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00:20What's up, Ghost Rider?
00:21You good?
00:22Never better.
00:23Okay, kids, bye-bye time.
00:25Thanks for the trip down memory lane.
00:27Um, where's Evans?
00:28Uh, I think she's by the family room.
00:31She is.
00:32Hey, hey, hey, where are you going?
00:34I'm not going to scan all this by myself.
00:35Cruz has a question on my cellulitis.
00:37I'll be right back.
00:38You better.
00:38Two minutes, tops.
00:39Where's Mel?
00:40Where's Donnie?
00:41They should be helping you.
00:42I don't know.
00:43Okay, day shift.
00:44Listen up.
00:44We're doing really well, but we still got a ways to go,
00:47and nobody's going home until all these paper charts are digitized,
00:49including me.
00:50And then we're free to celebrate our freedom?
00:52Exactly.
00:53Well, can you kick some ass and get the staff to hurry up on the EHR homepages?
00:57Where are Larry and Antoine?
00:59Uh, Antoine's fighting on the phone with his girlfriend outside,
01:01and Larry's on a cafeteria run.
01:04Yeah, that tracks.
01:07We've got five patients in beds waiting to be seen.
01:09How do you want to play this?
01:10Man to man or zone?
01:11Zone.
01:12Have Cruz and Ella split up the new five.
01:14You take north and central, I'll take south and prom.
01:16Cool.
01:17Want to switch at 1 a.m.?
01:18Why?
01:19Varieties of Spice Alive.
01:20I thought that was garlic.
01:22Oh, sorry.
01:25I told you I'd be fast.
01:27Okay, let's do this and get out of here.
01:29What's the hurry?
01:30Got some hay to pitch?
01:31Uh.
01:34Oh, shoot.
01:35What?
01:36Uh, my ID badge is missing.
01:39Oh, the one you just got?
01:40How'd you lose it?
01:41I don't know.
01:41It must have come off.
01:42Classic.
01:43Hope you remember your login and password.
01:45Okay, retrace your steps.
01:46Where'd you have it last?
01:47Uh, I was with Ogilvy in the ambulance bay.
01:50Out with Colonel Mustard in the library?
01:52Who's...
01:53Yeah, I'm just...
01:54What?
01:54No.
01:56That boy has no clue.
02:04Please don't do that.
02:06Oh, ma'am, I gotta go.
02:07I don't sit here any longer, I'm gonna get bed sores.
02:12I'm supposed to get some, uh, CT results.
02:15Any idea how much longer that's gonna be?
02:18Shouldn't be much longer.
02:20Where's that Nurse Vivi?
02:22You don't want any of that?
02:24No?
02:25No, she's out of your league.
02:27What league do you think I play in?
02:29Uh, old-timers night?
02:31Yeah, you're probably right.
02:33But some teams still appreciate a veteran presence.
02:36Well, don't say I didn't warn you.
02:38You are here for your heart, after all.
02:40My heart's been broken before.
02:42What's one more time?
02:43Uh, she's engaged to a jiu-jitsu instructor.
02:45With a bang, not a whimper, baby.
02:48And it's a cool bath a couple times a day for two days,
02:51followed by aloe vera to your skin.
02:53Okay, that's it?
02:54And, uh, sunscreen in your future.
02:56No, I'm never going outside ever again.
02:59I wouldn't swear off the sun entirely.
03:02You know, but like most things, moderation.
03:05Hey, we're getting kind of short-handed
03:07to get new charts out here.
03:08When you finish, can you come lend a hand?
03:09Yeah, happy to.
03:13I'm happy to.
03:14I mean, there's nothing I would rather do less.
03:17They keep you pretty busy.
03:20Yeah, and today has brought some new challenges.
03:23This is really putting a crimp
03:25in my Fourth of July evening plans.
03:28You're going to see the fireworks?
03:30Uh, no.
03:31I was going to maybe meet up with this guy.
03:33Though that's sounding less appealing
03:35than the three Bs at this point.
03:37The three Bs?
03:40Look, bath and bed.
03:42College kid with mono and hemorrhagic tonsils.
03:45Submit med surge or observation?
03:47Observation.
03:48Bleeding stop with TXA.
03:49She's had steroids,
03:50so should be ready for discharge in the morning.
03:52Cool.
03:53How was your first shift back?
03:55Uh, slow start.
03:57Finding my rhythm.
03:59You're a little rusty, rusty James.
04:01Now you won't have motorcycle boy
04:03What a big brother, you.
04:04Is that a Rumblefish reference?
04:05Sure is.
04:07And Robbie is my big brother in this analogy?
04:09Bingo.
04:11Yeah, I wouldn't say he's been looking out for me exactly.
04:14I'd probably prefer not to see me at all today, actually.
04:17And you think that's because he's mad at you?
04:21I think he feels like I let him down, because I did.
04:25Jesus, with all the martyrs around here.
04:27You think this was a passion play?
04:28What's your take?
04:32I worked with that man for ten months while you were gone.
04:34He's not mad at you.
04:36He's mad at himself for failing you.
04:38Rusty James.
04:40Really?
04:42It's just more white night, white noise.
04:45That's how it is.
04:48I'm sure we're going to be friends if you can.
04:50Thank you so much.
04:51Be kind, be safe, be brave.
04:53What you doing?
04:54Dr. Robbie.
04:56Sorry, I was just, um...
04:57One of your TikToks?
04:58Yeah, about those.
04:59Listen, I'm not so sure...
05:00No, no, I was just, um, sharing...
05:01No, I get it.
05:02I just, you know, we do have HIPAA laws here.
05:04We don't let anybody...
05:04I would never violate any HIPAA laws, Dr. Robbie.
05:06I understand.
05:07Even still, we're getting behind on scanning patient charts,
05:09so how about no TikTok on the company clock, Dr. J?
05:13Dr. Robbie, I think you're...
05:15Out of touch?
05:16Probably.
05:17You would be the first to accuse me of it.
05:18However, when I was in medical school...
05:20I didn't have cell phones or TikTok or Internet or ICE agents coming in here and taking away patients and
05:26staff.
05:28I get it.
05:34We did have cell phones.
05:35Maybe not in the beginning.
05:42Where do you think you're going?
05:43Ah, home.
05:45I kind of need you to hang out a little longer and help digitize some of these analog patient records.
05:49Normally, I would, truly, but I got to get home.
05:52Wife, baby, bed.
05:55Okay.
05:56Go get some rest.
05:57You sure you're okay to drive home?
05:58Absolutely.
05:59Just enough in the tank.
06:01Don't tell anybody I'll let you go.
06:03Deal.
06:04Safe travels.
06:06Be sure to send some pictures from the road.
06:25Fight over at Zazu's sports bar.
06:27The two combatants are pulling up soon.
06:28One's a stabbing.
06:29Ellis, double trauma coming in.
06:30Grab the easy one.
06:31Bring the stabbing to trauma two.
06:33We will get the room set up.
06:34All right.
06:34Roger.
06:36Okay, darling.
06:38Time for this dinosaur to head to extinction.
06:41You guys do a real jam today.
06:42Can't take you enough, Monica.
06:44Nice place to visit.
06:46Wouldn't want to live here anymore.
06:47Oh, we need this some days.
06:49But hey, Virginia Slim, you've come a long way.
06:52Glad I was wrong about you.
06:54Keep training them upright.
06:56Let's try.
06:57Okay, that's enough mush.
06:58Back to my life of mahjong and margaritas.
07:01Bye, Evans.
07:01Good help safe.
07:02I will.
07:03See ya.
07:03Bye.
07:09She's right.
07:10You are the mama bear glue that holds this place together.
07:17Hey.
07:19Is you okay?
07:20No.
07:22Sad or scared or some fucking thing.
07:28I'm worried.
07:30It's all right.
07:32Robbie's not got a bad feeling.
07:33He's...
07:35It's like I'm never going to see him again after tonight.
07:38He say something?
07:39Yeah, he said a lot of things.
07:40You should talk to him.
07:40He listens to you.
07:41He's a grown-up.
07:43He just needs to go on a vacation.
07:45Can't you at least try to get him to promise to come back in one piece?
07:51He doesn't like to listen.
07:52I don't know.
07:52I don't know.
07:53So make him.
08:01Fuck it.
08:01Check my DM.
08:02She hit me up.
08:03Cheryl, baby.
08:04I didn't even respond.
08:06Scavenger hunt?
08:07Yeah.
08:07Something like that.
08:08You need a hand?
08:09Nope, you do you.
08:13What do we got?
08:14Baradanko, 34.
08:15Decent vitals given he has old glory jammed in his chest.
08:18Fatting 91 on 15 liters. BP, 132 over 87.
08:22Taki at 112.
08:24Got that. Respecting one strong.
08:25No, no, no, no, man!
08:27What the fuck?
08:28I'll call you back, babe.
08:32Shit. I thought I cleared it.
08:34Was it sticking out?
08:35Sticking out my ass!
08:37Man, this is on you!
08:38You went wide and you clipped the shit.
08:40Bike shouldn't be parked there.
08:41It was sticking out.
08:43Had to be.
08:43There's no fucking way.
08:46Oh, no, you're paying for this.
08:47You or the city, but you're paying for this.
08:49Seriously, we don't need this hassle.
08:51I know, I know.
08:52Fuck.
08:52How bad is it?
08:53Not really good.
08:55Toby Schneider, 32.
08:57Took a beer bottle to the face.
08:58I'm gonna take this thing out of my chest and shove it up your fucking ass.
09:01You hit me with a fucking rolling rock, man, so you got Iwo Jima.
09:05You fucking cheated, man.
09:06Every detail must be covered.
09:08I don't care.
09:09Gentlemen, you're on different health journeys now.
09:11I'm gonna go see Ahmad.
09:13It's all gonna be on a security video.
09:16He's gonna shit.
09:18Ooh.
09:20Okay.
09:22Hey, a little help?
09:23All right, he's going straight to Trauma 2.
09:25What is his story?
09:26Bottle to the face.
09:27Strong vitals.
09:28Send me to pay a show lack.
09:29Hey, where do you want us?
09:30North floor just got clean.
09:32Abbott, single MVA on roof, five away.
09:35Olive, can you find Robbie and Alashimi?
09:37We may need a couple more hands until we get caught up with these two.
09:40Sir, we are gonna get you more pain meds, but you need to shut your fucking mouth.
09:43The acronym is SMART, Single Maintenance and Reliever Therapy.
09:47It's one inhaler that combines an inhaled corticosteroid with a fast-acting, long-lasting beta agonist.
09:53That's fancy talk for an anti-inflammatory and a lung muscle relaxer all rolled into one.
09:58Oh, really?
09:59But it's $400 and without Medicaid.
10:01We can help you look into coverage options.
10:04Of course.
10:05Grady should feel worlds better in a few hours.
10:09So, what are my chances of getting off of the table alive?
10:13Once you're cleared by the heart and lung specialists next week, chances of death are low, like 102%.
10:20And how long would I be in surgery for?
10:22Between three and five hours.
10:25Jeez.
10:26It's long, because they have to stop your heart.
10:31You will be on a heart-lung bypass machine, which will be circulating your blood while they repair the aneurysm
10:38with a graft.
10:39Well, what's the graft made out of?
10:42Synthetic fabric called Dacra. Super strong.
10:46Okay. New hoses, new gaskets. Then what happens after surgery?
10:51You will be in the hospital for about a week. No work for eight weeks after that. No strenuous activity.
10:57No lifting anything over five pounds.
11:00How am I supposed to take a piss?
11:04Nice.
11:08And how long until I'm back up to full speed?
11:11Three months. Maybe more like six, given your age.
11:17And if I don't get surgery?
11:2150% chance of death within 12 months if the aneurysm ruptures.
11:26What would I feel if it ruptured?
11:31Some chest pain. Maybe some shortness of breath for about a minute before you pass down from blood loss.
11:37And then the big fade out.
11:40Roll the credits.
11:48Quite the coin flip.
11:50No coin flip. This has to happen.
11:53But I do worry that you are not going to make your appointments or follow your aftercare instructions if I'm
11:57not here.
11:58Sorry, Robbie. I've been asking for me to grab you for an MBA on route.
12:04Do what you gotta do, man. I gotta sit with this for a minute.
12:09You can go ahead and get dressed.
12:12I'll come back.
12:12What are you doing?
12:18I need you.
12:22We need you in the house.
12:26You're strong.
12:29Do I see?
12:33I love you.
12:41Mom, we've got an ICU bed upstairs.
12:43We can take Orlando up now.
12:45It's open for transfer.
12:47Thanks, son.
12:48We need this room again in a minute.
13:00All good?
13:02Uh, totally.
13:04Ah, totally.
13:07Look, once more, I feel compelled to offer some unasked for and probably unwanted advice.
13:15Javadi wasn't making a TikTok video.
13:17She's been posting about Jesse trying to find someone who knows where he is.
13:21Ah.
13:23And even if she were making one of her videos, have you ever watched one?
13:27No.
13:29No, my account was suspended for erotically seditious content.
13:33Well, they're not what you think.
13:35They're actually kind of cool.
13:36It's like this badass self-care.
13:39Huh.
13:40Okay, that is it.
13:42I'm going to bury myself in charting and try to dig my way out.
13:45Edith Lynch, 46, right-sided chest pain for an hour.
13:48No cardiac history.
13:49Minimal relief from sublingual nitro.
13:50No STEMI on the 12-lead.
13:51Dana?
13:52So that's his team.
13:54Hi, Edith.
13:55I'm Dr. Al-Hashimi.
13:56We'll be taking care of you today.
13:58Absent lung sliding on the right.
14:00I could have told you that from here.
14:02God bless America.
14:04Hemodynamically stable.
14:04I'll put in a 20 French and then right up to the OR.
14:07Wait, whoa, whoa.
14:07Hold on.
14:08I need surgery?
14:09Sir, you have a collapsed lung.
14:10We need to put a tube in your chest to see how much internal bleeding there is.
14:13Oh, come on, man.
14:14Just pull it out.
14:15No.
14:16Okay, everyone knows what to do here, right?
14:18We're going to take this at a nice, slow pace, moving together.
14:21If anyone has an issue, speak up.
14:23There are a lot of moving parts here.
14:25Are you going up to ICU finally?
14:27Yes.
14:27Great.
14:28How are you doing?
14:29Is that a trick question or...
14:31Not intended to be, no.
14:33Then not great.
14:34This one got past me.
14:36Well, listen.
14:37You tried to find a viable payment plan.
14:39You tried to keep him here.
14:40You even tried to give him a goodie bag.
14:42But he left.
14:42I'm not sure what else you could have done.
14:44Been more persuasive.
14:45This was the patient's call.
14:47His life, his mistake.
14:49What mistake?
14:50Getting diabetes?
14:51Not picking a higher spot to jump from.
15:04History of hyperlipidemia.
15:05An hour of substernal chest pain.
15:08Minimal relief with nitro and 4 of MS.
15:11EKG is negative for STEMI.
15:12Heart score is 4.
15:14Gave 324 milligrams of chewable aspirin.
15:17Admit for new onset, Anjina.
15:19Don't mind me.
15:19I'm just passing through.
15:20Seems like you wanted an update.
15:22Well, as long as you feel like you got it covered.
15:24I do.
15:25Go ahead and repeat the 12 lead.
15:27Since I'm here, I did want to ask you about something I observed earlier.
15:30Oh, you've got to be fucking kidding me.
15:31What?
15:32Look where these anterior leads are placed.
15:34They're way too low.
15:36Holy shit, what's happening?
15:37Mrs. Lynch?
15:38V-TECH?
15:39No pulse.
15:40Charge to 200.
15:44Charged and clear.
15:48Okay, normal size.
15:49Strong pulse.
15:49Cycle at BP.
15:53Let's repeat that EKG, please.
15:54With the leads in the right fucking place.
15:56Who are the medics on this?
15:58Bosco and Otero.
15:59Bosco and Otero.
16:01Okay, Bosco and Otero.
16:03See you all Monday.
16:05May your night go smoother than my day.
16:08Happy 4th?
16:09Heard it's been crazy.
16:10They shut down when ICE came.
16:11Separate events.
16:12Get someone else to explain.
16:13I'm going home.
16:15Damn, what is that?
16:16That smells good.
16:17Food from home.
16:18I can't do the cafeteria.
16:20Oh, you've got to give me that recipe.
16:21I'm going home.
16:22Get home safe.
16:23Mm-hmm.
16:27Hey.
16:28Hey.
16:29I'm starving.
16:30Of course.
16:31I will give you $20.
16:32for whatever that smell is.
16:33I'll give you some.
16:34I mean, too much anyway.
16:36Just give me a sec.
16:37Yeah.
16:37How can I help you?
16:38My granddad just about cut his hand off
16:40with the tug-of-war rope.
16:41Hi.
16:42I remember you from earlier.
16:44You're having the family reunion, right?
16:45Yeah.
16:46Is your hand actively bleeding?
16:48Oh, not so bad here.
16:49Take a look.
16:51Mateo, want to come straight back?
16:52Oh, my God.
16:53Cover that up, please.
16:54I'll need to get his demographics from you.
16:56You got him already.
16:57Handsome, been in and out of here all day long.
16:59How did this happen?
17:01He had the rope wrapped around his hand.
17:02Oh, cut through it like I'm a steady.
17:04Have a seat, sir.
17:04Take you right back.
17:05And how would you rate your pain on a scale from 1 to 10?
17:08Oh, it's not too bad.
17:10Count on my sugars.
17:12With this diabetes, his sensation's a little off.
17:15Yeah.
17:16After you.
17:16Thanks.
17:18Ow, what the fuck?
17:20Trigeminal nerve is good.
17:21Shit, you're going to fix me or torture me?
17:24Whew.
17:25Ouch.
17:26Yeah, I need to call Plastics.
17:28I called the kiss off the tube off the rail.
17:31Fucker said I didn't call it.
17:33But yes, it was a bit noisy the 4th of Sticks night, but I called it.
17:37I have witnesses.
17:37Sticks?
17:38The band?
17:39Yeah.
17:40Love Sticks.
17:41I never heard of him.
17:43You never heard of Sticks?
17:44Mr. Roboto?
17:46Nice spot for ages and 62.
17:48Come stay the way.
17:50Lady, babe.
17:51I don't know.
17:52Yeah, it may be best if you don't talk.
17:55Looks like there's some sort of foreign body in there.
17:57Mm-hmm.
17:59Are you okay?
18:00Yeah, it's just an awkward position.
18:03Go home.
18:03Rest, heat, ice.
18:05Yeah, no, no, I know.
18:06I'm just waiting for things to slow down.
18:08Oh, express trains don't stop at your station.
18:11You just gotta jump.
18:14What is that?
18:15Heineken?
18:16You want to say?
18:17What?
18:19From the glass-lined tanks of old Latrobe.
18:22Ah, Rolling Rock.
18:23Nice.
18:29She's had four of morphine.
18:31How's the pain?
18:32Got it.
18:33I'm doing eight.
18:33There it is.
18:34Lateral STEMI.
18:35Okay, call it in.
18:36Will answer too well to catch it?
18:38Yes.
18:38Not the first time it's happening.
18:39You get a male medic who's more concerned about getting sued or a complaint for undoing a bra.
18:43See these anterior legs here?
18:45Come STEMI, stop 15.
18:45You're having a heart attack from a blockage in the artery that brings oxygen to your heart.
18:50So if we get you to the cat...
18:51Lateral STEMI, VTAC arrest.
18:52Got her back after one shock.
18:53She has cat-lucked.
18:54...revent serious heart damage.
18:55Oh, my God.
18:56You're going to be okay.
18:57Hello?
18:57I'm Dr. Kloos.
18:58And I'm Dr. Shen.
18:59How are you feeling?
19:00I'm really scared.
19:01Hey, we've got you.
19:02Anything else?
19:04Like I got kicked in the chest.
19:05Normal after a shock to the heart.
19:07Family?
19:08Yeah, husband's in root.
19:09Now, leave the defil pads on and take her up in a minute.
19:11I'm going to check her on a nerve block real quick.
19:12Go.
19:15Where's Dr. L.S. Sheeman?
19:17She was just here.
19:28Hello, everyone.
19:29I'm Dr. Shen.
19:30Heard a rumor someone needed a nerve block.
19:32I'm guessing that's you.
19:33Probably so.
19:35Although, you know, I don't have much pain.
19:37I guess it's my diabetes.
19:39Oh, we still need to numb you up to do proper deep clean.
19:43You guys do whatever you got to do.
19:45Yeah.
19:45Three shots.
19:46Menion, ulnar, and radial.
19:47Two grams of ANSIF.
19:48500 milligrams of gent for gram-negative coverage.
19:51How do you do this?
19:52Oh, family reunion tug-of-war.
19:54I wrapped the rope around my hand for better grip,
19:57and when we fell down, those bastards just kept pulling.
20:00Dirty.
20:01Ah, it's just the way we play.
20:07Michael, you got a sec?
20:08Uh, not really, no.
20:10Well, how about showing me a little respect and finding one?
20:14Sorry, Caleb.
20:15Are you feeling disrespected?
20:16Uh, given that you've been actively blowing me off all day,
20:19yeah, maybe a little bit.
20:20But I have a thick skin.
20:22What can I do for you?
20:24Should have found a higher place to jump from.
20:27It's an interesting diagnosis, doctor.
20:33No pithy retort.
20:35Yeah, I didn't think so.
20:37Uh, I just came to say goodbye.
20:39I'm leaving soon.
20:41I know you are, too.
20:44Yes.
20:47Keep my number handy?
20:48Just in case, huh?
20:50Yes, I promise.
20:50I will.
20:52Thank you, kid.
20:55We're gonna give you one diflucan pill to take home.
20:58Take it in three days if your symptoms persist.
21:00How do I get there?
21:02Where's that?
21:04Home.
21:05Do you know where you live?
21:07Of course I do.
21:08It's not far, but I don't have a way to get there.
21:12How'd you get here?
21:14My neighbor Gwen dropped me off, but she can't drive at night.
21:19We could call you an Uber or a taxi.
21:21I don't have any money.
21:24Excuse me.
21:25Can I help?
21:27Mrs. Clymer has been discharged, but has no way home.
21:30I'm so sorry.
21:31I don't mean to be a burden.
21:32No burden at all.
21:33Why don't we call you a Lyft?
21:36What is that?
21:37It's like a taxi service.
21:39If you put your address in here, a car will arrive in a few minutes to bring you home.
21:43Oh.
21:44My treat.
21:46Very kind of you.
21:48Truly.
21:50Okay.
21:50Perfect.
21:51Okay, Olive, could you take Mrs. Clymer out to the ambulance bay where Florian will be arriving in six minutes
21:57in a white Toyota Camry?
21:58You bet.
22:01Could you have some good karma?
22:03Okay.
22:07Oh, uh, hey.
22:11Relax, buddy.
22:13It's Advil.
22:14No, I didn't think you would.
22:18Headache?
22:20Uh, I, uh, tweaked my back a little, lifting that overheated kit.
22:25I guess I should get used to playing through the pain again, huh?
22:30You look like you got into shape since I saw you last.
22:32Didn't peg you as a gym guy.
22:34Oh, no, I'm, uh, maybe more of a barn guy.
22:39I'm helping out a friend on the farm, so.
22:43Nice.
22:44I'm picturing Babe, except instead of Farmer Hoggett, it's you, and instead of a pig...
22:49Can you cut the shit?
22:52Excuse me?
22:54The sarcasm thing, the, the, the, the, the little buddy routine, like, like, like, you're what?
22:58You're the skipper, I'm Gilligan?
23:00Dude, you're not the skipper.
23:02I know, I'm not the skipper.
23:03Robbie is the skipper.
23:04No, Robbie is the professor.
23:05Dane is the skipper.
23:06Okay, so I might just watch a lot of Nick at night, so who am I?
23:10Tell you whatever part you like.
23:12Just don't pick mine for me.
23:16Okay.
23:17Okay, that's fair.
23:19You got it.
23:23You had it home?
23:26Uh, no, I'm, I'm waiting on Robbie.
23:28He asked me to house sit while he's gone, so I'm, I'm waiting for the keys, the alarm code.
23:35Nice, nice, yeah, I've, uh, I've seen this place.
23:38You're in for a sweet setup.
23:40Cool.
23:42I'm sorry if I came across, uh, a little strong.
23:46Don't apologize for standing up for yourself.
23:48It's a healthy habit.
23:52You know, I really don't need to see this again.
23:54That is my favorite part.
23:56Ah!
23:57My hand's starting to cramp, we gotta be done soon.
23:59Oh, you can be done now.
24:00But if you want the hospital to cover you, okay, last one.
24:10Hey, Robbie.
24:11It was an accident, man.
24:13What are you talking about?
24:15Your bike.
24:24Son of a bitch.
24:28Oh, motherfucker!
24:31Robbie, GSW to the head.
24:33Somebody hit my bike.
24:35Dude, that sucks.
24:36Is it still rideable?
24:38It better be.
24:41Elbridge Jerry, 25, stable with good vitals.
24:44We're shooting a .22 caliber pistol in the air with an aluminum pot on his head for protection.
24:48Didn't work.
24:49About a quarter of a seagram seven would probably light up a tox screen like a Roman candle.
24:56Real wordsmith.
24:57Entry one in the frontal scalp.
24:59Seems to have tracked down the forehead.
25:00As alert and oriented as you can be after multiple bong hits.
25:03Got vital setting 98 on room air.
25:04Sorry, Robbie.
25:05I can't explain.
25:06I will be right back.
25:07What's this?
25:08Low velocity DSW.
25:10The head seems to have remained extra cranial.
25:12Lucky guy.
25:13Gloria, Gloria, here's a dollar.
25:17After a fireworks explosion resulting in the loss of two fingers.
25:23Ooh, that sounds nasty.
25:25Yeah, that was a sad one.
25:27Parents were deported.
25:29Big sister, works a full-time job and is the sole caregiver.
25:33Been there, done that.
25:35Your parents were deported?
25:36Oh, no, I thought she said departed.
25:40Did either of you guys work on the, uh, Revolutionary War reenactors earlier?
25:44Why, do you think you could pull off a tricorn hat?
25:48Maybe.
25:50I've always loved history and, uh, Colonial Williamsburg is my favorite school trip.
25:55And, you know, there's always the Ren Fair, but that's, that's just once a year.
26:00How often do you think the reenactors get together?
26:04No.
26:05You should definitely look into that.
26:07Hmm?
26:08Yeah, it's okay.
26:20Deep-throated husky with a touch of bitch.
26:22That's her tune.
26:23That's what I thought, but you're the expert.
26:24I just need to make sure.
26:28I was going through Billings once.
26:30Cops saw my colors.
26:31Jacked me up.
26:33Kept me overnight.
26:34They threw my sweetheart in the impound yard.
26:38They claimed someone backed into it, but you can see where they took a hammer to it, man.
26:43You gotta be careful out there.
26:45This is all pretty minor, though, right?
26:46Yeah, shit.
26:47This is just cosmetic.
26:48Bring it in tomorrow, and we'll get Bonnie right.
26:51Well, this will bend back.
26:52This will tighten up.
26:53I can do all that.
26:53Oh, Jesus, let me do it.
26:54There's no charge.
26:55What?
26:55You don't owe me anything except take care of yourself while I'm gone.
26:59Boy, this record never stops, huh?
27:01No, it's dance till you drop.
27:04Then what?
27:05Teach the kids the steps before you do.
27:08And then what?
27:09Hope they make it farther than you.
27:11Hey, Robbie.
27:11You coming or going?
27:12I'm going pretty soon.
27:13What do you got here?
27:14Lyman Payne, 53, single MVC.
27:17Trove into a telephone pole.
27:18Passage of space intrusion?
27:20No, head on.
27:21Intoxicated?
27:22No ETOH on his breath.
27:23Either syncope, seizure, or he just fell asleep at the wheel.
27:28Airbag deployed.
27:29Unconscious at the scene, but he's waking up.
27:31BP 140 over 80.
27:32Pulse 120.
27:34Pulse ox 98.
27:35No obvious injuries.
27:35Why don't you guys head on in?
27:36I'll meet you in a minute.
27:42Well, hey, buddy.
27:43I guess this is it.
27:45Make those appointments next week, you know?
27:47I'll call you from the road to make sure you do.
27:49Don't do that, man.
27:50What?
27:50Don't shine me on.
27:53I'm not.
27:54Jesus.
27:56I get it.
27:58Hard place to leave, harder place to stay.
28:03Yeah.
28:07Look, I'm not ready to say goodbye yet, so go do what you got to do,
28:11and I'll get some tools from the truck and see if I can't make Bonnie smile again for you.
28:21Okay.
28:23Okay, then.
28:31Robbie, man, I'm so sorry.
28:32We've been off for 14 straight.
28:33I thought I cleared it.
28:34It's all right.
28:35Honestly, I feel terrible.
28:36No real harm done.
28:37I was bound to make it up on the road anyway.
28:40First blood drawn.
28:41It's a good omen, really.
28:43I thought I'd be more pissed.
28:45I might.
28:45I might got punched.
28:46Chest and belly look good.
28:48Let me drag neurosurgery down here to deal with the C-spine before I go.
28:50You off?
28:51Yep.
28:52An hour ago.
28:53Can you tell?
28:54How you doing, sir?
28:55Actually, not too good.
28:57The singling's getting worse.
28:59It's in both my arms now.
29:00I feel like something's wrong.
29:02Hey, man.
29:03What are we looking at?
29:04Ran into a telephone pole.
29:06Airbag deployed.
29:07Seizure?
29:08Stroke?
29:09Not sure.
29:10Possible C-spine.
29:11CT showed you to set dislocation.
29:13I'm trying not to freak out.
29:15I'm having trouble breathing.
29:17Squeeze my hand.
29:19Real hard.
29:20Three out of five strengths.
29:22Okay.
29:23Ten milligrams dexamethasone.
29:25Dexamethasone?
29:25For spinal injury?
29:26It's compression from a jump facet and maybe some ischemia from a kink vessel.
29:30What's happening?
29:31Sir, you have a partial dislocation of two vertebrae in your neck.
29:35It's putting pressure on your spinal cord.
29:37How do you fix it?
29:38We need neurosurgery to screw a clamp into both sides of your skull
29:43and then use traction under x-ray guidance to get everything realigned.
29:48Like a chiropractic adjustment.
29:50It's a bit more complicated than that.
29:53I think I'm having a panic attack because I can't even get a shallow breath.
29:58Or he's losing C-3-4-5.
30:00Uh, page neurosurgery.
30:02Garcia went to go get them.
30:04No, page overhead.
30:05Find Robbie.
30:06He's still here.
30:07Any available neurosurgeon to ED trauma one stat?
30:10Any available neurosurgeon to ED trauma one?
30:16Dr. Robbie?
30:19Uh, yeah?
30:20We need it in trauma one.
30:23Okay.
30:25What patient?
30:26Dr. Landon.
30:26He's neck injury.
30:31I got the fellow.
30:32They could be down in 15 minutes.
30:33He's progressing too fast tonight.
30:35What's going on?
30:37Unit percent dislocation C-4-C-5.
30:40Paresthesia and decreased tidal volume.
30:41That's 85.
30:42We need to prepare for intubation.
30:44Any delay in reduction almost guarantees complete spinal cord injury.
30:48What are the options to get?
30:50Uh, I saw neurosurgery do a closed reduction once in ICU.
30:54Blind?
30:55That's crazy risky.
30:56You gotta do something.
30:56What's that procedure, Dr. Landon?
30:58It's just, it's traction on the neck.
31:00You flex the dislocated side and into slight extension.
31:03Quadriplegia if done wrong.
31:05I'm sorry, what?
31:05Did you say quadriplegia?
31:06It is a possibility, sir.
31:07It's also the same possibility if we do nothing.
31:10You want to try?
31:11I've never seen it done.
31:12You have.
31:13I can't feel my feet.
31:14Sat 79, 100% on our breathing.
31:16He is progressing, Dr. Landon.
31:17What is your plan?
31:19Uh, neurosurgery.
31:20Fuck, Donald.
31:20This is right here, right now.
31:21This guy's going to be a living head if we do nothing.
31:23I could paralyze him.
31:24Doctor, the fuck up.
31:31Sir, the partial dislocation of the two vertebrae in your neck
31:34is putting pressure on your spinal cord.
31:36I can try to move the neck bones back into place.
31:38That could help.
31:39There's no guarantees.
31:40If we do nothing, the weakness is definitely going to get worse.
31:43But either way, there's still a chance of paralysis.
31:46Do it.
31:47Please.
31:48Please.
31:4850th Fentanyl IV, you need to let us know if the weakness gets worse
31:51or if there's any sudden pain and we'll stop immediately.
31:54Uh, Dr. Cruz, Robbie, hold down his shoulders for counter traction.
31:58Okay.
31:59I'm going to pull on your head.
32:00Your job is to try to relax, breathe, so we can overcome the muscle spasm.
32:09Flexing to the right.
32:14Any change?
32:15My legs are starting to tickle.
32:18Last step.
32:23I felt something click.
32:24Oh, fuck.
32:25Oh, fuck.
32:25I felt it, too.
32:25Talk to us.
32:26What's going on?
32:29I think.
32:30I think.
32:32I'm starting to breathe easier.
32:34Any change in your hand or feet?
32:36Oh.
32:37Oh, this may be a little less numb.
32:39Philadelphia collar is ready.
32:40Talk to me.
32:41Langdon just reduced the unifacet cervical dislocation.
32:44What?
32:45Without neurosurgery?
32:46Don't try this at home, kids.
32:48He was deteriorating quickly.
32:49Your exam is improving.
32:50Oh, my God.
32:51It's definitely better.
32:52Oh, my God.
32:55Nice job.
32:57All right.
32:58Repeat CT, then neurosurgery can take him over a halo.
33:00Brass walls, buddy.
33:01See?
33:02You haven't lost it.
33:03Excuse me.
33:04I'm just going to step outside for a second.
33:21Langdon, honey, I just got a call from upstairs.
33:24Were you supposed to get a urine screen and turn it in by eight tonight?
33:26Fuck.
33:27Um.
33:29Oh, no.
33:30Uh, uh, yeah, yes.
33:32Can you just, can you tell them that I was under trauma?
33:33I'm going right now.
33:39Where's he off to?
33:40No idea.
33:42Did you find your ID badge yet?
33:44No, I've looked everywhere.
33:46I must have been thrown out on accident.
33:49They'll issue you a new one.
33:50You just have to fill out a bunch of forms.
33:51Oh, great.
33:56What?
33:58Cow and labor.
33:59No, I, I ordered a patient a Lyft.
34:02Now I have a $250 surcharge and a complaint on my account.
34:07What?
34:08What'd they do?
34:09It was a sweet old lady.
34:10Who apparently had some racist and abusive things to say right before puking in the back.
34:16You never know with some people.
34:19Where goes my first paycheck?
34:20St. Huckleberry.
34:22No good deed.
34:26I can see why you liked restoring this bike.
34:29You're a fixer.
34:31I fix bikes, but you fix people.
34:33That's pretty damn impressive, man.
34:35Some people can't be fixed.
34:39Look, I'm, I've done plenty of things I'm not proud of.
34:44Yeah, me too.
34:45No, bad things hurt people on purpose, hurt myself, and I did my time, but that doesn't
34:54wash away the regret.
34:55I wish I'd done things differently.
34:59I think about it every day.
35:02You know, they say that it's never too late to change.
35:05Some things can't be changed, like death.
35:09Death can't be changed.
35:11Hey, I know the surgery is scary.
35:13I'm not talking about me.
35:29Yeah, I don't know if I want to be here anymore.
35:34I don't know how you stand 12 minutes in there, let alone 12 hours or 20 years.
35:41No.
35:42That's the only place I can be.
35:45I have purpose in there.
35:46I can be distracted in there.
35:50I don't know that I want to be anywhere anymore.
36:03So, what's the plan?
36:06Ride.
36:08Toward what?
36:09I don't know.
36:10Away from what?
36:11Everything.
36:13Well, that's, that's not riding, that's running.
36:16That's your final lesson for these kids?
36:24What's up, Robby?
36:26Well, if it isn't medic, it's Bosco Notaro.
36:32You still on?
36:33Not for much longer.
36:34I was looking for you two.
36:36Rita Wolcott, 22.
36:38She was using a dumpster to climb the fire escape to get to a roof party.
36:41Slipped about six feet onto concrete.
36:44Possible tib-fib fracture.
36:45Can I please tell it?
36:47You're making me sound like an idiot.
36:48My friends and I were just trying to watch the fireworks from the roof of our building,
36:51but the roof access door and the stairwells stuck, so we decided to climb the fire escape.
36:56They were supposed to hold the dumpster still, but they didn't.
37:00Then I fell.
37:01Like I said, six feet onto concrete.
37:03Yeah, because they didn't hold it still.
37:05Well, it's a good thing she didn't need a 12 lead.
37:07Why's that?
37:08Because you guys put one on about a half hour to go wrong in Mr. Stemmy.
37:11Bullshit.
37:1246-year-old woman, minute after you left, VTAC.
37:15V PDKG showed a massive lateral stemmy.
37:17No way.
37:18Leads were so inferior, you might as well have not put them on at all.
37:22What were you afraid of?
37:23Her bra?
37:23What have we got?
37:24Got a 22-year-old probable tib-fib fracture from a six-foot fall.
37:28Why don't you take her to Central 13?
37:30Got it.
37:30Right this way.
37:31As I was saying, bad data is shit data.
37:33Maybe she was diaphoretic and they slid down en route.
37:35Yeah, she was moving a lot.
37:37Diaphoretic, my ass.
37:38She had big breasts.
37:38You didn't want to move them out of the way to get under her bra line.
37:40Come on, Robbie.
37:41Women are misdiagnosed for heart attacks all the time.
37:43This is a big reason why.
37:44Shall we put it to a vote?
37:46Hey, ladies in the room, show of hands.
37:48Death with modesty or life with brief nudity?
37:50Death or life?
37:53Look at that.
37:53Turns out women want to live.
37:55Got it.
37:56EKG's an amazing tool if you use it, right?
37:57You could have told us in private.
37:58I think this was more instructive.
38:00Agreed.
38:03Hey, hell of a save your boy made.
38:06On-the-fly reduction of a unifacent cervical dislocation?
38:09That's some cowboy shit.
38:10Yeah, it was.
38:11Where is he?
38:12We're in on for a drug test.
38:14Got your wish.
38:14You don't have to say goodbye.
38:20Fine.
38:21Hey, thank you for saying all that.
38:24I may have taken a slightly different approach, but...
38:27I seem to have lost my filter.
38:28I'm glad.
38:29I could use an honest second opinion on that case.
38:32Do you have five minutes to spare?
38:36Sure.
38:37Why not?
38:38What's the case?
38:38I have the chart pulled up in eight.
38:40I know I'm just feeling a little less dizzy, though.
38:44February?
38:45Yeah.
38:45You got any time?
38:47Last.
38:55I have some experience with this, but I'd appreciate a fresh perspective.
39:01After 14 hours, I don't know how fresh my perspective is, but I will give you what I got.
39:05Well, after working with you, Dr. Rubinovich, I've come to respect your opinion.
39:13Thank you, Dr. Elashimi.
39:17Likewise.
39:19Okay.
39:20Patient is a 40-year-old female with a history of seizure disorder for the past 35 years.
39:24She had no perineal complications and was in excellent health until age five when she had
39:28the onset seizure activity following prolonged illness with viral meningitis.
39:31Her ulcer mental status from the infection.
39:42Baran, is this you?
39:59Okay.
40:00Yeah.
40:13Okay.
40:15Yeah.
40:16Okay.
40:17Yeah.
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