome. 1039 00:45:40,195 --> 00:45:43,198 Again, I'm very, very sorry for your loss. 1040 00:45:56,712 --> 00:45:58,504 Where do you think you're going, Myrna? 1041 00:45:58,505 --> 00:46:02,759 Oh, none of your business, fruitcake. 1042 00:46:02,760 --> 00:46:05,136 Actually, everything that happens in this department 1043 00:46:05,137 --> 00:46:07,180 is my business. And you know what? 1044 00:46:07,181 --> 00:46:08,556 I put up with a lot around here. 1045 00:46:08,557 --> 00:46:10,391 I take very good care of you, 1046 00:46:10,392 --> 00:46:12,351 so you can call me Dr. Robinavitch, 1047 00:46:12,352 --> 00:46:14,061 or you can call me Dr. Robby, 1048 00:46:14,062 --> 00:46:16,230 or you can use my first name of Michael, 1049 00:46:16,231 --> 00:46:18,524 but I do not appreciate you calling me fruitcake. 1050 00:46:18,525 --> 00:46:23,946 Oh, did I hurt your feelings, cocksucker? 1051 00:46:23,947 --> 00:46:26,073 That said, it has a certain whimsical quality 1052 00:46:26,074 --> 00:46:28,159 to it that I can probably learn to live with. 1053 00:46:28,160 --> 00:46:30,161 Whatever you say, fruitcake. 1054 00:46:30,162 --> 00:46:33,080 Excuse me, Doctor, my father is starting to struggle again. 1055 00:46:33,081 --> 00:46:35,209 OK. 1056 00:46:39,129 --> 00:46:40,588 Don't you know those things will kill you? 1057 00:46:40,589 --> 00:46:42,173 I'm not that lucky. 1058 00:46:42,174 --> 00:46:43,466 Ow! 1059 00:46:43,467 --> 00:46:46,636 What the fuck? 1060 00:46:46,637 --> 00:46:48,555 Hey, they're stealing our rig! 1061 00:46:50,390 --> 00:46:51,808 Did you leave the keys in it? 1062 00:46:51,809 --> 00:46:53,851 Always, in case somebody needs to move it. 1063 00:46:53,852 --> 00:46:55,311 Yeah, you probably shouldn't have done that. 1064 00:46:55,312 --> 00:46:56,687 Why don't you come on inside, Ziggler? 1065 00:46:56,688 --> 00:46:58,231 - We'll look you over. - I'm fine. 1066 00:46:58,232 --> 00:47:00,024 Fuck that. 1067 00:47:00,025 --> 00:47:02,318 God, can you believe that shit? 1068 00:47:02,319 --> 00:47:04,404 It happens. 1069 00:47:07,366 --> 00:47:09,325 What can you do to make him more comfortable? 1070 00:47:09,326 --> 00:47:10,743 We can take the tube out. 1071 00:47:10,744 --> 00:47:13,037 But he needs that to breathe. 1072 00:47:13,038 --> 00:47:16,916 If we extubate, we would keep him on oxygen for comfort. 1073 00:47:16,917 --> 00:47:19,836 We would decrease his sedation. 1074 00:47:19,837 --> 00:47:22,255 He might regain consciousness. He could recognize you. 1075 00:47:22,256 --> 00:47:23,923 Maybe even speak. 1076 00:47:23,924 --> 00:47:25,716 Well, I don't want to do anything to jeopardize 1077 00:47:25,717 --> 00:47:29,595 - him getting better. - That's just the point, Helen. 1078 00:47:29,596 --> 00:47:31,180 He's never getting better. 1079 00:47:31,181 --> 00:47:33,391 - You don't know that. - I do know that, OK? 1080 00:47:33,392 --> 00:47:35,351 He knows that. 1081 00:47:35,352 --> 00:47:38,271 And Dad probably even knows it. 1082 00:47:38,272 --> 00:47:40,690 It's time to let him go. 1083 00:47:40,691 --> 00:47:42,608 I'm sorry if you've had your fill of Dad, 1084 00:47:42,609 --> 00:47:47,154 but I haven't, and I am not giving up on him. 1085 00:47:47,155 --> 00:47:49,366 Even if it's hurting him? 1086 00:47:52,035 --> 00:47:54,245 I'm sorry, but if there was anything I could do 1087 00:47:54,246 --> 00:47:56,247 to heal your father, I would do it. 1088 00:47:56,248 --> 00:47:58,457 But the most humane thing that I can do for him 1089 00:47:58,458 --> 00:48:02,378 is to allow him a painless, peaceful passing, 1090 00:48:02,379 --> 00:48:04,965 and that requires removing the breathing tube. 1091 00:48:07,009 --> 00:48:10,887 How long will it take once the tube's out? 1092 00:48:10,888 --> 00:48:12,805 From minutes to hours, 1093 00:48:12,806 --> 00:48:15,434 but we would ensure that he'd be in no physical discomfort. 1094 00:48:21,481 --> 00:48:23,275 OK.