1 00:00:14,139 --> 00:00:16,265 [monitors chiming] 2 00:00:16,350 --> 00:00:18,435 [bones cracking] - I'm in. 3 00:00:18,477 --> 00:00:19,770 Bag him. 4 00:00:23,023 --> 00:00:25,734 - Defib pads are in place. 5 00:00:25,817 --> 00:00:27,694 - OK, holding compressions. 6 00:00:27,778 --> 00:00:29,738 - Good square line on the End-Tidal CO2. 7 00:00:29,821 --> 00:00:32,366 - V-fib, charge to 200. 8 00:00:32,448 --> 00:00:33,700 [electricity whirs] 9 00:00:33,784 --> 00:00:35,035 - Charged. 10 00:00:35,118 --> 00:00:38,372 Clear. [thud] 11 00:00:38,455 --> 00:00:40,749 - Stand by with epi. 12 00:00:44,253 --> 00:00:46,171 - Suction that tube. 13 00:00:48,090 --> 00:00:49,299 You're not in the esophagus, are you? 14 00:00:49,383 --> 00:00:50,592 - Definitely not. 15 00:00:50,676 --> 00:00:52,010 I passed right through the cords. 16 00:00:52,094 --> 00:00:54,763 Good breath sounds. End-Tidal CO2 confirmed. 17 00:00:54,846 --> 00:00:56,139 - His lungs are filling up with blood. 18 00:00:56,181 --> 00:00:57,307 - I know. 19 00:00:57,349 --> 00:00:59,935 [suction whirring] 20 00:01:02,980 --> 00:01:04,272 OK, rhythm check. 21 00:01:04,355 --> 00:01:05,941 [sustained beep] 22 00:01:06,024 --> 00:01:07,484 - Asystole. Push the epi. 23 00:01:07,526 --> 00:01:09,236 - Fuck. 24 00:01:12,698 --> 00:01:14,491 - Patients with lunch trays have been admitted. 25 00:01:14,533 --> 00:01:15,826 They're boarders. 26 00:01:15,909 --> 00:01:17,661 They're waiting for a bed to open upstairs. 27 00:01:17,744 --> 00:01:19,830 - And what about the others? - Non-admitted patients. 28 00:01:19,913 --> 00:01:21,623 They can have sandwiches or juice boxes. 29 00:01:21,707 --> 00:01:24,001 Just make sure they're not NPO. 30 00:01:24,084 --> 00:01:25,335 That's "nil per os." 31 00:01:25,377 --> 00:01:26,503 It's Latin for "nothing by mouth." 32 00:01:26,587 --> 00:01:28,338 NPOs are waiting for surgery. 33 00:01:28,380 --> 00:01:30,173 They'll beg, spit, and curse for food, 34 00:01:30,215 --> 00:01:31,508 but you got to stay strong. 35 00:01:31,550 --> 00:01:32,968 - Hey, I've been waiting for an hour. 36 00:01:33,051 --> 00:01:34,803 When am I gonna see a fucking doctor? 37 00:01:34,886 --> 00:01:37,014 - Excuse me! 38 00:01:37,055 --> 00:01:39,015 Perhaps you didn't see this, which is strange, 39 00:01:39,098 --> 00:01:40,851 because they're all over the place. 40 00:01:40,892 --> 00:01:43,312 Aggressive behavior toward healthcare workers is a felony. 41 00:01:43,395 --> 00:01:45,188 $2,000 fine, possible jail time. 42 00:01:45,229 --> 00:01:46,523 Got it? 43 00:01:46,565 --> 00:01:49,067 - OK. I was just asking. 44 00:01:49,151 --> 00:01:50,735 - We're busy today. 45 00:01:50,819 --> 00:01:52,029 It's a holiday weekend. 46 00:01:52,112 --> 00:01:53,363 We see the sickest patients first, 47 00:01:53,405 --> 00:01:55,866 so be happy you're still waiting. 48 00:01:55,949 --> 00:01:59,995 [scoffs] Jag-off. [phone rings] 49 00:02:00,078 --> 00:02:01,622 PTMC charge nurse. 50 00:02:01,705 --> 00:02:04,374 Go ahead, Medic Command. 51 00:02:04,458 --> 00:02:07,127 OK. Got it. 52 00:02:07,210 --> 00:02:08,336 Incoming trauma. 53 00:02:08,419 --> 00:02:10,839 Come on. 54 00:02:10,922 --> 00:02:12,215 - Three minutes since the last epi. 55 00:02:12,299 --> 00:02:14,718 - Hold compressions. [sustained beep] 56 00:02:14,801 --> 00:02:16,053 - Asystole. 57 00:02:16,136 --> 00:02:18,347 Resume CPR. Another amp of epi. 58 00:02:18,430 --> 00:02:20,682 - Needs more suction. 59 00:02:20,766 --> 00:02:23,769 [monitors chiming] 60 00:02:26,480 --> 00:02:28,565 - Pulmonary hemorrhage from liver failure. 61 00:02:28,607 --> 00:02:30,484 - Is he going to make it? 62 00:02:35,739 --> 00:02:37,741 - Should we give PCC? 63 00:02:37,824 --> 00:02:40,035 - Too late for that. 64 00:02:40,118 --> 00:02:41,912 And he's not an ECMO candidate. 65 00:02:41,995 --> 00:02:43,997 - Nothing else we can do? 66 00:02:44,081 --> 00:02:47,125 [monitors chiming] 67 00:02:48,960 --> 00:02:51,254 - No, I think we're done. 68 00:02:51,296 --> 00:02:52,714 [sighs] 69 00:02:52,798 --> 00:02:55,759 [sustained beep] 70 00:02:55,841 --> 00:02:58,470 - [sighs] Louie. 71 00:03:02,474 --> 00:03:04,685 - 12:07. 72 00:03:11,483 --> 00:03:13,902 - Should we do a debrief? 73 00:03:13,985 --> 00:03:15,862 - We've got another motorcycle injury coming in, 74 00:03:15,946 --> 00:03:17,114 ETA 10 minutes. 75 00:03:17,197 --> 00:03:18,615 Why don't we get Louie cleaned up, 76 00:03:18,699 --> 00:03:20,659 move him to the viewing room? - Yeah. 77 00:03:20,742 --> 00:03:23,662 Anybody that wants to pay their respects can join us in there. 78 00:03:25,914 --> 00:03:27,666 Thank you, everyone. 79 00:03:34,965 --> 00:03:36,299 - I'll clean him up. 80 00:03:36,383 --> 00:03:38,468 - Why don't you take five first? 81 00:03:38,552 --> 00:03:41,096 Or ten. Yeah? 82 00:03:41,179 --> 00:03:42,597 Yep. 83 00:03:52,357 --> 00:03:54,484 - This is Dr. Jefferson from psychiatry. 84 00:03:54,567 --> 00:03:57,279 - Why do I need to see a psychiatrist? 85 00:03:57,320 --> 00:03:59,614 Jada, why do I need to see a psychiatrist? 86 00:03:59,698 --> 00:04:01,283 - It's gonna be OK, Jackson. 87 00:04:01,366 --> 00:04:03,827 Dr. Jefferson says he can help. 88 00:04:03,869 --> 00:04:06,580 - Do you know how you got here? 89 00:04:06,663 --> 00:04:08,999 - The medics brought me. 90 00:04:09,040 --> 00:04:11,835 I don't really remember. I--I was in the library. 91 00:04:11,877 --> 00:04:14,755 - What were you doing there? 92 00:04:14,838 --> 00:04:17,632 - I was--I was studying. 93 00:04:17,716 --> 00:04:20,302 I was trying to study. 94 00:04:20,385 --> 00:04:22,012 But then they wouldn't stop talking. 95 00:04:22,095 --> 00:04:24,222 - Who wouldn't stop talking? 96 00:04:24,306 --> 00:04:25,891 - They don't want me to pass the bar. 97 00:04:25,974 --> 00:04:27,517 - Who doesn't want you to pass the bar? 98 00:04:27,559 --> 00:04:29,561 - That's what they told me. - Hey, hey. 99 00:04:29,644 --> 00:04:30,854 Hey, look at me. Look at me. 100 00:04:30,896 --> 00:04:32,147 Who doesn't want you to pass the bar? 101 00:04:32,230 --> 00:04:33,982 - Let's give them some privacy. 102 00:04:34,024 --> 00:04:37,277 Dr. Jefferson will let us know when he's done. 103 00:04:37,360 --> 00:04:38,653 - They don't want me to pass the bar. 104 00:04:38,737 --> 00:04:40,489 - I'll be right outside, OK? 105 00:04:40,572 --> 00:04:44,034 I'll be right outside, Jackson. 106 00:04:44,075 --> 00:04:46,995 - Why don't they want you to pass the bar, Jackson? 107 00:04:47,037 --> 00:04:48,955 - They're afraid of me becoming a lawyer. 108 00:04:49,039 --> 00:04:51,957 - They're afraid of you becoming a lawyer? 109 00:04:52,042 --> 00:04:56,213 - He must have been studying with his law school friends. 110 00:04:56,254 --> 00:04:57,881 They--they should know what happened. 111 00:04:57,923 --> 00:05:00,550 I'm gonna call them. 112 00:05:00,592 --> 00:05:02,385 - If you need anything, let me know. 113 00:05:02,469 --> 00:05:04,930 - OK, thank you. - Mm-hmm. 114 00:05:12,270 --> 00:05:14,231 [speaking Tagalog] 115 00:05:14,314 --> 00:05:15,607 - Louie. 116 00:05:17,067 --> 00:05:20,195 - Pulmonary hemorrhage. 117 00:05:20,278 --> 00:05:22,572 - That was quick. 118 00:05:22,656 --> 00:05:25,075 - I'm gonna go clean him up. 119 00:05:25,158 --> 00:05:26,451 - I'll help. 120 00:05:26,535 --> 00:05:28,286 [person screams] 121 00:05:29,788 --> 00:05:30,956 - Go, go. 122 00:05:31,039 --> 00:05:32,415 [speaking Tagalog] 123 00:05:32,457 --> 00:05:34,626 - [groans] 124 00:05:34,709 --> 00:05:37,921 - Everything OK, Roxie? 125 00:05:38,004 --> 00:05:39,756 - I can't get off the bedpan. 126 00:05:39,840 --> 00:05:41,967 - Oh, that's what I'm here for. 127 00:05:47,973 --> 00:05:50,392 Your husband seems like a saint. 128 00:05:50,475 --> 00:05:53,687 How long you been married? 129 00:05:53,770 --> 00:05:56,231 - Too long. [both chuckle] 130 00:05:57,691 --> 00:06:00,610 Almost 20 years. 131 00:06:00,652 --> 00:06:02,404 - OK, put your arm around me. - Mm-hmm. 132 00:06:02,487 --> 00:06:04,239 - And I'll pull the bedpan on three. 133 00:06:04,322 --> 00:06:05,448 - OK. 134 00:06:05,490 --> 00:06:08,952 - One, two, three. 135 00:06:08,994 --> 00:06:10,620 One more. 136 00:06:10,662 --> 00:06:12,789 Great. - Mm. 137 00:06:12,873 --> 00:06:16,543 - 20? Wow. 138 00:06:16,626 --> 00:06:18,587 - Yeah. 139 00:06:18,628 --> 00:06:22,674 He's been by my side through all of this. 140 00:06:24,551 --> 00:06:28,471 I've watched the light go out of him. 141 00:06:28,555 --> 00:06:30,974 So have the kids. 142 00:06:31,016 --> 00:06:32,350 - That's what happened to my auntie 143 00:06:32,433 --> 00:06:35,687 when my Uncle Gerald got sick. 144 00:06:35,770 --> 00:06:38,315 But your husband does it because he loves you. 145 00:06:38,356 --> 00:06:39,774 - Mm. 146 00:06:39,858 --> 00:06:41,985 I don't know how you do it, 147 00:06:42,068 --> 00:06:44,613 care for people day after day. 148 00:06:44,696 --> 00:06:47,073 - I'll tell you my secret. 149 00:06:47,157 --> 00:06:49,993 I go home at the end of every shift, 150 00:06:50,034 --> 00:06:52,579 leave this all behind, 151 00:06:52,662 --> 00:06:54,497 and escape to "Love Island." 152 00:06:54,581 --> 00:06:56,291 - [laughs] 153 00:06:56,374 --> 00:06:57,834 - How's it going in here? 154 00:06:57,918 --> 00:06:59,711 - The higher-demand dose of morphine helped a little, 155 00:06:59,794 --> 00:07:01,796 but she's still in pain. - OK. 156 00:07:01,880 --> 00:07:04,633 - I got your order. 0.1 per kilo. 157 00:07:04,716 --> 00:07:06,301 - Thanks. - Mm-hmm. 158 00:07:06,384 --> 00:07:08,845 - This is a very low sub-dissociative dose 159 00:07:08,929 --> 00:07:10,055 of ketamine. 160 00:07:10,138 --> 00:07:11,556 You might feel a little weird, 161 00:07:11,640 --> 00:07:14,225 but I think it's gonna help with the pain. 162 00:07:16,728 --> 00:07:18,688 - Is my husband still in the cafeteria? 163 00:07:18,772 --> 00:07:20,774 - I think so. Want me to get him? 164 00:07:20,857 --> 00:07:23,443 - No, no. 165 00:07:23,526 --> 00:07:26,905 It's good for us to have a little time apart. 166 00:07:29,157 --> 00:07:31,493 - I'll get you another blanket. 167 00:07:35,580 --> 00:07:37,165 - Here. I'm headed that way. 168 00:07:37,248 --> 00:07:39,042 - Thank you. 169 00:07:39,125 --> 00:07:40,710 Back here for good? 170 00:07:40,794 --> 00:07:42,504 - Officially out of triage. 171 00:07:42,587 --> 00:07:45,715 They need extra hands with all the Westbridge hullabaloo. 172 00:07:45,757 --> 00:07:47,676 - How many cups have you had today? 173 00:07:47,759 --> 00:07:49,177 - Don't judge me. - Just asking. 174 00:07:49,260 --> 00:07:50,595 - You're judging. 175 00:07:52,472 --> 00:07:53,723 - Did you hear about Louie? 176 00:07:53,807 --> 00:07:55,183 - No. 177 00:07:55,225 --> 00:07:57,143 - Pulmonary hemorrhage. Didn't make it. 178 00:07:57,227 --> 00:07:59,729 - Shit. - Mm. 179 00:07:59,771 --> 00:08:01,398 - He's been here a hundred times. 180 00:08:01,439 --> 00:08:02,941 - I know. 181 00:08:03,024 --> 00:08:06,236 Debrief in the viewing room later. 182 00:08:06,277 --> 00:08:07,862 On a happier note, Perlah and I are planning 183 00:08:07,946 --> 00:08:09,447 a birthday party for Javadi. 184 00:08:09,531 --> 00:08:11,241 She's turning 21. 185 00:08:11,282 --> 00:08:14,035 - You two are thick as thieves. 186 00:08:14,119 --> 00:08:16,538 I don't have much of a social life these days, 187 00:08:16,621 --> 00:08:19,416 but I'll be sure to keep an eye out for the Partiful. 188 00:08:19,457 --> 00:08:22,377 - Let's discuss our incarcerated patient Gus. 189 00:08:22,460 --> 00:08:24,170 Prison infirmaries tend to be short-staffed, 190 00:08:24,254 --> 00:08:26,548 so we need to be thorough. 191 00:08:26,589 --> 00:08:29,759 What's in the differential diagnosis for malnutrition? 192 00:08:29,801 --> 00:08:32,929 - Inadequate intake, methamphetamine use, 193 00:08:32,971 --> 00:08:35,932 severe alcoholism, ADHD medication. 194 00:08:36,015 --> 00:08:37,600 - What else? 195 00:08:37,642 --> 00:08:39,936 - Cancer of the oropharynx, esophageal strictures, 196 00:08:39,977 --> 00:08:42,938 prior strokes, malabsorption, inflammatory bowel disease, 197 00:08:43,023 --> 00:08:44,941 none of which were in his medical record. 198 00:08:44,983 --> 00:08:47,318 - What about psychosocial causes? 199 00:08:47,402 --> 00:08:49,654 - Could be an intentional hunger strike. 200 00:08:49,738 --> 00:08:51,781 - Or refusing food to get to the infirmary. 201 00:08:51,865 --> 00:08:53,616 - Could also be abuse or neglect. 202 00:08:53,700 --> 00:08:55,952 Let's start with a nutrition history once he's back from CT. 203 00:08:55,994 --> 00:08:57,328 - Do you have a second to talk about Westbridge? 204 00:08:57,412 --> 00:08:59,122 - Mm-hmm. 205 00:08:59,164 --> 00:09:00,498 - Hey, we need to start moving some patients out of here. 206 00:09:00,582 --> 00:09:01,791 These walls are starting to fill up with gurneys. 207 00:09:01,875 --> 00:09:03,293 - Santos, Ogilvie, and King 208 00:09:03,334 --> 00:09:04,794 all have patients on the launching pad. 209 00:09:04,836 --> 00:09:06,588 I'll check in with them. 210 00:09:06,671 --> 00:09:08,256 - How many patients have we had rerouted from Westbridge? 211 00:09:08,339 --> 00:09:09,591 - Ten, and God knows how many more in the waiting room. 212 00:09:09,674 --> 00:09:11,259 Ambulance will be here in a few minutes 213 00:09:11,342 --> 00:09:13,094 with the accident victim; I'll stick him in Trauma Two. 214 00:09:13,136 --> 00:09:15,472 - What is the story with your incarcerated patient? 215 00:09:15,555 --> 00:09:17,432 - Gus Varney, three rib fractures 216 00:09:17,515 --> 00:09:20,101 with normal O2 sats currently, waiting on CT results. 217 00:09:20,143 --> 00:09:21,144 - OK, if he's stable at the two-hour mark, 218 00:09:21,186 --> 00:09:22,562 I'd say he's good to go. 219 00:09:22,645 --> 00:09:23,730 Let's get the ball rolling on discharge. 220 00:09:23,813 --> 00:09:25,148 - Let's wait on the CT results. 221 00:09:25,231 --> 00:09:26,649 - We can move him out of Trauma One, at least. 222 00:09:26,691 --> 00:09:27,942 - Yes, we can. What's open? 223 00:09:28,026 --> 00:09:29,652 - 13 and 14 will be discharged soon, 224 00:09:29,694 --> 00:09:31,404 15 once we move Louie to the viewing room 225 00:09:31,488 --> 00:09:32,822 and get it cleaned up. 226 00:09:32,906 --> 00:09:34,699 - Our paracentesis patient, Mr. Cloverfield? 227 00:09:34,783 --> 00:09:36,284 - V-fib arrest. 228 00:09:36,367 --> 00:09:37,494 We'll do a debrief when we know how many patients 229 00:09:37,577 --> 00:09:38,953 we're getting from Westbridge. 230 00:09:39,037 --> 00:09:41,998 - So Gus goes to 13, 14, or 15? 231 00:09:42,082 --> 00:09:43,665 - I kind of want to keep him in plain sight. 232 00:09:43,708 --> 00:09:45,668 What about BH-2? - Sold. 233 00:09:45,710 --> 00:09:47,462 - Why not give him some privacy? 234 00:09:47,545 --> 00:09:50,673 Everyone can see him in BH-2 like he's a monkey at the zoo. 235 00:09:50,715 --> 00:09:52,550 - Because he came in with an orange jumpsuit, 236 00:09:52,634 --> 00:09:54,469 and we need to think about patient and staff safety. 237 00:09:54,552 --> 00:09:56,513 - Safety first. BH-2 beats a prison cell. 238 00:09:56,596 --> 00:09:57,972 - Not by much. 239 00:09:58,056 --> 00:09:59,641 - Did you guys hear about Louie? 240 00:09:59,724 --> 00:10:02,310 - Yeah. - Yeah, chronic alcoholic. 241 00:10:02,393 --> 00:10:03,895 Go figure. 242 00:10:03,978 --> 00:10:06,481 - Hey, fent OD in South 20 is ready for discharge, 243 00:10:06,564 --> 00:10:08,483 but could you get Lupe to call him a ride? 244 00:10:08,566 --> 00:10:09,859 I need to check on Louie. 245 00:10:09,943 --> 00:10:12,946 - Uh, actually, Whitaker-- - He croaked. 246 00:10:13,029 --> 00:10:14,781 - What? - Five minutes ago. 247 00:10:14,864 --> 00:10:16,324 Robby called it. 248 00:10:26,417 --> 00:10:27,627 - I'm sorry, man. 249 00:10:27,710 --> 00:10:30,463 We didn't have time to find you. 250 00:10:30,547 --> 00:10:32,715 - What happened? 251 00:10:32,799 --> 00:10:35,343 - He was apneic and pulseless. 252 00:10:35,426 --> 00:10:38,012 We started CPR and intubated him. 253 00:10:38,096 --> 00:10:39,722 He had a massive pulmonary hemorrhage. 254 00:10:39,764 --> 00:10:42,517 Robby called it. 255 00:10:42,600 --> 00:10:43,726 - [sighs] 256 00:10:43,768 --> 00:10:45,728 - Found this with his stuff. 257 00:10:45,770 --> 00:10:48,022 Guess he was married at some point. 258 00:10:48,106 --> 00:10:49,858 Never knew that. 259 00:10:53,111 --> 00:10:55,738 Oh, didn't miss this part of the job. 260 00:10:55,822 --> 00:10:57,740 - Yeah. 261 00:10:57,824 --> 00:11:03,246 Perlah, did Louie ever mention anything about a wife and kids? 262 00:11:03,288 --> 00:11:04,873 - Not as far as I know. 263 00:11:04,956 --> 00:11:06,916 He only had eyes for Rita Moreno. 264 00:11:07,000 --> 00:11:10,670 - Well, this is not Rita Moreno. 265 00:11:10,753 --> 00:11:12,505 - No, it's not. 266 00:11:12,589 --> 00:11:16,593 - Can we check to see if there's an emergency contact? 267 00:11:16,676 --> 00:11:19,554 - Yeah, there's a number listed. 268 00:11:26,019 --> 00:11:30,064 - You were his primary. Do you want to... 269 00:11:30,148 --> 00:11:31,816 - No. 270 00:11:33,276 --> 00:11:35,236 [phone beeps] 271 00:11:35,320 --> 00:11:37,947 [phone ringing] 272 00:11:41,326 --> 00:11:43,745 - PTMC charge nurse. 273 00:11:43,828 --> 00:11:47,957 Langdon? Where are you? 274 00:11:47,999 --> 00:11:50,001 Makes sense that we'd be his emergency contact. 275 00:11:50,084 --> 00:11:53,630 Sorry to get your hopes up. 276 00:11:53,671 --> 00:11:55,506 Our social worker's gonna do their thing. 277 00:11:55,590 --> 00:11:59,302 If Louie had any family left, they'll find them. 278 00:11:59,385 --> 00:12:01,262 OK? 279 00:12:01,346 --> 00:12:02,972 - [sighs] 280 00:12:03,056 --> 00:12:05,850 Guess it's good it happened here, not out on the street. 281 00:12:05,934 --> 00:12:07,310 - You're off the hook with Louie. 282 00:12:07,393 --> 00:12:10,104 I'ma teach Emma here how to clean a dead body. 283 00:12:12,190 --> 00:12:13,942 - I'm sorry, but they need me in L&D. 284 00:12:14,025 --> 00:12:15,610 You might want to call for another interpreter. 285 00:12:15,693 --> 00:12:16,986 Busy day. 286 00:12:17,070 --> 00:12:18,488 - Shit, that's the girl in 12? 287 00:12:18,529 --> 00:12:20,156 - Yeah, she's been waiting for five hours. 288 00:12:20,240 --> 00:12:21,908 Didn't hear her name called the first time. 289 00:12:21,991 --> 00:12:23,451 - You check on her? 290 00:12:23,534 --> 00:12:24,827 - Need to brush up on my ASL. 291 00:12:24,869 --> 00:12:26,287 - You know sign language too? 292 00:12:26,371 --> 00:12:27,997 Princess here knows six languages. 293 00:12:28,081 --> 00:12:30,583 - I know French. - OK, it's not a contest. 294 00:12:30,667 --> 00:12:32,502 - [speaking French] - Ah! [speaking French] 295 00:12:32,585 --> 00:12:34,128 - No shit talking in front of me. 296 00:12:34,212 --> 00:12:36,506 I get enough of that from her and Perlah. 297 00:12:36,547 --> 00:12:39,259 Guess I'll call for backup. 298 00:12:39,342 --> 00:12:41,302 Yo, Donnie, did you discharge your butt abscess? 299 00:12:41,386 --> 00:12:43,680 - Not yet! 300 00:12:43,763 --> 00:12:45,181 - What the hell? 301 00:12:45,265 --> 00:12:46,516 - Your good friends upstairs sent doughnuts. 302 00:12:46,557 --> 00:12:47,892 Special thank-you for working the holiday. 303 00:12:47,976 --> 00:12:49,686 - You got to be kidding me. 304 00:12:49,769 --> 00:12:51,521 - What were you expecting, tacos and tequila? 305 00:12:51,604 --> 00:12:53,398 - Every single one of them can forget about extra shifts. 306 00:12:53,481 --> 00:12:55,566 Won't hire more nurses. - Won't pay us a decent wage. 307 00:12:55,650 --> 00:12:57,068 - Won't hire security that can actually 308 00:12:57,151 --> 00:12:58,194 protect us from patients. 309 00:12:58,236 --> 00:12:59,821 But absolutely, send doughnuts. 310 00:12:59,904 --> 00:13:01,322 Sure you want to go into this line of work? 311 00:13:01,406 --> 00:13:03,157 - Want me get you one? 312 00:13:03,241 --> 00:13:04,659 - Of course I do, but I'm not taking admin's blood pastries. 313 00:13:04,742 --> 00:13:07,537 [gasps] Et tu, Donnie? 314 00:13:07,578 --> 00:13:09,497 OK, move it or lose it. 315 00:13:09,580 --> 00:13:11,958 Meet me in South 15 with gowns and gloves. 316 00:13:12,041 --> 00:13:13,668 - Looks like happy hour in here. 317 00:13:13,751 --> 00:13:15,378 - Don't ask. What's up with Evel Knievel? 318 00:13:15,461 --> 00:13:17,839 - Brandon Li, 52, fell off a motorcycle pyramid 319 00:13:17,922 --> 00:13:19,465 at 25 miles per hour. 320 00:13:19,549 --> 00:13:21,384 - Motorcycle pyramid? You recruiting? 321 00:13:21,467 --> 00:13:22,802 Got a fellow rider in your midst. 322 00:13:22,885 --> 00:13:24,053 - No kidding. - How high up were you? 323 00:13:24,137 --> 00:13:25,888 - On top of a three, two, one. 324 00:13:25,930 --> 00:13:27,807 But the bottom guys are sitting down driving the choppers. 325 00:13:27,890 --> 00:13:29,517 I'm fine. I don't need all this. 326 00:13:29,559 --> 00:13:31,227 - Were you wearing a helmet? - Of course. 327 00:13:31,269 --> 00:13:33,521 - Oh, what do you know? They're still in style. 328 00:13:33,563 --> 00:13:36,065 - Good vitals, tender right wrist, and big left knee lac. 329 00:13:36,149 --> 00:13:38,401 - Hey, Joy, Perlah, Trauma Two. 330 00:13:38,484 --> 00:13:39,861 Who else can I have? 331 00:13:39,944 --> 00:13:41,487 - Santos and Whitaker are in with Louie. 332 00:13:41,571 --> 00:13:43,281 - Yeah, give me Whitaker. He could use a distraction. 333 00:13:43,364 --> 00:13:45,033 And Santos has been ducking traumas all day. 334 00:13:45,116 --> 00:13:46,451 - Well, she's behind in her charting. 335 00:13:46,534 --> 00:13:47,827 - Who isn't? 336 00:13:50,955 --> 00:13:54,417 - OK, even when it's not your fault, 337 00:13:54,500 --> 00:13:56,044 sometimes it's worse knowing 338 00:13:56,127 --> 00:13:58,212 that there was nothing you could do. 339 00:13:58,296 --> 00:14:00,590 - [yawning] Uh-huh. 340 00:14:00,631 --> 00:14:02,383 - Are you-- 341 00:14:02,467 --> 00:14:03,801 - Robby needs you both in Trauma Two, 342 00:14:03,885 --> 00:14:05,595 and I need you to discharge sweet Patty in 13 343 00:14:05,678 --> 00:14:06,971 as soon as you're done. 344 00:14:07,055 --> 00:14:08,473 - Can't catch a break. 345 00:14:08,556 --> 00:14:10,475 - I push you 'cause I know you can take it. 346 00:14:13,186 --> 00:14:14,520 [sighs] 347 00:14:14,604 --> 00:14:16,230 [whispers indistinctly] 348 00:14:22,820 --> 00:14:25,865 You ever clean a dead body? 349 00:14:25,948 --> 00:14:29,619 Probably never seen one either. 350 00:14:29,660 --> 00:14:32,580 No one tells you what it looks, feels, or smells like, 351 00:14:32,663 --> 00:14:36,793 but you get used to it over time. 352 00:14:36,834 --> 00:14:39,921 You pull off the gown. You wipe him down with towels. 353 00:14:40,004 --> 00:14:42,131 Then we'll roll him on his side, 354 00:14:42,215 --> 00:14:45,468 clean his back, stuff the sheet under him, 355 00:14:45,510 --> 00:14:48,012 wipe down the bed, roll him the other way, 356 00:14:48,096 --> 00:14:49,764 pull out the sheet, and repeat. 357 00:14:49,847 --> 00:14:52,433 Just follow my lead. 358 00:14:52,517 --> 00:14:56,437 Usually, you leave the ET tube in for the coroner, 359 00:14:56,479 --> 00:15:00,316 but Louie's a chronic alcoholic with end-stage liver disease. 360 00:15:00,358 --> 00:15:04,153 Not a coroner's case. 361 00:15:04,237 --> 00:15:07,490 - Did he have family? - Everyone has family. 362 00:15:07,532 --> 00:15:10,618 The social worker always tries to find them. 363 00:15:10,701 --> 00:15:12,995 Sometimes the family loved them, 364 00:15:13,037 --> 00:15:14,622 tried to get them to come home. 365 00:15:14,664 --> 00:15:17,291 Other times, the family wants nothing to do with them. 366 00:15:17,375 --> 00:15:21,129 - That's sad. - That's life. 367 00:15:21,212 --> 00:15:22,839 - What happens if no one claims his body? 368 00:15:22,922 --> 00:15:24,507 - He'll be cremated. 369 00:15:24,549 --> 00:15:26,008 - Where would his ashes go? 370 00:15:26,092 --> 00:15:27,468 - They'll keep him for a few months. 371 00:15:27,552 --> 00:15:28,845 Then he gets buried in a mass grave 372 00:15:28,928 --> 00:15:32,849 with all the other unclaimed bodies. 373 00:15:32,890 --> 00:15:35,810 OK, now we roll him. 374 00:15:38,855 --> 00:15:40,606 Ready. 375 00:15:40,690 --> 00:15:42,191 Go. - [wheezes] 376 00:15:42,275 --> 00:15:43,609 - Oh, my God, is he still alive? 377 00:15:43,693 --> 00:15:45,361 - No, that happens. 378 00:15:45,403 --> 00:15:48,197 [sighs] These frequent fliers. 379 00:15:48,239 --> 00:15:51,993 They can be a real pain in the ass, but... 380 00:15:52,076 --> 00:15:55,163 you miss them when they're gone. 381 00:16:01,836 --> 00:16:03,921 - I've been at every Millvale Fourth of July parade 382 00:16:04,005 --> 00:16:05,423 since '08. 383 00:16:05,506 --> 00:16:07,884 World record is 40 men on seven motorcycles. 384 00:16:07,925 --> 00:16:09,427 I plan to beat that someday. 385 00:16:09,510 --> 00:16:11,429 - Good lung sliding bilaterally. 386 00:16:11,512 --> 00:16:13,055 - Pupils equal and reactive. 387 00:16:13,097 --> 00:16:14,891 - What do you ride? - The Bullet. 388 00:16:14,932 --> 00:16:16,726 - Oh, Royal Enfield. Ankle breaker. 389 00:16:16,809 --> 00:16:19,061 Thumper. - BP 138 over 80. 390 00:16:19,145 --> 00:16:21,230 Pulse 94. Pulse ox 98. 391 00:16:21,314 --> 00:16:23,524 - All your vitals sound really good, Brandon. 392 00:16:23,608 --> 00:16:25,151 They call it an ankle breaker 'cause 393 00:16:25,234 --> 00:16:26,819 you got to kick over a big, fat single cylinder 394 00:16:26,903 --> 00:16:29,071 to get it started, sometimes five or six kicks. 395 00:16:29,113 --> 00:16:31,240 - Yeah, especially on a cold day. 396 00:16:31,324 --> 00:16:33,576 - Um, does anyone have any trauma scissors? 397 00:16:33,618 --> 00:16:35,411 I'll check the knee. - Uh, not yet. 398 00:16:35,495 --> 00:16:37,246 - Why not? - Dr. Santos. 399 00:16:37,330 --> 00:16:39,749 - Primary survey means rule out the life threats. 400 00:16:39,790 --> 00:16:41,834 Don't get distracted by lacerations or fractures. 401 00:16:41,918 --> 00:16:43,586 No free fluid in the belly. 402 00:16:43,628 --> 00:16:46,047 - Airway, breathing, circulation are fine. 403 00:16:46,130 --> 00:16:48,257 - OK, that's ABC. That just leaves two letters. 404 00:16:48,341 --> 00:16:50,468 Tell her about D, Dr. Santos. 405 00:16:50,551 --> 00:16:52,470 - Disability. Wiggle your toes, sir. 406 00:16:52,553 --> 00:16:54,722 - Any pain in your arms or legs? 407 00:16:54,805 --> 00:16:56,265 - Not really. 408 00:16:56,349 --> 00:16:57,600 - Does it hurt when I push here? 409 00:16:57,642 --> 00:16:59,477 - No. - OK, no midline tenderness. 410 00:16:59,560 --> 00:17:01,145 Nexus negative. 411 00:17:01,229 --> 00:17:03,314 - With no obvious brain injury or spinal cord injury. 412 00:17:03,397 --> 00:17:06,483 - That just leaves E. Joy. 413 00:17:06,567 --> 00:17:08,277 - Can I buy another vowel? 414 00:17:08,319 --> 00:17:10,445 - Dr. Whitaker. - Exposure. 415 00:17:10,530 --> 00:17:11,948 - AKA strip and flip. 416 00:17:12,031 --> 00:17:14,116 Cut off his clothes, and we'll log roll him. 417 00:17:14,157 --> 00:17:16,117 - What do we have? 418 00:17:16,202 --> 00:17:18,079 - Helmeted motorcycle acrobat. 419 00:17:18,119 --> 00:17:20,623 8-foot fall standing on top of five riders. 420 00:17:20,705 --> 00:17:22,290 Primary survey normal, E-FAST negative. 421 00:17:22,375 --> 00:17:24,252 - Another motorcycle accident. 422 00:17:24,292 --> 00:17:26,462 Hello, sir. I'm Dr. Garcia from surgery. 423 00:17:26,503 --> 00:17:27,922 - Hello. 424 00:17:28,005 --> 00:17:33,177 - OK, we will roll him in three, two, one. 425 00:17:37,181 --> 00:17:39,559 - Well, I grew up a block from Carrick, 426 00:17:39,642 --> 00:17:42,478 but my mom was a teacher at Brashear, so I had to go there. 427 00:17:42,520 --> 00:17:44,981 - The Bullets? - That's right. 428 00:17:45,022 --> 00:17:46,315 They were the Bullets when I was there. 429 00:17:46,399 --> 00:17:48,150 They changed to the Bulls when I left. 430 00:17:48,192 --> 00:17:49,652 - Oh. 431 00:17:49,694 --> 00:17:54,115 Hey, you think I could get something to eat? 432 00:17:54,198 --> 00:17:56,701 - Gus here is wondering if he's clear to eat. 433 00:17:56,784 --> 00:17:58,661 - As long as it's a liquid diet. 434 00:17:58,744 --> 00:18:01,539 We have the results of your CT scan. 435 00:18:01,622 --> 00:18:04,500 - Your jaw should heal without surgery, which is good news, 436 00:18:04,542 --> 00:18:07,044 but it will be a few weeks. 437 00:18:07,128 --> 00:18:08,546 - Before I can eat? 438 00:18:08,629 --> 00:18:10,339 - Solid foods, yes. 439 00:18:10,423 --> 00:18:14,176 Or you can have food pureed with liquid in a blender. 440 00:18:14,218 --> 00:18:16,846 - I don't have a blender. 441 00:18:16,887 --> 00:18:18,222 - Right. 442 00:18:18,306 --> 00:18:20,182 Sorry. 443 00:18:20,224 --> 00:18:23,519 - We have a calorie-rich supplement drink called Ensure. 444 00:18:23,603 --> 00:18:26,981 Comes in chocolate, vanilla, or strawberry. 445 00:18:27,064 --> 00:18:28,858 - Chocolate, please. 446 00:18:28,899 --> 00:18:30,526 - Good choice. - How many can I have? 447 00:18:30,568 --> 00:18:32,028 - Two a day is recommended. 448 00:18:32,069 --> 00:18:34,113 - I'll get it for you. 449 00:18:34,196 --> 00:18:37,533 - You have an appetite. That's good. 450 00:18:37,575 --> 00:18:39,660 - Mr. Varney, your blood tests indicate 451 00:18:39,744 --> 00:18:42,204 low levels of protein and vitamins. 452 00:18:42,288 --> 00:18:46,208 Can we ask you a few questions about your diet? 453 00:18:46,250 --> 00:18:49,503 How many meals or snacks do you have in a 24-hour period? 454 00:18:49,587 --> 00:18:50,880 - I don't know. 455 00:18:50,921 --> 00:18:52,840 Don't count. 456 00:18:52,923 --> 00:18:55,426 - Pretty sure it's three trays a day. 457 00:18:55,509 --> 00:18:57,094 - OK. 458 00:18:57,178 --> 00:19:00,348 How often do you eat cereals, fruits, or vegetables? 459 00:19:00,389 --> 00:19:03,559 - Not many fruits and vegetables in prison. 460 00:19:03,643 --> 00:19:05,311 - Slow and steady. 461 00:19:07,313 --> 00:19:09,398 - What year is your Bonneville? 462 00:19:09,440 --> 00:19:10,691 - '69. 463 00:19:10,775 --> 00:19:13,069 Rescued it from a motor graveyard. 464 00:19:13,110 --> 00:19:14,570 Brought it back to life with a buddy of mine, 465 00:19:14,654 --> 00:19:16,364 who's supposed to be coming in today. 466 00:19:16,447 --> 00:19:17,782 - How often do you ride? 467 00:19:17,865 --> 00:19:19,617 - I ride it in to work every day. 468 00:19:19,700 --> 00:19:20,868 - Good for you. 469 00:19:20,951 --> 00:19:22,536 - Don't encourage him. 470 00:19:22,620 --> 00:19:24,246 CT's ready for Brandon. 471 00:19:24,330 --> 00:19:28,250 - As soon as we take a look at this knee. 472 00:19:28,334 --> 00:19:30,586 - Whoa. - Through the deep fascia. 473 00:19:30,670 --> 00:19:31,879 - How's it look? 474 00:19:31,962 --> 00:19:32,922 - Definitely gonna need stitches. 475 00:19:32,963 --> 00:19:34,256 - How many? - A lot. 476 00:19:34,298 --> 00:19:35,758 - It could be an open joint. 477 00:19:35,841 --> 00:19:37,677 - We'll do a saline load after CT. 478 00:19:37,760 --> 00:19:39,220 - OK. 479 00:19:39,303 --> 00:19:41,097 - Lever sign negative. ACL intact. 480 00:19:41,180 --> 00:19:42,556 - OK, ready to roll. 481 00:19:47,603 --> 00:19:49,355 - Are you still coming over tonight? 482 00:19:49,438 --> 00:19:51,107 I think Whitaker is gonna be playing 483 00:19:51,190 --> 00:19:53,192 farm boy again this weekend, so he's not gonna be around. 484 00:19:53,275 --> 00:19:54,902 - I may need a rain check. 485 00:19:54,944 --> 00:19:56,570 - Hey, do you have an update on that nec fasc patient? 486 00:19:56,654 --> 00:19:57,988 - Last I heard, Miller was doing 487 00:19:58,072 --> 00:20:00,241 an above-the-knee amputation with ortho. 488 00:20:02,201 --> 00:20:04,578 - Langdon's waitress with the cellulitis? 489 00:20:04,662 --> 00:20:05,913 - Yeah. 490 00:20:05,955 --> 00:20:08,499 - Man, that took a turn. - Sure did. 491 00:20:08,582 --> 00:20:12,461 Hey, did you hear about Louie? 492 00:20:12,503 --> 00:20:14,964 - Yeah. - You OK? 493 00:20:15,005 --> 00:20:16,465 - Um, 494 00:20:16,507 --> 00:20:19,969 one of my uncles drank himself to death. 495 00:20:20,052 --> 00:20:22,847 I barely recognized him at the end. 496 00:20:22,930 --> 00:20:26,142 At least Louie always seemed happy. 497 00:20:26,225 --> 00:20:27,893 - I'm here if you want to talk. 498 00:20:33,482 --> 00:20:36,318 - Should've known I'd find you in here. 499 00:20:36,360 --> 00:20:40,156 You steal anyone's lunch, it's a $20 fine. 500 00:20:40,197 --> 00:20:41,824 Made a lot of changes while you were gone. 501 00:20:41,866 --> 00:20:43,451 - I can see that. 502 00:20:43,534 --> 00:20:44,910 - Look, I'll let you hide out a little bit longer, 503 00:20:44,994 --> 00:20:46,579 but then I need you to pick up more patients. 504 00:20:46,662 --> 00:20:48,164 You're not as fast as you used to be. 505 00:20:48,205 --> 00:20:50,291 Damn doughnuts! 506 00:20:50,374 --> 00:20:52,626 - Ouch. 507 00:20:52,710 --> 00:20:55,588 First day back, I get kicked in the nuts. 508 00:20:55,671 --> 00:20:57,757 One dead, one septic bounce-back. 509 00:20:57,840 --> 00:21:00,134 - Both of those not your fault. 510 00:21:02,720 --> 00:21:04,346 You expecting a party? 511 00:21:04,430 --> 00:21:06,056 - No, not really. 512 00:21:06,140 --> 00:21:08,601 Didn't hear from anyone while I was gone. 513 00:21:11,061 --> 00:21:12,813 - Sorry. 514 00:21:12,855 --> 00:21:16,484 - They ever, uh, arrest that guy who punched you? 515 00:21:16,525 --> 00:21:18,319 - Yeah. 516 00:21:18,360 --> 00:21:20,196 Wanted to know if I wanted to press charges, 517 00:21:20,279 --> 00:21:23,532 but didn't want to go through all that. 518 00:21:23,616 --> 00:21:26,160 Thought I was done, really did, but... 519 00:21:26,243 --> 00:21:29,830 I got bored at home, so only lasted a few weeks. 520 00:21:29,914 --> 00:21:31,624 You? 521 00:21:31,707 --> 00:21:34,335 - 10 months is a long time to be alone with your thoughts. 522 00:21:34,418 --> 00:21:36,879 I almost lost everything. 523 00:21:36,962 --> 00:21:39,048 I know a lot of women who would have taken the kids and left, 524 00:21:39,131 --> 00:21:42,343 but Abby stayed. - 'Cause she's a good woman. 525 00:21:42,426 --> 00:21:44,178 'Cause you deserve a second chance. 526 00:21:44,261 --> 00:21:45,805 - I'm not sure everyone agrees with you. 527 00:21:45,888 --> 00:21:47,223 - [sighs] Give it time. 528 00:21:47,306 --> 00:21:49,433 - Look, I-- 529 00:21:53,562 --> 00:21:56,065 I, um-- 530 00:21:56,106 --> 00:21:59,902 I've been working the 12 steps, trying to make amends. 531 00:21:59,985 --> 00:22:01,695 I was really selfish. 532 00:22:01,779 --> 00:22:03,572 I lied to myself, and I lied to you. 533 00:22:03,614 --> 00:22:04,907 I'm really sorry. 534 00:22:04,990 --> 00:22:06,367 - You can check me off your list, kid. 535 00:22:06,450 --> 00:22:08,244 We're good. 536 00:22:08,327 --> 00:22:10,412 - OK. - Yeah. 537 00:22:10,496 --> 00:22:12,081 Got a lovely patient for you in Two. 538 00:22:12,164 --> 00:22:14,124 Let's get you back on the horse. 539 00:22:17,127 --> 00:22:18,587 - Really need to talk with Robby. 540 00:22:18,629 --> 00:22:19,964 - I don't know if today's the best day for that. 541 00:22:20,047 --> 00:22:21,257 He leaves on vacation tomorrow. 542 00:22:21,340 --> 00:22:22,758 Let him get through the day in peace. 543 00:22:22,842 --> 00:22:24,260 - He's supposed to be gone for three months? 544 00:22:24,343 --> 00:22:26,262 - So he says. I give him one. 545 00:22:26,345 --> 00:22:27,763 Go get 'em, kid. 546 00:22:29,974 --> 00:22:33,269 - [chuckles] Dr. Langdon, this is Rocky. 547 00:22:33,310 --> 00:22:34,603 - Great name. 548 00:22:34,687 --> 00:22:38,274 What brings you in, Rocky? 549 00:22:38,315 --> 00:22:39,942 - Very sick. 550 00:22:40,025 --> 00:22:42,236 - When did it start? 551 00:22:42,319 --> 00:22:43,779 - An hour ago. 552 00:22:43,863 --> 00:22:46,448 - After he won a hot dog eating contest. 553 00:22:46,490 --> 00:22:48,993 - A hot dog eating contest? How many you eat? 554 00:22:51,829 --> 00:22:53,914 351 hot dogs? 555 00:22:58,043 --> 00:22:59,461 36. 556 00:22:59,545 --> 00:23:01,964 Still a lot. 557 00:23:02,047 --> 00:23:03,966 - I pulled eight of Zofran. - Go for it. 558 00:23:04,049 --> 00:23:05,426 - All right, this should help. 559 00:23:05,467 --> 00:23:07,094 Stick it under your tongue. Let it dissolve. 560 00:23:07,177 --> 00:23:08,304 - OK, are you taking any prescription-- 561 00:23:08,345 --> 00:23:10,180 - [retches] 562 00:23:13,726 --> 00:23:16,020 Oh, thank you. [exhales heavily] 563 00:23:16,103 --> 00:23:18,606 - Thanks. 564 00:23:18,689 --> 00:23:20,858 Santos, what's up with your ileus patient? 565 00:23:20,941 --> 00:23:22,860 - Admitted to medicine, and before you ask, 566 00:23:22,943 --> 00:23:24,653 13 has been discharged. 567 00:23:24,695 --> 00:23:26,947 - Great. 12 needs a doctor. 568 00:23:27,031 --> 00:23:28,824 - No, don't make me go back there. 569 00:23:28,866 --> 00:23:31,994 That disimpaction left a smell and stunk up the whole hallway. 570 00:23:32,036 --> 00:23:33,996 - So grab some coffee grounds from the lounge. 571 00:23:34,079 --> 00:23:36,665 - We need to admit our incarcerated patient, Gus. 572 00:23:36,707 --> 00:23:38,500 - What did the CT show? 573 00:23:38,584 --> 00:23:41,003 - Moderate pulmonary contusion, three rib fractures, 574 00:23:41,045 --> 00:23:43,797 no intra-abdominal bleeding, and oblique fracture 575 00:23:43,839 --> 00:23:46,425 in the body of the mandible anterior to the angle. 576 00:23:46,508 --> 00:23:48,636 - All favorable for healing. What's the treatment plan? 577 00:23:48,719 --> 00:23:50,471 - A pain med-- - Security. 578 00:23:50,554 --> 00:23:51,847 - People are trying to sleep. 579 00:23:51,931 --> 00:23:55,351 - Pain medication, antibiotics, liquid diet, 580 00:23:55,434 --> 00:23:57,353 um, a pulse ox a few times a day, 581 00:23:57,394 --> 00:24:00,189 and then also dressing changes for the laceration. 582 00:24:00,230 --> 00:24:02,691 - Which he can get at his correctional facility. 583 00:24:02,733 --> 00:24:04,944 - Or he stays here for a few days, 584 00:24:05,027 --> 00:24:07,863 and we get him on the right track to healing. 585 00:24:07,905 --> 00:24:09,907 - Why don't you two go check on your patients? 586 00:24:09,990 --> 00:24:12,660 - Got it. - Sure thing. 587 00:24:12,743 --> 00:24:14,495 - What am I missing? 588 00:24:14,578 --> 00:24:15,871 - He's not getting enough to eat 589 00:24:15,955 --> 00:24:17,373 at his correctional facility. 590 00:24:17,456 --> 00:24:18,999 The portions are tiny. 591 00:24:19,041 --> 00:24:20,918 Too many carbs, not enough fruits or vegetables. 592 00:24:21,001 --> 00:24:24,380 He's lucky he hasn't developed a chronic illness. 593 00:24:24,463 --> 00:24:26,215 - We don't have any inpatient beds. 594 00:24:26,256 --> 00:24:27,716 He would board down here for three days. 595 00:24:27,800 --> 00:24:29,259 We're still getting runs from Westbridge, 596 00:24:29,343 --> 00:24:31,595 and we cannot tie up Behavioral for that long. 597 00:24:31,679 --> 00:24:33,430 - Dr. Al-Hashimi, Dr. Jefferson wants to talk 598 00:24:33,514 --> 00:24:35,224 to you about our tasered kid. 599 00:24:39,103 --> 00:24:40,521 - Why don't I call the prison doctor 600 00:24:40,604 --> 00:24:42,231 and find out what they're working with over there? 601 00:24:42,272 --> 00:24:44,108 - Thank you. - My pleasure. 602 00:24:46,151 --> 00:24:48,487 - Dr. Jefferson seems to have a good rapport with Jackson. 603 00:24:48,570 --> 00:24:49,863 - That's excellent. 604 00:24:49,947 --> 00:24:51,198 How's the sister doing? 605 00:24:51,281 --> 00:24:52,574 - Still pretty upset. 606 00:24:52,616 --> 00:24:54,076 She's never seen him like this. 607 00:24:54,118 --> 00:24:55,703 - It's a lot to process. 608 00:24:55,786 --> 00:24:57,913 How's he doing? - He's scared. 609 00:24:57,997 --> 00:24:59,498 Droperidol had a positive effect, 610 00:24:59,581 --> 00:25:01,875 but he doesn't understand what's going on. 611 00:25:01,959 --> 00:25:03,919 He's been experiencing auditory hallucinations 612 00:25:03,961 --> 00:25:05,504 and paranoid delusions. 613 00:25:05,587 --> 00:25:08,716 Voices are telling him he isn't safe. 614 00:25:08,799 --> 00:25:09,967 - This has been going on for months. 615 00:25:10,050 --> 00:25:11,593 - Months? - Yeah. 616 00:25:11,677 --> 00:25:13,220 Turns out, his sister hasn't seen him in a while. 617 00:25:13,303 --> 00:25:15,264 - Family history of mental illness? 618 00:25:15,305 --> 00:25:17,433 - Not that we know of. 619 00:25:17,516 --> 00:25:21,270 I'm gonna give him a break and then continue the conversation. 620 00:25:21,353 --> 00:25:22,646 - Parents are on their way. 621 00:25:22,730 --> 00:25:23,647 We'll let you know when they get here. 622 00:25:23,731 --> 00:25:25,107 - Yes. Do. 623 00:25:25,190 --> 00:25:26,942 - OK, hospital bed, wheelchair, 624 00:25:27,026 --> 00:25:29,945 and shower chair have all been ordered. 625 00:25:30,029 --> 00:25:31,655 - What do you say, kid? 626 00:25:31,739 --> 00:25:33,699 Ready to go home? 627 00:25:35,993 --> 00:25:38,787 - How's your pain, Mrs. Hamler? 628 00:25:38,871 --> 00:25:40,289 - The same. 629 00:25:40,372 --> 00:25:42,624 - We're gonna write you a script for Keppra. 630 00:25:42,708 --> 00:25:43,959 You'll take that to prevent seizures 631 00:25:44,043 --> 00:25:45,794 once a day, starting tomorrow. 632 00:25:45,878 --> 00:25:47,796 - Between your broken leg and the bruises from your seizure, 633 00:25:47,838 --> 00:25:49,798 the pain will probably get a little worse. 634 00:25:49,882 --> 00:25:51,091 - Yeah, the most important thing is 635 00:25:51,175 --> 00:25:52,301 to let others help you. 636 00:25:52,342 --> 00:25:53,886 You'll need assistance showering 637 00:25:53,969 --> 00:25:55,387 and getting to the bathroom. 638 00:25:55,471 --> 00:25:57,306 - Yeah, no problem. I won't leave her side. 639 00:25:57,347 --> 00:25:59,641 - Paul, you need a break. 640 00:25:59,725 --> 00:26:04,146 You're--you're taking care of me, the kids, the house. 641 00:26:04,188 --> 00:26:07,399 It's too much for one person. 642 00:26:07,483 --> 00:26:09,651 - I'm not the one battling cancer. 643 00:26:09,735 --> 00:26:10,986 - Paul. 644 00:26:11,028 --> 00:26:14,448 - Hey, you're in pain every day, 645 00:26:14,531 --> 00:26:16,158 fighting for your life. 646 00:26:16,200 --> 00:26:18,827 I'm happy to do this for you. 647 00:26:18,869 --> 00:26:21,330 You're my wife. 648 00:26:21,413 --> 00:26:24,500 Now, let's go home and forget this day ever happened. 649 00:26:24,541 --> 00:26:25,959 - I'll call the transpo ambulance. 650 00:26:26,043 --> 00:26:27,336 - Thanks, Princess. 651 00:26:33,884 --> 00:26:35,344 - Hey. 652 00:26:35,427 --> 00:26:36,845 - Hmm? 653 00:26:36,887 --> 00:26:39,014 - Why don't you go ahead? 654 00:26:39,056 --> 00:26:40,057 - What? - Yeah. 655 00:26:40,140 --> 00:26:41,350 You can get the house ready. 656 00:26:41,433 --> 00:26:43,519 I'll be right behind you. 657 00:26:43,602 --> 00:26:45,187 - No. - Mm-hmm. 658 00:26:45,270 --> 00:26:49,358 - No, I'm--I'm riding in the back with you. 659 00:26:49,399 --> 00:26:52,319 - You know what? I'll stay with her. 660 00:26:53,862 --> 00:26:55,531 - Are you sure? 661 00:26:55,614 --> 00:26:57,825 - Mm-hmm. - Yeah. 662 00:26:57,908 --> 00:27:01,036 - OK. 663 00:27:01,078 --> 00:27:03,997 Um, call me if you need me to come back. 664 00:27:04,081 --> 00:27:05,833 - Mm-hmm. 665 00:27:05,916 --> 00:27:06,917 - [smooches] 666 00:27:11,088 --> 00:27:12,464 - When will the ambulance get here? 667 00:27:12,548 --> 00:27:13,549 - It shouldn't be long. 668 00:27:13,590 --> 00:27:15,592 - Mr. Francis, short of breath? 669 00:27:15,676 --> 00:27:17,052 - Yeah, I was worried the clot in my leg 670 00:27:17,136 --> 00:27:19,096 could have gone up to my lungs, so... 671 00:27:19,179 --> 00:27:20,931 - You're on Eliquis. That shouldn't happen. 672 00:27:21,014 --> 00:27:22,766 - Yeah, I know, but-- - Hey, Donnie, I got this. 673 00:27:22,850 --> 00:27:24,268 Don't worry, Mr. Francis. 674 00:27:24,351 --> 00:27:25,936 I'll order the D-dimer. I'll be back to see you. 675 00:27:26,019 --> 00:27:28,564 - Thank you, Dr. Mohan. 676 00:27:28,605 --> 00:27:30,566 - You know I'm an NP now. 677 00:27:30,607 --> 00:27:32,067 I can pick up a patient with dyspnea. 678 00:27:32,109 --> 00:27:33,569 - I'm sorry. 679 00:27:33,610 --> 00:27:35,946 I've seen him before, and he's asked for me. 680 00:27:36,029 --> 00:27:38,073 - Why even order the test? He's on Eliquis. 681 00:27:38,157 --> 00:27:39,408 - Mr. Francis comes in every month 682 00:27:39,491 --> 00:27:41,410 and always asks for a D-dimer. 683 00:27:41,493 --> 00:27:43,912 Just--he's worried, and it puts his mind at ease. 684 00:27:43,954 --> 00:27:46,540 Why not? - Yeah, OK. 685 00:27:46,623 --> 00:27:49,376 - Donnie's the best. You'll learn a lot from him. 686 00:27:49,459 --> 00:27:51,461 - That's right. 687 00:28:18,071 --> 00:28:20,115 - All right, fill me in. 688 00:28:20,199 --> 00:28:22,826 - This is Harlow Graham. She was seen in triage. 689 00:28:22,910 --> 00:28:25,245 CBC and CMP came back normal. 690 00:28:25,329 --> 00:28:27,748 IT was supposed to bring the VRI down, but they're slammed. 691 00:28:27,831 --> 00:28:29,458 I know a bit of sign language. 692 00:28:29,499 --> 00:28:34,963 Harlow, this is Dr. Santos. 693 00:28:35,005 --> 00:28:36,715 - Hi, Harlow. How are you feeling? 694 00:28:39,551 --> 00:28:40,802 - She has a headache. 695 00:28:40,886 --> 00:28:42,721 - OK. What else? 696 00:28:48,185 --> 00:28:49,770 What is she saying? 697 00:28:49,853 --> 00:28:51,897 - I think she had a stomachache, 698 00:28:51,980 --> 00:28:54,775 and she might have passed out. 699 00:28:57,861 --> 00:28:59,571 I'm not 100% sure. 700 00:28:59,655 --> 00:29:02,157 - OK, we're just gonna need to wait for an interpreter, 701 00:29:02,199 --> 00:29:03,825 'cause I need to ask a million questions, 702 00:29:03,867 --> 00:29:05,452 and I can't do it this way. 703 00:29:05,535 --> 00:29:07,621 So just call me when IT comes down. 704 00:29:18,924 --> 00:29:21,802 - CT head, neck, chest, abdomen, pelvis all negative. 705 00:29:21,885 --> 00:29:24,846 - It means we can get this collar off. 706 00:29:24,930 --> 00:29:27,015 - Thank you. 707 00:29:27,057 --> 00:29:28,392 - Roll to your side. 708 00:29:28,475 --> 00:29:30,686 We'll get you off this board. 709 00:29:30,727 --> 00:29:32,229 - How long is your trip? 710 00:29:32,312 --> 00:29:35,148 - 2,000 miles, all the way from here to Alberta. 711 00:29:35,232 --> 00:29:36,817 Couple stops along the way. 712 00:29:36,900 --> 00:29:38,360 Got the whole thing mapped out. 713 00:29:38,402 --> 00:29:40,529 - Sounds like heaven. - Let's sit you up. 714 00:29:40,612 --> 00:29:42,239 - Sorry, I got stuck with a patient. 715 00:29:42,322 --> 00:29:44,366 - You know the old saying, four wheels move the body, 716 00:29:44,408 --> 00:29:45,909 two wheels move the soul. 717 00:29:45,993 --> 00:29:47,411 You're gonna be living the dream. 718 00:29:47,494 --> 00:29:48,870 - Thank you, Brandon. 719 00:29:48,912 --> 00:29:50,372 Not everybody down here feels that way. 720 00:29:50,455 --> 00:29:52,708 OK, Whitaker, what's next? - Ortho assessment. 721 00:29:52,749 --> 00:29:55,877 Palpate all long bones, starting with the clavicle. 722 00:29:55,961 --> 00:29:57,212 - Got it. 723 00:29:57,254 --> 00:29:59,798 - I'll take the lower extremities. 724 00:30:02,926 --> 00:30:04,303 - [inhales sharply] 725 00:30:04,386 --> 00:30:05,554 - Distal radius tender. No deformities. 726 00:30:05,595 --> 00:30:06,722 Needs an X-ray. 727 00:30:06,805 --> 00:30:08,140 - No bony tenderness down here. 728 00:30:08,223 --> 00:30:09,558 No laxity of the knee. 729 00:30:09,599 --> 00:30:12,227 - Are you concerned about that knee lac? 730 00:30:12,311 --> 00:30:14,396 - If it's an open joint, he'll need a washout in the OR. 731 00:30:14,479 --> 00:30:16,398 - We could try a fluorescein injection. 732 00:30:16,440 --> 00:30:17,899 OK, we'll need a-- 733 00:30:17,941 --> 00:30:19,568 - Wood's lamp, 1% lido with epi, 734 00:30:19,609 --> 00:30:21,945 sterile saline, sterile basin, sterile fluoro-strip, 735 00:30:22,029 --> 00:30:26,074 18- and 27-gauge needles, 5- and 60-cc syringes. 736 00:30:26,158 --> 00:30:28,577 - How does she know all that? 737 00:30:28,618 --> 00:30:31,288 - She just does. 738 00:30:31,371 --> 00:30:32,706 - How are you feeling, Rocky? 739 00:30:32,789 --> 00:30:34,458 - Oh, much better. 740 00:30:34,541 --> 00:30:36,251 - He's had eight migs of ondansetron. 741 00:30:36,293 --> 00:30:37,711 - Any pain in the belly? 742 00:30:37,794 --> 00:30:39,963 - No, but my mouth is really dry. 743 00:30:40,047 --> 00:30:43,091 - No doubt from consuming mass quantities of salty hot dogs. 744 00:30:43,175 --> 00:30:44,968 - [chuckles] Could I have another sip of water? 745 00:30:45,052 --> 00:30:46,595 - Sure. A little sip. 746 00:30:46,636 --> 00:30:48,597 Take it slow. 747 00:30:48,680 --> 00:30:50,098 - Here you go. - Thank you. 748 00:30:50,182 --> 00:30:53,852 - Just enough to wet your whistle. 749 00:30:53,935 --> 00:30:56,605 So how'd you get your start as a competitive eater? 750 00:30:56,688 --> 00:30:57,981 - [retches] 751 00:31:01,526 --> 00:31:03,236 [retches] 752 00:31:05,489 --> 00:31:07,866 - Any pain here, Mr. Li? 753 00:31:07,949 --> 00:31:09,534 - Can't feel a thing. - Great. 754 00:31:09,618 --> 00:31:10,869 - Where is Santos? 755 00:31:10,952 --> 00:31:13,538 - Probably catching up on her charting. 756 00:31:13,622 --> 00:31:14,956 - Right. - Lights out. 757 00:31:14,998 --> 00:31:16,875 Wood's lamp on. 758 00:31:18,710 --> 00:31:20,545 OK. 759 00:31:22,172 --> 00:31:23,965 - I might want to use some of that on Halloween. 760 00:31:24,049 --> 00:31:26,802 - That is 250 ccs of sterile saline 761 00:31:26,885 --> 00:31:29,638 with one small touch of a sterile fluoro-strip. 762 00:31:29,679 --> 00:31:31,348 - OK. 763 00:31:31,431 --> 00:31:34,142 We're going to inject this fluid into your knee, Brandon, 764 00:31:34,226 --> 00:31:37,813 and if there's anything glowing in your wound, 765 00:31:37,854 --> 00:31:39,773 we know we have a leak. 766 00:31:39,856 --> 00:31:42,275 - Feeling some pressure. - Yeah, it's normal. 767 00:31:42,359 --> 00:31:45,153 As soon as I finish the test, I'll pull off the fluid. 768 00:31:45,237 --> 00:31:47,447 [monitor beeping] 769 00:31:47,531 --> 00:31:49,032 - That looks good. 770 00:31:49,116 --> 00:31:51,118 Laceration did not enter into the joint space. 771 00:31:51,201 --> 00:31:52,661 - Surgery not needed. 772 00:31:52,702 --> 00:31:54,329 - Excellent. I can get back to the parade. 773 00:31:54,371 --> 00:31:55,747 - No, we'll still need to 774 00:31:55,831 --> 00:31:57,165 stitch you up and splint your wrist. 775 00:31:57,207 --> 00:31:58,500 - Hanging a gram of Ancef. 776 00:31:58,542 --> 00:32:00,293 - Wait, he has a penicillin allergy. 777 00:32:00,377 --> 00:32:02,921 - No, PEN-FAST was negative. We're OK. 778 00:32:03,004 --> 00:32:05,674 - My mom said I got a rash with amoxicillin when I was two. 779 00:32:05,757 --> 00:32:07,634 - Yeah, probably not a true allergy. 780 00:32:07,717 --> 00:32:09,177 Go ahead and give it, Kim. 781 00:32:09,261 --> 00:32:11,179 - But have epi and Benadryl standing by, right? 782 00:32:11,263 --> 00:32:13,181 - Yes, to be on the safe side. 783 00:32:13,265 --> 00:32:15,475 - Most people who think they have a penicillin allergy 784 00:32:15,559 --> 00:32:17,436 actually don't. 785 00:32:17,519 --> 00:32:20,021 - Always listen to the nurses. They run the ER. 786 00:32:20,063 --> 00:32:22,107 We just try and stay out of their way. 787 00:32:28,989 --> 00:32:30,991 - Now we can really clean him up. 788 00:32:31,074 --> 00:32:32,659 - Didn't we already do that? 789 00:32:32,742 --> 00:32:34,870 - Dried blood on the face, neck, hands. 790 00:32:34,911 --> 00:32:37,747 If anyone comes, they shouldn't have to see that. 791 00:32:37,831 --> 00:32:39,875 Sometimes the local unhoused folks will pay a visit, 792 00:32:39,958 --> 00:32:41,543 but we always make them presentable 793 00:32:41,585 --> 00:32:44,045 in case anyone comes. 794 00:32:44,087 --> 00:32:47,174 That's the last thing we can do for them. 795 00:32:47,257 --> 00:32:50,844 Didn't get to do that during COVID. 796 00:32:50,927 --> 00:32:53,221 Once he's spotless, we'll tuck him in nice and tight, 797 00:32:53,263 --> 00:32:55,515 but we always leave one arm outside the sheet. 798 00:32:55,599 --> 00:32:57,809 - Because? 799 00:32:57,893 --> 00:33:00,395 - So loved ones can hold their hand. 800 00:33:00,479 --> 00:33:02,481 Here you go. - Thanks. 801 00:33:02,564 --> 00:33:04,107 - Yeah. 802 00:33:06,151 --> 00:33:08,361 - We're ready to discharge our cancer mom, Roxie. 803 00:33:08,445 --> 00:33:09,863 Ambulance is on the way; we just need 804 00:33:09,946 --> 00:33:11,740 to reconcile her home meds. - Sounds good. 805 00:33:11,781 --> 00:33:13,658 Hey, I thought I saw another charge nurse around here. 806 00:33:13,742 --> 00:33:15,410 - Oh, yeah. We travel in packs. 807 00:33:15,494 --> 00:33:16,912 - Aren't you sick of this place yet? 808 00:33:16,953 --> 00:33:18,997 - Oh, someone is ready for his sabbatical. 809 00:33:19,080 --> 00:33:20,665 - Guilty as charged. 810 00:33:20,749 --> 00:33:22,584 - Hey, I just got word that the at-home morphine pump 811 00:33:22,667 --> 00:33:23,752 is gonna be delayed. 812 00:33:23,835 --> 00:33:25,420 Hospital pharmacy has to mix it 813 00:33:25,504 --> 00:33:26,963 and then deliver it later today. 814 00:33:27,047 --> 00:33:28,757 - Well, should we keep her here until it's ready? 815 00:33:28,798 --> 00:33:30,091 - No, you can give her 816 00:33:30,133 --> 00:33:31,760 a 200-milligram tablet of MS Contin. 817 00:33:31,801 --> 00:33:33,929 - 200 milligrams? - Biggest pill they make. 818 00:33:33,970 --> 00:33:37,307 Releases over 12 hours for patients with opiate tolerance. 819 00:33:37,390 --> 00:33:38,934 - Got it. 820 00:33:38,975 --> 00:33:40,393 - Hey, do you want to stick around a little bit? 821 00:33:40,477 --> 00:33:41,811 Westbridge is closed to internal disaster. 822 00:33:41,895 --> 00:33:43,104 We're getting all their runs. - Yeah, I heard. 823 00:33:43,188 --> 00:33:44,648 I put 20 bucks on a plumbing issue. 824 00:33:44,731 --> 00:33:46,566 I just watched that poop cruise documentary. 825 00:33:46,650 --> 00:33:48,318 Oh, I cannot stop thinking about it. 826 00:33:48,401 --> 00:33:50,445 - That sounds like something I will absolutely never watch. 827 00:33:50,529 --> 00:33:52,072 - Dr. Robby, 828 00:33:52,113 --> 00:33:54,616 you gave us a clozapine ileus about an hour ago. 829 00:33:54,699 --> 00:33:56,284 Your resident reported no surgical history, 830 00:33:56,326 --> 00:33:58,537 but the chart says they've had an appendectomy. 831 00:33:58,620 --> 00:34:00,622 We're not admitting the patient without a surgery consult. 832 00:34:00,664 --> 00:34:02,958 - Who called it in? - A Dr. Trinity Santos. 833 00:34:02,999 --> 00:34:06,294 - Dr. Santos, you had an ileus patient. 834 00:34:06,336 --> 00:34:08,713 You neglected to mention a history of appendectomy. 835 00:34:08,797 --> 00:34:10,799 - There was no history of appendectomy. 836 00:34:10,840 --> 00:34:12,217 - It was in your note. 837 00:34:12,300 --> 00:34:14,969 - I may have forgotten to proof check it. 838 00:34:15,053 --> 00:34:17,138 I was using the app that Dr. Al-Hashimi suggested 839 00:34:17,179 --> 00:34:18,264 to catch up on my charting. 840 00:34:18,348 --> 00:34:19,766 - Wonderful. 841 00:34:19,849 --> 00:34:21,768 Ah, Dr. Al-Hashimi. - Yes? 842 00:34:21,810 --> 00:34:25,313 - Dr. Santos was just using your AI tool for her charting, 843 00:34:25,397 --> 00:34:28,650 and it hallucinated a history of appendicitis. 844 00:34:28,692 --> 00:34:31,945 - As I mentioned to Dr. Santos, generative AI is not perfect. 845 00:34:31,987 --> 00:34:34,322 We still need to proofread every chart it creates. 846 00:34:34,406 --> 00:34:36,992 - Mm-hmm, the patient also has a history of headache, 847 00:34:37,033 --> 00:34:39,119 followed by Dr. Park from Urology. 848 00:34:39,202 --> 00:34:41,830 - That should probably be Neurology. 849 00:34:41,871 --> 00:34:44,040 - Unless urologists are now treating migraines. 850 00:34:44,123 --> 00:34:45,500 - Another example that should have been caught 851 00:34:45,542 --> 00:34:47,127 by proofreading. 852 00:34:47,210 --> 00:34:49,462 AI's 2% error rate is still better than dictation. 853 00:34:49,545 --> 00:34:50,964 - Yeah, I don't really give a shit whether or not 854 00:34:51,047 --> 00:34:53,007 you want to use robots down here. 855 00:34:53,049 --> 00:34:55,467 I need accurate information in the medical record. 856 00:34:55,552 --> 00:34:56,886 - Understood. - OK. 857 00:34:56,969 --> 00:34:59,556 - Dr. Santos. 858 00:34:59,639 --> 00:35:01,641 Dr. Santos! [banging on desk] 859 00:35:01,725 --> 00:35:03,560 - Yup. Won't happen again. 860 00:35:06,229 --> 00:35:07,272 - Hoy. 861 00:35:08,940 --> 00:35:10,358 - Thanks, Perlah. 862 00:35:10,400 --> 00:35:12,736 - Six hours to go. You got this. 863 00:35:14,571 --> 00:35:17,532 - When a wound is gaping like this, 864 00:35:17,616 --> 00:35:19,993 you want to use sub-Q to bring the edges together. 865 00:35:20,076 --> 00:35:21,786 - A lot of meat to close. 866 00:35:21,870 --> 00:35:25,206 - What would happen if we just did a simple wound closure? 867 00:35:25,290 --> 00:35:27,000 - You take the stitches out in ten days, 868 00:35:27,083 --> 00:35:28,877 the wound opens, dehisces. 869 00:35:28,960 --> 00:35:30,211 - Exactly. 870 00:35:30,295 --> 00:35:32,255 So what suture do we use under the skin? 871 00:35:32,339 --> 00:35:33,840 - Vicryl provides support for a month. 872 00:35:33,923 --> 00:35:35,383 It takes two months to dissolve. 873 00:35:35,425 --> 00:35:38,720 - Mm-hmm. So 5-0 nylon on the skin. 874 00:35:38,762 --> 00:35:40,764 4-0 vicryl under the skin. 875 00:35:40,847 --> 00:35:42,891 - I'd go with a 3-0 vicryl. 876 00:35:42,974 --> 00:35:45,560 - You think? - Most definitely. 877 00:35:45,602 --> 00:35:47,896 - Donnie is the master of wound closure. 878 00:35:47,979 --> 00:35:51,274 - I do at least ten lacs a day out at triage, so... 879 00:35:51,358 --> 00:35:55,236 - Can we see your sub-Q? 880 00:35:55,320 --> 00:35:56,905 - Be my guest. 881 00:35:56,946 --> 00:35:58,990 - If you insist. 882 00:36:03,453 --> 00:36:05,705 So... [grunts] 883 00:36:05,789 --> 00:36:09,167 The secret is to be sure your entry point 884 00:36:09,250 --> 00:36:11,920 and exit point on both sides of the wound 885 00:36:12,003 --> 00:36:14,881 matches the depth on the other side. 886 00:36:14,964 --> 00:36:16,216 S-- 887 00:36:19,678 --> 00:36:21,388 Start deep. 888 00:36:21,471 --> 00:36:25,350 Come up at the dermis. 889 00:36:25,433 --> 00:36:28,228 - Big bites help the tissue close. 890 00:36:30,939 --> 00:36:34,109 - It's a mirror image on the other side. 891 00:36:34,150 --> 00:36:36,820 Superficial to deep. 892 00:36:38,655 --> 00:36:41,282 - So you bury the knot. - Bingo. 893 00:36:41,366 --> 00:36:44,119 - Avoids bumps on the scar line. 894 00:36:44,202 --> 00:36:47,914 - Three ties, not four. 895 00:36:47,997 --> 00:36:50,291 - Yeah, that's beautiful. 896 00:36:50,375 --> 00:36:53,461 And then you cut it short. 897 00:36:53,545 --> 00:36:55,130 Not too short. 898 00:36:55,171 --> 00:36:58,800 - I like to slide my scissors 899 00:36:58,842 --> 00:37:01,928 down on the knot, 900 00:37:02,011 --> 00:37:07,142 then rotate up 45 degrees before I cut. 901 00:37:07,225 --> 00:37:09,310 Could use two more sub-Qs, 902 00:37:09,394 --> 00:37:12,564 one above, one below. 903 00:37:12,647 --> 00:37:13,773 Have at it. 904 00:37:16,151 --> 00:37:19,195 - Interesting ink. Do they mean anything? 905 00:37:21,156 --> 00:37:24,743 - This, this is "death and chaos," 906 00:37:24,826 --> 00:37:27,162 and this is "miracles and blessings." 907 00:37:27,245 --> 00:37:30,957 Got this one after the PittFest shooting, 908 00:37:31,040 --> 00:37:35,378 and I got this after my daughter was born. 909 00:37:37,881 --> 00:37:39,174 - Put the head of the gurney up 910 00:37:39,215 --> 00:37:41,134 so people can see him, but not so high 911 00:37:41,217 --> 00:37:43,261 that his head flops to the side. 912 00:37:47,474 --> 00:37:48,725 What do you think? 913 00:37:48,808 --> 00:37:51,352 - He looks peaceful. 914 00:37:51,394 --> 00:37:53,897 What's the hardest part of this job? 915 00:37:53,980 --> 00:37:55,732 - It's pretty thankless, and that can be tough. 916 00:37:55,815 --> 00:37:57,192 You've seen burnout rates. 917 00:37:57,233 --> 00:37:58,985 I'm sure they teach you that in school. 918 00:37:59,068 --> 00:38:02,030 All my closest friends left after COVID. 919 00:38:02,113 --> 00:38:04,073 Some during. 920 00:38:04,157 --> 00:38:05,867 But I don't blame them. 921 00:38:05,950 --> 00:38:08,870 They needed to do what was best for their mental health. 922 00:38:08,953 --> 00:38:11,331 A lot of people broke. 923 00:38:11,414 --> 00:38:13,333 - Why do you keep coming back? 924 00:38:15,794 --> 00:38:18,046 - Why don't you, um, 925 00:38:18,087 --> 00:38:21,424 just finish up here and then go help Perlah for a bit? 926 00:38:25,595 --> 00:38:27,013 - Great. Thank you. 927 00:38:27,096 --> 00:38:28,348 No, that is exactly what I needed to know. 928 00:38:28,431 --> 00:38:29,891 OK. 929 00:38:29,974 --> 00:38:32,560 I just got off the phone with the physician assistant 930 00:38:32,602 --> 00:38:35,063 at the prison; they've got a 16-hour-a-day infirmary 931 00:38:35,104 --> 00:38:37,315 with NP and PA coverage giving everything that we need, 932 00:38:37,398 --> 00:38:39,108 and they've got an RN for overnights. 933 00:38:39,192 --> 00:38:40,735 - Even so, he's here because 934 00:38:40,819 --> 00:38:43,404 they're ignoring his basic needs. 935 00:38:43,446 --> 00:38:45,573 - He's here because somebody kicked the shit out of him. 936 00:38:45,615 --> 00:38:47,075 - I think you're missing the point. 937 00:38:47,116 --> 00:38:48,618 We have more to offer. 938 00:38:48,701 --> 00:38:50,745 - Robby, we've got four more coming our way. 939 00:38:50,829 --> 00:38:52,413 - OK, got it. 940 00:38:52,455 --> 00:38:53,873 What you're trying to do is very noble. 941 00:38:53,957 --> 00:38:55,250 We don't have the resources to spare. 942 00:38:55,333 --> 00:38:57,585 - OK, then why admit the unhoused man, Digby? 943 00:38:57,627 --> 00:38:59,128 Why not send him back to the street 944 00:38:59,212 --> 00:39:00,797 with antibiotics and a roll of gauze? 945 00:39:00,880 --> 00:39:02,423 - Because Digby lives on the street, 946 00:39:02,507 --> 00:39:05,093 and your incarcerated patient has a mid-level provider 947 00:39:05,134 --> 00:39:06,594 and a nurse looking after him. 948 00:39:06,678 --> 00:39:08,888 - We both know the quality of care is not the same. 949 00:39:08,972 --> 00:39:09,889 - Sorry, are you waiting for me? 950 00:39:09,973 --> 00:39:11,266 - No. 951 00:39:11,307 --> 00:39:12,892 Dr. Al-Hashimi, for the patient in Seven. 952 00:39:12,976 --> 00:39:14,185 - A few days here could make a world of difference 953 00:39:14,269 --> 00:39:15,603 for Gus' health. 954 00:39:15,687 --> 00:39:17,856 - We are a safety net, but nets have holes. 955 00:39:17,939 --> 00:39:19,274 We are not admitting him 956 00:39:19,357 --> 00:39:21,109 'cause this is not about social justice. 957 00:39:21,192 --> 00:39:23,278 - [scoffs] 958 00:39:23,319 --> 00:39:24,779 Everything I've done in my career 959 00:39:24,863 --> 00:39:27,282 is an effort to improve the system. 960 00:39:27,323 --> 00:39:28,950 Just because you know it's broken 961 00:39:29,033 --> 00:39:31,536 doesn't mean you stop trying. 962 00:39:31,619 --> 00:39:33,037 Excuse me. 963 00:39:37,500 --> 00:39:39,544 - I talked to Jackson's girlfriend. 964 00:39:39,627 --> 00:39:40,670 - OK. 965 00:39:40,753 --> 00:39:42,672 - She told me a lot of stuff. 966 00:39:42,755 --> 00:39:45,133 Um, she wants to come see him, 967 00:39:45,174 --> 00:39:47,927 but I just don't think that's a good idea. 968 00:39:48,011 --> 00:39:50,346 And my--my parents are asking a lot of questions. 969 00:39:50,430 --> 00:39:52,307 Can I just take him home? 970 00:39:52,348 --> 00:39:53,808 - I'm so sorry. 971 00:39:53,892 --> 00:39:55,977 Your--your brother is on an involuntary psych hold. 972 00:39:56,060 --> 00:39:57,312 He can't leave. 973 00:39:57,395 --> 00:39:58,479 It could take us weeks to figure out 974 00:39:58,521 --> 00:39:59,814 what's wrong with him. 975 00:39:59,856 --> 00:40:01,691 - What's wrong with him? 976 00:40:01,774 --> 00:40:03,526 - I'm so sorry. I did not mean it like that. 977 00:40:03,610 --> 00:40:04,861 - What's-- 978 00:40:04,944 --> 00:40:06,195 - Why don't we go somewhere quiet, yeah? 979 00:40:06,279 --> 00:40:08,364 - What's wrong with him? 980 00:40:08,448 --> 00:40:11,701 - Let's go over here. - What's wrong with him? 981 00:40:11,784 --> 00:40:13,661 What's wrong with him? 982 00:40:13,703 --> 00:40:15,330 [sobbing] 983 00:40:15,371 --> 00:40:17,415 What's wrong with him? 984 00:40:27,550 --> 00:40:29,177 - How's she doing? 985 00:40:29,218 --> 00:40:31,346 - She took three ounces of formula 986 00:40:31,429 --> 00:40:32,805 without vomiting or distress. 987 00:40:32,889 --> 00:40:34,307 - Excellent. 988 00:40:34,349 --> 00:40:37,185 Dr. Wolke from Pedes should be down shortly. 989 00:40:37,268 --> 00:40:40,146 - Yeah. I think I saw her smile. 990 00:40:40,229 --> 00:40:43,358 - A true social smile where the baby is awake, alert, 991 00:40:43,399 --> 00:40:45,151 and responding to facial expressions 992 00:40:45,193 --> 00:40:47,695 usually doesn't happen until six weeks or older. 993 00:40:47,737 --> 00:40:49,364 It was likely a reflex smile that happens 994 00:40:49,447 --> 00:40:52,492 while they're sleeping. 995 00:40:52,575 --> 00:40:56,079 But some parents have reported their babies 996 00:40:56,162 --> 00:40:58,581 smiled socially as early as four weeks, 997 00:40:58,665 --> 00:41:01,542 so who knows? 998 00:41:01,626 --> 00:41:03,169 - Jesse. - Hmm? 999 00:41:03,252 --> 00:41:04,837 - North 4 needs a blood draw when you have a sec. 1000 00:41:04,921 --> 00:41:05,922 - Got it. 1001 00:41:06,005 --> 00:41:07,173 - How we doing in here? 1002 00:41:07,256 --> 00:41:08,383 - Almost ready to head out. 1003 00:41:08,424 --> 00:41:09,550 - Looking good. 1004 00:41:09,592 --> 00:41:10,551 Heart rate 91. 1005 00:41:10,635 --> 00:41:12,220 BP is 115 over 82. 1006 00:41:12,303 --> 00:41:14,180 Oxygen sat's 95%. 1007 00:41:14,263 --> 00:41:15,807 - Great. 1008 00:41:15,890 --> 00:41:17,308 - I'm sending him home with some nonstick dressing 1009 00:41:17,392 --> 00:41:18,726 in case they don't stock them. 1010 00:41:18,810 --> 00:41:20,520 - Grab some burn net too. 1011 00:41:20,603 --> 00:41:23,147 - He's a good guy. He's a local. 1012 00:41:23,231 --> 00:41:25,525 - Yeah? You're from Pittsburgh? 1013 00:41:25,608 --> 00:41:27,151 - Yes, ma'am. Born and raised. 1014 00:41:27,235 --> 00:41:28,319 - Whereabouts? 1015 00:41:28,403 --> 00:41:30,571 - Bloomfield, Liberty Ave. 1016 00:41:30,655 --> 00:41:33,199 - Bloomfield? 1017 00:41:33,282 --> 00:41:34,867 You know Sonny's Tavern? 1018 00:41:34,951 --> 00:41:36,494 - Worked there through high school. 1019 00:41:36,577 --> 00:41:38,454 - No kidding. - You know Sonny's? 1020 00:41:39,956 --> 00:41:43,167 - Had my first kiss there. 1021 00:41:43,251 --> 00:41:45,586 - Hey, Donnie, my buddy Duke hasn't checked in yet? 1022 00:41:45,670 --> 00:41:47,296 - Nah, I told Lupe to keep an eye out. 1023 00:41:47,380 --> 00:41:48,798 - Thank you. - Yep. 1024 00:41:48,881 --> 00:41:51,217 - Right, left. Right, left. Yeah. That's it. 1025 00:41:54,846 --> 00:41:56,264 - You back to check our work? 1026 00:41:56,305 --> 00:41:58,433 - Nope. I need a silastic loop drain. 1027 00:41:58,474 --> 00:42:00,476 That looks great. 1028 00:42:00,560 --> 00:42:02,270 - It's thanks to your fine instruction. 1029 00:42:02,353 --> 00:42:06,274 - OK, he's going to need Kerlix and Xeroform. 1030 00:42:06,357 --> 00:42:08,151 - You should throw a neoprene sleeve on him. 1031 00:42:08,234 --> 00:42:09,944 Limits the range of motion at the knee 1032 00:42:09,986 --> 00:42:11,738 so the sutures don't pull out. - That's a good idea. 1033 00:42:11,821 --> 00:42:13,072 - Must be fun to work here. 1034 00:42:13,156 --> 00:42:15,825 - Oh, sure is. First week for these two. 1035 00:42:15,908 --> 00:42:17,285 How are you guys liking the Pitt? 1036 00:42:17,368 --> 00:42:18,786 - I feel like I was born to do this. 1037 00:42:18,828 --> 00:42:21,289 - [snorts] Hard pass. 1038 00:42:21,330 --> 00:42:23,249 I'm shooting for pathology. 1039 00:42:23,332 --> 00:42:24,625 I like medical mysteries, 1040 00:42:24,709 --> 00:42:26,794 but I don't really deal well with people. 1041 00:42:26,878 --> 00:42:28,713 - You have an interesting energy. 1042 00:42:28,796 --> 00:42:30,548 - What's that for? 1043 00:42:30,631 --> 00:42:32,717 - Splint starts at the knuckles, 1044 00:42:32,800 --> 00:42:36,262 comes up and around the elbow, 1045 00:42:36,345 --> 00:42:38,639 and back down to the palm. 1046 00:42:38,681 --> 00:42:41,476 - It needs to be smaller. I can't ride with a splint. 1047 00:42:41,517 --> 00:42:42,935 - Well, no, you shouldn't be riding at all. 1048 00:42:43,019 --> 00:42:44,896 Right now, that's a non-displaced fracture. 1049 00:42:44,979 --> 00:42:47,940 If you fall on it again, you're gonna need to go to the OR. 1050 00:42:48,024 --> 00:42:51,152 - No worries, Doc. I won't fall again. 1051 00:42:51,194 --> 00:42:52,361 - Uh-huh. 1052 00:42:52,445 --> 00:42:54,322 [knocking] [door buzzes] 1053 00:42:54,363 --> 00:42:56,282 - Robby, pulse ox just dropped. 1054 00:42:56,365 --> 00:42:57,784 - What happened? 1055 00:42:57,867 --> 00:42:59,202 - I don't know. I stepped out for a minute. 1056 00:42:59,285 --> 00:43:01,037 - It's down to 85%. 1057 00:43:01,120 --> 00:43:02,497 - Are you having some trouble breathing? 1058 00:43:02,538 --> 00:43:03,998 - A little. 1059 00:43:04,082 --> 00:43:05,666 - Start him on 2 liters oxygen, nasal cannula. 1060 00:43:05,750 --> 00:43:07,293 Titrate to 5. 1061 00:43:07,376 --> 00:43:08,878 Keep the pulse ox at 92 or higher 1062 00:43:08,961 --> 00:43:12,340 and have a rebreather standing by just in case. 1063 00:43:12,381 --> 00:43:14,175 He's gonna have to stay. 1064 00:43:14,217 --> 00:43:15,885 - For how long? 1065 00:43:15,968 --> 00:43:18,679 - Not sure. 1066 00:43:18,763 --> 00:43:20,598 - Sorry, boss, I only stepped out for a second. 1067 00:43:20,681 --> 00:43:22,141 - Let me know if anything changes. 1068 00:43:22,225 --> 00:43:23,684 You were in the room when his pulse ox dropped? 1069 00:43:23,768 --> 00:43:24,977 - I was. - What were you doing? 1070 00:43:25,061 --> 00:43:26,687 - D, still can't get a hold of Ortho. 1071 00:43:26,771 --> 00:43:30,024 - Leave them to me. 1072 00:43:30,066 --> 00:43:32,318 - Feeling better? - Oh, so much better. 1073 00:43:32,360 --> 00:43:35,488 - Well, I wrote you a script for Zofran, just in case. 1074 00:43:35,571 --> 00:43:37,949 - Thanks. I think I cleared it all out. 1075 00:43:38,032 --> 00:43:40,618 - So no more hot dogs, right? - Oh, not today. 1076 00:43:40,701 --> 00:43:42,120 But I'll be back next year. 1077 00:43:42,203 --> 00:43:43,454 Got to defend my title! - Yo. 1078 00:43:43,538 --> 00:43:44,872 - OK, well, best of luck to you. 1079 00:43:44,914 --> 00:43:46,374 - They got a Wiener World truck outside. 1080 00:43:46,457 --> 00:43:48,042 You want one? 1081 00:43:48,084 --> 00:43:49,710 - I think I'm good on hot dogs for the rest of my life. 1082 00:43:49,794 --> 00:43:51,587 Wait, didn't I just see you eating a doughnut? 1083 00:43:51,671 --> 00:43:53,256 - Don't judge. 1084 00:43:53,339 --> 00:43:54,882 - Stay here for a sec. 1085 00:43:57,760 --> 00:43:59,428 [knocks] 1086 00:44:00,930 --> 00:44:03,224 Transport ambulance is here. - Thanks, Princess. 1087 00:44:03,307 --> 00:44:05,726 This is a 200-milligram MS Contin. 1088 00:44:05,768 --> 00:44:09,063 This will give you 12 hours of relief. 1089 00:44:09,105 --> 00:44:10,898 OK. - Mm. 1090 00:44:10,982 --> 00:44:12,400 - Yes. 1091 00:44:14,277 --> 00:44:16,028 - Whenever you're ready, Rox. 1092 00:44:16,112 --> 00:44:17,905 - Hey, guys, this is Roxie Hamler. 1093 00:44:17,989 --> 00:44:19,740 - Hello, ma'am. 1094 00:44:19,782 --> 00:44:21,826 - Easy on the transfer, guys. - Yeah. 1095 00:44:25,746 --> 00:44:28,416 - [inhales sharply, groans] 1096 00:44:28,457 --> 00:44:30,585 - OK, on my count. 1097 00:44:30,668 --> 00:44:33,504 - No, no, no. This isn't gonna work out. 1098 00:44:33,588 --> 00:44:36,674 [grunts] I'm sorry. 1099 00:44:36,757 --> 00:44:38,342 I can't--I can't-- 1100 00:44:38,426 --> 00:44:41,929 I can't--I can't do this. 1101 00:44:42,013 --> 00:44:45,016 - It's OK. - I want to stay. 1102 00:44:45,099 --> 00:44:48,769 Please. 1103 00:44:48,811 --> 00:44:51,898 - It's OK. 1104 00:44:51,981 --> 00:44:53,774 - Can I assume that you've already called upstairs 1105 00:44:53,858 --> 00:44:55,651 to get Gus Varney a bed? 1106 00:44:55,735 --> 00:44:57,945 Do you want to tell me what you did? 1107 00:44:58,029 --> 00:45:00,448 - I don't know what you're talking about. 1108 00:45:00,531 --> 00:45:03,409 - His pulse ox was steady. We were about to discharge him. 1109 00:45:03,492 --> 00:45:05,161 Did Dr. Al-Hashimi put you up to that? 1110 00:45:05,244 --> 00:45:07,496 - Al-Hashimi? No. 1111 00:45:07,580 --> 00:45:08,998 - You know he's gonna go back to prison 1112 00:45:09,081 --> 00:45:12,793 after they discharge him upstairs. 1113 00:45:12,877 --> 00:45:14,587 I thought you didn't go the extra distance 1114 00:45:14,670 --> 00:45:16,047 for your patients anymore. 1115 00:45:22,678 --> 00:45:25,139 - It's Emma, right? - Yeah. 1116 00:45:25,223 --> 00:45:26,807 - How's your first day going? 1117 00:45:26,849 --> 00:45:28,559 - Good, I think. 1118 00:45:28,643 --> 00:45:31,938 Haven't killed anyone yet. 1119 00:45:32,021 --> 00:45:35,316 I'm sorry. I-- - It's OK. 1120 00:45:35,358 --> 00:45:38,819 - I guess time will tell if I'm cut out for this. 1121 00:45:38,903 --> 00:45:42,573 - Well, when in doubt, stick with her, kid. 1122 00:45:42,657 --> 00:45:44,075 - She scares me. 1123 00:45:44,158 --> 00:45:46,744 - No, that's just a-- it's a tough exterior. 1124 00:45:46,827 --> 00:45:50,498 She's warm and gooey on the inside. 1125 00:45:50,581 --> 00:45:53,417 Looks like they're doing the debrief for Louie. 1126 00:45:53,501 --> 00:45:55,461 - You coming? - I paid my respects. 1127 00:45:55,503 --> 00:45:57,713 Besides, who's gonna hold down the fort? 1128 00:46:09,767 --> 00:46:12,186 - Remember the day you found him passed out in the park? 1129 00:46:12,270 --> 00:46:13,479 - Sure do. 1130 00:46:13,562 --> 00:46:14,981 I had to drag his ass over here. 1131 00:46:15,064 --> 00:46:16,357 - Came in soaked to the bone. 1132 00:46:16,440 --> 00:46:18,192 - You saved his life. 1133 00:46:18,234 --> 00:46:20,194 - How about last summer when we didn't see him for months? 1134 00:46:20,278 --> 00:46:21,696 - He said he finally quit drinking, 1135 00:46:21,737 --> 00:46:23,489 so he didn't need to come in. - Mm-hmm. 1136 00:46:23,572 --> 00:46:25,866 - How many times did he say he was gonna quit drinking? 1137 00:46:25,950 --> 00:46:27,994 - Mm-hmm. 1138 00:46:28,077 --> 00:46:30,621 - He always asked about Harrison. 1139 00:46:30,705 --> 00:46:33,040 - Always said thank you. - Mm-hmm. 1140 00:46:33,082 --> 00:46:36,460 - Found this with his stuff. 1141 00:46:36,544 --> 00:46:38,045 Who knew he was married? 1142 00:46:38,087 --> 00:46:40,715 - Hmm. 1143 00:46:40,756 --> 00:46:43,217 - That's Rhonda, Louie's wife. 1144 00:46:43,301 --> 00:46:45,177 High school sweetheart. 1145 00:46:45,261 --> 00:46:48,306 About five years ago, I was covering a night shift. 1146 00:46:48,389 --> 00:46:51,559 He came in feeling talkative. 1147 00:46:51,600 --> 00:46:53,185 Born and raised in Pittsburgh. 1148 00:46:53,269 --> 00:46:55,563 Lifelong Steelers fan. 1149 00:46:55,604 --> 00:46:57,273 Groundskeeper at Three Rivers Stadium 1150 00:46:57,356 --> 00:46:58,774 until 1998. 1151 00:47:01,527 --> 00:47:04,363 He never really wanted kids, 1152 00:47:04,447 --> 00:47:06,741 but Rhonda wore him down, 1153 00:47:06,824 --> 00:47:08,409 and when she finally got pregnant, 1154 00:47:08,451 --> 00:47:11,120 he changed his tune, he got excited. 1155 00:47:11,203 --> 00:47:13,247 [soft chuckles] 1156 00:47:14,540 --> 00:47:16,792 And then about a month before the baby was due, 1157 00:47:16,876 --> 00:47:19,962 Rhonda and the baby were killed in a car crash. 1158 00:47:23,174 --> 00:47:25,676 Louie never really came back from that. 1159 00:47:29,680 --> 00:47:32,099 May his memory be a blessing. 1160 00:47:32,141 --> 00:47:34,477 - Amen. - May his memory be a blessing. 1161 00:47:36,479 --> 00:47:37,772 - Yep. 1162 00:47:37,813 --> 00:47:40,775 [soft music] 1163 00:47:40,816 --> 00:47:44,945 ♪ ♪ 1164 00:47:45,029 --> 00:47:48,115 - ♪ Can you see him tired and shivering ♪ 1165 00:47:48,157 --> 00:47:51,118 ♪ He's stumbling through the day ♪ 1166 00:47:51,160 --> 00:47:54,121 ♪ Can you see his lips a-quivering ♪ 1167 00:47:54,163 --> 00:47:57,291 ♪ Like he's forgotten how to pray ♪ 1168 00:47:57,333 --> 00:48:00,252 ♪ Can you see her way is perilous ♪ 1169 00:48:00,336 --> 00:48:03,672 ♪ She's absorbing all the blows ♪ 1170 00:48:03,756 --> 00:48:06,300 ♪ And who will now take care of us ♪ 1171 00:48:06,384 --> 00:48:09,428 ♪ In the hills and valleys, the highs and lows ♪ 1172 00:48:09,512 --> 00:48:12,014 ♪ All I know is ♪ 1173 00:48:12,098 --> 00:48:17,144 ♪ You'll need someone ♪ 1174 00:48:17,228 --> 00:48:19,188 ♪ In the by and by ♪ 1175 00:48:19,271 --> 00:48:23,818 ♪ Need someone who is gonna cry for you ♪ 1176 00:48:23,859 --> 00:48:29,615 ♪ Yeah, you'll need someone ♪ 1177 00:48:29,698 --> 00:48:31,617 ♪ In the by and by ♪ 1178 00:48:31,700 --> 00:48:37,623 ♪ Need someone who is gonna cry for you ♪ 1179 00:48:37,706 --> 00:48:44,713 ♪ ♪ 1180 00:48:49,844 --> 00:48:56,016 ♪ Need someone ♪ 1181 00:48:56,100 --> 00:49:03,107 ♪ Need ♪ 1182 00:49:03,774 --> 00:49:05,401 ♪ Someone ♪ 1183 00:49:05,484 --> 00:49:06,652 ♪ Need someone ♪ 1184 00:49:06,735 --> 00:49:10,739 ♪ Who is gonna cry for you ♪