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00:01Gracias.
00:30Gracias.
00:38What now?
00:39Now we wait.
00:41How long before?
00:43I have no idea.
00:45Could be hours.
00:47It doesn't feel right.
00:49Remember Robbie talked about...
00:51The deal feels wrong.
00:54This is Roxy's decision.
00:56Everything else in her life is out of her control except this.
01:00She wants to go out on her own terms.
01:03Very few of us get to do that.
01:05We should pick up more patients.
01:12So Adam lives at Middle Hill?
01:13He lives in Middle Hill.
01:15And he's three years older than you?
01:16He's three years older than me.
01:19And he asked you to be his girlfriend six months ago?
01:24He asked me to be his girlfriend at game night,
01:28and I said yes.
01:30I've got a patient waiting for a doctor.
01:31I've heard it go in 13.
01:32Okay, I'll be right there.
01:37Did Adam ask you if you wanted to have sex?
01:40I...
01:40Mel, I don't know if I can tell you.
01:43Of course you can tell me I'm your sister.
01:45Well, it's private.
01:47Look, it's just...
01:48It's really important that I know.
01:50Why?
01:50Because.
01:52Well, I can tell Dr. Langdon because Dr. Langdon is my doctor,
01:56but I don't think I can tell you.
01:59Becca, just tell me.
02:00Why are you yelling?
02:01I'm not yelling.
02:02It's just...
02:02Look, it's really important that I know.
02:04You're definitely yelling.
02:05Becca.
02:06Maybe we should step outside for a minute.
02:08Why won't you tell me?
02:09Dr. King.
02:11Why don't you get some air?
02:16Sorry.
02:19Sorry.
02:20Sorry.
02:25Hey, have you seen any of the x-ray techs around?
02:27Nope.
02:30Got an update for me?
02:31I'm just checking in.
02:33What are the chances of me getting out of here on time, do you think?
02:36It's up to you, Cap. We can handle this.
02:37Question us where you let us.
02:45Are you two getting along?
02:47I can play nice for another two hours.
02:52Kept calling me Doc.
02:54Didn't know he was the real Doc until a few months in.
02:57He was keeping his secret life from me.
02:59Hmm.
03:00Where are we with his chest this week?
03:02Uh, x-rays are still six or seven behind.
03:05When's the last time you checked?
03:07Maybe ten minutes ago.
03:09Stay on them?
03:10Yeah.
03:10Come on, give the kid a break.
03:11It says here it takes an hour to get an x-ray.
03:14He's gonna be the first person to have written this fucking thing all day.
03:18Huh.
03:19Don't get me started on those.
03:23How are you feeling?
03:25I'm good.
03:28You know I take Luxipro.
03:30It helps with panic attacks, not just depression.
03:32Promise?
03:33I'm fine.
03:35Sorry about that, Mrs. Torres.
03:37Are you okay?
03:38I thought you were going to bust out.
03:39Yep.
03:39All good.
03:40Let's just pick up where we left off.
03:44Mrs. Torres presents with one week of painful swollen right calf.
03:48No trauma, no fever, no history of hypercoagulable state.
03:53However, she did take a 15 hour bus ride from Orlando to Pittsburgh last week.
03:57Mrs. Torres, we're concerned about a possible blood clot in your leg that can lead to serious complications.
04:04We need to do an ultrasound, but no need to worry if it's positive we can treat with a blood
04:09thinner.
04:10Well, if there's something I learned is to stop worrying.
04:13Can all your worries add a single moment to your life?
04:20Fresh on the line.
04:21They said one's critical.
04:22They're supposed to call those up.
04:24I know.
04:24Every time they try, the red phone's been busy.
04:26Jesus Christ.
04:27This was resulted 25 minutes ago.
04:29Sodium 112.
04:30Low hand.
04:33Sprinkle some salt on your patient before he sees us.
04:36Where are we?
04:37Kidney stone patients not obstructed.
04:39Just waiting on meds.
04:40Ortho is performing the replantation on our water slide trauma, a perforated diverticulitis
04:45patient Howard, made it through surgery, and I'm calling the CYF resource navigator
04:50to see if we're getting anywhere with emergency foster care for baby Jane Doe.
04:54Other than that, labs and x-rays are way behind, but our golden girls are getting their steps
04:59in.
05:01Does Robbie usually leave as soon as his shift ends, or does he like to stick around for
05:05all the handoffs for night shift?
05:07Depends.
05:08He's usually pretty good about getting out of here.
05:14Shortness of breath and soft 16.
05:16He could totally decompensate.
05:19I'm hoping to catch another intubation before seven.
05:22One more gets me to three in my first week.
05:24Probably a record.
05:28I'm looking for an easy one.
05:30Shift ends in two hours.
05:33You're supposed to pick up the stable patients in order.
05:35Do you need a second opinion on that?
05:38No.
05:40Dr. McKay.
05:41Yeah?
05:42A girl named Kiki came into reception looking for you.
05:44Kiki?
05:45She said she'd be in the park.
05:46Yeah, great, thanks.
05:52Hey, I think the labs are back on your PID patient.
05:56Thanks.
05:58Is everything okay?
06:01Fantastic.
06:06Langdon.
06:06I was kind of hoping I would never see him again.
06:10You know, maybe he's changed.
06:15When you got a sec, there's something that...
06:18Santos!
06:18I need you to pick up food poisoning in 12.
06:21Yeah, sure, why not?
06:23What?
06:24No snark?
06:25No pushback?
06:25What have you done with Santos?
06:27Only two hours to go.
06:29I surrender.
06:31Well, that's the spirit.
06:39How's Becca?
06:40She's good.
06:41I'm trying to call her a living community, but they are not picking up.
06:45Wake on.
06:46No.
06:48Because I don't know anything about this Adam person.
06:51I mean, they've been dating for six months, and I don't know anything.
06:55She never said anything about wanting a boyfriend or even liking anyone.
07:00That doesn't mean she hasn't thought about it.
07:02I don't want to think about my sister thinking about having sex.
07:05I mean, we used to say he didn't take advantage of her.
07:08Middle Hill just let it happen.
07:10Why didn't they tell me?
07:11Well, maybe they didn't know about it.
07:13Six months, they had to have known.
07:16Maybe it was a mistake choosing Middle Hill.
07:18I mean, we saw a lot of good places, but that is where Becca wanted to go.
07:24Are you Becca's legal guardian?
07:27No, I have durable power of attorney, but we did this thing called supportive decision-making
07:31where she can make her own decisions.
07:35There you go.
07:36Well, this is different.
07:38Why?
07:39Because it is.
07:46My son, he's not moving.
07:52Come on, buddy.
08:00I got a hot and unresponsive child. I need a room, Dana.
08:03Trauma 2.
08:05We need a core temp ASAP.
08:08Hi, I'm Dr. Al-Hashimi. Are you mom?
08:10Brenda Azermendi.
08:11And this is...
08:12Micah?
08:13Has Micah been sick with a fever?
08:15No, he was fine all day. I found him in the car.
08:20Peoples are sluggish but reactive.
08:22No reaction to pain.
08:25Uh, airway is Peyton with low tidal volume.
08:28Uh, let's set up for intubation.
08:31Heart rate is 22 in 10 seconds. That's 132.
08:34Do you know his weight?
08:35No.
08:36Joy, the proslo?
08:37The what?
08:38The proslo tape gives us all the drug doses based on length.
08:41Assisting with ventilation. Somebody call respiratory.
08:44You said you just found him in the car?
08:46I was working in the garden while he rode his trike in the driveway.
08:49One minute he was there and then he wasn't.
08:51I thought he had gone into the house but I couldn't find him anywhere.
08:54He must have gotten tired and climbed in and fallen asleep.
08:59By the time I found him, I couldn't wake him up.
09:02How long was he in there?
09:03Uh, maybe 15 minutes or 20.
09:06And the car was just unlocked?
09:08Oh, it's a safe neighborhood.
09:10Uh, Joy?
09:11Okay.
09:12Okay.
09:12So, you're gonna wanna start at the head.
09:17Measure the length.
09:18And then read it off.
09:20Uh, approximate weight is 25 kilograms.
09:22250 bullets of LR.
09:24I have doses for rock and ketamine.
09:26Almost no tone. I can do this without meds.
09:28Uh, it's easy enough to bag. Let's wait for RT.
09:30When the temperature is this high, the muscles can lose their strength.
09:34So, we're going to help him breathe with a tooth.
09:36Uh, rectal temp is 105.5.
09:39Heat stroke.
09:40Ice packs to the groin and axilla.
09:41See if we have an arctic sun that's not in use.
09:43We need all the ice we can get.
09:45And a pediatric body bag.
09:51Still waiting on your ketorolac pills.
09:52I will keep following up with the pharmacy.
09:54I told my son I would meet him at the park.
09:56We always watch the fireworks together.
09:57Sorry, Mr. Green. We won't forget about you.
09:59All right.
10:05Heard you had a heart attack.
10:06I did not have a heart attack.
10:10Hey, Samira, how are you feeling?
10:11I am totally fine.
10:14I'm glad to hear it.
10:15Hey, do you mind watching my patients for five minutes?
10:17I have to step out for a sec.
10:19No problem.
10:19Ogilvy, you, uh, wanna get some air?
10:22Got a good case for you.
10:23Might an intubation be required?
10:26No.
10:27It's an unhoused patient I've treated on the street team.
10:41Hi, Becca.
10:43Hey.
10:54I'm sorry I yelled at you.
10:56I was just...
10:59Surprised you.
11:00The nurse said I can leave.
11:02Yeah, um...
11:03Can we just finish our conversation first?
11:05About what?
11:07Look, I know you don't have to tell me anything.
11:09I just...
11:12Kind of...
11:13You'd want to.
11:17When Adam asked you to have sex...
11:19He didn't ask me.
11:20I asked him.
11:23So you didn't pressure...
11:25No.
11:26So you wanted to have...
11:28Sex?
11:30I wanted to have sex.
11:31Sex is great.
11:32We talked about sex in my mind and body class.
11:35I told my therapist too.
11:39Hey, the, uh, pancreatitis in North 3 is still waiting for you.
11:42Okay.
11:43Can I go now?
11:44Uh, just one second.
11:45Uh, I'll be right there.
11:46I'm just gonna walk my sister out.
11:54Yeah, sorry, I'm right behind you.
11:58Curtis Larson, 42, called to the golf course for combative behavior with his buddies.
12:03No signs of trauma, just alcohol in the breath.
12:05Seems to have calmed down a bit.
12:07He was fighting us so hard we had to give four milligrams of Versed to get vitals in a line.
12:11Good BP, pulse ox 99 on two liters.
12:14Between the booze and the Versed, he'll be sleeping it off for a while.
12:16Central 14, guys.
12:25Roxy's gone.
12:27Is the husband still in there with her?
12:29Yeah, Jabadi's with him.
12:31She needs a death note.
12:32I can't find McKay.
12:34Okay, I'll be right there.
12:35Okay.
12:36Have you seen McKay anywhere?
12:38No.
12:42Have you ever seen a xylazine wound?
12:44No.
12:44But you know what it is.
12:46Yes.
12:47Then you know its street name is Trank and this shit is nasty and can lead to skin necrosis.
12:52I've never understood drug addiction.
12:54Well, you need to try.
12:56A little empathy goes a long way in this job.
12:59I am empathetic.
13:00I don't understand how an intelligent person allows themselves.
13:03Can make mistakes.
13:04Heal themselves.
13:05Take away the pain.
13:06Hide from the abuse.
13:08We're healers, not judges.
13:11Shouldn't we go to the crosswalk?
13:13No?
13:14Okay.
13:15This is what we're doing.
13:16I see organ donation in my future.
13:19Sorry.
13:19I've never done a huge part.
13:21Now, in order to be a pharmacy.
13:26That might be a mystery.
13:29Now, it's going to be a mystery.
13:33You're out of a mystery.
13:34That could be a mystery.
13:36It's not to lie.
13:42If you have a mystery.
13:43You're out of a mystery.
13:46You know how to do.
13:48That's a mystery.
13:49I'm sorry.
14:15¿Qué pasa, Kiki?
14:18¿Quién es esto?
14:19Oh, es, uh, Uncle V.
14:21He's a student doctor.
14:22He's able to help me.
14:23So, what's happening with you?
14:26My leg's getting stinky again.
14:28Yeah.
14:29Okay, let's take a look.
14:35Is that an injection site?
14:37No.
14:38No, xylozine wounds can show up anywhere.
14:41You, uh, you still using Trank?
14:43Sometimes.
14:45Sometimes it's not good, Kiki.
14:46You know, it's nasty stuff.
14:48I'm trying to quit.
14:49How are you going about that?
14:51I go to meetings, sometimes.
14:53Meetings are good.
14:55And not you seems even better.
15:00Uh, okay, what's your plan, Uncle V?
15:06Uncle V, you okay?
15:07Yes.
15:08Yeah?
15:09Absolutely.
15:10Uh, my plan is clean with saline antibiotics.
15:16Meta, honey, to break down the eschar.
15:18And then?
15:19Um, redress with Xeroform and an ABD pattern acrylics wrap.
15:24Yeah, that will do it.
15:25You need to change this dressing every day, Kiki, okay?
15:28I don't think I can do that.
15:29We'll give you all the supplies you can do it yourself.
15:32You won't even have to come back here.
15:34Yeah.
15:34I don't think I can do it yourself.
15:35Okay.
15:37Okay.
15:38Okay, pass the saline.
15:49Hey, I'm Dr. Whittaker.
15:51This is Dr. Santos.
15:53Roberto.
15:53Like Roberto Clemente.
15:56Oh, sorry.
15:57I don't know who that is.
16:00Pirates Hall of Famer Roberto Clemente.
16:03You don't watch baseball.
16:05Well, I am from Nebraska.
16:07We went to a few Storm Chasers games as a kid.
16:10That's about it.
16:11No major league team, you know.
16:14All right, what happened to your elbow?
16:16O'Neal Cruz hits a walk-off tater, right?
16:20And I, I, I catch it, you know.
16:23Um, but then somebody fell on top of me.
16:25And I, I think I heard a pop, but hard to tell with all the screaming.
16:29That sounds pretty dangerous.
16:30You're not one of those guys who steals balls from kids, are you?
16:34I didn't steal this.
16:35I wouldn't do that.
16:36I would never do that.
16:36I would never do that.
16:39Can you move your fingers for me?
16:43And the thumb?
16:47Uh, no.
16:48Okay, yeah, you know what?
16:49We can put that in a belongings.
16:50Ha, ha, ha, ha.
16:51No, thanks.
16:51I, um, I think I will hold on to this.
16:54Okay, uh, you know what?
16:56We can put you in a sling, and then you can hold on to the ball while we examine you.
17:02Okay, yeah, I guess.
17:06You're gonna throw in an IV and start with four morphine?
17:08No, no, no, no.
17:09I don't want to be knocked out.
17:11No, it's a low dose.
17:12You won't be knocked out.
17:13It'll just help with the pain.
17:14Might make you a little drowsy.
17:15No, I need to stay alert.
17:18Okay.
17:19Uh, we will order you an x-ray.
17:22Just please let us know if you change your mind.
17:25Okay, yeah.
17:30Temp is down to 103.5.
17:32Long way to 98.6.
17:35102, we take him off the ice.
17:36Otherwise, we can overshoot and cause hypothermia.
17:39I put in orders for C.K.
17:41What does the C.K. tell us, Julie?
17:44Wrapped open muscle breakdown can take out the kidneys.
17:46More concerned about his brain.
17:54It's two times a day for three days, and a nurse can crush it up.
17:58Dr. Langdon already told me.
18:00Okay, bye, Mel.
18:02I'll see you, uh, I'll see you at fireworks.
18:04Oh, I was going to watch fireworks with Adam and his parents.
18:09Where?
18:10At the park.
18:11They're picking us up.
18:12They go every year.
18:14We always watch the fireworks together.
18:15I have your headphones.
18:16Adam said he has extra.
18:18Okay, well, um, do you have Adam's parents' phone number?
18:21Why?
18:23In case I need to reach them.
18:27I want to go now.
18:28Well, I guess I could call this.
18:30Bye, Mel.
18:33So how long have you been part of the street team?
18:35Oh, about a year.
18:37And why do you do it?
18:39Oh, most of these unhoused folks feel abandoned.
18:42Sorry.
18:43They, uh, don't trust easily.
18:45Meeting them where they're at makes a big difference.
18:48I've been trying to get Kiki to come by for months.
18:51You should, uh, volunteer.
18:54It's great training.
18:55The street team could always use the help.
18:58Yeah.
18:58Uh, maybe.
19:00Thank you.
19:01Hey, how did the deposition go?
19:04Um, I'm glad it's over.
19:06But I didn't feel good about it at all.
19:09You know, I'm still not supposed to talk about it.
19:11No, but you can talk about how you feel.
19:13Who do you have to talk to when things aren't going so good?
19:15Friends?
19:16Family?
19:17Actually, I don't really have any...
19:19Hey, McKay, where have you been?
19:20Oh, I, uh, I stepped out.
19:22Did you tell anybody?
19:23I was, uh, treating a young woman I met on the street team.
19:27Did she check in as a patient?
19:29No.
19:29We treated her in the park.
19:32We?
19:35I, uh, I took Opal V.
19:37Oh, okay.
19:37So you treated her outside the ED on PTMC's diamond.
19:41You brought a medical student with you.
19:43Right when we're in the middle of crisis mode and we need all hands on deck.
19:46Gone for ten minutes.
19:47Tops.
19:47When you're here, I need you to be here.
19:49And while you stepped out, Roxy died.
19:53What?
19:58Oh, man, I'm sorry.
20:01I didn't think she would be gone that quickly.
20:07Excuse me.
20:08Um, she took a nasty fall.
20:10Her shoulder screamed in pain when we put the ties on.
20:13Hello, I'm Dr. Rabinovich.
20:14This is Dr. McKay.
20:15Agents Correa and Russo.
20:18She needs to be looked at before we process her.
20:20What's your name, ma'am?
20:24Renita.
20:25We're gonna take care of you, okay?
20:27You say she fell?
20:29We'll conduct in a sleep at a restaurant.
20:31Right when the kitchen took off, she was shoved down some alley stairs.
20:35Right.
20:36Could be a rotator cuff tear or an AC separation.
20:40Let's put her in a chair, find her a room.
20:42South 19.
20:48Just a few.
20:51Curtis.
20:52Dude.
20:53What happened?
20:54Medics had to sedate him to transport.
20:57Didn't realize he was such an angry drunk.
20:58So you've seen him drunk before?
21:00Sure.
21:01Yeah, but never like this.
21:03He tried to pick a fight with the guys in front of us.
21:05He said they were going too slow.
21:06That's what they call the cops.
21:08Would he have taken drugs?
21:10If he did, they were not the performance enhancing kind.
21:13He shot a 112.
21:16We'll order labs.
21:18See what we can figure out.
21:19Uh, any family we can contact?
21:22I have no idea.
21:22We don't talk about that shit.
21:23How long is he gonna be here?
21:25At least three or four hours till he sobers up.
21:27Cool.
21:28Is it okay if I just come back around nine?
21:30Sure.
21:31Great, thanks.
21:36Need those removed so I can check her vital signs.
21:42Okay, tender over the AC.
21:51Can you, uh, lift your right arm up above your shoulder like this?
22:01Heart rate's 110, pulse ox 98.
22:04Painful arc test is positive.
22:06Should I drop arm test?
22:07I'm gonna lift your arm up.
22:10And you just lower it as slowly as you can, okay?
22:15A positive drop arm test.
22:17What's that mean?
22:18That means that she's gonna require an x-ray.
22:20It's most likely a rotator cuff tear, which sometimes can come with a fracture.
22:24We need an x-ray to rule it out.
22:25How long is that gonna take?
22:27Our computers are down today.
22:29Everything's moving a little slower than usual, but we will fast track her.
22:32Is there anyone you want us to call, Pranita?
22:34No phone calls.
22:36Got a bathroom.
22:47Right there.
22:50I do not want these guys here any longer than they need to be, so let's find x-ray and
22:53fast track this one.
22:54Your family might be worried.
22:56Maybe I can call them.
22:57No, no, no.
22:57Just stay with her.
22:58Make sure she has everything she needs.
22:59We treat her injury, and that's it.
23:02Jaime Guerrero, to window three, please.
23:06Jaime Guerrero, to window three.
23:23What's going on?
23:25What's going on?
23:25What's going on here?
23:26Are you looking for someone?
23:27I don't know.
23:34Got a lateral.
23:37Best I could.
23:38Okay, posterior dislocation.
23:39No fracture.
23:40Thanks.
23:41Mm-hmm.
23:42Okay, good news, Roberto.
23:44No broken bones, but the elbow joint is dislocated, and you need to get the ball back in the socket.
23:49The best way is with sedation and pain meds.
23:52No, no, no.
23:52I know you said no morphine, but we can put local anesthetic into the joint to block the pain.
23:57That way you won't be sedated at all.
23:58Thanks, Doc. Just, just give me a bullet to bite on.
24:07The Raiders Joe's over in Greentree.
24:09Oh, man, I love that place.
24:10Brought on one of the employees.
24:12So ICE is here.
24:13People are leaving the waiting room. Ten patients are ready. What should I do?
24:16Just tell them the truth and hope they stay for the treatment that they need.
24:19Martha took off. I'm going to call her when I get a chance.
24:21Oh, shit. Yeah, make sure she's okay. Will you call the EVS department, too, and let them know?
24:25Will do.
24:26All right, hold down the fort. Let us know if you need backup.
24:28You got it.
24:29Can't we just tell the agents to fuck off?
24:32They are not going to leave without their patient.
24:34We just need to treat her.
24:36Even if she's undocumented?
24:37All patients, regardless of immigration status, have the right to emergency care under MTALA.
24:43Pranita is next in line for X-ray.
24:45Okay, good. Thank you.
24:49Propofol is down to 100 mics per minute.
24:51Tempest 101.8.
24:53Great. Let's get him off the ice.
24:55Okay, hands on my count. One, two, three.
25:02What's the latest?
25:04We've got some arm movement.
25:06That's a good sign.
25:09And pupils are minimally reactive.
25:14Planters are down going.
25:16All encouraging signs.
25:20Any luck getting a lawyer for a detainee?
25:23Uh, no.
25:24Keep me posted?
25:26Yeah.
25:32It's a pretty bracelet.
25:36My daughter made it for me.
25:40She doesn't know what I am.
25:41I just want her to know that I'm okay.
25:46You seriously won't let her make a phone call?
25:48Not until she's processed.
25:51Unbelievable.
25:54Thanks, and just let me know when she gets back.
25:57Uh, one other thing.
25:58Uh, do you have a resident named Adam?
26:01I was wondering if I could get his parents' phone number.
26:03Nope.
26:03I...
26:04Red phone is for emergencies only.
26:06This is kind of an emergency.
26:09Sorry.
26:10Bye.
26:12Hey, Mel, we need an R3 to supervise a reduction in North 4.
26:16You free?
26:16Uh, I guess.
26:18Should we move the deceased woman in Central 9 to viewing?
26:22Uh, no.
26:23Let's leave the husband in there for a little while longer.
26:25We need the room.
26:26We're not moving her yet.
26:28Okay.
26:29Sorry.
26:30I can do a room check.
26:32Pete's ICU says they'll have the bed soon.
26:35Okay.
26:41So, what do we think?
26:43About what?
26:44The mom of our heat stroke kid?
26:47Uh, that is not our job.
26:48That is what CYF is for.
26:50So you think it was on purpose?
26:52No, I did not say that.
26:54I just don't buy it.
26:55She lost her kid at home?
26:57Plus, she just looks guilty.
26:58Has anyone seen her cry?
27:02People don't always respond to trauma the way you expect them to.
27:05Stay focused on the kid.
27:11BP78042, SATs 87.
27:13You having some pain again, Mr. Green?
27:16Mr. Green?
27:17This one's yours?
27:18Yeah.
27:19Uh, kidney stone.
27:19Possible vasovagal.
27:20Yeah, I assume that we need some help here.
27:22Does he have an IV?
27:23No, he didn't need one.
27:26Hypotensive and hypoxic.
27:28Clear trauma room?
27:29Yes.
27:31He was just waiting on his discharge meds, pain-free.
27:36A few more patients are going from chair SAT 15 to COF 2.
27:40History of renal colic, heme positive urine, BP crashing.
27:43Heme positive urine doesn't always mean kidney stone.
27:46Two anticubital lines, biggest ones we've got.
27:48E-FAST.
27:49Let's get two units of whole blood hung, please.
27:53Good.
27:56Who worked up this patient?
27:57I did.
27:58Ultrasound showed dilated ureter and mild left hydronephrosis consistent with this history of renal colic.
28:04What about the aorta?
28:05I didn't look at the aorta.
28:07Who did you present to?
28:09Dr. Mohan?
28:09You said the rest of the ultrasound was normal.
28:11I meant that the other kidney was normal.
28:15Eight centimeter triple A with massive free fluid.
28:17Perhaps your aneurysm is bleeding out.
28:19Okay, go with the MTP.
28:20Sixteen gauge in the left AC, two units, whole blood on the infuser.
28:26Assisting ventilations, rest diagonal.
28:29Okay, who wants to intubate?
28:33Everybody?
28:34Sure.
28:35Okay, call for six more units of whole blood.
28:36You said it'd be a call surgery.
28:37If we stay ahead of him, we might get him up to the oar.
28:41Here we go.
28:56We're lightening up his sedation to see if he has any purposeful movement.
29:00If so, that will be an encouraging sign.
29:03He'll be back to normal?
29:06There's no certainty as to how much recovery Michael will have.
29:10His response over the next 24 hours will tell.
29:14There is a chance of cognitive impairment.
29:19But also a chance of meaningful recovery.
29:22Dr. Alashimi, the patient in 22 needs you.
29:27I will be right back.
29:45I'm in.
29:46Bag him.
29:47Nicely done.
29:47Good job.
29:48Unit three is up and running.
29:49I've got a 16 gauge UJ.
29:50That one goes on the rapid infuser.
29:52Good and tidal waveform.
29:56Strong radio pulse.
29:57That's a very good sign.
29:58BP's up.
29:5886 over 52.
30:00Some progress.
30:01About two grams TXA?
30:02Yeah.
30:03What else do we give after four units of blood?
30:08Calcium gluconate to counteract hypocalcemia.
30:10Closperides to train to attack a vagalent.
30:12Why don't you see if you can't squeeze a unit into that peripheral line?
30:19Should somebody place a central line?
30:21Long central line is slower than short, large bore peripheral.
30:23The flow is proportional to the fourth power of the radius.
30:26Physics.
30:28Right.
30:30Okay.
30:33Bite down on this.
30:36Okay.
30:37I'm stabilizing the humerus.
30:39All right.
30:40After I supinate with traction, Dr. Whittaker will apply downward pressure on the proximal forearm.
30:46Okay.
30:46This is going to hurt like hell, Roberto.
30:49One, two, three.
30:53Okay.
30:54And then flexing at the elbow.
31:02This dolly's down to 68.
31:04Units five and six are up and running.
31:08I'm here for Garcia.
31:09Vascular can't come down.
31:10Triple A with hemorrhaging shot.
31:12Most of these die in the field.
31:13He was stable, presented with a history of renal colic.
31:15And nobody saw the triple A on ultrasound?
31:18Was this you?
31:19No.
31:20Curious me.
31:23Looks like sinus attack.
31:25Nope.
31:25Lost the pulse.
31:25It's PEA.
31:26Bag him.
31:27Old movie, start compressions.
31:28We're having a hard time staying out of the blood loss here.
31:30Sterile gloves.
31:30Prep for a thoracotomy.
31:31Dr. Javadi, why don't you glove up and show Dr. Shamsie why you belong in the ED.
31:37We can cross-temp the aorta.
31:39We stop the blood flow from below the diaphragm.
31:41We can produce the heart and the brain.
31:46Ten blade.
31:47Can we get in there?
31:55May I have scissors?
32:11Let me know when you have enough exposure.
32:20Right there.
32:24Can you mean on suction?
32:25No, there's no blood in the chest.
32:26It's all in the belly.
32:27Yeah, keep squeezing.
32:33Aorta's clamped.
32:36Heart is empty.
32:37Okay, Javadi, get in there.
32:38Internal compressions.
32:38Go.
32:43Put two more units on the rabid infuser, please.
32:45They'll be units seven and eight.
32:54All right, neuro's intact.
32:55So we'll do a posterior splint, a sling, and an orthoreferral.
32:59You know, I'm actually kind of impressed you did that without putting it.
33:01Pay meds.
33:03Definitely worth it.
33:04You know, last year I caught McCutcheon's 300th career homer, but another fan stole it
33:08from me.
33:09I promised myself I would never let that happen again.
33:13Whitaker, can you write the procedure note?
33:15Yeah, you already filled in the tea sheets with me.
33:17Yeah, well, I'm already here.
33:18Yeah, I kind of had a handle.
33:19You said everything else, so can you just fill out the charge?
33:21You should probably finish it.
33:22Well, okay, someone do this.
33:23I don't, I don't, I don't care who.
33:27Yeah.
33:37Where's Mrs. Ezra Mendy?
33:38She stepped out.
33:40Stepped out?
33:47Feels like the heart's filling back up.
33:48Let's have a peek.
33:52Looks good.
33:54Really good.
33:55Strong radial pulse.
33:58Moist lap pads, prep for transfer.
34:01Systolic in 94, it's the best so far.
34:04Can I go with you?
34:06He's my patient.
34:08Okay by me.
34:10Bring two extra units.
34:17Ice is in the building.
34:19Word travels fast.
34:20Yeah, we have a detainee with a rotator cuff tear.
34:22Two of our nurses went home.
34:24They have temporary protected status,
34:25but they just don't feel safe.
34:30Um, I'm really sorry, Dr. Robbie.
34:33I should have checked the air.
34:33Too easy one to miss.
34:35Got a heartbeat back though, so still smoke.
34:38Oh.
34:39Oh.
34:40Oh.
34:41I'm sorry too.
34:43I, I should have asked Ogilvy if he'd checked the aorta.
34:45It's, it's my fault.
34:46It is.
34:48You're the senior resident.
34:49You don't look to others.
34:50Others look to you.
34:51I know.
34:52I'm really sorry.
34:53This is what happens when you bring your personal life into work.
34:55Patient almost died.
34:56I know.
34:58You have to think of these walls like a force field.
35:01You cannot let anything in.
35:02Your mother's not in here.
35:04She is out there.
35:04You keep everything out there.
35:06That is the key.
35:06That is the difference between the best doctors
35:08and the ones that don't make it.
35:10You're right.
35:13Maybe I just don't belong here.
35:19Punita's x-ray results.
35:21No fracture.
35:22Okay.
35:23We'll just have Jesse fit her for her sling, I guess,
35:25and then we have to discharge her.
35:27To the immigration guys?
35:28I'm afraid so.
35:32Okay, time for you to go.
35:34I was just having to chat with Speeders here.
35:37You can't see how busy this department is, right?
35:39You've been nothing but a distraction and a disruption since you've been here.
35:42I'm already short-staffed, and I just lost five nurses and half my environmental services team
35:46because you walked in.
35:49You know, patients come in here for help, right?
35:51Because they're either sick or they're injured,
35:52and documented or undocumented, they have a right to emergency care.
35:56TB, measles, fractures, none of it's getting treated
35:58because everybody's too scared to come in.
36:00But then they end up here anyway, but then it's too fucking late.
36:02So please, for the love of God, can you just go wait over there in the room
36:05with your detainees so I don't lose any more patients or staff?
36:20This is Asur Mendy.
36:25Brenda, where are you going?
36:29Brenda!
36:36Okay, okay, that's okay.
36:39Let's get you back inside to your son.
36:41That's okay, that's okay, that's okay, that's okay.
36:45Come on, she's cleared to go.
36:49Hold on, she needs to sleep.
36:50It'll only take a minute.
36:51We're leaving.
36:52Hey, man, you're hurting her.
36:56Jesus Christ, what's going on now?
36:58Robbie!
37:00You can't do this.
37:02What the hell is going on?
37:05He hurt her and Jesse stepped in.
37:07Oh, yeah, didn't do shit.
37:08I know, I know, I'm just kidding.
37:09I mean, no.
37:09Give me, give me.
37:10Give me, give me.
37:11No, we gotta go.
37:13No, no, come on, come on.
37:15Don't say anything.
37:16You don't have to say anything.
37:17They can't make you say anything.
37:18We'll get you an attorney.
37:18I promise we'll get you out.
37:21Call the hospital attorney again.
37:22I can't believe this shit.
37:24Can you at least tell us where you're taking them?
37:25No, no.
37:26Is there a detention center near Pittsburgh?
37:27That's got to be where they're going, right?
37:29Could be hours before he's processed.
37:31I'll stay on it.
37:33What can we do?
37:36Hey, Javadi, Javadi, please come back.
37:39Everybody, just go check on your patients.
37:41Assure them.
37:42Tell them what happened.
37:43But please, everybody get back to work.
37:44Who's going to take Jesse's patients?
37:46I can do it, dear.
37:47Thanks, Perla.
37:49Hey, you okay?
37:50Yeah, I'm okay.
37:51You okay?
37:52Yeah.
37:52The lawyers are tied up with the cyber attacks upstairs.
37:54They probably won't come down for a while.
37:58Where's the latest with the heat stroke kit?
38:00Let's send him up to Pete's ICU.
38:06What's going on?
38:08I found her outside wandering into the street.
38:10She almost got hit by a truck.
38:12I think it was intentional.
38:14Of course, I'm lying.
38:15I told nurse Kim not to let her out of her sight.
38:16We need to call a 302 and observe her.
38:19Dangerous, El?
38:19Is she going to be able to see her kid?
38:21No, if she's on an involuntary cycle.
38:24What happens if he's ready to be discharged before she is?
38:27Does she have a partner or a relative we can call?
38:29I can find out.
38:30Why don't you and I talk to her together?
38:31Sure.
38:32I just need to check on a patient, and I will meet you there.
38:34Okay.
38:36Okay.
38:52Hey, Emma, have you seen this patient?
38:54Oh, I haven't.
38:56Oh, she took off when those ICE guys arrested your nurse.
39:05I tried to get him down.
39:07He put me in the garden, but he just wanted to ride his trike.
39:13So I let him.
39:16Every time I looked over, he was just riding around.
39:24And then he wasn't.
39:28Have you ever thought about hurting yourself?
39:34CBC and blood alcohol are back in your goal for Curtis Larson.
39:370.14.
39:38Copy that.
39:39Okay, we'll wait for the other labs.
39:41You'll need to sleep it off in the meantime.
39:45Hey, Gabriel, can you wait up a sec?
39:47Do you have Duke Eakin's chest x-ray?
39:49Yeah.
39:49How's it look?
39:51Radiologist still needs to read it.
39:52Can you pull it up for me?
40:00I got to call the funeral home, start making arrangements.
40:03You could slow down.
40:05Take some time for yourself.
40:06How you doing?
40:08Oh, you know.
40:09Been better.
40:11I spend so much time with these people.
40:13You've become a part of their family.
40:14It's not like it is here where patients come and go.
40:16Don't stay for the night shift.
40:18I got reinforcements coming in.
40:19I'd rather work.
40:20I don't know if I want to sit with this at home.
40:22Try.
40:22For once, just listen to me.
40:23Take the night off.
40:24I'll cover for you until I can find someone else to come in.
40:27Go.
40:28Hey.
40:30Love you.
40:32Love you.
40:36You think she's going to be okay?
40:39I don't know.
40:40I just hope she can forgive herself.
40:50I've noticed some tension between you and Dr. Santos.
40:54You two have history?
40:55Uh, yeah.
40:57She doesn't like me very much.
41:01Um, we worked together one time.
41:05I was a pretty big asshole.
41:08She called me out on some things that I wasn't ready to face, and I overreacted.
41:16I'm going to talk to her.
41:17I just haven't found the right time.
41:20Good.
41:21Do.
41:32Oh, you might be in here.
41:34What's going on?
41:37The deposition of my sister coming in, it's been a day.
41:41Oh, it's a good deposition.
41:44Is your sister okay?
41:47Yeah.
41:48It's just a UTI, so meds all cleared up.
41:51Oh, that's good.
41:54She's a boyfriend.
41:57She didn't tell me about.
41:59And other things she didn't tell me about.
42:01Maybe she didn't know how.
42:03She's having sex.
42:06Great sex.
42:09And she lied to me.
42:10I mean, she lied to my face for six months.
42:13My sister is a fucking liar.
42:16She's just cursed.
42:20It's how I feel.
42:22Look, kid.
42:24I say this with love.
42:26People got their own reasons for keeping secrets.
42:30Most of the time, it's got nothing to do with you.
42:32I've seen Elf 164 times.
42:35Becca loves Elf, so we watch Elf.
42:38And she's got everything, and now she's got a boyfriend, and they're going to fall in love, and they're going
42:43to get married, and I'm going to be completely alone.
42:49Do you feel good to say that out loud?
42:53No.
42:57Mel, you're a good egg.
43:00But this is not about you.
43:03I learned a long time ago.
43:05I quit feeling sorry for myself.
43:07Now, come on.
43:08Pity party's over.
43:17Okay, so this is your heart, and these are your lungs.
43:21They look okay?
43:23Yeah, it's this part right here, this space right between your lungs.
43:26It's called the mediastinum, and it is enlarged.
43:29It is too wide.
43:30From what?
43:32I can't really tell from plain film.
43:34It could be any number of things.
43:35Yeah, stop the bullshit.
43:37It could be an enlarged thyroid.
43:39It could be enlarged lymph nodes from an infection.
43:43It could possibly be a tumor.
43:47You think I have lung cancer?
43:48No, I don't see that.
43:51The cancer of the lymph nodes is called lymphoma.
43:53And there are a lot of diseases of the aorta, which is this big artery that comes off the heart,
43:57which can get enlarged because of a weak spot in the wall, kind of like a bubble in a tire.
44:03They can have a blowout.
44:05And the only way to make sure is to do a CT scan of your chest today.
44:12How long does that take?
44:15A few hours, a couple of hours.
44:19You still going to be here?
44:25Yeah, I would not feel good about riding if I rushed this.
44:33This is important.
44:39Hey.
44:41I think the labs are back on your COPD patient.
44:45I saw them in the rack.
44:46Thanks.
44:48Uh, look.
44:49I don't know how to say this.
44:51Um.
44:55I know you don't like me.
44:57And that's fine.
44:59You don't have to.
44:59I just want to say I'm sorry for being an asshole on your first day.
45:04That was completely inappropriate.
45:06And if I could take back what happened, I would, but I can't.
45:13Okay.
45:18Hey, I'm sorry.
45:18I just, I don't buy it.
45:20Everyone thinks you're just an addict who went to rehab.
45:22And you've convinced everyone here that you've changed and you're owning up to your mistakes.
45:27And they welcome you back with open arms because you're still the golden boy.
45:30And I think it's bullshit.
45:33I'm genuinely sorry.
45:34And I can promise you I have faced my fair share of punishment for what I did.
45:38You fucking stole drugs from the hospital.
45:40Only three people here actually know that.
45:42Have you told anyone else what you did?
45:44Have you?
45:45Look, I'm just trying to get through my first day back.
45:47You shouldn't even be here.
45:49I should have reported you to the state medical board.
45:51You should have lost your license and gone to prison.
45:53You don't know what I've been through.
45:54What you've been through?
45:55My wife threatened to divorce me, okay?
45:57I almost lost my case.
45:58Yeah, that's what happens when you fuck up.
46:03You don't have to accept my apology.
46:05I just, I wanted to say it.
46:07Okay?
46:08You really want to atone for your sins?
46:11Tell everyone here you stole drugs and got kicked out of the ED because of it.
46:14Until then, stay out of my way.
46:29Oh, hi.
46:30What the fuck?
46:32I'm just checking your vital sign.
46:34Oh.
46:34Where am I?
46:36What are you doing to me?
46:38Ah!
46:39Ah!
46:41Ah!
46:43Ah!
46:44Ah!
46:44Ah!
46:46Ah!
46:46Ah!
46:47Ah!
46:48Ah!
46:52Ah!
46:56Ah!
47:00Ah!
47:01Ah!
47:08Ah!
47:09Ah!
47:10Ah!
47:12Ah!
47:13Ah!
47:14Ah!
47:24Ah!
47:25Ah!
47:27Ah!
47:27Ah!
47:56Gracias por ver el video.
48:15Gracias por ver el video.
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