- 13 hours ago
The Pitt Season 2 Episode 12
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00:20¡Suscríbete al canal!
00:30¡Suscríbete al canal!
01:00¡Suscríbete al canal!
01:14¡Suscríbete al canal!
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01:32¡Suscríbete al canal!
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02:13¡Suscríbete al canal!
02:16¡Suscríbete al canal!
03:00¡Suscríbete al canal!
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03:20¡Suscríbete al canal!
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03:34¡Suscríbete al canal!
03:46¡Suscríbete al canal!
03:50¡Suscríbete al canal!
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04:15¡Suscríbete al canal!
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04:20¡Suscríbete al canal!
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04:30¡Suscríbete al canal!
04:33y me pondría en contra cualquier departamento de emergencia en el país
04:36y es que será tuyo, así que no lo haría.
04:55No debería de smokear aquí.
04:58¿Really?
04:59Parece que está trabajando para mí hasta ahora.
05:04¿Qué?
05:04¿Qué?
05:06¿Qué?
05:07I'm 21.
05:09I'm Tuesday.
05:10Jeez, it's some kind of idiot savant.
05:14We no longer use that term.
05:17It's derogatory.
05:19You bruise easy millennials.
05:21Actually, I'm Gen Z.
05:23Even worse.
05:24I was stripping a purgatory to put myself through school when I was your age.
05:30Snowflake.
05:33Hey, Amy.
05:34Yeah, I'm getting off later than I thought.
05:37I'll give you a call when I get a better idea of when.
05:40I need help.
05:41I gotta go.
05:42I can't breathe.
05:42Wait.
05:44I got the airway.
05:45You take the pulse.
05:46Yeah.
05:48Oh, my God.
05:49Trying jaw thrust.
05:51Radios weak and thready.
05:52What's his name?
05:52My dad.
05:53Oliver.
05:54Hey, Oliver.
05:55Can you open your eyes for me?
05:56Sure.
05:57Okay.
05:58Here we go.
06:02Okay.
06:03One, two, three.
06:06Drive-in with severe respiratory distress.
06:08Last-sided dialysis.
06:09Shunt probable.
06:10Renal failure and fluid overload.
06:12I'm respiratory center.
06:13Bi-PAP.
06:14When was his last dialysis?
06:15It was supposed to be yesterday morning.
06:17Couldn't mean nitro drip ASAP.
06:19You got this?
06:20Yeah.
06:21Is that the guy who attacked Emma?
06:23Is he going to CT?
06:24Yeah.
06:24Miss Emma here needs an HMP.
06:26Uh, Cassie, can you give Emma here a workup?
06:28Started chart.
06:29Victim of assault.
06:30Really?
06:30I'm fine.
06:31He was choking you.
06:32He had me by the head mostly.
06:33You're a patient now.
06:34Full exam in South 18.
06:35In case she also needs to make a statement to the police.
06:37Is that really necessary?
06:40Yeah.
06:40Absolutely.
06:41Don't worry.
06:43Be there with you.
06:44I'll just get you a spot.
06:45Well, your guy just bought my guy for CT.
06:47No, he's my guy.
06:48He's got a new one because he's been sitting here forever.
06:49I'm never going to get out of here.
06:50Okay.
06:51Tell it to someone who cares.
06:52You know what?
06:52You should care because if you gave that guy a serious injury with force inflicted from
06:57a sedative, you are not licensed to prescribe him.
06:58Anyone else uses force to stop an assault?
07:00They're a hero, but a nurse doesn't and we're punished.
07:03You just happen to have a vial of her set in your pocket?
07:05It was extra from the medics.
07:06Good timing, I guess.
07:07When we waste a controlled substance, we need a witness to sign off.
07:10I was on my way to when I spotted that asshole attacking our girl.
07:13Anything else, Nancy Drew?
07:15Where are you going?
07:16Taking a pee.
07:16Do I need your permission to do that too now?
07:27Fuck!
07:28Fuck!
07:29Fuck!
07:29Fuck!
07:31Fuck!
07:32Fuck!
07:37Should we intubate?
07:39Best to avoid that if possible.
07:41Pressure support and afterload reduction buys us time for dialysis.
07:44BiPAP starting at 10 over 5.
07:45Good heart squeeze, good lung sliding, but there's a ton of B lines.
07:48Pulmonary edema.
07:49Which is best treated by Dr. Giovanni?
07:52Nitrates.
07:53Dose?
07:56BP 198 over 132.
07:58Pulse 120.
07:59Pulse talk's only 85.
08:01Good BP.
08:02Let's start at 400 mics per minute for two to five minutes.
08:03I was asking Dr. Giovanni.
08:05Don't you know I start low with nitro then titrate up?
08:07In flash pulmonary edema, we do the opposite.
08:10What he really needs is dialysis to get the fluid off.
08:13What's his dialysis schedule?
08:15Monday, Wednesday, Friday.
08:16He missed yesterday because of a wedding.
08:18We tried to go to the center this morning.
08:19It's usually open on Saturday, but I think they closed for the 4th.
08:22Where do you live?
08:23Brookville.
08:23It's like an hour and a half away.
08:25Yes ma'am.
08:25I tried Pine Ridge Hospital in Ford City, but I didn't know they shut down.
08:28Yeah, they sure did.
08:36All right, sister.
08:38How can I help uncluster this clusterfuck?
08:42Ready to finish our conversation?
08:44We talked.
08:45Okay, now I gotta need you.
08:46Please.
08:53Talk to me.
08:54I'm tired of this shit.
08:55Okay.
08:55It's the second time that Emma was attacked by patients today.
08:58Okay.
08:59I stuck one of my nurses.
09:00And these cyber assholes have thrown us back into 1999.
09:04Well, I'm worried about you.
09:05You are not yourself today.
09:07Like 2%.
09:09Do you have something you want to say?
09:12Go ahead.
09:13I can take it.
09:14All right, Danielle.
09:16Sometimes it's like you're just tempted to death because you don't give a shit anymore.
09:19So this is about the motorcycle?
09:20It's not just about the motorcycle.
09:21It's about the whole damn thing.
09:23Robin, you're actually telling people that you're going to a place called Smashing My Head In.
09:27Close.
09:28Not quite.
09:29Robbie, your buddy Duke is insisting on leaving and that MBA is here.
09:33Okay, okay.
09:34I'll be right there.
09:35What's open?
09:36South 15.
09:3778-year-old woman.
09:38Very low speed auto versus pedestrian with ground level falls.
09:41Bruising on her left hip.
09:42No head trauma.
09:43Her husband Eddie came along.
09:44Hi.
09:45How do you do, sir?
09:45I'm Dr. Robbie.
09:46Come with us.
09:46I'm going to get you set up right over here.
09:49Ah!
09:50Sorry, we'll get you something for the pain shortly.
09:52Thank you.
09:53Do you have any medical problems, Frida?
09:56Uh, high blood pressure, low thyroid, um, AFib.
10:00Any chest pain, shortness of breath?
10:02No.
10:03Front row seats.
10:04So, um, what happened?
10:06Well, she walked into the car.
10:10You hit me.
10:11No, I didn't hit you.
10:12You hit the car.
10:14You backed up right into me.
10:16I wasn't even moving.
10:19Well, you're both in very good hands now.
10:21Yes?
10:23Before we get you in a gown, we'd like to check your head.
10:26Of course.
10:30I am sorry.
10:31We had a whole bunch of craziness come in,
10:33and you got bumped down a patient or two for CT.
10:36But take comfort in knowing it was for some pretty nasty stuff.
10:39How am I supposed to find comfort in that?
10:42Or anything you've told me since I got here, for that matter?
10:44I don't know.
10:45But everything is supposed to come with a lesson, right?
10:47Oh, this is more of your Zen motorcycle bullshit.
10:51Maybe.
10:52No.
10:52No, the truth is I'm just stalling,
10:53because it's going to be a while longer.
10:55Okay, look, I appreciate the effort,
10:57but you guys are obviously jammed up,
10:59and I'll just come back when it's not our nation's birthday.
11:01You're already here.
11:02It's not going to be that much longer, I promise.
11:04Just stay and get your CT.
11:05I will do it all when you get back,
11:08and this place is less crazy.
11:09This place is always crazy.
11:10I don't know when I'm going to get back.
11:11Can you just sit the fuck down and wait a little bit longer?
11:13It won't kill you, but leaving might.
11:21Okay.
11:23No problem.
11:25Thank you.
11:28That's a nasty bruise.
11:30Do you take aspirin or any blood thinners?
11:33Uh, eloquist from my AFib.
11:37Any tenderness here?
11:39No, not really.
11:41Here?
11:42Oh, yeah.
11:43That hurts.
11:44Four of morphine and zofrin.
11:46What about up here?
11:47Not really.
11:50All right, so let's start with labs and plain film?
11:53No.
11:53CT abdomen pelvis will get a better view of the hip,
11:56and check for bleeding.
11:57The eloquist is concerning.
11:59Uh, you think she broke her hip?
12:01If it's broken, you broke it.
12:04Usually for a broken hip, the leg is shortened and rotates out.
12:08But we'll just wait for CT results.
12:18Mr. Cohen, I know that you were checked on scene,
12:22but I was wondering if I could do a quick examination of you.
12:25Oh, no, I'm fine.
12:26I was in the car.
12:27Just unofficially.
12:29Uh, okay.
12:33Deep breath for me.
12:36Good.
12:37Again?
12:40Great.
12:41Thanks, Eddie.
12:42Next thing.
12:43Would you mind taking your shoes off?
12:47What for?
12:48Just being safe.
12:53My back's not what it used to be.
12:55Let me help you.
13:00I, uh, could use a pedicure.
13:04You and me both.
13:05Dr. King, what do you think about doing a Romberg test?
13:09What is that?
13:10It's a general evaluation of balance.
13:13Um, can you stand up, sir?
13:16Yep.
13:17Okay.
13:18How are you doing, Oliver?
13:20Shats are not coming up.
13:21Pressure's holding on 400 and nitro.
13:22Let's up the BiPAP to 20 on 10.
13:24We could try phlebotomy, decrease the fluid burden on the lungs.
13:27Oh, it's cool.
13:28But right by time.
13:30Hemoglobin's only 9.2.
13:31He's anemic for renal failure.
13:32And he can't afford more blood loss.
13:34We need to intubate.
13:34We're losing this war.
13:36Intubation's not a trivial matter for immunosuppressed patients.
13:39Should we just drop a bunch of red tops?
13:41No, we do the collection on the floors if he's giving blood.
13:43We like medieval bloodletting.
13:45Essentially.
13:45And that is something you should step out for, Mason.
13:48Casey?
13:48Thank you.
13:49Got a good vein for 16.
13:50One donor back.
13:51500 cc's.
13:52No more.
13:57Okay, let it out.
13:59Same again.
14:00Deep breath in.
14:03Great.
14:04Hold on.
14:05How's she doing?
14:06Pull socks 100%.
14:07Normal exam.
14:08No evidence of injury.
14:09Great.
14:10I got way worse for my older brothers.
14:11I bet.
14:12Alright, I'll go write a picture.
14:16How about we call it a day?
14:19My shift isn't over.
14:20This was a shift and a half for anyone today.
14:22Believe me.
14:24If it's alright with you, I'd rather stay.
14:27I'm not a quitter.
14:29Okay, but someone good for you.
14:30But stick close to Donnie for the rest of the day, would you?
14:34Sure.
14:35And you also need to make a statement to the police.
14:38If we don't stand up for ourselves, no one else will.
14:40We're here to help.
14:41Not to be punching bags.
14:44Thank you for saving me.
14:46Got you, girl.
14:56Something wrong?
14:57That depends.
14:58Are you a four-month-old with severe diaper rash?
15:01No.
15:01I'm Dorian Cole and I'm pretty sure that I broke my collarbone.
15:04Okay.
15:05We can help with that.
15:05I'll be back.
15:06Are you serious?
15:07Can I at least get something for my pain?
15:09Sure.
15:10Sit tight.
15:11This place sucks.
15:11Tell me about it.
15:12Try working here.
15:14What?
15:14You're really working hard to boost those patient satisfaction scores.
15:17The chart for Central 7 doesn't match the patient that's in there.
15:19It's hanging there.
15:20We're almost over this.
15:21I was over this six hours ago.
15:23Sheriff's is looking like Mulaney's on St. Paddy's Day.
15:25They're gonna break through the doors like zombies if we don't start moving more than
15:28me back there.
15:29Dante Casella, 34.
15:31Blunt trauma from a fireworks explosion in his storage unit.
15:34A&O.
15:35Good vitals.
15:36Large scalp laceration and bruising to the chest.
15:38No meds or allergies.
15:39Partial or full thickness burns?
15:40No burns.
15:41The blast launched him into a rolled-down garage door frame.
15:44Am I fucking dying here?
15:45I'm Dr. Robbie.
15:46This is Dr. Santos.
15:47What?
15:48I can't hear you.
15:49Try the other side.
15:51I'm Dr. Santos.
15:53Can you hear me?
15:54Yeah, yeah.
15:54It's Dante.
15:55A lot of ringing.
15:57Hey, McKay.
15:58Joy.
15:58You're with us.
16:02One, two, three.
16:06I need, like, four doctors.
16:09Shit, I know it was bad.
16:10This is a teaching hospital.
16:12You need all the extra help you need.
16:15Airway and breathing intact.
16:17Good lung sliding bilaterally.
16:20Tender over the sternum.
16:22Possible fracture.
16:23That's your breastbone.
16:24No ectopy on monitor.
16:26No pericardial effusion.
16:27The heart looks good.
16:28130 over 85.
16:29Pulse 108.
16:30Sats 98 on two liters.
16:32Good enough for 50 effect.
16:34He's stuck through his head dressing.
16:35Let's take a peek.
16:36Normally, we don't deal with scap lax on the primary survey,
16:39only if there's active bleeding.
16:41Not with blast injuries.
16:42The pressure wave can transmit energy through the body
16:45and cause internal damage,
16:46even without any external visible signs,
16:48especially with organs that are air-filled.
16:50How are we looking, Dr. Santos?
16:51PFAS negative.
16:52No free fluid in the belly.
16:55Fuck me.
16:57What is that?
16:58It's a pretty big flap.
16:59Checking for bleeding source?
17:01Is that through the gale yet?
17:02It is indeed.
17:04Crack my head open or what?
17:05Don't worry.
17:06Your skull is intact.
17:07It's just a very deep cut.
17:12Okay.
17:13We got a couple arterials that need control.
17:16Figure of eight sutures.
17:17Dr. Santos is 300.
17:18What are rainy clips, Alex?
17:20Quicker than sutures.
17:21Ding, ding, ding, ding.
17:22Okay.
17:22Clamp those bleeders.
17:23Call for CT.
17:24I'll be next door.
17:25And Duke's CT line keeps growing.
17:32500 cc's out.
17:33How are you doing, Oliver?
17:34I don't know.
17:35I think it's progress in here.
17:37I can't tell if it was the phlebotomy
17:38or if the nitro finally kicked in.
17:40Oh, it could have been both.
17:42Potassium's high, 6.5.
17:44Be expected with a missed dialysis
17:45and the added heat stress.
17:47He needs, uh...
17:47Dr. Tavody?
17:48Uh, he needs insulin and glucose
17:50to shift the potassium intracellular.
17:52Exactly.
17:52Uh, 10 units.
17:53Ampathy 50.
17:54Start with five milligrams
17:55of nebulized albuterol.
17:56It'll shift the potassium intracellular.
17:57Give some potassium and help his breathing.
17:58He's at risk for arrhythmias.
18:01Mm-hmm.
18:02No peach T waves.
18:03No QRS widening.
18:04Insulin puts him at risk for hypoglycemia.
18:06And you'd tie up nurses
18:07with frequent accu-checks.
18:09Dr. Alishimi is right.
18:10The nebs will hold him over
18:10until dialysis gets here.
18:12You got this?
18:12Mm-hmm.
18:16All good in here?
18:17Yep.
18:21Uh, I'm gonna go give this guy's kid an update.
18:24He's probably freaking out.
18:25Come find me if you need me.
18:26Uh, yep.
18:30Um, hey.
18:32Where'd you learn that shoe trick?
18:34Oh, I did a clerkship at NJMS Senior Care.
18:37One of the attendees always said
18:39you can learn a lot about your patients
18:40just by looking at their feet.
18:44Bravo, ladies.
18:45Now on to the next lucky customers.
18:48Oh.
18:49Probably gonna have to stay late
18:50to catch up on all these patients.
18:52Night shift reinforcements will be here soon.
18:54It was supposed to be speeding up in the 11th hour,
18:55not slowing down.
18:56They don't call it the final sprint for nothing.
18:58Chop, chop.
19:05Is that the, uh, mom of the heat shark?
19:08Yeah.
19:09Do you believe it was just an accident?
19:12Does it matter?
19:14As a doctor?
19:15No.
19:16As a mom?
19:18Sometimes I can't tell if motherhood has made me
19:21more understanding or more judgmental.
19:26Dana, got a couple of visitors.
19:28Uh, my, my brother, there was an explosion.
19:30Hi, my mom was in a car accident.
19:32Uh, okay, Monica, can you help these fine folks
19:34find their loved ones?
19:35No.
19:36And princess, what are you still doing here?
19:38Don't you got some crazy
19:39Luau Pig Rose barbecue thing to get to?
19:41It's lichon, but yes, I do.
19:42I'm gonna sneak out on a few.
19:44Yeah, yeah.
19:44Go have some fun for both of us, all right?
19:47Don't stay too late.
19:48Okay.
19:50Hello, Miss Stevens.
19:52I'm Dr. McKay.
19:53How you feeling?
19:54Stupid.
19:55And really, really sore.
19:58Yeah, we'll, uh, get you something for your pain, okay?
20:02Your last patient left her blanket.
20:06Oh.
20:07Uh...
20:09Yeah, I...
20:11Yeah, I'll take it.
20:13Excuse me.
20:15Um, I'll be right back, Kim.
20:21Fuck!
20:23You good?
20:24Yeah, yeah.
20:25I, uh, I'm just, um...
20:26I'm looking for something to put this in.
20:28I, uh...
20:29A patient left it.
20:33She died, the, uh, cancer mom with the two kids.
20:37Sounds like a tough one.
20:39Yeah, that one sucked.
20:41Seeing those two young boys
20:42who said goodbye to their mother was brutal.
20:46Just...
20:47Makes you wanna cry.
20:49You should cry, you'll feel better.
20:51I wish I could.
20:54You know...
20:55I don't even...
20:56Remember the last time I cried.
20:59I'm not even sure I can anymore.
21:01Is that what this place does to you?
21:03We get pretty good at shutting down our feelings.
21:07Yeah, I'm, uh...
21:09A little scared I've shut them...
21:10Off for so long, I don't know how to turn them back on again.
21:14And...
21:15I just...
21:16Wish I could cry again, you know?
21:19I'll take care.
21:21You wanna hug?
21:23God, no.
21:26Your mom is stable, but she's still waiting on the imaging of her hip.
21:31Well, no more soon.
21:32You can wait with your dad in the meantime.
21:33I've told him a million times he shouldn't be driving anymore.
21:35May I ask what their home situation's like right now?
21:39I don't know.
21:39They live over in Squirrel Hill.
21:41Same house I grew up in, just the two of them.
21:44We noticed your father exhibiting signs of an unsteady gate,
21:47along with other balance and mobility issues.
21:50He sees an internist, neurologist, cardiologist, gastroenterologist.
21:54He's got a whole team of ologists.
21:57Both my parents used to be in pretty great shape,
21:59but lately it's like they can barely get up the stairs.
22:01Half their house isn't accessible to them.
22:03Have you looked into assisted living options?
22:06Yes, but they refuse to even talk about it with me.
22:09Mr. Cullen, you have a visitor.
22:11Care Bear.
22:13Dad, you feeling okay?
22:15No, I'm feeling dumb.
22:18Carrie, this is Dr. King, who will be assisting with your mother's care.
22:22I was just explaining that the treatment depends on the injuries,
22:26but there are complicating factors.
22:28We are required to report impairments that might affect driving,
22:32and you will likely have to take another driver's test to keep your license.
22:35What has that got to do with Frida?
22:37Well, if the hip injury is serious and you're also, uh, limited,
22:43then it could mean an unsafe to return home recommendation for your wife.
22:47You'd be looking at a temporary move to some form of assisted living and rehabilitation for Frida's care.
22:53How temporary?
22:55Fast case three to six months, but she may never return to the functionality she had prior to the injury
23:01and recovery.
23:02Okay, well, kill me now.
23:04See what I'm dealing with, Dad?
23:06You need to find somewhere to live that is safer and healthier for both of you.
23:10You know, um, the new communities are not anything like the old scary nursing homes.
23:14They're really nice, and you get your own apartment.
23:17And, um, you know, my sister actually lives in Munchies. She loves it.
23:20When the dog dies, we can talk.
23:23What if you fall?
23:24What if you have a heart attack or a stroke and there's no one there to help you?
23:27You worry too much?
23:29How can I not? Look what happened today.
23:32Look, um, we're gonna leave you two alone.
23:34We'll come back with Mrs. Cohn.
23:41Hey, Robbie.
23:43Our scalp victim is back from C2. They're prepping him now.
23:46Shit. Uh, okay. I'm coming. Um...
23:50Is your friend doing okay?
23:52He's almost like risk radar.
23:53Oh, and Dana put an okay on the guy who attacked the new nurse?
23:56Is she okay?
23:58Physically, yes.
23:59I heard you had a little chat with Langdon earlier.
24:02Yeah, water under the bridge.
24:03You have to figure out a way of working with him now that he's back.
24:06Or until he relapses.
24:08Becoming a very good doctor. Don't let old conflicts get in the way.
24:10Speaking of which, I want you and everybody else to see the trauma counselor while I'm gone.
24:15Yes?
24:15Yes.
24:16And I asked Whitaker to house sit for me while I'm gone.
24:19I figured that would distract from the whole farmer's widow thing.
24:21Wait, what?
24:21Bringing the mail, water the plants. Cool.
24:24Cool. Yeah, fine.
24:26That looks good. You can start the repair for this one.
24:29Feeling any pain, sir?
24:31No pain, just... wet.
24:34You already numbed him up?
24:35I did.
24:37One percent would that be.
24:38CT back it?
24:39No, not yet. I watched the slices come up.
24:42Isolated sternal fracture. Everything else looked normal.
24:44Could send him home, but given the mechanism, should probably watch him overnight.
24:48I agree with Dr. Garcia.
24:51I agree with Dr. Garcia, too.
24:54Three-layer closure. Galia, sub-Q, skin staples.
24:58Enjoy the fireworks.
25:00And hey, if I don't see you before you leave, don't forget to buy me a souvenir.
25:03Like a custom out-bone carved hunting blade.
25:05Nothing lasts for my favorite butcher.
25:07Aww.
25:08You're gonna make a great ex-husband one day, Rubinovich.
25:13Hospital's got his defense attorney looking for Jess.
25:15You probably took him to an ICE detention center, said we shouldn't hold our breath, though.
25:19Whatever happened to we the people, huh?
25:24Anything back on that drunk son of a bitch that attacked Emma?
25:27Not yet.
25:29Christ's sake.
25:30I'm making a run now. I'll ask.
25:32That's the guy who attacked Emma?
25:34It's intense.
25:36How you doing?
25:39Bitchy.
25:41That's me.
25:42Hey, you did what you had to do with that guy. Everything's gonna be fine.
25:46From your lips.
25:50Fuck's a class B launch tubes to the van.
25:53Next second.
25:55Kaboom!
25:56I get launched 10, 15 feet across the garage.
26:00Right up into the lift track.
26:02Hit something hard.
26:05I don't really remember the rest.
26:08Oh, just my brother's screaming.
26:10Ah, problem.
26:11I'm lying there thinking, oh, he must be dying.
26:15Guess it was me who was screaming about,
26:17Your brother is in the family room.
26:19He's waiting to see you.
26:20And he is alive and well.
26:24Oops.
26:25Oops.
26:27What's oops mean?
26:29Hello?
26:30Nothing to worry about.
26:34We never say oops in front of a patient.
26:41All right, try again.
26:42You sure?
26:44Mm-hmm.
26:47Better?
26:48Keep going?
26:49You might want to leave the fireworks to the professionals.
26:52We are professionals.
26:53Got our official PDA consumer license a few years back.
26:59Gunpowder's in my blood, man.
27:01Nothing like that.
27:07Ain't no fighting it.
27:09I'm more fatty.
27:12More like my memento amore.
27:17Am I like the only one who didn't study Latin for med school?
27:21Yep.
27:23And finished.
27:25Nicely done.
27:26Can I see my brother now?
27:28Yep.
27:29Oh, motherfucker.
27:31Chest pain?
27:32Only when I move.
27:34That would be the fracture in your sternum,
27:35Which we will give you another four more feet for that.
27:37Thank you.
27:38And try no laughing or sneezing for the next four weeks.
27:43Mr. Haas, we're gonna switch you over to a high flow nasal oxygen instead of the BiPAP and see how
27:48you do.
27:49This looks promising.
27:51Repeat potassium is at 6.1 with the albuterol.
27:59Oh, I'm feeling a...
28:02A little better.
28:06Don't you ever tell your mother about how fast you drove here.
28:09I thought you were gonna die.
28:11Any longer, I might have. So, good job.
28:15Boy just got his permit last week.
28:19Felt like I was living in one of those Fast and the Furious movies.
28:23I can't believe Pine Ridge closed. When did that happen?
28:28I read about it a few months ago. Medicare spend me cuts.
28:31Are there any other emergency rooms in the area?
28:34Nope.
28:35It's gonna be a long way to drive for folks out where we live.
28:38Mr. Haas, you'll need to stay here a few hours. Get you tuned up.
28:42Yeah. I know the drill.
28:44Yeah.
28:46Hey, you know, Mason, if you're hungry, we've got a pretty good cafeteria.
28:49Don't lie to him.
28:51We have a cafeteria.
28:53I'm just gonna stay here with my dad.
28:55Yeah, sure.
28:57Thank you for saving him.
29:06Are you still thinking oral emergency medicine when you're down here?
29:09I'm not thinking. Doing.
29:13Yeah, I hope there's still some hospitals left for you to work at.
29:15Yeah.
29:19Ah, it's on the march of the Walking Dead night ship again.
29:22First one in, Mattel. You get a gold star.
29:24What happened in here? Left you guys at the layup this morning.
29:26Don't ask.
29:28Speaking of layups, what up, Dr. J?
29:30Oh, right. That was, um, some sort of basketball player, wasn't it?
29:35Shame on you. Only the greatest sixer to ever play the game.
29:39Week one of year four of med school.
29:41You'll be ordering me around before you know it.
29:43You enjoy the dark side when you graduate?
29:45The emergency department?
29:47The night shift, baby. It's wild.
29:51I haven't even decided what residency I'm applying for yet.
29:54We'll figure it out. Got lots of time.
29:57Tell this to my parents.
29:59Dana, there's also backing your guy.
30:01Give me this.
30:08I choked her?
30:10No, I would never do something like that.
30:12But you did.
30:16Can you, uh, sorry, can you excuse me for a minute?
30:20Jesus Christ, Dana.
30:22Great.
30:25What's he saying, anyway?
30:27He's in a bit of shock.
30:29Claims he doesn't remember anything.
30:32Says he was on the golf course getting boozy,
30:35maybe a little too boozy.
30:36Things get hazy.
30:37Next thing you know, he's on the floor and everyone's screaming at him.
30:40How convenient.
30:42Maybe it's better for both of you that he doesn't remember what happened.
30:48Let me know when you're ready to take my statement.
30:57Well, the good news is your CT was negative for skull fracture and cranial hemorrhage.
31:03You mean that's good news for you and that blonde nurse lady?
31:07But your lab results were positive for alcohol and cocaine.
31:13Okay, you got me.
31:14I did a couple of birdie bumps on the turn, but we were just having fun on the golf course.
31:18Look, when alcohol is mixed with cocaine, your liver produces a metabolite called cocanethylene.
31:24But what does that have to do with me?
31:26Allegedly doing what you said.
31:28It's a psychoactive molecule, more toxic and potent than cocaine.
31:33And it can lead to confusion, paranoia, aggression, and even psychosis.
31:41What happens now?
31:45We're going to monitor you for a few hours, especially given your likely concussion.
31:49And you need to give a statement to the police outside in the meantime.
31:57Well, you lucky this was just a poke.
32:00Spared the muscle.
32:01See? It could have been worse.
32:03No shit, Sherman.
32:04The triangular bayonets they created back then were designed to leave wounds that are nearly impossible to stitch.
32:10Those bayonets have never met me.
32:12Oh, wow.
32:13What?
32:14It's all good. We got it covered.
32:15No, are you guys from the Fort Pitt Museum?
32:19Are you familiar?
32:20Yeah. I love you guys.
32:23My mom would take me to the fort every time we'd come down and visit family as a kid.
32:26We've been volunteering there as living historians for over 20 years.
32:29I probably saw you in.
32:30Man, I can't wait to tell my parents about this.
32:33Getting stabbed must have been scary.
32:35Yeah, well, Point Dexter here stumbled over his boots and nearly impaled me.
32:38It wouldn't have mattered if you weren't out of formation.
32:40Well, you're in good hands.
32:42This guy could have saved a lot of lives with his sutures back in 1776.
32:46That wasn't bad. You were out front.
32:50Hi again.
32:51Good news, Mrs. Cohen.
32:53Your imaging results show no hip fracture and no internal bleeding.
32:57But you do have a small hairline fracture of the superior pubic ringness.
33:02Well, that doesn't sound good.
33:03Well, if you're going to have a fracture, it's the best one to have.
33:06Do I need to stay in the hospital?
33:08Not necessarily.
33:10Your recovery should be pretty straightforward if we can control your pain.
33:13But you need to take it easy and stay off your feet for six to eight weeks.
33:18How can she go home if she can't walk?
33:19Oh, she can bear weight and walk with some help.
33:22And we'll get you a walker and schedule physical therapy.
33:26So, so we can go home.
33:28Dad, you can't take care of Mama by yourself.
33:32We'll manage.
33:33You guys, you need to be realistic.
33:35I don't want strangers hanging around in the house.
33:39It's not strangers, it's helpers.
33:41No, no, thanks.
33:43Doctors, please.
33:46I am worried about your ability to get the assistance you need, Mrs. Cohen.
33:51It may be time to think about some of those alternative living options we mentioned.
33:57I can take care of her.
33:59Are you going to be able to get her into the bathroom onto the toilet in the middle of the
34:03night?
34:03Are you going to help her change her clothes in the morning?
34:06Are you going to...
34:06We're fine.
34:07Dad, please, just try it.
34:11You don't have to sell the house right away.
34:13Just see if you like it.
34:16You could move in with us.
34:17No, I can't.
34:18I have work.
34:19I have the kids.
34:20I can't.
34:20No, no.
34:22No, okay?
34:23Just no.
34:26Carrie, could I speak with you outside for a minute?
34:37It's like that every time.
34:38It's tough to find the balance between respecting your loved one's needs for agency and doing what's best for their
34:43safety.
34:45I was wondering if you had your parents' medication lists with you or on your phone.
34:51Yeah.
34:52I'd like to take a quick look at it, if that's okay.
34:55Yeah.
34:59My man, how you doing?
35:01Like you better roll in a bar cart and a happy hour buffet if I'm going to be stuck in
35:05this place much longer.
35:06This place is a traffic jam. We're trying to merge you in, I promise.
35:08That's no traffic jam, that's a 20 car pile up.
35:12The sooner you get out, the sooner I get out, so you know I'm not bullshitting you.
35:17Why are you jonesing so hard to get out and start your ride shooting?
35:21I've got a schedule, I've got places to go, I've got people to see.
35:29I just have to get going.
35:33You're worried if you don't leave tonight, you won't leave at all?
35:38I get it, I can feel it in the air here, this place is like quicksand.
35:44Brian.
35:46Dr. Robbie, Dante the fireworks guy, something's wrong.
35:51Okay, shit.
35:53Do not go anywhere, you are next up. I'm going to deliver you myself.
35:56I'm starting to feel like a hostage in this place.
35:58How do you think I feel?
36:08Okay.
36:15What's going on?
36:16Fucking chest hurts.
36:18Systolic's down to 78.
36:20Blood loss from scalp plaque?
36:22Uh, that's highly unlikely. Dr. Santos?
36:24Good rest sounds, but neck veins are up, protecting the heart now.
36:27Okay, 500 CC bolus, 100% non-rebreather, please.
36:30Pericardial effusion, RV collapses, tamp plaque.
36:32Yeah, let's prep for pericardiocentesis.
36:34What's going on? Is he going to be okay? He said he was fine.
36:37CT scan was normal.
36:39Things change.
36:41Dante, there is a collection of blood around your heart.
36:44We need to drain it.
36:45Oh, fuck.
36:46Okay, 0.5 per kilo of ketamine, please.
36:49Won't that drop his pressure even more?
36:50We don't have a choice.
36:51We can undo this on a moving target.
36:54Dante, Jesus fucking Christ, it's my baby brother.
36:56Hey, Perla?
36:57Sir, I'm so sorry, but you can't be in there right now.
36:59What's wrong with him? Hey, Dante.
37:01Dante, just hang in there.
37:03Okay.
37:04So sorry, you can't be in there right now, okay?
37:06We have to stabilize him.
37:07They said he was fine.
37:08Okay, there's been a complication.
37:09I just need you to take a couple people...
37:11...and try to stay calm.
37:12Please.
37:13Just breathe them in.
37:14In.
37:14Okay, out.
37:15Look at me.
37:16Breathe in.
37:18Out.
37:19Very good.
37:20In.
37:21Out.
37:22Okay, stay calm, okay?
37:23We got this.
37:27I can't believe you've been there with us alone.
37:29They've been out of the shock.
37:30From what?
37:30Uh, I am guessing a small tear in the right atrium from a sterile fracture.
37:33If it was ventricular, he would have crashed in the field.
37:36I'll go cardiothoracic, see if they have an OR.
37:38Stalics down to 64.
37:39Okay, have you ever done an apical approach?
37:41Nope.
37:42Good time like the present.
37:43Colateral to my probe.
37:45Why not subcostal?
37:46Uh, this is a shorter distance.
37:47There are fewer structures.
37:48If you can see fluid, there's nothing between the probe and the pericardium.
37:52Mm-hmm.
37:52Mm-hmm.
37:52There are the needles in the effusion.
37:54Mm-hmm.
37:54Draw back.
37:56Good blood return.
37:57Okay, sometimes it only takes 20 cc's to let that heart fill again.
38:01Cardiac pulse much stronger.
38:02Thanks, Garrett.
38:03Start up.
38:04We'll have our room ready in five.
38:06All right, that is 40 cc's out.
38:08Blood pressure's up.
38:0990 systolic.
38:09Okay, now we're gonna place the J-wire, and we're gonna leave the catheter and the three-way stopcock.
38:14Still bleeding from the heart.
38:15He can live with a little blood loss, but not with a pressure bag squeezing his heart so it can't
38:19beat.
38:20Good thing we didn't send him home.
38:21Next day, Robbie.
38:23You too, Trinity.
38:24Is that an actual compliment?
38:25Sometimes you guys get lucky.
38:28Got a couple of bad ones.
38:30How old is he?
38:3184.
38:33Meclizine for vertigo.
38:34Anticholinergic effects can cause drowsiness.
38:36It's PRN, so maybe he doesn't take it all the time.
38:38He's also been prescribed methylcarbamol, another anticholinergic.
38:42Could definitely impair driving.
38:44And metoclopramide for his stomach.
38:46Well, that could cause gait problems.
38:49Exactly.
38:51Dr. Robbie, may we present?
38:53Yeah, what do you got?
38:53Hey, you should probably get started crossing your T's and dotting your I's for night shift handoff.
38:57Right.
38:57Well, vaya con Dios, or whatever the bikers are saying these days.
39:02Our elderly couple, Frida and Ed, we're anxious about their ability to recover at home, or to remain at home
39:08in general.
39:09But a number of Mr. Cohen's medications are on the beers list, and they may be contributing to his deteriorating
39:15health.
39:16Maybe.
39:17We can't be certain, but none of them are critical meds.
39:20We could have him stop them right now, follow up with his PCP, see how he's doing in a few
39:25weeks.
39:25Right by the family, sometimes just affirming a patient's independence, autonomy, can do a world of good.
39:33Um, hey, Dr. Mohan, I heard a rumor that you were looking for an elective.
39:37Have you considered geriatrics?
39:40It's as much of an art as a science.
39:42There's usually an opening, and you seem to have a predisposition to the pace.
39:53Have you seen Dan?
39:54I think she went out for a smoke, lucky girl.
40:14You ever gonna tell me what really happened in there?
40:17Nowhere.
40:21You could lose your nursing license.
40:24Let me guess, that violin verset in your pocket.
40:26You drew that up for Doug Driscoll.
40:28In case he ever came back, and now you've just been carrying it around ever since.
40:32I did exactly what I needed to.
40:33Now there's a young nurse who gets to go home in one piece because of me.
40:36Or Kay can sign the verset order for me if you will.
40:38I will sign the order.
40:40I will sign an extra order so you can have one when I'm gone.
40:43That's hardly the point.
40:45It's not exactly like I'm against nurse safety.
40:48I'm trying to advocate for your caution.
40:50Because you're the person who's supposed to be here keeping this running while I'm gone.
40:53Not roaming the halls like a vigilante with a loaded syringe and a vendetta.
40:57It's always do as I say, not as I do with you, isn't it?
40:59What is wrong with you today?
41:01Samira, Mr. Triple A.
41:03Mel and Alice had deposition.
41:04McKay's treating people in the park.
41:05Fucking Langdon.
41:06At some point you and Langdon gotta work this way.
41:08I don't want him here!
41:09He made a mistake and he paid for it.
41:10Did he? Did he go to jail?
41:11Because I let him get away with the crime, so what does that make me?
41:14Human!
41:15Are you angry at him?
41:16Or are you angry at you?
41:17Somebody could have died.
41:18Oh, let's see, D. Somebody's always dying.
41:20Go ahead and make jokes.
41:21Make jokes instead of acknowledging...
41:22Why didn't he kill anybody?
41:23That we know of.
41:24And he saved a lot of lives that we do know of.
41:27Our kids disappoint us sometimes.
41:29Langdon is not a kid.
41:30No, but he's your guy and you're taking him personally.
41:33Langdon fucked up and you think that makes you look bad, but it's on him.
41:38How am I supposed to leave this place when it's a shit show?
41:40First you can't stay, now you can't go.
41:43What is it, Rabinovich?
41:45No, I'm going.
41:46I just thought I could leave it a little better when I did.
41:48Oh, don't be such a martyr.
41:50This place is always teetering on the brink of disaster.
41:52With or without you.
41:53We do it every night, every day off.
41:55This place is bringing to one person.
41:57It'll survive without Adamson, it'll survive without me, and it'll survive without you.
42:06My meds are making me worse?
42:08Not worse, but they may be impacting your balance and mobility.
42:12Why would his doctors describe drugs that could harm him?
42:16Oh, it's not any one medication, it's the combination that could be impairing his daily functioning.
42:21We have a case manager that will put together a robust plan that I think will make everyone happy while
42:27allowing you to stay at home.
42:29There's regular physical therapy, an at-home nurse that visits a few times a week, and even personal shoppers to
42:36help with groceries.
42:38This sounds expensive.
42:41Actually, Medicare covers most of it with some assistance from the Area Agency on Aging.
42:45You know, every old person knows what it is to be young, but no young person can know what it
42:52is to be old.
42:54Thank you for listening.
42:57You guys are still coming with me to visit a few assisted living places just in case it's ever time.
43:02Well, maybe.
43:20Hey, you, uh, you doing alright?
43:23Never better, thanks. Bye.
43:32God, you're really just gonna keep standing there, aren't you?
43:34Yeah, what's going on?
43:41It was literally my first day of being a doctor.
43:44And Langdon gaslit me and made me question my skills over and over.
43:49And it's taken me a long time to feel like I belong here.
43:52And now he's back.
43:54And I don't even care that he was an addict.
43:56I care that he was a fucking asshole.
43:57And it's like no one here even remembers any of this.
44:01And everyone here talks about community and family.
44:05All while they throw you under the bus.
44:06And I...
44:08Robbie is the only attending who actually sees through the bullshit.
44:11But now he's leaving for some grand ego death spirit quest.
44:14And RoboDoc over there shoots me in the proverbial dick.
44:19Garcia's here. She likes you, right?
44:21She doesn't like me.
44:22She likes getting laid.
44:24And her stress relief squeeze toy, or was.
44:28You know, she and Langdon would make a great couple.
44:31Yeah.
44:32That's dark.
44:34I'm sorry.
44:36Yeah? Why do you care?
44:39Because we're friends, I thought, I think.
44:41Okay, are we?
44:42Because on top of all of that,
44:43you're the one who's being super shady about moving out on me.
44:46Moving out?
44:47Yeah, I heard you were gonna go squat at Robbie's sad bachelor pad.
44:50Honestly?
44:50I thought that was your idea, to get me to move out of the apartment.
44:54No, no.
44:54I wanted him to give you some fatherly advice about going all farmers only,
44:58and not giving you the keys to his fucking house.
45:03Oh, my God.
45:04No, I know.
45:04It was none of my business.
45:06No, it's not that, it's...
45:10You actually like living with me, don't you?
45:15What are you talking about?
45:17You leave your dirty clothes everywhere.
45:19You eat all of my avocados as soon as they ripen.
45:22You keep pausing the TV to ask the dumbest questions.
45:24And, you know, I'm going back to the avocado thing,
45:26because I've never seen someone consume so many, it's disgusting.
45:29Just say it, and I won't move out, okay?
45:31I'm not gonna be doing much of Robbie's,
45:32I'm gonna be taking in his mail and re-watering his plants.
45:36Say what?
45:40Admit that you like having me as your roommate.
45:45You are such a fuckleberry.
45:46Have fun with Robbie's plants.
45:51You have no idea how much joy that just brought me.
45:58Hey.
45:59How much longer until I get these things off and go home?
46:04Oh.
46:06You assaulted a nurse.
46:08Yeah.
46:09You said it was the cocoa-ethylite thing that made me go crazy.
46:13Well, if you're drunk and you kill someone, you still kill someone.
46:17So after we clear you in a few hours,
46:19you're gonna take a ride with the uniformed officer outside
46:21who's gonna take you in for processing.
46:23No, no, no, no, this cannot be happening.
46:24No, since you golf and can buy cocaine,
46:27I assume you can post bail after your arraignment.
46:29You're gonna ruin my fucking life!
46:30But it being our nation's big, beautiful birthday,
46:32that hearing may take longer than usual.
46:34So I'd cancel any grand plans you have for the fourth.
46:41You know, I...
46:43I can leave you with these.
46:46Rehab?
46:46Fuck off!
46:47I'm suing this whole hospital and you for personal injury.
46:51Well, good luck convincing a jury of that one.
46:54Oh, fuck this whole place!
46:55And fuck all of you!
46:57No, not you, officer.
47:00Fuck!
47:00Make sure discharge charts are bundled and placed in the 2B scan bin
47:04with nursing notes, order sheets, lab and x-ray results.
47:07Day shift needs completed T-sheets on every patient
47:10and to write on the board what tests are pending
47:11so nothing falls through the cracks while we wait to come back online.
47:17Westbridge and Good Dominion have settled their cyber dispute.
47:21They paid the ransom?
47:22Yeah.
47:23Our IT department is confident in our defenses
47:24so they will be rebooting everything soon.
47:27Slowly but surely.
47:29Okay, so when everything comes back on,
47:31all the residents have to do is scan all the completed paper charts
47:34and digitize them into the patient's EHRs before they go?
47:37I'm never getting out of this place.
47:40This means you're clear for takeoff.
47:43Nothing here we can't handle with night shift coming in.
47:46Yeah, right.
47:47I'm free to go.
47:49Uh, hey, I told you I would get you up there
47:52and I promise I'm not leaving until you're back and sent packing.
47:55Robbie, buddy, you got me to come in, got me to take my test.
47:59You don't gotta babysit me.
48:00That's why I have a nurse.
48:01What's your name, sweetheart?
48:02Nurse Vivi, sir.
48:03That's what I have the lovely nurse Vivi here.
48:05This will not take very long.
48:07Where have I heard that before?
48:11Hey, so, uh, this is it, huh?
48:14Uh, yeah.
48:16Don't let the place burn down.
48:20You know, in a previous life, I had a lot of friends who liked to see how close the edge
48:26was.
48:27As if it was a challenge they were called to meet.
48:31Trouble is, they all inevitably found it.
48:36Okay.
48:40I'm just picking up on a weird vibe from you today is all.
48:43Yeah.
48:45It's been a weird day.
48:52Are you leaving?
48:53Uh, yeah.
48:54My shift is over and I ain't getting paid to be here.
48:57Quite literally the opposite, in fact.
48:59Well, I-I don't know if you noticed, but we're sort of, uh, in disaster mode here still.
49:04No, we put in the extra time if we need it.
49:09You know 62% of VD docs report suffering from burnout?
49:13Painfully where?
49:15So, maybe all you lunatics need to learn how to set some boundaries.
49:19Like me.
49:21Well, see you tomorrow, Doc.
49:26Good luck in there.
49:27Sorry about the mess.
49:28Mess?
49:34Yep.
49:36Head trauma.
49:37Unwitness fall from the warehouse catwalk where he works as a security guard.
49:42Oh my God.
49:44Orlando.
49:45He left five hours ago.
49:51talking a little Terazbachè Lolesле.
49:55David.
49:55Thanks, redeemi.
49:56Angelina Donaud.
49:56Mmm.
50:01You're welcome.
50:04Hard to meet you, Angie?
50:05True.
50:11You're welcome.
50:19Closed you book,
50:48Gracias por ver el video
51:17Gracias por ver el video
51:20Gracias por ver el video
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