- 2 days ago
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00:18All right, everybody, settle down.
00:22Good.
00:23Now, Robbie has something important to say.
00:25I know that this isn't easy.
00:27We're going to help you address any challenges
00:28that you might be having.
00:29If you have any concerns, just raise your hand.
00:32I'm going to write all this down.
00:34Dr. Mohan.
00:35Medication orders aren't coming up from the pharmacy.
00:37Check with the clinical pharmacist to see if it's in the PDS.
00:40If it's not, then give the third copy of the order sheet
00:42to Dr. Nord.
00:44We're going to need more people to run it down.
00:46We'll work on it.
00:47Langdon.
00:47I can't find a patient clipboard.
00:48Clipboards need to stay here for orders and labs.
00:51Wait, so how do we write our notes?
00:52Take the T-sheet to the bedside, not the whole chart.
00:55Same goes for nursing notes.
00:57Quilches.
00:58Fax machine is down.
00:59Error message E6.
01:00What the hell does that mean?
01:01You can check the manual.
01:02There isn't one.
01:03Okay.
01:04Perla, why don't you take your phone out to the base?
01:05If you can get service, find a manual online.
01:07My inner person's piano don't even come over to me.
01:10What else?
01:13Ogilvy, put your hand down.
01:14Santos.
01:14We've gotten a few CT results back, but nothing on plain films.
01:17That's probably because they're all sitting on the portable machine, not getting to radiology.
01:21I'll take care of this.
01:22You be patient.
01:23Help each other.
01:26We need to call in extra help.
01:27At 3 p.m. on the holiday?
01:29I know, people, buddy.
01:30I have a 32-year-old woman with severe abdominal pain.
01:33Do we have a bed?
01:34Not at the moment.
01:35I'll take her.
01:36It's okay.
01:38Santos, Giovanni, you're up.
01:39Drama 1's open.
01:4112-year-old Jude Augustine, firecracker exploded, non-dominant left hand, good vitals, 25
01:47defense so far.
01:48Any other injuries?
01:49No, but seems to have lost two of his fingers.
01:50Did you bring him?
01:51Blown a bitch.
01:52It really hurts.
01:53I'm sure it does.
01:54We'll do something for that.
01:56Parents, not on scene.
02:00Ready?
02:01One, two, three.
02:03Hey, Jude, do you know your mom or your dad's telephone number?
02:07No, but I know my sister's.
02:09Okay.
02:11Good breath sounds.
02:12Hey, abdomen non-tender.
02:13Heart rate, 112.
02:14Put the saran at the left floor.
02:15Is that good?
02:16That is very good.
02:17I want to do another 25 of Fem before we open this bench.
02:21Can you tell us what happened?
02:22My friend said firecrackers.
02:24What if I had Fem on board?
02:25I lit one, and it went off fast.
02:28I dropped it, but we're going to take your band to drop now, okay?
02:32I don't want to see.
02:33You don't have to.
02:34Yeah, just look at me.
02:35Okay.
02:37Cutting.
02:41Sorry.
02:42You're doing great.
02:46That looks like a lot more than a firecracker.
02:49More like an M80 or a cherry bomb.
02:51It's really good that you dropped it.
02:53You saved the rest of your hand.
02:54Digits four and five of both.
02:56Distant metacarpals four and five also bond with exposed bone.
02:59Soft tissue damage in the palm of our aspect.
03:01Less though on dorsal.
03:02Some burns on wound edges.
03:03Jude, can you bend your fingers for me up and down?
03:08That's a really good job.
03:09Good job.
03:09How bad is it?
03:11You lost two fingers, but it seems like the rest are going to be okay.
03:15Oh, no.
03:16I fucked up!
03:18All right, can we do a wrist block for the pain?
03:19I want to do a very detailed motor and sensory exam first.
03:22We're going to continue our exam now, okay, Jude?
03:28Okay, thanks.
03:30I see you can take her after the next neuro exam.
03:32I see you.
03:33Just so she can be monitored for the rest of the day.
03:37Four millimeters in reactive.
03:41Mel, four millimeters in reactive.
03:44Yep, got it.
03:44I could sort of make out your hand.
03:50Can you cover your good eye?
03:53Any fingers of my holding up?
03:56Three.
03:59That's good news.
04:00So, the medicine worked?
04:02She's out of the woods?
04:03Um, possibly.
04:06It's...
04:06Okay, um, cover your eye again.
04:09Okay.
04:09All right, what do you see?
04:12Top nine is E.
04:14All right, and the next one?
04:18Nothing.
04:20Okay, well, that's $2,200.
04:23What meaning?
04:25Uh, what a healthy eye can see at 200 feet, she can see at 20 feet.
04:28Is that good?
04:29Yeah.
04:30It's much better.
04:31Um, and it can continue to improve over time.
04:35Thank you, Dr. King.
04:37Um, I'm going to take a quick break before my deposition.
04:41So, I'll let Robbie know that I'm off the clock for the time view.
04:45Good luck.
04:46Thanks.
04:50Mel.
04:51Hi.
04:51You have a visitor in chairs.
04:53What?
04:53Who?
04:54Said she's your sister.
04:55Rebecca?
05:01Yep, you have heat exhaustion.
05:03It usually gets better with a leave, but today was really bad.
05:07Same pain you had before?
05:09Mm-hmm.
05:09From a cyst?
05:10I think so.
05:11I have PCOS.
05:14Is the, uh, is the pain always on your left?
05:16Today it is.
05:17We will check a UA and your impregnancy test, and I'll give you a shot of Tordal.
05:22It's something a little stronger for the pain.
05:24I'm not pregnant.
05:26I promise.
05:26No, we have to.
05:28It's hospital policy.
05:30You guys still write stuff down on paper?
05:33Today we do.
05:34Yeah.
05:43Are you a doctor?
05:44I've been waiting hours to be seen.
05:46Quick question.
05:47Come.
05:47Who wants to walk her?
05:49This thing is useless.
05:51Sorry, I just, um, um, we're really busy, and someone will see you in a second.
05:58Becca.
05:59No, hi.
06:01Is everything okay?
06:02Uh, yeah, I have a stomachache.
06:04Did you see the residential care nurse?
06:05She was out for the fourth, but I talked to her on the phone.
06:08She told me to come here, and Jerry brought me.
06:11No problem.
06:12I'll wait for you.
06:13Okay.
06:14Okay.
06:14Come this way.
06:16Just, through here.
06:18Is it always like this?
06:20Yeah, pretty much.
06:22Wow.
06:22There are a lot of smelly people.
06:25Yeah.
06:26You going to help them all?
06:27Yeah, but, um, let's start with you first.
06:30Okay.
06:32How's the pain?
06:33I can't feel my hand anymore.
06:36And Sam's on the board.
06:37Okay, we're going to clean out your hand with saline, salt water.
06:40Okay.
06:45What's up?
06:47Hand versus M80.
06:48Surprised we've only seen one of these.
06:50They're still young yet.
06:52Lost fourth metacarpal mid-shaft.
06:54I'll look at this.
06:54Bummer.
06:57Hello, I'm Dr. Garcia from surgery.
06:59I'm going to have surgery.
07:00Yes.
07:00The first operation is to clean everything up and cover where the skin is missing.
07:05But you still have your thumb and your most important fingers.
07:13What'd you give me for pain?
07:14We did regional blocks.
07:16Hand surgery always wants to document their own neural exam.
07:19Sensation is intact.
07:20So light touch and pen break got the digits in our remaining hand.
07:25Um, yeah, FDS and FTPs and extensor function was all intact.
07:29Leave parental consent for surgery.
07:31Yeah, we're working on that.
07:32Dr. Robbie?
07:37I smell alcohol in his breath.
07:41He's in line for the OR.
07:42Might be a little bit of a weight ortho still in with Alan Billings,
07:45that open shoulder dislocation that came back from Westbridge.
07:47He's still in surgery?
07:48He waited an hour to be cleared by anesthesia.
07:50Is the insurance company going to cover the cost of the surgery?
07:52Yeah, since Westbridge is still down.
07:54Well, good, because the delay in care definitely increased the chance of a post-op infection.
07:57You've got to love it when insurance companies make medical decisions.
08:01Hey, what's up?
08:03Do you still need a rain check for washing fireworks tonight?
08:06I thought you were coming over.
08:08I made other plans.
08:10Okay, cool.
08:12I'll try hitting you up tomorrow.
08:14We're just keeping it casual, right?
08:16For sure.
08:21Yeah, thank you.
08:23Yeah, bye.
08:24Oh, uh, hey.
08:25I just got a hold of the sister of the heavy patient Abbott's taken at Presby.
08:29She still lives in Arizona, but she is willing to talk to him when he's back.
08:33That's good news.
08:34When do you think that might be?
08:37Depends on how crazy it is over at Presby.
08:39If it's anything like here, who knows?
08:41Yeah.
08:41Um, here's help on the way.
08:44Oh, you little faith.
08:45You got a gun van?
08:48Thanks.
08:49I keep losing these.
08:51Oh, it's a fucking day.
08:53I thought I was going to get a clean getaway from my trip.
08:55God gives his toughest battles to his strongest soldiers.
08:58Uh, Dana, is there a room open?
09:00This is my sister.
09:01She's in a lot of pain, and we need a bed at his house.
09:03My name is Becca, not my sister.
09:05Sorry, right, um, uh, Dana, uh, Dr. Robbie, this is my, my, Becca.
09:10Nice to meet you.
09:11You're Dr. Robbie?
09:13Cool.
09:14That's what, someone was just cleaned.
09:15Anything I can get you, hon?
09:16No, thank you.
09:21Oh, wait, Becca, come here.
09:24Come this way, we're going right in.
09:28All right, so, um, you're going to need to get undressed and get into the gown, which should
09:32be on the bed, then we're going to do an evaluation and take a history.
09:36That's a lot of questions, like, like, a lot, a lot of questions, which we'll do, and
09:40then a physical exam, of course.
09:41Mel, I've been to the doctors before.
09:45Right.
09:45Sorry.
09:46I just, I really want this to be done the right way.
09:53Do you need to take the call?
09:55Uh, no.
09:56It's, um, it's a reminder alarm for this important meeting I have in 15 minutes.
10:00Um, do you have to go?
10:03Let's just get you taken care of first, all right?
10:05So, just change the gown, I'll be behind the curtain.
10:07Okay.
10:10Okay.
10:20Ahem.
10:21Your grand prize.
10:24All I see is green, baby!
10:29It's madaya.
10:31Akala mo, di ko alam na binigyan ka nang tip nero sa Westbridge.
10:35Oh.
10:36What's that, wa?
10:38Pax machine is paid with jam.
10:40So annoying.
10:41Hmm.
10:43Makano pa na manihimik ka?
10:44Kalahat, eh.
10:4510%?
10:4540.
10:48Ay, it's...
10:49You want me to try?
10:50No.
10:52No, huzzah.
10:53I got it.
10:58What's it say?
10:59Replace toner.
11:00We live in hell.
11:01No, where can we get that?
11:021988.
11:03You ever seen one of these?
11:04Honestly, no.
11:05So, how are we going to get labs and x-rays to the ward?
11:07Still fashion, eh?
11:08Runners.
11:09I'll check if they can spare a couple of clerks from upstairs.
11:17When were you first diagnosed with polycystic ovarian syndrome?
11:20Last summer.
11:21That's when the symptoms started?
11:23No.
11:23I've had years of pain, hormonal changes, and an abnormal period.
11:27I was finally diagnosed after switching to a gyno who actually listened to me.
11:31I can take time to make the diagnosis.
11:35That sounds like an excuse for lazy doctoring.
11:38It doesn't help that some of you don't listen to women, let alone brown ones.
11:43It hasn't been easy.
11:45How's your pain now?
11:46Better.
11:47What was she giving?
11:48I am tortal.
11:49Have you had a transvaginal ultrasound before?
11:52I've lost count of how many times.
11:54Okay.
11:55If you want to scoot your bottom down, I'll help you put your feet and the leg rests here.
11:59Yep, you...
12:01Got it.
12:10Okay, ready to go here.
12:12Cold gel and some pressure.
12:17Okay.
12:20Okay, ectopic is unlikely since the year in pregnancy was negative.
12:24I'm hoping it'll be positive one day.
12:27Oh, are you trying?
12:28Not at the moment.
12:29I'm getting married in September.
12:31Congratulations.
12:33Okay.
12:35A bunch of small cysts, to be expected.
12:38But then there's one big one, about five centimeters.
12:41My gyno's been monitoring her.
12:44With a little bit of free fluid, checking blood flow to the ovary.
12:49Red is for artery, blue is for vein.
12:51Okay.
12:52Looks good.
12:53Coming out now.
12:56Sorry.
12:59We will be back when you get your blood test results.
13:05Hey, what do you think?
13:06She probably had a small fluid leak from the cyst that caused the pain that improved with
13:10a non-steroidal.
13:12And what's your plan?
13:13Discharge with naproxen.
13:15Do you think that just might be what her doctors in the past have done?
13:19She said she's feeling better.
13:21We can free up a bed.
13:22She didn't look good in triage, and her pain was way more severe than previous episodes.
13:26I think we observe her for a bit.
13:29Okay.
13:30Mr. Green, this is Dr. Mohan and student Dr. Ogilvy.
13:34Uh, what can you tell me about your flank pain?
13:36Feels like another kidney stone.
13:38You've had them before?
13:39I said another, which means an additional thing of the same type.
13:44I teach English at Point Park.
13:47Triggering.
13:48My dad's a high school English teacher.
13:50Oh.
13:51Well, you went into medicine.
13:52He must be really proud.
13:55You'd have to ask him.
13:57Getting back to your pain, it feels like something you've experienced before.
14:01Same as always.
14:02Left kidney, uh, started about 10 p.m. last night.
14:05Any fever, blood in the urine?
14:07No.
14:07Uh, no fever.
14:09Urine's a bit darker than normal.
14:11Dehydration can lead to stone formation.
14:13Lean forward a bit, please.
14:14Check for CDA tenderness.
14:16Yeah.
14:16All right.
14:19Let me know if there's any discomfort.
14:20Mm-hmm.
14:23Ah.
14:24Sorry.
14:24Yeah.
14:25We'll order medication in a few tests.
14:26Okay.
14:31Um, dip urine, chem 7, bedside ultrasound, a check for hydro, and Ketorolac for pain.
14:36Sounds good.
14:37Okay.
14:44Really putting me to work.
14:45It's been a very busy day, Dr. Barker.
14:47Call me Nick.
14:50What's all this?
14:52I brought radiology to us.
14:53Dr. Barker, Nick will have wet-read results for us in no time.
14:57Good idea.
14:59Wet-read?
15:00You ever take a photography class?
15:01Yeah, like middle school.
15:03So, before digital technology, X-ray films were physically developed in a dark room.
15:07Baths?
15:07Thus, right-read.
15:09Oh.
15:09Cool.
15:10He's picking up a lot of space.
15:13Got an update from Dylan and our abandoned baby.
15:16A CYF has requested an emergency custody authorization.
15:18Once we get a court order, we can place her in foster care.
15:21I love photography.
15:24Jesus Christ.
15:24Dr. Robbie, Dr. Robbie, can I borrow you for a second?
15:26Sure.
15:26What can I do for you?
15:27Well, she said she has a stomachache, but belly pain can mean a lot of different things,
15:30but she's not-
15:31Okay, okay, okay, breathe.
15:32I'm looking for Dr. Mel King.
15:34Yes?
15:36I'm Morgan Stiles, one of the hospital's attorneys.
15:39I'm here to escort you upstairs for your deposition.
15:41Right now?
15:43Morgan, can I borrow Dr. King for just a moment?
15:47Sure.
15:50It's gonna be fine.
15:51I can't go up now because of Becca.
15:53You probably shouldn't be caring for Becca.
15:55It's not a good idea to care for family members.
15:57It's hard to stay objective.
15:59Let's see who's available.
16:00Hey, are you free?
16:01Is anybody really free?
16:04Not an R2.
16:06Ah, it's the guy we were looking for.
16:08Need something?
16:09Yes, uh-huh.
16:11Sure.
16:11Dr. King's sister has a bellyache.
16:14The case is now yours.
16:15You can pick up the rest of her patients while she's doing your deposition.
16:18How am I supposed to catch up on my outstanding charts with extra patients and the computer system now?
16:22The same way that the rest of us do.
16:24You can finish your charting when you finish your shift.
16:27Fucking fantastic.
16:33Hi, Becca.
16:34Hi.
16:35Um, this is Dr. Langdon.
16:36He'll be taking care of you.
16:38You have really nice hair, Dr. Langdon.
16:40Oh, thank you.
16:43Mel, would you mind turning off the lights on your way out?
16:46Of course.
16:48And, um, I'll be back as soon as I'm done.
16:51And feel free to call me if anything comes up, because I can come, right?
16:54Don't worry.
16:55Becca's in good hands.
16:56I know.
17:07Mel says lots of nice things about you.
17:12Okay.
17:13Um, tell me the reason you're here today.
17:17I have a stomach ache.
17:18Your belly hurts?
17:20Where about?
17:21Right, um, right down here.
17:23Okay.
17:23Are you experiencing anything else, or is it just the stomach ache?
17:27It, it stings when I pee.
17:30Sometimes when that happens, women feel like they need to urinate all the time.
17:34Do you feel that way?
17:35Yes.
17:36And what happens when you go?
17:38Hardly anything comes out.
17:40That's what I thought.
17:42Really?
17:43How do you know?
17:45Well, I've seen a lot of patients with the same symptoms.
17:47So this is normal?
17:48Yes, it's totally normal.
17:50But we still need to fix it.
17:53Okay.
18:00Hey.
18:01So come on, Roxy.
18:03A little better.
18:05Yeah?
18:05You need more morphine?
18:13I've been in pain all this time, my love.
18:16Why did you tell me?
18:19I didn't want you guys to worry.
18:23I can't pretend anymore.
18:27Mom, it's so hot outside, the ice cream's melting.
18:31We, uh, we thought we'd indulge a pick.
18:36Wow.
18:37Yeah.
18:38Oh, looks amazing.
18:40So, uh, which flavor should we start with?
18:43Salty caramel, mom's favorite.
18:45You'll need lots more napkins.
18:50Mmm.
19:07How's it going in there?
19:09All good.
19:10Langdon's great with her.
19:11I got seven more films ordered waiting to be shot, but Dr. Nick here's tying up the machine.
19:16Isn't there a USB port on the front of that portable?
19:18And can't we just download the films to a workstation and watch them without the internet?
19:22Yes.
19:23Oh, right.
19:24Forgot about that.
19:25Is she actually helping or is she just distracting?
19:27Let's download these and start moving on the folks waiting for X-rays.
19:30Great.
19:30I'm caught up anyway.
19:31I'll be back with the next batch of writing.
19:33Dr. Robbie, the, uh, guardian of your missing fingers kit in Central 12 has arrived.
19:37Thank you, Olive.
19:37Will you ask Dr. Santos to come and meet me, too?
19:39On it.
19:39Who's in South 22?
19:41Nobody.
19:42Headache was discharged.
19:43Tell that to the lady on the bed.
19:44What lady?
19:45I just tried to put a hematuria patient in there, but, uh, it's occupied.
19:49South 22, you sure?
19:50I'm positive.
19:50South location.
19:52Then why isn't she on the board?
19:54I, she should be.
19:55Olive was bringing her back from triage.
19:57I picked her right up.
19:58I just assumed she made it to the board.
19:59You should have checked.
20:00You should have made sure.
20:01I, I haven't put anybody on the board.
20:02I thought the nurses did that.
20:03We all need to pitch in.
20:05There's no rooms at the moment.
20:06Put hematuria on the wall.
20:07Who's your patient?
20:09This is Burns with nausea.
20:10I've ordered labs and x-rays.
20:11Who are you seeing them with?
20:12I still need to present the case.
20:13Get busy.
20:14Find somebody with empty after their name.
20:18Oh, God.
20:19Kids.
20:22Hello.
20:23I'm Dr. Robbie.
20:24This is Dr. Santos.
20:26Chantal.
20:26How do you do?
20:27We've been caring for your brother.
20:28Are you Jew's legal guardian?
20:30Yeah.
20:31Our, uh, our parents aren't around.
20:33Is he gonna be okay?
20:35He got very lucky.
20:36He lost the fourth and fifth fingers on his non-dominant hand, but if he hadn't dropped
20:40the firecracker, it would have been a lot worse.
20:42He lost fingers from a firecracker?
20:45Will he be able to use his hand?
20:47Yes.
20:47He still has his three most important fingers, and they're fully functional.
20:51He'll need surgery to clean everything up, but it should heal well.
20:54What the fuck were you thinking?
20:56I'm sorry.
20:58Alex asked me to come over.
20:59His brother's had a stack of...
21:01You think I wanted to blow my hand off?
21:07Then you need to listen to me when I tell you something.
21:08You're not my mom!
21:09Do you think I want to be your mom?
21:12Why don't we take a step outside?
21:18So, I know that this can be very stressful.
21:20Yeah, he almost lost his hand being stupid.
21:22He's a really sweet kid.
21:24He used to be.
21:24We also found something in his blood work.
21:27What?
21:28He has a blood alcohol of 0.08.
21:32Well, he was drunk?
21:33Are you fucking kidding me?
21:35Does he drink regularly?
21:36No.
21:39I don't know.
21:40The boys at our apartment complex are really bad influences.
21:44And he's only 12.
21:46That is what concerns us.
21:47A positive blood alcohol immediately triggers a social service consult.
21:51Are you going to take my brother away from me?
21:53It's an evaluation to determine if the injury in the drinking is cause for some kind of intervention.
21:57Whoa, I won't let you separate us.
21:58We are required to...
21:59No!
22:0958-year-old woman with nausea vomited once after eating warm potato salad at a barbecue.
22:14Well hydrated, abdomen's pretty benign, just a little distended with mild tenderness.
22:17History of constipation, I give her Zofran.
22:19Well, abdomen abdominal series pending.
22:21Okay, let's take a look.
22:23Okay.
22:24Hi, Mrs. Burns.
22:25This is Dr. Whitaker.
22:25How are you feeling?
22:28Mrs. Burns?
22:30Hey, Mrs. Burns.
22:31Can you open your eyes for me?
22:32She was awake and alert last time I saw her.
22:33Okay, uh, feels warm.
22:36Thready pulse.
22:37Abduin's more distended than before.
22:38Okay, uh, agonal respiration.
22:41She's, she's hardly breathing.
22:42I'm just rigid.
22:43Yeah, yeah, yeah.
22:43Perla, we need a crash cart.
22:45Can you call respiratory?
22:46Pull the bed out for intubation, please.
22:47Yeah.
22:48I can give you guys some room.
22:51What's up?
22:52Hypotensive.
22:53Acute abdomen.
22:54She needs an airway.
22:55I'll find the bledscope.
22:56No time for that.
22:57We've got direct on the crash cart.
22:58Whitaker, you're up.
22:59I haven't done many directs.
23:00Then you need to do more.
23:01Induction nets.
23:02100 ketamine, 80 of rock.
23:04Javadi, what's the story?
23:06Presented with mild abdominal pain.
23:08Took a turn for the worse.
23:11AFib 122, BP-98, systolic.
23:14Okay, let's bolster another 500 cc's.
23:16You shocking her?
23:16Uh, maybe.
23:17After intubation.
23:18Check your light.
23:19Check your balloon.
23:19Javadi, AP pads in case we need to cardiovert.
23:22She's normally KG at triage.
23:23She wasn't in AFib.
23:24Stress from her condition probably put her there.
23:26Good.
23:26Let's roll her.
23:27Do we have any labs back?
23:29I don't think so.
23:29What else do we need?
23:30Um, blood cultures.
23:32Lactate, two liters.
23:34LR34375, Piptazo.
23:36Okay, she's loose.
23:36Go ahead, Winnie.
23:37Take a look.
23:38Okay.
23:46Hi, I'm Dr. Santos.
23:48This is student Dr. Kwan.
23:49How are you doing after the mist?
23:51Better than I was an hour ago.
23:53Okay, we are going to check your vitals.
23:57Temp is 100.2 and heart rate is 96.
24:02Okay, down from 101.5 and 120.
24:04Very good.
24:06You were out in the heat in that costume?
24:08Yeah, with about 18,000 of my friends.
24:11Were you at Anthrocon?
24:13Uh-huh.
24:13What's that?
24:14Pittsburgh's annual furry convention.
24:16My career.
24:18Ever been?
24:20Uh, it's not really my scene.
24:22Hmm.
24:23Yeah, furries get a bad rap, but there are great people in the community.
24:27Creative, welcoming, funny.
24:31I actually met my girlfriend at last year's convention.
24:33Hmm.
24:34That's cute.
24:35She gave me hope after struggling on the dating apps.
24:38Nice to hear that meeting people in real life still works.
24:41Wouldn't recommend it, especially at work.
24:44You should come to Anthrocon this weekend.
24:48Doesn't she need a fursuit for that?
24:50I think you'd make a good dragon.
24:55Okay, I'm in.
24:57Balloon up.
24:59Yeah, bagger.
25:02That was harder with that video.
25:04Won't always have video.
25:06AFib now, 152.
25:07Blood pressure's down to 76 over 44.
25:09Okay, Javadi.
25:09Sync mode.
25:10Javadi, sync mode, 200, please.
25:13Good in tidal waveform.
25:15Good.
25:16Breath sounds bilaterally.
25:19Charge for cardio aversion.
25:20Everyone clear.
25:25Normal sinus.
25:26Wrong radio pulse.
25:29Good.
25:30Keep fluids going.
25:31Let's see what labs are back on her.
25:35Nice.
25:36Very nice.
25:39What did you order?
25:40Um, CBC in our camp panel.
25:42Someone should be back.
25:43Vax machine ran out of tone.
25:44Check the chart.
25:45There is no chart in slot 22.
25:47Check the orders rack.
25:49Nothing here either.
25:51Where's the chart for Claire Burns?
25:55Claire Burns, order slipped.
25:57Never drawn, never sent off to the lab.
25:59That's because the patient wasn't on the board.
26:00Nurses are working zones.
26:01If the patient's not on the board, they don't exist.
26:04So they didn't shoot her X-ray?
26:05X-ray downtime box is empty.
26:06That means it was done.
26:07Then it's on the portable machine.
26:09Last I saw was headed north.
26:12Thanks, Taylor.
26:13Yep.
26:14Hey, Kayleigh, can you wait up a sec?
26:15If you need an X-ray, write the order.
26:17I'm out of downtime.
26:18Did you shoot a KU being in South 22?
26:19No, maybe another tech day.
26:20Hey, can you flick through the films, look for a patient Burns?
26:28Oh, shit.
26:29Oh, that is a classic sigmoid volvulus.
26:31Peritoneal cuts.
26:32Okay, call the OR.
26:32She's going to need surgery.
26:33ASAP.
26:43Urine shows three plus blood.
26:45No surprise.
26:47BUN and creatinine are normal.
26:49No evidence of renal insufficiency.
26:51I got a good look at the left kidney.
26:53Mild hydronephrosis, consistent with ureteral colic.
26:56How was the rest of the ultrasound?
26:58Normal.
26:59Pain improved after 15 Keturilac IM.
27:02No, you can give another 15 and observe.
27:07Just need you to co-sign my order.
27:12Oh, something on your mind?
27:15Yeah, I saw this regular an hour ago.
27:18He's in his 60s, fakes an ailment so he can come into chat every now and then because he's really
27:23lonely.
27:24You sure he just doesn't have a crush on you?
27:26Maybe, but it got me thinking about my mom.
27:29She's probably just been lonely.
27:32Yeah.
27:33You know, I, uh, I haven't really dated since my divorce.
27:38Medical school, my kid, residency.
27:41And now I'm feeling finally kind of ready.
27:43I was waiting until I got back to Jersey to work on finding a relationship, and now that's out the
27:47window.
27:48Maybe I waited too long.
27:50For what?
27:51Do you hear that?
27:53That painful, lonely silence is the sound of my eggs dying.
28:02So the rash of North 3 has been discharged.
28:04The tasered law student in Central 10 has gone up to psych.
28:07The eye stroke is now in the ICU, and the tongue laceration in South 15 has sobered up before we
28:12discharge.
28:12It better be soon, because we need the room.
28:14Okay, I'll grab a med student and get more patients heading out.
28:16You're not phased by any of this chaos?
28:18Hmm.
28:19What a fucking mess.
28:21Jesus Christ, we need you.
28:24Monica Peters, this is our new attending, Dr. Alashimi.
28:27Welcome.
28:29Monica's a retired clerk, best of the best.
28:31She was kind enough to come in on a holiday and help get us back into shape.
28:34Laid off by the digital revolution, not retired.
28:37And how's all this digital shit working out for you now?
28:40Also good.
28:41Exactly.
28:43All right, then.
28:44Who's handling the charts and the orders?
28:46That's us, right here.
28:47How long have you been clerks?
28:49Just today.
28:50We're medical assistants.
28:51Then get out of my space and go do something you know how to do.
28:55And no personal calls.
28:56Red phones are for emergencies only.
28:58This is a hospital, for God's sake.
29:00I'll call you back.
29:01Got a gum band?
29:03Hi, I'm Makeda from Admin Records.
29:05I have a new badge for Dr. Whitaker.
29:06Yeah.
29:07I'll get that to him.
29:09Heard you all need extra runners?
29:10Perfect timing.
29:11How fast can you move?
29:12I run marathons.
29:13Great.
29:14Grab the blood samples in the bin and get them up to the lab.
29:17I want a lab run every 15 minutes.
29:19Got it.
29:25I work at a shoe store in Oakland.
29:28Full-time and you're in school?
29:30Yes.
29:31Yes.
29:32Allegheny community.
29:33Does Jude go to summer school or camp while you're at work or school?
29:40Can't afford it.
29:42Are there any family members that could help with this care when you're not available?
29:45No.
29:50Chantal, we want to help you, but we can't help you if you won't talk to us.
29:54What?
29:55You're going to take Jude away and put him in foster care?
29:58I promised my parents that would never happen.
30:01Did your parents pass away?
30:03Nope.
30:05What happened to them?
30:13My parents were deported to Haiti nine months ago.
30:19They went in for their immigration hearing and were detained.
30:24I was a sophomore at Ithaca.
30:26I had to move back home to take care of my brother.
30:29I'm sorry.
30:31It was either that or he moved back to Haiti with them.
30:36We've never been there.
30:38We were both born here.
30:43My mom was so excited when I got into college.
30:47She worked so hard to save up and pay my tuition.
30:52And now all she wants is for my brother to finish high school.
30:59Being a big sister is a lot easier than being a surrogate mom.
31:05Just give us a moment, please.
31:07And I'll come grab you when we're done.
31:13Do we really need to get family services involved?
31:16You wanted to get them involved this morning with your eight-year-old ITP patient.
31:20That's different.
31:21Abuse trumps neglect.
31:22We can't separate her from her brother.
31:24It's not right.
31:25A lot of what happens to people around here, isn't it right?
31:33Okay.
31:34Patient's complaining of pain.
31:36Uh, yeah.
31:40Hey, Amaya.
31:41What's going on?
31:42Oh, it really fucking hurts again.
31:44Hey, Jessie, can you grab Whitaker?
31:46When did it get bad?
31:47Two minutes ago.
31:48Did I need some morphine to take the edge off?
31:51How severe?
31:51One to ten.
31:52Twelve.
31:53It's way worse.
31:54Okay.
31:54Hey, Amaya, the meds will kick in and we'll get you back on the footrest to see what's going on,
31:59okay?
32:06I had to call her husband in New York to get consent.
32:09Okay.
32:10Dr. Shemze will be operating.
32:12Is she presented with peritoneal signs?
32:14Why wasn't I called?
32:16There was a delayed presentation.
32:18The x-ray was shot an hour ago.
32:20Why didn't anybody read it?
32:21There's confusion with the digital systems down.
32:23It wasn't read.
32:24We didn't get a report.
32:25An hour ago, I could have fixed this in 60 seconds with a rectal tube.
32:29Now she needs major surgery.
32:32I'm sorry.
32:33Not good enough, Nepo baby.
32:34You fucked up.
32:35Don't trust anything or anybody else when the system's down.
32:39With all the chaos, she just fell through the cracks.
32:44She almost died.
32:48I could have killed her.
32:50Whitaker.
32:50No.
32:51McKay needs you in Central 11.
32:53We caught it in time.
32:55We won't let it happen again, okay?
33:10Oh, uh, Princess is looking for you.
33:12Um, she said something about Monica under her breath, but I couldn't make it out.
33:16Okay.
33:17We'll be back in a sec.
33:18Hey.
33:19Hey.
33:21I did good with that sexual assault victim.
33:25You were amazing with her.
33:27We do what we can to provide the best care to traumatize people in their darkest days.
33:33What'd you talk to her about when you took her out on the wall?
33:36I, um, told her there might be a time in the future when she changes her mind, wants to press
33:43charges.
33:45It's better to have the option to do it than not.
33:48Smart.
33:48Smart.
33:52It's every day like this?
33:54Minus the cyber attacks?
33:56Yeah.
33:58But you're only a few hours away from being done with your first of many.
34:02Be proud of that.
34:11You're going to want to be on a soft diet, so, uh, things like, uh, mashed potatoes, soup, mac and
34:17cheese are good.
34:19I was going to make your favorite three-bean dip tonight.
34:21It's so nice.
34:23See, I am nice.
34:25Could she have that?
34:27Uh, yeah, yeah, yeah, if you eat it with a spoon rather than anything, like, crunchy that could work its
34:32way into the laceration.
34:33Hmm, so, she'll need to be spoon-fed.
34:38Antibiotics, three times a day.
34:40Come back here in two days for a wound check.
34:42See you then, doctor.
34:46Checking blood flow to the ovary.
34:50Okay.
34:50Okay.
34:53Okay.
34:53Okay.
34:54Okay.
34:56What's that?
34:57I'm coming out now.
35:00We will slide you back.
35:02Thanks.
35:04Your ovary is twisting.
35:06I'm cutting off the blood supply.
35:08That's what's been causing me pain.
35:10You said the blood supply was fine before.
35:13Sometimes the ovary can twist randomly.
35:17In those cases, the pain can come and go.
35:21Can you fix it?
35:22With surgery.
35:24Surgery?
35:24The ovary needs to be untwisted and tacked down with a stitch so this doesn't happen again.
35:30If we can get you upstairs quickly, we can save it.
35:33I could lose my ovary?
35:36Will I still be able to have a baby?
35:38This shouldn't be an issue in the future.
35:40Dr. McKay made the right call to keep you in the ER for observation so we could catch it if
35:45the pain returned.
35:49I'll call GYN.
35:50Yeah.
35:53Hey, welcome back.
35:55How was the trip?
35:55Smooth sailing.
35:57Presby's pretty nice.
35:58I might have to pick up some day shifts over there.
36:01Dr. Abbott's funny.
36:02Trust me.
36:03His charm wears off.
36:04No, it doesn't.
36:05He's not sedated?
36:06I gave him Berset for the CT scan and the ride back, but I figured he'd need to be awake
36:10and alert to give consent.
36:11Consent?
36:11Yep.
36:12We're going to get you settled.
36:13Why don't you pay the rest of you to come down?
36:15Dr. Robbie?
36:16You got this?
36:16No, I got it.
36:17Yep.
36:19All right, Howard.
36:21Hey, I want to debrief with you later on your sigmoid volvulus patient.
36:25I finished with your fireworks kid sister.
36:26And?
36:27She's a responsible young woman and a good guardian to Jude.
36:29There is no reason to get family services involved today.
36:32That's good.
36:32Because he's in the hospital for surgery.
36:34But they will most likely make a home visit next week to evaluate the safety of their apartment
36:38and the care that Chantel can provide along with her other responsibilities.
36:41And then what?
36:41They take Jude?
36:43In my experience, they'll make the same assessment I did.
36:45They don't like to separate siblings.
36:47Anything else we can do for them?
36:49I'll get some resources together for Chantel.
36:51Some are after school programs, but there will come a point when he'd be better off with his parents in
36:55Haiti.
36:55His parents want him to stay here.
36:57That's what's best for the child.
36:58Says who?
36:59Dr. Santos.
37:00Come on.
37:04Welcome back, Mr. Knox.
37:05What did we discover?
37:06That particular abscess that progressed to perforation now with free air under the diaphragm.
37:10In English, please.
37:12There's a small hole in the colon that's spilling bacteria into the abdomen.
37:15You're likely to develop peritonitis and sepsis.
37:20How bad?
37:21You need surgery now.
37:22You have a 100% chance of death without it.
37:26With it?
37:3050% chance.
37:35I could die.
37:36Yes, but we're very good at what we do.
37:38That is what the consent is for.
37:41What about my sister?
37:43We found her.
37:45She'd like to speak with you.
37:46We don't have time for that.
37:47Any delay increases your mortality risks.
37:50I want to talk to my sister first.
37:57We're going to make that happen for you.
37:59I'll have them prep an OR, but make it fast.
38:02Very fast.
38:02Yeah.
38:03We're on the move again, Howard.
38:04We're on the move again, Howard.
38:05We're on the move again, Howard.
38:11We're on the move again.
38:20Ray.
38:21Ray.
38:24The ice cream party over?
38:28Yes.
38:30Do you need anything?
38:35A time machine?
38:40It would be nice, wouldn't it?
38:47I don't even know what hurts more.
38:51The cancer or knowing I'm never going to see my sons grow up?
39:02It feels like a cruel joke.
39:06Do I give me children and a husband I adore if you're just going to take them away from me?
39:15For what?
39:16Fucking lung cancer.
39:21I didn't even smoke.
39:31Do you believe in God?
39:35I like the concept.
39:41I'm sure you've seen a lot of death.
39:45I have seen my share.
39:50Any advice?
39:57I've never died before.
40:09Hey, sorry, we're outside.
40:12There's, um, there's no cell service inside right now, but, um, here he is.
40:18Oh, my God.
40:20Are you all right?
40:23Been better.
40:25You look beautiful.
40:29You're not looking so hot.
40:33Thank you for calling back.
40:38Of course.
40:40I'm sorry that it's been this long.
40:43All the stuff with Dad and the drinking, I...
40:47I had to do what's best for me and Tommy.
40:50How is Tommy?
40:53Starting his junior year in high school next month.
40:5716, and already has a girlfriend.
41:02Takes after his uncle.
41:06Maybe we can make a plan for you to see each other over the holidays.
41:15I'd love that.
41:18Is the doctor there?
41:22Hi, I'm Dr. Abbott.
41:23Can you call me when he gets out of surgery?
41:25Of course, but right now we need to get him up to the OR.
41:27Oh, I understand.
41:28Thanks.
41:29Talk to you soon, Howard.
41:33Oh, I forgot to tell him I love him.
41:37Oh, wow.
41:38Monica?
41:40Welcome back.
41:41Rabinovich.
41:43Two for the lab, three for CT.
41:45I'll take those.
41:46They may be upstairs.
41:47Only for CT.
41:48You're on a tight ship.
41:50Well, it's a work in progress.
41:51Is he going up?
41:52Yeah.
41:54He's a good guy.
41:57Our surgeons will get him through.
42:04I like her.
42:06More than me.
42:08Only time will tell.
42:10Yeah?
42:12Yeah.
42:13She has good command of staff and procedures.
42:15I think you're leaving your day shift in very capable hands.
42:18I hope so.
42:20All right.
42:21I'm out of here, man.
42:22I've got to be back in a few hours for my shift.
42:25Why?
42:25If I don't see him.
42:27I'm really doing this still.
42:30I don't think I can remember the last time he took three days off in a row.
42:33I've taken a vacation before.
42:36Name the last one.
42:40Point taken.
42:43It's going to be a lot of time to self-reflect.
42:48You sure you can handle that?
42:53Okay.
42:55You just make sure you come back.
42:57And if it gets dark, you call me.
43:01You listening?
43:08So the ankle's negative for fracture.
43:10Wait.
43:10Go back to the ankle.
43:12Do you see the normal mortis?
43:14Yeah, but the tibiofibular clear space looks enlarged and the tibiofibular overlap seems reduced.
43:20Maybe a little.
43:23Eight millimeters.
43:25Three millimeters.
43:27Seems like a tear in the synosmodic ligaments.
43:29Doesn't that need surgical fixation?
43:31They do.
43:31I can request an MRI.
43:33Hi.
43:34Um, have you done a radiology clerkship before?
43:37No.
43:38I'm just that good.
43:43I'm good at things too.
43:56Really great work earlier today, doctor.
44:01Oh, um, you can just call me Whitaker.
44:06Not a chance.
44:07You earned that.
44:08I'm proud of you.
44:09We all are.
44:12Busy day.
44:14Oh, yeah.
44:15So, you're a very empathetic soul.
44:18Yeah, I'd like to think I'm not finished yet.
44:20And you want to be there for all your patients.
44:23Don't you?
44:24Shh.
44:24Sorry?
44:25So this relationship that you're having with this woman, um, the widow of the burn victim who died last year?
44:31Amy?
44:32Santos tell you?
44:34I understand you're helping her out.
44:36Yeah.
44:37On the farm.
44:37Look, I grew up on one, and Amy's, Mrs. Miller, is getting pressure to sell, so I'm just helping out.
44:45What about her friends and family?
44:47Yeah, they're around.
44:49Supporting her?
44:51Yeah, I think they try to, but mostly she's just leaning on me.
45:01I'm sure she's really grateful for everything that you do, but it's important to have boundaries.
45:07Yeah.
45:11Hey, you want to do me a favor?
45:15Yeah?
45:15You want to house sit for me while I'm gone?
45:18You'd actually be helping me out, and you'd save some money on rent.
45:24Are you being serious?
45:25No smoking, no parties, no pets, no babies, yours or anybody else's.
45:30No, I don't have a baby.
45:31No, but she does.
45:33I was going to ask Abba, but he does nude yoga at sunrise, and I don't think some of my
45:37elderly neighbors would survive sitting there.
45:40Yeah, yeah, that would be amazing, that the house sitting not seeing habits tonight with yoga.
45:47If I don't come back, you've got a swinging bachelor pad.
45:50Okay.
45:52Come find me before you leave.
45:54I'll give you my keys and a security code.
45:58Who's the joker that did this?
46:01Oh.
46:04You too.
46:05Make sure to double check your work.
46:07Triage can use an extra hand.
46:09Princess, finish up here, then head that way.
46:11Three for C.T. now.
46:12Should I run it over?
46:13No, he'd taken off orders.
46:15C.T.'s going to get backed up if we wait on these.
46:17I know, but I can't waste a runner on that right now.
46:19How did you find a carrier sheet?
46:21Exactly where I filed it away ten years ago.
46:24I thought that thing didn't work.
46:25Can't receive, but it can't send.
46:35Stay hydrated, preferably with electrolyte-rich drinks like coconut water.
46:39I'm not a fan of coconuts.
46:40Hey, Gatorade's also an option.
46:42Just avoid alcohol and caffeine, and I suggest wearing light, breathable clothing.
46:45Boring.
46:46Come back if your symptoms worsen, if you develop a headache or confusion.
46:51Hey, can you turn that up?
47:07Oh, shit.
47:09And they're all coming to us.
47:10They're currently being airlifted to the hospital by help.
48:10They're currently being airlifted to the hospital by help.
48:40They're currently being airlifted to the hospital by help.
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