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03:30ยกSuscrรญbete al canal!
04:02ยกSuscrรญbete al canal!
04:30Ok, I'll let the hospital attorney know
04:32How are you doing, Oliver?
04:33Alive and kicking
04:34Mr. Haas, pulmonary edema after misdialysis
04:37Now stable with a sun mason at the bedside
04:40Hello
04:41I'm Dr. Shen, I'll be back
04:43Dialysis tech says I'm off the machine at 10.42
04:45Cut the call light and I'll come running
04:48South 21 next
04:52Mr. Digby
04:53Just Digby
04:55Dr. Mohan's patient
04:57Forearm cellulitis
04:58Admit med-surg awaiting a bed
05:00I can take him
05:01Sold, Dr. Tamarian
05:02Moving right along
05:05Good enough to eat
05:06We'll be back
05:10Lillian Stegman
05:11Tweet your knee water skiing
05:12Doing a 360 off a five foot ramp
05:15Respect
05:16X-rays ordered in triage
05:17That was hours ago
05:18Ma'am, I'm Dr. Cruz Henderson
05:21Let's get you home real fast
05:23That would be wonderful
05:24Okay, heading to north
05:26It's like our first scanning station is almost ready
05:29Whitaker Santos
05:30After rounds, this will be your post
05:32Seriously?
05:33For how long?
05:35Till we mop up this mess
05:36And away we go
05:38All right
05:40Now you know everything there is to know about rounds
05:42Fascinating, right?
05:44Yeah
05:45Here
05:45I've got something better for you
05:49So Digby
05:50We're gonna find you some new clothes
05:52But my friend Emma and I
05:53Wondered if you'd like to get cleaned up a bit first
05:56I already had a shower
05:58I know
05:59And you look good
06:00But the offer also comes with a shave and a haircut
06:02If you're interested
06:03No pressure
06:04Like I said
06:04You already look great
06:07Sure
06:08I guess
06:08Fantastic
06:10All right, kid
06:11Fill that basin with some warm water
06:12And lather him up
06:17Hey
06:17Stay safe out there
06:18Back at you in here
06:19Hey, Carrie
06:21You were on scene with Orlando
06:22Right?
06:23Did you notice anything about his fall?
06:26Like what?
06:27Like, um
06:28If there was a break in the railing
06:30Or
06:31If there were security cameras
06:33Too busy working on the guy
06:35IV
06:35Intubation
06:36Backboard
06:37Splint
06:37Thanks
06:38Thanks
06:38Oh, two names is a start
06:40Pretty soon we'll retire the clipboards
06:42Baby Jane Doe and Peds?
06:44Uh, yeah
06:44Abandoned in the waiting room bathroom at 7.30 a.m.
06:48Safe haven drop off?
06:49No, she's too old for that
06:50At least two months
06:51I'll take her
06:52Awaiting foster placement by CYF
06:54What if the mom comes back?
06:56Call the cops?
06:57Day shift
06:57Get to work scanning
06:58Night shift
06:59The room numbers on top of the dry erase board
07:01Need a doctor
07:01Who's in BH1?
07:03Psych holds danger to self
07:05What's the story?
07:06Doctors King and Langdon were on the case
07:08It's a sad story
07:09She says her five-year-old snuck in the backseat of the car to take a nap
07:12Heat stroke
07:14Mom was extremely distraught
07:15Walked out into traffic
07:16Brady Barnhill wheezing and not responding to albuterol
07:19Whole socks 87 is Mother Naomi
07:21Okay, trauma 2's open
07:22On our way
07:23Uh, mom, history of asthma?
07:25His whole life
07:26Never this fast
07:27Barely moving there
07:28Using all his accessory muscles
07:31Call our team
07:32Uh, continuous nebs
07:3420 milligrams an hour
07:35Yeah, at home nephew
07:36I've been giving him albuterol every hour
07:39Ready?
07:40On my count
07:41One, two, three
07:43Does he take any other medications?
07:45Just the albuterol
07:46He used to be on Montalukaz and Simbacor
07:48Why did you stop that?
07:49Because he lost his medication two months ago
07:52So tight, nothing's getting through
07:53Mel, EpiPen
07:54On it
07:550.3 milligrams
07:56That may open his lungs so the nebs can work
07:59All right, Grady, shot in the thigh
08:06Hi
08:08Something to scan?
08:10Critical labs on North 3
08:11Oh, it's, uh, it's not my patients
08:13She's about to be
08:16I'm, uh, I'm off the clock
08:19These were ordered three hours ago for triage
08:21So technically she is a day shift patient
08:24Just get the intern started
08:25I got a meeting upstairs with admin
08:26To get things back on track
08:29Sorry, everyone else is tied up
08:30Oh, that's okay
08:32How'd you get stuck on night shifts
08:33For your first rotation?
08:34Just lucky, I guess
08:35Yeah, I feel like a good horror movie
08:38Where was mid-school?
08:39Uh, UC Irvine
08:40California, right?
08:42Yep
08:42Pittsburgh's a little different
08:43Yeah, a lot more humidity
08:44Yeah, that'll go away with your first foot of snow
08:48Uh, hi, Mrs. Davis
08:50I am Dr. McKay
08:52This is Dr. Tumerian
08:53Hello
08:54Uh, your labs show a lot of inflammation in your liver
08:57So I am so nauseated
09:00Definitely, yeah
09:01Have you, um, noticed a change in your skin coloration?
09:04I've been using this bronzing cream
09:06So I don't look like a ghost in my bathing suit
09:08Do you remember the name of the bronzer?
09:11It could have a chemical that can cause it
09:13Oh, no, no
09:13It's 100% natural
09:14It's DHA from sugar beets
09:18Why would my liver be inflamed?
09:20Uh, there's a lot of possibilities
09:21Are you taking any prescription medications?
09:24Not a single one
09:25Tylenol?
09:25God, no
09:26We have to ask everybody about injection drug use
09:28Never
09:29Raw clams or oysters?
09:31I'm a vegan
09:33One step at a time
09:34Thanks
09:35We'll be back
09:38Digby Haas now on the big board
09:40Progress
09:40So he's just been waiting in the hall the whole time?
09:43Okay, well, can you maybe get to him next?
09:48Thank you
09:50Duke goes to CT and they bump him
09:51Yeah, he may end up waiting for hours over there
09:54Well, look at that
09:557.15 already
09:56Just a few more loose ends to tie up
09:58We've got more loose ends than a macrame wall hanging
10:02My mom had one
10:03Took up the whole goddamn wall
10:04Seriously, you should think about signing that
10:06Hitting the road
10:06Yeah, maybe you should too
10:07Oh, that's right
10:08You sent Nina home
10:09Are you planning on calling in a replacement
10:11Or are you just going to work till sunrise?
10:13I have to
10:14Oh, so you get to go the extra mile
10:16And the rest of us just get accused of being martyrs
10:19Robbie
10:19Excuse me
10:22What's the word?
10:23No subdural, no epidural
10:24He's brain swelling with effacement and compression of the ventricles
10:28C-spine, chest, abdomen, pelvis
10:30Left pulmonary contusion, no intradominal hemorrhage
10:33Which means I'm off the hook
10:34I'll send neurosurgery down
10:35If he doesn't need the OR, why neurosurgery?
10:37Wait and see
10:38Let's get busy
10:39CVPing an art line
10:40Orlando
10:42Orlando, squeeze my hand
10:44Open your eyes
10:45We already know his GCS is going to be free
10:48Hey, Javadi, anti-seizure prophylaxis
10:50Kept brush and he makes for kilo
10:51Mixing it now
10:52Better get this brain swelling down, Samira
10:54How are we going to do that?
10:56Samira
10:57What?
10:58We have to lower the intracranial pressure
11:01Manitol
11:02Not the best and cause diuresis and hypertension
11:04And hypertonic saline
11:0523%, 50 cc's through a central line
11:10It's so tight as a drum
11:11Good five minutes, 60 up here
11:12We can have one more EpiPen
11:14That's our borderline, 87
11:15How about BiPAP, 10 over 5?
11:18Yes, with inline nebs
11:19All right, Grady, shot number two
11:21Might as well throw in some magnesium, 50 per kilo
11:23I'm sorry, he's not ventilating
11:25We should be ready to intubate
11:26With an asthma patient?
11:27There's a high risk of cardiac arrest
11:29Naomi, has he ever been put on a breathing machine before?
11:32Never
11:33Hospitalized?
11:33No, we could always break him with a simbacort
11:35We're going to give the current treatment a few more minutes to help him drink
11:42I could probably do this myself now that my cast is off
11:45That's okay
11:47I don't mind
11:52How long have you been a nurse?
11:56This is my first day
12:00You're doing really good
12:04Thank you
12:10Shit, you okay?
12:11Yeah, there's water on the floor
12:13Sorry, I might have spilled
12:15Yeah, no worries
12:16I'm going to have to sort these all by patient before we scan them
12:20Is, uh, Joy still around?
12:23I heard she left at 6.59
12:25Smart girl
12:26Mm-hmm
12:27You know what, find Ogilvy
12:28He's just an ass kisser
12:29He might stay and scan all the charts himself
12:31Oh, he, uh, scrubbed in in the OR
12:33Scrubbed in on the ruptured AAA
12:35Or the kidney stone that wasn't
12:37That'll be four hours at least
12:41So, are you still going to Amy's after work?
12:44Yeah, maybe just for tonight
12:46After Robbie briefs me on all the house stuff
12:49Sounds fun
12:52When he asked, it was hard to say no
12:54Sure
12:58It's going to be very weird without him here
13:00Yeah
13:01You think Dr. Al-Hashimi can handle it?
13:04A word, no
13:05She's smart
13:07Yeah, it takes more than that
13:08Yeah, well, at least it's only three months
13:11Yeah, three long months
13:13Then you need to find a new home
13:16Not necessarily
13:17I mean, if I wanted, I could just check on Robbie's house once or twice a day
13:21Yeah
13:23Why would you do that?
13:25I don't know
13:27Why not?
13:32Hypertonics in?
13:32Maintenance LR in the AC
13:35It's like a halo sign
13:36Cerebral spinal fluid from a basal or skull fracture
13:39Well, the halo sign is neither sensitive nor specific for CSF
13:43Saline, tap water, and runny noses all separate from blood
13:46Hello, Linda
13:47Robbie
13:48Vision chief working on a holiday weekend
13:50Well, somebody's got to
13:52Saw the scans, this guy needs an EBD
13:55External ventricular drain to take down the pressure
13:57Because CPP equals MAP minus ICP
14:00Cerebral perfusion pressure in the brain
14:03Equals mean arterial blood pressure minus the pressure in the skull
14:07ICP less than 22 predicts survival and favorable outcome
14:11CPP from 60 to 70 reduces morbidity and mortality
14:15Can somebody assist?
14:17Dr. Mohan
14:18I'm good
14:20So Mary, you should lend a hand
14:21I said I'm good
14:23Javadi
14:24I don't think so
14:27Javadi
14:28As in daughter of Raymond and Eileen
14:31I was at your mother's baby shower
14:34She was a resident, you were in utero
14:38I don't know how she got through motherhood and training
14:40Feel free to join me
14:42Oh, my shift was over a while ago
14:45Okay, masks all around, two sterile gouts
14:47We brought the surgical towels, just need some beta dye
14:50It's kind of an amazing opportunity
14:53I'm exhausted
14:54The chief of neurosurgery is here
14:56She's kind of a legend
14:58Maybe one of the night residents can do it
14:59Is this about the vulvulus case from earlier?
15:02Because if it is, you made a mistake
15:04You need to move on
15:05I do not want to come back here
15:07And find that you've applied for a residency in Durham
15:11Step up to the plate
15:12Do it
15:13Javadi will assist
15:15Excellent
15:16You know, I think Eileen did her first DVD with me
15:18Back when I was a brand new assistant professor
15:22Time flies
15:26How you doing, Grady?
15:27Still retracting
15:28Any improvement?
15:30Not really
15:30You feeling tired?
15:33Do we have aerogen in the ED?
15:35Just in the unit
15:36How fast can you get back?
15:38Two minutes if I take the stairs
15:39Go
15:39Uh, aerogen?
15:41It has a 5mm mesh that vibrates over 120,000 times per second
16:07It produces droplets in the 2 to 5 micron range
16:19How's it going?
16:20Just about to start
16:21Securing the art line here
16:23Measure twice
16:23Cut once
16:24We enter 11cm back from the nasion
16:293cm lateral
16:30Without any direct imagery?
16:32Nope
16:32Straight shot into the lateral ventricle
16:34Tried and true since 1890
16:38Okay
16:39Go ahead with the incision
16:42Hey, you worked with Dr. Alashimi at the VA
16:44I did?
16:46For how?
16:47During my R2 rotation
16:49And then one again last year
16:55Okay
16:57Handrail's all set
16:58Maybe you should do this prick
16:59No, no
17:00There's a safety stop here
17:01You can't go too deep
17:02It's not brain surgery
17:06Okay
17:11Stay perpendicular
17:12Yeah
17:13Good
17:15Alright, now
17:15Four turns to get through the outer table
17:18Yep
17:18And half turns till you penetrate the skull
17:39Holy smoke
17:40I thought it was Tom Cruise for a second over here
17:43Nice job
17:44How's that feel, Digby?
17:46Pretty good
17:47I bet
17:48Well, you said we trim up those gorgeous locks here now
17:53I don't like having my hair cut
17:55I get it, Rapunzel
17:56But you need your ears lowered
17:58You'll feel better with the fresh summer look
18:00That won't go unnoticed by the ladies
18:04Maybe just the trim?
18:06Great
18:06I'm thinking of pixie cut
18:09What?
18:10I'm kidding
18:10A couple of husband Benji's here all the time
18:12Trust me
18:13You're gonna look fabulous
18:14When's the last time you had a haircut?
18:17Maybe my daughter's wedding
18:19A few years ago
18:21Where?
18:22St. Sebastian
18:23Our Lady of Mount Carmel Parish
18:24Does your daughter know where you are?
18:27Of course
18:28Well, I live in Pittsburgh
18:31In fact, they live in my old house
18:35Your daughter lives in your house?
18:38Yep
18:40Where do you live?
18:42Wherever I want
18:46You're gonna pass it five to six centimeters
18:48From the inner table of the skull
18:50Okay
18:53Centered
18:55Perpendicular
18:57Aiming for the medial canthus
19:00All yours
19:01And just keep going?
19:03You'll feel a pop when you pass the appendable lining
19:07All right, line is calibrated
19:08Good to go?
19:09I'll try the nicardine pain to a map of 85, please
19:12And if we can get the inner cranial pressure down to 20
19:17Dr. Mohan
19:19I'm sorry
19:20Map of 85, ICP of 20
19:22Um, cerebral perfusion pressure 65
19:25Which gives him the best shot at survival
19:28A third of patients like this die
19:30Half have long-term disability
19:32We'll know in two weeks
19:33If there's a possibility for a good prognosis
19:36Call to pop
19:37Remove this die let
19:42Okay
19:43Let it drain a bit
19:46And now
19:47Pinch it shut
19:50Perfect
19:51BP is down
19:52190 over 88
19:53Heart rate 67
19:58How are you guys doing?
20:01Yeah
20:01Making some progress
20:02You seen Abbott?
20:04Not since round
20:05He asked me to see a patient with the night intern
20:08He said yeah
20:0948 year old woman
20:11New onset jaundice
20:13Elevated liver enzymes
20:14No history of alcohol use
20:16Take your pick
20:17Hepatitis A, B, C, D, or E
20:20No risk factors
20:21No fever
20:22Tylenol?
20:23Never
20:23No prescription meds
20:25Does she eat polar bear liver?
20:28It can cause vitamin A toxicity
20:31No
20:32She doesn't eat meat
20:34Kind of a health nut
20:35Well maybe she's gulping down cod liver oil
20:38To prevent measles
20:38Vegan, no fish
20:40Would you mind laying eyes on her?
20:43Seriously
20:44You have a way of figuring out the weird stuff
20:46Take the compliment
20:49Okay fine
20:50Five minutes at the bedside
20:52That's it
20:53We're already going to be here for hours as it is
20:55Thank you
20:57What am I doing?
21:02Definitely improving
21:03Title volumes up
21:04Wheeze is now expiratory only
21:07Making some progress
21:08You feeling better baby?
21:11You scared the shit out of me
21:12Language
21:14Does he have a primary care doctor?
21:16Not anymore
21:17How do you get his prescriptions we need?
21:20Neighborhood clinic
21:21We pay cash
21:22Poputerol's cheap
21:23Semper cord
21:24Without Medicaid
21:25400 bucks
21:26A month
21:27Just for a little inhaler?
21:31Trocar's on the tube
21:32I tunnel underneath the scalp
21:36About five centimeters
21:37And poke through
21:38To prevent the infection
21:39Exactly
21:42Now you hold the knuckle steady
21:43While I pull it through
21:47And you can staple the wound shut
21:51That looks like something from Home Depot
21:53Yeah
21:54Big 4th of July sale
21:55The brain pressure is measured
21:56By the height of the fluid column
21:58We need to calibrate it to zero
21:59At the level of the tragus
22:00Stop coxon
22:02Ready to attach
22:02First troponin's normal
22:04But you need a second to rule out MI
22:07Hey, could you step out for a second?
22:15I really did do everything I could
22:16To try to make Orlando stay
22:18Yeah, I don't doubt it
22:19I wanted to ask you about
22:20Dr. Alashimi
22:21The VA
22:21Did you ever notice anything unusual
22:23About her behavior?
22:25Um, like what?
22:27Lapses in focus
22:28Attention
22:29No, she was always on top of her game
22:34But this morning
22:36When she was checking labs
22:38On baby Jane Doe
22:38It was like she zoned out
22:40For a few seconds
22:42Maybe she was just tired
22:51No congestion
22:52Nodules
22:53Or cirrhosis
22:55Good looking liver
22:56I should not be sick
22:58I worked so hard to stay healthy
23:01Diet
23:01Exercise
23:03Eight hours of sleep
23:04I can't remember the last time
23:06I got eight hours
23:08Maybe you should try sleep maxing
23:09Oh, you definitely should
23:11Yeah, cold room
23:13White noise
23:14Eye shades
23:14Kiwis before bedtime
23:16Lettuce water
23:17Mouth taping
23:18Who do you follow for health?
23:20A few naturopaths
23:21And some functional healers
23:22Do you buy vitamins from them?
23:24Oh, no, no
23:25I don't take vitamins
23:26Food is the best medicine
23:28Kale, blueberries
23:29Kidney beans
23:30Turmeric
23:31Turmeric?
23:32How long have you been taking that?
23:33For a few months
23:34It's an anti-inflammatory
23:35It detoxes the body
23:37And it can prevent Alzheimer's
23:38How much do you take?
23:40500 milligram capsules
23:41But I take five a day
23:45What?
23:46With doses that large of turmeric
23:48There have been cases of liver failure
23:51From eating a spice?
23:53All right, Digby
23:54Thank you
23:54Good to go
23:56Would you like to see?
24:10I haven't looked like this
24:11In a long time
24:12Your family won't recognize you
24:17How will they find me?
24:19They won't know what I look like
24:21They won't know this is me
24:22Of course they will
24:23They know your voice
24:24They know where you hang at
24:26They even remember
24:27That you used to look like this
24:30They remember the wedding
24:31I mean
24:35Did you dance with your daughter
24:37At her wedding?
24:40I did
24:42And she will always remember you
24:51Hey, I was just looking for you
24:53What's up?
24:54You tell me
24:54The asthma patient
24:55What about him?
24:57Seemed like you were hesitating
24:58Talking about using aerogen
24:59I was wondering if you were having
25:00Second thoughts
25:01No
25:01Just thinking
25:03About?
25:04The best treatment plan for the patient
25:06And I think he's on it
25:09Anything else?
25:09I don't know
25:10You tell me
25:10Anything else I need to know?
25:13I don't think so
25:15This is Dr. Robbie in the ED
25:17I'm checking out a patient at Eakins
25:18We can take Larson and Stevens
25:20Off the dryer race
25:21Consider it done
25:22He's in the scanner now?
25:24Oh
25:24Great
25:25No, I was just calling to confirm
25:26Thank you
25:27Any new information from upstairs?
25:29Nothing we all already know
25:30Same old story, huh?
25:32You think we should take up a collection
25:34For Jesse?
25:35For bail money?
25:36They don't usually send bail
25:37Until after you've appeared
25:38In front of a judge
25:39With the holiday
25:39It's not likely to happen
25:40Until Monday
25:41So he's going to be locked up
25:42All weekend?
25:43That sucks
25:44It does suck
25:47Dr. Langdon?
25:48Grady's worse
25:48Much worse
25:49Need an attending?
25:51No, we have Shun
25:52Shats down 83
25:53What's happening?
25:54Give us a minute
25:56He's tiring out
25:57Ketamine and rock
25:58It's time to intubate
25:59I'll call back
26:00Ma'am
26:01We have to put a tube
26:02Down your son's windpipe
26:04So machine can breathe for him
26:05Oh my god
26:06Hold on
26:07Hold on
26:07No lung sliding on the right
26:10Pneumothorax
26:11No need to intubate
26:13What's going on?
26:14He has a collapsed lung
26:16There was no history of trauma
26:18That would have caused
26:19The pneumothorax
26:19Club up, Dr. King
26:21In asthma
26:22You can get air trapping
26:24But when the lungs
26:25Can't fully exhale
26:26Eventually they overinflate
26:27Causing some of the tiny air sacs
26:28To burst
26:29How do you fix it?
26:36Like that
26:42It's a good thing Dr. Connelly was here
26:45Yeah
26:45We should probably try to find him
26:47In the neurocritical ICU
26:48But we don't want to board a patient like this
26:49Mm-hmm
26:50Hey Robbie
26:51Hey
26:52How did the scan go?
26:53Fine
26:54It is probably going to take a little while
26:55To get the results from the radiologist
26:57Well that's not a problem
26:58Nurse Devi and I
26:59Need a little time
27:00To coordinate our schedules
27:02Over the next few months
27:03Really?
27:04Yeah I've always wanted to learn
27:05How to ride a motorcycle
27:06And Duke offered to teach me
27:08Nobody knows motorcycles like Duke
27:10He's given me the health care worker discount
27:12He's quite the gentleman
27:13Let's get him back to his room
27:15How would next Saturday be for you, baby?
27:19Maybe we could have some dinner after
27:22Dr. Mohan, Lori Diaz is here
27:23She wants to see her husband
27:24She's heading back
27:25Okay, I'm on my way
27:29Mrs. Diaz?
27:30Hi
27:31Did Orlando go up to his room yet?
27:34No
27:35I brought him some dinner from Burgatory
27:37It's a chicken burger
27:38No bun, just lettuce
27:40Figured it would be better than hospital food?
27:46He's being treated by our top brain injury specialist
27:50Will he wake up?
27:52We won't know for several weeks
27:53And then he could be back to normal
27:56Best case scenario
27:58It would take about a year
27:59Before he could be independent at home
28:02And the worst case?
28:04Round-the-clock nursing care for severe disability
28:07Could you let him leave?
28:13He insisted on leaving to work at a second job
28:17You couldn't make him stink
28:19He was competent
28:20He knew the risks
28:22We honored his decision to leave
28:24Even if he was a stupid buddy
28:26I tried to stop him
28:27Offered to get him all the supplies he'd need
28:29To take care of himself at home
28:30But he left before I could give them to him
28:33He said he couldn't afford to lose a paycheck
28:43Dr. Langdon?
28:47Are you okay?
28:49Yeah, I'm just kind of, uh...
28:52Wondering if I'm really ready to be back here
28:55Well, of course you are
28:57Ten months is a long time
28:59I almost killed that kid with an intubation
29:03Didn't even occur to me
29:04To check for pneumothorax
29:06There isn't any trauma to indicate
29:08I should have caught it
29:15You know, I, um...
29:18I had a deposition today
29:22And
29:23All the lawyers' questions
29:24Made me feel like I was a really, really bad doctor
29:30We don't always get everything right
29:32First time
29:34You would have caught the collapsed lung
29:37And it may have taken a minute
29:38But you would have saved him
29:41I'm not sure Robbie would agree with you
29:43He's been
29:44Rioting me all day
29:46Well, Robbie's leaving for three months
29:48And, you know, with Robbie gone
29:51I really don't want you to leave either
29:56That which does not kill me makes me stronger
29:59Wow
30:00Frederick Nietzsche
30:02Yeah
30:03Nietzsche, yeah
30:05Not Kelly Clarkson
30:10Hey, that's a thick one
30:12Yeah, Austin Green
30:13Ogilvy's triple A
30:18Uh, G-R-E-E-N
30:20Yeah, why?
30:21What are you doing?
30:22Checking to see when we'll get Ogilvy back from the OR
30:25Oh, shit
30:26What?
30:27The guy didn't make it
30:28He died on the table about 40 minutes ago
30:31Then, where's Ogilvy?
30:34Oh, man
30:35His patient had a CT a year and a half ago
30:38That showed a four-centimeter triple A
30:40It's too small for surgery
30:42He was supposed to come back every six months for a repeat ultrasound
30:45But looks like he didn't
30:46He would have seen that if the computers were working
30:49Why wouldn't he tell Ogilvy?
30:51Maybe he forgot all about it
30:53Or Ogilvy didn't ask the right questions
30:56Dennis
30:56Hey, about a minute?
30:58Uh, sure
30:59What do you need?
31:01Teenager with jewelry magnets stuck to both sides of her nasal septum
31:04I tried to move them with a plastic cure
31:06Too much pain and then there was bleeding
31:08Those need to come off before they cause permanent damage
31:10Yeah, you think you could find, like, a senior or an attending?
31:14We're really trying to get off the clock here
31:15They're all busy
31:19I already took one for the team
31:21Yeah
31:21Fine
31:23Yeah, labs on your yell, lady
31:27INR is elevated 2.2
31:29Liver's in trouble, but not dead yet
31:31I told you to skip the turmeric admit for monitoring
31:33Follow the LFTs
31:35Got it
31:35Central 10?
31:37Yeah
31:42Sleep maxing, really?
31:44I'm gonna track the online trends
31:45Is that your secret for the tough ones?
31:49I just think, what's the stupidest thing this person could have done?
31:52I assume they did it
31:55Well, I mean, she was trying to be healthy
31:57Yeah, but I'm taking advice from fools
31:59Tumor is recommended by a lot of doctors
32:01Yeah, then ask your doctor for the dose
32:03Or check someplace reputable like the CDC
32:06Oh, right, I forgot
32:07It's not a medical toxic waste site
32:10She's in pretty bad shape
32:12If things get worse, she could need a liver transplant
32:14Oh, because she's a big fucking idiot
32:18Wow
32:20No, I actually appreciate her
32:22Our job security depends on all these big fucking idiots
32:27Okay
32:32Good night, Perla
32:33Monica
32:34Good night, Dr. Robbie
32:36Good night
32:37Bye, Emma
32:39You could stay to pitch in
32:41Dana told me to go and get some rest before tomorrow's shift
32:43Yeah, you had quite a day
32:45It wasn't so bad
32:49Why can't I find Duke's results?
32:51Oh, new patient, no EHR yet
32:53I can run over to radiology, get a printout
32:56Thank you, Monica
33:00Ready to pick up a few more
33:02Lando's all tucked in for now
33:03How's he doing?
33:04Numbers are good
33:05CPP 22
33:07Okay, so he's got a shot at a decent outcome at least
33:10You think he has a chance?
33:11Oh, I don't know that survival was the outcome he was hoping for
33:15What?
33:17He told Samir he's got $100,000 in medical debt
33:19That his life is probably
33:20Mrs. Diaz
33:24How can we help you?
33:25In the bathroom?
33:27Uh, yeah, Perla can show you the way
33:31What a great idea to have a private conversation about a patient in a public area
33:35I know
33:36You were about to start yet
33:38You didn't
33:42Okay
33:45How long have they been in there?
33:47At least two hours
33:48How did it happen?
33:50With my earring
33:51It was supposed to be, uh, red, white, and blue to look cool with the fireworks
33:56I told her for the nose one side only, but she never listens
33:58This can be pretty serious
34:00If we don't get them out quickly, it can cut off the blood supply and cause the septum to collapse
34:06Like, my nose could be deformed
34:10Oh my god, get them off
34:12Yeah, that's the plan
34:13Yeah, she tried already, it hurt like crazy
34:15Because they're stuck together by a very strong magnetic force
34:18Yeah
34:19No, no, no
34:20Oh, uh, I'm not gonna use the tips
34:22I'm gonna flip it around and use the handle
34:25It's still gonna hurt
34:26Probably not
34:27Just, uh, hold still
34:31Okay
34:37Voila
34:38Really?
34:39That was amazing
34:41I think another half hour we can send this dry race to Rebecca's storage
34:45With pleasure
34:45Dr. Rabinovich
34:47Yep
34:47Results on your friend
34:53Fuck
34:54Duke
35:00Are you gonna tell him?
35:01I want to talk to a surgeon
35:03Uh, Dr. Rabinovich
35:04I have an update on the patient
35:05But that was not a great time
35:06Oh, I thought you were going home
35:08Uh, I was
35:09Dr. Ogilvy is just sitting out in the ambulance bay
35:12Covered in blood
35:12Sorry, what's he doing out there?
35:14Kind of, uh, staring off into space
35:16I tried to talk to him
35:17But it was like he couldn't hear me
35:18Monica, can you stab page coding with the rest?
35:20Yeah, I'll go check on Ogilvy
35:22Please
35:24Oh
35:36Hey, Ogilvy
35:41Ogilvy
35:43You okay, man?
35:5199 on two liters
35:53Scattered end-expiratory wheezes
35:55He is so much better
35:57The steroids should kick in soon
36:00So he'll keep improving
36:02Home
36:03When can I go home?
36:05In a day or two
36:05And we will, uh, discharge you with a Symbicort inhaler
36:09That should last about a month
36:12Hopefully we'll be back on Medicaid by then
36:14How'd you lose it?
36:16They sent a redetermination letter to our old apartment
36:20It didn't get forwarded
36:22When I went to pick up his prescription
36:25Pharmacists told me we were no longer covered
36:28And you haven't been able to get it back since?
36:30I've been trying for months
36:33To get re-enrolled
36:34You need tax returns
36:35Pay stubs
36:36I cut hair
36:37My income fluctuates
36:39A lot of my regulars are struggling
36:42So
36:43It's been
36:44Tough
36:45Well, if you run out of Symbicort before your Medicaid kicks in
36:48You can come back and we'll, uh, set you up with another one
36:52Ah, is there a patient in here?
36:54Because everyone in this room looks extremely healthy to me
36:57Dr. Shen and I will be with Grady all night long
37:00Hey, day shift, we got this
37:02We're leaving you in good hands
37:04Um
37:06I was really scared
37:08Thank you
37:11You're very welcome
37:17Due to his injury, things have changed
37:21I was looking for Dr. Abbott
37:23I haven't seen him for a while
37:26Excuse me
37:30So now with a long-term disability, things may be easier
37:35Easier
37:36His condition will qualify him for Medicare and Medicaid
37:39So moving forward, costs should be covered
37:42Including home health care
37:43Okay
37:44Perhaps this isn't the best time
37:46I just wanted to reassure you about future costs
37:58Robbie?
37:59Noel?
38:02You're still here
38:03It's not the best day to try to get out on time
38:05Hmm
38:07So I guess this is it for a while
38:08Unless you want to come with me
38:10No
38:11But thank you
38:12Even if it isn't a legitimate offer
38:14What do you mean?
38:15Oh please
38:16I know well enough
38:17Not to get in between a man
38:18And his vision quest
38:21Vision quest
38:22That is my nice way of putting it
38:27I probably don't want to hear
38:28You're not so nice way of putting it
38:30No, probably not
38:33I hope that this is not
38:37About you running away from me
38:39I'm a big girl
38:39You can tell me just to get lost
38:41This has nothing to do with you
38:43Oh right
38:44It's the old
38:45It's not you
38:46It's me
38:48In this case
38:49It's actually true
38:57Excuse me
39:05I'll see you next week
39:06It's a three month sabbatical
39:07Like I said
39:08I will see you next week
39:16My first day here as a med student
39:19There was a patient
39:22He was a really nice guy
39:24Came in with belly pain
39:27I saw a gallstone on the ultrasound
39:30Normal EKG
39:32Troponin
39:33The pain resolved
39:34And he was in the hall
39:36When he had a cardiac arrest
39:41I couldn't save him
39:44People die
39:47And we do the best we can
39:50But people die
39:54You ever get used to that?
39:58No
40:00No
40:01No, you
40:03You try to accept it
40:07You try to find balance
40:14I don't know if I can take another day like today
40:19Primary care specialty sounds way better
40:22Peds maybe
40:23Yeah, maybe
40:27I know I'd be bored out of my fucking mind
40:31Seriously
40:32I like the challenge of undiagnosed illness
40:35Of quick decisions
40:38Of life-saving procedures
40:40And I like being here for people
40:43On the worst days of their lives
40:54You know what I think?
40:56What?
40:57I think you should go home
41:00I think you should sleep on it
41:01And I think you should at least wait till the morning
41:03To decide if you want to come back
41:08I don't really want to go back in there and see anybody
41:13Yeah
41:16Okay, pull off your gown
41:17I'll take it in
41:19Shift is over
41:21Go home
41:36Oh god
41:36No, I'm
41:37Sorry
41:38I'm good, I'm good
41:51I'm good
41:52Where have you been?
41:53I found Ogilvy
41:54And?
41:56And he's going home
41:58That's it?
41:59It's a long story
42:00Well, I got nothing but time
42:02I need to respect his privacy
42:04Where's the fun in that?
42:21I'm sorry
42:23Perfect
42:24Just give it a little love tap
42:27Kick it
42:30Jesus Christ
42:32I guess Mr. Dick B got a room upstairs
42:35In your dreams
42:36He's not in South 21
42:38Yeah, he is
42:40There's a new guy in the bed
42:42Short hair, clean shaves
42:44I take care of him
42:46Scout from Choramie's pathology
42:48So we're going to the CT injury
42:50Textbook is sending out again
42:51He was an 8 centimeters
42:5350% one-year mortality
42:55So he definitely needs surgery
42:56If he wants to live
42:57Okay, well, he's a friend
42:58So I will talk to him
43:00I'll get him admitted to your service
43:01Not today
43:02Why not?
43:03He needs to see cardiology
43:04And pulmonary first
43:05To be cleared for the OR
43:06They can do a stress echo
43:08PFGs
43:08He needs to be admitted
43:09And evaluated as an inpatient
43:10Nothing ever gets done
43:11Over a holiday weekend
43:12He can take it easy at home
43:13He's a ticking time bomb
43:14He's probably been that way for years
43:16We can get him in early next week
43:17With a specialist
43:18Get his testing done
43:19All goes well
43:19He's on the OR schedule in a week
43:21What happens if it ruptures before then?
43:22Call 911
43:24Sorry, Robbie
43:25Best we can do
43:25Text me his number
43:26I'll have my office coordinate
43:30Fuck!
43:31Hey!
43:31Take a walk
43:32Come on
43:37Two for discharge
43:38Yeah, please don't ring the bell
43:40The computers are back up and running
43:42Not for these two
43:43They don't have electronic health records yet
43:44Wait, hold up
43:46This kid had a wrist x-ray ordered
43:48Ugh, it never happened
43:49And water skiing lady's still waiting on a knee series
43:52I canceled the x-rays
43:53Diagnosed them both with ultrasound
43:56Really?
43:57Yeah
43:59The little boy had a simple buccal fracture
44:01Distal radius
44:02He got a Velcro splint
44:03And Mrs. Stegman had a small medial meniscus tear
44:06The immobilizer crutches
44:08And a follow-up with ortho
44:09Could have used you on the day shift today
44:11They don't teach us a lot of musculoskeletal ultrasound
44:14I know
44:15That's why I did electives at Harvard and Highland
44:18Are you applying for an ultrasound fellowship here?
44:21I am, but it is so competitive
44:24That's what I hear
44:24Kind of a long shot
44:26I only have one publication
44:27But it's a series of case reports
44:29Diagnosing shoulder dislocations with ultrasound only
44:32If you want to learn some MSK
44:33You can tag along
44:34I got three more to scan
44:35Maybe some other time
44:37Cool
44:42Hey, don't jam the shredder
44:44What is that, two charts?
44:45No, it's my ultrasound fellowship application
44:50Hey
44:52Sorry about your patient
44:55Yeah, Orlando's in pretty bad shape
44:57Oh, no
44:58I was talking about the AAA guy
45:00You worked on with Ogilvy
45:05He didn't make it through surgery
45:08I tried to talk to Robbie about it
45:10But I think he's busy
45:12Excuse me
45:16Oh, shit
45:21You think I'm on edge?
45:23We're just shaming Samira
45:24Then McKay
45:25They both need to be called out for an acceptance behavior
45:27Yeah, well, you do that in private
45:29Same place
45:29You share your thoughts about a patient's possible suicide
45:31And slamming stuff
45:32Please
45:33Sign out all this shit that's bugging you
45:35And get out of here
45:35I can't
45:37Yes, she can
45:37When either of my kids was acting like this
45:39I gave them a time out in their room
45:40Whoa, whoa, whoa
45:40You're not my mother
45:41Yeah?
45:42Well, too bad
45:42You need one
45:43No, I had one
45:44She left
45:44I don't need another one
45:45What I need is someone who can actually run this place while I'm gone
45:47Okay, I'm sorry
45:48I didn't know
45:49Nobody knows
45:50Who needs to know
45:51Who gives a fuck
45:52I think you need a break
45:54That is what the sabbatical is for
45:55That's started now
45:56Walk away
45:57I have too much to do
45:58Let someone else talk to Duke
45:59No, that needs to come from me
46:01Why?
46:03Because I owe him that
46:04It needs to come from a friend
46:05Not a stranger
46:06Otherwise he's gonna bail and drop dead while I'm gone
46:08Okay, wrap that up
46:10And then leave
46:12It's not just Duke
46:12I'm not sure that Alashimi is fit to run this place
46:15What's that supposed to mean?
46:15I'm not sure
46:16I'm trying to figure that out
46:17Did you know that she wants to have two attendings on at all times?
46:20No
46:20Is that something she's worked out with Gloria?
46:22I don't know
46:23I also don't know if Langdon is going to relapse
46:25I don't know if Whitaker is gonna be able to take care of my shit
46:27I don't know if Javadi is gonna give up on what she's good at
46:29Or if Samira is gonna flame out because it's a bullshit with her mother
46:32Is there anything else?
46:33Yeah, you
46:34I don't know about you running around with a full syringe of Verset in your pocket
46:38I'm worried about the people that I care about
46:41We'll all manage until you come back
46:43We always do
46:44Yeah, what if I don't come back?
47:29I don't know if I don't come back
48:02Gracias por ver el video.
48:15Gracias por ver el video.
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