1 00:00:04,091 --> 00:00:04,308 . 2 00:00:04,352 --> 00:00:05,483 - Move the CR! 3 00:00:05,527 --> 00:00:06,528 Stay with me. 4 00:00:06,571 --> 00:00:07,833 - So this is how it's gonna be? 5 00:00:07,877 --> 00:00:09,618 All day long, you've been talking down to me. 6 00:00:09,661 --> 00:00:11,098 - I should have given you credit. 7 00:00:11,141 --> 00:00:12,142 I was very impressed with the way 8 00:00:12,186 --> 00:00:13,796 you nearly killed our patient. 9 00:00:13,839 --> 00:00:15,885 [suspenseful music] 10 00:00:15,928 --> 00:00:20,411 - We are running low on a number of key supplies. 11 00:00:20,455 --> 00:00:22,674 - No, no, no, no, no! Stop! Stop! I need that dye. 12 00:00:22,718 --> 00:00:25,938 - We can't have one patient depleting our supplies. 13 00:00:25,982 --> 00:00:27,027 - So call into the hospital. 14 00:00:27,070 --> 00:00:28,767 - We're all in the same boat. 15 00:00:28,811 --> 00:00:30,726 - Dr. Cuevas and I have a strong hunch 16 00:00:30,769 --> 00:00:33,207 that David is developing schizoaffective disorder. 17 00:00:33,250 --> 00:00:35,035 - No! My boy isn't crazy. 18 00:00:35,078 --> 00:00:36,514 Stay away from us. 19 00:00:36,558 --> 00:00:39,213 - How is that boy supposed to get any help? 20 00:00:40,779 --> 00:00:42,303 - It is a real pleasure 21 00:00:42,346 --> 00:00:44,174 to finally meet you, Dr. Hawthorne. 22 00:00:44,218 --> 00:00:47,177 My colleague at Med, David Kwan, 23 00:00:47,221 --> 00:00:49,701 he sings your praises highly. 24 00:00:49,745 --> 00:00:51,529 - Oh, I'm not the doctor. 25 00:00:51,573 --> 00:00:53,749 I'm her assistant, Katherine. 26 00:00:53,792 --> 00:00:55,055 - Okay. 27 00:00:55,098 --> 00:00:57,753 - Sign and date these forms, please. 28 00:01:01,844 --> 00:01:04,238 Just wherever you see a highlight. 29 00:01:07,154 --> 00:01:08,459 While you're finishing up with that, 30 00:01:08,503 --> 00:01:11,245 I'll go over our policies and procedures. 31 00:01:13,856 --> 00:01:15,553 Everything you discuss with Dr. Hawthorne 32 00:01:15,597 --> 00:01:17,729 is confidential, except in the event she feels 33 00:01:17,773 --> 00:01:19,340 you're a danger to yourself. - You know what, Katherine? 34 00:01:19,383 --> 00:01:21,385 I'm--I'm actually a practicing psychiatrist myself, 35 00:01:21,429 --> 00:01:24,693 so, I mean, if you'd like, you can skip that part. 36 00:01:24,736 --> 00:01:25,998 - I totally get it, 37 00:01:26,042 --> 00:01:28,479 but Dr. Hawthorne, who you'll meet next week, 38 00:01:28,523 --> 00:01:31,265 requires we go through the policies together. 39 00:01:31,308 --> 00:01:33,745 If the doctor feels that you're a danger to yourself or others, 40 00:01:33,789 --> 00:01:35,573 she's required to report-- - You know what, Katherine? 41 00:01:35,617 --> 00:01:38,185 I appreciate you're just trying to do your job. 42 00:01:38,228 --> 00:01:42,102 But, um, maybe you could tell Dr. Hawthorne 43 00:01:42,145 --> 00:01:45,496 to give me a call when she has a chance 44 00:01:45,540 --> 00:01:48,108 to meet me herself in person, okay? 45 00:01:49,152 --> 00:01:51,502 Um, you know what? 46 00:01:51,546 --> 00:01:56,116 On second thought, maybe tell her not to bother. 47 00:01:57,943 --> 00:01:58,857 Yeah. 48 00:02:02,339 --> 00:02:03,993 - It's been a long time since 49 00:02:04,036 --> 00:02:05,168 you had to hunt for a therapist. 50 00:02:05,212 --> 00:02:06,430 Want me to shoot you some names? 51 00:02:06,474 --> 00:02:08,867 I got a small stockpile of referrals. 52 00:02:08,911 --> 00:02:09,999 - I gotta be honest, Sharon, 53 00:02:10,042 --> 00:02:11,435 after these last two experiences, 54 00:02:11,479 --> 00:02:13,785 my interest in the process might be waning. 55 00:02:13,829 --> 00:02:16,614 I mean, this morning in particular 56 00:02:16,658 --> 00:02:18,877 actually had me questioning the state of psychiatry. 57 00:02:18,921 --> 00:02:21,184 - Well, that assembly-line mentality 58 00:02:21,228 --> 00:02:23,230 is plaguing much of medicine these days, 59 00:02:23,273 --> 00:02:24,709 not just psychiatry. 60 00:02:24,753 --> 00:02:27,277 But don't worry, you'll find your person. 61 00:02:27,321 --> 00:02:29,366 See you later. - No coffee? 62 00:02:29,410 --> 00:02:30,976 - Ugh, no. I don't have any time. 63 00:02:31,020 --> 00:02:33,675 We're implementing a new drug shortage protocol, 64 00:02:33,718 --> 00:02:36,373 so I'll be in the ED all morning walking the staff 65 00:02:36,417 --> 00:02:37,809 through the new guidelines. 66 00:02:37,853 --> 00:02:39,594 - You couldn't get the enforcer, 67 00:02:39,637 --> 00:02:41,422 otherwise known as Maggie Lockwood on that? 68 00:02:41,465 --> 00:02:43,206 - [chuckles] She's in Paris. 69 00:02:43,250 --> 00:02:44,903 She and Ben never took their honeymoon, 70 00:02:44,947 --> 00:02:47,297 and she was gonna lose her vacation days. 71 00:02:47,341 --> 00:02:48,994 - Wow. - Yeah. 72 00:02:49,038 --> 00:02:50,170 - Well, still, not a great time 73 00:02:50,213 --> 00:02:51,214 to be short-staffed, though, right? 74 00:02:51,258 --> 00:02:52,911 - There's never a good time. 75 00:02:52,955 --> 00:02:55,131 - Yep, you got that right. - See you later. 76 00:02:55,175 --> 00:02:56,480 [alarm beeps] 77 00:02:56,524 --> 00:02:58,090 - Get these off me! 78 00:02:58,134 --> 00:02:59,353 - David Sullivan, 17-year-old male. 79 00:02:59,396 --> 00:03:01,398 - Oh, we've met. David, it's me, Dr. Archer. 80 00:03:01,442 --> 00:03:02,704 Do you remember me? - I can't stay here. 81 00:03:02,747 --> 00:03:04,488 They're gonna find me. I have to keep moving. 82 00:03:04,532 --> 00:03:06,055 I can't stay in one place! - It's okay, honey. 83 00:03:06,098 --> 00:03:07,491 You're safe. You're safe. - He ran naked into the street. 84 00:03:07,535 --> 00:03:09,667 Dad managed to grab him before he got hit by a car. 85 00:03:09,711 --> 00:03:11,582 No visible injuries that I can see. 86 00:03:11,626 --> 00:03:13,845 Gave him 0.5 of lorazepam en route. 87 00:03:13,889 --> 00:03:16,239 - Hello, again, Mrs. Sullivan. Is your husband all right? 88 00:03:16,283 --> 00:03:19,155 - [stammering] He's fine, yeah. He's just a bit shaken up. 89 00:03:19,199 --> 00:03:20,896 - He drove behind us, should be here any minute. 90 00:03:20,939 --> 00:03:23,028 - Doris, would you-- - Page psych. I'm on it. 91 00:03:23,072 --> 00:03:24,682 - Okay, finish my sentences for me, why don't you? 92 00:03:24,726 --> 00:03:27,163 Okay, David, we're gonna loosen your restraints now 93 00:03:27,207 --> 00:03:28,860 and move you to the bed. 94 00:03:28,904 --> 00:03:30,819 I need you to stay still. 95 00:03:30,862 --> 00:03:33,430 Keep your hands by your side, all right? 96 00:03:33,474 --> 00:03:34,692 Okay, ready, everybody? 97 00:03:34,736 --> 00:03:38,218 On my count, one, two, three. 98 00:03:38,261 --> 00:03:40,872 Good. Okay. 99 00:03:40,916 --> 00:03:42,526 Very good, okay. 100 00:03:42,570 --> 00:03:44,093 - Oh, no, no, no, no, no! - It's all right. 101 00:03:44,136 --> 00:03:45,399 It's all right. - David, please. 102 00:03:45,442 --> 00:03:47,227 Just let the doctor look at you, okay, honey? 103 00:03:47,270 --> 00:03:48,663 - They came inside the light. 104 00:03:48,706 --> 00:03:51,883 They're trying to steal my DNA so they can clone me. 105 00:03:51,927 --> 00:03:53,537 - Okay, so what do you think could have triggered this? 106 00:03:53,581 --> 00:03:55,322 - We were at a stoplight, 107 00:03:55,365 --> 00:03:57,149 and David became fixated on this billboard. 108 00:03:57,193 --> 00:03:59,369 It was just some random man selling car insurance. 109 00:03:59,413 --> 00:04:01,589 - He's not random. He works for them. 110 00:04:01,632 --> 00:04:03,068 There's a whole network. - I don't know. 111 00:04:03,112 --> 00:04:04,896 He started taking his clothes off and telling us 112 00:04:04,940 --> 00:04:07,986 that they were--they were bugged with recording devices. 113 00:04:08,030 --> 00:04:09,423 And then right when the light turned green, he bolted. 114 00:04:09,466 --> 00:04:11,686 He ran across four lanes of oncoming traffic. 115 00:04:11,729 --> 00:04:12,600 There was-- 116 00:04:12,643 --> 00:04:14,515 [suspenseful music] 117 00:04:14,558 --> 00:04:16,560 There was a pickup truck that was coming right at him. 118 00:04:16,604 --> 00:04:18,475 And he--[breathing heavily] - Eric. 119 00:04:18,519 --> 00:04:19,737 - Sir, are you all right? - Oh, my God, Eric! 120 00:04:19,781 --> 00:04:21,261 - All right, let's get him to the ground. 121 00:04:21,304 --> 00:04:22,697 - Eric! Eric! - Come on. 122 00:04:22,740 --> 00:04:24,002 - What's going on with him? - It was meant for me. 123 00:04:24,046 --> 00:04:25,308 They're gonna kill us all! - It's okay, honey. 124 00:04:25,352 --> 00:04:26,614 - Mom, we gotta get out of here now. 125 00:04:26,657 --> 00:04:27,658 - Let's get a gurney over here! - It's okay. 126 00:04:27,702 --> 00:04:28,616 - Come on! - Oh, my God. 127 00:04:28,659 --> 00:04:30,531 - No, no, no! No, no! 128 00:04:30,574 --> 00:04:32,097 - [breathing heavily] 129 00:04:32,141 --> 00:04:36,537 ♪ 130 00:04:40,454 --> 00:04:40,845 . 131 00:04:40,889 --> 00:04:43,674 - Your husband's CT angiogram showed an aortic dissection. 132 00:04:43,718 --> 00:04:46,721 That's essentially a tear in the wall of his aorta. 133 00:04:46,764 --> 00:04:48,331 - So Eric didn't have a heart attack? 134 00:04:48,375 --> 00:04:50,594 - Well, a dissection can often mimic 135 00:04:50,638 --> 00:04:52,379 heart attacks in presentation. 136 00:04:52,422 --> 00:04:55,556 This particular tear is very close to his heart, 137 00:04:55,599 --> 00:04:58,689 which is why we need to get him to surgery as soon as possible 138 00:04:58,733 --> 00:05:00,082 in order to repair it. 139 00:05:00,125 --> 00:05:02,389 - Open heart surgery? - Mm-hmm, yes. 140 00:05:02,432 --> 00:05:05,087 Dr. Morris, one of our cardiothoracic surgeons, 141 00:05:05,130 --> 00:05:06,523 will be performing the operation. 142 00:05:06,567 --> 00:05:08,569 He's on his way here now. 143 00:05:08,612 --> 00:05:10,048 - Oh. 144 00:05:10,092 --> 00:05:12,877 Okay, can I see Eric before he goes under? 145 00:05:12,921 --> 00:05:14,575 - Yes, of course. 146 00:05:14,618 --> 00:05:16,968 Once we get him to pre-op, I'll have a nurse come get you. 147 00:05:19,319 --> 00:05:21,103 - How about we go somewhere and chat for a bit? 148 00:05:21,146 --> 00:05:22,713 - [whispering] Thank you. 149 00:05:22,757 --> 00:05:24,019 Okay. 150 00:05:24,062 --> 00:05:25,542 I don't understand. 151 00:05:25,586 --> 00:05:28,719 Why would David think that this man on a billboard 152 00:05:28,763 --> 00:05:30,417 was after him? 153 00:05:30,460 --> 00:05:32,462 - It's what we call a delusion of persecution. 154 00:05:32,506 --> 00:05:36,292 - Yeah, one becomes convinced that some individual, 155 00:05:36,336 --> 00:05:38,947 you know, or group is conspiring to harm them 156 00:05:38,990 --> 00:05:40,340 or the people that they love. 157 00:05:40,383 --> 00:05:43,952 - And these delusions, that's something that 158 00:05:43,995 --> 00:05:45,388 you see with schizophrenia? 159 00:05:45,432 --> 00:05:46,520 - It is, yeah. 160 00:05:49,174 --> 00:05:53,570 - I know Eric and I weren't exactly receptive 161 00:05:53,614 --> 00:05:54,832 the last time we all spoke. 162 00:05:54,876 --> 00:05:55,964 - We completely understand. 163 00:05:56,007 --> 00:05:57,879 It's--it's a lot to take in. 164 00:05:57,922 --> 00:05:59,446 - I Just thought that David was going 165 00:05:59,489 --> 00:06:05,060 through some kind of phase, growing pains, you know? 166 00:06:05,103 --> 00:06:10,282 But in these last couple of days, it's like he's-- 167 00:06:10,326 --> 00:06:14,156 he's lost all touch with reality. 168 00:06:14,199 --> 00:06:18,203 It's just like, I feel him slipping away. 169 00:06:18,247 --> 00:06:21,424 - Mrs. Sullivan, I promise you, David is still there. 170 00:06:21,468 --> 00:06:24,122 - Yeah, and with treatment, these episodes will become 171 00:06:24,166 --> 00:06:26,168 less severe and less frequent. 172 00:06:26,211 --> 00:06:28,910 - And with proper management, they can even go away. 173 00:06:28,953 --> 00:06:30,346 - What do you mean, medication? 174 00:06:30,390 --> 00:06:33,436 - That's a crucial component, yeah. 175 00:06:33,480 --> 00:06:36,439 - David thinks people are trying to poison him. 176 00:06:36,483 --> 00:06:39,355 How am I going to convince him to take pills? 177 00:06:39,399 --> 00:06:41,662 - There are actually injectable versions 178 00:06:41,705 --> 00:06:44,186 of many antipsychotics. 179 00:06:44,229 --> 00:06:45,840 - Though we don't generally start there. 180 00:06:45,883 --> 00:06:47,232 Those are usually held in reserve 181 00:06:47,276 --> 00:06:49,017 for non-compliant patients. 182 00:06:49,060 --> 00:06:50,627 - Of course. 183 00:06:50,671 --> 00:06:54,065 I'm just saying, if he refuses or becomes non-cooperative, 184 00:06:54,109 --> 00:06:56,241 they're an option. - Right. 185 00:06:56,285 --> 00:06:59,027 But we'll cross that bridge if and when we get there. 186 00:06:59,070 --> 00:07:00,507 In the long run, it's just much better 187 00:07:00,550 --> 00:07:03,335 if we can get David on board with taking medication. 188 00:07:03,379 --> 00:07:05,468 - Okay. 189 00:07:08,340 --> 00:07:10,604 - Ms. Martin, I'm Doctor-- - [gags] 190 00:07:10,647 --> 00:07:14,695 - [spits] Liza. 191 00:07:14,738 --> 00:07:17,480 Sorry, you were saying? 192 00:07:17,524 --> 00:07:19,003 - Uh, I'm Dr. Choi. 193 00:07:19,047 --> 00:07:20,875 I understand you haven't been feeling well. 194 00:07:20,918 --> 00:07:22,877 - Yeah I can't keep anything down. 195 00:07:22,920 --> 00:07:25,270 - And you're 12 weeks along. 196 00:07:25,314 --> 00:07:29,318 - Uh, that's just an estimate. 197 00:07:29,361 --> 00:07:33,322 I only just recently found out I was pregnant. 198 00:07:33,365 --> 00:07:36,325 I haven't gotten around to see a doctor just yet. 199 00:07:36,368 --> 00:07:39,284 - Well, in that case, we'll go ahead and run an ultrasound. 200 00:07:39,328 --> 00:07:41,025 Doris, will you mind grabbing Dr. Asher? 201 00:07:41,069 --> 00:07:43,506 - Sure thing. - Thanks. 202 00:07:43,550 --> 00:07:45,900 - So when did the vomiting and diarrhea start? 203 00:07:45,943 --> 00:07:47,118 - Just last night. 204 00:07:47,162 --> 00:07:48,729 - And you haven't taken any medication? 205 00:07:48,772 --> 00:07:51,471 - No, nothing. 206 00:07:51,514 --> 00:07:53,734 I don't want to take anything while I'm pregnant. 207 00:07:53,777 --> 00:07:56,084 - Well, you know there are some nausea medications 208 00:07:56,127 --> 00:07:57,477 that are safe for pregnancy. 209 00:07:57,520 --> 00:07:59,653 - Still, I just-- 210 00:07:59,696 --> 00:08:01,350 I would rather not. 211 00:08:03,047 --> 00:08:04,571 I'll be fine. 212 00:08:04,614 --> 00:08:07,530 I just really came in here to make sure the baby's okay. 213 00:08:07,574 --> 00:08:10,054 - Understood. Mind if I press on your belly? 214 00:08:10,098 --> 00:08:11,752 I just want to see if anything feels tender. 215 00:08:11,795 --> 00:08:13,623 - Mm-hmm. 216 00:08:13,667 --> 00:08:15,930 [suspenseful music] 217 00:08:15,973 --> 00:08:17,758 No, no, no. No, no, no. 218 00:08:17,801 --> 00:08:19,586 I don't want her. 219 00:08:19,629 --> 00:08:21,588 You'll have to get me another doctor. 220 00:08:21,631 --> 00:08:23,154 - Dr. Asher? 221 00:08:23,198 --> 00:08:25,461 - Hannah Asher, right? 222 00:08:25,505 --> 00:08:27,115 - Yeah. She's an excellent physician. 223 00:08:27,158 --> 00:08:29,726 - She's an addict. 224 00:08:29,770 --> 00:08:31,423 You get me another doctor, or I'm leaving. 225 00:08:31,467 --> 00:08:32,947 - Whoa, whoa, whoa. Okay, okay, okay. 226 00:08:32,990 --> 00:08:33,948 Just hold on a moment. 227 00:08:33,991 --> 00:08:38,561 ♪ 228 00:08:38,605 --> 00:08:42,173 Hey, Hannah, sorry, I jumped the gun, actually. 229 00:08:42,217 --> 00:08:43,871 We're all good. 230 00:08:43,914 --> 00:08:45,568 - Oh, okay. 231 00:08:45,612 --> 00:08:47,004 Well, in that case, I'm grabbing breakfast 232 00:08:47,048 --> 00:08:50,225 if anybody's looking for me. 233 00:08:57,145 --> 00:08:59,277 - Dr. Tanaka-Reed, hold up a minute. 234 00:08:59,321 --> 00:09:01,149 Can you have them update that for me? 235 00:09:01,192 --> 00:09:02,585 Thank you. 236 00:09:02,629 --> 00:09:05,414 Look, I-- [clears throat] I wanted to clear the air. 237 00:09:05,457 --> 00:09:09,200 The other day, I may have come off a little condescending. 238 00:09:09,244 --> 00:09:11,507 - I appreciate the acknowledgment, Dr. Marcel. 239 00:09:11,551 --> 00:09:15,642 - Of course, and if there's anything you'd like to say-- 240 00:09:15,685 --> 00:09:17,992 - No, don't think so. 241 00:09:18,035 --> 00:09:20,603 We're all good. 242 00:09:20,647 --> 00:09:22,039 - What, you didn't have time to grab him 243 00:09:22,083 --> 00:09:24,433 flowers from the gift shop? 244 00:09:24,476 --> 00:09:26,217 Huh? 245 00:09:26,261 --> 00:09:27,479 I mean, I expect the other docs 246 00:09:27,523 --> 00:09:30,352 to go soft on the residents. 247 00:09:30,395 --> 00:09:32,180 I thought you had grit. 248 00:09:32,223 --> 00:09:33,790 - Well, no man's an island, right? 249 00:09:33,834 --> 00:09:35,183 - Aha. 250 00:09:35,226 --> 00:09:36,532 You know, island life's really not so bad. 251 00:09:36,576 --> 00:09:38,360 Maybe you just don't have the stomach for it. 252 00:09:38,403 --> 00:09:40,754 - Dr. Marcel, you've got a trauma incoming. 253 00:09:40,797 --> 00:09:43,017 - Well, thanks for that pep talk, coach. 254 00:09:43,060 --> 00:09:44,584 - Any time. 255 00:09:44,627 --> 00:09:46,847 - [groaning] 256 00:09:46,890 --> 00:09:48,326 - What do we got? 257 00:09:48,370 --> 00:09:50,764 - Marcus Walker, 50-year-old male, fall from standing. 258 00:09:50,807 --> 00:09:53,288 Gave him a 500 liter bolus en route. 259 00:09:53,331 --> 00:09:54,985 Pressure's hanging around 100, systolic. 260 00:09:55,029 --> 00:09:56,421 Heart rate's 120. 261 00:09:56,465 --> 00:09:58,423 - Yeah, I've never seen him in this much pain. 262 00:09:58,467 --> 00:10:00,817 It hasn't let up since he hit the pavement. 263 00:10:00,861 --> 00:10:01,862 - This is his sister, Janet. 264 00:10:01,905 --> 00:10:03,428 - Did you witness the fall, Janet? 265 00:10:03,472 --> 00:10:04,865 - He lost his balance stepping off the sidewalk. 266 00:10:04,908 --> 00:10:06,823 It didn't look that bad, but then he couldn't get up. 267 00:10:06,867 --> 00:10:08,303 - Okay, we'll give him something for the pain. 268 00:10:08,346 --> 00:10:09,478 We just got to find the source of it first. 269 00:10:09,521 --> 00:10:10,522 - Any medications we should know about? 270 00:10:10,566 --> 00:10:11,915 - Dialysis. 271 00:10:11,959 --> 00:10:13,351 Oh, and he takes ramipril for his blood pressure. 272 00:10:13,395 --> 00:10:14,526 - Okay, here we go, guys. 273 00:10:14,570 --> 00:10:15,876 Nice and easy on my count, okay? 274 00:10:15,919 --> 00:10:17,617 One, two, three. 275 00:10:17,660 --> 00:10:20,184 - [groans] - I'm sorry, Marcus. 276 00:10:20,228 --> 00:10:22,622 - I'm right here, Marcus. I'm right here. 277 00:10:22,665 --> 00:10:24,667 - Janet, let's give the doctor some room to work, okay? 278 00:10:24,711 --> 00:10:26,582 - We're gonna take care of him, Janet, we got this. 279 00:10:26,626 --> 00:10:27,975 - Let's hang a unit of whole blood. 280 00:10:28,018 --> 00:10:29,411 Pressure it in, Ron. 281 00:10:29,454 --> 00:10:32,414 Hey, Marcus, put your arms by your side for me. 282 00:10:32,457 --> 00:10:34,285 There you go, bud. Deep breaths. 283 00:10:34,329 --> 00:10:35,678 Okay, lungs are clear. 284 00:10:35,722 --> 00:10:37,419 - He's still shocking. - Yeah. 285 00:10:37,462 --> 00:10:38,986 He's bleeding from somewhere. 286 00:10:39,029 --> 00:10:40,770 Let's fast him, Dr. Taylor. 287 00:10:40,814 --> 00:10:44,165 [tense music] 288 00:10:44,208 --> 00:10:48,038 ♪ 289 00:10:48,082 --> 00:10:49,474 Belly's negative. 290 00:10:49,518 --> 00:10:51,041 - Really? 291 00:10:51,085 --> 00:10:52,782 - Yeah. 292 00:10:52,826 --> 00:10:54,828 - All right, let's get him on his side. 293 00:10:54,871 --> 00:10:57,657 Herbert, come over, please. 294 00:10:57,700 --> 00:10:59,702 All right, here we go. Nice and easy, all right? 295 00:10:59,746 --> 00:11:01,182 One, two, three. 296 00:11:01,225 --> 00:11:02,836 - [groans] 297 00:11:02,879 --> 00:11:04,141 - There you go. You're doing great. 298 00:11:04,185 --> 00:11:05,926 You're doing great, Marcus. 299 00:11:05,969 --> 00:11:09,930 ♪ 300 00:11:09,973 --> 00:11:11,888 - What is it? 301 00:11:11,932 --> 00:11:12,933 - Oh. 302 00:11:12,976 --> 00:11:14,108 - An abscess. 303 00:11:14,151 --> 00:11:15,109 - Looks like it. 304 00:11:15,152 --> 00:11:16,458 Pus under pressure. 305 00:11:16,501 --> 00:11:18,025 It's gotta be the source of the pain. 306 00:11:18,068 --> 00:11:20,636 All right, let's drain it. 307 00:11:20,680 --> 00:11:21,768 Scalpel. 308 00:11:21,811 --> 00:11:23,595 [groans] 309 00:11:27,774 --> 00:11:29,558 - Hematoma. 310 00:11:36,086 --> 00:11:37,218 - Yep. 311 00:11:37,261 --> 00:11:39,916 Hold pressure and pack it in. 312 00:11:39,960 --> 00:11:41,135 You got it? - Yeah. 313 00:11:41,178 --> 00:11:42,527 - Okay. - Got it. 314 00:11:42,571 --> 00:11:44,486 - All right, give me another unit of whole blood. 315 00:11:44,529 --> 00:11:48,838 Start DDAVP and a unit of platelets, stat. 316 00:11:48,882 --> 00:11:50,448 Come on, let's move, folks. 317 00:11:57,847 --> 00:11:58,065 . 318 00:11:58,108 --> 00:11:59,588 - Ms. Arya, hello again. 319 00:11:59,631 --> 00:12:01,242 - Indrani, please. 320 00:12:01,285 --> 00:12:03,984 - Indrani, I got the results back on your culture. 321 00:12:04,027 --> 00:12:05,550 Unfortunately, you tested positive 322 00:12:05,594 --> 00:12:07,335 for an infection called MRSA. 323 00:12:07,378 --> 00:12:10,817 - From an ingrown toenail? 324 00:12:10,860 --> 00:12:13,907 MRSA is really hard to treat, isn't it? 325 00:12:13,950 --> 00:12:16,039 - While it is resistant to many antibiotics, 326 00:12:16,083 --> 00:12:17,911 luckily, there are a couple that still work for it. 327 00:12:17,954 --> 00:12:20,043 - How long do I have to be on antibiotics? 328 00:12:20,087 --> 00:12:21,828 - About seven to ten days. - Oh. 329 00:12:21,871 --> 00:12:25,048 - See, I told you you wouldn't have to cancel your trip. 330 00:12:25,092 --> 00:12:26,789 - Oh, yeah? Where are you headed? 331 00:12:26,833 --> 00:12:28,791 - Well, I'm going to Scotland in a few weeks 332 00:12:28,835 --> 00:12:30,401 to hike the West Highland Way. 333 00:12:30,445 --> 00:12:33,796 It's a 96-mile trail through the Scottish Highlands. 334 00:12:33,840 --> 00:12:35,102 - 96 miles? 335 00:12:35,145 --> 00:12:37,321 - I've been training for the last year. 336 00:12:37,365 --> 00:12:40,107 I may be pushing 60, but I don't feel it. 337 00:12:40,150 --> 00:12:42,109 - Let's start with vancomycin. 338 00:12:42,152 --> 00:12:44,764 - No, I can't take vancomycin. I'm allergic. 339 00:12:44,807 --> 00:12:46,330 - Aha, I see that. 340 00:12:46,374 --> 00:12:48,637 - I had a terrible reaction when I was a kid. 341 00:12:48,680 --> 00:12:49,899 My throat closed up. 342 00:12:49,943 --> 00:12:51,727 - Then we will steer clear. Nancy? 343 00:12:51,771 --> 00:12:54,121 - Linezolid? On it. - Mm-hmm. 344 00:12:54,164 --> 00:12:55,905 We'll get you in tip top shape for Scotland, Indrani. 345 00:12:55,949 --> 00:12:57,951 - I've been wanting to do this a long time. 346 00:12:57,994 --> 00:13:00,954 - Um, Dr. Halstead, the pharmacy 347 00:13:00,997 --> 00:13:03,478 won't release the medication. 348 00:13:03,521 --> 00:13:05,306 - What? 349 00:13:05,349 --> 00:13:06,350 - Is there a problem? 350 00:13:06,394 --> 00:13:09,136 [suspenseful music] 351 00:13:09,179 --> 00:13:12,008 - No, just probably a system glitch. 352 00:13:12,052 --> 00:13:14,141 Sit tight, and I'll be right back. 353 00:13:14,184 --> 00:13:16,491 - Look, per the new protocol, 354 00:13:16,534 --> 00:13:18,972 you're gonna have to go through Infectious Disease first. 355 00:13:19,015 --> 00:13:21,670 And they're going to want to try incising 356 00:13:21,713 --> 00:13:23,324 and draining the infected tissue 357 00:13:23,367 --> 00:13:25,761 before they approve giving linezolid. 358 00:13:25,805 --> 00:13:26,849 - Incising and draining? 359 00:13:26,893 --> 00:13:28,329 So source control. 360 00:13:28,372 --> 00:13:29,896 That is not gonna cut it, Ms. Goodwin. 361 00:13:29,939 --> 00:13:31,767 She needs linezolid. 362 00:13:34,161 --> 00:13:36,163 I mean, can't we just say that, um, 363 00:13:36,206 --> 00:13:38,992 you know, Infectious Disease already signed off? 364 00:13:39,035 --> 00:13:40,994 - No, we cannot, Dr. Halstead. 365 00:13:41,037 --> 00:13:43,083 Linezolid is on the restricted list 366 00:13:43,126 --> 00:13:45,563 due to extremely low inventory. 367 00:13:45,607 --> 00:13:48,262 There's a region-wide shortage. 368 00:13:48,305 --> 00:13:50,830 - And we are dealing with a systemic MRSA infection. 369 00:13:50,873 --> 00:13:53,658 - You're looking at the patient in front of you. 370 00:13:53,702 --> 00:13:56,879 But the Oversight Committee designed the guidelines 371 00:13:56,923 --> 00:14:00,883 to ration these drugs to the most severe cases. 372 00:14:00,927 --> 00:14:05,845 I have seen early source control work wonders. 373 00:14:05,888 --> 00:14:07,498 Give it a shot. 374 00:14:12,764 --> 00:14:14,375 - [sighs] - Dr. Marcel. 375 00:14:14,418 --> 00:14:16,551 - Yeah? - I got Marcus' CAT scans. 376 00:14:16,594 --> 00:14:17,900 - Uh-huh. 377 00:14:17,944 --> 00:14:19,771 - Two very severe lumbar burst fractures. 378 00:14:19,815 --> 00:14:21,208 - All from a spill on the sidewalk? 379 00:14:21,251 --> 00:14:22,252 - Take a look. 380 00:14:23,775 --> 00:14:25,038 - Oof. 381 00:14:25,081 --> 00:14:27,127 Renal disease definitely sped up his bone loss. 382 00:14:27,170 --> 00:14:29,390 - He's gonna need spinal stabilization surgery. 383 00:14:29,433 --> 00:14:33,220 - Yeah, agreed, only option to get him walking again. 384 00:14:33,263 --> 00:14:34,917 Given his co-morbidities, without it, 385 00:14:34,961 --> 00:14:37,093 he's just gonna circle the drain. 386 00:14:37,137 --> 00:14:41,054 All right, let's-- let's go talk to neurosurgery. 387 00:14:42,446 --> 00:14:45,362 - And David, this voice that you're hearing, 388 00:14:45,406 --> 00:14:47,843 is it male or female? 389 00:14:47,887 --> 00:14:49,366 - I don't know. 390 00:14:49,410 --> 00:14:52,239 It's more like it has its own language, 391 00:14:52,282 --> 00:14:54,197 its own way of communicating. 392 00:14:54,241 --> 00:14:57,070 And then my brain translates messages 393 00:14:57,113 --> 00:14:59,072 so I can understand them. - Mm. 394 00:14:59,115 --> 00:15:01,291 Are you getting any messages right now? 395 00:15:01,335 --> 00:15:03,424 - That you're writing down everything 396 00:15:03,467 --> 00:15:05,513 I say because you work for them. 397 00:15:07,645 --> 00:15:10,387 ♪ 398 00:15:10,431 --> 00:15:13,782 You're one of their spies, aren't you? 399 00:15:13,825 --> 00:15:15,218 - No, I'm not a spy. 400 00:15:15,262 --> 00:15:17,394 - Then give me your notebook. 401 00:15:17,438 --> 00:15:18,874 - I'm not gonna give you my notebook, David. 402 00:15:18,918 --> 00:15:20,006 - Give it to me. 403 00:15:20,049 --> 00:15:20,963 - David, I need you to listen to me. 404 00:15:21,007 --> 00:15:22,225 I'm a doctor. 405 00:15:22,269 --> 00:15:23,357 I'm writing things down so I can 406 00:15:23,400 --> 00:15:24,619 better understand what's going-- 407 00:15:24,662 --> 00:15:26,447 - Get out of here! 408 00:15:26,490 --> 00:15:27,883 Out, now! 409 00:15:27,927 --> 00:15:29,624 - David, David, how about Dr. Cuevas 410 00:15:29,667 --> 00:15:30,886 puts her notebook away for now. 411 00:15:30,930 --> 00:15:33,106 Would that make you feel better? 412 00:15:33,149 --> 00:15:37,197 And I notice you've been checking out this vent. 413 00:15:37,240 --> 00:15:38,459 - There's a camera in there. 414 00:15:40,200 --> 00:15:42,115 - Huh. 415 00:15:42,158 --> 00:15:43,464 - They're always watching me. 416 00:15:43,507 --> 00:15:45,379 - There isn't a camera in there, David. 417 00:15:45,422 --> 00:15:47,468 - Yeah, I'm pretty sure that there isn't. 418 00:15:47,511 --> 00:15:48,860 But, you know, we're-- 419 00:15:48,904 --> 00:15:49,949 we're happy to cover it up if it'll 420 00:15:49,992 --> 00:15:52,647 make you more comfortable. 421 00:15:52,690 --> 00:15:54,127 Okay, good. 422 00:15:54,170 --> 00:15:56,825 So why don't I go see what I can scrounge up. 423 00:15:56,868 --> 00:15:59,001 And I have another couple of patients 424 00:15:59,045 --> 00:16:00,481 I need to check in on, but in the meantime, 425 00:16:00,524 --> 00:16:02,004 is there anything else I can get you? 426 00:16:02,048 --> 00:16:03,484 - Can I have a Coke? 427 00:16:03,527 --> 00:16:04,528 - Absolutely. 428 00:16:06,661 --> 00:16:08,184 Okay, so back in a bit. 429 00:16:08,228 --> 00:16:11,492 And Dr. Cuevas, can I just get a quick word, please? 430 00:16:11,535 --> 00:16:18,412 ♪ 431 00:16:18,455 --> 00:16:20,980 So with patients experiencing paranoia, 432 00:16:21,023 --> 00:16:24,287 I've found that it's probably not the best idea to push back 433 00:16:24,331 --> 00:16:25,897 too hard on their version of events, 434 00:16:25,941 --> 00:16:27,987 you know, especially at the outset. 435 00:16:28,030 --> 00:16:29,858 - There's actually evidence-based research 436 00:16:29,901 --> 00:16:31,773 suggesting the opposite, 437 00:16:31,816 --> 00:16:34,341 that you shouldn't reinforce a patient's delusion. 438 00:16:34,384 --> 00:16:35,995 Instead, you should try to explain to them 439 00:16:36,038 --> 00:16:38,171 why they're experiencing things differently. 440 00:16:38,214 --> 00:16:39,999 - I hear you, except that that's 441 00:16:40,042 --> 00:16:42,044 pretty much impossible if you haven't 442 00:16:42,088 --> 00:16:43,915 first established trust. 443 00:16:43,959 --> 00:16:46,005 But very glad to hear that you are 444 00:16:46,048 --> 00:16:47,397 keeping up on the literature. 445 00:16:47,441 --> 00:16:49,008 Way to go. 446 00:16:49,051 --> 00:16:54,752 ♪ 447 00:16:54,796 --> 00:16:57,059 - Ooh, got Choi as your advisor. 448 00:16:57,103 --> 00:16:59,366 Luck really isn't on your side. 449 00:16:59,409 --> 00:17:00,280 - Why? 450 00:17:00,323 --> 00:17:02,021 He's been really cool with me. 451 00:17:02,064 --> 00:17:03,848 - Yeah, well, I wouldn't get too comfortable. 452 00:17:03,892 --> 00:17:06,068 Word is, he's a real hard-ass. 453 00:17:06,112 --> 00:17:08,157 Got his last resident fired. 454 00:17:13,119 --> 00:17:14,990 - Olga, what are you doing down here? 455 00:17:15,034 --> 00:17:16,383 - I was gonna ask you the same thing. 456 00:17:16,426 --> 00:17:18,733 I assumed you were out today. - Why's that? 457 00:17:18,776 --> 00:17:20,822 - Oh, well, Dr. Choi asked me to ultrasound 458 00:17:20,865 --> 00:17:21,953 his pregnant patient. 459 00:17:24,826 --> 00:17:27,046 - I don't understand. Why would he ask you? 460 00:17:27,089 --> 00:17:28,743 I cover the ED. 461 00:17:28,786 --> 00:17:33,095 [tense music] 462 00:17:33,139 --> 00:17:35,141 So do you have a question about my qualifications 463 00:17:35,184 --> 00:17:37,099 or something? - Of course not, Hannah. 464 00:17:37,143 --> 00:17:39,145 - Then why would you ask another obstetrician 465 00:17:39,188 --> 00:17:41,843 to do an ultrasound in the ED when I'm here? 466 00:17:41,886 --> 00:17:43,584 Obviously, you don't trust me. 467 00:17:43,627 --> 00:17:44,715 - It's not that. 468 00:17:44,759 --> 00:17:46,891 I-- [sighs] 469 00:17:46,935 --> 00:17:49,111 The patient requested another doctor. 470 00:17:49,155 --> 00:17:52,767 She--she knew about your past. 471 00:17:52,810 --> 00:17:54,073 - What? How? 472 00:17:55,813 --> 00:17:57,250 Does she know me personally? 473 00:17:57,293 --> 00:17:58,555 - She didn't volunteer that information, 474 00:17:58,599 --> 00:18:00,296 so I didn't press it. - Fine. 475 00:18:00,340 --> 00:18:02,081 Forget it. - Hannah. 476 00:18:02,124 --> 00:18:05,997 - I'm just so sick of this following me everywhere I go. 477 00:18:06,041 --> 00:18:07,608 No matter how much progress I make, 478 00:18:07,651 --> 00:18:10,176 everyone's still judging me for who I used to be. 479 00:18:10,219 --> 00:18:15,790 ♪ 480 00:18:15,833 --> 00:18:16,965 - Nope. 481 00:18:17,008 --> 00:18:18,619 Medically, it's just too risky. 482 00:18:18,662 --> 00:18:21,100 Chronic hypertension, end-stage renal disease-- 483 00:18:21,143 --> 00:18:22,753 the list goes on and on with this patient. 484 00:18:22,797 --> 00:18:24,407 The real kicker is that platelet count. 485 00:18:24,451 --> 00:18:27,236 I'm not touching anyone whose platelet count's below 100k. 486 00:18:27,280 --> 00:18:29,847 - Listen, we know that he's not an ideal candidate. 487 00:18:29,891 --> 00:18:31,153 - Oh, wait, I almost forgot. 488 00:18:31,197 --> 00:18:33,112 You guys also hacked his back open in the ED, 489 00:18:33,155 --> 00:18:35,201 making a posterior approach impossible. 490 00:18:35,244 --> 00:18:36,637 Should I go on? 491 00:18:36,680 --> 00:18:38,769 - Look, I can give you great anterior exposure. 492 00:18:38,813 --> 00:18:40,641 All you have to do is stabilize his spine. 493 00:18:40,684 --> 00:18:42,164 I'll take care of everything else. 494 00:18:42,208 --> 00:18:44,775 - Oh, you'd be assisting me on this one? 495 00:18:44,819 --> 00:18:47,648 Wow, way to save your strongest argument for last. 496 00:18:47,691 --> 00:18:49,780 - Maybe you're just worried about your stats, Sam. 497 00:18:49,824 --> 00:18:51,782 - [scoffs] 498 00:18:51,826 --> 00:18:53,480 Send him up to interventional radiology. 499 00:18:53,523 --> 00:18:55,525 Have them inject cement into his fractures. 500 00:18:55,569 --> 00:18:57,484 That'll at least get him sitting up. 501 00:18:57,527 --> 00:18:59,181 - But that won't get him walking. 502 00:18:59,225 --> 00:19:00,791 And lack of movement is dangerous 503 00:19:00,835 --> 00:19:02,315 in Marcus's condition. 504 00:19:02,358 --> 00:19:04,621 He can develop pressure sores, blood clots, pneumonia. 505 00:19:04,665 --> 00:19:07,058 - All preferable to him bleeding out on my table. 506 00:19:09,713 --> 00:19:10,714 - [sighs] 507 00:19:13,717 --> 00:19:16,155 We just need to get his platelet count up. 508 00:19:16,198 --> 00:19:17,678 - Yeah, it's the only way to get Marcus 509 00:19:17,721 --> 00:19:19,984 healthy enough for surgery and Abrams on board. 510 00:19:20,028 --> 00:19:21,638 All right, I'll-- 511 00:19:21,682 --> 00:19:24,206 I'll order a couple of units of platelets, all right? 512 00:19:29,080 --> 00:19:30,343 [knock at door] 513 00:19:30,386 --> 00:19:33,520 - Patty, any updates on your husband? 514 00:19:33,563 --> 00:19:35,217 - Oh, he just went into surgery. 515 00:19:35,261 --> 00:19:36,827 Dr. Archer said it will be a while 516 00:19:36,871 --> 00:19:38,046 before there's any updates. 517 00:19:38,089 --> 00:19:40,048 - Okay, well, he's in very good hands. 518 00:19:40,091 --> 00:19:41,745 You can trust me on that. 519 00:19:41,789 --> 00:19:44,357 David, got that Coke you asked for 520 00:19:44,400 --> 00:19:46,359 and some stuff for the vent. 521 00:19:46,402 --> 00:19:49,231 Do you think you might be up for chatting a bit? 522 00:19:52,147 --> 00:19:53,279 You all right, pal? 523 00:19:53,322 --> 00:19:55,890 [suspenseful music] 524 00:19:55,933 --> 00:19:59,154 - Trini gave him something just to calm him down. 525 00:19:59,198 --> 00:20:00,286 - Huh. 526 00:20:03,114 --> 00:20:05,769 Okay, back in a second. 527 00:20:07,945 --> 00:20:08,903 - What did you give him? 528 00:20:08,946 --> 00:20:10,513 - 6 of risperidone. 529 00:20:10,557 --> 00:20:11,471 - What? 530 00:20:11,514 --> 00:20:13,473 Who the hell ordered that? 531 00:20:13,516 --> 00:20:14,300 - I did. 532 00:20:14,343 --> 00:20:19,827 ♪ 533 00:20:23,570 --> 00:20:23,787 . 534 00:20:23,831 --> 00:20:26,355 He became extremely agitated and was resisting restraints. 535 00:20:26,399 --> 00:20:27,835 - Lorazepam worked this morning. 536 00:20:27,878 --> 00:20:29,402 - You didn't see how upset he was. 537 00:20:29,445 --> 00:20:30,751 - Haldol then. 538 00:20:30,794 --> 00:20:32,666 - He was going to tear out his IV. 539 00:20:32,709 --> 00:20:34,058 His mom was freaking out, begging me to do-- 540 00:20:34,102 --> 00:20:35,669 - Well, you cannot let a family member 541 00:20:35,712 --> 00:20:37,801 pressure you into making a rushed treatment call. 542 00:20:37,845 --> 00:20:40,761 - It wasn't rushed. It was necessary. 543 00:20:40,804 --> 00:20:42,893 And besides, the meds will clear his system 544 00:20:42,937 --> 00:20:44,286 by tomorrow morning at the latest. 545 00:20:44,330 --> 00:20:45,635 - At which point, we'll be back at square one 546 00:20:45,679 --> 00:20:47,507 with David, if we're lucky, all right? 547 00:20:47,550 --> 00:20:50,118 Any trust established, down the drain. 548 00:20:50,161 --> 00:20:52,294 How about this, in the future, maybe at least page me 549 00:20:52,338 --> 00:20:55,558 before administering a very high dose of antipsychotics 550 00:20:55,602 --> 00:20:57,952 to a patient we're still evaluating? 551 00:20:57,995 --> 00:21:01,129 - With all due respect, Dr. Charles, 552 00:21:01,172 --> 00:21:03,436 I am not a trainee. 553 00:21:03,479 --> 00:21:06,526 And 6 milligrams is well within the standard of care, I-- 554 00:21:06,569 --> 00:21:08,092 - Standard of care, whatever that is, 555 00:21:08,136 --> 00:21:10,356 is not some blanket template you follow 556 00:21:10,399 --> 00:21:13,315 without any regard for the person in front of you 557 00:21:13,359 --> 00:21:14,664 you're supposed to be helping! 558 00:21:14,708 --> 00:21:17,667 [tense music] 559 00:21:17,711 --> 00:21:24,761 ♪ 560 00:21:27,677 --> 00:21:29,157 - Hey, Janet. 561 00:21:29,200 --> 00:21:31,246 I just want to let you know, the nurse will be by soon 562 00:21:31,290 --> 00:21:33,466 to start Marcus' platelet transfusion, okay? 563 00:21:33,509 --> 00:21:36,469 [apprehensive music] 564 00:21:36,512 --> 00:21:40,255 ♪ 565 00:21:40,299 --> 00:21:42,736 I know it's been a rough day. 566 00:21:42,779 --> 00:21:45,782 - More like a rough year. 567 00:21:45,826 --> 00:21:48,481 Lost my husband in January. 568 00:21:48,524 --> 00:21:51,310 - I'm so sorry. 569 00:21:51,353 --> 00:21:54,138 - Marcus came out from California for the funeral 570 00:21:54,182 --> 00:21:58,360 and just never went home, 571 00:21:58,404 --> 00:21:59,883 moved in with me. 572 00:21:59,927 --> 00:22:01,711 - You must really get on. 573 00:22:03,409 --> 00:22:08,327 - [sniffles] Never had a choice in the matter. 574 00:22:08,370 --> 00:22:11,155 We're twins, actually. 575 00:22:11,199 --> 00:22:15,377 Marcus was born 45 seconds before me, 576 00:22:15,421 --> 00:22:19,250 but you'd think he was years older, the way he acts. 577 00:22:19,294 --> 00:22:24,560 Seeing him here like this, so fragile-- 578 00:22:27,258 --> 00:22:29,478 - It's really hard. 579 00:22:29,522 --> 00:22:36,616 ♪ 580 00:22:38,618 --> 00:22:41,969 I want you to know that, uh, 581 00:22:42,012 --> 00:22:47,627 we're gonna do everything we can for Marcus, I promise. 582 00:22:47,670 --> 00:22:48,889 Okay. 583 00:22:53,415 --> 00:22:55,678 What is it? 584 00:22:55,722 --> 00:22:57,898 - I was just looking back in Marcus's history. 585 00:22:57,941 --> 00:23:00,074 His platelets have always been low. 586 00:23:00,117 --> 00:23:01,423 - Huh. 587 00:23:01,467 --> 00:23:02,903 Do you think this is chronic? 588 00:23:02,946 --> 00:23:05,514 Some kind of undiagnosed blood disorder, or...? 589 00:23:05,558 --> 00:23:07,603 - ITP would be my guess. - Oh, man. 590 00:23:07,647 --> 00:23:08,822 - And if that's the case, 591 00:23:08,865 --> 00:23:10,127 a transfusion is not gonna do much. 592 00:23:10,171 --> 00:23:11,564 I mean, his body would just keep chewing up 593 00:23:11,607 --> 00:23:13,087 any new platelets we give him. 594 00:23:13,130 --> 00:23:15,437 - Well, unless-- 595 00:23:15,481 --> 00:23:17,134 - Unless what? 596 00:23:18,919 --> 00:23:22,444 - Um, forget it, actually. 597 00:23:22,488 --> 00:23:23,837 I thought I had something. 598 00:23:23,880 --> 00:23:25,229 But let's just hope the transfusion 599 00:23:25,273 --> 00:23:28,319 moves the needle a little, okay? 600 00:23:28,363 --> 00:23:31,279 [suspenseful music] 601 00:23:31,322 --> 00:23:36,240 ♪ 602 00:23:36,284 --> 00:23:39,113 - Podiatry incised and drained the toe. 603 00:23:39,156 --> 00:23:42,029 They had to cut the nail out. 604 00:23:42,072 --> 00:23:43,813 - I'm not a doctor, but it looks like 605 00:23:43,857 --> 00:23:44,901 it's getting worse to me. 606 00:23:44,945 --> 00:23:46,903 - Don't worry. I'm on it. 607 00:23:46,947 --> 00:23:48,252 We're gonna get you the medicine you need. 608 00:23:48,296 --> 00:23:51,778 - Dr. Halstead, can I speak with you outside? 609 00:23:51,821 --> 00:23:54,476 - What's wrong? 610 00:23:54,520 --> 00:23:56,826 - Just give us a moment. 611 00:24:02,441 --> 00:24:05,052 - We're now completely out of linezolid. 612 00:24:05,095 --> 00:24:07,620 - You've gotta be kidding me. 613 00:24:07,663 --> 00:24:09,143 I knew it. 614 00:24:09,186 --> 00:24:11,885 I knew source control wasn't gonna cut it. 615 00:24:11,928 --> 00:24:13,539 How soon are we expecting to get it back in stock? 616 00:24:13,582 --> 00:24:15,671 - Tomorrow morning, at the earliest. 617 00:24:19,414 --> 00:24:21,285 - Order vancomycin. 618 00:24:21,329 --> 00:24:22,548 - She's allergic. 619 00:24:22,591 --> 00:24:25,376 - I know, all right, but I've got an idea. 620 00:24:29,032 --> 00:24:31,470 [knock at door] - Hey, Liza. 621 00:24:33,341 --> 00:24:35,386 So got your labs back, and they look good. 622 00:24:35,430 --> 00:24:37,998 Your white blood count is slightly elevated, 623 00:24:38,041 --> 00:24:40,304 but that's pretty common in pregnancy. 624 00:24:40,348 --> 00:24:43,220 I think we're just looking at a stomach bug. 625 00:24:43,264 --> 00:24:44,570 - Makes sense. 626 00:24:44,613 --> 00:24:45,919 I can go home then? 627 00:24:45,962 --> 00:24:48,008 - Yeah, Dr. Patchefsky sent down a list 628 00:24:48,051 --> 00:24:50,010 of OB-GYN referrals, 629 00:24:50,053 --> 00:24:52,403 as well as some genetic testing counselors. 630 00:24:52,447 --> 00:24:54,754 We'll just add those to your discharge. 631 00:24:54,797 --> 00:24:56,669 - Genetic testing? 632 00:24:56,712 --> 00:24:58,453 I thought she said the-- 633 00:24:58,497 --> 00:25:01,021 the baby looked healthy on the ultrasound. 634 00:25:01,064 --> 00:25:03,371 - Genetic testing for hereditary conditions 635 00:25:03,414 --> 00:25:04,285 is completely optional. 636 00:25:05,895 --> 00:25:09,551 - But the baby's healthy, right? 637 00:25:09,595 --> 00:25:10,726 - Yeah. 638 00:25:12,989 --> 00:25:14,817 Hey, listen, if-- 639 00:25:14,861 --> 00:25:16,515 - Liza, my dear. 640 00:25:18,342 --> 00:25:20,736 I have your discharge paperwork. 641 00:25:25,393 --> 00:25:28,614 - I'm not sure I'm following you. 642 00:25:28,657 --> 00:25:32,052 You want to give me a drug I told you almost killed me? 643 00:25:32,095 --> 00:25:34,358 - And we'll do everything we can to mitigate the chances 644 00:25:34,402 --> 00:25:36,578 of another adverse reaction. - How, exactly? 645 00:25:36,622 --> 00:25:39,102 - Through a process called desensitizing. 646 00:25:39,146 --> 00:25:41,365 We'll pre-medicate you with steroids and antihistamines 647 00:25:41,409 --> 00:25:44,455 and then administer the vancomycin via a slow IV drip. 648 00:25:44,499 --> 00:25:47,415 - And can you promise me that my throat 649 00:25:47,458 --> 00:25:48,634 won't close up again? 650 00:25:48,677 --> 00:25:50,374 - I can't promise that, no. 651 00:25:50,418 --> 00:25:51,985 But if you do go into anaphylaxis, 652 00:25:52,028 --> 00:25:53,334 we'll have epinephrine at the ready. 653 00:25:53,377 --> 00:25:54,944 Worst case scenario, we might need to intubate, 654 00:25:54,988 --> 00:25:56,598 but that would only be temporary. 655 00:25:56,642 --> 00:25:57,991 - Intubate me? No, no. 656 00:25:58,034 --> 00:25:59,383 I'll go to another hospital. 657 00:25:59,427 --> 00:26:01,211 - Well, we've called everywhere. 658 00:26:01,255 --> 00:26:02,735 The earliest anyone has linezolid is tomorrow. 659 00:26:02,778 --> 00:26:04,693 - So I'll wait. 660 00:26:04,737 --> 00:26:07,087 - As you're seeing, MRSA moves fast. 661 00:26:07,130 --> 00:26:08,436 I am afraid if we wait until tomorrow, 662 00:26:08,479 --> 00:26:10,307 it will have already spread to the bone. 663 00:26:10,351 --> 00:26:11,700 You could lose your leg, Indrani. 664 00:26:11,744 --> 00:26:18,054 ♪ 665 00:26:19,447 --> 00:26:21,449 - Give me the vancomycin. 666 00:26:21,492 --> 00:26:22,450 - Okay. 667 00:26:26,585 --> 00:26:29,762 - Marcus' platelet count rose from 50,000 to 105,000. 668 00:26:29,805 --> 00:26:30,763 Can you believe it? 669 00:26:30,806 --> 00:26:32,547 - That's great. 670 00:26:32,591 --> 00:26:34,288 - It's fantastic. 671 00:26:34,331 --> 00:26:36,333 He must not have ITP after all. 672 00:26:36,377 --> 00:26:37,596 - Do me a favor. 673 00:26:37,639 --> 00:26:39,598 Show Abrams these updated labs. 674 00:26:39,641 --> 00:26:43,471 I think he'll be more receptive if you deliver them solo. 675 00:26:43,514 --> 00:26:45,647 - How could he possibly refuse to operate now? 676 00:26:45,691 --> 00:26:47,431 - It's Abrams. 677 00:26:47,475 --> 00:26:49,172 - I'll get him on board. 678 00:26:49,216 --> 00:26:53,350 - Dr. Choi? We've got a problem. 679 00:26:53,394 --> 00:26:55,657 Liza? 680 00:26:55,701 --> 00:26:56,745 I thought she had left. 681 00:26:56,789 --> 00:26:57,833 I came in to turn over the room, 682 00:26:57,877 --> 00:26:59,095 and I found her passed out. 683 00:26:59,139 --> 00:27:00,140 - Let's get her back in the bed 684 00:27:00,183 --> 00:27:01,271 and up on the monitors. Ready? 685 00:27:01,315 --> 00:27:03,665 One, two, three. 686 00:27:03,709 --> 00:27:05,798 All right. All right. 687 00:27:05,841 --> 00:27:07,669 Liza? Liza, can you hear me? 688 00:27:07,713 --> 00:27:09,802 All right, let's re-start her IV and get a Foley in her. 689 00:27:09,845 --> 00:27:10,977 Grab OB. - Patchefsky, right? 690 00:27:11,020 --> 00:27:11,978 - No, no, no. No time. 691 00:27:12,021 --> 00:27:13,370 Grab Asher. - Okay. 692 00:27:13,414 --> 00:27:15,808 - She's hypotensive. BP 85/43. 693 00:27:15,851 --> 00:27:17,331 Maybe she vasovagaled? 694 00:27:17,374 --> 00:27:19,420 - Her white count was more significant than I thought. 695 00:27:19,463 --> 00:27:21,727 [alarm beeping] 696 00:27:21,770 --> 00:27:23,337 - Liza. 697 00:27:23,380 --> 00:27:25,644 - You know her? - Yeah, Doris filled me in. 698 00:27:25,687 --> 00:27:26,906 How long had she been experiencing symptoms 699 00:27:26,949 --> 00:27:27,994 when she came in? 700 00:27:28,037 --> 00:27:29,256 - Less than 24 hours. 701 00:27:29,299 --> 00:27:31,301 - And that's self-reported from the patient? 702 00:27:31,345 --> 00:27:32,607 - Yeah, why? 703 00:27:32,651 --> 00:27:36,002 ♪ 704 00:27:36,045 --> 00:27:37,351 - Bolus a liter of normal saline. 705 00:27:37,394 --> 00:27:38,831 - Hannah, we've been giving her fluids. 706 00:27:38,874 --> 00:27:40,354 Could this be sepsis? 707 00:27:40,397 --> 00:27:41,834 We could start a broad spectrum antibiotic. 708 00:27:41,877 --> 00:27:43,183 - Let's just see what this does first. 709 00:27:43,226 --> 00:27:44,706 I don't think we're looking at sepsis. 710 00:27:44,750 --> 00:27:48,710 I think she's hypovolemic from massive volume depletion. 711 00:27:48,754 --> 00:27:52,845 I suspect she's been sick a lot longer than she reported. 712 00:27:52,888 --> 00:27:54,803 - BP's starting to come up. 713 00:27:54,847 --> 00:27:58,024 [machine beeping] 714 00:27:58,067 --> 00:28:04,204 ♪ 715 00:28:16,520 --> 00:28:16,695 . 716 00:28:16,738 --> 00:28:19,610 - Appreciate you stepping up to the plate on this one, Sam. 717 00:28:19,654 --> 00:28:21,656 - His platelets sure turned around fast, didn't they? 718 00:28:21,700 --> 00:28:22,918 - Marcus is a fighter. 719 00:28:25,442 --> 00:28:26,966 - All right, this is my show. 720 00:28:27,009 --> 00:28:28,968 Once we get to the spine, you follow my lead, understood? 721 00:28:29,011 --> 00:28:30,491 - Fair enough. 722 00:28:30,534 --> 00:28:33,233 - Mia, start my playlist. 723 00:28:33,276 --> 00:28:34,713 [jazz music playing] 724 00:28:34,756 --> 00:28:37,019 All right, after you. 725 00:28:37,063 --> 00:28:38,194 - Scalpel. 726 00:28:38,238 --> 00:28:45,071 ♪ 727 00:28:51,599 --> 00:28:52,818 - Where are we at? 728 00:28:52,861 --> 00:28:55,124 - I gave 125 of the methylprednisolone 729 00:28:55,168 --> 00:28:57,083 and 50 of diphenhydramine. 730 00:28:57,126 --> 00:28:59,825 - All right, we're ready to start the vancomycin. 731 00:28:59,868 --> 00:29:01,565 Now, we're gonna take it slowly, 732 00:29:01,609 --> 00:29:03,567 gradually increase the dose over time. 733 00:29:03,611 --> 00:29:05,352 Are you ready? 734 00:29:05,395 --> 00:29:07,093 - As I'll ever be. 735 00:29:07,136 --> 00:29:10,052 [tense music] 736 00:29:10,096 --> 00:29:17,059 ♪ 737 00:29:19,670 --> 00:29:21,890 Something doesn't feel right. [machine beeping] 738 00:29:21,934 --> 00:29:23,587 - Okay. - Oh, my God. 739 00:29:23,631 --> 00:29:25,502 Oh, my God. My throat--I can't swallow. 740 00:29:25,546 --> 00:29:27,766 - Okay, we got you. Nancy, 0.3 of Epi. 741 00:29:27,809 --> 00:29:31,204 - [breathing heavily] I can't-- 742 00:29:31,247 --> 00:29:32,379 - It takes time to work. 743 00:29:32,422 --> 00:29:33,946 Just stay calm. Keep your eyes on me. 744 00:29:36,905 --> 00:29:39,952 Another 0.3 of Epi and another 50 of diphenhydramine. 745 00:29:43,520 --> 00:29:45,435 Mask. 746 00:29:45,479 --> 00:29:46,785 There you go. 747 00:29:52,138 --> 00:29:55,010 Get ready to intubate. 748 00:29:55,054 --> 00:29:56,446 Just a precaution. 749 00:29:56,490 --> 00:30:03,497 ♪ 750 00:30:10,765 --> 00:30:12,288 - I think it's working. 751 00:30:12,332 --> 00:30:13,594 - Slow, deep breaths. 752 00:30:13,637 --> 00:30:15,683 In through the nose, out through the mouth. 753 00:30:17,163 --> 00:30:20,079 - [exhales slowly] 754 00:30:21,384 --> 00:30:22,516 - That's it. 755 00:30:29,915 --> 00:30:33,222 - So how long have you actually been sick? 756 00:30:33,266 --> 00:30:35,659 - This is day six. 757 00:30:35,703 --> 00:30:40,664 Ever since I stopped using. 758 00:30:41,883 --> 00:30:43,493 - Did you know that these symptoms 759 00:30:43,537 --> 00:30:46,627 are a result of withdrawal? 760 00:30:46,670 --> 00:30:48,716 - I figured. 761 00:30:51,240 --> 00:30:54,461 Dr. Asher, if I outed you to your colleagues-- 762 00:30:54,504 --> 00:30:56,332 - No. 763 00:30:56,376 --> 00:30:57,812 No, you didn't. 764 00:30:57,856 --> 00:31:01,642 Everyone here knows that I'm in recovery. 765 00:31:01,685 --> 00:31:05,211 And you don't have to call me Dr. Asher. 766 00:31:06,255 --> 00:31:10,303 - It does feel kind of weird calling you by your last name. 767 00:31:11,739 --> 00:31:14,046 I won't tell anyone in group. 768 00:31:14,089 --> 00:31:15,874 - Thank you. 769 00:31:15,917 --> 00:31:17,701 - I don't even know if the drugs 770 00:31:17,745 --> 00:31:20,182 have cleared my system yet. 771 00:31:20,226 --> 00:31:23,011 I couldn't risk you running a drug test on me, 772 00:31:23,055 --> 00:31:25,405 given everything you know about me. 773 00:31:25,448 --> 00:31:30,062 I just--I don't want anyone taking my baby away. 774 00:31:32,151 --> 00:31:36,155 - Well, I commend you for quitting, Liza. 775 00:31:36,198 --> 00:31:38,548 Going cold turkey is really hard. 776 00:31:38,592 --> 00:31:40,594 [solemn music] 777 00:31:40,637 --> 00:31:43,902 There are some medications like Suboxone and methadone 778 00:31:43,945 --> 00:31:46,469 that can help curb the cravings. 779 00:31:46,513 --> 00:31:48,515 - Those are opiates, right? 780 00:31:48,558 --> 00:31:50,212 - Yes. 781 00:31:50,256 --> 00:31:52,519 But when you're medically supervised, 782 00:31:52,562 --> 00:31:55,652 you are allowed to be on them while you're pregnant. 783 00:31:55,696 --> 00:31:57,393 The risk to the fetus is minimal-- 784 00:31:57,437 --> 00:31:58,960 - No. 785 00:31:59,004 --> 00:32:02,050 If there are any risks, then no. 786 00:32:03,922 --> 00:32:07,969 I probably shot up, 787 00:32:08,013 --> 00:32:11,364 like, a half dozen times during my first trimester. 788 00:32:13,583 --> 00:32:19,633 And still, by some miracle, the baby seems to be okay. 789 00:32:22,244 --> 00:32:26,248 I can't do anything to jeopardize that. 790 00:32:26,292 --> 00:32:27,249 I won't. 791 00:32:30,644 --> 00:32:31,601 [knock at door] 792 00:32:31,645 --> 00:32:32,820 - Come in. 793 00:32:38,782 --> 00:32:40,654 - I was going to check with Mrs. Sullivan 794 00:32:40,697 --> 00:32:42,961 to see if she would agree to David spending 795 00:32:43,004 --> 00:32:45,702 a couple of nights in the psych ward. 796 00:32:45,746 --> 00:32:48,009 I figure we can talk to him more, 797 00:32:48,053 --> 00:32:52,709 begin to find the correct medication and dosage. 798 00:32:52,753 --> 00:32:54,363 - Well, that sounds good, Dr. Cuevas. 799 00:32:54,407 --> 00:32:55,974 Thank you. 800 00:32:56,017 --> 00:32:58,585 - Oh, and his father is out of surgery. 801 00:32:58,628 --> 00:33:00,021 No complications. 802 00:33:00,065 --> 00:33:04,069 - Well, good stuff. I'm glad to--glad to hear too. 803 00:33:08,769 --> 00:33:12,903 - I should have spoken to you first before medicating David. 804 00:33:12,947 --> 00:33:15,558 - Look, you know it was a chaotic situation, 805 00:33:15,602 --> 00:33:18,735 and I understand that you felt the need to act swiftly. 806 00:33:18,779 --> 00:33:20,172 I do. 807 00:33:20,215 --> 00:33:23,349 - I probably did jump to medication too quickly, 808 00:33:23,392 --> 00:33:24,654 if I'm being honest. 809 00:33:24,698 --> 00:33:27,657 [pensive music] 810 00:33:27,701 --> 00:33:31,487 I know I rely heavily on the literature 811 00:33:31,531 --> 00:33:33,794 and the standard of care, 812 00:33:33,837 --> 00:33:38,581 but I just don't always feel 813 00:33:38,625 --> 00:33:41,802 like I can trust my own instincts. 814 00:33:44,805 --> 00:33:49,592 - I mean, it took me years, years. 815 00:33:49,636 --> 00:33:50,811 And still, I have-- 816 00:33:50,854 --> 00:33:55,033 I have my days when--you know? 817 00:33:55,076 --> 00:33:58,123 But this, I can promise you, you will get there. 818 00:33:58,166 --> 00:33:59,385 You will. 819 00:33:59,428 --> 00:34:01,169 There's not a shred of doubt in my mind. 820 00:34:02,692 --> 00:34:03,954 Trust me on that. 821 00:34:03,998 --> 00:34:11,092 ♪ 822 00:34:20,275 --> 00:34:22,364 - Hey, Janet. 823 00:34:22,408 --> 00:34:23,974 Marcus did great. 824 00:34:27,717 --> 00:34:29,371 - I can't thank you both enough. 825 00:34:29,415 --> 00:34:30,633 - No need. 826 00:34:30,677 --> 00:34:31,852 He's got a long road ahead, 827 00:34:31,895 --> 00:34:33,593 but with physical therapy, I'm confident 828 00:34:33,636 --> 00:34:35,986 he'll be back on his feet. 829 00:34:36,030 --> 00:34:37,336 - [stammers] Can--can I see him? 830 00:34:37,379 --> 00:34:39,381 - Of course. I'll take you to recovery. 831 00:34:39,425 --> 00:34:42,123 Now, he's just waking up, so he might be a bit groggy, okay? 832 00:34:42,167 --> 00:34:43,385 This way. 833 00:34:47,824 --> 00:34:49,870 - Dr. Abrams, I heard the good news. 834 00:34:49,913 --> 00:34:51,219 I really appreciate-- 835 00:34:51,263 --> 00:34:53,743 - Yeah, you two ever pull a stunt like that again, 836 00:34:53,787 --> 00:34:54,788 I won't keep it to myself. 837 00:34:54,831 --> 00:34:56,224 I'll go straight to Goodwin. 838 00:34:56,268 --> 00:34:57,530 - Excuse me? 839 00:34:57,573 --> 00:34:59,358 - I don't appreciate being conned into surgery 840 00:34:59,401 --> 00:35:01,403 under false pretenses. - Wait. 841 00:35:01,447 --> 00:35:03,623 I'm sorry, Dr. Abrams. What are you talking about? 842 00:35:03,666 --> 00:35:07,366 [tense music] 843 00:35:07,409 --> 00:35:09,542 - My antenna went up when Marcus's platelets 844 00:35:09,585 --> 00:35:10,978 corrected so quickly. 845 00:35:11,021 --> 00:35:13,067 So I had the lab run an anti-platelet antibody test 846 00:35:13,111 --> 00:35:14,329 while we were in surgery. 847 00:35:14,373 --> 00:35:16,984 You might be interested in the results. 848 00:35:21,728 --> 00:35:23,251 - Marcus has ITP. - Mm-hmm. 849 00:35:23,295 --> 00:35:24,731 - But this doesn't make any sense. 850 00:35:24,774 --> 00:35:26,254 If Marcus has ITP, the transfusion 851 00:35:26,298 --> 00:35:28,604 shouldn't have worked. - Correct. 852 00:35:28,648 --> 00:35:31,477 Unless someone gave him a little assistance. 853 00:35:31,520 --> 00:35:38,136 ♪ 854 00:35:41,226 --> 00:35:41,443 . 855 00:35:41,487 --> 00:35:44,011 - You gave Marcus steroids, didn't you? 856 00:35:44,054 --> 00:35:45,360 And that's why his platelet count went up. 857 00:35:45,404 --> 00:35:47,188 - I know steroids can be controversial 858 00:35:47,232 --> 00:35:49,190 in the surgical settings-- - To put it lightly. 859 00:35:49,234 --> 00:35:52,324 You put him at greater risk of post-op infection. 860 00:35:52,367 --> 00:35:53,803 - Vanessa, believe me when I tell you, 861 00:35:53,847 --> 00:35:56,371 this was our only play. 862 00:35:56,415 --> 00:35:57,720 - Ouronly play? 863 00:35:57,764 --> 00:36:00,332 I was left in the dark. 864 00:36:00,375 --> 00:36:02,029 - Look, I didn't want you catching any heat 865 00:36:02,072 --> 00:36:03,552 if things went south, okay? 866 00:36:03,596 --> 00:36:05,859 I have more cover as an attending. 867 00:36:05,902 --> 00:36:07,208 I was trying to protect you. 868 00:36:07,252 --> 00:36:09,123 [tense music] 869 00:36:09,167 --> 00:36:10,820 - I do not need your protection. 870 00:36:10,864 --> 00:36:12,039 I need your respect. 871 00:36:12,082 --> 00:36:14,041 - Vanessa, of course I respect you. 872 00:36:14,084 --> 00:36:16,217 - It does not feel that way right now. 873 00:36:16,261 --> 00:36:20,221 ♪ 874 00:36:25,008 --> 00:36:27,141 - Looking much better, Indrani. 875 00:36:27,185 --> 00:36:29,099 Some techs will be back soon to move you upstairs. 876 00:36:29,143 --> 00:36:31,450 We're gonna keep you on IV vancomycin for a few days 877 00:36:31,493 --> 00:36:34,322 and then switch you over to the oral version. 878 00:36:34,366 --> 00:36:37,325 - Dr. Halstead, I can't thank you enough. 879 00:36:37,369 --> 00:36:39,719 - I'm just sorry we had to put you through all that. 880 00:36:39,762 --> 00:36:41,416 - Oh, it was worth it, believe me. 881 00:36:44,463 --> 00:36:46,334 That's where I'm going to be next month. 882 00:36:48,336 --> 00:36:50,120 - I'm adding it to my bucket list. 883 00:36:54,734 --> 00:36:55,865 Would you excuse me for a moment? 884 00:36:55,909 --> 00:36:57,127 - Of course. 885 00:36:59,608 --> 00:37:01,480 - Ms. Goodwin. 886 00:37:01,523 --> 00:37:03,786 - Stop by my office before you leave tonight. 887 00:37:03,830 --> 00:37:05,135 I'd like a word. 888 00:37:07,225 --> 00:37:09,096 - Will do. 889 00:37:12,969 --> 00:37:15,624 - Dr. Choi, 890 00:37:15,668 --> 00:37:19,193 uh, this is for you. 891 00:37:19,237 --> 00:37:20,586 I saw you were staying on for the night shift, 892 00:37:20,629 --> 00:37:23,763 so I figured you might need a caffeine boost. 893 00:37:23,806 --> 00:37:25,373 Oh, and these are also for you. 894 00:37:25,417 --> 00:37:27,767 It's my CV, in-progress research papers, 895 00:37:27,810 --> 00:37:29,203 and all my case logs to date. 896 00:37:30,987 --> 00:37:33,294 For our first advisor meeting tomorrow. 897 00:37:33,338 --> 00:37:38,386 - Ah, well, you are really prepared, Zach. 898 00:37:38,430 --> 00:37:39,518 Will you excuse me? 899 00:37:39,561 --> 00:37:41,476 - Yeah, of course. 900 00:37:41,520 --> 00:37:43,478 See you tomorrow. 901 00:37:43,522 --> 00:37:45,785 - See you tomorrow. 902 00:37:45,828 --> 00:37:48,135 Hey. - Hey. 903 00:37:48,178 --> 00:37:50,746 Liza agreed to be admitted overnight for observation. 904 00:37:50,790 --> 00:37:52,661 - Good. 905 00:37:52,705 --> 00:37:55,055 She's in withdrawal, I take it. 906 00:37:55,098 --> 00:37:56,970 Don't worry, I won't say anything. 907 00:37:57,013 --> 00:37:59,059 - I appreciate that, Ethan. 908 00:37:59,102 --> 00:38:00,843 And while I suspect that the drugs 909 00:38:00,887 --> 00:38:02,149 have already cleared her system, 910 00:38:02,192 --> 00:38:03,890 she's terrified someone might report her. 911 00:38:03,933 --> 00:38:05,587 - The last thing she needs is to be 912 00:38:05,631 --> 00:38:09,069 penalized for seeking care. 913 00:38:09,112 --> 00:38:11,158 - Look, you were absolutely right, by the way, 914 00:38:11,201 --> 00:38:13,203 to bring in Dr. Patchefsky. 915 00:38:13,247 --> 00:38:15,075 I never should have given you flack for that. 916 00:38:15,118 --> 00:38:18,078 - Look, I know how frustrating it is 917 00:38:18,121 --> 00:38:20,820 to always feel like you're being held 918 00:38:20,863 --> 00:38:23,475 to some former version of yourself. 919 00:38:23,518 --> 00:38:26,173 But on the flip side, because of who you were 920 00:38:26,216 --> 00:38:27,914 and what you went through, 921 00:38:27,957 --> 00:38:29,524 you were able to connect to Liza 922 00:38:29,568 --> 00:38:31,439 in a way no one else could. 923 00:38:31,483 --> 00:38:32,919 [pensive music] 924 00:38:32,962 --> 00:38:35,095 - Yeah. 925 00:38:35,138 --> 00:38:36,357 I guess that's true. 926 00:38:38,141 --> 00:38:40,361 - Maybe it's not always such a bad thing, 927 00:38:40,405 --> 00:38:42,537 having your reputation precede you. 928 00:38:42,581 --> 00:38:49,544 ♪ 929 00:38:50,502 --> 00:38:52,591 - Great work today, Sam. 930 00:38:52,634 --> 00:38:55,550 [tense music] 931 00:38:55,594 --> 00:38:58,771 ♪ 932 00:38:58,814 --> 00:38:59,989 Goodnight, Dr. Taylor. 933 00:39:05,604 --> 00:39:07,388 - Ooh, ouch. 934 00:39:07,432 --> 00:39:12,132 Why, I see you've got yourself quite the fan club. 935 00:39:12,175 --> 00:39:14,134 You know, maybe I was wrong about you. 936 00:39:14,177 --> 00:39:16,702 You might be cut out for island life after all. 937 00:39:16,745 --> 00:39:21,054 ♪ 938 00:39:21,097 --> 00:39:24,405 - So let me get this straight. 939 00:39:24,449 --> 00:39:27,277 You gave the patient an antibiotic 940 00:39:27,321 --> 00:39:29,279 you knew she was allergic to-- 941 00:39:29,323 --> 00:39:31,891 - Only after I advised her of the potential risks 942 00:39:31,934 --> 00:39:33,632 and with her full consent. 943 00:39:33,675 --> 00:39:35,938 - Which, trust me, wouldn't hold up in court 944 00:39:35,982 --> 00:39:38,550 if this thing had gone sideways. 945 00:39:38,593 --> 00:39:40,595 - Well, Ms. Goodwin, it wasn't my first choice. 946 00:39:40,639 --> 00:39:42,989 - I understand the new protocols got off 947 00:39:43,032 --> 00:39:44,817 to a bit of a rocky start today, but-- 948 00:39:44,860 --> 00:39:47,080 - They're not working. 949 00:39:47,123 --> 00:39:48,647 I have no doubt they were designed 950 00:39:48,690 --> 00:39:49,952 with the best of intentions, 951 00:39:49,996 --> 00:39:51,084 but as your boots on the ground, 952 00:39:51,127 --> 00:39:52,302 I have to give it to you straight. 953 00:39:52,346 --> 00:39:54,609 - Let me give it to youstraight. 954 00:39:54,653 --> 00:39:59,048 These supply chain issues are not gonna resolve anytime soon, 955 00:39:59,092 --> 00:40:02,051 and not for lack of trying on my part. 956 00:40:02,095 --> 00:40:06,447 So as imperfect as these new protocols may be, 957 00:40:06,491 --> 00:40:12,584 we need some sort of semblance of order in the ED. 958 00:40:12,627 --> 00:40:16,501 I can't have it turning into the Wild West! 959 00:40:18,328 --> 00:40:21,506 - Honestly, Ms. Goodwin, I think we're already there. 960 00:40:21,549 --> 00:40:28,469 ♪ 961 00:40:39,872 --> 00:40:42,831 [dramatic music] 962 00:40:42,875 --> 00:40:50,012 ♪ 963 00:41:09,945 --> 00:41:13,079 [wolf howls]