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00:33What now?
00:35Now we wait.
00:37How long before?
00:39I have no idea.
00:41Could be hours.
00:43It doesn't feel right.
00:45Remember Robbie talked about...
00:47The deal feels wrong.
00:50This is Roxy's decision.
00:52Everything else in her life is out of her control except this.
00:56She wants to go out on her own terms.
00:59Very few of us get to do that.
01:01I should pick up more patients.
01:07So Adam lives at Middle Hill?
01:09He lives in Middle Hill.
01:11And he's three years older than you?
01:12He's three years older than me.
01:15And he asked you to be his girlfriend six months ago?
01:20He asked me to be his girlfriend at game night, and I said yes.
01:25Got a patient waiting for a doctor.
01:27Better go in 13.
01:28Okay, I'll be right there.
01:33Did Adam ask you if you wanted to have sex?
01:36I...
01:36Mel, I don't know if I can tell you.
01:39Of course you can tell me I'm your sister.
01:41Well, it's private.
01:43Look, it's just...
01:44It's really important that I know.
01:46Why?
01:46Because.
01:48Well, I can tell Dr. Langdon because Dr. Langdon is my doctor, but...
01:53I don't think I can tell you.
01:55Becca, just tell me.
01:56Why are you yelling?
01:57I'm not yelling.
01:58It's just...
01:58Look, it's really important that I know.
02:00You're definitely yelling.
02:01Becca.
02:01Maybe we should step outside for a minute.
02:04Why won't you tell me?
02:05Dr. King.
02:07Why don't you get some air?
02:12Sorry.
02:15Sorry.
02:21Hey, have you seen any of the x-ray techs around?
02:23Nope.
02:26Got an update for me?
02:27I'm just checking in.
02:29What are the chances of me getting out of here on time, do you think?
02:32It's up to you, Cap.
02:32We can handle this.
02:33Question is, will you let us?
02:41How are you two getting along?
02:43I can play nice for another two hours.
02:47God.
02:48Kept calling me Doc.
02:50Didn't know he was the real Doc until a few months in.
02:53He was keeping a secret life from me.
02:55Hmm.
02:56Where are we with his chest this week?
02:58Our x-rays are still six or seven behind.
03:00When's the last time we checked?
03:03Maybe ten minutes ago.
03:04I had to stay on them?
03:06Come on, give the kid a break.
03:07It says here it takes an hour to get an x-ray.
03:10He's going to be the first person who's read this fucking thing all day.
03:15Don't get me started on those.
03:19How are you feeling?
03:21I'm good.
03:23You know, I take Luxipro.
03:26It helps with panic attacks, not just depression.
03:28Promise?
03:28I'm fine.
03:31Sorry about that, Mrs. Torres.
03:32Are you okay?
03:33I thought you were going to pass out.
03:35Yep.
03:35All good.
03:36Let's just pick up where we left off.
03:40Mrs. Torres presents with one week of painful swollen right calf.
03:44No trauma, no fever, no history of hypercoagulable state.
03:48However, she did take a 15-hour bus ride from Orlando to Pittsburgh last week.
03:53Mrs. Torres, we're concerned about a possible blood clot in your leg that can lead to serious
03:59complications.
04:00We need to do an ultrasound, but no need to worry.
04:03If it's positive, we can treat with a blood thinner.
04:06Well, if there's something I learned is to stop worrying.
04:09Can all your worries add a single moment to your life.
04:16Fresh on the line.
04:17They said one's critical.
04:18They're supposed to call those up.
04:19I know.
04:20Every time they try, the red phone's been busy.
04:22Jesus Christ.
04:23This was resulted 25 minutes ago.
04:25Sodium-112.
04:27Mohan.
04:29Sprinkle some salt on your patient before he sees this.
04:32Where are we?
04:33Kidney stomp patients not obstructed.
04:35Just waiting on meds.
04:36Ortho's performing the replantation on our water slide trauma.
04:39A perforated diverticulitis patient Howard made it through surgery.
04:43And I'm calling the CYF resource navigator to see if we're getting anywhere
04:47with emergency foster care for baby Jane Doe.
04:50Other than that, labs and x-rays are way behind,
04:53but our golden girls are getting their steps in.
04:57Does Robbie usually leave as soon as his shift ends,
04:59or does he like to stick around for all the handoffs to night shift?
05:03Depends.
05:04He's usually pretty good about getting out of here.
05:09A shortness of breath in soft 16, he could totally decompensate.
05:15I'm hoping to catch another intubation before 7.
05:18One more gets me to 3 in my first week.
05:20Probably a record.
05:23I'm looking for an easy one.
05:26Shift ends in two hours.
05:28You're supposed to pick up the stable patients in order.
05:31Do you need a second opinion on that?
05:34No.
05:36Dr. McKay.
05:37Yeah?
05:38A girl named Kiki came into reception looking for you.
05:40Kiki?
05:40She said she'd be in the park.
05:42Yeah, great, thanks.
05:48Hey, I think the labs are back on your PID patient.
05:52Thanks.
05:53Is everything okay?
05:56Ah, fantastic.
06:02Langdon.
06:03I was kind of hoping I would never see him again.
06:06You know, maybe he's changed.
06:11When you got a sec, there's something...
06:13Santos!
06:14I need you to pick up food poisoning in 12.
06:17Yeah, sure, why not?
06:18What?
06:19No snark?
06:21No pushback?
06:21What have you done with Santos?
06:23Only two hours to go.
06:25I surrender.
06:27That's the spirit.
06:35How's Becca?
06:36She's good.
06:38I'm trying to call her a living community, but they are not picking up.
06:41Why you calling her?
06:44Because I don't know anything about this Adam person.
06:47I mean, they've been dating for six months, and I don't know anything.
06:51She never said anything about wanting a boyfriend or even liking anyone.
06:56That doesn't mean she hasn't thought about it.
06:58I don't want to think about my sister thinking about having sex.
07:01I mean, she used to say he didn't take advantage of her.
07:04Middle Hill just let it happen.
07:06And why didn't they tell me?
07:07Well, maybe they didn't know about it.
07:09Six months, they had to have known.
07:12Just...
07:12Maybe it was a mistake choosing Middle Hill.
07:15I...
07:15I mean, we saw a lot of good places, but that is where Becca wanted to go.
07:20I...
07:20Are you Becca's legal guardian?
07:23No, I have durable power of attorney, but we did this thing called supportive decision-making
07:27where she can make her own decisions.
07:31There you go.
07:32Well, this is different.
07:33Why?
07:35Because it is.
07:36I...
07:42My son, he's not moving.
07:55I got a hot and unresponsive child.
07:58I need a room, Dana.
07:59Trauma two.
08:01We need a core tempest.
08:03Hi, I'm Dr. Al-Hashimi.
08:05Are you mom?
08:06Brenda Azarvendi.
08:07And this is...
08:07Micah.
08:09Has Micah been sick with a fever?
08:11No, he was fine all day.
08:13I found him in the car.
08:15Pupils are sluggish but reactive.
08:18No reaction to pain.
08:22Airway is Peyton with low tidal volume.
08:25Let's set up for intubation.
08:27Heart rate is 22 in 10 seconds.
08:29That's 132.
08:30Do you know his weight?
08:31No.
08:32Joy, the proselo?
08:33The what?
08:34The proselo tape gives us all the drug doses based on length.
08:37Assisting with ventilation.
08:38Somebody call respiratory.
08:40You said you just found him in the car?
08:41I was working in the garden while he rode his trike in the driveway.
08:45One minute he was there, and then he wasn't.
08:47I thought he had gone into the house, but I couldn't find him anywhere.
08:50He must have gotten tired and climbed in and fallen asleep.
08:55By the time I found him, I couldn't wake him up.
08:57How long was he in there?
08:59Maybe 15 minutes or 20.
09:02And the car was just unlocked.
09:04It's a safe neighborhood.
09:06Joy?
09:07Okay.
09:08So, you're going to want to start at the head.
09:12Measure the length.
09:14And then read it off.
09:16Approximate weight is 25 kilograms.
09:18250 bullets of LR.
09:20I have doses for rock and ketamine.
09:22Almost no tone.
09:23I can do this without meds.
09:24It's easy enough to bag.
09:25Let's wait for RT.
09:26When the temperature is this high, the muscles can lose their strength.
09:30So, we're going to help him breathe with the tooth.
09:32Rectal temp is 105.5.
09:35Heat stroke.
09:36Ice packs for the groin and axilla.
09:37See if we have an arctic sun that's not in use.
09:39We need all the ice we can get.
09:41And a pediatric body bag.
09:46Still waiting on your Ketorolac pills.
09:48I will keep following up with the pharmacy.
09:50I told my son I would meet him at the park.
09:52We always watch the fireworks together.
09:53Sorry, Mr. Green.
09:54We won't forget about you.
09:55All right.
10:01Heard you had a heart attack.
10:02I did not have a heart attack.
10:05Hey, Samira.
10:06How are you feeling?
10:07I am totally fine.
10:09I'm glad to hear it.
10:11Hey, do you mind watching my patients for five minutes?
10:13I have to step out for a sec.
10:14No problem.
10:15Ogilvy, you, uh, want to get some air?
10:18I've got a good case for you.
10:19Might an intubation be required?
10:22No.
10:23It's an unhoused patient I've treated on the street team.
10:27Hello.
10:37Hi, Becca.
10:38Hey.
10:50I'm sorry I yelled at you.
10:52I was just surprised.
10:56The nurse said I can leave.
10:58Yeah, um, can we just finish our conversation first?
11:01About what?
11:03Look, I know you don't have to tell me anything.
11:05I just kind of hope you'd want to.
11:13When Adam asked you to have sex...
11:15He didn't ask me.
11:16I asked him.
11:19So you didn't pressure...
11:21No.
11:22So you wanted to have sex?
11:25I wanted to have sex.
11:27Sex is great.
11:28We talked about sex in my mind and body class.
11:31I told my therapist, too.
11:35Okay, the, uh, pancreatitis in your three's still waiting for you.
11:38Okay.
11:39Can I go now?
11:40Uh, just one second.
11:41Uh, I'll be right there.
11:42I'm just gonna walk my sister out.
11:49Yep, sorry.
11:50I'm right behind you.
11:54Curtis Larson, 42, called to the golf course for combative behavior with his buddies.
11:59No signs of trauma, just alcohol on the breath.
12:01Seems to have calmed down a bit.
12:03I think he was fighting us so hard we had to give four milligrams of Versed to get vitals in
12:07a line.
12:07Good BP.
12:08Pulse ox 99 on two liters.
12:10Between the booze and the Versed, he'll be sleeping it off for a while.
12:12Central 14, guys.
12:21Roxy's gone.
12:23Is the husband still in there with her?
12:25Yeah.
12:26Javadi's with him.
12:27She needs a death note.
12:28I can't find McKay.
12:29Okay, I'll be right there.
12:31Okay.
12:32Have you seen McKay anywhere?
12:34No.
12:38Have you ever seen a xylozine wound?
12:40No.
12:41But you know what it is.
12:42Yes.
12:43Then you know its street name is Trank and this shit is nasty and can lead to skin necrosis.
12:48I've never understood drug addiction.
12:50Well, you need to try.
12:52A little empathy goes a long way in this job.
12:55I am empathetic.
12:56I don't understand how an intelligent person allows themselves.
12:59Can make mistakes, heal themselves, take away the pain, hide from the abuse.
13:04We're healers, not judges.
13:07Shouldn't we go to the crosswalk?
13:09No?
13:10Okay.
13:11This is what we're doing.
13:12I see we're going to lose you in my future.
13:14Sorry.
13:17I see we're going to lose you in my future.
14:11How's it going, Kiki?
14:14Who's this?
14:15Oh, it's, uh, Uncle V. He's a student doctor here to help me.
14:19So what's happening with you?
14:21My leg's getting stinky again.
14:23Yeah.
14:24Okay, let's take a look.
14:31Is that an injection site?
14:33No.
14:34No, xylozine wounds can show up anywhere.
14:37You, uh, you still using Trank?
14:39Sometimes.
14:40Sometimes.
14:41Sometimes it's not good, Kiki.
14:42You know, it's nasty stuff.
14:44I'm trying to quit.
14:45How are you going about that?
14:47I go to meetings, sometimes.
14:49Meetings are good.
14:50And not you seems even better.
14:56Uh, okay, what's your plan, Uncle V?
15:02Uncle V, you okay?
15:04Yes.
15:04Yeah?
15:05Absolutely.
15:06Uh, my plan is clean with saline antibiotics.
15:12Meta, honey, to break down the eschar.
15:14And then?
15:15Um, redress with Xeroform and an ABD pad and acrylics wrap.
15:20Yeah, that will do it.
15:21You need to change this dressing every day, Kiki, okay?
15:24I don't think I can do that.
15:25We'll give you all the supplies you can do it yourself.
15:28You won't even have to come back here.
15:30Yeah.
15:31Okay.
15:32Okay.
15:34Okay, pass the saline.
15:45Hey, I'm Dr. Whitaker.
15:47This is Dr. Santos.
15:49Roberto, like Roberto Clemente.
15:52Oh, sorry.
15:53I don't know who that is.
15:56Pirates Hall of Famer, Roberto Clemente.
15:59You don't watch baseball.
16:01Well, I am from Nebraska.
16:03We went to a few Storm Chasers games as a kid.
16:06That's about it.
16:07No Major League team, you know.
16:10All right, what happened to your elbow?
16:12O'Neal Cruz hits a walk-off tater, right?
16:16And I, I, I catch it.
16:18You know, um, but then somebody fell on top of me.
16:21And I, I think I heard a pop, but hard to tell with all the screaming.
16:24That sounds pretty dangerous.
16:26You're not one of those guys who steals balls from kids, are you?
16:30I didn't steal this.
16:31I wouldn't do that.
16:32I would never do that.
16:32I would never do that.
16:35Can you move your fingers for me?
16:39And the thumb?
16:43Uh, no.
16:44Okay, yeah, you know what?
16:45We can put that in a belongings.
16:46Ha, ha, ha, ha.
16:47No thanks.
16:47I, um, I think I will hold on to this.
16:50Okay, uh, you know what?
16:51We can put you in a sling, and then you can hold on to the ball while we examine you.
16:58Okay, yeah, I guess.
17:01Uh, you're gonna throw in an IV and start with 4-morphine?
17:04No, no, no, no.
17:05I don't want to be knocked out.
17:07No, it's a low dose.
17:08You won't be knocked out.
17:09It'll just help with the pain.
17:10Might make you a little drowsy.
17:11So, I need to stay alert.
17:14Okay.
17:15Uh, we will order you an x-ray.
17:17Just please let us know if you change your mind.
17:21Okay, yeah.
17:26Temp is down to 103.5.
17:28Long way to 98.6.
17:30102, we take them off the ice.
17:32Otherwise, we can overshoot and cause hypothermia.
17:35I put in orders for CK.
17:37What does the CK tell us, Julie?
17:39Wrapped over muscle breakdown can take out the kidneys.
17:42I'm more concerned about his brain.
17:50It's two times a day for three days, and a nurse can crush it up.
17:54Dr. Langdon already told me.
17:56Okay, bye, Mel.
17:58I'll see you at fireworks.
18:00Oh, I was going to watch fireworks with Adam and his parents.
18:05Where?
18:06At the park.
18:07They're picking us up.
18:08They go every year.
18:09We always watch the fireworks together.
18:11I have your headphones.
18:12Adam said he has extra.
18:14Okay, well, um, do you have Adam's parents' phone number?
18:17Why?
18:19In case I need to reach them.
18:22I want to go now.
18:24Well, I guess I could call this.
18:26Bye, Mel.
18:29So, how long have you been part of the street team?
18:31Oh, about a year.
18:33And why do you do it?
18:35Oh, most of these unhoused folks feel abandoned.
18:38Sorry.
18:39They, uh, don't trust easily.
18:41Meeting them where they're at makes a big difference.
18:44I've been trying to get Kiki to come by for months.
18:47You should, uh, volunteer.
18:50It's great training.
18:51Street Team could always use the help.
18:53Oh, yeah.
18:54Uh, maybe.
18:57Hey, how did the deposition go?
18:59Um, I'm glad it's over.
19:02But I didn't feel good about it at all.
19:05You know, I'm still not supposed to talk about it.
19:07No, but you can talk about how you feel.
19:09Who do you have to talk to when things aren't going so good?
19:11Friends?
19:12Family?
19:13Actually, I don't really have any.
19:14Hey, McKay, where have you been?
19:16Oh, I, uh, I stepped out.
19:18Did you tell anybody?
19:20I was, uh, treating a young woman I met on the street team.
19:22Did she check in as a patient?
19:24No.
19:25We treated her in the park.
19:28We?
19:30I, uh, I took local V.
19:33Oh, okay.
19:33So you treated her outside the ED on PTMC's diamond.
19:37You brought a medical student with you.
19:38Right when we're in the middle of crisis mode
19:40and we need all hands on deck.
19:41Gone for ten minutes.
19:43When you're here, I need you to be here.
19:44And while you stepped out, Roxy died.
19:49What?
19:54Oh, man, I'm sorry.
19:57I didn't think she would be gone that quickly.
20:02Excuse me.
20:04Um, she took a nasty fall.
20:06Her shoulder screamed in pain when we put the ties on.
20:09Hello, I'm Dr. Rabinovich.
20:10This is Dr. McKay.
20:11Agents Correa and Russo.
20:14She needs to be looked at before we process her.
20:16What's your name, ma'am?
20:19Renita.
20:21We're gonna take care of you, okay?
20:23You said she fell?
20:25We'll conduct in a sleep at a restaurant.
20:27Right when the kitchen took off,
20:29she was shoved down some alley stairs.
20:31Right.
20:32Could be a rotator, cuff tear, or an AC separation?
20:36Let's put her in a chair and find her room.
20:38South 19.
20:44Yeah, just to be here.
20:47Curtis.
20:48Dude, what happened?
20:50Medics had to sedate him in the transport.
20:53Didn't realize he was such an angry drunk.
20:55So you've seen him drunk before?
20:56Sure.
20:57Yeah, but never like this.
20:59He tried to pick a fight with the guys in front of us.
21:01He said they were going too slow.
21:02That's what they call the cops.
21:04Would he have taken drugs?
21:05If he did, they were not the performance-enhancing kind.
21:09He shot a 112.
21:12We'll order labs.
21:14See what we can figure out.
21:15Uh, any family we can contact?
21:17I have no idea.
21:18We don't talk about that shit.
21:19How long is he gonna be here?
21:21At least three or four hours till he sobers up.
21:23Cool.
21:24Is it okay if I just come back around nine?
21:26Sure.
21:27Great, thanks.
21:32Need those removed so I can check her vital signs.
21:38Okay, tender over the AC.
21:46Can you, uh, lift your right arm up above your shoulder like this?
21:57Heart rate's 110, pulse ox 98.
22:00Painful arc test is positive.
22:01Try a drop arm test.
22:03I'm gonna lift your arm up.
22:06And you just lower it as slowly as you can, okay?
22:11A positive drop arm test.
22:13What's that mean?
22:14That means that she's gonna require an x-ray.
22:16It's most likely a rotator cuff tear,
22:18which sometimes can come with a fracture.
22:19We need an x-ray to rule it out.
22:21How long's that gonna take?
22:23Our computers are down today.
22:25Everything's moving a little slower than usual,
22:26but we will fast track her.
22:28Is there anyone you want us to call, Pernita?
22:30No phone calls.
22:32Got a bathroom.
22:42Right there.
22:46I do not want these guys here any longer than they need to be,
22:48so let's find x-ray and fast track this one.
22:50Your family might be worried.
22:52Maybe I can call them?
22:53No, no, no.
22:53Just stay with her.
22:54Make sure she has everything she needs.
22:55We treat her injury, and that's it.
22:56Okay.
22:58Jaime Guerrero to window three, please.
23:01Jaime Guerrero to window three.
23:30Got a lateral.
23:32Best I could.
23:33Okay.
23:34Posterior dislocation.
23:35No fracture.
23:36Thanks.
23:37Mm-hmm.
23:38Okay.
23:39Good news, Roberto.
23:40No broken bones, but the elbow joint is dislocated,
23:43and we need to get the ball back in the socket.
23:45The best way is with sedation and pain meds.
23:47No, no, no.
23:48I know you said no morphine,
23:49but we can put local anesthetic into the joint to block the pain.
23:53That way you won't be sedated at all.
23:54Oh, thanks, Doc.
23:56Just give me a bullet to bite on her.
24:03The Raiders Joe's over in Greentree.
24:05Oh, man, I love that place.
24:06Brought on one of the employees.
24:08So ICE is here.
24:09People are leaving the waiting room.
24:10Ten patients are ready.
24:11What should I do?
24:12Just tell them the truth
24:13and hope they stay for the treatment that they need.
24:15Martha took off.
24:16I'm going to call them when I get a chance.
24:17Oh, shit.
24:18Yeah, make sure she's okay.
24:19Will you call the EVS department, too, and let them know?
24:21Will do.
24:22All right, hold down the fort.
24:23Let us know if you need backup.
24:24You got it.
24:25Can't we just tell the agents to fuck off?
24:28They are not going to leave without their patient.
24:30We just need to treat her.
24:32Even if she's undocumented?
24:33All patients, regardless of immigration status,
24:36have the right to emergency care under M. Tala.
24:39Pranita is next in line for her x-ray.
24:41Okay, good.
24:45Propofol's down to 100 mics per minute.
24:47Tempest 101.8.
24:48Great.
24:49Let's get him off the ice.
24:50Okay, hands.
24:52On my count.
24:53One, two, three.
24:57What's the latest?
24:59Uh, we got some arm movement.
25:02That's a good sign.
25:06And pupils are minimally reactive.
25:10Planters are down going.
25:12All encouraging signs.
25:17Any luck getting a lawyer for our detainee?
25:19Uh, no.
25:20Keep me posted?
25:22Yeah.
25:29It's a pretty bracelet.
25:32My daughter made it for me.
25:36She doesn't know what I am.
25:37I just wanted to know that I'm okay.
25:41You seriously won't let her make a phone call?
25:44Not until she's processed.
25:46Unbelievable.
25:49Thanks, and just let me know when she gets back.
25:52Uh, one other thing.
25:54Uh, do you have a resident named Adam?
25:57I was wondering if I could get his parents' phone number.
25:59No.
25:59I...
26:00Red phone is for emergencies only.
26:01This is kind of an emergency.
26:03This is kind of an emergency.
26:05Sorry.
26:06Bye.
26:08Hey, Mel, we need an R3 to supervise a reduction in North 4.
26:11You free?
26:12Uh, I guess.
26:14Should we move the deceased woman in Central 9 to viewing?
26:18Uh, no.
26:19Let's leave the husband in there for a little while longer.
26:21We need the room.
26:22We're not moving her yet.
26:24Okay.
26:25Sorry.
26:26I'm gonna do a room check.
26:28Heat's ICU says they'll have the bed soon.
26:31Okay.
26:37So what do we think?
26:39About what?
26:40The mom of our heat stroke kid?
26:42Uh, that is not our job.
26:44That is what CYF is for.
26:46So you think it was on purpose?
26:48No, I did not say that.
26:50I just don't buy it.
26:51She lost her kid at home?
26:53But she just looks guilty.
26:54Has anyone seen her cry?
26:58People don't always respond to trauma the way you expect them to.
27:01Stay focused on the kid.
27:088578042, SATS87.
27:09You having some pain again, Mr. Green?
27:12Mr. Green?
27:13This one's yours?
27:14Yeah.
27:15Uh, kidney stone.
27:15Possible vasovagal.
27:16Yeah, I assume that we need some help here.
27:18Does he have an IV?
27:19N-no, he didn't need one.
27:22Hypotensive and hypoxic.
27:24Clear a trauma room?
27:25Yes.
27:27Well, he was just waiting on his discharge meds, pain-free.
27:32I hope you more patients are going from Chair South 15 to Cough 2.
27:36History of renal colic, heen-positive urine, BP crashing.
27:39Heen-positive urine doesn't always mean kidney stone.
27:42Two anticubital lines, biggest ones we've got.
27:44E-fast.
27:45Let's get two units of whole blood hung, please.
27:48Good.
27:51Who worked up this patient?
27:53I did.
27:54Ultrasound showed dilated ureter and mild left hydronephrosis consistent with this history of renal colic.
28:00What about the aorta?
28:01I didn't look at the aorta.
28:03Who did you present to?
28:04Dr. Mohan.
28:05You said the rest of the ultrasound was normal.
28:07I meant that the other kidney was normal.
28:11Eight-centimeter triple-a with massive free fluid.
28:13Reptured hyaluronic aneurysm is bleeding out.
28:15Okay, go with the MTP.
28:1616 gauge in the left AC, two units of whole blood on the infuser.
28:21Assisting ventilations.
28:23Rest diagonal.
28:25Okay, who wants to intubate?
28:28Good body?
28:29Sure.
28:30Get a call for six more units of whole blood.
28:32You said we'll call surgery.
28:33If we stay ahead of him, we might get him up to the oar.
28:36Here you go.
28:52We're lighting up his sedation to see if he has any purposeful movement.
28:55And if so, that will be an encouraging sign.
28:59Need to be back to normal?
29:02There's no certainty as to how much recovery Michael will have.
29:06His response over the next 24 hours will tell.
29:10There is a chance of cognitive impairment.
29:15But also a chance of meaningful recovery.
29:18Dr. Alashimi, the patient in 2020.
29:23I will be right back.
29:41I'm in.
29:42Bag him.
29:42Nicely done.
29:43Good job.
29:44Unit 3 is up and running.
29:45I've got a 16 gauge UJ.
29:46That one goes on the rapid infuser.
29:48Good entitled waveform.
29:52Strong radio pulse.
29:53That's a very good sign.
29:54BP's up.
29:5486 over 52.
29:56Some progress.
29:57About two grams TXA?
29:58Yeah.
29:59What else do we give after four units of blood?
30:04Calcium gluconate to counteract hypocalcemia.
30:06Caused prevents the strain of a covalent.
30:08Why don't you see if you can't squeeze a unit into that peripheral line?
30:15Should somebody place a central line?
30:16Long central line is slower than short large bore peripheral.
30:19Flow is proportional to the fourth power of the radius.
30:22Physics.
30:24Right.
30:26Okay.
30:29Bite down on this.
30:32Okay.
30:33I'm stabilizing the humerus.
30:35All right.
30:35After I supinate with traction, Dr. Whittaker will apply downward pressure on the proximal forearm.
30:42Okay.
30:42This is going to hurt like hell, Roberto.
30:44One, two, three.
30:49Okay, and they're flexing at the elbow.
30:58This dolly's down to 68.
31:00Minutes five and six are up and running.
31:04I'm here for Garcia.
31:05Vascular can't come down.
31:06Triple A with hemorrhagic shot.
31:07Most of these die in the field.
31:09He was stable, presented with a history of renal colic.
31:11And nobody saw the triple A on ultrasound?
31:14Was this you?
31:15No.
31:16It goes me.
31:19Looks like sinus attack.
31:20Nope.
31:21Lost the pulse.
31:21It's PEA.
31:22Bag him.
31:23Ogilvy, start compressions.
31:24We're having a hard time staying out of the blood loss.
31:26Stead of the gloves.
31:26Prep for a thoracotomy.
31:28Dr. Gervati, why don't you glove up and show Dr. Shamsie why you belong in the ED?
31:33We can cross-tamp the aorta.
31:34We stop the blood flow from below the diaphragm.
31:37We can previews the heart and the brain.
31:42Ten blade.
31:43Can we get in there?
31:46Devo'o'o'o'o'o'o'o'o'o'o'o'o'o'o'o'o'o'o'o
31:59'o'o'o'o'o'o'o'o'.'o'o'o'o'o'o'o'o'o'o'o'o
32:01'o'o'o'.'o'o'o'o'o'.'o'o'o'o'o'o'o'.'o'o'o'o'o
32:01'o'o'o'o'o'o'o'o'o'o'o.'o'o'o'o'o'o'o'o'o'o
32:06'o'o'.'o'o'o','o'o'.'o'o'o'o'o'o'o'o'.'o'o'o'o'o
32:15'o'o'o'o,'o
32:16Right there.
32:20Can you give me on suction?
32:21No, there's no blood in the chest.
32:22It's all in the belly.
32:23Here, keep squeezing.
32:29Ayrrhda's clamped.
32:32Your heart is empty.
32:33Okay, Javada, get in there.
32:33Internal compressions.
32:34Go.
32:39Let's put two more units on the Ravna infuser, please.
32:41They'll be unit seven and eight.
32:49All right, neuro's intact.
32:51So we'll do a posterior splint, a sling, and an orthoreferral.
32:55You know, I'm actually kind of impressed you did that without pay meds.
32:58Definitely worth it.
33:00You know, last year I caught McCutcheon's 300th career homer,
33:03but another fan stole it from me.
33:05I promised myself I would never let that happen again.
33:09Whitaker, can you write the procedure now?
33:11Yeah, you already filled in the tea sheets.
33:13Yeah, well, I'm already here.
33:14Yeah, I kind of had a handle on it.
33:15Can you just fill out the tray?
33:17You should probably finish it.
33:18Well, okay, someone do this.
33:19I don't, I don't, I don't care who.
33:23Yeah.
33:33Where's Mrs. Azra Mendy?
33:34She stepped out.
33:36Stepped out?
33:42It feels like the heart's filling back up.
33:44Let's have a peek.
33:48Looks good.
33:50Really good.
33:51Strong radial pulse.
33:54Moist lap pads, prep for transfer.
33:57Systolic and 94th, the best so far.
33:59Can I go with you?
34:02He's my patient.
34:04Okay, by me.
34:06Bring two extra units.
34:13Ice is in the building.
34:15Word travels fast.
34:16Yeah, we have a detainee with a rotator cuff tear.
34:18Two of our nurses went home.
34:20They have temporary protected status,
34:21but they just don't feel safe.
34:26Um, I'm really sorry, Dr. Robby.
34:28I should have checked the aorta.
34:29Too easy one to miss.
34:31Got a heartbeat back, though, so still smoke.
34:37I'm sorry, too.
34:38I, I should have asked Ogilvy
34:40if he'd checked the aorta.
34:41It's, it's my fault.
34:42It is.
34:44You're the senior resident.
34:45You don't look to others.
34:46Others look to you.
34:47I know.
34:47I'm really sorry.
34:48This is what happens
34:49when you bring your personal life into work.
34:51The patient almost died.
34:52I know.
34:54You have to think of these walls
34:56like a force field.
34:57You cannot let anything in.
34:58Your mother's not in here.
35:00She is out there.
35:00You keep everything out there.
35:02That is the key.
35:02That is the difference
35:03between the best doctors
35:04and the ones that don't make it.
35:06You're right.
35:09Maybe I just don't belong here.
35:15Pranita's x-ray results,
35:17no fracture.
35:18Okay.
35:19I'll just have Jesse fit her
35:20for her sling, I guess,
35:21and then we have to discharge her.
35:22To the immigration guys?
35:24I'm afraid so.
35:28Okay, time for you to go.
35:30I was just having to chat
35:31when Speeder's here.
35:33You can see how busy
35:34this department is, right?
35:35You've been nothing but a distraction
35:37and a disruption
35:37since you've been here.
35:38I'm already short-staffed,
35:39and I just lost five nurses
35:41and half my environmental services team
35:42because you walked in.
35:44You know, patients come in here
35:46for help, right?
35:46Because they're either sick
35:47or they're injured,
35:48and documented or undocumented,
35:50they have a right to emergency care.
35:52TB, measles, fractures,
35:54none of it's getting treated
35:54because everybody's too scared
35:55to come in,
35:56but then they end up here anyway,
35:57but then it's too fucking late,
35:58so please, for the love of God,
35:59can you just go wait over there
36:00in the room with your detainees
36:02so I don't lose any more patients
36:03or staff?
36:06No problem, Doc.
36:18This is Asur Mendy.
36:23Brenda, where are you going?
36:26Brenda!
36:32Okay, okay, that's okay.
36:35Let's get you back inside to your son.
36:36That's okay, that's okay, that's okay.
36:41Come on, she's cleared to go.
36:45Hold on, she needs to sleep.
36:46This will only take a minute.
36:47We're leaving.
36:48Hey, man, you're hurting her.
36:52Jesus Christ, what's going on now?
36:54Robbie!
36:55No, no!
36:56You can't do this!
36:58What are you doing?
36:59What the hell is that?
37:00Get your hands on!
37:01He hurt her and Jesse stepped in!
37:03Yeah, I didn't do shit.
37:04I know, I know, I'm just kidding.
37:05I mean, no.
37:05Give me!
37:06Give me!
37:06Just give me no!
37:07No!
37:08We gotta go.
37:09No!
37:10No!
37:10Come on, come on.
37:11Don't say anything.
37:12You don't have to say anything.
37:13They can't make you say anything.
37:14We'll get you an attorney.
37:14I promise we'll get you out.
37:17Call the hospital attorney again.
37:18I can't believe this shit.
37:19Can you at least tell us where you're taking them?
37:22Is there a detention center near Pittsburgh?
37:24That's got to be where they're going, right?
37:25Could be hours before he's processed.
37:27I'll stay on it.
37:29What can we do?
37:31Uh, hey, Javadi?
37:33Javadi?
37:33Please come back.
37:34Everybody, just go check on your patients.
37:37Assure them.
37:38Tell them what happened.
37:38But please, everybody get back to work.
37:40Who's going to take Jesse's patients?
37:41I can do it, dear.
37:42Thanks, Perla.
37:45Hey, you okay?
37:46Yeah, I'm okay.
37:47You okay?
37:48Yeah.
37:48The lawyers are tied up with the cyber attacks upstairs.
37:50They probably won't come down for a while.
37:54Where's Elias with the heat stroke kit?
37:55Let's send him up to Pete's ICU.
38:02What's going on?
38:04I found her outside wandering into the street.
38:06She almost got hit by a truck.
38:08I think it was intentional.
38:10Christ almighty.
38:10I told Nurse Kim not to let her out of her side.
38:12We need to call a 302 and observe her.
38:15Dangerous self?
38:15Is she going to be able to see her kid?
38:17No, if she's on an involuntary cycle.
38:19Well, what happens if he's ready to be discharged before she is?
38:23Does she have a partner or a relitope who can call?
38:25I can find out.
38:26Why don't you and I talk to her together?
38:27Sure.
38:28I just need to check on a patient and I will meet you there.
38:30Okay.
38:34Okay.
38:43Okay.
38:48Hey, Emma, have you seen this patient?
38:50Oh, I haven't.
38:52Oh, she took off when those ICE guys arrested your nurse.
39:01I tried to get him to help me in the garden, but he just wanted to ride his trike.
39:09So I let him.
39:11Every time I looked over, he was just riding around.
39:20And then he wasn't.
39:23Have you ever thought about hurting yourself?
39:30CBC and blood alcohol are back on your goal for Curtis Larson, 0.14.
39:34Copy that.
39:35Okay, we'll wait for the other labs.
39:37He'll need to sleep it off in the meantime.
39:41Hey, Gabriel, can you wait up a sec?
39:43Do you have Duke Eakin's chest x-ray?
39:45Yeah.
39:45How's it look?
39:47Radiologist still needs to read it.
39:48Can you pull it up for me?
39:56I got to call the funeral home, start making arrangements.
39:59You could slow down.
40:00Take some time for yourself.
40:02How are you doing?
40:04Well, you know, been better.
40:06I spend so much time with these people.
40:09You've become a part of their family.
40:10It's not like it is here where patients come and go.
40:12Don't stay for the night shift.
40:14I got reinforcements coming in.
40:15I'd rather work.
40:16I don't know if I want to sit with this at home.
40:18Try.
40:18For once, just listen to me.
40:19Take the night off.
40:20I'll cover for you until I can find someone else to come in.
40:23Go.
40:24Hey.
40:26Love you.
40:32You think she's going to be okay?
40:35I don't know.
40:36I just hope she can forgive herself.
40:46I've noticed some tension between you and Dr. Santos.
40:50You two have history?
40:51Uh, yeah, she doesn't like me very much.
40:59Uh, we worked together one time.
41:01I was a pretty big asshole.
41:04She called me out on some things that I wasn't ready to face, and I overreacted.
41:11I'm going to talk to her.
41:13I just haven't felt in the right time.
41:16Good.
41:17Do good.
41:28Oh, you might be in here.
41:30What's going on?
41:33The deposition of my sister coming in, it's been a day.
41:36Oh, that's good, that position.
41:40Is your sister okay?
41:43Yeah.
41:44It's just a UTI, so meds all cleared up.
41:47Well, that's good.
41:50She's a boyfriend.
41:52She didn't tell me about.
41:55And other things she didn't tell me about.
41:57Maybe she didn't know how.
41:58She's having sex.
42:02Great sex.
42:05And she lied to me.
42:06I mean, she lied to my face for six months.
42:09My sister is a fucking liar.
42:12She's just cursed.
42:15It's how I feel.
42:18Well, kid, I say this with love.
42:22People got their own reasons for keeping secrets.
42:25Most of the time it's got nothing to do with you.
42:27I've seen Elf 164 times.
42:31Becca loves Elf, so we watch Elf.
42:34And she's got everything, and now she's got a boyfriend,
42:37and they're going to fall in love,
42:38and they're going to get married,
42:39and I'm going to be completely alone.
42:45Do I feel good to say that out loud?
42:49No.
42:53Mel, you're a good egg.
42:56But this is not about you.
42:59It was a long time ago.
43:01I quit feeling sorry for myself.
43:02Now, come on.
43:03Pity party's over.
43:04You're a good egg.
43:13Okay, so this is your heart,
43:15and these are your lungs.
43:17They look okay?
43:19Yeah, it's this part right here,
43:20this space right between your lungs.
43:22It's called the mediastinum,
43:23and it is enlarged.
43:25It is too wide.
43:26From what?
43:28I can't really tell from plain film.
43:30It could be any number of things.
43:31Yeah, stop the bullshit.
43:33It could be an enlarged thyroid.
43:35It could be enlarged lymph nodes from an infection.
43:38It could possibly be a tumor.
43:42You think I have lung cancer?
43:44No, I don't see that.
43:46The cancer of the lymph nodes is called lymphoma.
43:49And there are a lot of diseases of the aorta,
43:51which is this big artery that comes off the heart,
43:53which can get enlarged because of a weak spot in the wall,
43:56kind of like a bubble in a tire
43:59that can have a blowout.
44:01And the only way to make sure
44:03is to do a CT scan of your chest today.
44:08How long does that take?
44:11A few hours, a couple of hours.
44:15You still going to be here?
44:21Yeah, I would not feel good about writing
44:24if I rushed this.
44:28This is important.
44:35Hey.
44:37I think the, uh, labs are back on your COPD patient.
44:41Saw him in the rack.
44:42Thanks.
44:44Uh, look.
44:45I don't know how to say this.
44:48Um...
44:51I know you don't like me.
44:53And that's fine.
44:54You don't have to.
44:55I just...
44:56I want to say I'm sorry
44:58for being an asshole on your first day.
45:00That was completely inappropriate.
45:02And if I could
45:04take back what happened,
45:05I would, but I can't.
45:09Okay.
45:13Hey, I'm sorry.
45:14I just...
45:15I don't buy it.
45:16Everyone thinks you're just an addict
45:17who went to rehab.
45:19And you've convinced everyone here
45:20that you've changed
45:21and you're owning up to your mistakes
45:23and they welcome you back with open arms
45:24because you're still the golden boy
45:26and I think it's bullshit.
45:28I'm genuinely sorry.
45:30And I can promise you
45:32I have faced my fair share of punishment
45:33for what I did.
45:34You fucking stole drugs from the hospital.
45:36Only three people here actually know that.
45:38Have you told anyone else what you did?
45:40Have you?
45:41Look, I'm just trying to get through
45:42my first day back.
45:43You shouldn't even be here.
45:45I should have reported you
45:45to the state medical board.
45:47You should have lost your license
45:48and gone to prison.
45:49You don't know what I've been through.
45:50What you've been through?
45:51My wife threatened to divorce me, okay?
45:53I almost lost my case.
45:54Yeah, that's what happens
45:55when you fuck up.
45:59You don't have to accept my apology.
46:01I just...
46:01I wanted to say it.
46:02Okay?
46:04You really want to atone for your sins?
46:07Tell everyone here you stole drugs
46:08and got kicked out of the ED
46:09because of it.
46:10Until then,
46:11stay out of my way.
46:26What the fuck?
46:27I'm just checking your vital sign.
46:30Where am I?
46:32Guys, what are you doing to me?
46:34Ah!
46:35Ah!
46:37Ah!
46:37Ah!
46:37Ah!
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