1 00:00:13,638 --> 00:00:15,932 [indistinct chatter] 2 00:00:15,974 --> 00:00:19,185 [police radio chatter] 3 00:00:21,521 --> 00:00:24,274 - The man is in his element. - What's he doing? 4 00:00:24,315 --> 00:00:26,067 - Age-old ritual, meant to capitalize 5 00:00:26,109 --> 00:00:27,444 off the unknown origins 6 00:00:27,485 --> 00:00:31,114 of Westbridge's current state of affairs. 7 00:00:31,197 --> 00:00:33,533 Whoever guesses the reason they went code black wins the pot. 8 00:00:33,616 --> 00:00:36,953 - Ah, interesting. We didn't do this at the VA. 9 00:00:37,037 --> 00:00:38,246 - You game? - Of course. 10 00:00:38,288 --> 00:00:40,040 - Now, how's this look to you? 11 00:00:40,123 --> 00:00:41,624 - My wager is on flooding. 12 00:00:41,708 --> 00:00:43,084 They're going to be down for 3 hours, 13 00:00:43,126 --> 00:00:44,836 and we're going to get 20 of their patients. 14 00:00:44,919 --> 00:00:48,965 - Put me down for flooding, 4 hours and 30 patients. 15 00:00:49,007 --> 00:00:50,508 - Okay, okay, okay. 16 00:00:50,592 --> 00:00:52,135 Hey, Dr. Robby, looks like you got some competition. 17 00:00:52,218 --> 00:00:53,595 - Yes, it would appear that I do. 18 00:00:53,636 --> 00:00:55,305 - All right, guys and gals, enough fun. 19 00:00:55,388 --> 00:00:57,182 We have people to take care of. 20 00:00:57,265 --> 00:00:58,933 You want to bring Langdon back from triage 21 00:00:58,975 --> 00:01:00,310 for the extra hands? 22 00:01:00,393 --> 00:01:02,145 - No, I do not. I don't think that's necessary. 23 00:01:02,228 --> 00:01:03,938 We're doing just fine without him. 24 00:01:03,980 --> 00:01:05,065 - You're the boss, boss. 25 00:01:05,148 --> 00:01:07,150 [indistinct chatter] 26 00:01:07,233 --> 00:01:11,654 - Daniel Ortiz, tu licencia en el mostrador. 27 00:01:12,989 --> 00:01:15,033 - Next. [phone notifications pinging] 28 00:01:15,116 --> 00:01:17,327 - Hi. Uh, the doctor guy told me 29 00:01:17,410 --> 00:01:19,954 to put this mineral oil on my eye for 20 minutes. 30 00:01:19,996 --> 00:01:21,873 That was 2 hours ago. 31 00:01:21,956 --> 00:01:24,167 - We're really busy, but we'll get to you. 32 00:01:24,209 --> 00:01:26,377 - Oh, my God. Okay, when? - I will check. 33 00:01:26,461 --> 00:01:28,505 Listen for your name to be called. 34 00:01:28,588 --> 00:01:31,007 - Thanks. - Next. 35 00:01:31,091 --> 00:01:32,300 - Excuse me. 36 00:01:32,342 --> 00:01:34,260 Uh, hi. I heard my brother was brought here. 37 00:01:34,344 --> 00:01:36,763 His name is Jackson Davis. - Do you have ID? 38 00:01:36,846 --> 00:01:38,515 - Yes, yes, um, 39 00:01:38,556 --> 00:01:41,768 I am his sister Jada Davis. 40 00:01:43,770 --> 00:01:45,355 I'm sorry. I just, uh-- 41 00:01:45,396 --> 00:01:47,857 my friend told me that he was brought in by campus police. 42 00:01:47,941 --> 00:01:49,692 There was some sort of fight that broke out at his school. 43 00:01:49,776 --> 00:01:52,028 Is he okay? Is he here? - Don't know, hon. 44 00:01:52,070 --> 00:01:53,696 - Can you just tell me if he's a patient here? 45 00:01:53,738 --> 00:01:57,200 - I'll check. Take a seat. And I'll let you know. 46 00:01:57,283 --> 00:01:59,828 - Okay. - Next. 47 00:01:59,869 --> 00:02:02,789 - Is Harlow feeling lightheaded or faint now? 48 00:02:05,041 --> 00:02:07,127 - It's not as bad as it was before, 49 00:02:07,210 --> 00:02:09,379 but my head still hurts. 50 00:02:09,420 --> 00:02:11,631 And now my stomach does, too. 51 00:02:11,714 --> 00:02:14,968 - Well, did she eat before she took her ibuprofen? 52 00:02:16,136 --> 00:02:18,221 - Ugh, it's not my... 53 00:02:18,304 --> 00:02:21,015 - Breakfast is my least favorite meal of the day. 54 00:02:25,728 --> 00:02:28,398 - It's okay to look at me. 55 00:02:28,439 --> 00:02:29,732 - I don't bite. 56 00:02:29,774 --> 00:02:31,776 - [sighs] I'm sorry. 57 00:02:31,860 --> 00:02:35,572 Um, we're going to get started with some blood tests. 58 00:02:37,991 --> 00:02:40,410 - Is that baby from the bathroom going to be okay? 59 00:02:40,451 --> 00:02:41,411 - She'll be fine. 60 00:02:41,494 --> 00:02:43,079 Uh, good news-- 61 00:02:43,163 --> 00:02:46,708 nose swab came back negative for COVID, 62 00:02:46,749 --> 00:02:48,543 influenza, and RSV, 63 00:02:48,585 --> 00:02:50,920 but a lot of other viruses can cause a cough. 64 00:02:51,004 --> 00:02:52,297 - Lucky me. [device beeps] 65 00:02:52,380 --> 00:02:54,424 - You can take off your mask. 66 00:02:54,465 --> 00:02:57,302 - Pulse ox is at 91. 67 00:02:57,385 --> 00:02:59,137 - Your oxygen level is down 68 00:02:59,220 --> 00:03:00,972 since we checked you an hour ago, 69 00:03:01,055 --> 00:03:03,391 and your temp is up to 102.4. 70 00:03:03,433 --> 00:03:04,934 Let's get you some Tylenol. 71 00:03:05,018 --> 00:03:07,395 - Have you been outside today? It's already stifling. 72 00:03:07,437 --> 00:03:09,731 - Could be heat-related, but we're going to take you 73 00:03:09,772 --> 00:03:12,859 back to the big ER for a full evaluation. 74 00:03:12,942 --> 00:03:14,444 - Can't you just 75 00:03:14,527 --> 00:03:16,279 write me a prescription for some medicine? 76 00:03:16,362 --> 00:03:18,281 I'm sure it's just a summer cold. 77 00:03:18,323 --> 00:03:21,409 - Got somewhere to be? - Work. 78 00:03:23,494 --> 00:03:25,079 I know. It's Saturday. 79 00:03:25,121 --> 00:03:27,916 But I don't think I've had a day off since... 80 00:03:27,957 --> 00:03:31,127 - Well, your holiday weekend starts now. 81 00:03:31,211 --> 00:03:32,629 - Hey, Javadi. 82 00:03:32,670 --> 00:03:34,756 What are you doing for your birthday? 83 00:03:34,797 --> 00:03:37,425 - Who told you? - Word gets around. 84 00:03:37,467 --> 00:03:40,553 - Nothing. I hate celebrating my birthday. 85 00:03:40,637 --> 00:03:42,096 - You only turn 21 once. 86 00:03:42,138 --> 00:03:43,640 - It's your birthday? 87 00:03:43,723 --> 00:03:47,143 Oh, that makes you a Cancer, right? 88 00:03:47,227 --> 00:03:49,646 - I didn't peg you for an astrology girlie. 89 00:03:49,687 --> 00:03:51,272 - [chuckles] - Yeah. 90 00:03:51,314 --> 00:03:53,274 Been spending too much time around Santos. 91 00:03:53,316 --> 00:03:54,609 - Yes, you have. 92 00:03:54,651 --> 00:03:55,652 - I don't know how you guys do it. 93 00:03:55,693 --> 00:03:58,196 Live together and work together? 94 00:03:58,279 --> 00:04:00,031 - It's my cross to bear. 95 00:04:00,114 --> 00:04:02,700 - It can't be as bad as having to live with your parents. 96 00:04:02,784 --> 00:04:04,661 - I don't know. I haven't lived at home in years. 97 00:04:04,702 --> 00:04:06,663 I kind of miss it. - I can tell. 98 00:04:06,704 --> 00:04:08,790 You've been spending a lot of time on that farm. 99 00:04:08,831 --> 00:04:10,333 - "Farm"? 100 00:04:10,416 --> 00:04:12,335 - Remember the burned farmer who came in last year? 101 00:04:12,377 --> 00:04:14,504 Propane tank exploded, he died in the ICU? 102 00:04:14,545 --> 00:04:16,339 - Yeah, that was sad. 103 00:04:16,381 --> 00:04:18,091 - Well, this guy has been playing house 104 00:04:18,174 --> 00:04:20,426 with his widow and their baby. 105 00:04:20,510 --> 00:04:22,011 - Oh, that's messy. 106 00:04:22,095 --> 00:04:23,054 - No. 107 00:04:23,137 --> 00:04:25,306 It's not like that, okay? 108 00:04:25,348 --> 00:04:26,975 I've been helping Amy out on the farm 109 00:04:27,016 --> 00:04:29,519 after her husband died, and she is a friend. 110 00:04:29,560 --> 00:04:30,853 She's just a friend. 111 00:04:30,937 --> 00:04:33,690 - Sure, just a friend, with farm benefits. 112 00:04:33,731 --> 00:04:35,733 - What are farm benefits? 113 00:04:35,817 --> 00:04:37,652 - Oh, use your imagination. 114 00:04:37,694 --> 00:04:39,487 You ever see a milking machine? 115 00:04:39,529 --> 00:04:41,531 - Oh, can we not talk about this, please? 116 00:04:41,614 --> 00:04:43,032 - We're getting two runs rerouted 117 00:04:43,116 --> 00:04:45,368 from Westbridge already-- chest pain and belly pain. 118 00:04:45,451 --> 00:04:47,787 Robby wants you three out back. - Thank you. 119 00:04:47,870 --> 00:04:49,205 - Come on. 120 00:04:49,289 --> 00:04:52,333 - Dr. Santos, making progress on your charting, I hope? 121 00:04:52,375 --> 00:04:53,835 - Getting there. 122 00:04:53,876 --> 00:04:55,670 - Deficient charts leave a gap for the providers 123 00:04:55,712 --> 00:04:58,923 who give continuity of care and delays hospital billing. 124 00:04:59,007 --> 00:05:01,384 - Oh, I'd hate to delay billing. 125 00:05:03,303 --> 00:05:05,847 - Timely documentation is essential. 126 00:05:05,888 --> 00:05:08,516 Let's fix this before end of shift. 127 00:05:08,558 --> 00:05:11,561 - I'm on it, boss. - Good. 128 00:05:11,644 --> 00:05:14,022 You wouldn't want to repeat your R2 year again 129 00:05:14,063 --> 00:05:15,940 because of this. 130 00:05:18,818 --> 00:05:20,820 - [softly] Fuck. 131 00:05:20,903 --> 00:05:24,407 - God, it's humid as shit out here. 132 00:05:24,490 --> 00:05:25,908 It is. 133 00:05:25,950 --> 00:05:27,577 - What's going on at Westbridge? 134 00:05:27,618 --> 00:05:29,579 - They're closed, so we're covering their paramedic runs 135 00:05:29,662 --> 00:05:31,039 until they come back up. 136 00:05:31,080 --> 00:05:33,416 - As if a holiday weekend wasn't enough. 137 00:05:33,499 --> 00:05:36,419 - So, Dr. Al-Hashimi... 138 00:05:36,502 --> 00:05:37,420 - Yes? 139 00:05:37,503 --> 00:05:39,756 - Do we like her? 140 00:05:39,839 --> 00:05:41,924 - [laughs] - She seems pretty cool so far. 141 00:05:42,008 --> 00:05:44,927 - You're trying to gossip about an attending with an attending? 142 00:05:45,011 --> 00:05:48,014 - Dr. Robby doesn't mind. Do you? 143 00:05:50,183 --> 00:05:52,518 - Oh, uh, that's a nice bike, by the way. 144 00:05:52,602 --> 00:05:54,645 - Thank you. - Yeah. 145 00:05:56,856 --> 00:05:58,983 - Pamela Perry, 48, abdominal pain 146 00:05:59,067 --> 00:06:02,070 with vomiting after eating chilaquiles with fried eggs. 147 00:06:02,111 --> 00:06:05,281 BP 108 over 64, pulse 98, good sats. 148 00:06:05,365 --> 00:06:08,326 - Okay, let's see how she feels with some Zofran 149 00:06:08,409 --> 00:06:09,952 and a liter wide open. - Got it. 150 00:06:10,036 --> 00:06:12,246 - Yo, Whitaker. - How are you feeling? OK? 151 00:06:12,288 --> 00:06:13,831 - Not so good. 152 00:06:18,002 --> 00:06:19,754 - Who do we have here? - Jean Samba-- 153 00:06:19,796 --> 00:06:21,964 54, half an hour of left-sided chest pain. 154 00:06:22,006 --> 00:06:25,218 History of hypertension, on lisinopril and Crestor. 155 00:06:25,301 --> 00:06:26,969 Some relief with two nitro. 156 00:06:27,011 --> 00:06:29,347 Decent vitals, no STEMI on 12-lead. 157 00:06:29,430 --> 00:06:31,182 Gave him 324 of chewable aspirin. 158 00:06:31,265 --> 00:06:33,309 - Okay, we're going to give you a full evaluation, sir. 159 00:06:33,393 --> 00:06:36,479 - Oh, if I am to die, God willing, 160 00:06:36,562 --> 00:06:38,815 I will see His pearly gates. 161 00:06:38,898 --> 00:06:40,191 - What's the plan? 162 00:06:40,274 --> 00:06:41,651 - Repeat 12-lead, check a troponin, 163 00:06:41,734 --> 00:06:42,985 admit for new onset angina. 164 00:06:43,069 --> 00:06:44,654 - Evaluate for PE, aortic dissection. 165 00:06:44,737 --> 00:06:46,614 - That goes without saying. - Sounds good. 166 00:06:46,656 --> 00:06:48,282 I'm a minute behind you. 167 00:06:48,324 --> 00:06:51,494 [sirens wailing] 168 00:06:51,536 --> 00:06:53,663 [siren chirps] 169 00:07:02,505 --> 00:07:04,132 And who do we have here? 170 00:07:04,173 --> 00:07:06,968 - Vince Cole, 23, fell through the skylight of a florist shop, 171 00:07:07,009 --> 00:07:08,636 10 feet down to a bunch of ferns. 172 00:07:08,678 --> 00:07:10,555 Complained of headache, asking repetitive questions, 173 00:07:10,638 --> 00:07:12,223 and only responds to pain. 174 00:07:12,306 --> 00:07:13,766 - Multiple lacs from the glass. 175 00:07:13,850 --> 00:07:17,937 BP, 118 over 72, pulse 98, sats, 99 on 5 liters. 176 00:07:18,020 --> 00:07:19,355 No meds, no allergies. 177 00:07:19,439 --> 00:07:21,315 - Hey, Vince, how'd you fall through a skylight? 178 00:07:21,357 --> 00:07:22,608 Vince? 179 00:07:22,692 --> 00:07:24,193 Were you with him? 180 00:07:24,235 --> 00:07:26,195 - Yeah, we were parkouring, and he overshot a kong vault. 181 00:07:26,279 --> 00:07:27,488 - What, like, jumping off of buildings? 182 00:07:27,530 --> 00:07:28,739 People still do that? 183 00:07:28,823 --> 00:07:29,824 - It was almost an Olympic sport. 184 00:07:29,866 --> 00:07:32,368 - Now we know why it isn't. 185 00:07:34,912 --> 00:07:36,247 Pupils are equal and reactive. 186 00:07:36,330 --> 00:07:38,082 - What do you got? - A 10-foot fall, altered. 187 00:07:38,166 --> 00:07:40,168 - That's a long way down. - 10 feet is the threshold 188 00:07:40,209 --> 00:07:42,378 for trauma center activation-- 10 feet, 10% mortality. 189 00:07:42,420 --> 00:07:45,047 - 0%, anything over 0% is a concern. 190 00:07:45,089 --> 00:07:47,884 - Somebody's annoying, and it's not me. 191 00:07:47,925 --> 00:07:50,720 - Hey, you said two. You missed one. 192 00:07:50,761 --> 00:07:52,138 - Sent you backup, didn't I? 193 00:07:52,221 --> 00:07:54,474 - One, two, three. 194 00:07:54,557 --> 00:07:57,560 - Okay. Thanks, guys. Good to see you. 195 00:07:57,602 --> 00:07:58,686 - Get the EFAST. 196 00:07:58,728 --> 00:08:01,063 - Ogilvie, Joy, GCS, please. 197 00:08:01,105 --> 00:08:03,232 - Uh, open your eyes, sir. 198 00:08:03,274 --> 00:08:05,276 - [groans] - Two for eyes, two for verbal. 199 00:08:05,359 --> 00:08:07,195 - Uh, good lung sliding bilaterally. 200 00:08:07,236 --> 00:08:09,906 - Joy, finish GCS. 201 00:08:09,989 --> 00:08:12,700 - Squeeze my hand. 202 00:08:12,742 --> 00:08:14,535 He gets a 4 for motor. 203 00:08:14,577 --> 00:08:18,915 - Pulse ox 99, heart rate 102, blood pressure 114 over 78. 204 00:08:18,998 --> 00:08:21,584 - And EFAST is negative. - Music to my ears. 205 00:08:21,667 --> 00:08:23,419 - Somebody shooting a documentary here? 206 00:08:23,461 --> 00:08:25,213 - Whoa, whoa, whoa, you can't film in here. 207 00:08:25,254 --> 00:08:27,006 We've got patient-privacy laws. 208 00:08:27,089 --> 00:08:28,758 What happened to your hand? - Cut it. 209 00:08:28,799 --> 00:08:31,928 - Can somebody show Spielberg here out to the waiting room 210 00:08:32,011 --> 00:08:33,596 and get her registered at triage, please? 211 00:08:33,638 --> 00:08:35,598 - He's my creative partner-- I have his written consent 212 00:08:35,681 --> 00:08:37,433 to film everything for our TikTok page. 213 00:08:37,475 --> 00:08:38,976 - Put the camera down. 214 00:08:39,060 --> 00:08:40,728 - We have to drop this video for the Fourth tonight. 215 00:08:40,770 --> 00:08:42,271 - That literally means nothing to me. 216 00:08:42,355 --> 00:08:43,981 - Seriously, Sean, can you escort her out, please? 217 00:08:44,065 --> 00:08:45,900 Somebody will come and find you once he's stabilized. 218 00:08:45,942 --> 00:08:47,276 Thank you. 219 00:08:47,360 --> 00:08:49,153 - I would have let her stay if she'd asked nicely. 220 00:08:49,237 --> 00:08:50,905 - What is the, uh, story with surgery? 221 00:08:50,947 --> 00:08:52,615 You guys getting any Westbridge transfers yet? 222 00:08:52,698 --> 00:08:54,283 - Not yet, but I'm sure it's coming. 223 00:08:54,325 --> 00:08:56,786 Pan scan, head through pelvis. Let's get him to CT ASAP. 224 00:08:56,869 --> 00:08:58,454 - Absent gag. 225 00:08:58,496 --> 00:09:01,791 We need to intubate before CT. 226 00:09:01,832 --> 00:09:03,251 - C-can I do it? 227 00:09:03,292 --> 00:09:04,627 Uh, I'm keeping a procedure log, 228 00:09:04,710 --> 00:09:06,462 and I need more intubations on this rotation. 229 00:09:06,546 --> 00:09:08,798 - If Dr. McKay wants to teach? 230 00:09:08,881 --> 00:09:10,591 - Sure. 231 00:09:10,633 --> 00:09:12,260 - Okay, uh, I need suction. 232 00:09:12,301 --> 00:09:15,137 8-oh tube, etomidate and sux, end tidal CO2. 233 00:09:15,221 --> 00:09:16,597 - Ambitious. 234 00:09:16,639 --> 00:09:19,100 He reminds me of someone I know very well. 235 00:09:19,141 --> 00:09:21,602 [mouse clicking] 236 00:09:21,644 --> 00:09:23,479 - Can you not? 237 00:09:23,563 --> 00:09:24,814 - Yeah, sorry. 238 00:09:24,897 --> 00:09:26,816 - Hot off the press. 239 00:09:26,899 --> 00:09:28,234 - Okay. 240 00:09:28,317 --> 00:09:31,988 No STEMI, doesn't need to go right to the cath lab. 241 00:09:33,948 --> 00:09:35,157 And orders are in. 242 00:09:35,241 --> 00:09:36,492 Whitaker, try another nitro 243 00:09:36,534 --> 00:09:38,119 and let me know when the troponin's back. 244 00:09:38,160 --> 00:09:40,538 - Yeah. Hey, hey, Jesse? 245 00:09:40,621 --> 00:09:42,331 Do you think you could repeat this 246 00:09:42,373 --> 00:09:45,334 but with the chest leads on his back? 247 00:09:45,376 --> 00:09:46,794 - Why? 248 00:09:46,836 --> 00:09:49,630 - T Waves are kind of high with ST depression anterior. 249 00:09:49,672 --> 00:09:51,340 - We see ST depression all the time. 250 00:09:51,382 --> 00:09:53,884 - Yeah, but it could be a posterior MI. 251 00:09:53,968 --> 00:09:55,469 - All right, run it by the attending. 252 00:09:55,511 --> 00:09:57,054 If they agree, we'll do it. 253 00:09:57,138 --> 00:09:58,681 - Thank you. 254 00:09:58,764 --> 00:10:02,310 Uh, Victoria, if his CT's normal, he'll need an LP. 255 00:10:02,351 --> 00:10:04,353 - Got it. 256 00:10:04,437 --> 00:10:05,521 - Dr. Al-Hashimi. 257 00:10:05,605 --> 00:10:08,149 This is Jada Davis, Jackson's sister. 258 00:10:08,190 --> 00:10:10,484 - Oh, thank you. Hi. - Is he okay? 259 00:10:10,526 --> 00:10:11,944 And why is he asleep? 260 00:10:12,028 --> 00:10:14,280 - Well, he was uncooperative when he first arrived 261 00:10:14,363 --> 00:10:17,283 and needed to be sedated. - "Uncooperative"? 262 00:10:17,366 --> 00:10:20,453 That doesn't make any sense. What happened? 263 00:10:20,536 --> 00:10:22,622 - We're still trying to piece the story together. 264 00:10:22,705 --> 00:10:24,707 He was brought in by a campus security guard 265 00:10:24,790 --> 00:10:26,542 who Tased him after he was allegedly... 266 00:10:26,626 --> 00:10:28,169 - "Tased him"? - Combative and violent. 267 00:10:28,210 --> 00:10:29,712 - Wait, what do you mean, Tased him? 268 00:10:29,754 --> 00:10:31,464 - We've treated his injury, and now we're trying 269 00:10:31,547 --> 00:10:34,300 to understand why he was so agitated. 270 00:10:34,383 --> 00:10:36,218 - Okay, this doesn't sound like my brother. 271 00:10:36,260 --> 00:10:37,887 - Well, his drug screen came back negative, 272 00:10:37,970 --> 00:10:40,056 so now we're taking Jackson to get a CT scan of his brain 273 00:10:40,139 --> 00:10:42,516 to look for any abnormalities. - Can I go with him? 274 00:10:42,558 --> 00:10:44,060 - You can't go into the CT, 275 00:10:44,143 --> 00:10:46,604 but you can wait for him to come back. 276 00:10:46,687 --> 00:10:49,899 And then we can discuss next steps. 277 00:10:49,982 --> 00:10:52,068 - Okay. 278 00:10:52,151 --> 00:10:53,861 - Just did my first ER intubation. 279 00:10:53,903 --> 00:10:55,571 - That's great, man. - Such a prick. 280 00:10:55,655 --> 00:10:57,198 - You got a second? - What's up? 281 00:10:57,239 --> 00:10:59,700 - 12-lead on my chest-pain patient shows no STEMI, 282 00:10:59,742 --> 00:11:03,746 but the anterior leads might be suspicious for a posterior MI? 283 00:11:03,788 --> 00:11:05,748 - Uh... agreed. 284 00:11:05,790 --> 00:11:07,667 - Yeah, I was going to repeat, but with the chest leads 285 00:11:07,750 --> 00:11:09,251 on the back. - V7 through V9. 286 00:11:09,335 --> 00:11:11,128 Good idea. - Thank you. 287 00:11:13,923 --> 00:11:16,217 - Hey, Dr. Robby gave the go-ahead for the back leads. 288 00:11:16,258 --> 00:11:18,010 - Sorry, man, I got a call report 289 00:11:18,094 --> 00:11:20,596 on a septic patient going to the ICU. 290 00:11:20,638 --> 00:11:22,181 - Busy today, huh? 291 00:11:22,264 --> 00:11:24,433 - Uh, well, it's 10:15. 292 00:11:24,517 --> 00:11:26,519 We're actually just getting started. 293 00:11:26,602 --> 00:11:28,062 - Oh. - There she is. 294 00:11:28,104 --> 00:11:32,358 Dr. Mohan, uh, this is Lorrie Diaz, Orlando's wife. 295 00:11:32,441 --> 00:11:33,859 - Thank you, Perlah. - Thank you. 296 00:11:33,943 --> 00:11:35,027 - Hi, Mrs. Diaz. - Hi. 297 00:11:35,111 --> 00:11:36,779 - Let me take you to your husband. 298 00:11:36,862 --> 00:11:38,447 - Ay, mi amor. 299 00:11:38,489 --> 00:11:40,783 I'm sorry you have to be here alone. 300 00:11:40,825 --> 00:11:43,953 I missed my first bus transfer and-- 301 00:11:44,036 --> 00:11:46,080 Anyway... 302 00:11:46,122 --> 00:11:47,081 Hey. 303 00:11:47,123 --> 00:11:49,291 - How'd I get here? 304 00:11:49,333 --> 00:11:50,960 - You fell at your construction site. 305 00:11:51,001 --> 00:11:52,628 A coworker brought you in. 306 00:11:52,712 --> 00:11:54,839 - He's a lot better but doesn't remember anything. 307 00:11:54,922 --> 00:11:58,259 - That's common after a concussion or DKA. 308 00:11:58,300 --> 00:11:59,844 - DKA? 309 00:11:59,927 --> 00:12:03,139 - It's a serious complication of your husband's diabetes. 310 00:12:03,222 --> 00:12:05,141 - How serious? Can he go home? 311 00:12:05,182 --> 00:12:07,601 - We still have to clear the ketones from his bloodstream. 312 00:12:07,643 --> 00:12:10,479 He'll need to be on an insulin drip for a while 313 00:12:10,563 --> 00:12:12,898 until things get back to normal. 314 00:12:12,982 --> 00:12:16,235 Best if he stays in the hospital. 315 00:12:16,318 --> 00:12:17,778 - It's okay, Mom. 316 00:12:17,820 --> 00:12:19,989 - Things are headed in the right direction, Mrs. Diaz. 317 00:12:20,072 --> 00:12:22,408 He's going to be better. - Mm. 318 00:12:22,491 --> 00:12:24,744 [door clicks] 319 00:12:24,827 --> 00:12:27,246 - Sorry. I got to check his blood sugar. 320 00:12:27,329 --> 00:12:29,999 - Oh, do you mind? - Absolutely. 321 00:12:31,083 --> 00:12:34,170 - So the thing is... 322 00:12:34,211 --> 00:12:36,756 we don't have health insurance. 323 00:12:36,839 --> 00:12:38,174 So... 324 00:12:38,215 --> 00:12:41,510 [voice breaking] I don't think that we can afford this. 325 00:12:41,594 --> 00:12:45,181 - I'll have our case manager, Noelle Hastings, come by. 326 00:12:45,264 --> 00:12:47,475 She's an expert in health insurance. 327 00:12:47,516 --> 00:12:50,186 She might have some options for you for coverage. 328 00:12:50,227 --> 00:12:51,854 Okay. - Thank you. 329 00:12:51,896 --> 00:12:53,647 [door clicks] 330 00:12:55,608 --> 00:12:56,692 - [sighs] 331 00:12:56,734 --> 00:12:58,861 Crap. - What's wrong? 332 00:12:58,944 --> 00:13:01,739 - Uh, some of the leads aren't sticking here. 333 00:13:01,822 --> 00:13:03,866 - Can I lay down now? I'm tired. 334 00:13:03,949 --> 00:13:05,576 - Yeah, as soon as we're done here. 335 00:13:05,659 --> 00:13:08,370 - Whitaker, Louie's all numb. His tooth is ready for you. 336 00:13:08,412 --> 00:13:09,747 - That's great. 337 00:13:09,830 --> 00:13:12,875 Hey, I'm having some trouble here with adherence. 338 00:13:12,917 --> 00:13:14,835 - Oh. Of course you are. 339 00:13:14,877 --> 00:13:16,629 Uh, try this. 340 00:13:16,712 --> 00:13:18,380 - Oh, yeah. That makes sense. 341 00:13:18,422 --> 00:13:21,550 Uh, you think you could-- 342 00:13:21,634 --> 00:13:22,885 [sighs] 343 00:13:22,927 --> 00:13:25,054 Do you mind if I paint some sticky stuff on you? 344 00:13:25,095 --> 00:13:26,347 - Oh. 345 00:13:26,388 --> 00:13:30,017 If you must prolong the inevitable, so be it. 346 00:13:30,059 --> 00:13:32,645 - You'll get to lie down afterwards. 347 00:13:32,728 --> 00:13:34,480 - No success with the mineral oil. 348 00:13:34,563 --> 00:13:36,649 - That's what I said. 349 00:13:36,732 --> 00:13:38,400 So now what? 350 00:13:38,484 --> 00:13:39,819 - You can wait one to two weeks 351 00:13:39,902 --> 00:13:42,071 for the superglue to break down on its own. 352 00:13:42,154 --> 00:13:44,198 - I'm hosting a Fourth of July party tonight. 353 00:13:44,240 --> 00:13:46,408 You want me to show up like this? 354 00:13:46,450 --> 00:13:50,412 - The other option is I trim your eyelashes halfway down. 355 00:13:50,496 --> 00:13:53,249 That'll lower the strength of the glue holding them together. 356 00:13:53,332 --> 00:13:55,626 - Let's do that. 357 00:13:55,709 --> 00:13:57,920 - Lie back, please. 358 00:14:01,590 --> 00:14:04,051 I need you to hold your head perfectly still, 359 00:14:04,093 --> 00:14:05,594 keep your eye closed. 360 00:14:05,636 --> 00:14:08,264 - My eye can't open. That's why I'm here. 361 00:14:08,305 --> 00:14:10,933 - No, I mean, your other eye, too. 362 00:14:15,688 --> 00:14:17,398 Okay, here we go. 363 00:14:17,439 --> 00:14:19,441 - Perfect, Mr. Samba. 364 00:14:19,525 --> 00:14:21,777 All good here. 365 00:14:21,819 --> 00:14:24,446 [medical machine beeping] - Feeling... dizzy. 366 00:14:24,488 --> 00:14:28,284 - We'll put you down in a second. 367 00:14:28,325 --> 00:14:29,785 Holy shit. 368 00:14:29,869 --> 00:14:33,539 ST elevation, V7, V8, V9. 369 00:14:33,622 --> 00:14:36,208 It's a posterior STEMI. - What's that? 370 00:14:36,292 --> 00:14:38,210 - It's the worst kind of heart attack. 371 00:14:38,294 --> 00:14:40,921 [alarm blaring] Mr. Samba. 372 00:14:40,963 --> 00:14:42,298 Mr. Samba! 373 00:14:42,381 --> 00:14:44,800 Hey, I could use a second set of hands here! 374 00:14:44,884 --> 00:14:46,427 Pulseless V tach. 375 00:14:46,468 --> 00:14:48,637 Start compressions. 376 00:14:48,721 --> 00:14:50,472 Charging to 200. 377 00:14:50,514 --> 00:14:53,017 [machine whirs, beeping continues] 378 00:14:53,100 --> 00:14:55,519 Clear. 379 00:14:55,603 --> 00:14:57,938 Okay, resume compressions. 380 00:14:57,980 --> 00:14:59,523 Code STEMI. It was posterior. 381 00:14:59,607 --> 00:15:01,025 - Yeah, good call. 382 00:15:01,108 --> 00:15:03,694 - You put the defib pads on? - Yeah, just in case. 383 00:15:03,777 --> 00:15:05,613 Hold compressions. 384 00:15:05,654 --> 00:15:08,490 [steady beeping] 385 00:15:08,532 --> 00:15:10,993 Normal sinus. - All right. 386 00:15:11,035 --> 00:15:12,703 - Got a strong pulse. Check the BP. 387 00:15:12,786 --> 00:15:15,039 - All right, we'll prep him for cath lab. 388 00:15:15,122 --> 00:15:16,332 - [mumbles] 389 00:15:16,415 --> 00:15:19,501 - Hey, Mr. Samba, you're going to be okay. 390 00:15:19,585 --> 00:15:20,920 No pearly gates today. 391 00:15:21,003 --> 00:15:24,590 - Really good pickup, Whitaker. - Thank you. 392 00:15:24,673 --> 00:15:26,675 Ah... [chuckles] 393 00:15:26,717 --> 00:15:28,844 - Has a patient ever flirted with you? 394 00:15:28,886 --> 00:15:30,512 - Sure. Why? 395 00:15:30,554 --> 00:15:32,765 - There was this guy this morning-- 396 00:15:32,848 --> 00:15:34,475 he turned out to be a criminal, 397 00:15:34,516 --> 00:15:36,268 but, yeah, it was a nice distraction 398 00:15:36,352 --> 00:15:37,478 from the deposition. 399 00:15:37,519 --> 00:15:38,812 - [sighs] You still worried about that? 400 00:15:38,854 --> 00:15:40,272 - Yep. Yeah, counting down the hours. 401 00:15:40,356 --> 00:15:42,524 There are five left, if you're wondering. 402 00:15:42,608 --> 00:15:45,611 - [coughing] 403 00:15:45,694 --> 00:15:47,071 - Hi, Miss Ronson. 404 00:15:47,154 --> 00:15:48,364 - Phylicia, please. 405 00:15:48,405 --> 00:15:49,907 - Phylicia, I'm Dr. King. 406 00:15:49,990 --> 00:15:51,533 This is my colleague Dr. Santos. 407 00:15:51,575 --> 00:15:53,035 What brings you in today? 408 00:15:53,077 --> 00:15:55,412 - I've had this pretty bad cough for a few days now. 409 00:15:55,496 --> 00:15:56,705 - Do you smoke? 410 00:15:56,747 --> 00:15:58,374 Are coughing up anything, any chest pain? 411 00:15:58,415 --> 00:16:00,167 - No, no, and no. 412 00:16:00,209 --> 00:16:02,378 I honestly think I picked it up at work. 413 00:16:02,419 --> 00:16:04,171 It was going around. - Oh, where do you work? 414 00:16:04,213 --> 00:16:06,882 - I'm in corporate at PNC Bank. - Sit forward, please. 415 00:16:06,966 --> 00:16:08,592 - It could be an office bug. 416 00:16:08,676 --> 00:16:12,054 - Or I got it from the gym. I'm there all the time. 417 00:16:13,889 --> 00:16:16,225 [coughs] 418 00:16:16,266 --> 00:16:18,852 - Do you have anything to ask, Dr. Santos? 419 00:16:18,894 --> 00:16:20,312 - What? 420 00:16:20,396 --> 00:16:22,231 - Do you have any questions to ask our patient? 421 00:16:22,314 --> 00:16:24,191 - Uh, no, I'm good. 422 00:16:24,233 --> 00:16:25,734 - Okay. What'd you hear? 423 00:16:25,818 --> 00:16:28,070 - Maybe some crackles at the right base. 424 00:16:28,112 --> 00:16:31,657 - Okay, well, we're going to need a chest X-ray 425 00:16:31,740 --> 00:16:32,908 to check your lungs. 426 00:16:32,992 --> 00:16:34,368 - Will that take long? 427 00:16:34,410 --> 00:16:36,078 Maybe I can still make it to the office. 428 00:16:36,120 --> 00:16:38,747 - It shouldn't. 429 00:16:38,831 --> 00:16:42,292 You can go put the orders in. - Yeah. 430 00:16:44,753 --> 00:16:47,506 - How are we doing in here? - Oh, this is thrilling. 431 00:16:47,589 --> 00:16:50,259 Definitely worth $200,000 worth of student debt. 432 00:16:50,342 --> 00:16:51,635 Ha. 433 00:16:51,719 --> 00:16:53,303 - Superficial ones get a steri-strip. 434 00:16:53,387 --> 00:16:55,305 Full thickness, try Dermabond. 435 00:16:55,389 --> 00:16:57,474 How can you tell they need a suture, Joy? 436 00:16:57,558 --> 00:16:59,643 - If the edges are under significant tension. 437 00:16:59,727 --> 00:17:01,562 - I didn't realize your name was Joy. 438 00:17:01,603 --> 00:17:04,106 I'm going to have to tell my parents how trendy they were. 439 00:17:04,189 --> 00:17:05,774 [object clanks] 440 00:17:05,858 --> 00:17:08,277 - CT head, neck, chest, abdomen, and pelvis, 441 00:17:08,360 --> 00:17:10,404 all normal on preliminary read. - Lucky guy. 442 00:17:10,446 --> 00:17:11,822 - Little bit of oozing. 443 00:17:11,905 --> 00:17:13,490 - Uh, pressure for two minutes. 444 00:17:13,574 --> 00:17:16,118 Lidocaine and epi if that doesn't work. 445 00:17:16,201 --> 00:17:18,287 - Are the admit orders in for Surgical ICU? 446 00:17:18,328 --> 00:17:19,955 - Fuck! 447 00:17:19,997 --> 00:17:21,206 - What? 448 00:17:21,290 --> 00:17:23,709 - This. - Ah. 449 00:17:23,792 --> 00:17:26,712 - Irrigation saline. - It's just a small cut. 450 00:17:26,795 --> 00:17:28,797 - It is a work-related blood exposure, 451 00:17:28,839 --> 00:17:30,632 which means you're a patient now. 452 00:17:30,674 --> 00:17:31,800 - Are you serious? - Needle stick? 453 00:17:31,884 --> 00:17:33,427 - Piece of glass. 454 00:17:33,469 --> 00:17:35,596 - Here you go. - Thanks. 455 00:17:35,637 --> 00:17:36,722 [device beeps] 456 00:17:36,805 --> 00:17:38,390 - No past records on this guy. 457 00:17:38,474 --> 00:17:40,434 We don't know HIV or hepatitis status. 458 00:17:40,476 --> 00:17:44,146 - I'll put the orders in, HIV antibody, Hep B surface, 459 00:17:44,188 --> 00:17:45,481 and Hep C. 460 00:17:45,564 --> 00:17:47,483 - She needs post-exposure medication. 461 00:17:47,566 --> 00:17:48,817 - Maybe not. 462 00:17:48,901 --> 00:17:51,236 For occupational exposure, the rapid HIV test 463 00:17:51,320 --> 00:17:54,198 takes an hour or two. - Subcutaneous puncture wound. 464 00:17:54,281 --> 00:17:56,825 No risk of joint or tendon involvement. 465 00:17:56,909 --> 00:17:59,369 Elevate, pressure, and then a Band-Aid. 466 00:17:59,453 --> 00:18:01,455 - Give yourself a dose of PEP if you want 467 00:18:01,497 --> 00:18:02,873 while you're waiting for results. 468 00:18:02,956 --> 00:18:04,541 - Start a chart, and I'll find another nurse 469 00:18:04,625 --> 00:18:05,834 for your blood draw. 470 00:18:05,876 --> 00:18:07,628 - Great. 471 00:18:07,669 --> 00:18:10,005 - Looks like we've got a couple more diverted from Westbridge. 472 00:18:10,047 --> 00:18:12,007 - Any estimate on their downtime? 473 00:18:12,049 --> 00:18:14,635 - Not yet. 474 00:18:14,676 --> 00:18:16,512 Time to pull Dr. Langdon from triage? 475 00:18:16,553 --> 00:18:18,180 - No, no. First day back. 476 00:18:18,263 --> 00:18:20,808 I want to let him kind of ease into things. 477 00:18:20,849 --> 00:18:23,018 - Understood. I'll keep an eye on it. 478 00:18:23,102 --> 00:18:25,104 - Thank you very much. 479 00:18:25,187 --> 00:18:26,688 - Thinking about changing your bet? 480 00:18:26,772 --> 00:18:29,191 - I am just weighing my odds. 481 00:18:29,233 --> 00:18:33,112 - Don't worry. I'll buy you a drink with my winnings. 482 00:18:33,195 --> 00:18:36,406 [indistinct PA announcements] 483 00:18:38,617 --> 00:18:40,285 - Your brother should be back shortly. 484 00:18:40,369 --> 00:18:43,163 There was a little holdup at CT. 485 00:18:43,205 --> 00:18:45,499 - Um, should I be worried? 486 00:18:45,541 --> 00:18:48,669 - Let's wait and see what his test results say. 487 00:18:48,710 --> 00:18:51,296 - This is just, um... 488 00:18:51,380 --> 00:18:53,715 this just doesn't make any sense. 489 00:18:53,799 --> 00:18:55,884 It doesn't sound like my brother at all. 490 00:18:55,926 --> 00:18:58,679 He's the--the friendliest guy I know. 491 00:18:58,720 --> 00:19:00,931 He never even gets angry, barely yells. 492 00:19:01,014 --> 00:19:03,559 - He's never had an episode like this in the past? 493 00:19:03,642 --> 00:19:07,020 - No, or not that I know of. 494 00:19:07,062 --> 00:19:09,189 He's in a great relationship. 495 00:19:09,231 --> 00:19:10,899 And he's in law school 496 00:19:10,983 --> 00:19:13,610 'cause he wants to help people. 497 00:19:13,694 --> 00:19:16,572 He always tells me that I should, um... 498 00:19:16,655 --> 00:19:18,907 follow my dreams, 499 00:19:18,949 --> 00:19:22,244 even if it means my parents may disown me. 500 00:19:24,037 --> 00:19:25,539 Should I call them? 501 00:19:25,581 --> 00:19:28,500 - I think that's a good idea. 502 00:19:28,584 --> 00:19:31,086 This--this could be pretty serious. 503 00:19:35,674 --> 00:19:37,843 Thanks. - Mm-hmm. 504 00:19:43,765 --> 00:19:46,268 - The new radiologist is a hottie. 505 00:19:46,351 --> 00:19:47,895 - Okay. 506 00:19:47,936 --> 00:19:49,271 Um... 507 00:19:49,354 --> 00:19:52,441 his head CT is normal, as are his blood and urine tests. 508 00:19:52,524 --> 00:19:54,401 - Then--then what's wrong with him? 509 00:19:54,443 --> 00:19:56,445 - We're not, um, sure yet. 510 00:19:56,486 --> 00:19:59,114 There is another test-- a-a spinal tap. 511 00:19:59,198 --> 00:20:00,824 This could be, um, an infection 512 00:20:00,908 --> 00:20:03,410 in the fluid that surrounds the brain--viral encephalitis. 513 00:20:03,452 --> 00:20:05,746 Um, it can also cause... 514 00:20:05,787 --> 00:20:08,832 altered mental status and confusion. 515 00:20:08,916 --> 00:20:11,293 Can you treat it, if it is? 516 00:20:11,376 --> 00:20:12,753 - Yes. 517 00:20:14,338 --> 00:20:15,339 - Okay. 518 00:20:15,422 --> 00:20:17,132 Okay. 519 00:20:17,174 --> 00:20:19,468 - I'll go find Dr. Al-Hashimi, and--and we'll do it together. 520 00:20:19,509 --> 00:20:21,678 - Thank you. - Of course. 521 00:20:25,557 --> 00:20:28,894 - Just what we thought-- it's a fracture of your coccyx. 522 00:20:28,977 --> 00:20:30,395 It's your tailbone. 523 00:20:30,479 --> 00:20:32,773 Yeah, see, these pieces here 524 00:20:32,814 --> 00:20:35,901 should be lined up with that part here. 525 00:20:35,984 --> 00:20:37,945 - Do I need surgery? - No. 526 00:20:37,986 --> 00:20:41,698 No, no, these heal pretty well, but it'll take about six weeks. 527 00:20:43,158 --> 00:20:45,327 - "Six weeks"? 528 00:20:45,369 --> 00:20:47,788 I have dinner dates every weekend. 529 00:20:47,829 --> 00:20:50,082 - [chuckles] You can keep your-- 530 00:20:50,165 --> 00:20:52,167 still keep your dinner plans. 531 00:20:52,209 --> 00:20:56,255 - Dinner starts at Pino's, the best Italian in town. 532 00:20:56,338 --> 00:20:57,589 - Mm-hmm. 533 00:20:57,673 --> 00:20:59,841 - A nightcap at my place usually follows, 534 00:20:59,925 --> 00:21:02,302 and then breakfast in bed. 535 00:21:02,344 --> 00:21:04,513 - Ah, okay. 536 00:21:04,596 --> 00:21:06,014 Well, in that case, you might-- 537 00:21:06,056 --> 00:21:08,684 you might need to take a little break. 538 00:21:08,767 --> 00:21:12,354 - [sighs] My greatest joy in life is my social calendar. 539 00:21:12,396 --> 00:21:14,564 - Mm. - Hmm? 540 00:21:19,278 --> 00:21:22,030 Is there something else you can do? 541 00:21:22,072 --> 00:21:25,367 - W-well, there-- there is a procedure 542 00:21:25,450 --> 00:21:27,661 to push the fragments back in place. 543 00:21:27,703 --> 00:21:30,622 It could help it heal faster. - Now we're talking. 544 00:21:30,706 --> 00:21:33,125 - Yeah, but it'll hurt pretty bad but only for a second. 545 00:21:33,208 --> 00:21:35,002 - I can take it. 546 00:21:36,628 --> 00:21:38,046 - Okay. 547 00:21:38,130 --> 00:21:40,590 Come here. Back in the gown. 548 00:21:50,559 --> 00:21:52,477 How's it going over here? 549 00:21:52,561 --> 00:21:54,855 - Better now. 550 00:21:56,898 --> 00:21:58,984 - Uh... 551 00:22:00,110 --> 00:22:04,197 Oh, the X-ray is back on your foot, 552 00:22:04,239 --> 00:22:06,742 and no fracture. 553 00:22:06,783 --> 00:22:10,245 So, um, ACE wrap, ice, rest, and elevate, 554 00:22:10,329 --> 00:22:12,998 and you can take ibuprofen if you need it. 555 00:22:14,333 --> 00:22:15,709 - So that's it? 556 00:22:15,751 --> 00:22:17,711 - Well, if it's--if it's too painful to bear weight, 557 00:22:17,753 --> 00:22:20,964 we can give you crutches to use for a day or two. 558 00:22:21,048 --> 00:22:23,258 - So I won't be seeing you again. 559 00:22:23,342 --> 00:22:26,261 - [chuckles] Uh... 560 00:22:26,303 --> 00:22:28,722 as a patient, no, but... 561 00:22:28,764 --> 00:22:31,266 it was nice meeting you, Brian. 562 00:22:31,350 --> 00:22:34,019 - It was nice meeting you, too, Dr. McKay. 563 00:22:38,315 --> 00:22:41,234 - [sighs] 564 00:22:49,159 --> 00:22:51,870 You know, I was-- I was going to go check out 565 00:22:51,953 --> 00:22:55,457 a few of the art galleries in Lawrenceville tonight. 566 00:22:55,499 --> 00:22:58,293 - Have you been to that one on 40th and Butler? 567 00:22:58,377 --> 00:23:00,796 - No, I was, um, gonna go by. 568 00:23:00,879 --> 00:23:03,215 Maybe around 9:00? 569 00:23:03,298 --> 00:23:05,509 - Okay. [chuckles] 570 00:23:05,592 --> 00:23:07,719 Cool. - Cool. 571 00:23:09,971 --> 00:23:11,973 - Dude, I resuscitated that parkour guy 572 00:23:12,057 --> 00:23:13,183 and--and intubated a STEMI. 573 00:23:13,266 --> 00:23:14,518 I think I can handle this. 574 00:23:14,601 --> 00:23:16,812 - It's best if you watch the first one. 575 00:23:16,853 --> 00:23:18,355 How's that tooth feeling? 576 00:23:18,438 --> 00:23:20,982 - [groans] The whole side of my face is numb. 577 00:23:21,024 --> 00:23:23,360 - That's how we like it. 578 00:23:23,443 --> 00:23:26,822 Okay, we've got a... 579 00:23:26,863 --> 00:23:28,865 a fluctuant gumline at-- 580 00:23:28,949 --> 00:23:31,535 - Tooth number 23, lateral incisor. 581 00:23:31,618 --> 00:23:35,080 - With an extension to an-- - Apical abscess. 582 00:23:35,163 --> 00:23:37,999 - Right again. - Ah, the kid's smart. 583 00:23:38,083 --> 00:23:41,169 - Hook up the Yankauer. Get ready to retract the gum. 584 00:23:41,253 --> 00:23:43,755 - Hey, Louie, this is a temporary fix, okay? 585 00:23:43,839 --> 00:23:46,299 You're going to need to get that tooth pulled by a dentist. 586 00:23:46,341 --> 00:23:48,176 - Hey, you going to find me one? 587 00:23:48,218 --> 00:23:50,762 - We can have you talk to Dylan. 588 00:23:50,846 --> 00:23:53,014 - Is Dr. Collins around? 589 00:23:53,098 --> 00:23:55,517 Sister always helps me out. 590 00:23:55,600 --> 00:23:58,979 - Uh, Dr. Collins finished her residency, 591 00:23:59,020 --> 00:24:01,857 took up a job in Portland as an attending physician. 592 00:24:01,898 --> 00:24:03,024 - "Portland"? 593 00:24:03,108 --> 00:24:05,026 - Yeah, I think that's where she's from. 594 00:24:05,110 --> 00:24:06,361 She's adopting a baby. 595 00:24:06,403 --> 00:24:08,530 Wanted to be closer to her family. 596 00:24:08,613 --> 00:24:10,490 - Well, that's a beautiful thing. 597 00:24:10,532 --> 00:24:13,577 - We're set. - Okay. Ready? 598 00:24:15,078 --> 00:24:18,540 Okay, 3-cc syringe, 599 00:24:18,582 --> 00:24:22,544 20-gauge needle entering at the juiciest part, 600 00:24:22,586 --> 00:24:25,130 aiming for the apex. 601 00:24:27,174 --> 00:24:29,050 - Send that for culture? - No. 602 00:24:29,134 --> 00:24:30,594 Pen V.K. for a few days. 603 00:24:30,677 --> 00:24:32,888 Bugs in the mouth are old school. 604 00:24:32,929 --> 00:24:35,098 - Ah, just like me. 605 00:24:35,182 --> 00:24:36,725 [elevator bell dings] 606 00:24:36,808 --> 00:24:38,059 - Both parents work, 607 00:24:38,143 --> 00:24:39,978 but neither of them have health coverage? 608 00:24:40,061 --> 00:24:43,148 - Orlando and his wife have multiple part-time jobs 609 00:24:43,231 --> 00:24:45,233 that don't offer insurance. 610 00:24:45,317 --> 00:24:46,902 - Can they qualify for Medicaid? 611 00:24:46,943 --> 00:24:49,738 - Unfortunately, no, because their combined annual income 612 00:24:49,821 --> 00:24:52,073 is over the Medicaid threshold for a family of five. 613 00:24:52,157 --> 00:24:53,700 - So they make too much money? 614 00:24:53,742 --> 00:24:55,869 - And not enough at the same time. 615 00:24:55,911 --> 00:24:57,746 They live over the poverty line, 616 00:24:57,787 --> 00:25:01,708 and yet they are still living paycheck to paycheck. 617 00:25:01,750 --> 00:25:03,502 I think their best option 618 00:25:03,585 --> 00:25:05,879 would be to buy private insurance 619 00:25:05,921 --> 00:25:07,756 through the Affordable Care Act. 620 00:25:07,797 --> 00:25:09,716 - Thank you. 621 00:25:09,758 --> 00:25:12,594 - My parents don't have insurance? 622 00:25:12,636 --> 00:25:14,554 - I'm sorry, Ana. 623 00:25:14,596 --> 00:25:17,265 - How much will it cost to keep my dad in the hospital? 624 00:25:17,349 --> 00:25:19,935 - I don't know. 625 00:25:19,976 --> 00:25:25,106 But the ER visit alone will likely be in the thousands. 626 00:25:25,148 --> 00:25:28,818 We will figure something out, okay? 627 00:25:33,114 --> 00:25:34,783 - Purple top for the CBC. 628 00:25:34,824 --> 00:25:37,744 Red top for chemistries and serologies. 629 00:25:37,786 --> 00:25:39,204 - Okay. 630 00:25:40,830 --> 00:25:42,707 Ready? - Uh, yeah. 631 00:25:42,791 --> 00:25:46,545 I can be a hard stick, though. 632 00:25:46,628 --> 00:25:48,421 - Now or never, hon. 633 00:25:49,798 --> 00:25:51,800 - Okay. 634 00:25:51,841 --> 00:25:54,803 One, two... 635 00:25:54,844 --> 00:25:56,596 three. 636 00:25:56,638 --> 00:25:58,807 - Good blood return. - Oh, thank God. 637 00:25:58,848 --> 00:26:00,225 - Pop one on. 638 00:26:04,646 --> 00:26:06,731 - You're supposed to release the tourniquet now. 639 00:26:06,815 --> 00:26:08,900 - Right. Sorry. 640 00:26:12,112 --> 00:26:13,989 - Lab won't take it without your initials, 641 00:26:14,030 --> 00:26:15,365 time, and date drawn. 642 00:26:15,448 --> 00:26:16,825 How you feeling? - Peachy. 643 00:26:16,908 --> 00:26:20,370 Hopefully I get to do this several times every day. 644 00:26:20,453 --> 00:26:22,038 - All set. 645 00:26:23,248 --> 00:26:25,625 Keep some pressure here for a minute. 646 00:26:25,667 --> 00:26:27,877 - Initials, time, and date. 647 00:26:29,754 --> 00:26:31,047 - Oh. 648 00:26:33,675 --> 00:26:35,468 Shit. 649 00:26:37,053 --> 00:26:38,805 - Environmental to North. 650 00:26:38,847 --> 00:26:41,057 - Sorry. 651 00:26:41,141 --> 00:26:42,851 - How is he? 652 00:26:42,934 --> 00:26:45,478 - He's stable. He's doing great. 653 00:26:45,520 --> 00:26:48,189 - Doesn't look great. 654 00:26:48,273 --> 00:26:49,816 Is there brain damage? 655 00:26:49,858 --> 00:26:52,944 - The head CT showed no bleeding or skull fracture. 656 00:26:53,028 --> 00:26:54,696 It's most likely a bad concussion. 657 00:26:54,738 --> 00:26:57,866 It's hard to know when he'll regain consciousness. 658 00:26:57,907 --> 00:26:59,868 - Did he break any bones? - We don't think so. 659 00:26:59,951 --> 00:27:02,454 - He should thank those ferns. 660 00:27:02,537 --> 00:27:04,331 Uh, chest and abdomen CT scans 661 00:27:04,372 --> 00:27:06,875 also showed no major internal injuries. 662 00:27:06,916 --> 00:27:08,710 - Mm-hmm. 663 00:27:08,752 --> 00:27:10,503 - What's that? 664 00:27:13,840 --> 00:27:15,842 - Whoa, whoa, whoa, whoa, whoa. 665 00:27:15,884 --> 00:27:18,720 We need respiratory therapy in here! 666 00:27:20,138 --> 00:27:21,598 Okay. 667 00:27:21,681 --> 00:27:24,184 One, two, three, over. 668 00:27:24,225 --> 00:27:25,602 - You got a problem with the vent? 669 00:27:25,685 --> 00:27:27,020 - No, he's bleeding from the back. 670 00:27:27,062 --> 00:27:28,396 Got to prone him to take a look. 671 00:27:28,480 --> 00:27:30,774 Back away, Tanya. One, two, three, up. 672 00:27:30,857 --> 00:27:32,609 One, two, three, over. 673 00:27:32,692 --> 00:27:34,569 Good. - Oh, shit. 674 00:27:34,611 --> 00:27:36,404 - Left-flank area. - Careful. Careful, everybody. 675 00:27:36,488 --> 00:27:38,073 There might be glass. - That's a lot of blood. 676 00:27:38,114 --> 00:27:39,407 - 2-centimeter simple laceration. 677 00:27:39,491 --> 00:27:40,950 Open a suture kit, 4-0 Prolene. 678 00:27:41,034 --> 00:27:42,744 - He wasn't bleeding when we flipped him on arrival. 679 00:27:42,786 --> 00:27:44,579 - No, but when we moved him around for CT, 680 00:27:44,621 --> 00:27:46,331 it might have rubbed off a clot. 681 00:27:46,414 --> 00:27:47,582 - Slow venous oozing. 682 00:27:47,624 --> 00:27:50,001 - I might need a figure of eight. 683 00:27:50,085 --> 00:27:52,837 [beeping] 684 00:27:54,756 --> 00:27:56,758 - Yeah, little piece of glass in there. 685 00:27:56,841 --> 00:27:58,426 It's just under the skin. 686 00:27:58,510 --> 00:28:00,261 - Is it a loose fragment? - Yeah, I can wiggle it around. 687 00:28:00,303 --> 00:28:01,596 Here, I'll pull it out. - No, don't-- 688 00:28:01,680 --> 00:28:03,014 Shit. [alarm blaring] 689 00:28:03,098 --> 00:28:05,016 - Uh, that's--it's bigger than I thought it would be. 690 00:28:05,100 --> 00:28:06,434 - Shit. - That looks arterial. 691 00:28:06,518 --> 00:28:08,561 Can I get some 4-by-4s over here, please? 692 00:28:08,603 --> 00:28:10,021 - Oh, I'm going to be sick. 693 00:28:10,105 --> 00:28:11,523 - Put some pressure on this from all sides. 694 00:28:11,606 --> 00:28:12,691 Hard and deep, please. 695 00:28:12,774 --> 00:28:14,109 - I can push it back in. both: No! 696 00:28:14,150 --> 00:28:15,443 - No, you've done enough damage. 697 00:28:15,485 --> 00:28:16,986 - Should I keep pulling it out, then? 698 00:28:17,070 --> 00:28:19,447 - Absolutely not. The glass was tamponading a vessel. 699 00:28:19,489 --> 00:28:22,575 - Not anymore. BP's down. Page surgery! 700 00:28:22,617 --> 00:28:26,121 [blaring continues] 701 00:28:26,204 --> 00:28:29,124 - Ah, I was looking for you. - Well, you found me. 702 00:28:29,207 --> 00:28:31,960 - Um, the X-ray came back on the lady with the cough. 703 00:28:32,001 --> 00:28:33,962 Weird infiltrate. Have you seen it yet? 704 00:28:34,003 --> 00:28:36,089 - No, I've been trying to catch up on my charting. 705 00:28:36,131 --> 00:28:37,632 - Right here. - [clears throat] 706 00:28:37,674 --> 00:28:39,843 Yep, stringy right lower lobe. 707 00:28:39,926 --> 00:28:42,804 - It looks like aspiration pneumonia. 708 00:28:42,846 --> 00:28:44,180 Think about it. 709 00:28:44,264 --> 00:28:47,308 How do oral and gastric fluids end up in lungs? 710 00:28:47,392 --> 00:28:50,228 - Um, dysphagia, swallowing disorders. 711 00:28:50,311 --> 00:28:52,939 But she's not an old person choking on their food. 712 00:28:52,981 --> 00:28:55,066 - Right, and there's protracted vomiting. 713 00:28:55,150 --> 00:28:56,818 - Okay, maybe recent gastroenteritis, 714 00:28:56,860 --> 00:28:58,611 food poisoning. 715 00:28:58,653 --> 00:29:00,739 - Yeah, or... 716 00:29:00,822 --> 00:29:02,323 or... 717 00:29:02,365 --> 00:29:04,325 [sighs] An eating disorder. 718 00:29:04,367 --> 00:29:06,119 - You think she's bulimic? 719 00:29:06,161 --> 00:29:09,330 - I mean, she's fixated on working out. 720 00:29:09,372 --> 00:29:13,001 Check the, uh, enamel behind her front incisors. 721 00:29:13,042 --> 00:29:14,961 Um, oh, it's, uh-- 722 00:29:15,003 --> 00:29:17,672 if it's not in the differential, 723 00:29:17,714 --> 00:29:20,717 it won't be in the diagnosis. 724 00:29:20,800 --> 00:29:22,135 You know that-- 725 00:29:22,177 --> 00:29:25,054 Yeah, you know-- you know that. 726 00:29:27,307 --> 00:29:29,267 - [sighs] 727 00:29:29,934 --> 00:29:31,311 - Nice job on the tap. 728 00:29:31,352 --> 00:29:32,812 - Thanks. 729 00:29:32,854 --> 00:29:36,191 - Hi. You called for a consult on Jackson Davis? 730 00:29:36,232 --> 00:29:37,817 - Yes, we did. 731 00:29:37,859 --> 00:29:41,821 - I'll let Victoria present the case. 732 00:29:41,863 --> 00:29:43,490 - This is Jada, Jackson's sister. 733 00:29:43,531 --> 00:29:45,742 This is Dr. Jefferson from psychiatry. 734 00:29:45,825 --> 00:29:47,076 - "Psychiatry"? 735 00:29:47,160 --> 00:29:48,828 Do you think this is a mental-health problem? 736 00:29:48,870 --> 00:29:50,872 - We thought it best to cover all our bases. 737 00:29:50,914 --> 00:29:53,208 - We'll know more once I speak with your brother. 738 00:29:53,291 --> 00:29:55,251 - Okay. 739 00:29:57,045 --> 00:29:59,506 - Hi, Jackson. 740 00:29:59,547 --> 00:30:02,675 Jackson, can you wake up? 741 00:30:02,717 --> 00:30:05,178 Jackson. - They said he's sedated. 742 00:30:07,722 --> 00:30:10,016 - I'll come back a little later. 743 00:30:11,893 --> 00:30:13,311 - Oh, that was fast. - Yeah. 744 00:30:13,394 --> 00:30:16,022 Next time, maybe wait until the patient wakes up 745 00:30:16,064 --> 00:30:17,565 before calling me down. 746 00:30:17,607 --> 00:30:18,900 Psychiatrists do best 747 00:30:18,983 --> 00:30:22,570 when we can actually talk to our patients. 748 00:30:22,654 --> 00:30:24,697 - I got a little ahead of myself. 749 00:30:24,739 --> 00:30:26,783 Um, will do. 750 00:30:26,866 --> 00:30:28,910 Thank you. [chuckles awkwardly] 751 00:30:28,993 --> 00:30:30,912 Sorry. 752 00:30:30,995 --> 00:30:33,915 - Pressure's up with one unit type specific. 753 00:30:33,957 --> 00:30:35,959 [alarm blaring] 754 00:30:36,042 --> 00:30:37,752 - What the fuck? He was stable. 755 00:30:37,836 --> 00:30:40,713 - Slight change in status. - Okay, get the clamp ready. 756 00:30:40,755 --> 00:30:43,091 - Who's the genius who pulled that out? 757 00:30:43,132 --> 00:30:45,093 - I thought it was a loose fragment. 758 00:30:45,134 --> 00:30:47,095 - Next time, leave the decisions to the adults. 759 00:30:47,178 --> 00:30:49,514 - Okay, Dr. McKay, ready to go? 760 00:30:53,977 --> 00:30:55,603 - Whoa. - Hoo. 761 00:30:55,645 --> 00:30:56,938 Looks like an icicle. 762 00:30:56,980 --> 00:30:58,940 - Christmas in July. [telephone ringing] 763 00:30:59,023 --> 00:31:01,901 - Hey, Sophie, can you answer that? 764 00:31:01,943 --> 00:31:03,862 - Okay, I am injecting the X-stat. 765 00:31:03,945 --> 00:31:04,904 - Hello? - What is that? 766 00:31:04,946 --> 00:31:06,447 - It's a syringe filled 767 00:31:06,489 --> 00:31:09,242 with tiny, rapid-expanding hemostatic sponges. 768 00:31:09,284 --> 00:31:10,743 - Okay, got it. Thanks. 769 00:31:10,785 --> 00:31:13,121 Radiology attending says a resident missed something. 770 00:31:13,162 --> 00:31:14,706 There's a radiopaque foreign body 771 00:31:14,789 --> 00:31:17,041 in the left paralumbar musculature. 772 00:31:17,125 --> 00:31:18,418 - Not anymore. 773 00:31:18,459 --> 00:31:20,295 - Sounds like "first week in July" syndrome. 774 00:31:20,336 --> 00:31:21,796 - Mm-hmm. 775 00:31:21,838 --> 00:31:24,173 - Okay. 776 00:31:24,257 --> 00:31:27,635 That looks pretty dry. - On the surface. 777 00:31:27,719 --> 00:31:30,305 - Okay, let's turn him back down. 778 00:31:30,346 --> 00:31:34,142 Okay, one, two, three, over. 779 00:31:34,183 --> 00:31:36,811 One, two, three, flip. 780 00:31:36,853 --> 00:31:39,689 One, two, three, down. 781 00:31:39,772 --> 00:31:41,649 All right, CT is ready to rescan. 782 00:31:41,691 --> 00:31:43,526 Interventional radiology is holding a room. 783 00:31:43,610 --> 00:31:45,987 - Look at you-- so on top of things. 784 00:31:46,070 --> 00:31:47,864 Hasta la próxima. 785 00:31:47,947 --> 00:31:50,199 - How you doing over here? 786 00:31:50,283 --> 00:31:51,826 - Definitely not great. 787 00:31:51,910 --> 00:31:54,162 - Right, well, let's get you a ginger ale. 788 00:31:54,203 --> 00:31:57,165 - So we never, ever remove a deep foreign body in the ER. 789 00:31:57,206 --> 00:31:59,125 We always leave that to surgery. 790 00:31:59,167 --> 00:32:01,502 - It won't happen again. 791 00:32:01,544 --> 00:32:04,130 - I was just coming to find you. 792 00:32:04,172 --> 00:32:05,256 - Sure you were. 793 00:32:05,340 --> 00:32:07,175 It's almost like you're avoiding me. 794 00:32:07,216 --> 00:32:08,509 - Me? Never. 795 00:32:08,593 --> 00:32:10,178 No, I'm just having one of those busy days, 796 00:32:10,219 --> 00:32:12,472 you know, living the dream, saving America's tired, 797 00:32:12,513 --> 00:32:14,682 poor, huddled masses yearning to breathe free. 798 00:32:14,724 --> 00:32:17,477 - You're a saint. - I tell myself that every day. 799 00:32:17,518 --> 00:32:20,021 - I heard you had a, uh, motorcycle crash 800 00:32:20,063 --> 00:32:23,024 come through about an hour ago. - Yeah. 801 00:32:23,066 --> 00:32:24,859 Couldn't save him. 802 00:32:24,943 --> 00:32:27,195 And, no, he was not wearing a helmet. 803 00:32:27,278 --> 00:32:28,863 - Interesting. 804 00:32:28,905 --> 00:32:31,366 - One motorcycle crash is not going to scare me off my trip. 805 00:32:31,449 --> 00:32:33,368 - I didn't say it should. 806 00:32:33,409 --> 00:32:36,579 - I hope he died doing what he loved. 807 00:32:36,663 --> 00:32:39,374 - That's... optimistic. 808 00:32:39,457 --> 00:32:41,751 - "Glass half full" kind of guy. 809 00:32:43,252 --> 00:32:45,880 I am not on your couch. - I'm aware. 810 00:32:45,922 --> 00:32:48,508 Conflict of interest here. - Why? Because we're friends? 811 00:32:48,549 --> 00:32:51,552 - Ooh, look at you, using the F word. 812 00:32:51,636 --> 00:32:53,054 That's growth. 813 00:32:53,096 --> 00:32:54,347 - I use F words all the time. 814 00:32:54,389 --> 00:32:55,848 I guess this therapy must be working. 815 00:32:55,890 --> 00:32:58,351 - Ah, I got somebody new for you. 816 00:32:58,393 --> 00:33:00,895 She takes no shit. You'll love her. 817 00:33:00,979 --> 00:33:02,230 - I hope so. 818 00:33:02,271 --> 00:33:05,900 The last two have not exactly been... my speed. 819 00:33:05,942 --> 00:33:09,153 - Meaning what, empathetic? - [exhales] 820 00:33:09,237 --> 00:33:11,698 - Look, sometimes it just takes a little while 821 00:33:11,739 --> 00:33:13,491 to, you know, find the right fit. 822 00:33:13,574 --> 00:33:14,909 - Well, it's going to have to wait, 823 00:33:14,951 --> 00:33:16,202 because I'm going on my sabbatical tomorrow. 824 00:33:16,244 --> 00:33:17,745 - There's always Zoom therapy. 825 00:33:17,787 --> 00:33:20,873 - Motorcycle trip is zoom therapy. 826 00:33:22,834 --> 00:33:25,753 - I'll bet somebody set off fireworks in the shitter. 827 00:33:25,795 --> 00:33:28,089 [imitates explosion] - How dumb is that? 828 00:33:28,172 --> 00:33:30,258 - [scoffs] You think people are smart? 829 00:33:30,299 --> 00:33:32,593 - [laughs] - [chuckles] Yeah. 830 00:33:34,470 --> 00:33:35,972 - What's up, man? 831 00:33:36,055 --> 00:33:38,266 You want to get on the books? 832 00:33:38,307 --> 00:33:39,600 - Uh, yeah. 833 00:33:39,684 --> 00:33:41,394 Yeah, yeah. May--maybe. Yeah. 834 00:33:41,436 --> 00:33:42,395 - Hey, look here. 835 00:33:42,437 --> 00:33:44,105 I only take real money, 836 00:33:44,188 --> 00:33:46,107 none of that "I owe you" bullshit. 837 00:33:46,190 --> 00:33:47,734 - [scoffs] 838 00:33:47,775 --> 00:33:49,277 Okay, I have money, okay? 839 00:33:49,360 --> 00:33:52,613 My first direct deposit finally hit, so... 840 00:33:52,655 --> 00:33:54,782 - Nice. Hmm. 841 00:33:54,824 --> 00:33:58,286 - Put me down for $40... 842 00:33:58,327 --> 00:34:00,747 for power outage. 843 00:34:00,788 --> 00:34:02,790 - [chuckles] - Nice. 844 00:34:02,832 --> 00:34:05,376 - We got a big baller on our hands. 845 00:34:05,460 --> 00:34:07,086 - Congrats, Doctor. - Thank you. 846 00:34:07,128 --> 00:34:08,963 - I like this side of you, man. 847 00:34:09,005 --> 00:34:11,632 - Any improvement? - No. 848 00:34:11,716 --> 00:34:13,301 - What kind of super glue did you use? 849 00:34:13,342 --> 00:34:16,220 - Does it matter? My eye is still fucking shut. 850 00:34:16,304 --> 00:34:18,097 - Okay, there's one other thing I can try. 851 00:34:18,139 --> 00:34:20,058 - No. I'm done. I asked for Dr. J earlier, 852 00:34:20,141 --> 00:34:22,143 and I would like to see her now. 853 00:34:22,226 --> 00:34:24,103 - I haven't been in the hospital for a while. 854 00:34:24,145 --> 00:34:25,938 I don't know a Dr. J. 855 00:34:25,980 --> 00:34:29,442 - She's one of the best doctors in Pittsburgh. 856 00:34:34,238 --> 00:34:37,492 - Oh, Dr. J. 857 00:34:37,533 --> 00:34:38,618 Hmm. 858 00:34:38,659 --> 00:34:40,661 - Do what you must, milady. - Mm-hmm. 859 00:34:40,745 --> 00:34:44,624 Okay, first, I need to get a good grip for the reduction. 860 00:34:44,665 --> 00:34:46,876 - Uh-huh. 861 00:34:46,959 --> 00:34:48,377 - Here we go. 862 00:34:48,461 --> 00:34:50,004 Try to relax. 863 00:34:50,088 --> 00:34:53,049 Deep breath, with your mouth open. 864 00:34:53,132 --> 00:34:54,509 - [exhales sharply] Not how I imagined 865 00:34:54,550 --> 00:34:57,011 our first intimate encounter. 866 00:34:57,053 --> 00:35:00,056 - Okay, got it. 867 00:35:00,139 --> 00:35:02,809 Now, on three, okay? 868 00:35:02,850 --> 00:35:04,852 One... [crack] 869 00:35:04,894 --> 00:35:08,147 - Ah! Motherfucker. 870 00:35:08,189 --> 00:35:10,691 Ho-ho! You said "on three." 871 00:35:10,733 --> 00:35:11,859 - I--I know. 872 00:35:11,943 --> 00:35:14,278 Sorry. It keeps you from tensing up. 873 00:35:14,362 --> 00:35:16,114 - [exhales] - Okay, I think that worked. 874 00:35:16,197 --> 00:35:18,199 How does it feel? - Can I sit up? 875 00:35:18,282 --> 00:35:21,285 - Uh-huh. - Oh. 876 00:35:21,369 --> 00:35:22,620 Oh. 877 00:35:25,081 --> 00:35:28,042 [sighing] Oh, my God. 878 00:35:28,126 --> 00:35:30,336 Oh. 879 00:35:30,378 --> 00:35:33,381 That is definitely better. 880 00:35:33,464 --> 00:35:35,383 Oh, my God. 881 00:35:35,466 --> 00:35:37,426 - Great. - [laughing] 882 00:35:37,510 --> 00:35:39,053 Can I give you a hug? 883 00:35:39,095 --> 00:35:41,597 - Mm, maybe--maybe later, okay? 884 00:35:41,681 --> 00:35:44,267 [chuckles] 885 00:35:44,350 --> 00:35:47,228 - Aspiration pneumonia? How does that happen? 886 00:35:47,311 --> 00:35:49,897 - It's when bacteria from the mouth or stomach 887 00:35:49,981 --> 00:35:51,941 get into the breathing tube, 888 00:35:52,024 --> 00:35:53,734 uh, when you're choking, 889 00:35:53,776 --> 00:35:56,946 if you're eating or vomiting. 890 00:35:57,029 --> 00:35:58,072 - Oh. 891 00:35:58,156 --> 00:35:59,949 - Do you ever drink a lot of alcohol, 892 00:36:00,032 --> 00:36:02,201 maybe so much that you pass out? 893 00:36:02,243 --> 00:36:04,245 - No, I'm not a big drinker. 894 00:36:04,287 --> 00:36:07,915 - Have you had the stomach flu recently, food poisoning? 895 00:36:07,999 --> 00:36:09,625 - No and no. 896 00:36:10,918 --> 00:36:13,838 - Do you mind if we take a look inside your mouth? 897 00:36:17,675 --> 00:36:20,344 - [coughing] 898 00:36:20,428 --> 00:36:23,848 - You can lean your head back... 899 00:36:23,931 --> 00:36:25,683 and open up wide. 900 00:36:25,766 --> 00:36:28,394 [monitor beeping] 901 00:36:29,645 --> 00:36:31,272 - What? 902 00:36:31,314 --> 00:36:35,318 - The enamel on the back of your teeth is worn away. 903 00:36:35,401 --> 00:36:37,445 - What does that mean? 904 00:36:37,486 --> 00:36:38,905 - Um, it can happen 905 00:36:38,946 --> 00:36:41,407 if someone makes themselves vomit repeatedly. 906 00:36:41,449 --> 00:36:44,619 All the stomach acid dissolves the enamel. 907 00:36:44,660 --> 00:36:47,663 - What does that have to do with having pneumonia? 908 00:36:47,747 --> 00:36:49,373 - It may have caused it. 909 00:36:51,417 --> 00:36:54,253 - Can you just give me some medicine? 910 00:36:54,295 --> 00:36:55,880 - Yeah, we can do that. 911 00:36:59,342 --> 00:37:01,969 - Dr. J, finally. 912 00:37:02,011 --> 00:37:04,764 - It is so nice to meet you, Dr. J. 913 00:37:04,805 --> 00:37:08,309 This is Willow, your new patient. 914 00:37:09,477 --> 00:37:11,604 - I'm actually a student doctor. 915 00:37:11,646 --> 00:37:14,148 - I, uh, watch all of your videos. 916 00:37:14,232 --> 00:37:16,150 The one about coping with difficult coworkers 917 00:37:16,234 --> 00:37:17,818 was super helpful. 918 00:37:17,902 --> 00:37:19,445 - I got to watch that. 919 00:37:19,487 --> 00:37:22,156 - Um, um, so--so what is Willow's health issue? 920 00:37:22,198 --> 00:37:25,993 - Uh, my eye-- it's superglued shut. 921 00:37:26,077 --> 00:37:28,829 - Halfway trim and mineral oil didn't work? 922 00:37:28,871 --> 00:37:30,331 - Nope. 923 00:37:30,373 --> 00:37:33,334 - Then--then I would suggest cutting the full lash down. 924 00:37:33,417 --> 00:37:36,337 - I concur, Dr. J. 925 00:37:36,379 --> 00:37:39,799 - As long as you're the one doing it. 926 00:37:39,840 --> 00:37:41,342 - Oh. 927 00:37:41,425 --> 00:37:43,386 Okay, yeah, sure. 928 00:37:43,469 --> 00:37:45,638 [chuckles] Um, yeah. 929 00:37:45,680 --> 00:37:48,975 Uh, sit back for me. 930 00:37:49,016 --> 00:37:51,018 I'll get you to close both your eyes 931 00:37:51,060 --> 00:37:53,062 and be as still as possible. 932 00:37:53,145 --> 00:37:54,063 - Okay. 933 00:37:54,146 --> 00:37:55,481 - All you, Doc. 934 00:37:55,523 --> 00:37:58,859 - Thank you, Dr. Langdon. 935 00:37:58,943 --> 00:38:01,570 Okay, here we go. 936 00:38:03,531 --> 00:38:06,534 - How many followers do you have, Dr. J? 937 00:38:06,575 --> 00:38:09,578 - More than you'd guess, Dr. Langdon. 938 00:38:12,456 --> 00:38:13,541 There. 939 00:38:13,624 --> 00:38:15,751 - [sighs] 940 00:38:17,795 --> 00:38:19,505 - [chuckles] You did it. 941 00:38:19,547 --> 00:38:22,758 [giggles, sighs in relief] 942 00:38:25,219 --> 00:38:27,888 Oh, my God. This looks terrible. 943 00:38:27,972 --> 00:38:32,768 I can still put a false lash on it, though, right? 944 00:38:36,230 --> 00:38:38,733 - How are you feeling, Mr. Diaz? 945 00:38:38,774 --> 00:38:41,068 - Much better. 946 00:38:41,110 --> 00:38:43,237 - We need to talk about how your diabetes 947 00:38:43,279 --> 00:38:46,782 progressed to this place. 948 00:38:46,866 --> 00:38:49,243 This is Student Dr. Kwon. 949 00:38:49,285 --> 00:38:51,996 What you say here remains between us. 950 00:38:54,123 --> 00:38:57,960 - I'm taking a lower dose of insulin than I should be. 951 00:38:58,044 --> 00:39:01,422 - How much of your prescribed dose are you using at a time? 952 00:39:01,505 --> 00:39:03,090 - Half. 953 00:39:03,132 --> 00:39:05,051 I used to have insurance through work, 954 00:39:05,092 --> 00:39:07,928 but I lost that job when the pandemic hit. 955 00:39:07,970 --> 00:39:10,598 It was easy to keep up with my medication then. 956 00:39:10,639 --> 00:39:13,017 I had a great primary doctor, too. 957 00:39:13,100 --> 00:39:15,936 Now I'm kind of on my own. 958 00:39:15,978 --> 00:39:18,272 - Do you have a glucose monitor? 959 00:39:18,356 --> 00:39:20,066 - Uh, yes. 960 00:39:20,107 --> 00:39:22,443 But I can't afford the test strips every week. 961 00:39:22,485 --> 00:39:24,070 They're too expensive. 962 00:39:24,111 --> 00:39:26,447 Can we not talk about this in front of my family? 963 00:39:26,489 --> 00:39:28,032 - Hi. - Hi. 964 00:39:28,115 --> 00:39:29,867 - There are my girls. [sighs] 965 00:39:29,950 --> 00:39:32,286 Did you call your brothers? - They're still at soccer. 966 00:39:32,328 --> 00:39:35,373 - I have good news. I started a GoFundMe for Dad. 967 00:39:35,456 --> 00:39:36,707 - A what? 968 00:39:36,791 --> 00:39:38,459 - To help raise money for Dad's medical care 969 00:39:38,501 --> 00:39:41,003 since we don't have insurance. - No, no. 970 00:39:41,087 --> 00:39:44,090 Take it down, now. - But why? 971 00:39:44,131 --> 00:39:46,008 - I work hard. I don't need charity. 972 00:39:46,092 --> 00:39:47,635 - But, Dad, we've already-- 973 00:39:47,676 --> 00:39:49,804 - Ana, you heard me! 974 00:39:49,887 --> 00:39:50,846 Take it down. 975 00:39:50,930 --> 00:39:52,473 - Jesus, Orlando. 976 00:39:52,515 --> 00:39:55,851 - No necesito eso. 977 00:39:55,935 --> 00:39:58,979 - Louie, thought I'd sneak back here to check on you. 978 00:39:59,063 --> 00:40:01,148 - How we doing in here? - Good. 979 00:40:01,190 --> 00:40:05,027 Tooth's feeling much better. - Glad to hear it. 980 00:40:05,111 --> 00:40:07,696 Looks like you're stuck with us for the next three hours. 981 00:40:07,780 --> 00:40:09,657 We need to monitor your blood pressure. 982 00:40:09,698 --> 00:40:11,659 - How about a drink while I wait? 983 00:40:11,700 --> 00:40:13,077 [chuckles] 984 00:40:13,160 --> 00:40:14,662 - Water or orange juice? 985 00:40:14,703 --> 00:40:17,665 - Uh, never mind. 986 00:40:17,748 --> 00:40:19,500 So, uh... 987 00:40:19,583 --> 00:40:22,002 how are the kids doing? 988 00:40:22,086 --> 00:40:25,589 - Oh, they're perfect little monsters. 989 00:40:25,673 --> 00:40:28,259 Tanner's five now. Penny's three. 990 00:40:28,342 --> 00:40:30,928 - Oh, ain't that a blessing. 991 00:40:31,011 --> 00:40:34,014 - It is, but they have zero interest in bedtime. 992 00:40:34,056 --> 00:40:36,517 And there's the dog always digging up the yard. 993 00:40:36,600 --> 00:40:38,185 - [chuckles] 994 00:40:38,269 --> 00:40:40,187 How much sun does your lawn get? 995 00:40:40,271 --> 00:40:42,356 - I don't know. Plenty. 996 00:40:42,398 --> 00:40:45,484 - Seed it with perennial ryegrass. 997 00:40:45,526 --> 00:40:48,070 And you want to lightly water it 998 00:40:48,154 --> 00:40:52,032 and put up a temporary fence so the dog can't get back to it. 999 00:40:52,074 --> 00:40:54,201 - Color me impressed. 1000 00:40:54,243 --> 00:40:57,329 - What can I say? I like grass. 1001 00:40:57,371 --> 00:40:59,248 [both chuckle] 1002 00:40:59,331 --> 00:41:02,209 - No, seriously, how do you-- how do you know all that? 1003 00:41:02,293 --> 00:41:04,879 - [sighs] I was a groundskeeper. 1004 00:41:04,962 --> 00:41:09,341 I worked with gardens and lawns back in the day. 1005 00:41:10,634 --> 00:41:12,136 - Robby. 1006 00:41:14,180 --> 00:41:15,931 Got a sec? 1007 00:41:18,559 --> 00:41:21,145 - Dr. Langdon. - Dr. Al-Hashimi. 1008 00:41:21,228 --> 00:41:23,230 - How's triage looking? 1009 00:41:23,272 --> 00:41:24,899 - Donnie and I have it under control. 1010 00:41:24,982 --> 00:41:27,151 - Good. I want you to wrap up what you're doing out there 1011 00:41:27,234 --> 00:41:28,569 and join us back here. 1012 00:41:28,652 --> 00:41:31,197 We're expecting more diverted traffic from Westbridge. 1013 00:41:31,238 --> 00:41:32,406 - Will do. 1014 00:41:32,490 --> 00:41:34,492 - And I just want to say, I think it's great 1015 00:41:34,575 --> 00:41:36,744 that you're in the Physicians' Health Program. 1016 00:41:36,827 --> 00:41:39,038 I know it's a big commitment. 1017 00:41:39,079 --> 00:41:43,083 - Uh, yeah, it was hard at the beginning, 1018 00:41:43,167 --> 00:41:45,586 but, you know, I'm almost done with year one now. 1019 00:41:45,669 --> 00:41:48,797 Only four more years to go. - [chuckles] 1020 00:41:48,881 --> 00:41:50,591 - Penny for your thoughts. 1021 00:41:50,674 --> 00:41:53,052 - Oh, they're way more expensive than that. 1022 00:41:53,093 --> 00:41:55,221 - I'm on a budget. Take it or leave it. 1023 00:41:55,262 --> 00:41:57,640 - My day is not turning out the way that I expected. 1024 00:41:57,723 --> 00:42:00,809 - We had a callout. Langdon was available. 1025 00:42:00,893 --> 00:42:03,229 - I was sort of hoping to be on my sabbatical 1026 00:42:03,270 --> 00:42:04,897 when he came back. 1027 00:42:04,939 --> 00:42:06,565 - You two were very close. 1028 00:42:06,607 --> 00:42:08,442 Maybe this is the universe's way 1029 00:42:08,526 --> 00:42:11,111 of telling you it's time to clear the air. 1030 00:42:11,195 --> 00:42:13,155 - Maybe it is. 1031 00:42:13,239 --> 00:42:15,199 Maybe it isn't. 1032 00:42:19,370 --> 00:42:22,206 - Okay, so, um, we'll need to keep you for the day 1033 00:42:22,289 --> 00:42:26,877 for your IV antibiotics and to monitor your oxygen level. 1034 00:42:26,961 --> 00:42:29,088 - Okay. 1035 00:42:29,129 --> 00:42:30,631 - Okay. 1036 00:42:35,636 --> 00:42:37,429 - What if... 1037 00:42:37,471 --> 00:42:40,307 [sighs] 1038 00:42:40,349 --> 00:42:43,435 I have been making myself vomit? 1039 00:42:45,312 --> 00:42:47,773 - Well... 1040 00:42:47,815 --> 00:42:50,401 bulimia is treatable. 1041 00:42:52,194 --> 00:42:54,321 - I was going to stop. 1042 00:42:54,363 --> 00:42:56,448 I stopped before. 1043 00:42:58,909 --> 00:43:02,454 My family gathers around food. 1044 00:43:02,496 --> 00:43:05,374 We eat when we're celebrating. We eat when we're mourning. 1045 00:43:05,457 --> 00:43:06,834 We just eat. 1046 00:43:06,875 --> 00:43:08,210 But then I got to college, 1047 00:43:08,294 --> 00:43:10,671 and it was all about how you looked. 1048 00:43:10,713 --> 00:43:13,007 - That's a lot of pressure. 1049 00:43:17,386 --> 00:43:20,180 - I started vomiting. 1050 00:43:20,264 --> 00:43:22,808 Everyone said I looked great. 1051 00:43:22,850 --> 00:43:24,935 So I went to the gym more. 1052 00:43:25,019 --> 00:43:28,689 I didn't need to purge as much. 1053 00:43:28,731 --> 00:43:31,191 [heavy sigh] 1054 00:43:31,233 --> 00:43:32,860 Last year, I went through a breakup. 1055 00:43:32,943 --> 00:43:36,530 It all came back. 1056 00:43:36,572 --> 00:43:38,574 [sniffles] 1057 00:43:40,075 --> 00:43:41,368 - You're... 1058 00:43:41,452 --> 00:43:45,122 doing long-term damage to your body. 1059 00:43:45,205 --> 00:43:48,959 And it doesn't just go away on its own. 1060 00:43:49,043 --> 00:43:51,420 It's okay to ask for help. 1061 00:43:51,503 --> 00:43:52,588 - We can set you up 1062 00:43:52,671 --> 00:43:54,715 with our eating-disorder program upstairs. 1063 00:43:54,757 --> 00:43:58,427 - It's here in the hospital? - It's an outpatient program. 1064 00:43:58,510 --> 00:44:00,054 You'd meet with a therapist 1065 00:44:00,137 --> 00:44:04,266 for individual and group therapy once or twice a week. 1066 00:44:05,517 --> 00:44:08,771 Would you be open to meeting with a therapist? 1067 00:44:10,397 --> 00:44:12,566 - I guess. 1068 00:44:12,650 --> 00:44:14,735 - Do you have any preference for type of therapist-- 1069 00:44:14,777 --> 00:44:16,779 male, female? 1070 00:44:16,862 --> 00:44:19,740 - [crying] If there's a Black woman, I'd like that. 1071 00:44:19,823 --> 00:44:21,075 [sighs] 1072 00:44:21,116 --> 00:44:23,410 - Yeah, we can arrange that. 1073 00:44:23,452 --> 00:44:25,537 - [sniffles] 1074 00:44:25,579 --> 00:44:27,414 Thank you. 1075 00:44:30,584 --> 00:44:32,586 - That was a good catch. 1076 00:44:32,670 --> 00:44:34,421 - Black women tend to go underdiagnosed 1077 00:44:34,463 --> 00:44:36,006 when it comes to eating disorders. 1078 00:44:36,090 --> 00:44:38,092 - Really? - Yeah, unfortunately. 1079 00:44:38,175 --> 00:44:41,011 You know, I thought I had an eating disorder in high school, 1080 00:44:41,095 --> 00:44:43,430 and so I did a lot of research on the subject. 1081 00:44:43,514 --> 00:44:46,392 I didn't--no, I just-- 1082 00:44:46,433 --> 00:44:49,603 My sister and I were really picky eaters growing up, 1083 00:44:49,645 --> 00:44:51,105 you know? 1084 00:44:51,188 --> 00:44:53,315 Color and texture. 1085 00:44:53,399 --> 00:44:55,150 Vegetables and fish. 1086 00:44:55,234 --> 00:44:56,985 Oh, eggs. 1087 00:44:57,069 --> 00:45:00,239 Slimy okra, asparagus-- ugh, disgusting. 1088 00:45:00,280 --> 00:45:01,657 Drove our parents crazy. 1089 00:45:01,740 --> 00:45:04,326 - Oh, eggs, weird. 1090 00:45:04,410 --> 00:45:05,619 - It's not that weird. 1091 00:45:05,703 --> 00:45:08,789 - I got to catch up on my charting. 1092 00:45:08,831 --> 00:45:10,165 - Ah. 1093 00:45:10,249 --> 00:45:13,419 You know, if--if you want to talk, I'm around. 1094 00:45:13,460 --> 00:45:14,586 - Talk about what? 1095 00:45:14,628 --> 00:45:16,171 - Being an R2? 1096 00:45:16,255 --> 00:45:17,756 Way harder than intern year. 1097 00:45:17,798 --> 00:45:19,133 - Oh, yeah, um... 1098 00:45:19,174 --> 00:45:22,511 yeah, overseeing the med students, the interns, 1099 00:45:22,594 --> 00:45:24,471 having no time to do my own charts. 1100 00:45:24,555 --> 00:45:26,890 - Yeah, just wait until you get into Medical, 1101 00:45:26,974 --> 00:45:28,475 Surgical, and Cardiac ICU. 1102 00:45:28,517 --> 00:45:30,436 I stands for "intense." - [chuckles] 1103 00:45:30,477 --> 00:45:33,313 Somehow that seems like an understatement. 1104 00:45:33,397 --> 00:45:36,108 - Well, it does help you grow your clinical skills, 1105 00:45:36,150 --> 00:45:38,152 you know, caring for the sickest patients. 1106 00:45:38,193 --> 00:45:40,487 - Tell that to these charts. 1107 00:45:40,529 --> 00:45:43,490 - Um, dictate. Helps you go faster. 1108 00:45:46,243 --> 00:45:49,496 - Oh, uh, what happened with our patient from Westbridge? 1109 00:45:49,538 --> 00:45:51,331 You never grabbed me for his troponin. 1110 00:45:51,373 --> 00:45:53,834 - Mr. Samba-- it was a posterior STEMI. 1111 00:45:53,917 --> 00:45:56,170 - What? Didn't show on the 12-lead. 1112 00:45:56,253 --> 00:45:57,796 - Oh, usually doesn't. 1113 00:45:57,838 --> 00:46:01,008 And I think most clinicians would have missed it. 1114 00:46:01,091 --> 00:46:02,301 - But you didn't. 1115 00:46:02,342 --> 00:46:03,844 - [scoffs] 1116 00:46:03,927 --> 00:46:05,721 Guess I got lucky. 1117 00:46:07,264 --> 00:46:10,017 - Whatever, Fuckleberry. 1118 00:46:10,058 --> 00:46:12,478 - Okay, I'm sorry. Did I do something to bother you? 1119 00:46:12,519 --> 00:46:13,854 - Nope. 1120 00:46:15,856 --> 00:46:18,525 - [sighs] Okay. 1121 00:46:18,567 --> 00:46:20,235 - Yo. - What's up? 1122 00:46:20,319 --> 00:46:23,489 - I got a bounce-back. You remember Debbie Cohen? 1123 00:46:23,530 --> 00:46:25,699 - Not really. I've seen 16 patients this morning. 1124 00:46:25,741 --> 00:46:27,534 - The restaurant worker with cellulitis 1125 00:46:27,576 --> 00:46:29,787 on the dorsum of the foot? - Yes, yes, she's on Keflex. 1126 00:46:29,870 --> 00:46:31,371 I marked the border. 1127 00:46:31,455 --> 00:46:35,000 - Yeah, I got a hot pack on it, but, uh, you should take a look. 1128 00:46:38,712 --> 00:46:40,506 - Hi. Dr. Langdon. 1129 00:46:40,547 --> 00:46:43,217 - I wasn't expecting to see you back so soon. 1130 00:46:43,258 --> 00:46:45,719 Meds upset your stomach? - Uh, no. 1131 00:46:45,761 --> 00:46:48,722 The pain got worse, and you said to come back 1132 00:46:48,764 --> 00:46:51,225 if the redness spread outside the Sharpie line. 1133 00:46:51,308 --> 00:46:53,101 - Let's take a look. 1134 00:46:55,062 --> 00:46:56,480 - Ah. 1135 00:46:57,564 --> 00:47:00,692 [wincing] 1136 00:47:02,694 --> 00:47:04,071 - It looks like the infection 1137 00:47:04,112 --> 00:47:06,073 isn't responding to the pills I prescribed you, 1138 00:47:06,156 --> 00:47:08,575 so we need to get you on some IV antibiotics 1139 00:47:08,659 --> 00:47:10,619 and get you back to the ED now. 1140 00:47:10,702 --> 00:47:12,538 - Uh, i-is it bad? 1141 00:47:12,579 --> 00:47:15,207 - Not if we can get a handle on it. 1142 00:47:15,249 --> 00:47:17,876 - MRSA? - Or maybe worse. 1143 00:47:17,918 --> 00:47:20,337 [tense music]