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05:00No, no, no, no.
05:16Idiot savant.
05:18We no longer use that term.
05:21It's derogatory.
05:23You bruise easy millennials.
05:25Actually, I'm Gen Z.
05:27Even worse, I was stripping a purgatory
05:30to put myself through school when I was your age.
05:34Snowflake.
05:37Hey, Amy.
05:38Yeah, I'm getting off later than I thought.
05:41I'll give you a call when I get a better idea of when.
05:44I need help.
05:45I gotta go.
05:46I can't breathe.
05:47If I got the airway, you take the pulse.
05:50Yeah.
05:52Oh, my God.
05:53Can you try a jaw thrust?
05:55Radio's weak and thready.
05:56What's his name?
05:56My dad.
05:57Oliver.
05:58Hey, Oliver.
05:59Can you open your eyes for me?
06:01Okay, here we go.
06:06Okay.
06:07One, two, three.
06:37Drive-in.
06:38We'll examine Southgate team in case she also needs to make a statement to the police.
06:41Is that really necessary?
06:44Yeah.
06:45Absolutely.
06:46Don't worry.
06:47I'll be there with you.
06:48Come on, let's get you a spot.
06:49Well, your guy just bought my guy for CT.
06:51No, he's my guy.
06:52He's a new one because he's been sitting here forever.
06:53I'm never going to cry out of here.
06:54Tell it to someone who cares.
06:56You know what?
06:56You should care because if you gave that guy a serious injury with force inflicted from
07:01a sedative, you are not licensed to prescriber.
07:02No one else uses force to stop an assault.
07:04They're a hero, but a nurse does it and we're punished.
07:07You just happen to have a viola set in your pocket?
07:09It was extra for the medics.
07:10Good timing, I guess.
07:11There are ways to control the substance.
07:13We need a witness to sign off.
07:14I was on my way to when I spotted that asshole attacking our girl.
07:17Anything else, Nancy Drew?
07:19Where are you going?
07:20Taking a pee.
07:21Do I need your permission to do that too now?
07:31Fuck!
07:32Fuck!
07:32Fuck!
07:33Fuck!
07:41Should we intubate?
07:43Uh, best to avoid that if possible.
07:45Pressure support and afterload reduction buys us time for dialysis.
07:48BiPAP starting at 10 over 5.
07:49Good heart squeeze, good lung sliding, but there's a ton of B lines.
07:52Pulmonary edema.
07:53Which is best treated by what, Dr. Giovanni?
07:56Uh, nitrates.
07:57Dose?
08:00AP 198 over 132.
08:02Pulse 120.
08:03Pulse talk's only 85.
08:05Good BP list.
08:06Start at 400 mics per minute for two to five minutes.
08:08I was asking Dr. Giovanni.
08:10Don't you always start low with nitro, then titrate up?
08:11In flash pulmonary edema, we do the opposite.
08:14What he really needs is dialysis to get the fluid off.
08:17What's his dialysis schedule?
08:19Uh, Monday, Wednesday, Friday.
08:20He missed yesterday because of a wedding.
08:22We tried to go to the center this morning.
08:23It's usually open on Saturday, but I think they close for the 4th.
08:26Where do you live?
08:26Uh, Brookville.
08:28It's like an hour and a half away.
08:29Yes, ma'am.
08:29I tried Pine Ridge Hospital in Ford City, but I didn't know they shut down.
08:33Yeah, they sure did.
08:40All right, sister.
08:42How can I help uncluster this clusterfuck?
08:46Ready to finish our conversation?
08:48We talked.
08:49Okay, now I got to need you.
08:50Please.
08:57Talk to me.
08:58Tire of this shit.
08:59Okay.
08:59It's the second time that everyone was attacked by a patient today.
09:02Okay.
09:03I took one of my nurses, and these cyber assholes have turned us back into 1999.
09:08Well, I'm worried about you.
09:09You are not yourself today.
09:11Makes two of a sudden.
09:13Do you have something you want to say?
09:16Go ahead.
09:17I can take it.
09:18All right, Danielle.
09:20Sometimes it's like you're just tempted to death because you don't give a shit anymore.
09:23So this is about the motorcycle?
09:24It's not just about the motorcycle.
09:25It's about the whole damn thing.
09:26Robin, you're actually telling people that you're going to a place called Smash My Head
09:31End.
09:31Close.
09:32Not quite.
09:33And it's not the other thing.
09:33Robin, your buddy Duke is insisting on leaving, and that MBA is here.
09:37Okay, I'll be right there.
09:39What's open?
09:40Uh, South 15.
09:4178-year-old woman, very low-speed auto versus pedestrian with ground level fall.
09:45Bruising on her left hip.
09:46No head trauma.
09:47Your husband Eddie came along.
09:48Hi, how do you do, sir?
09:49I'm Dr. Robbie.
09:50Come with us, or we're going to get you set up right over here.
09:53Ah!
09:54Sorry, we'll get you something for the pain shortly.
09:56Thank you.
09:58Do you have any medical problems, Frida?
10:00Uh, high blood pressure, low thyroid, um, AFib.
10:04Any chest pain, shortness of breath?
10:06No.
10:07Front row seats.
10:08So, um, what happened?
10:10Well, she walked into the car.
10:14You hit me.
10:15No, I didn't hit you.
10:17You hit the car.
10:18You backed up right into me.
10:20I wasn't even moving.
10:23Well, you're both in very good hands now.
10:25Yes?
10:27Before we get you in a gown, we'd like to check your head.
10:31Of course.
10:34I am sorry.
10:35We had a whole bunch of craziness come in, and you got bumped down a patient or two for CT.
10:40But take comfort in knowing it was for some pretty nasty stuff.
10:43How am I supposed to find comfort in that?
10:46Or anything you've told me since I got here, for that matter.
10:49I don't know, but everything is supposed to come with a lesson, right?
10:51Oh, this is more of your Zen motorcycle bullshit.
10:55Maybe.
10:56No, no, the truth is I'm just stalling, because it's going to be a while longer.
10:59Okay, look, I appreciate the effort, but you guys are obviously jammed up.
11:03I'll just come back when it's not our nation's birthday.
11:05You're already here.
11:06It's not going to be that much longer, I promise.
11:08Just stay and get your CT.
11:09I will do it all when you get back, and this place is less crazy.
11:13This place is always crazy.
11:14I don't know when I'm going to get back.
11:15Can you just sit the fuck down and wait a little bit longer?
11:17It won't kill you, but leaving might.
11:25Okay.
11:27No problem.
11:29Thank you.
11:32That's a nasty bruise.
11:34Do you take aspirin or any blood thinners?
11:38Uh, eloquist from my AFIP.
11:41Any tenderness here?
11:43No, not really.
11:45Here?
11:46Oh, yeah.
11:47That hurts.
11:48Four of morphine and zofrin.
11:50What about up here?
11:51Not really.
11:54All right, so let's start with labs and plain film.
11:56No, CT abdomen pelvis will get a better view of the hip and check for bleeding.
12:01The eloquist is concerning.
12:02Uh, you think she broke her hip?
12:05If it's broken, you broke it.
12:08Usually for a broken hip, the leg is shortened and rotates out.
12:12But we'll just wait for CT results.
12:22Mr. Cohen, I know that you were checked on scene, but I was wondering if I could do a quick
12:28examination of you.
12:29Oh, no, I'm fine.
12:30I was in the car.
12:31Just unofficially.
12:33Uh, okay.
12:37Deep breath for me.
12:40Good.
12:41Again?
12:44Great.
12:45Thanks, Eddie.
12:46Next thing.
12:47Would you mind taking your shoes off?
12:50Uh, what for?
12:52Just being safe.
12:57My back's not what it used to be.
12:59Let me help you.
13:04I, uh, could use a pedicure.
13:08You and me both.
13:09Dr. King, what do you think about doing a Romberg test?
13:13What is that?
13:14It's a general evaluation of balance.
13:17Um, can you stand up, sir?
13:20Yep.
13:21Okay.
13:22How are you doing, Oliver?
13:24Shats are not coming up.
13:25Pressure's holding on 409.
13:26Sure, let's up the BiPAP to 20 on 10.
13:28We could try phlebotomy, decrease the fluid burden on the lungs.
13:31Old school, but right by time.
13:34Hemoglobin's only 9.2.
13:35He's anemic from renal failure.
13:36And he can't afford more blood loss.
13:38We need to intubate.
13:38We're losing this war.
13:40Intubation's not a trivial matter for immunosuppressed patients.
13:43So we just drop a bunch of red tops?
13:45No, we do the collection on the floors if he's giving blood.
13:47We like medieval bloodletting.
13:49Essentially.
13:50And that is something you should step out for, Mason.
13:52Casey, thank you.
13:53Got a good vein for 16.
13:54One donor bag, 500 cc's, no more.
14:01Okay, let it out.
14:03Same again, deep breath in.
14:07Great.
14:08All done.
14:09How's she doing?
14:09Pull socks, 100%.
14:11Normal exam, no evidence of injury.
14:13Great.
14:14I got way worse for my older brothers.
14:15I bet.
14:16All right, I'll go write a brochure.
14:20How about we call it a day?
14:23My shift isn't over.
14:24This was a shift and a half for anyone today.
14:26Believe me.
14:28If it's all right with you, I'd rather stay.
14:31I'm not a quitter.
14:33Okay, but someone good for you.
14:34But stick close to Donnie for the rest of the day, would you?
14:38Sure.
14:39And you also need to make a statement to the police.
14:42If we don't stand up for ourselves, no one else will.
14:44We're here to help, not to be punching bags.
14:48Thank you for saving me.
14:50Got you, girl.
15:00Something's wrong?
15:01That depends.
15:02Are you a four-month-old with severe diaper rash?
15:05No, I'm Dorian Cole, and I'm pretty sure that I broke my collarbone.
15:08Okay, we can help with that.
15:09I'll be back.
15:10Wait, wait, are you serious?
15:11Can I at least get something for my pain?
15:13Sure.
15:14Sit tight.
15:15This place sucks.
15:16Tell me about it.
15:16Try working here.
15:18Boy, you're really working hard to boost those patient satisfaction scores.
15:21The chart for Central 7 doesn't match the patient that's in there.
15:24Just hang in there.
15:24We're almost over this.
15:25I was over this six hours ago.
15:27Sheriff's is looking like Melanie's on St. Paddy's Day.
15:29They're going to break through the doors like zombies if you don't start moving more than
15:32me back there.
15:33Dante Casella, 34, blunt trauma from a fireworks explosion in his storage unit.
15:38A&O, good vitals, large scalp laceration and bruising to the chest.
15:42No meds or allergies.
15:43Partial or flow thickness burns?
15:44No burns.
15:45The blast launched him into a rolled-down garage door frame.
15:48Am I fucking dying here?
15:49I'm Dr. Robbie.
15:50This is Dr. Santos.
15:51I can't hear you.
15:53Try the other side.
15:55I'm Dr. Santos.
15:57Can you hear me?
15:58Yeah, yeah.
15:58Dante.
16:00A lot of ringing.
16:01Hey, McKay.
16:02Joy, you're with us.
16:06One, two, three.
16:10I need like four doctors.
16:13Shit, I know it was bad.
16:14This is a teaching hospital.
16:16You get all the extra help you need.
16:18Airway and breathing intact.
16:21Good lung sliding bilaterally.
16:24Tender over the sternum.
16:26Possible fracture.
16:27That's your breastbone.
16:28No ectopy on monitor.
16:30No pericardial effusion.
16:31The heart looks good.
16:32130 over 85, pulse 108, sats 98 on two liters.
16:36Good enough for 50, Effent.
16:38He's stuck through his headdressing.
16:39Let's take a peek.
16:41Normally, we don't deal with scaplax on the primary survey, only if there's active bleeding.
16:45With glass injuries, the pressure wave can transmit energy through the body and cause
16:49internal damage even without any external visible signs, especially with organs that
16:53are air-filled.
16:54How are we looking, Dr. Santos?
16:55PFAS negative.
16:56No free fluid in the belly.
16:59Fuck me.
17:01What is that?
17:02It's a pretty big flap.
17:03Checking for bleeding source?
17:05Is that through the gale yet?
17:06It is indeed.
17:08I'm going to crack my head open or what?
17:09Don't worry.
17:10Your skull is intact.
17:11It's just a very deep cut.
17:16Okay, we got a couple arterials that need control.
17:20A figure of eight sutures?
17:21Dr. Santos is right under.
17:22What are rainy clips, Alex?
17:24Quicker than sutures.
17:25Ding, ding, ding, ding.
17:26Okay, clamp those bleeders.
17:27Call for CT.
17:28I'll be next door.
17:29And Duke's CT line keeps growing.
17:36500 cc's out.
17:37How you doing, Oliver?
17:38I don't know.
17:39I think it's progress in here.
17:41Can't tell if it was the phlebotomy or if the nitro finally kicked in.
17:44Oh, could have been both.
17:46Potassium's high, 6.5.
17:48Be expected with the misdialysis and the added heat stress.
17:51He needs, uh...
17:51Dr. 5-0-D?
17:52Uh, he needs insulin and glucose to shift the potassium intracellular.
17:55Exactly.
17:57Uh, 10 units, ampethy 50.
17:58Start with 5 milligrams of nebulized albuterol.
18:01It'll shift some potassium and help his breathing.
18:02He's at risk for arrhythmias.
18:05Mm-hmm.
18:06No peach tea waves.
18:07No QRS widening.
18:08Insulin puts him at risk for hypoglycemia.
18:10And you tie up nurses with frequent acu-checks.
18:13Dr. Alshima's right.
18:14The nebs will hold him over until dialysis gets here.
18:16You got this?
18:16Mm-hmm.
18:20All good in here?
18:21Yep.
18:25Uh, I'm gonna go give this guy's kit an update.
18:28He's probably freaking out.
18:29Come find me if you need me.
18:30Uh, yep.
18:34Um, hey.
18:36Where'd you learn that shoe trick?
18:38Oh, I did a clerkship at NJMS Senior Care.
18:42One of the attendings always said you can learn a lot about your patients just by looking at their feet.
18:48Bravo, ladies.
18:49On to the next lucky customers.
18:53Oh, probably gonna have to stay late to catch up on all these patients.
18:56NJF reinforcements will be here soon.
18:58We're supposed to be speeding up in the 11th hour, not slowing down.
19:00They don't call it the final sprint for nothing.
19:02Chop, chop.
19:09Is that the, uh, mom of the heat shark?
19:12Yeah.
19:12Do you believe it was just an accident?
19:16Does it matter?
19:18As a doctor, no.
19:20As a mom, sometimes I can't tell if motherhood has made me more understanding or more judgmental.
19:31Dana, got a couple of visitors.
19:32Uh, my, my brother, there was an explosion.
19:34Hi, my mom was in a car accident.
19:36Uh, okay, Monica, can you help these fine folks find their loved ones?
19:39No.
19:40Princess, what are you still doing here?
19:42Don't you got some crazy Lou Alpego's barbecue thing to get to?
19:45It's lechon, but yes, I do.
19:46I'm gonna sneak out on a few.
19:48Yeah, yeah.
19:48Go have some fun for both of us, all right?
19:50Don't stay too late.
19:52Sure.
19:52Okay.
19:54Hello, Miss Stevens.
19:56I'm Dr. McKay.
19:57How you feeling?
19:58Stupid.
19:59And really, really sore.
20:02Yeah, we'll, uh, get you something for your pain, okay?
20:07And your last patient left her blanket.
20:10Oh, uh, yeah, I, yeah, I, yeah, I'll take it.
20:17Thanks.
20:17It's me.
20:19Um, I'll be right back here.
20:25Fuck!
20:27You good?
20:28Yeah, yeah.
20:28I, uh, I'm just, um, I'm looking for something to put this in.
20:32A, uh, patient left it.
20:37She died.
20:38The, uh, cancer mom with two kids.
20:41Sounds like a tough one.
20:43Yeah, that one sucked.
20:45Seeing those two young boys said goodbye to their mother was brutal.
20:50Just makes you want to cry.
20:53You should cry.
20:54You'll feel better.
20:56I wish I could.
20:58You know, I don't even remember the last time I cried.
21:03I'm not even sure I can anymore.
21:05Is that what this place does to you?
21:07You get pretty good at shutting down our feelings.
21:11Yeah, I'm, uh, a little scared I've shut them off for so long.
21:16I don't know how to turn them back on again.
21:19I just wish I could cry again, you know?
21:25You want a hug?
21:28God, no.
21:30Your mom is stable, but she's still waiting on the imaging of her hip.
21:35Well, no more soon.
21:36You can wait with your dad in the meantime.
21:37I just told him a million times he shouldn't be driving anymore.
21:39May I ask what their home situation's like right now?
21:43I don't know.
21:43They live over in Squirrel Hill.
21:45Same house I grew up in, just the two of them.
21:48We noticed your father exhibiting signs of an unsteady gate,
21:51along with other balance and mobility issues.
21:54He sees an internist, neurologist, cardiologist, gastroenterologist.
21:58He's got a whole team of ologists.
22:01Both my parents used to be in pretty great shape,
22:03but lately it's like they can barely get up the stairs.
22:06Half their house isn't accessible to them.
22:07Have you looked into assisted living options?
22:10Yes, but they refused to even talk about it with me.
22:13Mr. Cullen, we have a visitor.
22:16Care bear.
22:17Dad, you feeling okay?
22:19No, I'm feeling dumb.
22:22Carrie, this is Dr. King, who will be assisting with your mother's care.
22:26I was just explaining that the treatment depends on the injuries,
22:30but there are complicating factors.
22:32We are required to report impairments that might affect driving,
22:36and you will likely have to take another driver's test to keep your license.
22:40What has that got to do with Frida?
22:41Well, if the hip injury is serious and you're also limited,
22:47then it could mean an unsafe to return home recommendation for your wife.
22:51You'd be looking at a temporary move to some form of assisted living and rehabilitation for Frida's care.
22:57How temporary?
22:59Best case, three to six months,
23:01but she may never return to the functionality she had prior to the injury and recovery.
23:06Okay, well, kill me now.
23:09See what I'm dealing with, Dad?
23:10You need to find somewhere to live that is safer and healthier for both of you.
23:14You know, the new communities are not anything like the old scary nursing homes.
23:18They're really nice, and you get your own apartment.
23:21And, you know, my sister actually lives in Munchies.
23:23She loves it.
23:24When the dog dies, we can talk.
23:27What if you fall?
23:28What if you have a heart attack or a stroke and there's no one there to help you?
23:32You worry too much.
23:33How can I not?
23:34Look what happened today.
23:36We're going to leave you two alone.
23:38We'll come back with Mrs. Cohen.
23:45Hey, Robbie.
23:47Our scout victim is back from C2.
23:49They're prepping him now.
23:50Shit.
23:51Uh, okay.
23:52I'm coming.
23:53Um.
23:55Is your friend doing okay?
23:56He's on Munchies, that risk radar.
23:57Oh, and Dano put McKay on the guy who attacked the new nurse.
24:00Is she okay?
24:02Physically, yes.
24:03I heard you had a little chat with Langdon earlier.
24:06Yeah, water under the bridge.
24:08You have to figure out a way of working with him now that he's back.
24:10Or until he relapses.
24:12You're becoming a very good doctor.
24:13Don't let old conflicts get in the way.
24:15Speaking of which, I want you and everybody else to see the trauma counselor while I'm gone.
24:19Yes?
24:20Yes.
24:20And I asked Whitaker to house sit for me while I'm gone.
24:23I figured that would distract from the whole farmer's widow thing.
24:25Wait, what?
24:25Bring the mail, water the plants.
24:27Cool.
24:28Cool.
24:29Yeah, fine.
24:30That looks good.
24:31You can start the repair after this one.
24:33Feeling any pain, sir?
24:35No pain, just wet.
24:38You already numbed him up?
24:39I did.
24:411% with Epi.
24:42CT bag it?
24:43No, not yet.
24:44I watched the slices come up.
24:46Isolated sternal fracture.
24:47Everything else looked normal.
24:48Could send him home, but given the mechanism, should probably watch him overnight.
24:52I agree with Dr. Garcia.
24:55I agree with Dr. Garcia, too.
24:59Three-layer closure.
24:59Galia, sub-Q, skin staples.
25:02Enjoy the fireworks.
25:04And hey, if I don't see you before you leave, don't forget to buy me a souvenir, like a custom
25:08outbone carved hunting blade.
25:09Nothing lasts for my favorite butcher.
25:11Oh, you're going to make a great ex-husband one day, Rubinovich.
25:17Postbro's got his defense attorney looking for Jess.
25:19You probably took him to an ICE detention center, said we shouldn't hold our breath, though.
25:23Whatever happened to we the people, huh?
25:28Anything back on that drunk son of a bitch that attacked Emma?
25:31Not yet.
25:33Christ's sake.
25:34I'm making a run now.
25:35I'll ask.
25:36Yeah.
25:36That's the guy who attacked Emma?
25:38Some sense.
25:40How you doing?
25:43Beachy.
25:45Oh, that's me.
25:46Hey, you did what you had to do with that guy.
25:48Everything's going to be fine.
25:50From your lips.
25:54Fuck's a class B launch tubes to the van.
25:57Next second.
25:59Kaboom!
25:59I get launched 10, 15 feet across the garage, right up into the lift track.
26:06It's something hard.
26:09I don't really remember the rest.
26:12Oh, just my brother's screaming.
26:14Oh, problem.
26:15I'm lying there thinking, oh, he must be dying.
26:19I guess it was me who was screaming about.
26:21Your brother is in the family room.
26:23He's waiting to see you, and he is alive and well.
26:28Oops.
26:29Oops.
26:30What's oops mean?
26:33Hello?
26:34Nothing to worry about.
26:38We never say oops in front of a patient.
26:45All right, try again.
26:47You sure?
26:48Mm-hmm.
26:49Mm.
26:51Better?
26:52Keep going?
26:53You might want to leave the fireworks to the professionals.
26:56We are professionals.
26:57Got our official PDA consumer license a few years back.
27:03Gunpowder's in my blood, man.
27:05Nothing like that.
27:11Ain't no fightin' it.
27:14I'm more fatty.
27:15I like my memento mori.
27:19I like my memento mori.
27:21Am I, like, the only one who didn't study Latin for med school?
27:25Yep.
27:25Yes.
27:27And finished.
27:29Nicely done.
27:30Can I see my brother now?
27:32Yep.
27:33Oh, motherfucker.
27:35Chest pain?
27:36Only when I move.
27:38That would be the fracture in your sternum, which we would give you another four more feet
27:40for that.
27:41Thank you.
27:41And try no laughing or sneezing for the next four weeks.
27:47Mr. Haas, we're going to switch you over to a high-flow nasal oxygen instead of a biped
27:51and see how you do.
27:53This looks promising.
27:55Repeat, potassium is at 6.1 with the albuterol.
28:03Oh, I'm feeling a little better.
28:10Don't you ever tell your mother about how fast you drove here.
28:13I thought you were going to die.
28:15Any longer I might have, so good job.
28:19Boy just got his permit last week.
28:23Felt like I was living in one of those Fast and the Furious movies.
28:27I can't believe Pine Ridge closed.
28:30When did that happen?
28:31I read about it a few months ago.
28:34Medicare spend me cuts.
28:35Are there any other emergency rooms in the area?
28:38Nope.
28:39It's going to be a long way to drive for folks out where we live.
28:43Mr. Haas, you'll need to stay here a few hours to get you tuned up.
28:46Yeah.
28:46I know the drill.
28:48Hey, you know, Mason, if you're hungry, we've got a pretty good cafeteria.
28:53Don't lie to him.
28:55We have a cafeteria.
28:57I'm just going to stay here with my dad.
28:59Yeah, sure.
29:02Thank you for saving him.
29:10Are you still thinking oral emergency medicine when you're down here?
29:14I'm not thinking.
29:15Doing.
29:17Yeah, I hope there are still some hospitals left for you to work at.
29:19Yeah.
29:23Ah, it's on the march of the walking dead night shift again.
29:26First one in, Mattel.
29:27You get a gold star.
29:28What happened in here?
29:29Left you guys at the layup this morning.
29:30Don't ask.
29:32Well, speaking of layups, what up, Dr. J?
29:35Oh, right.
29:36That was some sort of basketball player, wasn't it?
29:39Shame on you.
29:40Only the greatest sixer to ever play the game.
29:43Week one of year four of med school.
29:45You'll be ordering me around before you know it.
29:47You enjoy the dark side when you graduate?
29:49The emergency department?
29:51The night shift, baby.
29:52It's wild.
29:55Um, I haven't even decided what residency I'm applying for yet.
29:58We'll figure it out.
29:59I've got lots of time.
30:01Tell this to my parents.
30:03Dana, results are back in your guy.
30:05Oh, give me this.
30:12I choked her?
30:14No, I would never do something like that.
30:16But you did.
30:20Can you, uh, sorry, can you excuse me for a minute?
30:24Jesus Christ.
30:26Great.
30:29What's he saying, anyway?
30:31He's in a bit of shock.
30:33Claims he doesn't remember anything.
30:36He says he was on the golf course getting boozy,
30:39maybe a little too boozy.
30:40Things get hazy.
30:41Next thing you know, he's on the floor
30:42and everyone's screaming at him.
30:44How convenient.
30:47Maybe it's better for both of you
30:48that he doesn't remember what happened.
30:52Let me know when you're ready to take my statement.
31:01Okay, well, the good news is your CT was negative
31:04for skull fracture and cranial hemorrhage.
31:07You mean that's good news for you
31:09and that blonde nurse lady?
31:11But your lab results were positive
31:12for alcohol and cocaine.
31:17Okay, you got me.
31:19I did a couple of birdie bumps on the turn,
31:21but we were just having fun on the golf course.
31:23Look, when alcohol is mixed with cocaine,
31:25your liver produces a metabolite
31:27called cocanethylene.
31:28Well, what does that have to do with me?
31:30Allegedly doing what you said.
31:33It's a psychoactive molecule,
31:34more toxic and potent than cocaine.
31:37And it can lead to confusion, paranoia,
31:40aggression, and even psychosis.
31:45What happens now?
31:49We're going to monitor you for a few hours,
31:51especially given your likely concussion.
31:53And you'll need to give a statement
31:54to the police outside in the meantime.
32:02Oh, you're lucky this was just a pope.
32:04Spared the muscle.
32:05See?
32:06It could have been worse.
32:07No shit, Sherman.
32:08The triangular bayonets they created back then
32:10were designed to leave wounds
32:12that are nearly impossible to stitch.
32:14Those bayonets that never met me.
32:16Oh, wow.
32:17What?
32:18It's all good.
32:19We got it covered.
32:20No, are you guys from the Fort Pitt Museum?
32:23Yeah, you familiar?
32:24Yeah, I love you guys.
32:27My mom would take me to the Fort
32:28every time we'd come down and visit family as a kid.
32:30We've been volunteering there
32:31as living historians for over 20 years.
32:33I probably saw you then.
32:34Man, I can't wait to tell my parents about this.
32:37Getting stabbed must have been scary.
32:39Yeah, well, point Dexter here
32:40stumbled over his boots and nearly impaled me.
32:42Wouldn't it matter if you weren't out of formation?
32:44Well, you're in good hands.
32:46This guy could have saved a lot of lives
32:47with his sutures back in 1776.
32:54Hi, again.
32:55Good news, Mrs. Cohen.
32:57Your imaging results show no hip fracture
32:59and no internal bleeding.
33:01But you do have a small hairline fracture
33:04of the superior pubic ringness.
33:06Well, that doesn't sound good.
33:08Well, if you're going to have a fracture,
33:09it's the best one to have.
33:10Do I need to stay in the hospital?
33:12Not necessarily.
33:14Your recovery should be pretty straightforward
33:16if we can control your pain.
33:17But you need to take it easy
33:19and stay off your feet for six to eight weeks.
33:22How can she go home if she can't walk?
33:23Oh, she can bear weight and walk with some help.
33:26And we'll get you a walker
33:27and schedule physical therapy.
33:29So, so we can go home.
33:32Dad, you can't take care of Mama by yourself?
33:36Oh, we'll manage.
33:37You guys, you need to be realistic.
33:40I don't want strangers hanging around in the house.
33:43It's not strangers, it's helpers.
33:45No, no, no, thanks.
33:47Doctors, please.
33:50I am worried about your ability
33:52to get the assistance you need, Mrs. Cullen.
33:55It may be time to think about
33:57some of those alternative living options we mentioned.
34:01I can take care of her.
34:03Dad, are you going to be able to get her
34:05into the bathroom, onto the toilet
34:06in the middle of the night?
34:07Are you going to help her change her clothes
34:09in the morning?
34:10We're fine.
34:11Dad, please, just try it.
34:15You don't have to sell the house right away.
34:17Just see if you like it.
34:20You could move in with us.
34:21No, I can't.
34:22I have work.
34:23I have the kids.
34:24I can't.
34:24No, no, no.
34:26No, okay?
34:27Just no.
34:31Carrie, could I speak with you outside for a minute?
34:41It's like that every time.
34:42It's tough to find the balance
34:44between respecting your loved one's needs for agency
34:46and doing what's best for their safety.
34:49I was wondering if you had your parents' medication lists
34:53with you or on your phone.
34:55Yeah.
34:56I'd like to take a quick look at it,
34:57if that's okay.
34:59Yeah.
35:03Now, man, how you doing?
35:05Like you better roll in a bar cart
35:07and a happy hour buffet
35:08if I'm going to be stuck in this place much longer.
35:10This place is a traffic jam.
35:11We're trying to merge you in, I promise.
35:13That's no traffic jam.
35:14That's a 20-car pileup.
35:16The sooner you get out, the sooner I get out,
35:18so you know I'm not bullshitting you.
35:21Why are you jonesing so hard
35:22to get out and start your ride for you?
35:25I have got a schedule.
35:27I've got places to go.
35:28I've got people to see.
35:33I just have to get going.
35:37You're worried if you don't leave tonight,
35:38you won't leave at all?
35:42I get it.
35:43I can feel it in the air here.
35:45This place is like quicksand.
35:48Brian.
35:50Dr. Robbie, Dante, the fireworks guy.
35:53Something's wrong.
35:56Okay, shit.
35:57Do not go anywhere.
35:58You are next up.
35:59I'm going to deliver you myself.
36:00I'm starting to feel like a hostage in this place.
36:02How do you think I feel?
36:03Okay.
36:04Sure, quick.
36:06All right.
36:07She told me to get it.
36:09I'm actually back in the back.
36:13I don't know.
36:14I don't know.
36:14I don't know.
36:14I don't know.
36:15I don't know.
36:15I don't know.
36:15I don't know.
36:15I don't know.
36:16Okay.
36:19What's going on?
36:20Fucking chest hurts.
36:22Histolic's down to 78.
36:25Blood loss from scalp plaque?
36:26Uh, that's highly unlikely.
36:27Dr. Santos?
36:28Good rest sounds, but neck veins are up.
36:29Protecting the heart now.
36:31Okay, 500 CC bolus.
36:32100% non-rebreather, please.
36:34Okay, pericardial effusion.
36:35RV collapses.
36:36Yeah, let's prep for pericardiocentesis.
36:38What's going on?
36:39Is he going to be okay?
36:40He said he was fine.
36:41TT scan was normal.
36:43Things change.
36:44Um, Dante, there is a collection of blood around your heart.
36:48We need to drain it.
36:49Oh, fuck.
36:50Okay, 0.5 per kilo ketamine, please.
36:53Won't that drop this pressure even more?
36:54We don't have a choice.
36:55We cannot do this on a moving target.
36:58Dante, Jesus fucking Christ.
36:59It's my baby brother.
37:00Hey, Perla?
37:01Sir, I'm so sorry, but you can't be in there right now.
37:03What's wrong with him?
37:04Hey, Dante.
37:05Nothing.
37:06Hey, just hand me in the car.
37:07Okay.
37:08So sorry, you can't be in there right now, okay?
37:10We have to stabilize it.
37:11They said he was fine.
37:12Okay, there's been a complication.
37:13I just needed to take a couple of papers and try to stay calm.
37:16Please.
37:17Just breathe with me.
37:18In.
37:19Okay, out.
37:19Look at me.
37:20Breathe in.
37:22Out.
37:23Very good.
37:24In.
37:25Out.
37:26Okay, stay calm, okay?
37:27We got this.
37:29Okay.
37:31I can't believe you've been there.
37:32It was alone.
37:33They've been out of the shock.
37:34From what?
37:34Uh, I am guessing a small tear in the right atrium from a sterile fracture.
37:37If it was ventricular, he would have crashed in the field.
37:40I'll call cardiothoracic.
37:41See if they have an OR.
37:42Stolic down to 64.
37:43Okay, have you ever done an apical approach?
37:45Nope.
37:46Good time, like the present.
37:47Collateral to my probe.
37:49Why not subcostal?
37:50Uh, this is a shorter distance.
37:51There are fewer structures.
37:52If you can see fluid, there's nothing between the probe and the pericardium.
37:56There are the needles in the effusion.
37:58Mm-hmm.
37:58Draw back.
38:00Good blood returned.
38:01Okay, sometimes it only takes 20 cc's to let that heart fill again.
38:05Carotid pulse much stronger.
38:06Thanks, Garrett.
38:08We'll have a room ready in five.
38:10All right, that is 40 cc's out.
38:12Blood pressure's up.
38:1390 systolic.
38:13Okay, now we're going to place the J-wire, and we're going to leave the catheter and the
38:17three-way stopcock.
38:18Still bleeding from the heart.
38:19He can live with a little blood loss, but not with a pressure bag squeezing his heart
38:23so it can't beat.
38:24Good thing we didn't send him home.
38:25Next day, Robbie.
38:27You too, Trinity.
38:28Is that an actual compliment?
38:29Sometimes you guys get lucky.
38:32Got a couple of bad ones.
38:34How old is he?
38:3584.
38:37Meclizine for vertigo.
38:38Anticholinergic effects can cause drowsiness.
38:40It's PRN, so maybe he doesn't take it all the time.
38:42He's also been prescribed methylcarbamol, another anticholinergic.
38:46It could definitely impair driving.
38:48And metoclopramide for his stomach.
38:50Well, that could cause gait problems.
38:53Exactly.
38:55Dr. Robbie, may we present?
38:57Yeah, what do you got?
38:58Hey, you should probably get started crossing your teeth and dotting your eyes for night shift
39:01handoff.
39:01All right, well, vaya con Dios, or whatever the bikers are saying these days.
39:07Our elderly couple, Frida and Ed, we're anxious about their ability to recover at home or to
39:12remain at home in general.
39:13But a number of Mr. Cohen's medications are on the beers list, and they may be contributing
39:18to his deteriorating health.
39:19Maybe.
39:21We can't be certain, but none of them are critical meds.
39:24We could have him stop them right now, follow up with his PCP, see how he's doing in a few
39:29weeks.
39:29Right by the family, sometimes just affirming a patient's independence, autonomy can do
39:34a world of good.
39:36Um, hey, Dr. Mohan, I heard a rumor that you were looking for an elective.
39:41Have you considered geriatrics as much of an art as a science?
39:45There's usually an opening, and you seem to have a predisposition to the pace.
39:57Have you seen Dana?
39:58I think she went out for a smoke, lucky girl.
40:19You ever going to tell me what really happened in there?
40:22Nowhere.
40:25You could lose your nursing license.
40:28Let me guess, that violin verset in your pocket.
40:30You drew that up for Doug Driscoll, in case he ever came back, and now you've just been
40:34carrying it around ever since.
40:36I did exactly what I needed to.
40:37Now there's a young nurse who gets to go home in one piece because of me.
40:40McKay can sign the verset order for me if you will.
40:42I will sign the order.
40:44I will sign an extra order so you can have one when I'm gone.
40:47That's hardly the point.
40:49It's not exactly like I'm against nurse safety.
40:52I'm trying to advocate for your caution, because you're the person who's supposed to be here
40:56keeping this running while I'm gone, not roaming the halls like a vigilante with a loaded syringe
41:00and a vendetta.
41:01It's always do as I say, not as I do with you, isn't it?
41:03What is wrong with you today?
41:05Samira, Mr. Triple A. Mel and Ellis had deposition McKay Street people in the park.
41:09Fucking Langdon.
41:10At some point, you and Langdon got to work this way.
41:12I don't want him here.
41:12He made a mistake and he paid for it.
41:14Did he?
41:14Did he go to jail?
41:15Because I let him get away with the crime.
41:17So what does that make me?
41:18Human!
41:19Are you angry at him or are you angry at you?
41:21Somebody could have died.
41:23Oh, let's see, D. Somebody's always on you.
41:24Go ahead, make jokes.
41:25Make jokes instead of acknowledging me.
41:26He didn't kill anybody.
41:27That we know of.
41:28And he saved a lot of lives that we do know of.
41:31Our kids disappoint us sometimes.
41:33Langdon is not a kid.
41:34No, but he's your guy and you're taking him personally.
41:37Langdon fucked up and you think that makes you look bad, but it's on him.
41:42How am I supposed to leave this place when it's a shit show?
41:45First you can't stay, now you can't go.
41:47What is it, Rabinovich?
41:49No, I'm going.
41:50I just thought I could leave it a little better when I did.
41:53Oh, don't be such a martyr.
41:54This place is always teetering on the brink of disaster.
41:56With or without you.
41:57We do it every night, every day off.
41:59This place is bringing to one person.
42:01It's a vibe without Adamson, it's a vibe without me,
42:04and it'll survive without you.
42:10My meds are making me worse?
42:13Not worse, but they may be impacting your balance and mobility.
42:16Why would his doctors prescribe drugs that could harm him?
42:20Oh, it's not any one medication.
42:22It's the combination that could be impairing his daily functioning.
42:25We have a case manager that will put together a robust plan
42:29that I think will make everyone happy while allowing you to stay at home.
42:33There's regular physical therapy,
42:36an at-home nurse that visits a few times a week,
42:38and even personal shoppers to help with groceries.
42:42This sounds expensive.
42:45Actually, Medicare covers most of it
42:47with some assistance from the Area Agency on Aging.
42:49You know, every old person knows what it is to be young,
42:53but no young person can know what it is to be old.
42:58Thank you for listening.
43:01You guys are still coming with me to visit
43:03a few assisted living places, just in case it's ever time.
43:06Well, maybe.
43:24Hey, you, uh, you doing all right?
43:27Never better. Thanks. Bye.
43:36God, you're really just going to keep standing there, aren't you?
43:38Yeah. What's going on?
43:45It was literally my first day of being a doctor.
43:48And Langdon gaslit me and made me question my skills over and over,
43:52and it's taken me a long time to feel like I belong here.
43:56And now he's back.
43:58And I don't even care that he was an addict.
44:00I care that he was a fucking asshole.
44:02And it's like no one here even remembers any of this.
44:05And everyone here talks about community and family,
44:09all while they throw you under the bus.
44:10And Robbie is the only attending who actually sees through the bullshit.
44:15But now he's leaving for some grand ego death spirit quest
44:18and robo-doc over there shoots me in the proverbial dick.
44:23Garcia's here.
44:24She likes you, right?
44:25She doesn't like me.
44:26She likes getting laid.
44:28And her stress relief squeeze toy, or was.
44:32You know, she and Langdon would make a great couple.
44:35Yeah, that's dark.
44:38I'm sorry.
44:40Yeah, why do you care?
44:43Because we're friends, I thought, I think.
44:45Okay, are we?
44:46Because on top of all of that,
44:47you're the one who's being super shady about moving out on me.
44:50Moving out?
44:51Yeah, I heard you were going to go squat at Robbie's sad bachelor pad.
44:54Honestly?
44:55I thought that was your idea,
44:57to get me to move out of the apartment.
44:58No, no, I wanted him to give you some fatherly advice
45:01about going all farmers only and not giving you the keys to his fucking house.
45:07Oh, my God.
45:08No, I know.
45:08It was none of my business.
45:10No, it's not that.
45:11It's...
45:14You actually like living with me, don't you?
45:19What are you talking about?
45:21You leave your dirty clothes everywhere.
45:23You eat all of my avocados as soon as they ripen.
45:26You keep pausing the TV to ask the dumbest questions.
45:28No, I'm going back to the avocado thing,
45:30because I've never seen someone consume so many.
45:32It's disgusting.
45:33Just say it, and I won't move out, okay?
45:35I'm not going to be doing much of Robbie's.
45:37I'm going to be taking in his mail and re-watering his plants.
45:40Say what?
45:45Admit that you like having me as your roommate.
45:49You are such a fuckleberry.
45:51Have fun with Robbie's plants.
45:56You have no idea how much joy that just brought me.
46:02Hey.
46:03How much longer until I get these things off and go home?
46:08Oh.
46:10You assaulted a nurse.
46:12Yeah.
46:13You said it was the cocoa-ethylite thing that made me go crazy.
46:17Well, if you're drunk and you kill someone, you still kill someone.
46:21So after we clear you in a few hours,
46:23you're going to take a ride with the uniformed officer outside
46:25who's going to take you in for processing.
46:27No.
46:27No, no, no.
46:28This cannot be happening.
46:29No.
46:29Since you golf and can buy cocaine,
46:31I assume you can post bail after your arraignment.
46:33You're going to ruin my fucking life!
46:34But it being our nation's big, beautiful birthday,
46:36that hearing may take longer than usual.
46:38So I'd cancel any grand plans you have for the 4th.
46:45You know, I...
46:47I can leave you with these.
46:50Rehab?
46:50Fuck off!
46:52I'm suing this whole hospital and you for personal injury.
46:55Well, good luck convincing a jury of that one.
46:58Oh, fuck this whole place!
46:59And fuck all of you!
47:02No, not you, officer.
47:04Fuck!
47:04Make sure discharge charts are bundled
47:06and placed in the 2B scan bin with nursing notes,
47:09order sheets, lab, and X-ray results.
47:11Day shift needs completed T-sheets on every patient
47:14and to write on the board what tests dependents
47:16so nothing falls through the cracks
47:17while we wait to come back online.
47:21Westbridge and Good Dominion have settled their cyber dispute.
47:25They paid the ransom?
47:26Yeah.
47:26Our IT department is confident in our defenses
47:29so they will be rebooting everything soon.
47:32Slowly but surely.
47:33Okay, so when everything comes back on,
47:36all the residents have to do
47:37is scan all the completed paper charts
47:38and digitize them into the patient's EHRs before they go.
47:41I'm never getting out of this place.
47:45This means you're clear for takeoff.
47:47Nothing here we can't handle with night shift coming in.
47:50Yeah, right.
47:51Free to go.
47:53Uh, hey!
47:54I told you I would get you up there
47:56and I promise I'm not leaving
47:57until you're back and sent packing.
47:59Robbie, buddy, you got me to come in,
48:01got me to take my test.
48:03You don't gotta babysit me.
48:04That's why I have a nurse.
48:05What's your name, sweetheart?
48:06Nurse Vivi, sir.
48:07That's what I have, the lovely nurse Vivi here.
48:09This will not take very long.
48:11Where have I heard that before?
48:14Hey.
48:15So, uh, this is it, huh?
48:18Uh, yeah.
48:20Don't let the place burn down.
48:24You know, in a previous life,
48:27I had a lot of friends who liked to see
48:29how close the edge was.
48:31As if it was a challenge they were called to meet.
48:35Trouble is, they all inevitably found it.
48:40Okay.
48:44I'm just picking up on a weird vibe
48:46from you today, is all.
48:47Yeah.
48:49It's been a weird day.
48:56You leaving?
48:57Uh, yeah.
48:58My shift is over and I ain't getting paid to be here.
49:01Quite literally the opposite, in fact.
49:03Well, I-I don't know if you noticed,
49:05but we're sort of, uh,
49:06in disaster mode here still.
49:08We put in the extra time if we need it.
49:13You know 62% of VD docs
49:15report suffering from burnout?
49:17Painfully where?
49:19So, maybe all you lunatics
49:21need to learn how to set some boundaries.
49:23Like me.
49:26Well, see you tomorrow, Doc.
49:30Good luck on there.
49:31Sorry about the mess.
49:32Mess?
49:38Yep.
49:40Head trauma.
49:41Unwitness fall from the warehouse catwalk
49:43where he works as a security guard.
49:46Oh, my God.
49:48Orlando.
49:49He left five hours ago.
49:56Oh, my God.
49:56Yeah.
50:24Gracias por ver el video
50:54Gracias por ver el video
51:22Gracias por ver el video
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