1
00:00:11,011 --> 00:00:12,344
You sent labs?
2
00:00:12,345 --> 00:00:13,679
No indication.
3
00:00:13,680 --> 00:00:15,014
Normal vitals, normal neuro exam.
4
00:00:15,015 --> 00:00:16,640
Dude just dropped--no warning.
5
00:00:16,641 --> 00:00:19,101
- What's open?
- Trauma 1.
6
00:00:19,102 --> 00:00:21,855
Grab Langdon or whoever else is avail.
7
00:00:24,357 --> 00:00:25,607
What have we got?
8
00:00:25,608 --> 00:00:27,192
Seizure in chairs.
9
00:00:27,193 --> 00:00:28,277
Thank you.
10
00:00:28,278 --> 00:00:29,611
How is it out there?
11
00:00:29,612 --> 00:00:31,990
Chaos. We're never gonna catch up.
12
00:00:33,533 --> 00:00:35,159
Lorazepam's on board.
13
00:00:35,160 --> 00:00:36,953
Okay, draw up another 4.
14
00:00:38,955 --> 00:00:40,414
Yeah, no history.
15
00:00:40,415 --> 00:00:42,499
Doesn't look like he's been here before.
16
00:00:42,500 --> 00:00:45,002
Satting low 90s on 5 liters.
17
00:00:45,003 --> 00:00:46,587
Another 4 milligrams.
18
00:00:46,588 --> 00:00:49,256
I can't get the top off.
19
00:00:49,257 --> 00:00:51,175
It's just the plastic, not the metal.
20
00:00:51,176 --> 00:00:52,634
No, I know. I know, I know.
21
00:00:52,635 --> 00:00:53,677
Here, give it to me.
22
00:00:53,678 --> 00:00:55,054
No, I got it.
23
00:00:55,055 --> 00:00:56,889
Okay.
24
00:00:56,890 --> 00:00:59,183
Ordering CBC, CMP,
25
00:00:59,184 --> 00:01:01,727
and a straight cath for a urine tox.
26
00:01:01,728 --> 00:01:05,147
All right. Pushing the second 4.
27
00:01:05,148 --> 00:01:07,024
If this doesn't work,
we need to prep Keppra.
28
00:01:07,025 --> 00:01:08,984
No, we'll give more lorazepam.
29
00:01:08,985 --> 00:01:10,277
It's already ordered.
30
00:01:10,278 --> 00:01:11,862
He's already had 8 milligrams.
31
00:01:11,863 --> 00:01:13,363
- He'll stop breathing.
- Then we'll intubate.
32
00:01:13,364 --> 00:01:15,074
Sometimes a patient needs a little more.
33
00:01:15,075 --> 00:01:17,201
- How long has he been seizing?
- About four minutes ago.
34
00:01:17,202 --> 00:01:18,702
He started seizing in chairs.
35
00:01:18,703 --> 00:01:20,496
He's already had 8 of lorazepam.
36
00:01:20,497 --> 00:01:22,956
I want to move on to Keppra,
but Dr. Langdon disagrees.
37
00:01:22,957 --> 00:01:25,000
I just want us to try another
2 milligrams before moving on.
38
00:01:25,001 --> 00:01:27,962
Dr. Langdon's patient, Dr. Langdon's call.
39
00:01:33,635 --> 00:01:35,928
Dennis Whitaker, meet Bob Chazen,
40
00:01:35,929 --> 00:01:38,472
a 53-year-old cyclist who injured his leg
41
00:01:38,473 --> 00:01:40,766
about ten days ago on a trip to Utah.
42
00:01:40,767 --> 00:01:43,560
I was in Moab, coming downhill fast,
43
00:01:43,561 --> 00:01:46,522
and jammed my pedal into my leg.
44
00:01:46,523 --> 00:01:47,648
Ouch.
45
00:01:47,649 --> 00:01:49,566
That's some gnarly road rash.
46
00:01:49,567 --> 00:01:51,401
White Rim Trail.
47
00:01:51,402 --> 00:01:53,946
I've been putting Neosporin
on it a couple times a day,
48
00:01:53,947 --> 00:01:56,532
but now it hurts to walk.
49
00:01:56,533 --> 00:01:57,826
What do you see, Whitaker?
50
00:01:58,827 --> 00:02:00,828
Outside of the wound looks cellulitic.
51
00:02:00,829 --> 00:02:01,995
What's that?
52
00:02:01,996 --> 00:02:03,539
It's a bacterial infection.
53
00:02:03,540 --> 00:02:05,582
We'll need to get you on oral antibiotics.
54
00:02:05,583 --> 00:02:06,750
Figured.
55
00:02:06,751 --> 00:02:08,044
What about the center of the wound?
56
00:02:09,254 --> 00:02:11,964
It's a simple hematoma.
57
00:02:11,965 --> 00:02:14,091
Which you can now debride.
58
00:02:14,092 --> 00:02:15,676
Whitaker will take off the
dead skin covering the blister
59
00:02:15,677 --> 00:02:16,969
to help it heal better.
60
00:02:16,970 --> 00:02:18,470
I'll be right back.
61
00:02:18,471 --> 00:02:20,264
Yeah, quick question.
62
00:02:20,265 --> 00:02:22,182
Get some Iris scissors,
toothed forceps, sterile gauze.
63
00:02:22,183 --> 00:02:24,144
No, it's just...
64
00:02:26,938 --> 00:02:28,605
Blister guy? Really?
65
00:02:28,606 --> 00:02:30,357
Mr. Chazen was the next patient on deck.
66
00:02:30,358 --> 00:02:31,859
I know I screwed up earlier.
67
00:02:31,860 --> 00:02:32,985
You didn't screw up.
68
00:02:32,986 --> 00:02:34,486
The patient died.
69
00:02:34,487 --> 00:02:35,988
It happens.
70
00:02:35,989 --> 00:02:39,409
Just don't amputate Mr. Chazen's leg.
71
00:02:43,204 --> 00:02:45,414
Okay. Hey.
72
00:02:45,415 --> 00:02:46,915
Another 2 of lorazepam.
73
00:02:46,916 --> 00:02:49,293
- For a total of 10.
- I'm well aware.
74
00:02:49,294 --> 00:02:50,670
He's still seizing.
75
00:02:51,963 --> 00:02:53,088
Call respiratory.
76
00:02:53,089 --> 00:02:54,339
I'm setting up an intubation tray.
77
00:02:54,340 --> 00:02:55,799
Which we won't need.
78
00:02:55,800 --> 00:02:59,094
Dr. Santos, what is the definition
of status epilepticus?
79
00:02:59,095 --> 00:03:01,805
A seizure lasting more than five minutes
or at least two seizures
80
00:03:01,806 --> 00:03:03,390
without full recovery in between.
81
00:03:03,391 --> 00:03:04,767
Excellent.
82
00:03:06,519 --> 00:03:07,936
Seizure activity has stopped.
83
00:03:07,937 --> 00:03:09,771
Also excellent.
84
00:03:09,772 --> 00:03:13,358
Spontaneous breathing, good tidal volume.
85
00:03:13,359 --> 00:03:15,194
Sats up to 98.
86
00:03:15,195 --> 00:03:16,862
Welcome back, Mr. Marino.
87
00:03:16,863 --> 00:03:19,698
Now we can do a Keppra load
slowly and safely.
88
00:03:19,699 --> 00:03:21,325
Nice work, Dr. Langdon.
89
00:03:21,326 --> 00:03:23,577
I will be at Central if you need me.
90
00:03:23,578 --> 00:03:25,037
This must have been a bad vial.
91
00:03:25,038 --> 00:03:26,747
8 milligrams should have worked.
92
00:03:26,748 --> 00:03:28,290
According to your textbook
of emergency medicine.
93
00:03:28,291 --> 00:03:29,583
But sometimes they need a little bit more.
94
00:03:29,584 --> 00:03:30,918
You'll learn that with time.
95
00:03:30,919 --> 00:03:32,127
Well, why couldn't I open the vial?
96
00:03:32,128 --> 00:03:33,921
Because you're an intern
97
00:03:33,922 --> 00:03:35,964
who also needs to learn
to trust her senior resident,
98
00:03:35,965 --> 00:03:38,259
especially in front of an attending.
99
00:03:39,594 --> 00:03:41,637
Now check his labs,
100
00:03:41,638 --> 00:03:43,513
babysit him until he goes to CT,
101
00:03:43,514 --> 00:03:46,516
and get some blankets on these side rails
102
00:03:46,517 --> 00:03:48,269
as a seizure precaution.
103
00:03:56,361 --> 00:03:58,278
- Is this gonna hurt?
- Oh, no.
104
00:03:58,279 --> 00:04:00,364
Skin's dead. You won't feel a thing.
105
00:04:00,365 --> 00:04:01,782
First time in Moab?
106
00:04:01,783 --> 00:04:03,116
No, no.
107
00:04:03,117 --> 00:04:06,161
I belong to a club, Gears and Beers.
108
00:04:06,162 --> 00:04:09,248
We started riding to Frick Park
during the pandemic--
109
00:04:09,249 --> 00:04:11,625
you know, just something
to do to get out of the house.
110
00:04:11,626 --> 00:04:15,588
But we all stuck with it,
and now we go on biking trips.
111
00:04:21,594 --> 00:04:23,012
Help! Do something, man!
112
00:04:24,389 --> 00:04:25,681
Dude!
113
00:04:25,682 --> 00:04:27,307
I need a little help here!
114
00:04:27,308 --> 00:04:28,351
Jesus!
115
00:04:30,895 --> 00:04:32,396
Hey. What's up?
116
00:04:32,397 --> 00:04:34,606
Arterial pumper under a blood blister.
117
00:04:34,607 --> 00:04:36,191
Let's see.
118
00:04:36,192 --> 00:04:38,110
- Jesus!
- Oh, God.
119
00:04:38,111 --> 00:04:39,611
Noob.
120
00:04:39,612 --> 00:04:41,697
Hi, I'm Dr. King. We can fix this.
121
00:04:41,698 --> 00:04:43,865
- Did you cut an artery?
- No, no.
122
00:04:43,866 --> 00:04:45,742
I punctured the top of the blood blister,
123
00:04:45,743 --> 00:04:47,327
but there was an artery
hiding under there.
124
00:04:47,328 --> 00:04:48,829
Hiding?
125
00:04:48,830 --> 00:04:50,664
Like you didn't know it was there?
126
00:04:50,665 --> 00:04:53,041
Don't you have to know basic
anatomy to become a doctor?
127
00:04:53,042 --> 00:04:54,334
He's a student doctor.
128
00:04:54,335 --> 00:04:56,044
What the fuck?
129
00:04:56,045 --> 00:04:57,337
Student?
130
00:04:57,338 --> 00:04:58,880
Oh, hell, no. No, no, no.
131
00:04:58,881 --> 00:05:00,173
Can you help me?
132
00:05:00,174 --> 00:05:02,134
- Can you fix it?
- Oh, absolutely.
133
00:05:02,135 --> 00:05:06,930
First, we are going to put this BP cuff on
to stop the bleeding.
134
00:05:06,931 --> 00:05:08,181
A little forward.
135
00:05:08,182 --> 00:05:09,559
There we go.
136
00:05:12,895 --> 00:05:15,105
All right, you can let go.
137
00:05:15,106 --> 00:05:17,232
Yeah?
138
00:05:17,233 --> 00:05:19,526
- Thank God.
- Oh, thank God.
139
00:05:19,527 --> 00:05:22,738
All right, Whitaker, 10 ccs
of 1% lidocaine with epi.
140
00:05:22,739 --> 00:05:24,156
Yep.
141
00:05:24,157 --> 00:05:27,993
The shot is gonna numb the area
and also constrict any blood vessels
142
00:05:27,994 --> 00:05:30,038
so that we can put
a little stitch in there.
143
00:05:32,707 --> 00:05:34,541
What happened in here?
144
00:05:34,542 --> 00:05:38,503
Hidden laceration of
an arteriole under the vesicle.
145
00:05:38,504 --> 00:05:40,839
Bleeding stopped at 180 on the BP cuff,
146
00:05:40,840 --> 00:05:43,050
and we are now injecting
lidocaine with epi.
147
00:05:43,051 --> 00:05:44,593
Thank you, Dr. King.
148
00:05:44,594 --> 00:05:46,887
Let's set up a suture tray with 3-0 nylon.
149
00:05:46,888 --> 00:05:48,638
Okay. A pinprick and some burning--
150
00:05:48,639 --> 00:05:51,641
Doc, Doc, can you step in here, please?
151
00:05:51,642 --> 00:05:53,728
You got this, Whitaker.
152
00:05:56,314 --> 00:05:58,732
That ambulance chase is on live TV.
153
00:05:58,733 --> 00:06:00,567
- What channel?
- Every channel.
154
00:06:00,568 --> 00:06:03,445
What do you think the over-under
on clipped cars should be?
155
00:06:03,446 --> 00:06:04,654
15.
156
00:06:04,655 --> 00:06:06,239
Come on.
157
00:06:06,240 --> 00:06:08,200
Can I put it on the TVs
in the waiting room?
158
00:06:08,201 --> 00:06:12,205
Fine by me. I just hope wherever it
ends up, it's out of our catchment zone.
159
00:06:15,458 --> 00:06:17,125
Got a second?
160
00:06:17,126 --> 00:06:19,086
It's never a second, but shoot.
161
00:06:19,087 --> 00:06:21,588
I think there was an issue
with a vial of lorazepam used
162
00:06:21,589 --> 00:06:23,382
on our last patient
and it should be reported
163
00:06:23,383 --> 00:06:24,716
to the drug manufacturer.
164
00:06:24,717 --> 00:06:26,176
What kind of issue?
165
00:06:26,177 --> 00:06:30,430
The cap was really hard to take off,
almost like it was super-sealed shut.
166
00:06:30,431 --> 00:06:32,015
I'm worried it could be a bigger issue.
167
00:06:32,016 --> 00:06:33,809
Like?
168
00:06:33,810 --> 00:06:37,771
Like maybe the temperature wasn't
properly controlled during transportation
169
00:06:37,772 --> 00:06:40,148
and the seal on the vial melted shut,
170
00:06:40,149 --> 00:06:41,900
which could mean the medication
is compromised.
171
00:06:41,901 --> 00:06:43,903
Any other vials affected?
172
00:06:45,321 --> 00:06:47,614
Just this one.
173
00:06:47,615 --> 00:06:49,116
Okay.
174
00:06:49,117 --> 00:06:50,784
Check the manufacturer's website,
175
00:06:50,785 --> 00:06:52,536
see if there's been
a recall of the lot number.
176
00:06:52,537 --> 00:06:54,788
And what if this is
the first irregular vial?
177
00:06:54,789 --> 00:06:57,874
Then hold on to the vial in case
there are any other issues.
178
00:06:57,875 --> 00:06:59,751
Hey, look who's in the house!
179
00:06:59,752 --> 00:07:01,461
Hey.
180
00:07:01,462 --> 00:07:03,255
Jake the Snake!
181
00:07:03,256 --> 00:07:05,549
It's 11:00 a.m.
Aren't you supposed to be in school?
182
00:07:05,550 --> 00:07:07,968
- Mom let me ditch for Pittfest.
- How's your mama?
183
00:07:07,969 --> 00:07:10,387
Oh, she's restoring some house
in Squirrel Hill,
184
00:07:10,388 --> 00:07:13,265
- so, you know, she's pretty busy.
- That's cool. You looking for Robby?
185
00:07:13,266 --> 00:07:14,558
Yeah, he's got our festival passes.
186
00:07:14,559 --> 00:07:15,976
Oh, you going together?
187
00:07:15,977 --> 00:07:17,644
We were supposed to, but, you know,
188
00:07:17,645 --> 00:07:20,647
- I decided to go with a friend.
- What's her name?
189
00:07:20,648 --> 00:07:22,232
- Leah.
- Okay. Okay.
190
00:07:22,233 --> 00:07:23,900
- Okay, okay.
- Don't hold out on us.
191
00:07:23,901 --> 00:07:28,071
We need details. Where'd you meet?
How long have you been together?
192
00:07:28,072 --> 00:07:31,741
We met at junior lifeguards this summer,
and we've been dating for two months.
193
00:07:31,742 --> 00:07:34,161
- Yeah, she's pretty great.
- That's sweet.
194
00:07:34,162 --> 00:07:35,745
I'm happy for you, kiddo.
195
00:07:35,746 --> 00:07:38,415
I'm gonna go find Robby,
let him know you're here.
196
00:07:38,416 --> 00:07:40,459
Hey.
197
00:07:40,460 --> 00:07:42,836
A little advice, man-to-man--
198
00:07:42,837 --> 00:07:45,046
always compliment her outfit,
199
00:07:45,047 --> 00:07:48,592
hold her hand in front of your friends,
200
00:07:48,593 --> 00:07:51,094
and always wrap it before you tap it.
201
00:07:51,095 --> 00:07:53,513
Okay.
202
00:07:53,514 --> 00:07:55,724
Slowly letting down the cuff pressure
203
00:07:55,725 --> 00:07:58,518
until we can identify the exact spot.
204
00:07:58,519 --> 00:08:00,145
Oh, I see it. I see it.
205
00:08:00,146 --> 00:08:01,480
Right there.
206
00:08:01,481 --> 00:08:03,064
Okay.
207
00:08:03,065 --> 00:08:04,858
Now you can place
a figure-of-eight suture.
208
00:08:04,859 --> 00:08:06,694
I've never done one of those before.
209
00:08:08,821 --> 00:08:10,238
Look, maybe you should just do it.
210
00:08:10,239 --> 00:08:11,865
You should definitely do it.
211
00:08:11,866 --> 00:08:13,325
Whitaker's got this.
212
00:08:13,326 --> 00:08:15,285
It's easy, just two stitches in one.
213
00:08:15,286 --> 00:08:17,621
Take a big bite,
a simple interrupted suture
214
00:08:17,622 --> 00:08:18,872
anterior to the bleeder.
215
00:08:18,873 --> 00:08:20,333
Okay.
216
00:08:22,835 --> 00:08:24,212
Okay.
217
00:08:29,717 --> 00:08:33,054
Now instead of tying,
throw another one posterior.
218
00:08:35,181 --> 00:08:36,473
Looks good.
219
00:08:36,474 --> 00:08:38,141
Now a normal tie for a figure-of-eight.
220
00:08:38,142 --> 00:08:40,477
What did I miss in here?
221
00:08:40,478 --> 00:08:42,229
I am so sorry. I just--
222
00:08:42,230 --> 00:08:44,481
Made an excellent catch
and saved Mr. Chazen's life.
223
00:08:44,482 --> 00:08:46,107
- Really?
- Really?
224
00:08:46,108 --> 00:08:47,359
Really?
225
00:08:47,360 --> 00:08:50,445
There was a cut arteriole
under a ballotable vesicle.
226
00:08:50,446 --> 00:08:52,405
If Mr. Chazen had gone home
without debridement,
227
00:08:52,406 --> 00:08:55,242
the blister could have eroded
with uncontrollable hemorrhage.
228
00:08:55,243 --> 00:08:57,202
Nice work.
229
00:08:57,203 --> 00:09:00,497
Jackson Pollock here might want
to go hit the scrubs exchange.
230
00:09:00,498 --> 00:09:02,124
Yeah.
231
00:09:15,680 --> 00:09:17,097
All right.
232
00:09:17,098 --> 00:09:19,808
Next up is an ingrown toenail.
233
00:09:19,809 --> 00:09:21,560
It should be pretty quick, though.
234
00:09:21,561 --> 00:09:22,687
And...
235
00:09:24,355 --> 00:09:26,189
Sherry, you're back.
236
00:09:26,190 --> 00:09:27,732
The kids get to school okay?
237
00:09:27,733 --> 00:09:29,442
- Yeah. Thanks.
- Hey, cool.
238
00:09:29,443 --> 00:09:30,986
Well, come with me,
239
00:09:30,987 --> 00:09:32,654
and we'll finish up your wound care, okay?
240
00:09:32,655 --> 00:09:34,698
Earl, what are you doing out here?
241
00:09:34,699 --> 00:09:36,408
I'm hungry.
242
00:09:36,409 --> 00:09:37,784
Head back inside,
and we'll get you a sandwich.
243
00:09:37,785 --> 00:09:40,245
- No egg salad.
- Sure. Come on.
244
00:09:40,246 --> 00:09:41,788
Excuse me. Excuse me.
245
00:09:41,789 --> 00:09:44,916
I've been here for over five hours, okay,
way longer than that chick.
246
00:09:44,917 --> 00:09:46,710
Can you check the list? Driscoll?
247
00:09:46,711 --> 00:09:48,462
Doug Driscoll.
248
00:09:50,256 --> 00:09:54,342
Everybody is seen as quickly as possible
and in order of medical care needed.
249
00:09:54,343 --> 00:09:55,760
Unless they die waiting.
250
00:09:55,761 --> 00:09:57,178
Would you look at that, Mr. Driscoll?
251
00:09:57,179 --> 00:09:58,388
It's actually time to bring you back.
252
00:09:58,389 --> 00:09:59,764
Thank God.
253
00:09:59,765 --> 00:10:01,099
Would you take care of Mr. Driscoll?
254
00:10:01,100 --> 00:10:02,892
Yeah, absolutely.
255
00:10:02,893 --> 00:10:04,520
Sherry, you're with me.
256
00:10:05,521 --> 00:10:07,063
Oh, yeah.
257
00:10:07,064 --> 00:10:08,941
Yeah, let's take care of this.
258
00:10:15,323 --> 00:10:17,073
Hey, I need a minute.
259
00:10:17,074 --> 00:10:20,160
I already put $20 on disgruntled ex-EMT
260
00:10:20,161 --> 00:10:22,078
caught outside of our catchment.
261
00:10:22,079 --> 00:10:24,539
And I will gladly take your money
when that mess is over,
262
00:10:24,540 --> 00:10:26,374
but this is about a patient.
263
00:10:26,375 --> 00:10:28,710
Kristi Wheeler, 17 years old, pregnant.
264
00:10:28,711 --> 00:10:31,129
These are Abbot's fetal
measurements from yesterday,
265
00:10:31,130 --> 00:10:33,757
and these are mine.
266
00:10:33,758 --> 00:10:35,759
10-5 and 11-2.
267
00:10:35,760 --> 00:10:38,345
Well, ultrasound is an art, not a science.
268
00:10:38,346 --> 00:10:40,847
Even in the very best hands,
the EGA differential can be
269
00:10:40,848 --> 00:10:42,807
within three to five days
in the first trimester.
270
00:10:42,808 --> 00:10:44,351
Definitely room for error.
271
00:10:44,352 --> 00:10:45,935
Not if you're here
for a medication abortion
272
00:10:45,936 --> 00:10:49,064
and you're past
the mandated 11-week cutoff.
273
00:10:49,065 --> 00:10:51,858
There can also be
inter-operator variability.
274
00:10:51,859 --> 00:10:54,027
I measured the gestational sac, 11-3,
275
00:10:54,028 --> 00:10:56,488
and the biparietal diameter, 11-1.
276
00:10:56,489 --> 00:10:58,698
I didn't get a single
measurement under 11 weeks.
277
00:10:58,699 --> 00:11:00,408
So what are you saying,
278
00:11:00,409 --> 00:11:02,369
that Abbot lowballed his
measurements to help a teen
279
00:11:02,370 --> 00:11:04,372
get the abortion that she wants?
280
00:11:06,165 --> 00:11:07,374
Maybe.
281
00:11:07,375 --> 00:11:08,833
Well, then you've got two choices.
282
00:11:08,834 --> 00:11:12,087
You can go with Abbot's measurements,
or you can redo your measurements,
283
00:11:12,088 --> 00:11:14,631
go back in, and pick an angle
that shows 11 weeks or less.
284
00:11:14,632 --> 00:11:16,049
Please tell me you're joking.
285
00:11:16,050 --> 00:11:17,842
You were ready to roll up your sleeves
286
00:11:17,843 --> 00:11:19,344
and arm-wrestle the Ethics Committee
a couple hours ago
287
00:11:19,345 --> 00:11:20,970
to override Mr. Spencer's children.
288
00:11:20,971 --> 00:11:23,556
- What changed?
- Apples and oranges.
289
00:11:23,557 --> 00:11:25,558
There was a clear,
bright line that Mr. Spencer
290
00:11:25,559 --> 00:11:27,435
was never going to make it.
291
00:11:27,436 --> 00:11:30,355
Falsifying medical records
for Kristi is flat-out illegal.
292
00:11:30,356 --> 00:11:32,607
She's 17. She deserves a life.
293
00:11:32,608 --> 00:11:34,275
Of course she does.
294
00:11:34,276 --> 00:11:37,112
But I will not jeopardize
my future in the process.
295
00:11:37,113 --> 00:11:38,988
You'll be fine.
296
00:11:38,989 --> 00:11:42,409
Someone finds out
I falsified medical records,
297
00:11:42,410 --> 00:11:44,327
I'll get booted
from the residency program.
298
00:11:44,328 --> 00:11:45,995
You've got tenure.
299
00:11:45,996 --> 00:11:49,874
Worst case, you have
to take a job in Youngstown.
300
00:11:49,875 --> 00:11:53,671
The risks are not the same
for you as they are for me.
301
00:11:56,757 --> 00:11:58,174
You're right.
302
00:11:58,175 --> 00:12:00,552
- I'll do it.
- What?
303
00:12:00,553 --> 00:12:03,179
Erase your history, physical,
and impression from Kristi's chart.
304
00:12:03,180 --> 00:12:04,389
It'll be like you never saw the patient.
305
00:12:04,390 --> 00:12:06,057
I will take over.
306
00:12:06,058 --> 00:12:07,642
I will complete a new chart
and upload my own image.
307
00:12:07,643 --> 00:12:09,185
Robby, I'm not asking you to--
308
00:12:09,186 --> 00:12:10,603
As your attending, it is my decision.
309
00:12:10,604 --> 00:12:12,188
I am a certified provider
for Mifepristone.
310
00:12:12,189 --> 00:12:13,690
You are not.
311
00:12:13,691 --> 00:12:15,400
And as a prudent physician,
I should examine
312
00:12:15,401 --> 00:12:16,609
every patient before I order medication--
313
00:12:16,610 --> 00:12:18,111
- Robby.
- Yeah.
314
00:12:18,112 --> 00:12:20,363
- Jake's here.
- Hey. Great.
315
00:12:20,364 --> 00:12:21,990
Any word back on Nick Bradley's
316
00:12:21,991 --> 00:12:23,616
- perfusion study results?
- Still waiting.
317
00:12:23,617 --> 00:12:25,160
Will you come find me
when the imaging's back?
318
00:12:25,161 --> 00:12:27,954
These people have already
been through enough.
319
00:12:27,955 --> 00:12:30,832
- Is that Mr. Spencer?
- Yeah.
320
00:12:30,833 --> 00:12:33,334
- Robby?
- Excuse me for one second.
321
00:12:33,335 --> 00:12:34,919
I want to go see if I can find
Mr. Spencer's children
322
00:12:34,920 --> 00:12:36,296
before they leave.
323
00:12:36,297 --> 00:12:38,214
You look a little peaked. You okay?
324
00:12:38,215 --> 00:12:40,175
I just need a good night's sleep.
325
00:12:40,176 --> 00:12:41,885
I'm gonna grab you a grilled cheese
326
00:12:41,886 --> 00:12:43,219
before the noon lunch rush;
it'll help some color
327
00:12:43,220 --> 00:12:44,971
- back to your cheeks.
- Thank you.
328
00:12:44,972 --> 00:12:46,307
I got you.
329
00:12:48,684 --> 00:12:50,435
Can someone please help?
330
00:12:50,436 --> 00:12:51,686
It's my mother.
331
00:12:51,687 --> 00:12:52,896
She fell.
332
00:12:52,897 --> 00:12:54,355
What happened?
333
00:12:54,356 --> 00:12:55,732
I fell in the yard.
334
00:12:55,733 --> 00:12:58,401
I hurt my arm. That's all.
335
00:12:58,402 --> 00:13:00,195
We've been hugging
this wall for almost an hour.
336
00:13:00,196 --> 00:13:01,863
Relax. We're just gonna take her vitals.
337
00:13:01,864 --> 00:13:03,448
Oh, Mom, you've got cuts all over.
338
00:13:03,449 --> 00:13:05,492
I fell in the rose bush.
339
00:13:05,493 --> 00:13:07,536
I'll be fine.
340
00:13:10,706 --> 00:13:12,999
I'm Dr. King. This is Perlah.
341
00:13:13,000 --> 00:13:15,127
- What's your name?
- Ginger Kitajima.
342
00:13:15,711 --> 00:13:17,212
I'm her daughter, Rita.
343
00:13:17,213 --> 00:13:18,797
Ginger, did you hit your head?
344
00:13:18,798 --> 00:13:20,131
No.
345
00:13:20,132 --> 00:13:21,800
Any chance she could have fainted?
346
00:13:21,801 --> 00:13:24,302
- I told you. I tripped.
- I don't know.
347
00:13:24,303 --> 00:13:26,262
I was taking a shower,
and she went outside.
348
00:13:26,263 --> 00:13:29,224
She's not supposed to go
outside anywhere without me.
349
00:13:29,225 --> 00:13:31,351
She needs 24-7 assistance with ADLs.
350
00:13:31,352 --> 00:13:32,727
Are you the primary caregiver?
351
00:13:32,728 --> 00:13:34,938
I'm her only caregiver.
352
00:13:34,939 --> 00:13:37,732
Ma'am, what medications are you on?
353
00:13:37,733 --> 00:13:40,401
Oh, just one.
354
00:13:40,402 --> 00:13:42,111
Risperidone.
355
00:13:42,112 --> 00:13:43,863
My mom has schizophrenia.
356
00:13:43,864 --> 00:13:46,241
BP 132 over 78.
357
00:13:46,242 --> 00:13:47,826
Pulse 84. Sats 98.
358
00:13:47,827 --> 00:13:49,452
I haven't seen this
young lady around before.
359
00:13:49,453 --> 00:13:50,870
Somebody new?
360
00:13:50,871 --> 00:13:52,747
Flattery will get you everywhere.
361
00:13:52,748 --> 00:13:55,041
Ground-level fall. Good vitals.
362
00:13:55,042 --> 00:13:56,501
No head trauma, no AMS,
363
00:13:56,502 --> 00:13:58,211
and just an isolated shoulder injury.
364
00:13:58,212 --> 00:13:59,754
You have any pain in your belly?
365
00:13:59,755 --> 00:14:01,297
No, but next time,
366
00:14:01,298 --> 00:14:03,133
buy me dinner before you do that.
367
00:14:04,593 --> 00:14:06,886
Okay, let's order some basic labs
368
00:14:06,887 --> 00:14:09,097
and get some pain meds on board.
369
00:14:09,098 --> 00:14:10,473
And call me when the X-rays are back.
370
00:14:10,474 --> 00:14:11,975
Your mom's in very good hands.
371
00:14:11,976 --> 00:14:13,268
You're leaving so soon?
372
00:14:13,269 --> 00:14:15,019
Oh, I'm never far away.
373
00:14:15,020 --> 00:14:16,604
I'll save a dance for you.
374
00:14:16,605 --> 00:14:18,648
I'll be counting on it.
375
00:14:18,649 --> 00:14:20,817
Looks like more than just vitals to me.
376
00:14:20,818 --> 00:14:22,735
That's it. You're on the list, Harley.
377
00:14:22,736 --> 00:14:24,571
Aw, shit. No.
378
00:14:24,572 --> 00:14:26,155
Perlah, I'm sorry!
379
00:14:26,156 --> 00:14:27,448
- I take it back!
- Too late!
380
00:14:27,449 --> 00:14:28,993
You're on the list.
381
00:14:44,466 --> 00:14:45,801
Okay.
382
00:14:50,556 --> 00:14:51,599
What?
383
00:14:57,730 --> 00:15:00,983
I like big butts, and I cannot lie.
384
00:15:02,318 --> 00:15:03,693
You scared me there.
385
00:15:03,694 --> 00:15:05,486
Want a pony ride, big boy?
386
00:15:05,487 --> 00:15:07,363
- What?
- Excuse me, Myrna.
387
00:15:07,364 --> 00:15:08,907
I need to discuss
a confidential patient issue
388
00:15:08,908 --> 00:15:10,116
with my colleague here.
389
00:15:10,117 --> 00:15:11,451
We need a little privacy.
390
00:15:11,452 --> 00:15:13,036
Catch you later, sweet cheeks.
391
00:15:13,037 --> 00:15:14,787
Don't mind Myrna. She's harmless.
392
00:15:14,788 --> 00:15:15,997
She's handcuffed.
393
00:15:15,998 --> 00:15:17,833
That's why she's harmless.
394
00:15:21,670 --> 00:15:24,631
You gotta stay on top
of Ozzie's ear infection.
395
00:15:24,632 --> 00:15:26,466
His meds are in the fridge.
396
00:15:26,467 --> 00:15:28,636
Our dog has really bad allergies.
397
00:15:29,637 --> 00:15:32,056
And I changed Ruby's food order to Monday.
398
00:15:33,057 --> 00:15:35,600
Bougie bitch.
She only likes the good stuff.
399
00:15:35,601 --> 00:15:37,227
Like mother, like daughter.
400
00:15:42,399 --> 00:15:44,400
Nice to know you still
make each other laugh.
401
00:15:44,401 --> 00:15:45,902
Make each other laugh.
402
00:15:45,903 --> 00:15:47,988
Make each other deliriously happy.
403
00:15:53,452 --> 00:15:56,412
Sorry. Didn't mean to get
all mushy in front of you.
404
00:15:56,413 --> 00:15:57,622
Are you kidding me?
405
00:15:57,623 --> 00:15:59,582
You two are the sweetest.
406
00:15:59,583 --> 00:16:02,460
I never got to see this kind of
love between a married couple.
407
00:16:02,461 --> 00:16:05,213
Your parents weren't the lovey-dovey type?
408
00:16:05,214 --> 00:16:07,216
My dad died when I was 13.
409
00:16:08,384 --> 00:16:09,592
I'm so sorry.
410
00:16:09,593 --> 00:16:11,094
Yeah, me too.
411
00:16:11,095 --> 00:16:13,471
He's the reason why I got into medicine
412
00:16:13,472 --> 00:16:15,682
and the reason why I'm conducting research
413
00:16:15,683 --> 00:16:17,558
on racial disparity in the ER.
414
00:16:17,559 --> 00:16:19,143
I'm doing a retrospective chart review
415
00:16:19,144 --> 00:16:21,479
on our past five years
of patients of color.
416
00:16:21,480 --> 00:16:24,232
Is that how you knew
what was going on with me?
417
00:16:24,233 --> 00:16:27,568
We don't treat sickle cell here
as well as they do in other hospitals,
418
00:16:27,569 --> 00:16:29,320
but I'm hoping to change that.
419
00:16:29,321 --> 00:16:31,239
Status, Dr. Mohan?
420
00:16:31,240 --> 00:16:33,658
Still on exchange transfusion
and high flow nasal oxygen,
421
00:16:33,659 --> 00:16:34,993
but oxygen sats are dropping.
422
00:16:34,994 --> 00:16:36,411
She's at 84.
423
00:16:36,412 --> 00:16:38,621
- That's really low.
- Yes, it is.
424
00:16:38,622 --> 00:16:40,832
The goal of exchange transfusion is
425
00:16:40,833 --> 00:16:44,002
to reduce the percentage
of sickle hemoglobin to under 30%.
426
00:16:44,003 --> 00:16:46,212
That is not happening at the rate
that your wife needs,
427
00:16:46,213 --> 00:16:48,548
which is causing your blood
to be unable to carry oxygen,
428
00:16:48,549 --> 00:16:49,966
causing further blocked blood cells.
429
00:16:49,967 --> 00:16:52,885
- What does that mean?
- Dr. Mohan.
430
00:16:52,886 --> 00:16:55,179
To prevent stroke or heart attack,
431
00:16:55,180 --> 00:17:00,185
we need to get you more oxygen,
but we will need to intubate.
432
00:17:02,896 --> 00:17:05,356
How long can we wait to see
if that's really necessary?
433
00:17:05,357 --> 00:17:07,817
Acute chest syndrome
can progress very quickly.
434
00:17:07,818 --> 00:17:09,485
It is the most common cause of death
435
00:17:09,486 --> 00:17:10,862
for patients with sickle cell.
436
00:17:10,863 --> 00:17:13,990
It is imperative that we intubate.
437
00:17:13,991 --> 00:17:15,159
I...
438
00:17:16,952 --> 00:17:18,536
I don't know.
439
00:17:18,537 --> 00:17:22,666
Why don't we give you and Ondine
some privacy so you can talk?
440
00:17:27,671 --> 00:17:29,172
Look, you want to be
their friend, but right now,
441
00:17:29,173 --> 00:17:30,506
you need to be Joyce's doctor.
442
00:17:30,507 --> 00:17:33,385
So get her to sign the consent form
and prep for the intubation.
443
00:17:36,638 --> 00:17:39,682
43, 44, 45,
444
00:17:39,683 --> 00:17:42,685
46, 47.
445
00:17:42,686 --> 00:17:44,563
You're not gonna beat my record.
446
00:17:45,773 --> 00:17:47,648
How the hell did you stay on for 80?
447
00:17:47,649 --> 00:17:50,277
I'm 17, and I'm more fit than you.
448
00:17:53,030 --> 00:17:54,697
That kid looks my age.
449
00:17:54,698 --> 00:17:56,282
Yeah, he is.
450
00:17:56,283 --> 00:17:58,451
What happened to him?
451
00:17:58,452 --> 00:18:00,787
Stressed-out 18-year-old took
some pills off the internet
452
00:18:00,788 --> 00:18:02,371
to help him sleep.
453
00:18:02,372 --> 00:18:04,832
They were laced with fentanyl.
454
00:18:04,833 --> 00:18:07,211
Is he gonna make it?
455
00:18:17,387 --> 00:18:18,888
Poor Huckleberry.
456
00:18:18,889 --> 00:18:22,100
Not even 11:30 and you've
already been demoted.
457
00:18:22,101 --> 00:18:24,393
They had only morgue scrubs
left in my size.
458
00:18:24,394 --> 00:18:25,728
Then I guess you better not
459
00:18:25,729 --> 00:18:27,523
fuck anything else up today, huh?
460
00:18:33,612 --> 00:18:34,737
Donahue.
461
00:18:34,738 --> 00:18:36,697
You get in on that ambulance-chase action?
462
00:18:36,698 --> 00:18:39,992
Yeah, $20 on catch,
chop shop, out of our zone.
463
00:18:39,993 --> 00:18:41,536
Bold.
464
00:18:41,537 --> 00:18:43,454
I like it.
465
00:18:43,455 --> 00:18:46,165
What can I do you for?
466
00:18:46,166 --> 00:18:48,084
Hypothetical question--
467
00:18:48,085 --> 00:18:52,547
would you ever go over a resident's head
to the attending?
468
00:18:52,548 --> 00:18:54,966
Hypothetically, I wouldn't recommend it
469
00:18:54,967 --> 00:18:57,426
unless it's a behavioral issue
or harassment.
470
00:18:57,427 --> 00:19:00,429
And in that case, you can make
a confidential report to HR.
471
00:19:00,430 --> 00:19:02,515
What if it's more patient care related?
472
00:19:02,516 --> 00:19:03,933
Depends.
473
00:19:03,934 --> 00:19:05,518
If it's something minor, leave it alone.
474
00:19:05,519 --> 00:19:07,687
If it's something
that endangers the patient,
475
00:19:07,688 --> 00:19:09,522
then definitely yes.
476
00:19:09,523 --> 00:19:11,149
Pick your battles.
477
00:19:11,150 --> 00:19:13,360
You don't want to be
the intern who cried wolf.
478
00:19:16,363 --> 00:19:19,198
- Yeah? Okay, still pretty raw.
- Yeah.
479
00:19:19,199 --> 00:19:22,577
Let me put some more anesthetic on there,
numb you up some more.
480
00:19:22,578 --> 00:19:24,829
It's my own fault.
481
00:19:24,830 --> 00:19:28,791
I should have known better
than to try to make s'mores over a Sterno,
482
00:19:28,792 --> 00:19:30,751
but they kept asking.
483
00:19:30,752 --> 00:19:32,920
Yeah. The things we do for our kids.
484
00:19:32,921 --> 00:19:34,213
Yeah.
485
00:19:34,214 --> 00:19:36,090
- You have a kid, right?
- Yeah.
486
00:19:36,091 --> 00:19:39,218
He's 11.
487
00:19:39,219 --> 00:19:41,220
And when he turned 8,
488
00:19:41,221 --> 00:19:43,182
he begged me
to go camping for his birthday.
489
00:19:44,808 --> 00:19:47,768
We drove four hours to New River Gorge.
490
00:19:47,769 --> 00:19:51,063
Took me an hour to set up the tent.
491
00:19:51,064 --> 00:19:53,649
Guess how long we lasted.
492
00:19:53,650 --> 00:19:55,484
Three hours?
493
00:19:55,485 --> 00:19:57,486
37 minutes.
494
00:19:57,487 --> 00:19:58,946
A thunderstorm came out of nowhere,
495
00:19:58,947 --> 00:20:00,573
filled the tent with water so fast,
496
00:20:00,574 --> 00:20:03,242
I felt like I was being
flushed down a toilet.
497
00:20:03,243 --> 00:20:05,536
I'm so sorry.
498
00:20:05,537 --> 00:20:08,581
Ran out of there like
a couple of gutter rats.
499
00:20:08,582 --> 00:20:11,834
Ended up celebrating his birthday
at 2:00 a.m. with a Happy Meal.
500
00:20:11,835 --> 00:20:14,421
Oh, what my kids wouldn't give
for a Happy Meal.
501
00:20:17,090 --> 00:20:21,594
Yeah, they must have
some pretty fancy McDonald's
502
00:20:21,595 --> 00:20:24,180
up there in Shadyside.
503
00:20:24,181 --> 00:20:25,349
Yeah.
504
00:20:26,141 --> 00:20:27,975
That's where you live?
505
00:20:27,976 --> 00:20:30,145
It's the address on your patient file.
506
00:20:31,521 --> 00:20:34,023
Technically, no.
507
00:20:34,024 --> 00:20:38,486
I just use the address so my kids can go
to a decent school.
508
00:20:38,487 --> 00:20:40,029
Right.
509
00:20:40,030 --> 00:20:41,739
I know it's illegal,
but it's just temporary.
510
00:20:41,740 --> 00:20:42,907
- Oh, God.
- I promise.
511
00:20:42,908 --> 00:20:44,742
No judgment here.
512
00:20:44,743 --> 00:20:46,535
My son always comes first, no matter what.
513
00:20:46,536 --> 00:20:48,037
Yeah.
514
00:20:48,038 --> 00:20:49,998
Even If it means I have to do without.
515
00:20:54,419 --> 00:20:56,170
I know, I'm a doctor, right?
516
00:20:56,171 --> 00:20:58,714
How bad could it be?
517
00:20:58,715 --> 00:21:01,884
But I used to be an addict.
518
00:21:01,885 --> 00:21:03,929
I even lost custody of my kid.
519
00:21:06,181 --> 00:21:08,099
I never would have guessed.
520
00:21:08,100 --> 00:21:09,809
Yeah.
521
00:21:09,810 --> 00:21:13,813
I went through some really dark times
before I finally got help.
522
00:21:13,814 --> 00:21:15,982
And I've been sober now 9 years,
523
00:21:15,983 --> 00:21:18,610
5 months, and 11 days.
524
00:21:19,903 --> 00:21:21,487
And your son?
525
00:21:21,488 --> 00:21:22,822
He's good.
526
00:21:22,823 --> 00:21:25,783
- Okay.
- You know, we're good.
527
00:21:25,784 --> 00:21:27,910
He gets to stay with me
every other weekend.
528
00:21:27,911 --> 00:21:29,830
And...
529
00:21:32,082 --> 00:21:34,542
We'll be back to joint custody
530
00:21:34,543 --> 00:21:38,380
just as soon as I get this
stupid thing off next week.
531
00:21:44,511 --> 00:21:47,054
Don't worry. I only killed three people.
532
00:21:47,055 --> 00:21:49,140
Oh, God, I'm kidding.
533
00:21:49,141 --> 00:21:51,810
I'm kidding. I'm sorry. It was a bad joke.
534
00:21:54,313 --> 00:21:57,898
The whole thing was just this...
535
00:21:57,899 --> 00:22:00,027
giant misunderstanding.
536
00:22:03,739 --> 00:22:07,408
I guess I'm oversharing
because I want you to know,
537
00:22:07,409 --> 00:22:10,454
not everybody has it
all figured out all the time.
538
00:22:11,455 --> 00:22:12,539
Yeah.
539
00:22:20,255 --> 00:22:22,174
I'm struggling.
540
00:22:23,759 --> 00:22:26,178
And I feel like such a bad mom.
541
00:22:29,473 --> 00:22:32,267
And every day is so hard.
542
00:22:33,810 --> 00:22:37,647
And I don't know what's gonna happen
tomorrow or the next day.
543
00:22:41,068 --> 00:22:45,238
Sometimes I wonder if they would
just be better off without me.
544
00:22:48,784 --> 00:22:50,409
Yeah?
545
00:22:50,410 --> 00:22:52,036
Do you...
546
00:22:52,037 --> 00:22:53,872
Not like that. I just...
547
00:22:55,123 --> 00:22:56,832
I've just messed up so much.
548
00:22:56,833 --> 00:22:59,211
- Yeah.
- And I don't know.
549
00:23:05,175 --> 00:23:07,593
You're their mom.
550
00:23:07,594 --> 00:23:10,721
You love them, and nothing
and no one can replace that.
551
00:23:10,722 --> 00:23:12,099
Yeah.
552
00:23:15,102 --> 00:23:18,938
You deserve a little grace, you know.
553
00:23:18,939 --> 00:23:21,358
Be kind to yourself.
554
00:23:24,653 --> 00:23:27,238
Well, you had a normal EKG
and chest X-ray.
555
00:23:27,239 --> 00:23:30,408
But it looks like you sustained
556
00:23:30,409 --> 00:23:34,578
a proximal humerus fracture
on the left upper arm.
557
00:23:34,579 --> 00:23:37,666
There goes my backhand.
558
00:23:39,668 --> 00:23:41,293
That was a joke, dear.
559
00:23:41,294 --> 00:23:44,547
Okay, because
the fracture isn't displaced,
560
00:23:44,548 --> 00:23:46,841
the good news is, you don't need surgery.
561
00:23:46,842 --> 00:23:49,301
Oh, that's a relief.
562
00:23:49,302 --> 00:23:51,720
The bad news is,
you do need to wear a sling
563
00:23:51,721 --> 00:23:53,764
for at least six weeks.
564
00:23:53,765 --> 00:23:56,559
And I have to insist,
absolutely no shoulder mobility
565
00:23:56,560 --> 00:23:58,352
for the first few weeks.
566
00:23:58,353 --> 00:24:01,105
And that means you're gonna
have to step up even more,
567
00:24:01,106 --> 00:24:02,982
because on top of your usual ADLs,
568
00:24:02,983 --> 00:24:04,984
you're also gonna have
to help your mom bathe,
569
00:24:04,985 --> 00:24:07,611
dress, and use the toilet.
570
00:24:07,612 --> 00:24:09,572
I'm so sorry, Mom.
571
00:24:09,573 --> 00:24:12,575
This would never have happened
if I was more on top of things.
572
00:24:12,576 --> 00:24:17,371
Any more on top, you'd be back in my womb.
573
00:24:17,372 --> 00:24:20,374
It's going to be fine.
574
00:24:20,375 --> 00:24:23,002
I know how hard it can be.
575
00:24:23,003 --> 00:24:24,837
I was my sister's primary caregiver
576
00:24:24,838 --> 00:24:27,214
until a few weeks ago.
577
00:24:27,215 --> 00:24:29,300
Where is she now?
578
00:24:29,301 --> 00:24:31,511
She's in an amazing facility
in North Hills.
579
00:24:34,514 --> 00:24:37,266
I know I can be a burden,
580
00:24:37,267 --> 00:24:41,103
but I like being in my own home,
581
00:24:41,104 --> 00:24:43,898
just me and my girl.
582
00:24:43,899 --> 00:24:46,108
You're not a burden.
583
00:24:46,109 --> 00:24:48,444
You're my mom.
584
00:24:48,445 --> 00:24:50,529
I'll refer you to Ortho.
585
00:24:50,530 --> 00:24:54,158
They'll get you set up
with PT and exercises.
586
00:24:54,159 --> 00:24:57,411
You're very lucky to have
such a caring daughter.
587
00:24:57,412 --> 00:24:59,914
Don't I know it.
588
00:24:59,915 --> 00:25:02,541
Park a red Subaru in the ambulance bay?
589
00:25:02,542 --> 00:25:03,792
Yes, that's me.
590
00:25:03,793 --> 00:25:06,253
Gonna need to move that
to open the space for ambulances.
591
00:25:06,254 --> 00:25:07,338
I'm so sorry.
592
00:25:07,339 --> 00:25:08,839
Okay.
593
00:25:08,840 --> 00:25:12,009
I'll walk Rita out. Perlah, would you stay
with Ginger for a minute?
594
00:25:12,010 --> 00:25:13,844
- I'll be right back.
- Yeah, no problem.
595
00:25:13,845 --> 00:25:15,555
Okay. After you.
596
00:25:19,559 --> 00:25:23,562
Look, I put your mom's prescription in
at the pharmacy,
597
00:25:23,563 --> 00:25:28,526
and by the time you get back from parking,
she should be ready to be discharged.
598
00:25:28,527 --> 00:25:31,111
Just don't worry.
599
00:25:31,112 --> 00:25:34,407
Things will be back to normal
in a few weeks.
600
00:25:36,201 --> 00:25:38,619
I'm not sure what normal is anymore.
601
00:25:38,620 --> 00:25:41,163
I can't even remember the last
time I slept through the night.
602
00:25:41,164 --> 00:25:43,165
It's just...
603
00:25:43,166 --> 00:25:44,376
It's a lot.
604
00:25:46,670 --> 00:25:48,588
Do you have any support at home?
605
00:25:49,464 --> 00:25:50,839
I wish.
606
00:25:50,840 --> 00:25:52,259
It's just us.
607
00:25:53,260 --> 00:25:55,928
You know, I hired a part-time aide
for my sister
608
00:25:55,929 --> 00:25:57,346
to cover me when I was at work.
609
00:25:57,347 --> 00:26:00,182
It was really helpful.
610
00:26:00,183 --> 00:26:02,101
It's out of our price range.
611
00:26:02,102 --> 00:26:03,686
I mean, I already work from home.
612
00:26:03,687 --> 00:26:05,729
And then there's
the cooking and the cleaning
613
00:26:05,730 --> 00:26:08,148
and the doctor's appointments.
614
00:26:08,149 --> 00:26:10,276
It never ends.
615
00:26:10,277 --> 00:26:14,154
You know, caretaker's fatigue
is a real thing.
616
00:26:14,155 --> 00:26:15,906
You have to take care of yourself.
617
00:26:15,907 --> 00:26:18,743
Otherwise, you're gonna
end up in here, too.
618
00:26:25,959 --> 00:26:28,252
I still don't understand why Kristi needs
619
00:26:28,253 --> 00:26:30,796
to go through this a third time
with a third doctor.
620
00:26:30,797 --> 00:26:32,256
Yeah, that's our bad.
621
00:26:32,257 --> 00:26:34,925
Our computerized medical records
have been glitching lately,
622
00:26:34,926 --> 00:26:38,053
and Dr. Collins' image
didn't upload properly.
623
00:26:38,054 --> 00:26:40,639
Okay, crown to rump--that's top
of the head to the bottom of the butt--
624
00:26:40,640 --> 00:26:44,561
is how you measure gestational age,
and we are at 10 weeks and 6 days.
625
00:26:45,729 --> 00:26:47,479
I made it by one day?
626
00:26:47,480 --> 00:26:48,981
I will order the medication.
627
00:26:48,982 --> 00:26:50,858
Dr. Collins will go over instructions
628
00:26:50,859 --> 00:26:52,985
on taking the pills when they
come back from the pharmacy.
629
00:26:52,986 --> 00:26:54,486
Thank you so much, Dr. Robby.
630
00:26:54,487 --> 00:26:56,238
Oh, I'm glad I could help.
631
00:26:56,239 --> 00:26:59,074
Even more glad to see you have
such a supportive mom.
632
00:26:59,075 --> 00:27:01,036
Okay, take care.
633
00:27:06,833 --> 00:27:08,709
Appreciate you stepping up.
634
00:27:08,710 --> 00:27:10,420
All good. I got you.
635
00:27:12,297 --> 00:27:14,506
Robby, I have Emma Isaacs
on line 3 for you.
636
00:27:14,507 --> 00:27:16,008
She's the organ donation counselor coming
637
00:27:16,009 --> 00:27:17,676
- to speak to Nick's parents.
- Thank you.
638
00:27:17,677 --> 00:27:19,219
What was that all about?
639
00:27:19,220 --> 00:27:20,846
- Oh, nothing.
- Didn't look like nothing.
640
00:27:20,847 --> 00:27:22,181
- Please.
- What?
641
00:27:22,182 --> 00:27:23,641
You two were once a thing.
642
00:27:23,642 --> 00:27:26,268
We dated briefly a million years ago.
643
00:27:26,269 --> 00:27:28,395
- Never again.
- Never say never.
644
00:27:28,396 --> 00:27:30,314
Settle down, Jane Austen.
645
00:27:30,315 --> 00:27:32,359
The lady doth protest too much.
646
00:27:35,695 --> 00:27:37,488
Jake!
647
00:27:37,489 --> 00:27:39,698
There he is--
the man, the myth, the legend.
648
00:27:39,699 --> 00:27:41,325
And there's the kid
who stole my concert pass
649
00:27:41,326 --> 00:27:42,785
and gave it to a girl.
650
00:27:42,786 --> 00:27:43,786
Where is she? Do I get to meet her?
651
00:27:43,787 --> 00:27:45,037
Need an assist!
652
00:27:45,038 --> 00:27:46,580
- Hold that thought.
- Okay.
653
00:27:46,581 --> 00:27:47,998
Travis Johnson, 17, had a tonsillectomy
654
00:27:47,999 --> 00:27:49,500
ten days ago at St. Michael's.
655
00:27:49,501 --> 00:27:51,210
Started spitting blood about an hour ago.
656
00:27:51,211 --> 00:27:53,337
- Good vitals.
- Hey, Travis. I'm Dr. Robby.
657
00:27:53,338 --> 00:27:54,963
- How much blood?
- Couple mouthfuls.
658
00:27:54,964 --> 00:27:56,174
Can you open up for me?
659
00:27:58,885 --> 00:28:01,679
Hey, Whitaker, Jesse.
Got a post-tonsillectomy hemorrhage.
660
00:28:01,680 --> 00:28:03,555
Nebulized TXA, quick as you can.
661
00:28:03,556 --> 00:28:05,391
- I'm on it. Let's go.
- Let's go, Trauma 2.
662
00:28:05,392 --> 00:28:07,184
So this can go south pretty quickly.
663
00:28:07,185 --> 00:28:08,477
- You up for it?
- Well, I can...
664
00:28:08,478 --> 00:28:09,562
Of course you are.
665
00:28:15,819 --> 00:28:17,403
Ready? Here we go.
666
00:28:17,404 --> 00:28:19,614
One, two, three.
667
00:28:25,245 --> 00:28:26,704
Take long, slow, deep breaths on that.
668
00:28:26,705 --> 00:28:28,539
The TXA is gonna help your blood clot.
669
00:28:28,540 --> 00:28:30,165
Any medical problems?
670
00:28:30,166 --> 00:28:31,458
No, just a ton of strep.
671
00:28:31,459 --> 00:28:32,626
That's why I had the surgery.
672
00:28:32,627 --> 00:28:33,836
You take aspirin?
673
00:28:33,837 --> 00:28:36,255
Any other medications?
674
00:28:36,256 --> 00:28:38,507
Lungs are clear bilaterally, no stridor.
675
00:28:38,508 --> 00:28:40,134
Okay, sure.
676
00:28:40,135 --> 00:28:42,302
You feel like throwing up?
Any pain in your belly?
677
00:28:42,303 --> 00:28:44,096
No.
678
00:28:44,097 --> 00:28:45,264
Labs?
679
00:28:45,265 --> 00:28:48,267
CBC, BMP, maybe coags?
680
00:28:48,268 --> 00:28:49,810
Add a type and screen, just in case.
681
00:28:49,811 --> 00:28:50,894
Yeah.
682
00:28:50,895 --> 00:28:52,438
Good sats at 98%.
683
00:28:52,439 --> 00:28:54,565
BP is 115 over 80.
684
00:28:54,566 --> 00:28:55,733
Okay, good.
685
00:28:55,734 --> 00:28:57,025
Four by four on a ring forceps.
686
00:28:57,026 --> 00:28:59,403
- Let's take a look.
- Okay.
687
00:28:59,404 --> 00:29:01,948
Head back, open wide for me.
688
00:29:03,491 --> 00:29:05,701
- What do you see?
- No active bleeding,
689
00:29:05,702 --> 00:29:07,369
but there's some white
and dark brown stuff
690
00:29:07,370 --> 00:29:09,079
- where the tonsils used to be.
- Oh, that's good.
691
00:29:09,080 --> 00:29:11,123
That's a fibrinous clot.
That means the TXA is working.
692
00:29:11,124 --> 00:29:12,541
Your parents on the way?
693
00:29:12,542 --> 00:29:13,876
They're in Baltimore for a wedding.
694
00:29:13,877 --> 00:29:15,252
I didn't want to bother them.
695
00:29:15,253 --> 00:29:18,380
Trust me. They're your parents,
and you are in an emergency room.
696
00:29:18,381 --> 00:29:19,965
It is never a bother.
697
00:29:19,966 --> 00:29:21,341
Write their numbers down,
and I will call them.
698
00:29:21,342 --> 00:29:22,843
Call Head and Neck.
699
00:29:22,844 --> 00:29:24,178
Stay with him until they get here, okay?
700
00:29:24,179 --> 00:29:25,220
Good.
701
00:29:25,221 --> 00:29:26,847
Pen.
702
00:29:26,848 --> 00:29:28,057
Can I get the...
703
00:29:35,899 --> 00:29:38,817
Sam Wallace, our Good Samaritan
who saved a Nepali lady,
704
00:29:38,818 --> 00:29:40,652
is in line for a repeat head CT
705
00:29:40,653 --> 00:29:43,238
to be sure there's no extension
of the intraparenchymal bleed.
706
00:29:43,239 --> 00:29:44,823
Okay, so we can dial down the sedation,
707
00:29:44,824 --> 00:29:46,825
and, if he's alert,
check extubation parameters.
708
00:29:46,826 --> 00:29:48,202
- Copy.
- Did you get the consent form
709
00:29:48,203 --> 00:29:49,286
signed by Joyce the sickler
710
00:29:49,287 --> 00:29:50,579
- for the intubation?
- Not yet.
711
00:29:50,580 --> 00:29:52,289
- Jesus fucking--
- She's scared.
712
00:29:52,290 --> 00:29:53,791
I just wanted to give her
some time to talk to her...
713
00:29:53,792 --> 00:29:55,167
To do what, make funeral arrangements?
714
00:29:55,168 --> 00:29:57,169
Joyce is hypoxic at 84.
715
00:29:57,170 --> 00:29:59,505
84. This goes on much longer,
716
00:29:59,506 --> 00:30:01,465
she runs the risk
of permanent lung damage,
717
00:30:01,466 --> 00:30:02,674
- heart attack...
- I know.
718
00:30:02,675 --> 00:30:04,176
- Stroke, death.
- I know.
719
00:30:04,177 --> 00:30:05,302
Then move!
720
00:30:05,303 --> 00:30:06,763
Now.
721
00:30:17,482 --> 00:30:19,817
Just have a seat,
and we'll be with you shortly.
722
00:30:19,818 --> 00:30:22,237
Oh, I've heard that load
of bullshit before.
723
00:30:26,324 --> 00:30:27,909
My fucking God.
724
00:30:43,383 --> 00:30:46,677
Took me all the way back there
just to stick a goddamn thermometer
725
00:30:46,678 --> 00:30:48,303
in my mouth, you know.
726
00:30:48,304 --> 00:30:51,307
Repeat vitals every four hours.
727
00:30:56,354 --> 00:30:57,938
Oh, dang!
728
00:30:57,939 --> 00:31:00,149
Saw how it swerved
and almost hit the taxi?
729
00:31:01,568 --> 00:31:03,026
I gotta get out of here;
I mean, this thing is
730
00:31:03,027 --> 00:31:04,778
totally gonna screw up
the traffic to Pittfest.
731
00:31:04,779 --> 00:31:06,780
Nice score. You going with Robby?
732
00:31:06,781 --> 00:31:08,282
Well, I was supposed to.
733
00:31:08,283 --> 00:31:09,950
But I have this new girlfriend,
734
00:31:09,951 --> 00:31:11,702
and she's super excited
about the lineup, so...
735
00:31:11,703 --> 00:31:14,496
So you ditched the old man
for a hot piece of ass.
736
00:31:14,497 --> 00:31:17,207
Been there, done that.
737
00:31:17,208 --> 00:31:19,793
Senior year, Lollapalooza, I met this guy.
738
00:31:19,794 --> 00:31:21,253
Think his name was Rich--
739
00:31:21,254 --> 00:31:22,421
or was it Rick?
740
00:31:22,422 --> 00:31:23,797
Doesn't matter.
741
00:31:23,798 --> 00:31:25,967
But he looked like Dave Navarro.
742
00:31:27,844 --> 00:31:31,513
Warm breeze, cool grass,
743
00:31:31,514 --> 00:31:34,267
a million stars in the sky.
744
00:31:35,643 --> 00:31:37,436
Best sex of my life.
745
00:31:37,437 --> 00:31:39,354
You had sex in public?
746
00:31:39,355 --> 00:31:41,107
We were under a blanket.
747
00:31:42,025 --> 00:31:43,108
It's turning around.
748
00:31:43,109 --> 00:31:44,610
It's turning around, baby.
749
00:31:44,611 --> 00:31:47,154
- Come home to Papa.
- Shit.
750
00:31:47,155 --> 00:31:49,949
I had money on it crashing
in Beaver County.
751
00:32:00,835 --> 00:32:02,753
Better safe than sorry.
752
00:32:02,754 --> 00:32:04,297
Okay.
753
00:32:06,758 --> 00:32:08,927
- Jake, what's up?
- Hey, how are you?
754
00:32:12,931 --> 00:32:14,641
Where's Rita?
755
00:32:16,225 --> 00:32:17,392
She went to park the car.
756
00:32:17,393 --> 00:32:19,019
Shouldn't have been
more than five minutes.
757
00:32:19,020 --> 00:32:21,856
Why don't you dial her number for me?
758
00:32:29,864 --> 00:32:31,990
- Did she pick up?
- Straight to voicemail.
759
00:32:31,991 --> 00:32:33,076
That's weird.
760
00:32:37,455 --> 00:32:42,085
Sole caretaker, overwhelmed, exhausted.
761
00:32:45,088 --> 00:32:50,009
I told her to take a break, but you don't
think she ditched her mom, do you?
762
00:32:50,885 --> 00:32:51,928
I mean, it happens.
763
00:32:54,889 --> 00:32:57,599
You're gonna need to use
the antibiotic ointment twice a day
764
00:32:57,600 --> 00:33:00,978
and come in for a wound check
in two days, okay?
765
00:33:00,979 --> 00:33:03,188
Mateo, can you grab me enough samples
to last a couple weeks?
766
00:33:03,189 --> 00:33:04,691
- Yeah, I'm on it.
- Thank you.
767
00:33:06,192 --> 00:33:07,651
Thanks.
768
00:33:07,652 --> 00:33:09,361
I really appreciate it.
769
00:33:09,362 --> 00:33:11,446
Yeah. No problem.
770
00:33:11,447 --> 00:33:14,074
Has Kiara been here yet?
771
00:33:14,075 --> 00:33:16,076
No, who's Kiara?
772
00:33:16,077 --> 00:33:17,869
Oh, she's the hospital social worker.
773
00:33:17,870 --> 00:33:19,621
She can help you out
with, like, housing and childcare
774
00:33:19,622 --> 00:33:21,039
- and food and security...
- You told her?
775
00:33:21,040 --> 00:33:23,291
- No, I...
- No, no, it's all free.
776
00:33:23,292 --> 00:33:24,626
The system works if you use it.
777
00:33:24,627 --> 00:33:25,837
- You just have to...
- Enough!
778
00:33:27,088 --> 00:33:28,923
I don't need your help.
779
00:33:30,591 --> 00:33:31,925
Nice speech.
780
00:33:31,926 --> 00:33:34,095
Next time, mind your own business.
781
00:33:39,767 --> 00:33:42,270
You ever heard of impact over intent?
782
00:33:44,105 --> 00:33:46,440
I would never intentionally
embarrass anybody.
783
00:33:46,441 --> 00:33:48,400
But you did.
784
00:33:48,401 --> 00:33:52,529
You didn't have a conversation with Sherry
or ask her what she needed.
785
00:33:52,530 --> 00:33:54,573
Instead, you walked in here
and told her what to do.
786
00:33:54,574 --> 00:33:58,493
You gotta slow down,
take a beat, and listen
787
00:33:58,494 --> 00:34:00,371
instead of judging people.
788
00:34:01,789 --> 00:34:03,123
- I don't judge.
- Please.
789
00:34:03,124 --> 00:34:05,418
You've been eyeing me sideways all day.
790
00:34:07,170 --> 00:34:09,671
Look, maybe I have a better
perspective because I've been
791
00:34:09,672 --> 00:34:12,382
on both sides,
but we gotta try to at least
792
00:34:12,383 --> 00:34:15,177
put ourselves in their shoes.
793
00:34:15,178 --> 00:34:18,930
Listening and building trust
will make us better doctors...
794
00:34:18,931 --> 00:34:20,558
and better people.
795
00:34:24,187 --> 00:34:25,479
I'm sorry.
796
00:34:25,480 --> 00:34:28,273
I'm not telling you this to reprimand you.
797
00:34:28,274 --> 00:34:31,944
I'm trying to teach you to help you.
798
00:34:33,696 --> 00:34:36,823
Wait, what about Sherry?
799
00:34:36,824 --> 00:34:38,825
I doubt she'll be back.
800
00:34:38,826 --> 00:34:41,954
But sadly, there will be many,
many more just like her.
801
00:34:46,292 --> 00:34:47,626
No. No, no, no.
802
00:34:47,627 --> 00:34:50,922
He had the surgery at St. Michael's,
but he's here now.
803
00:34:52,006 --> 00:34:53,840
No, he doesn't have a car.
804
00:34:53,841 --> 00:34:55,593
His parents are out of town.
805
00:34:57,762 --> 00:34:59,221
Okay, okay, well,
806
00:34:59,222 --> 00:35:00,597
how am I to send him
back to St. Michael's,
807
00:35:00,598 --> 00:35:02,557
call him an Uber?
808
00:35:02,558 --> 00:35:05,143
You can't--that doesn't make...
809
00:35:05,144 --> 00:35:07,187
Hey, hello.
810
00:35:07,188 --> 00:35:08,522
Hello!
811
00:35:08,523 --> 00:35:10,399
What's wrong?
812
00:35:14,237 --> 00:35:18,365
They said it is not their job to fix
another hospital's problem.
813
00:35:18,366 --> 00:35:20,451
Don't worry about it, though.
I'll talk to my attending--
814
00:35:21,619 --> 00:35:23,538
Oh, shit!
815
00:35:24,831 --> 00:35:26,374
I need a little help here!
816
00:35:27,708 --> 00:35:29,334
Okay, come on, open up.
817
00:35:29,335 --> 00:35:31,254
It's a post-tonsillectomy hemorrhage.
818
00:35:32,255 --> 00:35:34,214
Yankauer and sponge stick.
819
00:35:34,215 --> 00:35:35,924
He was stable. Then it just opened.
820
00:35:35,925 --> 00:35:37,467
Call the blood bank.
821
00:35:37,468 --> 00:35:40,137
Two units, whole blood. Get a second line.
822
00:35:40,138 --> 00:35:41,555
Head and Neck wouldn't come down
to see him.
823
00:35:41,556 --> 00:35:43,306
- Assholes.
- Tachy to 120.
824
00:35:43,307 --> 00:35:45,183
His sats are down to 90%.
825
00:35:45,184 --> 00:35:47,269
Okay, get a high-flow nasal cannula,
826
00:35:47,270 --> 00:35:48,687
100 of ketamine.
827
00:35:48,688 --> 00:35:50,773
Set up the GlideScope.
828
00:35:52,441 --> 00:35:53,733
Hold suction.
829
00:35:53,734 --> 00:35:55,944
I'm gonna try for direct pressure.
830
00:35:55,945 --> 00:36:00,073
If Head and Neck
still won't come down, call Garcia.
831
00:36:00,074 --> 00:36:02,409
You're good. You're good.
832
00:36:02,410 --> 00:36:05,620
Okay, before we begin,
let's take a time-out.
833
00:36:05,621 --> 00:36:07,581
This is Joyce St. Claire.
834
00:36:07,582 --> 00:36:09,875
Procedure is endotracheal intubation
835
00:36:09,876 --> 00:36:12,294
for hypoxia due to acute chest syndrome.
836
00:36:12,295 --> 00:36:14,171
We'll be using video laryngoscopy
837
00:36:14,172 --> 00:36:17,174
and an 8-0 ET tube with a 7.5 on standby.
838
00:36:17,175 --> 00:36:20,969
Induction with 75 of propofol,
100 rocuronium.
839
00:36:20,970 --> 00:36:22,637
Got it.
840
00:36:22,638 --> 00:36:25,348
For backup, we have a bougie
and an LMA ready.
841
00:36:25,349 --> 00:36:26,850
Yep.
842
00:36:26,851 --> 00:36:28,894
Any questions or concerns before we start?
843
00:36:28,895 --> 00:36:30,812
I wanna be awake.
844
00:36:30,813 --> 00:36:33,106
We can't perform an intubation that way.
845
00:36:33,107 --> 00:36:34,900
I mean after.
846
00:36:34,901 --> 00:36:37,485
After, we will lighten your sedation.
847
00:36:37,486 --> 00:36:40,488
You won't be able to talk,
but you can use a pen and paper
848
00:36:40,489 --> 00:36:42,533
or an iPad to communicate.
849
00:36:45,286 --> 00:36:48,580
I love you.
850
00:36:48,581 --> 00:36:50,458
Till the end of time.
851
00:36:51,959 --> 00:36:53,710
Robby, Trauma 2 right now.
852
00:36:53,711 --> 00:36:56,339
- Cover the intubation?
- Of course.
853
00:36:58,382 --> 00:37:00,383
- What happened?
- Bleeder opened up.
854
00:37:00,384 --> 00:37:01,551
Ketamine on board to intubate.
855
00:37:01,552 --> 00:37:02,928
Sats holding at 97.
856
00:37:02,929 --> 00:37:04,930
- Can you get an airway?
- Come on.
857
00:37:04,931 --> 00:37:06,389
Let's lie him down.
858
00:37:06,390 --> 00:37:08,017
Keep pressure on the scab.
859
00:37:09,518 --> 00:37:10,894
Nothing but blood.
860
00:37:10,895 --> 00:37:12,729
Can't see the cords.
861
00:37:12,730 --> 00:37:14,648
Sats 94.
862
00:37:14,649 --> 00:37:16,191
Not sure we have room for
the tube with the sponge stick.
863
00:37:16,192 --> 00:37:17,943
If I pull out, there's
gonna be even more blood.
864
00:37:17,944 --> 00:37:19,444
Doesn't look like you secured that airway.
865
00:37:19,445 --> 00:37:21,071
- He's working on it.
- Bougie.
866
00:37:21,072 --> 00:37:22,657
Open a crike tray and prep the neck.
867
00:37:24,784 --> 00:37:26,576
Hold on, I'm going in blind
with the bougie.
868
00:37:26,577 --> 00:37:28,161
I might be able to feel
the tracheal rings.
869
00:37:28,162 --> 00:37:30,247
And I might have a three-way with Madonna.
870
00:37:30,248 --> 00:37:32,540
Move.
871
00:37:32,541 --> 00:37:33,708
Not happening.
872
00:37:33,709 --> 00:37:34,918
Pressure.
873
00:37:34,919 --> 00:37:36,420
Make room for the grown-ups.
874
00:37:37,630 --> 00:37:38,964
Okay, okay. Hold on, hold on.
875
00:37:38,965 --> 00:37:40,423
We can try a retrograde intubation.
876
00:37:40,424 --> 00:37:41,841
- A what?
- There's no obstruction.
877
00:37:41,842 --> 00:37:43,218
We just can't see what we're doing.
878
00:37:43,219 --> 00:37:44,803
So we take a needle,
879
00:37:44,804 --> 00:37:46,680
and we put it in the cricothyroid.
880
00:37:46,681 --> 00:37:50,600
We run a guide wire up and out the mouth,
and we slide the ET tube up over the wire.
881
00:37:50,601 --> 00:37:52,560
- Never seen one before.
- Sats 90.
882
00:37:52,561 --> 00:37:53,937
No time to play MacGyver with this kid.
883
00:37:53,938 --> 00:37:55,897
- Time to crike.
- It'll be quick.
884
00:37:55,898 --> 00:37:57,566
You got one shot, and then I cut.
885
00:38:00,236 --> 00:38:02,320
Propofol and rock are on board.
886
00:38:02,321 --> 00:38:05,615
Now we wait for the sedative
and paralytic to start working.
887
00:38:05,616 --> 00:38:08,201
Should Dr. Robby be in here?
888
00:38:08,202 --> 00:38:11,246
Between Dr. Mohan and myself,
we've done hundreds of these.
889
00:38:11,247 --> 00:38:13,748
I'm getting sleepy.
890
00:38:13,749 --> 00:38:15,501
I'm right here, babe.
891
00:38:25,136 --> 00:38:27,095
Okay, I'm in.
892
00:38:27,096 --> 00:38:29,724
Guide wire.
893
00:38:33,561 --> 00:38:36,105
Let me know when you start
to feel it up top.
894
00:38:37,857 --> 00:38:39,482
Nothing yet.
895
00:38:39,483 --> 00:38:41,235
- More suction.
- I'm trying.
896
00:38:42,028 --> 00:38:43,153
Still can't find it.
897
00:38:43,154 --> 00:38:44,362
Well, keep feeling in there.
898
00:38:44,363 --> 00:38:45,822
It's gotta be there somewhere.
899
00:38:45,823 --> 00:38:48,533
- Maybe it's curling up.
- Sats down to 89.
900
00:38:48,534 --> 00:38:50,785
- Guys, this is not working.
- Just give me a second.
901
00:38:50,786 --> 00:38:52,203
- Until he arrests?
- Oh, my God.
902
00:38:52,204 --> 00:38:53,663
I'm gonna lose another patient.
903
00:38:53,664 --> 00:38:55,248
Shut up, Whitaker. Let's get on this.
904
00:38:55,249 --> 00:38:56,624
Sats down to 87.
905
00:38:56,625 --> 00:38:58,711
Okay, I'm gonna redirect the wire.
906
00:39:01,130 --> 00:39:03,257
Sats still dropping. 86.
907
00:39:05,134 --> 00:39:06,260
You got this.
908
00:39:11,932 --> 00:39:15,060
Ondine, if you'd like,
you can watch on the screen.
909
00:39:15,061 --> 00:39:16,812
I'm okay.
910
00:39:18,773 --> 00:39:20,900
Excellent view of the cords, Dr. Mohan.
911
00:39:22,818 --> 00:39:25,153
I'm in.
912
00:39:25,154 --> 00:39:27,031
Inflate the balloon.
913
00:39:35,664 --> 00:39:37,248
Good breath sounds bilaterally.
914
00:39:37,249 --> 00:39:39,876
Sats 92 and rising.
915
00:39:39,877 --> 00:39:42,170
That's it? You're done?
916
00:39:42,171 --> 00:39:43,254
Yes.
917
00:39:43,255 --> 00:39:45,800
It all went perfectly.
918
00:39:48,094 --> 00:39:49,803
How long until she gets better?
919
00:39:49,804 --> 00:39:51,221
Depends.
920
00:39:51,222 --> 00:39:53,973
It can take anywhere from a few days
to a few weeks for the lungs to heal
921
00:39:53,974 --> 00:39:55,600
from acute chest syndrome.
922
00:39:55,601 --> 00:39:57,602
I can ask the ICU to set up
a recliner for you
923
00:39:57,603 --> 00:39:59,646
in Joyce's room so you can stay with her.
924
00:39:59,647 --> 00:40:02,148
Thank you both so much.
925
00:40:02,149 --> 00:40:03,316
You're welcome.
926
00:40:03,317 --> 00:40:05,319
Take care.
927
00:40:10,741 --> 00:40:12,367
Sats 84. We need to bag him.
928
00:40:12,368 --> 00:40:14,244
- Still not seeing it.
- I'm suctioning like crazy.
929
00:40:14,245 --> 00:40:15,662
Okay, we're done playing doctor.
930
00:40:15,663 --> 00:40:16,996
Lose the wire. I'm criking this kid.
931
00:40:16,997 --> 00:40:18,164
All right, we tried. I'm sorry.
932
00:40:18,165 --> 00:40:19,666
No, wait. Wait.
933
00:40:19,667 --> 00:40:22,168
I've got it.
934
00:40:22,169 --> 00:40:23,795
You still don't have an airway.
935
00:40:23,796 --> 00:40:26,840
Okay, keep the laryngoscope in place
so the tube passes easily.
936
00:40:26,841 --> 00:40:30,093
Pass the T, the T tube over the wire.
937
00:40:30,094 --> 00:40:31,719
- Come on.
- Hang on to that wire.
938
00:40:31,720 --> 00:40:33,972
Do not let go of that wire.
939
00:40:33,973 --> 00:40:37,183
Okay.
940
00:40:37,184 --> 00:40:40,354
Okay, I'm gonna give you a little slack
so you can get past the cords.
941
00:40:41,981 --> 00:40:43,815
Yeah, yeah. I feel you at the trachea.
942
00:40:43,816 --> 00:40:45,984
25 centimeters at the lips.
943
00:40:45,985 --> 00:40:47,068
That ought to do it.
944
00:40:47,069 --> 00:40:49,237
Pull the wire, bag him.
945
00:40:49,238 --> 00:40:50,823
Balloon's up.
946
00:40:53,325 --> 00:40:54,993
Yellow on CO2. That's good.
947
00:40:54,994 --> 00:40:57,871
That is very good.
948
00:40:57,872 --> 00:40:59,664
Good breath sounds bilaterally.
949
00:40:59,665 --> 00:41:00,874
Sats coming up.
950
00:41:00,875 --> 00:41:03,460
90, 92.
951
00:41:03,461 --> 00:41:05,670
Guess you're gonna have
to save that scalpel for another day.
952
00:41:05,671 --> 00:41:08,214
- You guys got lucky.
- No, we got skills, baby.
953
00:41:08,215 --> 00:41:09,592
We got skills!
954
00:41:10,843 --> 00:41:11,885
Keep gauze on the clot.
955
00:41:11,886 --> 00:41:13,386
Yeah, copy.
956
00:41:13,387 --> 00:41:15,264
Ordering propofol and fentanyl drips.
957
00:41:16,932 --> 00:41:19,100
Oh, nice of you to join us, Dr. Flores.
958
00:41:19,101 --> 00:41:22,353
Sorry, I got stuck
in a nasty radical neck dissection.
959
00:41:22,354 --> 00:41:24,022
- Still bleeding?
- Not with direct pressure.
960
00:41:24,023 --> 00:41:25,940
We got the airway. You get the bleeder.
961
00:41:25,941 --> 00:41:27,275
OR's standing by.
962
00:41:27,276 --> 00:41:30,528
So I can cancel the Uber?
963
00:41:30,529 --> 00:41:32,364
Let's get him upstairs.
964
00:41:33,782 --> 00:41:35,950
Fresh sponge stick for you, Whitaker.
965
00:41:35,951 --> 00:41:37,368
You need me to stay with the--
966
00:41:37,369 --> 00:41:38,995
Your patient. You did a good job.
967
00:41:38,996 --> 00:41:40,413
It's only till the anesthesiologist
takes over.
968
00:41:40,414 --> 00:41:41,831
- You got it?
- Yeah, I got it.
969
00:41:41,832 --> 00:41:43,876
Get yourself a fresh pair of scrubs
on your way back down.
970
00:41:51,217 --> 00:41:52,967
I'm sorry that took so long.
971
00:41:52,968 --> 00:41:54,761
- I was just--
- Don't apologize.
972
00:41:54,762 --> 00:41:57,555
What you did in there, building
a relationship with your patients,
973
00:41:57,556 --> 00:42:01,059
earning their trust,
that's what this is all about.
974
00:42:01,060 --> 00:42:03,228
Robby doesn't seem to think so.
975
00:42:03,229 --> 00:42:05,355
Don't worry about him.
976
00:42:05,356 --> 00:42:09,234
You know, I should be apologizing to you.
977
00:42:09,235 --> 00:42:13,238
Slo-Mo, you deserve better.
978
00:42:13,239 --> 00:42:15,241
Keep doing you, Dr. Mohan.
979
00:42:17,284 --> 00:42:18,826
Where'd you get that move?
980
00:42:18,827 --> 00:42:21,120
Retrograde intubation,
that's an Adamson special.
981
00:42:21,121 --> 00:42:22,830
I learned that from the best.
982
00:42:22,831 --> 00:42:24,541
Well, you're not too shabby
yourself, Professor.
983
00:42:24,542 --> 00:42:26,417
Yeah, that got kind of rough in there.
984
00:42:26,418 --> 00:42:28,127
You kept your composure, though--
985
00:42:28,128 --> 00:42:31,548
exactly the kind of candidate they want
for the ED Medical Education Fellowship.
986
00:42:31,549 --> 00:42:34,592
Oh, there's probably over 50 applicants
for that one slot.
987
00:42:34,593 --> 00:42:36,010
Yeah, probably.
988
00:42:36,011 --> 00:42:38,179
But I know that they like
to go with someone that they know
989
00:42:38,180 --> 00:42:41,349
from firsthand experience
has the skills to be successful.
990
00:42:41,350 --> 00:42:44,352
At least that's what I told them
in my letter of recommendation.
991
00:42:44,353 --> 00:42:45,563
Thank you.
992
00:42:47,856 --> 00:42:49,232
Glad you stuck around.
993
00:42:49,233 --> 00:42:50,733
It's not like I had a choice, did I?
994
00:42:50,734 --> 00:42:53,111
No, not really.
995
00:42:53,112 --> 00:42:56,406
So how's your day going?
996
00:42:56,407 --> 00:42:57,615
It's going.
997
00:42:57,616 --> 00:43:00,201
Cool, cool, cool.
998
00:43:00,202 --> 00:43:01,661
Why do you ask?
999
00:43:01,662 --> 00:43:03,121
Guy can't ask?
1000
00:43:03,122 --> 00:43:04,664
You never ask me about my work.
1001
00:43:04,665 --> 00:43:06,708
What gives?
1002
00:43:06,709 --> 00:43:08,501
Mom wanted me to ask
because she just wants
1003
00:43:08,502 --> 00:43:10,086
to make sure that you're doing okay.
1004
00:43:10,087 --> 00:43:12,130
That's very sweet of her. I'm doing fine.
1005
00:43:12,131 --> 00:43:13,631
Thank you for these again.
1006
00:43:13,632 --> 00:43:16,259
You can thank me by finally introducing me
to your girlfriend.
1007
00:43:16,260 --> 00:43:18,428
- Not today but soon.
- Have fun.
1008
00:43:18,429 --> 00:43:21,764
Hey, I know it goes without saying,
but please be safe.
1009
00:43:21,765 --> 00:43:23,141
- I will.
- Seriously.
1010
00:43:23,142 --> 00:43:24,726
Don't take anything from anyone.
1011
00:43:24,727 --> 00:43:26,269
I've already seen
two fentanyl overdoses today.
1012
00:43:26,270 --> 00:43:27,812
- It's not even noon.
- I promise.
1013
00:43:27,813 --> 00:43:29,022
- Okay.
- Basketball Sunday?
1014
00:43:29,023 --> 00:43:30,440
Yep, wouldn't miss it.
1015
00:43:30,441 --> 00:43:31,774
Hey, before you go, before you go.
1016
00:43:31,775 --> 00:43:33,067
Please don't hand me a condom.
1017
00:43:33,068 --> 00:43:34,402
Condom?
1018
00:43:34,403 --> 00:43:35,862
I was gonna give you extra cash.
1019
00:43:35,863 --> 00:43:36,863
Wait, are you having sex?
1020
00:43:36,864 --> 00:43:38,449
Thank you.
1021
00:43:40,200 --> 00:43:44,203
Looks like the driver lost control
as the police cars were closing in.
1022
00:43:44,204 --> 00:43:46,372
The ambulance has definitely stopped.
1023
00:43:46,373 --> 00:43:47,874
Check it out.
1024
00:43:47,875 --> 00:43:49,459
It's difficult to tell from this angle,
1025
00:43:49,460 --> 00:43:51,753
but it does look like
they may have hit something.
1026
00:43:51,754 --> 00:43:54,297
- Damn!
- That's in our zone.
1027
00:43:54,298 --> 00:43:56,049
Ambulance crashed in our catchment.
1028
00:43:56,050 --> 00:43:57,467
Get ready for incoming.
1029
00:43:57,468 --> 00:44:01,179
- How many you think?
- Other than the driver? No idea.
1030
00:44:01,180 --> 00:44:05,433
Since you're past ten weeks,
you'll need to take mifepristone twice,
1031
00:44:05,434 --> 00:44:08,144
once now and once in 24 hours.
1032
00:44:08,145 --> 00:44:10,772
Then 24 hours after that,
you'll take misoprostol,
1033
00:44:10,773 --> 00:44:13,399
two pills which dissolve
between the cheek and the gum,
1034
00:44:13,400 --> 00:44:16,027
then two more of the same pills
six hours later.
1035
00:44:16,028 --> 00:44:17,278
That's a lot to remember.
1036
00:44:17,279 --> 00:44:19,614
Everything is clearly labeled
with the names of the meds,
1037
00:44:19,615 --> 00:44:22,867
the dose, and the exact time to take them.
1038
00:44:22,868 --> 00:44:24,494
Will it hurt?
1039
00:44:24,495 --> 00:44:27,246
You can expect some vaginal bleeding.
1040
00:44:27,247 --> 00:44:30,124
There may be some cramping,
like when you're on your period.
1041
00:44:30,125 --> 00:44:32,251
If you're bleeding
more than two pads an hour
1042
00:44:32,252 --> 00:44:34,504
or the pain gets to be too much,
1043
00:44:34,505 --> 00:44:36,130
come back in and see us.
1044
00:44:36,131 --> 00:44:38,425
And I'll be with you the whole time.
1045
00:44:43,639 --> 00:44:45,348
Kristi?
1046
00:44:45,349 --> 00:44:47,392
Kristi!
1047
00:44:47,393 --> 00:44:48,518
What the hell are you doing here?
1048
00:44:48,519 --> 00:44:50,061
Hey, language!
1049
00:44:50,062 --> 00:44:51,562
And I should be asking you the same thing.
1050
00:44:51,563 --> 00:44:52,772
Excuse me. Who are you?
1051
00:44:52,773 --> 00:44:55,149
- I'm her mom.
- Mom?
1052
00:44:55,150 --> 00:44:56,234
Aren't you her mom?
1053
00:44:56,235 --> 00:44:57,694
I can explain.
1054
00:44:57,695 --> 00:44:59,070
No, that's my sister, Lynette.
1055
00:44:59,071 --> 00:45:00,780
I am Kristi's mother.
1056
00:45:00,781 --> 00:45:01,990
Kris...
1057
00:45:02,991 --> 00:45:05,077
Kris, baby, what are you doing here?
1058
00:45:06,912 --> 00:45:08,622
I'm here for an abortion.
1059
00:45:10,374 --> 00:45:12,083
Did you do it already?
1060
00:45:12,084 --> 00:45:14,377
- Not yet.
- Okay. Thank God.
1061
00:45:14,378 --> 00:45:16,629
Okay, okay, can we all just
take a step back here and--
1062
00:45:16,630 --> 00:45:19,257
Mom, I want this. This is my decision.
1063
00:45:19,258 --> 00:45:20,341
- No.
- Just listen to her, El.
1064
00:45:20,342 --> 00:45:21,592
You can shut up!
1065
00:45:21,593 --> 00:45:23,845
You have done enough.
1066
00:45:23,846 --> 00:45:28,766
My daughter is a minor,
so she can't get this abortion
1067
00:45:28,767 --> 00:45:30,644
without my say-so, right?
1068
00:45:32,271 --> 00:45:33,439
Is that right?
1069
00:45:34,648 --> 00:45:37,025
That's correct.
1070
00:45:39,570 --> 00:45:42,572
Then there is no way this is happening.
1071
00:45:42,573 --> 00:45:44,158
Not now, not ever.