- 18 hours ago
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Short filmTranscript
00:00You
00:19Donnie, thank you. I'm sorry. We'll get another nurse to replace Jesse. Do we even know when he's ice assholes
00:24took him?
00:25No, but the hospital attorneys are all over. I know you get your own, babe. What's going on?
00:30It's a cold hula hoop central 14
00:39What the hell happened you're talking down you're right
00:48How do you get a bloody nose he said
00:53Let's see
00:54He had her in that look
00:58Where's Ogilvy?
01:00Upstairs they let him scrub in on that kidney stone turn triple-a great and the one day med students
01:05might actually be useful in the ED
01:08Oh present company excluded you're doing great
01:12Sure
01:12Hey, uh, can I get a selfie with you?
01:16Me?
01:16Yeah, you're kind of a legend among med students
01:19Really?
01:19I call you phantom of the pits
01:21On account of you secretly living in the hospital for months
01:24What? It wasn't months
01:26Still waiting on labs, x-rays, meds
01:30PTMC, go ahead medic command
01:32Where are all the nurses?
01:33Uh, there was a code hula hoop in central 14
01:36Oh no
01:37What's that?
01:38Hospital worker assault
01:40Who?
01:41Uh, the new nurse, Emma
01:42Is she okay?
01:43I don't know
01:44I think so
01:46Smoke them if you got them
01:47This place is going tits up
01:52Okay, are we all good in here?
01:54Oh yeah, boss, we got this
01:56Are you sure you're all right?
01:58Uh, yeah, I think so
01:59Good, come on
02:03So, what exactly happened?
02:04He grabbed him, I
02:05He threw it up against the wall
02:07I ran in and gave him a shot
02:08Right, and did he slip before or after the shot?
02:10Before
02:12Yeah, he had me in a headlock
02:13I didn't see what happened
02:15What did you give him?
02:16Four milligrams of Versed
02:17Who wrote the order?
02:18The head in my pocket
02:19Was on my way to waste
02:20It was sure it was sideways
02:22What?
02:24Okay, so now he's altered from alcohol
02:26Versed
02:27And a head trauma
02:27Now he's going to need a head CT
02:29To rule out intracranial bleeding in a fracture
02:30Would you rather be Emma
02:31With a head injury or worse?
02:33Don't worry about it
02:34We got this
02:34No, there's no we here
02:35You need to pass this patient off
02:37And report him
02:38Fine
02:39Emma, you're done with this bastard
02:40I'll handle him now
02:41No, no, this is my emergency department
02:42And I'm telling you to pass it off
02:44These are my nurses
02:45And I choose what cases they work
02:46And if you think for one minute
02:47Putting anyone else from my staff
02:49At risk with that asshole
02:49You better give your fucking head a shake
02:51Come on
02:52Come on
02:54NBA coming in?
02:55Okay, I'll be right there, thank you
03:01Did I kill my son?
03:03No
03:05He's not dead
03:06He's recovering in pediatric ICU
03:10We'll be back to check on you again shortly
03:11Massage Amanda
03:18Has her husband arrived yet?
03:20Yeah, but he went straight upstairs
03:21Really?
03:23He may have just wanted to see his child first
03:25Let's not jump to conclusions
03:27Dr. Robbie
03:28Can I have a word?
03:30Shoot
03:30In private
03:32I think we're going to start to talk
03:34Thank you
03:43What is this about?
03:47I'm going to recommend this ED have two attendings on shift at all times moving forward
03:52This department is clearly too much for one person to handle
03:56It's not healthy for you or the patients
03:58And I'm very concerned by what I've witnessed today with some of the staff
04:03What is going on with Langdon and Santos?
04:06I saw them having it out like it was fight night
04:07Dr. Langdon hasn't even been here for ten months
04:10And you told me this morning that there was nothing to worry about with Dr. Santos
04:13There isn't
04:14There isn't
04:14Santos and Langdon have beef because she's the one who turned in the room for taking meds
04:18I'm sorry, what?
04:20Santos is responsible for revealing Langdon's benzo addiction
04:27Was he stealing drugs from this ED?
04:31This ED is the best of the best
04:33And I would put it up against any emergency department in the country
04:36And it is going to be yours to fuck up, so don't fuck it up
04:55You're not supposed to smoke out here
04:58Really?
04:59Seems to be working for me so far
05:04How old are you, kid?
05:06I'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 to purgatory to put myself through school when I was your age
05:30Snowflake
05:32Hey, Amy
05:33Yeah, 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
05:41I can't breathe
05:42I got the airway, you take the pulse
05:45Yeah
05:48Oh my God
05:49Trying a jaw thrust
05:50Radio's weak and thready
05:52What's his name?
05:52My dad
05:53Oliver
05:54Hey, Oliver
05:55Can you open your eyes for me?
05:57Here we go
06:02Okay
06:03One, two, three
06:06Drive-in with severe respiratory distress
06:08Last-sided dialysis shunt probable renal failure and fluid overload
06:12I have respiratory center, BiPAP
06:14When was his last dialysis?
06:15It was supposed to be yesterday morning
06:16I'm going to need a 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, Miss Emma here needs an H&P
06:25Uh, Cassie, can you give Emma here a workup?
06:28Started chart, victim of assault
06:30Really?
06:30I'm fine
06:31He was choking you
06:32He had me by the head most
06:33You're a patient now
06:34Full exam in South Ate team
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
06:42Be there with you
06:43Come on, let's get you a spot
06:45Well, your guy just bumped my guy for CT
06:47And how he's my guy?
06:48New one because he's been sitting here forever
06:49I'm never going to get out of here
06:50Tell it to someone who cares
06:51You know what?
06:52You should care
06:53Because if you gave that guy a serious injury
06:56With force inflicted from a sedative
06:57You are not licensed to prescribe
06:58Anyone else uses force to stop an assault?
07:00They're a hero
07:01But a nurse does it
07:01And we're punished
07:02You just haven't had a vial of a sed in your pocket?
07:05It was extra from the medics
07:06Good timing, I guess
07:07When we waste a controlled substance
07:08We need a witness to sign off
07:10I was on my way to
07:11When I spotted that asshole attacking our girl
07:12Anything 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, fuck, fuck, fuck
07:37Should we intubate?
07:39Uh, best to avoid that if possible
07:40Pressure support and after load reduction
07:42Why is this time for dialysis?
07:44BiPAP's starting at 10 over 5
07:45Good hard squeeze
07:46Good lung sliding
07:47But there's a ton of B lines
07:48Pulmonary edema
07:49Which is best treated by what, Dr. Giovanni?
07:52Uh, nitrates
07:55Dose?
07:56BiP 198 over 132
07:58Pulse 120
07:59Pulse tox only 85
08:00Good BiP
08:01Let's start at 400 mics per minute
08:03For 2 to 5 minutes
08:03I was asking Dr. Giovanni
08:05Don't you know how I start low with nitro
08:07Then titrate up?
08:07In flash pulmonary edema
08:09We do the opposite
08:10What he really needs is dialysis
08:11To get the fluid off
08:13What's his dialysis schedule?
08:14Uh, Monday, Wednesday, Friday
08:16He missed yesterday
08:16Because of a wedding
08:18We tried to go to the center this morning
08:19It's usually open on Saturday
08:20But I think they close for the 4th
08:22Where do you live?
08:22Uh, Brookville
08:23It's like an hour and a half away
08:25Yes, ma'am
08:25I tried Pine Ridge Hospital
08:27In Ford City
08:27But I didn't know they shut down
08:28Yeah, they sure did
08:36All right, sister
08:38How can I help uncluster
08:39This clusterfuck?
08:41UTMC emergency
08:42You ready to finish our conversation?
08:44We talked
08:44Okay, now I gotta need you
08:46Please
08:53Talk to me
08:53I'm tired of this shit
08:54Okay
08:55It's the second time
08:56That everyone was attacked
08:57By a patient today
08:58Okay
08:58I used to quit on my nurses
09:00And these cyber assholes
09:01Have thrown us back into 1999
09:03Well, I'm worried about you
09:05You are not yourself today
09:07Makes two of us sound
09:09Do you have something you want to say?
09:12Go ahead
09:12I can take it
09:14All right, Danielle
09:16Sometimes it's like
09:16You're just tempted to death
09:17Because you don't give a shit anymore
09:18So this is about the motorcycle
09:19It's not just about the motorcycle
09:21It's about the whole damn thing
09:22Robbie
09:23You're actually telling people
09:25That you're going to a place
09:26Called smash my head, Ed
09:27Close
09:28Not quite
09:28Robbie
09:29Your buddy Duke
09:30Is insisting on leaving
09:31And that M.B.A. is here
09:33Okay, okay
09:34I'll be right there
09:35What's open?
09:36Uh, cells 15
09:3678-year-old woman
09:38Very low-speed auto
09:39Versus pedestrian
09:40With ground-level falls
09:41Bruising on her left hip
09:42No head trauma
09:43Her husband Eddie came along
09:44Hi, how do you do, sir?
09:45I'm Dr. Robbie
09:46Come with us
09:46We're going to get you
09:47Set up right over here
09:50Sorry, we'll get you
09:51Something for the pain shortly
09:52Thank you
09:53Do you have any medical problems, Frida?
09:56Uh, high blood pressure
09:57Low thyroid
09:58Um, afib
10:00Any chest pain, shortness of breath?
10:02No
10:03Front row seat, sir
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
10:25We'd like to check your head
10:26Of course
10:30I'm 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 send motorcycle bullshit
10:51Maybe
10:51No, no, 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
11:03I 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
11:15But 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?
11:34Uh, eloquist from my AFib
11:37Any tenderness here?
11:39No, not really
11:41Here?
11:42Oh, yeah
11:43That hurts
11:43Four of, uh, morphine and zofrin
11:46What about up here?
11:47Not really
11:50All right
11:50So let's start with labs in plain film
11:52No, CT abdomen pelvis
11:54Will get a better view of the hip
11:55And check for bleeding
11:56The eloquist is concerning
11:58Uh, you think she broke her hip?
12:01If it's broken, you broke it
12:04Usually for a broken hip
12:05The leg is shortened and rotates out
12:08But we'll just wait for CT results
12:18Mr. Cohen
12:19I know that you were checked on scene
12:22But I was wondering if I could do a quick examination of you
12:25Oh, hello, 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?
12:45Uh, what 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
13:03You and me both
13:05Dr. King
13:06What 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
13:16Okay
13:18How are you doing, Oliver?
13:20Stats are not coming up
13:20Pressure's holding on 409
13:22Sure, let's up the BiPAP to 20 on 10
13:24We could try phlebotomy
13:25Decrease the fluid burden on the lungs
13:27Oh, it's cool
13:28But right by time
13:29Hemoglobin's only 9.2
13:31He's anemic for renal failure
13:32And he can't afford more blood loss
13:33We need to intubate
13:34We're losing this war
13:35Intubation's not a trivial matter
13:37For immunosuppressed patients
13:39So we just
13:40Draw off a bunch of bread tops?
13:41No, we do the collection on the floors
13:42If he's giving blood
13:43We like medieval bloodletting
13:45Essentially
13:45And that is something
13:46You should step out for, Mason
13:48Casey, thank you
13:49Got a good vein for 16
13:50One donor bag
13:51500 cc's
13:52No more
13:56Okay, let it out
13:59Same again
14:00Deep breath in
14:03Great
14:04Hold on
14:05How's she doing?
14:06Postdoc's 100%
14:07Normal exam
14:08No evidence of injury
14:09Great
14:09I got way worse
14:10From my older brothers
14:11I bet
14:12All right, I'll go
14:13Write a brochure
14:16How about we call it a day?
14:18My shift isn't over
14:20This was a shift and a half
14:21For anyone today
14:22Believe me
14:24If it's all right with you
14:25I'd rather stay
14:27I'm not a quitter
14:28Okay, but something good for you
14:30But stick close to Donnie
14:31For the rest of the day
14:33Would you?
14:34Sure
14:34And you also need to make a statement
14:36To the police
14:38If we don't stand up for ourselves
14:39No 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's wrong?
14:57That depends
14:58Are you a four-month-old
14:59With severe diaper rash?
15:01No, I'm Dorian Cole
15:02And I'm pretty sure
15:02That I broke my collarbone
15:04Okay, we can help with that
15:05I'll be back
15:06Wait, are you serious?
15:07Can I at least get something
15:08For my pain?
15:09Sure, sit tight
15:10This place sucks
15:11Tell me about it
15:12Try working here
15:13Boy, you're really working hard
15:15To boost those patient satisfaction scores
15:17The chart for Central 7
15:18Doesn't match the patient
15:19That's in there
15:19Hang in there
15:20We're almost over this
15:21I was over this six hours ago
15:22Sheriff's is looking like
15:23Melanie's on St. Paddy's Day
15:25They're gonna break through
15:26The doors like zombies
15:27If you don't start moving
15:28More than me back there
15:29Dante Casella, 34
15:30Blunt trauma
15:31From a fireworks explosion
15:33In his storage unit
15:34A&O
15:35Good vitals
15:35Large scalp laceration
15:37And bruising to the chest
15:37No meds or allergies
15:39Partial or flow thickness burns
15:40No burns
15:41The blast launched him
15:42Into a rolled-down garage door frame
15:44Yeah, am I fucking dying here?
15:45Dr. Robbie
15:46This is Dr. Santos
15:47I can't hear you
15:49Try the other side
15:51I'm Dr. Santos
15:52Can you hear me?
15:54Yeah, yeah
15:54Dante
15:55A lot of ringing
15:56Hey, McKay
15:58Joy
16:01One, two, three
16:04I need like four doctors
16:08Shit, I know it was bad
16:10This is a teaching hospital
16:12You get all the extra help you need
16:14Airway and breathing intact
16:17Good lung sliding bilaterally
16:20Tender over the sternum
16:21Possible fracture
16:22That's your breastbone
16:23No ectopy on monitor
16:26No pericardial effusion
16:27The heart looks good
16:28130 over 85
16:29Pulse 108
16:30Sat's 98 on two looters
16:32Good enough for 50
16:33Offent
16:34He's stuck through his headdressing
16:35Let's take a peek
16:36Normally we don't deal
16:37With scapulax on the primary survey
16:39Only if there's active bleeding
16:40Not with glass injuries
16:42The pressure wave can transmit energy
16:44Through the body
16:45And cause internal damage
16:46Even without any external
16:47Visible signs
16:47Especially with organs
16:49That are air-filled
16:50How are we looking, Dr. Santos?
16:51PFAS negative
16:52No free fluid in the belly
16:55Fuck me
16:56What is this?
16:58It's a pretty big flap
16:59Checking for bleeding source
17:01Is that through the gale yet?
17:02It is indeed
17:03Crack my head open or what?
17:05Don't worry, your skull is intact
17:07It's just a very deep cut
17:12Okay, we got a couple arterials
17:14That need control
17:16Figure of eight sutures
17:17Dr. Santos is for 800
17:18What are rainy clips, Alex?
17:20Quicker than sutures
17:21Ding, ding, ding, ding
17:22Okay, clamp those bleeders
17:23Call for CT
17:24I'll be next door
17:25And Duke's CT line keeps growing
17:31500 cc's out
17:32How you doing, Oliver?
17:34I'm making some progress in here
17:36Can't tell if it was the phlebotomy
17:38Or if the nitro finally kicked in
17:39Oh, could have been both
17:42Potassium's high, 6.5
17:43Be expected with the missed dialysis
17:45And the added heat stress
17:46He needs, uh
17:47Dr. Tavody?
17:48Uh, he needs insulin and glucose
17:50To shift the potassium into cellular
17:52Exactly, uh, 10 units
17:53Ampathy 50
17:54Start with 5 milligrams
17:55Of nebulized albuterol
17:56It'll shift some potassium
17:57And help his breathing
17:58He's at risk for arrhythmias
18:01Mmm, no peach tea waves
18:03No QRS widening
18:04Insulin puts him at risk
18:05For hypoglycemia
18:06And you'd tie up nurses
18:07With frequent acu-checks
18:08Dr. Alashima's right
18:09The nebs will hold him over
18:10Until dialysis gets here
18:11You got this?
18:12Mm-hmm
18:16All good in here?
18:17Yep
18:21Uh, I'm gonna go
18:22Give this guy's kid an update
18:24He's probably freaking out
18:24Come 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
18:36At NJMS Senior Care
18:37One of the attendings
18:39Always said you can learn
18:39A lot about your patients
18:40Just by looking at their feet
18:44Bravo, ladies
18:45Now on to the next
18:45Lucky customers
18:49Oh, probably gonna have to stay late
18:50To catch up on all these patients
18:52Night shift reinforcements
18:53Will be here soon
18:54We're supposed to be speeding up
18:55In the 11th hour
18:55Not slowing down
18:56They don't call it the final sprint
18:57For nothing
18:58Chop, chop
19:05Is that the mom of the heat stroke?
19:08Yeah
19:08Do you believe it was just an accident?
19:12Does it matter?
19:14As a doctor, no
19:16As a mom
19:17Um, sometimes I can't tell
19:19If motherhood has made me
19:21More understanding
19:22Or more judgmental
19:26Dana, got a couple of visitors
19:28Uh, my brother
19:29There was an explosion
19:30Hi, my mom was in a car accident
19:32Uh, okay
19:33Monica, can you help
19:34These fine folks
19:34Find their loved ones?
19:35No
19:35And princess
19:36What are you still doing here?
19:38Don't you got some crazy
19:39Luau Pigaro's barbecue thing
19:40To get to?
19:41It's lichon
19:41I guess I do
19:42I'm gonna sneak out on a few
19:43Yeah, yeah
19:44Go have some fun
19:45For both of us, alright?
19:46Don't stay too late
19:47Okay
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
19:59Get you something
19:59For your pain, okay?
20:02And your last patient
20:04Left her blanket
20:06Oh, uh
20:08Yeah, I
20:11Yeah, I'll take it
20:12Excuse me
20:15Um, I'll be right back to you
20:21Fuck
20:23You good?
20:24Yeah, yeah
20:24I, uh, just, um
20:26I'm looking for something
20:27To put this in
20:28I, uh
20:29The patient left it
20:33She died
20:34The, uh
20:35Cancer mom
20:36With two kids
20:37Sounds like a tough one
20:38Yeah, that one sucked
20:40Seeing those two young boys
20:42Say goodbye to their mother
20:43Was brutal
20:45Just
20:46Makes you want to cry
20:49You should cry
20:50You should cry
20:50You'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
21:00Is that what this place does to you?
21:03You get pretty good at shutting down our feelings
21:07Yeah, I'm a little scared
21:10Yeah, I'm a little scared
21:10I've shut them off for so long
21:12I don't know how to turn them back on again
21:15I just wish I could cry again, you know?
21:19I'll take care of you
21:21You want a hug?
21:24God, no
21:26Your mom is stable
21:27But she's still waiting on the imaging of her head
21:30Well, no more soon
21:31You can wait with your dad in the meantime
21:33I've told him a million times
21:34He 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
21:42Just the two of them
21:44We noticed your father exhibiting signs of an unsteady gait
21:47Along with other balance and mobility issues
21:50He sees an internist
21:52Neurologist
21:52Cardiologist
21:53Gastroenterologist
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 refused to even talk about it with me
22:09Mr. Cullen, you have a visitor
22:12Care bear
22:13Dad, you feeling okay?
22:15No, I'm feeling dumb
22:18Carrie, this is Dr. King
22:20Who 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
22:31And you will likely have to take another driver's test to keep your license
22:35What has that got to do with Frida?
22:38Well, if the hip injury is serious and you're also limited
22:42Then it could mean an unsafe to return home recommendation for your wife
22:46You'd be looking at a temporary move to some form of assisted living and rehabilitation for Frida's care
22:52How temporary?
22:55Best case, three to six months
22:57But she may never return to the functionality she had prior to the injury and 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, the new communities are not anything like the old scary nursing homes
23:14They're really nice
23:15And you get your own apartment
23:17And, um, you know, my sister actually lives in Munches
23:19She's lost 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?
23:30Look what happened today
23:32Look, we're gonna leave you two alone
23:34We'll come back with Mrs. Cohen
23:41Hey, Robbie
23:43Our scout victim is back from C2
23:45They're prepping him now
23:46Shit
23:46Uh, okay
23:48I'm coming
23:48Um
23:50Is your friend doing okay?
23:52He's on my flight risk radar
23:53Oh, and Dana put McKay 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
24:03Have to figure out a way of working with him now that he's back
24:06Or until he relapses
24:07You're becoming a very good doctor
24:09Don'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
24:14Yes?
24:15Yes
24:16And I asked Whitaker to house sit for me while I'm gone
24:18I figured that would distract from the whole Farmer's Widow thing
24:21Wait, what?
24:21Bring the mail, water the plants
24:23Cool
24:24Cool, yeah, fine
24:25That looks good
24:26You can start the repair after this one
24:29Feeling any pain, sir?
24:31No pain, just wet
24:33You already numbed him up?
24:35I did
24:361% would that be
24:38CT back it?
24:39No, not yet
24:40I watched the slices come up
24:41Isolated sternal fracture
24:43Everything else looked normal
24:44Could send him home
24:45But given the mechanism
24:47Should probably watch him overnight
24:48I agree with Dr. Garcia
24:51I agree with Dr. Garcia, too
24:54Three-layer closure
24:55Galia, sub-Q, skin staples
24:58Enjoy the fireworks
25:00And hey, if I don't see you before you leave
25:02Don't forget to buy me a souvenir
25:03Like a custom outbone carved hunting blade
25:05Nothing lasts for my favorite butcher
25:07Oh, you'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
25:17Said 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
25:30I'll ask
25:31Yeah
25:32That's the guy who attacked Emma?
25:34Some tents
25:36How you doing?
25:39Beachy
25:40Oh, that's me
25:42Hey, you did what you had to do with that guy
25:44Everything's gonna be fine
25:45From your lips
25:50Class B launch tubes to the van
25:53Next second
25:55Kaboom
25:55I can get launched
25:5710, 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 screaming
26:11I'm lying there thinking
26:12Oh, he must be dying
26:15I guess it was me
26:16He 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
26:26What's oops mean?
26:29Hello?
26:30Nothing to worry about
26:33We never say oops in front of a patient
26:41All right, try again
26:43You sure?
26:44Mm-hmm
26:47Better?
26:48Keep going?
26:49You might want to leave the fireworks to the professionals
26:51We are professionals
26:53Got our official PDA consumer license
26:56A few years back
26:59Gunpowder's in my blood, man
27:00Nothing like that
27:07Ain't no fighting it
27:09I'm more fatty
27:11More like my memento mori
27:14We have two of those
27:17Am I like the only one who didn't study Latin for med school?
27:21Yep
27:21Yes
27:23And finished
27:24Nicely done
27:26Can I see my brother now?
27:28Yep
27:28Oh, motherfucker
27:30Chest pain?
27:32Only when I move
27:33That would be the fracture in your sternum
27:35Which we would give you another four more feet for that
27:37Thank you
27:37And try no laughing or sneezing for the next four weeks
27:43Mr. Haas, we're going to switch you over to a high-flow nasal oxygen
27:46Instead of the BiPAP and see how you do
27:49This looks promising
27:50Repeat, potassium is at 6.1 with the albuterol
28:00Feeling a little better
28:06Don't you ever tell your mother about how fast you drove here
28:09I thought you were going to die
28:11Any longer than he might have
28:13So, good job
28:15Boy just got his permit last week
28:19I felt like I was living in one of those
28:20Fast and the Furious movies
28:23I can't believe Pine Ridge closed
28:26When did that happen?
28:27I read about it a few months ago
28:29Medicare spent me cuts
28:31Are there any other emergency rooms in the area?
28:33Nope
28:35It's going to be a long way to drive for folks out where we live
28:38Mr. Haas, you'll need to stay here a few hours
28:40Get you tuned up
28:41Yeah
28:42I know the drill
28:44Yeah
28:46Hey, you know, Mason
28:47If you're hungry
28:48We've got a pretty good cafeteria
28:49Don't lie to him
28:51We have a cafeteria
28:53I'm just going to stay here with my dad
28:55Yeah, sure
28:58Thank you for saving you
29:06Are you still thinking rural emergency medicine when you're down here?
29:10I'm not thinking
29:11Doing
29:13Yeah, I hope there's just some hospitals left for you to work at
29:15Yeah
29:19Ah, it's in the March of the Walking Dead nightship again
29:21First one in, Mattel
29:23You get a gold star
29:24What happened in here?
29:25Left you guys at the layup this morning
29:26Don't ask
29:28Speaking of layups
29:29What up, Dr. J?
29:31Right
29:32That was, um, some sort of basketball player, wasn't it?
29:35Shame on you
29:36Only 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're going to drill the dark side when you graduate?
29:45The emergency department?
29:47The night shift, baby
29:48It's wild
29:50Um, I haven't even decided what residency I'm applying for yet
29:54You'll figure it out
29:55Got lots of time
29:57Tell this to my parents
29:59Dana, there's also back in your guy
30:01Oh, give me this
30:07I-I choked her?
30:10No, I would never do something like that
30:12But you did
30:16Can you, uh, sorry, can you excuse me?
30:19Wait for a minute
30:20Jesus Christ
30:21Dana
30:21Reed
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
30:34Maybe a little too boozy
30:36Things get hazy
30:37Next thing you know, he's on the floor
30:38And everyone's screaming at him
30:39How convenient
30:42Maybe it's better for both of you
30:44That he doesn't remember what happened
30:48Let me know when you're ready to take my statement
30:56All right, well, the good news is your CT was negative
31:00For 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-I did a couple of birdie bumps on the turn
31:17But we were just having fun on the golf course
31:18Look, when alcohol is mixed with cocaine
31:21Your liver produces a metabolite called cocanethylene
31:24Well, what does that have to do with me?
31:25Uh, uh, allegedly doing what you said
31:29It's a psychoactive molecule
31:30More toxic and potent than cocaine
31:33And it can lead to confusion, paranoia, aggression
31:37And even psychosis
31:41What happens now?
31:45We're gonna monitor you for a few hours
31:47Especially given your likely concussion
31:49And you need to give a statement to the police outside
31:51In the meantime
31:58Well, you lucky this was just a poke
32:00Spared the muscle
32:01See?
32:02It could have been worse
32:03No shit, Sherman
32:04The triangular bayonets they created back then
32:06Were designed to leave wounds
32:07That are nearly impossible to stitch
32:09Those 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?
32:19Yeah, you familiar?
32:20Yeah, I love you guys
32:23My mom would take me to the Fort
32:24Every time we'd come down and visit family as a kid
32:26We've been volunteering there
32:27As living historians for over 20 years
32:29I probably saw you then
32:30Man, I can't wait to tell my parents about this
32:33Getting stabbed must have been scary
32:34Yeah, well, Point Dexter here
32:36Stumbled over his boots
32:37And nearly impaled me
32:38Wouldn't it matter if you weren't out of formation?
32:40Well, you're in good hands
32:41This guy could have saved a lot of lives
32:43With his sutures back in 1776
32:46I was not out
32:48I was not out
32:50Hi again
32:51Good news, Mrs. Cohen
32:53Your imaging results show no hip fracture
32:55And no internal bleeding
32:57But you do have a small hairline fracture
33:00Of the superior pubic ringness
33:01Well, that doesn't sound good
33:03Well, if you're going to have a fracture
33:05It's the best one to have
33:05Do I need to stay in the hospital?
33:08Not necessarily
33:09Your recovery should be pretty straightforward
33:11If we can control your pain
33:13But you need to take it easy
33:15And stay off your feet for six to eight weeks
33:17How can she go home if she can't walk?
33:19Oh, she can bear weight
33:20And walk with some help
33:21And we'll get you a walker
33:23And schedule physical therapy
33:26So...
33:26So we can go home?
33:28Dad
33:29You can't take care of Momo by yourself?
33:32Oh, we'll manage
33:33You guys, you need to be realistic
33:35I don't want strangers
33:37Hanging around in the house
33:38It's not strangers
33:40It's helpers
33:41No, no, no, thanks
33:43Doctors, please
33:46I am worried about your ability
33:48To get the assistance you need, Mrs. Cullen
33:51It may be time to think about
33:53Some of those alternative living options
33:55We mentioned
33:57I can take care of her
33:59Dad
33:59Are you going to be able to get her
34:01Into the bathroom
34:01Onto the toilet in the middle of the night?
34:03Are you going to help her
34:04Change her clothes in the morning?
34:06Are you going to...
34:06We're fine
34:06Dad
34:07Dad
34:08Please
34:09Just try it
34:10You 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
34:20No, no, no
34:21No, okay
34:22Just no
34:26Carrie
34:27Could I speak with you outside for a minute?
34:37It's like that every time
34:38It's tough to find the balance between
34:40Respecting your loved one's needs for agency
34:42And doing what's best for their safety
34:45I was wondering if you had
34:47Your parents' medication lists with you
34:49Or on your phone
34:50Yeah
34:52I'd like to take a quick look at it
34:53If that's okay
34:55Yeah
34:58My man, how you doing?
35:01Like you better roll in a bar cart
35:02And a happy hour buffet
35:04If I'm going to be stuck in this place much longer
35:06This place is a traffic jam
35:07We're trying to merge you in
35:08I promise
35:08That's no traffic jam
35:10That's a 20 car pile of
35:12The sooner you get out
35:12The sooner I get out
35:13So you know I'm not bullshitting you
35:17Why are you jonesing so hard
35:18To get out and start your ride feeding?
35:21I've got a schedule
35:22I've got places to go
35:24I've got people to see
35:29I just have to get going
35:33You're worried if you don't leave tonight
35:34You won't leave at all?
35:38I get it
35:39I can feel it in the air
35:40Here's this place of life
35:41Quicksand
35:44Probably
35:45Dr. Robbie
35:47Dante, the fireworks guy
35:48Something's wrong
35:51Okay, shit
35:53Do not go anywhere
35:54You are next up
35:55I'm going to deliver you myself
35:56I'm starting to feel like a hostage
35:57In this place
35:58How do you think I feel?
36:14What's going on?
36:16Fucking chest hurts
36:17Systolic's down to 78
36:20Blood loss from scalp plaque
36:22That's highly unlikely
36:23Dr. Santos
36:23Good rest sounds
36:24But neck veins are up
36:25Protecting the heart now
36:26Okay, 500cc bolus
36:28100% non-rebreather please
36:30Pericardial effusion
36:31RV collapses
36:32Yeah, let's prep for
36:33Pericardial synthesis
36:34What's going on?
36:35Is he going to be okay?
36:36He said he was fine
36:37CT scan was normal
36:38Things 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 ketamine, please
36:48Won't that drop this pressure even more?
36:50We don't have a choice
36:51We cannot do this on a moving target
36:54Dante, Jesus fucking Christ
36:55It's my baby brother
36:56Hey, Perla?
36:57Sir, I'm so sorry
36:58But you can't be in the house right now
36:59What's wrong with him?
37:00Hey, Dante
37:01Dante, just hang in
37:02Okay
37:03So sorry, you can't be in there right now
37:05We have to stabilize
37:06He said he was fine
37:07Okay, there's been a complication
37:09I just needed to take a couple papers
37:11And try to stay calm
37:12Please
37:12Just breathe on me
37:13In
37:14Okay, out
37:15Look at me
37:16Breathe in
37:18Out
37:19Very good
37:19In
37:21Out
37:21Okay, stay calm, okay?
37:23We got this
37:27I can't believe you've been there
37:28Was alone
37:28I've been out of the shock
37:30From what?
37:30Uh, I'm guessing a small tear
37:32In the right atrium from a sterile fracture
37:33If it was ventricular
37:34He would have crashed in the field
37:35I'll call cardiothoracic
37:37See if they have an OR
37:38So it's down to 64
37:39Okay, have you ever done an apical approach?
37:41Nope
37:42Good time like the present
37:43Collateral to my probe
37:44Why not subcostal?
37:46Uh, this is a shorter distance
37:47There are fewer structures
37:48If you can see fluid
37:49There's nothing between the probe
37:51And the pericardium
37:51There, there are the needles in the effusion
37:54Draw back
37:56Good blood return
37:57Okay, sometimes it only takes
37:5820 cc's to let that heart fill again
38:01Carotid pulse much stronger
38:02Thanks, gear it up
38:04The hover room ready in five
38:05Alright, that is 40 cc's out
38:07Blood pressure's up
38:0890 systolic
38:09Okay, now we're gonna place the J-wire
38:11And we're gonna leave the catheter
38:13And the three-way stopcock
38:14Still bleeding from the heart
38:15He can live with a little blood loss
38:17But not with a pressure bag
38:18Squeezing his heart so it can't beat
38:20Good thing we didn't send him home
38:21Next day, Robbie
38:23You too, Trinity
38:23Is 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
38:40Another anticholinergic
38:42Could definitely impair driving
38:43And metoclopramide for his stomach
38:46Well, that could cause gate problems
38:48Exactly
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, well, vaya con Dios
38:59Or whatever the bikers are saying these days
39:03Our elderly couple, Frida and Ed
39:05We're anxious about their ability to recover at home
39:07Or to remain at home in general
39:09But a number of Mr. Cohen's medications are on the beers list
39:12And they may be contributing to his deteriorating health
39:15Maybe
39:16We can't be certain
39:18But none of them are critical meds
39:20We could have him stop them right now
39:22Follow up with his PCP
39:23See how he's doing in a few weeks
39:25Right by the family
39:26Sometimes just affirming a patient's independence, autonomy
39:30Can do a world of good
39:33Um, hey, Dr. Mohan
39:35I 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
39:41There's usually an opening
39:42And 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
40:20You could lose your nursing license
40:24Let me guess
40:25That violin verset in your pocket
40:26You drew that up for Doug Driscoll
40:28In case he ever came back
40:29And 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
40:36McKay can sign the verset order for me if you will
40:38I will sign the order
40:40I will sign an extra order
40:41So 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
40:52Keeping this running while I'm gone
40:53Not roaming the halls like a vigilante
40:55With a loaded syringe and a vendetta
40:56It's always do as I say
40:58Not 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 to deposition McKay Street people in the park
41:05Fucking Langdon
41:06At some point you and Langdon got to work this day
41:08I don't want him here
41:08He 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
41:13So 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 say ED
41:19Somebody's always angry at him
41:20Make jokes
41:21Make jokes instead of acknowledging
41:22He didn't 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
41:32Langdon fucked up
41:33And you think that makes you look bad
41:35But 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
41:42What 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's a vibe without Adamson
41:58It's a vibe without me
41:59And 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 prescribe drugs that could harm him?
42:16Oh, it's not any one medication
42:18It's the combination that could be impairing his daily functioning
42:21We have a case manager that will put together a robust plan
42:25That I think will make everyone happy
42:27While allowing you to stay at home
42:29There's regular physical therapy
42:32An at-home nurse that visits a few times a week
42:34And, oh, even personal shoppers to help with groceries
42:38This sounds expensive
42:41Actually, Medicare covers most of it
42:43With some assistance from the Area Agency on Aging
42:45You know, every old person knows what it is to be young
42:49But no young person can know what it is to be old
42:54Thank you for listening
42:57You guys are still coming with me to visit a few assisted living places
43:00Just in case it's ever time
43:01Well, maybe
43:19Hey, you, uh, you doing all right?
43:23Never better, thanks
43:24Bye
43:25Bye
43:32God, you're really just going to 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
43:48And it's taken me a long time to feel like I'm along here
43:52And now he's back
43:54And I don't even care that he was an addict
43:55I 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
44:04All while they throw you under the bus
44:06And I...
44:08Robbie is the only attending who actually sees through the bullshit
44:10But now he's leaving for some grand ego death spirit quest
44:13And RoboDoc over there shoots me in the proverbial dick
44:19Garcia's here
44:19She likes you, right?
44:21She doesn't like me
44:22She likes getting laid
44:23And her stress relief squeeze toy
44:26Or was
44:28You know, she and Langdon would make a great couple
44:31Yeah
44:32That's dark
44:34I'm sorry
44:36Yeah?
44:37Why do you care?
44:39Because we're friends, I thought, I think
44:41Are 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 going to go squat at Robbie's sad bachelor pad
44:50Honestly?
44:51I thought that was your idea
44:52To get me to move out of the apartment
44:54No, no, I wanted him to give you some fatherly advice about going all farmers only
44:58And not giving you the keys to his fucking house
45:02Oh my god
45:03No, I know
45:04It was none of my business
45:06No, it's not that
45:07It's
45:10You actually like living with me, don't you?
45:14What are you talking about?
45:17You leave your dirty clothes everywhere
45:19You eat all of my avocados as soon as they ripen
45:21You 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
45:28It's disgusting
45:28Just say it and I won't move out, okay?
45:31I'm not going to be doing much of Robbie's
45:32I'm going to 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
45:52You 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
46:07Yeah
46:08You 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 going to take a ride with the uniformed officer outside
46:21Who's going to take you in for processing
46:23No, no, no, no
46:24This 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 going to 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
46:42I 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
46:58No, not you, officer
46:59Fuck!
47:00Make sure discharge charts are bundled and placed in the 2B scan bin with nursing notes, order sheets, lab and
47:06x-ray results
47:07Day shift needs completed T-sheets on every patient and 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
47:22Our 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, all 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 and I promise I'm not leaving until you're back
47:54and sent packing
47:55Robbie, buddy, you got me to come in, got me to take my test, you 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
48:25was
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
48:42Yeah, it's been a weird day
48:52You leaving?
48:53Uh, yeah, my shift is over
48:55And 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
49:04We put in the extra time if we're needed
49:08You 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
49:22Well, see you tomorrow, Doc
49:26Good luck in there, sorry about the mess
49:27Mess?
49:34Head trauma
49:35Head trauma, unwitness fall from the warehouse catwalk where he works as a security guard
49:42Oh, my God
49:44Orlando
49:45He left five hours ago
50:15I don't know if I can to see you tomorrow
50:16Go in there you live
50:17And I can't point to wait
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